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Elderly medicine

John F Aloia, Melissa Fazzari, Shahidul Islam, Mageda Mikhail, Subhashini Katumuluwa, Ruban Dhaliwal, Alexandra Stolberg, Gianina Usera, Louis Ragolia
Black Americans have lower levels of serum 25(OH)D but superior bone health compared to white Americans. There is controversy over whether they should be screened for vitamin D deficiency and have higher vitamin D requirements than recommended by the Institute of Medicine (IOM). The purpose of this trial was to determine whether Vitamin D supplementation in elderly black women prevents bone loss. 260 healthy black American women, 60 years of age and older were recruited to take part in a two arm, double-dummy 3 year RCT of vitamin D3 vs...
June 15, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Takanobu Shioya, Susumu Sato, Masahiro Iwakura, Hitomi Takahashi, Yoshino Terui, Sachiko Uemura, Masahiro Satake
Physical activity (PA) is defined as bodily movement produced by skeletal muscles with energy expenditure beyond resting levels. PA is closely related to reduced morbidity and mortality in chronic obstructive pulmonary disease (COPD). Self-report questionnaires are often subject to recall bias, correlating poorly with objectively qualified PA, and do not provide an accurate estimate of free-living energy expenditure. PA may be objectively evaluated by newly developed tri-axial accelerometers by quantifying steps or body movements over a period of time...
June 11, 2018: Respiratory Investigation
Nitish Rai, G Venugopalan, Rashmita Pradhan, Akash Ambastha, Ashish Datt Upadhyay, Sadanand Dwivedi, Aparajit B Dey, Sharmistha Dey
Frailty in elderly is very much familiar with a decline in the musculoskeletal system. Muscle degeneration in the lower organism was observed due to loss of anti-oxidant protein Sestrin. The aim of the study is to determine the level of Sestrin1 and Sestrin2 in the serum of frail and non-frail elderly to associate their impact in frailty syndrome. Subjects with age ≥ 65 years were enrolled from Geriatric Medicine OPD of All India Institute of Medical Sciences, New Delhi (N= 92). Among them, 51 subjects were identified as frail and rest 41 were regarded as non-frail according to "deficit accumulation model of Rockwood...
April 2018: Aging and Disease
Nasser Davarzani, Sandra Sanders-van Wijk, Micha T Maeder, Peter Rickenbacher, Evgueni Smirnov, Joël Karel, Thomas Suter, Rudolf A de Boer, Dirk Block, Vinzent Rolny, Christian Zaugg, Matthias E Pfisterer, Ralf Peeters, Hans-Peter Brunner-La Rocca
Background: It is uncertain whether repeated measurements of a multi-target biomarker panel may help to personalize medical heart failure (HF) therapy to improve outcome in chronic HF. Methods: This analysis included 499 patients from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF), aged ≥ 60 years, LVEF ≤ 45%, and NYHA ≥ II, who had repeated clinical visits within 19 months follow-up...
June 2018: EPMA Journal
Alexandre Assuane Duarte, Shahriar Mohsin, Olga Golubnitschaja
Diabetes mellitus (DM) epidemic-on a global scale-is a major and snowballing threat to public health, healthcare systems and economy, due to the cascade of pathologies triggered in a long-term manner after the DM manifestation. There are remarkable differences in the geographic disease spread and acceleration of an increasing DM prevalence recorded. Specifically, the highest initial prevalence of DM was recorded in the Eastern-Mediterranean region in 1980 followed by the highest acceleration of the epidemic characterised by 0...
June 2018: EPMA Journal
Shuai Li, Uma Gaur, Cheong-Meng Chong, Shaofen Lin, Jiankang Fang, Zhiwen Zeng, Haitao Wang, Wenhua Zheng
Age-related macular degeneration (AMD) is the leading cause of central vision loss in the elderly with less effective treatment, especially for dry AMD (90% of AMD). Although the etiology of this disease is not well elucidated, increasing evidences indicate that excessive reactive oxygen species (ROS) impairing the physiological functions of retinal pigment epithelium (RPE) cells may be one of the main causes. Therefore, it could be a great strategy to find some drugs that can effectively protect RPE cells from oxidative damage which is desired to treat and slow the process of AMD...
June 12, 2018: International Journal of Molecular Sciences
Lisbeth A Evered, Brendan S Silbert
Postoperative cognitive dysfunction (POCD) is an objectively measured decline in cognition postoperatively compared with preoperative function. POCD has been considered in the anesthetic and surgical literature in isolation of cognitive decline which is common in the elderly within the community and where it is labeled as mild cognitive impairment, neurocognitive disorder, or dementia. This narrative review seeks to place POCD in the broad context of cognitive decline in the general population. Cognitive change after anesthesia and surgery was described over 100 years ago, initially as delirium and dementia...
