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https://www.readbyqxmd.com/read/28641678/cognitive-deterioration-in-moderate-and-severe-hypobaric-hypoxia-conditions
#1
Jeremy M A Beer, Barry S Shender, Daren Chauvin, Todd S Dart, Joseph Fischer
BACKGROUND: Hypoxia continues to present risks in military aviation. Hypoxia symptoms include sensory and cognitive effects; of these, it is important to identify which components of operator performance are most vulnerable to hypoxia-induced decline in order to determine which sensory modality is most effective for alerting an impaired aviator of an imminent hypoxic episode. METHODS: A study was performed in a hypobaric chamber to characterize deterioration of cognitive performance under moderate (MH) and severe (SH) hypoxia conditions, culminating in subjects' inability to perform tasks...
July 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28603638/clinician-agreement-and-influence-of-medication-related-characteristics-on-assessment-of-polypharmacy
#2
Gao-Jing Ong, Amy Page, Gillian Caughey, Sally Johns, Emily Reeve, Sepehr Shakib
It is not known how clinicians assess polypharmacy or the medication-related characteristics that influence their assessment. The aim of this study was to examine the level of agreement between clinicians when assessing polypharmacy and to identify medication-related characteristics that influence their assessment. Twenty cases of patients with varying levels of comorbidity and polypharmacy were used to examine clinician assessment of polypharmacy. Medicine-related factors within the cases included Beers and STOPP Criteria medicines, falls-risk medicines, drug burden index (DBI) medicines, medicines causing postural hypotension, and pharmacokinetic drug-drug interactions...
June 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28602709/factors-associated-with-the-use-of-potentially-inappropriate-medications-by-older-adults-with-cancer
#3
Cristiane Moreira Reis, Andrezza Gouvêa Dos Santos, Paula de Jesus Souza, Adriano Max Moreira Reis
OBJECTIVES: To determine the frequency and the factors associated with the use of potentially inappropriate medications (PIMs) by older adults with cancer at an onco-haematology ambulatory clinic of a teaching hospital in Brazil. MATERIAL AND METHODS: Patients aged 60years or older (n=160) subjected to parenteral antineoplastic chemotherapy from May to December 2015 and treated with one or more medications in the ambulatory clinic were interviewed. Data on medications, comorbidities, oncological diagnosis, and functional status were recorded...
June 8, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28571163/utilization-pattern-of-potentially-inappropriate-medications-in-geriatric-patients-in-a-tertiary-care-hospital-a-retrospective-observational-study
#4
Rajal Sudhir Narvekar, Nikhil Narayan Bhandare, Jonathan Joaquim Gouveia, Padma Narayan Bhandare
INTRODUCTION: Geriatric population is on the rise throughout the world, hence the quality and the safety of prescribing in the elderly is a global healthcare concern. It is important for the healthcare providers to be aware of the limitations in prescribing certain drugs to the elderly. This study was an attempt to shed light on the utilization pattern of Potentially Inappropriate Medications (PIMs) in elderly patients admitted in the medicine wards in a tertiary care hospital in Goa...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28569662/sliding-scale-insulin-use-in-long-term-care-an-updated-perspective
#5
Joy Woods, Micki Nadelson
Diabetes affects approximately 26% of individuals oldeR THAN 65 years of age in the United States and up to 33% of patients in long-term care facilities. The most commonly prescribed insulin therapy for patients in long-term care is sliding-scale insulin (SSI): the use of finger-stick blood glucose testing to assess the need for insulin administration based on current blood glucose levels. SSI has been on the Beers Criteria of Potentially Inappropriate Medications since 2012. However, its sole use for long-term treatment is specifically not recommended by the American Diabetes Association and other stakeholders in diabetes management...
