Journal of geriatrics and palliative care最新文献

{"title":"Management Patterns of the Older Population with Cancer during The Early State Of Alarm In the Valencian Autonomous Community: The GIDO GERICOV-2020 PROJECT","authors":"M. Climent, Soriano, Ferrero, J. Perea, Invi t ing Innova t ions","doi":"10.13188/2373-1133.1000024","DOIUrl":"https://doi.org/10.13188/2373-1133.1000024","url":null,"abstract":"In the current care scenario of the COVID-19 pandemic, older oncology patients are especially vulnerable and find themselves facing a double threat. On the one hand, the risk of contracting an infection that we still know little about facilitated by immunosuppression and potentially aggravated by the antineoplastic treatment toxicity, co-morbidities, and the cancer severity [1]. On the other, the neoplastic disease itself, along with the risk of losing an opportunity because of the reduction of medical cancer care, due to the limitation or re-allocation of resources [2]. Therefore, one priority aspect is establishing the individual risk associated with the neoplasm and the treatment, in the context of each type of oncological patient [3]. Although cancer is assumed to be an adverse prognostic factor in patients with COVID-19 and in older persons, there is still uncertainty and a lack of robust evidence. Recommendations have surged concerning therapeutic decisions in oncology patients, and the records of cancer patients with COVID. Nevertheless, the real impact of therapeutic decisions in clinical practice remains unknown, especially in the older patient group as well as the evolution of this population group. To increase the available evidence in the current pandemic, we aimed to retrospectively record the management of patients 70 years and older with cancer who received care in the Medical Oncology services of the hospitals belonging to the GIDO group during the early pandemic.","PeriodicalId":90595,"journal":{"name":"Journal of geriatrics and palliative care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66211809","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":"COVID-19 Vaccination with Special Reference to Adenoviral Vectors, Clotting Disorders and Old Age","authors":"Sergei V. Jargin","doi":"10.13188/2373-1133.1000023","DOIUrl":"https://doi.org/10.13188/2373-1133.1000023","url":null,"abstract":"Statistics about potential side effects of COVID-19 vaccination are of questionable reliability; adverse effects may be missed, ascribed to other causes or obfuscated. Under these circumstances, the role of theoretic argumentation based on patho physiological and biochemical mechanisms increases. For example, effects of the spike protein (SP) observed in COVID-19 patients can be expected to occur to some extent also after injections of vaccines containing SP (inactivated viral vaccines) or nucleic acids inducing the synthesis of SP by cells. SP can damage vascular endothelial cells by down regulating angiotensinconverting enzyme 2 (ACE2) and consequently inhibiting mitochondrial function [10]. SARS-CoV-2 uses ACE2 as a cellular receptor, which may lead to the ACE2 degradation and angiotensinII-mediated lung injury in COVID-19 [11]. SP is presented to the immune system inducing immune reactions and binds to ACE2 receptors on platelets activating them [11]. The endothelial damage together with the platelet activation would result in thromboses and thrombocytopenia wholly expressed in the entity known as vaccineinduced thrombotic thrombocytopenia [12]. Of note, D‐dimer level is usually high in patients with postvaccinal clotting disorders [12,13]. Thrombosis and thrombocytopenia may be caused not only by SP but also by adenoviral vectors in vaccines [14]. The vectors elicit cellular and humoral immune responses, bind to circulating platelets, inducing their activation and aggregation. There is evidence in favor of synergistic effects of SP and adenoviral vector in vaccines. These mechanisms may explain the comparatively high prevalence of thromboses and thrombocytopenia following application of adenoviral vector-based anti-SARS-CoV-2 vaccines e.g. cerebral and splanchnic vein thrombosis, pulmonary embolism and disseminated intravascular coagulation [14]. Moreover, SP has been shown in vitro to enter cell nuclei and to impair DNA repair [15], which may have far-reaching consequences to be studied in future. Letter to the Editor","PeriodicalId":90595,"journal":{"name":"Journal of geriatrics and palliative