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1.
Ann Lab Med ; 43(1): 82-85, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36045060

RESUMO

Cytokeratin 19 fragment antigen 21-1 (CYFRA 21-1) is useful for predicting and monitoring non-small cell lung cancer prognosis. We established reference intervals (RIs) of CYFRA 21-1 in Korean adults, including those older than 60 years. Data of 4,098 apparently healthy subjects (age range, 20-87 years) were analyzed after excluding those with a history of malignancy, high tumor marker concentrations (except CYFRA 21-1), and/or abnormal findings on a chest computed tomography scan through medical chart review. After removing two outliers, RIs of CYFRA 21-1 were determined using data of 4,096 subjects based on the non-parametric method (2.5th and 97.5th percentiles) according to CLSI guidelines EP28-A3c. The subjects were divided into two and four groups according to sex and age (20-40, 41-50, 51-60, and >60 years), respectively, and the median CYFRA 21-1 concentration was compared between the groups. The RI of CYFRA 21-1 was 0.66-3.84 ng/mL, applicable to both men and women. Regardless of sex, the CYFRA 21-1 concentration increased with age, suggesting that age-dependent RIs of CYFRA 21-1 should be applied. Rather than using a single RI provided by the manufacturer, the RI of CYFRA 21-1 should be continually verified and established in each clinical laboratory.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Neoplasias , Biomarcadores Tumorais , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Humanos , Queratina-19 , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , República da Coreia , Adulto Jovem
2.
Braz. j. biol ; 83: e246803, 2023. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1339417

RESUMO

Abstract Traditional medicine is cheaper and easily available to local people, to care for most frequent diseases in the Northern parts of Pakistan. Our study aimed at inventorying medicine from local plants, documenting their uses, and assessing their market value in 2015-2018 during spring, summer, and winter seasons. A total of 15 trips were made, 5 in each season. Semi-structured interviews with 165 inhabitant's age range between 20-80 years were conducted, analyzed the data is analyzed using Relative frequency of citation(RFC), Use Value(UV), Fidelity Level(FL), Informants consensus factor(ICF), and Jaccard index(JI) to find the most frequent and well-known used species in the area. A total of 86 species belonging to 39 vascular plant families, 33 genera were documented as medicinally important. Family Asteraceae was observed as the dominant family among all the families with 10 species, the leaf was the most used parts and decoction 36% was the most preferred preparation type. Herb was the predominant life form (67%). The maximum UV (0.92) was demonstrated by J. adhatoda L. species, while A. sativum L. shows maximum RFC (0.58), the highest ICF value represented by diarrhea and dermatitis 0.92, and high FL value is recorded 100%. According to our collections, wild species were 45%, invasive species were 38% and cultivated 17% recorded, dicots species were recorded more 81%. Seven 7 medicinal species is being economically important and export to the local and international market of the world, whereas P. integrima L. species were the most exported species according to the local dealers. The investigated area is rural and the local people depend on the area's plants for their health needs, and other uses like a vegetable, fuelwood, fodder, etc. The current result of RFC, UV, ICF, FL, and JI shows that medicinal flora needs to be pharmacologically and phytochemically investigated to prove their efficacy. The documentation of medicinal knowledge is important to preserve this precious old knowledge before it is lost forever, due to technological and environmental changes in the world.


Resumo A medicina tradicional é mais barata e facilmente disponível à população local para cuidar das doenças mais frequentes nas áreas do norte do Paquistão. Nosso estudo teve como objetivo inventariar medicamentos de plantas locais, documentar seus usos e avaliar seu valor de mercado em 2015-2018 durante as temporadas de primavera, verão e inverno. Foram feitas 15 viagens, 5 em cada temporada. Foram realizadas entrevistas semiestruturadas com 165 moradores na faixa etária de 20 a 80 anos, com dados analisados ​​por meio de frequência relativa de citação (RFC), valor de uso (UV), nível de fidelidade (FL), fator de consenso de informantes (CIF), e o índice de Jaccard (JI) para encontrar as espécies utilizadas mais frequentes e conhecidas na área. Um total de 86 espécies pertencentes a 39 famílias de plantas vasculares, 33 gêneros foram documentados como medicamente importantes. A família Asteraceae foi observada como a família dominante entre todas as famílias com 10 espécies, a folha foi a parte mais utilizada e a decocção 36% foi o tipo de preparação mais preferido. A erva foi a forma de vida predominante (67%). O UV máximo (0,92) foi demonstrado pelas espécies de J. adhatoda L., enquanto A. sativum L. mostra RFC máximo (0,58), o maior valor de ICF representado por diarreia e dermatite 0,92, e alto valor de FL é registrado 100%. De acordo com nossas coleções, as espécies selvagens foram 45%, as espécies invasoras 38% e as cultivadas 17% registradas, as espécies dicotiledôneas foram registradas mais 81%. Sete espécies medicinais estão sendo economicamente importantes e exportadas para o mercado local e internacional do mundo, enquanto as espécies de P. integrima L. foram as espécies mais exportadas de acordo com os comerciantes locais. A área investigada é rural e a população local depende das plantas da área para suas necessidades de saúde e outros usos como vegetal, lenha, forragem etc. O resultado atual de RFC, UV, ICF, FL e JI mostra que a flora medicinal precisa ser investigada farmacológica e fitoquimicamente para comprovar sua eficácia. A documentação do conhecimento medicinal é importante para preservar esse precioso conhecimento antigo antes que se perca para sempre, devido às mudanças tecnológicas e ambientais do mundo.


Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Plantas Medicinais , Paquistão , Inquéritos e Questionários , Folhas de Planta , Etnobotânica , Fitoterapia , Medicina Tradicional
3.
Clin Rehabil ; 37(1): 47-59, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36163694

RESUMO

OBJECTIVE: To test the feasibility of a walking programme for community-dwelling adults recovering from hip fracture. DESIGN: A randomized controlled trial with embedded qualitative analysis. SETTING: Community. PARTICIPANTS: Aged at least 60 years and living in the community after hip fracture. INTERVENTIONS: In addition to standard care, the experimental group received weekly home-based physiotherapy for 12 weeks to facilitate 100 minutes/week of moderate-intensity walking. MAIN OUTCOME MEASURES: Feasibility domains of demand, acceptability, implementation, practicality and limited efficacy. RESULTS: Of 158 potentially eligible, 38 participated (23 women, mean age 80 years, SD 9). The recruitment rate of 24% indicated low demand. Participants considered the walking programme highly acceptable. The programme was implemented as intended; the experimental group received a mean of 11 (SD 1) consultations and averaged more than 100 min of walking per week. The programme was practical with no serious adverse events and no between-group difference in risk of falling or hospital readmissions. Demonstrating evidence of efficacy, there were moderate standardized mean differences for physical activity favouring the experimental group, who increased daily moderate-intensity physical activity compared to the control group (MD 8 min, 95% CI 2-13). There were no between-group differences in mobility, walking confidence or quality of life. CONCLUSION: A walking programme for community-dwelling older adults after hip fracture was acceptable, could be implemented as intended and was practical and demonstrated preliminary evidence of efficacy in increasing physical activity. However, low demand would threaten the feasibility of such a programme.


Assuntos
Fraturas do Quadril , Qualidade de Vida , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Caminhada , Exercício Físico
4.
Arch Gerontol Geriatr ; 104: 104806, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36099728

RESUMO

PURPOSE: Thyroid deficiency may reduce mortality in older adults, but older adults prioritize independence over merely staying alive. We investigated the association between thyroid dysfunction and nursing home admission and all-cause mortality in community-dwelling older adults over 80. METHODS: We conducted a retrospective population-based open cohort study using data from laboratory registries covering 75% of Denmark supplemented by national registries. We included all community-dwelling older adults over 80 years with a first TSH measurement between 1996 and 2019. Participants with prior thyroid disorders or medication affecting the thyroid were excluded. Participants were followed from inclusion until nursing home admission, death or loss to follow-up due to emigration. RESULTS: We included 272,495 participants at baseline. Median follow-time was 3.71 years in analyses of nursing home admissions and 4.00 years for all-cause mortality. Hypothyroidism was associated with lower nursing home admission (TSH 5-10 mIU/l: HR 0.85, 95% CI: 0.80-0.91, P < 0.001); TSH >10 mIU/l HR 0.68, 95% CI: 0.54-0.85, P = 0.001) and with reduced all-cause mortality (TSH >10 mIU/l: HR 0.81, 95% CI: 0.70-0.93, P = 0.002). The association between hyperthyroidism and nursing home admission was of little clinical significance while hyperthyroidism was associated with increased all-cause mortality hazard both for low (HR 1.16, 95% CI 1.13-1.19, P < 0.001) and suppressed (HR 95% CI: 1.14 1.07-1.21, P < 0.001) TSH. CONCLUSION: Hypothyroidism is associated with a reduced nursing home admission hazard and to a lesser extent all-cause mortality in community-dwelling adults over 80 years, while hyperthyroidism is associated with increased all-cause mortality but not hazard of nursing home admission.


Assuntos
Hipertireoidismo , Hipotireoidismo , Humanos , Estudos de Coortes , Hipertireoidismo/complicações , Hipotireoidismo/complicações , Vida Independente , Casas de Saúde , Estudos Retrospectivos , Fatores de Risco , Tireotropina , Idoso de 80 Anos ou mais
5.
Arch Gerontol Geriatr ; 104: 104822, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36156408

RESUMO

BACKGROUND: Elevation of cardiac troponin (cTn) is associated with the worst prognosis not only in cardiovascular disease but also in non-cardiovascular disease. The aim of this study is to verify if cTn has a prognostic role in elderly and very elderly coronavirus disease 2019 (COVID-19) patients. METHODS: This study enrolled consecutive COVID-19 elderly patients hospitalized at INRCA hospital, with available admission high sensitivity cardiac troponin T (HS-cTnT) level. Patients were divided into three groups based on HS-cTnT level: group A (Hs-cTnT ≤ 40 pg/ml), group B (Hs-cTnT 41-100 pg/ml), and group C (Hs-cTnT ≥ 101 pg/ml). The correlation between HS-cTnT levels and mortality rates was analyzed. RESULTS: 461 patients (mean age 86 years; 59% female) were divided into group A (261 patients), group B (129 patients), and group C (71 patients). Group C resulted significantly older, more affected by heart failure, chronic obstructive pulmonary disease, chronic kidney disease, and dementia, and with higher levels of creatinine, C-reactive protein, pro-calcitonin, interleukin-6, ferritin, NT-proBNP, D-dimer then group A and group B. Mortality rate increased significantly across groups (group A: 18.4%; group B: 36.4%; group C: 62.0%; p<0.001). Group C had a significant increase in mortality risk compared to group A, both univariate analysis (HR 3.78) and multivariate analysis (model 2 HR 3.10; model 3 HR 3.59; model 4 HR 1.72). CONCLUSION: HS-cTnT has demonstrated a prognostic role in elderly and very elderly COVID-19 patients. HS-cTnT is a simple and inexpensive laboratory exam that gives clinicians important information on mortality risk stratification.


