Geriatric Medicine

The rise in life expectancy and fall in mortality at older ages has brought with it a fear of an increasedburden of chronic disease to society. Data suggest that these fears are perhaps overly pessimistic and thatthe proportion of one's…

Trigeminal neuralgia is a severe unilateral intermittent facial pain that is unresponsive to normal analgesics. First-line drug treatment is carbamazepine, but side-effects are common. Additionally, several surgical techniques are available…

The inexorable progression of type 2 diabetes frequently leads patients to need insulin replacement. Manybarriers exist to starting insulin therapy, including reluctance of patients to accept lifelong injections.Inhalation of insulin has…

More than 16,000 people die from bowel cancer each year in the UK. It is the second most commoncause of death from cancer.1 The aim of the NHS Bowel Cancer Screening Programme is to reducethe number of deaths by diagnosing patients at an…

We report on an unsual case of difficulty walking in an octogenerian on warfarin therapy.

Coeliac disease is an increasingly recognised autoimmune disease against gluten, a protein found infood such as wheat. This disease is controlled with a gluten-free diet. The consequences of coeliacdisease, especially if diagnosed later in…

This article discusses the evolution of central dual-energy X-ray absorptiometry (DXA) as a tool forthe diagnosis and management of postmenopausal osteoporosis. The derivation of normal values isconsidered and this is then linked with…

This article focuses on the diagnosis and treatment of men with breast cancer. Risk factors for developingthe condition are also examined. Because of the relative rarity of the condition in men, research evidenceis scant resulting in…

Alzheimer's disease seems to share the same vascular risk factors as vascular dementia and cardiovasculardisease. The evidence for this, although far from complete, continues to grow, and the potential toprevent and control Alzheimer's…

Sexual health in postmenopausal women€”a report of the meeting women of a certain age: the unspokensymptoms, held at the Royal College of Obstetricians and Gynaecologists, London, on March 11, 2008. Amix of health-care workers of differing…

This article reviews the leading causes of involuntary weight loss in older people. We look at the underlyingpsychiatric and neuropsychiatric causes including depression, dementia, and longstanding eating disorders.We consider the negative…

The classic triad of ataxia, dementia, and urinary incontinence is an increasingly recognised andpotentially reversible cause of dementia seen on geriatric wards. The exact pathogenesis is unknown,although many theories have been proposed…

This article outlines the definition, pathophysiology, and epidemiology of osteoporosis. We describe thestructure and function of bisphosphonates, and review the history and evidence for use of bisphosphonatetherapy in osteoporosis. We also…

In the UK, the coroner (or procurator fiscal in Scotland) will only return a verdict of suicide ifsuicidal intent can be proved beyond reasonable doubt. Suicidal intent is not a static concept andchanges with time. Among psychiatric…

Doctors will inevitably need to fill in a death certificate, but newly qualified doctors might not know what is expected. This article is intended as an aid to completing death certificates.