Prolonged Life Expectancy Research Articles

Treatment Algorithm of Periprosthetic Femoral Fracturens.

Introduction. The ever-expanding indications for total hip arthroplasty are leading to more implants being placed in younger as well as in older patients with high functional demand. Also, prolonged life expectancy is contributing to an overall increment of periprosthetic femoral fractures. The Vancouver classification has been the most used for guiding the surgeon choice since its proposal in 1995. Fractures occurring over a hip femoral implant can be divided into intra-operative and post-operative PFFs, and their treatment depends on factors that may severely affect the outcome: level of fracture, implant stability, quality of bone stock, patients’ functional demand, age and comorbidities, and surgeon expertise. There are many different treatment techniques available which include osteosynthesis and revision surgery or a combination of both. The goals of surgical treatment are patients’ early mobilization, restoration of anatomical alignment and length with a stable prosthesis and maintenance of bone stock. Significance. The aim of this review is to describe the state-of-the-art treatment and outcomes in the management of PFFs. We performed a systematic literature review of studies reporting on the management of PFFs around hip stems and inter-prosthetic fractures identifying 45 manuscripts eligible for the analysis. Conclusions. PFFs present peculiar characteristic that must be considered and special features that must be addressed. Their management is complex due to the extreme variability of stem designs, the possibility of having cemented or uncemented stems, the difficulty in identifying the “real” level of the fracture and the actual stability of the stem. As a result, the definition of a standardized treatment is unlikely, thereby high expertise is fundamental for the surgical management of PPFs, so this kind of fractures should be treated only in specialized centres with both high volume of revision joint arthroplasty and trauma surgery.

MO827: Clinical Characterization of Older People on Chronic Hemodialysis Nephrocare-Chile 2020–2021

Abstract BACKGROUND AND AIMS The Chilean population has experienced an accelerated demographic aging, expecting that by the year 2050, older people (60 years and over) [1] will reach 31.6% of the country's population [2]. In Chile, patients >60 years old on dialysis represent 53.6% of the total population with renal replacement therapy [3]. The objective of this work was to study the population of older people cared for in the NephroCare-Chile centers. METHOD A retrospective descriptive study, where the demographic and clinical characteristics of patients aged 60 years and over with chronic kidney disease on hemodialysis were analyzed, during the period January 2020–November 2021 in NephroCare-Chile dialysis network, distributed in 64 clinics, with information registered in Clinical Database- EuCliD [4]. Descriptive, association and/or dependency analyzes, and survival analyzes were performed using the Kaplan–Meier method, all this with Stata software. RESULTS A total of 6010 patients aged 60 years and over were studied, representing 60.8% of the total population attended in NephroCare-Chile for the period under study, who presented an average age of admission to dialysis of 66.2 ± 8.9 years, 57.6% of whom were men. Of this group, 5.3% were older than or equal to 85 years, and their average age at admission to dialysis was 82.0 ± 4.7 years, with statistically significant differences compared with the younger group (65.3 ± 8.2 years old). Of the older people studied (60 and over years), 52.5% were diabetic, 68% were hypertensive, 18.5% had malnutrition and 27.7% were at risk of malnutrition. At the end of the study period, the active vascular accesses were the Arteriovenous Fistula (54.1%) and Tunnelized Catheter (38.6%). A total of 82.7% of the cases had Albuminemia ≥3.5 g/dL, 67.6% had Hemoglobin levels ≥10 g/dL. Urea clearance estimated by Kt/V Single Pool revealed that 54.8% achieved Kt/Vsp ≥ 1.4. At the end of the study, 24% of the patients seen were deceased, at an average age of 72.4 ± 7.5 years. Of the patients seen who were older than or equal to 85 years, 40.0% were diabetic compared with the younger group (53.2%) (P < 0.05), 67.9% were hypertensive and 45.2% presented compromised nutritional status, the albumin level was <4 g/dL in 67.8%. The most frequent active vascular accesses in this group were the Tunnelized Catheter and the Arteriovenous Fistula (50.9% and 45.0%, respectively). Patients older than 85 years had lower serum levels of iPTH, Albumin and phosphorus compared with the younger group (P < 0.05). Mortality at the end of the study was 36.9% for the group older than 85 years, while for the younger group it was 23.5% (P < 0.05). The median overall survival of the patients seen in the study period was 155 months, regardless of their age at admission to hemodialysis. For those patients who were admitted between the ages of 60 and 84, their median survival was 115 months, while those patients who were admitted after the age of 85 had a survival of 96 months, not finding significant differences in these last two groups (log-rank >0.05). CONCLUSION Most of the patients older than 60 years on hemodialysis in NephroCare-Chile reach a survival of >10 years, being similar to the data published in the international literature. Hemodialysis patients >85 years present indicators of adequacy, nutrition and survival that justify their admission and permanence in it. Our results confirm that replacement therapy significantly prolongs life expectancy in older patients, including those who start their therapy aged 85 years or older [5].