Assuntos
COVID-19 , Troponina T , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Biomarcadores , COVID-19/diagnóstico , Mortalidade Hospitalar , Peptídeo Natriurético Encefálico , Prognóstico
6.
Parasitol Int ; 92: 102689, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36240994

RESUMO

This study aimed to estimate dynamic changes in seroprevalence of Toxoplasma gondii within the general population living in the northern part of the Republic of Serbia (Province of Vojvodina) during a 14-year period. The differences in prevalence of anti-toxoplasma antibodies were analyzed in correlation with age, gender, residential area (rural/urban) and meteorological factors. In this cohort retrospective study, 24,440 subjects between 1 and 88 years old were enrolled. To determine the presence of T. gondii-specific IgM and IgG antibodies in serum samples, commercially available ELISA kits were used (Euroimmun, Luebeck, Germany). During the study period, the overall T. gondii seroprevalence was 23.5%. The seroprevalence continuously decreased over time from 31.7% in 2008 to 20.4% in 2021 (0.81% per year, p < 0.001). Approximately 2% of patients had a serologic profile positive for both anti-Toxoplasma IgG and IgM antibodies. The seroprevalence was higher (28.87%) among men compared to women (24.28%), while urban residents (24.94%) had lower seroprevalence than the rural population (28.17%). A statistically significant negative correlation (r = -0.559) was found between serologic profile of patients positive for both T. gondii IgG and IgM antibodies and the annual mean air temperature. No significant association was observed between seropositivity to T. gondii infection and examined meteorological factors. These data could be useful to national and regional health authorities to create an optimal health policy to reduce rate of T. gondii infections.


Assuntos
Toxoplasma , Toxoplasmose , Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Estudos Soroepidemiológicos , Sérvia/epidemiologia , Iugoslávia , Estudos Retrospectivos , Anticorpos Antiprotozoários , Imunoglobulina G , Imunoglobulina M , Fatores de Risco
7.
Arch Gerontol Geriatr ; 104: 104799, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36070636

RESUMO

PURPOSE OF THE RESEARCH: Ageing entails a decrease in muscle mass and strength, known as sarcopenia, which also affects respiratory function. Physical exercise is an appropriate intervention to treat both conditions. This study aims to assess the efficacy of high-intensity resistance training (HIRT) on clinical parameters of respiratory function and health-related quality of life (QoL) in community-dwelling older women with sarcopenia. METHODS: Fifty-one sarcopenic community-dwelling women aged 70 years and older were randomized to either six months of HIRT (n = 24) or control (n = 27). At baseline and post-intervention, participants were assessed for skeletal-muscle sarcopenia; respiratory sarcopenia status; respiratory function: spirometry (FEV1, FVC, FEV1/FVC, and FEF25-75) and expiratory (MEP) and inspiratory (MIP) respiratory muscle strength parameters; and health-related QoL (EURO-QOL 5D-3 L). RESULTS: A group-by-time interaction effect for MEP (p = 0.044, È 2=0.108) was observed. CG showed a significant decrease in FEV1 (mean difference [MD] -0.12 L; 95% confidence interval [CI] -0.20, -0.05; p = 0.002); and FVC (MD -0.18 L; 95% CI -0.33, -0.03; p = 0.024) after six months, whereas the HIRT maintained respiratory function without change. Post-intervention, mean EQ-VAS increased in the HIRT and decreased in CG, resulting in a significant between-group difference (mean 73.0 standard deviation [SD] 16.99 vs 61.1 SD 18.2 points, respectively; p = 0.044). Respiratory sarcopenia status was reverted in the HIRT. CONCLUSIONS: HIRT increased muscle strength and halted age-related respiratory function decline in sarcopenic old women. A strength intervention could benefit health-related QoL and physical well-being. REGISTERED IN CLINICALTRIALS.GOV: NCT03834558.


Assuntos
Treinamento de Força , Sarcopenia , Feminino , Humanos , Idoso , Idoso de 80 Anos ou mais , Sarcopenia/terapia , Treinamento de Força/métodos , Qualidade de Vida , Força Muscular/fisiologia , Músculos Respiratórios
8.
Arch Gerontol Geriatr ; 104: 104804, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36084607

RESUMO

OBJECTIVES: Since there is limited knowledge with regard to the frequency and correlates of mild cognitive impairment and dementia among the oldest old based on large representative data (including institutionalized individuals), our objective was to fill this research gap. METHODS: For our study, data came from the representative "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)". This study included community-dwelling and institutionalized individuals aged 80 years and over (n = 1,173, mean age: 86 years) residing in the most populous state of Germany (North Rhine-Westphalia). The DemTect was used to quantify cognitive impairment (i.e., probable mild cognitive impairment and probable dementia). RESULTS: Overall, 73.1% of the individuals were not cognitively impaired, 17.0% of the individuals had probable mild cognitive impairment and 9.9% of the individuals had probable dementia. Compared to individuals without cognitive impairment, individuals with probable mild cognitive impairment were more likely to be male, live in an institutionalized setting, have a lower educational level, have a smaller network size, and have lower functional abilities. Moreover, compared to individuals without cognitive impairment, individuals with probable dementia were more likely to be older, live in an institutionalized setting, have a lower educational level, have a smaller network size, not be multimorbid, and have lower functional abilities. CONCLUSIONS: Our study identified several sociodemographic and health-related factors which are associated with probable mild cognitive impairment and probable dementia among the oldest old. This knowledge may help to address individuals at risk for mild cognitive impairment and dementia.


