检索结果-南通市图书馆

Chinese Medical Journal 2020年第4期133卷 381-387页

作者： Chun-Li Zhang Ru Feng Jiang-Tao Li Ting Wang Jie-Fei Bai Hui Liu Department of Hematology Beijing HospitalNational Center of GerontologyBeijing 100730China

Background:Acute myeloid leukemia(AML)is a common type of hematological malignancy in elderly people.Geriatricians developed comprehensive Geriatric assessment(CGA)methods for elderly patients;however,the tools used for CGA in AML are not uniform.Thus,we aimed to validate the instrumental activities of daily living(IADL)scales,age,comorbidities(Charlson Comorbidity Index),and albumin(IACA)index,which is a new tool for CGA,in elderly patients with AML.Methods:Patients aged>60 years who had been diagnosed with AML were screened for eligibility.Among the IACA low-,intermediate-,and high-risk groups,continuous variables were compared using the Mann-Whitney U test,and categorical variables were compared using/2 and Fisher exact tests.In addition,probabilities of overall survival(OS)were estimated using the Kaplan-Meier method.Results:A total of 21,34,and 6 patients were categorized into IACA low-risk(0 point),intermediate-risk(1-2 points),and high-risk(>3 points)groups,respectively.The rates of relapse/progression-related mortality were 23.8%,58.8%,and 100.0%in the IACA low-,intermediate-,and high-risk groups,respectively(χ^2=12.81,PGeriatric assessment in elderly AML patients.

关键词： Acute myeloid leukemia Albumin Comorbidity Instrumental activities of daily living Comprehensive Geriatric assessment

Value of a comprehensive Geriatric assessment for predicting one-year outcomes in patients undergoing transcatheter aortic valve implantation: results from the CGA-TAVI multicentre registry

在线全文

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2019年第6期16卷 468-477页

作者： Martijn S.van Mourik Nathalie van der Velde Giulio Mannarino Marie-Pierre Thibodeau Jean-Bernard Masson Gennaro Santoro Jan Baan Sofie Jansen Jana Kurucova Martin Thoenes Cornelia Deutsch ANDreas W.Schoenenberger ANDrea Ungar Peter Bramlage M Marije Vis Department of Cardiology Amsterdam UMC University of Amsterdam Department of Internal Medicine Section of Geriatric Medicine Amsterdam UMC University of Amsterdam Geriatric Intensive Care Unit Department of Geriatrics and Medicine Careggi Hospital and University of Florence Centre Hospitalier de l’Université de Montréal Edwards Lifesciences Institute for Pharmacology und Preventive Medicine Department of Geriatrics Inselspital Bern University Hospital University of Bern

Background In a three-month report from the CGA-TAVI registry, we found the Multidimensional Prognostic Index (MPI) and Short Physical Performance Battery (SPPB) to be of value for predicting short-term outcomes in elderly patients undergoing transcatheter aortic valve implantation (TAVI). In the present analysis, we examined the association of these tools with outcomes up to one year post-TAVI. Methods CGA-TAVI is an international, observational registry of Geriatric patients undergoing TAVI. Patients were assessed using the MPI and SPPB. Efficacy of baseline values and any postoperative change for predicting outcome were established using logistic regression. Kaplan- Meier analysis was carried out for each comprehensive Geriatric assessment tool, with survival stratified by risk category. Results One year after TAVI, 14.1% of patients deceased, while 17.4% met the combined endpoint of death and/or non-fatal stroke, and 37.7% the combined endpoint of death and/or hospitalisation and/or non-fatal stroke. A high-risk MPI score was associated with an increased risk of all-cause mortality (aOR = 36.13, 95% CI: 2.77–470.78, P = 0.006) and death and/or non-fatal stroke (aOR = 10.10, 95% CI: 1.48–68.75, P = 0.018). No significant associations were found between a high-risk SPPB score and mortality or two main combined endpoints. In contrast to a worsening SPPB, an aggravating MPI score at three months post-TAVI was associated with an increased risk of death and/or non-fatal stoke at one year (aOR = 95.16, 95% CI: 3.41–2657.01). Conclusions The MPI showed value for predicting the likelihood of death and a combination of death and/or non-fatal stroke by one year after TAVI in elderly patients.

