scholarly journals Increased frequency of antinuclear antibodies in elderly subjects: fact or artifact?

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Maria Cristina Sacchi ◽  
Aldo Bellora ◽  
Stefania Tamiazzo
Keyword(s):  
Elderly Patients ◽  
Rheumatic Diseases ◽  
Gold Standard ◽  
Antinuclear Antibodies ◽  
The Elderly ◽  
Diagnostic Methods ◽  
Elderly Subjects ◽  
Title 1 ◽  
Autoimmune Rheumatic Diseases ◽  
Real Increase

Objectives: To evaluate the frequency of antinuclear antibodies (ANA) positive in elderly patients. Methodology: Ana test was evaluate in 1000 eldery patients with Indirect Immunofluorescence (IFI), which still represents the gold standard for the research of this type of autoantibodies. Results: We enrolled 1000 elderly patients ≥ 75 years (75-97y) from September 2019 to April 2020. In 29% of patients we found a positive ANA with a title ≥ 1:160. Conclusions: Our results confirm the data present in the literature. The reasons because in these patients there is an increase in the positivity of ANA are not yet known. Therefore, are these results the expression of a real increase in autoimmune rheumatic diseases in the elderly (predictive antibodies) due to the presence of other concomitant pathologies and the intake of drugs or may they depend on the greater sensitivity of the latest generation diagnostic methods? More comprehensive studies are needed to better understand this phenomenon.

scholarly journals Energy Requirement Equations in Elderly Patients: A Systematic Review (P01-002-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Dario Gregori ◽  
Honoria Ocagli ◽  
Corrado Lanera ◽  
Giulia Lorenzoni
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Indirect Calorimetry ◽  
Gold Standard ◽  
Web Application ◽  
The Elderly ◽  
Energy Requirements ◽  
Elderly Subjects ◽  
Predictive Equation ◽  
Healthy Elderly

Abstract Objectives Elderly patients are at risk of malnutrition and need an appropriate assessment of energy requirements. In the clinical setting, predictive equations are widely used to estimate the Resting Energy Expenditure (REE). Although easy to use, these equations are not always validated for the elderly and, even if validated, they often provide different outputs of energy requirements for the same subject. This study aimed at doing a systematic review of the equations for the estimation of REE in the elderly with the final aim of developing a web-based application helping clinicians in finding out the most appropriate equation for estimating the REE for each subject. Methods The systematic review was carried out using PubMed and Scopus following PRISMA guidelines. Studies in subjects older than 65 years of age, testing the performance of a predictive equation for the estimation of REE vs. a gold standard (indirect calorimetry or doubly labeled water) were included in the review. Studies performed in critically ill elderly patients were excluded. Results The initial search identified 2035 studies. The final review included 50 studies. Included studies were mainly observational, conducted in healthy elderly subjects enrolled in the outpatient setting, and using indirect calorimetry as gold standard. The 50 studies included in the review corresponded to 189 different equations. Several parameters were included in the equations and they can be divided as following: anthropometric characteristics, body composition parameters, environmental measures, laboratory tests, presence of comorbidities, and physical activity frequency. Conclusions The assessment of the energy requirements in the elderly is crucial for the management of nutritional problems in this population group since nutritional problems are related to worse health outcomes. The present study showed a wide use of different type of equations for the estimation of REE in the elderly highlighting the need of choosing the most appropriate predictive equation according to the subject characteristics and health status. The web application that is currently under development will help clinicians in doing that. Funding Sources Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy.

Coronary artery disease in the elderly

1999 ◽  
Vol 9 (1) ◽  
pp. 13-21 ◽  
Author(s):  
SK Glen ◽  
NA Boon
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
The Elderly ◽  
Elderly Subjects ◽  
Younger Patients ◽  
Artery Disease ◽  
Morbid Conditions

Coronary artery disease is extremely common among elderly people and accounts for half of all deaths in those who are more than 65 years old. Although the condition is essentially the same as that encountered in younger patients, the management of coronary artery disease in elderly subjects can be difficult because the anticipated benefits and risks of the various treatment options are often altered by the presence of co-morbid conditions. Moreover, the results of the major outcome studies that underpin most treatment guidelines may not be relevant to the needs of many elderly patients for several reasons.