Assuntos
Disfunção Cognitiva , Demência , Idoso de 80 Anos ou mais , Masculino , Humanos , Feminino , Qualidade de Vida/psicologia , Demência/epidemiologia , Demência/psicologia , Disfunção Cognitiva/epidemiologia , Inquéritos e Questionários , Atividades Cotidianas
9.
J Infect Chemother ; 29(1): 82-86, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36162647

RESUMO

An 81-year-old man was admitted to our hospital because of fever and malaise that had persisted for 3 months. The patient had undergone two aortic valve replacements, 10 and 5 years previously, because of aortic valve regurgitation and infectious endocarditis. He also had had asymptomatic Mycobacterium abscessus complex (MABC) pulmonary disease for the two previous years. Contrast-enhanced computed tomography showed a mediastinal abscess and an ascending aortic aneurysm. Mycobacterium abscessus subsp. massiliense was cultured from his blood, suggesting the aortic aneurysm was secondary to infection of an implanted device. After enlargement over only a few days, a leakage of contrast medium to the mediastinal abscess was found on computed tomography. The patient was diagnosed with rupture of an infectious aortic aneurysm, and emergency aortic replacement and drainage of the mediastinal abscess were successful. The patient was treated with several antibiotics, including meropenem, amikacin, and clarithromycin, and his general condition improved. Cultures from both the mediastinal abscess and a pericardial patch that was placed at the time of surgery 5 years previously revealed MABC. In our case, the infected aortic aneurysm most likely resulted from MABC pulmonary disease rather than from previous intraoperative contamination. This route of infection is rare. Physicians should be aware of the possibility of dissemination and subsequent infection of implants related to MABC pulmonary disease.


Assuntos
Aneurisma Aórtico , Pneumopatias , Infecções por Mycobacterium não Tuberculosas , Mycobacterium abscessus , Masculino , Humanos , Idoso de 80 Anos ou mais , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/microbiologia , Abscesso , Claritromicina/uso terapêutico , Antibacterianos/uso terapêutico , Pneumopatias/microbiologia , Testes de Sensibilidade Microbiana
10.
Skeletal Radiol ; 52(1): 47-55, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35896734

RESUMO

OBJECTIVE: Gluteal muscle quality influences risk of falling and mobility limitation. We sought (1) to compare gluteal muscle fatty infiltration (FI) between groups of older women with urinary incontinence (UI) at risk for falling (at-risk group) and not at risk for falling (not-at-risk group), and (2) to determine correlation of gluteal FI with Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB) performance. MATERIALS AND METHODS: Prospective pilot study of gluteal FI on pelvis MRI for 19 women with UI, aged ≥ 70 years. A musculoskeletal radiologist selected axial T1-weighted MR images; then, two blinded medical student research assistants analyzed gluteal FI by quantitative fuzzy C-means segmentation. TUG and SPPB tests were performed. TUG ≥ 12 s defined participants as at risk for falling. Descriptive, correlation, and reliability analyses were performed. RESULTS: Mean age, 76.3 ± 4.8 years; no difference for age or body mass index (BMI) between the at-risk (n = 5) versus not-at-risk (n = 14) groups. SPPB score (p = 0.013) was lower for the at-risk group (6.4 ± 3.1) than for the not-at-risk group (10.2 ± 1.9). Fuzzy C-means FI-%-estimate differed between the at-risk group and the not-at-risk group for bilateral gluteus medius/minimus (33.2% ± 15.6% versus 19.5% ± 4.1%, p = 0.037) and bilateral gluteus maximus (33.6% ± 15.6% versus 19.7% ± 6.9%, p = 0.047). Fuzzy C-means FI-%-estimate for bilateral gluteus maximus had significant (p < 0.050) moderate correlation with age (rho = - 0.64), BMI (rho = 0.65), and TUG performance (rho = 0.52). Fuzzy C-means FI-%-estimates showed excellent inter-observer and intra-observer reliability (intraclass correlation coefficient, ≥ 0.892). CONCLUSION: Older women with UI at risk for falling have greater levels of gluteal FI and mobility limitation as compared to those not at risk for falling.


Assuntos
Limitação da Mobilidade , Incontinência Urinária , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Projetos Piloto , Estudos Prospectivos , Reprodutibilidade dos Testes , Incontinência Urinária/diagnóstico por imagem , Músculo Esquelético
11.
Ann Anat ; 245: 152016, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36280186

RESUMO

BACKGROUND: The transient receptor potential canonical 6 (TRPC6) channel has been studied in pathologies of the hepatobiliary system. Information on the localization of TRPC6-protein in anatomical and histological structures of the human hepatobiliary system in elderly with and without liver disease is lacking. METHODS: Samples were obtained from twelve nitrite pickling salt-ethanol-polyethylene glycol-fixed corpses of the four anatomical liver lobes, collum and the remaining gallbladder, the common bile duct (gender: 5 females, 41.67%; age [years]: median 84, range 20; postmortem interval before fixation [h]: median 60, range 74.15). Orienting histomorphologic assessment was done in a hematoxylin-eosin stain. Immunohistochemical labelling of TRPC6 was carried out following a cross-evaluation scheme. TRPC6-immunoreactivity was assessed regarding intensity (semi-quantification, three independent observers) and area (optical threshold method). Explorative statistical analyses were performed using R (inter-rater-reliability: Fleiss' kappa; comparisons: Wilcoxon-Rank-sum-test). RESULTS: Extensive autolysis was found in the liver of one and the biliary samples of three corpses. Extensive liver disease was found in 4 corpses, while 8 corpses only showed age-appropriate degeneration. Only the intrahepatic connective tissue showed no TRPC6-immunoreactivity. Individuals with extensively diseased livers exhibited statistically significantly less TRPC6-immunoreactive area in the bile duct and liver tissue while statistically significant more TRPC6-immunoreactive area in the gallbladder compared to individuals with age-appropriate degeneration of the liver only in the respective organ. CONCLUSION: Age-associated degeneration of the hepatobiliary system is likely to be associated with widespread, homogenous TRPC6-expression. Liver disease potentially influences the distribution of TRPC6-protein within the liver and within the biliary tract in elderly.


