Endodontics and the ageing patient.

Science.gov (United States)

Johnstone, M; Parashos, P

2015-03-01

Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient. © 2015 Australian Dental Association.

Hip Arthroscopy in Patients Age 40 or Older: A Systematic Review.

Science.gov (United States)

Horner, Nolan S; Ekhtiari, Seper; Simunovic, Nicole; Safran, Marc R; Philippon, Marc J; Ayeni, Olufemi R

2017-02-01

To (1) report clinical outcomes, complication rates, and total hip arthroplasty (THA) conversion rates for patients age 40 or older who underwent hip arthroscopy, and (2) report any age-related predictors of outcome identified in the literature. MEDLINE, EMBASE, and PubMed were searched for relevant studies and pertinent data were abstracted from eligible studies. No meta-analysis was performed because of heterogeneity amongst studies. Seventeen studies were included in this review comprising 16,327 patients, including 9,954 patients age 40 or older. All studies reported statistically significant improvements in outcomes after hip arthroscopy for femoral osteochondroplasty, labral repair, or unspecified indications. In patients 40 or older who underwent labral debridement, these improvements were not clinically significant. Obesity and osteoarthritic changes predicted poorer outcomes. Only 1 of 3 studies directly comparing the 2 groups found that patients 40 or older had a significantly less improvement in a standardized hip outcome score than patients under 40 after hip arthroscopy, but all found that patients 40 or older had significantly higher rates of THA conversion. The rate of conversion to THA was 18.1% for patients 40 or older, 23.1% for patients over 50, and 25.2% for patients over 60 with a mean of 25.0 months to THA. Indications for hip arthroscopy including femoral osteochondroplasty and labral repair resulted in clinically significant improvements in patients 40 or older in most research studies examined in this review, whereas labral debridement did not produce clinically significant improvements postoperatively in the same studies. In these studies, the rate of conversion to THA is higher than in patients under 40 and increases with each decade of life, with many individual studies showing a significant increase in the rate of THA conversion. Hip arthroscopy may be suitable for some patients 40 or older, but patient selection is key and patients

Radiation therapy in aged lung cancer patients

International Nuclear Information System (INIS)

Ohtake, Eiji; Tobari, Chitose; Matsui, Kengo; Iio, Masahiro.

1982-01-01

The results and problems of radiotherapy were analyzed in 57 lung cancer patients more than 65 years of age (average age: 74.8 years). Of these, 45 (79%) were irradiated with a total dose exceeding 40 Gy. In these patients, the median survival was 13 months for Stages I and II, 6.5 months for Stage III, and 5 months for Stage IV. The results of combined radiotherapy and chemotherapy were better than those of radiotherapy alone. Also, slightly better results were obtained in patients treated with split-course than continuous-course irradiation. In aged lung cancer patients the prognosis was highly influenced by their respiratory function. Double cancers were present in 9 (16%) of the 57 patients. (author)

Prevalence of pain medication prescriptions in France, Germany, and the UK - a cross-sectional study including 4,270,142 patients.

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Jacob, Louis; Kostev, Karel

2018-01-01

The goal of the present study was to analyze the prevalence of pain medication prescriptions in general practices in France, Germany, and the UK. This study included all patients aged ≥18 years followed in 2016 in general practitioner practices in France, Germany and the UK. The primary outcome was the prevalence of patients receiving prescriptions for pain medications in France, Germany, and the UK in 2016. The following drugs were included in the analysis: anti-inflammatory and antirheumatic products, non-steroids and analgesics including opioids, antimigraine preparations, and other analgesics and antipyretics. Demographic variables included age and gender. This study included 4,270,142 patients. The prevalences of pain medication prescriptions were 57.3% in France, 29.6% in Germany, and 21.7% in the UK. Although this prevalence generally remained consistent between age groups in France (54.3%-60.3%), it increased with age in Germany (18-30 years: 23.8%; >70 years: 35.8%) and in the UK (18-30 years: 9.3%; >70 years: 43.8%). Finally, the prevalence of pain medication prescriptions was higher in women than in men in all three countries. Paracetamol was prescribed to 82.3% and 60.1% of patients receiving pain medication in France and the UK, respectively, whereas ibuprofen was prescribed to 46.5% of individuals in Germany. The prevalence of pain medication prescriptions was higher in France than in Germany and the UK. Further research is needed to gain a better understanding of the differences in the prescription patterns between these three European countries.

Do Physician Recommendations for Colorectal Cancer Screening Differ by Patient Age?

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Maida J Sewitch

2007-01-01

Full Text Available Colorectal cancer screening is underutilized, resulting in preventable morbidity and mortality. In the present study, age-related and other disparities associated with physicians’ delivery of colorectal cancer screening recommendations were examined. The present cross-sectional study included 43 physicians and 618 of their patients, aged 50 to 80 years, without past or present colorectal cancer. Of the 285 screen-eligible patients, 45% received a recommendation. Multivariate analyses revealed that, compared with younger nonde-pressed patients, older depressed patients were less likely to receive fecal occult blood test recommendations, compared with no recommendation (OR=0.31, 95% CI 0.09 to 1.02, as well as less likely to receive colonoscopy recommendations, compared with no recommendation (OR=0.14; 95% CI 0.03 to 0.66. Comorbidity and marital status were associated with delivery of fecal occult blood test and colonoscopy recommendations, respectively, compared with no recommendation. In summary, patient age and other characteristics appeared to influence physicians’ delivery of colorectal cancer screening and choice of modality.

Development of a modified prognostic index for patients with aggressive adult T-cell leukemia-lymphoma aged 70 years or younger: possible risk-adapted management strategies including allogeneic transplantation.

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Fuji, Shigeo; Yamaguchi, Takuhiro; Inoue, Yoshitaka; Utsunomiya, Atae; Moriuchi, Yukiyoshi; Uchimaru, Kaoru; Owatari, Satsuki; Miyagi, Takashi; Taguchi, Jun; Choi, Ilseung; Otsuka, Eiichi; Nakachi, Sawako; Yamamoto, Hisashi; Kurosawa, Saiko; Tobinai, Kensei; Fukuda, Takahiro

2017-07-01

Adult T-cell leukemia-lymphoma is a distinct type of peripheral T-cell lymphoma caused by human T-cell lymphotropic virus type I. Although allogeneic stem cell transplantation after chemotherapy is a recommended treatment option for patients with aggressive adult T-cell leukemia-lymphoma, there is no consensus about indications for allogeneic stem cell transplantation because there is no established risk stratification system for transplant eligible patients. We conducted a nationwide survey of patients with aggressive adult T-cell leukemia-lymphoma in order to construct a new, large database that includes 1,792 patients aged 70 years or younger with aggressive adult T-cell leukemia-lymphoma who were diagnosed between 2000 and 2013 and received intensive first-line chemotherapy. We randomly divided patients into two groups (training and validation sets). Acute type, poor performance status, high soluble interleukin-2 receptor levels (> 5,000 U/mL), high adjusted calcium levels (≥ 12 mg/dL), and high C-reactive protein levels (≥ 2.5 mg/dL) were independent adverse prognostic factors used in the training set. We used these five variables to divide patients into three risk groups. In the validation set, median overall survival for the low-, intermediate-, and high-risk groups was 626 days, 322 days, and 197 days, respectively. In the intermediate- and high-risk groups, transplanted recipients had significantly better overall survival than non-transplanted patients. We developed a promising new risk stratification system to identify patients aged 70 years or younger with aggressive adult T-cell leukemia-lymphoma who may benefit from upfront allogeneic stem cell transplantation. Prospective studies are warranted to confirm the benefit of this treatment strategy. Copyright© 2017 Ferrata Storti Foundation.

Comparison of normotensive and glaucoma simplex patients according to age and sex

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Stojčić Milan

2012-01-01

Full Text Available Introduction. According to the level of intraocular pressure (IOP, open angle glaucoma is divided into high tension glaucoma (HTG and normal tension glaucoma (NTG. Objective. To determine if there are differences in the distribution of patients by age and sex between NTG and HTG. Methods. Our prospective study included 30 patients with NTG and 30 with HTG. A complete eye examination was performed. The examination included measuring of intraocular pressure by Goldmann applanation tonometry, examination of optic disc head by indirect ophthalmoscopy with Volk 90 D lens and visual field examination using the Octopus program. Results. The average damage of visual field in the group of patients with NTG was 8.14±4.43 dB, while in the group with HTG it was 7.40±2.84 dB (p>0.05. The average age of the group of patients with NTG was 66±11.58 years, while among those with HTG the average age was 59.7±11.63 years (p<0.01. Among the patients with NTG there were three times more women than men (χ2=9.124; p<0.01, while in the group of patients with HTG there were more men than women, but without statistically significant difference between the tested groups (χ2=1.851; p>0.05. Conclusion. Open angle glaucoma is a disease of elderly population. According to our results, risk factors for this disease can be age and sex. NTG is more frequently present than HTG among elderly population and females.

Older age impacts on survival outcome in patients receiving curative surgery for solid cancer

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Chang-Hsien Lu

2018-07-01

Full Text Available Summary: Background: Given the global increase in aging populations and cancer incidence, understanding the influence of age on postoperative outcome after cancer surgery is imperative. This study aimed to evaluate the impact of age on survival outcome in solid cancer patients receiving curative surgery. Methods: A total of 37,288 patients receiving curative surgeries for solid cancers between 2007 and 2012 at four affiliated Chang Gung Memorial Hospital were included in the study. All patients were categorized into age groups by decades for survival analysis. Results: The percentages of patient populations aged <40 years, 40–49 years, 50–59 years, 60–69 years, 70–79 years, and ≥80 years were 9.7%, 17.7%, 27.8%, 22.1%, 16.9%, and 5.7%, respectively. The median follow-up period was 38.9 months (range, 22.8–60.4 months and the overall, cancer-specific, and noncancer-specific mortality rates were 26.0%, 17.6%, and 8.5%, respectively. The overall mortality rate of patients in different age groups were 18.5%, 21.1%, 22.0%, 25.3%, 35.3%, and 49.0%, respectively. Compared to patients aged <40 years, more significant decrease in long-term survival were observed in aging patients. Multivariate analysis showed higher postoperative short-term mortality rates in patients older than 70 years, and the adjusted odds ratio of mortality risk ranged from 1.47 to 1.74 and 2.26 to 3.03 in patients aged 70–79 years and ≥80 years, respectively, compared to those aged <40 years. Conclusion: Aging was a negative prognostic factor of survival outcome in solid cancer patients receiving curative surgery. After adjustment of other clinicopathologic factors, the influence of age on survival outcome was less apparent in the elderly. Keywords: Age, Solid cancer, Surgical resection, Prognosis

Appraisal Of Quality Of Life Of Diabetic Patients, Including Life ...

African Journals Online (AJOL)

The review showed that patients with diabetes mellitus had signi cantly low ... of life (physical health, psychological health, social relations, and environment). ... of quality of life regarding gender, age, or the level of education of the patients. ... neuropathy, impaired vision, elevated blood lipids and amputation of toes or feet.

Neurocognitive profiles in MSUD school-age patients.

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Bouchereau, Juliette; Leduc-Leballeur, Julie; Pichard, Samia; Imbard, Apolline; Benoist, Jean-François; Abi Warde, Marie-Thérèse; Arnoux, Jean-Baptiste; Barbier, Valérie; Brassier, Anaïs; Broué, Pierre; Cano, Aline; Chabrol, Brigitte; Damon, Gilles; Gay, Claire; Guillain, Isabelle; Habarou, Florence; Lamireau, Delphine; Ottolenghi, Chris; Paermentier, Laetitia; Sabourdy, Frédérique; Touati, Guy; Ogier de Baulny, Hélène; de Lonlay, Pascale; Schiff, Manuel

2017-05-01

Maple syrup urine disease (MSUD), an inborn error of amino acids catabolism is characterized by accumulation of branched chain amino acids (BCAAs) leucine, isoleucine, valine and their corresponding alpha-ketoacids. Impact on the cognitive development has been reported historically, with developmental delays of varying degree. Currently, earlier diagnosis and improved management allow a better neurodevelopment, without requirement of special education. However, specific impairments can be observed, and so far, results of detailed neurocognitive assessments are not available. The aim of this study was to analyse neurocognitive profiles of French MSUD patients. This was a multicentre retrospective study on MSUD patients who underwent neurocognitive evaluation at primary school age. Twenty-one patients with classical neonatal onset MSUD were included. The patients' mean age at the time of evaluation was 8.7 years. The mean intellectual quotient (IQ) score was in the normal range (95.1 ± 12.6). In a subset of eight patients, a consistent developmental pattern of higher verbal than performance IQ was observed (mean of the difference 25.7 ± 8.7, p < 0.0001). No correlation could be established between this pattern and long-term metabolic balance (BCAA blood levels), or severity of acute metabolic imbalances, or leucine blood levels at diagnosis and time to toxin removal procedure. These data show that some MSUD patients may exhibit an abnormal neurocognitive profile with higher verbal than performance abilities. This might suggest an executive dysfunction disorder that would need to be further investigated by specialized testing. This pattern is important to detect in MSUD, as appropriate neuropsychological treatment strategies should be proposed.

[Echocardiographic indices of the right heart in patients with coronary artery disease in different age groups].

Science.gov (United States)

Gajfulin, R A; Sumin, A N; Arhipov, O G

2016-01-01

The aim of study was to examine echocardiographic indices of right heart chambers in patients with coronary artery disease in different age groups. On 678 patients aged 38-85 years, who underwent echocardiography, are including with the use of spectral tissue Doppler. Obtained 2 age groups: 1st - patients up to 60 years (n=282) and group 2nd - patients 60 years and older (n=396). In the analysis the obtained results in patients with coronary heart disease in older age groups showed an increase in right ventricular wall thickness, systolic and average pressure in the pulmonary artery. These changes were accompanied by deterioration in left ventricular diastolic function, while the systolic function of the left and right ventricle were independent of age. Thus, the results can be recommended for assessment of right ventricular dysfunction in patients of older age groups.

Computed tomographic study of aged schizophrenic patients

International Nuclear Information System (INIS)

Seno, Haruo; Fujimoto, Akihiko; Ishino, Hiroshi; Shibata, Masahiro; Kuroda, Hiroyuki; Kanno, Hiroshi.

1997-01-01

The width of interhemispheric fissure, lateral ventricles and third ventricle were measured using cranial computed tomography (CT; linear method) in 45 elderly inpatients with chronic schizophrenia and in 28 age-matched control subjects. Twenty-three patients were men and 22 were women. In addition, Mini-Mental State Examination, Brief Psychiatric Rating Scale (BPRS) and a subclass of BPRS were undertaken in all patients. There is a significant enlargement of the maximum width of the interhemispheric fissure (in both male and female) and a significant enlargement of ventricular system (more severe in men than in women) in aged schizophrenics, as seen with CT, compared with normal controls. These findings are consistent with previous studies of non-aged schizophrenic patients. Based upon the relation between psychiatric symptoms and CT findings, the most striking is a significant negative correlation between the third ventricle enlargement and the positive and depressive symptoms in all patients. This result suggests that the advanced third ventricle enlargement may decrease these symptoms in aged schizophrenics. (author)

Radiotherapy for cancer patients aged 80 and older: a study of effectiveness and side effects

International Nuclear Information System (INIS)

Zachariah, Babu; Balducci, Lodovico; Venkattaramanabalaji, G.V.; Casey, Linda; Greenberg, Harvey M.; Del Regato, Juan A.

1997-01-01

Purpose: To profile cancer patients aged 80 and older undergoing radiotherapy and to study the tumor response and side effects of therapy. Methods and Materials: We retrospectively analyzed the records of patients aged 80 and older who received radiation therapy at James A. Haley Veterans Hospital and H. Lee Moffitt Cancer Center between 1988 and 1995. A total of 203 patients aged 80-94 received radiotherapy during this period. Treatment sites included head and neck [50], breast [16], chest [37], pelvis [53], and miscellaneous [39]. Age, treatment site, field size, total dose, response to treatment, treatment interruptions, incidence and severity of weight loss, myelosuppression, diarrhea, mucositis, dermatitis, and follow-up status are assessed using our departmental records and hospital tumor registry. Results: Of 191 patients evaluated, 179 (94%) completed the treatment without serious complications. A total of 195 sites were irradiated. Twelve patients (6%) required interruption of the treatment. Therapeutic responses were seen in 86 out of 112 patients (77%) treated with curative intent (with 67% complete response) and in 67 out of 83 patients (81%) treated with palliative intent. The causes of treatment interruptions included weight loss from diarrhea, dysphagia, and progressive disease. Treatment interruptions were more likely in patients treated with large treatment fields. In patients treated for upper aero-digestive tract cancer, Grade 3 and 4 mucositis was noted in 20 and 2% of patients, respectively. Grade 1 and 2 enteritis was noted in 43% of patients treated for pelvic malignancies. Grade 3 dermatitis was noted only in 2% of patients. Conclusion: Radiotherapy is highly effective and well tolerated by the oldest old. Age is not a contraindication to aggressive radiotherapy

Clinicopathological features of patients with breast cancer aged 70 years or over.

Science.gov (United States)

Aytekin, Aydin; Karatas, Fatih; Sahin, Suleyman; Erdem, Gokmen U; Altundag, Kadri

2017-01-01

The risk of breast cancer (BC) increases in parallel with increasing age. Despite the increased disease burden in elderly patients, there is still a great uncertainty regarding "how to manage" BC in aging-population. The purpose of this study was to investigate the clinicopathological features and treatment approaches of patients with BC aged 70 years or over. The medical records of 4413 patients with BC followed between 1994-2015 were retrospectively analyzed. Of the 4413 patients, 238 with stage I to III disease aged 70 years or over at BC diagnosis were enrolled into this study. Patients were divided into 2 groups according to the age as group 1 (70-79 years, N=192) and group 2 (80 or over, N=46). Clinicopathological features of patients including tumor histology, grade, estrogen (ER) and progesterone receptor (PgR) status, human epidermal growth factor receptor 2 (HER2) status, tumor size, lymph node involvement (LNI), lymphovascular invasion (LVI), perineural invasion (PNI), clinical stage, type of surgery, treatments and comorbid diseases were evaluated. The median age was 74 for group 1 (range 70-79) and 82 for group 2 (range 80-92). Excluding tumor size and grade, no statictically significant difference was found between the two groups according to histopathological characteristics. Patients in group 2 had more commonly larger T stage (T4), and less frequently presented with grade I tumor (p=0.014 and p=0.044, respectively). Modified radical mastectomy and adjuvant chemotherapy were more commonly performed in group 1 (p=0.001 and p=0.001, respectively). In contrast, neoadjuvant treatment was more frequently applied in group 2 (p=0.003). There was no difference in disease-free survival (DFS) between the groups (p=0.012), however, median overall survival (OS) was significantly higher in group 1 (p=0.03). Excluding the tumor grade and tumor size, both groups had similar histopathological features. However, patients aged between 70-79 years were likely to

Effect of Age on Hypertension: Analysis of Over 4,800 Referred Hypertensive Patients

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Anderson Gunnar

1999-01-01

Full Text Available We evaluate in this study the factors associated with the effect of age on blood pressure in more than 4800 patients. Their physicians referred them to evaluate for secondary causes for their hypertension. Factors studied included history and physical examination, serum sodium, potassium and creatinine, a stimulated plasma renin and catecholamine. We also studied the blood pressure response to infusion of either saralasin (an angiotensin II analogue or enalapril (an angiotensin converting enzyme inhibitor, and plasma aldosterone and cortisol after infusion of saline. We measured serum thyroxin and thyroid stimulating hormone concentrations on 1061 consecutive patients in this series. The results of our study show that increased age is associated with a significant increase in the prevalence of hypertension and especially of systolic hypertension after age 60 years. Increased obesity between age 30-50 years is associated with significant increases in diastolic blood pressure and this trend is also seen in African-Americans who are heavier than whites. Increased age is associated with an increased prevalence of secondary forms of hypertension including atherosclerotic renovascular hypertension, renal insufficiency and primary hypothyroidism.

Age group analysis of psychological, physical and functional deterioration in patients hospitalized for pneumonia.

Science.gov (United States)

Martín-Salvador, Adelina; Torres-Sánchez, Irene; Sáez-Roca, Germán; López-Torres, Isabel; Rodríguez-Alzueta, Elisabeth; Valenza, Marie Carmen

2015-10-01

Hospital admissions due to pneumonia range from 1.1 to 4 per 1,000 patients and this figure increases with age. Hospitalization causes a decline in functional status. Physical impairment impedes recovery and constitutes a higher risk of disability and mortality in elderly people. The objective of this study is to assess the impact of hospital stay in patients with pneumonia related with age. A total of 116 patients with pneumonia were included in this study, and divided into two age groups:psychological and emotional profile were evaluated. Pneumonia severity, nutritional status, independence and comorbidities were also assessed. Statistical analyses revealed significant differences between both age groups in pneumonia severity and comorbidities. Significant improvements between admission and discharge were found in lung function in both groups (pgroup. Hospitalization leads to a significant physical impairment in patients admitted for pneumonia. This deterioration increases with age. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Whole body MRI, including diffusion-weighted imaging in follow-up of patients with testicular cancer.

Science.gov (United States)

Mosavi, Firas; Laurell, Anna; Ahlström, Håkan

2015-11-01

Whole body (WB) magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI) has become increasingly utilized in cancer imaging, yet the clinical utility of these techniques in follow-up of testicular cancer patients has not been evaluated. The purpose of this study was to evaluate the feasibility of WB MRI with continuous table movement (CTM) technique, including multistep DWI in follow-up of patients with testicular cancer. WB MRI including DWI was performed in follow-up of 71 consecutive patients (median age, 37 years; range 19-84) with histologically confirmed testicular cancer. WB MRI protocol included axial T1-Dixon and T2-BLADE sequences using CTM technique. Furthermore, multi-step DWI was performed using b-value 50 and 1000 s/mm(2). One criterion for feasibility was patient tolerance and satisfactory image quality. Another criterion was the accuracy in detection of any pathological mass, compared to standard of reference. Signal intensity in DWI was used for evaluation of residual mass activity. Clinical, laboratory and imaging follow-up were applied as standard of reference for the evaluation of WB MRI. WB MRI was tolerated in nearly all patients (69/71 patients, 97%) and the image quality was satisfactory. Metal artifacts deteriorated the image quality in six patients, but it did not influence the overall results. No case of clinical relapse was observed during the follow-up time. There was a good agreement between conventional WB MRI and standard of reference in all patients. Three patients showed residual masses and DWI signal was not restricted in these patients. Furthermore, DWI showed abnormally high signal intensity in a normal-sized retroperitoneal lymph node indicating metastasis. The subsequent (18)F-FDG PET/CT could verify the finding. WB MRI with CTM technique including multi-step DWI is feasible in follow-up of patients with testicular cancer. DWI may contribute to important added-value data to conventional MRI sequences

Pseudophakic retinal detachment in young-aged patients.

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Thomas Laube

Full Text Available To investigate the incidence and risk factors for retinal detachment (RD after cataract surgery or refractive lens exchange (RLE in patients aged below 61 years.Retrospective medical chart review of 7,886 patients (13,925 eyes who underwent cataract surgery or RLE. Patients aged below 61 years were selected. Age, gender, axial length, follow-up times, and the occurrence of RD were recorded. Additional characteristics documented for RD cases were: history of RD, preexisting retinal findings, laser capsulotomy, status of macula at RD, date and details of RD.From a total of 421 patients (677 eyes aged below 61 years 24 cases of RD were identified, resulting in an overall cumulative incidence per eyes of 3.55%. The mean follow-up time was 45 ± 32.8 months. Ninety-two % of all RDs occurred within 3.6 years from surgery. Axial length had a significant effect on the risk of RD after cataract/ RLE surgery (HR = 1.42, P = 0.0001, 95% CI 1.19-1.69. The highest incidence of RD occurred in the subgroup of 25 to 28.9 mm axial length (10.2%. With an increase in age of ten years, the hazard of postoperative RD was not significantly increased by a factor of 1.50 (P = 0.286, 95% CI 0.71-3.15. The highest incidence of RD occurred in patients aged 50-54 years (5.39%. Compared to females, males had an almost twofold not significant risk of postoperative RD (HR = 1.96, P = 0.123, 95% CI 0.83-4.63. None of the RD cases had a history of RD.Axial length is a significant risk factor for pseudophakic RD. The need for cataract surgery or RLE should be carefully considered in patients with axial lengths between 25 and 29 mm, aged 50-54 years, in males, and in case of preexisting retinal findings.

Microscopic age determination of human skeletons including an unknown but calculable variable

DEFF Research Database (Denmark)

Wallin, Johan Albert; Tkocz, Izabella; Kristensen, Gustav

1994-01-01

estimation, which includes the covariance matrix of four single equation residuals, improves the accuracy of age determination. The standard deviation, however, of age prediction remains 12.58 years. An experimental split of the data was made in order to demonstrate that the use of subgroups gives a false...

Peritoneal Fluid Transport rather than Peritoneal Solute Transport Associates with Dialysis Vintage and Age of Peritoneal Dialysis Patients

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Jacek Waniewski

2016-01-01

Full Text Available During peritoneal dialysis (PD, the peritoneal membrane undergoes ageing processes that affect its function. Here we analyzed associations of patient age and dialysis vintage with parameters of peritoneal transport of fluid and solutes, directly measured and estimated based on the pore model, for individual patients. Thirty-three patients (15 females; age 60 (21–87 years; median time on PD 19 (3–100 months underwent sequential peritoneal equilibration test. Dialysis vintage and patient age did not correlate. Estimation of parameters of the two-pore model of peritoneal transport was performed. The estimated fluid transport parameters, including hydraulic permeability (LpS, fraction of ultrasmall pores (αu, osmotic conductance for glucose (OCG, and peritoneal absorption, were generally independent of solute transport parameters (diffusive mass transport parameters. Fluid transport parameters correlated whereas transport parameters for small solutes and proteins did not correlate with dialysis vintage and patient age. Although LpS and OCG were lower for older patients and those with long dialysis vintage, αu was higher. Thus, fluid transport parameters—rather than solute transport parameters—are linked to dialysis vintage and patient age and should therefore be included when monitoring processes linked to ageing of the peritoneal membrane.

Peritoneal Fluid Transport rather than Peritoneal Solute Transport Associates with Dialysis Vintage and Age of Peritoneal Dialysis Patients

Science.gov (United States)

Waniewski, Jacek; Antosiewicz, Stefan; Baczynski, Daniel; Poleszczuk, Jan; Pietribiasi, Mauro; Lindholm, Bengt; Wankowicz, Zofia

2016-01-01

During peritoneal dialysis (PD), the peritoneal membrane undergoes ageing processes that affect its function. Here we analyzed associations of patient age and dialysis vintage with parameters of peritoneal transport of fluid and solutes, directly measured and estimated based on the pore model, for individual patients. Thirty-three patients (15 females; age 60 (21–87) years; median time on PD 19 (3–100) months) underwent sequential peritoneal equilibration test. Dialysis vintage and patient age did not correlate. Estimation of parameters of the two-pore model of peritoneal transport was performed. The estimated fluid transport parameters, including hydraulic permeability (LpS), fraction of ultrasmall pores (α u), osmotic conductance for glucose (OCG), and peritoneal absorption, were generally independent of solute transport parameters (diffusive mass transport parameters). Fluid transport parameters correlated whereas transport parameters for small solutes and proteins did not correlate with dialysis vintage and patient age. Although LpS and OCG were lower for older patients and those with long dialysis vintage, αu was higher. Thus, fluid transport parameters—rather than solute transport parameters—are linked to dialysis vintage and patient age and should therefore be included when monitoring processes linked to ageing of the peritoneal membrane. PMID:26989432

Merkel cells carcinoma of the aged patient

International Nuclear Information System (INIS)

Levy, A.; Assouline, A.; Mazeron, J.J.; Chargari, C.; Krzisch, C.

2009-01-01

The carcinoma at Merkel cells is a rare and aggressive skin cancer, principally of the aged adult. The surgery is the fundamental treatment. The interest of the adjuvant radiotherapy is discussed for the aged patient. In the limits of this retrospective analysis, the postoperative radiotherapy appeared to bring a similar benefit as for younger patients. (N.C.)

Relationship of aging and nutritional status to innate immunity in tube-fed bedridden patients.

Science.gov (United States)

Takeuchi, Yoshiaki; Tashiro, Tomoe; Yamamura, Takuya; Takahashi, Seiichiro; Katayose, Kozo; Kohga, Shin; Takase, Mitsunori; Imawari, Michio

2017-01-01

Aging and malnutrition are known to influence immune functions. The aim of this study was to investigate the relationship of aging and malnutrition to innate immune functions in tube-fed bedridden patients. A cross-sectional survey was performed in 71 tube-fed bedridden patients aged 50-95 years (mean age±SD, 80.2±8.5 years) with serum albumin concentrations between 2.5 and 3.5 g/dL. We evaluated associations of age and nutritional variables with natural-killer cell activity, neutrophilphagocytic activity, and neutrophil-sterilizing activity. Nutritional variables included body mass index, weightadjusted energy intake, total lymphocyte count, and serum concentrations of albumin, transferrin, prealbumin, total cholesterol, C-reactive protein, and zinc. Natural-killer cell activity, neutrophil-phagocytic activity, and neutrophil-sterilizing activity were normal or increased in 67 (94%), 63 (89%), and 69 (97%) patients, respectively. Multiple linear regression analysis with a backward elimination method showed that natural-killer cell activity correlated negatively with aging and lymphocyte counts (pbedridden patients with hypo-albuminemia, natural-killer cell activity may be associated with aging, body mass index, transferrin, and lymphocyte counts.

Effectiveness of maximal safe resection for glioblastoma including elderly and low karnofsky performance status patients. Retrospective review at a single institute

International Nuclear Information System (INIS)

Uzuka, Takeo; Takahashi, Hideaki; Aoki, Hiroshi; Natsumeda, Manabu; Fujii, Yukihiko

2012-01-01

Elderly and low Karnofsky performance status (KPS) patients have been excluded from most prospective trials. This retrospective study investigated glioblastoma treatment outcomes, including those of elderly and low KPS patients, and analyzed the prognostic factors using the medical records of 107 consecutive patients, 59 men and 48 women aged from 21 to 85 years (median 65 years), with newly diagnosed glioblastoma treated at our institute. There were 71 high-risk patients with age >70 years and/or KPS 6 -methylguanine-deoxyribonucleic acid methyltransferase-negative (p=0.027), and more than subtotal removal (p=0.003) were significant prognostic factors. The median postoperative KPS score tended to be better than the preoperative score, even in the high-risk group. We recommend maximal safe resection for glioblastoma patients, even those with advanced age and/or with low KPS scores. (author)

Protein carbonyl content: a novel biomarker for aging in HIV/AIDS patients.

Science.gov (United States)

Kolgiri, Vaishali; Patil, Vinayak Wamanrao

The major complications of "treated" Human Immunodeficiency Virus (HIV) infection are cardiovascular disease, malignancy, renal disease, liver disease, bone disease, and perhaps neurological complications, which are phenomena of the normal aging process occurring at an earlier age in the HIV-infected population. The present study is aimed to explore protein carbonyl content as a biomarker for detecting oxidative DNA damage induced ART toxicity and/or accelerated aging in HIV/AIDS patients. To investigate the potential of carbonyl content as a biomarker for detecting oxidative Deoxyribonucleic acid (DNA) damage induced Antiretroviral Theraphy (ART) toxicity and/or accelerated aging in HIV/AIDS patients. In this case-control study a total 600 subjects were included. All subjects were randomly selected and grouped as HIV-negative (control group) (n=300), HIV-infected ART naive (n=100), HIV-infected on first line ART (n=100), and HIV-infected on second line ART (n=100). Seronegative control subjects were age- and sex-matched with the ART naive patients and the two other groups. Carbonyl protein was determined by the method described in Levine et al. DNA damage marker 8-OH-dG was determined using 8-hydroxy-2-deoxy Guanosine StressXpress ELA Kit by StressMarq Biosciences. Protein carbonyl content levels and oxidative DNA damage were significantly higher (paging in HIV/AIDS patients. Larger studies are warranted to elucidate the role of carbonyl content as a biomarker for premature aging in HIV/AIDS patients. Copyright © 2016 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

NUTRITIONAL STATUS OF MAINTENANCE HEMODIALYSIS PATIENTS WITH DIFFERENT AGES

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Wenling Ye

2012-06-01

Full Text Available To investigate nutritional status and body composition in different ages of maintaining hemodialysis (HD patients. 129 patients (male 62, female 67 with the mean age 56.33±14.14 years on HD were divided into four groups with age under 40, 40-69, 60-69 and over 70 years. Body composition was evaluated with Multi-frequency bioelectric impedance analysis (BIA and 83 healthy subjects, matched for age and sex, were as the control. In all patients, about 6.2% were underweight with body mass index (BMI less than 18.5 Kg/m2. The incidence of underweight were 0%, 6.2%, 4.8% and 11.1% in groups under 40, 40-59, 60-69 and over 70 years respectively. Serum Creatinine, ALB, pre-ALB and normalized protein catabolic rate (nPCR were significantly decreased in patients over 70 years. The young patients under 40 years also displayed lower nPCR and CHO value compared with that of group 40-59 years. Body cell mass, lean tissue mass, lean tissue index and relative lean tissue mass in HD patients were significantly lower than that in age and sex matched control group. Meanwhile, fat mass, fat tissue index and relative fat were increase 20% than the control. They were less different between HD patients and controls in age of 40-59 years, however, difference significantly increased in other three groups and changes were most obvious in patients over 70 years. In conclusion, our study showed that nutritional status was significantly associated with the age in HD patients. Patients under 40 years and over 70 years old displayed much severer protein wasting and more fat tissue storage.

CHARACTERISTICS OF PATIENTS WITH CEREBRAL STROKE OR TRANSIENT ISCHEMIC ATTACK, INCLUDED INTO THE LIS-2 REGISTER (LYUBERTSY STUDY OF MORTALITY IN PATIENTS AFTER STROKE

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S. Yu. Martsevich

2015-01-01

Full Text Available Aim. To provide final data on the three-year period of the inclusion of patients; to give most accurate "portrait" of patients hospitalized with a brain stroke within the framework of the LIS-2 register (Lyubertsy study of mortality in patients after stroke.Material and methods. All patients (n=960 admitted to the Lyubertsy district hospital №2 with stroke for the period from 01.2009 to 12.2011 were included into the study.Results. Men accounted for 37.5%, women - 62.5%, mean age was 71.1±9.8 years. The history of hypertension was present in 833 patients (86.8%, atrial fibrillation in 252 (26.8% patients, 199 (20.7% patients had previously undergone stroke. In-hospital mortality was 21.6% (207 patients had died; mean age 72.9±9.8 years. Low frequency of the antihypertensive therapy (34.5%, lipid-lowering therapy (0.7%, antiplatelet agents (5.7%, anticoagulation therapy prescription in patients with atrial fibrillation was detected.Conclusion. Insufficient assignment of drugs with a proven effect on the prognosis in patients with risk factors prior to the development of the reference stroke draws attention. High incidence of recurrent strokes indicates an underactive secondary prevention.

Arterial wall stiffness in patients with essential hypertension at young age

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Kolesnik E.L.

2014-11-01

Full Text Available Research objective was investigating arterial wall stiffness in patients with hypertension at young age and assessing the relationship between subclinical target organs damage and ambulatory blood pressure monitoring (ABPM parameters. 30 male patients aged 18-35 years with essential hypertension stage I and II, hypertension 1 and 2nd grade were surveyed. The examination included general clinical methods, echocardiography, ABPM and suprasystolic sfigmography. It was found that the pulse wave velocity (PWVao (r = 0,557 p <0,01, central aortic blood pressure (SBPao (r = 0,492 p <0,01 and augmentation index (AIxao (r = 0,489 p <0.01 significantly increased with the pa¬tients’ age. Abdominal obesity (r = 0,566 p <0,01 and BMI (r = 0,599 p <0,01 impacted on the PWVao acceleration. Increasing of the left ventricular mass index (LVMI is highly associated with SBPao (r = 0,506 p <0,05 and PWVao (r = 0,434 p <0,05. According to ABPM the most significant correlation with arterial wall stiffness parameters demon¬strated diastolic blood pressure (DBP daytime level (AIxao (r = 0,418 p <0,01, with PWVao (r = 0,699 p <0.01 and SBPao (r = 0,695 p <0,01. Thus, age, excessive body weight and obesity should be considered as unfavorable factors that worsen arterial wall stiffness in patients with hypertension at the age before 35 years. Increase of DBP levels especially during the day causes maximum negative impact on the arterial wall stiffness parameters according to ABPM. Increased SBPao and PWVao in patients with hypertension at a young age are associated with increased left ventricular mass index.

Clinical decision making in cancer care: a review of current and future roles of patient age.

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Tranvåg, Eirik Joakim; Norheim, Ole Frithjof; Ottersen, Trygve

2018-05-09

Patient age is among the most controversial patient characteristics in clinical decision making. In personalized cancer medicine it is important to understand how individual characteristics do affect practice and how to appropriately incorporate such factors into decision making. Some argue that using age in decision making is unethical, and how patient age should guide cancer care is unsettled. This article provides an overview of the use of age in clinical decision making and discusses how age can be relevant in the context of personalized medicine. We conducted a scoping review, searching Pubmed for English references published between 1985 and May 2017. References concerning cancer, with patients above the age of 18 and that discussed age in relation to diagnostic or treatment decisions were included. References that were non-medical or concerning patients below the age of 18, and references that were case reports, ongoing studies or opinion pieces were excluded. Additional references were collected through snowballing and from selected reports, guidelines and articles. Three hundred and forty-seven relevant references were identified. Patient age can have many and diverse roles in clinical decision making: Contextual roles linked to access (age influences how fast patients are referred to specialized care) and incidence (association between increasing age and increasing incidence rates for cancer); patient-relevant roles linked to physiology (age-related changes in drug metabolism) and comorbidity (association between increasing age and increasing number of comorbidities); and roles related to interventions, such as treatment (older patients receive substandard care) and outcome (survival varies by age). Patient age is integrated into cancer care decision making in a range of ways that makes it difficult to claim age-neutrality. Acknowledging this and being more transparent about the use of age in decision making are likely to promote better clinical decisions

SPECT of aged backache patients

International Nuclear Information System (INIS)

Ito, Shigehiko; Nishikimi, Junzo; Mizuno, Naokado; Watanabe, Kentaro; Kondo, Masaki; Ozaki, Satoshi; Urasaki, Tetsuya; Muro, Toshiyuki

1995-01-01

Single photon emission computed tomography (SPECT) using 99m Tc-HMDP was performed on 53 middle-aged or elderly patients (male 20, female, 33; age range, 40-80 years old) with lumbago, i.e., 25 patients with lumbar spondylosis, 15 with lumbar degenerative spondylolisthesis, 4 with spondylolytic spondylolisthesis, 3 with compression fracture, 3 with pulurent spondylitis, 2 with spondylous osteoporosis, and 1 with spinal osteodesmosis. 99m Tc-HMDP (740 MBq) was intravenously injected and regular SPECT was performed at 3 hours. Gamma camera was performed for about 10 seconds with 5deg intervals, and 36 steps (180deg) of collection was completed after about 6 minutes. The radioisotope accumulation, the presence or absence of sthenia, and its site were evaluated. Forty-seven (88.7%) patients showed excessive accumulation, i.e., 40 (75.5%) in peripheral vertebral osteophyte, 31 (58.5%) in vertebral articulations, and 10 (18.9%) in whole vertebral body. Significantly increased bilateral excessive accumulation was admitted in the vertebral articulations of sliding disc in degenerative spondylolisthesis. SPECT is considered useful in understanding the pathophysiology of degenerative lumber diseases. (S.Y.)

MRI manifestations of thymus in myasthenia gravis (MG) patients in various age groups

International Nuclear Information System (INIS)

Wang Ying; Peng Xi; Li Zhizhao; Jiang Kuiming; Song Ting; Dong Tianfa; Xiao Youcheng

2003-01-01

Objective: To study MRI findings of the thymus in patients with myasthenia gravis (MG) in different age groups and to analyze the relationship between the morphological changes of thymus and the MG. Methods: In total 90 patients with MG (male: female=43:47) received MR scan and were divided into four groups (group A, B, C and D) by age. Fourteen patients out of 90 received additional enhanced scan. Group A included 33 patients aged under 10 years (m:f=18:15); 27 patients aged 11-25 years were in group B (m:f=12:15); group C had 17 patients aged 26-50 years (m:f=6:11); and in group D there were 13 patients whose ages were over 51 years (m:f=7:6). And 30 Non-MG patients aged 8-75 years were selected as control group, in which the thickness, the fat collection, and glandulous atrophy of thymus was studied on CT. Results: 1) The thymus was unremarkable in 44 cases out of 90 (48.88%). 2) Enlarged thymus was shown in 42 cases out of 90 (46.66%), in which non-nodular enlargement was revealed in 34 cases and nodular enlargement in 8 cases. There were 27 cases with abnormality of thymus out of 33 (81.81%) in group A, 12 cases out of 27 (44.44%) in group B and 3 cases in group C, but no abnormality was found in group D. 3) Only 4/90 patients (4.44%) had thymic mass that respectively seen in one case of group B, two of group C and one of group D. No evidence of the involvement of the adjacent structure was found on MRI in the cases of thymic mass. No thymus enlargement was revealed in control group. Fat collection in thymus was seen in both study groups and control group. Conclusion: Intimate relationship between the abnormality of the thymus gland and MG exists in children and teenagers. While in the middle-aged patients or the seniors, further studies should be made to find out whether there is a correlation

Accelerated age-related olfactory decline among type 1 Usher patients.

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Ribeiro, João Carlos; Oliveiros, Bárbara; Pereira, Paulo; António, Natália; Hummel, Thomas; Paiva, António; Silva, Eduardo D

2016-06-22

Usher Syndrome (USH) is a rare disease with hearing loss, retinitis pigmentosa and, sometimes, vestibular dysfunction. A phenotype heterogeneity is reported. Recent evidence indicates that USH is likely to belong to an emerging class of sensory ciliopathies. Olfaction has recently been implicated in ciliopathies, but the scarce literature about olfaction in USH show conflicting results. We aim to evaluate olfactory impairment as a possible clinical manifestation of USH. Prospective clinical study that included 65 patients with USH and 65 normal age-gender-smoking-habits pair matched subjects. A cross culturally validated version of the Sniffin' Sticks olfaction test was used. Young patients with USH have significantly better olfactory scores than healthy controls. We observe that USH type 1 have a faster ageing olfactory decrease than what happens in healthy subjects, leading to significantly lower olfactory scores in older USH1 patients. Moreover, USH type 1 patients showed significantly higher olfactory scores than USH type 2, what can help distinguishing them. Olfaction represents an attractive tool for USH type classification and pre diagnostic screening due to the low cost and non-invasive nature of the testing. Olfactory dysfunction should be considered among the spectrum of clinical manifestations of Usher syndrome.

Age-dependent risk factors for malnutrition in traumatology and orthopedic patients.

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Lambert, Christine; Nüssler, Andreas; Biesalski, Hans Konrad; Freude, Thomas; Bahrs, Christian; Ochs, Gunnar; Flesch, Ingo; Stöckle, Ulrich; Ihle, Christoph

2017-05-01

The aim of this study was to investigate the prevalence of risk of malnutrition (RoM) in an orthopedic and traumatology patient cohort with a broad range of ages. In addition to the classical indicators for risk assessment (low body mass index, weight loss, and comorbidity), this study aimed to analyze the effects of lifestyle factors (eating pattern, smoking, physical activity) on RoM. The prospective cohort study included 1053 patients in a level 1 trauma center in Germany. RoM was assessed by Nutritional Risk Screening (NRS) 2002 and for the elderly additionally by Mini Nutritional Assessment (MNA). Age-dependent risk factors identified in univariate statistical analysis were used for multivariate logistic regression models. The prevalence of patients at RoM (NRS ≥3) was 22%. In the three age categories (<50 y, 50-69 y, and ≥70 y), loss of appetite, weight loss, number of comorbidities, drugs and gastrointestinal symptoms significantly increased RoM in univariate statistical analysis. In patients ages ≥70 y, several disease- and lifestyle-related factors (not living at home, less frequent consumption of vegetables and whole meal bread, low physical activity, and smoking) were associated with RoM. Multivariate logistic regression model for the total study population identified weight loss (odds ratio [OR], 6.09; 95% confidence interval [CI], 4.14-8.83), loss of appetite (OR, 3.81; 95% CI, 2.52-5.78), age-specific low BMI (OR, 1.87; 95% CI, 1.18-2.97), number of drugs taken (OR, 1.19; 95% CI, 1.12-1.26), age (OR, 1.03; 95% CI, 1.02-1.04), and days per week with vegetable consumption (OR, 0.938; 95% CI, 0.89-0.99) as risk factors. Malnutrition in trauma and orthopedic patients is not only a problem related to age. Lifestyle-related factors also contribute significantly to malnutrition in geriatric patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of age on stroke prevention therapy in patients with atrial fibrillation: the atrial fibrillation investigators

DEFF Research Database (Denmark)

van Walraven, Carl; Hart, Robert G; Connolly, Stuart

2009-01-01

contains patient level-data from randomized trials of stroke prevention in atrial fibrillation. We used Cox regression models with age as a continuous variable that controlled for sex, year of randomization, and history of cerebrovascular disease, diabetes, hypertension, and congestive heart failure......BACKGROUND AND PURPOSE: Stroke risk increases with age in patients who have nonvalvular atrial fibrillation. It is uncertain whether the efficacy of stroke prevention therapies in atrial fibrillation changes as patients age. The objective of this study was to determine the effect of age...... on the relative efficacy of oral anticoagulants (OAC) and antiplatelet (AP) therapy (including acetylsalicylic acid and triflusal) on ischemic stroke, serious bleeding, and vascular events in patients with atrial fibrillation. METHODS: This is an analysis of the Atrial Fibrillation Investigators database, which...

Comparison of the prognosis among different age groups in elderly patients with hip fracture

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Hagino Tetsuo

2008-01-01

patients even in the elderly. There were two in-hospital deaths in group B, 11 in group C, and two in group D. Five of the 15 deaths were inoperable cases due to poor performance status at admission. Conclusion: Walking ability at discharge and survival prognosis worsened as age advanced. On the other hand, since surgical cases achieved better walking ability than conservatively treated cases, efforts should be made to achieve better functional prognosis even in the old-olds, including surgery together with early ambulation and rehabilitation.

The challenge of aging and pharmacoterapeutic complexity in the HIV + patient

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Ramón Morillo-Verdugo

2018-05-01

Full Text Available Objective: To describe the current knowledge and management of aging and pharmacotherapeutic complexity in HIV + patients. Method: A review of literature was carried out, including articles, originals or reviews, published in English or Spanish, from 2007 to 2017, which analysed the aging and pharmacotherapeutic complexity in HIV + patients. The terms «Polypharmacy»/»Polypharmacy», «Aging»/»Aging», «Frailty»/»Fragility», «Pharmacotherapeutic Complexity»/»Medication Regimen Complexity» and «HIV»/”HIV» were combined. The review was carried out independently by two authors. The degree of agreement, according to the Kappa index, was analysed. Results: A total of 208 references were analysed, including, finally, only 68. An aging of the population and an increase in associated comorbidities have been identified, especially over 50 years-old. Immunological changes similar to those that are generated in a non-infected elderly population have been described. These conditions influencing the prescription of antiretroviral treatment, according to studies identified. In parallel, polypharmacy is increasingly present, being defined exclusively by the concomitant use of five drugs. Pharmacotherapeutic complexity, through the Medication Regimen Complexity Index, has begun to analyse and relate to health outcomes. There has been a need to know and apply concepts already known in non-HIV-aged population, such as de-prescription, potentially inappropriate medication, cholinergic risk, although few results are available. Conclusions: There is a growing interest to know about the relationship between HIV and aging. Pharmacotherapeutic complexity is beginning to be used as a pharmacotherapeutic follow-up criterion due to its influence on health outcomes. It is necessary to manage and incorporate new concepts that help pharmacotherapeutic optimization in this population

Effect of Age on the Hemostatic Function in Patients with Degenerative Diseases of the Large Joints

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Igor L. Shlykov, PhD¹, ScD¹

2013-06-01

Full Text Available Background: Aging is associated with an increased hypercoagulable state. Degenerative diseases of the large joints are also accompanied by increased coagulation activity. We investigated the effect of age on the hemostatic function in patients with osteoarthritis. Material and Methods: The study included 192 patients with osteoarthritis admitted to the clinic for primary hip or knee arthroplasty. The patients were categorized into 5 age groups: the age group under 40 years, the 41–to-50 -year age group, the 51–to-60-year age group, the 61-to-70- year age group, and the age group over 70 years. The general blood clotting tests, platelet number, fibrinogen, antithrombin, protein C, TAT, D-dimer, vonWillebrand factor (vWF, PAI-1, ß-thromboglobulin were determined. Results: Among patients with osteoarthritis, the antithrombin III level significantly decreased by the age of 50; however, above the age of 60 there was a distinct decrease in platelet count, and over the age of 70 the activity of the extrinsic coagulation pathway and the plasminogen level dropped significantly. TAT and D-dimer levels were elevated in most of the patients. Conclusion: The decrease in platelet count coupled with the activity of the extrinsic coagulation pathway in elderly osteoarthritic patients may increase blood loss during total arthroplasty; also, the drop in the anticoagulant and fibrinolytic potential may play a negative role in strengthening the prothrombotic state during the postoperative period.

Baseline characteristics of patients with heart failure and preserved ejection fraction included in the Karolinska Rennes (KaRen) study.

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Donal, Erwan; Lund, Lars H; Oger, Emmanuel; Hage, Camilla; Persson, Hans; Reynaud, Amélie; Ennezat, Pierre-Vladimir; Bauer, Fabrice; Sportouch-Dukhan, Catherine; Drouet, Elodie; Daubert, Jean-Claude; Linde, Cecilia

2014-02-01

Karolinska Rennes (KaRen) is a prospective observational study to characterize heart failure patients with preserved ejection fraction (HFpEF) and to identify prognostic factors for long-term mortality and morbidity. To report characteristics and echocardiography at entry and after 4-8 weeks of follow-up. Patients were included following an acute heart failure presentation with B-type natriuretic peptide (BNP)>100 ng/L or N-terminal pro-BNP (NT-proBNP)>300 ng/L and left ventricular ejection fraction (LVEF)>45%. The mean ± SD age of 539 included patients was 77 ± 9 years and 56% were women. Patient history included hypertension (78%), atrial tachyarrhythmia (44%), prior heart failure (40%) and anemia (37%), but left bundle branch block was rare (3.8%). Median NT-proBNP was 2448 ng/L (n=438), and median BNP 429 ng/L (n=101). Overall, 101 patients did not return for the follow-up visit, including 13 patients who died (2.4%). Apart from older age (80 ± 9 vs. 76 ± 9 years; P=0.006), there were no significant differences in baseline characteristics between patients who did and did not return for follow-up. Mean LVEF was lower at entry than follow-up (56% vs. 62%; P<0.001). At follow-up, mean E/e' was 12.9 ± 6.1, left atrial volume index 49.4±17.8mL/m(2). Mean global left ventricular longitudinal strain was -14.6 ± 3.9%; LV mass index was 126.6 ± 36.2g/m(2). Patients in KaRen were old with slight female dominance and hypertension as the most prevalent etiological factor. LVEF was preserved, but with increased LV mass and depressed LV diastolic and longitudinal systolic functions. Few patients had signs of electrical dyssynchrony (ClinicalTrials.gov.- NCT00774709). Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Coronary vascular age: An alternate means for predicting stress-induced myocardial ischemia in patients with suspected coronary artery disease.

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Nappi, Carmela; Gaudieri, Valeria; Acampa, Wanda; Arumugam, Parthiban; Assante, Roberta; Zampella, Emilia; Mannarino, Teresa; Mainolfi, Ciro Gabriele; Imbriaco, Massimo; Petretta, Mario; Cuocolo, Alberto

2018-01-22

Coronary artery calcium (CAC) can be used to estimate vascular age in adults, providing a convenient transformation of CAC from Agatston units into a year's scale. We investigated the role of coronary vascular age in predicting stress-induced myocardial ischemia in subjects with suspected coronary artery disease (CAD). A total of 717 subjects referred to CAC scoring and 82 Rb PET/CT stress-rest myocardial perfusion imaging for suspected CAD were studied. CAC score was measured according to the Agatston method and coronary vascular age by equating estimated CAD risk for chronological age and CAC using the formula 39.1 + 7.25 × ln(CAC + 1). Stress-induced ischemia was present in 105 (15%) patients. Mean chronological age, CAC score, and coronary vascular age were higher (all P age was added to clinical variables. Including vascular age in the model, the global Chi square further increased from 68.77 to 106.38 (P age to clinical data, continuous net reclassification improvement (cNRI) was 0.57, while adding vascular age to clinical data and chronological age cNRI was 0.62. At decision curve analysis, the model including vascular age was associated with the highest net benefit compared to the model including only clinical data, to the model including chronological age and clinical data, and to a strategy considering that all patients had ischemia. The model including vascular age also showed the largest reduction in false-positive rate without missing any ischemic patients. In subjects with suspected CAD, coronary vascular age is strongly associated with stress-induced ischemia. The communication of a given vascular age would have a superior emotive impact improving observance of therapies and healthier lifestyles.

