Discover and read the best of Twitter Threads about #geriatrics

Most recents (17)

I’ve spent the morning scouring CDC vaccination, booster, case & death data for NHs. CDC reports all rates by 1,000 resident weeks (even staff data). Peak #COVID19 death rate among residents was 5.6 in December 2020. Nadir was 0.06 in late June 2021. We are now at 1.2.
Peak death rate among staff was 0.06 deaths/1,000 resident weeks in late November, 2020. We are now at 0.02. Nadir was June/July 2021 at <0.01. Of note, peak staff death count was 69 individuals in one week in July 2020. Latest count is 26 in a week.
Since July, 80+% NH residents have been vaccinated. Since mid-October, 85+%. Presently ~87%. Since November 1, 25+% boosted residents. Since December 5th, 53+%. Since January 2, 63+%. Now ~66%.
Read 13 tweets
🥳 Tooting my own horn 🥳

Just got back from a 1-week road trip vacation and learned... 3 papers were published while I was away!

Here's a quick #medthread 🧵about an epic week of publishing w/friends—what we learned, and what we created!
#AcademicTwitter #patientresearchers
Have you ever been asked to peer-review a manuscript and wondered if you were "doing it right?"

You are me.

@crblease & I published a template to help organize the thoughts of newbie reviewers (including patients).
informatics.bmj.com/content/28/1/e…
#academictwitter #patientresearchers A step-by-step guide to peer review: a template for patients
Now that #opennotes are mandatory, will clinician documentation change?

Rahimian et al., analyzed 143,888 notes from 60 #hemonc clinicians from 2012-16, before AND after introduction of open notes.

TL;DR: Notes became longer AND easier to read.🤔
academic.oup.com/jamiaopen/arti…
#hemonc Open notes sounds great, but will a provider’s documentati
Read 5 tweets
Alcohol related Korsakoffs disease is most likely non-progressive. Of those who do, there is probably an additional underlying disease process. #ANZSGM2021 Assoc. Professor Dr Steven Macfarlane #geriatrics #medtwitter
Discussing people with dementia who have Brodaty Tier 5-6+ behaviours and the role of Specialist Dementia Care Units. More info here: health.gov.au/initiatives-an…
#ANZSGM2021 Assoc. Professor Dr Steven Macfarlane #geriatrics #medtwitter
SDCP: behaviours need to be refractory to management by a specialist or specialist service. Behaviours might flare but if they are addressed by a geriatrician/psychogeriatrician or other specialist service and allowed to settle, then they will not meet criteria. #ANZSGM2021
Read 7 tweets
Up now at #ANZSGM2021: Vaccination considerations in the elderly. Professor Michael Woodward. Disclosure: Sponsored by GSK #geriatrics
Possible modulators of age-related decline in immunity
- mediteranean diet preferred: vegetable and fish sources of protein in preference over animal protein
- caloric restriction
#ANZSGM2021 Professor Michael Woodward #geriatrics
Shingles: VZV specific t-cells decline with age (starts around 50), drop below the threshold to develop shingles. 15% of people will suffer a neurological event ie stroke in those who have zoster opthalmicus.
#ANZSGM2021 Professor Michael Woodward #geriatrics
Read 10 tweets
1/ #Sleep & #Dementia: @NatureComms
 
Study of ~8,000 people followed for 25 years! Look at the figures. Sleeping <7 hrs per night chronically increases risk of dementia by 30%.  Get your sleep!

go.nature.com/3tjRxJB

#MedTwitter #MedEd #Geriatrics
2/ Sleep and Dementia Risk: @nytimes

@PamBelluck wrote a great article on this NatureComm paper showing heightened risk of #dementia for “short-sleepers,” defined as <7 hrs of sleep a night.

nyti.ms/3h7KZeV

#Aging #Delirium
3/ What’s the Mechanism?

Our brain’s “trash” clearance (like the body’s Lymphatic system but by brain’s “glial” cells & called Glymphatics) kicks into ⬆️ gear in sleep. So less sleep is like your waste management system going on strike. Kapische??

