Irene Turpie | McMaster University (original) (raw)
Papers by Irene Turpie
PubMed, Sep 1, 1989
Urinary incontinence is a prevalent problem affecting elders of both sexes in community and insti... more Urinary incontinence is a prevalent problem affecting elders of both sexes in community and institutional settings. Much of this problem is reversible. Detailed history, physical, and a residual urine test can provide sufficient information to begin treatment. There are three main types of incontinence: (1) stress, which may be alleviated by strengthening the pelvic floor muscles or by surgical intervention; (2) overflow; and (3) urge. These different types may co-exist. If the initial treatment is ineffective, it is recommended that referral be made for expert evaluation and urodynamic investigation.
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Jan 15, 1991
Topics in Geriatric Rehabilitation, Oct 1, 2009
This article describes an ongoing exercise program for frail community-dwelling older adults and ... more This article describes an ongoing exercise program for frail community-dwelling older adults and provides some preliminary evidence of impact on functional status and health service utilization. Four hundred sixty older adults participated in the Stay Well program over a 9-year period. Health service utilization, heart rate, functional status, and health-related quality of life were measured at enrolment and 1-year follow-up. Although there were no significant differences in health-related quality of life, there were significant improvements in functional status and reductions in health system utilization. This program represents an effective strategy for promoting health and functional independence for frail older adults.
Scottish Medical Journal, May 1, 2008
This is a description of a tuberculosis treatment programme in a country at war where security an... more This is a description of a tuberculosis treatment programme in a country at war where security and the absence of order pose problems to health care delivery. It is also a description of an epidemic of tuberculosis where treatment and diagnosis are difficult and the methods used have changed little in many years. More international pressure is needed.
Restructuring Canada's Health Systems: How Do We Get There From Here?, 1992
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Jan 15, 1986
To assess the need for a multidisciplinary geriatric unit in the treatment of elderly patients wi... more To assess the need for a multidisciplinary geriatric unit in the treatment of elderly patients with hip fractures, we reviewed the charts of all patients aged 60 years or older who were treated for hip fractures in five hospitals in Hamilton, Ont., between August 1982 and September 1983. We hypothesized that discharge to a different location from that before admission would indicate reduced functional status and classified the reasons for a change in residence as poor patient motivation, need for rehabilitation, compromised ambulation, postoperative complications and inevitable deterioration. We believed that geriatric care would be most beneficial to those in the first three groups. Of the 327 patients with hip fractures 40 (12%) died before discharge. Of the 287 surviving patients 149 (52%) had been discharged by 4 weeks, and only 29 (10%) remained in hospital by 12 weeks. Of the 287, 44 (15%) were discharged to a different location from that before admission: in 75% the cause app...
The Canadian journal of cardiology, 2004
In long-term care (LTC) facilities, heart failure is common but undertreated. No Canadian studies... more In long-term care (LTC) facilities, heart failure is common but undertreated. No Canadian studies of heart failure in LTC facilities have been reported. To estimate the prevalence of heart failure in Canadian LTC facilities; to document the management of heart failure in LTC; and to describe characteristics of LTC residents with heart failure and predictors of adherence to treatment guidelines. Cross-sectional survey in eight LTC facilities lodging 1223 residents. The prevalence of heart failure was 20%. LTC residents with heart failure were older, more often women, and more functionally impaired and burdened by comorbidity than were participants in heart failure trials. Documentation supporting the heart failure diagnosis was inadequate, with some symptoms possibly misattributed to chronic obstructive pulmonary disease. Angiotensin-converting enzyme (ACE) inhibitors were prescribed to 55% of residents, although only 45% received appropriate doses. Residents with hypertension or dia...
Journal of the American Geriatrics Society, 2006
DISCUSSION KA is a skin tumor that typically presents with a history of rapid growth over a short... more DISCUSSION KA is a skin tumor that typically presents with a history of rapid growth over a short period of time in people aged 50 and older. Sir Jonathan Hutchinson first described it in 1889 as ''crateriform ulcer of the face.'' 1 This tumor is most often a solitary pink or flesh-colored, dome-shaped nodule with a central keratin plug. A history of rapid growth over a period of 1 to 2 months, size of 1 to 2 cm, and spontaneous involution after 3 to 6 months is typical. Eighty-five percent of older people in the tropics and subtropics with this type of tumor develop it on the extremities, whereas 70% of lesions develop on the head and neck of people in temperate climates. 2,3 Etiology of this tumor is controversial. Viruses have been long suggested as an etiological agent, although the deoxyribonucleic acid sequence of the human papilloma virus has been detected only in a minority of the studied cases. Exposure to excessive sunlight is the most frequently noted incriminating factor in the etiology of KA. Other factors include tar exposure, immunosuppressive states, burns, psoriatic lesions previously treated using psoralen and ultraviolet A therapy, and other dermatoses. In recent years, there have been an increasing number of reports of KA arising at sites of trauma. 4-10 We present the first case of KA arising in an arthropod sting site. Tumorigenesis is a multistep process. We hypothesize that prolonged exposure to sunlight predisposes the development of KA in sites of trauma, and in this case of an elderly gentlemen with a history of a hornet sting, the arthropod sting served as the trigger.
