scholarly journals Pregnancy in acromegaly is safe and is associated with improvements in IGF-1 concentrations

2019 ◽  
Vol 180 (4) ◽  
pp. K21-K29 ◽  
Author(s):  
Anne Marie Hannon ◽  
Triona O’Shea ◽  
Claire A Thompson ◽  
Mark J Hannon ◽  
Rosemary Dineen ◽  
...  
Keyword(s):  
Case Series ◽  
Later Life ◽  
Reference Level ◽  
Somatostatin Analogue ◽  
Biochemical Control ◽  
Normal Range ◽  
Normal Limits ◽  
Age Related ◽  
Plasma Gh ◽  
Pituitary Macroadenomas

Pregnancy is rarely reported in acromegaly. Many patients are diagnosed in later life and younger patients may have subfertility due to hypopituitarism. We present a case series of 17 pregnancies in 12 women with acromegaly. Twelve women with acromegaly who completed pregnancy were identified from centres involved in the Irish Pituitary Study. Eleven women had pituitary macroadenomas and one woman had a microadenoma. Only 5/17 pregnancies had optimal biochemical control of acromegaly preconception, as defined by IGF-1 concentration in the age-related reference level and plasma GH concentration of <2 μg/L. In 6/17 pregnancies, dopamine agonist treatment was continued during pregnancy; all other acromegaly treatments were discontinued during pregnancy. Effect of pregnancy on acromegaly: No patient developed new visual field abnormalities, or symptoms suggestive of tumour expansion during pregnancy. In 9/12 patients, plasma IGF-1 concentrations that were elevated preconception normalised during pregnancy. There was a reduction in plasma IGF-1 concentrations, though not into the normal range, in a further two pregnancies. Effect of acromegaly on pregnancy: 15 healthy babies were born at term; one patient underwent emergency C-section at 32 weeks for pre-eclampsia, and one twin pregnancy had an elective C-section at 35 weeks’ gestation. Blood pressure remained within normal limits in the remainder of the pregnancies. Gestational diabetes did not develop in any pregnancy. Our data suggests that pregnancy in women with acromegaly is generally safe, from a maternal and foetal perspective. Furthermore, biochemical control tends to improve despite the withdrawal of somatostatin analogue therapy during pregnancy.

scholarly journals A Biomarker-based Biological Age in UK Biobank: Composition and Prediction of Mortality and Hospital Admissions

2021 ◽  
Author(s):  
Mei Sum Chan ◽  
Matthew Arnold ◽  
Alison Offer ◽  
Imen Hammami ◽  
Marion Mafham ◽  
...  
Keyword(s):  
Principal Components ◽  
Hospital Admissions ◽  
Later Life ◽  
Chronological Age ◽  
Uk Biobank ◽  
Hand Grip ◽  
Cox Proportional Hazard ◽  
Prediction Of Mortality ◽  
Age Related ◽  
Cox Proportional Hazard Models

Abstract Background Chronological age is the strongest risk factor for most chronic diseases. Developing a biomarker-based age and understanding its most important contributing biomarkers may shed light on the effects of age on later-life health and inform opportunities for disease prevention. Methods A subpopulation of 141 254 individuals healthy at baseline were studied, from among 480 019 UK Biobank participants aged 40–70 recruited in 2006–2010, and followed up for 6–12 years via linked death and secondary care records. Principal components of 72 biomarkers measured at baseline were characterized and used to construct sex-specific composite biomarker ages using the Klemera Doubal method, which derived a weighted sum of biomarker principal components based on their linear associations with chronological age. Biomarker importance in the biomarker ages was assessed by the proportion of the variation in the biomarker ages that each explained. The proportions of the overall biomarker and chronological age effects on mortality and age-related hospital admissions explained by the biomarker ages were compared using likelihoods in Cox proportional hazard models. Results Reduced lung function, kidney function, reaction time, insulin-like growth factor 1, hand grip strength, and higher blood pressure were key contributors to the derived biomarker age in both men and women. The biomarker ages accounted for &gt;65% and &gt;84% of the apparent effect of age on mortality and hospital admissions for the healthy and whole populations, respectively, and significantly improved prediction of mortality (p &lt; .001) and hospital admissions (p &lt; 1 × 10−10) over chronological age alone. Conclusions This study suggests that a broader, multisystem approach to research and prevention of diseases of aging warrants consideration.

