Changes in serum biochemical markers in relation to chief complaints and aging in general medicine

Published on Dec 1, 2018in Acta Medica Okayama0.642
· DOI :10.18926/AMO/56372
Daisuke Omura2
Estimated H-index: 2
(Okayama University),
Asuka Sato1
Estimated H-index: 1
+ 4 AuthorsFumio Otsuka35
Estimated H-index: 35
Sources
Abstract
To clarify potential relationships between chief complaints of patients and laboratory data with a focus on aging-related changes, we retrospectively analyzed the data of 843 patients who visited a general medicine department for the first time. Their chief complaints were classified into 8 major symptoms: visceral pain, somatic pain, fever, cough, dizziness, fatigue, appetite loss, and edema. We compared the laboratory data obtained from the patients with complaints with the data of symptom-free (control) patients. The serum sodium and potassium levels in the fever group were decreased compared to those in the control group. In the fever group, the serum sodium level was inversely correlated with age. The ratio of serum urea nitrogen to creatinine (UN/Cr) was increased in the appetite-loss group. There were significant age-dependent increases in the UN/Cr ratio in the appetite-loss and edema groups. Of note, serum levels of free thyroxin were lower in the dizziness group compared to the control group. In addition, the free thyroxin level was inversely correlated with age in the dizziness group but not in the asymptomatic control group. Collectively, the results indicated that osmolality-related laboratory data are strongly associated with individual primary symptoms at the first visit regardless of the final diagnosis. The consideration of age-dependent changes of these markers is helpful for diagnosing latent disorders based on various primary symptoms.
📖 Papers frequently viewed together
8 Citations
3 Citations
References0
Newest
#1Kosuke OkaH-Index: 2
#2Yoshihisa Hanayama (Okayama University)H-Index: 6
Last. Fumio OtsukaH-Index: 35
view all 8 authors...
We retrospectively analyzed the cases of 148 febrile patients whose body temperature (BT) was ≥ 37.5°C at our hospital. We categorized them into seven groups; those with bacterial and viral infection, nonspecific inflammation, neoplasm, connective tissue disease (CTD), drug-induced disease, and unidentified causes. Our analysis revealed that the patient’s BT at the 1st visit (BT-1st visit) and highest BT during the febrile period (BT-max) differed significantly among all categories except neopla...
1 CitationsSource
AbstractBackground:Mineralocorticoid responsive hyponatremia of the elderly (MRHE) is an emerging concept of hyponatremia in aged people. Diagnosis of MRHE requires exclusion of syndrome of inappropriate antidiuresis and adrenal dysfunction. Thus we aimed to evaluate the characteristics of all patie
3 CitationsSource
#1Christian A. Koch (UMMC: University of Mississippi Medical Center)H-Index: 38
#2Tibor Fülöp (Fresenius Medical Care)H-Index: 22
The population of elderly individuals is increasing worldwide. With aging, various hormonal and kidney changes occur, both affecting water homeostasis. Aging is a risk factor for chronic kidney disease (CKD) and many features of CKD are reproduced in the aging kidney. Dehydration and hyperosmolarity can be triggered by diminished thirst perception in this population. Elderly with dementia are especially susceptible to abnormalities of their electrolyte and body water homeostasis and should be (r...
24 CitationsSource
#1Christian Bucher (Kantonsspital St. Gallen)H-Index: 1
#2Daniel Tapernoux (Kantonsspital St. Gallen)H-Index: 1
Last. Samuel Henz (Kantonsspital St. Gallen)H-Index: 10
view all 7 authors...
Abstract Objectives Considerable variation in serum sodium (Na) and chloride (Cl) is found in patients at hospital admission. Our goal was to quantify the respective impact of drugs, comorbidities, demographic factors and weather conditions on serum Na and Cl. Design and methods For 13 277 consecutive patients without terminal kidney disease admitted to the Department of Internal Medicine of the Kantonsspital St. Gallen drug history on admission, age, sex, body weight, ICD-10 diagnoses, and labo...
5 CitationsSource
#1Hiromasa RyukoH-Index: 3
#2Fumio Otsuka (Okayama University)H-Index: 35
������������������������������� ������������������������������������������������ � �������������������������������������� ������������-����� ������ Primary care physicians often encounter patients with fever of unknown origin and without apparent causes. Recent advances in laboratory medicine have facilitated diagnostic procedures; however it is still difficult to determine the critical febrile factor at an early stage. We reviewed the medical records of 174 patients who were admitted due to a chi...
6 CitationsSource
#1Yoshinobu Kanda (Jichi Medical University)H-Index: 38
Although there are many commercially available statistical software packages, only a few implement a competing risk analysis or a proportional hazards regression model with time-dependent covariates, which are necessary in studies on hematopoietic SCT. In addition, most packages are not clinician friendly, as they require that commands be written based on statistical languages. This report describes the statistical software ‘EZR' (Easy R), which is based on R and R commander. EZR enables the app...
5,446 CitationsSource
> Every Quebecer wants his or her own family doctor, yet family medicine residents completing their training are shunning doctors’ offices. Is the way in which continuity of care is taught in family medicine units contributing to residents’ lack of interest in this area of practice? A newly
1 Citations
Many epidemiologic studies have examined age-related processes in humans. Some of the difficulties with these studies are noted. Endocrinologic changes of aging often are compensated for by feedback mechanisms and do not cause dysfunction. Common aging changes are reviewed.
5 CitationsSource
#1Stefano Mariotti (UniPi: University of Pisa)H-Index: 60
#2Giuseppe Barbesino (UniPi: University of Pisa)H-Index: 30
Last. Aldo Pinchera (UniPi: University of Pisa)H-Index: 115
view all 10 authors...
Several changes in thyroid function have been described in the elderly and largely attributed to concomitant nonthyroidal illness. The extent to which aging per se contributes to these changes remains to be elucidated, and scanty data are available in extremely old subjects. The present study was designed to focus on thyroid function during physiological aging, taking advantage of two groups of selected aged individuals: group A of healthy centenarians (n = 41; age range, 100-110 yr) and group B...
171 CitationsSource
#1Basil Rapoport (UCSF: University of California, San Francisco)H-Index: 57
Autoimmune Hashimoto's thyroiditis, the most common endocrine disorder, is primarily a subclinical disease. Whether or not subclinical hypothyroidism should be treated remains controversial. Recent advances have been made in understanding the molecular nature of the antigens that are the target of the immune system in Hashimoto's thyroiditis. The “microsomal antigen” is now recognized to be thyroid peroxidase.
31 CitationsSource
Cited By0
Newest