Elderly Male Group Research Articles

Global burden and epidemic trends of gout attributable to high body mass index from 1990 to 2019.

Gout is an inflammatory and metabolic disease characterized by arthritis and elevation of the serum uric acid (SUA) level. More and more studies have shown that high body mass index (BMI) has become one of the most important risk factors for gout. We used the data of gout burden attributed to high body mass index (BMI) from global burden of disease (GBD) study 2019 to provide insights for reducing the global burden of gout. From 1990 to 2019, the prevalence and DALYs of gout caused by high BMI worldwide has been increasing. The burden of gout caused by high BMI is heavier in the elderly male group and regions with high SDI worldwide. Our findings provide evidence for the burden of gout caused by high BMI. Developing a weight management plan and lifestyle habits for groups severely affected by gout will effectively reduce the global disease and economic burden.

Prevalence and pattern of iron deficiency and its correlation with different hematological parameters in a segment of patients coming to a tertiary care hospital in Lahore

Background: Iron is an essential micronutrient, abundantly present in nature. Very low quantities of iron are required in our daily diet to prevent its deficiency. But paradoxically, its deficiency is very common all around the world. In keeping with its wide and varied functions in the body, the deficiency of iron also has multiple manifestations. This study aimed to study the prevalence and pattern of iron deficiency in a segment of our population. The effect on various hematological parameters was also studied.
 Materials and Methods: Fifty cases including both genders and all ages were included in the study. The parameters analyzed were iron status and hematological indices. The status of serum iron levels was compared with total iron binding capacity (TIBC). Blood examination included total leukocyte count, differential leukocyte count, hemoglobin level, total RBC count, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and platelet count. The correlation of serum iron levels with the different hematological indices was analyzed.
 Results: Iron deficiency was even more prevalent than previously reported (70%). It was seen in both genders and all age groups. Only the elderly male group showed a mean that was in the normal range. Females were affected more severely than males in all age groups. Red cell indices showed expected correlation with serum iron levels. Platelet counts showed an increase with falling iron levels.
 Discussion: Iron deficiency continues to be rampant despite decades of public health measures to correct it. Iron deficiency anemia impacts multiple body functions with a myriad of health consequences. The ensuing symptoms are those classically related to anemia as well as some that are both unexpected and hard to explain. Increase in platelet count seen in iron deficiency carries the risk of creation of a thrombogenic state. The factors contributing to iron deficiency need to be identified and addressed.
 Key words: Serum iron levels, Complete Blood Count, iron deficiency, platelet count.

Impact of Clinical Association Between Gout and Dementia: A Nationwide Population-Based Cohort Study in Korea.

Hyperuricemia might have neuroprotective or neurodegenerative effects on dementia via oxidative stress or inflammatory response regulation. Few studies have explored the association of hyperuricemia or gout with dementia. This retrospective cohort study aimed to investigate the association between gout and dementia in Korea. Altogether, 5,052 gout patients and 25,260 age- and sex-matched controls were selected from the National Health Insurance Service (NHIS)-National Sample Cohort database. The incidence and risk of dementia were evaluated by reviewing the NHIS record. We also performed a subgroup analysis according to age group (age <65 or ≥65 years) using the standard age of 65 years for elderly and nonelderly groups and sex. During follow-up, 81 and 558 participants in the gout and control cohorts developed dementia, respectively. The mean follow-up duration was 4.38 years in gout patients and 4.94 years in controls. Gout patients had a hazard ratio (HR) of 0.79 for overall dementia (95% confidence interval [95% CI] 0.62-1.00) and significantly lower Alzheimer's disease risk (HR 0.73 [95% CI 0.54-0.98]) after adjusting for age, sex, household income, and comorbidities. In subgroup analysis stratified by age and sex, the inverse association between gout and the risk of overall dementia (HR 0.71 [95% CI 0.52-0.97]) and Alzheimer's disease (HR 0.67 [95% CI 0.46-0.97]) were observed in the elderly male group. On the other hand, age- and sex-adjusted analysis showed that the HR for vascular dementia of gout patients was 2.31 (95% CI 1.02-5.25) in the nonelderly male group. Gout decreased the risk of incident Alzheimer's disease-type dementia, especially in elderly patients. The association between gout and dementia risk may differ according to age and disease duration.

