scholarly journals A Case of Recurrent Palpitations in an Elderly Woman with Breast Cancer: Management of Recalcitrant Svt in the Emergency Department

2021 ◽  
Vol 7 (1) ◽  
pp. 01-04
Author(s):  
Lateef Fatimah
Keyword(s):  
Emergency Department ◽  
Supraventricular Tachycardia ◽  
Age Groups ◽  
The Elderly ◽  
Emergency Setting ◽  
Cancer Management ◽  
Oncological Patients ◽  
Rapid Heart Rate ◽  
Breast Cancer Management ◽  
History Of

Supraventricular tachycardia encompasses a group of cardiac rhythm disturbances characterised by a rapid heart rate, which arise from impulses originating above the bundle of His. This condition affects patients across all age groups and is a common occurrence in the emergency setting. We present the case of a 69-year-old woman with a history of breast carcinoma, hypertension and hyperlipidaemia, who presented to the emergency department with recurrent palpitations which were confirmed on electrocardiogram to be the result of supraventricular tachycardia. The management of recalcitrant supraventricular tachycardia in the emergency setting, including techniques described in recent literature, as well as special considerations for the elderly and oncological patients in the acute setting will be discussed.

Salicylate toxicity from chronic bismuth subsalicylate use

2020 ◽  
Vol 13 (11) ◽  
pp. e236929
Author(s):  
Sheliza Halani ◽  
Peter E Wu
Keyword(s):  
Emergency Department ◽  
Adverse Effects ◽  
Hearing Impairment ◽  
Reference Range ◽  
The Elderly ◽  
Intravenous Fluids ◽  
Over The Counter ◽  
Bismuth Subsalicylate ◽  
Salicylate Concentration ◽  
History Of

A 79-year-old man presented to the emergency department with a 1-week history of worsening confusion, falls and hearing impairment. An initial workup for infectious, metabolic and structural causes was unrevealing. However, further history discovered that he had been ingesting one to two bottles of Pepto-Bismol (bismuth subsalicylate) daily for gastro-oesophageal reflux symptoms. On his second day of admission, the plasma salicylate concentration was 2.08 mmol/L (reference range 1.10–2.20 mmol/L), despite no sources of salicylate in hospital. He was diagnosed with chronic salicylate toxicity and Pepto-Bismol use was discontinued. The patient was treated supportively with isotonic intravenous fluids only and plasma salicylate concentration fell to less than 0.36 mmol/L. Concurrently, all his symptoms resolved. This case highlights the potential adverse effects of over-the-counter medications. The diagnosis of chronic salicylate toxicity is challenging, specifically in the elderly and in undifferentiated presentations, as it can be missed if not suspected.

The Prevalence of Dementia in the Elderly: A Review

1994 ◽  
Vol 39 (5) ◽  
pp. 253-257 ◽  
Author(s):  
Kenneth Rockwood ◽  
Karen Stadnyk
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Age Groups ◽  
The Elderly ◽  
Community Studies ◽  
Prevalence Studies ◽  
Clinical Interviews ◽  
Dementia Prevalence ◽  
History Of ◽  
Definition Of

We reviewed the findings of the Canadian Study of Health and Aging in the context of studies published between January 1986 and June 1993 that documented dementia and Alzheimer's disease prevalence. Studies were identified using a MEDLINE literature search. Additional references were selected from the bibliography of identified articles. Most reports of all types of dementia prevalence are within a narrow range for each of the age groups 65+, 75+ and 85+ years. By contrast, two recent reports on the prevalence of Alzheimer's disease have reported much higher estimates (10.3% and 15.3%) in the elderly (65+ years). A variety of threats to both validity and generalizability of the estimates are present in all studies. In community studies which employed clinical interviews most subjects were only mildly affected; the natural history of impairment of this group requires further study if the consequences of these findings are to be understood. There is important variability in the definition of the functional consequences of cognitive impairment in the elderly which affects both the diagnosis and staging of dementia.

scholarly journals High incidence of asymptomatic SARS-CoV-2 infection, Chongqing, China

2020 ◽  
Author(s):  
Yang Tao ◽  
Panke Cheng ◽  
Wen Chen ◽  
Peng Wan ◽  
Yaokai Chen ◽  
...  
Keyword(s):  
Asymptomatic Patient ◽  
Medical Center ◽  
Age Groups ◽  
The Elderly ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Asymptomatic Patients ◽  
Imported Cases ◽  
History Of ◽  
Epidemiological Characteristics

