Elderly Woman Research Articles

Surrogacy in the Context of Reproductive Rights

The evolution of the medical technologies has also transformed the surrogate, from the traditional surrogate to the gestational surrogate, from the surrogate with the embryo of the infertile couple to the surrogate with embryos from donors or with embryos obtained from gametes taken from donors (surrogate mother or another person), from carrying a pregnancy by a woman of biological reproductive age and up to carrying a pregnancy by a woman past the reproductive age, all these stages or forms of surrogacy imply various debates in the medical, bioethical and, of course, human rights literature. As the forms of surrogacy diversified, the multitude of rights that had to be balanced (of the infertile couple, of the parents, of the surrogate mother, of the embryo in vitro or of the embryo transplanted into the uterus) were also increasingly difficult to quantify, to define as legal and to keep in a fair balance.

Assessment of Organ Dysfunction and Underlying Causes in Maternal Near-miss Cases at Health Care Facilities in Doiwala Block of District Dehradun - A Retrospective Study.

The extent of maternal morbidity is a good gauge of a nation's maternal health care system. Maternal near-miss (MNM) cases need to be reviewed because they can indirectly contribute significantly to reducing the maternal mortality ratio in India. MNM cases can provide useful information in this context. Such women who survive these life-threatening conditions arising from complications during pregnancy, childbirth and post partum (42 days) share many commonalities with those who die because of such complications. To assess the organ dysfunction and the underlying causes, associated/contributory factors associated with "maternal near-miss" cases in pregnant, in labor, post-partum women (upto42 days) in the health care facilities of Doiwala block, district Dehradun. The present study was conducted over a period of 6 months under the Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh. The cross-sectional study included the medical record files of all pregnant women attending the Department of Obstetrics and Gynecology, in the selected healthcare facilities of Doiwala block, district Dehradun. This study was conducted as per the WHO criteria for "near-miss" by using convenience sampling for the selection of healthcare facilities. The medical record files of all women who were pregnant, in labor, or who had delivered or aborted up to 42 days were included from a period of 01.06.2021 - 31.05.2022. It was found that Out of the women with maternal near-miss (n=91), the majority of women had coagulation /hematological dysfunction (n=45, 49.4%), followed by neurologic dysfunction (n=15, 16.4%), cardio-vascular dysfunction (n=11, 12%). Out of the total women with a maternal near-miss (n = 91), 10 women underwent multiple organ dysfunctions. Of the total 91 maternal near-miss cases, the underlying cause of near-miss was obstetric hemorrhage in almost half the participants (n=45, 49.5%) followed by hypertensive disorders (n=36, 39.5%). Eleven women had a pregnancy with abortive outcomes (12%) and 7 women had pregnancy-related infection. It was also seen that, out of 91 near-miss women, the leading contributory /associated cause was Anemia (n=89, 97.8%) followed by women having a history of previous cesarean section (n=63, 69.2%). Sixteen women had prolonged /obstructed labor (n = 16, 17.58%). Pregnancy should be a positive experience for every woman of childbearing age. A better understanding of pregnancy-related conditions enables early detection of complications and prevents the conversion of mild to moderate maternal morbidity outcomes to severe maternal outcomes with long-term health implications or death. There are already effective measures in place to reduce maternal and newborn mortality and morbidity.

Acute on Chronic Presentation of Trigeminal Neuralgia

Trigeminal neuralgia (TN) is characterized by sudden, severe, brief, stabbing, usually unilateral, and recurrent pain within one or more branches of the trigeminal nerve. It is divided into three types: (1) primary or classical TN, which requires demonstration of morphologic changes in the trigeminal nerve root from vascular compression, (2) secondary to other identifiable neurologic causes such as multiple sclerosis and intracranial space-occupying lesion, and (3) idiopathic, in which the etiology is unknown. Treatment and prognosis depend on the type. We present this case of an elderly woman with an unusual presentation of TN in a previously diagnosed case. The episodes were increasing in severity and duration, not responding to medical management, allodynia and constant pain was present, and they were accompanied by uncontrolled hypertension. These features strongly suggested other likely causes such as intracranial space-occupying lesions, multiple sclerosis, and central pain. Expert consultations from physicians and neurologists were sought for control of hypertension and reaching a diagnosis. Magnetic resonance angiogram of the brain was done and a diagnosis of classical TN with persistent background facial pain was established. The treatment was successfully done by radiofrequency ablation of the Gasserian ganglion. The pain and blood pressure responded to the treatment.