Novel Therapies for Alport Syndrome.

Alport syndrome (AS) is a hereditary kidney disease associated with proteinuria, hematuria and progressive kidney failure. It is characterized by a defective glomerular basement membrane caused by mutations in type IV collagen genes COL4A3/A4/A5 which result in defective type IV collagen α3, α4, or α5 chains, respectively. Alport syndrome has three different patterns of inheritance: X-linked, autosomal and digenic. In a study of CKD of unknown etiology type IV collagen gene mutations accounted for the majority of the cases of hereditary glomerulopathies which suggests that AS is often underrecognized. The natural history and prognosis in patients with AS is variable and is determined by genetics and environmental factors. At present, no preventive or curative therapies exist for AS. Current treatment includes the use of renin-angiotensin-aldosterone system inhibitors which slow progression of kidney disease and prolong life expectancy. Ramipril was found in retrospective studies to delay the onset of ESKD and was recently demonstrated to be safe and effective in children and adolescents, supporting that early initiation of Renin Angiotensin Aldosterone System (RAAS) blockade is very important. Mineralocorticoid receptor blockers might be favorable for patients who develop “aldosterone breakthrough.” While the DAPA-CKD trial suggests a beneficial effect of SGLT2 inhibitors in CKD of non-metabolic origin, only a handful of patients had Alport in this cohort, and therefore conclusions can't be extrapolated for the treatment of AS with SGLT2 inhibitors. Advances in our understanding on the pathogenesis of Alport syndrome has culminated in the development of innovative therapeutic approaches that are currently under investigation. We will provide a brief overview of novel therapeutic targets to prevent progression of kidney disease in AS. Our review will include bardoxolone methyl, an oral NRf2 activator; lademirsen, an anti-miRNA-21 molecule; sparsentan, dual endothelin type A receptor (ETAR) and angiotensin 1 receptor inhibitor; atrasentan, oral selective ETAR inhibitor; lipid-modifying agents, including cholesterol efflux transporter ATP-binding cassette A1 (ABCA1) inducers, discoidin domain receptor 1 (DDR1) inhibitors and osteopontin blocking agents; the antimalarial drug hydroxychloroquine; the antiglycemic drug metformin and the active vitamin D analog paricalcitol. Future genomic therapeutic strategies such as chaperone therapy, genome editing and stem cell therapy will also be discussed.

Postherpetic Neuralgia: A Patient’s and a Physician’s Perspective

Herpes zoster can plague anyone who has had varicella or has received the varicella or chickenpox vaccine. The incidence of herpes zoster increases with age and rises exponentially after 60 years of age. Postherpetic neuralgia (PHN) may occur after herpes zoster at any age but typically occurs after 50 years of age, with over 40% of persons over 60 years of age suffering from PHN after a shingles attack. Up to 1 million new cases of herpes zoster and 200,000 new cases of PHN may now be anticipated in the United States every year, with the incidence rate increasing as the population grows and ages with prolonged life expectancies. Although new antiviral medications will improve and shorten the course of herpes zoster, they do not guarantee the prevention of PHN. Given the high prevalence of PHN in an aging population and the availability of primary prevention by vaccination, the objectives of this review are to describe the epidemiology, pathophysiology, and clinical manifestations of zoster and PHN and to recommend a combination of strategies for the clinical management and prevention of PHN. Key words: evidence-based pain medicine, herpes zoster, neuropathic pain, postherpetic neuralgia

