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Choosing of drug for anesthesia in intensive therapy of traumatic disease for geriatric patients.

OBJECTIVE: The aim of the study was to find the most rational approach to postoperative pain relief in the complex of intensive care for the acute and early periods of traumatic diseasein elderly patients. PATIENTS AND METHODS: Materials and methods: 132 gerontology patients with multiple trauma were included in the study. Respiratory and cardiovascular systems parameters were assessed, coagulogram and inflammatory response markers, pain severity and analgesia quality were assed. RESULTS: Results: According to the data obtained from the evaluation of VAS and Likerts scale, as well as other r

Mortality following surgery for geriatric hip fractures: is it the timing or the co-morbidities?

BACKGROUND: Hip fractures are prevalent in the elderly population and present serious health, social and economic problems, with an impact on morbidity and mortality. Today, it is common practice to surgically repair these fractures as early as possible, preferably within 48 hours of hospital admission. However, there is conflicting evidence in the literature about the effect of the timing of surgery on postoperative mortality. OBJECTIVES: To assess the association between surgery delay and other demographic and clinical variables with an increased mortality rate after surgical treatment of h

Prospective GERiatric Observational (ProGERO) study: cohort design and preliminary results.

BACKGROUND: The demographic changes in Brazil as a result of population aging is one of the fastest in the world. The far-reaching new challenges that come with a large older population are particularly disquieting in low- and middle-income countries (LMICs). Longitudinal studies must be completed in LMICs to investigate the social and biological determinants of aging and the consequences of such demographic changes in their context. Therefore, we designed the Prospective GERiatric Observational (ProGERO) study, a longitudinal study of outpatient older adults in São Paulo, Brazil, to collect d

Characteristics and Real-Life Outcomes of Dementia and Cognitive Impairment at a Geriatric Clinic.

BACKGROUND: Various patterns of dementia care have been developed in different settings, depending on the availability of healthcare resources and facilities. The purpose of this study was to examine the epidemiology and characteristics of dementia care at a geriatric clinic, a field that has been subject to little prior evaluation. METHODS: A retrospective chart review was undertaken of cohort patients with cognitive impairment who had received a diagnosis and were still on active follow-up at a geriatric clinic. A total of 892 patients were included. In addition, 203 geriatric patients with

Assessment of Fractal Characteristics of Locomotor Activity of Geriatric In-Patients With Alzheimer's Dementia.

INTRODUCTION: Many physiological signals yield fractal characteristics, i.e., finer details at higher magnifications resemble details of the whole. Evidence has been accumulating that such fractal scaling is basically a consequence of interaction-dominant feedback mechanisms that cooperatively generate those signals. Neurodegenerative diseases provide a natural framework to evaluate this paradigm when this cooperative function declines. However, methodological issues need to be cautiously taken into account in order to be able to provide reliable as well as valid interpretations of such signal

Geriatric pharmacotherapy: Appraising new drugs for neurologic disorders in older patients.

New drug development for neurologic disorders has one of the highest attrition rates of all clinical drug developments. This is problematic when, with innovative technology available in so many aspects of life, modern societies expect to have effective treatments for neurodegenerative disorders and mental health conditions that provide something beyond simple symptomatic relief-the expectation is treatment that impacts and mitigates fundamental mechanisms that drive these disorders. The disease burden of neurologic disorders remains extremely high, whereas the proportion of patients receiving

Diminished Dynamic Physical Performance Is Associated With Orthostatic Hypotension in Geriatric Outpatients.

BACKGROUND AND PURPOSE: Orthostatic hypotension (OH), a blood pressure drop after postural change, is a highly prevalent and disabling syndrome in older adults. Yet, the association between physical performance and OH is not clearly established. The aim of this study was to determine whether different types of physical performance are associated with OH in a clinically relevant population of geriatric outpatients. METHODS: This cross-sectional study included 280 geriatric outpatients (mean age: 82.2 years, standard deviation: 7.1). Orthostatic hypotension was determined using intermittently m

Patterns of geriatric anemia: A hospital-based observational study in North India.

BackgroundGeriatric anemia is a global health problem because of its high prevalence and associated significant morbidity and mortality.AimThe objectives of this study were to estimate the pattern of anemia in the elderly patients and the underlying etiology of anemia.Research design and methodsThis was a hospital-based prospective observational study, conducted in patients aged 60 years and above at PGIMER, Chandigarh, a tertiary care center of North India. Anemia is defined as hemoglobin level less than 13 g/dl in men and 12 g/dl in women.ResultsAmong the 105 older patients with anemia, the

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… Iron deficiency anemia and anemia of chronic disease in geriatric hospitalized patients: How frequent are comorbidities as an additional explanation for the anemia? Geriatr Gerontol Int. 2014;15:931–5. doi: 10.1111/ggi.12371. 24. Fraenkel PG. Anemia of inflammation. … Ham's Primary Care Geriatrics: A Case-Based Approach. 6th ed. Philadelphia: Saunders Elsevier; 2014. p. 494. …

Drug-Induced Mitochondrial Toxicity in the Geriatric Population: Challenges and Future Directions.

