Papers by Ana Patricia Navarrete Reyes
Journal of Geriatric Oncology
Journal of the American Geriatrics Society, 2019
OBJECTIVES: Geriatric assessment and interventions improve the care of older adults with cancer, ... more OBJECTIVES: Geriatric assessment and interventions improve the care of older adults with cancer, but their effect on treatment decision making in resource-limited settings is unknown. We studied the effect of recommendations made by a consultative geriatric oncology clinic on treatment decision making by oncologists in Mexico. DESIGN, SETTING, AND PARTICIPANTS: Retrospective chart review of 173 consecutive patients with solid tumors referred before treatment initiation to the geriatric oncology clinic at a third-level public hospital in Mexico City between March 2015 and October 2017. Patients were evaluated by a multidisciplinary geriatric oncology clinic, and treatment recommendations were issued to treating oncologists. MEASUREMENTS: We determined the overall proportion of agreement between geriatric oncology recommendations and oncologists' treatment decisions. We assessed whether agreement increased when geriatric oncology recommendations were acknowledged in the treating oncologist's clinic note. The homogeneity of agreement was tested using the Stuart-Maxwell test. RESULTS: Median age was 79 years (range = 64-97 years). "Standard treatment" was recommended in 48% of cases, followed by "less intensive treatment" in 32%, and "best supportive care" in 20%. The overall proportion of agreement for the entire population was 80% (κ = 0.69), although agreement was heterogeneous (X 2 = 8.16, P = .02). Geriatric oncology recommendations were acknowledged in the treating oncologists' notes in 62% of cases. Overall agreement was higher when the evaluation was acknowledged (83%, κ = 0.74) than when it was not acknowledged (74%, κ = 0.60). Agreement was homogeneous only when recommendations were acknowledged in the oncologist's note (X 2 = 3.0, P = .22). CONCLUSIONS: The overall proportion of agreement between geriatric oncology recommendations and final treatment decisions was high, particularly when recommendations were acknowledged in the treating oncologists' note. Including geriatric oncology evaluations in everyday clinical practice and fostering interdisciplinary communication between geriatric oncology and treating oncologists may provide valuable guidance for physicians caring for older patients with cancer in resource-limited settings.
Clinical Lymphoma Myeloma and Leukemia, 2018
There is no standard regimen for diffuse large B-cell lymphoma (DLBCL) treatment in patients aged... more There is no standard regimen for diffuse large B-cell lymphoma (DLBCL) treatment in patients aged 60 years or older, due to comorbidities and potential toxicities. We report the results of adjusted chemotherapy according to frailty status as per the Cardiovascular Health Study (CHS) criteria. This tool is useful in decision-making because it identifies groups with different clinical behaviors.
The Journal of frailty & aging, 2015
Low cognitive performance has been associated with a wide array of adverse health-related outcome... more Low cognitive performance has been associated with a wide array of adverse health-related outcomes in elderly populations. Recently, the effect of vitamin D on cognition has been studied; however, its benefits are still controversial. Moreover, most studies have been carried out on North-American and European populations where vitamin D deficiency could represent a greater public-health issue when compared to Latin American ones. To investigate the association between 25-OH-vitamin D and cognitive performance in Mexican community-dwelling elderly. Cross-sectional study sample of 331 community-dwelling elderly aged 70 and older, participating in the Mexican Study of Nutritional and Psychosocial Markers of Frailty. Serum 25-OH-vitamin D, cognitive performance as per the Mini-Mental State Examination (MMSE) and the IST (Isaacs Set Test), as well as several elements from the comprehensive geriatric assessment. Mean age of participants was 79.3 years (SD 5.9), 54.1% were women. The mean ...
Journal of the American Geriatrics Society, 2015
Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituxim... more Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: A study by the Groupe d'Etudes des Lymphomes de l'Adulte.
Innovation in Aging, 2017
Journal of Frailty & Aging
Background:Frailty is a multidimensional problem in the elderly, but there is little information ... more Background:Frailty is a multidimensional problem in the elderly, but there is little information aboutits implications on health-related quality of life (HRQoL). Objectives:To determine the association betweenfrailty and HRQoL as well as the association between each component of the phenotype of frailty and thephysical (PCS) and mental (MCS) components summaries of QoL. Design, setting and participants:Cross-sectional study of 496 community-dwelling elderly aged 70 and older, participating in the Mexican Study ofNutritional and Psychosocial Markers of Frailty. Measurements:Frailty was defined by the presence of at leastthree of the following criteria: weight loss, exhaustion, low physical activity, slowness, and weakness. QoL andboth of its components were assessed through the SF-36. The association of each component of frailty with thePCS and the MCS of QoL was determined through the construction of multivariate lineal regression models.Final analyses were adjusted by socio-demogra...
