Pub Date : 2016-12-01DOI: 10.1016/J.JCGG.2016.05.004
D. George
{"title":"Why aren't medical students specializing in geriatrics, and can arts-based experiences with the elderly help? Insights from 4th-year trainees","authors":"D. George","doi":"10.1016/J.JCGG.2016.05.004","DOIUrl":"https://doi.org/10.1016/J.JCGG.2016.05.004","url":null,"abstract":"","PeriodicalId":100764,"journal":{"name":"Journal of Clinical Gerontology and Geriatrics","volume":"103 1","pages":"171-172"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78446582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01Epub Date: 2016-08-09DOI: 10.1016/j.jcgg.2016.06.001
Harry Harianto MBBS , Benjamin Watson MBBS , Julie van der Klift MBBS, BN , Sandi Valentine PGDip Critical Care , Jonathan Marriott MBBS
Background/Purpose
To investigate if systemic inflammatory response syndrome (SIRS), present on arrival to the emergency department, correlates with the timing of medical emergency team calls (MET calls), mortality, length of stay, and discharge destination.
Methods
A retrospective audit was performed on patients who had a MET call during their admission and were over the age of 75 years during a 6-month period. A total of 127 patients were included: 43 with SIRS and 84 without.
Results
There was a greater amount of MET calls within 48 hours for the SIRS group compared with the Non-SIRS group (48.8% vs. 27.4%), with an odds ratio of 2.54 (95% confidence interval: 1.18–5.45, p < 0.0175). A MET call greater than 48 hours was associated with a longer length of stay (7.91 days vs. 15.49 days, mean, p < 0.0003), and higher mortality rates, 28.9% versus 4.5%, with an odds ratio of 8.54 (95% confidence interval: 1.91–38.12, p < 0.0049).
Conclusion
The presence of SIRS on admission may be considered in assessing early deterioration, prognosis, and treatment aims for older patients.
{"title":"The impact of the presence of systemic inflammatory response syndrome in the emergency department on the timing and outcomes of medical emergency team calls after admission: A retrospective audit","authors":"Harry Harianto MBBS , Benjamin Watson MBBS , Julie van der Klift MBBS, BN , Sandi Valentine PGDip Critical Care , Jonathan Marriott MBBS","doi":"10.1016/j.jcgg.2016.06.001","DOIUrl":"https://doi.org/10.1016/j.jcgg.2016.06.001","url":null,"abstract":"<div><h3>Background/Purpose</h3><p>To investigate if systemic inflammatory response syndrome (SIRS), present on arrival to the emergency department, correlates with the timing of medical emergency team calls (MET calls), mortality, length of stay, and discharge destination.</p></div><div><h3>Methods</h3><p>A retrospective audit was performed on patients who had a MET call during their admission and were over the age of 75 years during a 6-month period. A total of 127 patients were included: 43 with SIRS and 84 without.</p></div><div><h3>Results</h3><p>There was a greater amount of MET calls within 48 hours for the SIRS group compared with the Non-SIRS group (48.8% vs. 27.4%), with an odds ratio of 2.54 (95% confidence interval: 1.18–5.45, <em>p</em> <!--><<!--> <!-->0.0175). A MET call greater than 48 hours was associated with a longer length of stay (7.91 days vs. 15.49 days, mean, <em>p</em> <!--><<!--> <!-->0.0003), and higher mortality rates, 28.9% versus 4.5%, with an odds ratio of 8.54 (95% confidence interval: 1.91–38.12, <em>p</em> <!--><<!--> <!-->0.0049).</p></div><div><h3>Conclusion</h3><p>The presence of SIRS on admission may be considered in assessing early deterioration, prognosis, and treatment aims for older patients.</p></div>","PeriodicalId":100764,"journal":{"name":"Journal of Clinical Gerontology and Geriatrics","volume":"7 4","pages":"Pages 119-123"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcgg.2016.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72245071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.1016/J.JCGG.2016.05.003
R. Kawamoto, Daisuke Ninomiyax, T. Kusunoki, Y. Kasai, N. Ohtsuka, T. Kumagi
