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Polymorbid patient

J Schuld, M Glanemann
Colorectal carcinoma is one of the most frequent tumor entities worldwide. The treatment of elderly and mostly polymorbid patients is an outstanding challenge in view of the demographic change with a continuously aging community. Due to the demographic changes the numbers of elderly (>65 years) and very old (≥80 years) patients are steadily increasing in surgical cohorts. This has resulted in higher morbidity and mortality rates in comparison to younger patients, with increased wound healing and cardiovascular complications but with comparable numbers of anastomotic insufficiency...
February 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
O Abrahamovych, M Abrahamovych, S Tolopko, O Fayura, M Ferko
In this study, we comprehensively examined 93 patients with liver cirrhosis, selected in a randomized manner, with the preliminary stratification by the presence of hepatopulmonary syndrome with the aim to study the nature and frequency of extrahepatic syntropic lesions of organs and systems and their dependence on the severity of lung injury that is necessary for the appointment of the most effective individualized comprehensive treatment. The results of our calculations showed that with the increasing of the hepatopulmonary syndromeseverity degree, the nature and the frequency of the syntropic co- and polymorbid functional and organic extrahepatic lesions of the organs and body systems was significantly (p<0...
November 2016: Georgian Medical News
Lukas Leitner, Ewald Musser, Norbert Kastner, Jörg Friesenbichler, Daniela Hirzberger, Roman Radl, Andreas Leithner, Patrick Sadoghi
Red blood cell concentrates (RCC) substitution after total knee arthroplasty (TKA) is correlated with multifold of complications and an independent predictor for higher postoperative mortality. TKA is mainly performed in elderly patients with pre-existing polymorbidity, often requiring permanent preoperative antithrombotic therapy (PAT). The aim of this retrospective analysis was to investigate the impact of demand for PAT on inpatient blood management in patients undergoing TKA. In this study 200 patients were retrospectively evaluated after TKA for differences between PAT and non-PAT regarding demographic parameters, preoperative ASA score > 2, duration of operation, pre-, and intraoperative hemoglobin level, and postoperative parameters including amount of wound drainage, RCC requirement, and inpatient time...
2016: Scientific Reports
Sophie Pautex, Catherine Weber
The number of patients with multimorbidity is steadily increasing due to medical progress and increased life expectancy. A palliative approach may be offered to some of these patients. It includes the detection and management of somatic and mental symptoms, the management of social and spiritual problems, the anticipation of care and support of the relatives. Its main goal is to improve patient's quality of life and reduce interventions that are unnecessary, or undesired by patients themselves.
May 11, 2016: Revue Médicale Suisse
Jürgen Eiche, Florian Schache
Pains belong to the most frequent reasons for a doctor's visit. In elderly people, it is the result of progressive degenerative processes (e. g. , arthrosis, Osteoarthritis, degenerative spinal changes) and a higher prevalence of cancer disease to a further increase of the patients who suffer unnecessarily from pains. By the increasing polymorbidity (e.g. diabetes mellitus, vascular disease) and a declining immune competence, the prevalence of polyneuropathy and post-herpetic neuralgia rises. Insufficiently treated chronic or periodically returning pain can lead to serious interferences of the physical, cognitive and social everyday competence and therefore to a limited quality of life...
April 2016: Deutsche Medizinische Wochenschrift
Lawrence B Afrin, Joseph H Butterfield, Martin Raithel, Gerhard J Molderings
Mast cell (MC) disease has long been thought to be just the rare disease of mastocytosis (in various forms, principally cutaneous and systemic), with aberrant MC mediator release at symptomatic levels due to neoplastic MC proliferation. Recent discoveries now show a new view is in order, with mastocytosis capping a metaphorical iceberg now called "MC activation disease" (MCAD, i.e. disease principally manifesting inappropriate MC activation), with the bulk of the iceberg being the recently recognized "MC activation syndrome" (MCAS), featuring inappropriate MC activation to symptomatic levels with little to no inappropriate MC proliferation...
2016: Annals of Medicine
Yu A Nikolaev, E V Sevostyanova, I M Mitrofanov, V Ya Polyakov, N A Dolgova
AIM: To examine the incidence of polymorbidity (PM) and changes in its rates in 2003 to 2011 in cardiac and gastroenterologic patients living in the Novosibirsk Region and the Republic of Sakha (Yakutia) in accordance with gender, occupation, and residence. SUBJECTS AND METHODS: The dynamics of PM rates was analyzed in 13 496 patients who had been examined and treated at the Cardiology and Gastroenterology Departments, Therapeutic Clinic, Research Institute of Experimental and Clinical Medicine (Novosibirsk), 2003-2011...
