scholarly journals Nanomechanical and molecular characterization of aging in dentinal collagen

2021 ◽  
Author(s):  
Christina MAP Schuh ◽  
Camila Leiva-Sabadini ◽  
Sophia Huang ◽  
Nelson P Barrera ◽  
Laurent Bozec ◽  
...  
Keyword(s):  
Principal Component ◽  
Organic Matrix ◽  
The Elderly ◽  
Ultrastructural Changes ◽  
Old Patients ◽  
Therapeutic Implications ◽  
Force Microscopy ◽  
Adhesive Dentistry ◽  
Human Dentin ◽  
Root Dentin

Methylglyoxal (MGO) is an important molecule derived from glucose metabolism with the capacity of attaching to collagen and generating advanced glycation end-products (AGEs), which accumulate in tissues over time and are associated to aging and diseases. However, the accumulation of MGO-derived AGEs in dentin and their effect on the nanomechanical properties of dentinal collagen remain unknown. Thus, the aim of the present study was to quantify MGO-based AGEs in the organic matrix of human dentin as a function of age and associate these changes with alterations in the nanomechanical and ultrastructural properties of dentinal collagen. For this, twelve healthy teeth from <26 year-old and >50 year-old patients were collected and prepared to obtain crown and root dentin discs. Following demineralization, MGO-derived AGEs were quantified with a competitive ELISA assay. In addition, atomic force microscopy (AFM) nano-indentation was utilized to measure changes in elastic modulus in both peritubular (PT) and intertubular (IT) collagen fibrils. Finally, principal component analysis (PCA) was carried out to determine aging profiles for both crown and root dentin. Results showed increased presence of MGO AGEs in the organic matrix of dentin in the >50 year-old compared to <26 year-old samples in both crown and root. Furthermore, an overall increase in PT and IT collagen elasticity was observed in the >50 year-old group associated to ultrastructural changes in the organic matrix determined by AFM analysis. Furthermore, PCA loading plots suggested different 'aging profiles' in both crown and root dentin, which could potentially have important therapeutic implications in restorative and adhesive dentistry approaches. Overall, these results demonstrate that the organic matrix of human dentin undergoes aging-related changes due to MGO-derived AGEs with important changes in nanomechanical behavior of collagen that may impact diagnostic and restorative procedures in the elderly.

Cell surface changes during aging of human bladder epithelium examined by lectin probes and SEM

1990 ◽  
Vol 48 (3) ◽  
pp. 966-967
Author(s):  
J. Jacob ◽  
M.F.M. Ismail
Keyword(s):  
The Elderly ◽  
Ultrastructural Changes ◽  
Pokeweed Mitogen ◽  
Asymmetric Structure ◽  
Luminal Surface ◽  
Bladder Epithelium ◽  
Aldehyde Groups ◽  
Cell Surface Changes ◽  
Phosphate Buffered Saline ◽  
Surface Changes

Ultrastructural changes have been shown to occur in the urinary bladder epithelium (urothelium) during the life span of humans. With increasing age, the luminal surface becomes more flexible and develops simple microvilli-like processes. Furthermore, the specialised asymmetric structure of the luminal plasma membrane is relatively more prominent in the young than in the elderly. The nature of the changes at the luminal surface is now explored by lectin-mediated adsorption visualised by scanning electron microscopy (SEM).Samples of young adult (21-31 y old) and elderly (58-82 y old) urothelia were fixed in buffered 2% glutaraldehyde for 10 m and washed with phosphate buffered saline (PBS) containing Ca++ and Mg++ at room temperature. They were incubated overnight at 4°C in 0.1 M ammonium chloride in PBS to block any remaining aldehyde groups. The samples were then allowed to stand in PBS at 37°C for 2 h before incubation at 37°C for 30 m with lectins. The lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) at a concentration of 500 mg/ml in PBS at pH 7.A.

scholarly journals How to Treat Hepatocellular Carcinoma in Elderly Patients

2021 ◽  
Vol 14 (3) ◽  
pp. 233
Author(s):  
Piera Federico ◽  
Emilio Francesco Giunta ◽  
Annalisa Pappalardo ◽  
Andrea Tufo ◽  
Gianpaolo Marte ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Elderly Patients ◽  
Elderly Population ◽  
Primary Tumour ◽  
The Elderly ◽  
Chronic Liver Diseases ◽  
Old Patients ◽  
Choice Of Treatment ◽  
Definition Of ◽  
Optimal Treatment Strategy