SPECT of aged backache patients

Energy Technology Data Exchange (ETDEWEB)

Ito, Shigehiko; Nishikimi, Junzo; Mizuno, Naokado; Watanabe, Kentaro; Kondo, Masaki; Ozaki, Satoshi; Urasaki, Tetsuya; Muro, Toshiyuki [Prefectural Tajimi Hospital, Gifu (Japan)

1995-12-01

Single photon emission computed tomography (SPECT) using {sup 99m}Tc-HMDP was performed on 53 middle-aged or elderly patients (male 20, female, 33; age range, 40-80 years old) with lumbago, i.e., 25 patients with lumbar spondylosis, 15 with lumbar degenerative spondylolisthesis, 4 with spondylolytic spondylolisthesis, 3 with compression fracture, 3 with pulurent spondylitis, 2 with spondylous osteoporosis, and 1 with spinal osteodesmosis. {sup 99m}Tc-HMDP (740 MBq) was intravenously injected and regular SPECT was performed at 3 hours. Gamma camera was performed for about 10 seconds with 5deg intervals, and 36 steps (180deg) of collection was completed after about 6 minutes. The radioisotope accumulation, the presence or absence of sthenia, and its site were evaluated. Forty-seven (88.7%) patients showed excessive accumulation, i.e., 40 (75.5%) in peripheral vertebral osteophyte, 31 (58.5%) in vertebral articulations, and 10 (18.9%) in whole vertebral body. Significantly increased bilateral excessive accumulation was admitted in the vertebral articulations of sliding disc in degenerative spondylolisthesis. SPECT is considered useful in understanding the pathophysiology of degenerative lumber diseases. (S.Y.).

Age-specific mortality among TB patients in Denmark 1998-2010

DEFF Research Database (Denmark)

Fløe, Andreas; Løkke, Anders; Ibsen, Rikke

Objective: To evaluate the age-specific mortality in a national TB cohort, and to estimate relative age-specific mortality compared with matched controls, in a retrospective case-control study. Methods: Using Danish National Patient Registry, we retrospectively identified TB-patients between 1998...... to matched controls. While the difference in survival is substantial among elderly patients, a high relative risk of dying is particularly of concern among young and middle-aged adult TB patients....

Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with multiple sclerosis.

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Broggi, G; Ferroli, P; Franzini, A; Servello, D; Dones, I

2000-01-01

To examine surgical findings and results of microvascular decompression (MVD) for trigeminal neuralgia (TN), including patients with multiple sclerosis, to bring new insight about the role of microvascular compression in the pathogenesis of the disorder and the role of MVD in its treatment. Between 1990 and 1998, 250 patients affected by trigeminal neuralgia underwent MVD in the Department of Neurosurgery of the "Istituto Nazionale Neurologico C Besta" in Milan. Limiting the review to the period 1991-6, to exclude the "learning period" (the first 50 cases) and patients with less than 1 year follow up, surgical findings and results were critically analysed in 148 consecutive cases, including 10 patients with multiple sclerosis. Vascular compression of the trigeminal nerve was found in all cases. The recurrence rate was 15.3% (follow up 1-7 years, mean 38 months). In five of 10 patients with multiple sclerosis an excellent result was achieved (follow up 12-39 months, mean 24 months). Patients with TN for more than 84 months did significantly worse than those with a shorter history (p<0.05). There was no mortality and most complications occurred in the learning period. Surgical complications were not related to age of the patients. Aetiopathogenesis of trigeminal neuralgia remains a mystery. These findings suggest a common neuromodulatory role of microvascular compression in both patients with or without multiple sclerosis rather than a direct causal role. MVD was found to be a safe and effective procedure to relieve typical TN in patients of all ages. It should be proposed as first choice surgery to all patients affected by TN, even in selected cases with multiple sclerosis, to give them the opportunity of pain relief without sensory deficits.

Age dependency of primary tumor sites and metastases in patients with Ewing sarcoma.

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Worch, Jennifer; Ranft, Andreas; DuBois, Steven G; Paulussen, Michael; Juergens, Heribert; Dirksen, Uta

2018-06-01

The median age of patients with Ewing sarcoma (EwS) at diagnosis is around 14-15 years. Older age is associated with a worse outcome. The correlation of age at diagnosis on sites of disease has not been fully described. The goal of this study was to evaluate the differences in sites of primary tumor and metastatic tumor involvement according to age groups. EwS data from the Gesellschaft für Pädiatrische Onkologie und Hämatology (GPOH) database of the Cooperative Ewing Sarcoma Study (CESS) 81/86 and the European Intergroup Cooperative Ewing's Sarcoma Study EICESS 92 and the EUROpean Ewing tumor Working Initiative of National Groups-99-Protocol (EURO-E.W.I.N.G.-99) study were analyzed. Patient and tumor characteristics were evaluated statistically using chi square tests. The study population included 2,635 patients with bone EwS. Sites of primary and metastatic tumors differed according to the age groups of young children (0-9 years), early adolescence (10-14 years), late adolescence (15-19 years), young adults (20-24 years), and adults (more than 24 years). Young children demonstrated the most striking differences in site of disease with a lower proportion of pelvic primary and axial tumors. They presented less often with metastatic disease at diagnosis. Site of primary and metastatic tumor involvement in EwS differs according to patient age. The biological and developmental etiology for these differences requires further investigations. © 2018 Wiley Periodicals, Inc.

Depression, anxiety, and somatic symptoms in older cancer patients: a comparison across age groups.

Science.gov (United States)

Cohen, Miri

2014-02-01

Previous studies have reported that older cancer patients experience lower psychological distress than younger patients, but most prior studies do not differentiate between age groups within the 'older' category. The aim of this study was to assess the intensity of the symptoms of depression, anxiety, and somatic symptoms among different age groups of older cancer patients. Participants were composed of 321 cancer patients 60 years and older, who were divided into three age groups: 60-69, 70-79, and 80+ years. The participants answered the Brief Symptom Inventory-18, which included subscales for depression, anxiety, and somatic symptoms and the cancer-related problem list, in addition to providing personal and cancer-related details. Depressive, anxiety, and somatic symptoms and cancer-related problems were lowest in the 70-79 years age group and highest in the 80+ years age group. Comparisons between pairs of groups showed significant differences between each of the groups in Brief Symptom Inventory total scores and between the 80+ years age group and the other two groups in regard to depressive symptoms and cancer-related problems. Differences, related to anxiety and somatic symptoms, were significant for the 70-79 year olds, in comparison with the youngest and oldest groups. Intensity of symptoms was explained by older age, higher number of cancer-related problems, female gender, and lower income. Nonlinear relations exist between age and psychological symptoms, which is in line with the postponement of age-related health and functional decline in the modern era. These results suggest that the study of psychological reactions to cancer should examine differences between age groups among older cancer patients. Copyright © 2013 John Wiley & Sons, Ltd.

Serum Antioxidative Enzymes Levels and Oxidative Stress Products in Age-Related Cataract Patients

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Dong Chang

2013-01-01

Full Text Available Purpose. To investigate the activity of antioxidative enzymes and the products of oxidative stress in patients with age-related cataracts and compare the findings with those in healthy control subjects. Method. Sixty patients with age-related cataract and sixty healthy controls of matched age and gender were included in this study. Serum samples were obtained to detect the antioxidative enzymes of superoxide dismutase (SOD, catalase (CAT, and glutathione peroxidase (GSH-Px, and oxidation degradation products of malondialdehyde (MDA, 4-hydroxynonenal (4-HNE, conjugated diene (CD, advanced oxidation protein products (AOPP, protein carbonyl (PC, and 8-hydroxydeoxyguanosine (8-OHdG. Results. Serum SOD, GSH-Px, and CAT activities in cataract group were significantly decreased as compared to the control subjects (P<0.05. The levels of MDA, 4-HNE, and CD in cataract patients were significantly higher than those in the control subjects (P<0.05, P<0.01. Cataract patients had higher levels of 8-OHdG, AOPP, and PC with respect to the comparative group of normal subjects (P<0.01. And there was no statistical significance in concentration of antioxidative enzymes and oxidative stress products in patients with different subtype cataract. Conclusions. Oxidative stress is an important risk factor in the development of age-related cataract, and augmentation of the antioxidant defence systems may be of benefit to prevent or delay cataractogenesis.

Oral cavity squamous cell carcinoma in 260 patients aged 80 years or more

International Nuclear Information System (INIS)

Ortholan, Cecile; Lusinchi, Antoine; Italiano, Antoine; Bensadoun, Rene-Jean; Auperin, Anne; Poissonnet, Gilles; Bozec, Alexandre; Arriagada, Rodrigo; Temam, Stephane; Benezery, Karen; Thariat, Juliette; Tao Yungan; Janot, Francois; Mamelle, Gerard; Vallicioni, Jacques; Follana, Philippe; Peyrade, Frederic; Sudaka, Anne; Bourhis, Jean; Dassonville, Olivier

2009-01-01

Purpose: We report the experience of two French cancer centers in the treatment of oral cavity squamous cell carcinoma (SCC) in patients aged ≥80 years. Materials and methods: Two hundred and sixty patients aged ≥80 years with a primary oral cavity SCC were included in this retrospective analysis. Results: Sex ratio was near to 1. Tobacco or alcohol intoxication was the main risk factor for 66% of men and 16% of women and leukoplakia, lichen planus, or oral traumatism for 55% of women and 11% of men (p < 0.0001). Two hundred patients received a loco-regional (LR) treatment with a curative intent (surgery and/or radiotherapy), 29 with a palliative intent and 31 did not receive a LR treatment. Curative treatments were initially planned to be adapted to age in 118 patients (59%). The median disease-specific survival (DSS) was 29 months. In multivariate analysis, the independent prognostic factors for DSS were stage (HR = 0.42 [0.24-0.72]), age (HR = 0.43 [0.24-0.75]) and performance status (HR = 0.50 [0.27-0.95]). The median overall survival (OS) was 14 months. In multivariate analysis, the independent prognostic factors for OS were age (HR = 0.52 [0.35-0.79]), stage (HR = 0.56 [0.38-0.84]), tumor differentiation (HR = 0.60 [0.33-0.93]) and performance status (HR = 0.6 [0.37-0.97]). In patients treated with a curative intent, treatment adapted to age was not associated with a decreased overall survival or disease-specific survival as compared with the standard treatment. However, prophylactic lymph node treatment in stages I-II tumors decreased the rate of nodal recurrence from 38% to 6% (p = 0.01). Conclusion: This study emphasizes the need for prospective evaluation of standard and adapted schedules in elderly patients with oral cavity cancer.

Accumulation of advanced glycation end (AGEs products in intensive care patients: an observational, prospective study

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Rommes Johannes H

2010-05-01

Full Text Available Abstract Background Oxidative stress plays an important role in the course and eventual outcome in a majority of patients admitted to the intensive care unit (ICU. Markers to estimate oxidative stress are not readily available in a clinical setting. AGEs accumulation has been merely described in chronic conditions, but can also occur acutely due to oxidative stress. Since AGEs have emerged to be stable end products, these can be a marker of oxidative stress. Skin autofluorescence (AF is a validated marker of tissue content of AGEs. We hypothesized that AGEs accumulate acutely in ICU patients. Methods We performed an observational prospective study in a medical surgical ICU in a university affiliated teaching hospital. All consecutively admitted ICU patients in a 2 month period were included. Skin AF was measured using an AGE reader in 35 consecutive ICU patients > 18 yrs. As a comparison, historical data of a control group (n = 231 were used. These were also used to calculate age-adjusted AF-levels (AFadj. Values are expressed as median and interquartile range [P25-P75]. Differences between groups were tested by non parametric tests. P Results AFadj values were higher in ICU patients (0.33 [0.00 - 0.68] than in controls (-0.07 [-0.29 - 0.24]; P adj were observed between acute or planned admissions, or presence of sepsis, nor was skin AFadj related to severity of disease as estimated by APACHE-II score, length of ICU, hospital stay or mortality. Conclusion Acute AGE accumulation in ICU patients was shown in this study, although group size was small. This can possibly reflect oxidative stress in ICU patients. Further studies should reveal whether AGE-accumulation will be a useful parameter in ICU patients and whether skin AF has a predictive value for outcome, which was not shown in this small study.

Accelerated age-related olfactory decline among type 1 Usher patients

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Ribeiro, João Carlos; Oliveiros, Bárbara; Pereira, Paulo; António, Natália; Hummel, Thomas; Paiva, António; Silva, Eduardo D.

2016-01-01

Usher Syndrome (USH) is a rare disease with hearing loss, retinitis pigmentosa and, sometimes, vestibular dysfunction. A phenotype heterogeneity is reported. Recent evidence indicates that USH is likely to belong to an emerging class of sensory ciliopathies. Olfaction has recently been implicated in ciliopathies, but the scarce literature about olfaction in USH show conflicting results. We aim to evaluate olfactory impairment as a possible clinical manifestation of USH. Prospective clinical study that included 65 patients with USH and 65 normal age-gender-smoking-habits pair matched subjects. A cross culturally validated version of the Sniffin’ Sticks olfaction test was used. Young patients with USH have significantly better olfactory scores than healthy controls. We observe that USH type 1 have a faster ageing olfactory decrease than what happens in healthy subjects, leading to significantly lower olfactory scores in older USH1 patients. Moreover, USH type 1 patients showed significantly higher olfactory scores than USH type 2, what can help distinguishing them. Olfaction represents an attractive tool for USH type classification and pre diagnostic screening due to the low cost and non-invasive nature of the testing. Olfactory dysfunction should be considered among the spectrum of clinical manifestations of Usher syndrome. PMID:27329700

Preferences for Depression Treatment Including Internet-Based Interventions: Results From a Large Sample of Primary Care Patients

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Marie Dorow

2018-05-01

Full Text Available Background: To date, little is known about treatment preferences for depression concerning new media. This study aims to (1 investigate treatment preferences for depression including internet-based interventions and (2 examine subgroup differences concerning age, gender and severity of depression as well as patient-related factors associated with treatment preferences.Methods: Data were derived from the baseline assessment of the @ktiv-trial. Depression treatment preferences were assessed from n = 641 primary care patients with mild to moderate depression regarding the following treatments: medication, psychotherapy, combined treatment, alternative treatment, talking to friends and family, exercise, self-help literature, and internet-based interventions. Depression severity was specified by GPs according to ICD-10 criteria. Ordinal logistic regression models were conducted to identify associated factors of treatment preferences.Results: Patients had a mean age of 43.9 years (SD = 13.8 and more than two thirds (68.6% were female. About 43% of patients had mild depression while 57% were diagnosed with moderate depression. The majority of patients reported strong preferences for psychotherapy, talking to friends and family, and exercise. About one in five patients was very likely to consider internet-based interventions in case of depression. Younger patients expressed significantly stronger treatment preferences for psychotherapy and internet-based interventions than older patients. The most salient factors associated with treatment preferences were the patients' education and perceived self-efficacy.Conclusions: Patients with depression report individually different treatment preferences.Our results underline the importance of shared decision-making within primary care. Future studies should investigate treatment preferences for different types of internet-based interventions.

Predictors of low self-rated health in patients aged 65+ after total hip replacement (THA)

DEFF Research Database (Denmark)

Hørdam, Britta; Hemmingsen, Lars

2013-01-01

predicting low self-rated health after surgery. Material and method: A cross-sectional study including 287 patients aged 65+, who had had THR within 12-months were performed. Patients from five Danish counties received a mailed questionnaire assessing health status and demographic data. Short Form-36...

The Comparison of Sagittal Spinopelvic Parameters between Young Adult Patients with L5 Spondylolysis and Age-Matched Control Group

OpenAIRE

Oh, Young Min; Choi, Ha Young; Eun, Jong Pil

2013-01-01

Objective To compare spinopelvic parameters in young adult patients with spondylolysis to those in age-matched patients without spondylolysis and investigate the clinical impact of sagittal spinopelvic parameters in patients with L5 spondylolysis. Methods From 2009 to 2012, a total of 198 young adult male patients with spondylolysis were identified. Eighty age-matched patients without spondylolysis were also selected. Standing lateral films that included both hip joints were obtained for each...

Percutaneous nephrolithotomy in very elderly patients (Age 75 and Over

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Hüseyin Çelik

2015-12-01

Full Text Available Objective: Percutaneous nephrolithotomy (PNL is a minimally invasive method used safely in surgical treatment of kidney stones in the world. The first PNL surgery performed in our clinic in March 1998 and first PNL surgery was performed in June 2000 over the age of seventy which was bilaterally side. In our study, PNL operations performed for 75 years and older patients were examined. Methods: PNL operations were performed under the general anesthesia. After cystoscopy in the supine position, ureteral catheter was inserted accompanied by C-arm fluoroscopy. Afterwards, patients were taken prone position then we entered into the kidney with a metal needle with fluoroscopic on. We dilated the entrance with Amplatzer renal dilatators set until the 30 F. After the procedure, the nephrostomy catheter was placed in the renal sheath. 4 mm residual fragments after the PNL operation were accepted as clinically insignificant stone residues (CIRF. Results: 3003 PNL procedures were performed between dates March 1998 - December 2014 in total 16 years. 28 patients of total were 75 years and over. 29 PNL surgeries performed to these patients, including one bilateral PNL procedure. Mean age was 79.36 years (75-88. Twenty (74% of the patients were concluded stone free. 2 patients had tubeless PNL surgery. There was no another complication. Conclusion: PNL is a minimally invasive method has became advantageous according to open surgery because of higher safety, lower complication rates, shorter hospitalization stay, more patient comfort and higher stone free rates. PNL is a safe and effective method in the surgical treatment of urinary tract stone diseases.

Enhancing the efficacy of treatment for temporomandibular patients with muscular diagnosis through cognitive-behavioral intervention, including hypnosis: a randomized study.

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Ferrando, Maite; Galdón, María José; Durá, Estrella; Andreu, Yolanda; Jiménez, Yolanda; Poveda, Rafael

2012-01-01

This study evaluated the efficacy of a cognitive-behavioral therapy (CBT), including hypnosis, in patients with temporomandibular disorders (TMDs) with muscular diagnosis. Seventy-two patients (65 women and 7 men with an average age of 39 years) were selected according to the Research Diagnostic Criteria for TMD, and assigned to the experimental group (n = 41), receiving the 6-session CBT program, and the control group (n = 31). All patients received conservative standard treatment for TMD. The assessment included pain variables and psychologic distress. There were significant differences between the groups, the experimental group showing a higher improvement in the variables evaluated. Specifically, 90% of the patients under CBT reported a significant reduction in frequency of pain and 70% in emotional distress. The improvement was stable over time, with no significant differences between posttreatment and 9-month follow-up. CBT, including hypnosis, significantly improved conservative standard treatment outcome in TMD patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Investigation of patients with atypical or severe hyperandrogenaemia including androgen-secreting ovarian teratoma.

LENUS (Irish Health Repository)

Dennedy, Michael Conall

2012-02-01

Approximately 7% of women of reproductive age manifest polycystic ovary syndrome (PCOS) and <0.5% have other causes of hyperandrogenism including congenital adrenal hyperplasia (CAH), androgen-secreting tumour of an ovary or an adrenal gland, Cushing\\'s syndrome or hyperthecosis. The presence of features atypical of PCOS should prompt more extensive evaluation than that usually undertaken. Features atypical of PCOS include the onset of symptoms outside the decade of 15-25 years, rapid progression of symptoms, the development of virilization and a serum testosterone concentration in excess of twice the upper limit of the reference range. Ethnic background, family history and specific clinical findings, e.g. Cushingoid appearance, may inform a focused investigation. Otherwise, patients should have measurement of 17-hydroxyprogesterone (17-OHP) under basal conditions ideally in the early morning, and if abnormal, they should have measurement of 17-OHP one hour after the administration of synthetic ACTH, 250 microg i.v., to screen for CAH, which is present in approximately 2% of hyperandrogenic patients. The overnight cortisol suppression test employing 1 mg dexamethasone at midnight is a sensitive test for Cushing\\'s syndrome. Coronal tomographic (CT) scanning of the adrenals and transvaginal ultrasonography of the ovaries are the investigations of choice when screening for tumours in these organs. Less frequently required is catheterization and sampling from both adrenal and ovarian veins, which is a technically demanding procedure with potential complications which may provide definitive diagnostic information not available from other investigations. Illustrative case reports highlight some complexities in the investigation of hyperandrogenic patients presenting with features atypical of PCOS and include only the ninth case report of an androgen-secreting ovarian teratoma.

Primary care patients' expectations regarding medical appointments and their experiences during a visit: does age matter?

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Jaworski M

2017-07-01

Full Text Available Mariusz Jaworski,1 Marta Rzadkiewicz,1 Miroslawa Adamus,1 Joanna Chylinska,1 Magdalena Lazarewicz,1 Gørill Haugan,2 Monica Lillefjell,3 Geir Arild Espnes,2 Dorota Wlodarczyk1 1Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland; 2Department of Public Health and Nursing, 3Department of Neuromedicine and Movement Science, NTNU Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway Introduction: There is evidence that meeting patients’ expectations toward health care correlates with involvement in the treatment they receive. The most important patient expectations concern certain types of information: explanation of disease and treatment, health promotion, and improvement in quality of life. Other demands include proper rapport and emotional support. The aim of this paper was to examine different patient groups over the age of 50 years and their expectations toward medical visits, evaluated before a visit and after the visit.Patients and methods: The study group consisted of 4,921 primary health-care patients. The patients received self-administered questionnaires that they filled in before and after the appointment with the doctor. Interviews with patients were conducted individually by specially trained interviewers. The PRACTA Patient Expectations Scale was used to measure the appointment-related expectations of the patients.Results: We observed differences related to age in patients’ expectations before medical visits regarding the following factors: disease explanation, treatment explanation, quality of life, rapport, and emotional support. The same differences were not observed on health promotion. Evaluation of patients’ appointment-related experiences after the visit showed that there were significant differences between the age-groups regarding all types of expectations included in the study. Differences between previsit and

Age-Related Health Hazards in Old Patients with First-Time Referral to a Rheumatologist: A Descriptive Study

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W. van Lankveld

2011-01-01

Full Text Available Objective. To study the prevalence of generic age-related health hazards in elderly patient referred to a rheumatologist. Methods. Patients aged 75 or older referred to a specialized gerontorheumatological outpatient service over a period of 2 years were studied prospectively to determine the prevalence of comorbidities, a history of falls, inactivity, cognitive dysfunction, loneliness, and depression in this patient group. Results. A group of 154 patients were included in the study. Comorbidities were observed in 88% of the patients. At least one fall was reported in the last year by 44% of the patients; 44% of the patients reported low levels of health-enhancing physical activity. Depressed mood and loneliness were elevated in 30% and 31% of the patients, respectively. Mild or moderate cognitive impairment was observed in 13% of the patients. Conclusion. Patients in this study were characterized by poor physical ability, high levels of pain, and high prevalence of age-related health hazards.

Prevalence of Electrolyte Disorders Among Cases of Diarrhea with Severe Dehydration and Correlation of Electrolyte Levels with Age of the Patients.

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Ahmad, Mirza Sultan; Wahid, Abdul; Ahmad, Mubashra; Mahboob, Nazia; Mehmood, Ramlah

2016-05-01

To find out the prevalence of electrolyte disorders among children with severe dehydration, and to study correlation between age and electrolyte, urea and creatinine levels. Prospective, analytical study. Outdoor and indoor of Fazle-Omar Hospital, Rabwah, Pakistan, from January to December 2012. All patients from birth to 18 years age, presenting with diarrhea and severe dehydration were included in the study. Urea, creatinine and electrolyte levels of all patients included in the study were checked and recorded in the data form with name, age and outcome. The prevalence of electrolyte disorders were ascertained and correlation with age was determined by Pearson's coefficient. At total of 104 patients were included in the study. None of the patients died. Hyperchloremia was the commonest electrolyte disorder (53.8%), followed by hyperkalemia (26.9%) and hypernatremia (17.3%). Hyponatremia, hypokalemia and hypochloremia were present in 10.6%, 7.7%, and 10.6% cases, respectively. Weak negative correlation was found between age and chloride and potassium levels. Different electrolyte disorders are common in children with diarrhea-related severe dehydration.

The challenge of aging and pharmacoterapeutic complexity in the HIV + patient.

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Morillo-Verdugo, Ramón; Blanco Ramos, José Ramón; Abdel-Kader Martín, Laila; Álvarez de Sotomayor, María

2018-05-01

To describe the current knowledge and management of aging and  pharmacotherapeutic complexity in HIV + patients. A review of literature was carried out, including articles, originals or  reviews, published in English or Spanish, from 2007 to 2017, which analysed the aging and pharmacotherapeutic complexity in HIV + patients. The terms  «Polypharmacy»/»Polypharmacy», «Aging»/»Aging», «Frailty»/»Fragility»,  «Pharmacotherapeutic Complexity»/»Medication Regimen Complexity» and  «HIV»/"HIV» were combined. The review was carried out independently by two  authors. The degree of agreement, according to the Kappa index, was analysed. Results: A total of 208 references were analysed, including, finally, only 68. An  aging of the population and an increase in associated comorbidities have been  identified, especially over 50 years-old. Immunological changes similar to those  that are generated in a non-infected elderly population have been described.  These conditions influencing the prescription of antiretroviral treatment,  according to studies identified. In parallel, polypharmacy is increasingly present,  being defined exclusively by the concomitant use of five drugs.  Pharmacotherapeutic complexity, through the Medication Regimen Complexity  Index, has begun to analyse and relate to health outcomes. There has been a  need to know and apply concepts already known in non-HIV-aged population,  such as de-prescription, potentially inappropriate medication, cholinergic risk, although few results are available. There is a growing interest to know about the relationship between HIV and aging. Pharmacotherapeutic complexity is  beginning to be used as a pharmacotherapeutic follow-up criterion due to its influence on health outcomes. It is necessary to manage and incorporate new  concepts that help pharmacotherapeutic optimization in this population. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All

[Effectiveness of magnetotherapy in elderly hypertensive patients aging at different rates].

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Abramovich, S G; Koriakina, A V; Brodach, L N; Akhmedzianov, Iu A; Makarychkin, S P

2000-01-01

Effectiveness of general magnetotherapy was studied in 84 patients with essential hypertension and 36 patients with isolated systolic arterial hypertension of old age. It is thought necessary to determine biological age of the cardiovascular system in hypertensive patients over 60 years of age to specify indications and contraindications to physiotherapy.

Patient-reported utilities in bilateral visual impairment from amblyopia and age-related macular degeneration.

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van de Graaf, Elizabeth S; Despriet, Dominiek D G; Klaver, Caroline C W; Simonsz, Huibert J

2016-05-17

Utility of visual impairment caused by amblyopia is important for the cost-effectiveness of screening for amblyopia (lazy eye, prevalence 3-3.5 %). We previously measured decrease of utility in 35-year-old persons with unilateral persistent amblyopia. The current observational case-control study aimed to measure loss of utility in patients with amblyopia with recent decrease of vision in their better eye. As these patients are rare, the sample was supplemented by patients with bilateral age-related macular degeneration with similar decrease of vision. From our out-patient department, two groups of patients with recent deterioration to bilateral visual acuity less than Snellen 0.5 (bilateral visual impairment, BVI) were recruited, with either persistent amblyopia and age-related macular degeneration (AMB + AMD), or with bilateral age-related macular degeneration (BAMD). To measure utility, the time trade-off method and the standard gamble method were applied through interviews. Correlations were sought between utility values and visual acuity, age and Visual Function Questionnaire-25 scores. Seventeen AMB + AMD patients (mean age 72.9 years), and 63 BAMD patients (mean age 79.6 years) were included in the study. Among AMB + AMD, 80 % were willing to trade lifetime in exchange for cure. The overall mean time trade-off utility was 0.925. Among BAMD, 75 % were willing to trade, utility was 0.917. Among AMB + AMD, 38 % accepted risk of death in exchange for cure, overall mean standard gamble utility was 0.999. Among BAMD, 49 % accepted risk of death, utility was 0.998. Utility was not related to visual acuity but it was to age (p = 0.02). Elderly patients with BVI, caused by persistent amblyopia and age-related macular degeneration (AMD) or by bilateral AMD, had an approximately 8 % loss of TTO utility. Notably, the 8 % loss in elderly with BVI differs little from the 3.7 % loss we found previously in 35-year-old persons with unilateral

B12 deficiency increases with age in hospitalized patients: a study on 14,904 samples.

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Mézière, Anthony; Audureau, Etienne; Vairelles, Stéphane; Krypciak, Sébastien; Dicko, Michèle; Monié, Marguerite; Giraudier, Stéphane

2014-12-01

Cobalamin deficiency is responsible for hematological, neurological, neurocognitive, and neuropsychiatric impairments and is a risk factor for cardiovascular diseases, particularly in the elderly people. In order to determine B12 status in old inpatients, a total number of 14,904 hospitalized patients in whom B12 measurements were performed in five hospitals in the Paris metropolitan area were included from January 1, 2011 to December 31, 2011. The aims of the study were to determine whether age had an impact on B12 and folate deficiencies and to evaluate correlations between B12 and biological parameters-folate, hemoglobin, mean cell volume, homocystein (tHcy)-and age. Patients were aged 70.3±19.5 years. Low B12 concentration ( 17 µmol/L), 20.4% had low folate concentration (folate 17 µmol/L), and 4.7% of patients were both functional B12 and folate deficient. The B12 or folate deficient patients had lower mean cell volume level than nondeficient patients. Increase in mean cell volume and tHcy concentrations with age and decrease in B12, folate, and hemoglobin levels with age were observed. Frequency of functional B12 deficiency was 9.6% in patients aged 30-60 years and 14.2% in patients over 90 years. Frequency of functional folate deficiency was 9.5% in 30-60 years and 12.1% in >90 years. In inpatients, functional B12 deficiency and functional folate deficiency increase with age and are not associated with anemia or macrocytosis. False vitamin B deficiencies are frequent. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effect of patient age awareness on diagnostic agreement of chronic or aggressive periodontitis between clinicians; a pilot study.

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Oshman, Sarah; El Chaar, Edgard; Lee, Yoonjung Nicole; Engebretson, Steven

2016-07-25

The aim of this pilot study was to test whether diagnostic agreement of aggressive and chronic periodontitis amongst Board Certified Periodontists, is influenced by knowledge of a patient's age. In 1999 at the International World Workshop age was removed as a diagnostic criteria for aggressive periodontitis. The impact of this change on the diagnostic reliability amongst clinicians has not yet been assessed. Nine periodontal case reports were twice presented to sixteen board certified periodontists, once with age withheld and again with patient age provided. Participants were instructed to choose a diagnosis of Chronic Periodontitis or Aggressive Periodontitis. Diagnostic agreement was calculated using the Fleiss Kappa test. Including the patients' age in case report information increased diagnostic agreement (the kappa statistic) from 0.49 (moderate agreement) to 0.61 (substantial agreement). These results suggest that knowledge of a patients' age influenced clinical diagnosis, when distinguishing between aggressive periodontitis and chronic periodontitis, which may in turn impact treatment decision-making.

Oncofertility in patients with stage I epithelial ovarian cancer: fertility-sparing surgery in young women of reproductive age.

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Jiang, Xuan; Yang, Jiaxin; Yu, Mei; Xie, Weimin; Cao, Dongyan; Wu, Ming; Pan, Lingya; Huang, Huifang; You, Yan; Shen, Keng

2017-08-15

Fertility-sparing surgery is indicated for patients with stage I epithelial ovarian cancers. We sought to evaluate the clinical outcomes and oncofertility in a cohort of patients of reproductive age with stage I epithelial ovarian cancer (EOC). Overall, 108 patients of reproductive age (≤ 40 years) diagnosed with stage I EOC who were treated at Peking Union Medical College Hospital between 1999 and 2013 were included in the study. The Kaplan-Meier model and Cox regression analyses were used for the survival analysis. The type of surgery included fertility-sparing surgery (FSS) (48.1%) and radical surgery (RS) (51.9%). After a median follow-up of 83 months, we observed that grade 3 or clear-cell carcinoma was the only independent risk factor for disease-free survival and tumor-specific survival in the multivariate analysis. Patients with grade 3 or clear-cell carcinoma tended to be older than 30 years, have endometriosis, and undergo RS (p Fertility-sparing surgery did not affect disease-free survival or tumor-specific survival among patients of reproductive age with stage I EOC and among high-risk patients with stage IC2-3, grade 3, or clear-cell carcinoma. Thirty-four out of 52 (65.4%) FSS patients attempted to get pregnant. Twenty-eight (82.4%) achieved a successful pregnancy with a full-term delivery. Grade 3 or clear-cell carcinoma was the only independent risk factor for survival of patients of reproductive age with stage I EOC. FSS can be safely performed on patients of reproductive age with grade 1-2, stage I EOC. The safety of FSS for grade 3 and clear-cell carcinoma warrants further investigation.

Distinctive Risk Factors and Phenotype of Younger Patients With Resistant Hypertension: Age Is Relevant.

Science.gov (United States)

Ghazi, Lama; Oparil, Suzanne; Calhoun, David A; Lin, Chee Paul; Dudenbostel, Tanja

2017-05-01

Resistant hypertension, defined as blood pressure >140/90 mm Hg despite using ≥3 antihypertensive medications, is a well-recognized clinical entity. Patients with resistant hypertension are at an increased risk of cardiovascular disease compared with those with more easily controlled hypertension. Coronary heart disease mortality rates of younger adults are stagnating or on the rise. The purpose of our study was to characterize the phenotype and risk factors of younger patients with resistant hypertension, given the dearth of data on cardiovascular risk profile in this cohort. We conducted a cross-sectional analysis with predefined age groups of a large, ethnically diverse cohort of 2170 patients referred to the Hypertension Clinic at the University of Alabama at Birmingham. Patients (n=2068) met the inclusion criteria and were classified by age groups, that is, ≤40 years (12.7% of total cohort), 41 to 55 years (32.1%), 56 to 70 years (36.1%), and ≥71 years (19.1%). Patients aged ≤40 years compared with those aged ≥71 years had significantly earlier onset of hypertension (24.7±7.4 versus 55.0±14.1 years; P hypertension, younger individuals have a distinct phenotype characterized by overlapping risk factors and comorbidities, including obesity, high aldosterone, and high dietary sodium intake compared with elderly. © 2017 American Heart Association, Inc.

Adjuvant chemotherapy for colorectal cancer: age differences in factors influencing patients' treatment decisions

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Jorgensen ML

2013-08-01

Full Text Available Mikaela L Jorgensen,1,2 Jane M Young,1,2 Michael J Solomon1,31Surgical Outcomes Research Centre (SOuRCe, Sydney School of Public Health, University of Sydney and Sydney Local Health District, NSW, Australia; 2Cancer Epidemiology and Services Research (CESR, Sydney School of Public Health, University of Sydney, NSW, Australia; 3Discipline of Surgery, University of Sydney, NSW, AustraliaPurpose: Older colorectal cancer patients are significantly less likely than younger patients to receive guideline-recommended adjuvant chemotherapy. Previous research has indicated that patient refusal of treatment is a contributing factor. This study aimed to identify potential barriers to adjuvant chemotherapy use in older patients by examining the associations between patient age, factors influencing chemotherapy treatment decisions, and preferences for information and decision-making involvement.Patients and methods: Sixty-eight patients who underwent surgery for colorectal cancer in Sydney, Australia, within the previous 24 months completed a self-administered survey.Results: Fear of dying, health status, age, quality of life, and understanding treatment procedures and effects were significantly more important to older patients (aged ≥65 years than younger patients in deciding whether to accept chemotherapy (all P < 0.05. Reducing the risk of cancer returning and physician trust were important factors for all patients. Practical barriers such as traveling for treatment and cost were rated lowest. Older patients preferred less information and involvement in treatment decision making than younger patients. However, 60% of the older group wanted detailed information about chemotherapy, and 83% wanted some involvement in decision making. Those preferring less information and involvement still rated many factors as important in their decision making, including understanding treatment procedures and effects.Conclusion: A range of factors appears to influence

Biological ageing and frailty markers in breast cancer patients.

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Brouwers, Barbara; Dalmasso, Bruna; Hatse, Sigrid; Laenen, Annouschka; Kenis, Cindy; Swerts, Evalien; Neven, Patrick; Smeets, Ann; Schöffski, Patrick; Wildiers, Hans

2015-05-01

Older cancer patients are a highly heterogeneous population in terms of global health and physiological reserves, and it is often difficult to determine the best treatment. Moreover, clinical tools currently used to assess global health require dedicated time and lack a standardized end score. Circulating markers of biological age and/or fitness could complement or partially substitute the existing screening tools. In this study we explored the relationship of potential ageing/frailty biomarkers with age and clinical frailty. On a population of 82 young and 162 older non-metastatic breast cancer patients, we measured mean leukocyte telomere length and plasma levels of interleukin-6 (IL-6), regulated upon activation, normal T cell expressed and secreted (RANTES), monocyte chemotactic protein 1 (MCP-1), insulin-like growth factor 1 (IGF-1). We also developed a new tool to summarize clinical frailty, designated Leuven Oncogeriatric Frailty Score (LOFS), by integrating GA results in a single, semi-continuous score. LOFS' median score was 8, on a scale from 0=frail to 10=fit. IL-6 levels were associated with chronological age in both groups and with clinical frailty in older breast cancer patients, whereas telomere length, IGF-1 and MCP-1 only correlated with age. Plasma IL-6 should be further explored as frailty biomarker in cancer patients.

Patterns of Mortality in Patients Treated with Dental Implants: A Comparison of Patient Age Groups and Corresponding Reference Populations.

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Jemt, Torsten; Kowar, Jan; Nilsson, Mats; Stenport, Victoria

2015-01-01

Little is known about the relationship between implant patient mortality compared to reference populations. The aim of this study was to report the mortality pattern in patients treated with dental implants up to a 15-year period, and to compare this to mortality in reference populations with regard to age at surgery, sex, and degree of tooth loss. Patient cumulative survival rate (CSR) was calculated for a total of 4,231 treated implant patients from a single clinic. Information was based on surgical registers in the clinic and the National Population Register in Sweden. Patients were arranged into age groups of 10 years, and CSR was compared to that of the reference population of comparable age and reported in relation to age at surgery, sex, and type of jaw/dentition. A similar, consistent, general relationship between CSR of different age groups of implant patients and reference populations could be observed for all parameters studied. Completely edentulous patients presented higher mortality than partially edentulous patients (P age groups showed mortality similar to or higher than reference populations, while older patient age groups showed increasingly lower mortality than comparable reference populations for edentulous and partially edentulous patients (P age groups of patients compared to reference populations was observed, indicating higher patient mortality in younger age groups and lower in older groups. The reported pattern is not assumed to be related to implant treatment per se, but is assumed to reflect the variation in general health of a selected subgroup of treated implant patients compared to the reference population in different age groups.

Cognitive Impairment in Patients with Chronic Neuropathic or Radicular Pain: An Interaction of Pain and Age

Directory of Open Access Journals (Sweden)

Orla Moriarty

2017-06-01

Full Text Available A growing body of empirical research has confirmed an association between chronic pain and cognitive dysfunction. The aim of the present study was to determine whether cognitive function is affected in patients with a diagnosis of chronic neuropathic or radicular pain relative to healthy control participants matched by age, gender, and years of education. We also examined the interaction of pain with age in terms of cognitive performance. Some limitations of previous clinical research investigating the effects of chronic pain on cognitive function include differences in the pain and cognitive scale materials used, and the heterogeneity of patient participants, both in terms of their demographics and pathological conditions. To address these potential confounds, we have used a relatively homogenous patient group and included both experimental and statistical controls. We have also specifically investigated the interaction effect of pain and age on cognitive performance. Patients (n = 38 and controls (n = 38 were administered a battery of cognitive tests measuring IQ, spatial and verbal memory, attention, and executive function. Educational level, depressive symptoms, and state anxiety were assessed as were medication usage, caffeine, and nicotine consumption to control for possible confounding effects. Both the level of depressive symptoms and the state anxiety score were higher in chronic pain patients than in matched control participants. Chronic pain patients had a lower estimated IQ than controls, and showed impairments on measures of spatial and verbal memory. Attentional responding was altered in the patient group, possibly indicative of impaired inhibitory control. There were significant interactions between chronic pain condition and age on a number of cognitive outcome variables, such that older patients with chronic pain were more impaired than both age-matched controls and younger patients with chronic pain. Chronic pain did not appear

Comparison of MRI-defined back muscles volume between patients with ankylosing spondylitis and control patients with chronic back pain: age and spinopelvic alignment matched study.

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Bok, Doo Hee; Kim, Jihye; Kim, Tae-Hwan

2017-02-01

To compare MRI-defined back muscle volume between AS patients and age, and spinopelvic alignment matched control patients with chronic back pain. 51 male patients with AS were enrolled. Age and spinopelvic alignment matched controls (male) were found among non-AS patients with chronic back pain. After matching procedure, fully matched controls were found in 31 of 51 AS patients (60.8%), who represent AS patients without deformity. However, matched controls were not found in 20 of 51 AS patients (39.2%), who represent AS patients with deformity. MRI parameters of back muscle (paraspinal muscle and psoas muscle) at L4/5 disc level including cross-sectional area (CSA) and fat-free cross-sectional area (FCSA) were compared between AS patients and matched controls. Covariates, including BMI, self-reported physical activity, and the presence of chronic disease, which can influence back muscle volume, were also investigated. There were no statistical differences in age, body mass index, score of back pain (NRS), and spinopelvic alignment, and physical activity between matched AS patients and control patients except for duration of back pain. All MRI parameters for paraspinal muscle volume in matched AS patients (without deformity) were significantly less than those of control patients, and significantly larger than those of non-matched AS patients (with deformity). Body size adjusted MRI parameters (relative CSA and relative FCSA) of paraspinal muscle showed strong correlations with lumbar lordosis and sacral slope. Such relationship between paraspinal muscle and spinopelvic parameters remained significant even after multivariate adjustment. AS patients without deformity already have decreased paraspinal muscle volume compared with age and spinopelvic alignment matched non-AS patients with chronic back pain. Such decrease in paraspinal muscle volume was significantly associated with kyphotic deformity of AS patients even after multivariate adjustment. Although the result

Preoperative renin-angiotensin system inhibitors protect renal function in aging patients undergoing cardiac surgery.

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Barodka, Viachaslau; Silvestry, Scott; Zhao, Ning; Jiao, Xiangyin; Whellan, David J; Diehl, James; Sun, Jian-Zhong

2011-05-15

Renal failure (RF) represents a major postoperative complication for elderly patients undergoing cardiac surgery. This observational cohort study examines effects of preoperative use of renin-angiotensin system (RAS) inhibitors on postoperative renal failure in aging patients undergoing cardiac surgery. We retrospectively analyzed a cohort of 1287 patients who underwent cardiac surgery at this institution (2003-2007). The patients included were ≥65 years old, scheduled for elective cardiac surgery, and without preexisting RF (defined by the criteria of the Society of Thoracic Surgeons as described in Method). Of all patients evaluated, 346 patients met the inclusion criteria and were divided into two groups: using (n = 122) or not using (n = 224) preoperative RAS inhibitors. A comparison of the two groups showed no significant differences in baseline parameters, including creatinine clearance, body mass index, history of diabetes and smoking, preoperative medicines (except that more patients with RAS inhibitors had a history of hypertension or congestive heart failure, fewer RAS inhibitor patients had chronic lung disease), in intraoperative perfusion and aortic cross-clamp time, and in postoperative complications and 30-d mortality. Multivariate logistic regression analysis demonstrated, however, that preoperative RAS inhibitors significantly and independently reduced the incidence of postoperative RF in the patients undergoing cardiac surgery compared with those not taking RAS inhibitors: 1.6% versus 7.6%, yielding an odds ratio of 0.19 (95 % CI 0.04-0.84, P = 0.029). Preoperative RAS inhibitors may have significant renoprotective effects for aging patients undergoing elective cardiac surgery. Copyright © 2011 Elsevier Inc. All rights reserved.

Prevalence of Electrolyte Disorders Among Cases of Diarrhea with Severe Dehydration and Correlation of Electrolyte Levels with Age of the Patients

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Ahmad, M. S.; Wahid, A.; Ahmad, M.; Mahboob, N.; Mehmood, R.

2016-01-01

Objective: To find out the prevalence of electrolyte disorders among children with severe dehydration, and to study correlation between age and electrolyte, urea and creatinine levels. Study Design: Prospective, analytical study. Place and Duration of Study: Outdoor and indoor of Fazle-Omar Hospital, Rabwah, Pakistan, from January to December 2012. Methodology: All patients from birth to 18 years age, presenting with diarrhea and severe dehydration were included in the study. Urea, creatinine and electrolyte levels of all patients included in the study were checked and recorded in the data form with name, age and outcome. The prevalence of electrolyte disorders were ascertained and correlation with age was determined by Pearson's coefficient. Result: At total of 104 patients were included in the study. None of the patients died. Hyperchloremia was the commonest electrolyte disorder (53.8 percentage), followed by hyperkalemia (26.9 percentage) and hypernatremia (17.3 percentage). Hyponatremia, hypokalemia and hypochloremia were present in 10.6 percentage, 7.7 percentage, and 10.6 percentage cases, respectively. Weak negative correlation was found between age and chloride and potassium levels. Conclusion: Different electrolyte disorders are common in children with diarrhea-related severe dehydration. (author)

[Renal patient's diet: Can fish be included?].

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Castro González, M I; Maafs Rodríguez, A G; Galindo Gómez, C

2012-01-01

Medical and nutritional treatment for renal disease, now a major public health issue, is highly complicated. Nutritional therapy must seek to retard renal dysfunction, maintain an optimal nutritional status and prevent the development of underlying pathologies. To analyze ten fish species to identify those that, because of their low phosphorus content, high biological value protein and elevated n-3 fatty acids EPA and DHA, could be included in renal patient's diet. The following fish species (Litte tunny, Red drum, Spotted eagleray, Escolar, Swordfish, Big-scale pomfret, Cortez flounder, Largemouth blackbass, Periche mojarra, Florida Pompano) were analyzed according to the AOAC and Keller techniques to determine their protein, phosphorus, sodium, potassium, cholesterol, vitamins D(3) and E, and n-3 EPA+DHA content. These results were used to calculate relations between nutrients. The protein in the analyzed species ranged from 16.5 g/100 g of fillet (Largemouth black bass) to 27.2 g/100 g (Red drum); the lowest phosphorus value was 28.6 mg/100 g (Periche mojarra) and the highest 216.3 mg/100 g (Spotted eagle ray). 80% of the fish presented > 100 mg EPA + DHA in 100 g of fillet. By its Phosphorus/gProtein ratio, Escolar and Swordfish could not be included in the renal diet; Little tunny, Escolar, Big-scale pomfret, Largemouth black-bass, Periche mojarra and Florida Pompano presented a lower Phosphorus/EPA + DHA ratio. Florida pompano is the most recommended specie for renal patients, due to its optimal nutrient relations. However, all analyzed species, except Escolar and Swordfish, could be included in renal diets.

Vitrectomy in patients over 90 years of age

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Muto T

2016-01-01

Full Text Available Tetsuya Muto, Tomoyuki Ide, Makoto Chikuda, Shigeki Machida Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan Purpose: The aim of this study was to evaluate vitrectomy procedures performed in patients over 90 years of age at the Dokkyo Medical University Koshigaya Hospital (Koshigaya, Japan.Patients and methods: Vitrectomies were performed in nine eyes of nine patients who were over 90 years of age between May 2010 and March 2015. Factors such as the underlying vitreoretinal disease, preoperative and postoperative best-corrected visual acuity (BCVA, surgical time, postoperative body position, need for a second surgery, systemic disease, and intraoperative changes in systemic conditions have been evaluated.Results: The most common cause of the underlying vitreoretinal disease was vitreous hemorrhage derived from age-related macular degeneration and posterior dislocation of the lens secondary to a posterior capsular rupture (two cases each. The mean values for the logarithm of the minimum angle of resolution BCVA were 2.15 preoperatively and 1.46 postoperatively (P=0.020, Wilcoxon signed-rank test. The mean surgical time was 109 minutes. Prone position was needed in two cases, and no second surgeries were needed. The most common cause of systemic disease was hypertension, which was found in six cases. Transient hypertension was found in two cases during surgery, and these patients were treated using intravenous calcium blocker injections.Conclusion: Patients over 90 years of age who underwent vitrectomy procedures did not have serious problems, except transient hypertension during surgery. The BCVA significantly improved. These results indicated that vitrectomies could be performed successfully in patients over 90 years of age. Keywords: vitrectomy, underlying vitreoretinal disease, transient hypertension

High Satisfaction and Return to Sports After Total Shoulder Arthroplasty in Patients Aged 55 Years and Younger.

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Garcia, Grant H; Liu, Joseph N; Sinatro, Alec; Wu, Hao-Hua; Dines, Joshua S; Warren, Russell F; Dines, David M; Gulotta, Lawrence V

2017-06-01

Young, active candidates for total shoulder arthroplasty (TSA) are a unique group of patients. Not only do they demand longevity and improved function, but they also desire a return to physical activities. To determine the rate of return to sports in patients aged ≤55 years undergoing TSA. Case series; Level of evidence, 4. This was a retrospective review of consecutive patients who underwent anatomic TSA at a single institution. Exclusion criteria included age at the time of surgery >55 years and sports questionnaire, American Shoulder and Elbow Surgeons (ASES) score, and visual analog scale (VAS) score. From 70 eligible patients, 59 patients (61 shoulders) were included with an average follow-up of 61.0 months (range, 25-103 months) and average age at the time of surgery of 48.9 years (range, 25-55 years). The average VAS score improved from 5.6 to 0.9 ( P sports. Moreover, patients in 96.4% of shoulders (55/57) restarted at least 1 sport at an average of 6.7 months. Direct rates of return were as follows: fitness sports (97.2%), golf (93.3%), singles tennis (87.5%), swimming (77.7%), basketball (75.0%), and flag football (66.7%). Patients in 47 shoulders (82.4%) returned to a similar or higher level of sports; 90.3% returned to high-demand sports, and 83.8% returned to high upper extremity sports. There was no significant difference in rates of return to sports by body mass index, sex, age, preoperative diagnosis, revision status, and dominant extremity. In patients aged ≤55 years undergoing TSA, there was a 96.4% rate of return to ≥1 previous sports at an average of 6.7 months. Furthermore, at an average follow-up of 61.0 months, no patients needed revision of their glenoid component, despite an 83.8% rate of return to high upper extremity sports. While caution should still be advised in young, active patients undergoing TSA, these results demonstrate a high satisfaction rate and improved ability to return to most sports after surgery.

Reassessing the NTCTCS Staging Systems for Differentiated Thyroid Cancer, Including Age at Diagnosis.

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McLeod, Donald S A; Jonklaas, Jacqueline; Brierley, James D; Ain, Kenneth B; Cooper, David S; Fein, Henry G; Haugen, Bryan R; Ladenson, Paul W; Magner, James; Ross, Douglas S; Skarulis, Monica C; Steward, David L; Xing, Mingzhao; Litofsky, Danielle R; Maxon, Harry R; Sherman, Steven I

2015-10-01

Thyroid cancer is unique for having age as a staging variable. Recently, the commonly used age cut-point of 45 years has been questioned. This study assessed alternate staging systems on the outcome of overall survival, and compared these with current National Thyroid Cancer Treatment Cooperative Study (NTCTCS) staging systems for papillary and follicular thyroid cancer. A total of 4721 patients with differentiated thyroid cancer were assessed. Five potential alternate staging systems were generated at age cut-points in five-year increments from 35 to 70 years, and tested for model discrimination (Harrell's C-statistic) and calibration (R(2)). The best five models for papillary and follicular cancer were further tested with bootstrap resampling and significance testing for discrimination. The best five alternate papillary cancer systems had age cut-points of 45-50 years, with the highest scoring model using 50 years. No significant difference in C-statistic was found between the best alternate and current NTCTCS systems (p = 0.200). The best five alternate follicular cancer systems had age cut-points of 50-55 years, with the highest scoring model using 50 years. All five best alternate staging systems performed better compared with the current system (p = 0.003-0.035). There was no significant difference in discrimination between the best alternate system (cut-point age 50 years) and the best system of cut-point age 45 years (p = 0.197). No alternate papillary cancer systems assessed were significantly better than the current system. New alternate staging systems for follicular cancer appear to be better than the current NTCTCS system, although they require external validation.

Reassessing the NTCTCS Staging Systems for Differentiated Thyroid Cancer, Including Age at Diagnosis

Science.gov (United States)

McLeod, Donald S.A.; Jonklaas, Jacqueline; Brierley, James D.; Ain, Kenneth B.; Cooper, David S.; Fein, Henry G.; Haugen, Bryan R.; Ladenson, Paul W.; Magner, James; Ross, Douglas S.; Skarulis, Monica C.; Steward, David L.; Xing, Mingzhao; Litofsky, Danielle R.; Maxon, Harry R.

2015-01-01

Background: Thyroid cancer is unique for having age as a staging variable. Recently, the commonly used age cut-point of 45 years has been questioned. Objective: This study assessed alternate staging systems on the outcome of overall survival, and compared these with current National Thyroid Cancer Treatment Cooperative Study (NTCTCS) staging systems for papillary and follicular thyroid cancer. Methods: A total of 4721 patients with differentiated thyroid cancer were assessed. Five potential alternate staging systems were generated at age cut-points in five-year increments from 35 to 70 years, and tested for model discrimination (Harrell's C-statistic) and calibration (R2). The best five models for papillary and follicular cancer were further tested with bootstrap resampling and significance testing for discrimination. Results: The best five alternate papillary cancer systems had age cut-points of 45–50 years, with the highest scoring model using 50 years. No significant difference in C-statistic was found between the best alternate and current NTCTCS systems (p = 0.200). The best five alternate follicular cancer systems had age cut-points of 50–55 years, with the highest scoring model using 50 years. All five best alternate staging systems performed better compared with the current system (p = 0.003–0.035). There was no significant difference in discrimination between the best alternate system (cut-point age 50 years) and the best system of cut-point age 45 years (p = 0.197). Conclusions: No alternate papillary cancer systems assessed were significantly better than the current system. New alternate staging systems for follicular cancer appear to be better than the current NTCTCS system, although they require external validation. PMID:26203804

Contributors to Frequent Telehealth Alerts Including False Alerts for Patients with Heart Failure: A Mixed Methods Exploration

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Radhakrishna, K.; Bowles, K.; Zettek-Sumner, A.