Effect of gender factor on the effective dose of oxycodone for inhibiting responses to laryngeal mask airway insertion in elderly patients undergoing ophthalmic surgery

Objective: To evaluate the effect of gender factor on the effective dose of oxycodone for inhibiting responses to laryngeal mask airway (LMA) insertion in elderly patients undergoing ophthalmic surgery. Methods: From June to October 2021, 56 elderly patients, including 26 females and 30 males, aged from 65 to 80 (72±5) years, with a body mass index (BMI) of 18.5-24.9 kg/m2 and American Society of Anesthesiologists (ASA) physical status of Ⅰ or Ⅱ, who underwent elective ophthalmic surgery requiring LMA insertion in the Beijing Tongren Hospital affiliated to Capital Medical University were selected. Patients were divided into two groups according to gender: elderly female group and elderly male group. The modified Dixon sequential method was used. Oxycodone 0.10 mg/kg was injected intravenously in the first patient. Etomidate 0.2 mg/kg and cisatracurium 0.1 mg/kg were administrated 5 min later. After 3 min, the laryngeal mask was placed when the bispectral index (BIS) ≤60. The positive response to LMA insertion was defined as an increase in the maximum mean arterial pressure or the maximum heart rate>20% of the baseline value within 2 min after insertion. When the response to LMA insertion was positive, the dose of oxycodone was increased in the next patient, otherwise the dose was decreased, and the ratio of adjacent dose was 1.1. This process was repeated until the 7th turning point occurred. The half-maximal effective doses (ED50) and 95% confidence intervals (CI) of oxycodone for inhibiting laryngeal mask insertion were calculated and compared between the two groups. Meanwhile, the adverse reactions during anesthesia induction were observed. Results: All 26 patients in the elderly female group completed the test, but one patient in the elderly male group withdrew due to poor alignment of laryngeal mask, and finally 29 patients completed the study. There were 13 cases and 14 cases who had positive response to LMA insertion in the elderly female and male groups, respectively. The ED50 (95%CI) of oxycodone for inhibiting laryngeal mask insertion in the elderly male group was 0.096 (0.083-0.112) mg/kg, which was higher than that in the elderly female group [0.081 (0.073-0.098) mg/kg, P=0.008]. No adverse reactions such as choking cough, muscle tremor, hypoxemia, nausea, vomiting, reflux and aspiration occurred in 55 patients, except that one patient in the elderly female group had transient hypotension after induction, which improved after symptomatic treatment. Conclusion: The ED50 of oxycodone for inhibiting laryngeal mask insertion reaction in ophthalmic surgery is different in patients with different genders, which is 0.096 (0.083-0.112) mg/kg in the elderly male group and 0.081 (0.073-0.098) mg/kg in the elderly female group.

R-Wave Singularity: A New Morphological Approach to the Analysis of Cardiac Electrical Dyssynchrony.

R-wave singularity (RWS) measures the intermittence or discontinuousness of R waves. It has been broadly used in QRS (QRS complex of electrocardiogram) detection, electrocardiogram (ECG) beats classification, etc. In this article, we novelly developed RWS to the analysis of QRS morphology as the measurement of ventricular dyssynchrony and tested the hypothesis that RWS could enhance the discrimination between control and acute myocardial infarction (AMI) patients. Holter ECG recordings were obtained from the Telemetric and Holter ECG Warehouse database, among which database Normal was extracted as normal controls (n = 202) and database AMI (n = 93) as typical subjects of autonomic nervous system dysfunction and cardiac electrical dyssynchrony with high risk for cardiac arrhythmias and sudden cardiac death. Experimental results demonstrate that RWS measured by Lipschitz exponent calculated from 5-min Holter recordings was significantly less negative in early AMI and late AMI than that in Normal subjects for overall, elderly, and elderly male groups, which suggested the heterogeneous depolarization of the ventricular myocardium during AMI. Receiver operating characteristic curve analyses show that combined with heart rate variability parameters, Lipschitz exponent provides higher accuracy in distinguishing between the patients with AMI and healthy control subjects for overall, elderly, elderly male, and elderly female groups. In summary, our study demonstrates the significance of using RWS to probe the cardiac electrical dyssynchrony for AMI. Lipschitz exponent may be valuable and complementary for existing cardiac resynchronization therapy and autonomic nervous system assessment.

