Paolo Giuseppe Limoli, Celeste Limoli, Marcella Nebbioso
Cataracts can reduce the quality of vision in visually impaired patients who already have a visual impairment. The most common causes of low vision include age-related macular degeneration (AMD), high myopia (HM), diabetic retinopathy (DR), glaucoma (GL), and inherited degenerative ocular diseases. The surgery aims to improve their independence, quality of life, and ability to engage in daily, social, and work activities. Phacoemulsification and intraocular lens (IOL) implantation, combined with visual rehabilitation, can improve visual acuity of visually impaired patients. Therefore, comprehensive guidelines for cataract surgery in patients with low vision would be beneficial to ensure optimal surgical outcomes by improving surgical planning, execution, and postoperative care, along with a well-coordinated rehabilitation process. In cases of reduced metabolism, such as low vision, oxidative stress can be aggravated by light exposure and surgical interventions. Thus, maintaining redox balance is crucial for stabilizing retinal conditions. Patients with visual impairments rely on retinal regions with the greatest residual function, and cataract surgery aims to enhance focus on these areas, improving reading quality and reducing scotoma perception. Thorough informed consent is crucial, ensuring that patients are fully aware of the potential risks, benefits, and limitations of surgery. Close postoperative follow-up in the first 6 months is crucial to detect and manage any complications promptly, such as reactivation of maculopathy. The aim of this work is to establish potential guidelines for optimal rehabilitation outcomes through careful literature analysis.
{"title":"Potential guidelines for cataract surgery and rehabilitation in visually impaired patients: Literature analysis","authors":"Paolo Giuseppe Limoli, Celeste Limoli, Marcella Nebbioso","doi":"10.1002/agm2.12386","DOIUrl":"10.1002/agm2.12386","url":null,"abstract":"<p>Cataracts can reduce the quality of vision in visually impaired patients who already have a visual impairment. The most common causes of low vision include age-related macular degeneration (AMD), high myopia (HM), diabetic retinopathy (DR), glaucoma (GL), and inherited degenerative ocular diseases. The surgery aims to improve their independence, quality of life, and ability to engage in daily, social, and work activities. Phacoemulsification and intraocular lens (IOL) implantation, combined with visual rehabilitation, can improve visual acuity of visually impaired patients. Therefore, comprehensive guidelines for cataract surgery in patients with low vision would be beneficial to ensure optimal surgical outcomes by improving surgical planning, execution, and postoperative care, along with a well-coordinated rehabilitation process. In cases of reduced metabolism, such as low vision, oxidative stress can be aggravated by light exposure and surgical interventions. Thus, maintaining redox balance is crucial for stabilizing retinal conditions. Patients with visual impairments rely on retinal regions with the greatest residual function, and cataract surgery aims to enhance focus on these areas, improving reading quality and reducing scotoma perception. Thorough informed consent is crucial, ensuring that patients are fully aware of the potential risks, benefits, and limitations of surgery. Close postoperative follow-up in the first 6 months is crucial to detect and manage any complications promptly, such as reactivation of maculopathy. The aim of this work is to establish potential guidelines for optimal rehabilitation outcomes through careful literature analysis.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 6","pages":"802-812"},"PeriodicalIF":2.2,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>According to the latest official report, the incidence and mortality rates of cardiovascular diseases continue to rise in China.<span><sup>1</sup></span> Among these, coronary heart disease (CHD) represents the most significant threat to public health and imposes substantial social burdens. Percutaneous coronary intervention (PCI) has rapidly advanced as a key treatment modality for CHD. With an aging population, the number of PCIs performed in China is projected to increase over the long term. To enhance the prognosis for patients with CHD, it is essential to improve the quality of care while ensuring a reasonable growth in the volume of procedures. In recent years, intravascular imaging-guided PCI has emerged as a crucial approach for the precise optimization of PCI procedures in clinical practice. This imaging primarily encompasses intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Since the 1990s, a wealth of clinical evidence has been published regarding the efficacy and safety of IVUS.<span><sup>2, 3</sup></span> However, despite OCT's superior image resolution, high-quality evidence concerning its impact on patient prognosis remains limited due to its more recent application. Results from two clinical trials comparing OCT-guided PCI with angiography-guided PCI were presented at the European Society of Cardiology Annual Meeting 2023 and subsequently published in the New England Journal of Medicine. The OCTOBER study demonstrated that OCT-guided PCI enhances clinical outcomes for complex bifurcation lesions.