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Latest & greatest articles for elderly
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[Optical coherence tomography (OCT) for neovascular age-related macular degeneration as well as diabetic retinopathy with macular oedema] Optische kohärenztomografie bei neovaskulärer altersbedingter makuladegeneration sowie beim makulaödem im rahmen der diabetischen retinopathie: abschlussbericht; auftrag D15-01 [Optical coherence tomography (OCT) for neovascular age-related macular degeneration as well as diabetic retinopathy with macular oedema] Optische kohärenztomografie bei neovaskulärer (...) altersbedingter makuladegeneration sowie beim makulaödem im rahmen der diabetischen retinopathie: abschlussbericht; auftrag D15-01 [Optical coherence tomography (OCT) for neovascular age-related macular degeneration as well as diabetic retinopathy with macular oedema] Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made
Cancer risk and survival in path_MMR carriers by gene and gender up to 75 years of age: a report from the Prospective Lynch Syndrome Database Most patients with path_MMR gene variants (Lynch syndrome (LS)) now survive both their first and subsequent cancers, resulting in a growing number of older patients with LS for whom limited information exists with respect to cancer risk and survival.This observational, international, multicentre study aimed to determine prospectively observed incidences (...) % and 18%; and for brain tumours 1%, 5% and 1%, respectively. Ovarian cancer occurred mainly premenopausally. By contrast, upper gastrointestinal, urinary tract and prostate cancers occurred predominantly at olderages. Overall 5-year survival for prostate cancer was 100%, urinary bladder 93%, ureter 85%, duodenum 67%, stomach 61%, bile duct 29%, brain 22% and pancreas 0%. Path_PMS2 carriers had lower risk for cancer.Carriers of different path_MMR variants exhibit distinct patterns of cancer risk
Comparison of clinical probability-adjusted D-dimer and age-adjusted D-dimer interpretation to exclude venous thromboembolism Two new strategies for interpreting D-dimer results have been proposed: i) using a progressively higher D-dimer threshold with increasing age (age-adjusted strategy) and ii) using a D-dimer threshold in patients with low clinical probability that is twice the threshold used in patients with moderate clinical probability (clinical probability-adjusted strategy). Our (...) objective was to compare the diagnostic accuracy of age-adjusted and clinical probability-adjusted D-dimer interpretation in patients with a low or moderate clinical probability of venous thromboembolism (VTE). We performed a retrospective analysis of clinical data and blood samples from two prospective studies. We compared the negative predictive value (NPV) for VTE, and the proportion of patients with a negative D-dimer result, using two D-dimer interpretation strategies: the age-adjusted strategy
Perioperative Gabapentin Does Not Reduce Postoperative Delirium in Older Surgical Patients: A Randomized Clinical Trial Postoperative pain and opioid use are associated with postoperative delirium. We designed a single-center, randomized, placebo-controlled, parallel-arm, double-blinded trial to determine whether perioperative administration of gabapentin reduced postoperative delirium after noncardiac surgery.Patients were randomly assigned to receive placebo (N = 347) or gabapentin 900 mg (N (...) = 350) administered preoperatively and for the first 3 postoperative days. The primary outcome was postoperative delirium as measured by the Confusion Assessment Method. Secondary outcomes were postoperative pain, opioid use, and length of hospital stay.Data for 697 patients were included, with a mean ± SD age of 72 ± 6 yr. The overall incidence of postoperative delirium in any of the first 3 days was 22.4% (24.0% in the gabapentin and 20.8% in the placebo groups; the difference was 3.20%; 95% CI
Can Cut-Off-Values for Tumor Size or Patient Age in Breast Ultrasound Reduce Unnecessary Biopsies or is it all About Bi-rads?â€“ A Retrospective Analysis of 763 Biopsied T1-Sized Lesions To assess whether it is possible to establish a size cut-off-value for sonographically visible breast lesions in a screening situation, under which it is justifiable to obviate a biopsy and to evaluate the grayscale characteristics of the identified lesions.Images of sonographically visible and biopsied breast (...) lesions of 684 patients were retrospectively reviewed and assessed for the following parameters: size, shape, margin, lesion boundary, vascularity, patient's age, side of breast, histological result, and initial BI-RADS category. Statistical analyses (t-test for independent variables, ROC analyses, binary logistic regression models, cross-tabulations, positive/negative predictive values) were performed using IBM SPSS (Version 21.0).Of all 763 biopsied lesions, 223 (29.2%) showed a malignant histologic
Self-efficacy of foot care behaviour of elderly patients with diabetes Elderly patients with diabetes are at a high risk of contracting diabetic foot problems. Self-efficacy is essential to help improve foot care behaviour.To identify levels of self-efficacy and foot care behaviour and their relationship with demographic characteristics in elderly patients with diabetes.A cross-sectional study was conducted in two general hospitals in Malaysia from May to June 2015. Diabetes patients aged 60