Comparison of Age-Related Anthropometric Changes Among Elderly Punjabi Males Residing in Old-Age Homes with Those Residing with Their Families

The present study was conducted to find out the changes in anthropometric measurements with advancing age among elderly males living in old-age homes and those living in family. Cross-sectional data on anthropometric measurements and other general information were obtained for 400 male subjects (200 living in old-age homes and 200 living with family) ageing 60 years and above, and data were collected from various districts in Punjab. Height decreased non-significantly and sitting height decreased significantly ( p = 0.03) from 60 years to ≥80 years of age in both the groups of elderly males. Weight decreased significantly among the elderly males residing in old-age homes ( p &lt; 0.001). Biceps ( p = 0.03) and thigh skinfold ( p = 0.009) thicknesses decreased significantly only among elderly residing in old-age homes. Abdominal ( p = 0.01) and supra-iliac ( p = 0.01) skinfold thickness measurements decreased significantly among elderly residing with their families. Circumference measurements on limbs decreased significantly ( p &lt; 0.01) among both the groups of elderly (except upper arm circumference among elderly residing with their families). Abdominal circumference decreased significantly ( p = 0.04) among the elderly males residing with their families. Elderly residing in old-age homes retained more abdominal subcutaneous fat mass and lost more appendicular fat mass as compared with those residing with their families. Elderly residing with their families lost lesser appendicular muscle mass as compared with their counterpart’s elderly residing in old-age homes.

Characteristics of quadriceps fatigue induced by continuous maximal knee extension among young and elderly adult men with different levels of physical activity

BACKGROUND: Skeletal muscle strength can be impacted by various factors. However, the possible effects of different forms of exercises on the elderly’s muscle strength remain unknown. Furthermore, whether the level of physical activity influences the effects of an exercise-based training also remains unclear. OBJECTIVE: To investigate the characteristics of fatigued quadriceps by continuous maximum knee extension movements among different male groups under different physical conditions. METHODS: A total of 36 male participants (24 elderly and 12 youth) were divided into three groups, namely, young male group, and two groups of elderly participants: physically active and physically inactive. All groups underwent two sets of fatigue procedures. They initially finished 30 isokinetic maximum knee extension contractions at 60∘/s. Three days later, they completed 50 isokinetic maximum knee extension at 180∘/s. Then, their muscle strength characteristics were assessed. RESULTS: During the 60∘/s fatigue test the total work of the dominant and non-dominant quadriceps in the two elderly groups was significantly lower than that of the young male group (p&lt; 0.05). Moreover, the total work of dominant quadriceps in physically active elderly male group was significantly higher than physically inactive male group in the middle (71.1 ± 12.0 vs. 52.0 ± 18.5 J) and the last third (60.9 ± 8.6 vs. 44.4 ± 15.4 J, p&lt; 0.05). During the 180∘/s fatigue test the total work of dominant and non-dominant quadriceps in young male group was significantly higher than their elderly counterparts (p&lt; 0.05). Moreover, the total work of dominant quadriceps in physically active elderly male group was significantly higher than in the physically inactive male group in the first (48.9 ± 4.6 vs. 31.7 ± 6.3 J), the middle (41.2 ± 4.8 vs. 26.1 ± 3.5 J), and the last third (33.3 ± 7.0 vs. 20.3 ± 3.1 J, p&lt; 0.05). CONCLUSION: Exercise is associated with improved function and fatigue resistance of the quadriceps in elderly people. Moreover, the implications of the bilateral quadriceps’ imbalance in this group may be of functional importance and should thus be clinically considered.

