Diagnostic Role of Prostate Resection in the Elderly Patients Who Experience Significant Co-Morbidity with a High Clinical Suspicion of Prostate Cancer

We compared radiotherapy outcomes between 241 elderly patients aged ≥75 years and 867 younger controls (age <75 years) with clinically localized prostate cancer. The elderly group showed an equivalent actuarial seven-year biochemical failure-free survival rate (7y-bNED) (94.9%) to the younger control group (96.4%, p = 0.593). The incidence of late genitourinary (GU) and gastrointestinal (GI) toxicities grade ≥2 was also similar between the elderly and younger cohorts, while no grade ≥4 adverse events occurred. We also examined the role of brachytherapy (BT) in the elderly group, in comparison with image-guided intensity-modulated radiotherapy (IG-IMRT). BT showed superior 7y-bNED (94.1%) than IG-IMRT (84.6%, p = 0.0183) in elderly patients, which was 100% (100% for BT and 100% for IG-IMRT, p > 0.999) for the low-risk group, 94.6% (92.8% and 100%, p = 0.203) for the intermediate-risk group, and 80.5% (91.2% and 73.6%, p = 0.0195) for the high-risk group. BT showed higher GU toxicity and equivalent GI toxicity to IG-IMRT. In conclusion, elderly patients showed bNED and toxicity that were equivalent to those observed in younger controls, and BT is a plausible option also for healthy elderly with potential to improve bNED, with higher but acceptable GU toxicity.

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The role of the internal medicine specialist in the management of infective complications in general surgical wards

Italian Journal of Medicine ◽

10.4081/itjm.2008.2.12 ◽

2013 ◽

pp. 12-19

Author(s):

Patrizia Zoboli ◽

Giuseppe Chesi ◽

Fabrizio Boni ◽

Federica Maselli ◽

Lisa Zambianchi

Keyword(s):

Internal Medicine ◽

Elderly Patients ◽

Risk Evaluation ◽

Medical Condition ◽

The Elderly ◽

Operative Management ◽

Surgical Team ◽

Medical Consultant ◽

Post Surgery

BACKGROUND Internal medicine specialists are often asked to evaluate a patient before surgery. Perioperative risk evaluation for elderly patients is important, because complications increase with age. The increasing age of the general population increases the probabilities of surgery in the older patients. The manifestation of a surgical problem, is more likely to be severe and complicated in the elderly patients. In fact, emergency surgery treatment occurs more frequently in the elderly (e.g., it is much more common to see intestinal obstruction complicating colorectal cancer in the elderly compared with a younger population). Old age is an independent factor for long hospital stay after surgery. The role of the preoperative medical consultant is to identify and evaluate a patient’s current medical status and provide a clinical risk profile, in order to decide whether further tests are indicated prior to surgery, and to optimise the patient’s medical condition in the attempt of reducing the risk of complications. The medical consultant must know which medical condition could eventually influence the surgery, achieve a good contact and communication between the medical and surgical team, in order to obtain the best management planning. AIM OF THE STUDY This paper focuses on the rational use of antibiotic prophylaxis and on the treatment of the complications of post-surgery infections (e.g., pulmonary complication, peritonitis, intra-abdominal infection). Specific aspects of pre-operative risk evaluation and peri and post-operative management are discussed. CONCLUSIONS The internal medicin specialist in collaboration with the surgical team is necessary in the peri and post-surgery management.

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Fascin-1 and its role as a serological marker in prostate cancer: a prospective case–control study

Future Science OA ◽

10.2144/fsoa-2021-0051 ◽

2021 ◽

pp. FSO745

Author(s):

Octavian Sabin Tătaru ◽

Orsolya Martha ◽

Felice Crocetto ◽

Biagio Barone ◽

Septimiu Voidazan ◽

...

Keyword(s):

Prostate Cancer ◽

Case Control Study ◽

Sandwich Elisa ◽

Case Control ◽

Elisa Method ◽

Diagnostic Role ◽

The Difference ◽

Blood Specimens ◽

Control Study

Aim: This study aims to investigate any modification of serological FSCN1 in prostate cancer patients compared with patients without neoplasia. Material & methods: Clinical data and blood specimens from patients with and without prostate cancer were obtained. A quantitative sandwich ELISA method was used to determine serological values of FSCN1. Results: Although serum values of FSCN1 were dissimilar in the two cohorts of patients (6.90 vs 7.33 ng/ml), the difference was not statistically significant (p = 0.20). Serum values of FSCN1 stratified for Gleason score groups were not significantly distinguishable (p = 0.65). A negative correlation (rho = -0.331; p = 0.009) was reported between FSCN1 and age. Conclusion: Further studies are required to evaluate a possible diagnostic role of FSCN1 in prostate cancer.

