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https://www.readbyqxmd.com/read/29317368/interdisciplinary-care-model-independently-decreases-use-of-critical-care-services-after-corrective-surgery-for-adult-degenerative-scoliosis
#1
Owoicho Adogwa, Aladine A Elsamadicy, Amanda R Sergesketter, Michael Ongele, Victoria Vuong, Syed Khalid, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE: Interdisciplinary management of elderly patients requiring spine surgery has been shown to improve short and long-term outcomes. The aim of this study is to determine whether an interdisciplinary team approach mitigates use of intensive care unit (ICU) resources. METHODS: A unique co-management model for elderly patients undergoing lumbar fusion surgery was implemented at a major academic medical center. The Peri-operative Optimization of Senior Health Program(POSH) was launched with the aim of improving outcomes in elderly patients(>65-years-old) undergoing complex lumbar spine surgery...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29285042/treatment-patterns-and-outcomes-in-elderly-patients-with-metastatic-breast-cancer-a-multicenter-retrospective-study
#2
Jin Hyun Park, In Sil Choi, Ki Hwan Kim, Jin-Soo Kim, Kyung-Hun Lee, Tae-Yong Kim, Seock-Ah Im, Se Hyun Kim, Yu Jung Kim, Jee Hyun Kim
Purpose: Currently, there is little information regarding optimal treatment for metastatic breast cancer (MBC) in elderly patients. In this retrospective study, we examined a cohort of elderly patients with MBC receiving a range of treatments, in terms of demographic and clinicopathologic characteristics, treatment patterns, and outcomes. Methods: Patients aged 65 years and older, and diagnosed with MBC between 2003 and 2015, were identified from the databases of three academic hospitals in South Korea...
December 2017: Journal of Breast Cancer
https://www.readbyqxmd.com/read/29230125/older-patients-with-acute-myeloid-leukemia-treatment-challenges-and-future-directions
#3
REVIEW
Laura Finn, Andrew Dalovisio, James Foran
Background: Even though acute myeloid leukemia (AML) occurs most commonly in adults ≥60 years, the treatment of AML in older patients remains a significant challenge. Methods: We reviewed the current literature regarding patient assessment tools, treatment options, and current therapies in clinical trial for patients with AML who are ≥60 years. Results: Our approach to the older patient with AML is evolving with better understanding of the unique disease epidemiology in this population and the development of tools to assess individual patient functional status, including grading systems for comorbidities, geriatric assessment tools, and measurements of frailty...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29222035/carriage-of-esbl-producing-enterobacteriaceae-in-french-hospitals-the-portablse-study
#4
B Pilmis, V Cattoir, D Lecointe, A Limelette, I Grall, A Mizrahi, G Marcade, I Poilane, T Guillard, N Bourgeois Nicolaos, J-R Zahar, A Le Monnier
BACKGROUND: Currently, contact precautions are recommended for patients colonized or infected with extended spectrum beta-lactamase producing enterobacteriaceae (ESBL-PE). Recent studies have challenged this strategy. This study aimed to assess the rate of ESBL-PE faecal carriage among hospitalized patients according to type of hospital ward, and to identify risk factors associated with carriage. METHODS: We conducted a point prevalence study in five different types of hospital wards (medical, surgical, intensive care unit (ICU), after care and rehabilitation and geriatric) in 8 French hospitals...
December 5, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29216345/effect-of-influenza-vaccination-against-postoperative-pneumonia-and-mortality-for-geriatric-patients-receiving-major-surgery-a-nationwide-matched-study
#5
Wan-Chi Liu, Chao-Shun Lin, Chun-Chieh Yeh, Hsin-Yun Wu, Yuarn-Jang Lee, Chi-Li Chung, Yih-Giun Cherng, Ta-Liang Chen, Chien-Chang Liao
Background: Limited information is available on the association between a influenza vaccination and postoperative outcomes. Methods: Using Taiwan's National Health Insurance Research Database reimbursement claims data from 2008 to 2013, we conducted a matched cohort study of 16,903 patients over age 66 who received influenza vaccinations and later underwent major surgery. Using propensity score matching procedure adjusted for socio-demographics, medical conditions, types of surgery and anesthesia, 16,903 controls who were not vaccinated were selected...
