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https://www.readbyqxmd.com/read/28634259/effectiveness-of-an-online-support-programme-supr-for-older-hearing-aid-users-study-protocol-for-a-cluster-randomised-controlled-trial
#1
Janine Fj Meijerink, Marieke Pronk, Bernadette Paulissen, Birgit I Witte, Bregje van der Wouden, Vera Jansen, Sophia E Kramer
BACKGROUND: An educational SUpport PRogramme called SUPR has been developed for hearing aid users (HAUs) and their communication partners (CPs) offering care beyond hearing aid fitting. SUPR teaches its users communication strategies, hearing aid handling skills and personal adjustment to hearing impairment. METHODS/DESIGN: Using a cluster randomised controlled trial design, 70 Dutch hearing aid dispenser practices were randomised into hearing aid fitting (care as usual, 34 practices) and hearing aid fitting including SUPR (36 practices)...
June 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28632519/age-is-the-most-significantly-associated-risk-factor-with-the-development-of-delirium-in-patients-hospitalized-for-more-than-five-days-in-surgical-wards-retrospective-cohort-study
#2
Keisuke Kubota, Akihiro Suzuki, Sachiko Ohde, Ui Yamada, Takashi Hosaka, Fumiko Okuno, Ikumi Fujitani, Aya Koitabashi, Gen Shimada, Akihiro Kishida
OBJECTIVE: The primary purpose of this study was to assess risk factors for delirium in patients staying in a surgical ward for more than 5 days. The secondary purpose was to assess outcomes in patients with delirium. BACKGROUND: Delirium is a syndrome characterized by acute fluctuations in mental status. Patients with delirium are at increased risk of adverse inpatient events, higher mortality and morbidity rates, prolonged hospital stays, and increased health care costs...
June 19, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28631455/the-prognostic-importance-of-chronic-end-stage-diseases-in-geriatric-patients-admitted-to-163-italian-icus
#3
Daniele Poole, Stefano Finazzi, Giovanni Nattino, Danilo Radrizzani, Giuseppe Gristina, Paolo Malacarne, Sergio Livigni, Guido Bertolini
BACKGROUND: The number of elderly patients undergoing major surgical interventions and then needing admission to intensive care unit (ICU) grows steadily. We investigated this issue in a cohort of 232,278 patients admitted in 5 years (2011-2015) to 163 Italian general ICUs. METHODS: Surgical patients older than 75 registered in the GiViTI MargheritaPROSAFE project were analysed. The impact on hospital mortality of important chronic conditions (severe COPD, NYHA class IV, dementia, end-stage renal disease, cirrhosis with portal hypertension) was investigated with two prognostic models developed yearly on patients staying in the ICU less or more than 24 hours...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28628893/one-year-mortality-after-hip-fracture-in-older-individuals-the-effects-of-delirium-and-dementia
#4
Rebecca Mitchell, Lara Harvey, Henry Brodaty, Brian Draper, Jacqueline Close
BACKGROUND: Delirium is common in older hip fracture patients, yet its association with mortality after hip fracture remains uncertain. This study aimed to determine whether delirium was associated with all-cause one-year mortality after hip fracture in older patients and whether the effect of delirium was independent of dementia status. METHOD: A retrospective analysis of linked hospitalisation and mortality data for patients aged ≥65 years with a hip fracture during 1 January 2010 to 30 June 2014 in New South Wales, Australia...
June 13, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28628773/temperament-and-behavior-in-toddlers-born-preterm-with-related-clinical-problems
#5
Rafaela Guilherme Monte Cassiano, Claudia Maria Gaspardo, Ricardo Augusto de Deus Faciroli, Francisco Eulógio Martinez, Maria Beatriz Martins Linhares
OBJECTIVE: The aim of this study was to compare temperament and behavior profiles among groups of preterm toddlers differentiated by level of prematurity and the presence of bronchopulmonary dysplasia (BPD) or retinopathy of prematurity (ROP), controlling for neonatal clinical conditions and chronological age. METHOD: The sample comprised 100 preterm toddlers segregated according to level of prematurity (75 very preterm and 25 moderate/late preterm) and presence of BPD (n=36) and ROP (n=63)...
