Luxación bilateral de cristalino en octogenaria / Bilateral luxation of crystalline lens in an octogenarian

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Particulate wear debris osteolysis, acute urinary retention and delirium as late complications of hip arthroplasty.

Intrapelvic mass formation as a result of particulate wear debris induced osteolysis is a recognised late complication of cementless total hip arthroplasty. Clinical presentation typically involves hip and/or leg pain resulting in functional impairment, and obstructive urinary symptoms developing 3-20 years after surgery. An acute confusional state has never been described in this scenario. We report the case of an 86-year-old gentleman with a diagnosis of dementia brought to our emergency department with an acute confusional state. Abdominal imaging revealed a distended bladder, a large pelvic mass and a lytic lesion within his right acetabulum. Cytological and microbiological examination of fluid obtained with radiologically guided aspiration of the mass was negative for neoplasia and infection.

Síncope por risa: descripción de un caso y revisión de la literatura / Laughter-induced syncope: description of a case and review of the literature

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Differences in fear of falling in the elderly with or without dizzines.

To compare prevalence and risk factors associated with fear of falling (FoF) in two groups of elderly people, 109 patients with recurrent dizziness and 109 controls without dizziness. FoF was defined as a positive response to the single question and with Falls Efficacy Scale of >50. The prevalence of FoF was greater (71.6%) in the dizzy group (control, 31.2%; p<0.001). Factors associated with FoF in the dizzy-group were diabetes, high General Health Questionnaire (GHQ-28) score and poor balance score. In the non-dizzy group, female gender, high GHQ, and poor gait score in Tinetti's scale were the association. Further research is needed to explore the relationship between dizziness and FoF.

Síndrome de temor a caerse en personas mayores de 65 años con mareos de repetición: estudio descriptivo / Fear of falling in the elderly with recurrent dizziness: A descriptive study

Introducción. Los objetivos de este estudio son analizar la prevalencia y los factores de riesgo del síndrome de temor a caerse (STAC) en personas mayores de 65 años con mareos de repetición. Métodos. Estudio transversal que incluye 109 pacientes derivados desde atención primaria o urgencias extrahospitalarias del centro de salud, desde enero a diciembre de 2008, en Archena (Murcia) por mareos de repetición. Se registra historia clínica, fármacos, grado de temor a caerse a través de pregunta simple y escala Falls Efficacy Scale (FES) y situación social y funcional mediante cuestionarios CUBRECAVI y GHQ-28. Resultados. El STAC ocurre en el 71,5% de esta población con mareos de repetición y afecta más a mujeres que a hombres. Las variables asociadas con alto riesgo para STAC tras análisis multivariante fueron diabetes mellitus (OR: 35,15; intervalo de confianza [IC]: 4,57–270,07; p<0,001) y consumo de antidepresivos (OR: 9,84; IC: 1,48–65,36; p=0,017), mientras que las variables asociadas con bajo riesgo para STAC fueron una mayor frecuencia de relaciones sociales (OR: 0,18; IC: 0,04–0,86; p=0,017) e independencia para las actividades de la vida diaria (OR: 0,17; IC: 0,04–0,76; p=0,021). Conclusiones. Entre pacientes mayores con mareos frecuentes se observa una muy elevada proporción de síndrome de miedo a caerse. Este resultado es uno de los más altos publicados. Los factores asociados al STAC en esta población fueron tener diabetes mellitus y tomar antidepresivos como factores de riesgo; mientras, la mayor frecuencia de relaciones sociales y mayor independencia para las actividades de la vida diaria son factores protectores. En esta población, haber sufrido caídas no se asocia al STAC(AU)

Introduction. The aims of this research are to analyse prevalence and risk factors of the fear of falling in people over 65 years with recurrent dizziness. Methods. This cross-sectional study includes 109 patients sent from General or Emergency Primary Care clinics of a Health Centre from January to December 2008 in Archena (Murcia). Data collected were clinical history, medication, fear of falling using a single question and Falls Efficacy Scale as well as social and functional status using Cubrecavi (Quality of Life Short Questionnaire) and GHQ-28 (General Health Questionnaire). Results. Fear of falling is detected in 71.5% of our elderly population with recurrent dizziness, and it affects women more often than men. The variables associated with fear of falling in the multivariate analysis were, diabetes mellitus (OR: 35.15; 95%CI: 4.57–270.07; P<0,001), taking antidepressants (OR: 9.84;95%CI: 1,48–5.36; P=0.017), and frequency of social relations (OR: 0.18; 95%CI: 0.04–0.86; P=0.017); and independence for activities of daily living (OR: 0.17;95% CI: 0.04–0.76; P=0.021). Conclusion. A very high proportion of fear of falling is observed among elderly patients with frequent dizziness. This is one of the highest proportions published. Associated factors with fear of falling were, having diabetes mellitus and taking antidepressants, as risk factors; and higher frequency of social relationships and higher independence for activities of daily living as protective factors. In this population, having had a fall is not related to fear of falling(AU)

[Fear of falling in the elderly with recurrent dizziness: a descriptive study]. / Síndrome de temor a caerse en personas mayores de 65 años con mareos de repetición: estudio descriptivo.

INTRODUCTION: The aims of this research are to analyse prevalence and risk factors of the fear of falling in people over 65 years with recurrent dizziness. METHODS: This cross-sectional study includes 109 patients sent from General or Emergency Primary Care clinics of a Health Centre from January to December 2008 in Archena (Murcia). Data collected were clinical history, medication, fear of falling using a single question and Falls Efficacy Scale as well as social and functional status using Cubrecavi (Quality of Life Short Questionnaire) and GHQ-28 (General Health Questionnaire). RESULTS: Fear of falling is detected in 71.5% of our elderly population with recurrent dizziness, and it affects women more often than men. The variables associated with fear of falling in the multivariate analysis were, diabetes mellitus (OR: 35.15; 95%CI: 4.57-270.07; P<0,001), taking antidepressants (OR: 9.84;95%CI: 1,48-5.36; P=0.017), and frequency of social relations (OR: 0.18; 95%CI: 0.04-0.86; P=0.017); and independence for activities of daily living (OR: 0.17;95% CI: 0.04-0.76; P=0.021). CONCLUSION: A very high proportion of fear of falling is observed among elderly patients with frequent dizziness. This is one of the highest proportions published. Associated factors with fear of falling were, having diabetes mellitus and taking antidepressants, as risk factors; and higher frequency of social relationships and higher independence for activities of daily living as protective factors. In this population, having had a fall is not related to fear of falling.

Fear of falling among elderly patients with dizziness and syncope in a tilt setting.

The objectives of this study were to assess the prevalence of fear of falling (FOF) among patients over age 60 with dizziness, falls, or syncope; and to analyze risk factors associated with FOF, including data from the tilt table test. This study included 200 older patients referred to a geriatric outpatient clinic specializing in dizziness, falls, and syncope. The primary outcome measure was the proportion of patients who experienced FOF (yes vs. no) and whether FOF restricted leaving home alone or performing activities of daily living. FOF occurred in 50 per cent of patients in this population. Among these, 44 per cent gave up going out alone and 10 per cent stopped doing basic activities of daily living. Beyond age 75, FOF was associated with recurrent dizziness, depression, and symptoms on standing, but not prior falls.