scholarly journals Sexuality in Later Life and Mental Health Among Older Black Gay Men

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 313-314
Author(s):  
Darlingtina Esiaka ◽  
Alice Cheng ◽  
Candidus Nwakasi
Keyword(s):  
Mental Health ◽  
Gay Men ◽  
Later Life ◽  
The United States ◽  
Mental Wellbeing ◽  
Self Identity ◽  
Sexual Identities ◽  
Age Related ◽  
Wide Range ◽  
Black Gay Men

Abstract Self-acknowledgement and integration of racial and sexual identities are significant to one’s overall sense of identity because of their implications for mental health and wellbeing. These issues are important as one ages because older people experience a wide range of factors that add layers to their ability to (re)integrate subsets of their identity into their overall self-identity such as age and age-related disabilities. This study examined the intersection of race and sexual identities on overall health status in older Black gay men, a demographic group that has historically received less attention. Data from the Social Justice Sexuality (SJS) survey of LGBTQ+ people of color which occurred over a 12-month period in the United States were analyzed. Participants (N=160), 50 years and over, responded to questions about their sexuality, social identity, family dynamics, community connection and engagement, and mental and physical health. Results show an association of mental wellbeing with racial and sexual identities. Further, results show that a strong sense of connection to other sexual minorities is positively associated with mental health in older Black gay men. We discuss the implication of findings for mental health interventions targeting this gendered population.

scholarly journals Biodegradable magnesium screws in elbow fracture fixation: Clinical case series

2021 ◽  
pp. 221049172098698
Author(s):  
Wai-Him Lam ◽  
Chi-Yin Tso ◽  
Ning Tang ◽  
Wing-Hoi Cheung ◽  
Ling Qin ◽  
...  
Keyword(s):  
Case Series ◽  
Elbow Fracture ◽  
Normal Range ◽  
Head Region ◽  
Screw Head ◽  
Loss Of Reduction ◽  
Clinical Series ◽  
Post Operation ◽  
Bioabsorbable Screws ◽  
Biodegradable Magnesium

Biodegradable magnesium-based implants are innovative alternatives that potentially eliminate the need for implant removal. Recent studies have demonstrated the osteogenic properties and bacterial inhibition potentials of magnesium screws. We reported a clinical series of three elbow fracture cases, where magnesium screws were used in the treatment of one radial head and two capitellum fractures. Postoperative clinical courses were uneventful, and fracture healing occurred within 3 months. In all cases, radiolucencies were observed around implants especially in the screw head region at 2 months post-operation, but disappeared with consolidation at 1 year post-operation. All patients achieved near normal range of motion, minimal symptoms and good functional outcomes. No complication such as failure of fixation, loss of reduction, malunion or infection was seen. No implant revision or removal was necessary. Magnesium bioabsorbable screws are shown to be a viable option for these fractures.

scholarly journals Physical Resilience as a Determinant of Healthspan and Lifespan in Mice

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 829-829
Author(s):  
Nathan LeBrasseur
Keyword(s):  
Middle Ages ◽  
Interest Group ◽  
Later Life ◽  
Cytotoxic Drugs ◽  
Geriatric Syndromes ◽  
Age Related ◽  
Fundamental Biology ◽  
Dynamic Measures ◽  
Biology Of Aging ◽  
Insight Into

Abstract Dynamic measures of physical resilience—the ability to resist and recover from a challenge—may be informative of biological age far prior to overt manifestations such as age-related diseases and geriatric syndromes (i.e., frailty). If true, physical resilience at younger or middle ages may be predictive of future healthspan and lifespan, and provide a unique paradigm in which interventions targeting the fundamental biology of aging can be tested. This seminar will discuss research on the development of clinically-relevant measures of physical resilience in mice, including anesthesia, surgery, and cytotoxic drugs. It will further highlight how these measures compare between young, middle-aged, and older mice, and how mid-life resilience relates to later-life healthspan. Finally, it will provide insight into whether interventions targeting the biology of aging can modify physical resilience in mice. Part of a symposium sponsored by Epidemiology of Aging Interest Group.

