OBM geriatrics最新文献

{"title":"Polymyalgia Rheumatica, an Age-Related Rheumatic Disease","authors":"Z. Schmidt, G. Poór","doi":"10.21926/obm.geriatr.2203202","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2203202","url":null,"abstract":"Polymyalgia rheumatica (PMR) is an age-related chronic inflammatory disease with rheumatic features at the fore. In addition to the high-grade systemic inflammation, it is characterized by typical “polymyalgic” musculoskeletal symptoms, including diffuse and severe pain and prolonged morning stiffness of the shoulder girdle, pelvic girdle, and neck. PMR is a member of the so-called giant cell arteritis complex; however, in spite of the marked systemic inflammation in PMR, the local vasculitis process aborts. The pathological background is synovitis, with a predominant inflammation of the extra-articular synovial structures. Synovitis of PMR is mild, transient, and non-erosive. Distal musculoskeletal symptoms are also observed but are more variable and less recognizable than the predominant proximal polymyalgic syndrome. PMR often overlaps with elderly-onset seronegative arthritides, elderly-onset rheumatoid arthritis, late-onset seronegative spondylarthritis, and the RS3PE1 syndrome. Although glucocorticoids are the cornerstone of PMR therapy, considerable hope is attached to tocilizumab, an IL-6 receptor inhibitor.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43744044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omega-3 Long-Chain Polyunsaturated Fatty Acids in the Elderly: A Review","authors":"P. Gareri","doi":"10.21926/obm.geriatr.2202198","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2202198","url":null,"abstract":"The omega-3 long-chain polyunsaturated fatty acids (omega-3 LC-PUFAs) family includes eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and docosapentaenoic acid (DPA). Although seafood is the richest source of omega-3 LC-PUFAs, because diet alone is often insufficient in older people, they may require food supplements and enriched food as sources of omega-3 LC-PUFAs. It has been reported that long-term intake of 3-5 g/d EPA + DHA as supplements is safe for adults; omega-3 LC-PUFAs exert cardio-metabolic protective effects and improve cognitive health, mood, diabetes, insulin resistance, and vascular endothelial cell function. Furthermore, these acids exert beneficial effects on heart disease, hypertension, diabetes, arthritis, inflammatory problems, autoimmune disease, and cancer. Their pleiotropic nature is manifested as reduced triglyceride levels, management of hypertension, and obesity/metabolic syndrome, and reduced mortality. These key nutrients modulate inflammation and platelet aggregation and are effective in preventing and treating negative consequences of aging. A recent meta-analysis of EPA trials revealed a higher reduction in the relative risk in cardiovascular outcomes for EPA than for EPA + DHA. This review analyzes the influence of omega-3 PUFAs on the brain, heart, metabolism, vascular endothelial and immune functions, and muscle and bone health in the elderly.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45815515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex Pathology of Cardiac Syncope in Old Patients","authors":"G. Cocco, Stefano Pandolfi","doi":"10.21926/obm.geriatr.2202200","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2202200","url":null,"abstract":"Syncope is characterized by a transient and rapid loss of consciousness for a short duration, with full spontaneous recovery within minutes. Syncope causes up to 2% of all emergency medical consultations. The incidence of syncope is similar in men and women, is higher in old patients (slightly higher in old women). The prevalence of syncope is up to 23% for the institutionalized elderly. In elderly patients, syncope often presents atypically, such as with falls; these patients might also have difficulty recalling events. The true incidence and prevalence of syncope in elderly patients are expected to be higher than those estimated in most studies. The causes of syncope are highly age-dependent. Reflex or neurally mediated syncope is the most common cause, particularly in younger patients. As individuals age, orthostatic hypotension and cardiac syncope become more frequent. In elderly patients, neurally mediated syncope is the most prevalent form of syncope. Orthostatic syncope is more frequent in the elderly than in young patients. In the elderly, cardiac causes account for about 15% of all cases, and in about 10% of the cases, the origin of syncope is unknown. A combination of different etiologies is common in geriatric patients because many pathophysiologies coexist, including age-related physiological changes, co-morbidities (e.g., neurological pathologies), multiple medications (with interactions, or with lowering of BP and HR), malnutrition, sarcolepsy, and prolonged bed rest. The available clinical guidelines for the diagnosis, investigation, and treatment of syncope are insufficient to address syncope in elderly patients. A comprehensive geriatric approach that considers the functional and cognitive capacities of individuals along with the medical and psychosocial aspects would be more appropriate. Modern medicine can be used to treat syncope in some geriatric patients and should be offered whenever possible.