A Case of Early Hereditary Transthyretin Amyloid Cardiomyopathy Recognition With Genetic Screening: A Case Report

Background: Transthyretin amyloid cardiomyopathy (ATTR-CM) is one of the most common types of cardiac amyloidosis. Amyloid cardiomyopathy more commonly affects men, elderly, and 3% to 4% of the African-American population. ATTR-CM suspicion and diagnosis is challenging; however, awareness of the disease is increasing, and best practices to identify it are being proposed. The approach to suspected cases of ATTR-CM relies on the presence of heart failure, red flag signs and symptoms, and age >65 or >70 for men and women respectively. Little is known about cases when it presents in early ages. Case: We report a 62-year-old African American male with past medical history of hyperlipidemia, prostate cancer, hypertension, bilateral carpal tunnel surgery that had debuted with a cardiac arrhythmia at age 55 and was diagnosed with heart failure several years later. Restrictive cardiomyopathy was suspected, and genetic screening was sent for ATTRm which confirmed a pathogenic trasnthyretin gene mutation. Endomyocardial biopsy was performed which confirmed cardiac amyloid deposition. Discussion: ATTR-CM is a rare disease with an increasing prevalence. Cases with out of proportion signs and symptoms of heart failure with preserved ejection fractions should raise the suspicion of ATTR-CM despite age.

Polypill eligibility and equivalent intake in a Swiss population-based study

The polypill has been advocated for cardiovascular disease (CVD) management. The fraction of the population who could benefit from the polypill in Switzerland is unknown. Assess (1) the prevalence of subjects (a) eligible for the polypill and (b) already taking a polypill equivalent; and (2) the determinants of polypill intake in the first (2009–2012) and second follow-ups (2014–2017) of a population-based prospective study conducted in Lausanne, Switzerland. The first and the second follow-ups included 5038 and 4596 participants aged 40–80 years, respectively. Polypill eligibility was defined as having a high CVD risk as assessed by an absolute CVD risk ≥ 5% with the SCORE equation for Switzerland and/or presenting with CVD. Four polypill equivalents were defined: statin + any antihypertensive with (A) or without (B) aspirin; statin + calcium channel blocker (CCB) (C); and statin + CCB + angiotensin-converting enzyme inhibitor (D). The prevalence of polypill eligibility was 20.6% (95% CI 19.5–21.8) and 27.7% (26.5–29.1) in the first and second follow-up, respectively. However, only around one-third of the eligible 29.5% (95% CI 26.7–32.3) and 30.4% (27.9–33.0) respectively, already took the polypill equivalents. All polypill equivalents were more prevalent among men, elderly and in presence of CVD. After multivariable adjustment, in both periods, male gender was associated with taking polypill equivalent A (OR: 1.93; 95% CI 1.45–2.55 and OR: 1.67; 95% CI 1.27–2.19, respectively) and polypill equivalent B (OR: 1.52; 95% CI 1.17–1.96 and OR: 1.41; 95% CI 1.07–1.85, respectively). Similarly, in both periods, age over 70 years, compared to middle-age, was associated with taking polypill equivalent A (OR: 11.71; CI 6.74–20.33 and OR: 9.56; CI 4.13–22.13, respectively) and equivalent B (OR: 13.22; CI 7.27–24.07 and OR: 20.63; CI 6.51–56.36, respectively). Former or current smoking was also associated with a higher likelihood of taking polypill equivalent A in both periods. A large fraction of the population is eligible for the polypill, but only one-third of them actually benefits from an equivalent, and this proportion did not change over time.

