keyword
https://read.qxmd.com/read/38648213/clinical-features-of-quadricuspid-aortic-valve-in-middle-aged-and-elderly-patients-insights-from-a-regional-study
#21
JOURNAL ARTICLE
Azumi Takiishi, Yuichi Baba, Yuri Ochi, Mizuki Hotta, Nagisa Okazaki, Yuna Yoshinaga, Shohei Miyamoto, Daigo Hirakawa, Juri Kawaguchi, Toru Kubo, Naohito Yamasaki, Shinji Tokuhiro, Hiroaki Kitaoka
BACKGROUND: Quadricuspid aortic valve (QAV) is a rare congenital disease. The clinical characteristics of this disease remain unclear except for those in relatively young patients reported from tertiary referral hospitals. The aim of this study was to determine the clinical features of QAV in a regional population. METHODS AND RESULTS: We retrospectively investigated 25 340 consecutive patients over middle age (median age, 73 (IQR 65-80) years; range, 45-102 years) who underwent transthoracic echocardiography (TTE) at our institute during the period from April 2008 to December 2023...
April 2024: Echocardiography
https://read.qxmd.com/read/38648048/a-mimicker-of-differentiated-vulvar-intraepithelial-neoplasia-reactive-atypia-from-noncompliance-with-lichen-sclerosus-therapy
#22
JOURNAL ARTICLE
Advaita S Chaudhari, Jason R McFadden, Jessica Bentz, Rebecca H Evans, Maria A Selim, Aravindhan Sriharan
Differentiated vulvar intraepithelial neoplasia (d-VIN) is an HPV-independent precursor to vulvar squamous cell carcinoma. The histology of d-VIN lesions is difficult to differentiate from that of non-neoplastic epithelial disorders, especially lichen sclerosus (LS). The authors present a case of LS, where relying on histopathology alone could have led to misdiagnosis. The patient was a 17-year-old female patient with clinical features of vulvar dermatitis and LS for 2 years. She was counseled to apply clobetasol 0...
April 23, 2024: American Journal of Dermatopathology
https://read.qxmd.com/read/38648027/follicular-infundibular-tricholemmal-squamous-cell-carcinoma-a-new-who-entity-clinicopathological-features-in-103-cases-including-follow-up-and-implications-for-patient-management
#23
JOURNAL ARTICLE
Richard A Carr, James Wiggins, David N Slater
AIMS: Cutaneous follicular (infundibular-tricholemmal) squamous cell carcinoma (FSCC) is a new World Health Organization entity. We present the largest series of published cases, summarizing clinical data, diagnostic criteria, differential diagnosis, and implications for patient management. METHODS: Cases were identified from 2004 to 2011. Inclusion criteria included discrete attachment(s) of the tumor to the overlying epidermis via follicular infundibula, tricholemmal keratinization, and cellular pleomorphism...
April 23, 2024: American Journal of Dermatopathology
https://read.qxmd.com/read/38646877/evaluating-targeted-therapies-in-older-patients-with-tp53-mutated-aml
#24
REVIEW
Jean M G Sabile, Ronan Swords, Jeffrey W Tyner
Mutation of thetumor suppressor gene, TP53 ( tumor protein 53 ), occurs in up to 15% of all patients with acute myeloid leukemia (AML) and is enriched within specific clinical subsets, most notably in older adults, and including secondary AML cases arising from preceding myeloproliferative neoplasm (MPN), myelodysplastic syndrome (MDS), patients exposed to prior DNA-damaging, cytotoxic therapies. In all cases, these tumors have remained difficult to effectively treat with conventional therapeutic regimens. Newer approaches fortreatmentof TP53- mutated AML have shifted to interventions that maymodulate TP53 function, target downstream molecular vulnerabilities, target non-p53 dependent molecular pathways, and/or elicit immunogenic responses...
April 22, 2024: Leukemia & Lymphoma
https://read.qxmd.com/read/38646562/clinical-outcomes-of-diverticular-disease-in-young-adults-results-from-a-tertiary-referral-center
#25
JOURNAL ARTICLE
Giovanni Santacroce, Marco Vincenzo Lenti, Giulia Maria Abruzzese, Giacomo Alunno, Francesco Di Terlizzi, Carmine Frenna, Antonella Gentile, Mario Andrea Latorre, Clarissa Petrucci, Damiano Ruggeri, Simone Soriano, Nicola Aronico, Annalisa De Silvestri, Gino Roberto Corazza, Marietta Iacucci, Antonio Di Sabatino
INTRODUCTION: Diverticular disease (DD), commonly associated with the elderly, is becoming more prevalent among younger individuals. This retrospective study aimed to evaluate the differences in the natural history and outcomes between young and old patients with DD. METHODS: Adult patients with DD diagnosed between 2010 and 2022 at an Italian tertiary referral center were enrolled, and their demographic and clinical data were retrieved. The patients were categorized as young or old based on the 25th percentile of the population's age at diagnosis...