Study on the chronic low-grade inflammation and its related factors in the elderly

Objective To investigate the state of chronic low-grade inflammation in healthy elderly adults and its related factors. Methods A total of 762 healthy people aged 30-99 years were retrospectively analyzed and assigned into 2 groups: the young group(30-59 years old, n=272)and the elderly group(60-99 years old, n=490). Patients in the elder group were subgrouped into 2 groups: the 60 to 79-year-old group(n=288)and the 80 to 99-year-old group(n=202). The differences in levels of tumor necrosis factor(TNFα)and hypersensitive C-reactive protein(hsCRP)were compared between groups.Correlations of TNFα or hsCRP levels with age, body mass index(BMI)and metabolic indexes were analyzed. Results The levels of TNFα and hsCRP were higher in elderly male group than in the young male group[(16.03±2.32)×10-15 mol/L vs.(15.28±2.63)×10-15 mol/L, (1.30±1.01 mg/L) vs.(0.79±0.61) mg/L, P=0.019 and 0.048], while there was no obvious difference between the 60 to 79-year-old male group and the 80 to 99-year-old male group(P=0.957 and 0.937). TNFα and hsCRP levels were higher in the elderly female group than in the young female group[(15.76±2.66)×10-15 mol/L vs.(14.43±3.18)×10-15 mol/L, (1.30±0.81) mg/L vs.(0.75±0.74) mg/L, P=0.006 and 0.001], and no difference were observed between the 60 to 79-year-old female group and the 80 to 99-year-old female group(P=0.282 and 0.389). Spearman`s rank correlation coefficient analysis showed that TNFα level was positively associated with age, total protein, albumin, total-cholesterol, glomerular filtration rate, uric acid(P<0.05)in man and positively associated with age, triacylglycerol and fasting blood glucose in woman, while hsCRP level was positively associated with age, body mass index, total-cholesterol and negatively associated with total bilirubin, direct bilirubin and indirect bilirubin(P<0.05)in man and was positively associated with age, alkaline phosphatase, triacylglycerol and fasting blood glucose and negatively associated with GFR(P<0.05)in woman. Conclusions Healthy elderly people are often in a state of chronic low-grade inflammation, which is closely related to several metabolic parameters. Key words: Encephalites; C-reactive protein; Tumor necrosis factor-alpha

한국사회의 나홀로 여가 특성 : 10대와 60대이상 남성 집단을 중심으로

한국사회의 나홀로 여가 특성 : 10대와 60대이상 남성 집단을 중심으로

Viscus fat area contributes to the Framingham 10-year general cardiovascular disease risk in patients with type 2 diabetes mellitus

ObjectiveTo explore the correlation of the viscus fat area (VFA) with the Framingham 10-year general cardiovascular disease risk in patients with type 2 diabetes mellitus (T2DM). MethodsA total of 202 patients with T2DM were divided into two groups based on VFA (a VFA ≥ 100 cm2 group and a VFA < 100 cm2 group), or four groups based on sex and age (a middle-aged male group, an elderly male group, a middle-aged female group, and an elderly female group). The correlation between the Framingham 10-year general cardiovascular disease risk and body fat indexes was analyzed. ResultsPatients in the VFA ≥ 100 cm2 group had higher body fat indexes and Framingham Risk Scores (FRSs) and lower levels of high density lipoprotein-cholesterol (HDL-C) when compared to the VFA < 100 cm2 group (P < 0.05). Female patients had higher body fat mass (BFM) and body fat percentage (BFP) levels and a lower VFA when compared to male patients. The VFA was significantly higher in the elderly than in the middle-aged patients. The waist hip fat ratio (WHFR) was significantly higher in elderly females than in elderly males (P < 0.05). Elderly females had the highest FRS of all patients. Multiple stepwise regression analysis revealed the VFA as a contributor to the Framingham 10-year general cardiovascular disease risk after statistical correction for other multiple factors affecting cardiovascular disease risk. ConclusionThe VFA is an independent factor that contributes to the Framingham 10-year general cardiovascular disease risk in patients with T2DM.

