Geriatrics Research Today is a free monthly online journal that collates and summarizes the latest research about Geriatrics, including details on old age, psychiatry, depression, medicine.

Biweekly carboplatin/gemcitabine in patients with advanced urothelial cancer who are unfit for cisplatin-based chemotherapy: report of efficacy, quality of life and geriatric assessment.

Bamias A, Lainakis G, Kastritis E, Antoniou N, Alivizatos G, Koureas A, Chrisofos M, Skolarikos A, Karayiotis E, Dimopoulos MA

Department of Clinical Therapeutics, Medical School, University of Athens, Athens, Greece. abamias@med.uoa.gr <abamias@med.uoa.gr>

OBJECTIVE: We evaluated safety and efficacy of first-line gemcitabine/carboplatin in unfit-for-cisplatin patients with advanced urothelial carcinoma and the effect on the quality of life and functional status of elderly patients (aged >70). METHODS: Unfit patients had ECOG performance status (PS) > or =2, creatinine clearance <50 ml/min or comorbidities precluding cisplatin administration. Carboplatin at area under the curve of 2.5 and gemcitabine 1,250 mg/m(2) were administered biweekly. Elderly patients were stratified into group 1 (no activities of daily living (ADL) or instrumental ADL dependency and no comorbidities), group 2 (instrumental ADL dependency or 1-2 comorbidities) and group 3 (ADL dependency or > or =2 comorbidities). RESULTS: Thirty-four patients were enrolled: 68% had PS 2-3, 69% a creatinine clearance <50 ml/min and 65% had 1 or more comorbidities. There were 3 cases of grade 3 toxicity (9%). Response rate was 24% [95% confidence interval (CI) 11-41]. Median follow-up was 8 months, median progression-free survival 4.4 months (95% CI 1.03-7.75) and median overall survival 9.8 months (95% CI 4.7-14.9). Patients in geriatric assessment groups 1 and 2 had a significantly longer median progression-free survival compared to group 3 [6.9 months (95% CI 1.3-12.4) vs. 1.9 months (95% CI 0.5-3.2); p = 0.005]. CONCLUSION: First-line gemcitabine/carboplatin combination is active in unfit-for-cisplatin patients with advanced urothelial carcinoma. Pretreatment quality of life and geriatric assessment may be useful in selecting patients likely to benefit from this treatment.

Published 19 June 2008 in Oncology, 73(5): 290-7.
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Articles on Geriatrics published 18 June 2008:

Repressive coping in geriatric patients' reports - Impact on fear of falling.   Z Gerontol Geriatr.

We investigated the influence of repressive coping, depression, cognition, education and age on geriatric patients' reports on health-related status in 80 geriatric patients with a history of injurious falls. For patient reports, subjective statements on activity avoidance, perception of terminal decline, falls, and fear of falling were assessed. Co-morbidity and number of medications were documented based on patient charts.Repressive coping was significantly associated with underreporting in ... [Abstract] [Full-text]

Articles on Geriatrics published 16 June 2008:

The effect of the geriatrics education for emergency medical services training program in a rural community.   J Am Geriatr Soc, 56(6): 1134-9.

The Geriatrics Education for Emergency Medical Service (EMS) (GEMS) course provides continuing education for EMS providers. This study evaluated the effect of the course on EMS providers in a rural county by performing a prospective cohort study using a pre-postsurvey design. The Geriatric Attitude Scale, the GEMS knowledge posttest, a class satisfaction survey, and a survey evaluating EMS providers' comfort in caring for older adults were used to measure the classes' effect. Eighty-eight EMS ... [Abstract] [Full-text]

Articles on Geriatrics published 13 June 2008:

Preventing the use of physical restraints on residents newly admitted to psycho-geriatric nursing home wards: A cluster-randomized trial.   Int J Nurs Stud.

BACKGROUND: Although there is an urgent need for restraint-free care, the number of randomized clinical trials on preventing or reducing physical restraints has been limited. OBJECTIVES: To investigate the effectiveness of an educational intervention to prevent the use of physical restraints on residents newly admitted to psycho-geriatric nursing home wards. DESIGN: Cluster-randomized trial. SETTING: Fourteen Dutch psycho-geriatric nursing home wards. PARTICIPANTS: 138 residents admitted to 14 ... [Abstract] [Full-text]

Regional Gray Matter Changes Are Associated with Cognitive Deficits in Remitted Geriatric Depression: An Optimized Voxel-Based Morphometry Study.   Biol Psychiatry.

BACKGROUND: We aimed to investigate structural abnormalities in first-episode remitted geriatric depression (RGD) with optimized voxel-based morphometry (VBM) in closely matched patients and healthy control subjects and examine the relationship of performances on neuropsychological tests with regional gray matter volumes. METHODS: Nineteen subjects with first-episode RGD and 16 well-matched healthy control subjects were recruited for this study, and neuropsychological tests and magnetic ... [Abstract] [Full-text]

Articles on Geriatrics published 9 June 2008:

Agrobacterium radiobacter bacteremia in oncologic and geriatric patients: presentation of two cases and review of the literature.   Int J Infect Dis.

INTRODUCTION: We report here two cases of Agrobacterium radiobacter bacteremia. These cases were observed at the same institution over a short time period (3 months). CASE REPORTS: The first patient was a female cancer patient receiving third-line chemotherapy for ovarian carcinoma. When she developed bacteremia, she was neutropenic and had an indwelling catheter that was removed as part of the treatment. The second case was a geriatric patient admitted from home with bacteremia, clinical signs ... [Abstract] [Full-text]

Articles on Geriatrics published 6 June 2008:

Does an association between increased homocystein levels and cognitive dysfunction also exist in multimorbid geriatric patients?   Z Gerontol Geriatr.

BACKGROUND : Total blood homocysteine (Hcys) and folate have been investigated in association with cognitive dysfunction (CD) in healthy but not in multimorbid elderly patients. We hypothesized that total Hcys and folate are adequate markers to identify multimorbid elderly patients with CD. METHODS : According to the Short Performance Cognitive Test (SKT) CD was determined in a cross-sectional study with 189 (131 f/58 m) multimorbid elderly patients with a mean age of 78.6 +/- 7.3 yrs. Besides ... [Abstract] [Full-text]

Articles on Geriatrics published 5 June 2008:

Chronic kidney disease, atherosclerosis, and cognitive and physical function in the geriatric group of the National Health and Nutrition Survey 1999-2002.   Atherosclerosis.

BACKGROUND: This study was designed to elucidate the relationship between chronic kidney disease (CKD), atherosclerotic complications, and the effects on functional performance in the elderly. METHODS: A total of 2431 subjects aged 65 and above from the National Health and Nutrition Survey (NHANES) 1999-2002 were included to formulate a population-based observational study. A structural equation model (SEM) was constructed to validate the relationship between renal impairment, atherosclerotic ... [Abstract] [Full-text]

Articles on Geriatrics published 3 June 2008:

Chronic pain and depression among geriatric psychiatry inpatients.   Int J Geriatr Psychiatry, 23(6): 637-42.

OBJECTIVES: We examined whether chronic pain among depressed geriatric inpatients was associated with several clinical variables-comorbid psychiatric and medical diagnoses, length of hospitalization, suicidal ideation, and sleep duration. METHODS: Medical charts of inpatients admitted to a geriatric psychiatry unit over 2 years were examined retrospectively; 148 patients with a depressive disorder were identified. Admission pain assessments were used to classify whether patients had chronic ... [Abstract] [Full-text]

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