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Geriatric neurology

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https://www.readbyqxmd.com/read/28497256/-pharmacotherapy-of-parkinson-s-disease-aspects-of-drug-safety
#1
REVIEW
S Müller-Rebstein, C Trenkwalder, W H Oertel, C Culmsee, G Eckermann, G U Höglinger
BACKGROUND: This overview focuses on the aspects of the pharmacotherapy of Parkinson's disease, which is one of the most common disorders of the nervous system. This article presents the complexity of the pharmacotherapy of geriatric patients with neurological diseases. OBJECTIVES: Information about the potential risk factors and aspects of drug safety in the pharmacotherapy of Parkinson's disease. MATERIALS AND METHODS: Selective literature search using PubMed and the scientific-clinical experience of the authors...
May 11, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28489834/endoscopic-gastrostomy-critical-analysis-in-a-regional-referral-hospital
#2
Gabriel Marques Fávaro, Tiago Franco Filho, Diego Soares Coca, Marco Antonio Cunha, Ricardo Sato Uemura, Carlos Kyoshi Furuya Júnior, Dayse Aparício, Everson L A Artifon
INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) is a safe and effective endoscopic surgical procedure for enteral access and gastrointestinal decompression, and it is an excellent alternative to surgical gastrostomy. There are various clinical indications and these mainly include the need for prolonged enteral nutritional support due to complications from neurological, geriatric and oncological diseases and decompression of the gastrointestinal tract. Although safe and effective, a number of possible complications relating to the time (early or late complications) and severity (minor or major complications) may occur...
January 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28474775/subcortical-hyperintensities-in-the-cholinergic-system-are-associated-with-improvements-in-executive-function-in-older-adults-with-coronary-artery-disease-undergoing-cardiac-rehabilitation
#3
Calvin Santiago, Nathan Herrmann, Walter Swardfager, Mahwesh Saleem, Paul I Oh, Sandra E Black, Janelle Bradley, Krista L Lanctôt
OBJECTIVE: Coronary artery disease (CAD) is frequently accompanied by white matter hyperintensities and executive dysfunction. Because acetylcholine is important in executive function, these symptoms may be exacerbated by subcortical hyperintensities (SH) located in cholinergic (CH) tracts. This study investigated the effects of SH on cognitive changes in CAD patients undergoing a 48-week cardiac rehabilitation program. METHODS: Fifty patients (age 66.5 ± 7.1 years, 84% male) underwent the National Institute of Neurological Disorders and Stroke - Canadian Stroke Network neurocognitive battery at baseline and 48 weeks...
May 5, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28472936/pain-severity-predicts-depressive-symptoms-over-and-above-individual-illnesses-and-multimorbidity-in-older-adults
#4
Louise Sharpe, Sarah McDonald, Helen Correia, Patrick J Raue, Tanya Meade, Michael Nicholas, Patricia Arean
BACKGROUND: Multi-morbidity in older adults is commonly associated with depressed mood. Similarly, subjective reports of pain are also associated with both physical illness and increased depressive symptoms. However, whether pain independently contributes to the experience of depression in older people with multi-morbidity has not been studied. METHODS: In this study, participants were 1281 consecutive older adults presenting to one of 19 primary care services in Australia (recruitment rate = 75%)...
May 4, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28465867/differences-in-antipsychotic-related-adverse-events-in-adult-pediatric-and-geriatric-populations
#5
Hersh Sagreiya, Yi-Ren Chen, Narmadan A Kumarasamy, Karthik Ponnusamy, Doris Chen, Amar K Das
In recent years, antipsychotic medications have increasingly been used in pediatric and geriatric populations, despite the fact that many of these drugs were approved based on clinical trials in adult patients only. Preliminary studies have shown that the "off-label" use of these drugs in pediatric and geriatric populations may result in adverse events not found in adults. In this study, we utilized the large-scale U.S. Food and Drug Administration (FDA) Adverse Events Reporting System (AERS) database to look at differences in adverse events from antipsychotics among adult, pediatric, and geriatric populations...
February 26, 2017: Curēus
https://www.readbyqxmd.com/read/28460714/core-outcome-sets-for-research-and-clinical-practice
#6
REVIEW
Alessandro Chiarotto, Raymond W Ostelo, Dennis C Turk, Rachelle Buchbinder, Maarten Boers
BACKGROUND: This masterclass introduces the topic of core outcome sets, describing rationale and methods for developing them, and providing some examples that are relevant for clinical research and practice. METHOD: A core outcome set is a minimum consensus-based set of outcomes that should be measured and reported in all clinical trials for a specific health condition and/or intervention. Issues surrounding outcome assessment, such as selective reporting and inconsistency across studies, can be addressed by the development of a core set...
