Hemodynamic Impact of the Trendelenburg Position: A Systematic Review and Meta-analysis.

Objective: To systematically evaluate the impact of the Trendelenburg position on hemodynamic parameters in adult patients.

Design: Systematic literature review and meta-analysis using PubMed and Medline.

Setting: All prospective interventional studies comparing the hemodynamic characteristics of patients in the horizontal supine position and Trendelenburg position.

Characteristics of older adults receiving enteral feeding at a geriatric medical center.

Background: Malnutrition is a prevalent and hard-to-treat condition in older adults. enteral feeding is common in acute and long-term care. Data regarding the prognosis of patients receiving enteral feeding in geriatric medical settings is lacking.

Factors Associated with In-Hospital Mortality in Elderly Internal Medicine Patients with Nasogastric Tube Feeding.

Purpose: To evaluate demographic, clinical, and laboratory variables, and their associations with in-hospital mortality, among elderly internal medicine patients with nasogastric tube (NGT) feeding.

Patients And Methods: Demographic, clinical, and laboratory data were collected retrospectively for 129 patients aged ≥80 years who initiated NGT feeding during their hospitalization in internal medicine wards. The data were compared between survivors and non-survivors.

[Multidisciplinary approach in cardio-oncology for high inferior vena cava thrombosis].

The authors present a 75-year-old patient with renal cell carcinoma and subdiaphragmatic inferior vena cava thrombosis. Renal cell carcinoma stage III T3bN1M0, inferior vena cava thrombosis, anemia, severe intoxication syndrome, coronary artery disease, multivessel atherosclerotic lesion of coronary arteries, angina pectoris class 2, paroxysmal atrial fibrillation, chronic heart failure NYHA class IIa and post-inflammatory lung lesion after previous viral pneumonia were diagnosed at admission. A council included urologist, oncologist, cardiac surgeon, endovascular surgeon, cardiologist, anesthesiologist and specialists for X-ray diagnosis.

Prolonged stay at an acute-care hospital in Israel among older adults awaiting transfer to post-acute care: retrospective study on risk factors and consequences.

Background: Older adults frequently experience deconditioning following acute illnesses and require discharge from acute-care facilities to post-acute care facilities, which are limited. Our study aimed to explore predictors and outcomes associated with elongated length of stay (LOS) among older adults awaiting discharge to skilled nursing facility (SNF).

Methods: Retrospective cohort study was conducted at Shamir Medical Center, Israel, among adults (> 65 years) eligible for SNF.

[GERIATRIC ONCOLOGY - CANCER TREATMENT IN OLDER ADULTS AND OLDEST-OLD].

Introduction: Geriatric oncology is the clinical field of cancer treatment in older adults (above 65 years) and in the oldest-old (above 80 years). As age is the most significant risk factor for cancer, and with the aging of the population, there is a vast increase in the number of older cancer patients.

Background: The cases highlight the unique challenges in geriatric oncology: disease goals may differ; treatment toxicities are higher; the extensive use of prescription medication increases the chances of harmful drug-drug interactions; finally, older adults have unique psychosocial needs.

The prognostic role of functional dependency in older inpatients with COVID-19.

Background: Coronavirus disease 2019 (COVID-19) is a pandemic infection with substantial risk of death, especially in elderly persons. Information about the prognostic significance of functional status in older patients with COVID-19 is scarce.

Methods: Demographic, clinical, laboratory and short-term mortality data were collected of 186 consecutive patients aged ≥ 65 years hospitalized with COVID-19.

[Endoscopy-assisted dilatational tracheostomy in patients with COVID-19].

Objective: To summarize an experience of endoscopy-assisted dilatational tracheostomies in patients with COVID-19.

Material And Methods: There were 31 endoscopy-assisted dilatational tracheostomies in patients with COVID-19 for the period from April 17 to June 10, 2020 (11 women and 19 men). Mean age of patients was 66.

Platelet distribution width: a novel prognostic marker in an internal medicine ward.

: Platelet distribution width (PDW) has demonstrated clinical significance in populations with specific disorders; its prognostic significance in internal medicine wards has not been investigated. : Demographic, clinical and laboratory data were collected prospectively for 1036 internal medicine inpatients. The primary outcome was 90-day mortality, secondary outcomes were: treatment with mechanical ventilation, prolonged hospital stay, in-hospital death, and all-cause mortality following discharge.

[Pharmacological neuroprotection for intracerebral hemorrhages in patients with polyvascular disease].

Aim: To evaluate the efficacy of pharmacological neuroprotection with protein, peptide and metabolic drugs as a part of basic intensive therapy for intracerebral hemorrhages in patients with polyvascular disease (PolyVD).

Material And Methods: Twenty-eight male patients with PolyVD referred to surgical treatment of intracerebral hemorrhages, who were on mechanical ventilation and received basic intensive care, were included in a single center prospective observational study. All patients were assigned either to routine daily i/v infusions of 10 ml cytoflavin in 0.

Prognostic significance of a prolonged international normalized ratio in elderly patients in an internal medicine ward.

