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Geriatric prognosis

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https://www.readbyqxmd.com/read/28222369/what-can-gait-tell-us-about-dementia-review-of-epidemiological-and-neuropsychological-evidence
#1
REVIEW
Vyara Valkanova, Klaus P Ebmeier
BACKGROUND: Cognitive impairment and gait disorders in people over the age of 65 represent major public health issues because of their high frequency, their link to poor outcomes and high costs. Research has demonstrated that these two geriatric syndromes are closely related. METHODS AND RESULTS: We aim to review the evidence supporting the relationship between gait and cognitive impairment, particularly focusing on epidemiological and neuropsychological studies in patients with Mild cognitive impairment, Alzheimer's disease and Vascular dementia...
February 9, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28215925/-elderly-patients-and-intensive-care-systematic-review-and-geriatrician-s-point-of-view
#2
H Vallet, B Riou, J Boddaert
The global population is aging and intensive care unit admission rate of elderly patients is dramatically increasing. The objective of this review is to provide an overview of the literature about the management of elderly patients in intensive care unit and more specifically about epidemiology, admission criteria, mortality, functional prognosis and ethical aspects. We also discuss the data on cardiorespiratory arrest, shock, acute respiratory failure and delirium. The mortality rate of patients over 80 years old in intensive care unit can reach up to 70% at 1year, but is dependent on many factors, such as comorbidities or frailty...
February 16, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28215493/comparison-of-nutritional-risk-scores-for-predicting-mortality-in-japanese-chronic-hemodialysis-patients
#3
Hiroshi Takahashi, Keiko Inoue, Kazue Shimizu, Keiko Hiraga, Erika Takahashi, Kaori Otaki, Taeko Yoshikawa, Kumiko Furuta, Chika Tokunaga, Tomoyo Sakakibara, Yasuhiko Ito
OBJECTIVE: Protein energy wasting (PEW) is consistently associated with poor prognosis in hemodialysis (HD) patients. We compared the predictability of PEW as diagnosed by The International Society of Renal Nutrition and Metabolism criteria (PEWISRNM) and geriatric nutritional risk index (GNRI) for all-cause mortality in Japanese HD patients. As cut-off values for body mass index (BMI) for PEW have not been established in PEWISRNM for Asian populations, these were also investigated. DESIGN AND SUBJECTS: The nutritional status from 409 HD patients was evaluated according to ISRNM and GNRI criteria...
February 16, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28207554/isolated-cardiac-troponin-rise-does-not-modify-the-prognosis-in-elderly-patients-with-hip-fracture
#4
Hélène Vallet, Alice Breining, Yannick Le Manach, Judith Cohen-Bittan, Anthony Mézière, Mathieu Raux, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert
Perioperative myocardial infarction remains a life-threatening complication in noncardiac surgery and even an isolated troponin rise (ITR) is associated with significant mortality. Our aim was to assess the prognostic value of ITR in elderly patients with hip fracture.In this cohort study, all patients admitted between 2009 and 2013 in our dedicated geriatric postoperative unit after hip fracture surgery with a cardiac troponin I determination were included and divided into Control, ITR, and acute coronary syndrome (ACS) groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28164133/the-geriatric-nutritional-risk-index-independently-predicts-mortality-in-diabetic-foot-ulcers-patients-undergoing-amputations
#5
Yuanyuan Xie, Hailing Zhang, Tingting Ye, Shengjie Ge, Ruyi Zhuo, Hong Zhu
Objective. Patients with diabetic foot ulcers undergoing amputations have poor prognosis. Malnutrition usually occurs in this population and is associated with increased risk of mortality. The geriatric nutritional risk index (GNRI) is a widely used, simple, and well-established tool to assess nutritional risk. The purpose of this study was to assess the association between GNRI and all-cause mortality in diabetic foot ulcers patients undergoing minor or major amputations. Methods. This was a retrospective cohort study including 271 adult patients...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28162786/base-excess-a-useful-marker-in-the-prognosis-of-chest-trauma-in-the-geriatric-population
#6
Y Peñasco, A González-Castro, J C Rodríguez-Borregán, J Llorca
OBJECTIVE: To determine the usefulness of the determination of base excess in a cohort of elderly patients admitted to an intensive care unit (ICU) with a diagnosis of chest trauma. MATERIAL AND METHOD: Two hundred and forty-nine patients were included aged 65 years and over with a diagnosis of thoracic trauma who required admission to the ICU. We made a statistical analysis in order to determine the association of the first base excess levels with mortality during the unit stay...