Effects of sedentary condition and longterm physical activity on postural balance and strength responses in elderly subjects

The aim of this study was to characterise postural control and lower limbs muscular strength in elderly people conditioned to long-term physical activity or sedentariness. Three groups of elderly males’ average age (mean ± SD) (67 ± 5 years) was studied: 11 tennis players (TP), 8 long-distance runners (LD) and 9 sedentary (S). The protocol consisted of standard balance tests with eyes open and closed in bipodalic (60 s) and monopodalic (30 s) conditions. Then, it was required to perform three isometric maximal voluntary contractions (MVCs) at the leg press to select the best one as reference. Postural static balance findings were further compared to a group of 15 young healthy sedentary males (average age 26 ± 1 years) (Y). TP showed more stability than S (p < 0.05) in bipodalic trials and greater force values during MVC than LD (p < 0.01). This group of elderly athletes showed the most similar postural characteristics to Y group. Post-hoc tests on MVC force showed a statistically significant difference (34 %, p < 0.01) between TP (1,456 ± 635 N) and LD (964 ± 219 N) groups. No statistically significant MVC differences were obtained between active and sedentary (1,129 ± 400 N) elderly groups. In TP force peak was found related with the average speeds in A-P and M-L planes of the balance performance (p < 0.05). It is possible to conclude that postural stability and lower limb’s muscular strength can be increased in elderly people with a power physical activity, such as tennis. Thus it is also possible to speculate that such a conditioning can be considered promising to decrease risks of falling.

The Magnetic Resonance Imaging Measurement of the Hippocampal Formation Volume of Normal Chinese Adults

The objective of this study was to measure the normal hippocampal formation of the adults in China and to provide data for the prevention and diagnoses of the related diseases. 3D-fSPGR sequence scanning was used in 68 cases of healthy adult brain to gain the image between lateral border of bilateral fourth ventricle and vitreous body. The image then was divided into 10 equal parts in the sagittal plane. We can trace the area of the hippocampal formation in each part and the data gained was analyzed by SPSS to calculate the volume. The calibrated normal adult average hippocampal formation volume on the right was 2649.92-2903.17 mm(3) while on the left was 2579.42-2803.27 mm(3). The male right average hippocampal formation volume was 2601.84-2986.44 mm(3) and the left was 2526.32-2886.94 mm(3). The female right average hippocampal formation volume was 2531.88-2819.06 mm(3) and the left was 2579.42-2803.27 mm(3). There was no obvious difference in various gender and age groups (P > 0.05), but there was a significant difference between bilateral hippocampal formation volume in middle-aged and elderly male group whether calibrated (t = 2.892, P< 0.05) or not (t = 2.924, P < 0.05). We can conclude that the hippocampal formation volume of normal Han adults has no relation to gender and age except that the bilateral fourth ventricle volume of middle-aged and elderly men were evidently different from each other.

GW24-e1261 Features and treatments of hypertension in elderly female with Stanford B aortic dissection

ObjectivesTo summarise the features and treatments of hypertension in elderly female with Stanford B aortic dissection.MethodsRetrospectively analysed the features and treatments of hypertension in the elderly male group (≥ 60...

Does Wearing Thermal Underwear in Mild Cold Affect Skin Temperatures and Perceived Thermal Sensation in the Hands and Feet of the Elderly?

