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Geriatric surgery

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https://www.readbyqxmd.com/read/28090354/what-weight-loss-treatment-options-do-geriatric-patients-with-overweight-and-obesity-want-to-consider
#1
M MacMillan, K Cummins, K Fujioka
INTRODUCTION: Since the 1990s, a number of weight loss medications have been removed from the USA and or European market because of adverse events associated with these medications. These medications include fenfluramine (heart valve thickening), sibutramine (cardiovascular risk) and rimonabant (depression). This history may affect a patient's desire to consider weight loss medications as an option for weight management. OBJECTIVE: This descriptive study was designed to observe what treatment options the geriatric patient (age 65 or higher) seeking weight loss would like to consider, as well as the reasons they felt they struggled with overweight or obesity...
December 2016: Obesity Science & Practice
https://www.readbyqxmd.com/read/28088377/intracapsular-hip-fractures-in-the-elderly-do-we-know-what-is-important
#2
Diana Crego-Vita, Coral Sanchez-Perez, Jose Adolfo Orellana Gomez-Rico, Celia Clemente de Arriba
BACKGROUND: Hip fractures in the elderly are a common reason for admission to the department of orthopaedic surgery, this condition asks an important part of health resources and is associated with high levels of co-morbidity and mortality. Many improvements have been introduced in the treatment of these patients, preoperative regional analgesia, intensive physical therapy, interdisciplinary care program; but still remain unresolved gaps. The aim of this study is to document the natural history of early versus delayed surgical intervention in elderly patients with hip fractures and to establish the prognostic factors of mortality and walking ability after discharge...
January 9, 2017: Injury
https://www.readbyqxmd.com/read/28062326/the-impact-of-comorbidity-on-surgical-outcomes-in-older-adults-with-cancer
#3
REVIEW
Virginia Sun, Peggy S Burhenn, Lily Lai, Arti Hurria
OBJECTIVES: To provide an overview of the impact of comorbidity on surgical outcomes and postoperative geriatric events in older adults with cancer, and review key components of quality perioperative nursing care of older adults with cancer. DATA SOURCES: Journal articles, research reports, state of the science papers, position papers, and clinical guidelines from professional organizations. CONCLUSION: The high prevalence of multiple comorbidities and the associated burden of geriatric events in older adults after cancer surgery have a substantial impact on surgical outcomes, quality of life, and health care costs...
January 3, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28061830/age-nutrition-chirugie-anc-study-impact-of-a-geriatric-intervention-on-the-screening-and-management-of-undernutrition-in-elderly-patients-operated-on-for-colon-cancer-a-stepped-wedge-controlled-trial
#4
Marine Dupuis, Elisabetta Kuczewski, Laurent Villeneuve, Sylvie Bin-Dorel, Max Haine, Claire Falandry, Thomas Gilbert, Guillaume Passot, Olivier Glehen, Marc Bonnefoy
BACKGROUND: Undernutrition prior to major abdominal surgery is frequent and increases morbidity and mortality, especially in older patients. The management of undernutrition reduces postoperative complications. Nutritional management should be a priority in patient care during the preoperative period. However undernutrition is rarely detected and the guidelines are infrequently followed. Preoperative undernutrition screening should allow a better implementation of the guidelines. METHODS/DESIGN: The ANC ("Age Nutrition Chirurgie") study is an interventional, comparative, prospective, multicenter, randomized protocol based on the stepped wedge trial design...
January 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28056465/the-impact-of-age-on-complications-survival-and-cause-of-death-following-colon-cancer-surgery
#5
Christopher T Aquina, Supriya G Mohile, Mohamedtaki A Tejani, Adan Z Becerra, Zhaomin Xu, Bradley J Hensley, Reza Arsalani-Zadeh, Francis P Boscoe, Maria J Schymura, Katia Noyes, John Rt Monson, Fergal J Fleming
BACKGROUND: Given scarce data regarding the relationship among age, complications, and survival beyond the 30-day postoperative period for oncology patients in the United States, this study identified age-related differences in complications and the rate and cause of 1-year mortality following colon cancer surgery. METHODS: The NY State Cancer Registry and Statewide Planning and Research Cooperative System identified stage I-III colon cancer resections (2004-2011)...
