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Geriatric surgery

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https://www.readbyqxmd.com/read/27911302/association-between-cognitive-status-before-surgery-and-outcomes-in-elderly-patients-with-hip-fracture-in-a-dedicated-orthogeriatric-care-pathway
#1
Lorene Zerah, Judith Cohen-Bittan, Mathieu Raux, Anthony Meziere, Cendrine Tourette, Christian Neri, Marc Verny, Bruno Riou, Frederic Khiami, Jacques Boddaert
BACKGROUND: Dementia is associated with a worse prognosis of hip fracture, but the impact of a dedicated geriatric care pathway on the prognosis of these patients has not been evaluated. OBJECTIVE: According to the cognitive status before surgery, our main objective was to compare mortality rate at 6 months; secondary outcomes were to compare in-hospital complications, the risk of new institutionalization, and the ability to walk at 6 months. METHODS: Between 2009 and 2015, all patients (>70 years) admitted after hip fracture surgery into a dedicated unit of peri-operative geriatric care were included: patients with dementia (DP), without dementia (NDP), and with cognitive status not determined (CSND)...
November 28, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27905087/robot-assisted-surgery-in-elderly-and-very-elderly-population-our-experience-in-oncologic-and-general-surgery-with-literature-review
#2
Graziano Ceccarelli, Enrico Andolfi, Alessia Biancafarina, Aldo Rocca, Maurizio Amato, Marco Milone, Marta Scricciolo, Barbara Frezza, Egidio Miranda, Marco De Prizio, Andrea Fontani
BACKGROUND: Although there is no agreement on a definition of elderly, commonly an age cutoff of ≥65 or 75 years is used. Nowadays most of malignancies requiring surgical treatment are diagnosed in old population. Comorbidities and frailty represent well-known problems during and after surgery in elderly patients. Minimally invasive surgery offers earlier postoperative mobilization, less blood loss, lower morbidity as well as reduction in hospital stay and as such represents an interesting and validated option for elderly population...
November 30, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27890486/towards-a-multidisciplinary-approach-to-understand-and-manage-obesity-and-related-diseases
#3
REVIEW
Stephan C Bischoff, Yves Boirie, Tommy Cederholm, Michael Chourdakis, Cristina Cuerda, Nathalie M Delzenne, Nicolaas E Deutz, Denis Fouque, Laurence Genton, Carmen Gil, Berthold Koletzko, Miguel Leon-Sanz, Raanan Shamir, Joelle Singer, Pierre Singer, Nanette Stroebele-Benschop, Anders Thorell, Arved Weimann, Rocco Barazzoni
Overnutrition and sedentary lifestyle result in overweight or obesity defined as abnormal or excessive fat accumulation that may impair health. According to the WHO, the worldwide prevalence of obesity nearly doubled between 1980 and 2008. In 2008, over 50% of both men and women in the WHO European Region were overweight, and approximately 23% of women and 20% of men were obese. Comprehensive diagnostic and therapeutic approaches should include nutritional treatment to favor the best metabolic and nutritional outcome, as well as to induce potential disease-specific benefits from selected nutritional regimens...
November 16, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27884346/survival-outcomes-of-geriatric-patients-with-clinically-resectable-gastric-cancer-to-operate-or-not
#4
Keng-Hao Liu, Chia-Yen Hung, Chang-Hsien Lu, Jun-Te Hsu, Ta-Sen Yeh, Yung-Chang Lin, Yu-Shin Hung, Wen-Chi Chou
BACKGROUND: Approximately, 50% of all gastric cancer patients are aged >70 y. Although curative surgery is the treatment of choice, many geriatric patients die of surgical complications. Therefore, we aimed to evaluate the impact of radical surgery on the survival outcome of geriatric patients with resectable gastric cancers. METHODS: About 488 patients diagnosed with resectable gastric cancers, aged ≥70 y, between January 2007 and December 2012 at Chang Gung Memorial Hospital (CGMH) Linkou branch were included in this study...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27876338/should-you-screen-nursing-home-residents-for-cancer
#5
REVIEW
Miriam B Rodin
When considering screening for early cancer detection physicians should anticipate how they plan to follow up a screen detected cancer. Geriatric oncology research has developed validated functional assessments to estimate the balance of risk and benefit for treating cancers in the elderly. Robust elderly can benefit from treatment and therefore might benefit from screening. However the majority of elderly in long term residential care (LTC, or "the nursing home") would not benefit from cancer screening. The 1...