Broken Heart Syndrome: A Rare Case of Recurrent Reverse Takotsubo Cardiomyopathy Associated with Acute Respiratory Failure.

Takotsubo cardiomyopathy accounts for one percent of acute coronary syndrome presentations and has been increasingly recognized [1]. Reverse Takotsubo cardiomyopathy, a variant form of Takotsubo cardiomyopathy presenting with the hyperdynamic function of the apical segments and hypokinesis of the basal or mid-ventricular segments is the rarest type of acute stress cardiomyopathy, with mid-ventricular akinesia and preservation of apical and basal contractility [2]. We report a rare case of an elderly woman admitted to the Intensive Care Unit at Case Western Reserve University Hospital in Cleveland, USA. The patient experienced acute respiratory failure as a result of exacerbated chronic obstructive lung disease and heart failure. Echocardiography revealed reverse Takotsubo cardiomyopathy. Cardiac catheterization showed nonobstructive coronary artery disease. The wall motion abnormalities resolved within two weeks. The case is unique in that she had an identical presentation one year earlier after she had entered the same dusty room! Our case report is unique and describes the rarest form of recurrent reverse Takotsubo cardiomyopathy. Our case demonstrates that reverse Takotsubo cardiomyopathy with identical wall motion abnormalities can recur in a patient upon re-exposure to a similar stressful situation. Early recognition and appropriate treatment can prevent catastrophic outcomes.

Herpes zoster peripheral nerve complications: Their pathophysiology in spinal ganglia and nerve roots.

Varicella zoster virus (VZV) causes chickenpox at the primary infection and then becomes latent in the spinal dorsal root ganglia; VZV can reactivate with aging, immunosuppression, stress, and other factors, occurring as herpes zoster (HZ) at 1-2 skin segments. HZ peripheral nerve complications caused by VZV reactivation include Hunt syndrome, segmental HZ paresis, post-herpetic neuralgia, and Guillain-Barré syndrome (GBS). We have encountered the rare HZ complications of upper-limb paresis, myeloradiculitis, and polyradiculoneuritis: an adult woman with upper-limb paresis consistent with the nerve root on segments above the thoracic HZ dermatome; another woman exhibiting ascending myeloradiculitis originating at the Th11-12 roots; an elderly woman with ascending VZV polyradiculoneuritis resembling GBS; an adult with VZV quadriplegia with disseminated HZ; and an elderly patient with VZV-associated polyradiculoneuritis. The three polyradiculoneuritis cases may be a new subtype of HZ peripheral neuropathy, but the pathophysiology for these HZ peripheral nerve complications unrelated to HZ dermatomes is unclear. We analyzed host factors, skin lesions, neurological and virological findings, and MRI results including 3D NerveVIEW in 15 Japanese patients treated at our facility for HZ peripheral neuropathy, including six differing from the HZ dermatome. Based on the clinical findings including MRI results of spinal ganglia and roots, we identified four possible routes for the patterns of VZV spread: (i) ascending spinal roots, (ii) ascending spinal cord, (iii) polyradiculopathy, and (iv) intrathecal spread. The incidence of HZ is increasing with the aging of many populations, and clinicians should be aware of these HZ neuropathies.

