Comparing the first and the second waves of COVID-19 in Italy: differences in epidemiological features and CT findings using a semi-quantitative score

Abstract Purpose CT findings of hospitalized COVID-19 patients were analyzed during both the first and the second waves of the pandemic, in order to detect any significant differences between the two groups. Methods In this observational, retrospective, monocentric study, all hospitalized patients who underwent CT for suspected COVID-19 pneumonia from February 27 to March 27, 2020 (first wave) and from October 26 to November 24, 2020 (second wave) were enrolled. Epidemiological data, radiological pattern according to the RSNA consensus statement and visual score extension using a semi-quantitative score were compared. Results Two hundred and eleven patients (mean age, 64.52 years ± 15.14, 144 males) were evaluated during the first wave while 455 patients (mean age, 68.26 years ± 16.34, 283 males) were studied during the second wave. The same prevalence of patterns was documented in both the first and the second waves (p = 0.916), with non-typical patterns always more frequently observed in elderly patients, especially the “indeterminate” pattern. Compared to those infected during the first wave, the patients of the second wave were older (64.52 vs.68.26, p = 0.005) and presented a slightly higher mean semi-quantitative score (9.0 ± 2.88 vs. 8.4 ± 3.06, p = 0.042). Age and semi-quantitative score showed a positive correlation (r = 0.15, p = 0.001). Conclusions There was no difference regarding CT pattern prevalence between the first and the second waves, confirming both the validity of the RSNA consensus and the most frequent radiological COVID-19 features. Non-typical COVID-19 features were more frequently observed in older patients, thus should not be underestimated in the elderly population.

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Are Standard Doses of Renally-Excreted Antiretrovirals in Older Patients Appropriate: A PBPK Study Comparing Exposures in the Elderly Population With Those in Renal Impairment

Drugs in R&D ◽

10.1007/s40268-019-00285-0 ◽

2019 ◽

Vol 19 (4) ◽

pp. 339-350 ◽

Cited By ~ 2

Author(s):

M. De Sousa Mendes ◽

Manoranjenni Chetty

Keyword(s):

Renal Impairment ◽

Older Patients ◽

Elderly Population ◽

The Elderly

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Nutrihealth Study: Seasonal Variation in Vitamin D Status Among the Slovenian Adult and Elderly Population

Nutrients ◽

10.3390/nu12061838 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1838 ◽

Cited By ~ 1

Author(s):

Maša Hribar ◽

Hristo Hristov ◽

Matej Gregorič ◽

Urška Blaznik ◽

Katja Zaletel ◽

...

Keyword(s):

Vitamin D ◽

Seasonal Variation ◽

Vitamin D Deficiency ◽

Elderly Population ◽

Sun Exposure ◽

Epidemiological Data ◽

The Elderly ◽

Vitamin D Insufficiency ◽

Ultraviolet B ◽

Vitamin D Status

Several studies conducted around the world showed substantial vitamin D insufficiency and deficiency among different population groups. Sources of vitamin D in the human body include ultraviolet B (UVB)-light-induced biosynthesis and dietary intake, but people’s diets are often poor in vitamin D. Furthermore, in many regions, sun exposure and the intensity of UVB irradiation during wintertime are not sufficient for vitamin D biosynthesis. In Slovenia, epidemiological data about vitamin D status in the population were investigated through a national Nutrihealth study—an extension to the national dietary survey SI.Menu (2017/18). The study was conducted on a representative sample of 125 adult (18–64 years) and 155 elderly (65–74 years old) subjects, enrolled in the study in different seasons. Their vitamin D status was determined by measuring the serum 25-hydroxy-vitamin D (25(OH)D) concentration. Thresholds for vitamin D deficiency and insufficiency were 25(OH)D levels below 30 and 50 nmol/L, respectively. Altogether, 24.9% of the adults and 23.5% of the elderly were found to be vitamin D deficient, while an insufficient status was found in 58.2% and 62.9%, respectively. A particularly concerning situation was observed during extended wintertime (November–April); vitamin D deficiency was found in 40.8% and 34.6%, and insufficient serum 25(OH)D levels were observed in 81.6% and 78.8%, respectively. The results of the study showed high seasonal variation in serum 25(OH)D levels in both the adult and elderly population, with deficiency being especially pronounced during wintertime. The prevalence of this deficiency in Slovenia is among the highest in Europe and poses a possible public health risk that needs to be addressed with appropriate recommendations and/or policy interventions.

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Nasopharyngeal Angiofibroma: A Forgotten Entity in Older Patients

Clinical Medicine Insights Case Reports ◽

10.1177/1179547619841062 ◽

2019 ◽

Vol 12 ◽

pp. 117954761984106

Author(s):

Vanessa C Stubbs ◽

Lauren E Miller ◽

Arjun K Parasher ◽

Jordan T Glicksman ◽

Nithin D Adappa ◽

...

