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https://www.readbyqxmd.com/read/30334441/liver-diseases-in-the-elderly
#1
Marilena Durazzo, Elena Ponzo, Silvia Bonetto, Sharmila Fagoonee, Rinaldo Pellicano
Due to the progressive increase in life expectancy, the number of elderly people in the world is growing rapidly. Although there are no liver diseases specific of older age, the ageing liver shows some anatomical and physiological changes that can affect the frequency and the clinical behavior of most hepatopathies. In particular, these changes tend to cause an increased vulnerability to acute liver injury and an increased susceptibility to liver fibrosis, accounting for the predisposition to a generally more severe course of liver diseases compared to younger patients...
October 11, 2018: Minerva Medica
https://www.readbyqxmd.com/read/30316825/varicocele-repair-versus-testosterone-therapy-for-older-hypogonadal-men-with-clinical-varicocele-and-low-testosterone
#2
REVIEW
Helen Levey Bernie, Marc Goldstein
As men age, serum testosterone levels decrease. This reduction in testosterone levels may cause symptoms leading to hypogonadism. In addition, the presence of a varicocele can impair Leydig cell function, resulting in decreased testosterone production in men. Varicocelectomy and testosterone replacement therapy are both viable treatment options for hypogonadism in elderly male patients. The correct modality of treatment will vary for each patient, but education is essential in order to help men understand their options...
October 10, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30315560/clinical-characteristics-and-therapeutic-outcomes-of-postneurosurgical-bacterial-meningitis-in-elderly-patients-over-65-a-hospital-based-study
#3
Jun-Jun Lee, Chia-Yi Lien, Chi-Ren Huang, Nai-Wen Tsai, Chiung-Chih Chang, Cheng-Hsien Lu, Wen-Neng Chang
PURPOSE: To investigate the clinical characteristics, laboratory features and prognostic factors of elderly patients with postneurosurgical bacterial meningitis. METHODS: Five hundred and forty patients with adult bacterial meningitis (ABM) were collected from 1986-2015, of whom 167 were ≥ 65 years. Of these 167 elderly patients, 82 had postneurosurgical infections and 85 had spontaneous infections. Clinical, laboratory and therapeutic data of these two groups were compared...
December 15, 2017: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/30315037/health-and-health-service-use-of-very-elderly-newfoundlanders
#4
Jillian Hurd, Andrea Pike, John Knight, Gary Tarrant, Kris Aubrey-Bassler, Shabnam Asghari, Marshall Godwin
OBJECTIVE: To develop a better understanding of the current health status and health care use of the population of very elderly Newfoundlanders to inform policy makers, decision makers, and health care providers about aspects of the health care system that might be in higher demand in the near future. DESIGN: Descriptive analysis using data from the Newfoundland and Labrador component of the Canadian Primary Care Sentinel Surveillance Network database for the 2013 calendar year...
October 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/30311830/systematic-review-of-light-exposure-impact-on-human-circadian-rhythm
#5
Leena Tähkämö, Timo Partonen, Anu-Katriina Pesonen
Light is necessary for life, and artificial light improves visual performance and safety, but there is an increasing concern of the potential health and environmental impacts of light. Findings from a number of studies suggest that mistimed light exposure disrupts the circadian rhythm in humans, potentially causing further health impacts. However, a variety of methods has been applied in individual experimental studies of light-induced circadian impacts, including definition of light exposure and outcomes. Thus, a systematic review is needed to synthesize the results...
October 12, 2018: Chronobiology International
https://www.readbyqxmd.com/read/30311718/should-emergentologists-follow-up-on-patients-diagnosed-with-uti-having-negative-urine-cultures-implications-for-processing-post-discharge-laboratory-results
#6
Jason D Woodfine, Carl van Walraven
OBJECTIVES: After patients are discharged from the emergency department (ED), follow-up of test results focuses on abnormal values. In the elderly, non-specific symptoms can result in an incorrect diagnosis of urinary tract infection (UTI). This study compared the outcomes of patients discharged from the ED with a diagnosis of UTI based on urine culture results. METHODS: We conducted a retrospective cohort study using linked health databases and chart review of a random sample of elderly patients (age > 65 years) discharged from the Ottawa Hospital ED between 2006 and 2014 with a diagnosis of UTI...
