A Geriatrician Reviews Cicero ’s “On Old Age”

As a geriatrician entering the twilight of my career, I look to the philosophers of my field for guidance on how to navigate my own later years. In addition to contemporary texts and journals I turned toward the ancients and discovered a gem in the writings of Cicero, one of the greatest philosophers of the Roman Empire. The work is entitled De Senectute – Latin for “On Old Age.” Cicero wrote this in 44 BC, the year before he was executed at age 63 by Marc Antony’s henchmen for his alliance with Julius Caesar’s assassins and political opposition to the rulers of Rome. On Old Age is an optimistic discussion of the spirit of man’s declining years, exploring the relationship with nature and outlining strategies to maximize the enjoyment of life. Old age and death are considered natural components of humanity. Unfortunately he does not discuss the point of view of women, a reflection of Roman culture in which the female gender had lower status – unable to vote or hold political office and largely relegated to managing the home. This flaw, however, does not warrant dismissal of the work. Born in 106 BC, Marcus Tullius Cicero spent his life intertwined with the politics of Rome, and is considered one of history’s greatest orators. His philosophical writings profoundly influenced Western civilization, including 18th Century Enlightenment theorists such as John Locke, David Hume, and others. Most of Cicero’s philosophica...
Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - Category: Geriatrics Authors: Tags: An Aging World Art & Medicine Featured Medical Articles art and aging art and medicine history medical history medicine and art Source Type: blogs

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We describe a case of a 33 years old gentleman who was clinically diagnosed as acute appendicitis at initial presentation in view of a one-week history of fever, right lower quadrant abdominal pain- and guarding at right iliac fossa. He had thrombocytopenia and lymphopenia on presentation. Mesenteric lymphadenitis and small bowel lesion were found intraoperatively, which was respectively biopsied and resected. Histopathological result confirms disseminated histoplasmosis. Retroviral screen was positive. He was treated with amphotericin B for one week, subsequently switched to oral itraconazole, followed by initiation of hi...
Source: Malaysian Journal of Pathology - Category: Pathology Tags: Malays J Pathol Source Type: research
We report a case of primary systemic ALK+ ALCL with a SC pattern that presented as secondary gastric lesions with a mixed LH and SC pattern that was masqueraded as inflammatory lesions. CASE REPORT: A 34-year-old woman with intractable epigastric pain was referred to have repeated endoscopy with biopsy. She was found to multiple gastric erosions and nodules that were diagnosed as inflammatory lesions both endoscopically and histologically. Meanwhile, she developed an acute onset of severe back pain associated with a pathologic compression fracture in the T3 thoracic vertebral body. Imaging studies disclosed a dissemina...
Source: Malaysian Journal of Pathology - Category: Pathology Tags: Malays J Pathol Source Type: research
We report a case of a 46-year-old Chinese male who presented with six months history of abdominal pain, weight loss and rectal bleeding. Diagnostic colonoscopy revealed multiple aphthous ulcers within the ileo-caecal region and distal transverse colon, separated by normal mucosa, mimicking skip lesions of Crohn's colitis. Computer topography (CT) scan of the abdomen showed multiple circumferential thickenings involving predominantly the right colon. A clinical diagnosis of colonic Crohn's disease with possible perforation was made. An extended right hemicolectomy was performed due to uncontrolled rectal bleeding. Histopath...
Source: Malaysian Journal of Pathology - Category: Pathology Tags: Malays J Pathol Source Type: research
A 41-year-old Congolese woman born in 1977 presented in February 2018 to our emergency department with severe abdominal pain. Her medical history was notable for idiopathic collapsing glomerulopathy for which she was being initially treated with corticosteroids, later switched to tacrolimus. Additionally she was on candesartan 16 mg/d, then later switched in 2014 to enalapril 20 mg/d. During 2017, she was poorly compliant with her medications. In February 2018, her medications included tacrolimus, furosemide, spironolactone, lercanidipine, and enalapril.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Image Source Type: research
An 82-year-old male, with a history of bowel cancer with partial colectomy, gastroesophageal reflux disease, remote partial gastrectomy for peptic ulcer disease, and no documented prior kidney disease, presents with several months of fatigue and subacute decline in kidney function. He had no history of diabetes, hypertension, kidney stones, or prior urinary tract infections. He denied use of nonsteroidal anti-inflammatory agents, herbal medications, and recent antibiotics. There was no family history of renal disease.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Make Your Diagnosis Source Type: research
Childhood sexual abuse (CSA) is a physical assault upon the body and considered to be a complex traumatic experience affecting both body and mind. Growing evidence indicates that long-term effects of CSA include maladies such as chronic pain and fibromyalg...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
Publication date: Available online 21 August 2019Source: Surgery (Oxford)Author(s): Gideon Blecher, Kara McDermott, Benjamin ChallacombeAbstractRenal carcinoma is a reasonably common cancer in the UK. Fortunately, its diagnosis is nowadays much earlier due to the increased utilization of radiological imaging. While surveillance is an option, particularly in older/comorbid patients, nephron-sparing surgery remains the gold standard treatment for small renal masses. Laparoscopic, robotic or open partial nephrectomy have excellent cure rates. For larger tumours, radical nephrectomy may be required. This again can be performed...
Source: Surgery (Oxford) - Category: Surgery Source Type: research
ConclusionWe report a rare case of patient with synchronous liver metastases from gastric cancer who experienced stable disease for 7 years and 3 months following multidisciplinary modalities. Future trials are required to prospectively investigate the established regimen of multidisciplinary treatment.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
This discussion and research on Dying with Dementia and the unnecessary care that often accompanies the late stages of dementia is worth discussing and considering.ByAlzheimer's Reading RoomThis topic is often overlooked and avoided until it is too late.I believe these issues should be considered, and when possible,discussed in support groups. This information is worth sharing and discussing with family members.Learn More -Coping with Alzheimer'sSince individuals with advanceddementia cannot report their symptoms, these symptoms often are untreated, leaving them vulnerable to pain, difficulty breathing and various other co...
Source: Alzheimer's Reading Room, The - Category: Neurology Tags: Alzheimer's Dementia assisted living and memory care facility care homes for elderly with dementia care of dementia patients care of dementia patients at home dementia care elderly dementia care Source Type: blogs
This discussion and research on Dying with Dementia and the unnecessary care that often accompanies the late stages of dementia is worth discussing and considering.ByAlzheimer's Reading RoomThis topic is often overlooked and avoided until it is too late.I believe these issues should be considered, and when possible,discussed in support groups. This information is worth sharing and discussing with family members.Learn More -Coping with Alzheimer'sSince individuals with advanceddementia cannot report their symptoms, these symptoms often are untreated, leaving them vulnerable to pain, difficulty breathing and various other co...
Source: Alzheimer's Reading Room, The - Category: Neurology Tags: Alzheimer's Dementia assisted living and memory care facility care homes for elderly with dementia care of dementia patients care of dementia patients at home dementia care elderly dementia care Source Type: blogs
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