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https://www.readbyqxmd.com/read/29125269/direct-oral-anticoagulants-use-in-elderly-patients-with-non-valvular-atrial-fibrillation-state-of-evidence
#1
Giulia Benedetti, Matteo Neccia, Luciano Agati
Non-valvular atrial fibrillation (NVAF) increases the risk of stroke by three- to five-fold, especially in elderly patients, creating a huge burden on medical system as well as a negative impact on patients lives. Balancing efficacy and bleeding risk is a challenge when considering anticoagulation therapy in elderly patients, because of their frequent high risk of both stroke and bleeding. Real world data reveal the underuse of anticoagulation in the elderly, especially due to physicians' fear of bleeding, often neglecting the thromboembolic risk...
November 10, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29119468/clinical-decision-support-and-optional-point-of-care-testing-of-renal-function-for-safe-use-of-antibiotics-in-elderly-patients-a-retrospective-study-in-community-pharmacy-practice
#2
Mette Heringa, Annemieke Floor-Schreudering, Peter A G M De Smet, Marcel L Bouvy
OBJECTIVE: The aim was to investigate the management of drug therapy alerts on safe use of antibiotics in elderly patients with (potential) renal impairment and the contribution of optional creatinine point of care testing (PoCT) in community pharmacy practice. METHODS: Community pharmacists used a clinical decision support system (CDSS) for seven antibiotics. Alerts were generated during prescription processing in the case of previously registered renal impairment and when no information on renal function was available for patients aged 70 and over...
November 8, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29108511/effects-of-benign-prostate-hyperplasia-on-allografts-in-kidney-transplant
#3
Ali Murat Gokce, Mehmet Remzi Erdem, Ruhi Caglar, Cevdet Kaya, Leyla Ozel, Mesut Izzet Titiz
OBJECTIVES: Benign prostate hyperplasia is frequently diagnosed in elderly chronic renal failure patients. Although it is asymptomatic because urine flow declines in those with chronic renal failure, it may become symptomatic when urine flow increases after renal transplant. Untreated benign prostate hyperplasia may lead to several complications that adversely affect the kidney allograft. MATERIALS AND METHODS: Our retrospective study investigated data from 286 male transplant patients...
October 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29104458/gender-specific-associations-between-low-skeletal-muscle-mass-and-albuminuria-in-the-middle-aged-and-elderly-population
#4
Hye Eun Yoon, Yunju Nam, Eunjin Kang, Hyeon Seok Hwang, Seok Joon Shin, Yeon Sik Hong, Kwi Young Kang
Objective This study assessed gender-specific associations between low muscle mass (LMM) and albuminuria. Methods Data from the Korea National Health and Nutrition Examination Survey 2011 were employed. The study consisted of 1,087 subjects (≥50 years old). Skeletal muscle index (SMI) was defined as the weight-adjusted appendicular skeletal muscle mass. Mild LMM and severe LMM were defined as SMI that were 1-2 and >2 standard deviations below the sex-specific mean appendicular skeletal muscle mass of young adults, respectively...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29097070/characterization-of-variables-for-potential-impact-on-vancomycin-pharmacokinetics-in-thermal-or-inhalation-injury
#5
Katie Elder, David M Hill, William L Hickerson
OBJECTIVE: To characterize the pharmacokinetics of vancomycin dosing in thermal or inhalation injury as they relate to percent total body surface area burn (TBSA) and days since injury (DSI). METHODS: This retrospective 3-year study included patients with thermal or inhalation injury receiving vancomycin. Patient demographics and course data were collected using the institution's electronic medical record. RESULTS: Six hundred and fifty-four patients were included in the study; 124 remained after exclusion...