of chemotherapeutic regimens.Given the high incidence of colorectal cancer and the median age of 68 years for patients at the time of diagnosis, health economic considerations should promote randomized controlled trials regarding the role of adjuvant chemotherapy in the elderly. (...) Effect of Adjuvant Chemotherapy on Elderly Colorectal Cancer Patients: Lack of Evidence Adjuvant chemotherapy has become the standard form of treatment for all patients with stage III colorectal cancer and is also recommended for patients with stage II disease and defined risk factors. However, clinical studies that evaluate the effect of adjuvant treatment regimens have a selection bias in favor of younger patients, so that even retrospective subgroup analyses cannot define the best
SMARCD1 regulates senescence-associated lipid accumulation in hepatocytes Previously, we have identified 16 senescence-associated genes by a subtractive proteomic analysis using presenescent and senescent human fibroblast cells, TIG-1. The aim of this study was to clarify the role of SMARCD1, one of the identified genes, also known as BAF60a, in hepatic senescence. SMARCD1 is a member of the SWI/SNF chromatin remodeling complex family, and regulates the transcription of target genes through (...) the alterations of chromatin structure. We demonstrated that the reduced expression of SMARCD1 triggers cellular senescence and induces the accumulation of lipids, suggesting that SMARCD1 acts as a mediator in these processes. Furthermore, palmitic acid treatment and high-fat diet led to a significant reduction of SMARCD1 expression, and consequently induced cellular senescence and lipid accumulation in HepG2 cells and mouse liver, respectively. The results obtained here suggest that dietary nutrient
Iomab-B for active, relapsed or refractory acute myeloid leukaemia in older patients (aged 55 years and older) Iomab-B for active, relapsed or refractory acute myeloid leukaemia in older patients (aged 55 years and older) | Innovation Observatory toggle menu Menu Search View All Filter by Speciality Filter by Year Filter by Category This search function provides links to outputs produced by NIHR Innovation Observatory. These are briefing notes or reports on new or repurposed technologies (...) . This search will not return all technologies currently in development as these outputs are produced as required for our stakeholders. > > > Iomab-B for active, relapsed or refractory acute myeloid leukaemia in older patients (aged 55 years and older) Iomab-B for active, relapsed or refractory acute myeloid leukaemia in older patients (aged 55 years and older) August 2017 Acute myeloid leukaemia (AML) is a type of cancer that causes the bone marrow to produce lots of immature white blood cells
Leukaemia (ALL) is a type of cancer affecting lymphocytes (a type of white blood cell), which results in overproduction of faulty lymphocytes. This means there are not enough healthy lymphocytes available to fight infection, increasing the risk of infections and bleeding. ALL most commonly occurs in children aged 2 to 5 years old. However it is considered a rare condition, affecting around 650 people per year in the UK. Some people will not respond to treatment (refractory) or some will respond (...) Axicabtagene ciloleucel IV for relapsed/refractory acute lymphoblastic leukaemia in children and adolecents (aged 2-21 years) – second line Axicabtagene ciloleucel IV for relapsed/refractory acute lymphoblastic leukaemia in children and adolecents (aged 2-21 years) – second line | Innovation Observatory toggle menu Menu Search View All Filter by Speciality Filter by Year Filter by Category This search function provides links to outputs produced by NIHR Innovation Observatory. These are briefing
Elderly peoplesâ€™ experiences of nursing homes in Bam city: A qualitative study With the increasing number of elderly, especially in recent decades, transfer to nursing homes and the number of centers has also increased but experiences and problems of elders in these centers is less considered. So, the goal of this study is to explore the Elderlypeoples' experiences of nursing homes.The current research was performed using a phenomenological approach in 2016. Participation in the study (...) is comprised of the elderly residents in a nursing home in Bam city who were selected based on an objective-oriented approach. The sampling was done until data saturation. Data collection methods were observation and an unstructured and in-depth interview. Data were analyzed using seven-stage Colaizzi process.In total, fifteen 68 - 82 years oldpeople participated in our study and 52 primary and conceptual codes that were eventually categorized in five main themes (sense of rejection, sense of daily
Challenges in Decision Making in Elderly Patients with Gastrointestinal Malignancies 29034257 2018 08 01 2297-4725 33 4 2017 Aug Visceral medicine Visc Med Challenges in Decision Making in Elderly Patients with Gastrointestinal Malignancies. 281-283 10.1159/000478806 Wedding Ulrich U Department of Internal Medicine II (Haematology, Oncology, Palliative Care), University Hospital Jena, Jena, Germany. Audisio Riccardo A RA Department of Surgery, University of Liverpool, St Helens Teaching (...) Hospital, St Helens, UK. Richter Konrad Klaus KK Department of Surgery, Southland Hospital, Invercargill, New Zealand. Dunedin Hospital and School of Medicine, Dunedin, New Zealand. Rostoft Siri S Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway. University of Oslo, Oslo, Norway. eng Journal Article 2017 08 22 Switzerland Visc Med 101681546 2297-4725 2017 10 17 6 0 2017 10 17 6 0 2017 10 17 6 1 ppublish 29034257 10.1159/000478806 vis-0033-0281 PMC5624260