June 8, 2018: Anesthesia and Analgesia
Sylvia Schick, Daniela Heinrich, Matthias Graw, Raúl Aranda, Uta Ferrari, Steffen Peldschus
Fatal falls are frequent and seem to be an increasing problem in the elderly. Especially ground level falls (GLFs) and falls on or from stairs and steps (stairs falls) are worth examining for forensic classification and in order to improve the development of preventive measures. We retrospectively analyzed 261 fatal falls of elderly age 65 + years, which were autopsied at the Institute of Legal Medicine in Munich between 2008 and 2014. After careful screening, the sub-set of all 77 GLFs and 39 stairs falls were analyzed towards socio-demographic characteristics, fall circumstances, injuries, and circumstances of death...
June 7, 2018: International Journal of Legal Medicine
Junji Uchino, Akira Nakao, Nobuyo Tamiya, Yoshiko Kaneko, Tadaaki Yamada, Kenichi Yoshimura, Masaki Fujita, Koichi Takayama
BACKGROUND: Advances in epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment led to research on the mechanism of the resistance have revealed that an occurrence of T790M gene mutation generated in exon 20 of the EGFR gene is associated with approximately 50% to 60% of observed resistance. Osimertinib, a 3rd-generation EGFR-TKI, has been shown to be effective against both EGFR tyrosine kinase inhibitor-sensitizing and T790M resistance mutations. In this study, we prospectively investigate the efficacy and safety of osimertinib in elderly patients aged ≥75 years, with ineffective prior EGFR-TKI treatment or with recurrence of EGFR-TKI mutation-positive or T790M mutation-positive nonsmall-cell lung cancer...
June 2018: Medicine (Baltimore)
Abrar-Ahmad Zulfiqar, Paul Blazejczyk, Nadir Kadri, Jean Doucet
Digitalis remains a treatment that is difficult to manage, especially in the elderly. METHODS: A retrospective, unicentric study carried out within the unit of Internal medicine and geriatrics, Reims University Hospital Center, between January and June 2014. Collection of all patients hospitalized, after 75 years, receiving treatment with digitalis, either as soon as they enter (present on the usual prescription of the patient), during their hospitalization and on their exit. RESULTS: 20 patients were included...
June 1, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
K Hager, T Temps, O Krause
BACKGROUND: Antidementia drugs, antidepressants and antipsychotics are among the most frequently prescribed medication in old and multimorbid patients. Due to side effects (e. g. prolonged QTc interval) in emergency medicine/intensive care unit or patients' wishes the question is often raised whether these drugs can be stopped and how this may be done. ANTIDEMENTIA DRUGS: If the cognition is stable under antidementia drugs or if the patient is in favour of the medication, it should be continued...
June 6, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Yuki Muraoka, Yuto Iida, Hanako O Ikeda, Sachiko Iwai, Masayuki Hata, Takeshi Iwata, Mao Nakayama, Nobuhiro Shimozawa, Yuko Katakai, Akira Kakizuka, Nagahisa Yoshimura, Akitaka Tsujikawa
Age-related macular degeneration (AMD) is a leading cause of blindness among elderly people. The appearance of drusen is a clinical manifestation and a harbinger of both exudative and atrophic AMD. Recently, antibody-based medicines have been used to treat the exudative type. However, they do not restore good vision in patients. Moreover, no effective treatment is available for atrophic AMD. We have created small chemicals (Kyoto University Substances; KUSs) that act as ATP regulators inside cells. In the present study, we examined the in vivo efficacy of KUS121 in C-C chemokine receptor type 2-deficient mice, a mouse model of AMD...
May 2018: Heliyon
Brian J Nagle, Andrea Berry, Laurel Gorman, Mariana Dangiolo
INTRODUCTION: The aging population is growing quickly and has a higher prevalence of comorbid and chronic diseases. A majority of this group resides in the home setting. The purpose of this study was to examine the attitudes of third-year medical students following a pilot component of an internal medicine clerkship, consisting of four in-home visits with geriatric patients. METHODS: A qualitative study design, utilizing focus groups, was used to assess general themes in students' responses regarding their attitudes to geriatrics, the field of geriatrics and the in-home care pilot program...