Postherpetic Neuralgia: A Patient’s and a Physician’s Perspective

Herpes zoster can plague anyone who has had varicella or has received the varicella or chickenpox vaccine. The incidence of herpes zoster increases with age and rises exponentially after 60 years of age. Postherpetic neuralgia (PHN) may occur after herpes zoster at any age but typically occurs after 50 years of age, with over 40% of persons over 60 years of age suffering from PHN after a shingles attack. Up to 1 million new cases of herpes zoster and 200,000 new cases of PHN may now be anticipated in the United States every year, with the incidence rate increasing as the population grows and ages with prolonged life expectancies. Although new antiviral medications will improve and shorten the course of herpes zoster, they do not guarantee the prevention of PHN. Given the high prevalence of PHN in an aging population and the availability of primary prevention by vaccination, the objectives of this review are to describe the epidemiology, pathophysiology, and clinical manifestations of zoster and PHN and to recommend a combination of strategies for the clinical management and prevention of PHN. This review contains 6 figures, 4 tables and 13 references Key words: evidence-based pain medicine, herpes zoster, neuropathic pain, postherpetic neuralgia

Outcomes and prognostic factors after surgery for bone metastases in the extremities and pelvis: A retrospective analysis of 140 patients

BackgroundSurgical therapy of bone metastases is becoming increasingly important due to prolonged life expectancy and improved oncological treatment options. In a mostly palliative approach, it is necessary to identify those patients who might benefit from surgery. The shorter the remaining lifetime, the more restricted the indication and the less radical the intervention should be. The aim of this study was to evaluate the postoperative outcomes and prognostic factors for survival of patients with surgically treated bone metastases. MethodsWe retrospectively included 140 patients who underwent surgery for 151 bone metastases in the extremities and pelvis at our hospital between 2010 and 2020. We examined patient demographics, surgical procedures, 30-day complications, local tumour progression, and reoperations. Survival was calculated using Kaplan-Meier analysis. Prognostic factors were investigated by univariate analysis using the log-rank test and multivariate analysis using the Cox regression hazard model. ResultsIn 138 patients, the median survival time was 12.3 months. The overall survival rates at one, two, three and five years were 52.3%, 37.6%, 28.0%, and 18.0%, respectively. In univariate analysis, lung cancer, renal cell carcinoma, pathological fracture, visceral metastasis and multiple bone metastases were significantly associated with prognosis. No significant influence was determined for gender, age, location of bone metastasis, type of surgical procedure and time between diagnosis of primary tumour and surgery for bone metastasis. Multivariate analysis confirmed that pathological fracture, visceral metastasis and lung cancer were negative prognostic variables in terms of survival. Within 30 days, the incidence of complications was 25.0% and mortality was 9.3%. The most common complications were urinary tract infections (5.0%), pneumonia (4.3%), and delirium (2.9%). Local tumour progression occurred in 12 patients (8.7%) and five reoperations (3.6%) were performed. There were no significant differences between patients treated with endoprosthetic replacement (n = 47) and those treated with internal fixation (n = 91) in terms of 30-day complications and mortality as well as local tumour progression. ConclusionsSurvival of patients after surgery for bone metastases in the extremities or pelvis is very limited. The presence of a pathological fracture, visceral metastasis and lung cancer were independent prognostic factors for poor survival. Both internal fixation and endoprosthetic replacement achieved similar outcomes.

Noise reduction and mammography image segmentation optimization with novel QIMFT-SSA method

Breast cancer is one of the most dreaded diseases that affects women worldwide and has led to many deaths. Early detection of breast masses prolongs life expectancy in women and hence the development of an automated system for breast masses supports radiologists for accurate diagnosis. In fact, providing an optimal approach with the highest speed and more accuracy is an approach provided by computer-aided design techniques to determine the exact area of breast tumors to use a decision support management system as an assistant to physicians. This study proposes an optimal approach to noise reduction in mammographic images and to identify salt and pepper, Gaussian, Poisson and impact noises to determine the exact mass detection operation after these noise reduction. It therefore offers a method for noise reduction operations called Quantum Inverse MFT Filtering and a method for precision mass segmentation called the Optimal Social Spider Algorithm (SSA) in mammographic images. The hybrid approach called QIMFT-SSA is evaluated in terms of criteria compared to previous methods such as peak Signal-to-Noise Ratio (PSNR) and Mean-Squared Error (MSE) in noise reduction and accuracy of detection for mass area recognition. The proposed method presents more performance of noise reduction and segmentation in comparison to state-of-arts methods. supported the work.