SummaryBackgroundSARS-CoV-2 has been a global pandemic, but the emergence of asymptomatic patients has caused difficulties in the prevention of the epidemic. Therefore, it is significant to understand the epidemiological characteristics of asymptomatic patients with SARS-CoV-2 infection.MethodsIn this single-center, retrospective and observational study, we collected data from 167 patients with SARS-CoV-2 infection treated in Chongqing Public Health Medical Center (Chongqing, China) from January to March 2020. The epidemiological characteristics and variable of these patients were collected and analyzed.Findings82.04% of the SARS-CoV-2 infected patients had a travel history in Wuhan or a history of contact with returnees from Wuhan, showing typical characteristics of imported cases, and the proportion of severe Covid-19 patients was 13.2%, of which 59% were imported from Wuhan. For the patients who was returnees from Wuhan, 18.1% was asymptomatic patients. In different infection periods, compared with the proportion after 1/31/2020, the proportion of asymptomatic patient among SARS-CoV-2 infected patient was higher(19% VS 1.5%). In different age groups, the proportion of asymptomatic patient was the highest(28.6%) in children group under 14, next in elder group over 70 (27.3%). Compared with mild and common Covid-19 patients, the mean latency of asymptomatic was longer (11.25 days VS 8.86 days), but the hospital length of stay was shorter (14.3 days VS 16.96 days).ConclusionThe SARS-CoV-2 prevention needs to focus on the screening of asymptomatic patients in the community with a history of contact with the imported population, especially for children and the elderly population.

FC13-04 - Suicide risk in relation to age and psychiatric hospitalization

2011 ◽  
Vol 26 (S2) ◽  
pp. 1885-1885
Author(s):  
J. Reutfors ◽  
L. Brandt ◽  
K. Sparring Björkstén ◽  
A. Ekbom ◽  
U. Ösby
Keyword(s):  
Suicide Risk ◽  
Psychiatric Hospitalization ◽  
Conditional Logistic Regression ◽  
Age Groups ◽  
The Elderly ◽  
Population Based ◽  
Age Group ◽  
Post Discharge ◽  
History Of ◽  
Control Study

IntroductionSuicide risk is increased in patients with a history of psychiatric hospitalization.AimTo explore how suicide risk varies by age during psychiatric hospitalization and in the year post-discharge.MethodsThis is a population-based case-control study of all suicides (n = 20,675; 70% male) in Sweden aged ≥18 years during 1991–2003. Each suicide was individually matched to 10 population controls by age, sex, and county of residence. Discharge diagnoses of a mental disorder (except dementia and other organic disorders) in the year prior to suicide were identified by register linkage. Odds ratios (OR) were calculated by conditional logistic regression to estimate the relative risk of suicide in those with psychiatric diagnoses compared to the general population. ORs were estimated by age group (18–34 years, 35–49 years, 50–64 years, and ≥ 65 years) and timing of the suicide in relation to discharge.ResultsDuring hospitalization, the youngest age group had the greatest suicide risk elevation [OR 64 (95% CI 44-92)]. In the first month post-discharge, the oldest age group had the highest suicide risk elevation [OR 162 (95% 66–399) in the first week and OR 127 (95% 67–242) in the second to fourth weeks]. In the remaining eleven months, suicide risk elevation was lower and relatively similar in different age groups.ConclusionsDuring the year following psychiatric hospitalization, an especially high attention should be paid to the suicide risk of the elderly patients in the first month post-discharge.

scholarly journals Audit of the Wheat Pill Cases at Medicolegal Clinic Mayo Hospital Lahore

2021 ◽  
pp. 86-90
Author(s):  
Kanwal Zahra ◽  
Maryam Shahid ◽  
Waqas Aslam ◽  
Usman Shahid Butt ◽  
Nida Zahra
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Mortality Rate ◽  
Age Groups ◽  
Descriptive Study ◽  
Monthly Basis ◽  
History Of ◽  
Medical University ◽  
Time Of Admission

Objective: To determine the audit of wheat pill cases at medicolegal clinic of Mayo Hospital Lahore. Materials and Methods: This descriptive study was conducted at Department of Forensic Medicine and Toxicology (medicolegal clinic), King Edward Medical University Lahore. This audit was of 9 months from September 2020 to May 2021. Patients presented at emergency department with attempt of wheat pills poisoning of all age groups and both genders were included. Cases were diagnosis via history of wheat pills consumption by the relatives. All the cases were given primary recovery and were shifted to the Intensive Care Unit (ICU). Data was collected on monthly basis form September 2020 to May 2021. All the data was collected via study proforma. Results: Total 49 wheat pill cases were observed during 9 months, their mean age was 29.26±12.68 years. Out of all 51.0% were males and 49.0% were females. Labourer males and housewives were most common 34.7% and 40.8% respectively. Frequency of wheat pill cases were high in months of September, October and May. At the time of admission 59.2% cases were seen conscious, 36.7% were semiconscious and 4.1% were unconscious. Out of all 59.2% were died. Conclusion: This study observed that the wheat pills are highly toxic with the quick and high mortality rate. Strict legislations are recommended to the sale control of these pills all over the country.

