scholarly journals POS1288 TUBERCULOUS SPONDYLODISCITIS IN ELDERLY: EPIDEMIOLOGY, CLINICAL, FEATURES, TREATMENT AND OUTCOMES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 926.1-926
Author(s):  
M. Mrabet ◽  
S. Boussaid ◽  
S. Jemmali ◽  
H. Sahli ◽  
H. Ajlani ◽  
...  
Keyword(s):  
Clinical Features ◽  
The Elderly ◽  
Lumbar Pain ◽  
Elderly Subjects ◽  
Normocytic Anemia ◽  
Imaging Features ◽  
X Rays ◽  
Significant Difference ◽  
Young Subjects ◽  
Tuberculous Spondylodiscitis

Background:Tuberculosis is still endemic all over the world. The incidence of tuberculous spondylodiscitis (TS) is steadily increasing. Clinical features and outcomes of this affection are various and depending on various parameters, including age.Objectives:Our objective was to explore the differences in presentation and the results of further investigations and the prognosis of TS between young and elderly subjects.Methods:We conduct a retrospective and descriptive study in a single rheumatology department. Data were collected from files of patients hospitalized in the past 20 years (2000-2020) who have been diagnosed with TS. We carried out a comparative study concerning the clinical biological, imaging features and outcomes between young subjects and subjects aged over 65 years.Results:Fifty-two cases of TS were collected (37F/15M). The mean age of the population was 55.21 years ± 17.79 [19-91]. Thirty-three patients (69.2%) were classified as young versus 16 elderly patients (30.8%), with female predominance in both groups (69.4% and 75% respectively, p = 0.57). Young subjects was more frequently vaccinated (88.9%) by Bacillus Calmette–Guérin (BCG) (p < 0.001). A delayed diagnosis was noted in both groups (p = 0.24). Lumbar spine involvement was the most common (57.7%). In the two age ranges, the onset of the disease was progressive (p = 0.22), characterized by segmental spine stiffness (p = 0.57) and lumbar pain with general signs (p = 0.27), such as: impaired general condition, fever, night sweats and weight loss. Biological inflammatory syndrome and normochrome normocytic anemia were encountered in both cases (p = 0.08 and p = 0.2, respectively). Standard X-rays and Computed tomography were more performed in young subjects (94.4% and 69.4%, respectively; p < 0.001), unlike magnetic resonance imaging which was more common in elderly subjects but with no statistically significant difference (p = 0.22). Disc pinch, erosion of vertebral plateaus and vertebral collapse were the major signs (82.7%, 65.4% and 67.3%, respectively). Clinical, biological and imaging arguments contributed to positive diagnosis in both groups (p = 0.24). Common medical treatment was anti-tuberculosis: Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), Ethambutol (E) and physical treatment such as immobilization witch was more common in the eldery (56.3%, p = 0.16). The evolution of the disease was characterized by a clear improvement of young subjects during the second week of treatment (p < 0.001). A more frequent clinical improvement in older subjects was during the fourth week but with no statistically significant difference (p = 0.13). The occurrence of immediate complications was more frequent in the elderly (p = 0.23) with a predominance for drug complications (56.3%) such as: hepatic cytolysis (12.5%), hyperuricemia (18.8%) and major intolerance to anti-tuberculosis (18.8%).Conclusion:TS is a frequent condition that needs to be treated rapidly. the clinical presentation of TS in the elderly is less noisy which leads to more frequent complications and mortality.Disclosure of Interests:None declared

scholarly journals POS1280 SPINAL LOCATION OF TUBERCULOSIS: WHAT HAS CHANGED OVER THE LAST YEARS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 923.3-923
Author(s):  
S. Boussaid ◽  
M. Mrabet ◽  
S. Jemmali ◽  
H. Sahli ◽  
H. Ajlani ◽  
...  
Keyword(s):  
Neurological Complications ◽  
Developing Nations ◽  
Lumbar Pain ◽  
X Rays ◽  
Resonance Imaging ◽  
Vertebral Collapse ◽  
The Past ◽  
Significant Difference ◽  
Tuberculous Spondylodiscitis ◽  
Different Parts