Journal of Cardiac Failure, 2013
Background: Heart failure (HF) is common in long-term care facilities (LTCs). This study compared... more Background: Heart failure (HF) is common in long-term care facilities (LTCs). This study compared mortality and hospitalization rates and examined predictors of these outcomes among new LTC residents with and without HF. Methods and Results: This prospective cohort study followed 546 newly admitted residents from 42 LTCs for up to 1 year. Health information was collected from participant and caregiver interviews, physicians' records, diagnostic procedures, and hospitalization records. Multivariate logistic regression modeling determined predictors of hospitalization among residents, and Cox proportional hazards regression determined predictors for time to mortality. HF prevalence was 21.4%. The sample was predominantly (O70%) female, and individuals with HF were significantly older with higher prevalence of reduced left ventricular ejection fraction. Overall annual mortality and hospitalization rates were 24% and 27%, respectively. Among residents with HF, 42% died and 31% were hospitalized within 1 year. Among residents with HF, use of major tranquilizers was the strongest predictor of sooner mortality; use of anticoagulants and major tranquilizers also increased mortality risk, whereas higher baseline function was associated with longer time to mortality. History of peripheral vascular disease was the strongest predictor of hospitalizations among residents with HF, and use of antiplatelet agents and history of any smoking exposure increased this risk. Conclusions: Among LTC residents, HF is associated with high mortality and hospitalization rates. Many factors contribute to mortality and hospitalizations among residents with HF, and comprehensive HF management programs are needed to improve outcomes.
Canadian Journal on Aging / La Revue canadienne du vieillissement, 1985
ABSTRACTRoutine thyroid function tests have been advocated for the geriatric population, as the c... more ABSTRACTRoutine thyroid function tests have been advocated for the geriatric population, as the clinical presentation both of hypothyroidism and hyperthyroidism may be atypical. Results are presented on the prevalence of dysthyroidism in patients referred to a geriatric service (2% hypothyroidism and 2% hyperthyroidism) and an attempt is made to distinguish between those suspected (hyperthyroid 6 cases, hypothyroid 11 cases) and those unsuspected on clinical grounds (hyperthyroid 4 cases, hypothyroid 7 cases). Outcome of treatment is examined and the cost of detecting one unsuspected but treatable case of hypothyroidism in this referred geriatric population is estimated at 1,000 to 2,653 1984 Canadian dollars.
Developments in Cardiovascular Medicine, 2004
Chapter 1 AGING AND HEART DISEASE Irene D. Turpie and George A. Heckman ... BMJ 1994;308:1604-!60... more Chapter 1 AGING AND HEART DISEASE Irene D. Turpie and George A. Heckman ... BMJ 1994;308:1604-!608. 6. Cacciatore F, Abete P, Ferrara N, Calabrese C, Napoli C, Maggi S, Varrichio M, Rengo F. Congestive heart failure and cognitive impairment in an older population. ...
Developments in Cardiovascular Medicine, 2004
A comprehensive approach is necessary in managing heart failure in frail older adults. To provide... more A comprehensive approach is necessary in managing heart failure in frail older adults. To provide optimal care, physicians need to draw on knowledge from the fields of internal medicine, geriatrics, and cardiology. The acronym "MORE" is a mnemonic for what heart failure management should include: multidisciplinary care, attention to other (ie, comorbid) diseases, restrictions (of salt, fluid, and alcohol), and discussion of end-of-life issues.
Canadian family physician Médecin de famille canadien, 1992
he large area and uneven population distribution in-Ontario pose problems of equal access to spec... more he large area and uneven population distribution in-Ontario pose problems of equal access to specialist health services. Although geriatric services arc becoming more available in urban areas, there is a serious shortage of such services in rural parts of the province. Access to geriatric services depends upon the availability of specialist physicians and health care professionals who work together in teams located in community and institutional settings. WNIhile these teams are generally unavailable in small, isolated communities, the services of specialists must be accessible to pcople living in rural communities.
Gerontology Geriatrics Education, 1987
1. Gerontol Geriatr Educ. 1986 Summer;6(4):59-67. The McMaster model for geriatric undergraduate ... more 1. Gerontol Geriatr Educ. 1986 Summer;6(4):59-67. The McMaster model for geriatric undergraduate experience. Turpie ID, Patterson C, Chalklin LW, Bayne R, Roy J, Neufeld C. PMID: 3653713 [PubMed - indexed for MEDLINE]. Publication Types: ...
