Effect of age on the pharmacokinetics of busulfan (Bu): An alliance study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 2533-2533
Author(s):  
Jan Hendrik Beumer ◽  
Lionel D. Lewis ◽  
Kouros Owzar ◽  
Chen Jiang ◽  
Julianne L. Holleran ◽  
...  
Keyword(s):  
Conditioning Regimen ◽  
Age Groups ◽  
Young Patients ◽  
The Elderly ◽  
Marrow Transplant ◽  
Glutathione S Transferase ◽  
Wilcoxon Rank Sum Test ◽  
Plasma Pharmacokinetics ◽  
Age Range

2533 Background: Older acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) patients (pts) have been excluded from myeloablative regimens including agents such as busulfan because of the potential for non-disease related morbidity and mortality. Busulfan, often used as part of myeloablative regimens, is cleared in part by glutathione–S-transferase and CYP3A4. We hypothesized that busulfan clearance (BuCL) in the elderly (> 60 years) would be reduced compared to that in young patients (< 60 years), thus potentially explaining differences in tolerability. Methods: AML and MDS pts in three CALGB bone marrow transplant studies across a wide age range (17-74) were treated with a conditioning regimen using IV busulfan, dosed at 12.8 mg/m2 in CALGB studies 10503 and 19808 and 6.4 mg/m2 in CALGB 100103. Blood samples were collected for determination of busulfan plasma pharmacokinetics (PK). Plasma busulfan was quantitated by LC-MS. BuCL was determined using non-compartmental modeling, and normalized to actual (ABW), ideal (IBW) and corrected (CBW) body weight (kg). Differences between age groups were examined using the Wilcoxon rank sum test. Results: A total of 185 pts were accrued and signed consent, of which 174 provided useable PK data. Twenty-nine pts ≥60 years old (median age 66.3) had a significantly higher mean BuCL vs those < 60 years old (median age 49.8); BuCL 263 vs 186 mL/min, p=0.0002; BuCL/ABW 3.22 vs 2.34 mL/min/kg, p=0.0001; BuCL/IBW 3.63 vs 2.91 mL/min/kg, p=0.0035; BuCL/CBW 3.50 vs 2.70 mL/min/kg, p=0.0005. Inter-patient variability in clearance (CV%) was up to 47% in the elderly and up to 48% in young patients. Phenytoin use, a potential confounder, did not affect BuCL, regardless of weight normalization (p=0.74). Conclusions: Contrary to our hypothesis, BuCL is significantly higher in pts ≥60 years old compared to younger patients and does not explain the previously reported increase in Bu toxicity observed in the elderly.

scholarly journals Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country

2021 ◽  
Vol 15 (4) ◽  
pp. e0009312
Author(s):  
Yi-Hua Pan ◽  
Mei-Ying Liao ◽  
Yu-Wen Chien ◽  
Tzong-Shiann Ho ◽  
Hui-Ying Ko ◽  
...  
Keyword(s):  
Older Adults ◽  
Adult Population ◽  
Age Groups ◽  
The Elderly ◽  
Denv Infection ◽  
Serum Samples ◽  
Increased Risk ◽  
Southern Taiwan ◽  
Older Populations ◽  
Age Range

A shift in dengue cases toward the adult population, accompanied by an increased risk of severe cases of dengue in the elderly, has created an important emerging issue in the past decade. To understand the level of past DENV infection among older adults after a large dengue outbreak occurred in southern Taiwan in 2015, we screened 1498 and 2603 serum samples from healthy residents aged ≥ 40 years in Kaohsiung City and Tainan City, respectively, to assess the seroprevalence of anti-DENV IgG in 2016. Seropositive samples were verified to exclude cross-reaction from Japanese encephalitis virus (JEV), using DENV/JEV-NS1 indirect IgG ELISA. We further identified viral serotypes and secondary DENV infections among positive samples in the two cities. The overall age-standardized seroprevalence of DENV-IgG among participants was 25.77% in Kaohsiung and 11.40% in Tainan, and the seroprevalence was significantly higher in older age groups of both cities. Although the percentages of secondary DENV infection in Kaohsiung and Tainan were very similar (43.09% and 44.76%, respectively), DENV-1 and DENV-2 spanned a wider age range in Kaohsiung, whereas DENV-2 was dominant in Tainan. As very few studies have obtained the serostatus of DENV infection in older adults and the elderly, this study highlights the need for further investigation into antibody status, as well as the safety and efficacy of dengue vaccination in these older populations.

