Clinical aspects of cobalamin deficiency in elderly patients. Epidemiology, causes, clinical manifestations, and treatment with special focus on oral cobalamin therapy

2007 ◽  
Vol 18 (6) ◽  
pp. 456-462 ◽  
Author(s):  
Emmanuel Andrès ◽  
Josep Vidal-Alaball ◽  
Laure Federici ◽  
Noureddine Henoun Loukili ◽  
Jacques Zimmer ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Clinical Manifestations ◽  
Cobalamin Deficiency ◽  
Clinical Aspects ◽  
Special Focus

scholarly journals Cobalamin Deficiency in Elderly Patients: A Personal View

2008 ◽  
Vol 2008 ◽  
pp. 1-7 ◽  
Author(s):  
Emmanuel Andrès ◽  
Thomas Vogel ◽  
Laure Federici ◽  
Jacques Zimmer ◽  
Ecaterina Ciobanu ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Elderly Patients ◽  
Clinical Manifestations ◽  
Vitamin B12 Deficiency ◽  
The Elderly ◽  
Cobalamin Deficiency ◽  
Personal View ◽  
B12 Deficiency ◽  
Cobalamin Malabsorption

Cobalamin (vitamin B12) deficiency is particularly common in the elderly (>65 years of age) but is often unrecognized because its clinical manifestations are subtle; however, they are also potentially serious, particularly from a neuropsychiatric and hematological perspective. In the elderly, the main causes of cobalamin deficiency are pernicious anemia and food-cobalamin malabsorption. Food-cobalamin malabsorption syndrome is a disorder characterized by the inability to release cobalamin from food or its binding proteins. This syndrome is usually caused by atrophic gastritis, related or unrelated toHelicobacter pyloriinfection, and long-term ingestion of antacids and biguanides. Management of cobalamin deficiency with cobalamin injections is currently well documented but new routes of cobalamin administration (oral and nasal) are being studied, especially oral cobalamin therapy for food-cobalamin malabsorption.

Polymyalgia Rheumatica - a Disease of the Elderly

2018 ◽  
Vol 69 (1) ◽  
pp. 152-154
Author(s):  
Vasilica Cristescu ◽  
Aurelia Romila ◽  
Luana Andreea Macovei
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
Temporal Arteritis ◽  
Viral Infections ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Clinical Aspects ◽  
Immune Disorder ◽  
Markers Of Inflammation

Polymyalgia rheumatica is a disease that occurs mostly in the elderly and is rarely seen in patients less than 50 years of age. Polymyalgia rheumatica is a vasculitis, which manifests itself as an inflammatory disease of the vascular wall that can affect any type of blood vessel, regardless of its size. It has been considered a form of giant cell arteritis, involving primarily large and medium arteries and to a lesser extent the arterioles. Clinical manifestations are caused by the generic pathogenic process and depend on the characteristics of the damaged organ. PMR is a senescence-related immune disorder. It has been defined as a stand-alone condition and a syndrome referred to as rheumatic polyarteritis with manifestations of giant cell arteritis (especially in cases of Horton�s disease and temporal arteritis) which are commonly associated with polymyalgia. The clinical presentation is clearly dominated by the painful girdle syndrome, with a feeling of general discomfort. Polymyalgia and temporal arteritis may coexist or be consecutive to each other in the same patient, as in most of our patients. The present study describes 3 cases of polymyalgia rheumatica, admitted to the Clinic of Rheumatology of Sf. Apostol Andrei Hospital, Galati. The cases were compared with the literature. Two clinical aspects (polymyalgia rheumatica and/or Horton�s disease) and the relationship between them were also considered. Polymyalgia rheumatica is currently thought to have a multifactorial etiology, in which the following factors play a role: genetic factors or hereditary predisposition (some individuals are more prone to this disease), immune factors and viral infections (triggers of the disease). Other risk factors of polymyalgia rheumatica include age over 50 years and the association with giant cell arteritis. The characteristic feature of the disease is girdle pain, with intense stiffness of at least one hour�s duration. Markers of inflammation, erythrocyte sedimentation rate and C-reactive protein are almost always increased at the onset of the disease. Diseases that can mimic the clinical picture of polymyalgia rheumatica are neoplasia, infections, metabolic disorders of the bone and endocrine diseases.

