ABSTRACT
Wall-eyed bilateral internuclear ophthalmoplegia is a rare neuroophthalmological condition characterized by dissociated abducting nystagmus, a large angle exotropia in primary gaze and supranuclearvertical gaze palsy.The authors present the case of an 83-year-old man admitted to theinternal medicine ward with the diagnosis of cholangitis that suddenlystarts with complaints of diplopia. Based on the clinical findings andresults of the diagnostic workup, was established the diagnosis ofWall-eyed bilateral internuclear ophthalmoplegia syndrome. (AU)
La oftalmoplejía internuclear bilateral es una rara condición neuroftalmológica caracterizada por nistagmo en abducción disociado, unaexotropía de gran ángulo en la mirada primaria y parálisis supranuclear de la mirada vertical.Los autores presentan el caso de un hombre de 83 años que ingresaen el servicio de medicina interna con el diagnóstico de colangitisque se inicia repentinamente con quejas de diplopía. Con base en loshallazgos clínicos y los resultados del estudio diagnóstico, se estableció el diagnóstico de síndrome de oftalmoplejía internuclear bilateral(síndrome WEBINO). (AU)
Subject(s)
Humans , Male , Aged, 80 and over , Ocular Motility Disorders/diagnostic imaging , Ocular Motility Disorders/etiology , Aspartate Aminotransferases , ExotropiaABSTRACT
The amyloidoses are a rare group of diseases that result from extracellular deposition of amyloid, a fibrillar material derived from variousprecursor proteins that self-assemble with highly ordered abnormal cross ß-sheet conformation. The authors present the case of a76-year-old woman with anemia and worsening renal function, whodevelops intermittent nodular lesions on the tongue and hemorrhagiclesions on the oral mucosa. The etiological study allowed the diagnosisof light chain amyloidosis. (AU)
Las amiloidosis son un grupo poco común de enfermedades que resultan de la deposición extracelular de amiloide, un material fibrilarderivado de varias proteínas precursoras que se autoensamblan conuna conformación de hoja ß cruzada anormal altamente ordenada.Los autores presentan el caso de una mujer de 76 años con anemia ydeterioro de la función renal, que desarrolla lesiones nodulares intermitentes en la lengua y lesiones hemorrágicas en la mucosa oral. Elestudio etiológico permitió el diagnóstico de amiloidosis de cadenasligeras. (AU)
Subject(s)
Humans , Female , Aged , Amyloidosis/diagnosis , Amyloidosis/etiology , AnemiaABSTRACT
BACKGROUND: COVID-19 poses a significantly more serious threat to adults aged 65 and above, with a higher mortality rate. This study aims to describe the outcome of COVID-19 patients in the elderly and very elderly population admitted to a tertiary care Portuguese hospital. The authors defined the elderly population (65 to 79 years) and the very elderly population (≥ 80 years). METHODS: We conducted a retrospective observational single center study in the internal medicine ward of a tertiary hospital from November 1, 2020 to January 31, 2021. All COVID-19 patients aged over 65 years were enrolled. RESULTS: Of the 824 patients with SARS-CoV-2 infection, 586 (71%) were aged above 65 years. Of them, 61.7% were very elderly and 32.9% were elderly. The hospital recorded 53 (27.5%) deaths in the elderly group and 182 (46.3%) in the over-80 group. In the elderly population, only 32 patients had critical illness compared to the 79 in the very elderly group. In addition to respiratory complications, acute kidney failure and liver dysfunction were noted. In both groups, mortality was higher when there was acute kidney injury (AKI). With respect to treatment, dexamethasone and azithromycin did not show a statistically significant difference between the groups. The need for oxygen therapy over 4L/min, high-flow therapy, and mechanical invasive ventilation was related to higher mortality in both groups. CONCLUSION: The very elderly group had a higher number of deaths compared to the elderly group due to multiple comorbidities. Respiratory failure was the most frequently occurring complication. Surprisingly, dexamethasone and azithromycin therapy did not show a statistically significant effect in both age groups despite their current widespread usage in COVID-19 treatment worldwide.
ABSTRACT
Background: Acute Physiology and Chronic Health Evaluation (APACHE) II and Simplified Acute Physiology Score (SAPS) II have become a necessary tool to describe intensive care unit (ICU) patients and to predict differences in mortality. Both are calculated in the first 24 hours of hospitalization, in whichhigher levels correspond to more serious diseases and a higher risk of death. Sepsis is a major cause of morbidity in ICU, it is estimated that about half of the patients have a healthcare-associated infection and are, therefore, at a higher risk of death. This study aims to determine the comparative efficacy of different scoring system (APACHE II and SAPS II scores) in assessing the prognosis of critically ill patients that were admitted to the ICU by sepsis in a tertiary hospital and compare them for prediction of the outcome in these patients in early mortality (up to 3 months). Methods: We performed a retrospective review of five hundred and thirty three patients admitted to the ICU from January 2018 to December 2019. We included all patients (medical or surgical patients) over the age 16 years old, and we selected those with the first diagnosis of sepsis. Patient selection and data collection were obtained through medical records. Predicted mortality was calculated using APACHE II and SAPS II and also the early mortality. Group comparisons between survivors and non-survivors from sepsis were performed using the Student-T test to compare continuous with categorical variables and chi square test for categorical variables. Pearsons correlation was used to compare two continuous variables Statistical analysis was performed using SPSS software version 27.0 (IBM, Armonk, NY, USA). Results: Out of 533 patients, 71 had sepsis (13%). Of these 71 patients, 36 (50.7%) died during the 3 month follow-up... (AU)
