scholarly journals Valproic Acid-Induced Myoclonus in a Demented Patient: A Case Report

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Tina M. Gardner ◽  
Rehan Aziz ◽  
Sunanda Muralee ◽  
Rajesh R. Tampi
Keyword(s):  
Valproic Acid ◽  
Case Report ◽  
Elderly Patients ◽  
Psychiatric Disorders ◽  
Early Onset ◽  
The Elderly ◽  
Demented Patient ◽  
Behavioral Disturbances ◽  
Neuropsychiatric Complications

Valproic acid and its derivatives are now commonly used to treat various psychiatric disorders in the elderly. Data indicates that the elderly patients are more susceptible to developing neuropsychiatric complications when treated with these medications. In this report, we describe the case of a 66-year-old woman with early-onset, Alzheimer's type dementia, who developed myoclonus when treated with a valproic acid preparation for behavioral disturbances associated with the dementia.

Age, Age of Onset and Course of Primary Depressive Illness in the Elderly*

1983 ◽  
Vol 28 (2) ◽  
pp. 102-104 ◽  
Author(s):  
Martin G. Cole
Keyword(s):  
Elderly Patients ◽  
Depressive Episode ◽  
Early Onset ◽  
Age Of Onset ◽  
Late Onset ◽  
The Elderly ◽  
Depressive Illness ◽  
Physical Illness ◽  
Course Of Illness

Thirty-eight elderly patients with primary depressive illness (Feighner criteria) were followed up for 7–31 months. In the absence of persistent organic signs and severe physical illness, age of onset (first depressive episode after 60) but not age was significantly related to course of illness. Compared to early onset depressives, late onset depressives were more likely to remain completely well during the follow-up period and less likely to have frequent or disabling relapses.

scholarly journals Comminuted Patella Fracture in Elderly Patients: A Systematic Review and Case Report

2017 ◽  
Vol 8 (3) ◽  
pp. 135-144 ◽  
Author(s):  
Brent Matthews ◽  
Kaushik Hazratwala ◽  
Sergio Barroso-Rosa
Keyword(s):  
Case Report ◽  
Elderly Patients ◽  
Treatment Options ◽  
The Elderly ◽  
Fracture Pattern ◽  
Patella Fracture ◽  
Level Of Evidence ◽  
Fixation Failure ◽  
Number Of Patients ◽  
Mesh Augmentation

Objectives: To review comminuted patella fracture in the elderly patients and examine the surgical options to avoid complications such as fixation failure and poor functional outcome. To provide an example of mesh augmentation in comminuted patella fracture in the elderly patients. Data Sources: A literature review was conducted by the authors independently using Ovid, Medline, Cochrane, PubMed, and Clinical Key in English. We aimed to review data on patients older than 65 with comminuted patella fracture. Search conducted between July and December 2015. Study Selection: Search terms included patella fracture, elderly, and fixation failure. Abstracts were included if they were a case report, cohort series, or randomized control trial. Further inclusion criteria were that they were available in full text and included patient age(s), operative details, follow-up, and outcome discussion. Data Extraction: Each study was assessed according to its level of evidence, number of patients, age of patients, fracture patterns described, complications of treatment, and results summarized. Data Synthesis: Paucity of data and heterogeneity of studies limited statistical analysis. Data are presented as a review table with the key points summarized. Conclusion: In patella fracture, age >65 years and comminuted fracture pattern are predictors of increased fixation failure and postoperative stiffness, warranting special consideration. There is a trend toward improved functional outcomes when augmented fixation using mesh or plates is used in this group. Further level 1 studies are required to compare and validate new treatment options and compared them to standard surgical technique of tension band wire construct.

Meta-Analysis of Controlled Pharmacologic Trials

1997 ◽  
Vol 8 (S3) ◽  
pp. 375-379 ◽  
Author(s):  
Lon S. Schneider
Keyword(s):  
Valproic Acid ◽  
Clinical Trials ◽  
Elderly Patients ◽  
Psychotropic Drugs ◽  
Meta Analysis ◽  
Behavioral Symptoms ◽  
Relative Efficacy ◽  
Behavioral Disturbances ◽  
Drug Classes ◽  
Adrenergic Blockers

Both pharmacologic and nonpharmacologic methods can be used to treat behavioral disturbances of dementia. Many drugs and drug classes have been advocated as having putative efficacy in treating nonspecific behavioral symptoms; the list includes neuroleptics, anxiolytics, antidepressants (e.g., trazodone), anticonvulsants (e.g., carbamazepine and valproic acid), lithium, β-adrenergic blockers, selegiline, and buspirone. Neuroleptics are among the most commonly prescribed psychotropic drugs for behavioral symptoms and have been described as being “modestly effective” in controlling agitation, both in patients with dementia and in elderly patients in general. To examine the relative efficacy of neuroleptics in treating behavioral disturbances of dementia, the author and colleagues performed a meta-analysis of clinical trials published in the literature from 1954 to 1989.

