The value of clinical characteristics from a standard questionnaire to discriminate cardiac from neurological syncope in the elderly.

Objectives: To identify signs and symptoms to differentiate cardiac from neurological syncope in patients over 70 using a standardized questionnaire.

Design: Prospective cohort study.

Setting: Five short-stay units in a French university hospital.

Clinical presentation of hypernatremia in elderly patients: a case control study.

Objectives: To assess early clinical signs and their prognostic value in elderly patients with hypernatremia.

Design: Prospective, case control study of 150 patients with hypernatremia matched to 300 controls.

Setting: Multicenter study including seven short- and long-term geriatric care facilities.

[Pulmonary infections among the elderly living in institutions: prevention].

Pneumonia amongst elderly people living in institutions is common and is a frequent cause of mortality and hospital admission. It is important to distinguish between prevention of viral pneumonia, which primarily consists of influenza vaccination programmes, and prevention of bacterial pneumonia. Prevention of influenza infection in institutions requires the vaccination of as many as possible of both residents and caregivers.

[Normocytic anemia in the elderly. Should the cause of anemia systematically investigated independently of hemoglobin concentration?].

Unlabelled: In clinical practice the will to find out the cause of normocytic anemia (NA) in elderly patients is preferentially based on individual physician's background rather than on objective data such as their hemoglobin level. However, it could be postulate that this clinical performance depends on this "cut off" of hemoglobin (more this value is decreased more it could be easy to find the cause of anemia). The aim of this study was to investigate the relationship between the number of cases with defined cause of NA (after a standardized procedure) and the level of hemoglobin.

[Respiratory tract infections in the elderly living in institutions: prevention].

Pneumonia amongst elderly people living in institutions is common and is a frequent cause of mortality and hospital admission. It is important to distinguish between prevention of viral pneumonia, which primarily consists of influenza vaccination programmes, and prevention of bacterial pneumonia. Prevention of influenza infection in institutions requires the vaccination of as many as possible of both residents and caregivers.

[Inappropriate prescription of heparin at curative doses in the hospital. Can the information to prescribing physicians decrease misuse?].

Objectives: To control whether prescriptions of curative doses of heparin (non fractioned heparins, enoxaparin, tinzaparin) in the hospital complied with the official recommendations; to provide the physicians with information adapted to the recorded misuse and to evaluate the influence of this information.

Methods: A prospective study was conducted between May and October 1999 on the prescriptions of 20 residents from 6 services in 3 phases: phase P1 with initial evaluation (particularly on the indications for heparin, the molecule administered, initial dose and monitoring), phase P2 with analysis and diffusion of an adapted information and phase P3 with final evaluation.

Results: 111 inpatients were included in the phase P1 (66.

Cardiac malignant lymphoma successfully treated with chemotherapy.

We report the case of an 83-year-old woman with diffuse large B-cell lymphoma located in the right cardiac ventricle revealed by acute congestive heart failure. Complete and long-lasting disappearance of the cardiac tumor was observed with monochemotherapy (cyclophosphamide).

Does age play a role in mylohyoideus muscle function?

Because swallowing disorders are frequent in the elderly, we assessed the relationship between age and mylohyoideus muscle contraction, which is an important component of the initial step in swallowing. In a prospective study, 120 subjects without any personal history of diseases associated with swallowing disorders underwent electromyographic recording (EMG) of mylohyoideus muscle activity. Four groups of equal size (n = 30) were defined according to age (< or = 50, 51-70, 71-85, >85 years).

[Is cognitive change related to hypothyroidism reversible with replacement therapy?].

Purpose: Although cognitive impairment related to hypothyroidism has been investigated, issues regarding treatment have been less extensively studied. The aim of this study was to assess cognitive function in patients with hypothyroidism just before treatment and after hypothyroidism had resolved.

Methods: Standardized psychometric assessment (including ten tests) was done in 30 outpatients with biochemical evidence of hypothyroidism (TSH = 92.

Does treatment of constipation improve faecal incontinence in institutionalized elderly patients?

Objective: to evaluate whether faecal incontinence can be improved by treatment of constipation in elderly patients with faecal incontinence associated with impairment of rectal emptying.

Design: a prospective randomized study with a 2-month follow-up.

Setting: five long-term care units.

Reboxetine versus imipramine in the treatment of elderly patients with depressive disorders: a double-blind randomised trial.

Background: Depression in older people is often unrecognised and untreated or under-treated. Antidepressant treatment may itself exacerbate a pre-existing illness, interact with concomitant medications or produce undesirable cognitive and sedative side effects. Newer antidepressants may offer advantages in terms of a lesser burden of adverse effects.

[Drug use in the elderly. Undesirable drug effects in the elderly: epidemiology and prevention].

Unlabelled: A COMMON PROBLEM: Adverse drug effects are common and severe in patients over 70. Most concern widely prescribed drugs or drugs with small safety margins.

Clinic: It is important to recognize the most frequently encountered modes of expression including cardiovascular, metabolic and neuropsychiatric manifestations.

Fecal incontinence in the institutionalized elderly: incidence, risk factors, and prognosis.

Purpose: This study was conducted to evaluate the incidence, identify the risk factors, and assess the prognosis of elderly institutionalized patients who develop fecal incontinence.

Patients And Methods: We enrolled 1,186 patients 60 years of age and older living in long-term care facilities who did not have fecal incontinence. We assessed their medical history, treatment, mobility, and cognitive function.

Nosocomial febrile illness in the elderly: frequency, causes, and risk factors.

Background: Although nosocomial febrile illness (NFI) is common in hospitalized patients, it has been less extensively studied in the elderly.

Objective: To determine the frequency, causes, and risk factors of NFI in elderly inpatients.

Methods: This prospective study involved 608 patients (> or = 65 years of age) admitted in an acute geriatric unit.

Pulmonary artery thrombosis in giant cell arteritis. A new case and review of literature.

Pulmonary artery thrombosis caused by giant cell arteritis is an extremely rare condition. We report the case of an 86-year-old woman, who was hospitalized for dyspnea. Pulmonary artery thrombosis was confirmed by pulmonary angiogram and was linked to giant cell arteritis.

Drug-drug interactions related to hospital admissions in older adults: a prospective study of 1000 patients.

Objective: To investigate the frequency, nature, and side effects of drug-drug interactions (DDI) in a group of geriatric inpatients.

Design: Study of drugs administered at home in the 2 weeks preceding hospitalization.

Setting: Evaluation of patients admitted to a geriatric unit from the emergency unit.

Is presentation of bacteremia in the elderly the same as in younger patients?

Objective: To compare the presentation of bacteremia in young and elderly patients.

Patients And Methods: Seventy-one elderly (mean age 80.4 years) and 34 younger inpatients (mean age 45.