Depression and Previous Alcoholism in the Elderly

1991 ◽  
Vol 158 (1) ◽  
pp. 72-75 ◽  
Author(s):  
Brian L. Cook ◽  
George Winokur ◽  
Michael J. Garvey ◽  
Vickie Beach
Keyword(s):  
Risk Factor ◽  
Elderly Population ◽  
Bipolar Depression ◽  
Past History ◽  
Previous History ◽  
The Elderly ◽  
Response To Treatment ◽  
History Of ◽  
A Prospective Study

A prospective study of male in-patients over 55 years old who met Feighner criteria for non-bipolar depression was performed to determine if a previous history of alcoholism significantly influenced treatment or response to treatment. Among 58 subjects with complete follow-up information, the 16 who had a history of alcoholism had a presentation at index which differed from that of the non-alcoholics, and on follow-up they clearly had more chronic illness. This elderly sample with alcoholism resembles ‘neurotic-reactive’ depressives described in younger samples, and supports a past history of alcoholism as being a risk factor for chronicity of depression on follow-up in the elderly population.

Abstract 4427: Electrocardiographic Left Ventricular Hypertrophy Predicts Long Term Fatal Outcomes in Elderly Hypertensives Despite Diuretic-Based Antihypertensive Treatment: 14-Year Follow-Up of the Systolic Hypertension in the Elderly Program (SHEP)

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tudor Vagaonescu ◽  
Alan C Wilson ◽  
John B Kostis
Keyword(s):  
Antihypertensive Treatment ◽  
Ventricular Hypertrophy ◽  
Previous History ◽  
The Elderly ◽  
Cardiovascular Death ◽  
Left Ventricular ◽  
All Cause Mortality ◽  
History Of

Background: To assess if diuretic-based antihypertensive treatment improves long term fatal (cardiovascular) outcomes in the elderly with isolated systolic hypertension (ISH) and ECG documented left ventricular hypertrophy (LVH). Methods: Retrospective analysis of the SHEP database of 4,736 patients age ≥60 years and ISH and subsequent vital status ascertainment by matching to the National Death Index. Results: 348 subjects (7.35%) of SHEP participants had ECG documented LVH at baseline. Subjects with LVH had at baseline: higher SBP and pulse pressure (p<0.0001), carotid bruits (13% vs. 7%, p<0.0001) and previous history of myocardial infarction (8% vs. 4%, p=.0008) when compared with participants without LVH. There were no significant differences with regard to age, sex, heart rate, body mass index, smoking and alcohol use, previous history of stroke, diabetes, angina, and assignment to treatment or placebo group. Over 14.3 years (mean) of follow up subjects with baseline LVH experienced significantly more all cause mortality (51% vs. 40%, p<0.0001) and cardiovascular death (24% vs. 19%, p=0.002) than participants without baseline LVH. In the group of participants with LVH at baseline active treatment of hypertension did not decrease all cause mortality (51% vs. 50%, NS) or cardiovascular death (26% vs. 24%, NS). There was no statistically significant interaction between LVH and the assignment to treatment (antihypertensive medication vs. placebo). In a multivariable analysis, the adjusted Cox hazard ratio of developing any fatal outcome in the LVH group was 1.181 (95% CI 1.005–1.387, p=0.043) after adjusting for age, sex, race, history of myocardial infarction, diabetes, alcohol smoking status, education, blood pressure, and assignment to treatment or to placebo group. Conclusion: In the elderly with ISH the presence of LVH documented by ECG increased the risk for long term fatal outcomes despite treatment with diuretic-based antihypertensive therapy. Although active treatment lowered risk in the SHEP study, treated participants with LVH had a higher risk for fatal outcomes than treated subjects without LVH.

scholarly journals Treatment Trends in Dry Eye Disease and Factors Associated with Ophthalmic Follow-up Discontinuation in Japan

2019 ◽  
Vol 8 (8) ◽  
pp. 1120 ◽  
Author(s):  
Miki Uchino ◽  
Norihiko Yokoi ◽  
Motoko Kawashima ◽  
Yamanishi Ryutaro ◽  
Yuichi Uchino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Dry Eye ◽  
Past History ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
History Of

