EPIDEMIOLOGY AND PROGNOSTIC FACTORS IN PATIENTS WITH SUBDURAL HEMATOMA

SDH was first described in 1658 and in 1914 trauma was recognized as one of the causes. Acute SDH is more common in younger population while chronic is common in the elderly with the peak of incidence of 7.35/100000 per year in the age group 70-79 years. Trauma is one of the main causes of SDH although in 30-50% of patients direct trauma to the head can be omitted. Other predisposing factors include: anticoagulant therapy, epilepsy, and hypertension. The aim of the study was to determine risk factors and prognostic factors for the occurrence of SDH, also to show what age group is most at risk for developing chronic and acute SDH. Identify the diagnostic steps in proving SDH and the best method of treatment. The study includes 267 patients treated in the period from 1.1.2019 to 31.12.2019 at the Clinic for Neurosurgery CCS. SDH was diagnosed by neurological examination and brain CT in all patients and all were treated conservatively or surgically. The analytical statistics were used parametric and non-parametric tests of difference. The study included 185 men and 82 women of middle age 68 ± 17.19 years. Most patients were between 6-8 decades. Multiple changes in CT were observed in 63.3% of patients. Chronic SDH had 50.5% of patients and 45.6% had acute SDH. The most common symptoms were headache, psycho-organic syndrome, and hemiparesis. Patients with a GCS score of more than 8 had a better prognosis and outcome. Surgical treatment was the main course of treatment in our study. CT with / without contrast is the gold standard in detecting SDH. Men are at higher risk for the occurrence of SDH. Symptoms can occur later in the clinical presentation so we need to take caution when performing neurological examination. Factors that can lead us to suspect possible SDH are: age, gender, type of injury, clinical presentation, and time of occurrence.

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Spontaneous resolution of large non-traumatic bilateral acute-on-chronic subdural hematoma

Romanian Neurosurgery ◽

10.1515/romneu-2017-0002 ◽

2017 ◽

Vol 31 (1) ◽

pp. 8-16

Author(s):

D. Adam ◽

D. Iftimie ◽

Gina Burduşa ◽

Cristiana Moisescu

Keyword(s):

Conservative Treatment ◽

Subdural Hematoma ◽

Clinical Presentation ◽

Surgical Intervention ◽

Chronic Subdural Hematoma ◽

The Elderly ◽

Neurological Status ◽

Spontaneous Resolution ◽

Subdural Hematomas ◽

Gcs Score

Abstract Background and importance: Chronic subdural hematomas are a frequently encountered neurosurgical pathology, especially in the elderly. They often require surgical evacuation, but recent studies have shown good results with conservative treatment in selected cases. Clinical presentation: We report the case of a 72-year old patient that developed large, non-traumatic, bilateral, acute-on-chronic subdural hematoma after repeated abdominal surgery for appendicular carcinoma. He presented an abdominal wound infection and good neurological status (GCS score of 14 points), factors that indicated the delay of surgical intervention. Subsequent clinical and radiological improvement forestalled the operation altogether and he presented complete spontaneous resolution of subdural hematomas at only 5 months after diagnosis. Conclusion: Although surgical treatment is performed in the majority of chronic subdural hematomas, in clinically and radiologically selected cases, the operation can be avoided. The hematoma can present resolution, either spontaneously or with the help of conservative treatment.

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Traumatic Perforation of Tympanic Membrane: A Rural Profile of Bangladesh

Medicine Today ◽

10.3329/medtoday.v28i2.32932 ◽

2017 ◽

Vol 28 (2) ◽

pp. 79-82

Author(s):

Jahangir Alam Mazumder ◽

Syed Mohiuddin Nasir ◽

Shazibur Rashid ◽

Arif Morshed Khan

Keyword(s):

Tympanic Membrane ◽

Rural Areas ◽

Healing Rate ◽

Clinical Presentation ◽

Surgical Intervention ◽

Age Group ◽

Spontaneous Healing ◽

Early Appearance ◽

Major Mode ◽

Type Of Injury

To determine the various etiological factors, clinical presentation and outcome of traumatic perforation of tympanic membrane (TM) in a rural area of Bangladesh. A retrospective study of 210 cases of traumatic perforation of TM in upazilla health complex, Nangalkot and Muradnagar, Comilla, Bangladesh within the period of March 2013 to February 2014. The study showed middle age people of 20-39 years age group were mostly affected (61.89%), where males are more than females at the ratio of 1.18:1. Domestic violence was a major factor (50%) and husbands are only culprit for 35.13% of housewives and slap was the major mode of injury (52.86%) affecting the left ear mostly (70.95%). Spontaneous healing rate was very satisfactory and it was 88% within 03 months in our study. Traumatic perforation of TM is a common type of injury in rural areas. Unnecessary surgical intervention or unskilled handling should be discouraged. Early appearance and watchful treatment reduces the morbidity.Medicine Today 2016 Vol.28(2): 79-82

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A Study of Community-Acquired Pneumonias in Elderly Individuals in Bijapur, India

