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https://www.readbyqxmd.com/read/28634098/sepsis-within-30-days-of-geriatric-hip-fracture-surgery
#1
Daniel D Bohl, Stephanie E Iantorno, Bryan M Saltzman, Matthew W Tetreault, Brian Darrith, Craig J Della Valle
BACKGROUND: Sepsis after hip fracture typically develops from one of the 3 potential infectious sources: urinary tract infection (UTI), pneumonia, and surgical site infection (SSI). The purpose of this investigation is to determine (1) the proportion of cases of sepsis that arises from each of these potential infectious sources; (2) baseline risk factors for developing each of the potential infectious sources; and (3) baseline risk factors for developing sepsis. METHODS: The National Surgical Quality Improvement Program database was searched for geriatric patients (aged >65 years) who underwent surgery for hip fracture during 2005-2013...
May 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28632549/biomechanical-investigation-of-a-novel-revision-device-in-an-osteoporotic-model-pullout-strength-of-pedicle-screw-anchor-versus-larger-screw-diameter
#2
Jacinto Manon, Mir M Hussain, Jonathan Harris, Mark Moldavsky, Frank La Marca, Brandon S Bucklen
STUDY DESIGN: In vitro cadaveric biomechanical study. OBJECTIVE: To assess revision pullout strength of novel anchored screws (AS) versus conventional larger diameter traditional pedicle screws (TPS) in an osteoporotic model. SUMMARY OF BACKGROUND DATA: Pedicle screws are the most ubiquitous method of treating spinal pathologies requiring lumbar fusion. Although these screws are effective in providing 3-column stabilization of the spine, revision surgeries are occasionally necessary, particularly for geriatric and osteoporotic populations...
July 2017: Clinical Spine 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/28625940/prodromal-stage-of-disease-dementia-with-lewy-bodies-how-to-diagnose-in-practice
#4
Frédéric Blanc, Marc Verny
Disease with Lewy bodies or dementia with Lewy bodies (DLB), particularly at the prodromal stage, is a complex disease to diagnose because of different clinical beginnings and variable paths in terms of clinical expression. Thus DLB can be entcountered in different input modes: mild cognitive impairment, depression, acute behavioral disorders, confusion and delirium, or sleep disorders. In the aim to better diagnose the disease, should be sought obviously to search for the key symptoms: fluctuations, hallucinations, extra-pyramidal syndrome, and REM sleep behavior disorder...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28618686/re-comprehensive-geriatric-assessment-is-a-useful-predictive-tool-for-postoperative-delirium-after-gastrointestinal-surgery-in-old-old-adults
#5
Tomas L Griebling
No abstract text is available yet for this article.
July 2017: Journal of Urology
https://www.readbyqxmd.com/read/28615514/prognostic-value-of-the-c-reactive-protein-prognostic-nutritional-index-ratio-after-hip-fracture-surgery-in-the-elderly-population
#6
Hanru Ren, Lianghao Wu, Wankun Hu, Xiuzhang Ye, Baoqing Yu
BACKGROUND: More and more older patients receive the surgery after hip fracture. However, the mortality rate is high. Prognostic nutritional index (PNI) is associated with prognosis in hip fracture patients. In the current study, we proposed a novel prognostic score, named c-reactive protein/PNI ratio (CRP/PNI ratio), for predicting the prognosis for geriatric orthopedic population. METHODS: This is a prospective study. Eighty cases of hip fracture surgery in the elderly population were studied to reveal the relationship between the CRP/PNI ratio and the clinicopathological characteristics of the elderly patients...
May 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#7
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28602710/controversial-issues-in-the-management-of-older-adults-with-early-breast-cancer
#8
REVIEW
Anna Rachelle Mislang, Kwok-Leung Cheung, Marije E Hamaker, Ian Kunkler, Christos Markopoulos, Roberto Orecchia, Etienne Brain, Laura Biganzoli
It is well recognized that the incidence of breast cancer increases significantly with age. Despite this, older people remain under-represented in many clinical trials and their management relies on extrapolation of data from younger patients. Providing an aggressive intervention can be challenging, particularly in less fit older patients where a conservative approach is commonly perceived to be more appropriate. The optimal management of this population is unknown and treatment decision should be personalized...