June 16, 2017: Early Human Development
https://www.readbyqxmd.com/read/28628748/does-young-age-really-put-the-heart-at-risk
#6
Michael P Belanger, Luke Yang Tan, Carin Wittnich
Despite significant advances in the management and treatment of heart disease in children, there continue to be patients who have worse outcomes than might be expected. A number of risk factors that could be responsible have been identified. Evidence based findings will be reviewed including whether young age and/or reduced body weight exacerbate these responses. For example, newborn children undergoing congenital cardiac surgery are known to have worse outcomes than older children. Evidence exists that newborn hearts do not tolerate ischemia as well as adults; developing irreversible injury sooner and exhibiting at risk metabolic profiles...
June 19, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28628594/telehealth-wearable-sensors-and-the-internet-will-they-improve-stroke-outcomes-through-increased-intensity-of-therapy-motivation-and-adherence-to-rehabilitation-programs
#7
Jane H Burridge, Alan Chong W Lee, Ruth Turk, Maria Stokes, Jill Whitall, Ravi Vaidyanathan, Phil Clatworthy, Ann-Marie Hughes, Claire Meagher, Enrico Franco, Lucy Yardley
BACKGROUND AND PURPOSE: Stroke, predominantly a condition of older age, is a major cause of acquired disability in the global population and puts an increasing burden on health care resources. Clear evidence for the importance of intensity of therapy in optimizing functional outcomes is found in animal models, supported by neuroimaging and behavioral research, and strengthened by recent meta-analyses from multiple clinical trials. However, providing intensive therapy using conventional treatment paradigms is expensive and sometimes not feasible because of social and environmental factors...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28625254/-a-multicenter-confirmatory-study-about-precision-and-practicability-of-sepsis-3
#8
Xiaotong Hu, Mingjie Wu, Qiang Fang
OBJECTIVE: To clinically validate the precision of diagnostic Sepsis-3 criteria, and to guide and generalize its clinical application. METHODS: A multicenter retrospective observational study was conducted. The patients admitted to intensive care unit (ICU) of 6 tertiary hospitals in Zhejiang Province from January to June 2015 were enrolled, and the patients satisfying the diagnostic criteria of Sepsis-2 and Sepsis-3 were screened. Population characteristics between the patients satisfying two editions were compared, and the diagnosis accuracy rate in different degree hospitals were investigated...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28618329/therapy-of-older-persons-with-acute-myeloid-leukaemia
#9
REVIEW
Utz Krug, Robert Peter Gale, Wolfgang E Berdel, Carsten Müller-Tidow, Matthias Stelljes, Klaus Metzeler, M Cristina Sauerland, Wolfgang Hiddemann, Thomas Büchner
Most persons age≥60 y with acute myeloid leukaemia (AML) die from their disease. When interpreting clinical trials data from these persons one must be aware of substantial selection biases. Randomized trials of post-remission treatments can be performed upfront or after achieving defined landmarks. Both strategies have important limitations. Selection of the appropriate treatment is critical. Age, performance score, co-morbidities and frailty provide useful data to treatment selection. If an intensive remission induction therapy is appropriate, therapy with cytarabine and an anthracycline is the most common regimen...