November 18, 2016: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/27871564/effect-of-remifentanil-and-fentanyl-on-postoperative-cognitive-function-and-cytokines-level-in-elderly-patients-undergoing-major-abdominal-surgery
#6
Germano De Cosmo, Flaminio Sessa, Federico Fiorini, Elisabetta Congedo
PURPOSE: Postoperative cognitive dysfunction is a frequent complication occurring in geriatric patients. Type of anesthesia and the patient's inflammatory response may contribute to postoperative cognitive dysfunction (POCD). In this prospective randomized double-blinded controlled study we hypothesized that intraoperative remifentanil may reduce immediate and early POCD compared to fentanyl and evaluated if there is a correlation between cognitive status and postoperative inflammatory cytokines level...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871540/comparison-of-the-effects-of-truview-pcd%C3%A2-video-laryngoscopy-and-macintosh-blade-direct-laryngoscopy-in-geriatric-patients
#7
Muhammed M Kurnaz, Aykut Sarıtaş
STUDY OBJECTIVE: To compare the effects of Truview PCD™ video laryngoscopy (TVL) and Macintosh blade direct laryngoscopy (MDL) on hemodynamic responses observed during laryngoscopy and orotracheal intubation conditions in geriatric patients. DESIGN: Randomized prospective study. SETTING: Operating room. PATIENTS: One hundred patients in the risk group American Society of Anesthesiologists I to III aged 65 years and older underwent elective surgery under general anesthesia...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27869890/-anmco-sic-sici-gise-sicch-consensus-document-risk-stratification-in-elderly-patients-undergoing-cardiac-surgery-and-transcatheter-aortic-valve-implantation
#8
Giovanni Pulignano, Michele Massimo Gulizia, Samuele Baldasseroni, Francesco Bedogni, Giovanni Cioffi, Ciro Indolfi, Francesco Romeo, Adriano Murrone, Francesco Musumeci, Alessandro Parolari, Leonardo Patanè, Paolo Giuseppe Pino, Annalisa Mongiardo, Carmen Spaccarotella, Roberto Di Bartolomeo, Giuseppe Musumeci
Aortic stenosis is one the most frequent valvular diseases in developed countries, and its impact on public healthcare resources and assistance is increasing. A substantial proportion of elderly patients with severe aortic stenosis is frequently not eligible for surgery because of advanced age, frailty and multiple comorbidities. Transcatheter aortic valve implantation (TAVI) enables the treatment of very elderly patients at high or prohibitive surgical risk considered ineligible for surgery and with an acceptable life expectancy...
September 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27847786/use-of-a-comprehensive-geriatric-assessment-to-predict-short-term-postoperative-outcome-in-elderly-patients-with-colorectal-cancer
#9
Yoon Hyun Lee, Heung-Kwon Oh, Duck-Woo Kim, Myong Hoon Ihn, Jee Hyun Kim, Il Tae Son, Sung Il Kang, Gwang Il Kim, Soyeon Ahn, Sung-Bum Kang
PURPOSE: This study was conducted to identify the effectiveness of a preoperative comprehensive geriatric assessment (CGA) for predicting postoperative morbidity in elderly patients who underwent surgery for colorectal cancer. METHODS: Elderly patients (≥70 years old) who underwent surgery for colorectal cancer at a tertiary hospital in Korea were identified, and their cases were analyzed using data from a prospectively collected database to establish an association between major postsurgical complications and 'high-risk' patient as defined by the CGA...
