Modulating Effect of Contextual Factors on Factor Structure and Reliability of SARC-F
We read with interest the study by Woo et  al which concluded that the 5-item SARC-F may be shortened to 3 items by dropping the items on “rise from a chair” and “falls.”1 (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 13, 2018 Category: Health Management Authors: Wee Shiong Lim, Laura Tay, Audrey Yeo, Suzanne Yew, Noor Hafizah, Yew Yoong Ding Tags: Letter to the Editor Source Type: research

Long-term Care Status in Centenarians and Younger Cohorts of Oldest Old in the Last 6  Years of Life: Trajectories and Potential Mechanisms
A large proportion of the oldest old and centenarians live in long-term care facilities. Although there may be distinct care patterns in centenarians compared with other cohorts of oldest old, the exact development concerning prevalence, length of stay, and factors that are associated with long-term care status in the last years before death is unknown. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 13, 2018 Category: Health Management Authors: Paul Gellert, Simon Eggert, Christine Zwillich, Stefan H örter, Adelheid Kuhlmey, Dagmar Dräger Tags: Original Study Source Type: research

Identifying and Supporting Nonpharmacological Dementia Interventions Ready for Pragmatic Trials: Results From an Expert Workshop
In October 2017, the National Institute on Aging (NIA) convened the National Research Summit on Care, Services and Supports for Persons with Dementia and their Caregivers. The summit was a national 2-day research conference to discuss accelerating improvements in care for people with Alzheimer's disease and related dementias (ADRD) and their caregivers.1 Improving ADRD care is a national priority.2 Over 5 million Americans currently live with ADRD; the lifetime cost of caring for a person with ADRD is $321,780,3 and on a population level annual costs exceed $226 billion. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 13, 2018 Category: Health Management Authors: Rosa R. Baier, Susan L. Mitchell, Eric Jutkowitz, Vincent Mor Tags: Editorial Source Type: research

Does Cognitive Impairment and Agitation in Dementia Influence Intervention Effectiveness? Findings From a Cluster-RCT With the Therapeutic Robot, PARO
To explore whether severity of cognitive impairment and agitation of older people with dementia predict outcomes in engagement, mood states, and agitation after a 10-week intervention with the robotic seal, PARO. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 13, 2018 Category: Health Management Authors: Cindy Jones, Wendy Moyle, Jenny Murfield, Brian Draper, David Shum, Elizabeth Beattie, Lukman Thalib Tags: Brief Report Source Type: research

Research Long-term Cognitive Impairment After Off-Pump Versus On-Pump Cardiac Surgery: Involved Risk Factors
Off-pump cardiac surgery was developed to reduce perioperative complications associated with the use of cardiopulmonary bypass ( “on-pump”), including neurologic injury.1 Postoperative cognitive impairment (PCI) is considered to be a relevant neurologic complication after cardiac surgery.2,3 Cardiopulmonary bypass and nonspecific surgery factors have been related to PCI but the evidence is inconclusive.3–5 PCI is define d as a decline in performance on neuropsychological tests relative to preoperative levels and several cognitive domains could be affected. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 10, 2018 Category: Health Management Authors: Luis M. P érez-Belmonte, Mercedes Florido-Santiago, Mercedes Millán-Gómez, Miguel A. Barbancho, Ricardo Gómez-Huelgas, José P. Lara Tags: Letter to the Editor Source Type: research

Process Evaluation of an Intervention for the Management of Neuropsychiatric Symptoms in Young-Onset Dementia
A process evaluation was performed for an intervention aimed at improvement of the management of neuropsychiatric symptoms in young-onset dementia. Data about sample quality and intervention quality was evaluated to better understand internal and external validity. In addition, data about the implementation strategy and factors affecting implementation were evaluated to improve further implementation of the intervention. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 10, 2018 Category: Health Management Authors: Britt Appelhof, Christian Bakker, Jeannette C.L. van Duinen-van den IJssel, Sandra A. Zwijsen, Martin Smalbrugge, Frans R.J. Verhey, Marjolein E. de Vugt, Sytse U. Zuidema, Raymond T.C.M. Koopmans Tags: Original Study Source Type: research

