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General Geriatrics

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14 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27542429/cancer-screening-in-older-adults
#1
REVIEW
Ashley H Snyder, Allison Magnuson, Amy M Westcott
When screening for cancer in older adults, it is important to consider the risks of screening, how long it takes to benefit from screening, and the patient's comorbidities and life expectancy. Delivering high-value care requires the consideration of evidence-based screening guidelines and careful selection of patients. This article considers the impact of cancer. It explores perspectives on the costs of common cancer screening tests, illustrates how using life expectancy can help clinicians determine who will benefit most from screening, and provides tools to help clinicians discuss with their older patients when it may be appropriate to stop screening for cancer...
September 2016: Medical Clinics of North America
https://www.readbyqxmd.com/read/27418577/management-of-adults-with-hospital-acquired-and-ventilator-associated-pneumonia-2016-clinical-practice-guidelines-by-the-infectious-diseases-society-of-america-and-the-american-thoracic-society
#2
Andre C Kalil, Mark L Metersky, Michael Klompas, John Muscedere, Daniel A Sweeney, Lucy B Palmer, Lena M Napolitano, Naomi P O'Grady, John G Bartlett, Jordi Carratalà, Ali A El Solh, Santiago Ewig, Paul D Fey, Thomas M File, Marcos I Restrepo, Jason A Roberts, Grant W Waterer, Peggy Cruse, Shandra L Knight, Jan L Brozek
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia...
September 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27445466/orthogeriatric-care-improving-patient-outcomes
#3
REVIEW
Francisco José Tarazona-Santabalbina, Ángel Belenguer-Varea, Eduardo Rovira, David Cuesta-Peredó
Hip fractures are a very serious socio-economic problem in western countries. Since the 1950s, orthogeriatric units have introduced improvements in the care of geriatric patients admitted to hospital because of hip fractures. During this period, these units have reduced mean hospital stays, number of complications, and both in-hospital mortality and mortality over the middle term after hospital discharge, along with improvements in the quality of care and a reduction in costs. Likewise, a recent clinical trial has reported greater functional gains among the affected patients...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27654002/2016-update-on-medical-overuse-a-systematic-review
#4
Daniel J Morgan, Sanket S Dhruva, Scott M Wright, Deborah Korenstein
Importance: Overuse of medical care is an increasingly recognized problem in clinical medicine. Objective: To identify and highlight original research articles published in 2015 that are most likely to reduce overuse of medical care, organized into 3 categories: overuse of testing, overtreatment, and questionable use of services. The articles were reviewed and interpreted for their importance to clinical medicine. Evidence Review: A structured review of English-language articles on PubMed published in 2015 and review of tables of contents of relevant journals to identify potential articles that related to medical overuse in adults...
September 19, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/26559744/effects-of-intensive-blood-pressure-lowering-on-cardiovascular-and-renal-outcomes-updated-systematic-review-and-meta-analysis
#5
REVIEW
Xinfang Xie, Emily Atkins, Jicheng Lv, Alexander Bennett, Bruce Neal, Toshiharu Ninomiya, Mark Woodward, Stephen MacMahon, Fiona Turnbull, Graham S Hillis, John Chalmers, Jonathan Mant, Abdul Salam, Kazem Rahimi, Vlado Perkovic, Anthony Rodgers
BACKGROUND: Recent hypertension guidelines have reversed previous recommendations for lower blood pressure targets in high-risk patients, such as those with cardiovascular disease, renal disease, or diabetes. This change represents uncertainty about whether more intensive blood pressure-lowering strategies are associated with greater reductions in risk of major cardiovascular and renal events. We aimed to assess the efficacy and safety of intensive blood pressure-lowering strategies. METHODS: For this updated systematic review and meta-analysis, we systematically searched MEDLINE, Embase, and the Cochrane Library for trials published between Jan 1, 1950, and Nov 3, 2015...
January 30, 2016: Lancet
https://www.readbyqxmd.com/read/27394021/urinary-tract-infections-in-the-older-adult
#6
REVIEW
Lindsay E Nicolle
Urinary infection is the most common bacterial infection in elderly populations. The high prevalence of asymptomatic bacteriuria in both men and women is benign and should not be treated. A diagnosis of symptomatic infection for elderly residents of long-term care facilities without catheters requires localizing genitourinary findings. Symptomatic urinary infection is overdiagnosed in elderly bacteriuric persons with nonlocalizing clinical presentations, with substantial inappropriate antimicrobial use. Residents with chronic indwelling catheters experience increased morbidity from urinary tract infection...
August 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27471129/a-chapter-a-day-association-of-book-reading-with-longevity
#7
Avni Bavishi, Martin D Slade, Becca R Levy
Although books can expose people to new people and places, whether books also have health benefits beyond other types of reading materials is not known. This study examined whether those who read books have a survival advantage over those who do not read books and over those who read other types of materials, and if so, whether cognition mediates this book reading effect. The cohort consisted of 3635 participants in the nationally representative Health and Retirement Study who provided information about their reading patterns at baseline...
