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Elif G Umıt, Mehmet Baysal, Volkan Bas, Ismail Asker, Onur Kırkızlar, Ahmet M Demır
PURPOSE: Multiple myeloma is a chronic, uncurable hematological cancer with the involvement of multiple organ systems. As a disease affecting older patients, the treatment of multiple myeloma should be based on individual patient characteristics. Polypharmacy is an increasing problem in the care of older patients and in patients with multiple myeloma, polypharmacy is almost inevitable. We aimed to evaluate the applicability of polypharmacy definitions and the relation of polypharmacy with disease outcomes in patients with multiple myeloma...
March 19, 2019: Journal of Oncology Pharmacy Practice
Veronica Falcone, Grammata Kotzaeridi, Melanie Hanne Breil, Ingo Rosicky, Tina Stopp, Gülen Yerlikaya-Schatten, Michael Feichtinger, Wolfgang Eppel, Peter Husslein, Andrea Tura, Christian S Göbl
BACKGROUND: An early identification of the risk groups might be beneficial in reducing morbidities in patients with gestational diabetes mellitus (GDM). Therefore, this study aimed to assess the biochemical predictors of glycemic conditions, in addition to fasting indices of glucose disposal, to predict the development of GDM in later stage and the need of glucose-lowering medication. METHODS: A total of 574 pregnant females (103 with GDM and 471 with normal glucose tolerance [NGT]) were included...
March 12, 2019: Diabetes & Metabolism Journal
William B Weeks, Manish K Mishra, David Curto, Curtis L Petersen, Pedro Cano, Yulin Hswen, Silvia Villamarín Serra, Glyn Elwyn, Marjorie M Godfrey, Pedro Sánchez Soro, José Francisco Tomás
BACKGROUND/OBJECTIVE: In nursing homes across the world, and particularly in Spain, there are concerns that psychotropic medications are being overused. For older Spanish nursing home residents who had dementia, we sought to evaluate the association between applying interventions designed to reduce inappropriate psychotropic medication use and subsequent psychotropic use. DESIGN: Retrospective, propensity score-matched, controlled, patient-level observational analysis...
March 8, 2019: Journal of the American Geriatrics Society
Antonio Nuñez-Montenegro, Alonso Montiel-Luque, Esther Martin-Aurioles, Felicisima Garcia-Dillana, Monica Krag-Jiménez, Jose A González-Correa
To asses inappropriate prescribing and its predisposing factors in polymedicated patients over the age of 65 in primary health care. DESIGN: cross-sectional study. SETTING: Primary care centres in the Costa del Sol Health District and Northern Health Area of Malaga in southern Spain. PARTICIPANTS: Patients older than 65 years who use multiple medications. Data collection was conducted during 1 year in a population of 425 individuals who comprised a stratified randomized sample of the population of health care users in the study area...
March 4, 2019: Journal of Clinical Medicine
Denis Curtin, Paul F Gallagher, Denis O'Mahony
Polypharmacy and prescribing of potentially inappropriate medications (PIMs) are the key elements of inappropriate medication use (IMU) in older multimorbid people. IMU is associated with a range of negative healthcare consequences including adverse drug events and unplanned hospitalizations. Furthermore, prescribing guidelines are commonly derived from randomized controlled clinical trials which have specifically excluded older adults with multimorbidity. Consequently, indiscriminate application of single disease pharmacotherapy guidelines to older multimorbid patients can lead to increased risk of drug-drug interactions, drug-disease interactions and poor drug adherence...
2019: Therapeutic Advances in Drug Safety
Meghan S Karuturi, Holly M Holmes, Xiudong Lei, Michael Johnson, Carlos H Barcenas, Scott B Cantor, Gary E Gallick, Robert C Bast, Sharon H Giordano
PURPOSE: Screening for potentially inappropriate medications (PIM) is recommended in older patients with cancer receiving chemotherapy, given the concern for adverse drug reactions, drug-drug interactions and non-adherence. Our objective was to determine the impact of PIM on outcomes in patients with breast and colorectal cancers receiving chemotherapy. METHODS: We used data from the SEER-Medicare database, including patients >/= 66 years old with a diagnosis of Stage II/III breast and colorectal cancer made between 7/1/2007-12/31/2009...