2016: Terapevticheskiĭ Arkhiv
Claudia Stöllberger, Maria Heger, Josef Finsterer
Spontaneous hemopericardium is a complication of anticoagulant therapy with not only vitamin-K-antagonists, but also with nonvitamin-K-antagonist oral anticoagulants. We report a polymorbid 75-year old male under a therapy with dabigatran, valsartan, amlodipine, nicorandil, furosemide, atorvastatin, bisoprolol, metformin, tizanidine, pantoprazole, and tramadol. He suffered from chest pain for 4 months. Coronary angiography showed only ectatic coronary arteries. He started taking nonsteroidal anti-inflammatory drugs...
March 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Ulrich W Kolck, Britta Haenisch, Gerhard J Molderings
Traditionally, mast cell activation disease (MCAD) has been considered as just one rare (neoplastic) disease, mastocytosis, focused on the mast cell (MC) mediators tryptase and histamine and the suggestive, blatant symptoms of flushing and anaphylaxis. Recently another form of MCAD, the MC activation syndrome, has been recognized featuring inappropriate MC activation with little to no neoplasia and likely much more heterogeneously clonal and far more prevalent than mastocytosis. Increasing expertise and appreciation has been established for the truly very large menagerie of MC mediators and their complex patterns of release, engendering complex, nebulous presentations of chronic and acute illness best characterized as multisystem polymorbidity of generally inflammatory ± allergic theme...
August 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
V N Meshchaninov, E L Tkachenko, S V Zharkov, I V Gavrilov, Iu E Katyreva
We've estimated the cellular and metabolic part of geroprophylactic effects of short synthetic tripeptides vesugen and pinealon for correction of the biological age. 32 people (18 men, 12 women) aged 41-83 years with polymorbidity and the organic brain syndrome in remission participated in the study. The preparations of "Pinealon" and "Vesugen" have had the significant anabolic effect. They have improved the activity of the Central nervous system and other vital organs, which slows the rate of aging by biological age indicators...
2015: Advances in Gerontology, Uspekhi Gerontologii
P Kaiser, G Schmidle, C Raas, M Blauth
OBJECTIVE: Rapid recovery of the skin and soft tissue of the affected knee joint with surgical debridement of the wound and gentle, as well as risk-balanced partial resection of the traumatic lacerated prepatellar bursa. Functional aftercare with directed administration of antibiotics only. INDICATIONS: Acute, traumatic laceration of the prepatellar bursa. CONTRAINDICATIONS: Heavy contamination of the wound. Large, not closable skin defect or deep abrasion...
October 2015: Operative Orthopädie und Traumatologie
Delphine Renard, Eve Rubli, Nathalie Voide, François-Xavier Borruat, Laura E Rothuizen
BACKGROUND: Digoxin intoxication results in predominantly digestive, cardiac and neurological symptoms. This case is outstanding in that the intoxication occurred in a nonagenarian and induced severe, extensively documented visual symptoms as well as dysphagia and proprioceptive illusions. Moreover, it went undiagnosed for a whole month despite close medical follow-up, illustrating the difficulty in recognizing drug-induced effects in a polymorbid patient. CASE PRESENTATION: Digoxin 0...
2015: BMC Research Notes
Lawrence B Afrin, Dieter Pöhlau, Martin Raithel, Britta Haenisch, Franz L Dumoulin, Juergen Homann, Uwe M Mauer, Sabrina Harzer, Gerhard J Molderings
Neurologists and psychiatrists frequently encounter patients whose central and/or peripheral neurologic and/or psychiatric symptoms (NPS) are accompanied by other symptoms for which investigation finds no unifying cause and for which empiric therapy often provides little to no benefit. Systemic mast cell activation disease (MCAD) has rarely been considered in the differential diagnosis in such situations. Traditionally, MCAD has been considered as just one rare (neoplastic) disease, mastocytosis, generally focusing on the mast cell (MC) mediators tryptase and histamine and the suggestive, blatant symptoms of flushing and anaphylaxis...
