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geriatric urology

Philip Cornford, Joaquim Bellmunt, Michel Bolla, Erik Briers, Maria De Santis, Tobias Gross, Ann M Henry, Steven Joniau, Thomas B Lam, Malcolm D Mason, Henk G van der Poel, Theo H van der Kwast, Olivier Rouvière, Thomas Wiegel, Nicolas Mottet
OBJECTIVE: To present a summary of the 2016 version of the European Association of Urology (EAU) - European Society for Radiotherapy & Oncology (ESTRO) - International Society of Geriatric Oncology (SIOG) Guidelines on the treatment of relapsing, metastatic, and castration-resistant prostate cancer (CRPC). EVIDENCE ACQUISITION: The working panel performed a literature review of the new data (2013-2015). The guidelines were updated, and the levels of evidence and/or grades of recommendation were added based on a systematic review of the literature...
August 31, 2016: European Urology
Nicolas Mottet, Joaquim Bellmunt, Michel Bolla, Erik Briers, Marcus G Cumberbatch, Maria De Santis, Nicola Fossati, Tobias Gross, Ann M Henry, Steven Joniau, Thomas B Lam, Malcolm D Mason, Vsevolod B Matveev, Paul C Moldovan, Roderick C N van den Bergh, Thomas Van den Broeck, Henk G van der Poel, Theo H van der Kwast, Olivier Rouvière, Ivo G Schoots, Thomas Wiegel, Philip Cornford
OBJECTIVE: To present a summary of the 2016 version of the European Association of Urology (EAU) - European Society for Radiotherapy & Oncology (ESTRO) - International Society of Geriatric Oncology (SIOG) Guidelines on screening, diagnosis, and local treatment with curative intent of clinically localised prostate cancer (PCa). EVIDENCE ACQUISITION: The working panel performed a literature review of the new data (2013-2015). The guidelines were updated and the levels of evidence and/or grades of recommendation were added based on a systematic review of the evidence...
August 25, 2016: European Urology
Aurélie Van Lancker, Dimitri Beeckman, Sofie Verhaeghe, Nele Van Den Noortgate, Ann Van Hecke
BACKGROUND: Accurate detection of symptoms is essential in palliative care. Identification of clustering of symptom is valuable to develop target interventions. This area is largely understudied in older palliative cancer patients. OBJECTIVES: To identify symptom clustering in older palliative cancer patients, and patient groups based on the clustering of symptoms, and to evaluate the difference in functional dependence and experiencing life as not meaningful between the identified patient groups...
September 2016: International Journal of Nursing Studies
Philip Braude, Anna Goodman, Tania Elias, Gordana Babic-Illman, Ben Challacombe, Danielle Harari, Jugdeep K Dhesi
OBJECTIVE: To assess the impact of introducing and embedding a structured geriatric liaison service, POPS-Urology, using comprehensive geriatric assessment methodology, on an inpatient urology ward. PATIENTS AND METHODS: A phased quality improvement project was undertaken using stepwise interventions. Phase 1 - A before-and-after study with initiation of a daily board round, weekly multidisciplinary meeting, and targeted geriatrician-led ward rounds for elective and emergency urology patients ≥65 years admitted over two one-month periods...
May 11, 2016: BJU International
F Hanke, M Plum, A Wiedemann
In Germany, too, adverse drug events (ADEs) have been identified as a central problem in the care of geriatric patients. Especially in elderly patients with multimorbidity and increasing frailty, ADEs are among the most frequent and cost-intensive causes of illness in healthcare. In most cases, they are due to drug-related diseases, which necessitate enhanced risk awareness and improved cooperation between physicians, medical specialists, geriatric nurses and pharmacists. In this context, the use of urologic medication for geriatric patients requires particular attention by the consultant...
February 2016: Aktuelle Urologie
Tomas L Griebling
No abstract text is available yet for this article.
March 2016: Current Opinion in Urology
Bernhard Grubmueller, Christian Seitz, Shahrokh F Shariat
PURPOSE OF REVIEW: Bladder cancer is an age-related cancer and because of aging population, an increase of patients with muscle-invasive bladder cancer (MIBC) seems inevitable. Decisions regarding the treatment of geriatric patients with MIBC are complex and require a multidisciplinary approach. RECENT FINDINGS: In addition to a specific urological oncology evaluation, a general geriatric evaluation is of great importance for all geriatric patients with MIBC. Standard of care in appropriate geriatric MIBC patients is radical cystectomy with urinary diversion and neoadjuvant platinum-based combination chemotherapy...
March 2016: Current Opinion in Urology
Anne M Suskind, J Quentin Clemens
PURPOSE OF REVIEW: The US healthcare system is undergoing fundamental changes in an effort to improve access to care, curtail healthcare spending, and improve quality of care. These efforts largely focused on Medicare, and therefore, will have a fundamental impact on the care of geriatric patients. This article reviews contemporary health policy issues, with a focus on how these issues may impact the care of geriatric urology patients. RECENT FINDINGS: The Affordable Care Act has broadened the scope of Medicare coverage...
March 2016: Current Opinion in Urology
S Pridgeon, E Nagarajan, G Ellis, J S Green
INTRODUCTION: The super-elderly population is a small but expanding group of patients who will pose a significant challenge to future healthcare resources. A snapshot audit was completed of all emergency and elective urological nonagenarian activity in a UK general hospital, including surgical outcomes in this group of patients. METHODS: Prospective and retrospective databases and clinical records were examined to identify all patients aged 90-99 years who had patient episodes between January 2006 and August 2012...