2024: Frontiers in Medicine
https://read.qxmd.com/read/38646462/association-between-preoperative-sleep-disturbance-and-postoperative-delirium-in-elderly-a-retrospective-cohort-study
#26
JOURNAL ARTICLE
Hao Guo, Li-Heng Li, Xiao-Hong Lv, Feng-Zhi Su, Jie Chen, Fei Xiao, Min Shi, Yu-Bo Xie
PURPOSE: Postoperative sleep disturbance, characterized by diminished postoperative sleep quality, is a risk factor for postoperative delirium (POD); however, the association between pre-existing sleep disturbance and POD remains unclear. This study aimed to evaluate the association between preoperative sleep disturbance and POD in elderly patients after non-cardiac surgery. PATIENTS AND METHODS: This retrospective cohort study was conducted at a single center and enrolled 489 elderly patients who underwent surgery between May 1, 2020, and March 31, 2021...
2024: Nature and Science of Sleep
https://read.qxmd.com/read/38646458/complete-congenital-absence-of-the-left-pericardium-in-elderly-patient-a-case-report
#27
Sintayehu Mekonnen, Hawi Farris, Daniel Azmeraw
Congenital pericardial absence is an uncommon heart condition that is usually undiagnosed due to a lack of symptoms and awareness. In this case study, we present a 72-year-old patient who initially presented for medical evaluation due to unexplained weight loss, a displaced cardiac apex, and poor echocardiographic windows. An extracardiac tumor was suspected at first, but it was later determined that the patient had a congenital complete absence of the left pericardium. This case illustrates the possibility for benign pathology to present abnormally and details the clinical features, imaging findings, and management of congenital absence of the pericardium...
2024: International Medical Case Reports Journal
https://read.qxmd.com/read/38646456/enhancing-colonoscopy-preparation-in-elderly-constipation-patients-a-personalized-approach-with-peg-and-exercise-a-case-study
#28
Lanlang Zhang, Lixia Huang, Shanshan Liu, Xiaofeng Sun
This study aimed to optimize bowel preparation efficacy for colonoscopy in elderly constipation patients. A 71-year-old patient with chronic constipation and a history of poor bowel preparation. To address these challenges, we implemented a personalized strategy combining of PEG administration and walking exercise. The PEG was administered according to a protocol, with intermittent exercise breaks of 10 minute. Bowel cleanliness was assessed using the Boston Bowel Preparation Scale (BBPS). Adverse reactions and tolerance were closely monitored throughout the intervention...
2024: International Medical Case Reports Journal
https://read.qxmd.com/read/38646447/machine-learning-based-on-the-eeg-and-structural-mri-can-predict-different-stages-of-vascular-cognitive-impairment
#29
JOURNAL ARTICLE
Zihao Li, Meini Wu, Changhao Yin, Zhenqi Wang, Jianhang Wang, Lingyu Chen, Weina Zhao
BACKGROUND: Vascular cognitive impairment (VCI) is a major cause of cognitive impairment in the elderly and a co-factor in the development and progression of most neurodegenerative diseases. With the continuing development of neuroimaging, multiple markers can be combined to provide richer biological information, but little is known about their diagnostic value in VCI. METHODS: A total of 83 subjects participated in our study, including 32 patients with vascular cognitive impairment with no dementia (VCIND), 21 patients with vascular dementia (VD), and 30 normal controls (NC)...
2024: Frontiers in Aging Neuroscience
https://read.qxmd.com/read/38646321/chronic-visual-abnormality-in-an-elderly-patient-with-temporal-lobe-epilepsy
#30
Kiyohiro Atsuji, Shuichiro Neshige, Narumi Ohno, Hirofumi Maruyama
A 79-year-old woman visited our department for chronic visual field abnormalities with a floating sensation for two months. Neurological and ophthalmologic examinations yielded normal results, except for brain MRI indicating left hippocampal atrophy. Cognitive function tests were normal. EEG revealed frequent spikes and slow waves in the left frontotemporal region, corroborated by reduced accumulation in 123 I-iomazenil single photon emission computed tomography. A diagnosis of temporal lobe epilepsy was established, and treatment with lacosamide resulted in a remarkable improvement in symptoms and EEG findings...
March 2024: Curēus
https://read.qxmd.com/read/38646287/multiple-complicated-concurrent-hernias-in-a-single-patient-a-case-report
#31
Huy Q Nguyen, Toan K Dang, Hien T Tran, Huy L Phan, Dang Khoa D Ho
Multiple complicated concurrent hernias with obturator hernia and paraesophageal hernia unusually occur in clinical settings. The obturator hernias belong to a rare pelvic hernia that accounts for a minority of all abdominal hernias. Besides, paraesophageal hernias occur commonly in elderly female patients. Clinical manifestations of these hernias are usually unspecific and the diagnosis is based on computed tomography (CT). In this paper, we presented a case of multiple complicated hernias in an 81-year-old woman...
