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Acute care of the elderly

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https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#1
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28436194/impact-of-living-arrangements-on-clinical-outcomes-among-older-patients-with-dementia-or-cognitive-impairment-admitted-to-the-geriatric-evaluation-and-management-unit-in-taiwan
#2
Cheng-Hao Hung, Ting-Ching Tang, Chih-Jen Wang, Li-Kuo Liu, Li-Ning Peng, Liang-Kung Chen
AIM: To evaluate the impact of living arrangements on mortality and functional decline among older patients with dementia or cognitive impairment after discharge from a geriatric evaluation and management unit (GEMU) in Taiwan. METHODS: The present retrospective cohort study used data from the Veteran Affairs Comprehensive Geriatric Assessment from January 2015 to May 2016 for analysis. Data of patients aged 65 years and older with dementia or cognitive impairment at admission to the GEMU of Taipei Veterans General Hospital during the study period were retried for study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#3
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28389758/comparison-of-outcomes-of-operative-versus-non-operative-treatment-of-acetabular-fractures-in-the-elderly-and-severely-comorbid-patient
#4
Kempland C Walley, P T Appleton, E K Rodriguez
BACKGROUND: Acetabular fractures in the elderly and severely comorbid patient can be associated with high morbidity and mortality; however, differences in outcomes of acute ORIF versus non-operative care of acetabular fractures in a subgroup of elderly (>75 years) and/or severely comorbid younger patients (>65) remain unclear. PATIENTS AND METHODS: A retrospective review of 243 patients who sustained an acetabular fracture between April 2005 and November 2014 was performed...
April 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28384882/polymyxin-b-induced-diffuse-cutaneous-hyperpigmentation
#5
Sandeep Lahiry, Shouvik Choudhury, Ayan Mukherjee, Prajesh Kiran Bhunya, Moumita Bala
Polymyxin B is a polypeptide-antibiotic, primarily used for resistant Gram-negative infections, first obtained from bacterium Bacillus polymyxa in the late 1940s. Antibiotic spectrum are restricted to mainly gram negative bacterias like Enterobacter, E. coli, Klebsiella, Salmonella, Pasteurella, Bordetella, Shigella; and particularly organisms like Pseudomonas aeruginosa and Acinetobacter baumannii, which are extremely potent to acquire antibiotic resistance. Side effects include neurotoxicity and acute renal tubular necrosis...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28373621/sudden-cardiac-death-during-first-time-jogging
#6
Hiromitsu Kurata, Akiko Ishigami, Itsuo Tokunaga, Yasushi Nagasaki, Akiyoshi Nishimura
With increased interest in fitness and health care, jogging has become more popular as an exercise to promote health. However, sudden cardiac death during sports or exercise has also been reported. Some apparently healthy elderly individuals take up sports for both recreation and health improvement based only on completion of a questionnaire, without undergoing medical evaluation. We report the case of a 66-year-old Japanese man who suddenly died of acute ischemic heart disease during first-time jogging. He collapsed an hour after starting...
2017: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/28368543/morbidity-and-mortality-associated-with-surgery-of-traumatic-c2-fractures-in-octogenarians
#7
Sanjay S Dhall, John K Yue, Ethan A Winkler, Praveen V Mummaneni, Geoffrey T Manley, Phiroz E Tarapore
BACKGROUND: Management of axis fractures in the elderly remains controversial. As the US population increasingly lives past 80 years, published C2 fracture morbidity/mortality profiles in younger cohorts (55+) have become less applicable to octogenarians. OBJECTIVE: To report associations between surgery and mortality, hospital length of stay and discharge disposition in octogenarians with traumatic C2 fractures. METHODS: Retrospective cohort study of 3847 patients age ≥ 80 years representing 17 702 incidents nationwide, divided into surgery/nonsurgery cohorts, using the National Sample Program of the National Trauma Data Bank from 2003 to 2012...
March 23, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28364993/medication-reconciliation-in-long-term-care-and-assisted-living-facilities-opportunity-for-pharmacists-to-minimize-risks-associated-with-transitions-of-care
#8
REVIEW
Linda G Gooen
The transitions of care process involves pharmacists and other members of the health care team who are in a position to collect, review, and analyze medications lists to help improve health care outcomes. Medication reconciliation is a complex process, especially when providing care to elderly population due to increased medication use, the movement of the patient from one health care setting to another, the number of acute and chronic illnesses, and the intervention of multiple health care providers in different facilities...