care","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66211705","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":"Antiseptic, Antiperspirant and Deodorant Diaper for the Frail Older Adult with Urinary Incontinence","authors":"P. Leung","doi":"10.13188/2373-1133.1000022","DOIUrl":"https://doi.org/10.13188/2373-1133.1000022","url":null,"abstract":"Introduction: Urinary incontinence is a common complaint among older people which could cause great burden to the carer and healthcare system. The idea of creating a special diaper for the older and frail older people suffering from urinary incontinence to prevent complications arising from over-night and persistent wetting of the perineal region therefore appear appealing and beneficial. Aim of the study: The aim of this s tudy was to perform further laboratory studies to understand the sweat modulation effect of the herbal formula, and to determine whether the herbal formula and the herbal formula containing diaper would cause any skin toxicity. Materials and Methods: In vitro studies including the Acetylcholinesterase (AChE) activity assay, and measurement of chloride efflux by short circuit current assay was performed to understand the sweat modulation effect of the herbal formula. In vitro skin toxicity test was also performed to determine whether the herbal formula and the herbal formula containing diaper would cause any skin toxicity. Results: Our herbal formula containing Cortex Fraxini, Mori Follium and Calamine significantly increased the acetylcholinesterase activity in PC12 cells. This formula also significantly inhibited the UTP-evoked Clsecretion and ACh-induced Cltransport. Further skin toxicity test suggested this formula exerted no significant toxicity to the cells in the skin. Conclusion: These data further supported the positive data observed in two clinical studies previously completed which demonstrated that the herbal formula could reduce sweat secretion, reduce odour, skin irritations and the herbal extract-containing diaper could improve the quality of life of individuals with urinary incontinence. Citation: Wat E, Wang YP, Tsz Chan HY, Wong S, Hung Ko W, et al. Antiseptic, Antiperspirant and Deodorant Diaper for the Frail Older Adult with Urinary Incontinence. J Geriatrics Palliative Care 2019;6(1): 5. J Geriatrics Palliative Care 6(1): 5 (2019) Page 02 ISSN: 2373-1133 herbal extract. Comparing with their control diapers, the majority of volunteers preferred the herbal extract containing diapers due to the less leakage and unpleasant odour. They were also found to have better skin conditions [4]. These clinical studies demonstrated that our herbal extract containing diapers could reduce sweat production and improve the quality of life of the elderly people. Here, we have reported further laboratory studies to understand the underlying mechanism contributing to the observed beneficial effects of the herbal extract in previous clinical studies. We conducted several in vitro studies including the Acetylcholinesterase (AChE) activity assay to understand the anti-cholinergic effects of the herbal extract; and measurement of chloride efflux by short circuit current assay to understand the sweat modulation mechanism of the herbal extract. In vitro skin toxicity test was also performed to determine whether the herbal extract and ","PeriodicalId":90595,"journal":{"name":"Journal of geriatrics and palliative care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66211620","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":"A Pilot Psychometric Study on the Validation of the Older Women's Non-Medical Stress Scale (OWN-MSS) on an Ethnically Diverse Sample.","authors":"Luciana Laganà,&nbsp;Roxanne R Prilutsky","doi":"10.13188/2373-1133.1000014","DOIUrl":"https://doi.org/10.13188/2373-1133.1000014","url":null,"abstract":"<p><strong>Introduction: </strong>Older women often experience various types of stressors, including the death of a spouse and associated financial stress (often with a lack of social support), emotional stress due to factors such as caregiving and being single, and the challenges of the aging process. These circumstances could produce or aggravate anxious symptomatology that can in turn compound the negative effects of aging. A brief scale of perceived stress that is not confounded with health status and covers multiple culturally relevant potential stressors is needed for quick use in busy medical settings.