ABSTRACT
Nonbacterial thrombotic endocarditis (NBTE) is a manifestation of prothrombotic status observed in patients with malignancy. Most cases are discovered only in the advanced stages. However, cancer in early stages may also induce NBTE development. We herein report an 87-year-old man with NBTE with multiple thromboembolization coexisting with lung cancer in early clinical stage. Autopsy findings revealed platelet- and fibrin-rich vegetations in both the tricuspid and mitral valves without evidence of bacterial infection. NBTE should be considered in cases with occult thromboembolization. Not only the presence of typical vegetation but irregular leaflet thickening should be monitored with careful echocardiographic examinations.
Subject(s)
Endocarditis, Non-Infective , Endocarditis , Lung Neoplasms , Male , Humans , Aged, 80 and over , Lung Neoplasms/complications , Endocarditis/complications , Endocarditis/diagnosis , Endocarditis, Non-Infective/complications , Endocarditis, Non-Infective/diagnostic imaging , Mitral Valve/pathology , AutopsyABSTRACT
PURPOSE: Dry axilla can sometimes be found among dehydrated older patients. In this study, we measured the axillary moisture and assessed it as possible marker for dehydration. METHODS: Twenty-nine older patients admitted with acute medical conditions participated in this study. Dehydration was diagnosed by the calculated serum osmolality of greater than 295 mOsm/L. The moisture of axilla was measured by a skin moisture impedance meter which was applied at the center of axilla of patients. RESULTS: 11 patients (7 males and 4 females) were diagnosed as dehydrated and 18 patients (10 males and 8 females) were diagnosed as non-dehydrated. The mean axillary moisture (33%) in the dehydrated group was significantly lower than that (42%) in the non-dehydrated group (p<0.05). The axillary moisture ≥50% showed the sensitivity of 88%. The axillary moisture <30% showed the specificity of 91%. Use of a single cutoff value of 40% moisture produced the sensitivity of 59% and the specificity of 9%. As for the physical signs, dry axilla had also moderate sensitivity and excellent specificity to detect dehydration. CONCLUSIONS: The measurement of the axillary moisture could help assess dehydration. Dehydration could be ruled out when the axillary moisture ≥50%, while it could be ruled-in when the axillary moisture is <30%.
Subject(s)
Body Water/metabolism , Dehydration/diagnosis , Skin/metabolism , Age Factors , Aged , Aged, 80 and over , Axilla , Biomarkers/metabolism , Dehydration/blood , Dehydration/metabolism , Electric Capacitance , Electric Impedance , Female , Humans , Male , Osmolar Concentration , Patient Discharge , Pilot Projects , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
OBJECTIVE: Dehydration is a common condition and frequent cause of hospitalization in older people, despite the caregiver's high attention in attempt to avoid its occurrence. In this study, various physical signs were examined as clinical signs of dehydration in elderly. METHODS: A prospective observational study was conducted in an acute care teaching hospital. Consecutive elderly patients who were admitted to the Department of Medicine were evaluated. Dehydration was defined as a calculated serum osmolality above 295 mOsm/L. The patients diagnosed as dehydrated or not dehydrated were observed for physical signs of dehydration. Data of blood and urine chemistry analysis were also compared between the two groups. RESULTS: A total of 27 elderly patients admitted with acute medical conditions were included in this study. For the physical signs, dry axilla had moderate sensitivity (44%) and excellent specificity (89%) to detect dehydration. Sunken eyes and delayed capillary refill time also showed relatively good specificity (83%). For laboratory data, the mean concentrations of serum sodium of the dehydrated group (146 mEq/L) was significantly higher (p<0.01) than those of the non-dehydrated group (134 mEq/L). CONCLUSION: Physical signs of dehydration in elderly showed relatively good specificity but poor sensitivity. The evaluation of the axillary moisture could help assess dehydration as well as laboratory data analysis such as serum sodium concentration.
Subject(s)
Dehydration/diagnosis , Aged , Aged, 80 and over , Axilla , Dehydration/blood , Dehydration/urine , Female , Humans , Male , Physical Examination , Prospective Studies , Sensitivity and Specificity , Sodium/bloodABSTRACT
An on-site colorimetric technique was developed for the routine determination of chromium, iron and copper in bath solutions for the chromium(III) conversion coating. A portable colorimeter with a red-green-blue light emitting diode was used for the absorbance measurements. Iron and copper were determined as Fe(III)-thiocyanate and Cu(I)-bathocuproindisulfonate, respectively. Chromium(III) was determined simultaneously with iron or copper using green and blue light. A correction method of the matrix effect was proposed and its applicability was demonstrated. Analytical errors were within 500, 5 and 0.3 mg L(-1) for chromium(III), iron and copper, respectively.
