Diabetic mastopathy in an elderly woman: a case report

We report a case of diabetic mastopathy in an elderly woman with type II diabetes. The patient, a 66-year-old woman with a 6-year history of diabetes mellitus, has been received an oral diabetic agent. She noticed a lump in her right breast two months previously. Mammography of the breast showed a low density mass, but there was no microcalcification or architectural distortion. Ultrasonography of the lesion revealed a hypoechoic mass with a distinct margin. Fine needle aspiration cytology was performed but sufficient tissue was not obtained. However, a cluster of small epithelial cells with nucleus swelling and increased chromatin was demonstrated. Excisional biopsy was performed and diabetic mastopathy was demonstrated histologically.     

Synchronous liver cancers: A rare tumor combination in an elderly Japanese woman

Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) may occur simultaneously in a person with primary liver cancer However HCC and CC arising from separate foci is extremely rare. This is a case presentation of a 66-year-old woman with primary combined HCC-CC, who had no risk factors for either tumor.     

The pattern of plasma sodium abnormalities in an acute elderly care ward: A cross-sectional study

Introduction

The combination of ageing, illness, and medications can lead to hyponatraemia or hypernatraemia.

Aims

To describe the distribution of plasma sodium levels in older patients admitted to hospital.

Methods

We carried out a hospital based cross-sectional study examining 1,511 serum sodium concentrations ([Na⁺]) among 336 elderly patients and attempted to elucidate the cause(s) of the abnormal serum [Na⁺].

Results

The study population had a mean age of 81.4. Ninety-two (27.4%) patients had hyponatraemia and seven patients (2.1%) had hypernatraemia during their hospitalisation. The distribution of [Na⁺] results was towards the lower end of the normal range. The mortality rate of patients with hyponatraemia was 14.1% and that of patients with normal serum [Na⁺] was 8.9%. Six patients with hypernatraemia died in hospital. Lower respiratory tsuract infection and medication accounted for the majority of cases.

Conclusions

Deranged [Na⁺] is common among elderly patients admitted to hospital.     

A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6-month postdischarge death in an international registry

Context  Accurate estimation of risk for untoward outcomes after patients have been hospitalized for an acute coronary syndrome (ACS) may help clinicians guide the type and intensity of therapy. Objective  To develop a simple decision tool for bedside risk estimation of 6-month mortality in patients surviving admission for an ACS. Design, Setting, and Patients  A multinational registry, involving 94 hospitals in 14 countries, that used data from the Global Registry of Acute Coronary Events (GRACE) to develop and validate a multivariable stepwise regression model for death during 6 months postdischarge. From 17 142 patients presenting with an ACS from April 1, 1999, to March 31, 2002, and discharged alive, 15 007 (87.5%) had complete 6-month follow-up and represented the development cohort for a model that was subsequently tested on a validation cohort of 7638 patients admitted from April 1, 2002, to December 31, 2003. Main Outcome Measure  All-cause mortality during 6 months postdischarge after admission for an ACS. Results  The 6-month mortality rates were similar in the development (n = 717; 4.8%) and validation cohorts (n = 331; 4.7%). The risk-prediction tool for all forms of ACS identified 9 variables predictive of 6-month mortality: older age, history of myocardial infarction, history of heart failure, increased pulse rate at presentation, lower systolic blood pressure at presentation, elevated initial serum creatinine level, elevated initial serum cardiac biomarker levels, ST-segment depression on presenting electrocardiogram, and not having a percutaneous coronary intervention performed in hospital. The c statistics for the development and validation cohorts were 0.81 and 0.75, respectively. Conclusions  The GRACE 6-month postdischarge prediction model is a simple, robust tool for predicting mortality in patients with ACS. Clinicians may find it simple to use and applicable to clinical practice.