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in males was not significant (95% CI= -0.50 to 0.41, p=0.125). In females, the dental age and chronological age was not significant for females at 0.06 years (95% CI = -0.23 to 0.36, p=0.685). Overestimation of age was found in all age cohorts except 8-year old and 13- to 15-year old children. #5) Esan/2017 Demirjian method: 14109 subjects (6581 males and 7528 females) aged 4 to 18 years. Willems method: 10,832 children (5,176 males and 5,656 females) aged 3 to 18 years. Meta-Analysis Key results (...) Willems Is a Relatively Accurate Method of Dental Age Estimation as Compared to Demirjian UTCAT3391, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Willems Is a Relatively Accurate Method of Dental Age Estimation as Compared to Demirjian Clinical Question Is the Willems method of dental age estimation accurate than the Demirjian method in estimating the chronological of children and adolescents? Clinical Bottom Line
of Contents4 Canadian Guidelines on Opioid Use Disorder Among Older Adults Scope T he Canadian Coalition for Seniors Mental Health (CCSMH) received a grant from the Substance Use and Addictions Program (SUAP) of Health Canada to create a set of guidelines on the prevention, assessment, and management of substance use disorders among older adults . This guideline on opioid use disorder (OUD) in older adults (age = 65) is one in a series of four that also includes alcohol, cannabis, and benzodiazepines (...) now grown to epidemic proportions, with the unchecked distribution of potent illicit opioids (Volkow et al ., 2019) . Globally, according to the World Health Organization people over the age of 50 accounted for 27% of deaths from drug use disorders in 2000, a figure that rose to 39% by 2015 . Of those deaths in older adults (age = 65), approximately 75% were linked to the use of opioids (Degenhardt & Hall, 2012; UNODC, 2018) . Despite these numbers, there is a paucity of data about the many ways
Circulation. ;0:CIR.0000000000000741 Abstract Longevity is increasing, and more adults are living to the stage of life when age-related biological factors determine a higher likelihood of cardiovascular disease in a distinctive context of concurrent geriatric conditions. Older adults with cardiovascular disease are frequently admitted to cardiac intensive care units (CICUs), where care is commensurate with high age-related cardiovascular disease risks but where the associated geriatric conditions (...) Older Adults in the Cardiac Intensive Care Unit: Factoring Geriatric Syndromes in the Management, Prognosis, and Process of Care: A Scientific Statement From the American Heart Association Older Adults in the Cardiac Intensive Care Unit: Factoring Geriatric Syndromes in the Management, Prognosis, and Process of Care: A Scientific Statement From the American Heart Association | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search December 2019 November
Practice Advisory: Management of Pregnant and Reproductive-Aged Women during a Measles Outbreak Practice Advisory: Management of Pregnant and Reproductive-Aged Women during a Measles Outbreak - ACOG Menu ▼ Practice Advisory: Management of Pregnant and Reproductive-Aged Women during a Measles Outbreak Page Navigation ▼ Practice Advisory: Management of Pregnant and Reproductive-Aged Women during a Measles Outbreak Background The United States is currently experiencing the greatest number (...) are currently experiencing. Measles is highly contagious. An estimated 92-95% of individuals in a community must be immune to prevent ongoing transmission. Measles can cause serious illness and infects approximately nine out of every ten susceptible individuals exposed in close-contact settings 2 . Anyone who is unvaccinated or is undervaccinated is at risk. Certain individuals, including unvaccinated and undervaccinated pregnant women, infants 12 months of age or younger, and severely immunocompromised
. of Psychiatry, University of Toronto Dr. David Hogan, MD, FACP , FRCPC Co-Lead Academic Lead, Brenda Strafford Centre on Aging O’Brien Centre for Public Health Professor, Department of Medicine, Cumming School of Medicine University of Calgary Lori Amdam, B.Sc.N., M.S.N. Education Consultant, Gerontology CCSMH Steering Committee Member, Canadian Coalition for Seniors’ Mental Health Dr. Keri-Leigh Cassidy, MD, FRCPC Professor of Psychiatry, Clinical Academic Director, Geriatric Psychiatry Program, Department (...) in commonly used lists of medications to avoid in older adults (Hamilton et al ., 2011; Kuhn-Thiel et al ., 2014; American Geriatrics Society, 2019) . Age-related changes in pharmacokinetics and pharmacodynamics result in a greater risk of adverse effects with BZRAs in older adults at doses lower than cited as effective (Tamblyn et al ., 2005; Vaapio et al ., 2015) . Adverse effects include falls, fractures, cognitive impairment, delirium, incontinence, respiratory depression, and unplanned
