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Latest & greatest articles for elderly
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Intraoperative Infusion of Dexmedetomidine for Prevention of Postoperative Delirium and Cognitive Dysfunction in Elderly Patients Undergoing Major Elective Noncardiac Surgery: A Randomized Clinical Trial Postoperative delirium occurs in 10% to 60% of elderly patients having major surgery and is associated with longer hospital stays, increased hospital costs, and 1-year mortality. Emerging literature suggests that dexmedetomidine sedation in critical care units is associated with reduced (...) ) and secondarily for postoperative cognitive decline. Participants were elderly (>68 years) patients undergoing major elective noncardiac surgery. The study dates were February 2008 to May 2014.Dexmedetomidine infusion (0.5 µg/kg/h) during surgery and up to 2 hours in the recovery room.The primary hypothesis tested was that intraoperative dexmedetomidine administration would reduce postoperative delirium. Secondarily, the study examined the correlation between dexmedetomidine use and postoperative cognitive
Parecoxib Supplementation to Morphine Analgesia Decreases Incidence of Delirium in Elderly Patients After Hip or Knee Replacement Surgery: A Randomized Controlled Trial Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery.In a randomized, double-blind, 2-center trial (...) , patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline). All patients received combined spinal-epidural anesthesia during surgery and IV morphine for postoperative analgesia. The primary outcome was the incidence of delirium within 5 days after surgery.Between January 2011 and May 2013, 620 patients were enrolled and were
Effect of a Modified Hospital Elder Life Program on Delirium and Length of Hospital Stay in Patients Undergoing Abdominal Surgery: A Cluster Randomized Clinical Trial Older patients undergoing abdominal surgery commonly experience preventable delirium, which extends their hospital length of stay (LOS).To examine whether a modified Hospital Elder Life Program (mHELP) reduces incident delirium and LOS in older patients undergoing abdominal surgery.This cluster randomized clinical trial of 577 (...) eligible patients enrolled 377 older patients (≥65 years of age) undergoing gastrectomy, pancreaticoduodenectomy, and colectomy at a 2000-bed urban medical center in Taipei, Taiwan, from August 1, 2009, through October 31, 2012. Consecutive older patients scheduled for elective abdominal surgery with expected LOS longer than 6 days were enrolled, with a recruitment rate of 65.3%. Participants were cluster randomized by room to receive the mHELP or usual care.The intervention (implemented by an mHELP
Minimal invasive percutaneous plate osteosynthesis (MIPPO) through deltoid-pectoralis approach for the treatment of elderly proximal humeral fractures Current treatments for proximal humeral fractures include conservative treatment, conventional open reduction internal fixation (ORIF) and MIPPO through deltoid-splitting approach. The aim of this study was to evaluate the clinical outcome of MIPPO versus ORIF via the deltoid-pectoralis approach in elderly patients with proximal humeral (...) that MIPPO through the deltoid-pectoralis approach is an effective alternative for the treatment of proximal humeral fractures in elderly patients.The trial registration number (TRN): ChiCTR-INR-17011098 (retrospectively registered at 2017-04-09).
coverage policies of bariatric surgery in patients under 21. Overweight and obesity are among the main death risk and disease burden factors worldwide. In Argentina, according to the 2012 Global School-Based Student Health Survey, 28.5% and 5.9% of adolescents 13-15 years old have overweight and obesity, respectively. In our country, since 2009, our Mandatory Medical Plan covers surgical treatment for obesity starting at the age of 21. It is estimated that bariatric surgery might have a role (...) Bariatric surgery to treat obesity in individuals under 21 years old Bariatric surgery to treat obesity in individuals under 21 years old Bariatric surgery to treat obesity in individuals under 21 years old Rodríguez B, Augustovski F, Pichon-Riviere A, García Martí S, Alcaraz A, Bardach A, Ciapponi A, López A, Rey-Ares L 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
[Vandetanib (medullary thyroid carcinoma in children and adolescents from the age of 5) - Benefit assessment according to õ 35a Social Code Book V] Vandetanib (Schilddrüsenkarzinom): nutzenbewertung gemäß § 35a SGB V; dossierbewertung; auftrag A17-01 [Vandetanib (medullary thyroid carcinoma in children and adolescents from the age of 5) – benefit assessment according to § 35a Social Code Book V] Vandetanib (Schilddrüsenkarzinom): nutzenbewertung gemäß § 35a SGB V; dossierbewertung; auftrag A17 (...) -01 [Vandetanib (medullary thyroid carcinoma in children and adolescents from the age of 5) – benefit assessment according to § 35a Social Code Book V] 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 for the HTA database. Citation Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. Vandetanib
