Latest & greatest articles for geriatrics

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Top results for geriatrics

21. Group-Based vs Individual Pelvic Floor Muscle Training to Treat Urinary Incontinence in Older Women: A Randomized Clinical Trial

-text links Cite Display options Display options Format Abstract Importance: Urinary incontinence is one of the most prevalent health concerns experienced by older women (aged ≥60 years). Individual pelvic floor muscle training (PFMT) is the recommended first-line treatment for stress or mixed urinary incontinence in women, but human and financial resources limit its delivery. Whether group-based PFMT performs as well as individual PFMT in this population remains unclear. Objective: To assess (...) the efficacy of group-based PFMT relative to individual PFMT for urinary incontinence in older women. Design, setting, and participants: The Group Rehabilitation or Individual Physiotherapy (GROUP) study is a single-blind, randomized, noninferiority trial conducted in 2 Canadian research centers, from July 1, 2012, to June 2, 2018. A total of 362 community-dwelling women aged 60 years or older with symptoms of stress or mixed urinary incontinence were enrolled. Interventions: After an individual session

2020 EvidenceUpdates

22. ECG predictors of cardiac arrhythmias in older adults with syncope

ECG predictors of cardiac arrhythmias in older adults with syncope Prognosis Critical Appraisal Form Citation: Nishijima, D. K., Lin, A. L., Weiss, R. E., Yagapen, A. N., Malveau, S. E., Adler, D. H., . . . Sun, B. C. (2018). ECG Predictors of Cardiac Arrhythmias in Older Adults With Syncope. Annals of Emergency Medicine, 71(4)..2017.11.014 Methodology: Prospective convenience sample of 11 academic ED’s in the USA. Authors attempted to assess patients over the age of 60 with a complaint (...) and may overrepresent those with more serious overall outcomes of 9%. Which is higher than generally reported in syncope data of serious adverse events of 3-5% A majority of their patients were admitted to an observation unit and it is unclear what the mean period of observation was or what their observation protocol was. In some ways yes- obviously we see plenty of elderly patients, although the number of white people do seem over- represented. Also given this was largely performed in large cities

2020 Emergency Medicine Journal Club

23. Nifurtimox (Lampit) - To treat Chagas disease in certain pediatric patients younger than age 18

Nifurtimox (Lampit) - To treat Chagas disease in certain pediatric patients younger than age 18 Drug Approval Package: LAMPIT U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: LAMPIT Company: Bayer HealthCare Pharmaceuticals, Inc. Application Number: 213464 Approval Date: 08/6/2020 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA Application (...) Review Files (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) Date created: August 31, 2020 Vision impaired people having problems accessing certain pages of a PDF file may call (301) 796-3634 for assistance. Note: Documents in PDF format require the . Note: If you need help accessing information in different file formats, see . Language Assistance Available: | | | | | | | | | | | | | | | FDA Popular Content Product Areas

2020 FDA - Drug Approval Package

24. Low-Dose Edoxaban in Very Elderly Patients with Atrial Fibrillation. (Abstract)

Low-Dose Edoxaban in Very Elderly Patients with Atrial Fibrillation. Implementation of appropriate oral anticoagulant treatment for the prevention of stroke in very elderly patients with atrial fibrillation is challenging because of concerns regarding bleeding.We conducted a phase 3, multicenter, randomized, double-blind, placebo-controlled, event-driven trial to compare a once-daily 15-mg dose of edoxaban with placebo in elderly Japanese patients (≥80 years of age) with nonvalvular atrial (...) , 1.87; 95% CI, 0.90 to 3.89; P = 0.09). There were substantially more events of gastrointestinal bleeding in the edoxaban group than in the placebo group. There was no substantial between-group difference in death from any cause (9.9% in the edoxaban group and 10.2% in the placebo group; hazard ratio, 0.97; 95% CI, 0.69 to 1.36).In very elderly Japanese patients with nonvalvular atrial fibrillation who were not appropriate candidates for standard doses of oral anticoagulants, a once-daily 15-mg dose

2020 NEJM

25. Invasive versus non-invasive management of older patients with non-ST elevation myocardial infarction (SENIOR-NSTEMI): a cohort study based on routine clinical data. Full Text available with Trip Pro

Invasive versus non-invasive management of older patients with non-ST elevation myocardial infarction (SENIOR-NSTEMI): a cohort study based on routine clinical data. Previous trials suggest lower long-term risk of mortality after invasive rather than non-invasive management of patients with non-ST elevation myocardial infarction (NSTEMI), but the trials excluded very elderly patients. We aimed to estimate the effect of invasive versus non-invasive management within 3 days of peak troponin (...) concentration on the survival of patients aged 80 years or older with NSTEMI.Routine clinical data for this study were obtained from five collaborating hospitals hosting NIHR Biomedical Research Centres in the UK (all tertiary centres with emergency departments). Eligible patients were 80 years old or older when they underwent troponin measurements and were diagnosed with NSTEMI between 2010 (2008 for University College Hospital) and 2017. Propensity scores (patients' estimated probability of receiving

