PEMBlog

OCTOBER 18, 2023

This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. The night prior to presentation, mom noticed he was not feeding as well and seemed fussy. This is the first of the four cases. link] Takahashi, N.,

Diagnosis 59

Diagnosis Diagnose Illness Patients 59

PEMBlog

SEPTEMBER 6, 2023

However, the vast majority of pediatric patients with psychiatric complaints do not present with undifferentiated acute psychosis; rather, they are seen for behavioral concerns or suicidal ideation. These presentations include behavior concerns, depression, anxiety, and harm to self or others.

Lab Testing 52

Lab Testing Medical Patients Mental Health 52

GeriPal

OCTOBER 13, 2022

We have a discussion about the decision to remove race, a social construct, from clinical risk calculators (though I’m not 100% sold that race should always be removed – if removal is likely to worsen disparities for example – at least until a superior race-blind calculator can be developed). So you’re right.

Complication 97

Complication Patient-Centered IT Patients 97

PEMBlog

OCTOBER 2, 2024

I’ll make the important distinction between gastritis – which is diagnosed only via endoscopy – and dyspepsia, the term best used to describe the symptoms many patients experience. I’ll dive into the latest clinical practice guidelines and discuss evidence-based approaches to diagnosis and treatment.

Diagnosis 52

Diagnosis Management IT Patient-Centered 52

GeriPal

DECEMBER 2, 2022

Rather they’re Ill, maybe they’re aging unsuccessfully, but never really resilient. How do you maintain successful aging, which is often free of disease or illness or disability? And then the people with the other kinds of diagnoses feel left out because we talk about Alzheimer’s all the time. There is no cure.

Community 101

Community IT Individual Patient-Centered 101

GeriPal

JUNE 27, 2024

I have so many questions, and I promise we’re going to get to the management of anxiety and serious illness. If you look in the diagnostical statistical manual, right, the sort of handbook for diagnoses, most of the diagnostic criteria are in some important ways kind of arbitrary, right? Alex Gamble, do you have a song?

Illness 129

Illness IT Diagnosis Patient-Centered 129

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. One of the primary tools used in diagnosing fever is the thermometer, an instrument that measures body temperature. Infrared thermometers, which measure temperature from the forehead or ear, are also prevalent in clinical settings. FEVER FAQs (contd.)

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Diagnosis Management Illness Diagnose 130

GeriPal

SEPTEMBER 22, 2022

Coming off as rote and scripted during a serious illness conversation can have a similar off-putting impact on patients and families. And I think also some of the stuff we’ll be talking about, when it comes to communication, I mean, a lot of the clinical encounter is listening to the music. Eric: So yeah. It flows very well.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

JUNE 13, 2024

Summary Transcript Summary I always find cachexia in serious illness puzzling. In today’s podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. So cachexia, I would put it involuntary weight loss is the number one way to diagnose it.

Illness 133

Illness Patient-Centered Patients IT 133

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 105

Telehealth Patient-Centered IT Patients 105

GeriPal

FEBRUARY 22, 2024

As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved. Today we talk with two psychologists who are deeply invested in addressing psychological aspects of care for people living with serious illness. That rings true to me.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

SEPTEMBER 1, 2022

Social workers augment a team’s ability to provide whole-person care, often aiding to identify and meaningfully address the wide variety of challenges and unmet needs faced by individuals and families facing serious illness. Jennifer Temel study did not have a social worker as part of the clinical team. So … Barbara: Yeah.

IT 102

IT Families Family Clinic 102

PEMBlog

MARCH 27, 2024

She is a member of the Clinical Genome Resource Inborn Errors of Metabolism (IEM) Clinical Domain Working Group, where as a biocurator she assesses the pathogenicity of variants in IEM-associated genes to facilitate expedited genetic diagnosis for IEMs. On clinical presentation. But now I’m going to pass the mic.

Consulting 59

Consulting Individual Families Family 59

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? So let’s just say you have a healthy 55 year old or 65 year old in your clinic.

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Primary Care Diagnosis Screening IT 96

GeriPal

OCTOBER 20, 2022

There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. And I think that’s where this clinical trial which looked at seven versus 14 days was really practice-changing for many of us. It’s very rare and they may be a male patient. So you’re right.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

FEBRUARY 23, 2023

My favorite line from Emily’s paper: “Geriatric assent has not been widely adopted in clinical care, but bioethicists should advocate for this, as adoption of partial-involvement strategies can prolong the period in which individuals are (appropriately) engaged in decisions about their health care.” This is a clinical intervention.

Families 98

Families Family Patient-Centered IT 98

GeriPal

JANUARY 11, 2024

To be eligible in Canada patients must have a “ grievous and irremediable ” condition, including disability ; they do not have to have a terminal illness with a prognosis of less than 6 months. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. Bill, welcome back to GeriPal.

Illness 144

Illness IT Medical Provider 144

GeriPal

JULY 21, 2022

Love to talk about also in the serious illness population. I don’t practice clinically in outpatient settings, and often the folks I’m seeing are there for other kinds of issues. Eric: Let’s say I have a panel of older adults that I’m seeing, or a palliative care outpatient clinic. Absolutely.