<span><sup>4</sup></span> Conversely, the ILUMIEN IV study reported negative findings. Although OCT-guided PCI achieved a larger postoperative minimum stent area (MSA) in clinically high-risk patients and/or high-risk coronary lesions, there was no significant difference in the incidence of target vessel failure (TVF) at 2 years between the two groups.<span><sup>5</sup></span> These contrasting results invite a deeper examination of the prognostic value of OCT-guided PCI. Therefore, this article provides a comprehensive review of the clinical significance and application of OCT-guided PCI in elderly patients, informed by an analysis of these two trials.</p><p>To effectively interpret randomized controlled trials (RCTs) and integrate their findings into clinical practice, adherence to the “PICOS principle,” which encompasses Population, Intervention, Comparison, Outcome, and Study design, is crucial. An analysis of the two clinical trials presented in Table 1 highlights that both studies are direct RCTs assessing the effectiveness of OCT compared to angiography-guided PCI and share similar definitions for their primary end points. However, the inclusion criteria exhibit notable differences. The OCTOBER study is dedicated to validating the use of OCT specifically in true bifurcation lesions with clear indications for PCI. In contrast, the ILUMIEN IV study considers a more diverse population with a wider range of lesi
{"title":"OCT-guided PCI in elderly patients","authors":"Yanwen Fang, Mengyue Yu","doi":"10.1002/agm2.12381","DOIUrl":"10.1002/agm2.12381","url":null,"abstract":"<p>According to the latest official report, the incidence and mortality rates of cardiovascular diseases continue to rise in China.<span><sup>1</sup></span> Among these, coronary heart disease (CHD) represents the most significant threat to public health and imposes substantial social burdens. Percutaneous coronary intervention (PCI) has rapidly advanced as a key treatment modality for CHD. With an aging population, the number of PCIs performed in China is projected to increase over the long term. To enhance the prognosis for patients with CHD, it is essential to improve the quality of care while ensuring a reasonable growth in the volume of procedures. In recent years, intravascular imaging-guided PCI has emerged as a crucial approach for the precise optimization of PCI procedures in clinical practice. This imaging primarily encompasses intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Since the 1990s, a wealth of clinical evidence has been published regarding the efficacy and safety of IVUS.<span><sup>2, 3</sup></span> However, despite OCT's superior image resolution, high-quality evidence concerning its impact on patient prognosis remains limited due to its more recent application. Results from two clinical trials comparing OCT-guided PCI with angiography-guided PCI were presented at the European Society of Cardiology Annual Meeting 2023 and subsequently published in the New England Journal of Medicine. The OCTOBER study demonstrated that OCT-guided PCI enhances clinical outcomes for complex bifurcation lesions.<span><sup>4</sup></span> Conversely, the ILUMIEN IV study reported negative findings. Although OCT-guided PCI achieved a larger postoperative minimum stent area (MSA) in clinically high-risk patients and/or high-risk coronary lesions, there was no significant difference in the incidence of target vessel failure (TVF) at 2 years between the two groups.<span><sup>5</sup></span> These contrasting results invite a deeper examination of the prognostic value of OCT-guided PCI. Therefore, this article provides a comprehensive review of the clinical significance and application of OCT-guided PCI in elderly patients, informed by an analysis of these two trials.</p><p>To effectively interpret randomized controlled trials (RCTs) and integrate their findings into clinical practice, adherence to the “PICOS principle,” which encompasses Population, Intervention, Comparison, Outcome, and Study design, is crucial. An analysis of the two clinical trials presented in Table 1 highlights that both studies are direct RCTs assessing the effectiveness of OCT compared to angiography-guided PCI and share similar definitions for their primary end points. However, the inclusion criteria exhibit notable differences. The OCTOBER study is dedicated to validating the use of OCT specifically in true bifurcation lesions with clear indications for PCI. In contrast, the ILUMIEN IV study considers a more diverse population with a wider range of lesi","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 6","pages":"676-678"},"PeriodicalIF":2.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the effects of suberoylanilide hydroxamic acid (SAHA) on lung fibroblast activation and to examine the role of p66Shc in this process.
