PSYCHOBEHAVIORAL DISORDERS, ORTHOSTATIC HYPOTENSION, AND FALLS RELATED TO A PHEOCHROMOCYTOMA IN A VERY ELDERLY SUBJECT: A CASE REPORT

''A case of meningitis due to Achromobacter xylosoxidans denitrificans 60 years after a cranial trauma''

International audience; ''Background: Achromobacter xylosoxidans (AX) is a non-fermentative aerobic Gram-negative bacillus. It is an opportunistic pathogen and the causative agent of various infections. We report an original case of late posttraumatic meningitis due to AX denitrificans. Case Report: An 83-year-old man was hospitalized for acute headache, nausea and vomiting. The emergency brain computer tomography (CT) scan did not reveal any anomaly. In his medical history, there was an auditory injury due to a cranial trauma incurred in a skiing accident 60 years earlier. Cytobiochemical analysis of the cerebrospinal fluid (CSF) revealed increased levels of neutrophils and proteins. The C…

Faut-il réaliser un « Mini-Mental State Examination » chez tout sujet âgé hypertendu ?

Hypertension constitutes a recognized risk factor of vascular dementia but also of Alzheimer-type dementia. Various longitudinal studies showed that midlife blood pressure level is one of the factors conditioning the onset of dementia syndrome in late life. The high risk of dementia is linked to leukoaraiosis, vascular rigidity, microcirculation disorders, oxidative stress, blood pressure fluctuations including orthostatic hypotension and strokes, all of those being associated with hypertension. Numerous clinical trials showed the positive effect of effective treatment of hypertension on the prevention of cognitive disorders and dementias. Thus, screening and early management of dementia an…

Potentially inappropriate use of furosemide in a very elderly population: An observational study

International audience; ObjectiveLittle is known about furosemide prescription modalities in elderly people. We describe furosemide prescription in ambulatory elderly patients.MethodsAll patients aged over 80 years, affiliated to Mutualité Sociale Agricole de Bourgogne, a French regional health insurance plan, with a medical prescription delivered in March 2015, were retrospectively included.ResultsAmong 15 141 patients with a median age of 86 years, comprising 61.3% of women, 3937 patients (26%) had a prescription for furosemide. Severe heart failure was the most common chronic comorbidity (27.7%). Furosemide was considered a long-term therapy for almost all patients (98.7% with prescripti…

Décompensation cardiorespiratoire au cours d’une polyarthrite rhumatoïde

Rheumatoid arthritis (RA) may include rare extra-articular manifestations, and particularly cardiopulmonary involvement. We report a 83-year-old woman, with RA, who presented with both pulmonary and heart failures that were related to the RA, resulting from the presence of mediastinal and axillary lymph nodes, and pleural and pericardial effusions. This was confirmed by the dramatic improvement after a specific treatment of RA.