Letter to Editor

Introduction Medical professionalism is one of the key competencies of physicians and the basis of a trust-based relationship between physician and patient. It has become more important with recent advances and challenges in Medicine. The present study investigated the attitudes of Geriatric Medicine residents toward medical professionalism and determined areas of difference. Materials and Methods In this qualitative study, the six principles of medical professionalism were presented in the form of a clinical scenario and the residents were asked to read them and discuss one or two question(s). Data were evaluated by content analysis method. Results There was no significant difference between the variables of age, sex and stages of the residents and their general attitude toward the principles of medical professionalism. In general, the level of familiarity and attention of participants to the concepts of justice and excellence were lower than other principles. Conclusion Despite the positive attitude of the residents to the general concepts of medical professionalism, there is still a serious vacuum in the field of education, assessment and adherence. Medical educators should be more concerned with training in this field. Future studies are needed to help identify the teaching mission.

The physiology of aging affects nearly every organ system including cardiovascular, pulmonary, renal and gastrointestinal. Altered physiology may also be associated with comorbid conditions including hypertension, cardiac, COPD, chronic renal disease and altered drug metabolism. American Geriatric Association has published a Criteria for potentially inappropriate medication in older adults that should be used in management of elderly trauma patients. Falls are the most common mechanism in elderly trauma patients. An Underreported injury in Geriatric group is elderly abuse, which could be in a wide range of verbal insults, cuts and bruise and scratches to sexual abuse. Severely injured older patients may not display standard signs of hemodynamic instability, especially traumatic brain injury so imaging with head CT in elderly trauma patients should be used liberally.

Introduction: Vertigo, disequilibrium and the consecutive falls in Geriatrics have always been one of the major challenges that both patients and medical staffs encounter. Numerous factors make the diagnosis and treatment processes rather difficult in the elderly compared to the younger adults. Once these conditions left unattended, the underlying etiologies of Geriatrics vertigo not only can pose a threat to the patients' safety and lead to physical impairments, but also might result in psychological consequences like isolation from society. In this review article we intend to investigate the key points regarding the Geriatrics vertigo.Materials and methods: The online databases including Pubmed, Google Scholar, Cochrane and Science Direct were searched using the key words: Geriatrics, Elderly, Older people, Imbalance, Disequilibrium, and Vertigo for the papers that were published from the year 1972 to 2013.Results: A total number of 218 original articles and 30 review articles were found using the abovementioned key words. The titles, abstracts and conclusions were studied. Eventually, 45 articles were found appropriate for the purpose of this study.Conclusion: The recent increases in the elderly population and their physical impairments have resulted in a soar in such symptoms as vertigo and disequilibrium among these participants. By the age of 75, dizziness is the first reason for which elderly pay visits to medical centers and 80% of patients older than 75 years old complain of vertigo and dizziness. Plenty of central and arterial lesions in the elderly have clinical manifestations which resemble symptoms of benign peripheral vestibular dysfunctions, and result in difficulty in diagnosis of the disease. Furthermore, rehabilitative treatments in this age group might be delayed due to concomitant neural and muscular impairments. In the elderly, the clinical presentations and nystagmus characteristics are the most critical findings that can play a significant role in differential diagnosis of peripheral and central vertigoes.

Objectives: “Ageing” has created challenges for societies, particularly in developing countries. In this regard, the “Research Agenda on Ageing for the 21st century” (RAA-21) has been prepared and published through a joint project of the “United Nations Program on Ageing” and the “International Association of Gerontology and Geriatrics.” The University of Social Welfare and Rehabilitation Sciences is the first university in Iran that has admitted students in Gerontology, and currently has the largest number of students studying the subject of “Ageing.” The current study aims to compare the topics of dissertations on ageing in the University with the priorities of RAA-21, because no similar study has been conducted at the University so far.Methods & Materials: total of 248 dissertations and proposals on “Ageing” were included in this study. The titles were categorized into three levels (priority, research area, and specific topic) with a deductive content analysis approach using RAA-21 guidelines. The results were qualitatively described and compared with RAA-21 priorities.Results: The fourth and fifth priorities of RAA-21 (“healthy ageing” as well as “biology and diseases”) were identified as the most common priorities in the dissertations of both the University and the Gerontology Department (39.9% and 21%, respectively). The second priority of RAA-21 (“material security”) had the least number of dissertations (3.3%). With respect to “research areas,” the highest number of dissertations was conducted in the “physical and mental function” (21.8%) and then “biomedical” and “healthy ageing” (19% each) subcategories. “Macro-societal changes and development” and “poverty” subcategories had the least number of dissertations (0.0% and 0.4%, respectively).Conclusion: distribution of dissertation topics conducted on “Ageing” at the University does not match with the priorities of RAA-21. As a descriptive study cannot present a certain causal relationship, an investigation into the reason for the differences is suggested for further studies. Moreover, it is also useful to prepare the national priorities for research on “Ageing,” using need assessment and RAA-21 as guidelines.