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https://www.readbyqxmd.com/read/28472415/acupressure-for-frail-older-people-in-community-dwellings-a-randomised-controlled-trial
#1
Clara W C Chan, Pui Hing Chau, Angela Y M Leung, Kwai Ching Lo, Huafeng Shi, Tin Pui Yum, Yeuk Yiu Lee, Lei Li
Background: 'Frailty' is being increasing recognised as a geriatric syndrome of growing importance in the medical field. Acupressure is a non-pharmacological, non-invasive Traditional Chinese Medicine (TCM) treatment, which may serve to improve the quality of life (QOL) or prevent the progressive advancement of frailty in the aged population. Objective: to investigate the effects of a 12-week, TCM-principle guided acupressure intervention on the QOL of the frail older people living in the community...
May 2, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28467578/approach-to-inguinal-hernia-in-high-risk-geriatric-patients-should-it-be-elective-or-emergent
#2
Rıza Gürhan Işıl, Pınar Yazıcı, Uygar Demir, Cemal Kaya, Özgür Bostancı, Ufuk Oğuz İdiz, Canan Tülay Işıl, Mahmut Kaan Demircioğlu, Mehmet Mihmanlı
BACKGROUND: Elderly patients are more prone to have inguinal hernia due to weakened abdominal musculature. However, surgical repair of inguinal hernia (SRIH) may not be performed or may be delayed due to greater risk in presence of comorbidities. Present study is investigation of outcome of elective and emergency SRIH in geriatric patients. METHODS: Records of total of 384 high-risk (American Society of Anesthesiology classification III-IV) patients aged >65 years who underwent SRIH between January 2010 and December 2014 were reviewed...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28405846/cancer-specific-geriatric-assessment-and-quality-of-life-important-factors-in-caring-for-older-patients-with-aggressive-b-cell-lymphoma
#3
Karin Ribi, Stéphanie Rondeau, Felicitas Hitz, Ulrich Mey, Milica Enoiu, Thomas Pabst, Anastasios Stathis, Natalie Fischer, Kerri M Clough-Gorr
PURPOSE: To evaluate the efficacy and tolerability of chemotherapy, a geriatric assessment is recommended in elderly patients with cancer. We aimed to characterize and compare patients with aggressive lymphoma by objective response and survival status based on pre-treatment cancer-specific geriatric (C-SGA) and quality of life (QoL) assessments. METHODS: Patients not eligible for anthracycline-based first-line therapy or intensive salvage regimens completed C-SGA and QoL assessment before and after a rituximab-bendamustine-lenalidomide (R-BL) treatment in a phase II clinical trial...
April 13, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28403091/effects-of-preoperative-chronic-hypoxemia-on-geriatrics-outcomes-after-hip-arthroplasty-a-hospital-based-retrospective-analysis-study
#4
Furong Zhang, Ruqiang Zhang, Liang He, Jianwei Yin, Fang Wang, Junmin Li
The partial pressure of oxygen decreases as altitude increases, the preoperative chronic hypoxemia (CH) may have a plausible clinical impact. Risk factors for postoperative serious adverse events (pSAEs) in patients living in high altitudes during primary hip arthroplasty (HA) are not clear.This is an observational study embracing patients from January 1, 2011 to December 31, 2015 at Yan'an Hospital of Kunming City, a 1338-bed municipal teaching hospital of Kunming Medical University. Univariate analysis revealed that significant differences between patients with and without preoperative CH occurred in intraoperative hypotension (77 [33%] vs 34 [47%], P = ...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28392431/-urinary-catheters-prevalence-study-in-a-university-hospital
#5
J Carrouget, C Legeay, A Poirier, A-R Azzouzi, J-R Zahar, P Bigot
INTRODUCTION: Urinary tract infection is the most common healthcare-association infection, especially because of urinary catheter. We evaluated our practices concerning catheter insertion and management in our institution. MATERIALS AND METHODS: We conducted a single-centre descriptive cross-sectional study during 1 week in September 2014 in all adult departments. We noted prevalence, indications, length, management of urinary catheter (UC) and symptomatic catheter-associated urinary tract infections (SCAUTI)...
April 6, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28364991/polypharmacy-and-delirium-in-critically-ill-older-adults-recognition-and-prevention
#6
REVIEW
Erik Garpestad, John W Devlin
Among older adults, polypharmacy is a sequelae of admission to the intensive care unit and is associated with increased medication-associated adverse events, drug interactions, and health care costs. Delirium is prevalent in critically ill geriatric patients and medications remain an underappreciated modifiable risk for delirium in this setting. This article reviews the literature on polypharmacy and delirium, with a focus on highlighting the relationships between polypharmacy and delirium in critically ill, older adults...
