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Geriatric rheumatology

Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
Dwi R Helianthi, Christina Simadibrata, Adiningsih Srilestari, Edy R Wahyudi, Rudy Hidayat
AIM: to compare the effectiveness of active laser acupuncture with placebo on reducing pain intensity and improving functional outcome in geriatric patients with knee osteoarthritis (OA). METHODS: a double-blind randomized controlled trial was conducted in geriatrics with knee OA at Medical Acupuncture Outpatient Clinic, Integrated Geriatric Outpatient Clinic, Rheumatology Outpatient Clinic of Cipto Mangunkusumo Hospital, Jakarta, during May to October 2015. Sixty two patients with knee OA were randomly assigned into two groups: active laser acupuncture group or placebo laser acupuncture group...
April 2016: Acta Medica Indonesiana
Sophia Eilat-Tsanani, M Weingarten, M Ben-Ami, Mordechai Dayan, H Tabenkin
BACKGROUND: Teaching Internal Medicine is mainly hospital-based. Chronic diseases are treated mostly in community-based ambulatory care. This study describes our experience during the first year of teaching Internal Medicine in the community, with a focus on chronic disease management. METHODS: This was an observational study describing the content of clinical exposure and the feedback from students after a two-week clerkship in community health centers. RESULTS: Over a period of three months, 54 students spent two weeks in health centers singly or in pairs...
September 2015: Education for Health: Change in Training & Practice
Salvador Sitjar Martínez de Sas, María Teresa Aguilera de la Fuente, Josep Combalía Romera, Ignacio Menacho Pascual, Susana González Martínez, Andreu Altés Boronat
OBJECTIVE: To assess the persistence of treatment with monthly risedronate and know the reasons of persistence and nontherapeutic persistence and the profile of the non-persistent patients. DESING: Observational, postmarketin and prospective study. LOCATION: Primary care, traumatology, rheumatology, gynecology and geriatrics of Catalonia. PARTICIPANTS: Women with osteoporosis treated with monthly risedronate that previously had abandoned weekly bisphosphonate therapy...
May 2016: Atencion Primaria
F van Stiphout, J E F Zwart-van Rijkom, J E C M Aarts, H Koffijberg, E Klarenbeek-deJonge, M Krulder, K C B Roes, A C G Egberts, E W M T ter Braak
BACKGROUND: Using information technology for medication management is an opportunity to help physicians to improve the quality of their documentation and communication and ultimately to improve patient care and patient safety. Physician education is necessary to take full advantage of information technology systems. In this trial, we seek to determine the effectiveness of an intensive educational intervention compared with the standard approach in improving information technology-mediated medication management and in reducing potential adverse drug events in the outpatient clinic...
2015: Trials
John R Jochum, Amy E Begley, Mary Amanda Dew, Debra K Weiner, Jordan F Karp
BACKGROUND: Fibromyalgia (FM) is common in older adults suffering from mood disorders. However, clinical diagnosis of FM is challenging, particularly in psychiatric settings. We examined the prevalence of FM and the sensitivity of three simple screeners for FM. METHODS: Using cross-sectional data, we evaluated three tests against the American College of Rheumatology (ACR) 1990 Criteria for the Classification of FM: a "Do you often feel like you hurt all over?" question, a pain map score, and the Pope and Hudson (PH) interview for FM...
September 2015: International Psychogeriatrics
P Anyfanti, A Pyrpasopoulou, A Triantafyllou, S Chatzimichailidou, S Aslanidis, S Douma
BACKGROUND: The overall world prevalence of rheumatoid arthritis (RA) ranges from 0.5-1.0%. The annual incidence of RA in most European countries ranges from roughly 0.4 to >2.5 per 1,000 adults, increasing with age. A significant proportion of newly diagnosed cases will evolve into true erosive RA. METHODS: The aim of this cohort study was to study the characteristics of new developing, acute (<1 year), rheumatoid arthritis in an elderly (>65 years) population; its presenting features, accompanying manifestations and laboratory findings...
July 2014: Hippokratia
Jean-Laurent Le Quintrec, Bernard Verlhac, Christian Cadet, Philippe Bréville, Jean M Vetel, Jean B Gauvain, Claude Jeandel, Emmanuel Maheu
BACKGROUND: Rheumatologic and geriatric scholarly organisations recommendations for the management of hip and knee osteoarthritis, which emphasise the usefulness of non-pharmacological therapies, are not scaled according to patient's age and physical condition. We conducted a systematic review of clinical trials on exercise and weight loss in hip and knee osteoarthritis in very old patients. METHODS: Electronic search in MEDLINE, EMBASE, PASCAL database, systematic search of the Cochrane Reviews, manual search in guidelines, meta-analyses and identified relevant articles...