February 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28545260/thermostabilization-of-the-uronate-dehydrogenase-from-agrobacterium-tumefaciens-by-semi-rational-design
#6
Teresa Roth, Barbara Beer, André Pick, Volker Sieber
Aldaric acids represent biobased 'top value-added chemicals' that have the potential to substitute petroleum-derived chemicals. Until today they are mostly produced from corresponding aldoses using strong chemical oxidizing agents. An environmentally friendly and more selective process could be achieved by using natural resources such as seaweed or pectin as raw material. These contain large amounts of uronic acids as major constituents such as glucuronic acid and galacturonic acid which can be converted into the corresponding aldaric acids via an enzyme-based oxidation using uronate dehydrogenase (Udh)...
December 2017: AMB Express
https://www.readbyqxmd.com/read/28540648/impact-of-2015-update-to-the-beers-criteria-on-estimates-of-prevalence-and-costs-associated-with-potentially-inappropriate-use-of-antimuscarinics-for-overactive-bladder
#7
Brandon T Suehs, Cralen Davis, Daniel B Ng, Katherine Gooch
BACKGROUND: Research has demonstrated that the use of potentially inappropriate medication (PIM) is highly prevalent among older individuals and may lead to increased healthcare costs, adverse drug reactions, hospitalizations, and mortality. OBJECTIVES: The purpose of this study was to examine the impact of the 2015 updates to the Beers Criteria on estimates of prevalence and cost associated with potentially inappropriate use of antimuscarinic medications indicated for treatment of overactive bladder (OAB)...
May 24, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28514134/-well-child-visits-regarding-growth-and-development-of-infants-a-cross-cultural-comparison
#8
Yana Shraga, Orly Sarid, Julie Cwikel, Haim Reuveni
AIMS: 1. To examine the rate of WCV among mothers in four ethno-cultural groups: native-born Jewish, Bedouin and immigrants from the Former Soviet Union (FSU) and Ethiopia; 2. to test the relationship between WCV in the first and second year of the infant's life; 3. to assess the effect of sociodemographic variables on WCV. BACKGROUND: Consistent infant well-child visits (WCV) have been found to be related to better health status and a decrease in visits to the emergency room and hospitalizations...
July 2016: Harefuah
https://www.readbyqxmd.com/read/28506569/-identifying-potentially-inappropriate-prescriptions-in-patients-over-65-years-old-using-original-beers-criteria-and-their-spanish-adaptation
#9
Josep Pastor Cano, Ana Aranda García, Juan José Gascón Cánovas, José Francisco Sánchez Ruiz, Víctor José Rausell Rausell, Mariana Tobaruela Soto
OBJECTIVE: To compare the detection of potentially inappropriate medication (PIM) using the original Beers criteria, a global reference for evaluating prescriptions in the elderly, and their Spanish version. DESIGN: Retrospective observational study LOCATION: A Primary Care area in the province of Murcia, Spain. PARTICIPANTS: A total of 7,856 subjects aged 65 and over, with at least one drug prescribed in a Primary Care Area of Spain during study period...
May 13, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28490560/nursing-home-team-care-deprescribing-study-a-stepped-wedge-randomised-controlled-trial-protocol
#10
Chong-Han Kua, Cindy Ying Ying Yeo, Cheryl Wai Teng Char, Cheryl Wei Yan Tan, Poh Ching Tan, Vivienne Sl Mak, Shaun Wen Huey Lee, Ian Yi-Onn Leong
INTRODUCTION: An ageing population has become an urgent concern for Asia in recent times. In nursing homes, polypharmacy has also become a compounding issue. Deprescribing practice is an evidence-based strategy to provide a better outcome in this group of patients; however, its implementation in nursing homes is often challenging, and prospective outcome data on deprescribing practice in the elderly is lacking. Our study assesses the implementation of team-care deprescribing to understand the benefits of this practice in geriatric setting and to explore the factors affecting deprescribing practice...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28467623/opioids-and-other-central-nervous-system-active-polypharmacy-in-older-adults-in-the-united-states
#11
Lauren B Gerlach, Mark Olfson, Helen C Kales, Donovan T Maust
OBJECTIVES: To determine patterns of and trends in contributions to central nervous system (CNS) polypharmacy, defined by the Beers Criteria as three or more CNS-active medications of each medication class, of adults aged 65 and older seen in U.S. outpatient medical practices. DESIGN: National Ambulatory Medical Care Survey (2004-2013). SETTING: U.S. outpatient medical care. PARTICIPANTS: Visits by older adults to outpatient physicians (N = 97,910)...
