Extreme Age Groups Research Articles

Impact of disability in the quality of life of patients with traumatic brachial plexus injuries based on a questionnaire survey in a tertiary center in South India.

The aim of the study was to assess the disability and its impact in the health-related quality of life (HRQOL) and its various domains in patients with traumatic brachial plexus injury (TBPI). A descriptive cross-sectional questionnaire survey was conducted on 41 patients with TBPI in a tertiary care center in South India. The assessment of disability and HRQOL was done as per the guidelines of the Gazette of India (2001) and WHO BREF questionnaire, respectively. The association between disability and HRQOL was determined using Chi-square test. All patients were males in the age group 16-60 years (mean age 36.8 ± 14.4 years). Etiology was road traffic accident in 90.2% of cases. About 51.2% had pan-plexus injuries and 53.7% had their dominant limb affected. The mean total disability was 80.39 ± 13.86% and the mean total HRQOL score was 188.46 ± 83.44 out of 400. It was found that disability due to TBPI significantly reduced the HRQOL (Fisher's exact P = 0.005) and the psychological domain was the most significantly affected (P = 0.017, Kruskal-Wallis test). Pan-plexus injuries with an involvement of dominant upper limb had significant impact in the HRQOL. Twenty-one patients (51.2%) complained of neuropathic pain and they had a significantly reduced quality of life (QOL) (mean QOL = 23.3, P < 0.001). It was also found that productive age group (26-55 years) had a significantly reduced QOL as compared to the extreme age groups (P = 0.000). Unemployed patients had a significantly reduced QOL as compared to those with permanent/temporary job (P = 0.024). Marital status was found to have no significant relationship with the total HRQOL (P = 0.647). Those belonging to the poor socioeconomic strata (below poverty line) had poor HRQOL as compared to those above poverty line and the relationship was found to be significant (P = 0.000). TBPIs significantly affected all domains of QOL, especially in unemployed patients in the productive age group in the poor socioeconomic strata. The pan-brachial plexus involvement of dominant upper limb and associated neuropathic pain were the most important factors which negatively affected the QOL. Among the codomains of the QOL, psychological domain was the most significantly affected irrespective of the severity of the injury.

Thyroid Function Abnormalities in Patients with Different Stages of Chronic Kidney Disease

Introduction: Thyroid hormones are crucial for renal development and physiology. Thyroidal hormones affect the cardiovascular system through their influence on renal blood flow as it modulates the glomerular function, the tubular secretory and absorptive capacities as well as the electrolyte pumps and the kidney structure. Objective: To assess the thyroid function abnormalities in patients with different stages of chronic kidney disease. Materials and Methods: The cross sectional observation study was conducted in Department of Medicine, 250 Bed District Hospital, Habiganj, Bangladesh from January to April 2021. Included 54 CKD patients not on dialysis, who are only on conservative management. Results: In our study the age matched graph shows that maximum number of patients in the category of 40-49 years with 8 males and 6 females, 50- 59 years had 8 males and 6 females, whereas between 60 to 69 years there were 6 males and 6 females. The extreme age groups had few patients chronic kidney disease above 70 there were 2 females and 2 males between 18-29 years there were 3 males and 3 females and 30-39 years had 1 male and 3 females. In our study the number of chronic kidney patients having low T3 were 39 which constitutes 72.2%,the patients with normal T3 were 12 constituting 22.2% and those with high T3 were 3, suggesting primary hyperthyroidism, so excluding them 75% of our patients had low T3 syndrome. In our study 39 patients had low T3, 26 had low T4 with 49 patients being normal TSH, only 4 had high high TSH. Excluding patients with primary hypothyroidism. Patients with low T3 low T4 were clustered in more towards end stage renal disease with 60%. Patients also were in moderate number with low T3 and low T4 in stage 4 chronic kidney disease. 20% in stage 3 chronic kidney disease T4 and TSH were almost normal with only 10% patients had low T3 syndrome. In stage 2 chronic kidney disease 10% had low T3, low T4 with rest being normal TSH. In our study patients .....