Assuntos
Hepatopatias , Canal de Cátion TRPC6 , Idoso , Feminino , Humanos , Cadáver , Expressão Gênica , Hepatopatias/genética , Reprodutibilidade dos Testes , Canal de Cátion TRPC6/genética , Masculino , Idoso de 80 Anos ou mais
12.
Urol Oncol ; 41(1): 49.e1-49.e6, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36283931

RESUMO

INTRODUCTION: We sought to identify the most effective way to refer patients with prostate cancer to germline testing. METHODS: After IRB approval, we queried the electronic medical records (EMR) to identify patients (ages 18-89) with prostate cancer who were referred for or offered germline testing for prostate cancer from May 1, 2019 to February 24, 2021 through either telephone referral, EMR referral or in-office testing. The 3 cohorts were compared on receipt of testing and time to testing. Multivariate logistic regression and Cox regression evaluated the influence of referral cohort and reason for testing on receipt of testing and time to testing, respectively. RESULTS: A total of 184 patients met study inclusion criteria; 47 were referred for germline testing via telephone, 70 were referred through the EMR and 67 were offered testing in the office. No significant demographic or clinical differences were observed. Telephone referral yielded the lowest response (17%; P < 0.001) with the longest time interval between referral and testing (103 days; P < 0.001); in-office testing yielded the highest response (66%). More patients were referred because of both family history and high risk characteristics in the EMR and in-office testing cohorts (21.4% and 25.4% respectively). Referral method was significantly (P < 0.001) associated with receipt of test, while reason for testing was not. Referral method was also independently related to time to testing (P < 0.001) while reason for referral was not. CONCLUSIONS: Urologists should offer germline testing in the office for the most effective and expedient results.


Assuntos
Neoplasias da Próstata , Masculino , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/genética , Encaminhamento e Consulta , Urologistas , Estudos de Coortes , Células Germinativas , Testes Genéticos/métodos
13.
Bone ; 166: 116570, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36182103

RESUMO

It is mandatory to manage musculoskeletal disorders in the elderly to prevent their becoming bed-ridden or requiring long-term care. However, the prevalence of musculoskeletal disorders such as osteoporosis and sarcopenia in otherwise healthy people over 85 years old is not completely known. Here we enrolled 1026 healthy subjects between 85 and 89 years old and evaluated them for the presence of osteoporosis, sarcopenia and fragility fracture(s), and how those conditions were related. We also evaluated biomarkers such as serum levels of insulin-like growth factor 1 (IGF1) and vitamin D status. The prevalence of osteoporosis, sarcopenia or fragility fracture(s) in these subjects was 22.4, 10.2 or 15.0 %, respectively. Serum IGF1 and 25(OH)D were significantly and negatively correlated with osteoporosis or sarcopenia. Osteoporosis and either sarcopenia or fragility fracture(s) were significantly related and shown to be risk factors for each other, even after adjustment for gender and BMI, while sarcopenia and fragility fracture(s) were not associated. Our data may provide a health platform for the very elderly and suggest strategies to prevent musculoskeletal disorders in this population.


Assuntos
Fraturas Ósseas , Osteoporose , Sarcopenia , Humanos , Idoso , Idoso de 80 Anos ou mais , Sarcopenia/complicações , Sarcopenia/epidemiologia , Fator de Crescimento Insulin-Like I , Osteoporose/complicações , Osteoporose/epidemiologia , Fraturas Ósseas/epidemiologia , Vitamina D , Densidade Óssea
14.
Methods Mol Biol ; 2561: 293-337, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36399277

RESUMO

Studies show that patients with Alzheimer's disease (AD) have both Aß and tau prions, and thus, AD is a double-prion disease. AD patients with the greatest longevity exhibited low levels of both Aß and tau prions; tau prions were nearly absent in the brains of almost half of the patients who lived beyond 80 years of age. Using cellular bioassays for prions in postmortem samples, we found that both Aß and tau proteins misfold into prions leading to AD, which is either a sporadic or familial dementing disorder. Although AD is transmissible experimentally, there is no evidence that AD is either communicable or contagious. Since the progression of AD correlates poorly with insoluble Aß in the central nervous system (CNS), it was difficult to distinguish between inert amyloids and Aß prions. To measure the progression of AD, we devised rapid bioassays to measure the abundance of isoform-specific Aß prions in the brains of transgenic (Tg) mice and in postmortem human CNS samples from AD victims and people who died of other neurodegenerative diseases (NDs). We found significant correlations between the longevity of individuals with AD, sex, and genetic background, despite the fact that all postmortem brain tissue had essentially the same confirmed neuropathology.Although brains from all AD patients had measurable levels of Aß prions at death, the oldest individuals had lower Aß prion levels than the younger ones. Additionally, the long-lived individuals had low tau prion levels that correlated with the extent of phosphorylated tau (p-tau). Unexpectedly, a longevity-dependent decrease in tau prions was found in spite of increasing amounts of total insoluble tau. When corrected for the abundance of insoluble tau, the tau prion levels decreased exponentially with respect to the age at death with a half-time of approximately one decade, and this correlated with the abundance of phosphorylated tau.Even though our findings with tau prions were not unexpected, they were counterintuitive; thus, tau phosphorylation and tau prion activity decreased exponentially with longevity in patients with AD ranging from ages 37 to 99 years. Our findings demonstrated an inverse correlation between longevity in AD patients and the abundance of neurotoxic tau prions. Moreover, our discovery may have profound implications for the selection of phenotypically distinct patient populations and the development of diagnostics and effective therapeutics for AD.