Methods
An in vitro pulmonary fibrosis model was established using transforming growth factor-β (TGF-β)-induced MRC-5 lung fibroblasts. The proliferation and migration capacities of MRC-5 cells, along with the expression of fibrosis-related genes, were assessed following treatment with SAHA and/or silence of p66Shc.
Results
In TGF-β-induced MRC-5 lung fibroblasts, SAHA treatment significantly inhibited cell proliferation and migration, as well as the expression of fibrosis-related genes, including collagen I and α-smooth muscle actin (SMA). Western blot and immunofluorescence assays revealed that SAHA increased p66Shc expression in both whole cells and mitochondria. Additionally, mito-SOX assay confirmed that SAHA treatment led to a marked accumulation of mitochondrial reactive oxygen species (ROS). However, silencing of p66Shc significantly reversed the aforementioned effects of SAHA on MRC-5 cells. Furthermore, chromatin immunoprecipitation (ChIP) assays demonstrated that SAHA enhanced active histone markers, H3K9Ac and H3K4Me3, in the p66Shc gene region.
Conclusions
SAHA alleviates lung fibroblast activation and migration by increasing p66Shc expression and mitochondrial ROS generation through epigenetic modifications of histone 3.
{"title":"SAHA inhibits lung fibroblast activation by increasing p66Shc expression epigenetically","authors":"Yiheng Dong, Jieting Peng, Xiangyu Zhang, Qiong Wang, Xing Lyu","doi":"10.1002/agm2.12385","DOIUrl":"10.1002/agm2.12385","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the effects of suberoylanilide hydroxamic acid (SAHA) on lung fibroblast activation and to examine the role of p66Shc in this process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An in vitro pulmonary fibrosis model was established using transforming growth factor-β (TGF-β)-induced MRC-5 lung fibroblasts. The proliferation and migration capacities of MRC-5 cells, along with the expression of fibrosis-related genes, were assessed following treatment with SAHA and/or silence of p66Shc.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In TGF-β-induced MRC-5 lung fibroblasts, SAHA treatment significantly inhibited cell proliferation and migration, as well as the expression of fibrosis-related genes, including collagen I and α-smooth muscle actin (SMA). Western blot and immunofluorescence assays revealed that SAHA increased p66Shc expression in both whole cells and mitochondria. Additionally, mito-SOX assay confirmed that SAHA treatment led to a marked accumulation of mitochondrial reactive oxygen species (ROS). However, silencing of p66Shc significantly reversed the aforementioned effects of SAHA on MRC-5 cells. Furthermore, chromatin immunoprecipitation (ChIP) assays demonstrated that SAHA enhanced active histone markers, H3K9Ac and H3K4Me3, in the p66Shc gene region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SAHA alleviates lung fibroblast activation and migration by increasing p66Shc expression and mitochondrial ROS generation through epigenetic modifications of histone 3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 6","pages":"790-801"},"PeriodicalIF":2.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aysha Rajeev, Connor Hunter, Saurav Krishnan, Atta Ullah, George Koshy, Gateshead Health Foundation NHS Trust
Objectives
The prevalence of low Vitamin D levels (<30 nmol/L) is about 15.7% globally. The aim of this study was to examine the prevalence of vitamin D deficiency in elderly patients with fragility fractures of the hip by estimating 25-hydroxyvitamin D levels and to assess whether low vitamin D levels at the time of admission affect functional outcomes at 3 months and mortality at 28 days and 1 year.
Methods
We conducted a retrospective study of all patients admitted with a fracture of the neck of the femur between January 2018 and March 2022. Data were obtained from the National Hip Fracture Database (NHFD) and Medway software. A total of 1440 patients were included. Patient demographics, including age, sex, fracture pattern, vitamin D levels at the time of admission, functional status at 120 days, and mortality at 1 month and 1 year, were analyzed.
