P87 The treatment of long-term co-morbidities in older patients with metastatic cancer

2009 ◽  
Vol 72 (1) ◽  
pp. S49
Author(s):  
J. Cashman ◽  
J. Wright ◽  
A. Ring
Keyword(s):  
Older Patients ◽  
Metastatic Cancer

scholarly journals An ARF GTPase module promoting invasion and metastasis through regulating phosphoinositide metabolism

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Marisa Nacke ◽  
Emma Sandilands ◽  
Konstantina Nikolatou ◽  
Álvaro Román-Fernández ◽  
Susan Mason ◽  
...  
Keyword(s):  
Metastatic Cancer ◽  
Cellular Responses ◽  
Signalling Pathways ◽  
External Signal ◽  
Phosphoinositide Metabolism ◽  
Invasion And Metastasis ◽  
3 Dimensional

AbstractThe signalling pathways underpinning cell growth and invasion use overlapping components, yet how mutually exclusive cellular responses occur is unclear. Here, we report development of 3-Dimensional culture analyses to separately quantify growth and invasion. We identify that alternate variants of IQSEC1, an ARF GTPase Exchange Factor, act as switches to promote invasion over growth by controlling phosphoinositide metabolism. All IQSEC1 variants activate ARF5- and ARF6-dependent PIP5-kinase to promote PI(3,4,5)P3-AKT signalling and growth. In contrast, select pro-invasive IQSEC1 variants promote PI(3,4,5)P3 production to form invasion-driving protrusions. Inhibition of IQSEC1 attenuates invasion in vitro and metastasis in vivo. Induction of pro-invasive IQSEC1 variants and elevated IQSEC1 expression occurs in a number of tumour types and is associated with higher-grade metastatic cancer, activation of PI(3,4,5)P3 signalling, and predicts long-term poor outcome across multiple cancers. IQSEC1-regulated phosphoinositide metabolism therefore is a switch to induce invasion over growth in response to the same external signal. Targeting IQSEC1 as the central regulator of this switch may represent a therapeutic vulnerability to stop metastasis.

scholarly journals Assessment of long-term cognitive dysfunction in older patients who undergo heart surgery

Neurología ◽  
2021 ◽  
Author(s):  
M. Florido-Santiago ◽  
L.M. Pérez-Belmonte ◽  
J. Osuna-Sánchez ◽  
M.A. Barbancho ◽  
M. Ricci ◽  
...  
Keyword(s):  
Cognitive Dysfunction ◽  
Older Patients ◽  
Heart Surgery

Older Patients’ and Next of Kin’s Perspectives on Continuity in Long-Term Home Health Care

2016 ◽  
Vol 28 (3) ◽  
pp. 142-149 ◽  
Author(s):  
Edith Roth Gjevjon ◽  
Tor Inge Romøren ◽  
Line Kildal Bragstad ◽  
Ragnhild Hellesø
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Older Patients ◽  
Home Health

Exercise therapy is effective at improving short- and long-term mobility, ADL and balance in older patients following hip fracture: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Signe Hulsbæk ◽  
Carsten Juhl ◽  
Alice Røpke ◽  
Thomas Bandholm ◽  
Morten Tange Kristensen
Keyword(s):  
Hip Fracture ◽  
Exercise Therapy ◽  
Lower Limb ◽  
Older Patients ◽  
Meta Analysis ◽  
Term Effect ◽  
Short Term ◽  
Short And Long Term ◽  
Moderate Effect

Abstract Background A systematic review and meta-analysis was performed to evaluate the short- and long-term effect of exercise therapy on physical function, independence and wellbeing in older patients following hip fracture, and secondly, whether the effect was modified by trial level characteristics such as intervention modality, duration and initiation timepoint. Methods Medline, CENTRAL, Embase, CINAHL and PEDro was searched up-to November 2020. Eligibility criteria was randomized controlled trials investigating the effect of exercise therapy on physical function, independence and wellbeing in older patients following hip fracture, initiated from time of surgery up-to 1-year. Results Forty-nine studies involving 3905 participants showed a small to moderate effect of exercise therapy at short term (end of intervention) on mobility (Standardized mean difference, SMD 0.49, 95%CI 0.22-0.76); Activities of Daily Living (ADL) (SMD 0.31, 95%CI 0.16-0.46); lower limb muscle strength (SMD 0.36, 95%CI 0.13-0.60); balance (SMD 0.34, 95%CI 0.14-0.54). At long term (closest to 1-year), small to moderate effects were found for mobility (SMD 0.74, 95%CI 0.15-1.34); ADL (SMD 0.42, 95%CI 0.23-0.61); balance (SMD 0.50, 95%CI 0.07-0.94) and Health related Quality of Life (HRQoL) (SMD 0.31, 95%CI 0.03-0.59). Certainty of evidence was evaluated using GRADE ranging from moderate to very low, due to study limitation and inconsistency. Conclusion We found low certainty of evidence for a moderate effect of exercise therapy on mobility in older patients following hip fracture at end-of-treatment and follow-up. Further, low evidence was found for small to moderate short-term effect on ADL, lower limb muscle strength and balance.

scholarly journals Clinical Course, Serologic Response, and Long-Term Outcome in Elderly Patients with Early Lyme Borreliosis

2018 ◽  
Vol 7 (12) ◽  
pp. 506 ◽  
Author(s):  
Katarina Boršič ◽  
Rok Blagus ◽  
Tjaša Cerar ◽  
Franc Strle ◽  
Daša Stupica
Keyword(s):  
Lyme Borreliosis ◽  
Older Patients ◽  
Erythema Migrans ◽  
Middle Aged ◽  
Patient Age ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Incomplete Response ◽  
Patient Âgé

Infected elderly people often present with signs and symptoms that differ from those in younger adults, but data on the association between patient age and presentation of early Lyme borreliosis (LB) are limited. In this study, the association between patient age (18–44 years, young vs. 45–64 years, middle-aged vs. ≥ 65 years, elderly) and disease course, microbiologic characteristics, and the long-term outcome of treatment was investigated prospectively in 1220 adult patients with early LB manifesting as erythema migrans (EM) at a single-center university hospital. Patients were assessed at enrolment and followed-up for 12 months. Age was associated with comorbidities, previous LB, presenting with multiple EM, and seropositivity to borreliae at enrolment. The time to resolution of EM after starting antibiotic treatment was longer in older patients. At 12 months, 59/989 (6.0%) patients showed incomplete response. The odds for incomplete response decreased with time from enrolment (odds ratio (OR) of 0.49, 0.50, and 0.48 for 2-month vs. 14-days, 6-month vs. 2-month, and 12-month vs. 6-month follow-up visits, respectively), but were higher with advancing age (OR 1.57 for middle-aged vs. young, and 1.95 for elderly vs. young), in women (OR 1.41, 95% confidence interval (CI) 1.01–1.96), in patients who reported LB-associated constitutional symptoms at enrolment (OR 7.69, 95% CI 5.39–10.97), and in those who presented with disseminated disease (OR 1.65, 95% CI 1.09–2.51). The long-term outcome of EM was excellent in patients of all age groups. However, older patients had slower resolution of EM and higher odds for an unfavorable outcome of treatment (OR 1.57, 95% CI 1.05–2.34 for middle-aged vs. young; and OR 1.95, 95% CI 1.14–3.32 for elderly vs. young), manifested predominantly as post-LB symptoms. The presence of LB-associated constitutional symptoms at enrolment was the strongest predictor of incomplete response.

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