Decade Of Age Research Articles

A comprehensive study of the effects of long-term thermal aging on the fracture resistance of cast austenitic stainless steels

Loss of fracture resistance due to thermal aging degradation is a potential limiting factor affecting the long-term (80+ year) viability of nuclear reactors. To evaluate the effects of decades of aging in a practical time frame, accelerated aging must be employed prior to mechanical characterization. In this study, a variety of chemically and microstructurally diverse austenitic stainless steels were aged between 0 and 30,000 h at 290–400 °C to simulate 0–80+ years of operation. Over 600 static fracture tests were carried out between room temperature and 400 °C. The results presented include selected J-R curves of each material as well as K0.2mm fracture toughness values mapped against aging condition and ferrite content in order to display any trends related to those variables. Results regarding differences in processing, optimal ferrite content under light aging, and the relationship between test temperature and Mo content were observed. Overall, it was found that both the ferrite volume fraction and molybdenum content had significant effects on thermal degradation susceptibility. It was determined that materials with >25 vol% ferrite are unlikely to be viable for 80 years, particularly if they have high Mo contents (>2 wt%), while materials less than 15 vol% ferrite are viable regardless of Mo content.

Fahr Disease with Seizure as Clinical Manifestation: A Case Series

Brain calcification can occur physiologically and pathologically. Physiological calcification is associated with a degenerative process with globus pallidus as the most common location. Pathological calcifications are associated with several causes such as idiopathic or secondary due to disturbances in mineral metabolism in the body. Fahr disease is a syndrome characterized by calcium and phosphate deposition in several areas, namely the periventricular area, cerebellum and dentate nucleus. Fahr disease is a rare disease with an incidence of <1:100,000 in the general population. In this case report, we describe 2 cases Fahr's disease both in 6th decade of age. Both of these cases present with a clinical manifestation of seizures. The etiology behind the first case is hypoparathyroid post-thyroidectomy while the second case is idiopathic. Imaging showed bilateral calcifications of the basal ganglia and other areas such as the cerebellum and ventricles.

Visualization of wrist anatomy\u2014a comparison between 7T and 3T MRI

ObjectiveInjuries to the wrist are, due to its small size and complex anatomical structures, difficult to assess by MR, and surgical interventions such as diagnostic arthroscopy are often necessary. Therefore, improved visualization using non-invasive methods could be of clinical value. As a first step of improvement, the purpose of this study was to evaluate visualization of anatomical structures at 7T compared with 3T MR.MethodsEighteen healthy volunteers (three males and three females from each age decade between 20 and 49 years) were examined with 7T and 3T MR. Four musculoskeletal radiologists graded 2D and 3D images on a five-level grading scale for visibility of ligaments, cartilage, nerves, trabecular bone, and tendons, as well as overall image quality (i.e., edge sharpness, perceived tissue contrast, and presence of artefacts). Statistical analysis was done using a visual grading characteristics (VGC) analysis.ResultsVisibility of cartilage, trabecular bone, tendons, nerves, and ligaments was graded significantly higher at 7T with an area under the curve (AUCVGC) of 0.62–0.88 (95% confidence interval [CI] 0.50–0.97, p = < 0.0001–0.03) using either 2D or 3D imaging. Imaging with 3T was not graded as superior to 7T for any structure. Image quality was also significantly superior at 7T, except for artefacts, where no significant differences were found.ConclusionsTendons, trabecular bone, nerves, and ligaments were all significantly better visualized at 7T compared to 3T.Key Points• MRI of the wrist at 7T with a commercially available wrist coil is feasible at similar acquisition times as for 3T MRI.• The current study showed 7T to be superior to 3T in the visualization of anatomical structures of the wrist, including ligaments, tendons, nerves, and trabecular bone.• Image quality was significantly superior at 7T, except for artefacts, where no significant differences were found.