Relevance of cycle threshold values in mass screening by reverse-transcription-PCR during COVID-19 pandemic in Belgium: a decision-making support?

Aim: The Belgium’s strategy against COVID-19 was partly based on mass screening. Here, we reported the results observed in a Belgian mass screening center. Materials & methods: Between October 2020 and February 2021, 32,089 samples were collected analyzed with reverse-transcription PCR (Thermo Fisher Scientific kits and apparatus). Patients were categorized according to their contagiousness (extrapolated from the cycle threshold [Ct] values and the recommendation of Sciensano). Results: We observed association between Ct values and age, with higher Ct observed in extreme age groups (<6 years and >75 years). Conclusion: The analysis of the evolution of the contagiousness of these patients tested twice within a 7-day period showed the relevancy of the recommendation edited by Sciensano.

In vivo multiphoton multiparametric 3D quantification of human skin aging on forearm and face

Quantifying skin aging changes and characterizing its 3D structure and function in a non-invasive way is still a challenging area of research, constantly evolving with the development of imaging methods and image analysis tools. In vivo multiphoton imaging offers means to assess skin constituents in 3D, however prior skin aging studies mostly focused on 2D analyses of dermal fibers through their signals’ intensities or densities. In this work, we designed and implemented multiphoton multiparametric 3D quantification tools for in vivo human skin pigmentation and aging characterization. We first demonstrated that despite the limited field of view of the technic, investigation of 2 regions of interest (ROIs) per zone per volunteer is a good compromise in assessing 3D skin constituents in both epidermis and superficial dermis. We then characterized skin aging on different UV exposed areas—ventral and dorsal forearms, face. The three major facts of aging that are epidermal atrophy, the dermal–epidermal junction (DEJ) flattening and dermal elastosis can be non-invasively quantified and compared. Epidermal morphological changes occur late and were only objectified between extreme age groups. Melanin accumulation in suprabasal layers with age and chronic exposure on ventral and dorsal forearms is less known and appears earlier. Superficial dermal aging changes are mainly elastin density increase, with no obvious change in collagen density, reflected by SHGto2PEF ratio and SAAID index decrease and ImbrN index increase on all skin areas. Analysis of the z-dermal distribution of these parameters highlighted the 2nd 20 µm thickness normalized dermal sub-layer, that follows the DEJ shape, as exhibiting the highest aging differences. Moreover, the 3D ImbrN index allows refining the share of photoaging in global aging on face and the 3D SAAID index on forearm, which elastin or fibrillar collagens densities alone do not allow. Photoaging of the temple area evolves as a function of chronic exposure with a more pronounced increase in elastin density, also structurally modified from thin and straight elastic fibers in young volunteers to dense and compact pattern in older ones. More generally, multiphoton multiparametric 3D skin quantification offers rich spatial information of interest in assessing normal human skin condition and its pathological, external environment or product induced changes.

Exploring the Instrumental and Emotional Supports for Sustainability and Social Participation

The prevalence of instrumental and emotional support received was investigated, and several psychosocial characteristics were studied in a Spanish population of all ages (10–85 years) and different social groups, by using an 88-item online questionnaire, with a total of 2013 respondents. Participants reported on the instrumental and emotional supports they receive, and on a set of psychosocial variables (emotion management, motivation, self-efficacy, social and communication skills, and social support), as well as their sociodemographic data; all of which were considered as contributions to a sustainable world. Instrumental and emotional supports for sustainability were significantly less prevalent among older participants, men, people with low educational levels, low autonomy levels, retired individuals, and those with a low-income level. Older and female participants were able to manage their own and other peoples’ emotions significantly more frequently. Participant motivation was less prevalent among the participants with low autonomy levels and low-income levels. Younger participants with low autonomy levels were significantly less able to perform activities related to their self-efficacy. Extreme age groups, those with higher educational levels, singles, and those living alone, reported feeling lonely more often. These results help identify sociocultural characteristics of adults with low social participation, which is critical for developing useful strategies to promote community engagement and related benefits for older adults.

