PEMBlog

JANUARY 21, 2025

Differentiating these pathogens based on clinical presentation is crucial for targeted management, minimizing unnecessary diagnostic tests, and optimizing healthcare resources. Common Complications : Otitis media : Diagnosis is supported by the presence of a bulging tympanic membrane with purulent effusion.

Clinic 52

Clinic Complication Diagnosis Illness 52

GeriPal

OCTOBER 13, 2022

Sonali Advani and Lona Mody talk about their recent JAGS article highlighting three recent articles that every clinician caring for older adults should be aware of in the treatment of infectious diseases (hint: I’ve never finished a course of antibiotics, and maybe your patients don’t need that full course either). AlexSmithMD.

Complication 97

Complication Patient-Centered IT Patients 97

PEMBlog

OCTOBER 26, 2023

“Clinically, Meckel diverticulum should be suspected in any child younger than 2 years of age with painless rectal bleeding. STAT Pearls, 2023 Wrap Up Meckel diverticulum is a congenital anomaly of the small intestine that can present with various clinical manifestations, including rectal bleeding and obstruction. .”

Diagnosis 64

Diagnosis Complication Consulting Management 64

GeriPal

MARCH 14, 2024

So, the consult will come in and then we’ll do what we call a clinical bedside evaluation, where we’ll go and see the patient at the bedside. You see something on a bedside swallow, or on a FEES, you’re diagnosing what you think it is. Here at UW Health, we call it our Swallow Service. Eric: Fancy. Raele: Yes.

IT 125

IT Hospital Patient-Centered Individual 125

GeriPal

JULY 19, 2024

There’s an article about her in New York Times. Joe 03:55 You know, my thoughts are screening is important for a variety of reasons, and certainly Doctor Boris and Soo and Anna, Doctor chodos can provide a lot greater clinical insight than I. But it seems very apropos to the topic. Soo 01:37 It’s a little obvious.

Screening 120

Screening Primary Care Patient-Centered IT 120

GeriPal

NOVEMBER 9, 2023

On the other hand, there is a concerning side, described in this Guardian article titled, I’m a life coach, you’re a life coach: rise of an unregulated industry. We make a diagnosis. I was coaching someone this morning, who really wanted to know, what does your clinic template look like, and how do you respond to patient messages?

Board-Certified 111

Board-Certified IT Primary Care Referral 111

GeriPal

DECEMBER 2, 2022

We discuss the importance of viewing individuals with dementia from a lens of resilience, the importance of creative engagement ( as noted in Anne and Susan’s wonderful article on this subject) , the role of collaborative care, and what we can do to improve inclusivity for individuals with dementia in our community and health care systems.

Community 102

Community IT Individual Patient-Centered 102

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. In case you have missed it, click below to read- FEVER FAQ- Part 1 Fever Diagnosis: How is your health assessed? When assessing a fever, we doctors employ a systematic approach to ensure accurate diagnosis and effective management. FEVER FAQs (contd.)

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

MAY 11, 2023

There I was, extremely overly trained with brain stuff, and I wanted to learn how to do clinical research. I just thought there was so much we could learn and offer from every sense, from the clinical point of view, from the family point of view, from prevention, from treatment, epidemiology, et cetera. This is Eric Widera.

Physicals 86

Physicals IT Hypertension Education 86

GeriPal

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? We address the following questions with Nate: Has anything changed for the primary care doctor when diagnosing Alzheimers? How should we screen for cognitive impairment? Does a good history matter anymore?

Primary Care 97

Primary Care Diagnosis Screening IT 97

GeriPal

JANUARY 18, 2024

In particular, we talk about Katie’s and Jesica’s paper in NEJM titled “ Juggling Two Full-Time Jobs — Methadone Clinic Engagement and Cancer Care ,” which described the difficulty in managing cancer pain and methadone for opioid use disorder. We got a couple of articles to discuss and a lot of different components of this.

Illness 137

Illness Patient-Centered Screening Clinic 137

GeriPal

JANUARY 30, 2025

Find out on this weeks podcast where we invite Joseph Greer, Simone Rinaldi, and Vicki Jackson to talk about their recent JAMA article on Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer – A Multisite Randomized Clinical Trial. So no differences between the modalities.