First Street, NE, Washington, DC 20002-4242. E-mail: email@example.com. APA GUIDELINE FOR THE TREATMENT OF DEPRESSION ii Abstract The American Psychological Association (APA) developed this clinical practice guideline to provide recommendations for the treatment of depressive disorders (including major depression, subsyndromal depression, and persistent depressive disorder). It addresses three developmental cohorts: children and adolescents; general adults; and older adults (ages 60 and over). Ten (...) Across Three Age Cohorts 1 Scope of the Problem 1 Children and Adolescents 2 General Adult Population 11 Older Adult Population 14 The Need for a Clinical Practice Guideline and Decisions about Scope and Goals of the Clinical Practice Guideline 18 The APA Clinical Practice Guideline for the Treatment of the Problem 19 Guideline Purpose and Scope: What the Guideline Does and Does Not Address 23 APA GUIDELINE FOR THE TREATMENT OF DEPRESSION iv Process and Method 26 Vetting and Appointment of Members
) signified a 3.2 higher mortality hazard (95% confidence interval 3.1 to 3.2) over three years. Mortality varied noticeably with age, with a hazard ratio of 10.6 (8.5 to 13.3) in 18-29 year olds and 1.5 (1.4 to 1.6) in those older than 90. A positive troponin result was associated with an approximately 15 percentage points higher absolute three year mortality across all age groups. The excess mortality with a positive troponin result was heavily concentrated in the first few weeks. Results were analysed (...) Association of troponin level and age with mortality in 250 000 patients: cohort study across five UK acute care centres. To determine the relation between age and troponin level and its prognostic implication.Retrospective cohort study.Five cardiovascular centres in the UK National Institute for Health Research Health Informatics Collaborative (UK-NIHR HIC).257 948 consecutive patients undergoing troponin testing for any clinical reason between 2010 and 2017.All cause mortality.257 948
Internet based vestibular rehabilitation with and without physiotherapy support for adults aged 50 and older with a chronic vestibular syndrome in general practice: three armed randomised controlled trial. To investigate the clinical effectiveness and safety of stand alone and blended internet based vestibular rehabilitation (VR) in the management of chronic vestibular syndromes in general practice.Pragmatic, three armed, parallel group, individually randomised controlled trial.59 general (...) practices in the Netherlands.322 adults aged 50 and older with a chronic vestibular syndrome.Stand alone VR comprising a six week, internet based intervention with weekly online sessions and daily exercises (10-20 minutes a day). In the blended VR group, the same internet based intervention was supplemented by face-to-face physiotherapy support (home visits in weeks 1 and 3). Participants in the usual care group received standard care from a general practitioner, without any restrictions.The primary
18F-fluorodeoxyglucose (FDG) positron emission tomography-computed-tomography (PET CT) as part of radical radiotherapy treatment planning for oesophageal cancer (all ages) NHS England » 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed-tomography (PET CT) as part of radical radiotherapy treatment planning for oesophageal cancer (all ages) Search Search Menu 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed-tomography (PET CT) as part of radical radiotherapy (...) treatment planning for oesophageal cancer (all ages) Document first published: 12 April 2019 Page updated: 12 April 2019 Topic: Publication type: , NHS England will not routinely commission 18F-FDG-PET CT as part of radical radiotherapy treatment planning for oesophageal cancer in accordance with the criteria outlined in this document. In creating this policy NHS England has reviewed this clinical condition and the options for its treatment. It has considered the place of this treatment in current
Pazopanib for inoperable and metastatic malignant granular cell tumour (all ages) NHS England » Pazopanib for inoperable and metastatic malignant granular cell tumour (all ages) Search Search Menu Pazopanib for inoperable and metastatic malignant granular cell tumour (all ages) Document first published: 12 April 2019 Page updated: 12 April 2019 Topic: Publication type: , This policy statement is to confirm that pazopanib is not recommended as a treatment option for inoperable and metastatic (...) malignant granular cell tumours (all ages). Document PDF 62 KB 3 pages Document PDF 58 KB 3 pages Document PDF 51 KB 4 pages Document PDF 87 KB 2 pages
Emicizumab as prophylaxis in people with severe congenital haemophilia A without factor VIII inhibitors (all ages) NHS England » Emicizumab as prophylaxis in people with severe congenital haemophilia A without factor VIII inhibitors (all ages) Search Search Menu Emicizumab as prophylaxis in people with severe congenital haemophilia A without factor VIII inhibitors (all ages) Document first published: 21 August 2019 Page updated: 21 August 2019 Topic: Publication type: , NHS England (...) will commission emicizumab as prophylaxis in people with severe congenital haemophilia A without factor VIII inhibitors in accordance with the criteria outlined in this policy. Document PDF 308 KB 22 pages Document PDF 446 KB 35 pages Document PDF 103 KB 4 pages Document PDF 103 KB 5 pages Document PDF 129 KB 2 pages
