scholarly journals Cardiac Effects of Anticancer Therapy in the Elderly

2014 ◽  
Vol 32 (24) ◽  
pp. 2654-2661 ◽  
Author(s):  
Melissa K. Accordino ◽  
Alfred I. Neugut ◽  
Dawn L. Hershman
Keyword(s):  
Clinical Trial ◽  
Elderly Patients ◽  
Clinical Trial Data ◽  
The Elderly ◽  
Cardiac Risk ◽  
Long Term Effects ◽  
Cardiac Events ◽  
Long Term Follow Up ◽  
Clinical Trial Evidence

Cancer incidence increases with age, and as life expectancy increases, the number of elderly patients with cancer is increasing. Cancer treatments, including chemotherapy and radiotherapy, have significant short- and long-term effects on cardiovascular function. These cardiotoxic effects can be acute, such as changes in electrocardiogram (ECG), arrhythmias, ischemia, and pericarditis and/or myocarditis-like syndromes, or they can be chronic, such as ventricular dysfunction. Anticancer therapies can also have indirect effects, such as alterations in blood pressure, or can cause metabolic abnormalities that subsequently increase risk for cardiac events. In this review, we explore both observational and clinical trial evidence of cardiac risk in the elderly. In both observational and clinical trial data, risk of cardiotoxicity with anthracycline-based chemotherapy increases with age. However, it is less clear whether the association between age and cardiotoxicity exists for newer treatments. The association may not be well demonstrated as a result of under-representation of elderly patients in clinical trials and avoidance of these therapies in this population. In addition, we discuss strategies for surveillance and prevention of cardiotoxicity in the elderly. In the elderly, it is important to be aware of the potential for cardiotoxicity during long-term follow-up and to consider both prevention and surveillance of these late effects.

scholarly journals Eradication of Helicobacter pylori may improve dyspepsia in the elderly for the long term

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ikko Tanaka ◽  
Shoko Ono ◽  
Yoshihiko Shimoda ◽  
Masaki Inoue ◽  
Sayoko Kinowaki ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Elderly Patients ◽  
Epigastric Pain ◽  
Eradication Therapy ◽  
The Elderly ◽  
Long Term Effects ◽  
Postprandial Fullness ◽  
Abdominal Symptoms ◽  
H Pylori

Abstract Background Therapy for eradication of Helicobacter pylori (H. pylori) improves symptoms of H. pylori-associated dyspepsia (HPD), but the effects of eradication in elderly patients are unclear. The aim of our study was to investigate dyspepsia symptoms and long-term effects of eradication in elderly patients. Methods This retrospective study included 496 patients who received H. pylori eradication therapy. The patients were divided into a group of elderly patients (group E: ≧ 65 years old) and a group of non-elderly patients (group N: < 65 years old). Abdominal symptoms were evaluated using a questionnaire about abdominal symptoms before eradication and after eradication (1–2 months and more than one year). Dyspepsia was defined as a score of 4 points or more for at least one of 4 items (postprandial fullness, early satiety, epigastric pain, and hunger pain). Improvement of symptoms was defined on the basis of changes in Global Overall Systems scores. Results There were no differences in abdominal symptoms before eradication between the two groups. Successful eradication improved symptoms in patients with dyspepsia within 2 months (in 75.6% (56/74) of the patients in group N and in 64.5% (20/31) of the patients in group E). The questionnaire showed that 80% (32/40) of the patients in group N and 60% (12/20) of the patients in group E had long-term relief of dyspepsia. The scores for abdominal symptoms in group E continued to improve for a mean period of 54.8 months after eradication. Conclusions Eradication of H. pylori age-independently improved dyspepsia symptoms for the long term.

The development of CLINDATA, a clinical trial data management system

1981 ◽  
Vol 3 (3) ◽  
pp. 129-136 ◽  
Author(s):  
T. Ravenscroft ◽  
D.E. Smith
Keyword(s):  
Clinical Trial ◽  
Data Management ◽  
Management System ◽  
Clinical Trial Data ◽  
Trial Data ◽  
Data Management System ◽  
Long Term Follow Up ◽  
On Line

The paper describes the design and implementation of a clinical trial data management system at the Wellcome Research Laboratories. Based on an IBM 3031 computer, the system provides the capability for on-line data input, search ing and comprehensive data analysis. The database also performs an adverse reaction reporting function and provides for long term follow-up of patients.

scholarly journals Gender-wise Long-term Predictors for Major Adverse Cardiac Events Following Percutaneous Coronary Intervention in the Elderly Population

2020 ◽  
Vol 5 (01) ◽  
pp. 18-24
Author(s):  
A. Siva Ramakrishna ◽  
V. Satish Kumar Rao ◽  
Garre Indrani
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Elderly Patients ◽  
Univariate Analysis ◽  
Coronary Intervention ◽  
The Elderly ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary

Abstract Background We aimed to recognize the predictors of long-term major adverse cardiac events (MACE) in the elderly candidates for elective percutaneous coronary intervention (PCI) in relation to gender at our center. Methods In this retrospective cohort study, we reviewed the data of the elderly patients (age ≥70 years) who underwent elective PCI who met our study criteria in our institution during 2008 and 2018. Demographical data, clinical history, angiographic details, PCI procedure, and follow-up data of the patients enrolled in the study were studied by using the angiographic and PCI procedure details. Patients were characterized in the study group as those with or without MACE, which were then compared and analyzed using the statistical analysis in a univariable and binary linear regression analysis. Results A total of 355 elderly patients (older than 70 years) undergoing elective PCI were selected who fulfilled the inclusion criteria; 277 patients were men and had more comorbidities, including hypertension, diabetes mellitus (DM), chronic obstructive pulmonary disease, history of heart failure, previous coronary artery bypass graft, and presentation with acute coronary syndrome. MACE occurred in 24 events patients of whom 20 were suffering from DM. Binary logistic regression showed that the only determinant for the 1-year follow-up outcome is diabetes (p = 0.000). Even in univariate analysis, DM (0.01) is the determinant. DM is a strong predictor for death in univariate analysis (p = 0.00). Conclusion PCI is a safe and effective method of coronary revascularization in elderly patients, and some risk factors can predict long-term MACE in this group of patients.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

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