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https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#1
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27904025/early-raas-blockade-exerts-renoprotective-effects-in-autosomal-recessive-alport-syndrome
#2
Nao Uchida, Naonori Kumagai, Kandai Nozu, Xue Jun Fu, Kazumoto Iijima, Yoshiaki Kondo, Shigeo Kure
Alport syndrome is a progressive renal disease caused by mutations in COL4A3, COL4A4, and COL4A5 genes that encode collagen type IV alpha 3, alpha 4, and alpha 5 chains, respectively. Because of abnormal collagen chain, glomerular basement membrane becomes fragile and most of the patients progress to end-stage renal disease in early adulthood. COL4A5 mutation causes X-linked form of Alport syndrome, and two mutations in either COL4A3 or COL4A4 causes an autosomal recessive Alport syndrome. Recently, renin-angiotensin-aldosterone system (RAAS) blockade has been shown to attenuate effectively disease progression in Alport syndrome...
2016: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/27875831/social-support-systems-and-social-network-characteristics-of-older-adults-with-hiv
#3
Mark Brennan-Ing, Liz Seidel, Stephen E Karpiak
Social networks of older adults with HIV have been characterized as fragile, with a greater reliance on friends as compared to family. However, we know little about the subgroup differences in the social network constellations of this population, how such characteristics are related to social support resources, and their relationship with psychosocial well-being. We developed a typology of social networks of older HIV-positive adults and examined if they would be related to receipt of informal assistance, perceptions of support sufficiency, and psychosocial well-being...
2017: Interdisciplinary Topics in Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27852598/frailty-and-bone-health-in-european-men
#4
Michael J Cook, Alexander Oldroyd, Stephen R Pye, Kate A Ward, Evelien Gielen, Rathi Ravindrarajah, Judith E Adams, David M Lee, Gyorgy Bartfai, Steven Boonen, Felipe Casanueva, Gianni Forti, Aleksander Giwercman, Thang S Han, Ilpo T Huhtaniemi, Krzysztof Kula, Michael E Lean, Neil Pendleton, Margus Punab, Dirk Vanderschueren, Frederick C Wu, Terence W O'Neill
BACKGROUND: frailty is associated with an increased risk of fragility fractures. Less is known, however, about the association between frailty and bone health. METHODS: men aged 40-79 years were recruited from population registers in eight European centres for participation in the European Male Aging Study. Subjects completed a comprehensive assessment which included quantitative ultrasound (QUS) scan of the heel (Hologic-SAHARA) and in two centres, dual-energy bone densitometry (dual-energy x-ray absorptiometry, DXA)...
November 16, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27823868/effects-of-glimepiride-versus-saxagliptin-on-%C3%AE-cell-function-and-hypoglycemia-a-post-hoc-analysis-in-older-patients-with-type-2-diabetes-inadequately-controlled-with-metformin
#5
Shira Perl, William Cook, Cheryl Wei, Peter Ohman, Boaz Hirshberg
PURPOSE: The management of hyperglycemia is challenging in older patients with type 2 diabetes owing to excess fragility and risk for adverse outcomes should hypoglycemia episodes occur. We evaluated baseline β-cell function as a potential risk factor for the development of hypoglycemia when saxagliptin or glimepiride was added in patients aged ≥65 years whose type 2 diabetes was poorly controlled on stable metformin monotherapy. METHODS: A post hoc analysis of data from the GENERATION (Efficacy and Tolerability of Saxagliptin Compared with Glimepiride in Elderly Patients with Type 2 Diabetes: A Randomized, Controlled Study) trial, which enrolled 720 patients aged ≥65 years, was conducted...