scholarly journals One-year outcomes of fixed-dosing Aflibercept therapy for pre treated and naive polypoidal choroidal vasculopathy patient

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hun Gu Choo ◽  
Jin Hae Lee ◽  
Hyun Sub Oh ◽  
Soon Hyun Kim ◽  
Yong Sung You ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Vision Loss ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Research Information ◽  
Age Related ◽  
Case Series Study ◽  
Treatment Naïve ◽  
One Year ◽  
Choroidal Vasculopathy

Abstract Background Polypoidal choroidal vasculopathy (PCV) is a type of age-related macular degeneration that can cause permanent vision loss. The purpose of this paper was to report the one-year outcomes of fixed-dosing aflibercept therapy for the treatment of PCV. Methods This was a prospective, single-arm, interventional case series study of 25 PCV patients; 12 pre-treated and 13 treatment-naïve patients. The patients were treated and monitored for 12 months. Each patient was administered with an aflibercept (2.0 mg) injection every month for the first 3 months (the loading phase), and thereafter, once every 2 months. At every follow-up visit, best-corrected visual acuity (BCVA) test, fundus examination, and optical coherence tomography for measuring the central subfield macular thickness (CSMT) were performed. Fluorescein and indocyanine green angiography were conducted at baseline and at 4 and 12 months. Results After 12 months of aflibercept therapy, the mean BCVA of the patients significantly improved from 65.48 letters at baseline to 69.91 letters (p=0.001), and the CSMT significantly decreased from 406.92 um at baseline to 276.12 um (p< 0.001). Additionally, ten patients (40%) showed complete polyp regression. The treatment-naïve patients showed a statistically significant improvement in BCVA from 66.58 letters at baseline to 76.36 letters at 12 months, and a significant decrease in CSMT, from 462 to 243 um. In the pre-treated group, there was no change in BCVA (64.46 letters), and the decrease in CSMT from 356.08 to 303.69 um was not statistically significant. Conclusions The fixed-dosing aflibercept regimen is effective for treating patients with PCV and is more effective in treatment-naïve patients than in pre-treated patients. Trial registration Clinical Research Information Service (CRiS), Republic of Korea. Identifer: KCT0005798, Registered: Jan 20, 2021. Retrospectively registered, URL: https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=18546

scholarly journals Developing a recovery-focused therapy for older people with bipolar disorder: a qualitative focus group study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049829
Author(s):  
Elizabeth Tyler ◽  
Fiona Lobban ◽  
Rita Long ◽  
Steven H Jones
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Focus Group ◽  
Older People ◽  
Focus Groups ◽  
Later Life ◽  
Focus Group Study ◽  
Age Related ◽  
Health Related ◽  
Age Related Changes

ObjectivesAs awareness of bipolar disorder (BD) increases and the world experiences a rapid ageing of the population, the number of people living with BD in later life is expected to rise substantially. There is no current evidence base for the effectiveness of psychological interventions for older adults with BD. This focus group study explored a number of topics to inform the development and delivery of a recovery-focused therapy (RfT) for older adults with BD.DesignA qualitative focus group study.SettingThree focus groups were conducted at a university in the North West of England.ParticipantsEight people took part in the focus groups; six older adults with BD, one carer and one friend.ResultsParticipant’s responses clustered into six themes: (1) health-related and age-related changes in later life, (2) the experience of BD in later life, (3) managing and coping with BD in later life, (4) recovery in later life, (5) seeking helping in the future and (6) adapting RfT for older people.ConclusionsParticipants reported a range of health-related and age-related changes and strategies to manage their BD. Participants held mixed views about using the term ‘recovery’ in later life. Participants were in agreement that certain adaptations were needed for delivering RfT for older adults, based on their experience of living with BD in later life. The data collected as part of the focus groups have led to a number of recommendations for delivering RfT for older adults with BD in a randomised controlled trial (Clinical Trial Registration: ISRCTN13875321).