2014: Open Rheumatology Journal
Jamie E Rayahin, Joan S Chmiel, Karen W Hayes, Orit Almagor, Laura Belisle, Alison H Chang, Kirsten Moisio, Yunhui Zhang, Leena Sharma
OBJECTIVE: Few strategies to improve pain outcome in knee osteoarthritis (OA) exist in part because how best to evaluate pain over the long term is unclear. Our objectives were to determine the frequency of a good pain experience outcome based on previously formulated OA pain stages and test the hypothesis that less depression and pain catastrophizing and greater self-efficacy and social support are each associated with greater likelihood of a good outcome. METHODS: Study participants, all with knee OA, reported pain stage at baseline and 2 years...
December 2014: Arthritis Care & Research
Piotr Głuszko, Roman S Lorenc, Elżbieta Karczmarewicz, Waldemar Misiorowski, Maciej Jaworski
To decrease the risk of osteoporotic fractures in Poland, the Multidisciplinary Osteoporotic Forum has set up a joint Working Group including the representatives of the Polish Associations of Orthopedics and Traumatology, Rehabilitation, Gerontology, Rheumatology, Family Medicine, Diabetology, Laboratory Diagnostics, Andropause and Menopause, Endocrinology, Radiology, and the STENKO group as well as experts in the fields of rheumatology, obstetrics, and geriatrics to update the Polish guidelines for the diagnosis and management of osteoporosis in men and postmenopausal women in Poland...
2014: Polskie Archiwum Medycyny Wewnętrznej
Robert L Barkin
Robert L Barkin talks to Roshaine Gunawardana, Commissioning Editor: Dr Barkin has authored over 150 publications including journals, book chapters and CD-Roms. He is a reviewer for over 30 journals, on the editorial board of nine journals and is an Associate Editor of the American Journal of Therapeutics. He received his BSc. Pharmacy degree from St Louis College of Pharmacy and Allied Science St Louis, MO, USA in 1963, an MBA in Healthcare Administration at DePaul University Chicago, IL, USA in 1976 and a doctorate in Clinical Pharmacy at Purdue University, IN, USA in 1985...
September 2012: Pain Management
Emily Lubart, Arthur Leibovitz, Vadim Shapir, Refael Segal
BACKGROUND: Musculoskeletal and joint disorders are extremely common in the elderly. They directly affect mobility, gait stability, quality of life, and independence. OBJECTIVES: To assess the nature of joint problems encountered in a geriatric inpatient population and evaluate the contribution of a rheumatologist. METHODS: We reviewed the rheumatology consultation records that were conducted in a geriatric medical center over a 10 year period...
January 2014: Israel Medical Association Journal: IMAJ
R Garrett, R Salcido
Shoulder dysfunction is a common but complex clinical problem among the aged. The shoulder is a diarthrodial joint that is designed to complement the elbow and wrist in stabilizing the arm and the hand. This complex joint has the greatest range of motion (ROM) of any joint in the human body. Unfortunately, the aging process increases the shoulder's vulnerability to many pathological conditions that decrease its ROM and interfere with self-care tasks. While initial therapy is typically managed by the primary care physician, the complexity of this problem often requires consultation across disciplines to assure pertinent management...
January 1, 1994: Journal of Back and Musculoskeletal Rehabilitation
Alexa Simon Meara, Lee S Simon
OBJECTIVE: Non-steroidal anti-inflammatory drugs (NSAIDs) are some of the most commonly used medications due to their well-known analgesic, anti-inflammatory, and antipyretic actions. Due to their known benefits and inherent risks, there have been multiple guidelines from national professional societies that suggest appropriate use to provide both maximum benefit and mitigate risk of adverse events, particularly in older individuals. DESIGN: A literature search was undertaken using PubMed and search terms including pain, aging, treatment, non-steroidal anti-inflammatory drugs, arthritis, older patient, and guidelines...
December 2013: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Paul Monsarrat, Jean-Noël Vergnes, Alain Cantagrel, Nadège Algans, Sarah Cousty, Philippe Kémoun, Caroline Bertrand, Elise Arrivé, Christophe Bou, Cyril Sédarat, Thierry Schaeverbeke, Cathy Nabet, Michel Sixou
BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory disorder that leads to joint damage, deformity, and pain. It affects approximately 1% of adults in developed countries. Periodontitis is a chronic oral infection, caused by inflammatory reactions to gram-negative anaerobic bacteria, and affecting about 35 to 50% of adults. If left untreated, periodontitis can lead to tooth loss. A significant association has been shown to exist between periodontitis and RA in observational studies...
