Journal of the American Geriatrics Society
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To determine whether advanced age is an independent prognostic factor that may increase the risk of complications and reduce the immediate and long-term survival after treatment with intra-aortic balloon pumping (IABP) for acute ischemic heart disease. ⋯ Several anamnestic and clinical variables, rather than advanced age itself, are independent, prognostic factors negatively affecting the outcome of treatment with IABP. Technique-related complications are independent of age. Thus, old age should not be considered as a criterion to exclude any patient, a priori, from the potential benefits of this type of cardiocirculatory assistance.
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To survey physicians to determine whether sociodemographic and practice-related variables are predictive of their attitudes toward suicide. ⋯ These results suggest that physicians' attitudes toward suicide are multidetermined. Although gender, age, medical specialty, and knowledge of depression and suicide predict certain attitudes, the logistic regression analyses were not highly successful in predicting respondents' attitudes. Given the power of physicians to command public attention and to influence public and legal opinion, it is vital that future research continue to explore the determinants of physicians' attitudes toward self-determined death.
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To determine factors associated with success or failure of oral antibiotic treatment for nursing home-acquired pneumonia (NHAP). ⋯ The majority of NHAP episodes were treated successfully with oral antibiotics, but 31% failed treatment in the NH. Patients with a mechanically altered diet or requiring feeding assistance by staff had significantly higher failure rates. Feeding dependence and need for a mechanically altered diet as well as abnormal vital signs are associated with oral antibiotic treatment failure. These factors should be considered in treatment decisions for NHAP.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized comparison of intravenous amrinone versus dobutamine in older patients with decompensated congestive heart failure.
To compare the hemodynamic effects of amrinone and dobutamine in patients 75 years of age or older who have severe congestive heart failure requiring invasive hemodynamic monitoring and inotropic support. ⋯ Both amrinone and dobutamine are efficacious in improving hemodynamics in older patients with severe congestive heart failure caused by left ventricular contractile dysfunction. Despite the effect of aging on beta-adrenergic responsiveness, dobutamine is at least as effective as amrinone but may be associated with a higher incidence of arrhythmic side effects.
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To determine life satisfaction and its association with physical, functional, socioeconomic, psychological, and social support characteristics in Hong Kong Chinese aged 70 years and older. ⋯ In older Chinese, social factors such as the support provided by family members, as well as adequate income to meet living expenses, play a role equal to that of physical factors in contributing to life satisfaction.