Consequences of Sarcopenia in Older People: The Epidemiological Evidence

Sarcopenia is a common condition in older people. Increasing literature is showing its importance for negative health outcomes, also beyond the perimeter of geriatric medicine. In this chapter, we will discuss the consequences of sarcopenia. Overall, epidemiological research suggests that sarcopenia is significantly associated with falls and fractures also suggesting a strong association between muscle and bone loss conditions, as in the case of osteosarcopenia. Moreover, sarcopenia is associated with disability, hospitalization (particularly in older people already hospitalized), and finally mortality. Increasing research is also showing that sarcopenia is associated with negative outcomes…

EDITORIALE –Saluti del nuovo Direttore

LA DOMOTICA A FAVORE DEGLI ANZIANI

Oral Magnesium Supplementation and Endothelial Function in diabetic and Hypertensive Older Patients

Dietary Patterns and Healthy Ageing

Ageing is a complex process in which multiple factors are involved that can contribute to determine whether a person will or not be affected by diseases that are more frequently observed in advanced age. The factors involved comprise genetic, environmental, behavioural, and dietary factors, which influence pathways that regulate the ageing process and the life expectancy, rendering longevity a multifaceted phenomenon. Even if a miraculous elixir or pill is not yet available, there is general agreement that nutrition has a major impact on the overall mortality and on the development of age-related chronic non-communicable diseases. Nutrition research has focused for decades on single nutrien…

Magnesium and health outcomes: An umbrella review of systematic reviews and meta-analyses of observational and intervention studies

Purpose: To map and grade all health outcomes associated with magnesium (Mg) intake and supplementation using an umbrella review. Methods: Umbrella review of systematic reviews with meta-analyses of observational studies and randomized controlled trials (RCTs) using placebo/no intervention as control group. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values, 95% prediction intervals, heterogeneity, small-study effects and excess significance. For meta-analyses of RCTs, outcomes with a random-effect p value < 0.005 and a high-GRADE assessment were classified as strong evidence. Results: From 2048 abstracts, 16 meta-analyses an…

Glucose-induced alterations of cytosolic free calcium in cultured rat tail artery vascular smooth muscle cells

We have previously suggested that hyperglycemia per se may contribute to diabetic hypertensive and vascular disease by altering cellular ion content. To more directly investigate the potential role of glucose in this process, we measured cytosolic free calcium in primary cultures of vascular smooth muscle cells isolated from Sprague-Dawley rat tail artery before and after incubation with 5 (basal), 10, 15, and 20 mM glucose. Glucose significantly elevated cytosolic free calcium in a dose- and time-dependent manner, from 110.0 +/- 5.4 to 124.5 +/- 9.0, 192.7 +/- 20.4, and 228.4 +/- 21.9 nM at 5, 10, 15, and 20 mM glucose concentrations, respectively. This glucose-induced cytosolic free calci…

Prevalence of unwillingness and uncertainty to vaccinate against COVID-19 in older people: A systematic review and meta-analysis.

The coronavirus disease 2019 (COVID-19) has been shown to have more severe health outcomes in older people specifically in relation to mortality and disability. Vaccination seems to be efficacious and safe for preventing the negative consequences of COVID-19, but vaccine hesitancy seems to be high in older adults. We therefore aimed to investigate the prevalence of unwillingness and the uncertainty to vaccinate against COVID-19 in older people and the factors that can be associated with the unwillingness to vaccinate. For this work, we searched several databases until 18th June 2021 for studies reporting the prevalence of unwillingness and the uncertainty to vaccinate against COVID-19 in pe…

I LUOGHI DELLA CURA E DEL MORIRE: REPARTO DI GERIATRIA: TRE ANNI DI ATTIVITÀ

MAGNESIUM AND THE CARDIOMETABOLIC SYNDROME

Effect of acetyl-l-carnitine in the treatment of diabetic peripheral neuropathy : A systematic review and meta-analysis

Background/aim: Deficiency of acetyl-L-carnitine (ALC) and L-carnitine (LC) appears to play a role in peripheral diabetic neuropathy, although the evidence in humans is still limited. We conducted a systematic review and meta-analysis investigating the effect of ALC on pain and electromyographic parameters in people with diabetic neuropathy. Methods: A literature search in major databases, without language restriction, was undertaken. Eligible studies were randomized controlled trials (RCTs) or pre-and post-test studies. The effect of ALC supplementation on pain perception and electromyographic parameters in patients with diabetic neuropathy was compared vs. a control group (RCTs). The effe…

EQUILIBRIO ACIDO-BASE E SQUILIBRI IDROELETTROLITICI NELL’ANZIANO

MILD COGNITIVE IMPAIRMENT (MCI): LA ZONA GRIGIA

Dietary acrylamide and incident osteoporotic fractures: an 8-year prospective cohort study

Abstract Background Acrylamide, a component of fried foods, has been associated with several negative health outcomes. However, the relationship between dietary acrylamide and osteoporotic fractures has been explored by a few cross-sectional studies. Aims To investigate if dietary acrylamide is associated with the onset of fractures in North American participants at high risk/having knee osteoarthritis (OA), over 8 years of follow-up. Methods A Cox’s regression analysis, adjusted for baseline confounders was run and the data were reported as hazard ratios (HRs) and 95% confidence intervals (CIs). Dietary acrylamide intake was assessed at the baseline using a food frequency questionnaire and…

Dietary acrylamide and physical performance tests: A cross-sectional analysis

Background Dietary acrylamide is found in certain foods, such as deep frying, baking and roasting, and is associated with higher inflammatory and oxidative stress parameters. The association between dietary acrylamide and physical performance has not yet been explored. The aim of the study was to investigate the relationship between dietary acrylamide intake and physical performance tests in a large cohort of North American individuals affected by knee osteoarthritis or at high risk for this condition. Methods Dietary acrylamide intake was obtained through a food frequency questionnaire and reported in quartiles and as an increase in deciles. Physical performance was explored using the 20-…

Collagen overglycosylation: a biochemical feature that may contribute to bone quality.

Skeletal ability to resist mechanical stress is determined by bone amount and quality, which relies on macro- and micro-architecture, turnover, bone matrix, and mineralisation; the role of collagen has not been clearly elucidated. Numerous post-translational steps are involved in collagen type I biosynthesis, including residue hydroxylation and glycosylation catalysed by enzymes that work until the protein folds forming the triple helix; therefore, folding rate regulates these processes. Overglycosylated hydroxylysines are poor substrates for epsilon-amino group deamination which initiates cross-link formation. Three clinical conditions associated with fractures may relate collagen overglyc…

Increased Adiposity Appraised with CUN-BAE Is Highly Predictive of Incident Hypertension. The SUN Project

Overweight and obesity are growing worldwide and strongly associated with hypertension. The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) index is proposed as an optimal indicator of body fatness. We aimed to investigate the association of body fat as captured by the CUN-BAE index with incident hypertension in a Mediterranean population. We assessed 15,950 participants of the SUN (Seguimiento Universidad de Navarra) prospective cohort (63.7% women) initially free of hypertension. Participants completed follow-up questionnaires biennially. A validated 136-item food-frequency questionnaire was administered at baseline. We used Cox models adjusted for multiple confounders. …

DEFICIT COGNITIVO E DIABETE MELLITO. STUDIO OSSERVAZIONALE

FATTORI SCATENANTI LA SINDROME DEL BURNOUT NELLA RELAZIONE MEDICO-PAZIENTE

Intermittent intramuscular clodronate therapy: a valuable option for older osteoporotic women

POOR DIET, LITTLE EXERCISE, SMOKING: WESTERN WAYS THAT PROMOTE HEART DISEASE

The Paradigm of Life Extension

SUCCESSFUL AGING: QUALITY AND QUANTITY

Effects of Aging on Serum Ionized and Cytosolic Free Calcium

Abstract —Elevated cytosolic free calcium (Ca i ) and reciprocally reduced, extracellular ionized calcium (Ca-ion) levels are observed in both hypertension and non–insulin-dependent diabetes mellitus (NIDDM). Because the changes of vascular function and insulin sensitivity in these conditions resemble the changes associated with “normal” aging, we wondered to what extent similar alterations in calcium metabolism occur with aging per se in the absence of overt hypertension or diabetes. We therefore measured platelet Ca i levels by spectrofluorometry and serum Ca-ion levels in normotensive, nondiabetic, healthy, normal, elderly (>65 years old) subjects, mean age ±SEM, 72.2±1.5 years old (…

Choice and Outcomes of Rate Control versus Rhythm Control in Elderly Patients with Atrial Fibrillation: A Report from the REPOSI Study

Background: Among rate-control or rhythm-control strategies, there is conflicting evidence as to which is the best management approach for non-valvular atrial fibrillation (AF) in elderly patients. Design: We performed an ancillary analysis from the ‘Registro Politerapie SIMI’ study, enrolling elderly inpatients from internal medicine and geriatric wards. Methods: We considered patients enrolled from 2008 to 2014 with an AF diagnosis at admission, treated with a rate-control-only or rhythm-control-only strategy. Results: Among 1114 patients, 241 (21.6%) were managed with observation only and 122 (11%) were managed with both the rate- and rhythm-control approaches. Of the remaining 751 patie…

222. DEPRESSIONE E M. DI PARKINSON: VALUTAZIONE DEL TONO DELL’UMORE IN 20 PAZIENTI ULTRASETTANTENNI IN TRATTAMENTO CON L-DOPA E/O DOPAMINO-AGONISTI. DATI PRELIMINARI

ANEMIA E DECLINO FUNZIONALE NELL’ANZIANO

European undergraduate curriculum in geriatric medicine developed using an international modified Delphi technique.

Introduction: the rise in the number of older, frail adults necessitates that future doctors are adequately trained in the skills of geriatric medicine. Few countries have dedicated curricula in geriatric medicine at the undergraduate level. The aim of this project was to develop a consensus among geriatricians on a curriculum with the minimal requirements that a medical student should achieve by the end of medical school. Methods: a modified Delphi process was used. First, educational experts and geriatricians proposed a set of learning objectives based on a literature review. Second, three Delphi rounds involving a panel with 49 experts representing 29 countries affiliated to the European…

INDUCTION OF VEGF AND B-FGF RELEASE BY ELECTRO NEUROSTIMULATION (FREMS) IN DIABETIC POLYNEUROPATHY

Quality of life in osteoporotic women with inadequate clinical response to antiresorptive drugs: results from the ICARO study.

Treatment of Congestive Heart Failure in the Elderly

Congestive heart failure (CHF) is a complex clinical syndrome which constitutes the epilogue of the natural history of virtually all heart diseases and in its advanced stages, has a poor prognosis. In the elderly, heart failure exhibits particular characteristics linked to the age-related alterations of cardiovascular system, to the association with other pathologies, to the atypical clinical presentation and to the increased iatrogenic risk. Heart failure now afflicts over 1% of the general population with nearly 1 in 10 elderly subjects affected, and the frequency of CHF is progressively increasing in most industrialized societies1,2. Further, CHF remains a significant cause of death and …

Influenza Vaccination and COVID-19 Outcomes in People Older than 50 Years: Data from the Observational Longitudinal SHARE Study

Existing literature on the association between influenza vaccination and COVID-19 infection/outcomes is conflicting. Therefore, we aimed to investigate the association between influenza vaccination and COVID-19 outcomes in a large cohort of adults who participated in the SHARE (Survey of Health, Ageing, and Retirement in Europe). Information regarding influenza vaccination in the previous year, and medical and demographic characteristics, were self-reported. Positivity for COVID-19, symptomatology, and hospitalization were also ascertained using self-reported information. An adjusted logistic regression analysis (including 15 baseline factors or propensity score) was used to assess the asso…

Erratum: Effect of magnesium supplementation on glucose metabolism in people with or at risk of diabetes: a systematic review and meta-analysis of double-blind randomized controlled trials

Although higher dietary intakes of magnesium (Mg) seem to correspond to lower diabetes incidence, research concerning Mg supplementation in people with or at risk of diabetes is limited. Thus, we aimed to investigate the effect of oral Mg supplementation on glucose and insulin-sensitivity parameters in participants with diabetes or at high risk of diabetes compared with placebo. A literature search in PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Clinicaltrials.gov without language restriction, was undertaken. Eligible studies were randomized controlled trials (RCTs) investigating the effect of oral Mg supplementation vs placebo in patients with diabetes or at h…

The Multidomain Nature of Malnutrition in Older Persons

Pain Increases the Risk for Sarcopenia in Community-Dwelling Adults: Results From the English Longitudinal Study of Ageing

AbstractBackgroundPain and sarcopenia are common in older people. Cross-sectional studies have reported a significant association between these two conditions, but cohort studies exploring pain as a potential risk factor for sarcopenia are scarce. Given this background, the aim of the present work was to investigate the association between pain (and its severity) at baseline, and the incidence of sarcopenia over 10 years of follow-up in a large representative sample of the English older adult population.MethodsPain was diagnosed using self-reported information and categorized as mild to severe pain at four sites (low back, hip, knee, and feet). Incident sarcopenia was defined as having low …

Increased plasminogen activator inhibitor antigen levels in diabetic patients with stable angina

PAI-1 antigen, tPA antigen and thrombin - antithrombin III complexes (TAT) levels were measured in 10 males with stable angina and type-II diabetes mellitus and in 16 males with stable angina without diabetes or other risk factors (hyperfibrinogenaemia, hyperlipidaemia, diabetes, hypertension, smoking and obesity) known to increase PAI levels. Ten healthy men of equivalent age served as controls. Because only diabetics with coronary artery disease (CAD) showed a decreased fibrinolytic capacity, a second study was performed on the 16 non-diabetic CAD patients to determine whether submaximal workload induces significant changes of tPA and PAI levels. TAT levels were increased in CAD, and sign…

Presbyphagia and dysphagia in old age

Although presbyphagia is a clinically relevant problem among elderly population, possibly leading to dysphagia in old age, it remains a still underestimated health condition. The present review analyzes swallowing related anatomical and functional changes during aging, both in healthy people and in those affected by dysphagia. First of all, dysphagia in old people must not be confused with presbyphagia. To distinguish these two different conditions, a correct definition of both should be considered. Subsequently, a comprehensive evaluation including instrumental analysis should be carried out. The aim of this narrative review is to analyze the current knowledge of this clinical condition an…

New measurement of the 242Pu(n,γ) cross section at n-TOF-EAR1 for MOX fuels: Preliminary results in the RRR

The spent fuel of current nuclear reactors contains fissile plutonium isotopes that can be combined with 238U to make mixed oxide (MOX) fuel. In this way the Pu from spent fuel is used in a new reactor cycle, contributing to the long-term sustainability of nuclear energy. The use of MOX fuels in thermal and fast reactors requires accurate capture and fission cross sections. For the particular case of 242Pu, the previous neutron capture cross section measurements were made in the 70’s, providing an uncertainty of about 35% in the keV region. In this context, the Nuclear Energy Agency recommends in its “High Priority Request List” and its report WPEC-26 that the capture cross section of 242Pu…

Interventions for Improving Long COVID-19 Symptomatology: A Systematic Review

Introduction: Although the understanding of several aspects of long COVID-19 syndrome is increasing, there is limited literature regarding the treatment of these signs and symptoms. The aim of our systematic review was to understand which therapies have proved effective against the symptoms of long COVID-19. Methods: A systematic search for randomized controlled or clinical trials in several databases was conducted through 15 May 2022. Specific inclusion criteria included: (1) intervention studies, either randomized controlled (RCTs) or clinical trials; (2) diagnosis of long COVID-19, according to the World Health Organization criteria; (3) presence of long COVID-19 for at least 12 weeks af…

Similar prediction of the decreased total mortality, diabetes incidence or cardiovascular events using a relative- and an absolute-component Mediterranean diet score: the sun COHORT .

Abstract Background and Aim: Accumulated evidence supports the effectiveness of Mediterranean-type diets (MeDiet) in reducing mortality and preventing several chronic diseases. Widely used scores to assess adherence to MeDiet are based on specific sample characteristics; alternatively, they might be built according to absolute/normative cut-off points for the consumption of specific food groups (pre-defined servings/day or/week). The aim of this study was to compare sample-specific MeDiet adherence scores (MDS) versus absolutenormative scores (Mediterranean Diet Adherence Screener e MEDAS) on their association with macronutrient intake, total mortality and incidence of chronic diseases. Des…

Systemic Immune Responses in Alzheimer's Disease: In Vitro Mononuclear Cell Activation and Cytokine Production

To investigate the systemic signs of immune-inflammatory responses in Alzheimer's disease (AD), in the present study we have analyzed blood lymphocyte subsets and the expression of activation markers on peripheral blood mononuclear cells (PBMCs) from AD patients and age-matched healthy controls (HC) activated in vitro by recombinant amyloid-beta peptide (rAbeta42). Our study of AD lymphocyte subpopulations confirms the already described decrease of the absolute number and percentage of B cells when compared to HC lymphocytes, whereas the other subsets are not significantly different in patients and controls. We report the increased expression of the activation marker CD69 and of the chemoki…

VALUTAZIONE DELLA PERFORMANCE COGNITIVA IN PAZIENTI POST ICTUS

TYPE 2 DIABETES AND ALZHEIMER’S DISEASE

Epidemiological and biological evidences support a link between type 2 diabetes mellitus (DM2) and Al-zheimer’s disease (AD). Persons with diabetes have a higher incidence of cognitive decline and an increased risk of developing all types of dementia. Cognitive deficits in persons with diabetes mainly affect the ar-eas of psychomotor efficiency, attention, learning and memory, mental flexibility and speed, and executive function. The strong epidemiological association has suggested the existence of a physiopathological link. The determinants of the accelerated cognitive decline in DM2, however, are less clear. Increased cortical and subcortical atrophy have been evidenced after con-trolling…

LOW-COST CALORIES AND THE EPIDEMIC OF CARDIOVASCULAR DISEASE IN LESS DEVELOPED COUNTRIES

RIABILITAZIONE NEUROMOTORIA NELLA M. DI PARKINSON: CONDIZIONAMENTO SENSORIALE

MAGNESIUM METABOLISM IN TYPE 2 DIABETES MELLITUS

Violenza contro le persone anziane

Abuse against elderly persons is extremely frequent, although very often is not declared, and entails high human and financial costs. There are on the whole three types of abuse including domestic, institutional, and auto inflicted. It is difficult to get enough information to define the real dimension of the problem, but data from the National Elder Abuse Incidence Study (NEAIS) describe an increasing and expanding phenomenon. The large proportions of this type of violence has lead the World Health Organization to propose strategies primarily focused on three points: Awareness, Education en Defence. An important role in the prevention and diagnosis of elderly abuse is in the hands of the p…

New Trends in the Treatment of Osteoporosis

Osteoporosis is “a systemic disease characterized by a reduction in bone mass and a microarchitectonic alteration of the skeleton, with a consequent increase in skeleton fragility and susceptibility to fractures”, as defined by the last Consensus Development Conference1. With this definition, the alteration in skeletal structure, which is not yet easy to evaluate, becomes an important factor determining the risk of fracture of the osteoporotic patient, in addition to the bone mass, which to certain limit can be easily evaluated. This is an aspect that may create some problems at the time of taking a decision on how to proceed with a subject with decreased bone mass. Currently, the measureme…

Cardiac arrhythmias as correlated with the circadian rhythm of arterial pressure in hypertensive subjects with and without left ventricular hypertrophy

To evaluate the relationship among supraventricular and ventricular arrhythmias with blood pressure and heart rate (HR) values, we studied 2 groups of 20 hypertensive men with (group I) and without (group II) left ventricular hypertrophy. Ambulatory electrocardiographic tracings were recorded continuously, together with ambulatory arterial pressure. Systolic (SBP) and diastolic (DBP) blood pressure values measured over 24 h showed no difference between the two groups, but we found greater variability in SBP in group I. The incidence of ventricular and supraventricular arrhythmias was significantly higher in patients of group I; moreover, we found a strong correlation between the incidence o…

MAGNESIUM METABOLISM IN TYPE 2 DIABETES MELLITUS, METABOLIC SYNDROME AND INSULIN RESISTANCE.

Multidimensional frailty and quality of life: data from the English Longitudinal Study of Ageing

Abstract Purpose Frailty has been found to be associated with poor quality of life (QoL) in older people, but data available are limited to cross-sectional studies. We therefore aimed to assess the association between multidimensional frailty, determined by Multidimensional Prognostic Index (MPI), with mortality and good QoL expectancy (GQoLE) in a large representative sample of older adults, over 10 years of follow-up. Methods In the English Longitudinal Study of Ageing, using the data from 2004–2005 and 2014–2015, MPI was calculated using a weighted score of domains of comprehensive geriatric assessment, i.e., number of difficulties in activities of daily living (ADL) and instrumental ADL…

What changed in the Italian internal medicine and geriatric wards during the lockdown

A total of 48 internal medicine or geriatric wards among the 93 adhering to the register REPOSI answered an online questionnaire aimed to investigate the characteristics and activities of converted and non-converted wards in the crucial period of the first wave of the epidemic, 22 February-4 May 2020

EFFECTS OF POLYENOIC ω-3 FATTY ACIDS ON OXIDATIVE STRESS IN HYPERTENSIVE ELDERLY SUBJECTS

STUDIO "EUROFAMCARE": SINTESI DEI PRINCIPALI RISULTATI RELATIVI AL CAMPIONE ITALIANO DI CAREGIVERS

FUNCTIONAL ASSESSMENT OF OLDER PERSONS: ROLE OF COMPREHENSIVE GERIATRIC ASSESSMENT IN GERIATRIC ONCOLOGY

QUALITÀ DELLA VITA NELL’ANZIANO

7Be(n,α) and 7Be(n,p) cross-section measurement for the cosmological lithium problem at the n-TOF facility at CERN

One of the most puzzling problems in Nuclear Astrophysics is the “Cosmological Lithium Problem”, i.e the discrepancy between the primordial abundance of \(^{7}\)Li observed in metal poor halo stars (Asplund et al. in Astrophys J 644:229–259, 2006, [1]), and the one predicted by Big Bang Nucleosynthesis (BBN). One of the reactions that could have an impact on the problem is \(^{7}\)Be(n,p)\(^{7}\)Li. Despite of the importance of this reaction in BBN, the cross-section has never been directly measured at the energies of interest for BBN. Taking advantage of the innovative features of the second experimental area at the n\(\_\)TOF facility at CERN (Sabate-Gilarte et al. in Eur Phys J A 53:210,…

Severe hypoglycemia is associated with antidiabetic oral treatment compared with insulin analogs in nursing home patients with type 2 diabetes and dementia: results from the DIMORA study.