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45301910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kampo Medicine for Older People: A Review","authors":"T. Nogami, M. Arai, K. Iwasaki","doi":"10.21926/obm.geriatr.2201191","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2201191","url":null,"abstract":"Several countries have entered the super-aging era. In Japan, the recently reported average life expectancy is approximately 90 years. Kampo medicine (a form of traditional Japanese medicine) is a part of the official medical service in Japan and is widely used for treating various illnesses of older people. However, although general physicians often prescribe Kampo preparations, most Japanese general physicians do not have an intimate understanding of the iatrology of Kampo. Kampo is based on traditional Chinese medicine modified according to the Japanese environment, characteristics, and society. Although Kampo prescriptions are beneficial in geriatric medicine, they were initially developed and applied according to the medical principles of traditional Japanese and Chinese medicine. Moreover, improper administration of these traditional preparations can lead to severe adverse consequences. In this review, we have described the efficacy of Kampo medicine for geriatric syndromes and the traditional meanings and rules underlying Kampo prescriptions.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48915524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Identification 5S nrDNA Unit Classes in Genera of Plants and Selected Non-Vertebrate Animals and Their Potential for the Study of Species Relationships","authors":"B. Baum, Douglas A. Johnson","doi":"10.21926/obm.genet.2202152","DOIUrl":"https://doi.org/10.21926/obm.genet.2202152","url":null,"abstract":"We have investigated the utility of the 5S nrDNA, a conserved, multicopy gene family organized into tandem repeats as a tool for genetic analyses in a wide variety of genera. Previous work in the Triticeae (Poaceae) demonstrated that the prior identification of unit classes based upon the 5S nrDNA NTS, greatly facilitates analysis. We investigated the potential of defining unit classes in other plant genera and several animal genera as a step towards future phylogenetic analyses. Our results demonstrate that in in several plant and animal genera there are sufficient numbers of DNA accessions in GenBank™ to point to different unit classes within species and that in some genera several potential unit classes are found across species. These results justify both more in-depth sampling within species and more breadth in sampling within. Further investigation of additional DNA sequences will help to define true unit classes.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48424974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mammalian MutY Homolog (MYH or MUTYH) is Critical for Telomere Integrity under Oxidative Stress.","authors":"Aditi Gupta,&nbsp;Bor-Jang Hwang,&nbsp;Daniel Benyamien-Roufaeil,&nbsp;Sara Jain,&nbsp;Sophie Liu,&nbsp;Rex Gonzales,&nbsp;Robert A Brown,&nbsp;Michal Zalzman,&nbsp;A-Lien Lu","doi":"10.21926/obm.geriatr.2202196","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2202196","url":null,"abstract":"<p><p>Telomeres consist of special features and proteins to protect the ends of each chromosome from deterioration and fusion. The telomeric DNA repeats are highly susceptible to oxidative damage that can accelerate telomere shortening and affect telomere integrity. Several DNA repair factors including MYH/MUTYH DNA glycosylase, its interacting partners Rad9/Rad1/Hus1 checkpoint clamp, and SIRT6 aging regulator, are associated with the telomeres. MYH prevents C:G to A:T mutation by removing adenine mispaired with a frequent oxidative DNA lesion, 8-oxoguanine. Here, we show that <i>hMYH</i> knockout (KO) human HEK-293T cells are more sensitive to H₂O₂ treatment, have higher levels of DNA strand breaks and shorter telomeres than the control <i>hMYH</i> ^+/+ cells. SIRT6 foci increase at both the global genome and at telomeric regions in H₂O₂-treated <i>hMYH</i> ^+/+ cells. However, in untreated <i>hMYH</i> KO HEK-293T cells, SIRT6 foci only increase at the global genome, but not at the telomeric regions. In addition, the <i>hMYH</i> KO HEK-293T cells have increased extra-chromosomal and intra-chromosomal telomeres compared to the control cells, even in the absence of H₂O₂ treatment. After H₂O₂ treatment, the frequency of extra-chromosomal telomeres increased in control HEK-293T cells. Remarkably, in H₂O₂-treated <i>hMYH</i> KO cells, the frequencies of extra-chromosomal telomeres, intra-chromosomal telomeres, and telomere fusions are further increased. We further found that the sensitivity to H₂O₂ and shortened telomeres of <i>hMYH</i> KO cells, are restored by expressing wild-type hMYH, and partially rescued by expressing hMYH^Q324H mutant (defective in Hus1 interaction only), but not by expressing hMYH^V315A mutant (defective in both SIRT6 and Hus1 interactions). Thus, MYH interactions with SIRT6 and Hus1 are critical for maintaining cell viability and telomeric stability. Therefore, the failure to coordinate 8-oxoG repair is detrimental to telomere integrity.</p>","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9086929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Point System Table to Estimate the Risk of Cardiovascular Events in Patients with Hypertension and Left Ventricular Hypertrophy: The LIFE Study","authors":"D. Hille, S. Kjeldsen, S. Julius, K. Wachtell, P. Okin, R. Devereux","doi":"10.21926/obm.geriatr.2201189","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2201189","url":null,"abstract":"We aimed to assess some readily available patient characteristics such as urinary albumin excretion as predictors of a primary composite event of myocardial infarction, cerebral stroke, and cardiovascular death among patients with hypertension and left ventricular hypertrophy, and develop risk algorithms for the outcomes. A “Cox proportional hazards” model identified the baseline variables that significantly affected the occurrence of the composite endpoint in 9193 elderly hypertensive patients with left ventricular hypertrophy in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. We developed a risk point table, which assigned points to various risk factors, including the important age-gender interaction term, by adapting the point system algorithm developed from Framingham data. The Cox model identified 12 predictors of risk for the endpoint. Points for age were calculated separately for females and males due to the age-gender interaction. The risk estimates that were defined by total points were compared to those that were determined by the Cox model, and the weighted κ value for the agreement was 0.89. Thus, several patient characteristics predicted cardiovascular events in patients with hypertension and left ventricular hypertrophy, with age, gender, and urinary albumin excretion being the most important. The risk point table is an intuitive method to compare the relative contribution of the cardiovascular risk predictors and explain complicated statistical models such as the interaction term to patients and their physicians.