October 12, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/30308206/laboratory-results-epidemiological-features-and-outcome-analyses-of-microbial-keratitis-a-15-year-review-from-saint-louis
#7
Hugo Y Hsu, Benjamin Ernst, Eric J Schmidt, Rohit Parihar, Chelsea Horwood, Sean L Edelstein
PURPOSE: To evaluate the laboratory results and prognostic factors of poor clinical outcomes in microbial keratitis cases over 15 years at Saint Louis University. DESIGN: Retrospective cohort and trend study. METHODS: Microbiological and clinical information from culture-positive cases seen at Saint Louis University from 1999-2013 were reviewed retrospectively. Statistical analyses were used to determine microbiological and antibiotic susceptibility trends...
October 8, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/30306778/unusual-high-blood-glucose-in-ketoacidosis-as-first-presentation-of-type-1-diabetes-mellitus
#8
Sebastian Hörber, Sarah Hudak, Martin Kächele, Dietrich Overkamp, Andreas Fritsche, Hans-Ulrich Häring, Andreas Peter, Martin Heni
Diabetic ketoacidosis is a life-threatening complication of diabetes mellitus. It usually occurs in patients with type 1 diabetes where it is typically associated with only moderately increased blood glucose. Here, we report the case of a 52-year-old female patient who was admitted to the emergency unit with severely altered mental status but stable vital signs. Laboratory results on admission revealed very high blood glucose (1687 mg/dL/93.6 mmol/L) and severe acidosis (pH <7) with proof of ketone bodies in serum and urine...
September 25, 2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/30293714/influence-of-dietary-protein-intake-on-body-composition-in-chronic-kidney-disease-patients-in-stages-3-5-a-cross-sectional-study
#9
Guillermina Barril, Angel Nogueira, Mar Ruperto López, Yone Castro, José Antonio Sánchez-Tomero
INTRODUCTION: A controlled protein intake has shown beneficial effects to preserve renal function and nutritional status in chronic kidney disease (CKD) patients. This study aimed to analyze usual dietary protein intake and its potential contribution to body composition in CKD patients in stages 3-5. METHOD: Cross-sectional study in 134 CKD patients in stages 3-5 (mean e-GFR: 19.4±8.7ml/min/1.73m2 ; males 68.7% and primary CKD etiology was diabetes mellitus, 35...
October 4, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/30290835/a-rare-case-of-large-pyosalpinx-in-an-elderly-patient-with-well-controlled-type-2-diabetes-mellitus-a-case-report
#10
Mayuko Hida, Takatoshi Anno, Fumiko Kawasaki, Hideaki Kaneto, Kohei Kaku, Niro Okimoto
BACKGROUND: Pyosalpinx, which is one of the pelvic inflammatory diseases, is usually observed in young women; it is rarely found in older women. Possible causative agents are thought to be Chlamydia trachomatis and Neisseria gonorrhea in addition to some Enterobacteriaceae. On the other hand, type 2 diabetes is a disease with a lot of complications such as hyperglycemia, inflammation, and immune disorders. Therefore, patients with type 2 diabetes mellitus have an increased susceptibility to infection especially when glycemic control is poor...
October 6, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/30286820/efficacy-and-safety-of-policosanol-plus-fenofibrate-combination-therapy-in-elderly-patients-with-mixed-dyslipidemia-a-randomized-controlled-clinical-study
#11
Hai-Ya Wang, Qing-Ping Jiao, Shu-Yan Chen, Jing Sheng, Hua Jiang, Jie Lu, Song-Bai Zheng, Ning-Yuan Fang
BACKGROUND: Policosanol is a mixture of long-chain alcohols isolated from sugar cane. This controlled, randomized clinical trial was designed to compare the efficacy and safety of fenofibrate, policosanol and a combination of these 2 in lowering low-density-lipoprotein cholesterol (LDL-C) in elderly patients with mixed dyslipidemia. METHODS: A total of 102 patients aged ≥60years were randomly assigned into 3 groups: patients receiving a 24-week therapy of fenofibrate (200 mg/day), policosanol (20 mg/day) or fenofibrate + policosanol combination...
