Clinical interventions in aging
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Randomized Controlled Trial
Cognitive function affects trainability for physical performance in exercise intervention among older adults with mild cognitive impairment.
Although much evidence supports the hypothesis that cognitive function and physical function are interrelated, it is unclear whether cognitive decline with mild cognitive impairment influences trainability of physical performance in exercise intervention. The purpose of this study was to examine the association between cognitive function at baseline and change in physical performance after exercise intervention in older adults with mild cognitive impairment. ⋯ General cognitive function was associated with improvements in physical performance after exercise intervention in subjects with mild cognitive impairment. Further research is needed to examine the effects of exercise programs designed to address cognitive obstacles in older adults with mild cognitive impairment.
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Patients leaving the hospital are at increased risk of functional decline and hospital readmission. The Employee and Community Health service at Mayo Clinic in Rochester developed a care transition program (CTP) to provide home-based care services for medically complex patients. The study objective was to determine the relationship between CTP use, 30-day hospital readmission, and Emergency Room (ER) visits for adults over 60 years with high Elder Risk Assessment scores. ⋯ Based on this pilot study of care transition, we found nonsignificant lower hospital and ER utilization rates and improved physical QOL scores for patients in the CTP group. However, the data leads us to recommend future studies with larger sample sizes (N = 250).
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Chronic low back pain is a disabling phenomenon that can cause a severe reduction in quality of life, especially in elderly patients. Surgical treatment is sometimes a big challenge for these elderly patients. Radiofrequency (RF) ablation is an increasingly popular method for treating low back pain caused by facet syndrome. The purpose of this study was to evaluate whether RF neurotomy is effective in terms of pain reduction and functional outcome in elderly patients. ⋯ RF is a safe and partially effective procedure for treating elderly patients with mechanical back pain due to facet syndrome.
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The purpose of this study was to examine whether long-term use of anticoagulants in elderly patients with atrial fibrillation (AF) and chronic kidney disease (CKD) influences renal function. ⋯ Warfarin therapy may delay deterioration in renal function and improve survival of elderly patients with CKD and AF.
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Comparative Study
Clinical investigation of transradial access for emergent percutaneous coronary intervention in patients with acute myocardial infarction.
Use of intensive anticoagulation and antiplatelet therapy in acute myocardial infarction (AMI) potentially increases the risk of bleeding complications during percutaneous coronary intervention via the transfemoral route. Recently, the transradial access has been intensively employed as an alternative means for diagnostic and interventional procedures. A low incidence of vascular access site bleeding complications suggests that the transradial access is a safe alternative to the transfemoral technique in patients with AMI. The safety and efficacy of transradial access for emergent percutaneous coronary intervention in patients with AMI has not been investigated in the People's Republic of China. ⋯ Transradial access for emergent percutaneous coronary intervention is safe and effective in patients with AMI, and it is suggested that this route could be used more widely in these patients.