Geriatric Care最新文献

{"title":"An interdisciplinary intervention is associated with overall improvement of older inpatients in a non-geriatric setting: A retrospective analysis of an observational, longitudinal study with one-year follow up","authors":"F. Müller, A. Meyer, L. Pickert, A. Heeß, I. Becker, T. Benzing, M. Polidori","doi":"10.4081/GC.2021.9723","DOIUrl":"https://doi.org/10.4081/GC.2021.9723","url":null,"abstract":"Older persons often loose independence during hospitalization. This analysis aimed at retrospectively evaluating the effects of a pilot individualized multidimensional intervention (IMI) on the comprehensive geriatric assessment (CGA)-based prognosis of older multimorbid patients in an acute internal medicine setting. Records from 72 patients aged 65 years and above who received the IMI were compared to those from 403 patients who received standard of care (SOC). All patients had undergone the CGA-based Multidimensional Prognostic Index (MPI) calculation on admission and at discharge. Patients were divided into three risk groups according to MPI score: Low-risk (MPI-1, 0-0.33), medium-risk (MPI-2, 0.34-0.66) and high-risk (MPI-3, 0.67-1). From admission to discharge, IMI patients showed significant improvements in their MPI score (P=0.014) and subdomains compared to SOC. This was particularly evident in MPI-2 and MPI-3 as well as in patients with poorer functions on MPI admission subdomains. An early geriatric intervention during hospitalization for disease-specific treatments in internal medicine settings improves overall individual prognosis in older multimorbid patients. Prospective randomized studies are needed to confirm these preliminary retrospective observations.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44637760","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}

{"title":"Is Yoga possible for elderly care?","authors":"Siu Kan Law, Albert Wingnang Leung, Chuanshan Xu","doi":"10.4081/GC.2021.9815","DOIUrl":"https://doi.org/10.4081/GC.2021.9815","url":null,"abstract":"Yoga is possible for elderly care as it promotes and balance among mind–brainbody functions through mental, physical, and emotional practices. Growing evidence has shown that yoga practices strengthen muscle, body flexibility, and boost the immune system as well as improve the physical and psychological conditions.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46800207","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}

{"title":"Abstract Book of the 35º Congresso Nazionale SIGOT - Live streaming, 16-18 giugno 2021","authors":"Alberto Pilotto","doi":"10.4081/GC.2021.9915","DOIUrl":"https://doi.org/10.4081/GC.2021.9915","url":null,"abstract":"Abstract Book of the 35º Congresso Nazionale SIGOT - Live streaming, 16-18 giugno 2021.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49065202","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}

{"title":"The impact of COVID-19 first wave on long term care facilities of an Italian Province: an historical reference","authors":"A. Tramarin, N. Gennaro, Giancarlo Dal Grande, L. Bragagnolo, M. Carta, D. Giavarina, M. Pascarella, M. Rassu, Antonio Matteazzi, G. Stopazzolo","doi":"10.4081/GC.2021.9654","DOIUrl":"https://doi.org/10.4081/GC.2021.9654","url":null,"abstract":"The coronavirus disease 2019 (COVID-19) pandemic will leave a profound imprint in the collective memory of humanity. In Italy, Long-Term Care Facilities (LTCFs) have seen a disproportionally high number of deaths during and the COVID-19 pandemic and, certainly, they may be considered as its epicenter. Aiming to leave a symbolic mark of what the pandemic did in these care settings, we report on an outbreak in a single LTCF where, 53 out of 64 residents, resulted infected. Our narration is based on an epidemiological field investigation together with a calendar of passages through the stages of disease in the infected population. We found an age-gradient in all clinical and epidemiological variables explored such as symptoms onset, illness severity, recovery from symptoms and deaths. According to the disease staging, 26 (49%) were asymptomatic; 9 (17%) had a mild disease; 7 (13%) a moderate stage and 11 (21%) a severe illness severity of whom 10 died. For a more comprehensive description of the impact of the pandemic on LTCFs, we compared the standard mortality ratio (SMR) in the first six months of 2020 to that of 2018 and 2019 in all the 34 facilities of the Vicenza province. Overall, there was a SMR higher 60% than the equivalent period of the previous years. Introduction On December 12, 2019, 27 cases of pneumonia of unknown causes were reported in Wuhan, Hubei Province, China. With the evolving pandemic, the coronavirus disease 2019 (COVID-19) spread rapidly from China around the entire world. Italy was the first European nation to be affected by COVID-19. On January 31, 2020, two Chinese tourists resulted positive at the severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) swab test in Rome. An outbreak of 16 confirmed cases, never been travelling from and to China, were then reported in the Veneto and in the Lombardy Regions.1 The number of cases rose rapidly with a geometric progression in the two Regions (Veneto and Lombardy) and through all the country. In response to the growing pandemic of COVID-19, the Italian government imposed a national quarantine, restricting the movement of the population except for necessities such as work and health circumstances. On May 31, the Italian Ministry of Health reported 233,515 confirmed total cases and 33,530 deaths.2 Preliminary studies found that, at a community-level, COVID-19 had a rapid spread and high morbidity and mortality among older adults in Long Term Care Facilities (LTCFs) A retrospective analysis of individual cases data from China, and elsewhere, showed a strong age gradient in the case fatality ratio.3-5 Cardiovascular diseases, hypertension, diabetes mellitus were the comorbidities most frequently associated with COVID-19. All these comorbidities are common among dependent elderly housed in institution and many elderly died by the association between their original comorbidities and the novel virus.6 In the initial emergency, data from LTCFs not only stressed the vuln","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48034622","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}