2013-01-01

Summary Background Telehealth data overload through high alert generation is a significant barrier to sustained adoption of telehealth for managing HF patients. Objective To explore the factors contributing to frequent telehealth alerts including false alerts for Medicare heart failure (HF) patients admitted to a home health agency. Materials and Methods A mixed methods design that combined quantitative correlation analysis of patient characteristic data with number of telehealth alerts and qualitative analysis of telehealth and visiting nurses’ notes on follow-up actions to patients’ telehealth alerts was employed. All the quantitative and qualitative data was collected through retrospective review of electronic records of the home heath agency. Results Subjects in the study had a mean age of 83 (SD = 7.6); 56% were female. Patient co-morbidities (ppatient characteristics along with establishing patient-centered telehealth outcome goals may allow meaningful generation of telehealth alerts. Reducing avoidable telehealth alerts could vastly improve the efficiency and sustainability of telehealth programs for HF management. PMID:24454576

Tympanogram findings in patients with cleft palates aged six months to seven years

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Yanti, A.; Widiarni, D.; Alviandi, W.; Tamin, S.; Mansyur, M.

2017-08-01

Cleft palate is one of the most common congenital craniofacial deformities. Otitis media with effusion (OME) is a middle ear disease having a prevalence of almost 90% in patients with cleft palates. Tympanometry is a fast, safe, non-invasive, and easy tool for diagnosing middle ear disease qualitatively and quantitatively. Studies have been conducted using tympanometry to detect middle ear conditions in patients with cleft palates, but no research has studied tympanogram findings in patients with cleft palates in Indonesia. The aim of this study is to determine the tympanogram findings in Indonesian children aged six months to seven years with cleft palates. This is a cross-sectional study of 30 patients (17 males and 13 females) with Veau classification of palatal clefts aged six months to seven years (median 26.5 months) who underwent tympanometry examinations using a 226 Hztympanometer. Tympanograms were classified using the Jerger/Liden classification. Examinations of 58 ears found that type B tympanograms occurred most frequently (70.7%). The quantitative values of tympanometry analyzed included SAA (0.1-0.2 cm3), TPP value (-197.2-(-146.8 daPa)), Vec value (0.5-0.6 cm3), and gradient value (0.03-0.07 cm3). Using the Fisher test, a significant relationship was found between age and type of tympanogram (p = 0.0039) with the risk of type B and C tympanograms in infants (6-60 months) as high as 4.8 times that of children without cleft palates. The type B tympanogram was most frequently seen in patients with cleft palates aged six months to seven years old with the quantitative values of tympanometry lower than the normal values. Therefore, there was a significant difference in the type of tympanogram seen with age.

Results of surgical treatment of cervical cancer patients of childbearing age

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V. S. Navruzova

2015-01-01

Full Text Available The world marked increase in the incidence of cervical cancer in young women, especially from 29 to 45 years old. Analysis showed that in patients with preserved ovarian function, not only the effectiveness of the treatment, but also the quality of life. It is associated with the acceleration, earlier puberty and the onset of sexual activity. In recent years more and more widely used radical surgery with preservation of the ovaries and the abduction of the radiation castration and preservation of reproductive function. In the National Cancer Research Centre of the Ministry of Health of the Republic of Uzbekistan analyzed the results of surgical treatment of 204 patients with cervical cancer younger. Age of patients from 23 to 45 years, that is, in the most hard-working, reproductive period. In our study patients met principally with exophytic – 82 (40.2 % and 68 (33.3 % еndophytic growth cervical tumors. Histological in 197 (96.6 % patients with squamous cervical cancer patients with 7 (3.4%. Adenocarcinoma of cervical cancer. Handard examination of the patient are further adapted to determine the level of sex hormones (estradiol, progesterone, determination of the tumor marter CA-125 levels of calcium and phosphate in the blood. 112 patients from the main group and the combined complex therapy surgical treatment with organ-component (conservation and ovarian transposition. The first group included 112 (55.1 % patients, who as part of combination therapy was performed and complex surgical treatment of ovarian transposition. The second group included 92 (44.9% patients who as part of combination therapy and complex surgery performed without ovarian transposition. Each group was divided into 3 subgroup included patients with stage process T1b–2aN0M0. Which performs the combined radiotherapy. The second subgroups included patients with stage process that runs systemic chemotherapy, surgery, combined radiotherapy. The third group included

Younger Age Is Associated with Poorer Survival in Patients with Signet-Ring Cell Carcinoma of the Colon without Distant Metastasis

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Ben Huang

2016-01-01

Full Text Available Background. In general, younger age is associated with better survival in patients with colon cancer. In this study, we aim to analyze the impact of age on cancer-specific survival (CSS in patients with signet-ring cell carcinoma (SRCC of the colon, a particularly aggressive type of colon cancer. Methods. Information on patients with SRCC of the colon with no distant metastasis was extracted from the US Surveillance, Epidemiology, and End Results (SEER database. An X-tile plot was used to determine the optimal cutoff age at diagnosis. Results. A total of 776 patients were included in data analysis. The X-tile program revealed an optimal cutoff at 35 years of age. A higher percentage of stage III disease and a higher percentage of N2 disease were observed in patients ≤ 35 years of age. The multivariate Cox proportional model demonstrated that patients ≤ 35 years of age were more likely to have a poorer survival outcome compared with patients aged >35 years (HR 1.411, 95% CI 1.032–1.929, and P=0.031. Conclusion. In contrast to the association of younger age with better survival in colon cancer patients, younger age (≤35 years is associated with poorer survival outcome in patients with SRCC of the colon without distant metastasis.

Negative impact of asthma on patients in different age groups.

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Alith, Marcela Batan; Gazzotti, Mariana Rodrigues; Montealegre, Federico; Fish, James; Nascimento, Oliver Augusto; Jardim, José Roberto

2015-01-01

To evaluate the impact of asthma on patients in Brazil, by age group (12-17 years, 18-40 years, and ≥ 41 years). From a survey conducted in Latin America in 2011, we obtained data on 400 patients diagnosed with asthma and residing in one of four Brazilian state capitals (São Paulo, Rio de Janeiro, Curitiba, and Salvador). The data had been collected using a standardized questionnaire in face-to-face interviews. For the patients who were minors, the parents/guardians had completed the questionnaire. The questions addressed asthma control, number of hospitalizations, number of emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. We stratified the data by the selected age groups. The proportions of patients who responded in the affirmative to the following questions were significantly higher in the 12- to 17-year age group than in the other two groups: "Have you had at least one episode of severe asthma that prevented you from playing/exercising in the last 12 months?" (p = 0.012); "Have you been absent from school/work in the last 12 months?" (p age group reported that normal physical exertion was very limiting (p = 0.010 vs. the other groups), whereas 14% of the patients in the ≥ 41-year age group described social activities as very limiting (p = 0.011 vs. the other groups). In this sample, asthma had a greater impact on the patients between 12 and 17 years of age, which might be attributable to poor treatment compliance.

Efficacy and safety of endoscopic retrograde cholangiopancreatography in aged and elderly geriatric patients to treat acute cholecystitis

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GAO Feng

2013-03-01

Full Text Available ObjectiveTo retrospectively evaluate the therapeutic efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP for treating acute cholecystitis in geriatric patients 75 years and older in age. MethodsThe clinical records of our institute were searched to identify aged (75-84 years old and elderly (85 years and older patients who underwent ERCP between January 2008 and December 2012 for new or long-term cholecystitis. The cholecystitis was clinically characterized as acute attack time(s of one to five days and diagnosis was confirmed by imaging analysis (including abdominal ultrasound, computed tomography, and/or magnetic resonance cholangiopancreatography. All surgeries were carried out with the endoscopic nasogallbladder drainage (ENGBD procedure. Postoperative symptoms (such as abdominal pain and fever and clinical findings (such as C-reactive protein (CRP level, imaging findings, and bile drainage volume and consistency were recorded, along with follow-up data of outcome and symptomology, for summary evaluation. ResultsA total 24 patients, including 13 men and 11 women between the ages of 75 and 88 (mean: 81.00±3.23 years, underwent ERCP examination. The cases included general cholecystitis (75.0%, n=18 and acalculous cholecystitis (25.0%, n=6. In addition, 13 (54.2% cases had biliary stones and two (8.3% cases had bile pancreatitis. The ENGBD tube was successfully inserted into the gallbladder in all cases. Twenty-one (87.5% patients experienced relief of abdominal pain and fever within 24 h of the surgery. CRP level decreased to normal for all (100% patients within six days of the surgery. Two (8.3% patients experienced hyperamylasemia within three days of the surgery, and both cases resolved prior to hospital release. There were no cases of ERCP-related hemorrhage, perforation, pancreatitis, or death. Follow-up time ranged from three to 12 months, during which 23 (95.8% patients showed long-term remission. The presence

Characteristics and outcomes of patients with multiple myeloma aged 21-40years versus 41-60years

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Jurczyszyn, Artur; Nahi, Hareth; Avivi, Irit

2016-01-01

We compared the outcomes of multiple myeloma (MM) patients aged 21-40 and 41-60years in the novel agent era. This case-control study included 1089 patients between 2000 and 2015. Cases and controls were matched for sex, International Staging System (ISS) stage and institution. There were 173 pati...

Characteristics and outcomes of patients with Ewing sarcoma over 40 years of age at diagnosis.

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Karski, Erin E; Matthay, Katherine K; Neuhaus, John M; Goldsby, Robert E; Dubois, Steven G

2013-02-01

The peak incidence of Ewing sarcoma (EWS) is in adolescence, with little known about patients who are ≥40 years at diagnosis. We describe the clinical characteristics and survival of this rare group. This retrospective cohort study utilized the Surveillance Epidemiology and End Results database. 2780 patients were identified; including 383 patients diagnosed ≥40 years. Patient characteristics between age groups were compared using chi-squared tests. Survival from diagnosis to death was estimated via Kaplan-Meier methods, compared with log-rank tests, and modeled using multivariable Cox methods. A competing risks analysis was performed to evaluate death due to cancer. Patients ≥40 years of age were more likely to have extra-skeletal tumors (66.1% vs. 31.7%; p extra-skeletal tumors, metastatic disease, and axial primary tumors suggesting a difference in tumor biology. Independent of differences in these characteristics, older patients also have a lower survival rate. Copyright © 2012 Elsevier Ltd. All rights reserved.

Radiotherapy for carcinoma of the esophagus in aged patients

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Nomoto, Satoshi; Imada, Hajime; Yamashita, Shigeru; Terashima, Hiromi; Nakata, Hajime; Itoh, Hideaki; Ohsato, Keiichi; Okamura, Takeshi

1995-01-01

One hundred and fifty-four patients with esophageal carcinoma were treated with either irradiation alone or irradiation combined with surgery at the University of Occupational and Environmental Health Hospital between January 1980 and February 1992. The number of patients 75 years old and older was 25. In patients 74 years old and younger, the overall five-year survival rate by Kaplan-Meier method was 24.5%. The survival rate was best in the patients who were treated by a combination of irradiation and surgery. In patients 75 years old and older, the one-year survival rate was 59%, and the three-year rate was 20%. Aged patients had a tendency to be worse in performance status, and there was no correlation between treatment modality and survival time. We conclude that radiotherapy is useful for treating esophageal cancer in aged patients particularly when maintenance of the quality of life is considered. (author)

Radiotherapy for patients with malignant diseases aged 85 years or older

International Nuclear Information System (INIS)

Asakura, Hirofumi; Mizumoto, Masashi; Zenda, Sadamoto

2007-01-01

The purpose of this study was to assess the efficacy and problems of radiotherapy for patients aged 85 or older. Forty-five patients were assessed (oldest old group): They were 85 years of age or older and had received radiotherapy between September 2002 and September 2005. Sixty-nine patients, 75 years of age at the start of radiotherapy, were also assessed (old group). In the oldest old group, there were 21 men and 24 women, and median age was 87 years (range; 85-99). The sites of disease were: 10 in head and neck, 5 in lung, 5 in malignant lymphoma, 4 in skin, 4 in esophagus, 2 in breast, 2 in uterine cervix, 2 in rectum, 2 in soft tissue, 2 in metastatic bone tumor, 7 in others. The treatment was deemed curative in 49%, palliative in 40%, and others in 11%. Treatment fields were limited due to performance status (PS) or age in 13 patients. The rate of treatment completion was 91% (41/45). Eleven of 26 inpatients were admitted because of difficulty in hospital visit. Seventeen of 19 outpatients needed familial escort. Of patients completed radiotherapy, 47% of the patients achieved complete response (CR), 37% achieved partial response (PR), and 16% achieved no change (NC) in the group of curative radiotherapy, and 88% of the patients achieved effective response, and only 2 cases resulted in ineffective response in the group of palliative radiotherapy. While only one patient received grade 3 dermatitis and mucositis, other patients received grade 2 and below adverse events. Three patients resulted in deterioration of PS, and 2 patients deteriorated dementia. Although higher rates in female patients, worse PS, and limitation of treatment field were seen in the oldest old group, there were no significant difference in terms of the rate of treatment completion, effectiveness, and adverse events between the two groups. Our study showed radiotherapy is effective and well tolerated in patients aged 85 or older. Considering the oldest old requiring radiotherapy

Age and total and free prostate-specific antigen levels for predicting prostate volume in patients with benign prostatic hyperplasia.

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Coban, Soner; Doluoglu, Omer Gokhan; Keles, Ibrahim; Demirci, Hakan; Turkoglu, Ali Riza; Guzelsoy, Muhammet; Karalar, Mustafa; Demirbas, Murat

2016-06-01

To investigate the predictive values of free prostate-specific antigen (fPSA), total PSA (tPSA) and age on the prostate volume. The data of 2148 patients with lower urinary tract symptoms were analyzed retrospectively. The patients who had transrectal ultrasonography guided 10 core biopsies owing to the findings obtained on digital rectal examination and presence of high PSA levels (PSA = 2.5-10 ng/dl), and proven to have BPH histopathologically were included in the study. Age, tPSA, fPSA and the prostate volumes (PV) of the patients were noted. One thousand patients that fulfilled the inclusion criteria were included in the study. The PV of the patients were significantly correlated with age, tPSA and fPSA (p < 0.001 and r = 0.307, p < 0.001 and r = 0.382, p < 0.001 and r = 0.296, respectively). On linear regression model, fPSA was found as a stronger predictive for PV (AUC = 0.75, p < 0.001) when compared to age (AUC = 0.64, p < 0.001), and tPSA (AUC = 0.69, p = 0.013). Although tPSA is an important prognostic factor for predicting PV, the predictive value of fPSA is higher. PV can easily be predicted by using age, and serum tPSA and fPSA levels.

Aging and physiological changes of the kidneys including changes in glomerular filtration rate.

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Musso, Carlos G; Oreopoulos, Dimitrios G

2011-01-01

In addition to the structural changes in the kidney associated with aging, physiological changes in renal function are also found in older adults, such as decreased glomerular filtration rate, vascular dysautonomia, altered tubular handling of creatinine, reduction in sodium reabsorption and potassium secretion, and diminished renal reserve. These alterations make aged individuals susceptible to the development of clinical conditions in response to usual stimuli that would otherwise be compensated for in younger individuals, including acute kidney injury, volume depletion and overload, disorders of serum sodium and potassium concentration, and toxic reactions to water-soluble drugs excreted by the kidneys. Additionally, the preservation with aging of a normal urinalysis, normal serum urea and creatinine values, erythropoietin synthesis, and normal phosphorus, calcium and magnesium tubular handling distinguishes decreased GFR due to normal aging from that due to chronic kidney disease. Copyright © 2011 S. Karger AG, Basel.

Assessment of biochemical liver function tests in relation to age among steady state sickle cell anemia patients.

Science.gov (United States)

Akuyam, S A; Abubakar, A; Lawal, N; Yusuf, R; Aminu, S M; Hassan, A; Musa, A; Bello, A K; Yahaya, I A; Okafor, P A

2017-11-01

Multiorgan failure including liver dysfunction is a common finding in sickle cell anemia (SCA) patients, the cause of which is multifactorial with advancing age said to be a major determinant. There is a paucity of data on liver function among SCA patients in relation to age in northern Nigerian hospitals, including Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. This study was to assess the biochemical liver function tests (LFTs) as they relate to age among SCA patients in steady state, with a view to improving the overall monitoring of these patients. This study was carried out in ABUTH, Zaria, Northern Nigeria. LFTs were carried out in 100 SCA and 100 apparently healthy participants (controls). The SCA group was made up of fifty adults and fifty children diagnosed of SCA, whereas the control group was made up of fifty adults and fifty children who were apparently healthy and had hemoglobin AA. Paired two-tailed Student's t-test for matched samples and Pearson's linear correlation statistical methods were employed for the data analysis using Microsoft Office Excel 2007. A P ≤ 0.05 was considered as statistically significant. The serum concentrations of total bilirubin (TB), alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and AST/ALT ratio were significantly higher in SCA patients compared to the controls (P = 0.001, P = 0.001, P = 0.05, P = 0.05 and P = 0.001, respectively). Serum total protein (TP) and ALB were significantly lower (P = 0.01 and P < 0.05, respectively) in SCA patients compared with the controls. The levels of TB, ALT, AST, ALP, and AST/ALT were significantly lower in SCA adults compared to SCA children, whereas TP and ALB were higher in SCA adults compared to the SCA children. There were significant negative correlations between age and each of TB, ALT, AST, ALP, and AST/ALT, and significant positive correlations between age and each of TP and ALB in SCA patients. There are mild LFTs derangements

Does age affect prognosis in salivary gland carcinoma patients?

DEFF Research Database (Denmark)

Bjørndal, Kristine; Larsen, Stine R; Therkildsen, Marianne H

2016-01-01

in the young group were WHO performance status 0 and in disease stage I + II, and they presented with significantly more histological low grade tumors. In multivariate analysis, chronological age seemed to be of no prognostic significance to salivary gland carcinoma patients as opposed to performance status......, disease stage and histological grade. CONCLUSIONS: Salivary gland carcinoma patients over the age of 70 years have a poor prognosis compared to younger patients, which can be explained by higher disease stages, more histological high grade subtypes and a poorer performance status at the time of diagnosis.......AIM: To compare incidence, histology, treatment modalities, disease stages, and outcome in elderly patients (≥70 years) compared to younger (

Comorbidities in patients over 60 years of age treated at the rehabilitation clinic

Directory of Open Access Journals (Sweden)

Pietrzyńska Magdalena

2015-12-01

Full Text Available Patients aged above 60 represent a very diversified population group with respect to their health condition. This may result from multimorbidity. In the rehabilitation process of elderly patients it is especially crucial to identify not only the underlying diseases which constituted the grounds for referral to the rehabilitation clinic, but also the comorbidities that have to be taken into consideration while planning their rehabilitation. The aim of the present paper is the assessment of comorbidities in patients of the rehabilitation clinic. The study population included 1616 patients (447 man and 1169 women treated at the rehabilitation clinic. The factors put through analysis were the age and gender of the patient, the main diagnosed (underlying illness subject to rehabilitation treatment, as well as comorbidities. All diseases, both the underlying conditions and the comorbidities have been classified according to the International Statistical Classification of Diseases and Related Health Problems (10th revised edition. The main reasons for the treatment at the rehabilitation outpatient clinic were arthrosis of the spine, knee and hip joints, polyarthritis, osteoporosis, diseases of the central nervous system diseases and paralytic syndromes as consequences of strokes, hypertension or atherosclerosis, as well as post-traumatic conditions.

Pain Intensity Moderates the Relationship Between Age and Pain Interference in Chronic Orofacial Pain Patients.

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Boggero, Ian A; Geiger, Paul J; Segerstrom, Suzanne C; Carlson, Charles R

2015-01-01

BACKGROUND/STUDY CONTEXT: Chronic pain is associated with increased interference in daily functioning that becomes more pronounced as pain intensity increases. Based on previous research showing that older adults maintain well-being in the face of pain as well as or better than their younger counterparts, the current study examined the interaction of age and pain intensity on interference in a sample of chronic orofacial pain patients. Data were obtained from the records of 508 chronic orofacial pain patients being seen for an initial evaluation from 2008 to 2012. Collected data included age (range: 18-78) and self-reported measures of pain intensity and pain interference. Bivariate correlations and regression models were used to assess for statistical interactions. Regression analyses revealed that pain intensity positively predicted pain interference (R(2) = .35, B = 10.40, SE = 0.62, t(507) = 16.70, p theories, including socioemotional selectivity theory, which posits that as people age, they become more motivated to maximize positive emotions and minimize negative ones. The results highlight the importance of studying the mechanisms older adults use to successfully cope with pain.

Retrospective cohort study shows that the risks for retinopathy of prematurity included birth age and weight, medical conditions and treatment.

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Ali, Aliaa A; Gomaa, Nancy A S; Awadein, Ahmed R; Al-Hayouti, Huda H; Hegazy, Ahmed I

2017-12-01

This study described the characteristics and risk factors of neonates who developed retinopathy of prematurity (ROP) and severe treatable ROP in two Egyptian neonatal intensive care units (NICUs). This retrospective cohort study comprised 108 preterm neonates who were screened for ROP after being admitted to the two NICUs run by Cairo University Hospital from June 2014 to May 2015. Patients were examined using digital fundus photography and indirect ophthalmoscopy was performed if ROP was detected. Retinopathy of prematurity occurred in 75 patients. Late-onset sepsis, ventilation and hypercapnia were independently associated with ROP. Patients who developed severe treatable ROP had a younger gestational age (GA) than patients who did not develop ROP or developed mild or moderate ROP (29 weeks, range 27-33 weeks versus 32 weeks, range 28-36 weeks, p = 0.002) and a lower birthweight (1200 g, range 980-1590 g versus 1460 g, range 770-2475 g, p = 0.029). The risk factors associated with severe treatable ROP included the duration of admission, the duration of incubator oxygen, late-onset sepsis, intraventricular haemorrhage, total parenteral nutrition and the duration of caffeine citrate therapy. This study showed that the risks for ROP were wide-ranging and included GA and weight, medical conditions and treatment. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Age-Specific Patient Navigation Preferences Among Adolescents and Young Adults with Cancer.

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Pannier, Samantha T; Warner, Echo L; Fowler, Brynn; Fair, Douglas; Salmon, Sara K; Kirchhoff, Anne C

2017-11-23

Patient navigation is increasingly being directed at adolescent and young adult (AYA) patients. This study provides a novel description of differences in AYA cancer patients' preferences for navigation services by developmental age at diagnosis. Eligible patients were diagnosed with cancer between ages 15 and 39 and had completed at least 1 month of treatment. Between October 2015 and January 2016, patients completed semi-structured interviews about navigation preferences. Summary statistics of demographic and cancer characteristics were generated. Differences in patient navigation preferences were examined through qualitative analyses by developmental age at diagnosis. AYAs were interviewed (adolescents 15-18 years N = 8; emerging adults 19-25 years N = 8; young adults 26-39 years N = 23). On average, participants were 4.5 years from diagnosis. All age groups were interested in face-to-face connection with a navigator and using multiple communication platforms (phone, text, email) to follow-up. Three of the most frequently cited needs were insurance, finances, and information. AYAs differed in support, healthcare, and resource preferences by developmental age; only adolescents preferred educational support. While all groups preferred financial and family support, the specific type of assistance (medical versus living expenses, partner/spouse, child, or parental assistance) varied by age group. AYAs with cancer have different preferences for patient navigation by developmental age at diagnosis. AYAs are not a one-size-fits-all population, and navigation programs can better assist AYAs when services are targeted to appropriate developmental ages. Future research should examine fertility and navigation preferences by time since diagnosis. While some navigation needs to span the AYA age range, other needs are specific to developmental age.

Risk and benefit of dual antiplatelet treatment among non-revascularized myocardial infarction patients in different age groups.

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Juul, Nikolai; Gislason, Gunnar; Olesen, Jonas Bjerring; Lamberts, Morten; Hansen, Morten Lock; Karasoy, Deniz; Christiansen, Christine Benn; Torp-Pedersen, Christian; Sorensen, Rikke

2017-09-01

Dual anti-platelet treatment with clopidogrel and aspirin is indicated for most patients after myocardial infarction. We examined the risk/benefit relationship of dual anti-platelet treatment according to age in a nationwide cohort of 30,532 myocardial infarction patients without revascularization. Patients admitted with first-time myocardial infarction in 2002-2010, not undergoing revascularization, were identified from nationwide Danish registers. Dual anti-platelet treatment use was assessed by claimed prescriptions. Stratified into age groups, risk of bleeding, all-cause mortality and a combined endpoint of cardiovascular death, recurrent myocardial infarction and ischaemic stroke was analysed by Cox proportional-hazard models and tested in a propensity-score matched population. A total of 21,302 users and 9230 non-users of dual anti-platelet treatment were included (mean age 67.02 (±13.8) years and 64.7% males). Use of dual anti-platelet treatment decreased with age: 80% (79 years). We found a reduced risk of cardiovascular death, recurrent myocardial infarction and ischaemic stroke in users 79 years (HR=0.92; 95% CI 0.84-1.01, NS). Risk of bleeding increased with dual anti-platelet treatment use in patients aged 79 years (HR=1.46; 95% CI 1.22-1.74). Similar tendencies in all four age groups were found in the propensity-matched population. Dual anti-platelet treatment use was less likely among elderly patients although similar effects regarding both risk and benefit were found in all age groups. Increased focus on initiating dual anti-platelet treatment in elderly, non-invasively treated myocardial infarction patients is warranted.

Rate of shunt revision as a function of age in patients with shunted hydrocephalus due to myelomeningocele.

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Dupepe, Esther B; Hopson, Betsy; Johnston, James M; Rozzelle, Curtis J; Jerry Oakes, W; Blount, Jeffrey P; Rocque, Brandon G

2016-11-01

OBJECTIVE It is generally accepted that cerebrospinal fluid shunts fail most frequently in the first years of life. The purpose of this study was to describe the risk of shunt failure for a given patient age in a well-defined cohort with shunted hydrocephalus due to myelomeningocele (MMC). METHODS The authors analyzed data from their institutional spina bifida research database including all patients with MMC and shunted hydrocephalus. For the entire population, the number of shunt revisions in each year of life was determined. Then the number of patients at risk for shunt revision during each year of life was calculated, thus enabling them to calculate the rate of shunt revision per patient in each year of life. In this way, the timing of all shunt revision operations for the entire clinic population and the likelihood of having a shunt revision during each year of life were calculated. RESULTS A total of 655 patients were enrolled in the spina bifida research database, 519 of whom had a diagnosis of MMC and whose mean age was 17.48 ± 11.7 years (median 16 years, range 0-63 years). Four hundred seventeen patients had had a CSF shunt for the treatment of hydrocephalus and thus are included in this analysis. There were 94 shunt revisions in the 1st year of life, which represents a rate of 0.23 revisions per patient in that year. The rate of shunt revision per patient-year initially decreased as age increased, except for an increase in revision frequency in the early teen years. Shunt revisions continued to occur as late as 43 years of age. CONCLUSIONS These data substantiate the idea that shunt revision surgeries in patients with MMC are most common in the 1st year of life and decrease thereafter, except for an increase in the early teen years. A persistent risk of shunt failure was observed well into adult life. These findings underscore the importance of routine follow-up of all MMC patients with shunted hydrocephalus and will aid in counseling patients and

Restoration of Functional Integrity After Evacuation of Chronic Subdural Hematoma-An Age-Adjusted Analysis of 697 Patients.

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Schoedel, Petra; Bruendl, Elisabeth; Hochreiter, Andreas; Scheitzach, Judith; Bele, Sylvia; Brawanski, Alexander; Schebesch, Karl-Michael

2016-10-01

Although chronic subdural hematoma (CSH) can be treated by surgery, little is known about age-dependent symptoms and age-adjusted rates of restoring functional integrity. To evaluate the clinical symptoms and the course of CSH in patients of different age groups (AGs), we reviewed patients with CSH treated at our department over the past 22 years. This retrospective analysis included 697 patients with CSH (461 men, 236 women; mean age 70.1 years). Subgroup analysis was done according to AG 1) 95 years. Most patients had been treated with burr-hole trephination and implantation of a subdural drain (96.5%; n = 673). No significant difference concerning surgical morbidity and mortality was found between the AGs, but patients >75 years more frequently required reoperation (P = 0.001). Preoperatively, the most common symptoms were headache in AGs 1 and 2 (56.3% and 48.5%) and mnestic deficits in AGs 3-5 (54.9%, 51.9%, and 50.0%). After surgery, the clinical symptoms of CSH had significantly abated in all age groups. The most common clinical residuals were motor deficits in AG 1 (10.4%), mnestic deficits in AG 2 (10.7%), AG 4 (24.1%), and AG 5 (50.0%), and organic brain syndrome in AG 3 (15.0%). CSH predominantly caused unspecific symptoms such as headache and cognitive decline. CSH surgery immediately relieved symptoms in patients of all AGs. However, improvement rates significantly depended on patient age. This should be taken into consideration when advising on surgical treatment of CSH. Copyright © 2016 Elsevier Inc. All rights reserved.

Patient information comes of age.

Science.gov (United States)

Murphy, Jeannette

2017-12-01

This virtual issue (VI) has been assembled to coincide with the 8th Annual Patient Information Conference 2013 organised by the UK Patient Information Forum (PiF). The conference theme 'Information and support - a service in its own right' is a response to policy documents and initiatives in both Scotland and England which signal the coming of age of patient/consumer information. The VI consists of a collection of open access articles and addresses the question 'What can health science librarians do to ensure that the public are able to find, appraise and use health information?' This material provides research evidence, and examples of the types of initiatives librarians have undertaken to make information a health and care service in its own right. Two recurrent messages are that health science librarians need to form partnerships with healthcare providers and they have a role to play in improving health literacy skills. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group.

Private Prayer and Optimism in Middle-Aged and Older Patients Awaiting Cardiac Surgery

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Ai, Amy L.; Peterson, Christopher; Bolling, Steven F.; Koenig, Harold

2002-01-01

Purpose: This study investigated the use of private prayer among middle-aged and older patients as a way of coping with cardiac surgery and prayer's relationship to optimism. Design and Methods: The measure of prayer included three aspects: (a) belief in the importance of private prayer, (b) faith in the efficacy of prayer on the basis of previous…

Age-Related Macular Degeneration in Patients With Chronic Myeloproliferative Neoplasms

DEFF Research Database (Denmark)

Bak, Marie; Sørensen, Torben Lykke; Flachs, Esben Meulengracht

2017-01-01

, and December 31, 2013, of essential thrombocythemia, polycythemia vera, myelofibrosis, or unclassifiable MPNs. For each patient, 10 age- and sex-matched controls were included. All patients without prior AMD were followed up from the date of diagnosis (or corresponding entry date for the controls) until......, 3063 with polycythemia vera, 547 with myelofibrosis, and 1720 with unclassifiable MPNs) and 4.3 (95% CI, 4.1-4.4) for the 77445 controls, while the 10-year risk of AMD was 2.4% (95% CI, 2.1%-2.8%) for patients with MPNs and 2.3% (95% CI, 2.2%-2.4%) for the controls. The risk of AMD was increased...... overall for patients with MPNs (adjusted HR, 1.3; 95% CI, 1.1-1.5), with adjusted HRs for the subtypes of 1.2 (95% CI, 1.0-1.6) for essential thrombocythemia, 1.4 (95% CI, 1.2-1.7) for polycythemia vera, 1.7 (95% CI, 0.8-4.0) for myelofibrosis, and 1.5 (95% CI, 1.1-2.1) for unclassifiable MPNs...

[The influence of age and illness duration on cognitive impairment in aging patients with relapsing-remitting multiple sclerosis (RR-MS)].

Science.gov (United States)

Leclercq, Eugénie; Cabaret, Maryline; Guilbert, Alma; Jougleux, Caroline; Vermersch, Patrick; Moroni, Christine

2014-09-01

The aim of this study was to dissociate age and duration of illness effects on cognitive impairment of patients with relapsing-remitting multiple sclerosis. Cognitive impairment among patients with multiple sclerosis (MS) is well known. However, few studies were devoted to assess the respective role of disease duration and age on cognitive functions in MS patients. Therefore, two studies were carried out on relapsing-remitting MS (RR-MS) patients using some tests of the BCcogSEP--a French test battery evaluating cognitive functions in MS. The cognitive deficits of RR-MS patients aged 50 years and over and whose symptoms had been present for more than 20 years were more severe than those of MS patients with a shorter illness duration (less than 10 years) or matched-age control participants. The more impaired cognitive functions were information-processing speed, episodic memory, verbal fluency and attention. On the other hand, cognitive performances of young RR-MS patients were similar to those of older RR-MS patients when all patients had the same illness duration (8 years in this study). Older patients even achieved better performance than younger ones on verbal fluency. This can be partly explained by the theory of cognitive reserve, as reported in previous cognitive aging studies. In RR-MS patients, the influence of illness duration seems to be a predominant factor in the development of cognitive impairment.

[METABOLIC STATUS OF PATIENTS OF DIFFERENT AGE GROUPS ON THE STAGES OF OSTEOARTHRITIS].

Science.gov (United States)

Stogov, M V; Ovchinnikov, E N; Sazonova, N V

2015-01-01

This study investigated the biochemical parameters of blood and urine in patients with osteoarthritis in the stages of the pathological process in different age groups. The patients of all age groups in the stages of osteoarthritis demonstrated metabolic acidosis, activation of the antioxidant system and increase in acute phase proteins. In addition to the total for all age groups metabolic shifts the characteristic age-related changes were observed: activated reaction of lipid peroxidation in middle-aged patients and negative calcium balance, with increasing energy metabolism disorders in elderly patients.

Personalized therapy in multiple myeloma according to patient age and vulnerability

DEFF Research Database (Denmark)

Palumbo, Antonio; Bringhen, Sara; Ludwig, Heinz

2011-01-01

Most patients with newly diagnosed multiple myeloma (MM) are aged > 65 years with 30% aged > 75 years. Many elderly patients are also vulnerable because of comorbidities that complicate the management of MM. The prevalence of MM is expected to rise over time because of an aging population. Most...... elderly patients with MM are ineligible for autologous transplantation, and the standard treatment has, until recently, been melphalan plus prednisone. The introduction of novel agents, such as thalidomide, bortezomib, and lenalidomide, has improved outcomes; however, elderly patients with MM are more......, occurrence of serious nonhematologic adverse events during treatment should be carefully taken into account to adjust doses and optimize outcomes....

Early vascular aging in young and middle-aged ischemic stroke patients: the Norwegian Stroke in the Young Study.

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Sahrai Saeed

Full Text Available Ischemic stroke survivors have high risk of cardiovascular morbidity and mortality even at young age, suggesting that early arterial aging is common among such patients.We measured aortic stiffness by carotid-femoral pulse wave velocity (PWV in 205 patients (69% men aged 15-60 years with acute ischemic stroke in the prospective Norwegian Stroke in the Young Study. High for age carotid-femoral PWV was identified in the reference normogram.Patients were on average 49 ± 10 years old, 34% had a history of hypertension and 37% had metabolic syndrome (MetS. In the total study population, higher PWV was associated with history of hypertension (β = 0.18, higher age (β = 0.34, systolic blood pressure (BP (β = 0.28 and serum creatinine (β = 0.18 and lower high-density lipoprotein (HDL cholesterol (β = -0.10, all p < 0.01 in multivariate linear regression analysis (multiple R2 = 0.42, p < 0.001. High for age PWV was found in 18% of patients. In univariate analyses, known hypertension was associated with a 6-fold, MetS with a 4-fold and presence of carotid plaque with a 3.7-fold higher risk for high for age PWV (all p < 0.01. In multiple logistic regression analysis higher systolic BP (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.02-1.06; p < 0.01, history of hypertension (OR 3.59; 95% CI 1.52-8.51; p < 0.01, low HDL cholesterol (OR 3.03; 95% CI 1.00-9.09; p = 0.05 and higher serum creatinine (OR 1.04; 95% CI 1.01-1.06; p < 0.01 were associated with high for age PWV.Higher PWV is common in younger and middle-aged ischemic stroke patients and associated with a clustering of classical cardiovascular risk factors. ClinicalTrials.gov NCT01597453.

Left Ventricular Diastolic Function in Essential Hypertensive Patients: Influence of Age and Left Ventricular Geometry

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Rosa Eduardo Cantoni

2002-01-01

Full Text Available PURPOSE - To evaluate diastolic dysfunction (DD in essential hypertension and the influence of age and cardiac geometry on this parameter. METHODS - Four hundred sixty essential hypertensive patients (HT underwent Doppler echocardiography to obtain E/A wave ratio (E/A, atrial deceleration time (ADT, and isovolumetric relaxation time (IRT. All patients were grouped according to cardiac geometric patterns (NG - normal geometry; CR - concentric remodeling; CH- concentric hypertrophy; EH - eccentric hypertrophy and to age (60 years. One hundred six normotensives (NT persons were also evaluated. RESULTS - A worsening of diastolic function in the HT compared with the NT, including HT with NG (E/A: NT - 1.38±0.03 vs HT - 1.27±0.02, p<0.01, was observed. A higher prevalence of DD occurred parallel to age and cardiac geometry also in the prehypertrophic groups (CR. Multiple regression analysis identified age as the most important predictor of DD (r²=0.30, p<0.01. CONCLUSION - DD was prevalent in this hypertensive population, being highly affected by age and less by heart structural parameters. DD is observed in incipient stages of hypertensive heart disease, and thus its early detection may help in the risk stratification of hypertensive patients.

Age-related cutoffs for cervical movement behaviour to distinguish chronic idiopathic neck pain patients from unimpaired subjects.

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Niederer, Daniel; Vogt, Lutz; Wilke, Jan; Rickert, Marcus; Banzer, Winfried

2015-03-01

The present study aims to develop age-dependent cutoff values in a quasi-experimental, cross-sectional diagnostic test study. One hundred and twenty (120) asymptomatic subjects (n = 100, 36♀, 18 75 years, for normative values; n = 20, 23-75 years, 15♀, for selectivity analyses) and 20 patients suffering from idiopathic neck pain (selectivity analyses, 22-71 years, 15♀) were included. Subjects performed five repetitive maximal cervical flexion/extension movements in an upright sitting position. Cervical kinematic characteristics (maximal range of motion (ROM), coefficient of variation (CV) and mean conjunct movements in rotation and flexion (CM)) were calculated from raw 3D ultrasonic data. Regression analyses were conducted to reveal associations between kinematic characteristics and age and gender and thus to determine normative values for healthy subjects. Age explains 53 % of the variance in ROM (decrease 10.2° per decade), 13 % in CV (increase 0.003 per decade) and 9 % in CM (increase 0.57° per decade). Receivers operating characteristic (ROC) analyses were conducted for differences between individual values of the kinematic characteristics and normative values to optimise cutoff values for distinguishing patients from unimpaired subjects (20 patients and 20 healthy). Cutoff values distinguished asymptomatic subjects' and chronic nonspecific neck patient's movement characteristics with sufficient quality (sensitivity 70-80 %, specificity 65-70 %). By including such classifications, the present findings expand actual research stating an age-related decrease in kinematic behaviour only using categorising span widths across decades. Future study is warranted to reveal our results' potential applicability for intervention onset decision making for idiopathic neck pain patients.

Characteristics and Outcome of Patients Diagnosed With HIV at Older Age.

Science.gov (United States)

Asher, Ilan; Guri, Keren Mahlab; Elbirt, Daniel; Bezalel, Shira Rosenberg; Maldarelli, Frank; Mor, Orna; Grossman, Zehava; Sthoeger, Zev M

2016-01-01

To characterize the clinical, virological, and immunological status at presentation as well as the outcome of patients diagnosed with HIV above the age of 50. A retrospective study of 418 patients newly diagnosed with HIV in 1 Israeli center, between the years 2004 and 2013. Patients with new HIV diagnosis ≥ 50 years of age defined as "older' and < 50 defined as "younger.' Patients were evaluated every 1 to 3 months (mean follow-up 53 ± 33 months). Patients with < 2 CD4/viral-load measurements or with < 1 year of follow-up were excluded. Time of HIV infection was estimated by HIV sequence ambiguity assay. Ambiguity index ≤ 0.43 indicated recent (≤ 1 year) HIV infection. Eighty nine (21%) patients were diagnosed with HIV at an older age. Those older patients presented with significant lower CD4 cell counts and higher viral-load compared with the younger patients. At the end of the study, the older patients had higher mortality rate (21% vs 3.5%; P < 0.001) and lower CD4 cell counts (381 ± 228 vs 483 ± 26 cells/μL; P < 0.001) compared with the younger patients. This difference was also observed between older and younger patients with similar CD4 cell counts and viral load at the time of HIV diagnosis and among patients with a recent (≤ 1 year) HIV infection. One-fifth of HIV patients are diagnosed at older age (≥ 50 years). Those older patients have less favorable outcome compared with the younger patients. This point to the need of educational and screening programs within older populations and for a closer follow-up of older HIV patients.

Comparison of the Quality of Life in Elderly With Young and Middle Age Chronic Renal Failure Patients

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Masomeh Rambod

2011-04-01

Full Text Available Objectives: The aim of this study was to compare the quality of life in elderly with the young and middle age chronic renal failure Patients. Methods & Materials: This cross-sectional study of 202 chronic renal failure patients included young (age≤40 years, middle age (41-59 years, and elderly (age≥60 years patients. The subjects were selected by census method. The data were collected using the "Ferrans and Powers quality of life index- dialysis version" and were analyzed using SPSS-14 with one-way ANOVA and Scheffe’s test. Results: In general, 43.6%, 40.1% and 16.3% of the participants were elderly, middle age and young patients respectively. There were no significant differences in overall quality of life between the three groups (F=1.51, P>0.05. Socioeconomic familial subscale of quality of life was not statistically different in the groups (P0.05. Conclusion: This study indicated that socioeconomic familial subscale of quality of life in young patients was lower than elderly and middle age. Therefore, comprehensive insurance and referring to renal and transplant support society for young patients are suggested in order to improve the patients’ quality of life, especially in the socioeconomic domain.

Age and type of aphasia in patients with stroke.

Science.gov (United States)

Eslinger, P J; Damasio, A R

1981-01-01

The age and gender of a series of patients with different types of aphasia were analysed. Regardless of gender, patients with Broca and conduction aphasias were significantly younger than those with Wernicke and global aphasias. Considering the established cerebral localisation of each of those aphasia types, it appears that, with age, stroke in the territory of the middle cerebral artery will tend to either shift posteriorly (producing Wernicke aphasia) or occupy most of the middle cerebral artery territory (producing global aphasia). But in the absence of concurrent verification of the locus of lesion in each of the cases in our sample, a possible alternative hypothesis must be entertained: that there might be age-related changes in the neurophysiological mechanism subserving language, such that some types of aphasia would tend to be more prevalent with age, regardless of lesion location. PMID:7264683

Valvular Heart Disease in Patients ≥80 Years of Age.

Science.gov (United States)

Kodali, Susheel K; Velagapudi, Poonam; Hahn, Rebecca T; Abbott, Dawn; Leon, Martin B

2018-05-08

In the United States, the octogenarian population is projected to triple by 2050. With this aging population, the prevalence of valvular heart disease (VHD) is on the rise. The etiology, approach to treatment, and expected outcomes of VHD are different in the elderly compared with younger patients. Both stenotic and regurgitant lesions are associated with unfavorable outcomes if left untreated. Surgical mortality remains high due to multiple co-morbidities, and long-term survival benefit is dependent on many variables including valvular pathology. Quality of life is an important consideration in treatment decisions in this age group. Increasingly, octogenarian patients are receiving transcatheter therapies, with transcatheter aortic valve replacement having the greatest momentum. Numerous transcatheter devices for management of other valve lesions are currently in early clinical trials. This review will describe the epidemiology, etiology, diagnosis, and therapeutic options for VHD in the oldest old, with a focus on transcatheter technologies. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Age as a prognostic variable in patients undergoing transurethral prostatectomy

DEFF Research Database (Denmark)

Krogh, J; Jensen, J S; Iversen, H G

1993-01-01

In a retrospective study the outcome of transurethral prostatectomy (TURP) for benign prostatic hyperplasia (BPH) in patients more than 80 years old was compared to a control group of patients with a mean age ten years younger. The elderly had significantly more tissue resected and presented...... with a higher rate of preoperative urinary tract infection. More urological complications were seen among the elderly but these were generally short lived and had no influence on the morbidity, mortality and symptomatic outcome. The perioperative mortality was 3.2% among elderly and 0% in the younger age group....... A cardiorespiratory risk score could not predict patients at risk. In conclusion the age per se had no major influence on the outcome of TURP....

Age modifies the association between serum obestatin, appetite and nutritional status in maintenance hemodialysis patients.

Science.gov (United States)

Katkov, Anna; Sinuani, Inna; Azar, Ada; Shapiro, Gregory; Efrati, Shai; Beberashvili, Ilia

2018-01-23

Increased age is strongly associated with anorexia and protein-energy wasting (PEW) in maintenance hemodialysis (MHD) population. We hypothesized that the association of obestatin, a recently discovered anorexigenic gut hormone, with appetite and nutritional status differs by age groups. We performed a cross-sectional study on 261MHD patients. Obestatin, acyl-ghrelin, markers of inflammation (CRP, IL-6, TNF-α) and nutrition (self-reported appetite, dietary intake, biochemical nutritional parameters, and body composition) were measured. Obestatin was associated with appetite in multivariate analyses even after controlling for such confounders as lean body mass (LBM), IL-6 and acyl-ghrelin in patients younger than 71 years. For each ng/ml increase in obestatin levels, the odds for diminished appetite was 0.75 (95% CI: 0.59-0.96). However, these associations were not observed in patients 71 years and older. Multivariable logistic regression models (including appetite) also showed increasing odds for PEW (defined by ESPEN consensus-based criteria for the diagnosis of malnutrition) across increasing serum obestatin levels (OR: 1.51, 95% CI: 1.05-2.18) in patients 71 years and older. However, after lean body mass (LBM) was added to this model, the association between obestatin and malnutrition was abolished (OR: 1.26, 95% CI: 0.83-1.91). The association between serum obestatin, appetite and PEW differs depending on age in MHD patients. A positive link with appetite exists in patients younger than 71 years, whereas this relationship disappears by the age of 71. In older MHD patients, obestatin is associated with PEW through mechanisms related to LBM, but not to appetite.

Oestrogen receptors in breast tumours: associations with age, menopausal status and epidemiological and clinical features in 735 patients.

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Elwood, J M; Godolphin, W

1980-11-01

Comparisons between oestrogen-receptor (RE)-positive or negative patients were made on a continuous series of 735 patients with primary breast tumours seen at the major treatment centre in British Columbia between 1975 and 1978. RE positivity was commoner in older patients, and was not associated with menopausal status independently of age. The concentration of receptor protein also increased with increasing age, but was not affected by menopausal status. Neither RE status nor quantity was associated with any of the epidemiological risk factors studied, which included parity, age at first birth, weight, family history and exposure to oestrogenic drugs and oral contraceptives. Patients with RE- tumours were more likely to present with symptoms other than a breast lump, pain or nipple inversion, and had less-differentiated tumours; they did not differ from RE+ patients in terms of stage, size of tumour, or interval from first symptom. These findings are discussed in terms of the biological origin and determinants of oestrogen receptors.

Perforated gastric carcinoma in a young-age patient

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Feng-Hsu Wu

2018-06-01

Full Text Available Perforation is a rare complication of gastric carcinoma, and it occurs in less than 5% of all gastric carcinoma cases and in less than 1% within all acute abdomen cases. The diagnosis of malignancy is usually not validated preoperatively. In previous reported English literature, all patients with perforated gastric cancer have the feature of old age. This feature might be able to guide the surgeon to impress the differential diagnosis of malignancy before or during the emergent operation of gastric perforation.This 32-year-old male patient suffered from sudden onset of epigastric pain. We performed emergent operation under the impression of hollow organ perforation. The postoperative pathologic report of gastric ulcer revealed gastric carcinoma. We performed second-stage operation of total gastrectomy with D2 lymphadenectomy smoothly 7 days later. As we know, this is the youngest patient having the condition of perforated gastric carcinoma reported in the literature. This case reminds us that it is possible for perforated gastric carcinoma to occur in young-age patients. Keywords: Gastric cancer, Acute abdomen, Gastric perforation

Under-utilisation of preventive medication in patients with cardiovascular disease is greatest in younger age groups (PREDICT-CVD 15).

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Mehta, Suneela; Wells, Sue; Riddell, Tania; Kerr, Andrew; Pylypchuk, Romana; Marshall, Roger; Ameratunga, Shanthi; Chan, Wing Cheuk; Thornley, Simon; Crengle, Sue; Harrison, Jeff; Drury, Paul; Elley, C Raina; Bell, Fionna; Jackson, Rod

2011-06-01

Blood pressure-lowering (BPL) and lipid-lowering (LL) medications together reduce estimated absolute five-year cardiovascular disease (CVD) risk by >40%. International studies indicate that the proportion of people with CVD receiving pharmacotherapy increases with advancing age. To compare BPL and LL medications, by sociodemographic characteristics, for patients with known CVD in primary care settings. The study population included patients aged 35-74 with known CVD assessed in primary care from July 2006 to October 2009 using a web-based computerised decision support system (PREDICT) for risk assessment and management. Clinical data linked anonymously to national sociodemographic and pharmaceutical dispensing databases. Differences in dispensing BPL and LL medications in six months before first PREDICT assessment was analysed according to age, sex, ethnicity and deprivation. Of 7622 people with CVD, 1625 <55 years old, 2862 were women and 4609 lived in deprived areas (NZDep quintiles 4/5). The study population included 4249 European, 1556 Maori, 1151 Pacific and 329 Indian peoples. BPL medications were dispensed to 81%, LL medications to 73%, both BPL and LL medications to 67%, and 87% received either class of medication. Compared with people aged 65-75, people aged 35-44 were 30-40% less likely and those aged 45-54 were 10-15% less likely to be dispensed BPL, LL medications or both. There were minimal differences in likelihood of dispensing according to sex, ethnicity or deprivation. BPL and LL medications are under-utilised in patients with known CVD in New Zealand. Only two-thirds of patients in this cohort are on both. Younger patients are considerably less likely to be on recommended medications.

Motor and non-motor symptoms in old-age onset Parkinson's disease patients.

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Mendonça, Marcelo D; Lampreia, Tania; Miguel, Rita; Caetano, André; Barbosa, Raquel; Bugalho, Paulo

2017-07-01

Advancing age is a well-known risk factor for Parkinson's disease (PD). With population ageing it is expected that the total number of patients with PD onset at oldage increases. Information on the motor but particularly on non-motor phenotype of this late-onset population is lacking. We recruited 24 patients with PD onset at or over 75 years. Each patient was matched with 1 control patient with PD onset between the ages of 40 and 65 and matched for disease duration. Both groups were assessed with the UPDRS, the Non-motor symptoms scale (NMSS) and other scales to assess non-motor symptoms. Groups were compared with conditional logistic regression analysis. Old-age onset PD was, on average, 80 years at the time of PD onset while middle-age onset were 59. Disease duration was approximately 5 years in both groups. While no difference was observed in the total UPDRS-III scores, old-age onset PD was associated with higher axial symptoms (7.42 vs. 4.63, p = 0.011) and a higher frequency of dementia (7/24 vs. 0/24, p = 0.009). While no difference in the total number of non-motor symptoms was observed (6.79 vs. 6.22, p = 0.310), old-age onset patients had a higher prevalence of gastrointestinal symptoms (20/24 vs. 12/24, p = 0.037). For the same disease duration, older age onset is associated with worse axial motor dysfunction and dementia in PD patients. Beside gastrointestinal symptoms, non-motor symptoms are not associated with age.

Patients with neuromyelitis optica have a more severe disease than patients with relapsingremitting multiple sclerosis, including higher risk of dying of a demyelinating disease

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Denis Bernardi Bichuetti

2013-05-01

Full Text Available Although neuromyelitis optica (NMO is known to be a more severe disease than relapsing-remitting multiple sclerosis (RRMS, few studies comparing both conditions in a single center have been done. Methods: Comparison of our previously published cohort of 41 NMO patients with 177 RRMS patients followed in the same center, from 1994 to 2007. Results: Mean age of onset was 32.6 for NMO and 30.2 for RRMS (p=0.2062 with mean disease duration of 7.4 years for NMO and 10.3 years for RRMS. Patients with NMO had a higher annualized relapse rate (1.0 versus 0.8, p=0.0013 and progression index (0.9 versus 0.6, p≪0.0001, with more patients reaching expanded disability status scale (EDSS 6.0 (39 versus 17%, p=0.0036. The odds ratio for reaching EDSS 6.0 and being deceased due to NMO in comparison to RRMS were, respectively, 3.14 and 12.15. Conclusion: Patients with NMO have a more severe disease than patients with RRMS, including higher risk of dying of a demyelinating disease.

Changes of serum sex hormones levels in aged patient with peptic ulcer

International Nuclear Information System (INIS)

Huang Xiuhai; Xiao Chuangqing; He Yunnan; Li Xuewen; Bi Chao; Zhang Yifan

2005-01-01

Objective: To investigate the changes of serum contents of testosterone (T), estradiol (E 2 ) and cortisol (Cor) in aged patients with peptic ulcer. Methods: Serum T, E 2 and Cor levels were determined with CLIA in 86 aged patients with peptic ulcer both before treatment (active stage) and after treatment for 6 weeks (healing stage) as well as in 76 controls. Results: Serum contents of T and E 2 in the patients during active stage were significantly lower than those in patients during healing stage and in controls (both P 0.05). Conclusion: A lower serum T and E 2 contents was present in aged patients with peptic ulcer during active stage. (authors)

Radiotherapy for cancer patients aged 85 or older

International Nuclear Information System (INIS)

Kan, Tomoko; Kodani, Kazuhiko; Michimoto, Koichi; Ogawa, Toshihide

2009-01-01

The purpose of this study was to investigate the clinical efficacy and problems of radiotherapy for cancer patients aged 85 or older. Fifty-three patients (26 men, 27 women) who underwent radiotherapy were analyzed retrospectively. Median age was 87 years (range; 85-99). Treatment policy was classified into curative, semi-curative (treatment field or total dose were limited due to performance status) and palliative therapy. Head-and-neck, bladder and skin cancer were the most common primary disease. The treatment was deemed curative in 27%, semi-curative in 13%, and palliative in 49%. Total dose of semi-curative therapy was almost same compared with curative therapy. The rate of treatment completion and effectiveness were not significantly different in curative therapy and semi-curative therapy. We should consider to reduce the field size to gross target volume, but to treat with substantial dose to make radiotherapy safe and effective. We must be aware that elderly patients have basically low tolerability. (author)

Does the Age of Donor Kidneys Affect Nocturnal Polyuria in Patients With Successful Real Transplantation?

