A Simple Test for the Most Common Cause or Aggravating Factor of the Neck, Shoulder, or Upper Extremity Pain

2020 ◽  
Author(s):  
Rohollah Khajeh ◽  
Yousef Fallah
Keyword(s):  
Blood Pressure ◽  
Upper Extremity ◽  
Older Patients ◽  
Laboratory Tests ◽  
Correct Diagnosis ◽  
Age Groups ◽  
Symptomatic Treatment ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Antiinflammatory Drugs ◽  
Common Cause

Background: Shoulder pain and neck pain affect respectively 25% and 43% of the population. The aim of this clinical study is to assess the proportion, correct diagnosis, and treatment of hypertension (HTN) in patients with pain in the neck, shoulder, and upper extremity. Methods: 300 patients with complaints of neck, shoulder, or upper extremity pain without trauma or infection were studied from January 2015 to December 2017. After taking the history and examination, the blood pressure of these patients was recorded. Laboratory tests, x-ray, and magnetic resonance imaging (MRI) of the neck and affected shoulder joint were requested. Antihypertensive and symptomatic treatments were prescribed for patients with HTN. In the next visits, new history and examination, including the range of motion (ROM) of neck, shoulder, and upper extremity, blood pressure, and the results of laboratory tests, and images were checked. The final data were analyzed using chi-square test in SPSS software. Results: The Prevalence of HTN in patients in the age groups of 20-30, 31-60, and above 60 years were 21%, 44%, and 56 %, respectively. Neck, shoulder, and upper extremity pain and motion improved significantly after antihypertensive and symptomatic treatment in patients with HTN. Conclusion: HTN is the most common cause of neck, shoulder, and upper extremity pain in the adults and older patients referring to a physician. Thus, checking blood pressure by a physician or specialist is recommended for adults or older patients with neck, shoulder, or upper extremity pain. Antihypertensive and symptomatic treatments must be prescribed for nonsteroidal antiinflammatory drugs (NSAIDs), and acetaminophen-codeine and corticosteroids should be prohibited for the patients with HTN.

ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

2019 ◽  
Vol 72 (8) ◽  
pp. 1466-1472
Author(s):  
Grażyna Kobus ◽  
Jolanta Małyszko ◽  
Hanna Bachórzewska-Gajewska
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Elderly Patients ◽  
Older Patients ◽  
Age Groups ◽  
Kidney Injury ◽  
The Elderly ◽  
Younger Patients ◽  
Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

scholarly journals Treatment of hypertension in older patients

2020 ◽  
Vol 27 (4) ◽  
pp. 90-98
Author(s):  
O. M. Kovalyova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Older Patients ◽  
Age Groups ◽  
Blood Pressure Targets ◽  
Clinical Investigations ◽  
Treatment Of Hypertension ◽  
American Society ◽  
European Society Of Cardiology ◽  
Randomised Controlled

The article is dedicated to the strategy of management of arterial hypertension in older patients based on the Guidelines of the International Society of Hypertension, the European Society of Cardiology, the European and the American Society of Hypertension, the American College of Physicians and the American Academy of Family Physicians. According to the results of epidemiological and clinical investigations is shown the influence of high blood pressure on cardiovascular outcomes and mortality in the population of older persons. Due to the analyses of randomised controlled trials is pointed out the convicing data the need for differtntiated control of blood pressure according to the level of arterial hypertension and factors of cardiovascular risk. The methodology of initial antihypertensive therapy in persons of different age groups is taken in comparative aspects. The main discussed questions related to the blood pressure targets in the dynamics of antihypertensive treatment in patients 65–79 years and age ≥ 80 years are emphasized. The requirements for individual medical tactics of older hypertensive patients taken into account anamnesis, fit and mental state, clinical features, comorbidity, complications and hypertension-mediated organ damages are recommended.

Blood Pressure in Native Americans Switched from Celecoxib to Rofecoxib

2005 ◽  
Vol 39 (5) ◽  
pp. 797-802 ◽  
Author(s):  
Jefferson Fredy ◽  
Daniel A Diggins ◽  
Gregory B Morrill
Keyword(s):  
Blood Pressure ◽  
Native American ◽  
Native Americans ◽  
Index Date ◽  
Medical Center ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Cardiovascular Safety ◽  
Antiinflammatory Drugs ◽  
The Mean ◽  
Cox 2

BACKGROUND: Nonsteroidal antiinflammatory drugs have been associated with exacerbation of hypertension. Differing effects on blood pressure (BP) have been reported in studies comparing celecoxib and rofecoxib. Concern regarding the cardiovascular safety of the cyclooxygenase-2 (COX-2) inhibitor class has intensified since the removal of rofecoxib from the market. OBJECTIVE: To evaluate the effect of a formulary change from celecoxib to rofecoxib on the BP of Native American patients at an Indian Health Service medical center. METHODS: Medical records of patients switched from celecoxib to rofecoxib were retrospectively reviewed. BP during the respective treatments was compared as follows: measurements recorded while taking celecoxib within 6 months before the index date and while taking rofecoxib from 1 week after the index date through 6 months of treatment were averaged. Differences in systolic and diastolic BP before and after the therapy change were evaluated using a paired Student's t-test. Subgroup analysis was performed for patients with preexisting hypertension. RESULTS: During rofecoxib therapy, the mean systolic BP was 2.9 mm Hg higher (p = 0.015) and the mean diastolic BP was 1.5 mm Hg higher (p = 0.042) than during celecoxib therapy. Among hypertensive patients, the respective mean systolic and diastolic BPs were 4.8 mm Hg (p = 0.009) and 2.0 mm Hg (p = 0.063) higher while taking rofecoxib. CONCLUSIONS: Switching patients from celecoxib to rofecoxib resulted in an increase in BP, with a larger difference observed in patients with hypertension. Future studies assessing the cardiovascular safety of currently marketed and investigational COX-2 inhibitors should evaluate the possible contribution of BP effects of these agents to overall risk.

