Pathogenesis and clinical implications of HIV-related anemia in 2013

Hematology ◽  
2013 ◽  
Vol 2013 (1) ◽  
pp. 377-381 ◽  
Author(s):  
Amanda J. Redig ◽  
Nancy Berliner
Keyword(s):  
Antiretroviral Therapy ◽  
Accelerated Aging ◽  
The Elderly ◽  
Chronic Obstructive ◽  
Combination Antiretroviral Therapy ◽  
Obstructive Pulmonary Disease ◽  
Related Disease ◽  
Age Related ◽  
Entry Points ◽  
The Face

AbstractAnemia is a common feature of HIV-related disease and has been uniformly demonstrated to be an independent predictor of morbidity and mortality. Although anemia often responds to combination antiretroviral therapy, many patients remain anemic despite therapy and such persistent anemia continues to negatively affect prognosis regardless of drug response. Anemia is also a common feature of normal aging. We postulate that the pathophysiology of anemia in HIV, especially that which persists in the face of combination antiretroviral therapy, is a reflection of underlying proinflammatory pathways that are also thought to contribute to anemia in the elderly, as well as other age-related chronic diseases such as cardiovascular disease and chronic obstructive pulmonary disease. This suggests that HIV induces inflammatory pathways that are associated with a pattern of accelerated aging and that anemia is a biomarker of these processes. A better understanding of the pathophysiology of HIV-related anemia may provide important entry points for improving the chronic manifestations of HIV-related disease.

scholarly journals Asthma in the Elderly: Can We Distinguish It from COPD?

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Eleni G. Tzortzaki ◽  
Athanasia Proklou ◽  
Nikolaos M. Siafakas
Keyword(s):  
Late Onset ◽  
Airflow Obstruction ◽  
Bronchial Hyperresponsiveness ◽  
The Elderly ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Inflammatory Pattern ◽  
Common Clinical Practice ◽  
Elderly Asthmatics

Asthma in older adults affects quality of life and results in a higher hospitalization rate and mortality. In common clinical practice, asthma in the elderly is underdiagnosed and undertreated or overdiagnosed and mistreated. The age-related reduction in perception of shortness of breath and the high incidence of comorbidities make the diagnosis and management more difficult and challenging for the physicians. Chronic obstructive pulmonary disease (COPD) is usually easy to distinguish from asthma, but sometimes the distinction from late-onset asthma in older patients, particularly in cigarette smokers, is difficult and may be impossible. Both diseases are characterized by the presence of airflow obstruction but have distinct pathogenesis, inflammatory pattern, and prognosis. The distinction between Asthma and COPD based simply on spirometric parameters is difficult especially in the elderly asthmatics. The combination of lung function testing, bronchial hyperresponsiveness (BHR) and atopy status, HRCT scans, and the newly developed biological techniques, allowing the assessment of biomarker profiles, could facilitate the distinction between these diseases.

scholarly journals Ageing and the border between health and disease

2014 ◽  
Vol 44 (5) ◽  
pp. 1332-1352 ◽  
Author(s):  
William MacNee ◽  
Roberto A. Rabinovich ◽  
Gourab Choudhury
Keyword(s):  
Negative Impact ◽  
Inflammatory Diseases ◽  
The Elderly ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Progressive Degeneration ◽  
Age Related ◽  
Chronic Pulmonary Diseases ◽  
Health And Disease ◽  
And Function

Ageing is associated with a progressive degeneration of the tissues, which has a negative impact on the structure and function of vital organs and is among the most important known risk factors for most chronic diseases. Since the proportion of the world’s population aged >60 years will double in the next four decades, this will be accompanied by an increased incidence of chronic age-related diseases that will place a huge burden on healthcare resources.There is increasing evidence that many chronic inflammatory diseases represent an acceleration of the ageing process. Chronic pulmonary diseases represents an important component of the increasingly prevalent multiple chronic debilitating diseases, which are a major cause of morbidity and mortality, particularly in the elderly. The lungs age and it has been suggested that chronic obstructive pulmonary disease (COPD) is a condition of accelerated lung ageing and that ageing may provide a mechanistic link between COPD and many of its extrapulmonary effects and comorbidities. In this article we will describe the physiological changes and mechanisms of ageing, with particular focus on the pulmonary effects of ageing and how these may be relevant to the development of COPD and its major extrapulmonary manifestations.