Multimodal Treatment Approaches to Chronic Diseases

The prevalence of chronic diseases, which is a worldwide public health problem, is increasing with prolonged life expectancy worldwide. Cardiovascular diseases (CVD), diabetes, respiratory system diseases, and cancers are among the most important chronic diseases. Chronic diseases, which affect individuals physically, psychologically, and sociologically, negatively affect daily self-care activities, treatment costs, length of hospital stay, and quality of life. Therefore, a multimodal approach is required to protect or regain the health of individuals with bio-psycho-socio-cultural and spiritual dimensions. A multimodal approach to chronic diseases deals with risk assessment, classification, diagnosis, pharmacological treatment, lifestyle changes, management of psychosocial factors, and surgical intervention with a multidisciplinary approach. It is known that this approach, which expresses patient-centered and holistic care, increases patient satisfaction, reduces health costs and inequalities, and improves the quality of care and health outcomes by addressing the biological, physiological, social, cultural, and spiritual needs of patients. In this review, the multimodal approach to CVD, diabetes, and chronic obstructive pulmonary disease is included in line with current guidelines.

Treatment Patterns and Outcomes of Elderly Patients With Potentially Curable Esophageal Cancer.

ObjectivesThe proportion of elderly patients with esophageal cancer (EC) is increasing due to prolonged life expectancy and aging process. The aim of the study is to explore the optimal treatment strategy for elderly patients (aged ≥70 years) with locally advanced EC.MethodsEligible patients with cT2-4aNxM0 EC were identified in the Surveillance, Epidemiology, and End Results database from 2010 to 2016. Treatment patterns were divided into six groups: surgical resection (S), chemoradiotherapy (CRT), trimodality therapy (CRT+S), radiotherapy (RT), chemotherapy (CT), or observation with no treatment (Obs). Survival between groups was compared using the log-rank test, and the Cox proportional hazards model was used to identify factors associated with overall survival (OS).ResultsA total of 2917 patients with potentially curable EC were identified. Of all the patients included, 6.7%, 51.8%, 18.0%, 9.4% and 3.6%received S, CRT, CRT+S, RT, and CT, respectively, whereas 10.6% underwent Obs. The 3-year OS estimates were 30.2% (95% confidence interval [CI]: 23.5–38.9%), 25.4% (95% CI: 22.8–28.3%),44.3% (95% CI: 39.3–49.9%), 11.4% (95% CI: 7.7–17.0%), 16.1% (95% CI: 9.1–28.3%), and 5.6% (95% CI: 3.2–9.8%) for S, CRT, CRT+S RT, CT, and Obs (p<0.001), respectively. Overall, patents underwent CRT+S had the longest OS, compared to other treatment patterns, and the survival difference was not significant between patients receiving CRT and S (p=0.12) in the elderly population. However, the survival benefits of trimodality therapy over CRT gradually weakened with the increase in age, and became statistically non-significant for EC patients aged ≥80 years (p=0.35). Multivariate analysis showed that treatment patterns, age, sex, tumor grade, T stage, N stage, and marital status were significantly associated with OS.ConclusionGenerally, the use of trimodality therapy was associated with the longest OS, the survival benefits were comparable between CRT and S alone, and CRT was superior to RT or CT alone in elderly patients with curable EC. For patients intolerable to surgery or aged ≥80 years, definitive CRT should be considered as a preferable option.

THE INDIVIDUAL EXISTENTIAL SECURITY IN THE CONTEXT OF THE CRISIS OF THE HUMANISTIC PHILOSOPHY

Personal security is one of the important components of Russian national security. A serious challenge to the existential security of the individual comes from modern biomedical and information technologies, the use of which creates opportunities for changing the biosocial nature of a person. The distortion of the moral content of the philosophical principle of humanism in the conditions of the Fourth Industrial Revolution gave rise to the spread of the philosophy and ideology of transhumanism and post-humanism. The introduction of Trans-human and Post-human images into the public consciousness is a global threat to the continued existence of mankind.&#x0D; Purpose is to trace the historical transformation of the philosophy of humanism, which led to the formation of modern concepts of Trans-human and Post-human.&#x0D; Methodology: the article uses the methodology of historical and philosophical research approaches.&#x0D; Results:&#x0D; 1) A brief overview of the evolution of understanding of the essence of man and the principle of humanism in the history of philosophical thought is given.&#x0D; 2) The danger of deepening the gap between man and the technologies he creates is shown, especially in the conditions of the Fourth Industrial Revolution.&#x0D; 3) The content of the ideology and philosophy of transhumanism is revealed.&#x0D; 4) Various images of the Post-human, replacing Homo Sapiens, are considered.&#x0D; 5) The possible negative consequences for humanity of attempts to artificially change human nature are indicated.&#x0D; Practical implications: scientific discussions, expert activity, educational process.&#x0D; Conclusions:&#x0D; 1) A serious challenge to the security of the individual in modern society is the implementation in practice of the ideas of «cybernetic evolution», which call into question the continuation of human existence as a biological species.&#x0D; 2) The philosophy of classical humanism, based on the recognition of human life as the highest ethical value, is being blurred and distorted today.&#x0D; 3) Advances in the development of biomedical and information technologies have created favorable opportunities for attempts to revise the very nature of man in order to prolong life expectancy and overcome mortality, which was expressed in the concepts of Trans-human and Post-human.&#x0D; 4) The philosophy of transhumanism and post-humanism consistently leads to the destruction of the human personality.&#x0D; 5) The task of global management of post-humanity is greatly facilitated by the use of genetic and information technologies.

