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Latest & greatest articles for elderly
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Role of candida in pathogenesis of antibiotic-associated diarrhoea in elderly inpatients. The part that candida plays in antibiotic-associated diarrhoea was investigated in 24 elderly inpatients (mean age 74 years) who tested negative for Clostridium difficile toxin and other intestinal pathogens. 7 had intestinal overgrowth of Candida species (greater than or equal to 10(5) cfu/ml). None of the 24 matched, antibiotic-treated controls without diarrhoea had candida overgrowth. All 5 patients
Terodiline with bladder retraining for treating detrusor instability in elderly people. To compare terodiline with bladder retraining against placebo with bladder retraining in the treatment of detrusor instability in frail elderly patients.Randomised, double blind, parallel group study. Treatment lasted for six weeks. Frequency of micturition and episodes of incontinence recorded on diary chart by patients.Incontinence clinic and a geriatric day hospital at two teaching hospitals.37 frail
Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. To assess the ability of antihypertensive drug treatment to reduce the risk of nonfatal and fatal (total) stroke in isolated systolic hypertension.Multicenter, randomized, double-blind, placebo-controlled.Community-based ambulatory population in tertiary care centers.4736 persons
Sensitivity to triazolam in the elderly. Elderly persons frequently appear to be sensitive to the effects of many drugs that depress the central nervous system. We studied the effect of age on the pharmacokinetics and pharmacodynamics of the benzodiazepine hypnotic agent triazolam, now the most frequently prescribed hypnotic drug in the United States.Twenty-six healthy young subjects (mean age, 30 years) and 21 healthy elderly subjects (mean age, 69 years) participated in a four-way crossover (...) study. After a single-blind adaptation trial with placebo, each subject received, in random order and in double-blind fashion, single doses of placebo, 0.125 mg of triazolam, and 0.25 mg of triazolam. For 24 hours after the administration of each of the three study medications, plasma triazolam levels were determined and psychomotor performance, memory, and degree of sedation were assessed.Plasma triazolam concentrations increased in proportion to the dose, but the elderly subjects had higher plasma
Management of myocardial infarction in the elderly: admission and outcome on a coronary care unit Management of myocardial infarction in the elderly: admission and outcome on a coronary care unit Management of myocardial infarction in the elderly: admission and outcome on a coronary care unit Haigh R, Castleden M, Woods K, Fletcher S, Bowns I, Gibson M, Soper J Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract (...) contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Thrombolytic therapy with streptokinase for elderly patients with myocardial infarction in addition to treatment in a Coronary Care Unit. This was compared with similar treatment for younger patients. Time of administration of therapy was also a factor. Type of intervention Treatment. Economic study type Cost-utility
Economic evaluation of a support program for caregivers of demented elderly Economic evaluation of a support program for caregivers of demented elderly Economic evaluation of a support program for caregivers of demented elderly Drummond M F, Mohide E A, Tew M, Streiner D L, Pringle D M, Gilbert J R Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results (...) and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Caregiver support programme. Type of intervention Palliative/community care. Economic study type Cost-utility analysis. Study population Those caring for elderly relatives at home. Setting The study was carried out in Canada. Dates to which data relate Price related to 1988. Source of effectiveness data Single study. Study sample It is unknown whether there is evidence
Screening the elderly in the community: controlled trial of dependency surveillance using a questionnaire administered by volunteers. To test the benefits of regular surveillance of the elderly at home using an activities of daily living questionnaire administered by volunteers.Randomised controlled study.539 Subjects aged 75 and over from two general practices.All subjects were visited at the beginning and end of the study by volunteers, who completed a scored activity of daily living
Frequency of adverse reactions to influenza vaccine in the elderly. A randomized, placebo-controlled trial. Concern about side effects constitutes a major deterrent to patient compliance with influenza vaccination, yet there is a paucity of data about the occurrence of adverse reactions in the population targeted for immunization. We conducted a randomized, double-blind, crossover trial to compare the frequency of adverse reactions following administration of 1988-1989 trivalent split-antigen
Dietary supplementation in elderly patients with fractured neck of the femur. 59 elderly patients (mean age 82) with femoral neck fractures were randomised into two groups. 27 patients received daily an oral nutrition supplement (250 ml, 20 g protein, 254 kcal) for a mean of 32 days; 32 patients acted as controls. On admission most patients had nutritional deficiencies. Despite being offered adequate quantities, nutritional requirements were not met during the hospital stay. Clinical outcome (...) of elderly patients with femoral neck fracture can be improved by once daily dietary oral supplementation.