October 30, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29075132/urinary-protein-profiles-in-ketorolac-associated-acute-kidney-injury-in-patients-undergoing-orthopedic-day-surgery
#6
Filippo Mariano, Chiara Cogno, Fulvia Giaretta, Ilaria Deambrosis, Simona Pozza, Maurizio Berardino, Giuseppe Massazza, Luigi Biancone
BACKGROUND: Parenteral administration of ketorolac is very effective in controlling postoperative pain for orthopedic surgery. Ketorolac can induce clinically relevant renal alterations in elderly patients, whereas its short course is considered safe for young adults with normal preoperative renal function. In this study, of a cohort of young adults undergoing elective orthopedic day surgery, we sought cases complicated by readmission due to acute kidney injury (AKI). PATIENTS AND METHODS: Among 1397 young adults, aged 18-32 years who were admitted to undergo orthopedic day surgery from 2013 to 2015, four patients (0...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29070944/evaluation-of-various-equations-for-estimating-renal-function-in-elderly-chinese-patients-with-type-2-diabetes-mellitus
#7
Mei Guo, Jian-Ying Niu, Xian-Wu Ye, Xiao-Jie Han, Ying Zha, Yang Hong, Hong Fang, Yong Gu
BACKGROUND: The clinical assessment of kidney function based on the estimated glomerular filtration rate (GFR) in older patients remains controversial. This study evaluated the concordance and feasibility of using various creatinine-based equations for estimating GFR in elderly Chinese patients with type 2 diabetes mellitus (T2DM). METHODS: A cross-sectional analytical study was conducted in 21,723 older diabetic patients (≥60 years) based on electronic health records (EHR) for Minhang District, Shanghai, China...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29062740/outcomes-of-surgical-and-transcatheter-aortic-valve-replacement-in-the-octogenarians-surgery-still-the-gold-standard
#8
Sameer A Hirji, Fernando Ramirez-Del Val, Ahmed A Kolkailah, Julius I Ejiofor, Siobhan McGurk, Ritam Chowdhury, Jiyae Lee, Pinak B Shah, Piotr S Sobieszczyk, Sary F Aranki, Marc P Pelletier, Prem S Shekar, Tsuyoshi Kaneko
BACKGROUND: Contemporary options for aortic valve replacement (AVR) include transcatheter and surgical approaches (TAVR and SAVR). As evidence accrues for TAVR in high and intermediate risk patients, some clinicians advocate that all patients aged over 80 years should only receive TAVR. Our aim was to investigate the utility of SAVR and minimally invasive AVR (mAVR) among octogenarians in the current era of TAVR. METHODS: From 2002 to 2015, 1,028 octogenarians underwent isolated AVR; 306 TAVR and 722 SAVR, of which 378 patients underwent mAVR...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29055803/optimal-blood-pressure-decreases-acute-kidney-injury-after-gastrointestinal-surgery-in-elderly-hypertensive-patients-a-randomized-study-optimal-blood-pressure-reduces-acute-kidney-injury
#9
Xiujuan Wu, Zongming Jiang, Jing Ying, Yangyang Han, Zhonghua Chen
STUDY OBJECTIVE: To determine the appropriate mean arterial pressure (MAP) control level for elderly patients with hypertension during the perioperative period. DESIGN: A prospective, randomized study. SETTING: Three teaching hospitals in China. PATIENTS: Six hundred seventy-eight elderly patients with chronic hypertension undergoing major gastrointestinal surgery. INTERVENTIONS: Patients were randomly allocated to three groups and the target MAP level was strictly controlled to one of three levels: level I (65-79mmHg), level II (80-95mmHg), or level III (96-110mmHg)...
October 18, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29040701/comparison-of-glomerular-filtration-rate-estimating-equations-derived-from-creatinine-and-cystatin-c-validation-in-the-age-gene-environment-susceptibility-reykjavik-elderly-cohort
#10
Jonas Björk, Anders Grubb, Vilmundur Gudnason, Olafur S Indridason, Andrew S Levey, Runolfur Palsson, Ulf Nyman
Background: Validation studies comparing glomerular filtration rate (GFR) equations based on standardized creatinine and cystatin C assays in the elderly are needed. The Icelandic Age, Gene/Environment Susceptibility-Kidney cohort was used to compare two pairs of recently developed GFR equations, the revised Lund-Malmö creatinine equation (LMRCr) and the arithmetic mean of the LMRCr and Caucasian, Asian, Paediatric and Adult cystatin C equations (MEANLMR+CAPA), as well as the Full Age Spectrum creatinine equation (FASCr) and its combination with cystatin C (FASCr+Cys), with the corresponding pair of Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPICr and CKD-EPICr+Cys)...
October 5, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29019912/validation-and-assessment-of-three-methods-to-estimate-24-h-urinary-sodium-excretion-from-spot-urine-samples-in-high-risk-elder-patients-of-stroke-from-the-rural-areas-of-shaanxi-province
#11
Wenxia Ma, Xuejun Yin, Ruijuan Zhang, Furong Liu, Danrong Yang, Yameng Fan, Jie Rong, Maoyi Tian, Yan Yu
Background: 24-h urine collection is regarded as the "gold standard" for monitoring sodium intake at the population level, but ensuring high quality urine samples is difficult to achieve. The Kawasaki, International Study of Sodium, Potassium, and Blood Pressure (INTERSALT) and Tanaka methods have been used to estimate 24-h urinary sodium excretion from spot urine samples in some countries, but few studies have been performed to compare and validate these methods in the Chinese population. Objective: To compare and validate the Kawasaki, INTERSALT and Tanaka formulas in predicting 24-h urinary sodium excretion using spot urine samples in 365 high-risk elder patients of strokefrom the rural areas of Shaanxi province...