Hospitalizations due to and with chronic obstructive pulmonary disease in Galicia: 20 years of evolution

ObjectiveThis work aims to analyze the evolution of COPD-related hospitalizations in Galicia from 1996 to 2018 both as main cause of admission (DUE TO COPD) or when coded in any diagnostic order (WITH COPD), assessing the influence of age, sex, seasonality, and other main causes of the hospitalization. MethodsAn analysis was conducted of administrative healthcare database (CMBD) data on index COPD-related hospitalizations in Galicia from 1996 to 2018. Crude, specific, and standardized rates were calculated for the entire sample and according to age and sex groups. ResultsIn the period from 1996 to 2018, there were 310,883 index admissions WITH COPD in Galicia, of which 29.6% were DUE TO COPD. Both WITH COPD and DUE TO COPD admission rates increased, mainly in men. There was a clear seasonality that was especially relevant in the DUE TO COPD group. The mean male-to-female ratio was approximately 4:1 in both groups, although it was lower in the extreme age groups, with no change over time. The mean age at admission increased three years in men during this period; there were no changes among women. The main causes of admission in those not hospitalized DUE TO COPD were heart failure and pneumonia. ConclusionThe combined evaluation of records of hospital admissions WITH COPD and DUE TO COPD offers additional information for a better understanding of the trends of this disease and allows for establishing hypotheses that explain the results described, providing information for better healthcare planning.

Hospitalizaciones por y con enfermedad pulmonar obstructiva crónica en Galicia: 20 años de evolución

ObjectiveThis work aims to analyze the evolution of COPD-related hospitalizations in Galicia from 1996 to 2018 both as main cause of admission (DUE TO COPD) or when coded in any diagnostic order (WITH COPD), assessing the influence of age, sex, seasonality, and other main causes of the hospitalization. MethodsAn analysis was conducted of administrative healthcare database (CMBD) data on index COPD-related hospitalizations in Galicia from 1996 to 2018. Crude, specific, and standardized rates were calculated for the entire sample and according to age and sex groups. ResultsIn the period from 1996 to 2018, there were 310,883 index admissions WITH COPD in Galicia, of which 29.6% were DUE TO COPD. Both WITH COPD and DUE TO COPD admission rates increased, mainly in men. There was a clear seasonality that was especially relevant in the DUE TO COPD group. The mean male-to-female ratio was approximately 4:1 in both groups, although it was lower in the extreme age groups, with no change over time. The mean age at admission increased three years in men during this period; there were no changes among women. The main causes of admission in those not hospitalized DUE TO COPD were heart failure and pneumonia. ConclusionThe combined evaluation of records of hospital admissions WITH COPD and DUE TO COPD offers additional information for a better understanding of the trends of this disease and allows for establishing hypotheses that explain the results described, providing information for better healthcare planning.

Addition of Lavender Essential Oil (Lavandula angustifolia) in Manufacture Baby Products Diaper Rash Cream