Pain in dementia

2021 ◽  
Vol 26 (3) ◽  
pp. 15-22
Author(s):  
T. M. Manevich ◽  
E. A. Mkhitaryan
Keyword(s):  
Pain Relief ◽  
Life Expectancy ◽  
Elderly Patients ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Diagnosis And Treatment ◽  
Prevalence Of Pain

Increasing life expectancy of the world’s population is accompanied by increasing number of elderly patients with dementia. According to various studies, the prevalence of pain syndrome in elderly patients with dementia ranges from 35.3% to 63.5%. The review represents data on the epidemiology, clinical manifestations, methods of diagnosis and treatment of pain syndrome in patients with dementia. Medicinal and non-pharmacological methods of pain relief are discussed.

scholarly journals Relationship between cobalamin deficiency and delirium in elderly patients undergoing cardiac surgery

2015 ◽  
pp. 2033 ◽  
Author(s):  
Utkan Sevük ◽  
Erkan Baysal ◽  
Nurettin Ay ◽  
Yakup Altas ◽  
Rojhat Altindag ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Elderly Patients ◽  
Cobalamin Deficiency

Neuropathic pain models in the development of analgesic drugs

2011 ◽  
Vol 2 (4) ◽  
pp. 172-177 ◽  
Author(s):  
Per Hartvig Honoré ◽  
Anna Basnet ◽  
Laila Eljaja ◽  
Pernille Kristensen ◽  
Lene Munkholm Andersen ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Animal Models ◽  
Nerve Injury ◽  
Clinical Manifestations ◽  
Pharmacological Intervention ◽  
Special Focus ◽  
Surgical Performance ◽  
Neuropathic Pain Syndrome ◽  
Pain Models ◽  
Rats And Mice

AbstractIntroductionAnimal disease models are predictive for signs seen in disease. They may rarely mimic all signs in a specific disease in humans with respect to etiology, cause or development. Several models have been developed for different pain states and the alteration of behavior has been interpreted as a response to external stimulus or expression of pain or discomfort. Considerable attention must be paid not to interpret other effects such as somnolence or motor impairment as a pain response and similarly not to misinterpret the response of analgesics.Neuropathic pain is caused by injury or disease of the somatosensory system. The clinical manifestations of neuropathic pain vary including both stimulus-evoked and non-stimulus evoked (spontaneous) symptoms. By pharmacological intervention, the threshold for allodynia and hyperalgesia in the various pain modalities can be modulated and measured in animals and humans. Animal models have been found most valuable in studies on neuropathic pain and its treatment.Aim of the studyWith these interpretation problems in mind, the present text aims to describe the most frequently used animal models of neuropathic pain induced by mechanical nerve injury.MethodsThe technical surgical performance of these models is described as well as pain behavior based on the authors own experience and from a literature survey.ResultsNerve injury in the hind limb of rats and mice is frequently used in neuropathic pain models and the different types of lesion may afford difference in the spread and quality of the pain provoked. The most frequently used models are presented, with special focus on the spared nerve injury (SNI) and the spinal nerve ligation/transection (SNL/SNT) models, which are extensively used and validated in rats and mice. Measures of mechanical and thermal hypersensitivity with von Frey filaments and Hargreaves test, respectively, are described and shown in figures.ConclusionsA number of animal models have been developed and described for neuropathic pain showing predictive value in parallel for both humans and animals. On the other hand, there are still large knowledge gaps in the pathophysiologic mechanisms for the development, maintenance and progression of the neuropathic pain syndromeImplicationsBetter understanding of pathogenic mechanisms of neuropathic pain in animal models may support the search for new treatment paradigms in patients with complex neuropathic pain conditions

scholarly journals Clinical, Aetiologic, And Evolution-Related Aspects Of Pleurisy In Children

2015 ◽  
Vol 21 (4) ◽  
pp. 212-216
Author(s):  
Frecus Corina ◽  
Balasa Adriana ◽  
Ungureanu Adina ◽  
Mihai Larisia ◽  
Cuzic Viviana ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Clinical Manifestations ◽  
Clinical Aspects ◽  
Age Group ◽  
Adequate Treatment ◽  
Radiologic Imaging ◽  
Specific Pathogen ◽  
Laboratory Investigations ◽  
Group Distribution ◽  
Clinical Emergency

Abstract Objectives: Establishing the frequency of pleurisy from the total number of admissions in the Paediatrics Department, as well as the frequency of pleurisy from the total number of respiratory ailments that required hospitalization; evaluating age group distribution and determining the influence of environmental factors; describing clinical manifestations, laboratory, radiologic, and bacteriological investigations in patients with pleurisy; quantifying clinical manifestations and investigations so as to establish an appropriate therapeutic approach; identifying clinical aspects that indicate a favourable/unfavourable evolution; analyzing the evolution of cases after treatment as revealed by radiologic imaging. Method: Retrospective study on 47 patients diagnosed with pleurisy and admitted in the Paediatrics Department of Constanta Clinical Emergency Hospital, over a span of 3 years (2011-2013), based on data collected from observation sheets. Results: A downward trend in what regards the frequency of pleurisy can be observed from 2011 to 2013. Rural provenience and other environmental factors continue to play an important role. Clinical manifestations tend to be more significant for younger patients and they are directly related to the specific pathogen identified during laboratory investigations. Conclusion: Following an early diagnosis and a subsequent adequate treatment, evolution tends to be favourable in most cases, although certain post-hospitalization measures still need to be implemented in order to ensure full recovery and restitution ad integrum.

