European Geriatric Medicine - Supplement 1 - Volume 7 - October 2016

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hemicolectomy was performed. RS3PE can be a paraneoplastic
manifestation of an occult malignancy and an extensive clinical eva-
luation may be beneficial to exclude secondary causes.
P-518
Drug-induced lupus – a diagnostic challenge
A.R. Nogueira 1,2, D. Ferreira1,2, H. Clemente1,2, G. Vidal 2, M. Pereira 1,2,
A.R. Alves 2, S. Leitão1,2, A. Aragão2, M.T. Veríssimo1,2, A. Carvalho 1,2.
1Faculty of Medicine of the University of Coimbra, 2Coimbra Hospital and
Universitary Center, Portugal
Autoimmune diseases are not limited to younger ages and their
manifestations in the elderly frequently require a high level of
suspicion. We present a case of a 74 years old female patient, who
had multiple hospitalizations during the past year due to anorexia,
asthenia and significant weight loss, developing slowly through the
last months. At the beginning of the symptoms she had bilateral
thrombosis of internal saphenous vein. Subsequently the patient
developed chronic non-bloody diarrhea, ascites and leg edema. Her
family reported cognitive deterioration and decreased visual acuity.
She suffered from type 2 diabetes, arterial hypertension, dyslipidemia
and peptic ulcer disease. The patient’s medication history included
pantoprazole, linagliptin, furosemide, carvedilol, atorvastatin, mirta-
zapine and enoxaparin. The physical examination was compatible
with severe sarcopenia, ascites, leg edema and bilateral pleural
effusion. We also identified triphasic Raynaud’s phenomenon. The
neurologic exam revealed left homonymous hemianopsia and right
homonymous quadrantanopsia, with anosognosia. After exclusion of
an infectious disease and with an unremarkable colonoscopy, the
laboratory findings revealed mild bicytopenia and proteinuria.
Furthermore, the autoimmunity screening detected a high titer of
anti-nuclear antibodies (1:1280), with a homogenous pattern and the
presence of anti-dsDNA antibody (8,67 IU/mL) and anti-histone
antibodies (>200 U/mL). Complement levels (C3 and C4) were
decreased and antiphospholipid syndrome antibodies were absent.
We assumed the diagnosis of drug induced lupus possibly secondary
to consumption of statins or angiotensin converting enzyme inhibi-
tors. After suspension of these medications, the treatment was started
with prednisolone (1 mg/Kg) and hydroxychloroquine with initial
satisfactory response.
P-519
Outcomes in older patients with advanced chronic kidney disease:
six-month follow-up
M.E. Portilla 1, L. Gómez1, R. Sosa1, F. Tornero2, J.A. Herrero2, C. Verdejo1.
1Department of Geriactrics, Hospital Clinico San Carlos, 2Department of
Nephrology, Hospital Clinico San Carlos, Madrid, Spain
Objectives: To evaluate the occurrence of fatal and nonfatal events in
older patients with Advanced Chronic Kidney Disease (ACKD) during a
6-month follow-up.
Methods: Patients ≥65 years old assessed in ACKD clinics (not on
dialysis) with estimated glomerular filtration rate (eGFR) <20 mL/min
(CKD-EPI formula). Baseline variables: socio-demographic data, func-
tional status (Barthel, Lawton, Functional Ambulation Classification),
comorbidity (CIRS-G), drugs, basal lab tests. Outcomes included Fatal
events: initiation of Renal Replacement Therapy (RRT) and/or death;
and Non-fatal events: hospitalization due to medical causes.
Results: 80 patients, mean age 78.3 years (±7.4). Rate of fatal events
13.8%. Analysis showed protective association with albumin <3.5 g/dL
(OR 0.03), prealbumin <22 mg/dL (OR 0.09), and increased risk with
HUGE formula >8 (OR 13.81). Statins showed a protective tendency
(OR 0.17). Rate of Nonfatal events 38.3%. Analysis showed association
with atrial fibrillation (AF) (OR 3,142), potassium levels >5 (OR 2.9).
