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Geriatric AND cancer AND comorbidity

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https://www.readbyqxmd.com/read/28942563/polypharmacy-in-the-geriatric-oncology-population
#1
REVIEW
Lauren R Hersh, Kathryn Beldowski, Emily R Hajjar
PURPOSE OF REVIEW: This review explores the multiple definitions, epidemiology, and impact of polypharmacy in geriatric oncology patients. Risk factors and clinical implications of polypharmacy are delineated and potential clinical approaches to reduce polypharmacy are reviewed. RECENT FINDINGS: Most sources currently define polypharmacy as the administration of multiple medications that are non-essential, unnecessary, duplicative, or ineffective. Possible risk factors associated with polypharmacy in geriatric cancer patients include comorbid conditions, prescribing cascades, and hospitalization...
September 23, 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28933175/-hiv-infection-a-new-disease-of-internal-medicine
#2
Svatava Snopková
Modern antiretroviral treatment belongs to the greatest success of current medicine. HIV infection has gone from a death sentence to a manageable chronic disease which develops several decades. Thanks to treatment advances, people with HIV can and do live long and full lives. In the last two decades, the incidence AIDS defining illnesses have been dramatically reduced especially opportunistic infections and malignancies, whereas the role of non-infection comorbidities has risen than age-matched HIV uninfected adults...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28923227/advancing-treatment-approach-to-the-older-patient-with-cancer-through-clinical-trials-participation
#3
REVIEW
Efrat Dotan
The aging of the population worldwide brings a "Tsunami" of older patients to oncology practices. Oncologists are faced with determining the fitness of patients for therapy and tailoring appropriate therapy. Ongoing treatment of this patient population is challenging because of physiologic changes of aging, comorbidities, and various geriatric syndromes. Underrepresentation of older patients in clinical trials results in a gap in knowledge and lack of clear evidence to guide treatment approach. In recent years, some advancements have been made with publication of elderly specific studies...
October 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28860112/risk-factors-for-falls-in-older-patients-with-cancer
#4
Xiaotao Zhang, Ming Sun, Suyu Liu, Cheuk Hong Leung, Linda Pang, Uday R Popat, Richard Champlin, Holly M Holmes, Vicente Valero, Colin P Dinney, Debu Tripathy, Beatrice J Edwards
OBJECTIVES: A rising number of patients with cancer are older adults (65 years of age and older), and this proportion will increase to 70% by the year 2020. Falls are a common condition in older adults. We sought to assess the prevalence and risk factors for falls in older patients with cancer. METHODS: This is a single-site, retrospective cohort study. Patients who were receiving cancer care underwent a comprehensive geriatric assessments, including cognitive, functional, nutritional, physical, falls in the prior 6 months and comorbidity assessment...
August 31, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28801975/trends-in-aging-related-services-during-nephrectomy-implications-for-surgery-in-an-aging-population
#5
Hung-Jui Tan, Mark S Litwin, Karim Chamie, Debra Saliba, Jim C Hu
OBJECTIVES: To characterize the extent to which geriatric and related healthcare services are provided to older adults undergoing surgery for kidney cancer, a potential growth area in geriatrics and oncology. DESIGN: Population-based observational study. SETTING: Surveillance, Epidemiology, and End Results cancer data linked with Medicare claims. PARTICIPANTS: Adults aged 65 and older with kidney cancer treated surgically from 2000 to 2009 (N = 19,129)...
August 11, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28793879/septic-arthritis-significantly-increased-the-long-term-mortality-in-geriatric-patients
#6
Chia-Jung Wu, Chien-Cheng Huang, Shih-Feng Weng, Ping-Jen Chen, Chien-Chin Hsu, Jhi-Joung Wang, How-Ran Guo, Hung-Jung Lin
BACKGROUND: The elderly are predisposed to septic arthritis (SA) because of the aging nature and increasing comorbidities. SA may in turn increase the long-term mortality in the geriatric patients; however, it remains unclear. We conducted this prospective nationwide population-based cohort study to clarify this issue. METHODS: Using Taiwan National Health Insurance Research Database (NHIRD), we identified 1667 geriatric participants (≥ 65 years) with SA and 16,670 geriatric participants without SA matched at a ratio of 1:10 by age, sex, and index date between 1999 and 2010...