Urban-Rural Differences in Skilled Nursing Facility Rehospitalization Rates
To examine the association of rurality with skilled nursing facility (SNF) all-cause 30-day risk-adjusted rehospitalization rates. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 10, 2018 Category: Health Management Authors: Jan P. Clement, Jaya Khushalani, Marianne Baernholdt Tags: Original Study Source Type: research

Research Long-term Cognitive Impairment After Off-Pump Versus On-Pump Cardiac Surgery: Involved Risk Factors
Off-pump cardiac surgery was developed to reduce perioperative complications associated with the use of cardiopulmonary bypass ( “on-pump”), including neurologic injury.1 Postoperative cognitive impairment (PCI) is considered to be a relevant neurologic complication after cardiac surgery.2,3 Cardiopulmonary bypass and nonspecific surgery factors have been related to PCI but the evidence is inconclusive.3–5 PCI is define d as a decline in performance on neuropsychological tests relative to preoperative levels and several cognitive domains could be affected. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 10, 2018 Category: Health Management Authors: Luis M. P érez-Belmonte, Mercedes Florido-Santiago, Mercedes Millán-Gómez, Miguel A. Barbancho, Ricardo Gómez-Huelgas, José P. Lara Tags: Letter to the Editor Source Type: research

Process Evaluation of an Intervention for the Management of Neuropsychiatric Symptoms in Young-Onset Dementia
A process evaluation was performed for an intervention aimed at improvement of the management of neuropsychiatric symptoms in young-onset dementia. Data about sample quality and intervention quality was evaluated to better understand internal and external validity. In addition, data about the implementation strategy and factors affecting implementation were evaluated to improve further implementation of the intervention. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 10, 2018 Category: Health Management Authors: Britt Appelhof, Christian Bakker, Jeannette C.L. van Duinen-van den IJssel, Sandra A. Zwijsen, Martin Smalbrugge, Frans R.J. Verhey, Marjolein E. de Vugt, Sytse U. Zuidema, Raymond T.C.M. Koopmans Tags: Original Study Source Type: research

Urban-Rural Differences in Skilled Nursing Facility Rehospitalization Rates
To examine the association of rurality with skilled nursing facility (SNF) all-cause 30-day risk-adjusted rehospitalization rates. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 10, 2018 Category: Health Management Authors: Jan P. Clement, Jaya Khushalani, Marianne Baernholdt Tags: Original Study Source Type: research

Who Is Responsible? A Man With Dementia Wanders From Home, Is  Hit by a Train, and Dies
The impact of dementia and Alzheimer's disease extends far beyond the healthcare needs of the person with dementia. As the disease progresses, individuals with dementia often require ongoing formal or informal care for their basic daily routine because of behavior changes and continuing loss of cognitive function. Most of the care for people with dementia takes place at home, and the unpaid, informal caregivers are often spouses or other relatives. Providing long-term informal care at home for someone with dementia is psychologically, physically, and financially draining. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 27, 2018 Category: Health Management Authors: Yuchi Young, Maksim Papenkov, Taeko Nakashima Tags: Controversies in Long-term Care Source Type: research

Can Sepsis Be Detected in the Nursing Home Prior to the Need for Hospital Transfer?
To determine whether and to what extent simple screening tools might identify nursing home (NH) residents who are at high risk of becoming septic. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 26, 2018 Category: Health Management Authors: Philip D. Sloane, Kimberly Ward, David J. Weber, Christine E. Kistler, Benjamin Brown, Katherine Davis, Sheryl Zimmerman Tags: Original Study Source Type: research

Physical Activity and Sarcopenia in the Geriatric Population: A  Systematic Review
Sarcopenia is an aging-related health problem in the geriatric population. Sarcopenia reduces muscle mass, muscle strength, and physical performance. Although physical activity is protective against sarcopenia for older adults, there are limited studies in this area. The purpose of this study was to integrate and analyze research on physical activity and sarcopenia in the geriatric population. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 26, 2018 Category: Health Management Authors: Szu-Ying Lee, Heng-Hsin Tung, Chieh-Yu Liu, Liang-Kung Chen Tags: Review Article Source Type: research