scholarly journals Displaced olecranon fractures in the elderly: outcomes after non-operative treatment – a narrative review

2020 ◽  
Vol 5 (7) ◽  
pp. 391-397
Author(s):  
Olga D. Savvidou ◽  
Panagiotis Koutsouradis ◽  
Angelos Kaspiris ◽  
Leon Naar ◽  
George D. Chloros ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Elderly Patients ◽  
Operative Treatment ◽  
Treatment Option ◽  
Gold Standard ◽  
Elderly Population ◽  
Standard Of Care ◽  
The Elderly ◽  
Small Series ◽  
Olecranon Fractures

Operative treatment with tension band wiring or plate is the gold standard of care for displaced olecranon fractures. In elderly patients, multiple comorbidities combine with increased intraoperative risks, and postoperative complications may yield poor results. There are small series in the literature that show promising results with non-operative treatment. Non-operative treatment may provide reasonable function and satisfaction in the elderly population and could be considered as a treatment option in this group, especially for those with comorbidities, to avoid postoperative complications and the need for re-operation. Cite this article: EFORT Open Rev 2020;5:391-397. DOI: 10.1302/2058-5241.5.190041

scholarly journals Noninvasive Testing for Diagnosis of Stable Coronary Artery Disease in the Elderly

2020 ◽  
Vol 21 (17) ◽  
pp. 6263
Author(s):  
Sergey G. Kozlov ◽  
Olga V. Chernova ◽  
Elena V. Gerasimova ◽  
Ekaterina A. Ivanova ◽  
Alexander N. Orekhov
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Elderly Population ◽  
The Elderly ◽  
The United States ◽  
Diagnostic Methods ◽  
Exercise Stress ◽  
Attractive Alternative ◽  
Artery Disease

Efficient diagnostic approaches to detect coronary artery disease (CAD) in elderly patients are necessary to ensure optimal and timely treatment. The population of suspected CAD patients older than 70 years is especially vulnerable and constantly growing. Finding the optimal diagnostic approach is challenging due to certain features of this population, such as high prevalence of comorbidities, existing contraindications to exercise tests or cognitive decline, which hinders correct assessment of the patient’s situation. Moreover, some symptoms of CAD can have variable significance in the elderly compared to younger adult groups. In this review, we present current recommendations of the United States (US) and European cardiologists’ associations and discuss their applicability for diagnostics in the elderly population. Exercise electrocardiogram (ECG) and exercise stress echocardiography (SE) tests are not feasible for a substantial proportion of elderly patients. Coronary computed tomography angiography (CTA) appears to be an attractive alternative for such patients, but is not universally applicable; for instance, it is problematic in patients with significant calcification of the vessels. Moreover, more studies are needed to compare the results delivered by CTA to those of other diagnostic methods. Future efforts should be focused on comparative studies to better understand the limits and advantages of different diagnostic methods and their combinations. It is possible that some of the currently used diagnostic criteria could be improved to better accommodate the needs of the elderly population.

Medication-Use Behavior of Elderly Patients in Baghdad City: A Cross-Sectional Study

2021 ◽  
Vol 1 ◽  
pp. 72-77
Author(s):  
Massara Salah Abbas ◽  
Marwa Jamal ◽  
Mustafa Mohammed Sabri ◽  
Zainab Abdulrahman ◽  
Saad Abdulrahman Hussain
Keyword(s):  
Side Effects ◽  
Elderly Patients ◽  
Product Information ◽  
Medication Use ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Elderly Subjects ◽  
Sectional Study ◽  
Cross Sectional ◽  
Survey Form

Background: As our society ages, the incidence of chronic diseases increases, and so does drug use and polypharmacy. Aim: To evaluate the medication use behaviors of selected elderly patients who lived in Baghdad city. Methods: This cross-sectional study included 225 subjects aged >60 years who lived in Baghdad city and consumed chronically prescribed medications. Data were collected using a survey form, and the survey was conducted through face-to-face interviews. The data are presented as numbers, percentages, and averages. Results: The majority were treated through polypharmacy, using various drugs. The most commonly used drugs included those used to treat cardiovascular diseases, DM, and dyslipidemia. 74.6% did not know about the side effects of the drugs they used, and 55.6% did not read the product information leaflet (PIL) of the drugs. Also, 70.7% said that the health care personnel did not educate them about their drugs. Of the elderly who were informed about their drugs, 128 obtained the information from the physician and 91 from the pharmacist. Conclusion: The majority of the elderly subjects used more than one drug, and the main drug class used was the cardiovascular agents. they are unaware of the side effects of the prescribed agents.