Primary Malignant Tumors of the Thyroid Gland. Histology, Age and Sex Distribution and Pathologic Correlations in 139 Cases

1983 ◽  
Vol 69 (3) ◽  
pp. 205-213 ◽  
Author(s):  
Carlo D. Baroni ◽  
Liborio Manente ◽  
Vincenzo Maccallini ◽  
Giorgio Di Matteo
Keyword(s):  
Thyroid Gland ◽  
Malignant Tumors ◽  
Regional Lymph Node ◽  
Age Groups ◽  
Young Patients ◽  
The Elderly ◽  
Regional Metastases ◽  
Total Female ◽  
Toxic Goiter ◽  
University Of Rome

The classification proposed by Woolner et al. (1961, 1971) has been applied to 139 cases of primary malignant tumors of the thyroid gland diagnosed in one of the largest hospitals of Rome, Italy, over a period of 5 years, from 1977 to 1981. These cases come from 1418 patients with enlargement of the thyroid surgically treated at the 5th Surgical Clinic of the University of Rome. All the histologic slides were re-examined, and the pathology records were re-evaluated. Of these tumors, 56.8% were papillary, 30.9% follicular, 9.3% anaplastic or undifferentiated, and 2.1% medullary. There was a female predominance in all age groups and for all types of tumors, reflecting a total female to male ratio of 1.9:1. Papillary carcinoma occurred most commonly in young and young-adult patients, follicular in the middle-age group, and anaplastic in the elderly. The extent of the primary tumor, the presence of regional metastases, and the association with other thyroid nonneoplastic diseases such as lymphocytic and Hashimoto's thyroiditis, and nontoxic and toxic goiter were also recorded. Multicentric rumors were found in 38.9% of cases principally represented by papillary carcinomas. Regional lymph node metastases were observed mainly in young patients, and no correlation was found between thyroid cancer incidence and other nonneoplastic thyroid diseases.

Translocation Carcinomas of the Kidney After Chemotherapy in Childhood

2006 ◽  
Vol 24 (10) ◽  
pp. 1529-1534 ◽  
Author(s):  
Pedram Argani ◽  
Marick Laé ◽  
Edgar T. Ballard ◽  
Mahul Amin ◽  
Carlos Manivel ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Wilms Tumor ◽  
Conditioning Regimen ◽  
Young Patients ◽  
Molecular Data ◽  
Marrow Transplant ◽  
Cytotoxic Chemotherapy ◽  
Secondary Malignancy ◽  
Increased Risk ◽  
Hurler’S Syndrome

Purpose Children who survive cancer are at more than 19-fold increased risk of developing another malignancy. Renal cell carcinoma (RCC) occurring as a secondary malignancy is uncommon. Translocation RCC, bearing TFE3 or TFEB gene fusions, are recently recognized entities for which risk factors have not been identified. Patients and Methods We describe the clinical, pathologic, cytogenetic, and molecular data on six translocation RCCs that arose in five young patients who had received chemotherapy. Results The ages at time of diagnosis of the RCC ranged from 6 to 22 years. Histologically, these tumors showed typical features previously described for translocation RCCs. At the molecular level, three tumors contained the ASPL-TFE3 fusion, two contained Alpha-TFEB, and one contained PRCC-TFE3. The intervals between chemotherapy and the diagnosis of RCC ranged from 4 to 13 years. The indications for the antecedent chemotherapy were varied and included acute promyelocytic leukemia, acute myeloid leukemia with t(9;11), bilateral Wilms' tumor, systemic lupus erythematosus, and conditioning regimen of bone marrow transplant for Hurler's syndrome. Only the latter patient had also received radiation. Hence, among 39 genetically confirmed translocation RCCs in our personal experience, six (15%) have arisen in patients who had received cytotoxic chemotherapy. Conclusion Cytotoxic chemotherapy may predispose to the development of renal translocation carcinomas.

