MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'geriatrics'. Sat, 03 Sep 2011 01:58:39 +0100 http://www.medworm.com/index.php?rid=5169561&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F08%2Fthe-challenge-of-obesity.html For those interested in epidemiology, chronic disease, and obesity. This week's edition of the Lancet has a series of four articles and several commentaries that review the economics, epidemiology, social, and policymaking issues affecting obesity that are well worth reading in full. The take away message is that this is an extremely complicated area. There is an emphasis by the authors and commentators that correction of obesity will take government action. Government action in this area tends to resolve around police actions, and taxation. Taxation policies have worked to a significant extent in reducing tobacco consumption in Europe. However, smoking is not a survival necessity whereas eating is. We have to be very careful about the use of police power for public health policy with the ... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5169561 Fri, 26 Aug 2011 17:05:04 +0100 5169561 http://www.medworm.com/index.php?rid=5096393&cid=t_91934_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FlOErA1jP2ho%2Friba-patient-transport-robot-update.html Japanese fascination with humanoid robots continues unabated as the RIBA, or Robot for Interactive Body Assistance, got a bit of an upgrade.  The cute and scary RIBA II can now lift people up to 175 pounds (previously only 135), place them into a wheelchair, and it seems to move more gently than before. Nevertheless, it doesn’t seem to actually be a robot, but rather a complicated forklift that’s directly controlled by an operator pushing buttons. See for yourself: Flashback: Robotic Nurse Assistant to Ferry Patients Around Hospital Wards.. (hat tip: ZDNet) (Source: Medgadget) Medgadget blogs http://www.medworm.com/rss/comments.php?id=5096393 Wed, 03 Aug 2011 19:10:50 +0100 5096393 http://www.medworm.com/index.php?rid=5069478&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsocial-network-keeps-seniors-connected%2F2011.07.26 Care Innovations, a joint venture between GE and Intel, has released Connect, a service designed to address social isolation in seniors. Connect software runs on a touch screen device and features social networking, as well as health management and reporting tools. The system has been undergoing a successful user trial at a nursing home in Michigan since last year. More about Connect from the announcement: (more…) *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5069478 Tue, 26 Jul 2011 16:00:44 +0100 5069478 http://www.medworm.com/index.php?rid=5028527&cid=t_91934_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FvPy0suBD4qg%2Fresearchers-create-driving-simulator-for-patient-rehabilitation-and-finding-the-origin-of-the-lead-foot.html A team at Clemson University has developed a new driving simulator that is now is being used at 11 U.S. Army, Navy and Veterans Affairs facilities around the United States and Europe. However, this simulator isn’t meant for teaching platoons how to parallel park in an Iraqi desert. Designed specifically for rehabilitative therapy, the technology allows patients to retrain their cognitive, perceptual and physical skills through safe and realistic driving exercises. As the development team included researchers from Clemson’s psychology department, the simulators were also created in mind to study factors such as the driving capabilities and limitations of the elderly. Such data could be useful in the future to develop safer and more efficient vehicles, as well as devices that w... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5028527 Thu, 14 Jul 2011 16:22:23 +0100 5028527 http://www.medworm.com/index.php?rid=4984448&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fosteoporosis-treatment-with-bisphosphonates-is-exercise-good-or-dangerous%2F2011.06.30 My 86 year-old mother, who is generally in good health, slipped and fell recently and suffered a fractured femur. She was unfortunate to have suffered the accident, but had the good fortune to be discovered quickly, treated promptly and well by the paramedics who responded to her, and then to have a swift and skillful operation by an orthopedic surgeon to repair the fracture. Almost miraculously, she was standing upright (with a considerable amount of pain) the next day and had begun the rehabilitation process. At her age—indeed at any age—a fractured femur is a very significant injury. This past year, I have learned of friends and others who have suffered falls and broken their legs, ankles, or backs, as well as others who suffered “pathological fractures.” The latter group had th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4984448 Thu, 30 Jun 2011 11:00:00 +0100 4984448 http://www.medworm.com/index.php?rid=4968531&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F06%2Fdiscoveries-in-mitochondria-open-new-field-of-cancer-research.html Researchers at Virginia Commonwealth University Massey Cancer Center have revealed novel mechanisms in mitochondria that have implications for cancer as well as many other age-related diseases such as Parkinson’s disease, heart disease and hypertension. This discovery has pioneered the formation of a whole new field within epigenetics research ripe with possibilities of developing future gene therapies to treat cancer and age-associated diseases (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4968531 Thu, 23 Jun 2011 17:35:32 +0100 4968531 http://www.medworm.com/index.php?rid=4934410&cid=t_91934_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2Fc8F1doWV1Us%2Fpolyremedy-delivers-personalised-wound-dressings-to-patient-homes.html PolyRemedy Inc. from Concord, Massachusetts is working on a personalized wound care system that will help managing chronic wounds by using informatics and personalized dressing that are delivered to the patient’s front door. The first part of company’s product is an assessment tool that simplifies and standardizes assessment of wounds and automates dressing selection based on expert protocols. When ready, it automatically orders the dressing from PolyRemedy. The patient receives a custom-sized dressing with optimal levels of absorbency, hydration, and oxygen permeability, labeled with patient’s name and treatment date. The last part is a real-time feedback and alerts system for the treating physician, that provides feedback on the patient’s healing trajectory. It al... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4934410 Wed, 15 Jun 2011 15:52:26 +0100 4934410 http://www.medworm.com/index.php?rid=4934412&cid=t_91934_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FPRizppjueyk%2Fearlysense%25e2%2580%2599s-contact-free-patient-monitoring-system-gets-a-wifi-upgrade.html Israel-based EarlySense Ltd. has announced the latest improvements to its contact-free patient monitoring solution. The newly FDA cleared and CE marked component makes the EverOn System even easier to use by adding wifi functionality. The EverOn system’s sensor is placed under the patient’s mattress, and can monitor heart rate, respiratory rate, and patient motion. From the press release: EarlySense’s contact-free patient monitoring system, which was FDA cleared and CE approved in 2010, automatically and continuously monitors a patient’s vital signs and movement, from the moment the patient enters the bed, using a contact-free sensor that is placed under the mattress. The system records and documents the cardiac, respiratory, and motion parameters for a full hospital unit. It alert... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4934412 Wed, 15 Jun 2011 14:46:00 +0100 4934412 http://www.medworm.com/index.php?rid=4911525&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F06%2Flow-t-a-myth.html ScienceDaily - A decline in testosterone levels as men grow older is likely the result -- not the cause -- of deteriorating general health, say Australian scientists, whose new study finds that age, in itself, has no effect on testosterone level in healthy older men. The results were presented June 6 at The Endocrine Society's 93rd Annual Meeting in Boston. Some researchers believe that an age-related testosterone deficiency contributes to the deteriorating health of older men and causes nonspecific symptoms, such as tiredness and loss of libido”. Handelsman and his team, however, found that serum (blood) testosterone levels did not decline with increasing age in older men who reported being in excellent health with no symptoms to complain of. Comment: This is unlikely to affect the ... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4911525 Wed, 08 Jun 2011 18:28:50 +0100 4911525 http://www.medworm.com/index.php?rid=4911528&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F06%2Flaw-on-end-of-life-care-rankles-doctors.html Jane e. Brody-NYT-6-8-2011. Doctors object to laws telling them how to practice medicine, as does New York State’s new Palliative Care Information Act. Vehemently opposed by the Medical Society of the State of New York, the law passed last summer by a two-thirds majority of the Legislature and took effect in February. The legislation was written in collaboration with Compassion and Choices of New York, an organization that advocates for informed choices and greater physical and emotional comfort at the end of life. Comment: Laws on applied practice of medicine are inappropriate, but expect more of the same in states like NY & California which are becoming public health police states. Nannyism is rampant. While the concept of laudable is should be part of the standards of practice... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4911528 Wed, 08 Jun 2011 18:22:34 +0100 4911528 http://www.medworm.com/index.php?rid=4902505&cid=t_91934_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FCImvPI3csDg%2Fwi-go-helps-wheelchair-users-go-shopping.html Wheelchair users should get mad props for tirelessly dealing with the tasks of life that go smoother with two feet. Despite milestones such as the Americans With Disabilities Act, there are some things that laws cannot easily fix. Take grocery shopping, for example. Such a straightforward task becomes a burdensome chore when one must deal with propelling both a wheelchair and a produce-filled shopping cart up and down the aisles of the local mega-mart. Thanks to designer Luis de Matos of Portugal, and Microsoft’s miracle-working Kinect sensor, shopping may become a little easier for wheelchair users. He’s invented a grocery cart of sorts, which he calls the “wi-GO”, that literally follows you around. The wi-GO consists of a motorized cart with a laptop and Kinect s... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4902505 Mon, 06 Jun 2011 16:50:52 +0100 4902505 http://www.medworm.com/index.php?rid=4828935&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F05%2Fas-time-goes-by-it-gets-tougher-to-remember-new-information.html ScienceDaily:  The older we get, the more difficulty we seem to have remembering things. We reassure ourselves that our brains' "hard drives" are too full to handle the new information that comes in daily. But a neuroscientist now suggests that our aging brains are unable to process this information as "new" because the brain pathways leading to the hippocampus become degraded over time. As a result, our brains cannot accurately "file" new information. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4828935 Sat, 14 May 2011 14:18:32 +0100 4828935 http://www.medworm.com/index.php?rid=4803135&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcalcium-supplements-good-for-your-bones-but-bad-for-your-heart%2F2011.05.10 Calcium is good for us, right? Milk products are great sources of calcium, and we’re told to emphasize milk products in our diets. Don’t (or can’t) eat enough dairy? Calcium supplements are very popular, especially among women seeking to minimize their risk of osteoporosis. Osteoporosis prevention and treatment guidelines recommend calcium and vitamin D as an important measure in preserving bone density and reducing the risk of fractures. For those who don’t like dairy products, even products like orange juice and Vitamin Water are fortified with calcium. The general perception seemed to be that calcium consumption was a good thing – the more, the better. Until recently. In a pattern similar to that I described with folic acid, there’s new safety signals from trials with calciu... Better Health blogs http://www.medworm.com/rss/comments.php?id=4803135 Tue, 10 May 2011 13:00:59 +0100 4803135 http://www.medworm.com/index.php?rid=4803557&cid=t_91934_158_f&fid=38949&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FAgingWithGraceCareconnection%2F%7E3%2F5u6cEmukrZU%2Fphysicians-focus-on-importance-of.html The Merry Widows, as they call themselves, were blinged out, Florida-style, to celebrate Elayne Weisburd’s 79th birthday at a sprawling community for seniors. Mylar balloons levitated above their table, and sparklers twinkled from a cake. The guest of honor and her two friends were beaming when Dr. Marc E. Agronin, a geriatric psychiatrist and the director of mental health, arrived with a hug for everyone long after what would be normal office hours. The Merry Widows moved to the community when their husbands developed Alzheimer’s disease and looked to Dr. Agronin to prepare them for what lay ahead. But while treating their husbands’ disease, he became their psychiatrist, too. He urged the women to attend therapy groups, made suggestions about medication for anxiety and encouraged ... Aging with Grace CareConnection blogs http://www.medworm.com/rss/comments.php?id=4803557 Mon, 09 May 2011 19:56:00 +0100 4803557 http://www.medworm.com/index.php?rid=4794872&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F05%2Fcheap-drug-is-as-good-at-treating-eye-disorder-as-more-expensive-product-trial-shows.html Numerous news stories this week focused on the results of an eagerly awaited trial which has shown that millions of dollars a year could be saved through the use of an anticancer drug to treat the neovascular or "wet" form of age related macular degeneration (wet AMD). The trial showed that bevacizumab (marketed as Avastin) is as effective in improving sight as ranibizumab (Lucentis), at a fraction of the cost. COMMENT: Neither the FDA nor CMS have made any recommendation to use the newer cheaper drug and limit the spiralling cost of medical care.. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4794872 Fri, 06 May 2011 15:57:00 +0100 4794872 http://www.medworm.com/index.php?rid=4789653&cid=t_91934_158_f&fid=38949&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FAgingWithGraceCareconnection%2F%7E3%2FHT6umFPlq5g%2Freport-warns-that-older-americans-will.html The report, published this month in the Journal of the American Geriatric Society, warns that as the proportion of older adults spikes from 12% to a projected 20% by 2030, caring for 70 million people 65 and older and 10 million 85 and older will be a challenge. Other types of health care providers will need to work in teams with the doctors to help coordinate patient care, according to the report. "There are not going to be enough geriatricians," says physician Gregg Warshaw, an author of the report and chair of the division of geriatrics at the University of Cincinnati. Currently, he says, "80% of pediatric patients see pediatricians, while 80% of geriatric patients see primary care doctors or internists." Earlier studies by physicians groups predicted 36,000 additional geriatricians ... Aging with Grace CareConnection blogs http://www.medworm.com/rss/comments.php?id=4789653 Wed, 04 May 2011 14:47:00 +0100 4789653 http://www.medworm.com/index.php?rid=4775393&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-alzheimer%25e2%2580%2599s-guidelines-emphasize-early-detection-frighten-some%2F2011.05.02 For the first time in 30 years, an expert panel has updated guidelines for the diagnosis of Alzheimer’s disease. The long overdue facelift should favorably impact care for millions and accelerate badly needed research on the disease. The guidelines were produced by representatives from the National Institute on Aging and the Alzheimer’s Association. They portray Alzheimer’s for the first time as a three-stage disease. In addition to ‘Stage 3,’—the full-blown clinical syndrome that had been described in earlier versions of the guidelines—the new guidelines describe an earlier ‘Stage 2,’ of mild cognitive impairment due to Alzheimer’s, and a ‘Stage 1, or preclinical’ phase of the disease. The latter can only be detected with biochemical marker tests and brain scans.Th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4775393 Mon, 02 May 2011 11:00:06 +0100 4775393 http://www.medworm.com/index.php?rid=4762779&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F04%2Few-diagnostic-criteria-for-alzheimers.html The guidelines published today were "extensively revised" from those presented last summer, Creighton H. Phelps, director of the Alzheimer's Disease Centers Program at NIA, told reporters during a press teleconference Monday. "The revised guidelines that we're presenting today address particularly the difference between information that can be used in clinical practice and that which is intended for use only in research settings," Dr. Phelps said. "They also present a distinction between the underlying disease process and clinically observable disease states." (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4762779 Thu, 28 Apr 2011 18:49:48 +0100 4762779 http://www.medworm.com/index.php?rid=4723872&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F04%2Fdartmouth-researchers-release-report-on-end-of-life-care.html The New York Times (4/12, A22,) reports, "At the end of life, people with chronic diseases like cancer get more aggressive medical care in the New York area than anyplace else in the country, continuing a trend going back decades, according to a report released on Monday by researchers at Dartmouth College." The researchers, who "looked at federal data from 2007, the most recent year available, found that 46 percent of chronically ill patients in the Manhattan hospital region, which also covers most of Brooklyn and Staten Island, were being treated at hospitals when they died, as opposed to dying at home or in hospices or nursing homes. That rate was the highest in the country." (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4723872 Sun, 17 Apr 2011 22:00:41 +0100 4723872 http://www.medworm.com/index.php?rid=4714741&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-a-patient-who-asks-for-salt-for-his-eggs-could-cost-a-hospital-2-5-million%2F2011.04.14 This was a classic moment of comical clarity that only comes along once a week.  As you may or may not know, starting in 2013, The Medicare National Bank has promised to take back 1% of all  of a hospital’s total Medicare revenue (to increase in future years) if the hospital has a higher 30 day readmission rate for  congestive heart failure, acute myocardial infarction or pneumonia than an as yet undefined acceptable 30 day rate of readmission. What does this mean?  