Abstract Objectives Severe hypoglycemia is associated with cognitive decline and dementia in older persons with type 2 diabetes. The role of antidiabetic treatments on severe hypoglycemia is unknown in dementia. The aims were to determine the prevalence of severe hypoglycemic events and investigate associations among severe hypoglycemic and specific antidiabetic treatments (classes of oral agents and types of insulin analogs) in a large sample of nursing home patients with diabetes according to dementia status. Design Cross-sectional observational study. Setting A total of 150 nursing homes across Italy. Participants A total of 2258 patients with type 2 diabetes (dementia = 1138, no dementi…

Serum magnesium and lipids: More clarity is needed

alpha-Glycerophosphocholine in the mental recovery of cerebral ischemic attacks. An Italian multicenter clinical trial.

The clinical efficacy and the tolerability of alpha-glycerophosphocholine (alpha-GPC), a drug able to provide high levels of choline for the nervous cells of the brain and to protect their cell walls, have been tested in a clinical open multicenter trial on 2044 patients suffering from recent stroke or transient ischemic attacks. alpha-GPC was administered after the attack at the daily dose of 1000 mg im for 28 days and orally at the dose of 400 mg tid during the following 5 months after the first phase. The evaluation of the efficacy on the psychic recovery was done by the Mathew Scale (MS) during the period of im drug administration, and using the Mini Mental State Test (MMST), the Cricht…

MALATTIA DI PARKINSON: FATTORI AMBIENTALI E GENETICI

TORRE DI LONDRA: DEMENZA FRONTO-TEMPORALE E DISTURBO DELL’ UMORE

MAGNESIUM METABOLISM IN INSULIN RESISTENCE, METABOLIC SYNDROME AND TYPE 2 DIABETES MELLITUS

Thyroid Disorders in Old Age

Thyroid disorders are more frequent in old age, especially in women. Overt thyroid dysfunction may manifest as aging itself or as age-associated disorders of other organs. Therefore, an accurate clinical suspicion is essential for their detection in elders with multiple comorbidities, malnutrition, and chronic polypharmacy. Because chronic diseases are more prevalent in old age, nonthyroidal illness is also common in this age group. Most thyroid nodules in older persons are benign, yet a comprehensive individualized evaluation is needed in order to timely detect malignancy. While there is still debate on the decision to treat or not to treat subclinical thyroid disorders, current recommenda…

COVID in 2022. Clinical risk management of sars-cov-2 positive patients admitted to an internal medicine ward

HYPERTENSION AS A RISK FACTOR FOR COGNITIVE IMPAIRMENT AND DEMENTIA IN THE ELDERLY

PSEUDODEMENZA, DEPRESSIONE E DEMENZA

An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of Hydroxychloroquine and chloroquine therapy

Background & aims: Hydroxychloroquine (HCQ) and chloroquine (CQ) are anti-malarial drugs frequently used in the rheumatologic field. They were recently identified as potential therapeutic options for Coronavirus Disease (COVID-19). The present study aims to map and grade the diverse health outcomes associated with HCQ/CQ using an umbrella review approach. Methods: Umbrella review of systematic reviews of observational and intervention studies. For observational studies, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. The quality…

Non-healing ulcers: domiciliary assistance including electrical neurostimulation - clinical outcome and cost reduction

DEPRESSIONE, ANZIANI E PSICOTERAPIA

Should we recommend reductions in saturated fat intake or in red/processed meat consumption? The SUN prospective cohort study

Summary Background & aims While most studies have shown increased mortality associated with excessive red/processed meat consumption, the association of saturated fatty acids (SFA) intake with mortality is less homogeneous. We aimed to prospectively assess the association of both, meat consumption (red, processed, red + processed, and total) and SFA intake, with the risk of all-cause death. Methods We assessed 18,540 participants of the SUN (Seguimiento Universidad de Navarra) cohort, followed-up for a mean of 9.5 years. A validated 136-item FFQ was administered at baseline. We used Cox models adjusted for potential confounders. Results We observed 255 deaths during 176,916 person-years of …

Association between multidimensional prognostic index (MPI) and infections in a population of older people affected by COVID-19

Background: Only limited studies analyzed a possible relationship between frailty and infections. Our aim was to investigate the possible association between higher multidimensional prognostic index (MPI) values, a tool for evaluating multidimensional frailty, and the prevalence of infectious diseases, including antibiotics' cost and the prevalence of MDR (multidrug resistance) pathogens. Methods: Older patients, affected by COVID-19, were enrolled in the hospital of Palermo over four months. Results: 112 participants (mean age 77.6, 55.4% males) were included. After adjusting for potential confounders, frailer participants had a higher odds of any positivity to pathogens (prevalence: 61.5%…

VALUTAZIONE DELLE ALTERAZIONI COMPORTAMENTALI IN PAZIENTI CON DEMENZA DI ALZHEIMER

Efficacy and tolerability of lercanidipine in monotherapy in elderly patients with isolated systolic hypertension

To investigate the efficacy and tolerability of lercanidipine, used as monotherapy once a day, in elderly patients with isolated systolic hypertension (ISH), 83 patients were enrolled in this multicenter, double-blind, randomized, placebo-controlled study. All patients were older than 60 years, and their mean age was 66.7 +/- 5.4 years. ISH was defined as SBPor = 160 mmHg, and DBP95 mmHg. After wash-out and placebo run-in periods, patients were randomly assigned to placebo or lercanidipine (10 mg once a day) treatment for 4 weeks. Non-responding patients of the lercanidipine-treated group were later treated with 20 mg of lercanidipine once a day for 4 additional weeks. At the end of the stu…

L’ASSISTENZA DOMICILIARE INTEGRATA (ADI) E LE LESIONI DA PRESSIONE

Healthy ageing: From a myth to a reality

The dream of living long and healthy has accompanied man since the beginning of time. The present remarkable increased life expectancy is most probably the result of better living conditions, medical progress, and better health care organization. Dramatic demographic changes occur not only in industrialised countries, but primarily affect the least developed part of the world. This extraordinary success of humanity brings with it many challenges to build a future with healthy seniors. The recently released World report on ageing and health, one of the most important WHO documents in recent years, confirms the crucial importance of the maintenance of functional ability throughout life.

Effect of Calcifediol on Physical Performance and Muscle Strength Parameters: A Systematic Review and Meta-Analysis

There is general agreement that optimal vitamin D status is necessary for bones, muscles, and general health, particularly in older adults, who are at higher risk of negative consequences of vitamin D deficiency, including sarcopenia; vitamin D supplementation is proposed as a potential intervention to mitigate sarcopenia. Several RCTs have reported that calcifediol (25(OH)D) was more potent than cholecalciferol in increasing plasma 25(OH)D. The present systematic review and meta-analysis aimed to summarize the effects of calcifediol on physical performance and muscle strength. We searched databases from inception to 1 January 2022 for studies investigating calcifediol on physical performan…

L’IPOTIROIDISMO NELLE PERSONE ANZIANE: IMPORTANZA DI UNA ADEGUATA TERAPIA SOSTITUTIVA ORMONALE

La prevalenza dei disturbi della ghiandola tiroidea aumenta con l’età, soprattutto nelle donne. L’ipofunzione tiroidea conclamata in età avanzata può manifestarsi clinicamente con sintomi e segni simili alle modificazioni che normalmente accompagnano l’invecchiamento o come disturbi di altri organi. Per tale motivo, un alto indice di sospetto è essenziale per rilevare l’ipotiroidismo in anziani con comorbilità multiple, alterazioni nutrizionali e/o polifarmacoterapia. La decisione di iniziare una terapia sostitutiva ormonale nell’ipotiroidismo conclamato non è discutibile. Viceversa, esiste ancora controversia sulla decisione di trattare o non trattare l’ipotiroidismo subclinico; le raccoma…

Oral Magnesium Supplementation for Treating Glucose Metabolism Parameters in People with or at Risk of Diabetes: A Systematic Review and Meta-Analysis of Double-Blind Randomized Controlled Trials

There is a large and growing body of literature focusing on the use of oral magnesium (Mg) supplementation for improving glucose metabolism in people with or at risk of diabetes. We therefore aimed to investigate the effect of oral Mg supplementation on glucose and insulin-sensitivity parameters in participants with diabetes or at high risk of diabetes, compared with a placebo. Several databases were searched investigating the effect of oral Mg supplementation vs placebo in patients with diabetes or conditions at high risk of diabetes. Data were reported as standardized mean differences (SMDs) with their 95% confidence intervals (CIs) using follow-up data of glucose and insulin-sensitivity …

Verbal Fluency in Mild Alzheimer's Disease: Transcranial Direct Current Stimulation over the Dorsolateral Prefrontal Cortex

Background: Recent studies showed that in healthy controls and in aphasic patients, inhibitory trains of repetitive transcranial magnetic stimulation (rTMS) over the right prefrontal cortex can improve phonemic fluency performance, while anodal transcranial direct current stimulation (tDCS) over the left prefrontal cortex can improve performance in naming and semantic fluency tasks. Objective: This study aimed at investigating the effects of cathodal tDCS over the left or the right dorsolateral prefrontal cortex (DLPFC) on verbal fluency tasks (VFT) in patients with mild Alzheimer’s disease (AD). Methods: Forty mild AD patients participated in the study (mean age 73.17±5.61 years). All part…

EFFETTI BENEFICI DELLA DIETA MEDITERRANEA. PIÙ LONGEVI CONSUMANDO OLIO D’OLIVA

LA DIETA MEDITERRANEA E L’OLIO D’OLIVA: CENT’ANNI DI … SALUTE!

In Sicilia zoledronic acid is cost effective when compared to both alendronate and risedronate and this choice shows a small uncertainty range.

Vascular effects of progesterone: Role of cellular calcium regulation

Abstract —Vascular actions of progesterone have been reported, independently of estrogen, affecting both blood pressure and other aspects of the cardiovascular system. To study possible mechanisms underlying these effects, we examined the effects of P in vivo in intact rats and in vitro in isolated artery and vascular smooth muscle cell preparations. In anesthetized Sprague-Dawley rats , bolus intravenous injections of P (100 μg/kg) significantly decreased pressor responses to norepinephrine (0.3 μg/kg). In vitro, progesterone (10 −8 to 10 −5 mmol/L) produced a significant, dose-dependent relaxation of isolated helical strips, both of rat tail artery precontracted with KCl (60 mmol/L) or a…

Magnesium metabolism in type 2 diabetes mellitus, metabolic syndrome and insulin resistance

Type 2 diabetes is characterized by cellular and extracellular Mg depletion. Epidemiologic studies showed a high prevalence of hypomagnesaemia and lower intracellular Mg concentrations in diabetic subjects. Insulin and glucose are important regulators of Mg metabolism. Intracellular Mg plays a key role in regulating insulin action, insulin-mediated-glucose uptake and vascular tone. Reduced intracellular Mg concentrations result in a defective tyrosine-kinase activity, post-receptorial impairment in insulin action, and worsening of insulin resistance in diabetic patients. Mg deficit has been proposed as a possible underlying common mechanism of the "insulin resistance" of different metabolic…

Recommendations on Physical Activity and Exercise for Older Adults Living in Long-Term Care Facilities: A Taskforce Report.

A taskforce, under the auspices of The International Association of Gerontology and Geriatrics-Global Aging Research Network (IAGG-GARN) and the IAGG European Region Clinical Section, composed of experts from the fields of exercise science and geriatrics, met in Toulouse, in December 2015, with the aim of establishing recommendations of physical activity and exercise for older adults living in long-term care facilities (LTCFs). Due to the high heterogeneity in terms of functional ability and cognitive function that characterizes older adults living in LTCFs, taskforce members established 2 sets of recommendations: recommendations for reducing sedentary behaviors for all LTCF residents and r…

NECESSITÀ DEL RICOVERO IN RSA IN ALCUNI PAZIENTI CON DEMENZA DI ALZHEIMER. CASO CLINICO

CORRELAZIONE TRA DEMENZA E DEPRESSIONE. Studio su 60 pazienti ambulatoriali

Walking in Natural Environments as Geriatrician’s Recommendation for Fall Prevention: Preliminary Outcomes from the “Passiata Day” Model

Background: The Geriatric Unit of the University of Palermo developed the “Passiata Day” model, a green exercise intervention consisting of a one-hour walk, once/week, in a city park. The purpose of this study was to assess body balance in older people who walked regularly compared to sedentary people. Methods: 106 older people (75 women and 31 men; mean age: 72.3 ± 8.2 years) without fall history were invited to participate voluntarily in this natural environment walking program. After six months, both the participants who had taken part regularly in the walk (i.e., the physical activity group (PAG; n = 72; 54 women and 18 men; mean age: 70.7 ± 7.2 years)), and wh…

Magnesium homeostasis and aging.

Aging is very often associated with magnesium (Mg) deficit. Total plasma magnesium concentrations are remarkably constant in healthy subjects throughout life, while total body Mg and Mg in the intracellular compartment tend to decrease with age. Dietary Mg deficiencies are common in the elderly population. Other frequent causes of Mg deficits in the elderly include reduced Mg intestinal absorption, reduced Mg bone stores, and excess urinary loss. Secondary Mg deficit in aging may result from different conditions and diseases often observed in the elderly (i.e. insulin resistance and/or type 2 diabetes mellitus) and drugs (i.e. use of hypermagnesuric diuretics). Chronic Mg deficits have been…

Effects of drug therapy on cardiac arrhythmias and ischemia in hypertensives with LVH.

Left ventricular hypertrophy (LVH) in hypertensive subjects is associated with an increased prevalence of ventricular arrhythmias. To evaluate the effect of antihypertensive treatment on cardiac arrhythmias (CA) and transient episodes of myocardial ischemia (TEMI), we studied 46 hypertensive patients with LVH, divided into four groups randomly treated with enalapril, hydrochlorothiazide (HCTZ), atenolol, or verapamil (SR-V) for 6 months. Office blood pressure and office heart rate values were recorded, in basal conditions, after 1 and 6 months of treatment, and all patients underwent echocardiography, electrocardiographic Holter monitoring, and stress testing. All drugs significantly lowere…

20Ca The Role of Calcium As a Metallotherapeutic Drug

The n_TOF facility: Neutron beams for challenging future measurements at CERN

The CERN n TOF neutron beam facility is characterized by a very high instantaneous neutron flux, excellent TOF resolution at the 185 m long flight path (EAR-1), low intrinsic background and coverage of a wide range of neutron energies, from thermal to a few GeV. These characteristics provide a unique possibility to perform high-accuracy measurements of neutron-induced reaction cross-sections and angular distributions of interest for fundamental and applied Nuclear Physics. Since 2001, the n TOF Collaboration has collected a wealth of high quality nuclear data relevant for nuclear astrophysics, nuclear reactor technology, nuclear medicine, etc. The overall efficiency of the experimental prog…

LA STIMOLAZIONE ELETTRICA FREMS NEL TRATTAMENTO DELLE LESIONI ULCERATIVE CUTANEE DIFFICILI IN PAZIENTI IN ASSISTENZA DOMICILIARE. DESCRIZIONE DI DUE CASI

CARDIOMETABOLIC SYNDROME AND SARCOPENIC OBESITY IN OLDER PERSONS

The aging of the world's population is a major contributor to the growing prevalence of the cardiometabolic syndrome (CMS) because older persons are more affected by the constellation of cardiovascular risk factors that constitute the syndrome. The prevalence of CMS has been related to the increasing prevalence of obesity, which is growing progressively even among older age groups. Indeed, obesity and aging are 2 overlapping mounting public health problems. It is currently accepted that CMS predicts cardiovascular mortality and/or the development of type 2 diabetes mellitus, and this is also true in studies including older persons. CMS is further complicated by modifications in body composi…

Evaluating the effectiveness and risks of oral anticoagulant treatments in multimorbid frail older subjects with atrial fibrillation using the multidimensional prognostic index

Background: Previous studies suggested that a different risk of mortality may influence the oral anticoagulant prescription in older patients with atrial fibrillation (AF). Recently, the Multidimensional Prognostic Index (MPI) demonstrated a high grade of accuracy, calibration and feasibility to predict mortality in hospitalized and community-dwelling older people. Prognostic information, as calculated by the MPI, however, is not included in the decision algorithm of treatments in older patients with AF Purpose: The aim of this international multicenter prospective observational study was to evaluate whether a different prognostic profile, as determined by the MPI, is associated with differ…

MAGNESIUM INTAKE IN THE PATHOPHYSIOLOGY AND TREATMENT OF THE CARDIOMETABOLIC SYNDROME: WHERE ARE WE IN 2006?

L’AZITROMICINA NEL TRATTAMENTO DELLA GASTROPARESI DIABETICA NELL’ANZIANO: UN CASO CLINICO

EFFETTO DEGLI ESTRATTI DI PAPAYA FERMENTATA SULLO STRESS OSSIDATIVO IN PAZIENTI CON MALATTIA DI ALZHEIMER

Brain tissue is particularly susceptible to oxidative damage, which has been associated with pathological findings of Alzheimer's disease (AD), such as amyloid plaques and protein fibrils. Oxidative stress alterations, including increased production of reactive oxygen metabolites, decline of antioxidant systems, and decreased efficiency in repairing molecules, have been linked to the development of AD. Postmortem studies on brain tissue from AD patients have shown several oxidative damage markers, such as increased lipid peroxidation, oxidative damage of proteins, glyco-oxidation, and reduction of antioxidant systems. We studied 40 patients referred to our Geriatric Unit (age 78,2 ± 1,1 yea…

INTEGRATIVE MEDICINE

Dietary fiber intake and the Mediterranean population

Abstract Dietary fiber encompasses carbohydrates not digested or absorbed in the small intestine, arriving intact to the colon. Its role in human health has been mentioned since the times of Hippocrates but only in the 1970s of the 20th century, and subsequently a myriad of epidemiological and clinical studies has shown that a diet with low content of dietary fiber is associated with several chronic diseases such as diabetes, cardiovascular diseases, certain neoplastic diseases, specially colon cancer, and also obesity. The Western dietary pattern, which is spreading in our current globalized world and in which many components are ultraprocessed, has very low fiber content. Conversely the M…

Fast food consumption and gestational diabetes incidence in the SUN project.

Background: Gestational diabetes prevalence is increasing, mostly because obesity among women of reproductive age is continuously escalating. We aimed to investigate the incidence of gestational diabetes according to the consumption of fast food in a cohort of university graduates. Methods: The prospective dynamic ‘‘Seguimiento Universidad de Navarra’’ (SUN) cohort included data of 3,048 women initially free of diabetes or previous gestational diabetes who reported at least one pregnancy between December 1999 and March 2011. Fast food consumption was assessed through a validated 136-item semi-quantitative food frequency questionnaire. Fast food was defined as the consumption of hamburgers, …

The biology of the metabolic syndrome and aging.

Aging of the world population is a major contributor to the growing prevalence of the metabolic syndrome, as older persons are frequently affected by the constellation of cardiovascular and metabolic risk factors that constitute the syndrome. The metabolic syndrome has been related to the increasing prevalence of obesity, which is escalating even among older age groups. The present review covers data on the novel proposed biological mediators of the metabolic syndrome, which are as well linked to the aging process.Relevant biological mediators of metabolic syndrome and unhealthy aging include sarcopenic obesity, insulin resistance with ectopic fat accumulation, magnesium metabolism alterati…

Impact of Mediterranean Diet on Chronic Non-Communicable Diseases and Longevity

The average life expectancy of the world population has increased remarkably in the past 150 years and it is still increasing. A long life is a dream of humans since the beginning of time but also a dream is to live it in good physical and mental condition. Nutrition research has focused on recent decades more on food combination patterns than on individual foods/nutrients due to the possible synergistic/antagonistic effects of the components in a dietary model. Various dietary patterns have been associated with health benefits, but the largest body of evidence in the literature is attributable to the traditional dietary habits and lifestyle followed by populations from the Mediterranean re…

DEFICIT COGNITIVO E DIABETE. STUDIO OSSERVAZIONALE

CHIRURGIA BARIATRICA COME CAUSA DI OSTEOMALACIA / OSTEOPOROSI E DISABILITÀ SEVERE. CASO CLINICO

STUDIO DELLA PERCEZIONE OLFATTIVA E GUSTATIVA IN SOGGETTI ANZIANI OSPEDALIZZATI

Paradoxes in the old age – reverse epidemiology

MAGNESIUM HOMEOSTASIS AND AGING

aGING IS VERY OFTEN ASSOCIATED WITH MAGNESIUM (mG) DEFICIT.tOTAL PLASMA MAGNESIUM CONCENTRATIONS ARE REMARKABLY CONSTANT IN HEALTHY SUBJECTS THROUGHOUT LIFE

Knee osteoarthritis and adverse health outcomes: an umbrella review of meta-analyses of observational studies

Abstract Background Knee osteoarthritis (OA) is a common condition, associated with a high rate of disability and poor quality of life. Despite the importance of such evidence in public health, no umbrella review (i.e., a review of other systematic reviews and meta-analyses) has systematically assessed evidence on association between knee OA and adverse health outcomes. Aims To map and grade all health outcomes associated with knee OA using an umbrella review approach. Methods The search was made across several databases up to 22 April 2022. We used an umbrella review of systematic reviews with meta-analyses of observational studies assessing the effect sizes, based on random effect summary…

Magnesium and Other Biometals in Oxidative Medicine and Redox Biology

No abstract available.

MILD COGNITIVE IMPAIRMENT: LA ZONA GRIGIA

TERAPIA DELLA SARCOPENIA

La sarcopenia e la cachessia sono i disordini muscolari più comune negli adulti. La principale differenza tra le due condizioni è che, a livello istologico, la sarcopenia rappresenta una condizione età correlata che si accompagna a neurodegenerazione, mentre la cachessia è una malattia infiammatoria del muscolo, che è associata a perdita di tessuto adiposo e ad anoressia. E’ stato dimostrato che entrambe le condizioni, nonostante le differenze nella etiologia e fisiopatologia, rispondono positivamente a trattamenti che aumentano la massa e la forza muscolare. Il gold standard attuale della terapia della sarcopenia è l'esercizio fisico. Inoltre, esistono una serie di farmaci che sono disponi…

INTERVENTI SUL CAREGIVER DEL PAZIENTE CON DEMENZA

Teriparatide (1-34) vs. parathyroid hormone (1-84) in women with severe postmenopausal osteoporosis: a randomized, head-to-head study.

