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Verhoeff M, Snijders BMG, de Winter-de Vries S, Roos MJ, Keijsers CJPW, van Deudekom FJA. [Hypothermia in elderly patients]. Ned Tijdschr Geneeskd 2023; 167:D7923. [PMID: 38175569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Hypothermia in older patients is a serious symptom, with high morbidity and mortality, and often an atypical presentation of an underlying problem. The most common causes are an infection and exposure to extreme cold ('accidental hypothermia'), but there are other, less common causes. These two cases show hypothermia as one of the symptoms in atypical presentations of underlying conditions. It is important to run diagnostics for infectious diseases and other underlying causes, and start antibiotics promptly. If there is no response to antibiotics and diagnostics do not reveal evidence of an infection, clinicians need to consider other causes of hypothermia.
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van Deudekom FJA, Knapen MC, Frenkel N, van de Vorst IE, de Regt MJA. [HIV as a new diagnose in older patients]. Ned Tijdschr Geneeskd 2023; 167:D7684. [PMID: 37930163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
We describe two patients diagnosed with an HIV-1 infection at an older age. In this article we emphasize the importance of knowledge of HIV indicator diseases and keeping a low threshold for HIV-testing.
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Affiliation(s)
| | - Maria C Knapen
- OLVG, locatie Oost en West, Amsterdam. Afd. Interne Geneeskunde
| | - Nanne Frenkel
- OLVG, locatie Oost en West, Amsterdam. Afd. Interne Geneeskunde
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Minnema J, Tap L, van der Bol JM, van Deudekom FJA, Faes MC, Jansen SWM, van der Linden CMJ, Lucke JA, Mooijaart SP, van Munster B, Noordam R, van Raaij BFM, Ruiter R, Smits RAL, Willems HC, Mattace-Raso FUS, Polinder-Bos HA. Delirium in older patients with COVID-19: Prevalence, risk factors and clinical outcomes across the first three waves of the pandemic. Int J Geriatr Psychiatry 2023; 38:e6024. [PMID: 37909117 DOI: 10.1002/gps.6024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVES Delirium is a serious condition, which poses treatment challenges during hospitalisation for COVID-19. Improvements in testing, vaccination and treatment might have changed patient characteristics and outcomes through the pandemic. We evaluated whether the prevalence and risk factors for delirium, and the association of delirium with in-hospital mortality changed through the pandemic. METHODS This study was part of the COVID-OLD study in 19 Dutch hospitals including patients ≥70 years in the first (spring 2020), second (autumn 2020) and third wave (autumn 2021). Multivariable logistic regression models were used to study risk factors for delirium, and in-hospital mortality. Differences in effect sizes between waves were studied by including interaction terms between wave and risk factor in logistic regression models. RESULTS 1540, 884 and 370 patients were included in the first, second and third wave, respectively. Prevalence of delirium in the third wave (12.7%) was significantly lower compared to the first (22.5%) and second wave (23.5%). In multivariable-adjusted analyses, pre-existing memory problems was a consistent risk factor for delirium across waves. Previous delirium was a risk factor for delirium in the first wave (OR 4.02), but not in the second (OR 1.61) and third wave (OR 2.59, p-value interaction-term 0.028). In multivariable-adjusted analyses, delirium was not associated with in-hospital mortality in all waves. CONCLUSION Delirium prevalence declined in the third wave, which might be the result of vaccination and improved treatment strategies. Risk factors for delirium remained consistent across waves, although some attenuation was seen in the second wave.