scholarly journals Pancreatic Cancer in a Young Male in His Twenties

2020 ◽  
Vol 95 (1) ◽  
pp. 50-55
Author(s):  
Seung-Ho Baek ◽  
Seung Soo Lee ◽  
Ji Hoon Kim ◽  
So Hyun Kim ◽  
Jihye Lim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Literature Review ◽  
Elderly Patients ◽  
Early Onset ◽  
Young Male ◽  
The Elderly ◽  
Genetic Mutations

Pancreatic cancer is one of the most lethal malignancies worldwide. The risk of developing pancreatic cancer increases with age. Pancreatic cancer is seen mostly in the elderly; patients under the age of 30 years are rare. Known risk factors for pancreatic cancer include genetic mutations, smoking, chronic pancreatitis, and diabetes mellitus. We report a case of pancreatic cancer in a 27-year-old man without the PRSS1 mutation. Chronic pancreatitis and smoking may have contributed to the development of pancreatic cancer in this patient. We also conducted a literature review on early onset pancreatic cancer.

scholarly journals Rehabilitation of Vertical Dimension Decreased Cases in Elderly Patients

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Nova Adrian
Keyword(s):  
Case Report ◽  
Elderly Patients ◽  
Elderly Person ◽  
The Elderly ◽  
Vertical Dimension ◽  
Patient Case ◽  
Periodic Control ◽  
Dental Practitioners ◽  
Tooth Migration

Introduction: An elderly person is considered elderly when he or she reaches 60 years or more. Among the problems that occur in the elderly is the loss of teeth. Elderly patients who lose several teeth might decrease the vertical dimension; additional tooth migration causes extensive loss contact. Obtaining an ideal occlusal schema was challenging for dental practitioners. A suitable and efficient preprosthetic plan might be essential to acquire comfortable and good dentures for patients. Our objective is to organize a suitable and efficient preprosthetic, planning to acquire comfortable for patient. Case Report: A 69 year old man who had lost several teeth due to caries on teeth 15, 14, 13, 12, 11, 21, 24, 25, 26, 34, 37, 44, 46 and 47. He had used dentures over the last 15 years and needed a new one because the previous dentures was impaired. We determined the tentative vertical dimension and position to the articulator. Preprosthetic planning fixed the prosthesis on 36 and 27 with extraction on 18. A second impression was made and placed on the articulator, arranging the teeth and try in wax dentures continously. We used a definitive dentures and suggest a periodic control. Conclusion: The loss of several teeth decreased vertical dimensions, and existing tooth migration caused extensive loss contact. The systematic preprosthetic planning might be arranged on behalf of success prosthesis.

scholarly journals Chorea Associated with Diabetic Striatopathy in an Elderly Female: A Case Report

2022 ◽  
Vol 40 (1) ◽  
pp. 65-67
Author(s):  
Md Rashedul Islam ◽  
Tanbin Rahman ◽  
Mohammad Sakhawat Hossen Khan
Keyword(s):  
Diabetes Mellitus ◽  
Case Report ◽  
Elderly Patients ◽  
The Elderly ◽  
Elderly Female ◽  
Rare Manifestation ◽  
Asian Descent ◽  
Hyperosmolar Hyperglycemic State

Diabetic striatopathy is a rare manifestation of diabetes mellitus. The disease commonly affects individuals of Asian descent, female, and the elderly. Patients usually present with hemiballism-hemichorea caused by hyperosmolar hyperglycemic state. Prompt recognition of a hyperglycemiainduced hemiballism-hemichorea is essential because the symptoms are reversible with correction of hyperglycemia. Diagnosis is possible based on blood reports and neuroimaging findings. J Bangladesh Coll Phys Surg 2022; 40: 65-67

scholarly journals Stiff-person syndrome in a patient with comorbid bipolar and panic disorders: A case report and literature review

2020 ◽  
Vol 10 (3) ◽  
pp. 95-99
Author(s):  
Karishma Patel ◽  
Lauren Stummer ◽  
Krina Patel
Keyword(s):  
Valproic Acid ◽  
Case Report ◽  
Panic Disorder ◽  
Literature Review ◽  
Psychiatric Disorders ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Muscle Stiffness ◽  
Stiff Person Syndrome ◽  
Comorbid Psychiatric Disorders ◽  
Muscle Spasms

Abstract Stiff-person syndrome (SPS) is a neurologic disorder characterized by muscle stiffness, rigidity, and muscle spasms, and it can increase a patient's risk for falls. It is recognized as a rare disease with limited clinical guidelines to manage the condition and its symptoms. Currently, there is even less clinical guidance for the management of common comorbid conditions in these patients. This patient case report aims to evaluate the efficacy of various medications for symptom management in a patient with SPS and comorbid psychiatric disorders, specifically bipolar I and panic disorder. Throughout the patient's course of treatment, various medications were trialed, including fluoxetine, hydroxyzine, valproic acid, propranolol, and clonazepam. Ultimately, fluoxetine, hydroxyzine, and propranolol were discontinued due to adverse drug reactions and incomplete symptom resolution. The patient's bipolar I disorder was adequately managed with valproic acid. Once the clonazepam was changed from as-needed to scheduled dosing, the patient's panic disorder and anxiety-triggered spasms were well controlled. The efficacy of benzodiazepines, specifically high doses of diazepam, in alleviating muscle spasms and anxiety in SPS has been demonstrated in the literature. Case reports including patients with SPS that are prescribed selective serotonin reuptake inhibitors provide controversial evidence as some studies report exacerbation of SPS symptoms with prolonged use. As this case report and literature review suggest, patients with SPS and comorbid panic disorder and anxiety-triggered spasms may benefit from the use of benzodiazepines. The use of other medication classes for the treatment of other comorbid psychiatric disorders in a patient with SPS is lacking evidence.

