Advanced
Search

Browse Geriatrics/Aging General

Showing 1 to 20 of 168 Articles

Filter Results

Sort By:

  • Original Article

    Off-Pump versus On-Pump Coronary-Artery Bypass Grafting in Elderly Patients

    There is an ongoing debate about the benefits and shortcomings of coronary-artery bypass grafting (CABG) without cardiopulmonary bypass (off-pump CABG). Cardiopulmonary bypass can have detrimental effects.– Initial trials have shown that off-pump CABG is feasible in selected low-risk patients and…

    • March 28, 2013
    • Diegeler A., Börgermann J., Kappert U., et al.
    • N Engl J Med 2013; 368:1189-1198

      Elderly patients were randomly assigned to CABG with cardiopulmonary bypass (on-pump CABG) or without it (off-pump CABG). At 30 days and at 1 year, there was no significant difference in the composite outcome of death, stroke, MI, repeat revascularization, or new renal-replacement therapy.

    • Original Article

      Long-Term Outcomes in Elderly Survivors of In-Hospital Cardiac Arrest

      Little is known about the long-term outcomes in survivors of in-hospital cardiac arrest. Previous studies have focused on rates of in-hospital survival,– and the few studies that have examined longer-term rates of survival– have had modest samples and limited generalizability. Although the…

      • March 14, 2013
      • Chan P.S., Nallamothu B.K., Krumholz H.M., et al.
      • N Engl J Med 2013; 368:1019-1026

        In a population of survivors of in-hospital cardiac arrest, 59% were alive at 1 year and 50% at 2 years. Within the first year, a third of the patients were readmitted to the hospital. This study provides long-term outcome data on elderly survivors of in-hospital cardiac arrest.

      • Review Article

        Mechanisms of Disease: Autophagy in Human Health and Disease

        The complex integration of biologic and physiological processes such as inflammation, apoptosis, cell proliferation, differentiation, and metabolism can influence the pathogenesis of human diseases. Understanding the cellular and molecular bases of these processes is crucial for identifying new…

        • February 14, 2013
        • Choi A.M.K.Ryter S.W.Levine B.
        • N Engl J Med 2013; 368:651-662

          This review discusses the cellular process of autophagy (“self-eating”), which plays key roles in normal development of the immune system and adaptation to stress, as well as in a wide range of disease states.

        • Clinical Practice

          Paget's Disease of Bone

          Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations. Stage. A 73-year-old…

          • February 14, 2013
          • Ralston S.H.
          • N Engl J Med 2013; 368:644-650
          • CME
          • Full Text Audio

          Paget's disease of bone may present with bone pain but is often asymptomatic. Treatment (typically with bisphosphonates) is indicated in patients with pain that is localized to an affected site but not in asymptomatic patients.

        • Perspective

          Epidemic Influenza — Responding to the Expected but Unpredictable

          In the United States, influenza viruses can be counted on to cause outbreaks sometime between fall and spring each year. However, the timing and severity of these epidemics and the distribution of circulating viruses are highly variable and difficult to predict (see figure). For example, according…

          • February 14, 2013
          • Bresee J. and Hayden F.G.
          • N Engl J Med 2013; 368:589-592
          • Free Full Text
          • Interactive/Multimedia

          The number of U.S. cases of influenza-like illness has already exceeded the baseline for 7 weeks this season, and related hospitalizations and deaths are increasing. The causes of variability in the timing and severity of influenza epidemics are incompletely understood.

        • Perspective

          The Underside of the Silver Tsunami — Older Adults and Mental Health Care

          Approximately 5.6 million to 8 million Americans 65 years of age or older have mental health or substance-use disorders, and the Institute of Medicine (IOM) estimates that their numbers will reach 10.1 million to 14.4 million by 2030. Yet the American Geriatrics Society estimates that there are…

          • February 7, 2013
          • Bartels S.J. and Naslund J.A.
          • N Engl J Med 2013; 368:493-496
          • Free Full Text
          • Audio

          By 2030, the United States will have less than one geriatric psychiatrist per 6000 older adults with mental health or substance-use disorders. Perhaps innovations in other types of workforce expansion, use of technology, and federal policy can help to fill the gap.

        • Clinical Implications of Basic Research

          Diet and Healthy Aging

          The primary goal of research into aging is to improve the health of older persons. The discovery in the 1930s that a reduction in food intake could greatly extend the life span of laboratory rodents was a striking demonstration that aging is malleable. These calorie-restricted animals not only…

          • December 27, 2012
          • Partridge L.
          • N Engl J Med 2012; 367:2550-2551

            Two long-term studies of the effect of calorie restriction in rhesus monkeys conflict: one concludes that restriction does not affect mortality, and the other concludes that it does. Differences in dietary composition and extent of restriction may explain the discrepant results.

