scholarly journals Author reply to what are the clinical signs of thiamine deficiency in elderly patients?

2021 ◽  
Author(s):  
Ryuichi Ohta ◽  
Yoshinori Ryu ◽  
Shuzo Hattori ◽  
Chiaki Sano
Keyword(s):  
Elderly Patients ◽  
Thiamine Deficiency ◽  
Clinical Signs ◽  
Author Reply

scholarly journals Arthroscopic “Debridement and Implant Retention” With Local Administration of Exebacase (Lysin CF-301) Followed by Suppressive Tedizolid as Salvage Therapy in Elderly Patients for Relapsing Multidrug-Resistant S. epidermidis Prosthetic Knee Infection

2021 ◽  
Vol 8 ◽  
Author(s):  
Tristan Ferry ◽  
Cécile Batailler ◽  
Aubin Souche ◽  
Cara Cassino ◽  
Christian Chidiac ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Salvage Therapy ◽  
Clinical Signs ◽  
Multidrug Resistant ◽  
Sinus Tract ◽  
Local Administration ◽  
Loss Of Function ◽  
Prosthetic Knee ◽  
Implant Retention ◽  
Prosthetic Knee Infection

Exebacase, a recombinantly produced lysin has recently (i) reported proof-of-concept data from a phase II study in S. aureus bacteremia and (ii) demonstrated antibiofilm activity in vitro against S. epidermidis. In patients with relapsing multidrug-resistant (MDR) S. epidermidis prosthetic knee infection (PKI), the only surgical option is prosthesis exchange. In elderly patients who have undergone several revisions, prosthesis explantation could be associated with definitive loss of function and mortality. In our BJI reference regional center, arthroscopic debridement and implant retention with local administration of exebacase (LysinDAIR) followed by suppressive tedizolid as salvage therapy is proposed for elderly patients with recurrent MDR S. epidermidis PKI with no therapeutic option or therapeutic dead end (for whom revision or transfemoral amputation is not feasible and no other oral option is available). Each use was decided in agreement with the French health authority and in accordance with the local ethics committee. A written consent was obtained for each patient. Exebacase (75 mg/mL; 30 mL) was administered directly into the joint during arthroscopy. Four patients (79–89 years old) were treated with the LysinDAIR procedure. All had several previous prosthetic knee revisions without prosthesis loosening. Three had relapsing PKI despite suppressive antibiotics following open DAIR. Two had clinical signs of septic arthritis; the two others had sinus tract. After the LysinDAIR procedure, no adverse events occurred during arthroscopy; all patients received daptomycin 8 mg/kg and linezolid 600 mg bid (4–6 weeks) as primary therapy, followed by tedizolid 200 mg/day as suppressive therapy. At 6 months, recurrence of the sinus tract occurred in the two patients with sinus tract at baseline. After >1 year follow up, the clinical outcome was favorable in the last two patients with total disappearance of clinical signs of septic arthritis even if microbiological persistence was detected in one of them. Exebacase has the potential to be used in patients with staphylococci PKI during arthroscopic DAIR as salvage therapy to improve the efficacy of suppressive antibiotics and to prevent major loss of function.

Clinical signs and diagnosis of thiamine deficiency in juvenile goshawks (Accipiter gentilis)

2008 ◽  
Vol 163 (7) ◽  
pp. 215-217 ◽  
Author(s):  
M. Carnarius ◽  
H. M. Hafez ◽  
A. Henning ◽  
H. J. Henning ◽  
M. Lierz
Keyword(s):  
Thiamine Deficiency ◽  
Clinical Signs ◽  
Accipiter Gentilis

Subclinical thiamine deficiency in patients with abdominal cancer

2017 ◽  
Vol 16 (4) ◽  
pp. 497-499 ◽  
Author(s):  
Hideki Onishi ◽  
Mayumi Ishida ◽  
Iori Tanahashi ◽  
Takao Takahashi ◽  
Yoshitada Taji ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Thiamine Deficiency ◽  
Storage Capacity ◽  
Clinical Symptoms ◽  
Performance Status ◽  
Clinical Signs ◽  
Medical Emergency ◽  
Wernicke Encephalopathy ◽  
Appetite Loss ◽  
Pancreatic Body Cancer

AbstractObjectiveThiamine is an essential coenzyme for oxidative metabolisms; however, it is not synthesized in the human body, and the average thiamine storage capacity is approximately 18 days. Therefore, thiamine deficiency (TD) can occur in any condition of unbalanced nutrition. If TD is left untreated, it causes the neuropsychiatric disorder Wernicke encephalopathy (WE). Although WE is a medical emergency, it is sometimes overlooked because most patients with WE do not exhibit all of the typical symptoms, including delirium, ataxia, and ophthalmoplegia. If all of the typical clinical symptoms of WE are absent, diagnosis of TD or WE becomes more difficult.MethodFrom a series of cancer patients, we reported three patients who developed TD without the typical clinical symptoms of WE.ResultA 69-year-old woman with pancreatic body cancer receiving chemotherapy with paclitaxel and gemcitabine for six months. Her performance status (PS) was 1. A detailed interview revealed that she had appetite loss for six months. Another 69-year-old woman with ovarian cancer received nedaplatin; her PS was 0. A detailed interview revealed that she had appetite loss for three months. A 67-year-old woman with colon cancer receiving ramucirumab in combination with second-line fluorouracil with folinic acid and irinotecan. Her PS was 1. A detailed interview revealed that she had appetite loss for three weeks. None exhibited typical clinical signs of WE, but they developed appetite loss for six months, three months, and three weeks, respectively. The diagnosis of TD was supported by abnormally low serum thiamine levels.Significance of the resultsThis report emphasizes the possibility of TD in cancer patients even when patients do not develop typical clinical signs of WE. The presence of appetite loss for more than two weeks may aid in diagnosing TD. Patients receiving chemotherapy may be at greater risk for developing TD.