EXTRA VIRGIN OLIVE OIL IMPROVES LEARNING AND MEMORY IN SAMP8 MICE

Abstract. Polyphenols are potent antioxidants found in extra virgin olive oil (EVOO); antioxidants have been shown to reverse age- and disease-related learning and memory deficits. We examined the effects of EVOO on learning and memory in SAMP8 mice, an age-related learning/memory impairment model associated with increased amyloid- protein and brain oxidative damage. We administered EVOO, coconut oil, or butter to 11 month old SAMP8 mice for 6 weeks. Mice were tested in T-maze foot shock avoidance and one-trial novel object recognition with a 24 h delay. Mice which received EVOO had improved acquisition in the T-maze and spent more time with the novel object in one-trial novel object recogni…

SCONTRI AUTOMOBILISTICI NEI PAZIENTI CON DISTURBI COGNITIVI: QUALI SOLUZIONI?

MAGNESIUM AND ANABOLIC HORMONES IN OLDER MEN

Optimal nutritional and hormonal statuses are determinants of successful age-ing. The age associated decline in anabolic hormones such as testosterone and insulin-like growth factor 1 (IGF-1) is a strong predictor of metabolic syn-drome, diabetes and mortality in older men. Studies have shown that magne-sium intake affects the secretion of total IGF-1 and increase testosterone bioactivity. This observation suggests that magnesium can be a modulator of the anabolic ⁄ catabolic equilibrium disrupted in the elderly people. However, the relationship between magnesium and anabolic hormones in men has not been investigated. We evaluated 399 ‡65-year-old men of CHIANTI in a study population repres…

IPERTENSIONE ARTERIOSA E DETERIORAMENTO COGNITIVO

ATTUALE APPROCCIO TERAPEUTICO NEI PAZIENTI CON MALATTIA DI ALZHEIMER

Beyond Physical Exercise: The Role of Nutrition, Gut Microbiota and Nutraceutical Supplementation in Reducing Age-related Sarcopenia

Sarcopenia is a commonly prevalent geriatric condition mainly characterized by progressive loss of the skeletal muscle mass that results in noticeably reduced muscle strength and quality. Most of the geriatric population above 60 years of age are overweight, leading to the accumulation of fat in the muscles resulting in abated muscle function. The increased loss of muscle mass is associated with high rates of disability, poor motility, frailty and mortality. The excessive degeneration of muscles is now also being observed in middle-aged people. Therefore, geriatrics has recently started shifting towards the identification of early stages of the disability in order to expand the life span o…

Healthy Aging and Dietary Patterns

A number of factors contribute to the complex process of aging, which finally define whether someone will or not develop age-associated chronic diseases in late life. These determinants comprise genetic susceptibility as well as various behavioral, environmental, and dietary factors, all of which have been shown to influence specific pathways regulating the aging process and the extension of life, which makes longevity a multidimensional phenomenon. Although a “miraculous elixir” or a “nutrition pill” are not plausible, researchers agree on the notion that nutritional factors have major impact on the risk of age-associated chronic non-communicable diseases and mortality. In recent years nut…

DISTURBI DEL SONNO IN SOGGETTI ANZIANI

Test-and-treat strategy for Helicobacter pylori (HP) infection in older patients.

Abstract Despite Helicobacter pylori (HP) infection is highly prevalent in older populations, low rates of HP diagnosis and eradication are reported in older persons, even in geriatric wards. We aim to evaluate the results of a HP-eradicating program in a sample of older patients in relation to dyspeptic symptoms and to endoscopic findings. A pool of 140 subjects (female/ale = 86/54, mean age 68.6 ± 5.4 years) with positive C 13 -urea breath test were recruited, clinically evaluated to investigate the presence and characteristics of dyspepsia and abdominal pain, and underwent gastric endoscopic examination. HP-eradication was obtained in 87.9% of subjects with first-line triple therapy, reg…

DEPRESSIONE E RISCHIO DI EVENTI CEREBROVASCOLARI ACUTI

ETHICS AND AGING: FOCUS ON LIVING WILL FOR PATIENTS WITH DEMENTIA

Today dementia certainly represents a public health priority with a huge global impact on wordwide population. However, clinical and social issues related to dementia have long been marginalized. The actual high prevalence of dementias requires also to face issues from a bioethical perspective, regarding how to deal with demented patient’s disposition. There are currently no specific guidelines on the national territory regarding whether to draw up a living will by a patient with dementia, neither about the informative role of physicians during the progressive story of the disease.

7. INAPPROPRIATE PRESCRIPTION OF ALLOPURINOL AND FEBUXOSTAT AND RISK OF ADVERSE EVENTS IN THE ELDERLY: RESULTS FROM THE REPOSI REGISTRY

Purpose To investigate the prevalence of xanthine oxidase (XO) inhibitors prescription at admission and discharge in elderly hospital in-patients, to analyze the appropriateness of their use in relation to evidence-based indications, to evaluate the predictors of inappropriate prescription at discharge and the association with adverse events 3 months after hospital discharge. Methods This cross-sectional study, based upon a prospective registry, was held in 95 Italian internal medicine and geriatric hospital wards. The sample included 4035 patients aged 65 years or older at admission and 3502 at discharge. The prescription of XO inhibitors was considered appropriate in patients with diagnos…

IL PAZIENTE ANZIANO CON FRATTURA DI FEMORE: VALUTAZIONE E SUPPORTO NUTRIZIONALE

Osteoporosis in the elderly population is a major health problem worldwide, because it is associated with fragility fractures with consequent financial burden for health systems. Europe and North America are the regions where half of all hip fractures among elderly people occurred today, with Scandinavian countries reporting the highest incidence worldwide. Undernutrition, particularly protein malnutrition, is frequent in elderly with osteoporotic hip fracture, although, the role of dietary protein intake in osteoporosis remains controversial. Poor nutritional status is associated with higher comorbidity indices, mortality and readmissions in patients with femoral fracture. Another crucial …

Test-and-treat strategy for helicobacter pylori infection in older patients.

THE ROLE OF CALCIUM AS A METALLOTHERAPEUTIC DRUG

DIABETE E IPERTENSIONE: IMPORTANZA DEL CONTROLLO PRESSORIO OTTIMALE E DELLE MODIFICAZIONI DELLO STILE DI VITA

QUALITA’ DI VITA NEGLI ANZIANI: POSSIBILI INDICATORI

Oral magnesium supplementation improves vascular function in elderly diabetic patients

Magnesium (Mg) ions directly influence vascular tone and responsiveness and are cofactors for acetylcholine-induced endothelium-dependent relaxation. Alterations in extracellular Mg are able to modify the formation and release of nitric oxide (NO), altering arterial smooth muscle tone. Previous in vivo studies in humans have shown that parenteral or oral Mg supplementation increase endothelial-dependent vasodilation. The aim of the present study was to evaluate the effects of Mg oral supplementation on endothelial function in elderly diabetic and hypertensive subjects. Sixty elderly (≥ 65 years) diabetic patients were recruited (mean age: 71.1 ± 6.1 years; M/F: 35/25). Endothelial function,…

Agreement between different versions of MNA.

Malnutrition occurs frequently in the elderly with important clinical and functional consequences. Moreover, the treatment of malnutrition in the elderly may be effective if clinical and nutritional interventions are performed in the early stages. Therefore the early identification of the risk of malnutrition using validated and handy tools plays a pivotal role in terms of clinical outcome. Mini Nutritional Assessment (MNA) was validated for this purpose since many years but it is still ongoing the debate over whether the use of different items in certain clinical conditions can be effective without affecting the validity of the nutritional status evaluation. The aim of this study was to as…

Magnesium Intake in the Pathophysiology and Treatment of the Cardiometabolic Syndrome: Where Are We in 2006?

Multidimensional frailty increases cardiovascular risk in older people: An 8-year longitudinal cohort study in the Osteoarthritis Initiative.

Background:\ud \ud Cardiovascular diseases (CVDs) are the most important cause of mortality and an important cause of disability. Frailty seems to be associated with higher cardiovascular risk, but limited research has been done using a multidimensional approach to frailty. Thus, the present study aimed to investigate whether the multidimensional prognostic index (MPI), based on comprehensive geriatric assessment (CGA), is associated with CVD risk in the Osteoarthritis Initiative (OAI) study.\ud \ud Methods:\ud \ud Community-dwellers affected by knee OA or at high risk for this condition were followed for 8 years. A standardized CGA including information on functional, nutritional, mood, co…

Use of corticosteroids in Coronavirus disease 2019 pneumonia: A systematic review of the literature

The aim was to investigate the effectiveness of glucocorticoid therapy in patients with COVID-19. A systematic search of the literature across nine databases was conducted from inception until 15th March 2020, following the PRISMA guidelines. Patients with a validated diagnosis of COVID-19 and using corticosteroids were included, considering all health outcomes. Four studies with 542 Chinese participants were included. Two studies reported negative findings regarding the use of corticosteroids in patients with COVID-19, i.e., corticosteroids had a detrimental impact on clinical outcomes. One study reported no significant association between the use of corticosteroids and clinical outcomes. …

Dietary Approaches and Supplements in the Prevention of Cognitive Decline and Alzheimer';s Disease

Age-associated cognitive decline and dementia are conditions in which there is deterioration in memory, thinking, and behavior, with profound effects on the ability to perform everyday activities and well-being. Even if dementia mainly affects older persons, it is not a normal part of aging. Alzheimer's disease accounts for 60-75% of dementia cases. The number of persons affected will increase in the next decades in parallel with aging of the world population. Hence, unless some approach is found to reduce age-related deterioration of cognitive functions, health care costs will continue to rise exponentially. There is a wealth of epidemiological evidence supporting a relationship between di…

A Research Agenda: The Changing Relationship Between Body Weight and Health in Aging

Similar prediction of total mortality, diabetes incidence and cardiovascular events using relative- and absolute-component Mediterranean diet score: the SUN cohort.

Abstract Background and Aim Accumulated evidence supports the effectiveness of Mediterranean-type diets (MeDiet) in reducing mortality and preventing several chronic diseases. Widely used scores to assess adherence to MeDiet are based on specific sample characteristics; alternatively, they might be built according to absolute/normative cut-off points for the consumption of specific food groups (pre-defined servings/day or/week). The aim of this study was to compare sample-specific MeDiet adherence scores (MDS) versus absolute-normative scores (Mediterranean Diet Adherence Screener – MEDAS) on their association with macronutrient intake, total mortality and incidence of chronic diseases. Des…

[Cardiac arrhythmias in hypertensive subjects with and without left ventricular hypertrophy compared to the circadian profile of the blood pressure].

To evaluate possible correlations between cardiac arrhythmias and circadian pattern of blood pressure (BP) and of heart rate (HR), we studied 2 groups of 20 males with stable arterial hypertension of mild to moderate entity, with (Group I) or without (Group II) left ventricular hypertrophy (LVH). In patients with LVH the mean age (56 vs 46 years), the duration of the hypertensive state (48.1 vs 15.7 months), the thickening of interventricular septum (IVS; 13.7 vs 9.6 mm) and of the posterior wall of the left ventricle (13.2 vs 9.2 mm) and the mass of LV (149.8 vs 99.7 g/m2) were significantly greater (p less than 0.01). On the contrary, the 2 groups did not show significant differences conc…

Magnesium and Health

Magnesium (Mg) is the second most abundant cation after potassium in the intracellular compartment and has a critical role in modulating a large variety of cellular activities and metabolic pathways. Mg is cofactor in over 300 enzymatic reactions including all reactions that involve ATP utilization and transfer [1,2]. Over the past decades, the clinical relevance of Mg and its impact on health has been documented. In the human body, around 24 grams (1 mole) of Mg are present. Less than 1% of total Mg is in the serum; normal serum Mg concentrations range between 0.75-0.95 mmol/L (1.7-2.5 mg/dL or 1.5-1.9 meq/L). In healthy adults, daily Mg requirement is around 300-400 mg (5 to 6 mg/kg/day) …

LEPTINA E BMI IN SOGGETTI ANZIANI DIABETICI E NON DIABETICI

Una svolta per il Giornale di Gerontologia: dopo 60 anni in stampa, il GdG adotta la pubblicazione solo digitale

PREVENZIONE DELLE MALATTIE NEURODEGENERATIVE NELL’ANZIANO

LA RIABILITAZIONE PSICOSOCIALE IN PAZIENTI CON DEFICIT COGNITIVO LIEVE O LIEVE-MODERATO: L’ESPERIENZA DELL’ AREA TEMPO LIBERO

[Osteoporosis and diabetes].

Diabetes mellitus and osteoporosis are chronic diseases with an elevated and growing incidence in the elderly. Recent epidemiological studies have demonstrated an elevated risk of hip, humerus and foot fractures in elder diabetic subjects. While type 1 diabetes is generally associated with a mild reduction in bone mineral density (BMD), type 2 diabetes, more prevalent in old subjects, is frequently linked to a normal or high BMD. Studies on experimental models of diabetes have suggested an altered bone structure that may help to explain the elevated risk of fractures observed in these animals and may as well help to explain the paradox of an incremented risk of fractures in type 2 diabetic …

DECLINO COGNITIVO E CADASIL: CASO CLINICO

SENILE ANOREXIA IN DIFFERENT GERIATRIC SETTINGS IN ITALY

INCREMENTO DELLA ASPETTATIVA DI VITA IN PAZIENTI CON TALASSEMIA INTERMEDIA: CASO CLINICO

TEST-AND-TREAT ANCHE PER LA POPOLAZIONE GERIATRICA CON HP-INFEZIONE?

Risk of progression to diabetes and mortality in older people with prediabetes: The English longitudinal study on ageing

Abstract Aims Prediabetes is used to identify people at increased risk for diabetes. However, the importance of prediabetes in older populations is still poorly explored. Therefore, we aimed to investigate the prevalence of prediabetes, based on either glycated haemoglobin (HbA1c) levels or fasting glucose (FG) levels, or both and the progression of prediabetes to diabetes or to mortality in older participants of the English Longitudinal Study on Ageing. Materials and methods Prediabetes was categorized based on HbA1c levels (5.7%–6.4%) and/or FG levels (5.6–7.0 mmol/L). Information regarding mortality and incident diabetes were recorded during follow-up period of 10 years. Results In 2027 …

Clinical Utility of Midregional Proadrenomedullin in Patients with COVID-19

Abstract Objective The aim of the study was to assess the role of midregional proadrenomedullin (MR-proADM) in patients with COVID-19. Methods We included 110 patients hospitalized for COVID-19. Biochemical biomarkers, including MR-proADM, were measured at admission. The association of plasma MR-proADM levels with COVID-19 severity, defined as a requirement for mechanical ventilation or in-hospital mortality, was evaluated. Results Patients showed increased levels of MR-proADM. In addition, MR-proADM was higher in patients who died during hospitalization than in patients who survived (median, 2.59 nmol/L; interquartile range, 2.3–2.95 vs median, 0.82 nmol/L; interquartile range, 0.57–1.03; …

Magnesium in Aging, Health and Diseases

Several changes of magnesium (Mg) metabolism have been reported with aging, including diminished Mg intake, impaired intestinal Mg absorption and renal Mg wasting. Mild Mg deficits are generally asymptomatic and clinical signs are usually non-specific or absent. Asthenia, sleep disorders, hyperemotionality, and cognitive disorders are common in the elderly with mild Mg deficit, and may be often confused with age-related symptoms. Chronic Mg deficits increase the production of free radicals which have been implicated in the development of several chronic age-related disorders. Numerous human diseases have been associated with Mg deficits, including cardiovascular diseases, hypertension and s…

DEPRESSIONE E DISTURBI COGNITIVI NELL’ANZIANO

Circulating magnesium levels and disability in elderly hospitalized subjects

In-hospital complications of acute myocardial infarction in hypertensive subjects

Recent studies have shown a worse in-hospital outcome in hypertensive than in normotensive patients with acute myocardial infarction (AMI), which has been attributed to more frequent complications. The aim of this study was to investigate clinical patterns, risk factors, and in-hospital complications in hypertensive and normotensive patients with AMI.Of 4994 consecutive patients with AMI admitted to the intensive care unit, hypertensive patients with first infarction (n = 915; mean age 68.8 +/- 11.4 years) and 915 gender- and age-matched normotensive subjects were retrospectively studied.In the univariate analysis, hypertensive subjects presented more frequently non-Q-wave infarction and ST…

Trattamento delle lesioni ulcerative cutanee difficili: esistono spazi di miglioramento?

DOMOTICA, UTENZA DEBOLE E ANZIANI

Multimorbidity increases the risk of dementia: a 15 year follow-up of the SHARE study.

Abstract Aims the literature regarding the association between multimorbidity and dementia is still unclear. Therefore, we aimed to explore the potential association between multimorbidity at the baseline and the risk of future dementia in the SHARE (Survey of Health, Ageing and Retirement in Europe) study, a large European research survey, with a follow-up of 15 years. Methods in this longitudinal study, multimorbidity was defined as the presence of two or more chronic medical conditions, among 14 self-reported at the baseline evaluation. Incident dementia was ascertained using self-reported information. Cox regression analysis, adjusted for potential confounders, was run and hazard ratios…

PSICOTERAPIA CON PAZIENTI GERIATRICI: IL GRUPPO TERAPEUTICO COME STRUMENTO DI CAMBIAMENTO IN QUADRO DI UMORE DEPRESSO

OXIDATIVE STRESS AND ALZHEIMER’S DISEASE

Introduction: Brain tissue is particularly susceptible to oxidative damage, which has been associated with pathological findings of Alzheimer’s disease (AD), such as amyloid plaques and protein fibrils. Oxidative stress alterations, including increased production of reactive oxygen metabolites, decline of antioxidant systems, and decreased efficiency in repairing damaged molecules, have been linked to the development of AD. Postmortem studies on brain tissue from AD patients have shown several oxidative damage markers, such as increased lipid peroxidation, oxidative damage of proteins, glyco-oxidation, and reduction of antioxidant enzyme systems. Methods: We studied 40 patients referred to …

GLUCOSE CONTROL IN THE OLDER PATIENT: FROM INTENSIVE CONTROL TO EFFECTIVE AND SAFE CONTROL

Multidimensional Frailty and Vaccinations in Older People: A Cross-Sectional Study

It is known that influenza, herpes zoster, pneumococcal and pertussis infections may increase morbidity and mortality in older people. Vaccinations against these pathogens are effective in older adults. Frailty seems to be an important determinant of vaccination rates, yet data supporting this association are still missing. Therefore, we aimed to investigate the prevalence of four recommended vaccinations (influenza, herpes zoster, pneumococcal and diphtheria-tetanus-pertussis) and the association with multidimensional frailty assessed using a self-reported comprehensive geriatric assessment tool, i.e., the multidimensional prognostic index (SELFY-MPI). Older participants visiting the outpa…

Obesity in Aging and Art

THIS issue of Journal of Gerontology: Medical Sciences highlights new findings on obesity in older persons and its consequences for health and function (1,2,3). The obesity epidemic is spreading rapidly in both developed and developing countries, and perspectives on the negative effects of overweight and obesity abound in recent medical literature. What do we know so far about obesity over the lifetime? Obesity does not spare older persons (4). Obese older persons experience a wide range of negative consequences, including metabolic abnormalities, arthritis, pulmonary diseases, cataracts, cancer, impaired mobility, disability, and mortality. Given the already extensive knowledge base, why a…

Effects of Dehydroepiandrosterone Sulfate on Cellular Calcium Responsiveness and Vascular Contractility

Abstract Dehydroepiandrosterone sulfate (DHEAS) is an endogenous steroid having a wide variety of biological effects, but its physiological role remains undefined. Since an age-related decline of DHEAS corresponds to the progressive onset of atherosclerosis, cardiovascular diseases, and overall mortality, we investigated a possible protective role of DHEAS in vascular disease by studying the effects of this hormone (10 −7 to 10 −5 mol/L) on cytosolic free calcium and contractility in different in vitro vascular tissue preparations. DHEAS produced a significant, dose-dependent relaxation of isolated helical strips of rat tail artery precontracted with KCl (60 mmol/L) (89.7±18.7%, P <.01)…

Osteoporosis: Economic Burden of Disease in Italy.

Background and Objective: Today, osteoporosis is the most common bone disease and an important public health problem in all developed countries. The objective of this study was to estimate the costs associated with the management and treatment of osteoporosis in order to assess the economic burden in Italy for 2017, in terms of direct medical costs and social security costs. Methods: A cost of illness model was developed to estimate the average cost per year sustained by the NHS (National Health Service) and Social Security System in Italy. A systematic literature review was performed to obtain epidemiological, direct and indirect costs parameters where available. Hospitalisation costs were…

ALTERAZIONI NUTRIZIONALI DELL’ANZIANO

Be7(n,α)He4Reaction and the Cosmological Lithium Problem: Measurement of the Cross Section in a Wide Energy Range at n_TOF at CERN

The energy-dependent cross section of the (7)Bed(n,alpha)He-4 reaction, of interest for the so-called cosmological lithium problem in big bang nucleosynthesis, has been measured for the first time from 10 meV to 10 keV neutron energy. The challenges posed by the short half-life of Be-7 and by the low reaction cross section have been overcome at n_TOF thanks to an unprecedented combination of the extremely high luminosity and good resolution of the neutron beam in the new experimental area (EAR2) of the n_TOF facility at CERN, the availability of a sufficient amount of chemically pure Be-7, and a specifically designed experimental setup. Coincidences between the two alpha particles have been…

Low Dietary Magnesium and Overweight/Obesity in a Mediterranean Population: A Detrimental Synergy for the Development of Hypertension. The SUN Project

Hypertension is the strongest independent modifiable risk factor for cardiovascular disease. We aimed to investigate the association of magnesium intake with incident hypertension in a Mediterranean population, and the potential modification of this association by body mass index BMI. We assessed 14,057 participants of the SUN (Seguimiento Universidad de Navarra) prospective cohort (67.0% women) initially free of hypertension. At baseline, a validated 136-item food frequency questionnaire was administered. We used Cox models adjusted for multiple socio-demographic, anthropometric, and lifestyle factors, and prevalent conditions present at baseline. Among a mean 9.6 years of follow-up we obs…

Comprehensive geriatric assessment in older people: an umbrella review of health outcomes

Abstract Background Comprehensive geriatric assessment (CGA) has been in use for the last three decades. However, some doubts remain regarding its clinical use. Therefore, we aimed to capture the breadth of outcomes reported and assess the strength of evidence of the use of comprehensive geriatric assessment (CGA) for health outcomes in older persons. Methods Umbrella review of systematic reviews of the use of CGA in older adults searching in Pubmed, Embase, Scopus, Cochrane library and CINHAL until 05 November 2021. All possible health outcomes were eligible. Two independent reviewers extracted key data. The grading of evidence was carried out using the GRADE for intervention studies, whil…

Magnesium and hypertension in old age

Hypertension is a complex condition in which various actors and mechanisms combine, resulting in cardiovascular and cerebrovascular complications that today represent the most frequent causes of mortality, morbidity, disability, and health expenses worldwide. In the last decades, there has been an exceptional amount of experimental, epidemiological, and clinical studies confirming a close relationship between magnesium deficit and high blood pressure. Multiple mechanisms may help to explain the bulk of evidence supporting a protective effect of magnesium against hypertension and its complications. Hypertension increases sharply with advancing age, hence older persons are those most affected…

QUALITÀ DELLA VITA NEGLI ANZIANI: POSSIBILI INDICATORI

INVECCHIAMENTO DELLA POPOLAZIONE E DINAMICHE MIGRATORIE: UNA VALUTAZIONE EPIDEMIOLOGICA, SOCIO-CULTURALE E FUNZIONALE IN PAZIENTI ANZIANI MIGRANTI

LO STUDIO EUROFARMCARE: SERVIZI DI SUPPORTO PER CAREGIVERS FAMILIARI DI ANZIANI IN EUROPA: SINTESI DEI PRINCIPALI RISULTATI

Glucose control in the older patient: from intensive, to effective and safe.