Results
The average age of the patients was 81.91 years (range 60–108). Of the patients, 1009 (70%) were female and 431 (30%) were male. Vitamin D levels were low in 796 patients (55.3%). Mobility significantly declined in patients with vitamin D deficiency within 3 months after surgery for proximal femur fractures. The 28-day and one-year mortality rates were 6.7% and 30.3%, respectively, in patients with low vitamin D levels, compared to 4.7% and 22.3% in those with normal levels. Patients with low vitamin D levels at the time of admission had higher mortality rates at both 28 days and 1 year compared to those with normal levels.
Conclusion
Our study demonstrates that low vitamin D levels at the time of admission for proximal femur fractures are associated with poorer functional mobility and higher perioperative and 1-year mortality rates.
{"title":"The prevalence and outcomes of pre-admission vitamin D levels in the management of proximal femur fractures","authors":"Aysha Rajeev, Connor Hunter, Saurav Krishnan, Atta Ullah, George Koshy, Gateshead Health Foundation NHS Trust","doi":"10.1002/agm2.12375","DOIUrl":"10.1002/agm2.12375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The prevalence of low Vitamin D levels (<30 nmol/L) is about 15.7% globally. The aim of this study was to examine the prevalence of vitamin D deficiency in elderly patients with fragility fractures of the hip by estimating 25-hydroxyvitamin D levels and to assess whether low vitamin D levels at the time of admission affect functional outcomes at 3 months and mortality at 28 days and 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective study of all patients admitted with a fracture of the neck of the femur between January 2018 and March 2022. Data were obtained from the National Hip Fracture Database (NHFD) and Medway software. A total of 1440 patients were included. Patient demographics, including age, sex, fracture pattern, vitamin D levels at the time of admission, functional status at 120 days, and mortality at 1 month and 1 year, were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average age of the patients was 81.91 years (range 60–108). Of the patients, 1009 (70%) were female and 431 (30%) were male. Vitamin D levels were low in 796 patients (55.3%). Mobility significantly declined in patients with vitamin D deficiency within 3 months after surgery for proximal femur fractures. The 28-day and one-year mortality rates were 6.7% and 30.3%, respectively, in patients with low vitamin D levels, compared to 4.7% and 22.3% in those with normal levels. Patients with low vitamin D levels at the time of admission had higher mortality rates at both 28 days and 1 year compared to those with normal levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study demonstrates that low vitamin D levels at the time of admission for proximal femur fractures are associated with poorer functional mobility and higher perioperative and 1-year mortality rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 6","pages":"699-704"},"PeriodicalIF":2.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amr Badary, Sarah Zuhair Kurdi, Yasser F. Almealawy, Sura N. Alrubaye, Vivek Sanker, Bipin Chaurasia, Oday Atallah
Objective
Ependymomas, rare neuroglial tumors originating from ependymal cells, can occur in the CNS and typically affect the brain's ventricles or spinal cord. Prognosis is influenced by tumor grade, location, resection extent, and preoperative Karnofsky Performance Status Scale (KPSS) scores. This study evaluates clinical features, treatment outcomes, and factors affecting prognosis in patients with intracranial ependymomas.
Methods
A retrospective review of 23 patients with intracranial ependymomas, treated from 2018 to 2023, was conducted. Data included demographics, clinical presentations, KPSS scores, imaging findings, and treatment details. Outcomes assessed were postoperative complications, recurrence rates, and functional status. Statistical analysis used SPSS version 26, with significance set at p < 0.05.
Results
The cohort was predominantly male (87.0%), with a mean age of 27 years. Tumors were mostly in the fourth ventricle (82.6%), with an average diameter of 68.9 mm. Complete resection was achieved in 87.0% of cases. Postoperative radiotherapy was given to 91.0% of grade 2 and all grade 3 tumors. Recurrence occurred in 17.4% of grade 2 ependymomas, but none of grade 3. The seven-month mortality rate was 4.3%. Higher preoperative KPSS scores correlated with better outcomes.