ISRN Pulmonology ◽

10.5402/2012/936790 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10

Author(s):

Bilal Bin Abdullah ◽

Mohammed Zoheb ◽

Syed Mustafa Ashraf ◽

Sharafath Ali ◽

Nida Nausheen

Keyword(s):

Elderly Patients ◽

Clinical Presentation ◽

Empirical Therapy ◽

The Elderly ◽

Community Acquired Pneumonia ◽

Klebsiella Pneumonia ◽

Age Group ◽

Delay In Diagnosis ◽

Altered Sensorium ◽

Etiological Agents

Community-acquired pneumonia (CAP) in elderly has different clinical presentation and higher mortality than CAP in other age group. Clinical presentation may vary from mere presence of fever to altered sensorium. The incomplete clinical picture of CAP in the elderly may be associated with a delay in establishing the diagnosis and, consequently, in starting adequate antibiotic therapy. Delay in diagnosis and treatment may contribute to the higher observed death rate in the elderly population with CAP. Hence the following study was undertaken to study the clinical, radiological, and bacteriological profile of community-acquired pneumonia in elderly. A total of 50 patients were studied. Age group varied from 66 years to 88 years. Presentation varied from typical symptoms to altered sensorium. Smoking and COPD were most common predisposing conditions. Most common organisms responsible were Streptococcus pneumonia, Klebsiella pneumonia, Pseudomonas, H. influenza, and Staphylococcus aureus. Etiological agents could not be identified in many cases because of difficulty in collecting sputum in elderly patients, lower yield of culture, and various atypical and difficult to isolate causative organisms. Hence there is need for an empirical therapy covering both typical and atypical organisms. Better understanding of these aspects may help a long way in managing elderly patients with pneumonia.

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Elderly Onset Celiac Disease: A Narrative Review

Clinical Medicine Insights Gastroenterology ◽

10.4137/cgast.s38454 ◽

2016 ◽

Vol 9 ◽

pp. CGast.S38454 ◽

Cited By ~ 5

Author(s):

Maria Cappello ◽

Gaetano C. Morreale ◽

Anna Licata

Keyword(s):

Celiac Disease ◽

Elderly Population ◽

Clinical Presentation ◽

Diagnostic Delay ◽

The Elderly ◽

Lower Sensitivity ◽

Age Group ◽

Serological Tests ◽

Delay In Diagnosis ◽

Elderly Onset

Celiac sprue is a chronic disease, which usually occurs in children and young adults. However, it can develop in any age group, and the prevalence is increasing even in the elderly population. The atypical patterns of clinical presentation in this age group sometimes can cause a delay in diagnosis. Given the lower sensitivity and specificity of serological tests in the aged population, clinical suspect often arises in the presence of complications (autoimmune disorders, fractures, and finally, malignancy) and must be supported by endoscopic and imaging tools. In this review, we highlight the incidence and prevalence of celiac disease in the elderly, the patterns of clinical presentation, diagnosis, and the most frequent complications, with the aim of increasing awareness and reducing the diagnostic delay of celiac disease even in the elderly population.

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651. Comparative Analysis Between Bacterial And Fungal Malignant Otitis Externa

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.845 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S383-S384

Author(s):

Fatma Hammami ◽

Makram Koubaa ◽

Amal Chakroun ◽

Fatma Smaoui ◽

Khaoula Rekik ◽

...

Keyword(s):

Otitis Externa ◽

Clinical Presentation ◽

The Elderly ◽

Causative Organism ◽

Diabetic Patients ◽

Duration Of Treatment ◽

Evolutionary Features ◽

Significant Difference ◽

Malignant Otitis Externa ◽

History Of

Abstract Background Malignant otitis externa is a fatal infection of the external ear and temporal bone. Pseudomonas aeruginosa is the most common causative organism, while fungi are a rare cause of malignant otitis externa. We aimed to compare the clinical, therapeutic and evolutionary features between bacterial and fungal malignant otitis externa. Methods We conducted a retrospective study including all patients hospitalized for malignant otitis externa in the infectious diseases department between 2000 and 2018. Results Overall, we encountered 82 cases of malignant otitis externa, among which there were 54 cases (65.9%) of bacterial malignant otitis externa (BMO) and 28 cases (34.1%) of fungal malignant otitis externa (FMO). The males were predominant among BMO cases (57.4% vs 50%; p=0.5). Patients with FMO were significantly older (70±9 years vs 61±10 years; p< 0.001) and had medical history of diabetes mellitus more frequently (96.4% vs 77.8%; p=0.03). The use of topical corticosteroids was significantly more reported among FMO cases (28.6% vs 5.6%; p=0.006). Otalgia (96.4% vs 81.5%), otorrhea (75% vs 66.7%) and cephalalgia (46.4% vs 42.6%) were the revealing symptoms among FMO and BMO, respectively, with no significant difference. Tenderness to palpation of the mastoid bone (64.3% vs 38.9%; p=0.02) and stenosis of the external auditory canal (92.9% vs 72.2%; p=0.02) were significantly more frequent among FMO cases. Complications were significantly more frequent among FMO cases (42.9% vs 9.3%; p< 0.001). Treatment duration was significantly longer among FMO cases (70[40-90] days vs 45[34-75] days; p=0.03). Conclusion Our study showed that FMO affected more frequently the elderly and diabetic patients, when compared with BMO. Regardless of the causative agent, the clinical presentation was similar. However, the outcome was poor among FMO cases with the occurrence of complications, requiring a longer duration of treatment. Disclosures All Authors: No reported disclosures