August 9, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28781062/value-of-geriatric-screening-and-assessment-in-predicting-postoperative-complications-in-patients-older-than-70-years-undergoing-surgery-for-colorectal-cancer
#7
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
OBJECTIVES: This study examines the association between geriatric screening and geriatric assessment (GA) and the risk of 30-day postoperative complications (30d-POCs) in older patients undergoing surgery for colorectal cancer (CRC). MATERIALS AND METHODS: Patients were identified from a prospectively collected database (2009-2015). All patients underwent geriatric screening with the G8 screening tool and the Flemish version of the Triage Risk Screening Tool (fTRST)...
August 3, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28776149/how-do-oncologists-make-decisions-about-chemotherapy-for-their-older-patients-with-cancer-a-survey-of-australian-oncologists
#8
E B Moth, B E Kiely, V Naganathan, A Martin, P Blinman
PURPOSE: Oncologists are making treatment decisions on increasing numbers of older patients with cancer. Due to comorbidities and frailty that increase with age, such decisions are often complex. We determined factors influencing oncologists' decisions to prescribe chemotherapy for older adults. METHODS: Members of the Medical Oncology Group of Australia (MOGA) were invited to complete an online survey in February to April 2016. RESULTS: Ninety-three oncologists completed the survey of which 69 (74%) were consultants and 24 (26%) were trainees, with most (72, 77%) working predominantly in a public hospital-associated practice...
August 3, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28739160/using-heat-maps-to-assess-the-multidimensional-association-of-comorbidities-with-survival-in-older-cancer-patients-treated-with-chemotherapy
#9
Jae Jin Lee, Jongphil Kim, Marina Sehovic, Lu Chen, Martine Extermann
OBJECTIVE: To date, most comorbidity studies have analyzed either a subgroup of frequent diseases, or used summary instruments such as the Charlson score or the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Yet, comorbidity is a multidimensional construct and impacts function, treatment tolerance, and survival. We assessed how heat maps can unveil specific patterns of comorbidities associated with overall survival (OS) in older cancer patients treated with chemotherapy. MATERIAL AND METHODS: We reviewed four trials that prospectively evaluated comorbidities using CIRS-G...
September 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28736363/-clinical-characteristics-and-risk-factors-affecting-outcomes-of-elderly-patients-with-non-small-cell-lung-cancer-complicated-by-chronic-obstructive-pulmonary-disease
#10
Peng Wang, Dong Zhang, Xue-Guang Guo, Bao-Jun Sun, Xiang-Qun Fang, Ge-Ping Qu, Chang-Ting Liu
OBJECTIVE: To investigate the clinical features, treatment strategy and risk factors affecting the prognosis of elderly patients with non-small cell lung cancer (NSCLC) complicated by chronic obstructive pulmonary disease (COPD). METHODS: We retrospectively analyzed the data of elderly patietns (>60 years) with newly diagnosed NSCLC complicated by COPD at the Geriatric Institution of General Hospital of PLA between January, 2000 and June, 2015. The clinical data collected included history of smoking, pulmonary function test results, initial treatments, TNM stage, chief complaints, comorbidities and laboratory tests...
July 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28734776/a-preoperative-score-to-predict-early-death-after-pancreatic-cancer-resection
#11
Gianpaolo Balzano, Erica Dugnani, Stefano Crippa, Marina Scavini, Valentina Pasquale, Francesca Aleotti, Daniela Liberati, Alessandra Gandolfi, Giulio Belfiori, Michele Reni, Claudio Doglioni, Giacomo Ruffo, Cristina Marmorale, Massimo Falconi, Lorenzo Piemonti
BACKGROUND: This study aimed to develop and validate a preoperative prognostic model for death within one year post-surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC). METHODS: A derivation cohort study of 296 patients who underwent surgical resection of PDAC was prospectively enrolled in an observational study. Preoperative predictors of one year mortality were used to develop a risk score which was then validated in an external cohort of 182 patients with resectable PDAC...
