Immunotherapy for Peripheral Nerve Disorders
Inflammatory peripheral neuropathies can be disabling for any patient. Selecting the most appropriate agent for treatment, especially in the elderly, is no simple task. Several factors should be considered. Herein, we discuss immunotherapeutic options for peripheral nerve diseases and the important considerations required for choosing one in the geriatric population. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 23, 2021 Category: Geriatrics Authors: Andre Granger, Elina Zakin Source Type: research
A Clinical Approach to Disease of Peripheral Nerve
Peripheral neuropathy is one of the most prevalent neurologic conditions encountered by neurologists and nonneurologists. Geriatricians and primary care physicians often face the task of screening patients for early neuropathy when they have underlying conditions such as diabetes mellitus and evaluating patients who report new symptoms that suggest neuropathy. An understanding about different forms of neuropathies based on anatomic pattern and type of nerve fiber involvement and ability to perform basic neurologic examination reliably can help determine how to pursue further investigations and identify those patients who a...
Source: Clinics in Geriatric Medicine - March 23, 2021 Category: Geriatrics Authors: Rajeev Motiwala Source Type: research
Electrodiagnostic Testing for Disorders of Peripheral Nerves
Nerve conduction studies and electromyography are useful diagnostic tools that neurologists use to diagnose diseases of the peripheral nerves, neuromuscular junction, and muscles. These tests are considered an extension of clinical history and examination, and their results should always be interpreted with the clinical context. Neuromuscular diseases are common and affect a large proportion of the elderly population. With an aging population in expansion, these diseases are expected to become even more prevalent. It is important to highlight the basics of electrophysiology and provide a reference for providers who are pla...
Source: Clinics in Geriatric Medicine - March 23, 2021 Category: Geriatrics Authors: Joseph M. Choi, Gianluca Di Maria Source Type: research
Common Compression Neuropathies
Compression neuropathies, also known as entrapment neuropathies, are common neurologic conditions seen in medicine. These often are due to mechanical injury, either compression or stretch of the affected nerve, and initially result in focal demyelinating changes. If left untreated, secondary axonal injury and lasting disability can result. Patients typically present with pain, sensory changes, and potentially weakness in the distribution of the affected nerve; therefore, a basic knowledge of neuromuscular anatomy is necessary to identify these conditions. Initial treatment of mild to moderate cases often is conservative. I...
Source: Clinics in Geriatric Medicine - March 23, 2021 Category: Geriatrics Authors: Svetlana Faktorovich, Asia Filatov, Zufe Rizvi Source Type: research
Diverticulosis, Diverticulitis, and Diverticular Bleeding
Diverticulosis is an anatomic change in the colon that is characterized by outpouching of the mucosa and submucosa through the muscularis. Its prevalence increases with age so most of the elderly patients have this condition. Although diverticulosis is common, diverticular disease, in which there are clinical sequelae, is rare. This collective term includes diverticulitis, diverticular hemorrhage and less well-defined entities such as segmental colitis associated with diverticulosis, and symptomatic uncomplicated diverticular disease. Diverticulitis presents as acute lower abdominal pain, and initial management traditional...
Source: Clinics in Geriatric Medicine - November 17, 2020 Category: Geriatrics Authors: David Wan, Tibor Krisko Source Type: research
Upper Gastrointestinal Bleeding
Upper gastrointestinal (GI) bleeding is a common reason for hospital admission in older adult patients and carries a high morbidity and mortality if not properly managed. Risk factors include advanced age, Helicobacter pylori infection, medication use, smoking, and history of liver disease. Patients with known or suspected liver disease and suspected variceal bleeding should also receive antibiotics and somatostatin analogues. Risk stratification scores should be used to determine patients at highest risk for further decompensation. Upper endoscopy is both a diagnostic and therapeutic tool used in the management of upper G...
Source: Clinics in Geriatric Medicine - November 17, 2020 Category: Geriatrics Authors: Nicholas J. Costable, David A. Greenwald Source Type: research
Gastroenterology
CLINICS IN GERIATRIC MEDICINE (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 17, 2020 Category: Geriatrics Authors: Amir E. Soumekh, Philip O. Katz Source Type: research
Copyright
ELSEVIER (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 17, 2020 Category: Geriatrics Source Type: research
Contributors
AMIR E. SOUMEKH, MD (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 17, 2020 Category: Geriatrics Source Type: research
Contents
Amir E. Soumekh and Philip O. Katz (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 17, 2020 Category: Geriatrics Source Type: research
Forthcoming Issues
Peripheral Nerve Disease in the Geriatric Population (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 17, 2020 Category: Geriatrics Source Type: research
Nutrition and Weight Management in the Elderly
“Aging alters the way the body digests food, absorbs nutrients, and metabolizes energy. Changes in deglutition, digestion, and metabolism in this population are well described and may lead to alterations in oral intake, body composition, and overall health status. Elderly persons are at high risk for developing sarcopenia as well as sarcopenic obesity characterized by accelerated reduction in lean muscle mass and enhancement of body fat. Nutritional screening is important to identify high-risk individuals and facilitate care management planning. The most common assessment tool in elderly pat ients is the Mini Nutritional...
Source: Clinics in Geriatric Medicine - November 2, 2020 Category: Geriatrics Authors: Carolyn Newberry, Gregory Dakin Source Type: research
Nonsteroidal Antiinflammatory Drugs, Anticoagulation, and Upper Gastrointestinal Bleeding
Advanced age, history of peptic ulcer disease, Helicobacter pylori, coadministration of nonsteroidal antiinflammatory drugs (NSAIDs), corticosteroids, anticoagulation, and antiplatelets are risk factors for gastrointestinal bleeding in the elderly. Awareness of these risks and appropriate use of NSAIDs, particularly in those needing antiplatelet or anticoagulant therapy, is critical to optimal management. Careful selection of elderly patients requiring antiplatelet, anticoagulation, or chronic NSAID therapy for cotherapy with proton pump inhibitors can significantly reduce morbidity and mortality from gastrointestinal blee...
Source: Clinics in Geriatric Medicine - October 31, 2020 Category: Geriatrics Authors: Mindy Winghin Lee, Philip O. Katz Source Type: research
Evaluation and Treatment of Constipation in the Geriatric Population
Chronic constipation affects one-third of the US population and occurs disproportionately in the elderly and female individuals, increasing in older individuals who are institutionalized. This condition has a significant impact on health care costs and quality of life. Clinicians need to consider primary as well as secondary causes of constipation in elderly individuals because the cause is often multifactorial. Diagnostic algorithms should eliminate red-flag symptoms that may indicate a malignancy but also consider pelvic floor dysfunction, which is more common in this age group. An appropriate treatment plan is tailored ...
Source: Clinics in Geriatric Medicine - October 31, 2020 Category: Geriatrics Authors: Susan Lucak, Tisha N. Lunsford, Lucinda A. Harris Source Type: research
Common Diarrheal Illnesses in the Elderly
Diarrhea is a fairly common problem among the elderly that has a higher morbidity and mortality compared with the general population. There are multiple reasons for diarrhea in the elderly that can be stratified by different mechanisms: infectious, osmotic, secretory, inflammatory, and malabsorptive. Oral hydration and dietary management are the basic management principles for all forms of diarrhea but specific treatment should address the root cause of diarrhea in order to improve outcomes. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 31, 2020 Category: Geriatrics Authors: Enad Dawod, Carl V. Crawford Source Type: research