January 5, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28033277/a-propensity-matched-analysis-of-surgery-and-stereotactic-body-radiotherapy-for-early-stage-non-small-cell-lung-cancer-in-the-elderly
#6
Peng Wang, Dong Zhang, Xue-Guang Guo, Xiao-Mei Li, Le-Hui Du, Bao-Jun Sun, Xiang-Qun Fang, Ying-Hua Guo, Jun Guo, Li An, Ge-Ping Qu, Chang-Ting Liu
Elderly patients with early stage non-small cell lung cancer (NSCLC) who undergo surgical resection are at a high risk of treatment-related complications. Stereotactic body radiation therapy (SBRT) is considered an alternative treatment option with a favorable safety profile. Given that prospective comparative data on SBRT and surgical treatments are limited, we compared the 2 treatments for early stage NSCLC in the elderly.We retrospectively collected information from the database at our geriatric institution on patients with clinical stage IA/B NSCLC who were treated with surgery or SBRT...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28032558/early-learners-as-health-coaches-for-older-adults-preparing-for-surgery
#7
Jennifer A Kaplan, Zabecca Brinson, Rebecca Hofer, Patricia O'Sullivan, Anna Chang, Helen Horvath, George J Chang, Emily Finlayson
BACKGROUND: Few opportunities exist for early learners to engage in authentic roles on health care teams. In a geriatric optimization clinic for frail high-risk surgical patients, first-year medical and nurse practitioner students were integrated into an interprofessional team as health coaches. MATERIALS AND METHODS: Frail surgical patients with planned operations were referred to a new preoperative optimization clinic to see a geriatrician, occupational, and physical therapists and a nutritionist...
October 20, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28000268/implants-for-elderly-patients
#8
REVIEW
Martin Schimmel, Frauke Müller, Valérie Suter, Daniel Buser
In the developed world, the large birth cohorts of the so-called baby boomer generation have arrived in medical and dental practices. Often, elderly patients are 'young-old' baby boomers in whom partial edentulism is the predominant indication for implant therapy. However, the generation 85+ years of age represents a new challenge for the dental profession, as their lives are frequently dominated by dependency, multimorbidity and frailty. In geriatric implant dentistry, treatment planning is highly individualized, as interindividual differences become more pronounced with age...
February 2017: Periodontology 2000
https://www.readbyqxmd.com/read/27999879/-perioperative-patient-management-in-orthogeriatrics
#9
P Moldzio, J Peters
The management of major orthopedic surgery in the elderly prototypically reflects the perioperative risks of geriatric, often very frail patients reflecting an aging population. To improve outcome, the risks of anesthesia and surgery as well as of patient comorbidities must be thoroughly assessed and balanced using a multidisciplinary approach. Particular risks include cardiopulmonary morbidity, anemia, risk of hemorrhage and the management by anticoagulation, cerebral impairments as well as frailty and limited physiological reserves in general...
December 20, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27994985/mortality-in-tongue-cancer-patients-treated-by-curative-surgery-a-retrospective-cohort-study-from-cgrd
#10
Ming-Shao Tsai, Chia-Hsuan Lai, Chuan-Pin Lee, Yao-Hsu Yang, Pau-Chung Chen, Chung-Jan Kang, Geng-He Chang, Yao-Te Tsai, Chang-Hsien Lu, Chih-Yen Chien, Chi-Kuang Young, Ku-Hao Fang, Chin-Jui Liu, Re-Ming A Yeh, Wen-Cheng Chen
BACKGROUND: Our study aimed to compare the outcomes of surgical treatment of tongue cancer patients in three different age groups. METHODS: From 2004 to 2013, we retrospectively analyzed the clinical data of 1,712 patients who were treated in the four institutions constituting the Chang Gung Memorial Hospitals (CGMH). We divided and studied the patients in three age groups: Group 1, younger (<65 years); Group 2, young old (65 to <75); and Group 3, older old patients (≥75 years)...
2016: PeerJ
https://www.readbyqxmd.com/read/27986531/patient-function-and-the-value-of-surgical-care-for-kidney-cancer
#11
Hung-Jui Tan, Joseph D Shirk, Karim Chamie, Mark S Litwin, Jim C Hu
PURPOSE: Frailty and functional status have emerged as significant predictors of morbidity and mortality for patients undergoing cancer surgery. To articulate their impact on value (i.e., quality per cost), we compared perioperative outcomes and expenditures according to patient function for older adults undergoing kidney cancer surgery. MATERIALS AND METHODS: Using linked SEER-Medicare data, we identified 19,129 elderly patients with kidney cancer treated with non-ablative surgery from 2000-2009...
December 13, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27977443/anterior-versus-posterior-approaches-for-odontoid-fracture-stabilization-in-patients-older-than-65-years-30-day-morbidity-and-mortality-in-a-national-database
#12
Joseph T Patterson, Alexander A Theologis, David Sing, Bobby Tay
STUDY DESIGN: Retrospective cohort analysis. OBJECTIVE: To compare 30-day perioperative clinical outcomes of surgical odontoid stabilization by an anterior or posterior operative approach in elderly patients. SUMMARY OF BACKGROUND DATA: Surgical stabilization of odontoid fractures is superior to nonoperative management in geriatric patients. How elderly patients with odontoid fractures fare after anterior and posterior approaches, however, is not well defined...
December 13, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27974304/improving-hip-fracture-outcomes-with-integrated-orthogeriatric-care-a-comparison-between-two-accepted-orthogeriatric-models
#13
Mark Middleton, Bettina Wan, Ruy da Assunçāo
BACKGROUND: our orthopaedic trauma unit serves a large elderly population, admitting 400-500 hip fractures annually. A higher than expected mortality was detected amongst these patients, prompting a change in the hip fracture pathway. The aim of this study was to assess the impact of a change in orthogeriatric provision on hip fracture outcomes and care quality indicators. PATIENTS AND METHODS: the hip fracture pathway was changed from a geriatric consultation service to a completely integrated service on a dedicated orthogeriatric ward...