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Affiliation(s)
- Julia Minnema
- Division of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Lisanne Tap
- Division of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | | | | | - Miriam C Faes
- Department of Geriatrics, Amphia Hospital, Breda, The Netherlands
| | - Steffy W M Jansen
- Department of Geriatrics, Catharina Hospital, Eindhoven, the Netherlands
| | | | - Jacinta A Lucke
- Department of Emergency Medicine, Spaarne Gasthuis, Haarlem, The Netherlands
| | - Simon P Mooijaart
- Department of Internal Medicine, Section of Geriatrics and Gerontology, Leiden University Medical Centre, Leiden, The Netherlands
- LUMC Center of Medicine for Older People, Leiden University Medical Centre, Leiden, The Netherlands
| | - Barbara van Munster
- Department of Internal Medicine and Geriatrics, University Medical Centre Groningen, Groningen, The Netherlands
| | - Raymond Noordam
- Department of Internal Medicine, Section of Geriatrics and Gerontology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Bas F M van Raaij
- Department of Internal Medicine, Section of Geriatrics and Gerontology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Rikje Ruiter
- Department of Internal Medicine, Maasstad Ziekenhuis, Rotterdam, The Netherlands
| | - Rosalinde A L Smits
- Department of Internal Medicine, Section of Geriatrics and Gerontology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Hanna C Willems
- Department of Internal Medicine and Geriatrics, AmsterdamUMC, Amsterdam, The Netherlands
| | - Francesco U S Mattace-Raso
- Division of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Harmke A Polinder-Bos
- Division of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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van Deudekom FJA, Rauwerdink A, Westendorp VS. [A spherical abnormality on a chest X-ray]. Ned Tijdschr Geneeskd 2023; 167:D7757. [PMID: 37823875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
A 80-year-old man had spherical abnormality on radiography of the chest. The differential diagnosis includes a tumor, hernia of Morgagni or a pericardial diverticulum. CT-scan demonstrated a pericardial cyst with a diameter of 13 cm. Pericardial cysts are rare and are commonly located at the right cardiophrenic angle.
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van Eijk E, van der Spek YM, van Deudekom FJA, van den Bos F, Mooijaart SP, Trompet S. Temporal changes in characteristics and external validity of randomized controlled trials in older people from 2012 to 2019. BMC Geriatr 2023; 23:324. [PMID: 37226093 DOI: 10.1186/s12877-023-04018-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/04/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Older individuals are often underrepresented in clinical trials. In 2012 only 7% of RCT's specifically studied older people and their geriatric characteristics were poorly reported. The aim of this review was to investigate temporal changes in characteristics and external validity of randomized controlled trials in older people from 2012 to 2019. METHODS PubMed was searched for randomized clinical trials (RCTs) published in 2019. Firstly, the proportion of RCTs specially designed for older people were determined by the following criteria: a reported mean age of ≥ 70 years or a lower age cutoff of ≥ 55. Secondly, the trials with a majority of older people, defined by a reported mean age of ≥ 60 years, were screened for reporting of geriatric assessments. Both parts were compared with identical reviews performed in 2012. RESULTS From a 10% random sample, 1446 RCTs were included in this systematic review. First, 8% of trials were specifically designed for older people in 2019 compared to 7% in 2012. Secondly, 25% of the trials included a majority of older people in 2019, compared to 22% in 2012. Thirdly, in 52% of these trials in 2019 one or more of the geriatric assessments were reported compared to 34% in 2012. CONCLUSIONS Although in 2019 the proportion of published RCTs specifically designed for older people remains low, more characteristics on geriatric assessments were reported compared to 2012. Continued efforts should be paid to increase both the number and the validity of trials for older people.
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Affiliation(s)
- Estelle van Eijk
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | - Yanna M van der Spek
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | | | - Frederiek van den Bos
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | - Simon P Mooijaart
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
- LUMC Center for Medicine for Older People, Leiden, The Netherlands
| | - Stella Trompet
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands.
- LUMC Center for Medicine for Older People, Leiden, The Netherlands.