scholarly journals Selection of PPI in a comorbid patient with NSAIDgastroesophagopathy: case study

2019 ◽  
pp. 48-54
Author(s):  
I. G. Pakhomova
Keyword(s):  
Sharp Increase ◽  
Older Patients ◽  
Age Groups ◽  
The Elderly ◽  
Antiinflammatory Drugs ◽  
The Past ◽  
Prevention And Treatment ◽  
Adult Morbidity ◽  
Selection Of

Over the past decades, there have been significant changes in the structure of adult morbidity. Clinicians are increasingly faced with the problems of combined pathology and development of comorbidity, as well as to solve the issues of rational tactics of management of such patients. Polypragmasia due to comorbidity leads to a sharp increase in the probability of developing systemic and undesirable effects of drugs, while prolonged use of several drugs can lead to the development of complications that develop into independent nosological forms, which is especially important in older age groups. The most common forms of comorbidity in the elderly are in one or another combination of the following diseases: hypertension, coronary heart disease, diabetes, diseases of the musculoskeletal system. It is known that the leading place in the relief of pain in the latter is occupied by non-steroidal antiinflammatory drugs (NSAIDs), the use of which can be prolonged and induce the development of serious gastrotoxic reactions. Well studied and described NSAIDs-induced gastropathy, which, in most cases, is asymptomatic even in the presence of erosive and ulcerative changes. However, NSAIDs may be associated with the emergence of various dyspeptic complaints and lesions of the esophagus, which can be viewed in the framework of NSAID-associated esophageal, especially relevant in older patients. The article deals with the problem of comorbidity, polypragmasia, therapeutic tactics in the management of comorbid patients with NSAIDsesophagogastropathy and the possibility of prescribing for the prevention and treatment of not only effective, but also safe means of correction of these clinical and endoscopic manifestations.

Carotidynia: An Unusual Pain in the Neck

1994 ◽  
Vol 110 (4) ◽  
pp. 387-390 ◽  
Author(s):  
C. Ron Cannon
Keyword(s):  
Head And Neck ◽  
Correct Diagnosis ◽  
Treatment Protocol ◽  
Neck Surgery ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Treatment Modalities ◽  
Laboratory Studies ◽  
Antiinflammatory Drugs ◽  
Temporomandibular Joint Syndrome ◽  
Physical Findings

Described by Fay in 1927, carotidynia has not received much attention in the otolaryngology-head and neck surgery literature. This unusual entity is characterized by ipsilateral neck pain in the region of the carotid artery near its bifurcation. The differential diagnosis is extensive and includes thyroiditis, migraine headache, aneurysm of the carotid system, temporomandibular joint syndrome, giant cell arteritis, and head and neck neoplasms. A correct diagnosis is usually achieved by careful review of the history and physical examination. Laboratory studies are obtained primarily to exclude other causes. Successful treatment is most often effected with the use of nonsteroidal antiinflammatory drugs, although other treatment modalities may be needed. A series of 25 patients treated during the past 10 years is presented. The symptoms, physical findings, appropriate laboratory studies, and a treatment protocol for this uncommon entity are detailed.

Hyponatraemia in older patients: a clinical and practical approach

2015 ◽  
Vol 25 (1) ◽  
pp. 31-52 ◽  
Author(s):  
I Runkle ◽  
E Gomez-Hoyos ◽  
M Cuesta-Hernández ◽  
J Chafer-Vilaplana ◽  
P de Miguel
Keyword(s):  
Elderly Patient ◽  
Nutritional Status ◽  
Older People ◽  
Older Patients ◽  
Correct Diagnosis ◽  
Hormone Secretion ◽  
The Elderly ◽  
Common Cause ◽  
Risk Of Fracture ◽  
Diuretic Hormone

SummaryHyponatraemia is frequent in older people and induces marked motor and cognitive dysfunction, even in patients deemed ‘asymptomatic’. Nutritional status is worse than in euvolaemic-matched controls, and the risk of fracture is increased following incidental falls. Yet hyponatraemia is undertreated, in spite of the fact that its correction is accompanied by a clear improvement in symptoms. Both evaluation of neurological symptoms and classification by volaemia are essential for a correct diagnosis and treatment of the hyponatraemic elderly patient. The syndrome of inappropriate anti-diuretic hormone secretion (SIADH) is the most common cause of hyponatraemia in older people. Nutritional status and chronicity of SIADH should be taken into account when deciding therapy. We propose an 8-step approach to the management of the elderly patient with hyponatraemia.

Sign in / Sign up

Export Citation Format

Share Document