CG CLASSIFIEDS
We are looking for a second fellowship-trained Geriatrician to join our amazing rural Upstate New York community.
Supplements & Special Projects
Issue
We’re all hearing a lot right now about “pay for performance”—programs that offer physicians and other health care providers financial rewards for meeting certain quality or cost-effectiveness standards. Private insurers started introducing pay-for-performance (P4P) programs in the 1990s. These days, “P4P” is making headlines because efforts to introduce it into Medicare are rapidly gaining ground.
An array of policymakers and stakeholders, including The Centers for Medicare & Medicaid Services (CMS), Congress, nongovernmental organizations, and medical societies are involved.
CASE PRESENTATION
An 86-year-old woman presented to the emergency department complaining of left-sided flank pain that had awoken her from sleep earlier that morning. She rated the pain severity as 6 on a scale of 1 to 10, with radiation to the left groin and no relief on position change. She had no hematuria, dysuria, fever, or chills. Past medical history included a stroke at age 83, with no residual deficits, hypertension, atrial fibrillation, depression, and pacemaker for sick sinus syndrome. Her medications were warfarin 5 mg daily, digoxin 0.25 mg daily, fosinopril 10 mg daily, and mirAs we start another calendar year, many individuals ponder what New Year’s resolutions they will try to keep for the coming year. Will they include noble goals such as trying to work toward world peace, or something more tangible to attain in their busy lives? Many wish for something they want that they hope will bring them either physical or emotional fulfillment. For me, I give thanks for what I DO NOT have, and I try to keep this as a theme every day of the year.
Remember the last time you had a muscle strain or common cold? How often you wished it would go away while “suffering”
Herpes zoster (HZ) affects millions of older adults annually worldwide and lowers quality of life in a substantial number of older individuals via acute and chronic pain or postherpetic neuralgia (PHN). Herpes zoster is caused by the reactivation of varicella-zoster virus (VZV) in sensory ganglia and is spread in afferent peripheral nerves in the setting of age, disease, and drug-related decline in cellular immunity to VZV. This article reviews treatment strategies and recent research for the prevention and treatment of HZ and PHN. Pharmacotherapeutic strategies to reduce HZ pain include antiv
CASE PRESENTATION
Mrs. M is a 77-year-old married woman who was brought to the emergency room after her husband found her to be confused and diaphoretic. She has a prior history of a right middle cerebral artery stroke, with left hemiplegia 3 months ago. Mrs. M was diagnosed with depression while undergoing rehabilitation. She was able to regain ambulation with a walker and was discharged home 1 month ago. She has a history of hypertension, atrial fibrillation, osteoporosis, and gastroesophageal reflux disease (GERD). Her current medications include venlafaxine extended-release 150 mg dailyRS is a 75-year-old Caucasian man with essential hypertension and type 2 diabetes mellitus of 7 years duration. He denies diabetic complications and takes only glipizide and atenolol. Physical exam shows weight 218 pounds, height 70”, body mass index 31, blood pressure 152/82 mm Hg, and absent reflexes at the ankles. Patients such as RS, who represent a common office scenario, raise several important questions regarding appropriate treatment:
• What are the risk factors for atherosclerotic vascular disease (ASVD) in this patient?
• Could he already have subclinical disease?
Clinical Geriatrics Blogs
Coming in Future Issues of Clinical Geriatrics
Series: Diabetes in the Elderly
Series: Cancer in Older Adults
First Report® Conference Coverage: American Academy of Neurology, American Diabetes Association, 2010 Digestive Disease Week
Assessment and Classification of Pain in the Elderly Patient
Pharmacologic Management of Pain in Older Patients
Miscellaneous Pain Syndromes in Older Adults
Nonhernia Causes of Inguinal Pain in the Elderly