Background:Tuberculosis (TB) is no longer a disease limited to developing nations and is still a major cause of significant morbidity and mortality worldwide. It can affect the different parts of the spine.Objectives:The aim of this study was to determine the preferred spinal location of TB.Methods:We conduct a retrospective and descriptive study in a single rheumatology department. Data were collected from observations of patients hospitalized in the past 20 years (2000-2020) who have been diagnosed with tuberculous spondylodiscitis (TS).Results:Fifty-two patients were included (37F/15M). Their mean age was 55.21 years ± 17.79 [19-91]. TS was more frequently unifocal (75%) than multifocal (25%). Lumbar spine involvement was the most common (57.7%) and more frequent in women (63.3%) but with no statistically significant difference (p = 0.2). Other localizations were described such as: dorso-lumbar (21.2%), dorsal (15.4%), lumbosacral (3.8%) and cervical (1.9%). Lumbar pain was present in 34 patients (65.4%) and 29 patients (55.8%) suffered from segmental lumbar stiffness. Imaging was contributive by showing the vertebral location using standard X-rays, computed tomography and magnetic resonance imaging. Disc pinch, erosion of vertebral plateaus and vertebral collapse were the major signs (82.7%, 65.4% and 67.3%, respectively).Conclusion:TS is a rare but serious clinical condition which may lead to severe deformity and early or late neurological complications. Spinal involvement is often unifocal and mostly diagnosed with lumbar pain or stiffness. Multifocal forms, touching several parts of the spine, however remain rare. Our findings remain consistent with those of the literature.Disclosure of Interests:None declared

Decreased Neutrophil Cyclic AMP Response to Isoprenaline Stimulation in the Elderly

1983 ◽  
Vol 65 (2) ◽  
pp. 155-157 ◽  
Author(s):  
T. G. Cotter ◽  
K. O'Malley
Keyword(s):  
Monoclonal Antibodies ◽  
Cyclic Amp ◽  
The Elderly ◽  
Population Heterogeneity ◽  
Elderly Subjects ◽  
Age Related ◽  
Significant Difference ◽  
Young Subjects ◽  
Drug Free

1. Neutrophils from drug-free elderly subjects produced approximately 50% less cyclic AMP in response to isoprenaline than did neutrophils from young subjects. A significant difference in basal cyclic AMP levels was also evident (elderly 2.8 ± 0.37; young 4.9 ± 0.36 pmol of cAMP/107 cells; P < 0.05). 2. With a range of anti-neutrophil monoclonal antibodies no evidence of age-related neutrophil population heterogeneity was found. 3. These findings indicate that the age-related decline in β-adrenoceptor responsiveness is not due to changes in the neutrophil population. 4. The present results support the hypothesis that there is a generalized decline in β-adrenoceptor-mediated responsiveness in the elderly.

scholarly journals AB0938 PARTICULARITIES OF INFECTIOUS SPONDYLODISCITIS IN THE ELDERLY: COMPARATIVE STUDY WITH THE YOUNG SUBJECT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1768.2-1768
Author(s):  
L. Ben Ammar ◽  
A. Ben Tekaya ◽  
M. Ben Hammamia ◽  
O. Saidane ◽  
S. Bouden ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cauda Equina ◽  
The Elderly ◽  
Cord Compression ◽  
Elderly Subjects ◽  
Significant Difference ◽  
Infectious Spondylodiscitis ◽  
Older Subjects ◽  
Young Subjects