February 2, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28150170/-duodenal-ulcers-gastric-ulcers-and-helicobacter-pylori
#7
Peter Dovjak
The mortality in elderly patients over the age of 80 years with peptic ulcers in the case of complications, such as bleeding and perforation is higher than in the general population. Duodenal ulcers are associated with Helicobacter pylori infections in 90% of cases and in 70% of gastric ulcers. The treatment of elderly patients is often difficult due to multimorbidity and polypharmacy and necessitates a geriatric approach. Ulcers are often caused by medication with nonsteroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid...
February 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28125958/long-term-mortality-in-older-patients-discharged-after-acute-decompensated-heart-failure-a-prospective-cohort-study
#8
Pierre-André Natella, Philippe Le Corvoisier, Elena Paillaud, Bertrand Renaud, Isabelle Mahé, Jean-François Bergmann, Hervé Perchet, Dominique Mottier, Olivier Montagne, Sylvie Bastuji-Garin
BACKGROUND: Data are available on short- and intermediate-term mortality rates after discharge for acutely decompensated heart failure (ADHF). However, few studies specifically addressed ADHF outcomes in patients aged 75 years or over, who contribute more than half of all ADHF admissions. Our objectives here were to estimate the long-term mortality of patients aged 75 years or over who were discharged after admission for ADHF and to identify factors, especially geriatric findings, independently associated with 2-year mortality...
January 26, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28116745/response-to-cabazitaxel-beyond-20-cycles-in-a-patient-with-penile-metastasis-of-prostate-cancer-a-case-report
#9
Elif Atag, Huseyin Salih Semiz, Seher Nazli Kazaz, Emine Burcin Tuna, Ozhan Ozdogan, Ozan Bozkurt, Omer Demir, Aziz Karaoglu
Penile metastases are extremely rare events and generally occurs at a late stage of primary disease. They mostlyoriginate from prostate and bladder in the genitourinary tract. Penile metastases have a dismal prognosis and verylow survival rates. We report a case of penile metastasis in 70-year-old geriatric male patient with prostatic adenocarcinomawho was treated with cabazitaxel chemotherapy beyond 20 cycles with a good response and acceptableminimal toxicity.
January 18, 2017: Urology Journal
https://www.readbyqxmd.com/read/28077811/nutrition-status-predicts-severity-of-vascular-calcification-in-non-dialyzed-chronic-kidney-disease
#10
Kazuhiro Harada, Susumu Suzuki, Hideki Ishii, Kenshi Hirayama, Toshijiro Aoki, Yohei Shibata, Yosuke Negishi, Takuya Sumi, Kazuhiro Kawashima, Ayako Kunimura, Yosuke Tatami, Toshiki Kawamiya, Dai Yamamoto, Ryota Morimoto, Yoshinari Yasuda, Toyoaki Murohara
BACKGROUND: Vascular calcification is a major complication in chronic kidney disease (CKD) that increases the risk of adverse clinical outcomes. Geriatric nutritional risk index (GNRI) is a simple nutritional assessment tool that predicts poor prognosis in elderly subjects. The purpose of the present study was to evaluate the correlation between GNRI and severity of vascular calcification in non-dialyzed CKD patients.Methods and Results:We enrolled 323 asymptomatic CKD patients. To evaluate abdominal aortic calcification (AAC), we used aortic calcification index (ACI) determined on non-contrast computed tomography...