Profile of SGOT And SGPT Level Check in Pulmonary Tuberculosis Patients

Liver disfunction is characterized by increased levels of SGOT and SGPT. The mechanism of liver disfunction by anti-tuberculosis drug (ATD) is not yet clearly known, but several research mention the occurrence of hepatotoxicity which caused by direct effect or through the complex production of drug enzyme which have consequences in cell disfunction as well as membrane disfunction. Hepatotoxicity due to ATD does not occur in each patient, but it could cause liver injury. research objective to find out the description of examination of SGOT and SGPT levels in patients of pulmonary tuberculosis. The research type was descriptive using medical records data and laboratory data of RSUP patients of pulmonary TB in January-March 2020. Research results : the normal SGOT levels in men 6-33 U/L as much as 63,33%, and SGOT normal 50-66 U/L as much as 2,35%. The normal SGOT levels in women 10-25 U/L as much as 25,88%, and SGOT normal in women 15-63 U/L as much as 8,24%. The normal SGPT levels in men 3-43 U/L as much as 62,35%, and SGPT normal 55-65 U/L as much as 3,53%. The normal SGPT levels in women 7-29 U/L as much as 34,12%. Hepatotoxicity based on SGOT levels as many as 9 people (10,59%), namely 2 men (elderly and old man) and 7 women (adolescent, adult, and elderly). Hepatotoxicity based on SGPT levels as many as 3 people (3,53%) in elderly and old man.

Anticancer drugs and cardiovascular-related hospitalization in metastatic colorectal cancer: Insights from the AVOCETTE population-based study

We aimed to investigate the association between anticancer drugs and cardiovascular-related hospitalization (CVRH) in metastatic colorectal cancer (mCRC) patients. A cohort study was conducted using the French county Calvados registry of digestive tumors. Incident mCRC cases between 2008 and 2014 were included. The follow-up end date was December 2016. Data from the county hospital center pharmacy and medical information departments were matched with the registry data. A competing risk approach was used. Statistical tests were two-sided. A total of 1,116 mCRC patients were included; they were administered 12,374 rounds of treatment; fluorouracil, oxaliplatin, irinotecan and bevacizumab were most common. A total of 208 CVRH events occurred in 145 patients (13.0%). The International Cancer Survival Standards type 1 standardized incidence was 84.0 CVRH per 1,000 person-years (95% confidence interval: 72.6-95.5). Anticancer drugs were not associated with a higher incidence of CVRH. Men, elderly patients, patients with a prior history of CVRH and patients with a higher Charlson comorbidity index were associated with a higher incidence of CVRH. CVRH was significantly associated with a higher all-cause mortality (multivariable hazard ratio for death 1.58, 95%CI 1.28-1.95). Anticancer drugs were not associated with a higher incidence of CVRH in mCRC patients.

Hypertriglyceridemic Waist and Associated Factors: A Cross-Sectional Study of Bank Employees

Objectives This paper investigates the prevalence of hypertriglyceridemic waist in bank workers and its association with socioeconomic, labor, behavioral, anthropometric and health condition factors. Methods This is a cross-sectional study based on information from 525 bank workers. Hypertriglyceridemic waist was defined by the simultaneous presence of abdominal obesity, verified by the waist circumference, and elevated serum triglycerides. Associations were verified with sociodemographic, labor, behavioral, anthropometric and health condition variables. Results The investigation resulted in a phenotype prevalence of 19.4%, being higher in men, elderly, married and working in the bank for more than 5 years. The phenotype was also associated with overweight, low HDL-c (high-density lipoprotein), mixed hyperlipidemia, high triglyceride/HDL-c ratio and arterial hypertension. Being over 50 years of age and being overweight increased the chances of the bankers presenting the phenotype. Being female and having adequate levels of HDL-c were shown to be protective factors against the phenotype. Conclusions It was concluded that the prevalence of hypertriglyceridemic waist is high and is associated mainly with the excess weight and unfavorable lipid profile of this population. Funding Sources This research received no external funding.

