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Limitations of studies with elderly

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https://www.readbyqxmd.com/read/28230262/evaluation-of-the-immunogenicity-of-the-dabigatran-reversal-agent-idarucizumab-during-phase-i-studies
#1
Stephen Norris, Steven Ramael, Ippei Ikushima, Wouter Haazen, Akiko Harada, Viktoria Moschetti, Susumu Imazu, Paul A Reilly, Benjamin Lang, Joachim Stangier, Stephan Glund
AIMS: Idarucizumab, a humanized monoclonal anti-dabigatran antibody fragment, is effective in emergency reversal of dabigatran anticoagulation. Pre-existing and treatment-emergent anti-idarucizumab antibodies (antidrug antibodies; ADA) may affect the safety and efficacy of idarucizumab. This analysis characterized the pre-existing and treatment-emergent ADA and assessed their impact on the pharmacokinetics and pharmacodynamics (PK/PD) of idarucizumab. METHODS: Data were pooled from three phase I, randomized, double-blind idarucizumab studies in healthy Caucasian; elderly, renally impaired subjects; and healthy Japanese subjects...
February 23, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28228654/low-ft3-a-possible-marker-of-frailty-in-the-elderly
#2
Aldo Bertoli, Alessia Valentini, Maria Assunta Cianfarani, Elena Gasbarra, Umberto Tarantino, Massimo Federici
INTRODUCTION: Frailty is associated with a functional decline of multiple physiological systems, of which they may be a cause or consequence. The objective of the study was to evaluate the prevalence of thyroid hormone modifications in elderly frail subjects and its relationship with frailty. STUDY POPULATION AND METHODS: An observational study was carried out at the University Hospital "Tor Vergata" in Rome among ambulatory and hospitalized patients. The study population consisted of 112 elderly subjects: 62 were hospitalized following hip fracture and 50 control subjects were outpatients...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28228454/sex-differences-in-long-term-mortality-after-stroke-in-the-instruct-international-stroke-outcomes-study-a-meta-analysis-of-individual-participant-data
#3
Hoang T Phan, Christopher L Blizzard, Mathew J Reeves, Amanda G Thrift, Dominique Cadilhac, Jonathan Sturm, Emma Heeley, Petr Otahal, Vemmos Konstantinos, Craig Anderson, Priya Parmar, Rita Krishnamurthi, Suzanne Barker-Collo, Valery Feigin, Yannick Bejot, Norberto L Cabral, Antonio Carolei, Simona Sacco, Nicolas Chausson, Stephane Olindo, Peter Rothwell, Carolina Silva, Manuel Correia, Rui Magalhães, Peter Appelros, Janika Kõrv, Riina Vibo, Cesar Minelli, Seana Gall
BACKGROUND: Women are reported to have greater mortality after stroke than men, but the reasons are uncertain. We examined sex differences in mortality at 1 and 5 years after stroke and identified factors contributing to these differences. METHODS AND RESULTS: Individual participant data for incident strokes were obtained from 13 population-based incidence studies conducted in Europe, Australasia, South America, and the Caribbean between 1987 and 2013. Data on sociodemographics, stroke-related factors, prestroke health, and 1- and 5-year survival were obtained...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28224694/the-clinical-relevance-of-orthostatic-hypotension-in-elderly-patients
#4
Laura Hartog, Nanne Kleefstra, Rene Luigies, Sophia de Rooij, Henk Bilo, Kornelis van Hateren
AIM: Orthostatic hypotension (OH) is highly prevalent in old age. The impact of OH on orthostatic complaints and falling is questionable. We wondered if the consensus definition of OH plays an essential role in the accuracy and direction of the prediction of these endpoints. We aimed to explore the relation between different definitions of OH, including relative decrease of blood pressure, and orthostatic complaints and falling. METHODS: A cross-sectional study was performed with 1415 participants aged ≥65 years visiting a mobile fall-prevention team...
February 22, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28224377/curcumin-attenuates-surgery-induced-cognitive-dysfunction-in-aged-mice
#5
Xiang Wu, Huixin Chen, Chunhui Huang, Xinmei Gu, Jialing Wang, Dilin Xu, Xin Yu, Chu Shuai, Liping Chen, Shun Li, Yiguo Xu, Tao Gao, Mingrui Ye, Wei Su, Haixiong Liu, Jinrong Zhang, Chuang Wang, Junping Chen, Qinwen Wang, Wei Cui
Post-operative cognitive dysfunction (POCD) is associated with elderly patients undergoing surgery. However, pharmacological treatments for POCD are limited. In this study, we found that curcumin, an active compound derived from Curcuma longa, ameliorated the cognitive dysfunction following abdominal surgery in aged mice. Further, curcumin prevented surgery-induced anti-oxidant enzyme activity. Curcumin also increased brain-derived neurotrophic factor (BDNF)-positive area and expression of pAkt in the brain, suggesting that curcumin activated BDNF signaling in aged mice...
