scholarly journals Hypertension in older people: current management options

Prescriber ◽  
2006 ◽  
Vol 17 (9) ◽  
pp. 12-21
Author(s):  
Rebecca Bancroft ◽  
John Clague
2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Gustavo Cancela e Penna ◽  
Henrique Gomes Mendes ◽  
Adele O. Kraft ◽  
Cynthia Koeppel Berenstein ◽  
Bernardo Fonseca ◽  
...  

Thyroglossal duct cyst (TDC) is a cystic expansion of a remnant of the thyroglossal duct tract. Carcinomas in the TDC are extremely rare and are usually an incidental finding after the Sistrunk procedure. In this report, an unusual case of a 36-year-old woman with concurrent papillary thyroid carcinoma arising in the TDC and on the thyroid gland is presented, followed by a discussion of the controversies surrounding the possible origins of a papillary carcinoma in the TDC, as well as the current management options.


2017 ◽  
Vol 21 (6) ◽  
pp. 562-563 ◽  
Author(s):  
Maya Deeb ◽  
Renée A. Beach

Alopecia areata (AA) is an autoimmune-mediated, nonscarring form of hair loss. Despite its prevalence, current management options are limited, especially when the disease has progressed to alopecia totalis (AT) or alopecia universalis (AU). Recent evidence that janus kinase (JAK) signaling contributes to AA pathogenesis prompted the investigation of JAK inhibitors such as tofacitinib and ruxolitinib as possible oral treatments. However, the potential for significant adverse effects with systemic JAK inhibition makes local administration a more attractive option. Yet, a paucity of data exists on topical JAK inhibition in AA. A success of topical ruxolitinib (0.6% cream) use in a young patient with AU has been reported to date. Here we report the treatment of a 66-year-old with AA with the same formulation of topical ruxolitinib, where it failed to induce hair growth. Our report demonstrates the importance of examining the factors contributing to variation in treatment response in a clinical trial of topical JAK inhibitors in AA. It is likely that both intrinsic factors specific to individual patients and extrinsic factors relating to treatment regimen are involved. Furthermore, characterisation of the specific JAKs overexpressed in AA may better target medication. Finally, this report highlights the need to compare the outcomes of topical vs oral ruxolitinib administration in patients with severe AA, AT, and AU and may support the possibility that extensive disease is more adequately treated with oral administration of ruxolitinib.


2019 ◽  
Author(s):  
Alice Moult ◽  
Tom Kingstone ◽  
Carolyn Chew-Graham

Abstract Background Anxiety and depression are prevalent in older adults, however, older people may be reluctant to seek medical help and may manage their own mood problems. Due to stigma, older adults are more likely to perceive and/ or recognise their mood problems as distress. Whilst previous literature has focused on how younger adults self-manage mood problems, little research has explored how older people self-manage distress. The study reported here seeks to address this gap through qualitative methods. Methods This study was approved by Keele University’s ethical review panel. Older adults who self-identified as distressed, depressed or anxious within the previous 12 months were recruited from community groups in North Staffordshire, England. Data were generated through semi-structured interviews and analysed thematically using constant comparison methods. A public and patient involvement and engagement group contributed to development of the research questions and methods, and offered their perspectives on the findings. Results Data saturation was achieved after 18 interviews. Key themes were: experiences of distress, actions taken, help-seeking from healthcare services and perceptions of treatments offered in primary care. Various forms of loss contributed to participants’ distress. Participants initiated their own self-management strategies which included: pursuing independent activities, seeking social support and attending community groups and church. Five participants reported having consulted a GP when distressed but described a lack of acceptable treatments offered. Conclusions To support older adults who are distressed, primary care healthcare professionals need to explore patients’ existing ways of managing mood problems, provide information about a range of management options and consider the use of sign-posting older adults to community resources.


2017 ◽  
Vol 59 (3) ◽  
pp. 20-28
Author(s):  
Nicholus Magongwa ◽  
Natalie Schellack

Allergic diseases affect many people across the globe. They are considered to significantly disturb the quality of life of the people who are affected, creating personal and economic predicaments. Some of the most commonly diagnosed allergic diseases include atopic dermatitis, rhinitis, allergic conjunctivitis and sinusitis. Some conditions, such as eosinophilic esophagitis, are on the rise and are being diagnosed across all continents except for Africa. The use of antihistamines has been the mainstay of therapy for most allergic conditions, except for other conditions that require corticosteroids, or in severe allergic conditions such as anaphylaxis where antihistamines are ineffective as main therapy. It is important to consider first versus second-generation options when treating allergic diseases, also bearing in mind the duration of therapy and any comorbid conditions that a patient might have. This article provides an overview of these conditions and their current management options.


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