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Constipation in elderly

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https://www.readbyqxmd.com/read/29316322/incarcerated-obturator-hernia-treated-using-a-hybrid-laparoscopic-and-anterior-preperitoneal-approach-a-case-report
#1
Yuta Yamazaki, Yasunori Otowa, Shunsuke Kusano, Koichi Nakajima, Shinsuke Satake, Yoshisada Yamasaki
Obturator hernia (OH) is a rare cause of bowel obstruction. Although several surgical approaches, including the laparoscopic approach, have been reported to date, a standard approach for treating OH has not been established. A 101-year-old woman who presented with constipation and vomiting was admitted to our hospital. CT revealed an incarcerated small bowel within the left obturator foramen, and a diagnosis of left-sided incarcerated OH with small bowel ileus was made. With the patient under general anesthesia, exploratory laparoscopy was performed; we identified an OH with an incarcerated small bowel, which was judged viable after hernia reduction...
January 8, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29260692/-faecal-impaction-in-elderly-patients-is-a-potential-severe-condition
#2
Søren Kabell Nissen, Morten Roos Stenberg, Jesper Ryg
This case report presents an old hemiparetic male admitted to hospital from nursing home due to dark-coloured emesis. Transdermal buprenorphine 5 mcg/h had been instigated without laxatives in the preceding month. Upon arrival, an enlarged tense abdomen was found. A CT-scan dem-on-strated a 19 cm wide faecal colon impaction. Limited effect of enemas and endoscopic disimpaction resulted in surgery. The patient died shortly after discharge. The case stresses the prevention of constipation when using opioids; in particular in immobilized patients...
December 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29250315/hepatic-portal-venous-gas-acute-deterioration-in-an-elderly-patient
#3
Brett Sydney Bernstein, Rory George Callan, Darryl Ethan Bernstein, Tom Pampiglione
A 91-year-old female presented to the Emergency Department with a 10-day history of constipation and abdominal pain. Abdominal examination was normal and rectal examination showed faecal loading. A phosphate enema was given and the patient was admitted. Overnight, the patient's GCS dropped from 15/15 to 3/15 and an arterial blood gas showed a lactate of 8 mmol/L (1.5 on admission). Abdomen remained soft throughout. A CT scan showed a large amount of free air and free fluid within the abdomen and pelvis, highly suspicious for perforation...
December 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29224251/efficacy-and-safety-of-fesoterodine-treatment-for-overactive-bladder-symptoms-in-elderly-women-with-and-without-hypertension
#4
Osamu Yokoyama, Hidetomi Yamagami, Shintaro Hiro, Shinichi Hotta, Masaki Yoshida
OBJECTIVE: To assess fesoterodine treatment in elderly women with overactive bladder with and without hypertension. METHODS: Data for 2527 elderly women with overactive bladder symptoms, including urgency urinary incontinence, were pooled from 10 double-blind, placebo-controlled fesoterodine studies. RESULTS: A total of 1523 elderly women (60.3%) had a history of hypertension, and 1004 women (39.7%) had no hypertension history. Overactive bladder symptoms, mean bodyweight and mean body mass index at baseline were significantly higher in women with overactive bladder and hypertension versus those without hypertension (P < 0...
December 10, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29198061/development-and-pilot-testing-of-pharao-a-decision-support-system-for-pharmacological-risk-assessment-in-the-elderly
#5
Ylva Böttiger, Kari Laine, Tuomas Korhonen, Janne Lähdesmäki, Tero Shemeikka, Margaretha Julander, Maria Edlert, Marine L Andersson
PURPOSE: The aims of this study are to describe the development of PHARAO (Pharmacological Risk Assessment Online), a decision support system providing a risk profile for adverse events, associated with combined effects of multiple medicines, and to present data from a pilot study, testing the use, functionality, and acceptance of the PHARAO system in a clinical setting. METHODS: About 1400 substances were scored in relation to their risk to cause any of nine common and/or serious adverse effects...
December 2, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29193561/effectiveness-and-tolerability-of-therapy-with-exenatide-once-weekly-versus-basal-insulin-among-injectable-na%C3%A3-ve-elderly-or-renal-impaired-patients-with-type-2-diabetes-in-the-united-states
#6
Anita M Loughlin, Qing Qiao, Anthony Philip Nunes, Peter Öhman, Stephen Ezzy, Laura Yochum, C Robin Clifford, Robert Gately, David D Dore, John Seeger
AIM: To evaluate the effectiveness and tolerability of exenatide once-weekly (EQW) compared to basal insulin (BI) among injectable-naïve T2DM patients who are elderly or have renal impairment (RI). METHODS AND MATERIALS: Initiators of EQW and BI with T2DM were identified from 2012-2015 within a United States electronic health record database and matched by propensity score. Matched EQW and BI initiators aged 65+ years or who have RI were compared. Weight, HbA1c, eGFR, blood pressure, and lipids were obtained at baseline and quarterly (Q1-Q4) or semi-annually for one year following drug initiation...