March 2024: Curēus
https://read.qxmd.com/read/38646280/trivial-neck-bite-resulting-in-a-stroke-in-an-18-month-old-child-a-case-report
#32
Ruthwik Duvuru, Ahmad Alawadhi, Shivani Raju, Haitham ElBashir
Stroke is often viewed as a diagnosis found In the elderly with or without comorbidities, but it is vital to not rule it out in a pediatric patient presenting with signs and symptoms of stroke. Here, we present a case of an 18-month-old boy who arrived at the emergency department with left arm weakness and left-sided seizures a few minutes after a right-sided trivial neck bite that was initially overlooked by the parents until symptoms occurred. Urgent imaging further with a computed tomography scan of the brain revealed a hypodense lesion in the area covering the lateral part of the frontal lobe, insula, and parietal cortex of the right hemisphere...
March 2024: Curēus
https://read.qxmd.com/read/38646210/herpes-zoster-ophthalmicus-initially-diagnosed-as-cluster-headache-complicated-by-delayed-eruption
#33
Hidenori Sanayama, Michito Namekawa, Yoshio Sakiyama, Hitoshi Sugawara
Herpes zoster ophthalmicus (HZO) manifests as a consequence of the reactivation of the Varicella-zoster virus (VZV) and primarily affects the ophthalmic division of the trigeminal nerve. Identification of the vesicular eruption is central to the diagnostic process; however, the delayed manifestation of this cutaneous phenomenon poses a challenge to timely and accurate diagnosis. This report elucidates the case of a 61-year-old Japanese male with painful trigeminal neuropathy attributed to VZV that was initially diagnosed as cluster headache, mainly due to the delayed cutaneous eruption...
March 2024: Curēus
https://read.qxmd.com/read/38646150/effect-of-anticoagulation-on-the-incidence-of-venous-thromboembolism-major-bleeding-and-mortality-among-hospitalized-covid-19-patients-an-updated-meta-analysis
#34
Xinwang Chen, Suyun Zhang, Haiyu Liu, Qianyuan Zhang, Jinghan Chen, Qixian Zheng, Ningjing Guo, Yuanyuan Cai, Qiong Luo, Qian Xu, Sheng Yang, Xiangqi Chen
OBJECTIVE: Anticoagulation is crucial for patients hospitalized with coronavirus disease 2019 (COVID-19) due to the high risk of venous thromboembolism (VTE). However, the optimal anticoagulation regimen needs further exploration. Therefore, we evaluated the efficacy and safety of diverse anticoagulation dosage dosages for COVID-19. METHODS: An updated meta-analysis was performed to assess the effect of thromboprophylaxis (standard, intermediate, and therapeutic dose) on the incidence of VTE, mortality and major bleeding among COVID-19 patients...
2024: Frontiers in Cardiovascular Medicine
https://read.qxmd.com/read/38645963/hidden-intruder-plasmacytoma-causing-uncontrolled-epistaxis-in-an-elderly-patient
#35
Omar Younis, Anas Odeh, Motaz Saifi, Yazan Dumaidi, Mazen Kazlak
Extramedullary plasmacytoma (EMP) is an uncommon tumor marked by the monoclonal growth of plasma cells without the characteristics of multiple myeloma. EMP represents 3% of all plasma cell tumors. An 89-year-old male patient with hypertension was admitted to our tertiary care hospital with uncontrolled unilateral epistaxis. After a year and a half of recurring epistaxis, the patient's bleeding became more frequent and could no longer be controlled with nasal packing. Angiofibroma was suspected as the initial differential diagnosis, and angiofibroma embolization was performed...
July 2024: Radiology Case Reports
https://read.qxmd.com/read/38645913/monoclonal-gammopathy-of-renal-significance-mgrs-case-series-from-a-tertiary-center-in-kerala
#36
Priya Padmanabhan, Jayameena P, Neena Mampilly, Shinto Francis, Ajmal Sherif, Sunil George, Thomas Mathew
Monoclonal gammopathy of renal significance (MGRS) has gained importance because identifying the monoclonal deposit and addressing it, rather than treating renal dysfunction as the primary pathology, has salvaged the patients from progressing into end-stage renal disease. Since it affects elderly population, there could be a propensity to misdiagnose them with cardiorenal syndrome. We present four patients of MGRS diagnosed from our center. They presented with proteinuria or unexplained renal dysfunction. Three of the patients were diagnosed to have amyloidosis, of which two had lambda-type and one had kappa amyloidosis...