Essential oils are known by the name of ethereal oil or flying oil (ethereal oil or volatile oil ) which is produced by plants. At high concentrations, essential oils can be used as local anesthetics. Essential oils have strong antibacterial and antifungal properties, one of which is lavender essential oil which has commercial relevance in pharmaceutical applications due to its therapeutic properties, such as anticonvulsive, sedative, antidepressant, antiseptic, antihypertensive, antioxidant, and anti-inflammatory. Not only lavender essential oil, coconut oil or commonly known as VCO is an oil that contains vitamin E that the skin needs and is medically useful for healing cracked skin. Coconut oil or VCO is rich in antibacterial, antiaging, antioxidant, wound healing, and anti-inflammatory properties. Pharmaceutical applications that are very important for humans are antioxidant, anti-inflammatory and antibacterial, especially for babies. Infants are an extreme age group who are at risk of damage to skin integrity in the perianal area. This can be due to factors such as increased humidity causing a rash. The purpose of this study was to determine the benefits of using lavender essential oil using coconut oil VCO in the manufacture of baby diaper rash cream products to prevent skin integrity in infants such as rashes. The method used in this study is a qualitative descriptive analysis test. Where using testing 5 times on 4 samples, it was proven that the 4th sample had a good level of characteristics. The results of this study, the test was proven by organoleptic testing carried out, namely the color produced was white, the aroma was lavender, and it had a creamy texture. Homogeneity test has homogeneous results. The pH test resulted in 7.84. The stickiness test on the 4th sample lasted for 1 minute 10 seconds. The dispersion test with a load of 50 grams is 2 cm, a load of 100 grams is 3.7 cm, a load of 150 grams is 4 cm, a load of 200 grams is 4.2 cm, and a load of 250 grams is 4.5 cm.

A Cross-sectional Comparative Study to Observe the Obstetric Complication Associated with Extreme (&lt;18 - &gt;35) Maternal Age

Aim: To assess the frequency and association of obstetric complications in extreme of maternal ages.&#x0D; Methods: A cross-sectional comparative study was conducted at a tertiary care hospital of district Nawabshah, Sindh and Suleman Roshan Medical College during the period April 2019- May 2020. The data regarding adverse obstetric outcomes of all teenage (&lt;18 years) compared with the reference group of (19-22 years) and women of (&gt;35 years) were compared with reference (31-34 years of age) delivering at the facility. The frequencies, percentages were derived as part of descriptive statistics, chi-square was used for parametric testing with 0.05 level of significance and odds ratio were applied to compare the risk of extreme age groups with their respective reference groups.&#x0D; Results: A total of 104 participants were recruited in this study among 16.3% accounted for teenage (&lt;18 years) and 34.6% accounted for advanced maternal age (&gt; 35 years). Multivariate association between maternal age groups and the adverse obstetric variables were taken into account. Elevated rates for all adverse obstetric outcomes were observed between the variables among extreme-age mothers compared to reference group. The differences were statistically significant with p-value of 0.001 respectively. The chi-square test was found to be insignificant for other factors such as socio demographics, obstetric history and mode of delivery. Odds ratio was calculated to measure the risk associated with extreme age. Those women who were &lt;18 years of age attributed 3.2 odds of developing fetal complications and 3.9 odds of developing maternal complication whereas women &gt;35 years of age attributed 3.7 odds of developing fetal and odds 10.7 developing maternal complications.&#x0D; Conclusion: Women in extreme age group were at a higher risk for developing adverse fetal and maternal obstetric complications as compared to their reference group.

Maternal Mortality in Brazil, 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019.

INTRODUCTION Maternal death continues to be one of the most challenging public health problems that needs to be addressed in low and middle-income countries. The objective of this study was to describe the problem of maternal death in Brazil, using estimates from the Global Burden of Disease Study (GBD).METHODS This study used data from the GBD 2019 to show the numbers of deaths and the Maternal Mortality Ratio (MMR) - number of deaths/100,000 live births - in Brazil and its 27 Federated Units (FU), for ages 10 to 54 years, from 1990 to 2019. The annual variation of the MMR was estimated in 1990, 2010, and 2019. The MMR were shown for specific causes as well as for five-year age groups. The estimates were presented with 95% uncertainty intervals (UI).RESULTS The number of maternal deaths, as well as the MMR showed a 49% reduction from 1990 to 2019. This reduction occurred heterogeneously throughout the country, and the profile of the MMR for specific causes changed between 1990 and 2019: from hypertensive gestation diseases, to indirect maternal deaths, followed by hypertensive gestation diseases. In the extreme age groups, the MMR is higher, with mortality increasing exponentially in direct proportion with age.CONCLUSIONS Maternal deaths in Brazil have decreased substantially since 1990; however, the numbers still fall short of what was established by the World Health Organization (WHO). Indirect causes are the greatest problem in more than 60% of the FU, especially for hypertensive pregnancy diseases.