Physiology of Geriatrics

2019 ◽  
Author(s):  
Christina M. Matadial
Keyword(s):  
Healthy Aging ◽  
Postoperative Cognitive Dysfunction ◽  
The Elderly ◽  
Adverse Outcomes ◽  
The Body ◽  
Chronic Obstructive ◽  
Medical Conditions ◽  
Compensatory Mechanisms ◽  
Obstructive Pulmonary Disease ◽  
Age Related

The aging population is growing and life expectancy is prolonged. The elderly population is able to enjoy prolonged life with good management of their chronic conditions. Many elderly do not have medical conditions but we still see a decline in their organ function and physiologic reserve that weighs in on their daily living. As well these changes in anatomy, physiology and chemistry puts them at risk of developing medical conditions and experience adverse outcomes during surgery and anesthesia. The central nervous, cardiovascular, respiratory, hepatic and renal systems all work together and are affected as a whole with aging causing physiologic changes but also compensatory mechanisms. In this review we will study the aging physiology of the body and touch on its implications in anesthesia. This review contains 5 figures, 3 tables, and  55 references. Keywords: Healthy aging, age-related changes, Postoperative cognitive dysfunction, diastolic dysfunction, vascular stiffening, ventricular arterial coupling, Chronic obstructive pulmonary disease, Spirometry, Glomerular Filtration Rate, hallmarks of aging

scholarly journals Redox Dysregulation in Aging and COPD: Role of NOX Enzymes and Implications for Antioxidant Strategies

Antioxidants ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1799
Author(s):  
Caspar Schiffers ◽  
Niki L. Reynaert ◽  
Emiel F. M. Wouters ◽  
Albert van der Vliet
Keyword(s):  
Lung Disease ◽  
Lung Diseases ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Antioxidant Responses ◽  
Related Disease ◽  
Age Related ◽  
The Impact ◽  
Important Enzyme

With a rapidly growing elderly human population, the incidence of age-related lung diseases such as chronic obstructive pulmonary disease (COPD) continues to rise. It is widely believed that reactive oxygen species (ROS) play an important role in ageing and in age-related disease, and approaches of antioxidant supplementation have been touted as useful strategies to mitigate age-related disease progression, although success of such strategies has been very limited to date. Involvement of ROS in ageing is largely attributed to mitochondrial dysfunction and impaired adaptive antioxidant responses. NADPH oxidase (NOX) enzymes represent an important enzyme family that generates ROS in a regulated fashion for purposes of oxidative host defense and redox-based signalling, however, the associations of NOX enzymes with lung ageing or age-related lung disease have to date only been minimally addressed. The present review will focus on our current understanding of the impact of ageing on NOX biology and its consequences for age-related lung disease, particularly COPD, and will also discuss the implications of altered NOX biology for current and future antioxidant-based strategies aimed at treating these diseases.

scholarly journals Geriatric Chest Imaging: When and How to Image the Elderly Lung, Age-Related Changes, and Common Pathologies

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
J. Gossner ◽  
R. Nau
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
The Elderly ◽  
Global Perspective ◽  
Lung Imaging ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Peripheral Venous Access

Even in a global perspective, societies are getting older. We think that diagnostic lung imaging of older patients requires special knowledge. Imaging strategies have to be adjusted to the needs of frail patients, for example, immobility, impossibility for long breath holds, renal insufficiency, or poor peripheral venous access. Beside conventional radiography, modern multislice computed tomography is the method of choice in lung imaging. It is especially important to separate the process of ageing from the disease itself. Pathologies with a special relevance for the elderly patient are discussed in detail: pneumonia, aspiration pneumonia, congestive heart failure, chronic obstructive pulmonary disease, the problem of overlapping heart failure and chronic obstructive pulmonary disease, pulmonary drug toxicity, incidental pulmonary embolism pulmonary nodules, and thoracic trauma.

scholarly journals Hypoxia resistance among the agedpatients with chronic obstructive lung disease: possibilities of using hypoxic trains

2020 ◽  
Vol 1 (1) ◽  
pp. 12-18
Author(s):  
Iryna Dyba ◽  
Ervin Asanov ◽  
Seviliya Asanova ◽  
Juliya Holubova
Keyword(s):  
Elderly Patients ◽  
Chronic Obstructive Lung Disease ◽  
The Elderly ◽  
The Body ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Resistance To Hypoxia ◽  
Functional Changes ◽  
Age Related

