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Hospitalized older adults

Lorene Zerah, René-Sosata Bun, Sylvie Guillo, Jean-Philippe Collet, Dominique Bonnet-Zamponi, Florence Tubach
BACKGROUND: Oral antithrombotic (AT) drugs, which include antiplatelet and anticoagulant therapies, are widely implicated in serious preventable bleeding events. Avoiding inappropriate oral AT combinations is a major concern. Numerous practical guidelines have been released; a document to enhance prescriptions of oral AT combinations for adults would be of great help. OBJECTIVE: To synthesize guidelines on the prescription of oral AT combinations in adults and to create a prescription support-tool for clinicians about chronic management (≥ one month) of oral AT combinations...
2019: PloS One
Javier Jerez-Roig, Francisca Sueli Monte Moreira, Saionara Maria Aires da Câmara, Lidiane Maria de Brito Macedo Ferreira, Kenio Costa Lima
AIMS: To verify the incidence of urinary continence decline and the probability of maintaining urinary continence, as well as identify the prognostic factors of urinary continence decline in institutionalized older people. METHODS: A 2-year longitudinal study (with five 6-month waves) was conducted with subjects ≥60 years old who lived in 10 nursing homes in the city of Natal-RN (Brazil). Urinary incontinence was assessed by the Minimum Data Set version 3.0. Sociodemographic, institution-related and health-related variables were considered to establish the baseline...
February 14, 2019: Neurourology and Urodynamics
Jonas Reinold, Francesca Palese, Federico Romanese, Giancarlo Logroscino, Oliver Riedel, Federica E Pisa
OBJECTIVES: To evaluate changes in the use of antipsychotics and medications with anticholinergic activity (MACs) during hospitalization in older adults with dementia and factors associated with antipsychotic prescriptions and increased anticholinergic burden (ACB). METHODS AND DESIGN: This retrospective cohort study included all patients aged ≥65 years with a discharge diagnosis of dementia hospitalized at the university hospital of Udine, Italy, 2012-2014. Medications dispensed within 3 months before and after hospitalization, respectively, were identified in community-pharmacy dispensations while those prescribed at discharge were collected from Hospital Electronic Medical Records (EMR)...
February 13, 2019: International Journal of Geriatric Psychiatry
Andrew D Wiese, Marie R Griffin, Carlos G Grijalva
Pneumonia is one of the leading causes of morbidity and mortality among children and older adults. Pneumococcal conjugate vaccines (PCVs) were introduced into the US routine infant vaccination schedule leading to substantial reductions of invasive pneumococcal diseases (IPD). PCVs introduction also led to reductions in all-cause pneumonia among US children, though the indirect impact of PCVs on pneumonia in adults is difficult to quantify, especially due to the recent US recommendation for direct PCV use in older adults...
February 13, 2019: Expert Review of Vaccines
Zemenu Tamir, Abdurahaman Seid, Haftay Haileslassie
BACKGROUND: Hematologic abnormalities involving peripheral blood cell cytopenias are strong predictors of morbidity, mortality and poor antiretroviral therapy (ART) outcomes of HIV infected individuals. However, limited studies are conducted in resource-limited settings of sub-Saharan Africa that have addressed the magnitude and associated factors of cytopenias. This study aimed to investigate the magnitude and associated factors of cytopenias among ART naïve HIV infected adult Ethiopians...
2019: PloS One
Zoe Lysy, Kinwah Fung, Vasily Giannakeas, Hadas D Fischer, Chaim M Bell, Lorraine L Lipscombe
BACKGROUND: Starting insulin therapy in hospitalized patients may be associated with an increase in serious adverse events after discharge. OBJECTIVE: Determine whether post-discharge risks of death and rehospitalization are higher for older hospitalized patients prescribed new insulin therapy compared with oral hypoglycemic agents (OHAs). DESIGN: Retrospective population-based cohort study including hospital admissions in Ontario, Canada, between April 1, 2004, and Nov 30, 2013...
February 12, 2019: Journal of General Internal Medicine
Sara Campagna, Silvia Gonella, Paola Berchialla, Giacomo Morano, Carla Rigo, Pietro Antonio Zerla, Raffaella Fuzzi, Gianvito Corona, Silvana Storto, Valerio Dimonte, Baudolino Mussa
BACKGROUND: Peripherally inserted central catheters (PICCs) are central venous catheters (CVCs) that are commonly used in onco-hematologic settings for chemotherapy administration. As there is insufficient evidence to recommend a specific CVC for chemotherapy administration, we aimed to ascertain PICC-related adverse events (AEs) and identify independent predictors of PICC removal in patients with cancer receiving chemotherapy. MATERIALS AND METHODS: Information on adult patients with cancer with a PICC inserted for chemotherapy administration between September 2007 and December 2014 was extracted from six hospital databases...