Older adults represent an extensive proportion of Type 2 diabetic patients. Managing diabetes in this population is challenging, because complex comorbidity and disability often mean that guidelines are not suitable on an individual basis. Recent evidence has raised animated discussion of the possibility that intensive glucose control may cause more harm than benefit, especially in older adults. The benefit of glycemic control on microvascular diabetic complications has been consistently demonstrated, but the evidence of benefit on macrovascular disease is not uniform in all studies. Glycemic control appears to prevent the development of cardiovascular events, but is less helpful in seconda…

Magnesium and Type 2 Diabetes: An Update

The link between magnesium (Mg) deficiency and type 2 diabetes mellitus is well known. Type 2 diabetes is frequently associated with both extracellular and intracellular Mg deficits. A chronic latent Mg deficit or an overt clinical hypomagnesaemia is common in subjects with type 2 diabetes, especially in those with poorly controlled glycemic profiles. Insulin and glucose are important regulators of Mg metabolism. Intracellular Mg plays a key role in regulating insulin action, insulin-mediated-glucose-uptake and vascular tone. Reduced intracellular Mg concentrations result in a defective tyrosine-kinase activity, postreceptorial impairment in insulin action and worsening of insulin resistanc…

Neutron capture cross section measurement ofU238at the CERN n_TOF facility in the energy region from 1 eV to 700 keV

The aim of this work is to provide a precise and accurate measurement of the U238(n,γ) reaction cross section in the energy region from 1 eV to 700 keV. This reaction is of fundamental importance for the design calculations of nuclear reactors, governing the behavior of the reactor core. In particular, fast reactors, which are experiencing a growing interest for their ability to burn radioactive waste, operate in the high energy region of the neutron spectrum. In this energy region most recent evaluations disagree due to inconsistencies in the existing measurements of up to 15%. In addition, the assessment of nuclear data uncertainty performed for innovative reactor systems shows that the u…

Association Between Pollution and Frailty in Older People: A Cross-Sectional Analysis of the UK Biobank

Objectives: Frailty is a relevant issue in older people, being associated with several negative outcomes. Increasing literature is reporting that pollution (particularly air pollution) can increase the risk of frailty, but the research is still limited. We aimed to investigate the potential association of pollution (air, noise) with frailty and prefrailty among participants 60 years and older of the UK Biobank study. Design: Cross-sectional. Settings and participants: Older participants (age ≥ 60 years) participating to the UK Biobank. Methods: Frailty and prefrailty presence were ascertained using a model including 5 indicators (weakness, slowness, weight loss, low physical activity, and e…

DEPRESSIONE E AUTO PERCEZIONE DELLA SALUTE IN SOGGETTI ANZIANI ITALIANI: EUROPEAN STUDY ON ADULT WELL-BEING (ESAW)

La valutazione clinica degli anziani

Hospital Care of Older Patients With COPD: Adherence to International Guidelines for Use of Inhaled Bronchodilators and Corticosteroids

Abstract Objectives We aimed to analyze the prevalence and impact of COPD in older patients hospitalized in internal medicine or geriatric wards, and to investigate adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, associated clinical factors, and outcomes. Design Data were obtained from REgistro POliterapie SIMI (REPOSI), a prospective multicenter observational registry that enrolls inpatients aged ≥65 years. Setting and Participants Older hospitalized patients enrolled from 2008 to 2016 with a diagnosis of COPD. Measures We evaluated adherence to the 2018 GOLD guidelines at admission and discharge, by examining the prescription of inhaled bronchodi…

CGA with Easy-care: priorities for research and development.

Vitamin D substrate-product relationship in idiopathic hypercalciuria.

Absorptive hypercalciuria (AH) is associated with elevated levels of 1,25-dihydroxyvitamin D (1,25(OH)(2)D). While no increase of 1,25(OH)(2)D after oral administration of 25-hydroxyvitamin D (25OHD) at high doses has been claimed in normal subjects, a substrate-product relationship has been reported in normal children, young people after UV irradiation, older persons, postmenopausal women, primary hyperparathyroidism, renal failure, osteomalacia, and sarcoidosis. No data of this relationship in AH is available. To investigate 25OHD-1,25(OH)(2)D substrate-product relationship in AH, 161 AH patients (mean age 60.9+/-11.7 years) and 110 age- and sex-matched controls (mean age 61.5+/-12.4 year…

MALATTIA DI ALZHEIMER: PREDISPOSIZIONE, PREVENZIONE E TERAPIE FARMACOLOGICHE

Diabetes and Dementia

Persons with type 2 diabetes mellitus (DM2) have an increased incidence of cognitive decline and dementia. An increased cortical and subcortical atrophy has been found after controlling for vascular disease and inadequate cerebral circulation. A possible role of insulin resistance and hyperinsulinemia has been suggested to mediate the link between DM2 and Alzheimer’s Disease (AD). Altered insulin signaling may contribute to AD biochemical and histopathological lesions. Both hyperglycemia and hypoglycemia may contribute to cognitive decline in DM2. Recurrent symptomatic and asymptomatic hypoglycemic episodes have been suggested to cause subclinical brain damage, and permanent cognitive impai…

Malnutrition in elderly: Social and economic determinants

Abstract: Malnutrition occurs frequently in the frailest groups of the population, especially in people who are on a low income and elderly subjects, overall if they are institutionalized. The aim of this study was to assess the prevalence of malnutrition in a sample of elderly people living in different settings and to identify the determinants of malnutrition. Methods: A total of 718 subjects, 472 females (F) and 246 males (M), were recruited from nursing homes or were free living in three different regions in Italy. Nutritional status, depression, social, functional and cognitive status, were evaluated. Results: According to the Mini Nutritional Assessment (MNA), a high prevalence of mal…

ARE NEUROLOGISTS MORE LIKELY TO PRESCRIBE ANTITHROMBOTIC THERAPY AFTER STROKE?

Magnesium, Oxidative Stress, and Aging Muscle

Abstract Magnesium (Mg) deficiency, aside from having a negative impact on the energy production pathways required by the mitochondria to generate ATP, also reduces the threshold antioxidant capacity of the aging organism and its resistance to free-radical damage. Mg acts as an antioxidant against free radical damage of the mitochondria. Chronic Mg deficiency results in excessive production of oxygen-derived free radicals and low-grade inflammation. Chronic inflammation and oxidative stress have been identified as pathogenic factors in several age-related conditions. Aging is often associated with Mg inadequacy, muscle loss, and sarcopenia. Although the importance of magnesium as a determin…

Magnesium and Micro-Elements in Older Persons

Macro- and micro-element deficiencies are widely diffused in older people. The deficiency of these elements in older people is often attributable to malnutrition, even if other medical conditions (such as gastrointestinal problem) or non-medical conditions (such as polypharmacy) can lead to these deficiencies [1]. It is estimated that malnutrition is present in 1.3–47.8% of older people living in the community, being higher in other settings and in low-middle income countries [2].

Role of magnesium in insulin action, diabetes and cardio-metabolic syndrome X

Magnesium (Mg) is one of the most abundant ions present in living cells and its plasma concentration is remarkably constant in healthy subjects. Plasma and intracellular Mg concentrations are tightly regulated by several factors. Among them, insulin seems to be one of the most important. In vitro and in vivo studies have demonstrated that insulin may modulate the shift of Mg from extracellular to intracellular space. Intracellular Mg concentration has also been shown to be effective in modulating insulin action (mainly oxidative glucose metabolism), offset calcium-related excitation-contraction coupling, and decrease smooth cell responsiveness to depolarizing stimuli. A poor intracellular M…

Association of a dietary score with incident type 2 Diabetes: the dietary-based diabetes-risk score (DDS)

Background Strong evidence supports that dietary modifications may decrease incident type 2 diabetes mellitus (T2DM). Numerous diabetes risk models/scores have been developed, but most do not rely specifically on dietary variables or do not fully capture the overall dietary pattern. We prospectively assessed the association of a dietary-based diabetes-risk score (DDS), which integrates optimal food patterns, with the risk of developing T2DM in the SUN (“Seguimiento Universidad de Navarra”) longitudinal study. Methods We assessed 17,292 participants initially free of diabetes, followed-up for a mean of 9.2 years. A validated 136-item FFQ was administered at baseline. Taking into account prev…

Altered cellular magnesium responsiveness to hyperglycemia in hypertensive subjects.

Abstract — — Previous studies by our group have identified ionic aspects of insulin resistance in hypertension, in which cellular responses to insulin were influenced by the basal intracellular ionic environment—the lower the cytosolic free magnesium (Mg i ), the less Mg i increased following insulin stimulation. To investigate whether this ionic insulin resistance represents a more general abnormality of cellular responsiveness in hypertension, we studied Mg i responses to nonhormonal signals such as hyperglycemia (15 mmol/L) and used 31 P-nuclear magnetic resonance (NMR) spectroscopy to measure Mg i in erythrocytes from normal (NL, n=14) and hypertensive (HTN, n=12) subjects before and 3…

The Nuclear astrophysics program at n_TOF (CERN)

An important experimental program on Nuclear Astrophysics is being carried out at the n_TOF since several years, in order to address the still open issues in stellar and primordial nucleosynthesis. Several neutron capture reactions relevant to s-process nucleosynthesis have been measured so far, some of which on important branching point radioisotopes. Furthermore, the construction of a second experimental area has recently opened the way to challenging measurements of (n, charged particle) reactions on isotopes of short half-life. The Nuclear Astrophysics program of the n_TOF Collaboration is here described, with emphasis on recent results relevant for stellar nucleosynthesis, stellar neut…

Oxidative stress in patients with Alzheimer's disease: Effect of extracts of fermented papaya powder

Brain tissue is particularly susceptible to oxidative stress (OS). Increased production of reactive oxygen species (ROS), reduced antioxidant systems, and decreased efficiency in repairing mechanisms have been linked to Alzheimer’s disease (AD). Postmortem studies in AD patients’ brains have shown oxidative damage markers (i.e., lipid peroxidation, protein oxidative damage, and glycoxidation). Fermented papaya (FPP, a product ofCarica papaya Linnfermentation with yeast) is a nutraceutical supplement with favorable effects on immunological, hematological, inflammatory, and OS parameters in chronic/degenerative diseases. We studied 40 patients (age 78.2 ± 1.1 years), 28 AD patients, and 12 co…

L’ALIMENTAZIONE NEI PAZIENTI ISTITUZIONALIZZANTI AFFETTI DA DEMENZA TIPO ALZHEIMER

Neurological diseases and COVID-19: prospective analyses using the UK Biobank

COVID-19 (Coronavirus disease-19) may present with neurological signs, but whether people already affected by neurological conditions are at a higher risk of contracting COVID-19 is still not known. We, therefore, aimed to investigate the association of previously diagnosed neurological conditions with COVID-19. 502,536 community-dwelling UK Biobank participants (54.4% male, mean age 56.6 ± 10.3 years) were included. Among these, 57,463 participants had a diagnosis of neurological conditions (11.43%) and a total of 1326 COVID-19-positive cases were identified (0.26%). Neurological conditions were identified through medical history and linkage to data on hospital admissions (ICD-10 code G00–…

Dietary fiber intake and mortality in a Mediterranean population: the “Seguimiento Universidad de Navarra” (SUN) project

Purpose To prospectively assess the association of dietary fiber intake (from different dietary sources) with all-cause mor-tality in a Mediterranean cohort. Methods We assessed 19,703 participants of the SUN (Seguimiento Universidad de Navarra) cohort (mean follow-up: 10.1 years). A validated 136-item FFQ was administered at baseline. We used Cox proportional hazards models adjusted for multiple socio-demographic, anthropometric, lifestyle factors, and prevalent conditions at baseline. Results We observed 323 deaths during 198,341 person-years of follow-up. A significantly inverse linear trend in Cox models was observed for the association of total dietary fiber intake and all-cause mortal…

DOLORE E QUALITA' DELLA VITA.L'IMPORTANZA DELLA VMD

Appropriateness of oral anticoagulant therapy prescription and its associated factors in hospitalized older people with atrial fibrillation

Aims: Although oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), they are often underused in this particularly high-risk population. The aim of the present study was to assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older. Methods: Data were obtained from the retrospective phase of Simulation-based Technologies to Improve the Appropriate Use of Oral Anticoagulants in Hospitalized Elderly Patients With Atrial Fibrillation (SIM-AF) study, held in 32 Italian internal medicine and geriatric wards. The appropriateness of OAC prescription was assessed, grouping patients …

USO DI IPOGLICEMIZZANTI ORALI SECRETAGOGHI E CADUTE IN PAZIENTI DIABETICI ANZIANI RICOVERATI IN UN REPARTO PER ACUTI

Toward a new prognostic-therapeutic index in geriatric oncology

Influenza vaccination reduces dementia risk: A systematic review and meta-analysis

Animal models have indicated that influenza vaccination may prevent or delay the onset of dementia. However, the epidemiological evidence in human beings is still limited. Given this background, this systematic review and meta-analysis aimed to summarize the current state of the art of observational studies investigating the association between influenza vaccination and the risk of dementia. We searched Scopus and Pubmed/Medline until 24 September 2021 for studies investigating the risk of dementia by influenza vaccination status. After adjustment for potentially important confounding variables, data were reported as risk ratios (RRs) with 95% confidence intervals (CIs). Among 273 articles …

The Interplay between Magnesium and Testosterone in Modulating Physical Function in Men

The role of nutritional status as determinant of successful aging is very well recognized. There is recent evidence that nutrition may exert its beneficial effects through the modulation of the hormonal anabolic milieu. Under-nutrition and anabolic hormonal deficiency frequently coexist in older individuals determining an increased risk of mobility impairment and adverse outcomes. Mineral dietary assessment has received attention as key component of the nutritional modulation of anabolic status and physical performance. There is evidence that several minerals, including magnesium, exert a positive influence on Insulin-like Growth Factor-1 (IGF-1) secretion in both sexes, and Testosterone (T…

INDUCTION OF VEGF RELEASE BY TRANSCUTANEOUS FREQUENCY MODULATED NEURAL STIMULATION IN DIABETIC POLYNEUROPATHY

Il percorso ideale nella gestione del paziente con osteoporosi severa:dalla valutazione del rischio all'approccio multidisciplinare

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Prevention of Functional Decline by Reframing the Role of Nursing Homes?

Institutionalization is generally a consequence of functional decline driven by physical limitations, cognitive impairments, and/or loss of social supports. At this stage, intervention to reverse functional losses is often too late. To be more effective, geriatric medicine must evolve to intervene at an earlier stage of the disability process. Could nursing homes (NHs) transform from settings in which many residents dwell to settings in which the NH residents and those living in neighboring communities benefit from staff expertise to enhance quality of life and maintain or slow functional decline? A task force of clinical researchers met in Toulouse on December 2, 2015, to address some of t…

Adherence to a healthy lifestyle and multiple sclerosis: a case–control study from the UK Biobank

Background: Multiple sclerosis (MS) is a common and disabling condition. The importance of healthy lifestyle for this disease is poorly explored. Objective: To test whether adherence to healthier lifestyle patterns is associated with a lower presence of multiple sclerosis (MS). Methods: By using a case–control design, we investigated the combined association of four healthy lifestyle-related factors (no current smoking, healthy diet, exercising regularly, body mass index <30 kg/m2) and the prevalence of MS. A logistic regression analysis, adjusted for potential confounders, was used and data reported as odds ratios (ORs) with their 95% confidence intervals (CIs). Results: 728 participant…

ANTIAGING STRATEGIES

PROTEIN SUPPLEMENTATION IN FRAIL OLDER PERSONS: OFTEN NECESSARY BUT NOT ALWAYS SUFFICIENT

COLLAGEN OVERGLYCOSYLATION: A BIOCHEMICAL FEATURE THAT MAY CONTRIBUTE TO BONE QUALITY

Skeletal ability to resist mechanical stress is determined by bone amount and quality, which relies on macro- and micro-architecture, turnover, bone matrix, and mineralisation; the role of collagen has not been clearly elucidated. Numerous post-translational steps are involved in collagen type I biosynthesis, including residue hydroxylation and glycosylation catalysed by enzymes that work until the protein folds forming the triple helix; therefore, folding rate regulates these processes. Overglycosylated hydroxylysines are poor substrates for e-amino group deamination which initiates cross-link formation. Three clinical conditions associated with fractures may relate collagen overglycosylat…

L’IPONATRIEMIA NELL’ANZIANO: UNA PROBLEMATICA SEMPRE ATTUALE

Le alterazioni della concentrazione plasmatica del sodio rappresentano una delle disionie di più frequente riscontro nei pazienti ricoverati e che l’incidenza e la prevalenza aumentano con l’età. Molteplici fattori correlati all’invecchiamento giocano un ruolo in tal senso; ad esempio, variazioni anatomiche e funzionali, modificazioni della composizione corporea, alterazioni dei meccanismi fisiologici che regolano il metabolismo e l’omeostasi del sodio e dell’acqua. L’aumento dell’incidenza di tali disturbi nella popolazione anziana rappresenta un chiaro esempio di come l’invecchiamento è in grado di compromettere le capacità di compenso, di adattamento e l’omeostasi dell’organismo. Alterat…

VALUTAZIONE MULTIDIMENSIONALE IN UN GRUPPO DI PAZIENTI ANZIANI IMMIGRATI

Magnesium and Alzheimer’s Disease

Environmental factors, including nutrition and metal elements, are implicated in the pathophysiology of Alzheimer’s disease (AD). Several in vitro and in vivo data indicate a role for magnesium (Mg) in many biological and clinical aspects of AD. Mg deficiency, aside from having a negative impact on the energy production pathways required by the mitochondria to generate adenosine triphosphate, also affects many biochemical mechanisms vital for neuronal properties and synaptic plasticity, including the response of N-methyl- d -aspartate receptors to excitatory amino acids, stability, and viscosity of the cell membrane. Mg also has an action as a mild calcium antagonist, and as an antioxidant …

Human Monkeypox: A Comprehensive Narrative Review and Analysis of the Public Health Implications.

