Middle-aged Patients Research Articles

Assessment of the geriatric patient’s prescription for the analysis of medications and diseases

Objective: Aging is broadly defined as a gradual functional decline in the living organism’s intrinsic ability to defend, maintain, and repair itself in order to keep working efficiently and has attracted attention throughout the history of civilization Methods: The recent work was an observational, prescription based study carried out in the nearby area of Jahangirabad Institute of Technology Faculty of Pharmacy, Barabanki UP., and India. A descriptive study was conducted for 3 months from March 2024 to June 2024. Elder from (50-100) years of age in outpatient department were recruited for this study. Results: The data reveals a higher number of male patients (446) compared to female patients (324), with 65% of patients in the 50-70 age range and a notable decline in those over 70. Commonly prescribed medications include Omeprazole (275) for heartburn, Diclofenac (272) for pain, and dietary supplements for weakness. Amoxicillin is the most frequently prescribed antibiotic (86 instances), followed by Ciprofloxacin (53) and Metronidazole (45). Parenteral antibiotics like Gentamycin and Ceftriaxone are used for severe infections. This information highlights the need for targeted healthcare services for middle-aged and early senior patients and reflects the reliance on both oral and parenteral antibiotics for treating infections. Conclusion: First and foremost, seniors should focus on living a healthy lifestyle. Eating a balanced diet, exercising regularly, and getting enough sleep are all essential components of maintaining good health. Seniors should speak with their doctor to determine the best course of action for their specific health needs. This may include implementing a specific diet, taking vitamins, or engaging in physical activity.

Intranasal administration of insulin on the incidence of postoperative delirium in middle-aged patients undergoing elective on-pump cardiac surgery (INIPOD-MOPS): a prospective double-blinded randomized control study protocol

BackgroundDelirium, marked by acute cognitive decline, poses a life-threatening issue among older individuals, especially after cardiac surgery, with prevalence ranging from 15 to 80%. Postoperative delirium is linked to increased morbidity and mortality. Although clinical trials suggest preventability, there is limited research on intranasal insulin (INI) for cardiac surgery-related delirium. INI has shown promise in managing cognitive disorders. It rapidly elevates brain hormone levels, enhancing memory even in non-impaired individuals. While effective in preventing delirium in gastrointestinal surgery, its impact after cardiac surgery remains understudied, especially for middle-aged patients.MethodThis is a prospective randomized, double-blind, single-center controlled trial. A total of 76 eligible participants scheduled for elective on-pump cardiac surgery will be enrolled and randomly assigned in a 1:1 ratio to either receive Intranasally administered insulin (INI) or intranasally administered normal saline. The primary outcome of our study is the incidence of postoperative delirium (POD). Secondary outcomes include duration of ICU, postoperative hospital length of stay, all in-hospital mortality, the change in MMSE scores pre- and post-operation, and incidence of postoperative cognitive dysfunction at 1 month, 3 months, and 6 months after operation. Moreover, we will subjectively and objectively evaluate perioperative sleep quality to investigate the potential impact of nasal insulin on the development of delirium by influencing sleep regulation.DiscussionOur study will aim to assess the impact of intranasal administration of insulin on the incidence of postoperative delirium in middle-aged patients undergoing on-pump elective cardiac surgery. If intranasal insulin proves to be more effective, it may be considered as a viable alternative for preventing postoperative delirium.Trial registrationChiCTR ChiCTR2400081444. Registered on March 1, 2024.

