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https://www.readbyqxmd.com/read/28441373/cost-effectiveness-analysis-of-interventions-to-reduce-risk-of-aspiration-in-elderly-cancer-survivors-residing-in-skilled-nursing-facilities
#1
S Mantravadi
BACKGROUND: Aspiration can occur in patients of any age group, but it can be prevented. The primary population at risk is made up of survivors of cancer because of their increased risk of mucositis, mucosal atrophy, and dysphagia associated with chemotherapy, radiotherapy, and the disease process itself. The rate of incidence of aspiration cannot be quantified, because minor cases of aspiration often go unreported. Sequelae ensuing from aspirations can include pneumonia, end-stage kidney disease, dialysis, and death...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28439956/biologic-treatments-for-elderly-patients-with-psoriasis
#2
Mami Momose, Akihiko Asahina, Mitsuha Hayashi, Koichi Yanaba, Yoshinori Umezawa, Hidemi Nakagawa
The number of elderly patients with psoriasis is increasing in Japan. However, biologic treatment is generally considered to be challenging in elderly patients, due to their increased risk of complications compared with younger patients. Our retrospective study aimed to evaluate the safety profile and efficacy of biologics in senior elderly patients (≥75 years old) with psoriasis. The study involved a cohort of 27 patients aged 75-88 years who were being treated with biologics over a period of more than 1 year...
April 25, 2017: Journal of Dermatology
https://www.readbyqxmd.com/read/28427747/percutaneous-endoscopic-gastrostomy-for-aspiration-pneumonia-a-10-year-single-center-experience
#3
Hiromi Tomioka, Shyuji Yamashita, Nobuaki Mamesaya, Masahiro Kaneko
BACKGROUND: The significance of percutaneous endoscopic gastrostomy (PEG) in patients with aspiration pneumonia is unknown. The purpose of this study was to evaluate the clinical characteristics and outcomes of aspiration pneumonia patients who underwent PEG. METHODS: A retrospective cohort study of consecutive patients hospitalized with pneumonia who underwent PEG from 2005 to 2014. RESULTS: Of 2281 cases of pneumonia, 92 patients with aspiration pneumonia underwent PEG during their hospital stay...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28419746/factors-for-postoperative-complications-following-pressure-ulcer-operation-stepwise-multiple-logistic-regression-analysis
#4
Hyun Ho Han, Jun Gul Ko, Jong Won Rhie
Patients with pressure ulcers are generally older, have a long hospital stay and often have a variety of comorbidities. The decision to perform surgery for pressure ulcer management can be difficult because of concerns about the risk of postoperative complications. The aim of this study was to analyse the relationship between comorbid conditions and surgical outcomes in order to guide patient selection for pressure ulcer surgery. In 57 patients, data on age, defect size, operating time, hospital stay, body mass index, surgical site, mobility state, cardiac ischaemic history, diabetes, renal failure, ventilator dependency, tracheostomy state, use of haemodilution therapy and cancer were evaluated using stepwise multiple logistic regression analysis to determine the relationships between variables...
April 17, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28416961/predictive-factors-of-methicillin-resistant-staphylococcus-aureus-infection-in-elderly-patients-with-community-onset-pneumonia
#5
Hyeyoung Jwa, Jong Wook Beom, Jong Hoo Lee
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a severe and life-threatening disease in patients with community-onset (CO) pneumonia. However, the current guidelines lack specificity for a screening test for MRSA infection. METHODS: This study was retrospectively conducted in elderly patients aged ≥65 years, who had contracted CO-pneumonia during hospitalization at the Jeju National University Hospital, between January 2012 and December 2014...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28413497/antibiotic-de-escalation-principle-in-elderly-patients-with-chronic-obstructive-pulmonary-disease-complicated-with-severe-pneumonia
#6
Baohong Xiao, Mei Wang, Xiaoling Hu, Jinfeng Li, Fangfang Wang, Jiaxing Sun
The present study investigated the clinical effect of antibiotic de-escalation therapy in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with severe pneumonia. According to the parity method of hospitalization number, 86 cases were selected and divided into the observation and control group with 43 cases each. Based on empirical antibiotic application, levofloxacin and cephalosporin antibiotics were used in the control group. After treatment for 3 days, the regimen was adjusted to antibiotics active against Gram-positive (G+) and Gram-negative (G-) bacteria such as the third or fourth generation cephalosporin antibiotics, combined with aminoglycoside, or macrolide antibiotics according to their effects...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28412164/diagnosis-and-management-of-oropharyngeal-dysphagia-among-older-persons-state-of-the-art
#7
REVIEW
Omar Ortega, Alberto Martín, Pere Clavé
Oropharyngeal dysphagia (OD) is a condition recognized by the World Health Organization and defined as the difficulty or inability to move a bolus safely and effectively from the oral cavity to the esophagus, and can include aspirations, choking, and residue. OD is pandemic among different phenotypes of older people, affecting between 27% and 91% of the population 70 years or older. Although OD can be diagnosed by well-defined clinical methods and complementary explorations, in the clinical setting OD is seldom systematically screened and treated, and awareness among the medical/geriatric community is scarce...
