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Case Report
Helping an Older Man Quit Smoking
Case Presentation
Mr. D is a 67-year-old married male who comes to the Emergency Department (ED) with complaints of chest pain and shortness of breath. He is accompanied by his wife, who reports that Mr. D has been having episodes of coughing and shortness of breath for several months but has refused to see his doctor. Earlier that day he developed chest pain in addition to coughing and shortness of breath, so Mrs. D called 911.
Cardiac Stunning: An Infrequent Phenomenon with Unclear Etiology
Introduction
5-fluorouracil (5-FU) capecitabine is the cornerstone of chemotherapy in patients with gastrointestinal cancers, colon cancer, head and neck cancer, or breast and pancreatic cancer. The widespread use of this drug has increased the incidence of drug-related cardiotoxicity. 5-FU and related agents can cause cardiac stunning, defined as the short, persistent defect in the contractility of myocardium, which reverses by itself with time once the initial insult is over. Advancing age is a risk factor for the development of drug-related cardiotoxicity, and as the elderly population increases, older adults will have increased potential for exposure to 5-FU. It is important for physicians to consider the possibility of cardiotoxicity in elderly patients undergoing 5-FU chemotherapy for various cancers.
Case Presentation
Dementia with Lewy Bodies: Parkinsonism and Dementia in an Older Man
Introduction
Dementia with Lewy bodies (DLB) is either the second or third most common cause for dementia in the economically developed world,1 yet it is frequently not recognized. While it is often mistaken for Alzheimer’s disease (AD) early in the course because the parkinsonian features frequently develop after the dementia has begun, making the correct diagnosis leads to better management. The development of parkinsonism in a person with dementia not taking neuroleptics or on very low doses should always raise this consideration,2 but other signs and symptom
Unsuspected Malabsorption Syndrome Causing Acute Oxalate Nephropathy
Introduction
The incidence of acute kidney injury (AKI) is increasing. In an analysis using the Medicare 5% Sample Beneficiary Standard Analytical File for the years 1992 through 2001, Xue et al1 noted that the incidence rate of AKI increased by approximately 11% per year. Chronic kidney disease commonly complicates AKI and may lead to end-stage renal disease (ESRD), requiring chronic renal replacement therapy. We present a case of an elderly woman who developed ESRD as a complication of absorptive hyperoxaluria, a rare and potentially reversible cause of ESRD.
Case
Persistent Nodular Rash in an Older Patient
Case Presentation
A 62-year-old white male presented to a same-day clinic with a complaint of painless, nonpruritic maculopapular lesions on his back, chest, and shoulders. The lesions first appeared 2 weeks prior, and the patient had treated them unsuccessfully with bacitracin ointment. His past medical history was significant for Crohn’s disease, hyperlipidemia, a cerebrovascular accident (CVA), and recurrent methicillin-resistant Staphylococcus aureus (MRSA) furunculosis. Overall, his medical problems were well controlled, and he was compliant with his care. His medications inc
Spontaneous Iliopsoas Hematoma with Femoral Neuropathy—An Unusual Complication of Anticoagulation
Introduction
We report a case of spontaneous iliopsoas hematoma presenting with femoral neuropathy in an 84-year-old anticoagulated patient. Spontaneous iliopsoas hematoma is a rare but well-recognized complication of anticoagulation that may result in significant neurological disability. Pain or weakness in the groin or thigh of an anticoagulated patient should raise the suspicion of an iliopsoas hematoma and prompt urgent imaging, ideally with contrast-enhanced computed tomography (CECT). Both conservative and invasive management strategies may be adopted depending on the patien
Foot Gangrene From Complication of Heparin-Induced Thrombocytopenia
Introduction
Heparin-induced thrombocytopenia (HIT) is a serious, immune system–mediated complication of heparin therapy. If the condition of HIT is not detected in a timely manner, it often results in devastating thromboembolic outcomes. Since thrombocytopenia is common in hospitalized older patients, occurring in up to 58% of critically ill patients, and can be caused by a variety of factors,1 HIT, unfortunately, often remains unrecognized. Heparin, especially low-molecular-weight heparin (LMWH), is a widely used drug in hospitals. It is important to be aware of HIT by recogni
Ascending Paralysis, Hyperkalemia, and Acute Renal Failure in an Older Woman
Introduction
Acute ascending paralysis secondary to hyperkalemia is a serious but reversible medical emergency. While the adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with renal failure are very well known, it is important to remember that they can cause serious damage even in patients with preserved renal function in the setting of dehydration.
Case Presentation
A 75-year-old woman was admitted to the Emergency Service with generalized weakness and paresthesias. She had a history of chronic edema of the lower limbs, which was being tre
Treatment Algorithms and Management Options for Psoriasis and Psoriatic Arthritis
Psoriasis affects approximately 2.1% of U.S. adults,
up to 7.5 million people, of whom about 30% will develop psoriatic arthritis.
Click here for the latest clinical information on treating your patients with psoriasis.
Clinical Geriatrics Blogs
Coming in Future Issues of Clinical Geriatrics
Series: Diabetes in the Elderly
Series: Cancer in Older Adults
First Report® Conference Coverage: American Academy of Neurology, American Diabetes Association, 2010 Digestive Disease Week
Assessment and Classification of Pain in the Elderly Patient
Pharmacologic Management of Pain in Older Patients
Miscellaneous Pain Syndromes in Older Adults
Nonhernia Causes of Inguinal Pain in the Elderly