Prophylaxis of Venous Thromboembolism in Geriatric Settings: A  Cluster-Randomized Multicomponent Interventional Trial
To evaluate the efficacy of an intervention on the practice of venous thromboembolism prevention. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 26, 2018 Category: Health Management Authors: Jean Paul Rwabihama, Etienne Audureau, Marie Laurent, Lalaina Rakotoarisoa, Marc Jegou, Sofiane Saddedine, S ébastien Krypciak, Stéphane Herbaud, Hind Benzengli, Lauriane Segaux, Esther Guery, Gabin Ambime, Marie-Thérèse Rabus, Jean-Guy Perilliat, Jea Tags: Original Study Source Type: research

Can Sepsis Be Detected in the Nursing Home Prior to the Need for Hospital Transfer?
To determine whether and to what extent simple screening tools might identify nursing home (NH) residents who are at high risk of becoming septic. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 26, 2018 Category: Health Management Authors: Philip D. Sloane, Kimberly Ward, David J. Weber, Christine E. Kistler, Benjamin Brown, Katherine Davis, Sheryl Zimmerman Tags: Original Study Source Type: research

Physical Activity and Sarcopenia in the Geriatric Population: A  Systematic Review
Sarcopenia is an aging-related health problem in the geriatric population. Sarcopenia reduces muscle mass, muscle strength, and physical performance. Although physical activity is protective against sarcopenia for older adults, there are limited studies in this area. The purpose of this study was to integrate and analyze research on physical activity and sarcopenia in the geriatric population. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 26, 2018 Category: Health Management Authors: Szu-Ying Lee, Heng-Hsin Tung, Chieh-Yu Liu, Liang-Kung Chen Tags: Original Study Source Type: research

Prophylaxis of Venous Thromboembolism in Geriatric Settings: A  Cluster-Randomized Multicomponent Interventional Trial
To evaluate the efficacy of an intervention on the practice of venous thromboembolism prevention. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 26, 2018 Category: Health Management Authors: Jean Paul Rwabihama, Etienne Audureau, Marie Laurent, Lalaina Rakotoarisoa, Marc Jegou, Sofiane Saddedine, S ébastien Krypciak, Stéphane Herbaud, Hind Benzengli, Lauriane Segaux, Esther Guery, Gabin Ambime, Marie-Thérèse Rabus, Jean-Guy Perilliat, Jea Tags: Original Study Source Type: research

Erratum
The Journal of the American Medical Directors Association (JAMDA) apologizes for errors in the organization name for the following article. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 22, 2018 Category: Health Management Tags: Erratum Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 22, 2018 Category: Health Management Source Type: research

Table of Contents
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 22, 2018 Category: Health Management Source Type: research

General Information
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 22, 2018 Category: Health Management Source Type: research

Directions & Connections
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 22, 2018 Category: Health Management Source Type: research

Can Muscle Strength Be Considered a Composite Biomarker of Sarcopenia?
Changes in the age-specific prevalence and severity of functional impairment are expected to have major implications for health care costs.1 According to the Global Health and Aging report released by the World Health Organization, “the number of people aged 65 or older is projected to grow from an estimated 524 million in 2010 to nearly 1.5 billion in 2050, with most of the increase in developing countries.”2 Although aging is not synonymous with poor health or loss of independence, the risk of developing diseases and dis abilities increases with advancing age. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 17, 2018 Category: Health Management Authors: Francesco Landi, Riccardo Calvani, Anna Picca, Emanuele Marzetti Tags: Editorial Source Type: research

Representation in the Care Planning Process for Nursing Home Residents With Dementia
We describe the prevalence of family participation in the care planning process for long-stay NH residents with varying degrees of cognitive impairment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 10, 2018 Category: Health Management Authors: Ellen McCreedy, Lacey Loomer, Jennifer A. Palmer, Susan L. Mitchell, Angelo Volandes, Vincent Mor Tags: Original Study Source Type: research