May 3, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28466395/over-the-counter-medications-containing-diphenhydramine-and-doxylamine-used-by-older-adults-to-improve-sleep
#12
Olufunmilola Abraham, Loren Schleiden, Steven M Albert
Background The unintentional misuse of over-the-counter sleep aids among older adults is an important public health problem and a focus of Healthy People 2020. Accordingly, the 2015 Beers Criteria for Potentially Inappropriate Medication Use in Older Adults recommends that individuals 65 years or older avoid use of diphenhydramine and doxylamine; however, many over-the-counter sleep products contain these active ingredients. Objective To identify the proportion of older adults using an over-the-counter medication containing diphenhydramine or doxylamine, and compare their characteristics with older adults using an over-the-counter medication that does not contain these ingredients...
May 2, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28458417/evaluation-of-polypharmacy-and-appropriateness-of-prescription-in-geriatric-patients-a-cross-sectional-study-at-a-tertiary-care-hospital
#13
K B Rakesh, Mukta N Chowta, Ashok K Shenoy, Rajeshwari Shastry, Sunil B Pai
OBJECTIVES: To assess the polypharmacy and appropriateness of prescriptions in geriatric patients in a tertiary care hospital. METHODS: An observational study was done in geriatric patients (>60 years) of either gender. The data collected from patients included: Socio-demographic data such as age, gender, marital status, educational status, socioeconomic status, occupation, nutritional status, history of alcohol/smoking, exercise history, details of comorbid diseases, medication history, findings of clinical examination etc...
January 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28458294/deprescribing-using-the-guidelines-for-medical-treatment-and-its-safety-in-the-elderly-and-changes-in-patient-qol-and-activities-of-daily-living
#14
Shigeru Ohshima, Ayaka Hara, Takumi Abe, Hayato Akimoto, Kousuke Ohara, Akio Negishi, Mitsuyoshi Okita, Shinji Oshima, Naoko Inoue, Sachihiko Numajiri, Etsushi Ogawa, Minoru Saiki, Daisuke Kobayashi
 Pharmacists applied deprescribing, which is a process for the rational use of drugs, for 13 at-home patients. The standard used for the rational use of drugs was the "Guidelines for Medical Treatment and Its Safety in the Elderly" (the Guidelines). The results of the deprescribing were discussed with physicians to determine prescriptions. After the prescription change, activities of daily living (ADL) and QOL were assessed using the Barthel Index and SF-36v2, respectively. Potentially inappropriate medications (PIMs) were detected in 10 of the 13 patients (76...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28456279/calibration-transfer-of-a-raman-spectroscopic-quantification-method-from-at-line-to-in-line-assessment-of-liquid-detergent-compositions
#15
D Brouckaert, J-S Uyttersprot, W Broeckx, T De Beer
The industrial production of liquid detergent compositions entails delicate balance of ingredients and process steps. In order to assure high quality and productivity in the manufacturing line, process analytical technology tools such as Raman spectroscopy are to be implemented. Marked chemical specificity, negligible water interference and high robustness are ascribed to this process analytical technique. Previously, at-line calibration models have been developed for determining the concentration levels of the being studied liquid detergents main ingredients from Raman spectra...
June 8, 2017: Analytica Chimica Acta
https://www.readbyqxmd.com/read/28455830/the-iatrogenic-triad-polypharmacy-drug-drug-interactions-and-potentially-inappropriate-medications-in-older-adults
#16
Priscila Horta Novaes, Danielle Teles da Cruz, Alessandra Lamas Granero Lucchetti, Isabel Cristina Gonçalves Leite, Giancarlo Lucchetti
Background The elderly population is often in continuous use of several medications and is more subject to the "iatrogenic triad" of polypharmacy, potentially inappropriate medication use and drug-drug interactions. However, few studies have investigated these three factors concomitantly. Purpose To assess the prevalence and inter-relationship of potentially inappropriate medication (PIM) use, polypharmacy and drug-drug interactions in older adults, together with their associated factors. Setting city of Juiz de Fora, Brazil...