Profile of SGOT and SGPT levels in Patients with Pulmonary Tuberculosis

Liver disfunction is characterized by increased levels of SGOT and SGPT. The mechanism of liver disfunction by anti-tuberculosis drug (ATD) is not yet clearly known, but several research mention the occurrence of hepatotoxicity which caused by direct effect or through the complex production of drug enzyme which have consequences in cell disfunction as well as membrane disfunction. Hepatotoxicity due to ATD does not occur in each patient, but it could cause liver injury. research objective to find out the description of examination of SGOT and SGPT levels in patients of pulmonary tuberculosis. The research type was descriptive using medical records data and laboratory data of RSUP patients of pulmonary TB in January-March 2020. Research results : the normal SGOT levels in men 6-33 U/L as much as 63,33%, and SGOT normal 50-66 U/L as much as 2,35%. The normal SGOT levels in women 10-25 U/L as much as 25,88%, and SGOT normal in women 15-63 U/L as much as 8,24%. The normal SGPT levels in men 3-43 U/L as much as 62,35%, and SGPT normal 55-65 U/L as much as 3,53%. The normal SGPT levels in women 7-29 U/L as much as 34,12%. Hepatotoxicity based on SGOT levels as many as 9 people (10,59%), namely 2 men (elderly and old man) and 7 women (adolescent, adult, and elderly). Hepatotoxicity based on SGPT levels as many as 3 people (3,53%) in elderly and old man.

Boys’ Club or Good Ol’ Boys Club? Corruption and the Parliamentary Representation of Young and Old Men and Women

Research on political representation has shown that corruption is not gender-neutral: it benefits the recruitment of men to political office more than it does women. Yet, it is unclear if all men or a specific type of men, elderly men, benefits the most from corrupt networks in terms of political presence. The ‘old boys’ network thesis’ would single out older men as the most likely beneficiaries of the homosocial capital gained through informal ties in corrupt settings. In this article, we test this thesis based on a dataset comprising 98 national parliaments. Through bivariate and multivariate analyses, we find that corruption tends to benefit the presence of men regardless of their age. We further conjecture that the inclusion of young male patrons into nepotistic and clientelistic networks could further explain why these networks of ‘gendered’ corruption have been so sticky over time.

PERFIL EPIDEMIOLÓGICO E ATUAÇÃO FISIOTERÁPICA EM PACIENTES HOSPITALIZADOS– ANÁLISE RESTROSPECTIVA

The prevalence of chronic degenerative diseases and life expectancy has increased, which is associated with the higher number of hospitalizations among the elderly. In this sense, physical therapy is an alternative treatment in this population and has several rehabilitation alternatives in order to favor the patient's functionality. The objective of this study was to characterize the profile of hospitalized patients and to point out the physiotherapeutic techniques used. This study is retrospective, with an analysis of records with physical therapy prescription of a public hospital in the period from 2015 to 2017. It was observed that the majority of the patients are men, elderly, with hypertension or more than one risk factor, smokers/ex-smokers, alcoholics, with normal BMI, mean hospital stay of 8 to 19 days and diagnosis in specialty oncology. The most used techniques are exercises breathing, diaphragmatic reeducation, active mobilization and walking. The most frequently used techniques depend on the active participation of the patient, which allows us to conclude the importance of the physiotherapist in hospital units, given their incentive profile to promote activities that can reestablish the patients' functionality