Reduction in daily ambient PM2.5 pollution and potential life gain by attaining WHO air quality guidelines in Tehran

BackgroundFine particulate matter pollution (PM2.5) is widely considered to be a top-ranked risk factor for premature mortality and years of life lost (YLL). However, evidence regarding the effect of daily air quality improvement on life expectancy is scarce, especially in the Middle East such as Iran. This study aimed to investigate the potential benefits in life expectancy at concentrations meeting the daily PM2.5 standards during 2012–2016 in Tehran, Iran. MethodsWe collected daily non-accidental mortality and data on air pollutants and weather conditions from Tehran, Iran, 2012–2016. A quasi-Poisson or Gaussian time-series regression was employed to fit the associations between ambient PM2.5 and mortality or YLL. Potential gains in life expectancy (PGLE) and attributable fraction (AF) were estimated by assuming that daily PM2.5 concentrations attained the World Health Organization air quality guidelines (WHO AQG) 2005 (25 μg/m3) and 2021 (15 μg/m3). ResultsDuring the study period, a total of 221,231 non-accidental deaths were recorded in Tehran, resulting in 3.6 million YLL. The mean concentration of ambient PM2.5 was 34.7 μg/m3 (standard deviation: 15.3 μg/m3). For a 10-μg/m3 rise in 4-day moving average (lag 03-day) in PM2.5 concentration, non-accidental mortality and YLL increased by 1.12% (95% confidence interval: 0.60, 1.65) and 20.73 (7.08, 34.39) person years, respectively. A relatively higher effect was observed in males and young adults aged 18–64 years. We estimated that 39830 [AF = 1.1%] and 74284 [AF = 2.1%] YLL could potentially be avoided if daily PM2.5 concentrations attained the WHO AQG 2005 and 2021, respectively, which corresponded to potential gains in life expectancy of 0.18 (0.06, 0.30) and 0.34 (0.11, 0.56) years for each deceased person. PM2.5-associated PGLE estimates were largely robust when performing sensitivity analyses. ConclusionsOur findings indicated that short-term exposure to PM2.5 is associated with increased non-accidental YLL and mortality. Prolonged life expectancy could be achieved if the particulate matter air pollution level were kept under a stricter standard.

Overcoming the blood–brain barrier by using a multistage exosome delivery system to inhibit central nervous system lymphoma

Due to the presence of blood–brain barrier (BBB), various chemotherapy drugs against B-cell lymphoma cannot be effectively transmitted into the brain, leading to poor prognosis of primary central nervous system lymphoma (PCNSL). Exosomes can cross the BBB as a bio- and immune-compatible drug carrier. In this study, we developed a novel drug delivery system, in which the exosomes (Exo) are conjugated with anti-CD22 monoclonal antibody fragments (CD22-F(ab’)2) and encapsulate doxorubicin (DOX) to form CD22-F(ab’)2-Exo-DOX. We showed that CD22-F(ab’)2-Exo-DOX can cross BBB and deliver DOX precisely to tumor cells. The average apoptosis rate of lymphoma cells was 84.60% ± 10.69%. The tumor-bearing mice treated with CD22-F(ab’)2-Exo-DOX have significantly prolonged life expectancy and the enhanced anti-tumor activity. CD22-F(ab’)2-Exo-DOX might be ingested by brain microvascular endothelial cells through endocytosis to cross the BBB. Therefore, targeted chemotherapy mediated by CD22-F(ab’)2-Exo-DOX is a promising option for the treatment of PCNSL.

