106 / 210
S98
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
infiltrated lymph nodes was 36.9% versus 30.9%. Only the difference
in estrogen receptors was statistically significant between the two
groups while differences in progesterone receptors, expression of
Ki-67, size of tumour, tumour grading, lymph node infiltration and
expression of cerbB2 were not significant.
Conclusions:
In the present series tumours of elderly patients had
significantly higher levels of estrogen receptors as compared to
tumours of younger patients. Nevertheless, due to lack of significant
differences regarding the rest of the studied variables, breast cancer
in the elderly could not be considered less aggressive.
P-248
Is a Head-up-tilt-table test a useful diagnostic tool in elderly
patients with an unclear reason for syncope?
N. Krabbe
1
, E.M. Damsgaard
2
1
Hospitalsenhed Vest, Region Midtjylland, Herning, Denmark;
2
Department of Geriatrics, Aarhus University Hospital, Aarhus C,
Denmark
Objective:
To study if a resource demanding Head-up-tilt-table test
(HUT) may be diagnostically useful in elderly patients with unclear
causes of syncope.
Methods:
In order to answer our question we reviewed the
literature. We hypothesized that patients with a positive HUT more
often 1. report a longer history of syncopes, 2. take vasoactive
medicine, or 3. are unable to discriminate clearly between e.g.
unexplained fall and syncope. Finally we hypothesize that there is
no association between typical vaso-vagal symptoms and outcome
of the HUT.
We searched Pubmed, Cinahl, Embase, and Cochrane with the
keywords: “Syncope” AND (“Aged” OR “Aged, 80 and over”) AND
“Tilt-table test”. Specific exclusion criteria were lack of clear patient
inclusion criteria, or studies with lack of exclusion of patients
with cardial syncope, orthostatic hypotension, and carotid sinus
syndrome.
Results:
534 articles were found. In the end five articles were
included. Only two included patients with mean age 65+ years.
It appeared that a longer period with attacks of syncope does
not predict the outcome of the HUT, nor did presumed vasovagal
symptoms or ongoing vasoactive medication. Whether lack of
relevant anamnestic information about causes of syncope is a
predictor for the outcome of HUT was not addressed in the articles.
Conclusion:
We found a very limited number of relevant
articles. No association was demonstrated between certain clinical
parameters and outcome of the HUT. Studies on the usefulness of
HUT as a diagnostic tool in patients with an unclear reason for
syncope are recommended.
P-249
Evaluation of axillary lymph node status in patients with early
breast cancer by age-at-diagnosis
L.W. Lietzen
1
, D.P. Cronin-Fenton
2
, P. Christiansen
3
, H. Toft
Sørensen
4
, B. Ejlertsen
5
, R.A. Silliman
6
, T.L. Lash
7
1
Department of Geriatrics, Aarhus University Hospital, Aarhus C,
Denmark;
2
Department of Clinical Epidemiology, Aarhus N, Denmark;
3
Department of Surgery, Aarhus C, Denmark;
4
Department of Clinical
Epidemiology, Aarhus University Hospital, Aarhus N, Denmark;
5
DBCG
secretary, Copenhagen University Hospital, København Ø, Denmark;
6
Department of Medicine, Boston University School of Medicine,
Boston, USA, United States of America;
7
Emory University, Atlanta,
United States of America
Background:
Lymph node status at diagnosis is an important
prognostic factor for survival among women with breast
cancer (BC). In Denmark, BC survival among women
>
70 years
did not improve the past decade as it did among women
<
70 years.
Among older patients, increasing age-at-diagnosis is associated
with decreasing adherence to surgical guidelines. We aimed to
examine the association between age-at-diagnosis and surgical
lymph node evaluation (LNE) in a large population-based cohort
of women with BC.
Methods:
We used Danish nationwide medical registries to
assemble a cohort of women diagnosed with BC during 2000–2013.
We examined time trends for age-at-diagnosis and distribution of
LNE, using a stacked bar chart and an area chart. Women with no
registered pathologic lymph node status were classified unknown
surgical LNE.
Results:
The study included 62,393 women with invasive BC. Of
these, 29% were ≥70 years old. 14% had unknown surgical LNE and
of these 61% were aged ≥70. The overall proportion of patients with
positive lymph node status decreased from 41% to 33% from 2000
to 2013, while the proportion with unknown surgical LNE remained
at approximately 16%.
Conclusion:
Women aged ≥70 with BC are less likely than younger
women to undergo surgical LNE. This may partly explain why
survival among women with BC in this age group lags that of
their younger counterparts. Whether the decline in adherence to
surgical guidelines is justified or not, or whether it can be altered
by geriatric interventions, should be evaluated in future studies.
P-250
An unusual cause of chronic cough
–
foreign body aspiration
P. Lopes
1
, J. Duarte
2
, J. Celmlyn-Jones
2
, J. Porto
2
, M. Ver´ıssimo
2
1
Centro Hospitalar e Universit´ario de Coimbra, Tent´ugal, Portugal;
2
Centro Hospitalar e Universit´ario de Coimbra, Coimbra, Portugal
Introduction:
Coughing is a natural reflex of the respiratory system,
which arises as a consequence of irritation process. In many ways it
is beneficial because it helps expel secretions or foreign bodies (FB).
Any cough persisting beyond 8 weeks is considered chronic. The
most common causes of chronic cough in nonsmokers are postnasal
drip syndrome, asthma, gastroesophageal reflux, or the use of ACE
inhibitor drugs.
Case:
Man 76 years, he is sent to the medical appointment, he has
a persistent dry cough, with a year long, without other symptoms.
Irrelevant personal history. Unchanged blood tests. Chest X-ray:
nodule in the right upper lobe. For suspected cancer/metastasis he
was performed CT-chest “slight loss of the right upper lobe volume,
with multiple cylindrical bronchiectasis, which are associated with
discrete areas of vaguely nodular density, contours spiky”, after that
he performed bronchoscopy and it was removed FB in the main
right bronchus, about 2 cm, wrapped in granulation tissue, when it
placed in formalin, it was a chicken bone. In a reevaluation, after
one week, the patient no longer had coughing.
Conclusion:
We present a classic case of FB aspiration. The FB was
in the right lower lobe, consistent with the majority of cases in adult
patients years ago. Removal of the FB led to prompt improvement
in symptoms. FB aspiration should be considered in adult patients
with risk factors for aspiration and chronic or recurring pulmonary
symptoms. Bronchoscopy is safe and effective for diagnosis and
treatment.
P-251
Acarbose and postprandial hypotension
K. Madden
1
, D. Harris
1
, G. Meneilly
1
1
University of British Columbia, Vancouver, Canada
Objectives:
Postprandial hypotension (PPH) is a common
intractable etiology for syncope in older adults with Type 2
diabetes, and there are no reliable treatments for this condition.
The purpose of this study was to demonstrate how acarbose,
an
a
-glucosidase inhibitor, affects postprandial hypotensive events
(PHEs) in older adults with Type 2 diabetes.
Methods:
15 adults (9 women, 6 men) with an average age of 76.1
years (range: 67–85) and an individual history of Type 2 diabetes
attended a treatment (acarbose 50mg orally) and placebo session