The Netherlands journal of medicine
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Diagnosis of vitamin B12 deficiency is difficult, as there is no conclusive single test for this disorder. We evaluated the association of serum B12 and methylmalonic acid (MMA) with haematologic parameters and physical and cognitive functioning in an effort to use such clinical parameters to improve the interpretation of serum values. ⋯ A large proportion of individuals with a decreased serum B12 concentration still has normal MMA concentrations. Elevated MMA concentrations were more strongly associated with poor functional performance than serum B12.
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Comparative Study
The APOP screener and clinical outcomes in older hospitalised internal medicine patients.
Acutely hospitalised older patients with indications related to internal medicine have high risks of adverse outcomes. We investigated whether risk stratification using the Acutely Presenting Older Patient (APOP) screening tool associates with clinical outcomes in this patient group. ⋯ The APOP screener identifies acutely hospitalised internal medicine patients at high risk for poor short and long-term outcomes. Early risk stratification at admission could aid in individualised treatment decisions to optimise outcomes for older patients.
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Case Reports
Viral encephalitis associated with rituximab maintenance therapy: two cases and a review of literature.
Rituximab is increasingly used in the treatment of CD20-positive B-cell-mediated disease. Prolonged use may cause B-cell dysfunction, dose-dependent T-cell dysfunction, and hypogammaglobulinaemia and result in severe non-neutropenic infections. We present two cases of viral encephalitis in patients treated with rituximab maintenance therapy: one patient presented with deafness; the other patient with paroxysmal light flashes, apraxia, and weakness.