November 30, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29187328/survey-of-the-prescription-of-step-2-analgesics-in-persons-aged-75-years-and-older-in-general-practitioners
#7
Adrien Brocard, Sofia Da Silva, Maurice Giroud, Alain Putot, Patrick Manckoundia
Although step-2 analgesics (S2A) are recommended when step-1 analgesics (S1A) are ineffective or in cases of moderate to severe pain, their efficacy varies. This study evaluated the place attributed by general practitioners (GPs) to S2A in the treatment of nociceptive pain in elderly persons (EP). Descriptive, transversal and declarative study conducted among GPs in Burgundy. In total, 115 GPs took part in the survey. Among these, 60.8% had at least one consultation/day for pain. After paracetamol, which was systematically preferred, 56...
December 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29184612/efficacy-of-prucalopride-in-bowel-cleansing-before-colonoscopy-results-of-a-pilot-study
#8
Vito Domenico Corleto, Giulio Antonelli, Chiara Coluccio, Lucia D'Alba, Emilio di Giulio
Colonoscopy is a crucial diagnostic instrument for colorectal cancer screening and an adequate bowel preparation is definitely decisive for the success of the procedure. Especially in elderly patients, bowel cleansing is considered a big issue, because it is often poorly tolerated for many reasons (like inability to swallow large volume of liquids or unlikable taste); this can cause a suboptimal preparation that may lead to miss a neoplastic lesion. There is relatively little data about how to improve preparation tolerability...
November 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29176541/diffuse-peritoneal-and-bowel-wall-infiltration-by-light-chain-al-amyloidosis-with-omental-calcification-mimicking-abdominal-carcinomatosis-an-elderly-female-with-incidental-finding-of-light-chain-monoclonal-gammopathy-of-undetermined-significance-lc-mgus
#9
Shoaib Junejo, Yasir Ali, Sandeep Singh Lubana, Sandeep S Tuli
BACKGROUND Amyloidosis is the extracellular tissue deposition of plasma proteins, which after conformational changes, forms antiparallel beta pleated sheets of fibrils. Amyloid light-chain (AL) is a type of amyloidosis that is due to deposition of proteins derived from immunoglobulin (Ig) light chains. Gastrointestinal tract (GIT) involvement most often found in amyloid A (AA) amyloidosis type. There have been no reports of obstructive GIT AL amyloid patients having monoclonal gammopathy of undetermined significance (MGUS)...
November 25, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29156911/prognostic-indicators-of-neuromuscular-disorders-for-palliative-care-referral
#10
Richard Shek-Kwan Chang, Yuen Kwun Wong
BACKGROUND: Most of the neuromuscular disorders (NMDs) have poor prognosis and lead to various symptoms amendable to palliative care. However, the suitable time of referral is uncertain. METHODS: A retrospective study was conducted to describe the trajectories of NMDs. Early death within one year after NMD diagnosis was set as the outcome. Total of 86 adult NMD patients were recruited in a university hospital. Demographic variable including gender, age at diagnosis and early-onset symptoms including dyspnea, dysphagia, loss of mobility, constipation, mood and sleep disorders, and pain were correlated with the outcome...
September 29, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29066862/localized-neuropathic-pain-an-expert-consensus-on-local-treatments
#11
REVIEW
Gisèle Pickering, Elodie Martin, Florence Tiberghien, Claire Delorme, Gérard Mick
BACKGROUND: Pain localization is one of the hallmarks for the choice of first-line treatment in neuropathic pain. This literature review has been conducted to provide an overview of the current knowledge regarding the etiology and pathophysiology of localized neuropathic pain (LNP), its assessment and the existing topical pharmacological treatments. MATERIALS AND METHODS: Literature review was performed using Medline from 2010 to December 2016, and all studies involving LNP and treatments were examined...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29025285/safety-and-efficacy-of-canagliflozin-in-elderly-patients-with-type-2-diabetes-mellitus-a-1-year-post-marketing-surveillance-in-japan
#12
Maki Goda, Tomoko Yamakura, Kazuyo Sasaki, Takumi Tajima, Makoto Ueno
Objective To evaluate the safety and efficacy of canagliflozin in elderly patients with type 2 diabetes mellitus (T2DM) in clinical settings. Methods We conducted a 1-year post-marketing surveillance (PMS) of canagliflozin in almost all the elderly patients (≥65 years old) with T2DM who began taking canagliflozin during the first 3 months after its launch in Japan. The main outcomes included the incidences of adverse drug reactions (ADRs), serious ADRs and the changes of laboratory tests as well as efficacy variables...
October 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28944983/oral-prolonged-release-oxycodone-naloxone-for-managing-pain-and-opioid-induced-constipation-a-review-of-the-evidence
#13
REVIEW
Bart J Morlion, Stefan A Mueller-Lissner, Renato Vellucci, Wojciech Leppert, Benoît C Coffin, Sara L Dickerson, Tony O'Brien
BACKGROUND: Opioids provide effective relief from moderate-to-severe pain and should be prescribed as part of a multifaceted approach to pain management when other treatments have failed. Fixed-dose oxycodone/naloxone prolonged-release tablets (OXN PR) were designed to address the opioid class effect of opioid-induced constipation (OIC) by combining the analgesic efficacy of oxycodone with the opioid receptor antagonist, naloxone, which has negligible systemic availability when administered orally...