Recently, numerous cases of monkeypox were reported from several non-endemic countries in Europe, North America, and Oceania, suggesting an unusual and alarming public health issue, particularly considering that the disease is not directly related to human or animal travels. Attention is currently being drawn to this phenomenon since more than 70% of the global population is no longer vaccinated against smallpox. Indeed, the smallpox vaccination also confers some indirect degree of protection against other poxviruses, including monkeypox. We performed a narrative review to describe the existing literature with regard to monkeypox using the MEDLINE, EMBASE, and Scopus databases. This review …

Magnesium in Infectious Diseases in Older People

Reduced magnesium (Mg) intake is a frequent cause of deficiency with age together with reduced absorption, renal wasting, and polypharmacotherapy. Chronic Mg deficiency may result in increased oxidative stress and low-grade inflammation, which may be linked to several age-related diseases, including higher predisposition to infectious diseases. Mg might play a role in the immune response being a cofactor for immunoglobulin synthesis and other processes strictly associated with the function of T and B cells. Mg is necessary for the biosynthesis, transport, and activation of vitamin D, another key factor in the pathogenesis of infectious diseases. The regulation of cytosolic free Mg in immune…

Improving adherence in osteoporosis: a new management algorithm for the patient with osteoporosis

Introduction: Bisphosphonates are the first-choice treatment for osteoporosis. They effectively increase bone mineral density, reduce markers of bone resorption, and lower the incidence of new fractures in patients with osteoporosis-related fracture. However, the efficacy observed in clinical trials may not be realized in a real-life setting, partly due to poor adherence to therapy, with a significant worsening of clinical outcomes. Several issues contribute to poor adherence to osteoporosis medication, including inconvenient dosing regimens and concerns about possible adverse events. Although strategies to improve adherence have been investigated, new approaches are required. Areas covered…

DIETA MEDITERRANEA E LONGEVITÀ: RUOLO DELL’OLIO EXTRAVERGINE DI OLIVA

IL PAZIENTE GERIATRICO COMPLESSO E LA SINDROME DI FRAGILITÀ: SPECIFICITÀ DELLA GERIATRIA

INVECCHIAMENTO DELLA POPOLAZIONE NEL MAGHREB

SEPSI IN SOGGETTI PORTATORI DI ELETTROCATETERE INTRACARDIACO

MALATTIA DI ALZHEIMER: PREDISPOSIZONE, PREVENZIONE E TERAPIE FARMACOLOGICHE

Sex-Differences in the Pattern of Comorbidities, Functional Independence, and Mortality in Elderly Inpatients: Evidence from the RePoSI Register

Background: The RePoSi study has provided data on comorbidities, polypharmacy, and sex dimorphism in hospitalised elderly patients. Methods: We retrospectively analysed data collected from the 2010, 2012, 2014, and 2016 data sets of the RePoSi register. The aim of this study was to explore the sex-differences and to validate the multivariate model in the entire dataset with an expanded follow-up at 1 year. Results: Among 4714 patients, 51% were women and 49% were men. The disease distribution showed that diabetes, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, and malignancy were more frequent in men but that hypertension, anaemia, osteoarthritis, de…

QUALITY OF LIFE FOR OLDER PERSONS

COENZIMA Q E MALATTIA DI PARKINSON

QUALITY OF LIFE IN OSTEOPOROTIC WOMEN WITH INADEQUATE RESPONSE TO ANTIRESORPTIVE DRUGS

Ambiente e anziano: la domotica come ausilio per disabili e anziani

The relevance of nutrition for the concept of cognitive frailty

Purpose of review Physical and cognitive frailty are interrelated and synergistic syndromes more frequently seen in old age, which represent intermediate stages between aging successfully and disability. Poor nutrition is a fundamental determinant for both conditions, while various dietary components are proposed to prevent and/or improve them. This updated review discusses the possible influence of nutritional factors on cognitive frailty and its potential mediators. Recent findings Oxidative stress, low-grade systemic inflammation, neuroinflammation, and altered autophagy, all associated with obesity, metabolic syndrome and insulin resistance, are proposed mechanisms to explain the influe…

TERAPIA ACUTA DEL DOLORE E CAPACITÀ FUNZIONALE IN PAZIENTI AMBULATORIALI

Specific approaches to patients affected by dementia and covid-19 in nursing homes: the role of the geriatrician

The coronavirus disease 19 (COVID-19) is relevant in older people. Attention was given to the nursing homes in which frailer people are usually admitted. In this review, we discuss the approaches for daily problems found in nursing home as geriatricians and potentially new research directions. We start with the problem of the older people affected by dementia and Behavioral and Psychological Symptoms of Dementia for which also the execution of a simple diagnostic test (such as nasopharyngeal swab) could be problematic. Another important problem is the management of wandering patients for which the re-organization of the spaces and vaccination could be the solutions. The relationship with fa…

Age, homocysteine, and oxidative stress: Relation to hypertension and type 2 diabetes mellitus

Abstract OBJECTIVES: Hyperhomocysteinemia and oxidative stress are independent risk factors for cardiovascular events, which occur more frequently in old age. We evaluated these parameters in relation to age and the presence of hypertension and type 2 diabetes mellitus. METHODS: Two hundred eighty-two subjects (female/male: 142/140; 141 were >65 years and 141 were <65 years; mean age 73.9 +/- 6.6 years and 52.5 +/- 8.2 years, respectively) were randomly recruited from those attending our institution. Blood pressure, anthropometric parameters, oxidative stress parameters (reactive oxygen species [ROS] and malondialdehyde [MDA]), and homocysteine levels were evaluated in participants. RESULTS…

Insulin Resistance and the Cardiometabolic Syndrome in HIV Infection

Highly active antiretroviral therapy (HAART) has dramatically improved the prognosis of HIV-positive patients. However, long-term adverse effects of this therapy include dyslipidemia, insulin resistance (IR), changes in body fat distribution (lipodystrophy), and cardiometabolic syndrome (CMS). IR in HIV-positive patients does not seem to represent a significant independent risk factor for the development of cardiovascular disease; nevertheless, the association with other metabolic complications (dyslipidemia, fat redistribution) and CMS may increase the risk of type 2 diabetes and cardiovascular disease. The use of nucleoside analogue reverse transcriptase inhibitors is associated with the …

Social frailty increases the risk of all-cause mortality: A longitudinal analysis of the English Longitudinal Study of Ageing

Objectives\ud Social frailty is a common condition in older people, but its consequences are largely unknown. Therefore, in this longitudinal analysis, we aimed to investigate the association between social frailty and risk of all-cause mortality in a large sample of older people.\ud Design\ud Longitudinal, cohort.\ud Settings and participants\ud Older people participating to the English Longitudinal Study of Ageing (ELSA).\ud Methods\ud Social frailty was defined based on financial difficulty, household status, social activity, and contacts with other people: social frailty was defined as ≥2 points, social pre-frailty (1 point), and robustness (0 points). Survival status during ten years o…

AZITHROMYCIN IN AN OLDER WOMAN WITH DIABETIC GASTROPARESIS

Diabetic neuropathy is a common chronic complication of diabetes and cause of significant morbidity and mortality, because it may involve the autonomous and peripheral nervous systems. Autonomic diabetic neuropathy is a challenging chronic complication of long-standing diabetes manifested with hypotension, syncope, gastroparesis, diarrhea, constipation, bladder dysfunction, sexual dysfunction, cardiac arrest, and/or sudden death. We present a case of diabetic gastroparesis in an older woman. The patient was an 83-year-old woman with a 40-year history of type 2 diabetes who was admitted with hypoglycemia, malnutrition, persistent vomiting, and obstinate constipation. After several unsuccessf…

IPERCALCEMIA

Dissimilar PTH, Gastrin, and Calcitonin Responses to Oral Calcium and Peptones in Hypocalciuric Hypercalcemia, Primary Hyperparathyroidism, and Normal Subjects: A Useful Tool for Differential Diagnosis

We analyzed gastrin, PTH, and calcitonin responses to oral calcium and peptones in hypocalciuric hypercalcemia, mild primary hyperparathyroidism, and normal controls. We observed diverse hormonal responses that may help in the differential diagnosis of these conditions. Introduction: Hypocalciuric hypercalcemia (HH) is consequent to calcium-sensing receptor (CaSR) genetic mutations or anti-CaSR antibodies. CaSR is expressed in parathyroid tissue, thyroid C cells, and gastrin-secreting cells, where it has been suggested that on calcium and/or amino acid allosteric activation, promotes gastrin secretion. Materials and Methods: We evaluated gastrin, PTH, and calcitonin responses to oral calciu…

PROGNOSTIC VALUE OF ESTIMATED GLOMERULAR FILTRATION RATE IN HOSPITALIZED ELDERLY PATIENTS

A multicenter observational study, REPOSI (REgustri POliterapie Società Italiana di Medicina Interna), was conducted to assess the prognostic value of glomerular filtration rate (eGFR) on in-hospital mortality, hospital readmission and death within 3 months, in a sample of elderly patients (n=1,363) admitted to 66 internal medicine and geriatric wards. Bases on eGFR, calculated by the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, subjects at hostpital admission were classified into three groups: group 1 with normal eGFR (60 ml/min/1.73m2, reference group), group 2 with moderately reduced eGFR (30-59 ml/min/1.73 m2) and group 3 with severely reduced eGFR (<30 ml/m…

COMORBIDITY, POLYMORBIDITY, POLYPHARMACY

APPROCCIO MULTIDISCIPLINARE PER IL PAZIENTE ANZIANO FRAGILE

MCI ED EVOLUZIONE IN DEMENZA

The 33S(n,α)30Si cross section measurement at n TOF-EAR2 (CERN): From 0.01 eV to the resonance region

The 33S(n,α)30Si cross section measurement, using 10B(n,α) as reference, at the n TOF Experimental Area 2 (EAR2) facility at CERN is presented. Data from 0.01 eV to 100 keV are provided and, for the first time, the cross section is measured in the range from 0.01 eV to 10 keV. These data may be used for a future evaluation of the cross section because present evaluations exhibit large discrepancies. The 33S(n,α)30Si reaction is of interest in medical physics because of its possible use as a cooperative target to boron in Neutron Capture Therapy (NCT).

Nutrition, physical activity, and other lifestyle factors in the prevention of cognitive decline and dementia

Multiple factors combined are currently recognized as contributors to cognitive decline. The main independent risk factor for cognitive impairment and dementia is advanced age followed by other determinants such as genetic, socioeconomic, and environmental factors, including nutrition and physical activity. In the next decades, a rise in dementia cases is expected due largely to the aging of the world population. There are no hitherto effective pharmaceutical therapies to treat age-associated cognitive impairment and dementia, which underscores the crucial role of prevention. A relationship among diet, physical activity, and other lifestyle factors with cognitive function has been intensive…

TRATTAMENTO DELLE LESIONI ULCERATIVE CUTANEE DIFFICILI: ESISTONO MARGINI DI MIGLIORAMENTO?

Perspective: Protein Supplementation in Frail Older Persons: Often Necessary but Not Always Sufficient

Magnesium metabolism in hypertension and type 2 diabetes mellitus.

The increasing evidence for the clinical relevance of altered magnesium metabolism to states of altered insulin resistance confirms the role of magnesium deficit as a possible underlying common mechanism of the "insulin resistance" of hypertension and altered glucose tolerance. The pioneer work of Lawrence M. Resnick and his group using the cellular ion-based approach that we are only partially presenting here has consistently contributed to the progress of the field, demonstrating (a) the critical importance of magnesium metabolism in regulating insulin sensitivity as well as vascular tone, and blood-pressure homeostasis; (b) that magnesium deficiency, defined on the basis of intracellular…

The Association between Masticatory Muscles Activation and Foot Pressure Distribution in Older Female Adults: A Cross-Sectional Study

The association between craniofacial muscles and postural control is well-known because of numerous anatomical connections. However, there are a few conflicting studies that correlated the activity of the masticatory muscles with the distribution of body weight pressure on the feet, which can strongly influence balance. Therefore, the purpose of our study was to evaluate the association between the masseter and temporalis muscle activity and foot pressure distribution. Fifty-two women were recruited, and baropodometric and EMG analyses of the masseter and temporalis baseline activities were analyzed. An ipsilateral association was found between the right temporal muscle activity and the rig…

Serum ionized magnesium levels in relation to metabolic syndrome in type 2 diabetic patients

Objective: To evaluate circulating serum ionized magnesium (i-Mg) concentrations in patients with type 2 diabetes mellitus, and to investigate its relationship with the components of the metabolic syndrome. Design: cross-sectional study. Setting: Outpatients' service for diabetic patients at the University Hospital of Messina, Italy. Subjects: 290 patients with type 2 diabetes mellitus. Measures of Outcome: Serum i-Mg was measured by ion selective electrode. Age, gender, body mass index (BMI), waist circumference, blood pressure, fasting glucose, HbA1c, HDL cholesterol, triglycerides, and urinary albumin excretion rate (UAER) were considered in the analyses. Patients with hypomagnesemia, de…

Altered ionized magnesium levels in mild-to-moderate Alzheimer's disease.

Abstract. Magnesium deficiency is present in several chronic, age-related diseases, including cardiovascular, metabolic and neurodegenerative diseases. Alzheimer’s disease (AD) is the most common cause of dementia. The aim of the present study was to study magnesium homeostasis in patients with mild to moderate AD. One hundred and one elderly (≥65 years) patients were consecutively recruited (mean age: 73.4±0.8 years; M/F: 42/59). In all patients, a comprehensive geriatric assessment was performed including cognitive and functional status. Admission criteria for the AD group (diagnosed according to the DSM-IV and the NINCDS-ADRDA criteria) included: mild to moderate cognitive impairment (MM…

VITAMIN D SUBSTRATE-PRODUCT RELATIONSHIP IN IDIOPATHIC HYPERCALCIURIA

Absorptive hypercalciuria (AH) is associated with elevated levels of 1,25-dihydroxyvitamin D (1,25(OH)(2)D). While no increase of 1,25(OH)(2)D after oral administration of 25-hydroxyvitamin D (25OHD) at high doses has been claimed in normal subjects, a substrate-product relationship has been reported in normal children, young people after UV irradiation, older persons, postmenopausal women, primary hyperparathyroidism, renal failure, osteomalacia, and sarcoidosis. No data of this relationship in AH is available. To investigate 25OHD-1,25(OH)(2)D substrate-product relationship in AH, 161 AH patients (mean age 60.9+/-11.7 years) and 110 age- and sex-matched controls (mean age 61.5+/-12.4 year…

LA SINDROME DA IMMOBILIZZAZIONE

MAGNESIUM METABOLISM IN HYPERTENSION AND TYPE 2 DIABETES MELLITUS

ORAL GLUCOSE TOLERANCE EFFECT ON INTRACELLULAR FREE MAGNESIUM IN NORMAL, DIABETIC AND HYPERTENSIVE SUBJECTS

Effect of COVID-19 quarantine on cognitive, functional and neuropsychiatric symptoms in patients with mild cognitive impairment and dementia.

Abstract Background During the last two years, COVID-19 affected older people with dementia or mild cognitive impairment (MCI), but conflicting and sparse results are still present. The objective of this study was to investigate the frequency and type of changes in functional, cognitive and behavioral and psychological symptoms of dementia (BPSD), and caregiver’s stress during the period of quarantine in 2020 in patients affected by dementia/MCI living in Palermo, Sicily. Methods Outpatients affected by MCI/dementia were evaluated before and after COVID-19 quarantine. Functional status was investigated using basic and instrumental activities of daily living (ADL); cognitive performance with…

Apolipoprotein profile in type II diabetic patients with and without coronary heart disease.

Diabetes mellitus is frequently associated with lipid metabolism abnormalities. In the present study the lipid and apolipoprotein profiles have been compared in type II diabetic subjects with (n = 30) and without (n = 30) coronary heart disease (CHD). All subjects were studied after good metabolic control had been achieved. Significant differences in plasma lipids and apolipoproteins were seen in diabetic patients with CHD in comparison with diabetics without CHD. Patients with CHD presented higher total cholesterol, triglyceride, LDL-cholesterol, apo B, apo CII and apo CIII levels and total cholesterol/HDL-cholesterol and LDL-cholesterol HDL-cholesterol ratios and lower HDL-cholesterol val…

Effects of vitamin e and glutathione on glucose metabolism: Role of magnesium

Abstract —Vitamin E is an antioxidant that has been demonstrated to improve insulin action. Glutathione, another natural antioxidant, may also be important in blood pressure and glucose homeostasis, consistent with the involvement of free radicals in both essential hypertension and diabetes mellitus. Our group has recently suggested that the effects of reduced glutathione on glucose metabolism may be mediated, at least in part, by intracellular magnesium levels (Mg [i] ). Recent evidence suggests that vitamin E enhances glutathione levels and may play a protective role in magnesium deficiency–induced cardiac lesions. To directly investigate the effects of vitamin E supplementation on insul…

L’IPERCALCIURIA IDIOPATICA

SENILE ANOREXIA IN ACUTE WARD AND REHABILITATION SETTINGS

MAGNESIO, DIABETES Y SINDROME METABOLICO

DEMENZA E DISTURBI DELL’ALIMENTAZIONE

Blood pressure and cardiac autonomic nervous system in obese type 2 diabetic patients: effect of metformin administration

Background: Hyperinsulinemia/insulin resistance and elevated plasma free fatty acids (FFA) levels are involved in the hypertension and cardiac sympathetic overactivity. Metformin improves insulin action and lower plasma FFA concentrations. We investigate the possible effect of metformin on arterial blood pressure (BP) and cardiac sympathetic nervous system. Methods: One hundred twenty overweight type 2 diabetic patients were treated by placebo (n = 60) + diet or metformin (850 mg twice daily) (n = 60) + diet for 4 months, to evaluate the effect of metformin treatment on the cardiac autonomic nervous system. Insulin resistance was measured by the Homeostasis Model Assessment (HOMA) index. He…

Altered cellular calcium responsiveness to insulin in normal and hypertensive pregnancy.

Objective To investigate the glucose-independent calcium-related effects of insulin from subjects with normal and hypertensive pregnancies. Method We used lndo-l fluorescence spectroscopy to measure cytosolic free calcium levels (Cai) in peripheral blood mononuclear cells (PBM) from 17 women (aged 20-40 years), six nonpregnant controls (NPC), five pregnant normotensive (PNT) women and six pregnant hypertensive (PHT) women, before and 5, 30, 60, 120 and 180 min after in vitro incubation with 200 microU/ml insulin. Results Basal Cai levels were significantly higher in PHT women (175.2 +/- 18.8 nmol/l) than they were in NPC women (122.8 +/- 2.8 nmol/l) and PNT women (123.9 +/- 3.5 nmol/l). The…

Diagnosing and Managing Thyroid Disease in the Nursing Home

Thyroid disorders occur at any age, but hypothyroidism is more common in older than in younger adults. In fact, the prevalence of thyroid disorders increases with age, and it is higher in old-old frail residents in nursing homes. Since thyroid diseases in older age, both overt reduced and increased function, may manifest as disorders of other organs, physicians need a high index of suspicion to detect thyroid dysfunction in an older person with multiple comorbidities and chronic polypharmacy. This is particularly true for residents of long-term facilities, where multiple chronic diseases may make it less attractive to direct attention to thyroid function. Subclinical hyperthyroidism and hyp…

Curcumin, inflammation, ageing and age-related diseases

Abstract A Symposium regarding the Pathophysiology of Successful and Unsuccessful Ageing was held in Palermo, Italy between April 7 and 8th 2009. Here the lecture by Sikora with some input from the chairpersons Scapagnini and Barbagallo is summarized. Ageing is manifested by the decreasing health status and increasing probability to acquire age-related disease such as cancer, Alzheimer's disease, atherosclerosis, metabolic disorders and others. They are likely caused by low grade inflammation driven by oxygen stress and manifested by the increased level of pro-inflammatory cytokines such as IL-1, IL-6 and TNF-α, encoded by genes activated by the transcription factor NF-κB. It is believed th…

Effect of obesity on left ventricular function studied by radionuclide angiocardiography

Several studies have shown a significant association of obesity with cardiovascular morbidity and mortality. The present study was carried out to investigate central and systemic haemodynamics in overweight and moderate obese, but otherwise healthy subjects, and in a lean control group to determine whether obesity can influence left ventricular performance per se. In this study an attempt has been made to eliminate misleading factors, such as diabetes, lipid abnormalities and hypertension. A total of 67 subjects, 44 with overweight or moderate obesity and 23 lean healthy subjects, were included. Patients were divided into three groups according to BMI levels and Garrow's criteria as follows…

Pattern of comorbidities and 1-year mortality in elderly patients with COPD hospitalized in internal medicine wards: data from the RePoSI Registry

Currently, chronic obstructive pulmonary disease (COPD) represents the fourth cause of death worldwide with significant economic burden. Comorbidities increase in number and severity with age and are identified as important determinants that influence the prognosis. In this observational study, we retrospectively analyzed data collected from the RePoSI register. We aimed to investigate comorbidities and outcomes in a cohort of hospitalized elderly patients with the clinical diagnosis of COPD. Socio-demographic, clinical characteristics and laboratory findings were considered. The association between variables and in-hospital, 3-month and 1-year follow-up were analyzed. Among 4696 in-patient…

Effetti collaterali della terapia farmacologica dell'ipertensione arteriosa nel soggetto anziano

Antiaging Medicine

• The factors best demonstrated to delay aging are fruit and vegetables, exercise, not smoking, drinking one or two glasses of alcohol daily, and fish consumption. • Vitamin D replacement, in persons with low 25[OH] vitamin D levels, decreases hip fractures, improves muscle strength, enhances function, and decreases mortality. • Antiaging medicine has been hijacked by charlatans who promote unproven or dangerous remedies to a naïve aging public. • Too often animal studies that produce longevity are directly applied to humans before appropriate clinical trials have been carried out. • There is no evidence that hormones or megadoses of vitamins prolong life. • Numerous products of varying qua…

OSTEOPOROSI E DIABETE MELLITO

Type 2 diabetes mellitus and Alzheimer’s disease

Epidemiological and biological evidences support a link between type 2 diabetes mellitus (DM2) and Alzheimer’s disease (AD). Persons with diabetes have a higher incidence of cognitive decline and an increased risk of developing all types of dementia. Cognitive deficits in persons with diabetes mainly affect the areas of psychomotor efficiency, attention, learning and memory, mental flexibility and speed, and executive function. The strong epidemiological association has suggested the existence of a physiopathological link. The determinants of the accelerated cognitive decline in DM2, however, are less clear. Increased cortical and subcortical atrophy have been evidenced after controlling fo…

ELEVATI LIVELLI DI OMOCISTEINA E RIDOTTA FORZA MUSCOLARE IN SOGGETTI ANZIANI

Measurement of the Pu-242(n,gamma) cross section from thermal to 500 keV at the Budapest research reactor and CERN n_TOF-EAR1 facilities

The design and operation of innovative nuclear systems requires a better knowledge of the capture and fission cross sections of the Pu isotopes. For the case of capture on 242Pu, a reduction of the uncertainty in the fast region down to 8-12% is required. Moreover, aiming at improving the evaluation of the fast energy range in terms of average parameters, the OECD NEA High Priority Request List (HPRL) requests high-resolution capture measurements with improved accuracy below 2 keV. The current uncertainties also affect the thermal point, where previous experiments deviate from each other by 20%. A fruitful collaboration betwen JGU Mainz and HZ Dresden-Rossendorf within the EC CHANDA project…

The place of frailty and vulnerability in the surgical risk assessment: should we move from complexity to simplicity?

