Trending Articles
-
Randomized Controlled Trial Multicenter Study Comparative Study Pragmatic Clinical Trial
Management of multimorbidity using a patient-centred care model: a pragmatic cluster-randomised trial of the 3D approach.
The management of people with multiple chronic conditions challenges health-care systems designed around single conditions. There is international consensus that care for multimorbidity should be patient-centred, focus on quality of life, and promote self-management towards agreed goals. However, there is little evidence about the effectiveness of this approach. Our hypothesis was that the patient-centred, so-called 3D approach (based on dimensions of health, depression, and drugs) for patients with multimorbidity would improve their health-related quality of life, which is the ultimate aim of the 3D intervention. ⋯ National Institute for Health Research.
-
Am J Geriatr Psychiatry · Aug 2015
Multicenter StudyThe clinical utility of the Cornell Scale for Depression in Dementia as a routine assessment in nursing homes.
To examine the clinical utility of the Cornell Scale for Depression in Dementia (CSDD) in nursing homes. ⋯ When administered by nursing home staff the clinical utility of the CSDD is highly questionable in identifying depression. The complexity of the scale, the time required for collecting relevant information, and staff skills and knowledge of assessing depression in older people must be considered when using the CSDD in nursing homes.
-
J. Gerontol. A Biol. Sci. Med. Sci. · Jun 2014
Multicenter StudySerum carboxymethyl-lysine, disability, and frailty in older persons: the Cardiovascular Health Study.
Advanced glycation endproducts are biologically active compounds that accumulate in disordered metabolism and normal aging. Carboxymethyl-lysine (CML), a ubiquitous human advanced glycation endproduct, has been associated with age-related conditions and mortality. Our objective was to ascertain the relationship between CML and geriatric outcomes (disability and frailty) in a large cohort of older men and women. ⋯ Higher serum CML levels in late life are associated with incident disability and prevalent frailty. Further work is needed to understand CML's value as a risk stratifier, biomarker, or target for interventions that promote healthy aging.
-
Clin. Orthop. Relat. Res. · Jan 2014
Multicenter StudyCauses, risk factors, and trends in failures after TKA in Korea over the past 5 years: a multicenter study.
Failure after total knee arthroplasty (TKA) may be related to emerging technologies, surgical techniques, and changing patient demographics. Over the past decade, TKA use in Korea has increased substantially, and demographic trends have diverged from those of Western countries, but failure mechanisms in Korea have not been well studied. ⋯ Despite a recent remarkable increase in TKA use and differences in demographic features, the causes and risk factors for failures in Korea were similar to those of Western countries. Infection was the most common cause of failure, but loosening has emerged as the most common cause in more recent years, which would prompt us to scrutinize the cause and solution to reduce it.
-
Multicenter Study
Impacts of early insulin treatment vs glimepiride in diabetic patients with background metformin therapy: A nationwide retrospective cohort study.
Type 2 diabetes mellitus (T2DM) is a progressive disease. After metformin failure, the addition of insulin or sulfonylureas might increase the risk of hypoglycemia and cardiovascular (CV) morbidity. Here, the risk of all-cause mortality was compared between early insulin treatment and glimepiride use in T2DM patients with background metformin therapy. ⋯ The adjusted hazard ratio of mortality was 14.47 (95% CI: 8.64-24.24; P value <.001) as insulin compared with glimepiride users. The insulin users had significantly higher risk of CV death (adjusted hazard ratio 7.95, 95% CI 1.65-38.3, P = .01) and noncardiovascular death (adjusted hazard ratio 14.9, 95% CI 8.4-26.3, P < .001). The nationwide study demonstrated that metformin plus insulin therapy was associated with higher risk of all-cause mortality.