May 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28353488/management-of-central-venous-access-device-associated-skin-impairment-an-evidence-based-algorithm
#7
Daphne Broadhurst, Nancy Moureau, Amanda J Ullman
Patients relying on central venous access devices (CVADs) for treatment are frequently complex. Many have multiple comorbid conditions, including renal impairment, nutritional deficiencies, hematologic disorders, or cancer. These conditions can impair the skin surrounding the CVAD insertion site, resulting in an increased likelihood of skin damage when standard CVAD management practices are employed. Supported by the World Congress of Vascular Access (WoCoVA), developed an evidence- and consensus-based algorithm to improve CVAD-associated skin impairment (CASI) identification and diagnosis, guide clinical decision-making, and improve clinician confidence in managing CASI...
May 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28325586/-prognostic-indices-for-older-adults-during-the-year-following-hospitalization-in-an-acute-medical-ward-an-update
#8
Josephine Thomazeau, Samantha Huo Yung Kai, Yves Rolland, Sandrine Sourdet, Nicolas Saffon, Fati Nourhashemi
CONTEXT: As population grow older, chronic diseases are more prevalent. It leads to an increase of hospitalization for acute decompensation, sometimes iterative. Management of these patients is not always clear, and care provided is not always proportional to life expectancy. Making decisions in acute situations is not easy. OBJECTIVE: This review aims to list and describe mortality scores within a year following hospitalization of patients of 65 years or older...
March 18, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28290728/diffuse-large-b-cell-lymphoma-in-the-elderly-standard-treatment-and-new-perspectives
#9
REVIEW
Annalisa Chiappella, Alessia Castellino, Maura Nicolosi, Elisa Santambrogio, Umberto Vitolo
Diffuse large B-cell lymphoma (DLBCL) is the most common histotype in non Hodgkin lymphoma, with a peak incidence in the sixth decade. The standard treatment for elderly FIT DLBCL patients is Rituximab-CHOP; in unfit and frail patients, chemotherapy at reduced intensity should be considered. Areas covered: In this article, we will review use of standard therapies and new drugs investigated such as immonomudulating agents (IMiDs), Bruton Tyrosine Kinase (BTK), in fit, unfit, frail and very elderly DLCBL patients...
April 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28263374/determinants-of-dropout-and-nonadherence-in-a-dementia-prevention-randomized-controlled-trial-the-prevention-of-dementia-by-intensive-vascular-care-trial
#10
Cathrien R L Beishuizen, Nicola Coley, Eric P Moll van Charante, Willem A van Gool, Edo Richard, Sandrine Andrieu
OBJECTIVES: To explore and compare sociodemographic, clinical, and neuropsychiatric determinants of dropout and nonadherence in older people participating in an open-label cluster-randomized controlled trial-the Prevention of Dementia by Intensive Vascular care (preDIVA) trial-over 6 years. DESIGN: Secondary analysis. SETTING: One hundred sixteen general practices in the Netherlands. PARTICIPANTS: Community-dwelling individuals aged 70 to 78 (N = 2,994)...
March 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28259059/evaluation-of-medication-related-clinical-decision-support-alert-overrides-in-the-intensive-care-unit
#11
Adrian Wong, Mary G Amato, Diane L Seger, Sarah P Slight, Patrick E Beeler, Patricia C Dykes, Julie M Fiskio, Elizabeth R Silvers, E John Orav, Tewodros Eguale, David W Bates
PURPOSE: Medication-related clinical decision support (CDS) has been identified as a method to improve patient outcomes but is historically frequently overridden and may be inappropriately so. Patients in the intensive care unit (ICU) are at a higher risk of harm from adverse drug events (ADEs) and these overrides may increase patient harm. The objective of this study is to determine appropriateness of overridden medication-related CDS overrides in the ICU. MATERIALS AND METHODS: We evaluated overridden medication-related alerts of four alert categories from January 2009 to December 2011...
June 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28223789/the-determinants-of-coping-with-pain-in-chronically-ill-geriatric-patients-the-role-of-a-sense-of-coherence
#12
Anna Andruszkiewicz, Małgorzata Anna Basińska, Mirosława Felsmann, Mariola Banaszkiewicz, Alicja Marzec, Kornelia Kędziora-Kornatowska
BACKGROUND: Given the rising population of the elderly in modern societies, the concern for their good functioning poses a challenge for the 21st century medicine and social services. Senior citizens are at an increased risk of developing chronic conditions, which in turn increase discomfort associated with physiological processes of aging. Sensations of pain have a particular influence on the mentioned discomfort, and pain is prevalent among older people. Therefore, from the perspective of an elderly person and senior care, it is crucial to identify determinants of effective coping with chronic pain...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28215925/-elderly-patients-and-intensive-care-systematic-review-and-geriatrician-s-point-of-view
#13
H Vallet, B Riou, J Boddaert
The global population is aging and intensive care unit admission rate of elderly patients is dramatically increasing. The objective of this review is to provide an overview of the literature about the management of elderly patients in intensive care unit and more specifically about epidemiology, admission criteria, mortality, functional prognosis and ethical aspects. We also discuss the data on cardiorespiratory arrest, shock, acute respiratory failure and delirium. The mortality rate of patients over 80 years old in intensive care unit can reach up to 70% at 1year, but is dependent on many factors, such as comorbidities or frailty...