Mitochondrial function declines with age, leading to a variety of age-related diseases (metabolic, central nervous system-related, cancer, etc.) and medication usage increases with age due to the increase in diseases. Drug-induced mitochondrial toxicity has been described for many different drug classes and can lead to liver, muscle, kidney and central nervous system injury and, in rare cases, to death. Many of the most prescribed medications in the geriatric population carry mitochondrial liabilities. We have demonstrated that, over the past decade, each class of drugs that demonstrated mitoc

[Clinical application of multidisciplinary team co-management in geriatric hip fractures].

OBJECTIVE: To observe the clinical application of multidisciplinary team (MDT) treatment in the management of geriatric hip fractures and evaluate its effectiveness. METHODS: The clinical data of 76 elderly patients with hip fracture managed by MDT approach between August 2016 and February 2018 (MDT group) were retrospectively analyzed and compared with 102 patients managed by traditional orthopedics approach between January 2014 and December 2015 (conventional group). There was no significant difference in gender, age, fracture type, surgical procedure, and other general data between the two

Perioperative comprehensive geriatric assessment: what do we need to know?

As a consequence of an ageing population greater numbers of elderly patients are presenting for both elective and emergency surgery. These older patients typically present with an increased burden of age-related problems and multimorbidity, which is associated with an increased risk of adverse postoperative outcomes. Traditional preoperative assessment models are adept at discerning patients' suitability for anaesthesia and surgery, but there is minimal focus on improving postoperative outcomes. Comprehensive geriatric assessment is a multidisciplinary approach used both to assess existing 'kn

Venous thromboembolism following initiation of atypical antipsychotics in two geriatric patients.

BACKGROUND: Although not formally highlighted as a risk factor in current practice guidelines, several observational studies have reported a possible association between antipsychotic use and development of venous thromboembolism (VTE). However, it is unclear to what extent the risk is elevated. CASE REPORT: Described are 2 cases of VTE following recent initiation of second-generation antipsychotics in elderly patients. Ms A was a 65-year-old woman with newly diagnosed bipolar I disorder who was hospitalized for acute mania and psychosis. She was treated with risperidone along with traditiona

Is Patient Satisfaction Associated with Objective Measures of Geriatric Hip Fracture Care?

BACKGROUND: Patient satisfaction is publicly reported and used as a subjective measure of quality of care in alternative payment reimbursement models. In this study, we evaluated the association between patient satisfaction scores and objective measures of geriatric hip fracture care. Therefore, according to patient satisfaction score, we investigated the differences for geriatric hip fracture admissions in regard to 1. surgical delay during the index admission and 2. mortality within 1 year. METHODS: We identified 65,974 patients between the ages of 60 and 99 years with a primary diagnosis o

Geriatric distal femoral fractures: A retrospective study of 30 day mortality.

INTRODUCTION: Distal femoral fractures have many of the same challenges as hip fractures, but there has been limited research into outcomes following these. The aim of this study was to assess 30 day mortality following distal femoral fractures in comparison to hip fractures presenting to a single institution Secondary outcomes included risk factors for mortality, post-operative complications and union. METHODS: A retrospective case series of all distal femoral fragility fractures in patients over 65, and hip fractures over a 5 year period at a single institution. RESULTS: 88 distal femoral

Applications of PET Imaging in the Evaluation of Musculoskeletal Diseases Among the Geriatric Population.

Medical imaging plays a particularly important role in the care of elderly patients, in whom complex symptomatology and a high prevalence of musculoskeletal diseases necessitate sensitive imaging modalities. MRI is the most commonly used imaging modality in the evaluation of various musculoskeletal disorders. The integration of positron emission technique and computed tomography as well as magnetic resonance imaging allows for generating complimentary data for accurate and quantitative diagnosis. This article highlights the implementations of molecular imaging probes in the assessment of preva

The association between nutritional status and frailty characteristics among geriatric outpatients.

BACKGROUND: Frailty is a common clinical syndrome in older adults and is associated with an increased risk of poor health outcomes, e.g. falls, disability, hospitalization, and mortality. Nutritional status might be an important factor contributing to frailty. This study aims to describe the association between nutritional status and characteristics of frailty in patients attending a geriatric outpatient clinic. METHODS: Clinical data was collected of 475 patients who visited the geriatric outpatient department of a Dutch hospital between 2005 and 2010. Frailty was determined by: incontinence

Comparative characteristic of antimicrobial resistance in geriatric hospital: a retrospective cohort study.

BACKGROUND AND AIMS: To examine antimicrobial resistance of commonly isolated pathogens in elderly hospitalized patients. METHODS: Data regarding all clinically significant isolates from blood and urine cultures of patients admitted to a multilevel geriatric hospital during March 2015 to April 2016 were collected. Antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standard Institute guidelines. RESULTS: Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae were the most common isolates, with proportions of extended spectrum beta-lactamase positiv

Management of multiple myeloma in older adults: Gaining ground with geriatric assessment.

Multiple myeloma increases in incidence with age. With the aging of the population, the number of cases of multiple myeloma diagnosed in older adults each year will nearly double in the next 20years. The novel therapeutic agents have significantly improved survival in older adults, but their outcomes remain poorer than in younger patients. Older adults may be more vulnerable to toxicity of therapy, resulting in decreased dose intensity and contributing to poorer outcomes. Data are beginning to emerge to aid in identifying which individuals are at greater risk for toxicity of therapy; comorbidi