C. Verdejo Bravo

Protocolo diagnóstico y terapéutico de la incontinencia y del síndrome vesical irritativo

Urinary problems, especially urinary incontinence, overactive bladder and benign prostatic hyperplasia, are a quite common and specific group of pathological disorders of the lower urinary tract on the older population, that cause a significant impairment on the quality of life. A multidimensional assessment, as well as the clinical and quality of life impacts, of the older people with these problems is required, due to their multifactorial origin. The clinical and quality of life questionnaires constitute a very important tool in the initial assessment and also in the follow-up and in the evaluation of the treatments response. The medical management of these problems is very wide and varied, underlying the conservative therapies (hygienic and medical recommendations plus changes in the life style) as well as the drugs, especially the antimuscarinic drugs in the treatment of urge urinary incontinence and overactive bladder, together with the alpha-blockers and the inhibitors of 5 alpha-reductase in benign prostatic hyperplasia.

Protocolo diagnóstico y tratamiento del síndrome constitucional en los pacientes mayores

The constitutional syndrome supposes the association of asthenia, anorexia and significant weight loss (defined as an involuntary decrease of 5% of total body weight in 6 months). Its etiology can be multiple and variable in the older people, so a comprehensive assessment (clinical history, physical examination, and complementary tests) is required in order to do the etiological orientation of the clinical syndrome. This clinical problem can be a common chief complaint in clinical practice among older people, and sometimes to suppose a challenge diagnostic. When the cause of the constitutional syndrome is not found, it is necessary to reevaluate the patient in a period of 1 to 6 months. A multidisciplinary approach is recommended to get better diagnostic results, especially in cases where weight loss has not an easy objective organic cause.

Patología digestiva en el paciente geriátrico. Alteraciones por reflujo gastroesofágico. Trastornos del ritmo intestinal. Valoración diagnóstica y actitud terapéutica

Se revisan los procesos patologicos digestivos mas frecuentes en el anciano, principalmente: enfermedad por reflujo gastroesofagico, gastritis cronica atrofica, ulcus peptico, sobrecrecimiento bacteriano, diverticulosis colonica, trastornos del ritmo intestinal, isquemia mesenterica y cancer colorrectal.

Manejo de la insuficiencia cardíaca del viejo. ¿Quién y dónde? Visión del geriatra

Resumen La insuficiencia cardiaca supone una entidad prevalente en el paciente geriatrico comunicandose que la edad es un factor de riesgo para el desarrollo de la misma. En este articulo se exponen las principales caracteristicas del paciente geriatrico, asi como la metodologia empleada por los geriatras para conocer todas esas caracteristicas y disenar el plan de tratamiento mas adecuado para cada paciente. Asimismo se presentan las caracteristicas diferenciales de la insuficiencia cardiaca en el paciente geriatrico, comentandose las principales peculiaridades en cuanto a su valoracion diagnostica. Con respecto al tratamiento de la insuficiencia cardiaca en el paciente geriatrico se exponen las lineas basicas del manejo farmacologico, con las modificaciones para el paciente geriatrico, y se describen los principales resultados del manejo no farmacologico, que cada vez desempena un papel mas relevante en el manejo de esta entidad clinica.