Skip to main content

Stocking Stuffers for Your Favorite Geriatrician


Don't know what to get your favorite geriatrician for the holidays? Out of ideas as you bought your geriatrician a snuggy last year and this year amazon.com is telling you that the healthcare reform package you ordered is unlikely to be delivered in time for Christmas? Well, good news! The BMJ Christmas edition is here and it is chock-full of articles that you and your Geriatrician will be sure to enjoy. Here are two samples:

  • Perceived age as clinically useful biomarker of ageing. Your geriatrician is probably tired of looking up prognostic indexes to aid in complex decision making around age appropriate cancer screening. It turns out that there may be an easier way. A group from the University of Southern Denmark report that someone’s perceived age, or "how old you think someone looks", correlates with lifespan. The researchers photographed 1,826 Danish twins older than age 70. These photos were then shown to a panel of 20 geriatric nurses, 10 young male student teachers, and 11 older women, who evaluated the perceived age of each twin. Dannish Death records were subsequently used to track the survival of the twins over a seven year period. The results show that the member of each twin set who looked older was more likely to die first, even after adjusting for chronological age, sex, and other biomarkers of aging.
  • Lying obliquely—a clinical sign of cognitive impairmentGeriatricians will jump for joy once they are taught the “oblique sign”. A group of neurologists from Germany decided to determine if patients who fail to “spontaneously orient the body along the longitudinal axis of a hospital bed when asked to lie down” are more likely to have cognitive impairment. They tested 110 inpatients aged 60 or more by asking them to lie down from a sitting position on the side of the examination bed. The researchers then took a photograph of the patient in bed to determine the “obliqueness” of the patient. The results show that an “angular deviation” of at least 7° predicted cognitive impairment according to the three different cognitive tests. Their conclusion – “suspect cognitive impairment in mobile older inpatients with neurological disorders who spontaneously position themselves obliquely when asked to lie on a bed.”
Oh, but there is so much more.  Don't miss the articles on the use of "Nellie the Elephant" as a learning aid during CPR (and why its use should be discontinued), Ageism and the Economist, and how Santa Claus is a public health pariah.

Comments

I have always loved th BMJ Christmas edition. Thanks for posting these I forgot to look for it this year.

Popular posts from this blog

Practical Advice for the End of Life: A Podcast with BJ Miller

This week we talk with BJ Miller, hospice and palliative care physician, public speaker, and now author with Shoshana Berger of the book "A Beginner's Guide to the End."

As we note on the podcast, BJ is about as close as we get to a celebrity in Hospice and Palliative Care.  His TED Talk "What Really Matters at the End of Life" has been viewed more than 9 million times.  As we discuss on the Podcast, this has changed BJ's life, and he spends most of his working time engaged in public speaking, being the public "face" of the hospice and palliative care movement.

The book he and Berger wrote is filled to the brim with practical advice.  I mean, nuts and bolts practical advice.  Things like:
How to clean out not only your emotional house but your physical house (turns out there are services for that!)Posting about your illness on social media (should you post to Facebook)What is the difference between a funeral home and mortuaryCan I afford to die?  …

Improving Advance Care Planning for Latinos with Cancer: A Podcast with Fischer and Fink

In this week's GeriPal podcast we talk with Stacy Fischer, MD and Regina Fink, RN, PhD, both from the University of Colorado, about a lay health navigator intervention to improve advance care planning with Latinos with advanced cancer.  The issue of lay health navigators raises several issues that we discuss, including:
What is a lay health navigator?What do they do?  How are they trained?What do lay health navigators offer that specialized palliative care doesn't?  Are they replacing us?What makes the health navigator intervention particularly appropriate for Latinos and rural individuals?  For advance care planning? Eric and I had fun singing in French (yes French, not Spanish, listen to the podcast to learn why).
Enjoy! -@AlexSmithMD




You can also find us onYoutube!



Listen to GeriPal Podcasts on:
iTunes Google Play MusicSoundcloudStitcher

Transcript

Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: And Alex, I'm really excited about toda…

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …