Latest & greatest articles for elderly

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Top results for elderly

981. Treatment response to sildenafil in men with erectile dysfunction relative to concomitant comorbidities and age (Abstract)

Treatment response to sildenafil in men with erectile dysfunction relative to concomitant comorbidities and age To evaluate treatment response in men with erectile dysfunction (ED) and concomitant comorbidities.Data were pooled from 42 placebo-controlled, flexible-dose sildenafil trials. In most trials, the sildenafil dose was 50 mg, taken ~1 hour before sexual activity but not more than once daily, with adjustment to 100 or 25 mg as needed. The overall population (N=9413) was stratified by age (...) with no comorbidity (77% vs 33%), cardiovascular disease/hypertension only (71% vs 27%), diabetes only (63% vs 24%) or depression only (78% vs 29%). Using an IIEF-EF score ≥26, treatment response was significantly greater (P<.0001) with sildenafil vs placebo in men with no comorbidity (49% vs 17%), cardiovascular disease/hypertension only (48% vs 12%), diabetes only (40% vs 12%) or depression only (60% vs 17%). With each definition, the treatment response for each age and comorbidity was significantly greater (P

2017 EvidenceUpdates

982. Association Between HIV Infection and the Risk of Heart Failure With Reduced Ejection Fraction and Preserved Ejection Fraction in the Antiretroviral Therapy Era: Results From the Veterans Aging Cohort Study Full Text available with Trip Pro

Association Between HIV Infection and the Risk of Heart Failure With Reduced Ejection Fraction and Preserved Ejection Fraction in the Antiretroviral Therapy Era: Results From the Veterans Aging Cohort Study With improved survival, heart failure (HF) has become a major complication for individuals with human immunodeficiency virus (HIV) infection. It is unclear if this risk extends to different types of HF in the antiretroviral therapy (ART) era. Determining whether HIV infection is associated (...) with HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), or both is critical because HF types differ with respect to underlying mechanism, treatment, and prognosis.To investigate whether HIV infection increases the risk of future HFrEF and HFpEF and to assess if this risk varies by sociodemographic and HIV-specific factors.This study evaluated 98 015 participants without baseline cardiovascular disease from the Veterans Aging Cohort Study, an observational cohort

2017 JAMA cardiology

983. Can Health-care Assistant Training improve the relational care of older people? (CHAT) A development and feasibility study of a complex intervention

Can Health-care Assistant Training improve the relational care of older people? (CHAT) A development and feasibility study of a complex intervention Can Health-care Assistant Training improve the relational care of older people? (CHAT) A development and feasibility study of a complex intervention Can Health-care Assistant Training improve the relational care of older people? (CHAT) A development and feasibility study of a complex intervention Arthur A, Aldus C, Sarre S, Maben J, Wharrad H (...) , Schneider J, Barton G, Argyle E, Clark A, Nouri F & Nicholson C Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Arthur A, Aldus C, Sarre S, Maben J, Wharrad H, Schneider J, Barton G, Argyle E, Clark A, Nouri F & Nicholson C. Can Health-care Assistant Training improve the relational care of older people? (CHAT) A development and feasibility study

2017 Health Technology Assessment (HTA) Database.

984. An elderly man with an air-fluid level in the middle ear Full Text available with Trip Pro

An elderly man with an air-fluid level in the middle ear A 68-year-old Malay man who is a rubber tapper, presented with a large painful right-sided neck swelling for 6 months, which was gradually increasing in size and associated with odynophagia, dysphagia, hoarseness and significant weight loss. He did not complain of any ear symptoms, but on further questioning, he admitted having a 3-week history of occasional tinnitus and reduced hearing on the right ear. Other ear symptoms were negative.

