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Clinics in Geriatric Medicine

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https://www.readbyqxmd.com/read/27886701/rheumatic-diseases-in-older-adults
#1
EDITORIAL
James D Katz, Brian Walitt
No abstract text is available yet for this article.
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886700/sj%C3%A3-gren-syndrome-and-other-causes-of-sicca-in-older-adults
#2
REVIEW
Alan N Baer, Brian Walitt
Dry eye and dry mouth symptoms are each reported by up to 30% of persons more than 65 years of age, particularly in women. Medication side effects are the most common contributing factors. The evaluation of these symptoms requires measures of ocular and oral dryness. Sjögren syndrome is the prototypic disease associated with dryness of the eyes and mouth and predominantly affects women in their perimenopausal and postmenopausal years. In addition to topical treatment of the mucosal dryness, patients with Sjögren syndrome may require treatment with systemic immunomodulatory and immunosuppressive agents to manage a variety of extraglandular manifestations...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886699/rheumatologic-manifestations-of-malignancy
#3
REVIEW
Mandana Hashefi
A variety of conditions mimicking rheumatologic syndromes may be associated with an underlying malignancy. Therefore, distinguishing these syndromes from more common, nonparaneoplastic rheumatologic conditions can be perplexing. Some autoimmune conditions and the medications used for their management can be associated with increased future risk of malignancy. Some cancers can directly involve the musculoskeletal structures, whereas others present with systemic manifestations at sites away from the tumor and its metastases...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886698/regional-rheumatic-disorders-and-rehabilitation-in-older-adults
#4
REVIEW
Ana T Acevedo, Adrienne Jackson, Katharine E Alter
Musculoskeletal problems are the most frequently reported complaints among older adults living in the community. The impact of the aging process on skeletal muscles and joints can have a profound effect on the ability of individuals with and without disabilities to function. This article reviews the rehabilitation medicine approach to the evaluation of older adults with regional rheumatic disorders, and the rehabilitation medicine considerations for clinical interventions. Future research considerations are encouraged in order to gain a greater understanding of the subject matter and its impact on the provision of care and patients' quality of life...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886697/nonsurgical-management-of-osteoarthritis-knee-pain-in-the-older-adult
#5
REVIEW
Nora Taylor
Symptomatic knee osteoarthritis is a common complaint of many elderly patients in primary care offices. For those unable or unwilling to undergo knee replacement, the primary practitioners' understanding of the strengths and weaknesses of the available treatment modalities for pain relief is critical to successful in-office counseling and expectation management. Treatment requires a multimodal approach of nonpharmacologic and pharmacologic therapies to achieve a maximal clinical benefit. The focus of this review is on the nonsurgical options for treatment of knee osteoarthritis in patients aged 65 and older...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886696/a-review-of-osteoporosis-in-the-older-adult
#6
REVIEW
Paloma Alejandro, Florina Constantinescu
Osteoporosis in the elderly population is common. It results in more than 1.5 million fractures per year in the United States. The goal of managing osteoporosis is to prevent fractures. In men, osteoporosis is underrecognized and undertreated. More men than women die every year as a consequence of hip fractures. A review of diagnosis and treatment of osteoporosis is described in this article. Bisphosphonates are the first-line treatment for men and women. In the past several years, advances in bone biology have resulted in major therapeutic advances...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886695/pathogenesis-and-management-of-sarcopenia
#7
REVIEW
Robinder J S Dhillon, Sarfaraz Hasni
Sarcopenia represents a loss of muscle strength and mass in older individuals. Sarcopenia in the elderly has now become a major focus of research and public policy debate due to its impact on morbidity, mortality, and health care expenditure. Despite its clinical importance, sarcopenia remains under-recognized and poorly managed in routine clinical practice. This is, in part, due to a lack of available diagnostic testing and uniform diagnostic criteria. The management of sarcopenia is primarily focused on physical therapy for muscle strengthening and gait training...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886694/update-on-crystal-induced-arthritides
#8
REVIEW
Hossam El-Zawawy, Brian F Mandell
The prevalence of gout increases with age. Once serum concentration of urate exceeds the saturation/solubility point, it deposits in and around the joints. Clinical presentation in the elderly often has "atypical" features and is challenging to diagnose. Treatment depends on the stage of the disease and the patient's health status and comorbidities. Elderly patients often have several confounding issues; thus, treatment decisions can be complicated and therapeutic options limited. To prevent the recurrence of gout attacks, serum concentration of urate should be maintained well below the saturation threshold of 6...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886693/gaps-in-aging-research-as-it-applies-to-rheumatologic-clinical-care
#9
REVIEW
Una E Makris, Devyani Misra, Raymond Yung
The incidence and prevalence of rheumatologic conditions are increasing and the rheumatology workforce must be aware of aging-specific issues. This article reviews specific barriers to understanding the biology of aging and aging-related mechanisms that may underlie development of rheumatologic diseases in older adults. It summarizes gaps in the assessment, outcomes measurement, and treatment of these diseases in this unique population. It also highlights potential solutions to these barriers and suggests possible ways to bridge the gap, from a research and education standpoint, so that clinicians can be better prepared to effectively manage older adults with rheumatologic conditions...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886692/cardiovascular-disease-risk-in-patients-with-rheumatic-diseases
#10
REVIEW
Rachel H Mackey, Lewis H Kuller, Larry W Moreland
Evidence suggests the greater than 1.5 increased risk of cardiovascular disease (CVD) in rheumatoid arthritis (RA) is related to an accelerated burden of subclinical atherosclerosis that develops before the diagnosis of RA. Dyslipidemia in RA is better quantified by lipoproteins and apolipoproteins than cholesterol levels. Current risk factors likely underestimate CVD risk partly by underestimating prior risk factor levels. To reduce CVD risk in RA, control disease activity and aggressively treat CVD risk factors...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886691/pharmacotherapy-pearls-for-the-geriatrician-focus-on-oral-disease-modifying-antirheumatic-drugs-including-newer-agents
#11
REVIEW
Ann J Biehl, James D Katz
Providing safe and effective pharmacotherapy to the geriatric patients with rheumatological disorders is an ongoing struggle for the rheumatologist and geriatrician alike. Cohesive communication and partnership can improve the care of these patients and subvert adverse outcomes. Disease-modifying antirheumatic drugs, including methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide, and the newest oral agent for treatment of rheumatoid arthritis, tofacitinib, have distinctive monitoring and adverse effect profiles...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27741972/preface
#12
M Carrington Reid
No abstract text is available yet for this article.