2024: Indian Journal of Nephrology
https://read.qxmd.com/read/38645871/-application-and-effect-of-patient-portal-system-in-the-remote-management-of-chronic-diseases-for-older-adults-with-coronary-heart-disease
#37
JOURNAL ARTICLE
Fangyuan Wen, Guanghui DU, Feng Tian, Xiaojuan Zhao
OBJECTIVE: To investigate the application of personal health record (PHR) and chronic disease management platform established on the basis of patient portal system (PPS) in managing older adults with coronary heart disease and to examine the effect on patients' self-care ability, coping mode, and quality of life. METHODS: A total of 532 elderly patients with coronary heart disease were included in the study. All the participants enrolled were admitted to a tertiary-care hospital between January 2019 and June 2021...
March 20, 2024: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://read.qxmd.com/read/38645862/-identification-of-osteoarthritis-inflamm-aging-biomarkers-by-integrating-bioinformatic-analysis-and-machine-learning-strategies-and-the-clinical-validation
#38
JOURNAL ARTICLE
Qiao Zhou, Jian Liu, Yan Zhu, Yuan Wang, Guizhen Wang, Yajun Qi, Yuedi Hu
OBJECTIVE: To identify inflamm-aging related biomarkers in osteoarthritis (OA). METHODS: Microarray gene profiles of young and aging OA patients were obtained from the Gene Expression Omnibus (GEO) database and aging-related genes (ARGs) were obtained from the Human Aging Genome Resource (HAGR) database. The differentially expressed genes of young OA and older OA patients were screened and then intersected with ARGs to obtain the aging-related genes of OA. Enrichment analysis was performed to reveal the potential mechanisms of aging-related markers in OA...
March 20, 2024: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://read.qxmd.com/read/38644785/atypical-case-of-choroidal-osteoma-associated-to-polypoidal-choroidal-vasculopathy-and-preretinal-neovascular-membrane
#39
JOURNAL ARTICLE
Mohamed Ben Brahem, Khaled El Matri, Yousra Fafloul, Amel Chebbi, Olfa Fekih, Leila Nacef, Leila El Matri
PURPOSE: To report a very rare and atypical case of an elderly Caucasian female patient who developed perilesional multiple polypoidal choroidal vasculopathy (PCV) as a probable complication of choroidal osteoma (CO), associated to preretinal neovascular membrane overlying the lesion. METHODS: Observational case report. CASE OBSERVATION: A 60-year-old Caucasian woman presented with blurred vision in her right eye (RE). Fundus examination revealed a round white-yellowish calcified deep lesion in the juxta-papillary superior area, measuring 4 disc-diameters, with well-defined scalloped margins and an irregular surface...
April 22, 2024: European Journal of Ophthalmology
https://read.qxmd.com/read/38644730/italian-guidelines-for-the-management-of-sporadic-primary-hyperparathyroidism
#40
Fabio Vescini, Giorgio Borretta, Iacopo Chiodini, Marco Boniardi, Marina Carotti, Elena Castellano, Cristiana Cipriani, Cristina Eller-Vainicher, Sandro Giannini, Maurizio Iacobone, Antonio Stefano Salcuni, Federica Saponaro, Stefano Spiezia, Annibale Versari, Guido Zavatta, Zuzana Mitrova, Rosella Saulle, Simona Vecchi, Debora Antonini, Michele Basile, Alexia Giovanazzi, Agostino Paoletta, Enrico Papini, Agnese Persichetti, Irene Samperi, Alessandro Scoppola, Roberto Novizio, Pietro Giorgio Calò, Filomena Cetani, Luisella Cianferotti, Sabrina Corbetta, Maria Luisa De Rimini, Alberto Falchetti, Giovanni Iannetti, Stefano Laureti, Celestino Pio Lombardi, Bruno Madeo, Claudio Marcocci, Sandro Mazzaferro, Vittorio Miele, Salvatore Minisola, Andrea Palermo, Jessica Pepe, Alfredo Scillitani, Laura Tonzar, Franco Grimaldi, Renato Cozzi, Roberto Attanasio
AIM: This guideline (GL) is aimed at providing a clinical practice reference for the management of sporadic primary hyperparathyroidism (PHPT) in adults. PHPT management in pregnancy was not considered. METHODS: This GL has been developed following the methods described in the Manual of the Italian National Guideline System. For each question, the panel appointed by Associazione Medici Endocrinology (AME) and Società Italiana dell'Osteoporosi, del Metabolismo Minerale e delle Malattie dello Scheletro (SIOMMMS) identified potentially relevant outcomes, which were then rated for their impact on therapeutic choices...
December 23, 2023: Endocrine, Metabolic & Immune Disorders Drug Targets
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