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Mitsui, T; Morita, K; Iwami, D; Kitta, T; Kanno, Y; Moriya, K; Takeda, M; Shinohara, N

We investigated whether the age of donor kidneys influences the incidence of nocturnal polyuria in patients with successful renal transplantation (RTX). Eighty-five patients (45 men and 40 women) undergoing RTX (median age, 47 years) were included in this study. Twenty-four-hour bladder diaries were kept for 3 days, and nocturnal polyuria was defined as a nocturnal polyuria index (nocturnal urine volume/24-hour urine volume) of >0.33. Risk factors for nocturnal polyuria were analyzed in patients with RTX by means of the Mann-Whitney U test, χ 2 test, and a logistic regression analysis. End-stage renal disease (ESRD) developed from diabetes mellitus in 16 patients (19%). Sixty-five patients (76%) received pre-transplant dialysis, with a median duration of 5 years. The median serum creatinine level and body mass index at the most recent visit were 1.2 mg/dL and 21.2 kg/m 2 , respectively. On the basis of the 24-hour bladder diaries, nocturnal polyuria was identified in 48 patients (56%). A logistic regression analysis revealed that diabetes mellitus as the original disease for ESRD was the only risk factor for nocturnal polyuria (odds ratio, 8.95; 95% confidence interval, 2.01-65.3; P = .0028). The age of donor kidneys at examination did not affect the incidence of nocturnal polyuria (P = .9402). Nocturnal polyuria was not uncommon in patients with successful RTX. Diabetes mellitus as the original disease for ESRD was the only risk factor for nocturnal polyuria, whereas the age of donor kidneys at examination did not affect the incidence of nocturnal polyuria. Thus, nocturnal polyuria is caused by recipient factors but not donor factors. Copyright © 2016 Elsevier Inc. All rights reserved.

Relation of age with symptom severity and quality of life in patients with fibromyalgia.

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Jiao, Juan; Vincent, Ann; Cha, Stephen S; Luedtke, Connie A; Oh, Terry H

2014-02-01

To examine the relation of age with symptom severity and quality of life (QOL) in patients with fibromyalgia, and to compare physical and mental health of our female patients with those of the US female general population. We studied 978 patients with fibromyalgia from May 1, 2001 through April 30, 2004, and divided them into age groups of young (≤39 years), middle-aged (40-59 years), and older (≥60 years). They completed the Fibromyalgia Impact Questionnaire and the Short Form-36 Health Status Questionnaire (SF-36). Standardized SF-36 physical and mental health summary scores were compared with those of the US female general population of similar age. One-way analysis of variance and post hoc paired t test analyses were performed to detect differences across age groups. Pairwise comparison found young and middle-aged patients having worse fibromyalgia symptoms in all subscales except the anxiety subscale compared with older patients (P≤.01). Similarly, these young and middle-aged patients had worse QOL in the SF-36 mental component summary, as well as SF-36 general health perceptions, vitality, social functioning, and mental health index, compared with older patients (all Pfibromyalgia, with young and middle-aged patients having poorer QOL and worse fibromyalgia symptoms than do older patients. QOL in physical health was reduced more than in mental health, particularly in young patients, compared with the general population. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Results of radiotherapy for brain metastases in old-aged patients

International Nuclear Information System (INIS)

Nieder, C.; Niewald, M.; Schnabel, K.

1995-01-01

To evaluate which patients older tahn 70 years will benefit by radiotherapy for their brain metastases the data of 35 patients in this age-group who were treated between 1983 and 1994 were retrospectivley analyzed. All patients were previously untreated and received a whole-brain irradiation and concomitantly corticosteroids. The median total dose was 30 Gy (fractionation: 10 times 3 Gy in 2 weeks). Six patients each received lower or higher total doses with 50.4 Gy at maximum. Six patients failed to complete their prescribed treatment (17%). The median survival of all patients who completed their radiotherapy course was 67 days only. Patients with extracerebral metastases had a median survival of 31 days. Survival was not dependent on total dose of radiotherapy. In 56% of all cases the general condition of the patients improved or remained stable at a high level. Karnofsky-performance status was the most important prognostic factor. Advanced age is an unfavourable prognostic factor. Only patients in good general condition without extracerebral metastases had survival times which justify radiotherapy for their brain metastases. (orig./MG) [de

Association of HTRA1 rs11200638 with age-related macular degeneration (AMD) in Brazilian patients.

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Lana, Tamires Prates; da Silva Costa, Sueli Matilde; Ananina, Galina; Hirata, Fábio Endo; Rim, Priscila Hae Hyun; Medina, Flávio MacCord; de Vasconcellos, José Paulo Cabral; de Melo, Mônica Barbosa

2018-01-01

Age-related macular degeneration is a multifactorial disease that can lead to vision impairment in older individuals. Although the etiology of age-related macular degeneration remains unknown, risk factors include age, ethnicity, smoking, hypertension, obesity, and genetic factors. Two main loci have been identified through genome-wide association studies, on chromosomes 1 and 10. Among the variants located at the 10q26 region, rs11200638, located at the HTRA1 gene promoter, has been associated with age-related macular degeneration in several populations and is considered the main polymorphism. We conducted a replication case-control study to analyze the frequency and participation of rs11200638 in the etiology of age-related macular degeneration in a sample of patients and controls from the State of São Paulo, Brazil, through polymerase chain reaction and enzymatic digestion. The frequency of the A allele was 57.60% in patients with age-related macular degeneration and 36.45% in controls (p value age-related macular degeneration group compared to the control group (p = 1.21 e-07 and 0.0357, respectively). No statistically significant results were observed after stratification in dry versus wet types or advanced versus non-advanced forms. To our knowledge, this is the first time the association between rs11200638 and overall age-related macular degeneration has been reported in South America.

Lower extremity venous thrombosis in patients younger than 50 years of age

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Kreidy R

2012-03-01

Full Text Available Raghid Kreidy1, Pascale Salameh2, Mirna Waked31Department of Vascular Surgery, Saint George Hospital, University Medical Center, University of Balamand, 2Laboratory of Clinical and Epidemiological Research, Faculty of Pharmacy, Lebanese University, 3Department of Pulmonary Medicine, Saint George Hospital, University Medical Center, University of Balamand, Beirut, LebanonAim: Lower extremity deep venous thrombosis in the young adult is uncommon and has not been well studied in the literature. The aim of this study is to define risk factors for deep venous thrombosis among patients younger than 50 years of age, to compare them with a control group, and to suggest recommendations for the management and treatment of venous thrombosis in this particular group of patients.Methods: From January 2003 to January 2011, 66 consecutive Lebanese patients (29 males and 37 females younger than 50 years, diagnosed in an academic tertiary-care center with lower extremity deep venous thrombosis by color flow duplex scan, were retrospectively reviewed. Their age varied between 21 and 50 years (mean 38.7 years. The control group included 217 patients (86 males and 131 females older than 50 years (range: 50–96 years; mean 72.9 years.Results: The most commonly reported risk factors in the younger age group were inherited thrombophilia (46.9% compared with 13.8% in the control group; P < 0.001, pregnancy (18.2% compared with 0.5%; P < 0.001, treatment with estrogen drugs (13.6% compared with 2.3%; P = 0.001, and family history of venous thromboembolism (9.1% compared with 3.8%; P = 0.084.Conclusion: Inherited thrombophilia is the most commonly observed risk factor among patients younger than 50 years, with a prevalence of three times more than the control group. Young adults should be screened for thrombophilia even in the presence of transient acquired risk factors. Pregnancy and treatment with estrogen drugs essentially when associated with inherited thrombophilia

Reduced ability to work both before and after infectious spondylodiscitis in working-age patients

DEFF Research Database (Denmark)

Kehrer, Michala; Hallas, Jesper; Bælum, Jesper

2017-01-01

BACKGROUND: As little is known about the ability to work in patients with infectious spondylodiscitis, we compared the relation between the workforce before infection with that of a reference population and described the patients' ability to work after infection including predictors of return...... to work (RTW). METHODS: We identified all patients aged 20-57 years treated for infectious spondylodiscitis January 1994-May 2009 at hospitals in Funen County, Denmark. The work status of each week from 2 years before until 2 years after index date was compared with that of a reference population. Time...... before infection compared with a reference population and infection further lowered their ability to RTW....

[Depression in Patients with Age-Related Macular Degeneration].

Science.gov (United States)

Narváez, Yamile Reveiz; Gómez-Restrepo, Carlos

2012-09-01

Age-related macular degeneration is a cause for disability in the elderly since it greatly affects their quality of life and increases depression likelihood. This article discusses the negative effect depression has on patients with age-related macular degeneration and summarizes the interventions available for decreasing their depression index. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Cervical vertebral maturation and dental age in coeliac patients.

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Costacurta, M; Condò, R; Sicuro, L; Perugia, C; Docimo, R

2011-07-01

The aim of the study was to evaluate the cervical vertebral maturation and dental age, in group of patients with coelic disease (CD), in comparison with a control group of healthy subjects. At the Paediatric Dentistry Unit of PTV Hospital, "Tor Vergata" University of Rome, 120 female patients, age range 12.0-12.9 years were recruited. Among them, 60 subjects (Group 1) were affected by CD, while the control group (Group 2) consisted of 60 healthy subjects, sex and age-matched. The Group 1 was subdivided, according to the period of CD diagnosis, in Group A (early diagnosis) and Group B (late diagnosis). The skeletal age was determined by assessing the cervical vertebral maturation, while the dental age has been determined using the method codified by Demirjiyan. STATISTICS.: The analyses were performed using the SPSS software (version 16; SPSS Inc., Chicago IL, USA). In all the assessments a significant level of alpha = 0.05 was considered. There are no statistically significant differences between Group 1 and Group 2 as for chronological age (p=0.122). Instead, from the assessment of skeletal-dental age, there are statistically significant differences between Group 1 - Group 2 (pcervical vertebral maturity can be assessed with a low cost, non invasive, easy to perform exam carried out through the routine radiographic examinations such as orthopanoramic and lateral teleradiography.

Age-Related Differences in Clinical Characteristics and Esophageal Motility in Patients with Dysphagia.

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Nakato, Rui; Manabe, Noriaki; Kamada, Tomoari; Matsumoto, Hideo; Shiotani, Akiko; Hata, Jiro; Haruma, Ken

2017-06-01

Dysphagia in elderly patients has a major effect on nutrition and quality of life (QOL). Although several studies have shown that aging itself is associated with changes in esophageal motility, the impact of these changes on dysphagia symptoms and QOL is unknown. This study assessed the manometric diagnoses of elderly patients with dysphagia compared with diagnoses in younger counterparts. Participants included 116 consecutive patients examined for dysphagia from 2007 to 2014. We divided patients into three groups by age: Group A, 66 years and older (24 men, 23 women); Group B, 45-65 years (18 men, 24 women); and Group C, 44 years and younger (15 men, 12 women). The three groups were compared in regard to symptoms, esophageal motility, and health-related QOL (HRQOL). All patients underwent esophageal manometry examination and completed a self-administered questionnaire concerning their symptoms; HRQOL assessment was based on results of the Short Form-8 General Health Survey. Symptoms rated ≥4 points on the Likert scale were defined as significant. Although all patients had dysphagia as a major symptom, more elderly patients reported globus sensation, whereas more young patients reported heartburn as the primary symptom. Manometric diagnoses were generally similar across the three groups. Ineffective esophageal motility was more prevalent in Groups A and C than in Group B, although the difference was not statistically significant. No significant differences in manometric parameters or HRQOL were detected among the three groups. Despite differences in symptom patterns, broad manometric diagnoses and impairment of HRQOL in elderly patients with dysphagia are similar to those in younger counterparts.

Younger age is an independent predictor of worse prognosis among Lebanese nonmetastatic breast cancer patients: analysis of a prospective cohort

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El Chediak A

2017-06-01

Full Text Available Alissar El Chediak,1 Raafat S Alameddine,1 Ayman Hakim,1 Lara Hilal,2 Sarah Abdel Massih,1 Lana Hamieh,3 Deborah Mukherji,1 Sally Temraz,1 Maya Charafeddine,1 Ali Shamseddine1 1Division of Hematology/Oncology, Department of Internal Medicine, 2Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon; 3Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA, USA Background: Several retrospective studies have reported that younger age at presentation is associated with a worse prognosis for nonmetastatic breast cancer patients. In this study, we prospectively assessed the association between different baseline characteristics (age, tumor characteristics, mode of treatment, etc and outcomes among newly diagnosed nonmetastatic Lebanese breast cancer patients.Methods: We recruited a sample of 123 women newly diagnosed with nonmetastatic breast cancer presenting to American University of Beirut Medical Center. Immunohistochemical, molecular (vitamin D receptor, methylene tetrahydrofolate reductase polymorphisms, and genetic assays were performed. Patient characteristics were compared by age group (<40 and ≥40 years. A Cox regression analysis was performed to evaluate the variables affecting the disease-free survival (DFS. Outcome data were obtained, and DFS was estimated.Results: Among the 123 patients, 47 were 40 years of age or younger, and 76 were older than 40 years. Median follow-up duration was 58 months. Nine out of 47 patients <40 years (19.1% experienced disease relapse in contrast to four out of 76 patients >40 years (5.2%. A wide immunohistochemical panel included Ki-67, cyclin B1, p53, platelet-derived growth factor receptor, and vascular endothelial growth factor receptor, and did not reveal any significant difference in these markers between the two age groups. Older patients had a larger percentage of Luminal A than younger patients. On multivariate analysis

Long-term pain relief with optimized medical treatment including antioxidants and step-up interventional therapy in patients with chronic pancreatitis.

Science.gov (United States)

Shalimar; Midha, Shallu; Hasan, Ajmal; Dhingra, Rajan; Garg, Pramod Kumar

2017-01-01

Abdominal pain is difficult to treat in patients with chronic pancreatitis (CP). Medical therapy including antioxidants has been shown to relieve pain of CP in the short-term. Our aim was to study the long-term results of optimized medical and interventional therapy for pain relief in patients with CP with a step-up approach. All consecutive patients with CP were included prospectively in the study. They were treated medically with a well-balanced diet, pancreatic enzymes, and antioxidants (9000 IU beta-carotene, 0.54 g vitamin C, 270 IU vitamin E, 600 µg organic selenium, and 2 g methionine). Endoscopic therapy and/or surgery were offered if medical therapy failed. Pain relief was the primary outcome measure. A total of 313 patients (mean age 26.16 ± 12.17; 244 males) with CP were included; 288 (92%) patients had abdominal pain. The etiology of CP was idiopathic in 224 (71.6%) and alcohol in 82 (26.2%). At 1-year follow-up, significant pain relief was achieved in 84.7% of patients: 52.1% with medical therapy, 16.7% with endoscopic therapy, 7.6% with surgery, and 8.3% spontaneously. The mean pain score decreased from 6.36 ± 1.92 to 1.62 ± 2.10 (P pain free at those follow-up periods. Significant pain relief is achieved in the majority of patients with optimized medical and interventional treatment. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Aging-related systemic manifestations in COPD patients and cigarette smokers.

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Laurent Boyer

Full Text Available Chronic obstructive pulmonary disease (COPD is often associated with age-related systemic abnormalities that adversely affect the prognosis. Whether these manifestations are linked to the lung alterations or are independent complications of smoking remains unclear.To look for aging-related systemic manifestations and telomere shortening in COPD patients and smokers with minor lung destruction responsible for a decline in the diffusing capacity for carbon monoxide (DLCO corrected for alveolar volume (KCO.Cross-sectional study in 301 individuals (100 with COPD, 100 smokers without COPD, and 101 nonsmokers without COPD.Compared to control smokers, patients with COPD had higher aortic pulse-wave velocity (PWV, lower bone mineral density (BMD and appendicular skeletal muscle mass index (ASMMI, and shorter telomere length (TL. Insulin resistance (HOMA-IR and glomerular filtration rate (GFR were similar between control smokers and COPD patients. Smokers did not differ from nonsmokers for any of these parameters. However, smokers with normal spirometry but low KCO had lower ASMMI values compared to those with normal KCO. Moreover, female smokers with low KCO, had lower BMD and shorter TL compared to those with normal KCO.Aging-related abnormalities in patients with COPD are also found in smokers with minor lung dysfunction manifesting as a KCO decrease. Decreased KCO might be useful, particularly among women, for identifying smokers at high risk for aging-related systemic manifestations and telomere shortening.

Pulp Revascularization on Permanent Teeth with Open Apices in a Middle-aged Patient.

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Wang, Yu; Zhu, Xiaofei; Zhang, Chengfei

2015-09-01

Pulp revascularization is a promising procedure for the treatment of adolescents' immature permanent teeth with necrotic pulp and/or apical periodontitis. However, the ability to successfully perform pulp revascularization in a middle-aged patient remains unclear. A 39-year-old woman was referred for treatment of teeth #20 and #29 with necrotic pulp, extensive periapical radiolucencies, and incomplete apices. Pulp revascularization procedures were attempted, including root canal debridement, triple antibiotic paste medication, and platelet-rich plasma transplantation to act as a scaffold. Periapical radiographic and cone-beam computed tomographic examinations were used to review the changes in the apical lesions and root apex configuration. The patient remained asymptomatic throughout the 30-month follow-up. Periapical radiographic examination revealed no change in the apical lesions of either tooth at 8 months. The periapical radiolucency disappeared on tooth #20 and significantly decreased on tooth #29 by the 30-month follow-up, findings that were also confirmed by cone-beam computed tomographic imaging. No evidence of root lengthening or thickening was observed. Successful revascularization was achieved in a middle-aged patient's teeth. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Patient's anxiety and fear of anesthesia: effect of gender, age, education, and previous experience of anesthesia. A survey of 400 patients.

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Mavridou, Paraskevi; Dimitriou, Varvara; Manataki, Adamantia; Arnaoutoglou, Elena; Papadopoulos, Georgios

2013-02-01

Patients express high anxiety preoperatively, because of fears related to anesthesia and its implications. The purpose of this survey was to gain insight into these fears and to study whether they are affected by patients' sex, age, education, or previous experience of anesthesia. Questionnaires with fixed questions were distributed to consenting, consecutive surgical patients before the pre-anesthetic visit. The questionnaires included patients' demographics and questions related to their fears about anesthesia. Four-hundred questionnaires were collected and analyzed. Eighty-one percent of patients experience preoperative anxiety. The main sources of their anxiety were fear of postoperative pain (84 %), of not waking up after surgery (64.8 %), of being nauseous or vomiting (60.2 %), and of drains and needles (59.5 %). Patients are less concerned about being paralyzed because of anesthesia (33.5 %) or of revealing personal issues (18.8 %). Gender seems to affect patients fears, with women being more afraid (85.3 vs. 75.6 % of men, p = 0.014). The effects of patients' age, level of education, and previous experience of anesthesia are minor, except for individual questions. Sixty-three percent of our patients (mostly women 67.4 vs. 57.4 % of men, p = 0.039) talk about these fears with their relatives, although a vast majority of 95.5 % would prefer to talk with the anesthesiologist and be reassured by him. All patients, mostly women, express fears about anesthesia; this fear leads to preoperative anxiety. Slight differences are observed for some individual questions among patients of different sex, education level, and previous experience of anesthesia.

[A comparison of characteristics of pathologic hobbies in schizophrenic patients of different age].

Science.gov (United States)

Sergeev, I I; Deych, R V; Malinochka, S A

2016-01-01

To analyze age-related pathologic hobbies in patients with schizophrenia spectrum disorders. Forty-three inpatients, aged from 4 to 16 years, and 31 patients, aged from 18 to 65 years, were studied. Clinical/psychopathological analysis, psychological experiment and clinical statistics were used. Pathological hobbies substantially differed depending on the age (3-6, 7-15 and 18-65 years). In preschool age, hobbies were immature and infantile, arose autochthonously, their course was relatively stable and they had limited maladaptive effects. In junior school/teenager age, hobbies were more distinct and were associated with more diverse and mature realization patterns. Their origin was more depended on environmental factors, the course was persistent or attack-like with more pronounced and steady maladaptive effects. In some cases, there was a trend to pathological hobby progression. Abnormal hobbies in patients of mature age were the most diverse in their subjects and forms of realization as well as in their clinical variants and dynamic types. In the group of mature patients with schizophrenic spectrum disorders, there was a significantly higher percentage of psychotic forms of pathological hobbies.

The frequency of diagnostic errors in radiologic reports depends on the patient's age

International Nuclear Information System (INIS)

Diaz, Sandra; Ekberg, Olle

2010-01-01

Background: Patients who undergo treatment may suffer preventable medical errors. Some of these errors are due to diagnostic imaging procedures. Purpose: To compare the frequency of diagnostic errors in different age groups in an urban European population. Material and Methods: A total of 19 129 reported radiologic examinations were included. During a 6-month period, the analyzed age groups were: children (aged 0-9 years), adults (40-49 years), and elderly (86-95 years). Results: The frequency of radiologic examinations per year was 0.3 in children, 0.6 in adults, and 1.1 in elderly. Significant errors were significantly more frequent in the elderly (1.7%) and children (1.4%) compared with adults (0.8%). There were 60 false-positive reports and 232 false-negative reports. Most errors were made by staff radiologists after hours when they reported on examinations outside their area of expertise. Conclusion: Diagnostic errors are more frequent in children and the elderly compared with middle-aged adults

Impact of age on the false negative rate of human papillomavirus DNA test in patients with atypical squamous cells of undetermined significance.

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Won, Kyu-Hee; Lee, Jae Yeon; Cho, Hye-Yon; Suh, Dong Hoon; No, Jae Hong; Kim, Yong-Beom

2015-03-01

Human papillomavirus (HPV) test was incorporated into the triage of lesser abnormal cervical cytologies: atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL). This study aimed to evaluate the impact of age on the efficacy of HPV testing in patients with lesser abnormal cervical cytologies. A total of 439 patients with ASCUS or LSIL were included. The association between age groups and the diagnostic performances of HPV test for high-grade cervical intraepithelial neoplasia (CIN2+) was evaluated. Median age was 44 years (range, 17 to 75 years). ASCUS was more frequently observed in older patients while LSIL was more common in younger patients (P=0.002). CIN2+ was found in 11.3% (32/284) of the ASCUS patients and 12.9% (20/155) of patients with LSIL. Older patients with ASCUS showed lower HPV infection rates (P=0.025), but not LSIL (P=0.114). However, the prevalence of CIN2+ was similar between the age groups with ASCUS or LSIL. In patients with ASCUS, the false negative rate of HPV test for CIN2+ was 6.2%. The false negative rate of the HPV test became higher with increasing of the age after the age of 50 (P=0.034). Our findings suggest that false negative rate of the HPV test for CIN2+ in ASCUS patients older than 50 years might become higher with increasing of the age. Negative HPV results in patients of the age >50 years with ASCUS should be carefully interpreted.

Identification of chronic heart failure patients with a high 12-month mortality risk using biomarkers including plasma C-terminal pro-endothelin-1.

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Ewa A Jankowska

Full Text Available OBJECTIVES: We hypothesised that assessment of plasma C-terminal pro-endothelin-1 (CT-proET-1, a stable endothelin-1 precursor fragment, is of prognostic value in patients with chronic heart failure (CHF, beyond other prognosticators, including N-terminal pro-B-type natriuretic peptide (NT-proBNP. METHODS: We examined 491 patients with systolic CHF (age: 63±11 years, 91% men, New York Heart Association [NYHA] class [I/II/III/IV]: 9%/45%/38%/8%, 69% ischemic etiology. Plasma CT-proET-1 was detected using a chemiluminescence immunoassay. RESULTS: Increasing CT-proET-1 was a predictor of increased cardiovascular mortality at 12-months of follow-up (standardized hazard ratio 1.42, 95% confidence interval [CI] 1.04-1.95, p = 0.03 after adjusting for NT-proBNP, left ventricular ejection fraction (LVEF, age, creatinine, NYHA class. In receiver operating characteristic curve analysis, areas under curve for 12-month follow-up were similar for CT-proET-1 and NT-proBNP (p = 0.40. Both NT-proBNP and CT-proET-1 added prognostic value to a base model that included LVEF, age, creatinine, and NYHA class. Adding CT-proET-1 to the base model had stronger prognostic power (p<0.01 than adding NT-proBNP (p<0.01. Adding CT-proET-1 to NT-proBNP in this model yielded further prognostic information (p = 0.02. CONCLUSIONS: Plasma CT-proET-1 constitutes a novel predictor of increased 12-month cardiovascular mortality in patients with CHF. High CT-proET-1 together with high NT-proBNP enable to identify patients with CHF and particularly unfavourable outcomes.

QOL in caregivers of Japanese patients with Prader-Willi syndrome with reference to age and genotype.

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Ihara, Hiroshi; Ogata, Hiroyuki; Sayama, Masayuki; Kato, Aya; Gito, Masao; Murakami, Nobuyuki; Kido, Yasuhiro; Nagai, Toshiro

2014-09-01

This study aimed to measure quality of life (QOL) of the primary family caregivers for patients with Prader-Willi syndrome (PWS). Comparisons were made between caregivers' QOL in regard to their dependents' genotype and age group. The participants with PWS consisted of 22 children (aged from 6 to 12 years) and 23 adolescents (aged from 13 to 19 years), including 6 children and 7 adolescents with maternal uniparental disomy (mUPD) and 16 children and 16 adolescents with deletion (DEL). The QOL of the primary family caregiver for each patient was assessed using the Japanese version of the WHOQOL-BREF. To examine the effect that age (children vs. adolescents) and genotype (DEL vs. mUPD) have on the QOL of caregivers, a two-way ANOVA was conducted, followed by the Bonferroni procedure to test the simple main effects. The two age groups and the two genotypes of PWS were used as independent variables and the total QOL of caregivers as a dependent variable. The two-way ANOVA (F(1, 41) = 6.98, P caregivers of DEL adolescents showed little difference from that with DEL children, but the QOL of caregivers for mUPD adolescents was shown to be lower than that with mUPD children along with that of caregivers with DEL adolescents. There is hence a growing tendency for the deterioration in the QOL of caregivers to manifest itself later in the patients' adolescence, found mainly with mUPD patients. © 2014 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc.

Postoperative delirium after partial laryngectomy in a middle-aged patient: A case report.

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Yu, Huiqian; Shen, Xia

2018-02-01

Postoperative delirium is a common occurrence in older patients. However, reports of postoperative delirium in middle-aged patients are limited, and the underlying mechanism of delirium in this patient population is not clear. A 45-year-old man who developed postoperative delirium on the second day after partial laryngectomy. Interviews of the surgical team, patient, and patient's spouse revealed that the patient was psychologically stressed, but had not been diagnosed or treated. The patient also suffered impairment in physiological functioning and sleep disturbance after surgery. Postoperative delirium. The postoperative delirium was treated with an antipsychotic drug. The patient recovered well. Preoperative psychological stress, which is often undiagnosed and untreated, can increase the risk of postoperative delirium in middle-aged patients undergoing laryngectomy. Therefore, screening for psychological stress and implementing strategies to prevent delirium should be considered for patients who undergo laryngectomy, even if they are not in high-risk older age groups.

Does age really matter? Recall of information presented to newly referred patients with cancer.

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Jansen, Jesse; Butow, Phyllis N; van Weert, Julia C M; van Dulmen, Sandra; Devine, Rhonda J; Heeren, Thea J; Bensing, Jozien M; Tattersall, Martin H N

2008-11-20

To examine age- and age-related differences in recall of information provided during oncology consultations. Two hundred sixty patients with cancer diagnosed with heterogeneous cancers, seeing a medical or radiation oncologist for the first time, participated in the study. Patients completed questionnaires assessing information needs and anxiety. Recall of information provided was measured using a structured telephone interview in which patients were prompted to remember details physicians gave about diagnosis, prognosis, and treatment. Recall was checked against the actual communication in audio-recordings of the consultations. Recall decreased significantly with age, but only when total amount of information presented was taken into account. This indicates that if more information is discussed, older patients have more trouble remembering the information than younger ones. In addition, recall was selectively influenced by prognosis. First, patients with a poorer prognosis recalled less. Next, the more information was provided about prognosis, the less information patients recalled, regardless of their actual prognosis. Recall is not simply a function of patient age. Age only predicts recall when controlling for amount of information presented. Both prognosis and information about prognosis are better predictors of recall than age. These results provide important insights into intervention strategies to improve information recall in patients with cancer.

Protein carbonyl content: a novel biomarker for aging in HIV/AIDS patients

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Vaishali Kolgiri

2017-01-01

Conclusions: Carbonyl content may has a role as a biomarker for detecting oxidative DNA damage induced ART toxicity and/or accelerated aging in HIV/AIDS patients. Larger studies are warranted to elucidate the role of carbonyl content as a biomarker for premature aging in HIV/AIDS patients.

Radiation therapy for cancer in elderly patients over 80 years of age

International Nuclear Information System (INIS)

Nozaki, Miwako; Murakami, Yuko; Furuta, Masaya; Izawa, Yasuyuki; Iwasaki, Naoya

1998-01-01

The elderly population has recently increased, and the need for cancer care and treatment for the elderly is likely to grow. We report on radiation therapy for cancer in elderly patients over 80 years of age. During the period from 1985 to 1996, 90 elderly patients (54 men, 36 women) aged over 80 years were treated with radiation therapy. Many patients had primary tumors of the esophagus, head and neck, and lungs, in that order of frequency. Fifty-seven percent of the patients were treated with radical radiotherapy, and 70% were treated with radiotherapy alone. The rate of completion of radiation therapy was 90%, and the response rate was 82%. Radiation therapy played an important role in the treatment of the patients over 80 years of age. The half of our patients had concurrent medical problems, and were dependent on their home physicians both before and after radiation therapy. We consider that radiation oncologists should make an effort to form a good relationship with home physicians. (author)

Comparison of Apraxia between Patients with Senile Dementia of Alzheimer Type and Normal Aged People

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Fariba Yadegari

2007-07-01

Full Text Available Objective: In addition to memory deficits and aphasia, many patients with Alzheimer’s disease (AD are apraxic which may bring about disturbances in their daily living. The purpose of present study was investigating the presence of any apraxic disorder in patients with senile dementia of Alzheimer type (SDAT and comparison with normal aged people. Materials & Methods: In this case–control and analytical study 14 SDAT patients were compared with 20 normal ageing people that they were matched with patients according to age and education. Patients were selected from Iranian Alzheimer Association clients with psychiatrist diagnostic confirmation and MMSE scores between 15-27 and compared with controls with MMSE scores between 25-30. Apraxia Test was administered on both groups. The Test included 4 subtests: conceptual movements gestured conceptual movements, oral and respiratory movements & pantomime of movements of object manipulations. Data was analyzed by using Kolmogoroff – Smirnoff test, Man – Witney, T-test for independent groups and pearsonian correlation coefficient. Results: Findings showed that apraxia scores were significantly (P<0/001 different between groups so that (SDAT patients were diagnosed as apraxic and controls were not. Besides, comparison of subtests scores of (SDAT patients revealed that conceptual movements scores were significantly (P<0/001 less than the other subtests (more apraxic and oral and respiratory movements scores were significantly (P<0/001 higher than the other subtests (less apraxic. Conclusion: Apraxia could be considered as one of the neuropsychological signs early in the disease development. It can be applied complementarily for differential diagnosis. Also apraxia subgroup scoring could be used for apraxia categorization, understanding observed disorders and determining possible rehabilitation ways.

Cataract surgery in patients with neovascular age-related macular degeneration

DEFF Research Database (Denmark)

Kessel, Line; Theil, Pernille Koefoed; Sørensen, Torben Lykke

2016-01-01

Purpose To examine the outcome after cataract surgery in patients with neovascular age-related macular degeneration (AMD) treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections in routine clinical practice. Methods We extracted information about patients recorded...

Aging-Related Systemic Manifestations in COPD Patients and Cigarette Smokers

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Boyer, Laurent; Marcos, Elisabeth; Margarit, Laurent; Le Corvoisier, Philippe; Vervoitte, Laetitia; Hamidou, Leila; Frih, Lamia; Audureau, Etienne; Covali-Noroc, Ala; Andujar, Pascal; Saakashvili, Zakaria; Lino, Anne; Ghaleh, Bijan; Hue, Sophie; Derumeaux, Geneviève; Housset, Bruno; Dubois-Randé, Jean-Luc; Boczkowski, Jorge; Maitre, Bernard; Adnot, Serge

2015-01-01

Rationale Chronic obstructive pulmonary disease (COPD) is often associated with age-related systemic abnormalities that adversely affect the prognosis. Whether these manifestations are linked to the lung alterations or are independent complications of smoking remains unclear. Objectives To look for aging-related systemic manifestations and telomere shortening in COPD patients and smokers with minor lung destruction responsible for a decline in the diffusing capacity for carbon monoxide (DLCO) corrected for alveolar volume (KCO). Methods Cross-sectional study in 301 individuals (100 with COPD, 100 smokers without COPD, and 101 nonsmokers without COPD). Measurements and Main Results Compared to control smokers, patients with COPD had higher aortic pulse-wave velocity (PWV), lower bone mineral density (BMD) and appendicular skeletal muscle mass index (ASMMI), and shorter telomere length (TL). Insulin resistance (HOMA-IR) and glomerular filtration rate (GFR) were similar between control smokers and COPD patients. Smokers did not differ from nonsmokers for any of these parameters. However, smokers with normal spirometry but low KCO had lower ASMMI values compared to those with normal KCO. Moreover, female smokers with low KCO, had lower BMD and shorter TL compared to those with normal KCO. Conclusions Aging-related abnormalities in patients with COPD are also found in smokers with minor lung dysfunction manifesting as a KCO decrease. Decreased KCO might be useful, particularly among women, for identifying smokers at high risk for aging-related systemic manifestations and telomere shortening. PMID:25785739

Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values.

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Ubeda, Carlos; Miranda, Patricia; Vano, Eliseo

2015-02-01

To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there may be large differences in child size. These DRLs were obtained at the largest pediatric hospital in Chile, with an active optimization program, and could be used by other hospitals in the Latin America region to compare their current patient dose values and determine whether corrective action is appropriate. © 2015 American Association of Physicists in Medicine.

Including patients’ perspectives in patient information leaflets: A polyocular approach

DEFF Research Database (Denmark)

Fage-Butler, Antoinette Mary

2013-01-01

Existing research reveals that patients’ perspectives are missing from mandatory patient information leaflets (PILs). At the same time, there is overwhelming consensus that they should be included in this genre, and a corresponding need for potential approaches to tackle this problem. This paper ...

Extending PSA models including ageing and asset management - 15291

International Nuclear Information System (INIS)

Martorell, S.; Marton, I.; Carlos, S.; Sanchez, A.I.

2015-01-01

This paper proposes a new approach to Ageing Probabilistic Safety Assessment (APSA) modelling, which is intended to be used to support risk-informed decisions on the effectiveness of maintenance management programs and technical specification requirements of critical equipment of Nuclear Power Plants (NPP) within the framework of the Risk Informed Decision Making according to R.G. 1.174 principles. This approach focuses on the incorporation of not only equipment ageing but also effectiveness of maintenance and efficiency of surveillance testing explicitly into APSA models and data. This methodology is applied to a motor-operated valve of the auxiliary feed water system (AFWS) of a PWR. This simple example of application focuses on a critical safety-related equipment of a NPP in order to evaluate the risk impact of considering different approaches to APSA and the combined effect of equipment ageing and maintenance and testing alternatives along NPP design life. The risk impact of several alternatives in maintenance strategy is discussed

Changes of coagulation and fibrinolysis in middle-old aged patients with nonvalvular atrial fibrillation

International Nuclear Information System (INIS)

Li Xi; Xie Ying; Zhang Weijun; Zhao Ruixiang; Peng Xinjie; Zhang Wen; Zhang Yan; Cheng Xiuqin; Wang Longhua; Guo Yonghe; Zhou Yujie; Wen Shaojun; Liu Jielin

2008-01-01

Objective: To evaluate the changes of coagulation and fibrinolysis function in the middle-old aged patients with nonvalvular atrial fibrillation. Methods: The levels of D-Dimer and tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) were detected in 92 middle-aged patients with nonvalvular atrial fibrillation (AF group) and 60 patients with sinus rhythm (control group) by immune turbidimetry and enzyme linked immunoadsorbent assay (ELISA). Univariate analysis was used to determine the differences between two groups, and covariance analysis was used to determine the factors which might affect coagulation and fibrinolysis indexes. Results: 1)The plasma levels of D-Dimer [(0.16±0.10) mg·L -1 ] and t-PA [(42.58± 30.28) μg·L -1 ] and PAI-1 [(86.03 ± 21.43) μg·L -1 ] in AF group were significantly higher than those in the control group [(0.10 ± 0.08) mg·L -1 , (26.02±13.84) μg·L -1 , (64.94±24.35) μg·L -1 ] (P<0.05 or P <0.001). The ratio of PAI-1/t-PA in AF group was higher than that in control group slightly. 2) After adjustment of the factors which included sex, age and plasma creatinine, uric acid, blood sugar, triglyceride and cholesterol, the levels of D-Dimer (P=0.047), t-PA (P=0.264) and PAI-1 (P=0.001) in AF group were higher than those in the control group. Conclusion: The middle-old aged patients with nonvalvular atrial fibrillation lose their balance of coagulation and fibrinolysis in the state of hypercoagulated and hypofibrinolysis. (authors)

Effect of Age on Allergen Responses of Allergic Patients in Southern Taiwan

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Wen Chiang

2004-07-01

Full Text Available To survey airborne and food allergen patterns in southern Taiwan and to analyze the effect of age on response to different allergens, we tested samples from 4,411 allergic patients at Kaohsiung Medical University Hospital using the MAST-CLA test (new Taiwan panel. A total of 2,212 (50.1% samples showed a positive response. We grouped allergic patients into five age groups. Milk and egg white were the main food allergens in the younger groups (< 3 years old and 3-6 years old. Shrimp, crab, and shellfish were the main allergens in the groups aged 7-12, 13-18, and more than 18 years. Among airborne allergens, house dust and mites Dermatophagoides farinae and D. pteronyssinus were the main allergens in all age groups, whereas the frequency of response to cockroach allergen was low in the group aged less than 3 years, but increased in the other age groups. There was a sharp increase in the frequency of response to airborne allergens after 3 years old and a sharp decrease in response to food allergens. Among subjects allergic to both airborne and food allergens, there was a positive MAST-CLA rate of 19.9% to 26% (all five age groups, no significant difference. When we compared our results with those from Taipei Veterans General Hospital in northern Taiwan, there were significant differences for yeast, peanut, feather mix, dog dander, cockroach, D. farinae and D. pteronyssinus allergens (p < 0.01. These differences were probably caused by differences in patient location, patient age, disease patterns and allergen panels.

Outcomes of basilar artery occlusion in patients aged 75 years or older in the Basilar Artery International Cooperation Study.

Science.gov (United States)

Vergouwen, Mervyn D I; Compter, Annette; Tanne, David; Engelter, Stefan T; Audebert, Heinrich; Thijs, Vincent; de Freitas, Gabriel; Algra, Ale; Jaap Kappelle, L; Schonewille, Wouter J

2012-11-01

Patients with an acute basilar artery occlusion (BAO) have a high risk of long-lasting disability and death. Only limited data are available on functional outcome in elderly patients with BAO. Using data from the Basilar Artery International Cooperation Study, we aimed to determine outcomes in patients ≥75 years. Primary outcome measure was poor functional outcome (modified Rankin scale score 4-6). Secondary outcomes were death, insufficient vessel recanalization (defined as thrombolysis in myocardial infarction score 0-1) and symptomatic intracranial hemorrhage (SICH). Patients were divided into four age-groups, based on quartiles: 18-54, 55-64, 65-74, and ≥75 years. Outcomes were compared between patients ≥75 years and patients aged 18-54 years. Risk ratios with corresponding 95 % confidence intervals (CI) were calculated and Poisson regression analyses were performed to calculate adjusted risk ratios (aRR). We included 619 patients [18-54 years n = 153 (25 %), 55-64 years n = 133 (21 %), 65-74 years n = 171 (28 %), and ≥75 years n = 162 (26 %)]. Compared with patients aged 18-54 years, patients ≥75 years were at increased risk of poor functional outcome [aRR 1.33 (1.14-1.55)] and death [aRR 2.47 (1.75-3.51)]. Nevertheless, 35/162 (22 %, 95 % CI 15-28 %) of patients ≥75 years had good functional outcome. No significant differences between age groups were observed for recanalization rate and incidence of SICH. Although patients ≥75 years with BAO have an increased risk of poor outcome compared with younger patients, a substantial group of patients ≥75 years survives with a good functional outcome.

Experiences of 23 patients ≥ 90 years of age treated with radiation therapy

International Nuclear Information System (INIS)

Oguchi, Masahiko; Ikeda, Hiroshi; Watanabe, Toshikazu; Shikama, Naoto; Ohata, Takeo; Okazaki, Youichi; Kiyono, Kunihiro; Sone, Shusuke

1998-01-01

Purpose: To present 23 patients ≥ 90 years old treated with radiotherapy, and to retrospectively evaluate the results of radiotherapy and tolerance in these patients. Methods and Materials: The clinical records of 27 patients over 90 years of age who were treated with radiotherapy at the Department of Radiology, Shinshu University Hospital, and eight affiliated general hospitals from 1990 until 1995 were reviewed. The strategy of radiotherapy was individually planned depending on the stage of the disease and performance status (PS) of the patient; however, it was not modified, based solely on chronologic age. The overall survival rate and disease-free survival rate were determined using the Kaplan-Meier method. The Radiation Therapy Oncology Group scoring criteria of acute and late reactions of radiation therapy were used. Results: This group of patients accounted for 0.37% of all patients treated with radiotherapy in these hospitals. Of these, 23 patients in whom cancer was pathologically confirmed and whose follow-up data were available for retrospective analysis were included in the final evaluation of data. The age of the 23 patients ranged from 90 to 96 years (median 93). Tumor was untreated and in the early stage in five patients, locoregionally advanced in 13, recurrent in four, and systemic in one. Definitive radiation therapy was administered in 12 patients (13 sites), preoperative intent in one, and palliative intent in 10. The period of observation ranged from 2.5 to 6 years (median 18 months). Seven patients were alive for 15-67 months. Fourteen patients died because of intercurrent diseases or senility associated with active cancer, and two because of senility without evidence of cancer. The overall and relapse-free survival rates were 65% and 30% at 1 year and 30% and 21% at 2 years, respectively. Definitive radiation therapy was completed in 13 of 13 patients (100%), and local control was attained in 9 of 13 patients at 6 months (62%). Palliative

Structural knee joint pathology in patients aged 40 years or older with meniscal tears

DEFF Research Database (Denmark)

Pihl, Kenneth; Englund, Martin; Lohmander, L S

2017-01-01

Purpose: Recent studies have challenged the tenet that mechanical symptoms of the knee (i.e. the sensation of catching or locking) are caused by degenerative meniscal tears per se and relieved by surgery. We explored the potential associations between meniscal and other knee joint pathologies...... identified at meniscal surgery with the presence of patient-reported mechanical symptoms. Methods: This study included patients aged 40 years or older undergoing surgery for a meniscal tear from the Knee Arthroscopy Cohort Southern Denmark (KACS). Patients were consecutively recruited from February 2013...... score (KOOS), together with information on previous meniscal surgery. At arthroscopy, the operating surgeon recorded information about specific meniscal pathology (tear location, depth, type, length, meniscal tissue quality and circumferential and radial location) and other structural knee pathologies...

[Relationship between dysphagia and malnutritition in patients over 65 years of age].

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Galán Sánchez-Heredero, María José; Santander Vaquero, Cecilio; Cortázar Sáez, Milagros; de la Morena López, Felipe; Susi García, Rosario; Martínez Rincón, María Del Carmen

2014-01-01

The main objective of this study was to understand the relationship between oropharyngeal dysphagia, nutritional risk factors and functional impairment in the elderly (>65y) admitted to a medical-surgical hospital unit. Secondary objectives were to determine the prevalence of oropharyngeal dysphagia, the nutritional status and their functional capacity. A cross-sectional observational study was performed. It included patients over 65 years of age admitted to the Gastroenterology-Urology Department in La Princesa University Hospital (Madrid, Spain) during the months of February and March. The following variables were recorded: age, sex, body mass index, family support, diagnosis, comorbidity, oropharyngeal dysphagia (EAT-10 and volume-viscosity evaluation method), malnutrition (Mininutritional Assessment) and functional capacity (Barthel index). A total of 167 patients were recruited, with 30.8% and 15.4% prevalence of dysphagia and malnutrition, respectively. Prevalence of malnutrition increased to 75% in patients with oropharyngeal dysphagia. The logistic regression analysis showed how conditions as low score on the Barthel index (OR 0.97 [95% CI, 0.95-0.99]), comorbidity (OR 7.98 [CI 95%, 3.09-20.61]) and dysphagia (OR 4.07 [CI 95%, 1.57-10.52]) were associated with a greater likelihood of suffering malnutrition. Oropharyngeal dysphagia is one of the most underdiagnosed and underestimated conditions among elderly patients and one that has a greater effect on their nutritional status. Accordingly, we suggest using established diagnostic methods with a multidisciplinary team collaboration for its early detection. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers

OpenAIRE

Dobie, Robert A; Wojcik, Nancy C

2015-01-01

Objectives The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60?years. By comparison, recent data (1999?2006) show that hearing thresholds in the US population have improved....

Five-year follow-up of low-level laser therapy (LLLT) in patients with age-related macular degeneration (AMD)

Science.gov (United States)

Koev, K.; Avramov, L.; Borissova, E.

2018-03-01

The objective of this study was to examine long-term effects of low-level laser therapy (LLLT) in patients with age-related macular degeneration (AMD). The research was implemented for a period of five years. For LLLT, a He-Ne Laser with continuous emission at 633 nm (0.1 mW/cm2) was used in patients with AMD of all stages (dry to wet exudative forms were included). In total, 33 patients (16 men and 17 women – 66 eyes) with AMD of various stages and a mean age of 68.7 ± 4.2 years were included in the study. Progressive, exudative AMD was diagnosed in 8 eyes. 58 eyes had drusen or were depigmented. Laser radiation was applied transpupillary to the macula for six times for three minutes once in two days; 22 patients with AMD (44 eyes) were randomly selected to receive mock treatment (control group 10 men and 12 women with a mean age of 69.3 ± 4.8 years). The visual acuity was followed for a five-year period. The perimetry and Amsler test were used to screen central scotomas. The fluorescein angiography of AMD and the control groups was examined. The visual acuity remained unchanged in all patients in the control group. There was a statistically significant increase in the visual acuity (p<0.001, end of study versus baseline) for AMD patients for the period of five years after the treatment. The edema and hemorrhage in the patients with progressive, exudative AMD significantly decreased. No side effects were observed during the therapy. The prevalence of metamorphopsia, scotoma in AMD group was reduced. In conclusion, this study shows that LLLT may be a novel long-lasting therapeutic option for both forms of AMD. It is a highly-effective treatment that results in a long-term improvement of the visual acuity.

Long-term (60-month) results for the implantable miniature telescope: efficacy and safety outcomes stratified by age in patients with end-stage age-related macular degeneration

Science.gov (United States)

Boyer, David; Freund, K Bailey; Regillo, Carl; Levy, Marc H; Garg, Sumit

2015-01-01

Background The purpose of this study was to evaluate the long-term results of an implantable miniature telescope (IMT) in patients with bilateral, end-stage, age-related macular degeneration (AMD). Methods A prospective, open-label, multicenter clinical trial with fellow eye controls enrolled 217 patients (mean age 76 years) with AMD and moderate-to-profound bilateral central visual acuity loss (20/80–20/800) resulting from untreatable geographic atrophy, disciform scars, or both. A subgroup analysis was performed with stratification for age (patient age 65 to 30 days after surgery (7/70; 10%) and persistent corneal edema (3/70; 4.3%); and in group 2 were a decrease in BCDVA in the implanted eye or IMT removal (10/127 each; 7.9%), corneal edema >30 days after surgery (9/127; 7.1%), and persistent corneal edema (6/127; 4.7%). Significant adverse events included four corneal transplants, comprising two (2.9%) in group 1 and two (1.6%) in group 2. At 60 months, one patient in group 1 (3.2%) and three patients in group 2 (9.4%) had lost ≥2 lines of vision. The IMT was removed in one (1.4%) and ten (7.9%) patients in group 1 and group 2, respectively. Mean ECD loss was 20% at 3 months. Chronic loss was 3% per year. ECD loss was less in group 1 than in group 2 (35% versus 40%, respectively) at 60 months. Conclusion Long-term results show substantial retention of improvement in BDCVA. Chronic ECD loss was consistent with that reported for conventional intraocular lenses. The IMT performed as well in group 1 (the younger group) as it did in group 2 through month 60. Younger patients retained more vision than their older counterparts and had fewer adverse events. Although not a specified outcome for this study, patients younger than 65 years also fared better than those in group 2 and retained more vision with fewer adverse events through month 60. PMID:26124633

THE EFFECT OF CARDIOVSCULAR REHABILITATION ON THE EXTENT OF OBESITY AND LIPID RISK FACTORS IN RELATION TO PATIENTS' AGE

Directory of Open Access Journals (Sweden)

Katarina Petrović

2009-12-01

Full Text Available It has been established that multifactorial rehabilitation programs that include physical activity, nutritional education, consulting, psychological support and pharmacological treatment, have the most favourable influence on lipid level.The Objective was to establish the effect of cardiovascular rehabilitation on the extent of obesity and lipid risk factors depending on the age of patients after myocardial infarction.The investigated group included 65 years old and older (n=67 patients, average age 72.1±3.2, and the control group with patients younger than 65 years old (n=46 average age 50.7±4.1. Laboraory tests were performed on all the examined both in and out patients (glycemia, lipid status, total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride, as well as waist circumference measurement, body mass (BM and body mass index (BMI.A group of older patients, in comparison to a control group of younger patients, did not significantly differ in the extent or type of obesity. The analyses of values, before and after the rehabilitation treatment showed that in both groups of the examined patients and in all patients on CV rehabilitation program, significant reduction in BMI and waist circumeference was found after the RH treatment. In both groups of patients values of lipid parameters (total, LDL cholesterol and triglyceride and morning glucemia were significantly lower after the RH program had been finished, while the values of HDL cholesterol showed significant increase after the RH program. Values of most atherogenic indexes were significantly higher in younger patients in comparison to the group of older patients.In both groups of patients on cardiovascular rehabilitation program there were significant reductions of BMI and OS, as well as improvement of lipid disorders and impaired glicoregulation. After the CV rehabilitation, values of all atherogenic indexes were significantly reduced. This is the indicator of the importance

Nationwide real-world database of 20,462 patients enrolled in the Japanese Acute Myocardial Infarction Registry (JAMIR): Impact of emergency coronary intervention in a super-aging population.

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Kojima, Sunao; Nishihira, Kensaku; Takegami, Misa; Nakao, Yoko M; Honda, Satoshi; Takahashi, Jun; Takayama, Morimasa; Shimokawa, Hiroaki; Sumiyoshi, Tetsuya; Ogawa, Hisao; Kimura, Kazuo; Yasuda, Satoshi

2018-09-01

Cardiovascular diseases, including acute myocardial infarction (AMI), are leading causes of death among the Japanese, who have the longest life expectancy in the world. Over the past 50 years in Japan, the percentage of elderly individuals has increased 4-fold, from 5.7% in 1960 to 23.1% in 2010. To explore medical practices and emergency care for AMI in this aging society, the Japan Acute Myocardial Infarction Registry (JAMIR) was established as a nationwide real-world database. JAMIR conducted retrospective analysis of 20,462 AMI patients (mean age, 68.8 ± 13.3 years; 15,281 men [74.7%]) hospitalized between January 2011 and December 2013. The rates of ambulance use and emergency PCI were 78.9% and 87.9%, respectively. The median door-to-balloon time was 80 min (interquartile range, 53-143 min). Overall in-hospital mortality was 8.3%, including 6.6% due to cardiac death. JAMIR included 4837 patients aged ≥80 years (23.6%). In this age group, patients who underwent PCI (79.9%) had significantly lower in-hospital mortality than those who did not (11.1% vs. 36.9%, P  < 0.001). The large JAMIR database, with 24% of AMI patients aged ≥80 years, could provide useful information about medical care in an aging society. The reasonable in-hospital outcomes observed may justify consideration of PCI for patients with AMI aged ≥80 years.

Radiation therapy for stage I-II non-small cell lung cancer in patients aged 75 years and older

International Nuclear Information System (INIS)

Furuta, Masaya; Hayakawa, Kazushige; Katano, Susumu

1996-01-01

Between 1976 and 1992, 32 patients aged 75 and older with stage I-II non-small cell lung cancer (NSCLC) were given definitive radiation therapy. These patients did not undergo surgery because of old age, poor cardiac/pulmonary condition, or refusal to give consent. The mean age was 79 years, and 11 patients were over 80 years old. The histologic type was squamous cell carcinoma in 25 patients and adenocarcinoma in 7. The clinical T and N stage was T1N0 in 4 patients, T2N0 in 9, and T2N0 in 19. The total dose of radiation therapy given to each patient exceeded 60 Gy using 10-MV X-rays. The treatment was completed in all 32 patients without treatment-related complications. The 2- and 5-year overall actuarial survival rates were 40% and 16%, respectively. Eleven intercurrent deaths occurred, including 7 patients who died of heart disease. The 2- and 5-year cause-specific survival rates were 57% and 36%, respectively. None of the patients developed severe pneumonitis requiring hospitalization. All but three patients received radiation therapy on an inpatient basis. The mean duration of the hospital stay for initial treatment was 56 days, and mean ratio to total survival period (mean 739 days) was 8%. Although many elderly patients have concurrent medical complications such as heart disease and chronic pulmonary disease, the present study showed that elderly patients with clinical stage I-II NSCLC can expert a realistic probability of long-term survival with definitive radiation therapy. (author)

Transarterial chemo embolization for the treatment of hepatocellular carcinoma: A single center experience including 221 patients

International Nuclear Information System (INIS)

Zeeneldin, A.A.; Salem, S.E.; Ibrahim, A.A.; Tabashy, R.H.; Alieldin, N.H.