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6
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Smits RAL, Trompet S, van der Linden CMJ, van der Bol JM, Jansen SWM, Polinder-Bos HA, Willems HC, Barten DG, Blomaard LC, de Boer MGJ, van Deudekom FJA, Ellerbroek JLJ, Festen J, van de Glind EMM, Kampschreur LM, Karimi O, Kroon B, van Lanen MGJA, Lucke JA, Maas HAAM, Mattace-Raso FUS, van Munster BC, Reijerse L, Robben SHM, Ruiter R, Schouten HJ, Spies PE, Wassenburg A, Wijngaarden MA, Mooijaart SP. Characteristics and outcomes of older patients hospitalised for COVID-19 in the first and second wave of the pandemic in The Netherlands: the COVID-OLD study. Age Ageing 2022; 51:6540140. [PMID: 35235650 PMCID: PMC8890695 DOI: 10.1093/ageing/afac048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Indexed: 12/15/2022] Open
Abstract
Background as the coronavirus disease of 2019 (COVID-19) pandemic progressed diagnostics and treatment changed. Objective to investigate differences in characteristics, disease presentation and outcomes of older hospitalised COVID-19 patients between the first and second pandemic wave in The Netherlands. Methods this was a multicentre retrospective cohort study in 16 hospitals in The Netherlands including patients aged ≥ 70 years, hospitalised for COVID-19 in Spring 2020 (first wave) and Autumn 2020 (second wave). Data included Charlson comorbidity index (CCI), disease severity and Clinical Frailty Scale (CFS). Main outcome was in-hospital mortality. Results a total of 1,376 patients in the first wave (median age 78 years, 60% male) and 946 patients in the second wave (median age 79 years, 61% male) were included. There was no relevant difference in presence of comorbidity (median CCI 2) or frailty (median CFS 4). Patients in the second wave were admitted earlier in the disease course (median 6 versus 7 symptomatic days; P < 0.001). In-hospital mortality was lower in the second wave (38.1% first wave versus 27.0% second wave; P < 0.001). Mortality risk was 40% lower in the second wave compared with the first wave (95% confidence interval: 28–51%) after adjustment for differences in patient characteristics, comorbidity, symptomatic days until admission, disease severity and frailty. Conclusions compared with older patients hospitalised in the first COVID-19 wave, patients in the second wave had lower in-hospital mortality, independent of risk factors for mortality. The better prognosis likely reflects earlier diagnosis, the effect of improvement in treatment and is relevant for future guidelines and treatment decisions.
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Affiliation(s)
- Rosalinde A L Smits
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands
- Address correspondence to: Rosalinde A. L. Smits, Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2 2333 ZA Leiden. Tel: 071-5261850; Fax: 071-5266881.
| | - Stella Trompet
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands
| | | | | | - Steffy W M Jansen
- Department of Geriatrics, Catharina Hospital, Eindhoven, The Netherlands
| | - Harmke A Polinder-Bos
- Department of Internal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Hanna C Willems
- Section Geriatrics, Department of Internal Medicine, Amsterdam University Medical Centre, Location AMC, Amsterdam, The Netherlands
| | - Dennis G Barten
- Department of Emergency Medicine, VieCuri Medical Centre, Venlo, The Netherlands
| | - Laura C Blomaard
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mark G J de Boer
- Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
| | - Floor J A van Deudekom
- Department of Internal Medicine and Geriatrics, OLVG Hospital, Amsterdam, The Netherlands
| | | | | | | | - Linda M Kampschreur
- Department of Internal Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Ouafae Karimi
- Department of Geriatric Medicine, St Jansdal Hospital, Harderwijk, The Netherlands
| | - Bart Kroon
- Department of Internal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Marc G J A van Lanen
- Department of Pulmonary Medicine, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Jacinta A Lucke
