Assessing the Accessibility of Content for Geriatric Fellowship Programs.

The information available on program websites concerning geriatric fellowships in internal medicine and family medicine is a crucial factor in generating applicants' interest in individual programs. Our study aimed to quantify the accessibility and quality of information available on accredited geriatric (family medicine and internal medicine) fellowship program websites and further analyze the implications of the results obtained. A list of geriatric (family medicine and internal medicine) fellowship programs was analyzed through quantified measures after being verified for accreditation. Certain criteria were evaluated for each of these programs, such as website accessibility and whether critical information was available on online program websites. These criteria were centered on academic, administrative, and application-based factors. Hundred and fifty eight Family Medicine and Internal Medicine geriatric fellowship programs were identified in total, of which only 150 were accredited by the Accreditation Council for Graduate Medical Education and considered for analysis. Of these, 20 (13.33%) programs had website links that were nonfunctional and only 145 programs had websites at all. On programs' websites, information regarding aspects such as contact information-including phone number or email for the program-were lacking. Other information regarding past and current fellows, research, and curriculum were also generally lacking. Geriatric Fellowship websites in Family Medicine and Internal Medicine can gain better traction from those interested in applying for their programs by updating information more often and providing more and better information concerning critical aspects of the programs themselves online.

The Impact of Gender on Postoperative Complications after Revision Total Knee Arthroplasty.

Knee osteoarthritis is a common form of arthritis, often treated by total knee arthroplasty (TKA). Complications can arise after TKAs, which may necessitate revision TKAs and further treatments. However, there remains a paucity of literature regarding influence of gender on postoperative complication rates after revision TKA. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database. Patients who received revision TKAs between 2007 and 2014 were identified and recorded as male or female. Univariate and multivariate analysis was used to evaluate the incidence of multiple adverse events within 30 days of revision TKA. This study included 9,914 patients who underwent revision TKA (females = 5,728 [57.8%]; males = 4 186 [42.2%]). Male patients were shown to be at greater risk for developing 7 of 17 complications compared with female patients, and female patients were shown to be at greater risk for urinary tract infection (UTI) development. Multivariate analysis showed males as an independent risk factor for four complications and females as an independent risk factor for UTI development. Male patients were more likely to develop more complications postoperatively than female patients. Although the possibility of developing complications is relatively low, orthopaedic surgeons should be aware of increased postoperative complication rates when counseling patients who undergo revision TKA.

Altered mental status in an elderly woman with concurrent takotsubo syndrome and polymyalgia rheumatica: a case of treatable geriatric delirium.

We present a unique case of a patient, aged 80 years, who presented with delirium and takotsubo syndrome. Also known as "broken heart syndrome" because it often originates following an emotional stress, takotsubo syndrome may be difficult to distinguish from myocardial infarction because of similar symptoms and demographics. However, the distinction of these opposing diagnoses is significant because takotsubo syndrome is associated with more favorable prognosis for complete recovery, especially with early diagnosis and expedient supportive therapy. To our knowledge, we present the first case of takotsubo syndrome in which the diagnosis was made in an elderly patient presenting with delirium and in the absence of the hallmark symptoms of chest pain and dyspnea. Finally, we describe this patient's coexistent diagnosis of polymyalgia rheumatica and speculate on its possible theoretic relationship to takotsubo syndrome.