July 1, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28731942/geriatric-assessment-and-tools-for-predicting-treatment-toxicity-in-older-adults-with-cancer
#12
Daneng Li, Enrique Soto-Perez-de-Celis, Arti Hurria
Cancer is a disease of older adults, and the majority of new cancer cases and deaths occur in people 65 years or older. However, fewer data are available regarding the risks and benefits of cancer treatment in older adults, and commonly used assessments in oncology fail to adequately evaluate factors that affect treatment efficacy and outcomes in the older patients. The geriatric assessment is a multidisciplinary evaluation that provides detailed information about a patient's functional status, comorbidities, psychological state, social support, nutritional status, and cognitive function...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28708810/role-of-normalized-t-cell-subsets-in-predicting-comorbidities-in-a-large-cohort-of-geriatric-hiv-infected-patient
#13
A Calcagno, S Piconi, E Focà, S Nozza, F Carli, C Montrucchio, A M Cattelan, G Orofino, B M Celesia, V Morena, G V De Socio, G Guaraldi
BACKGROUND: Adults aging with HIV are at greater risk for several comorbidities. The CD4+ cell count and CD4+/CD8+ ratio often fail to normalize in elderly patients despite prolonged antiretroviral therapy; this has been associated with concomitant diseases and poor prognosis. METHODS: A cross-sectional analysis in antiretroviral-treated HIV-positive patients aged ≥65 years. Aim of the study was to describe the predictors of normalized T cell subsets ("nT", CD4+/CD8+ ratio ≥1 and CD4+ ≥500 cells/uL) in a cohort of geriatric HIV-positive patients and its association with HIV-associated non-AIDS conditions (HANA)...
July 8, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28700153/-frequent-uro-geriatric-symptoms-helpful-tools-for-general-practitioners
#14
Guillaume Altwegg, Jacques Klein, Grégory Wirth, Christophe E Iselin
Each developed country faces an aging population. Increase of age rises the risk to develop urologic pathology especially in men. Routine investigation and diagnostic of urologic pathology important, however must take into account the patient in his globality (including age, comorbidities, drug medication as well as sociocultural environment). The aim of this article is to help the general practitioner in taking decisions with frequent uro-geriatric symptoms. Bladder catheterization remains an invasive treatment and indication should be regularly re-evaluated...
November 30, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28687577/frailty-index-developed-from-a-cancer-specific-geriatric-assessment-and-the-association-with-mortality-among-older-adults-with-cancer
#15
Emily J Guerard, Allison M Deal, YunKyung Chang, Grant R Williams, Kirsten A Nyrop, Mackenzi Pergolotti, Hyman B Muss, Hanna K Sanoff, Jennifer L Lund
Background: An objective measure is needed to identify frail older adults with cancer who are at increased risk for poor health outcomes. The primary objective of this study was to develop a frailty index from a cancer-specific geriatric assessment (GA) and evaluate its ability to predict all-cause mortality among older adults with cancer. Patients and Methods: Using a unique and novel data set that brings together GA data with cancer-specific and long-term mortality data, we developed the Carolina Frailty Index (CFI) from a cancer-specific GA based on the principles of deficit accumulation...
July 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28664916/geriatric-assessment-is-superior-to-oncologists-clinical-judgement-in-identifying-frailty
#16
Lene Kirkhus, Jūratė Šaltytė Benth, Siri Rostoft, Bjørn Henning Grønberg, Marianne J Hjermstad, Geir Selbæk, Torgeir B Wyller, Magnus Harneshaug, Marit S Jordhøy
BACKGROUND: Frailty is a syndrome associated with increased vulnerability and an important predictor of outcomes in older cancer patients. Systematic assessments to identify frailty are seldom applied, and oncologists' ability to identify frailty is scarcely investigated. METHODS: We compared oncologists' classification of frailty (onc-frail) based on clinical judgement with a modified geriatric assessment (mGA), and investigated associations between frailty and overall survival...
