Calciphylaxis in End-Stage Renal Disease: A Rare Condition With High Mortality.

Calciphylaxis is a rare but life-threatening condition, seen in patients with end-stage renal disease (ESRD) on renal replacement therapy. Its pathogenesis is not completely known, but microvascular calcification and thrombosis are considered the likely processes. It is characterized by significant morbidity due to severe pain and nonhealing wounds with frequent hospitalizations. Sepsis is the most common cause of mortality with more than 50% of patients dying within the first year after diagnosis. Optimal management requires a multidisciplinary approach. We describe a case of a 66-year-old female with ESRD on hemodialysis (HD) who presented with severe progressive calciphylaxis wounds on both lower extremities and died within two months after diagnosis. She had multiple admissions in the past for cellulitis when she presented with swelling in the legs and chronic wounds. Our goal is to increase awareness among physicians to include calciphylaxis in their differential diagnosis when treating ESRD patients with significant risk factors to detect it early and prevent morbidity and mortality.

Pulmonary Kaposi Sarcoma: An Uncommon Cause of Respiratory Failure in the Era of Highly Active Antiretroviral Therapy-Case Report and Review of the Literature.

Kaposi Sarcoma (KS) is the most common malignancy associated with Acquired Immune Deficiency Syndrome (AIDS) and is caused by Human Herpesvirus 8 (HHV 8) or Kaposi Sarcoma Herpesvirus (KSHV). In about 90% of cases Kaposi Sarcoma is associated with cutaneous lesions; however visceral disease can occur in the absence of cutaneous involvement. In the era of Highly Active Antiretroviral Therapy (HAART), the incidence of KS has declined. Clinical features of pulmonary KS might be difficult to distinguish from pneumonia in the immunocompromised patients and could lead to diagnostic challenges. First-line treatment of KS is with HAART and the incidence has declined with its use. Systemic chemotherapy may play a role depending on the extent of the disease. We report the case of a young man who presented with pulmonary symptoms and was later found to have pulmonary KS. Interestingly this diagnosis was made in the absence of the classic skin lesions. His disease was complicated by progressive respiratory failure and he eventually died.

Active aging: a medical student's perspective

This presentation aims to look at promoting active aging from a life course perspective. The study is based on literature review and incorporates views from the World Health Organisation Aging and Health Policy, other experts in the field and from the authors. Stastitics indicate that the year 2025 over 10 percent of the population of most Caribbean countries will be over 70 years old. The current life expectancy at birth in Jamaica and most Caribbean countries is over 72 years for both males and females. This increase in life expectancy has occurred largely due to increased access to, and qualify of, medical care, the increased use of antibiotics, better environmental health, and education. These have all significantly contributed to a decrease in the spread of communicable diseases. The present and future health care professional must understand that active aging is the only way to improve the quality of longevity. This presentation looks at strategies to promote active aging from a life course perspective. This is based on a proactive approach which incorporates educational programmes which focus on all aspects of life and encourage the individual to realize that healthy lifestyles from an early age have lifetime benefits. The teachings of geriatic medicine in medical schools, as well as social and corporate policy and community involvement, are also important aspects of the active aging approach. CONCLUSION: Healthy children have a much greater probability of becoming healthy adults, and healthy older people. It is imperative that this life course perspective of aging be encouraged so that life can be added to the years, even as years are being added to life.(Au)