Background:The incidence of infectious spondylodiscitis is steadily increasing. The prognosis depends on various parameters, including age.Objectives:To explore the differences in presentation and the results of further investigations and the prognosis of spondylodiscitis between young and elderly subjects.Methods:This is a retrospective study of 113 patients admitted to our department over a period of 20 years [1998-2018]. The epidemiological, clinical, biological, radiological and progressive aspects of spondylodiscitis in subjects over the age of 65 were compared to cases of spondylodiscitis in young subjects whose age is less than 65 years.Results:Of the 113 identified patients, 33 (29.2%) were classified as older, with male predominance in both groups (56.2 and 51.5% respectively; p=0.6). The presence of risk factors, particularly diabetes, was more frequent in the older subjects but without a statistically significant difference (p=0.2). Hepathopathies were also more frequent in the elderly but without statistically significant difference (p=0.3). The mean duration of progression was 3 months with no statistically significant difference between the two groups (4 and 5 months respectively, p=0.1).The presence of neurological symptoms, especially radiculalgia, was more frequently reported in younger subjects (p=0.01). Also, young subjects were more likely to have a fever (p=0.005). On the other hand, a biological inflammatory syndrome was more frequently encountered in older subjects (p=0.03).We found no statistically significant difference in the location of spondylodiscitis (p=0.4). Also, multifocal involvement was more frequent in older subjects but without a statistically significant difference.Radiologically, para-vertebral abscesses, epiduritis and spinal cord compression were more common in the elderly group (p=0.03; p=0.01 and p=0.01, respectively). While the frequency of intervertebral pinching and erosions was similar in both groups (p=0.1; p=0.8, respectively).Tuberculosis was the most involved germ in more than 50% of cases with no statistically significant difference between the two groups (57.5 and 51.5% respectively; p=0.5).All patients received targeted antibiotic therapy.The occurrence of immediate complications was more frequent in the elderly but without a statistically significant difference (p=0.1). They included neurological complications (spinal cord compression and Cauda equina syndrome) that occurred in 6.3% of cases in younger subjects versus 36.4% of cases in the elderly (p=0.07). Followed by treatment side effects dominated by disturbance of liver function due mainly to antituberculosis drugs occurring in 16.3% of cases in the younger group and 15.2% of cases in older subjects (p=0.8). Finally, there were 2 deaths in each group (p=0.5).Conclusion:Our series has shown that the picture of spondylodiscitis in the elderly is less noisy. However, the neurological damage is more pronounced on imaging. The misleading symptomatology in the elderly explains the delay in diagnosis and treatment, which leads to more frequent complications and excess mortality.Disclosure of Interests:None declared

scholarly journals Extra Virgin Olive Oil Prevents the Age-Related Shifts of the Distribution of HDL Subclasses and Improves Their Functionality

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2235
Author(s):  
Alyann Otrante ◽  
Amal Trigui ◽  
Roua Walha ◽  
Hicham Berrougui ◽  
Tamas Fulop ◽  
...  
Keyword(s):  
Olive Oil ◽  
Virgin Olive Oil ◽  
Density Lipoprotein ◽  
Extra Virgin Olive Oil ◽  
The Elderly ◽  
High Density ◽  
Lipoprotein Cholesterol ◽  
Elderly Subjects ◽  
Age Related ◽  
Young Subjects

