Platypnea-Orthodeoxia Syndrome Masked by Delirium in an 85-Year-Old Woman

On February 3, 2016, an 85-year-old woman was brought to the emergency department (ED) because of mental confusion and intolerance of the sitting position, which had begun suddenly 2 days before. She had been wheelchair-bound for the past 9 years after a stroke that had left her with mild left-sided hemiparesis but without cognitive impairment. According to her medical records at the ED, she was initially found hypoxemic (SO2  = 75% in room air) and disoriented. She was diagnosed with pneumonia, and because there was major improvement regarding her oxygenation after hydration (SO2 = 94% in room air), she was discharged home with a prescription of oral amoxicillin-clavulanate.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Tags: Letter to the Editor Source Type: research

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I tried to kill my father for years. To be fair, I was following his wishes. He’d made it clear that when he no longer recognized me, when he could no longer talk, when the nurses started treating him like a toddler, he didn’t want to live any longer. My father was 58 years old when he was diagnosed with Alzheimer’s disease. He took the diagnosis with the self-deprecating humor he’d spent a lifetime cultivating, constantly cracking jokes about how he would one day turn into a zombie, a walking corpse. We had a good 10 years with him after the diagnosis. Eventually, his jokes came true. Seven years ...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Alzheimer's Disease Source Type: news
DiscussionNo systematic review has attempted to summarise the evidence for oropharyngeal dysphagia interventions in acute and critical care. Results of the proposed systematic review will inform practice and the design of future clinical trials.Systematic review registrationPROSPERO CRD 42018116849 (http://www.crd.york.ac.uk/PROSPERO/)
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research
ConclusionBoth neurologic and medical complications were common in majority of stroke patients. But the management protocol for stroke patients was sub-optimal and lagging behind the recommended guidelines due to lack of skilled personnel, appropriate treatment and diagnostic agents. The clinical team involved in the care of stroke patients should make preparations to take preventive measures that will save a lot of lives.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
AbstractBackgroundDespite the tremendous impact of swallowing disorders on outcome following ischemic stroke, little is known about the incidence of dysphagia after subarachnoid hemorrhage (SAH) and its contribution to hospital complications, length of intensive care unit stay, and functional outcome.MethodsThis is a retrospective analysis of an ongoing prospective cohort study. Swallowing ability was assessed in consecutive non-traumatic SAH patients admitted to our neurological intensive care unit using the Bogenhausen Dysphagia Score (BODS). A BODS  >  2 points indicated dysphagia. Functional outcome wa...
Source: Neurocritical Care - Category: Neurology Source Type: research
Publication date: Available online 13 November 2019Source: Clinica Chimica ActaAuthor(s): Julia Oto, Álvaro Fernández-Pardo, Manuel Miralles, Emma Plana, Francisco España, Silvia Navarro, Pilar MedinaAbstractActivated protein C (APC) acts as an “on demand” anticoagulant, reducing thrombin formation. Reduced plasma levels of APC or protein C (PC) are associated with an increased risk of venous thromboembolism. APC also displays cytoprotective functions and its therapeutic use has been evaluated in severe sepsis and is under evaluation in several diseases with an important inflammatory compon...
Source: Clinica Chimica Acta - Category: Laboratory Medicine Source Type: research
CONCLUSIONS: A comprehensive therapy for dysphagia is effective and can reduce serious complications of swallowing disorders in clinical practice. CLINICAL IMPLICATIONS: The results of this study could improve the clinical treatment of dysphagia. PMID: 31724147 [PubMed - as supplied by publisher]
Source: Neurologia i Neurochirurgia Polska - Category: Neurology Authors: Tags: Neurol Neurochir Pol Source Type: research
In conclusion, preoperative use of mammography was strongly associated with fewer perioperative complications and less in-hospital mortality after major surgeries. The evidence provided by this study justifies the implementation of preoperative health checks in clinical practice.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
varro S, Medina P Abstract Activated protein C (APC) acts as an "on demand" anticoagulant, reducing thrombin formation. Reduced plasma levels of APC or protein C (PC) are associated with an increased risk of venous thromboembolism. APC also displays cytoprotective functions and its therapeutic use has been evaluated in severe sepsis and is under evaluation in several diseases with an important inflammatory component. In addition, different studies have revealed a potential role of PC/APC in disorders such as obesity, pneumonia, disseminated intravascular coagulation, Alzheimer, stroke, etc. Accordingly, ...
Source: International Journal of Clinical Chemistry - Category: Chemistry Authors: Tags: Clin Chim Acta Source Type: research
Source: Clinical Interventions in Aging - Category: Geriatrics Tags: Clinical Interventions in Aging Source Type: research
Abstract Hypoxia reoxygenation (HR) injury perturbs structural and functional syncytium in lung tissues. It is commonly implicated in conditions such as stroke, lung transplant or severe pneumonia. In the present study, we investigated the cytoprotective action of 20-hydroxyeicosatetraenoic acid (20-HETE) on pulmonary vascular endothelial cells (PMVECs) under normoxic and hypoxic niche followed by HR. 20-HETE pretreatment showed a protective effect at a concentration of 1μM as there was a marked increase (20%) in the cell viability compared to control and HR groups. Pretreatment of 20-HETE in HR induced injury ...
Source: Acta Histochemica - Category: Biochemistry Authors: Tags: Acta Histochem Source Type: research
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