{"title":"Different diagnostic strategies for different settings","authors":"F. Petrazzuoli","doi":"10.4081/GC.2021.9538","DOIUrl":"https://doi.org/10.4081/GC.2021.9538","url":null,"abstract":"Diagnostic strategies should always take into consideration the setting in which they are administered. The predictive value, positive or negative of a clinical sign or diagnostic test has a different weight in family medicine than in the hospital setting. Many tests have not been formally evaluated in primary care; unfortunately, very often low prevalence settings are used to conduct screening in these populations, and often result in unrealistically high prevalence estimates for chronic disease and these results are then used to conclude that General Practitioners are not good at detecting diseases. In primary care, the prevalence and incidence of disease differs from what appears in the hospital setting, and severe disease occurs less frequently in general practice than in hospital because there is no preventive selection. This requires a specific probability-based decision-making process, based by the knowledge of patients and the community. In primary care, the diagnostic strategy should begin with complaints and symptoms and address uncertainty and complexity, using step-by-step strategies, including watchful waiting, presumptive symptomatic treatment, and focusing on low-tech strategies. The diagnostic process There are 2 fundamental strategies in the diagnostic process in Medicine. (Unpublished data: Terry Shaneyfelt, https: //ebmteacher.com/open-teaching-resources/ accessed 28/11/2020): i) pattern recognition: e.g. shingles, where the presence of specific signs and symptoms is pathognomonic of the disease; ii) probabilistic: e.g. deep vein thrombosis, where the probability of a disease is influenced by the diagnostic test accuracy.1 The pre-test probability is the probability that a patient is affected by a disease, prior to any further diagnostic studies. In the probabilistic diagnostic paradigm, we start form the pre-test probability and after the test result we have a revised probability (post-test probability). Table 1 shows how can we estimate the pre-test probability. When to use a supplementary diagnostic test? Figure 1 shows the diagnostic process that should guide us in establishing a diagnosis. If further testing is needed, then the next step is to choose a diagnostic test. Because there are often multiple tests that could be ordered for a given disease we need to pick the right one for the situation. How to choose a diagnostic test? Before ordering a test, doctors need to think carefully of the pre-test probability. What do we want to do with a test? Rule in a disease or rule out a disease? In order to do this, doctors need to compare the operating characteristics of a test before selecting one, and above all, to think about what they will do with the results of a test. Comparing the operating characteristics of a test before selecting one Table 2 illustrates the role of testing. Do we need a sensitive or a specific test? It depends on the role of testing (rule in or rule out). When we want to rule in a disease, we need a spec","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46803591","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}

{"title":"Participatory community-based arts for older people living with dementia in the community: how are they evaluated? A scoping review","authors":"Azam Bazooband, H. Courtney-Pratt, K. Doherty","doi":"10.4081/GC.2021.9470","DOIUrl":"https://doi.org/10.4081/GC.2021.9470","url":null,"abstract":"Although the interests in participative arts for people living with a dementia has increased over the last decade, what is yet to be reviewed is how participatory community-based arts activities for this group of people are evaluated. The overall aim of the following scoping review is to understand the scope of measurement/evaluation methods/approaches used in studies that recruited participants with dementia from the community (not from health/clinical or residential aged care settings or nursing homes) and delivered community-based participatory arts activities/programs (not art therapy programs) to them. The methodological framework by Arksey and O’Malley (2005) for undertaking a scoping review article was applied to this study. Collation, summarizing and reporting the results was carried out considering the research questions. 7 articles met inclusion/exclusion criteria published from 2013 to 2020. The type of arts activities included co-designs and co-creation of various types of arts (n=1), museum visiting and art-making activities (n=4), artistic education-based program (n=1), group","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47045752","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}

{"title":"Frailty and risk of mortality and hospitalization in nursing home residents affected by COVID-19","authors":"N. Veronese, Vanni Stangherlin, P. Mantoan, Marco Chiavalin, Florina Tudor, Gianfranco Pozzobon","doi":"10.4081/GC.2021.9635","DOIUrl":"https://doi.org/10.4081/GC.2021.9635","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) is a widespread condition in nursing homes (NHs). However, no research was made regarding frailty in NH residents during COVID-19 pandemic. The aim of this study was to assess whether frailty, assessed by the multidimensional prognostic index (MPI), can predict mortality/hospitalization in COVID-19 NH residents. A Cox’s regression analysis was used, reporting the results as hazard ratios (HRs) with 95% confidence intervals (CIs). 1146 NH residents affected by COVID-19 were included (mean age: 86 years; 75.4% females). During the followup period, we observed 286 deaths and 239 hospitalizations. Taking those with MPI <0.41 as reference, an MPI ≥0.50 was associated with a higher risk of death (HR=1.41; 95%CI: 1.07-1.85). Similar results were obtained using the MPI score increase in 0.10 points (HR=1.12; 95%CI: 1.03-1.23). Using hospitalization as outcome, only MPI score as continuous variable was associated with this outcome (HR=1.08; 95%CI: 1.002-1.17). In conclusion, frailty, as assessed by the MPI, was associated with a significant higher risk of mortality and hospitalization in NH residents affected by COVID-19 further indicating the necessity of assessing frailty in NH.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43107326","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}