Prevalence of SARS-CoV-2 IgG antibodies and their association with clinical symptoms of COVID-19 in Estonia (KoroSero-EST-1 study)

PurposeIn Estonia, during the first wave of COVID-19 total number of cases confirmed by PCR was 13.3/10,000, similar in most regions, including capital Tallinn, but in the hotspot of Estonian epidemic, an island Saaremaa, the cumulative incidence was 166.1/10,000. We aimed to determine the prevalence of SARS-CoV-2 IgG antibodies in these two regions, symptoms associated with infection and factors associated with antibody concentrations. MethodsParticipants were selected using stratified (formed by age decades) random sampling and recruited by general practitioners. IgG or neutralizing antibodies were determined from sera by four assays. Symptoms associated with seropositivity were analyzed by multiple correspondence analysis, antibody concentrations by multiple linear regression. ResultsTotal of 3608 individual were invited and 1960 recruited from May 8 to July 31, 2020. Seroprevalence was 1.5% (95% confidence interval (CI) 0.9–2.5) and 6.3% (95% CI 5.0–7.9), infection fatality rate 0.1% (95% CI 0.0–0.2) and 1.3% (95% CI 0.4–2.1) in Tallinn and Saaremaa, respectively. Of seropositive subjects 19.2% (14/73) had acute respiratory illness. Fever, diarrhea and the absence of cough and runny nose were associated with seropositivity in individuals aged 50 or more years. IgG, but not neutralizing antibodies concentrations were higher if fever, difficulty breathing, shortness of breath, chest pain or diarrhea was present, or hospitalization required. ConclusionSimilarly to other European countries the seroprevalence of SARS-CoV-2 in Estonia was low even in the hotspot region Saaremaa suggesting that majority of population is susceptible to SARS-CoV-2. Focusing only on respiratory symptoms may delay accurate diagnosis of SARS-CoV-2 infection.

PO-1976 Has the Covid-19 Pandemic increased willingness to engage with remote collection of outcome data?

Purpose or Objective: Remote healthcare applications have been developing over many years, however clinical implementation has been cautious. As society has embraced technology during the Covid-19 pandemic, the question is: have attitudes towards remote healthcare technology also changed? One particular aspect of healthcare that could be addressed remotely is the collection of patient reported outcome measures (PROMs) using a digital voice assistant (DVA) such as the Amazon Echo (Alexa). This could improve both the frequency and quality of data collected. Materials and Methods: A questionnaire was developed to evaluate patient and carer opinions on using a DVA to report radiotherapy-related side effects. This was distributed to the adult patients in the radiotherapy department in February 2019 and to the Teenager, Young Adult and Paediatric radiotherapy department in mid 2019. It was redistributed in September 2020, allowing a pre/post Covid-19 comparison. To maximise engagement with the questionnaire, it was decided to ask a small number of simple questions. These four questions sought to ascertain whether the respondent was a patient or carer, respondent age (decade grouping), how knowledgeable they were about the Amazon Echo, and how willing they would be to participate in a hypothetical study in which they would use an Amazon Echo to record the side effects they experienced as a result of their cancer treatment. A comments box was included to allow participants to convey additional information. Results: 85 completed questionnaires were collected in 2019 and 43 in 2020. The median age of the initial survey cohort was 60-69 years old whilst for the second cohort was 50-59 years old. The slight difference in median age of the cohorts is likely a reflection on modifications to clinical practice due to Covid-19. 16% of the initial cohort and 19% of the second cohort were carers. 67% of the initial cohort responded that they had some or good knowledge of Amazon Echo, this increased to 84% in the second cohort (fig. 1). Willingness to participate was highest in the group of patients with good knowledge. 44% of the initial cohort were willing to take part in a study using an Amazon Echo to record side effects, increasing to 58% in the subsequent cohort (fig. 2). However, the percentage of respondents who were not willing to take part also increased from 32% to 37% with a reduction in the number of respondents who didn’t know (25% to 5%). Willingness to participate varied with age. Comments were diverse and included concerns about using technology and data security but also positive comments on the potential to reduce hospital visits. (Figure Presented) Conclusion: Overall, the survey results indicate an increased knowledge of DVA. There was also an increased willingness to engage with a DVA for remote collection of radiotherapy outcome data following the first wave of the Covid-19 pandemic.