</p><p><strong>Aim: </strong>To assess the reliability and the validity of an original stress scale designed to measure perceptions of stress beyond health status in a non-clinical convenience sample of community-dwelling older women.</p><p><strong>Method: </strong>In this cross-sectional pilot investigation, via conducting item-total correlations and correlational tests of validity, we studied the psychometric properties of our measure using data from volunteer older subjects (mainly low-income and from non-Caucasian backgrounds). The domains covered by the nine items of the tool were selected based on a literature review of common stressors experienced by older adults, especially by older women. Data were collected face-to-face using a demographic list, a well-established depression measure, a brief posttraumatic stress disorder (PTSD) screener, and our 9-item stress tool. Primary outcomes: reliability and validity of the scale of older women's non-medical stress. Secondary outcomes: demographic characteristics of the sample and correlations between stress items.</p><p><strong>Results: </strong>Based on our sample of older women (N=40, mean age 71 years), good internal consistency between the items of the stress scale was found (Cronbach's a=.66). The findings of the data analyses also revealed that our psychometric tool has good convergent validity with the PTSD screener (r=.53). Moreover, in contrast with most other stress tools, it has strong discriminant validity (r=.11) with a well-validated depression scale.</p><p><strong>Conclusion: </strong>Our results suggest that this new measure is psychometrically strong. Future research directions encompass using larger samples, ideally including older men with the modification of the scale's name, as well as validating this tool against more measures. Clinical implications of our findings are briefly discussed.</p>","PeriodicalId":90595,"journal":{"name":"Journal of geriatrics and palliative care","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933309/pdf/nihms777045.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34647011","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":"Quantitative Fecal Lactoferrin as a Biomarker for Severe <i>Clostridium difficile</i> Infection in Hospitalized Patients.","authors":"Laurie R Archbald-Pannone","doi":"10.13188/2373-1133.1000006","DOIUrl":"https://doi.org/10.13188/2373-1133.1000006","url":null,"abstract":"<p><strong>Background: </strong>The incidence and severity of <i>Clostridium difficile</i> infection (CDI) have increased over the past decade, especially among hospitalized patients. In this study, we determined the value of published criteria for severe CDI in predicting 3 month mortality, as well as the utility of fecal lactoferrin as a biomarker for severe CDI.</p><p><strong>Methods: </strong>Pilot Year 1 of IRB approved (HSR-IRB# 13630) prospective cohort study of hospitalized patients with CDI at US academic medical center (10/08-4/10). Medical records of hospitalized patients with clinically diagnosed CDI, via toxin assay, were evaluated to objectively define severe CDI based on current guidelines. A stool sample from CDI diagnosis was analyzed for amount of fecal lactoferrin (IBD-SCAN, TechLab, Inc.). Data was analyzed using SPSS for student's t-test and chi-squared, significance p ≤ 0.05.</p><p><strong>Results: </strong>79 subjects consented and enrolled, mean age was 64 years (standard deviation, sd, 17.2), 48 (61%) female, and average Charlson co-morbidity score was 5.8 (sd 3.8). Subjects with severe CDI were 5 times more likely to die within 3 months of diagnosis (Odds Ratio 5.66 (95% Confidence Interval 2.03-15.79), p=0.001) and had significantly more fecal lactoferrin (580.0 (sd 989.0) vs. 181.7 (sd 244.2) µg/mL, p=0.018), compared to those that did not meet severe CDI criteria.</p><p><strong>Conclusion: </strong>In this pilot study, subjects who meet defined criteria for severe CDI had higher mortality and more intestinal inflammation. These preliminary results were, however, underpowered to show a direct association of lactoferrin with mortality. Larger cohort studies are needed to optimize a criterion for severe CDI and evaluate a direct association of lactoferrin and mortality in hospitalized patients with CDI.</p>","PeriodicalId":90595,"journal":{"name":"Journal of geriatrics and palliative care","volume":"2 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230709/pdf/nihms596686.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32818115","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}