April 12, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28410813/post-hoc-analysis-of-a-randomized-controlled-trial-diabetes-mellitus-modifies-the-efficacy-of-the-13-valent-pneumococcal-conjugate-vaccine-in-elderly
#8
Susanne M Huijts, Cornelis H van Werkhoven, Marieke Bolkenbaas, Diederick E Grobbee, Marc J M Bonten
BACKGROUND: The 13-valent pneumococcal conjugate-vaccine (PCV13) was effective in preventing vaccine-type Community-Acquired Pneumonia (VT-CAP) and Invasive Pneumococcal Disease (VT-IPD) in elderly subjects, but vaccine efficacy (VE) in patients with comorbidities at time of vaccination is unknown. METHODS: This is a post hoc analysis of the CAPiTA study, a double blind, randomized controlled trial with 84,496 immunocompetent participants aged ⩾65years, receiving PCV13 or placebo vaccination...
April 12, 2017: Vaccine
https://www.readbyqxmd.com/read/28409118/isolated-streptococcus-intermedius-pulmonary-nodules
#9
Stephen Catalya, Bushra Komal, Sunil Tulpule, Nazar Raoof, Shuvendu Sen
Streptococcus intermedius, a member of the Streptococcal anginosus group of alpha-hemolytic streptococci, remains a notable infectious agent causing necrotizing pneumonia and abscesses. We report a case of a young male with pulmonary nodules found to have Streptococcus intermedius and no other underlying hepatic or dental history who was treated with ceftriaxone and avoided surgical intervention. A review of the literature reveals cases that are typically treated with a combined surgical and medical approach...
2017: IDCases
https://www.readbyqxmd.com/read/28408060/bacterial-epidemiology-and-antimicrobial-resistance-profiles-of-urinary-specimens-of-the-elderly
#10
F Gravey, G Loggia, A de La Blanchardière, V Cattoir
OBJECTIVE: Although urinary tract infections are the second leading cause of infections among patients aged above 65 years, data on bacterial epidemiology of urinary specimens in these patients is scarce. Our aim was to describe the main bacterial species found at significant levels in urine specimens of the elderly and to determine their antimicrobial resistance profiles. METHODS: From October 2012 to October 2015, all urinary specimens (catheter-related or not) received at the laboratory of microbiology of the university hospital of Caen (France) were retrospectively studied...
April 10, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28407209/neutrophil-to-lymphocyte-ratio-an-emerging-marker-predicting-prognosis-in-elderly-adults-with-community-acquired-pneumonia
#11
Emanuela Cataudella, Chiara M Giraffa, Salvatore Di Marca, Alfredo Pulvirenti, Salvatore Alaimo, Marcella Pisano, Valentina Terranova, Thea Corriere, Maria L Ronsisvalle, Rosario Di Quattro, Benedetta Stancanelli, Mauro Giordano, Carlo Vancheri, Lorenzo Malatino
OBJECTIVES: To explore the performance of the neutrophil-to-lymphocyte ratio (NLR), an index of systemic inflammation that predicts prognosis of several diseases, in a cohort of elderly adults with community-acquired pneumonia (CAP). DESIGN: Prospective clinical study from January 2014 to July 2016. SETTING: Unit of Internal Medicine, University of Catania, Catania, Italy. PARTICIPANTS: Elderly adults admitted for CAP (N = 195)...