Avoiding the “Great Filter”: A Projected Timeframe for Human Expansion Off-World

A foundational model has been developed based on trends built from empirical data of space exploration and computing power through the first six plus decades of the Space Age, which projects the earliest possible launch dates for human-crewed missions from cis-lunar space to selected Solar System and interstellar destinations. The model uses computational power, expressed as transistors per microprocessor, as a key broadly limiting factor for deep space missions’ reach and complexity. The goal of this analysis is to provide a projected timeframe for humanity to become a multi-world species through off-world colonization, and in so doing all but guarantee the long-term survival of the human race from natural and human-caused calamities that could befall life on Earth. Beginning with the development and deployment of the first nuclear weapons near the end of World War II, humanity entered a ‘Window of Peril’, which will not be safely closed until robust off-world colonies become a reality. Our findings suggest that the first human-crewed missions to land on Mars, selected Asteroid Belt objects, and selected moons of Jupiter and Saturn can occur before the end of the 21st century. Launches of human-crewed interstellar missions to exoplanet destinations within roughly 40 lightyears of the Solar System are seen as possible during the 23rd century and launch of intragalactic missions by the end of the 24th century. An aggressive and sustained space exploration program, which includes colonization, is thus seen as critical to the long-term survival of the human race.

‘If the IOC Finds Out about This, All of You Will Be Declared Professionals’: The Professionalization of Finnish Track Athletes from the 1960s to 1980s

For most of the twentieth century a characteristic feature of international athletics was the association of ‘shamateurism’ with elite athletes. The amateur rules of the International Olympic Committee and the International Association of Athletics Federations ushered professionally motivated athletes towards under-the-table payments of gate and sponsor money, ostensible jobs, and tax avoidance. After the deterioration of Olympic amateurism in the 1970s and 1980s, professionalism was finally accepted at the turn of the 1990s. This paper contributes to the understanding of the professionalization of athletics by tracing career paths of Finnish athletes in the last decades of the amateur age. Taking some of the most successful Finnish athletes in the 1970s and 1980s as case studies, the underlying mechanics of Finnish sports system are analyzed with source material that reflects the perspective of athletes. Some athletes adroitly seized on the opportunities that the underground culture presented and gained both full-time training conditions and financial profits, whereas others remained nearly genuine amateurs. A watershed moment was the establishment of trust funds in 1983, after which the culture of shamateurism gradually fell apart. New revenue streams also created ways for Finnish women to become fully professional track athletes.

The Level of Conus Medullaris in 629 Healthy Japanese Individuals.

The conus medullaris typically terminates at the L1 level; however, variations in its level and the factors associated with the conus medullaris level are unclear. We investigated the level of conus medullaris on magnetic resonance imaging in healthy volunteers. In total, 629 healthy adult volunteers (≥50 individuals of each sex and in each decade of age from 20 to 70) were enrolled. The level of the conus medullaris was assessed based on the T2-weighted sagittal magnetic resonance images, and factors affecting its level were investigated employing multivariate regression analysis including the participants’ background and radiographical parameters. L1 was the most common conus medullaris level. Participant height was significantly shorter in the caudally placed conus medullaris (p = 0.013). With respect to the radiographical parameters, pelvic incidence (p = 0.003), and pelvic tilt (p = 0.03) were significantly smaller in participants with a caudally placed conus medullaris. Multiple regression analysis showed that the pelvic incidence (p < 0.0001) and height (p < 0.0001) were significant factors affecting the conus medullaris level. These results indicated that the length of the spinal cord varies little among individuals and that skeletal differences affect the level of the conus medullaris.

Biventricular Morphology and Function Reference Values Derived From a Large Sample of Healthy Chinese Adults by Magnetic Resonance Imaging.

