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https://www.readbyqxmd.com/read/28632340/prescribing-in-the-oldest-old-inpatients-a-retrospective-analysis-of-patients-referred-for-specialist-geriatric-consultation
#1
Sivarajah Ilango, Peter Pillans, Nancye M Peel, Ian Scott, Leonard C Gray, Ruth E Hubbard
INTRODUCTION: While medications may prolong life and prevent morbidity in older people, adverse effects of polypharmacy are increasingly recognised. As patients age and become frail, prescribing may be expected to focus more on symptom control and minimise potentially harmful preventive medication use that confer little benefit within a short lifespan. Whether prescribing practice shifts to one of symptom control among the oldest old admitted to hospital remains unclear. METHODS: Retrospective analysis of all patients aged ≥85 years referred for comprehensive geriatric assessment at a tertiary care hospital between May 2006 and December 2014 for whom all prescribed medications were documented...
June 20, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28601836/contextual-and-individual-inequalities-of-multimorbidity-in-brazilian-adults-a-cross-sectional-national-based-study
#2
Bruno P Nunes, Alexandre D P Chiavegatto Filho, Sanghamitra Pati, Doralice S Cruz Teixeira, Thaynã R Flores, Fabio A Camargo-Figuera, Tiago N Munhoz, Elaine Thumé, Luiz A Facchini, Sandro R Rodrigues Batista
OBJECTIVES: The study aims to evaluate the magnitude of multimorbidity in Brazilian adults, as well to measure their association with individual and contextual factors stratified by Brazilian states and regions. METHODS: A national-based cross-sectional study was carried out in 2013 with Brazilian adults. Multimorbidity was evaluated by a list of 22 physical and mental morbidities (based on self-reported medical diagnosis and Patient Health Questionnaire-9 for depression)...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28510585/the-prevalence-of-underweight-overweight-and-obesity-in-bangladeshi-adults-data-from-a-national-survey
#3
Tuhin Biswas, Sarah P Garnett, Sonia Pervin, Lal B Rawal
BACKGROUND: Over the two last decades Bangladesh, a low-income country, has experienced a rapid demographic and epidemiological transition. The population has increased substantially with rapid urbanization and changing pattern of disease, which at least in part, can be explained by nutritional changes. However, the nutritional status of the adult population has not been previously described. Hence, the objective of this study was to estimate the prevalence and explore socio-demographic determinants of underweight, overweight and obesity among the Bangladeshi adult population...
2017: PloS One
https://www.readbyqxmd.com/read/28506233/measurement-and-decomposition-of-socioeconomic-inequality-in-single-and-multimorbidity-in-older-adults-in-china-and-ghana-results-from-the-who-study-on-global-ageing-and-adult-health-sage
#4
Rasha Kunna, Miguel San Sebastian, Jennifer Stewart Williams
BACKGROUND: Globally people are living longer and enduring non-communicable diseases (NCDs) many of which co-occur as multimorbidity. Demographic and socioeconomic factors are determinants of inequalities and inequities in health. There is a need for country-specific evidence of NCD inequalities in developing countries where populations are ageing rapidly amid economic and social change. The study measures and decomposes socioeconomic inequality in single and multiple NCD morbidity in adults aged 50 and over in China and Ghana...
May 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28499387/evolution-of-the-fourth-stage-of-epidemiologic-transition-in-people-aged-80%C3%A2-years-and-over-population-based-cohort-study-using-electronic-health-records
#5
Nisha C Hazra, Martin Gulliford
BACKGROUND: In the "fourth stage" of epidemiological transition, the distribution of non-communicable diseases is expected to shift to more advanced ages, but age-specific changes beyond 80 years of age have not been reported. METHODS: This study aimed to evaluate demographic and health transitions in a population aged 80 years and over in the United Kingdom from 1990 to 2014, using primary care electronic health records. Epidemiological analysis of chronic morbidities and age-related impairments included a cohort of 299,495 participants, with stratified sampling by five-year age group up to 100 years and over...