trial compared lenalidomide as maintenance therapy with placebo in elderly patients with DLBCL who achieved a complete response (CR) or partial response (PR) to R-CHOP induction. Methods Patients with previously untreated DLBCL or other aggressive B-cell lymphoma were 60 to 80 years old, had CR or PR after six or eight cycles of R-CHOP, and were randomly assigned to lenalidomide maintenance 25 mg/d or placebo for 21 days of every 28-day cycle for 24 months. The primary end point was progression-free (...) Lenalidomide Maintenance Compared With Placebo in Responding Elderly Patients With Diffuse Large B-Cell Lymphoma Treated With First-Line Rituximab Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone Purpose The standard treatment of patients with diffuse large B-cell lymphoma (DLBCL) is rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Lenalidomide, an immunomodulatory agent, has shown activity in DLBCL. This randomized phase III
Predictive Value of Age-Adjusted Charlson Co-Morbidity Index for 1-, 3-, and 5-Year Mortality in Patients Requiring Transcatheter Mitral Valve Repair Co-morbidities increase markedly with aging, and they often negatively affect its prognosis. Although mortality with transcatheter mitral valve repair (TMVr) is significantly less than for open mitral valve surgery in patients at high surgical risk, it remains a concern to identify which patients will benefit from this treatment. Some prognostic (...) metrics have been reported to guide better patient selection; however, universal risk stratification measures have not been established. This study aimed to determine if age-adjusted Charlson co-morbidity index (CCI) could predict mortality in patients who underwent TMVr and to assess its discriminatory performance in long-term outcomes. We retrospectively reviewed 222 patients who underwent TMVr, and 7 who died in hospital was excluded. Cox proportional hazard models were applied to select
[Bariatric surgery as treatment for obesity in subjects over 65 years old] [Bariatric surgery as treatment for obesity in subjects over 65 years old] [Bariatric surgery as treatment for obesity in subjects over 65 years old] Rodríguez B, Augustovski F, Pichon-Riviere A, García Martí S, Alcaraz A, Bardach A, Ciapponi A, López A, Rey-Ares L 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 for the HTA database. Citation Rodríguez B, Augustovski F, Pichon-Riviere A, García Martí S, Alcaraz A, Bardach A, Ciapponi A, López A, Rey-Ares L. [Bariatric surgery as treatment for obesity in subjects over 65 years old] Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). Documentos de Evaluación de Tecnologías Sanitarias, Informe de Respuesta Rapida No 508. 2017 Authors' conclusions Low-quality evidence shows that bariatric surgery might be considered
IPH submission to recent Citizens? Assembly meeting: ?How we respond to the Challenges and Opportunities of an Ageing Population? IPH submission to recent Citizens’ Assembly meeting: ‘How we respond to the Challenges and Opportunities of an Ageing Population’ | Institute of Public Health in Ireland Corporate menu Search Main navigation Breadcrumb IPH submission to recent Citizens’ Assembly meeting: ‘How we respond to the Challenges and Opportunities of an Ageing Population’ Division IPH Twitter
Age, PaO2/FIO2, and Plateau Pressure Score: A Proposal for a Simple Outcome Score in Patients With the Acute Respiratory Distress Syndrome PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
The Association between Activity Limitation Stages and Admission to Facilities Providing Long-term Care among Older Medicare Beneficiaries This study aimed to examine whether activity limitation stages are associated with admission to facilities providing long-term care (LTC).Cohort study using Medicare Current Beneficiary Survey data from the 2005-2009 entry panels. A total of 14,580 community-dwelling Medicare beneficiaries 65 years or older were included. Proportional subhazard models (...) ), and ADL stage IV (complete limitation), respectively. Compared to instrumental ADL (IADL) stage 0, the hazard ratios, and 95% CIs for IADL stages I to IV were 2.0 (1.4-2.7), 3.7 (2.6-5.4), 4.6 (3.3-6.5), and 7.6 (4.6-12.3), respectively.Activity limitation stages are strongly associated with future admission to LTC and may therefore be useful in identifying specific supportive care needs among vulnerable older community-dwelling adults, which may reduce or the delay need for admission to LTC.