Background: Quantification of cardiac structure and function is essential for diagnostic interpretation and clinical decision making. We sought to establish cardiovascular magnetic resonance (CMR) reference values of left and right ventricular (LV and RV) morphology and function based on a large sample of healthy Chinese adults.Methods: Five hundred fifty validated healthy Chinese adults (aged 21–70 years; 323 men) free of hypertension, diabetes, and obesity were included in this study. All the subjects were stratified by gender (men and women) and age decades. On cine CMR, measurements of biventricular end-diastolic, end-systolic, and stroke volumes (EDV, ESV, and SV), ejection fraction (EF), and end-diastolic LV wall thickness (LVWT) and mass (LVM) were obtained.Results: Men had greater LVEDV (111.6 ± 19.8 vs. 94.6 ± 15.6 ml), LVESV (36.5 ± 9.8 vs. 28.2 ± 7.9 ml), LVM (121.1 ± 19.9 vs. 86.1 ± 14.5 g), global end-diastolic LVWT (8.1 ± 1.1 vs. 6.7 ± 1.0 mm), RVEDV (128.0 ± 23.6 vs. 101.7 ± 17.0 ml), and RVESV (53.5 ± 13.7 vs. 36.8 ± 8.9 ml), while women had greater LVEF (67.5 ± 5.4 vs. 70.4 ± 5.7%) and RVEF (58.5 ± 5.2 vs. 64.0 ± 5.3%) (all p < 0.001). For both men and women, age was negatively correlated with LVEDV (r = −0.31 and r = −0.32), LVESV (r = −0.37 and r = −0.47), RVEDV (r = −0.31 and r = −0.29), and RVESV (r = −0.33 and r = −0.44), while it was positively correlated with LVEF (r = 0.28 and r = 0.43) and RVEF (r = 0.28 and r = 0.41) (all p < 0.001). Aging was associated with increasing global end-diastolic LVWT and LVM/LVEDV in both sexes (all p < 0.001). Older age was associated with increasing LVM only in women (r = 0.36, p < 0.001), not in men (r = 0.05, p = 0.359).Conclusions: We systematically provide age-, sex-, and body size-specific CMR reference values for biventricular morphology and function based on a large sample of healthy Chinese adults. Biventricular structure and function are significantly associated with age and sex.

Vocal Changes of Men and Women from Different Age Decades: An Analysis from 30 Years of Age

ObjectiveTo verify the modifications in auditory-perceptual and acoustic parameters of the fundamental frequency, short-term perturbation, noise, and cepstral measures of voice in young and elderly were distributed over the age of decades. MethodsThe study was conducted on 265 subjects (140 females and 125 males), aged 30 to 79 years, without a history of vocal complaints or dysphonia, distributed in five age groups for females and males (30-39 years until 70-79 years). Three speech therapists voice specialists performed the perceptual-auditory analysis using a 100-mm visual analog scale, based on the overall dysphonia grade (overall grade), roughness, and breathiness from the sustained vowel /a/. The smoothed cepstral peak prominence (CPPS), average fundamental frequency (F0), standard deviation of the fundamental frequency (std-F0), jitter percentage (%), shimmer percentage (%), noise-to-harmonic ratio (NHR), voice turbulence index (VTI), and soft phonation index (SPI) were extracted for the acoustic analysis ResultsIn the case of the auditory-perceptual characteristics, the comparison between aged groups showed that, in men, the vocal quality did not show significant differences in the overall grade, roughness, and breathiness. However, women in the 3rd decade of life presented higher breathiness than those in the 5th, 6th, and 7th decades. Men had a higher overall grade and roughness than women. In the case of the acoustic data, the cepstral measure showed that in the 3rd decade, men presented higher CPPS than females. The noise measures, in the comparison by age groups, only VTI and SPI were different for women: VTI was higher in the 7th decade than in the 4th, whereas SPI was higher in the 4th decade than in older women. In the male population, the SPI in the 4th decade was also higher than that in the older population ConclusionThe analysis by age groups of life allowed the identification of breathiness as a sensitive parameter in the different stages of adult life in women. The CPPS analysis showed that the 7th age decade is the period of the appearance of vocal changes for females, characterized by higher CPPS. The results related to traditional short-term perturbation and noise measurements showed that changes in F0, jitter, shimmer, and NHR were not found. Among the other noise measurements, VTI and SPI demonstrated some changes in different decades of life.

Normative data for peripheral quantitative computed tomography (pQCT) bone parameters in Australian men

