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Biomedical subjects

A Gentric

Publications and source records attributed to A Gentric.

At least 19 recordsLinked to original sources
PubMed2005

[Use of anticoagulant treatments in the elderly].

PURPOSE: The frequency of pathologies requiring anticoagulant treatment (thromboembolic disease, atrial fibrillation) is particularly high in people above 75. The risk of haemorrhagic complications is also highest in this population of patients.Therefore, the assessment of the risk/benefit ratio of an anticoagulant treatment may overestimate the haemorrhagic risk and lead to the under-using of anticoagulant treatment in such pathologies as atrial fibrillation. CURRENT KNOWLEDGE AND KEY-POINTS: However, the use of "classical" anticoagulant treatments such as non-fractionated heparin, low-molecular-weight heparin, and above all, antivitamin K requires special precautions. Several hemorrhagic risk factors are well known and should be spotted out. Finally, the risk/benefit ratio of an anticoagulant treatment in the elderly patients must rely on a comprehensive geriatric assessment. PROSPECTS AND PROJECTS: In the era of "new anticoagulant treatments", and particularly of per-os antithrombin, it may seem anachronous to issue a statement over the use of "classical anticoagulant treatments", but in the present state of knowledge, the evaluation of these new molecules is not sufficient in the elderly population of patients.

Aged↗
PubMed2002

[Oropharyngeal colonization by Gram-negative bacteria in elderly hospitalized patients: incidence and risk factors].

PURPOSE: In a prospective study, we determined the predisposing conditions and the course of aerobic Gram-negative bacilli oropharyngeal colonization during the hospital stay in patients older than 70 years. METHODS: We studied 116 patients admitted in our internal medicine unit. Medical characteristics were documented for each patient. Oropharyngeal swabs were collected on the first, third, and seventh days after admission, and then once a week until discharge. Positive culture was defined as the presence of at least one colony of Gram-negative bacilli. RESULTS: We collected 306 samples from the 116 patients. The mean hospital stay was 10.6 days. Fifty patients (43%) had at least one positive oropharyngeal culture. Thirty-three patients (30%) were colonized on admission, but this prevalence decreased during hospital stay: 20% on the third day and 14% on the seventh day. In an univariate analysis, prior administration of antibiotics (P < 0.01) and use of nonsteroid anti-inflammatory drugs (P < 0.05) were associated with colonization. CONCLUSION: Aerobic Gram-negative bacilli oropharyngeal colonization was transient during the hospital stay in the elderly. The use of nonsteroidal anti-inflammatory drugs and the previous treatment with antibiotics are possible risk factors for colonization.

Age Factors↗
PubMed2001

[Sicca syndromes in the elderly].

Sicca syndromes, especially salivary sicca syndromes, are prevalent in the elderly. Even, in the absence of local complications, they can impair the quality of life and lead to denutrition. Drugs are essentially responsible for these sicca syndromes. Paraclinic investigations (tests for autoimmunity, biopsy of minor salivary glands) are useful when uncommon Sjögren syndrome is hypothesized. This autoimmune disease, probably rare in the elderly, has to be suspected when general manifestations are present. The treatment of sicca syndromes is based on the reduction of drug prescriptions and on local care.

Age Distribution↗
PubMed1998

[A sociomedical geriatric assessment in the emergency units: an alternative to the hospitalization of aged patients?].

BACKGROUND: Elderly patients admitted to the emergency unit are usually hospitalized in medical units. Could a gerontologic evaluation in the emergency room lead to another solution than hospitalization? METHODS: Since January 1993, a sociomedical geriatric reception has been operating in the emergency unit of the university hospital in Brest, France, every day from 10 AM. to 6 PM. Patients older than 75 years, dependent or at risk of dependence are examined by a geriatrician. The medical situation is evaluated. The nutrition status, the cognitive functions, the thymic functions, the gait, and the functional abilities are systematically studied. In the same time the social evaluation is realised by a social worker. RESULTS: From January 1993 to December 1996, 1,514 patients have been cared for by the social medical team. Once the assessment of each patient was made only 49% of them actually had to be hospitalized in a medical department. The outcome of 100 patients discharged between January 1994 and June 1994 was evaluated one year after their discharge at home, 11 patients were rehospitalized. The reason for rehospitalization were different from the reasons for the first hospitalization. CONCLUSION: A gerontologic assessment in the emergency room permits to avoid hospitalization in 50% of the cases. One year after discharge at home only 11% of the patients were rehospitalized.