Assuntos
Doença de Alzheimer , Príons , Humanos , Animais , Camundongos , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Proteínas tau/metabolismo , Camundongos Transgênicos
15.
Maturitas ; 167: 32-38, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36302337

RESUMO

OBJECTIVE: Hysterectomy is one of the most common gynecological surgeries conducted around the world. Previous studies reported inconsistent results on depressive symptoms experienced after hysterectomy. This study explored the association between hysterectomy with or without oophorectomy and the use of antidepressants. STUDY DESIGN: This cross-sectional study included 4888 subjects between 20 and 80 years old who participated in the US National Health and Nutrition Examination Survey (NHANES) between 2015 and 2018. The associations between hysterectomy with or without oophorectomy and the use of antidepressants were estimated using multivariable logistic regression models. MAIN OUTCOME MEASURES: There was a positive relationship between hysterectomy, both with and without oophorectomy, and the use of antidepressants after adjusting for all potential confounders (OR = 2.13, 95 % CI = 1.43-3.17, p = 0.000; OR = 2.04, 95 % CI = 1.35-3.06 p = 0.001). In the subgroup analysis stratified by race, a positive association between hysterectomy without oophorectomy was found among non-Hispanic white women (OR = 1.89, 95 % CI = 1.04-3.44, p = 0.038) and women of other races (OR = 3.14, 95 % CI = 1.30-7.56, p = 0.010), and a positive association between hysterectomy with oophorectomy was found among non-Hispanic black women (OR = 3.09, 95 % CI = 1.15-8.27, p = 0.024). However, no association was found among non-Hispanic black and Mexican American women who had undergone hysterectomy with oophorectomy, and it was not reported in women of non-Hispanic white, Mexican American or other race who underwent hysterectomy with oophorectomy. CONCLUSION: This study suggested that hysterectomy was significantly associated with antidepressant use, but the extent of the associations may vary by race.


Assuntos
Antidepressivos , Histerectomia , Feminino , Humanos , Idoso , Idoso de 80 Anos ou mais , Inquéritos Nutricionais , Estudos Transversais , Ovariectomia/efeitos adversos , Histerectomia/efeitos adversos , Histerectomia/métodos , Antidepressivos/uso terapêutico
16.
Maturitas ; 167: 53-59, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36306667

RESUMO

OBJECTIVES: Atherosclerosis has become a leading public health problem. Previous studies suggest that enhanced muscle strength and muscle-derived cytokines (myokines) are linked with atherosclerosis. However, no previous prospective study has examined the relationship between grip strength (GS) and carotid atherosclerosis (CAS) in middle-aged and older adults. We therefore designed a cohort study to investigate the association between GS and the incidence of CAS in a population aged 45 years and over. METHODS: The cohort study (n = 1258; follow-up range: 1-6 years, median: 4.0 years, age range: 45-85 years) was performed from 2013 to 2019 in Tianjin, China. CAS was measured using a carotid artery B-mode ultrasound system and defined by increased carotid intima-media thickness and plaques. GS was measured using a handheld digital dynamometer. Adjusted Cox proportional hazards regression models were used to assess the association between quartiles of GS and CAS. RESULTS: The incidence of CAS was 122 cases per 1000 person-years. In the final multivariable models, the adjusted hazard ratios (HRs) [95 % confidence interval (CI)] for CAS across quartiles of weight-adjusted GS (Q1-Q4) were as follows: 1.00 (reference), 0.82 (0.63, 1.06), 0.92 (0.71, 1.19), 0.69 (0.52, 0.91) and the HRs (95 % CI) across quartiles of GS (Q1-Q4) were as follows: 1.00 (reference), 1.06 (0.83, 1.36), 0.78 (0.59, 1.02), 0.76 (0.58, 0.995). For one unit and one standard deviation (SD) increase in weight-adjusted GS, the adjusted HRs (95 % CI) of CAS were 0.16 (0.05, 0.52) and 0.82 (0.72, 0.93), respectively. For one unit and one SD increase in GS, the adjusted HRs (95 % CI) of CAS were 0.98 (0.96, 0.995), and 0.47 (0.26, 0.83), respectively. CONCLUSIONS: Higher GS was associated with a lower incidence of carotid atherosclerosis in middle-aged and older adults. Further studies are required to clarify the causality.


Assuntos
Aterosclerose , Doenças das Artérias Carótidas , Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Espessura Intima-Media Carotídea , Estudos de Coortes , Fatores de Risco , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/epidemiologia , Força da Mão , Artérias Carótidas/diagnóstico por imagem
17.
Addict Behav ; 137: 107538, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36368277

RESUMO

Gambling harms can impact the health and wellbeing of both individuals who gamble and those close to them. While harms occur across a spectrum of gambling risk levels, most research is conducted on people close to those gamblers who have severe problems. This study examined the health and wellbeing of people living with gamblers across the entire spectrum of gambling risk levels, via secondary analysis of the nationally-representative Household Income and Labour Dynamics in Australia Survey (HILDA). The subsample of interest comprised 13,698 respondents without a gambling problem of their own, aged between 15 and 84, and who lived in households where all residents completed the Problem Gambling Severity Index (PGSI). Health and wellbeing were measured via the SF-6D, the SF-36, and subjective wellbeing measures. Compared to those living in non-problem gambling households, participants living in problem-gambling households reported significantly lower mean SF-6D scores, lower scores on the SF-36 mental health domain, and significantly less satisfaction with both their financial situation and with feeling part of their local community. Participants living in moderate-risk gambling households also reported less satisfaction with their financial situation than those in non-problem gambling households. Conclusions: The results indicate that measurable impacts to the health and wellbeing of those living with gamblers occur predominantly at the more severe end of the risk level spectrum, except for financial dissatisfaction, which is also evident in those residing with gamblers categorised as moderate-risk.