Assessment of the drinking water quality for planning endogenic prevention of dental caries

2021 ◽  
Vol 21 (2) ◽  
pp. 88-93
Author(s):  
A. B. Shashmurina ◽  
O. L. Mishutina ◽  
V. R. Shashmurina
Keyword(s):  
Drinking Water ◽  
Dental Caries ◽  
Water Supply ◽  
Fluoride Concentration ◽  
Water Hardness ◽  
Drinking Water Supply ◽  
Ion Concentration ◽  
Normal Range ◽  
Hydrogen Ion Concentration ◽  
Normal Limits

Relevance. Dental caries is a leading dental disease in children. Aim – to study the quality of drinking water in Smolensk and its region to provide evidence for implementing dental caries preventive measures in children.Materials and methods. We took tap water samples from ten water intake points in seven districts of Smolensk and six Smolensk regions. An accredited testing laboratory of the Center for Hygiene and Epidemiology in the Smolensk Region carried out water chemical analysis. The study analyzed standard parameters of drinking water quality: pH 6.5-8.5, fluoride content 0.60-1.2 mg/l; water hardness 7.0-9.0 (Sanitary Regulations and Standards 2.1.4.1116-02). The parameter was considered normal if its 95% confidence interval was within the reference range.Results. In Smolensk, the hydrogen ion concentration in centralized drinking water supply systems is within normal limits and amounts to 7.39 (95% CI: 7.32-7.46; р < 0,05) pH units. The mean fluoride concentration in the Smolensk water is 0.19 (95% CI: 0.14-0.23; р < 0,05) mg/l, which is below the normal range. In most Smolensk districts, water hardness is within normal limits, 8.21 mmol/l (95% CI: 7.03-9.39; р < 0,05). However, the upper limit of the confidence interval of 9.39 mg/l and the maximum of 12.0 mg/l exceed the normal range. In the Smolensk region cities, the hydrogen ion concentration is 7.2 (95% CI: 7.02-7.38; р < 0,05) pH units in the centralized drinking water supply. The fluoride concentration in the Smolensk region water is 0.45 mg/l (95% CI: 0.23-0.68; р < 0,05), which demonstrates the fluoride deficiency in water. In the Smolensk region cities, mean water hardness is 6.66 mmol/l (95% CI: 6.00-7.03; р < 0,05), which is below the normal values. However, the CI upper limit of 7.03 mmol/l and the maximum of 7.05 mmol/l are within normal limits.Conclusions. The water of the centralized drinking water supply system in Smolensk and the Smolensk region is low in fluorides. Urgent community and individual preventive measures should be taken to expose children to fluoride.

Chronic physical stress differences between genders in a military training on the Amazon jungle

2015 ◽  
Vol 11 (1) ◽  
pp. 17-21
Author(s):  
Y.R. de Souza ◽  
F.B. Feitosa
Keyword(s):  
Plasma Levels ◽  
Scientific Literature ◽  
Military Training ◽  
Female Gender ◽  
Physical Stress ◽  
Male Gender ◽  
Normal Range ◽  
Male And Female ◽  
Normal Limits ◽  
Before And After

This study aimed to investigate the gender difference in the manifestation of physical stress in a strenuous military training on Amazon jungle, using alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK) and lactate dehydrogenase (LDH) markers, measured before and after an adaptation to jungle training. The sample consisted of 49 military volunteers, 35 male and 14 female, recently moved to the Amazon region. All plasma levels rose after the training. Serum ALT (male and female) and AST (male and female), although borderline, remained within normal limits. Already plasma levels of CK (both male and female) and LDH (male and female) largely exceeded the normal range. The average of all markers listed in female gender remained below the levels of the male gender. However, significant differences in biomarkers ALT, AST and CK between genders were found. The study points out that, in a jungle environment, biometric markers ALT, AST, CK and LDH are efficient for monitoring chronic physical stress in both genders, when used in combination. The influence of the weather on the occurrence of physical stress in unacclimated people of both genders, and the lower responses in the levels of ALT, AST, LDH and CK in females were discussed basing on the scientific literature.