2013-01-01

Background: Hepatocellular carcinoma (HCC) is a major health problem in Egypt as well as in many countries. Trans arterial chemo embolization (TACE) is a treatment modality applicable to locally advanced HCC beyond surgery or ablative therapies and is associated with survival improvements. The aim of this study was to assess the outcomes of TACE in our center over the past four years. Methods: This is a retrospective cohort study that included 221 patients with locally advanced HCC treated with TACE in a single center between the years 2007 and 2010. The median age was 57 years with male predominance. Liver cirrhosis, viral hepatitis and Bilharziasis were encountered in 64%, 31% and 8% of patients, respectively. Abdominal pain was the most common presenting symptom (67%). Most cases were diagnosed based on radiology (57%) with a TNM stage I or II (73%) and a median AFP value of 150 ng/m L. Results: 221 patients received 440 cycles of TACE with a median of 2 cycles per patient. Cisplatin and doxorubicin (50 mg per cycle, each) were the most commonly used drugs. Impaired liver function was the most common toxicity. Liver cell failure occurred in 17% of patients. An objective tumor response was achieved in 44% of cases. The median overall survival (OS) was 16 months (95% Cl, 13-19 months) and the median progression free survival (PFS) was 6 months (95% Cl, 4.3-7.8 months). Responding patients, Child-Pugh class A and patients receiving standard doses of chemotherapy had a significantly better OS than their counterparts. Only Child-Pugh class A was associated with significantly longer PFS (p < 0.001). Conclusion: TACE produces reasonable responses and fair survival rates in locally advanced HCC but with noticeable toxicities. Proper patients selection and prompt liver support are mandates for improving TACE outcomes.

Effect of age and disease on bone mass in Japanese patients with schizophrenia.

Science.gov (United States)

Sugawara, Norio; Yasui-Furukori, Norio; Umeda, Takashi; Tsuchimine, Shoko; Fujii, Akira; Sato, Yasushi; Saito, Manabu; Furukori, Hanako; Danjo, Kazuma; Matsuzaka, Masashi; Takahashi, Ippei; Kaneko, Sunao

2012-02-20

There have been a limited number of studies comparing bone mass between patients with schizophrenia and the general population. The aim of this study was to compare the bone mass of schizophrenia patients with that of healthy subjects in Japan. We recruited patients (n = 362), aged 48.8 ± 15.4 (mean ± SD) years who were diagnosed with schizophrenia or schizoaffective disorder based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Bone mass was measured using quantitative ultrasound densitometry of the calcaneus. The osteosono-assessment index (OSI) was calculated as a function of the speed of sound and the transmission index. For comparative analysis, OSI data from 832 adults who participated in the Iwaki Health Promotion Project 2009 was used as representative of the general community. Mean OSI values among male schizophrenic patients were lower than those in the general population in the case of individuals aged 40 and older. In females, mean OSI values among schizophrenic patients were lower than those in the general community in those aged 60 and older. In an analysis using the general linear model, a significant interaction was observed between subject groups and age in males. Older schizophrenic patients exhibit lower bone mass than that observed in the general population. Our data also demonstrate gender and group differences among schizophrenic patients and controls with regard to changes in bone mass associated with aging. These results indicate that intervention programs designed to delay or prevent decreased bone mass in schizophrenic patients might be tailored according to gender.

Age as a prognostic variable in patients undergoing transurethral prostatectomy

DEFF Research Database (Denmark)

Krogh, J; Jensen, J S; Iversen, H G

1993-01-01

In a retrospective study the outcome of transurethral prostatectomy (TURP) for benign prostatic hyperplasia (BPH) in patients more than 80 years old was compared to a control group of patients with a mean age ten years younger. The elderly had significantly more tissue resected and presented...

A technique of including the effect of aging of passive components in probabilistic risk assessments

International Nuclear Information System (INIS)

Phillips, J.H.; Weidenhamer, G.H.

1992-01-01

The probabilistic risk assessments (PRAS) being developed at most nuclear power plants to calculate the risk of core damage generally focus on the possible failure of active components. The possible failure of passive components is given little consideration. We are developing methods for selecting risk-significant passive components and including them in PRAS. These methods provide effective ways to prioritize passive components for inspection, and where inspection reveals aging damage, mitigation or repair can be employed to reduce the likelihood of component failure. We demonstrated a method by selecting a weld in the auxiliary feedwater (AFW) system, basing our selection on expert judgement of the likelihood of failure and on an estimate of the consequence of component failure to plant safety. We then modified and used the Piping Reliability Analysis Including Seismic Events (PRAISE) computer code to perform a probabilistic structural analysis to calculate the probability that crack growth due to aging would cause the weld to fail. The PRAISE code was modified to include the effects of changing design material properties with age and changing stress cycles. The calculation included the effects of mechanical loads and thermal transients typical of the service loads for this piping design and the effects of thermal cycling caused by a leaking check valve. However, this particular calculation showed little change in low component failure probability and plant risk for 48 years of service. However, sensitivity studies showed that if the probability of component failure is high, the effect on plant risk is significant. The success of this demonstration shows that this method could be applied to nuclear power plants. The demonstration showed the method is too involved (PRAISE takes a long time to perform the calculation and the input information is extensive) for handling a large number of passive components and therefore simpler methods are needed

Implications for would healing of patient age and time elapsed since burn injury.

Science.gov (United States)

Mountford, E M; Blight, A; Cheshire, I M

1995-01-01

To determine the relationship between growth potential in culture and the age of the patient, skin biopsies were obtained from over 60 patients of varying ages. The relationship between the length of time elapsed since burn injury and growth potential was also examined, using biopsies obtained from patients with burns during their treatment. Keratinocytes were extracted from biopsies and assessed for colony-forming ability by standard methods. Repeated subculture of cells was undertaken to determine the reproductive capacity of cells in vitro. Age had no effect on the colony-forming ability of keratinocytes in primary culture; however age did affect the total number of generations achieved by these cells. The growth potential of keratinocytes from patients with severe burns showed considerable variation according to the amount of time which had elapsed since the injury. This was most apparent around one week post-burn. These results need to be investigated further to understand their clinical implications. The study provides an insight into the influence of age and physiological response on the wound healing process in burn injuries.

Compliance of patients concerning recommended radiotherapy in breast cancer. Association with recurrence, age, and hormonal therapy

International Nuclear Information System (INIS)

Winzer, K.J.; Gruber, C.; Badakhshi, H.; Charite Universitaetsmedizin Berlin; Hinkelbein, M.; Denkert, C.

2012-01-01

Background and purpose: In this study, we investigated how often guidelines for radiation therapy in patients with breast cancer are not complied with, which patient group is mostly affected, and how this influences local recurrence. Patients and methods: All patients (n = 1,903) diagnosed between November 2003 and December 2008 with primary invasive or intraductal breast cancer in the interdisciplinary breast center of the Charite Hospital Berlin were included and followed for a median 2.18 years. Results: Patients who, in contrast to the recommendation of the interdisciplinary tumor board, did not undergo postoperative radiation experienced a fivefold higher local recurrence rate (p < 0.0005), corresponding to a 5-year locoregional recurrence-free survival of 74.5% in this group. The 5-year locoregional recurrence-free survival of patients following the recommendations was 93.3%. Guideline compliance was dependent on age of patients, acceptance of adjuvant hormonal treatment or chemotherapy, and increased diameter of the primary tumor. Multiple logistic regression analysis showed an association between compliance and age or hormonal therapy. Conclusion: In order to avoid local recurrence patients should be motivated to comply with guideline driven therapy. Since a higher number of local recurrences is observed in health services research compared to clinical research, studies on the value of adjuvant treatment following local recurrence should be performed. (orig.)

The Evaluation of More Lymph Nodes in Colon Cancer Is Associated with Improved Survival in Patients of All Ages.

Directory of Open Access Journals (Sweden)

Wouter B Aan de Stegge

Full Text Available Improvement in survival of patients with colon cancer is reduced in elderly patients compared to younger patients. The aim of this study was to investigate whether the removal of ≥ 12 lymph nodes can explain differences in survival rates between elderly and younger patients diagnosed with colon cancer.In a population-based cohort study, all patients (N = 41,074 diagnosed with colon cancer stage I to III from 2003 through 2010 from the Netherlands Cancer Registry were included. Age groups were defined as 75 years of age. Main outcome measures were overall and relative survival, the latter as a proxy for disease specific survival.Over an eight years time period there was a 41.2% increase in patients with ≥ 12 lymph nodes removed, whereas the percentage of patients with the presence of lymph node metastases remained stable (35.7% to 37.5%. After adjustment for patient and tumour characteristics and adjuvant chemotherapy, it was found that for patients in which ≥ 12 lymph nodes were removed compared to patients with 75: HR: 0.734 (95% CI, 0.700-0.771 and relative survival ( 75: RER: 0.621 (95% CI, 0.567-0.681 in all three age groups.The removal of ≥ 12 lymph nodes is associated with an improvement in both overall and relative survival in all patients. This association was stronger in the elderly patient. The biology of this association needs further clarification.

Reflux esophagitis and gastroesophageal reflux disease: a cross-sectional study of gastroesophageal reflux disease patients by age group

Directory of Open Access Journals (Sweden)

Flora Filho Rowilson

1999-01-01

Full Text Available The purpose of this study was to explore the relationship between the intensity of acid reflux and severity of esophageal tissue damage in a cross-sectional study of patients with gastroesophageal reflux disease (GERD. Seventy-eight patients with were selected in accordance with the strict 24-hour ambulatory esophageal pHmetry (24h-pHM criteria and distributed into three age groups: Group A: 14 - 24 years of age. Group B: 25 - 54; and Group C: 55 - 64. The 24h-pHM was carried out in accordance with DeMeester standardization, and the Savary-Miller classification for the diagnosis of reflux esophagitis was used. The groups were similar in 24h-pHM parameters (p > 0.05, having above normal values. For the study group as a whole, there was no correlation between age group and intensity of acid reflux, and there was no correlation between intensity of acid reflux and severity of esophageal tissue damage. However, when the same patients were sub-grouped in accordance with the depth of their epithelial injury and then distributed into age groups, there was a significant difference in esophagitis without epithelial discontinuity. Younger patients had less epithelial damage than older patients. Additionally, although there was a significant progression from the least severe to the moderate stages of epithelial damage among the age groups, there was no apparent difference among the age groups in the distribution between the moderate stages and most severe stages. The findings support the conclusion that the protective response of individuals to acid reflux varies widely. Continued aggression by acid reflux appears to lead to the exhaustion of individual mechanisms of epithelial protection in some patients, but not others, regardless of age or duration of the disease. Therefore, the diagnosis and follow-up of GERD should include both measurements of the quantity of refluxed acid and an assessment of the damage to the esophageal epithelium.

Survey of atypical antipsychotic prescribing by Canadian child psychiatrists and developmental pediatricians for patients aged under 18 years.

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Doey, Tamison; Handelman, Kenneth; Seabrook, Jamie A; Steele, Margaret

2007-06-01

To describe self-reported patterns of prescribing atypical antipsychotics (ATAs) and monitoring practices of child psychiatrists and developmental pediatricians in Canada. We surveyed members of the Canadian Academy of Child and Adolescent Psychiatry and members of the Developmental Paediatrics Section of the Canadian Paediatric Society regarding the types and frequencies of ATAs they prescribed, the ages and diagnoses of patients for whom they prescribed these medications, and the types and frequencies of monitoring used. Ninety-four percent of the child psychiatrists (95% CI, 90% to 97%) and 89% of the developmental pediatricians (95% CI, 75% to 96%) prescribed ATAs, most commonly risperidone (69%). Diagnoses included psychotic, mood, anxiety, externalizing, and pervasive developmental disorders. Prescribing for symptoms such as aggression, low frustration tolerance, and affect dysregulation was also common. Twelve percent of all prescriptions were for children under age 9 years. Most clinicians monitored patients, but there were wide variations in the type and frequency of tests performed. Despite the lack of formal indications, ATAs were prescribed by this group of clinicians for many off-label indications in youth under age 18 years, including very young children. Neither evidence-based guidelines nor a consensus on monitoring exist for this age group.

Impact of age on the false negative rate of human papillomavirus DNA test in patients with atypical squamous cells of undetermined significance

OpenAIRE

Won, Kyu-Hee; Lee, Jae Yeon; Cho, Hye-Yon; Suh, Dong Hoon; No, Jae Hong; Kim, Yong-Beom

2015-01-01

Objective Human papillomavirus (HPV) test was incorporated into the triage of lesser abnormal cervical cytologies: atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL). This study aimed to evaluate the impact of age on the efficacy of HPV testing in patients with lesser abnormal cervical cytologies. Methods A total of 439 patients with ASCUS or LSIL were included. The association between age groups and the diagnostic performances of ...

Relationship between age at menarche and skeletal maturation stages in Taiwanese female orthodontic patients.

Science.gov (United States)

Lai, Eddie Hsiang-Hua; Chang, Jenny Zwei-Chieng; Jane Yao, Chung-Chen; Tsai, Shih-Jaw; Liu, Jen-Pei; Chen, Yi-Jane; Lin, Chun-Pin

2008-07-01

The age at menarche reflects a pubertal girl's physiologic maturity. The aims of this study were to evaluate the relationship between the age at menarche and skeletal maturation in female orthodontic patients. Hand-wrist radiographs and lateral cephalometric radiographs from 304 adolescent female subjects (age, 8-18.9 years) were selected from the files of the Department of Orthodontics, National Taiwan University Hospital (NTUH). Hand-wrist bone maturation stages were assessed using the NTUH Skeletal Maturation Index (NTUH-SMI). Cervical vertebral maturation stages (CVMS) were determined using the latest CVMS Index. Menarcheal ages were self-reported by the patients and verified by the patients' mothers. The relationships between the NTUH-SMI or CVM stages and menarcheal status were investigated. More than 90% of the 148 subjects who had already attained menstruation had skeletal maturation beyond the NTUH-SMI stage four or CVMS III. However, the subjects who had never experienced menarche mostly had skeletal maturation before NTUH-SMI stage five or CVMS IV. During the period of orthodontic treatment, 19 females experienced their menarche. The mean age at menarche for the 167 female patients in total was 11.97 years. In average, menarche occurred between NTUH-SMI stages four and five or between CVM stages III and IV. The percentage of girls with menses increased from 1.2% at age 9 to 6.6% at age 10, 39.5% at age 11, 81.4% at age 12, 97% at age 13, and 100% at age 14. Compared with the results obtained 20 years previously, we found a downward shift of 0.47 years per decade for the mean age at menarche in female orthodontic patients. The majority of female orthodontic patients have passed the pubertal growth spurt when they experience their menarche. Menarche usually follows the pubertal growth spurt by about 1 year and occurs after NTUH-SMI stage four or CVMS III.

Health anxiety and medical utilization: The moderating effect of age among patients in primary care.

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Fergus, Thomas A; Griggs, Jackson O; Cunningham, Scott C; Kelley, Lance P

2017-10-01

Health anxiety is commonly seen in medical clinics and is related to the overutilization of primary care services, but existing studies have not yet considered the possible moderating effect of age. We examined if age moderated the association between health anxiety and medical utilization. A secondary aim was to examine potential racial/ethnic differences in health anxiety. An ethnoracially diverse group of patients (N=533) seeking treatment from a primary care clinic completed a self-report measure of health anxiety. Three indices of medical utilization were assessed using medical records, including the number of: (a) clinic visits over the past two years, (b) current medications, and (c) lab tests over the past two years. Age moderated the effect of health anxiety on multiple indices of medical utilization. Supplemental analyses found that the moderating effect of age was specific to a somatic/body preoccupation, rather than health worry, dimension of health anxiety. Mean-level differences in health anxiety were either not supported (health anxiety composite, somatic/body preoccupation) or were small in magnitude (health worry) among self-identifying Black, Latino, and White participants. Results indicate that assessing for health anxiety could be particularly important for older adult patients who frequently seek out medical services. Copyright © 2017 Elsevier Ltd. All rights reserved.

Satisfactory patient-based outcomes after surgical treatment for idiopathic clubfoot: includes surgeon's individualized technique.

Science.gov (United States)

Mahan, Susan T; Spencer, Samantha A; Kasser, James R

2014-09-01

Treatment of idiopathic clubfoot has shifted towards Ponseti technique, but previously surgical management was standard. Outcomes of surgery have varied, with many authors reporting discouraging results. Our purpose was to evaluate a single surgeon's series of children with idiopathic clubfoot treated with a la carte posteromedial and lateral releases using the Pediatric Outcomes Data Collection Instrument (PODCI) with a minimum of 2-year follow-up. A total of 148 patients with idiopathic clubfoot treated surgically by a single surgeon over 15 years were identified, and mailed PODCI questionnaires. Fifty percent of the patients were located and responded, resulting in 74 complete questionnaires. Median age at surgery was 10 months (range, 5.3 to 84.7 mo), male sex 53/74 (71.6%), bilateral surgery 31/74 (41.9%), and average follow-up of 9.7 years. PODCI responses were compared with previously published normal healthy controls using t test for each separate category. Included in the methods is the individual surgeon's operative technique. In PODCIs where a parent reports for their child or adolescent, there was no difference between our data and the healthy controls in any of the 5 categories. In PODCI where an adolescent self-reports, there was no difference in 4 of 5 categories; significant difference was only found between our data (mean = 95.2; SD = 7.427) and normal controls (mean = 86.3; SD = 12.5) in Happiness Scale (P = 0.0031). In this group of idiopathic clubfoot patients, treated with judicious posteromedial release by a single surgeon, primarily when surgery was treatment of choice for clubfoot, patient-based outcomes are not different from their normal healthy peers through childhood and adolescence. While Ponseti treatment has since become the treatment of choice for clubfoot, surgical treatment, in some hands, has led to satisfactory results. Level III.

Arthroscopic repair of the rotator cuff: prospective study of tendon healing after 70 years of age in 145 patients.

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Flurin, P-H; Hardy, P; Abadie, P; Boileau, P; Collin, P; Deranlot, J; Desmoineaux, P; Duport, M; Essig, J; Godenèche, A; Joudet, T; Kany, J; Sommaire, C; Thelu, C-E; Valenti, P

2013-12-01

The level of activity of patients older than 70 years is tending to increase, as are their expectations in terms of joint function recuperation. It has not been proven that rotator cuff repair healing is satisfactory in the elderly. The main hypothesis of this study was: repair of supraspinous lesions in patients older than 70 years is reliable in terms of both clinical results and healing. The secondary hypothesis was: tendon healing is significantly correlated with the Constant, ASES, and SST scores as well as with age, tendon retraction, and fatty infiltration. Multicenter prospective study on 145 patients older than 70 years, with 135 patients reviewed at 1 year (93%). The mean age was 73.9 years. Full-thickness tears of the supraspinatus extended at most to the upper third of the infraspinatus and retraction limited to Patte stages 1 and 2 were included. Clinical assessment was carried out in accordance with the Constant, ASES, and SST scores. Healing was evaluated with ultrasound. A significant improvement was noted in the Constant (44/76)+31.5 (P0.0001) scores at 1 year of follow-up. The healing rate was 89% with 15 re-tears, nine of which were stage 1 and six stage 2. The clinical result was not correlated with patient age (Constant, P=0.24; ASES, P=0.38; SST, P=0.83) nor with the retraction stage (Constant, P=0.71; ASES, P=0.35; SST, P=0.69) or the stage of fatty infiltration (P>0.7). Healing was correlated with the quality of the clinical result (Constant, P=0.02; ASES, P=0.03) and age (P=0.01) but was not correlated with retraction or the fatty infiltration stage (P>0.3). Arthroscopic repair significantly improves the clinical results, even in patients older than 70 years. The clinical results are not correlated with age (but deterioration of the result was not noted after 75 years) or frontal retraction (but the study only included retractions limited to stages 1 and 2). The healing rate is satisfactory, but this study is limited to small ruptures of

Gender influences headache characteristics with increasing age in migraine patients.

Science.gov (United States)

Bolay, Hayrunnisa; Ozge, Aynur; Saginc, Petek; Orekici, Gulhan; Uludüz, Derya; Yalın, Osman; Siva, Aksel; Bıçakçi, Şebnem; Karakurum, Başak; Öztürk, Musa

2015-08-01

Migraine headache is one of the most common primary headache disorders and is three times more prevalent in women than in men, especially during the reproductive ages. The neurobiological basis of the female dominance has been partly established. The present study aimed to investigate the effect of gender on the headache manifestations in migraine patients. The study group consisted of 2082 adult patients from five different hospitals' tertiary care-based headache clinics. The relationship between headache characteristics and gender was evaluated in migraine with aura (MwA) and migraine without aura (MwoA). The duration, severity, frequency of headache and associated symptoms were evaluated in both genders and age-dependent variations and analyzed in two subgroups. Women with migraine were prone to significantly longer duration and intensity of headache attacks. Nausea, phonophobia and photophobia were more prevalent in women. Median headache duration was also longer in women than in men in MwA (p = 0.013) and MwoA (p < 0.001). Median headache intensity was higher in women than in men in MwA (p = 0.010) and MwoA (p = 0.009). The frequency of nausea was significantly higher in women than in men in MwA (p = 0.049). Throbbing headache quality and associated features (nausea, photophobia, and phonophobia) were significantly more frequent in women than in men in MwoA. The gender impact varied across age groups and significant changes were seen in female migraineurs after age 30. No age-dependent variation was observed in male migraineurs. Gender has an influence on the characteristics of the headache as well as on the associated symptoms in migraine patients, and this impact varies across the age groups, particularly in women. © International Headache Society 2014.

Increased active von Willebrand factor during disease development in the aging diabetic patient population.

Science.gov (United States)

Chen, Shuang Feng; Xia, Zuo Li; Han, Ji Ju; Wang, Yi Ting; Wang, Ji Yue; Pan, Shao Dong; Wu, Ya Ping; Zhang, Bin; Li, Guang Yao; Du, Jing Wei; Gao, Hen Qiang; de Groot, Philip G; de Laat, Bas; Hollestelle, Martine J

2013-02-01

Type 2 diabetes is known to cause endothelial activation resulting in the secretion of von Willebrand factor (VWF). We have shown that levels of VWF in a glycoprotein Ib-binding conformation are increased in specific clinical settings. The aim of the current study is to investigate whether active VWF levels increase during aging and the development of diabetes within the population of patients suffering from type 2 diabetes. Patients and controls were divided into two groups based on age: older and younger than 60 years of age. VWF antigen, VWF propeptide, VWF activation factor and total active VWF were measured. Patients older than 60 years of age had increased levels of total active VWF, VWF activation factor and VWF propeptide compared to younger patients and controls. All measured VWF parameters were associated with age in diabetic patients. Total active VWF and VWF propeptide correlated with the period of being diagnosed with diabetes. Regression analyses showed that especially the VWF activation factor was strongly associated with diabetes in patients older than 60 years of age. In conclusion, we found that the conformation of VWF could be involved in the disease process of diabetes and that the VWF in a glycoprotein Ib-binding conformation could play a role as risk marker during the development of diabetes in combination with an increase in age. Our study shows that the active quality of VWF was more important than the quantity.

Impact of a pain protocol including hypnosis in major burns.

Science.gov (United States)

Berger, Mette M; Davadant, Maryse; Marin, Christian; Wasserfallen, Jean-Blaise; Pinget, Christophe; Maravic, Philippe; Koch, Nathalie; Raffoul, Wassim; Chiolero, René L

2010-08-01

Pain is a major issue after burns even when large doses of opioids are prescribed. The study focused on the impact of a pain protocol using hypnosis on pain intensity, anxiety, clinical course, and costs. All patients admitted to the ICU, aged >18 years, with an ICU stay >24h, accepting to try hypnosis, and treated according to standardized pain protocol were included. Pain was scaled on the Visual Analog Scale (VAS) (mean of daily multiple recordings), and basal and procedural opioid doses were recorded. Clinical outcome and economical data were retrieved from hospital charts and information system, respectively. Treated patients were matched with controls for sex, age, and the burned surface area. Forty patients were admitted from 2006 to 2007: 17 met exclusion criteria, leaving 23 patients, who were matched with 23 historical controls. Altogether patients were 36+/-14 years old and burned 27+/-15%BSA. The first hypnosis session was performed after a median of 9 days. The protocol resulted in the early delivery of higher opioid doses/24h (ppatient. A pain protocol including hypnosis reduced pain intensity, improved opioid efficiency, reduced anxiety, improved wound outcome while reducing costs. The protocol guided use of opioids improved patient care without side effects, while hypnosis had significant psychological benefits.

The relationship between patients' perceptions of care quality and three factors: nursing staff job satisfaction, organizational characteristics and patient age.

Science.gov (United States)

Kvist, Tarja; Voutilainen, Ari; Mäntynen, Raija; Vehviläinen-Julkunen, Katri

2014-10-18

The relationship between nurses' job satisfaction and their perceptions of quality of care has been examined in previous studies. There is little evidence, however, about relationships between the job satisfaction of nursing staff and quality of care perceived by the patients. The aim of this study was to analyze, how the job satisfaction of nursing staff, organizational characteristics (hospital and unit type), and patients' age relate to patients' perceptions of the quality of care. The study was cross-sectional and descriptive, based on a secondary analysis of survey data acquired during the At Safe study in Finland. The study included 98 units at four acute care hospitals between autumn 2008 and spring 2009. The participants were 1909 patients and 929 nursing staff. Patients' perceptions of quality of care were measured using the 42-item RHCS questionnaire. Job satisfaction of nursing staff was measured with the 37-item KUHJSS scale. Statistical analyses included descriptive statistics, principal component analysis, t-tests, analysis of variance, linear regression, and multivariate analysis of variance. Patients' perceptions of overall quality of care were positively related to general job satisfaction of nursing staff. Adequate numbers of staff appeared to be the clearest aspect affecting quality of care. Older patients were more satisfied with staff number than younger patients. Patients cared for in outpatient departments felt more respected than patients in wards, whereas patients in wards reported better care of basic needs (e.g., hygiene, food) than outpatients. The evaluation of resources by nursing staff is related to patients' perceptions of the adequacy of nursing staff levels in the unit. The results emphasize the importance of considering patients' perceptions of the quality of care and assessments by nurses of their job satisfaction at the hospital unit level when evaluating quality of care.

Tolerability and outcomes of radiotherapy or chemoradiotherapy for rectal cancer in elderly patients aged 70 years and older

International Nuclear Information System (INIS)

Cai, Xin; Wu, Hongbin; Peng, Junjie; Zhu, Ji; Cai, Sanjun; Cai, Gang; Zhang, Zhen

2013-01-01

To assess the safety and outcomes of radiotherapy (RT) or chemoradiotherapy (CRT) in elderly patients (≥70) with rectal cancer. Elderly patients aged 70 and older with rectal cancer, who were treated with RT or CRT at a single institution, were retrospectively analyzed. Performance status (KPS and ECOG score) and comorbidity (Charlson comorbidity index) were calculated, and their correlation with treatment toxicity and overall survival were studied. Risk factors for overall survival were investigated using univariate and multivariate survival analysis. A total of 126 patients with locally advanced disease, local recurrence or synchronous metastasis were included, with a 3-year OS rate of 48.1%. Scheduled dosage of radiation was delivered to 69% of patients. Grade 3 toxicities occurred more often in patients treated with CRT versus RT. The occurrence of grade 3 toxicities was not related to KPS score, ECOG score, number of comorbidities, and Charlson score. Multivariate analysis found that only age and Charlson score were independent prognostic factors for predicting patients’ 3-year OS. The 3-year OS rate was significantly higher in patients with Charlson score <4 vs Charlson score ≥4 (71.1% vs. 26.4%, P=0.0003). Although toxicities may be significant, elderly patients with rectal cancer of varied stages can be safely treated with RT or CRT with careful monitoring and frequent modification of treatment. Except for patients’ age, Charlson comorbidity index may be helpful in assessing patients’ outcomes in elderly patients with rectal cancer

The computer-based Symbol Digit Modalities Test: establishing age-expected performance in healthy controls and evaluation of pediatric MS patients.

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Bigi, Sandra; Marrie, R A; Till, C; Yeh, E A; Akbar, N; Feinstein, A; Banwell, B L

2017-04-01

Decreased information processing speed (IPS) is frequently reported in pediatric multiple sclerosis (MS) patients. The computerized version of the Symbol Digit Modalities Test (c-SDMT) measures IPS over eight consecutive trials per session and additionally captures changes in performance within the session. Here, we establish normative c-SDMT performance and test-retest reliability in healthy children (HC) and explore differences in the overall c-SDMT-performance between HC and MS patients. This cross-sectional study included 478 HC (237 female, 49.5%) divided into five age groups (2 years each), and 27 MS patients (22 female, 81.5%) aged 8-18 years. The average time to complete the c-SDMT increased with age (|r| 0.70, 95% CI -0.74, -0.64). Test-retest reliability was high (ICC = 0.91) in HC. The total time to complete the c-SDMT did not differ between children with MS and sex- and age- matched HC (p = 0.23). However, MS patients were less likely to show faster performance across all the successive eight trials compared to HC (p = 0.0001). Healthy children demonstrate faster IPS with increasing age, as well as during successive trials of the c-SDMT. The inability of pediatric MS patients to maintain the increase in processing speed over successive trials suggests a reduced capacity for procedural learning, possibly resulting from cognitive fatigue.

Characterizing the relationship between age and venous thromboembolism in adult trauma patients: findings from the National Trauma Data Bank and the National Inpatient Sample.

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Nastasi, Anthony J; Canner, Joseph K; Lau, Brandyn D; Streiff, Michael B; Aboagye, Jonathan K; Kraus, Peggy S; Hobson, Deborah B; Van Arendonk, Kyle J; Haut, Elliott R

2017-08-01

Venous thromboembolism (VTE) is a tremendous burden in health care. However, current guidelines lack recommendations regarding the prevention of VTE in older adult trauma patients. Furthermore, the appropriate method of modeling of age in VTE models is currently unclear. Patients included in the National Trauma Data Bank (NTDB) between the years 2008 and 2014 and patients included in the National Inpatient Sample (NIS) between 2009 and 2013 were analyzed. Multiple logistic regression of VTE on age was performed. Of 3,598,881 patients in the NTDB, 34,202 (1.0%) were diagnosed with VTE compared to 5405 (1.1%) of the 505,231 patients in NIS. In both the fully adjusted NTDB and NIS model, age was positively associated with odds of VTE diagnosis under 65 years (NTDB, adjusted odds ratio [aOR]: 1.018, 95% confidence interval [CI]: 1.017-1.019, P < 0.001; NIS, aOR: 1.025, 95% CI 1.022-1.027, P < 0.001). In patients aged ≥65 years, age was negatively associated with odds of VTE diagnosis in the NTDB (aOR: 0.995, 95% CI: 0.992-0.999, P = 0.006) but not in the NIS (aOR: 0.998, 95% CI 0.994-1.002, P = 0.26). Incidence of VTE among adult trauma patients steadily increases with age until 65 years, after which the odds of VTE appear to level off or even slightly decrease. These findings should be applied for improved modeling of VTE in trauma patients. The mechanism behind these findings should be explored before using them to update guidelines for standardized VTE prevention in older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of age and disease on bone mass in Japanese patients with schizophrenia

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Sugawara Norio

2012-02-01

Full Text Available Abstract Background There have been a limited number of studies comparing bone mass between patients with schizophrenia and the general population. The aim of this study was to compare the bone mass of schizophrenia patients with that of healthy subjects in Japan. Methods We recruited patients (n = 362, aged 48.8 ± 15.4 (mean ± SD years who were diagnosed with schizophrenia or schizoaffective disorder based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV. Bone mass was measured using quantitative ultrasound densitometry of the calcaneus. The osteosono-assessment index (OSI was calculated as a function of the speed of sound and the transmission index. For comparative analysis, OSI data from 832 adults who participated in the Iwaki Health Promotion Project 2009 was used as representative of the general community. Results Mean OSI values among male schizophrenic patients were lower than those in the general population in the case of individuals aged 40 and older. In females, mean OSI values among schizophrenic patients were lower than those in the general community in those aged 60 and older. In an analysis using the general linear model, a significant interaction was observed between subject groups and age in males. Conclusions Older schizophrenic patients exhibit lower bone mass than that observed in the general population. Our data also demonstrate gender and group differences among schizophrenic patients and controls with regard to changes in bone mass associated with aging. These results indicate that intervention programs designed to delay or prevent decreased bone mass in schizophrenic patients might be tailored according to gender.

The effect of age on result of straight leg raising test in patients suffering lumbar disc herniation and sciatica

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Homayoun Tabesh

2015-01-01

Full Text Available Background: Ninety percent of all people sometimes during their lives experience low back pain, and 30-40% develops radicular leg pain with the sciatica characteristics. Although for clinical diagnosis of lumbar disc herniation (LDH straight leg raising (SLR test in 85-90% of cases indicates LDH, but in our practice with LDH patients this test is frequently negative despite radicular leg pain due to LDH. Hence, we decided to evaluate this test in LDH in different age groups. Materials and Methods: All patients with leg pain referring to neurosurgery clinic were enrolled. Those with a history of pain other than sciatica excluded and SLR test and magnetic resonance imaging (MRI of the lumbosacral spine performed. The patients with negative MRI findings excluded and finally 269 patients with true sciatica and positive MRI were included. SLR tests were performed for different age groups. Results: Of 269 patients, 167 were male. The age range was 16-80 years. The most involved levels were L5-S1 (47% and L4-L5 (42%, respectively. The rate of positive SLR result, which was 100%, 87% and 82% for 10-19, 20-29 and 30-39 years age group respectively. With an increment of age, the rate of positive test regularly declined . The chance of positive SLR in men is 1.3 times the women (odds ratio [OR] 2.4; 95% confidence interval [CI] = 1.265-4.557; P = 0.007. Increasing the age has suppression effect in positivity of SLR so that for each 1-year the chance of SLR become 0.27 times less to become positive and this is also statically meaningful (OR = 0.271;95% CI = 0.188-0.391; P,0.001. The chance of positive SLR for patients under 60 is 5.4 folds more than patients above 60 years old (OR = 5.4; 95% CI = 4-8.3; P, 0.001. Conclusion: Age, sex (male, and disk level had statistically the effect on SLR positive test.

Risks of newly onset hemorrhagic stroke in patients with neovascular age-related macular degeneration.

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Lee, Wan-Ju Annabelle; Cheng, Ching-Lan; Lee, Cheng-Han; Kao Yang, Yea-Huei; Lin, Swu-Jane; Hsieh, Cheng-Yang

2017-10-01

Age-related macular degeneration (AMD) is an eye disease causing blindness in the elderly. It shares many common possible pathogenic mechanisms with cardiovascular diseases. Many studies have discussed the association between AMD and stroke, but the results were inconsistent. Our aim was to determine the associations between neovascular AMD and the risk of stroke in the Taiwanese population. This is a retrospective cohort study. We used claims data from National Health Insurance Research Database. Patients aged more than 45 years without stroke, myocardial infarction, or any AMD were selected from 2001 to 2008 and followed until 2010. The index date was defined as the date of nAMD diagnosis (ICD-9 code, 362.52). The comparison group was patients without an nAMD diagnosis with age- and sex-matched to nAMD subjects at a ratio of up to 10 to 1. Kaplan-Meier survival analysis and Cox regression analysis were used. The incidence of stroke events (ICD-9 codes, 430-434) and their subtypes (hemorrhagic and ischemic) were primary outcomes. Secondary outcomes included acute myocardial infarction (AMI), composite AMI/stroke, and all-cause mortality. Patients with nAMD had a higher risk of developing stroke, with an adjusted HR of 1.30 (95% CI, 1.01-1.68). A higher risk for hemorrhagic stroke (HR, 1.70, 95% CI, 1.03-2.83) was also found. No significant differences were observed in ischemic stroke, the composite of AMI/stroke, and all-cause mortality. Patients with nAMD had a significantly higher risk of developing stroke, which was driven mainly by the increased risk of developing the hemorrhagic subtype. Copyright © 2017 John Wiley & Sons, Ltd.

Abnormal functional connectivity of the amygdala in first-episode and untreated adult major depressive disorder patients with different ages of onset.

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Ye, Jing; Shen, Zonglin; Xu, Xiufeng; Yang, Shuran; Chen, Wei; Liu, Xiaoyan; Lu, Yi; Liu, Fang; Lu, Jin; Li, Na; Sun, Xuejin; Cheng, Yuqi

2017-03-01

Major depressive disorder (MDD) is a common mental disorder with high morbidity. As a part of the limbic system, the amygdala is important in the processing of emotional information. Structural and functional connectivity (FC) abnormalities in the amygdala have been observed in MDD patients. The present study was carried out to identify the features of amygdala FC in adult MDD patients with different ages of onset. Sixty-nine first-episode and untreated MDD patients and 81 healthy controls (CTLs) were included in this study and underwent 3D structural imaging and resting-state functional MRI scanning. The patients and CTLs were divided into two groups according to age of onset: young adult (abnormal resting-state FC with other regions compared with matched controls. However, in old adult patients, compared with matched controls, the right amygdala showed more abnormal changes in the resting-state FC with other regions. MDD patients with different ages of onset showed different changes in the structure and FC of the amygdala. These results might help us to understand the high heterogeneity of MDD.

Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values

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Ubeda, Carlos, E-mail: cubeda@uta.cl [Medical Technology Department, Radiological Sciences Center, Health Sciences Faculty, Tarapaca University, Arica 1000000 (Chile); Miranda, Patricia [Hemodynamic Department, Cardiovascular Service, Luis Calvo Mackenna Hospital, Santiago 7500539 (Chile); Vano, Eliseo [Radiology Department, Faculty of Medicine, Complutense University and IdIS, San Carlos Hospital, Madrid 28040 (Spain)

2015-02-15

Purpose: To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Methods: Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Results: Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for <1 yr; 213 for 1 to <5 yr; 82 for 5 to <10 yr; and 102 for 10 to <16 yr. The third quartile values obtained for DAP by diagnostic and therapeutic procedures and age range were 1.17 and 1.11 Gy cm{sup 2} for <1 yr; 1.74 and 1.90 Gy cm{sup 2} for 1 to <5 yr; 2.83 and 3.22 Gy cm{sup 2} for 5 to <10 yr; and 7.34 and 8.68 Gy cm{sup 2} for 10 to <16 yr, respectively. The third quartile value obtained for the DAP/body weight ratio for the full sample of procedures was 0.17 (Gy cm{sup 2}/kg) for diagnostic and therapeutic procedures. Conclusions: The data presented in this paper are an initial attempt at establishing local DRLs in pediatric interventional cardiology, from a large sample of procedures for the standard age bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there

Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values

International Nuclear Information System (INIS)

Ubeda, Carlos; Miranda, Patricia; Vano, Eliseo

2015-01-01

Purpose: To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Methods: Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Results: Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for <1 yr; 213 for 1 to <5 yr; 82 for 5 to <10 yr; and 102 for 10 to <16 yr. The third quartile values obtained for DAP by diagnostic and therapeutic procedures and age range were 1.17 and 1.11 Gy cm 2 for <1 yr; 1.74 and 1.90 Gy cm 2 for 1 to <5 yr; 2.83 and 3.22 Gy cm 2 for 5 to <10 yr; and 7.34 and 8.68 Gy cm 2 for 10 to <16 yr, respectively. The third quartile value obtained for the DAP/body weight ratio for the full sample of procedures was 0.17 (Gy cm 2 /kg) for diagnostic and therapeutic procedures. Conclusions: The data presented in this paper are an initial attempt at establishing local DRLs in pediatric interventional cardiology, from a large sample of procedures for the standard age bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there may be large differences

Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study.

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Giustino Parruti

Full Text Available Psychological factors are known predictors of cardiovascular disease in many clinical settings, but data are lacking for HIV infection. We carried out a prospective cohort study to evaluate potential psychological predictors of preclinical and clinical vascular disease in HIV patients.HIV patients were consecutively enrolled. Demographics, viral and immune parameters and traditional cardiovascular predictors were considered; Intima-Media Thickness (c-IMT, continuous measure and Carotid Plaques (CPs, focal thickening ≥1.5 mm were investigated by B-mode ultrasonography; depressive symptoms by the Beck Depression Inventory (BDI-II, Type D personality (Distressed Personality or Type D by the DS14, alexithymia by the Toronto Alexithymia Scale (TAS-20. Vascular outcomes included transient ischemic attacks or stroke, acute coronary syndrome, myocardial or other organ infarction. We enrolled 232 HIV subjects, 73.9% males, aged 44.5±9.9 y, 38.2% with AIDS diagnosis, 18.3% untreated. Mean Nadir CD4 T-cell counts were 237.5±186.2/mmc. Of them, 224 (96.5% attended IMT measurements; 201 (86.6% attended both IMT assessment and psychological profiling. Mean follow-up was 782±308 days. Fifty-nine patients (29.4% had CPs at baseline. Nineteen patients (9.5% had ≥1 vascular event; 12 (6.0% died due to such events (n = 4 or any cause. At baseline cross-sectional multivariate analysis, increasing age, total cholesterol, current smoking and Alexithymia score≥50 were significantly associated with both increased cIMT (linear regression and CPs (logistic regression. At follow-up analysis, log-rank tests and Cox's regression revealed that only older age (p = 0.001, current smoking (p = 0.019 and alexithymia score≥50 (p = 0.013 were independently associated with vascular events.In HIV-infected subjects, the Alexithymic trait emerges as a strong predictor of increased IMT, presence of CPs and vascular events. Such results are preliminary and require

Medial versus anterior open reduction for developmental hip dislocation in age-matched patients.

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Hoellwarth, Jason S; Kim, Young-Jo; Millis, Michael B; Kasser, James R; Zurakowski, David; Matheney, Travis H

2015-01-01

The difference between medial (MAOR) and anterior (AAOR) approaches for open reduction of developmental hip dysplasia in terms of risk for avascular necrosis (AVN) and need for further corrective surgery (FCS, femoral and/or acetabular osteotomy) is unclear. This study compared age-matched cohorts undergoing either MAOR or AAOR in terms of these 2 primary outcomes. Prognostic impact of presence of ossific nucleus at time of open reduction was also investigated. Institutional review board approval was obtained. Nineteen hips (14 patients) managed by MAOR were matched with 19 hips (18 patients) managed by AAOR based on age at operation (mean 6.0; range, 1.4 to 14.9 mo). Patients with neuromuscular conditions and known connective tissue disorders were excluded. Primary outcomes assessed at minimum 2 years' follow-up included radiographic evidence of AVN (Kalamchi and MacEwen) or requiring FCS. MAOR and AAOR cohorts were similar regarding age at open reduction, sex, laterality, and follow-up duration. One hip in each group had AVN before open reduction thus were excluded from AVN analysis. At minimum 2 years postoperatively (mean 6.2; range, 1.8 to 11.7 y), 4/18 (22%) MAOR and 5/18 (28%) AAOR met the same criteria for AVN (P=1.0). No predictors of AVN could be identified by regression analysis. Presence of an ossific nucleus preoperatively was not a protective factor from AVN (P=0.27). FCS was required in 4/19 (21%) MAOR and 7/19 (37%) AAOR hips (P=0.48). However, 7/12 (54%) hips failing closed reduction required FCS compared with 4/26 (16%) hips without prior failed closed reduction (P=0.024). Cox regression analysis showed that patients who failed closed reduction had an annual risk of requiring FCS approximately 6 times that of patients without a history of failed closed reduction (hazard ratio=6.1; 95% CI, 1.5-24.4; P=0.009), independent of surgical approach (P=0.55) or length of follow-up (P=0.78). In this study of age-matched patients undergoing either MAOR or

Patent foramen ovale in a large population of ischemic stroke patients: diagnosis, age distribution, gender, and race.

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Gupta, Vishal; Yesilbursa, Dilek; Huang, Wen Ying; Aggarwal, Kul; Gupta, Vijaya; Gomez, Camilo; Patel, Vinod; Miller, Andrew P; Nanda, Navin C

2008-02-01

Patent foramen ovale (PFO) is a well-recognized risk factor for ischemic strokes. The true prevalence of PFO among stroke patients is still under debate. Transesophageal echocardiography (TEE) is the "gold standard" in diagnosing PFO but the physiology requires right-to-left atrial shunting. In this report, we evaluate the prevalence of PFO in a diverse group of ischemic stroke patients studied by TEE. TEE of 1,663 ischemic stroke patients were reviewed for cardiac source of embolism, including PFO and atrial septal aneurysm (ASA). Agitated saline bubble injection was performed to look for right to left atrial shunting. Success of maneuvers to elevate right atrial pressure (RAP) was noted by looking at the atrial septal bulge. Among 1,435 ischemic stroke patients analyzed, the presence or absence of PFO could not be determined in 32.1% because bulging of the septum could not be demonstrated in patients with negative contrast study despite aggressive maneuvers to elevate RAP. Of the remaining 974 patients, 294 patients (30.2%) had a PFO. The mean age was 61.5 years in both groups, with a bimodal distribution of PFO and the highest prevalence occurring in gender or racial difference in the prevalence of PFO, but there was a bimodal distribution in prevalence with age.

Age is not associated with increased surgical complications in patients after laparoscopic sleeve gastrectomy.

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Jędrzejewski, Emil; Liszka, Maciej; Maciejewski, Marcin; Kowalewski, Piotr K; Walędziak, Maciej; Paśnik, Krzysztof; Janik, Michał R

2018-03-01

Age is considered as a risk factor in bariatric surgery. The observation was made on the basis of results from studies where patients underwent different type of surgery, but laparoscopic sleeve gastrectomy (LSG) was not among them. It is necessary to reevaluate the association of age with adverse events in the group of patients after LSG. To investigate the association of age with surgery-related adverse events in patients after LSG. Retrospective analysis of medical data was performed. The study involved 345 patients who underwent LSG in our institution between January 2013 and December 2014. The patients were subdivided by age into four groups according to quartiles. In 30-day follow-up adverse events were evaluated. We considered the presence of the following events as the endpoint of our study: death, medical events and surgical events. In general, we observed adverse events in 36 (10.4%) patients. The mortality rate in our study was 0.59%. Nineteen events were surgical and 18 medical. In 1 patient a surgical event was associated with a medical event. Bleeding was the most common surgical event and was observed in 17 (4.9%) cases. Age was not associated with surgical events (OR = 1.032, 95% CI: 0.991-1.075, p = 0.33) or medical events (OR = 0.997, 95% CI: 0.956-1.039, p = 0.89). The LSG is a safe bariatric procedure with low mortality. Bleeding is the most frequent surgical complication. Our findings suggest that age is not associated with increased risk of surgical or medical adverse events after LSG.

A Molecular Clock Infers Heterogeneous Tissue Age Among Patients with Barrett's Esophagus.

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Kit Curtius

2016-05-01

Full Text Available Biomarkers that drift differentially with age between normal and premalignant tissues, such as Barrett's esophagus (BE, have the potential to improve the assessment of a patient's cancer risk by providing quantitative information about how long a patient has lived with the precursor (i.e., dwell time. In the case of BE, which is a metaplastic precursor to esophageal adenocarcinoma (EAC, such biomarkers would be particularly useful because EAC risk may change with BE dwell time and it is generally not known how long a patient has lived with BE when a patient is first diagnosed with this condition. In this study we first describe a statistical analysis of DNA methylation data (both cross-sectional and longitudinal derived from tissue samples from 50 BE patients to identify and validate a set of 67 CpG dinucleotides in 51 CpG islands that undergo age-related methylomic drift. Next, we describe how this information can be used to estimate a patient's BE dwell time. We introduce a Bayesian model that incorporates longitudinal methylomic drift rates, patient age, and methylation data from individually paired BE and normal squamous tissue samples to estimate patient-specific BE onset times. Our application of the model to 30 sporadic BE patients' methylomic profiles first exposes a wide heterogeneity in patient-specific BE onset times. Furthermore, independent application of this method to a cohort of 22 familial BE (FBE patients reveals significantly earlier mean BE onset times. Our analysis supports the conjecture that differential methylomic drift occurs in BE (relative to normal squamous tissue and hence allows quantitative estimation of the time that a BE patient has lived with BE.

Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program.

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Bozec, Alexandre; Benezery, Karen; Chamorey, Emmanuel; Ettaiche, Marc; Vandersteen, Clair; Dassonville, Olivier; Poissonnet, Gilles; Riss, Jean-Christophe; Hannoun-Lévi, Jean-Michel; Chand, Marie-Eve; Leysalle, Axel; Saada, Esma; Sudaka, Anne; Haudebourg, Juliette; Hebert, Christophe; Falewee, Marie-Noelle; Demard, François; Santini, José; Peyrade, Frédéric

2016-09-01

The objective of the study is to evaluate the nutritional status and determine its impact on clinical outcomes in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy (ICT)-based larynx preservation program without prophylactic feeding-tube placement. All patients with locally advanced (T3/4, N0-3, M0) hypopharyngeal squamous cell carcinoma, technically suitable for total pharyngolaryngectomy, treated by docetaxel, cisplatin and 5-fluorouracil (TPF)-ICT for larynx preservation at our institution between 2004 and 2013, were included in this retrospective study. Patients' nutritional status was closely monitored. Enteral nutrition was used if and when a patient was unable to sustain per-oral nutrition and hydration. The impact of nutritional status on clinical outcomes was investigated in univariate and multivariate analysis. A total of 53 patients (42 men and 11 women, mean age = 58.6 ± 8.2 years) were included in this study. Six (11.3 %) patients had lost more than 10 % of their usual body weight before therapy. Compared with patients' usual weight, the mean maximum patient weight loss during therapeutic management was 8.7 ± 4.5 kg. Enteral nutrition was required in 17 patients (32 %). We found no influence of the tested nutritional status-related factors on response to ICT, toxicity of ICT, overall, cause-specific and recurrence-free survival, and on post-therapeutic swallowing outcome. Maximum weight loss was significantly associated with a higher risk of enteral tube feeding during therapy (p = 0.03) and of complications (grade ≥3, p = 0.006) during RT. Without prophylactic feeding-tube placement, approximately one-third of the patients required enteral nutrition. There was no significant impact of nutritional status on oncologic or functional outcomes.

Prediction of Massive Transfusion in Trauma Patients with Shock Index, Modified Shock Index, and Age Shock Index

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Cheng-Shyuan Rau

2016-07-01

Full Text Available Objectives: The shock index (SI and its derivations, the modified shock index (MSI and the age shock index (Age SI, have been used to identify trauma patients with unstable hemodynamic status. The aim of this study was to evaluate their use in predicting the requirement for massive transfusion (MT in trauma patients upon arrival at the hospital. Participants: A patient receiving transfusion of 10 or more units of packed red blood cells or whole blood within 24 h of arrival at the emergency department was defined as having received MT. Detailed data of 2490 patients hospitalized for trauma between 1 January 2009, and 31 December 2014, who had received blood transfusion within 24 h of arrival at the emergency department, were retrieved from the Trauma Registry System of a level I regional trauma center. These included 99 patients who received MT and 2391 patients who did not. Patients with incomplete registration data were excluded from the study. The two-sided Fisher exact test or Pearson chi-square test were used to compare categorical data. The unpaired Student t-test was used to analyze normally distributed continuous data, and the Mann-Whitney U-test was used to compare non-normally distributed data. Parameters including systolic blood pressure (SBP, heart rate (HR, hemoglobin level (Hb, base deficit (BD, SI, MSI, and Age SI that could provide cut-off points for predicting the patients’ probability of receiving MT were identified by the development of specific receiver operating characteristic (ROC curves. High accuracy was defined as an area under the curve (AUC of more than 0.9, moderate accuracy was defined as an AUC between 0.9 and 0.7, and low accuracy was defined as an AUC less than 0.7. Results: In addition to a significantly higher Injury Severity Score (ISS and worse outcome, the patients requiring MT presented with a significantly higher HR and lower SBP, Hb, and BD, as well as significantly increased SI, MSI, and Age SI. Among

Relation between visual function index and falls-related factors in patients with age-related cataract

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Mei-Na Huang

2016-01-01

Full Text Available AIM:To investigate the relation between vision function index and falls-related factors in patients with age-related cataract.METHODS:Ninety-six patients with age-related cataract were interviewed using a seven-item visual function questionnaire(VF-7, then classified into poor, moderate, or good visual function group. The differences of the three groups on visual acuity, balance and mobility function, cognition, depressive symptoms, self-reported fear of falling were analyzed. RESULTS:The patients in poor visual function group had older age, tendency to depression, was more afraid of falling, compared with groups with higher score in VF-7, and they had worse visual acuity, performed worse on all balance and mobility tests. CONCLUSION:Poor visual function is related to worse visual acuity, weaker balance and mobility performance in patients with age-related cataract. The VF-7, as a simple and convenient self-reported method, can be used as a falling risk monitoring in patients with age-related cataract.

Low employment and low willingness of being reemployed in Chinese working-age maintained hemodialysis patients.