关键词： Comprehensive Geriatric assessment Multidimensional prognostic index Short physical performance battery Silver code Transcatheter aortic valve implantation

Opportunistic screening for atrial fibrillation with a single lead device in Geriatric patients

在线全文

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2020年第3期17卷 149-154,I0008页

作者： Lennaert AR Zwart Rene WMM Jansen Jacob H Ruiter Tjeerd Germans Suat Simsek Martin EW Hemels Department of Geriatric Medicine North West ClinicsWilhelminalaanAlkmaarthe Netherlands Department of Geriatric Medicine Dijklander HospitalMaelsonstraatHoornthe Netherlands Department of Cardiology North West ClinicsWilhelminalaanAlkmaarthe Netherlands Department of Internal Medicine North West ClinicsWilhelminalaanAlkmaarthe Netherlands Department of Cardiology Rijnstate HospitalArnhemthe Netherlands Department of Cardiology Radboud University Medical CentreGeert Grooteplein ZuidNijmegenthe Netherlands

Objective To determine the diagnostic yield of repeated screening for atrial fibrillation(AF)among Geriatric patients.Methods A pragmatic prospective cohort study into applying opportunistic screening for AF with a handheld single lead ECG device(SLD)in a Geriatric cohort.Consecutive patients of 65 years old and older visiting the Geriatric outpatient clinic were eligible for inclusion.A 12 lead ECG was performed,followed by measurements with the SLD during every visit to the Geriatric outpatient clinic.A frailty index was based on the accumulation of deficits model.Results 478 patients were eligible.Patients were excluded if they did not give informed consent(17 patients),had a pacemaker or implantable cardioverter defibrillator(20 patients),or had incomplete medical files(two patients).After exclusion,439 patients participated in this study.The mean age was 78 years(range 65 to 100 years),54%were female.AF was known in 89 patients(20%),first detected on the baseline ECG in four patients(1%)and first detected with the SLD in 20 patients(5%)during follow up visits.Sensitivity of the SLD was 90.0%,specificity 99.0%,negative predictive value 99.7%,and positive predictive value 73.5%.Most patients(82%)with AF were frail and 53%were severely frail.Conclusion Repeated screening in Geriatric patients has a five times higher diagnostic yield than usual care.It was easily combined with usual care.Because of the positive predictive value of 73.5%,it remains necessary to confirm AF with a 12 lead ECG or 24-h Holter monitoring.

关键词： Atrial fibrillation Frailty Geriatric patients Opportunistic screening The elderly

Geriatric Anesthesia-related Morbidity and Mortality in China： Current Status and Trend

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2017年第22期130卷 2738-2749页

作者： Yang Liu Wei Xiao Ling-Zhong Meng Tian-Long Wang Department of Anesthesiology and Operating Theatre Xuanwu Hospital Capital Medical University Beijing 100053 China Department of Anesthesiology Yale University School of Medicine New Haven CT 06520 USA

Objective： The population of elderly patients and the amount of Geriatric anesthesia have been growing rapidly in China. Thus, understanding the morbidity and mortality associated with Geriatric anesthesia in China is critical to the improvement of anesthesia quality and outcome. The aim of the review was to discuss the Geriatric anesthesia-related morbidity and mortality in China, as well as to point out the future trend. Data Sources： Articles in this review were all searched from Wanfang, China National Knowledge Infrastructure （CNKI）, VIP, PubMed, and Web of Science databases, based on the reports originated in China from January 2011 to December 2016. Study Selection： A total of 57 studies were selected for further study, including 12 retrospective studies, 35 prospective studies, 3 meta-analyses, 4 reviews, 1 viewpoint, and 2 case reports. Of the total studies, 42 studies were in Chinese while 15 were in English. Results： The mortality and morbidity associated with Geriatric anesthesia in China are not yet completely reported. Some factors have been recognized, while some are yet to be identified and confirmed. Several studies addressed postoperative cognitive dysfunction and postoperative delirium, whereas only a few studies can be found on renal complications. Thus, a nationwide registry is essential for Geriatric anesthesia-associated adverse outcomes. The mortality associated with Geriatric anesthesia in China should be reported promptly. In the future, the perspective of Geriatric anesthesia needs to be expanded into perioperative Geriatric medicine to improve the perioperative management strategy based on the postoperative outcome-directed concept transformation. Conclusions： Anesthesiologists should evaluate the physiological and medical status and focus on the prevention of potential complications in the perioperative setting with the goal to enhance elderly patients＇ long-term well-being and survival quality.