2020 Lancet

26. Radiotherapy for neovascular age-related macular degeneration. Full Text available with Trip Pro

Radiotherapy for neovascular age-related macular degeneration. Radiotherapy has been proposed as a treatment for new vessel growth in people with neovascular age-related macular degeneration (AMD).To examine the effects of radiotherapy on neovascular AMD.We searched CENTRAL, MEDLINE, Embase, LILACS and three trials registers and checked references of included studies. We last searched the databases on 4 May 2020.  SELECTION CRITERIA: We included all randomised controlled trials in which (...) radiotherapy was compared to another treatment, sham treatment, low dosage irradiation or no treatment in people with choroidal neovascularisation (CNV) secondary to AMD.We used standard procedures expected by Cochrane. We graded the certainty of the evidence using GRADE. We considered the following outcomes at 12 months: best-corrected visual acuity (BCVA) (loss of 3 or more lines, change in visual acuity), contrast sensitivity, new vessel growth, quality of life and adverse effects at any time point

2020 Cochrane

27. In older adults, some antidepressants were associated with increased fracture risk. (Abstract)

In older adults, some antidepressants were associated with increased fracture risk. Tamblyn R, Bates DW, Buckeridge DL, et al. Multinational investigation of fracture risk with antidepressant use by class, drug, and indication. J Am Geriatr Soc. 2020;68:1494-503. 32181493.

2020 Annals of Internal Medicine

28. Immunogenicity and safety of a recombinant adenovirus type-5-vectored COVID-19 vaccine in healthy adults aged 18 years or older: a randomised, double-blind, placebo-controlled, phase 2 trial. Full Text available with Trip Pro

Immunogenicity and safety of a recombinant adenovirus type-5-vectored COVID-19 vaccine in healthy adults aged 18 years or older: a randomised, double-blind, placebo-controlled, phase 2 trial. This is the first randomised controlled trial for assessment of the immunogenicity and safety of a candidate non-replicating adenovirus type-5 (Ad5)-vectored COVID-19 vaccine, aiming to determine an appropriate dose of the candidate vaccine for an efficacy study.This randomised, double-blind, placebo (...) -controlled, phase 2 trial of the Ad5-vectored COVID-19 vaccine was done in a single centre in Wuhan, China. Healthy adults aged 18 years or older, who were HIV-negative and previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-free, were eligible to participate and were randomly assigned to receive the vaccine at a dose of 1 × 1011 viral particles per mL or 5 × 1010 viral particles per mL, or placebo. Investigators allocated participants at a ratio of 2:1:1 to receive a single

2020 Lancet

29. A Phase 2 Study of Pimodivir (JNJ-63623872) in Combination with Oseltamivir in Elderly and NonElderly Adults Hospitalized with Influenza A Infection: OPAL study Full Text available with Trip Pro

efficacy). Pimodivir is a first-in-class antiviral for influenza A under development for these patients. Methods: Hospitalized patients with influenza A infection were randomized 2:1 to receive pimodivir 600 mg plus oseltamivir 75 mg or placebo plus oseltamivir 75 mg twice daily for 7 days in this phase 2b study. The primary objective was to compare pimodivir pharmacokinetics in elderly (aged 65-85 years) versus non-elderly adults (aged 18-64 years). Secondary endpoints included time-to-patient (...) -reported symptom resolution. Results: Pimodivir pharmacokinetic parameters in non-elderly and elderly patients were similar. Time-to-influenza symptom resolution was numerically shorter with pimodivir (72.45 hours) than placebo (94.15 hours). There was a lower incidence of influenza-related complications in the pimodivir group (7.9%) versus placebo group (15.6%). Treatment was generally well tolerated. Conclusions: No apparent relationship was observed between pimodivir pharmacokinetics and age. Our

2020 EvidenceUpdates

30. Abdominal aorta aneurysm (AAA) screening of men aged 65

Abdominal aorta aneurysm (AAA) screening of men aged 65 Abdominal aorta aneurysm (AAA) screening of men aged 65 - NIPH Search for: Søk Menu To top level Close Infectious diseases & Vaccines Mental & Physical health Environment & Lifestyle Health in Norway Quality & Knowledge Research & Access to data About NIPH Close Abdominal aorta aneurysm (AAA) screening of men aged 65 Order Download: Key message Abdominal aortic aneurysm (AAA) is a weakening of the aortic wall resulting in an abnormal (...) dilatation of the abdominal aortic artery. AAAs bears the risk of rupture, which is a dramatic emergency condition with a high risk of death. In Norway, about 1% of all deaths among men older than 65 years are caused by AAA rupture. The mortality rate due to AAA rupture is approximately 75%, with about half of the deaths occurring before the patient reaches the hospital. The larger the AAA, the higher is the risk of rupture. Prevalence of AAA among men varies across countries from approx. 1.5-3