Prevencija tromboembolije u ortopedskoj hirurgiji - primena rivaroksabana kod artroplastičnih procedura

Arthroplastic surgeries, the installation of total hip and knee prostheses are expanding, as a consequence of the increasing elderly population and the consequent increase in degenerative joint diseases. Prolonged life expectancy has also increased the number of patients with hip fractures requiring surgical treatment. In both groups of patients there is a marked risk of developing deep vein thrombosis (DVT) and pulmonary embolism (PE), which as serious complications, both during and after hospitalization, can be fatal. Therefore, prevention of DVT is necessary in all these patients. This article presents widely used methods of mechanical prophylaxis in orthopedic practice, along with essential methods of pharmacological prophylaxis, which include aspirin, vitamin K antagonists, unfractionated heparin (UFH), and also more modern low molecular weight heparins (LMWH), as well as new preparations - direct oral anticoagulants (DOAC), with special reference to rivaroxaban. It is recommended that in patients with hip fractures and patients after arthroplastic procedures, DVT prophylaxis is applied for 42 days before and after the operation.

The Global Socioeconomic Impact of Mental Health

This paper outlines the arguments and counterarguments within the scientific communities on the issue of common genetic factors discovered in mental disorders. The main objective of the research is to analyse the relationship between genetics and mental health. The relevance of this study by FAAVM Canada, (North America), is to help recognize that major mental health disorders share certain genetic defects. These findings may also point to apply better multidisciplinary scientific research methodologies to diagnose and treat these conditions. However, genetic factors can increase the risks of mental health issues, or make us more vulnerable to developing them, by reducing the brain’s ability to deal with or compensate for traumas and other cognitive disruptions. This research empirically confirms and theoretically proves that the results can be useful for vaccine and pharmaceutical drug development. Across the European Union (EU) region, approximately 165 million people are affected annually by mental illnesses, for the most part, anxiety, mood, and substance abuse disorders. On average, over 50% of the general population in middle-income and high-income countries will experience at least one mental illness at some point in their lives. That being said, mental illnesses are by no means limited to a minority group of predisposed persons but are a major public health challenge. These scientific attributes are in fact mandatory diagnostic criteria that exert considerable socio-economic repercussions not only for those affected but also for their families, communities, social, and employment related environments. In the first year of the Coronavirus (COVID-19) global pandemic, global frequency of anxiety and depression increased by an immense 25%, according to a scientific summary released by the World Health Organization (WHO). Mental illnesses and substance abuse disorders account for over 10.4% of the global burden of mental health diseases, owing to demographic changes and prolonged life expectancy, and were the leading cause of years lived with disability among all disease groups.

The versatile emodin: A natural easily acquired anthraquinone possesses promising anticancer properties against a variety of cancers.

Cancers are generally recognized as the leading cause of death and a predominant barrier to prolonging life expectancy in both developed and developing countries. Emodin is a typical anthraquinone derivative from various plants that exhibits a wide spectrum of biological activities, such as anticancer, antibacterial, hepatoprotective and anti-inflammatory activities. Much previous preclinical evidence has demonstrated that emodin exhibits reliable effects on several cancer types, including lung cancer, liver cancer, colon cancer, breast cancer, pancreatic cancer, leukemia, cervical cancer, and ovarian cancer, etc. The related molecular mechanisms corresponding to the anticancer activities of emodin are involved in the induction of apoptosis, inhibition of cell proliferation, enhanced reactive oxygen species (ROS) accumulation, and induction of autophagy, etc. In the present review, we summarized the sources, anticancer properties in vitro and in vivo, molecular mechanisms, metabolic transformation and toxicities of emodin. In addition, we also discussed the limitations of the present investigations of emodin against cancers and gave some perspectives for them, which would be beneficial for the further exploration and development of this natural compound as a clinical cancer drug.

Angiotensin Receptor Neprilysin Inhibitor [ARNI] and Its Implications Ejection Fraction Preserved Heart Failure: A Recent Review

This review article discusses the Angiotensin Receptor-Neprilysin Inhibitor which is remedy made up of two anti-hypertensive pharmaceuticals (sacubitril and valsartan). These medications may prolong life expectancy more than ACE inhibitors, which have been routinely used to treat heart failure. ARNi is now being used to treat individuals with heart failure those who have a low ejection fraction, which means their basic pumping chamber isn't working properly. Patients must be symptomatic despite receiving effective medical treatment for heart failure or be unable to tolerate a sufficient dose of ACE inhibitors to be eligible. Sacubitril and/or Valsartan are the debut members of a latest class of drugs described as angiotensin receptor neprilysin inhibitors to receive FDA approval (ARNI). The FDA has approved the medicine for the management of chronic heart failure sufferers with a lower ejection fraction and NYHA classifications II, III, or IV.&#x0D; Before commencing sacubitril and/or valsartan, patients must have to be able to accommodate ACEI or ARB. This intervention covers the instances, mode of action, approaches of administration, significant toxic reactions, risks and benefits, bioactivity, and surveilling of sacubitril &amp; valsartan so as to the practitioners can control patients under therapy in settings into which it implies as a part of the effective interprofessional.