November 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27741971/expanding-targets-for-intervention-in-later-life-pain-what-role-can-patient-beliefs-expectations-and-pleasant-activities-play
#13
REVIEW
M Carrington Reid
Clinicians are often challenged to find targets for intervention in older adults with chronic pain. This article highlights 3 targets clinicians should consider when formulating their multimodal treatment plans to include older patients' attitudes and beliefs about pain and pain treatments, expectations regarding treatment outcomes, and pleasurable activity pursuits.
November 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27741970/role-of-emerging-technologies-in-geriatric-pain-management
#14
Rachael Elizabeth Docking
This article provides a brief overview of the challenges and opportunities of new technologies in the area of geriatric pain management. It also reviews emerging evidence to demonstrate the role technology may play in improving and advancing assessment and management of pain in older adults.
November 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27741969/interventional-techniques-for-management-of-pain-in-older-adults
#15
Amber K Brooks, Mercy A Udoji
Chronic pain in older patients is often treated with pain medications, physical rehabilitation, interventional pain management, and/or psychological interventions. The administration of pain medications is the most common form of chronic pain treatment. Physiologic changes in older adults make them more susceptible to the potential side effects of oral pain medications, especially opioids. Interventional pain management offers an alternative treatment option. This article reviews some of the interventional techniques used to treat the most common sites of pain in older adults: back, knee, and hip...
November 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27741968/psychological-approaches-to-coping-with-pain-in-later-life
#16
Christopher Eccleston, Abby Tabor, Rhiannon Terri Edwards, Edmund Keogh
A psychological model of coping with the demands of aging is outlined. Chronic pain is conceptualized as a challenge to normal aging, because it threatens identity, risks affective disorder (depression), and interferes with action. The sparse evidence for psychological interventions is reviewed, and a case is made for the types of interventions that should be developed to address the specific presentation of geriatric pain management.
November 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27741967/exercise-and-movement-based-therapies-in-geriatric-pain-management
#17
Sean Laubenstein, Katherine Beissner
Exercise is often recommended for older adults with pain, but pain itself is often a barrier to increased activity. This article reviews the evidence on the impact of various forms of exercise and related movement therapies on older adults with pain problems. The literature is reviewed with respect to published guidelines. When prescribing exercise, it is important to consider appropriate intensity, type, and duration of exercise as well as incorporating a plan for progression. Strategies to ensure adherence to exercise programs are also important...
November 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27741966/the-role-of-opioid-analgesics-in-geriatric-pain-management
#18
REVIEW
Jennifer Greene Naples, Walid F Gellad, Joseph T Hanlon
When possible, chronic noncancer pain (CNCP) in older adults should be managed by nonpharmacologic modalities in conjunction with nonopioid analgesics. If moderate-to-severe pain persists despite these approaches, however, nonparenteral opioids may be considered as adjunctive therapy. This article reviews the epidemiology of opioid use and their effectiveness for CNCP in older adults and summarizes important age-related changes in opioid pharmacokinetics and pharmacodynamics that increase the risks of adverse effects in the elderly...
November 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27741965/pharmacotherapies-in-geriatric-chronic-pain-management
#19
REVIEW
Zachary A Marcum, Nakia A Duncan, Una E Makris
Pharmacologic management of chronic pain in older adults is one component of the multimodal, interdisciplinary management of this complex condition. In this article, we summarize several of the key barriers to effective pharmacologic management in older adults and review the existing (albeit limited) evidence for its effectiveness and safety, especially in a medically complex population with multimorbidity. This review covers topical formulations, acetaminophen, oral nonsteroidal antiinflammatory drugs, and adjuvant therapies...
November 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27741964/interdisciplinary-approaches-to-managing-pain-in-older-adults
#20
Abigail Wickson-Griffiths, Sharon Kaasalainen, Keela Herr
An interdisciplinary approach to managing pain has been widely used in managing specific pain conditions (eg, lower back and fibromyalgia) but not reviewed specifically for older adults. Interdisciplinary approaches have been used in primary, residential long-term, and acute care settings, where a variety of health care professionals work on pain teams to manage pain in older adults. Given the multidimensional nature of pain in older adults, interdisciplinary approaches to managing pain are recommended in practice...
November 2016: Clinics in Geriatric Medicine
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