scholarly journals Hand pain in elderly patients

2015 ◽  
Vol 10 (4) ◽  
pp. 342-347
Author(s):  
Adriana Sarah NICA ◽  
◽  
Gilda MOLOGHIANU ◽  
Roxana NARTEA ◽  
Mariana-Isabela CONSTANTINOVICI ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Functional Outcomes ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Aspects ◽  
Common Symptom ◽  
Aged People ◽  
Hand Pain ◽  
Functional Consequences ◽  
Clinical Signs And Symptoms

Painful hand of aged people is a very common symptom but is often disregarded in comparaison with other clinical signs and symptoms analyzed in these patients. When is reported, are rarely taken into account the multiple pathophysiological and clinical aspects of aging that characterize also the hand. Pain and all these other signs induce unexpected aspects of dysfunctions, from functional impairment to disability. Our aim was to present a review of the most common situations related to painful hand in elderly patients, especially in rheumatological and posttraumatic context. This paper is an update of the most common situations in older patients, that often neglect their distal upper limb in a context of polipathology or in a problematically family and social environment. Also are presented the associated functional consequences and the main therapeutic objectives related to pathophysiological, clinical and functional outcomes.

Polioencephalomalacia of Dogs with Thiamine Deficiency

1977 ◽  
Vol 14 (2) ◽  
pp. 103-112 ◽  
Author(s):  
D. H. Read ◽  
R. D. Jolly ◽  
M. R. Alley
Keyword(s):  
Thiamine Deficiency ◽  
Neurological Disease ◽  
Thermal Destruction ◽  
Spastic Paraparesis ◽  
Clinical Signs ◽  
Thiamine Hydrochloride ◽  
Naturally Occurring ◽  
Brainstem Nuclei ◽  
Cooked Meat ◽  
Dietary Deficiency

A naturally occurring neurological disease occurred in six dogs fed cooked meat. Clinical signs were anorexia, progressive spastic paraparesis, recumbency, convulsions and death. The disease was characterized by bilaterally symmetrical spongy change and necrosis of brainstem nuclei with a lesion distribution pattern similar to that in thiamine deficient foxes and cats. An associated thiamine deficiency was evidenced by decreased thiamine levels in the blood of one dog and in the food of another, and rapid remission of clinical signs in a dog given thiamine hydrochloride. Thermal destruction of thiamine through cooking of the foods probably caused the dietary deficiency.

Feasibility of orthopaedic teleconsulting in a geriatric rehabilitation service

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 85-87 ◽  
Author(s):  
P Couturier ◽  
J Tyrrell ◽  
J Tonetti ◽  
C Rhul ◽  
C Woodward ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Clinical Signs ◽  
Scar Tissue ◽  
Rehabilitation Service ◽  
Face To Face ◽  
Clinical Investigations ◽  
Telemedicine Consultation ◽  
The Face ◽  
High Level

Fifteen elderly patients participated in a teleconsultation with an orthopaedic surgeon, which was then followed by a conventional, face-to-face consultation. The comparison between the surgeon's ratings for both types of consultation suggested that the telemedicine consultation was satisfactory in terms of the quality of image and sound, the clinical examination and general simplicity. The telemedicine consultations did not generate a need for any additional clinical investigations, although in two cases a face-to-face consultation was necessary to clarify clinical signs (shortening of a limb and scar tissue). The surgeon's rating of his decision level was superior in the face-to-face situation in four cases, and for 11 patients it was equal. Similarly, the surgeon's level of confidence in decision making was superior in the conventional situation for five patients and equal for 10 patients. Patient attitudes towards teleconsulting were favourable. There was a high level of patient satisfaction. Teleconsulting between orthopaedic surgeons and elderly patients therefore appears to be possible, provided that certain technical, clinical and psychological considerations are addressed.

scholarly journals Comparative characteristics of patients with gastroesophageal reflux disease in the age aspect

2017 ◽  
Vol 89 (4) ◽  
pp. 53-56
Author(s):  
O A Denisova ◽  
M A Livzan ◽  
A P Denisov
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Elderly Patients ◽  
Reflux Disease ◽  
Clinical Signs ◽  
The Elderly ◽  
Control Group ◽  
Age Related ◽  
Wide Range ◽  
Ph Metry

Aim. To compare the characteristics of patients with gastroesophageal reflux disease (GERD) by age groups, a wide range of clinical signs, including life-of-quality (QOL) indicators, and instrumental findings. Subjects and methods. A total of 110 patients aged 18 to 86 years with GERD were examined in accordance with the standard protocol. Two groups with equal numbers of patents were formed. A study group included elderly and senile patients and a control group consisted of young and adult ones. Results. The elderly patients with GERD were observed to have a number of age-related clinical features and age-unrelated symptoms. The scores in the scales characterizing the physical health component and those in the general health and vital activity scales were markedly decreased in patients older than 60 years of age. No age-related statistically significant differences were found in the esophageal, gastric, and duodenal mucosae. Daily pH-metry in the elderly showed indirect evidence for esophageal hypomotor dyskinesia in the predominance of alkaline refluxes. Conclusion. The cohort of elderly patients with GERD was ascertained to have statistically significant clinical characteristics, and QOL and pH-metry indicators, which will be able to improve methods for diagnosis and early prevention in this age group.

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