Conclusion
Complete tumor resection and postoperative radiotherapy are crucial for improved outcomes in ependymomas. Higher preoperative KPSS scores and tumor location significantly impact prognosis. Tumors in the lateral ventricles are associated with higher recurrence risks. These findings highlight the need for aggressive surgical management and personalized adjuvant therapy to enhance patient outcomes.
目的：室管膜瘤是一种罕见的起源于室管膜细胞的神经胶质肿瘤，可发生在中枢神经系统，通常影响脑室或脊髓。预后受肿瘤分级、位置、切除程度和术前Karnofsky Performance Status Scale （KPSS）评分的影响。本研究评估颅内室管膜瘤患者的临床特征、治疗结果和影响预后的因素。方法：回顾性分析2018 - 2023年收治的23例颅内室管膜瘤患者的临床资料。数据包括人口统计学、临床表现、KPSS评分、影像学结果和治疗细节。评估的结果包括术后并发症、复发率和功能状态。统计学分析采用SPSS 26版本，显著性设置为p。结果：队列以男性为主（87.0%），平均年龄27岁。肿瘤以第四脑室居多（82.6%），平均直径68.9 mm。87.0%的病例完全切除。91.0%的2级肿瘤和所有3级肿瘤术后给予放疗。17.4%的2级室管膜瘤复发，而3级室管膜瘤无复发。7个月死亡率为4.3%。术前KPSS评分越高，预后越好。结论：肿瘤完全切除和术后放疗是改善室管膜瘤预后的关键。术前较高的KPSS评分和肿瘤位置对预后有显著影响。侧脑室肿瘤有较高的复发风险。这些发现强调需要积极的手术管理和个性化的辅助治疗来提高患者的预后。
{"title":"Intracranial ependymoma: A retrospective analysis of clinical features, treatment modalities, and long-term outcome","authors":"Amr Badary, Sarah Zuhair Kurdi, Yasser F. Almealawy, Sura N. Alrubaye, Vivek Sanker, Bipin Chaurasia, Oday Atallah","doi":"10.1002/agm2.12378","DOIUrl":"10.1002/agm2.12378","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Ependymomas, rare neuroglial tumors originating from ependymal cells, can occur in the CNS and typically affect the brain's ventricles or spinal cord. Prognosis is influenced by tumor grade, location, resection extent, and preoperative Karnofsky Performance Status Scale (KPSS) scores. This study evaluates clinical features, treatment outcomes, and factors affecting prognosis in patients with intracranial ependymomas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of 23 patients with intracranial ependymomas, treated from 2018 to 2023, was conducted. Data included demographics, clinical presentations, KPSS scores, imaging findings, and treatment details. Outcomes assessed were postoperative complications, recurrence rates, and functional status. Statistical analysis used SPSS version 26, with significance set at <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort was predominantly male (87.0%), with a mean age of 27 years. Tumors were mostly in the fourth ventricle (82.6%), with an average diameter of 68.9 mm. Complete resection was achieved in 87.0% of cases. Postoperative radiotherapy was given to 91.0% of grade 2 and all grade 3 tumors. Recurrence occurred in 17.4% of grade 2 ependymomas, but none of grade 3. The seven-month mortality rate was 4.3%. Higher preoperative KPSS scores correlated with better outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Complete tumor resection and postoperative radiotherapy are crucial for improved outcomes in ependymomas. Higher preoperative KPSS scores and tumor location significantly impact prognosis. Tumors in the lateral ventricles are associated with higher recurrence risks. These findings highlight the need for aggressive surgical management and personalized adjuvant therapy to enhance patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 6","pages":"679-688"},"PeriodicalIF":2.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicolas Farina, Uzma Niazi, Riona Mc Ardle, Johanna Eronen, Ruth Lowry, Sube Banerjee
Objectives
To understand how psychosocial factors associated with physical activity differ based on disease severity in people with dementia, and how these factors are associated with physical activity participation.
Methods
Eighty-seven people with dementia, alongside their family carer were asked to complete a series of questions related to physical activity participation, including barriers, motivators, and facilitators. Regression models were developed to understand how psychosocial factors were associated with physical activity participation in the cohort.
