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Eskind Library Synthesized Information - Geriatrics
The information provided below is developed by EBL librarians in response to questions from VUMC clinicians. The
syntheses provided are copyrighted by the EBL and should not be re-used without
permission. Please also review this disclaimer.
What is the current management for recurrent infection with chronic urinary calculi?
What is the efficacy of Synvisc in elderly patients with osteoarthritis? What is average duration of benefit (if any)? Note: ok to include international studies with other injectable forms of synthetic cartilage replacement.
This patient has an elevated LDL of 228. She is reluctant to be seen in lipid clinic because of past adverse effects with cholesterol-lowering therapy. Her cardiac risk factors are positive family history (father\'s MI at 52) and hyperlipidemia. She reported to me that there is increased risk of treating elevated lipids in women over 65. What is the evidence to support treatment of hyperlipidemia in women over age 65?
In patients over age 65 with aortic stenosis and mitral regurgitation diagnoses:
- What is the surgical risk when patients have heart failure symptoms?
- Are there some more limited procedures (catheter-based valvuloplasty or mini-thoracotomy) with less risk and what long term outcomes are known?
- What is the risk of continued medical treatment alone?
- Are these risks increased in the presence of other co-morbidities (dementia, malnutrition, diabetes, renal failure, stroke, frailty)?
What is the evidence for survival of patients with dementia who receive percutaneous gastrostomy (PEG) tubes versus those that do not?
Cerebral amyloid angiopathy is found in older individuals and results in weakened blood vessels with a tendency to bleed causing cerebral hemorrhage. Supposedly there is an MRI protocol that can recognize this condition and this then could be used to exclude patients being considered for warfarin therapy (for example for atrial fibrillation as in this patient), since there would be increased risk of intracerebral bleeding.
- What are the data that cerebral amyloid angiopathy can be recognized by MRI?
- What are the data that such MRIs ought to be done prior to institution of warfarin in elderly patients?
- Are there any published guidelines regarding this?
In patients over age 65, what strategies have been shown to reduce the risk of accidental falls?
Please help me with the evidence to support the Varicella vaccine for the elderly (patients > 65 years old). Is there a current recommendation for this as well?
In patients with urinary incontinence, what are current recommended evaluation and management concerns? What is the recommended sequence of evaluation? When should they be referred for surgical considerations?
What are recommended strategies to maximize food intake and stimulate appetite in patients over age 65 suffering from weight loss?