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Latest & greatest articles for elderly
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Evaluating physical function and activity in the elderly patient using wearable motion sensors Wearable sensors, in particular inertial measurement units (IMUs) allow the objective, valid, discriminative and responsive assessment of physical function during functional tests such as gait, stair climbing or sit-to-stand.Applied to various body segments, precise capture of time-to-task achievement, spatiotemporal gait and kinematic parameters of demanding tests or specific to an affected limb (...) are the most used measures.In activity monitoring (AM), accelerometry has mainly been used to derive energy expenditure or general health related parameters such as total step counts.In orthopaedics and the elderly, counting specific events such as stairs or high intensity activities were clinimetrically most powerful; as were qualitative parameters at the 'micro-level' of activity such as step frequency or sit-stand duration.Low cost and ease of use allow routine clinical application but with many options
and treat comorbidities such as diabetes and osteoporosis.In the absence of severe systemic comorbidities, the results after open reduction and internal fixation of malleolar fractures in patients above and below 60 years of age are nearly identical, while nonoperative treatment of unstable fractures leads to significantly inferior outcomes. Therefore, the general indications for surgery in elderly patients should not differ from those in younger patients.However, it is essential to detect severe (...) Management of ankle fractures in the elderly The incidence and severity of ankle fractures in elderly patients is increasing steadily. These injuries are challenging to treat and prone to complications.Individual fracture treatment is tailored depending on bone quality, skin conditions, comorbidities, and functional demand of the patient. This article provides a review of current techniques to obtain stable fixation despite poor bone quality. To avoid complications, it is imperative to consider
Impact of falling on social participation and social support trajectories in a middle-aged and elderly European sample Whereas falls are frequent and traumatic events for the elderly, their long-term consequences in terms of the social lives of older fallers are understudied. This study aimed to identify the impact of falling on the trajectories of social participation and social support of olderpeople in Europe. Our sample consisted of 16,583 peopleaged 50-95 years from 10 European countries (...) who responded to the waves 1, 2 and 4 of the Survey of Health Ageing and Retirement in Europe. The impact of falling on the trajectories of social participation and social support was examined using generalised estimating equation (GEE) models. The effect of the interactions between falling and frailty and between falling and social support on social participation was assessed. Falls were negatively associated with social participation (OR=0.73, p<0.001) and positively associated with social
Nitrogen deficiency impacts on leaf cell and tissue structure with consequences for senescence associated processes in Brassica napus Improvement of nutrient use efficiency is a major goal for several crop plants, especially Brassica napus. Indeed, the low nitrogen use efficiency (NUE) in this crop results in negative economic and ecological consequences. The low NUE of oilseed rape is mainly due to low remobilization of nitrogen from vegetative parts to growing organs. Remobilization of leaf (...) nitrogen takes place during senescence, a process known to strongly modify cell and tissue structure. This study focused on the impact of moderate N depletion, expected to induce 30 % reduction of seed yield, on these structural modifications. Two genotypes (Aviso and Express) were studied, with different tolerance of nitrogen depletion, evaluated through seed yield and dry mass production. Structural modifications of leaf cells and tissues were investigated through NMR relaxometry and light microscopy
Age-related functional changes and susceptibility to eccentric contraction-induced damage in skeletal muscle cell Depending upon external loading conditions, skeletal muscles can either shorten, lengthen, or remain at a fixed length as they produce force. Fixed-end or isometric contractions stabilize joints and allow muscles to act as active struts during locomotion. Active muscles dissipate energy when they are lengthened by an external force that exceeds their current force producing capacity (...) . These unaccustomed eccentric activities often lead to muscle weakness, soreness, and inflammation. During aging, the ability to produce force under these conditions is reduced and appears to be due to not only reductions in muscle mass but also to alterations in the basic mechanisms of contraction. These alterations include impairments in the excitation-contraction process, and the action of the cross-bridges. Also, it is well known that age-related skeletal muscle atrophy is characterized by a preferential
Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged â‰¥75 Years: A Randomized Clinical Trial. The appropriate treatment target for systolic blood pressure (SBP) in older patients with hypertension remains uncertain.To evaluate the effects of intensive (<120 mm Hg) compared with standard (<140 mm Hg) SBP targets in persons aged 75 years or older with hypertension but without diabetes.A multicenter, randomized clinical trial of patients aged 75 years (...) ]), 4.0% vs 2.7% for electrolyte abnormalities (HR, 1.51 [95% CI, 0.99-2.33]), 5.5% vs 4.0% for acute kidney injury (HR, 1.41 [95% CI, 0.98-2.04]), and 4.9% vs 5.5% for injurious falls (HR, 0.91 [95% CI, 0.65-1.29]).Among ambulatory adults aged 75 years or older, treating to an SBP target of less than 120 mm Hg compared with an SBP target of less than 140 mm Hg resulted in significantly lower rates of fatal and nonfatal major cardiovascular events and death from any cause.clinicaltrials.gov Identifier
Correlation of objectively measured light exposure and serum vitamin D in men aged over 60â€‰years Diminished vitamin D is common among older individuals. Sunlight contributes more to vitamin D synthesis than diet or supplementation. This study examined associations between objectively measured light exposure, vitamin D serum levels, and bone biomarkers in 100 men aged over 60 years. Light exposure was measured in lux via Actigraph monitors for 1 week. Significantly, greater levels of vitamin D
Persistence of Antipsychotic Treatment in Elderly Dementia Patients: A Retrospective, Population-Based Cohort Study Antipsychotics are commonly used to manage behavioral and psychological symptoms of dementia. Concerns over their safety and efficacy in this role have resulted in antipsychotics typically being recommended for short-term usage only when used among dementia patients. However, there is little work examining the duration of antipsychotic treatment in the elderly dementia patient (...) population.To determine the persistence of use of antipsychotics in elderly dementia patients and the role of dose on therapy duration.A retrospective, population-based cohort study using administrative data, including dispensing records from a provincial public drug program, from Ontario, Canada between 2009 and 2012. Elderly dementia patients newly initiated onto antipsychotics were followed until drug discontinuation, death, 2-year follow-up, or end of study. Competing risk analysis was performed
Ornithine transcarbamylase deficiency that developed at the age of 19 years with acute brain edema A 19-year-old man had nausea, diarrhea, and general malaise the day before requesting emergency transport to his former primary physician. The patient became restless and had tonic seizures after admission. The patient was transferred to our hospital as there had been no improvement in his level of consciousness. On arrival, cranial computed tomography showed generalized swelling, and blood
Emergent transcatheter arterial embolization for norovirusâ€associated lifeâ€threatening ulcer bleeding to achieve successful hemostasis in 2â€yearâ€old boy We report a 2-year-old boy with duodenal ulcer with active bleeding that occurred as a result of norovirus gastroenteritis. On admission, the patient presented with shock accompanied with vomiting and melena. Abdominal contrast enhanced computed tomography scan showed signs of duodenal bleeding.He was successfully treated with emergent
Considering the healthcare needs of olderpeople with multimorbidity: managing Alice 29090174 2018 11 13 2235-042X 6 2 2016 Journal of comorbidity J Comorb Considering the healthcare needs of olderpeople with multimorbidity: managing Alice. 53-55 10.15256/joc.2016.6.86 Chew-Graham Carolyn A CA Research Institute, Primary Care and Health Sciences, Keele University, Staffordshire, UK. Rasmussen Jill J Maskrey Neal N School of Pharmacy, Keele University, Staffordshire, UK. eng Editorial 2016 05
Spirituality, religiosity, aging and health in global perspective: A review Persistent population aging worldwide is focusing attention on modifiable factors that can improve later life health. There is evidence that religiosity and spirituality are among such factors. Olderpeople tend to have high rates of involvement in religious and/or spiritual endeavors and it is possible that population aging will be associated with increasing prevalence of religious and spiritual activity worldwide (...) . Despite increasing research on religiosity, spirituality and health among older persons, population aging worldwide suggests the need for a globally integrated approach. As a step toward this, we review a subset of the literature on the impact of religiosity and spirituality on health in later life. We find that much of this has looked at the relationship between religiosity/spirituality and longevity as well as physical and mental health. Mechanisms include social support, health behaviors, stress
young adult control C57BL/6 male mice (age 12 weeks, YCON group) and 14 aged C57BL/6 male mice (age 19 months), randomly divided into two groups (old control, OCON, n = 7; old resistance exercise, ORT, n = 7). Resistance ladder climbing exercise was conducted 3 d/wk for 12 weeks. Soleus and tibialis anterior muscles were collected for body composition, relative grip strength, and muscle wet weight and for enzyme-linked immunosorbent assay protein analysis.Relative soleus muscle wet weight (...) Resistance exercise reduced the expression of fibroblast growth factor-2 in skeletal muscle of aged mice Fibroblast growth factor-2 (FGF-2) protein level has been shown to be elevated in aged mice muscle compared to adult mice. It activates the satellite cell quiescence, which leads to satellite cell depletion and may accelerate aging process. The purpose of this study was to see the effect of resistance exercise on skeletal muscle FGF-2 protein level in aged mice.This study included eight