BackgroundPeripheral quantitative computed tomography (pQCT) can provide information complementary to dual x-ray absorptiometry (DXA), however, there is sparse normative data to enable meaningful clinical interpretation and comparison. This study aimed to develop age-stratified normative data for pQCT-derived bone parameters in Australian men. MethodsParticipants were men (n = 508, age 33-96 yr) from the Geelong Osteoporosis Study. Bone parameters at 4% (n = 469) and 66% (n = 436) of radial length, and 4% (n = 449) and 66% (n = 438) of tibial length were acquired using pQCT (XCT 2000, Stratec Medizintechnik, Pforzheim, Germany). Best models of age, height and weight for each parameter were developed and where parameters exhibited variation with age, age decade mean (±SD) values were determined. Scatterplots were used to visualise the relationships between each of the parameters and age, height and weight. ResultsThirteen parameters at tibial and radial sites were correlated with age, height and weight, allowing for their inclusion in multiple linear regression models. A positive association with age was found for total area of the tibia or radius (as appropriate) (mm2) at all sites, trabecular bone area (mm2) at 4% sites, and total bone area (both long bones) (mm2) at 66% sites. A negative association with age was found for cortical density (mg/cm3) and cortical thickness (mm) at both radial and tibial 66% sites, but total density (mg/cm3) at the 66% radial site and total cortical density of both long bones (mg/cm3) at the 66% tibial site only. ConclusionThis study presents normative data for pQCT-derived bone parameters and describes age related associations in a number of these variables. Broadly, parameters of bone area were positively associated with age, whereas parameters associated with bone density and structure were negatively associated with age. These data have the potential to be used in clinical settings when assessing age-related decline in bone health. Mini abstractNormative data for pQCT parameters in Australian men are presented, adjusted for age, height and weight.

Long-term Trajectories of C-Reactive Protein Among Men Living With and Without HIV Infection in the Multicenter AIDS Cohort Study.

C-reactive protein (CRP) is an inflammatory biomarker associated with all-cause mortality and morbidities such as cardiovascular disease. CRP is increased with HIV infection and thought to increase with age, though trajectories of CRP with aging have not been well characterized. We investigated trajectories of CRP in men from the Multicenter AIDS Cohort Study, according to HIV infection and HIV viral load status. CRP measurements from 12 250 serum samples, provided by 2132 men over a span of 30 years, were categorized by HIV status at sample collection: HIV uninfected (HIV-, n = 1717), HIV infected with undetectable RNA (HIV+ suppressed, n = 4075), and detectable HIV RNA (HIV+ detectable, n = 6458). Age-related trajectories of CRP were fit to multivariable linear mixed models; we tested for differences in trajectories by HIV status. CRP increased with age in all sample groups. HIV+ detectable and HIV+ suppressed samples had higher CRP than HIV- samples throughout the observed age range of 20-70 years (p < .05). CRP concentrations at age 45 years were 38% (95% CI: 26%-50%) and 26% (15%-38%) higher in HIV+ detectable and HIV+ suppressed samples, respectively, relative to HIV- samples. HIV+ detectable samples showed more rapid linear increases with age (8% higher/decade, 0.3%-16%) than HIV- samples. We observed higher concentrations of CRP across 5 decades of age in men living with HIV, and steeper increases with age in men with detectable HIV RNA, relative to HIV- men. These results are consistent with a contribution of inflammation to the higher risk of age-related comorbidities with HIV infection.

Factors Underlying Individual Differences in Speech-Recognition Threshold (SRT) in Noise Among Older Adults.

Many older adults have difficulty understanding speech in noisy backgrounds. In this study, we examined peripheral auditory, higher-level auditory, and cognitive factors that may contribute to such difficulties. A convenience sample of 137 volunteer older adults, 90 women, and 47 men, ranging in age from 47 to 94 years (M = 69.2 and SD = 10.1 years) completed a large battery of tests. Auditory tests included measures of pure-tone threshold, clinical and psychophysical, as well as two measures of gap-detection threshold and four measures of temporal-order identification. The latter included two monaural and two dichotic listening conditions. In addition, cognition was assessed using the complete Wechsler Adult Intelligence Scale-3rd Edition (WAIS-III). Two monaural measures of speech-recognition threshold (SRT) in noise, the QuickSIN, and the WIN, were obtained from each ear at relatively high presentation levels of 93 or 103 dB SPL to minimize audibility concerns. Group data, both aggregate and by age decade, were evaluated initially to allow comparison to data in the literature. Next, following the application of principal-components factor analysis for data reduction, individual differences in speech-recognition-in-noise performance were examined using multiple-linear-regression analyses. Excellent fits were obtained, accounting for 60–77% of the total variance, with most accounted for by the audibility of the speech and noise stimuli and the severity of hearing loss with the balance primarily associated with cognitive function.