IT 102

IT Families Family Diagnosis 102

GeriPal

MARCH 7, 2024

In addition to being a palliative and hospice RN, she is the Executive Director for Goodwin Hospice , a large non-profit hospice that added end-of-life doula care to their services in collaboration with Jane and John’s doula organization, Present for You. He looked very ill. Jane, welcome to the GeriPal podcast. John: Yeah.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

APRIL 13, 2023

Summary Transcript Summary Social connections impact our health in profound ways, whether it is the support we receive from family and friends in navigating serious illness, the joy from shared social activities, or connecting with our community. I moved to Baltimore in 2015 and did clinical fellowship in geriatrics.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

FEBRUARY 16, 2023

The last time this happened to me I immediately went on the defensive despite years of training in serious illness communication skills. Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? How did you react? Afterwards, I thought there must be a better way.

Patients 109

Patients IT Families Family 109

GeriPal

APRIL 4, 2024

She was resuscitated by EMS, but did not regain higher brain function, and was eventually diagnosed as being in a persistent vegetative state. In case you miss the introductions at the start of the podcast, Bernie and Laurie are married, and offer wonderful reminiscence of their clinical practice over the last several decades.

Families 112

Families Family Patient-Centered IT 112

GeriPal

JUNE 19, 2025

Eric 01:04 So we’re going to be talking about transgender health in older adults and those with serious illness. You present your. But you know, the clinical piece, I think it starts out with collecting sexual orientation, gender identity in your databases. Happy pride and thanks for the invitation, Alex and E.

Individual 82

Individual Community IT Chronic Condition 82

GeriPal

FEBRUARY 9, 2023

For example, we spend the first half talking about a RCT simulation study of clinician verbal and non-verbal communication with a seriously ill patient with cancer. Amber tells the moving story of how these findings led a clinical colleague, her chief, to question and change his behavior. Welcome to the GeriPal Podcast, Amber.

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Patient-Centered Patients IT Healthcare 111

GeriPal

AUGUST 24, 2023

Fox gives patients hope there may be a place that illness doesn’t touch Depression is a Liar Why is Being a Patient Such a Difficult Pill to Swallow Better Patient Care Calls for a ‘Platinum Rule’ to Replace the Golden One. And that includes what we call illness-related concerns, the things that are directly mediated by the illness itself.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

OCTOBER 3, 2024

How the act of drawing can help us sloooow down, pay attention to the people and world around us, and ultimately let go… The possibility of incorporating drawings in research and even clinical care. First you have to be a volunteer and see what it’s like to be present at the bedside. And I said, you can’t take any photos.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

SEPTEMBER 21, 2023

So what I saw in the clinical space also both in the United States and in my home country of The Bahamas just made it made sense for me to look into this a little bit more. I’m concerned about how can I get my dad diagnosed or get this proper care.” Alex: Yeah. Karen: Yeah. This is what they’re projecting.”

Community 128

Community Families Family IT 128

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. Eric 01:13 So we got a lot to cover today on sexuality, sexual health and serious illness. Clearly this issue is important to patients.

Illness 130

Illness IT Physicals Patients 130

GeriPal

MARCH 27, 2025

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. Alex 02:44 Still suffering from some illness from there, which is why I was sick and not in the office with Eric today. We did it by the clinic level. I’ve had fun relearning Spanish.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. So the palliative performance scale, or PPS, is essentially a tool to help clinicians with prognostication for seriously ill or palliative care populations.

Families 106

Families Family Patient-Centered Patients 106

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. Eric 16:08 Yeah.

Primary Care 94

Primary Care IT Clinic Provider 94

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. That’s in my view as analogous as to any other illness. Alex: That’s right.

IT 116

IT Clinic Illness Hypertension 116

GeriPal

SEPTEMBER 14, 2023

If you are interested in learning more and meeting a community of folks interested in hospital-at-home, check out the hospital-at-home user group at hahusersgroup.org or some of these publications: Hospital-Level Care at Home for Acutely Ill Adults: A Randomized Controlled Trial. ” We put together a clinical pilot study.

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Hospital Patient-Centered Supply Chain IT 115

PEMBlog

DECEMBER 4, 2024

We will review the clinical presentation, diagnostic strategies, management protocols, infection control practices, and vaccination updates. Pertussis infection in infants and children: Clinical features and diagnosis. Daniels, Camille Sabella; Bordetella pertussis (Pertussis). Pediatr Rev May 2018; 39 (5): 247–257.

IT 52

IT Vaccination Diagnosis Complication 52

GeriPal

JULY 16, 2024

Eric Widera reminds us of the history of the Goldwater Act created by the American Psychological Association in the 1960s which states that psychiatrists should refrain from diagnosing public figures, and the American Medical Association code of ethics which likewise discourages armchair diagnosis (rule established in 2017).

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Diagnosis Diagnose IT Physicals 141

PEMBlog

MAY 9, 2024

Do All Children Who Present With a Complex Febrile Seizure Need a Lumbar Puncture? Febrile seizures are due to the degree of fever, not the rate of temperature rise, even though we see them as the temperature is increasing rapidly in the early parts of the illness. who have more febrile illnesses. Ann Emerg Med. 2016.11.024.

Illness 59

Illness Vaccination Families Family 59