scholarly journals External hemorrhoidal thrombosis in the elderly patients: conservative and surgical management

2020 ◽  
Vol 75 (2) ◽  
Author(s):  
Chiara Eberspacher ◽  
Domenico Mascagni ◽  
Pavlos Antypas ◽  
Gianmarco Grimaldi ◽  
Lisa Fralleone ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Surgical Management ◽  
The Elderly

scholarly journals Surgical Decisions in the Elderly: The Importance of Biological Age

2001 ◽  
Vol 94 (5) ◽  
pp. 232-235 ◽  
Author(s):  
S M Farquharson ◽  
Ramesh Gupta ◽  
R J Heald ◽  
B J Moran
Keyword(s):  
Elderly Patients ◽  
Medical History ◽  
Surgical Management ◽  
The Elderly ◽  
Biological Age ◽  
Star Rating ◽  
Patient Groups ◽  
Surgical Conditions ◽  
The One ◽  
Independent Existence

Summary Surgeons will sometimes advise against an operation because the patient is ‘old and frail’. A simple starring system (one to five), based on performance and lifestyle, has been devised to assess the biological age of elderly patients. 10 consultant surgeons and 10 trainees answered questions about their treatment recommendations for hypothetical patients of standard age and medical history but with various star ratings and surgical conditions. 1000 decisions were available for analysis. The four and five star patients (those leading an independent existence) were recommended 266 interventions, the one and two star patients 55. Trainees were more inclined to intervene than consultants, recommending operations in half the patients rather than one-third. These results indicate that decisions on surgical management are strongly influenced by the patient's star rating or biological age. If the starring method proves reproducible in other patient groups and settings, it could allow better communication on an important factor in clinical decisions.

Liver Resection of Colorectal Metastases in Elderly Patients

2010 ◽  
Vol 06 (02) ◽  
pp. 37
Author(s):  
Prashant Bhangui ◽  
Rene Adam ◽  
◽  
Keyword(s):  
Elderly Patients ◽  
Surgical Management ◽  
Relevant Literature ◽  
The Elderly ◽  
Colorectal Metastases ◽  
Ageing Population ◽  
Term Survival ◽  
Functional Changes ◽  
Intention To Treat

The ageing population, the specific epidemiology of colorectal cancer (CRC) and the high incidence of colorectal liver metastases (CRLM) have all led to a significant increase in elderly patients with CRLM seeking surgical management. Due to physiological and functional changes with advancing age (which may decrease the ability of the elderly to sustain aggressive treatment) and the lack of validated guidelines, surgeons still hesitate to plan surgical resection of CRLM in the elderly. Recently, a few studies have suggested that resection of CRLM in the elderly is feasible and yields good short- and long-term outcomes in the context of an intention-to-treat strategy. This article discusses the relevant literature and tries to put forth possible recommendations for the surgical management of elderly patients with CRLM. No chronological upper age limit should contraindicate curative treatment and well-selected elderly patients with advanced CRC can be offered a similar chance of long-term survival with the use of an optimal onco-surgical strategy.

106 Precipitating factors in the elderly patients admitted with the diagnosis of heart failure. Are easy to find?

2006 ◽  
Vol 5 (1) ◽  
pp. 25-26
Author(s):  
R VIDALPEREZ ◽  
E ABUASSI ◽  
M PARAMODEVEGA ◽  
P VELOSO ◽  
A VARELAROMAN ◽  
...  
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
The Elderly ◽  
Precipitating Factors

Evaluation of R-CHOP and R-CVP in the treatment of elderly patient with non-Hodgkin lymphoma

MedPharmRes ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 1-6
Author(s):  
Truc Phan ◽  
Tram Huynh ◽  
Tuan Q. Tran ◽  
Dung Co ◽  
Khoi M. Tran
Keyword(s):  
Elderly Patients ◽  
Hodgkin Lymphoma ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
The Elderly ◽  
Free Survival ◽  
Non Hodgkin Lymphoma ◽  
Common Sign ◽  
Related Mortality

Introduction: Little information is available on the outcomes of R-CHOP (rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone) and R-CVP (rituximab with cyclophosphamide, vincristine and prednisone) in treatment of the elderly patients with non-Hodgkin lymphoma (NHL), especially in Vietnam. Material and methods: All patients were newly diagnosed with CD20-positive non-Hodgkin lymphoma (NHL) at Blood Transfusion and Hematology Hospital, Ho Chi Minh city (BTH) between 01/2013 and 01/2018 who were age 60 years or older at diagnosis. A retrospective analysis of these patients was perfomed. Results: Twenty-one Vietnamese patients (6 males and 15 females) were identified and the median age was 68.9 (range 60-80). Most of patients have comorbidities and intermediate-risk. The most common sign was lymphadenopathy (over 95%). The proportion of diffuse large B cell lymphoma (DLBCL) was highest (71%). The percentage of patients reaching complete response (CR) after six cycle of chemotherapy was 76.2%. The median follow-up was 26 months, event-free survival (EFS) was 60% and overall survival (OS) was 75%. Adverse effects of rituximab were unremarkable, treatment-related mortality accounted for less than 10%. There was no difference in drug toxicity between two regimens. Conclusions: R-CHOP, R-CVP yielded a good result and acceptable toxicity in treatment of elderly patients with non-Hodgkin lymphoma. In patients with known cardiac history, omission of anthracyclines is reasonable and R-CVP provides a competitive complete response rate.

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.

Letter to the Editor: Craniopharyngiomas in the elderly: the crucial influence of tumor topography on surgical risk assessment

2021 ◽  
Author(s):  
José M. Pascual ◽  
Ruth Prieto
Keyword(s):  
Risk Assessment ◽  
Elderly Patients ◽  
Tumor Tissue ◽  
Significant Proportion ◽  
Wide Band ◽  
The Elderly ◽  
Surgical Risk ◽  
Definition Of ◽  
Weighted Sequences ◽  
Tumor Topography

Classifying CPs within the overly vague, uninformative category “suprasellar” prevents gaining any true insight regarding the risks associated with the surgical procedure employed. Routine MRI obtained with conventional T1- and T2-weighted sequences along the midsagittal and coronal trans-infundibular planes allow an accurate and reliable preoperative definition of CP topography. CPs developing primarily within the infundibulum and/or tuberal region of the hypothalamus, as well as those wholly located within the 3V, should be distinguished preoperatively from those lesions originally expanding beneath the 3V floor (3VF), the true suprasellar tumors. Among adult patients, about 40% of CPs correspond to infundibulo-tuberal tumors expanding primarily within the 3VF, above an intact pituitary gland and stalk. This subgroup of CPs shows strong adherences to the surrounding hypothalamus, as they are embedded within a wide band of reactive gliotic tissue, usually infiltrated by microscopic finger-like solid cords of tumor tissue. In elderly patients, a significant proportion of CPs correspond to papillary tumors developing above an intact 3VF, usually showing small pedicle-like or sessile-like attachments to the infundibulum. With the current diagnostic MRI workup routinely employed for CPs, it is possible, for the majority of lesions, to preoperatively differentiate these topographical variants and predict the type of CP-hypothalamus relationship that will be found during surgery.

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