December 14, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27966433/operative-outcome-of-hong-kong-centenarians-with-hip-fracture
#14
M Y Cheung, A Wh Ho, S H Wong
INTRODUCTION: International clinical guidelines recommend early surgical treatment for geriatric patients with hip fracture. There are, however, few data concerning the operative outcome of centenarians. This study aimed to report the epidemiology of hip fracture and postoperative mortality rate, and to discuss whether operation is justified in centenarians in Hong Kong. METHODS: This observational study was carried out in all public hospitals of Hong Kong. All patients aged 100 years or above who underwent hip fracture surgery in any public hospital between 1 January 2010 and 31 December 2013 were included...
December 14, 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27959354/delivering-comprehensive-geriatric-assessment-in-new-settings-advice-for-frontline-clinicians
#15
J R Gladman
Over the decades, as the principles of comprehensive geriatric assessment have been established, there have been attempts to apply its principles to settings other than acute hospital medical wards or the general communitydwelling older population, for example, to other settings where older people with infirmity are found. The purpose of this paper is to describe and reflect upon the application of and evidence for comprehensive geriatric assessment in these new settings and give some advice to clinicians about how to optimise their contributions to these processes...
September 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27942737/prothrombin-complex-concentrates-an-alternative-to-fresh-frozen-plasma
#16
David R Burk, Jordan L Smith, Jason R Wild
Insufficiency fractures are a common cause of morbidity among geriatric patients worldwide. Improved outcomes are known to result from decreased delay to definitive operative fixation and mobilization. Use of warfarin is an important potential cause of delay. The ideal mode of warfarin reversal is currently unknown. Prothrombin complex concentrates (PCCs) offer rapid correction with small infusion volume, both of which are important for elderly patients with multiple comorbidities. The authors present 2 cases of insufficiency fractures occurring in geriatric patients receiving warfarin therapy reversed with a 3-factor PCC...
December 8, 2016: Orthopedics
https://www.readbyqxmd.com/read/27940954/frailty-and-cardiac-rehabilitation-a-call-to-action-from-the-eapc-cardiac-rehabilitation-section
#17
Carlo Vigorito, Ana Abreu, Marco Ambrosetti, Romualdo Belardinelli, Ugo Corrà, Margaret Cupples, Constantinos H Davos, Stefan Hoefer, Marie-Christine Iliou, Jean-Paul Schmid, Heinz Voeller, Patrick Doherty
Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation...
December 11, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27919768/proximal-femoral-fractures-in-centenarians-a-retrospective-analysis-of-39-patients
#18
A Morice, N Reina, G Gracia, P Bonnevialle, J-M Laffosse, K Wytrykowski, E Cavaignac, N Bonnevialle
BACKGROUND: A corollary of the current population ageing in France is an increase in proximal femoral fractures (PFFs), particularly among centenarians. The outcomes of PFFs in centenarians in France are unknown. We therefore conducted a retrospective study of centenarians with PFFs both to assess: (1) assess clinical outcomes according to geriatric and trauma scores, (2) and to determine whether routine surgery is warranted. HYPOTHESIS: Morbidity and mortality in a single-centre cohort of centenarians with surgically treated PFFs are consistent with previous reports...
December 2, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27919650/association-between-dysfunction-of-upper-extremity-and-locomotive-syndrome-in-general-population
#19
Tsuyoshi Tajika, Atsushi Yamamoto, Noboru Oya, Chisa Okura, Satoshi Shinagawa, Takanori Kitagawa, Hiroki Kobayashi, Haku Iizuka, Kenji Takagishi
OBJECTIVE: This study investigated the relation between self-assessment of upper extremity function and locomotive syndrome in a general population. METHODS: Using the 25-question Geriatric Locomotive Function (GLFS-25) test, 320 Japanese people (115 men, 205 women, mean age 67.6 years, 40-92 years) were evaluated for locomotive dysfunction. All had completed a self-administered questionnaire including items for sex, weight, height, dominant hand, and the degree of frequency of hand in ADL...
December 2, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27917612/fear-of-falling-and-physical-function-in-older-adults-with-cataract-exploring-the-role-of-vision-as-a-moderator
#20
Anna Palagyi, Jonathon Q Ng, Kris Rogers, Lynn Meuleners, Peter McCluskey, Andrew White, Nigel Morlet, Lisa Keay
AIM: To examine fear of falling and associated factors in a cohort of older adults with cataract, and investigate the interplay of vision and physical function with respect to fear of falling. METHODS: We analyzed baseline data from a longitudinal study of adults aged ≥65 years referred for cataract surgery. Fear of falling was assessed by the Short Falls Efficacy Scale-International. Physical function was determined by the Short Physical Performance Battery...
December 4, 2016: Geriatrics & Gerontology International
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