April 28, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28423857/the-association-between-the-stopp-start-criteria-and-gastro-intestinal-track-bleedings-in-elderly-patients
#17
Anouk Veldhuis, Danielle Sent, Linette Bruin-Huisman, Erna Beers, Ameen Abu-Hanna
Potentially inappropriate prescribing is a common problem, especially in elderly care. To tackle this problem, Irish medical experts have developed a list of criteria when medication should be added or omitted based upon the patient's physical condition and medication use, known as the STOPP and START criteria. The STOPP and START criteria have been formulated to identify the prescribing of potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs). One of the most common problems of inappropriate prescribing is gastro-intestinal track bleedings...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28422415/impact-of-hospitalization-in-an-acute-geriatric-unit-on-polypharmacy-and-potentially-inappropriate-prescriptions-a-retrospective-study
#18
Marta Gutiérrez-Valencia, Mikel Izquierdo, Vincenzo Malafarina, Javier Alonso-Renedo, Belén González-Glaría, Beatriz Larrayoz-Sola, María Pilar Monforte-Gasque, Pello Latasa-Zamalloa, Nicolás Martínez-Velilla
AIM: Polypharmacy is a highly prevalent geriatric syndrome, and hospitalizations can worsen it. The aim of the present study was to analyze the influence of hospitalization on polypharmacy and indicators of quality of prescribing, and their possible association with health outcomes. METHODS: A retrospective study of 200 patients discharged from an acute geriatric unit was carried out. Indicators of quality of prescription were registered at admission and discharge: polypharmacy defined as ≥5 medications, hyperpolypharmacy (≥10), potentially inappropriate prescribing by Beers and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, potentially prescribing omissions by Screening Tool to Alert doctors to the Right Treatment (START) criteria, drug interactions and anticholinergic burden measured with the Anticholinergic Risk Scale...
April 19, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28388818/enhancing-quality-of-provider-practices-for-older-adults-in-the-emergency-department-equipped
#19
Melissa Stevens, Susan N Hastings, Alayne D Markland, Ula Hwang, William Hung, Ann E Vandenberg, William Bryan, Dewayne Cross, James Powers, Gerald McGwin, Noor Fattouh, William Ho, Carolyn Clevenger, Camille P Vaughan
EQUiPPED is a multicomponent quality improvement initiative combining education, electronic clinical decision support, and individual provider feedback to influence prescribing and improve medication safety for older adults. The objective here was to evaluate the effectiveness and sustainability of EQUiPPED to reduce the use of potentially inappropriate medications (PIMs), as defined by the American Geriatrics Society 2012 Beers Criteria, prescribed to older Veterans at the time of emergency department (ED) discharge...
April 7, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28371121/clinical-medication-review-tool-for-polypharmacy-mapping-approach-for-pharmacotherapeutic-classifications
#20
Fumihiro Mizokami, Tomohiro Mizuno, Tomoyo Mori, Tadashi Nagamatsu, Hideharu Endo, Tomoyuki Hirashita, Takanobu Ichino, Masahiro Akishita, Katsunori Furuta
AIM: Polypharmacy is an extremely important problem, because it increases the risk of adverse drug reactions. The aim of the current study was to create a clinical medication review tool to detect inappropriate medication use, and assess this new method with elderly Japanese patients. METHODS: The new method involves optimizing prescription drugs from indications, based on the chronic disease-anatomical therapeutic class code list. The present study investigated the prevalence of potentially inappropriate medications in 5667 Japanese patients aged ≥65 years with polypharmacy (≥5 drugs) in comparison with the Beers criteria 2012...
March 30, 2017: Geriatrics & Gerontology International
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