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47735344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Atrial Systolic Force in Hypertensive Patients with Left Ventricular Hypertrophy-: A Predictor of Incident Atrial Fibrillation. The LIFE Study","authors":"L. Gerholt, C. Bang, E. Gerdts, A. Larstorp, S. Kjeldsen, S. Julius, K. Wachtell, P. Okin, R. B. Devereux","doi":"10.21926/obm.geriatr.2201194","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2201194","url":null,"abstract":"It remains unknown whether left atrial systolic force (LASF), a measure of left atrial function, can be used as a predictor of new-onset atrial fibrillation (NOAF). Furthermore, the effect of the treatment with atenolol and losartan on LASF is unclear. A total of 758 patients without atrial fibrillation at baseline were enrolled from the Losartan Intervention For Endpoint (LIFE) reduction in hypertension echocardiography sub-study. Participants of the LIFE study were randomized to either atenolol-or losartan-based treatment. The mean follow-up was 59 months. LASF was calculated using the average mitral orifice area and mitral peak. The velocity was obtained by Doppler echocardiography. At baseline, 25% of patients had a LASF ≤ 10.3 kdyn. Compared to other quartiles, this quartile had a higher proportion of men, lower heart rate, body mass index, and age. After controlling for these variables, patients in the first quartile had a lower stroke volume compared to other quartiles. New-onset AF occurred in 29 (8.1/1,000 patient-years of follow-up) patients. In multivariable Cox regression analyses with backward elimination, increasing LASF was associated with a lower risk of NOAF (hazard ratio [HR] = 0.90 [95% confidence interval 0.85-0.96], p = 0.001). Integrated discrimination improvement was 0.054 (p = 0.004) and there was a borderline significant net reclassification improvement of 19.2% (p = 0.075). Over time LASF decreased more in the atenolol-based than the losartan-based treatment group ( < 0.001). Low LASF was associated with a higher risk of new-onset AF. Losartan-based treatment was associated with better preservation of LASF compared to atenolol-based treatment.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48105352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The COVID-19 Geropsychiatry Rounds: A Curriculum for Healthcare Providers","authors":"A. Seritan","doi":"10.21926/obm.geriatr.2201187","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2201187","url":null,"abstract":"Older adults’ mental health needs significantly increased during the COVID-19 pandemic. Geriatric psychiatry is an area of extreme workforce shortage globally. A novel curriculum was developed to educate healthcare providers on COVID-19-related geriatric and geropsychiatry topics. Monthly lectures were presented from November 2020 to June 2021. Evaluations were collected after each lecture via an anonymous survey. Overall lecture quality and relevance for the participants’ clinical practices were rated on a 1-3 Likert-type scale. 217 participants attended lectures; 72 evaluations were collected (33% response rate). Overall lecture rating score was 2.82 ± 0.38 and relevance score was 2.77 ± 0.45. The curriculum was well received and relevant to participants. Future studies should collect more details regarding participants’ clinical practices. To our knowledge, this is the first COVID-19-related geriatric psychiatry curriculum developed to educate healthcare providers and empower them to care for older adults during the pandemic.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43721901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Determining Subjective Health Perception Among Middle-and Upper-Middle Aged Individuals","authors":"T. Hatta, Taketoshi Hatta, J. Hatta, A. Iwahara, Kazumi Fujiwara, Kimiko Kato, Y. Hasegawa","doi":"10.21926/obm.geriatr.2201190","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2201190","url":null,"abstract":"In the present study, we identified the factors of cognitive and physical performances predicting self-rated health perception (SRH) using an SRH questionnaire in 660 (298 men and 362 women) upper-middle-aged community dwellers. In addition, neuropsychological test battery and physical ability tests were applied. A multiple regression analysis was conducted using the forced entry method; digit cancellation test (D-CAT1), logical memory test, verbal fluency test, back strength, timed-up and-go (TUG), balancing test, age, and sex were independent variables, and SRH was used as the dependent variable. The results showed that variables of D-CAT1(β = 0.175, p < 0.001), TUG(β = −0.095, p < 0.026) and body mass index (BMI; β = 0.095, p < 0.018) significantly predicted participants’ SRH, whereas other variables, including sex, did not contribute significantly. D-CAT1 exerted the strongest effect on SRH. These findings indicate that upper-middle-aged individuals use their cognitive and physical performances that strongly relate to the prefrontal cortex functions to form SRH. Based on these findings, we discussed the possible effective strategies that the health-promoting staff of the local government can implement to sustain or increase the SRH of community dwellers.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46408575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}