The effects of antihypertensive therapy on left ventricular mass in elderly patients. Left ventricular mass sometimes decreases during treatment of hypertension, but this response is inconsistent and its effects on left ventricular function are unknown. In a six-month randomized trial, we studied the ability of verapamil and atenolol to reduce left ventricular mass in 42 elderly patients with hypertension and the effects of this reduction in mass on cardiac function. The mean blood pressure (...) ejection rate, were significantly higher than before treatment (2.42 +/- 0.2 vs. 3.31 +/- 0.4 [P less than 0.05] and 0.61 +/- 0.03 to 0.85 +/- 0.05 [P less than 0.05], respectively). Diastolic filling was unchanged in the group that had no reduction in left ventricular mass. Cardiac output and the ejection fraction at rest and during mild exercise were unchanged in both groups as compared with baseline values. We conclude that left ventricular mass can be reduced in elderly patients with hypertension
Locomotor disability in very elderly people: value of a programme for screening and provision of aids for daily living. To assess the prevalence of potentially reversible locomotor disabilities in elderly subjects and the cost effectiveness of providing aids for daily living.Population based randomised controlled trial of subjects aged greater than or equal to 85 living independently in an inner London borough.21 Electoral wards of the London Borough of Hackney.1255 Subjects aged greater than (...) intervention group v control group: raised toilet seat, 71 v 13 teapot tipper 100 v 33; tap turner 100 v 0; saucepan 88 v 0; shoe horn 50 v 13) and time taken to complete the tasks. A cost benefit analysis of this screening-intervention programme suggested a total cost of 32 pounds per individual benefit.Appreciable degrees of unrecognised locomotor disability are detected on screening of very elderly people living independently. Providing aids offers a feasible and cost effective means of improving
Measuring blood pressure in the elderly: does atrial fibrillation increase observer variability? To compare the interobserver and intraobserver variability of blood pressure measurements in geriatric patients in atrial fibrillation and in sinus rhythm.Prospective assessment of blood pressure measurements carried out in random order in two groups of elderly patients by five doctors unaware of the aims of the study.Acute assessment wards for geriatric medicine, Cardiff Royal Infirmary.50 Elderly
Relation between mortality and treated blood pressure in elderly patients with hypertension: report of the European Working Party on High Blood Pressure in the Elderly. To investigate the relation between mortality and treated systolic and diastolic blood pressures.Randomised double blind placebo controlled trial. Mortality in the two treatment groups was examined in thirds of treated systolic and diastolic blood pressures.339 And 352 patients allocated to placebo and active treatment
Reduction in hospital readmission stay of elderly patients by a community based hospital discharge scheme: a randomised controlled trial. To compare a community support scheme using care attendants with standard aftercare for their effects on independence and morale of elderly patients discharged from hospital and on their use of health and social services.Randomised controlled study of cohort of patients over 75 discharged to their own homes.District general hospital and community.Total of 903
Comparison of mastectomy with tamoxifen for treating elderly patients with operable breast cancer. Comparison of tamoxifen and mastectomy in treatment of breast cancer in elderly patients.Randomised trial of treatment of operable breast cancer by wedge mastectomy or tamoxifen, with median follow up 24 and 25 months respectively (range 1-63).University hospital; most patients from primary catchment area.135 consecutive patients with breast cancer aged over 70 with operable tumours (less than 5 (...) and free of local recurrence at 24 months; in tamoxifen group only 47% remained alive and free of local progression. In mastectomy group locoregional recurrence occurred in 16 patients and metastatic disease in 13; in tamoxifen group locoregional progression occurred in 29 patients and metastatic disease in seven.As a high proportion of patients treated with tamoxifen eventually required surgery treatment of elderly patients with breast cancer should include mastectomy. Optimum treatment may include
Prospective randomised trial of tamoxifen versus surgery in elderly patients with breast cancer. 116 patients aged 70 or over who were judged to have surgically resectable cancer of the breast were prospectively randomised to tamoxifen 20 mg daily or surgical resection. At a median follow-up of three years, local relapse or progression was seen in 15 (25%) of 60 patients in the tamoxifen group and 21 (37.5%) of 56 in the surgical arm. Distant metastases occurred in 8 (13%) in the tamoxifen
Effectiveness of geriatric rehabilitative care after fractures of the proximal femur in elderly women: a randomised clinical trial. To compare postoperative collaborative care between orthopaedic surgeons and physicians in geriatric medicine with routine orthopaedic care in elderly women with proximal femoral fracture.Exclusion of patients dying before fit enough to enter trial, those with pathological fractures, those likely to be discharged within seven days of entering the trial, and those (...) remaining unfit for transfer to a peripheral hospital. Remainder allocated to two groups: treatment group and control group.District hospital acute admission ward and rehabilitation ward.144 sequentially admitted elderly women with proximal fracture of the femur; 36 excluded on above criteria and remainder entered into trial.Both treatment and control groups (n = 54 in each) received physiotherapy and other services. The treatment group also received thrice weekly supervision by a geriatrician.Physical
Cost-effectiveness of primary tetanus vaccination among elderly Canadians Cost-effectiveness of primary tetanus vaccination among elderly Canadians Cost-effectiveness of primary tetanus vaccination among elderly Canadians Hutchison B G, Stoddart G L Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment (...) among elderly Canadians. CMAJ: Canadian Medical Association Journal 1988; 139(12): 1143-1151 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Aged; Canada; Cost-Benefit Analysis; Female; Humans; Male; Postal Service; Tetanus /economics /prevention & Tetanus Toxoid; Vaccination /economics; control AccessionNumber 21995005282 Date bibliographic record published 06/08/1996 Date abstract record published 06/08/1996 NHS Economic Evaluation Database (NHS EED) Produced by the Centre
Therapy vs no therapy for bacteriuria in elderly ambulatory nonhospitalized women. This prospective randomized study was undertaken to determine the efficacy of antimicrobial therapy compared with no therapy for bacteriuria in elderly ambulatory nonhospitalized women. Sixty-one women (mean age, 85.8 years) with bacteriuria were in the no therapy control group and 63 women (mean age, 85.8 years) with bacteriuria were in the therapy group; none had symptoms of urinary tract infection. One short (...) in elderly ambulatory nonhospitalized women, short-course antimicrobial therapy is effective at two-week follow-up and that antimicrobial therapy can eliminate bacteriuria in most of these women for at least a six-month period.
Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly trial. A double-blind randomised placebo-controlled trial of antihypertensive treatment was conducted in patients over the age of 60. Entry criteria included both a sitting diastolic blood pressure on placebo treatment in the range 90-119 mm Hg and a systolic pressure in the range 160-239 mm Hg. 840 patients were randomised either to active treatment (hydrochlorothiazide + triamterene