PubMed, Sep 1, 1989
Urinary incontinence is a prevalent problem affecting elders of both sexes in community and insti... more Urinary incontinence is a prevalent problem affecting elders of both sexes in community and institutional settings. Much of this problem is reversible. Detailed history, physical, and a residual urine test can provide sufficient information to begin treatment. There are three main types of incontinence: (1) stress, which may be alleviated by strengthening the pelvic floor muscles or by surgical intervention; (2) overflow; and (3) urge. These different types may co-exist. If the initial treatment is ineffective, it is recommended that referral be made for expert evaluation and urodynamic investigation.
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Jan 15, 1991
Topics in Geriatric Rehabilitation, Oct 1, 2009
This article describes an ongoing exercise program for frail community-dwelling older adults and ... more This article describes an ongoing exercise program for frail community-dwelling older adults and provides some preliminary evidence of impact on functional status and health service utilization. Four hundred sixty older adults participated in the Stay Well program over a 9-year period. Health service utilization, heart rate, functional status, and health-related quality of life were measured at enrolment and 1-year follow-up. Although there were no significant differences in health-related quality of life, there were significant improvements in functional status and reductions in health system utilization. This program represents an effective strategy for promoting health and functional independence for frail older adults.
Scottish Medical Journal, May 1, 2008
This is a description of a tuberculosis treatment programme in a country at war where security an... more This is a description of a tuberculosis treatment programme in a country at war where security and the absence of order pose problems to health care delivery. It is also a description of an epidemic of tuberculosis where treatment and diagnosis are difficult and the methods used have changed little in many years. More international pressure is needed.
Restructuring Canada's Health Systems: How Do We Get There From Here?, 1992
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Jan 15, 1986
To assess the need for a multidisciplinary geriatric unit in the treatment of elderly patients wi... more To assess the need for a multidisciplinary geriatric unit in the treatment of elderly patients with hip fractures, we reviewed the charts of all patients aged 60 years or older who were treated for hip fractures in five hospitals in Hamilton, Ont., between August 1982 and September 1983. We hypothesized that discharge to a different location from that before admission would indicate reduced functional status and classified the reasons for a change in residence as poor patient motivation, need for rehabilitation, compromised ambulation, postoperative complications and inevitable deterioration. We believed that geriatric care would be most beneficial to those in the first three groups. Of the 327 patients with hip fractures 40 (12%) died before discharge. Of the 287 surviving patients 149 (52%) had been discharged by 4 weeks, and only 29 (10%) remained in hospital by 12 weeks. Of the 287, 44 (15%) were discharged to a different location from that before admission: in 75% the cause app...
The Canadian journal of cardiology, 2004
In long-term care (LTC) facilities, heart failure is common but undertreated. No Canadian studies... more In long-term care (LTC) facilities, heart failure is common but undertreated. No Canadian studies of heart failure in LTC facilities have been reported. To estimate the prevalence of heart failure in Canadian LTC facilities; to document the management of heart failure in LTC; and to describe characteristics of LTC residents with heart failure and predictors of adherence to treatment guidelines. Cross-sectional survey in eight LTC facilities lodging 1223 residents. The prevalence of heart failure was 20%. LTC residents with heart failure were older, more often women, and more functionally impaired and burdened by comorbidity than were participants in heart failure trials. Documentation supporting the heart failure diagnosis was inadequate, with some symptoms possibly misattributed to chronic obstructive pulmonary disease. Angiotensin-converting enzyme (ACE) inhibitors were prescribed to 55% of residents, although only 45% received appropriate doses. Residents with hypertension or dia...
Journal of the American Geriatrics Society, 2006
DISCUSSION KA is a skin tumor that typically presents with a history of rapid growth over a short... more DISCUSSION KA is a skin tumor that typically presents with a history of rapid growth over a short period of time in people aged 50 and older. Sir Jonathan Hutchinson first described it in 1889 as ''crateriform ulcer of the face.'' 1 This tumor is most often a solitary pink or flesh-colored, dome-shaped nodule with a central keratin plug. A history of rapid growth over a period of 1 to 2 months, size of 1 to 2 cm, and spontaneous involution after 3 to 6 months is typical. Eighty-five percent of older people in the tropics and subtropics with this type of tumor develop it on the extremities, whereas 70% of lesions develop on the head and neck of people in temperate climates. 2,3 Etiology of this tumor is controversial. Viruses have been long suggested as an etiological agent, although the deoxyribonucleic acid sequence of the human papilloma virus has been detected only in a minority of the studied cases. Exposure to excessive sunlight is the most frequently noted incriminating factor in the etiology of KA. Other factors include tar exposure, immunosuppressive states, burns, psoriatic lesions previously treated using psoralen and ultraviolet A therapy, and other dermatoses. In recent years, there have been an increasing number of reports of KA arising at sites of trauma. 4-10 We present the first case of KA arising in an arthropod sting site. Tumorigenesis is a multistep process. We hypothesize that prolonged exposure to sunlight predisposes the development of KA in sites of trauma, and in this case of an elderly gentlemen with a history of a hornet sting, the arthropod sting served as the trigger.