Age-related hearing loss and communication at a PACE Day Health Center
For the nearly two-thirds of adults older than 70  years with hearing loss,1 trying to understand speech in a noisy environment can be difficult and may lead to social withdrawal.2,3 Given the importance of social engagement to healthy aging,4 enhancing communication for adults is important. The Program for All-inclusive Care for the Elderly (PACE ) is a comprehensive health care program for adults who are aged ≥55 years, nursing home eligible, and living in the community at the time of enrollment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 8, 2018 Category: Health Management Authors: Sara K. Mamo, Samantha J. Mayhew, Olivia Nirmalasari, Esther S. Oh, Matthew K. McNabney, Jack Rund, Frank R. Lin Tags: Letter to the Editor Source Type: research

Research on Frailty: Continued Progress, Continued Challenges
Frailty is a geriatric syndrome characterized by impaired performance and reduced functional reserve across multiple physiologic systems, and associated with increased vulnerability to adverse health outcomes from stressor events.1,2 It has gained increased attention in clinical medicine and health policy largely because of its high prevalence at advanced age and predictive capacity for negative outcomes (including falls, fractures, increased dependency in activities of daily living, hospitalizations, nursing home placement, and death). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 8, 2018 Category: Health Management Authors: Philip D. Sloane, Matteo Cesari Tags: Editorial Source Type: research

Age-related hearing loss and communication at a PACE Day Health Center
For the nearly two-thirds of adults older than 70  years with hearing loss,1 trying to understand speech in a noisy environment can be difficult and may lead to social withdrawal.2,3 Given the importance of social engagement to healthy aging,4 enhancing communication for adults is important. The Program for All-inclusive Care for the Elderly (PACE ) is a comprehensive health care program for adults who are aged ≥55 years, nursing home eligible, and living in the community at the time of enrollment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 8, 2018 Category: Health Management Authors: Sara K. Mamo, Samantha J. Mayhew, Olivia Nirmalasari, Esther S. Oh, Matthew K. McNabney, Jack Rund, Frank R. Lin Tags: Letter to the Editor Source Type: research

Screening Sarcopenia in Community-Dwelling Older Adults: SARC-F vs SARC-F Combined With Calf Circumference (SARC-CalF)
To compare the diagnostic value of the 5-component questionnaire that measures strength, assistance walking, rise from a chair, climb stairs, and falls (SARC-F) and SARC-F combined with calf circumference (SARC-CalF) for screening sarcopenia in community-dwelling older adults. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Ming Yang, Xiaoyi Hu, Lingling Xie, Luoying Zhang, Jie Zhou, Jing Lin, Ying Wang, Yaqi Li, Zengli Han, Daipei Zhang, Yun Zuo, Ying Li, Linna Wu Tags: JAMDA Online Source Type: research

A Case of Flecainide Induced Cardiac Arrythmia Due to Polypharmacy
Flecainide is a class IC anti-arrhythmic agent recommended for maintenance of sinus rhythm in patients with atrial fibrillation and/or supraventricular tachycardia who don't have structural heart disease. Flecainide is well known to be pro-arrhythmic as well. Polypharmacy is defined as taking four or more drugs by a patient. Polypharmacy is common in eledryl population with an estimated prevalence of 40%. Polypharmacy poses a significant hazard due to significant durg-drug interactions. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Mohamed Mortagy, M. Mortagy Tags: Case Report Source Type: research

A Case of Peri-mucositis: The Importance of the Oral Cavity Exam in Evaluating New Behavioral Disturbance in a Patient with Advanced Dementia
With the growth in the aging population, poor dentition and the incidence of dental implants is on the rise. Dental implants have a high association with peri-mucositis and peri-implantitis, which is a source of discomfort in patients and can be a source of agitation and cause of behavioral disturbance in patients with dementia who cannot verbalize their discomfort. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Kledia Blloshmi, K. Blloshmi, K. Sharma Tags: Case Report Source Type: research

A Miracle Cure - Novel Treatment Regimen for Recurrent UTI in Neurogenic Bladder
This is a case showing successful management of recurrent UTI by gentamicin bladder instillations in a patient with neurogenic bladder in long-term care setting. This innovative treatment model significantly eliminated multiple inpatient hospitalizations, reduced MDRO infection and improved quality of life in our case patient. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Shenbagam Dewar, S. Dewar Tags: Case Report Source Type: research

