108 / 210
S100
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
Demographic and patient data and TTT results were collected from
the HISS system and stored on an excel sheet. Simple statistics were
used to analyse the data.
Results:
549 patients had TTT in the audit period; the mean
age was 63 years, with 55% (302) females and 45% (247) males.
37% (204/549) of patients were younger than 60 years and
63% (345/549) were older. 35% (192) were referred because
of syncope, 23% (127) had recurrent syncope, 25% (139) had
presyncope and 17% (91) for other symptoms suggestive of reflex
syncope; 40% of whom (36/91) had falls).
28% (152/549) of the TTT were positive. 20% (41/204) of the younger
patients have a positive test compared to 32% (111/345) of older
people.
In younger and older groups vasodepressor response was the
commonest type of positive response (51%, 55%) followed by mixed
response (22%, 29%) and cardio inhibitory response was the least
common (12%, 1%). 28% of men and 27% of women had a positive
TTT result; vasodepressor response was the commonest type of
positive response in both (54%, 53%) followed by mixed response
(29%, 25%) and cardio inhibitory response was the least common
(12%, 11%).
Conclusion:
In both younger (
<
60 years)and older (
>
60 years)
patients; whether men or women, vasodepressor response was the
commonest type of positive response followed by mixed response,
and cardio inhibitory response was the least common.
P-256
Prevalence and types of neurally mediated syncope in older
people
N. Obiechina
1
, A. Michael
2
, D. Bezzina
1
, M. Oldfield
1
, L. Jones
1
,
L. Barber
1
, N. Naseer
1
, C. Jackson
1
, C. Jayakumar
1
1
Queen’s Hospital, Burton on Trent, United Kingdom;
2
Russells Hall
Hospital, Dudley, United Kingdom
Introduction:
Neurally mediated (reflex) syncope is the most
common cause of syncope. It includes: vasovagal, situational and
carotid sinus syncope and atypical forms. We studied the prevalence
and types of the haemodynamic response in patients with positive
Tilt Table Tests (TTT).
Methods:
Audit of all patients, referred as part of syncope and falls
work-up, that had a TTT in a 62 month period in a UK district
general hospital. The modified Westminster protocol was used.
Demographic and patient data and TTT results were collected from
the HISS system and stored on an excel sheet. Simple statistics were
used to analyse the data.
Results:
549 patients had TTT in the audit period; the mean age
was 63 years, with 55% (302) females and 45% (247) males.
35% (192) were referred because of syncope, 23% (127) had
recurrent syncope, 25% (139) had presyncope and 17% (91) for other
symptoms suggestive of reflex syncope; 40% of whom (36/91) had
falls.
28% (152/549) of the TTT were positive.
66% (100/152)had neurocardiogenic (vasovagal) syncope, 26%
(40/152) had carotid hypersensitivity, 3% (4/152) had hypotension
and 3% (5/152) had POTS. Result was unavailable for 2% (3/152).
Of those 100 patients who had neurocardiogenic (vasovagal)
syncope; 68% had vasodepressor response, 25% mixed type,
6% cardioinhibitory 2A and 1% cardioinhibitory 2B.
Of those who had Carotid hypersensitivity 35% (14/40) had
vasodepressor response, 5% (2/40) cardioinhibitory 2A and
20% (8/40) cardioinhibitory 2B, and 40% (16/40) mixed type.
Conclusion:
In this audit, more than 1 in 4 patients had a positive
tilt table result. With good clinical selection, based on history and
examination, TTT is a useful clinical tool to investigate syncope and
falls.
In the studied population neurocardiogenic (vasovagal) syncope
represented the commonest variety of neutrally mediated syncope
(two thirds of positive cases) followed by carotid hypersensitivity
(one quarter of positive cases).
P-257
Analysis of gastric cancer in a geriatric population
A. Nogueira
1
, R. Garcia
2
, N. Saraiva
2
, P. Jacinto
2
, J. Ribeiro
2
,
N. Bonito
2
, M. Marques
2
, H. Gerv ´asio
2
1
Coimbra’s Portuguese Institute of Oncology, Coimbra, Portugal;
2
IPOC
FG, Coimbra, Portugal
Objectives:
Characterization of a geriatric population with gastric
cancer.
Methods:
We, retrospectively, reviewed data from 71 patients
(minimal age 75) diagnosed with gastric cancer between
2006–2012. The charateristics considered were: age, gender,
comorbidities, clinical presentation, tumor location, lymph node
status, T and N stage, differentiation grade, histologic subtype,
therapeutic proposal (surgery, chemotherapy, best supportive care,
clinical surveillance) and toxicities.
Results:
In this population, median age was 78 (range, 75 to 92),
most were male (52.1%) and had an ECOG 1 (64.8%). Gastric pain
(42.3%) was the most common clinical presentation. Tumors were
predominantly located in the pyloric antrum (57.7%).
At diagnosis, 19.7% had stage IV diseases. From those, 71.4%
underwent palliative chemotherapy and 28.6% referred to best
supportive care.
From those candidates to curative surgery (66.2%), subtotal
gastrectomy was performed in 91.4%. Concerning pathologic stage,
pT1, pT2, pT3 and pT4 were diagnosed in 39.6%, 25%, 29.2% and
6.2% and pN0, pN1, pN2 and pN3 in 52.1%, 22.9%, 14.6% and 10.4%,
respectively.
Considering histology, 80.3% were intestinal type and 59.1% grade
1. The median metastatic/excised lymph node ratio was 0.16.
Following surgery, 11.6% underwent adjuvant chemotherapy and
the others stayed on clinical surveillance.
From those submited to chemotherapy, 61.5% had toxicity grade 3
or 4. Only 3.6% were subjected to a second line of chemotherapy.
Conclusions:
Geriatric population are often underrepresented
on clinical trials. It is of most relevance to understand their
characteristics and adjust the therapy to patient’s frailty instead
of age, as they can benefit from it.
P-258
The importance of measuring bone mineral density (BMD)
in a patient with liver transplantation
–
patient case report
R. Pircalabu
1
, R. Hnidei
2
, B. Morosanu
2
1
NIGG Ana Aslan, Bucharest, Romania;
2
NIGG, Bucharest
Introduction:
Osteoporosis is a major problem of public health.
With the increase in the number of organs transplanted and the
improved survival of transplant patients, osteoporosis has emerged
as a frequent complication of the transplantation process.
Objectives:
The aim of this study was to determine BMD in a male
adult after liver transplantation.
Methods:
In this study we present a man at 61 years old who has
liver transplantation. We determined lumbar spine BMD and hip
with Dual-energy X-ray absorptiometry method (DXA).We don’t
know which BMD level before the surgery was.
Results:
BMD and Tscore values determined by DXA method
at left femoral neck, indicated osteopenia (BMD = 0.852 g/cm
2
;
Tscore = −1.7DS). Mean BMD and Tscore values measured at
the lumbar spine showed severe osteopenia (BMD = 0.996 g/cm
2
;
Tscore = −1.9DS). Large decrease in BMD at lumbar spine and
hip associated with immunosuppressive drugs, increase the risk
to osteoporosis and fractures.
Conclusions:
All transplant candidates should be evaluated, by
osteoporosis, before and after liver transplantation. It is necessary