Vikas Gupta MD, MRCP(UK), MRCPath, Department of Medical Oncology and Hematology, Princess Margaret Hospital/University Health Network; University of Toronto, Toronto, ON.

Old age is usually considered a significant risk factor for venous thromboembolism (VTE), and the incidence of VTE increases exponentially with age. Associated comorbid conditions such as heart failure, postoperative states, malignancy and long-term immobility contribute considerably towards the higher incidence of these hypercoagulable disorders in this subgroup of patients. The optimal, cost-effective laboratory work-up for underlying thrombophilic or hypercoagulable states is not clear in older patients. The main aim of this article is to review the inherited thrombophilic disorders and discuss their clinical relevance in older patients.
Key words: hypercoagulable disorders, thrombophilia, venous thromboembolism, risk factors.

Jeremy L. Freeman, MD, FRCSC, FACS, Professor of Otolaryngology, University of Toronto; Temmy Latner/Dynacare Chair in Head and Neck Oncology, Otolaryngologist-in-Chief, Mount Sinai Hospital, Toronto, ON.

Carsten E. Palme, MB BS, FRACS, Fellow, Head and Neck Oncology, Department of Otolaryngology, University of Toronto, Toronto, ON.

The management of thyroid nodules in the elderly patient involves paying specific attention to risk factors for malignancy. Certainly, patients over 45 years of age have a higher risk of harbouring a malignancy than younger patients. When a decision is made for intervention, one must keep in mind comorbidity issues balanced against the risk of surgery for a potential malignant tumour of low biological activity.
Key words: thyroid, risk factors, comorbidity, malignant tumour.