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https://www.readbyqxmd.com/read/28804902/the-geriatrician-circa-2030
#1
John E Morley
No abstract text is available yet for this article.
August 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28797368/geriatric-assessment-for-primary-care-providers
#2
REVIEW
Hong-Phuc T Tran, Susan D Leonard
Because of a growing, aging population and a shortage of geriatricians in the United States, the care of geriatric patients will mostly devolve to primary care providers. This article reviews the different aspects of a multidimensional, multidisciplinary geriatric assessment. Assessment tools and training of office staff to take on larger roles can help primary care providers reduce the burden of work associated with performing a comprehensive geriatric assessment.
September 2017: Primary Care
https://www.readbyqxmd.com/read/28792787/validation-of-the-supportive-and-palliative-care-indicators-tool-in-a-geriatric-population
#3
Reine De Bock, Nele Van Den Noortgate, Ruth Piers
BACKGROUND: Timely identification of patients in need of palliative care is especially challenging in a geriatric population because of prognostic uncertainty. The Supportive and Palliative Care Indicators Tool (SPICT™) aims at facilitating this identification, yet has not been validated in a geriatric population. OBJECTIVE: This study validates the SPICT in a geriatric patient population admitted to the hospital. DESIGN: This is a retrospective cohort study...
August 9, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28790096/paraneoplastic-cerebellar-degeneration-secondary-to-ovarian-carcinosarcoma-a-cerebellar-conundrum
#4
Julian David Birch, Arup Sen, Katherine Rowland, Tatyana Viner
We present a case of an elderly female patient who presented with a 6-month history of progressive slurred speech, vertigo, unsteadiness and falls. She underwent an extensive battery of neurological and cardiovascular investigations, none of which demonstrated a diagnostic cause for her symptoms. She was referred to the stroke and neurology teams and was started on treatment for presumed anxiety. As her symptoms continued to progress, she was referred to the falls service. Following a multidisciplinary team discussion, she was reviewed by the consultant geriatrician who felt this may be due to a malignancy so the consultant geriatrician arranged blood testsand CT scan of her chest, abdomen and pelvis...
August 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28765771/2017-consensus-of-the-asia-pacific-heart-rhythm-society-on-stroke-prevention-in-atrial-fibrillation
#5
Chern-En Chiang, Ken Okumura, Shu Zhang, Tze-Fan Chao, Chung-Wah Siu, Toon Wei Lim, Anil Saxena, Yoshihide Takahashi, Wee Siong Teo
Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2-fold increase in mortality and a 5-fold increase in stroke. The Asian population is rapidly aging, and in 2050, the estimated population with AF will reach 72 million, of whom 2.9 million may suffer from AF-associated stroke. Therefore, stroke prevention in AF is an urgent issue in Asia. Many innovative advances in the management of AF-associated stroke have emerged recently, including new scoring systems for predicting stroke and bleeding risks, the development of non-vitamin K antagonist oral anticoagulants (NOACs), knowledge of their special benefits in Asians, and new techniques...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765416/the-physician-s-role-in-perioperative-management-of-older-patients-undergoing-surgery
#6
Adam L Gordon, Barry J Evans, Jugdeep Dhesi
Life-sustaining and life-improving surgical interventions are increasingly available to older, frailer patients, many of whom have multimorbidity. Physicians can help support perioperative multidisciplinary teams with assessment and preoperative optimisation of physiological reserve, comorbidities and associated geriatric syndromes. Similar structured support can be useful in the postoperative period where older patients are at increased risk of delirium, medical complications, increased functional dependency and where discharge planning can prove more difficult than in younger cohorts...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28765414/acute-geriatrics-at-the-front-door
#7
Simon Conroy, Stuart Parker
Older people with frailty and urgent care needs are major uses of health and social care services. Comprehensive geriatric assessment (CGA) is an evidence-based approach to improving their outcomes, as well as improving service outcomes. Geriatricians form a small proportion of the overall workforce and cannot address the population need alone, so all clinicians (doctors, nurses, therapists and so on) need to engage in delivering CGA as a process of care, underpinned by specific competencies - which can be developed...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28764876/determinants-of-potentially-inappropriate-medication-use-in-long-term-and-acute-care-settings-a-systematic-review
#8
REVIEW
Stephanie K Nothelle, Ritu Sharma, Allison H Oakes, Madeline Jackson, Jodi B Segal
BACKGROUND: Potentially inappropriate medications (PIMs) are widely used in institutionalized older adults, yet the key determinants that drive their use are incompletely characterized. METHODS: We systematically searched published literature within MEDLINE and Embase from January 1998 to March 2017. We searched for studies conducted in the United States that described determinants of PIM use in adults ≥60 years of age in a nursing home or residential care facility, in the emergency department (ED), or in the hospital...