Cardiovascular complications were associated with age ≥80 years (OR
4.5) and AF (OR 3.9). There was a high risk of bleeding in users of
acenocumarol (OR 10.7).
Conclusions: These preliminary results show that mortality and
initiation of RRT were related to malnutrition parameters and higher
scores on the HUGE formula. Also, that AF increases the risk of hospital
admissions, and the use of acenocumarol the risk of bleeding, and
finally that patients older than 80 years and those with AF have higher
risk of cardiovascular complications.
P-520
Risk factors and complications of arterial hypotension in older
people
G.I. Prada1,2, R.M. Nacu1,2, L.E. Lungu1,2, A.G. Prada2, A.C. Ilie3, A.
I. Pislaru3, I.D. Alexa3, A.M. Herghelegiu1. 1“Ana Aslan”National Institute
of Gerontology and Geriatrics, 2“Carol Davila” University of Medicine and
Pharmacy, Bucharest, 3“Gr.T. Popa” University of Medicine and Pharmacy,
Iasi, Romania
Introduction: Arterial hypotension is a major problem in elderly
and has significant consequences: syncope, falls, stroke, myocardial
infarction, even death. Study objective was to identify risk factors and
complication of this condition in elderly.
Material andmethods: A total of 277 subjects, age-range 44 –95 years,
were included. They were divided into two groups, both presenting
arterial hypotension: 136 adults (44–64 years) 136 and 141 elderly
(75–95 years).
Results: Three types of arterial hypotension have been identified in
elderly: orthostatic hypotension, post-prandial, post-exercise hypo-
tension. In our sample, most cases had orthostatic hypotension, other
variants had less than 4% prevalence. Parkinson disease was more
often seen in older patients (p < 0.05). Type 2 diabetes mellitus and
chronic renal disease were also more prevalent in elderly (p < 0.05).
Smoking was more prevalent in adult males. Three groups of medi-
cines were involved: psychoactive, antiparkinsonian, vasodilator
drugs. Age of menopause younger than 46 years was more prevalent
in elderly women with arterial hypotension (chi square = 9.762,
p < 0.05). Anemia was significantly more prevalent in elderly (p <
0.001). Stroke and myocardial infarction was significantly more
prevalent in elderly patients (p < 0.01). Vertigo and syncope occurred
as complications of arterial hypotension more often in elderly
(p < 0.01), as well as falls, fractures and ischemic heart disease.
Orthostatic hypotension was identified in elderly more than twice in
adults. Headache and asthenia occurred more often in elderly
(p < 0.05).
Conclusions: Identifying arterial hypotension, its forms and addres-
sing some of its most important risk factors, could improve standing
and prevent falls and other complications in elderly.
P-521
Prostate intrafraction motion during radiotherapy of prostate
cancer assessed by cone beam CT
B. Radavičius1, L. Jaruševičius2. 1Faculty of Medicine of Vilnius University,
Vilnius, 2Lithuanian University of Health Sciences, Oncology and
Hematology Clinic, Kaunas, Lithuania
Background: Radical prostate radiotherapy is one of the prostate
cancer treatment’ s options. Daily cone beam CT (CBCT) helps to create
an irradiation target, but prostate motion problem remains. Aim:
To assess prostate intrafractionmotion during radiotherapy in geriatric
patients.
Methods: We analized 335 CT fractions in 12 prostate cancer patients,
which were treated in Lithuanian University of health sciences,
Oncology and Hematology clinic, Radiotherapy Department in 2012–
2013. Before treatment a pre-treatment CBCT and immediately after
treatment, a second CBCT was performed.
Results: Patients median age 70.58 years. Fraction time 6.5 ± 1.19 min.
Post-treatment CBCT showed the prostate motion in sagital axis
was from 0 to 22 mm (mean – 1.81 ± 2.27), transverse motion: 0 to
12 mm (mean – 0.73 ± 1.17), vertical axis motion: 0 to 24 mm (mean –
2.16 ± 2.92). The post-treatment prostate position deviations showed
that prostate motion in the transverse axis is significantly lower than
in the vertical or sagital axes (p < 0.001). The evaluation of the
prostate motion in two time groups showed that during radiotherapy
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S166