September 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/30286094/assessing-the-pedestrian-response-to-urban-outdoor-lighting-a-full-scale-laboratory-study
#12
Johan Rahm, Maria Johansson
This study identifies and applies methods for evaluating the human response to pedestrian lighting applications intended for future use by the municipality of Malmö, Sweden. The methods employed provide a supplementary perspective to that given by the photometric properties of the lighting applications. The study involved 89 participants from two age groups (Young: N: 43, 19-31 yrs.; Elderly: N: 46, 62-77 yrs.). Data were collected in a full-scale laboratory using a mock-up pedestrian pathway. Three lighting applications (one ceramic metal halide and two LED) were presented and the participants' behavior (walking speed), perception (ability to perform visual tasks-recognize facial expressions, detect obstacles, read street signpost), affective response, and evaluation of the lighting quality were assessed...
2018: PloS One
https://www.readbyqxmd.com/read/30267533/lack-of-relationships-between-serum-prolactin-concentrations-and-classical-cardiovascular-risk-factors-in-eastern-croatian-older-adults
#13
Sanja Bekić, Šefket Šabanović, Nataša Šarlija, Zvonimir Bosnić, Nikola Volarić, Ljiljana Majnarić Trtica
BACKGROUND Relationships between serum prolactin concentrations and various CV risk factors in older adults have rarely been assessed. The aim of this study was to examine the relationships between serum prolactin concentrations and CV risk factors in older patients with multiple CV risk factors. MATERIAL AND METHODS This case-control study included 92 patients, 50-89 years old (median, 69 years), with multiple CV risk factors. We used data from general practice electronic health records and biochemical laboratory tests...
September 29, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/30258268/unusual-magnetic-resonance-imaging-abnormality-in-nonketotic-hyperglycemia-related-epilepsia-partialis-continua
#14
Jui-Ping Tsai, Jau-Jiuan Sheu, Kevin Li-Chun Hsieh
Epilepsia partialis continua (EPC) is a rare epileptic syndrome, presenting as continuous focal motor seizures for a period of minutes, hours, or days. EPC may develop in patients with cerebral cortical lesions and occasionally may develop in patients with metabolic disorders, such as nonketotic hyperglycemia (NKH). Here, we report a case of EPC following NKH, showing an unusual magnetic resonance imaging (MRI) finding of concurrent hypointensity on susceptibility-weighted image (SWI) and T2-weighted image (T2WI) with leptomeningeal and cortical enhancement, which have never been reported...
July 2018: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/30254413/infant-cholestasis-patient-with-a-novel-missense-mutation-in-the-akr1d1-gene-successfully-treated-by-early-adequate-supplementation-with-chenodeoxycholic-acid-a-case-report-and-review-of-the-literature
#15
Hui-Hui Wang, Fei-Qiu Wen, Dong-Ling Dai, Jian-She Wang, Jing Zhao, Kenneth Dr Setchell, Li-Na Shi, Shao-Ming Zhou, Si-Xi Liu, Qing-Hua Yang
Steroid 5β-reductase [aldo-keto reductase family 1 member D1 ( AKR1D1 )] is essential for bile acid biosynthesis. Bile acid deficiency caused by genetic defects in AKR1D1 leads to life-threatening neonatal hepatitis and cholestasis. There is still limited experience regarding the treatment of this disease. We describe an infant who presented with hyperbilirubinemia and coagulopathy but normal bile acid and γ-glutamyltransferase. Gene analysis was performed using genomic DNA from peripheral lymphocytes from the patient, his parents, and his elder brother...