February 21, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28217923/limiting-the-testing-of-urea-urea-along-with-every-plasma-creatinine-test
#6
Gao-Ming Zhang, Xu-Xiao Guo, Guo-Ming Zhang
BACKGROUND: We found that it is not necessary to simultaneously detect both creatinine (CREA) and urea until the concentration of CREA is lower than the certain level. To reduce urea testing, we suggest measuring urea only when CREA or estimated glomerular filtration rate (eGFR) exceeds a predetermined limit. MATERIALS AND METHODS: CREA and urea data were analyzed consisting of almost all of people age above 65 years old check-up (n=95441) in Shuyang countryside, and inpatients (n=101631), outpatients (n=18474) and Routine Health Check-up (n=20509) in Shuyang People's Hospital...
February 20, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28215968/unicompartmental-knee-arthroplasty-vs-total-knee-arthroplasty-for-medial-compartment-arthritis-in-patients-older-than-75-years-comparable-reoperation-revision-and-complication-rates
#7
Homayoun Siman, Atul F Kamath, Nazly Carrillo, William S Harmsen, Mark W Pagnano, Rafael J Sierra
BACKGROUND: Prior studies comparing unicompartmental knee arthroplasty (UKA) with total knee arthroplasty (TKA) in the elderly are limited by heterogeneity in arthritic disease patterns and patient selection. We report the results of UKA and TKA in patients 75 years and older with isolated medial compartmental arthritis, with special emphasis on immediate postoperative recovery, complications, reoperation rates, and implant survivorship at midterm follow-up. METHODS: A retrospective review was performed of all patients 75 years and older who underwent UKA or TKA at our institution between 2002 and 2012...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214386/management-and-prognosis-of-hcc-in-the-elderly-results-of-an-in-field-multicenter-cohort-study
#8
Mauro Borzio, Elena Dionigi, Alessandro Vitale, Angelo Rossini, Massimo Marignani, Fabio Fornari, Susanna Vicari, Ilario De Sio, Fabio Farinati, Emanuela Bertolini, Filippo Oliveri, Gioacchino Leandro, Giampiero Francica, Mario Mitra, Barbara Omazzi, Sergio Boccia, Andrea Salmi, Anna Toldi, Rodolfo Sacco
AIMS: This multicentre cohort study evaluated the role of aging on clinical characteristics, treatment allocation, and outcome of new HCCs, in clinical practice. MATERIAL AND METHODS: From September 2008, 541 patients aged > 70 years old (elderly group), and 527 ≤ 70 years old (non elderly group) with newly diagnosed HCC were consecutively enrolled in 30 Italian centres. Differences in clinical characteristics and treatment allocation between groups were described by a multivariable logistic regression model measuring the inverse probability weight to meet the elderly group...
February 18, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28211362/marrow-isolated-adult-multilineage-inducible-cells-embedded-within-a-biologically-inspired-construct-promote-recovery-in-a-mouse-model-of-peripheral-vascular-disease
#9
Cristina Grau-Monge, Gaëtan J-R Delcroix, Andrea Bonnin-Marquez, Mike Valdes, Ead Lewis Mazen Awadallah, Daniel F Quevedo, Maxime R Armour, Ramon B Montero, Paul C Schiller, Fotios M Andreopoulos, Gianluca D'Ippolito
Peripheral vascular disease is one of the major vascular complications in individuals suffering from diabetes and in the elderly that is associated with significant burden in terms of morbidity and mortality. Stem cell therapy is being tested as an attractive alternative to traditional surgery to prevent and treat this disorder. The goal of this study was to enhance the protective and reparative potential of marrow-isolated adult multilineage inducible (MIAMI) cells by incorporating them within a bio-inspired construct (BIC) made of two layers of gelatin B electrospun nanofibers...
