Wake up babe, new @societyhospmed.bsky.social Rapid Clinical Update on #insomnia in the hospital!
And LOOK! 👀It's one of our digital media fellows, @jawoodardmd.bsky.social! With @ethanmh.bsky.social and @vineetaroramd.bsky.social!
Check it out \WEDNESDAY! Live or later!
https://t.co/rOAkxaCZBW
Garmin needs a physician mode for the times you're working nights because I'm pretty sure my watch thinks I'm on the brink of death this week
Also go get vaccinated! Walgreens does NOT require a prescription for flu or COVID.
Finally a day off after 8 days of work/conferencing and I'm so glad it's fall candle season because this Mulled Cider candle is ~hitting~
My biggest contribution to medicine this year has been via memes about Taylor and Travis and I think I feel pretty good about it? @jhospmedicine.bsky.social #twdfnr
So proud of all the med students and residents submitting case reports with me 😭
Deprescribing insulin for older adults is my *favorite* - less discomfort all around!
Excited and grateful that we were chosen for this grant - can't wait to build this Geriatrics education sim! #gerisky #geriatrics #meded www.medicine.wisc.edu/news/051625-...
Great narrative medicine session this morning at #SGIM25 with a great crew! @societygim.bsky.social
Thickened liquids have *thin* evidence for mortality benefit. Risks for dehydration, decreased food intake, decreased quality of life with modified liquids.
#ags25 #agslitreview @amergeriatrics.bsky.social #thickenedliquidchallenge
Limitations - timing unclear, missing confounders, dietary fluidity in groups.
Higher rates of respiratory complications in thick liquids, lower risk of intubation. No change in in-hospital mortality.
Over 13k patients, 1/3 received thickened liquids for most of hospital stay.
One RCT showed no difference between thickened liquids and chin tuck (aspiration risk was the same)
Thick liquids and outcomes in Alzheimer's disease - retrospective cohort study comparing hospitalized patients with dementia who had thick vs thin liquids for >75% of hospital stay.
Routine cath/PCI is not indicated in patients over 75 admitted for NSTEMI! #ags25 #agslitreview @amergeriatrics.bsky.social
All cause mortality was higher in invasive group (36.1%) vs conservative (32.3%) - though not statistically significant. HR 1.13 (CI 0.95-1.34)
SENIOR-RITA RCT looked at 1518 people admitted with NSTEMI. Looked over 4.1 years for CV death or non-fatal MI - similar rates invasive vs conservative (HR 0.94).
What to do with NSTEMI patients over age 75? Conservative therapy vs PCI
#ags25 #agslitreview @amergeriatrics.bsky.social @ewidera.bsky.social @alexsmithmd.bsky.social
Specifically looked at PSA testing, urine testing, and diabetes over treatment.
No differences between study groups for hospitalizations, harms. Some previously controlled diabetics had increased A1c > 9%
Can we reduce unnecessary testing for older adults?
18 mo study in primary care clinics with intervention nudges, case education
The more difficult it is for patients to see us, the more they are seeing us. How can we decrease the burden on patients?
#ags25 #agslitreview @amergeriatrics.bsky.social
Factors associated with increased healthcare contact -
Increased age, female sex, ADL difficulty, behavioral characteristics (do you see the doctor as soon as you are feeling bad?)
Health care contact days for older adults with the health system - it is a burden on patients and caregivers to see us and patients may prefer to spend their time in activities other than medical visits.
Maybe blood markers are useful in mild dementia or MCI if deciding on anti-amyloid therapy. NOT useful in normal cognitive function, moderate or severe dementia. 🧠
#ags25 #agslitreview @amergeriatrics.bsky.social
Blood biomarkers had 92% CSF biomarker accuracy and was better than clinician guess - but was it clinically useful?
Study in Sweden in primary care and memory clinics - patients with cognitive symptoms ranging from subjective concerns to dementia. Compared blood vs CSF biomarkers and clinician guess
Blood based biomarkers for AD - could be helpful for differentiating from other forms of dementia but not helpful for screening.
