Evaluation of Treatment Strategies for Gastric Cancer in the Elderly According to the Number of Abnormal Parameters on Preoperative Examination

Background: Arginine is considered a semi-essential amino acid in healthy adults and the elderly. This amino acid seems to improve the immune system, stimulate cell growth and differentiation, and increase endothelial permeability, among other effects. For those reasons, it has been theorized that arginine supplementation may be used as an adjuvant to conventional cancer therapy treatments. Objective: This review aims to evaluate the existing knowledge of the scientific community on arginine supplementation in order to improve the efficacy of current cancer treatment. Results: Despite the continued efforts of science to improve treatment strategies, cancer remains one of the greatest causes of death on the planet in adults and elderly people. Chemo and radiotherapy are still the most effective treatments but at the cost of significant side effects. Conclusion: Thus, new therapeutic perspectives have been studied in recent years, to be used in addition to traditional treatments or not, seeking to treat or even cure the various types of cancer with fewer side effects.

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An age-dependent outcome analysis of microvascular decompression and percutaneous thermocoagulation in trigeminal neuralgia

BMC Neurology ◽

10.1186/s12883-021-02197-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Naureen Keric ◽

Darius Kalasauskas ◽

Sophia L. Kreth ◽

Martin B. Glaser ◽

Harald Krenzlin ◽

...

Keyword(s):

Trigeminal Neuralgia ◽

Microvascular Decompression ◽

Complication Rate ◽

Age Groups ◽

Treatment Strategies ◽

The Elderly ◽

Outcome Analysis ◽

Neurovascular Compression ◽

Duration Of Symptoms ◽

Ganglion Gasseri

Abstract Background Trigeminal neuralgia (TN) is a severe pain condition and the most common facial neuralgia. While microvascular decompression (MVD) presents an excellent treatment in neurovascular compression cases, percutaneous thermocoagulation (PT) of the ganglion Gasseri is an alternative option. This study aimed to evaluate post-operative complication rate and outcome of both treatment strategies related to the patient’s age. Methods The medical records of all patients with the diagnosis of trigeminal neuralgia undergoing an MVD or PT of the ganglion Gasseri (between January 2007 and September 2017) were reviewed to determine the efficacy and the complication rate of both methods in regard to the patient’s age. Results Seventy-nine patients underwent MVD surgery and 39 a PT. The mean age of patients in the MVD group was 61 years and 73 years in the PT group. There were 59 (50%) female patients. Nerve-vessel conflict could be identified in 78 (98.7%) MVD and 17 (43.6%) PT patients on preoperative MRI. Charlson comorbidity index was significantly higher in PT group (2.4 (1.8) versus 3.8 (1.8) p < 0.001). The Barrow pain score (BPS) at the last follow-up demonstrated higher scores after PT (p = 0.007). The complication rate was markedly higher in PT group, mostly due to the facial hypesthesia (84.6% versus 27.8%; p < 0.001). Mean symptom-free survival was significantly shorter in the PT group (9 vs. 26 months, p < 0.001). It remained statistically significant when stratified into age groups: (65 years and older: 9 vs. 18 months, p = 0.001). Duration of symptoms (OR 1.005, 95% CI 1.000–1.010), primary procedure (OR 6.198, 95% CI 2.650–14.496), patient age (OR 1.033, 95% CI 1.002–1.066), and postoperative complication rate (OR 2.777, 95% CI 1.309–5.890) were associated with treatment failure. Conclusion In this patient series, the MVD is confirmed to be an excellent treatment option independent of patient’s age. However, while PT is an effective procedure, time to pain recurrence is shorter, and the favorable outcome (BPS 1 and 2) rate is lower compared to MVD. Hence MVD should be the preferred treatment and PT should remain an alternative in very selected cases when latter is not possible but not in the elderly patient per se.

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Acute myocardial infarction in the elderly: Treatment strategies and 28-day-case fatality from the MONICA/KORA myocardial infarction registry

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.26159 ◽

2015 ◽

Vol 87 (4) ◽

pp. 680-688 ◽

Cited By ~ 6

Author(s):

Ute Amann ◽

Inge Kirchberger ◽

Margit Heier ◽

Wolfgang von Scheidt ◽

Bernhard Kuch ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Treatment Strategies ◽

Case Fatality ◽

The Elderly ◽

Day Case

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Pharmacological treatment strategies in mood, panic and obsessive compulsive disorders

Acta Neuropsychiatrica ◽

10.1017/s092427080003725x ◽

1996 ◽

Vol 8 (1) ◽

pp. 17-24

Author(s):

W.M.A. Verhoeven ◽

S. Tuinier ◽

J.B.G.M. Noten

Keyword(s):