- Department of Emergency Medicine, Spaarne Hospital, Haarlem, The Netherlands
| | - Huub A A M Maas
- Department of Geriatric Medicine, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Francesco U S Mattace-Raso
- Section Geriatrics, Department of Internal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Barbara C van Munster
- Department of Internal Medicine and Geriatrics, University Medical Centre Groningen, Groningen, The Netherlands
| | - Lisette Reijerse
- Department of Emergency Medicine, VieCuri Medical Centre, Venlo, The Netherlands
| | - Sarah H M Robben
- Department of Geriatric Medicine, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Rikje Ruiter
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - Henrike J Schouten
- Department of Geriatric Medicine and Centre of Excellence for Old Age Medicine, Gelre Hospitals, Apeldoorn and Zutphen, The Netherlands
| | - Petra E Spies
- Geriatrician and Clinical Pharmacologist, Department of Geriatric Medicine and Centre of Excellence for Old Age Medicine Gelre Hospitals, Apeldoorn & Zutphen, The Netherlands
| | - Anna Wassenburg
- Department of Internal Medicine, Alrijne Hospital, Leiderdorp, The Netherlands
| | - Marjolein A Wijngaarden
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands
| | - Simon P Mooijaart
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands
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7
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Blomaard LC, van der Linden CMJ, van der Bol JM, Jansen SWM, Polinder-Bos HA, Willems HC, Festen J, Barten DG, Borgers AJ, Bos JC, van den Bos F, de Brouwer EJM, van Deudekom FJA, van Dijk SC, Emmelot-Vonk MH, Geels RES, van de Glind EMM, de Groot B, Hempenius L, Kamper AM, Kampschreur LM, de Koning MMM, Labots G, Looman R, Lucke JA, Maas HAAM, Mattace-Raso FUS, el Moussaoui R, van Munster BC, van Nieuwkoop C, Oosterwijk L(BLE, Regtuijt M(EM, Robben SHM, Ruiter R, Salarbaks AM, Schouten HJ, Smit OM, Smits RAL, Spies PE, Vreeswijk R, de Vries OJ, Wijngaarden MA, Wyers CE, Mooijaart SP. Frailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands: the COVID-OLD study. Age Ageing 2021; 50:631-640. [PMID: 33951156 PMCID: PMC7929372 DOI: 10.1093/ageing/afab018] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Indexed: 01/04/2023] Open
Abstract
Background During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, older patients had an increased risk of hospitalisation and death. Reports on the association of frailty with poor outcome have been conflicting. Objective The aim of the present study was to investigate the independent association between frailty and in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands. Methods This was a multicentre retrospective cohort study in 15 hospitals in the Netherlands, including all patients aged ≥70 years, who were hospitalised with clinically confirmed COVID-19 between February and May 2020. Data were collected on demographics, co-morbidity, disease severity and Clinical Frailty Scale (CFS). Primary outcome was in-hospital mortality. Results A total of 1,376 patients were included (median age 78 years (interquartile range 74–84), 60% male). In total, 499 (38%) patients died during hospital admission. Parameters indicating presence of frailty (CFS 6–9) were associated with more co-morbidities, shorter symptom duration upon presentation (median 4 versus 7 days), lower oxygen demand and lower levels of C-reactive protein. In multivariable analyses, the CFS was independently associated with in-hospital mortality: compared with patients with CFS 1–3, patients with CFS 4–5 had a two times higher risk (odds ratio (OR) 2.0 (95% confidence interval (CI) 1.3–3.0)) and patients with CFS 6–9 had a three times higher risk of in-hospital mortality (OR 2.8 (95% CI 1.8–4.3)). Conclusions The in-hospital mortality of older hospitalised COVID-19 patients in the Netherlands was 38%. Frailty was independently associated with higher in-hospital mortality, even though COVID-19 patients with frailty presented earlier to the hospital with less severe symptoms.