2020 Norwegian Institute of Public Health

31. The Effect of a Cartoon and an Information Video About Intravenous Insertion on Pain and Fear in Children Aged 6 to 12 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial

The Effect of a Cartoon and an Information Video About Intravenous Insertion on Pain and Fear in Children Aged 6 to 12 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial The Effect of a Cartoon and an Information Video About Intravenous Insertion on Pain and Fear in Children Aged 6 to 12 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features (...) : 10.1016/j.jen.2020.04.011. Online ahead of print. The Effect of a Cartoon and an Information Video About Intravenous Insertion on Pain and Fear in Children Aged 6 to 12 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial , , , , , PMID: 32690314 DOI: Item in Clipboard The Effect of a Cartoon and an Information Video About Intravenous Insertion on Pain and Fear in Children Aged 6 to 12 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial Duygu Sönmez Düzkaya et al. J

2020 EvidenceUpdates

32. Evidence review on the benefits of physical activity for older people

of developing functional limitations or a decline in Basic Activities of Daily Living (BADL) disability 14 15 was reduced Institute of Public Health 6 by participation in physical activity 15 . Emerging evidence also highlights the positive impact of physical activity on the healthy ageing process, by improving QoL and increasing the odds of maintaining wellbeing in older age 16 . Finally, as the global population ages, the number of people living with cognitive impairment or dementia is expected (...) 18 19 . Growing evidence also reports that physical activity can improve cognitive function and, consequently, delay the progression of cognitive impairment in older adults 14 20 21 . Implications for Research and Policy Physical activity plays a key role in healthy ageing across the life cycle but especially in later years in the management of one’s health and wellbeing. The goal of public health is to decrease the time spent in ill- health as people age and ensure that an increase in life

2020 Institute of Public Health in Ireland

33. Alteplase for Acute Ischemic Stroke in Patients Aged >80 Years: Pooled Analyses of Individual Patient Data Full Text available with Trip Pro

: alteplase; elderly; ischemic stroke; recombinant tissue-type plasminogen activator; thrombolysis. Figures Figure 1. 5 Estimated effect of alteplase vs… Figure 1. 13 Estimated effect of alteplase vs placebo on the odds of good stroke outcome… Figure 1. Estimated effect of alteplase vs placebo on the odds of good stroke outcome by time to treatment, patient age, and stroke severity. A , Time to treatment ( P =0.0203 for interaction). B , Patient age ( P =0.7383 for interaction). C , Stroke severity (...) JA, Lindsberg PJ, Ringleb PA, Wahlgren NG, Lees KR; VISTA Collaborators; SITS Collaborators Thrombolysis in very elderly people: controlled comparison of SITS International Stroke Thrombolysis Registry and Virtual International Stroke Trials Archive. BMJ 2010341c6046.doi: 10.1136/bmj.c6046 - - Show all 33 references Related information LinkOut - more resources Full Text Sources Research Materials Miscellaneous Full-text links [x] [x] Citation text Copy Download .nbib Format: Send To [x] Connect

2020 EvidenceUpdates

34. Effects of Whole-Body Vibration Training on the Physical Function of the Frail Elderly: An Open, Randomized Controlled Trial

Cite Abstract Objective: To investigate the feasibility and benefits of whole-body vibration (WBV) exercise as a safe and effective training tool for countering sarcopenia and age-related declines in mobility and function in the frail elderly. Design: An open, randomized controlled trial. Setting: Residential care facilities. Participants: Male and female volunteers (N=117; 82.5±7.9y). Interventions: After prescreening for contraindications, participants were randomly allocated to a control (...) Effects of Whole-Body Vibration Training on the Physical Function of the Frail Elderly: An Open, Randomized Controlled Trial Effects of Whole-Body Vibration Training on the Physical Function of the Frail Elderly: An Open, Randomized Controlled Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. COVID-19 is an emerging, rapidly

2020 EvidenceUpdates

35. Cost-effectiveness of a preventive self-care health management program for community-dwelling older adults: a randomised controlled trial

for community-dwelling older adults: a randomised controlled trial , , Affiliations Expand Affiliations 1 School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. 2 School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. PMID: 32638995 DOI: Item in Clipboard Cost-effectiveness of a preventive self-care health management program for community-dwelling older adults: a randomised controlled trial Arkers Kwan Ching Wong et al. Age Ageing . 2020 (...) provide some evidence to suggest that the addition of a home-based, preventive self-care health management program may have effects on cost outcomes for community-dwelling older adults in Hong Kong. Keywords: community-dwelling older adults; cost-effectiveness; self-care; self-efficacy. © The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com. Similar articles Lewis H

