Patient risk factors and adverse drug interactions in the treatment of acute gouty arthritis in the elderly: a case report

Owing to the different means of ascertaining prevalence between studies, it is difficult to compare prevalence across countries. Country-specific studies that collect data with the same methodology show that the prevalence of gout is increasing. Factors that influence the prevalence of gout are inherited genetic factors and environmental exposures. Some foods that increase serum urate levels and trigger acute gouty arthritis are risk factors—red meat and beer are the best established, but seafood and sugar-sweetened beverages also increase serum urate levels and are strong anecdotal triggers of flares. Diuretics associate with increased serum urate and the risk of gout. Hyperuricaemia and gout are co-morbid with other metabolic conditions, the most prominent being heart disease, renal disease, and type 2 diabetes. Collectively the evidence does not suggest that increased serum urate levels are clinically detrimental, except in gout, nephrolithiasis, and perhaps progression of heart and kidney disease.

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The elderly emergency surgical patient: Risk factors that alter perioperative management

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2019.06.033 ◽

2019 ◽

Vol 58 ◽

pp. 121-122

Author(s):

Basma A. Mohamed ◽

Brenda G. Fahy

Keyword(s):

Risk Factors ◽

Perioperative Management ◽

The Elderly ◽

Surgical Patient ◽

Patient Risk

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Interaction of the p.Q141K Variant of the ABCG2 Gene with Clinical Data and Cytokine Levels in Primary Hyperuricemia and Gout

Journal of Clinical Medicine ◽

10.3390/jcm8111965 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1965 ◽

Cited By ~ 2

Author(s):

Veronika Horváthová ◽

Jana Bohatá ◽

Markéta Pavlíková ◽

Kateřina Pavelcová ◽

Karel Pavelka ◽

...

Keyword(s):

Risk Factors ◽

Age Of Onset ◽

Gouty Arthritis ◽

Disease Onset ◽

Acute Gouty Arthritis ◽

Reactive Protein ◽

Coding Regions ◽

Cytokine Levels ◽

Multiplex Cytokine ◽

Abcg2 Gene

Gout is an inflammatory arthritis influenced by environmental risk factors and genetic variants. The common dysfunctional p.Q141K allele of the ABCG2 gene affects gout development. We sought after the possible association between the p.Q141K variant and gout risk factors, biochemical, and clinical determinants in hyperuricemic, gouty, and acute gouty arthritis cohorts. Further, we studied the correlation of p.Q141K allele and levels of pro-/anti-inflammatory cytokines. Coding regions of the ABCG2 gene were analyzed in 70 primary hyperuricemic, 182 gout patients, and 132 normouricemic individuals. Their genotypes were compared with demographic and clinical parameters. Plasma levels of 27 cytokines were determined using a human multiplex cytokine assay. The p.Q141K variant was observed in younger hyperuricemic/gout individuals (p = 0.0003), which was associated with earlier disease onset (p = 0.004), trend toward lower BMI (p = 0.056), and C-reactive protein (CRP, p = 0.007) but a higher glomerular filtration rate (GFR, p = 0.035). Levels of 19 cytokines were higher, mainly in patients with acute gouty arthritis (p < 0.001), irrespective of the presence of the p.Q141K variant. The p.Q141K variant influences the age of onset of primary hyperuricemia or gout and other disease-linked risk factors and symptoms. There was no association with cytokine levels in the circulation.

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The Art of Safe and Judicious Deprescribing in an Elderly Patient: A Case Report

Geriatrics ◽

10.3390/geriatrics5030057 ◽

2020 ◽

Vol 5 (3) ◽

pp. 57

Author(s):

Pietro Gareri ◽

Luca Gallelli ◽

Antonino Maria Cotroneo ◽

Valeria Graziella Laura Manfredi ◽

Giovambattista De Sarro

Keyword(s):