关键词： Anesthesia China Geriatric Morbidity Mortality

Auto-refraction versus subjective refraction in different phakic and pseudophakic conditions:the Tehran Geriatric Eye Study(TGES)

在线全文

学校读者我要写书评

暂无评论

International Journal of Ophthalmology(English edition) 2023年第8期16卷 1309-1316页

作者： Hassan Hashemi Amir Asharlous Alireza Jamali Abolghasem Mortazavi Alireza Hashemi Mehdi Khabazkhoob Noor Research Center for Ophthalmic Epidemiology Noor Eye HospitalTehran ***Iran Noor Ophthalmology Research Center Noor Eye HospitalTehran ***Iran Rehabilitation Research Center Department of OptometrySchool of Rehabilitation SciencesIran University of Medical SciencesTehran ***Iran Department of Neurosurgery Sina HospitalTehran University of Medical SciencesTehran ***Iran Department of Basic Sciences School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehran ***Iran

AIM:To compare the subjective refraction data with non-cycloplegic auto-refraction findings in the Geriatric population above 60 years of age according to the different crystalline lens conditions.METHODS:This report is a part of the Tehran Geriatric Eye Study(TGES)that was conducted from January 2019 to January 2020 on elderly population 60 years of age and above in Tehran.The samples were selected by multistage stratified random cluster sampling.Of 3791 individual invitees,3310(response rate:87.3%)participated in this study.All study participants underwent non-cycloplegic autorefraction(auto-refractometer/keratometer Nidek ARK-510)and subjective refraction.RESULTS:Regarding the sphere,eyes with mixed cataract had the worst limits of agreement(LoA:-1.24 to 0.87)and the best agreement was related to the pseudophakic eyes(LoA:-0.83 to 0.54).The highest(0.27±0.31 D)and lowest(0.21±0.27 D)differences between the two methods regarding the cylinder power were observed in eyes with cortical cataract and normal eyes,respectively.The worst LoA between the two methods in measuring the cylinder power was related to the eyes with mixed cataract(LoA:-0.44 to 0.96).Regarding the J0(horizontal/vertical components of astigmatism),the mean values of J0 obtained by auto-refraction were tended more toward against the rule direction in all crystalline lens conditions,and the two methods had the greatest difference in cortical cataract cases(0.05±0.17 D).Regarding the J45(oblique components of astigmatism),the lowest(0±0.11 D)and highest(-0.01±0.12 D)differences were observed in normal eyes and eyes with cortical cataract,respectively.CONCLUSION:The auto-refractometer/keratometer Nidek ARK-510 results in the elderly with different phakic and pseudophakic conditions do not correspond well with subjective refraction findings.This discrepancy in spherical findings is more pronounced in individuals with mixed cataract than in other cases.