June 1, 2017: Leukemia Research
https://www.readbyqxmd.com/read/28616203/reduced-rate-of-intensive-care-unit-acquired-gram-negative-bacilli-after-removal-of-sinks-and-introduction-of-water-free-patient-care
#10
Joost Hopman, Alma Tostmann, Heiman Wertheim, Maria Bos, Eva Kolwijck, Reinier Akkermans, Patrick Sturm, Andreas Voss, Peter Pickkers, Hans Vd Hoeven
BACKGROUND: Sinks in patient rooms are associated with hospital-acquired infections. The aim of this study was to evaluate the effect of removal of sinks from the Intensive Care Unit (ICU) patient rooms and the introduction of 'water-free' patient care on gram-negative bacilli colonization rates. METHODS: We conducted a 2-year pre/post quasi-experimental study that compared monthly gram-negative bacilli colonization rates pre- and post-intervention using segmented regression analysis of interrupted time series data...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28615953/characteristics-of-pesticide-poisoning-in-rural-and-urban-settings-in-uganda
#11
REVIEW
Bastian Pedersen, Charles Ssemugabo, Victoria Nabankema, Erik Jørs
Pesticide poisoning is a significant burden on health care systems in many low-income countries. This study evaluates cases of registered pesticide poisonings treated in selected rural (N = 101) and urban (N = 212) health facilities in Uganda from January 2010 to August 2016. In the urban setting, pesticides were the most prevalent single poison responsible for intoxications (N = 212 [28.8%]). Self-harm constituted a significantly higher proportion of the total number of poisonings in urban (63.3%) compared with rural areas (25...
2017: Environmental Health Insights
https://www.readbyqxmd.com/read/28615004/understanding-heart-failure-explaining-telehealth-a-hermeneutic-systematic-review
#12
Trisha Greenhalgh, Christine A'Court, Sara Shaw
BACKGROUND: Enthusiasts for telehealth extol its potential for supporting heart failure management. But randomised trials have been slow to recruit and produced conflicting findings; real-world roll-out has been slow. We sought to inform policy by making sense of a complex literature on heart failure and its remote management. METHODS: Through database searching and citation tracking, we identified 7 systematic reviews of systematic reviews, 32 systematic reviews (including 17 meta-analyses and 8 qualitative reviews); six mega-trials and over 60 additional relevant empirical studies and commentaries...
June 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28612615/-new-drugs-in-the-treatment-of-acute-myeloid-leukemia-in-the-elderly
#13
Z Šustková, M Čulen, L Semerád, I Ježíšková, D Dvořáková, Z Ráčil, J Mayer
BACKGROUND: At the time of diagnosis, most patients with acute myeloid leukemia are older than 65 years of age. Treatment of this group of patients is challenging because they become less tolerant to aggressive chemotherapy with increasing age. Less than one-third of elderly patients are considered eligible for intensive treatment; nevertheless, the survival analysis for this population remains poor. Due to numerous comorbidities and an overall deteriorating condition, most elderly patients with acute myeloid leukemia receive only palliative or best supportive care, which are associated with a high mortality rate...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28612171/carer-characteristics-and-health-wellbeing-and-employment-outcomes-of-older-australian-baby-boomers
#14
Kate O'Loughlin, Vanessa Loh, Hal Kendig
Supporting caregivers and enabling continued workforce participation are central strategies in Australia's response to an ageing population, however these strategies have potential disadvantages for carers, particularly women, including reduced workforce participation and retirement income, and poorer health status. This paper explores the nexus between paid work and caregiving for Australia's baby boomer cohort as this group faces unprecedented pressures to manage paid work alongside caring longer and more intensively for family members, including grandchildren...
June 13, 2017: Journal of Cross-cultural Gerontology
https://www.readbyqxmd.com/read/28610934/boarding-icu-patients-are-our-rounding-practices-subpar
#15
Andrew M Nunn, Justin S Hatchimonji, Daniel N Holena, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Niels D Martin, Patrick M Reilly, C William Schwab, Jose L Pascual
INTRODUCTION: Surgical Intensive Care Unit (SICU) patients "boarding" in ICUs other than the designated home unit have been shown to suffer increased rates of complications. We hypothesized that ICU rounding practices are different when SICU patients are housed in home vs. boarding ICUs. MATERIAL AND METHODS: SICU rounds were observed at an academic quaternary medical center. Individual patient rounding time and order seen on rounds along with patient data and demographics were recorded...