September 25, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28934715/stercoral-perforation-of-the-rectosigmoid-colon-due-to-chronic-constipation-a-case-report
#14
Mustafa Fevzi Celayir, Hakan Mustafa Köksal, Mehmet Uludag
INTRODUCTION: Chronic constipation is very common in elderly patients. As a result of this situation fecaloma is also frequently seen at these ages. However, the stercoral perforation caused by fecaloma is a rare situation to occur. The rectosigmoid colon is the most affected colonic segment. It is seen in older patients with concomitant diseases and a low quality of life. PRESENTATION OF CASE: Here in this case, we have to report an 83 - year-old male patient who came to the emergency room with complaints of abdominal pain and constipation for two days...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28801825/intractable-constipation-in-the-elderly
#15
REVIEW
Noemi Baffy, Amy E Foxx-Orenstein, Lucinda A Harris, Susan Sterler
Chronic constipation is a common gastrointestinal disorder disproportionately affecting the elderly. Immobility, polypharmacy, and physiologic changes contribute to its increased prevalence in this population. Unidentified and undertreated constipation leads to a significant negative impact on quality of life and an increase in healthcare spending. Careful physical examination and exploration of the clinical history can unmask primary and secondary forms of constipation, guiding diagnostic and therapeutic considerations...
September 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28737064/the-effects-of-delirium-prevention-guidelines-on-elderly-stroke-patients
#16
Jihye Song, Minkyung Lee, Dukyoo Jung
This study aimed to evaluate the effectiveness of the delirium prevention interventions recommended by the Delirium Prevention Guidelines for Elderly Stroke Patients (DPGESP). The DPGESP comprises nine dimensions with 28 interventions, including risk factor assessment, orientation disorder prevention, sleeping pattern maintenance, sensory interventions, constipation, dehydration, hypoxia and infection prevention, pain management, and appropriate nutrition maintenance. This quasi-experimental study used a nonequivalent control group and a pretest-posttest design...
July 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28660594/thalidomide-combined-with-chemotherapy-in-treating-elderly-patients-with-advanced-gastric-cancer
#17
Ya Li, Yanjun Chu, Ruifeng Song, Feng Xu
AIM: The current systemic chemotherapy brings toxicity to human body, which elder patients suffer more than young people. The effective and well-tolerated treatment methods are of great importance for elderly advanced GC patients. This paper proposed an effective way of combining thalidomide with chemotherapy to treat elderly advanced GC patients, on the purpose of improving life quality and the treatment efficacy. METHODS: In the control group, capecitabine was given with 2000 mg/m(2) daily in a manner of 2 weeks on and 1 week off for elderly advanced GC patients...
June 28, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28658792/serous-microcystic-adenoma-of-pancreas-a-case-series-from-a-tertiary-care-centre-in-southern-india
#18
K Rajasree Varma, Saji Francis, P P Sathi, C Saikiran Reddy
Serous microcystic adenoma is a rare exocrine tumour of the cystic neoplasm of pancreas seen predominantly in the elderly population. The first patient was a 56-year-old diabetic woman with abdominal pain, constipation and loss of weight since two months. The second patient was a 73-year-old female with complaints of abdominal pain and back pain since one year. The third patient was a 72-year-old diabetic man with complaints of burning sensation in the right lumbar region since two months. Clinical and laboratory examinations were normal...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28639056/relevance-of-the-clinical-and-psychophysiological-variables-in-the-dyssynergic-defecation-a-comparative-study-in-elderly-subjects
#19
Miguel A Simón, Ana M Bueno
The relevance of several clinical and psychophysiological variables in the dyssynergic defecation in elderly subjects was investigated in this study. To accomplish this, 30 elderly subjects (10 without anorectal disorders, 10 with chronic constipation and 10 with dyssynergic defecation) were repeatedly assessed once per week for 4 weeks, with the following measures being collected at each session: EMG-activity (µV) of the external anal sphincter (at rest, during squeezing, and during straining to defecate), stool frequency, difficulty defecation level, pain grade during defecation, and satisfaction level after evacuation...
June 21, 2017: Applied Psychophysiology and Biofeedback
https://www.readbyqxmd.com/read/28575811/perforation-of-the-cecum-resulting-from-a-closed-loop-obstruction-in-a-patient-with-an-adenocarcinoma-of-the-sigmoid-colon-a-case-report
#20
Jefferson Sing Toledo, Marley Moreira Correia, Rafael Rodrigues Coutinho, Eduardo Fukamachi Kifer, Diego de Faria Magalhães Torres
INTRODUCTION: Bowel obstruction is one of the principal non-traumatic causes of general surgery emergencies, both in Brazil and worldwide. This condition can be classified according to the degree (complete or incomplete), clinical course (acute or chronic) or nature (mechanical, vascular or functional) of the obstruction. CASE REPORT: ESS, a 62-year old Brazilian woman from Rio de Janeiro, was admitted to the emergency department complaining of constipation of two weeks' duration...
2017: International Journal of Surgery Case Reports
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