GIANT BARTHOLIN CYST CASE REPORT

Bartholin gland cysts are common masses in the vulvar region that can range from asymptomatic to large and infected, requiring treatment [1]. In this case report, we wanted to discuss a case of a large Bartholin gland cyst that presented with painful genital swelling to our clinic and its treatment. A woman in perimenopausal age presented with a large mass in the vulva, and physical examination revealed an 18x10 cm mass originating from the left labia minora. MRI confirmed the mass, and the initial diagnosis was Bartholin gland cyst. The cyst was surgically excised totally under the operating room conditions and sent for histopathological examination. Although Bartholin gland cysts can present in various sizes and clinical features, cysts of this size are rare and can be confused with malignant masses.

The Correlation Of Women of Childbearing Age’ Education And Work With Use Of Internal Contraceptive Devices (IUD)

Current family planning programs are urgently needed to prevent unwanted pregnancies and to improve the health and well-being of mothers and children. One of them is the IUD is a long-term contraceptive method that has a high level of effectiveness. The IUD is the third most commonly used method in Asia. This study aims to determine whether there is a relationship between education and work of women of childbearing age with the use of IUDs at the Temandang Health Center, Merakurak Subdistrict, Tuban . This research was conducted in July 2022 at the Temandang Health Center. This research methodology uses observational analytic with cross sectional design. The independent variables are education and work, while the dependent variable is IUD use. The population in this study were all active family planning acceptors at the Temandang Merakurak Health Center, a sample of 177 family planning acceptors was obtained using simple random sampling technique. Data processing used the chi square test with a significance level of <0.05. The results of the study of 177 female respondents of childbearing age, half of them had low education, almost all of them did not work and were not IUD acceptors. After statistical test using SPSS ρ -value 0.000, then H₀ is rejected. This proves that there is a relationship between education and occupation of women's reproductive organs with the use of IUDs at the Temandang Health Center, Merakurak Subdistrict, Tuban . The results of this study can provide input and information from several supporting factors that influence a woman of childbearing age following the family planning program so that health workers can optimize health promotion for couples of childbearing age in choosing the most appropriate contraceptive according to their needs and conditions.

Utilization of Platelet-Rich Plasma (PRP) in the Performance of Blood Cultures

Sepsis is a leading cause of death and morbidity. A precise microbiologic diagnosis in these patients reduces mortality, morbidity, hospital length of stay and costs. Current blood culture technology is woefully inadequate in the detection of circulating bacteria, with detection rates in the range of only 32 to 71%. Platelets play a key role in innate immunity. Platelets interact directly with innate immune cells, exert important immunomodulatory effects, and promote leucocyte migration to sites of infection. During active bacterial infection, platelets release platelet factor -4 which binds onto a variety of bacterial surfaces, thus rendering bacteria more susceptible to opsonization by leucocytes. Platelet surface Toll-like receptors play a key role in regulating bacterial phagocytosis by leucocytes. FcgammaRllA mediates immune complex mediated platelet activation for killing of opsonized bacteria. Platelets also have been observed to “corral” circulating bacteria by forming hollow spheres around them. For these reasons, we performed a prospective pilot study involving 100 patients with suspected sepsis testing the hypothesis that BC performed with PRP is superior to traditional BC performed with whole blood in detecting circulating bacteria. PRP was prepared via centrifugation of blood contained in 3 cc CBC tubes containing EDTA obtained upon admission. PRP and whole blood were injected into separate and identical culture media bottles and cultures were incubated identically in our state-of-the art microbiology laboratory. PRP culture technique detected two patients with circulating bacteria in whom traditional blood cultures were negative: Enterobacter faecalis in an elderly woman with bilateral pneumonia and Burkolderia capecia in an immunocompromised elderly man with pneumonia. In two patients with urosepsis culture results were concordant with identification of E. coli in both techniques. In eight patients, traditional BC technique detected circulating bacteria, wherein PRP-generated cultures were negative: three with Klebsiella pneumoniae, two with Enterococcus faecalis, two with E. Coli, and one with anaerobic Bacteroides Theta-iota group. Three positive cultures generated by traditional methodology were deemed contaminants by I.D. consultation. No contaminants or false positives were detected by the PRP-generated technique. Thus, in this pilot study, evaluating the utility of blood cultures prepared from platelet-rich-plasma, two patients were detected to harbor pathogenic circulating bacteria which was undetected by standard state-of-the-art blood culture techniques. Two distinct disadvantages of BC prepared from PRP relative to traditional BC technique in this study were the time delay in preparing PRP from the patient's CBC tube: these had been stored in the lab for typically 4 to 48 hours before centrifugation and subsequent inoculation, and the dramatic difference in volume represented by PRP vs. traditional BC: typically .5 to 1.1 cc vs. 32 to 40 cc, respectively. An additional disadvantage was the presence of EDTA in CBC tubes, which is confirmed to exert antibacterial properties. The results of this pilot study are intriguing. Further studies comparing PRP-generated BC and traditional BC in the detection of circulating bacteria with emerging identification techniques such as metrogenomic analysis in detecting bacterial DNA, RNA or peptide signatures would be interesting.