Despite the importance of dry eye disease (DED) treatment, the rate of DED treatment discontinuation, especially discontinuation of ophthalmic follow-up, remains unknown. This study aimed to assess the prevalence and risk factors of ophthalmic follow-up discontinuation for DED. A cross-sectional survey of 1030 participants was conducted using a self-administered web-survey instrument. We collected lifestyle information, history of DED diagnosis, types of treatment, frequency of eye-drop usage, symptoms, and the reasons for discontinuing treatment. Statistical analyses including logistic regression were used to evaluate the risk factors of discontinuing ophthalmic follow-up for DED. A past history of clinical DED diagnosis was reported by 155 (15.0%) subjects. Of those, 130 had persistent DED, and 88 (67.7%) of the subjects reported discontinuation of ophthalmic follow-up for DED. The most prevalent reasons for ophthalmic follow-up discontinuation were time restrictions, followed by dissatisfaction with the DED treatment. Duration after DED diagnosis was the only significant risk factor for discontinuing ophthalmic follow-up after adjusting for age and sex (odds ratio = 1.09, 95% confidence interval = 1.02–1.17, p = 0.009). In conclusion, longer DED duration after diagnosis was a significant risk factor for discontinuing ophthalmic follow-up for DED. This study showed that DED ophthalmic follow-up discontinuation involves both medical and non-medical reasons. Clinicians need to be aware of them, and preventative effort is needed to avoid discontinuation.

Outcome of the depressed elderly living in the community in Liverpool: a 5-year follow-up

1998 ◽  
Vol 28 (6) ◽  
pp. 1329-1337 ◽  
Author(s):  
V. K. SHARMA ◽  
J. R. M. COPELAND ◽  
M. E. DEWEY ◽  
D. LOWE ◽  
I. DAVIDSON
Keyword(s):  
Elderly Population ◽  
Depressive Disorders ◽  
The Elderly ◽  
Structured Interview ◽  
Depression Score ◽  
History Of ◽  
Elderly Living ◽  
Selection Of

Background. Comparatively little is known about the long-term natural history of depressive disorders in the elderly living in the community. This is a follow-up of a subsample of the Continuing Health in the Community study random sample of the elderly population living in Liverpool.Methods. The investigators followed up 120 cases of depression identified by a semi-structured interview schedule (GMS) for a period of 5 years. A similar number of other subjects defined as subcases of depression, other cases of mental illness and a random selection of non-cases were also included.Results. The 5-year outcome for the cases of depression was worse than the outcome of the non-cases (relative mortality risk of 2·1, 95% confidence interval 1·1 to 3·9). Thirty-four per cent of the cases of depression died and 28% had dropped out during the follow-up. Of the 46 cases of depression who had a complete follow-up, 22% recovered from their symptoms, 30% were found to be AGECAT cases at one of the three follow-up waves, 24% were AGECAT cases at two of the three follow-up waves and the remaining 24% were AGECAT cases at each follow-up wave. Fifteen per cent of the surviving cases of depression were organic cases at the follow-up. Their anxiety co-morbid state and depression score were identified as predictors of poor outcome.Conclusion. The findings of this study indicate that depressive disorders (most of which were untreated) found in the elderly community have a poor prognosis.

De Novo Aneurysm: Case Reports and Literature Review

Neurosurgery ◽  
2011 ◽  
Vol 69 (3) ◽  
pp. E761-E767 ◽  
Author(s):  
Nunung Nur Rahmah ◽  
Tetsuyoshi Horiuchi ◽  
Yoshikazu Kusano ◽  
Tetsuo Sasaki ◽  
Kazuhiro Hongo
Keyword(s):  
Arterial Hypertension ◽  
De Novo ◽  
Past History ◽  
Case Reports ◽  
Previous History ◽  
Anterior Circulation ◽  
Risk Of Rupture ◽  
History Of ◽  
The Mean

Abstract BACKGROUND AND IMPORTANCE: Formation of cerebral de novo aneurysms (CDNAs) is rare, and the pathogenesis remains obscure. We analyzed factors involved in formation of CDNAs and suggest guidelines for follow-up of patients. CLINICAL PRESENTATION: We retrospectively reviewed intracranial aneurysms at our institute and published reports from 1964 to 2008. Eleven patients were found with CDNAs, and 138 patients were collected from the published literature. We assessed the clinical characteristics, such as sex, size, and site of CDNA, past history, and time to occurrence of CDNAs. Of 11 patients, 10 were female and 1 was male; the mean age of the first onset was 53 years (range, 25-69 years). The mean time between first aneurysms and CDNAs was 10.6 years (range, 3-29 years). The most common site of occurrence was anterior circulation. One patient experienced contralateral occurrence, and 2 patients changed from anterior to posterior circulation CDNAs. Six (54.5%) patients had a history of arterial hypertension. Results from analysis of the whole series from the literature revealed that the risk of rupture increased with a previous history of hemorrhage. Contralateral occurrence of CDNAs was related to previous location, and multiplicity, whereas the occurrence of anterior to posterior changes of CDNAs and shorter interval only correlated with an older age group. CONCLUSION: Although the formation of CDNAs is rare, several factors may contribute to its occurrence. Female patients with a history of arterial hypertension were at a higher risk for CDNA occurrence. We recommend follow-up imaging studies within 10 years after the initial aneurysms; therefore, at least 50% of CDNAs can be found before rupture.