February 19, 2019: Journal of Geriatric Oncology
Johanna Calderon, David C Bellinger, Catherine Hartigan, Alison Lord, Christian Stopp, David Wypij, Jane W Newburger
INTRODUCTION: Executive function (EF) impairments are among the most prevalent neurodevelopmental morbidities in youth with congenital heart disease (CHD). To date, no studies have investigated the efficacy of cognitive interventions to improve EF outcomes in children with CHD. METHODS AND ANALYSIS: This is a single-centre, single-blinded, two-arm randomised controlled trial to test the efficacy of Cogmed Working Memory Training (Cogmed) versus standard of care in children with CHD after open-heart surgery in infancy...
February 19, 2019: BMJ Open
Amanda H Lavan, Denis O'Mahony, Paul Gallagher, Richard Fordham, Evelyn Flanagan, Darren Dahly, Stephen Byrne, Mirko Petrovic, Adalsteinn Gudmundsson, Olafur Samuelsson, Antonio Cherubini, Alfonso J Cruz-Jentoft, Roy L Soiza, Joseph A Eustace
BACKGROUND: The aim of this trial is to evaluate the effect of SENATOR software on incident, adverse drug reactions (ADRs) in older, multimorbid, hospitalized patients. The SENATOR software produces a report designed to optimize older patients' current prescriptions by applying the published STOPP and START criteria, highlighting drug-drug and drug-disease interactions and providing non-pharmacological recommendations aimed at reducing the risk of incident delirium. METHODS: We will conduct a multinational, pragmatic, parallel arm Prospective Randomized Open-label, Blinded Endpoint (PROBE) controlled trial...
February 13, 2019: BMC Geriatrics
Michael Winterhalter, Steffen Rex, Christian Stoppe, Peter Kienbaum, Hans-Helge Müller, Ines Kaufmann, Hermann Kuppe, Aristidis Dongas, Bernhard Zwissler
PURPOSE: Perioperative right ventricular (RV) failure due to pressure overload from pulmonary hypertension (PH) worsens postoperative outcomes after cardiac surgery. Inhaled iloprost is a potent pulmonary vasodilator improving RV performance, ameliorating myocardial and pulmonary ischemia-reperfusion injury and attenuating inflammation. We hypothesized that the prophylactic inhalation of iloprost would reduce postoperative ventilation times after cardiac surgery. METHODS: In this phase III, multicentre, randomized, double-blind, placebo-controlled trial, we randomly assigned 253 cardiac surgical patients at high risk of perioperative RV failure to the prophylactic inhalation of 20 µg iloprost or placebo before and during weaning from extracorporeal circulation...
February 12, 2019: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Chi-Hsien Huang, Hiroyuki Umegaki, Yuuki Watanabe, Hiroko Kamitani, Atushi Asai, Shigeru Kanda, Hideki Nomura, Masafumi Kuzuya
BACKGROUND: Although potentially inappropriate medications (PIMs) have been linked to poor health outcomes, country-specific PIM criteria have not been compared. Thus, we compared the identification of PIMs between the Screening Tool for Older Person's Appropriate Prescriptions for Japanese (STOPP-J) and the 2015 American Geriatrics Society Beers Criteria in elderly patients receiving home-based medical services. METHODS: A 5-year prospective cohort study was conducted with 196 patients receiving home-based medical services...
2019: PloS One
Eike Christian Kühn, Anna Slagman, Ellen C D Kühn-Heid, Julian Seelig, Christian Schwiebert, Waldemar B Minich, Christian Stoppe, Martin Möckel, Lutz Schomburg
OBJECTIVE: Selenium-binding protein 1 (SELENBP1) is an intracellular protein with variable expression in response to cellular stress. As the selenium (Se) status is affected by inflammation and hypoxia, we hypothesized that SELENBP1 contributes to disease-specific Se metabolism. To test this hypothesis, a quantitative assay was developed and used to monitor SELENBP1 in patients with acute coronary syndrome (ACS). MATERIALS AND METHODS: SELENBP1 was expressed, antibodies were generated and a luminometric immuno assay (LIA) was established and characterized...