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Affiliation(s)
- Laura C Blomaard
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | | | | | - Steffy W M Jansen
- Department of Geriatrics, Catharina Hospital, Eindhoven, the Netherlands
| | - Harmke A Polinder-Bos
- Section Geriatrics, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Hanna C Willems
- Section Geriatrics, Department of Internal Medicine, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands
| | | | - Dennis G Barten
- Department of Emergency Medicine, VieCuri Medical Center, Venlo, the Netherlands
| | - Anke J Borgers
- Department of Geriatrics, Deventer Hospital, Deventer, the Netherlands
| | - Jeannet C Bos
- Department of Internal Medicine, Reinier de Graaf Hospital, Delft, the Netherlands
| | - Frederiek van den Bos
- Department of Geriatrics, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Floor J A van Deudekom
- Department of Internal Medicine and Geriatrics, OLVG Hospital, Amsterdam, the Netherlands
| | - Suzanne C van Dijk
- Department of Geriatric Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | | | - Raya E S Geels
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Department of Geriatrics, Alrijne Hospital, Leiderdorp, the Netherlands
| | | | - Bas de Groot
- Department of Emergency Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Liesbeth Hempenius
- Department of Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Ad M Kamper
- Department of Internal Medicine, Isala Hospital, Zwolle, the Netherlands
| | - Linda M Kampschreur
- Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Marre M M de Koning
- Department of Geriatric Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Geert Labots
- Department of Internal Medicine, Haga Teaching Hospital, The Hague, the Netherlands
| | - Roy Looman
- Section Geriatrics, Department of Internal Medicine, Zaans Medical Center, Zaandam, the Netherlands
| | - Jacinta A Lucke
- Department of Emergency Medicine, Spaarne Gasthuis, Haarlem, the Netherlands
| | - Huub A A M Maas
- Department of Geriatric Medicine, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | | | | | - Barbara C van Munster
- Department of Internal Medicine and Geriatrics, University Medical Center Groningen, Groningen, the Netherlands
| | - Cees van Nieuwkoop
- Department of Internal Medicine, Haga Teaching Hospital, The Hague, the Netherlands
| | - Leanne (B L E) Oosterwijk
- Section Geriatrics, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Sarah H M Robben
- Department of Geriatric Medicine, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Rikje Ruiter
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Aisha M Salarbaks
- Department of Geriatrics, Hospital Group Twente, Almelo, the Netherlands
| | - Henrike J Schouten
- Department of Geriatric Medicine, Gelre Hospitals, Apeldoorn, the Netherlands
| | - Orla M Smit
- Section Geriatrics, Department of Internal Medicine, Zaans Medical Center, Zaandam, the Netherlands
| | - Rosalinde A L Smits
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Petra E Spies
- Department of Geriatric Medicine, Gelre Hospitals, Apeldoorn, the Netherlands
| | - Ralph Vreeswijk
- Department of Geriatrics, Spaarne Gasthuis, Haarlem, the Netherlands
| | - Oscar J de Vries
- Department of Internal Medicine and Geriatrics, OLVG Hospital, Amsterdam, the Netherlands
| | - Marjolein A Wijngaarden
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Caroline E Wyers
- Department of Internal Medicine, VieCuri Medical Center, Venlo, the Netherlands
| | - Simon P Mooijaart
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
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van Deudekom FJA, Kuper IMJA, Groote ME. [A man with an abnormality of the upper arm on an X-ray of the chest]. Ned Tijdschr Geneeskd 2015; 159:A9423. [PMID: 26556494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 82-year-old man was referred to our hospital because of a history of falling. Routine radiography of the chest accidentally showed an abnormality of the left upper arm. The x-ray showed calcifications - rings and arcs - also known as popcorn calcifications. This is a typical radiological sign which may indicate a tumour of the condroid matrix.
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van Deudekom FJA, Stradmeijer MD, Kuijer PMM. [A woman with red discolouration of the lower leg]. Ned Tijdschr Geneeskd 2013; 157:A6880. [PMID: 24382041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A 22-year-old women visited the Emergency Department with purpura of the right lower extremity subsequent to four days of hiking 40 kilometres daily. The diagnosis 'exercise-induced vasculitis' was made. This is a harmless and self-limiting disease that can occur due to exercising in warm weather.
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