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Treatment with CPAP in Elderly Patients with Obstructive Sleep Apnoea

Journal of Clinical Medicine ◽

10.3390/jcm9020546 ◽

2020 ◽

Vol 9 (2) ◽

pp. 546 ◽

Cited By ~ 1

Author(s):

Tomas Posadas ◽

Grace Oscullo ◽

Enrique Zaldívar ◽

Alberto Garcia-Ortega ◽

José Daniel Gómez-Olivas ◽

...

Keyword(s):

Clinical Trials ◽

Elderly Patients ◽

Obstructive Sleep Apnoea ◽

The Elderly ◽

Sleep Apnoea ◽

Age Group ◽

Obstructive Sleep ◽

Receive Treatment ◽

Therapeutic Tools

The population pyramid is changing as a result of the ever-increasing life expectancy, which makes it crucial to acquire an in-depth understanding of the diseases that most often affect the elderly. Obstructive sleep apnoea (OSA) affects 15%–20% of the population aged over 65 years. Despite this prevalence, there have been very few specific studies on the management of OSA in this age group, even though over 60% of the patients aged over 65-70 years who attend sleep units with suspicion of OSA receive treatment with continuous positive airway pressure (CPAP), on the basis of an extrapolation of the positive results achieved by CPAP in clinical trials involving middle-aged males. However, the latter’s form of presentation, evolution and, probably, prognosis comparing with OSA are not the same as those of elderly patients. Recent clinical trials performed on an exclusive series of elderly patients have shed light on the possible role of CPAP treatment in elderly patients with OSA, but there are still many questions that need to be answered. The physiological increase in the number of sleep-related disorders with the passing of years, and the lack of validated diagnostic and therapeutic tools for this age group are probably the greatest obstacles to define, diagnose and treat OSA in the elderly.

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Diagnostic Role of Magnetic Resonance Imaging-Targeted Biopsy for Prostate Cancer in Biopsy-Naïve Men: A Meta-Analysis

Urologia Internationalis ◽

10.1159/000504028 ◽

2019 ◽

Vol 104 (3-4) ◽

pp. 187-198 ◽

Cited By ~ 1

Author(s):

Xiang Tu ◽

Zhenhua Liu ◽

Chichen Zhang ◽

Tiancong Chang ◽

He Xu ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

Meta Analysis ◽

Targeted Biopsy ◽

Resonance Imaging ◽

Diagnostic Role

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Associate Members: A Life Worth Living

British Journal of Occupational Therapy ◽

10.1177/030802268604901108 ◽

1986 ◽

Vol 49 (11) ◽

pp. 362-364 ◽

Cited By ~ 1

Author(s):

Jean Parker

Keyword(s):

Elderly Patients ◽

Long Term Care ◽

The Elderly ◽

Worth Living ◽

Term Care ◽

Life Worth Living ◽

Meaningful Existence ◽

Time And Energy

Long-term care patients need a meaningful existence. It is our responsibility to ensure that time and energy are channelled into purposeful solutions for the disease of ‘time with nothing to do’. The author has taken up this challenge. Working as an activities organizer with the elderly for 11 years, she was determined never to take the role of a baby-sitter. The recreation unit has grown from its first eight guests to a purpose-built unit with approximately 1,500 attendances per month. A busy happy atmosphere now prevails where once there was a sea of dead faces. The choice to retain a sense of dignity and purpose should be available to all elderly patients who require long-term care.

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The Role of Spinal Orthoses in Osteoporotic Vertebral Fractures of the Elderly Population (Age 60 Years or Older): Systematic Review

Global Spine Journal ◽

10.1177/2192568220948036 ◽

2020 ◽

pp. 219256822094803

Author(s):

Barry Ting Sheen Kweh ◽

Hui Qing Lee ◽

Terence Tan ◽

Joost Rutges ◽

Travis Marion ◽

...