Ten German versions of Rey’s auditory verbal learning test: Age and sex effects in 4,000 adults of the Rhineland Study

ABSTRACT Introduction Detecting early pathological cognitive decline is critical for dementia and aging-related research and clinical diagnostics. Rey’s Auditory Verbal Learning Test (AVLT) is commonly used to measure episodic verbal memory. The test requires participants to learn a list of 15 words over several trials. Since multiple testing is often required to detect cognitive decline, but repeating the same test can bias results, we developed 10 German AVLT word lists. Method We randomly assigned the lists to 4,000 participants (aged 30–94 years) from a population-based cohort to test their comparability, as well as aging effects and sex differences. Results Nine lists were highly comparable, with only one being slightly more difficult. Recall performance decreased on average by 0.6–1.1 words per trial per decade of age. Perseveration errors decreased with increasing age. Women remembered on average between 0.8 and 1.5 words per trial more than men, regardless of age. Women also outperformed men in the sum of Trials 1–5, learning over trials, retroactive inhibition, and false-positive and interference errors. Proactive inhibition remained stable across age and was unaffected by sex. Conclusion This German AVLT version presents comparable lists including detailed age and sex references and therefore allows test repetition excluding training effects. These versions are a valuable resource for research and clinical application.

Active and Healthy Aging After COVID-19 Pandemic in Portugal and Other European Countries: Time to Rethink Strategies and Foster Action.

The population aging in Europe imposes challenges to societies that require adaptations and responses at various levels to minimize impacts and figuring out opportunities. Portugal has been committed to the World Health Organization and European Union's values and policy frameworks concerning active and healthy aging. In 2017, an inter-ministerial working group developed the National Strategy for Active and Healthy Aging. In the face of the COVID-19 pandemic that exposed the vulnerabilities of older populations, the launch of the Decade of Healthy Aging 2021–2030 and its baseline report and the 2018 Active Aging Index Analytical Report may constitute an opportunity to strategically think about the aging of the population as a national purpose in Portugal and in the other European countries that face similar challenges.

Are You Prepared for the Decade of Healthy Aging 2020-2030?

The World Health Organization's Decade of Healthy Aging began in 2020. This article focuses on nutrition's role in healthy aging with examples of older adult nutrition programs in Canada, the European Union, and the United States, including work of the Canadian Malnutrition Task Force, the European Malnutrition in the Elderly Knowledge Hub, and the Commonwealth of Massachusetts Executive Office of Elder Affairs. These programs have integrated screening for frailty and malnutrition into older adult care across the spectrum of settings, which has become increasingly important during the global COVID-19 pandemic. This article demonstrates the important role of nutrition in promoting healthy aging.

A retrospective review of phyllodes tumors of the breast from a single institution.

Phyllodes tumors (PTs) are rare fibroepithelial breast tumors with diverse biological behavior. This study aimed to analyze the characteristics, management, and outcome of phyllodes tumors. Patients diagnosed with PTs in our institution from January 2013 to December 2017 were identified retrospectively by the ICD-10 code. Data were collected from medical records. The diagnosis of this tumor was based on histopathological results. Variables analyzed included age, tumor site, surgical option, axillary lymph nodes, chemotherapy and radiotherapy, metastases, disease-free survival (DFS), and overall survival (OS) rate. Sixty-nine cases of PTs were diagnosed during the period, of which 31 were benign, 38 were malignant, and 1 was a case of bilateral metachronous tumors. We did not find any borderline pathologic cases. The patient's ages ranged from 20 to 71 years, with the highest number of cases (28) from the 40-49-year-old age group. The majority of patients (42) had PT on the right side. Simple mastectomy was the most performed treatment, with 53 such cases, including both benign and malignant. The axillary staging was carried out in 16 cases, of which none had nodal metastasis. Ten cases received chemotherapy, and 16 cases of malignant phyllodes received postoperative radiotherapy. We found 4 cases with distant metastases and 5 cases that developed local recurrence. The DFS rate reached 92.75%, and the overall 5-year survival rate was 84.21%. The incidence of PTs is highest in women in the 3rd and fourth decades of age. Simple mastectomy and wide excision are the treatments of choice, with a low recurrence rate in both benign and malignant PTs cases.