Purpose: To investigate clinical characteristics and the prognostic significance of a prolonged international normalized ratio (INR) without obvious cause or anticoagulant treatment, in elderly inpatients.

Methods: Demographic, clinical, and laboratory data, in-hospital death and 30day-mortality were prospectively registered for 100 consecutive patients aged ≥75years admitted to an internal medicine ward for a variety of acute medical disorders, and compared according to normal (≤1.15) and prolonged (>1.

[Evaluation of the hemostatic potential at coronary artery bypass surgery during long-term aspirin therapy].

Aim: To estimate thrombin generation test parameters in patients with coronary heart disease during coronary artery bypass surgery under extracorporeal circulation after transfusion of donor platelet concentrates during long-term therapy with acetylsalicylic acid (ASA).

Subjects And Methods: A total of 148 patients with coronary heart disease who had undergone elective primary coronary artery bypass surgery under extracorporeal circulation during preserved therapy with ASA (75-100 mg/day) were examined. According to donor platelet concentrate transfusion, all the patients were divided into 2 groups: 1) 76 patients undergoing donor platelet transfusion and 2) 72 without this procedure.

Use of thrombin generation test for monitoring hemostasis in coronary bypass surgery.

To evaluate the parameters of the thrombin generation test (TGT) in coronary artery disease (CAD) patients on prolonged aspirin therapy during on-pump coronary artery bypass grafting (CABG) after donor platelet concentrate transfusion. A total of 148 patients with CAD on prolonged aspirin therapy (75-100 mg/day) who have undergone elective on-pump CABG were consecutively included in the study. Patients were divided randomly into two groups.

[THE ROLE OF LOW-FREQUENCY PIEZOTHROMBOELASTOGRAPHY IN THE COMPREHENSIVE EVALUATION OF HEMOSTASIS IN CORONARY BYPASS SURGERY WITH CARDIOPULMONARY BYPASS].

Aim: To monitor the hemostatic system during platelet concentrate transfusions using low-frequency piezothromboelastography in patients with coronary bypass surgery given aspirin therapy.

Materials And Methods: The study involved 148 patients with coronary bypass surgery, with 76 ones undergoing intraoperative transfusion of platelet concentrate and 72 treated without transfusion. The control group consisted of 20 healthy individuals.

[PHARMACOLOGICAL CARDIOPROTECTION DURING REPERFUSION OF ISOLATED HEART].

Purpose: To study the contractile function, the degree of damage and regional myocardial metabolism in the isolated rat heart model subjected to cardioplegic stop and reperfusion under the protection of levosimendan.

Materials And Methods: The study was performed on isolated rat hearts Wistar (group using "Custodiol" vs group using "Custodiol" + "Levosimendan". We assessed the extent of myocardial damage (in terms of markers of myocardial necrosis), the contractile function of the myocardium (coronary flow, heart rate, left ventricular pressure), the dynamics of redox processes during reperfusion with a parallel study of histology of the myocardium.

[Therapeutic hypothermia: the potential and prospects].

Hypothermia is a most powerful tool for the protection of various organs especially brain. The review is focused on the mechanisms of protective action (modulation ofmetabolism and local inflammatory reaction, prevention of blood-brain barrier disorders, normalization of nitric oxide synthesis) and technology of therapeutic hypothermia. Main clinical situations in which the most effective and safe application of this technology was achieved are described.

Biochemical, immunological and enzymatic components of saliva in prolonged naso-gastric-fed elderly patients.

Background And Aims: We have previously shown that naso-gastric tube (NGT)-fed patients harbor pathogenic flora in their oropharynx. The purpose of this study was to examine comparatively the biochemical, immunological and enzymatic components of the saliva of these patients with that of orally-fed counterparts.

Methods: The study group consisted of 19 elderly NGT-fed patients and 18 comparable patients on oral feeding.

Saliva secretion and oral flora in prolonged nasogastric tube-fed elderly patients.

Background: In a previous study we showed that prolonged nasogastric tube feeding is associated with pathogenic oral flora.

Objective: To reexamine the impact of prolonged nasogastric tube feeding on the oral microbiota and to explore the salivary flow and composition in elderly patients in long-term care.

Methods: We compared a group of elderly patients fed by nasogastric tube with a control group of elderly patients in long-term care who are fed orally.

Rhinoscleroma in an octogenarian woman.

Rhinoscleroma, a granulomatous infection caused by Klebsiella rhinoscleromatis and usually afflicting young adults, was diagnosed in an 81-year-old woman. Treatment was started with orally administered antibiotics but was soon halted because of side effects. She was treated instead by local spread of a 3% rifampin ointment.

Pathogenic colonization of oral flora in frail elderly patients fed by nasogastric tube or percutaneous enterogastric tube.

Background: Aspiration of infected oropharyngeal content is the main cause of aspiration pneumonia. This complication, mainly related to gram-negative bacteria, threatens percutaneous enterogastric tube as well as nasogastric tube (NGT) fed patients. The objective of this study was to examine the oral microbiota of tuboenterally fed patients and compare it with that of orally fed counterparts.