[Usefulness of scoring risk for adverse outcomes in older patients with the Identification of Seniors at Risk scale and the Triage Risk Screening Tool: a meta-analysis]. A considerable proportion of the geriatric population experiences unfavorable outcomes of hospital emergency department care. An assessment of risk for adverse outcomes would facilitate making changes in clinical management by adjusting available resources to needs according to an individual patient's risk. Risk assessment (...) tools are available, but their prognostic precision varies. This systematic review sought to quantify the prognostic precision of 2 geriatric screening and risk assessment tools commonly used in emergency settings for patients at high risk of adverse outcomes (revisits, functional deterioration, readmissions, or death): the Identification of Seniors at Risk (ISAR) scale and the Triage Risk Screening Tool (TRST). We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials
Challenges in Decision Making in Elderly Patients with Gastrointestinal Malignancies 29034251 2019 01 16 2297-4725 33 4 2017 Aug Visceral medicine Visc Med Challenges in Decision Making in Elderly Patients with Gastrointestinal Malignancies. 244 10.1159/000480254 Wedding Ulrich U Department of Internal Medicine II (Haematology, Oncology, Palliative Care), University Hospital Jena, Jena, Germany. Richter Konrad Klaus KK Department of Surgery, Southland Hospital, Invercargill, New Zealand
A case of severe acute necrotizing pancreatitis in a 38-year-old woman postpartum due to a parathyroid adenoma Lethal necrotizing pancreatitis postpartum due to primary hyperparathyroidism caused by a parathyroid adenoma can be considered as a rarity. Due to the unspecific clinical signs and uncommonness this disorder may be overseen very easily. The reported case illustrates the very importance of early diagnosis of this endocrine disorder in pregnancy in order to avoid a lethal course.
Thyroid Cancer Incidences From Selected South America Population-Based Cancer Registries: An Age-Period-Cohort Study The incidence of thyroid cancer (TC) has increased substantially worldwide. However, there is a lack of knowledge about age-period-cohort (APC) effects on incidence rates in South American countries. This study describes the TC incidence trends and analyzes APC effects in Cali, Colombia; Costa Rica; Goiânia, Brazil; and Quito, Ecuador.Data were obtained from the Cancer Incidence (...) in Five Continents series, and the crude and age-standardized incidence rates were calculated. Trends were assessed using the estimated annual percentage change, and APC models were estimated using Poisson regression for individuals between age 20 and 79 years.An increasing trend in age-standardized incidence rates was observed among women from Goiânia (9.2%), Costa Rica (5.7%), Quito (4.0%), and Cali (3.4%), and in men from Goiânia (10.0%) and Costa Rica (3.4%). The APC modeling showed
Ulinastatin did not reduce mortality in elderly multiple organ failure patients: a retrospective observational study in a single center ICU Our aim was to evaluate the effect of ulinastatin on 28-day mortality in patients who developed multiple organ failure (MOF) related to their acute illness and were admitted to the intensive care unit (ICU).We carried out a retrospective observational study of MOF patients in a general ICU of a tertiary care hospital in Japan from January 2009 to December (...) 2012. The primary outcome was 28-day all-cause mortality. Secondary outcomes were ventilator-free days, ICU-free days, and vasopressor-free days at day 28. We investigated the association between ulinastatin treatment and outcomes using multivariable regression analysis.A total of 212 MOF patients were included, 79 (37%) of whom received ulinastatin. The median age was 70 years (interquartile range, 60-77) and median APACHE II score was 25 (interquartile range, 19-29). Overall 28-day mortality
Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21st standard: analysis of CHERG datasets. Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard.Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts (...) with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions
; and intervening factors were age, gender, education, ethnicity, hypertension, diabetes mellitus, hypothyroidism, renal failure, dementia, stroke, dyslipidaemia, depression, smoking, alcoholism, obesity, andropause, and cardiac arrhythmia. To analyse the association between vitamin D deficiency and risk of heart failure, we used the bivariate logistic analysis, followed by analysis through the multivariate logistic regression model. Of the 137 elderly, the study found the following: women (75.9%); overweight (...) Association between vitamin D deficiency and heart failure risk in the elderly The aim of this study was to evaluate the association between vitamin D deficiency and risk of heart failure in elderly patients of cardiology outpatient clinics.A cross-sectional study with an analytical approach was employed. Clinical data were collected from the elderly from August 2015 to February 2016. The dependent variable was the risk of heart failure; the independent variable was vitamin D deficiency
Erythropoiesis-stimulating agents in elderly patients with anemia: response and cardiovascular outcomes A specific cause of anemia cannot be identified in many elderly patients. Erythropoiesis-stimulating agents (ESAs) may play a role in treating these patients with anemia of unknown etiology (AUE). This study examines hemoglobin and cardiovascular outcomes among elderly anemic patients treated with ESAs. We conducted a retrospective cohort study that included all anemic patients older than age