February 16, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28206931/a-comprehensive-investigation-of-comorbidities-mechanisms-injury-patterns-and-outcomes-in-geriatric-blunt-trauma-patients
#14
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/28176431/comparison-between-clinical-gait-and-daily-life-gait-assessments-of-fall-risk-in-older-people
#15
Matthew A Brodie, Milou J Coppens, Andreas Ejupi, Yves J Gschwind, Janneke Annegarn, Daniel Schoene, Rainer Wieching, Stephen R Lord, Kim Delbaere
AIM: Falls are a leading cause of disability in older people. Here we investigate if daily-life gait assessments are better than clinical gait assessments at discriminating between older people with and without a history of falls. METHODS: A total of 96 independent-living participants (age 75.5 ± 7.8) underwent sensorimotor, psychological and cognitive assessments, and the Timed Up and Go and 10-m walk tests. Participants wore a small pendant sensor device for a week in their home environment, from which the new remote assessments of daily-life gait were determined...
February 8, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28162786/base-excess-a-useful-marker-in-the-prognosis-of-chest-trauma-in-the-geriatric-population
#16
Y Peñasco, A González-Castro, J C Rodríguez-Borregán, J Llorca
OBJECTIVE: To determine the usefulness of the determination of base excess in a cohort of elderly patients admitted to an intensive care unit (ICU) with a diagnosis of chest trauma. MATERIAL AND METHOD: Two hundred and forty-nine patients were included aged 65 years and over with a diagnosis of thoracic trauma who required admission to the ICU. We made a statistical analysis in order to determine the association of the first base excess levels with mortality during the unit stay...
May 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28156541/contribution-of-polypharmacy-and-potentially-inappropriate-medication-use-to-inferior-survival-in-older-patients-with-aggressive-lymphoma
#17
Robin Guo, Daniel Jacob Becker, Michael L Grossbard, Catherine S Magid Diefenbach
129 Background: Survival outcomes for older patients with aggressive non-Hodgkin's lymphoma (NHL) are disproportionally inferior to those of younger patients. While differences in tumor biology may play a role, older patients are often frail with comorbidities, polypharmacy, and use potentially inappropriate medications (PIM). METHODS: Using Cox proportional hazard and logistic regression models, we retrospectively analyzed all aggressive NHL patients age 60 and older diagnosed and treated at our institution from 2009-2014 to examine the effect of polypharmacy and PIM use on progression-free survival (PFS), overall survival (OS), and treatment-related toxicities...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28149026/validation-of-a-prognostic-score-for-mortality-in-elderly-patients-admitted-to-intensive-care-unit
#18
Luis Alejandro Sánchez-Hurtado, Adrian Ángeles-Veléz, Brigette Carmen Tejeda-Huezo, Juan Carlos García-Cruz, Teresa Juárez-Cedillo
CONTEXT: The performance of a prognostic score must be evaluated prior to being used. The aim of the present study was to evaluate the predictive ability of hospital mortality of Simplified Acute Physiology Score 3 (SAPS 3) score in elderly patients admitted to Intensive Care Units (ICUs). AIMS: The aim of the present study was to evaluate the SAPS 3 score predictive ability of hospital mortality in elderly patients admitted to ICU. SETTINGS AND DESIGN: This study was conducted as a prospective cohort, in two mixed ICUs...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28125760/resource-use-and-medicare-costs-during-lay-navigation-for-geriatric-patients-with-cancer
#19
Gabrielle B Rocque, Maria Pisu, Bradford E Jackson, Elizabeth A Kvale, Wendy Demark-Wahnefried, Michelle Y Martin, Karen Meneses, Yufeng Li, Richard A Taylor, Aras Acemgil, Courtney P Williams, Nedra Lisovicz, Mona Fouad, Kelly M Kenzik, Edward E Partridge
Importance: Lay navigators in the Patient Care Connect Program support patients with cancer from diagnosis through survivorship to end of life. They empower patients to engage in their health care and navigate them through the increasingly complex health care system. Navigation programs can improve access to care, enhance coordination of care, and overcome barriers to timely, high-quality health care. However, few data exist regarding the financial implications of implementing a lay navigation program...
January 26, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28115288/therapeutic-effect-of-human-ghrelin-and-growth-hormone-attenuation-of-immunosuppression-in-septic-aged-rats
#20
Mian Zhou, Weng-Lang Yang, Monowar Aziz, Gaifeng Ma, Ping Wang
Sepsis is a leading cause of mortality in intensive care units, and is more common in the geriatric population. The control of hyperinflammation has been suggested as a therapeutic approach in sepsis, but to date clinical trials utilizing this strategy have not lead to an effective treatment. In addition to hyperinflammation, patients with sepsis often experience a state of immunosuppression, which serves as an important determinant for increased morbidity and mortality. We previously used aged animals to demonstrate the effectiveness of combined treatment with human ghrelin (Ghr) and human growth hormone (GH) in improving organ injury and survival in septic animals...
January 20, 2017: Biochimica et Biophysica Acta
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