Results
In the final models, only the absence of intrapersonal barriers was associated with overall physical activity and regular moderate-to-vigorous physical activity. Feelings of relatedness were associated with regular moderate-to-vigorous physical activity only.
Conclusion
Reducing intrapersonal barriers would appear to be a potentially useful strategy to promote physical activity in people with dementia. However, a tailored approach is needed depending on the desired physical activity outcome.
{"title":"Psychosocial factors associated with physical activity in people with dementia: A pilot cross-sectional study","authors":"Nicolas Farina, Uzma Niazi, Riona Mc Ardle, Johanna Eronen, Ruth Lowry, Sube Banerjee","doi":"10.1002/agm2.12364","DOIUrl":"https://doi.org/10.1002/agm2.12364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To understand how psychosocial factors associated with physical activity differ based on disease severity in people with dementia, and how these factors are associated with physical activity participation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eighty-seven people with dementia, alongside their family carer were asked to complete a series of questions related to physical activity participation, including barriers, motivators, and facilitators. Regression models were developed to understand how psychosocial factors were associated with physical activity participation in the cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the final models, only the absence of intrapersonal barriers was associated with overall physical activity and regular moderate-to-vigorous physical activity. Feelings of relatedness were associated with regular moderate-to-vigorous physical activity only.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Reducing intrapersonal barriers would appear to be a potentially useful strategy to promote physical activity in people with dementia. However, a tailored approach is needed depending on the desired physical activity outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 5","pages":"543-552"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12364","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142588047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yi-Xuan Liao, Yang Ju, He Wang, Xiao-Man Du, Jing Wang, Fan Zhang, Yan-Ming Li
The construction of a quality control system for respiratory medicine is of great significance for improving the quality and homogenization of the diagnosis and treatment of respiratory diseases. The national respiratory quality control work conducted by the China National Respiratory Medicine Quality Control Center was summarized.
{"title":"Respiratory medical quality control system construction in China","authors":"Yi-Xuan Liao, Yang Ju, He Wang, Xiao-Man Du, Jing Wang, Fan Zhang, Yan-Ming Li","doi":"10.1002/agm2.12369","DOIUrl":"https://doi.org/10.1002/agm2.12369","url":null,"abstract":"<p>The construction of a quality control system for respiratory medicine is of great significance for improving the quality and homogenization of the diagnosis and treatment of respiratory diseases. The national respiratory quality control work conducted by the China National Respiratory Medicine Quality Control Center was summarized.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 5","pages":"539-542"},"PeriodicalIF":2.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142588273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alzheimer's disease (AD) is a neurodegenerative disease that is characterized by amyloid plaques, neurofibrillary tangles, and neuronal loss. Early cerebral and body iron dysregulation and accumulation interact with AD pathology, particularly in the precuneus, a crucial functional hub in cognitive functions. Quantitative susceptibility mapping (QSM), a novel post-processing approach, provides insights into tissue iron levels and cerebral oxygen metabolism and reveals abnormal iron accumulation early in AD. Increased iron deposition in the precuneus can lead to oxidative stress, neuroinflammation, and accelerated neurodegeneration. Metabolic disorders (diabetes, non-alcoholic fatty liver disease (NAFLD), and obesity), genetic factors, and small vessel pathology contribute to abnormal iron accumulation in the precuneus. Therefore, in line with the growing body of literature in the precuneus region of patients with AD, QSM as a neuroimaging method could serve as a non-invasive biomarker to track disease progression, complement other imaging modalities, and aid in early AD diagnosis and monitoring.