Journal of Gerontology and Geriatrics, 2022
How to cite this article: Chambergo-Michilot D, Corcuera-Ciudad R, Runzer-Colmenares FM, et al. P... more How to cite this article: Chambergo-Michilot D, Corcuera-Ciudad R, Runzer-Colmenares FM, et al. Pain management, activities of daily living and the assessment of the WHOQOL-OLD module: results of a cross-sectional analysis of a cohort of older men with oncological diagnoses.
Journal of Frailty & Aging, 2014
An epidemiological transition is occurring regarding Human Immunodeficiency Virus (HIV) infection... more An epidemiological transition is occurring regarding Human Immunodeficiency Virus (HIV) infection.This phenomenon, explained by several mechanisms (e.g.: physiologic changes, pharmacologic advances, sexualbehaviors), is demonstrated by a significant increase in the number of patients aged 50 years and older diagnosedwith this infection. The immunological changes observed in HIV-infected patients may prompt the appearance ofan accelerated aging process as well as that of comorbidities and other pathological entities commonly diagnosedin older adults. Frailty is a biologic syndrome characterized by a multi-systemic decrease of the individual’sphysiologic and homeostatic reserves, leading to diminished resistance against stressors and increasedvulnerability. The purpose of this review is to describe the common molecular changes seen in both frailty andHIV-1 infection, offering an in-depth analysis of their pathophysiology and specifying common processes wheretheir pathways meet.
Essentials of Cancer Survivorship, 2021
Journal of the American Geriatrics Society, 2012
an outbreak was first documented suggests collateral damage caused by the continued overuse of qu... more an outbreak was first documented suggests collateral damage caused by the continued overuse of quinolones. A restriction of quinolone use in LTCF A was therefore implemented to limit the selection of quinolone-resistant bacteria. These findings highlight several important concerns First, comparison of the antibiogram for LTCF A with that of its associated hospital-documented higher resistance rates in LTCF A. The resistance patterns documented in specific areas of LTCF A helped to direct attention to locations where enhanced infection control practices would have the greatest effect (the ventilator unit). Antibiotic stewardship programs and continued surveillance, including the creation of specific antibiograms, are necessary for appropriate antibiotic prescription in areas where patients are most debilitated, have multiple sources of infection (tracheostomy sites, feeding tube sites, pressure ulcers, peripherally inserted central catheter lines, and urinary catheters), and often receive several antibacterial agents. In addition, as patients approach the end of life, it may be prudent for physicians to discuss a more-palliative approach and avoid inappropriately prescribing antibiotics for organism eradication without the hope of cure. In this manner, physicians can focus on improving their patients’ quality of life and reduce the selection of multi-drug-resistant bacteria. In conclusion, LTCFs should generate specific antibiograms to guide antibiotic stewardship and not rely on their associated hospital’s antibiogram, because antibiotic susceptibility patterns vary dramatically between facilities. This practice, in conjunction with stewardship initiatives, is now being implemented in LTCF A and will be monitored to assess its overall effect.
Journal of the American Geriatrics Society, 2013
Barba developed the conceptualization and design of the study, performed the analyses, and interp... more Barba developed the conceptualization and design of the study, performed the analyses, and interpreted the data. He wrote the manuscript under the supervision of Drs. Navarrete-Reyes and Avila-Funes. The coauthors certify that they have participated substantially in the conceptualization and design of this work, the analysis of the data, and the writing of the manuscript. They have reviewed the final version of the manuscript and have approved it for publication. Sponsor's Role: None.
Critical Care Medicine, 2014
Objective: To evaluate the association of maternal serum 25-hydroxyvitamin D (25[OH]D) status wit... more Objective: To evaluate the association of maternal serum 25-hydroxyvitamin D (25[OH]D) status with glucose homeostasis and obstetric and newborn outcomes in women screened for gestational diabetes mellitus (GDM). Methods: Consecutive women were screened for GDM at 24 to 28 weeks' gestation during the months of maximal sunlight exposure in Spain (June through September). Serum 25(OH)D levels and parameters of glucose homeostasis were measured. Outcomes of the delivery and newborn were collected. Results: Two hundred sixty-six women were screened. Vitamin D deficiency (25[OH]D <20 ng/mL) was observed in 157 women (59%). We observed an inverse correlation between 25(OH)D levels and hemoglobin A 1c , homeostasis model assessment of insulin resistance, serum insulin, and fasting and 1-hour oral glucose tolerance test glucose levels (P<.001). With a 25(OH)D concentration less than 20 ng/mL, the odds ratios were 3.31 for premature birth (95% confidence interval, 1.52-7.19; P<.002) and 3.93 for cesarean delivery (95% confidence interval, 2.00-7.73; P<.001). A 25(OH)D concentration of 20 ng/mL had 79% sensitivity and 51% specificity for cesarean delivery and 80% sensitivity and 45% specificity for premature birth. The cutoffs with the best combination of sensitivity and specificity were 16 ng/mL for cesarean delivery (62.9% sensitivity and 61.2% specificity) and 14 ng/mL for premature birth (66.7% sensitivity and 71.0% specificity). Conclusions: In the population we sampled, vitamin D deficiency is very common during pregnancy. Lower 25(OH)D levels are associated with disorders of glucose homeostasis and adverse obstetric and newborn outcomes.