October 11, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29018006/%C3%AE-galactosidase-a-genotype-n215s-induces-a-specific-cardiac-variant-of-fabry-disease
#12
Daniel Oder, Dan Liu, Kai Hu, Nurcan Üçeyler, Tim Salinger, Jonas Müntze, Kristina Lorenz, Reinhard Kandolf, Hermann-Josef Gröne, Claudia Sommer, Georg Ertl, Christoph Wanner, Peter Nordbeck
BACKGROUND: Hypertrophic cardiomyopathy is the most common type of cardiomyopathy, but many patients lack sarcomeric/myofilament mutations. We studied whether cardio-specific α-galactosidase A gene variants are misinterpreted as hypertrophic cardiomyopathy because of the lack of extracardiac organ involvement. METHODS AND RESULTS: All subjects who tested positive for the N215S genotype (n=26, 13 females, mean age 49±17 [range, 14-74] years) were characterized in this prospective monocentric longitudinal cohort study to determine genotype-specific clinical characteristics of the N215S (c...
October 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/28992097/association-of-serum-albumin-levels-with-kidney-function-decline-and-incident-chronic-kidney-disease-in-elders
#13
Joshua Lang, Ronit Katz, Joachim H Ix, Orlando M Gutierrez, Carmen A Peralta, Chirag R Parikh, Suzanne Satterfield, Snezana Petrovic, Prasad Devarajan, Michael Bennett, Linda F Fried, Steven R Cummings, Mark J Sarnak, Michael G Shlipak
Background: Previous studies in HIV-infected individuals have demonstrated serum albumin to be strongly associated with kidney function decline, independent of urine albumin and inflammatory markers. Lower serum albumin concentrations may be an under-appreciated risk factor for kidney function decline in elders. Methods: We performed a cohort analysis in the Health Aging and Body Composition Study, a cohort of well-functioning, bi-racial, community-dwelling elders between the age of 70 and 79 years...
August 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28988219/differences-in-levels-of-albumin-alt-ast-%C3%AE-gt-and-creatinine-in-frail-moderately-healthy-and-healthy-elderly-individuals
#14
Maria Edvardsson, Märtha Sund-Levander, Anna Milberg, Ewa Wressle, Jan Marcusson, Ewa Grodzinsky
BACKGROUND: Reference intervals are widely used as decision tools, providing the physician with information about whether the analyte values indicate ongoing disease process. Reference intervals are generally based on individuals without diagnosed diseases or use of medication, which often excludes elderly. The aim of the study was to assess levels of albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine and γ-glutamyl transferase (γ-GT) in frail, moderately healthy and healthy elderly indivuduals...
October 9, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28981553/dabigatran-versus-warfarin-for-acute-venous-thromboembolism-in-elderly-or-impaired-renal-function-patients-pooled-analysis-of-re-cover-and-re-cover-ii-pooled-analysis-of-re-cover-and-re-cover-ii
#15
Samuel Z Goldhaber, Sam Schulman, Henry Eriksson, Martin Feuring, Mandy Fraessdorf, Jörg Kreuzer, Elke Schüler, Sebastian Schellong, Ajay K Kakkar
Management of acute venous thromboembolism (VTE) with anticoagulants in elderly patients and those with chronic kidney disease poses special challenges. The RE-COVER and RE-COVER II trials showed that dabigatran 150 mg twice daily was as effective as warfarin over 6 months in preventing recurrent VTE, with a lower bleeding risk. We now assess the effects of old age and renal impairment (RI) on pooled trial outcomes in 5,107 patients: 4,504 aged <75 years and 603 aged ≥75 years. The primary efficacy outcome was symptomatic VTE/VTE-related death...
October 4, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28980380/safety-and-feasibility-of-same-day-early-discharge-after-endovascular-revascularization-of-lower-extremities-in-elderly-senior-er-registry
#16
Adam Janas, Krzysztof Milewski, Piotr P Buszman, Ksenia Janas, Aleksandra Blachut, Maciej Pruski, Szymon Wiernek, Aleksander Zurakowski, Pawel E Buszman, Stefan R Kiesz
OBJECTIVE: The aim of the study was to assess safety and feasibility of one-day early discharge (ODD) after endovascular revascularization (ER) of lower extremities in elderly. BACKGROUND: Safety and feasibility of ODD after ER have never been investigated in the elderly, despite the PAD rate has been rising in well-developed countries as their populations are getting older. METHODS: The consecutive data of 477 patients after ER who were intended to ODD were reviewed...