March 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28444038/difficulties-in-accessing-services-that-are-of-medium-complexity-in-small-municipalities-a-case-study
#7
Camila Ribeiro Silva, Brigida Gimenez Carvalho, Luiz Cordoni, Elisabete de Fátima Pólo de Almeida Nunes
The study aimed to describe the specialized health services and to identify areas of greater difficulty of access to specialized consultations offered by SUS in small cities in the 18th Regional Health Area of Paraná State, Brazil, using case study methodology. The data were collected between January and April 2015. Managers, management teams and the board of directors of the CIS (Consórcio Intermunicipal de Saúde) were interviewed. The 21 studied specialist areas were rated like Sufficient Quota, Insufficient Quota, Inexistent Supply, and Assistance Gap...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28371000/uncertainty-and-depression-in-people-with-parkinson-s-disease-a-cross-sectional-study
#8
Sangwoo Ahn, JuHee Lee, Sang Hui Chu, Young H Sohn
Adults with chronic disease may experience uncertainty and depression when coping with their illness. This study identifies degrees of uncertainty and depression, as well as factors associated with depression in people with Parkinson's disease. The 120 participants included patients who visited the neurology outpatient department of a tertiary hospital in Seoul and individuals who attended public events managed by the Korean Parkinson's Disease Association. The mean age of the sample was 65.01 and 50.8% of patients were men...
March 29, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/28340250/improving-safety-culture-in-hospitals-facilitators-and-barriers-to-implementation-of-systemic-falls-investigative-method-sfim
#9
Aleksandra A Zecevic, Alvin Ho-Ting Li, Charity Ngo, Michelle Halligan, Anita Kothari
Objective: The purpose of this study was to assess the facilitators and barriers to implementation of the Systemic Falls Investigative Method (SFIM) on selected hospital units. Design: A cross-sectional explanatory mixed methods design was used to converge results from a standardized safety culture survey with themes that emerged from interviews and focus groups. Findings were organized by six elements of the Ottawa Model of Research Use framework. Setting: A geriatric rehabilitation unit of an acute care hospital and a neurological unit of a rehabilitation hospital were selected purposefully due to the high frequency of falls...
March 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28333648/mobile-stride-length-estimation-with-deep-convolutional-neural-networks
#10
Julius Hannink, Thomas Kautz, Cristian Pasluosta, Jens Barth, Samuel Schulein, Karl-Gunter Gassmann, Jochen Klucken, Bjoern Eskofier
OBJECTIVE: Accurate estimation of spatial gait characteristics is critical to assess motor impairments resulting from neurological or musculoskeletal disease. Currently, however, methodological constraints limit clinical applicability of state-ofthe- art double integration approaches to gait patterns with a clear zero-velocity phase. METHODS: We describe a novel approach to stride length estimation that uses deep convolutional neural networks to map stride-specific inertial sensor data to the resulting stride length...
March 9, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28320146/stroke-related-stigma-among-west-africans-patterns-and-predictors
#11
Fred Stephen Sarfo, Michelle Nichols, Suparna Qanungo, Abeba Teklehaimanot, Arti Singh, Nathaniel Mensah, Raelle Saulson, Mulugeta Gebregziabher, Uvere Ezinne, Mayowa Owolabi, Carolyn Jenkins, Bruce Ovbiagele
BACKGROUND: Disability-adjusted life-years lost after stroke in Low & Middle-Income Countries (LMICs) is almost seven times those lost in High-income countries. Although individuals living with chronic neurological and mental disorders are prone to stigma, there is a striking paucity of literature on stroke-related stigma particularly from LMICs. OBJECTIVE: To assess the prevalence, severity, determinants and psycho-social consequences of stigma among LMIC stroke survivors...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28270270/a-review-of-suvorexant-doxepin-ramelteon-and-tasimelteon-for-the-treatment-of-insomnia-in-geriatric-patients
#12
Chelsey Edmonds, Michael Swanoski
Geriatric patients often experience insomnia because of physiological and neurological changes that occur during the aging process. Use of benzodiazepines, nonbenzodiazepine hypnotics, and diphenhydramine for the treatment of insomnia pose an increased risk of cognitive impairment, falls, and fractures in this patient population. Therapeutic alternatives approved by the Food and Drug Administration include suvorexant, doxepin, ramelteon, and tasimelteon, which have shown efficacy and safety in various studies...
March 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28253468/variation-in-outpatient-consultant-physician-fees-in-australia-by-specialty-and-state-and-territory
#13
Gary L Freed, Amy R Allen
OBJECTIVES: To determine the mean, median and 10th and 90th percentile levels of fees and out-of-pocket costs to the patient for an initial consultation with a consultant physician; to determine any differences in fees and bulk-billing rates between specialties and between states and territories. DESIGN, PARTICIPANTS AND SETTING: Analysis of 2015 Medicare claims data for an initial outpatient appointment with a consultant physician (Item 110) in 11 medical specialties representative of common adult non-surgical medical care (cardiology, endocrinology, gastroenterology, geriatric medicine, haematology, immunology/allergy, medical oncology, nephrology, neurology, respiratory medicine and rheumatology)...