VÍTIMAS DE TRAUMA POR QUEDAS ATENDIDAS EM UNIDADE DE PRONTO SOCORRO ADULTO: ESTUDO TRANSVERSAL

Objetivo: Caracterizar o perfil sociodemográfico, dos atendimentos e condições de alta das vítimas de queda atendidas no Pronto- Socorro Adulto de um hospital público de ensino. Método: Estudo transversal, retrospectivo através de análise documental no período de 2014-2015. Resultados: Prevaleceram os homens (63,1%), idade acima de 60 anos (39,5%), cor branca (65,6%) e baixa escolaridade (29,1%). A região corporal mais lesionada foi os membros superiores (37,9%). As admissões prevaleceram nos meses de maio e julho, ambos com (12,1%), o dia de quinta - feira (17,2%) e o período vespertino (37,6%). A maioria dos pacientes apresentou grau leve de incapacidade funcional (29,4%) na alta hospitalar. Conclusão: O perfil das vítimas foi de homens, idosos, brancos, baixa escolaridade e incapacidade funcional leve. Este estudo pode contribuir para a organização de serviços de saúde e de enfermagem e na elaboração de políticas públicas voltadas para prevenção e controle desses agravos na população idosa. Descritores: Acidentes por quedas; Enfermagem em emergência; Serviço hospitalar de emergência; Causas externas; Idoso.VICTIMS OF TRAUMA BY FALLS ATTENDED IN ADULT EMERGENCY ROOM : CROSS -SECTIONAL STUDYObjective: To characterize the sociodemographic profile, the attendance and discharge conditions of the victims of falls attended in the Adult Emergency Room of a public teaching hospital. Method: Cross-sectional, retrospective study through documentary analysis in the period 2014-2015. Results: Men (63.1%), age over 60 (39.5%), white (65.6%) and low schooling (29.1%) prevailed. The most injured body region was the upper limbs (37.9%). Admissions prevailed in May and July, both with (12.1%), Thursday (17.2%) and afternoon (37.6%). The majority of patients had a mild degree of functional disability (29.4%) at hospital discharge. Conclusion: The profile of the victims was of men, elderly, white, low schooling and mild functional disability. This study may contribute to the organization of health and nursing services and the elaboration of public policies aimed at prevention and control of these diseases in the elderly population.Descriptors: Fall accidents; Emergency nursing; Emergency hospital service; External causes; Aged.VÍCTIMAS DE TRAUMA POR CAÍDAS ATENDIDAS EN UNIDAD DE PRONTO SOCORRO ADULTO: ESTUDIO TRANSVERSALObjetivo: Caracterizar el perfil sociodemográfico, de las atenciones y condiciones de alta de las víctimas de caída atendidas en el Pronto-Socorro Adulto de un hospital público de enseñanza. Método: Estudio transversal, retrospectivo a través de análisis documental en el período de 2014-2015. Resultados: Prevalecían los hombres (63,1%), edad superior a 60 años (39,5%), color blanco (65,6%) y baja escolaridad (29,1%). La región corporal más lesionada fue los miembros superiores (37,9%). Las admisiones prevalecieron en los meses de mayo y julio, ambos con (12,1%), el día de jueves (17,2%) y el período vespertino (37,6%). La mayoría de los pacientes presentó un grado leve de incapacidad funcional (29,4%) en el alta hospitalaria. Conclusión: El perfil de las víctimas fue de hombres, ancianos, blancos, baja escolaridad e incapacidad funcional leve. Este estudio puede contribuir a la organización de servicios de salud y de enfermería y en la elaboración de políticas públicas dirigidas a la prevención y control de esos agravios en la población anciana.Descriptores: Accidentes por caída; Enfermería en emergencia; Servicio hospitalario de emergencia; Causas externas; Anciano.

Nutrients intake in elderly residing in Lebanese nursing homes

Purpose The purpose of this study was to assess nutrient intakes in elderly living in Lebanese nursing homes (NHs). Design/methodology/approach This cross-sectional study was conducted in 36 long-term care institutions from all over Lebanon. Out of 2,094 residents, 98 (69 women and 29 men) elderly met the inclusion criteria and successfully completed the interview question. Dietary food intake was assessed using the 24-h food recall. The analysis used a Chi-square test and independent samples t-test or Mann–Whitney test, as appropriate. Findings A high percentage of elderly (reaching 100 per cent) had a low intake of energy, protein, linolenic acid, linoleic acid, fibers, vitamins and minerals, and the prevalence of nutrient inadequacy was significantly different between sexes for copper intake (p = 0.02). The results of this study highlight the nutrient inadequacies among the majority of elderly living in long-term care institutions and particularly in women and elderly residing in NHs located away from the capital Beirut. Originality/value This study is quite original; this is the first study performed nationwide in Lebanon covering not only the largest number of NHs in various locations but also elderly under custodial settings and with diverse backgrounds.