Diagnosing Suspected Stroke: A Cost-Effectiveness Analysis

1985 ◽  
Vol 1 (1) ◽  
pp. 147-158 ◽  
Author(s):  
Mona Britton ◽  
Egon Jonsson ◽  
Lars-Åke Marké ◽  
Veronica Murray
Keyword(s):  
The Elderly ◽  
Elderly Persons ◽  
Industrialized Countries ◽  
Public Concern ◽  
Effectiveness Analysis ◽  
Suspected Stroke ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Acute cerebrovascular disease (CBVD) has an annual incidence of 100–300 per 100,000 inhabitants in the industrialized countries (1,2). CBVD occurs mainly in the elderly. Acute mortality is around 15%. Disablement and decreased quality of life are common consequences. Institutionalized care will be needed after the acute phase for around one-third of the patients (3). Considering the volume of patients and the growing proportion of elderly persons in most countries, stroke poses a major problem for health care. An effective diagnostic work-up as the base for therapy to improve the situation is, therefore, a matter of great public concern, for humanitarian as well as economic reasons.

scholarly journals Heart failure in the elderly: A geriatric syndrome. Picture of the modern situation

2019 ◽  
Vol 89 (1) ◽  
Author(s):  
Valentina Fagotto ◽  
Alessandro Cavarape ◽  
Alessandro Boccanelli
Keyword(s):  
Heart Failure ◽  
Older Patients ◽  
Clinical Presentation ◽  
The Elderly ◽  
Geriatric Syndrome ◽  
Diagnostic Work ◽  
Patient’S History ◽  
Work Up ◽  
Diagnostic Work Up

Among the older patients’ cohort, the aetiology of heart failure is peculiar and differs in many ways from the younger one, both in its epidemiology, diagnostic work-up and clinical presentation. Focusing on this population, we could assume that heart failure is a real geriatric syndrome, characterized by several features, which coexist with other comorbidities and require specific and targeted cares. It is therefore necessary to examine the global burden of heart failure and the patient’s history rather than the causal cardiomyopathy - frequently more than one in the elderly - facing with the condition, bearing in mind the quality of life even before its duration.

Cancer Diagnosis in Children, by L. D. Samuels, M.D. Cleveland: The Chemical Rubber Company, 1972, 131 pp., $25.00

PEDIATRICS ◽  
1972 ◽  
Vol 50 (5) ◽  
pp. 834-835
Author(s):  
Norman Jaffe
Keyword(s):  
Child Health ◽  
Cancer Diagnosis ◽  
General Physician ◽  
Paramedical Personnel ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Cancer Diagnosis in Children is a review of the diagnostic work-up which the author claims will be of interest to the general physician, paramedical personnel, students, and anyone concerned with child health. The text is presented in readable style, culminating in an extremely useful appendix (Chapter 7) . This provides a concise resume of the information presented in the previous six chapters. It adds to the quality of the book which could have been further enhanced by the inclusion of an index, which I found sadly lacking.

scholarly journals Bullous Pemphigoid and Other Pemphigoid Dermatoses

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1061
Author(s):  
Valeryia Pratasava ◽  
Vikram Sahni ◽  
Aishwarya Suresh ◽  
Simo Huang ◽  
Abhirup Are ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
Clinical Presentation ◽  
The Elderly ◽  
Mucous Membrane Pemphigoid ◽  
Skin Fragility ◽  
Treatment Refractory ◽  
Diagnostic Work ◽  
Work Up ◽  
Variable Clinical Presentation ◽  
Diagnostic Work Up

The pemphigoid family of dermatoses is characterized by autoimmune subepidermal blistering. The classic paradigm for pemphigoid, and the most common member, is bullous pemphigoid. Its variable clinical presentation, with or without frank bullae, is linked by significant pruritus afflicting the elderly. Mucous membrane pemphigoid is an umbrella term for a group of subepidermal blistering dermatoses that favor the mucosal membranes and can scar. Epidermolysis bullosa acquisita is a chronic blistering disorder characterized by skin fragility, sensitivity to trauma, and its treatment-refractory nature. Clinicians that encounter these pemphigoid disorders may benefit from an overview of their clinical presentation, diagnostic work-up, and therapeutic management, with an emphasis on the most frequently encountered pemphigoid disease, bullous pemphigoid.

Do Drugs Work for ΟΑΒ Following Prostate Cancer Surgery

2020 ◽  
Vol 21 (15) ◽  
pp. 1515-1526
Author(s):  
Vasileios Sakalis ◽  
Anastasia Gkotsi
Keyword(s):  
Bladder Dysfunction ◽  
Outlet Obstruction ◽  
Detrusor Underactivity ◽  
External Urethral Sphincter ◽  
Pde5 Inhibitors ◽  
Significant Burden ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

: There is evidence that post-radical prostatectomy (post-RP) incontinence is not just the insufficiency of the external urethral sphincter mechanism. Up to a third of men with post-RP incontinence suffer from bladder dysfunction, namely overactive bladder (OAB). OAB is a complex symptom syndrome with poorly defined pathophysiology. It causes a significant burden to patients, negatively affects the quality of their life and its management might be difficult and challenging. : The incidence of post-RP OAB ranges from 15.2 to 37.8%. The aetiology is multifactorial and includes the partial decentralization of the bladder, the detrusor underactivity, the bladder outlet obstruction and the co-existence with stress urinary incontinence (SUI). Post-RP SUI may lead to defunctionalized bladder and activation of urethrovesical reflex which further deteriorate post-RP continence. The diagnostic work-up of men with post-RP OAB should aim to identify potential aetiologic factors and personalize the treatment accordingly. : Until now, there is no robust data from literature with regards to post-RP OAB management. It seems that anticholinergics and PDE5 inhibitors are effective in improving OAB parameters.