April 13, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28406337/inhaled-corticosteroid-use-in-chronic-obstructive-pulmonary-disease-and-risk-of-pneumonia-a-nested-case-control-population-based-study-in-lazio-italy-the-outpul-study
#12
Silvia Cascini, Ursula Kirchmayer, Valeria Belleudi, Lisa Bauleo, Riccardo Pistelli, Mirko Di Martino, Giulio Formoso, Marina Davoli, Nera Agabiti
Inhaled corticosteroid (ICS) use in chronic obstructive pulmonary disease (COPD) patients is associated with a reduction of exacerbations and a potential risk of pneumonia. The objective was to determine if ICS use, with or without long-acting β2-agonist, increases pneumonia risk in COPD patients. A cohort study was performed using linked hospital and drug prescription databases in the Lazio region. Patients (45+) discharged with COPD in 2006-2009 were enrolled and followed from cohort entry until first admission for pneumonia, death or study end, 31 December, 2012...
April 13, 2017: COPD
https://www.readbyqxmd.com/read/28397100/the-burden-and-epidemiology-of-community-acquired-central-nervous-system-infections-a-multinational-study
#13
H Erdem, A Inan, E Guven, S Hargreaves, L Larsen, G Shehata, E Pernicova, E Khan, L Bastakova, S Namani, A Harxhi, T Roganovic, B Lakatos, S Uysal, O R Sipahi, A Crisan, E Miftode, R Stebel, B Jegorovic, Z Fehér, C Jekkel, N Pandak, A Moravveji, H Yilmaz, A Khalifa, U Musabak, S Yilmaz, A Jouhar, N Oztoprak, X Argemi, M Baldeyrou, G Bellaud, R V Moroti, R Hasbun, L Salazar, R Tekin, A Canestri, L Čalkić, L Praticò, F Yilmaz-Karadag, L Santos, A Pinto, F Kaptan, P Bossi, J Aron, A Duissenova, G Shopayeva, B Utaganov, S Grgic, G Ersoz, A K L Wu, K C Lung, A Bruzsa, L B Radic, H Kahraman, M Momen-Heravi, S Kulzhanova, F Rigo, M Konkayeva, Z Smagulova, T Tang, P Chan, S Ahmetagic, H Porobic-Jahic, F Moradi, S Kaya, Y Cag, A Bohr, C Artuk, I Celik, M Amsilli, H C Gul, A Cascio, M Lanzafame, M Nassar
Risk assessment of central nervous system (CNS) infection patients is of key importance in predicting likely pathogens. However, data are lacking on the epidemiology globally. We performed a multicenter study to understand the burden of community-acquired CNS (CA-CNS) infections between 2012 and 2014. A total of 2583 patients with CA-CNS infections were included from 37 referral centers in 20 countries. Of these, 477 (18.5%) patients survived with sequelae and 227 (8.8%) died, and 1879 (72.7%) patients were discharged with complete cure...
April 10, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28395288/safety-and-effectiveness-of-bis-chloroethylnitrosourea-wafer-chemotherapy-in-elderly-patients-with-recurrent-glioblastoma
#14
Johann Klein, Tareq A Juratli, Yordan Radev, Dirk Daubner, Silke Soucek, Gabriele Schackert, Dietmar Krex
OBJECTIVE: To assess the safety and effectiveness of bis-chloroethylnitrosourea (BCNU) wafers in elderly patients with recurrent glioblastoma (GBM). METHODS: Patients with recurrent GBM operated on between 2007 and 2014 were divided into 3 groups: >65 years with BCNU wafer implantation, >65 years without BCNU wafer implantation, and ≤65 years with BCNU wafer implantation. We compared survival and complications. RESULTS: A total of 79 patients were identified: 24 in the older BCNU group (median age 68...
April 11, 2017: Oncology
https://www.readbyqxmd.com/read/28391586/swallowing-impairment-is-a-significant-factor-for-predicting-life-prognosis-of-elderly-at-the-end-of-life
#15
Koji Naruishi, Yasufumi Nishikawa
BACKGROUND: In end-of-life care of elderly, the decision of care plan including gastrostomy is difficult frequently because of insufficient knowledge relating the life prognosis of elderly. It is important the families to decide correctly the life prognosis of elderly with geriatric diseases. Our purpose is to examine the significant factors for predicting life prognosis of elderly in end-of-life care. METHODS: A total of 320 elderly patients was enrolled (male/female 151/169; averaged age: male 84...
