These tweeps love #GeriMedJC and we hope you do too!

It's been just over a year since we launched #GeriMedJC, the Twitter complement to the traditional format Geriatric Medicine journal club at the University of Toronto.  Reflecting on the experience, these are some tweets about #GeriMedJC that illustrate the interest:

What could be more fun than #GeriMedJC on a Friday morning?  We've had fun this year, and hopefully you have too!

As Geriatric Medicine trainees come and go, it's great to see they take #GeriMedJC with them to their new locations of practice.

We're thrilled to have social media in medicine gurus like Bernadette Keefe join in and retweet to her wider audience:

Even though the live version of #GeriMedJC is in Toronto, Canada, it's great to learn that our colleagues across the pond are at least lurking!

Even when #GeriMedJC fans are vacationing in Disney World, the most magical place on earth, there's time for #GeriMedJC.  Take that, Mickey Mouse!

And even after a year of participating in the live version of #GeriMedJC through the Ontario Telehealth Network, we're glad to hear participants seeing the added value of the Twitter complement.  We think it's a great medical education, advocacy and networking tool and hope you do too!

We look forward to another year of international engagement!  Thanks, tweeps!

A great turnout for Sep 2015 #GeriMedJC

The first half-hour of the live version of #GeriMedJC was facilitated by Amanda Gardhouse (@agardhouse), a Geriatric Medicine postgraduate trainee at the University of Toronto.  After conducting a focus group mid-way through out first year of #GeriMedJC, we learned that one of the barriers to faculty and trainee engagement on #GeriMedJC was due to a lack of familiarity with Twitter.  We gained 33 new followers since the last month, of which many were faculty in our division at the university.  Welcome tweeps!

During the second hour, this article was critically appraised:

Mossello E, Pieraccioli M, Nesti N, Bulgaresi M, Lorenzi C, Caleri V, Tonon E, Cavallini MC, Baroncini C, Di Bari M, Baldasseroni S, Cantini C, Biagini CA, Marchionni N, Ungar A.Effects of low blood pressure in cognitively impaired elderly patients treated with antihypertensive drugs. JAMA Intern Med. 2015 Apr;175(4):578-85. 

Overall, the audience thought the conclusions may have been a bit of a stretch and the follow-up was on the short side.  Nevertheless, caution should be raised in the setting of low blood pressure.  View the entire tweet chat transcript here.  Thank you to all the participants for making this one of the biggest #GeriMedJC sessions!

We're grateful to Dr. Bernadette Keefe (@nxtstop1), social media in medicine guru, from North Carolina who storified this discussion (click here)!

We'll see you next time on #GeriMedJC (October 30, 2015 at 08:00 ET / 12:00 GMT).

Something a bit different for the September 2015 #GeriMedJC

Did you know that the live version of the Geriatric Medicine Journal Club held at the University of Toronto, is on the last Friday of the month from 08:00-09:00 ET?  Postgraduate subspecialty trainees in Geriatric Medicine take turns leading the critical appraisal.  Article selection is guided by a clinician-scientist.  The first 45 minutes of the hour is devoted to the presentation and discussion of the long article and the latter 15 minutes is reserved for presentation and appraisal of the short article. The live version is also broadcast to several different hospitals in several different cities via the Ontario Telemedicine Network.

#GeriMedJC, the Twitter-complement to the traditional format journal club, has been up and running for over a year.  The intention is to engage an international dialogue across all time zones as a tweetchat should have no time restrictions.  

We obtained feedback about the first year's experience from our postgraduate trainees and faculty. One of the challenges was hesitancy to engage on the Twitter medium due to unfamiliarity with Twitter. However, there was recognition and appreciation for #GeriMedJC to engage international experts and dialogue. Therefore, in the September 2015 live version of #GeriMedJC, we will be devoting the first half of the hour on how to get started on using Twitter for journal clubs as well as tips for the advanced tweep.  In the meantime, check out our cool new infographic, How to #GeriMedJC. Another feedback suggestion was to have a repository of the previous articles and transcripts of the tweet chats much like the #RheumJC and #NephJC folks.  Look out for our new #GeriMedJC website which is under construction!  