May 12, 2017: Population Health Metrics
https://www.readbyqxmd.com/read/28474459/use-of-guideline-recommended-adjuvant-therapies-and-survival-outcomes-for-people-with-colorectal-cancer-at-tertiary-referral-hospitals-in-south-australia
#6
Pamela Adelson, Kellie Fusco, Christos Karapetis, David Wattchow, Rohit Joshi, Timothy Price, Greg Sharplin, David Roder
RATIONALE, AIMS AND OBJECTIVES: Adjuvant care for colorectal cancer (CRC) has increased over the past 3 decades in South Australia (SA) in accordance with national treatment guidelines. This study explores the (1) receipt of adjuvant therapy for CRC in SA as related to national guideline recommendations, with a focus on stage C colon and stage B and C rectal cancer; (2) timing of these adjuvant therapies in relation to surgery; and (3) comparative survival outcomes. METHODS: Data from the SA Clinical Cancer Registry from 4 tertiary referral hospitals for 2000 to 2010 were examined...
May 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28390184/outcomes-in-older-adults-with-multimorbidity-associated-with-predominant-provider-of-care-specialty
#7
Julie P W Bynum, Chiang-Hua Chang, Andrea Austin, Don Carmichael, Ellen Meara
OBJECTIVES: To determine whether receiving the predominance of ambulatory visits from a primary care provider compared to a specialty provider is associated with better outcomes in older adults with multi morbidity. DESIGN: Observational study using propensity score matching. SETTING: Medicare fee-for-service, 2011-12. PARTICIPANTS: Beneficiaries aged 65 and older with multimorbidity. MEASUREMENTS: The independent variable was an indicator for having a specialty (versus primary care) as the predominant provider of care (PPC)...
April 8, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28296975/socioeconomic-inequalities-in-health-in-the-context-of-multimorbidity-a-korean-panel-study
#8
Myung Ki, Yo Han Lee, Yong-Soo Kim, Ji-Yeon Shin, Jiseun Lim, James Nazroo
Socioeconomic inequalities in health are commonly known to decrease at late age. Yet, it remains unclear whether socioeconomic inequalities in health at late age appear in relation to multimorbidity, particularly in Korea where social support remains unsatisfactory for older people. Using three waves of Korea Health Panel, data of 19,942 observations with repeated measure were constructed to ensure a temporal sequence between three socioeconomic measures (i.e., poverty, employment status, and education) and multimorbidity with a t to t+1 year transition...
2017: PloS One
https://www.readbyqxmd.com/read/28273230/effects-of-air-pollution-caused-by-sugarcane-burning-in-western-s%C3%A3-o-paulo-on-the-cardiovascular-system
#9
Paula Roberta da Silva Pestana, Alfésio Luís Ferreira Braga, Ercy Mara Cipulo Ramos, Ariadna Ferraz de Oliveira, Christian Robert Osadnik, Aline Duarte Ferreira, Dionei Ramos
OBJECTIVE: To evaluate the effects of acute exposure to air pollutants (NO2 and PM10) on hospitalization of adults and older people with cardiovascular diseases in Western São Paulo. METHODS: Daily cardiovascular-related hospitalization data (CID10 - I00 to I99) were acquired by the Department of Informatics of the Brazilian Unified Health System (DATASUS) from January 2009 to December 2012. Daily levels of NO2 and PM10 and weather data were obtained from Companhia Ambiental do Estado de São Paulo (CETESB - São Paulo State Environmental Agency)...
March 2, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/27648920/insulin-like-growth-factor-1-and-risk-of-depression-in-older-people-the-english-longitudinal-study-of-ageing
#10
S Chigogora, P Zaninotto, M Kivimaki, A Steptoe, G D Batty
Depressive disorders are a leading cause of disability in older age. Although the role of psychosocial and behavioural predictors has been well examined, little is known about the biological origins of depression. Findings from animal studies have implicated insulin-like growth factor 1 (IGF-1) in the aetiology of this disorder. A total of 6017 older adults (mean age of 65.7 years; 55% women) from the English Longitudinal Study of Ageing provided serum levels of IGF-1 (mean=15.9 nmol l(-1), s.d. 5.7) during a nurse visit in 2008...