scholarly journals Ectopic pregnancy in a tertiary care centre of Jharkhand, India

2019 ◽  
Vol 8 (8) ◽  
pp. 2969
Author(s):  
Meetali Parashar ◽  
Meena Mehta
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Previous History ◽  
First Trimester ◽  
Near Miss ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Β Hcg ◽  
A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

scholarly journals Parenchymal mucinous cystadenoma of the kidney: a case report and literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mahmoudreza Kalantari ◽  
Shakiba Kalantari ◽  
Mahdi Mottaghi ◽  
Atena Aghaee ◽  
Salman Soltani ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Left Kidney ◽  
Previous History ◽  
Mucinous Cystadenoma ◽  
Single Layer ◽  
Renal Cysts ◽  
Cystic Mass ◽  
Flank Pain ◽  
History Of

Abstract Background Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts. Case presentation A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month. Conclusion It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.

scholarly journals An Emulation of Randomized Trials of Administrating Antipsychotics in PTSD Patients for Outcomes of Suicide-Related Events

2021 ◽  
Vol 11 (3) ◽  
pp. 178
Author(s):  
Noah R. Delapaz ◽  
William K. Hor ◽  
Michael Gilbert ◽  
Andrew D. La ◽  
Feiran Liang ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Previous History ◽  
Current Treatment ◽  
Careful Consideration ◽  
P Value ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
History Of ◽  
Almost All

Post-traumatic stress disorder (PTSD) is a prevalent mental disorder marked by psychological and behavioral changes. Currently, there is no consensus of preferred antipsychotics to be used for the treatment of PTSD. We aim to discover whether certain antipsychotics have decreased suicide risk in the PTSD population, as these patients may be at higher risk. A total of 38,807 patients were identified with a diagnosis of PTSD through the ICD9 or ICD10 codes from January 2004 to October 2019. An emulation of randomized clinical trials was conducted to compare the outcomes of suicide-related events (SREs) among PTSD patients who ever used one of eight individual antipsychotics after the diagnosis of PTSD. Exclusion criteria included patients with a history of SREs and a previous history of antipsychotic use within one year before enrollment. Eligible individuals were assigned to a treatment group according to the antipsychotic initiated and followed until stopping current treatment, switching to another same class of drugs, death, or loss to follow up. The primary outcome was to identify the frequency of SREs associated with each antipsychotic. SREs were defined as ideation, attempts, and death by suicide. Pooled logistic regression methods with the Firth option were conducted to compare two drugs for their outcomes using SAS version 9.4 (SAS Institute, Cary, NC, USA). The results were adjusted for baseline characteristics and post-baseline, time-varying confounders. A total of 5294 patients were eligible for enrollment with an average follow up of 7.86 months. A total of 157 SREs were recorded throughout this study. Lurasidone showed a statistically significant decrease in SREs when compared head to head to almost all the other antipsychotics: aripiprazole, haloperidol, olanzapine, quetiapine, risperidone, and ziprasidone (p < 0.0001 and false discovery rate-adjusted p value < 0.0004). In addition, olanzapine was associated with higher SREs than quetiapine and risperidone, and ziprasidone was associated with higher SREs than risperidone. The results of this study suggest that certain antipsychotics may put individuals within the PTSD population at an increased risk of SREs, and that careful consideration may need to be taken when prescribed.

scholarly journals Predictive factors of epilepsy outcome in a sample of Egyptian pre-elderly and elderly population

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Steven Emil Gerges ◽  
Mahmoud Hemeda El Rakawy ◽  
Naglaa Mohammed El Khayat ◽  
Yousry Abo Elnaga Abdelhamid ◽  
Ahmed Mohammed Hazzou ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Elderly Population ◽  
Laboratory Data ◽  
The Elderly ◽  
Medical Comorbidities ◽  
Mri Brain ◽  
Group Data ◽  
History Of ◽  
Eeg Changes ◽  
International League

