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Elderly patients

Sapan H Shah, Brian E Schwartz, Aaron R Schwartz, Benjamin A Goldberg, Samuel J Chmell
The rate of total knee arthroplasty (TKA) utilization in younger patients (< 65 years old) is increasing. Little is known regarding demographics and in-hospital outcomes in this population. The National Hospital Discharge Survey (NHDS) database was searched using International Classification of Diseases, Ninth Revision (ICD-9) procedure codes for patients admitted to U.S. hospitals for unilateral primary TKA between 2001 and 2010. Patients were separated into young (< 65 years of age) and senior cohorts (≥ 65 years of age)...
October 24, 2016: Journal of Knee Surgery
Annamaria Cattaneo, Nadia Cattane, Samantha Galluzzi, Stefania Provasi, Nicola Lopizzo, Cristina Festari, Clarissa Ferrari, Ugo Paolo Guerra, Barbara Paghera, Cristina Muscio, Angelo Bianchetti, Giorgio Dalla Volta, Marinella Turla, Maria Sofia Cotelli, Michele Gennuso, Alessandro Prelle, Orazio Zanetti, Giulia Lussignoli, Dario Mirabile, Daniele Bellandi, Simona Gentile, Gloria Belotti, Daniele Villani, Taoufiq Harach, Tristan Bolmont, Alessandro Padovani, Marina Boccardi, Giovanni B Frisoni
The pathway leading from amyloid-β deposition to cognitive impairment is believed to be a cornerstone of the pathogenesis of Alzheimer's disease (AD). However, what drives amyloid buildup in sporadic nongenetic cases of AD is still unknown. AD brains feature an inflammatory reaction around amyloid plaques, and a specific subset of the gut microbiota (GMB) may promote brain inflammation. We investigated the possible role of the GMB in AD pathogenesis by studying the association of brain amyloidosis with (1) GMB taxa with pro- and anti-inflammatory activity; and (2) peripheral inflammation in cognitively impaired patients...
August 31, 2016: Neurobiology of Aging
T Ilyicheva, A Durymanov, I Susloparov, N Kolosova, N Goncharova, S Svyatchenko, O Petrova, A Bondar, V Mikheev, A Ryzhikov
The influenza epidemic in 2015-2016 in Russia is characterized by a sharp increase of influenza cases (beginning from the second week of 2016) with increased fatalities. Influenza was confirmed in 20 fatal cases registered among children (0-10 years), in 5 cases among pregnant women, and in 173 cases among elderly people (60 years and older). Two hundred and ninety nine people died from influenza were patients with some chronic problems. The overwhelming majority among the deceased (more than 98%) were not vaccinated against influenza...
2016: PloS One
Khaled M Kebaish, Benjamin D Elder, Sheng-Fu L Lo, Timothy F Witham
STUDY DESIGN: Technical report and case illustration. OBJECTIVE: To review the rationale and steps for a sublaminar decompression in the setting of adult deformity surgery and in degenerative spondylosis. SUMMARY OF BACKGROUND DATA: Several variations of lumbar laminotomy and posterior decompressions have been reported, although these are primarily in the setting of isolated lumbar stenosis, and often focus on treatment of central stenosis...
October 21, 2016: Clinical Spine Surgery
L-Z Qin, W Li, Y Huang, F Lu, S-J Li, H-Q Yang, J-W Zhang
OBJECTIVE: This study aims to investigate the expression of pentraxin3 (PTX3) in elderly patients with acute cerebral infarction (ACI) and to analyze the relationship of PTX3 with the severity and prognosis of ACI. PATIENTS AND METHODS: Between June 2014 and August 2015, 96 elderly patients with first-onset of ACI admitted to our institution were enrolled in the present study. Also, 70 healthy elderly subjects were included as controls in this study. Levels of PTX3, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, homocysteine (Hcy), fibrinogen (FIB), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined in all patients both pre-therapeutically and 30 days post-therapeutically...
October 2016: European Review for Medical and Pharmacological Sciences
Angela J Drake-Holland, Mark I M Noble
Hyponatremia is the most common electrolyte abnormality and is often neglected, especially in elderly and seemingly terminal patients. Hyponatremia can be asymptomatic or can cause symptoms ranging from nausea and lethargy to convulsions and coma. This condition has become increasingly common over time with a similar time course to the increase in adoption of low salt diets. The popularization of low salt may not be justified in people with normal kidney function in whom the compatible statistically based evidence that salt causes hypertension has been challenged by experimental evidence to the contrary...