March 2019: Journal of Trace Elements in Medicine and Biology
Marko Stojanović, Milica Vuković, Milan Jovanović, Srđan Dimitrijević, Miroslav Radenković
RATIONALE, AIMS, AND OBJECTIVE: There is limited information about the comparative effectiveness of the START/STOPP (Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment) criteria and the Ghent Older People's Prescriptions community Pharmacy Screening tool (GheOP3 S tool) for the screening of potentially inappropriate prescribing (PIP) in the geriatric population. Considering this, the aim of this study was to compare the ability of the START/STOPP criteria and GheOP3 S tool to identify the PIP and potential prescribing omissions (PPOs) among elderly patients visiting their primary care physician...
February 5, 2019: Journal of Evaluation in Clinical Practice
Patrick Meybohm, Simone Lindau, Sascha Treskatsch, Roland Francis, Claudia Spies, Markus Velten, Maria Wittmann, Erdem Gueresir, Christian Stoppe, Ana Kowark, Mark Coburn, Sixten Selleng, Marcel Baschin, Gregor Jenichen, Melanie Meersch, Thomas Ermert, Alexander Zarbock, Peter Kranke, Markus Kredel, Antonia Helf, Rita Laufenberg-Feldmann, Marion Ferner, Eva Wittenmeier, Karl-Heinz Gürtler, Peter Kienbaum, Marcel Gama de Abreu, Michael Sander, Michael Bauer, Timo Seyfried, Matthias Gruenewald, Suma Choorapoikayil, Markus M Mueller, Erhard Seifried, Oana Brosteanu, Holger Bogatsch, Dirk Hasenclever, Kai Zacharowski
BACKGROUND: Perioperative anaemia leads to impaired oxygen supply with a risk of vital organ ischaemia. In healthy and fit individuals, anaemia can be compensated by several mechanisms. Elderly patients, however, have less compensatory mechanisms because of multiple co-morbidities and age-related decline of functional reserves. The purpose of the study is to evaluate whether elderly surgical patients may benefit from a liberal red blood cell (RBC) transfusion strategy compared to a restrictive transfusion strategy...
February 4, 2019: Trials
Stefanie Thevelin, Leïla El Mounaouar, Sophie Marien, Benoit Boland, Séverine Henrard, Olivia Dalleur
BACKGROUND: Older persons are at significant risk of drug-related admissions (DRAs). We previously demonstrated that 27% of hospitalizations in geriatric patients were associated with potentially inappropriate medicines (PIMs) and/or potential prescribing omissions (PPOs) identified by the Screening Tool of Older People's Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START) criteria version 1 (v1 ). The updated STOPP/START criteria version 2 (v2 ) comprised a 31% increase in prescribing criteria...
January 29, 2019: Drugs & Aging
Sabine Westphal, Christian Stoppe, Matthias Gruenewald, Berthold Bein, Jochen Renner, Jochen Cremer, Mark Coburn, Gereon Schaelte, Andreas Boening, Bernd Niemann, Frank Kletzin, Jan Roesner, Ulrich Strouhal, Christian Reyher, Rita Laufenberg-Feldmann, Marion Ferner, Ivo F Brandes, Martin Bauer, Andreas Kortgen, Sebastian N Stehr, Maria Wittmann, Georg Baumgarten, Rafael Struck, Tanja Meyer-Treschan, Peter Kienbaum, Matthias Heringlake, Julika Schoen, Michael Sander, Sascha Treskatsch, Thorsten Smul, Ewa Wolwender, Thomas Schilling, Frauke Degenhardt, Andre Franke, Soeren Mucha, Lukas Tittmann, Madeline Kohlhaas, Georg Fuernau, Oana Brosteanu, Dirk Hasenclever, Kai Zacharowski, Patrick Meybohm
BACKGROUND: The aim of our study was the identification of genetic variants associated with postoperative complications after cardiac surgery. METHODS: We conducted a prospective, double-blind, multicenter, randomized trial (RIPHeart). We performed a genome-wide association study (GWAS) in 1170 patients of both genders (871 males, 299 females) from the RIPHeart-Study cohort. Patients undergoing non-emergent cardiac surgery were included. Primary endpoint comprises a binary composite complication rate covering atrial fibrillation, delirium, non-fatal myocardial infarction, acute renal failure and/or any new stroke until hospital discharge with a maximum of fourteen days after surgery...