scholarly journals Criterion validity of a Wechsler-III scale short form in a sample of Brazilian Elderly

2010 ◽  
Vol 4 (3) ◽  
pp. 207-213
Author(s):  
Eliane Ferreira Carvalho Banhato ◽  
Isabel Cristina Gonçalves Leite ◽  
Danielle Viveiros Guedes ◽  
Alfredo Chaoubah
Keyword(s):  
Short Form ◽  
Age Groups ◽  
The Elderly ◽  
Total Sample ◽  
Criterion Validity ◽  
Predictive Values ◽  
Clock Drawing Test ◽  
Sensitivity Specificity ◽  
Age Range ◽  
And Control

Abstract Although a normative process, changes in cognitive functioning vary among older adults. The differential diagnosis between normal and pathological aging must be made early using psychometrically adequate measures. Objectives: To assess the evidence of criterion validity of a Short Form (SF) of the Wechsler-III Scale containing eight subtests (SF8) by determining its sensitivity, specificity, positive and negative predictive values and cut-off points for Brazilian elderly from different age groups. Methods: 168 individuals, aged 60 years or above, living in the community or in an institution, were assigned to case and control groups, and investigated according to age range. Measures included a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), Verbal Fluency Test, Clock-Drawing Test and the SF8. Results: More than two thirds of the sample was women (73.8%), mean age was 74.5 years (SD=8.9), mean education was 6.2 years (SD=4.8) and 40.5% were widows/widowers. In the total sample, the best cut-off point for the SF8 was 142 while cut offs among individuals aged 60 to 69 years, 70 to 79 years, and more than 80 years were 160, 129 and 129, respectively. Conclusions: The results demonstrated the importance of different cut-off points for different age ranges. Sensitivity and specificity values of the SF8 were sufficiently high to warrant the use of the SF8 as an instrument to identify cognitive impairment in the elderly.

A pooled analysis of the effect of age on adjuvant cisplatin-based chemotherapy for completely resected non-small cell lung cancer (NSCLC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7553-7553 ◽  
Author(s):  
M. Fruh ◽  
H. Tribodet ◽  
J. Pignon ◽  
T. Winton ◽  
T. Le Chevalier ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Performance Status ◽  
Age Groups ◽  
Young Patients ◽  
Disease Free Survival ◽  
The Elderly ◽  
Pooled Analysis ◽  
Severe Toxicity ◽  
Cox Models

7553 Background: Adjuvant cisplatin-based chemotherapy (CT) has been shown to increase survival in NSCLC, but uncertainty exists concerning its efficacy and toxicity in elderly patients (≥ 70). Methods: We performed a pooled analysis using individual patient data from 4,584 patients in the LACE database with resected stage IA-III NSCLC enrolled in 5 randomized trials, comparing postoperative CT to no CT (ALPI, ANITA, BLT, IALT and JBR10). Patient and treatment characteristics, CT toxicity and delivery, overall survival, disease-free survival (DFS) and cause-specific mortality were compared among 3 age groups: 3,269 (71%) young (<65), 901 (20%) mid-category (65–69) and 414 (9%) elderly (≥70). The analysis was performed on an intent-to-treat basis. Cox models stratified by trials and adjusted for age, associated drug, planned radiotherapy, total dose of cisplatin (<300, 300, >300), gender, stage, performance status, type of surgery and histology were used with a test for trend to study the effect of CT on survival according to age. Results: Baseline characteristics differed among the age groups, but this was due mainly to the different trial populations and designs. No difference in severe toxicity rate was observed among the age groups. Elderly patients received significantly smaller total doses of cisplatin than the other patients (Chi2-test: p<0.0001) and also the cisplatin doses received were more often lower than the planned one (Kruskal-Wallis test: p<0.0001). The Hazard ratio (HR) of death for the young patients was 0.82 (95% CI 0.73–0.92), 0.86 (95% CI 0.70–1.07) for the mid category and 1.01 (95% CI 0.78–1.32) for elderly patients (test for trend: p=0.17). The HR for DFS was 0.79 (95% CI 0.71–0.87) for the young, 0.76 (95% 0.62–0.93) for the mid category and 0.94 (95% CI 0.73–1.22) for the elderly patients (test for trend: p=0.35). More elderly patients died from non- lung cancer related causes (10% young, 16% mid category and 20% elderly; p<0.0001). Conclusions: The survival benefit from cisplatin-based adjuvant therapy for NSCLC patients was not significantly different according to age, but this may be due to lack of power. Supported by unrestricted grants from PHRC and LNCC No significant financial relationships to disclose.