Brolucizumab–dbll (Beovu) - wet age-related macular degeneration CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 761125Orig1s000 CLINICAL PHARMACOLOGY REVIEW(S) 1 Office of Clinical Pharmacology Review BLA Number 761125 Link to EDR Link Submission Date 02/07/2019 Submission Type Priority Proposed Brand Name Beovu Generic Name Brolucizumab (RTH258) Dosage Form and Strength 120 mg/mL solution for intravitreal injection Route of Administration Local Proposed Indication Treatment (...) of neovascular age-related macular degeneration (AMD) Applicant Novartis Pharmaceuticals Corporation Associated IND IND 112023 OCP Review Team Abhay Joshi, Ph.D. Philip Colangelo, Pharm.D., Ph.D. OCP Final Signatory John A. Lazor, Pharm.D. Office of Clinical Pharmacology Division IV Director Reference ID: 44719932 Table of Contents Table of Contents 2 1. EXECUTIVE SUMMARY 3 1.1 Recommendations 3 1.2 Post-Marketing Requirements and Commitments 4 2. SUMMARY OF CLINICAL PHARMACOLOGY ASSESSMENT 4 2.1
Effect of Clinical Geriatric Assessments and Collaborative Medication Reviews by Geriatrician and Family Physician for Improving Health-Related Quality of Life in Home-Dwelling Older Patients Receiving Polypharmacy: A Cluster Randomized Clinical Trial Polypharmacy and inappropriate drug regimens are major health concerns among older adults. Various interventions focused on medication optimization strategies have been carried out, but the effect on patient-relevant outcomes remains uncertain.To (...) investigate the effect of clinical geriatric assessments and collaborative medication reviews by geriatrician and family physician (FP) on health-related quality of life and other patient-relevant outcomes in home-dwelling older patients receiving polypharmacy.Cluster randomized, single-blind, clinical trial. Norwegian FPs were recruited from March 17, 2015, to March 16, 2017, to participate in the trial with their eligible patients. Participants were home-dwelling patients 70 years or older, using
Increasing Influenza and Pneumococcal Vaccination Uptake in Seniors Using Point-of-Care Informational Interventions in Primary Care in Singapore: A Pragmatic, Cluster-Randomized Crossover Trial Objectives. To evaluate the effectiveness of point-of-care informational interventions in general practitioner clinics to improve influenza and pneumococcal vaccination uptake among elderly patients.Methods. We conducted a pragmatic, cluster-randomized crossover trial in 22 private general practitioner (...) clinics in Singapore, from November 2017 to July 2018. We included all patients aged 65 years or older. Clinics were assigned to a 3-month intervention (flyers and posters encouraging vaccination) plus 1-month washout period, and a 4-month control period (usual care). Primary outcomes were differences in vaccination uptake rates between periods. Secondary outcomes were identification of other factors associated with vaccination uptake.Results. A total of 4378 and 4459 patients were included
Effect of the Tailored, Family-Involved Hospital Elder Life Program on Postoperative Delirium and Function in Older Adults: A Randomized Clinical Trial Postoperative delirium (POD) is a common condition for older adults, contributing to their functional decline.To investigate the effectiveness of the Tailored, Family-Involved Hospital Elder Life Program (t-HELP) for preventing POD and functional decline in older patients after a noncardiac surgical procedure.A 2-arm, parallel-group, single (...) . Secondary outcomes included the pattern of functional and cognitive changes (activities of daily living [ADLs], instrumental activities of daily living [IADLs], Short Portable Mental Status Questionnaire [SPMSQ]) from hospital admission to 30 days after discharge, and the length of hospital stay (LOS).Of the 475 patients screened for eligibility, 281 (171 [60.9%] male, mean [SD] age 74.7 [5.2] years) were enrolled and randomized to receive t-HELP (n = 152) or usual care (n = 129). Postoperative delirium
terms: 'hospital', 'volunteer', 'sitter', 'acute care', 'older adults', 'confusion', 'dementia' and 'frail'. The search was limited to papers written in English and published from 2002-2017. Inclusion criteria were studies involving the use of hospital volunteers in the care or support of older adult patients aged ≥ 65 years, or ≥ 50 years for Indigenous peoples, with chronic health conditions, cognitive impairment and/or physical decline or frailty, within the acute inpatient settings.Of the 199 (...) The effect of volunteers' care and support on the health outcomes of older adults in acute care: A systematic scoping review To examine the available evidence on the effects of care and support provided by volunteers on the health outcomes of older adults in acute care services.Acute hospital inpatient populations are becoming older, and this presents the potential for poorer health outcomes. Factors such as chronic health conditions, polypharmacy and cognitive and functional decline