关键词： refraction subjective Geriatric noncycloplegic autorefraction

Prevalence of depression and anxiety and associated factors among Geriatric orthopedic trauma inpatients:A cross-sectional study

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2022年第3期10卷 919-928页

作者： Jia-Lei Chen Rong Luo Ming Liu Department of Orthopedics West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Common mental disorders such as anxiety and depression in Geriatric orthopedic trauma patients have received little attention in research.AIM To investigate the prevalence of emotional disorders among Geriatric orthopedic trauma patients and identify demographic,social and clinical risk factors.METHODS This cross-sectional study was performed in Geriatric patients(aged≥60 years,both sexes)with orthopedic trauma admitted to a level I trauma center between May 2015 and December 2017.Demographic,social,and clinical characteristics were described.Huaxi Emotional-Distress Index(HEI)was used to evaluate the severity of anxiety and depression status.Differences in continuous variables were tested using the t-test,and differences in categorical variables were assessed using the Pearsonχ2 test.Binary logistic regression analyses were used to identify the factors associated with a HEI score>8.RESULTS Among the 966 patients,487 were male and 479 were female,with a mean age of 70.2±7.1 years.The age ranged from 60 to 90 years.Seventy-five patients had an HEI score>8,accounting for about 7.8%of all patients.A higher Injury Severity Score(4.17±3.10 vs 7.96±6.68,P8.On logistic regression,a higher education level was a protective factor for emotional disorders(P=0.047),whereas Injury Severity Score(P=0.024),Visual Analog Score(PGeriatric patients with orthopedic trauma.Clinicians should remain vigilant of emotional disorders in Geriatric patients and screen for anxiety and depression in higher risk groups.

关键词： Anxiety Depression Geriatric Trauma Orthopedic

Combined fascia iliaca compartment block and monitored anesthesia care for Geriatric patients with hip fracture: Two case reports

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2021年第27期9卷 8268-8273页

作者： Li Zhan Yu-Jie Zhang Jing-Xian Wang Department of Anesthesiology Lu’an Affiliated Hospital of Anhui Medical UniversityAnhui Medical UniversityLu’an 237005Anhui ProvinceChina

BACKGROUND Major hip surgery usually requires neuraxial or general anesthesia with tracheal intubation and may be supplemented with a nerve block to provide intraoperative and postoperative pain relief.CASE SUMMARY This report established that hip surgical procedures can be performed with a fascia iliaca compartment block(FICB)and monitored anesthesia care(MAC)while avoiding neuraxial or general anesthesia.This was a preliminary experience with two Geriatric patients with hip fracture,American Society of Anesthesiologists status III,and with many comorbidities.Neither patient could be operated on within 48 h after admission.Both general anesthesia and neuraxial anesthesia were high-risk procedures and had contraindications.Hence,we chose nerve block combined with a small amount of sedation.Intraoperative analgesia was provided by single-injection ultrasound-guided FICB.Light intravenous sedation was added.Surgical exposure was satisfactory,and neither patient complained of any symptoms during the procedure.CONCLUSION This report showed that hip surgery for Geriatric patients can be performed with FICB and MAC,although complications and contraindications are common.The anesthetic program was accompanied by stable respiratory and circulatory system responses and satisfactory analgesia while avoiding the adverse effects and problems associated with either neuraxial or general anesthesia.

关键词： Fascia iliaca compartment block Monitored anesthesia care Geriatric Hip fracture Ultrasound-guided Case report

Open globe injuries in Geriatric population in Iran: characteristics and outcomes

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

International Journal of Ophthalmology(English edition) 2021年第8期14卷 1237-1240页

作者： Maryam Zamani Seyed Ali Tabatabaei Akbar Fotouhi Morteza Naderan Mohammad Soleimani Ocular Trauma and Emergency Department Eye Research CenterFarabi Eye HospitalTehran University of Medical SciencesTehran ***Iran Department of Epidemiology and Biostatistics School of Public HealthTehran University of Medical SciencesTehran ***Iran