It means if the government decides that 20% is an acceptable rate for congestive heart failure 30 day readmission, and the hospital has a readmission rate of 25%, the hospital will be told to return 1% of all Medicare revenue for the year, not just their heart failure revenue. Let’s use some hypothetical numbers... Better Health blogs http://www.medworm.com/rss/comments.php?id=4714741 Thu, 14 Apr 2011 21:00:00 +0100 4714741 http://www.medworm.com/index.php?rid=4684321&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-elderly-men-be-screened-for-prostate-cancer%2F2011.04.06 A study in the Journal of Clinical Oncology found that “that men in their seventies had prostate cancer screening nearly twice as often as men in their early fifties, who are more likely to benefit from prostate cancer detection and treatment.” An American Society for Clinical Oncology news release includes this quote: “Our findings show a high rate of elderly and sometimes ill men being inappropriately screened for prostate cancer. We’re concerned these screenings may prompt cancer treatment among elderly men who ultimately have a very low likelihood of benefitting the patient and paradoxically can cause more harm than good,” said senior author Scott Eggener, MD, assistant professor of surgery at the University of Chicago. “We were also surprised to fin... Better Health blogs http://www.medworm.com/rss/comments.php?id=4684321 Wed, 06 Apr 2011 14:00:27 +0100 4684321 http://www.medworm.com/index.php?rid=4670110&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwaiting-to-die%2F2011.04.02 Surgeons are not so good at standing back, yet sometimes doing nothing is exactly what needs to be done. I remember one time that this turned out to be slightly humorous in a morbid sort of way. I was in my vascular rotation which was not too much fun (except for a short moment). Generally if a patient came in in the late afternoon requiring an operation, your entire night would be destroyed. And there was pretty much nothing worse than an abdominal aorta aneurysm (AAA). Scratch that. A bleeding AAA was a lot worse than an AAA. So when casualties called and said they had a bleeding AAA my heart sank. The patient was pale and clammy and his heart was racing. But the thing that struck me the most was his age. The man was 89 years old. The casualty officer also mentioned that he had previousl... Better Health blogs http://www.medworm.com/rss/comments.php?id=4670110 Sat, 02 Apr 2011 15:00:00 +0100 4670110 http://www.medworm.com/index.php?rid=4605826&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-surprising-discovery-and-the-value-of-the-physical-exam%2F2011.03.17 I’ve remarked in the past how rarely I ever learn anything useful from physical exam. It’s one of those irritating things about medicine — we spent all that time in school learning arcane details of the exam, esoteric maneuvers like pulsus paradoxus, comparing pulses, Rovsing’s sign and the like. But in the modern era, it seems like about half the diagnoses are made by history and the other half are made by ancillary testing. Some people interpreted my comments to mean I don’t do an exam, or endorse a half-assed exam, which I do not. I always do an exam, as indicated by the presenting condition. I just don’t often learn much from it. But I always do it. The other day, for example, I saw this elderly lady who was sent in for altered mental status. There w... Better Health blogs http://www.medworm.com/rss/comments.php?id=4605826 Thu, 17 Mar 2011 23:00:00 +0100 4605826 http://www.medworm.com/index.php?rid=4544967&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fhealthecommunications.files.wordpress.com%2F2011%2F02%2Ffalls.jpg We hear about stories like this all time: An elderly person falls and breaks something — a hip, a wrist, or an arm. Soon what once was a healthy, independent senior begins an inexorable downhill slide. Such is the case of my 89-year-old mother who recently fell and broke her wrist. Turns out that 30 percent of people age 65 and older fall each year. Predictably, seniors with the following risk factors are more prone to falls: Using sedatives Cognitive impairment Problems walking Urinary tract infection Eye problems Balance issues Similarly, when a person does fall, a cascading series of predictable clinical events occurs. It even has a name: “Post-fall syndrome.” This syndrome is characterized by things like fear of falling again, increased immobility, loss of muscle and contr... Better Health blogs http://www.medworm.com/rss/comments.php?id=4544967 Thu, 03 Mar 2011 22:00:05 +0100 4544967 http://www.medworm.com/index.php?rid=4455284&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F02%2Fhope-for-stroke-victims.html ScienceDaily (Feb. 8, 2011) — Much of the devastation of stroke and head trauma is due to damage caused the overproduction of a substance in the brain called glutamate. Preventing this damage has been impossible, until now, as many drugs don't cross the so-called blood-brain barrier, and those that do often don't work as intended. But a method originally devised at the Weizmann Institute of Science may, in the future, offer a way to avert such glutamate-induced harm. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4455284 Wed, 09 Feb 2011 16:11:30 +0100 4455284 http://www.medworm.com/index.php?rid=4389182&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbaby-boomers-2011-a-new-frontier-with-few-guideposts%2F2011.01.23 This is a guest post by Dr. John Schumann. ********** In 2011, the first wave of baby boomers will turn 65 years old. Sixty-five still has currency because that’s the age at which non-disabled Americans are eligible to be covered under the Medicare program (now itself having reached middle age). As our economy continues to recover (hopefully) from the Great Recession, the entrance of millions of Americans to the Medicare rolls over the next decade and a half will be a formidable planning challenge. Look at this chart to see how the baby boomers population has surged: So is the promise of healthcare reform (the “PPACA“), which will enlarge Medicaid by an additional 16 million Americans — about half of the projected growth in coverage for those currently uninsured.... Better Health blogs http://www.medworm.com/rss/comments.php?id=4389182 Sun, 23 Jan 2011 20:00:00 +0100 4389182 http://www.medworm.com/index.php?rid=4266299&cid=t_91934_158_f&fid=38949&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FAgingWithGraceCareconnection%2F%7E3%2Fxj0oTn2ufUA%2Fseniors-lose-out-with-payment-cuts-to.html The temporary fix that Congress has passed to stave off the looming 23 percent reduction in Medicare reimbursements to physicians is better than nothing - but the long-term problem remains unsolved. Lawmakers have for years kicked down the road tough choices on a critical issue - and those who stand to suffer the most should physician pay be cut are elderly Americans.Dr. Jerald Winakur has been a private practice geriatrician for 35 years. He has managed to keep his office doors open despite the edicts that have come down from Medicare year after year.He is not against all payment cuts for physicians' services. There is growing recognition among doctors that many of the services at issue - primarily technical procedures - are over-compensated. We can thank the American Medical Association ... Aging with Grace CareConnection blogs http://www.medworm.com/rss/comments.php?id=4266299 Thu, 16 Dec 2010 16:54:00 +0100 4266299 http://www.medworm.com/index.php?rid=4258893&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F12%2Fhdl-cholesterol-associated-with-reduced-risk-of-alzheimers.html According to a study published Dec. 14 in the Archives of Neurology, HDL cholesterol may reduce the "risk of developing Alzheimer's disease later in life." In a study of 1,130 senior citizens, researchers found that, "compared to those with the lowest levels of high-density lipoprotein...volunteers with the highest levels were 60% less likely to be told they had a probable or possible case of Alzheimer's." Comment: it appears serendipitously, that enhancing HDL to prevent heart disease may also reduce the likelihood of developing Alzheimer's disease. This is a good ”two for one” if other research supports this. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4258893 Tue, 14 Dec 2010 17:20:55 +0100 4258893 http://www.medworm.com/index.php?rid=4214147&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F11%2Felderly-to-outnumber-children-by-2050.html ScienceDaily (Nov. 27, 2010) — The fact that the world population is growing older will not only affect our pensions. In just a few decades there will be more elderly people than children in most parts of the world (with the exception of Africa). Comment: this information should give pause falls to those legislators who think that medical costs can be reined in by giving everyone access to health insurance but being unwilling to require that all care be evidence-based. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4214147 Mon, 29 Nov 2010 19:37:01 +0100 4214147 http://www.medworm.com/index.php?rid=4167958&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhappy-birthday-baby-boomers-one-more-eligible-for-medicare-every-8-seconds%2F2010.11.15 Today begins a lame duck session of Congress before it breaks for Thanksgiving. It’s the final chance to work out a temporary patch to Medicare reimbursement before a 23 percent cut takes effect Dec. 1. Doctors are going to stop taking new Medicare patients if the cuts happen. And, as one breast cancer surgeon explains, if Medicare stops paying, so to private insurers and even military health programs. Congress will meet in December, but the damage will be done. This all is happening two weeks before the baby boomers become eligible for Medicare. That populous generation starts to turn 65 beginning on Jan. 1, which means they become eligible for Medicare on Dec. 1, which, as we mentioned, is the day the 23 percent Medicare pay cut kicks in. Boomers will continue to become eligible ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4167958 Mon, 15 Nov 2010 19:00:00 +0100 4167958 http://www.medworm.com/index.php?rid=3998990&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-old-age-be-a-cause-of-death%2F2010.09.24 The Washington Post asks whether “old age” should be reconsidered as a legitimate cause of death for the elderly. Because more people are dying at very advanced ages with multiple system failure, it’s often harder for physicians to pinpoint the specific underlying cause, but using “old age” as a catch-all term could make mortality data less meaningful, the article said. An upcoming revision of the International Classification of Diseases might provide some guidance: “Each revision of the ICD is the right moment to reconsider this question,” the co-head of the ICD’s mortality statistics committee told the Post. (Washington Post) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3998990 Fri, 24 Sep 2010 12:00:00 +0100 3998990 http://www.medworm.com/index.php?rid=3813001&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F08%2Fnano-fix-for-diabetes.html Nanoparticles coated with islet-specific peptides and major histocompatibility complex trigger expansion of a select population of immune cells, which then help reverse autoimmunity and cure type 1 diabetes in mice. S. Tsai et al., Immunity, 32:568-80, 2010. Eval by E. Charles Snow, Univ. of KY Med. Center; Peter Van Endert, Inst. National de la Sante et de la Recherche Med. ID: 3060957 Comment:  Now if we can move the experiment form micec to people we will eb in business. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3813001 Mon, 02 Aug 2010 15:32:28 +0100 3813001 http://www.medworm.com/index.php?rid=3794816&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F07%2Faging-population-faces-geriatrician-shortage.html The CBS Evening News (7/25, story) reported, "Another crisis may be brewing at the other end of the age spectrum as baby boomers age by the millions, and the number of doctors trying to care for them shrinks." Notably, "there are just over 7,000 certified geriatricians in the United States. It's estimated" that 16,000 are currently needed and that "by 2030," there will be a need for "36,000 geriatricians to care for an aging population. Still, it's a specialty that attracts few new doctors." Among the factors contributing to the shortage in geriatricians are the "anti-aging" sentiments of society at large, as well as "an average income...much lower than other specialties." Nonetheless, "a study of job satisfaction among doctors showed geriatricians are the most satisfied." Comment: this is... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3794816 Tue, 27 Jul 2010 17:54:11 +0100 3794816 http://www.medworm.com/index.php?rid=3757864&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-research-on-alzheimers-disease%2F2010.07.15 Data presented at the International Conference on Alzheimer’s Disease in Honolulu this week indicated that exercise and adequate vitamin D levels could help reduce risk for the disorder. Framingham Heart Study researchers found that risk for dementia was halved in “moderate to heavy exercisers” compared with more sedentary people, while researchers on a separate study found that vitamin D deficiency can greatly increase risk for mental impairment. Another study found that injecting the compound florbetapir into the brain of patients with dementia and then performing a PET scan could help pinpoint the size and location of plaques. Researchers also reported that tea consumption was linked to a slower rate of cognitive decline in older adults without cognitive impairment, bu... Better Health blogs http://www.medworm.com/rss/comments.php?id=3757864 Thu, 15 Jul 2010 16:00:00 +0100 3757864 http://www.medworm.com/index.php?rid=3740595&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fno-forgetting-to-take-your-meds%2F2010.07.09 Normally, the patient calls the pharmacy for a prescription. Now, the prescription is doing that by itself. GlowCaps, a prescription bottle cap made by Vitality, has assumed control for medication compliance. The bottle cap fits prescription bottles, but has uses cellphone technology to tap into wireless networks. Once connected, the pill bottle does everything imaginable to remind patients to take their pills. There’s lights — plenty of them. The bottle cap really does glow and make noise to remind patients. Plug-in units wirelessly connected to the bottle cap can be placed anywhere there’s a wall socket. Oh, and it will call you, too, if you forget. The company calls this “Reminders Ramp from Subtle to Insistent.” (Add “relentless” to that.) Ulti... Better Health blogs http://www.medworm.com/rss/comments.php?id=3740595 Sat, 10 Jul 2010 03:47:23 +0100 3740595 http://www.medworm.com/index.php?rid=3733088&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-win-win-referral%2F2010.07.07 One of my patients is an elderly woman who is completely bedbound due to osteoarthritis. Since she’s considered “too old,” she isn’t considered a surgical candidate for a knee replacement. Her son, George, is her caregiver. George had been referred to our practice through word-of-mouth from a geriatric care consultant. When he called me for an initial visit, his mother had a spot on her left forearm that was growing rapidly. The nodule was red and tender. Both of them wanted a doctor to look at and remove it, and at the house if possible. (more…) (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3733088 Wed, 07 Jul 2010 12:00:55 +0100 3733088 http://www.medworm.com/index.php?rid=3683637&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F06%2Fresearchers-unzip-symptoms-of-the-male-menopause.html In a study from the University of Manchester researchers, working with colleagues at Imperial College London, say that unlike the female menopause, which affects all women, the male menopause is relatively rare, affecting only 2% of elderly men, and is often linked to poor general health and obesity. Comment: This should help reduce the advertising blitz now seen on TV about ‘male menopause, which encourages all males to toke additional testosterone.  Barnum & Bailey are alive and well.  The FDA which has been adver6ising its interest in reducing false advertising by drug companies seem uninterested in halting these TV ads! (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3683637 Mon, 21 Jun 2010 16:49:41 +0100 3683637 http://www.medworm.com/index.php?rid=3676623&cid=t_91934_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F06%2F18%2Fjournal-of-the-american-medical-association-2010-vol-303-no-21%2F This article discusses the case of Mrs. F an 83 year old patient and presents an evidence-based discussion of available incontinence treatments. An NHS Athens password is required to access this article online. alternatively contact the Library for a copy of this article. Filed under: Athens Password, Current Awareness, E-Journals, Journals, Ooops Missed Category! Tagged: Genito-urinary Medicine, Geriatrics, Incontinence, Older People (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3676623 Fri, 18 Jun 2010 09:02:45 +0100 3676623 http://www.medworm.com/index.php?rid=3652407&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffoundations-of-life-still-dancing-at-93%2F2010.06.10 Dance legend Mary Anthony has had a life-long love of dance. At 93 years old, she continues to dance and teach students. Dr. Jon LaPook talks with Anthony about her philosophy on life. Watch CBS News Videos Online Dancing At 93 Years Old Twenty-five years ago, Jennifer Dunning wrote in The New York Times: “DANCE doesn’t seem to take much stock of its wise elders. Among those veterans is Mary Anthony, one of the city’s most highly respected modern dance teachers.” I’m a big fan of wise elders. It’s how I learned medicine. So when I got the chance to meet the now 93-year-old Ms. Anthony earlier this week, off I went to her beautifully-lit, peaceful but active studio in the East Village of New York City. My goal as a doctor: try to gain some insight into her longevity.�... Better Health blogs http://www.medworm.com/rss/comments.php?id=3652407 Thu, 10 Jun 2010 21:00:33 +0100 3652407 http://www.medworm.com/index.php?rid=3621705&cid=t_91934_90_f&fid=34474&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2Fq14My-279Ek%2FGKMpUyddFyo%26amp%3Bhl%3Den_US%26amp%3Bfs%3D1%26amp%3B May 10, 2010 — Health Benefits of Pets.People will do a lot for their pets - see below:- Somebody found a solution: Smokers are motivated to quit to protect their pets from secondhand smoke http://is.gd/iZ58- "Do it for Fido: smokers may quit smoking because of their pet" http://is.gd/iZtQ Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images - Blog) Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=3621705 Wed, 02 Jun 2010 15:32:00 +0100 3621705 http://www.medworm.com/index.php?rid=3618068&cid=t_91934_147_f&fid=39202&url=http%3A%2F%2Fnicolaziady.wordpress.com%2F2010%2F05%2F31%2F6-million-more-seniors-using-the-web-than-five-years-ago%2F We all are aware of the biggest demographic in healthcare is geriatrics and according to a Neilsen report those aged 65 and over, who still make < 10% of active Internet users, are on the rise. We may have to alter our healthcare marketing to include this adaptive audience. In the last five years, the number of seniors actively using the Internet has increased by more than 55 percent, from 11.3 million active users in November 2004 to 17.5 million in November 2009. Among people 65+, the growth of women in the last five years has outpaced the growth of men by 6 percentage points. Not only are more people 65 and older heading online, but they are also spending more time on the Web. Time spent on the Internet by seniors increased 11 percent in the last five years, from approximately 52 hou... Nicola Ziady blogs http://www.medworm.com/rss/comments.php?id=3618068 Mon, 31 May 2010 22:44:54 +0100 3618068 http://www.medworm.com/index.php?rid=3611909&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcan-we-stop-aging%2F2010.05.29 Dr. Aubrey de Grey, a contemporary popularizer of the very old idea that biological aging can be put on hold, gave this talk at TEDMED 2009: *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3611909 Sat, 29 May 2010 16:00:21 +0100 3611909 http://www.medworm.com/index.php?rid=3581616&cid=t_91934_90_f&fid=34474&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FHybrj9UCgUc%2Fsign-of-times.html One more sign of the increasing geriatric population - in 2009 the adult size diapers outnumbered the baby diapers at the U.S. waste sites for the first time. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images - Blog) Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=3581616 Thu, 20 May 2010 14:34:00 +0100 3581616 http://www.medworm.com/index.php?rid=3567894&cid=t_91934_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-your-family-has-a-technology-gap%2F2010.05.15 Do you have a technology participation gap in your family? We do. In fact, most families do somewhere. For us, we have a few older relatives who firmly believe that technology is for “the younger generation.” What’s interesting is that some of these people are not that old — at least not “old” as I define it. One relative, for example, was a working woman in her younger days. Retired now, she never bought into any technology past the 1970s! Beyond the automobile, refrigerator, TV, radio, dishwasher, washer and drier, she has seen no need for anything else. Although  she has grudgingly begun to use email and the Web, she has deemed herself  ”old” and refused to use a cell phone or any other “high-tech device.” (more…) *This blog post was originall... Better Health blogs http://www.medworm.com/rss/comments.php?id=3567894 Sat, 15 May 2010 12:00:10 +0100 3567894 http://www.medworm.com/index.php?rid=3556043&cid=t_91934_87_f&fid=34935&url=http%3A%2F%2Fmedicine.com.my%2Fwp%2F%3Fp%3D8548 It’s sad to read the report Hospital wants to ‘evict’ octogenarian Cheah Say Choo, 86, who has been bed-ridden at the hospital for three years and four months, is in a quandary as the hospital is asking her three children to take her home. “She does not want to be a burden to her family and neither does she want to be placed in a nursing home,” said her youngest son Chan Thye Choon, who added that his mother preferred family members to visit her at the hospital. Goodness. 3 years + in hospital? That seems to me like it’s a long overdue discharge. It was not uncommon years ago to have wards chock full of patients who had no where to go as relatives were not keen to look after them, particularly geriatric patients. In our Asian society extended family support is d... Malaysian Medical Resources blogs http://www.medworm.com/rss/comments.php?id=3556043 Tue, 11 May 2010 23:00:00 +0100 3556043 http://www.medworm.com/index.php?rid=3545445&cid=t_91934_90_f&fid=34474&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2Fs59K26buSVI%2FjYOsWWKHZVw%26amp%3Bhl%3Den_US%26amp%3Bfs%3D1%26amp%3B From the British tabloid Daily Mail:"Sometimes we forget just how short and precious our time on this planet really is. It's for this reason that John Lewis's new television ad seems to have struck an uncharacteristic chord.You won't find many people admitting to crying over the usual flood of formulaic adverts on our screens - yet this 'moving' ad has got Britain talking - and sobbing into their breakfast bowls.At 91 seconds long, and costing £6 million, the ad shows the the life cycle of a woman from birth to old-age - infancy, a girl's birthday party, a clumsy kiss in a university corridor, marriage, pregnancy, parenthood and the path into old age." Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases ... Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=3545445 Sat, 08 May 2010 13:46:00 +0100 3545445 http://www.medworm.com/index.php?rid=3443719&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F04%2Fthe-challenge-of-multiple-comorbidity-for-the-us-health-care-system.html A Commentary in JAMA today [Anand K. Parekh, MD, MPH; Mary B. Barton, MD, MPP JAMA. 2010;303(13):1303-1304.] reminds us how important studies of comorbidities, particularly for chronic diseases have become. The aging of the US population, combined with improvements in modern medicine, has created a new challenge: approximately 75 million people in the United States have multiple (2 or more) concurrent chronic conditions, defined as "conditions that last a year or more and require ongoing medical attention and/or limit activities of daily living."1-2 Is the 21st-century US health care system prepared to deal with the consequences of successfully treating patients who have conditions, often multiple, that they would not have survived in the early 20th century?  Current indications ... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3443719 Wed, 07 Apr 2010 16:34:03 +0100 3443719 http://www.medworm.com/index.php?rid=3370473&cid=t_91934_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F03%2F16%2F7-ways-to-beat-depression-for-seniors%2F Roughly a quarter of people age 65 or older suffer from depression. More than half of doctor’s visits by the elderly involve complaints of emotional distress. Twenty percent of suicides in this country are committed by seniors, with the highest success rate belonging to older, white men. According to a recent report in the Journal of the American Geriatrics Society, depression is one of the major causes of decline in the health-related quality of life for senior citizens. Why all the depression? Rafi Kevorkian, M.D. calls them the five D’s: disability, decline, diminished quality of life, demand on caregivers, and dementia. To combat senior depression, then, requires coming up with creative methods to counter the five D’s. Here are 7 strategies to do just that, to help pe... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3370473 Tue, 16 Mar 2010 10:09:10 +0100 3370473 http://www.medworm.com/index.php?rid=3362480&cid=t_91934_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2010%2F03%2Fneuropsychology-abstract-of-day_12.html Elfgren C, Gustafson L, Vestberg S, & Passant U. Subjective memory complaints, neuropsychological performance and psychiatric variables in memory clinic attendees: A 3-year follow-up study. Archives of Gerontology and Geriatrics. 2010 Mar 6. [Epub ahead of print]Department of Geriatric Psychiatry, Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden.The aims were to evaluate the cognitive performance and clinical diagnosis in patients ( (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=3362480 Sat, 13 Mar 2010 02:51:00 +0100 3362480 http://www.medworm.com/index.php?rid=3287758&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F02%2Finfluenza-vaccines-poor-evidence-for-effectiveness-in-elderly.html Once again another study shows evidence for the safety and efficacy of influenza vaccines in the over 65s is poor, despite the fact that vaccination has been recommended for the prevention of influenza in older people for the past 40 years. These are the conclusions of a new Cochrane Systematic Review. "As the evidence on effectiveness in the elderly is so scarce at the moment, we should be looking at other strategies to complement vaccinations. Some of these are very simple things like personal hygiene, and adequate food and water," says Jefferson. "Meanwhile, we need to undertake a high quality, publicly funded trial that runs over several seasons to try to resolve some of the uncertainties we're currently facing." (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3287758 Thu, 18 Feb 2010 17:18:34 +0100 3287758 http://www.medworm.com/index.php?rid=3023394&cid=t_91934_137_f&fid=35426&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTheAlzheimersReadingRoom%2F%7E3%2FtSFGN-Is_Gc%2Ftoo-many-are-exhibiting-signs-of.html I meet families on a regular basis, and met with thousands throughout my career. I am still surprised to meet with families who suspect their loved one has Alzheimer’s, yet have not had a comprehensive evaluation for an accurate diagnosis.... By Angil Tarach Alzheimer's Reading Room Bob DeMarco and I have both written articles on causes of dementia. What we have reported is there are reversible and irreversible causes of dementia. Unless a person has a comprehensive evaluation by a geriatric specialist, you don’t know if the dementia is reversible. Worse, you cannot be certain that the diagnosis is correct or accurate. Subscribe to The Alzheimer's Reading Room--via Email As some of you know, I have 2 chronic incurable illnesses, Sjogren’s Syndrome, and Chronic Fatigue Immune ... Alzheimer's Reading Room, The blogs http://www.medworm.com/rss/comments.php?id=3023394 Mon, 23 Nov 2009 19:15:31 +0100 3023394 http://www.medworm.com/index.php?rid=2894521&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F10%2Fquality-improvements.html The Commonwealth Fund just released its State Scorecard on Health System Performance. The scorecard points to substantial opportunities to improve. If all states could reach the level achieved by the top performing states: •Twenty-nine million more people would have health insurance—cutting the number of uninsured by more than half; •Nearly 78,000 fewer adults and children would die prematurely every year from conditions that could have been prevented with timely and effective health care; •Nine million more adults age 50 and older would receive recommended preventive care, and almost 800,000 more children would receive key vaccinations; •Five billion dollars could be saved annually by avoiding preventable hospital admissions and readmissions for vulnerable elderly and disabl... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2894521 Wed, 14 Oct 2009 19:08:03 +0100 2894521 http://www.medworm.com/index.php?rid=2605983&cid=t_91934_90_f&fid=34474&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FJFbENtsnlTQ%2Fsecrets-of-longevity-from-greek-island.html Icaria, Island Chain: North Aegean. Image source: Wikipedia, public domain.From CNN:"Since at least the sixth century B.C., Icaria was known to the ancient Greeks and Romans as a health destination -- largely for its hot springs believed to relieve pain, joint problems and skin ailments.For much of the ensuing two millenniums, people here lived in relative isolation. The people here evolved a unique diet that we believe is a more heart-protective version of the Mediterranean diet. We're doing pharmacological analyses of dozens of herbal teas and unique honey produced by bees that draw pollen of thyme, fir and erica. We think we'll find anti-cancer, anti-oxidant and probiotic properties in these locally produced products.We also know that people here have a vastly different character than t... Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=2605983 Thu, 16 Jul 2009 11:32:00 +0100 2605983 http://www.medworm.com/index.php?rid=2523028&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F06%2Fnumber-of-people-aged-65-and-o.html The AP reports, "The world's 65-and-older population will triple by mid-century to 1 in 6 people, leaving the US and other nations struggling to support the elderly." In fact, the "number of senior citizens has already jumped 23 percent since 2000 to 516 million, according to census estimates released on Tuesday. That's more than double the growth rate for the general population." Currently, seniors "comprise just under 8 percent of the world's 6.8 billion people. But, demographers warn the biggest shift is yet to come. They cite a coming wave of retirements from baby boomers and China's Red Guard generation that will shrink pensions, and add to rising healthcare costs." Data show that, in the US for instance, "residents who are 65 and older currently make up 13 percent of the population, ... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2523028 Wed, 24 Jun 2009 16:48:18 +0100 2523028 http://www.medworm.com/index.php?rid=2523040&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F06%2Fgeography-and-history-shape-ge.html ScienceDaily (June 7, 2009) -- New research indicates that natural selection may shape the human genome much more slowly than previously thought. Other factors -- the movements of humans within and among continents, the expansions and contractions of populations, and the vagaries of genetic chance - have heavily influenced the distribution of genetic variations in populations around the world. Comment: Is there any chance that these studies can lead to a change in racial animositt? We are all mongrels. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2523040 Sun, 07 Jun 2009 19:07:41 +0100 2523040 http://www.medworm.com/index.php?rid=2442631&cid=t_91934_137_f&fid=35426&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTheAlzheimersReadingRoom%2F%7E3%2FMxUnbw4-rmA%2Fexercise-works-nursing-home-enviroment.html I can attest, exercise makes a difference. My mother now has the tendency to sit around all day. On those days when I can get her to go to Gold's Gym with me she is a completely different person. The look on her face, from dull to smiling, is more than enough to tell me that exercise works to her benefit.You should note. My mother suffers from Alzheimer's disease. She is 92 years old. And, I am talking about the effect of exercise in a single day.Nursing home residents with Alzheimer's disease who participate in a moderate exercise program have a significantly slower deterioration than those who receive routine medical care.At the end of the 12 month study, the average activities-of-daily-living score was significantly more improved in the exercise group than in the routine medical care gr... Alzheimer's Reading Room, The blogs http://www.medworm.com/rss/comments.php?id=2442631 Fri, 29 May 2009 02:03:47 +0100 2442631 http://www.medworm.com/index.php?rid=2239828&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F03%2Flets_not_turn_elderly_people_i.html From today’s BMJ [BMJ 2009;338:b873] Michael Oliver, professor emeritus of cardiology, University of Edinburgh says primary prevention among young and middle aged adults should be encouraged and supported. But should this apply equally to fit elderly people? Nowadays few elderly people are allowed to enjoy being healthy. A bureaucratic demand for documentation can lead to overdiagnosis, overtreatment, and unnecessary anxiety. Preventive action may be irrelevant and even harmful in elderly people. More than 30 years ago, in his book Medical Nemesis, Ivan Illich called this trend "the medicalisation of health." (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2239828 Thu, 05 Mar 2009 16:07:01 +0100 2239828 http://www.medworm.com/index.php?rid=2184042&cid=t_91934_122_f&fid=36582&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSharpBrains%2F%7E3%2F539056946%2F The IMPACT study which we reported on in December 2007, funded by Posit Science, conducted  by the Mayo Clinic and USC Davis, has just announced publication at the Journal of the American Geriatrics Society. Reference: - Smith et al. A Cognitive Training Program Designed Based on Principles of Brain Plasticity: Results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training Study. Journal of the American Geriatrics Society, April 2009. Computer Exercises Improve Memory And Attention, Study Suggests (Science Daily) - "The Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) study was funded by the Posit Science Corporation, which owns the rights to the Brain Fitness Program, tested in the study." - "Of the 487 healthy adul... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=2184042 Fri, 13 Feb 2009 18:25:52 +0100 2184042 http://www.medworm.com/index.php?rid=1974559&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2008%2F11%2Fts_may_some_day_medically_assi.html HealthDay reported that "in the not-so-distant future, American seniors may turn to helpful, uncomplaining robots to fill the worrisome 'care gap' that many face today." Already, University of Massachusetts researchers have created the uBOT-5, which is "capable of carrying out simple tasks, while it monitors the home environment." The $65,000 prototype "can even spot trouble -- such as a person falling down -- and call 911 if necessary." According to co-inventor Rod Grupen, Ph.D., "any 'authorized user' can jump into and guide the robot," meaning that "if you can't get to your doctor, your doctor can now come to you." Moreover, "the UMass team hopes that the uBOT-5 will someday be capable of running simple medical tests, such as measuring blood pressure or blood sugar." (Source: Dr. Butter... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=1974559 Wed, 19 Nov 2008 19:10:08 +0100 1974559 http://www.medworm.com/index.php?rid=1879806&cid=t_91934_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2008%2F10%2Faging-research.html A press release from the NIH earlier today:NIA and McKnight Brain Research Foundation Join Forces to Support Cognitive Aging ResearchThe Research Partnership in Cognitive Aging is a newly launched public-private effort to support current and emerging research on age-related changes in the brain and cognition. Jointly funded by the National Institute on Aging (NIA), one of the National Institutes of Health (NIH), and the McKnight Brain Research Foundation, through the Foundation for the National Institutes of Health (FNIH), this effort is expected to award an estimated $20 million in research grants over the next five years. The research partnership is aimed at expanding understanding of how we think, learn and remember with age and at developing interventions to maintain cognitive health a... BrainBlog blogs http://www.medworm.com/rss/comments.php?id=1879806 Wed, 15 Oct 2008 23:20:00 +0100 1879806 http://www.medworm.com/index.php?rid=1859467&cid=t_91934_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2008%2F10%2Fneuropsychology-abstract-of-day.html CONCLUSION: Interindividual variability in the face of competing outcomes supports individualizing decision-making to individual priorities. In the current example, this may mean forgoing antihypertensive medications or compromising on blood pressure reduction for some individuals. (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=1859467 Tue, 07 Oct 2008 14:06:00 +0100 1859467 http://www.medworm.com/index.php?rid=1811273&cid=t_91934_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2008%2F09%2Fself-navigating-wheelchair.html From the website, MedGadget::A Wheelchair with Ears and Brainhttp://www.medgadget.com/archives/2008/09/a_wheelchair_with_ears_and_brain.html (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=1811273 Fri, 19 Sep 2008 15:55:00 +0100 1811273 http://www.medworm.com/index.php?rid=1605621&cid=t_91934_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2008%2F07%2Fgterm_care_fraught_with_uncert.html The continued decline of the nursing home — once the mainstay care for the frail elderly — and an upsurge in popularity of assisted living will lead to many dramatic changes in long-term care, according to a University of Florida expert and editor of a new book on the subject. “The American public has expressed a strong distaste for going to a nursing home because it smacks of a hospital-like, institutional way of living and receiving care,” said Stephen Golant, a UF geography professor and expert on elderly housing. “Assisted living has emerged as a highly attractive option for older persons who have experienced some physical or cognitive decline and feel less secure about receiving care in their own home.” Comment: Having visited many Nursing Homes while a State Health Commis... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=1605621 Thu, 10 Jul 2008 15:00:34 +0100 1605621 http://www.medworm.com/index.php?rid=1274981&cid=t_91934_154_f&fid=35946&url=http%3A%2F%2Fcanadianmedicine.blogspot.com%2F2008%2F03%2Fsmitherman-diaper-remarks-earn-derision.html Ontario Health Minister George Smitherman (right) may have meant well when he announced last Wednesday that he was thinking of trying out the incontinence diapers to see if they were sufficient for Ontario longterm care residents, but his remarks immediately sparked criticism from far and wide. He was called insensitive and arrogant, and rival politicians called for his resignation. He's since apologized for the PR gaffe, but that didn't stop the National Post's Scott Stinson from poking a little fun in an imaginary Smitherman diary over the weekend:TUESDAYMajor confession, diary. I tried out an incontinence diaper today. It was so ... freeing. I had three large coffees from Tims -- but no winners :(-and then I sat through a three-hour meeting with a bunch of bureaucrats.No pee breaks! It ... Canadian Medicine blogs http://www.medworm.com/rss/comments.php?id=1274981 Mon, 03 Mar 2008 17:11:00 +0100 1274981 http://www.medworm.com/index.php?rid=1259921&cid=t_91934_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2008%2F02%2Fneuropsychology-abstract-of-day-mild_26.html CONCLUSION: By studying 2 MCI populations, converters versus nonconverters, we found atrophy beyond the medial temporal lobe to be characteristic of patients with MCI who will progress to dementia. Atrophy of structures such as the left lateral temporal lobe and left parietal cortex may independently predict conversion.PMID: 18296551 [PubMed - as supplied by publisher] (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=1259921 Wed, 27 Feb 2008 00:17:00 +0100 1259921 http://www.medworm.com/index.php?rid=1124220&cid=t_91934_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2008%2F01%2Fneuropsychology-abstract-of-day.html CONCLUSIONS: In 95-year-olds, dementia, as