Living in endemic area for infectious diseases accelerates epigenetic age.

Inflammaging is a low-grade inflammatory state generated by the aging process that can contribute to frailty and age-related diseases in the elderly. However, it can have distinct effects in the elderly living in endemic areas for infectious diseases. An increased inflammatory response may confer protection against infectious agents in these areas, although this advantage can cause accelerating epigenetic aging. In this study, we evaluated the inflammatory profile and the epigenetic age of infected and noninfected individuals from an endemic area in Brazil. The profile of cytokines, chemokines and growth factors analyzed in the sera of the two groups of individuals showed similarities, although infected individuals had a higher concentration of these mediators. A significant increase in IL-1ra, CXCL8, CCL2, CCL3 and CCL4 production was associated with leprosy infection. Notably, elderly individuals displayed distinct immune responses associated with their infection status when compared to adults suggesting an adaptive remodelling of their immune responses. Epigenetic analysis also showed that there was no difference in epigenetic age between the two groups of individuals. However, individuals from the endemic area had a significant accelerated aging when compared to individuals from São Paulo, a non-endemic area in Brazil. Moreover, the latter cohort was also epigenetically aged in relation to an Italian cohort. Our data shows that living in endemic areas for chronic infectious diseases results in remodelling of inflammaging and acceleration of epigenetic aging in individuals regardless of their infectious status. It also highlights that geographical, genetic and environmental factors influence aging and immunosenescence in their pace and profile.

Clinical course of multiple sclerosis and labour-force absenteeism: a longitudinal population-based study.

BACKGROUND AND PURPOSE: Multiple sclerosis (MS) is a chronic neurological disease associated with substantial disability and morbidity. The objective of our study was to assess the long-term consequences of MS clinical course on sick leave and disability pension. METHODS: Patients with relapsing-remitting MS (RRMS), secondary progressive MS (SPMS) and primary progressive MS (PPMS) were identified through the Swedish Multiple Sclerosis Registry. We calculated the mean annual prevalence and number of sick leave and disability pension days by clinical course, age and year pre- and post-diagnosis, and compared outcomes using Welch's t-tests and ANOVA models, mixed-effects regression and survival analysis. RESULTS: The sample included 5371 patients (4568 with RRMS, 390 with SPMS and 413 with PPMS). The mean annual number of days with sick leave and disability pension ranged from 101 at 1 year after diagnosis to 164 after 11 years for patients with RRMS. Corresponding estimates for PPMS were 188 and 311 days. Higher levels of absenteeism were observed in patients with PPMS versus RRMS 7 years before diagnosis for sick leave (P < 0.025) and 10 years before diagnosis for disability pension (P < 0.034). Differences between SPMS and PPMS were minor. CONCLUSIONS: Patients with RRMS had substantially lower levels of sick leave and disability pension over time compared with their counterparts with SPMS and PPMS, whereas labour-force absenteeism was similar for patients with SPMS and PPMS. These findings contribute to the understanding of the impact of MS on socioeconomic outcomes and help inform the discussion on the clinical classification of different courses of the disease.

[The role of the semi natural cycle as option of treatment of patients with a poor prognosis for successful in vitro fertilization]. / La place du cycle semi-naturel dans la prise en charge de patientes ayant un mauvais pronostic en fécondation in vitro.

OBJECTIVE: To evaluate the efficacy of semi natural cycle as option of treatment for the patients who have a poor prognosis to controlled ovarian hyperstimulation (COH). PATIENTS AND METHODS: Prospective study. Sixty-six patients with an ovulatory cycle who presented either altered ovarian status (AOS) or implantation failure (IMF) and had carried out a total of 133 semi natural IVF cycles were included. Once follicular dominance was established, the growth of this follicule was controlled by administration of the GnRH antagonist with exogenous gonadotrophins. RESULTS: Groups AOS (n = 47) and IMF (n = 19) were similar with regard to oocyte pickup rate (81.2% and 81.1%), the oocyte recovery rate (61.4% and 64.8%) and clinical pregnancies per oocyte pickups rate (15.4% and 16.6%), respectively. CONCLUSIONS: The semi natural cycle appears as option of treatment for patients who have a poor prognosis for successful in vitro fertilization.

Comparative study of physical and mental incapacities among Portuguese airline pilots under and over age 60.

This study evaluated the number of definitive flight incapacitations and deaths which occurred among Portuguese airline pilots between 1945 and 1983. Also, all pilots over 60, no longer flying, continued to be submitted to the same medical, psychological and psychomotor tests as before. The number of incapacities and deaths was related to the number of pilots by age groups of 5 years from age 20-24 to 65-69, in a total of 1528 pilots at risk. Under age 60, the pilots' careers were interrupted for pathological reasons (8) and deaths (13), mainly through unforeseen severe diseases (13) and violent deaths (6). Over age 60, no deaths occurred and the majority of the psycho-physiological problems susceptible to being considered incapacitating (10) were expressed by expected degenerative disorders which were strictly connected with aging. The rate of incapacities became higher than under age 60, but 64% of over 60 examinees were absolutely fit for flight duties.