Since the first half of the hour of this month's live #GeriMedJC will be devoted to How to #GeriMedJC, the critical appraisal of the short article will commence at 08:30 ET / 12:30 GMT. 

The association between blood pressure and cognitive function remains controversial with studies showing mixed results.  This may yet be another example of 'not one size fits all'. People are individuals, not numbers.

Mossello E, Pieraccioli M, Nesti N, Bulgaresi M, Lorenzi C, Caleri V, Tonon E, Cavallini MC, Baroncini C, Di Bari M, Baldasseroni S, Cantini C, Biagini CA, Marchionni N, Ungar A.Effects of low blood pressure in cognitively impaired elderly patients treated with antihypertensive drugs. JAMA Intern Med. 2015 Apr;175(4):578-85. 

PMID: 25730775

Access the article here or read the abstract below:

IMPORTANCE:
The prognostic role of high blood pressure and the aggressiveness of blood pressure lowering in dementia are not well characterized.

OBJECTIVE:
To assess whether office blood pressure, ambulatory blood pressure monitoring, or the use of antihypertensive drugs (AHDs) predict the progression of cognitive decline in patients with overt dementia and mild cognitive impairment (MCI).

DESIGN, SETTING, AND PARTICIPANTS:
Cohort study between June 1, 2009, and December 31, 2012, with a median 9-month follow-up of patients with dementia and MCI in 2 outpatient memory clinics.

MAIN OUTCOMES AND MEASURES:
Cognitive decline, defined as a Mini-Mental State Examination (MMSE) score change between baseline and follow-up.

RESULTS:
We analyzed 172 patients, with a mean (SD) age of 79 (5) years and a mean (SD) MMSE score of 22.1 (4.4). Among them, 68.0% had dementia, 32.0% had MCI, and 69.8% were being treated with AHDs. Patients in the lowest tertile of daytime systolic blood pressure (SBP) (≤ 128 mm Hg) showed a greater MMSE score change (mean [SD], -2.8 [3.8]) compared with patients in the intermediate tertile (129-144 mm Hg) (mean [SD], -0.7 [2.5]; P = .002) and patients in the highest tertile (≥ 145 mm Hg) (mean [SD], -0.7 [3.7]; P = .003). The association was significant in the dementia and MCI subgroups only among patients treated with AHDs. In a multivariable model that included age, baseline MMSE score, and vascular comorbidity score, the interaction term between low daytime SBP tertile and AHD treatment was independently associated with a greater cognitive decline in both subgroups. The association between office SBP and MMSE score change was weaker. Other ambulatory blood pressure monitoring variables were not associated with MMSE score change.

CONCLUSIONS AND RELEVANCE:
Low daytime SBP was independently associated with a greater progression of cognitive decline in older patients with dementia and MCI among those treated with AHDs. Excessive SBP lowering may be harmful for older patients with cognitive impairment. Ambulatory blood pressure monitoring can be useful to help avoid high blood pressure overtreatment in this population.

Can't join us live? No worries!  Engage in the discussion on Twitter on August 28, 2015 at 08:00 ET / 12:00 GMT and don't forget to use the hashtag #GeriMedJC.

Want to #GeriMedJC, but don't know how? Check out our new infographic!

A special thanks to Thomas Galati, a Masters of Computer Science student at UOIT!

Study author joins us for a successful August 2015 #GeriMedJC

The two articles critically appraised and discussed during the August 2015 #GeriMedJC were:

Delayed-start analysis: Mild Alzheimer's disease patients in solanezumab trials, 3.5 years. Alzheimer's & Dementia: Translational Research & Clinical Interventions. In press. 2015. 

Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med. 2015 May 28;372(22):2087-96. 

It was a nice treat to have one of the study authors from the Zoster vaccine trial, Dr. Jan McElhaney, join us live via the Ontario Telemedicine Network and Twitter (@vitality_md) for commentary.

We continue to grow and now have close to 550 followers!

Missed the discussion?  You can get the transcript of the #GeriMedJC tweet chat here.

Thanks again to all those who participated in the Tweet chat:

You may also view articles discussed at prior #GeriMedJC tweetchats at PubMed Commons. (link) The next #GeriMedJC will be on September 25, 2015 at 08:00 ET / noon GMT. Stay tuned for the articles!