High-density lipoproteins (HDL) maintain cholesterol homeostasis through the role they play in regulating reverse cholesterol transport (RCT), a process by which excess cholesterol is transported back to the liver for elimination. However, RCT can be altered in the presence of cardiovascular risk factors, such as aging, which contributes to the increase in the incidence of cardiovascular diseases (CVD). The present study was aimed at investigating the effect of extra virgin olive oil (EVOO) intake on the cholesterol efflux capacity (CEC) of HDL, and to elucidate on the mechanisms by which EVOO intake improves the anti-atherogenic activity of HDL. A total of 84 healthy women and men were enrolled and were distributed, according to age, into two groups: 27 young (31.81 ± 6.79 years) and 57 elderly (70.72 ± 5.6 years) subjects. The subjects in both groups were given 25 mL/d of extra virgin olive oil (EVOO) for 12 weeks. CEC was measured using J774 macrophages radiolabeled with tritiated cholesterol ((3H) cholesterol). HDL subclass distributions were analyzed using the Quantimetrix Lipoprint® system. The HDL from the elderly subjects exhibited a lower level of CEC, at 11.12% (p < 0.0001), than the HDL from the young subjects. The CEC of the elderly subjects returned to normal levels following 12 weeks of EVOO intake. An analysis of the distribution of HDL subclasses showed that HDL from the elderly subjects were composed of lower levels of large HDL (L-HDL) (p < 0.03) and higher levels of small HDL (S-HDL) (p < 0.002) compared to HDL from the young subjects. A multiple linear regression analysis revealed a positive correlation between CEC and L-HDL levels (r = 0.35 and p < 0.001) as well as an inverse correlation between CEC and S-HDL levels (r = −0.27 and p < 0.01). This correlation remained significant even when several variables, including age, sex, and BMI as well as low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glucose levels (β = 0.28, p < 0.002, and β = 0.24, p = 0.01) were accounted for. Consuming EVOO for 12 weeks modulated the age-related difference in the distribution of HDL subclasses by reducing the level of S-HDL and increasing the level of intermediate-HDL/large-HDL (I-HDL/L-HDL) in the elderly subjects. The age-related alteration of the CEC of HDL was due, in part, to an alteration in the distribution of HDL subclasses. A diet enriched in EVOO improved the functionality of HDL through an increase in I-HDL/L-HDL and a decrease in S-HDL.

Cold-induced Increases in Erythrocyte Count, Plasma Cholesterol and Plasma Fibrinogen of Elderly People without a Comparable Rise in Protein C or Factor X

1994 ◽  
Vol 86 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Penelope J. Neild ◽  
Denise Syndercombe-Court ◽  
W. R. Keatinge ◽  
G. C. Donaldson ◽  
M. Mattock ◽  
...  
Keyword(s):  
Elderly People ◽  
Plasma Volume ◽  
Arterial Thrombosis ◽  
Protein C ◽  
Plasma Cholesterol ◽  
The Elderly ◽  
Erythrocyte Count ◽  
Elderly Subjects ◽  
Factor X ◽  
Young Subjects

1. Six elderly (66-71 years) and six young (20-23 years) subjects (half of each group women) were cooled for 2 h in moving air at 18°C to investigate possible causes of increased mortality from arterial thrombosis among elderly people in cold weather. Compared with thermoneutral control experiments, skin temperature (trunk) fell from 35.5 to 29.5°C, with little change in core temperature. 2. Erythrocyte count rose in the cold from 4.29 to 4.69 × 1012/l, without a change in mean corpuscular volume, indicating a 14% or 438 ml decline in plasma volume; increased excretion of water, Na+ and K+ accounted for loss of only 179 ml of extracellular water. 3. Plasma cholesterol and fibrinogen concentrations rose in the elderly subjects from 4.9 mmol/l and 2.97 g/l (control) to 5.45 mmol/l and 3.39 g/l in the cold, and in the young subjects from 3.33 mmol/l and 1.84 g/l (control) to 3.77 mmol/l and 2.07 g/l in the cold. Increases were significant for the elderly subjects, the young subjects and the group as a whole, except for cholesterol in the young subjects, and all were close to those expected from the fall in plasma volume. 4. Plasma levels of Protein C and factor X did not increase significantly in the cold in the elderly subjects, young subjects, or the group as a whole. 5. The results suggest that loss of plasma fluid in the cold concentrates major risk factors for arterial thrombosis, while small molecules, including protective Protein C, redistribute to interstitial fluid.