Revista de Salud Pública, 2020
Latinoamérica, al igual que el resto del mundo, se está enfrentando actualmente a las consecuenci... more Latinoamérica, al igual que el resto del mundo, se está enfrentando actualmente a las consecuencias del envejecimiento poblacional, entre las que se incluye el aumento en la incidencia de neoplasias malignas en adultos mayores, con un subsecuente incremento en la uso de servicios de salud oncológicos. La oncología geriátrica es una disciplina de reciente creación que suma principios geriátricos a los avances oncológicos para ofrecer un tratamiento individualizado a los adultos mayores con cáncer. Este abordaje multidisciplinario actualmente es recomendado en el cuidado oncológico rutinario en adultos mayores. En Latinoamérica existen varias iniciativas asistenciales de enseñanza e investigación en oncología geriátrica; sin embargo, el número de centros especializados y la disponibilidad de personal capacitado en el área es limitada en comparación con los recursos disponibles en países de ingresos altos. En este trabajo se describen recomendaciones internacionales para la implementac...
Geriatrics Gerontology and Aging, 2021
Vaccination is one of the most effective means of preventing infections and should be widely prom... more Vaccination is one of the most effective means of preventing infections and should be widely promoted, especially in immunocompromised patients, such as older adults with cancer and older cancer survivors. However, adherence is low, which is due in part to lack of awareness, fear of side effects, hesitancy to vaccinate and rejection of vaccination, especially for COVID-19. The objective of this paper is to clarify current indications for vaccination in these populations and underscore its importance.
5. Pepersack T. "Minimum geriatric screening tools to detect common geriatric problems".
Cancer screening refers to the identification of subclinical disease in a population through rapi... more Cancer screening refers to the identification of subclinical disease in a population through rapid and easy examinations and/or tests. The design and implementation of cancer screening requires the creation of mechanisms for systematic followup of individuals with abnormal results, a robust participation of the target population (at least 70%), and the infrastructure to offer the test and to further investigate and/or treat any abnormal findings (World Health Organization 2018; Maxim et al. 2014). Overview In 2018, the four most common malignancies among people aged 65 years worldwide were those of the lung, colon, prostate, and breast, all of which are susceptible to screening (Ferlay et al. 2018). Ideally, detecting (and treating) cancer at an early stage should lead to a reduction in mortality. However, most randomized controlled trials (RCT) of screening strategies have included mostly younger individuals, and the benefit of these interventions in older adults is not completely known (Kotwal and Schonberg 2017). Moreover, screening may derive in short-or long-term harm to patients. Since some older adults may not live long enough to achieve the potential benefits of screening, predicted life expectancy should be incorporated in screening decisions. Unfortunately, up to 55% of patients with limited life expectancy received inappropriate cancer screening in the USA between 2000 and 2010 (Royce et al. 2014). A practical way of estimating life expectancy is the use of online calculators (Fig. 1). Calculating 5-and 10-year life expectancy is useful when considering screening, due to the lag time to benefit of interventions (Lee et al. 2013).
Journal of Frailty & Aging, 2014
Background: The phenotype of frailty proposed by Fried et al has shown to predict several adverse... more Background: The phenotype of frailty proposed by Fried et al has shown to predict several adverse health-related outcomes in elderly populations worldwide; however, the description of such associations in Latin America is still scarce. Objective: To describe the association between frailty and recent hospitalization, disability for basic (ADL) and instrumental activities of daily living (IADL). Design, Setting and Participants:Cross-sectional study of 1,124 community-dwelling adults aged 70 and older participating in the Coyoacán cohort. Measurements: Frailty was defined by the presence of at least three of the following criteria: weight loss, exhaustion, low physical activity, slowness, and weakness. Multiple regression analyses were used to test the association between frailty and the outcomes of interest, adjusting for potential confounders. Results: Mean age was 78.2 (SD ±6.1) years. Prevalence of frailty was 14.1%. Adjusted multivariate models showed that frail status was assoc...
Encyclopedia of Gerontology and Population Aging, 2021
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Papers by Ana Patricia Navarrete Reyes