June 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28606020/neonatal-hearing-screening-in-remote-areas-of-china-a-comparison-between-rural-and-urban-populations
#16
Wu Wenjin, Tang Xiangrong, Li Yun, Lü Jingrong, Chen Jianyong, Wang Xueling, Huang Zhiwu, Wu Hao
Objectives Universal neonatal hearing screening (UNHS) started late in some underdeveloped areas in China, with relatively scarce screening resources and a wide regional distribution. This study aimed to compare the screening performance between rural and urban populations, and to examine the characteristics and problems of UNHS in underdeveloped regions in China. Methods A two-step hearing screening program was used in neonates born in Liuzhou Maternal and Child Health Hospital and in patients who were born in other hospitals, but admitted to the neonatal intensive care unit...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28602411/survival-outcomes-of-elderly-patients-with-glioblastoma-multiforme-in-their-75th-year-or-older-treated-with-adjuvant-therapy
#17
Georgia Harris, Dasantha Jayamanne, Helen Wheeler, Cecelia Gzell, Marina Kastelan, Geoff Schembri, David Brazier, Raymond Cook, Jonathan Parkinson, Mustafa Khasraw, Sandra Louw, Michael Back
PURPOSE: To assess the outcomes of the most elderly cohort of patients with a diagnosis of glioblastoma multiforme (GBM) after intensity modulated radiation therapy (IMRT). METHODS AND MATERIALS: The data of patients with GBM who had underwent IMRT from May 2007 to December 2015 were entered into a prospective database. Analysis was performed on the data from patients diagnosed during or after 75 years of age. The primary endpoint was the median survival. Univariate and multivariate analyses were performed with respect to survival for patients aged 74 to 80 versus >80 years, Eastern Cooperative Oncology Group performance status of 0 to 1 versus 2 to 3, extent of resection, a high radiation dose (60 Gy) versus any hypofractionated schedule, MGMT methylation status, planning target volume, and the use of temozolomide (TMZ) versus no TMZ...
July 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28601322/the-center-volume-outcome-effect-in-pancreas-transplantation-a-national-analysis
#18
Young Kim, Vikrom K Dhar, Koffi Wima, Andrew D Jung, Brent T Xia, Richard S Hoehn, Tayyab S Diwan, Shimul A Shah
BACKGROUND: Although increased hospital volume has been correlated with improved outcomes in certain surgical procedures, the effect of center volume on pancreas transplantation (PT) is less understood. Our study aims to establish whether a volume-outcome effect exists for PT. METHODS: Through an established linkage between the University HealthSystem Consortium and the Scientific Registry of Transplant Recipients (SRTR) databases, we performed a retrospective cohort analysis of adult PT recipients between 2009 and 2012...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601131/detection-and-management-of-preexisting-cognitive-impairment-in-the-critical-care-unit
#19
REVIEW
Mark A Oldham, Walter Piddoubny, Ryan Peterson, Hochang B Lee
Older adults account for half of intensive care unit (ICU) admissions and ICU days, and approximately 2 in 5 older adults in the ICU have preexisting cognitive impairment (PCI). PCI identification is important for risk stratification and may influence ICU utilization and decision-making surrogacy. PCI is overlooked in more than half of patients without screening; however, screening instruments can identify PCI in less than 5 minutes. Management of PCI in the ICU involves addressing associated neuropsychiatric symptoms...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28599256/cirrhosis-patients-stroke-risks-and-adverse-outcomes-two-nationwide-studies
#20
Hsin-Yun Wu, Chao-Shun Lin, Chun-Chieh Yeh, Chaur-Jong Hu, Chun-Chuan Shih, Yih-Giun Cherng, Ta-Liang Chen, Chien-Chang Liao
BACKGROUND & AIMS: The association between liver cirrhosis (LC) and stroke is not completely understood. Our purpose was to evaluate stroke risk and post-stroke outcomes in patients with LC. METHODS: We identified 6944 adults aged 20 years and older, newly diagnosed with LC, using the Taiwan's National Health Insurance Research Database from 2000 to 2005. The comparison cohort consisted of 27,776 adults without LC, randomly selected by frequency matching in age and sex...
May 25, 2017: Atherosclerosis
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