scholarly journals Profil Darah Ikan Gelodok (Periophthalmodon schlosseri) dan (Boleophthalamus boddarti) di Desa Kuala Tambangan Pelaihari, Kalimantan Selatan

2020 ◽  
Vol 7 (2) ◽  
pp. 176
Author(s):  
Nita Azhari ◽  
Hidayaturrahmah Hidayaturrahmah
Keyword(s):  
Normal Limit ◽  
Hemoglobin Concentration ◽  
Mangrove Ecosystem ◽  
Normal Range ◽  
Blood Profile ◽  
Normal Limits ◽  
Range Type ◽  
Periophthalmodon Schlosseri ◽  
The Village ◽  
Mean Cell Hemoglobin

Profil darah memiliki peran yang sangat penting dalam fisiologi metabolisme dan aktifitas tubuh hewan. Kuala Tambangan memiliki banyak potensi sumber daya ikan salah satunya ikan gelodok. Ikan gelodok di kawasan ini mudah ditemukan, akan tetapi sampai sekarang belum dimanfaatkan dengan baik oleh masyarakat. Tujuan penelitian ini untuk mengetahui profil darah ikan gelodok jenis Periophthalmodon schlosseri dan Boleophthalamus boddarti pada ekosistem mangrove yang berada di desa Kuala Tambangan, Kabupaten Tanah Laut, Kalimantan Selatan. Metode yang digunakan pada penelitian ini yaitu metode penangkapan hewan langka yaitu line transek, metode hemositometer dan metode sahli parameter yang dihitung hemoglobin, eritrosit, leukosit, hematokrit, MCV (Mean Corpusculla Volume), MCH (Mean Cell Hemoglobin), MCHC (Mean Cell Hemoglobin Concentration) pada 2 jenis ikan gelodok 34 ekor P. schlosseri dan 34 ekor B. boddarti. Hasil yang didapatkan adalah eritrosit P. schlosseri 3,87±0,58 x 106 sel/μL; B. boddarti 3,78±0,73 x 106 sel/μL 2 jenis ikan gelodok ini memiliki nilai eritrosit diatas batas normal; leukosit P. schlosseri 11,91±5,61 x103 sel/μL dan B. boddartii 9,72±4,24 x103 sel/μL nilai leukosit pada 2 jenis ikan gelodok ini berada di atas batas normal; hemoglobin P. schlosseri 11,59±1,75 % dan B. boddartii 11,75±1,96 % dari hasil yang didapat kadar hemoglobin pada 2 jenis ikan gelodok ini berada di atas batas normal kadar hemoglobin ikan pada umumnya; hematokrit P. schlosseri 34,32±5,57 % dan B. boddartii 35,71±5,44 % hasil hematokrit yang didapat dari 2 jenis ikan gelodok ini yaitu di atas batas normal; jenis P. schlosseri memiliki nilai MCV 88,72±6,62 μm3 yang berada di bawah batas normal; MCH 29,92±0,69 pg/sel yang berada di bawah batas normal; MCHC 33,99±3,97 g/dL pada jenis ini nilai MCHC masih berada pada batas normal; jenis B. boddartii memiliki nilai MCV 96,16±17,96 μm3 yang berada di bawah batas normal; MCH 31,51±5,50 pg/sel yang masih berada di batas normal; MCHC 32,87±1,77 g/dL nilai MCHC pada jenis ini masih berada pada batas normal. Blood profile has a very important role in the physiology of metabolism and animal body activities. Kuala Tambangan has a lot of potential fish resources, one of which is the fish Mudskipper. Mudskipper fish in this area are easy to find, but until now it has not been utilized properly by the community. The purpose of this study was to determine the blood profile of the Periophthalmodon Schlosseri and Boleophthalamus boddarti fish species in the mangrove ecosystem in the village of Kuala Tambangan, Tanah Laut District, South Kalimantan . The method used in this study is the method of catching endangered animals namely trasnek line, hemocytometer method and parameter Sahli method which is calculated hemoglobin, erythrocytes, leukocytes, hematocrit, MCV (Mean Corpuscular Volume), MCH (Mean Cell Hemoglobin), MCHC (Mean Cell Hemoglobin Concentration) on 2 types of fish, 34 Periophthalmodon schlosseri and 34 Boleophthalmus boddarti. The results obtained were P. schlosseri erythrocytes 3.87 ± 0.58 x 106 cells / μL; B. boddarti 3.78 ± 0.73 x 106 cells / μL 2 types of fish Mudskipper has erythrocyte values above the normal limit; P. schlosseri leukocytes 11.91 ± 5.61 x103 cells / μL and B. boddartii 9.72 ± 4.24 x103 cells / μL leukocyte values in these 2 types of jagged fish are above normal limits; hemoglobin P. schlosseri 11.59 ± 1.75 % and B. boddartii 11.75 ± 1.96 % from the results obtained by the hemoglobin levels in these 2 types of fishes are above the normal limit of fish hemoglobin levels in general; hematocrit P.schlosseri 34.32 ± 5.57 % and B. boddartii 35.71 ± 5.44 % hematocrit results obtained from these 2 types of mudskipper fish are above normal limits; P.schlosseri species had MCV values of 88.72 ± 6.62 μm3 which were below normal limits; MCH 29.92 ± 0.69 pg / cell that is below the normal range; MCHC 33.99 ± 3.97 g / dL in this type the MCHC value is still in the normal range; type B. boddartii has a MCV value of 96.16 ± 17.96 μm3 which is below normal limits; MCH 31,51 ± 5.50 pg / cell which is still in the normal range; MCHC 32.87 ± 1.77 g / dL MCHC values in this type are still within normal limits.Keywords: gelodok, blood, kuala tambangan

