Benefits, risks and impacts on quality of life of medications used in multimorbid older adults: a Delphi study

Conclusions Medications recommended in clinical guidelines for individual diseases are generally considered positive for multimorbid older patients. Nevertheless, a non-negligible number of medications was deemed negative or very negative by our panelists. For multimorbid patients, individualizing treatment according to their preferences seems of utmost importance.
Source: International Journal of Clinical Pharmacy - Category: Drugs & Pharmacology Source Type: research

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CONCLUSIONS: The presence of one or more prognostic factors as well as the various risk prediction models can guide selection of ACS patient subgroups for which a prophylactic CEA should or should not be offered. Decisions to offer prophylactic CEA should weigh in factors like surgeon's experience and hospital expertise/volume. Asymptomatic patients not expected to live long enough to benefit from the procedure should not be considered for CEA, but should be offered best medical treatment. PMID: 31814375 [PubMed - as supplied by publisher]
Source: International Angiology - Category: Cardiology Tags: Int Angiol Source Type: research
We examined the association between HR obtained at admission at Day 4 and at discharge and long ‐term mortality in a cohort of 672 patients discharge from hospital after management of acute HF.Methods and resultsAll patients examined were in sinus rhythm. HR was derived from electrocardiogram and was defined as the first reported HR in the medical record. At 1  year follow up, 60 patients died. Median HR was 86 ± 17 b.p.m. (first tertile: 75 b.p.m., third tertile: 97 b.p.m.) at admission, 76 ± 14 b.p.m. (first tertile: 67 b.p.m., third tertile 85 b.p.m....
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Short Communication Source Type: research
This study demonstrates for the first time that senescent cells secrete functional LTs, significantly contributing to the LTs pool known to cause or exacerbate idiopathic pulmonary fibrosis. Against Senolytics https://www.fightaging.org/archives/2019/11/against-senolytics/ There is no consensus in science that is so strong as to have no heretics. So here we have an interview with a naysayer on the matter of senolytic treatments, who argues that the loss of senescent cells in aged tissues will cause more harm to long-term health than the damage they will do by remaining. To be clear, I think this to be a ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
CONCLUSIONS: Common comorbidities modify the association of frailty with postoperative survival; however, this effect was only apparent when analyses accounted for effect modification on the absolute risk difference, as opposed to relative scale. While the relative scale is more commonly used in biomedical research, smaller effects may be easier to detect on the risk difference scale. The concurrent presence of dementia, COPD, and HF with frailty were all associated with excess mortality on the absolute risk difference scale. PMID: 31743191 [PubMed - in process]
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
Objectives: To assess the particularities of patients with obstructive sleep apnea syndrome (OSAS) and heart failure (HF) focusing in the latest guideline recommendation of mid-range ejection fraction (HFmrEF) and comparing with reduced EF (HFrEF) and preserved EF (HFpEF).Methods: A number of 143 older patients with OSAS and HF were evaluated in 3 sleep labs of Victor Babes Hospital and Cardiovascular Institute, Timisoara, Western Romania. We collected general data, sleep questionnaires, anthropometric, comorbidities, lab test results and performed polysomnography and echocardiographic measurements.Results: Patients were d...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
Introduction: Obstructive sleep apnea (OSA) and chronic obstructive pulmonary (COPD), are usually accompanied by several comorbidities. Aim of the study was to assess the prevalence of comorbidities in OSA and COPD-OSA overlap syndrome (OS) patients and to explore differences between these two groups.Methods: Included were consecutive OS (n=163, 138 males, AHI>5/h and FEV1/FVC5/h and FEV1/FVC>0.7), matched in terms of gender, age, BMI, and smoking history, diagnosed with polysomnography and pulmonary function testing.Results: As mentioned, the two groups were matched in age (p=0.221), BMI (p=0.496) and neck circumfer...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
This study will report the results of a series of descriptive and survival analyses compare an exposure of COPD in people over 40 years old (N=22,942) to predict the outcomes of: heart failure, depression, anxiety, coronary artery disease, diabetes, anemia, hypertension, ischemic heart disease, underweight, and osteoporosis while controlling for EHR status of: smoking, age, sex, and rurality. Results will be computed in March 2019. By the date of the ERS Congress 2019, we will be able to report the results of the aforementioned analyses, which will demonstrate the utility of using large EMR datasets to illustrate comorbid ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: General practice and primary care Source Type: research
Background: Although sepsis has prognostic implications to patients with chronic obstructive pulmonary disease (COPD), its economics burden, healthcare utilization remains uncertain. We conducted a population-level study to answer these questions.Methods: We excerpted data relevant to sepsis (ICD-9 coding 995.91, 995.92) from 609,281 patients with COPD (ICD-9 coding 491, 492, 496) and registered by the Taiwan National Health Insurance Administration System between 2010 and 2015. Propensity-score matching was applied to balance the age and gender between patients with or without sepsis.Results: Among them, 13.4%(81,466/609,...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Ethics and economics Source Type: research
Introduction: Arterial Stiffness Index (ASI) is associated to cardiovascular mortality in patients with chronic obstructive pulmonary disease(COPD) and Heart Failure (HF). It is observe that in patients with cardiopulmonary disease there are changes in the pulmonary arteries and these are related with endothelial dysfunction and arterial stiffness (AS). Nevertheless, there are no reports about these and structural changes by echocardiography.Purpose: To evaluate ASI in patients with cardiopulmonary disease and related changes in the echocardiography.Material and Methods: Cross sectional Study. Patients with COPD and HF wer...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Monitoring airway disease Source Type: research
Conclusions: Positive correlations between AQHI and health outcomes are found in this study which revealed that making the public aware of air pollution using AQHI may be helpful to reduce the impact of air pollution in people living with chronic diseases.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Occupational and environmental health Source Type: research
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