S138 9th Congress of the EUGMS / European Geriatric Medicine 4 (2013) S81–S141 plete recovery to death. CVST diagnosis can be challenging due to its rarity and heterogeneity in clinical presentation, which most often consists of nonspeciﬁc symptoms such as headache that in the elderly is usually less noticeable. Likewise, the choice of an appropriate treatment may not be easy because of the absence of a uniform therapeutic strategy. We describe the case of a 87-year-old woman affected by multiple comorbidities presented with continu- ous mild headache and recurrent hypertensive crisis. Brain CT Scan revealed superior sagittal and transverse sinus thrombosis with a small intracerebral hemorrhage associated. Although some of the patient’s comorbidities were probably predisposing conditions to CVST our subsequent investigation allowed us to ﬁnd at least two new possible underlying causes for CVST namely chronic ethmoid sinusitis and in the ﬁnding on clinical laboratory tests of hyperthy- roidism. Despite the presence of intracranial bleeding after a careful clinical consideration anticoagulation therapy was started followed by clinical improvement and subsequent almost complete resolu- tion of the cerebral sinus thrombosis. Our report underscore the need of a high index of clinical suspicion to diagnose this uncom- mon condition in the elderly and emphasizes the importance of the individualization of treatment. http://dx.doi.org/10.1016/j.eurger.2013.07.453 P391 Randomised controlled trial of specialist geriatric medical assessment for patients discharged from hospital acute assessment units J. Edmans a,b , L. Bradshaw a,b , M. Franklyn a,b , J.R.F. Gladman a,b , S. Conroy a,b a University of Nottingham, Nottingham, United Kingdom b University Hospitals of Leicester, Leicester, United Kingdom Background.– Many older people presenting to acute medical assessment units are discharged after only a short stay, yet many re-present to hospital or die within 1 year. Objective.– To evaluate the effect of specialist geriatric medical management on the outcomes of high-risk older people discharged from acute medical assessment units (AMU). Design.– Multi-centre, individual patient RCT. Participants Patients aged > 70 who were discharged within 72 hours of attending an acute medical assessment unit and at high risk of decline as indi- cated by a score of 2 or more on the Identiﬁcation of Seniors At Risk score. Intervention Assessment made on the AMU and further out- patient management by geriatricians, including advice and support to primary care services. Outcome measurement.– The primary outcome was the number of days spent at, or days spent in the same care home in the 90 days from randomisation. Secondary outcomes included mortality, insti- tutionalisation, dependency, mental well-being, quality of life, and resource use. Results.– The two groups were well matched for baseline charac- teristics and withdrawal rates. Mean days at home over 90 days follow-up were 80.2 days in the control group and 79.7 in the intervention group, 95% conﬁdence interval (CI) for the difference in means -4.6 days to 3.6 days, P = 0.31. There were no signiﬁcant differences in any of the secondary outcomes. Conclusions.– An isolated specialist geriatric medical intervention applied to a high-risk population of older people being discharged from acute medical units had no impact on subsequent use of sec- ondary or long-term care services. http://dx.doi.org/10.1016/j.eurger.2013.07.454 P392 European fundamental rights, biomedical research and vulnerability of elderly people È. Gennet a,b a Institute for Biomedical Ethics, University of Basel & UMR Anthropology, law, ethics and health, Basel, Switzerland b University of Aix-Marseille, Marseille, France Text.– Biomedical research with older adults is a particularly rele- vant topic because such an investigation is current, topical, and of greater importance for our ageing population. With increasing life expectancy, older persons now live with different comorbidities and increasing frailty due to physical and/or neurological decline. Nevertheless, many authors criticize that there are very few clini- cal trials carried out on older adults, even for common medications, supposedly in order to protect their vulnerability. As part of an interdisciplinary PhD project in law, normative ethics and empirical ethics, I offer to present the ﬁrst results of my research. Thus this contribution would be related to the ethical and medical concepts of vulnerability in order to compare it to the emerging yet undeﬁned legal concept in Europe. The timing is particularly appropriate as vulnerability, clinical trials and fun- damental rights of elderly people are a growing European interest (Mostly the European Union but also the Council of Europe and the UNESCO). The aim is to use these concepts as a basis to show the reasons why elderly people are disproportionately excluded from clinical trials, and why with the exact same concept we can promote their right to personalized medicine and to newer cutting edge medical care. http://dx.doi.org/10.1016/j.eurger.2013.07.455 P393 The frequency of muscle pain in patients with primary hypothyroidism and biochemical characteristics according to age F. Sarac , S. Savas , M.A. Yalcin , F. Akcicek Ege University School of Medicine, Department of Internal Medicine, Geriatrics Section, Izmir, Turkey Introduction.– First complaints of patients with hypothyroidism for both children and adults may be symptoms of the musculoskeletal system. High rate of hypothyroid myopathy (30%–80%) in patients with hypothyroidism has been reported. Hypothyroid myopathy is reported to cause symptoms like; proximal muscle weakness, mild exercise-onset muscle pain, muscle cramps, decreased deep tendon reﬂexes. In the present study; amongst the patients with primary hypothyroidism over 60 years and below the age of 60, biochemical properties were evaluated regarding the frequency of muscle pain. Methods.– In our study, ≥ 60 years old 27 (mean age 63.3 ± 9.1 years, 19 women, 8 men) and < 60 years 30 (mean age 39.1 ± 5.3 years, 23 female, 7 male) patients were recruited from the Internal Medicine Department outpatient clinic. After physical examination and query, biochemical levels were measured in all patients. Results.– In the group over the age of 60, 25 patients deﬁned muscle aches; in the < 60 age group there were 20 patients with muscle aches. In the ﬁrst group mean TSH, FT3, FT4 and creatinine phosphocinase (CPK) levels were 16.9 ± 3.79 IU/ml, 2.0 ± 0.1 pg/ml, 0.9 ± 0.01 ng/dl, 440.0 ± 70.9 U/L, and in the second group; 22.8 ± 5.3 IU/ml, 1.9 ± 0.9 pg/ml, 0.80 ± 0.1 ng/dl, 307.5 ± 54.6 U/L; P = 0.001, P = 0.03, P = 0.30, P = 0.02 respectively. Key conclusions.– In patients with hypothyroidism and advanced age the frequency of muscle pain was higher than the group below 60 years of age. Blood levels of CPK was higher in the elderly group too. http://dx.doi.org/10.1016/j.eurger.2013.07.456