The present study was to investigate whether increasing thermal insulation affects thermal sensation in the hands and feet; and whether aging is an influential factor in the relationship between thermal responses and subjective thermal perceptions. Six young males (YM), 5 young females (YF), 6 elderly males (OM), and 6 elderly females (OF) volunteered as subjects. Subjects conducted two trials at a constant air temperature of 19 degrees C: One condition included thermal underwear (19CUW) while the other did not (19C). The results showed that (1) rectal temperature (T(re)) did not show any significant differences between conditions with and without thermal underwear. The T(re) of the OF was greater than that of the YF (p<0.05) for the 19C condition, while the young and elderly male groups showed similar values. (2) The hand and foot skin temperatures (T(hand), T(foot)) were greater in the OF than in the YF group for the 19C condition (p<0.001). (3) For overall thermal sensation, the OF group was less sensitive to differences between the 19CUW and 19C condition, when compared with the old male and young groups. (4) For thermal sensation in the hands and feet, the elderly groups were less sensitive than the YF. In particular, all elderly females felt the hands were thermally neutral, even in the 19C condition. (5) Hand thermal sensation for the OF group appeared to be irrelevant to T(hand). (6) Thermal preference of the elderly groups did not change significantly after adding thermal underwear compared to the young group. In conclusion, wearing thermal underwear in mild cold did not affect local skin temperatures and thermal sensation in the hands and feet for the elderly male and female groups. Adding thermal underwear in mild cold affected the hand skin temperature and thermal sensation of the young female group. In particular, elderly females had specific features concerning local skin temperatures and thermal sensations distinguished from elderly males and young groups.

A quantitative morphometric study of rectal mucosa in adult and aged healthy subjects

Rectal mucosa is relatively susceptible to pathological processes and frequently it is affected by various diseases. However, there is a notable lack of quantitative data regarding normal rectal mucosa, which would provide a reference for histoquantitative studies of the pathologically changed tissue. Therefore, we obtained the tissue from 27 healthy patients subjected to diagnostic rectoscopy during active screening for asymptomatic cancer of the large intestine, in which no disease was found. Using computer-aided morphometric analysis, we studied all structural elements of the rectal mucosa. The patients were divided into four groups according to the age and sex: adult males, elderly males, adult females and elderly females. The patients under 60 years of age were grouped as adult and those older than 60 years as aged subjects. A decreased height of surface epithelium was registered in both elderly male and female groups. This finding, however, was significant only when adult and elderly male groups were compared. The tendency towards reduction of the mucosal height was also registered comparing male adult and elderly groups. The number of crypts per 0.1 mm2 of tissue increased with aging in both males and females, whereby the crypts were always more numerous in males than in females. The increase in number of crypts in male subjects was accompanied by a decrease in their diameter and perimeter. The changes associated with ageing were discrete and affected only the male subjects.

Vocal Intensity Characteristics inNormal and Elderly Speakers

The relationship of lung pressure, fundamental frequency, peak airflow, open quotient, and maximal flow declination rate to vocal intensity for a normal speaking, young male control group and an elderly male group was investigated. The control group consisted of 17 healthy male subjects with a mean age of 30 years and the elderly group consisted of 11 healthy male subjects with a mean age of 77 years. Data were collected at three levels of vocal intensity: soft, comfortable, and loud, corresponding to 25%, 50%, and 75% of dynamic range, respectively. Phonational threshold pressure and lung pressure were obtained using the intraoral technique. The oral airflow waveform was inverse filtered to provide an approximation to the glottal airflow waveform from which measures of fundamental frequency, peak airflow, open quotient, and maximal flow declination rate were determined. Excess lung pressure was calculated as lung pressure minus estimated phonational threshold pressure. The results show for both groups an increase in sound pressure level across the conditions, with corresponding increases in lung pressure, excess lung pressure, fundamental frequency, peak airflow, and maximal flow declination rate. Open quotient decreased with increasing vocal intensity. Lung pressure, sound pressure level, and peak airflow were all found to be significantly greater for the control group than for the elderly group at each condition. Open quotient was found to be significantly lower in the control group than in the elderly group at each condition. No significant difference was observed for excess lung pressure, phonational threshold pressure, fundamental frequency, or maximal flow declination rate between the two groups. These results show that a difference in vocal intensity does exist between young and elderly voices and that this difference is the result of differences in lung pressure, peak airflow, and open quotient.

