[Analysis of 736 blood transfusions in a geriatric teaching hospital].

Background: Red blood cell transfusion in elderly patients with anemia requires taking into account a hemoglobin threshold, as well as comorbidities that may be decompensated by anemia. In the absence of consensual indications for blood transfusion in the elderly population, it seems important to evaluate the practical approach of blood transfusion in geriatrics. We analyzed prescriptions of red blood cell transfusion in very old patients hospitalized in a geriatric teaching hospital.

[Focus on digitalis intoxication in the elderly. Report of a case treated with digoxin-specific Fab antibody fragments].

The indications for digoxin are currently limited to rare cases of heart failure and/or atrial fibrillation. Its use should be even more rare in geriatrics its pharmacological characteristics, associated with age-related changes and comorbidities, particularly increase the risk of digoxin poisoning in the elderly. However, at least a third of aged patients suffering from heart failure and/or atrial fibrillation is treated by digitalis.

Anemia in the elderly: usefulness of an easy and comprehensive laboratory screen.

Anemia, the most common hematological disorder in the elderly, increases the risk of mortality and morbidity and adversely affects quality of life. However, few studies focused specifically on anemia in the elderly, especially regarding the underlying causes. The main objective of this prospective study was to evaluate the causes of anemia in non-institutionalized elderly patients.

[Sleep apnea syndrome and cognitive impairment].

The sleep apnoea syndrome is a common disorder, unrecognised in the elderly. Several studies have shown that it can cause or exacerbate cognitive impairment, mainly related to attention, memory and learning and adaptation abilities. However, continuous positive airway pressure treatment appears to be effective on these cognitive disorders, including in elderly patients.

[Management of complications with antivitamin K in elderly people].

latrogenic complications with antivitamin K (AVK) largely entail haemorrhages, apparently more frequent in the elderly. Recent French and North American recommendations are available and must be widely circulated, in community practices as well as hospitals, in order to improve the treatment of overdoses and/or haemorrhagic accidents under AVK.

[Divisibility of warfarin and fluindione tablets tested in elderly patients and their family circle].

Background: Vitamin K antagonist tablets are often split to fractionate the dose by elderly patients. We performed a study in order to assess the divisibility of one dosage strength of score-lined warfarin and of score-lined fluindione.

Methods: Due to a recent change in the pharmaceutical form of fluindione in order to improve the divisibility, the study was performed over 2 different periods (with the « old » and with the « new » pharmaceutical form).

[Hodgkin lymphoma in the elderly].

We report a case of Hodgkin's lymphoma in a patient aged 75, presenting with acute cardiopulmonary insufficiency, hospitalized in a geriatrics ward. The deterioration of his general condition and the discovery of several lymph nodes led us to perform an aspiration of a lymph node and a bone marrow biopsy. Reed-Sternberg cells, pathognomonic of Hodgkin's disease were identified on the smears and biopsy sections.

Reversal of overanticoagulation in very elderly hospitalized patients with an INR above 5.0: 24-hour INR response after vitamin K administration.

Background: Reversal of overanticoagulation to minimize the bleeding risk is important in elderly inpatients receiving vitamin K antagonist therapy. However, no study has specifically focused on this population. The objective of this study is to evaluate whether guidelines based on American College of Chest Physicians recommendations for the management of overanticoagulation (international normalized ratio [INR] ≥5.

[Screening for thrombophilic abnormalities in very elderly patients].

Few data are available regarding biological risk factors for venous thromboembolism in the elderly who are at high risk of thrombosis. In the present study, we assessed the prevalence of antithrombin, protein C, protein S deficiency, G1691A factor V Leiden and G20210A prothrombin (FII) gene variant, and antiphospholipid antibodies in patients over 75 years who were referred to us for thrombophilia testing and who presented with unprovoked recurrent venous thromboembolic disease or venous thrombosis at unusual site. Seventy-eight patients, mean aged 86 years, were included in the cohort.