Geriatric in-patient dermatoses are diverse. Few data in Morocco describe the epidemiological profile and factors associated with average length of stay (LOS). Our aim was to identify these dermatoses and determine the factors associated with LOS.

The superior lumbar hernia or hernia of GRYNFELTT is a rare pathology. It accounts for less than 1.5% of all hernias in the abdomen. An 84 year-old man with upper right lumbar swelling. The clinical examination revealed a right upper lumbar swelling of 5 cm in diameter, soft, gurgling, reducible, impulsive to cough and expansive to intra-abdominal hyperpressure. There was no history of trauma, surgery, tuberculosis or dysuria. The diagnosis of an uncomplicated upper lumbar hernia was retained. Intra-operatively, the sac was dissected up to the hernia opening, separated from the edges of the hernia orifice and discharged. The repair was performed by suturing the back of the hernia opening with a non absorbable thread. The patient was released on day 1 postoperatively. The suites were simple.
La hernie lombaire supérieure ou hernie de GRYNFELTT est une pathologie rare. Elle représente moins de 1,5% de toutes les hernies de l\'abdomen. Un homme de 84 ans a été reçu pour une tuméfaction lombaire supérieure droite. L\'examen clinique a permis de mettre en évidence une tuméfaction lombaire supérieure droite de 5cm de diamètre, molle, gargouillante, réductible, impulsive à la toux et expansive à l\'hyperpression intra-abdominale. Il n\'y avait pas d\'antécédents de traumatisme, de chirurgie, de tuberculose ou de dysurie. Le diagnostic d\'une hernie lombaire supérieure non compliquée a été retenu. En peropératoire, le sac a été disséqué jusqu\'à l\'orifice herniaire, séparé des bords de l\'orifice herniaire et refoulé. La réparation a été faite par suture en surjet aller-retour des berges de l\'orifice herniaire avec du fil non résorbable. Le malade a été libéré à J1 post-opératoire. Les suites ont été simples.

UNASSIGNED: The occurrence of bilateral extradural hematomas (EDH) is a rare consequence of craniocerebral trauma, and acute symmetrical bilateral epidural hematomas are extremely rare even more so in elderly subjects.
METHODS: We report the case of an 82-year-old patient who had fallen down a flight of stairs. Scalp examination was consistent with a bi-parietal subgaleal hematoma. Clinically, he was confused with a glascow score of 13/15. His brain scan showed bilateral and symmetrical parietal EDH with simple fractures of both parietal bones. The patient underwent a two-stage evacuation of the extra-dural hematomas.
UNASSIGNED: The management of bilateral EDH cases requires careful planning, adequate exposure, judicious surgical approach and time management for good results.
CONCLUSIONS: To our knowledge, no case of bilateral hematoma in an elderly subject has been reported in the literature.

Direct oral anticoagulants (DOACs) are tending to supplant antivitamin K inhibitors (VKAs) in their common indications, dominated in elderly patients by atrial fibrillation and venous thromboembolism. Nevertheless, it remains necessary to know how best to use VKAs for which there are still indications. It is also important not to assume that AODs can be prescribed without risk, while ignoring certain particularities in their handling, particularly in the most fragile patients with co-morbidities and multiple medications.

OBJECTIVE: Reverse total shoulder arthroplasty (RSA) has revolutionized the management of proximal humerus fractures (PHF) in the elderly patients. There is few or no consensus regarding to management of postoperative rehabilitation in elderly patients. An early rehabilitation from D1 allowed better functional results compared to rehabilitation started to D30 independently from tuberosities consolidation.
METHODS: 94 patients operated on for PHF were evaluated retrospectively, with a minimum radio-clinical follow-up of 2 years. Clinical evaluation included mobilities and four functional scores: ASES, quick DASH, gross constant, weighted constant. Radiological evaluation was performed on a frontal shoulder X-ray with evaluation of tuberosities\' consolidation.
RESULTS: The mean follow-up was 45 ± 19 months (24-88 months). Early rehabilitation was significantly associated with a better Constant Score (71.1 ± 17.2 vs. 56.4 ± 15.8; p < 0.001), better adjusted Constant score (92.4 ± 14.2 vs. 80.3 ± 19.5; p < 0.001), better quick DASH (22.8 ± 19.8 vs. 36.7 ± 21.3; p < 0.01), better ASES (78.6 ± 20.2 vs. 63 ± 22; p < 0.001).
CONCLUSIONS: In traumatology, functional result of RSA seems not related in tuberosities\' union but in rehabilitation in order to limit postoperative stiffness of operated shoulder. An early rehabilitation is related with better clinical and functional results, independently of tuberosities\' union.
METHODS: 3, control-case study.