February 12, 2019: Oncologist
Melissa A Hornor, Victoria L Tang, Julia Berian, Thomas N Robinson, JoAnn Coleman, Mark R Katlic, Ronnie A Rosenthal, Kataryna Christensen, Tracey Baker, Emily Finlayson, Sandhya A Lagoo-Deenadaayalan, Clifford Y Ko, Marcia M Russell
BACKGROUND: The American College of Surgeons Coalition for Quality in Geriatric Surgery is a multidisciplinary stakeholder group that aims to systematically improve the surgical care of older adults by establishing a verifiable quality improvement program with standards based on best evidence. Prior work confirmed the validity of a preliminary set of 308 standards to improve the quality of geriatric surgery, but concerns exist as to whether the standards are feasible for hospitals to implement...
February 12, 2019: Journal of the American Geriatrics Society
Shu-Fang Chang, Chih-Ling Cheng, Hsiang-Chun Lin
BACKGROUND: The World Health Organization has identified frailty as a crucial factor affecting successful aging. Systematic literature reviews have yet to focus on the relationship between stages of frailty and disability in community-dwelling older adults. PURPOSE: The purpose of this study was to investigate the relationships between various frailty types and disability in community-dwelling older adults and to explore how various frailty criteria have been used to assess disability in this population...
February 8, 2019: Journal of Nursing Research: JNR
Kim M Nielsen, Ann-Dorthe Zwisler, Rod S Taylor, Jesper H Svendsen, Jane Lindschou, Lindsey Anderson, Janus C Jakobsen, Selina K Berg
BACKGROUND: An effective way of preventing sudden cardiac death is the use of an implantable cardioverter defibrillator (ICD). In spite of the potential mortality benefits of receiving an ICD device, psychological problems experienced by patients after receiving an ICD may negatively impact their health-related quality of life, and lead to increased readmission to hospital and healthcare needs, loss of productivity and employment earnings, and increased morbidity and mortality. Evidence from other heart conditions suggests that cardiac rehabilitation should consist of both exercise training and psychoeducational interventions; such rehabilitation may benefit patients with an ICD...
February 12, 2019: Cochrane Database of Systematic Reviews
A L Zorilă, M V Zorilă, R Ș Țolescu, R E Zăvoi, D Cernea
Traumatic brain injury (TBI) represents a common cause of presentation in the emergency room and is considered a major health problem all over the world. Our study objective was to provide a regional perspective from a county hospital regarding epidemiologic aspect of TBI in a single year and to compare it with existing studies. 592 patients fulfilled the inclusions criteria and their characteristics were noted. We observed that the highest rate of TBI was among older people with an age over >60 years with 40...
April 2018: Current Health Sciences Journal
Cátia Reis, Sara Dias, Ana Maria Rodrigues, Rute Dinis Sousa, Maria João Gregório, Jaime Branco, Helena Canhão, Teresa Paiva
Background: Adequate sleep is essential for health. Both, short and long sleep durations are associated to worse quality of life and poor health outcomes. Portugal represents a specific population model, since according to European statistics it has high rates of chronic diseases like depression, hypertension, diabetes and stroke; and low quality of life as well as low index of physical activity, while in parallel it has some other good health indicators such as: low age-standardized mortality for both genders, nutrition in terms of energy and fruit consumption, smoking and alcohol, obesity and overweight prevalence...
July 2018: Sleep Science
Melinda R Steis, Lynn Unruh, Varadraj Prabhu Gurupur, Emilia Shettian, Meredeth Rowe, Adam Golden
Study findings support targeted interventions that facilitate early recognition and appropriate action. ABSTRACT: Background: When older adults with cognitive impairment develop new physical or behavioral symptoms, their family caregivers face a difficult decision: whether and when to seek professional medical care. Most family caregivers lack formal training in assessment and may have difficulty making such decisions. The Veterans Health Administration's home-based primary care (HBPC) program, which is widely available, offers community-dwelling frail veterans and their family caregivers guidance, with the goal of reducing hospitalization and institutionalization in long-term care facilities...