April 3, 2018: Curēus
Wee Jie Chee, Huda Abdullahi, Yolanda Chan, Amelia Rattle, Stephanie Snedden, Ralph Junckerstorff
BACKGROUND: Statins are one of the most commonly prescribed medications in Australia. Although the cardioprotective effects of statins are well documented, questions remain regarding their risk-benefit profile in elderly adults, especially those with limited life expectancies. AIM: To describe the prevalence and pattern of statin use in elderly patients admitted to a General Medicine Unit. METHODS: We retrospectively reviewed medical records of patients aged ≥80 years who were admitted under the General Medical Unit at Monash Medical Centre between 1st January 2015 and 30th June 2015...
June 5, 2018: Internal Medicine Journal
Nicoleta Aurelia Popescu, Jayadev M Umakanthan, Prajwal Dhakal, Krishna Gundabolu, Scott A Koepsell, Muhamed Baljevic
Congenital factor VII deficiency is a challenging disorder to manage, as it is associated with varied genotypes that do not clinically correlate with a bleeding phenotype. Individuals with severe factor VII deficiency (FVII: c <1%) might be asymptomatic, while patients with moderate deficiency (FVII: c level >5%) may experience severe hemorrhages. In modern medicine, due to extensive routine pre-operative laboratory testing, clinically asymptomatic patients without any bleeding history might be incidentally discovered, raising clinical dilemmas...
March 2018: Mædica
Seul Ah Lee, Sung-Min Moon, Seul Hee Han, Eun Ju Hwang, Bo-Ram Park, Jae-Sung Kim, Do Kyung Kim, Chun Sung Kim
Osteoarthritis (OA) is a common degenerative joint disease, characterized by cartilage degradation and inflammation, in the elderly population. Anthriscus sylvestris has been used in Korean traditional medicine and contains many polyphenolic compounds such as cynaroside and chlorogenic acid, which are major active components responsible for its antioxidant effect. In this study, we aimed to evaluate the chondroprotective effect of an aqueous extract of A. sylvestris leaves (AE-ASL) on OA, both in vitro and in vivo...
July 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Hiroka Nagaoka
 Palliative care had a role in maintaining and improving the patient's QOL. To optimize symptomatic management, that cannot be controlled using commercial formulations, in-house pharmaceutical preparations customized to meet an individual's clinical needs are sometimes administered. Despite a growing arsenal of oncology drugs, opioids, and other compounds, many elderly cancer patients have a wide spectrum of comorbid conditions that require the help of skilled pharmacists. Although drugs prepared in in-house pharmacies can be customized to the conditions of individual patients, their preparation is time- and resource-intensive, and their benefits sometimes do not outweigh the costs...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Miguel Julião, Carla Courelas, Manuel João Costa, Nadine Correia Santos, Filipa Fareleira, Bárbara Antunes, Susana Magalhães, Paulo Faria de Sousa, Harvey Max Chochinov
BACKGROUND: Modern medicine can be impersonal and routinized, paying insufficient attention to issues of personhood. The Patient Dignity Question (PDQ) and This Is ME (TIME) Questionnaire are clinical tools developed with the aim of probing for personhood, reinforcing dignity and promoting health care attitudes based on looking at people for who they are and not defining them solely based on their medical condition. This study aimed to translate and validate the TIME Questionnaire and the PDQ into European Portuguese, coined as Questionário Este Sou EU (ESEU) and Pergunta da Dignidade (PD), respectively...
May 11, 2018: Annals of Palliative Medicine
William Egan, Eric Steinberg, Jeremy Rose
A 24-year-old female, otherwise healthy, presented to the Emergency Department (ED) with difficulty walking and bilateral leg pain. The patient was a recreational nitrous oxide (NO2 ) user, also known as "whippets" or simply nitrous. Neurologic examination demonstrated an unsteady gait and positive Romberg sign along with normal deep tendon reflexes and normal muscle strength in upper and lower extremities. Laboratory results demonstrated macrocytic erythropoiesis, reduced B12 , elevated homocysteine, and elevated methylmalonic acid...
May 24, 2018: American Journal of Emergency Medicine
Aldiane Gomes de Macedo Bacurau, Priscila Maria Stolses Bergamo Francisco
The objective was to estimate the prevalence of influenza vaccination in adults and elderly with chronic respiratory diseases (CRDs). The sample included individuals 20 to 59 years of age (n = 23,329) and ≥ 60 years (n = 9,019) that participated in the Brazilian National Survey on Access, Utilization, and Promotion of Rational Use of Medicines (PNAUM) in 2013-2014. We estimated influenza vaccination prevalence rates and respective 95% confidence intervals (95%CI). Associations were verified with the Rao-Scott chi-square test, with significance set at 5%...
2018: Cadernos de Saúde Pública
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