Due to aging of the world population, older patients accessing health services are becoming continuously more frequent. This has increased the interest in assessing frailty and vulnerability in all specialties and general medicine. Although the term frailty has been recognized for over 30 years, there is not yet a universally recognized definition, and different care providers assess frailty and vulnerability with dissimilar tools, from very complex to very simple validated scales. Being treated with respect and dignity at the right time and place is the key message, as well as after undergoing a global evaluation both in urgency/emergency and in programmed surgery for all older surgical pa…

Chronic Non-cancer Pain Management in a Tertiary Pain Clinic Network: a Retrospective Study

Introduction: Chronic pain is a distressing condition that should be treated in specialized pain clinics. Pain clinics offer a holistic, evidence-based approach, including pharmacological, complementary, and invasive treatments. This study aimed to provide preliminary information regarding chronic pain treatments and identify reasons for accessing an important hub-spoke pain clinic network. Methods: A retrospective multicenter cross-sectional study was carried out. A total of 1606 patients’ records were included. Patients were selected from the 26 pain clinics of a single region in Italy. Univariate and multivariate logistic regression models were used. Results: Multivariate models showed t…

Acute parathyroid hormone increase by oral peptones administration after roux-en-Y gastric bypass surgery in obese subjects: Role of phosphate in the rapid control of parathyroid hormone release

It is generally considered that changes in serum phosphate levels do not alter parathyroid hormone (PTH) secretion in the absence of concomitant changes in ionized serum calcium level in humans. An acute rise in PTH was shown after phosphate administration by intraduodenal gavage in rats. We aimed to study gastrin, phosphate, PTH, ionized calcium (iCa), and blood pH responses to oral peptones in morbidly obese patients before and after roux-en-Y gastric bypass (RYGB) surgery.These parameters were evaluated in response to an oral peptone load in 24 (18 male and 6 female) obese subjects before and 6 months after RYGB surgery. In 12 gastric bypass patients, we also evaluated PTH and phosphate …

Magnesio e Invecchiamento

ALTERAZIONI DEL METABOLISMO DEL SODIO NELL’ANZIANO: CASISTICA DI UN REPARTO DI GERIATRIA PER ACUTI

Premessa. Le alterazioni della concentrazione plasmatica del sodio rappresentano gli squilibri elettrolitici più frequenti nei pazienti ospedalizzati e l’incidenza e la prevalenza aumentano con l’età. L’invecchiamento rappresenta un fattore di rischio indipendente e molto significativo per le alterazioni del bilancio del sodio e dell’acqua. Numerosi sono i fattori che cooperano nell’aumentare la suscettibilità dell’anziano a tali squilibri, dipendendo da modificazioni fisiologiche età correlate dei meccanismi che regolano il bilancio idro-salino dell’organismo, dalla progressiva riduzione delle capacità di compenso che caratterizza il fenomeno stesso dell’invecchiamento e dalle comorbilità,…

Dietary Strategies and Supplements for the Prevention of Cognitive Decline and Alzheimer’s Disease

Abstract Cognitive decline and dementia are increasing and will continue to do so in parallel with aging of the world population. Because effective pharmaceutical treatments for age-related cognitive decline are lacking, alternative strategies comprising dietary approaches have been proposed. Several dietary components and supplements have been studied regarding their association with cognitive decline. Dietary patterns combine foods and nutrients that may act synergistically and may provide stronger benefit than those conferred by individual dietary components. Higher adherence to the Mediterranean dietary pattern has been associated with decreased cognitive decline and incident Alzheimer’…

LONG-TERM CARE NELL’ITALIA CHE INVECCHIA

Calcium Metabolism in the Elderly

Mineral homeostasis represents one of the multiple areas at risk in the elder population. This includes the ion calcium, which is the most abundant inorganic element in the human body and an essential key for many physiologic processes (1).

IL SOSTEGNO AI CAREGIVER DI MALATI DI DEMENZA E/O ALZHEIMER: UNA RISORSA PER IL TRATTAMENTO EFFICACE. ESPEIENZA DI UN GRUPPO DI “AUTO-AIUTO”

Mediterranean diet and longevity

The world average life expectancy has increased remarkably in the past century and continues to increase relentlessly. A long life is desirable but best if lived in good physical and mental health. Among the various dietary patterns, a large body of research data suggest that the traditional dietary habits and lifestyle unique to the Mediterranean region are associated with lower incidence of chronic diseases and improve longevity. Starting with the first data from the Seven Countries Study, numerous observational, prospective, and trial-based investigations in different populations have thereafter supported the benefits of adhering to the Mediterranean dietary pattern regarding reduced mor…

Osteoporosis in men: a case report

Osteoporosis in men is frequently not considered, underdiagnosed and often undertreated. In contrast with osteoporosis occurring in women, the genesis is frequently secondary (30-60%) with a complex diagnostic approach. A careful anamnesis and physical examination associated with laboratory and instrumental evaluation are necessary for an accurate diagnosis. The clinical case presented concerns a 70-year-old man with negative family history for osteoporosis and a personal history of depression, HBV carrier, and chronic obstructive pulmonary disease (COPD) in a heavy ex-smoker with history of alcoholism. The comprehensive geriatric evaluation allowed us to diagnose a multifactorially seconda…

Predictors of clinical events occurring during hospital stay among elderly patients admitted to medical wards in Italy.

Abstract Background Clinical events occurring during hospital stay are independent predictors of prolonged hospitalization, in-hospital mortality and readmission among elderly patients admitted to medical wards. Purpose To identify predictors of intercurrent clinical events (ICE) during hospital stay among the main demographic, functional and clinical characteristics assessed at hospital admission in a multicenter sample of elderly inpatients in Italy. Methods This observational prospective cohort study was conducted in 66 internal and geriatric medicine hospital wards in 2010. It enrolled 1267 inpatients aged 65 years or older living at home before hospitalization. Multivariable Poisson re…

NECESSITÀ DI UNA PERIODICA ASSISTENZA GERIATRICA DOMICILIARE. DESCRIZIONE DI UN CASO CLINICO

Vitamin D Sources, Metabolism, and Deficiency: Available Compounds and Guidelines for Its Treatment

Studies on vitamin/hormone D deficiency have received a vast amount of attention in recent years, particularly concerning recommendations, guidelines, and treatments. Moreover, vitamin D’s role as a hormone has been confirmed in various enzymatic, metabolic, physiological, and pathophysiological processes related to many organs and systems in the human body. This growing interest is mostly due to the evidence that modest-to-severe vitamin D deficiency is widely prevalent around the world. There is broad agreement that optimal vitamin D status is necessary for bones, muscles, and one’s general health, as well as for the efficacy of antiresorptive and anabolic bone-forming treatments. Food su…

TREATMENT WITH DAILY SUBCUTANEOUS TERIPARATIDE (1-34) COMPARED WITH DAILY SUBCUTANEOUS PARATHYROID HORMONE (1-84) IN WOMEN WITH SEVERE POSTMENOPAUSAL OSTEOPOROSIS: A RANDOMIZED, HEAD-TO-HEAD STUDY

DEMENZE E RISCHIO DI FRATTURE OSTEOPOROTICHE NEGLI ANZIANI. STUDIO OSSERVAZIONALE IN UN’UNITA’ VALUTATIVA ALZHEIMER (n°6) DI PALERMO

Sarcopenia and fall-related injury among older adults in five low- and middle-income countries

Sarcopenia is a common condition in older people and increasing evidence suggests that it can be considered as a potential risk factor for falls and fractures. However, no studies on this topic from low- and middle-income countries (LMICs) are available. Thus, we assessed this association among older adults from five LMICs (China, India, Ghana, Mexico, and Russia). Community-based, nationally representative, cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. The presence of fall-related injury was ascertained t…

UN NUOVO INDICE PROGNOSTICO-TERAPEUTICO IN ONCOLOGIA GERIATRICA

FATTORI DI RISCHIO CARDIOVASCOLARI E METABOLICI NEI CENTENARI

TERIPARATIDE: DATI DI SICUREZZA

Magnesium and muscle performance in older persons: the InCHIANTI study1–3

BACKGROUND The role of magnesium in maintaining muscle integrity and function in older adults is largely unknown. OBJECTIVE We aimed to investigate the relation between serum magnesium concentrations and muscle performance in older subjects. DESIGN Data are from the baseline examination conducted between September 1998 and March 2000 of the InCHIANTI (aging in the Chianti area) study, a prospective epidemiologic survey of risk factors for late-life disability. From among 1453 randomly selected community residents completing a home interview, 1138 men (46%) and women (aged 66.7 +/- 15.2 y; x +/- SD) with complete data on muscle performance and serum magnesium who were not severely cognitivel…

DEPRESSIONE E DEMENZA: STUDIO NEUROPSICOLOGICO

Nuclear Data for the Thorium Fuel Cycle and the Transmutation of Nuclear Waste

Neutron-induced reaction cross sections play an important role in a wide variety of research fields, ranging from stellar nucleosynthesis, the investigation of nuclear level density studies, to applications of nuclear technology, including the transmutation of nuclear waste, accelerator-driven systems, and nuclear fuel cycle investigations. Simulations of nuclear technology applications largely rely on evaluated nuclear data libraries. These libraries are based both on experimental data and theoretical models. An outline of experimental nuclear data activities at CERN’s neutron time-of-flight facility, n_TOF, will be presented.

Anti-aging: Myth or reality

Aging of the world populations embodies a remarkable success of humankind and a source of challenge. Aging is a complex, continuous, multifactorial process that is accompanied by a progressive loss of physical and mental functions and the onset of various age-related diseases, which are not caused by aging per se. Currently, an increasing number of people are asking to arrive at advanced age in good health overcoming the modifications elicited by aging (the dream of remaining young forever). In the past decades there have been remarkable advances in the understanding of the aging process from results of biogerontological research in experimental models, that is, life extension through genet…

The 236U neutron capture cross-section measured at the n TOF CERN facility

International audience; The $^{236}$U isotope plays an important role in nuclear systems, both for future and currently operating ones. The actual knowledge of the capture reaction of this isotope is satisfactory in the thermal region, but it is considered insufficient for Fast Reactor and ADS applications. For this reason the $^{236} \text{U}(n, \gamma)$ reaction cross-section has been measured for the first time in the whole energy region from thermal energy up to 1 MeV at the n_TOF facility with two different detection systems: an array of C$_6$D$_6$ detectors, employing the total energy deposited method, and a 4$\pi$ total absorption calorimeter (TAC), made of 40 BaF$_2$ crystals. The t…

DIFFICOLTÀ DI DIAGNOSI DELLA DEPRESSIONE NELL’ANZIANO

OSTEOPOROSI MASCHILE. CASO CLINICO

Effect of testosterone on intracellular Ca++ in vascular smooth muscle cells.

ANZIANI E DEPRESSIONE. COME RICONOSCERLA TEMPESTIVAMENTE

High precision measurement of the radiative capture cross section of 238U at the n_TOF CERN facility

The importance of improving the accuracy on the capture cross-section of 238U has been addressed by the Nuclear Energy Agency, since its uncertainty significantly affects the uncertainties of key design parameters for both fast and thermal nuclear reactors. Within the 7th framework programme ANDES of the European Commission three different measurements have been carried out with the aim of providing the 238U(n,γ) cross-section with an accuracy which varies from 1 to 5%, depending on the energy range. Hereby the final results of the measurement performed at the n-TOF CERN facility in a wide energy range from 1 eV to 700 keV will be presented. © The Authors, published by EDP Sciences, 2017.

SINTOMI COGNITIVI E DEPRESSIVI IN SOGGETTI NON DEMENTI CON MALATTIA CEREBROVASCOLARE SOTTOCORTICALE

THERAPEUTIC OPTIONS IN OSTEOPOROSIS

Magnesium Role in Health and Longevity

Reduced Magnesium (Mg) intake is a frequent cause of Mg deficit with age. A decreased intestinal Mg absorption and an increased Mg loss may also contribute, as well as the use of medicaments. Furthermore, Mg requirements may be higher with aging. Alterations of Mg metabolism with age, cellular Mg transport systems and problems with measurement methods are discussed. Mg contained in water is more bio-available than Mg in food and it is a possible alternative to Mg supplementation in the correction of Mg deficiencies. Mild to moderate Mg deficits are generally asymptomatic and clinical signs are usually absent or non-specific. Hyperemotionality, tremor, asthenia, sleep disorders, and amnesic …

Effects of Glutathione on Red Blood Cell Intracellular Magnesium

Abstract —Recent evidence suggests that the endogenous antioxidant glutathione may play a protective role in cardiovascular disease. To directly investigate the role of glutathione in the regulation of glucose metabolism in hypertension, we studied the acute effects of in vivo infusions of this antioxidant (alone or in combination with insulin) on whole body glucose disposal (WBGD) using euglycemic glucose clamp and the effects on total red blood cell intracellular magnesium (RBC-Mg) in hypertensive (n=20) and normotensive (n=30) subjects. The relationships among WBGD, circulating reduced/oxidized glutathione (GSH/GSSG) levels, and RBC-Mg in both groups were evaluated. The in vitro effects…

Physiology of the aging bone and mechanisms of action of bisphosphonates.

Fragility fractures, a major public health concern, are expected to further increase due to aging of the world populations because age remains a cardinal, independent determinant of fracture risk. With aging the balance between bone formation and resorption during the remodeling process becomes negative, with increased resorption and reduced formation. Bisphosphonates (BPs) are widely prescribed anti-resorptive agents that inhibit osteoclasts attachment to bone matrix and enhance osteoclast apoptosis. BPs can be divided into nitrogen-containing (N-BPs) and non-nitrogen-containing BPs (non-N-BPs). Both classes induce apoptosis but they evoke it differently. Several studies have examined the …

DEPRESSIONE, AUTOPERCEZIONE DELLA SALUTE E STATO FUNZIONALE NEL PAZIENTE ANZIANO: EUROPEAN STUDY ON ADULT WELL-BEING (ESAW)

PARKINSON E DEMENZA : VALUTAZIONE COMPARATIVA TRA INDICI NEUROPSICOLOGICI E NEURORADIOLOGICI

Joint use of cardio-embolic and bleeding risk scores in elderly patients with atrial fibrillation.

ASSOCIAZIONE TRA LIVELLI DI MAGNESIO ED ORMONI ANABOLICI NEL SOGGETTO ANZIANO DI SESSO MASCHILE

Radiative neutron capture on Pu242 in the resonance region at the CERN n_TOF-EAR1 facility

The spent fuel of current nuclear reactors contains fissile plutonium isotopes that can be combined with uranium to make mixed oxide (MOX) fuel. In this way the Pu from spent fuel is used in a new reactor cycle, contributing to the long-term sustainability of nuclear energy. However, an extensive use of MOX fuels, in particular in fast reactors, requires more accurate capture and fission cross sections for some Pu isotopes. In the case of Pu242 there are sizable discrepancies among the existing capture cross-section measurements included in the evaluations (all from the 1970s) resulting in an uncertainty as high as 35% in the fast energy region. Moreover, postirradiation experiments evaluat…

Outcome predictors in SARS-CoV-2 disease (COVID-19): The prominent role of IL-6 levels and an IL-6 gene polymorphism in a western Sicilian population

The measurement programme at the neutron time-of-flight facility n_TOF at CERN

Neutron-induced reaction cross sections are important for a wide variety of research fields ranging from the study of nuclear level densities, nucleosynthesis to applications of nuclear technology like design, and criticality and safety assessment of existing and future nuclear reactors, radiation dosimetry, medical applications, nuclear waste transmutation, accelerator-driven systems and fuel cycle investigations. Simulations and calculations of nuclear technology applications largely rely on evaluated nuclear data libraries. The evaluations in these libraries are based both on experimental data and theoretical models. CERN’s neutron time-of-flight facility n TOF has produced a considerabl…

IL DISTURBO DA PANICO NEGLI ANZIANI

Magnesium Responsiveness to Insulin and Insulin-Like Growth Factor I in Erythrocytes from Normotensive and Hypertensive Subjects

Depletion of intracellular free magnesium (Mg(i)) is a characteristic feature of insulin resistance in essential hypertension, but it is not clear to what extent low Mg(i) levels contribute to insulin resistance, result from it, or both. As insulin-like growth factor I (IGF-I) may improve insulin resistance, we investigated whether this peptide could similarly improve Mg(i) responsiveness to insulin in hypertension, and whether this effect was related to any direct IGF-I effect on Mg(i). 31P-Nuclear magnetic resonance spectroscopy was used to measure Mg(i) in erythrocytes from 13 fasting normotensive and 10 essential hypertensive subjects before and 30, 60, and 120 min after incubation with…

Ageing and sexuality

Abstract Sexuality is a dimension that concerns human health with profound implications not only in the biological and psychological aspects, but also in the social and cultural dimensions, affecting all ages of life. Sexuality in old age is still conditioned by biases, prejudices and from a stereotyped vision, which considered older people as “asexual”, in spite of several studies and surveys showing that older persons have sexual potential to express. In population surveys, a fair number of men and women aged over 60 years reported having sex at least once a month. The most influential predictor of sexual activity seems to be the physical health in older men, and the quality of the relati…

FRATTURE OSTEOPOROTICHE IN PAZIENTI CON DEMENZA

Induction of vascular endothelial growth factor release by transcutaneous frequency modulated neural stimulation in diabetic polyneuropathy

Background: Pharmacological treatment for diabetic polyneuropathy (DP) has shown limited benefit; frequency-modulated electrical stimulation (FREMS) has shown positive results in pain control and nerve conduction velocity in DP. Objective: To investigate the effects of FREMS vs transcutaneous electrical nerve stimulation (TENS) on the release of vascular endothelial growth factor (VEGF) in Type 2 diabetic and in non-diabetic subjects. Methods: 10 non-diabetic [mean age 37±5 yr; females (F)/males (M): 6/4] and 10 Type 2 diabetic subjects (mean age 52±6 yr; F/M: 5/5) with DP underwent TENS (for 10 min) followed by 30 min interval without electrical stimulation, and then FREMS (for 10 min) ove…

Terapia con ipoglicemizzanti orali secretagoghi in pazienti anziani diabetici ricoverati in acuto

FRAGILITY FRACTURES IN OLDER PERSONS WITH ALTERED THYROID FUNCTION

Gli ormoni tiroidei sono peptidi che svolgono molteplici e complesse funzioni nell’organismo umano. Lo sche-letro è uno dei tessuti bersaglio degli ormoni tiroidei, ed una loro carenza o un loro eccesso ha importanti conseguenze sul tessuto osseo soprattutto nel periodo dello sviluppo e durante l’invecchiamento. I disturbi a carico della tiroide si osservano con maggior frequenza nei soggetti in età avanzata rispetto ai giovani. La tire-otossicosi è una causa nota di osteoporosi secondaria. L’ipertiroidismo conclamato e l’ipertiroidismo iatrogeno dovuto ad un eccesso nel dosaggio della terapia sostitutiva con ormoni tiroidei sono possibili cause di fratture ossee da fragilità. L’ipertiroidi…

IPOTENSIONE ORTOSTATICA NELL’ANZIANO: PREVALENZA IN UNA NOSTRA CASISTICA DI PAZIENTI RICOVERATI IN REGIME DI DAY HOSPITAL

Effect of Magnesium Supplementation on Inflammatory Parameters: A Meta-Analysis of Randomized Controlled Trials

Magnesium (Mg) may have several beneficial effects on human health outcomes. One hypothesized mechanism eliciting such effects is the action of Mg on serum inflammatory parameters. However, studies on this topic to date have several important limitations. Therefore, the present systematic review and meta-analysis aimed to summarize the current state of the art of all randomized control trials (RCTs) investigating the effects of Mg supplementation versus placebo on serum parameters of inflammation. We searched several databases until 23rd November 2021 for RCTs. Eligible studies were RCTs investigating the effect of oral Mg supplementation vs. placebo and having serum inflammatory markers as…

Determinants of adherence to osteoporosis treatment in clinical practice.

Introduction: Poor adherence to prescribed treatments is widespread in clinical practice and this can lead to potentially life-threatening events. This problem is apparently very common for osteoporosis treatment but the causes of discontinuation and low compliance are complex and poorly defined. Methods: Global adherence to osteoporosis treatment was specifically addressed in a nation-wide survey carried out in 9851 postmenopausal women referred to 141 Italian centres for osteoporosis management for a follow-up assessment, at least one year after having been prescribed a treatment with one of the following drugs: calcium±vitamin D supplements alone (CaVitD), hormone replacement therapy (HR…

Prevalenza dell’anoressia nel paziente anziano in ospedale.

DIAGNOSING AND MANAGING THYROID DISEASE IN THE NURSING HOME

Anorexia and Eating Patterns in the Elderly

Objectives To evaluate the change in eating habits occurring in community- dwelling and institutionalized elderly subjects with senile anorexia. Design Cross- sectional, observational. Setting Community, nursing homes and rehabilitation or acute care facilities in four Italian regions. Participants A random sample of 526 subjects, aged 65 years and older (217 free living individuals, 213 residents in nursing homes, and 93 patients in rehabilitation and acute wards). Measurements All subjects underwent a multidimensional geriatric evaluation of: nutritional status, anthropometric parameters, health and cognitive status, depression, taste, chewing and swallowing function, and some hormones re…

Cellular ionic alterations with age: relation to hypertension and diabetes.

BACKGROUND: Cytosolic free calcium (Cai) and magnesium (Mgi) are vital to cellular homeostasis and function. OBJECTIVE: To evaluate cellular divalent cations in normal subjects at different ages and their relationship to ion levels in essential hypertension and diabetes. DESIGN: A cross-sectional study. SETTING: A university hospital in New York. PARTICIPANTS: A total of 103 subjects (32 older, 71.1 ± 1.2 y/o, and 71 young/middle aged subjects, 51.1 ± 2.3 y/o). INTERVENTION: Oral glucose tolerance test. MEASUREMENTS: 19F and 31P NMR spectroscopy were used to measure Cai and Mgi levels in erythrocytes from normal (>65 y/o, n = 11; 65 y/o, n = 9; 65 y/o, n = 12; <65 y/o, n = 15) subjects; the…

ANEMIA NELL’ANZIANO: PREVALENZA IN UNA POPOLAZIONE DI SOGGETTI GERIATRICI OSPEDALIZZATI

Prescription of Antithrombotic Therapy in Older Patients Hospitalized for Transient Ischemic Attack and Ischemic Stroke: The GIFA Study

Background and Purpose— Antithrombotic therapy has been demonstrated as an effective tool for secondary ischemic stroke prevention. Nevertheless, scant data are available on actual prescription of this therapy in clinical practice. Methods— A total of 17 337 patients admitted to geriatric and internal medicine wards participating in the study in the 1993 to 1998 survey period were analyzed. Patients with coded diagnoses of ischemic stroke and transient ischemic attack (TIA) were selected. Data recorded included demographic and clinical characteristics and medication prescription during hospital stay and at discharge. Logistic regression analyses were used to identify conditions associated …

Hypertension, diabetes mellitus, and insulin resistance: the role of intracellular magnesium.