The influence of dynamic visual environments on postural sway in the elderly

1999 ◽  
Vol 9 (3) ◽  
pp. 197-205
Author(s):  
L.L. Borger ◽  
S.L. Whitney ◽  
M.S. Redfern ◽  
J.M. Furman
Keyword(s):  
Visual Information ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Age Groups ◽  
The Elderly ◽  
Visual Scene ◽  
Elderly Subjects ◽  
Mean Velocity ◽  
Healthy Elderly ◽  
Young Subjects

Postural sway during stance has been found to be sensitive to moving visual scenes in young adults, children, and those with vestibular disease. The effect of visual environments on balance in elderly individuals is relatively unknown. The purpose of this study was to compare postural sway responses of healthy elderly to those of young subjects when both groups were exposed to a moving visual scene. Peak to peak, root mean squared, and mean velocity of the center of pressure were analyzed under conditions combining four moving scene amplitudes ( 2 . 5 ∘ , 5 ∘ , 7 . 5 ∘ , 10 ∘ ) and two frequencies of scene movement (0.1 Hz, 0.25 Hz). Each visual condition was tested with a fixed floor and sway referenced platform. Results showed that elderly subjects swayed more than younger subjects when experiencing a moving visual scene under all conditions. The elderly were affected more than the young by sway referencing the platform. The differences between the two age groups were greater at increased amplitudes of scene movement. These results suggest that elderly are more influenced by dynamic visual information for balance than the young, particularly when cues from the ankles are altered.

CLINICALAND ELECTROPHYSIOLOGICAL STUDY OF THE PERIPHERAL NERVOUS SYSTEM IN THE ELDERLY PEOPLE IN DARBHANGA

2021 ◽  
pp. 19-21
Author(s):  
Nutan Bala ◽  
Priyanka Priyanka ◽  
Sheela Kumari ◽  
Debarshi Jana
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Linear Models ◽  
Electrophysiological Study ◽  
The Elderly ◽  
Elderly Subjects ◽  
Neurophysiological Studies ◽  
Age Dependent ◽  
Young Subjects ◽  
Effect Of Age

The effect of age on the peripheral nervous system was investigated by clinical examination and neurophysiological studies in 59 subjects aged 60- 103 years and 23 young subjects. Afull laboratory screen for factors which, though clinically silent, may constitute risk factors (RFs) for peripheral neuropathy was also performed in the elderly subjects. Our ndings show that the presence of RFs affects exceptionally the electrophysiological parameters in a statistically signicant way. The age-dependent changes in nerve conduction parameters were well predicted by non-linear models. The simultaneous electromyographical study demonstrates the re-innervation capacity of the motor system

scholarly journals Characteristics of Lower Limb Muscle Activity in Elderly Persons After Ergometric Exercise

2020 ◽  
Vol 6 ◽  
pp. 233372142097980
Author(s):  
Kenichi Kaneko ◽  
Hitoshi Makabe ◽  
Kazuyuki Mito ◽  
Kazuyoshi Sakamoto ◽  
Yoshiya Kawanori ◽  
...  
Keyword(s):  
Lower Limb ◽  
Muscle Activity ◽  
The Elderly ◽  
Elderly Subjects ◽  
Elderly Persons ◽  
Lower Limb Muscle ◽  
Limb Muscle ◽  
Lower Limb Muscles ◽  
The Mean ◽  
Young Subjects

This study examined the characteristics of lower limb muscle activity in elderly persons after ergometric pedaling exercise for 1 month. To determine the effect of the exercise, surface electromyography (SEMG) of lower limb muscles was subjected to Daubechies-4 wavelet transformation, and mean wavelet coefficients were compared with the pre-exercise coefficients and the post-exercise coefficients in each wavelet level. The characteristics of muscle activity after pedaling exercise were also compared between the elderly subjects and young subjects. For the elderly subjects, the mean wavelet coefficients were significantly decreased in the tibialis anterior and the gastrocnemius medialis at wavelet levels of 3, 4, and 5 (125–62.5, 62.5–31.25, and 31.25–15.625 Hz, respectively), by pedaling exercise. However, the mean power of wavelet levels of 2 and 3 (250–125 and 125–62.5 Hz) within the rectus femoris and the biceps femoris were significantly increased in the young subjects. The effect of pedaling exercise is different from the effects of heavy-resistance training. It was suggested that the muscle coordination, motor unit (MU) firing frequency, and firing fiber type of lower limb muscles are changed with the different characteristics between elderly and young persons by pedaling exercise for 1 month.