Acquired Hemophilia A Misdiagnosed as Cellulitis
Acquired Hemophilia A (AHA) is rare bleeding disorder caused by inhibitors (auto-antibodies) to factor VIIIA. (1,2) It is associated with severe bleeding. AHA clinical presentation is different from the inherited hemophilia that leads to misdiagnosis. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Joel Goodin, D. Hasan, J.B. Goodin, K. Chaffee, A. Riggs Tags: Case Report Source Type: research

Acrokeratosis Paraneoplastica: A Harbinger of Hidden Malignancy
A rare case of severe seborrheic type dermatoses which is not responding to conventional treatment can be the first presenting symptom of an underlying Malignancy. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Joel Goodin, M. Kodali, J.B. Goodin, B.Z. Ozdemir Tags: Case Report Source Type: research

Aging with Cancer: A Comprehensive and Multidisciplinary Approach
Older population is increasing; 46.2 million of people were 65 and older in 2014, and for 2060 this number will double. Cancer is a frequent condition in this group. It is estimated that 70% of cancers in the US will affect patients above 65. Dealing with cancer in older adults places primary care physicians, geriatricians and oncologists in front of new medical and ethical challenges, especially considering the limited research and education focused in this topic, and that the information described in guidelines does not necessarily apply to this group that has multiple active medical conditions. (Source: Journal of the A...
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Miriam Zylberglait Lisigurski, M. Zylberglait Lisigurski, F. Farooqi, A. Sintow, H. Feiz Tags: Case Report Source Type: research

Asymptomatic Persistent Eosinophilia in Elderly Female
The most common disorders associated with an eosinophilia are infection (especially parasitic), allergy, drugs and hypersensitivity disorders (such as asthma, acute urticaria, and atopic dermatitis); these account for>95% of cases. Less common reactive causes are GVHD, Churg-Strauss syndrome, connective tissue and autoimmune disease. Literature talks less about it, although surgical mesh has been associated with more robust GVD and immune complications. There is a paucity of literature with respect to elderly with such conditions, even though the elders are more likely to have undergone such surgeries and therefore, at ...
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Raza Haque, R. Haque Tags: Case Report Source Type: research

Battlefield Acupuncture for Pain Management after Hip Surgery
We present a nonpharmacological treatment for a demented patient who suffered from severe postoperative pain. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Rezanne Khalil, R. Khalil, X. Shao Tags: Case Report Source Type: research

Delirium in Dementia: Looking Beyond the Basics
Delirium with underlying dementia is often misconstrued as dementia associated with behavioral disturbances leading to inappropriate management and prescription. It's paramount to understand the natural progression of both syndromes. Healthcare providers must remain cognizant of the significance of a thorough H&P when formulating a diagnosis as well as a care plan. Providers must remain open to various diagnoses in the absence of a clear etiology. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Noel Yarze, N. Yarze, J. Mwesige Tags: Case Report Source Type: research

Hypoglycemia in a Skilled Nursing Facility Resident
Patients admitted to Skilled Nursing Facilities (SNF) for post-acute care often have complex medication regimens. Frequently the medication schedule is modified during prior hospitalization. SNF patients are vulnerable to adverse drug events (ADE) during these times of transition. Insulin is a medication that is frequently associated with ADE in SNFs. The increasing prevalence of obesity linked to insulin resistance in the United States has created the need to use larger doses of insulin. Since 1994 a Regular insulin U-500 vial, a concentrated form of regular insulin (500 units/ml), is available. (Source: Journal of the Am...
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Daniel Sanchez Pellecer, D.E. Sanchez Pellecer, K. Thyssen, A. Chandra Tags: Case Report Source Type: research

Jehovah ’s Witnesses and Bloodless Medicine: What the Care Team Needs to Know
Jehovah ’s Witnesses (JWs), a denomination of Christianity, are unique in their refusal of blood transfusions. Better understanding of JWs, why they refuse blood transfusions, and the acceptable alternatives will help providers uphold patient autonomy, while optimally treating anemia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Gerdie Jean-Smith, G. Jean-Smith, R. Gopalraj Tags: Case Report Source Type: research