well as cognitive performance in the subjects without dementia, influences mortality. When controlling for other severe medical conditions we found dementia to be the leading cause of deaths among the oldest old. The reason why dementia and cognitive function predict life expectancy requires further elucidation.PMID: 18040013 [PubMed - indexed for MEDLINE] (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=1124220 Tue, 01 Jan 2008 16:14:00 +0100 1124220 http://www.medworm.com/index.php?rid=1117587&cid=t_91934_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2007%2F12%2Falzheimers-dementia.html An nice feature article in today's New York Times:Scientists Want to Find Alzheimer’s Before a Mind FailsBy DENISE GRADYThe New York TimesPublished: December 26, 2007[ ... Read the full article ... ] (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=1117587 Wed, 26 Dec 2007 14:16:00 +0100 1117587 http://www.medworm.com/index.php?rid=1087556&cid=t_91934_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2007%2F12%2Fgame-brain.html The New York Times continues its coverage of cognitive agility with a column today by Jane Brody discussing different cognitive and physical ways to promote a fit mind:Mental Reserves Keep Brains Agileby Jane E. BrodyThe New York Times11 December 2007[ ... Read the full column ... ] (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=1087556 Tue, 11 Dec 2007 20:35:00 +0100 1087556 http://www.medworm.com/index.php?rid=1081510&cid=t_91934_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2007%2F12%2Falzheimers-disease-ad-dementia.html Tomorrow's Sunday New York Times Magazine is its annual new ideas of the past year issue. Among the many shiny ideas presented is telephone screening for dementia:Alzheimer’s Telephone ScreeningBy RON FEEMSTERThe New York TimesPublished: December 9, 2007This year, researchers completed work on a 50-question telephone quiz to help them identify Alzheimer’s patients long before they exhibit typical symptoms. Such a quiz may soon become part of regular medical care.This new tool measures what the researchers call “cognitive vital signs” like short-term memory loss, which is the most important early sign of Alzheimer’s, and detects declines in everyday abilities like using a telephone, preparing meals or managing finances. The quiz also picks up behavioral warning signs including apa... BrainBlog blogs http://www.medworm.com/rss/comments.php?id=1081510 Sat, 08 Dec 2007 16:18:00 +0100 1081510 http://www.medworm.com/index.php?rid=1070192&cid=t_91934_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2007%2F12%2Falzheimers-to-screen-ot-not-to-screen.html A short piece in today's Washington Post about the potential problems and potential benefits of broad screenings for dementia of Alzheimer's disease in the general population of aging persons:To Screen, or Not to ScreenExperts Debate Mass Testing For Alzheimer's DiseaseBy Alicia AultSpecial to The Washington Post Tuesday, December 4, 2007; Page HE01 [ ... Read the full article ... ] (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=1070192 Tue, 04 Dec 2007 16:26:00 +0100 1070192 http://www.medworm.com/index.php?rid=1051216&cid=t_91934_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2007%2F11%2Fcalling-all-iowans-alzheimers-disease.html From the Radio Iowa website:Task force seeks public input on Alzheimer's diseaseMonday, November 26, 2007, 8:46 AMBy Pat Curtis "A task force in Iowa that's looking for ways to improve services to Alzheimer's patients is asking for your help. John McCalley, director of the Iowa Department of Elder Affairs, says all Iowans are invited to take an on-line survey.He says the survey is mainly designed for Alzheimer's patients and their family members or care givers. McCalley, who also chairs the 17-member Alzheimer's disease Task Force, says the state's current services to dementia patients are somewhat uncoordinated. He says funding is provided to Area Agencies on Aging across the state, but those services face limited funding, especially in rural areas. An estimated 65,000 Iowans have Alzheim... BrainBlog blogs http://www.medworm.com/rss/comments.php?id=1051216 Mon, 26 Nov 2007 18:57:00 +0100 1051216 http://www.medworm.com/index.php?rid=796896&cid=t_91934_90_f&fid=34474&url=http%3A%2F%2Fcasesblog.blogspot.com%2F2007%2F08%2Fus-life-expectancy-shorter-than-41.html According to the National Center for Health Statistics, the life expectancy in the U.S. is shorter than 41 countries including most of Europe and Japan.Dr. Christopher Murray, head of the Institute for Health Metrics and Evaluation, comments that "something's wrong here when one of the richest countries in the world, the one that spends the most on health care, is not able to keep up with other countries."What are the likely causes?- High prevalence of obesity in the U.S.- Racial disparities- Relatively high infant mortality rate- 45 million Americans lack health insuranceThe life expectancy ranges from 82.6 years in Japan to 39.2 years in Swaziland - see the map. Many of the countries with the lowest life expectancies, e.g. Swaziland, Botswana, Lesotho, Zimbabwe, Zambia, Mozambique, South... Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=796896 Tue, 14 Aug 2007 00:38:00 +0100 796896 http://www.medworm.com/index.php?rid=777584&cid=t_91934_116_f&fid=34686&url=http%3A%2F%2Fwww.pallimed.org%2F2007%2F08%2Fbowel-obstructions-buccal-fentanyl.html It's August, it's hot, I'm jealous of Tom Quinn who has seemed to be on an endless vacation (please give us the details when you get back), my little boy is about to take his first steps, I know all the secrets of the Harry Potter series, and my wee brain isn't working well, so I'm just going to touch on the interesting items cluttering my inbox this week.1)The latest issue of the Journal of Supportive Oncology has several notable articles (table of contents here; JSO is always available free online). There's a review on endoscopic procedures for malignant bowel obstructions (both small and large), particularly focusing on the use of self-expanding metal stents. It contains, among other things, a narrative review of the research surrounding SEMS use, and makes a good place to start for tho... Pallimed: A Hospice & Palliative Medicine Blog blogs http://www.medworm.com/rss/comments.php?id=777584 Fri, 03 Aug 2007 14:38:00 +0100 777584 http://www.medworm.com/index.php?rid=763606&cid=t_91934_90_f&fid=34474&url=http%3A%2F%2Fcasesblog.blogspot.com%2F2007%2F07%2Fcat-scan-predicts-end-of-life.html Oscar is a cat at a nursing home in Providence, Rhode Island. It seems to have the strange ability to predict the imminent death of some of the nursing home residents.The whole story was reported in an essay in the NEJM. See the CNN video.References:A Day in the Life of Oscar the Cat. David M. Dosa, M.D., M.P.H. NEJM, 2007. (Source: Clinical Cases and Images - Blog) Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=763606 Sat, 28 Jul 2007 03:20:00 +0100 763606 http://www.medworm.com/index.php?rid=760352&cid=t_91934_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2007%2F07%2Fcdscat-decision-support.html I'm sure the national media is jumping all over a "Perspective" essay in the July 26 New England Journal of Medicine about a cat named Oscar (at right) at Steere House Nursing and Rehabilitation Center who has "an uncanny ability to predict when residents are about to die," the report says."His mere presence at the bedside is viewed by physicians and nursing home staff as an almost absolute indicator of impending death, allowing staff members to adequately notify families," writes David M. Dosa, M.D, a geriatrician at Rhode Island Hospital in Providence.According to an Associated Press/Yahoo story, Oscar recently received a wall plaque publicly commending his "compassionate hospice care."I guess if you don't have advanced information systems with full clinical decision support, you rely on... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=760352 Thu, 26 Jul 2007 16:27:00 +0100 760352 http://www.medworm.com/index.php?rid=779264&cid=t_91934_154_f&fid=35946&url=http%3A%2F%2Fcanadianmedicine.blogspot.com%2F2007%2F07%2Fdecrepitude-of-modern-geriatrics.html (Source: Canadian Medicine) Canadian Medicine blogs http://www.medworm.com/rss/comments.php?id=779264 Tue, 24 Jul 2007 13:59:00 +0100 779264 http://www.medworm.com/index.php?rid=747119&cid=t_91934_116_f&fid=34686&url=http%3A%2F%2Fwww.pallimed.org%2F2007%2F07%2Fchanging-treatment-preferences-over.html 1)The most recent Journal of the American Geriatrics Society has a few articles I wanted to mention.First is one on changing treatment preferences over time in older adults with life-limiting illnesses. It looked at ~180 community dwelling, cognitively intact, older adults with chronic illnesses (CHF, COPD, cancer) and at least one dependency in IADL's. They were interviewed at least every 4 months for up to 3 years. The subjects were asked questions along the lines of the following and then given different survival/recovery scenario/statistics:"Think again about if you were suddenly to get sick with an illness that would require you to be in the hospital for a few days to a week. It would either be that your (CHF, COPD, cancer) worsened or you got sick with a different illness. In the hos... Pallimed: A Hospice & Palliative Medicine Blog blogs http://www.medworm.com/rss/comments.php?id=747119 Fri, 20 Jul 2007 16:18:00 +0100 747119 http://www.medworm.com/index.php?rid=723742&cid=t_91934_113_f&fid=22291&url=http%3A%2F%2Fwww.medgadget.com%2Farchives%2F2007%2F07%2Fsouth_koreas_etri_develops_fall_sensor_for_seniors_or_winos.html Technology innovation reminds us of romantic comedies. Why, you say? Because most romantic comedies are the same plot, recast with different relatively big-name actors in incrementally different situations. It works by picking the 2 remaining stars that haven't been portrayed falling in love, and it works by joining previously un-combined emerging technologies in an application no one's thought of. For example, we have a fall sensor developed by the Electronics and Telecommunications Research Institute (of South Korea). It's a mash-up of an accelerometer that connects (presumably) via bluetooth to a cell phone equipped with GPS, that alert a local hospital as to the tumbler's location... The phone is equipped with GPS (global positioning system) technology, making it possible to check whe... Medgadget blogs http://www.medworm.com/rss/comments.php?id=723742 Tue, 10 Jul 2007 04:00:00 +0100 723742 http://www.medworm.com/index.php?rid=567919&cid=t_91934_116_f&fid=34686&url=http%3A%2F%2Fwww.pallimed.org%2F2007%2F04%2Fvideo-assisted-advance-care-planning.html 1)Archives of Internal Medicine has a couple notable articles. First is an intriguing one on using instructional videos in advance care planning for patients with dementia. 