{"title":"Oxidative stress is associated with increased arterial stiffness in middle-aged and elderly community-dwelling persons","authors":"R. Kawamoto, Daisuke Ninomiyax, T. Kusunoki, Y. Kasai, N. Ohtsuka, T. Kumagi","doi":"10.1016/J.JCGG.2016.05.003","DOIUrl":"https://doi.org/10.1016/J.JCGG.2016.05.003","url":null,"abstract":"","PeriodicalId":100764,"journal":{"name":"Journal of Clinical Gerontology and Geriatrics","volume":"35 1","pages":"136-140"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84532245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.1016/J.JCGG.2016.02.001
G. Saito, T. Higuchi, Ryosuke Koyamada, Sadamu Okada
{"title":"Successful treatment with rituximab of a very elderly patient with refractory thrombotic thrombocytopenic purpura","authors":"G. Saito, T. Higuchi, Ryosuke Koyamada, Sadamu Okada","doi":"10.1016/J.JCGG.2016.02.001","DOIUrl":"https://doi.org/10.1016/J.JCGG.2016.02.001","url":null,"abstract":"","PeriodicalId":100764,"journal":{"name":"Journal of Clinical Gerontology and Geriatrics","volume":"9 1","pages":"168-170"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84369096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Progressive supranuclear palsy (PSP) is an unusual neurodegenerative disorder with variant clinical phenotypes. Accurate diagnosis is challenging in the early stage, especially in psychiatric clinics, where misdiagnoses with psychiatric illness are common. A case of PSP was difficult to differentiate from other Parkinsonian syndromes initially, and the patient's affective symptoms predated the onset of other symptoms. Gaze abnormality and frontal lobe syndromes emerged and she was diagnosed with PSP 5 months after the first psychiatric visit. Heightened awareness of PSP and its diagnosis are important, not only because of prognostic implications, but also because of appropriate interventions and focused therapeutic targets.
{"title":"Diversified psychiatric presentation in a case of progressive supranuclear palsy","authors":"Yu-Wen Chiu MD , Shwu-Hua Lee MD , Tu-Hsueh Yeh PhD","doi":"10.1016/j.jcgg.2016.05.001","DOIUrl":"https://doi.org/10.1016/j.jcgg.2016.05.001","url":null,"abstract":"<div><p>Progressive supranuclear palsy (PSP) is an unusual neurodegenerative disorder with variant clinical phenotypes. Accurate diagnosis is challenging in the early stage, especially in psychiatric clinics, where misdiagnoses with psychiatric illness are common. A case of PSP was difficult to differentiate from other Parkinsonian syndromes initially, and the patient's affective symptoms predated the onset of other symptoms. Gaze abnormality and frontal lobe syndromes emerged and she was diagnosed with PSP 5 months after the first psychiatric visit. Heightened awareness of PSP and its diagnosis are important, not only because of prognostic implications, but also because of appropriate interventions and focused therapeutic targets.</p></div>","PeriodicalId":100764,"journal":{"name":"Journal of Clinical Gerontology and Geriatrics","volume":"7 4","pages":"Pages 164-167"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcgg.2016.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72245068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01Epub Date: 2016-07-01DOI: 10.1016/j.jcgg.2016.05.002
Seonghun Hong MD , Sunyoung Kim MD , Jinho Yoo MD , Byung Sung Kim MD, PhD , Hyun Rim Choi MD, PhD , Sung Eun Choi PhD , Chang Gi Hong MD , Chang Won Won MD, PhD
Background/Purpose
Slower gait speed is a good predictor of falls, dependency, disability, and mortality. However, the cutoff point of the gait speed to best predict the bad outcomes is controversial. The purpose of this study was to determine the cutoff point of gait speed that best predicts Instrumental Activities of Daily Living (IADL) dependency.
Methods
The study targeted 8000 people aged ≥ 65 years who had been enrolled in 2008 and followed up in 2011 for the Living Profiles of Older People Survey in Korea. The population was divided into an independent group and a dependent group with 2011 Korean Instrumental Activities of Daily Living (K-IADL) scores of 10 and ≥ 11, respectively. The gait speed was measured as the time taken to walk 2.5 m at a usual pace without any help, and the best result of two trials was chosen for analysis.