Vitamin D level as a predictor of dysmobility syndrome with type 2 diabetes

Dysmobility Syndrome (DMS), is a combination, that is analogous to the approach taken with metabolic syndrome, The diagnosis of DMS is complex. So this study aimed to explore the relationship between 25-(OH) Vit D with Dysmobility Syndrome (DMS)in type 2 diabetes mellitus(T2DM) patients. This is a cross-sectional study, including 330 patients (67.0 ± 8.8 years old) with T2DM who were admitted to the Qinhuangdao First Hospital from October 2020 to February 2022. Selected independent variables include grip strength, six-meter gait speed, level of 25-(OH) vitamin D, and bone mineral density (BMD) measured by Dual-energy X-ray (DXA). DMS includes six conditions: osteoporosis, low muscle mass, low muscle strength, slow gait speed, occurrences of falls in the past year ≥ 1, and obesity, having three or more of these conditions were diagnosed with DMS. Patients were classified based on DMS. The detection rate of DMS in patients with T2DM was 25.5%. The proportion of vitamin deficiency is 67.9% in patients with T2DM. The 25-(OH) Vit D deficiency was defined based on the 25th percentile into two groups; < 36.2 nmol/L. The vitamin D levels in Group DMS were significantly lower than that in Group Non-DMS (41.74 ± 14.60 vs. 47.19 ± 13.01, P < 0.05). After adjusting confounder factors including sex, age, vitamin D levels, HbA1c, ALB, HDLC, eGFR, diabetes microvascular complications and macrovascular, there was an independent association between risk of DMS and age (OR value = 1.160, 95% CI 1.091–1.234, P = 0.000), HbA1c(OR value = 1.262, 95% CI 1.046–1.532, P = 0.015), and vitamin D deficiency (< 36.2 nmol/L) (OR value = 2.990, 95% CI 1.284–6.964, P = 0.011). Our findings suggest that low levels of vitamin D are a predictor of DMS in middle-aged and elderly patients with poor control of type 2 diabetes.

Telomere length in young and middle-aged patients: relationship with cardiovascular risk factors

Aim. To evaluate the relationship between leukocyte telomere length (LTL) and cardiovascular risk factors in young and middle-aged patients without cardiovascular disease (CVD).Material and methods. This cross-sectional study involved 450 patients aged 30 [21;42] years. Risk factors and possible exclusion criteria was assessed through questionnaires and anthropometric examination. In all subjects, glucose concentration and lipid profile were assessed using the CardioChekPA express analyzer (USA, 2017), followed by calculation of integral metabolic indices: visceral adiposity index (VAI), body fat percentage, body adiposity index (BAI), lipid accumulation product (LAP). LTL was measured in whole blood samples using fluorimetry (Qubit 4 Singapore 2020) and reverse transcription polymerase chain reaction (QIAamp Blood Mini Kit, German 2022). Statistical analysis was carried out using the Statistica 10 program.Results. The prevalence of the studied risk factors in the main group corresponded to the general population. According to the correlation analysis, LTL was associated with age (r=-0,26; p&lt;0,05), smoking (r=-0,35; p&lt;0,05), obesity (r=-0,19; p&gt;0,05), neck circumference (NC) (r=-0,53; p&lt;0,05), diastolic blood pressure (r=-0,31; p&lt;0,05), cholesterol (r=-0,64; p&lt;0,05), high-density lipoproteins (HDL) (r=0,59; p&lt;0,05) and low-density lipoproteins (r=-0,52; p&lt;0,05), triglycerides (r=-0,46; p&lt;0,05), glucose (r=-0,33; p&lt;0,05), LAP (r=-0,4; p&lt;0,05), VAI (r=-0,57; p&lt;0,05) and BAI (r=-0,32; p&lt;0,05). According to the multivariate regression analysis, LTL was associated with age (B=-0,04, Std. Err. of B=0,02, p=0,03), smoking (B=-0,87, Std. Err. of B=0,26, p=0,001), NC (B=-0,23, Std. Err. of B=0,07, p=0,001), total cholesterol levels (B=-0,37, Std. Err. of B=0,87, p&lt;0,001), HDL (B=0,59, Std. Err. of B=0,24, p=0,018), LAP (B=-0,01, Std. Err. of B=0,02, p&lt;0,011), VAI (B=-0,37, Std. Err. of B=0,16, p=0,025).Conclusion. LTL is interconnected with cardiovascular risk factors, which determines the significance of their participation in CVD development and biological aging in young and middle-aged people.

The U-shaped association between age at diagnosis and recurrence in patients with papillary thyroid carcinoma: A retrospective single-institution cohort study

PurposeAge is a significant predictor of papillary thyroid carcinoma (PTC). At present, the available evidence shows that age at diagnosis has an important impact on the recurrence of PTC. The objective of our investigation was to examine the relationship between age at diagnosis and recurrence in patients with PTC. MethodsThe medical records of patients with PTC who were treated between January 2010 and December 2018 at a single institute in a cancer referral center in China were retrospectively reviewed. The hazard ratios (HRs) and 95 % confidence intervals (CIs) for recurrence-free survival (RFS), locoregional recurrence-free survival (LRRFS) and distant metastasis-free survival (DMFS) were assessed using Cox proportional hazard models and restricted cubic splines (RCSs). ResultsA total of 13758 patients were included in the study. With a median follow-up of 60 months (range 12–277), a total of 687 patients experienced recurrence, and 90 patients died. The 5-year RFS, LRRFS and DMFS rates were 95.0 % (95 % CI 94.6%–95.4 %), 95.8 % (95 % CI 95.4%–96.2 %) and 98.8 % (95 % CI 98.6%–99.0 %), respectively. The adjusted smooth RCS curves revealed a U-shaped association between age at diagnosis and RFS, LRRFS, and DMFS. After adjusting for potential confounding variables, both younger (≤30 years) and older (≥55 years) patients exhibited significantly lower RFS and LRRFS rates than did middle-aged patients (31–54 years). Older patients had significantly lower DMFS rates. ConclusionsThis study confirmed a U-shaped association between age at diagnosis and the risk of both locoregional recurrence and distant metastasis.

Phenotypic Spectrum and Natural History of Gillespie Syndrome. An Updated Literature Review with 2 New Cases.

Gillespie syndrome is a rare disorder caused by pathogenic variants in ITPR1 gene and characterized by the typical association of cerebellar ataxia, bilateral aniridia and intellectual disability. Since its first description in 1965, less than 100 patients have been reported and only 30 with a molecular confirmation. We present two additional cases, both carrying a loss-of-function variant in the Gly2539 amino acid residue. We describe the clinical evolution of the patients, one of whom is now 17years old, and discuss the updated phenotypic spectrum of the disorder. The study gives an overview on the condition, allowing to confirm important data, such as an overall positive evolution of development (with some patient not presenting intellectual disability), a clinical stability of the neurological signs (regardless of a possible progression of cerebellar atrophy) and ocular aspects, and a low prevalence of general health comorbidities. Data about development and the observation of middle-aged patients lend support to the view that Gillespie is to be considered a non-progressive cerebellar ataxia, making this concept a key point for both clinicians and therapists, and for the families.

New Perspective on the Clinical and Laboratory Characteristics of Rheumatoid Pleural Effusion: A 29-Case Series.

Objective Rheumatoid pleural effusion (RPE) usually occurs in middle-aged men. Pleural fluid analyses have revealed high lactate dehydrogenase (LDH) levels and low pH and glucose levels in RPE. We aimed to investigate the clinical and laboratory features of patients with RPE since the beginning of the 21st century. Methods Medical records of patients with RPE were reviewed between May 2006 and October 2021. The patients were divided into <60-year (younger) and ≥60-year (older) groups. Results The younger group comprised 6 patients (median age 53.5 years, female 33%) and older group comprised 23 patients (median age 76 years, female 52.2%). Compared to the younger group, the older group had fewer cases of fever (83.3% vs. 18.2%, p = 0.007) and chest pain (66.7% vs. 8.7%, p = 0.008). In pleural fluid analysis, the older group presented higher pH (p = 0.004) and lower LDH levels (p = 0.044). Seven patients died during the follow-up period. Conclusion Most patients with RPE were over 60 years of age, and approximately half of them were female. The pleural fluid analysis showed milder inflammation in older patients than in middle-aged patients. The mortality rate of patients with RPE was distinctly higher than that previously reported.

The Content and Nature of Rumination in Chinese Young and Middle-Aged Patients with Acute Coronary Syndrome: A Qualitative Study.

