Geriatric Registrar I need some big hitters to give my lowly free website abcmedicalnotes.com a push. Its an amazing FREE resource by one person working solidly night and day for 10 years. From a Gerries doc in the UK. Please RT

Being surprised that your patient used to drive a car, or walk before admission, is not something that should happen to you several weeks into an admission.

Hospital clinicians sometimes cannot believe their patients used to be able to do some things not that long ago, or that they might in the future. It’s because we see patients at their lowest and we don’t see them before they were unwell, or after

Sean Ninan @Andromedary123 Jacob de Wolff 🇳🇱🚲☕️ Agreed impact of calcium supplementation alone on fracture in most people is minimal. Even bisphosphonates shown to be efficacious without calcium supplementation. However calcium supplementation (and vitamin D) in people at risk of deficiency important, especially if on Dmab.

1) look for infection, but don’t panic if no sign of infection because you can 2) rehydrate 3) treat constipation 4) stop anticholinergics 5) treat urinary retention (normally caused distressed behaviour) 6) give analgesia 7) assist with food 8) reorientate 9) involve caregivers

Not heard this phrase before but I like it. Huge advantages to being an outsider. It means you’ve observed how to fit into different situations. Code Switch | NEJM nejm.org/doi/full/10.10…

Restrictive transfusion strategy for MI jamanetwork.com/journals/jama/…

amazing how deep the myth of contrast nephropathy has seeped into the medical literature. if you have a critically ill patient who needs a CT angio, just get the CT angio. don't pass go, don't collect 200$, don't check the creatinine - just get the scan. pubmed.ncbi.nlm.nih.gov/32668115/

Nice paper going into detail on Rockwood CFS scoring, and some tweaks to terminology. ncbi.nlm.nih.gov/pmc/articles/P…

Imagine. For every older person that comes into hospital, all the MDT know how they normally walk, and how they walk now, and why that’s different. We track this progress like we track bloods. ncbi.nlm.nih.gov/pmc/articles/P…. Kenneth Rockwood

Sadly, I’ve seen this. “Home when completed remdesevir.” If you’re keeping patients in to complete remdesevir, you’ve really completely missed the point that was never really there in the first place…It is depressing how we’ve all gone along with this

For all frail older people in hospital…How do they walk/function now? How do they normally function? If there is a gap, what are the reasons?

Wow. This is a long but important review. Thanks Mikel Izquierdo and @lucy_bul Key messages: exercise is great for older people and for frail people. Don’t be afraid to encourage *challenging* levels of exertion. Sustainability is key, eg one leg washing up! 😊🕺🏻🏃🏽‍♂️💃🏋️‍♂️🎖🎖🎖

Key messages for recognising and referring patients with #dysphagia in hospital to #SLT RCSLT 💙

REVIEW: Rockwood et al. write about the degree of #frailty as a translational measure of health in #aging - from comprehensive geriatric assessment and individual care plans to #geroscience and back @KrocDoc Susan Howlett Dalhousie University nature.com/articles/s4358…

Maimonides first differentiated between sarcopenia, cachexia and malnutrition. Geriatric Registrar Geriatrics at Yale David Oliver (also on Blue Sky) Desmond (Des) O'Neill @Geriminion @mia_geri28 @macesari Martin Vernon Rolland Yves Defeat Malnutrition Today @anorexiajunkie Journal of Cachexia, Sarcopenia and Muscle

Maimonides was first to identify the common causes of weight loss Desmond (Des) O'Neill David Oliver (also on Blue Sky) @macesari Reshma Merchant Geriatric Registrar @Geriminion @mia_geri28

POPS British Geriatrics Society Geriatric Registrar