REF: bit.ly/3eQxtte
Read 5 tweets
1/ Last wk I asked #medtwitter how to ⬇️ barriers to #covidvaccination in elders👇🏾. Reframe the question: Who’s at risk for missing the vaccine? #geriatrics must play a ⬆️ role. Amplifying: @wassdoc @geri_doc @LouiseAronson @sharon_inouye @MLRobertsonMD
@DavidCGrabowski
2/@judith_graham writes on aging for @KHNews & wrote an excellent piece about the barriers to the #covidvaccine in older adults for @cnn 👇🏾. Honored to offer a quote alongside @PreetiNMalani & others. 🙏🏽

@UABNews @uabmedicine @UABSOM @DrVickersUAB @DrJeanneM @DrEllenEaton
3/ Stories like this one from @arghavan_salles & others highlight how sad the complicated vaccine rollout has been for older adults. And these are elders w/ physician children who are having difficulties.
Read 11 tweets
1/ In #COVID19, we must learn from #BRAIN masters Engel & Romano, who described #DELIRIUM to #DEMENTIA relationship in the 1950s! Here are my TOP 10 CLASSIC quotes from their famous 1959 article:
bit.ly/2SePA1a
 
#medtwitter #meded #tipsfornewdocs #neurology #geriatrics Image
2/ The problem of delirium is far from an academic one. Not only does the presence of #delirium often complicate and render more difficult the treatment of a serious illness, but also it carries the serious possibility of permanent irreversible brain damage.
 
#dementia #COVID
3/ The deficiencies in the education of many physicians ill equip them to recognize any but the most flagrant examples of delirium.
 
#A2Fbundle #tipsforolddocs
Read 12 tweets
1/ Rikers Island Prison & #COVID19:

The New Yorker: bit.ly/3fgxnt3

Many think of inmates as young strong healthy dangerous men, when in reality they are often #AGING, sick, and definitely #VULNERABLE. Covid on top of this is a time 💣

#geriatrics #MedTwitter #pulmcc
2/ Rikers Island Prison & #COVID

#Anxiety & #Fear. You can’t implement effective social distancing in an room that houses dozens of men. You cannot implement effective social distancing when those ~40 men are using the same sinks.

#medicalstudenttwitter
3/fin Rikers Island Prison & #COVID19

You cannot implement effective social distancing in a prison when staff interact with them & has to touch them in course of day. This isn’t going to play out well. Read article. #empathy starts here. I don’t know the solution!

#disparity
Read 3 tweets
1/Leo consternado en la prensa canadiense sobre lo encontrado por su ejército en las residencias de #PersonasMayores de Ontario durante #COVID-19. No hace falta saber inglés para entender el titular:”Canadian military details horrific conditions in nursing homes ...”. Abro hilo
2/Informe de la Unión Europea sobre recursos de cuidados de larga duración(RCLD) en la epidemia: en Bélgica el 51% de los muertos en RCLD, en Noruega el 61% de los muertos en residencias y otras RCLD, en Suecia, Francia, Alemania, España, Reino Unido... situación similar.
3/Además del drama de las personas fallecidas se habla de: hacinamiento, personas atadas, falta de material, falta de contacto y relación, personal que desaparece, personal que se encierra con los mayores, muertes en malas condiciones ,mayores que no son llevados a hospitales...
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Who are we? We’re the family docs & specialists in #Ontario communities taking care of you.

Yet we’re struggling to remain open. We need @ONThealth to address this BEFORE we close. There’s a story you don’t know.

Dr Giles explains:

(1/3)

#MedTwitter #onpoli #cdnmedia #Ottawa Image
Who are we? We’re the family docs and specialists in #Ontario taking care of you.

Yet #primarycare is at risk.

5,265 people signed our petition for equitable access to models of care:
chng.it/ynTHQtNw4B

Dr Lewin explains:

(2/3)

#MedTwitter #onpoli #cdnmedia #Ottawa Image
Who are we? We’re the family docs and specialists taking care of #WomensHealth, #vulnerable populations, #geriatrics, #Pediatrics, #mentalhealth, people with #disabilities, #LGBTQ, #Indigenous communities.

Advocate for us.