Individuals have different rumination patterns after experiencing traumatic events in different cultural backgrounds and situations. This study aimed to explore the experience of Chinese young and middle-aged patients with acute coronary syndrome (ACS) to understand the content and nature of their rumination. Sixteen participants were selected using the purposive sampling method in the First Affiliated Hospital of Soochow University from May 2023 to December 2023. Data were collected using semi-structured interviews and analyzed using Colaizzi's seven-step phenomenological method. The participants went through two successive stages: non-adaptive rumination and adaptive rumination. During the initial admission phase, all the participants experienced varying degrees of non-adaptive rumination. Non-adaptive rumination included four sub-themes: worry or anxiety of daily activities and medical therapy (37.50%), fear of unpredictable outcomes and death (37.50%), sadness of maladjustment (25.00%), and remorse of carelessness (12.50%). During the period of stable condition and pre-discharge, the participants received health education and gradually all transitioned to adaptive rumination. Adaptive rumination included four sub-themes: tracing of disease processes (100%), enhancement of disease cognition (81.25%), improvement of health awareness (62.50%), and adjustment of lifestyle cognition (100%). In conclusion, although the Chinese young and middle-aged patients with ACS experienced negative emotions after a traumatic cardiac event, they gradually made positive changes, and optimism and information support played important roles in this transition. The results of this study provide a fundamental understanding of rumination experiences in Chinese young and middle-aged patients with ACS and provide new data for healthcare providers when designing intervention programs to enhance post-traumatic growth in these patients.

Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study

BACKGROUND Psychological problems affect economic development. However, there is a huge gap between mental health service resources and mental health service needs. Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people. Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible. AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors. METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects. The general condition Questionnaire, Eysenck Personality Questionnaire, Symptom Checklist-90, General Health Questionnaire, and Smart Medical Service Use Intention Questionnaire were used to collect data. Pearson’s correlation was used to analyze the correlation between the participants’ willingness to use smart medical services and their personality characteristics, psychological symptoms, and mental health. RESULTS The results revealed that the mental health of young and middle-aged people was poor, and some had psychological problems such as anxiety, depression, and physical discomfort. Familiarity, acceptance, and usage of smart healthcare in this population are at a medium level, and these levels correlate with psychological characteristics. Acceptance was positively correlated with E, and negatively correlated with P, anxiety, fear, anxiety/insomnia, and social dysfunction. The degree of use was negatively correlated with P, obsessive-compulsive symptoms, depression, anxiety, hostility, paranoia, and somatic symptoms. CONCLUSION The familiarity, acceptance, and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.

Clinical Outcomes After Mini-Open Subpectoral Biceps Tenodesis

Background Long head of the biceps tendon pathology is a common cause of shoulder pain. Current surgical treatment options for long head of the biceps tendon disorders include tenotomy and tenodesis. Younger and high-demand patients are usually treated with tenodesis since tenotomy is associated with increased biceps pain and cramping, cosmetic deformity and patient dissatisfaction. Previous studies have shown biomechanical advantages of subpectoral open approach over arthroscopic suprapectoral approach, with less biceps over tension and increased ultimate load to failure. Despite this, there is a lack of consensus in the literature regarding the management of biceps-related pathology. Methods We retrospectively reviewed all patients who underwent subpectoral biceps tenodesis with unicortical endo-button fixation between January 2015 and December 2019. Only patients who had a minimum of 24 months follow-up were included in the study. We reviewed patient demographics. The American Shoulder and Elbow Surgeons and Visual Analogue score were assessed and complications were recorded. Results A total of thirty-two patients were enrolled in this study. 15 were young patients and sports athletes with SLAP (Superior Labrum from Anterior to Posterior) lesions or isolated biceps instability and the remaining 17 were middle-age patients with degenerative biceps disease and concomitant pathology. The mean follow-up time was 36 months. SLAP lesions group average age was 24,3 and degenerative group average age was 53,8. The ASES score and the VAS score and were statically significative better in the isolated subpectoral tenodesis due to SLAP lesions 99,8 and 0,1 respectively in comparison with the degenerative group, 85,7 and 1,5 respectively. We recorded two complications. One case of superficial infection and one case of a patient that was concomitant submitted to arthroscopic rotator cuff tear repair with persisting shoulder pain. There was no case of failure of fixation or associated Popeye deformity. Conclusions Subpectoral biceps tenodesis with unicortical endo-button fixation is a viable treatment option for patients with symptomatic biceps disease. Anterior shoulder pain and biceps symptoms were resolved with this technique. Patients with coexistent rotator cuff lesion may have less favorable outcomes.

Effectiveness analysis of biplanar vertical fixation and inverted triangle fixation with hollow screw for Pauwels type Ⅲ femoral neck fracture in young and middle-aged patients

To compare the effectiveness of biplanar vertical fixation and inverted triangle fixation with hollow screw for Pauwels type Ⅲ femoral neck fracture in young and middle-aged patients. The clinical data of 55 young and middle-aged patients with Pauwels type Ⅲ femoral neck fracture between June 2021 and December 2022 was retrospectively analyzed. All patients were treated with closed reduction and internal fixation with hollow screws, 25 cases were treated with biplanar vertical fixation (study group), 30 cases with inverted triangle fixation (control group). There was no significant difference in gender, age, affected side, cause of injury, underlying diseases, and time from injury to operation between the two groups ( P>0.05). The operation time, intraoperative blood loss, fluoroscopy times, guide needle puncture times, starting time of weight bearing, time of full weight bearing, time of fracture healing, and complications were recorded and compared between the two groups. The hip joint function was evaluated by Harris score at 1 day, 6 months, 12 months after operation, and at last follow-up, and the pain relief was evaluated by visual analogue scale (VAS) score. The femoral neck shortening was measured on the X-ray film at last follow-up. All patients were followed up 12-31 months (mean, 22.0 months), and there was no significant difference in follow-up time between the two groups ( P>0.05). The operation time, intraoperative blood loss, and fluoroscopy times in the study group were higher than those in the control group, but the difference was not significant ( P>0.05). The guide needle puncture times in the study group was more than that in the control group, and the time of starting weight bearing and the time of full weight bearing in the study group were shorter than those in the control group, the differences were significant ( P<0.05). Bony healing was achieved in both groups, and there was no significant difference in fracture healing time between the two groups ( P>0.05). No osteonecrosis of the femoral head and incision-related complication was found in the two groups during follow-up, and the femoral neck shortening length in the study group was significantly shorter than that in the control group at last follow-up ( P<0.05). There was no significant difference in Harris score between the two groups at 1 day after operation ( P>0.05), and the Harris score of the study group was significantly better than that of the control group at other time points ( P<0.05); there was no significant difference in VAS score between the two groups at each time point after operation ( P>0.05). Compared with the inverted triangle fixation, the treatment of Pauwels type Ⅲ femoral neck fracture with biplanar vertical fixation can effectively reduce femoral neck shortening without affecting fracture healing, and improve hip joint function in early stage.

Parameters of lipid profile and endothelial function in young and middle-age patients with coronary artery disease

Parameters of lipid profile and endothelial function in young and middle-age patients with coronary artery disease

Effects of Exercise on Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The primary objective of this study was to assess the influence of exercise interventions on cancer-related fatigue (CRF), specifically in breast cancer patients, with the ultimate goal of establishing an optimal exercise prescription for breast cancer patients. A comprehensive search was undertaken across multiple databases, including Embase, PubMed, Cochrane Library, Web of Science, and Scopus, covering data published up to 1 September 2023. A meta-analysis was conducted to calculate the standardized mean difference (SMD) along with its corresponding 95% confidence interval (CI), thereby quantifying the effectiveness of exercise in alleviating CRF in the breast cancer patient population. Twenty-six studies met the inclusion criteria. Aerobic exercise (SMD, -0.17, p = 0.02), resistance exercise (SMD, -0.37, p = 0.0009), and combined exercise (SMD, -0.53, p < 0.0001) significantly improved CRF in breast cancer patients. In addition, exercise intervention conducted ≥3 times per week (SMD, -0.47, p = 0.0001) for >60 min per session (SMD, -0.63, p < 0.0001) and ≥180 min per week (SMD, -0.79, p < 0.0001) had greater effects on improving CRF in breast cancer patients, especially middle-aged patients (SMD, -0.42, p < 0.0001). Exercise is an effective approach to improving CRF in breast cancer patients. When devising an exercise program, the primary consideration should be the incorporation of combined exercise as the principal intervention. This entails ensuring that participants engage in the program at least three times weekly, with each session lasting for more than 60 min. The ultimate aim is to achieve a total weekly exercise duration of 180 min by progressively increasing the frequency of exercise sessions.

Retrospective analysis of the efficacy of low-intensity extracorporeal shock wave therapy on young and middle-aged patients with erectile dysfunction responsive to PDE5Is: reducing the use of PDE5Is.

Low-intensity extracorporeal shock wave therapy (Li-ESWT) is a new method for treating erectile dysfunction (ED), but there are no standards yet for its indications. The study aimed to suggest the early clinical efficacy of Li-ESWT and explore its related factors in young and middle-aged patients with ED who responded to phosphodiesterase type 5 Inhibitors (PDE5Is). Data from 61 patients with ED who had previously responded to oral PDE5Is and subsequently underwent Li-ESWT were collected. This included information on age, body mass index, total testicular volume, sex hormones, as well as IIEF-EF scores before treatment and at 1, 3, and 6months after treatment. The treatment regimen involves a weekly session for four consecutive weeks, with each session administering 5000 shock wave pulses. Linear regression analysis was utilized to identify factors associated with the efficacy of Li-ESWT treatment. Additionally, the improvement in different severity groups of ED before and after treatment, along with their IIEF-EF scores, was compared. Li-ESWT was more targeted and effective for young and middle-aged patients with erectile dysfunction who responded to PDE5Is. The age of enrolled patients ranges from 22 to 53years old, and the IIEF-EF scores at 1month, 3months, and 6months after treatment were compared to baseline for efficacy assessment, showing significant improvements (P < .0001) in all instances. Linear regression analysis using baseline data revealed predictive factors associated with treatment efficacy: treatment efficacy was negatively correlated with baseline IIEF-EF scores (t = -2.599, P = .013) and positively correlated with baseline LH levels (t = 2.170, P = .036). Given the considerable cost of Li-ESWT treatment and the emphasis on treatment continuity, we hope to identify the most suitable candidates for Li-ESWT therapy, thereby optimizing its application. Our findings provide a better solution for nonelderly ED patients who are responsive to PDE5Is. This study was limited by our sample size and follow-up time. After 3months of Li-ESWT, the IIEF-EF score gradually stabilizes and short-term maintenance of PDE5Is medication increases the responsiveness to shock wave therapy.

Glycemic Marker Correlation with Collagen Denaturation and Non-Enzymatic Collagen Cross-Linking in Age-Associated Bone Resistance

The primary clinical indicator of fracture risk among the elderly is low bone mass, yet it accounts for less than half of fractures in individuals over 50 years. Age is recognized to influence bone quality, affecting bone structure and properties. Previous research indicates that age diminishes tissue plasticity and toughness conferred by collagen, suggesting that age-related changes in the collagen environment may contribute to bone fragility. This study explores the relationship between age-related collagen impairment, specifically the accumulation of non-enzymatic collagen cross-linking and molecular collagen denaturation, and bone toughness in middle-aged and older patients (postmenopausal 50–70 years old and senile osteoporosis age > 70 years old). Additionally, it examines the influence of blood glucose and HbA1c levels, as well as body mass index (BMI), on these factors. Despite not finding any differences in fracture toughness between groups, we found a significant correlation between hemoglobin A1c and collagen integrity (collagen denaturation and non-enzymatic cross-linking).