2013: Trials
Bonnie Fiala, Ryan E Rhodes, Chris Blanchard, John Anderson
OBJECTIVE: The purpose of this study was to apply Bandura's (1998) social-cognitive theory to understand preoperative exercise and walking behavior in a sample of individuals waiting for total joint replacement (TJR) surgery. METHOD: Participants (N = 78) were individuals waiting for TJR who completed measures of the social-cognitive theory, e.g., barrier efficacy, task efficacy, outcome expectancy, self-regulation, neighborhood walking environment, WOMAC-pain, WOMAC-physical function (Western Ontario and McMaster Universities Arthritis Index; In N...
May 2013: Rehabilitation Psychology
Rafaela Ortega Castro, Pilar Font Ugalde, M Carmen Castro Villegas, Jerusalén Calvo Gutiérrez, Elisa Muñoz Gomariz, Pedro Zarco Montejo, Raquel Almodóvar, Juan Mulero Mendoza, Juan Carlos Torre-Alonso, Jordi Gratacós Masmitjá, Xavier Juanola Roura, Rafael Ariza Ariza, Pilar Fernández Dapica, Luis Francisco Linares Ferrando, M Elia Brito Brito, Eduardo Cuende Quintana, Carlos Vázquez Galeano, Manuel José Moreno Ramos, Eugenio Giménez Úbeda, José Carlos Rodríguez Lozano, Manuel Fernández Prada, Rubén Queiro Silva, Estefanía Moreno Ruzafa, Enrique Júdez Navarro, Antonio Juan Más, Cristina Medrano Le Quement, Enrique Ornilla, Carlos Montilla Morales, Manuel Pujol Busquets, Teresa Clavaguera Poch, M Cruz Fernández-Espartero, Loreto Carmona Ortell, Eduardo Collantes Estévez
OBJECTIVE: To describe the differential characteristics by gender and time since disease onset in patients diagnosed with ankylosing spondylitis (AS) attending the Spanish rheumatology clinics, including those on the "Spanish Registry of spondyloarthritis" (REGISPONSER), as well as the diagnostic and therapeutic implications that this entails. PATIENTS AND METHODS: This is a transversal and observational study of 1514 patients with AS selected from 2367 spondyloarthritis cases included in REGISPONSER...
July 2013: Reumatología Clinica
Shawn Marshall, Erin M Demmings, Andrew Woolnough, Danish Salim, Malcolm Man-Son-Hing
BACKGROUND: Many specialists encounter issues related to fitness to drive in their practices. We sought to determine the attitudes and practices of Canadian specialists regarding the assessment of medical fitness to drive in older persons. METHODS: We present data from a postal survey of 842 physicians certified in cardiology, endocrinology, geriatric medicine, neurology, neurosurgery, orthopaedic surgery, physical medicine and rehabilitation, or rheumatology regarding their attitudes and practices relating to the assessment of their patients' fitness to drive...
December 2012: Canadian Geriatrics Journal: CGJ
Mark T Reding, David L Cooper
BACKGROUND: Bleeding symptoms commonly seen by multiple physician specialties may belie undiagnosed congenital or acquired bleeding disorders. Acquired hemophilia is a potentially life-threatening cause of unexplained acute bleeding manifested by an abnormal activated partial thromboplastin time (aPTT) that does not correct with 1:1 mixing with normal plasma. METHODS: Practicing physicians (hematology/oncology, emergency medicine, geriatrics, internal medicine, rheumatology, obstetrics and gynecology, critical care medicine, and general surgery) completed an online survey based on a hypothetical case scenario...
2012: Journal of Multidisciplinary Healthcare
F K Lekpa, S Ndongo, O Ka, D Zeba, C Compaoré, A Pouye, M M Ka, T M Diop
Data on characteristics of neuropathic pain (NP) in sub-Saharan Africa are scarce, especially in the elderly. We conducted this study to appreciate the socio-demographic and clinical profile of chronic pain (CP) with neuropathic characteristics in sub-Saharan African elderly with musculoskeletal pain. From January to December 2011, we performed a cross-sectional study in all Rheumatology outpatients over 60 years at the Center for Gerontology and Geriatrics, Dakar, Senegal. In this study, we included patients who experienced musculoskeletal pain for 3 months or longer (CP) and with a DN4 score ≥ 4 (NP)...
July 2013: European Journal of Pain: EJP
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