Mazen Bader and David S.

¶ … Mazen Bader and David S. McKinsey, the authors of "Viral infections in the elderly" (2005) are associated with academic places of research. Specifically, Bader is a Canadian assistant professor of medicine and infectious diseases at Memorial University of Newfoundland Health Sciences Center, St. John's. McKinsey is a clinical professor of medicine at the University of Kansas School of Medicine, Kansas City and an attending physician at Infectious Disease Associates, Kansas City, Missouri.

This suggests that the authors do not have an inherent bias or vested interest in the research findings, and also they have the advantage of bringing both research-based and in the case of McKinsey, clinical experience to their conclusions. Type of article Postgraduate Medicine is a peer-reviewed journal with a largely professional audience. As exemplified in its title, its target audience is practicing physicians and researchers of medical issues with experience in the field of medical research and practice.

Introduction: What is the article about? The article is an epidemiological overview of the problems of managing viral infections in the elderly, including the difficulties of diagnosis and treatment. It also offers advice on preventative care, such as vaccinations. The article focuses on the herpes zoster virus (more commonly known as shingles) and respiratory diseases caused by influenza and respiratory syncytial virus (RSV). Regarding herpes zoster, many people have the virus incubated within their system because they contracted chicken pox as young adults.

As people age, their immune system weakens making them vulnerable to an attack of shingles, a reoccurrence of the virus. The most common symptoms are rash, and after pain. Influenza, although problematic for any age group and population, is a particularly severe problem for older adults living in either the larger community or in long-term care facilities.

Influenza can pose more significant problems for the elderly, not the least of which, from a clinical perspective, is that of diagnosis, as the elderly may exhibit atypical symptoms as compared with younger patients, and they are more likely to develop secondary bacterial influenza Claims: Does the article make any claims about treatment of the infectious disease? The article makes an implicit claim of the impact shingles after-pain can have on an elderly individual's life, including loss of sleep and weight, a loss of independence, social isolation, and an inability to perform tasks of daily living.

It may eventually lead to a loss of independence and, ultimately, depression and isolation. The article warns that side effects in the elderly must be guarded against when considering drugs to treat the ailment. Influenza likewise can result in difficulties performing positional activities necessary to the acts of daily life like getting out of a chair and instrumental activities of daily living like housework. Some elderly patients may also suffer an exacerbation of their other medical conditions such as chronic obstructive pulmonary disease or congestive heart failure.

The article stresses the need for prevention actions, specifically in regards to influenza which can be controlled through by yearly administration of inactivated influenza virus vaccine. This is especially important for adults aged 50 years and older and for all residents of long-term care facilities. The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention recommends influenza vaccination for all elderly patients and residents of long-term facilities.

Does the article provide a national or global perspective about the infectious disease? The article does not provide a global study of epidemiology in the sense that it is not concerned with differing methods of treatment or rates of the ailment in different nations. The focus of the article is upon the unique constitution and needs of the elderly, not upon herpes zoster or influenza as a national phenomenon particular to the United States.

However, all of the studies it cites are based in the United States, and RSV has been primarily studied as a phenomenon occurring in the U.S. The prevalence of nursing homes in the United States might also make the article more relevant to U.S. practitioners, and the regulatory and drug treatments it discusses are particular to North American, such as the FDA.

Supporting evidence: What scientific evidence does the author(s) present to support his or her claims? The article's most conclusive evidence is found in its treatment of influenza. It notes that in the 40% to 60% of elderly patients in whom the influenza vaccine produces the desired immunity, an effective immune response can be mounted within 10 to 14 days after vaccination. Also, reflecting its national orientation, it notes that studies in the U.S.

show that influenza vaccination consistently decreased frequencies of congestive heart failure, hospitalization for respiratory disease and death from any cause in elderly adults. Additionally, vaccination of the elderly in long-term care facilities is associated with decreased risk of pneumonia and death. Its discussion of shingles is less conclusive in its prescriptions, other than the assertion that patients should avail themselves of the FDA approved drugs that are least apt to produce side effects. Its discussion of RSV is also quite brief.

This may be due to the fact that RSV a relatively recently discovered cause of lower respiratory tract infection in elderly patients, which is treated with primarily supportive treatment such as rest and fluids. The greater proportion of the article devoted to influenza seems to reflect the author's assumption that a clearly preventable ailment with a single treatment is more worthy of discussion, than illnesses with a less certain methodology of care. Conclusion.