March 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28244557/goal-setting-instruments-in-geriatric-rehabilitation-a-systematic-review
#14
R van Seben, L Reichardt, S Smorenburg, B Buurman
This systematic review summarizes the psychometric properties of goal-setting instruments that are applied within geriatric rehabilitation. PubMed Medline and Embase were systematically searched for eligible articles. Studies were included if they were conducted in a somatic or neurological rehabilitation setting, included patients aged ≥55 years and provided data on instruments' psychometric properties (validity, reliability, responsiveness), utility and/or feasibility. Eleven studies were included. Seven studies, all conducted by one research group, evaluated Goal-Attainment Scaling (GAS), two studies assessed the Canadian Occupational Performance Measure (COPM) and one study the Self-Identified Goals Assessment (SIGA), which is based on the COPM...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28243177/comorbidity-impact-on-social-functioning-after-hip-fracture-the-role-of-rehabilitation
#15
Natasa Radosavljevic, Dejan Nikolic, Milica Lazovic, Marija Hrkovic, Olivera Ilic-Stojanovic
OBJECTIVE: To analyze the impact of rehabilitation treatment on social functioning in elderly patients after hip fracture during a rehabilitation program. METHODS: This study included 203 patients with hip fracture. Four groups were analyzed on rehabilitation: Group 1, at admission, Group 2, at discharge, Group 3, three months after discharge and Group 4, six months after discharge. The analyzed parameters included: musculoskeletal, neurological and cognitive impairments...
July 2016: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28214074/subspecialty-training-and-certification-in-geriatric-psychiatry-a-25-year-overview
#16
Dorthea Juul, Christopher C Colenda, Jeffrey M Lyness, Laura B Dunn, Rita Hargrave, Larry R Faulkner
The Institute of Medicine estimated that by 2030, from 10.1 to 14.4 million Americans aged 65 years or older will have mental health or substance use disorders. This article reviews the history and current status of training, certification, and practice in geriatric psychiatry against the backdrop of this "silver tsunami." The American Board of Psychiatry and Neurology (ABPN) administered the first subspecialty examination in geriatric psychiatry in 1991, and through 2015 3,329 certificates were awarded. The Accreditation Council for Graduate Medical Education approved the training requirements in 1993...
January 9, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28197663/-in-patient-early-rehabilitation
#17
Claus-W Wallesch, Sindy Lautenschläger
It is difficult to develop the financing and hospital provision of interventions for early rehabilitation within the diagnosis-related group (DRG) system. In addition to a range of partially rehabilitative complex interventions, the system recognizes three main forms of early rehabilitative interventions: geriatric, neurological/neurosurgical, and interdisciplinary and others. In this article, the appropriate definitions and cost-effectiveness of these procedures are analyzed and compared. The early rehabilitative interventions are characterized by constant cooperation in the therapeutic team, especially neurological early rehabilitation through the incorporation of nursing as a therapeutic profession...
February 14, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28144788/-expectations-and-attitudes-concerning-geriatric-counseling-results-of-a%C3%A2-survey-among-general-practitioners-and-hospital-based-providers-in-two-german-states
#18
H Burkhardt, C Trojan
BACKGROUND: Expertise in geriatrics in the field of ambulatory and hospital-based treatment does not have access to comparable medical specialist structures, such as those in internal medicine and neurology; therefore, it is recommended that geriatric diagnostics by general practitioners can be supported by networking with hospital-based geriatric centers for geriatric counseling. The attitudes and experiences of both faculties in Germany are, however, not well known. METHODS: Representative samples of general practitioners and hospital-based faculty departments for internal medicine in two regions of Germany (Baden-Württemberg and Hessen) were identified using a systematic selection method...
January 31, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28000558/coarse-classification-to-region-scalable-refining-for-white-matter-lesions-segmentation-in-multi-channel-mri
#19
Renping Yu, Liang Xiao, Zhihui Wei
Brain lesions, especially White Matter Lesions (WMLs) that mostly found on magnetic resonance images of elderly people, are not only associated with normal aging, but also with various geriatric disorders including cardiovascular diseases, vascular disease, psychiatric disorders and dementia. Quantitative analysis of WMLs in large clinical trials is crucial in scientific investigations of such neurological diseases as well as in studying aging processes. Exploiting the different appearances of WMLs in multiple modalities, we propose a novel coarse classification to region-scalable refining method to segment WMLs in Magnetic Resonance Imaging (MRI) sequences without user intervention...
December 20, 2016: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/27910252/memory-performance-on-the-story-recall-test-and-prediction-of-cognitive-dysfunction-progression-in-mild-cognitive-impairment-and-alzheimer-s-dementia
#20
Jong-Hwan Park, Hyuntae Park, Sang Wuk Sohn, Sungjae Kim, Kyung Won Park
AIM: To determine the factors that influence diagnosis and differentiation of patients with mild cognitive impairment (MCI) and Alzheimer's dementia (AD) by comparing memory test results at baseline with those at 1-2-year follow up. METHODS: We consecutively recruited 23 healthy participants, 44 MCI patients and 27 patients with very mild AD according to the National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorder Association criteria for probable Alzheimer's disease and Petersen's clinical diagnostic criteria...
December 1, 2016: Geriatrics & Gerontology International
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