Mortality and Survival after Surgical Treatment of Colorectal Cancer in Patients Aged over 80 Years The purpose of this study was to identify the clinical factors and tumor characteristics that predict the outcome of colorectal cancer patients aged >80 years.The data of 186 patients aged >80 years with colorectal cancer were collected from a computer database, and the variables were analyzed by both uni- and multivariate analyses.The 30-day mortality was 4% and the 90-day mortality 10%. The 1 (...) -year survival was 76%, and 27 (61%) of the 44 deaths were unrelated to cancer. The overall 5-year survival was 36%, the median survival 38 months, and the cancer-specific survival 40%. The recurrence rate after radical surgery was 22% and it was not affected by age. Kaplan-Meier estimates indicated that age, number of underlying diseases, radical operation, Union for International Cancer Control stage of the tumor, tumor size, number of lymph nodes involved, venous invasion, and recurrent disease
Information management flow for tele-homecare for the elderly; An emerging need for continuity of care Tele-homecare methods can be used to provide home care for the elderly, if information management is provided. The aim of this study was to compare the places and methods of the data collection and media that use Tele-homecare for the elderly in selected countries in 2015.A comparative-applied library study was conducted in 2015. The study population were five countries, including Canada (...) , Australia, England, Denmark, and Taiwan. The data collection tool was a checklist based on the objectives of study. Persian and English papers from 1998 to 2014, related to the Electronic Health Record, home care and the elderly were extracted from authentic journals and reference books as well as academic and research websites. Data were collected by reviewing the papers. After collecting data, comparative tables were prepared and the weak and strong points of each case were investigated and analyzed
one year old in Ilam county (Iran).Prevalence of Cryptosporidium spp. was estimated using a cross-sectional study. Fecal samples from 400 calves under 1 year old were collected in Ilam County, from March 2014 to February 2015 and they were microscopically analyzed using modified Ziehl-Neelsen method (mZN).The overall prevalence of Cryptosporidiosis in calves was 16% (64/400). According to age categories, the highest infection was observed in calves under one month old, and the lowest infection (...) occurred in calves 6 to 12 months old. Age was significantly associated with Cryptosporidium spp. infection (p<0.05). The prevalence of Cryptosporidiosis in diarrheic and none diarrheic calves was 27.3 and 12.4 % respectively, which indicated a significant association between positivity and diarrhea (p<0.05). The highest prevalence was observed in winter followed by autumn, spring and summer respectively. No statically difference was found between prevalence of Cryptosporidiosis and seasons of sampling
a 9-year period in Babol, Northern Iran.This was a cross-sectional study among 2,080 children aged 3-6 years old in Babol, Northern Iran. The studied samples were examined from May 2007 to June 2015. Oral examinations were performed with visual-touch technique. S-ECC was measured as number of decayed, missing, and filled teeth surface (dmfs). Data were evaluated by SPSS software for Windows version 23 and were analyzed using the one-way ANOVA, chi-square test and independent-samples t-test. Level (...) Nine yearsâ€™ trend of dental caries and severe early childhood caries among 3â€“6-year-old children in Babol, Northern Iran Malnutrition, pain, and insomnia are common adverse effects of early dental caries among 3-6-year-old children. To increase our understanding of the dental caries status which will help in the control and prevention of it, this study aimed to assess the trend of dental caries, Severe Early Childhood Caries (S-ECC) and its related factors among 3-6-year-old children during
Ethnicity, sex, and age are determinants of red blood cell storage and stress hemolysis: results of the REDS-III RBC-Omics study Genetic polymorphisms in blood donors may contribute to donor-specific differences in the survival of red blood cells (RBCs) during cold storage and after transfusion. Genetic variability is anticipated to be high in donors with racial admixture from malaria endemic regions such as Africa and Asia. The purpose of this study was to test the hypothesis that donor
Poor prognosis of elderly individuals >80 years of age with acute retinal necrosis To report the clinical features and prognosis of acute retinal necrosis (ARN) in elderly (>80 years of age) individuals.Six consecutive patients with unilateral ARN who attended the Department of Ophthalmology at Yamaguchi University Hospital between 2014 and 2015 were retrospectively reviewed. Clinical characteristics, causative virus, time from symptom onset to physician visit, visual acuity at presentation (...) and final visit, and treatment were evaluated and compared between the three elderly and three middle-aged (<80 years) patients.Varicella zoster virus (VZV) DNA was detected in aqueous humor by the polymerase chain reaction in all six cases. The mean ± SD time between symptom onset and medical attention was 18.0 ± 8.7 and 8.3 ± 1.5 days in the elderly and middle-aged groups, respectively. All patients were treated with intravenous aciclovir, oral prednisolone, and a nonsteroidal anti-inflammatory drug
Efficacy of Recombinant Influenza Vaccine in Adults 50 Years of Age or Older. Improved influenza vaccines are needed to control seasonal epidemics. This trial compared the protective efficacy in older adults of a quadrivalent, recombinant influenza vaccine (RIV4) with a standard-dose, egg-grown, quadrivalent, inactivated influenza vaccine (IIV4) during the A/H3N2-predominant 2014-2015 influenza season, when antigenic mismatch between circulating and vaccine influenza strains resulted (...) in adults who were 50 years of age or older. The diagnosis of influenza infection was confirmed by means of RT-PCR assay and culture of nasopharyngeal swabs obtained from participants with symptoms of an influenza-like illness. The primary end point was RT-PCR-confirmed, protocol defined, influenza-like illness between 14 days or more after vaccination and the end of the influenza season.A total of 9003 participants were enrolled and underwent randomization; 8855 (98.4%) received a trial vaccine