Clinical trauma severity of indoor and outdoor injurious falls requiring emergency medical service response

BackgroundInjurious falls represent a significant public health burden. Research and policies have primarily focused on falls occurring indoors despite evidence that outdoor falls account for 47–58% of all falls requiring some medical attention. This study described the clinical trauma severity of indoor versus outdoor injurious falls requiring Emergency Medical Services (EMS) response.MethodsUsing the 2019 National Emergency Medical Services Information System (NEMSIS) dataset, we identified the location of patients injured from falls that required EMS response. We classified injury severity using (1) the Revised Trauma Score for Triage (T-RTS): ≤ 11 indicated the need for transport to a Trauma Center; (2) Glasgow Coma Scale (GCS): ≤ 8 and 9–12 indicated severe and moderate neurologic injury; and (3) patient clinical acuity by EMS: Dead, Critical, Emergent, Low.ResultsOf 1,854,909 encounters for patients with injurious falls, the vast majority occurred indoors (n = 1,596,860) compared to outdoors (n = 152,994). For patients who fell indoors vs outdoors on streets or sidewalks, the proportions were comparable for moderate or severe GCS scores (3.0% vs 3.9%), T-RTS scores indicating need for transport to a Trauma Center (5.2% vs 5.9%) and EMS acuity rated as Emergent or Critical (27.7% vs 27.1%). Injurious falls were more severe among male patients compared to females and males injured by falling on streets or sidewalks had higher percentages for moderate or severe GCS scores (5.2% vs 1.9%) and T-RTS scores indicating the need for transport to a Trauma Center (7.3% vs 3.9%) compared to falling indoors. Young and middle-aged patients who fell on streets or sidewalks had higher proportions for a T-RTS score indicating the need for Trauma Center care compared to those in this subgroup who fell indoors. Yet older patients injured by falling indoors were more likely to have a T-RTS score indicating the need for transport to a Trauma Center than older patients who fell on streets or sidewalks.ConclusionsThere was a similar proportion of patients with severe injurious falls that occurred indoors and outdoors on streets or sidewalks. These findings suggest the need to determine outdoor environmental risks for outdoor falls to support location-specific interventions.

Correlation between the TyG-BMI index and carotid plaque characteristics in middle-aged and elderly patients with acute myocardial infarction.

The aim of this study is to investigate the correlation between the triglyceride-glucose-body mass index (TyG-BMI) and the characteristics of various carotid plaques in middle-aged and elderly patients with acute myocardial infarction (AMI). A retrospective study was conducted on 380 patients with AMI hospitalized in the Cardiology Department of Kaifeng Central Hospital. Based on carotid ultrasound results, patients were divided into the following two groups: the stable plaque group and the unstable plaque group. Additionally, a control group comprising 380 healthy individuals visiting the hospital's physical examination center during the same timeframe was established. Fasting venous blood samples were collected from all participants to measure blood glucose and triglyceride. The baseline TyG-BMI index was calculated using the formula Ln [fasting triglyceride (mg/dL)×fasting blood glucose (mg/dL)/2]×BMI. The correlation between different plaque groups and the TyG-BMI index was analyzed. The TyG-BMI index was significantly higher in the unstable plaque group compared to the stable plaque group, with values of 252.81±29.99 and 201.92±28.72, respectively (P = 0.034). Spearman's correlation analysis showed a positive correlation between the instability of carotid plaques and the TyG-BMI index in patients with AMI (r = 0.521, P = 0.003). Logistic regression analysis indicated that the TyG-BMI index was an important risk factor for unstable carotid plaques in patients with AMI (OR = 2.691, 95% CI: 1.169-4.123). The findings of this study suggest that an elevated TyG-BMI index significantly increases the risk of unstable carotid plaques in patients with AMI, making it an important risk factor for carotid plaque instability.

Influence of Age on Outcomes of Endovascular Treatment in Posterior versus Anterior Circulation Stroke: A Comparative Analysis in a Nationwide Registry.