2020 EvidenceUpdates

36. State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses. Full Text available with Trip Pro

sales in 2007 and 2008, respectively; and West Virginia and Wyoming, which increased the age for handgun sales in 2010.Adolescents aged 13 to 20 years(554 461 961 from 2001 to 2017) in the regression discontinuity analysis, and adolescents aged 18 to 20 years (168 934 041 from 2002 to 2014) in the main difference-in-differences analysis.Suicide rate per 100 000 adolescents.In the regression discontinuity analysis, state policies that limited the sale of handguns to those aged 18 or older (relative (...) to 21 or older) were associated with an increase in suicide rate among adolescents aged 18 to 20 years equivalent to 344 additional suicides in each state where they were in place between 2001 and 2017. In the difference-in-differences analysis, state policies that limited the sale of handguns to those aged 21 or older were associated with 1.91 fewer suicides per 100 000 adolescents aged 18 to 20 years (95% confidence interval -3.13 to -0.70, permutation adjusted P=0.025). In the difference

2020 BMJ

37. The Contribution of the Age Distribution of Cases to COVID-19 Case Fatality Across Countries: A 9-Country Demographic Study. Full Text available with Trip Pro

diagnosed cases is the same as that among undiagnosed cases and that individuals of all ages are equally susceptible to severe acute respiratory syndrome coronavirus 2 infection.Selective testing and identifying of older cases considerably warps estimates of the lethality of COVID-19 within populations and comparisons across countries. Removing age distortions and focusing on differences in age-adjusted case fatality will be essential for accurately comparing countries' performance in caring (...) The Contribution of the Age Distribution of Cases to COVID-19 Case Fatality Across Countries: A 9-Country Demographic Study. There is wide variation in coronavirus disease 2019 (COVID-19) case-fatality rates (CFRs) across countries, leading to uncertainty about the true lethality of the disease. A large part of this variation may be due to the ages of individuals who are tested and identified.To measure the contribution of distortions from the age distributions of confirmed cases to CFRs within

2020 Annals of Internal Medicine

38. Insufficient evidence for benefits/harms of cognitive impairment screening in asymptomatic older adults. (Abstract)

Insufficient evidence for benefits/harms of cognitive impairment screening in asymptomatic older adults. US Preventive Services Task Force, Owens DK, Davidson KW, et al. Screening for cognitive impairment in older adults: US Preventive Services Task Force recommendation statement. JAMA. 2020;323:757-63. 32096858.

2020 Annals of Internal Medicine

39. Interventions outside the workplace for reducing sedentary behaviour in adults under 60 years of age. (Abstract)

Interventions outside the workplace for reducing sedentary behaviour in adults under 60 years of age. Adults spend a majority of their time outside the workplace being sedentary. Large amounts of sedentary behaviour increase the risk of type 2 diabetes, cardiovascular disease, and both all-cause and cardiovascular disease mortality.Primary • To assess effects on sedentary time of non-occupational interventions for reducing sedentary behaviour in adults under 60 years of age Secondary (...) • To describe other health effects and adverse events or unintended consequences of these interventions • To determine whether specific components of interventions are associated with changes in sedentary behaviour • To identify if there are any differential effects of interventions based on health inequalities (e.g. age, sex, income, employment) SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, Cochrane Database of Systematic Reviews, CINAHL, PsycINFO, SportDiscus, and ClinicalTrials.gov on 14 April

2020 Cochrane

40. Ivacaftor (combination with ivacaftor/tezacaftor, cystic fibrosis, 12 years and older, with F508del mutation, homozygous) - Addendum to Commission A19-70

with cystic fibrosis (CF) aged 12 years and older who are homozygous for the F508del mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This adjusted indirect comparison (see Figure 1) was used for the benefit assessment. In its dossier [2], the company had presented analyses for the outcomes “serious adverse events (SAEs)” and “discontinuation due to adverse events (AEs)”. The results of these outcomes contained events that can be both symptoms of the underlying disease (...) (IQWiG) - 2 - 2 Assessment The company had presented analyses on the basis of an indirect comparison (see Figure 1) in its dossier for the assessment of ivacaftor in combination with tezacaftor/ivacaftor in patients with CF aged 12 years and older who are homozygous for the F508del mutation in the CFTR gene. For the outcomes “SAEs” and “discontinuation due to AEs”, the company had shown analyses that contained events that form part of the symptoms of the underlying disease or that can be both side

2020 Institute for Quality and Efficiency in Healthcare (IQWiG)