#MedTwitter #InThisTogether #CdnMedia #onpoli #Ontario Image
Read 3 tweets
Umbereen S Nehal MD MPH: who is this person? Several people have been asking

A thread

Where am I from? Hooboy.
Let’s say, citizen of the world, human ping pong ball. Third culture kid. Genetic mutt

Born: 🇺🇸
🇵🇰 parents - when my parents born colonial rule, pre-Pakistan
To thoroughly annoy my Twitter bestie, @DrvanTilburg

Am an ENFP - a cross between Snoopy, Robin Willians, Ellen Degeneres, Dr. Seuss, Charles Dickens, Upton Sinclair

I border on ENTP - love new info and love to challenge in order to break through barriers or limitations
My great-grandfather was given title "Khan Bahadur" (brave). As a judge, a brown man under Colonial rule, he threw the book at a British attorney. "Learn the law" if in his courtroom. Hence my stiff moral backbone

My mom & me:

(She loves this song)
Read 52 tweets
In #FamilyMedicine we care across the lifespan. We have long-term relationships with our patients. We're in a unique position to advocate for our patients and for changes in our healthcare system. Here's my clinic's journey and why I worry (1/5) #onpoli #MedTwitter #primarycare Image
When I finished training to become a #FamilyDoctor, I wanted to create a space for everyone to feel safe and supported. I converted a little brick house into a clinic and opened CommonGroundGlebe (2/5). #MedTwitter #DoctorsDay #onpoli Image
We do #perinatal care, #Pediatrics, #geriatrics, #psychotherapy. We care for multiple generations. We do #palliative care home visits. I’ve cried at the bedside when patients gave birth, and also when they died. This is in jeopardy (3/5). #MedTwitter #onpoli #DoctorsDay #COVID19 Image
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#Covid_19 and older patients: a thread.
A group of my friends asked me for advice on preparing for #coronavirus. I emailed them:
- You do not need to be scared for your kids.
- You DO need to be scared for the old people in your lives.
1/
Everything we have learned so far is that the disease is far more dangerous to older adults than any other group.
2/
Many illnesses present differently in older adults than in younger adults. While at this point, we don’t know specifics about COVID, common features of other respiratory illnesses are:
-Malaise
-Orthostasis
-Delirium
-Tachypnea
3/
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My grandma’s PCP recommended she stop going to gym because she may fall.

I don’t agree with this advice. Here’s why:

1/
My grandma is a safe community ambulator when using a walker.

She has a handicap parking placard allowing her to park close to the gym.

If she doesn’t go to the gym, she admits she will likely sit around at home and watch TV, further allowing her strength to deteriorate.

2/
My grandma’s main source of social interactions occur at the gym.

She has many friends who meet her there daily. It’s a way for her to stay social and exercise. And she enjoys going!

3/
Read 13 tweets
This week, I taught the @UCSF IM residents about tools for cognitive assessment in hospitalized patients. For my very first #tweetorial – I’m sharing my pearls with #medtwitter! #FOAM #geriatrics #MedEd 1/
@UCSF Throughout my training, I was taught to use the MoCA (Montreal Cognitive Assessment). But after a few months seeing patients at @VABostonHC, I noticed that most of my patients were getting a score of 21-23. Everyone especially seemed to think this was a hippo. 2/
@UCSF @VABostonHC I wanted to know why! So I looked into the development and validation of the MoCA a bit. Turns out, a cognitive test developed in a mostly white, highly educated, bilingual population (aka the people of Montreal) hasn’t really panned out for use among other groups. 3/
Read 16 tweets
I listen to ~90 #Podcasts on a (semi) regular basis. Let me give you a rundown of ALL of them and why you should listen to some amazing #FOAMed, especially for all the new #EmergencyMedicine interns. #FOAMed #MedEd #medtwitter
First of all, you need a good podcast app. I absolutely love Downcast. Great app, gives you more control over playback, downloading, and allows you to categorize your podcasts into playlists (picture 2). This is where you get to customize your #FOAMed experience! #medtwitter
In no particular order,

- Anesthesia and Critical Care Reviews and Commentary (ACCRAC). Great insight into Crit Care from an anesthesia perspective. Coming from EM, this is great to listen to- much different from my day-to-day! #FOAMed #FOAMcc #CriticalCare
Read 88 tweets
Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status–Older Adults With ESRD: The Seniors Optimizing Community Integration to Advance Better Living With ESRD (SOCIABLE) Study bit.ly/2Dzz3OE

@DrDeidraCrews @sarah_szanton @tkmcudjoe
This is an innovative pilot tested home based program for older low socioeconomic status adults on hemodialysis aimed at improving physical and social function.

@JanieceLTaylor @lakencroberts @DeanDrexelCNHP @Aging_scholar
Why: Older ESRD patients experience increased morbidity, fatigue and decreased physical function. Multiple studies note improvement in health/functional outcomes with social support however few intervention studies aim at improving this..
Read 8 tweets

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