October 2016: Annals of Coloproctology
https://www.readbyqxmd.com/read/27842907/are-enhanced-recovery-programs-in-colorectal-surgery-feasible-and-useful-in-the-elderly-a-systematic-review-of-the-literature
#10
M-V Launay-Savary, M Mathonnet, A Theissen, S Ostermann, A Raynaud-Simon, K Slim
INTRODUCTION: Enhanced recovery programs (ERP) are no longer questionable in the management of patients undergoing surgery. However, there is some doubt as to their feasibility and efficacy in the elderly. Our goal was to systematically review the evidence-based literature concerning the feasibility of ERP in elderly patients undergoing colorectal surgery. MATERIAL AND METHODS: The PubMed and Cochrane Database for systematic reviews as well as the "grey" literature between 2000 and 2015 were sought...
November 11, 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27837461/ventral-mesh-rectopexy-versus-conventional-suture-technique-a-single-institutional-experience
#11
Gaetano Luglio, Rachele Tarquini, Mariano Cesare Giglio, Viviana Sollazzo, Roberto Peltrini, Michele Sacco, Giovanni Spiezio, Bruno Amato, Giovanni Domenico De Palma, Luigi Bucci
AIMS: Anterior mesh rectopexy is a novel surgical technique for the treatment of complete rectal prolapse, a common disorder in female elderly patients. Aim of the study was to evaluate functional outcomes after ventral mesh rectopexy and conventional suture rectopexy. PATIENTS AND METHODS: Forty patients have been enrolled in this prospective study. Patients were divided into two groups: 20 patients (group A) had a conventional suture rectopexy with a standard technique and 20 patients (group B) underwent an anterior mesh rectopexy...
November 11, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27833782/telescoping-technique-to-engage-left-main-coronary-artery-in-a-case-of-giant-aortic-aneurysm-in-a-geriatric-patient
#12
Priyank Shah, Rahul Vasudev, Mahesh Bikkina, Hartaj Virk
We present a case of a geriatric male with giant ascending aortic aneurysm (AAA) who underwent successful coronary angiography using telescoping technique for evaluation his coronary arteries before surgery for AAA. Since the ascending aorta and root were extremely dilated, we knew it would not have been possible to engage the coronaries using regular catheters and standard technique. Hence, telescopic technique was used. Amplatz left 3 (AL3) 7F (French) guide catheter (90 cm) was initially used, and nonselective injection of contrast was done to see the coronary ostium...
2016: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/27812813/-coagulation-management-in-geriatric-surgery
#13
H Eichler
BACKGROUND: Elderly patients often suffer from cardiovascular diseases and are treated with anticoagulation medications, which must be taken into consideration when planning elective surgery. OBJECTIVE: The etiology, diagnostic work-up and clinical management of selected inherited and acquired hemophilic and thrombophilic coagulation disorders are described. METHODS: Data from clinical studies, current guidelines and expert opinions are discussed...
November 3, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27800463/hemiprosthesis-for-femoral-neck-fractures-in-the-elderly-a-retrospective-study-of-319-patients
#14
Axel Prokop, Marc Chmielnicki
BACKGROUND: In geriatric patients with Pauwels types II and III femoral neck fractures, hemiprosthesis is the therapy of choice. OBJECTIVES: This study was conducted to analyze the results after cemented hemiprosthesis placement, the first year after surgery. PATIENTS AND METHODS: This retrospective study was conducted on 319 patients over 70 years with displaced femoral neck fractures treated surgically at our hospital from 2007 to 2012. All medical information was available including retrospective posthospital discharge records as well as inpatient course and one-year mortality...
September 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/27787380/is-surgery-indicated-for-elderly-patients-with-early-stage-nonsmall-cell-lung-cancer-in-the-era-of-stereotactic-body-radiotherapy
#15
Nam P Nguyen, Juan Godinez, Wei Shen, Vincent Vinh-Hung, Helena Gorobets, Juliette Thariat, Fred Ampil, Jacqueline Vock, Ulf Karlsson, Alexander Chi
BACKGROUND: The aim of this article is to assess the influence of comorbidities among elderly patients (at least 70 year old) undergoing surgery for early stage nonsmall cell lung cancer (NSCLC) and to explore the tolerability and efficacy of surgery in relation to stereotactic body radiotherapy (SBRT) in this patient population. METHODS: A review of the literature on the prevalence of comorbidities among elderly patients with early stage NSCLC, and the impact of comorbidity factors on survival following surgery was conducted...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27770800/does-cognitive-physical-screening-in-an-outpatient-setting-predict-institutionalization-after-hip-fracture
#16
Markus T Hongisto, Maria Nuotio, Tiina Luukkaala, Olli Väistö, Harri K Pihlajamäki
BACKGROUND: Institutionalization after hip fracture is a socio-economical burden. We examined the predictive value of Instrumental Activities of Daily Living (IADL) and Mini Mental State Examination (MMSE) for institutionalization after hip fracture to identify patients at risk for institutionalization. METHODS: Fragility hip fracture patients ≥65 years of age (n = 584) were comprehensively examined at a geriatric outpatient clinic 4 to 6 months after surgery and followed 1 year postoperatively...
October 22, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27760535/the-haiti-medical-education-project-development-and-analysis-of-a-competency-based-continuing-medical-education-course-in-haiti-through-distance-learning
#17
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27743591/preoperative-assessment-of-surgical-risk-creation-of-a-scoring-tool-to-estimate-1-year-mortality-after-emergency-abdominal-surgery-in-the-elderly-patient
#18
Olubode A Olufajo, Gally Reznor, Stuart R Lipsitz, Zara R Cooper, Adil H Haider, Ali Salim, Erika L Rangel
BACKGROUND: The risk of mortality after emergency general surgery (EGS) in elderly patients is prolonged beyond initial hospitalization. Our objective was to develop a preoperative scoring tool to quantify risk of 1-year mortality. METHODS: Three hundred ninety EGS patients aged 70 years or more were analyzed. Risk factors for 1-year mortality were identified using stepwise-forward logistic multivariate regression and weights assigned using natural logarithm of odds ratios...
September 3, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27726223/performance-of-the-multidimensional-geriatric-assessment-and-multidimensional-prognostic-index-in-predicting-negative-outcomes-in-older-adults-with-cancer
#19
V Giantin, C Falci, E De Luca, E Valentini, M Iasevoli, P Siviero, S Maggi, B Martella, G Crepaldi, S Monfardini, E Manzato
: The Multidimensional Geriatric Assessment (MGA) is currently used for assessing geriatric oncological patients, but a new prognostic index - the Multidimensional Prognostic Index (MPI) - has a demonstrated prognostic value in cancer patients too. The present work was designed to compare the MPI and MGA as predictors of 12-month mortality. 160 patients ≥70 years old with locally-advanced or metastatic solid cancers consecutively joining our Geriatric Oncology Program were administered a Comprehensive Geriatric Assessment to calculate their MGA and MPI scores...
October 10, 2016: European Journal of Cancer Care
https://www.readbyqxmd.com/read/27699555/adjuvant-radiation-use-in-older-women-with-early-stage-breast-cancer-at-johns-hopkins
#20
YaoYao G Pollock, Amanda L Blackford, Stacie C Jeter, Jean Wright, Ashley Cimino-Mathews, Melissa Camp, Susan Harvey, Fariba Asrari, Nancy L Schoenborn, Vered Stearns
PURPOSE: In 2004, The National Comprehensive Cancer Network (NCCN) Guidelines incorporated omission of radiation therapy after breast-conservation surgery in women ≥70 years old with stage I, estrogen receptor-positive breast cancer who plan to receive endocrine therapy. One study demonstrated wide variation in implementing this change across 13 NCCN institutions. We evaluated the practice pattern at our institution. METHODS: We identified women ≥70 years old treated at our institution from 2009 to 2014...
November 2016: Breast Cancer Research and Treatment
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