{"title":"Iron accumulation/overload and Alzheimer's disease risk factors in the precuneus region: A comprehensive narrative review","authors":"Sana Mohammadi, Sadegh Ghaderi, Farzad Fatehi","doi":"10.1002/agm2.12363","DOIUrl":"https://doi.org/10.1002/agm2.12363","url":null,"abstract":"<p>Alzheimer's disease (AD) is a neurodegenerative disease that is characterized by amyloid plaques, neurofibrillary tangles, and neuronal loss. Early cerebral and body iron dysregulation and accumulation interact with AD pathology, particularly in the precuneus, a crucial functional hub in cognitive functions. Quantitative susceptibility mapping (QSM), a novel post-processing approach, provides insights into tissue iron levels and cerebral oxygen metabolism and reveals abnormal iron accumulation early in AD. Increased iron deposition in the precuneus can lead to oxidative stress, neuroinflammation, and accelerated neurodegeneration. Metabolic disorders (diabetes, non-alcoholic fatty liver disease (NAFLD), and obesity), genetic factors, and small vessel pathology contribute to abnormal iron accumulation in the precuneus. Therefore, in line with the growing body of literature in the precuneus region of patients with AD, QSM as a neuroimaging method could serve as a non-invasive biomarker to track disease progression, complement other imaging modalities, and aid in early AD diagnosis and monitoring.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 5","pages":"649-667"},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142588268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of this study is to examine the epidemiological characteristics of very elderly patients (aged over 80 years) with cancer admitted to the intensive care unit (ICU), and to elucidate the association between Acute Physiology Score III (APS-III) and 28-day mortality.
Method
A retrospective analysis was conducted using data extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients aged 80 years and above were assigned to three groups: non-cancer group, non-metastatic cancer group, and metastatic cancer group, based on their cancer diagnosis and its extent, Kaplan–Meier curves were constructed among these patient groups. Furthermore, patients were divided into a survival group and a non-survival group based on their 28-day survival status after ICU admission. Univariate and multivariate logistic regression analyses were performed to detect the risk factors for 28-day mortality among these patients. Additionally, this investigation sought to establish a dose–response relationship by exploring the graded association between APS-III scores and the 28-day mortalities among patients diagnosed with cancer.
Results
A total of 42,037 medical records were screened, from which 11,461 elderly patients aged over 80 years were included, comprising 1020 (8.90%) with non-metastatic cancer, 537 (4.68%) with metastatic cancer, and 9904 (86.41%) without cancer. Significant differences in 28-day mortality were observed between both the non-metastatic and metastatic cancer groups compared to the non-cancer group (20.98% and 22.35% vs. 15.75%, p < 0.001). However, no statistically significant difference was detected in the 28-day mortality rate when comparing the non-metastatic cancer group directly with the metastatic cancer group (20.98% vs. 22.35%, p = 0.576). Univariate analysis revealed significant differences (p < 0.001) in age, gender, BMI, aCCI excluding cancer point, ventilation, presence of cancer, and status of metastatic cancer between the survival and non-survival groups. In the multivariate logistic regression, the odds ratio (OR) for ventilation was found to be 2.154 (95% CI: 1.799–2.578), cancer conferred an OR of 1.499 (95% CI: 1.137–1.975), metastatic cancer showed an OR of 1.171 (95% CI: 0.745–1.841), APS-III showed an OR of 1.038 (95% CI: 1.034–1.042). A dose–response relationship was observed, demonstrating that when the APS-III score exceeded 80 points, the 28-day mortality rate surpassed 50% among the very elderly cancer patients in ICU.
