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Karel Smetana, Lukáš Lacina, Pavol Szabo, Barbora Dvořánková, Prokop Brož, Aleksi Šedo
An ageing population is a typical feature of many developed countries across the world. Analyzed from a biomedical and philosophical point of view, this phenomenon is also a potential risk factor for social sustainability of communities. The association between ageing and cancer seems to be more than apparent. Therefore, the further increase of epidemic-like incidence of malignant tumors in a population can be expected in the near future. Elderly people usually suffer from age-dependent diseases, and such polymorbidity can seriously affect the treatment of malignant tumors...
October 2016: Anticancer Research
Aude Desnoyer, Bertrand Guignard, Pierre-Olivier Lang, Jules Desmeules, Nicole Vogt-Ferrier, Pascal Bonnabry
BACKGROUND: Potentially inappropriate prescriptions include over-prescription, which refers to prescription of more drugs than clinically needed, mis-prescription which refers to incorrect prescription of a drug that is needed (as per drug, dose, drug interactions, duration of therapy, duplication, follow-up, etc.) and under-prescription which stands for failure to prescribe drugs that are needed. They are associated with adverse drug events, increased use of health-care services, morbimortality and health-care costs, and poorer quality of life...
November 2016: La Presse Médicale
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 4, 2016: 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
A M Zaprudnov, L A Kharitonova, K I Grigoriev, L V Bogomaz
The nomenclature of digestive diseases in children was supplemented by the "new" diseases: of esophagus--gastroesophageal reflux disease (GERD), Barrett's esophagus, Zenker's diverticulum; of stomach and duodenum--gastroduodenitis, peptic ulcer disease, polyps, ectopic pancreas in the stomach wall; of the intestine--jejunitis, ileocolitis, Crohn's disease, celiac disease, bacterial overgrowth syndrome in the small intestine; of biliary tract--cholelithiasis, gallbladder cholesterosis, anomalies of the biliary tract; of pancreas--acute and chronic pancreatitis, annular pancreas (2)...
2015: Experimental & Clinical Gastroenterology
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
Lawrence B Afrin, Frank M Cichocki, Kamal Patel, Gerhard J Molderings
Mast cell (MC) activation syndrome (MCAS) is a recently recognized, likely prevalent collection of heterogeneous illnesses of inappropriate MC activation with little to no MC neoplasia likely driven by heterogeneous patterns of constitutively activating mutations in MC regulatory elements including various tyrosine kinases (TKs, dominantly KIT). MCAS typically presents as chronic multisystem polymorbidity of generally inflammatory ± allergic theme. As with indolent systemic mastocytosis (SM), treatment of MCAS focuses more against MC mediators than MC neoplasia, but some cases prove refractory even to the TK inhibitor (TKI) imatinib reported useful both in uncommon SM cases not bearing SM's usual imatinib-resistant KIT-D816V mutation and in some cases of MCAS (which rarely bears KIT-D816V)...
December 2015: European Journal of Haematology
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
Cedric Annweiler, Anastasiia Kabeshova, Mathilde Legeay, Bruno Fantino, Olivier Beauchet
OBJECTIVES: Hypovitaminosis D is highly prevalent among seniors. Although evidence is insufficient to recommend routine vitamin D screening in seniors, universal vitamin D supplementation is not desirable either. To rationalize vitamin D determination, our objective was to elaborate and test a clinical diagnostic tool for the identification of seniors with hypovitaminosis D without using a blood test. DESIGN: Derivation of a clinical diagnostic tool using artificial neural networks (multilayer perceptron; MLP) in randomized training subgroup of Prévention des Chutes, Réseau 4' cohort, and validation in randomized testing subgroup...
June 1, 2015: Journal of the American Medical Directors Association
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
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