Magnesium is one of the most abundant ions present in living cells and its plasma concentration is remarkably constant in healthy subjects. Plasma and intracellular magnesium concentrations are tightly regulated by several factors. Among them, insulin seems to be one of the most important. In fact, in vitro and in vivo studies have demonstrated that insulin may modulate the shift of magnesium from extracellular to intracellular space. Intracellular magnesium concentration has also been shown to be effective on modulating insulin action (mainly oxidative glucose metabolism), offset calcium-related excitation-contraction coupling, and decrease smooth cell responsiveness to depolarizing stimul…

AGING IN EUROPE AND GERIATRIC CARE

Europeans are living longer than ever, and this pattern is expected to continue. The increased life expectancy is a remarkable achievement, which however poses obvious challenges for health care and geriatric assistance. There is a progressive increase of older persons living alone and in need of assistance. European countries are handling these challenges with very different approaches. There are countries and regional differences in social policies and sanitary assistance, in providers of care, in quality of the assistance and in lodging costs. The long term care models are also very different (cash benefits, public provision of care services, or hybrid rather than pure models of care). T…

L’ASSISTENZA SANITARIA ALLA POPOLAZIONE ANZIANA IN ITALIA: IL PROGETTO U.L.I.S.S.E. (UN LINK INFORMATICO SUI SERVIZI SANITARI ESISTENTI PER L’ANZIANO)

COMMENTARY TO THE LETTER TO THE EDITOR

mrh.2011.0274 Auteur(s) : Mario Barbagallo mabar@unipa.it, Ligia J Dominguez Geriatric Unit, Dept. of Internal Medicine and Emergent Pathologies, University of Palermo, Italy Correspondence: M. Barbagallo Dear Editor, We thank Dr Kisters for his comments; we agree with the potentiality of magnesium supplementation in the management of hypertension. However, although our data show the effectiveness of magnesium supplementation to improve endothelial vascular function [1], we would be more [...]

Suicide risk in caregivers of people with dementia: a systematic review and meta-analysis.

Abstract Background Interest in physical and mental health outcomes in caregivers of patients with dementia is increasing. However, there is limited data available on the prevalence of suicidal ideation, suicidal attempts, and suicide rates among caregivers of those with dementia. Therefore, we aimed to systematically review these outcomes to address this gap in the literature and thus provide information to inform future policy and intervention for the benefit of caregivers of dementia patients. Methods We searched several databases from inception to the 10th November 2021, for studies investigating suicidal ideation, suicidal attempts, and suicide rates of caregivers of patients with deme…

POLIMIALGIA REUMATICA

IDROCEFALO CRONICO NELL’ANZIANO: CASO CLINICO

Combination of intensive cognitive rehabilitation and donepezil therapy in Alzheimer’s disease.

Health care for older people in Italy: The U.L.I.S.S.E. Project (Un link informatico sui servizi sanitari esistenti per l'anziano - a computerized network on health care services for older people).

OBJECTIVES: The U.L.I.S.S.E. study is aimed at describing older patients who are cared for in hospitals, home care or nursing homes in Italy. DESIGN: The U.L.I.S.S.E. study is an observational multicenter prospective 1-year study. SETTING: Overall, 23 acute geriatric or internal medicine hospital units, 11 home care services and 31 nursing homes participated in the study. MEASUREMENTS: The patient's evaluation was performed using comprehensive geriatric assessment instruments, i.e. the interRAI Minimum Data Set, while data on service characteristics were recorded using ad-hoc designed questionnaires. RESULTS: The older subjects who are in need of acute and long term care in Italy have simil…

IPOTIROIDISMO POST AMIODARONE, DETERIORAMENTO COGNITIVO E FIBRILLAZIONE ATRIALE

CORRELAZIONI TRA RISCHIO DI CADUTE E UTILIZZO DI NEUROLETTICI IN PAZIENTI ISTITUZIONALIZZANTI

ONE HUNDRED YEARS OF… HEALTH! MEDITERRANEAN DIET AND LONGEVITY: ROLE OF OLIVE OIL.

Consensus Document on substitution therapy with DHEA in the elderly

Dietary Patterns and Cognitive Decline: key features for prevention

The decline in cognitive function is generally the result of the complex interaction of several factors. First of all, age, but also demographic, educational, genetic, socio-economic, and environmental determinants, including nutrition. Cognitive decline and dementia prevalence are increasing, and they are projected to continue increasing in the next decades due to the aging of the world population. Currently, there are no effective pharmacological treatments for these devastating and disabling conditions, which emphasize the key role of preventive strategies. There is compelling evidence of the role of diet and lifestyle on cognitive function. Therefore, dietary/ nutritional approaches th…

INVECCHIAMENTO DELLA POPOLAZIONE E DINAMICHE MIGRATORIE: UNA VALUTAZIONE EPIDEMIOLOGICA, SOCIO-CULTURALE E FUNZIONALE IN PAZIENTI ANZIANI MIGRANTI

Combination of intensive cognitive rehabilitation and donepezil therapy in Alzheimer's disease (AD).

Acetylcholinesterase inhibitors (AchEIs) are extensively used in Alzheimer's disease (AD) while reality orientation therapy (ROT) is a cognitive rehabilitation indicated for mentally deteriorated patients. We aimed to evaluate the efficacy of the combination of donepezil with an intensive ROT with active participation of the caregiver. Patients with AD (n=100, mean age 78.4±4.3 years) initiated treatment with donepezil, 5mg/day; 62 of them underwent a 3-week, daily ROT and physical reactivation training with the caregiver (Group A); 38 participants received only donepezil therapy (Group B). All subjects were tested for cognitive and functional abilities at baseline, at the end of the traini…

OSTEOPOROSI NELL’ANZIANO: UPDATE SULLE TERAPIE FARMACOLOGICHE E NON FARMACOLOGICHE

MAGNESIUM METABOLISM IN INSULIN RESISTANCE, METABOLIC SYNDROME, AND TYPE 2 DIABETES MELLITUS

Magnesium plays a key role in regulating insulin action, insulin-mediated glucose uptake, and vascular tone. Intracellular magnesium depletion may result in a defective tyrosine—kinase activity at the insulin receptor level, in a postreceptorial impairment in insulin action, and clinically in a worsening of insulin resistance. Intra- and extracellular alterations of magnesium metabolism have been identified in clinical states characterized by insulin resistance, such as metabolic syndrome, hypertension, altered glucose tolerance, type 2 diabetes, and aging. Several studies, from our and other’s groups, have confi rmed the clinical relevance of alterations of magnesium homeostasis in these c…

Prevalence of older in-patients at risk of clopidogrel resistance according to the STIB score. Results from REPOSI registry

The phenomenon of resistance to copidogrel catches the attention of a growing number of clinicians because of its frequency and the severity of adverse events related to it. The identification of patients with high platelet reactivity (HPR may help to improve their therapy applying the concept of personalized medicine, most important in the older people treated with polypharmacy. The existece of such a simple clinical method as the STIB score, that allows to predict the possible resistace to clopidogrel at the bedside without using expensive laboratory investigations, provides an attractive approach to the problem.

Adherence to antithrombotic therapy guidelines improves mortality among elderly patients with atrial fibrillation: insights from the REPOSI study

Background: Atrial fibrillation (AF) is associated with a substantial risk of thromboembolism and mortality, significantly reduced by oral anticoagulation. Adherence to guidelines may lower the risks for both all cause and cardiovascular (CV) deaths. Methods: Our objective was to evaluate if antithrombotic prophylaxis according to the 2012 European Society of Cardiology (ESC) guidelines is associated to a lower rate of adverse outcomes. Data were obtained from REPOSI; a prospective observational study enrolling inpatients aged ≥65 years. Patients enrolled in 2012 and 2014 discharged with an AF diagnosis were analysed. Results: Among 2535 patients, 558 (22.0 %) were discharged with a diagnos…

HEALTHY LONGEVITY THANKS TO THE MEDITERRANEAN DIET

HOSPICE E TERMINALITÀ IN PAZIENTI CON DEMENZA

MAGNESIUM METABOLISM IN INSULIN RESISTANCE, CARDIOMETABOLIC SYNDROME AND TYPE 2 DIABETES

Polypharmacy in older people: lessons from 10 years of experience with the REPOSI register

As a consequence of population aging, we have witnessed in internal medicine hospital wards a progressive shift from a population of in-patients relatively young and mainly affected by a single ailment to one of ever older and more and more complex patients with multiple chronic diseases, followed as out-patients by many different specialists with poor integration and inevitably treated with multiple medications. Polypharmacy (defined as the chronic intake of five or more drugs) is associated with increased risks of drug-drug interactions and related adverse effects, prescription and intake errors, poor compliance, re-hospitalization and mortality. With this background, the Italian Society …

Characterization and First Test of an i-TED Prototype at CERN n_TOF

International audience; Neutron capture cross section measurements are of fundamental importance for the study of the slow process of neutron capture, so called s-process. This mechanism is responsible for the formation of most elements heavier than iron in the Universe. To this aim, installations and detectors have been developed, as total energy radiation C$_{6}$ D$_{6}$ detectors. However, these detectors can not distinguish between true capture gamma rays from the sample under study and neutron induced gamma rays produced in the surroundings of the setup. To improve this situation, we propose (Domingo Pardo in Nucl Instr Meth Phys Res A 825:78–86, 2016, [1]) the use of the Compton princ…

Cardiovascular risk factors in centenarians"

Several studies have shown that centenarians have better cardiovascular risk profiles compared to younger old people. Some reports have revealed that cardiovascular diseases (i.e. hypertension, diabetes, angina and/or myocardial infarction) are less common in centenarians respect to 70 and 80 years old persons. In order to explain this evidence, there is a growing number of hypothesis that consider a combination of genetic factors and lifestyle aspects to elucidate the exceptional longevity of centenarians, able to overcome the most frequent mortality cause, which is a cardiovascular event. It has been suggested that a role on this better cardiovascular risk profile may be played by the inc…

TUMORE GASTROINTESTINALE STROMALE INDIFFERENZIATO (GIST) E PREGRESSA BILLROTH II IN UN PAZIENTE ANZIANO: SOLO CASUALITÀ?

Magnesium and anabolic hormones in older men

Optimal nutritional and hormonal statuses are determinants of successful ageing. The age associated decline in anabolic hormones such as testosterone and insulin-like growth factor 1 (IGF-1) is a strong predictor of metabolic syndrome, diabetes and mortality in older men. Studies have shown that magnesium intake affects the secretion of total IGF-1 and increase testosterone bioactivity. This observation suggests that magnesium can be a modulator of the anabolic/catabolic equilibrium disrupted in the elderly people. However, the relationship between magnesium and anabolic hormones in men has not been investigated. We evaluated 399 ≥65-year-old men of CHIANTI in a study population representat…

Should we use gait speed in COPD, FEV 1 in frailty and dyspnoea in both?

Frailty is a progressive physiological decline in multiple organ systems marked by loss of function, loss of physiological reserve and increased vulnerability to disease [1]. Biological (inflammation and loss of hormones), clinical ( e.g. sarcopenia and osteoporosis) and social factors are involved in frailty onset, evolution and prognosis [2, 3]. Links between frailty, dyspnoea and chronic respiratory diseases represent a novel and practical approach

TERAPIE DI RIABILITAZIONE COGNITIVA NEL COMPLESSO PARKINSON-DEMENZA NELL’ANZIANO. Caso clinico

Insulin-Mimetic Action of Vanadate

Abstract — — The insulin-mimetic effect of vanadate is well established, and vanadate has been shown to improve insulin sensitivity in diabetic rats and humans. Although the exact mechanism(s) remain undefined, we have previously demonstrated a direct relation of intracellular free magnesium (Mg i ) levels to glucose disposal, to insulinemic responses following glucose loading, and to insulin-induced ionic effects. To investigate whether the insulin-mimetic effects of vanadate could similarly be mediated by Mg i , we utilized 31 P-nuclear magnetic resonance spectroscopy to measure Mg i in erythrocytes from normal (NL, n=10) and hypertensive (HTN, n=12) subjects, before and after incubation…

THYROID DISORDERS

Multimorbidity increases the risk for sarcopenia onset: Longitudinal analyses from the English Longitudinal Study of Ageing.

Background-\ud \ud Cross-sectional studies have demonstrated that multimorbidity is associated with sarcopenia. However, to date, this association has not been extensively investigated longitudinally. Therefore, the aim of the present paper was to explore the association between multimorbidity at baseline and sarcopenia onset over 12 years of follow-up in a large representative sample of the English older adult population.\ud \ud Methods-\ud \ud Representative data from the English Longitudinal Study of Ageing (ELSA) were analyzed. Multimorbidity at baseline was defined as ≥2 medical conditions, of 17 conditions included. Participants were considered to have sarcopenia if they had low handg…

DELIRIUM DURANTE LA DEGENZA OSPEDALIERA IN UN REPARTO GERIATRICO

Happy Aged People Are All Alike, While Every Unhappy Aged Person Is Unhappy in Its Own Way

Aging of the world’s population represents one of the most remarkable success stories of medicine and of humankind, but it is also a source of various challenges. The aim of the collaborative cross-cultural European study of adult well being (ESAW) is to frame the concept of aging successfully within a causal model that embraces physical health and functional status, cognitive efficacy, material security, social support resources, and life activity. Within the framework of this project, we show here that the degree of heterogeneity among people who view aging in a positive light is significantly lower than the degree of heterogeneity of those who hold a negative perception of aging. We base…

Anti-aging medicine: pitfalls and hopes

Since the beginnings of time humans have searched for a fountain of youth. This has led to many extravagant claims which have been highly profitable for their proponents. This area has become known as anti-aging medicine and has deservedly been frowned upon by the medical establishment. On the other hand, in the last decades dramatic advances in our understanding of the aging process have come from studies in worms, flies and mice. This article reviews some of these advances and places the extravagant claims of anti-aging medicine in perspective. We conclude that a balanced diet of moderate proportions and exercise remain today the only proven fountain of youth. © 2009 Informa UK Ltd.

Measurement of the 241Am neutron capture cross section at the n-TOF facility at CERN

New neutron cross section measurements of minor actinides have been performed recently in order to reduce the uncertainties in the evaluated data, which is important for the design of advanced nuclear reactors and, in particular, for determining their performance in the transmutation of nuclear waste. We have measured the 241 Am(n,γ) cross section at the n TOF facility between 0.2 eV and 10 keV with a BaF2 Total Absorption Calorimeter, and the analysis of the measurement has been recently concluded. Our results are in reasonable agreement below 20 eV with the ones published by C. Lampoudis et al. in 2013, who reported a 22% larger capture cross section up to 110 eV compared to experimental …

LE IPERNATRIEMIE NELL’ANZIANO

L’pernatremia è caratterizzata da un deficit di acqua corporea totale rispetto al sodio ed è definita da una concentrazione plasmatica superiore a 145 mmol/L. L’ipersodiemia nella popolazione geriatrica è un disturbo comune, associato ad una significativa morbilità e mortalità. Le persone anziane sono predisposte a sviluppare ipernatriemia a causa di modificazioni fisiologiche legate all'età: ad esempio la diminuzione della sete, una ridotta capacità di concentrazione delle urine e la diminuzione del contenuto di acqua corporea totale. I farmaci possono aumentare questa predisposizione. Nelle case di cura e di riposo, l’ipernatremia e la disidratazione sono considerate prevenibili, per cui …

Lower limb muscle strength and muscle mass are associated with incident symptomatic knee osteoarthritis: a Longitudinal Cohort Study

Recent literature suggests that sarcopenia, often represented by low lower limbs muscle mass and strength, can be considered a potential risk factor for knee osteoarthritis (OA), but the available literature is still limited. We therefore aimed to investigate whether sarcopenia is associated with a higher risk of radiographic (ROA) and symptomatic knee OA (SxOA) in a large cohort of North American people in the context of the OA initiative. Sarcopenia at baseline was diagnosed in case of low skeletal muscle mass (i.e., lower skeletal mass index) and poor performance in the chair stands test. The outcomes of interest for this study included ROA (radiographical osteoarthritis) if a knee devel…

MIGRATION, CARDIOVASCULAR RISK AND BLOOD PRESSURE MODIFICATIONS

Anemia as a risk factor for disease progression in patients admitted for COVID-19: data from a large, multicenter cohort study

: In respiratory infections, anemia is both a consequence of acute inflammation and a predictor of poor clinical outcomes. There are few studies investigating the role of anemia in COVID-19, suggesting a potential role in predicting disease severity. In this study, we aimed to assess the association between the presence of anemia at admission and incidence of severe disease and death in patients hospitalized for COVID-19. Data from all adult patients admitted for COVID-19 in University Hospital "P. Giaccone" Palermo, and University Hospital of Bari, Italy, were retrospectively collected from 1st of September 2020 to 31 August 2022. The association between anemia (defined as Hb &lt; 13 g/dl …

Le lesioni da decubito: fra sofferenze individuali e costi sociali

Le ulcere/lesioni da pressione hanno una genesi multifattoriale e possono essere causa di svariate complicanze. Un aspetto troppo spesso dimenticato è il loro costo per il Sistema Sanitario Nazionale (SSN). I casi di due pazienti ricoverate presso il reparto di Geriatria e Lungodegenza dell’Azienda Ospedaliera Universitaria “Paolo Giaccone” di Palermo sono in proposito emblematici

Nuclear data activities at the n_TOF facility at CERN

International audience; Nuclear data in general, and neutron-induced reaction cross sections in particular, are important for a wide variety of research fields. They play a key role in the safety and criticality assessment of nuclear technology, not only for existing power reactors but also for radiation dosimetry, medical applications, the transmutation of nuclear waste, accelerator-driven systems, fuel cycle investigations and future reactor systems as in Generation IV. Applications of nuclear data are also related to research fields as the study of nuclear level densities and stellar nucleosynthesis. Simulations and calculations of nuclear technology applications largely rely on evaluate…

LA DEPRESSIONE NELL’ANZIANO. NOSTRO STUDIO SU 100 SOGGETTI

Cien años de... ¡salud, dieta mediterránea y longevidad: el papel del aceite de olivas

Magnesium and aging.

Over the past decades, the clinical relevance and biological significance of magnesium (Mg) have been documented. Deficiency in Mg, aside from having a negative impact on the energy production pathway required by mitochondria to generate ATP, also reduces the threshold antioxidant capacity of the aging organism and its resistance to free-radical damage. Mg also acts as an antioxidant against free radical damage of the mitochondria. Chronic inflammation and oxidative stress have both been identified as pathogenic factors in aging and in several age-related diseases. Chronic Mg deficiency results in excessive production of oxygen-derived free radicals and low grade inflammation. Aging is very…

Magnesium and type 2 diabetes.

Type 2 diabetes is frequently associated with both extracellular and intracellular magnesium (Mg) deficits. A chronic latent Mg deficit or an overt clinical hypomagnesemia is common in patients with type 2 diabetes, especially in those with poorly controlled glycemic profiles. Insulin and glucose are important regulators of Mg metabolism. Intracellular Mg plays a key role in regulating insulin action, insulin-mediated-glucose-uptake and vascular tone. Reduced intracellular Mg concentrations result in a defective tyrosine-kinase activity, postreceptorial impairment in insulin action and worsening of insulin resistance in diabetic patients. A low Mg intake and an increased Mg urinary loss app…

Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second c…

Prevalence of use and appropriateness of antidepressants prescription in acutely hospitalized elderly patients.

Depression is often under-recognized in older patients, even if antidepressants (AD) are commonly prescribed, with a prevalence of use that increase with ageing [ 1 ]. Nevertheless, even if a diagnosis of depression is established, inappropriate treatment can occur [ 2 ]. Beers criteria are the most widely screening tools used to detect inappropriate prescription of drugs in people aged 65 years or more [ 3 ]. Since 2010, attempts to adapt the Beers' criteria have been made in Europe [ 4 , 5 ]. Tricyclic drugs are the ADs to be always avoided in the elderly, owing to their anticholinergic side effects, such as cognitive impairment, delirium, urinary retention and falls [ 3 ]. Selective sero…

RELAZIONE TRA M. DI PARKINSON E DEMENZA DI ALZHEIMER. CASO CLINICO

MALATTIA OSSEA DI PAGET

DISTURBI D’ANSIA NELL’ANZIANO

IL DOLORE NELLA DEMENZA. STUDIO SU 100 PAZIENTI

DELIRIUM, ANZIANI E OSPEDALE

L'azitromicina nella gastroparesi diabetica in una donna anziana ospedalizzata

THE IMPORTANCE OF TIGHT BLOOD PRESSURE CONTROL IN DIABETIC HYPERTENSIVE PATIENTS

VITAMIN D REPLETION AND TREATMENT RESPONSE TO ANTIRESORPTIVE AGENTS IN POSTMENOPAUSAL OSTEOPOROSIS

Rate of hospitalizations and mortality of Respiratory Syncytial Virus infection compared to influenza in older people: a systematic review and meta-analysis

Respiratory Syncytial Virus (RSV) is commonly regarded as an infection typical of children, but increasing literature is showing its importance in older people. Since the data regarding the impact of RSV are still limited for older people, the aim of this systematic review and meta-analysis is to compare the rate of hospitalization and mortality between RSV and influenza in this population. A systematic literature search until 15 June 2022 was done across several databases and including studies reporting incidence rate and cumulative incidence of hospitalization and mortality in RSV and influenza affecting older people. Among 2295 records initially screened, 16 studies including 762,084 old…

The relevance of magnesium homeostasis in COVID-19

Abstract Purpose In less than one and a half year, the COVID-19 pandemic has nearly brought to a collapse our health care and economic systems. The scientific research community has concentrated all possible efforts to understand the pathogenesis of this complex disease, and several groups have recently emphasized recommendations for nutritional support in COVID-19 patients. In this scoping review, we aim at encouraging a deeper appreciation of magnesium in clinical nutrition, in view of the vital role of magnesium and the numerous links between the pathophysiology of SARS-CoV-2 infection and magnesium-dependent functions. Methods By searching PubMed and Google Scholar from 1990 to date, we…

IL RANK LIGANDO QUALE TARGET TERAPEUTICO NEL TRATTAMENTO DELLE PAZIENTI ANZIANE CON OSTEOPOROSI

Cortical and trabecular bone undergo a continuous and balanced remodeling process, which consists of a phase of resorption, mediated by osteoclasts, and a phase of neoformation mediated by osteoblasts. The activity of both, osteoblasts and osteoclasts, is regulated by the osteocytes, which are the most abundant cells in bone tissue. An imbalance of this process with an excessive resorption activity causes a loss of bone mass and microarchitectural deterioration of the skeleton, with consequent reduction of bone strength and increased risk of fractures. The ligand for the “Receptor Activator of Nuclear Factor Kappa- B” (RANK-L), a protein expressed by osteoblasts, plays a fundamental role in…

OSTEOPOROSI MASCHILE: UN CASO DI PARAPARESI CONSEGUENTE A MIELOPATIA DORSALE DA FRATTURA VERTEBRALE SEVERA

M.P.S. e M.C.I. segni e sintomi

Increased prevalence of cardiac arrhythmias and transient episodes of myocardial ischemia in hypertensives with left ventricular hypertrophy but without clinical history of coronary heart disease.

