Search results for "Geriatrics"

Spinal metastases: Is stereotactic body radiation therapy supported by evidences?

2016

Stereotactic body radiotherapy (SBRT) is becoming widely adopted in the treatment of primary and secondary tumors. Spinal bone metastases are frequently discovered in cancer patients, and in the past have been usually treated with a palliative goal. Nevertheless, in some particular clinical settings, such as oligometastatic patients and/or those with a long life expectancy, spinal SBRT could be considered a valid therapeutic option to obtain long-lasting palliation and, when possible, with a curative goal. This review aims to summarize available clinical and dosimetric data of published studies about spinal SBRT.

PROTON MAGNETIC RESONANCE SPECTROSCOPY IN DEMENTIA OF ALZHEIMER TYPE

1997

Reduced N-acetyl aspartate (NAA) and increased myo-inositol (MI) levels have been reported in patients with dementia of Alzheimer type (DAT) in comparison with controls. We wished to assess the validity of these findings and to evaluate possible correlations of metabolite proportions with cognitive dysfunction in DAT. Twelve patients with DAT and 10 healthy age-matched controls were included. The severity of dementia was assessed using different scales including the Mini-Mental State Examination. MRS was performed with a conventional 1.5 Tesla scanner in a single voxel in the centrum semi-ovale (TE = 30 ms or TE = 136 ms; TR = 1500 ms). The evaluation of MRS results was limited by low inter…

Langerhans’s cell histiocytosis in old subjects: two rare case reports and review of the literature

2012

doi: 10.1111/j.1741-2358.2012.00629.x Langerhans’s cell histiocytosis in old subjects: two rare case reports and review of the literature Background:  Langerhans cell histiocytosis (LCH) is a proliferative disease of histiocyte-like cells that generally affects children; LCH onset is rare in adults; immunohistochemistry is essential to obtain the correct diagnosis, and treatment protocols are controversial. Objective:  To describe two new cases of adult onset oral LCH. Case reports:  Case 1: a 71-year-old woman, complaining of diffuse oral pain, presented with erythematous mucosal lesions; the panoramic radiograph and CT scan showed multiple mandible radiolucent areas. Immunohistochemical a…

Sequential and combined treatment of prolidase deficiency leg ulcers

2010

Background The Authors report a case of chronic cutaneous lesions in a patient affected by prolidase deficiency, a rare disorder inherited through an autosomal recessive gene (50 cases reported ). The enzyme prolidase is widely distributed throughout the body and it is important in the recycling of proline and hydroxyproline. Among the clinical presentations, the most striking manifestation is the skin fragility with leg ulceration (see Table ​Table11) Table 1 Clinical signs of prolidase deficiency The deficiency of the enzyme prolidase is responsible for massive loss of proline in the urine which is estimated to be as high as 3 g/die. The diagnosis is ascertained by iminopeptiduria greater…

Perioperative care of the elderly oncology patient: A report from the SIOG task force on the perioperative care of older patients with cancer

2012

Abstract The increasing number of older cancer patients seen in daily practice demands reflection on how to optimize their care during the perioperative period. Optimally tailored surgical management, at present the most successful cancer treatment, firmly rests on an accurate and careful anesthesiological management. The unique peculiarities of anesthesia in older cancer patients prompted the International Society of Geriatric Oncology (SIOG) to put together a panel of international experts with the aim of reviewing the literature and drafting a consensus document. This article summarizes their views.

Paradoxes in the old age – reverse epidemiology

2012

Microvascular Sex- and Age- Dependent Phosphodiesterase Expression

2021

Objective: The cyclic nucleotide second messengers, cAMP and cGMP, are pivotal regulators of vascular functions; their cellular levels are tightly controlled by the cyclic nucleotide hydrolases, phosphodiesterases (PDE). Biologic sex and age are recognized as independent factors impacting the mechanisms mediating both vascular health and dysfunction. This study focused on microvessels isolated from male and female rats before (juvenile) and after (adult) sexual maturity under resting conditions. We tested the hypothesis that sexual dimorphism in microvascular PDE expression would be absent in juvenile rats, but would manifest in adult rats.Methods: Abdominal skeletal muscle arterioles and v…

Associations Between Accelerometer-Based Free-Living Walking and Self-Reported Walking Capability Among Community-Dwelling Older People

2021

The authors examined whether accelerometer-based free-living walking differs between those reporting walking modifications or perceiving walking difficulty versus those with no difficulty. Community-dwelling 75-, 80-, or 85-year-old people (N = 479) wore accelerometers continuously for 3–7 days, and reported whether they perceived no difficulties, used walking modifications, or perceived difficulties walking 2 km. Daily walking minutes, walking bouts, walking bout intensity and duration, and activity fragmentation were calculated from accelerometer recordings, and cut points for increased risk for perceiving walking difficulties were calculated using receiver operating characteristic analys…

Anti-Tumour Necrosis Factor-?? Therapy for Rheumatoid and Other Inflammatory Arthropathies

2006

Anti-tumour necrosis factor (TNF)-alpha represents a major advance in the treatment of rheumatoid arthritis (RA), ankylosing spondylitis and psoriatic arthritis. It is usually well tolerated, but a potential increase in the incidence of some infections in patients taking anti-TNFalpha agents has been reported. Compared with younger people, elderly patients have more co-morbidities and are likely to be taking more medications. Moreover, the aging process induces an increase in the rate of infections. Nevertheless, in recent studies analysing the databases of etanercept trials, the normalised incidence of adverse events, serious adverse events, medically important infections and deaths was no…

A systematic review of neuropsychiatric symptoms in mild cognitive impairment.

2009

Mild cognitive impairment (MCI) is a clinical concept proposed as an intermediate state between normal aging and dementia. This condition has multiple heterogeneous sources, including clinical presentation, etiology, and prognosis. Recently, the prevalence and associated features of neuropsychiatric symptoms (NPS) in MCI have been described. We systematically searched the PubMed database (last accessed on August 31, 2008) for articles on NPS in MCI. Included articles used strict selection criteria, and outcome variables were extracted in duplicate; of the 27 articles included, 14 (52%) used prospective cohorts. The global prevalence of NPS in MCI ranged from 35% to 85%. The most common beha…