Geriatrics
M-A: Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis – although Etoricoxib 60 mg/day and diclofenac 150 mg/day seem to be most effective treatments, topical diclofenac 70-81 mg/day is safer and should be considered as first line treatment.
17 Oct, 2021 | 21:14h | UTCNews release: Topical pain-killers more effective, safer than opioids for knee osteoarthritis pain – St. Michael’s Hospital
Commentary: Network meta-analysis compares analgesic regimens for osteoarthritis – medwire News
Commentary on Twitter
Etoricoxib 60 mg/day and diclofenac 150 mg/day seem to be the most effective oral NSAIDs for knee and hip osteoarthritis pain and physical function, but might not be appropriate in the presence of comorbidities or for long term use, concludes #BMJResearchhttps://t.co/rrtX3BnQE5
— The BMJ (@bmj_latest) October 16, 2021
WHO provides guidance to address the shortage of quality palliative care services.
14 Oct, 2021 | 09:59h | UTCNews release: WHO takes steps to address glaring shortage of quality palliative care services – World Health Organization
See Guidance:
Commentary on Twitter (thread – click for more)
Today is World Hospice and Palliative Care Day!
DYK❓ Over 5⃣5⃣ million people around the 🌐 are in need of #PalliativeCare but only 12% of the global need is met.
Access to palliative care services is a human right to health 👉https://t.co/MebmzEstql pic.twitter.com/WQ3d40dH6d
— World Health Organization (WHO) (@WHO) October 9, 2021
USPSTF draft statement revises previous guidance and now recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults aged 60 years or older.
13 Oct, 2021 | 01:36h | UTCCommentaries:
Advice shifting on aspirin use for preventing heart attacks – Associated Press
Taking aspirin to prevent heart attack may cause more harm than good, task force says – NPR
Related Randomized Trials:
Randomized Trial: Aspirin for Primary Prevention of Cardiovascular Disease
Randomized Trial: Effects of Aspirin for Primary Prevention in Persons with Diabetes
Randomized Trial: Effect of Aspirin on All-Cause Mortality in the Healthy Elderly
Related Meta-Analysis:
Meta-Analysis: Efficacy and Safety of Aspirin for Primary Prevention of Cardiovascular Events
Related Opinions:
Aspirin for Primary Prevention: Is This the End of the Road?
Evidence evolving on aspirin as prevention – ACP Internist
Commentary on Twitter
Low Dose Aspirin in the Primary Prevention of Cardiovascular Disease: #USPSTF recommends individualized decision making between 50 and 59 years, and against aspirin use in 60 years+. What a difference a few years can make, with more data and evidence. https://t.co/3nC3jpjTDq pic.twitter.com/SN8K3Z9XJj
— Muin J. Khoury (@MuinJKhoury) October 12, 2021
RCT: Laser treatment not better than sham treatment on symptom severity in women with postmenopausal vaginal symptoms.
13 Oct, 2021 | 01:30h | UTCEffect of Fractional Carbon Dioxide Laser vs Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms: A Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Time for a “Pause” on the Use of Vaginal Laser (free for a limited period)
Author Interview: Effect of Carbon Dioxide Laser vs Sham Therapy on Women With Postmenopausal Vaginal Symptoms
Commentary: Vagina lasering for postmenopausal women ‘may be placebo’ – The Guardian
Commentary on Twitter
In a randomized clinical trial among women with postmenopausal vaginal symptoms, treatment with fractional carbon dioxide laser vs sham treatment did not improve vaginal symptoms after 12 months https://t.co/XXv5edTLiL
— JAMA (@JAMA_current) October 12, 2021
Survey finds misperceptions associated with palliative care are widespread – stigma may be perpetuated by those who falsely believe they understand its meaning.
11 Oct, 2021 | 23:54h | UTCPublic knowledge and attitudes concerning palliative care – BMJ Supportive & Palliative Care
Commentary on Twitter
Public misperceptions & stigma around palliative care are significant issues even for very well developed health systems. 29% of Canadian sample believed pall care meant doctors were 'giving up'. https://t.co/gpCFwFrk8z pic.twitter.com/TZsqwdbQnt
— Richard Sullivan (@SullivanProf) October 10, 2021
U.S. Data: Drug-resistant Infections led to $1.9 billion in health care costs, more than 10,000 deaths among older adults in one year.
8 Oct, 2021 | 10:11h | UTCCommentaries:
Study highlights impact of antibiotic resistance on older Americans – CIDRAP
Deprescribing in palliative patients with cancer: a concise review of tools and guidelines.
8 Oct, 2021 | 10:07h | UTC
Choosing Wisely: Seven things physicians and residents/patients should question in long term care.
7 Oct, 2021 | 10:31h | UTCSee complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
SILENCE Randomized Trial: In patients at the end of life, prophylactic subcutaneous scopolamine butylbromide reduces the occurrence of the death rattle (noisy breathing caused by mucus in the upper respiratory tract).
6 Oct, 2021 | 09:54h | UTCEffect of Prophylactic Subcutaneous Scopolamine Butylbromide on Death Rattle in Patients at the End of LifeThe SILENCE Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Preventing Death Rattle With Prophylactic Subcutaneous Scopolamine Butylbromide – JAMA (free for a limited period)
Author interview: Scopolamine Butylbromide for Preventing End-of-Life Death Rattle – JAMA
Commentary on Twitter
In a randomized clinical trial among patients near the end of life, prophylactic subcutaneous scopolamine butylbromide significantly reduced the occurrence of death rattle https://t.co/e6BDI5yirY pic.twitter.com/hHfhC2iYHh
— JAMA (@JAMA_current) October 5, 2021
Series from the Lancet journals: Hematological malignancies in older people.