Telehealth 106

Telehealth Patient-Centered IT Patients 106

GeriPal

OCTOBER 20, 2022

This all came out from JAGS just published their first Clin-STAR corner, which is, and we’ll talk about what that is, but it’s a series of articles bringing in specialists to talk about updates in the last couple years within their field. Mody for the mentorship and for the opportunity to bring together these articles.

Complication 52

Complication Patient-Centered IT Patients 52

PEMBlog

JUNE 2, 2025

What you can expect to learn from this article: Recognize signs of end-organ injury when BP is 95th percentile + 30 mmHg. Clinical Case You are a senior resident working in the busy emergency department on an overnight shift. Additional lab testing can be completed to account for the broader differential diagnoses.

Hypertension 75

Hypertension Management Physicals Lab Testing 75

GeriPal

APRIL 14, 2022

And if you want to learn more about buprenorphine from these amazing palliative care clinicians and others, check out of some of these articles: Learn more about caring for those with substance use disorder: . Article on buprenorphine in the elderly. This is both a research and a clinical interest of yours. Transcript.

Illness 103

Illness Patient-Centered IT Patients 103

GeriPal

JUNE 16, 2022

First, we talk with Christine, a researcher and geriatrician from the University of North Carolina, who recently published a JAGS article titled Overdiagnosis of urinary tract infections by nursing home clinicians versus a clinical guideline. But really those urinary tract signs and symptoms should be driving your diagnosis.

Management 123

Management IT Medical Patient-Centered 123

GeriPal

SEPTEMBER 1, 2022

So in preparation for this, I read a couple articles about social work leadership in palliative care. And the title of his article is, does culture of modern day palliative care social work leave room for leadership, where he interviewed six leaders in palliative care, five or six for social workers. Eric: All right, Barbara.

IT 102

IT Families Family Clinic 102

GeriPal

OCTOBER 17, 2024

I’d also like to give a shout out to a recent ACP article on HFpEF with an outstanding contribution from Ariela Orkaby, geriatrician extraordinaire (we also just did a podcast with her on frailty ). ** This podcast is not CME eligible. He’s a medical director of H ebrew S enior L ife outpatient clinic at Newbridge.

Primary Care 114

Primary Care Patient-Centered IT Patients 114

GeriPal

JUNE 15, 2023

Alex: And joining us via Zoom, we have Charlotta Lindvall, who is a palliative care physician researcher who studies the intersection of natural language processing and communication data at Dana Farber Cancer Institute, where she also works in clinical informatics. Welcome to the GeriPal podcast, Charlotta. Charlotta: Thank you. Eric: Yeah.

IT 100

IT Patient-Centered Patients Healthcare 100

GeriPal

AUGUST 17, 2023

Praised by the FDA, Alzheimer’s Association (AA), and Pharma as a “game changer”, but derided by others for the drug’s lack of clinical efficacy, risk of severe adverse effects, absence of diversity in trial populations, high costs, and an FDA approval process that was in the kindest words “rife with irregularities”. That was an FDA decision.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

JULY 28, 2022

And I just want to highlight, Jennifer has a great JPSM article that just came out. Would you also just mind mentioning kind of the JPSM article too? What drove you to write that article on this important trip to Seattle? And my article is about when I was a mid to junior faculty member trying to build this career.

Illness 111

Illness Hospital Patient-Centered Patients 111

GeriPal

FEBRUARY 27, 2025

Substance use disorder is one of those complex issues in which clinical practice is changing rapidly. Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. Do you need to be an addiction medicine trained physician to start such a clinic (no: Sach is not). What do they do?

Patients 74

Patients Clinic Patient-Centered Illness 74

GeriPal

FEBRUARY 22, 2024

Is it that they’re clinically depressed or that they’re understandably sad at the situation that they’re in or specific issues? We might say, “Of course you’re sad, you just got a very serious diagnosis.” It’s high, it’s too high. Or is it that I’m just not screening? Eric: Yeah.

Mental Health 123

Mental Health Patient-Centered Illness Screening 123

GeriPal

FEBRUARY 23, 2023

Today we talk with Anne Rohlfing, Lynn Flint, and Anne Kelly, authors of a JGIM article on the reasons we shouldn’t stop at “no.” In general, the case is a patient who wound up with a new diagnosis of metastatic cancer during the course of the admission and at a certain point had full capacity, was able to make decisions and communicate.

Families 98

Families Family Patient-Centered IT 98

GeriPal

OCTOBER 27, 2022

As Alex Lee says on our podcast today, all prognostic models will be wrong (in some circumstances and for some patients); our job is to make prognostic models that are clinically useful. As Sei Lee notes, the argument for developing prognostic models has won the day, and we increasingly use prognostic scores in clinical decision making.

