Acute oesophageal necrosis: an important differential in the elderly population with haematemesis

Acute oesophageal necrosis is a rare cause of haematemesis associated with high mortality and morbidity in elderly patients with multiple comorbidities. Acute oesophageal necrosis is thought to be caused by a combination of hypoperfusion, vascular disease and duodenal disease causing transient gastric outlet obstruction and therefore reflux of gastric contents. The subsequent necrosis is associated with significant morbidity and mortality. We present a case of an 83-year-old man presenting with sepsis secondary to gallstone cholangitis, who developed haematemesis 2 days post admission. Oesopho-gastro-duodenoscopy demonstrated necrosis to the oesophagus and duodenal ulceration. This was the first case of acute oesophageal necrosis observed within our hospital. We review the literature on the management of acute oesophageal necrosis and discuss the impact of acute oesophageal necrosis and its complications on the patient’s long-term outcome.

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Pituitary Tumor Surgery in the Elderly: Perioperative Complications and Long-Term Outcome

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0032-1314047 ◽

2012 ◽

Vol 73 (S 02) ◽

Cited By ~ 1

Author(s):

P. Plaha ◽

A. Chari ◽

N. Haslam ◽

E. Pereira ◽

A. Rogers ◽

...

Keyword(s):

Pituitary Tumor ◽

Perioperative Complications ◽

The Elderly ◽

Tumor Surgery ◽

Term Outcome ◽

Long Term Outcome ◽

Surgery In The Elderly

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Health risk assessment and countermeasure analysis of the elderly population exposed to PM2.5 microenvironment

Work ◽

10.3233/wor-205361 ◽

2021 ◽

pp. 1-11

Author(s):

Yan Xu ◽

Wantian Cui

Keyword(s):

Mental Health ◽

Health Risk ◽

Elderly Population ◽

Mental Health Problems ◽

Negative Impact ◽

The Elderly ◽

Exposure Concentration ◽

Physical Diseases ◽

The Impact

BACKGROUND: China’s atmospheric PM2.5 pollution is serious, and PM2.5 exerts a negative impact on the human respiratory system, cardiovascular, and mental health, and even more serious health risk for the elderly with weak immunity. OBJECTIVE: This work aims to analyse the impacts of PM2.5 microenvironment exposure on the health of the elderly and provide corresponding countermeasures. METHODS: The survey subjects are 118 retired elderly people in the community. PM2.5 exposure concentrations are monitored in summer (June 10 ∼ July 10, 2019) and winter (November 25 ∼ December 25, 2019). RESULTS: The exposure concentration in winter is higher than that in summer, with statistical difference (P < 0.05). Under the impact of PM2.5 microenvironment exposure, smoking in the elderly can increase the concentration of PM2.5, and long-term exposure to PM2.5 in the elderly can cause mental health problems. CONCLUSION: Long-term exposure of the elderly to the PM2.5 microenvironment leads to physical diseases and even psychological problems, which requires attention.

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The impact of isolated local recurrence on long-term outcome in early-breast cancer patients after breast-conserving therapy

European Journal of Cancer ◽

10.1016/j.ejca.2021.06.018 ◽

2021 ◽

Vol 155 ◽

pp. 28-37

Author(s):

Conny Vrieling ◽

Samson Y. Assele ◽

Lotte Moser ◽

Nicolas Sauvé ◽

Saskia Litière ◽

...

Keyword(s):

Breast Cancer ◽

Local Recurrence ◽

Cancer Patients ◽

Breast Conserving Therapy ◽

Breast Cancer Patients ◽

Term Outcome ◽

Long Term Outcome ◽

Isolated Local Recurrence ◽

The Impact

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Perinatal Care at the Threshold of Viability

PEDIATRICS ◽

10.1542/peds.96.5.974 ◽

1995 ◽

Vol 96 (5) ◽

pp. 974-976

Author(s):

◽

Keyword(s):

Perinatal Care ◽

Survival Rates ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infants ◽

Term Outcome ◽

Long Term Outcome ◽

Obstetric Management ◽

The Cost ◽

The Impact

The survival rate for infants at the threshold of viability has been improving. However, there are insufficient data regarding the cost(s) of initial and ongoing care of these infants and the long-term outcome of survivors. Furthermore, there has been little study of the impact of obstetric management on the survival rates of extremely low birth weight infants and on long-term morbidities. Continued research on these issues is imperative, and physicians need to remain informed of changing statistics.