Can we predict toxicity and efficacy in older patients with cancer? Older patients with colorectal cancer as an example Colorectal cancer is a disease of the elderly. As older and frail patients are under-represented in clinical trials, most of the evidence available on treatment of older metastatic colorectal patients with cancer originates from pooled analyses of the older patients included in large prospective clinical trials and from community-based studies. The aging process is highly (...) individual and cannot be based on the chronological age alone. It is characterised by a decline in organ function with an increased risk of comorbidity and polypharmacy. These issues can result in an increased susceptibility to the complications of both the disease and treatment. Therefore, evaluation of performance status and the chronological age alone is not sufficient, and additionally assessment must be included in the treatment decision process. In the present review, we will focus on clinical
Development of a curriculum and roadside screening tool for Law enforcement identification of medical impairment in aging drivers An estimated one in five drivers will be over 65 by 2030. Compared with their younger counterparts, older adults are more likely to experience health and functional impairments, including cognitive dysfunction, which may interfere with their ability to drive safely. Law enforcement officers, as part of the public safety community, need help in developing
Recurrent convulsions, hypocalcemia, and hypoparathyroidism related to delayed diagnosis of 22q11.2 deletion syndrome in a middleâ€aged man A 49-year-old man had idiopathic epilepsy with recurrent convulsions and history of cleft palate, mental retardation, schizophrenia, and cataract. He had convulsions the day before and on the day of admission. Fosphenytoin was given i.v.; his convulsion stopped, but he lost consciousness 2 h later and was admitted. Glasgow Coma Scale score on arrival was 3
Briviact (brivaracetam) - To treat partial onset seizures in patients age 16 years and older with epilepsy. Drug Approval Package: Briviact (brivaracetam) U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: Briviact (brivaracetam) Company: UCB, Inc. Application No.: 205836, 205837 & 205838 Approval Date: February 18, 2016 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. (PDF) (PDF) (PDF) (PDF (...) ) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) Date created: March 30, 2016 Vision impaired people having problems accessing certain pages of a PDF file may call (301) 796-3634 for assistance. Note: Documents in PDF format require the . Note: If you need help accessing information in different file formats, see . Language Assistance Available: | | | | | | | | | | | | | | | FDA Popular Content Product Areas
Evaluation of the Risk of Nitrofurantoin Lung Injury and Its Efficacy in Diminished Kidney Function in Older Adults in a Large Integrated Healthcare System: A Matched Cohort Study To determine the risk to older adults of lung injury associated with treatment of cystitis using nitrofurantoin and the risk of treatment failure in the presence of diminished creatinine clearance (CrCl).Retrospective, matched cohort.Integrated healthcare system.Individuals aged 65 and older with a diagnosis (...) CrCl groups.Nitrofurantoin exposure was not statistically significantly associated with lung injury (adjusted risk ratio (aRR) = 0.90, 95% confidence interval (CI) = 0.80-1.00), but chronic nitrofurantoin therapy was associated with greater risk of lung injury than acute exposure (aRR = 1.53, 95% CI = 1.04, 2.24). Treatment failure rates did not differ according to CrCl.This large, retrospective, matched-cohort study conducted in older adults supports the 2012 American Geriatrics Society Updated
Accurate prediction of gestational age using newborn screening analyte data Identification of preterm births and accurate estimates of gestational age for newborn infants is vital to guide care. Unfortunately, in developing countries, it can be challenging to obtain estimates of gestational age. Routinely collected newborn infant screening metabolic analytes vary by gestational age and may be useful to estimate gestational age.We sought to develop an algorithm that could estimate gestational (...) age at birth that is based on the analytes that are obtained from newborn infant screening.We conducted a population-based cross-sectional study of all live births in the province of Ontario that included 249,700 infants who were born between April 2007 and March 2009 and who underwent newborn infant screening. We used multivariable linear and logistic regression analyses to build a model to predict gestational age using newborn infant screening metabolite measurements and readily available
of variance models were used to compare differences between robotics and laparotomy and age groups.We identified 16,980 patients who had surgery for endometrial cancer with either a robotic approach (age ≥65 years, n = 1228; age <65 years, n = 1574) or laparotomy (age ≥65 years, n = 5914; age <65 years, n = 8264). Older patients had a higher Charlson Comorbidity Index score at the time of surgery (2.6 vs 2.5, P < .001). In laparotomy cases, intraoperative complication rates were similar (4.1% vs 3.7%, P (...) 1.67 days, P < .001), and lower rates of discharge to home (88.8% vs 96.8%, P < .001). With both approaches, as age increased, perioperative surgical and medical complications also increased in a linear fashion. In a subanalysis of older patients (n = 7142), there were lower rates of perioperative surgical (8.3% vs 20.5%, P < .001) and medical (12.3% vs 23.3%, P < .001) complications, death (0.0% vs 0.8%, P < .001), shorter LOS (2.00 vs 5.13 days, P < .001) and higher rate of discharge to home