2017 Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia

985. Diffuse large B-cell lymphoma in very elderly patients over 80 years old: Incorporating consolidative radiation therapy into management decisions Full Text available with Trip Pro

Diffuse large B-cell lymphoma in very elderly patients over 80 years old: Incorporating consolidative radiation therapy into management decisions The population of patients aged 80 years or older who are diagnosed with diffuse large B-cell lymphoma (DLBCL) continues to increase, but an optimal treatment strategy has not been established. We sought to examine the influence of consolidative radiation therapy (RT) on outcome and toxicity among the very elderly diagnosed with stage I-IV DLBCL.We (...) more frequently among ES patients who received 6 to 8 cycles of chemotherapy alone. Among advanced-stage patients with bulky disease (n = 35), consolidative RT to sites of bulky disease may have improved local control (3-year local control, 100% vs 60.3%, P = .160).Among patients aged 80 years or older who have with ES DLBCL, 3 to 4 cycles of chemotherapy followed by RT is at least equivalent in efficacy to chemotherapy alone and is associated with lower levels of toxicity, which suggests

2017 Advances in radiation oncology

986. Opposing activities of oncogenic MIR17HG and tumor suppressive MIR100HG clusters and their gene targets regulate replicative senescence in human adult stem cells Full Text available with Trip Pro

Opposing activities of oncogenic MIR17HG and tumor suppressive MIR100HG clusters and their gene targets regulate replicative senescence in human adult stem cells Growing evidence suggests that many diseases of aging, including diseases associated with robust changes and adipose deports, may be caused by resident adult stem cell exhaustion due to the process called cellular senescence. Understanding how microRNA pathways can regulate cellular senescence is crucial for the development of novel (...) diagnostic and therapeutic strategies to combat these pathologies. Herein, using integrated transcriptomic and semi-quantitative proteomic analysis, we provide a system level view of the regulation of human adipose-derived stem cell senescence by a subset of mature microRNAs (termed senescence-associated-microRNAs) produced by biogenesis of oncogenic MIR17HG and tumor-suppressive MIR100HG clusters. We demonstrate functional significance of these mature senescence-associated-microRNAs in the process

2017 NPJ aging and mechanisms of disease

987. Racial Differences in Associations of Blood Pressure Components in Young Adulthood With Incident Cardiovascular Disease by Middle Age: Coronary Artery Risk Development in Young Adults (CARDIA) Study Full Text available with Trip Pro

Racial Differences in Associations of Blood Pressure Components in Young Adulthood With Incident Cardiovascular Disease by Middle Age: Coronary Artery Risk Development in Young Adults (CARDIA) Study Data are sparse regarding which blood pressure (BP) components in young adulthood optimally determine cardiovascular disease (CVD) by middle age.To assess which BP components best determine incident CVD events in young adults and determine whether these associations vary by race and age at BP (...) measurement.Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, this study assessed the longitudinal race-stratified associations between BP and cardiovascular outcomes. CARDIA is a community-based cohort that recruited black and white individuals (age range, 18-30 years) from March 26, 1985, through June 7, 1986. CARDIA followed up participants for up to 28 years, and 94% of the surviving cohort completed at least 1 telephone interview or examination from August 2009 through

2017 JAMA cardiology

988. Association of Coronary Artery Calcium in Adults Aged 32 to 46 Years With Incident Coronary Heart Disease and Death Full Text available with Trip Pro

Association of Coronary Artery Calcium in Adults Aged 32 to 46 Years With Incident Coronary Heart Disease and Death Coronary artery calcium (CAC) is associated with coronary heart disease (CHD) and cardiovascular disease (CVD); however, prognostic data on CAC are limited in younger adults.To determine if CAC in adults aged 32 to 46 years is associated with incident clinical CHD, CVD, and all-cause mortality during 12.5 years of follow-up.The Coronary Artery Risk Development in Young Adults (...) (CARDIA) Study is a prospective community-based study that recruited 5115 black and white participants aged 18 to 30 years from March 25, 1985, to June 7, 1986. The cohort has been under surveillance for 30 years, with CAC measured 15 (n = 3043), 20 (n = 3141), and 25 (n = 3189) years after recruitment. The mean follow-up period for incident events was 12.5 years, from the year 15 computed tomographic scan through August 31, 2014.Incident CHD included fatal or nonfatal myocardial infarction, acute