120 adult outpatients (median age 58, 70% women, over half non-white) who didn’t have family members with advanced dementia were given verbal information about advanced dementia and asked, essentially, if you were in this state would you want full, aggressive life prolonging care, less aggressive life prolonging care (hospitalization, antibiotics, etc. but no CPR, vent, or ICU level care), or comfort-only care? Then they were shown a video of a patient with advanced dementia being cared for (you can watch the clip here) and then were asked the same thing. After hearing a description of dementia, about half said the... Pallimed: A Hospice & Palliative Medicine Blog blogs http://www.medworm.com/rss/comments.php?id=567919 Tue, 24 Apr 2007 21:57:00 +0100 567919 http://www.medworm.com/index.php?rid=545371&cid=t_91934_133_f&fid=35096&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAutismVox%2F%7E3%2F109271880%2F This is from the April 15th New York Times: For four days last December, America’s pleasure dome in the desert, Las Vegas, played host to a convention dedicated to the proposition that [X] is “a treatable medical condition.” Booths advertising vitamins, hormones and pharmaceutical drugs, along with an array of oxygenating or detoxifying paraphernalia, filled the exhibition hall of the Venetian Resort Hotel Casino. What do you think [X] is? The Autism Research Institute (ARI) has its “Autism Is Treatable” campaign. Autism is described as a “treatable medical illness” by Jaquelyn McCandless, M.D.. But it’s not autism the New York Times article is talking about. [X] is aging. The title of the article is Aging: Disease or Business Opportunity?. Regarding t... Autism Vox blogs http://www.medworm.com/rss/comments.php?id=545371 Sun, 15 Apr 2007 17:42:56 +0100 545371 http://www.medworm.com/index.php?rid=542525&cid=t_91934_116_f&fid=34686&url=http%3A%2F%2Fwww.pallimed.org%2F2007%2F04%2Fend-of-life-care-of-holocaust-survivors.html Day to Day, a radio program on NPR, had a good segment (4:47) on the difficulties and opoprtunities in caring for Holocaust survivors as they age. The primary focus was not end-of-life situations but it has implications for hospice & palliative medicine. The piece is a good example of how understanding and knowing the individual can really help give the best medical care. I have only cared for two holocaust patients (that I am aware of), but I did not encounter any of the issues brought up in the piece. Often a pleasant or at least neutral situation with patients near the end-of-life is when they 'see' or 'hear' people or re-experience memories from the past. For a holocaust survivor this may be much more difficult. April 16th is Yom Hashoah, also known as Holocaust Remembrance Day.One hig... Pallimed: A Hospice & Palliative Medicine Blog blogs http://www.medworm.com/rss/comments.php?id=542525 Fri, 13 Apr 2007 18:25:00 +0100 542525 http://www.medworm.com/index.php?rid=492197&cid=t_91934_116_f&fid=34686&url=http%3A%2F%2Fwww.pallimed.org%2F2007%2F03%2Fdo-not-hospitalize-orders-honesty.html 3 things:1)The latest Journal of the American Geriatrics Society has an article on factors associated with 'do not hospitalize' orders in demented nursing home patients. It involved a nation-wide (U.S.) sample of patients (~90,000) and used minimum data set data. Overall 7% of demented NH residents had DNH orders (wide range--0.7% in Oklahoma and over 25% in Rhode Island). Things that were associated with having a DNH order included increased age, being white, being in an urban NH with a wealthier patient mix, being on a special dementia unit, being in a NH with an NP or PA on staff, and having a living will and health care power of attorney. The percent of your NH's patients receiving hospice care was not associated with having a DNH order although being in an area in which fewer NH pat... Pallimed: A Hospice & Palliative Medicine Blog blogs http://www.medworm.com/rss/comments.php?id=492197 Fri, 23 Mar 2007 00:58:00 +0100 492197 http://www.medworm.com/index.php?rid=484971&cid=t_91934_116_f&fid=34686&url=http%3A%2F%2Fwww.pallimed.org%2F2007%2F03%2Fethics-in-icu-prognosis-computers-to.html Many, many items in brief....1)Critical Care Medicine had a supplement in February about ethics in the ICU. Many articles here, including one on end of life ethics in the unit. It opens with this rather remarkable salvo:"Originally conceived and operated as short-term, life-saving vehicles for acutely ill or injured patients, modern intensive care units (ICUs) have expanded into entities that care also for chronically, although seriously, ill people; in fact, ICUs often become repositories for patients who have little or no chance for survival. Sophisticated technology frequently takes on a life of its own; the sheer momentum of processes inherent to ICUs may prevent healthcare providers from taking a step back to make well-considered decisions, especially at the end of a human life."The r... Pallimed: A Hospice & Palliative Medicine Blog blogs http://www.medworm.com/rss/comments.php?id=484971 Wed, 21 Mar 2007 02:16:00 +0100 484971 http://www.medworm.com/index.php?rid=469513&cid=t_91934_116_f&fid=34686&url=http%3A%2F%2Fwww.pallimed.org%2F2007%2F03%2Fpharmacogenetics-of-opioids-pain-meds.html 1)The latest Clinical Pharmacology & Therapeutics has an article on the pharmcogenetics of opioids (related Pallimed post here). I have to admit my excitement for this article waned as I read it: it's incredibly basic-science heavy and difficult for the average clinician (at least me) to read (another article in this issue about methylphenidate and alcohol caught my eye although I realized I couldn't even make it through its abstract before going cross-eyed). In retrospect I don't know what I was expecting. I find the topic interesting, I guess, because it offers a promise of "hard" answers to many of the vagaries and seemingly-random hazards of my clinical practice; this, however, is currently wishful thinking on my part.... Anyway, for those of you who share my curiosity about this topic... Pallimed: A Hospice & Palliative Medicine Blog blogs http://www.medworm.com/rss/comments.php?id=469513 Tue, 13 Mar 2007 01:26:00 +0100 469513 http://www.medworm.com/index.php?rid=463973&cid=t_91934_116_f&fid=34686&url=http%3A%2F%2Fwww.pallimed.org%2F2007%2F03%2Fdeaths-secondary-to-opioid-poisoning.html Some of you may have seen an email circulating from the Wisconsin Pain & Policy Study Group (PPSG) about an article from last summer's Pharmacoepidemiology and Drug Safety. The email highlights an article and two commentaries regarding a causal association between increasing opioid prescriptions and increasing deaths from opioid 'poisoning*.'The conclusion of the article is that we have entered a national epidemic of drug poisoning deaths, around the same time as increases in prescription opioid dispensing, and these may be related (inadvertently). Of the increase in unintentional deaths from poisoning, the opiate group had one of the largest % changes (+91%). In 2002, prescription opioids were implicated in more poisoning deaths (5528) than heroin (1937) or cocaine (3909). (For compari... Pallimed: A Hospice & Palliative Medicine Blog blogs http://www.medworm.com/rss/comments.php?id=463973 Tue, 06 Mar 2007 05:04:00 +0100 463973 http://www.medworm.com/index.php?rid=463976&cid=t_91934_116_f&fid=34686&url=http%3A%2F%2Fwww.pallimed.org%2F2007%2F02%2Fadvance-directives-maybe-do-something.html Two from the latest JAGS and one from Journal of Medical Ethics...1)First is a mortality follow-back study on advance directives and quality of terminal care. I have expressed skepticism about AD's on this blog before--wondering whether they really improve end of life care etc.--and I'm happy to report that here is a bit of data proving me wrong. The study was a typical, solid Teno mortality follow-back survey of ~1500 bereaved family members. About 70% of patients had AD's before they died; those with AD's were more likely to be older, female, and white. AD's were definitely associated with 'better' terminal care:"For decedents with written ADs, the last place of care was most likely to be a nursing home. Those with an AD used less life-sustaining treatment in the last month of life, beca... Pallimed: A Hospice & Palliative Medicine Blog blogs http://www.medworm.com/rss/comments.php?id=463976 Tue, 27 Feb 2007 23:26:00 +0100 463976 http://www.medworm.com/index.php?rid=396206&cid=t_91934_90_f&fid=34474&url=http%3A%2F%2Fcasesblog.blogspot.com%2F2007%2F01%2Fsign-of-times-nytimes-first-video.html The Pulitzer Prize-winning writer Art Buchwald announced his own death in the first NYTimes video obituary: "Hi, I'm Art Buchwald and I just died."According to the newspaper:"Last February doctors told him he had only a few weeks to live. “I decided to move into a hospice and go quietly into the night,” he wrote three months later. “For reasons that even the doctors can’t explain, my kidneys kept working.”Refusing dialysis, he continued to write his column, reflecting on his mortality while keeping his humor even as he lost a leg. He spent the summer on Martha’s Vineyard and published a book “Too Soon to Say Goodbye.”Art Buchwald died on January 17, 2007.References:Art Buchwald, 81, Columnist and Humorist Who Delighted in the Absurd. NYTimes.Buchwald Announces Own Death In ... Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=396206 Fri, 19 Jan 2007 19:02:00 +0100 396206