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Psychological profiles derived by cluster analysis of Minnesota Multiphasic Personality Inventory and long term clinical outcome after coronary artery by pass grafting

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2012.141 ◽

2015 ◽

Vol 78 (1) ◽

Author(s):

Maddalena Modica ◽

Roberta Carabalona ◽

Rosa Spezzaferri ◽

Monica Tavanelli ◽

A. Torri ◽

...

Keyword(s):

Cluster Analysis ◽

Coronary Artery ◽

Clinical Characteristics ◽

Minnesota Multiphasic Personality Inventory ◽

Personality Inventory ◽

Psychological Characteristics ◽

Term Outcome ◽

Long Term Outcome ◽

The Impact

Background: To evaluate the psychological characteristics of coronary heart disease (CHD) patients after coronary artery bypass grafting (CABG) by cluster analysis of Minnesota Multiphasic Personality Inventory (MMPI-2) questionnaires and to assess the impact of the profiles obtained on long-term outcome. Methods: 229 CHD patients admitted to cardiac rehabilitation filled in self-administered MMPI-2 questionnaires early after CABG. We assessed the relation between MMPI- 2 profiles derived by cluster analysis, clinical characteristics and outcome at 3-year follow-up. Results: Among the 215 patients (76% men, median age 66 years) with valid criteria in control scales, we identified 3 clusters (G) with homogenous psychological characteristics: G1 patients (N=75) presented somatoform complaints but overall minimal psychological distress. G2 patients (N=72) presented type D personality traits. G3 subjects (N=68) showed a trend to cynicism, mild increases in anger, social introversion and hostility. Clusters overlapped for clinical characteristics such as smoking (G1 21%, G2 24%, G3 24%, p ns), previous myocardial infarction (G1 43%, G2 47%, G3 49% p ns), LV ejection fraction (G1 60 [51 – 60]; G2 58 [49- 60]; G3 60 [55-60], p ns), 3-vessel-disease prevalence (G1 69%, G2 65%, G3 71%, p ns). Three-year event rates were comparable (G1 15%; G2 18%; G3 15%) and Kaplan- Meier curves overlapped among clusters (p ns). Conclusions: After CABG, the interpretation of MMPI- 2 by cluster analysis is useful for the psychological and personological diagnosis to direct psychological assistance. Conversely, results from cluster analysis of MMPI-2 do not seem helpful to the clinician to predict long term outcome.

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The impact of individual extended donor criteria on short- and long-term outcome after liver transplant in the MELD-score era

HPB ◽

10.1016/j.hpb.2019.10.1354 ◽

2019 ◽

Vol 21 ◽

pp. S1002

Author(s):

V.J. Lozanovski ◽

E. Khajeh ◽

C.W. Michalski ◽

H. Fonouni ◽

R. von Haken ◽

...

Keyword(s):

Liver Transplant ◽

Meld Score ◽

Term Outcome ◽

Long Term Outcome ◽

Short And Long Term ◽

Donor Criteria ◽

The Impact ◽

Extended Donor Criteria

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Fluvastatin reduces the impact of diabetes on long-term outcome after coronary intervention—A Lescol Intervention Prevention Study (LIPS) substudy

American Heart Journal ◽

10.1016/j.ahj.2004.03.067 ◽

2005 ◽

Vol 149 (2) ◽

pp. 329-335 ◽

Cited By ~ 19

Author(s):

Chourmouzios A. Arampatzis ◽

Dick Goedhart ◽

Patrick W. Serruys ◽

Francesco Saia ◽

Pedro A. Lemos ◽

...

