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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 (...) of postoperative complications between the 2 groups (12.3% [38/310] with placebo versus 11.6% [36/310] with parecoxib; P = .80).For low-risk elderly patients undergoing elective total hip or knee replacement surgery, multidose parecoxib supplemented to IV morphine decreased the incidence of postoperative delirium without increasing adverse events.
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 (...) 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
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).
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
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
Use of Antipsychotic Drugs by Elderly Primary Care Patients and the Effects of Medication Reviews: A Cross-Sectional Study in Sweden Antipsychotics form a class of drugs that should be used with caution among elderly people because of a high risk of adverse events. Despite the risks and modest effects, their use is estimated to be high, especially in nursing homes.The aim was to explore the effects of medication reviews on antipsychotic drug use for elderly primary care patients and describe (...) reviews reduced the use of antipsychotics by 23% (p < 0.001) in this study. Of the 206 patients using antipsychotics, 43% (n = 93) had an approved indication, while for 15% (n = 32) the indication was not given. Antipsychotic drug use was more common with increasing number of drugs (p = 0.001), and in nursing home residents (p < 0.01). It was also more frequent in patients with cognitive impairment, depressive symptoms or sleeping problems.The use of antipsychotic drugs is high in elderly patients
Information and Communication Technologies in the Care of the Elderly: Systematic Review of Applications Aimed at Patients With Dementia and Caregivers. The interest in applying information and communications technology (ICT) in older adult health care is frequently promoted by the increasing and unsustainable costs of health care services. In turn, the unprecedented growth of the elderly population around the globe has urged institutions, companies, industries, and governments to respond (...) (56%, 9/16), treatment (56%, 9/16), and management (50%, 8/16). Furthermore, it was found that 20 studies (77%, 8/26) evaluated their ICT applications through carrying out tests with patients with dementia and caregivers.The key finding of this systematic review revealed that the use of ICT tools can be strongly recommended to be used as a lifestyle in the elderly in order to improve the quality of life for the elderly and their primary caregivers. Since patients with AD are completely dependent
Decisional balance and self-efficacy of physical activity among the elderly in Rasht in 2013 based on the transtheoretical model Regular physical activity has been considered as health promotion, and identifying different effective psycho-social variables on physical has proven to be essential.To identify the relationship between decisional balance and self-efficacy in physical activities using the transtheoretical model in the members of a retirement center in Rasht, Guillen.A descriptive (...) cross-sectional study was conducted in 2013 by using convenient sampling on 262 elderly people who are the members of retirement centers in Rasht. Data were collected using Stages of change, Decisional balance, Self-efficacy and Physical Activity Scale for the Elderly (PASE). Data was analyzed using SPSS-16 software, descriptive and analytic statistic (Pearson correlation, Spearman, ANOVA, HSD Tukey, linear and ordinal regression).The majority of participants were in maintenance stage. Mean
The social network among the elderly and its relationship with quality of life Attention to the needs of the elderly is a social necessity, and it seems that evaluating the social network and quality of life of the elderly can be useful in a better understanding of their needs. This study was performed to determine the relationship between the social network and the quality of life of the elderly in the city of Bojnoord in Iran.In this cross-sectional study, 201 elderly people aged 60 years (...) or more were selected by continuous and consecutive sampling method in Bojnoord, Iran in 2014. Data were collected using demographic questionnaire, Lubben social network scale and LEIPAD elderly quality of life questionnaire. Data were analyzed by SPSS 16 and using descriptive statistics and independent-samples t-test, ANOVA and Pearson product-moment coefficient.The results showed that 30.3% of elderly people studied, were subjected to a high risk of isolation. The highest mean in social network
Prevalence of substance abuse and socio-economic differences in substance abuse in an Australian community-dwelling elderly sample A sample of 324 55-90-year-old Australian adults participated in a survey on elderly substance abuse using the Clinical Assessment Scales for the Elderly. Overall, males had a higher prevalence rate of substance abuse than females. Significant differences in substance abuse mean scores were found for gender, age, income, community involvement, and retirement
Association Between Bone Mineral Density and Pancreatic Î²-Cell Function in Elderly Men and Postmenopausal Women To explore the association between bone mineral density (BMD) and β-cell function.A cross-sectional study was performed in Fujian, China, from 2011 to 2012. The study included 572 elderly men older than age 60 years and 1558 postmenopausal women aged 45 to 86 years, excluding those with diabetes and insulin resistance. Fasting glucose and insulin concentrations were measured (...) . Pancreatic β-cell function was estimated by using the homeostasis model assessment (HOMA-β). Calcaneus BMD was measured by using quantitative ultrasonography. Multiple regression analyses were applied to explore the association.Participants with decreased BMD had lower fasting glucose (P < 0.001 in postmenopausal women; P = 0.007 in elderly men) and greater HOMA-β (P = 0.001 in postmenopausal women; P = 0.008 in elderly men) than those with normal BMD, whereas no statistical differences in insulin were