To evaluate the behavior of cardiac arrhythmias (CA) and transient episodes of myocardial ischemia (TEMI), in relation to the circadian pattern of blood pressure in patients suffering from arterial hypertension, with or without echocardiographically ascertained left ventricular hypertrophy (LVH), we studied 128 patients, 87 men (M) and 41 women (F), aging from 21 to 76 years, subdivided into two groups: Group I, including 66 patients with LVH (45 M and 21 F; mean age of 53.7 ± 9.1 years; Group II, including 62 patients without LVH ( 42 M and 20 F; mean age of 49.7 ± 9.5 years). Office blood pressure (OBP) as well as nighttime ambulatory blood pressure (ABP) were higher in patients with LVH …

Bisphosphonates and atherosclerosis: why?

The increasing knowledge on bone calcification processes has revealed some similarities with vascular tissue, where calcifications of arteries and cardiac valves contribute to several cardiovascular problems, such as heart failure, systolic hypertension, and myocardial and peripheral ischemic disease. Bisphosphonates have been used extensively for over two decades for the treatment of diseases associated with excessive bone resorption, i.e., osteoporosis, osteolytic bone metastasis, hypercalcemia and Paget’s disease, by blocking osteoclastic function. Etidronate, pamidronate and clodronate has been shown to inhibit the development of experimental atherosclerosis, and proposed mechanisms fo…

Serum ionized magnesium in diabetic older persons

Objective. Several alterations of magnesium metabolism have been associated with type 2 diabetes pathophysiology, a condition particularly frequent in older persons. We aimed to evaluate serum total (Mg-tot) and serum ionized magnesium (Mg-ion) in older persons with type 2 diabetes in order to explore clinically applicable methods for the detection of magnesium deficit. Material/Methods: Mg-tot and Mg-ion were measured in 105 fasting subjects with type 2 diabetes (mean age: 71.10.8 years; M/F: 45/60) and in 100 age-matched non-diabetic control persons (mean age: 72.20.8 years; M/F: 42/58). Results: Mg-ion concentrations were significantly lower in diabetic persons compared with controls (…

A Research Agenda: The Changing Relationship Between Body Weight and Health in Aging

It is increasingly recognized that changes in weight and body composition with age are strongly connected with health status and physical function. Aging is typically associated with reductions in total and lean mass, so that in the last few years of life, older people frequently report having lost weight and strength (1–3). We know only a few important facts about this process. On average, muscle mass declines with age, and even in older persons with stable weight, muscle is replaced by fat over time (4,5). Increasing fatty infiltration of muscle tissue is associated with decreasing muscle strength (6). The general pattern of weight change over the lifetime is that weight increases through…

Safety of rofecoxib in subjects with a history of adverse cutaneous reactions to aspirin and/or non-steroidal anti-inflammatory drugs

Background Adverse reactions to non-steroidal anti-inflammatory drugs (NSAID)s are frequent, and the need to identify a safe alternative drug is a common problem in clinical practice. Objective To assess the tolerability of rofecoxib, a drug that specifically inhibits COX-2, in a group of NSAID-sensitive patients. Methods One-hundred and four subjects (29 males and 75 females, mean age 35.6 ± 14.1) were enrolled. All subjects had experienced one or more episode characterized by cutaneous symptoms (erythema, and/or urticaria angioedema) following the assumption of NSAIDs; 92 subjects experienced reactions to only one NSAID (single intolerance: SI) and 12 subjects had reactions to multiple NS…

CORRELAZIONE TRA LLC-B E INFEZIONE DA HCV NELL’ANZIANO.

Can the Multidimensional Prognostic Index Improve the Identification of Older Hospitalized Patients with COVID-19 Likely to Benefit from Mechanical Ventilation? An Observational, Prospective, Multicenter Study

Objective: Data on prognostic tools for indicating mechanical ventilation in older people with COVID-19 are still limited. The aim of this research was to evaluate if the Multidimensional Prognostic Index (MPI), based on the Comprehensive Geriatric Assessment (CGA), may help physicians in identifying older hospitalized patients affected by COVID-19 who might benefit from mechanical ventilation.Design: Longitudinal, multicenter study.Settings and Participants: 502 older people hospitalized for COVID-19 in 10 European hospitals.Methods: MPI was calculated using 8 different domains typical of the CGA. A propensity score, Cox's regression analysis was used for assessing the impact of mechanical…

ENVEJECER SIN VOLVERSE VIEJO. SIGLO XXI Y ENVEJECIMIENTO: LA GERIATRIA, UNA ESPECIALIDAD EN CRECIMIENTO

MAGNESIUM AND ALZHEIMER’S DISEASE: IMPLICATIONS FOR DIET AND NUTRITION

Effects of drug therapy on cardiac arrhythmias and ischemia in hypertensives with LVH.

Left ventricular hypertrophy (LVH) in hypertensive subjects is associated with an increased prevalence of ventricular arrhythmias. To evaluate the effect of antihypertensive treatment on cardiac arrhythmias (CA) and transient episodes of myocardial ischemia (TEMI), we studied 46 hypertensive patients with LVH, divided into four groups randomly treated with enalapril, hydrochlorothiazide (HCTZ), atenolol, or verapamil (SR-V) for 6 months. Office blood pressure and office heart rate values were recorded, in basal conditions, after 1 and 6 months of treatment, and all patients underwent echocardiography, electrocardiographic Holter monitoring, and stress testing. All drugs significantly lowere…

Cellular-free magnesium depletion in brain and muscle of normal and preeclamptic pregnancy: A nuclear magnetic resonance spectroscopic study

Preeclampsia is a pregnancy disorder of unknown origin, characterized by vasospasm, elevated blood pressure, and increased neuromuscular irritability, features common to syndromes of magnesium deficiency. Evidence of serum and ionized magnesium metabolism disturbances have been observed in women with preeclampsia. This and the therapeutic utility of magnesium in preeclampsia led us to investigate the extent to which an endogenous tissue magnesium deficiency might be present in and contribute to its pathophysiology. We used 31 P nuclear magnetic resonance spectroscopy to noninvasively measure in situ intracellular-free magnesium levels in brain and skeletal muscle of fasting nonpregnant wom…

Ostruzione polmonare ed aritmia respiratoria

Il monitoraggio di pazienti tramite segnali fotopletismografici (PhotoPlethysmoGram, PPG) acquisiti sul polso, arteria radiale, piuttosto che sulla punta dell’indice, permette di ottenere un segnale più stabile e con maggiori informazioni, come la gittata cardiaca, la durata della contrazione ventricolare e la chiusura dell’aorta. In questo lavoro è presentata un’attività preliminare per rilevare condizioni come l’ostruzione polmonare e le apnee notturne. Si è indagato l’andamento dell’aritmia respiratoria in relazione ad eventuali difficoltà respiratorie. Per il momento ci si è limitati ad osservare soggetti sani e l’ostruzione è stata simulata facendo respirare i soggetti attraverso una c…

Urinary incontinence and quality of life: a longitudinal analysis from the English Longitudinal Study of Ageing

Objectives-\ud To explore the longitudinal association between urinary incontinence (UI) and quality of life (QoL) in the English Longitudinal Study on Ageing, a large study of older UK adults with ten years of follow-up.\ud Study design-\ud Cohort study.\ud Main outcomes interest-\ud To determine the presence of UI, participants reported whether they had lost urine beyond their control in the last 12 months. Participants also reported whether UI lasted more than one month, indicating a more chronic problem. QoL was measured using the CASP (control, autonomy, self-realisation and pleasure)-19, with higher values indicating a higher QoL.\ud Results-\ud Of the 8028 participants (mean age: 65.…

VALUTAZIONE EPIDEMIOLOGICA NEL TERRITORIO DI PALERMO E PROVINCIA SULL’UTILIZZO DEI FARMACI NELLA TERAPIA DEL DOLORE ALLA LUCE DELLE NUOVE NORMATIVE

Incidence of long COVID-19 in people with previous SARS-Cov2 infection: a systematic review and meta-analysis of 120,970 patients

The long-term consequences of the coronavirus disease 19 (COVID-19) are likely to be frequent but results hitherto are inconclusive. Therefore, we aimed to define the incidence of long-term COVID signs and symptoms as defined by the World Health Organization, using a systematic review and meta-analysis of observational studies. A systematic search in several databases was carried out up to 12 January 2022 for observational studies reporting the cumulative incidence of long COVID signs and symptoms divided according to body systems affected. Data are reported as incidence and 95% confidence intervals (CIs). Several sensitivity and meta-regression analyses were performed. Among 11,162 papers …

HOMOCYSTEINE AND OXIDATIVE STRESS IN HYPERTENSIVE AND DIABETIC OLDER PATIENTS

IN-HOSPITAL COMPLICATIONS OF ACUTE MYOCARDIAL INFARCTION IN HYPERTENSIVE SUBJECTS

BACKGROUND: Recent studies have shown a worse in-hospital outcome in hypertensive than in normotensive patients with acute myocardial infarction (AMI), which has been attributed to more frequent complications. The aim of this study was to investigate clinical patterns, risk factors, and in-hospital complications in hypertensive and normotensive patients with AMI. METHODS: Of 4994 consecutive patients with AMI admitted to the intensive care unit, hypertensive patients with first infarction (n = 915; mean age 68.8 +/- 11.4 years) and 915 gender- and age-matched normotensive subjects were retrospectively studied. RESULTS: In the univariate analysis, hypertensive subjects presented more frequen…

Appropriateness of oral anticoagulant therapy prescription and its associated factors in hospitalized older people with atrial fibrillation

Aims Although oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), they are often underused in this particularly high-risk population. The aim of the present study was to assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older. Methods Data were obtained from the retrospective phase of Simulation-based Technologies to Improve the Appropriate Use of Oral Anticoagulants in Hospitalized Elderly Patients With Atrial Fibrillation (SIM-AF) study, held in 32 Italian internal medicine and geriatric wards. The appropriateness of OAC prescription was assessed, grouping patients in…

Senile anorexia in acute-ward and rehabilitations settings.

The most common pathological change in eating behaviour among older persons is anorexia, which accounts for a large percent of undernutrition in older adults. The main research aims are to determine, in a sample of acute and rehabilitation elderly subjects, the prevalence of anorexia of aging and the causes most impacting on senile anorexia.Methods: four different Units cooperated to this research study. Patients were recruited from geriatric acute and rehabilitation wards in Italy. Each Research Unit, for the estimation of the prevalence of anorexia in elderly subjects evaluated all the patients aged over 65 recruited from April 2006 to June 2007. Nutritional status, depression, social, fu…

IAGG/IAGG GARN International Survey of End-of-Life Care in Nursing Homes

Item does not contain fulltext This article reports the findings of a survey on end-of-life (EOL) care in nursing homes of 18 long-term care experts across 15 countries. The experts were chosen as a convenience-based sample of known experts in each country. The survey was administered in 2016 and included both open-ended responses for defining hospice care, palliative care, and "end of life," and a series of questions related to the following areas-attitudes toward EOL care, current practice and EOL interventions, structure of care, and routine barriers. Overall experts strongly agreed that hospice and palliative care should be available in long-term care facilities and that both are define…

Prevalence of multidimensional frailty and pre-frailty in older people in different settings: A systematic review and meta-analysis.

Frailty is a common condition in older people. The epidemiological data available, however, are mainly based on the physical frailty phenotype. An extensive literature has suggested that frailty should be identified using a multidimensional approach. Based on these recommendations, we estimated the prevalence of frailty and pre-frailty in the older population, using the multidimensional prognostic index (MPI), a common tool for defining multidimensional frailty. We searched several databases until 10th May 2021 for studies reporting the prevalence of frailty according to MPI values. MPI was categorized, where possible, in &lt; 0.33 (robustness), 0.33–0.66 (pre-frailty) and &gt; 0.66 (frailt…

Heart failure and chronic kidney disease in a registry of internal medicine wards

Background: The aim of the present study was to evaluate the association between heart failure (HF) and chronic kidney disease (CKD) in tertiary care centers using the clinical records of patients enrolled in internal medicine departments.Patients and methods: We used the clinical records of 1380 elderly patients to identify patients with a history of HF and CKD using admission ICD codes and glomerular filtration rate (GFR) formulas. Magnitude and strength of such associations were investigated by univariable and multivariable analysis.Results: Of the 1380 patients enrolled, 27.9% had HF (age 80 ± 7, BMI 27 ± 6 kg/m2) and 17.4% CKD (age 81 ± 7, BMI 26.8 ± 6 kg/m2). Both groups were signific…

Gerontology is essential to the identity of geriatric medicine

The concept of the preeminence of multidimensional func-tional status in health care, one of the first achievements of geriatric medicine, has been endorsed by diverse sources, and is now a cultural patrimony of medicine. One of the main goals of geriatric medicine is to allow older people to remain as independent as possible for as long as possible. The integrated research of geriatricians and gerontologists has been at the forefront of the development, testing, and application of tools to assess functional status, including activities of daily living, gait and mobility, cognition, psy-chological status, depression, and social support.

SOMMINISTRAZIONE ORALE DI MAGNESIO E FUNZIONE ENDOTELIALE IN ANZIANI DIABETICI E IPERTESI

CONSEGUENZE A LUNGO TERMINE DELLE FRATTURE DA FRAGILITÀ

La riduzione della resistenza ossea che predispone le persone affette ad un aumentato rischio di fratture e di disabilità è molto frequente nell’anziano. L'età avanzata è un fattore di rischio anche per le cadute che di solito si associano all’evento fratturativo. Dopo una frattura di femore circa il 5% delle persone muore nel periodo immediatamente successivo, ~20% muore entro un anno, ~30% rimane disabile, ~40% non recupera più la propria autonomia e 12-20% richiede l’istituzionalizzazione. L’impatto delle fratture femorale a lungo termine è particolarmente severo negli anziani fragili. Le fratture vertebrali possono causare dolore cronico, deformità, disfagia e ridotta funzionalità polmo…

Effect of Age and Lipoperoxidation in Rat and Human Adipose Tissue-Derived Stem Cells

A wide range of clinical applications in regenerative medicine were opened decades ago with the discovery of adult stem cells. Highly promising adult stem cells are mesenchymal stem/stromal cells derived from adipose tissue (ADSCs), primarily because of their abundance and accessibility. These cells have multipotent properties and have been used extensively to carry out autologous transplants. However, the biology of these cells is not entirely understood. Among other factors, the regeneration capacity of these cells will depend on both their capacity of proliferation/differentiation and the robustness of the biochemical pathways that allow them to survive under adverse conditions like thos…

Osteoporosi nell’anziano.

IL DOLORE NELLA DEMENZA

IL CONTROLLO GLICEMICO NELL’ANZIANO DIABETICO: COSA CI INSEGNANO I RISULTATI DEI TRIALS?

Multidimensional prognostic index and the risk of fractures: an 8-year longitudinal cohort study in the Osteoarthritis Initiative

Abstract Summary In this longitudinal study, with a follow-up of 8 years, multidimensional prognostic index (MPI), a product of the comprehensive geriatric assessment, significantly predicted the onset of fractures in older people affected by knee osteoarthritis. Purpose Frailty may be associated with higher fracture risk, but limited research has been carried out using a multidimensional approach to frailty assessment and diagnosis. The present research aimed to investigate whether the MPI, based on comprehensive geriatric assessment (CGA), is associated with the risk of fractures in the Osteoarthritis Initiative (OAI) study. Methods Community-dwellers affected by knee OA or at high risk f…

Dietary Magnesium and Incident Frailty in Older People at Risk for Knee Osteoarthritis: An Eight-Year Longitudinal Study.

Inadequate magnesium (Mg) intake is associated with lower physical performance, but the relationship with frailty in older people is unclear. Therefore, we aimed to investigate whether higher dietary Mg intake is associated with a lower risk of frailty in a large cohort of North American individuals. Details regarding Mg intake were recorded through a food-frequency questionnaire (FFQ) and categorized as greater than/equal to Recommended Dietary Allowance (RDA) vs. lower. Frailty was defined using the Study of Osteoporotic Fractures index. Multivariable Cox’s regression analyses, calculating hazard ratios (HRs) with 95% confidence intervals (CIs), were undertaken by sex. In total, 4421 in…

LESIONI ULCERATIVE CUTANEE: PROGETTO PILOTA PER IL TRATTAMENTO INTEGRALE TERRITORIALE INCLUDENDO STIMOLAZIONE ELETTRICA FREMS. MIGLIORAMENTI CLINICI E RIDUZIONE DEI COSTI

MISURARE LA FRAGILITÀ DEL PAZIENTE ONCOLOGICO ANZIANO

BPCO E OSTEOPOROSI

COPD and osteoporosis are frequently associated because they have common risk factors, including age, smoking habits and reduced physical activity. COPD is also characterized by systemic inflammation, malnutrition (up to cachexia), hypovitaminosis D, and the use of local and systemic corticosteroids, all of which could cause deterioration in bone quality with a consequent increase in fragility fractures. These fractures may further impair mobility and increase disability and mortality. The vertebral and rib fractures can directly further affect lung function and promote exacerbations. As a result, the assessment of fracture risk in patients with COPD is of vital importance from the earliest…

Discrepancy between food offered and consumed during hospitalization in older adult patients

AbstractMalnutrition is one of the most frequent geriatric syndromes and a key contributor to frailty. Ageing is commonly associated with modifications in eating habits with changes in appetite and food intake. Malnutrition is not only a sign of illness, but its presence increases morbidity, hospital stay, institutionalization, poor quality of life, in-hospital complications, expenses, and mortality. Hospitalized patients have increased calorie requirements to overcome the increased energy expenditure due to acute disease. We aimed to evaluate the actual consumption of the food offered to a sample of hospitalized older adults. Sixty hospitalized patients (women/men = 23/37) were recruited s…

Bisoprolol and captopril effects on insulin receptor tyrosine kinase activity in essential hypertension.

Angiotension converting enzyme (ACE) inhibitors and beta-blockers have been reported to possess disparate effects on insulin sensitivity. The aim of this study was to study the effects of the selective beta-1 blocker bisoprolol and of the ACE inhibitor captopril on cellular insulin action in hypertensive individuals. After washout, 12 mild to moderate essential hypertensives were randomized in a double-blind manner to 5 mg bisoprolol daily or 25 mg captopril twice daily for 8 weeks. Erythrocyte insulin binding and insulin-stimulated tyrosine kinase (TK) activity were measured before and after therapy. Both agents decreased diastolic blood pressure significantly (bisoprolol 96.5+/-0.9 to 87.…

Treatment of heart failure with preserved ejection fraction.

Heart failure, in its diverse forms based on the value of the ejection fraction, is associated to high mortality and the frequent need for hospitalization, with a consequent heavy burden on healthcare resources. For an appropriate treatment of heart failure with preserved ejection fraction (HFpEF), there are no specific drugs effective for this condition. Those indicated in HF with reduced EF (HFrEF) are of more benefit in that form of HF, according to the guidelines of the European Society of Cardiology of 2016: ACE-inhibitors, beta-blockers, anti-aldosterones are all indicated with a class of recommendation/level of evidence IA; therapy with loop diuretics is indicated in the case of clin…

Magnesium in Type 2 Diabetes Mellitus, Obesity, and Metabolic Syndrome

Metabolic syndrome is a constellation of risk factors, including obesity, hypertension, insulin resistance, and altered lipid profile, which, if left untreated, will often progress to type 2 diabetes, which frequently complicates the syndrome [...]

INSULIN RESISTANCE AND CARDIOMETABOLIC SYNDROME IN HIV INFECTION

The Ionic Hypothesis of Aging

The clinical association of essential hypertension with metabolic abnormalities, such as hyperinsulinemia, insulin resistance, obesity, altered glucose tolerance and/or frank non-insulin dependent diabetes mellitus (NIDDM) has long been appreciated(1). Each of the above clinical conditions is extremely frequent in the elderly. The association of these different clinical states, that is also common at younger ages, has been termed “Syndrome X” and more recently “Generalized Cardiovascular-Metabolic Disease.”(2,3) Although several hypothesis have been proposed, including a primary role of hyperinsulinemia and insulin resistance, the mechanism(s) of this linkage has not been established. This …

Bronchial reactivity and intracellular magnesium: a possible mechanism for the bronchodilating effects of magnesium in asthma

1.Increased bronchial smooth muscle contractility with consequent bronchial hyperreactivity are characteristic physiopathological events of asthma. Since magnesium intervenes in calcium transport mechanisms and intracellular phosphorylation reactions, it constitutes an important determinant of the contraction/relaxation state of bronchial smooth muscle. In the present study we investigated the relationship between bronchial reactivity, assessed by methacholine-provocation test, and magnesium concentrations both at extracellular and intracellular levels measured by spectrophotometry. Twenty-two patients with mild-to-moderate asthma and 38 non-asthmatic subjects with allergic rhinitis (24 all…

Omega-3 Fatty Acid Supplementation and Oxidative Stress in Hypertensive Older Subjects

Die Bedeutung von Magnesium für Insulinresistenz, metabolisches Syndrom und Diabetes mellitus - Empfehlungen der Gesellschaft für Magnesium-Forschung e.V

Mangel an Magnesium (Mg) ist ein wichtiges und haufiges Begleitphanomen bei Patienten mit Diabetes mellitus oder Vorstufen eines Diabetes Typ 2 wie dem Metabolischen Syndrom. Mg-Mangel erhoht das Risiko, einen Diabetes Typ 2 zu entwickeln. Diese Empfehlungen resumieren die gegenwartigen Kenntnisse zur Physiologie des Mg im Kohlenhydratstoffwechsel und die pathophysiologischen Folgen des Mg-Mangels bei Diabetikern. Diabetiker und Patienten mit dessen Vorstufen profitieren von vier Kategorien der Mg-Wirkmechanismen: Insulin-sensitizing-Effekt, Ca-Antagonismus, Stress-Regulation und Endothel-stabilisierender Effekt. Klinische Studiendaten mit Mg-Comedikation zeigen verminderte Insulinresistenz…

IL DOLORE NELLA DEMENZA. STUDIO SU 100 PAZIENTI

THE IMPORTANCE OF TIGHT BLOOD PRESSURE CONTROL IN DIABETIC HYPERTENSIVE PATIENTS