Hepatocellular carcinoma (HCC) is the primary tumour of the liver with the greatest incidence, particularly in the elderly. Additionally, improvements in the treatments for chronic liver diseases have increased the number of elderly patients who might be affected by HCC. Little evidence exists regarding HCC in old patients, and the elderly are still underrepresented and undertreated in clinical trials. In fact, this population represents a complex subgroup of patients who are hard to manage, especially due to the presence of multiple comorbidities. Therefore, the choice of treatment is mainly decided by the physician in the clinical practice, who often tend not to treat elderly patients in order to avoid the possibility of adverse events, which may alter their unstable equilibrium. In this context, the clarification of the optimal treatment strategy for elderly patients affected by HCC has become an urgent necessity. The aim of this review is to provide an overview of the available data regarding the treatment of HCC in elderly patients, starting from the definition of “elderly” and the geriatric assessment and scales. We explain the possible treatment choices according to the Barcelona Clinic Liver Cancer (BCLC) scale and their feasibility in the elderly population.

HYPERTENSION IN ELDERLY:OUR CURRENT TRENDS

2021 ◽  
pp. 56-57
Author(s):  
Rohit Arora ◽  
D.K Sharma
Keyword(s):  
Blood Pressure ◽  
Elderly Patients ◽  
The Elderly ◽  
Common Disease ◽  
Old Patients ◽  
Current Trends ◽  
Increased Risk ◽  
Individualized Approach ◽  
Risk Of Falls ◽  
Optimal Target

Hypertension is a common disease in the elderly associated with signicant morbidity and mortality. Due to the complexity of this population, the optimal target of blood pressure (BP) control is still controversial. In this article, we conduct a literature review of trials published in English in the last 10 years which were specically designed to study the efcacy and safety of various BP targets in patients who are 70 years or older. Using these criteria, we found that the benets in the positive studies were demonstrated even with a minimal BPcontrol (systolic BP[SBP] <150 mmHg) and continued to be reported for a SBP<120 mmHg. On the other hand, keeping SBP<140 mmHg seemed to be safely achieved in elderly patients. Although the safety of lowering SBP to <120 mmHg is debated, Systolic Blood Pressure Intervention Trial study has shown no increased risk of falls, fractures, or kidney failure in elderly patients with SBP lower than this threshold. While the recent guidelines recommended to keep BP <130/80 mmHg in the elderly, more individualized approach should be considered to achieve this goal in order to avoid undesirable complications. Furthermore, further studies are required to evaluate BPtarget in very old patients or those with multiple comorbidities.

scholarly journals Small Extracellular Vesicles Isolated from Serum May Serve as Signal-Enhancers for the Monitoring of CNS Tumors

2020 ◽  
Vol 21 (15) ◽  
pp. 5359 ◽  
Author(s):  
Gabriella Dobra ◽  
Matyas Bukva ◽  
Zoltan Szabo ◽  
Bella Bruszel ◽  
Maria Harmati ◽  
...  
Keyword(s):  
Extracellular Vesicles ◽  
Serum Proteins ◽  
Lumbar Disc ◽  
Principal Component ◽  
Cns Tumors ◽  
Serum Samples ◽  
Force Microscopy ◽  
Isolation And Characterization ◽  
Atomic Force ◽  
Patient Groups

Liquid biopsy-based methods to test biomarkers (e.g., serum proteins and extracellular vesicles) may help to monitor brain tumors. In this proteomics-based study, we aimed to identify a characteristic protein fingerprint associated with central nervous system (CNS) tumors. Overall, 96 human serum samples were obtained from four patient groups, namely glioblastoma multiforme (GBM), non-small-cell lung cancer brain metastasis (BM), meningioma (M) and lumbar disc hernia patients (CTRL). After the isolation and characterization of small extracellular vesicles (sEVs) by nanoparticle tracking analysis (NTA) and atomic force microscopy (AFM), liquid chromatography -mass spectrometry (LC-MS) was performed on two different sample types (whole serum and serum sEVs). Statistical analyses (ratio, Cohen’s d, receiver operating characteristic; ROC) were carried out to compare patient groups. To recognize differences between the two sample types, pairwise comparisons (Welch’s test) and ingenuity pathway analysis (IPA) were performed. According to our knowledge, this is the first study that compares the proteome of whole serum and serum-derived sEVs. From the 311 proteins identified, 10 whole serum proteins and 17 sEV proteins showed the highest intergroup differences. Sixty-five proteins were significantly enriched in sEV samples, while 129 proteins were significantly depleted compared to whole serum. Based on principal component analysis (PCA) analyses, sEVs are more suitable to discriminate between the patient groups. Our results support that sEVs have greater potential to monitor CNS tumors, than whole serum.