The frequency and clinical aspects of Barrett’s esophagus in elderly patients

Vrach ◽  
2019 ◽  
Vol 30 (6) ◽  
Author(s):  
V. Tsukanov ◽  
E. Onuchina ◽  
A. Vasyutin ◽  
Yu. Tonkikh
Keyword(s):  
Elderly Patients ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Clinical Aspects

Rickettsial Infections around the World, Part 1: Pathophysiology and the Spotted Fever Group

2005 ◽  
Vol 9 (2) ◽  
pp. 54-62
Author(s):  
Jashin J. Wu ◽  
David B. Huang ◽  
Katie R. Pang ◽  
Stephen K. Tyring
Keyword(s):  
Spotted Fever ◽  
Clinical Manifestations ◽  
Review Article ◽  
Learning Activity ◽  
Clinical Aspects ◽  
Spotted Fever Group ◽  
Infectious Agents ◽  
Important Group ◽  
Rickettsial Infections ◽  
Rickettsial Diseases

Background: The rickettsial diseases are an important group of infectious agents that have dermatological manifestations. These diseases are important to consider in endemic areas, but in certain suspicious cases, possible acts of bioterrorism should warrant prompt notification of the appropriate authorities. Objective: In this two part review article, we review these diverse diseases by examining established and up-to-date information about the pathophysiology, epidemiology, clinical manifestations, and treatment of the ricksettsiae. Methods: Using PubMed to search for relevant articles, we browsed over 500 articles to compose a clinically based review article. Results: Part one focuses on pathophysiology of the rickettsial diseases and the clinical aspects of the spotted fever group. Conclusions: At the completion of part one of this learning activity, participants should be able to discuss all of the clinical manifestations and treatments of the sported fever group. Participants should also be familiar with the pathophysiology of the rickettsial diseases.

scholarly journals Angiogenic Abnormalities in Diabetes Mellitus: Mechanistic and Clinical Aspects

2019 ◽  
Vol 104 (11) ◽  
pp. 5431-5444 ◽  
Author(s):  
Gian Paolo Fadini ◽  
Mattia Albiero ◽  
Benedetta Maria Bonora ◽  
Angelo Avogaro
Keyword(s):  
English Language ◽  
Molecular Mechanisms ◽  
Evidence Synthesis ◽  
Clinical Manifestations ◽  
Vascular Complications ◽  
Peripheral Circulation ◽  
Clinical Aspects ◽  
Therapeutic Implications ◽  
Diabetes Onset ◽  
Increased Risk

Abstract Context Diabetes causes severe pathological changes to the microvasculature in many organs and tissues and is at the same time associated with an increased risk of coronary and peripheral macrovascular events. We herein review alterations in angiogenesis observed in human and experimental diabetes and how they contribute to diabetes onset and development of vascular complications. Evidence Acquisition The English language medical literature was searched for articles reporting on angiogenesis/vasculogenesis abnormalities in diabetes and their clinical manifestations, mechanistic aspects, and possible therapeutic implications. Evidence Synthesis Angiogenesis is a complex process, driven by a multiplicity of molecular mechanisms and involved in several physiological and pathological conditions. Incompetent angiogenesis is pervasive in diabetic vascular complications, with both excessive and defective angiogenesis observed in various tissues. A striking different angiogenic response typically occurs in the retina vs the myocardium and peripheral circulation, but some commonalities in abnormal angiogenesis can explain the well-known association between microangiopathy and macroangiopathy. Impaired angiogenesis can also affect endocrine islet and adipose tissue function, providing a link to diabetes onset. Exposure to high glucose itself directly affects angiogenic/vasculogenic processes, and the mechanisms include defective responses to hypoxia and proangiogenic factors, impaired nitric oxide bioavailability, shortage of proangiogenic cells, and loss of pericytes. Conclusions Dissecting the molecular drivers of tissue-specific alterations of angiogenesis/vasculogenesis is an important challenge to devise new therapeutic approaches. Angiogenesis-modulating therapies should be carefully evaluated in view of their potential off-target effects. At present, glycemic control remains the most reasonable therapeutic strategy to normalize angiogenesis in diabetes.

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