January 24, 2019: BMC Cardiovascular Disorders
U G S Siripala, S P K Premadasa, N R Samaranayake, C A Wanigatunge
Background There is a dearth of published data from resource-limited settings on appropriateness of medicines in older adults using explicit criteria, but it is unclear if the STOPP/START criteria can be helpful. Objective To assess the usefulness of STOPP/START criteria in assessing appropriateness of medicines in a resource-limited setting. Setting Medical, diabetic and psychiatric clinics of a tertiary care hospital and elderly living in a selected locality in Colombo district. Method A descriptive cross-sectional study was conducted over a 2 months period among adults > 60 years on long-term medicines...
January 22, 2019: International Journal of Clinical Pharmacy
Johannes Gleich, Daniel Pfeufer, Christian Zeckey, Wolfgang Böcker, Markus Gosch, Christian Kammerlander, Carl Neuerburg
BACKGROUND: Multimorbidity and polypharmacy are common challenges in the treatment of older trauma patients. Therefore, various integrated care models were developed over the last few years, merging the expertise of geriatricians and trauma surgeons. The aim of this study was to evaluate, if the number of prescriptions of potentially inappropriate medication (PIM) could be reduced in these patients by an interdisciplinary co-managed concept compared to conventional trauma care. METHODS: We conducted a retrospective, dual-center cohort study, including all patients aged 70 years and older admitted with a fracture of the hip or the proximal humerus within the study period...
January 22, 2019: European Journal of Medical Research
Robert Deisz, Susanne Rademacher, Katrin Gilger, Rudolf Jegen, Barbara Sauerzapfe, Christina Fitzner, Christian Stoppe, Carina Benstoem, Gernot Marx
BACKGROUND: Sepsis is a major health care problem with high morbidity and mortality rates and affects millions of patients. Telemedicine, defined as the exchange of medical information via electronic communication, improves the outcome of patients with sepsis and decreases the mortality rate and length of stay in the intensive care unit (ICU). Additional telemedicine rounds could be an effective component of performance-improvement programs for sepsis, especially in underserved rural areas and hospitals without ready access to critical care physicians...
January 15, 2019: Journal of Medical Internet Research
Marte Sofie Wang-Hansen, Torgeir Bruun Wyller, Lara T Hvidsten, Hege Kersten
PURPOSE: The purpose of the study is to identify and explore risk factors of serious adverse drug events (SADE) and SADE-related admissions in acutely hospitalized multimorbid older adults and assess whether these could have been prevented by adherence to the prescription tools Screening Tool of Older Persons' Prescriptions (STOPP) and The Norwegian General Practice (NORGEP) criteria. METHODS: Cross-sectional study of acutely admitted patients to a medical department in a Norwegian regional hospital...
January 20, 2019: European Journal of Clinical Pharmacology
Kieran Dalton, Denis O'Mahony, David O'Sullivan, Marie N O'Connor, Stephen Byrne
BACKGROUND: Two randomised controlled trials (RCTs) conducted simultaneously in the same Irish university teaching hospital have shown that provision of Screening Tool of Older Persons' Prescriptions (STOPP)/Screening Tool to Alert doctors to Right Treatment (START) recommendations to attending prescribers by a physician or a pharmacist can reduce in-hospital adverse drug reactions (ADRs) in older adults (≥ 65 years). The aims of this study were to compare the prescriber implementation rates of STOPP/START recommendations between the physician approach and the pharmacist approach in these two RCTs and to provide a narrative summary of the comparable clinical outcomes...
January 19, 2019: Drugs & Aging
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