scholarly journals Heart failure in the elderly: A geriatric syndrome. Picture of the modern situation

2019 ◽  
Vol 89 (1) ◽  
Author(s):  
Valentina Fagotto ◽  
Alessandro Cavarape ◽  
Alessandro Boccanelli
Keyword(s):  
Heart Failure ◽  
Older Patients ◽  
Clinical Presentation ◽  
The Elderly ◽  
Geriatric Syndrome ◽  
Diagnostic Work ◽  
Patient’S History ◽  
Work Up ◽  
Diagnostic Work Up

Among the older patients’ cohort, the aetiology of heart failure is peculiar and differs in many ways from the younger one, both in its epidemiology, diagnostic work-up and clinical presentation. Focusing on this population, we could assume that heart failure is a real geriatric syndrome, characterized by several features, which coexist with other comorbidities and require specific and targeted cares. It is therefore necessary to examine the global burden of heart failure and the patient’s history rather than the causal cardiomyopathy - frequently more than one in the elderly - facing with the condition, bearing in mind the quality of life even before its duration.

Diagnosing Suspected Stroke: A Cost-Effectiveness Analysis

1985 ◽  
Vol 1 (1) ◽  
pp. 147-158 ◽  
Author(s):  
Mona Britton ◽  
Egon Jonsson ◽  
Lars-Åke Marké ◽  
Veronica Murray
Keyword(s):  
The Elderly ◽  
Elderly Persons ◽  
Industrialized Countries ◽  
Public Concern ◽  
Effectiveness Analysis ◽  
Suspected Stroke ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Acute cerebrovascular disease (CBVD) has an annual incidence of 100–300 per 100,000 inhabitants in the industrialized countries (1,2). CBVD occurs mainly in the elderly. Acute mortality is around 15%. Disablement and decreased quality of life are common consequences. Institutionalized care will be needed after the acute phase for around one-third of the patients (3). Considering the volume of patients and the growing proportion of elderly persons in most countries, stroke poses a major problem for health care. An effective diagnostic work-up as the base for therapy to improve the situation is, therefore, a matter of great public concern, for humanitarian as well as economic reasons.

scholarly journals Bullous Pemphigoid and Other Pemphigoid Dermatoses

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1061
Author(s):  
Valeryia Pratasava ◽  
Vikram Sahni ◽  
Aishwarya Suresh ◽  
Simo Huang ◽  
Abhirup Are ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
Clinical Presentation ◽  
The Elderly ◽  
Mucous Membrane Pemphigoid ◽  
Skin Fragility ◽  
Treatment Refractory ◽  
Diagnostic Work ◽  
Work Up ◽  
Variable Clinical Presentation ◽  
Diagnostic Work Up

The pemphigoid family of dermatoses is characterized by autoimmune subepidermal blistering. The classic paradigm for pemphigoid, and the most common member, is bullous pemphigoid. Its variable clinical presentation, with or without frank bullae, is linked by significant pruritus afflicting the elderly. Mucous membrane pemphigoid is an umbrella term for a group of subepidermal blistering dermatoses that favor the mucosal membranes and can scar. Epidermolysis bullosa acquisita is a chronic blistering disorder characterized by skin fragility, sensitivity to trauma, and its treatment-refractory nature. Clinicians that encounter these pemphigoid disorders may benefit from an overview of their clinical presentation, diagnostic work-up, and therapeutic management, with an emphasis on the most frequently encountered pemphigoid disease, bullous pemphigoid.

Conceptualizing geriatric syndromes

2017 ◽  
pp. 355-362 ◽  
Author(s):  
Marcel G. M. Olde Rikkert
Keyword(s):  
Older Patients ◽  
Main Part ◽  
Preliminary Evidence ◽  
Geriatric Syndrome ◽  
Geriatric Syndromes ◽  
Warning Signals ◽  
Slowing Down ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Geriatric syndromes, such as falling, delirium, and malnutrition, are common in older patients, and characterized by the presence of several disorders at the same time. These geriatric syndromes can be divided into acute (e.g. delirium) and non-acute (e.g. dizziness, falls) geriatric syndromes. The main criterion of multicausality is directly linked to frailty in older patients, as frailty results in a closer linkage and increased interaction between organ functions, which explains why several organs, diseases, and stressors are involved in each geriatric syndrome. There is interesting preliminary evidence for the existence of generic warning signals for the recurrence of acute geriatric syndromes, of which the most important is slowing down of recovery after a perturbation of the organ functions involved in a geriatric syndrome. All these pathophysiological mechanisms have important implications for diagnostic work up and treatment of geriatric syndromes, which together makes up the main part of geriatric patient care.

Cancer Diagnosis in Children, by L. D. Samuels, M.D. Cleveland: The Chemical Rubber Company, 1972, 131 pp., $25.00

PEDIATRICS ◽  
1972 ◽  
Vol 50 (5) ◽  
pp. 834-835
Author(s):  
Norman Jaffe
Keyword(s):  
Child Health ◽  
Cancer Diagnosis ◽  
General Physician ◽  
Paramedical Personnel ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Cancer Diagnosis in Children is a review of the diagnostic work-up which the author claims will be of interest to the general physician, paramedical personnel, students, and anyone concerned with child health. The text is presented in readable style, culminating in an extremely useful appendix (Chapter 7) . This provides a concise resume of the information presented in the previous six chapters. It adds to the quality of the book which could have been further enhanced by the inclusion of an index, which I found sadly lacking.