AIM:To investigate the patterns and outcomes of open globe injuries in the elderly population in Iran.METHODS:In this retrospective cross-sectional chart review,medical records of 248 patients(aged 60 y and more)with the diagnosis of open globe injury from 2006 to 2016 were reviewed.Demographic features,type,and mechanism of open globe injury,ocular trauma score(OTS),visual acuity before and after treatment,the zone of injuries,and the associated injuries found at the presentation or thereafter were documented.RESULTS:A total of 248 eyes of 248 patients were included.The mean age was 69.2±5.8 y(range:60-90 y).Male/female ratio was about 3:1(187 vs 61).The three most common causes of injury were falling(25.2%),sharp objects(18.9%),and tree branches(13.9%).Penetrating injury accounted for most of the Geriatric ocular trauma(50.4%),followed by globe rupture(40.3%),intraocular foreign body(IOFB;7.3%),and perforating injury(2.0%).The median raw OTS for the population was 60.5 and the most common OTS class was 3.The injuries tend to affect zoneⅠmore than zoneⅡand zoneⅢ.The only predictor of final visual acuity was the class of OTS(PGeriatric open globe injury should be valued specifically.The most common type of open globe injury in Iran is penetrating injuries but falling remain the main cause.The OTS class must be considered as an important predictor of final visual acuity.

关键词： Geriatric ocular trauma ocular trauma score open globe injury

Severe trauma in the Geriatric population

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Critical Care Medicine 2017年第2期6卷 99-106页

作者： Juan Antonio Llompart-Pou Jon Pérez-Bárcena Mario Chico-Fernández Marcelino Sánchez-Casado Joan Maria Raurich Servei de Medicina Intensiva Hospital Universitari Son Espases Servicio de Medicina Intensiva UCI Trauma y EmergenciasHospital Universitario 12 de Octubre Servicio de Medicina Intensiva Hospital Virgen de la Salud

Geriatric trauma constitutes an increasingly recognized problem. Aging results in a progressive decline in cellular function which leads to a loose of their capacity to respond to injury. Some medications commonly used in this population can mask or blunt the response to injury. Falls constitute the most common cause of trauma and the leading cause of trauma-related deaths in this population. Falls are complicated by the widespread use of antiplatelets and anticoagulants, especially in patients with brain injury. Under-triage is common in this population. Evaluation of frailty could be helpful to solve this issue. Appropriate triaging and early aggressive management with correction of coagulopathy can improve outcome. Limitation of care and palliative measures must be considered in cases with a clear likelihood of poor prognosis.

关键词： Geriatric trauma Elderly patients Severe trauma Triage Outcome

The Relationship Between Mean Platelet Volume and In-Hospital Mortality in Geriatric Patients with ST Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Cardiovascular Innovations and Applications 2019年第B07期4卷 135-141页

作者： Omer Satiroglu Murtaza Emre Durakoglugil Huseyin Avni Uydu Hakan Duman Mustafa Cetin Yuksel Cicek Turan Erdogan Department of Cardiology Faculty of MedicineRecep Tayyip Erdogn University53100 RizeTurkey Department of Medical Biochemistry Faculty of MedicineRecep Tayyip Erdogn University53100 RizeTurkey

Objective:We planned to investigate the effect of mean platelet volume(MPV)on in-hospital mortality and coronary risk factors in Geriatric patients with ST segment elevation myocardial infarction(STEMI)who underwent primary percutaneous coronary intervention(PCI).Methods:We enrolled 194 consecutive STEMI patients.The study population was divided into two groups on the basis of admission MPVs.The high-MPV group(n=49)included patients in the highest tertile(>8.9 fL),and the low-MPV group(n=145)included patients with a value in the lower two tertiles(≤8.9 fL).Clinical characteristics,in-hospital mortality,cardiovascular risk factors,and outcomes of primary PCI were analyzed.Results:The patients in the high-MPV group were older,more of them had three-vessel disease,and they had higher in-hospital mortality.Patients with in-hospital death were older,had higher Gensini score,creatinine concentration,and MPV,and had lower HDL cholesterol concentration.MPV,age,HDL cholesterol concentration,creatinine concentration,and Gensini score were found to be independent predictors of in-hospital death.Conclusion:These results suggest that high admission MPV levels are associated with increased in-hospital mortality in Geriatric patients with STEMI undergoing primary PCI.

关键词： Geriatric ST segment elevation myocardial infarction primary percutaneous coronary intervention mean platelet volume in-hospital mortality