Hypothalamic pituitary dysfunction after nasopharyngeal carcinoma irradiation.

PURPOSE: Radiotherapy (RT) is the corner stone of nasopharyngeal carcinoma (NPC) treatment but it exposes to late effects especially hypothalamic pituitary deficiency (HPD). In this article,we aimed to assess the impact of RT on pituitary function in NPC survivors. METHODS: We included 55 patients treated in the radiation oncology department, of Farhat Hached Hospital in Sousse, Tunisia. RESULTS: All patients received facio-cervical RT with a mean dose of 73.3 Gy to the nasopharynx. After a mean follow up of 9.56 years, 34 patients (61.8%) presented HPD. Associated peripheral involvement was seen in 18.2%. The most prevalent deficiency was of the GH axis in 50.9% followed by secondary adrenal insufficiency in 20%. Panhypopituitarism was noted in 8.8%. The development of HPD wasn't related to RT dose (OR: 0.41(0.05-2.92), p = 0.36) but was significantly associated with male gender (OR: 1.67 (1.21-2.37), p = 0.01). CONCLUSION: HPD post RT is a common phenomenon. Therefore, we recommend regular assessment of pituitary function amongst patients treated with RT for NPC because identification of deficits is crucial to allow early and appropriate hormone replacement therapy in order to improve patients quality of life.

Associations of frailty with partial and absolute sedentary behaviours among older adults: A STROBE-compliant analysis of modifiability by gender and age.

BACKGROUND: Research shows that frailty is associated with higher sedentary behaviour, but the evidence to date regarding this association is inconclusive. This study assessed whether the above association is moderated or modified by gender and age, with sedentary behaviour measured with a more inclusive method. METHODS: This study adopted a STROBE-compliant cross-sectional design with sensitivity analyses and measures against common methods bias. The participants were community-dwelling older adults (mean age = 66 years) in two Ghanaian towns. A self-reported questionnaire was used to collect data from 1005 participants after the minimum sample size necessary was calculated. The hierarchical linear regression analysis was used to analyse the data. RESULTS: After adjusting for the ultimate confounders, frailty was associated with higher sedentary behaviour (ß = 0.14; t = 2.93; p <0.05) as well as partial and absolute sedentary behaviour. Gender modified the above associations in the sense that frailty was more strongly associated with sedentary behaviour among women, compared with men. Age also modified the association between frailty and sedentary behaviour, which suggests that frailty was more strongly associated with higher sedentary behaviour at a higher age. CONCLUSION: Sedentary behaviour could be higher at higher frailty among older adults. Frailty is more strongly associated with sedentary behaviour at a higher age and among women, compared with men.

Associations of Social Networks with Physical Activity Enjoyment among Older Adults: Walkability as a Modifier through a STROBE-Compliant Analysis.

The available evidence suggests that social networks can contribute to physical activity (PA) enjoyment, which is necessary for the maintenance of PA over the life course. This study assessed the associations of active and sedentary social networks with PA enjoyment and ascertained whether walkability moderates or modifies these associations. A cross-sectional design compliant with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) was employed. The participants were 996 community-dwelling older Ghanaians aged 50 years or older. A hierarchical linear regression analysis was used to analyse the data. After adjusting for age and income, the study found that the active social network size (ß = 0.09; p < 0.05) and sedentary social network size (ß = 0.17; p < 0.001) were positively associated with PA enjoyment. These associations were strengthened by walkability. It is concluded that active and sedentary social networks may better support PA enjoyment in more walkable neighbourhoods. Therefore, enabling older adults to retain social networks and live in more walkable neighbourhoods may be an effective way to improve their PA enjoyment.

Information technology ability mediates the association between older adults' subjective age and social activity: A STROBE-compliant cross-sectional analysis.

BACKGROUND: The association between subjective age and social activity has been reported in the extant literature, but whether this association is mediated by information technology ability and its domains (i.e., internet use assessment, packaged software use assessment, and innovativeness attitude) has not been examined. AIM: To assess the association between subjective age and social activity and to ascertain whether this association is mediated by information technology ability. METHODS: This study adopted a cross-sectional design characterising sensitivity analyses and common methods bias. The participants were 895 community-dwelling older adults aged 60 years or higher in Accra, Ghana. We measured subjective age, information technology ability, and social activity with previously validated Likert scales, each of which was internally consistent at a Cronbach's α ≥0.7. The data were analysed with partial least squares structural equation modelling (PLS-SEM) and hierarchical linear regression (HLR) analysis. RESULTS: Subjective age was positively associated with social activity, and this association was partially mediated by information technology ability but none of the three domains of information technology ability mediated this relationship. Subjective age was positively associated with information technology ability and its three domains. Information technology ability (but not its domains) was positively associated with social activity. CONCLUSION: Older subjective age was associated with higher social activity through information technology ability. Social activity and information technology ability levels among older adults depend on subjective age, which has implications for ageing and gerontology as reported in this paper.

A randomised clinical trial to compare octyl cyanoacrylate with absorbable monofilament sutures for the closure of laparoscopic cholecystectomy port incisions.

Tissue adhesives have gained increasing use as a possible method of wound closure. We compared the use of 2-octyl cyanoacrylate (OCA) or subcuticular suture in incisions sutures for the closure of laparoscopic cholecystectomy port incisions. A prospective randomised controlled trial was performed. Patients were randomised to have closure of laparoscopic port sites using either OCA or sutures. Patients were reviewed at 24 hours and returned for follow-up 1 week and 1 month after postoperatively. At these times, different wound characteristics were documented: Two tools were used to measure the cosmetic result using Hollander wound evaluation scale (HWES) and the patient and observer scar assessment scale (POSAS). A total of 70 patients, 35 in each group were enrolled. The wounds were closed significantly faster in the OCA group (mean 229.16 [±43.7] seconds versus 258.82 [±51.7] seconds, P = .01). Statistically significant difference in favour of using OCA was found for dehiscence (17.1% versus none in the suture group, P = .025) after 1 week. However, no difference was found for wound dehiscence after 1 month. OCA and suture groups did not differ significantly on patient satisfaction. There were no differences in the percentage of wounds achieving optimal scores on the HWES (suture 85.7% versus OCA 74.2%, P = .169). Nerveless, wound evolution was judged to be significantly better in the OCA group using POSAS. Patients' median POSAS was 9.45 (6-11) and 11.43 (10-13) in the OCA and suture groups, respectively (P = .005), and surgeon's median POSAS was 9.42 (6-11) and 11.48 (10-13) in the OCA and suture groups, respectively (P = .006). N-butyl-cyanoacrylate tissue adhesive is an acceptable technique for the closure of laparoscopic wounds with less operative time, and cosmetic results are comparable to suturing.