scholarly journals Mitochondrial Depletion Syndromes in Children and Adults

2013 ◽  
Vol 40 (5) ◽  
pp. 635-644 ◽  
Author(s):  
Josef Finsterer ◽  
Uwe Ahting
Keyword(s):  
Early Onset ◽  
Genetic Background ◽  
Clinical Presentation ◽  
Progressive External Ophthalmoplegia ◽  
Adult Onset ◽  
Chain Defects ◽  
Diagnostic Work ◽  
Work Up ◽  
Respiratory Chain Defects ◽  
Diagnostic Work Up

Abstract:To highlight differences between early-onset and adult mitochondrial depletion syndromes (MDS) concerning etiology and genetic background, pathogenesis, phenotype, clinical presentation and their outcome. MDSs most frequently occur in neonates, infants, or juveniles and more rarely in adolescents or adults. Mutated genes phenotypically presenting with adult-onset MDS include POLG1, TK2, TyMP, RRM2B, or PEO1/twinkle. Adult MDS manifest similarly to early-onset MDS, as myopathy, encephalo-myopathy, hepato-cerebral syndrome, or with chronic progressive external ophthalmoplegia (CPEO), fatigue, or only minimal muscular manifestations. Diagnostic work-up or treatment is not at variance from early-onset cases. Histological examination of muscle may be normal but biochemical investigations may reveal multiple respiratory chain defects. The outcome appears to be more favorable in adult than in early-onset forms. Mitochondrial depletion syndromes is not only a condition of neonates, infants, or juveniles but rarely also occurs in adults, presenting with minimal manifestations or manifestations like in the early-onset forms. Outcome of adult-onset MDS appears more favorable than early-onset MDS.

ANEMIA IN THE ELDERLY: INFLUENCE ON PHYSICAL, FUNCTIONAL STATUS AND PROGNOSIS

2020 ◽  
pp. 501-506
Author(s):  
Н. О. Ховасова ◽  
А. В. Наумов ◽  
О. Н. Ткачева
Keyword(s):  
Iron Deficiency ◽  
Functional Status ◽  
Iron Deficiency Anemia ◽  
Older Patients ◽  
Older Persons ◽  
The Elderly ◽  
Deficiency Anemia ◽  
Comparable Efficacy ◽  
Geriatric Syndrome

Анемия у пожилых пациентов может рассматриваться как гериатрический синдром, ухудшающий качество жизни, функциональный статус, снижающий автономность и влияющий на прогноз. Анемия связана с другими гериатрическими синдромами, такими как старческая астения, саркопения, падения и переломы, дефицит витамина D , деменция и другие. Наиболее распространенной является железодефицитная анемия. Чаще всего у лиц пожилого возраста причины ее развития - хронические кровопотери и синдром мальнутриции. Лабораторными критериями, подтверждающими железодефицитную анемию, являются снижение гемоглобина, микроцитоз, низкое сывороточное железо и ферритин. Это является основанием для назначения препаратов железа, среди которых выделяют двух-и трехвалентные (пероральные и парентеральные). Трехвалентные препараты железа на основе железа (III) гидроксид полимальтозного комлекса наиболее предпочтительны у пациентов пожилого возраста, так как обладают лучшей переносимостью и меньшей частотой побочных эффектов при сопоставимой эффективности с двухвалентными препаратами. Anemia in older patients can be seen as a geriatric syndrome that impairs quality of life, functional status, reduces autonomy, and affects prognosis. Anemia is associated with other geriatric syndrome such as frailty, sarcopenia, falls and fractures, vitamin D deficiency, dementia and others. Iron deficiency anemia is the most common. Most often in older persons, the causes of its development are chronic blood loss and malnutrition. Laboratory criteria confirming iron deficiency anemia are hemoglobin reduction, microcytosis, low serum iron and ferritin. This is the basis for the administration of iron preparations, among which two- and threevalent ones are isolated. Trivalent iron preparations are most preferred in older patients because they have better tolerance and less frequency of side effects with comparable efficacy with divalent preparations.

Hypertension in specific conditions/co-morbidities

ESC CardioMed ◽  
2018 ◽  
pp. 2465-2473
Author(s):  
Enrico Agabiti Rosei ◽  
Maria Lorenza Muiesan ◽  
Massimo Salvetti
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Age Groups ◽  
Optimal Management ◽  
Hypertensive Patients ◽  
Accurate Evaluation ◽  
Associated Conditions ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

The optimal management of hypertensive patients requires accurate evaluation of cardiovascular risk factors and co-morbidities. The therapeutic approach to hypertension may, in fact, be significantly different according to associated conditions. Among them, the presence of coronary heart disease, heart failure, cerebrovascular disease, chronic kidney disease, and specific age groups deserve special attention. In this chapter, the initial diagnostic work-up, the thresholds and targets for treatment, and the preferred drugs in specific conditions/co-morbidities will be briefly discussed.

Acute heart failure: diagnosis

ESC CardioMed ◽  
2018 ◽  
pp. 1911-1917 ◽  
Author(s):  
Adriaan A. Voors ◽  
Piotr Ponikowski
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Medical Condition ◽  
Specific Treatment ◽  
Length Of Hospital Stay ◽  
Clinical History ◽  
Life Threatening ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Acute heart failure is a life-threatening medical condition typically leading to urgent hospital admission. Early diagnosis is of great importance, since it will lead to earlier and better targeted treatment, leading to a decrease in length of hospital stay, and most importantly to improved clinical outcome. The initial diagnostic work-up includes a clinical history, evaluation of symptoms and signs, an electrocardiogram, chest X-ray, natriuretic peptide levels, echocardiography and perhaps lung ultrasound. After the initial work-up, a clinical classification according to blood pressure, congestion, and peripheral perfusion should be performed, since it will guide treatment. During the diagnostic work-up, treatable and life-threatening conditions always need to be considered since they need immediate and case-specific treatment.

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