Geriatrics
A better way to care for the dying
28 Apr, 2017 | 16:39h | UTCA better way to care for the dying – The Economist (a few articles per month are free) (RT @EricTopol see Tweet)
“How the medical profession is starting to move beyond fighting death to easing it”.
Exercise interventions for cognitive function in adults older than 50
26 Apr, 2017 | 16:07h | UTCMeta-analysis: Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis – British Journal of Sports Medicine (free)
Source: Exercise Could Benefit Cognition in Older Adults – Physician’s First Watch (free)
“Physical exercise interventions significantly improved cognitive function in adults older than 50 years, regardless of baseline cognitive status”.
After Knee or Hip Replacement, No Place Like Home
27 Apr, 2017 | 16:28h | UTCAfter Knee or Hip Replacement, No Place Like Home – The New York Times (10 articles per month are free)
See also: Time to Rethink Inpatient Rehab After Knee Replacement? – The Rheumatologist (free)
Original article abstract ($ for full-text): Effect of Inpatient Rehabilitation vs a Monitored Home-Based Program on Mobility in Patients With Total Knee Arthroplasty: The HIHO Randomized Clinical Trial – JAMA (free)
The NYT commentary talks about the futility of some interventions currently used to postpone surgery and about the benefits of outpatient rehabilitation.
Caring for High-Need, High-Cost Patients
24 Apr, 2017 | 15:30h | UTCPerspective: Focusing on High-Cost Patients — The Key to Addressing High Costs? – NEJM Catalyst (free) (RT @brhospitalist)
Related commentaries: Caring for High-Need, High-Cost Patients — An Urgent Priority – New England Journal of Medicine (free) AND Richard Smith: The challenge of high need, high cost patients – The BMJ Blogs (free)
Playbook: Better Care for People with Complex Needs – Institute for Healthcare Improvement (free)
Use of Medications of Questionable Benefit at the End of Life
20 Apr, 2017 | 14:34h | UTCUse of Medications of Questionable Benefit at the End of Life in Nursing Home Residents with Advanced Dementia – Journal of the American Geriatrics Society (link to abstract – $ for full-text)
See also: Use of Medications of Questionable Benefit at the End of Life in Nursing Home Residents with Advanced Dementia – CBCNews (free) AND Many With Advanced Dementia Receiving Drugs of Uncertain Benefit – Medscape (free registration required)
“Too much use of meds of questionable benefit at the end of life: Just Stop.” (RT @DeeMangin see Tweet)
Prostate Cancer Screening Draft Recommendations – USPSTF
12 Apr, 2017 | 15:58h | UTCProstate Cancer Screening Draft Recommendations – U.S. Preventive Services Task Force (free)
Viewpoint: The US Preventive Services Task Force 2017 Draft Recommendation Statement on Screening for Prostate Cancer: An Invitation to Review and Comment – JAMA (free)
See also: Should you get screened for prostate cancer? We break down the latest advice – STAT News (free)
For those aged 55 to 69 it recommends “informed, individualized decision making based on a man’s values and preferences”. According to a useful infographic from the draft recommendations, the benefits are likely small. For every 1000 men offered PSA based screening over a period of 10-15 years, the test would avoid cancer spreading in 3 men and death from prostate cancer in 1-2 men, with the undesired consequences of false positives and subsequent procedures in many patients.
Management of Osteoarthritis of the Hip
12 Apr, 2017 | 15:55h | UTCManagement of Osteoarthritis of the Hip – American Academy of Orthopedic Surgeons (free PDF)
Source: AAOS releases new clinical practice guideline for osteoarthritis of the hip – Medical Express (free)
How Many Pills Are Too Many?
12 Apr, 2017 | 15:56h | UTCHow Many Pills Are Too Many? – The New York Times (10 articles per month are free)
“Evidence has mounted about the dangers of taking multiple, perhaps unnecessary, medications” (from Tweet)
Seniors are given so many drugs, it’s madness
10 Apr, 2017 | 15:54h | UTCSeniors are given so many drugs, it’s madness – The Globe and Mail (free) (RT @RasoiniR)
“While most prescribing is well-intentioned, it’s also unco-ordinated; there is a tendency to overmedicate and leave people on drugs for too long”.
American College of Radiology (ACR) Appropriateness Criteria Adds Topics
4 Apr, 2017 | 21:19h | UTCACR Appropriateness Criteria Adds Topics, Covers More Clinical Variants Than Ever Before (free)
Browse Appropriateness Criteria Topics (free)
Source: Newswise
This comprehensive guide from American College of Radiology (ACR) covers 230 topics with more than 1,100 clinical indications and has just been updated. It is a very useful resource for doctors in all specialties to guide which exam is most appropriate in each clinical situation.
Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism
5 Apr, 2017 | 15:02h | UTCSource: Levothyroxine Shows No Benefit in Older Adults with Subclinical Hypothyroidism – Physician’s First Watch (free)
Management of Inpatient Hyperglycemia and Diabetes in Older Adults
4 Apr, 2017 | 21:18h | UTCManagement of Inpatient Hyperglycemia and Diabetes in Older Adults – Diabetes Care (free)
Source: Management of Hyperglycemia in Elderly, Hospitalized Adults – PracticeUpdates (free registration required)
Cognitive Dysfunction in Older Adults With Diabetes
3 Apr, 2017 | 19:18h | UTCCognitive Dysfunction in Older Adults With Diabetes: What a Clinician Needs to Know – Diabetes Care (free)
Source: Management of Older Adults With Diabetes and Cognitive Dysfunction – PracticeUpdate (free registration required)
“Recommendations include the need for simplified medication regimens, avoidance of glucose-lowering drugs with a high risk of hypoglycemia, periodic reassessment of glycemic goals, and repeated education of the patient and caregiver” (from PracticeUpdate commentary above)
Impact of total knee replacement practice: cost effectiveness analysis
31 Mar, 2017 | 19:01h | UTCSee also: Knee Replacement Should Be Reserved for More Severe Osteoarthritis, Study Suggests – Physician’s First Watch (free)
Total knee replacement for patients with osteoarthritis had minimal effects on quality of life in this study. Severely affected patients seem to benefit the most from the procedure.
Approach to preventive care in the elderly
31 Mar, 2017 | 18:57h | UTCApproach to preventive care in the elderly – Canadian Family Physician (free)
Genetic assessment of age-associated Alzheimer disease risk
23 Mar, 2017 | 17:01h | UTCGenetic assessment of age-associated Alzheimer disease risk: Development and validation of a polygenic hazard score – PLOS Medicine (free) (RT @EricTopol see Tweet)
See also: New Alzheimer’s test can predict age when disease will appear – The Guardian (free)
*Very interesting, but do we want to know?*
Pregabalin for Acute and Chronic Sciatica
23 Mar, 2017 | 17:15h | UTCTrial of Pregabalin for Acute and Chronic Sciatica – New England Journal of Medicine (link to abstract – $ required for full-text)
Pregabalin did not reduce pain and was associated with higher incidence of adverse events.
Dementia Across the Lifespan and Around the Globe
23 Mar, 2017 | 16:59h | UTCPLOS Medicine special issue edited by Carol Brayne & Bruce Miller: Dementia Across the Lifespan and Around the Globe (free) (RT @tshakey)
Prosthetic joint infection management
23 Mar, 2017 | 16:57h | UTCComprehensive review with practical algorithm.