          • Original Article

            Long-Term Comparison of Endovascular and Open Repair of Abdominal Aortic Aneurysm

            Each year, 40,000 patients in the United States undergo elective procedures to repair abdominal aortic aneurysms. These procedures result in about 1250 perioperative deaths — more than for any other general or vascular surgical procedure, with the exception of colectomy. Endovascular repair was…

            • November 22, 2012
            • Lederle F.A., Freischlag J.A., Kyriakides T.C., et al.
            • N Engl J Med 2012; 367:1988-1997
            • Free Full Text

            This clinical trial compared endovascular with open repair of unruptured abdominal aortic aneurysm. An early survival advantage with endovascular repair was not sustained after 3 years. Aneurysm rupture remains a concern with this type of repair.

          • Perspective

            Drug Policy for an Aging Population — The European Medicines Agency's Geriatric Medicines Strategy

            In almost every country, the proportion of people over 60 years of age is growing faster than any other age group, as a result of longer life expectancy and declining fertility rates. In Europe, the median age is already the highest in the world, and in 2050 there are projected to be 88.5 million…

            • November 22, 2012
            • Cerreta F.Eichler H.-G.Rasi G.
            • N Engl J Med 2012; 367:1972-1974
            • Free Full Text

            At the European Medicines Agency, the aging of the population has prompted an analysis of whether the regulatory system is adapted to taking the needs of older people into account in the development, approval, and use of medications.

          • Editorial

            Is the Dream of EVAR Over?

            Abdominal aortic aneurysm (AAA) is a vascular disorder fraught with contradictions. It is mostly benign, causing no limitation in daily activity. Yet the first occasion of symptoms, aneurysm rupture, is often lethal. Moreover, surgical repair of the asymptomatic AAA causes substantial morbidity and…

            • November 22, 2012
            • Beckman J.A.
            • N Engl J Med 2012; 367:2041-2043

              Abdominal aortic aneurysm (AAA) is a vascular disorder fraught with contradictions. It is mostly benign, causing no limitation in daily activity. Yet the first occasion of symptoms, aneurysm rupture, is often lethal. Moreover, surgical repair of the ...

            • Case Records of the Massachusetts General Hospital

              Case 35-2012 — A 69-Year-Old Chronically Ill Man with Weakness, Anorexia, and Diffuse Pain

              Presentation of Case. Dr. Yin Ge (Medicine): A 69-year-old man with a history of diabetes mellitus, heart disease, peripheral vascular disease, and renal transplantation was admitted to this hospital because of increasing weakness, malaise, anorexia, diffuse pain, and a history of falling. Twenty…

              • November 15, 2012
              • Greenwald J.L.McDermott S.Dighe A.S.
              • N Engl J Med 2012; 367:1940-1948
              • CME

              Presentation of Case

              Dr. Yin Ge (Medicine): A 69-year-old man with a history of diabetes mellitus, heart disease, peripheral vascular disease, and renal transplantation was admitted to this hospital because of increasing weakness, malaise, anorexia, ...

            • Original Article

              Anticholinergic Therapy vs. OnabotulinumtoxinA for Urgency Urinary Incontinence

              Urgency urinary incontinence is characterized by unpredictable loss of urine; it is a prevalent condition that occurs disproportionately in women, affecting up to 19% of older women in the United States. Anticholinergic medications are used as the primary treatment for this condition. A recent…

              • November 8, 2012
              • Visco A.G., Brubaker L., Richter H.E., et al.
              • N Engl J Med 2012; 367:1803-1813
              • Free Full Text
              • CME

              In a trial comparing onabotulinumtoxinA with an anticholinergic drug, both reduced urgency incontinence episodes. The rates of urinary retention and urinary tract infections were higher with onabotulinumtoxinA, but the rate of dry mouth was higher with anticholinergics.

            • Clinical Therapeutics

              Deep-Brain Stimulation for Parkinson's Disease

              Foreword. This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are…

              • October 18, 2012
              • Okun M.S.
              • N Engl J Med 2012; 367:1529-1538
              • CME

              Foreword

              This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this ...

            • Special Article

              Physicians' Warnings for Unfit Drivers and the Risk of Trauma from Road Crashes

              Physicians' warnings to patients who are potentially unfit to drive are a medical intervention intended to prevent trauma from motor vehicle crashes. Advocates point out the similarity to physicians' warnings with regard to communicable infections, arguing that formal warnings are needed because…

              • September 27, 2012
              • Redelmeier D.A.Yarnell C.J.Thiruchelvam D.Tibshirani R.J.
              • N Engl J Med 2012; 367:1228-1236
              • Free Full Text

              Physicians' warnings to patients who are potentially unfit to drive are a medical intervention intended to prevent trauma from motor vehicle crashes. Advocates point out the similarity to physicians' warnings with regard to communicable infections, ...

