Articles related to Geriatrics

More than half of adult Americans (60%) have at least one chronic condition that eventually lead to disability, mortality, and reduced quality of life. And chronic conditions account for 90% of America’s $3.8 trillion in annual healthcare costs. The CDC says these are the eight most expensive.

Publication: JAMADesign: Multicenter, randomized, double-blind, placebo-controlled trial performed in six hospices in the Netherlands of 162 patients with a life expectancy of three or more days. Administration of subcutaneous scopolamine butylbromide, 20 mg four times a day (n = 79) or placebo (n=78) in the 157 patients included in the primary analysis.Results: A death rattle occurred in 10 patients (13%) in the scopolamine group compared with 21 patients (27%) in the placebo group.

Publication: ASH Clinical NewsOriginal Source: Journal of the National Care InstituteDesign: Assessment of longitudinal changes in memory, attention, and executive function in men and women with lymphoma (n=248; 62.5% male) prior to and six months after initiation of chemotherapy. A group of age- and sex-matched people without cancer was used as a control arm (n=212; 59% male).Results: At baseline, patients with lymphoma self-reported significantly more issues on the FACT-Cog scale (perceived cognitive impairment [PCI] and total scores) compared with sex-matched controls (p<0.05). In addition, patients with lymphoma reported significantly more attentional difficulty (p=0.01) and significantly greater PCI (p<0.03).

How could complete silence possibly be considered music (John Cage’s 4’33”), or a blank canvas a masterpiece of art (Robert Rauschenberg’s White Painting)? This oncology medical student explains how after truly listening to a dying patient’s wishes, the student’s silence provided the canvas for the patient’s thoughts, becoming an advocate for his needs: “Silence is not merely the absence of sound but rather an invitation for others to be heard.”

Reference Source: JAMA Network OpenDesign: Retrospective study of 8,953 patients from the National Cancer Database; compared the use of definitive treatment between 2004 and 2014 of 1,280 young adults (YAs, aged 18-39 years); 3,937 patients aged 40-64 years; and 3,756 patients age 65+.Results: Amputation – 8.1% (YAs), 5.5% (40-64), 5.3% (65+). Chemotherapy – 39.4% (YAs), 29.5% (40-64), 9.3% (65+). Radiation – 59.3% (YAs), 69.1% (40-64), 63.4% (65+). Unique to young adults, clinical stage II disease vs. stage I disease and positive surgical margins were not associated with the use of radiation.

Publication: Blood AdvancesStudy Design: Prospective study with unmatched health care workforce control group, receiving either Moderna or Pfizer COVID vaccination.Study Population: 23 patients with CLL (61%), lymphoma (39%) (including DLBCL), MCL (13%) and 4% with less common lymphomas.Outcome: Lymphoma patients had significantly lower anti-S IgG titers 28 days post-vaccination compared with controls. Related Article: Efficacy of the BNT162b2 mRNA COVID-19 Vaccine in Patients with B-Cell Non-Hodgkin Lymphoma