December 5, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29214518/outcome-of-older-persons-admitted-to-intensive-care-unit-mortality-prognosis-factors-dependency-scores-and-ability-trajectory-within-1%C3%A2-year-a-prospective-cohort-study
#6
Claude Level, Eric Tellier, Patrick Dezou, Karim Chaoui, Aissa Kherchache, Philippe Sejourné, Anne Marie Rullion-Pac Soo
BACKGROUND: The outcome and functional trajectory of older persons admitted to intensive care (ICU) unit remain a true question for critical care physicians and geriatricians, due to the heterogeneity of geriatric population, heterogeneity of practices and absence of guidelines. AIM: To describe the 1-year outcome, prognosis factors and functional trajectory for older people admitted to ICU. METHODS: In a prospective 1-year cohort study, all patients aged 75 years and over admitted to our ICU were included according to a global comprehensive geriatric assessment...
December 6, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29202811/high-prevalence-of-prescription-of-psychotropic-drugs-for-older-patients-in-a-general-hospital
#7
Inken Arnold, Kati Straube, Wolfgang Himmel, Stephanie Heinemann, Vivien Weiss, Laura Heyden, Eva Hummers-Pradier, Roland Nau
BACKGROUND: Many elderly patients receive psychotropic drugs. Treatment with psychotropic agents is associated with serious side effects including an increased risk of falls and fractures. Several psychotropic drugs are considered potentially inappropriate for treatment of the elderly. METHODS: A retrospective chart review was conducted covering all patients aged ≥ 65 years who were admitted to Evangelisches Krankenhaus Göttingen-Weende between 01/01/2013 and 03/31/2013...
December 4, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29198046/is-treatment-of-geriatric-hip-fracture-patients-cost-covering-results-of-a-prospective-study-conducted-at-a-german-university-hospital
#8
Rene Aigner, Juliana Hack, Daphne Eschbach, Steffen Ruchholtz, Matthias Knobe, Richard Dodel, Benjamin Buecking
INTRODUCTION: Hip fractures have increased medical and socio-economic importance due to demographic transition. Information concerning direct treatment costs and their reimbursement in Germany is lacking. MATERIALS AND METHODS: Four hundred two hip fracture patients older than 60 years of age were observed prospectively at a German University Hospital. Treatment costs were determined with up to 196 cost factors and compared to the reimbursement. Finally, statistical analysis was performed to identify clinical parameters influencing the cost-reimbursement relation...
December 2, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29196576/apathy-is-associated-with-incident-dementia-in-community-dwelling-older-people
#9
Jan Willem van Dalen, Lennard L Van Wanrooij, Eric P Moll van Charante, Edo Richard, Willem A van Gool
OBJECTIVE: To assess whether apathy and depressive symptoms are independently associated with incident dementia during 6-year follow-up in a prospective observational population-based cohort study. METHODS: Participants were community-dwelling older people in the Prevention of Dementia by Intensive Vascular Care trial, aged 70-78 years, without dementia at baseline. Apathy and depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15)...
December 1, 2017: Neurology
https://www.readbyqxmd.com/read/29179708/comparing-doctors-legal-compliance-across-three-australian-states-for-decisions-whether-to-withhold-or-withdraw-life-sustaining-medical-treatment-does-different-law-lead-to-different-decisions
#10
Ben P White, Lindy Willmott, Colleen Cartwright, Malcolm Parker, Gail Williams, Juliet Davis
BACKGROUND: Law purports to regulate end-of-life care but its role in decision-making by doctors is not clear. This paper, which is part of a three-year study into the role of law in medical practice at the end of life, investigates whether law affects doctors' decision-making. In particular, it considers whether the fact that the law differs across Australia's three largest states - New South Wales (NSW), Victoria and Queensland - leads to doctors making different decisions about withholding and withdrawing life-sustaining treatment from adults who lack capacity...
