scholarly journals Geriatric epistaxis: Management of epistaxis in the geriatric patient group

2021 ◽  
Vol 9 (3) ◽  
pp. 98-103
Author(s):  
Kemal Koray Bal

OBJECTIVE: In this study, given the recent increases in the geriatric population and the consequent impacts on healthcare services, we examined the characteristics of geriatric patients admitted to the emergency department due to epistaxis. METHODS: This retrospective study included 55 patients (33 males, 22 females; mean age: 72±6.8 years; range, 65 to 93 years) with epistaxis admitted to the Cukurova University Emergency Medicine Department and University of Health Sciences Adana City Training and Research Hospital Otolaryngology Emergency Polyclinic between 01.05.2019-01.04.2020. The patients were divided into two groups according to age: Group 1 consisted of patients aged 65 to 75 years; Group 2 consisted of patients over 75. Postoperative bleeding and trauma history were excluded in all patients in the study. RESULTS: There were no significant differences between the two groups regarding the rate of hospital discharge (p=1.00). Patients with posterior hemorrhage and posterior nasal tampons required significantly more hospitalizations (p<0.001). CONCLUSION: The presence of comorbidities and drug use may cause persistent and recurrent epistaxis. It is necessary for physicians to be more cautious about the use of off-label antiaggregants and anticoagulants.

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 28-33
Author(s):  
T S Amyan ◽  
S G Perminova ◽  
L V Krechetova ◽  
V V Vtorushina

Study objective. To evaluate the efficacy of intrauterine administration of autologous peripheral blood mononuclear cells (PBMC) prior to embryo transfer in patients with recurrent implantation failures in IVF program. Materials and methods. The study enrolled 129 patients with recurrent implantation failures in an IVF programme. Group 1 - 42 patients who had intrauterine administration of autologous PBMC activated with hCG (Pregnyl 500 IU). Group 2 - 42 patients who had intrauterine administration of autologous PBMC without hCG activation. Group 3 (placebo) - 45 patients who had intrauterine administration of saline. Study results. In the hCG-activated PBMC group, the rates of positive blood hCG tests, implantation, and clinical pregnancy were significantly higher than the respective rates in the non-activated PBMC group and in the placebo group, both in a stimulated cycle and in an FET cycle (р≤0.05). Conclusion. Intrauterine administration of autologous PBMC prior to embryo transfer in an IVF/ICSI programme increases the efficacy of IVF program in patients with a history of recurrent implantation failures.


2002 ◽  
pp. 461-465 ◽  
Author(s):  
A Lasco ◽  
S Cannavo ◽  
A Gaudio ◽  
N Morabito ◽  
G Basile ◽  
...  

OBJECTIVE: To evaluate the effects of a 6 month administration of raloxifene hydrochloride, a selective estrogen receptor modulator which was recently approved for the prevention of osteoporosis, on serum gonadotropin and prolactin (PRL) levels and on TRH-stimulated PRL responsiveness in postmenopausal women who have not undergone estrogen replacement therapy. DESIGN AND METHODS: Sixteen healthy postmenopausal women were divided into two groups on the basis of their bone status, evaluated by dual energy X-ray absorptiometry at the lumbar level. Eight women (chronological age 52.4+/-4.1 (s.d.) years, menopausal age 42.4+/-3.9 years), in whom T-score L2-L4 was less than -2.5 s.d., were treated with raloxifene (60 mg p.o.) administered daily for 6 months (group 1), while the other eight women (chronological age 52.6+/-2.5 years, menopausal age 42.1+/-3.6 years), in whom the T-score L2-L4 ranged between -1 and -2.5 s.d., were used as a control group (group 2). Serum PRL, FSH, LH and 17beta-estradiol (E2) levels were evaluated at baseline and after 3 and 6 months of treatment. In all subjects, PRL responsiveness to TRH (200 microg i.v.) administration was evaluated at baseline and at the end of the study. RESULTS: At baseline, mean PRL, LH and FSH levels were not significantly different in the two groups (PRL 133.6+/-21.7 vs 136.7+/-28.1 mIU/l (NS), LH 25.1+/-6.8 vs 24.4+/-6.7 mIU/ml (NS), FSH 74.4+/-25.0 vs 71.1+/-24.1 mIU/ml (NS), in group 1 and group 2 respectively). No significant variations in serum FSH and LH values, in either group, or in serum PRL levels in group 2, were observed at the 3 and 6 month examinations. On the contrary, serum PRL values decreased significantly in group 1 after 3 months (100.1+/-47.7 mIU/l, P<0.05) and 6 months (81.5+/-30.2 mIU/l, P<0.001). At baseline, no significant differences were observed in the TRH-stimulated serum PRL peak between the groups (1015.4+/-30.5 vs 1030.2+/-25.7 mIU/l in group 1 and in group 2 respectively), while it decreased significantly at the 6 month examination in group 1 (770.5+/-47.4 mIU/l, P<0.001) and it was significantly lower than in group 2 (1068.1+/-301.8 mIU/l, P=0.02). Serum E2 was not detected at baseline and at each examination, in all patients. CONCLUSIONS: The decrease of PRL values induced by long-term raloxifene administration in postmenopausal women could be explained by a direct antiestrogenic effect of raloxifene on lactotrope cells or by the recently suggested increase of opiatergic tone on the hypothalamic-pituitary region.


