Evaluation of long-term outcomes of very old patients admitted to intensive care: Survival, functional status, quality of life, and quality-adjusted life-years.

PURPOSE: To evaluate long-term outcomes among a population of very old patients (≥80years) after nonelective intensive care unit (ICU) admission. METHODS: A retrospective study of very old patients admitted to a mixed ICU between 2006 and 2012 was conducted. A detailed description was made; functional status was assessed through the modified Rankin Scale and quality of life through EQ-5D-3L. Follow-up results are compared between 3 groups: very old with "old" (66-79 years) and "non-old" (≤65years) patients. RESULTS: A total of 278 very old patients were admitted into the ICU representing 10.3% of admissions. The mean (SD) Simplified Acute Physiology Score II was 61 (16) predicting a hospital mortality of 70%, and the observed hospital mortality was 53%. Two-year survival rate was 38%. Of the 158 patients who survived in the ICU, 51 were evaluated in the outpatient clinic, and of those, 25 (51%) had already resumed previous functional activity. Evaluation through the modified Rankin Scale showed that 29 (60%) remained independent in their daily activities. When comparing the 3 groups, several differences were observed between theme, with the oldest groups (>80years) reporting more problems in motility, self-care, and usual activities. The respondent's self-rated health through the median visual analog scale score on the day of the outpatient clinic appointment decreased with age. CONCLUSIONS: For those who survive, return to previous functional activity was likely. Long-term survival and quality of life achieved afterward were translated in more than a year of perfect health status gained.

Characteristics of Neuro-Behçet's Disease in a Case-Series from a Single Centre in Northern Portugal.

INTRODUCTION: Behçet's disease (BD) is a multisystem inflammatory disease of unknown etiology that may affect the CNS - Neuro-Behçet (NB). Our aim was to evaluate the frequency of neurological involvement and characterize a cohort of our NB patients. METHODS: We retrospectively revised the clinical, laboratory and imaging data of a cohort of BD patients, followed in our hospital outpatient clinic. RESULTS: We identified 138 BD patients. Twenty-five out of 138 had NB (15 female). Four patients presented with neurological symptoms. We identified a total of 37 attacks. Twenty-one attacks were classified as parenchymatous, four non-parenchymatous and 12 as other syndromes. Seventeen patients had CSF analysis performed (20 samples). Five samples were normal, 15 showed CSF pleocytosis. The most frequent finding on MRI performed in the acute phase was extensive lesions involving the brainstem. Two patients died due to the neurological involvement of BD. CONCLUSION: We found 18.1% prevalence of NB and a higher female-to-male ratio in our group than in other series. Gastrointestinal and vascular involvement was more frequent in the NB group. The fact that neurological involvement may be the first manifestation of BD with therapeutic implications and associated morbidity points out the relevance of an early diagnosis.

14th International Congress on Antiphospholipid Antibodies Task Force Report on Catastrophic Antiphospholipid Syndrome.

The 'Task Force on Catastrophic Antiphospholipid Syndrome (CAPS)' was developed on the occasion of the 14th International Congress on Antiphospholipid Antibodies. The objectives of this Task Force were to assess the current knowledge on pathogenesis, clinical and laboratory features, diagnosis and classification, precipitating factors and treatment of this condition in order to address recommendations for future research. This article summarizes the studies analyzed by the Task Force, its recommendations and the future research agenda.

Lucky to meet RS3PE.

We present a florid case of remitting seronegative symmetrical synovitis with pitting edema that was actually a paraneoplastic syndrome of an asymptomatic undiagnosed adenosquamous lung cell carcinoma. The arthritis led to a screening for lung cancer and an early enough diagnosis for a curative intervention.