August 8, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28659138/the-effect-of-geriatric-intervention-in-frail-elderly-patients-receiving-chemotherapy-for-colorectal-cancer-a-randomized-trial-gerico
#17
C M Lund, K K Vistisen, C Dehlendorff, F Rønholt, J S Johansen, D L Nielsen
BACKGROUND: Better surgical techniques, chemotherapy and biological therapy have improved survival in patients with colorectal cancer (CRC), most markedly in younger patients. About half of patients over 70 years receive dose reductions or early treatment discontinuation of the planned adjuvant or first-line treatment due to side effects. The Comprehensive Geriatric Assessment (CGA) is a multidisciplinary evaluation of an elderly individual's health status. This assessment in older patients with cancer can predict survival, chemotherapy toxicity and morbidity...
June 28, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28646457/national-survey-among-radiation-oncology-residents-related-to-their-needs-in-geriatric-oncology
#18
Rachel Leifer, Bonnie Bristow, Martine Puts, Shabbir Alibhai, Xingshan Cao, Barbara-Ann Millar, Meredith Giuliani, Tina Hsu, Maureen Trudeau, Rajin Mehta, Ines Menjak, Mireille Norris, Barbara Liu, Francois Gallant, Ewa Szumacher
Currently, there is no formal curriculum addressing geriatric oncology within Canadian radiation oncology (RO) residency programs. Knowledge related to geriatric medicine may help radiation oncologists modify RT based on frailty status and geriatric considerations. Understanding specific learning needs allow program coordinators to align the current curriculum with residents' geriatric oncology learning needs. The purpose of this study is to determine the geriatric oncology educational needs of the Canadian RO residents and to inform Canadian RO residency training...
June 24, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28602414/the-older-adult-with-locoregionally-advanced-head-and-neck-squamous-cell-carcinoma-knowledge-gaps-and-future-direction-in-assessment-and-treatment
#19
REVIEW
Ronald Maggiore, Zachary S Zumsteg, Karlynn BrintzenhofeSzoc, Kelly M Trevino, Ajeet Gajra, Beatriz Korc-Grodzicki, Joel B Epstein, Stewart M Bond, Ira Parker, Julie A Kish, Barbara A Murphy, Noam A VanderWalde
Older adults with head and neck squamous cell carcinoma (HNSCC) pose unique treatment and supportive care challenges to oncologists and other cancer care providers. The majority of patients with HNSCC present with locoregionally advanced disease, for which combined-modality treatment integrating chemotherapy and radiation therapy is often necessary to maximize tumor control. However, applying these approaches to an older population with concomitant comorbidities and a higher risk of functional impairments remains challenging and is exacerbated by the paucity of studies involving older adults...
July 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28557393/-melatonin-as-a-marker-of-the-grade-of-cardiac-disorders-during-cachexia-development-in-oncological-patients-of-different-ages
#20
M F Ballyuzek, M V Mashkova, A V Arutjunyan, V A Duke
We have examined 103 patients at the age from 28 to 78 with the newly diagnosed oncological disease at stages II-IV before the beginning of anticancer treatment. The identification of the signs of the cachexia syndrome and its stage (pre-cachexia, cachexia) were carried out in the accordance with the CASCO criteria (2011) and taking into the account the age of the patients. The cardiovascular infringements were found to be comorbid to the oncological disease significantly more often in patients with signs of cachexia syndrome on the pre-cachexia stage and the total index of cardiovascular disorders in oncological patients increases with the severity of cachexia...
2017: Advances in Gerontology, Uspekhi Gerontologii
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