Extreme age and spontaneous intracerebral haemorrhage

Background: Spontaneous intracerebral haemorrhage (ICH) is an intraparenchymal bleeding in the absence of trauma or surgery. Although it occur lesser in relation to ischemic one but is most disabling and deadly type of stroke. Adult age is more prone than younger age group; regarding incidence in very older group is still ambiguous. This study is done to observe spontaneous haemorrhagic stroke in relation of extreme age group. Materials and Methods: The study design is prospective study. Total 195 patients were diagnosed as spontaneous ICH and they have been first time reported &amp; admitted in Combined Military Hospital (CMH) Dhaka, between Jan 2018 and December 2019. Diagnosis was based on history, clinical examination and confirmed by non-contrast Computed Tomography (CT) scan of brain. Statistical analyses were done with using the Statistical Package for Social Sciences (SPSS) version 26. Results: Total admitted 195 patients in CMH Dhaka from Jan 2018- Dec 2019 are included in our study who full-fill the criteria. Males were 141(72.31%), females were 54(27.69%) and were aged between 18 and 95 years. There is significant relationship of spontaneous ICHs with the age. Rate of spontaneous intracerebral haemorrhage among age group, &ge;25 &ndash; 74 years, 182(93.33%) whereas Ë‚25 years only 1(.51%) and &ge;75 years 12(6.15%) patients; so extreme age group affected only 13(6.67%). Regarding aetilogy of 195 patients, Hypertensive 127(65.13%), Coagulopathy 16(8.21%), Unknown aetiology 12(6.15%) and most common association is hypertension. Conclusion: Mostly affected intracerebral hemorrhage is middle age group population. Hypertension is also major factor for this incidence. Extreme age is less vulnerable for spontaneous ICH.

Humoral response to SARS-COV-2 in COVID-19-recovered patients and correlation with various factors

<b>CONTEXT:</b> On exposure to SARS-CoV-2 in participants anti-SARS-CoV-2 antibodies are expected to appear as a humoral response. Furthermore, various factors affect their expression. <b>AIMS:</b> The aim of this study is to investigate the humoral response of COVID-19-recovered participants and correlation with duration of disease, duration of COVID positive to date of test, occupation, blood group, age group, weight, gender, and symptoms of anti-SARS-CoV-2 antibodies. <b>SETTINGS AND DESIGN:</b> This prospective observational study was conducted at the Department of Transfusion Medicine, at a tertiary care center in North India. <b>METHODS:</b> Seventy-two participants were tested for anti-SARS-CoV-2 antibodies on chemiluminescent microparticle immunoassay postgetting COVID negative. <b>STATISTICAL ANALYSIS:</b> The data were analyzed using Kruskal–Wallis and Mann–Whitney test. To correlate variables such as duration of disease, duration of COVID positive to date of test of immunoglobulin G (IgG), occupation, blood group, weight, gender, symptoms, and age group Chi-square test were used. <b>RESULTS:</b> The correlation of anti-SARS-CoV-2 antibodies with a duration of disease (<i>P</i> > 0.05), duration of COVID positive to date of test of IgG (<i>P</i> > 0.05), occupation (<i>P</i> > 0.05), blood group (<i>P</i> > 0.05), weight (<i>P</i> > 0.05), gender (<i>P</i> > 0.05), and symptoms (<i>P</i> > 0.05) is insignificant and whereas significant correlation with age group (<i>P</i> < 0.05) seen. <b>CONCLUSIONS:</b> A significant correlation was seen in anti-SARS-COV-2 antibodies and age group. Higher antibody levels were seen in participants of the upper extreme age group (50–60 years).

