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Frailty assessment scales for the elderly and their application in primary care: A systematic literature review

evaluation. SEGA grid ( 25 ) functional decline, including age, provenance, drugs, mood, perceived health, history of falls, nutrition, comorbidities, IADL, mobility, continence, feeding and cognitive functions Strawbridge questionnaire ( 25 ) two or more functional domains (physical, cognitive, sensory and nutritive). unintentional weight loss (10 lbs in past year), self-reported exhaustion, Frailty phenotype ( 25 , 44 ) weakness (grip strength), slow walking speed, and low physical activity 3.2 Main Characteristics of the Research

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Characteristics of Cardiac Rhythm and Conduction Abnormalities Diagnosed in Mobile Emergency Units in Central Romania

Abstract

Background: Cardiac arrhythmias and conduction abnormalities are frequently identified by emergency medical service staff in patients requesting emergency services.

Methods: We conducted a prospective observational study that aimed to analyze the characteristics of rhythm and conduction abnormalities in prehospital settings, in patients who requested emergency medical assistance for symptoms indicative for an arrhythmia or conduction abnormalities.

Results: From 180 patients included in the study (90 from a tertiary and 90 from a non-tertiary medical center), 92.78% presented an arrhythmia and 15.56% a conduction abnormality. A clear etiology was found in only 29.44% of cases. Ischemic patients presented a higher rate of atrial fibrillation (AF) (p <0.0001), while sinus tachycardia was more common in non-ischemic subjects (p = 0.02). Patients younger than 50 years of age presented higher rates of sinus tachycardia (p <0.0001) and right bundle branch block (p = 0.001), while those older than 50 years presented higher rates of AF (p <0.0001) and ventricular extrasystole (p = 0.014). There were no differences regarding the type of arrhythmia diagnosed in emergency settings, neither between genders or provenance environments, nor between regions served by a tertiary versus non-tertiary base station hospital.

Conclusions: The most frequently diagnosed arrhythmias in prehospital settings were atrial fibrillation and sinus tachycardia, while atrioventricular blocks were the most frequent conduction disturbances. Young patients more frequently present sinus tachycardia or right bundle branch blocks, while older subjects are more prone to develop ischemia-related AF and ventricular extrasystole. The lack of any significant differences between systems served by a tertiary vs. non-tertiary medical center indicates an efficient emergency system of care regardless of the geographical region.

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Phagocytosis in Mesocestoides vogae-induced peritoneal monocytes/macrophages via opsonin-dependent or independent pathways

containing β-glucan. Immunology, 104: 198 – 206 10.1046/j.1365-2567.2001.01291.x Reichner JS Fitzpatrick PA Wakshull E Albina JE 2001 Receptor-mediated phagocytosis of rat macrophages is regulated differentially for opsonized particles and non-opsonized particles containing β-glucan Immunology 104 198 206 Ruckerl, D., Allen, J.E. (2014): Macrophage proliferation, provenance and plasticity in macroparasite infection. Immunol. Rev., 262: 113 – 133. DOI: 10.1111/imr.12221 10.1111/imr.12221 Ruckerl D Allen JE 2014 Macrophage proliferation, provenance and plasticity in

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Pulmonary tuberculosis with rhinosinusal and otic manifestations - diagnostic challenge

Abstract

BACKGROUND. Unfortunately, tuberculosis is still being diagnosed among patients, independent of their age, gender, provenance or social category. The etiologic agent of tuberculosis is Mycobacterium tuberculosis, which is known to have a period of latency between the initial infection and the clinical manifestation. The most common localization is pulmonary, but it can affect, secondarily, other organs, especially in the ENT regions, mimicking other systemic diseases.

MATERIAL AND METHODS. We are presenting a case of a 51-year-old female patient, who was referred to our ENT Clinic with the suspicion of Behcet’s disease with rhinosinusal manifestations. She had a pulmonary assessment in another hospital, as she was known with left lung bronchiectasis, but the sputum samples were negative. The clinical otorhinolaryngologic examination together with the rheumato-logical assessment and the result of the nasal mucosa biopsy were suggestive for Behcet’s disease and the patient received 6 weeks of Prednisolone. The specific immunologic tests (cANCA, pANCA, HLA B51) were negative. The patient returned to our clinic after 2 months, accusing symptomatology reacutization with right otorrhea and bilateral hearing loss aggravation. Nasal and rhinopharyngeal mucosa biopsies were repeated and the anatomopathological result was specific for tuberculosis.

RESULTS. She was referred to the Pneumology Service where she received the diagnosis of pulmonary tuberculosis with rhinosinusal and otic manifestations. Currently, the patient is under tuberculostatic treatment.

CONCLUSION. Extrapulmonary tuberculosis symptoms might be confused with other systemic diseases with rhinosinusal manifestations. Thorough examination and multidisciplinary approach are mandatory in order to establish a correct diagnosis followed by an appropriate treatment.

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