Vitamin D Status in Patients with Osteopenia or Osteoporosis – an Audit of an Endocrine Clinic

2006 ◽  
Vol 76 (5) ◽  
pp. 307-313 ◽  
Author(s):  
Kocjan ◽  
Tan ◽  
Conway ◽  
Prelevic
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Age Groups ◽  
Young Patients ◽  
The Elderly ◽  
Dietary Advice ◽  
Mineral Density ◽  
Serum 25Ohd ◽  
Number Of Patients ◽  
Increase Fracture Risk

Vitamin D deficiency and insufficiency may further increase fracture risk in patients with decreased bone mineral density. We audited serum 25-hydroxyvitamin D (25OHD) concentrations in patients with osteopenia or osteoporosis attending endocrine osteoporosis clinics in North London between January 1998 and September 2001. The total number of patients analyzed was 448 (age range 17–89 years), with 191 patients being < 50 years old (42.6%). The following cut-off points for serum 25OHD were used: levels ≤ 30 nmol/L for deficiency, > 30–50 nmol/L for insufficiency, and > 50 nmol/L for sufficiency. The overall prevalence of vitamin D deficiency was 30.5% and of vitamin D insufficiency was 35.9%. Vitamin D deficiency was as prevalent in young patients as in older ones: the prevalence of serum 25OHD ≤ 30 nmol/L in those < 50 years of age was 33.0% (n = 63 of 191), compared with 31.1% (n = 80 of 257) in patients aged ≥ 50 years. Our results indicate that vitamin D deficiency and insufficiency is a common problem in patients with osteopenia or osteoporosis. This situation persists despite dietary advice and prescription of vitamin D3 supplementation. Vitamin D deficiency affects all age groups, not merely the elderly.

scholarly journals Prevalence of Erectile Dysfunction and Awareness of Its Treatment in Abuja, Nigeria

2019 ◽  
pp. 1-10
Author(s):  
S. Abu ◽  
T. Atim ◽  
N. R. Ripiye
Keyword(s):  
Erectile Dysfunction ◽  
Age Groups ◽  
The Elderly ◽  
Health Seeking ◽  
Cross Sectional ◽  
Threatening Condition ◽  
Seeking Behavior ◽  
Life Threatening ◽  
Young Subjects ◽  
Age Range

Introduction: Erectile dysfunction (ED) is the most common male sexual dysfunction all over the World. It is underestimated in developing countries including Nigeria because it is assumed not to be a life threatening condition which is associated with stigmatization and poor health seeking behavior. The Prevalence rate of ED among specific age groups has not been reported in most available local studies. This study was aimed at determining the prevalence rates of ED and the severity of ED among different age groups and patients’ awareness of its treatment. Methods: The study was a descriptive cross-sectional hospital based survey among men aged 18 years and above seen in the outpatient clinics of University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria. Self reported erectile dysfunction was obtained using proforma. The prevalence and severity of ED was obtained using International Index of Erectile Function-5 Questionnaire (IIEF-5). Results: A total of 378 subjects were recruited for this study with age range of 18-76 years. The prevalence of ED in this study using IIEF-5 was 66.4%. The prevalence of ED was noted to increase with increasing age as ED was more prevalent (59%) among men aged 60-79 year. ED was least common among the young subjects (15.7%) and the most severe ED found among the elderly There was a positive correlation between age and ED (rho =0.306). There was statistically significance association between ED and co-morbidities with hypertension accounting for 22.5% and diabetes 16.7%. The percentage of subjects aware of treatment for ED was 39.4% and 20.4% of the subjects had sought help from doctors. Only about a quarter (26.5%) of the subjects had their sexual challenges discussed with the doctor. Conclusion: ED is a common medical and social problem in our environment though still shrouded in secrecy. ED is more prevalent and severe among age 60-79 years. Awareness of treatment seeking behavior and the ability of the attending physicians to discuss with men about their sexual health remains quite poor in our environment.