2016: Frontiers in Cardiovascular Medicine
Edwina A Brown, Frederic O Finkelstein, Osasuyi U Iyasere, Alan S Kliger
Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal dialysis enables dialysis at home. As with any disease management decision, patients approaching end-stage renal disease need all the appropriate facts about their prognosis, the natural history of their disease without dialysis, and the resulting outcomes and complications of the different dialysis modalities...
October 20, 2016: Kidney International
John Jose, Geetesh Manik, Mohamed Abdel-Wahab
Transcatheter aortic valve implantation (TAVI) has revolutionized the management of elderly patients with symptomatic severe aortic stenosis in the western world. It is a valuable alternative to surgical aortic valve replacement in patients, who are inoperable or at high surgical risk due to co-morbidities. The prevalence of aortic stenosis increases sharply with age after the sixth decade and is expected to have a significant impact on the geriatric health care system of India, given the rapid increase in life expectancy in recent years...
September 2016: Indian Heart Journal
Toni M Mueller, Stefani D Yates, Vahram Haroutunian, James H Meador-Woodruff
Glycosylation is a post-translational modification that is an essential element in cell signaling and neurodevelopmental pathway regulation. Glycan attachment can influence the tertiary structure and molecular interactions of glycosylated substrates, adding an additional layer of regulatory complexity to functional mechanisms underlying central cell biological processes. One type of enzyme-mediated glycan attachment, fucosylation, can mediate glycoprotein and glycolipid cell surface expression, trafficking, secretion, and quality control to modulate a variety of inter- and intracellular signaling cascades...
October 20, 2016: Schizophrenia Research
Lance M Larson, Robert Sliter, Stephen D Helmer, Jared Reyes, Greg Crawford, James M Haan
BACKGROUND: Falls are the leading cause of trauma-related death in the elderly, but postdischarge outcomes' data are lacking. The purpose of this study was to evaluate 12-month postdischarge mortality and causes of death. METHODS: A retrospective review was conducted of patients 65 years and older admitted for a fall and discharged alive. Data collection included demographics, injury characteristics, hospitalization details, and outcomes. A state death database and hospital records were queried to identify patients who died within 12 months of hospital discharge...
September 29, 2016: American Journal of Surgery
Christopher Bliemel, Ludwig Oberkircher, Benjamin Bockmann, Eric Petzold, Rene Aigner, Thomas Jan Heyse, Steffen Ruchholtz, Benjamin Buecking
INTRODUCTION: Compromised bone quality and the need for early mobilization continue to lead to implant failure in elderly patients with distal femoral fractures. The cement augmentation of screws might facilitate improving implant anchorage. The aim of this study was to analyse the impact of cement augmentation of the condylar screws on implant fixation in a human cadaveric bone model. MATERIAL AND METHODS: Ten pairs of osteoporotic femora (mean age: 90 years, range: 84-99 years) were used...
October 18, 2016: Injury
C Toyas, C Aspiroz, R M Martínez-Álvarez, A I Ezpeleta, P Arazo, J C Ferrando
OBJECTIVE: To describe the characteristics of bacteraemias, according to age, in a community hospital. MATERIAL AND METHOD: A prospective study of bacteraemias was conducted in 2011. The patients were classified into 3 age groups: younger than 65 years, 65 to 79, and 80 or older. The study collected variables on the patients and episodes. RESULTS: The study analysed 233 bacteraemias in 227 patients (23.8% in those younger than 65 years; 38...
October 20, 2016: Revista Clínica Española
Hajime Yoshimura, Riki Matsumoto, Hiroyuki Ueda, Koichi Ariyoshi, Michi Kawamoto, Junko Ishii, Akio Ikeda, Ryosuke Takahashi, Nobuo Kohara
OBJECTIVE: To delineate the clinical characteristics and functional outcome of status epilepticus (SE) in elderly people, and elucidate prognostic implications of SE-associated rhythmic and periodic patterns (RPPs) in electroencephalography and hyperintensities on diffusion-weighted imaging. METHODS: We retrospectively investigated 107 consecutive patients with SE aged≥65years in a comprehensive community hospital. RPPs were classified using the 2012 American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology...