2017 JAMA cardiology

989. Longitudinal Assessment of PTH in Community-Dwelling Older Women—Elevations Are Not Associated With Mortality Full Text available with Trip Pro

Longitudinal Assessment of PTH in Community-Dwelling Older Women—Elevations Are Not Associated With Mortality In older women, the magnitude of elevated parathyroid hormone (PTH) and its consequence is unclear.To describe normal PTH profiles over time and the association with mortality.There were 1044 community-dwelling women in the Malmö Osteoporosis Prospective Risk Assessment cohort (OPRA) who attended baseline (age 75 years). Follow-ups were attended by 715 (age 80 years) and 382 (age 85 (...) years).PTH, estimated glomerular filtration rate (eGFR), 25-hydroxyvitamin D (25OHD) and mortality.At age 75 years, PTH levels for most (n = 877, 88%) were within the normal reference range (NRR) (i.e., <6.9 pmol/L). Longitudinally, between ages 75 and 80 years, PTH increased in 60% of all women (n = 390) but increases of up to 50% above baseline values (64%; n=250) still resulted in PTH levels within the NRR. These women had lower 25OHD levels (74 vs 83 nmol/L, P = 0.001). Only when increases were

2017 Journal of the Endocrine Society

990. Low back pain in older adults: risk factors, management options and future directions Full Text available with Trip Pro

Low back pain in older adults: risk factors, management options and future directions Low back pain (LBP) is one of the major disabling health conditions among older adults aged 60 years or older. While most causes of LBP among older adults are non-specific and self-limiting, seniors are prone to develop certain LBP pathologies and/or chronic LBP given their age-related physical and psychosocial changes. Unfortunately, no review has previously summarized/discussed various factors that may (...) affect the effective LBP management among older adults. Accordingly, the objectives of the current narrative review were to comprehensively summarize common causes and risk factors (modifiable and non-modifiable) of developing severe/chronic LBP in older adults, to highlight specific issues in assessing and treating seniors with LBP, and to discuss future research directions. Existing evidence suggests that prevalence rates of severe and chronic LBP increase with older age. As compared to working-age

2017 Scoliosis and spinal disorders

991. Associations of Maternal Antidepressant Use During the First Trimester of Pregnancy With Preterm Birth, Small for Gestational Age, Autism Spectrum Disorder, and Attention-Deficit/Hyperactivity Disorder in Offspring. Full Text available with Trip Pro

Associations of Maternal Antidepressant Use During the First Trimester of Pregnancy With Preterm Birth, Small for Gestational Age, Autism Spectrum Disorder, and Attention-Deficit/Hyperactivity Disorder in Offspring. Prenatal antidepressant exposure has been associated with adverse outcomes. Previous studies, however, may not have adequately accounted for confounding.To evaluate alternative hypotheses for associations between first-trimester antidepressant exposure and birth (...) weeks), small for gestational age (birth weight <2 SDs below the mean for gestational age), and first inpatient or outpatient clinical diagnosis of autism spectrum disorder and attention-deficit/hyperactivity disorder in offspring.Among 1 580 629 offspring (mean gestational age, 279 days; 48.6% female; 1.4% [n = 22 544] with maternal first-trimester self-reported antidepressant use) born to 943 776 mothers (mean age at childbirth, 30 years), 6.98% of exposed vs 4.78% of unexposed offspring were

2017 JAMA

992. Immune dysfunctionality of replicative senescent mesenchymal stromal cells is corrected by IFNγ priming Full Text available with Trip Pro