scholarly journals DETERMINATION OF DENTAL AGE OF 10-13 YEAR-OLD CHILDREN OF THE CARPATHIAN REGION OF UKRAINE BY THE CAMERIERE METHOD IN COMPARISON WITH THEIR CHRONOLOGICAL AGE

2019 ◽  
pp. 63-70
Author(s):  
V.F. Makieyev ◽  
O.O. Isakova
Keyword(s):  
Age Groups ◽  
High Accuracy ◽  
Permanent Teeth ◽  
Chronological Age ◽  
Age Group ◽  
Dental Age ◽  
Ray Method ◽  
Significant Difference ◽  
Age Range

Purpose:  to evaluate the chronological and dental age of children in Lviv and the Lviv region aged 10-13 years with the help of the modified formula Cameriere.  Methods. Оrthopantomograms  46 children (26 boys and 20 girls) aged 10-13 years from Lviv and Lviv region have been used for this study. A questionnaire was developed for the submission of individual patient data and a standardized format for making their indicators derived from orthopantomograms (OPG). The examination of the area of the lower seven teeth on the left was done using the Cameriere method and the age of the child was evaluated, which was further compared with the chronological age.  Results.The obtained results of the study showed a high accuracy and reliability of the estimation of dental age in children up to 10-13 years with the help of the Cameriere formula modified by us. The research is based on the detection of physiological changes (the rate of formation of the roots) in the permanent teeth of children using the X-ray method.  Evaluating the results obtained by two methods, among girls and boys of the selected age group, a statistically significant strong correlation between the chronological age and the age calculated by the Cameriere method was revealed. Cameriere research has been carried out in many countries around the world and, in particular, in European countries, by implementing the general formula. Children in the period of occlusive bite remain the most critical in terms of age and, therefore, the determination of the correct time for dental interventions. In this age group, the development of permanent teeth passes through different stages and depends on many factors of the environment, genetic, geographical and food factors. The process of teething also affects many local factors, such as space and space for a permanent tooth in the dental artery and the loss of temporary precursors. Even with a large number of factors affecting the eruption and formation of permanent teeth in children, this method showed high accuracy and independence. In order to assess the Cameriere method among the children under study and its further practical application, a comparison was made between the age obtained using this methodology and the chronological age of the children under study in different age groups, both among boys and girls. Analyzing the obtained data, it was found that the mean of chronological age among the studied boys aged 10-11 (n = 14) was 11.02 ± 0.59 years, and the Cameriere method was 10.63 ± 1.03 years.  Student's assessment did not reveal a significant difference between the data (p = 0.22) for the age group of 10-11 years.  Further analysis among the studied boys revealed that in the age group 12-13 years the average chronological age was 12.94 ± 0.49 years, and the age was determined by the Cameriere method 12.59 ± 0.63 years, and no significant difference was established between them  (p = 0.14). The results of the studies have shown the suitability of the Cameriere formula modified during the process, based on the assessment of open tops and the number of teeth with completed root formation as a marker for the physiological development of the child and one that can be used to determine the child's age.Since studies had a limited age range on a particular sample of dental patients, further studies should evaluate the utility of this method in a larger sample of children in the extended age range of the given region of Ukraine and, if possible, adjust the formula we modified for the stability of the averaged indicators in different samples by age and sex. 

scholarly journals 109 Hyponatraemia in Older Patients is Often Untreated, Despite Greater Mortality Burden; Results of A Prospective Cohort Study