Results
The area under the curve was highest (0.642) at gait speed of 0.6 m/s, with a sensitivity and specificity of 68.44% and 55.09%, respectively. The dependency hazard ratio of IADL was statistically significant in the group with gait speed less than 0.6 m/s, 1.974 (95% confidence interval, 1.646–2.367). The dependency hazard ratio of IADL was also statistically significant in the same group after adjusting for all relevant variables, 1.613 (95% confidence interval, 1.332–1.955).
Conclusion
The gait speed of 0.6 m/s may be considered as the new standard of a screening tool to predict IADL dependency in Korean people aged ≥ 65 years.
{"title":"Slower gait speed predicts decline in Instrumental Activities of Daily Living in community-dwelling elderly: 3-year prospective finding from Living Profiles of Older People Survey in Korea","authors":"Seonghun Hong MD , Sunyoung Kim MD , Jinho Yoo MD , Byung Sung Kim MD, PhD , Hyun Rim Choi MD, PhD , Sung Eun Choi PhD , Chang Gi Hong MD , Chang Won Won MD, PhD","doi":"10.1016/j.jcgg.2016.05.002","DOIUrl":"https://doi.org/10.1016/j.jcgg.2016.05.002","url":null,"abstract":"<div><h3>Background/Purpose</h3><p>Slower gait speed is a good predictor of falls, dependency, disability, and mortality. However, the cutoff point of the gait speed to best predict the bad outcomes is controversial. The purpose of this study was to determine the cutoff point of gait speed that best predicts Instrumental Activities of Daily Living (IADL) dependency.</p></div><div><h3>Methods</h3><p>The study targeted 8000 people aged ≥ 65 years who had been enrolled in 2008 and followed up in 2011 for the Living Profiles of Older People Survey in Korea. The population was divided into an independent group and a dependent group with 2011 Korean Instrumental Activities of Daily Living (K-IADL) scores of 10 and ≥ 11, respectively. The gait speed was measured as the time taken to walk 2.5 m at a usual pace without any help, and the best result of two trials was chosen for analysis.</p></div><div><h3>Results</h3><p>The area under the curve was highest (0.642) at gait speed of 0.6 m/s, with a sensitivity and specificity of 68.44% and 55.09%, respectively. The dependency hazard ratio of IADL was statistically significant in the group with gait speed less than 0.6 m/s, 1.974 (95% confidence interval, 1.646–2.367). The dependency hazard ratio of IADL was also statistically significant in the same group after adjusting for all relevant variables, 1.613 (95% confidence interval, 1.332–1.955).</p></div><div><h3>Conclusion</h3><p>The gait speed of 0.6 m/s may be considered as the new standard of a screening tool to predict IADL dependency in Korean people aged ≥ 65 years.</p></div>","PeriodicalId":100764,"journal":{"name":"Journal of Clinical Gerontology and Geriatrics","volume":"7 4","pages":"Pages 141-145"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcgg.2016.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72245050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.1016/J.JCGG.2016.03.001
K. Hill, E. Wee, Soula Margelis, H. Menz, J. Bartlett, N. Bergman, S. McMahon, D. Hare, P. Levinger
{"title":"Falls in people prior to undergoing total hip or total knee replacement surgery: Frequency and associated factors","authors":"K. Hill, E. Wee, Soula Margelis, H. Menz, J. Bartlett, N. Bergman, S. McMahon, D. Hare, P. Levinger","doi":"10.1016/J.JCGG.2016.03.001","DOIUrl":"https://doi.org/10.1016/J.JCGG.2016.03.001","url":null,"abstract":"","PeriodicalId":100764,"journal":{"name":"Journal of Clinical Gerontology and Geriatrics","volume":"6 1","pages":"146-152"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76071795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.1016/J.JCGG.2016.06.001
Harry Harianto, Benjamin Watson, Julie van der Klift, S. Valentine, J. Marriott
{"title":"The impact of the presence of systemic inflammatory response syndrome in the emergency department on the timing and outcomes of medical emergency team calls after admission: A retrospective audit","authors":"Harry Harianto, Benjamin Watson, Julie van der Klift, S. Valentine, J. Marriott","doi":"10.1016/J.JCGG.2016.06.001","DOIUrl":"https://doi.org/10.1016/J.JCGG.2016.06.001","url":null,"abstract":"","PeriodicalId":100764,"journal":{"name":"Journal of Clinical Gerontology and Geriatrics","volume":"13 1","pages":"119-123"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81276336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.1016/J.JCGG.2016.05.005