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Nutrition Study People over 80 Years

European Journal of Investigation in Health, Psychology and Education ◽

10.3390/ejihpe2030007 ◽

2012 ◽

Vol 2 (3) ◽

pp. 77-89

Author(s):

Javier Benítez ◽

Nieves Perejón ◽

Marcelino Arriaza ◽

Pilar Bellanco

Keyword(s):

Quality Of Life ◽

The Elderly ◽

Blood Chemistry ◽

Living Alone ◽

Age Group ◽

Nutrition Study ◽

Geriatric Evaluation ◽

The Mean ◽

Elderly Living

Loneliness has always been associated and reported as a risk factor of malnutrition in the elderly. People over 80 who live alone have deserved this study to detect their situation and potential for action to improve their quality of life. Objectives: To determinate the nutritional status of people over 80 living alone in the area of “La Laguna”, Cádiz. Material and method: In PIAMLA`80 program analyse those parameters and their possible correlations in a group of 342 elderly living alone over 80 years old. Different parameters were measured: Integral Geriatric Evaluation, Barthel, Lawton-Brody, Lobo, Gijon, specific analytical blood chemistry and MNA. Results: In a population of 984 people, were selected 342 initially, but finally the group decreases to 247 people. The mean Barthel was 80.42 points, 5.76 Lawton and Gijon from 11.3 Lobo 26.48. The MNA for the whole population was 24.25/30 detecting only a risk age group in women of 85-95. Correlation between nutrition and the biochemical test values showed positive for haemoglobin (0.19), total protein (0.26), Fe (0.32) and albumin (0.46). Conclusions: In our research we have not detected malnutrition in any age group or gender. The use of nutrition test MNA and its MINI version must be generalized as an accurate, clear, quick and easy tool to use.

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Clinical presentation, therapeutic approach, and outcome of young patients admitted for COVID-19, with respect to the elderly counterpart

Clinical and Experimental Medicine ◽

10.1007/s10238-021-00684-1 ◽

2021 ◽

Vol 21 (2) ◽

pp. 249-268

Author(s):

Martino Pepe ◽

Charbel Maroun-Eid ◽

Rodolfo Romero ◽

Ramón Arroyo-Espliguero ◽

Inmaculada Fernàndez-Rozas ◽

...

Keyword(s):

Therapeutic Approach ◽

Clinical Presentation ◽

Young Patients ◽

The Elderly

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Hip fractures among the elderly in Kyoto, Japan: a 10-year study

Archives of Osteoporosis ◽

10.1007/s11657-021-00888-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Maki Asada ◽

Motoyuki Horii ◽

Kazuya Ikoma ◽

Tsuyoshi Goto ◽

Naoki Okubo ◽

...

Keyword(s):

Hip Fracture ◽

Femoral Neck ◽

Incidence Rate ◽

Acute Care ◽

Hip Fractures ◽

Age Groups ◽

The Elderly ◽

Femoral Neck Fractures ◽

Age Group ◽

Trochanteric Fractures

Abstract Summary In Kyoto Prefecture, Japan, the number of hip fractures increased during 2013–2017 compared to 2008–2012. However, the estimated overall incidence rate increased only in femoral neck fractures in men aged ≥75 and women aged ≥85. Purpose The incidence rate of hip fractures in Japan has plateaued or decreased. We investigated the annual hip fracture occurrences in Kyoto Prefecture, Japan, from 2008 to 2017. Methods Patients aged 65 years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The total number of beds in these institutions was 3701, accounting for 21.5% of the 17,242 acute-care beds in Kyoto Prefecture. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015. Results The total number of hip fractures was 10,060, with 47.5% femoral neck fractures and 52.5% trochanteric fractures. A decrease in number was seen only in trochanteric fractures in the group of 75- to 84-year-old women. The population-adjusted numbers of femoral neck fractures showed a significant increase in all age groups in men, whereas in women, there was an increase in femoral neck fractures in the ≥85 group and trochanteric fractures in the age group 65–74, and a decrease in trochanteric fractures in the age group 75–84. The estimated change in incidence rate showed an increase in femoral neck fractures in men aged ≥75 and women aged ≥85. Conclusion In Kyoto Prefecture, the number of hip fractures increased in the second half of the study period (2013–2017) compared to the first half (2008–2012). However, the incidence rate had not increased, except in femoral neck fractures in men aged ≥75 and women aged ≥85.

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