November 4, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27818369/french-law-what-about-a-reasoned-reimbursement-of-serum-vitamin-d-assays
#6
Jean-Claude Souberbielle, Claude Laurent Benhamou, Bernard Cortet, Mickael Rousière, Christian Roux, Vered Abitbol, Cédric Annweiler, Maurice Audran, Justine Bacchetta, Pierre Bataille, Olivier Beauchet, Rémi Bardet, Alexandra Benachi, Francis Berenbaum, Hubert Blain, Françoise Borson-Chazot, Véronique Breuil, Karine Briot, Philippe Brunet, Jean-Claude Carel, Philippe Caron, Olivier Chabre, Philippe Chanson, Roland Chapurlat, Pierre Cochat, Régis Coutant, Sophie Christin-Maitre, Martine Cohen-Solal, Christian Combe, Catherine Cormier, Marie Courbebaisse, Grégory Debrus, Brigitte Delemer, Georges Deschenes, Marc Duquenne, Guillaume Duval, Patrice Fardellone, Denis Fouque, Gérard Friedlander, Jean-Bernard Gauvain, Lionel Groussin, Pascal Guggenbuhl, Pascal Houillier, Thierry Hannedouche, William Jacot, Rose-Marie Javier, Guillaume Jean, Claude Jeandel, Dominique Joly, Peter Kamenicky, Bertrand Knebelmann, Marie-Hélène Lafage-Proust, Yves LeBouc, Erick Legrand, Florence Levy-Weil, Agnès Linglart, Laurent Machet, Emmanuel Maheu, Eric Mallet, Christian Marcelli, Pierre Marès, Christophe Mariat, Gérard Maruani, Yves Maugars, France Montagnon, Bruno Moulin, Philippe Orcel, Henri Partouche, Virginie Personne, Charles Pierrot-Deseilligny, Michel Polak, Claire Pouteil-Noble, Dominique Prié, Agathe Raynaud-Simon, Yves Rolland, Jean-Louis Sadoul, Bernard Salle, Corinne Sault, Anne-Marie Schott, Isabelle Sermet-Gaudelus, Martin Soubrier, Ivan Tack, Eric Thervet, Isabelle Tostivint, Philippe Touraine, Florence Tremollières, Pablo Urena-Torres, Jean-Paul Viard, Jean-Louis Wemeau, Georges Weryha, Norbert Winer, Jacques Young, Thierry Thomas
The number of serum 25-hydroxyvitamin D (25OHD) assays has increased tenfold in France in less than 10 years, sometimes for invalidated reasons. In 2013, the French National Authority for Health (Haute autorité de santé, or HAS) limited the indications for serum 25OHD measurements to rickets/osteomalacia, older adults with recurrent falls, monitoring of kidney transplant in adults, and surgical treatment of obesity in adults. Our aim here was to note that other indications for serum 25OHD measurements are supported by previous literature and by a number of national and international recommendations, in particular the following: any situation of bone fragility, any chronic renal failure <45 mL/min/1...
November 4, 2016: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/27808666/multimodal-therapy-is-feasible-in-elderly-anal-cancer-patients
#7
Jon Espen Dale, Sigrun Sebjørnsen, Sabine Leh, Cornelia Rösler, Stein Aaserud, Bjørn Møller, Øystein Fluge, Christian Erichsen, Saied Nadipour, Hartwig Kørner, Frank Pfeffer, Olav Dahl
BACKGROUND: Many patients are diagnosed with an anal cancer in high ages. We here present the outcome after oncological therapy for patients above 80 years compared with younger patients. MATERIALS AND METHODS: A series of 213 consecutive patients was diagnosed and treated at a single institution from 1984 to 2009. The patients received similar radiation doses but with different techniques, thus progressively sparing more normal tissues. The majority of patients also had simultaneous [5-fluorouracil (5FU) and mitomycin C] or induction chemotherapy (cisplatin and 5FU)...
November 3, 2016: Acta Oncologica
https://www.readbyqxmd.com/read/27788941/long-term-outcomes-of-external-repair-as-a%C3%A2-rescue-operation-for-atrioventricular-groove-disruption
#8
Nikola Dobrilovic, Jaishankar Raman, James G Fingleton, Andrew Maslow, Arun K Singh
BACKGROUND: Atrioventricular groove disruption (AVGD) is an uncommon but lethal complication of mitral valve operations associated with mortality approaching 90%. Traditionally, an "internal" repair is performed requiring prosthesis explantation, complete atrioventricular groove reconstruction using a patch positioned from within the cardiac cavity, and subsequent prosthesis reimplantation. This is a massive undertaking that is usually unsuccessful. We examine the utility of an alternative, "external" approach for rescue of AVGD...