March 2016: Annals of the Royal College of Surgeons of England
I Füsgen, A Wiedemann
Chronic constipation, faecal and urinary incontinence are a geriatric syndrome. Chronic constipation is particularly important for the field of urology as it may be considered to trigger urological incontinence problems. Both chronic constipation and urinary incontinence are age-dependent symptoms, which are associated with a significant impact on quality of life. Chronic constipation must be taken into consideration during the diagnostic work-up and treatment of urinary incontinence.
February 2016: Aktuelle Urologie
Aurore Goineau, Bénédicte d'Aillières, Laure de Decker, Stéphane Supiot
Despite current advancements in the field, management of older prostate cancer patients still remains a big challenge for Geriatric Oncology. The International Society of Geriatric Oncology (ISGO) has recently updated its recommendations in this area, and these have been widely adopted, notably by the European Association of Urology. This article outlines the principles that should be observed in the management of elderly patients who have recently undergone prostatectomy for malignancy or with a biochemical relapse following prostatectomy...
2015: Frontiers in Oncology
Tomas Lindor Griebling
No abstract text is available yet for this article.
November 2015: Clinics in Geriatric Medicine
Bo Zhao, Petros D Grivas
Current data on systemic therapy in geriatric populations with genitourinary malignancies are largely derived from retrospective analyses of prospectively conducted trials or retrospective reviews. Although extrapolation of these data to real-world patients should be cautious, patients aged 65 years or older with good functional status and minimal comorbidities seem to enjoy similar survival benefit from therapy as their younger counterparts. Chronologic age alone should generally not be used to guide management decisions...
November 2015: Clinics in Geriatric Medicine
Nicole T Townsend, Thomas N Robinson
Almost two-thirds of urology operations are performed in patients 65 years and older. Older adults are at higher risk for complications and mortality compared with their younger counterparts. There are 2 primary methods to quantify surgical risk in these patients, frailty measurement and organ/comorbidity-based surgical risk calculators. A frailty assessment can be used to independently forecast the risk of postoperative complications. A paradigm shift in the preoperative assessment of the geriatric patient has occurred, which emphasizes the evaluation of frailty over more traditional surgical risk assessment, which uses comorbidities and single end-organ dysfunction to define risk...
November 2015: Clinics in Geriatric Medicine
Phongthara Vichitvejpaisal, Benjamas Preechakoon, Wannipa Supaprom, Sasitorn Sriputtaruk, Saichol Rodpaewpaln, Rattanapom Saen-Ubol, Kitiya Vessuwan
OBJECTIVE: Study the prevalence of cognitive impairment using the Montreal Cognitive Assessment (MoCA), its relationship to physiologic age-related change, and the preoperative drugs used in geriatric patients. MATERIAL AND METHOD: At the preoperative visit, the co-researchers invited 322 general/vascular patients (190 male, 132 female) and 260 urological patients (220 male, 40 female) who met the inclusion criteria and were scheduled for elective surgery to join the study...
August 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Leanne Schimke, Jill Schinike
Falls are a leading cause of morbidity and mortality in the elderly. In prospective studies, lower urinary tract symptoms (LUTS) have been shown to be an independent risk factor for falls. Alpha-blockers, frequently used to treat LUTS and benign prostatic hyperplasia, can increase the risk of falls in the elderly due to their class effect of orthostatic hypotension. In the urology setting, risk factors for falls may be addressed through evaluation and counseling, and by careful selection and monitoring of medications for LUTS...
September 2014: Urologic Nursing
Benedict F DiGiovanni, Leigh T Sundem, Richard D Southgate, David R Lambert
BACKGROUND: Musculoskeletal (MSK) conditions are common, and their burden on the healthcare system is increasing as the general population ages. It is essential that medical students be well prepared to evaluate and treat MSK disorders in a confident manner as they enter the workforce. Recent studies and the American Association of Medical Colleges have raised concern that medical schools may not give sufficient instruction on this topic. Other authors have shown that preclinical instruction has increased over the past decade; however, it is unclear if required clinical instruction also has followed that trend...
April 2016: Clinical Orthopaedics and related Research
Ginah Nightingale, Emily Hajjar, Krystal Guo, Stephanie Komura, Eric Urnoski, Jocelyn Sendecki, Kristine Swartz, Andrew Chapman
OBJECTIVES: The prevalence of complementary and alternative medication (CAM) use in senior adult oncology (SAO) patients is widely variable and little is known about whether polypharmacy (PP) and potentially inappropriate medication (PIM) use influences CAM use given the increased number of comorbidities and polypharmacy. One approach to optimize medication management is through utilization of pharmacists as part of a team-based, healthcare model. MATERIALS AND METHODS: Prevalence of CAM and factors influencing CAM use was examined in a secondary analysis of 248 patients who received an initial comprehensive geriatric oncology assessment between January 2011 and June 2013...
September 2015: Journal of Geriatric Oncology
A Wiedemann, R Maykan, J Pennekamp, H Heppner
OBJECTIVE: Detection of changes in cognition after transurethral resection (TURP) or 180-Watt green-light XPS laser treatment (GLL) of the prostate is required by the German "Krankenhausbedarfsplan" which demands an interdisciplinary dialogue including special aspects of the operating discipline. This has as yet not been investigated in Germany or in Europe. METHODS: Assessments of the cognitive capacity were made by application of the "Mini Mental State Examination" and the "Uhrentest" preoperatively and on postoperative day 2 in addition to documentation of clinical parameters such as patient age, prostate size, duration of surgery, comorbidities, co-medication, changes in haemoglobin and sodium...
February 2016: Aktuelle Urologie
Angela Testa
This article aims to assist urologic nurses in the assessment and management of adults with urinary incontinence, with special consideration given to the geriatric patient. Additionally, discussion will include classifications of the disorder, risk factors, and applicable age-related impacts.
March 2015: Urologic Nursing
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