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Elderly medicine

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https://www.readbyqxmd.com/read/28534147/hypothyroidism-in-hospitalized-elderly-patients-a-sign-of-worse-prognosis
#1
N Sforza, J Rosenfarb, R Rujelman, M Rosmarin, E Blanc, C Frigerio, P Fossati, D Caruso, C Faingold, T Meroño, G Brenta
PURPOSE: Overt hypothyroidism has adverse clinical consequences and might worsen prognosis in critically ill elderly patients. However, the difficult interpretation of thyroid function tests (TFT) due to non-thyroidal illness (NTI) has led to discouragement of screening for thyroid dysfunction. Our aim was to determine the prevalence of TFT compatible with hypothyroidism and to study its influence on mortality among hospitalized elderly patients. METHODS: In this prospective study we consecutively included all patients ≥60 years admitted by the Internal Medicine Department to the hospital ward (n = 451) of the Cesar Milstein Hospital in Buenos Aires, Argentina...
May 22, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28532628/milestones-barriers-and-beacons-shared-decision-making-in-canada-inches-ahead
#2
France Légaré, Dawn Stacey, Pierre-Gerlier Forest, Marie-France Coutu, Patrick Archambault, Laura Boland, Holly O Witteman, Annie LeBlanc, Krystina B Lewis, Anik M C Giguere
Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation...
May 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28530332/-treatment-of-mechanically-ventilated-patients-in-an-internal-medicine-department-overview-2013
#3
Jacov Kogan, Alex Rodnitsky, Ornit Cohen, Svetlana Turkot, Yevgenia Tziba, Boris Golzman
BACKGROUND: Over recent years the number of mechanically ventilated patients in internal medicine departments has grown. These patients are elderly, mostly disabled and suffer from many chronic illnesses. Most of them require prolonged mechanical ventilation. OBJECTIVES: The study aimed to evaluate the population of mechanically ventilated patients in an internal department, the treatment and outcomes, particularly the morbidity in hospitalization and to identify the prognostic causes of death...
August 2016: Harefuah
https://www.readbyqxmd.com/read/28530309/-monitoring-units-in-departments-of-internal-medicine-frequency-impact-and-satisfaction
#4
David Raveh-Brawer, Tanya Itzekson, Ruth Henshke-Bar-Meir, Noa Sylvetsky, Reuven Friedmann, Ranana Siegman, Tanya Mor, Moshe Hersch, Amos M Yinnon, Shoshana Zevin
BACKGROUND: Due to increasing numbers of elderly, seriously ill patients and shortage of ICU beds, many hospitals have established monitoring units (MU) in their medical departments. OBJECTIVES: (1) To assess the national prevalence of MUs in medical departments; (2) to determine the outcome of consecutively admitted MU patients; (3) to evaluate patient/ family satisfaction with care. METHODS: The case control study included all 123 patients hospitalized in the MU during a 5-month period, compared with two control groups: (1) 123 patients admitted to medical departments, matched at a ratio of 1:1 by gender, age±10 years and mechanical ventilation; (2) all 52 medical patients treated in the ICU...
January 2017: Harefuah
https://www.readbyqxmd.com/read/28525961/passive-and-active-immunization-against-respiratory-syncytial-virus-for-the-young-and-old
#5
Tonya Villafana, Judith Falloon, M Pamela Griffin, Qing Zhu, Mark T Esser
Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in infants worldwide and also causes significant disease in the elderly. Despite 60 years of RSV research and vaccine development, there is only one approved medicine to prevent RSV infections. Palivizumab, a monoclonal antibody (mAb) against the RSV fusion (F) protein, is indicated for preterm infants and children at high-risk for RSV infections. It is an active time in RSV vaccine and mAb development with 14 vaccines and 2 mAbs currently being tested in clinical trials as of 13 February 2017...
May 19, 2017: Expert Review of Vaccines
https://www.readbyqxmd.com/read/28524624/pulmonary-arterial-hypertension-progress-in-understanding-the-disease-and-prioritizing-strategies-for-drug-development
#6
REVIEW
P Ghataorhe, C J Rhodes, L Harbaum, M Attard, J Wharton, M R Wilkins
Pulmonary arterial hypertension (PAH), at one time a largely overlooked disease, is now the subject of intense study in many academic and biotech groups. The availability of new treatments has increased awareness of the condition. This in turn has driven a change in the demographics of PAH, with an increase in the mean age at diagnosis. The diagnosis of PAH in more elderly patients has highlighted the need for careful phenotyping of patients and for further studies to understand how best to manage pulmonary hypertension associated with, for example, left heart disease...