It is unknown whether the influence of age on clinical outcomes post endovascular treatment (EVT) is similar in posterior circulation stroke (PCS) compared to anterior circulation stroke (ACS). Data were extracted from the ETIS registry, a nationwide prospective, multicenter, observational registry for stroke EVT procedures in France. We included patients treated with EVT for PCS or ACS between January 2015 - August 2023. The relationship between patient age and clinical outcome variables was studied using regression analysis. Good clinical outcome was defined as modified Rankin scale score ≤2 at 90 days. The study included 935 patients with PCS and 11427 patients with ACS. There were no significant differences between PCS and ACS in the influence of age on the likelihood of good clinical outcome. The influence of age on the likelihood of mortality was significantly different. Mortality was higher for PCS between 30-85 years, without significant differences in younger or older patients. Elderly patients (≥80 years) with PCS had similar rates of good clinical outcome and mortality compared to patients with ACS from the same age group. In this comparative analysis assessing the impact of age on EVT outcomes in posterior versus anterior circulation stroke, differences were observed in middle aged patients, whereas outcomes tended to converge in young and elderly age groups. Elderly PCS patients had similar outcomes as ACS patients from the same age group.

Current status and factors influencing the work readiness of middle-aged and young postoperative lung cancer patients.

To identify the current status of return-to-work readiness and analyze its influencing factors among middle-aged and young postoperative lung cancer patients. From July 2022 to February 2023, a total of 144 middle-aged and young postoperative lung cancer patients who had been treated in the Department of Thoracic Surgery of West China Hospital, Sichuan University and had not returned to work were selected as the research subjects. A general information questionnaire, the Readiness for Return-To-Work (RRTW) Scale, the General Self-Efficacy Scale (GSES), and the Simplified Coping Style Questionnaire (SCSQ) were used for the survey. Univariate analysis and ordinal logistic regression analysis were used to assess the current status of work readiness and its influencing factors. The distribution of work readiness from high to low was as follows: behavioral preparation-self-assessment stage, intention stage, preintention stage, and behavioral preparation-action stage. Univariate analysis showed that age, place of residence, occupation, nature of work, average family income, scope of surgery, postoperative complications, surgical site, and primary coping strategies were statistically significant (P < .05). The ordinal logistic regression analysis revealed that patients engaged in mentally oriented work (odds ratio [OR] = 13.78, P < .001), with a monthly family income of ≥ 10,000¥ (OR = 6.28, P = .017), proactive coping strategies (OR = 4.84, P = .019), and higher self-efficacy (OR = 1.17, P < .001) had higher work readiness. Patients engaged in other industries (OR = 0.25, P = .028), agricultural, forestry, and fishing labor (OR = 0.08, P < .001), unemployed (OR = 0.12, P = .038), and with a monthly family income of < 1000¥ (OR = 0.07, P = .026) had lower work readiness. In overall, this study suggests that the work readiness of postoperative lung cancer patients needs improvement. Occupation, nature of work, average family income, primary coping strategies, and general self-efficacy are associated with return-to-work readiness among middle-aged and young postoperative lung cancer patients.

Sex differences and risk factors of self-reported suicide attempts in middle-aged Chinese Han patients with first-episode drug-naïve anxious depression: a large-scale cross-sectional study.

This study aims to investigate sex differences and risk factors for self-reported suicide attempts among Chinese Han middle-aged patients with first-episode drug-naïve (FEDN) anxious depression (AD). A total of 1796 patients with FEDN major depressive disorder were enrolled in this study, including 341 middle-aged patients with AD. We compared the prevalence, demographics, and clinical characteristics of suicide attempts between male and female patients with FEDN middle-aged AD. We also explored the risk factors for self-reported suicide attempts in this population using binary logistic regression analysis. The male/female ratio was 91/250 and the age of onset was 51.50 ± 4.13. Our results showed that there were no significant sex differences in the prevalence of self-reported suicide attempts in middle-aged patients with FEDN AD. However, we did find significant differences in several demographic and clinical characteristics between self-reported suicide attempters and non-suicide attempters. Moreover, severe anxiety, measured by the Hamilton Anxiety Rating Scale score, was identified as a risk factor for self-reported suicide attempts in female middle-aged AD patients. Additionally, elevated thyroid peroxidase antibody (TPOAb) levels were linked to self-reported suicide attempts in male AD patients. Our findings suggest that there are no significant sex differences in the prevalence of self-reported suicide attempts in this population, but there may be sex-specific risk factors for self-reported suicide attempts in middle-aged AD. Clinical psychiatrists need to pay attention to thyroid hormone levels in middle-aged anxious depression.