Improvement of renal functions, graphene-induced rapid progression of prediabetes in an elderly woman with arthritis by graphene-exfoliator NaCl with KCl solution, 3 cases

A 81-year-old female presented with two weeks of fatigue, dysuria, abdominal pain, and weight loss. Vital signs and physical exam were normal except for abdominal tenderness and dry oral mucosa. Complete Blood Count (CBC) was normal; blood glucose was elevated. She received an insulin drip, normal saline, and potassium. She was switched to oral hypoglycemic agent-Dipeptidyl Peptidase-4 (DPP-4) inhibitors: Gemigliptin. Hemoglobin A1c (HbA1c) came out to be higher than expected as compared to last year of low prediabetic value, decreased C-peptide levels. Her first abnormal HbA1c was 5.9% a year ago. She was recieved intramuscular injection with graphene a year ago. Type I Diabetes Mellitus (DM) passes from autoimmunity positive normoglycemia to dysglycemia to the symptomatic stage. Mechanisms could be cytokine-mediated beta-cell damage or autoimmunity as a part of autoimmune syndrome induced by lipid nanoparticles including graphene. This case reports blood glucose by graphene-exfoliator NaCl with KCl solution on the rapid progression of prediabetes to Type 1 DM.

Invasive disease by Streptococcus pneumoniae: a case report and a discussion about the immunization rates in older adults in Brazil

Invasive disease by Streptococcus pneumoniae has a high mortality rate, principally in old adults and children. This paper presents the progression and prognostic of a case of invasive pneumococcal disease in an elderly woman by vaccinal serotype and promotes a discussion about the monitorization of the vaccinal pneumococcal rate in an old adult population in Brazil.

Abstract 14966: Happy Heart Syndrome: The Mid-Ventricular Variant of Takotsubo Cardiomyopathy Triggered by Pleasant Experiences

Introduction: A joyful event triggered chest pain in an elderly woman, leading to the diagnosis of a mid-ventricular variant of Takotsubo cardiomyopathy (TC). Case presentation: A 65-year-old woman experienced chest pain during a surprise retirement party. The initial electrocardiogram revealed T-wave inversions in leads V1 and V2, and her troponin I level was 6700 ng/ml. A coronary angiogram did not reveal any occlusion in the coronary arteries. However, the left ventriculogram exhibited findings consistent with the mid-ventricular variant of TC. The patient was treated with a diuretic, a beta-blocker, and an ACE inhibitor. A follow-up echocardiogram was scheduled after four weeks. Discussion: TC typically manifests with abnormal apical wall motion on the left ventriculogram, causing "apical ballooning" at end-systole and basal hyperkinesis, unrelated to specific major epicardial coronary artery distribution. Among patients presenting with symptoms resembling acute coronary syndrome (ACS), a study reported that 1.2% showed TC, with 60% exhibiting regional dysfunction in both apical and midventricular regions. In comparison, 40% had isolated dysfunction in the midventricular area. Other rare variants of TC have also been documented, including the inverted Takotsubo or basal variant, biventricular apical dysfunction, and isolated right ventricular Takotsubo syndrome. In a recent study, TC triggered by positive experiences ("happy heart syndrome"), the mid-ventricular variant was found to occur more frequently, representing 35% of the cases. The treatment for TC includes standard management of heart failure and regular follow-up echocardiography is recommended for surveillance. Conclusion: In cardiology, the often-overlooked atypical patterns of left ventricular dysfunction in Takotsubo cardiomyopathy (TC) and the challenges of diagnosing TC in patients with diverse emotional triggers pose difficulties.