May 19, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28524039/-prevention-of-traditional-chinese-medicine-gubiao-pixie-prescription-for-nosocomial-infection-in-elderly-population
#7
Wanxiang Zhang, Bochao Wang, Zhijun Li
OBJECTIVE: To observe the curative effect of traditional Chinese medicine (TCM) Gubiao Pixie prescription on the prevention of nosocomial infection in elderly patients with susceptible factors. METHODS: A prospective observational study was conducted. The elderly patients aged over 70 years admitted to the Department of Integrated TCM and Western Medicine of Tianjin First Center Hospital from March 2015 to March 2016 were enrolled. The patients were divided into experiment group and control group by random number table...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28513795/balance-of-macronutrient-intake-among-brazilian-elderly-analysis-of-the-national-dietary-survey-2008-2009
#8
Agatha Nogueira Previdelli, Rita Maria Monteiro Goulart, Rita de Cássia de Aquino
Objective: This study aimed at evaluating the balance in the intake of protein, carbohydrate, and fat among the Brazilian elderly population. Methods: The data analyzed were taken from the National Dietary Survey 2008-2009, from a total of 4,286 Brazilian elders (60-104 years old). Based on the dietary intake obtained from two food records, the Multiple Source Method (MSM) was used to evaluate the macronutrients and saturated fat. The AMDR (Acceptable Macronutrient Distribution Range), by the Institute of Medicine (IOM), was used to evaluate the macronutrient energy percentage (%E)...
January 2017: Revista Brasileira de Epidemiologia, Brazilian Journal of Epidemiology
https://www.readbyqxmd.com/read/28512604/traditional-dentistry-knowledge-among-serbs-in-several-balkan-countries
#9
Dragan V Ilic, Biljana Andjelski Radicevic, Anely Nedelcheva, Ivana Djurovic, Dejan Ostojic
BACKGROUND/AIM: There are still unrevealed treasures of traditional dental medicine, that is, the reason to investigate and present various ways in treatment of oral and orofacial tissues, as well as magic and religious elements involved in representative areas among Serbs. MATERIALS AND METHODS: Information was collected from the elderly non-professional folk dentists and herbalists with the additional help of local physicians and dentists that was done through questionnaire and personal interviews...
April 2017: Journal of Intercultural Ethnopharmacology
https://www.readbyqxmd.com/read/28509689/risk-factors-of-allopurinol-induced-severe-cutaneous-adverse-reactions-in-a-thai-population
#10
Niwat Saksit, Wichittra Tassaneeyakul, Nontaya Nakkam, Parinya Konyoung, Usanee Khunarkornsiri, Pansu Chumworathayi, Chonlaphat Sukasem, Sumitra Suttisai, Napacha Piriyachananusorn, Pawinee Tiwong, Nathorn Chaiyakunapruk, Kittisak Sawanyawisuth, Ticha Rerkpattanapipat, Wongwiwat Tassaneeyakul
BACKGROUND: Allopurinol is one of the most common causes of severe cutaneous adverse drug reactions (SCARs) including drug reactions with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). This study identified the risk factors associated with the development of allopurinol-induced SCARs in a Thai population. PATIENTS AND METHODS: Eighty-six allopurinol-induced SCARs (i.e. 19 DRESS and 67 SJS/TEN) and 182 allopurinol-tolerant patients were enrolled in the study...
May 15, 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28508776/development-and-validation-of-a-multivariable-prediction-model-for-the-occurrence-of-delirium-in-hospitalized-gerontopsychiatry-and-internal-medicine-patients
#11
Diether Kramer, Sai Veeranki, Dieter Hayn, Franz Quehenberger, Werner Leodolter, Christian Jagsch, Günter Schreier
Delirium is an acute confusion condition, which is common in elderly and often misdiagnosed in hospitalized patients. Early identification and prevention of delirium could reduce morbidity and mortality rates in those affected and reduce hospitalization costs. We have developed and validated a multivariate prediction model that predicts delirium and gives an early warning to physicians. A large set of patient electronic medical records have been used in developing the models. Classical learning algorithms have been used to develop the models and compared the results...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28502741/high-metabolic-activity-of-tissue-nonspecific-alkaline-phosphatase-not-only-in-young-but-also-in-adult-bone-as-demonstrated-using-a-new-histochemical-detection-protocol
#12
I Piotr Maly, Elisabeth Eppler, Magdalena Müller-Gerbl
Tissue-nonspecific alkaline phosphatase (TNAP) is playing a key role in bone calcification, as has been demonstrated in different mammalian species including human and rodents. However, to investigate age-related changes during life history, histochemical demonstration of TNAP is severely hampered, particularly in the elderly, by technical difficulties associated with sectioning calcified tissue. Sufficient fixation must precede decalcification since poorly fixed bone tissue is exposed to the deleterious effects of decalcification reagents...
May 11, 2017: General and Comparative Endocrinology
https://www.readbyqxmd.com/read/28498779/evaluation-of-the-education-clinical-telemedicine-e-health-in-the-curriculum-of-medical-students-at-the-university-of-zurich
#13
Christiane Brockes, Thomas Grischott, Magdalena Dutkiewicz, Sabine Schmidt-Weitmann
BACKGROUND: Digitalization and patient empowerment result in new requirements and challenges. In response, the module "Clinical Telemedicine/e-Health" was implemented by the Faculty of Medicine of Zurich in 2008. The module was systematically evaluated to determine if the students would benefit from this course. In 2011, 2015, and 2016 further evaluations were performed. METHOD: In 2008 and 2009, students evaluated 16 statements. We calculated the combined mean value and medians for both evaluations...