Evaluation of Prl secretion in elderly subjects

1982 ◽  
Vol 100 (3) ◽  
pp. 351-357 ◽  
Author(s):  
Ermanno Rolandi ◽  
Gianni Magnani ◽  
Antonello Sannia ◽  
Tommaso Barreca
Keyword(s):  
Elderly Patients ◽  
Pituitary Gland ◽  
Elderly Women ◽  
The Elderly ◽  
Elderly Subjects ◽  
Endocrine Disorders ◽  
Normal Sleep ◽  
Secretory Pattern

Abstract. Prl secretion was evaluated in 76 elderly patients (71–86 years) without endocrine disorders (38 men and 38 women) in basal conditions, after TRH, sulpiride and levodopa administration and during a 24 h period. An impaired Prl response to the administered drugs was found in the elderly women but not in the men. On the contrary, normal sleep-related serum Prl changes were found in the majority of the subjects studied. These results suggest that the pituitary gland can maintain a good Prl secretory pattern in the elderly.

scholarly journals A web-based application for estimating energy requirements in elderly patients

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Dario Gregori ◽  
Giulia Lorenzoni ◽  
Corrado Lanera ◽  
Honoria Ocagli
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Indirect Calorimetry ◽  
Gold Standard ◽  
Web Application ◽  
The Elderly ◽  
Energy Requirements ◽  
Predictive Equation ◽  
Web Based ◽  
The Web

AbstractElderly patients are at risk of malnutrition and need an appropriate assessment of energy requirements. In the clinical setting, predictive equations are widely used to estimate the Resting Energy Expenditure (REE). Although easy to use, these equations are not always validated in the elderly and, even if validated, they often provide different outputs of energy requirements for the same subject. The aim of the present work is to develop a web-based application helping clinicians in finding out the most appropriate equation for estimating the REE for each subject. The web-based application is based on a systematic review of the equations for the estimation of REE in the elderly. The systematic review was carried out on PubMed and Scopus following the PRISMA guidelines. Studies in subjects older than 65 years of age that tested the performance of a predictive equation for the estimation of REE vs. a gold standard (indirect calorimetry or doubly labeled water) were included in the review. Studies performed in critically ill elderly patients were excluded. The initial search identified 2035 studies. The final review included 50 studies. Included studies were mainly observational, conducted in healthy elderly subjects enrolled in the outpatient setting, and using indirect calorimetry as the gold standard. The 50 studies included in the review corresponded to 189 different equations. Several parameters were included in the equations, and they can be divided as following: anthropometric characteristics, body composition parameters, environmental measures, laboratory tests, the presence of comorbidities, and physical activity frequency. The equations retrieved were tested on a sample of 88 subjects aged > 65 years enrolled in an Italian nursing home. Based on the systematic review and the pilot testing of the equations, it has been developed a web application (http://r-ubesp.dctv.unipd.it:3838/equationer) that allows for the estimation of REE using the equation most appropriate according to the subject's characteristic and parameters available. The assessment of the energy requirements in the elderly is crucial for the management of nutritional problems in this population group since nutritional problems are related to worse health outcomes. The present study showed a wide use of different type of equations for the estimation of REE in the elderly highlighting the need of choosing the most appropriate predictive equation according to the subject characteristics and health status. The web application will help clinicians in doing that.

scholarly journals Az időskori gyógyszerterápia alapjai

2019 ◽  
Vol 160 (23) ◽  
pp. 896-907
Author(s):  
András Telekes ◽  
Dániel Deme
Keyword(s):  
Elderly Patients ◽  
Daily Practice ◽  
The Elderly ◽  
Developed Countries ◽  
Elderly Subjects ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Important Place ◽  
Pharmaceutical Therapy ◽  
The Social ◽  
The Developed Countries

