Topical Cellular/Tissue and Molecular Aspects Regarding Nonpharmacological Interventions in Alzheimer's Disease-A Systematic Review.

One of the most complex and challenging developments at the beginning of the third millennium is the alarming increase in demographic aging, mainly-but not exclusively-affecting developed countries. This reality results in one of the harsh medical, social, and economic consequences: the continuously increasing number of people with dementia, including Alzheimer's disease (AD), which accounts for up to 80% of all such types of pathology. Its large and progressive disabling potential, which eventually leads to death, therefore represents an important public health matter, especially because there is no known cure for this disease. Consequently, periodic reappraisals of different therapeutic possibilities are necessary. For this purpose, we conducted this systematic literature review investigating nonpharmacological interventions for AD, including their currently known cellular and molecular action bases. This endeavor was based on the PRISMA method, by which we selected 116 eligible articles published during the last year. Because of the unfortunate lack of effective treatments for AD, it is necessary to enhance efforts toward identifying and improving various therapeutic and rehabilitative approaches, as well as related prophylactic measures.

Ce/Sm/Sr-Incorporating Ceramic Scaffolds Obtained via Sol-Gel Route.

Three different inorganic scaffolds were obtained starting from the oxide system SiO2‒P2O5‒CaO‒MgO, to which Ce4+/Sm3+/Sr2+ cations were added in order to propose novel materials with potential application in the field of hard tissue engineering. Knowing the beneficial effects of each element, improved features in terms of mechanical properties, antibacterial activity and cellular response are expected. The compositions were processed in the form of scaffolds by a common sol-gel method, followed by a thermal treatment at 1000 and 1200 °C. The obtained samples were characterized from thermal, compositional, morphological and mechanical point of view. It was shown that each supplementary component triggers the modification of the crystalline phase composition, as well as microstructural details. Moreover, the shrinkage behavior is well correlated with the attained compression strength values. Sm was proven to be the best choice, since in addition to a superior mechanical resistance, a clear beneficial influence on the viability of 3T3 fibroblast cell line was observed.

Composite Fiber Networks Based on Polycaprolactone and Bioactive Glass-Ceramics for Tissue Engineering Applications.

In this work, composite fibers connected in three-dimensional porous scaffolds were fabricated by electrospinning, starting from polycaprolactone and inorganic powders synthesized by the sol-gel method. The aim was to obtain materials dedicated to the field of bone regeneration, with controllable properties of bioresorbability and bioactivity. The employed powders were nanometric and of a glass-ceramic type, a fact that constitutes the premise of a potential attachment to living tissue in the physiological environment. The morphological characterization performed on the composite materials validated both the fibrous character and oxide powder distribution within the polymer matrix. Regarding the biological evaluation, the period of immersion in simulated body fluid led to the initiation of polymer degradation and a slight mineralization of the embedded particles, while the osteoblast cells cultured in the presence of these scaffolds revealed a spatial distribution at different depths and a primary networking tendency, based on the composites' geometrical and dimensional features.

PCL-ZnO/TiO2/HAp Electrospun Composite Fibers with Applications in Tissue Engineering.

The main objective of the tissue engineering field is to regenerate the damaged parts of the body by developing biological substitutes that maintain, restore, or improve original tissue function. In this context, by using the electrospinning technique, composite scaffolds based on polycaprolactone (PCL) and inorganic powders were successfully obtained, namely: zinc oxide (ZnO), titanium dioxide (TiO2) and hydroxyapatite (HAp). The novelty of this approach consists in the production of fibrous membranes based on a biodegradable polymer and loaded with different types of mineral powders, each of them having a particular function in the resulting composite. Subsequently, the precursor powders and the resulting composite materials were characterized by the structural and morphological point of view in order to determine their applicability in the field of bone regeneration. The biological assays demonstrated that the obtained scaffolds represent support that is accepted by the cell cultures. Through simulated body fluid immersion, the biodegradability of the composites was highlighted, with fiber fragmentation and surface degradation within the testing period.

Findings regarding the relationships between sociodemographic, psychological, comorbidity factors, and functional status, in geriatric inpatients.

OBJECTIVE: To assess the impact of socio-demographic and comorbidity factors, and quantified depressive symptoms on disability in inpatients. METHODS: Observational cross-sectional study, including a number of 80 elderly (16 men, 64 women; mean age 72.48 years; standard deviation 9.95 years) admitted in the Geriatrics Clinic of "St. Luca" Hospital, Bucharest, between May-July, 2012. We used the Functional Independence Measure, Geriatric Depression Scale and an array of socio-demographic and poly-pathology parameters. Statistical analysis included Wilcoxon and Kruskal-Wallis tests for ordinal variables, linear bivariate correlations, general linear model analysis, ANOVA. RESULTS: FIM scores were negatively correlated with age (R=-0.301; 95%CI=-0.439 -0.163; p=0.007); GDS scores had a statistically significant negative correlation (R=-0.322; 95% CI=-0.324 -0.052; p=0.004) with FIM scores. A general linear model, including other variables (gender, age, provenance, matrimonial state, living conditions, education, respectively number of chronic illnesses) as factors, found living conditions (p=0.027) and the combination of matrimonial state and gender (p=0.004) to significantly influence FIM scores. ANOVA showed significant differences in FIM scores stratified by the number of chronic diseases (p=0.035). DISCUSSION AND CONCLUSIONS: Our study objectified the negative impact of depression on functional status; interestingly, education had no influence on FIM scores; living conditions and a combination of matrimonial state and gender had an important impact: patients with living spouses showed better functional scores than divorced/widowers; the number of chronic diseases also affected the FIM scores: lower in patients with significant polypathology. These findings should be considered when designing geriatric rehabilitation programs, especially for home--including skilled--cares.

Role of comorbidities in caring for chronicly ill elderly patients with and without dementia.

BACKGROUND AND AIM: The aim of this study is to highlight the presence of co-morbidities and their role in caring for chronicly ill patients with and without dementia. PATIENTS AND METHODS: The study was performed on a group of 213 chronic patients. We used CIRS-G (Cumulative Illness Rating Scale in Geriatric Population) and IADL (Instrumental Activity Daily Living) scales. We compared the scores of severity and dependency. RESULTS: The most frequent co-morbidities in the study group were cardiac, vascular, locomotor, sensory organs and metabolic diseases. For the study group, the highest medium score of severity according to the CIRS-G scale was represented by cardiovascular diseases. For patients with dementia, psychiatric, cardiac, vascular, metabolic, genitourinary, sensory organs and locomotion domains had the highest score of severity and dependency. CONCLUSIONS: The health status of chronic patients with and without dementia is characterized by multiple pathologies with various degrees of severity and dependency.