6 Oct, 2021 | 08:47h | UTCHomepage: Haematological malignancies in older people – The Lancet Haematology
Commentary: Living longer and better with haematological malignancies: a promise for older adults too? (free registration required)
A comprehensive approach to therapy of haematological malignancies in older patients (free registration required)
Frailty assessment in the care of older people with haematological malignancies
Haematopoietic stem-cell transplantation in older adults: geriatric assessment, donor considerations, and optimisation of care (free registration required)
Review: Optimizing care for critically ill older adults.
5 Oct, 2021 | 08:51h | UTCOptimizing care for critically ill older adults – Canadian Medical Association Journal
Systematic Review: Is exercise an effective therapy to treat long-lasting low back pain?
3 Oct, 2021 | 22:32h | UTCSummary: Is exercise an effective therapy to treat long-lasting low back pain? – Cochrane Library
Original Study: Exercise therapy for chronic low back pain – Cochrane Library
Commentary on Twitter
New @CochraneBack Cochrane review – 249 RCTs – ~25,000 participants – consistent, moderately strong evidence that #exercise treatment was more effective than no treatment or usual care for the management of chronic #backpain 📚 #systematicreview: https://t.co/X10rUtnNNb pic.twitter.com/O0AtZK2gZq
— Cochrane UK (@CochraneUK) October 2, 2021
Review: COVID-19 in older adults.
1 Oct, 2021 | 10:27h | UTCCOVID-19 in older adults – Cleveland Clinic Journal of Medicine
Guideline Synopsis: The Non-Surgical Management of Hip and Knee Osteoarthritis.
1 Oct, 2021 | 10:00h | UTC
AUA Guidelines: Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia.
1 Oct, 2021 | 09:58h | UTCManagement of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA GUIDELINE – The Journal of Urology
PART I—Initial Work-up and Medical Management
PART II—Surgical Evaluation and Treatment
NCCN Guideline: Older Adult Oncology
30 Sep, 2021 | 09:59h | UTC
Never Waste a Pandemic: Strategies to Increase Advance Care Planning Now.
29 Sep, 2021 | 10:22h | UTCNever Waste a Pandemic: Strategies to Increase Advance Care Planning Now – Mayo Clinic Proceedings
Guideline for Perioperative Care for People Living with Frailty Undergoing Elective and Emergency Surgery.
29 Sep, 2021 | 10:10h | UTCNews release and infographic: Perioperative Care of People Living with Frailty – Centre for Perioperative Care
Commentary on Twitter
🆕 Perioperative care for people with frailty: important new guideline
🔶 Note the emphasis on education & training
➡️ Strong presence of need for #delirium assessment & good care
🔗 https://t.co/TwDX7BYr5C@GeriSoc @CPOC_News @APSForg @ASER_hq @AgeAnaesthesia pic.twitter.com/x4YO9fHuQo
— Alasdair MacLullich (@A_MacLullich) September 28, 2021
Review: Sensory Dysfunction in Old Age.
29 Sep, 2021 | 09:57h | UTCSensory Dysfunction in Old Age – Deutsches Ärzteblatt International
Systematic review: Can non-pharmacological measures prevent or reduce Covid-19 (SARS-CoV-2) infections in long term care facilities?
28 Sep, 2021 | 09:47h | UTC
RCT: Methylphenidate may improve apathy in patients with Alzheimer Disease.
28 Sep, 2021 | 09:06h | UTCEffect of Methylphenidate on Apathy in Patients With Alzheimer Disease: The ADMET 2 Randomized Clinical Trial – JAMA Neurology (free for a limited period)
Editorial: Methylphenidate for Apathy in Alzheimer Disease—Why Should We Care? (free for a limited period)
Commentary on Twitter
Small to medium effects of methylphenidate for apathy in AD. Good to see a positive symptomatic treatment trial but I wonder just how important the improvements are to patients and their families. https://t.co/nGSxlAntAd
— Robert Howard (@ProfRobHoward) September 27, 2021
Phenotypes and subphenotypes of delirium: a review of current categorizations and suggestions for progression.
23 Sep, 2021 | 09:54h | UTC
Cluster RCT: Implementing C reactive protein point-of-care testing in nursing homes may reduce antibiotic prescribing for suspected lower respiratory tract infections.
22 Sep, 2021 | 10:02h | UTC
Palliative and End-of-Life Care: Prioritizing Compassion Within the ICU and Beyond.
22 Sep, 2021 | 09:57h | UTC
AAOS Updates Clinical Practice Guideline for Osteoarthritis of the Knee.
21 Sep, 2021 | 09:03h | UTCNews release: AAOS Updates Clinical Practice Guideline for Osteoarthritis of the Knee – American Academy of Orthopaedic Surgeons
Guideline summary: Management of Osteoarthritis of the Knee (Non-Arthroplasty) (3rd Edition) – American Academy of Orthopaedic Surgeons
Full paper: Management of Osteoarthritis of the Knee (Non-Arthroplasty) Evidence-Based Clinical Practice Guideline