November 2015: Brain, Behavior, and Immunity
N B Petrukhina, O A Zorina, I M Rabinovich, A M Shilov
The study of risk factors for cardio-vascular continuum (CVC), the influence of the digestive tract endobiosis on lipid-carbohydrate metabolism and clinical status, a retrospective analysis of 1000 medical records of patients, suffering from various diseases of internal organs (Gastrointestinal tract, coronary heart disease, type 2 diabetes, obesity) in combination with periodontitis of varying severity, aged 20 to 55 years. A statistically significant relationship is directly proportional to the severity of inflammation of periodontal tissues with body mass index (BMI), especially pronounced in patients with a BMI ≥225 kg/m2 which is the "calling card" of the metabolic syndrome - clinical model polymorbidity...
2015: Stomatologii︠a︡
S E Huttmann, J H Storre, W Windisch
Home mechanical ventilation represents a valuable therapeutic option to improve alveolar ventilation in patients with chronic respiratory failure. For this purpose both invasive ventilation via tracheostomy and noninvasive ventilation via facemasks are available. The primary goal of home mechanical ventilation is a reduction of symptoms, improvement of quality of life and in many cases reduction of mortality. Elective establishment of home mechanical ventilation is typically provided for noninvasive ventilation in respect to clinical symptoms and partial pressure of carbon dioxide depending on the underlying disease...
June 2015: Der Anaesthesist
A Y Ryabova, T G Shapovalova, M M Shashina, T N Guzenko, S V Volkov
Presented case report of an.elderl patient having polymorbidity pathology. Clinical "mask" of the destructive cholecystitisis an acut emyocardial infarction complicated bycardia casthma. The diagnosis of myocardial infarction has not been confirmed. Onemergency indications was performed cholecystectomy.
2015: Experimental & Clinical Gastroenterology
T Mittlmeier, A Eschler
OBJECTIVE: The goal of treatment is a plantigrade, stable, ulcer-free foot which can be addressed with diabetes-adapted insoles and/or DNOAP shoes. INDICATIONS: Charcot foot of the midfoot with/without infection-free ulcers. CONTRAINDICATIONS: Inacceptable anesthesiological risk in polymorbidity. Severe anesthesiological risks in multimorbid patients; symptomatic peripheral arterial occlusive disease not suitable for reconstruction; infections PEDIS/IWGDF grade 3 or 4, nonreconstructable osseous defects...
April 2015: Operative Orthopädie und Traumatologie
Chih-Wei Huang, Shabbir Syed-Abdul, Wen-Shan Jian, Usman Iqbal, Phung-Anh Alex Nguyen, Peisan Lee, Shen-Hsien Lin, Wen-Ding Hsu, Mai-Szu Wu, Chun-Fu Wang, Kwan-Liu Ma, Yu-Chuan Jack Li
OBJECTIVE: The aim of this study is to analyze and visualize the polymorbidity associated with chronic kidney disease (CKD). The study shows diseases associated with CKD before and after CKD diagnosis in a time-evolutionary type visualization. MATERIALS AND METHODS: Our sample data came from a population of one million individuals randomly selected from the Taiwan National Health Insurance Database, 1998 to 2011. From this group, those patients diagnosed with CKD were included in the analysis...
March 2015: Journal of the American Medical Informatics Association: JAMIA
Radek Kucera, Ondrej Topolcan, Ladislav Pecen, Judita Kinkorova, Sarka Svobodova, Jindra Windrichova, Radka Fuchsova
BACKGROUND: IGF1 is responsible for regulation of growth, metabolism and differentiation of human cells. IGFBP3 is the most abundant of the carrier proteins for IGF1 in the blood. IGF1/IGFBP3 molar ratio is an indicator of IGF1 bioavailability. We decided to create a file of reference ranges of IGF1, IGFBP3 and IGF1/IGFBPP3 ratio for the adult Czech population across the age spectrum. METHODS: We selected a group of 1022 subjects, 467 males and 555 females (ages 20-98 years), from several regions in the Czech Republic...
April 15, 2015: Clinica Chimica Acta; International Journal of Clinical Chemistry
Philipp Schuetz, Drahomir Aujesky, Christian Müller, Beat Müller
Polymorbid patients, diverse diagnostic and therapeutic options, more complex hospital structures, financial incentives, benchmarking, as well as perceptional and societal changes put pressure on medical doctors, specifically if medical errors surface. This is particularly true for the emergency department setting, where patients face delayed or erroneous initial diagnostic or therapeutic measures and costly hospital stays due to sub-optimal triage. A "biomarker" is any laboratory tool with the potential better to detect and characterise diseases, to simplify complex clinical algorithms and to improve clinical problem solving in routine care...
2015: Swiss Medical Weekly
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