scholarly journals High incidence of asymptomatic SARS-CoV-2 infection, Chongqing, China

2020 ◽  
Author(s):  
Yang Tao ◽  
Panke Cheng ◽  
Wen Chen ◽  
Peng Wan ◽  
Yaokai Chen ◽  
...  
Keyword(s):  
Asymptomatic Patient ◽  
Medical Center ◽  
Age Groups ◽  
The Elderly ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Asymptomatic Patients ◽  
Imported Cases ◽  
History Of ◽  
Epidemiological Characteristics

Abstract Background SARS-CoV-2 has been a global pandemic, but the emergence of asymptomatic patients has caused difficulties in the prevention of the epidemic. Therefore, it is significant to understand the epidemiological characteristics of asymptomatic patients with SARS-CoV-2 infection. Methods In this single-center, retrospective and observational study, we collected data from 167 patients with SARS-CoV-2 infection treated in Chongqing Public Health Medical Center (Chongqing, China) from January to March 2020. The epidemiological characteristics and variable of these patients were collected and analyzed. Findings 82.04% of the SARS-CoV-2 infected patients had a travel history in Wuhan or a history of contact with returnees from Wuhan, showing typical characteristics of imported cases, and the proportion of severe Covid-19 patients was 13.2%, of which 59% were imported from Wuhan. For the patients who was returnees from Wuhan, 18.1% was asymptomatic patients. In different infection periods, compared with the proportion after 1/31/2020, the proportion of asymptomatic patient among SARS-CoV-2 infected patient was higher(19% VS 1.5%). In different age groups, the proportion of asymptomatic patient was the highest(28.6%) in children group under 14, next in elder group over 70 (27.3%). Compared with mild and common Covid-19 patients, the mean latency of asymptomatic was longer (11.25 days VS 8.86 days), but the hospital length of stay was shorter (14.3 days VS 16.96 days). Conclusion The SARS-CoV-2 prevention needs to focus on the screening of asymptomatic patients in the community with a history of contact with the imported population, especially for children and the elderly population.

scholarly journals Pattern of morbidity among elders attending general practice: health needs assessment of geriatric patients in Oman

2018 ◽  
Vol 4 (4) ◽  
Author(s):  
Shaikh Muhammad Naeem ◽  
Firdous Jahan ◽  
Muhammad Asadullah Siddiqui ◽  
Muhammad Moazzam Khan
Keyword(s):  
Age Groups ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Male Predominance ◽  
Face To Face ◽  
High Prevalence ◽  
History Of ◽  
Walking Difficulty ◽  
Outpatient Settings

The main purpose of this study was to identify specific problems and pattern of morbidities that is common in the elderly. A cross sectional study surveying the health status and needs of targeted population was conducted in selected primary health care (PHC) outpatient settings. All consenting individuals aged 60 years and above who visited the selected PHC clinics were interviewed. Information was collected using face-to-face interviews based on a structured, pre-tested questionnaire. A total of 185 people were evaluated in this study. About 75% of participants were age 60-70 years. Overall, male predominance was noted with 137 (74.1%) males and among all participant’s 80% were married. The mean BMI was 26.47±4.98 kg/m2 and mean waist circumference was 90.16±12.97 cm. The prevalence of smoking, DM, HTN, dyslipidaemia and history of IHD among participants were 7.6%, 37.8%, 49.7%, 27.6% and 8.1%, respectively and males showed a significantly higher prevalence than females in smoking and HTN (p<0.05). Hypertension was common comorbid ailment with 29.2% of stage I and 19.5% of stage II hypertension among 60-70 age groups. The majority of the participants were taking shower; using toilet, feeding and get dressed independently, 88.6%, 87.6%, 87% and 87.6% respectively. These findings provide important information on high prevalence of overweight, hypertension, diabetes, smoking and dyslipidaemia among elders. The other common morbidities were impaired vision, walking difficulty, and hearing problems. The activity of daily living (bathing dressing toileting feeding) is preserved in most of older people.

scholarly journals Estimating age-specific COVID-19 fatality risk and time to death by comparing population diagnosis and death patterns: Australian data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ian C. Marschner
Keyword(s):  
Age Groups ◽  
Case Fatality ◽  
The Elderly ◽  
Specific Model ◽  
Fatality Risk ◽  
Individual Level ◽  
Time To Death ◽  
History Of ◽  
Case Fatality Risk ◽  
Dynamics Models