October 24, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27786552/use-of-antidementia-drugs-and-risk-of-pneumonia-in-older-persons-with-alzheimer-s-disease
#9
Pasi Lampela, Anna-Maija Tolppanen, Antti Tanskanen, Jari Tiihonen, Piia Lavikainen, Sirpa Hartikainen, Heidi Taipale
INTRODUCTION: Persons with Alzheimer's disease are at an increased risk of pneumonia, but the comparative risks during specific antidementia treatments are not known. We compared the risk of pneumonia in use of donepezil, rivastigmine (oral, transdermal), galantamine and memantine. PATIENTS AND METHODS: We used data from a nationwide cohort of community-dwelling individuals diagnosed with Alzheimer's disease during 2005-2011 in Finland, who initiated monotherapy with acetylcholinesterase inhibitor or memantine (n = 65481)...
October 27, 2016: Annals of Medicine
https://www.readbyqxmd.com/read/27776984/understanding-mortality-of-femoral-fractures-following-low-impact-trauma-in-persons-with-and-without-care-need
#10
Tobias Bluhmki, Raphael Simon Peter, Kilian Rapp, Hans-Helmut König, Clemens Becker, Ivonne Lindlbauer, Dietrich Rothenbacher, Jan Beyersmann, Gisela Büchele
OBJECTIVES: Persons with osteoporotic fracture history are subject to an increased risk for subsequent fractures and mortality. The aim of this retrospective study was to investigate the impact of a previous osteoporotic low-impact (fragility) index fracture (eg, forearm, lower leg) on mortality of a subsequent femoral fracture. DESIGN: Retrospective cohort study. PARTICIPANTS/MEASUREMENTS: Claims data of a German health insurance agency including >1...
October 21, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27742502/trends-in-oral-anti-osteoporosis-drug-prescription-in-the-united-kingdom-between-1990-and-2012-variation-by-age-sex-geographic-location-and-ethnicity
#11
R Y van der Velde, C E Wyers, E Teesselink, P P M M Geusens, J P W van den Bergh, F de Vries, C Cooper, N C Harvey, T P van Staa
INTRODUCTION: Given the expected increase in the number of patients with osteoporosis and fragility fractures it is important to have concise information on trends in prescription rates of anti-osteoporosis drugs (AOD). METHODS: We undertook a retrospective observational study using the UK Clinical Practice Research Datalink (CPRD) in the UK between 1990 and 2012 in subjects 50years or older, stratified by age, sex, geographic region and ethnicity. Yearly prescription incidence rates of any AOD and of each specific AOD were calculated as the number of patients first prescribed these AODs per 10,000person-years (py)...
January 2017: Bone
https://www.readbyqxmd.com/read/27733331/medication-management-the-macrocognitive-workflow-of-older-adults-with-heart-failure
#12
Robin S Mickelson, Kim M Unertl, Richard J Holden
BACKGROUND: Older adults with chronic disease struggle to manage complex medication regimens. Health information technology has the potential to improve medication management, but only if it is based on a thorough understanding of the complexity of medication management workflow as it occurs in natural settings. Prior research reveals that patient work related to medication management is complex, cognitive, and collaborative. Macrocognitive processes are theorized as how people individually and collaboratively think in complex, adaptive, and messy nonlaboratory settings supported by artifacts...
October 12, 2016: JMIR Human Factors
https://www.readbyqxmd.com/read/27725999/added-clinical-use-of-trabecular-bone-score-to-bmd-for-major-osteoporotic-fracture-prediction-in-older-chinese-people-the-mr-os-and-ms-os-cohort-study-in-hong-kong
#13
Y Su, J Leung, D Hans, B Aubry-Rozier, T Kwok
: The thresholds of trabecular bone score (TBS) require validation for clinical application in older Chinese people. The lower threshold of TBS significantly improved the accuracy of prediction by bone mineral density-based osteoporosis status for major osteoporotic fracture in older Chinese men. INTRODUCTION: Trabecular bone score (TBS) is a relatively new indicator of skeletal fragility. Its clinical application warrants further investigations. Our aim was to validate and recommend practical thresholds of TBS for fracture prediction in older Chinese people...
October 11, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27703044/older-men-with-severe-disc-degeneration-have-more-incident-vertebral-fractures-the-prospective-minos-cohort-study
#14
Charline Estublier, Roland Chapurlat, Pawel Szulc
OBJECTIVE: Data on the relationship between disc degeneration (DD) and fragility fractures in men are limited. The aim of this study was to prospectively analyse the risk of vertebral and non-vertebral fractures in men with thoracolumbar DD according to the severity of its radiological signs: disc space narrowing (DSN), osteophytes and endplate sclerosis. METHODS: Men >50 years of age (n = 765) had lateral spine radiographs and DXA and were monitored prospectively...