Age-related morphological and functional changes in the body lead to the development of arterial hypoxemia, tissue hypoxia and hypoxic changes, which reduces the body's resistance to hypoxia and contributes to the development of lung diseases, in particular chronic obstructive pulmonary disease (COPD) in the elderly. The aim of the study was to clarify the effect of interval normobaric hypoxic training (INHT) on hypoxia resistance in elderly patients with COPD. The survey showed that with an increase in bronchial obstruction, the shifts of blood saturation during hypoxia increase. The course of INHT leads to increased resistance to hypoxia, and also increases the ventilation response to hypoxia in elderly patients with COPD.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

scholarly journals Medically Treated Opioid Overdoses Among the U.S. Elderly: Trends and Correlates

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 54-54
Author(s):  
Peter Treitler ◽  
Stephen Crystal ◽  
Richard Hermida ◽  
Jennifer Miles
Keyword(s):  
Older Adults ◽  
Pain Management ◽  
The Elderly ◽  
Opioid Use Disorder ◽  
Chronic Obstructive ◽  
Medicare Beneficiaries ◽  
Older Individuals ◽  
Opioid Use ◽  
Policy And Practice ◽  
Obstructive Pulmonary Disease

Abstract High rates of opioid prescribing and comorbid medical conditions increase risk of overdose among older adults. As the US population ages and the rates of opioid use disorder (OUD) increase in the elderly population, there is a need to characterize trends and correlates of overdose in order to more effectively target policy and practice. Using a ~40% random sample of 2015-2017 Medicare beneficiaries ages 65 and older with Part D pharmacy coverage, this study examined medically treated opioid overdoses among US older adults. The sample included 13-14 million beneficiaries per year. The rate of medically treated opioid overdoses among elderly Medicare beneficiaries increased by 15% from 6 per 10,000 in 2015 to 6.9 per 10,000 in 2017. Those with overdose were disproportionately female (63%), non-Hispanic white (83%), with diagnoses of pain conditions (96%), with diagnoses of major depression (63%), and with high rates of conditions that decrease respiratory reserve such as chronic obstructive pulmonary disease. 13% had co-occurring diagnosed alcohol use disorder, 36% were diagnosed with opioid dependence or abuse, and 12% were diagnosed with hepatitis C. Older individuals with overdose represent a complex mix of risk factors; identifying those most at risk (as well as those who have very low risk, whose pain management may be compromised by overly-rigid interpretation of opioid use guidelines) is key in order to address multiple risks, balancing risk reduction with appropriate pain management.

scholarly journals Rescuing Immunosenescence via Non-Specific Vaccination

Immuno ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 231-239
Author(s):  
Alexander I. Mosa
Keyword(s):  
Immune Responses ◽  
The Elderly ◽  
Short Review ◽  
Functional Markers ◽  
Healthy Life ◽  
Related Disease ◽  
Age Related ◽  
Population Vulnerability ◽  
Mechanistic Basis ◽  
Promising Avenue

Discrepancies in lifespan and healthy-life span are predisposing populations to an increasing burden of age-related disease. Accumulating evidence implicates aging of the immune system, termed immunosenescence, in the pathogenesis of multiple age-related diseases. Moreover, immune dysregulation in the elderly increases vulnerability to infection and dampens pathogen-specific immune responses following vaccination. The health challenges manifesting from these age related deficits have been dramatically exemplified by the current SARS-CoV-2 pandemic. Approaches to either attenuate or reverse functional markers of immunosenescence are therefore urgently needed. Recent evidence suggests systemic immunomodulation via non-specific vaccination with live-attenuated vaccines may be a promising avenue to at least reduce aged population vulnerability to viral infection. This short review describes current understanding of immunosenescence, the historical and mechanistic basis of vaccine-mediated immunomodulation, and the outstanding questions and challenges required for broad adoption.

scholarly journals Aspiração de Corpo Estranho no Idoso

2016 ◽  
Vol 29 (5) ◽  
pp. 340
Author(s):  
Cátia Oliveira Matos ◽  
Manuel Mário Sousa
Keyword(s):  
Oral Intake ◽  
The Elderly ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Clinical Suspicion ◽  
Chronic Obstructive ◽  
History Taking ◽  
Therapeutic Procedure ◽  
Obstructive Pulmonary Disease ◽  
History Of

Foreign body aspiration is common in children and in the elderly, who may present with subtle symptoms. Clinical suspicion is crucial and bronchoscopy is the main diagnostic and therapeutic procedure available. This is the case of a man, 78 years old, with a history of chronic obstructive pulmonary disease, who presented with respiratory distress following oral intake of tablets. History taking and physical examination raised suspicion. The diagnosis was confirmed with flexible bronchoscopy and rigid bronchoscopy was carried out for treatment. The patient’s condition is stable and he is under investigations for dysphagia.

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