{"title":"Overview of COVID-19 patients treated in University Hospital Split, Croatia - specifics related to patients age","authors":"Marija Cavar, Danijela Budimir Mrsic, Ante Luetić, Lara Perkovic Tabak, M. Petricevic, K. Dolić","doi":"10.4081/GC.2021.9351","DOIUrl":"https://doi.org/10.4081/GC.2021.9351","url":null,"abstract":"Different aspects of the coronavirus disease 2019 (COVID-19) infection have been widely investigated since the onset of a pandemic in December 2019. Several studies investigated differences in disease development and presentation compared to patient characteristics. In this paper we present an overview of the first COVID-19 pandemic wave in Dalmatia, Croatia with specifics related to patients’ age. Demographic, clinical and radiological data from hospitalized COVID-19 positive patients in the Clinical Hospital Split over a three-month period were collected and analyzed. Subgrouping and additional analysis were performed: Octogenarians vs Non-octogenarians, and senior residence vs nonsenior residence. 160 COVID-19 positive patients were enrolled. Of those, 61% were females. Median age was 78. More than a half of all patients were senior residents. No differences in final outcome were observed comparing specific medicament treatment. Among Octogenarians group, there were more asymptomatic cases, and higher mortality rate. Some differences in radiological presentation were also observed. Senior COVID-19 positive patients are more often asymptomatic but with higher mortality rates. More attention should be paid to early detection on COVID-19 infection in the senior population.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44580424","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}

{"title":"COVID-19 vaccination concerns among elderly people in Hong Kong","authors":"Siu Kan Law, Albert Wingnang Leung, Chuanshan Xu","doi":"10.4081/GC.2021.9629","DOIUrl":"https://doi.org/10.4081/GC.2021.9629","url":null,"abstract":"Not available","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49020672","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}

{"title":"Role of high dose IV vitamin C and zinc in coronavirus","authors":"A. Fatima, Muhammad Yasoob Ali Khan, M. Najeeb, Muhammad Yasoob Ali Khan, F. Haq","doi":"10.4081/GC.2021.9338","DOIUrl":"https://doi.org/10.4081/GC.2021.9338","url":null,"abstract":"Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV2), is now considered as an ongoing global pandemic. Common symptoms include pyrexia, cough, dyspnea, fatigue, sore throat, and loss of sense of taste and smell. Complications that can result from more severe insult on lung tissue is pneumonia and acute respiratory distress syndrome (ARDS), which can further lead to septic shock. It is also not uncommon to find neurological symptoms in patients suffering from COVID-19. The primary treatment for COVID-19 is symptomatic treatment and supportive care. As there is no known vaccination and antiviral therapy for this disease, there is a desperate need to find an alternative to control and stop the spread of disease. Maintaining adequate micronutrient balance might enhance the immunity and protect from viral infections as well. Vitamin C and zinc helps in improving symptoms and shortening the duration of the common cold. Vitamin C (L-ascorbic acid) possesses pleiotropic physiological activity. High dose Vitamin C has shown to be effective against the common flu, rhinovirus, avian virus, chikungunya, Zika, ARDS, and influenza, and there is evidence that supports the protective effect of high dose IV vitamin C during sepsis-induced ARDS due to COVID-19. Zinc has a profound impact on the replication of viruses. Increasing intracellular zinc concentration along with pyrithione (zinc ionophore) has been shown to impair the replication of several RNA viruses efficiently, including poliovirus, influenza virus and several picornaviruses. A combination of zinc and can also inhibit the replication of SARScoronavirus in cell culture. Introduction In December of 2019 large number of patients were presented to the hospitals in the city of Wuhan in the Hubei province of China. All these patients had symptoms related to pneumonia, and the etiological agent was unknown. Epidemiologically patients were all related to the seafood market of the Wuhan region.1,2 This pneumonia causing agent was identified as a novel coronavirus and causes coronavirus disease (COVID-19).3 Coronavirus has genetic makeup related to the family of coronaviruses and is related genetically to severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).4 As compared to SARS caused by coronavirus 1, patients with COVID-19 can be infectious in the asymptomatic stage during their incubation period.5 There are multiple variables of the course of the disease and management that need optimization.5 As of 18 June 2020, there are 8,242,999 confirmed cases and 445,535 deaths worldwide.6 The COVID-19 pandemic requires a quick response but developing vaccination or antivirals specific to COVID-19 is taking time.7 Till now, there are no Food and Drug Administration approved treatments or vaccines for highly pathogenic coronaviruses.8 Strategies that could immediately save lives are needed desperately.7 Patients with coronavi","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44427496","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}