Analysis of single cell data as it relates to aging and longevity

Age-related disability and diseases are known to be delayed in people living to 100 years or more. Changes in the immune system with age are known, including in cell type composition and gene expression differences. To further explore changes in extreme longevity subjects, we investigated peripheral blood immune system cell subpopulations across age and extreme longevity at a single cell resolution. We performed an integrative analysis of public scRNA-seq datasets to define consensus cell types of longevity and age, and classified cell types in our novel New England Centenarian Study dataset. We integrated these datasets together to investigate cell type specific differences at a composition and gene expression level. Our findings identified higher cell type diversity in extreme longevity subjects compared to younger age groups, but no significant difference among younger age groups demonstrating that overall composition differences are unique to longevity. We identified novel differences in myeloid and lymphocyte populations; Extreme longevity subjects have higher composition of CD14+ Monocytes, Natural Killer cells, and T gamma delta populations and lower composition of CD16+ Monocytes and dendritic populations. We characterized gene expression differences between extreme longevity and younger age groups and differences in aging across younger age groups. We found that extreme longevity cell type specific signatures overlapped with the aging signatures by at least 50%. We identified unique genes to extreme longevity that are enriched for pathways specific to immune activation and inflammation, suggesting a protective mechanism for centenarians through efficient activation and regulation of immune subpopulations in peripheral blood.

Sex Differences in the Amount and Patterns of Car-Driving Exposure in Spain, 2014 to 2017: An Application of a Quasi-Induced Exposure Approach.

We designed a cross-sectional study in Spain, from 2014 to 2017. Our objective was to assess sex-related differences in the amount of driving exposure of car drivers, overall and stratified by the main environment-related driving conditions. We compared the sex distribution across three populations: (1) total number of person-years aged > 18 years; (2) total number of person-years aged > 18 years holding a valid car-driving license; and (3) total number of non-responsible car drivers involved in crashes with another offending driver, stratified by different environmental variables. The quasi-induced exposure approach was applied: the non-responsible drivers were considered as representative of the entire population of drivers on the road at the place and time at which the crash occurred. We calculated the female-to-male odds ratio (OR) by comparing population 2 versus 1, and population 3 versus 2. Finally, we performed separate regression models in population 3 for each environment-related variable as the dependent variable and driver’s age and sex as the independent variables. The female-to-male OR for the first comparison was 1.12, but values below 1 were found for extreme age groups. In the second comparison, an OR of 0.50 (0.49–0.51) was found, with progressively lower OR values as age increased. In population 3, women were found to drive less than men in environments known to be high risk (i.e., open roads, night-time, poor light conditions, and weekends). A significant gender gap exists in the amount and type of driving exposure. Although women obtain a driving license more frequently than men, they drive much less and tend to avoid high-risk environments. These results emphasize the need to incorporate a gender perspective in the development and implementation of road safety interventions.

Hubungan Antara Usia Ibu Hamil dengan Preeklampsia Tipe Lambat di Rumah Sakit PKU Muhammadiyah Surabaya

Preeclampsia is one of the most common complications in pregnancy that can lead to various complications such assevere illness, long-term disability, andmaternal, fetal, and neonatal mortality. The prevalence of preeclampsia, 30%-40% can cause maternal mortality, and 30%-50% can lead to perinatal mortality. Maternal age is one of the riskfactors for late-onset preeclampsia. Maternal age is grouped into two categories; extreme age (&lt;20 years and&gt; 35 years)and reproductive age (21-35 years). This studyaims to determine the relationship between maternal age and late-onsetpreeclampsia at PKU Muhammadiyah Surabaya Hospital from January to June 2020. The research method used isobservational analytic with case control design. The samples involved were pregnant women visiting PKUMuhammadiyah Surabaya Hospital from January to June 2020. The data were analyzed using a statistical test ofcontingency coefficient correlation. The results showed that respondents who experienced late-onset preeclampsia inthe extreme age group (&lt;20 years and&gt; 35 years) were 37 respondents (100%) and in reproductive age (21-35 years)were 28 respondents (80%), the respondent who did not experience late-onset preeclampsia in extreme ages (&lt;20 yearsand&gt; 35 years) was 0 respondents(0%) and in reproductive age (21-35 years) were 7 respondents (20%). The resultsof the statistical test for the contingency coefficient correlation showed a p-value of 0.004 below (≤0.05). All thingsconsidered, there was a significant relationship between maternal age and late-onset preeclampsia at the PKUMuhammadiyah Surabaya Hospital from January to June 2020.