Significance of accumulation of arteriosclerotic risk factors in elderly people: from a study conducted in Tanno-Sobetsz

Data from an 18-year prospective study were used to investigate the effect of accumulation of arteriosclerotic risk factors in elderly people on cerebrovascular and cardiovascular disease mortality rates. Risk factors include smoking, hypertension, diabetes mellitus, hyperlipidemia, and obesity. We compared survival rates between a group with few risk factors (< two risk factors) and a group with many risk factors (> or = two risk factors) in four groups of subjects: middle-aged men (< 61-years-old) and middle-aged women and elderly men (> or = 61-years-old) and elderly women. In the elderly male group, the survival rate was lower in subjects with many risk factors than in those with few risk factors. In the middle-aged male group, however, there was no difference between the two risk groups. On the other hand, in the middle-aged female group, the survival rate was lower in subjects with many risk factors than in those with few risk factors, while no difference was found between the two risk groups in the elderly female group. The results indicated that the effects of an accumulation of risk factors are different in men and women and greater in elderly men than in elderly women.

Hormonal regulation of serum lipoprotein (a) levels: effects of parenteral administration of estrogen or testosterone in males.

When given orally, estrogens, as well as androgens, lower serum lipoprotein (a)[Lp(a)]levels. To determine whether these effects occur also after parenteral administration of steroids, Lp(a) levels were determined in two groups of elderly males suffering from prostatic carcinoma, who were randomized to treatment with parenteral estrogen (n = 8) or orchidectomy (n = 6). One group of healthy male volunteers (n = 9) was studied after parenteral administration of testosterone. Estrogen was given as im polyestradiol phosphate, 240 mg twice monthly, and testosterone was given as im injections, 250 mg/week. In the orchidectomized subjects, Lp(a) levels increased by 20% by month 3 after treatment (P < 0.05). In spite of drastic changes in serum hormone levels, no change in Lp(a) levels was observed in the estrogen-treated subjects. Concomitantly, low-density lipoprotein cholesterol levels were lowered by 15% and high-density lipoprotein cholesterol levels increased by 20%. Testosterone administration lowered Lp(a) levels by 20% (P < 0.05). No significant changes in serum lipid levels were observed in the testosterone-treated subjects or in the orchidectomy group. Thus, during parenteral administration of estrogens or androgens, diverging effects on Lp(a) and serum lipoproteins were observed. In particular, the mode of administration of estrogen influenced the response in Lp(a) levels. This suggests that the regulatory role of sex hormones on serum Lp(a) levels may depend on their capability to influence hepatic metabolic pathways of Lp(a).

Hemispheric bias of the mini-mental state examination in elderly males.

In this study we examined the influence of lateralized brain lesions on Mini-Mental State Examination (MMSE) performance using the psychometric concepts of intercept and slope bias. Four patient groups of elderly males (normal control, right-hemisphere stroke, left-hemisphere stroke, and dementia) were studied. Right-and left-hemisphere stroke groups were equated for global level of neuropsychological impairment independently of their MMSE performances. Results indicated that the right-hemisphere stroke patients' MMSE scores did not differ from those of controls but were significantly superior to the left-hemisphere stroke and dementia patients' MMSE performances. Additionally, correlations between the MMSE and three neuropsychological composite measures assessing global, verbal, and nonverbal skills, demonstrated poor correspondence among patients with lateralized lesions, especially those with right-hemisphere brain dysfunction. Results are interpreted as supporting the presence of both intercept and slope bias when the MMSE is used with patients having unilateral lesions.

Snoring and Anxiety Dreams

In a group of elderly males who had been exposed to excessive stress during World War II, 56% of whom suffered from current post-traumatic stress disorder, a significant association was found between snoring and the occurrence of anxiety dreams, independent of the use of sedatives, antidepressants, smoking and alcohol and coffee consumption. Anxiety dream incidence was highest when snoring was accompanied by respiratory pauses. The underlying pathophysiologic mechanisms are thought to be hypercapnia and autonomic-vegetative arousal, resulting from obstructive sleep apneic episodes in heavy snoring. Polysomnographic sleep studies are needed to confirm this hypothesis.