            • Clinical Implications of Basic Research

              Eyeing Macular Degeneration — A Few Inflammatory Remarks

              Age-related macular degeneration (AMD) is the world's leading cause of the loss of central vision. It is usually classed as one of two forms: a dry form, characterized by the appearance of drusen (Figure 1), which are proteinaceous collections at the level of the retinal pigment epithelium, and by…

              • August 23, 2012
              • Rosenbaum J.T.
              • N Engl J Med 2012; 367:768-770

                Age-related macular degeneration (AMD) is the world's leading cause of the loss of central vision. It is usually classed as one of two forms: a dry form, characterized by the appearance of drusen (Figure 1), which are proteinaceous collections at the ...

              • Original Article

                Treatment of Older Patients with Mantle-Cell Lymphoma

                Patients with mantle-cell lymphoma typically present with extensive disease and involvement of multiple lymph nodes as well as the spleen, bone marrow, blood, and gastrointestinal tract. The median age at diagnosis is about 65 years. Standard therapy for these patients consists of chemotherapy (e.g.…

                • August 9, 2012
                • Kluin-Nelemans H.C., Hoster E., Hermine O., et al.
                • N Engl J Med 2012; 367:520-531
                • Free Full Text

                This international prospective study showed that maintenance therapy with rituximab was more effective than interferon alfa in prolonging the duration of remission and extending survival in older patients with mantle-cell lymphoma.

              • Clinical Practice

                Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms

                Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations. Stage. A 59-year-old…

                • July 19, 2012
                • Sarma A.V. and Wei J.T.
                • N Engl J Med 2012; 367:248-257
                • CME
                • Full Text Audio
                • Comments

                Lower urinary tract symptoms affect more than half of older men. Options for bothersome symptoms include α-adrenergic-receptor blockers, 5α-reductase inhibitors, phosphodiesterase-5 inhibitor therapy, and antimuscarinic therapy.

              • Original Article

                Cognitive Trajectories after Postoperative Delirium

                Cognitive impairment is common after cardiac surgery, and prevention efforts have not always been successful.– Although a large proportion of patients return to their preoperative level of cognitive function within 3 months,, many do not. Older age, lower educational level, and the presence of…

                • July 5, 2012
                • Saczynski J.S., Marcantonio E.R., Quach L., et al.
                • N Engl J Med 2012; 367:30-39
                • Free Full Text
                • CME

                In this prospective study of older patients undergoing cardiac surgery, 46% had postoperative delirium. Patients with delirium had larger declines in cognitive function: at 6 months, only 60% were at their preoperative level, as compared with 76% of those without delirium.

              • Images in Clinical Medicine

                Bladder Stone

                Figure 1.

                • June 7, 2012
                • Cervera C. and Peri L.
                • N Engl J Med 2012; 366:e34
                • Free Full Text

                A 76-year-old man with paraplegia and a long-term indwelling Foley catheter presented with fever. His physical examination was otherwise unremarkable, and he was hemodynamically stable.

              • Original Article

                Registry of Transcatheter Aortic-Valve Implantation in High-Risk Patients

                Aortic stenosis is now the most frequently diagnosed valvular disease. Surgical aortic-valve replacement is the definitive therapy for patients with severe symptomatic aortic stenosis. Operative mortality is low among selected elderly patients but increases with the number and severity of…

                • May 3, 2012
                • Gilard M., Eltchaninoff H., Iung B., et al.
                • N Engl J Med 2012; 366:1705-1715
                • Free Full Text

                Data from a French registry of nearly 3200 transcatheter aortic-valve implantation (TAVI) procedures complement data from randomized clinical trials. This emerging technique shows promise in the treatment of high-risk patients with aortic stenosis.

              Page

              Medical Meetings Emergency Medicine Conferences and Meetings

              A Primary Care Guide To Emergencies

              The conference will be held in London, Dec. 28 and 29.

              Contact Pascale Anthone, Medical-Credits, Heide 29, 2235 Westmeerbeek, Belgium; or call (32) 16438402; or e-mail info@medical-credits.com; or see http://www.medical-credits.com .

              More Medical Meetings

              Trends

              Most Viewed (Last Week)

              More Trends

              Article Category
              Research
              Reviews
              Clinical Cases
              Perspective
              Commentary
              Other
              Browse all articles
              Multimedia
              Videos in Clinical Medicine
              Images in Clinical Medicine
              Interactive Medical Cases
              Weekly Audio Summaries
              Browse all multimedia
              This Week
              Last Week
              Browse full index
              Selected Specialties
              Cardiology
              Endocrinology
              Gastroenterology
              Genetics
              Hematology/Oncology
              Infectious Disease
              Nephrology
              Neurology/Neurosurgery
              Obstetrics/Gynecology
              Pediatrics
              Primary Care/Hospitalist
              Pulmonary/Critical Care
              Surgery
              Browse all Specialties & Topics
              Featured Topics
              Clinical Practice Center
              Health Policy and Reform
              Medicine and Society
              Global Health
              Influenza A (H7N9)
              Author Center
              Submit a Manuscript or Letter
              Track a Manuscript
              Help