Seksuell helse hos eldre.

Good sexual health promotes quality of life and coping skills, and this also applies to older adults. This clinical review article presents updated knowledge on older adults' sexuality, normal challenges related to ageing and conjugal relationships, and sexual challenges caused by chronic diseases, adverse effects of medications, and cognitive failure. The review describes measures to improve sexual health. Healthcare personnel should take the initiative to talk about sexual health with older adults.

Algorithms for early detection of silent liver fibrosis in the primary care setting - a scoping review.

INTRODUCTION: Fatty liver disease affects almost 30% of the adult population worldwide. Most patients are asymptomatic, and there is not a linear relationship between exposure to risk factors and the risk of developing fibrosis. The combination of a very large, asymptomatic risk population where only a few percent will develop life-threatening liver disease is a growing diagnostic challenge for the health services. Accurate fibrosis assessment in primary care is limited by poor correlation with liver blood tests and low availability of elastography. Non-invasive tests are promising tools, but little is known about their diagnostic accuracy in low-risk populations. AREAS COVERED: A scoping review was conducted to identify articles that focused on the current use of biomarkers and algorithms in primary care for the detection of patients with fatty liver disease in need of referral for further work-up. EXPERT OPINION: Currently available algorithms for targeted screening for liver fibrosis perform better than the individual routine liver blood tests or liver ultrasonography. However, primary care physicians urgently need algorithms with even higher diagnostic accuracies than what is available today. The main limitation of the existing widely accessible algorithms, such as the FIB-4, is the large number of false-positive tests, resulting in overdiagnosis and futile referrals to secondary care.

Preanalytical stability of plasma biomarkers for Alzheimer's disease pathology.

Introduction: Plasma tests have demonstrated high diagnostic accuracy for identifying Alzheimer's disease pathology. To facilitate the transition to clinical utility, we assessed whether plasma storage duration and temperature affect the biomarker concentrations. Methods: Plasma samples from 13 participants were stored at +4°C and +18°C. Concentrations of six biomarkers were measured after 2, 4, 6, 8, 10, and 24 h by single molecule array assays. Results: Phosphorylated tau 181 (p-tau181), phosphorylated tau 231 (p-tau231), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP) concentrations were unchanged both when stored at +4°C and +18°C. Amyloid-ß 40 (Aß40) and amyloid-ß 42 (Aß42) concentrations were stable for 24 h at +4°C but declined when stored at +18°C for longer than 6 h. This decline did not affect the Aß42/Aß40 ratio. Discussion: Plasma samples can be stored for 24 h at +4°C or +18°C and result in valid assay results for p-tau181, p-tau231, Aß42/Aß40 ratio, GFAP, and NfL. HIGHLIGHTS: Plasma samples were stored for 24 h at +4°C and +18°C, mimicking clinical practice.Concentrations for Alzheimer's disease biomarkers were measured at six time-points.p-tau181, p-tau231, NfL, and GFAP concentrations were unchanged during the experiment.Storage at +18°C affected Aß40 and Aß42 concentrations while storage at +4°C did not. The Aß42/Aß40 ratio was unaffected.These plasma tests seem suitable for use in general practice.

Use of a Smart Pump and Dedicated Medication Line to Reduce Peripherally Inserted Central Catheter Damage.

BACKGROUND: Neonatal intensive care unit (NICU) infants frequently require peripherally inserted central catheter (PICC) placement for medication and nutrition. The occurrence of leaking catheters led to practice evaluation of manual intravenous (IV) flush and medication push technique in an upper Midwest NICU. A variation in unit practice was revealed. PURPOSE: To describe an evidence-based practice change that standardized medication administration, eliminating routine manual IV push medication and flush administration and reducing catheter malfunction. Emergency "code" medication administration was not addressed. METHODS: A systematic review of the literature was performed. A unit practice investigation ensued to study medication administration techniques and syringe size utilization, understand syringe pressure generated by various sizes of syringes, select optimal IV tubing supplies, review the smart pump library, electronic order sets/documentation, and address staff knowledge and skills. Practice change eliminating IV push and recommendations incorporating best evidence occurred. RESULTS: Moving from a traditional method of manual pushing/flushing medication to use of medication delivery via smart pump can decrease or eliminate PICC damage and potential harm to neonatal patients. IMPLICATIONS FOR PRACTICE: Examination of IV push technique may identify opportunities for safer medication administration. Use of an infusion pump and a dedicated medication line can be a feasible option to deliver most IV medication doses in the NICU. IMPLICATIONS FOR RESEARCH: Safe medication administration practices for the neonatal population and barriers to that practice.Video Abstract available athttps://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=41.