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Huang, Bihong; Lai, Bihong; Xu, Ling; Wang, Ying; Cao, Yanpei; Yan, Ping; Chen, Jing

2017-11-01

Returning to society plays an important role in improving the quality of life in maintenance hemodialysis (MHD) patients, and retention of employment is one of the core enablers. The study is to assess the employment status and to determine the variables for unemployment in Chinese MHD patients. Prevalent MHD patients from four dialysis centers in Shanghai China were enrolled. We assessed patients' employment status, current social functioning, hemodialysis modality, annual income and general health condition. Among current unemployed working-age patients, the reasons of quitting jobs and willingness of being reemployed were evaluated. A total of 231 patients were studied, among which 114 patients were unemployed 1 year before hemodialysis. Among 117 employed patients, 16 patients quitted jobs before dialysis inception, while 49 patients quitted jobs at the initiation of HD, and 26 patients followed after a few months' HD. The main reasons for ceasing employment were physical insufficiency, conflict between dialysis and work schedules, lack of support from employers and resistance from family members. Among the 166 patients who were in their working age, 26 patients were employed. The unemployed patients had the characters of elder age, lower education level, higher annual family income, higher female ratio, lower blood flow, lower physical functioning, and social functioning and lower frequency of weekend hemodialysis and HDF/HF. Among the 140 unemployed patients, only 47 patients had the willingness of being reemployed. Their unemployment status was positively associated with elder age ((OR) 3.13, 95% CI, 1.08-9.1), lower education level ((OR) 1.97, 95% CI, 1.05-5.92), and higher family income ((OR) 7.75, 95% CI, 2.49-24.14). Ratio of employment and willingness of being reemployed was low in MHD working-age patients. Lack of social and family's support also hampered patient's returning to society except for the HD treatment quality.

ALGORITHM OF DIAGNOSTICS AND TREATMENT OF AN AGE-RELATED MACULAR DEGENERATION AT PATIENTS WITH CHRONIC PERIPHERAL UVEITIS

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Yu. I. Khoroshikh

2014-01-01

Full Text Available The results of clinical trial of various approaches in treatment the exudative forms of macular degenerations, including age-related, against chronic slow intensity inflammatory process on the extreme retinal periphery of an eye are described in represented material. There were 91 patients (105 eyes in the research with different types of an exudative macular degeneration. The general criteria of inclusion were: age of 18–80 years old, complaints to discomfort in eyes, a spot before an eye, distortions and decrease in the central sight, ophthalmoscopic symptoms of hypostasis in the central and peripheral areas of a retina. It is analyzed the general criteria of diagnostics and treatment of the disease in the article. Considering defeat of the chorioretinal structures located near the ora serrata at persons of young and advanced age. Practical recommendations to a choice of methods of diagnostics and treatment of various clinical and morphological forms of the disease are made. Screening methods of identification of patients with the peripheral uveitis are offered. The scheme of risk calculation of development the macular pathology at persons with changes on the extreme periphery of a retina, that can be used as a method of prevention of development predictively adverse of “wet" forms of an age-related macular degeneration, by means of timely sparing treatment at patients with chronic inflammatory diseases of eyes is given.

The outcome and the influencing factors of the age of onset in post-mortem of chronic bronchitis patients: a retrospective study

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Zhu L

2018-02-01

Full Text Available Linyun Zhu,1 Zhenhua Ni,2 Xuming Luo,1 Zhuhua Zhang,1 Shiqiang Wang,1 Ziyu Meng,1 Xiandong Gu,1 Xiongbiao Wang1 1Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 2Central Laboratory, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China Purpose: Chronic bronchitis is thought to occur in elderly patients, and smoking seems to be an important risk factor. The outcomes related to the age of onset in patients with chronic bronchitis are still unclear. Patients and methods: A retrospective study was conducted on deceased patients whose diagnosis included bronchitis from 2010 to 2016. Patients were separated into two groups according to the age of onset (Group I, age ≤50 years old; Group II, age >50 years old. Information regarding disease course, smoking history, death age, number of admissions per year, Hugh Jones Index, and self-reported comorbidities of the patients was recorded. Results: The courses of chronic cough and sputum were 33.38±7.73 years and 14.44±8.60 years in Group I and Group II, respectively (p<0.05. The death ages of Group I and Group II were 77.65±7.87 years and 84.69±6.67 years, respectively (p<0.05. There was a significant negative correlation between the number of hospital admissions per year and the age of onset. The age of onset was negatively associated with daily smoking count (r=-0.210 and total smoking count (r=-0.146. In Group I, there were fewer cases of coronary heart disease (OR =0.41 [0.24–0.71], neurological diseases (OR =0.48 [0.24–0.97], and total comorbidities (OR =0.67 [0.54–0.85] than in Group II. Conclusion: Patients with early onset chronic bronchitis had a longer history, younger death age, poorer health status, and lower incidence of comorbidities. Keywords: chronic airway disease, comorbidity, Hugh Jones Index, smoking, hospital admission, disease course

Prevalence of protein-energy malnutrition in hospital patients over 75 years of age admitted for hip fracture.

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Drevet, S; Bioteau, C; Mazière, S; Couturier, P; Merloz, P; Tonetti, J; Gavazzi, G

2014-10-01

One percent of falls in over-75 years old cause hip fracture (HF). Protein-energy malnutrition (PEM) is associated with falls and fracture. PEM screening and perioperative nutritional management are recommended by the European Society of Parenteral and Enteral Nutrition, yet data on nutritional status in elderly HF patients are sparse. The Mini Nutritional Assessment (MNA) score is presently the most effective screening tool for PEM in over-75 years old. The principal objective of the present study was to determine the prevalence on MNA of PEM in patients aged over 75 years admitted for HF. Secondary objectives were to identify factors associated with PEM and its role as a factor of evolution. A prospective observational epidemiological study included 50 patients aged over 75 years admitted for HF in an 8-bed orthopedic surgery department with a geriatric follow-up unit. PEM was defined by MNApatients was 86.1 years (range, 77-94 years). Prevalence of PEM was 28%; a further 58% of patients were at risk for PEM. PEM was associated with elevated CIRS-G (Ppatients aged over 75 years, supporting longer hospital stay. MNA is a diagnostic gold standard, not to be replaced by albuminemia or body-mass index in this perioperative clinical situation. Given the present economic stakes relating to geriatric trauma patients' hospital stay, it is essential to prevent, diagnose and treat PEM in elderly subjects. Level IV; prospective cohort study. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Cerebellar abnormalities contribute to disability including cognitive impairment in multiple sclerosis.

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Katrin Weier

Full Text Available The cerebellum is known to be involved not only in motor but also cognitive and affective processes. Structural changes in the cerebellum in relation to cognitive dysfunction are an emerging topic in the field of neuro-psychiatric disorders. In Multiple Sclerosis (MS cerebellar motor and cognitive dysfunction occur in parallel, early in the onset of the disease, and the cerebellum is one of the predilection sites of atrophy. This study is aimed at determining the relationship between cerebellar volumes, clinical cerebellar signs, cognitive functioning and fatigue in MS. Cerebellar volumetry was conducted using T1-weighted MPRAGE magnetic resonance imaging of 172 MS patients. All patients underwent a clinical and brief neuropsychological assessment (information processing speed, working memory, including fatigue testing. Patients with and without cerebellar signs differed significantly regarding normalized cerebellar total volume (nTCV, normalized brain volume (nBV and whole brain T2 lesion volume (LV. Patients with cerebellar dysfunction likewise performed worse in cognitive tests. A regression analysis indicated that age and nTCV explained 26.3% of the variance in SDMT (symbol digit modalities test performance. However, only age, T2 LV and nBV remained predictors in the full model (r(2 = 0.36. The full model for the prediction of PASAT (Paced Auditory Serial Addition Test scores (r(2 = 0.23 included age, cerebellar and T2 LV. In the case of fatigue, only age and nBV (r(2 = 0.17 emerged as significant predictors. These data support the view that cerebellar abnormalities contribute to disability, including cognitive impairment in MS. However, this contribution does not seem to be independent of, and may even be dominated by wider spread MS pathology as reflected by nBV and T2 LV.

Case-control study of factors associated with chronic Chagas heart disease in patients over 50 years of age

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Silvana de Araújo Silva

2007-11-01

Full Text Available A case-control study on chronic Chagas heart disease (CCHD was carried out between 1997 and 2005. Ninety patients over 50 years of age were examined for factors related to (CCHD. Fourty-six patients (51.1% with Chagas heart disease (anomalous ECG were assigned to the case group and 44 (48.9% were included in the control group as carriers of undetermined forms of chronic disease. Social, demographic (age, gender, skin color, area of origin, epidemiological (permanence within an endemic zone, family history of Chagas heart disease or sudden death, physical strain, alcoholism, and smoking, and clinical (systemic hypertension variables were analyzed. The data set was assessed through single-variable and multivariate analysis. The two factors independently associated with heart disease were age - presence of heart disease being three times higher in patients over 60 years of age (odds ratio, OR: 2.89; confidence interval of 95%: 1.09-7.61 - and family history of Chagas heart disease (OR: 2.833, CI 95%: 1.11-7.23. Systemic hypertension and gender did not prove to hold any association with heart disease, as neither did skin color, but this variable showed low statistical power due to reduced sample size.

Safety comparison of four types of rabies vaccines in patients with WHO category II animal exposure: An observation based on different age groups.

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Peng, Jun; Lu, Sha; Zhu, Zhenggang; Zhang, Man; Hu, Quan; Fang, Yuan

2016-11-01

To evaluate the safeties of 4 types of rabies vaccines for patients with WHO category II animal exposure, especially in different age groups.A total of 4000 patients with WHO category II animal exposure were randomly divided into 4 vaccine groups, and were respectively given with Vaccines A, B, C, and D. And subjects in each vaccine group were divided into 4 age groups (≤5, 5-18, 19-60, and ≥60-year-old groups). Then adverse events (including local and systemic ones) were recorded and compared. Consequently, except for Vaccine B, patients under the age of 5 in Groups A, C, and D suffered from more adverse reactions than those in other age groups. Furthermore, for the children aged less than 5 years, incidence of adverse events following administration of Vaccine B, with the dose of 0.5 mL and production of bioreactor systems, was significantly lower than Vaccines A and D.Our data showed that rabies vaccines with smaller doses and more advanced processing techniques are of relatively high safety for the patients, especially for the young children.

A Population-based Study of Age Inequalities in Access to Palliative Care Among Cancer Patients

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Burge, Frederick I.; Lawson, Beverley J.; Johnston, Grace M.; Grunfeld, Eva

2013-01-01

Background Inequalities in access to palliative care programs (PCP) by age have been shown to exist in Canada and elsewhere. Few studies have been able to provide greater insight by simultaneously adjusting for multiple demographic, health service, and socio-cultural indicators. Objective To re-examine the relationship between age and registration to specialized community-based PCP programs among cancer patients and identify the multiple indicators contributing to these inequalities. Methods This retrospective, population-based study was a secondary data analysis of linked individual level information extracted from 6 administrative health databases and contextual (neighborhood level) data from provincial and census information. Subjects included all adults who died due to cancer between 1998 and 2003 living within 2 District Health Authorities in the province of Nova Scotia, Canada. The relationship between registration in a PCP and age was examined using hierarchical nonlinear regression modeling techniques. Identification of potential patient and ecologic contributing indicators was guided by Andersen’s conceptual model of health service utilization. Results Overall, 66% of 7511 subjects were registered with a PCP. Older subjects were significantly less likely than those center had a major impact on registration. Conclusions Age continues to be a significant predictor of PCP registration in Nova Scotia even after controlling for the confounding effects of many new demographic, health service, and ecologic indicators. PMID:19300309

International collaboration including patients is essential to develop new therapies for patients with myositis.

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Lundberg, Ingrid E; Vencovsky, Jiri

2017-05-01

To discuss the needs for international collaborations between investigators in different disciplines working with myositis and with patients with myositis. Recent advances in detection of several myositis-specific autoantibodies that are associated with distinct clinical phenotypes, will enable studies in new well defined clinically homogenous subgroups of myositis This is likely to lead to development of new information on molecular pathogenesis that might be different in different myositis subgroups. Subgrouping patients according to autoantibody profile may also be important to assess outcome, to identify prognostic biomarkers and in clinical trials. As these are rare disorders international collaboration is essential to enrol large enough cohorts of the subgroups. To facilitate such collaboration we have developed a web-based international myositis register, www.euromyositis.eu, which includes validated outcome measures and patient reported outcome measures. This register is to support research but also to support decision-making in the clinic. We welcome investigators to join the Euromyositis register. Myositis is a heterogeneous disorder with varying treatment response and outcome. There is a high unmet need for new therapies which can only be achieved by increased knowledge on molecular disease mechanisms. Subgrouping patients according to autoantibody profile may be a new way forward to get a better understanding on disease mechanisms and to develop novel therapies.

NATURAL COURSE OF PATIENTS DISCONTINUING TREATMENT FOR AGE-RELATED MACULAR DEGENERATION AND FACTORS ASSOCIATED WITH VISUAL PROGNOSIS.

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Kim, Jae Hui; Chang, Young Suk; Kim, Jong Woo

2017-12-01

To evaluate the 24-month natural course of visual changes in patients discontinuing treatment despite persistent or recurrent fluid and factors predictive of visual prognosis. This retrospective, observational study included 35 patients (35 eyes) who initially received anti-vascular endothelial growth factor treatment for neovascular age-related macular degeneration (AMD), but discontinued treatment despite persistent or recurrent fluid. The best-corrected visual acuity (BCVA) at treatment discontinuation was determined and compared with the 24-month BCVA, which was then compared between polypoidal choroidal vasculopathy and other neovascular age-related macular degeneration subtypes. Baseline characteristics predictive of visual outcome and the degree of visual change were also analyzed. The mean number of anti-vascular endothelial growth factor injections before treatment discontinuation was 4.0 ± 1.6. The mean logarithm of minimal angle of resolution of BCVA at treatment discontinuation and that at 24 months were 1.02 ± 0.20 (Snellen equivalents = 20/209) and 1.60 ± 0.56 (20/796), respectively (P age-related macular degeneration subtypes (P = 0.803). The type of fluid (intraretinal fluid vs. no intraretinal fluid) was predictive of 24-month BCVA (P = 0.004) and the degree of changes in BCVA (P = 0.043). Marked deterioration in visual acuity was noted in patients discontinuing treatment, regardless of neovascular age-related macular degeneration subtypes. The presence of intraretinal fluid was associated with worse visual prognosis, suggesting that patients with intraretinal fluid should be strongly warned about their poor prognosis before they decide to discontinue treatment.

Age, gender and risk factor disparities in first-stroke Jewish and Arab patients in Israel undergoing rehabilitation.

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Greenberg, Elina; Treger, Iuly; Schwarz, Juliana

2011-11-01

Little is known of the risk factor disparities in first stroke among Jewish and Arab patients undergoing rehabilitation in Israel. To investigate the age, gender and risk factor disparities in first stroke among Jewish (immigrant and non-immigrant) and Arab patients undergoing rehabilitation and to compare the prevalence and odds ratio of stroke risk factors in these patients. The database of the Department of Neurological Rehabilitation C at Loewenstein Rehabilitation Center was used to investigate first ischemic and hemorrhagic stroke patients admitted for hospital rehabilitation over a 15 year period, January 1993 to December 2008. Particular attention was paid to age, gender and risk factor disparities. The 2000 patients with first stroke who were included in the study were grouped as Jewish (immigrant and non-immigrant) orArab; there were 237 Arabs, 370 non-immigrant Jews and 1393 immigrant Jews. A high percentage of Arab patients were found to have hypertension and diabetes mellitus, while a high percentage of Jewish immigrants had stenosis of the internal carotid artery. The study demonstrated some differences in the effect of risk factors between the groups. It may be important to address such differences when developing stroke preventative strategies in this population of Jewish and Arab stroke survivors in Israel.

Diabetes Mellitus and Younger Age Are Risk Factors for Hyperphosphatemia in Peritoneal Dialysis Patients

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Rameez Imtiaz

2017-02-01

Full Text Available Hyperphosphatemia has been associated with adverse outcomes in patients with end stage kidney disease (ESKD. The purpose of this study was to determine risk factors for hyperphosphatemia in ESKD patients treated with peritoneal dialysis (PD. This information will be used to develop a patient specific phosphate binder application to facilitate patient self-management of serum phosphate. Adult PD patients documented their food, beverage, and phosphate binder intake for three days using a dietitian developed food journal. Phosphate content of meals was calculated using the ESHA Food Processor SQL Software (ESHA Research, Salem, UT, USA. Clinic biochemistry tests and an adequacy assessment (Baxter Adequest program were done. Univariate logistic regression was used to determine predictors of serum phosphate >1.78 mmol/L. A multivariable logistic regression model was then fit including those variables that achieved a significance level of p < 0.20 in univariate analyses. Sixty patients (38 men, 22 women completed the protocol; they were 60 ± 17 years old, 50% had a history of diabetes mellitus (DM and 33% had hyperphosphatemia (PO4 > 1.78 mmol/L. In univariate analysis, the variables associated with an increased risk of hyperphosphatemia with a p-value < 0.2 were male gender (p = 0.13, younger age (0.07, presence of DM (0.005, higher dose of calcium carbonate (0.08, higher parathyroid serum concentration (0.08, lower phosphate intake (0.03, lower measured glomerular filtration rate (0.15, higher phosphate excretion (0.11, and a higher body mass index (0.15. After multivariable logistic regression analysis, younger age (odds ratio (OR 0.023 per decade, 95% confidence interval (CI 0.00065 to 0.455; p = 0.012, presence of diabetes (OR 11.40, 95 CI 2.82 to 61.55; p = 0.0003, and measured GFR (OR 0.052 per mL/min decrease; 95% CI 0.0025 to 0.66 were associated with hyperphosphatemia. Our results support that younger age and diabetes mellitus are

Does age really matter? Recall of information presented to newly referred patients with cancer

NARCIS (Netherlands)

Jansen, J.; Butow, P.N.; van Weert, J.C.M.; van Dulmen, S.; Devine, R.J.; Heeren, T.J.; Bensing, J.M.; Tattersall, M.H.N.

2008-01-01

Purpose To examine age- and age-related differences in recall of information provided during oncology consultations. Patients and Methods Two hundred sixty patients with cancer diagnosed with heterogeneous cancers, seeing a medical or radiation oncologist for the first time, participated in the

Does age really matter? Recall of information presented to newly referred patients with cancer.

NARCIS (Netherlands)

Jansen, J.; Butow, P.N.; Weert, J.C.M. van; Dulmen, S. van; Devine, R.J.; Heeren, T.J.; Bensing, J.M.; Tattersall, M.H.N.

2008-01-01

Purpose: To examine age- and age-related differences in recall of information provided during oncology consultations. Patients and Methods: Two hundred sixty patients with cancer diagnosed with heterogeneous cancers, seeing a medical or radiation oncologist for the first time, participated in the

Ten-year outcome including patterns of failure and toxicity for adjuvant whole abdominopelvic irradiation in high-risk and poor histologic feature patients with endometrial carcinoma

International Nuclear Information System (INIS)

Stewart, Kimberly D.; Martinez, Alvaro A.; Weiner, Sheldon; Podratz, Karl; Stromberg, Jannifer S.; Schray, Mark; Mitchell, Christina; Sherman, Alfred; Chen, Peter; Brabbins, Donald A.

2002-01-01

Purpose: To evaluate the long-term results of treatment using adjuvant whole abdominal irradiation (WAPI) with a pelvic/vaginal boost in patients with Stage I-III endometrial carcinoma at high risk of intra-abdominopelvic recurrence, including clear cell (CC) and serous-papillary (SP) histologic features. Methods and Materials: In a prospective nonrandomized trial, 119 patients were treated with adjuvant WAPI between November 1981 and April 2000. All patients were analyzed, including those who did not complete therapy. The mean age at diagnosis was 66 years (range 39-88). Thirty-eight patients (32%) had 1989 FIGO Stage I-II disease and 81 (68%) had Stage III. The pathologic features included the following: 64 (54%) with deep myometrial invasion, 48 (40%) with positive peritoneal cytologic findings, 69 (58%) with high-grade lesions, 21 (18%) with positive pelvic/para-aortic lymph nodes, and 44 (37%) with SP or CC histologic findings. Results: The mean follow-up was 5.8 years (range 0.2-14.7). For the entire group, the 5- and 10-year cause-specific survival (CSS) rate was 75% and 69% and the disease-free survival (DFS) rate was 58% and 48%, respectively. When stratified by histologic features, the 5- and 10-year CSS rate for adenocarcinoma was 76% and 71%, and for serous papillary/CC subtypes, it was 74% and 63%, respectively (p=0.917). The 5- and 10-year DFS rate for adenocarcinoma was 60% and 50% and was 54% and 37% serous papillary/CC subtypes, respectively (p=0.498). For surgical Stage I-II, the 5-year CSS rate was 82% for adenocarcinoma and 87% for SP/CC features (p=0.480). For Stage III, it was 75% and 57%, respectively (p=0.129). Thirty-seven patients had a relapse, with the first site of failure the abdomen/pelvis in 14 (38%), lung in 8 (22%), extraabdominal lymph nodes in 7 (19%), vagina in 6 (16%), and other in 2 (5%). When stratified by histologic variant, 32% of patients with adenocarcinoma and 30% with the SP/CC subtype developed recurrent disease. Most

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes

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Graeme Kohler

2017-11-01

Full Text Available n a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. Methods The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs at decision-making points in primary healthcare (PHC based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. Results The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. Conclusion This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability.

Adipose-derived mesenchymal stromal cells from aged patients with coronary artery disease keep mesenchymal stromal cell properties but exhibit characteristics of aging and have impaired angiogenic potential.

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Efimenko, Anastasia; Dzhoyashvili, Nina; Kalinina, Natalia; Kochegura, Tatiana; Akchurin, Renat; Tkachuk, Vsevolod; Parfyonova, Yelena

2014-01-01

Tissue regeneration is impaired in aged individuals. Adipose-derived mesenchymal stromal cells (ADSCs), a promising source for cell therapy, were shown to secrete various angiogenic factors and improve vascularization of ischemic tissues. We analyzed how patient age affected the angiogenic properties of ADSCs. ADSCs were isolated from subcutaneous fat tissue of patients with coronary artery disease (CAD; n = 64, 43-77 years old) and without CAD (n = 31, 2-82 years old). ADSC phenotype characterized by flow cytometry was CD90(+)/CD73(+)/CD105(+)/CD45(-)/CD31(-) for all samples, and these cells were capable of adipogenic and osteogenic differentiation. ADSCs from aged patients had shorter telomeres (quantitative reverse transcription polymerase chain reaction) and a tendency to attenuated telomerase activity. ADSC-conditioned media (ADSC-CM) stimulated capillary-like tube formation by endothelial cells (EA.hy926), and this effect significantly decreased with the age of patients both with and without CAD. Angiogenic factors (vascular endothelial growth factor, placental growth factor, hepatocyte growth factor, angiopoetin-1, and angiogenin) in ADSC-CM measured by enzyme-linked immunosorbent assay significantly decreased with patient age, whereas levels of antiangiogenic factors thrombospondin-1 and endostatin did not. Expression of angiogenic factors in ADSCs did not change with patient age (real-time polymerase chain reaction); however, gene expression of factors related to extracellular proteolysis (urokinase and its receptor, plasminogen activator inhibitor-1) and urokinase-type plasminogen activator receptor surface expression increased in ADSCs from aged patients with CAD. ADSCs from aged patients both with and without CAD acquire aging characteristics, and their angiogenic potential declines because of decreasing proangiogenic factor secretion. This could restrict the effectiveness of autologous cell therapy with ADSCs in aged patients.

Seizure threshold and the half-age method in bilateral electroconvulsive therapy in Japanese patients.

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Yasuda, Kazuyuki; Kobayashi, Kaoru; Yamaguchi, Masayasu; Tanaka, Koichi; Fujii, Tomokazu; Kitahara, Yuichi; Tamaoki, Toshio; Matsushita, Yutaka; Nunomura, Akihiko; Motohashi, Nobutaka

2015-01-01

Seizure threshold (ST) in electroconvulsive therapy (ECT) has not been reported previously in Japanese patients. We investigated ST in bilateral ECT in Japanese patients using the dose-titration method. The associations between demographic and clinical characteristics and ST were analyzed to identify the predictors of ST. Finally, the validity of the half-age method for the stimulus dose was evaluated. Fifty-four Japanese patients with mood disorder, schizophrenia, and other psychotic disorders received an acute course of bilateral ECT using a brief-pulse device. ST was determined at the first session using a fixed titration schedule. ST was correlated with age, sex, body mass index, history of previous ECT, and psychotropic drugs on multiple regression analysis. Furthermore, the rate of accomplished seizures was calculated using the half-age method. Mean ST was 136 mC. ST was influenced by age, sex, history of previous ECT, and medication with benzodiazepines. The accomplished seizure rate using the half-age method was 72%, which was significantly lower in men and subjects on benzodiazepines. ST in Japanese patients was equal to or slightly higher than that previously reported in other ethnic groups, which might be attributable, at least in part, to high prevalence of and large-dose benzodiazepine prescription. Higher age, male gender, no history of ECT, and benzodiazepines were related to higher ST. The half-age method was especially useful in female patients and subjects without benzodiazepine medication. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Outcome and Risk Factors Presented in Old Patients Above 80 Years of Age Versus Younger Patients After Ischemic Stroke

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Bentsen, Line; Christensen, Louisa; Christensen, Anders

2014-01-01

. METHODS: The analysis was based on consecutive patients admitted within 6 hours after stroke onset and discharged with ischemic stroke, surviving at least 3 months after ictus. To prevent bias, the analysis was based on a registry from before implementation of tissue plasminogen activator treatment; all...... of age or older presented with significantly more severe strokes than younger patients, median Scandinavian Stroke Scale score 39 vs 42 (P = .003). Median mRS score before stroke was significantly higher in patients aged 80 years or older (P ictus (P...

The utility of the short version of the Depression Anxiety Stress Scales (DASS-21) in elderly patients with persistent pain: does age make a difference?

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Wood, Bradley M; Nicholas, Michael K; Blyth, Fiona; Asghari, Ali; Gibson, Stephen

2010-12-01

This study examined the assessment of the negative emotional constructs of depression, anxiety and stress with the short version (21 items) of the Depression Anxiety Stress Scales (DASS-21) in elderly patients (age > 60 years) with persistent pain. A convenience sample of 2,045 patients attending a tertiary referral pain centre were categorized by age and included a group aged 60 years and under (n=1,245) for assessment of age differences. Elderly patients (n=800) were divided into 3 groups: 61-70 years (n=366), 71-80 years (n=308) and 81 years and over (n=126). Patients completed the DASS-21 as part of an initial clinical assessment process. The failure rate for scale completion increased across age groups and was significantly higher in the oldest group compared to the youngest group. All scales demonstrated reasonable convergent and divergent validity. Confirmatory factor analysis confirmed a three-factor structure and is consistent with previous studies. Age differences in depression, anxiety and stress scores were also assessed. Interestingly, patients aged 60 years and under had significantly higher Depression and Stress scores compared to all other age groups. This group also had significantly higher Anxiety scores compared to patients aged 61-70 years. Overall, the DASS-21 is a reliable and valid measure of depression, anxiety and stress in elderly patients with persistent pain. There are some age differences in the normative values for the reporting of mood symptoms and these need to be taken into account when assessing pain-related mood disturbance in older populations. Wiley Periodicals, Inc.

131I therapy of teen-age hyperthyroidism: the primary results in 46 patients

International Nuclear Information System (INIS)

Wang Kaiming

2001-01-01

Objective: To explore various conditions of teen-age hyperthyroidism with 131 I therapy. Methods: 46 patients were administrated with 131 I, the changes of T 3 and T 4 level of serum were tested by radioimmunoassay. The improvement of clinical symptoms has been observed in 46 cases with teen-age hyperthyroidism by 131 I before and after treatment. Results: 39 of 46 (84%) has been proved complete responses (CR), partial responses (PR) 7 cases. 3 months later; we found that 39 patients have hypothyroidism symptoms, T 3 and T 4 level of serum decreased. There are significance increases of TSH 23 percent patients. Conclusion: It has been proved that treatment of teen-age hyperthyroidism by 131 I is effective and safe

Risk Factor Analysis for AKI Including Laboratory Indicators: a Nationwide Multicenter Study of Hospitalized Patients

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Sasa Nie

2017-10-01

Full Text Available Background/Aims: Risk factor studies for acute kidney injury (AKI in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. Methods: All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes’ definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality. Results: The morbidity of AKI was 0.97%. Independent risk factors for AKI were advancing age, male gender, hypertension, and chronic kidney disease. All-cause mortality was 16.5%. The predictors of mortality in AKI patients were advancing age, tumor, higher uric acid level and increases in Acute Physiologic Assessment and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. The hazard ratio (HR for mortality with uric acid levels > 9.1 mg/dl compared with ≤ 5.2 mg/dl was 1.78 (95% CI: 1.23 to 2.58 for the AKI patients as a group, and was 1.73 (95% CI: 1.24 to 2.42 for a propensity score-matched set. Conclusion: In addition to traditional risk factors, uric acid level is an independent predictor of all-cause mortality after AKI.

Radioactive iodine therapy for patients with Graves' disease aged 18 or younger

International Nuclear Information System (INIS)

Ogawa, Takahiro; Goshi, Kazuto; Tajiri, Junichi

2008-01-01

There have been few reports concerning radioactive iodine therapy (RI therapy) for Graves' disease in children, even in the United States of America (USA), and there have been no reports of such treatment in Japan. We evaluated the short-term results of RI therapy for Graves' disease aged 18 or younger. A total of 36 patients (10 male and 26 female) with Graves' disease, aged 18 and younger (range, 13 to 18 years; mean age, 15.8±1.5 years), received RI therapy on an outpatient basis at our clinic between July 1999 and July 2005. The mean interval from initiation of an antithyroid drug (ATD) to RI therapy was 25.3±21.5 months (range, 1 to 78 months). Twenty patients received therapy once, 14 twice, and 2 three times. The mean initial dose of radioactive iodine was 7.8±2.9 mCi (range, 3.6 to 13.0 mCi) and the mean total dose was 12.3±7.7 mCi (range, 3.6 to 29.8 mCi). The mean estimated weight of the thyroid gland was 42.6±23.4 g (range, 15.5 to 99.4 g) before RI therapy and 7.1±3.0 g (range, 2.0 to 13.6 g) after RI therapy. The mean follow-up period after RI therapy was 41.1±18.0 months (range, 6 to 71 months). Currently, 15 patients (42%) have hypothyroidism, 8 (22%) have subclinical hypothyroidism, 5 (14%) have euthyroidism, and 8 (22%) have subclinical hyperthyroidism. Patients taking thyroid hormone were considered hypothyroid. Patients with subclinical hypothyroidism are currently being monitored without treatment. No patients with subclinical hyperthyroidism are taking an ATD or KI (potassium iodide). A total of 36 patients with Graves' disease, aged 18 and younger, received RI therapy, and the short-term outcome in these patients were favorable. However, prolonged follow-up observation is required to confirm long-term safety. (author)

The reliability and validity of Chinese version of SF36 v2 in aging patients with chronic heart failure.

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Dong, Aishu; Chen, Sisi; Zhu, Lianlian; Shi, Lingmin; Cai, Yueli; Zeng, Jingni; Guo, Wenjian

2017-08-01

Chronic heart failure (CHF), a major public health problem worldwide, seriously limits health-related quality of life (HRQOL). How to evaluate HRQOL in older patients with CHF remains a problem. To evaluate the reliability and validity of the Chinese version of the Medical Outcomes Study Short Form version 2 (SF-36v2) in CHF patients. From September 2012 to June 2014, we assessed QOL using the SF-36v2 in 171 aging participants with CHF in four cardiology departments. Convergent and discriminant validity, factorial validity, sensitivity among different NYHA classes and between different age groups, and reliability were determined using standard measurement methods. A total of 150 participants completed a structured questionnaire including general information and the Chinese SF-36v2; 132 questionnaires were considered valid, while 21 patients refused to take part. 25 of the 50 participants invited to complete the 2-week test-retest questionnaires returned completed questionnaires. The internal consistency reliability (Cronbach's α) of the total SF-36v2 was 0.92 (range 0.74-0.93). All hypothesized item-subscale correlations showed satisfactory convergent and discriminant validity. Sensitivity was measured in different NYHA classes and age groups. Comparison of different NYHA classes showed statistical significance, but there was no significant difference between age groups. We confirmed the SF-36v2 as a valid instrument for evaluating HRQOL Chinese CHF patients. Both reliability and validity were strongly satisfactory, but there was divergence in understanding subscales such as "social functioning" because of differing cultural background. The reliability, validity, and sensitivity of SF-36v2 in aging patients with CHF were acceptable.

Aging well with smart technology.

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Cheek, Penny; Nikpour, Linda; Nowlin, Heather D

2005-01-01

As baby-boomers age, the need for long-term nursing care services increases. In the future, there will simply not be enough long-term care facilities to accommodate all of these patients. In addition, many people prefer to grow old at home, a concept known as aging-in-place. Smart home technology facilities aging-in-place by assisting patients with emergency assistance, fall prevention/detection, reminder systems, medication administration and assistance for those with hearing, visual or cognitive impairments. Benefits include making aging-in-place a reality, continuous monitoring, and improved psychosocial effects. Concerns of this technology include cost, availability of technology, retrofitting complications, and potential inappropriate use of the technology. Overall, the concept of smart homes is gaining in popularity and will expand the role of the nurse in the future. It is important for all nurses to understand how their practices will be transformed as smart homes become a reality for the aging population.

Endoscopic endonasal transsphenoidal surgery for patients aged over 80 years with pituitary adenomas: Surgical and follow-up results.

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Fujimoto, Kenji; Yano, Shigetoshi; Shinojima, Naoki; Hide, Takuichiro; Kuratsu, Jun-Ichi

2017-01-01

With the rapid aging of the general population, the number of pituitary adenoma (PA) diagnosed in elderly patients is increasing. The aim of this study was to evaluate the efficacy of endoscopic endonasal transsphenoidal surgery (ETSS) for PA in patients aged ≥80 years. We retrospectively reviewed the medical records of all patients aged ≥80 years who underwent ETSS for PA at our hospital from January 2001 through December 2014. Treatment results were assessed by the extent of surgical removal, symptom improvement, postoperative complications, and Karnofsky performance status (KPS). The results were also compared with the surgical result of PA patients aged <80 years. Twelve patients aged ≥80 years underwent ETSS for PA. Recovery of visual function was observed in 11 patients (91.7%). Postoperative cerebrospinal fluid (CSF) leakage was observed in 3 patients. New hormonal replacement therapy was required in 2 patients. These complications had not affected patient prognosis. During the follow-up periods, deterioration of KPS was observed in 2 patients due to pneumonia or cerebral infarction. In total, 150 PA patients aged <80 years were compared with the patients aged ≥80 years. The percentage of total removal was significantly higher in the younger patient group than that in the older one (54.0% vs 16.6%, respectively; P = 0.016). Visual improvement was observed in 93.2% of the younger patient group, which was almost equal to that in the older one. ETSS is a safe and effective surgical technique in PA patients aged ≥80 years.

Correlation of matrix metalloproteinases-1 and -3 with patient age and grade of lumbar disc herniation.

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Zigouris, Andreas; Batistatou, Anna; Alexiou, George A; Pachatouridis, Dimitrios; Mihos, Evaggelos; Drosos, Dimitrios; Fotakopoulos, George; Doukas, Michail; Voulgaris, Spyridon; Kyritsis, Athanasios P

2011-02-01

The authors studied the histological alterations and the expression of matrix metalloproteinase (MMP)-1 and MMP-3 in disc specimens of patients who had undergone operations for lumbar disc herniation. Forty-three lumbar disc specimens were evaluated histopathologically for degenerative changes and immunohistochemical expression of MMP-1 and MMP-3. The observed degenerative changes provided a degenerative score that was applied in each patient. Sections of disc immunostained for MMP-1 and MMP-3 were evaluated semiquantitatively. Patients were categorized in 3 age groups: 60 years of age. The expression of MMP-1 and MMP-3 were correlated to patient's age, degenerative score, and grade of lumbar disc herniation. There was no statistically significant difference in the degenerative score between the age groups. Degenerative changes were more pronounced in greater grades of herniation (p correlation between MMP-1 and MMP-3 expression and both degenerative score and herniation grade. For the group of patients 30-60 years of age, there was no significant difference between MMP-1 expression and degenerative score, but the correlation between MMP-1 expression and grade of herniation was significant. There was a significant correlation between MMP-3 expression and both degenerative score and herniation grade. Regarding the patients > 60 years of age, there was a significant correlation between MMP-1 and MMP-3 expression and both degenerative score and herniation grade. There was a significantly lower expression of both MMP-1 and MMP-3 in the group correlation was found in MMP-1 and MMP-3 expression between the groups of patients who were 30-60 and > 60 years of age. Interestingly, in age groups > 30 years, there were no statistically significant differences between the expression of MMP-1 and MMP-3, whereas in patients correlated to the age of the patients and the grade of herniation. An important finding in this study is the differential expression of MMP-1 and MMP-3

Distribution of the incidence and location of the Helicobacter pylori according to age and gender in patients who undergone endoscopy

Directory of Open Access Journals (Sweden)

Levent Demirtas

2014-09-01

Full Text Available Objective:The aim of this study was to define the distribution of the incidence and location of Helicobacter pylori in terms of the age and gender in the gastritis patients undergone endoscopy. Methods:Endoscopy and pathology reports of 1,405 patients who undergone biopsy of upper gastrointestinal system endoscopy were retrospectively examined. The frequency and location of Helicobacter pylori infection were evaluated according to the locations, gender and age groups. Based on the Sydney classification, the patients were scored as none (-, low (+, medium (++ and high (+++. Results: A total of 1405 patients (58.6% females, 41.4% males who had both antrum and corpus biopsies were included. Mean age was 48.58±16.96 (15-94 years. The Helicobacter pylori positivity was significantly higher in males than in the female patients (p=0.012. Helicobacter pylori positivity both in corpus and antrum was 1,101 (78.4%, Helicobacter pylori was negative in 304 (21.6% patients. Although, females had higher positivity rate, no significant difference was found between the age and gender groups. In 1,064 patients (75.7% Helicobacter pylori was positive while it was found as negative in 341 (24.3% biopsies taken from the antrum. While in 572 (40.7% of the biopsy outcomes taken from the corpus Helicobacter pylori was found as positive, it was found as negative in 833 (59.3%. No statistically significant differences were found between the age groups in terms of the positivity of Helicobacter pylori both in antrum and in corpus. Conclusion: In our study, the frequency of the Helicobacter pylori positivity was 78.4%. This can be accepted as a serious public health problem in terms of the associated diseases.

Radiotherapy in digestive tumours in elderly patients; Radiotherapie dans les tumeurs digestives chez le patient age

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Guillerme, F.; Clavier, J.B.; Nehme-Schuster, H.; Schumacher, C.; Noel, G. [Centre de lutte contre le cancer Paul-Strauss, Strasbourg (France)

2011-10-15

The authors comment the taking into care of a digestive cancer in the case of elderly patient. These patients are treated by radiotherapy, operative radiotherapy with concomitant chemotherapy, or pre-operative radiotherapy, depending on the age, on the cancer type, with an adaptation of the total dose or with a hypo-fractionation of the treatment. Short communication

Next-generation sequencing analysis of the ARMS2 gene in Turkish exudative age-related macular degeneration patients.

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Bardak, H; Gunay, M; Ercalik, Y; Bardak, Y; Ozbas, H; Bagci, O

2017-01-23

Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. It is a complex disease with both genetic and environmental risk factors. To improve clinical management of this condition, it is important to develop risk assessment and prevention strategies for environmental influences, and establish a more effective treatment approach. The aim of the present study was to investigate age-related maculopathy susceptibility protein 2 (ARMS2) gene sequences among Turkish patients with exudative AMD. In addition to 39 advanced exudative AMD patients, 250 healthy individuals for whom exome sequencing data were available were included as a control group. Patients with a history of known environmental and systemic AMD risk factors were excluded. Genomic DNA was isolated from peripheral blood and analyzed using next-generation sequencing. All coding exons of the ARMS2 gene were assessed. Three different ARMS2 sequence variations (rs10490923, rs2736911, and rs10490924) were identified in both the patient and control group. Within the control group, two further ARMS2 gene variants (rs7088128 and rs36213074) were also detected. Logistic regression analysis revealed a relationship between the rs10490924 polymorphism and AMD in the Turkish population.

Heterochronicity of white matter development and aging explains regional patient control differences in schizophrenia.

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Kochunov, Peter; Ganjgahi, Habib; Winkler, Anderson; Kelly, Sinead; Shukla, Dinesh K; Du, Xiaoming; Jahanshad, Neda; Rowland, Laura; Sampath, Hemalatha; Patel, Binish; O'Donnell, Patricio; Xie, Zhiyong; Paciga, Sara A; Schubert, Christian R; Chen, Jian; Zhang, Guohao; Thompson, Paul M; Nichols, Thomas E; Hong, L Elliot

2016-12-01

Altered brain connectivity is implicated in the development and clinical burden of schizophrenia. Relative to matched controls, schizophrenia patients show (1) a global and regional reduction in the integrity of the brain's white matter (WM), assessed using diffusion tensor imaging (DTI) fractional anisotropy (FA), and (2) accelerated age-related decline in FA values. In the largest mega-analysis to date, we tested if differences in the trajectories of WM tract development influenced patient-control differences in FA. We also assessed if specific tracts showed exacerbated decline with aging. Three cohorts of schizophrenia patients (total n = 177) and controls (total n = 249; age = 18-61 years) were ascertained with three 3T Siemens MRI scanners. Whole-brain and regional FA values were extracted using ENIGMA-DTI protocols. Statistics were evaluated using mega- and meta-analyses to detect effects of diagnosis and age-by-diagnosis interactions. In mega-analysis of whole-brain averaged FA, schizophrenia patients had lower FA (P = 10 -11 ) and faster age-related decline in FA (P = 0.02) compared with controls. Tract-specific heterochronicity measures, that is, abnormal rates of adolescent maturation and aging explained approximately 50% of the regional variance effects of diagnosis and age-by-diagnosis interaction in patients. Interactive, three-dimensional visualization of the results is available at www.enigma-viewer.org. WM tracts that mature later in life appeared more sensitive to the pathophysiology of schizophrenia and were more susceptible to faster age-related decline in FA values. Hum Brain Mapp 37:4673-4688, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Results of endoscopic third ventriculostomy in elderly patients ≥65 years of age.

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Niknejad, Hamid Reza; Depreitere, Bart; De Vleeschouwer, Steven; Van Calenbergh, Frank; van Loon, Johannes

2015-03-01

Endoscopic third ventriculostomy (ETV) has been accepted as the procedure of choice for the treatment of obstructive hydrocephalus in children and adults. The role and outcome of this procedure in the elderly has not been evaluated yet. Over an 11-year interval we retrospectively analyzed data of patients, 65+ years of age, who underwent ETV in our center. Success of the procedure was assessed in terms of symptom relief and/or elimination of the need for shunting. Additionally pre- and postoperative ventricular volumes were estimated using Evan's index (Ei) and fronto-occipital horn ratio (FOR). In our analysis we compared the results of the elderly patients with those of the pediatric and adult age groups treated in our center. We obtained data of 16 elderly cases (11 males, 5 females), mean age 72.8 years (66-83 years) out of the 91 patients treated with ETV in total. The success rate was 75% in this age group; mean follow-up 18.4 months (2-55 months). In 10 patients a mass lesion was the underlying cause of hydrocephalus. Mean ventricular size reduction was 18% and 13.5% (Ei and FOR) in the success group vs. 7.6% and 6.2% in the failure group. Three out of four patients who had shunting pre-EVT, became shunt independent post-operatively. The presence of flow void over the stoma was 100% correlated with success. All 7 patients with a primary or metastatic brain tumor were able to receive radiation therapy. Also in elderly, ETV is a safe and efficient procedure, with success rates similar to the younger population. Further research is required to set up a prognostic scoring system for this age group. Copyright © 2014 Elsevier B.V. All rights reserved.

Different postconditioning cycles affect prognosis of aged patients undergoing primary percutaneous coronary intervention.

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Zhang, Jie; Zhang, Xin; Cui, Yuqi; Ferdous, Misbahul; Cui, Lianqun; Zhao, Peng

2017-07-17

Postconditioning can affect the infarct size in acute myocardial infarction (AMI). However, few studies show an effect of different postconditioning cycles on AMI aged patients. This study sought to assess the effect of different postconditioning cycles on prognosis in aged patients with AMI who underwent primary percutaneous coronary intervention (PCI). 74 aged patients were randomly assigned to three groups. Control group; PC-1 group accepted postconditioning 4 cycles of 30 s inflation and 30 s deflation; PC-2 group accepted postconditioning 4 cycles of 60 s. Creatine kinase MB (CK-MB), troponin I (cTnI), high-sensitive C-reactive protein (hs-CRP) and corrected Thrombolysis in Myocardial Infarction (TIMI) frame counts (CTFC) were analyzed before andafter treatment. All patients received an echocardiographic examination for whole heart function, wall motion score index (WMSI) and single-photon emission computed tomography (SPECT) examination at 7 days and 6 months after treatment. S: The peak of CK-MB, postoperative 72 h cTnI and CTFC were significantly attenuated by postconditioning when compared with the control group. The hs-CRP of the postconditioning group was lower than the control group 24 h postoperative. No difference was observed between PC-1 and PC-2 group about the effect described above. At 7 days, heart function in the postconditioning group was improved when compared with the control group. At 6 months, the WMSI and SPECT score significantly reduced in the PC-2 group compared with the control and PC-1 groups, but there was no difference among the three groups about echo data except the left ventricular end-systolic diameter. Postconditioning is significantly beneficial to prognosis in aged patients with AMI. The cardiac protective effect of 4 cycles of 60 s procedure was observed in WMSI and SPECT. It is favorable to implement this procedure in aged patients with AMI in clinic.

Advanced glycation end product (AGE) modified proteins in tears of diabetic patients.

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Zhao, Zhenjun; Liu, Jingfang; Shi, Bingyin; He, Shuixiang; Yao, Xiaoli; Willcox, Mark D P

2010-08-11

High glucose level in diabetic patients may lead to advanced glycation end product (AGE) modified proteins. This study investigated AGE modified proteins in tears and compared their levels in diabetic patients (DM) with non-diabetic controls (CTL). Basal tears were collected from DM with (DR) or without (DNR) retinopathy and CTL. Total AGE modified proteins were detected quantitatively by a dot immunobinding assay. The AGE modified proteins were separated in 1D- and 2D-SDS gels and detected by western-blotting. The individual AGE modified proteins were also compared between groups using densitometry. Compared with the CTL group, tear concentrations of AGE modified proteins were significantly elevated in DR and DNR groups. The concentration of AGE modified proteins in diabetic tears were positively correlated with AGE modified hemoglobin (HbA1c) and postprandial blood glucose level (PBG). Western blotting of AGE modified proteins from 1D-SDS gels showed several bands, the major one at around 60 kDa. The intensities of AGE modified protein bands were higher in DM tears than in CTL tears. Western blotting from 2D-SDS gels showed a strongly stained horizontal strip, which corresponded to the major band in 1D-SDS gels. Most of the other AGE modified protein species were within molecular weight of 30-60 kDa, PI 5.2-7.0. Densitometry analysis demonstrated several AGE modified proteins were elevated in DR or DNR tears. Total and some individual AGE modified proteins were elevated in DM tears. AGE modified proteins in tears may be used as biomarkers to diagnose diabetes and/or diabetic retinopathy.

Autonomous nodule of the thyroid: correlation of patient age, nodule size, and functional status

International Nuclear Information System (INIS)

Blum, M.; Shenkman, L.; Hollander, C.S.

1975-01-01

In light of new techniques for measuring circulating thyroid hormones and for studying the thyroid gland, we present our experience with 35 patients with solitary autonomous nodules of the thyroid to define more precisely the clinical course of patients with this disorder. The patients ranged in age from 19 to 80 years and 31 of the 35 were female. Younger patients were generally euthyroid and sought attention because of a thyroid mass; virtually all older patients were hyperthyroid. Eighteen had obvious clinical features of hyperthyroidism and 5 over age 70 had apathetic hyperthyroidism; all 5 of the elderly and 13 of the 18 under age 70 had elevated thyroxine (T 4 ) and triiodothyronine (T 3 ) levels. Isolated elevation of T 3 and elevated basal metabolic rate were observed in 5 previously untreated clinically hyperthyroid young patients. In each of these, thyroid uptake of 131 I was not suppressible with exogenous T 3 and BMR was elevated in those tested. Two elderly patients, who had previously been treated for conventional hyperthyroidism with radioactive iodine, had T 3 toxicosis when hyperthyroidism recurred. There was a strong positive correlation between the age of the patient, the size of the nodule and the thyroid functional state. The mean area of the nodules projected on 131 I rectilinear scan for euthyroid patients was 5.1 cm 2 . The mean area of the nodules in hyperthyroid subjects was significantly higher, 13.4 cm 2 in patients with T 3 toxicosis and 19.3 cm 2 in subjects with conventional hyperthyroidism. Progression from a euthyroid state to hyperthyroidism was observed in four patients. One of these became thyrotoxic within days after an injection of iodinated contrast medium. Spontaneous resolution of nodules occurred in two patients

Visual pathway function and structure in Wolfram syndrome: patient age, variation and progression.

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Hoekel, James; Narayanan, Anagha; Rutlin, Jerrel; Lugar, Heather; Al-Lozi, Amal; Hershey, Tamara; Tychsen, Lawrence

2018-01-01

To report alterations in visual acuity and visual pathway structure over an interval of 1-3 years in a cohort of children, adolescents and young adults who have Wolfram syndrome (WFS) and to describe the range of disease severity evident in patients with WFS whose ages differed by as much as 20 years at first examination. Annual, prospective ophthalmological examinations were performed in conjunction with retinal nerve fibre layer (RNFL) analysis. Diffusion tensor MRI-derived fractional anisotropy was used to assess the microstructural integrity of the optic radiations (OR FA). Mean age of the 23 patients with WFS in the study was 13.8 years (range 5-25 years). Mean log minimum angle resolution visual acuity was 0.66 (20/91). RNFL thickness was subnormal in even the youngest patients with WFS. Average RNFL thickness in patients with WFS was 57±8 µ or ~40% thinner than that measured in normal (94±10 µ) children and adolescents (P<0.01). Lower OR FA correlated with worse visual acuity (P=0.006). Subsequent examinations showed declines (P<0.05) in visual acuity, RNFL thickness and OR FA at follow-up intervals of 12-36 months. However, a wide range of disease severity was evident across ages: some of the youngest patients at their first examination had deficits more severe than the oldest patients. The genetic mutation of WFS causes damage to both pregeniculate and postgeniculate regions of the visual pathway. The damage is progressive. The decline in visual pathway structure is accompanied by declines of visual function. Disease severity differs widely in individual patients and cannot be predicted from their age.

Combining macula clinical signs and patient characteristics for age-related macular degeneration diagnosis: a machine learning approach.

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Fraccaro, Paolo; Nicolo, Massimo; Bonetto, Monica; Giacomini, Mauro; Weller, Peter; Traverso, Carlo Enrico; Prosperi, Mattia; OSullivan, Dympna

2015-01-27

To investigate machine learning methods, ranging from simpler interpretable techniques to complex (non-linear) "black-box" approaches, for automated diagnosis of Age-related Macular Degeneration (AMD). Data from healthy subjects and patients diagnosed with AMD or other retinal diseases were collected during routine visits via an Electronic Health Record (EHR) system. Patients' attributes included demographics and, for each eye, presence/absence of major AMD-related clinical signs (soft drusen, retinal pigment epitelium, defects/pigment mottling, depigmentation area, subretinal haemorrhage, subretinal fluid, macula thickness, macular scar, subretinal fibrosis). Interpretable techniques known as white box methods including logistic regression and decision trees as well as less interpreitable techniques known as black box methods, such as support vector machines (SVM), random forests and AdaBoost, were used to develop models (trained and validated on unseen data) to diagnose AMD. The gold standard was confirmed diagnosis of AMD by physicians. Sensitivity, specificity and area under the receiver operating characteristic (AUC) were used to assess performance. Study population included 487 patients (912 eyes). In terms of AUC, random forests, logistic regression and adaboost showed a mean performance of (0.92), followed by SVM and decision trees (0.90). All machine learning models identified soft drusen and age as the most discriminating variables in clinicians' decision pathways to diagnose AMD. Both black-box and white box methods performed well in identifying diagnoses of AMD and their decision pathways. Machine learning models developed through the proposed approach, relying on clinical signs identified by retinal specialists, could be embedded into EHR to provide physicians with real time (interpretable) support.

Radiation therapy for the old aged patient suffered from carcinoma of the uterine cervix

International Nuclear Information System (INIS)

Arai, Tatsuo; Morita, Shinroku; Fukuhisa, Kenjiro; Wada, Susumu.

1984-01-01

Since a majority of old aged patients have the troublesome complications and their physical or mental emaciation is clearly appeared, it is necessary for them to adopt a new treatment method which was considered about thier such conditions. The crude survival rate of old aged, over 71, patients suffered from carcinoma of the uterine cervix were 63.6% (7/11) for stage 1, 60% (36/60) for stage 2, 50% (53/106) for stage 3 and 28.6% (8/28) for stage 4. About 20% of patients in each stages were suffered from the complications. We considered the treatment method for the old aged patients such as follows: the radiation dose must be reduced 10% for 71 to 75 year old and 20% for 76 to 80 year old. In the case of over 81 year old, an intracavitary irradiation is only applied for the palliative aim at the out patient clinic. (author)

The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery.