Depressive Disorders ◽

Psychiatric Comorbidity ◽

Treatment Strategies ◽

The Elderly ◽

Tricyclic Antidepressant ◽

Obsessive Compulsive ◽

Obsessive Compulsive Disorders ◽

Potential Interactions ◽

Compulsive Disorders ◽

Isozyme System

SummarySince the introduction of the monoamine oxydase inhibitors and the first tricyclic antidepressant (TCA) imipramine in the late fifties, the treatment of depressive disorders has been changed dramatically. Althought a great variety of antidepressants such as TCA's, selective serotoninte-re-uptake inhibitors (SSRI's) mianserin, trazodone, mirtazapine, moclobemide and venlafaxine has become available, the exact mode of action is not revealed as yet, and classification should be done according to the interference of antidepressants with central monoaminergic processes.As to the potential of causing interactions, special attention has to be given to the SSRI's because of their interference with the CYP450 isozyme system. Therapeutic monotoring is recommended for the TCA's. The choiseforan antidepressant should be based on various factors like symptomatology and severity of the depression, potential interactions and somatic and/or psychiatric comorbidity.Extensive clinical research has demonstrated that TCA's are the most effective for major depression with melancholia (vital depression) and depressive disorders in the elderly.

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Bioactive compounds from Lactarius deterrimus interfere with the invasive potential of gastric cancer cells

Acta Biochimica Polonica ◽

10.18388/abp.2020_5915 ◽

2021 ◽

Author(s):

Kamila Król ◽

Maciej Pudełek ◽

Gracjana Krzysiek-Mączka ◽

Mateusz Wierdak ◽

Bożena Muszyńska ◽

...

Keyword(s):

Gastric Cancer ◽

Bioactive Compounds ◽

Treatment Strategies ◽

Cancer Therapies ◽

Invasive Potential ◽

Gastric Cancer Cells ◽

Ags Cells ◽

Phenolic Fraction ◽

Atp Production ◽

Cytoskeleton Rearrangements

Stomach cancer is the 4th most common cancer diagnosed worldwide. Despite intensive research on its etiopathology, its treatment strategies have not changed in the last 50 years. Mushrooms have recently attracted much attention as the source of bioactive compounds that can potentially complement cancer therapies. Here, we extracted a phenolic fraction from Lactarius deterrimus and analyzed its composition and bioactivity against the gastric cancer (AGS) cells. The complexity of L. deterrimus compounds was revealed by an HPLC assay, and was accompanied by cytostatic, cytotoxic and anti-invasive effects of the L. deterrimus extract (LDE). These are illustrated by inhibition of the AGS cells’ proliferation, metabolic activity and motility, and by induction of the cytoskeleton rearrangements. Apparently, these effects are exerted via activation of intracellular oxidative stress and decreased ATP production in AGS cells that could not be compensated by induction of autophagy. Less severe LDE effects were seen on physiology of normal gastric fibroblasts; however, inhibition of their motility indicates that LDE can interfere with gastric cancer development via an effect on stromal cells. Along with the observed synergy of LDE and cisplatin/5-fluorouracil effects on AGS cells, our data show the potential of LDE for supplementation of the gastric cancer therapy.

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Survival Based On The Pathologic Lymph Node Ratio For Local Advanced Gastric Cancer; Elderly Patients Versus Non Elderly Patients

10.21203/rs.3.rs-1176546/v1 ◽

2021 ◽

Author(s):

Omer Yalkin ◽

Nidal Iflazoglu ◽

Olgun Deniz ◽

Mustafa Yener Uzunoglu ◽

Ezgi Isil Turhan

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Elderly Patients ◽

Advanced Gastric Cancer ◽

Lymph Node Ratio ◽

Locally Advanced ◽

Survival Rates ◽

The Elderly ◽

Survival Difference ◽

Node Ratio

Abstract Objective: The aim of this study was to clarify the prognostic value of the pathological lymph node ratio for elderly and non-elderly gastric cancer patients and to evaluate whether there is a difference in the survival of patients with the same LNR (Lymph Node Ratio).Materials and Methods: A total of 222 patients diagnosed with locally advanced gastric cancer and who underwent gastrectomy were included. The patients were divided into two groups according to age. Clinicopathological properties of the two groups were compared. Potential prognostic factors affecting survival were analyzed. Subsequently, the effect of lymphadenectomy and LNR on survival in both groups was evaluated. Results: Significant differences were detected in terms of the location of primary lesions, hemoglobin and albumin levels between elderly patients and non-elderly patients (p < .05). Overall survival (OS) was significantly worse in elderly patients (22 months vs. 67 months, p<0.001). The survival rates in elderly patients were significantly lower from those of non-elderly in the subgroup LNR Stage 2 (12.1% vs. 47.9 %, P = 0.004) and LNR Stage 3 classification (9.1% vs. 34.1%, P = 0.039). LNR was found to be significant for OS with a cut-off point of 0.18. Conclusion: A survival difference was found between the elderly and non-elderly patients with the same LNR. LNR was found to be an independent factor for survival especially in elderly patients. Survival was found to be further decreased in elderly patients compared to non-elderly patients with increasing LNR.