Journal of Cardiac Failure, 2013
Background: Heart failure (HF) is common in long-term care facilities (LTCs). This study compared... more Background: Heart failure (HF) is common in long-term care facilities (LTCs). This study compared mortality and hospitalization rates and examined predictors of these outcomes among new LTC residents with and without HF. Methods and Results: This prospective cohort study followed 546 newly admitted residents from 42 LTCs for up to 1 year. Health information was collected from participant and caregiver interviews, physicians' records, diagnostic procedures, and hospitalization records. Multivariate logistic regression modeling determined predictors of hospitalization among residents, and Cox proportional hazards regression determined predictors for time to mortality. HF prevalence was 21.4%. The sample was predominantly (O70%) female, and individuals with HF were significantly older with higher prevalence of reduced left ventricular ejection fraction. Overall annual mortality and hospitalization rates were 24% and 27%, respectively. Among residents with HF, 42% died and 31% were hospitalized within 1 year. Among residents with HF, use of major tranquilizers was the strongest predictor of sooner mortality; use of anticoagulants and major tranquilizers also increased mortality risk, whereas higher baseline function was associated with longer time to mortality. History of peripheral vascular disease was the strongest predictor of hospitalizations among residents with HF, and use of antiplatelet agents and history of any smoking exposure increased this risk. Conclusions: Among LTC residents, HF is associated with high mortality and hospitalization rates. Many factors contribute to mortality and hospitalizations among residents with HF, and comprehensive HF management programs are needed to improve outcomes.
Canadian Journal on Aging / La Revue canadienne du vieillissement, 1985
ABSTRACTRoutine thyroid function tests have been advocated for the geriatric population, as the c... more ABSTRACTRoutine thyroid function tests have been advocated for the geriatric population, as the clinical presentation both of hypothyroidism and hyperthyroidism may be atypical. Results are presented on the prevalence of dysthyroidism in patients referred to a geriatric service (2% hypothyroidism and 2% hyperthyroidism) and an attempt is made to distinguish between those suspected (hyperthyroid 6 cases, hypothyroid 11 cases) and those unsuspected on clinical grounds (hyperthyroid 4 cases, hypothyroid 7 cases). Outcome of treatment is examined and the cost of detecting one unsuspected but treatable case of hypothyroidism in this referred geriatric population is estimated at 1,000 to 2,653 1984 Canadian dollars.
Developments in Cardiovascular Medicine, 2004
Chapter 1 AGING AND HEART DISEASE Irene D. Turpie and George A. Heckman ... BMJ 1994;308:1604-!60... more Chapter 1 AGING AND HEART DISEASE Irene D. Turpie and George A. Heckman ... BMJ 1994;308:1604-!608. 6. Cacciatore F, Abete P, Ferrara N, Calabrese C, Napoli C, Maggi S, Varrichio M, Rengo F. Congestive heart failure and cognitive impairment in an older population. ...
Developments in Cardiovascular Medicine, 2004
A comprehensive approach is necessary in managing heart failure in frail older adults. To provide... more A comprehensive approach is necessary in managing heart failure in frail older adults. To provide optimal care, physicians need to draw on knowledge from the fields of internal medicine, geriatrics, and cardiology. The acronym "MORE" is a mnemonic for what heart failure management should include: multidisciplinary care, attention to other (ie, comorbid) diseases, restrictions (of salt, fluid, and alcohol), and discussion of end-of-life issues.
Canadian family physician Médecin de famille canadien, 1992
he large area and uneven population distribution in-Ontario pose problems of equal access to spec... more he large area and uneven population distribution in-Ontario pose problems of equal access to specialist health services. Although geriatric services arc becoming more available in urban areas, there is a serious shortage of such services in rural parts of the province. Access to geriatric services depends upon the availability of specialist physicians and health care professionals who work together in teams located in community and institutional settings. WNIhile these teams are generally unavailable in small, isolated communities, the services of specialists must be accessible to pcople living in rural communities.
Gerontology Geriatrics Education, 1987
1. Gerontol Geriatr Educ. 1986 Summer;6(4):59-67. The McMaster model for geriatric undergraduate ... more 1. Gerontol Geriatr Educ. 1986 Summer;6(4):59-67. The McMaster model for geriatric undergraduate experience. Turpie ID, Patterson C, Chalklin LW, Bayne R, Roy J, Neufeld C. PMID: 3653713 [PubMed - indexed for MEDLINE]. Publication Types: ...