November 28, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29140924/the-association-between-pain-and-frailty-among-chinese-community-dwelling-older-adults-depression-as-a-mediator-and-its-interaction-with-pain
#11
Xiaoyu Tian, Cuili Wang, Xiaoxia Qiao, Na Liu, Lijuan Dong, Mary Butler, Huaxin Si, Yaru Jin
Pain and frailty are both prevalent and have severe health impacts among older adults. We conducted a cross-sectional observational study to examine the association between pain and frailty, and depression as a mediator and its interaction with pain on frailty among 1788 Chinese community-dwelling older adults. Physical frailty, pain intensity and depressive symptoms were assessed using the Frailty Phenotype, the revised Faces Pain Scale (FPS-R), and the 5-item Geriatric Depression Scale (GDS-5), respectively...
November 13, 2017: Pain
https://www.readbyqxmd.com/read/29078902/admission-of-elderly-blunt-thoracic-trauma-patients-directly-to-the-intensive-care-unit-improves-outcomes
#12
Owen J Pyke, Jerry A Rubano, James A Vosswinkel, Jane E McCormack, Emily C Huang, Randeep S Jawa
INTRODUCTION: Blunt thoracic trauma in the elderly has been associated with adverse outcomes. As an internal quality improvement initiative, direct intensive care unit (ICU) admission of nonmechanically ventilated elderly patients with clinically important thoracic trauma (primarily multiple rib fractures) was recommended. METHODS: A retrospective review of the trauma registry at a level 1 trauma center was performed for patients aged ≥65 y with blunt thoracic trauma, admitted between the 2 y before (2010-2012) and after (2013-2015) the recommendation...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28984103/outcome-of-geriatric-patients-admitted-to-intensive-care-unit-after-surgery-the-burden-of-chronic-diseases
#13
Tiziano Cassina, Marc Licker
No abstract text is available yet for this article.
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28970660/an-appraisal-of-mortality-in-intensive-care-unit-of-a-level-iii-military-hospital-of-bangladesh
#14
Md Rabiul Alam, Mainul Haque, Mozibul Haque
BACKGROUND: Mortalities in Intensive Care Units (ICUs) are high and widely variable. The unpredictability of death rates is attributable to age, sex, nature and severity of illness, comorbidity, well-timed medical attention, quality of the attending staffs, iatrogenic events, total management facilities, and overall grade of the ICU in general. MATERIALS AND METHODS: A total of seventy patients who died in the ICU of a Level III Combined Military Hospital within a period of 2 years were studied in retrospect to review the mortality pattern...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28932975/the-effect-of-a-geriatric-evaluation-on-treatment-decisions-for-older-patients-with-colorectal-cancer
#15
N M Verweij, E T D Souwer, A H W Schiphorst, H A Maas, J E A Portielje, A Pronk, F van den Bos, M E Hamaker
BACKGROUND: Treating elderly colorectal cancer patients can be challenging. It is very important to carefully weigh the risks and benefits of potential treatments in individual patients. This treatment decision making can be guided by geriatric consultation. Our aim was to assess the effect of a geriatric evaluation on treatment decisions for older patients with colorectal cancer. METHODS: Colorectal cancer patients who were referred for a geriatric consultation between 2013 and 2015 in three Dutch teaching hospitals were included in a prospective database...
November 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28913934/the-incidence-of-sarcopenia-among-hospitalized-older-patients-results-from-the-glisten-study
#16
Anna Maria Martone, Lara Bianchi, Pasquale Abete, Giuseppe Bellelli, Mario Bo, Antonio Cherubini, Francesco Corica, Mauro Di Bari, Marcello Maggio, Giovanna Maria Manca, Emanuele Marzetti, Maria Rosaria Rizzo, Andrea Rossi, Stefano Volpato, Francesco Landi
BACKGROUND: New evidence is emerging on the importance of lean body mass during periods of illness and recovery. The preservation of lean body mass during such periods of intense stress impacts both patient and treatment outcomes. However, data concerning the incidence of sarcopenia among older people during hospitalization are scarce. The objective of this study was to evaluate the development of sarcopenia in a sample of hospitalized older subjects. METHODS: We used data of 394 participants from the multicentre Italian Study conducted by the Gruppo Lavoro Italiano Sarcopenia-Trattamento e Nutrizione (GLISTEN) in 12 Acute Care Wards (Internal Medicine and Geriatrics) of University Hospitals across Italy...
