Multimorbidity and Its Impact in Older United States Veterans Newly Treated for Advanced Non-Small Cell Lung Cancer.

Rationale: Older adults make up the majority of patients with advanced non-small cell lung cancer (NSCLC) and often carry multiple other comorbidities (multimorbidity) when initiating treatment. The nature and impact of multimorbidity remain largely unknown, given the limitations of standard count-based comorbidity indices in aging patients and their exclusion from clinical trials.

Objective: Our objective is to identify and define multimorbidity patterns in older U.

Frailty integration in medical specialties: Current evidence and suggested strategies from the Clin-STAR frailty interest group.

Frailty is a syndrome that can inform clinical treatments and interventions for older adults. Although implementation of frailty across medical subspecialties has the potential to improve care for the aging population, its uptake has been heterogenous. While frailty assessment is highly integrated into certain medical subspecialties, other subspecialties have only recently begun to consider frailty in the context of patient care.

Natural Language Processing Algorithm to Extract Multiple Myeloma Stage From Oncology Notes in the Veterans Affairs Healthcare System.

Purpose: Stage in multiple myeloma (MM) is an essential measure of disease risk, but its measurement in large databases is often lacking. We aimed to develop and validate a natural language processing (NLP) algorithm to extract oncologists' documentation of stage in the national Veterans Affairs (VA) Healthcare System.

Methods: Using nationwide electronic health record (EHR) and cancer registry data from the VA Corporate Data Warehouse, we developed and validated a rule-based NLP algorithm to extract oncologist-determined MM stage.

The performance status gap in immunotherapy for frail patients with advanced non-small cell lung cancer.

Purpose: In advanced non-small cell lung cancer (NSCLC), immune checkpoint inhibitor (ICI) monotherapy is often preferred over intensive ICI treatment for frail patients and those with poor performance status (PS). Among those with poor PS, the additional effect of frailty on treatment selection and mortality is unknown.

Methods: Patients in the veterans affairs national precision oncology program from 1/2019-12/2021 who received first-line ICI for advanced NSCLC were followed until death or study end 6/2022.

Tailoring Therapy in Older Adults With Hematologic Malignancies.

Hematologic malignancies most often present in the sixth or seventh decade of life. Even so, many older adults may be unable to tolerate standard chemotherapy or require supplementary care or dose adjustments to do so. Both in community and academic centers, geriatric assessment (GA) can be used to improve the care of older adults with blood cancers.

Nail dystrophy for the surgeon.

Injuries to the fingertips are the most frequently occurring damage to the hand. The nail is an exceptional structure within the human body that offers both stability and protection, as well as the ability to perform fine and precise movements. Nail dystrophies are numerous, post-traumatic, post-infection or even degenerative.

Physiology of the nail apparatus: Surgical consequences.

Knowledge of nail physiology is mandatory to understand nail pathologies, and to know what to repair and what to expect from your repair. Unfortunately, nail physiology in humans is not completely understood. However, there are some data that have been validated and must be known before treating patients.

Hook nail deformity.

Hook-nail deformity is frequently seen after a fingertip amputation, whether or not flap reconstruction has been done. It is more frequent if the bony support is missing. The deformity results in esthetic and functional impairment which can lead to complete finger amputation.

Complications in nail surgery and how to avoid them.

Complications in nail surgery are not that frequent. Apart from complications that are common to every hand procedure, intense pain is the major issue with nail surgery. To prevent complications, good knowledge of anatomy and physiology is required to avoid misdiagnosis or inappropriate technique.

Surgical anatomy of the nail.

Knowledge of nail anatomy is a prerequisite for both diagnostic and therapeutic purposes. The nail apparatus is a highly specialized structure, but is in close relationship to the distal phalanx which supports it and to the pulp which carries the sensory receptors and is involved in pinching. It can be divided by the nail plate into the perionychium underneath, and the paronychium above.

Baseline correlates of frailty and its association with survival in United States veterans with acute myeloid leukemia.

Frailty is an important construct to measure in acute myeloid leukemia (AML). We used the Veterans Affairs Frailty Index (VA-FI) - calculated using readily available data within the VA's electronic health records - to measure frailty in U.S.

Construct validity of the electronic Veterans Affairs Frailty Index against clinician frailty assessment.

Background: Electronic frailty indices (eFIs) can expand measurement of frailty in research and practice and have demonstrated predictive validity in associations with clinical outcomes. However, their construct validity is less well studied. We aimed to assess the construct validity of the VA-FI, an eFI developed for use in the U.

Illness severity assessment of older adults in critical illness using machine learning (ELDER-ICU): an international multicentre study with subgroup bias evaluation.

Background: Comorbidity, frailty, and decreased cognitive function lead to a higher risk of death in elderly patients (more than 65 years of age) during acute medical events. Early and accurate illness severity assessment can support appropriate decision making for clinicians caring for these patients. We aimed to develop ELDER-ICU, a machine learning model to assess the illness severity of older adults admitted to the intensive care unit (ICU) with cohort-specific calibration and evaluation for potential model bias.

More intensive therapy as more effective treatment for frail patients with multiple myeloma [corrected].

Although randomized controlled trial data suggest that the more intensive triplet bortezomib-lenalidomide-dexamethasone (VRd) is superior to the less intensive doublet lenalidomide-dexamethasone (Rd) in patients newly diagnosed with multiple myeloma (MM), guidelines have historically recommended Rd over VRd for patients who are frail and may not tolerate a triplet. We identified 2573 patients (median age, 69.7 years) newly diagnosed with MM who were initiated on VRd (990) or Rd (1583) in the national US Veterans Affairs health care System from 2004 to 2020.

Benefits and Barriers of Technology for Home Function and Mobility Assessment: Perspectives of Older Patients With Blood Cancers, Caregivers, and Clinicians.

Purpose: Advances in digital health technology can overcome barriers to measurement of function and mobility for older adults with blood cancers, but little is known about how older adults perceive such technology for use in their homes.

Methods: To characterize potential benefits and barriers associated with using technology for home functional assessment, we conducted three semistructured focus groups (FGs) in January 2022. Eligible patients came from the Older Adult Hematologic Malignancies Program at Dana-Farber Cancer Institute (DFCI), which includes adults 73 years and older enrolled during their initial consult with their oncologist.