scholarly journals COVID-19: A Geriatric Emergency

Geriatrics ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 24 ◽  
Author(s):  
Virginia Boccardi ◽  
Carmelinda Ruggiero ◽  
Patrizia Mecocci
Keyword(s):  
Intensive Care ◽  
Early Diagnosis ◽  
Older Patients ◽  
Early Recognition ◽  
Health Conditions ◽  
Italian Population ◽  
Management Skills ◽  
Atypical Symptoms ◽  
Clinical Complexity ◽  
Compensatory Effort

The older Italian population is posing a challenge in the number of deaths for coronavirus disease 2019 (COVID-19). According to previous data from China, pre-existing health conditions dramatically increase the risk of dying from COVID-19. The presence of multiple diseases in older patients may be considered as a mark of frailty, which increases the person’s vulnerability to stress and impairs the multisystemic compensatory effort to restore homeostasis. The clinical complexity associated with the management of frailty may increase the risk of complications during infection as well as the lack of the early recognition of atypical symptoms. There is an urgent need to share expertise and clinical management skills with geriatricians as well as the need for early diagnosis to start treatment at the earliest convenience in the community, with the aim to avoid the collapse of intensive care units.

scholarly journals Tick-Borne-Associated Illnesses in the Pediatric Intensive Care Unit

2020 ◽  
Vol 15 (06) ◽  
pp. 269-275
Author(s):  
Kaila Lessner ◽  
Conrad Krawiec
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Early Recognition ◽  
Spotted Fever ◽  
Pediatric Intensive Care ◽  
Rocky Mountain ◽  
Rocky Mountain Spotted Fever ◽  
Life Threatening ◽  
Human Ehrlichiosis

AbstractWhen unrecognized and antibiotic delay occurs, Lyme disease, Rocky Mountain–spotted fever, babesiosis, and human ehrlichiosis and anaplasmosis can result in multiorgan system dysfunction and potentially death. This review focuses on the early recognition, evaluation, and stabilization of the rare life-threatening sequelae seen in tick-borne illnesses that require admission in the pediatric intensive care unit.

scholarly journals Aspartate aminotransferase to alanine aminotransferase ratio is associated with frailty and mortality in older patients with heart failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daichi Maeda ◽  
Nobuyuki Kagiyama ◽  
Kentaro Jujo ◽  
Kazuya Saito ◽  
Kentaro Kamiya ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Patients ◽  
Early Recognition ◽  
Walk Distance ◽  
Failure Data ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
One Year ◽  
Independent Marker

AbstractFrailty is a common comorbidity associated with adverse events in patients with heart failure, and early recognition is key to improving its management. We hypothesized that the AST to ALT ratio (AAR) could be a marker of frailty in patients with heart failure. Data from the FRAGILE-HF study were analyzed. A total of 1327 patients aged ≥ 65 years hospitalized with heart failure were categorized into three groups based on their AAR at discharge: low AAR (AAR < 1.16, n = 434); middle AAR (1.16 ≤ AAR < 1.70, n = 487); high AAR (AAR ≥ 1.70, n = 406). The primary endpoint was one-year mortality. The association between AAR and physical function was also assessed. High AAR was associated with lower short physical performance battery and shorter 6-min walk distance, and these associations were independent of age and sex. Logistic regression analysis revealed that high AAR was an independent marker of physical frailty after adjustment for age, sex and body mass index. During follow-up, all-cause death occurred in 161 patients. After adjusting for confounding factors, high AAR was associated with all-cause death (low AAR vs. high AAR, hazard ratio: 1.57, 95% confidence interval, 1.02–2.42; P = 0.040). In conclusion, AAR is a marker of frailty and prognostic for all-cause mortality in older patients with heart failure.

