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Hypopituitarism in older adults
Patients with hypopituitarism may present with many different signs and symptoms which result from reduced secretion of one or more of pituitary hormones. Severe hyponatremia and hypoglycemia are rare but potentially life threatening presenting clinical features of hypopituitarism. As these abnormalities are completely restored with replacement therapy and patients are often undiagnosed until admission, a high clinical suspicion is necessary to diagnose a patient with hypopituitarism. We present five cases exhibiting rare symptoms of hypopituitarism?severe hyponatremia, hypoglycemia and osteoporosis? as the only presenting feature; these cases illustrate that hypopituitarism must be considered in the differential diagnosis of these abnormalities, especially in older patients.
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Treatment of heart failure with reduced left ventricular ejection fraction
Heart failure (HF) affects approximately 5 million persons in the United States each year. HF is predominantly a disease of the elderly: Approximately 80% of patients hospitalized with HF are older than age 65. Approximately one-half of older adult patients with CHF have a decreased ejection fraction. Elderly patients with HF and a reduced LVEF have a higher mortality than elderly patients with HF with a normal LVEF.
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Delirium: Concisely Condition is associated with increased morbidity, mortality, and length of hospitalization
Delirium is a common neuropsychiatric condition that affects 15% to 70% of elderly medical and surgical patients. It tends to be a transient disorder, although long-term complications are not uncommon. Medical comorbidity is the rule, and predisposing, as well as precipitating, factors are important to consider in its management. Major risk factors for delirium include advanced age, cognitive impairment, and chronic medical illness. Delirium is associated with several adverse outcomes including mortality, increased length of hospital stay, increased risk of dementia, and high rates of institutional placement.
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Erythema, edema, and fissuring around mouth
A 61-year-old man has a 3-month history of a persistent irritation at the corners of his mouth. He has type 2 diabetes mellitus and is being treated with insulin. Otherwise, he is in good health.
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