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Song, Inkyung; Kim, Dong Yeon; Kim, Youn Jin

2012-11-01

Inflation and deflation of a pneumatic tourniquet used in total knee replacement surgery induces various changes in patient's hemodynamic and metabolic status, which may result in serious complications, especially in aged patients. Near-infrared spectroscopy (NIRS) is a monitoring device designed to estimate the regional cerebral oxygen saturation. We evaluated the effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery, using NIRS. Twenty-eight American Society of Anesthesiologists physical status I or II patients, over the age of sixty-five years undergoing total knee replacement surgery, were included. Under general anesthesia, the mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), stroke volume (SV), and regional cerebral oxygen saturation (rSO(2)) were recorded before induction of anesthesia and every 2 min after tourniquet deflation for 20 min. Arterial blood gas analysis was performed 5 min before, in addition to 0, and 10 min after tourniquet deflation. The decrease of rSO(2) was not significant during 20-min deflation period. MAP, CO and SV showed significant decrease during 2 to 12, 4 to 6 and 2 to 6-min period after tourniquet deflation, respectively (P deflation caused significant changes in hemodynamic and metabolic status, but not in regional cerebral oxygen saturation. It is recommended to monitor neurologic status, as well as hemodynamic and metabolic status to avoid serious complications, especially in aged patients.

Age-related X-ray feature of the spine in patients with achondroplasia

International Nuclear Information System (INIS)

Shevtsov, V.I.; D'yachkova, G.V.; Novikova, O.S.

1999-01-01

Age-related X-ray features of the spine in patients with achondroplasia are studied. It gives the time course of changes in the shape of vertebrae, the specific features of apophyseal ossification, provides a quantitative account of the shorter caudal lumbar vertebral arch root distance symptom. The time course of changes in the size of the lumbosacral angle was examined. The findings suggest that there are not only considerable static changes in the spine of patients with achondroplasia, but also significant age-related features of vertebral tissue growth and differentiation [ru

Prevalence of dental fluorosis in children taking part in an oral health programme including fluoride tablet supplements from the age of 2 years

DEFF Research Database (Denmark)

Eckersten, Charlotte; Pylvänen, Lena; Schröder, Ulla

2010-01-01

To investigate the prevalence of dental fluorosis in children who had participated in an oral health programme between the ages 2-5 years, including fluoride tablets from the age of 2 years.......To investigate the prevalence of dental fluorosis in children who had participated in an oral health programme between the ages 2-5 years, including fluoride tablets from the age of 2 years....

Long-term (60-month results for the implantable miniature telescope: efficacy and safety outcomes stratified by age in patients with end-stage age-related macular degeneration

Directory of Open Access Journals (Sweden)

Boyer D

2015-06-01

adverse events included four corneal transplants, comprising two (2.9% in group 1 and two (1.6% in group 2. At 60 months, one patient in group 1 (3.2% and three patients in group 2 (9.4% had lost ≥2 lines of vision. The IMT was removed in one (1.4% and ten (7.9% patients in group 1 and group 2, respectively. Mean ECD loss was 20% at 3 months. Chronic loss was 3% per year. ECD loss was less in group 1 than in group 2 (35% versus 40%, respectively at 60 months.Conclusion: Long-term results show substantial retention of improvement in BDCVA. Chronic ECD loss was consistent with that reported for conventional intraocular lenses. The IMT performed as well in group 1 (the younger group as it did in group 2 through month 60. Younger patients retained more vision than their older counterparts and had fewer adverse events. Although not a specified outcome for this study, patients younger than 65 years also fared better than those in group 2 and retained more vision with fewer adverse events through month 60. Keywords: end-stage age-related macular degeneration, implantable miniature telescope, low vision

Food hypersensitivity in patients over 14 years of age suffering from atopic dermatitis.

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Celakovská, Jarmila; Ettler, K; Ettlerová, K; Vaněčková, J

2014-05-01

Patients suffering from atopic dermatitis often describe food hypersensitivity. Rising prevalence of food hypersensitivity and severe allergic reactions to foods have been reported, but the data are scarce. Evaluation of food hypersensitivity reactions in patients suffering from atopic dermatitis. The dermatological examination was performed in patients of age 14 years and above and the detailed history was taken concerning the food hypersensitivity. A total of 228 patients were examined-72 men, 156 women, average age 26.2 (SD 9.5) years. The food hypersensitivity reactions were recorded in 196 patients from 228 (86%), no reactions were recorded in 32 patients (24%). Foods with the most often recorded reactions are: Nuts (in 35% of patients), tomatoes (in 20%), and kiwi (in 17, 5%), apples and spices (in 16%), tangerines and oranges (in 15%), capsicum (in 13%), fishes (in 12%), celery (in 9%), and chocolate (in 7%). Food hypersensitivity reactions are recorded in 86% of patients suffering from atopic dermatitis. Nuts, tomatoes, and pollen-associated foods play a role in the majority of patients suffering from atopic dermatitis.

Do Additional Cardiac Surgical Procedures Increase the Surgical Risk in Patients 80 Years of age or Older Undergoing Coronary Bypass Gragting

Directory of Open Access Journals (Sweden)

Korhan Erkanlı

2014-03-01

Full Text Available Aim: In association with increasing life expectancy, the number of elderly individuals undergoing coronary bypass grafting (CABG and additional cardiac surgical procedures are increasing. In this study, we evaluated the effects of additional cardiac procedures and preoperative risk factors for postoperative mortality and morbidity in patients 80 years of age and older. Methods: The records of 29 patients aged 80 years and older (82.86±2.91 who had undergone coronary bypass surgery in the department of cardiac surgery between September 2009 and June 2012, were retrospectively reviewed. The subjects were divided into two groups: group 1 included the patients who had undergone CABG, group 2 consisted of those who had undergone CABG and additional cardiac procedures. Results: The mean age of the patients [14 male (48.3% 15 female (51.7%] was 82.86±2.91 years. The left internal thoracic artery was harvested for all patients. The mean number of graft per patient was 3.07±0.95. Carotid endarterectomy was performed in 3 patients before CABG. CABG and aortic valve replacement were performed in 1 patient. CABG, mitral valve replacement ant tricuspid plasty were performed in another patient. Furthermore, in one patient, abdominal aortic graft replacement due to ruptured abdominal aortic aneurysm and CABG was performed at the same session. The mean EuroSCORE was 5.06±5.16. Postoperative 30 days mortality was 6.8%, and the mean length of stay in hospital was 10.45±8.18 days. Conclusion: Coronary bypass surgery is an acceptable treatment method in patients 80 years of age and older. Although additional cardiac procedures may increase sugical risks, they can be successfully performed. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 14-8

Rehabilitation of patients aged 65 and over after total hip replacement

DEFF Research Database (Denmark)

Hørdam, Britta

by a randomised clinical trial by using telephone interviews and counseling postoperatively, and testing improvement in patients´health status after THR. The last study involved testing the effect of nursing intervention by providing a measurement of patients´healthrelated quality of life.......The overall aim of this thesis was to investigate improvement in health status of patients aged 65 and over after total hip replacement (THR) as a result of nursing rehabilitation. The projects conssits of three studies, first a description of patients´health status after THR, followed...

Phase I dose-escalation study of the c-Met tyrosine kinase inhibitor SAR125844 in Asian patients with advanced solid tumors, including patients with MET-amplified gastric cancer.

Science.gov (United States)

Shitara, Kohei; Kim, Tae Min; Yokota, Tomoya; Goto, Masahiro; Satoh, Taroh; Ahn, Jin-Hee; Kim, Hyo Song; Assadourian, Sylvie; Gomez, Corinne; Harnois, Marzia; Hamauchi, Satoshi; Kudo, Toshihiro; Doi, Toshihido; Bang, Yung-Jue

2017-10-03

SAR125844 is a potent and selective inhibitor of the c-Met kinase receptor. This was an open-label, phase I, multicenter, dose-escalation, and dose-expansion trial of SAR125844 in Asian patients with solid tumors, a subgroup of whom had gastric cancer and MET amplification (NCT01657214). SAR125844 was administered by intravenous infusion (260-570 mg/m 2 ) on days 1, 8, 15, and 22 of each 28-day cycle. Objectives were to determine the maximum tolerated dose (MTD) and to evaluate SAR125844 safety and pharmacokinetic profile. Antitumor activity was also assessed. Of 38 patients enrolled (median age 64.0 years), 22 had gastric cancer, including 14 with MET amplification. In the dose-escalation cohort ( N = 19; unselected population, including three patients with MET -amplification [two with gastric cancer and one with lung cancer]), the MTD was not reached, and the recommended dose was established at 570 mg/m 2 . Most frequent treatment-emergent adverse events (AEs) were nausea (36.8%), vomiting (34.2%), decreased appetite (28.9%), and fatigue or asthenia, constipation, and abdominal pains (each 21.1%); none appeared to be dose-dependent. Grade ≥ 3 AEs were observed in 39.5% of patients and considered drug-related in 7.9%. SAR125844 exposure increased slightly more than expected by dose proportionality; dose had no significant effect on clearance. No objective responses were observed in the dose-escalation cohort, with seven patients (three gastric cancer, two colorectal cancer, one breast cancer, and one with cancer of unknown primary origin) having stable disease. Modest antitumor activity was observed at 570 mg/m 2 in the dose-expansion cohort, comprising patients with MET -amplified tumors ( N = 19). Two gastric cancer patients had partial responses, seven patients had stable disease (six gastric cancer and one kidney cancer), and 10 patients had progressive disease. Single-agent SAR125844 administered up to 570 mg/m 2 has acceptable tolerability and modest

Fever in trauma patients: evaluation of risk factors, including traumatic brain injury.

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Bengualid, Victoria; Talari, Goutham; Rubin, David; Albaeni, Aiham; Ciubotaru, Ronald L; Berger, Judith

2015-03-01

The role of fever in trauma patients remains unclear. Fever occurs as a response to release of cytokines and prostaglandins by white blood cells. Many factors, including trauma, can trigger release of these factors. To determine whether (1) fever in the first 48 hours is related to a favorable outcome in trauma patients and (2) fever is more common in patients with head trauma. Retrospective study of trauma patients admitted to the intensive care unit for at least 2 days. Data were analyzed by using multivariate analysis. Of 162 patients studied, 40% had fever during the first 48 hours. Febrile patients had higher mortality rates than did afebrile patients. When adjusted for severity of injuries, fever did not correlate with mortality. Neither the incidence of fever in the first 48 hours after admission to the intensive care unit nor the number of days febrile in the unit differed between patients with and patients without head trauma (traumatic brain injury). About 70% of febrile patients did not have a source found for their fever. Febrile patients without an identified source of infection had lower peak white blood cell counts, lower maximum body temperature, and higher minimum platelet counts than did febrile patients who had an infectious source identified. The most common infection was pneumonia. No relationship was found between the presence of fever during the first 48 hours and mortality. Patients with traumatic brain injury did not have a higher incidence of fever than did patients without traumatic brain injury. About 30% of febrile patients had an identifiable source of infection. Further studies are needed to understand the origin and role of fever in trauma patients. ©2015 American Association of Critical-Care Nurses.

Age as a factor in assessing risks to patients from the use of x-rays

International Nuclear Information System (INIS)

Le Heron, J.

1996-01-01

Effective dose is currently widely used as a means of quantifying patient dose (and hence patient risk) in diagnostic radiology. Its appeal stems primarily from being able to normalise partial body irradiations into equivalent whole body irradiations, and additionally from being linked to a sound definition of radiation detriment. However there are several aspects of effective dose that should lead to its use being accompnied by a degree of caution. One such factor is age. Calculation of age specific tissue weighting factors for the tissues used in the formulation of effective dose show that the relative contributions of the tissues vary considerably as a function of age. When this is combined with age specific risk factors for cancers and hereditary effects, the implications of a given 'effective dose' for an x-ray procedure depend markedly on the age of the patient. Because of the elderly component of the patient population, the ensuing risks arising from diagnostic radiology are at a level considerably less than that assessed using the population-averaged approach. (author)

[Effects of Meek skin grafting on patients with extensive deep burn at different age groups].

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Di, H P; Niu, X H; Li, Q; Li, X L; Xue, J D; Cao, D Y; Han, D W; Xia, C D

2017-03-20

Objective: To investigate the effect of Meek skin grafting on patients with extensive deep burn at different age groups. Methods: Eighty-four patients with extensive deep burns conforming to the study criteria were hospitalized in our unit from April 2011 to April 2015. Patients were divided into children group (C, with age less than 12 years old), young and middle-aged group (YM, with age more than 18 years and less than 50 years old), and old age group (O, with age more than 55 years old) according to age, with 28 patients in each group. All patients received Meek skin grafting treatment. The use of autologous skin area, operation time, wound healing time, and hospitalization time were recorded. The survival rate of skin graft on post operation day 7, complete wound healing rate in post treatment week 2, and the mortality were calculated. Data were processed with one-way analysis of variance, t test, and χ (2) test. Results: The use of autologous skin area of patients in group C was (5.1±1.0)% total body surface area (TBSA), significantly less than (8.3±1.0)%TBSA and (8.3±1.4)%TBSA in groups YM and O, respectively (with t values 32.900 and 52.624, respectively, P values below 0.05). The operation time, wound healing time, and hospitalization time of patients in group C were (1.368±0.562) h, (9.6±0.6) and (32±11) d, significantly shorter than those in group YM [(3.235±0.011) h, (16.9±2.6) and (48±12) d, respectively] and group O [(3.692±0.481) h, (17.3±2.6) and (46±13) d, respectively, with t values from 4.350 to 21.160, P values below 0.05]. The survival rate of skin graft of patients on post operation day 7 in group C was (92±15)%, significantly higher than (81±10)% and (72±12)% in groups YM and O, respectively (with t values 5.509 and 3.229, respectively, P values below 0.05). The above indexes in groups YM and O were similar (with t values from 0.576 to 22.958, P values above 0.05). Complete wound healing rate in post treatment week 2 and the

Effects of age, comorbidity and adherence to current antimicrobial guidelines on mortality in hospitalized elderly patients with community-acquired pneumonia.

Science.gov (United States)

Han, Xiudi; Zhou, Fei; Li, Hui; Xing, Xiqian; Chen, Liang; Wang, Yimin; Zhang, Chunxiao; Liu, Xuedong; Suo, Lijun; Wang, Jinxiang; Yu, Guohua; Wang, Guangqiang; Yao, Xuexin; Yu, Hongxia; Wang, Lei; Liu, Meng; Xue, Chunxue; Liu, Bo; Zhu, Xiaoli; Li, Yanli; Xiao, Ying; Cui, Xiaojing; Li, Lijuan; Purdy, Jay E; Cao, Bin

2018-04-24

Limited information exists on the clinical characteristics predictive of mortality in patients aged ≥65 years in many countries. The impact of adherence to current antimicrobial guidelines on the mortality of hospitalized elderly patients with community-acquired pneumonia (CAP) has never been assessed. A total of 3131 patients aged ≥65 years were enrolled from a multi-center, retrospective, observational study initiated by the CAP-China network. Risk factors for death were screened with multivariable logistic regression analysis, with emphasis on the evaluation of age, comorbidities and antimicrobial treatment regimen with regard to the current Chinese CAP guidelines. The mean age of the study population was 77.4 ± 7.4 years. Overall in-hospital and 60-day mortality were 5.7% and 7.6%, respectively; these rates were three-fold higher in those aged ≥85 years than in the 65-74 group (11.9% versus 3.2% for in-hospital mortality and 14.1% versus 4.7% for 60-day mortality, respectively). The mortality was significantly higher among patients with comorbidities compared with those who were otherwise healthy. According to the 2016 Chinese CAP guidelines, 62.1% of patients (1907/3073) received non-adherent treatment. For general-ward patients without risk factors for Pseudomonas aeruginosa (PA) infection (n = 2258), 52.3% (1094/2090) were over-treated, characterized by monotherapy with an anti-pseudomonal β-lactam or combination with fluoroquinolone + β-lactam; while 71.4% of intensive care unit (ICU) patients (120/168) were undertreated, without coverage of atypical bacteria. Among patients with risk factors for PA infection (n = 815), 22.9% (165/722) of those in the general ward and 74.2% of those in the ICU (69/93) were undertreated, using regimens without anti-pseudomonal activity. The independent predictors of 60-day mortality were age, long-term bedridden status, congestive heart failure, CURB-65, glucose, heart rate, arterial oxygen

The clonic phase of seizures in patients treated with electroconvulsive therapy is related to age and stimulus intensity

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Chih-Chieh eTseng

2013-12-01

Full Text Available Background: Electroconvulsive therapy (ECT is effective in the treatment of major depressive disorder and schizophrenia in patients who are drug-naïve or less-receptive to antipsychotic drugs. Several studies have discussed the correlation between patient characteristics, input current volume and seizure duration. According to the present principle of ECT guidelines, the therapeutic effect of ECT mostly correlates with seizure duration. As the tonic phase is different from the clonic phase with respect to brain function and activity, it is informative to analyse both the tonic and clonic phases. Thus, this study sought to clarify the relationship between the features of the two phases, and to re-examine and refine guidelines regarding ECT treatment.Method: ECT-course data from 44 schizophrenia patients were recollected, including the number of treatments that they had received, their gender, age, and the association of these characteristics with motor seizure duration was analysed. A two-factor correlation was employed to test the relationship between each of the two factors.Result: The meta-analysis results indicate that seizure duration and age are significantly correlated. Older patients had relatively short seizure durations after ECT-treatment. Notably, a negative correlation was only found between age and the clonic phase of the seizure, not between age and the tonic phase. Furthermore, this study also found an inverse relationship between ECT-intensity and the clonic phase, but not between ECT-intensity and the tonic phase.Conclusion: This study demonstrated that age and ECT-intensity are negatively correlated with seizure duration, particularly in the clonic phase. The present observations are not fully consistent with the basic guidelines of the APA-ECT practical manual. Accordingly, the predictions regarding the therapeutic effect of ECT can be based on both the seizure duration and the clonic phase.

Genetic counselling, BRCA1/2 status and clinico-pathologic characteristics of patients with ovarian cancer before 50 years of age

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Cvelbar Mirjam

2017-05-01

Full Text Available In Slovenia like in other countries, till recently, personal history of epithelial ovarian cancer (EOC has not been included among indications for genetic counselling. Recent studies reported up to 17% rate of germinal BRCA1/2 mutation (gBRCA1/2m within the age group under 50 years at diagnosis. The original aim of this study was to invite to the genetic counselling still living patients with EOC under 45 years, to offer gBRCA1/2m testing and to perform analysis of gBRCA1/2m rate and of clinico-pathologic characteristics. Later, we added also the data of previously genetically tested patients with EOC aged 45 to 49 years.

Middle-aged patients with an MRI-verified medial meniscal tear report symptoms commonly associated with knee osteoarthritis

DEFF Research Database (Denmark)

Hare, Kristoffer B.; Stefan Lohmander, L.; Kise, Nina Jullum

2017-01-01

Background and purpose — No consensus exists on when to perform arthroscopic partial meniscectomy in patients with a degenerative meniscal tear. Since MRI and clinical tests are not accurate in detecting a symptomatic meniscal lesion, the patient’s symptoms often play a large role when deciding...... when to perform surgery. We determined the prevalence and severity of self-reported knee symptoms in patients eligible for arthroscopic partial meniscectomy due to a degenerative meniscal tear. We investigated whether symptoms commonly considered to be related to meniscus injury were associated...... with early radiographic signs of knee osteoarthritis. Patients and methods — We included individual baseline items from the Knee injury and Osteoarthritis Outcome Score collected in 2 randomized controlled trials evaluating treatment for an MRI-verified degenerative medial meniscal tears in 199 patients aged...

The state of cognitive functions in patients with adult onset type 2 diabetes mellitus depending on sex, age and level of education

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N.M. Zherdova

2017-08-01

Full Text Available Background. According to the meta-analysis of studies, patients with diabetes mellitus (DM have worse memory performance, information processing speed, executive functions compared to patients without DM. The level of education, the age of the patient are also important factors in the development of dementia. But research was conducted on selected populations, and the impact of demographic and social factors was studied in a particular area. The purpose of our work was to study the influence of sex, age, education level on the state of cognitive function in patients with type 2 DM in the Ukrainian population. Materials and methods. Eighty one patients with type 2 DM were examined, including 43 women and 38 men. Evaluation of the cognitive impairment was carried out in the morning using the following methods: a “5 words” test, a mental status assessment scale, a battery of tests for frontal dysfunction, an assessment of a clock drawing test. Results. The average age of patients was 55.03 ± 0.37 years, the average level of HbA1c — 8.75 ± 0.16 %, the average duration of DM — 10.03 ± 1.03 years. There was no reliable difference between men and women in the performance of neuropsychological tests. Also, no differences were found between the groups by age and level of education and the state of cognitive function. But the negative effect of age on cognitive function was found according to the Mini-Mental State Examination. Conclusions. A negative relationship between age and the state of cognitive functions was found. It is necessary to carry out further studies on the effect of other socio-cultural factors on the state of cognitive function in patients with type 2 DM.

Phenylalanine tolerance can already reliably be assessed at the age of 2 years in patients with PKU.

Science.gov (United States)

van Spronsen, F J; van Rijn, M; Dorgelo, B; Hoeksma, M; Bosch, A M; Mulder, M F; de Klerk, J B C; de Koning, T; Rubio-Gozalbo, M Estela; de Vries, M; Verkerk, P H

2009-02-01

The clinical severity of phenylalanine hydroxylase deficiency is usually defined by either pre-treatment phenylalanine (Phe) concentration or Phe tolerance at 5 years of age. So far, little is known about the course of Phe tolerance or the ability of both pre-treatment Phe and Phe tolerance at early age to predict Phe tolerance at later age. This study was conducted to investigate the course of the individual Phe tolerance and to assess the predictive value of both the pre-treatment Phe concentration and Phe tolerance at 1 and 6 months and 1, 2, 3 and 5 years for Phe tolerance at 10 years of age. Data on blood Phe concentration, prescribed Phe intake and weight of 213 early and continuously treated Dutch PKU patients up to 10 years of age were collected. Data acquired under good metabolic control were used in the study. Tolerance was expressed in mg/day and mg/kg per day. Data at 1 and 6 months and at 1, 2, 3 and 5 years of 61, 58, 59, 57, 56 and 59 patients were included for comparison with the Phe tolerance at 10 years. Phe tolerances (mg/kg per day) at 2, 3 and 5 years showed a clear correlation with the tolerance at 10 years of age (r = 0.608, r = 0.725 and r = 0.661). Results for tolerance expressed as mg/day were comparable. Pre-treatment Phe concentrations did not correlate significantly with the tolerance. Pre-treatment Phe is unreliable but Phe tolerance is a reliable predictor of the tolerance at 10 years of age, starting at 2 years of age.

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes.

Science.gov (United States)

Kohler, Graeme; Sampalli, Tara; Ryer, Ashley; Porter, Judy; Wood, Les; Bedford, Lisa; Higgins-Bowser, Irene; Edwards, Lynn; Christian, Erin; Dunn, Susan; Gibson, Rick; Ryan Carson, Shannon; Vallis, Michael; Zed, Joanna; Tugwell, Barna; Van Zoost, Colin; Canfield, Carolyn; Rivoire, Eleanor

2017-03-06

Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to

Usefulness of ultrasonography for detection of breast cancer in patients under 30 years of age

Energy Technology Data Exchange (ETDEWEB)

Kim, Ji Hyung; Oh, Ki Keun; Yoon, Sang Wook [Yongdong Severance Hospital, Seoul (Korea, Republic of)

1995-04-15

The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest reasonable guideline of breast imaging in breast cancer patients under 30 years of age in whom breast cancer shows different clinicopathologic characteristics compared with breast cancer in older women. Authors reviewed medical records of 27 patients under 30 years of age with pathologically-proven breast cancer. Age, family history, physical examination findings, indications for breast sonography were reviewed. Cases in whom breast cancer lesion is detectable and cases in whom not detectable using mammography or breast sonography were reviewed. And then, authors evaluated the usefulness of each method and reasons for nonvisualization of lesion on mammography. Among 27 patients, 25 patients had palpable breast mass as indication of mammography and breast sonography. Cancer lesions were detectable in 16 of 25 patients (64%) on mammography and 24 of 25 patients (96%) on breast ultrasonography. Reasons for nonvisualization of cancer lesions on mammography were dense breast with nodular parenchyma pattern and minimal breast change of ductal carcinoma in situ. In breast cancer patients under 30 years of age who have palpable breast mass as a initial, and main clinical problem, breast ultrasonography is superior to mammography in detecting and diagnosing breast cancer. We suggest that guidelines can avoid unnecessary mammography in these patients.

Usefulness of ultrasonography for detection of breast cancer in patients under 30 years of age

International Nuclear Information System (INIS)

Kim, Ji Hyung; Oh, Ki Keun; Yoon, Sang Wook

1995-01-01

The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest reasonable guideline of breast imaging in breast cancer patients under 30 years of age in whom breast cancer shows different clinicopathologic characteristics compared with breast cancer in older women. Authors reviewed medical records of 27 patients under 30 years of age with pathologically-proven breast cancer. Age, family history, physical examination findings, indications for breast sonography were reviewed. Cases in whom breast cancer lesion is detectable and cases in whom not detectable using mammography or breast sonography were reviewed. And then, authors evaluated the usefulness of each method and reasons for nonvisualization of lesion on mammography. Among 27 patients, 25 patients had palpable breast mass as indication of mammography and breast sonography. Cancer lesions were detectable in 16 of 25 patients (64%) on mammography and 24 of 25 patients (96%) on breast ultrasonography. Reasons for nonvisualization of cancer lesions on mammography were dense breast with nodular parenchyma pattern and minimal breast change of ductal carcinoma in situ. In breast cancer patients under 30 years of age who have palpable breast mass as a initial, and main clinical problem, breast ultrasonography is superior to mammography in detecting and diagnosing breast cancer. We suggest that guidelines can avoid unnecessary mammography in these patients

Midterm results of endovascular stent graft treatment for descending aortic aneurysms including high-risk patients

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Gussmann, Andreas

2006-04-01

Full Text Available Methods: 21 patients (17 men, 4 women; mean age 66.1 years, range 29-90 years with 15 true aneurysms, and 6 type B-dissections were treated by implantation of a TalentTM Endoluminal Stentgraft System from February 2000 to July 2003. In 3 cases it was necessary to overstent the left subclavian artery, in 1 case to overstent the left common carotid. Results: 2 patients (9.5% died during the first 30 days (1 myocardial infarction, 1 pneumonia. Two patients (9.5% suffered from cerebral ischemia and needed revascularisation. No paraplegia, no stroke occurred. One endoleak required additional stenting. No patient needed conversion. Follow-up, average 25.4 months (range 0-39, was 100% complete. During this another two patients died of myocardial infarction i.e. 9.5% (the above mentioned endoleak, but no late migration were detected in the remaining patients. In all cases the graft lumen stayed patent. Conclusions: Treatment of descending thoracic aortic aneurysm with an endovascular approach has acceptable mortality and morbidity-rates even in high risk patients. Procedural overstenting of the subclavian artery requires subclavian revascularisation in a minority of cases.

Clinicopathological and Prognostic Significance of Cancer Antigen 15-3 and Carcinoembryonic Antigen in Breast Cancer: A Meta-Analysis including 12,993 Patients

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Xuan Li

2018-01-01

Full Text Available Purpose. The prognostic role of serum cancer antigen 15-3 (CA15-3 and carcinoembryonic antigen (CEA in breast cancer remains controversial. In this study, we conducted a meta-analysis to investigate the prognostic value of these two markers in breast cancer patients. Methods. After electronic databases were searched, 36 studies (31 including information regarding CA15-3 and 23 including information regarding CEA with 12,993 subjects were included. Based on the data directly or indirectly from the available studies, the hazard ratios (HRs and odds ratios (ORs and their 95% confidence intervals (CIs were pooled according to higher or lower marker levels. Results. Elevated CA15-3 or CEA was statistically significant with poorer DFS and OS in breast cancer (multivariate analysis of OS: HR = 2.03, 95% CI 1.76–2.33 for CA15-3; HR = 1.79, 95% CI 1.46–2.20 for CEA; multivariate analysis of DFS: HR = 1.56, 95% CI 1.06–1.55 for CA15-3; HR = 1.77, 95% CI 1.53–2.04 for CEA. Subgroup analysis showed that CA15-3 or CEA had significant predictive values in primary or metastasis types and different cut-offs and included sample sizes and even the study publication year. Furthermore, elevated CA15-3 was associated with advanced histological grade and younger age, while elevated CEA was related to the non-triple-negative tumor type and older age. These two elevated markers were all associated with a higher tumor burden. Conclusions. This meta-analysis showed that elevated serum CA15-3 or CEA was associated with poor DFS and OS in patients with breast cancer, and they should be tested anytime if possible.

Prenatal Exposure to Organohalogens, Including Brominated Flame Retardants, Influences Motor, Cognitive, and Behavioral Performance at School Age

NARCIS (Netherlands)

Roze, Elise; Meijer, Lisethe; Bakker, Attie; Van Braeckel, Koenraad N. J. A.; Sauer, Pieter J. J.; Bos, Arend F.

2009-01-01

BACKGROUND: Organohalogen compounds (OHCs) are known to have neurotoxic effects on the developing brain. OBJECTIVE: We investigated the influence of prenatal exposure to OHCs, including brominated flame retardants, on motor, cognitive, and behavioral outcome in healthy children of school age.

Age-associated decrease in global DNA methylation in patients with major depression

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Tseng PT

2014-11-01

Full Text Available Ping-Tao Tseng,1,2,* Pao-Yen Lin,1,3,* Yu Lee,1 Chi-Fa Hung,1 For-Wey Lung,4,5 Cheng-Sheng Chen,6,7 Mian-Yoon Chong1 1Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 2Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s Home, Taiwan; 3Center for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; 4Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; 5Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan; 6Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 7Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan *These authors contributed equally to this work Background: Evidence has supported a role of DNA methylation in the pathophysiology of mood disorders. The purpose of the current study is to examine 5-methylcytosine (5-mc and 5-hydroxymethylcytosine (5-hmc levels in patients with major depressive disorder (MDD at different disease states.Methods: Forty-nine patients with MDD and 25 healthy control subjects were included. The severity in the disease was assessed by using the 17-item Hamilton Rating Scale of Depression (HAM-D (HAM-D ≥19 for severe MDD and HAM-D ≤7 for remitted MDD. The 5-mc and 5-hmc levels in leukocyte DNA were measured using an enzyme-linked immunosorbent assay-based method.Results: We found a significant decrease in 5-hmc and trends of decreasing 5-mc levels in patients with severe MDD compared to healthy controls (P=0.059 for 5-mc and P=0.013 for 5-hmc. The decrease in the level exists only in the older age group (P=0.035 for 5-mc and P=0.002 for 5-hmc but not in the younger age group (P=0.077 for 5-mc and P=0.620 for 5-hmc. In addition, the 5-mc level was found to be inversely correlated with disease severity (P=0.011.Conclusion: Our

Lower cognitive function in patients with age-related macular degeneration: a meta-analysis

Science.gov (United States)

Zhou, Li-Xiao; Sun, Cheng-Lin; Wei, Li-Juan; Gu, Zhi-Min; Lv, Liang; Dang, Yalong

2016-01-01

Objective To investigate the cognitive impairment in patients with age-related macular degeneration (AMD). Methods Relevant articles were identified through a search of the following electronic databases through October 2015, without language restriction: 1) PubMed; 2) the Cochrane Library; 3) EMBASE; 4) ScienceDirect. Meta-analysis was conducted using STATA 12.0 software. Standardized mean differences with corresponding 95% confidence intervals were calculated. All of the included studies met the following four criteria: 1) the study design was a case–control or randomized controlled trial (RCT) study; 2) the study investigated cognitive function in the patient with AMD; 3) the diagnoses of AMD must be provided; 4) there were sufficient scores data to extract for evaluating cognitive function between cases and controls. The Newcastle–Ottawa Scale criteria were used to assess the methodological quality of the studies. Results Of the initial 278 literatures, only six case–control and one RCT studies met all of the inclusion criteria. A total of 794 AMD patients and 1,227 controls were included in this study. Five studies were performed with mini-mental state examination (MMSE), two studies with animal fluency, two studies with trail making test (TMT)-A and -B, one study with Mini-Cog. Results of the meta-analysis revealed lower cognitive function test scores in patients with AMD, especially with MMSE and Mini-Cog test (P≤0.001 for all). The results also showed that differences in the TMT-A (except AMD [total] vs controls) and TMT-B test had no statistical significance (P>0.01). The Newcastle–Ottawa Scale score was ≥5 for all of the included studies. Based on the sensitivity analysis, no single study influenced the overall pooled estimates. Conclusion This meta-analysis suggests lower cognitive function test scores in patients with AMD, especially with MMSE and Mini-Cog test. The other cognitive impairment screening tests, such as animal fluency test and

Age-Related Differences of Maximum Phonation Time in Patients after Cardiac Surgery

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Kazuhiro P. Izawa

2017-12-01

Full Text Available Background and aims: Maximum phonation time (MPT, which is related to respiratory function, is widely used to evaluate maximum vocal capabilities, because its use is non-invasive, quick, and inexpensive. We aimed to examine differences in MPT by age, following recovery phase II cardiac rehabilitation (CR. Methods: This longitudinal observational study assessed 50 consecutive cardiac patients who were divided into the middle-aged group (<65 years, n = 29 and older-aged group (≥65 years, n = 21. MPTs were measured at 1 and 3 months after cardiac surgery, and were compared. Results: The duration of MPT increased more significantly from month 1 to month 3 in the middle-aged group (19.2 ± 7.8 to 27.1 ± 11.6 s, p < 0.001 than in the older-aged group (12.6 ± 3.5 to 17.9 ± 6.0 s, p < 0.001. However, no statistically significant difference occurred in the % change of MPT from 1 month to 3 months after cardiac surgery between the middle-aged group and older-aged group, respectively (41.1% vs. 42.1%. In addition, there were no significant interactions of MPT in the two groups for 1 versus 3 months (F = 1.65, p = 0.20. Conclusion: Following phase II, CR improved MPT for all cardiac surgery patients.

Age-Related Differences of Maximum Phonation Time in Patients after Cardiac Surgery.

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Izawa, Kazuhiro P; Kasahara, Yusuke; Hiraki, Koji; Hirano, Yasuyuki; Watanabe, Satoshi

2017-12-21

Background and aims: Maximum phonation time (MPT), which is related to respiratory function, is widely used to evaluate maximum vocal capabilities, because its use is non-invasive, quick, and inexpensive. We aimed to examine differences in MPT by age, following recovery phase II cardiac rehabilitation (CR). Methods: This longitudinal observational study assessed 50 consecutive cardiac patients who were divided into the middle-aged group (<65 years, n = 29) and older-aged group (≥65 years, n = 21). MPTs were measured at 1 and 3 months after cardiac surgery, and were compared. Results: The duration of MPT increased more significantly from month 1 to month 3 in the middle-aged group (19.2 ± 7.8 to 27.1 ± 11.6 s, p < 0.001) than in the older-aged group (12.6 ± 3.5 to 17.9 ± 6.0 s, p < 0.001). However, no statistically significant difference occurred in the % change of MPT from 1 month to 3 months after cardiac surgery between the middle-aged group and older-aged group, respectively (41.1% vs. 42.1%). In addition, there were no significant interactions of MPT in the two groups for 1 versus 3 months (F = 1.65, p = 0.20). Conclusion: Following phase II, CR improved MPT for all cardiac surgery patients.

Cervical Lordosis Actually Increases With Aging and Progressive Degeneration in Spinal Deformity Patients.

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Kim, Han Jo; Lenke, Lawrence G; Oshima, Yasushi; Chuntarapas, Tapanut; Mesfin, Addisu; Hershman, Stuart; Fogelson, Jeremy L; Riew, K Daniel

2014-09-01

Retrospective. The authors hypothesized that cervical lordosis (CL) would decrease with aging and increasing degeneration. It is theorized that with age and degeneration, the cervical spine loses lordosis and becomes progressively more kyphotic; however, no studies support these conclusions in patients with various spinal deformities. The authors performed a radiographic analysis of asymptomatic adults (referring to their cervical spine) of varying ages, with differing forms of spinal deformity to the thoracic/lumbar spine to see how cervical lordosis changes with increasing age. A total of 104 total spine EOS X-rays of adult (aged >18 years) spinal deformity patients without documented neck pain, prior neck surgery, or cervical deformity were reviewed. The researchers only reviewed EOS X-rays because they allow complete visualization from occiput to feet. Cervical lordosis, standard Cobb measurements, sagittal balance parameters, and cervical degeneration were quantified radiographically by the method previously described by Gore et al. Statistical analysis was performed with 1-way analysis of variance to compare significant differences between groups aged 60 years as well as changes in sagittal balance. A p-value 60 years, respectively; p 60 years, respectively; p < .01), with the highest degeneration at the C5-6 and C6-7 disc spaces (3.7 ± 3.3 and 3.2 ± 2.9, respectively; p < .01). This increase did not correlate with the increase in CL seen with aging (r = 0.02; p = .84). Cervical lordosis increased with aging in adult spinal deformity patients. There was no relationship between cervical degeneration and lordosis despite the strong relationship seen between increasing CL in older age groups. Copyright © 2014 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

Change of the State of the Natural Antioxidant Barrier of a Body and Psychological Parameters in Patients Aged above 60

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Katarzyna Porzych

2017-01-01

Full Text Available Background. The goal of this study is to assess the natural antioxidant barrier of the organism and selected psychological aspects of the aging process in patients above 60 years old. Methods. The study included a total of 52 patients aged above 60 (mean age 67 ± 3.4 and 32 healthy subjects (mean age 22 ± 3.4 as a control group. All patients underwent psychological assessment using Test of Attentional Performance version 2.3 (TAP 2.3, four subtests: alertness, cross-modal integration, neglect with central task, and working memory and biochemical analysis of venous blood concerning values of the selected parameters of oxidative stress (HT, GSH, GPXOS, GPXRBC, GRRBC1, SODRBC1, MDARBC1, NO2−/NO3−, and CP. Results. Disorders of attention were observed mainly in elderly people, but an assumption that elderly people have developed more efficient ways of working memory use than younger people may be true. Results showed the reduced effectiveness of the body’s natural antioxidant barrier in elderly people. Moderate positive and negative correlations among parameters of oxidative stress and psychological parameters were observed in the control group. Discussion. Intensification of the attention deficits and oxidative stress may be observed as one of the pathogenic factors of age-dependent diseases.

Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs.

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Giorlando, Francesco; Teister, Julia; Dodd, Seetal; Udina, Marc; Berk, Michael

2013-07-01

Hyponatraemia is a serious adverse event commonly reported in elderly people treated with serotonergic antidepressants. The mechanism, incidence and risk factors for antidepressant induced hyponatraemia are not fully understood. In a retrospective chart analysis, depressed patients aged >63 years were investigated for change in serum sodium levels between two time points, separated by a median period of 45.5 days, with the first specimen taken prior to treatment. Patients were grouped into three cohorts; treated with an SSRI or SNRI (n=77), treated with an antidepressant other than an SSRI or SNRI (n=54) and not treated with an antidepressant (n=128). For change in sodium level between measurements and total number of patients with hyponatraemia, there was no significant difference between cohorts. However, the rate of reduction of serum sodium levels between time points was significantly greater for SSRI and SNRI treated patients (pmodelling showed that the risk of hyponatraemia increases with increased age, female gender, and particularly the antidepressant agents sertraline and escitalopram. The findings are of clinical significance as they demonstrate that hyponatraemia can occur rapidly with antidepressants, and SSRI/SNRI medications induce more rapid changes. They support the use of electrolyte monitoring early in antidepressant treatment in patients receiving antidepressants.

Natural course of hypogonadism diagnosed during hospitalization in aged male patients.

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Iglesias, P; Prado, F; Muñoz, A; Guerrero, M T; Macías, M C; Ridruejo, E; Tajada, P; García-Arévalo, C; Díez, J J

2015-04-01

Our aim was to assess short-term natural course of hypogonadism diagnosed during hospitalization for acute disease in aged male patients after discharge. A group of 43 hypogonadal males, aged 86.7±5.7 year, was studied. Serum concentrations of testosterone (T) and gonadotropins (follicle-stimulating hormone, FSH, and luteinizing hormone, LH) were measured in every patient both at admission and one month after discharge. Mean serum T at entry was 115.4±48.0 ng/dl. Hypogonadism was hyper-, hypo-, and normogonadotropic in 20 (46.5%), 20 (46.5%), and 3 (7.0%) patients, respectively. One month after discharge serum T concentrations increased significantly (230.9±135.6 ng/dl, phypogonadism (n=16, 32.7%; 82.8±51.6 ng/dl, phypogonadism discovered during hospitalization spontaneously normalize their serum T concentrations one month after discharge. Serum gonadotropin concentrations also increased after discharge. Serum T levels at admission was an independent predictor for the normalization of serum T concentrations.

Quality of Life in Patients of Different Age Groups before and after Coronary Artery By-Pass Surgery

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Jovanovic-Markovic, Snežana; Peric, Dejan; Rasic, Dragisa; Novakovic, Tatjana; Dejanovic, Bogdan; Borzanovic, Milorad

2015-01-01

Purpose: The study evaluates the changes in quality of life (QOL) six months after coronary artery bypass grafting (CABG) related to the patients’ age. Methods: The total of 243 consecutive patients completed the Nottingham Health Profile Questionnaire part 1 before and six months after CABG. Postoperative questionnaire was completed by 226 patients. Patients were divided into four examined groups (<50, 50–59, 60–69 and ≥70 years), according to their age. Results: Six months after CABG, the quality of life in different sections has been significantly improved in most patients.The analysis of the relation between the age and the changes in QOL of patients six months after CABG showed a significant correlation among the patients’ age and the improvement of QOL in the sections of physical mobility (r = 0.18, p = 0.008), social isolation (r = 0.17, p = 0.01) and energy ( r = 0.21, p = 0.002). The most prominent improvement was found in older patients. The age was not an independent predictor of QOL deterioration after CABG. Conclusions: The most noticeable improvement of QOL six months after CABG was found in older patients. Age is not the independent predictor of deterioration of QOL after CABG. PMID:26328597

Clinical characteristics and long-term response to mood stabilizers in patients with bipolar disorder and different age at onset

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Dell’Osso, Bernardo; Buoli, Massimiliano; Riundi, Riccardo; D’Urso, Nazario; Pozzoli, Sara; Bassetti, Roberta; Mundo, Emanuela; Altamura, A Carlo

2009-01-01

Introduction Bipolar disorder (BD) is a prevalent, comorbid, and impairing condition. Potential predictors of response to pharmacological treatment are object of continuous investigation in patients with BD. The present naturalistic study was aimed to assess clinical features and long-term response to mood stabilizers in a sample of bipolar subjects with different ages at onset. Methods The study sample included 108 euthymic patients, diagnosed as affected by BD, either type I or II, according to the DSM-IV-TR, who were started on mood stabilizer treatment. Patients were followed-up for 24 months and the occurrence of any mood episode collected. At the end of the follow-up, patients were divided in 3 subgroups according to the age at onset (early-onset ≤30 years, middle-onset >30–≤45 years, and late-onset >45 years, respectively) and the long-term response to mood stabilizers was compared between them along with other clinical features. Results The three subgroups showed significant differences in terms of clinical and demographic features and, with respect to long-term response to mood stabilizers, the early-onset subgroup showed a better outcome in terms of reduction of major depressive episodes during the 24-month follow-up compared to the other subgroups (one way ANOVA, F = 3.57, p = 0.032). Conclusions Even though further controlled studies are needed to clarify the relationship between age at onset and outcome in BD, the present follow-up study suggests clinical peculiarities and different patterns of response to mood stabilizers across distinct subgroups of patients with BD and different ages at onset. PMID:19649214

Assessment of peritrochanteric high T2 signal depending on the age and gender of the patients

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Haliloglu, Nuray, E-mail: nurayunsal2@hotmail.co [Ankara University School of Medicine, Department of Radiology (Turkey); Inceoglu, Deniz; Sahin, Gulden [Ankara University School of Medicine, Department of Radiology (Turkey)

2010-07-15

Introduction: The aim of this study is to evaluate the incidence of peritrochanteric high T2 signal (peritrochanteric edema, peritendinitis) on routine MR imaging studies and to determine whether reporting peritrochanteric edema is always clinically relevant depending on the age and gender of the patients. Materials and methods: We evaluated 79 consecutive bilateral hip MR images performed in our department between January 2006 and December 2006 (57 female, 22 male patients, mean age 49 years). Each study was evaluated for areas of T2 hyperintensity representing edema around the greater trochanter. Patients with a known fracture, tumor, history of radiation therapy, history of hip surgery and prothesis were excluded from the study. Patients with signal intensity alterations within the thickened gluteus medius/minimus tendons (tendinitis) or peritrochanteric bursal fluid accumulation (bursitis) were also excluded. All patients were scanned with our routine MR imaging protocol for hip imaging. Results: In 55 of the 79 patients (70%) peritrochanteric edema was detected on MR images and 52 of these 55 patients (95%) had these changes on both hips. The median age was 56 years for the patients with peritrochanteric edema and 35.5 years for the patients without peritrochanteric edema. There was statistical significance between the median ages of the patients and a significant increased risk of peritrochanteric edema was found over 40 years of age. There was no significant difference between male and female patients. Conclusion: Bilateral peritrochanteric high T2 signal may be a part of the degeneration process and we suggest that it may not be necessarily reported if the clinical findings do not support greater trochanteric pain syndrome.

Assessment of peritrochanteric high T2 signal depending on the age and gender of the patients

International Nuclear Information System (INIS)

Haliloglu, Nuray; Inceoglu, Deniz; Sahin, Gulden

2010-01-01

Introduction: The aim of this study is to evaluate the incidence of peritrochanteric high T2 signal (peritrochanteric edema, peritendinitis) on routine MR imaging studies and to determine whether reporting peritrochanteric edema is always clinically relevant depending on the age and gender of the patients. Materials and methods: We evaluated 79 consecutive bilateral hip MR images performed in our department between January 2006 and December 2006 (57 female, 22 male patients, mean age 49 years). Each study was evaluated for areas of T2 hyperintensity representing edema around the greater trochanter. Patients with a known fracture, tumor, history of radiation therapy, history of hip surgery and prothesis were excluded from the study. Patients with signal intensity alterations within the thickened gluteus medius/minimus tendons (tendinitis) or peritrochanteric bursal fluid accumulation (bursitis) were also excluded. All patients were scanned with our routine MR imaging protocol for hip imaging. Results: In 55 of the 79 patients (70%) peritrochanteric edema was detected on MR images and 52 of these 55 patients (95%) had these changes on both hips. The median age was 56 years for the patients with peritrochanteric edema and 35.5 years for the patients without peritrochanteric edema. There was statistical significance between the median ages of the patients and a significant increased risk of peritrochanteric edema was found over 40 years of age. There was no significant difference between male and female patients. Conclusion: Bilateral peritrochanteric high T2 signal may be a part of the degeneration process and we suggest that it may not be necessarily reported if the clinical findings do not support greater trochanteric pain syndrome.

Food hypersensitivity in patients over 14 years of age suffering from atopic dermatitis

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Jarmila Čelakovská

2014-01-01

Full Text Available Background: Patients suffering from atopic dermatitis often describe food hypersensitivity. Rising prevalence of food hypersensitivity and severe allergic reactions to foods have been reported, but the data are scarce. Aims and Objectives: Evaluation of food hypersensitivity reactions in patients suffering from atopic dermatitis. Materials and Methods: The dermatological examination was performed in patients of age 14 years and above and the detailed history was taken concerning the food hypersensitivity. Results: A total of 228 patients were examined-72 men, 156 women, average age 26.2 (SD 9.5 years. The food hypersensitivity reactions were recorded in 196 patients from 228 (86%, no reactions were recorded in 32 patients (24%. Foods with the most often recorded reactions are: Nuts (in 35% of patients, tomatoes (in 20%, and kiwi (in 17, 5%, apples and spices (in 16%, tangerines and oranges (in 15%, capsicum (in 13%, fishes (in 12%, celery (in 9%, and chocolate (in 7%. Conclusion: Food hypersensitivity reactions are recorded in 86% of patients suffering from atopic dermatitis. Nuts, tomatoes, and pollen-associated foods play a role in the majority of patients suffering from atopic dermatitis.

Comparison of Aorta-sacral Promontory Distance with Age and BMI in Female Patients Undergoing CT

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Sneha Mary Varghese; Suresh Sukumar; Abhimanyu Pradhan

2017-01-01

Introduction: Sacral colpopexy is the gold standard procedure for pelvic organ prolapse. During sacral colpopexy, various complications such as haemorrhage can occur. Careful dissection of presacral space is essential to minimize complications. Aim: The aim of the study was to compare patient age and Body Mass Index (BMI) with Computed Tomography (CT) measured aorta-sacral promontory distance. Materials and Methods: From 172 samples data such as age and BMI of female patients aged 18 ye...

Unique transcriptomic response to sepsis is observed among patients of different age groups.

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Raymond, Steven L; López, María Cecilia; Baker, Henry V; Larson, Shawn D; Efron, Philip A; Sweeney, Timothy E; Khatri, Purvesh; Moldawer, Lyle L; Wynn, James L

2017-01-01

Sepsis is a major cause of morbidity and mortality, especially at the extremes of age. To understand the human age-specific transcriptomic response to sepsis, a multi-cohort, pooled analysis was conducted on adults, children, infants, and neonates with and without sepsis. Nine public whole-blood gene expression datasets (636 patients) were employed. Age impacted the transcriptomic host response to sepsis. Gene expression from septic neonates and adults was more dissimilar whereas infants and children were more similar. Neonates showed reductions in inflammatory recognition and signaling pathways compared to all other age groups. Likewise, adults demonstrated decreased pathogen sensing, inflammation, and myeloid cell function, as compared to children. This may help to explain the increased incidence of sepsis-related organ failure and death in adults. The number of dysregulated genes in septic patients was proportional to age and significantly differed among septic adults, children, infants, and neonates. Overall, children manifested a greater transcriptomic intensity to sepsis as compared to the other age groups. The transcriptomic magnitude for adults and neonates was dramatically reduced as compared to children and infants. These findings suggest that the transcriptomic response to sepsis is age-dependent, and diagnostic and therapeutic efforts to identify and treat sepsis will have to consider age as an important variable.

Association between age and risk of stroke or death from carotid endarterectomy and carotid stenting: a meta-analysis of pooled patient data from four randomised trials.

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Howard, George; Roubin, Gary S; Jansen, Olav; Hendrikse, Jeroen; Halliday, Alison; Fraedrich, Gustav; Eckstein, Hans-Henning; Calvet, David; Bulbulia, Richard; Bonati, Leo H; Becquemin, Jean-Pierre; Algra, Ale; Brown, Martin M; Ringleb, Peter A; Brott, Thomas G; Mas, Jean-Louis

2016-03-26

Age was reported to be an effect-modifier in four randomised controlled trials comparing carotid artery stenting (CAS) and carotid endarterectomy (CEA), with better CEA outcomes than CAS outcomes noted in the more elderly patients. We aimed to describe the association of age with treatment differences in symptomatic patients and provide age-specific estimates of the risk of stroke and death within narrow (5 year) age groups. In this meta-analysis, we analysed individual patient-level data from four randomised controlled trials within the Carotid Stenosis Trialists' Collaboration (CSTC) involving patients with symptomatic carotid stenosis. We included only trials that randomly assigned patients to CAS or CEA and only patients with symptomatic stenosis. We assessed rates of stroke or death in 5-year age groups in the periprocedural period (between randomisation and 120 days) and ipsilateral stroke during long-term follow-up for patients assigned to CAS or CEA. We also assessed differences between CAS and CEA. All analyses were done on an intention-to-treat basis. Collectively, 4754 patients were randomly assigned to either CEA or CAS treatment in the four studies. 433 events occurred over a median follow-up of 2·7 years. For patients assigned to CAS, the periprocedural hazard ratio (HR) for stroke and death in patients aged 65-69 years compared with patients younger than 60 years was 2·16 (95% CI 1·13-4·13), with HRs of roughly 4·0 for patients aged 70 years or older. We noted no evidence of an increased periprocedural risk by age group in the CEA group (p=0·34). These changes underpinned a CAS-versus CEA periprocedural HR of 1·61 (95% CI 0·90-2·88) for patients aged 65-69 years and an HR of 2·09 (1·32-3·32) for patients aged 70-74 years. Age was not associated with the postprocedural stroke risk either within treatment group (p≥0·09 for CAS and 0·83 for CEA), or between treatment groups (p=0·84). In these RCTs, CEA was clearly superior to CAS in

Age but not Philadelphia positivity impairs outcome in older/elderly patients with acute lymphoblastic leukemia in Sweden.

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Kozlowski, Piotr; Lennmyr, Emma; Ahlberg, Lucia; Bernell, Per; Hulegårdh, Erik; Karbach, Holger; Karlsson, Karin; Tomaszewska-Toporska, Beata; Åström, Maria; Hallböök, Heléne

2017-08-01

Older/elderly patients with acute lymphoblastic leukemia (ALL) are poorly represented in clinical trials. Using Swedish national leukemia registries, we investigated disease/patient characteristics, treatment choices, outcome, and the impact of an age-adapted protocol (introduced in 2009) in this population-based study of patients aged 55-85 years, diagnosed with ALL 2005-2012. Of 174 patients, 82% had B-phenotype, 11% Burkitt leukemia (excluded), and 7% T-phenotype. Philadelphia chromosome positivity (Ph+) occurred in 35%. Of the 155 B- and T-ALL patients, 80% were treated with intensive protocols, and 20% with a palliative approach. Higher age and WHO performance status ≥2 influenced the choice of palliation. Intensive, palliative, and both approaches resulted in complete remission rate 83/16/70% and 3-year overall survival (OS) 32/3/26%. The age-adapted protocol did not improve outcome. With intensive treatment, platelet count ≤35×10 9 /L and age ≥75 years were adverse prognostic factors for OS, Ph+ was not. Male sex was an adverse prognostic factor in the 55-64 year age-group. We report a high frequency of Ph+ in older/elderly patients, with no evidence of poorer outcome compared to Ph-negative disease. Overall prognosis for elderly patients with ALL remains dismal, despite the use of age-adapted treatment. © 2017 The Authors. European Journal of Haematology Published by John Wiley & Sons Ltd.

Assessment of serum lipids in patients with age related macular degeneration from Pakistan

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Ambreen, F.; Qureshi, I. Z.