Author(s):  
Karan B. Shah ◽  
Sapna D. Gupta ◽  
Devang A. Rana ◽  
Supriya D. Malhotra ◽  
Pankaj R. Patel

Background: Electrolytes play an important role in various physiological functions of the body. Electrolyte disturbances are one of the most common problems encountered in critically ill patients. Drugs are also known to cause adverse electrolyte consequences. These drugs could be anti-hypertensive agents, hormones, antipsychotics or steroids. There is paucity of published literature on electrolyte disturbances caused by drugs. The purpose of our study was to evaluate the electrolyte disturbances caused by various drugs in critically ill patients.Methods: Following approval of the Institutional Ethics Committee, data collection was started. Adverse Drug Reactions (ADRs) presenting as an electrolyte disturbance in emergency medicine department or occurring in hospitalized patients in the Intensive care unit (ICU) of our hospital was be collected. ADRs resulting into electrolyte disturbances were identified and analysed in detail for demographic details, types of electrolyte disturbances, seriousness, severity, causality and preventability of ADRs. Fisher's exact test was done to find out the statistical difference between the electrolyte disturbances and different drugs.Results: Total 58 ADRs were reported as an electrolyte disturbance. Mean age of the patients affected was 52.48 years. Highest number of ADRs were observed in the age group of 61 to 70 years. Hypokalemia constituted 32 cases (55.2%) followed by hyponatremia (25.9%), hyperkalemia (6.9%), hypernatremia (6.9%), hypocalcemia (1.7%), hypomagnesemia (1.7%) and hypophosphatemia (1.7%). Insulin was associated with maximum cases of ADRs (27.6%).Conclusions: Electrolyte disturbances constitutes a major chunk of ADRs especially in critically ill patients. The physicians must be well-versed with the dynamics of fluid-electrolyte balance.


2012 ◽  
Vol 19 (02) ◽  
pp. 187-192
Author(s):  
EJAZ HUSSAIN SIDDIQUI ◽  
SAAD SIDDIQUI ◽  
NOREEN SHAH

Objectives: To assess common presenting features and the role of Ultrasound in evaluation of Hepatobiliary diseases in ourpopulation. Design: Cross sectional study. Setting: Khyber X rays, Khyber Medical Centre, Peshawar. Period: August 2010 to December2010. Material and Methods: Data from patients presenting for evaluation of Hepatobiliary diseases was analyzed for presenting complaintsand ultrasound findings according to objectives of the study. Results: In total 197 cases were included in the study. The age wise categorizationincluded pediatric population (6.1%) adult population (87.3%) and geriatric population (6.6%). Upper abdominal pain was the most commonpresenting feature in all age groups as well as in both genders. Cholelithiasis with or without cholecystitis was the most common ultrasoundfinding in all age groups. No statistically significant difference was found between presenting features or ultrasound findings in different agegroups as well as across gender. Conclusions: Hepatobiliary diseases are among major illnesses in our region. Ultrasound is a sensitive anduseful tool for screening and evaluation of Hepatobiliary disorders.


Doctor Ru ◽  
2021 ◽  
Vol 20 (9) ◽  
pp. 17-20
Author(s):  
E.M. Illarionova ◽  
◽  
N.P. Gribova ◽  
◽  

Study Objective: To study the balance in patients with vestibular bilious headache (BH) and possible use of a special comprehensive stabilometrical program for dizziness objectification in them. Study Design: open comparative study. Materials and Methods. The study included 188 patients. Group 1 were 94 patients with confirmed BH (according to the International Headache Classification). Group 2 were 94 patients with common migraine. The stabilometrical control group included 94 healthy subjects. The balance and dizziness objectification were assessed using a special comprehensive method comprising a set of stabilometrical tests. Study Results. The most marked changes in stabilometrical parameters were recorded in patients with BH. Primary frequency spectra of these patients were in a range of 0.3 Hz and above 2 Hz, showing the dysfunction of the postural system and vestibular component in particular. The rate of pressure centre deviation and statokinesigram area were increased in the patients from group 2 vs controls; however, statistically significant differences were noted only in opticokinetic test, sensory and vestibular, and closed-eye tandem results. Comparison of the two clinical groups demonstrates significant differences in basic stabilometrical parameters of all challenge tests. Visual control exclusion as well as substandard visual stimulation had significant impact on changes in the analysed parameters. Conclusion. The use of special stabilometrical tests (opticokinetic stimulation, sensory and vestibular and tandem tests) described in this article allows assessing the balance, quantifying vestibular dysfunction in patients with BH, and objectifying dizziness. Keywords: dizziness, balance, vestibular migraine, computer-aided stabilometry.


