Country Fresh Orlando, LLC. of Orlando, Florida, is recalling 5,999 cases of diced bell pepper, vegetable kabobs, and creole and fajita mixed diced vegetables (product descriptions attached), because they have the potential to be contaminated with Listeria monocytogenes. Listeria monocytogenes is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.
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Tuesday, September 5, 2017
Associations Between Falls and Driving Outcomes in Older Adults: Systematic Review and Metaanalysis - American Geriatric Society
Objectives
To examine associations between falls and subsequent motor vehicle crashes (MVCs), crash-related injuries, driving performance, and driving behavior.
Design
Systematic review and metaanalysis.
Participants
Observational studies including drivers aged 55 and older or with a mean age of 65 and older.
Measurements
Two authors independently extracted study and participant characteristics, exposures, and outcomes and assessed risk of bias. Pooled risk estimates for MVCs and MVC-related injuries were calculated using random-effects models. Other results were synthesized narratively.
Results
From 3,286 potentially eligible records, 15 studies (N = 27–17,349 subjects) met inclusion criteria. Risk of bias was low to moderate, except for cross-sectional studies (n = 3), which all had a high potential for bias. A fall history was associated with a significantly greater risk of subsequent MVC (summary risk estimate = 1.40, 95% confidence interval (CI) = 1.20–1.63; I2 = 28%, N = 5 studies). One study found a significantly greater risk of MVC-related hospitalizations and deaths after a fall (hazard ratio = 3.12, 95% CI = 1.71–5.69). Evidence was inconclusive regarding an association between falls and driving cessation and showed no association between falls and driving performance or behavior.
Conclusion
Falls in older adults appear to be a risk marker for subsequent MVCs and MVC-related injury. Given the nature of the evidence, which is limited to observational studies, the identified associations may also result at least partly from confounding or bias. Further research is needed to clarify the mechanisms linking falls to crash risk and to develop effective interventions to ensure driving safety in older adults with a history of falls.
from Journal of the American Geriatrics Society http://ift.tt/2xLWqji
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Geriatrics Literature 2016 Year in Review - American Geriatric Society
We present 10 of the most effective articles from 2016 in geriatric medicine. They address wide-ranging topics including the use of antipsychotics for delirium in palliative care, fall prevention and mobility interventions, efficacy and potential risks of testosterone, cranberry capsules and their effect on bacteriuria and pyuria, beta-blockers after acute myocardial infarction in a nursing home population, the effect of a healthy lifestyle on disability, a goals-of-care intervention in individuals with advanced dementia, the benefits of regional anesthesia in hip repair, and mindfulness in chronic pain management.
from Journal of the American Geriatrics Society http://ift.tt/2x7AaTO
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Treatment Effectiveness in Heart Failure with Comorbidity: Lung Disease and Kidney Disease - American Geriatric Society
Objectives
To assess the clinical effectiveness of beta-blocker therapy in individuals with heart failure (HF) and chronic lung disease and of angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin II receptor blockers (ARBs) in individuals with HF and chronic kidney disease.
Design
Retrospective cohort study.
Setting
Community.
Participants
Individuals with HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF).
Methods
We undertook separate new-user cohort studies to assess the effectiveness of beta-blocker therapy in treating HF and chronic lung disease and ACE-Is and ARBs in treating HF and chronic kidney disease (CKD). Individuals with a chronic lung disease diagnosis were included in the group with HF and chronic lung disease (International Classification of Diseases, Ninth Revision, codes 490–496, 518). Individuals with an estimated glomerular filtration rate less than 60 mL/min per 1.73 m2 were included in the group with HF and CKD. The clinical outcomes of interest were death from any cause, hospitalization for HF, and hospitalization for any reason. We fitted pooled logistic marginal structural models using inverse probability weighting, stratified according to HF type.
Results
For individuals with HFrEF with chronic lung disease, beta-blocker therapy was protective against death (relative risk (RR) = 0.58, 95% confidence interval (CI) = 0.44–0.77) and hospitalization for HF (RR = 0.78, 95% CI = 0.60–1.00). For those with HFpEF, no statistically significant associations between beta-blocker therapy use and any of the outcomes were observed. We found ACE-I and ARB use to be protective against all three outcomes of interest in individuals with HFrEF (death from any cause: RR = 0.60, 95% 0.40–0.91; hospitalization for HF: RR = 0.43, 95% CI = 0.28–0.67; hospitalization for any reason: RR = 0.63, 95% CI = 0.45–0.89, respectively) and those with HFpEF (death from any cause: RR = 0.52, 95% CI = 0.33–0.81; hospitalization for HF: RR = 0.35, 95% CI = 0.18–0.68; hospitalization for any reason: RR = 0.67, 95% CI = 0.47–0.95).
Conclusion
Large observational studies may allow for identification of important subgroups of individuals with HF that might benefit from existing treatment approaches. Our findings may also better inform the design of more-definitive future observational studies and randomized trials.
from Journal of the American Geriatrics Society http://ift.tt/2wDSssV
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Patterns and Predictors of Frailty Transitions in Older Men: The Osteoporotic Fractures in Men Study - American Geriatric Society
Objectives
To describe the natural history of frailty transitions in a large cohort of community-dwelling older men and identify predictors associated with progression to or improvement from states of greater frailty.
Design
Prospective cohort study.
Setting
Six U.S. sites.
Participants
Community-dwelling men aged 65 and older (N = 5,086).
Measurements
Frailty was measured at baseline and an average of 4.6 years later. Frailty was defined as having three or more of the following components (low lean mass, weakness, self-reported exhaustion, low activity level, and slow walking speed); prefrailty was defined as having one or two components. Separate multivariable logistic regression models were analyzed for progression and improvement in frailty status.
Results
Of the 5,086 men, 8% were frail, 46% were prefrail, and 46% were robust at baseline. Between baseline and follow-up, 35% progressed in frailty status or died, 56% had no change in frailty status, and 15% of prefrail or frail participants improved, although only 0.5% improved across two levels, from frail to robust. In multivariable models, factors associated with improvement in frailty status included greater leg power, being married, and good or excellent self-reported health, whereas presence of any instrumental activity of daily living (IADL) limitations, low albumin levels, high interleukin-6 levels, and presence of chronic obstructive pulmonary disease or diabetes mellitus were associated with lower likelihood of improvement in frailty status.
Conclusion
Improvement in frailty status was possible in this cohort of community-dwelling older men, but improvement from frail to robust was rare. Several predictors were identified as possible targets for intervention, including prevention and management of comorbid medical conditions, prevention of IADL disability, physical exercise, and nutritional and social support.
from Journal of the American Geriatrics Society http://ift.tt/2w2BGS2
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