Keyword(s):

Coronary Intervention ◽

Prevention Study ◽

Term Outcome ◽

Long Term Outcome ◽

The Impact

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Abstract 2008: Impact of Hyperglycemia on Myocardial Damage and its Prognostic Implications in Patients with Acute ST-Segment Elevation Myocardial Infarction (STEMI) Assessed by Contrast-Enhanced Cardiac Magnetic Resonance Imaging (CMR)

Circulation ◽

10.1161/circ.118.suppl_18.s_656 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Christoph J Jensen ◽

Markus Jochims ◽

Kai Nassenstein ◽

Michael Bell ◽

Thomas Schlosser ◽

...

Keyword(s):

Logistic Regression Model ◽

Microvascular Obstruction ◽

Myocardial Damage ◽

Term Outcome ◽

Long Term Outcome ◽

Glucose Levels ◽

Contrast Enhanced ◽

Lv Mass ◽

The Impact

To investigate the impact of admission glucose levels on myocardial damage and long term outcome in patients with acute STEMI using contrast-enhanced CMR. 130 consecutive patients (104 males; mean age 59.4±11.8 years) with first reperfused STEMI were included. Hyperglycemia was defined as glucose levels above 7.8mmol/l. CMR was performed within 3.9±2.2 days after admission on a 1.5 Tesla MR System. The imaging protocol included SSFP cine sequences for the calculation of LV function, volumes and mass. Total no reflow volumes (NRV) and delayed enhancement volumes (DEV) were calculated from planimetry of the IR-SSFP stacks of short axis images by disc-summation performed early / late following administration of 0.2mmol/kg/BW of gadodiamid. NRV and DEV were expressed as percent of LV Mass (NR%, DE%). Continuous variables were compared by Mann-Whitney test. Correlation of admission hyperglycemia and NR% was tested by spearman rank test. Patients were prospectively followed for 30±9 months. A stepwise logistic regression model was used to analyze the impact of hyperglycemia and CMR parameters on NR% and outcome. 55 of 130 (42%) patients had hyperglycemia on admission. Patients with admission hyperglycemia had lower LV ejection fraction (38.6±12.9% vs. 47.7±11.9%, p=0.001), greater ESV (89.2±39.2ml vs. 71.7±34.1ml, p=0.002), greater LV Mass (156.7±40.4g vs. 136.3±36.7g, p=0.003), larger DE% (19.3±13.8% vs. 9.7±8.5%, p<0.001) and larger NR% (8.1± 9.2% vs. 2.3± 4.2%, p<0.001). Admission hyperglycemia correlated moderate but significant to DE% (r=0.386, p<0.001) and NR% (r=0.421, p<0.001). In a multivariable logistic regression model admission hyperglycemia was an independent predictor (OR 6.8; CI 2.8 −16.6) of extensive (> median) microvascular obstruction, extensive delayed enhancement (OR 3.2; CI 1.5–7.1) and was associated with an increased risk for death and reinfarction (OR 4.7; CI 1.2–18.3) during follow up. Admission hyperglycemia in acute, reperfused STEMI is independently related to the extent of microvascular obstruction on early contrast-enhanced CMR and is associated with worse long-term outcome. Thus, CMR may play a major role in monitoring effects of glucose control on myocardial damage in AMI.

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The Institutional Effect

Capital Women ◽

10.1093/oso/9780190847883.003.0007 ◽

2019 ◽

pp. 159-198

Author(s):

Jan Luiten

Keyword(s):

Family Structure ◽

Nuclear Family ◽

The Elderly ◽

Institutional Arrangements ◽

Institutional Diversity ◽

Top Down ◽

Term Outcome ◽

Long Term Outcome ◽

Institutional Effect

This chapter addresses several issues, all with the underlying intention of refining and reorienting the nuclear-hardship debate. There is a need for such reorientation, as several indicators show that the long-term outcome of this process toward a society built upon nuclear households has not led to more hardship; quite the contrary. Nor would it be fair to claim that this outcome has to be entirely due to top-down provisions, and then in particular, to charity. In this chapter the authors stress the institutional diversity of the solutions for hardship and focus on one particular group in society, namely the elderly. They demonstrate that the elderly had more “agency” than is usually expected and that a combination of institutional arrangements in addition to the top-down provisions granted the elderly more options to deal with the supposed hardship of growing old in a nuclear family structure.

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