scholarly journals Peritubular Dentin Lacks Piezoelectricity

2007 ◽  
Vol 86 (9) ◽  
pp. 908-911 ◽  
Author(s):  
S. Habelitz ◽  
B.J. Rodriguez ◽  
S.J. Marshall ◽  
G.W. Marshall ◽  
S.V. Kalinin ◽  
...  
Keyword(s):  
High Resolution ◽  
Piezoresponse Force Microscopy ◽  
Collagen Fibrils ◽  
Force Microscopy ◽  
Collagenous Tissue ◽  
Mineralized Tissues ◽  
Human Dentin ◽  
High Resolution Images ◽  
Resolution Imaging ◽  
Apatite Mineral

Dentin is a mesenchymal tissue, and, as such, is based on a collagenous matrix that is reinforced by apatite mineral. Collagen fibrils show piezoelectricity, a phenomenon that is used by piezoresponse force microscopy (PFM) to obtain high-resolution images. We applied PFM to image human dentin with 10-nm resolution, and to test the hypothesis that zones of piezoactivity, indicating the presence of collagen fibrils, can be distinguished in dentin. Piezoelectricity was observed by PFM in the dentin intertubular matrix, while the peritubular dentin remained without response. High-resolution imaging of chemically treated intertubular dentin attributed the piezoelectric effect to individual collagen fibrils that differed in the signal strength, depending on the fibril orientation. This study supports the hypothesis that peritubular dentin is a non-collagenous tissue and is thus an exception among mineralized tissues that derive from the mesenchyme.

P1564Atrial fibrillation and thromboembolic prophylaxis: focus on the frail oldest patient. how net clinical benefit influences anticoagulant therapy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G I Greco ◽  
C Ninivaggi ◽  
A Graceffa ◽  
S Novello ◽  
F Bonfante ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Major Bleeding ◽  
Clinical Benefit ◽  
The Elderly ◽  
Thromboembolic Events ◽  
Intracranial Hemorrhages ◽  
Old Patients ◽  
The Difference ◽  
Net Clinical Benefit ◽  
Very Old Patients

Abstract Background Atrial fibrillation is highly prevalent among the elderly population, which is also frequently prone to thromboembolic complications. Anticoagulant prophylaxis is underused in the elderly due to fear of bleeding, which tends to be more frequent and severe within this group. Randomized controlled trials and several observational studies have shown the comparative effectiveness of direct oral anticoagulant (DOAC) against vitamin K antagonists (VKA), and their superior safety, at least in terms of intracranial bleeding. However, for patients aged 85 or older, there is still insufficient literature, leaving unanswered the question of which prophylaxis to use. Purpose The aim of the study is to compare the incidence of established outcomes and to investigate the net clinical benefit between DOAC and VKA in patients aged ≥85 years. Methods A cohort of 553 outpatients from the real world began treatment using DOACs at our clinic. The prospective follow-up on average lasted 1.97 years. Main endpoints were stroke and systemic thromboembolism, major hemorrhage, myocardial infarction and mortality for all causes. A sample of the 160 patients aged ≥85 years was compared with the remaining younger ones and with a second cohort of 298 outpatients aged ≥85 years. Retrospectively analyzed, with follow-ups at our center, who started VKAs; the average time was 2.03 years. The “net clinical benefit” of DOACs against VKAs was calculated as the difference between thromboembolic events with VKAs and with DOACs, minus the difference (weighted by 1.5) between spontaneous intracranial bleeding with DOACs and VKAs. Results In terms of thromboembolic events, DOACs and VKAs (2.43% p-y vs. 1.82% p-y, p=0.975) have shown comparable efficacy in a higher risk sample (CHA2DS2-VASc score: 5.2 vs. 4.5; p<0.001). There were no differences in spontaneous intracranial hemorrhages (0.81% p-y vs. 1.16% p-y; p=0.419). Major bleeding was more frequent in DOACs (10.11% p-y vs. 4.13% p-y, p<0.05), although they are comparable if we consider patients in VKAs achieving a time in therapeutic range (TTR) <60%. Mortality, in all cases similar (13.75% p-y vs. 9.92% p-y; p=0.778), but was reduced in patients with VKAs therapy, with a TTR ≥60%. The net clinical benefit of DOACs compared to VKAs is noticeable in patients with a previous stroke or with CHA2DS2-VASc score <6, while VKAs may be more beneficial to patients with vascular disease or with CHA2DS2-VASc score ≥6. Conclusions DOACs are as effective in very old patients with atrial fibrillation compared to very old patients receiving VKAs, but they are associated with increased major bleeding. The same is true when compared with younger DOACs users. TTR, representing quality achieved by the anticoagulation with a VKA, can influence the comparison with DOACs. Considering ischemic strokes and spontaneous intracranial hemorrhages, there is however a net benefit for DOACs use in specific categories of elderly patients.