November 15, 2016: Journal of the Neurological Sciences
George L Bakris, John M Burkart, Eric D Weinhandl, Peter A McCullough, Michael A Kraus
Hypertension is a cardinal feature of end-stage renal disease (ESRD). Hypertensive nephropathy is the primary cause of ESRD for nearly 30% of patients, and the prevalence of hypertension is >85% in new patients with ESRD. In contemporary hemodialysis (HD) patients, mean predialysis systolic blood pressure (SBP) is nearly 150mmHg, and about 70%, 50%, and 40% use β-blockers, calcium channel blockers, and renin-angiotensin system inhibitors, respectively. Predialysis SBP generally exhibits a U-shaped association with mortality risk...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Maeve Leonard, Henry O'Connell, Olugbenga Williams, Fahad Awan, Chris Exton, Margaret O'Connor, Dimitrios Adamis, Colum Dunne, Walter Cullen, David J Meagher
OBJECTIVE: Efficient detection of neurocognitive disorders is a key diagnostic challenge. We explored how simple bedside tests of attention, vigilance and visuospatial function might assist in identifying delirium in hospitalized patients. METHODS: Performance on a battery of bedside cognitive tests was compared in elderly medical inpatients with DSM-IV delirium, dementia, comorbid delirium-dementia, and no neurocognitive disorder. RESULTS: 193 patients [mean age 79...
November 2016: Journal of Psychosomatic Research
Elizabeth Fink, Katherine Fuller, Brian Agan, Edward A Berger, Andrew Saphire, Gerald V Quinnan, John H Elder
The purpose of this study was to assess humoral antibody responses as a function of disease progression in a well-defined HIV+ cohort. We quantified antibodies to HIV-1 gp120, Gag and CD4 receptor by ELISA in sera from a cohort of 97 HIV+ subjects at defined stages of disease progression. We also measured antibody-dependent cellular cytotoxicity (ADCC) as a function of the clinical status of the patients. We purified antibodies to CD4 and gp120 and assessed them for specificity, ability to block gp120 binding to target cells, ability to block virus infection, and ability to facilitate ADCC...
October 22, 2016: AIDS Research and Human Retroviruses
Maliha Khan, Armaghan-E-Rehman Mansoor, Tapan M Kadia
Acute myeloid leukemia (AML) is a markedly heterogeneous hematological malignancy that is most commonly seen in elderly adults. The response to current therapies to AML is quite variable, and very few new drugs have been recently approved for use in AML. This review aims to discuss the issues with current trial design for AML therapies, including trial end points, patient enrollment, cost of drug discovery and patient heterogeneity. We also discuss the future directions in AML therapeutics, including intensification of conventional therapy and new drug delivery mechanisms; targeted agents, including epigenetic therapies, cell cycle regulators, hypomethylating agents and chimeric antigen receptor T-cell therapy; and detail of the possible agents that may be incorporated into the treatment of AML in the future...
October 24, 2016: Future Oncology
Guido Grassi, Fosca Quarti-Trevano, Anna Casati, Raffaella Dell'Oro
PURPOSE OF REVIEW: Detection of elevated blood pressure values in elderly patients represents a common clinical condition associated with an increased cardiovascular risk. This has been shown to be the case in both systodiastolic and isolated systolic hypertension as well. However, despite the evidence of the benefits of the blood pressure lowering intervention in terms of reduction of cardiovascular morbidity and mortality, at least two issues related to antihypertensive drug treatment in aged individuals are still undefined: (1) the blood pressure threshold at which antihypertensive drug should be initiated and (2) the blood pressure goals of the therapeutic intervention...
December 2016: Current Atherosclerosis Reports
Guido Grassi, Gino Seravalle, Gianmaria Brambilla, Raffaella Dell'Oro, Fosca Quarti Trevano, Francesco Fici, Luc van Bortel, Giuseppe Mancia
INTRODUCTION: The present study was aimed at comparing the antihypertensive efficacy, tolerability, and side effects profile of nebivolol/hydrochlorothiazide (NH) vs irbesartan/hydrochlorothiazide (IH) combination in elderly patients with isolated systolic hypertension (ISH). METHODS: 124 ISH patients aged 69.1 ± 5.1 years (mean ± SD) were enrolled by 13 general practitioners in Netherlands and Belgium and randomized in a double-blind fashion to receive either NH (5/12...
October 22, 2016: Advances in Therapy
Sung Ok Hong, Chae-Yoon Lee, Junho Jung, Deog-Yoon Kim, Christian Walter, Yong-Dae Kwon
OBJECTIVE: The objective of this study were to find the annual case trend of inflammatory jawbone diseases and to investigate the impact of medication-related osteonecrosis of the jaws (MRONJ). MATERIAL AND METHODS: A retrospective study of 372 patients diagnosed with inflammatory jawbone condition except for alveolar osteitis from 2007 to 2015 was initiated. History taking and investigation of etiologic factors MRONJ, osteoradionecrosis (ORN), odontogenic infection, foreign body, and trauma were investigated...
October 22, 2016: Clinical Oral Investigations
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