IT 95

IT Clinic Screening Patients 95

GeriPal

MARCH 7, 2024

Check out the Pub Crawl GeriPal post for more info, and follow #HPMParty on Twitter to keep us as we crawl! ** In the last several years, I’ve seen more and more articles about end-of-life doulas ( like this NY Times article from 2021 ). I’m unsure what they do, how often they’re used, and who pays for their work. Is that right, Jane?

Provider 119

Provider Illness IT Healthcare 119

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. And yet, we know little about the clinical experience of people with dementia in hospice. It’s something we need to pay attention to, which is what we were talking about in the article.

Families 107

Families Family IT Patients 107

GeriPal

JANUARY 11, 2024

Alex: We’re delighted to welcome Leonie Herx, who’s a palliative care physician and clinical professor at the University of Calgary. Sonu: Prior to that it was illegal and actually in the criminal code, so not only illegal, it’s actually a prohibition in the clinical code. Bill, welcome back to GeriPal. Eric: Yeah.

Illness 144

Illness IT Medical Provider 144

GeriPal

APRIL 18, 2024

Because I remember there was an article maybe six months ago in JAGS, maybe it was longer than that, everybody was talking about ChatGPT-3.5, And you say, “Okay, that’s fine, but can it really … What about a real live clinical situation?” Let me ask you a question. They had no idea.

IT 140

IT Electronics Patients Healthcare 140

GeriPal

SEPTEMBER 19, 2024

So you, Jennifer, probably have, like, the most cited, probably should be the most cited randomized controlled trial of palliative care and lung cancer patients that everybody, every palliative care article I’ve seen, whether or not it works, always includes, it was outpatient palliative care in lung cancer patients. All of this is.

Patient-Centered 120

Patient-Centered IT Patients Hospital 120

GeriPal

JUNE 26, 2025

But from our clinical work, many of us are familiar with people with dementia who experience sudden shocks to their health, think hip fracture, think hospitalization for pneumonia. Sometimes people call them health shocks, but we kind of all, like, clinically, intuitively know what these things are. Has really changed.

Illness 63

Illness Hospital IT Patient-Centered 63

GeriPal

MAY 1, 2025

One in 10 people with newly diagnosed HIV is an older adult. Funding for research and clinical care is at risk, as USAID and PEPFAR (which is under USAID), are shuttered. And when she was here, she co founded the Golden Compass Clinic at San Francisco General Hospital for older adults living with HIV.

Primary Care 96

Primary Care IT Clinic Provider 96

GeriPal

JULY 25, 2024

Summary Transcript Summary We are dusting off our crystal balls today with three amazing guests who have all recently published an article on prognosis over the last couple months: Kara Bischoff, James Deardorff, and Elizabeth Lilley. Eric 00:13 And Alex, we have a super special today, three different articles. This is Eric W id era.

Families 108

Families Family Patient-Centered Patients 108

GeriPal

MARCH 27, 2025

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. Eric 08:37 And that’s because you randomized clinics, you didn’t randomize patients interventions. We did it by the clinic level. And so everyone who’s in that clinic was.

Primary Care 80

Primary Care IT Clinic Patient-Centered 80

GeriPal

JULY 6, 2023

I have 24,500 veterans on our caseload, 14,000 individuals with diagnosed mental health issue, 8,500 with an alcohol and substance abuse. Eric: Which is, so let’s say I am a provider, a healthcare provider taking, let’s say a nurse practitioner working in an older, a clinic that’s mainly caring for older adults.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

DECEMBER 1, 2023

Summary Transcript Summary There is a growing push to change how we define Alzheimer’s disease from what was historically a clinically defined syndrome to a newer biological definition based on the presence of positive amyloid biomarkers. So too systolic hypertension in elderly people, clinical trials. This is Eric Widera.

IT 117

IT Clinic Illness Hypertension 117

GeriPal

JUNE 6, 2024

Sharon Bober, clinical psychologist at DFCI, notes that clinicians can get caught in an anxiety cycle, in which they are afraid to ask, don’t ask, then have increased anxiety about not asking. And it actually came up during a clinical encounter that I had. So this is about two and a half, three years out from leukemia diagnosis.

Illness 131

Illness IT Physicals Patients 131