scholarly journals How Much Is One Life Worth? The Right to Equity Healthcare for Improving Older Patients’ Health Infected by COVID-19

2020 ◽  
Vol 12 (17) ◽  
pp. 6848
Author(s):  
Guiomar Merodio ◽  
Mimar Ramis-Salas ◽  
Diana Valero ◽  
Adriana Aubert
Keyword(s):  
Older People ◽  
Family Relationships ◽  
Older Patients ◽  
Social Inequalities ◽  
Negative Impact ◽  
Well Being ◽  
The Elderly ◽  
Resource Scarcity ◽  
Elderly Persons ◽  
Old Patients

Ageism has a tremendous negative impact on elderly persons and society. Discrimination against the elderly is a driver of health and social inequalities. The COVID-19 pandemic has posed new social and health challenges regarding resource scarcity and shortfalls. Under these difficult circumstances, discourses excluding, and discrimination against, older people have aroused. This article gathers evidence on hospital healthcare experiences of older people infected by COVID-19 during the pandemic outbreak in Spain and it analyzes elements that have positively influenced older patients’ perceived health and well-being. We conducted nine qualitative in-depth interviews in Madrid—one of the regions of Spain most affected by COVID-19—with older people that were hospitalized and recovered from COVID-19, family members of old patients infected with COVID-19, and nurses that attended infected older patients. Findings show the challenging experiences faced by older people who were hospitalized due to COVID-19, on the one hand, and the relevance of transformative aspects related to family relationships, solidarity actions, and humanized care that overcame age discrimination, favoring social and equity healthcare for the elderly on the other hand.

scholarly journals P0806RESIDUAL RENAL FUNCTION IS COMPLEMENTARY TO GERIATRIC ASSESSMENT SCORE IN ASSESSING CLINICAL RISK OF ELDERLY PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alberto Castagna ◽  
Davide Bolignano ◽  
Irma Figlia ◽  
Rosa Paola Cerra ◽  
Carmen Ruberto ◽  
...  
Keyword(s):  
Renal Function ◽  
Risk Stratification ◽  
Activities Of Daily Living ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Daily Living ◽  
The Elderly ◽  
Residual Renal Function ◽  
Elderly Subjects ◽  
Old Patients

Abstract Background and Aims Renal function impairment is highly pervasive in the elderly and triggers increased morbidity and mortality. Comprehensive geriatric assessment (CGA) is a validated multidisciplinary instrument to assess medical, psychosocial and functional limitations of old patients with diagnostic and risk-stratification purposes. In a focused cohort of frail individuals, we aimed at evaluating possible relationships between single CGA items and renal function. Method 254 consecutive elderly subjects (mean age 79.9±6.6 years, female 65.8%) from the geriatric division of a large Italian community hospital were studied. We collected clinical data including CGA and renal function (CKD-EPI formula). CGA single items included the Cumulative Illness Rating Scale (CIRS), the Exton Smith Scale (ESS), the Mini Nutritional Assessment Short Form (MNA-SF), the Katz‘s Activities of Daily Living (ADL), the Lawton’s Instrumental Activities of Daily Living (IADL), the Short Portable Mental Status Questionnaire (SPMSQ) and the amount of drugs administered (AD). Results Mean eGFR was 66.37±30.94 mL/min/1.73 m2. Overall, the reported CIRS, ESS, MNA, ADL and AD scores were low (7.6±3.3) while IADL and SPMQ were on a mild range, denoting a potential alarm signal for poor prognosis and the risk for adverse outcomes. At univariate analyses, eGFR was significantly associated with CIRS (R=-0.389, p&lt;0.0001), ESS (R=0.355, p&lt;0.0001), MNA (R=0.394, p&lt;0.0001), ADL (R=0.394, p&lt;0.0001), AD (R=-0.374, p&lt;0.0001. while a weak, although significant correlation was found with IADL (R=0.131, p=0.038) and SPMSQ (R=-0.141, p=0.038). In a fully adjusted multivariate analyses only SPMSQ (ß=-0.174, p=0.04), ADL (ß=0.182, p=0.012), IADL (ß =0.209, p=0.003) and AD (ß=-0.354, p&lt;0.0001) remained significant predictors of residual renal function. Conclusion In elderly frail subjects, residual renal function may influence daily life and cognitive activities, the perceived quality of living and the entity of drug assumption. Inclusion of renal function within a comprehensive geriatric assessment could help improving risk stratification in the elderly