Keyword(s):

Surgical Resection ◽

Older Patients ◽

Elderly Population ◽

Nasal Congestion ◽

The Elderly ◽

Middle Cranial Fossa ◽

Nasopharyngeal Angiofibroma ◽

Staging Systems ◽

Local Destruction ◽

Cranial Fossa

Introduction: Nasopharyngeal angiofibroma (NA) characteristically affects adolescent men. Although benign, these tumors can cause local destruction and surgical resection is warranted. Objective: We present a case of a 62-year-old man with nasal congestion and epistaxis, found to be a right NA on pathology. We also present a review of the available NA staging systems. Findings: In this case of NA, imaging revealed an aggressive, hypervascular mass in the nasal cavity with involvement of the middle cranial fossa and cavernous sinus. The patient underwent complete endoscopic surgical resection following vascular embolization. Conclusions: Although it is rare, NA should not be disregarded in the elderly population.

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Management of Elderly Patients with Rapidly Progressive Glomerulonephritis

Blood Purification ◽

10.1159/000485368 ◽

2018 ◽

Vol 45 (1-3) ◽

pp. 213-217

Author(s):

Zdenka Hruskova ◽

Vladimir Tesar

Keyword(s):

Elderly Patients ◽

Older Patients ◽

Elderly Population ◽

Retrospective Studies ◽

Severe Disease ◽

Immunosuppressive Treatment ◽

Rapidly Progressive Glomerulonephritis ◽

The Elderly ◽

Younger Patients ◽

Common Diagnosis

Background: Rapidly progressive glomerulonephritis (RPGN) is characterized by a rapid deterioration of renal function and by extracapillary proliferation in >50% of glomeruli. The most common type of RPGN is “pauci-immune” glomerulonephritis caused by anti-neutrophil cytoplasmic antibodies-associated vasculitis (AAV). Summary: The incidence of AAV increases with age and pauci-immune glomerulonephritis is the most common diagnosis found in renal biopsies in the elderly population. Age was identified as an independent negative risk factor for both death and end-stage renal disease in AAV, and the mortality of older patients was uniformly higher than in younger patients in all retrospective studies. Early diagnosis may be difficult particularly in elderly patients with renal-limited disease but is important for the good outcome of the patients. Immunosuppressive treatment options include cyclophosphamide or rituximab combined with corticosteroids with or without plasma exchange in case of severe disease. Data from randomized trials are completely missing for patient aged >75 years. Based on retrospective studies, elderly patients seem to respond to immunosuppressive drugs just as younger patients are able to, but they are at a higher risk of adverse events. Key Messages: RPGN is relatively common in the elderly patients. Immunosuppressive treatment in older patients with AAV or RPGN may be useful but needs to be strictly individualized with all the risks taken into consideration. Further studies are needed to examine the role of novel therapeutic options in the elderly population with RPGN.

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CHEST RADIOGRAPHS OF COVID-19 PATIENTS AFFECTED IN FIRST AND SECOND COVID WAVE IN INDIA: A COMPARATIVE STUDY

10.36106/ijar/7103193 ◽

2021 ◽

pp. 29-30

Author(s):

Vicky Bakshi ◽

Sheeba Rana

Keyword(s):

The Elderly ◽

X Rays ◽

Age And Gender ◽

X Ray ◽

Classi Cation ◽

Chest X Ray ◽

Radiological Pattern ◽

The Difference ◽

And Gender ◽

Second Wave

INTRODUCTION: The COVID-19 pandemic in India is part of the global coronavirus disease pandemic of 2019 (COVID-19), which is caused by the coronavirus that causes severe acute respiratory syndrome (SARS-CoV-2). India was the rst country to report over 400,000 new cases in a 24-hour period on April 30, 2021. The problems with the second wave were increasing manifolds as the symptoms of COVID-19 infections were strange and not common to the rst wave. The majority of those infected in the rst wave were the elderly with various comorbidities, but as the second wave began, the trend shifted, with younger people becoming infected. This study was conducted to evaluate the difference between chest X rays of the subjects affected in the rst and the second wave of COVID19 in India MATERIAL AND METHODS: This was a retrospective study in which chest X ray PA view of 40 COVID positive patients from rst wave of pandemic and 40 such patients from second wave of pandemic were selected. The age and gender of the patient were also noted. Chest X rays were evaluated and classied according to BSTI(11) and Brixia scoring system(12). RESULTS AND DISCUSSION: Out of total 40 patients in the rst wave 14 (35%) were female and 26 (65%) male, whereas in second wave subjects 22 (55%) were male and 18 (45%) female. BSTI classication revealed that classical features of COVID19 pneumonia were more common in the rst wave. Chest X-rays were also classied according to Brixia scoring. The average Brixia score in wave 1 and wave 2 subjects was 6.925 and 8.825 respectively. CONCLUSION: Mutations occurring within the coronavirus and vaccination against it may play a possible role in the difference of radiological pattern and extent of the disease in the consecutive waves.