Immune dysfunctionality of replicative senescent mesenchymal stromal cells is corrected by IFNγ priming Industrial-scale expansion of mesenchymal stromal cells (MSCs) is often used in clinical trials, and the effect of replicative senescence on MSC functionality is of mechanistic interest. Senescent MSCs exhibit cell-cycle arrest, cellular hypertrophy, and express the senescent marker β-galactosidase. Although both fit and senescent MSCs display intact lung-homing properties in vivo, senescent (...) MSCs acquire a significant defect in inhibiting T-cell proliferation and cytokine secretion in vitro. IFNγ does not upregulate HLA-DR on senescent MSCs, whereas its silencing did not reverse fit MSCs' immunosuppressive properties. Secretome analysis of MSC and activated peripheral blood mononuclear cell coculture demonstrate that senescent MSCs are significantly defective in up (vascular endothelial growth factor [VEGF], granulocyte colony-stimulating factor [GCSF], CXCL10, CCL2) or down (IL-1ra

2017 Blood advances

993. Links between primary occupation and functional limitations among older adults in Mexico Full Text available with Trip Pro

Links between primary occupation and functional limitations among older adults in Mexico Social inequalities in health and disability are often attributed to differences in childhood adversity, access to care, health behavior, residential environments, stress, and the psychosocial aspects of work environments. Yet, disadvantaged people are also more likely to hold jobs requiring heavy physical labor, repetitive movement, ergonomic strain, and safety hazards. We investigate the role of physical (...) work conditions in contributing to social inequality in mobility among older adults in Mexico, using data from the Mexican Health and Aging Survey (MHAS) and an innovative statistical modeling approach. We use data on categories of primary adult occupation to serve as proxies for jobs with more or less demanding physical work requirements. Our results show that more physically demanding jobs are associated with mobility limitations at older ages, even when we control for age and sex. Inclusion

2017 SSM - population health

994. Effect of Resveratrol on Walking Performance in Older People With Peripheral Artery Disease: The RESTORE Randomized Clinical Trial Full Text available with Trip Pro

Effect of Resveratrol on Walking Performance in Older People With Peripheral Artery Disease: The RESTORE Randomized Clinical Trial Research shows that resveratrol, a sirtuin activator in red wine, improves exercise endurance and skeletal-muscle oxidative metabolism in animals and may enhance vascular function in humans. Resveratrol supplement sales exceed $30 million annually in the United States, but few data are available regarding its efficacy in humans.To determine whether resveratrol, 125 (...) mg/d or 500 mg/d, improves the 6-minute walk performance in patients with peripheral artery disease (PAD).This parallel-design, double-blind, randomized clinical trial, called Resveratrol to Improve Outcomes in Older People With PAD (RESTORE), was conducted at Northwestern University. Sixty-six participants 65 years or older with PAD were randomized to receive a daily capsule of resveratrol, 125 mg or 500 mg, or placebo for 6 months. Participants were randomized using a randomly permuted block

2017 JAMA cardiology Controlled trial quality: predicted high

995. Drought and the risk of hospital admissions and mortality in older adults in western USA from 2000 to 2013: a retrospective study Full Text available with Trip Pro

Drought and the risk of hospital admissions and mortality in older adults in western USA from 2000 to 2013: a retrospective study Occurrence, severity and geographic extent of droughts are anticipated to increase under climate change, but the health consequences of drought conditions are unknown. We estimate risks of cardiovascular and respiratory-related hospitalization and mortality associated with drought conditions for the western U.S. elderly population.For counties in the western U.S. (N (...) =618) and for the period 2000 to 2013, we use data from the U.S. Drought Monitor to identify: 1) full drought periods; 2) non-drought periods; and 3) worsening drought periods stratified by low- and high-severity. We use Medicare claims to calculate daily rates of cardiovascular admissions, respiratory admissions, and deaths among adults 65 years or older. Using a two-stage hierarchical model, we estimated the percentage change in health risks when comparing drought to non-drought period days

2017 The Lancet. Planetary health

996. Genetics of Sex Hormone-Binding Globulin and Testosterone Levels in Fertile and Infertile Men of Reproductive Age Full Text available with Trip Pro

Genetics of Sex Hormone-Binding Globulin and Testosterone Levels in Fertile and Infertile Men of Reproductive Age Testosterone (T) is a central androgenic hormone, and sex hormone-binding globulin (SHBG) is the major determinant of its bioactivity. There are no acknowledged genetic variants with clear-cut clinical implications, modulating T levels in men.To confirm genetic associations of top loci (SHBG, GCKR, SLCO1B1, and JMJD1C) from genome-wide association (GWA) studies for serum SHBG (...) are hypotestosteronemia among aging men and pharmacogenetics of hormone replacement therapy.