January 12, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28074459/comparison-of-revised-trauma-score-injury-severity-score-and-trauma-and-injury-severity-score-for-mortality-prediction-in-elderly-trauma-patients
#11
Shahrokh Yousefzadeh-Chabok, Marieh Hosseinpour, Leila Kouchakinejad-Eramsadati, Fatemeh Ranjbar, Reza Malekpouri, Alireza Razzaghi, Zahra Mohtasham-Amiri
BACKGROUND: Trauma is the fifth leading cause of death in patients 65 years and older. This study is a comparison of results of Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) in prediction of mortality in cases of geriatric trauma. METHODS: This is a cross-sectional study of records of 352 elderly trauma patients who were admitted to Pour-Sina Hospital in Rasht between 2010 and 2011. Injury scoring systems were compared in terms of specificity, sensitivity, and cut-off points using receiver operating characteristic curve of patient prognosis...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28060439/factors-associated-with-unexpected-admissions-and-mortality-among-low-functioning-older-patients-receiving-home-medical-care
#12
Hiroyuki Umegaki, Atushi Asai, Shigeru Kanda, Keiko Maeda, Takuya Shimojima, Hideki Nomura, Masafumi Kuzuya
AIM: The need for and availability of home medical care for elderly patients with limitations in terms of access to medical facilities has been increasing. We investigated the association between low function, malnutrition, dementia and multicomorbidity with patient prognosis, focusing on unexpected hospital admissions and mortality in elderly non-cancer patients receiving home care. METHODS: The study included 124 Japanese patients receiving home medical care in the form of regular visits from doctors and nurses for physical and/or mental disability...
January 6, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28049616/three-decades-of-comprehensive-geriatric-assessment-evidence-coming-from-different-healthcare-settings-and-specific-clinical-conditions
#13
REVIEW
Alberto Pilotto, Alberto Cella, Andrea Pilotto, Julia Daragjati, Nicola Veronese, Clarissa Musacchio, Anna Maria Mello, Giancarlo Logroscino, Alessandro Padovani, Camilla Prete, Francesco Panza
Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults to develop a coordinated plan to maximize overall health with aging. Specific criteria used by CGA programs to evaluate patients include age, medical comorbidities, psychosocial problems, previous or predicted high healthcare utilization, change in living situation, and specific geriatric conditions. However, no universal criteria have been agreed upon to readily identify patients who are likely to benefit from CGA...
February 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28031705/earlier-nephrology-consultation-may-not-be-associated-with-improved-short-term-survival-of-acute-kidney-injury-in-very-elderly-men
#14
Qinglin Li, Meng Zhao, Jing Du, Xiaodan Wang
OBJECTIVES: A delayed nephrology consultation (NC) may be associated with a poor prognosis in acute kidney injury (AKI) patients. The aims of this study were to compare the clinical and laboratory characteristics of elderly AKI patients evaluated and not evaluated by nephrologists and to generate a hypothesis regarding the relationship between the timing of the NC and 90-day outcomes. METHODS: From 2007 to 2015, this study explored associations among the presence and timing of NC with the non-intensive care unit stay and 90-day mortality in elderly AKI patients at the Geriatric Department of the Chinese People's Liberation Army General Hospital...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28030446/cancer-related-cognitive-impairment-in-older-adults
#15
Andrew Edelstein, Denise Pergolizzi, Yesne Alici
PURPOSE OF REVIEW: Cancer, aging, and cognition form a complicated interface that can challenge patients, caretakers, and healthcare professionals. Although the typical aging process allows for compensatory mechanisms to help maintain daily functioning, cancer and cancer treatments can remove the fail-safes and exacerbate cognitive decline. As a result, older cancer patients can experience increased morbidity and mortality. The goal of this article is to provide additional assessment strategies, diagnostic considerations, and treatment options for providers taking care of this growing population...
March 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/27940954/frailty-and-cardiac-rehabilitation-a-call-to-action-from-the-eapc-cardiac-rehabilitation-section
#16
Carlo Vigorito, Ana Abreu, Marco Ambrosetti, Romualdo Belardinelli, Ugo Corrà, Margaret Cupples, Constantinos H Davos, Stefan Hoefer, Marie-Christine Iliou, Jean-Paul Schmid, Heinz Voeller, Patrick Doherty
Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation...