Assuntos
Jogo de Azar , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Jogo de Azar/psicologia , Austrália/epidemiologia , Inquéritos e Questionários , Emprego , Satisfação Pessoal
18.
rev.cuid. (Bucaramanga.2010) ; 13(1): 1-18, 20221213.
Artigo em Português | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1369133

RESUMO

Introdução: a literatura já aponta que a família, muitas vezes, é o principal obstáculo que impede as pessoas idosas vivenciarem sua sexualidade. Porém, até onde sabemos, não existem estudos que identifiquem os efeitos da sexualidade na funcionalidade familiar. Objetivo: analisar os efeitos da sexualidade sobre a funcionalidade familiar e sobre a qualidade de vida de pessoas idosas. Materiais e métodos: estudo seccional realizado com 692 pessoas idosas entre os meses de julho e outubro de 2020 por meio da utilização de instrumentos autoaplicáveis. Os dados foram analisados com o teste de Kruskal-Wallis, correlação de Pearson e modelagem de equações estruturais. Resultados: as pessoas idosas com algum grau de disfuncionalidade familiar apresentaram pior vivência na sexualidade e pior qualidade de vida. O domínio relações afetivas da sexualidade foi o único a exercer efeito de forma positiva, de moderada a forte magnitude com a funcionalidade familiar (CP=0,472 [IC95%=0,301-0,642] p<0,001). A qualidade de vida, por sua vez, sofreu efeito positivo, de fraca a moderada magnitude, de todos os domínios da sexualidade: ato sexual (CP=0,339 [IC95%=0,190-0,488] p<0,001); relações afetivas (CP=0,117 [IC95%= -0,041-0,275] p<0,001) e adversidades física e social (CP=0,150 [IC95%=0,074-0,226] p<0,001). Conclusão: a sexualidade entre as pessoas idosas pode ser explorada com maior frequência nos serviços de saúde, uma vez que, exerceu efeitos positivos na funcionalidade familiar e na qualidade de vida dessa população. Espera-se que com os resultados deste estudo, haja valorização da temática nos serviços assistenciais e que a sexualidade na velhice seja explorada com as pessoas idosas, especialmente na atenção primária à saúde.


Introduction: the literature already points out that the family is often the main obstacle that prevents elderly people from experiencing their sexuality. However, there are no studies that identify the effects of sexuality on family functioning. Objective: analyzing the effects of sexuality on family functionality and on the quality of life of the elderly. Materials and methods: a cross-sectional study conducted with 692 elderly people between the months of July and October 2020 by self-administered instruments. Data were analyzed using the Kruskal-Wallis test, Pearson correlation and structural equation modeling. Results: the elderly with some degree of family dysfunction had a worse experience in sexuality and a worse quality of life. The affective relationships domain of sexuality was the only one to exert a positive effect, from moderate to strong magnitude on family functionality (PC=0.472 [CI95%=0.301-0.642] p<0.001). Quality of life, in turn, had a positive effect, from weak to moderate magnitude, in all domains of sexuality: sexual act (PC=0.339 [CI95%=0.190-0.488] p<0.001); affective relationships (PC=0.117 [CI95%= -0.041-0.275] p<0.001) and physical and social adversities (PC=0.150 [CI95%=0.074-0.226] p<0.001). Conclusion: sexuality among the elderly can be explored more frequently in health services, as it exerted positive effects on family functionality and quality of life in this population. It is expected that with the results of this study, there is an appreciation of the theme in care services and that sexuality in old age is explored with the elderly, especially in primary health care


Introducción: la literatura ya señala que la familia es muchas veces el principal obstáculo que impide que las personas mayores experimenten su sexualidad. Sin embargo, hasta donde sabemos, no existen estudios que identifiquen los efectos de la sexualidad en el funcionamiento familiar. Objetivo: analizar los efectos de la sexualidad sobre la funcionalidad familiar y la calidad de vida de las personas mayores. Materiales y métodos: un estudio transversal realizado con 692 adultos mayores entre los meses de julio y octubre de 2020 utilizando instrumentos autoadministrados. Los datos se analizaron mediante la prueba de Kruskal-Wallis, la correlación de Pearson y el modelado de ecuaciones estructurales. Resultados: los ancianos con algún grado de disfunción familiar tuvieron peor experiencia en sexualidad y peor calidad de vida. El dominio de las relaciones afectivas de la sexualidad fue el único que ejerció un efecto positivo, de moderada a fuerte magnitud acerca de la funcionalidad familiar (CP = 0,472 [IC95% = 0,301-0,642] p <0,001). La calidad de vida, a su vez, tuvo un efecto positivo, de débil a moderada magnitud, en todos los dominios de la sexualidad: acto sexual (CP = 0,339 [IC95% = 0,190-0,488] p <0,001); relaciones afectivas (CP = 0,117 [IC95% = -0,041-0,275] p <0,001) y adversidades físicas y sociales (CP = 0,150 [IC95% = 0,074-0,226] p <0,001). Conclusión: la sexualidad entre los adultos mayores puede ser explorada con mayor frecuencia en los servicios de salud, ya que ejerció efectos positivos acerca de la funcionalidad familiar y la calidad de vida en esta población. Se espera que, con los resultados de este estudio, se aprecie la temática en los servicios de atención y que se explore la sexualidad en la vejez con los ancianos, especialmente en la atención primaria de salud.