Low Dose Steroid Replacement Therapy Causes Hepatitis B Virus Reactivation in Long-term Health Care Facility Patient
We present a case of HBV reactivation in a post-acute long-term patient on low dose steroid replacement therapy. Low dose steroid replacement therapy is not well described as a cause HBV reactivation. This case illustrates that long-term facility residents are at risk of HBV reactivation with low dose steroid replacement therapy. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Ahmed Eltanbedawi, A.N. Eltanbedawi Tags: Case Report Source Type: research

Perforated Appendicitis in a Nursing Home Resident with Advanced Multiple Sclerosis
Acute appendicitis is the most common surgical emergency and becomes serious when it perforates. The principal presenting complaint of patients with acute appendicitis is abdominal pain. The diagnosis may be missed in patients with neurological disorders- in this case multiple sclerosis (MS) and quadriplegia-who do not complain of pain. There are limited research and practice guidelines for patients with chronic neurodegenerative disorders with acute abdomen. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Paria Pourmalek, X. Shao, P. Pourmalek, N. Taheri Tags: Case Report Source Type: research

Prevention of Rehospitalization in Non-Compliant Patients Utilizing Transitional Care Program (TCM): A Bundle Payment Care Initiative (BPCI Model 3) Case Study
A case of post Skilled Nursing Facility (SNF) rehospitalization prevention using CMEC transitional care protocol in a non-compliant patient. This patient underwent right lower extremity major joint replacement and was participating in BPCI Model 3 program with 90-day episode risk sharing. The SNF assumes risk for all services provided within the episode. This includes services provided directly by the SNF and those delivered by other providers including any Part A and Part B services i.e. physician services, DME, services provided by another PAC provider and related acute readmissions. (Source: Journal of the American Medi...
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Chandan Cheema, A. Narwan, R. Brar, C. Cheema Tags: Case Report Source Type: research

Rare Cutaneous Melanoma in a Centenarian
Malignant cutaneous neoplasms with combined phenotypical features of high-grade basal cell carcinoma& malignant melanoma are exceptionally rare. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Saeeda Qadri, S. Qadri, P. Coll Tags: Case Report Source Type: research

Urethral Polyembolokoilamania: An Unusual Cause of Urinary Incontinence and Scrotal Pain
Foreign bodies in the bladder are among the rarest differential diagnoses in the lower urinary tract symptoms and may be missed in initial medical evaluations. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Ashley Sarasan, A. Sarasan, A. Chandra, R. Connolly Tags: Case Report Source Type: research

Wellens' Warning: A Case of Critical Stenosis
Wellens' Syndrome, also known as Coronary T-wave Inversion Syndrome, was identified in the 1980's after a group of patients with unstable angina and characteristic precordial T wave changes on electrocardiogram (ECG) went on to develop large anterior myocardial infarctions. ECG findings are due to critical stenosis in the proximal left anterior descending (LAD) artery. Of patients who present with unstable angina, this ECG pattern is present in 14-18% of cases. Progression from Wellens' Syndrome to anterior myocardial infarction occurs after a mean of 8.5 days and the unique ECG pattern classically presents during chest pa...
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Katherine Thyssen, K. Thyssen, D.E. Sanchez Pellecer, M. Mendoza de la Garza, E. Tung, A. Chandra Tags: Case Report Source Type: research

When Back Pain Becomes Ominous: A Case of High Grade Neuroendocrine Carcinoma of Kidney Origin in a Geriatric Patient
Back pain is a common geriatric complaint. 70% of adults in Germany have at least one episode of back pain a year. Consistently back pain ranks in the top 5 disabling disorders in the United states. Multiple providers including chiropractors are often consulted, Unfortunately, back pain can be a herald sign for serious pathology and this is commoner in the elderly. Red flags including onset with minimal injury, unintentional weight loss of at least 10% of body weight in 6 months are pointers to non-benign nature. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Olusola Onoviran, O.F. Onoviran Tags: Case Report Source Type: research

When Back Pain Is Not Benign: A Case of Spinal Osteomyelitis and Diskitis
Back pain is a common complaint in the post acute and long term case setting. The most common causes include musculoskeletal pain and degenerative disease, but back pain may also be secondary to more serious causes, such as malignancy and infection. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 22, 2018 Category: Health Management Authors: Caitlin Jones, C. Jones, T. Rose, J. Thomas Tags: Case Report Source Type: research