scholarly journals Massive megarectum secondary to constipation in institutionalized patient

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Dawit Ayalew ◽  
Yahya Alwatari ◽  
Lin M Riccio
Keyword(s):  
Chronic Constipation ◽  
Elderly Population ◽  
The Elderly ◽  
Mental Disability ◽  
Common Cause ◽  
Surgical Options ◽  
Diagnostic Work ◽  
Work Up ◽  
Case Basis ◽  
Diagnostic Work Up

Abstract Chronic constipation is a common cause of morbidity in the elderly and institutionalized population. It can be associated with significant morbidity and socioeconomical burden. Chronic resistance constipation can rarely be associated with megarectum. Herein, we present the case of a patient with physical and mental disability that presented with refractory constipation associated with extreme stool burden and a massive megarectum. We discuss chronic constipation in the elderly population, its etiologies and diagnostic work-up including surgical options. The management of chronic constipation with megarectum should be on a case-by-case basis.

scholarly journals Stroke masquerading as cardiac arrest: the artery of Percheron

2021 ◽  
Vol 14 (1) ◽  
pp. e238681
Author(s):  
Megan Quetsch ◽  
Sureshkumar Nagiah ◽  
Stephen Hedger
Keyword(s):  
Cardiac Arrest ◽  
Clinical Assessment ◽  
Altered Consciousness ◽  
Cognitive Changes ◽  
Consciousness Level ◽  
Artery Of Percheron ◽  
Conscious Level ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

The artery of Percheron (AOP) is a rare arterial variant of the thalamic blood supply. Due to the densely packed collection of nuclei it supplies, an infarction of the AOP can be devastating. Here we highlight a patient who had an AOP stroke in the community, which was initially managed as cardiac arrest. AOP strokes most often present with vague symptoms such as reduced conscious level, cognitive changes and confusion without obvious focal neurology, and therefore are often missed at the initial clinical assessment. This case highlights the importance of recognising an AOP stroke as a cause of otherwise unexplained altered consciousness level and the use of MRI early in the diagnostic work-up.

scholarly journals Death of unknown cause? Post-mortem diagnosis of fulminant course of an EBV-associated secondary hemophagocytic lymphohistiocytosis

2021 ◽  
Author(s):  
Josia Fauser ◽  
Stefan Köck ◽  
Eberhard Gunsilius ◽  
Andreas Chott ◽  
Andreas Peer ◽  
...  
Keyword(s):  
Immune Response ◽  
Case Report ◽  
Macrophage Activation ◽  
Post Mortem ◽  
Life Threatening ◽  
Appropriate Therapy ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up ◽  
Secondary Hemophagocytic Lymphohistiocytosis

SummaryHLH is a life-threatening disease, which is characterized by a dysregulated immune response with uncontrolled T cell and macrophage activation. The often fulminant course of the disease needs a fast diagnostic work-up to initiate as soon as possible the appropriate therapy. We present herein the case of a 71-year-old patient with rapidly progressive hyperinflammatory syndrome, which post mortem resulted in the diagnosis of EBV-associated HLH. With this case report, we intend to highlight the relevance of the HScore in the diagnosis of HLH, to create a greater awareness for EBV as a trigger of HLH, and to demonstrate the importance of treating EBV-associated HLH as early as possible.

scholarly journals COVID-19 lung injury as a primer for immune checkpoint inhibitors (ICIs)-related pneumonia in a patient affected by squamous head and neck carcinoma treated with PD-L1 blockade: a case report

2021 ◽  
Vol 9 (2) ◽  
pp. e001870
Author(s):  
Angelo Dipasquale ◽  
Pasquale Persico ◽  
Elena Lorenzi ◽  
Daoud Rahal ◽  
Armando Santoro ◽  
...  
Keyword(s):  
Lung Injury ◽  
Head And Neck ◽  
Checkpoint Inhibitors ◽  
Experimental Therapy ◽  
Common Mechanism ◽  
Nasopharyngeal Swab ◽  
Immune Mediated ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

By the beginning of the global pandemic, SARS-CoV-2 infection has dramatically impacted on oncology daily practice. In the current oncological landscape, where immunotherapy has revolutionized the treatment of several malignancies, distinguishing between COVID-19 and immune-mediated pneumonitis can be hard because of shared clinical, radiological and pathological features. Indeed, their common mechanism of aberrant inflammation could lead to a mutual and amplifying interaction.We describe the case of a 65–year-old patient affected by metastatic squamous head and neck cancer and candidate to an experimental therapy including an anti-PD-L1 agent. COVID-19 ground-glass opacities under resolution were an incidental finding during screening procedures and worsened after starting immunotherapy. The diagnostic work-up was consistent with ICIs-related pneumonia and it is conceivable that lung injury by SARS-CoV-2 has acted as an inflammatory primer for the development of the immune-related adverse event.Patients recovered from COVID-19 starting ICIs could be at greater risk of recall immune-mediated pneumonitis. Nasopharyngeal swab and chest CT scan are recommended before starting immunotherapy. The awareness of the phenomenon could allow an easier interpretation of radiological changes under treatment and a faster diagnostic work-up to resume ICIs. In the presence of clinical benefit, for asymptomatic ICIs-related pneumonia a watchful-waiting approach and immunotherapy prosecution are suggested.

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