2017 Journal of the Endocrine Society

997. Outcome of Elderly Patients with Diffuse Large B-cell Lymphoma Treated with R-CHOP: Results from the UK NCRI R-CHOP14v21 trial with combined analysis of molecular characteristics with the DSHNHL RICOVER-60 trial. Full Text available with Trip Pro

-CHOP-14 and R-CHOP-21 in newly diagnosed DLBCL patients aged 19-88 years, but data on elderly patients have not been reported in detail so far. Here, we provide a subgroup analysis of patients ≥60 years treated on the R-CHOP14v21 trial with extended follow-up.Six hundred and four R-CHOP14v21 patients ≥60 years were included in this subgroup analysis, with a median follow-up of 77.7 months. To assess the impact of MYC rearrangements (MYC-R) and double-hit-lymphoma (DHL) on outcome in elderly (...) Outcome of Elderly Patients with Diffuse Large B-cell Lymphoma Treated with R-CHOP: Results from the UK NCRI R-CHOP14v21 trial with combined analysis of molecular characteristics with the DSHNHL RICOVER-60 trial. There is an on-going debate whether 2- or 3-weekly administration of R-CHOP is the preferred first-line treatment for elderly patients with diffuse large B-cell lymphoma (DLBCL). The UK NCRI R-CHOP14v21 randomized phase 3 trial did not demonstrate a difference in outcomes between R

2017 Annals of oncology : official journal of the European Society for Medical Oncology Controlled trial quality: uncertain

998. Multimorbidity: constellations of conditions across subgroups of midlife and older individuals, and related Medicare expenditures Full Text available with Trip Pro

syndromes were prominently present with higher CCMM counts. Among fee-for-service Medicare beneficiaries aged 50-64 years, 26.7% of the participants presented with ≥10 CCMM, but incurred 48% of the expenditure. In those aged ≥65 years, these percentages were 16.9% and 34.4%, respectively.Functional limitations and geriatric syndromes considerably add to the MM burden in midlife and older adults. This burden is much higher than previously reported. (...) Multimorbidity: constellations of conditions across subgroups of midlife and older individuals, and related Medicare expenditures The Department of Health and Human Services' 2010 Strategic Framework on Multiple Chronic Conditions called for the identification of common constellations of conditions in older adults.To analyze patterns of conditions constituting multimorbidity (CCMM) and expenditures in a US representative sample of midlife and older adults (50-64 and ≥65 years of age

2017 Journal of comorbidity

999. Relationship between skeletal muscle mass and cardiac function during exercise in community‐dwelling older adults Full Text available with Trip Pro

Relationship between skeletal muscle mass and cardiac function during exercise in community‐dwelling older adults This study aimed to investigate the relationship between skeletal muscle mass and cardiac functional parameters in older adults during cardiopulmonary exercise testing (CPET).Sixty-three Japanese community-dwelling older adults were enrolled (20 men and 43 women; mean age 80 years, range 65-97 years). Cardiac functional parameters during exercise were assessed using CPET. Skeletal

2017 ESC heart failure

1000. Survival outcomes in the very elderly with DLBCL prior to and after the introduction of rituximab: a US population-based study Full Text available with Trip Pro

Survival outcomes in the very elderly with DLBCL prior to and after the introduction of rituximab: a US population-based study 29296703 2018 11 13 2473-9529 1 10 2017 Apr 11 Blood advances Blood Adv Survival outcomes in the very elderly with DLBCL prior to and after the introduction of rituximab: a US population-based study. 615-618 10.1182/bloodadvances.2016002675 Giri Upama U 0000-0002-3676-6193 Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN

2017 Blood advances