June 8, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28585992/complex-lumbar-spine-fusion-for-an-elderly-patient-under-spinal-anesthesia
#9
Noah L Lessing, Charles C Edwards, Charles Lin, Charles H Brown
Spinal anesthesia for spine surgery is an emerging technique. Because of their lack of physiologic reserve, elderly patients are an appealing population for this technique. Unfortunately, the safe limits of spine surgery using spinal anesthesia for the geriatric population are not well defined. The authors describe an elderly patient with severe spine degeneration who elected for a 5-level lumbar spine fusion with spinal anesthesia. Adequate anesthesia was maintained throughout the procedure, which lasted 3 hours and 24 minutes...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28584740/impact-of-preoperative-echocardiography-on-perioperative-management-in-geriatric-hip-trauma-a-retrospective-observational-study
#10
Chhavi Sawhney, Vivek Trikha, Sai Janani, Sukhminder Jit Singh Bajwa, Vijay Sharma, Menaal Khanna
BACKGROUND AND AIM: Hip fractures are associated with a significant risk of morbidity and mortality in the elderly population. Current guidelines propose that these patients should be operated as early as possible. Preoperative cardiac investigations, especially echocardiography, have been considered to delay surgery with few changes in the patient management. The present study has been conducted to evaluate whether preoperative echocardiography improve or worsen the prognosis in such hip trauma surgery...
April 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28581701/mini-nutritional-assessment-short-form-as-a-useful-method-of-predicting-poor-1-year-outcome-in-elderly-patients-undergoing-orthopedic-surgery
#11
Che-Sheng Chu, Chih-Kuang Liang, Ming-Yueh Chou, Ti Lu, Yu-Te Lin, Chin-Liang Chu
AIM: The present study aimed to determine whether the Mini-Nutritional Assessment Short-Form (MNA-SF) can predict the 1-year outcome of orthopedic fracture surgery in elderly patients. METHODS: This 1-year prospective study assessed nutrition using the MNA-SF at baseline, and postoperatively at 6 and 12 months. Repeated measures analysis of covariance was used to examine functional change over time for two MNA-SF categories. Multivariable logistic regression analysis with forward stepwise modeling was carried out to identify risk factors of functional decline, emergency department visit, hospital readmission and mortality at follow up...
June 5, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28573781/outpatient-thyroidectomy-is-safe-in-the-elderly-and-super-elderly
#12
Jamie Segel Grubey, Yazdan Raji, William S Duke, David J Terris
OBJECTIVES: 1) Determine the safety of outpatient thyroidectomy in the geriatric patient population. 2) Analyze the risk of postoperative complications from thyroid surgery in patients aged over 65 years (elderly) and aged over 80 years (super-elderly) undergoing ambulatory thyroidectomy compared to patients aged 21 through 40 years. STUDY DESIGN: A retrospective analysis of consecutive patients undergoing thyroidectomy between January 2008 and July 2015 at a tertiary academic institution...
June 2, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28572583/perioperative-and-anesthesia-related-cardiac-arrests-in-geriatric-patients-a-systematic-review-using-meta-regression-analysis
#13
Karen S Braghiroli, José R C Braz, Bruna Rocha, Regina El Dib, José E Corrente, Mariana G Braz, Leandro G Braz
The worldwide population is aging, and the number of surgeries performed in geriatric patients is increasing. This systematic review evaluated anesthetic procedures to assess global data on perioperative and anesthesia-related cardiac arrest (CA) rates in geriatric surgical patients. Available data on perioperative and anesthesia-related CA rates over time and by the country's Human Development Index (HDI) were evaluated by meta-regression, and a pooled analysis of proportions was used to compare perioperative and anesthesia-related CA rates by HDI and time period...