Swallowing disorders, which are frequent in geriatrics, are linked to multiple pathologies: cancer, stroke, neurocognitive disorders, acute confusion, vigilance disorders, etc. They can have serious consequences and therefore require special care. From the identification of the disorders by the doctor, the nurse, the caregiver, to the speech therapy assessment, through the adaptation of the diet by the dietician, the management of swallowing disorders concerns all the medical and paramedical staff. The aim of this article is to present the main existing recommendations to promote the patient\'s feeding despite the presence of these disorders.

Home delivery has expanded across all retail sectors. During the first waves of the Covid-19 pandemic, pharmacists were approached by many of their patients who wanted to receive their medications at home. The question is whether this development is sustainable or merely cyclical.

BACKGROUND: Nobiletin exerts beneficial effects on cognitive function in various animal models of Alzheimer\'s disease. The present study aimed to investigate the benefits and safety of a combination food of nobiletin-rich extract from C. depressa peel for healthy elderly subjects.
METHODS: The nobiletin-containing test food (Nobilex®) comprised high-purity nobiletin powder combined with dried root powder of K. parviflora and dried lead powder of P. japonicum and was administered to elderly Japanese subjects once a day for 16 weeks. The Japanese version of the Wechsler Memory Scaled-Revised (WMS-R) was used as a primary evaluation item for the assessment of global memory. Data from a protocol-matched population (Per Protocol Set: PPS) (n = 108) were analyzed.
RESULTS: The scores of \"general memory\" or \"visual memory\" in the indices of WMS-R were significantly higher in the nobiletin-containing test food group than in the placebo group. The difference in the total WMS-R score was significantly higher in the test-food group (9.0 ± 7.20) than in the placebo group (5.9 ± 7.70). An age-stratified analysis of the WMS-R test showed similar changes in subjects aged ≦74 years to those in the overall subject population. In the stratified analysis involving subjects with an MMSE-J score of between 24 and 28, the \"figural memory\" subscale score in WMS-R was significantly higher in the test food group than in the placebo group.
CONCLUSIONS: The present results indicate that the nobiletin-containing test food is beneficial for improving memory dysfunction in healthy elderly subjects.

Panic disorder in the elderly is an understudied disorder, despite being associated with substantial functional impairment, a diminished quality of life and an increased suicide risk in this population. This disorder is likely to be underdiagnosed and sometimes inadequately treated due to the absence of national and international guidelines for this vulnerable population. Few therapeutic trials have specifically focused on the efficacy and tolerability of pharmacological and psychotherapy treatments for panic disorder in the elderly and current approaches to detect and manage this disorder are mainly based on expert opinions or extrapolation from data available on younger adults. This report aims to provide a summary of current knowledge on pharmacological and psychotherapeutic treatments for panic disorder in the elderly and to propose a medical treatment algorithm, which should be viewed as a tool that may contribute to the choice of treatment, especially for treatment-resistant older patients with panic disorder. The main results here are the emphasis on antidepressant treatment, such as selective serotonin reuptake inhibitor (SSRI), restricted benzodiazepine usage, awareness of drug interactions and the importance of psychotherapy such as cognitive behavioural therapy (CBT).

Acute coronary syndrome (ACS) is a pathology frequently encountered in emergency rooms, especially in the elderly. Caregivers must know how to recognize an ACS despite an often heterogeneous and atypical presentation. Management should include an overall assessment of the patient in order to decide on the best management for the patient.