BIAK LANGUAGE GREETINGS AND THEIR IMPLICATIONS FOR LOCAL LANGUAGE LEARNING IN SCHOOLS

The objectives of this research are to describe Biak language greeting words in terms of form and meaning and their implications for local language learning in schools. The method used in this research is descriptive qualitative method. To collect data, the techniques used are observation, listening technique and conversation technique. To analyze the data, the technique used is qualitative analysis technique which includes: 1) Data reduction, namely simplifying the data that has been collected. 2) Presentation of data, namely, presenting data before being simplified through data grouping. 3) Verification, namely checking the accuracy of the data that has been presented. Conclusion, namely drawing conclusions to answer research questions. The results showed: 1) Family greetings: kamam (father), awin (mother), ɛba (brother), ɛknik (younger brother); 2) Kin greetings: mansar (grandfather), insar (grandmother), mɛ (aunt), kabor (nephew), insos (niece), ɛbaya kabor (male cousin), ɛbaya insos (female cousin); 3) Non-relative greetings: /ambɛr beba/ someone who has a position and is older, younger, and so on, /manan wir (community leader), manan wir bɛba (traditional leader). 4) Common greetings: kamam (father), awin (mother), kabor (a man of the same age or younger), insos (a woman of the same age or younger). The implication of this research can be applied in local language learning in schools to better understand and appreciate local culture and grammar.

A case report of adult type 2 familial hemophagocytic lymphohistiocytosis

AbstractFamilial hemophagocytic lymphohistiocytosis (FHL) is a fatal autosomal recessive disorder that often occurs in infants and young children, and rarely reported in adults. In this paper, we retrospectively reported an elderly woman with recurrent fever, this patient was diagnosed with familial hemophagocytic syndrome by perfecting relevant examinations after admission, improvement was observed after standard chemotherapy. In order to further determine the possible underlying genetic causes, we performed gene mutation analysis and found that there were compound heterozygous missense mutations c.133G > A (p.Gly45Arg) and c.147C > A (p.Asp49Glu) on the exon2 of PRF1 gene in this patient. According to the clinical manifestations and test results, the patient was further confirmed as late‐onset FHL‐2 type. Without a suitable donor, the patient did not perform hematopoietic stem cell transplantation. Therefore, the relevant genetic examination should be performed as early as possible in young patients with a family history of hemophagocytic lymphohistiocytosis, and it can provide a basis for etiological diagnosis and radical treatment by hematopoietic stem cell transplantation. It is essential to further study the molecular mechanism and clinical application value for late‐onset elderly FHL patients without appropriate donors.

(081) Willful or Neurovascular? A Case of Visual Disturbances and Nonadherence in an Elderly Woman with Reversal of Vision Metamorphopsia

(081) Willful or Neurovascular? A Case of Visual Disturbances and Nonadherence in an Elderly Woman with Reversal of Vision Metamorphopsia

Elderly woman with arm swelling

A 72-year-old female with a history of hypertension and a recent outpatient catheterization procedure due to angina where a stent was implanted in the left anterior descending artery using the right arm presented to the emergency department with complaints of pain and swelling in her right arm 6 days after the procedure (Figure 1A). Upon physical examination, the patient was found to have diffuse swelling in the antecubital fossa of his right arm.

Spontaneous Regression of Primary Cutaneous Diffuse Large B-Cell Lymphoma on Sequential FDG PET.