Kasumi Daidoji, Y. Sakata, Kenta Sumitomo, M. Ishii, T. Toyoda, M. Kawaguchi
{"title":"Concomitant use of psychotropics and donepezil in Japanese patients with dementia: Pooled postmarketing surveillance data analysis","authors":"Kasumi Daidoji, Y. Sakata, Kenta Sumitomo, M. Ishii, T. Toyoda, M. Kawaguchi","doi":"10.1016/J.JCGG.2016.05.005","DOIUrl":"https://doi.org/10.1016/J.JCGG.2016.05.005","url":null,"abstract":"","PeriodicalId":100764,"journal":{"name":"Journal of Clinical Gerontology and Geriatrics","volume":"33 1","pages":"131-135"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77591511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-10-23DOI: 10.24816/JCGG.2017.V8I2.0
V. Siaw, Susan W. Kim, P. Hakendorf, C. Horwood, T. To
Background: Recent reports have suggested that mortality and morbidity in patients with concomitant upper limb and hip fractures vary depending on the sites of fracture. Objectives: To determine the mortality outcomes in elderly patients with concomitant upper limb (wrist or humerus) and hip fractures compared to patients with isolated hip fractures. The secondary objective was to determine the length of hospital stay during acute care, morbidity characteristics and perioperative complication rates. Methods: 144 older adults with concomitant upper limb and hip fractures were compared to 2,690 older adults with isolated hip fractures in a single-centre tertiary hospital. Blinded patient data were extracted from our Inpatient Separation Information System based on ICD-10 codes for analysis and comparison between the groups. A multivariate regression survival analysis was performed to determine mortality outcomes. Results: No difference in mortality was shown between patient groups in the short and long term. Older adults with concomitant humeral and hip fractures had a higher prevalence of cognitive disorders and chronic kidney disease, while those with concomitant wrist and hip fractures had the lowest. Those with concomitant upper limbs fracture had a longer length of stay during the acute care, as well as a greater requirement for blood transfusions. Conclusions: When compared to isolated hip fracture patients, older adults with concomitant hip and humeral fractures may represent a frailer group, but not necessary in those with concomitant hip and wrist fractures.
{"title":"Concomitant upper limb and hip fractures in older adults - does the site matter? A retrospective clinical observation study","authors":"V. Siaw, Susan W. Kim, P. Hakendorf, C. Horwood, T. To","doi":"10.24816/JCGG.2017.V8I2.0","DOIUrl":"https://doi.org/10.24816/JCGG.2017.V8I2.0","url":null,"abstract":"Background: Recent reports have suggested that mortality and morbidity in patients with concomitant upper limb and hip fractures vary depending on the sites of fracture. Objectives: To determine the mortality outcomes in elderly patients with concomitant upper limb (wrist or humerus) and hip fractures compared to patients with isolated hip fractures. The secondary objective was to determine the length of hospital stay during acute care, morbidity characteristics and perioperative complication rates. Methods: 144 older adults with concomitant upper limb and hip fractures were compared to 2,690 older adults with isolated hip fractures in a single-centre tertiary hospital. Blinded patient data were extracted from our Inpatient Separation Information System based on ICD-10 codes for analysis and comparison between the groups. A multivariate regression survival analysis was performed to determine mortality outcomes. Results: No difference in mortality was shown between patient groups in the short and long term. Older adults with concomitant humeral and hip fractures had a higher prevalence of cognitive disorders and chronic kidney disease, while those with concomitant wrist and hip fractures had the lowest. Those with concomitant upper limbs fracture had a longer length of stay during the acute care, as well as a greater requirement for blood transfusions. Conclusions: When compared to isolated hip fracture patients, older adults with concomitant hip and humeral fractures may represent a frailer group, but not necessary in those with concomitant hip and wrist fractures.","PeriodicalId":100764,"journal":{"name":"Journal of Clinical Gerontology and Geriatrics","volume":"64 1","pages":"47-51"},"PeriodicalIF":0.0,"publicationDate":"2016-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81084046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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