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A Mark Clarfield

Publications and source records attributed to A Mark Clarfield.

14 recordsLinked to original sources
PubMed2004

Healthy aging around the world: Israel too?

Mortality rates have been falling at all ages, even for very old cohorts, in most western countries as well as in Israel. The question remains open as to whether morbidity rates are also decreasing, especially for Israel's elderly. While health is improving in almost all industrialized countries, the situation in Israel is not yet resolved. While the more recent cohorts of the young-old (65-74 years) are healthier than their predecessors, Israel's old-old (75+) may still be lagging behind other countries with regard to improvements in health status. This phenomenon is not well understood but could be explained in part by the more severe formative experiences of many of Israel's very elderly cohort.

Activities of Daily Living↗
PubMed2003

The decreasing prevalence of reversible dementias: an updated meta-analysis.

BACKGROUND: In 1988, 2 meta-analyses suggested that the prevalence of reversible dementia was significantly lower than had been previously estimated. It was predicted that further work would indicate an even lower rate. The present study represents an updated meta-analysis of the true prevalence of reversible dementia. METHODS: MEDLINE was searched from 1987 through 2002. References were also gleaned from pertinent articles and relevant textbooks. Data were extracted on the nature and provenance of the studies, dementia etiology, and the proportion of cases that were potentially reversible and reversed. RESULTS: Fifty articles were identified of which 39 met the study criteria, representing 7042 patients of whom 5620 (87.2%) had dementia. Patients were classified according to etiology and, where possible (in 23 [59%] of 39 studies), whether the dementia partially or completely resolved. A much higher proportion of studies than was previously the case were either community-based (31%) or observed subjects from outpatient departments (54%). Alzheimer disease was still the commonest cause of dementia (56.3%) followed by a vascular etiology (20.3%). Conditions requiring neuroimaging made up only 2.2% of cases. Potentially reversible causes were seen in 9%, and only 0.6% of dementia cases actually reversed (0.29% partially, 0.31% fully). CONCLUSIONS: The reported proportion of dementias that reverse is much lower than previously thought. While comorbidity should always be treated for its own sake and in the hope that cognitive decline may at least be delayed, the present findings have significant clinical and economic implications for the workup of dementia.

Dementia↗
PubMed2003

SCOPE: SCripture Oriented Preventive Education.

BACKGROUND: Counseling to effect lasting change in health behaviors has proven only moderately effective. The Torah, or Five Books of Moses, conveys many of the key messages regularly promulgated by prevention professionals. The promise of synergy with the behavioral messages of preventive medicine among devout Scripture-based adherents led to the development of a SCripture Oriented Preventive Education (SCOPE) tool. METHODS: Forty-eight SCOPE articles were written to complement the weekly Torah portion read throughout the year in Orthodox Jewish synagogues. These were disseminated via newsletter within a modern Orthodox Jewish community in Israel. Two articles are included. An age-stratified, 25% random sample (120/471) of community readership was surveyed to ascertain receptivity to SCOPE and to gauge support for future implementation. RESULTS: Response rate was 76% (92/120). Lifestyle behavior-related articles were most popular (77% found them interesting) and injury prevention the least (41%). Knowledge gained was the most common benefit reported (55% of respondents), followed by attitude change (24%). Those aged 30 to 49 years were significantly more likely than others to report behavior change (p=0.002) and health improvement (p=0.005) secondary to SCOPE. Clinical prevention (p=0.007) and environmental health (p=0.03) articles were significantly more popular in people aged > or =30 and 30 to 49, respectively. Between 69% and 84% supported the implementation of SCOPE in secondary schools, by physicians, and/or rabbis. CONCLUSIONS: SCOPE was designed to deliver prevention materials to faith communities via a Scripture-based vehicle. A postexposure readership survey in an Israeli Orthodox Jewish community demonstrated its effectiveness. SCOPE's ultimate utility as a counseling adjunct in Scripture-adherent communities awaits broader assessment.

Adult↗
PubMed2003

Ethical issues in end-of-life geriatric care: the approach of three monotheistic religions-Judaism, Catholicism, and Islam.

Ethical dilemmas pervade modern geriatric medicine. What is considered right or wrong will differ depending on, among other things, the patient's religion. The three Abrahamic monotheistic religions, Judaism, Christianity (its Catholic variant), and Islam all have carefully considered positions on medical ethics. Although much is held in common, there are significant differences. The authors present three clinical cases, each of which presents ethical dilemmas typical of geriatric care, especially at the end of life. On the basis of these scenarios, the normative ethical position of each religion is compared and contrasted. It is hoped that this approach will offer the geriatrician a useful approach to treating patients in an increasingly multicultural society.

Aged↗
PubMed2002

Agranulocytosis associated with initiation of famotidine therapy.

OBJECTIVE: To report a case of agranulocytosis associated with initiation of famotidine. CASE SUMMARY: An 87-year-old white man was admitted to the internal medicine department of an acute care hospital because of fever and agranulocytosis (granulocyte count 0). Eight days prior to admission, famotidine therapy had been initiated. Famotidine was discontinued and granulocyte-macrophage colony stimulating factor was administered, with concomitant recovery of the granulocyte count and subsequent development of a leukemoid reaction. DISCUSSION: According to the Naranjo probability scale, famotidine was the probable cause of agranulocytosis. This is a rare adverse effect of this medication; only a few other cases have been reported. CONCLUSIONS: Although agranulocytosis is a rare adverse effect of famotidine, the pharmacist and physician should be aware of this potentially fatal event. If any patient treated with famotidine develops fever, the clinician should consider, among other things, performing a white blood cell count.

Aged↗
PubMed2002

Rembrandt's late self-portraits: psychological and medical aspects.

The Dutch painter Rembrandt (1606-1669) left behind the largest series of self-portraits in the history of art. These paintings were produced over a period of time from age 22 years until just a few months before Rembrandt's death at age 63. This series gives us a unique opportunity to explore the development, maturity, and aging of the artist. The changes in Rembrandt's face and expression from one self-portrait to the next may be attributable to any combination of the following factors: normal aging changes, modifications and developments of his artistic style, alterations in the way he viewed himself, and changes in the way Rembrandt wanted us to see him. In addition, the modifications may be attributed in part to some illnesses from which the artist may have suffered and/or to a decline in his eyesight that may have influenced both his ability to detect details and his ability to paint.

Aging↗
PubMed2002

Teaching public health related to the elderly.

It has become axiomatic that the world is aging, not just in the developed countries, but in the less developed regions as well. In 1992 the global elderly population (age 65+) was estimated to be almost 350,000,000 persons, or more than 6% of the world total. During that year the net balance of the world's elderly grew by more than 800,000 persons each month. Projections to the year 2010 indicate that the net monthly gain will rise to more than 1.1 million elderly people. In the early 1990s, 26 countries had more than 2,000,000 elderly persons. The projections suggest that this number could increase to more than 50 nations by the year 2025. And this increase in number of elderly leads to an absolute rise in problems of age-related diseases, such as Alzheimer's disease, cardiovascular disease, stroke, and osteoporosis (with related falls and fractures). At the same time, there is a school of thought that emphasizes the elderly are living longer and healthier lives through better awareness of healthy nutrition, exercise, and other lifestyle factors, as well as improving access to modern medical care that is itself more effective than in previous decades. While the public health practitioner will not be called upon to treat individuals with these pathologies, it is important to know something about them in order to understand their effect on health care systems and to help plan for preventive and health promotion programmes. The preparation of the public health person requires an understanding of these issues and thus some tools for program development for primary, secondary, and tertiary prevention for this high-risk group.

Aged↗