February 7, 2019: American Journal of Nursing
Laurie Bernick, Anne McKye, Andrea Brown-Strachan, Georgina Corsianos
A hospital-based falls prevention program offered in the community enabled older adults to sustain participation in physical activity beyond completion of the six-week program. The participants sustained gains with the support of an interdisciplinary comprehensive falls risk assessment, individualized goal setting, group exercise and education, home visits by health professionals when needed and partnership with community agencies for follow-up exercises. Participants (n = 162) demonstrated improvement at three months in comparison with their baseline Berg Balance Scale and Falls Efficacy Scale - International confidence scores and a 55% reduction in the average number of falls...
October 2018: Healthcare Quarterly
Sandeep Singh, Rupak Desai, Hee Kong Fong, Ashish Sadolikar, Suparn Samani, Hemant Goyal
With a great interest, we read the article by Neidenbach et al. on non-cardiac comorbidities in German adults with congenital heart disease (ACHD). ACHD always bear an increased risk of developing concomitant non-cardiac comorbidities and complications and impose a great healthcare burden. Limited large-scale data from the United States (US) on this focus incited us to write this brief report. Gilboa et al. estimated nearly 2.4 million people living with CHD (1.4 million adults, 1 million children) in the US in 2010...
December 2018: Cardiovascular Diagnosis and Therapy
Sofia Altuna-Venegas, Raul Aliaga-Vega, Jorge L Maguiña, Jose F Parodi, Fernando M Runzer-Colmenares
INTRODUCTION: Sarcopenia is a geriatric syndrome characterized by loss of muscle mass and strength. The prevalence in people between 60-70 years is about 5-13% and in adults over 80 years, between 11-50% in the USA. Sarcopenia increases the risk of mortality and nosocomial infections. Community-acquired pneumonia is the first infectious-related cause of death in elderly people. However, there is lack of evidence about the association between sarcopenia and pneumonia. The aim of our study was to determine the incidence and risk factors of community-acquired pneumonia in older adults with sarcopenia in a Peruvian hospital...
January 29, 2019: Archives of Gerontology and Geriatrics
Ruopeng Sun, Roberto G Aldunate, Vignesh R Paramathayalan, Rama Ratnam, Sanjiv Jain, Daniel G Morrow, Jacob J Sosnoff
Falls are a major health problem for older adults with significant physical and psychological consequences. The first step of successful fall prevention is to identify those at risk of falling. Recent technology advancement offers the possibility of objective, lowcost and self-guided fall risk assessment. The present work evaluated the preliminary validity and usability of a Kinect camera-based selfinitiated fall risk assessment system in a hospital setting. A convenience sample of 29 female participants (77...
January 31, 2019: Archives of Gerontology and Geriatrics
Hülya Leblebícíglu, Leyla Khorshid, Ziynet Öndogan, Günseli Oztürk
Research related to the design and development of new incontinence containment products for women is scarce. PURPOSE: The purpose of this 2-part study was to 1) develop a new incontinence containment product for fecal incontinence and 2) examine the effect of this new product on the occurrence of incontinence-associated dermatitis (IAD). METHODS: In part 1, a new incontinence containment product was designed, developed, and trialed among 10 healthy female volunteers...
January 2019: Wound management & prevention
Jeffrey Freeman
Treatment of older adults with type 2 diabetes (T2D) is complex because they represent a heterogeneous group with a broad range of comorbidities, functional abilities, socioeconomic status, and life expectancy. Older adults with T2D are at high risk of recurring hypoglycemia, a condition associated with marked morbidity and mortality, because their counter-regulatory mechanism to hypoglycemia is attenuated, and recurring hypoglycemic episodes can lead to hypoglycemia unawareness. In addition, polypharmacy, a result of multiple chronic comorbidities (including heart disease, stroke, and chronic kidney disease), can increase the risk of severe hypoglycemia, especially when patients are taking sulfonylureas or insulin...
February 6, 2019: Postgraduate Medicine
Joseph Barker, Karl Smith Byrne, Aiden Doherty, Charlie Foster, Kazem Rahimi, Rema Ramakrishnan, Mark Woodward, Terence Dwyer
Background: Physical inactivity is associated with an increased risk of major chronic diseases, although uncertainty exists about which chronic diseases, themselves, might contribute to physical inactivity. The objective of this study was to compare the physical activity of those with chronic diseases to healthy individuals using an objective measure of physical activity. Methods: We conducted a cross-sectional analysis of data from 96 706 participants aged 40 years or older from the UK Biobank prospective cohort study (2006-10)...
February 5, 2019: International Journal of Epidemiology
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