Case Report ◽

Drug Interactions ◽

Brain Magnetic Resonance Imaging ◽

Cognitive Disorders ◽

Clinical History ◽

The Elderly ◽

Chronic Obstructive ◽

Walking Ability ◽

Inappropriate Drugs ◽

Increased Risk

Prescription for inappropriate drugs can be dangerous to the elderly due to the increased risk of adverse drug reactions and drug-interactions. In this manuscript, we report the complexity of polypharmacy and the possible harmful consequences in an old person. An 81-year-old man with a clinical history of diabetes, blood hypertension, non-valvular atrial fibrillation, chronic obstructive pulmonary disease, osteoarthritis, anxiety, and depression, was admitted to our attention for cognitive disorders and dementia. Brain magnetic resonance imaging showed parenchymal atrophy with lacunar state involving thalami and internal capsules. Neuropsychological tests revealed cognitive impairment and a depressed mood. History revealed that he was taking 11 different drug severy day with a potential risk of 55 drug–drug interactions. Therefore, risperidone, chlorpromazine, N-demethyl-diazepam, and L-DOPA/carbidopa were gradually discontinued and citicoline (1g/day), cholecalciferol (50,000 IU once a week), and escitalopram (5 mg/day) were started. Furthermore, he started a program of home rehabilitation. During the follow-up, three months later, we recorded an improvement in both mood and cognitive tests, as well as in walking ability. The present case report shows the need for a wise prescription and deprescribing in older people.

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Attempted Suicide and the Elderly Trauma Patient: Risk Factors and Outcomes

Journal of Trauma and Acute Care Surgery ◽

10.1097/01.ta.0000229784.88927.6e ◽

2007 ◽

Vol 62 (4) ◽

pp. 1021-1028 ◽

Cited By ~ 14

Author(s):

Marie Crandall ◽

Fred Luchette ◽

Thomas J. Esposito ◽

Michael West ◽

Michael Shapiro ◽

...

Keyword(s):

Risk Factors ◽

Trauma Patient ◽

Attempted Suicide ◽

The Elderly ◽

Patient Risk

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8-mm portal incarcerated hernia after robotic colectomy: case report

Revista Eletrônica Acervo Saúde ◽

10.25248/reas.e6824.2021 ◽

2021 ◽

Vol 13 (4) ◽

pp. e6824

Author(s):

João Victor Tavares Mendonça Garretto ◽

Yara Tavares Mendonça Garretto ◽

Thales Hott Fernandes Morais ◽

Sofia Gonzaga Garcia ◽

Luisa Leal Barbosa Correia De Andrade ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Case Report ◽

Robotic Surgery ◽

Incarcerated Hernia ◽

Patient Risk ◽

Left Colectomy ◽

Left Flank ◽

Intestinal Contents ◽

Adenocarcinoma Of The Colon

Objective: The objective of this work is to report a hernia derived from the access portal used in robotic surgery. Details of the case: A 72-year-old woman, diagnosed with splenic angle adenocarcinoma of the colon, underwent robotic left colectomy and lymphadenectomy. On the 12th postoperative day, she developed vomiting and interrupted the elimination of feces and flatus. Computed tomography revealed hernia on the left flank with an 8 mm orifice with intestinal contents. Incisional herniorrhaphy was performed to correct the defect. PSH are associated with patient risk factors. They are also related to the diameter of the trocar and its place of passage. For its prevention, it is important to assess the need to close the aponeurosis according to each case. Final considerations: The disturbances created by the passage of 12 mm and 10 mm trocars must be closed. Those created by 5 mm trocars do not need to be closed, and those of 8 mm may or may not be closed, depending on the risk factors involved.

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Topical tropicamide induced delirium and psychosis: case report

Jornal Brasileiro de Psiquiatria ◽

10.1590/s0047-20852010000100012 ◽

2010 ◽

Vol 59 (1) ◽

pp. 74-76 ◽

Cited By ~ 4

Author(s):

Renato P. Munhoz ◽

Mariana M. Moscovich ◽

Luciane Filla ◽

Maria Cecília Beltrame Carneiro

Keyword(s):

Risk Factors ◽

Case Report ◽

Female Patient ◽

Clinical Manifestations ◽

The Elderly ◽

Acute Psychosis ◽

Anticholinergic Agents ◽

Review Of The Literature ◽

Confusional States ◽

Case Effect

Acute psychosis and confusional states are known complications of treatment with anticholinergic agents in the elderly. We report an 87-year-old female patient presenting with acute neurobehavioral abnormalities requiring hospitalization immediately after starting treatment for openangle glaucoma with the topic cycloplegic muscarinic receptor blocker tropicamide. Case-effect relationship was confirmed. The authors make a review of the literature trying to identify the clinical manifestations and risk factors for this complication.

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