April 8, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28391291/rejuvenation-of-mucosal-immunosenescence-by-adipose-tissue-derived-mesenchymal-stem-cells
#16
Akitoshi Tsuruhara, Kazuyoshi Aso, Daisuke Tokuhara, Junichiro Ohori, Masaki Kawabata, Yuichi Kurono, Jerry R McGhee, Kohtaro Fujihashi
Age-associated alterations in the mucosal immune system are generally termed mucosal immunosenescence. The major change seen in the aged mucosa is a failure to elicit an antigen-specific secretory IgA (SIgA) antibody response, which is a central player for host defense from various pathogens at mucosal surfaces. In this regard, it would be a first priority to compensate for mucosal dysregulation in the elderly in order to maintain their health in aging. We have successfully established antigen-specific SIgA antibody responses in aged (2 years old) mice, which provide protective immunity from Streptococcus pneumoniae and influenza virus infections, by using a new adjuvant system consisting of a plasmid encoding Flt3 ligand (pFL) and CpG ODN...
January 1, 2017: International Immunology
https://www.readbyqxmd.com/read/28389165/cytomegalovirus-retinitis-followed-by-immune-recovery-uveitis-in-an-elderly-patient-with-rheumatoid-arthritis-undergoing-administration-of-methotrexate-and-tofacitinib-combination-therapy
#17
Kunio Yanagisawa, Yoshiyuki Ogawa, Mayumi Hosogai, Daisuke Todokoro, Takeki Mitsui, Akihiko Yokohama, Shoji Kishi, Hiroshi Handa
Cytomegalovirus (CMV) retinitis is an opportunistic ocular infection most commonly observed in patients infected with human immunodeficiency virus (HIV). We present a rare case of CMV retinitis that developed in a non-HIV patient with rheumatoid arthritis (RA). Over the preceding 5 months, a family doctor had been treating the 78-year-old male patient with a combination therapy of methotrexate (MTX) and tofacitinib (TOF). CMV retinitis occurred when the patient's CD4+ T cells were low (196 cells/μl), and preceded the onset of Pneumocystis pneumonia...
April 4, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28384882/polymyxin-b-induced-diffuse-cutaneous-hyperpigmentation
#18
Sandeep Lahiry, Shouvik Choudhury, Ayan Mukherjee, Prajesh Kiran Bhunya, Moumita Bala
Polymyxin B is a polypeptide-antibiotic, primarily used for resistant Gram-negative infections, first obtained from bacterium Bacillus polymyxa in the late 1940s. Antibiotic spectrum are restricted to mainly gram negative bacterias like Enterobacter, E. coli, Klebsiella, Salmonella, Pasteurella, Bordetella, Shigella; and particularly organisms like Pseudomonas aeruginosa and Acinetobacter baumannii, which are extremely potent to acquire antibiotic resistance. Side effects include neurotoxicity and acute renal tubular necrosis...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28382266/impact-of-lifestyle-diseases-on-postoperative-complications-and-survival-in-elderly-patients-with-stage-i-non-small-cell-lung-cancer
#19
Sang Seok Jeong, Pil Jo Choi, Jung Hoon Yi, Sung Sil Yoon
BACKGROUND: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. METHODS: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied...
April 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28380279/causes-and-consequences-of-the-leishmania-infantum-burden-in-patients-with-kala-azar-ndash-a-study-of-625-patients
#20
Danielle A Zacarias, Nuno Rolão, Flaviane A de Pinho, Ingridi Sene, Jailthon C Silva, Teresinha C Pereira, Dorcas L Costa, Carlos H N Costa
BACKGROUND: An infected host's Leishmania infantum load in blood is considered to be an estimate of his or her total parasite burden. Therefore, the measurement of blood parasite burden is important in the identification of factors involved in parasite control. METHODS: Quantitative polymerase chain reaction was performed on blood samples from 625 patients with kala-azar consecutively admitted to a reference hospital in Teresina, Brazil. Primers were used to amplify a segment of kDNA using the TaqMan system...
April 5, 2017: Tropical Medicine & International Health: TM & IH
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