Characteristics of patients who stop falling after a risk-based multidisciplinary intervention initiated in a geriatric day hospital.

BACKGROUND: Multidisciplinary interventions for fallers have provided conflicting results in part due to the diversity of fallers' profiles. OBJECTIVES: to determine the characteristics of the subgroup of patients with a positive response to a multidisciplinary fall prevention program initiated in a geriatric day hospital. DESIGN: Prospective observational study in day hospital. METHODS: Patients > 75 years referred for falls during the last 3 months benefited from a multidisciplinary assessment to record their characteristics at baseline and to tailor a risk-based multidisciplinary intervention for fall prevention. Patients free from falls at the 3rd or 6th month were compared to persistent fallers for baseline characteristics. RESULTS: Sixty-nine patients were assessed at baseline (mean age 85.2 y (SD=0.6)), 44 at the 3rd month and 21 at the 6th month. Baseline characteristics of the patients free from falls at the 3rd month were the lower number of previous non-serious falls (p=0.013), living in nursing home (p=0.045), a higher Berg balance score (p=0.02) and a better mental health-related quality of life (M HQol, p=0.045). On multivariate analysis restricted to home-dwelling patients, the positive predictive factors were less isolation at home (OR=0.028, 95%CI [0-0.813], p=0.037), a lower number of non-serious previous falls (OR= 0.526 [0.309- 0.894], p=0.018), a better M HQol (OR=1.205 [1.000-1.452], p=0.050) and a trend for younger age (OR= 0.662, [0.426-1.027], p=0.066). CONCLUSION: Being able to call upon a support person (familial or institutional) to apply advice and a less serious risk of falling may be preliminary conditions for success in a multidisciplinary intervention initiated in a day hospital.

Effect of cholestasis and biliary diversion on the absorption of Na octanoate in the rat.

The intestinal absorption and portal vein transport of Na octanoate by isolated jejunal segments perfused in vivo were unchanged in rats studied 48 h after bile duct ligation or fistula.

The effect of bile and of sodium taurocholate on the epithelial cell dynamics of the rat small intestine.

The absence of bile from the intestinal lumen of rats for a period of 48 hr led to: a decreased proliferative cell pool, reduced cell shedding, and a 50% decrease of the labeling index in the ileum. The constant duodenal perfusion of Na taurocholate for periods of 48, 60, 72, and 96 hr in animals with a biliary diversion was associated with: deepening of crypts and decreased crypt/villus ratios as well as with acceleration of the epithelial cell migration rate on the crypt-villus units. The data suggest that bile and bile acids constitute important regulatory factors influencing enterocyte proliferation, migration and loss.