Magnesium, aging, and the elderly patient.

Magnesium, beyond any doubt, plays an important role in metabolism. Alterations of magnesium levels have an impact on many organs and systems, especially during aging. We had 156 participants aged 60-93 years (average 74.7 years) in our survey. Of them, 49 were men and 107 were women. Treatment with loop diuretics (Furosemid and Bumetanide) and magnesium levels was correlated, as well as the influence of magnesium levels on life span. Serum magnesium levels were measured in patients receiving diuretics and in the control group. Also, magnesium levels were measured in patients who passed away in the course of their disease and were compared with the control group. Magnesium levels in the diuretic group (100 patients) were 0.93 +/- 0.094 mmol/l, while the average levels in the control group of 56 patients were 0.89 +/- 0.075 mmol/l. In 29 patients who passed away, average magnesium levels were 0.92 +/- 0.078 mmol/l, while in the control group (127 patients), magnesium levels were 0.93 +/- 0.083 mmol/l. The differences were not statistically significant. There were no differences in serum magnesium of the elderly persons investigated regarding age group, gender, or type of diuretics. If methods of determining ionizing magnesium in serum or intracellular magnesium are not available, normal magnesium values in the serum are to be taken with a qualified acceptance.

[Subclinical and manifested hypothyroidism as a consequence of thyroid autoimmune disease].

Chronic thyroiditis (Hashimoto's disease) is a slowly developing persistent inflamation of the thyroid gland, which frequently leads to hypothyroidism. Some of the up-to-date knowledge about hypothyroidism, both subclinical and manifested, caused by autoimmune disease, was presented. Autoimmune thyroid gland disease can occur at any age, but predominantly affects women after periods of high emotional and physical stress or accidents, as well as during periods of hormonal changes. It can also develop in families, and having an autoimmune disease slightly increases the risk of developing another. This paper showed an increasing incidence of subclinical hypothyroidism (4.17%) in elderly, and, at the same time, the incidence of primary hypothyroidism accounting for 1%. It is very usefull to estimate the stimulated thyrotropin (TSH) response, as well as the value of fast, short time thyroid gland reserves, analyzed by T3 and T4 serum level at 60th minute after TRH stimulation. Treatment of choice for HT (hypothyroidism of any cause) is thyroid hormone replacement. Drug of choice is orally administered levothyroxine sodium, usually for life-time. The standard dose is 1.6-1.8 mcg/kg body weight per day, but is in most cases patient dependent. Elderly patients usually require smaller replacement dose of levothyroxine, sometimes less than 1 mcg/kg body weight per day with coronary dilatator at the same time.

[Prognostic value of early post-infarction angina in elderly patients].

Although numerous studies have shown that early post-infarction angina was a predictor of poor prognosis in patients with acute myocardial infarction, not a single study has considered this issue in the elderly. The goal of this study, based on a five-year follow-up of elderly patients with acute myocardial infarction, was to determine whether early post-infarction angina in the elderly had any influence on mortality and the incidence of additional coronary events. The study population consisted of 51 patients, aged 60 years or more, with acute myocardial infarction. Early post-infarction angina occurred in 31 subjects (Group 1), while it did not in 20 subjects (Group 2). Patients were monitored for five years and the incidences of death and new coronary events were recorded. A survival analysis was carried out using the Kaplan-Meier method. The survival analysis showed no difference between the observed groups concerning the following probabilities: death (p = 0.9459), cardiac death (p = 0.8253), myocardial reinfarction (p = 0.7405), new coronary events (p = 0.1708), unstable angina (p = 0.1788), myocardial revascularisation (p = 0.0691), and heart failure (p = 0.7047). In contrast to the younger population, where numerous studies have confirmed the link between early post-infarction angina and poor long-term prognosis, such findings could not be replicated in this study of the elderly population.