Comparisons of symptoms reported by elderly and non-elderly patients with GERD

Background  

The characteristics of symptoms reported by elderly patients with gastroesophageal reflux disease (GERD) have not been fully investigated. We performed this study to clarify these characteristics in elderly patients with GERD.     

Gemcitabine as first-line chemotherapy in elderly patients with unresectable pancreatic carcinoma

Background  

Gemcitabine (GEM) is the key drug for the chemotherapy of unresectable pancreatic cancer. However, the efficacy and safety of GEM has not been established in elderly patients. We retrospectively examined the prognosis of elderly pancreatic cancer patients treated with GEM.     

Is cholecystectomy necessary after endoscopic treatment of bile duct stones in patients older than 80 years of age?

Background and aims  

Although patients with cholecystocholedocholithiasis are generally referred to cholecystectomy after endoscopic sphincterotomy (ES) and common bile duct clearance, we often have a conflict whether cholecystectomy is necessary in very elderly patients with comorbid diseases. The aim of this study is to assess whether cholecystectomy in very elderly patients is justified after ES.     

EUS and ERCP Complication Rates Are Not Increased in Elderly Patients

Background  

Further studies evaluating the safety of advanced endoscopic procedures in elderly patients are needed.     

Postoperative recurrence factors of GERD in the elderly after laparoscopic fundoplication

Background  

Assessment of the outcomes of laparoscopic fundoplication in elderly patients with gastroesophageal reflux disease (GERD) is insufficient.     

A Retrospective Study of the Safety and Efficacy of ERCP in Octogenarians

Background  

Pancreatobiliary disease is increased in elderly patients. Because of significant comorbidities, these patients may be at greater risk of developing complications related to endoscopic retrograde cholangiopantreatography (ERCP).     

Combined sedation with midazolam/propofol for gastrointestinal endoscopy in elderly patients

Background  

Although gastrointestinal endoscopy with sedation is increasingly performed in elderly patients, data on combined sedation with midazolam/propofol are very limited for this age group.     

Second-line chemotherapy with paclitaxel and doxifluridine after failure of S-1 in elderly patients with unresectable advanced or recurrent gastric cancer

Purpose  

There is no standard second-line treatment for patients with unresectable advanced or recurrent gastric cancer (URGC) in the event that first-line treatment fails. Moreover, the benefits of second-line chemotherapy in elderly patients remain uncertain. The aim of this study was to identify the benefits of the second-line paclitaxel (PTX) plus doxifluridine (5′-DFUR) regimen for URGC in elderly patients in comparison to nonelderly patients.     

Provider Recommendations for Colorectal Cancer Screening in Elderly Veterans

BACKGROUND  

Decisions regarding colorectal cancer (CRC) screening in the elderly depend on providers’ assessment of likelihood of benefit partly based on patient comorbidity and past screening history. We aimed to describe providers’ experiences and practice patterns regarding screening for CRC in elderly patients in the VA system.     

Cardiac resynchronization therapy is effective even in elderly patients with comorbidities

Purpose  

The purpose of this study was to compare the effects of cardiac resynchronization therapy (CRT) in elderly patients (≥65 years) with younger patients and to assess the impact of comorbidities in CRT remodeling response.     

Increasing incidence of primary central nervous system lymphoma but no improvement in survival in Sweden 2000‐2013

Objectives

This study aims to characterize the epidemiology of immunocompetent Primary central nervous system lymphoma (PCNSL) diagnosed 2000‐2013 in Sweden.

Methods

Cases were identified in the population‐based Swedish Lymphoma Register. Incidence per 100 000 person‐years and 95% confidence intervals (CI) were calculated, and PCNSL‐specific survival was estimated using relative survival. Tests for temporal trends were performed using Poisson regression. Population incidence of all brain tumors was retrieved for comparison.

Results

With 359 identified PCNSL cases (median age 66 years), overall incidence was 0.26 (95% CI: 0.24‐0.29) and the average annual increase 4% (P = .002). The increasing trend was primarily observed among elderly individuals (70+ years). Similarly, an increase in incidence of all brain tumors was noted only among the elderly. There was no significant improvement in relative survival across the study period although, among fit patients (with Eastern Cooperative Oncology Group, EGOC 0), survival plateaued 6 years after diagnosis.

Conclusion

The increasing PCNSL incidence in the elderly was consistent with an increasing incidence of brain tumors of any type and may in part be attributable to improved diagnostics and reporting in this group. New treatment options have not yet translated into general survival improvements in a population‐based setting, although the presence of long‐term survivors among fit patients is encouraging.     

Gender- and Age-Related Differences in Muscular and Nerve-Mediated Responses in Human Colon

Background  

Gender- and age-related differences in muscular and nerve-mediated responses in human colon are poorly characterized. We studied carbachol-induced motor responses and electrically evoked contractions in sigmoid circular muscle from adult and elderly patients of different gender.     

