Scurvy is Back.

Background And Objective: Scurvy, caused by vitamin C deficiency, first described by Hippocrates, is known to many as 'The Pirates' Disease'. Although a disease rarely acknowledged in modern medicine, we present 2 cases of elderly gentlemen found to have scurvy, who improved significantly on treatment.

Methods: This study presents a case report of 2 patients undergoing rehabilitation at Karin Grech Hospital in Malta, noted to have signs and symptoms of vitamin C deficiency.

Comparison of informal caregiver and named nurse assessment of symptoms in elderly patients dying in hospital using the palliative outcome scale.

Objectives: A prospective study of symptom assessments made by a healthcare professional (HCP; named nurse) and an informal caregiver (ICG) compared with that of the patient with a terminal diagnosis. To look at the validity of HCP and ICG as proxies, which symptoms they can reliably assess, and to determine who is the better proxy between HCP and ICG.

Methods: A total of 50 triads of patient (>65 years) in the terminal phase, ICG and named nurse on medical wards of an acute general hospital.

Do not underestimate your patient's back pain.

Back pain is a common complaint in the elderly population which is often attributed to osteoarthritis or vertebral collapse secondary to osteoporosis. The following case reports describe an easily-missed cause of back pain which is becoming increasingly important and thus should be actively sought.

A pagetic elderly lady with back pain.

An elderly lady suffering from Paget's disease presented with severe back pain after sustaining a fall. The rise in inflammatory markers and poor response to analgesics led to the diagnosis of septic discitis [corrected] that was confirmed by MRI. A high index of suspicion for septic discitis [corrected] is necessary in elderly patients presenting with back pain and an associated rise in inflammatory markers.

Perspectives of relatives and health care workers on care of terminally ill patients in the UK.

Two parallel questionnaires were used to explore perceptions of healthcare workers (HCWs) and the relatives of terminally ill patients on the quality of care received by the patients. There was general agreement between the two groups of respondents in most of the assessed areas. The relatives, however were more satisfied with the control of pain and psychological symptoms than the HCWs, and the HCWs perceived the control of diarrhea, skin problems, and swallowing problems more positively than did the relatives.