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Geriatric neurology

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https://www.readbyqxmd.com/read/28716256/post-stroke-depression-in-ghana-characteristics-and-correlates
#1
Fred Stephen Sarfo, Carolyn Jenkins, Arti Singh, Mayowa Owolabi, Akin Ojagbemi, Nathaniel Adusei, Raelle Saulson, Bruce Ovbiagele
BACKGROUND: Poststroke depression (PSD) is prevalent and is an important determinant of functional recovery, quality of life and mortality after stroke. Scanty data on the nature of PSD among stroke survivors in sub-Saharan Africa prompted this study. OBJECTIVE: To assess the prevalence and predictors of depression in a convenience sample of Ghanaian stroke survivors. METHODS: We evaluated consecutive stroke survivors encountered at a comprehensive neurology clinic in a tertiary medical center in Ghana...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28707192/-geriatrics-or-geriatricization-of-medicine-quo-vadis-geriatrics
#2
REVIEW
G F Kolb
This article examines the question whether and how geriatrics will change in the future and whether in view of the demographic changes the trend will go more in the direction of a further expansion of geriatrics or more towards a geriatricization of individual specialist medical fields. The different development of geriatrics in the individual Federal States can only be understood historically and is absolutely problematic against the background of the new hospital remuneration system. Geriatrics is a typical cross-sectional faculty and still has demarcation problems with other faculties but has also not yet clearly defined the core competence...
July 13, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28683706/sarcopenia-what-should-a-pharmacist-know
#3
Alfonso J Cruz-Jentoft
Sarcopenia (or muscle insufficiency) is a geriatric syndrome characterized by a progressive and generalized loss of skeletal muscle mass and function which has adverse consequences, particularly physical disability, falls and death. It can develop slowly, as a chronic condition that emerges over many years, or acutely, generally due to immobilization associated with an acute disease. The physiopathology of sarcopenia is complex, and affects both the muscle and its neurological and hormonal regulation...
July 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28682462/need-to-recalibrate-research-outcomes-in-alzheimer-s-disease-focus-on-neuropsychiatric-symptoms
#4
Marco Canevelli, Matteo Cesari, Flaminia Lucchini, Martina Valletta, Michele Sabino, Eleonora Lacorte, Nicola Vanacore, Giuseppe Bruno
OBJECTIVES: To determine whether neuropsychiatric symptoms (NPSs) are adequately considered in clinical research on Alzheimer's disease (AD). DESIGN: Systematic review. SETTING: Randomized controlled trials (RCTs) recruiting individuals with AD and published during the last 10 years in 16 major general medicine, neurology, psychiatry, and geriatric psychiatry journals and RCTs registered on clinicaltrials.gov and currently enrolling individuals with AD...
July 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28642851/sarcopenia-neurological-point-of-view
#5
REVIEW
Young Nam Kwon, Sung Sang Yoon
Sarcopenia is an age-related geriatric syndrome which is characterized by the gradual loss of muscle mass, muscle strength, and muscle quality. There are a lot of neurologic insults on sarcopenia at various levels from the brain to the neuromuscular junctions (NMJs) to generate a volitional task. Dopaminergic downregulation, inadequate motor programming and motor coordination impairment lead to decline of supraspinal drive. Motor unit reorganization and inflammatory changes in motor neuron decrease conduction velocity and amplitude of compound muscle action potential...
May 2017: Journal of Bone Metabolism
https://www.readbyqxmd.com/read/28636480/the-emerging-role-of-pimavanserin-in-the-management-of-parkinson-s-disease-psychosis
#6
Neal Hermanowicz, Gustavo Alva, Fernando Pagan, Alberto J Espay, Amita Patel, Katya Cruz Madrid, Daniel Kremens, Jim Kenney, Sheila Arquette, Gary Tereso, Maria Lopes, Carolyn Farnum
A panel of experts drawn from neurology, psychiatry, geropsychiatry, geriatrics, and pharmacy representatives of 3 health plans convened in New York City on July 30, 2016, with the objective of sharing opinions, ideas, and information regarding the optimal management of Parkinson's disease psychosis (PDP). Three key points emerged from the discussion: (1) Because of the nature of Parkinson's disease and PDP, finding appropriate treatment can prove challenging; (2) emerging therapies may present an opportunity for effective disease management; and (3) moving forward, provider and patient education regarding PDP and available treatment options is essential for well-managed symptoms and better quality of life...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#7
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28571819/chronic-eczematous-dermatitis-in-patients-with-neurodegenerative-diseases-may-be-an-early-marker-of-bullous-pemphigoid
#8
Ping-Song Chou, Tsai-Ching Chou, Chung-Hsing Chang, Sebastian Yu, Chih-Hung Lee
The number of elderly patients with chronic pruritus has been gradually increasing in aging countries. Bullous pemphigoid, a common autoimmune blister disease in the elderly, is always heralded by pruritic eczematous dermatitis and is often associated with neurodegenerative diseases. We hypothesized that chronic eczematous dermatitis in patients with neurodegenerative diseases may be an early marker of bullous pemphigoid. By conducting retrospective chart review, we found neurodegenerative diseases are more prevalent in elderly patients with chronic eczematous dermatitis...
June 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28534301/effects-of-acetyl-l-carnitine-in-diabetic-neuropathy-and-other-geriatric-disorders
#9
REVIEW
G Sergi, S Pizzato, F Piovesan, C Trevisan, N Veronese, E Manzato
A long history of diabetes mellitus and increasing age are associated with the onset of diabetic neuropathy, a painful and highly disabling complication with a prevalence peaking at 50% among elderly diabetic patients. Acetyl-L-carnitine (ALC) is a molecule derived from the acetylation of carnitine in the mitochondria that has an essential role in energy production. It has recently been proposed as a therapy to improve the symptoms of diabetic neuropathy. ALC is widely distributed in mammalian tissues, including the brain, blood-brain barrier, brain neurons, and astrocytes...
May 22, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28497256/-pharmacotherapy-of-parkinson-s-disease-aspects-of-drug-safety
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
June 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
#18
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...
June 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28333648/mobile-stride-length-estimation-with-deep-convolutional-neural-networks
#19
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
#20
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
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