Part of the book: eHealth and Remote Monitoring
In this chapter, we report and discuss the current literature of nutrient-deficiency anemia, also called nutritional anemia, in elderly patients in developed countries. For this purpose, a review of medical literatures was conducted searching PubMed, textbooks of hematology, internal medicine and geriatrics, and information collected from international meetings were also included. The term nutrient deficiency or nutritional anemia covers any anemia, defined by a hemoglobin level <13 g/dL (<130 g/L) in men and <12 g/dL (<120 g/L) in women, resulting from a deficiency of materials essential for erythropoiesis. Patients with nutritional anemia often have mild to moderate anemia, with hemoglobin levels between 8 and 10 g/dL (80 and 100 g/L). In practice, nutritional anemia represents one-third of all anemia in elderly patients. About two-third of nutritional anemia is associated with iron deficiency and most of those cases are the result of chronic blood loss from gastrointestinal lesions. The remaining cases of nutritional anemia are usually associated with vitamin B12 (cobalamin), most frequently related to food-cobalamin malabsorption (especially in case of atrophic gastritis), and Biermer’s disease (pernicious anemia); and/or vitamin B9 (folate) deficiency, most frequently related to inadequate dietary intake or malnutrition, several drugs (as methotrexate, cotrimoxazole) and chronic alcohol intake. In clinical practice, recognition of these disorders and deficiencies is essential for optimal treatment (nutrient-deficiency replacement).
Part of the book: Current Topics in Anemia
In this chapter, we report and discuss the diagnosis and management of idiosyncratic drug-induced, or drug-associated, severe neutropenia, and agranulocytosis (neutrophil count of <0.5 × 109/L). In this setting, neutropenia remains a potentially serious adverse event due to the frequency of severe sepsis, with severe deep tissue infections (e.g., pneumonia), life-threatening infections, septicemia, and septic shock in two-thirds of all hospitalized patients. Recently, several poor prognostic factors, impacting the hematological recovery, the duration of hospitalization, and the outcome have been identified that may be helpful when identifying “frailty” patients. These factors include: old age, poor performance status, septicemia or shock, comorbidities such as renal failure, and a neutrophil count below 0.1 × 109/L. recovery. In this situation, modern management, with broad-spectrum antibiotics in case of any sepsis sign and hematopoietic growth factors (HGF) (particularly G-CSF), is likely to improve the prognosis, with a current mortality rate around 5%.
Part of the book: Hematology
Background: This is a short narrative review of the literature pertaining to telemedicine projects developed in the field of chronic heart failure (CHF), with particular focus on non-invasive telemonitoring projects including the French ones.
Part of the book: Topics in Heart Failure Management
Since the beginning of the 1990s, several telemedicine projects and studies focused on type 1 and type 2 diabetes have been developed, including very few elderly diabetic patients. Several of these projects specifically concerned elderly subjects (n = 4). Mainly, these projects and studies show that telemonitoring diabetes results in improved blood glucose control—a significant reduction in HbA1c, improved patient ownership of the disease, greater patient adherence to therapeutic and hygiene-dietary measures, positive impact on comorbidities (hypertension, weight, dyslipidemia), improved quality of life for patients, and at least good patient receptivity and accountability. To date, the magnitude of its effects remains debatable, especially with the variation in patients’ characteristics (e.g., background, ability for self-management, medical condition), sample selection, and approach for treatment of control groups. Over the last 5 years, numerous telemedicine projects based on connected objects and new information and communication technologies (ICT) (elements defining telemedicine 2.0) have emerged or are still under development.
Part of the book: Geriatric Medicine and Gerontology
In recent years, several technological innovations have become part of the daily lives of patients suffered from chronic diseases. It is the case for diabetes mellitus and chronic heart failure with noninvasive glucose sensors, intelligent insulin pumps, artificial pancreas, telemedicine, and artificial intelligence for an optimal management. A review of the literature dedicated to these technologies and devices supports the efficacy of the latter. Mainly, these technologies have shown a beneficial effect on diabetes or chronic heart failure management with mainly improvement for these two diseases of patient ownership of the disease; patient adherence to therapeutic and hygiene-dietary measures; the management of comorbidities (hypertension, weight, dyslipidemia); and at least, good patient receptivity and accountability. Especially, the emergence of these technologies in the daily lives of these patients suffered from chronic disease has led to an improvement of the quality of life for patients. Nevertheless, the magnitude of its effects remains to date debatable or to be consolidated, especially with the variation in patients’ characteristics and methods of experimentation and in terms of medical and economic objectives.
Part of the book: Recent Advances in Digital System Diagnosis and Management of Healthcare