Keyword(s):

Systematic Review ◽

Elderly Patients ◽

Vertebral Fractures ◽

Postural Stability ◽

Elderly Population ◽

The Elderly ◽

Functional Improvement ◽

Osteoporotic Vertebral Fractures ◽

Spinal Orthoses

Study Design: Systematic review. Objective: Spinal orthoses have been generally used in the management of osteoporotic vertebral fractures in the elderly population with purported positive biomechanical and functional effects. To our knowledge, this is the first systematic review of the literature examining the role of spinal orthoses in osteoporotic elderly patients who sustain low energy trauma vertebral fractures. Methods: A systematic literature review adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. Methodical searches utilizing MEDLINE, EMBASE, Google Scholar, and Cochrane Databases was performed. Results: Of the 2019 articles initially retrieved, 7 published articles (4 randomized controlled trials and 3 prospective cohort studies) satisfied the inclusion criteria. Five studies reported improvement in quantitative measurements of spinal column stability when either a rigid or semirigid orthosis was used, while 1 study was equivocal. The studies also showed the translation of biomechanical benefit into significant functional improvement as manifested by improved postural stability and reduced body sway. Subjective improvement in pain scores and quality of life was also noted with bracing. Conclusion: The use of spinal orthoses in neurologically intact elderly patients aged 60 years and older with osteoporotic compression vertebral fractures results in improved biomechanical vertebral stability, reduced kyphotic deformity, enhanced postural stability, greater muscular strength and superior functional outcomes.

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4013 POSTER Obesity in the Elderly: on the Role of Adipokines in Prostate Cancer Progression

European Journal of Cancer ◽

10.1016/s0959-8049(11)71256-4 ◽

2011 ◽

Vol 47 ◽

pp. S277

Author(s):

A. Angelucci ◽

G. Pace ◽

P. Sanitá ◽

C. Vicentini ◽

M. Bologna

Keyword(s):

Prostate Cancer ◽

Cancer Progression ◽

The Elderly ◽

Prostate Cancer Progression

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The Diagnostic Role of 18F-Choline, 18F-Fluciclovine and 18F-PSMA PET/CT in the Detection of Prostate Cancer With Biochemical Recurrence: A Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.684629 ◽

2021 ◽

Vol 11 ◽

Author(s):

Rang Wang ◽

Guohua Shen ◽

Mingxing Huang ◽

Rong Tian

Keyword(s):

Prostate Cancer ◽

Diagnostic Accuracy ◽

Biochemical Recurrence ◽

Meta Analysis ◽

Detection Rates ◽

Psma Pet ◽

Pet Ct ◽

Diagnostic Role ◽

Sensitivity Specificity

BackgroundDiagnosing the biochemical recurrence (BCR) of prostate cancer (PCa) is a clinical challenge, and early detection of BCR can help patients receive optimal treatment. We conducted a meta-analysis to define the diagnostic accuracy of PET/CT using 18F-labeled choline, fluciclovine, and prostate-specific membrane antigen (PSMA) in patients with BCR.MethodsMultiple databases were searched until March 30, 2021. We included studies investigating the diagnostic accuracy of 18F-choline, 18F-fluciclovine, and 18F-PSMA PET/CT in patients with BCR. The pooled sensitivity, specificity, and detection rate of 18F-labeled tracers were calculated with a random-effects model.ResultsA total of 46 studies met the included criteria; 17, 16, and 13 studies focused on 18F-choline, fluciclovine, and PSMA, respectively. The pooled sensitivities of 18F-choline and 18F-fluciclovine were 0.93 (95% CI, 0.85–0.98) and 0.80 (95% CI, 0.65–0.897), and the specificities were 0.91 (95% CI, 0.73–0.97) and 0.66 (95% CI, 0.50–0.79), respectively. The pooled detection rates of 18F-labeled choline, fluciclovine and PSMA were 66, 74, and 83%, respectively. Moreover, the detection rates of 18F-labeled choline, fluciclovine, and PSMA were 35, 23, and 58% for a PSA level less than 0.5 ng/ml; 41, 46, and 75% for a PSA level of 0.5–0.99 ng/ml; 62, 57, and 86% for a PSA level of 1.0–1.99 ng/ml; 80, 92, and 94% for a PSA level more than 2.0 ng/ml.ConclusionThese three 18F-labeled tracers are promising for detecting BCR in prostate cancer patients, with 18F-choline showing superior diagnostic accuracy. In addition, the much higher detection rates of 18F-PSMA showed its superiority over other tracers, particularly in low PSA levels.Systematic Review RegistrationPROSPERO, identifier CRD42020212531.

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