{"title":"Short-term mortality among very elderly cancer patients in the intensive care unit: A retrospective cohort study based on the Medical Information Mart for Intensive Care IV database","authors":"Taotao Liu, Runyu Ding","doi":"10.1002/agm2.12358","DOIUrl":"https://doi.org/10.1002/agm2.12358","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to examine the epidemiological characteristics of very elderly patients (aged over 80 years) with cancer admitted to the intensive care unit (ICU), and to elucidate the association between Acute Physiology Score III (APS-III) and 28-day mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective analysis was conducted using data extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients aged 80 years and above were assigned to three groups: non-cancer group, non-metastatic cancer group, and metastatic cancer group, based on their cancer diagnosis and its extent, Kaplan–Meier curves were constructed among these patient groups. Furthermore, patients were divided into a survival group and a non-survival group based on their 28-day survival status after ICU admission. Univariate and multivariate logistic regression analyses were performed to detect the risk factors for 28-day mortality among these patients. Additionally, this investigation sought to establish a dose–response relationship by exploring the graded association between APS-III scores and the 28-day mortalities among patients diagnosed with cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 42,037 medical records were screened, from which 11,461 elderly patients aged over 80 years were included, comprising 1020 (8.90%) with non-metastatic cancer, 537 (4.68%) with metastatic cancer, and 9904 (86.41%) without cancer. Significant differences in 28-day mortality were observed between both the non-metastatic and metastatic cancer groups compared to the non-cancer group (20.98% and 22.35% vs. 15.75%, <i>p</i> < 0.001). However, no statistically significant difference was detected in the 28-day mortality rate when comparing the non-metastatic cancer group directly with the metastatic cancer group (20.98% vs. 22.35%, <i>p</i> = 0.576). Univariate analysis revealed significant differences (<i>p</i> < 0.001) in age, gender, BMI, aCCI excluding cancer point, ventilation, presence of cancer, and status of metastatic cancer between the survival and non-survival groups. In the multivariate logistic regression, the odds ratio (OR) for ventilation was found to be 2.154 (95% CI: 1.799–2.578), cancer conferred an OR of 1.499 (95% CI: 1.137–1.975), metastatic cancer showed an OR of 1.171 (95% CI: 0.745–1.841), APS-III showed an OR of 1.038 (95% CI: 1.034–1.042). A dose–response relationship was observed, demonstrating that when the APS-III score exceeded 80 points, the 28-day mortality rate surpassed 50% among the very elderly cancer patients in ICU.</p>\u0000 </se","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 5","pages":"580-587"},"PeriodicalIF":2.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142588259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alberto Castagna, Vincenzo Militano, Carmen Ruberto, Ciro Manzo, Giovanni Ruotolo
The geriatric vision of palliative care is based on a multidisciplinary, patient-centered approach, looking for a balance between human dignity and medical treatments with a particular focus on the social and ethical aspects. In order to develop the best care models, there is a rising need for a tighter collaboration of all the involved players (i.e., doctors, nurses, social workers). Indeed, the idea of a fragmented system without considering the patient or his/her family is not at all applicable to older patients with chronic disease. The causes of death, the phase of death changes, and the extend of last period of life could be a long phase characterized by complicated treatment decisions, difficult management of symptoms, multiple psychosocial problems, and complex spiritual distress. Recently, Italian guidelines on Comprehensive Geriatric Assessment (CGA) have been published. However, none of the identified studies on patients in hospice and other palliative care facilities met the criteria for inclusion. These findings underscore the need for further research to determine the potential benefits of a multidimensional approach for patients in hospice and other palliative care settings. Our reflections and suggestions on the CGA use for older persons in palliative care may be a starting point for an open and continuous dialogue with all the operators concerned.
{"title":"Comprehensive geriatric assessment and palliative care","authors":"Alberto Castagna, Vincenzo Militano, Carmen Ruberto, Ciro Manzo, Giovanni Ruotolo","doi":"10.1002/agm2.12367","DOIUrl":"https://doi.org/10.1002/agm2.12367","url":null,"abstract":"<p>The geriatric vision of palliative care is based on a multidisciplinary, patient-centered approach, looking for a balance between human dignity and medical treatments with a particular focus on the social and ethical aspects. In order to develop the best care models, there is a rising need for a tighter collaboration of all the involved players (i.e., doctors, nurses, social workers). Indeed, the idea of a fragmented system without considering the patient or his/her family is not at all applicable to older patients with chronic disease. The causes of death, the phase of death changes, and the extend of last period of life could be a long phase characterized by complicated treatment decisions, difficult management of symptoms, multiple psychosocial problems, and complex spiritual distress. Recently, Italian guidelines on Comprehensive Geriatric Assessment (CGA) have been published. However, none of the identified studies on patients in hospice and other palliative care facilities met the criteria for inclusion. These findings underscore the need for further research to determine the potential benefits of a multidimensional approach for patients in hospice and other palliative care settings. Our reflections and suggestions on the CGA use for older persons in palliative care may be a starting point for an open and continuous dialogue with all the operators concerned.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 5","pages":"645-648"},"PeriodicalIF":2.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12367","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142588033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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