October 5, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28978997/beta-trace-protein-does-not-outperform-creatinine-and-cystatin-c-in-estimating-glomerular-filtration-rate-in-older-adults
#17
Natalie Ebert, Camilla Koep, Kristin Schwarz, Peter Martus, Nina Mielke, Jan Bartel, Martin Kuhlmann, Jens Gaedeke, Markus Toelle, Markus van der Giet, Mirjam Schuchardt, Elke Schaeffner
Despite intense research the optimal endogenous biomarker for glomerular filtration rate (GFR) estimation has not been identified yet. We analyzed if ß-trace protein (BTP) improved GFR estimation in elderly. 566 participants aged 70+ from the population-based Berlin Initiative Study were included in a cross-sectional validation study. BTP, standardized creatinine and cystatin C were measured in participants with iohexol clearance measurement as gold standard method for measured GFR (mGFR). In a double logarithmic linear model prediction of mGFR by BTP was assessed...
October 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28973026/low-serum-phosphate-as-an-independent-predictor-of-increased-infection-related-mortality-in-dialysis-patients-a-prospective-multicenter-cohort-study
#18
Ji-Eun Lee, Jeong-Hoon Lim, Hye Min Jang, Yon Su Kim, Shin-Wook Kang, Chul Woo Yang, Nam-Ho Kim, Eugene Kwon, Hyun-Ji Kim, Jeung-Min Park, Hee-Yeon Jung, Ji-Young Choi, Sun-Hee Park, Chan-Duck Kim, Jang-Hee Cho, Yong-Lim Kim
BACKGROUND: The role of mineral metabolism in mortality among dialysis patients has received increased attention, but some aspects remain unclear. The aim of the present study was to investigate the prognostic value of serum calcium and phosphate levels for all-cause mortality and cause-specific mortality in dialysis patients. METHODS: Patients on hemodialysis and peritoneal dialysis were enrolled from a multicenter prospective cohort study in Korea (NCT00931970)...
2017: PloS One
https://www.readbyqxmd.com/read/28972237/the-effects-of-weight-and-waist-change-on-the-risk-of-long-term-mortality-in-older-adults-the-bambu%C3%A3-brazil-cohort-study-of-aging
#19
A M Beleigoli, M D F H Diniz, E Boersma, J L Silva, M F Lima-Costa, A L Ribeiro
OBJECTIVE: We aimed to investigate the risk of long-term mortality associated with weight and waist circumference (WC) change among older adults, particularly the overweight and obese ones. DESIGN: Cohort Study. SETTING: The Bambuí (Brazil) Cohort Study of Aging. PARTICIPANTS: Community-dwelling elderly (n=1138). MEASUREMENTS: Weight and WC were reassessed three years after baseline. Mortality risk associated with a 5% weight/WC loss and gain was compared to that of weight/WC stability by Cox models adjusted for clinical, behavioral and social known risk factors for death (age, gender, BMI, smoking, diabetes, total cholesterol, hypertension, Chagas disease, major electrocardiographic changes, physical activity, B-type natriuretic peptide, C-reactive protein, creatinine, education and household income)...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28969968/efficacy-and-safety-of-rivaroxaban-in-extreme-elderly-patients-with-atrial-fibrillation-analysis-of-the-shikoku-rivaroxaban-registry-trial-srrt
#20
Shigenobu Bando, Akiyoshi Nishikado, Norikazu Hiura, Shuntaro Ikeda, Akiyoshi Kakutani, Katsuhito Yamamoto, Noriyoshi Kaname, Masahiko Fukatani, Yuichiro Takagi, Kazushi Yukiiri, Yamato Fukuda, Yutaka Nakaya
BACKGROUND: The Shikoku Rivaroxaban Registry Trial (SRRT) is a retrospective survey of the use of rivaroxaban for stroke prevention in elderly patients in Shikoku, Japan. METHODS: The SRRT enrolled 1339 patients from 8 hospitals. Patients were divided into two groups according to their age, the extreme elderly group (453 patients aged ≧80 years) and the control group (886 patients aged <80 years). RESULTS: In the extreme elderly group, 41...
September 29, 2017: Journal of Cardiology
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