July 29, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28754053/complex-decision-making-in-patients-with-dementia-in-an-internal-medicine-department
#9
Ladislav Kabelka
With the increase of polymorbidity, extending life expectancy and improving treatment options for chronic diseases, the care for dementia is moving into other areas of medicine. The length and quality of life with advanced dementia is directly dependent on the quality of medical and nursing care, early detection and treatment of complications, nutritional support and palliative care plan. Significant is also the support for family carers. The key coordinators of care for patients with dementia are general practitioners (GPs), geriatricians, psychiatrists, and an increasingly important role play internists...
October 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28751439/recent-advances-in-the-treatment-of-erectile-dysfunction
#10
David F Mobley, Mohit Khera, Neil Baum
Erectile dysfunction (ED) is one of the most common conditions affecting middle-aged and older men. Nearly every primary care physician, internist and geriatrician will be called upon to manage this condition or to make referrals to urologists, endocrinologists and cardiologists who will assist in the treatment of ED. This article will briefly discuss the diagnosis and management of ED. In addition, emerging concepts in ED management will be discussed, such as the use of testosterone to treat ED, the role of the endothelium in men with ED and treating the partner of the man with ED...
July 27, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28733759/management-of-gait-changes-and-fall-risk-in-mci-and-dementia
#11
REVIEW
Gilles Allali, Joe Verghese
Gait disorders and falls are very prevalent in aging, especially in older adults with cognitive impairment: older adults with dementia are 2-3 times more likely to fall than their non-demented counterparts. The management of gait disorders and falls in older adults with mild cognitive impairment (MCI) or dementia begins by their identification with the use of specific screening tools, such as measuring gait speed, use of dual-task gait tests, or diagnosing motoric cognitive risk syndrome, a newly described pre-dementia syndrome...
September 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28727796/effects-of-health-risk-assessment-and-counselling-on-physical-activity-in-older-people-a-pragmatic-randomised-trial
#12
Anna Marie Herghelegiu, André Moser, Gabriel Ioan Prada, Stephan Born, Matthias Wilhelm, Andreas E Stuck
BACKGROUND: Interventions to increase physical activity (PA) among older community-dwelling adults may be enhanced by using multidimensional health risk assessment (HRA) as a basis for PA counselling. METHODS: The study was conducted among nondisabled but mostly frail persons 65 years of age and older at an ambulatory geriatric clinic in Bucharest, Romania. From May to July 2014, 200 participants were randomly allocated to intervention and control groups. Intervention group participants completed an initial HRA questionnaire and then had monthly counselling sessions with a geriatrician over a period of six months that were aimed at increasing low or maintaining higher PA...
2017: PloS One
https://www.readbyqxmd.com/read/28724392/a-prospective-study-assessing-agreement-and-reliability-of-a-geriatric-evaluation
#13
Isabella Locatelli, Stéfanie Monod, Jacques Cornuz, Christophe J Büla, Nicolas Senn
BACKGROUND: The present study takes place within a geriatric program, aiming at improving the diagnosis and management of geriatric syndromes in primary care. Within this program it was of prime importance to be able to rely on a robust and reproducible geriatric consultation to use as a gold standard for evaluating a primary care brief assessment tool. The specific objective of the present study was thus assessing the agreement and reliability of a comprehensive geriatric consultation...
July 19, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28724356/a-one-year-follow-up-study-of-chronic-pain-in-community-dwelling-older-adults-with-and-without-neuropathic-pain
#14
Susanna Rapo-Pylkkö, Maija Haanpää, Helena Liira
BACKGROUND: Chronic, mostly musculoskeletal pain is common among older adults. Little is known about the prognosis of chronic pain and the neuropathic pain qualities in older adults. We studied a cohort of community-dwelling older adults, clinically assessed their pain states, classified their type of pain (nociceptive, neuropathic or combined) and followed them up for a year. METHODS: At baseline, a geriatrician clinically examined all study patients and classified their type of pain in collaboration with a pain specialist...