Considerations regarding the relationship between Fitness, Wellness and Healthy Lifestyle

Introduction. Currently, the crises triggered by the pandemic, in the fields of health, freedom of movement, economic, with impact in the social and cultural spheres, bring back today the practical applicability of the concepts of fitness and wellness. Material and method. In our study we will refer to the effects of the pandemic on health (everyone's well-being), to see how they accentuated the negative effects of the risks that specialists linked to sedentary lifestyle; increased stress; static anti-physiological positions for prolonged periods of time, which result in cardiovascular disease, metabolic syndrome and even cancer, to which is added an irrational diet. We will also refer to the relationship between the quality of life of people and the need to find the most effective ways to combat the negative effects of risk factors, by overcoming the obstacles posed by the financial situation and cultural patterns both in terms of lifestyle, as well as the eating behavior of people from different backgrounds. Results and discussions. We are of the opinion that specialists must go in their approaches, from the cultural understanding of man, to find ways to individualize the means of intervention so as to achieve the proposed objectives. The framework could be, for children and adolescents - the reorganization of school physical education, and for young people and adults - leisure activities, in which the emphasis could be falls on the concepts of Fitness and Wellness, with a beneficial effect on quality of life and personal satisfaction. Conclusion In this context, we believe that it is necessary to reconsider the need to make the population aware of the formation of a healthy lifestyle. The means could be physical fitness, wellness, rational nutrition and recovery according to the effort made, their benefits can have a major impact on health and prolong life expectancy. Keywords: Fitness, Wellness, Health, Physical education, cultural perspectives,

Tre-P-29 - Vindesine dexamethasone as a therapeutic option in elderly blastic plasmacytoid dendritic cell neoplasms: a monocentric experience

Tre-P-29 - Vindesine dexamethasone as a therapeutic option in elderly blastic plasmacytoid dendritic cell neoplasms: a monocentric experience

Substitution of Sugar-Sweetened Beverages for Other Beverages: Can It Be the Next Step Towards Healthy Aging?

With the prolongation of life expectancy, the gap between lifespan and "health span," the disease-free lifespan, has been widening due to the massive burden of age-related chronic diseases and research on healthy aging has been gaining momentum. A growing body of evidence suggests that diet is a strong determinant of healthy aging and consumption of sugar-sweetened beverages (SSB), a major source of added sugars, predicts poor health outcomes in the aging population, including cardiovascular disease, diabetes, and cancer. Evidence further supports a link between sugar-sweetened beverages-triggered pathological processes and biologic factors of aging, including inflammaging, oxidative stress, and alterations in intestinal microbiota. At present, substitution of sugar-sweetened beverages with healthier alternative beverage remains the most robust strategy to limit the deleterious effects of sugar-sweetened beverages on health worldwide and may help achieve healthy longevity. The purpose of this review is to provide an overview of mechanisms by which sugar-sweetened beverages consumption may impact the physiological aging process and how a simple intervention of beverage replacement may promote healthy aging. Recent findings indicate that SSB are associated with accelerated aging phenotype and activate various adverse biological processes such as chronic inflammation, oxidative stress, insulin resistance, and gut dysbiosis. Replacing SSB with healthier beverages may be a reasonable option to reduce the burden of chronic disease in the aging population and even prolong life and healthspan.

State-of-the-art technology for cardiovascular research

Heart and vascular diseases are responsible for tens of millions of deaths annually, underscoring an urgent need to improve the existing clinical practice in order to benefit patients. Advancement of basic science and technology enables understanding of disease etiology and pathogenesis at a deeper level of complexity. This mini-review article provides a summary of recent methods of cell and molecular biology applicable for current cardiovascular research. Widespread application of these approaches in cardiovascular disease research will be a key factor in the prolonged longevity and life expectancy of the general population.