Case Report
Gastric Antral Vascular Ectasia (“Watermelon Stomach”) as a Cause of Chronic Gastrointestinal Bleeding (Full title below)
Gastric Antral Vascular Ectasia (“Watermelon Stomach”) as a Cause of Chronic Gastrointestinal Bleeding in an Elderly Bedridden Patient
Introduction
Clinical Considerations for Antipsychotic Use in Elderly Patients with Schizophrenia: A Case Series
Treating elderly persons with schizophrenia poses several challenges for clinicians. Antipsychotic side-effect profiles, medical conditions, physiologic effects of aging, and government regulations can complicate the clinical scenario. Important guidelines for use of antipsychotics in the elderly population include starting at low doses and increasing slowly, checking basic laboratory studies periodically and doing routine physical examinations, and weighing the risks versus benefits of discontinuing treatment with an antipsychotic medication.
The Aging Patient with Chronic Schizophrenia
Schizophrenia is a disease marked by delusions, hallucinations, and disordered thinking. Currently, the overall worldwide prevalence of schizophrenia is 1%, with two-thirds of cases becoming chronic. As more people survive into their later years, the number of people over age 65 years with schizophrenia is likely to increase.
Ciprofloxacin-Induced Mania in an Elderly Male
Author Affiliations: Dr. Sohn is Associate Director, Sepulveda VA Nursing Home Care Unit, VA Greater Los Angeles Health Care System, and Assistant Clinical Professor, UCLA School of Medicine/Geriatrics, CA.
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Ciprofloxacin is a broad-spectrum fluoroquinolone antibiotic. The newer drugs in this class differ from earlier agents with increased potency, broader spectrum of antibacterial activity, and pharmacokinetics that permit treatment of systemic bacterial infections. The fluoroquinolone antibiotics have a relatively benign side-effect profile, but there
The Effectiveness of an Environmental and Behavioral Approach to Treating Behavior Problems
Author Affiliations:
Dr. Huh is Associate Director of Education and Evaluation at the VA Palo Alto Health Care System, Geriatric Research, Education, and Clinical Center; Dr. Areán is Associate Professor, Dr. Bornfeld is Staff Psychologist, and Dr. Elite-Marcandonatou is Staff Therapist at the Department of Psychiatry, University
of California, San Francisco.
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In a Patient with Dementia with Lewy Bodies
Introduction and Background
Dementia with Lewy bodies (DLB) is considered the second most prevalent dementia after Alzheime
Osteonecrosis of the Mandible in a Nursing Home Resident Receiving Bisphosphonate Therapy
Case Presentation
Brief History
Mrs. O is a 71-year-old female resident of a long-term care (LTC) facility who presented in January 2007 with the chief complaint of “swelling below her chin.” The patient had been complaining of pain in her gums for several weeks. She had only two teeth remaining in her lower mandible. Given her risk factors for osteonecrosis of the jaw, she had been referred for dental evaluation a few weeks previously. A full examination and an orthopantography revealed no bone abnormalities. Her dentures were found to be ill-fitting, and recommendations
Clozapine-Induced Hypothermia in an Elderly Female
Introduction
Hypothermia is defined as a core temperature below 35 degrees C (95 degrees F), and can be further classified by severity1 (Table I). Fever is the most commonly encountered disorder of thermoregulation; however, hypothermia was the reported cause of death of 16,655 persons in the United States between 1979 and 2002 (average, 689 persons/yr). Nearly one-half of these deaths involved patients older than age 65 years, with an overall male-to-female ratio of 2.5:1.2,3 In addition, researchers have speculated that hypothermia could explain some of the unexpected sudden deaths
Neuroleptic Malignant Syndrome in a Skilled Nursing Facility Resident
A case of neuroleptic malignant syndrome (NMS) in a nursing facility resident that was initially misdiagnosed as a urinary tract infection is presented. The author reviews the etiology and diagnosis of NMS, including the differential diagnosis, and discusses how other syndromes can generate similar symptoms.
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The Case
Mrs. F is a 64-year-old female resident in a skilled nursing facility (SNF) with a history of early-onset dementia of the Alzheimer’s type, who was noted by staff at the facility to be more confused and restless. The patient developed a fever with
Ephedrine Abuse in a Patient with Dementia
Introduction
Alcohol and drug dependence are two of the leading causes of disability in the world.1 However, the full extent of substance abuse in older patients is unknown.2 Despite the common occurrence and disability associated with substance use in older adults, these problems often go undiagnosed in this population.3 There is a myth fueled by age-related bias that substance use disorders occur in young and middle-aged adults but not in the elderly.4 As the number of older adults increases, the scope of mental health problems—including substance abuse—will increase.5 As elderly pers
Long-Term Care for the Stroke Patient in Family Home Care
Stroke patients are the largest patient population receiving long-term care, and their number is steadily increasing worldwide. Management of the care for these patients in their own homes could contribute to substantial Medicare savings. It seems necessary to investigate the various aspects of long-term care provided by the patients’ families, especially doctor-family cooperation.
The objective of this case report is to describe how doctor-family cooperation in long-term care for a patient with hemorrhagic stroke can deal with medical complications in accord with bioethical principles,
Springfield , Massachusetts
Anytown, Alabama
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