Abstract Background Mortality is a key component of the natural history of COVID-19 infection. Surveillance data on COVID-19 deaths and case diagnoses are widely available in the public domain, but they are not used to model time to death because they typically do not link diagnosis and death at an individual level. This paper demonstrates that by comparing the unlinked patterns of new diagnoses and deaths over age and time, age-specific mortality and time to death may be estimated using a statistical method called deconvolution. Methods Age-specific data were analysed on 816 deaths among 6235 cases over age 50 years in Victoria, Australia, from the period January through December 2020. Deconvolution was applied assuming logistic dependence of case fatality risk (CFR) on age and a gamma time to death distribution. Non-parametric deconvolution analyses stratified into separate age groups were used to assess the model assumptions. Results It was found that age-specific CFR rose from 2.9% at age 65 years (95% CI:2.2 – 3.5) to 40.0% at age 95 years (CI: 36.6 – 43.6). The estimated mean time between diagnosis and death was 18.1 days (CI: 16.9 – 19.3) and showed no evidence of varying by age (heterogeneity P = 0.97). The estimated 90% percentile of time to death was 33.3 days (CI: 30.4 – 36.3; heterogeneity P = 0.85). The final age-specific model provided a good fit to the observed age-stratified mortality patterns. Conclusions Deconvolution was demonstrated to be a powerful analysis method that could be applied to extensive data sources worldwide. Such analyses can inform transmission dynamics models and CFR assessment in emerging outbreaks. Based on these Australian data it is concluded that death from COVID-19 occurs within three weeks of diagnosis on average but takes five weeks in 10% of fatal cases. Fatality risk is negligible in the young but rises above 40% in the elderly, while time to death does not seem to vary by age.

scholarly journals Special considerations of breast cancer management in the elderly

2020 ◽  
pp. BMT46
Author(s):  
Lauren F Cornell ◽  
Sarah A Mclaughlin ◽  
Sandhya Pruthi ◽  
Dawn M Mussallem
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Elderly Patients ◽  
Management Strategies ◽  
The Elderly ◽  
Evidence Based ◽  
Limited Evidence ◽  
Cancer Management ◽  
Breast Cancer Management ◽  
Evidence Based Guidelines

There are increasing numbers of elderly patients diagnosed with breast cancer. These patients are under-represented in available clinical trials, and as such, there are limited evidence-based guidelines for treatment in this population. Elderly patients have unique needs and management strategies should be tailored accordingly. This article reviews available literature regarding breast cancer management and special considerations in elderly patients.

scholarly journals Screening for Coronavirus Disease 2019 (COVID-19) at the Pediatric Emergency Department During Different Pandemic Phases

2021 ◽  
Vol 9 ◽  
Author(s):  
Indrė Stacevičienė ◽  
Sigita Burokienė ◽  
Aušra Steponavičienė ◽  
Daiva Vaičiūnienė ◽  
Roma Puronaitė ◽  
...  
Keyword(s):  
Emergency Department ◽  
Phase I ◽  
Phase Ii ◽  
Wide Spectrum ◽  
Age Groups ◽  
Pediatric Emergency ◽  
Phase Iii ◽  
Pediatric Emergency Department ◽  
Test Results ◽  
History Of

The wide spectrum of COVID-19 symptoms complicates the selection of target groups for screening. We aimed to compare data of children screened for COVID-19 at the pediatric emergency department in Vilnius between different phases throughout 1 year (Phase I: March–May, 2020; Phase II: June–September, 2020; and Phase III: October, 2020–February, 2021) and to evaluate the possible predictors of the disease. SARS-CoV-2 PCR tests were positive for 2.7% of tested children (248/9,238), significantly higher during the Phase III (5.5%) compared with the Phase I (0.6%, p = 0.000) and Phase II (0.3%, p = 0.000). Infants and teenagers (12–17 years) accounted for a larger proportion of COVID-19 patients (24.6 and 26.2%, respectively) compared to other age groups: 1–2 years (18.9%), 3–6 years (14.9%), and 7–11 years (15.3%). There were more COVID-19 cases among children with a known SARS-CoV-2 exposure compared to those who did not declare any contact (18.2 vs. 1.1%, p = 0000). When symptoms were adjusted for age, gender and known exposure to SARS-CoV-2, we found that fever (OR 2.66; 95% CI 1.89–3.81), pharyngitis (OR 1.35; 95% CI 1.01–1.80), headache (OR 1.81; 95% CI 1.09–2.90), and anosmia/ageusia (OR 6.47; 95% CI 1.61–22.47) were the most significant predictors.Conclusion: Although high numbers of testing were maintained throughout the year, the positive test results were significantly higher during the Phase III. Age (&lt;1 year, 12–17 years), a history of exposure to SARS-CoV-2 and some symptoms, such as fever, pharyngitis, headache and anosmia/ageusia could aid in targeting groups for screening for COVID-19 in children.

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