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Year-old Patient (year-old + patient)

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Selected Abstracts

Strain persistence of invasive Candida albicans in chronic hyperplastic candidosis that underwent malignant change

GERODONTOLOGY, Issue 2 2001
DW Williams
Abstract Objectives: The aim of this study was to assess persistence and tissue invasion of Candida albicans strains isolated from a 65 year-old patient with chronic hyperplastic candidosis (CHC), that subsequently developed into squamous cell carcinoma (SCC). Materials and Methods: C. albicans (n=7) were recovered from the oral cavity of the patient over seven years. Confirmation of CHC and SCC in this patient was achieved by histopathological examination of incisional biopsy tissue. DNA fingerprinting was performed on the seven isolates from the CHC patient together with a further eight isolates from patients with normal oral mucosa (n=2), chronic atrophic candidosis (n=1), SCC (n=1) and CHC (n=4). Genotyping involved the use of inter-repeat PCR using the eukaryotic repeat primer 1251. Characterisation of the tissue invasive abilities of the isolates was achieved by infecting a commercially available reconstituted human oral epithelium (RHE; SkinEthic, Nice, France). After 24 h. C. albicans tissue invasion was assessed by histopathological examination. Results: DNA fingerprinting demonstrated strain persistence of C. albicans in the CHC patient over a seven year period despite provision of systemic antifungal therapy. The strain of C. albicans isolated from this patient was categorised as a high invader within the RHE compared to other isolates. Conclusions: Candidal strain persistence was evident in a patient with CHC over seven years. This persistence may be due to incomplete eradication from the oral cavity following antifungal therapy or subsequent recolonisation from other body sites or separate exogenous sources. The demonstration of enhanced in vitro tissue invasion by this particular strain may, in part, explain the progression to carcinoma. [source]

Distribution of amyloid and BIG-H3 in the cornea and limbus of a patient with lattice corneal dystrophy.

ACTA OPHTHALMOLOGICA, Issue 2009
Unique findings in donated eyes
Purpose The lattice corneal dystrophies (LCDs) are hereditary diseases involving the formation of opaque or refractile, amyloid-containing filaments in the corneal stroma. We report the distribution of amyloid and big-h3 protein in cornea and limbus in a patient suffering with LCD. Methods An 84 year-old patient with lattice corneal dystrophy died and donated her eyes for further study. The corneal and limbal tissue of the patient processed for light and electron microscopy. The primary polyclonal antibody big-h3 was located by secondary, goat anti-rabbit antibody conjugated with gold. Results In cornea amyloid deposits were observed below epithelium, and in the anterior and middle stroma. The epithelium was thin and invaginated by the amyloid deposits. In the limbus, large numbers of amyloid deposits were observed in sub-epithelial region, and in the mid and deep stroma. Subepithelial amyloid was also present in the substantia propria beneath the bulbar conjunctival epithelium. The amyloid deposits contained very thin amyloid fibrils and strongly stained with big-h3 antibody. There were also numerous long spacing collagen fibrils observed in the mid stroma, which also labelled with the antibody. Conclusion This is the first report of structural changes in the peripheral cornea and limbus in LCD. It is thought that mutated big-h3 protein diffuse into the stroma from the corneal epithelium to form amyloid deposits. The presence of amyloid and big-h3 at the limbus and in the adjacent bulbar conjunctiva and perilimbal cornea, suggests that Big-h3 is overproduced in these regions, which are normally free from clinically detectable disease. [source]

Prevalence of vision, hearing, and combined vision and hearing impairments in patients with hip fractures

JOURNAL OF CLINICAL NURSING, Issue 21 2009
Else Vengnes Grue
Aims and objectives., To examine the prevalence of hearing and vision impairments in 65+ year-old patients with hip fractures. Background., Many older people believe sensory problems are inevitable and thus avoid medical assessment and assistance. Furthermore, health professionals often overlook sensory problems, though it is known that sensory impairments can increase the risk of falling and sustaining hip fractures. Design., A prospective, observational study. Methods., We admitted 544 consecutive patients to an orthogeriatric ward from October 2004,July 2006; 332 were screened for study inclusion with the Resident Assessment Instrument for Acute Care (InterRAI-AC) and a questionnaire (KAS-Screen). We conducted patient interviews, objective assessments, explored hospital records and interviewed the family and staff. Impairments were defined as problems with seeing, reading regular print or hearing normal speech. Results., Sixteen per cent of the patients had no sensory impairments, 15·4% had vision impairments, 38·6% had hearing impairments and 30·1% had combined sensory impairments. Among the impaired, 80·6% were female, the mean age was 84·3 years (SD 6·8), 79·9% were living alone, 48·0% had cognitive impairments, 89·6% had impaired activities of daily living, 70·6% had impaired instrument activities in daily living, 51·0% had bladder incontinence and 26·.8% were underweight. Comorbidity and polypharmacy were common. Delirium was detected in 17·9% on day three after surgery. Results showed the prevalence of combined sensory impairments was: 32·8% none; 52·2% moderate/severe; and 15·1% severe. Conclusion., Patients with hip fractures frequently have hearing, vision and combined impairments. Relevance to clinical practice., We recommend routine screening for sensory impairments in patients with hip fractures. Most sensory problems can be treated or relieved with environmental adjustments. Patients should be encouraged to seek treatment and training for adapting to sensory deficiencies. This approach may reduce the number of falls and improve the ability to sustain independent living. [source]

Multiple organ failure and severe bone marrow dysfunction in two 18 year-old Caucasian patients: Epstein,Barr virus and the haemophagocytic syndrome

ANAESTHESIA, Issue 11 2008
P. A. Berry
Summary Haemophagocytic lymphohistiocytosis secondary to viral infection is an unusual but well recognised cause of bone marrow dysfunction and multiple organ failure in young patients. Two 18 year-old patients were admitted to a tertiary liver unit with features of acute liver failure, cardio-respiratory collapse and pancytopenia. Serological tests and bone marrow examination with in-situ hybridisation revealed severe acquired haemophagocytic lymphohistiocytosis secondary to acute Epstein,Barr virus infection. Both patients died despite full supportive therapy; the first due to pulmonary haemorrhage, the second due to acute respiratory distress syndrome refractory to high frequency oscillatory ventilation. The clinical spectrum, diagnostic features and current evidence based recommendations for treatment of this condition are explored. The diagnosis of haemophagocytic lymphohistiocytosis should be considered in young patients with marked bone marrow dysfunction and multiple organ failure. Further research into appropriate therapy for patients with acute severe forms of the disease who require intensive organ support is required. [source]