Abstract: The proportion of elderly patients is getting increased in the developed countries as a consequence of which pharmacotherapy takes a more and more important place in the healthcare system. Important biological alterations are characteristic for the elderly subjects, which have effect on the pharmacokinetics and pharmacodynamics of the pharmaceuticals. Gradually decreased kidney function may demand the modification of the administration of the pharmaceuticals. Certain pharmaceuticals and drug-interactions are potentially dangerous for this population. Therefore several factors have to be taken into account in conjunction with the therapy of elderly patients including co-morbidities, cognitive function and the social state. At the same time, the risk–benefit ratio of the pharmaceuticals is the worst among elderly patients with pharmaceutical therapy including polypragmasy. Thus, it is inevitable for the development of geriatric pharmacotherapy that the physiologic alteration of elderly has to be taken into account not only in the daily practice but also during the development and formulation of a pharmaceutical. The present paper gives an overview of the most important factors influencing the pharmacotherapy of the elderly. Orv Hetil. 2019; 160(23): 896–907.

DFS70 antibodies – biomarkers for the exclusion of ANA-associated autoimmune rheumatic diseases

2015 ◽  
Vol 38 (6) ◽  
Author(s):  
Karsten Conrad ◽  
Nadja Röber ◽  
Sebastian Rudolph ◽  
Michael Mahler
Keyword(s):  
Rheumatic Diseases ◽  
Antinuclear Antibodies ◽  
Laboratory Diagnosis ◽  
Healthy Individuals ◽  
Autoimmune Rheumatic Diseases ◽  
Novel Biomarkers ◽  
Specific Autoantibody ◽  
Well Differentiated ◽  
Dsdna Antibodies ◽  
Posttest Probability

AbstractDespite the progress in the establishment of specific autoantibody assays, screening for antinuclear antibodies (ANA) by indirect immunofluorescence on HEp-2 cells for quality-oriented laboratory diagnosis of ANA associated rheumatic diseases (AARD) remains indispensable. Research results on the relevance of the dense fine speckled (DFS) pattern and DFS70 antibodies disclosed novel possibilities to optimize the serological stepwise diagnostics of AARD. The DFS pattern on HEp-2 cells is well differentiated from the classic “homogeneous” ANA pattern associated with dsDNA antibodies. In DFS pattern positive sera the most important detectable ANA specificity is the DFS70 antibody (synonym LEDGF antibody). This antibody is also the most frequent ANA specificity in ANA positive healthy persons. The prevalence of DFS70 antibodies in AARD patients is significantly lower compared with the prevalence in ANA-positive healthy individuals. There is a negative association between DFS70 antibodies and AARD, especially if no concomitant AARD-specific autoantibodies are found. Isolated DFS70 antibodies are detectable in <1% of AARD, but are detectable in 5%–11% of healthy individuals. In the presence of an isolated DFS70 antibody, the posttest probability for AARD is reduced significantly. DFS70 antibodies are valuable novel biomarkers for the improved interpretation of positive ANA but without detectable AARD associated autoantibodies and should be integrated in modified test algorithms to avoid unnecessary referrals and examinations of ANA-positive subjects.

Receipt of Prescription Drug Information by the Elderly

1983 ◽  
Vol 17 (12) ◽  
pp. 920-923 ◽  
Author(s):  
Steven R. Moore ◽  
Mma Kalu ◽  
Supachai Yavaprabbas
Keyword(s):  
Elderly Patients ◽  
Health Professionals ◽  
Telephone Survey ◽  
Drug Information ◽  
The Elderly ◽  
General Information ◽  
Elderly Subjects ◽  
Specific Information ◽  
Younger Patients ◽  
Age Related

Analysis of responses of 267 elderly subjects to a telephone survey dealing with communications between patients and health professionals about prescribed medications indicated several age-related differences. Results showed that elderly patients received less general information and less drug-specific information than younger patients did. This occurred in both pharmacist and physician encounters.

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