2014-01-01

Objective: To determine serum lipids in patients with age related macular degeneration from Pakistani population. Methods: The study was a cross sectional, randomized and case-control. Selected subjects ages were >50 years and were normotensive, non-diabetic with no family history of any such disease and no complication of posterior ocular chamber other than age related macular degeneration (AMD). Controls were age matched healthy individuals with no symptoms of AMD. Diagnosis of AMD was done through conventional diagnostic techniques by professional ophthalmologists. Serum samples were analyzed for total cholesterol, triglycerides, LDL and HDL using commercially available kits. Data were compared with Student's t-test. Pearson correlation was calculated for relationship between different parameters. P<0.05 was considered significant. Results: Compared to controls, AMD patients had significantly greater total cholesterol concentration (p<0.041), and power HDL/LDL ratio (p<0.038), while serum triglycerides, HDL and LDL were non-significantly different from control subjects. Total cholesterol in AMD patients was significantly correlated with TG, LDL and HDL (p<0.0001). Conclusion: The study indicates that high cholesterol might be a predictor of AMD and can be a diagnostic parameter. (author)

Age- and Gender-Specific Prevalence of Risk Factors in Patients with First-Ever Ischemic Stroke in China

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Xiao-ying Yao

2012-01-01

Full Text Available Background. Evidences are accumulating that age and gender have great impact on the distribution of stroke risk factors. Such data are lacking in Chinese population. Methods. 1027 patients with first-ever ischemic stroke (IS were recruited and divided into young adult (80 years groups according to stroke onset ages. Vascular risk factors were collected and compared among groups. Results. Female patients were globally older than male patients at stroke onset and having higher prevalence of diabetes mellitus (DM, heart diseases, and atrial fibrillation (AF. However, females were less likely to drink heavily or smoke than males. Young patients had a much higher proportion of smoking and drinking than middle-aged and very old patients and the highest family history of hypertension, while very old patients had the highest prevalence of heart diseases and AF but lowest proportion of positive family history of vascular diseases. Hypertension and DM were equally frequent among three groups. Conclusion. Our study showed that vascular risk factors had a specific age and gender distribution pattern in Chinese IS patients. Secondary prevention strategy should emphasize on the control of different risk factors based on patient’s age and gender.

Age Features Of Peptic And Duodenal Ulcer Disease

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Е.А. Islamova

2009-12-01

Full Text Available Peptic ulcer disease is one of the most widespread diseases. 6-10 % of adult population in Russia suffer from it. Demographic processes in the Russian Federation determine the increase of patients' number aged over 60 with peptic ulcer disease. It counts 10-35 % of all patients with this disease. The modern views on pathogenesis of peptic ulcer disease, including factor of Helicobacter pylori, in patients of different age groups have been highlighted in the article. Pathogenetic features and clinical morphological manifestations of peptic ulcer disease in young and aged patients have been considered

Impact of age on efficacy of postoperative oxaliplatin-based chemotherapy in patients with rectal cancer after neoadjuvant chemoradiotherapy.

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Huang, Xuan-Zhang; Gao, Peng; Song, Yong-Xi; Sun, Jing-Xu; Chen, Xiao-Wan; Zhao, Jun-Hua; Ma, Bin; Wang, Jun; Wang, Zhen-Ning

2016-04-12

Clinical practice guidelines focusing on age-related adjuvant chemotherapy for rectal cancer are currently limited. The present study aimed to explore the impact of age on the efficacy of adjuvant oxaliplatin-based chemotherapy in patients with rectal cancer after neoadjuvant chemoradiotherapy. We performed a retrospective cohort analysis using data from the Surveillance, Epidemiology, and End Results-Medicare-linked database from 1992-2009. We enrolled patients with yp stages I-III rectal cancer who received neoadjuvant chemoradiotherapy and underwent curative resection. The age-related survival benefit of adding oxaliplatin to adjuvant 5-fluorouracil (5-FU) chemotherapy was evaluated using Kaplan-Meier survival analysis with propensity score-matching and Cox proportional hazards models. Comparing the oxaliplatin group with the 5-FU group, there were significant interactions between age and chemotherapy efficacy in terms of overall survival (OS) (p for interaction = 0.017) among patients with positive lymph nodes (ypN+). Adding oxaliplatin to 5-FU could prolong survival in patients aged rectal cancer who have already received neoadjuvant chemoradiotherapy and undergone curative resection, adding oxaliplatin to 5-FU could prolong OS in patients aged < 73 years and ypN+ category. However, adding oxaliplatin did not translate into survival benefits in patients age ≥ 73 years and ypN+ category, or in ypN- patients.

The changing face of orthostatic and neurocardiogenic syncope with age.

LENUS (Irish Health Repository)

Cooke, J

2012-01-31

AIM: Reports of the outcomes of syncope assessment across a broad spectrum of ages in a single population are scarce. It is our objective to chart the varying prevalence of orthostatic and neurocardiogenic syncope (NCS) as a patient ages. METHODS: This was a retrospective study. All consecutive patients referred to a tertiary referral syncope unit over a decade were included. Patients were referred with recurrent falls or orthostatic intolerance. Tilt tests and carotid sinus massage (CSM) were performed in accordance with best practice guidelines. RESULTS: A total of 3002 patients were included (1451 short tilt, 127 active stand, 1042 CSM and 382 prolonged tilt). Ages ranged from 11 to 91 years with a median (IQR) of 75 (62-81) years. There were 1914 females; 1088 males. Orthostatic hypotension (OH) was the most commonly observed abnormality (test positivity of 60.3%). Those with OH had a median (IQR) age of 78 (71-83) years. Symptomatic patients were significantly younger than asymptomatic (P = 0.03). NCS demonstrated a bimodal age distribution. Of 194 patients with carotid sinus hypersensitivity, the median age (IQR) was 77 (68-82) years. Those with vasovagal syncope (n = 80) had a median (IQR) age of 30 (19-44) years. There were 57 patients with isolated postural orthostatic tachycardia syndrome. Of the total patients, 75% were female. They had a median (IQR) age of 23 (17-29) years. CONCLUSION: We have confirmed, in a single population, a changing pattern in the aetiology of syncope as a person ages. The burden of disease is greatest in the elderly.

BURNOUT SYNDROME IN PATIENTS WITH WORKPLACE HYPERTENSION

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Yu. P. Zinchenko; E. I. Pervichko; O. D. Ostroumova

2016-01-01

Aim. To study the presence, severity and qualitative characteristics of «burnout syndrome» in patients with «workplace hypertension» (WPH), in comparison with patients with essential hypertension and healthy people.Material and methods. Untreated patients with hypertension stage II, degree 1-2 (n=170; age 32-52 years; mean age 46.7Ѓ}4.1 years) were examined. Group 1 included 85 patients with WPH (mean age 44.7Ѓ}4.3 years) and Group 2 included 85 patients without WPH (mean age 47.4Ѓ}4.5 years)...

The influence of general anesthesia on the brain in aged patients with previous ischemic cerebrovascular disease

International Nuclear Information System (INIS)

Kokubo, Yasuaki; Kayama, Takamasa; Kondo, Rei; Oki, Masato; Takaoka, Seiji

2008-01-01

Whenever we discuss the overall results of surgical treatment for unruptured cerebral aneurysms, especially in aged patients, we tend to consider advanced age or general anesthesia as causes for unfavorable results. There are no reports concerning ischemic stroke events following general anesthesia in aged patients with a prior history of cerebrovascular disease. The purpose of this study is to clarify the influence of general anesthesia on the brats in aged patients with a previous history of ischemic cerebrovascular disease. The subjects were 30 consecutive patients over 70 years of age with previous ischemic cerebrovascular disease who underwent various surgeries except brain and cardiac surgery under general anesthesia. The patients were 70 to 85 years old, with a mean age of 76. Twenty-three were men and 7 were women. Surgical procedures were 12 gastrointestinal, 6 orthopedic and 4 urogenital and others. The type of cerebrovascular disease evaluated by neuroradiologist and anesthesiologist based on MR imaging was devided as follows: 16 patients had minor stroke, 7 had transient ischemic attack/reversible ischemic neurological deficit (TIA/RIND) and 7 had asymptomatic cerebral infarction. MR angiography was also assessed to evaluate the main artery in the brain. Blood pressure and arterial blood gas (PaCO 2 ) during general anesthesia were analyzed, and the rate of systemic and neurological complications following general anesthesia were evaluated. MR angiography revealed no occlusion or severe stenosis of the main artery in the brain of any of the patients. The minimum systolic blood pressure showed less than 100 mmHg transiently for 5-20 minutes in 28 of 30 patients during general anesthesia. The minimum value was 65 mmHg maintained for 5 minutes. The minimum PaCO 2 during general anesthesia was as follows: 1 case 36 mmHg. There were no neurological complications following general anesthesia in this study. One of 30 patients (3.3%) had suffered from pneumonia

Outcomes of oblique lateral interbody fusion for degenerative lumbar disease in patients under or over 65 years of age.

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Jin, Chengzhen; Jaiswal, Milin S; Jeun, Sin-Soo; Ryu, Kyeong-Sik; Hur, Jung-Woo; Kim, Jin-Sung

2018-02-20

Oblique lateral interbody fusion (OLIF) offers the solution to problems of anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF). However, OLIF technique for degenerative spinal diseases of elderly patients has been rarely reported. The objective of this study was to determine the clinical and radiological results of OLIF technique for degenerative spinal diseases in patients under or over 65 years of age. Sixty-three patients who underwent OLIF procedure were enrolled, including 29 patients who were less than 65 years of age and 34 patients who were over 65 years of age. Fusion rate, change of disc height and lumbar lordotic angle, Numeric Rating Scale (NRS), return to daily activity, patient's satisfaction rate (PSR), and Oswestry disability index (ODI) were used to assess clinical and functional outcomes. The mean NRS scores for back and leg pain decreased, respectively, from 4.6 and 5.9 to 2.3 and 1.8 in the group A (less than 65 years) and from 4.5 and 6.8 to 2.6 and 2.2 in the group B (over 65 years) at the final follow-up period. The mean ODI scores improved from 48.4 to 24.0% in the group A and from 46.5 to 25.2% in the group B at the final follow-up period. In both groups, the NRS and ODI scores significantly changed preoperatively to postoperatively (p degenerative lumbar diseases in elderly patients showed favorable clinical and radiological outcomes.

No Excess Mortality in Patients Aged 50 Years and Older Who Received Treatment for Ductal Carcinoma In Situ of the Breast

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Esther Bastiaannet

2012-01-01

Full Text Available Background. The incidence of ductal carcinoma in situ (DCIS has increased at a fast rate.The aim of this study was to assess the incidence and treatment in the Netherlands and estimate the excess mortality risk of DCIS. Methods. From the Netherlands Cancer Registry, adult female patients (diagnosed 1997–2005 with DCIS were selected. Treatment was described according to age. Relative mortality at 10 years of follow-up was calculated by dividing observed mortality over expected mortality. Expected mortality was calculated using the matched Dutch general population. Results. Overall, 8421 patients were included in this study. For patients aged 50–64, and 65–74 an increase in breast-conserving surgery was observed over time (50 years experienced no excess mortality regardless of treatment (relative mortality 1.0. Conclusion. The present population-based study of almost 8500 patients showed no excess mortality in surgically treated women over 50 years with DCIS.

Community-acquired pneumonia in older patients: does age influence systemic cytokine levels in community-acquired pneumonia?

LENUS (Irish Health Repository)

Kelly, Emer

2009-03-01

Community-acquired pneumonia (CAP) is a major cause of death in the elderly. The age-related increase in comorbid illnesses plays a part but the effect of aging on the immune response may be equally important. We aimed to evaluate patients with CAP for evidence of a muted response to infection in elderly patients admitted to hospital compared with a younger patient group.

The role of the DLPFC in inductive reasoning of MCI patients and normal agings: an fMRI study.

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Yang, YanHui; Liang, PeiPeng; Lu, ShengFu; Li, KunCheng; Zhong, Ning

2009-08-01

Previous studies of young people have revealed that the left dorsolateral prefrontal cortex (DLPFC) plays an important role in inductive reasoning. An fMRI experiment was performed in this study to examine whether the left DLPFC was involved in inductive reasoning of MCI patients and normal aging, and whether the activation pattern of this region was different between MCI patients and normal aging. The fMRI results indicated that MCI patients had no difference from normal aging in behavior performance (reaction time and accuracy) and the activation pattern of DLPFC. However, the BOLD response of the DLPFC region for MCI patients was weaker than that for normal aging, and the functional connectivity between the bilateral DLPFC regions for MCI patients was significantly higher than for normal aging. Taken together, these results indicated that DLPFC plays an important role in inductive reasoning of aging, and the functional abnormity of DLPFC may be an earlier marker of MCI before structural alterations.

Glutamate-glutamine and GABA in brain of normal aged and patients with cognitive impairment.

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Huang, Dandan; Liu, Dan; Yin, Jianzhong; Qian, Tianyi; Shrestha, Susan; Ni, Hongyan

2017-07-01

To explore the changes of glutamate-glutamine (Glx) and gamma-aminobutyric acid (GABA) in the brain in normal old age and cognitive impairment using magnetic resonance spectroscopy (MRS). Seventeen normal young controls (NYC), 15 normal elderly controls (NEC), 21 patients with mild cognitive impairment (MCI) and 17 with Alzheimer disease (AD) patients were included in this study. Glx and GABA+ levels in the anterior cingulate cortex (ACC) and right hippocampus (rHP) were measured by using a MEGA-PRESS sequence. Glx/Cr and GABA+/Cr ratios were compared between NYC and NEC and between the three elderly groups using analysis of covariance (ANCOVA); the tissue fractions of voxels were used as covariates. The relationships between metabolite ratios and cognitive performance were analysed using Spearman correlation coefficients. For NEC and NYC groups, Glx/Cr and GABA+/Cr ratios were lower in NEC in ACC and rHP. For the three elderly groups, Glx/Cr ratio was lower in AD in ACC compared to NEC and MCI; Glx/Cr ratio was lower in AD in rHP compared to NEC. There was no significant decrease for GABA+/Cr ratio. Glx and GABA levels may decrease simultaneously in normal aged, and Glx level decreased predominantly in AD, and it is helpful in the early diagnosis of AD. • Glx and GABA levels may decrease simultaneously in normal aged. • Glx level may decrease predominantly in Alzheimer disease. • The balance in excitatory-inhibitory systems may be broken in AD. • Decreased Glx level may be helpful in early diagnosis of AD.

Patient-Reported Outcomes, Quality of Life, and Satisfaction Rates in Young Patients Aged 50 Years or Younger After Total Knee Arthroplasty.

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Goh, Graham Seow-Hng; Liow, Ming Han Lincoln; Bin Abd Razak, Hamid Rahmatullah; Tay, Darren Keng-Jin; Lo, Ngai-Nung; Yeo, Seng-Jin

2017-02-01

Recent studies have shown a discrepancy between traditional functional outcomes and patient satisfaction, with some reporting less than 85% satisfaction in older patients undergoing total knee arthroplasty (TKA). As native knee biomechanics are not completely replicated, the resulting functional limitations may cause dissatisfaction in higher-demand individuals. Few studies have recorded patient-reported outcomes, health-related quality of life scores, and patient satisfaction in a young population undergoing TKA. One hundred thirty-six primary TKAs were performed in 114 patients aged 50 years or younger (mean age, 47.0 years; range, 30-50 years) at a single institution. The main diagnoses were osteoarthritis (85%) and rheumatoid arthritis (10%). The range of motion, Knee Society Score, Oxford Knee Score, and Physical and Mental Component Scores of Short Form-36 increased significantly (P patients had good/excellent knee scores, 71.3% had good/excellent function scores, 94.9% met the minimal clinically important difference for the Oxford Knee Score, and 84.6% met the minimal clinically important difference for the Physical Component Score. We found that 88.8% of patients were satisfied with their surgeries, whereas 86.8% had their expectations fulfilled. Survivorship using revision as an end point was 97.8% at a mean of 7 years (range, 3-16 years). Patients aged 50 years or younger undergoing TKA can experience significant improvements in their quality of life, have their expectations met, and be satisfied with their surgeries, at rates similar to those of non-age-restricted populations. Surgeons should inform them of these benefits and the potential risk of revision surgery in the future, albeit increasingly shown to be low. Copyright © 2016 Elsevier Inc. All rights reserved.

Xeroderma pigmentosum and other diseases of human premature aging and DNA repair: Molecules to patients

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Niedernhofer, Laura J.; Bohr, Vilhelm A.; Sander, Miriam; Kraemer, Kenneth H.

2012-01-01

A workshop1 to share, consider and discuss the latest developments in understanding xeroderma pigmentosum and other human diseases caused by defects in nucleotide excision repair (NER) of DNA damage was held on September 21–24, 2010 in Virginia. It was attended by approximately 100 researchers and clinicians, as well as several patients and representatives of patient support groups. This was the third in a series of workshops with similar design and goals: to emphasize discussion and interaction among participants as well as open exchange of information and ideas. The participation of patients, their parents and physicians was an important feature of this and the preceding two workshops. Topics discussed included the natural history and clinical features of the diseases, clinical and laboratory diagnosis of these rare diseases, therapeutic strategies, mouse models of neurodegeneration, molecular analysis of accelerated aging, impact of transcriptional defects and mitochondrial dysfunction on neurodegeneration, and biochemical insights into mechanisms of NER and base excision repair. PMID:21708183

[Quality of life in patients with age-related macular degeneration - medical and social problem].

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Muzyka-Woźniak, Maria; Misiuk-Hojło, Marta; Wesolowska, Alicja

2011-01-01

Age-related macular degeneration (AMD) is a leading cause of blindness over the age of 50 in western countries. People with AMD are suffering from serious vision-related disability and their social life is compromised. The aim of our study was to assess quality of life (QoL) in patients with exudative AMD. The study group was 100 patients treated for AMD, the control group were 30 age and sex matched subjects without ophthalmic disorders. Patients were treated with anti-VEGF therapy, by means of National Eye Institute Visual Function Questionnaire (NEI VFQ-25). As well as visual function, the NEI-VFQ investigates social functioning, mental health and dependency. There was statistically significant difference in QoL overall score between study group and control group. Patients with AMD obtained 51.1 (+/- 20.5 ) overall score, control group reached 83.7 (+/- 11.7) overall score, p = 0.001. Detailed analysis of study group revealed low acceptance of the disease and strong dependency. QoL in patients with AMD assessed with NEI VFQ-25, is significantly impaired. Low quality of life and difficulties in performing daily activities point at the need of formal psychological and social care.

Sensorimotor control of tracking movements at various speeds for stroke patients as well as age-matched and young healthy subjects.

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Di Ao

Full Text Available There are aging- and stroke-induced changes on sensorimotor control in daily activities, but their mechanisms have not been well investigated. This study explored speed-, aging-, and stroke-induced changes on sensorimotor control. Eleven stroke patients (affected sides and unaffected sides and 20 control subjects (10 young and 10 age-matched individuals were enrolled to perform elbow tracking tasks using sinusoidal trajectories, which included 6 target speeds (15.7, 31.4, 47.1, 62.8, 78.5, and 94.2 deg/s. The actual elbow angle was recorded and displayed on a screen as visual feedback, and three indicators, the root mean square error (RMSE, normalized integrated jerk (NIJ and integral of the power spectrum density of normalized speed (IPNS, were used to investigate the strategy of sensorimotor control. Both NIJ and IPNS had significant differences among the four groups (P<0.01, and the values were ranked in the following order: young controls < age-matched controls patients patients, which could be explained by the stroke- and aging-induced increase in reliance on feedback control. The RMSE increased with the increase in the target speed and the NIJ and IPNS initially declined and then remained steady for all four groups, which indicated a shift from feedback to feedforward control as the target speed increased. The feedback-feedforward trade-off induced by stroke, aging and speed might be explained by a change in the transmission delay and neuromotor noise. The findings in this study improve our understanding of the mechanism underlying the sensorimotor control and neurological changes caused by stroke and aging.

Serum levels of Th1/Th2 cytokines in aged patients and their correlation with eczema development and clinical manifestation

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Wei-Gang Wang

2016-05-01

Full Text Available Objective: To investigate variations of Th1/Th2 cytokine levels, as well as their correlation with eczema development and clinical manifestation in aged patients. Methods: A total of 92 patients (above 60 years old with eczema diagnosed by the outpatient department of dermatology and venerology of our hospital were included as the eczema group, while 60 aged patients without eczema as the healthy group. Patients' serum levels of Th1/Th2 cytokines were examined for inter-group comparison and stratified analysis as per clinical manifestation. Results: Serum levels of interleukin (IL-2, IL-4, IL-10, IL-12, tumor necrosis factor (TNF- α and interferon (IFN- γ were all significantly higher in patients of the eczema group than the healthy group. Acute stage levels of IL-2, IL-4, IL-10 and IFN-γ were significantly higher in patients of the eczema group than the healthy group. There was no significant difference in the levels of IL-12 and TNF-α between patients of the acute stage and those of the chronic stage. And no significant difference existed in the levels of IL-2, IL-4, IL-10, IL-12, TNF-α and IFN-γ between generalized and localized eczema patients. Conclusion: Compared with the healthy population, Th1/Th2 cytokine levels are significantly different in eczema patients, especially those in the acute stage.

Effect of age on left ventricular function during exercise in patients with coronary artery disease

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Hakki, A.H.; DePace, N.L.; Iskandrian, A.S.

1983-01-01

The purpose of this study was to assess the effect of age on left ventricular performance during exercise in 79 patients with coronary artery disease (greater than or equal to 50% narrowing of one or more major coronary arteries). Fifty patients under the age of 60 years (group I) and 29 patients 60 years or older (group II) were studied. Radionuclide angiograms were obtained at rest and during symptom-limited upright bicycle exercise. The history of hypertension, angina or Q wave myocardial infarction was similar in both groups. Multivessel coronary artery disease was present in 30 patients (60%) in group I and in 19 patients (66%) in group II (p . not significant). There were no significant differences between the two groups in the hemodynamic variables (at rest or during exercise) of left ventricular ejection fraction, end-diastolic volume, end-systolic volume and cardiac index. Exercise tolerance was higher in group I than in group II (7.8 +/- 0.4 versus 5.7 +/- 0.4 minutes, p . 0.009), although the exercise heart rate and rate-pressure product were not significantly different between the groups. There was poor correlation between age and ejection fraction, end-diastolic volume and end-systolic volume at rest and during exercise. Abnormal left ventricular function at rest or an abnormal response to exercise was noted in 42 patients (84%) in group I and in 25 patients (86%) in group II (p . not significant). Thus, in patients with coronary artery disease, age does not influence left ventricular function at rest or response to exercise. Older patients with coronary artery disease show changes in left ventricular function similar to those in younger patients with corresponding severity of coronary artery disease

Hormonal Modulation in Aging Patients with Erectile Dysfunction and Metabolic Syndrome

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Inês Campos Costa

2013-01-01

Full Text Available Erectile dysfunction (ED, metabolic syndrome (MetS, and hypogonadism are closely related, often coexisting in the aging male. Obesity was shown to raise the risk of ED and hypogonadism, as well as other endocrinological disturbances with impact on erectile function. We selected 179 patients referred for ED to our andrology unit, aiming to evaluate gonadotropins and estradiol interplay in context of ED, MetS, and hypogonadism. Patients were stratified into groups in accordance with the presence (or not of MetS and/or hypogonadism. Noticeable differences in total testosterone (TT and free testosterone (FT levels were found between patients with and without MetS. Men with MetS evidenced lower TT circulating levels with an increasing number of MetS parameters, for which hypertriglyceridemia and waist circumference strongly contributed. Regarding the hypothalamic-pituitary-gonadal axis, patients with hypogonadism did not exhibit raised LH levels. Interestingly, among those with higher LH levels, estradiol values were also increased. Possible explanations for this unexpected profile of estradiol may be the age-related adiposity, other estrogen-raising pathways, or even unknown mechanisms. Estradiol is possibly a molecule with further interactions beyond the currently described. Our results further enlighten this still unclear multidisciplinary and complex subject, raising new investigational opportunities.

Effects of Diabetes Mellitus, Age, and Duration of Dialysis on Parathormone in Chronic Hemodialysis Patients

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Nasri Hamid

2008-01-01

Full Text Available Secondary hyperparathyroidism (SHPTH can develop early in the course of chronic renal failure and becomes more prominent as kidney function declines. We studied the effect of diabetes, age, and dialysis on parathyroid function in 60 (21 women, 39 males; 44 non-diabetic, 16 diabetic hemodialysis (HD patients. Serum intact PTH (iPTH, calcium, phosphorus, alkaline phosphatase (ALP, and magnesium (Mg were measured. Adequacy of HD was evaluated by calculating the urea reduction rate (URR. There were significantly lower values of serum iPTH, ALP, and dialysis adequacy among diabetic than non-diabetes HD patients. In addition, there were an inverse correlation of age and serum iPTH (r= -0.27, p= 0.034 as well as age and serum phosphorus (r= -0.28, p= 0.031. There was also a positive correlation between serum iPTH with the duration (r= 0.001, p=0.42 and doses of dialysis treatment (r= 0.38, p= 0.002. We conclude that a significant negative correlation between age and serum phosphorus and lower parathyroid activity in diabetic HD patients, which implies more prevalence of bone disease in elderly diabetic HD patients. Further study of bone disease in this group of patients is required to evaluate its effect on outcome and different therapeutic interventions.

Comparison of the prevalence of islet autoantibodies according to age and disease duration in patients with type 1 diabetes mellitus

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Young Hwa Kong

2013-06-01

Full Text Available PurposeThis study investigated the prevalence of islet autoantibodies in children and adults with T1DM according to their age and the duration of disease.MethodsWe measured the levels of islet autoantibodies, including antiglutamic acid decarboxylase antibody (anti-GAD Ab, and combined these with anthropometric measurements and laboratory tests of 137 patients newly diagnosed with T1DM during the last 20 years. The subjects were subdivided into four groups according to their age at the onset of the disease. We then compared the prevalence of islet autoantibodies in the different age groups with the duration of disease.ResultsAmong the 137 patients, 68.9% tested positive for islet autoantibodies (71.4% within 1 year; 67.7% after 1 year of the disease onset. Within 1 year of the onset of the disease, 66.3% of the patients were positive for the anti-GAD Ab, and 35.6% were positive for IAAs. The prevalence of islet autoantibodies was significantly higher in the prepubertal groups than in the postpubertal groups (80.0% vs. 58.3%. The rate of positive islet autoantibodies changed with the duration of disease, and it differed according to the type of autoantibody and the age of the patient.ConclusionThe rates of positive islet autoantibodies were significantly higher in younger than in older patients at the time of the diagnosis of the disease. The positive rates were significantly changed 1 year after the onset of the disease in the preschool and the children groups. So these findings suggest that we need to diagnose type 1B diabetes distinguished T2DM in aldolescent group, carefully.

Age is not a limiting factor for brachytherapy for carcinoma of the node negative oral tongue in patients aged eighty or older

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Kakimoto Naoya

2010-12-01

Full Text Available Abstract Background To examine the role of brachytherapy for aged patients 80 or more in the trend of rapidly increasing number. Methods We examined the outcomes for elderly patients with node negative oral tongue cancer (T1-3N0M0 treated with brachytherapy. The 21 patients (2 T1, 14 T2, and 5 T3 cases ranged in age from 80 to 89 years (median 81, and their cancer was pathologically confirmed. All patients underwent definitive radiation therapy, with low dose rate (LDR Ra-226 brachytherapy (n = 4; median 70Gy, with Ir-192 (n = 12; 70Gy, with Au-198 (n = 1 or with high dose rate (HDR Ir-192 brachytherapy (n = 4; 60 Gy. Eight patients also underwent external radiotherapy (median 30 Gy. The period of observation ranged from 13 months to 14 years (median 2.5 years. We selected 226 population matched younger counterpart from our medical chart. Results Definitive radiation therapy was completed for all 21 patients (100%, and acute grade 2-3 mucositis related to the therapy was tolerable. Local control (initial complete response was attained in 19 of 21 patients (90%. The 2-year and 5-year local control rates were 91%, (100% for T1, 83% for T2 and 80% for T3 tumors after 2 years. These figures was not inferior to that of younger counterpart (82% at 5-year, n.s.. The cause-specific survival rate was 83% and the regional control rate 84% at the 2-years follow-up. However, 12 patients died because of intercurrent diseases or senility, resulting in overall survival rates of 55% at 2 years and 34% at 5 years. Conclusion Age is not a limiting factor for brachytherapy for appropriately selected elderly patients, and brachytherapy achieved good local control with acceptable morbidity.

Effect of Age on Glasgow Coma Scale in Patients with Moderate and Severe Traumatic Brain Injury: An Approach with Propensity Score-Matched Population

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Cheng-Shyuan Rau

2017-11-01

Full Text Available Background: The most widely used methods of describing traumatic brain injury (TBI are the Glasgow Coma Scale (GCS and the Abbreviated Injury Scale (AIS. Recent evidence suggests that presenting GCS in older patients may be higher than that in younger patients for an equivalent anatomical severity of TBI. This study aimed to assess these observations with a propensity-score matching approach using the data from Trauma Registry System in a Level I trauma center. Methods: We included all adult patients (aged ≥20 years old with moderate to severe TBI from 1 January 2009 to 31 December 2016. Patients were categorized into elderly (aged ≥65 years and young adults (aged 20–64 years. The severity of TBI was defined by an AIS score in the head (AIS 3‒4 and 5 indicate moderate and severe TBI, respectively. We examined the differences in the GCS scores by age at each head AIS score. Unpaired Student’s t- and Mann–Whitney U-tests were used to analyze normally and non-normally distributed continuous data, respectively. Categorical data were compared using either the Pearson chi-square or two-sided Fisher’s exact tests. Matched patient populations were allocated in a 1:1 ratio according to the propensity scores calculated using NCSS software with the following covariates: sex, pre-existing chronic obstructive pulmonary disease, systolic blood pressure, hemoglobin, sodium, glucose, and alcohol level. Logistic regression was used to evaluate the effects of age on the GCS score in each head AIS stratum. Results: The study population included 2081 adult patients with moderate to severe TBI. These patients were categorized into elderly (n = 847 and young adults (n = 1234: each was exclusively further divided into three groups of patients with head AIS of 3, 4, or 5. In the 162 well-balanced pairs of TBI patients with head AIS of 3, the elderly demonstrated a significantly higher GCS score than the young adults (14.1 ± 2.2 vs. 13.1 ± 3

Impact of Advanced Age on Procedural and Acute Angiographic Outcomes in Patients Treated for Peripheral Artery Disease With Orbital Atherectomy: A CONFIRM Registries Subanalysis.

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Lee, Michael S; Beasley, Robert; Adams, George L

2015-08-01

Data on the outcomes of elderly patients with peripheral arterial disease (PAD) who undergo orbital atherectomy are limited. This analysis compares the procedural and acute angiographic outcomes of PAD patients treated with orbital atherectomy stratified by age (≥ 75 years of age [elderly] vs atherectomy. The composite rate of adverse events including dissection, perforation, slow flow, vessel closure, spasm, embolism, and thrombus formation was compared between groups. Elderly patients had a higher proportion of females (47.5% vs 35.3%; Patherectomy resulted in similar composite rates of adverse events despite the elderly having unfavorable baseline Rutherford classification and lesion characteristics. The higher rate of perforation may be explained by longer and more below-the-knee lesions.

Physical activity patterns in patients with early and late age-related macular degeneration

DEFF Research Database (Denmark)

Subhi, Yousif; Sørensen, Torben Lykke

2016-01-01

INTRODUCTION: Age-related macular degeneration (AMD) leads to visual impairment that affects visual functioning and thereby the ability to be physically active. We investigated physical activity patterns in patients with AMD. METHODS: Patients with early and late AMD and elderly controls were...

Analysis of spirometry results in hospitalized patients aged over 65 years

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Wróblewska I

2015-06-01

Full Text Available Izabela Wróblewska,1 Piotr Oleśniewicz,2 Donata Kurpas,3 Mariusz Sołtysik,2 Jerzy Błaszczuk41Faculty of Health Science, Wroclaw Medical University, 2Institute of Tourism and Recreation, University School of Physical Education in Wroclaw, 3Department of Family Medicine, 4Faculty of Postgraduate Medical Training, Wroclaw Medical University, Wroclaw, Lower Silesia, PolandIntroduction and objective: The growing population of the elderly, as well as the occurrence of coexisting diseases and polypharmacy, is the reason why diseases of patients aged ≥65 years belong to the major issues of the contemporary medicine. Among the most frequent diseases of the elderly, there are respiratory system diseases. They are difficult to diagnose because of the patient group specificity, which is the reason for increased mortality among seniors, caused by underdiagnosis. The study objective was to assess the factors influencing spirometry results in hospitalized patients aged ≥65 years with respiratory system disorders.Material and methods: In the research, 217 (100% patients aged ≥65 years who underwent spirometry at the Regional Medical Center of the Jelenia Góra Valley Hospital in Poland were analyzed. In the statistical analysis, the STATISTICA 9.1 program, the t-test, the Shapiro–Wilk test, the ANOVA test, and the Scheffé’s test were applied.Results: The majority of the patients (59.4% were treated in the hospital. The most frequent diagnosis was malignant neoplasm (18%. The study showed a statistically significant dependence between the forced vital capacity (FVC, forced expiratory volume in 1 second (FEV1, and FEV1/FVC parameters and the time of hospitalization, as well as between the FVC and FEV1 parameters and the age of patients. The FVC parameter values turned out to be dependent on the main diagnosis. Highest results were noted in patients with the diagnosis of sleep apnea or benign neoplasm. A low FVC index can reflect restrictive

Cystic fibrosis - Comparison between patients in paediatric and adult age.

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Santos, V; Cardoso, A V; Lopes, C; Azevedo, P; Gamboa, F; Amorim, A

Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasians. Although most cases are diagnosed in childhood, diagnosis in adults is apparently increasing. Evaluate the adult population with CF, comparing patients who were diagnosed before and after 18 years of age. Retrospective analysis of patients followed in three main medical centres in Portugal in 2012. Comparison of two groups: G1 - patients diagnosed at <18 years and G2 - patients diagnosed at ≥18 years. 89 adults were identified: 61.8% in G1, 38.2% in G2. Gender distribution was similar in both groups. Average age in G2 was higher (38.3±8.4 vs. 26.8±6.1 years, p<0.001). Respiratory symptoms most frequently led to CF diagnosis in all patients, mainly in adulthood. There was a greater percentage of patients homozygous for the mutation delF508 in G1 (43.6 vs. 8.8%, p=0.02). Respiratory and pancreatic function, and body mass index (BMI) showed a higher severity in G1 (G1 vs. G2: FEV1: 54.6±27.3 vs. 29.9±64.6%, p=0.177; pancreatic insufficiency 72.7 vs. 26.5%, p<0.001; BMI 20.2±3.4 vs. 22.2±4.8, p=0.018). Pseudomonas aeruginosa and methicillin-sensitive Staphylococcus aureus were the most frequently isolated microorganisms. Lung transplantation rate was higher in G2 (20.6 vs. 10.9%, p=0.231) while mortality rate was higher in G1 (0 vs. 3.6%, p=0.261). Hospital admission rate was higher in G1 as well as mortality rate. The results suggest that patients with CF diagnosed in childhood have characteristics that distinguish them from those diagnosed in adulthood, and these differences may have implications for diagnosis, prognosis and life expectancy. Copyright © 2016 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

Variability of disease activity in patients treated with ranibizumab for neovascular age-related macular degeneration.

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Enders, P; Scholz, P; Muether, P S; Fauser, S

2016-08-01

PurposeTo analyze choroidal neovasularization (CNV) activity and recurrence patterns in patients with neovascular age-related macular degeneration (nAMD) treated with ranibizumab, and the correlation with individual intraocular vascular endothelial growth factor (VEGF) suppression time (VST).MethodsPost-hoc analysis of data from a prospective, non-randomized clinical study. Patients with nAMD treated with ranibizumab on a pro re nata regimen. Disease activity was analyzed monthly by spectral-domain optical coherence tomography and correlated with VSTs.ResultsOverall, 73 eyes of 73 patients were included in the study with a mean follow-up of 717 days (range: 412-1239 days). Overall, the mean CNV-activity-free interval was 76.5 days (range: 0-829 days). The individual range of the length of dry intervals was high. A total of 42% of patients had a range of more than 90 days. Overall, 16% of patients showed persistent activity. And 12% stayed dry after the initial ranibizumab treatment. No significant correlation was found between the CNV-recurrence pattern and VST (P=0.12).ConclusionsCNV activity in nAMD is irregular, which is reflected in the range of the duration of dry intervals and late recurrences. The biomarker VST solely seems not to be sufficient to explain recurrence pattern of CNV in all AMD patients.

An Outcome Analysis of Mechanically Ventilated Middle Aged and Elderly Taiwanese Patients Undergoing Tracheostomy

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Yueh-Chih Chung

2013-06-01

Conclusions: This study demonstrated that the utilization of medical resources and the decline in the number of tracheostomies performed were higher in patients aged ≥ 65 compared to patients under 65.

Relationship between serum insulin level and age and sex in 980 patients with essential hypertension

International Nuclear Information System (INIS)

Cai Jianlin; Ji Naijun; Mei Yubin; Wang Chengyao; Fan Bifu; Chen Donghai; Guan Li; Tong Lijun; Li Fuyuan; Gao Meiying

2004-01-01

Objective: To investigate the change of serum insulin level in essential hypertension patients and its relationship with age and sex. Methods: The levels of serum insulin were determined with radioimmunoassay in 980 essential hypertension patients and 120 controls. Results: The levels of serum insulin in the essential hypertension patients were significantly higher than those in the controls (t=4.280, P<0.01). However, there were no significant differences among the levels in different sex and age groups. The same held true for women before and after menopause as well as different stages of hypertension. Conclusion: The average serum insulin level in EH patients was significantly higher than the level in controls, and had positive correlation to mean arterial pressure. But no significant differences were found among different sex and age groups, so serum insulin could be a new independent risk factor of essential hypertension

The Comparison of Sagittal Spinopelvic Parameters between Young Adult Patients with L5 Spondylolysis and Age-Matched Control Group

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Oh, Young Min; Choi, Ha Young

2013-01-01

Objective To compare spinopelvic parameters in young adult patients with spondylolysis to those in age-matched patients without spondylolysis and investigate the clinical impact of sagittal spinopelvic parameters in patients with L5 spondylolysis. Methods From 2009 to 2012, a total of 198 young adult male patients with spondylolysis were identified. Eighty age-matched patients without spondylolysis were also selected. Standing lateral films that included both hip joints were obtained for each subject. Pelvic incidence (PI), sacral slope (SS), pelvic tilt, lumbar lordosis angle, sacral inclination, lumbosacral angle, and sacral table angle were measured in both groups. A comparative study of the spinopelvic parameters of these two groups was performed using SPSS 15.0 (SPSS Inc., Chicago, IL, USA). Results Among the aforementioned spinopelvic parameters, PI, SS and STA were significantly different between patients with spondylolysis and those without spondylolysis. PI and SS were higher in the spondylolysis group than in the control group, but STA was lower in the spondylolysis group than in the control group. Conclusion PI and SS were higher in the spondylolysis group than in the control group, but STA was lower in the spondylolysis group than in the control group. Patients with spondylolysis have low STA at birth, which remains constant during growth; a low STA translates into high SS. As a result, PI is also increased in accordance with SS. Therefore, we suggest that STA is an important etiologic factor in young adult patients with L5 spondylolysis. PMID:24278649

Do tumor size or patient age influence the accuracy of sentinel lymph node (Sn) detection in breast cancer?

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Cortes, M.; Fernandez, A.; Benito, E.; Azpeitia, D.; Ricart, Y.; Escobedo, A.; Martin-Comin, J.

2002-01-01

Full text: The aim was to analyze the influence of the age of the patient and tumor size on the accuracy to identify SN in patients with breast cancer. The whole population are 250 patients with breast cancer. In 236 data on size and age were available. Mean age was 53.6 years, range 28-87 years. Patients were classified 1) depending an age: 40 60 years: 73 p and 2) depending on tumor size (mm): 30: 46 p. Examination protocol: All patients received a peritumoral injection of 111 MBq (3mCi) of 99mTc-HSA-nanocolloid in 1 - 3 ml. 2 h later 300 seconds anterior and lateral thoracic scans were obtained. A 57-Co flood phantom was positioned back to the patient to outline the anatomical contour and help to localize SN. SN was marked on the skin with permanent ink. Intraoperative SN localization was performed using a gamma probe. Histopathologic analysis of SN was done with haematoxylin/eosin, immunohistochemistry and PCR. Histopathology of the SN was compared to the histopathology of all the other lymph nodes drawn out by the surgeon. SN were identified by lymphoscintigraphy in 227 cases of 250 (91 %). 221 of them (97 %) were localized in axyla. In 210 of 221 SN could be localized and drawn out at surgery. The no detection and false negative rate were much higher in patients aged > 60 (29 and 33 %) and in tumors > 30 mm (32 and 19 %) than in patients 60 y and tumors > 30 mm (46 %) and the highest false negative rate appears in patients >60 and tumors > 30 mm (33 %) 1) No FN were found in patients with tumor size <10 mm. 2) No FN were found in patients aged under 40 years. 3) FN rate seems to be higher in older patients. 4) The age of patients and the size of tumor seem to influence an the SN detection rates. (author)

The prognostic value of age for 1030 patients with early stage breast cancer after postoperative radiotherapy

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Xu Liming; Li Ruiying; Wang Ping; Xu Liang; Hao Jianlei; Liu Xiaobin; Pang Qingsong; Zhu Li; Cui Yong

2010-01-01

Objective: To analyze the prognostic value of age in patients with early stage breast cancer. Methods: The clinical characteristics of 1030 patients with early stage breast cancer (the number of positive axillary lymph nodes was less than 3) were retrospectively reviewed. Of all the patients, 468(stage I, n = 227; and stage II , n = 241) received breast conserving surgery (BCS) and 562 (stage I, n =184; and stage II, n= 378) received modified mastectomy. Patients were divided into young-age group (≤35, 136 patients), middle-age group (> 35-≤60,738 patients) and old-age group (> 60, 156 patients). The number of patients without postoperative radiation therapy after BCS is 16, 60 and 39 in the three groups, respectively. Two-dimensional conventional fractionated radiotherapy was administered. The prognostic value of the tumor size, status of axillary lymph nodes or hormonal receptors, postoperative radiation therapy were analyzed. Results: The follow-up rate was 97.86%. Of 795 patients followed up more than 5 years, 110, 569 and 116 patients were devided into the three groups, respectively. There were 40, 202 and 87 patients without radiation therapy in the three groups. The 5-year recurrence rates of the three groups were 6.2%, 8.7% and 10.4% (χ 2 = 1.14, P= 0.567). The 5-year distant metastasis rates were 4.3% , 9.5 % and 2. 5% (χ 2 = 5.31 , P = 0.070) . The 5 - year survival rates were 91.2% , 92.6% and 82.1% (χ 2 = 6. 83, P = 0.033). The young-age group had more tumors smaller than 2. 0 cm (65.4%), less positive axillary lymph nodes (13.2%), poorer differential tumor and less positive hormone acceptors (48.0%). Of patients with tumor larger than 2. 0 cm who had no radiotherapy after BCS, the 5-year survival rates were 94%, 87% and 71% (χ 2 = 20.69, P= 0.000) in the three groups. The corresponding recurrence rates were 23%, 18% ,7%, (χ 2 = 9.97, P = 0.007), and distant metastasis rates were 23%, 25% and 10% (χ 2 =8.51, P=0.014). Conclusions: The age is

Incidence of primary hypothyroidism in patients exposed to therapeutic external beam radiation, where radiation portals include a part or whole of the thyroid gland

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B A Laway

2012-01-01

Full Text Available Introduction: Hypothyroidism is a known consequence of external-beam radiotherapy to the neck encompassing a part or whole of the thyroid gland. In this non-randomized prospective study, we have tried to evaluate the response of the thyroid gland to radiation by assessing thyroid function before irradiation and at regular intervals after irradiation. Aims and Objectives: The aim of this study were to assess in the cancer patients, who were exposed to the therapeutic external beam radiation, where radiation portals include a part or whole of the thyroid gland: the incidence of primary hypothyroidism, the time required to become hypothyroid, any relation between the total dose for the development of hypothyroidism, and whether there are any patient or treatment-related factors that are predictive for the development of hypothyroidism, including the use of concurrent chemotherapy. Materials and Methods: This non-randomized, prospective study was conducted for a period of 2 years in which thyroid function was assessed in 59 patients (cases of head and neck cancer, breast cancer, lymphoma patients and other malignancies, who had received radiotherapy to the neck region. 59 euthyroid healthy patients (controls were also taken, who had not received the neck irradiation. These patients/controls were assessed periodically for 2 years. Results: The incidence of hypothyroidism after external beam radiation therapy (EBRT to neck where radiation portals include part or whole of the thyroid gland was 16.94%, seven cases had subclinical hypothyroidism (11.86% and three cases had clinical hypothyroidism (5.08%. Mean time for development of hypothyroidism was 4.5 months. There was no effect of age, gender, primary tumor site, radiation dose and chemotherapy, whether neoadjuvant or concurrent with the development of hypothyroidism. Conclusion: In summary, we found that thyroid dysfunction is a prevalent, yet easily treatable source of morbidity in patients

Aging and sexuality.

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Yee, Lesley

2010-10-01

Sexuality has become a medical issue in association with aging. This is due to a number of factors, including increasing age of survival, a positive societal construct that promotes sexuality as important for quality of life as we age, and the medicalisation of sexuality with the advent of prescription medications to treat sexual dysfunction. This article reviews the factors surrounding aging and sexuality and also considers special situations with age, such as institutionalised care and the possibility of elder abuse. Normal physiological changes with aging affect both genders in terms of sexual desire and performance. Other medical conditions increase with age, and these and their treatments will impact on sexuality and the way it can be expressed. Medical practitioners require an understanding of these changes in order to find ways to optimise sexual function in older patients.

Oropharyngeal Dysphagia in Dermatomyositis: Associations with Clinical and Laboratory Features Including Autoantibodies.

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Mugii, Naoki; Hasegawa, Minoru; Matsushita, Takashi; Hamaguchi, Yasuhito; Oohata, Sacihe; Okita, Hirokazu; Yahata, Tetsutarou; Someya, Fujiko; Inoue, Katsumi; Murono, Shigeyuki; Fujimoto, Manabu; Takehara, Kazuhiko

2016-01-01

Dysphagia develops with low frequency in patients with dermatomyositis. Our objective was to determine the clinical and laboratory features that can estimate the development of dysphagia in dermatomyositis. This study included 92 Japanese patients with adult-onset dermatomyositis. The associations between dysphagia and clinical and laboratory features including disease-specific autoantibodies determined by immunoprecipitation assays were analyzed. Videofluoroscopy swallow study (VFSS) was performed for all patients with clinical dysphagia (n = 13, 14.1%) but not for patients without clinical dysphagia. Typical findings of dysphagia (pharyngeal pooling, n = 11 and/or nasal regurgitation, n = 4) was detected by VFSS in all patients with clinical dysphagia. Eleven patients with dysphagia (84.6%) had anti-transcription intermediary factor 1γ (TIF-1γ) antibody. By univariate analysis, the average age and the male to female ratio, internal malignancy, and anti-TIF-1γ antibody were significantly higher and the frequency of interstitial lung diseases and manual muscle testing (MMT) scores of sternomastoid and dertoid muscles were significantly lower in patients with dysphagia than in patients without dysphagia. Among patients with anti-TIF-1γ antibody, the mean age, the ratios of male to female and internal malignancy were significantly higher and mean MMT scores of sternomastoid muscle were significantly lower in patients with dysphagia compared with patients without dysphagia. By multivariable analysis, the risk of dysphagia was strongly associated with the existence of internal malignancy and ant-TIF-1γ antibody and was also associated with reduced scores of manual muscle test of sternomastoid muscle. Dysphagia was markedly improved after the treatment against myositis in all 13 patients. These findings indicate that dysphagia can develop frequently in patients with internal malignancy, anti-TIF-1γ antibody, or severe muscle weakness of sternomastoid muscle.

Systematic aging of commercial LiFePO4|Graphite cylindrical cells including a theory explaining rise of capacity during aging

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Lewerenz, Meinert; Münnix, Jens; Schmalstieg, Johannes; Käbitz, Stefan; Knips, Marcus; Sauer, Dirk Uwe

2017-03-01

The contribution introduces a new theory explaining the capacity increase that is often observed in early stages of life of lithium-ion batteries. This reversible and SOC-depending capacity rise is explained by the passive electrode effect in this work. The theory assumes a slow, compensating flow of active lithium between the passive and the active part of the anode, where the passive part represents the geometric excess anode with respect to the cathode. The theory is validated using a systematic test of 50 cylindrical 8 Ah LiFePO4|Graphite battery cells analyzed during cyclic and calendaric aging. The cyclic aging has been performed symmetrically at 40 °C cell temperature, varying current rates and DODs. The calendar aging is executed at three temperatures and up to four SOCs. The aging is dominated by capacity fade while the increase of internal resistance is hardly influenced. Surprisingly shallow cycling between 45 and 55% SOC shows stronger aging than aging at higher DOD and tests at 4 C exhibit less aging than aging at lower C-rates. Aging mechanisms at 60 °C seem to deviate from those at 40 °C or lower. The data of this aging matrix is used for further destructive and non-destructive characterization in future contributions.

Varied autopsy findings in five treated patients with Gaucher disease and parkinsonism include the absence of Gaucher cells.

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Monestime, Gianina; Borger, Daniel K; Kim, Jenny; Lopez, Grisel; Allgaeuer, Michael; Jain, Dhanpat; Vortmeyer, Alexander; Wang, Hao-Wei; Sidransky, Ellen

2016-05-01

Enzyme replacement therapy is standard of care for patients with Gaucher disease, as it significantly improves skeletal, visceral, and hematological symptoms. Few pathological studies have documented the extent of pathological findings in treated patients. Autopsy findings in five treated patients, who ultimately developed parkinsonism, ranged from the complete absence of Gaucher pathology to extensive involvement of multiple tissues, without correlation to age, genotype, spleen status, or dose/duration of therapy. Additional autopsies may elucidate modifiers and biomarkers contributing to disease burden and response to therapy. Published by Elsevier Inc.

Impact of aging on cardiac sympathetic innervation measured by {sup 123}I-mIBG imaging in patients with systolic heart failure

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Rengo, Giuseppe; Ferrara, Nicola [Scientific Institute of Telese Terme, Salvatore Maugeri Foundation, IRCCS, Telese Terme (Italy); University of Naples Federico II, Division of Geriatrics, Department of Translational Medical Sciences, Naples (Italy); Pagano, Gennaro; Formisano, Roberto; Komici, Klara; Petraglia, Laura; Parisi, Valentina; Femminella, Grazia Daniela; De Lucia, Claudio; Cannavo, Alessandro; Memmi, Alessia; Leosco, Dario [University of Naples Federico II, Division of Geriatrics, Department of Translational Medical Sciences, Naples (Italy); Vitale, Dino Franco [Scientific Institute of Telese Terme, Salvatore Maugeri Foundation, IRCCS, Telese Terme (Italy); Paolillo, Stefania [Institute of Diagnostic and Nuclear Development, SDN Foundation, Naples (Italy); Attena, Emilio [Fatebenefratelli Hospital, Department of Cardiology, Naples (Italy); Pellegrino, Teresa [Institute of Biostructures and Bioimages of the National Council of Research, Naples (Italy); Federico II University of Naples, Division of Imaging, Radiotherapy, Neuroradiology, and Medical Physics, Department of Advanced Biomedical Sciences, Naples (Italy); Dellegrottaglie, Santo [Ospedale Medico-Chirurgico Accreditato Villa dei Fiori, Division of Cardiology, Acerra, Naples (Italy); Trimarco, Bruno; Filardi, Pasquale Perrone [Federico II University of Naples, Division of Cardiology, Department of Advanced Biomedical Sciences, Naples (Italy); Cuocolo, Alberto [Institute of Diagnostic and Nuclear Development, SDN Foundation, Naples (Italy); Federico II University of Naples, Division of Imaging, Radiotherapy, Neuroradiology, and Medical Physics, Department of Advanced Biomedical Sciences, Naples (Italy)

2016-12-15

Sympathetic nervous system (SNS) hyperactivity is a salient characteristic of chronic heart failure (HF) and contributes to the progression of the disease. Iodine-123 meta-iodobenzylguanidine ({sup 123}I-mIBG) imaging has been successfully used to assess cardiac SNS activity in HF patients and to predict prognosis. Importantly, SNS hyperactivity characterizes also physiological ageing, and there is conflicting evidence on cardiac {sup 123}I-mIBG uptake in healthy elderly subjects compared to adults. However, little data are available on the impact of ageing on cardiac sympathetic nerve activity assessed by {sup 123}I-mIBG scintigraphy, in patients with HF. We studied 180 HF patients (age = 66.1 ± 10.5 years [yrs]), left ventricular ejection fraction (LVEF = 30.6 ± 6.3 %) undergoing cardiac {sup 123}I-mIBG imaging. Early and late heart to mediastinum (H/M) ratios and washout rate were calculated in all patients. Demographic, clinical, and echocardiographic data were also collected. Our study population consisted of 53 patients aged >75 years (age = 77.7 ± 4.0 year), 67 patients aged 62-72 years (age = 67.9 ± 3.2 years) and 60 patients aged ≤61 year (age = 53.9 ± 5.6 years). In elderly patients, both early and late H/M ratios were significantly lower compared to younger patients (p < 0.05). By multivariate analysis, H/M ratios (both early and late) and washout rate were significantly correlated with LVEF and age. Our data indicate that, in a population of HF patients, there is an independent age-related effect on cardiac SNS innervation assessed by {sup 123}I-mIBG imaging. This finding suggests that cardiac {sup 123}I-mIBG uptake in patients with HF might be affected by patient age. (orig.)