scholarly journals Intraocular Injection of Stivant® (A Biosimilar to Bevacizumab): A Case Series

2021 ◽  
Author(s):  
Ahmad Mirshahi ◽  
Alireza Lashay ◽  
Hamid Riazi-Esfahani ◽  
Nazanin Ebrahimiadib ◽  
Hassan Khojasteh ◽  
...  
Keyword(s):  
Macular Edema ◽  
Intravitreal Injection ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Intraocular Injection ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Limited Experience ◽  
The Mean

Purpose: To report the results of intravitreal injection of a bevacizumab biosimilar called Stivant®. Methods: This prospective interventional case series was conducted on eyes with neovascular age-related macular degeneration (nAMD), retinal vein occlusion (RVO), and diabetic macular edema (DME). Stivant® was injected in three consecutive months and changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline and monthly up to one month after the third injection. Results: Three hundred and eighty-five eyes with DME (234 eyes, 61%), nAMD (87 eyes, 22%), and macular edema secondary to RVO (64 eyes, 17%) were enrolled. The mean ± standard deviation age of the patients was 61.7 ± 7.20 years. The mean BCVA and CMT changed from 0.63 ± 0.3 to 0.51 ± 0.3 LogMAR (P = 0.12 ) and from 420.4 ± 47.3μm at baseline to 316.7 ± 50.6 μm (P < 0.001) in the DME group; from 0.79 ± 0.3 to 0.68 ± 0.3 LogMAR (P = 0.19) and from 376.1 ± 31.7 μm to 303 ± 31.3 μm (P = 0.019) in the nAMD group; and from 0.81 ± 0.4 to 0.63 ± 0.4 LogMAR (P = 0.05) and from 424.21 ± 18 μm to 303.4 ± 18.8 μm (P < 0.001) in the RVO group, respectively. Conclusion: Our limited experience showed that the intravitreal injection of Stivant® was well tolerated. Although the results of this case series showed relative improvement in CMT one month after the last injection of Stivant®, BCVA improvement was statistically significant only in the RVO group. This would be essential to design a randomized clinical trial to evaluate the non-inferiority of Stivant® in comparison to bevacizumab.

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