May 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28350970/mannheim-peritonitis-index-mpi-and-elderly-population-prognostic-evaluation-in-acute-secondary-peritonitis
#9
G Salamone, L Licari, N Falco, G Augello, R Tutino, S Campanella, G Guercio, G Gulotta
INTRODUCTION: Acute Secondary Peritonitis due to abdominal visceral perforation is characterized by high mortality and morbidity risk. Risk stratification allows prognosis prediction to adopt the best surgical treatment and clinical care support therapy. In Western countries elderly people represent a significant percentage of population Aim. Evaluation of Mannheim Peritonitis Index (MPI) and consideration upon old people. PATIENTS AND METHODS: Retrospective study on 104 patients admitted and operated for "Acute Secondary Peritonitis due to visceral perforation"...
November 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28350792/association-between-delirium-superimposed-on-dementia-and-mortality-in-hospitalized-older-adults-a-prospective-cohort-study
#10
Thiago J Avelino-Silva, Flavia Campora, Jose A E Curiati, Wilson Jacob-Filho
BACKGROUND: Hospitalized older adults with preexisting dementia have increased risk of having delirium, but little is known regarding the effect of delirium superimposed on dementia (DSD) on the outcomes of these patients. Our aim was to investigate the association between DSD and hospital mortality and 12-mo mortality in hospitalized older adults. METHODS AND FINDINGS: This was a prospective cohort study completed in the geriatric ward of a university hospital in São Paulo, Brazil...
March 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28340935/individual-and-hospital-related-determinants-of-potentially-inappropriate-admissions-emerging-from-administrative-records
#11
Marco Fusco, Alessandra Buja, Paolo Piergentili, Maria Teresa Golfetto, Gianni Serafin, Silvia Gallo, Livio Dalla Barba, Vincenzo Baldo
INTRODUCTION: The appropriate use of health care is an important issue in developed countries. The purpose of this study was to ascertain the extent of potentially inappropriate hospital admissions and their individual, clinical and hospital-related determinants. METHODS: Medical records were analyzed for the year 2014 held by the Local Heath Unit n. 13 in the Veneto Region of north-east Italy (19,000 records). The outcomes calculated were: admissions for conditions amenable to day hospital care; brief medical admissions; outlier lengths of stay for elderly patients' medical admissions; and medical admissions to surgical wards...
November 2016: Health Policy
https://www.readbyqxmd.com/read/28325858/incidence-of-bloodstream-infections-a-nationwide-surveillance-of-acute-care-hospitals-in-switzerland-2008-2014
#12
Niccolò Buetti, Andrew Atkinson, Jonas Marschall, Andreas Kronenberg
BACKGROUND: Bloodstream infections are often associated with significant mortality and morbidity. We aimed to investigate changes in the epidemiology of bloodstream infections in Switzerland between 2008 and 2014. METHODS: Data on bloodstream infections were obtained from the Swiss antibiotic resistance surveillance system (ANRESIS). RESULTS: The incidence of bloodstream infections increased throughout the study period, especially among elderly patients and those receiving care in emergency departments and university hospitals...
March 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28297624/genomics-of-acute-myeloid-leukemia-diagnosis-and-pathways
#13
Lars Bullinger, Konstanze Döhner, Hartmut Döhner
In recent years, our understanding of the molecular pathogenesis of myeloid neoplasms, including acute myeloid leukemia (AML), has been greatly advanced by genomics discovery studies that use novel high-throughput sequencing techniques. AML, similar to most other cancers, is characterized by multiple somatically acquired mutations that affect genes of different functional categories, a complex clonal architecture, and disease evolution over time. Patterns of mutations seem to follow specific and temporally ordered trajectories...
March 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28289681/thanatophobia-death-anxiety-in-the-elderly-the-problem-of-the-child-s-inability-to-assess-their-own-parent-s-death-anxiety-state
#14
Gary Sinoff
Thanatophobia is omnipresent in our lives. Research has shown separate but connected constructs: fear of death or fear of the dying process. The influences on death anxiety are varied including religiosity, gender, psychological state, and age. It is often assumed by the children of the elderly that the fear of death is prevalent in their parents. Daily the medical staff encounters the presence of death anxiety: from family members or the staff itself. In order to understand this phenomenon, a three-tier study was conducted on non-terminal elderly inpatients in an acute geriatric care ward...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28277048/the-use-of-a-swedish-telephone-medical-advice-service-by-the-elderly-a-population-based-study
#15
K Dahlgren, M J Holzmann, A C Carlsson, P Wändell, J Hasselström, T Ruge
OBJECTIVE: The present study aimed to describe contact made by the elderly to Sweden's nationwide medical helpline, Healthcare Guide 1177 by Phone (HGP). Other objectives were to study potential gender differences and the association between different HGP referral levels and acute visits to hospital-based emergency departments and acute visits to primary care centres. DESIGN: De-identified data from recorded calls to HGP was extracted for analysis (n = 7477 for the oldest age group)...