January 1, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27924216/atrial-fibrillation-management-in-older-heart-failure-patients-a-complex-clinical-problem
#17
REVIEW
Giovanni Pulignano, Donatella Del Sindaco, Maria Denitza Tinti, Stefano Tolone, Giovanni Minardi, Antonio Lax, Massimo Uguccioni
BACKGROUND: Atrial fibrillation (AF) and heart failure (HF), two problems of growing prevalence as a consequence of the ageing population, are associated with high morbidity, mortality, and healthcare costs. AF and HF also share common risk factors and pathophysiologic processes such as hypertension, diabetes mellitus, ischemic heart disease, and valvular heart disease often occur together. Although elderly patients with both HF and AF are affected by worse symptoms and poorer prognosis, there is a paucity of data on appropriate management of these patients...
January 2016: Heart International
https://www.readbyqxmd.com/read/27911302/association-between-cognitive-status-before-surgery-and-outcomes-in-elderly-patients-with-hip-fracture-in-a-dedicated-orthogeriatric-care-pathway
#18
Lorene Zerah, Judith Cohen-Bittan, Mathieu Raux, Anthony Meziere, Cendrine Tourette, Christian Neri, Marc Verny, Bruno Riou, Frederic Khiami, Jacques Boddaert
BACKGROUND: Dementia is associated with a worse prognosis of hip fracture, but the impact of a dedicated geriatric care pathway on the prognosis of these patients has not been evaluated. OBJECTIVE: According to the cognitive status before surgery, our main objective was to compare mortality rate at 6 months; secondary outcomes were to compare in-hospital complications, the risk of new institutionalization, and the ability to walk at 6 months. METHODS: Between 2009 and 2015, all patients (>70 years) admitted after hip fracture surgery into a dedicated unit of peri-operative geriatric care were included: patients with dementia (DP), without dementia (NDP), and with cognitive status not determined (CSND)...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27890486/towards-a-multidisciplinary-approach-to-understand-and-manage-obesity-and-related-diseases
#19
REVIEW
Stephan C Bischoff, Yves Boirie, Tommy Cederholm, Michael Chourdakis, Cristina Cuerda, Nathalie M Delzenne, Nicolaas E Deutz, Denis Fouque, Laurence Genton, Carmen Gil, Berthold Koletzko, Miguel Leon-Sanz, Raanan Shamir, Joelle Singer, Pierre Singer, Nanette Stroebele-Benschop, Anders Thorell, Arved Weimann, Rocco Barazzoni
Overnutrition and sedentary lifestyle result in overweight or obesity defined as abnormal or excessive fat accumulation that may impair health. According to the WHO, the worldwide prevalence of obesity nearly doubled between 1980 and 2008. In 2008, over 50% of both men and women in the WHO European Region were overweight, and approximately 23% of women and 20% of men were obese. Comprehensive diagnostic and therapeutic approaches should include nutritional treatment to favor the best metabolic and nutritional outcome, as well as to induce potential disease-specific benefits from selected nutritional regimens...
November 16, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27890293/avian-oncology-diseases-diagnostics-and-therapeutics
#20
REVIEW
Cecilia S Robat, Melanie Ammersbach, Christoph Mans
Companion birds are increasingly living longer due to improved husbandry, nutrition, and veterinary care. As a consequence, a growing number of geriatric disease conditions are diagnosed and managed by veterinarians. Awareness of bird owners of diagnostic and treatment options for neoplastic diseases in humans and domestic animals has led to increasing demand to provide advanced diagnostic and treatment modalities for companion birds diagnosed with neoplasia. Treatment remains challenging in many companion birds due to the lack of information regarding prognosis and efficacy of antineoplastic treatments in these species...
January 2017: Veterinary Clinics of North America. Exotic Animal Practice
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