Treating chronically psychotic patients in nursing homes

2016 ◽  
Vol 33 (S1) ◽  
pp. S37-S37 ◽  
Author(s):  
J. Gauillard
Keyword(s):  
Nursing Home ◽  
Psychotic Disorders ◽  
Psychiatric Symptoms ◽  
Psychiatric Hospitals ◽  
The Elderly ◽  
Sheltered Housing ◽  
Psychiatric Disease ◽  
Public Health Issue ◽  
Old Patients ◽  
Alzheimer Dementia

The increase of aging patients with schizophrenia becomes a public health issue. The exponential demography of the elderly, the improvement of cares associated with better physical follow-up directly impact the number of old patients with chronic psychiatric disease. Deinstitutionalization associated with a dramatic enhancement of ambulatory and community cares has led to a reduction of beds in psychiatric hospitals. When dependency occurs, due to physical comorbid illness or a worsening of the negative symptoms, psychiatric teams should find appropriate housing and no longer the psychiatric hospital. Nursing home and sheltered housing for the elderly dependent persons become a solution, but geriatric staffs are not always prepared to receive resident with schizophrenia and other psychotic disorders. They often are at a loss when faced with the expression of psychiatric symptoms or with the specificity of caring for often-younger patients whose behavior is different from older people with neurodegenerative disorders.How psychiatric teams could long-term assist the sheltered housing and nursing home and bring a psychiatric know-how within staffs often reluctant to deal with psychotic patients who could burden caregivers. How could they be trained to cope with complex cognitive functions impairments of schizophrenia, far from cognitive impairments of Alzheimer dementia? How to change the representation of psychiatric illness, which often leads to a double stigmatization (old age and madness)? Improving the quality of life of aging patients with severe chronic mental illness in homes for seniors is a great challenge for psychiatric teams in collaboration with geriatric caregivers.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals In situ X-ray scattering evaluation of heat-induced ultrastructural changes in dental tissues and synthetic hydroxyapatite

2014 ◽  
Vol 11 (95) ◽  
pp. 20130928 ◽  
Author(s):  
Tan Sui ◽  
Michael A. Sandholzer ◽  
Alexander J. G. Lunt ◽  
Nikolaos Baimpas ◽  
Andrew Smith ◽  
...  
Keyword(s):  
Heat Exposure ◽  
Organic Matrix ◽  
Material Design ◽  
Ultrastructural Changes ◽  
X Ray ◽  
Ultrastructural Alterations ◽  
Dental Tissues ◽  
X Ray Scattering ◽  
Ray Scattering

Human dental tissues consist of inorganic constituents (mainly crystallites of hydroxyapatite, HAp) and organic matrix. In addition, synthetic HAp powders are frequently used in medical and chemical applications. Insights into the ultrastructural alterations of skeletal hard tissues exposed to thermal treatment are crucial for the estimation of temperature of exposure in forensic and archaeological studies. However, at present, only limited data exist on the heat-induced structural alterations of human dental tissues. In this paper, advanced non-destructive small- and wide angle X-ray scattering (SAXS/WAXS) synchrotron techniques were used to investigate the in situ ultrastructural alterations in thermally treated human dental tissues and synthetic HAp powders. The crystallographic properties were probed by WAXS, whereas HAp grain size distribution changes were evaluated by SAXS. The results demonstrate the important role of the organic matrix that binds together the HAp crystallites in responding to heat exposure. This is highlighted by the difference in the thermal behaviour between human dental tissues and synthetic HAp powders. The X-ray analysis results are supported by thermogravimetric analysis. The results concerning the HAp crystalline architecture in natural and synthetic HAp powders provide a reliable basis for deducing the heating history for dental tissues in the forensic and archaeological context, and the foundation for further development and optimization of biomimetic material design.

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