British Hospital

About: British Hospital is a healthcare organization based out in Montevideo, Uruguay. It is known for research contribution in the topics: Population & Hazard ratio. The organization has 445 authors who have published 358 publications receiving 7878 citations. The organization is also known as: British Hospital.

Sleep characteristics of amyotrophic lateral sclerosis in patients with preserved diaphragmatic function.

Abstract: There are a number of sleep studies in amyotrophic lateral sclerosis (ALS), in general including a heterogeneous population of patients. We aimed to study sleep in a population of selected ALS patients by investigating nocturnal polysomnography (PSG) characteristics in ALS patients with normal respiratory function tests and preserved diaphragmatic innervation. Ninety-two ALS patients were screened by percutaneous nocturnal oximetry (PNO). Eleven ALS patients with normal respiratory function tests, phrenic motor responses and preserved motor units on needle electromyography of the diaphragm, but abnormal PNO, were selected for PSG. REM was present in eight patients, but normal in only three. Three patients had mixed apnoea-hypopnoea, severe in one. Seven showed a pattern of periodic mild O(2) desaturation, which occurred in REM 3, REM and NREM 3 and in NREM sleep 1. One patient studied six months later had more severe changes in the second evaluation. In conclusion, the most common sleep disordered breathing was periodic mild O(2) desaturation independent of the sleep stage (REM, NREM). This might represent central drive dysfunction or respiratory muscle fatigue in ALS.

Characteristics of Early-Onset vs Late-Onset Colorectal Cancer A Review

Abstract: Importance The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Observations Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. Conclusions and Relevance The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.

Nonconvulsive status epilepticus in the elderly: a case-control study

Abstract: Summary: Background: Nonconvulsive status epilepticus (NCSE) is a usually underdiagnosed and potentially treatable cause of altered awareness in the elderly. To assess etiologies, associations with other medical problems, and prognosis of NCSE in a population aged >75 years we performed a nested case–control study. Methods: We retrospectively evaluated the clinical manifestations and EEG findings in 19 consecutive elderly patients (mean age 83.3 years) presenting with NCSE and compared them with 34 elderly patients (mean age 83.3 years) with altered mental status but without EEG evidence of NCSE. The variables compared included brain lesions on CT or MRI, number of concomitant chronic active diseases, previous neurological disorders, acute medical problems, the use and withdrawal of medications, and outcome. Statistical analysis was performed using chi-square test, t-test, Fisher's exact two-tailed test, and Wilcoxon rank sum test. Results: The etiology of NCSE was epilepsy in 2, acute medical disorders in 14, and a cryptogenic cause in 4. The NCSE group had a more frequent history of epilepsy, 35% versus 8.8% (p = 0.028); tramadol use, 31% versus 0% (p = 0.00151); longer hospitalization, 25 days versus 7 days (p = 0.0004); and unfavorable outcome, 50% versus 5.8% (p = 0.00031). No significant differences were found in the other variables. Unfavorable outcome was associated with a higher number of comorbidities (>2) and to a severely altered mental status. Conclusions: NCSE is a serious cause of altered mental status in the elderly. Although its direct role in brain damage is controversial, elderly patients with NCSE have higher morbidity and worst prognosis than those with altered mental status without NCSE.