Psychiatric disorders among the elderly on non-psychiatric wards in an African setting

2007 ◽  
Vol 19 (4) ◽  
pp. 691-704 ◽  
Author(s):  
Noeline Nakasujja ◽  
Seggane Musisi ◽  
James Walugembe ◽  
Daphne Wallace
Keyword(s):  
Elderly Patients ◽  
Psychiatric Disorders ◽  
Psychological Health ◽  
Psychiatric Illness ◽  
Depressive Disorders ◽  
Psychiatric Morbidity ◽  
The Elderly ◽  
High Rate ◽  
Cross Sectional ◽  
Self Reporting Questionnaire

Background: The elderly are vulnerable to illness and particularly to psychiatric illness. Many mentally ill elderly patients end up on non-psychiatric wards owing to somatization of their illnesses. Even for these patients, a psychiatric diagnosis may not be made. The literature on the elderly in Uganda is very scanty. This study aims to establish the prevalence and factors associated with psychiatric disorders among elderly patients admitted to non-psychiatric wards.Methods: We carried out a descriptive cross-sectional study of 127 consenting elderly patients. They were administered a standardized questionnaire comprising the Self Reporting Questionnaire 25, the Mini-mental State Examination and the Structured Clinical Interview for the Diagnostic and Statistical Manual IV. Study variables included socio-demographic characteristics, physical illnesses, psychiatric disorders and the treatment given.Results: The rate of psychiatric morbidity was 48%. The sex ratio was 1:1; however, women had a higher rate of psychiatric illness than men, 54.6% and 41.3% respectively. Being widowed or separated and having cancer were associated with SRQ > 5, p = 0.02 and p = 0.04 respectively. Depressive disorders were the most common at 25.2% and were more common in women. Increasing age was associated with dementia (p < 0.00).Conclusion: There is a high rate of psychiatric morbidity among the elderly in Uganda. Particular attention should be given to the psychological health of elderly people admitted to general hospitals.

scholarly journals The neuropsychiatric burden of neurological diseases in the elderly

2005 ◽  
Vol 17 (3) ◽  
pp. 341-351 ◽  
Author(s):  
JEFFREY L. CUMMINGS
Keyword(s):  
Substance Abuse ◽  
Psychiatric Disorders ◽  
Psychotic Disorders ◽  
Late Onset ◽  
Neurological Diseases ◽  
The Elderly ◽  
Behavioral Disturbances ◽  
High Prevalence ◽  
Substance Abuse Disorders ◽  
History Of

Psychogeriatrics began as an extension of psychiatry, with an emphasis on the unique manifestation of psychiatric disorders in the elderly. Early in the history of psychogeriatrics there was an emphasis on late-onset or late-enduring depression; paraphrenia and late-onset psychotic disorders; the late-life phases of schizophrenia; and anxiety and substance abuse disorders in the elderly. Growing recognition of the increasing frequency of Alzheimer's disease (AD) in the course of aging and the high prevalence of behavioral disturbances in patients with AD led psychogeriatricians to study the diagnosis and management of this disorder.

Clinical Experiences and Methodologic Challenges in Conducting Clinical Trials on the Behavioral Disturbances of Dementia

1996 ◽  
Vol 8 (S2) ◽  
pp. 151-164 ◽  
Author(s):  
Sanford I. Finkel ◽  
Carolyn Cooler
Keyword(s):  
Clinical Trials ◽  
Elderly Patients ◽  
Elderly People ◽  
The Elderly ◽  
Behavioral Symptoms ◽  
Pharmaceutical Companies ◽  
World Population ◽  
Clinical Experiences ◽  
Behavioral Disturbances ◽  
Burden Of Caring

With a world population increasing in size and age, the number of elderly people with behavioral distrubances in dementia (BDD) is becoming an increasing problem. The burden of caring for someone with BDD may be so great that it leads to premature institutionalization of the patient. Few clinical trials have focused on noncognitive behavioral symptoms in this group of elderly patients, and little is known about the efficacy of drugs against these symptoms. The pharmaceutical companies have recently begun to assess different medications, but clinical trials in the elderly present a variety of problems not encountered in other patient populations. This article describes how the administration, initiation, logistics, finances, and methodology of such trials must be carefully assessed. Consideration of these factors together with improved definitions of behavioral symptoms and the advances in medication in this area should lead to an improvement in the treatment and management of behavioral disorders in the elderly.

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