Our outdated and inflexible system was not able to manage my cancer properly, says Dr Andrew Lawson
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Monday, 5 August 2013
Dr Andrew Lawson: 'If I'd relied solely on the NHS to treat me, I might well be dead'
Would you be a geriatrician? Student career preferences and attitudes to a career in geriatric medicine
Background: career intentions of medical students may impact on education and workforce planning. We sought to determine (i) career choices of senior medical students; (ii) interest in geriatric medicine; (iii) factors influencing such choices; and (iv) the impact of a 6-week Medicine in the Community module.
Methods: cross-sectional survey of all senior UCD medical students, before and after completion of a ‘Medicine in the Community’ module, 2009–11.
Results: eighty-two per cent (274/336) completed the survey at module's end. Two-thirds (174) had chosen a future speciality, most frequently general practice (32.1%) and internal medicine (17%). Half (49.8%) believed career selection is made during medical school. Thirty-one per cent would consider a career in geriatric medicine; reasons cited were interesting field (34.5%), clinical variety (25%) and perception as emotionally rewarding (20.2%). Commonest deterrents were perceived slowness-of-pace and not wanting to work with older patients. Female students (adjusted OR: 1.89, P = 0.05) and those prioritising travel opportunities (adjusted OR: 2.77, P = 0.01) were more likely to consider geriatric medicine. Half (51.5%) reported that the community medicine module increased their interest in geriatric medicine; 91.3% that it would positively influence how they treated older patients. Students reporting a positive influence of the module were more likely to consider a career in geriatric medicine (OR: 1.62, P = 0.02).
Conclusion: two-thirds of students had already chosen a future speciality. One-third would consider geriatric medicine. This may have important implications for workforce planning and development of geriatric medicine. Undergraduate exposure to the discipline may increase interest in geriatric medicine as a career, and positively influence management of older patients.
Inoperable isolated cardiac hydatid cyst controlled with albendazole in an older adult with dementia
Hydatid cyst, a human parasitic disease, remains a clinical problem in undeveloped and developing countries. Although liver and lungs are regular sites of infection, rarely other organs such as the heart can be involved. Herein, we report an isolated cardiac hydatid cyst in an 87-year-old man. He had a history of dementia for 5 years and no history for cardiac or pulmonary disease. He presented with exertional dyspnoea which continued up to 6 months. The diagnosis was made by echocardiography and computed tomography (CT). The patient was inoperable and was treated with albendazole 10 mg/kg for 6 months. After a 6-month follow-up, echocardiography revealed reduction in the size of the cyst. We believe this is the first documented case of cardiac hydatid cyst which regressed with only medical treatment in an older adult with dementia.
Cross-national disparities in sex differences in life expectancy with and without frailty
Background: with continued ageing, levels of frailty are an increasing concern. Women live longer than men, but how life expectancies (LE) with frailty differ between men and women and whether sex differences are the same for all European countries is unknown.
Objective: to compare sex differences in LE in phenotypic frailty categories and disability at age ≥50 between European countries.
Design: the Survey of Health, Ageing and Retirement in Europe (SHARE).
Subjects: a total of 50,351 people aged ≥50 from SHARE wave 4 (included countries: Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Hungary, Italy, the Netherlands, Poland, Portugal, Slovenia, Spain, Sweden).
Methods: the SHARE Frailty Instrument for Primary Care and the Global Activity Limitation Indicator were combined to define four phenotypic frailty and disability categories: robust, pre-frail, frail and severely limited. LEs with each state by sex and country were calculated using Sullivan's method.
Results: at age 70, the LE robust ranged from 4.1 to 10.4 years (men) and 3.0 to 8.9 years (women), LE pre-frail from 0.8–3.1 years (men) and 2.2–5.5 years (women), LE frail from 0.1–1.8 years (men) and 0.4–5.5 years (women) and LE with severe activity limitation from 1.9 to 4.4 years (men) and 2.9 to 7.5 years (women). At all ages and both sexes the fewest years were spent frail.
Conclusions: this study is the first to compare differences in LE in frailty categories across European countries. In most European countries, years spent robust (free of frailty or limitation) are significantly less for women than men, perhaps due to socio-economic as well as biological factors.
Pensioner bailed over parking space death
The 65-year-old man was held by police following the incident at an Asda supermarket car park in Biggleswade, Bedfordshire, on Saturday. The victim, from Sandy, was taken to Addenbrookes Hospital in Cambridge, where he died yesterday afternoon, a spokesman for Bedfordshire Police said.
Man killed in parking space row
A pensioner arrested on suspicion of manslaughter after a 64-year-old man was killed in a row over a disabled parking space in Bedfordshire, has been released on bail, police said.
Sunday, 4 August 2013
OAP Has Stroke After Savage Attack In Home
A pensioner suffered a stroke after he was robbed and "savagely" beaten in his own home in Bolton, Greater Manchester.
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