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Underestimated Value of Sarcopenia in Gastric Cancer Surgery

Lietuvos chirurgija ◽

10.15388/lietchirur.2020.19.20 ◽

2020 ◽

Vol 19 (1-2) ◽

pp. 12-19

Author(s):

Martynas Lukšta ◽

Raminta Lukšaitė-Lukštė ◽

Augustinas Baušys ◽

Kęstutis Strupas

Keyword(s):

Gastric Cancer ◽

Clinical Trials ◽

Clinical Practice ◽

Treatment Strategies ◽

Significant Risk ◽

Bioelectrical Impedance ◽

Significant Risk Factor ◽

Impedance Analysis ◽

Routine Clinical Practice ◽

Gastric Cancer Treatment

Surgery remains the only potentially curative option for gastric cancer, although it is related to high postoperative morbidity and mortality rate. Approximately every second gastric cancer patient is diagnosed with sarcopenia, which is a significant risk factor for postoperative complications and poor long-term outcomes. However, sarcopenia is underestimated in routine clinical practice, since it remains the interest of clinical trials. Sarcopenia diagnostic criteria are not fully standardized, but it consists of tests for muscle strength, quantity and quality. They include grip strength, chair stand test, computed tomography, magnetic resonance imaging, ultrasound, bioelectrical impedance analysis and densitometry tests. Regarding the growing evidence for sarcopenia impact on surgical gastric cancer treatment results, it is a high probability that sarcopenia assessment will come to routine clinical practice. Although, until then there is a need for further clinical trials to standardize the diagnostic and to find effective treatment strategies.

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Skrining Osteoporosis Dengan Ultrasonografi Kalkaneus Sebagai Upaya Pencegahan Patah Tulang Pada Usia Lanjut

Society ◽

10.37802/society.v1i2.132 ◽

2021 ◽

Vol 1 (2) ◽

pp. 122-134

Author(s):

Basuki Supartono ◽

Sofia Wardhani ◽

Prita Kusumaningsih

Keyword(s):

Community Service ◽

Bone Densitometry ◽

Screening Program ◽

Treatment Strategies ◽

Osteoporotic Fractures ◽

The Elderly ◽

Osteoporosis Prevention ◽

Osteoporosis Screening ◽

The Government ◽

Ultrasound Bone

Abstrak Latar Belakang. Patah tulang osteoporosis pada usia lanjut menimbulkan banyak komplikasi dan menjadi beban ekonomi. Pemerintah telah melakukan strategi pencegahan dan pengobatan namun belum melakukan strategi skrining osteoporosis. Bila hal ini tidak dilakukan maka beban tersebut akan semakin berat di masa mendatang. Skrining dapat dilakukan menggunakan alat pengukur densitas tulang ultrasonografi kalkaneus. Alat ini ringan, mudah dipindah-pindahkan, aman, nyaman dan hasilnya akurat untuk skrining tulang. Alat ini adalah alternatif diagnosis osteoporosis secara dini sebagai strategi pencegahan patah tulang osteoporosis pada kaum lanjut usia terutama bagi warga desa. Kegiatan skrining akan maksimal hasilnya bila menggunakan pendekatan kolaborasi dengan melibatkan berbagai pemangku kepentingan. Analisis situasi. Kelurahan Tugu, Kecamatan Cimanggis, Depok mempunyai banyak warga lanjut usia yang berisiko patah tulang. Terdapat kegiatan pos pembinaan terpadu (Posbindu) namun tidak mempunyai program pencegahan osteoporosis. Permasalahan. Belum adanya kegiatan pencegahan osteoporosis bagi warga desa lanjut usia. Solusi. Kegiatan pengabdian masyarakat berupa skrining osteoporosis dengan melibatkan Pos Pembinaan Terpadu menggunakan alat ultrasonografi kalkaneus. Kesimpulan. Pencegahan osteoporosis wanita lansia di desa berhasil dilakukan melalui skrining tulang menggunakan alat ultrasonografi kalkaneus berkolaborasi dengan Posbindu setempat. Kata Kunci: pengabdian masyarakat, osteoporosis, patah tulang, usia lanjut, ultrasonografi kalkaneus Abstract Background. Osteoporotic fractures in the elderly cause many complications and become an economic burden. The government has implemented prevention and treatment strategies but has not implemented osteoporosis screening strategies. If this is not done, the burden will become heavier in the future. Screening can be performed using a calcaneus ultrasound bone densitometry. This device is lightweight, portable, safe, comfortable, and accurate for bone screening. This tool is an alternative early diagnosis of osteoporosis as a strategy to prevent osteoporosis fractures in the elderly, especially for rural residents. Screening activities will have maximum results when using a collaborative approach involving various stakeholders. Situation analysis. Tugu Village, Cimanggis District, Depok has many elderly populations who are at risk of fractures. This village has an Integrated Healthcare Center (Posbindu), but it has no osteoporosis prevention program. Problem. There are no osteoporosis prevention activities for elderly villagers. Solution. Community service activities in the form of an osteoporosis screening program involving the Integrated Guidance Post using a calcaneus ultrasound. densitometry Conclusion. The prevention of osteoporosis fracture in elderly villagers has been successfully carried out through bone screening using a calcaneus ultrasound bone densitometry in collaboration with the local Posbindu. Keywords: community service, osteoporosis, fractures, elderly, calcaneus ultrasound densitometry

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