October 3, 2016: Rheumatology
https://www.readbyqxmd.com/read/27697401/high-prevalence-of-dementia-in-women-with-osteoporosis
#15
Adamah Amouzougan, Ludovic Lafaie, Hubert Marotte, Delphine Dẻnariẻ, Philippe Collet, Béatrice Pallot-Prades, Thierry Thomas
INTRODUCTION: Alzheimer's disease or other Dementias (ADD) and postmenopausal osteoporosis are two major public health problems with a huge impact on mortality. Here, we examined the prevalence of ADD in postmenopausal women with osteoporosis, monitored within a dedicated fracture liaison service. METHODS: We conducted a cross-sectional observational study in a population of 2041 women, visiting the university hospital of Saint-Etienne for a peripheral fragility fracture...
September 30, 2016: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/27682248/hypocalcaemia-after-denosumab-in-older-people-following-fracture
#16
Jessica Chen, Peter Smerdely
: Hypocalcaemia following denosumab therapy can be observed in older adults. This is more common if their pre-treatment corrected serum calcium concentrations are less than 2.28 mmol/L. Denosumab remains a safe treatment in older people but we recommend a cautious approach in people at risk. INTRODUCTION: Previous studies have indicated that denosumab, an anti-RANK ligand (RANKL) monoclonal antibody, for treatment of osteoporosis is well-tolerated. There is little data specifically regarding its adverse effect profile in a hospitalised older person...
September 28, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27676796/an-alternative-treatment-for-contractures-of-the-elderly-institutionalized-persons-microinvasive-percutaneous-needle-tenotomy-of-the-finger-flexors
#17
Alexis Schnitzler, Aurelie Diebold, Bernard Parratte, Laurent Tliba, Francois Genêt, Philippe Denormandie
OBJECTIVE: Almost 10% of older adults in nursing homes have a fixed flexion deformity of the fingers (claw hand). Such contractures have important functional consequences, often leading to hygiene difficulties. Medical treatment (such as botulinum toxin injections, physiotherapy or positioning) is not always effective and surgery is often not possible in such fragile patients. Microinvasive tenotomy with a large needle could be a useful alternative because it can be carried out in an ambulatory setting under local anaesthesia...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27669735/bone-densitometry-in-children-and-adolescents
#18
Laura K Bachrach, Catherine M Gordon
Concerns about bone health and potential fragility in children and adolescents have led to a high interest in bone densitometry. Pediatric patients with genetic and acquired chronic diseases, immobility, and inadequate nutrition may fail to achieve expected gains in bone size, mass, and strength, leaving them vulnerable to fracture. In older adults, bone densitometry has been shown to predict fracture risk and reflect response to therapy. The role of densitometry in the management of children at risk of bone fragility is less clear...
September 26, 2016: Pediatrics
https://www.readbyqxmd.com/read/27627096/-prevention-and-therapy-of-sarcopenia-in-the-ageing
#19
Zdeněk Zadák
UNLABELLED: Sarcopenia is one of the severe disorders associated with nutritional imbalance. While sarcopenia is an inseparable part of the process of ageing as people get older, it plays a vital role in pathological situations such as protein-calorie and kwashiorkor malnutrition, it accompanies various diseases of rheumatic character and is an almost ever-present feature of the clinical picture of oncological patients. Sarcopenia in people under strain is fatally manifested mainly in the elderly, medically fragile patients...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27621124/low-vegetable-intake-increases-the-risk-of-fall-related-fragility-fracture-in-postmenopausal-taiwanese-women-a-prospective-pilot-study-in%C3%A2-the%C3%A2-community
#20
Chu-Hsu Lin, Kai-Hua Chen, Chien-Min Chen, Chia-Hao Chang, Tung-Jung Huang, Hung-Chih Hsu, Shih-Yang Huang
BACKGROUND: The aim of this prospective study was to investigate the relationship between lifestyle factors including nutrition intake and the incidence of fall-related fragility fractures in postmenopausal women. METHODS: A total of 1169 female volunteers were recruited from participants at the morning health examinations held at each local public health center in the West Chiayi County of Taiwan at the beginning of the study. Laboratory examinations, anthropometric measurements, and questionnaire interviews inquiring about lifestyle factors, including weekly nutrition intake, were performed...
June 2016: Biomedical Journal
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