March 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28272915/national-trends-in-admission-for-aspiration-pneumonia-in-the-united-states-in-2002-2012
#16
Chao-Ping Wu, Yu-Wei Chen, Min-Jung Wang, Evgeny Pinelis
RATIONALE: Aspiration pneumonia is a subset of pneumonias prevalent in elderly patients and patients with neurologic disorders. Previous studies mostly reported incidence and/or mortality rates from regional data or in specific subgroups of patients. There is paucity of nationwide data in contemporary United States population. OBJECTIVES: To describe United States national trends in acute care hospital admission for aspiration pneumonia from 2002 to 2012. METHODS: We used the US Nationwide Inpatient Sample (NIS) database to identify patients admitted with a primary diagnosis of aspiration pneumonia between 2002 and 2012...
March 8, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28272239/cutaneous-presentation-preceding-acute-monocytic-leukemia-a-care-compliant-article
#17
Xianhua Jin, Fuqiu Li, Xue Li, Wenjing Zhu, Yan Mou, Yang Huang, Huanyu Zhao, Wei Gao, Jianxin Xia
RATIONALE: Cutaneous presentation preceding acute myeloid leukemia (AML) is rare, and the prognosis is poor. PATIENT CONCERNS: We report 4 cases of AML cutis, where skin infiltration precedes any blood or bone marrow evidence of leukemia. We also reviewed 13 cases reported in English and Chinese literature. The 4 cases all presented typical cutaneous lesions without any systemic evidence of leukemia. Histopathological examination found that dense monomorphous cell infiltration involved the dermis...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28267949/buprenorphine-related-complications-in-elderly-hospitalised-patients-a-case-series
#18
S Richards, L Torre, B Lawther
We report a case series of buprenorphine-related respiratory and neurological depression in opioid-naïve elderly hospitalised patients who received buprenorphine for acute pain management at our institution over a 24-month period. All six patients had risk factors for respiratory depression such as advanced age, concurrent comorbidities, or the ingestion of other potential central nervous system depressants. All patients required escalation of management with additional monitoring, with some transferred to a high dependency or intensive care unit...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28265980/outcomes-in-elderly-patients-admitted-to-the-intensive-care-unit-with-solid-tumors
#19
Edouard Auclin, Anaïs Charles-Nelson, Baptiste Abbar, Emmanuel Guérot, Stéphane Oudard, Caroline Hauw-Berlemont, Constance Thibault, Alexandra Monnier, Jean-Luc Diehl, Sandrine Katsahian, Jean-Yves Fagon, Julien Taieb, Nadia Aissaoui
BACKGROUND: As the population ages and cancer therapies improve, there is an increased call for elderly cancer patients to be admitted to the intensive care unit (ICU). This study aimed to assess short-term survival and prognostic factors in critically ill patients with solid tumors aged ≥65 years. METHODS: We conducted a retrospective study. The primary endpoint was ICU mortality. Resumption of anticancer therapy in patients who survived the ICU stay and 90-day mortality were secondary endpoints...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28260868/the-diagnosis-of-delirium-in-an-acute-care-hospital-in-moscow-what-does-the-pandora-s-box-contain
#20
Olga N Tkacheva, Nadezda K Runikhina, Arkadiy L Vertkin, Irina V Voronina, Natalia V Sharashkina, Elen A Mkhitaryan, Valentina S Ostapenko, Elena A Prokhorovich, Tamar Freud, Yan Press
BACKGROUND: Delirium, a common problem among hospitalized elderly patients, is not usually diagnosed by doctors for various reasons. The primary aim of this study was to evaluate the effect of a short training course on the identification of delirium and the diagnostic rate of delirium among hospitalized patients aged ≥65 years. The secondary aim was to identify the risk factors for delirium. METHODS: A prospective study was conducted in an acute-care hospital in Moscow, Russia...
2017: Clinical Interventions in Aging
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