Abstract Background Elderly people with epilepsy are large, but neglected group. Data on the predictive factors for recurrent seizures in the elderly population are inconclusive or are not known for the majority of patients. This is especially true for the Egyptian population as no specific study was concluded to address this issue before. Objectives The aim of this study was to detect the predictive factors of epilepsy outcome in a sample of Egyptian aged population. Materials and methods A total of 100 patients aged 50 years or older with epilepsy diagnosed according to International League Against Epilepsy (ILAE) latest definition were included in the study and followed up for 6 months as regards seizure control. All participants were prospectively evaluated for epidemiological, clinical, radiological, electrodiagnostic, and laboratory data. Results The outcome was statistically significant affected in relation to absence of medical comorbidities (P = 0.037), seizure etiology (P = 0.007), history of status epilepticus (P <  0.001), MRI brain findings (P = 0.005), EEG changes (P <  0.001), Ca (P = 0.01), and Mg level (P = 0.046). Conclusion We conclude that aged Egyptian epileptic population with no medical comorbidities, normal MRI brain, or normal EEG can be predicted to have good outcome of their epilepsy while patients with post stroke epilepsy, abnormal MRI brain, and abnormal EEG, with low serum Ca or Mg level can be predicted to have poor outcome.

scholarly journals A longitudinal study over 40 years to study the metabolic syndrome as a risk factor for cardiovascular diseases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lars Lind ◽  
Johan Sundström ◽  
Johan Ärnlöv ◽  
Ulf Risérus ◽  
Erik Lampa
Keyword(s):  
Metabolic Syndrome ◽  
Risk Factor ◽  
Longitudinal Study ◽  
Clinical Intervention ◽  
The Elderly ◽  
Adult Men ◽  
The Metabolic Syndrome ◽  
The Impact ◽  
Over 40 Years

AbstractThe impact of most, but not all, cardiovascular risk factors decline by age. We investigated how the metabolic syndrome (MetS) was related to cardiovascular disease (CVD) during 40 years follow-up in the Uppsala Longitudinal Study of Adult Men (ULSAM, 2,123 men all aged 50 at baseline with reinvestigations at age 60, 70, 77 and 82). The strength of MetS as a risk factor of incident combined end-point of three outcomes (CVD) declined with ageing, as well as for myocardial infarction, ischemic stroke and heart failure when analysed separately. For CVD, the risk ratio declined from 2.77 (95% CI 1.90–4.05) at age 50 to 1.30 (95% CI 1.05–1.60) at age 82. In conclusion, the strength of MetS as a risk factor of incident CVD declined with age. Since MetS was significantly related to incident CVD also at old age, our findings suggest that the occurrence of MetS in the elderly should not be regarded as innocent. However, since our data were derived in an observational study, any impact of MetS in the elderly needs to be verified in a randomized clinical intervention trial.

Efficacy of local treatments in Prurigo Pigmentosa after Bariatric surgery

2021 ◽  
Vol 07 (02) ◽  
pp. 01-03
Author(s):  
Mezoun Almuhaimeed
Keyword(s):  
Bariatric Surgery ◽  
Clinical Presentation ◽  
Response To Treatment ◽  
Single Female ◽  
Provisional Diagnosis ◽  
Patient Response ◽  
Medical City ◽  
History Of ◽  
Multivitamin Supplements

A 22-year-old single female presented to primary care Wazarat Health Center at Prince Sultan Military Medical City in Riyadh, with a 3 weeks history of itchy erythematous papules and vesicles and papulo-vesicles over the neck, chest, and upper back and face, which started 4 to 5 days after bariatric surgery. The patient on daily multivitamin supplements, vitamin D (50,000 IU, weekly / 2 months). The patient has lost 4kg since the operation, family history of atopy was positive regarding the mother physical examination shows erythematous papules and vesicles and papulo-vesicles over the neck with crust, chest, and upper back, Based on medical history and clinical presentation a provisional diagnosis was Prurigo Pigmentosa. The patient was prescribed topical mometasone furoate cream (BID for one week). Two -week follow-up showed improvement of the eruption. The course of the disease was shorter than usual in such cases the patient response to treatment was reactive to the topical mometasone without taking the oral minocyline, which major of such cases need in the late course of the disease The patient starts to improve within 2 weeks compared to others who need an average of 6 weeks to improve in such cases

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