Improving comfort around dying in elderly people: a cluster randomised controlled trial. Over 50% of elderly people die in acute hospital settings, where the quality of end-of-life care is often suboptimum. We aimed to assess the effectiveness of the Care Programme for the Last Days of Life (CAREFuL) at improving comfort and quality of care in the dying phase in elderly people.We did a cluster randomised controlled trial in acute geriatric wards in ten hospitals in Flemish Region, Belgium
Surgical treatment of acetabular fractures in the elderly: a systematic review of the results. We performed a systematic review of the literature involving a number of databases to identify studies that included outcomes of surgical treatment of acetabular fractures in patients aged > 55 years. An initial search identified 1564 studies. After exclusion by two independent reviewers, 15 studies met the inclusion criteria. All studies were case series and the mean Coleman Methodology score
Physician age and outcomes in elderly patients in hospital in the US: observational study. Objectives To investigate whether outcomes of patients who were admitted to hospital differ between those treated by younger and older physicians.Design Observational study.Setting US acute care hospitals.Participants 20% random sample of Medicare fee-for-service beneficiaries aged ≥65 admitted to hospital with a medical condition in 2011-14 and treated by hospitalist physicians to whom they were assigned
Experiences of the home-dwelling elderly in the use of telecare in home care services: a qualitative systematic review protocol. The objective of this systematic review is to identify and synthesize the best evidence on the home-dwelling elderly's experiences with the use of telecare in home care services. Furthermore, the study will identify experiences with telecare devices and examine what beliefs the home-dwelling elderly hold regarding the impact of telecare on the ability to age (...) in place.Review question 1: How do the home-dwelling elderly experience the use of telecare in the context of home care services?Review question 2: How do the home-dwelling elderly experience telecare devices?Review question 3: What beliefs do the home-dwelling elderly hold regarding the impact of telecare on the ability to age in place?
Antibiotic Prescribing for Nonbacterial Acute Upper Respiratory Infections in Elderly Persons. Reducing inappropriate antibiotic prescribing for acute upper respiratory tract infections (AURIs) requires a better understanding of the factors associated with this practice.To determine the prevalence of antibiotic prescribing for nonbacterial AURIs and whether prescribing rates varied by physician characteristics.Retrospective analysis of linked administrative health care data.Primary care (...) percentage points [CI, 2.7 to 5.5 percentage points], respectively).Physician rationale for prescribing was unknown.In this low-risk elderly cohort, 46% of patients with a nonbacterial AURI were prescribed antibiotics. Patients were more likely to receive prescriptions from mid- or late-career physicians with high patient volumes and from physicians who were trained outside of Canada or the United States.Ontario Ministry of Health and Long-term Care, Academic Medical Organization of Southwestern Ontario
An elderly man with an air-fluid level in the middle ear A 68-year-old Malay man who is a rubber tapper, presented with a large painful right-sided neck swelling for 6 months, which was gradually increasing in size and associated with odynophagia, dysphagia, hoarseness and significant weight loss. He did not complain of any ear symptoms, but on further questioning, he admitted having a 3-week history of occasional tinnitus and reduced hearing on the right ear. Other ear symptoms were negative.
Diffuse large B-cell lymphoma in very elderly patients over 80 years old: Incorporating consolidative radiation therapy into management decisions The population of patients aged 80 years or older who are diagnosed with diffuse large B-cell lymphoma (DLBCL) continues to increase, but an optimal treatment strategy has not been established. We sought to examine the influence of consolidative radiation therapy (RT) on outcome and toxicity among the very elderly diagnosed with stage I-IV DLBCL.We
Outcome of Elderly Patients with Diffuse Large B-cell Lymphoma Treated with R-CHOP: Results from the UK NCRI R-CHOP14v21 trial with combined analysis of molecular characteristics with the DSHNHL RICOVER-60 trial. There is an on-going debate whether 2- or 3-weekly administration of R-CHOP is the preferred first-line treatment for elderly patients with diffuse large B-cell lymphoma (DLBCL). The UK NCRI R-CHOP14v21 randomized phase 3 trial did not demonstrate a difference in outcomes between R (...) -CHOP-14 and R-CHOP-21 in newly diagnosed DLBCL patients aged 19-88 years, but data on elderly patients have not been reported in detail so far. Here, we provide a subgroup analysis of patients ≥60 years treated on the R-CHOP14v21 trial with extended follow-up.Six hundred and four R-CHOP14v21 patients ≥60 years were included in this subgroup analysis, with a median follow-up of 77.7 months. To assess the impact of MYC rearrangements (MYC-R) and double-hit-lymphoma (DHL) on outcome in elderly