scholarly journals Age-related changes in multifinger synergies in accurate moment of force production tasks

2007 ◽  
Vol 102 (4) ◽  
pp. 1490-1501 ◽  
Author(s):  
Halla Olafsdottir ◽  
Wei Zhang ◽  
Vladimir M. Zatsiorsky ◽  
Mark L. Latash
Keyword(s):  
Hand Function ◽  
The Elderly ◽  
Time Profile ◽  
Uncontrolled Manifold ◽  
Elderly Subjects ◽  
Total Force ◽  
Dominant Hand ◽  
Total Moment ◽  
Age Related ◽  
Young Subjects

The purpose of this investigation was to document and quantify age-related differences in the coordination of fingers during a task that required production of an accurate time profile of the total moment of force by the four fingers of a hand. We hypothesized that elderly subjects would show a decreased ability to stabilize a time profile of the total moment of force, leading to larger indexes of moment variability compared with young subjects. The subjects followed a trapezoidal template on a computer screen by producing a time profile of the total moment of force while pressing down on force sensors with the four fingers of the right (dominant) hand. To quantify synergies, we used the framework of the uncontrolled manifold hypothesis. The elderly subjects produced larger total force, larger variance of both total force and total moment of force, and larger involvement of fingers that produced moment of force against the required moment direction (antagonist moment). This was particularly prominent during supination efforts. Young subjects showed covariation of commands to fingers across trials that stabilized the moment of total force (moment-stabilizing synergy), while elderly subjects failed to do so. Both subject groups showed similar indexes of covariation of commands to the fingers that stabilized the time profile of the total force. The lack of moment-stabilizing synergies may be causally related to the documented impairment of hand function with age.

scholarly journals Description of suicide ideation among older adults and a psychological profile: a cross-sectional study in Turkey

2019 ◽  
Vol 24 (5) ◽  
pp. 1865-1874 ◽  
Author(s):  
Murat Aslan ◽  
Cicek Hocaoglu ◽  
Bulent Bahceci
Keyword(s):  
Suicidal Ideation ◽  
Suicide Ideation ◽  
Psychiatric Morbidity ◽  
Depression Scale ◽  
The Elderly ◽  
Elderly Subjects ◽  
Reasons For Living ◽  
Low Level ◽  
Significant Difference ◽  
The Mean

Abstract This study investigates the suicidal ideation and the possible causes for suicidal behaviour in the elderly. Subjects were 150 patients aged 65 and older who were evaluated using the sociodemographic data collection forms, Geriatric Depression Scale (GDS), Suicidal Ideation Scale (SIS), Reasons for Living Inventory (RLI), and Beck Hopelessness Scale (BHS). Of 150 patients, 72.7% were women and 27.3% were men, ages ranged from 65 to 88 years. Suicidal ideation was noted in 30.7% of patients. When the mean of BHS total score between patients with and without suicidal ideation and the mean of BHS subscale’s feelings and expectations regarding the future and loss of motivation and hope in terms of subscales were evaluated between the groups with and without suicidal ideation, the scores had a significant difference. When RLI was evaluated in terms of total scores, the suicidal ideation mean score was 243.74 ± 32.28, while the non-suicidal ideation mean score was 267.27 ± 24.36. There was a significant relationship between the two groups. We found low level of education, low level of reasons for living and higher psychiatric morbidity (generalized anxiety disorder and comorbid depressive disorder) in with suicidal ideation in the elderly.

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