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Aim To assess the incidence and associated risk factors of asymptomatic urinary retention in elderly women upon admission to the Internal Medicine department. Methods Two hundred and two consecutive elderly women (mean age 84.4 ± 5.7 years) who were admitted to four Internal Medicine departments at a tertiary medical center were prospectively enrolled. All patients underwent post-void residual urine (PVR) measurements on the morning following the admission day. The measurements were undertaken by using a portable ultrasound bladder scan. Asymptomatic urinary retention was defined as PVR ≥ 200 ml without lower urinary tract symptoms, or abdominal pain, in two consecutive measurements. Results Asymptomatic urinary retention was diagnosed in 29 (14.4%) women (mean PVR: 353.1 ± 155.2 ml; range: 200-712 ml). The mean age, prevalence of chronic diseases, and the use of opioid and antimuscarinic drugs were similar in women with versus without asymptomatic urinary retention. A binary logistic regression analysis showed that asymptomatic urinary retention was significantly and independently associated with low mobility, measured by the functional independence measure (FIM) scale (odds ratio = 0.7, 95% confidence interval 0.6-0.9, P = 0.026), and hypothyroidism (odds ratio = 2.4, 95% confidence interval 1.0-5.8, P = 0.049). Among 174 (86.1%) patients in whom thyroid-stimulating hormone (TSH) serum levels were measured, a statistically significant correlation was demonstrated between TSH values and PVR measurements. Conclusions Asymptomatic urinary retention in elderly women upon admission to the Internal Medicine department is not infrequent and is independently associated with hypothyroidism and low mobility. PVR measurements should, therefore, be considered in all women with a low level of mobility and/or hypothyroidism upon admission to the Internal Medicine department. Neurourol. Urodynam. 36:794-797, 2017. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Introduction: Functional Independence Measure (FIM) is a scale used to evaluate functional status during rehabilitation. The association between FIM scale scores upon hip fracture rehabilitation completion and functional status of older adults according to the Israeli Ministry of Health (MOH) guidelines has never been studied., Aims: To study the association between FIM scale scores upon hip fracture rehabilitation completion and functional status of older adults., Methods: A retrospective cross-sectional study was conducted at the Geriatric-Orthopedic unit at the Sheba Medical Center. The medical charts of older adults (age ≥65) admitted for rehabilitation following hip fracture during 2007-2012 were studied. Age, gender, total FIM score upon rehabilitation completion, functional status upon rehabilitation completion according to the Israeli MOH guidelines, and moving to a nursing-home were documented., Results: The cohort included 453 older adults: 374 (82.6%) females; mean age 82.9±6.7 years. Most older adults were severely dependent upon rehabilitation completion (n=320, 70.6%) and 84 (26.3%) of whom moved to or returned to a nursing-home. Median total FIM scores upon rehabilitation completion was 100 (interquartile range (IQR): 92-111) in mildly dependent older adults, 72 (IQR: 53-87) in severely dependent community-dwelling older adults, and 39 (IQR: 29-58) in severely dependent nursing-home residents (p<0.001). Total FIM score of 85 (or less) had the highest sensitivity (78.4%) and specificity (91.0%) in representing severely dependent older adults., Conclusions: These findings may assist Israeli geriatricians to define the functional status of older adults upon hip fracture rehabilitation completion.

The diagnosis of pulmonary embolism is challenging in symptomatic COVID-19 patients since shortness of breath, chest pain, tachycardia, tachypnoea, fever, oxygen desaturation and high D-dimer blood levels might be features of both diseases. We present two COVID-19 patients in whom pulmonary embolism was suspected (and diagnosed) due to a discrepancy between an increase in D-dimer blood levels and a decrease in C-reactive protein blood levels over time. We believe that an opposite change in the blood levels of both biomarkers over time may be used as a novel method to predict pulmonary embolism in COVID-19 patients., Learning Points: The diagnosis of pulmonary embolism is challenging in COVID-19 patients since symptoms, signs and high D-dimer blood levels might be similar in both diseases.An increase in D-dimer blood levels and a decrease in C-reactive protein blood levels over time may be used as a novel method to predict pulmonary embolism in COVID-19 patients., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2020.)