May 12, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28493608/the-epidemiology-of-emergency-department-trauma-discharges-in-the-united-states
#14
Charles J DiMaggio, Jacob B Avraham, David C Lee, Spiros G Frangos, Stephen P Wall
OBJECTIVE: Injury related morbidity and mortality is an important emergency medicine and public health challenge in the United States (US). Here we describe the epidemiology of traumatic injury presenting to US emergency departments, define changes in types and causes of injury among the elderly and the young, characterize the role of trauma centers and teaching hospitals in providing emergency trauma care, and estimate the overall economic burden of treating such injuries. METHODS: We conducted a secondary retrospective, repeated cross-sectional study of the Nationwide Emergency Department Data Sample (NEDS), the largest all-payer emergency department survey database in the US...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28492914/antibiotic-prescribing-for-nonbacterial-acute-upper-respiratory-infections-in-elderly-persons
#15
Michael Silverman, Marcus Povitz, Jessica M Sontrop, Lihua Li, Lucie Richard, Sonny Cejic, Salimah Z Shariff
Background: Reducing inappropriate antibiotic prescribing for acute upper respiratory tract infections (AURIs) requires a better understanding of the factors associated with this practice. Objective: To determine the prevalence of antibiotic prescribing for nonbacterial AURIs and whether prescribing rates varied by physician characteristics. Design: Retrospective analysis of linked administrative health care data. Setting: Primary care physician practices in Ontario, Canada (January-December 2012)...
May 9, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28491913/teaching-our-doctors-to-care-for-the-elderly-a-geriatrics-needs-assessment-targeting-internal-medicine-residents
#16
Ramy Sedhom, David Barile
No abstract text is available yet for this article.
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28472914/low-testosterone-levels-and-metabolic-syndrome-in-aging-male
#17
Rodrigo Blaya, Patrícia Blaya, Luiza Rhoden, Ernani Luis Rhoden
Advances in medicine and progressive improvements in the health of the general population in developed countries have led to considerable increases in life expectancy over recent years. Metabolic syndrome (MetS) affects approximately 25% of the adult population and its prevalence is increasing all over the world. Central obesity plays an important role in emergence of MetS. Some studies have suggested that there may be link between low Total Testosterone levels and emergence of MetS. The objective of this review is to analyze the complex network of interactions between MetS and low testosterone levels in elderly men, considering etiologic, diagnostic, and therapeutic aspects...
May 3, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28472843/targeting-multiple-myeloma-cancer-stem-cells-with-natural-products-lessons-from-other-hematological-malignancies
#18
Mark E Issa, Sylvian Cretton, Muriel Cuendet
Multiple myeloma is characterized by the accumulation of malignant plasma cells in the bone marrow. Multiple myeloma is the second most frequently diagnosed hematological malignancy, predominantly affecting the elderly. Despite recent advances in the development of novel therapies, multiple myeloma remains an incurable malignancy where the majority of patients relapse, develop resistance, and eventually die from the disease. This has been attributed to the fact that conventional therapy currently in use targets mainly the bulk of tumor cells, but not the tumor-initiating cancer stem cells...
May 4, 2017: Planta Medica
https://www.readbyqxmd.com/read/28471943/clinical-implications-of-aging-with-hiv-infection-perspectives-and-the-future-medical-care-agenda
#19
Giovanni Guaraldi, Frank J Palella
: The increasing number of aging HIV-infected (HIV+) persons comprises a unique population at risk for illnesses and syndromes traditionally associated with the elderly. As a result, similar to the current need for primary care providers to manage chronic noninfectious comorbidities among aging persons with well controlled HIV infection, HIV clinical care will need to routinely involve geriatric medicine in a new HIV-geriatric discipline. The objective of this article is to provide a conceptual framework in which HIV and geriatric management considerations for healthcare professionals caring for HIV+ persons are integrated...
June 1, 2017: AIDS
https://www.readbyqxmd.com/read/28471760/magnesium-supplementation-in-vitamin-d-deficiency
#20
Pramod Reddy, Linda R Edwards
BACKGROUND: Vitamin D and magnesium (Mg) are some of the most studied topics in medicine with enormous implications for human health and disease. Majority of the adults are deficient in both vitamin D and magnesium but continue to go unrecognized by many health care professionals. AREAS OF UNCERTAINTY: Mg and vitamin D are used by all the organs in the body, and their deficiency states may lead to several chronic medical conditions. Studies described in the literature regarding these disease associations are contradictory, and reversal of any of these conditions may not occur for several years after adequate replacement...
May 3, 2017: American Journal of Therapeutics
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