Aged↗
PubMed1993

Dopamine B hydroxylase deficiency responsible for severe dysautonomic orthostatic hypotension in an elderly patient.

We report the case of an elderly woman with severe dysautonomic orthostatic hypotension in whom a deficit in dopamine B hydroxylase has been established. In the literature, such a deficit has been described in six young adults with long standing symptoms of postural hypotension. This enzyme catalyses the conversion of dopamine to noradrenaline. In our elderly patient, noradrenaline and adrenaline were undetectable in the plasma, but plasma dopamine was detectable. Treatment with the synthetic amino acid, DL-threo-dihydroxyphenylserine, which is converted to noradrenaline by dopa-decarboxylase, resulted in a significant increase in blood pressure. The mechanism of this acquired deficit is not elucidated.

Aged↗
PubMed1991

Nonorgan-specific autoantibodies in individuals infected with type 1 human immunodeficiency virus.

Fifty-six human immunodeficiency virus-1-positive asymptomatic carriers were tested for the presence of a variety of nonorgan-specific autoantibodies. Antinuclear antibodies were detected in 34 sera, of which 27 were directed to the mitotic spindle apparatus and all were of the IgG isotype. Anti-Golgi complex, anti-centriole, and anti-vimentin antibodies were also present in 20.4, and 4 sera, respectively. Ten patients had less than 500 CD4-carrying T lymphocytes per cubic millimeter. Nine of them had more than one autoantibody. No correlation could be demonstrated between the number of autoantibodies and the level of serum immunoglobulins.

Adult↗
PubMed1991

Immediate and long-term prognosis in acute renal failure in the elderly.

Acute renal failure (ARF) is particularly frequent in the elderly. A few studies have reviewed immediate prognosis of ARF in older patients, but these do not allow any conclusion on long-term renal prognosis. Our retrospective study included 46 patients over 65 years referred to our renal unit between 1983 and 1989. Survivors were followed up 6-71 months after discharge (mean: 39 months). The evolution of renal function was evaluated by measurement of serum creatinine. Data analysis employed chi 2 with Yates correction, Student t, and Mann-Whitney tests to compare survivors and deceased, and to compare patients with normal and abnormal renal function at follow-up. During hospitalisation 11 patients (24%) died. Our univariate analysis reveals that three variables independently influence mortality: consciousness disturbance (P less than 0.001), high urea concentration (P less than 0.01), and hypoalbuminaemia (P less than 0.001). Age does not adversely affect prognosis. At follow-up 15 patients (43%) had a complete functional recovery, eight (23%) had incomplete renal recovery and two (6%) were on chronic haemodialysis. These results are similar to those observed in a younger population. In conclusion we believe that age alone should not be used to predict the immediate survival or the long-term renal outcome in ARF in the elderly.

Acute Kidney Injury↗
PubMed1990

Serological arguments for classifying Raynaud's phenomenon as idiopathic.

Twenty-five patients with idiopathic Raynaud's phenomenon were followed prospectively for a mean period of 48 months. Clinical and laboratory assessments were performed on admission and on followup. The sera were analyzed for the presence of autoantibodies (antinuclear, antiskeleton and antiorganelle antibodies). Sixteen patients were antinuclear antibody positive and 2 anticentromere antibody positive. Eight patients produced antivimentin, 5 antimitochondrial, 4 anti-Golgi complex, and 3 anticentriol antibodies. Eleven patients produced antidesmosome antibodies. Only one patient (anti-RNP and antidesmosome antibody positive) developed a systemic disease (mixed connective tissue disease) during followup. The initial screening of sera may help to classify Raynaud's phenomenon as idiopathic more accurately.

Adolescent↗
PubMed1988

Activation of peripheral blood lymphocytes in patients with primary Sjögren's syndrome.

The peripheral blood from 15 patients with primary Sjögren's syndrome and from 15 matched controls was examined for the presence of activated T and B lymphocytes, by using monoclonal antibodies directed to interleukin-2 (IL-2) and transferrin receptors, and to HLA-DR determinants. The number of circulating positive-T cells was significantly greater in the patients than in the controls, irrespective of disease activity. There were more of the CD8 cells than of the CD4 cells that expressed IL-2 receptors. There was a small but significant increase in activated B cells in the patients, since this population is virtually absent from the normal blood.

Adult↗