September 20, 2016: Translational Psychiatry
https://www.readbyqxmd.com/read/27595357/adult-cancers-in-adolescents-and-young-adults
#11
REVIEW
Valérie Laurence, Maria Marples, Daniel P Stark
The pattern of cancer seen in young people changes with increasing age, transitioning from childhood- to adult-type cancer in adolescence and the third decade. The risk factors, presentation and biology of cancer in young adults differ from those in the older adult population. Factors of particular significance in adolescents and young adults (AYAs) include genetic predisposition to adult-type cancer, diagnostic uncertainty, long-term morbidity and considerations of fertility. New systemic therapies are being introduced that can prolong life and even increase the chance of cure, but the impact on AYAs is uncertain, as these patients are often under-represented in clinical trials...
2016: Progress in Tumor Research
https://www.readbyqxmd.com/read/27527842/patterns-of-psychotropic-prescribing-and-polypharmacy-in-older-hospitalized-patients-in-ireland-the-influence-of-dementia-on-prescribing
#12
Kieran Anthony Walsh, Niamh A O'Regan, Stephen Byrne, John Browne, David J Meagher, Suzanne Timmons
BACKGROUND: Neuropsychiatric Symptoms (NPS) are ubiquitous in dementia and are often treated pharmacologically. The objectives of this study were to describe the use of psychotropic, anti-cholinergic, and deliriogenic medications and to identify the prevalence of polypharmacy and psychotropic polypharmacy, among older hospitalized patients in Ireland, with and without dementia. METHODS: All older patients (≥ 70 years old) that had elective or emergency admissions to six Irish study hospitals were eligible for inclusion in a longitudinal observational study...
November 2016: International Psychogeriatrics
https://www.readbyqxmd.com/read/27367545/new-findings-in-hcv-genotype-distribution-in-selected-west-european-russian-and-israeli-regions
#13
Vladimir Kartashev, Matthias Döring, Leonardo Nieto, Eleda Coletta, Rolf Kaiser, Saleta Sierra
BACKGROUND: HCV affects 185 million people worldwide and leads to death and morbidities. HCV has a high genetic diversity and is classified into seven genotypes and 67 subtypes. Novel anti-HCV drugs (Direct-Acting-Antivirals) eligibility, resistance and cure rates depend on HCV geno/subtype (GT). OBJECTIVES: Analysis of epidemiological information and viral GT from patients undergoing viral genotyping in 2011-2015. STUDY DESIGN: Anonymized information from 52 centers was analyzed retrospectively...
August 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/27346422/the-older-they-are-the-harder-they-fall-injury-patterns-and-outcomes-by-age-after-ground-level-falls
#14
Bishwajit Bhattacharya, Adrian Maung, Kevin Schuster, Kimberly A Davis
BACKGROUND: Trauma centers are seeing an increasing number of geriatric patients that are more susceptible to injuries even from relatively minor insults such as a ground level fall (GLF). As life expectancy increases, people are living in the geriatric age bracket for decades and often use anticoagulation agents for various comorbidities. We hypothesize that this patient population is not homogenous and we investigated the injury patterns and outcomes after GLF as a function of age and anticoagulation use...
September 2016: Injury
https://www.readbyqxmd.com/read/27105883/multimorbidity-in-adults-from-a-southern-brazilian-city-occurrence-and-patterns
#15
Bruno Pereira Nunes, Fabio Alberto Camargo-Figuera, Marília Guttier, Paula Duarte de Oliveira, Tiago N Munhoz, Alicia Matijasevich, Andréa Dâmaso Bertoldi, Fernando César Wehrmeister, Marysabel Pinto Telis Silveira, Elaine Thumé, Luiz Augusto Facchini
OBJECTIVES: The aim of this study was to evaluate occurrences and patterns of multimorbidity in adults from a southern Brazilian city. METHODS: A population-based cross-sectional study was carried out in 2012 through face-to-face interviews with adults (20 or more years) living in Pelotas, southern Brazil. Multimorbidity was evaluated by a list of 11 morbidities (based on medical diagnosis; Patient Health Questionnaire 9 for depression; and Anatomical Therapeutic Chemical index) and operationalized according to two cutoff points: ≥2 and ≥3 morbidities...