September 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/30248286/a-rare-cause-of-acute-abdomen-isolated-necrosis-of-the-cecum
#16
Kemal Eyvaz, Hasan Ediz Sıkar, Mehmet Gökçeimam, Hasan Fehmi Küçük, Necmi Kurt
We would like to present the case of a 76-year-old female patient with cecal necrosis, which is a rare cause of acute abdomen in elderly women and a variant of ischemic colitis. The patient was admitted to our hospital with abdominal pain, anorexia, and nausea. Physical examination, laboratory parameters, and abdominal computed tomography revealed acute abdomen. We operated the patient with an infra-umbilical midline incision. Considering the pain localized to the right lower quadrant, our initial diagnosis was acute appendicitis; however, we kept in mind other differential diagnoses as well...
September 11, 2018: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/30247600/varicella-zoster-virus-vasculopathy
#17
Maria A Nagel, Andrew N Bubak
Varicella zoster virus (VZV) is a ubiquitous, exclusively human alphaherpesvirus that produces varicella then becomes latent in ganglionic neurons. In elderly and immunocompromised individuals, VZV reactivates and typically produces herpes zoster. Studies of patients with VZV vasculopathy have identified key clinical, imaging, and laboratory features to assist in diagnosis and treatment. Complementary studies have further expanded the spectrum of VZV vasculopathy to include the extracranial circulation and identified mechanisms contributing to its pathogenesis...
September 22, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/30245090/surgical-management-for-middle-or-lower-thoracic-spinal-tuberculosis-t5-t12-in-elderly-patients-posterior-versus-anterior-approach
#18
Zhongyang Li, Fei Lei, Peng Xiu, Xi Yang, Lei Wang, Ganjun Feng, Limin Liu, Yueming Song, Chunguang Zhou
BACKGROUND: Spinal tuberculosis accounts for more than 50% of bone tuberculosis cases. This study compared clinical, radiological and functional outcomes between anterior and posterior approaches for treatment of middle or lower thoracic spinal tuberculosis in elderly patients. METHODS: We retrospectively examined middle or lower thoracic spinal tuberculosis (T5-T12) in patients over 65 years. All procedures included debridement, decompression, autologous bone graft and fixation...
September 20, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/30235686/etiology-and-clinical-manifestations-of-bacterial-liver-abscess-a-study-of-102-cases
#19
Wen-Jing Wang, Zhen Tao, Hui-Ling Wu
This study aimed to analyze the clinical manifestations of patients with pyogenic liver abscess and characteristics of pathogenic that caused their infections, in order to provide guidance for the identification of the pathogens that cause liver abscess and selection of antibiotics for treatment of this disease.In the present study, the clinical characteristics, laboratory results, as well as the species and drug resistance of pathogens in patients with bacterial liver abscesses admitted to our hospital from January 2013 to December 2015 were retrospectively analyzed...
September 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30227144/limitations-of-platform-assays-to-measure-serum-25ohd-level-impact-on-guidelines-and-practice-decision-making
#20
Maya Rahme, Laila Al Shaar, Ravinder Singh, Rafic Baddoura, Georges Halaby, Asma Arabi, Robert H Habib, Rose Daher, Darina Bassil, Karim El-Ferkh, Maha Hoteit, Ghada El-Hajj Fuleihan
CONTEXT: Liquid Chromatography Mass Spectroscopy (LC-MS/MS) is the preferred method to measure 25 hydroxyvitamin D (25OHD) levels, but laboratories are increasingly adopting automated platform assays. OBJECTIVE: We assessed the performance of commonly used automated immunoassays, with that of LC-MS/MS, and the National Institute of Standards and Technology (NIST) reference values, to measure 25OHD levels. METHODS/SETTING: We compared serum 25OHD levels obtained from 219 elderly subjects, enrolled in a vitamin D trial, using the Diasorin Liaison platform assay, and the tandem LC-MS/MS method...
September 15, 2018: Metabolism: Clinical and Experimental
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