Efficacy and safety of CHG regimen (low-dose cytarabine,homoharringtonine with G-CSF priming) as induction chemotherapy for elderly patients with high-risk MDS or AML transformed from MDS

Background  

To evaluate the efficacy and toxicity of CHG regimen (low-dose cytarabine, homoharringtonine with G-CSF priming) as an induction chemotherapy for elderly patients with high-risk MDS or acute myeloid leukemia transformed from MDS (MDS–AML).     

Therapeutic management of elderly patients with esophageal cancer

Background  

In an aging population, it is important to evaluate the therapeutic management of diseases. Esophagectomy is a reliable treatment for esophageal cancer, but it remains controversial for elderly patients as it could carry additional postoperative risks.     

An unusual association of diffuse adenomyomatosis with dysplastic adenoma in chronic calculous cholecystitis: case presentation

Background  

Gallbladder adenomyomatosis is an epithelial proliferation and hypertrophy of the muscularis mucosae of the gallbladder. Rokitansky-Aschoff sinuses are a characteristic of this condition. The segmental adenomyomatosis has a higher risk of developing into gallbladder carcinoma, especially in the fundal region of elderly patients.     

Particularités cliniques de l’embolie pulmonaire chez la personne âgée : étude comparative de 64 patients

Purpose

To date only a few studies regarding pulmonary embolism (PE) in elderly have been published. The aim of this study was to determine the clinical features of PE in elderly patients (≥ 75 years).

Methods

All patients hospitalized for PE in our internal medicine department from January 2005 to December 2010 were included in the study. The aim was to compare the features of PE in elderly patients (≥ 75 years) to those of patients younger than 75 years. The following data were recorded: past medical history, risk factors for venous thrombo-embolism (VTE), clinical features, and PE etiologies.

Results

The population was composed of 64 patients (women 56%) with a median age of 82 years (IQR: 13.5). There was no statistical difference for risk factors of VTE. Syncope was more frequent in elderly patients (33% versus 7%, P = 0.04) whereas thoracic pain predominated in younger patients (36,5% versus 7%, P = 0.005). Chronic obstructive pulmonary disease was more frequent in the past medical history of elderly patients. The diagnostic of PE was less suspected in elderly patients (47% versus 72%, P = 0.035). The etiologies were similar between the two groups.

Conclusion

Our study highlights the frequency of syncope as the presenting feature of PE in elderly, whereas thoracic pain is uncommon. We confirmed the difficulty to diagnose PE in elderly population.     

Results of comprehensive geriatric assessment effect survival in patients with malignant lymphoma

Purpose  

The prevalence of elderly and comorbid patients (pts) with malignant lymphoma (ML) will steadily increase in future. Elderly patients comprise a heterogeneous population. Comprehensive geriatric assessment (CGA) is an established diagnostic tool in geriatric medicine. However, the prognostic value in patients with ML is unclear. We sought to establish a relationship between results of CGA and survival time in patients with ML.     

Predicting the ability of elderly diabetes patients to acquire the insulin self‐injection technique based on the number of animal names recalled

Aims/Introduction

To our knowledge, no studies have reported that cognitive tests can be used to evaluate whether or not patients can acquire the insulin self‐injection technique. We investigated whether or not the number of animal names recalled in 1 min by elderly diabetes patients could be used as a predictor of the patients’ ability to acquire the insulin self‐injection technique within 1 week.

Materials and Methods

We enrolled 57 inpatients with type 2 diabetes aged >60 years who were starting insulin therapy. We carried out the Mini‐Mental State Examination and verbal fluency tests, which included recalling animal names and common nouns starting with the letters ‘a,’ ‘ka’ and ‘shi’ (Japanese letters). We used 12 checkpoints for insulin self‐injection to judge the patients’ levels of acquisition of the technique. The most predictive cognitive test was determined by multivariate logistic regression analysis.

Results

In the present study, multivariate logistic analysis showed that the number of animal names recalled was the most reliable predictor of the ability to acquire the insulin self‐injection technique within 1 week. A figure of 11 animal names predicted a successful acquisition, with a sensitivity of 73% and a specificity of 91% being observed (area under the curve 0.87, 95% confidence interval 0.76–0.97, P < 0.01).

Conclusions

The number of animal names recalled in 1 min was the most useful indicator of the ability of elderly diabetes patients to learn to manage insulin self‐injection therapy within 1 week. The cut‐off value was 11 animal names.     

Outcome of Colonoscopy in Elderly African-American Patients

Background  

Average-risk individuals should be offered a screening colonoscopy beginning at 50 years of age. However, there is no clear consensus on an age at which patients should no longer be offered a screening colonoscopy. The purpose of this study was to analyze the outcome of colonoscopy in elderly individuals based on the preprocedure indication.     

Severe symptomatic hyponatremia during citalopram therapy - a case report

Background  

Hyponatremia secondary to the syndrome of inappropriate secretion of antidiuretic hormone is an uncommon complication of treatment with the new class of antidepressant agents, the selective serotonin reuptake inhibitors. The risk of hyponatremia seems to be highest during the first weeks of treatment particularly, in elderly females and in patients with a lower body weight.