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Assessing Cognitive Functioning in Older Patients: The Why, Who, What, and How

Perspectives on Gerontology ◽

10.1044/gero17.1.17 ◽

2012 ◽

Vol 17 (1) ◽

pp. 17-26 ◽

Cited By ~ 2

Author(s):

Laura L. Murray

Keyword(s):

Service Provision ◽

Cognitive Assessment ◽

Older Patients ◽

Epidemiological Data ◽

Brain Structures ◽

The Elderly ◽

Census Bureau ◽

National Life ◽

Attention Memory ◽

The U.S

In the coming years, speech-language pathologists (SLPs) can expect the numbers of older patients on their caseloads to increase. Epidemiological data indicate that the elderly represent one of the fastest growing segments of the U.S. population as national life expectancy continues to increase (U.S. Census Bureau, 2011). Unfortunately, as people age, they become more vulnerable to medical conditions and diseases (e.g., hypertension, Alzheimer's disease, Parkinson's disease) that compromise the integrity of their brain structures and functioning (Alzheimer's Association, 2011; Roger et al., 2010). These conditions and diseases negatively affect our cognitive and communication abilities. In this article, I will focus on cognitive assessment, an important component of service provision to older patients. More specifically, I will review the rationale, issues, and procedures pertaining to evaluating attention, memory, and executive functioning abilities in older patients.

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The Incidence of Community-Acquired Pneumonia in the Elderly Population of the United States of America: A Systematic Review and Meta-Analysis

10.20944/preprints202105.0563.v1 ◽

2021 ◽

Author(s):

Ryan Sadjadi

Keyword(s):

Systematic Review ◽

Elderly Population ◽

Meta Analysis ◽

Epidemiological Data ◽

The Elderly ◽

The United States ◽

Incidence Rates ◽

Community Acquired Pneumonia ◽

Adverse Outcomes ◽

The Us

Current epidemiological data reports that adults aged 65 years and older comprise the most vulnerable age group with the highest proportion of CAP-attributable hospitalizations. Pneumococcal vaccine efficacy (VE) has been shown to decrease over time, contributing to increasing incidence rates of CAP. A holistic evaluation of age, sex, seasonality, and VE are is conducted in this systematic review and meta-analysis of 12 prospective and retrospective cohort studies. The findings suggest that incidence and age are positively associated and that incidence in females is more often reported to be higher in females than in males. In studies that observed seasonality of CAP, high seasons and low seasons were reported to be in winter and summer months, respectively. Lastly, studies that reviewed the effect of vaccination on incidence consistently found decreased observance of CAP in elderly adults following reception of PCV13 or PPSV23. However, one study suggested that such vaccinations may have decreased effectiveness in elderly populations and that research examining potential explanations for this require further investigation. Furthermore, distinct diagnostic and case ascertainment standards, descriptive measures, and methods of prevention and treatment of CAP used across the US are outlined in this review. Public health guidance such as encouraging the reception of pneumococcal vaccinations and mask-wearing during high seasons of CAP, and communicating the risks of not adhering to the aforementioned preventative measures can facilitate an effort to reduce the incidence of CAP and its associated adverse outcomes in the US elderly population.

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Validity and Reliability of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)

GeroPsych ◽

10.1024/1662-9647/a000209 ◽

2019 ◽

Vol 32 (3) ◽

pp. 145-151

Author(s):

Mahshid Foroughan ◽

Zahra Jafari ◽

Ida Ghaemmagham Farahani ◽

Vahid Rashedi

Keyword(s):

Psychometric Properties ◽

Elderly Population ◽

Formal Education ◽

The Elderly ◽

Cognitive State ◽

Validity And Reliability ◽

Internal Reliability ◽

Dsm Iv ◽

Test Retest Reliability ◽

Farsi Version

Abstract. This study examines the psychometric properties of the IQCODE and its applicability in the Iranian elderly population. A group of 95 elderly patients with at least 4 years of formal education who fulfilled the criteria of DSM-IV-TR for dementia were examined by the MMSE and the AMTs. The Farsi version of the IQCODE was subsequently administered to their primary caregivers. Results showed a significant correlation ( p = .01) between the score of the questionnaire and the results of the MMSE ( r = −0.647) and AMTs ( r = −0.641). A high internal reliability of the questionnaire was confirmed by Cronbach’s alpha coefficient (α = 0.927) and test-retest reliability by correlation coefficient ( r = 0.81). This study found that the IQCODE has acceptable psychometric properties and can be used for evaluating the cognitive state in the elderly population of Iran.

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