February 17, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28211169/a-first-in-human-study-of-ds-1040-an-inhibitor-of-the-activated-form-of-thrombin-activatable-fibrinolysis-inhibitor-in-healthy-subjects
#10
Jin Zhou, Jarema Kochan, Ophelia Yin, Vance Warren, Cynthia Zamora, George Atiee, Joseph Pav, Yasushi Orihashi, Vijay Vashi, Victor Dishy
BACKGROUND: Current treatments for acute ischemic stroke and venous thromboembolism, such as recombinant tissue plasminogen activator and thrombectomy, are limited by a narrow time window and the risk of bleeding. DS-1040 is a novel low-molecular weight compound inhibiting the activated form of thrombin-activatable fibrinolysis inhibitor (TAFIa), developed as a fibrinolysis enhancer for treatment of thromboembolic diseases. OBJECTIVES: This first-in-human, randomized, placebo-controlled, three-part, phase 1 study was conducted to evaluate the safety, pharmacokinetics (PK), and pharmacodynamics (PD) of DS-1040 in healthy subjects...
February 17, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28208849/finger-length-ratio-2d-4d-in-central-india-and-an-attempt-to-verify-fraternal-birth-order-effect-a-population-based-cross-sectional-study
#11
Arjun Maitra, Chaitali Maitra, Dilip Kumar Jha, Rakesh Biswas
INTRODUCTION: A normal physiology of a human being is not mere a series of functions occurring with specific intensities and timing. There are lot of factors that may change the normal physiological activity within normal limits. Finger length ratio is one of the markers of intrauterine androgen exposure and it is debated and contradicted by many authors. Digit ratio varies among the ethnicities. Many Indian studies show that there is considerable difference in finger length ratio in different population...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208604/reducing-fall-risk-with-combined-motor-and-cognitive-training-in-elderly-fallers
#12
Francesco Barban, Roberta Annicchiarico, Matteo Melideo, Alessia Federici, Maria Giovanna Lombardi, Simone Giuli, Claudia Ricci, Fulvia Adriano, Ivo Griffini, Manuel Silvestri, Massimo Chiusso, Sergio Neglia, Sergio Ariño-Blasco, Raquel Cuevas Perez, Yannis Dionyssiotis, Georgios Koumanakos, Milo Kovačeić, Nuria Montero-Fernández, Oscar Pino, Niels Boye, Ulises Cortés, Cristian Barrué, Atia Cortés, Peter Levene, Stelios Pantelopoulos, Roberto Rosso, José Antonio Serra-Rexach, Angelo Maria Sabatini, Carlo Caltagirone
BACKGROUND: Falling is a major clinical problem in elderly people, demanding effective solutions. At present, the only effective intervention is motor training of balance and strength. Executive function-based training (EFt) might be effective at preventing falls according to evidence showing a relationship between executive functions and gait abnormalities. The aim was to assess the effectiveness of a motor and a cognitive treatment developed within the EU co-funded project I-DONT-FALL...
February 10, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28207328/socioeconomic-determinants-of-sodium-intake-in-adult-populations-of-high-income-countries-a-systematic-review-and-meta-analysis
#13
Carlos de Mestral, Ana-Lucia Mayén, Dusan Petrovic, Pedro Marques-Vidal, Murielle Bochud, Silvia Stringhini
BACKGROUND: A poorer quality diet among individuals with low socioeconomic status (SES) may partly explain the higher burden of noncommunicable disease among disadvantaged populations. Because there is a link between sodium intake and noncommunicable diseases, we systematically reviewed the current evidence on the social patterning of sodium intake. OBJECTIVES: To conduct a systematic review and a meta-analysis of the evidence on the association between SES and sodium intake in healthy adult populations of high-income countries...
February 16, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28206931/a-comprehensive-investigation-of-comorbidities-mechanisms-injury-patterns-and-outcomes-in-geriatric-blunt-trauma-patients
#14
Carlos V R Brown, Kevin Rix, Amanda L Klein, Brent Ford, Pedro G R Teixeira, Jayson Aydelotte, Ben Coopwood, Sadia Ali
The geriatric population is growing and trauma providers are often tasked with caring for injuries in the elderly. There is limited information regarding injury patterns in geriatric trauma patients stratified by mechanism of injury. This study intends to investigate the comorbidities, mechanisms, injury patterns, and outcomes in geriatric blunt trauma patients. A retrospective study of the 2012 National Trauma Databank was performed. Adult blunt trauma patients were identified; geriatric (>/=65) patients were compared with younger (<65) patients regarding admission demographics and vital signs, mechanism and severity of injury, and comorbidities...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28199263/travel-distance-to-cancer-treatment-facilities-in-the-deep-south
#15
Mary J Wills, Marilyn V Whitman, Thomas M English
Despite ongoing efforts to improve rural healthcare, the health problems facing rural communities persist. The lack of healthcare providers and infrastructure in rural areas has been linked to a number of negative consequences. Among the elderly rural population, the lack of proximal access presents greater barriers because many elderly people are further limited in their ability to travel and pay for services. In the Deep South specifically, rural residents experience limited access to care and overall poor health outcomes...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28196115/nutritional-assessment-of-community-dwelling-older-adults-in-rural-nepal
#16
Saruna Ghimire, Binaya Kumar Baral, Karen Callahan
BACKGROUND: Demographic transition in Nepal, like in many developing countries, has resulted in a burgeoning elderly population whose health status is not currently monitored. One pillar of health is adequate nutrition. Yet, little is known about the nutritional health status of the elderly in Nepal. The financial, material, and personnel limitations in Nepal's health delivery services necessitate health screening instruments that require minimal clinical staff and resources. To our knowledge, no such nutritional assessment tool has been validated in Nepal...