September 14, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28892951/outcomes-of-mechanically-ventilated-critically-ill-geriatric-patients-in-intensive-care-unit
#17
Vivek Aggarwal, Rajeshwar Singh, Jung Bahadur Singh, Jps Bawa, Nimish Gaur, Sandeep Kumar, I V Nagesh
INTRODUCTION: Increase in life expectancy across the globe has led to rise in geriatric population. Geriatric population is now living longer and healthier. This rise in geriatric population has also led to increase in the geriatric ailments leading to increased number of geriatric patients requiring intensive care including mechanical ventilation. Data on outcomes of geriatric patients requiring mechanical ventilation from India is scarce. AIM: To study the profile and outcome of geriatric patients more than equal to 60 years requiring mechanical ventilation in Intensive Care Unit (ICU)...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28877802/a-comprehensive-investigation-of-comorbidities-mechanisms-injury-patterns-and-outcomes-in-geriatric-blunt-trauma-patients
#18
COMPARATIVE STUDY
Carlos V R Brown, Kevin Rix, Amanda L Klein, Brent Ford, Pedro G R Teixeira, Jayson Aydelotte, Ben Coopwood, Sadia Ali
The geriatric population is growing and trauma providers are often tasked with caring for injuries in the elderly. There is limited information regarding injury patterns in geriatric trauma patients stratified by mechanism of injury. This study intends to investigate the comorbidities, mechanisms, injury patterns, and outcomes in geriatric blunt trauma patients. A retrospective study of the 2012 National Trauma Databank was performed. Adult blunt trauma patients were identified; geriatric (>/=65) patients were compared with younger (<65) patients regarding admission demographics and vital signs, mechanism and severity of injury, and comorbidities...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28868075/determinants-of-invasive-strategy-in-elderly-patients-with-non-st-elevation-myocardial-infarction
#19
Antonin Negers, Jacques Boddaert, Lucie Mora, Jean-Louis Golmard, Laura Moïsi, Ariel Cohen, Jean-Philippe Collet, Alice Breining
BACKGROUND: Knowledge gaps across literature prevent current guidelines from providing the profile of elderly patients most likely to derive benefit from invasive strategy (IS) in non ST-elevation myocardial infarction (NSTEMI). Furthermore, the benefit of IS in a real-world elderly population with NSTEMI remains unclear. The aims of this study were to determine factors that lead the cardiologist to opt for an IS in elderly patients with NSTEMI, and to assess the impact of IS on the 6-month all-cause mortality...
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28867781/low-docosahexaenoic-acid-dihomo-gamma-linolenic-acid-and-arachidonic-acid-levels-associated-with-long-term-mortality-in-patients-with-acute-decompensated-heart-failure-in-different-nutritional-statuses
#20
Shohei Ouchi, Tetsuro Miyazaki, Kazunori Shimada, Yurina Sugita, Megumi Shimizu, Azusa Murata, Takao Kato, Tatsuro Aikawa, Shoko Suda, Tomoyuki Shiozawa, Masaru Hiki, Shuhei Takahashi, Hiroshi Iwata, Takatoshi Kasai, Katsumi Miyauchi, Hiroyuki Daida
The clinical significance of polyunsaturated fatty acids (PUFAs) in acute decompensated heart failure (ADHF) in various nutritional statuses remains unclear. For this study, we enrolled 267 patients with ADHF admitted to the cardiac intensive care unit at Juntendo University hospital between April 2012 and March 2014. The association between long-term mortality, the geriatric nutritional risk index (GNRI), and levels of PUFAs, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), dihomo-gamma-linolenic acid (DGLA), and arachidonic acid (AA) was investigated...
August 30, 2017: Nutrients
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