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Saúde Pública , Saúde do Idoso , Assistência Integral à Saúde , Sexualidade , Relações Familiares
19.
J. Health Biol. Sci. (Online) ; 10(1): 1-6, 01/jan./2022.
Artigo em Português | LILACS | ID: biblio-1366907

RESUMO

Objetivos: estabelecer diagnóstico diferencial das demências em ambulatório de geriatria no Distrito Federal, calculando-se sua prevalência por meio de exame clínico e avaliação multifuncional. Método: estudo longitudinal, retrospectivo, com amostra de pessoas com 60 anos ou mais residentes no Distrito Federal-Brasil, com déficit cognitivo caracterizado por Transtorno Neurocognitivo (TNC) Maior (demência), cadastradas durante os anos de 2010 a 2018. A coleta de dados foi realizada em prontuários para selecionar e avaliar o perfil do idoso com diagnóstico de TNC seguida de avaliação geriátrica ampla e avaliação multifuncional. A análise de dados foi realizada com o cálculo da prevalência, estatística descritiva e índice V de Cramer. Resultados: 158 indivíduos conseguiram concluir todas as avalições. 52,5% possuem de 80 a 89 anos, 62,5% são mulheres e 62,7% caucasianos, 50,6% viúvos e 47,5% analfabetos. A prevalência inicial de Doença de Alzheimer (DA) foi de 45,6%, reduzindo-se para 35,4% após um período de acompanhamento e a demência vascular (DV) foi de 34,2%, inicialmente, e 45,6% ao final. Utilizou-se o Coeficiente V de Cramer, em que se encontrou uma relação fraca de fatores de risco com os diagnósticos das demências apresentados. Conclusão: DV foi a mais prevalente na área estudada. Entende-se ser a maior frequência de DA esteja relacionada à avaliação superficial uma vez que esse tipo de demência é mundialmente mais frequente


Objetivos: estabelecer diagnóstico diferencial das demências em ambulatório de geriatria no Distrito Federal, calculando-se sua prevalência por meio de exame clínico e avaliação multifuncional. Método: estudo longitudinal, retrospectivo, com amostra de pessoas com 60 anos ou mais residentes no Distrito Federal-Brasil, com déficit cognitivo caracterizado por Transtorno Neurocognitivo (TNC) Maior (demência), cadastradas durante os anos de 2010 a 2018. A coleta de dados foi realizada em prontuários para selecionar e avaliar o perfil do idoso com diagnóstico de TNC seguida de avaliação geriátrica ampla e avaliação multifuncional. A análise de dados foi realizada com o cálculo da prevalência, estatística descritiva e índice V de Cramer. Resultados: 158 indivíduos conseguiram concluir todas as avalições. 52,5% possuem de 80 a 89 anos, 62,5% são mulheres e 62,7% caucasianos, 50,6% viúvos e 47,5% analfabetos. A prevalência inicial de Doença de Alzheimer (DA) foi de 45,6%, reduzindo-se para 35,4% após um período de acompanhamento e a demência vascular (DV) foi de 34,2%, inicialmente, e 45,6% ao final. Utilizou-se o Coeficiente V de Cramer, em que se encontrou uma relação fraca de fatores de risco com os diagnósticos das demências apresentados. Conclusão: DV foi a mais prevalente na área estudada. Entende-se ser a maior frequência de DA esteja relacionada à avaliação superficial uma vez que esse tipo de demência é mundialmente mais frequente


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Avaliação Geriátrica/métodos , Demência/diagnóstico , Demência/epidemiologia , Brasil/epidemiologia , Demência Vascular/diagnóstico , Demência Vascular/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Estudos Longitudinais , Diagnóstico Diferencial , Estudos Ecológicos , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/epidemiologia , Testes de Estado Mental e Demência
20.
Braz. j. oral sci ; 21: e226709, jan.-dez. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1392989

RESUMO

Studying the different indicators of functional dentition classification can contribute to the understanding of the associated factors, and thus help in the definition of strategies associated with oral health care. This approach has been little explored in the literature, especially when considering the older age group. Aim:The aim of this study is to evaluate the factors associated with three distinct functional dentition classification. Methods: Cross-sectional exploratory study using secondary data from the Frailty in Older Brazilians (FIBRA) Project of 876 older adults living in Campinas, Brazil. The indicators of dental function assessed was number of natural teeth present, occluding pairs of teeth and the Eichner index, which were verified by trained dentists, following the World Health Organization criteria for epidemiological studies in oral health. The explanatory variable assessed was the self-perception of oral health-related quality of life measured by the Geriatric Oral Health Assessment Index (GOHAI) and its dimensions. It was also collected sociodemographic information such as age, gender, race/ethnicity, schooling, family income, smoking behavior and frailty status. The association was verified through Poisson regressions for number of teeth and pairs of teeth in occlusion and multinomial regression for the Eichner index, adjusted by sociodemographic and health variables. Results: Lower prevalence of participants with less than 21 teeth who negatively perceived GOHAI ́s pain and discomfort dimension and higher prevalence of having less teeth among the ones that negatively perceived GOHAI ́s physical and functional dimensions. No association was found between the perception of quality of life and occlusion pairs of teeth and the Eichner Index. Conclusion: Two out of three indicators assessed were associated with quality of life. Therefore, it is important to select sensitive indicators to be able to identify and better comprehend this relationship


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida , Saúde Bucal , Dentição , Fatores Sociodemográficos
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