Laryngeal cancer

2021 ◽  
pp. 175573802110105
Author(s):  
Kelvin Miu
Keyword(s):  
Head And Neck Cancer ◽  
Early Diagnosis ◽  
Head And Neck ◽  
Patient Outcomes ◽  
Laryngeal Cancer ◽  
Neck Cancer ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Diagnosis And Treatment

Laryngeal cancer is a common head and neck cancer and typically presents with voice hoarseness in patients older than 60 years. Early recognition of signs and symptoms of laryngeal cancer can lead to early diagnosis and treatment, therefore improving patient outcomes. This article aims to provide an overview of the anatomy of the larynx, presentation and management of laryngeal cancer, and common follow-up problems.

scholarly journals Teaching Self-Management Skills in Persons with Chronic Lower Limb Swelling and Limited Mobility: Evidence for Usability of Telerehabilitation

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Becky L. Faett ◽  
David M. Brienza ◽  
Mary Jo Geyer ◽  
Leslie A Hoffman
Keyword(s):  
Integrated System ◽  
Lower Limbs ◽  
Health Conditions ◽  
Self Management ◽  
Management Skills ◽  
Limited Mobility ◽  
Home Based ◽  
Perceived Usability ◽  
Predominately Female ◽  
Viable Method

The purpose of this study was to evaluate the usability of telerehabilitation as a method of teaching self-management for chronic swelling of the lower limbs in persons with limited mobility. An in-home telerehabilitation self-management education protocol for chronic swelling of the lower limbs, termed Telerehabilitation to Empower You to Manage and Prevent Swelling (TR-PUMPS), was implemented using the Versatile and Integrated System for Telerehabilitation (VISYTER) software platform. Participants (n=11) were 36-79 years old, predominately female (72.7%) and diagnosed with a variety of health conditions. Participants’ perceived usability scores of the remote delivery of TR-PUMPS was high with a median score of 6.67 (range 4.90 - 7.00) on a Likert scale: 1= disagree to 7= agree. There was no correlation between participants’ familiarity with information technology and their perception of telerehabilitation usability. These results support telerehabilitation as a viable method for teaching a home-based, self-management

Unusual Nasogastric Tube Position Leading to Delay in Diagnosis of Tracheoesophageal Fistula

2021 ◽  
pp. 097321792110367
Author(s):  
Monika Kaushal ◽  
Saima Asghar ◽  
Ayush Kaushal
Keyword(s):  
Early Diagnosis ◽  
Nasogastric Tube ◽  
Common Type ◽  
X Ray ◽  
Delay In Diagnosis ◽  
Atypical Symptoms ◽  
Tube Position ◽  
Esophageal Pouch ◽  
High Index Of Suspicion ◽  
Surgical Unit

Aim: This case highlights the importance of high index of suspicion for early diagnosis and thorough clinical examination of a newborn with tracheoesophageal atresia and fistula. Case Report: We report a case of most common type of tracheoesophageal atresia with fistula where diagnosis was missed due to unusual gastric position of nasogastric tube. Nasogastric tube reached stomach in esophageal atresia with fistula, delaying the diagnosis and management of condition. After accidental removal of tube and failure to pass again raised suspicion and was confirmed with coiled tube in esophageal pouch in X-Ray chest. Baby shifted to surgical unit for treatment, fortunately baby recovered and discharged home after surgical correction. Conclusion: Tracheoesophageal atresia with fistula can present with atypical symptoms and unusual events, challenging the early diagnosis and treatment of common types of conditions. Other association like VACTERL should be looked for, in patients.

Risk factors for poor outcome in older patients admitted in a surgical intensive care unit

2021 ◽  
Author(s):  
Emilie Occhiali ◽  
Pierre Prolange ◽  
Florence Cassiau ◽  
Frédéric Roca ◽  
Benoit Veber ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Older Patients ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Poor Outcome

scholarly journals Case Report: Frontalis sign for early bedside consideration of impending uncal herniation

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 125
Author(s):  
Sunil Munakomi ◽  
Bijoy Mohan Kumar
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Early Recognition ◽  
Mass Effect ◽  
Tertiary Centre ◽  
Valuable Adjunct ◽  
Neurosurgical Patients ◽  
Pupillary Size ◽  
Timely Referral ◽  
Simple Bedside

It is prudent to have early diagnosis and timely management of uncal herniation for better management of neurosurgical patients. There are several clinical and radiological armamentariums that aid in early recognition of the condition. Through this case report, we try to highlight a simple bedside clinical sign that can be a valuable adjunct in early recognition of the impending uncal herniation especially in scenarios wherein it is difficult to assess the pupillary size and reactivity correctly. The improvement in the sign also confirms the resolution of the mass effect in the postoperative period. This is especially helpful for doctors working in the periphery or in resource restrained areas, for a timely referral of the patient to tertiary centre.

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