Search results for " expectancy"
showing 10 items of 187 documents
The Evolution of Cardiovascular Surgery in Elderly Patient: A Review of Current Options and Outcomes
2014
Due to the increase in average life expectancy and the higher incidence of cardiovascular disease with advancing age, more elderly patients present for cardiac surgery nowadays. Advances in pre- and postoperative care have led to the possibility that an increasing number of elderly patients can be operated on safely and with a satisfactory outcome. Currently, coronary artery bypass surgery, aortic and mitral valve surgery, and major surgery of the aorta are performed in elderly patients. The data available show that most cardiac surgical procedures can be performed in elderly patients with a satisfactory outcome. Nevertheless, the risk for these patients is only acceptable in the absence of…
Renal cancer surgery in the elderly.
2009
Renal cell carcinoma mainly develops in the sixth or seventh decade of life. As life expectancy increases, urologists have to deal with elderly patients presenting with renal cancer. The introduction of ablative techniques has even widened our armamentarium of treating elderly patients with renal cancer apart from the standard laparoscopic and open surgical procedures. Our review highlights the current literature focusing on the functional and oncological outcome of surgically treated renal cancer in elderly patients.Despite the higher percentage of comorbidities, perioperative morbidity and declined renal reserve in elderly patients, radical or partial nephrectomy being performed open or l…
Natural history and prognostic indicators of survival in cirrhosis: A systematic review of 118 studies
2006
Liver transplantation significantly improves the survival and quality of life of patients with end-stage cirrhosis. However, a large proportion of cirrhotic patients still die while on the transplant list because of an insufficient number of donors and because of the lack of an accurate prediction of life expectancy. Although many prognostic models have been proposed in the last two decades to predict mortality in cirrhosis, the Child–Pugh score [1] is by far the most largely used both in clinical practice and in clinical research. Recently, the model for end stage liver disease (MELD) has replaced the Child–Pugh score in the United States for prioritizing liver donor allocation [2]. MELD i…
A Decision Support Tool for Appropriate Glucose-Lowering Therapy in Patients with Type 2 Diabetes
2015
Contains fulltext : 152084.pdf (Publisher’s version ) (Open Access) BACKGROUND: Optimal glucose-lowering therapy in type 2 diabetes mellitus requires a patient-specific approach. Although a good framework, current guidelines are insufficiently detailed to address the different phenotypes and individual needs of patients seen in daily practice. We developed a patient-specific decision support tool based on a systematic analysis of expert opinion. MATERIALS AND METHODS: Based on the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) 2012 position statement, a panel of 12 European experts rated the appropriateness (RAND/UCLA Appropriateness Method) of tre…
Vaccination greatly reduces disease, disability, death and inequity worldwide
2007
In low-income countries, infectious diseases still account for a large proportion of deaths, highlighting health inequities largely caused by economic differences. Vaccination can cut health-care costs and reduce these inequities. Disease control, elimination or eradication can save billions of US dollars for communities and countries. Vaccines have lowered the incidence of hepatocellular carcinoma and will control cervical cancer. Travellers can be protected against "exotic" diseases by appropriate vaccination. Vaccines are considered indispensable against bioterrorism. They can combat resistance to antibiotics in some pathogens. Noncommunicable diseases, such as ischaemic heart disease, c…
The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness.
2019
The poor physical health of people with mental illness is a multifaceted, transdiagnostic, and global problem. People with mental illness have an increased risk of physical disease, as well as reduced access to adequate health care. As a result, physical health disparities are observed across the entire spectrum of mental illnesses in low-income, middle-income, and high-income countries. The high rate of physical comorbidity, which often has poor clinical management, drastically reduces life expectancy for people with mental illness, and also increases the personal, social, and economic burden of mental illness across the lifespan. This Commission summarises advances in understanding on the…
Intervenciones preventivas en el ámbito de la atención primaria. El ejemplo del PAPPS. Informe SESPAS 2012
2012
ResumenObjetivosEl Programa de Actividades Preventivas y de Promoción de la Salud (PAPPS), que la Sociedad Española de Medicina de Familia y Comunitaria (semFYC) puso en marcha a finales de la década de 1980, tiene como objetivo la integración de las actividades preventivas y de promoción de la salud en el seno de las tareas desarrolladas en las consultas de atención primaria. Se pretende conocer el grado de cumplimentación del PAPPS en atención primaria.MétodosSe ha realizado una búsqueda bibliográfica de las publicaciones relacionadas con el PAPPS con el fin de evaluar su implementación y el impacto sus programas.ResultadosLas evaluaciones periódicas que se han ido realizando desde su ini…
The risks of using continuous deep palliative sedation within the context of euthanasia
2016
Although palliative care is one of the main arguments among the opponents of euthanasia, the individual medical activities implemented within it are not always evaluated unequivocally. Considering that patient in such care centres arrives mainly at the last stages of the disease when intensive treatments are no longer able to help, to reduce discomfort and relieve pain caused by the disease, analgesic means can be used that can shorten the patient's life expectancy and cause death. Such undesirable consequences can be seen in the deep and continuous palliative sedation, which not only is the last resort for pain prevention process, but also is still quite debatable medical and legal doctrin…
Thrombosis
2014
Background— Thrombosis is the common pathology underlying ischemic heart disease, ischemic stroke, and venous thromboembolism (VTE). The Global Burden of Disease Study 2010 (GBD 2010) documented that ischemic heart disease and stroke collectively caused 1 in 4 deaths worldwide. GBD 2010 did not report data for VTE as a cause of death and disability. Objective— To review the literature on the global burden of disease caused by VTE. Approach and Results— We performed a systematic review of the literature on the global disease burden because of VTE in low-, middle-, and high-income countries. Studies from Western Europe, North America, Australia, and Southern Latin America (Argentina) yielded…
Mortality studies for multiple sclerosis: still a useful tool to analyse long-term outcome
2017
Mortality studies represent a useful way to look at the prognosis of a chronic complex disease and to evaluate the impact of therapeutic and caring strategies on long-term outcomes. Results should be interpreted keeping always in mind the following important aspects: first, to what extent the disease affects patient’s life in terms of life expectancy. Second, what is at this moment the real impact that the strategies and measures we adopt to cure and to take care of patients really have on clear and strong endpoints like mortality? In their JNNP manuscript, Lunde et al .1 show a significant reduction in life expectancy in people affected by multiple sclerosis (MS) over a study period of abo…