June 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28561714/personalizing-adjuvant-therapy-for-stage-ii-iii-colorectal-cancer
#14
Nadine Jackson McCleary, Al B Benson, Rodrigo Dienstmann
This review focuses on three areas of interest with respect to the treatment of stage II and III colon and rectal cancer, including (1) tailoring adjuvant therapy for the geriatric population, (2) the controversy as to the optimal adjuvant therapy strategy for patients with locoregional rectal cancer and for patients with colorectal resectable metastatic disease, and (3) discussion of the microenvironment, molecular profiling, and the future of adjuvant therapy. It has become evident that age is the strongest predictive factor for receipt of adjuvant chemotherapy, duration of treatment, and risk of treatment-related toxicity...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28539681/risk-of-falls-in-the-rheumatic-patient-at-geriatric-age
#15
REVIEW
Agnieszka Prusinowska, Arkadiusz Komorowski, Teresa Sadura-Sieklucka, Krystyna Księżopolska-Orłowska
Evaluating the risk of falling of a geriatric rheumatic patient plays an essential role not only in planning and carrying out the physiotherapeutic process. The consequences of falls may be different and, although they do not always result in serious repercussions such as fractures or injuries, it is sufficient that they generate the fear of falling and cause a significant reduction in physical activity. Assessing functional capacity to define the risk of falling is of utmost importance in the case of patients after joint arthroplasty surgeries...
2017: Reumatologia
https://www.readbyqxmd.com/read/28534471/management-of-acetabular-fractures-in-the-geriatric-patient
#16
Marc Hanschen, Sebastian Pesch, Stefan Huber-Wagner, Peter Biberthaler
INTRODUCTION: Open reduction and internal fixation (ORIF) is standard care for most acetabular fractures. With increasing numbers of acetabular fractures in the elderly, the risk of revision surgery and conversion to total hip replacement (THR) is increasing. Alarmingly, about 20-25% of acetabular fractures in the elderly following ORIF needed revision and conversion to delayed THR. METHODS: Recently, prognostic factors have been identified, which correlate with an increased risk of worse outcomes following ORIF of acetabular fractures in the elderly patient...
2017: SICOT-J
https://www.readbyqxmd.com/read/28528805/acute-response-of-non-motor-symptoms-to-subthalamic-deep-brain-stimulation-in-parkinson-s-disease
#17
Margherita Fabbri, Miguel Coelho, Leonor Correia Guedes, Mario M Rosa, Daisy Abreu, Nilza Gonçalves, Angelo Antonini, Joaquim J Ferreira
BACKGROUND: Subthalamic deep brain stimulation (STN-DBS) is an established treatment for the motor complications of Parkinson's disease (PD) and may have beneficial effects on non-motor symptoms (NMS). However, the acute effect of STN stimulation on NMS has only been explored in small PD cohorts with short post-surgical follow-up. OBJECTIVE: To study NMS response to an acute stimulation challenge in an STN-DBS PD population with a medium/long-term post-surgical follow-up...
May 8, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28500499/-anesthesiological-care-of-trauma-patients-in-orthogeriatric-co-management
#18
Markus F Luger, Thomas J Luger
Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification...
May 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28497218/to-evaluate-the-efficacy-of-an-acellular-flowable-matrix-in-comparison-with-a-wet-dressing-for-the-treatment-of-patients-with-diabetic-foot-ulcers-a-randomized-clinical-trial
#19
F Campitiello, M Mancone, A Della Corte, R Guerniero, S Canonico
The authors aimed to evaluate the efficacy of an advanced wound matrix (Integra Flowable Wound Matrix, Integra LifeScience Corp, Plainsboro, NJ, USA) for treating wounds with irregular geometries versus a wet dressing in patients with diabetic foot ulcers. Sixty patients with diabetic foot ulcers (Grades 3 Wagner) were included in this randomized clinical trial. The study was conducted in the General Surgery Unit and Geriatric of the Second University of Naples, Italy, in the last 12 months. Forty-six cases of diabetic foot ulcers were equally and randomly divided into control and test groups...
May 11, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28497099/acetabular-fractures-in-the-senior-population-epidemiology-mortality-and-treatments
#20
Reza Firoozabadi, William W Cross, James C Krieg, Milton L Chip Routt
BACKGROUND: Management of acetabular fractures in the senior population can be one of the most challenging injuries to manage. Furthermore, treating surgeons have a paucity of information to guide the treatment in this patient population. THE PURPOSE OF THIS STUDY WAS TO DETERMINE: (1) demographic and epidemiologic data, (2) mortality rates for nonoperative compared to operative management at different time points, (3) common fracture configurations, and (4) fracture fixation strategies in senior patients treated with acetabular fractures...
March 2017: Archives of Bone and Joint Surgery
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