Antimicrobial Resistance Pattern of Bacterial Meningitis Among Patients in Quetta, Pakistan.

IntroductionBacterial meningitis (BM) is a lethal infectious disease that persists as a substantial cause of morbidity and mortality. The antimicrobial drug resistance in BM pathogens poses a major threat to the community while raising challenges for clinicians. For the first time, we elucidate the incidence rate of BM and its drug resistance among the population of Quetta, Balochistan.MethodsA cross-sectional study was conducted (from January 2018 to March 2021) among meningitis patients admitted to government hospitals in Quetta. The cerebrospinal fluid (CSF) specimen was collected and processed for microbiological and cytological analysis. Bacterial isolates were identified and confirmed using phylogenetic analysis of the 16S rRNA gene.ResultsWe found 35.9% (321/894) confirmed cases of BM among the population of Quetta, Balochistan. The identified bacterial isolates comprised Streptococcus pneumoniae 14.7% (130/894), Staphylococcus aureus 6.9% (61/894), Neisseria meningitidis 5.7% (51/894), Haemophilus influenzae 2.5% (22/894), Escherichia coli 4.5% (40/894), and Klebsiella pneumoniae 1.9% (17/894). A high percentage in male patients of 20.8% (186/894) was identified as compared to female patients of 15.1% (135/894). Extreme age groups such as infants (age range: 1 month to 1 year) and adults (age range: 61 years to 99 years) with low immunity were critically affected by BM. Clinical parameters such as abnormal CSF appearance, pH, and high WBCs in BM patients with endocarditis as the underlying disease were significantly at elevated risk of fatal outcome. 16S rRNA gene phylogenetic analysis confirmed the evolutionary similarity of isolated strains with prevailing pathogenic strains in Asia. Furthermore, age was identified as a significant risk factor for clinical outcomes.ConclusionThe majority of the identified BM patients belonged to rural areas with limited health-care facilities and paramedic staff. The high case fatality rate 11% demonstrates increased antibiotic resistance among BM isolates, thereby stimulating its devastation in underdeveloped regions. Timely detection and intensive treatment of BM may improve critical outcomes in patients.

Chronopharmacology in Therapeutic Drug Monitoring-Dependencies between the Rhythmics of Pharmacokinetic Processes and Drug Concentration in Blood.

The objective of the optimization of pharmacotherapy compliant with the basic rules of clinical pharmacology is its maximum individualization, ensuring paramount effectiveness and security of the patient’s therapy. Thus, multiple factors that are decisive in terms of uniqueness of treatment of the given patient must be taken into consideration, including, but not limited to, the patient’s age, sex, concomitant diseases, special physiological conditions (e.g., pregnancy, lactation, extreme age groups), polypharmacotherapy and polypragmasia (particularly related to increased risk of drug interactions), and patient’s phenotypic response to the administered drug with possible genotyping. Conducting therapy while monitoring the concentration of certain drugs in blood (Therapeutic Drug Monitoring; TDM procedure) is also one of the factors enabling treatment individualization. Furthermore, another material, and yet still a marginalized pharmacotherapeutic factor, is chronopharmacology, which indirectly determines the values of drug concentrations evaluated in the TDM procedure. This paper is a brief overview of chronopharmacology, especially chronopharmacokinetics, and its connection with the clinical interpretation of the meaning of the drug concentrations determined in the TDM procedure.

Outcomes in Nonagenarians with Hip Fractures Treated Conservatively and Surgically.

