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ARTERIOSCLEROSIS.ATEROESCLEROSIS SENIOR

Someone said " I have the old have my arteries "

The atherosclerosis, the main cause of atherosclerosis, is associated with cardiovascular disease more prevalent.

Its frequency is increasing by the aging population and changes in habits of life (diet, stress, ..)

vascular endothelial injury and subsequent deposition of substances and cells give rise to the plaque that causes narrowing of the lumen.

risk factors such as hypertension , excess blood lipids, smoking, diabetes mellitus, obesity and others, along with factors genetic, contribute to the development of atherosclerosis.

The clinical manifestations are caused by decreased blood flow to the affected organ or organs, brain, heart, aorta, aneurysm, kidney, and lower extremities. Treatment depends on the location and severity of injuries, prevention remains the best treatment.

The diagnosis is made with the history and additional tests using mainly ultrasound and arteriography. Plain radiography may show vascular changes that indicate the presence of atherosclerosis, but is not a test done for that purpose.

Images exposed under a 93 year old male who suffered a trauma to the left thigh region, where, besides degenerative bone lesions, severe calcification was seen iliac artery, femoral and popliteal atherosclerosis.

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olecranon fracture

91 year old woman suffering a fall by imbalance and right elbow hits the ground.
has elbow pain and swollen, edematous, swollen, retaining the flexion-extension and supination. There is pain and crepitus when palpating the back of the elbow.
The image shows the fracture line, transverse, in olecranon without displacement (type I). We proceed to semiflexion elbow immobilization with plaster, in the coming weeks.
Such fractures are more common in young adults and often tend to be displaced fragments. (Picture taken with mobile phone)

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ADVERSE REACTIONS TO DRUGS IN ELDERLY WITH CLOPIDOGREL

Two recent articles bearing on the importance of this issue in the elderly:

preevención Recommendations on adverse drug reactions in older people with dementia. J.Gómez-Pavón et al. in English Journal of Geriatrics and Gerontology. 2010, 45 (2) :89-96
The authors, on behalf of the Working Group and Iatrogenic Drugs and Dementia Group of the English Society of Geriatrics and Gerontology and focused on the importance of polypharmacy, give us a series of recommendations for the use of drugs in the patient with dementia, with or without associated behavioral disorders, with an algorithm to manage these symptoms.

In another article, adverse drug events in hospitalized patients in internal medicine. A.Zapatero-Gaviria et al, RevClinEsp.2010.doi: 10.1016/j.rce.2009.12.010 , study 1,567,659 done on diagnoses, coded according to ICD-9 hospital discharge of internal medicine in the hospitals of the national health system, more adverse reactions observed in the elderly, mean age 72'28 and in women . The incidence of adverse reactions in this study is 5'55%, which the authors consider lower than expected by the underreporting of these adverse events in the discharge report.

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INTERACTION INHIBITORS PROTON PUMP

Third note on this blog on the subject, this my friend sent me the pharmacist Pantxo Mariscal.

New data confirm that omeprazole may reduce levels of active metabolite of clopidogrel and reduce antiplatelet effect, the English Agency for Medicines and Medical Devices (Competent Authority) recommends that health professionals:

• In patients treated with clopidogrel is not recommended the concomitant use of omeprazole or esomeprazole, unless deemed absolutely necessary. In the latter case, space is not recommended at the time the administration of both drugs, and it does not prevent the interaction between them.

• These recommendations do not currently apply to other PPIs, but not be completely ruled out the interaction, the available evidence does not support this caution. In any case, it is recommended to individually evaluate the need for treatment IBP in patients treated with clopidogrel and the benefits expected of it in relation to their potential risks.

· We advise against concomitant use of clopidogrel with other inhibitors of CYP2C19 than omeprazole or esomeprazole, such as fluvoxamine, fluoxetine, moclobemide, voriconazole, fluconazole, ticlopidine, ciprofloxacin, cimetidine, carbamazepine, oxcarbazepine and chloramphenicol, but it is considered strictly necessary. Read more