Author(s):  
Aman Mallick ◽  
Gaurav Malhotra ◽  
Pradeep Shukla ◽  
Prerna Kataria ◽  
C. S Joshi

Introduction: Dentine hypersensitivity (DH) occurs on exposed dentine and is dependent on the patency of dentinal tubules. This study compared the effectiveness of toothpaste containing Strontium Chloride, Novamine, Pro-Arginine in occluding dentine tubules along with comparision of those. Materials and Method: 45 freshly extracted teeth were randomly divided (15 each) into 3 groups: Group 1 15 Teeth treated with toothpaste containing Strontium Chloride. Group 2 15 Teeth treated with toothpaste containing Novamine Group 3 15 Teeth treated with toothpaste containing Pro-Arginine. Each specimen was brushed with the dentifrice slurries and examined under SCM. Result: The mean of occluded dentinal tubules on the dentin surface after brushing with three dentifrices were significant among them Pro-arginine group showed maximum occlusion. Conclusion: The present in vitro SEM study results revealed that:  All the experimental agents– Strontium chloride, novamin, Pro- Argenine were effective in occluding dentinal tubules & the percentage (%) of occluded tubules was found to be highest for Pro- Argenine as compared to the other groups. Keywords: SCM, DH


Perfusion ◽  
2006 ◽  
Vol 21 (6) ◽  
pp. 329-342 ◽  
Author(s):  
Serdar Gunaydin ◽  
Kevin McCusker ◽  
Venkataramana Vijay ◽  
Selim Isbir ◽  
Tamer Sari ◽  
...  

Objectives: The relative benefits of strategic leukofiltration on polymer-coated and low-dose heparin protocol on heparin-coated circuits were studied across EuroSCORE patient risk strata for three different cohorts. Methods: In a prospective, randomized study, 270 patients undergoing coronary artery bypass grafting were allocated into three groups (n = 90): Group 1 -polymethoxyethylacrylate-coated circuits+leukocyte filters; Group 2 -polypeptide-based heparin-bonded circuits with reduced heparinization; and Group 3 -Control: uncoated circuits. Each group was further divided into three subgroups (n = 30), with respect to low- (EuroSCORE 0-2), medium- (3-5), and high- (6+) risk patients. Blood samples were collected at T1: following induction of anesthesia; T2: following heparin administration; T3: 15 min after CPB; T4: before cessation of CPB; T5: 15 min after protamine reversal; and T6: ICU. Results: In high-risk cohorts, leukocyte counts demonstrated significant differences at T4 and T5 in Group 1, and at T4 in Group 2. Platelet counts were preserved significantly better at T4 and T5 in both groups (p <0.05 versus control). Serum IL-2 and C3a levels were significantly lower at T3, T4 and T5 in Group 1, and T4 and T5 in Group 2 (p <0.05). Postoperative bleeding, respiratory support time and incidence of atrial fibrillation were lower in the study groups versus control. Cell counts on filter mesh and heparin-coated fibers/circuits were significantly higher in the high-risk cohorts versus uncoated fibers. Phagocytic capacity increased on filter mesh, especially in high-risk specimens. SEM evaluation demonstrated better preserved coated circuits. Conclusion: Leukofiltration and coating reduced platelet adhesion, protein adsorption, atrial fibrillation and reduced heparinization acted via modulation of systemic inflammatory response in high-risk groups.


2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii43-ii43
Author(s):  
Yoko Nakasu ◽  
Koichi Mitsuya ◽  
Satoshi Nakasu ◽  
Kazuhiko Nozaki

Abstract BACKGROUND Little is known about indications and outcome prediction of systemic therapy for elderly patients with brain tumours. Clinical conditions of individuals are heterogenous from healthy to frail or diseased,moreover,are often reversible. METHOD We retrieved the literature of brain tumour,systemic therapy,chemotherapy,immunotherapy,in randomized controlled trials (RCTs) and reviews on PubMed database from 2008 to 2018. RESULTS 1) Definition of elderly by age in years: Depending on each protocol,the definition is arbitrary. Patients older than 60 or 70 years are usually in the elderly group. 2) Systemic evaluation: Performance status (PS) and visceral function are not sufficient to assess elderly patients. Assessment tools specifically developed for the geriatric population are recommended to evaluate individual patients. 3) Effects and toxicity of systemic therapy: Only a few RCT showed no inferiority of outcome in patients older than 60 or 65 years. There are only few evidences about the senile fragility of blood-brain barrier or distribution of drugs in the elderly brain. Molecular subtyping of brain tumours might predict the effects and toxicities of therapies for elderly patients. CONCLUSION Feasibility of modern systemic therapies are not well studied for elderly patients with brain tumours. Clinical condition varies in individual elderly patients. We need prospective studies of systemic therapy in elderly patients based on an eligibility with not only chronologic age but comprehensive geriatric assessments.


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