Left Axillary Intra-Aortic Balloon Pump Prolapsing in the Ascending Aorta in an End-Stage Heart Failure Patient Awaiting Transplant.

Patients with end-stage heart failure with reduced ejection fraction requiring mechanical support while awaiting heart transplant present a clinical dilemma. Intra-aortic balloon pump (IABPs) provide a modest improvement in hemodynamics and are easy to implant. Left axillary IABP implantation allows patients to engage in daily physical activity pre-transplant.

Bilateral lower extremity ulcerations, less is more.

The differential diagnosis of lower extremity ulcers must be broad since debridement can be harmful in certain conditions such as pyoderma gangrenosum. Biologic agents may be helpful in the treatment of pyoderma gangrenosum.

New learning programs in cognitive vitality, Alzheimer's disease, and related dementias.

As the population continues to age there remains an unmet need in preventing, identifying, treating, and managing mental/behavioral health problems among older adults. The purpose of this paper is to describe educational and training programs offered through three Geriatric Education Centers: (1) the Meharry Consortium Geriatric Education Center, which offers a certificate program on Cognitive Vitality dispelling myths that dementias are part of the normal aging process, (2) the Harvard Upper New England Geriatric Education Center, which offers a self-study web-based learning module on Alzheimer's Disease and related dementias, and (3) the South Carolina Geriatric Education Center, which has developed multi-use and train-the-trainer programs for counseling drivers with dementia and communicating effectively with cognitively impaired older adults. The programs together begin to address the wide range of mental health issues clinicians may encounter in older adult health care delivery and the ways in which Geriatric Education Centers help to prepare an educated workforce.