September 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/27323265/the-abc-stroke-risk-score-was-superior-to-the-cha2ds2-vasc-score-for-predicting-stroke-in-atrial-fibrillation
#8
Graeme J Hankey
No abstract text is available yet for this article.
June 21, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27192671/danazol-treatment-for-telomere-diseases
#9
Danielle M Townsley, Bogdan Dumitriu, Delong Liu, Angélique Biancotto, Barbara Weinstein, Christina Chen, Nathan Hardy, Andrew D Mihalek, Shilpa Lingala, Yun Ju Kim, Jianhua Yao, Elizabeth Jones, Bernadette R Gochuico, Theo Heller, Colin O Wu, Rodrigo T Calado, Phillip Scheinberg, Neal S Young
BACKGROUND: Genetic defects in telomere maintenance and repair cause bone marrow failure, liver cirrhosis, and pulmonary fibrosis, and they increase susceptibility to cancer. Historically, androgens have been useful as treatment for marrow failure syndromes. In tissue culture and animal models, sex hormones regulate expression of the telomerase gene. METHODS: In a phase 1-2 prospective study involving patients with telomere diseases, we administered the synthetic sex hormone danazol orally at a dose of 800 mg per day for a total of 24 months...
May 19, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27037872/effects-of-exercise-on-cognition-the-finnish-alzheimer-disease-exercise-trial-a-randomized-controlled-trial
#10
RANDOMIZED CONTROLLED TRIAL
Hannareeta Öhman, Niina Savikko, Timo E Strandberg, Hannu Kautiainen, Minna M Raivio, Marja-Liisa Laakkonen, Reijo Tilvis, Kaisu H Pitkälä
OBJECTIVES: To examine whether a regular, long-term exercise program performed by individuals with Alzheimer's disease (AD) at home or as group-based exercise at an adult daycare center has beneficial effects on cognition; to examine secondary outcomes of a trial that has been published earlier. DESIGN: Randomized, controlled trial. SETTING: Community. PARTICIPANTS: Community-dwelling dyads (N = 210) of individuals with AD and their spousal caregivers randomized into three groups...
April 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27004732/antipsychotic-medication-for-prevention-and-treatment-of-delirium-in-hospitalized-adults-a-systematic-review-and-meta-analysis
#11
REVIEW
Karin J Neufeld, Jirong Yue, Thomas N Robinson, Sharon K Inouye, Dale M Needham
OBJECTIVES: To evaluate the effectiveness of antipsychotic medications in preventing and treating delirium. DESIGN: Systematic review and meta-analysis. SETTING: PubMed, EMBASE, CINAHL, and ClinicalTrials.gov databases were searched from January 1, 1988, to November 26, 2013. PARTICIPANTS: Adult surgical and medical inpatients. INTERVENTION: Antipsychotic administration for delirium prevention or treatment in randomized controlled trials or cohort studies...
April 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/26782850/effect-of-vascular-risk-factors-and-diseases-on-mortality-in-individuals-with-dementia-a-systematic-review-and-meta-analysis
#12
REVIEW
Irene E van de Vorst, Huiberdina L Koek, Rehana de Vries, Michiel L Bots, Johannes B Reitsma, Ilonca Vaartjes
OBJECTIVES: To assess the effect of cardiovascular diseases and risk factors on mortality in individuals with dementia. DESIGN: Systematic review and meta-analysis. English- and Dutch-language studies in PubMed, EMBASE, and PsycINFO databases were searched in April 2014 with hand-searching of in-text citations and no publication limitations. Inclusion criteria were original studies reporting on cardiovascular risk factors or diseases and their relationship with survival in individuals with dementia...
January 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/26566405/nutrition-for-sarcopenia
#13
REVIEW
Hidekatsu Yanai
Aging-related sarcopenia means that muscle mass, strength, and physical performance tend to decline with age, and malnutrition is associated with sarcopenia. Therefore, nutritional interventions may make an important contribution to prevent the development of sarcopenia. Here I reviewed published articles about the effects of nutritional factors on sarcopenia in elderly people. A growing body of evidence suggests that metabolic factors associated with obesity and diabetes induce the progression of sarcopenia...
December 2015: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/26408108/how-we-diagnose-and-treat-iron-deficiency-anemia
#14
REVIEW
Michael Auerbach, John W Adamson
It is estimated that one-third of the world's population is anemic, the majority being due to iron deficiency (ID). In adults, ID is associated with fatigue in the absence of anemia, restless legs syndrome, pica and, in neonates, delayed growth and development. In adolescents, ID is associated with decrements in learning and behavioral abnormalities. In the absence of a clear cause, search for a source of bleeding is indicated. No single test is diagnostic of ID unless the serum ferritin is low or the percent transferrin saturation is low with an elevated total iron binding capacity...
January 2016: American Journal of Hematology
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