December 2016: International Journal of Public Health
https://www.readbyqxmd.com/read/27098011/concurrent-use-of-prescription-drugs-and-herbal-medicinal-products-in-older-adults-a-systematic-review-protocol
#16
Taofikat Agbabiaka, Barbara Wider, Leala Kay Watson, Claire Goodman
BACKGROUND: There has been a global increase in the use of herbal medicinal products (HMPs). About a quarter of UK adults use HMPs, bought over the counter by self-prescription and often not disclosed to healthcare professionals. Potential herb-drug interaction is a clinical concern, with older people at greater risk because of co-morbidities and slower clearance of pharmacologically active compounds. While there is a good understanding of general herbal medicine use by older people, less is known about the extent and implications of concurrent use with prescription medicines...
April 21, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/26940708/posttraumatic-stress-symptoms-co-morbid-psychiatric-symptoms-and-distorted-cognitions-among-flood-victims-of-different-ages
#17
Man Cheung Chung, Sabeena Jalal, Najib Ullah Khan
BACKGROUND: In literature, the effect of age on posttraumatic stress disorder (PTSD) is inconclusive; the effect on flood-related PTSD is particularly unclear. Little is known on distorted cognitions among flood victims, although cognition distortions and PTSD have been linked among victims of other traumas. AIMS: To investigate: (1) whether flood-related PTSD, psychiatric co-morbidity and cognitive distortions would differ according to age and (2) distinctive patterns of association between the preceding variables for different age groups...
March 3, 2016: Journal of Mental Health
https://www.readbyqxmd.com/read/26759599/pneumococcal-colonization-in-older-adults
#18
Susanna Esposito, Daniela Mari, Luigi Bergamaschini, Annalisa Orenti, Leonardo Terranova, Luca Ruggiero, Valentina Ierardi, Monia Gambino, Francesco Della Croce, Nicola Principi
BACKGROUND: Little is known about pneumococcal carrier states in older adults. The main aim of this study was to evaluate pneumococcal colonization patterns among older adults in two centres in Milan, Italy, before the widespread use of the 13-valent pneumococcal vaccine (PCV13) in this age group, to investigate demographic and clinical features that are associated with pneumococcal colonization and to estimate the potential coverage offered by PCV13. RESULTS: Among 417 adults ≥65 years old (171, 41...
2016: Immunity & Ageing: I & A
https://www.readbyqxmd.com/read/26751042/regional-variations-in-the-public-delivery-of-bariatric-surgery-an-evaluation-of-the-center-of-excellence-model
#19
Aristithes G Doumouras, Fady Saleh, Scott Gmora, Mehran Anvari, Dennis Hong
OBJECTIVE: We evaluated regional access to bariatric surgery within the high-volume, center of excellence (COE) model of Ontario, Canada. BACKGROUND: In 2009, Ontario implemented Canada's first regionalized bariatric surgical care system based on a COE. Because of this, a small number of COEs service a large population and geographic area. METHODS: This study identified all patients older than 18 years, who received bariatric surgery from April 2009 to March 2012...
February 2016: Annals of Surgery
https://www.readbyqxmd.com/read/26640505/peripheral-blood-t-cell-signatures-from-high-resolution-immune-phenotyping-of-%C3%AE-%C3%AE-and-%C3%AE-%C3%AE-t-cells-in-younger-and-older-subjects-in-the-berlin-aging-study-ii
#20
Kilian Wistuba-Hamprecht, Karin Haehnel, Nicole Janssen, Ilja Demuth, Graham Pawelec
BACKGROUND: Aging and latent infection with Cytomegalovirus (CMV) are thought to be major factors driving the immune system towards immunosenescence, primarily characterized by reduced amounts of naïve T-cells and increased memory T-cells, potentially associated with higher morbidity and mortality. The composition of both major compartments, γδ as well as αβ T-cells, is altered by age and CMV, but detailed knowledge of changes to the γδ subset is currently limited. RESULTS: Here, we have surveyed a population of 73 younger (23-35 years) and 144 older (62-85 years) individuals drawn from the Berlin Aging Study II, investigating the distribution of detailed differentiation phenotypes of both γδ and αβ T-cells...
2015: Immunity & Ageing: I & A
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