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i34-i36 ◽  
Author(s):  
O Thorpe ◽  
M Cuesta ◽  
W T Tormey ◽  
M Sherlock ◽  
D J Williams ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Older Patients ◽  
Prospective Observational Study ◽  
Age Groups ◽  
Young Patients ◽  
The Elderly ◽  
Plasma Sodium ◽  
Single Centre ◽  
Similar Frequency ◽  
Mortality Burden

Abstract Introduction Hyponatraemia is associated with increased morbidity and mortality, and is commoner in elderly patients. The aetiology and outcomes of hyponatraemia in the elderly has not been defined in prospective studies. Methods A single-centre 9 month prospective observational study of hyponatraemic (HN) patients (&lt;/= 130 mmol/L) was performed. Clinical outcomes in patients ≥65 years (Elderly patients, EP) and those &lt;65 years (Young Patients, YP) were analysed, and compared with age-matched eunatremic controls, Analysis was performed using Graphpad-Prism 7. Results 1321 consecutive admissions with hyponatraemia (67% EP, median age of EP 77 (65–98) years) and 1122 eunatremic controls (63% EP, median age of EP 77 (65–99) years) were analysed. Median nadir plasma sodium was similar in both groups with HN, 128 (107–130) mmol/L EP vs 128(110–130) mmol/L YP (p = 0.62). EP hyponatraemic patients were more likely to have hypovolaemic hyponatraemia (34%) compared with YP with hyponatraemia (28%, p = 0.03). Diuretic-induced hyponatraemia was twice as common in EP (8%) compared with YP (4%, p = 0.01). Malignancy-induced SIAD occurred with similar frequency in both groups (7% in EP SIAD vs 8% in YP SIAD, p = 0.65). Respiratory disease was causative in 10% cases of EP SIAD, compared with 4% in YP SIAD, p = 0.0004. Hyponatraemia was corrected in 53% of EP, compared with 64% of YP, p = 0.0001. Length of stay and re-admissions rates were similar across hyponatraemia age groups. EP with HN were 2.4 times more likely to die in hospital, compared with eunatremic age-matched controls, (OR 2.4, 95% CI 1.6–3.7, p &lt; 0.0001). Conclusions The causation of hyponatraemia is different in elderly patients. Hyponatraemia in EP is often uncorrected, despite increased mortality compared with eunatremic age-matched controls.

scholarly journals Increased Oxidative Stress Response in Granulocytes from Older Patients with a Hip Fracture May Account for Slow Regeneration

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Zhiyong Wang ◽  
Sabrina Ehnert ◽  
Christoph Ihle ◽  
Lilianna Schyschka ◽  
Stefan Pscherer ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Stress Response ◽  
Age Groups ◽  
Young Patients ◽  
The Elderly ◽  
Oxidative Stress Response ◽  
Proximal Femur Fracture ◽  
Mapk Activation ◽  
Stress Markers ◽  
Stress Response System

Proximal femur fracture, a typical fracture of the elderly, is often associated with morbidity, reduced quality of life, impaired physical function and increased mortality. There exists evidence that responses of the hematopoietic microenvironment to fractures change with age. Therefore, we investigated oxidative stress markers and oxidative stress-related MAPK activation in granulocytes from the young and the elderly with and without fractured long bones. Lipid peroxidation levels were increased in the elderly controls and patients. Aged granulocytes were more sensitive towards oxidative stress induced damage than young granulocytes. This might be due to the basally increased expression of SOD-1 in the elderly, which was not further induced by fractures, as observed in young patients. This might be caused by an altered MAPK activation. In aged granulocytes basal p38 and JNK activities were increased and basal ERK1/2 activity was decreased. Following fracture, JNK activity decreased, while ERK1/2 and p38 activities increased in both age groups. Control experiments with HL60 cells revealed that the observed p38 activation depends strongly on age. Summarizing, we observed age-dependent changes in the oxidative stress response system of granulocytes after fractures, for example, altered MAPK activation and SOD-1 expression. This makes aged granulocytes vulnerable to the stress stimuli of the fracture and following surgery.

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