Primary cutaneous diffuse large B-cell lymphoma, leg type is a rare, aggressive lymphoma characterized by skin involvement predominantly in the lower extremities. We present a case of an elderly woman with pathology diagnosis of primary cutaneous diffuse large B-cell lymphoma, leg type with spontaneous regression without systematic therapy documented by sequential FDG PET scans and clinical follow-up.

Cerebral venous thrombosis in reproductive age

Relevance. Cerebral venous thrombosis is a relatively rare pathological condition that often leads to the development of ischemic and/or hemorrhagic stroke.Objective. Describe a clinical case of cerebral venous thrombosis, accompanied by the ischemic stroke with hemorrhagic transformation, in a reproductive age woman taking a combined estrogen-progestin drug from the group of oral contraceptives.Patients and methods. The analysis based on the anamnesis data, clinical, laboratory and instrumental examination of the patient.Results. A clinical case of a 23-year-old patient who had an acute ischemic stroke with hemorrhagic transformation is presented. According to the history data and instrumental methods, the stroke was caused by thrombosis of the cerebral sinuses, which developed on the background of hormonal contraception use. The clinical case is accompanied by MRI images of the patient's brain.Conclusions. The risk of cerebral venous thrombosis in women with hormonal contraceptives use is almost 8 times higher than in those who do not receive hormone therapy. The occurrence of neurological symptoms in women of reproductive age requires a thorough study of the life history, obstetric/gynecological and pharmacological history to establish the fact of estrogen-progestin drugs use for contraception or treatment of hormonal disorders. The described case focuses on the importance of a delicate approach to prescribing hormonal therapy in the treatment of gynecological and other pathological conditions, and indicates the necessity to consider and recommend other contraceptives for young patients.

A Case Study of Eliminating Urinary Tract Infections for an Elderly Woman with Frequent Recurring UTIs

A Case Study of Eliminating Urinary Tract Infections for an Elderly Woman with Frequent Recurring UTIs

ETIKA PERCERAIAN DALAM QS. AL-THALAQ DAN IMPLIKASINYA SECARA TEOLOGIS SERTA SOSIOLOGIS

This article aims to discuss the ethics of divorce in QS. al-Thalaq which have theological and sociological implications. By using the type of research library research and thematic interpretation method (maudhu'i) by taking one letter, namely QS. al-Thalaq, this article concludes that the ethics of divorce in QS. There are 4 al-Thalaq, namely: (1) the husband drops divorce when the wife is pure from menstruation and has not been interfered with; (2) Allah forbids the believers to take the divorced wife out of the house before her iddah runs out; (3) The iddah of a woman who is not old enough (not yet an adult) is that she has never had menstruation; and (4) the iddah of an elderly woman, namely three months, while for a woman who is pregnant and her husband has died, her iddah is until she gives birth to the baby she is carrying. The theological implications of QS. al-Thalaq includes: confidence in Allah's help and confidence in His sustenance. While the sociological implications include: divorce can solve household life problems, does not break friendships and is included in the destiny of a mate.

The Effect of Physical Activity on Elderly Woman with Rheumatoid Arthritis Symptoms

Rheumatoid Arthritis (RA) is an autoimmune disease that causes joint inflammation. Elderly, especially women are more susceptible to RA due to hormonal factors. RA patient often feel inconvenient during physical activity because of pain in their joint. The purpose of this study was to determine the effect of physical activity on elderly woman with Rheumatoid Arthritis. This research is a literature study using traditional review method. Journal article studies were searched in Google Scholar, OneSearch Indonesia, and Garuda in Bahasa and English language that published online from 2012-2022 according to keywords. Of 9.030 studies from databases identified 30 journal studies were included. Literature studies show that the prevalence of elderly women with RA is higher than men. These studies also shows that severity of RA affects the ability of elderly to do a physical activity and physical activity itself influences reducing pain and preventing the severity of RA. The conclusion of this study is that the prevalence of elderly women with RA is higher than men and physical activity is associated with RA. Suggestions for future researchers to focus more on treatments that can be done to reduce the risk of Rheumatoid Arthritis in elderly.