Introduction:We aimed to assess the clinical outcomes in nonagenarians following a hip fracture. We also further investigated the factors that influence these outcomes, such as method of treatment (operative versus conservative), co-morbidities, and pre-morbid function.Materials and methods:We studied 65 nonagenarians that were identifiable from our hospital hip fracture database. We reviewed various parameters of these patients admitted after sustaining a hip fracture (neck of femur or intertrochanteric) and investigated how these parameters affected patient outcomes. The main outcomes studied were: inpatient morbidity, and mortality at one year.Results:Inpatient morbidity was more likely in patients with an ASA grade of 3 to 5. Urinary tract infection was the most common medical complication. The 1-year mortality was 15.4% and was significantly influenced by advancing age. Surgically managed patients had a 1-year mortality rate (14.3%) slightly less than non-operative patients (17.4%). Post injury mobility was significantly better in those who received operative treatment with 63% of surgical cases regaining ambulatory status versus 7% of conservatively managed patients.Conclusions:We presented the outcomes of hip fractures in an extreme age group in the population. In nonagenarians with hip fractures surgery was associated with a 1-year mortality rate of 14.3% which is comparable to the general hip fracture population and less than the mortality rate of conservatively managed patients (17.4%). The primary advantage of surgery would be that two-thirds of patients return to ambulatory status. This information is useful to counsel patients and their families especially since the elderly are often more fearful of surgical intervention.

BIOLOGICAL AGE: METHODOLOGY FOR DETERMINING

The analytical review is devoted to the methodology for quantifying age-related changes, namely, the determination of biological age (BA). In contrast to the chronological age (CA), which is the same for all people born at the same time, BA can vary significantly and characterizes the rate of aging. Diagnostics of accelerated aging is of great clinical importance, as it allows predicting the development of age-related pathology. In addition, the BA calculation is used to assess various effects on the body, including geroprotectors. To calculate BA, a set of biomarkers of aging (BMA) is used. The most accurate method for determining BA is by measuring the methylation of certain genes (Horvath clock). However, this method is not available for clinical practice yet. Therefore, the development of BA models based on clinical BMS remains relevant. In addition, there is a need to assess the degree of age-related changes at the level of individual functional systems of the body (functional age). The list of BMA available for use in clinical practice is given in this review. The requirements are given that allow using the indicator of age-related changes as BMA. The main methods for calculating BV are multiple linear regression (MLR), principal component analysis (PCA), Klemera and Doubal method (KDM), and neural network analysis. The criteria for assessing the quality of the BA model are described in this review. The MLR method, due to its simplicity, is most often used in clinical practice, however, it has a significant drawback, namely, the systematic error in calculating age, which is most pronounced in the extreme age groups. The article provides a method for correcting this error developed by the authors. The methodology of using MLR to obtain a formula for determining BA from a dataset BMA is described in detail. The theoretical foundations of the use of neural network algorithms for assessing the rate of aging are presented. The use of neural networks for assessing BA has shown their high efficiency by all criteria, in particular, the absence of a systematic error inherent in MLR-based methods. Keywords: biological age, biomarkers of aging, calculation methods.

Carriage of Multidrug-Resistant Bacteria in Healthy People: Recognition of Several Risk Groups.

The increase in multidrug-resistant (MDR) bacteria in hospitalized people and the hospital environment has been thoroughly documented. In contrast, little is known about their presence in the community. However, increasing evidence is showing a high level of carriage in people without infectious signs. Colonized people can later develop infections due to MDR bacteria and may be able to transmit them to susceptible people (the number of which is increasing worldwide), for example, people with comorbidities such as diabetes, cancer, or inflammatory diseases and those in extreme age groups. Risk factors for the acquisition of MDR bacteria are as follows: (1) residence or travel in countries with high levels of MDR bacteria; (2) occupational risks such as health workers or people with close contact with animals (farmers, veterinarians) who frequently use antibiotics; and (3) comorbidities. Eradication is rather difficult and, thus far, has not shown clear-cut results. Preventive measures will be important in the future with a reinforcement of hygienic measures not only in the hospital, but also in the community.