2017: PloS One
https://www.readbyqxmd.com/read/28195648/hematology-and-biochemistry-of-aging-evidence-of-anemia-of-the-elderly-in-old-dogs
#17
Lauren B Radakovich, Stephen C Pannone, Matthew P Truelove, Christine S Olver, Kelly S Santangelo
BACKGROUND: Effects of aging on hematologic and biochemical variables are well described in people. Anemia of the elderly is attributed to iron deficiency, anemia of chronic disease, chronic kidney disease, myelodysplasia, or idiopathic causes. Limited studies have examined these variables in aging dogs, but they have typically examined single breeds in research settings. OBJECTIVE: The objective of this study was to identify differences in CBC and biochemistry values between adult and aged dogs of many breeds...
February 13, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28194905/a-proinflammatory-secretome-mediates-the-impaired-immunopotency-of-human-mesenchymal-stromal-cells-in-elderly-patients-with-atherosclerosis
#18
Özge Kizilay Mancini, Maximilien Lora, Dominique Shum-Tim, Stephanie Nadeau, Francis Rodier, Inés Colmegna
Inflammation plays a pivotal role in the initiation and progression of atherosclerosis (ATH). Due to their potent immunomodulatory properties, mesenchymal stromal cells (MSCs) are evaluated as therapeutic tools in ATH and other chronic inflammatory disorders. Aging reduces MSCs immunopotency potentially limiting their therapeutic utility. The mechanisms that mediate the effect of age on MSCs immune-regulatory function remain elusive and are the focus of this study. Human adipose tissue-derived MSCs were isolated from patients undergoing coronary artery bypass graft surgery...
February 14, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28194052/once-weekly-1-6%C3%A2-mg-m-2-bortezomib-bcd-regimen-in-elderly-patients-with-newly-diagnosed-multiple-myeloma-who-are-unfit-for-standard-dose-chemotherapy
#19
Yong Tang, Ye-Hua Yu, Yi-Yun Yao, Li-Fang Zou, Hong-Ju Dou, Lei Wang, Qi Zhu
Bortezomib has shown anti-myeloma effects in combination with alkylating agents, but clinical benefits can be limited by neurotoxicity. There is less information on the efficacy and tolerability of once-weekly 1.6 mg/m(2) bortezomib combined with cyclophosphamide and dexamethasone (BCD) regimen in elderly patients with newly diagnosed multiple myeloma who are unfit for standard dose chemotherapy. Here, we report our experience of weekly 1.6 mg/m(2) intravenous bortezomib in this group of patients. Between March 2010 and February 2015, we treated 34 newly diagnosed elderly patients with the combination of bortezomib 1...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28191550/mapping-lifetime-brain-volumetry-with-covariate-adjusted-restricted-cubic-spline-regression-from-cross-sectional-multi-site-mri
#20
Yuankai Huo, Katherine Aboud, Hakmook Kang, Laurie E Cutting, Bennett A Landman
Understanding brain volumetry is essential to understand neurodevelopment and disease. Historically, age-related changes have been studied in detail for specific age ranges (e.g., early childhood, teen, young adults, elderly, etc.) or more sparsely sampled for wider considerations of lifetime aging. Recent advancements in data sharing and robust processing have made available considerable quantities of brain images from normal, healthy volunteers. However, existing analysis approaches have had difficulty addressing (1) complex volumetric developments on the large cohort across the life time (e...
October 2016: Medical Image Computing and Computer-assisted Intervention: MICCAI ..
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