July 19, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28706089/evaluation-of-the-geriatric-co-management-for-patients-with-fragility-fractures-of-the-proximal-femur-geriatric-fracture-centre-gfc-concept-protocol-for-a-prospective-multicentre-cohort-study
#15
Alexander Joeris, Anahí Hurtado-Chong, Denise Hess, Vasiliki Kalampoki, Michael Blauth
INTRODUCTION: Treatment of fractures in the elderly population is a clinical challenge due partly to the presence of comorbidities. In a Geriatric Fracture Centre (GFC), patients are co-managed by a geriatrician in an attempt to improve clinical outcomes and reduce morbidity and mortality. Until now the beneficial effect of orthogeriatric co-management has not been definitively proven. The primary objective of this study is to determine the effect of GFC on predefined major adverse events related to a hip fracture compared to usual care centres (UCC)...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28704157/survival-rate-and-pressure-ulcer-prevalence-in-patients-with-and-without-dementia-a-retrospective-study
#16
E Jaul, J P Rosenzweig, O Meiron
OBJECTIVE: This retrospective study aimed to investigate the prevalence of pressure ulcers (PUs) in older patients with advanced dementia versus older patients without dementia but with other comorbidities, such as diabetes, ischaemic heart disease and chronic renal failure. PUs were thought to be more prevalent and to present a higher risk of mortality in patients with dementia. METHOD: PUs were assessed on admission using the European Pressure Ulcer Advisory Panel (EPUAP) staging system...
July 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28699936/clinician-attitudes-regarding-icd-deactivation-in-dnr-dni-patients
#17
Andrew Bradley, Adam Marks
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) offer lifesaving therapies but can become burdensome at the end of life. Many ICD patients choose to implement a do-not-resuscitate/do-not-intubate (DNR/DNI) order. When hospitalized, patients are seen by a range of clinicians whose beliefs about ICD management in DNR/DNI patients may vary. OBJECTIVE: To assess clinician opinions on managing ICDs in DNR/DNI patients and stratify it by specialty and training level...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28692142/big-g-and-little-g-geriatrics-education-for-physicians
#18
Kathryn E Callahan, Nina Tumosa, Rosanne M Leipzig
In the July 2016 issue of this journal, Dr. Mary Tinetti proposed that geriatric medicine abandon attempts to increase the numbers of board-certified geriatricians and change focus to the development of a "small elite workforce." What would be gained and what sacrificed by accepting this challenge? We agree that the best clinical use of a scarce resource, specialty trained geriatricians, is to care for frail, complex, severely ill elderly adults and to help design and study novel interventions in research, education, and care models to improve the care of all older adults, but for this to happen, all other providers must attain specific competency in the care of older adults...
July 10, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28692138/the-2025-big-g-geriatrician-defining-job-roles-to-guide-fellowship-training
#19
Deborah Simpson, Rosanne M Leipzig, Karen Sauvigné
Changes in health care that are already in progress, including value- and population-based care, use of new technologies for care, big data and machine learning, and the patient as consumer and decision maker, will determine the job description for geriatricians practicing in 2025. Informed by these future certainties, 115 geriatrics educators attending the 2016 Donald W. Reynolds Foundation Annual meeting identified five 2025 geriatrician job roles: complexivist; consultant; health system leader and innovator; functional preventionist; and educator for big "G" and little "g" providers...
July 10, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28686082/providing-dementia-consultations-to-veterans-using-clinical-video-telehealth-results-from-a-clinical-demonstration-project
#20
Stuti Dang, Carlos A Gomez-Orozco, Maria H van Zuilen, Silvina Levis
PURPOSE: Veterans with dementia and their caregivers in remote areas may not have access to specialists to provide diagnosis, treatment, and education. The purpose of this clinical demonstration project was to examine the feasibility, acceptability, and impact of a video consultations clinic for veterans with dementia or memory complaints and their caregivers. METHODS: The dementia clinical video telehealth (CVT) consultation clinic was established to identify, diagnose, and treat dementia in veterans at sites distant from the main medical center...
July 7, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
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