Journal of the American Geriatrics Society
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To assess the agreement between infrared emission detection (IRED) ear and rectal temperatures and to determine the validity of IRED ear thermometry in detecting rectal fever. ⋯ The degree of agreement between rectal temperature and the highest of six IRED ear temperatures was acceptable. Using an optimal IRED ear fever threshold of 37.2 degrees C (99 degrees F), IRED ear thermometry had acceptable sensitivity and specificity for predicting rectal fever.
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To describe the findings of a retrospective study of the treatment of nursing home-acquired pneumonia (NHAP) in 11 nursing homes in one community and the development of a treatment guideline for NHAP using data from the retrospective study. ⋯ A treatment guideline for NHAP was developed primarily on the basis of the practices of geriatricians in one community. These treatment practices were similar to those reported in the literature in terms of the proportion of patients treated in nursing homes and the antibiotics prescribed. The guideline also provided specific recommendations for timing of the switch to an oral agent after parenteral therapy and for duration of treatment. Studies are in progress to determine if use of this guideline will reduce some of the variation observed in the treatment of NHAP.
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To examine demographic characteristics, clinical features, neuroimaging data, and outcome of all acute stroke events occurring in individuals aged 85 years or older. ⋯ Very old patients with acute stroke showed a differential clinical profile, different frequency of stroke subtypes, and a poorer outcome compared with stroke patients who were younger than 85 years of age. Clinical and neuroimaging factors that are indicative of the severity of stroke and that were available at the time of the initial diagnosis and at the time of the development of cardiac and respiratory complications showed a predominant influence on in-hospital mortality and may help clinicians to establish prognosis more accurately.
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To determine whether there is a difference in crash rates and characteristics between drivers with dementia of the Alzheimer type (DAT) and nondemented older persons who were controls. ⋯ In our sample, individuals with very mild or mild DAT who continued to drive seemed to have crash rates similar to those of the controls. There may be significant differences between the causes and the consequences of crashes involving drivers with DAT when compared with cognitively intact age-matched controls, but none were found in this pilot study. Further research on crash characteristics is needed in larger samples of community-based drivers with DAT across wider ranges of dementia severity to address issues such as driving competency and public safety.