Estudio epidemiológico de las fracturas de la extremidad distal de radio en el área sanitaria de Vigo

IntroductionDistal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe. MethodEvery DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Age, sex, season of the year, mechanism of injury, presence of associated injuries and type of treatment were analysed. Results1,121 DRF in 1,108 patients, 903 women (81.5%) and 205 men (18.5%), were registered. Left side was affected in 612 cases (54.6%) and right side in 509 cases (45.4%). The average age of our sample was 65.9 years old (CI95%: 65-67.9 years old). The incidence rate of DRF in our population was 158.5 fractures per 100,000 people-year; 49.2% were classified as type A of AO-OTA classification and 19% were treated surgically. ConclusionIncidence of DRF had a maximum during males and women sixth decade of age. Type A fractures of AO-OTA classification were the most frequent. Most part of the fractures were treated non-surgically. The usual patient treated surgically was a woman, over 50 years old with a distal radius intraarticular complex fracture.

Serum neurofilament light chain levels in healthy individuals: A proposal of cut-off values for use in multiple sclerosis clinical practice

BackgroundSerum Neurofilament Light (sNFL) is the most promising marker for patient's monitoring in Multiple Sclerosis (MS). However, operating reference values for use in clinical practice are still lacking. Here, we defined sNFL reference cut-off values in a cohort of healthy controls (HC) and assessed their performance in Multiple Sclerosis (MS) patients, as well as the intra-individual sNFL variability. MethodsWe measured sNFL by single molecule array (Simoa) assay in 79 HC assessing their correlation with age. Changes of sNFL levels were evaluated during a short-term follow-up (median 67 days between consecutive samples) in a subgroup of 27 participants. sNFL were tested in 23 untreated MS patients, at both diagnostic time and start of therapy (median 80 days after), considering disease activity. ResultsFindings confirmed a correlation between sNFL levels and age in HC, thus cut-off values specific for age decades were calculated. sNFL did not vary significantly with time during short-term follow-up (median CV 13%).sNFL levels in MS patients were higher and demonstrated a higher variability between diagnostic time and treatment start (median CV 39%). According to cut-off values, “pathologic” sNFL levels were found in 57% of MS patients at diagnostic time, and in 30% of samples at treatment start. In particular, “pathologic” sNFL levels were found in 80% of samples (16/20) obtained during a phase of disease activity, while a total of 85% of samples (22/26) associated with inactive disease showed sNFL in the normal range. ConclusionThis study demonstrates an overall intra-individual stability of sNFL values in the short-term in HC and suggests age-dependent reference cut-off values that could be beneficial for sNFL implementation in clinical practice.

Mortality of neuromyelitis optica spectrum disorders in a Chinese population.

ObjectiveNeuromyelitis optica spectrum disorder (NMOSD) is a rapidly disabling disease. Epidemiologic studies have suggested varying NMOSD mortality across ethnic groups. However, NMOSD mortality data in China are scarce. This study’s objectives were to explore mortality and causes of death among Chinese NMOSD patients and to identify independent predictors of death.MethodsWe performed a retrospective study with a 10‐year follow‐up of Chinese NMOSD patients. A Cox proportional hazards model was used to identify independent predictors of death.ResultsFive hundred and sixty‐nine patients were included; 24 patients died during follow‐up, for overall mortality of 4.2%. In these patients, the median disease duration at the time of death was 3.4 years. The most common cause of death was secondary infection (62.5%), especially respiratory infection (45.8%). The second most common cause of death was extensive cervical myelitis with respiratory failure (16.7%). Other causes included suicide (8.3%), cancer (4.2%), cerebral embolism (4.2%), and unknown causes (4.2%). The multivariate Cox analyses indicated that a short first interattack interval (HR = 0.93, 95% CI 0.89–0.98, p = 0.003), lack of regular immunotherapy (HR = 10.34, 95% CI 4.05–26.37, p < 0.001), and older age at onset were independent predictors of death. Every increasing decade of onset age increased the risk of death 2.59 times (95% CI 1.74–3.86, p < 0.001).InterpretationInfections were more common in patients not treated with any immunotherapy, indicating that early and consequent immunotherapy might prevent death by infections, which is of great importance for further treatment of NMOSD patients to avoid undertreatment due to fear of treatment‐associated infections.