Elderly Subjects Research Articles

Empathy mitigates the relationship between ageism and subjective age in late life

This study corresponds with a dispute in gerontology literature about whether a younger subjective age acts as a psychological defense for older adults by perceiving themselves as younger in order to dissociate from their age-group or as a marker of good physical health. This cross-sectional study presents a preliminary step to clarify this dispute. We examined the role of emotional empathy (measured by the Multifaceted Empathy Test) as a moderator in the ageism (measured implicitly by the Brief Implicit Association Test) and subjective age (measured on Likert scale) association on a convenience sample of 203 community-dwelling older adults (aged 65–90, M = 74.54, SD = 6.76). It was hypothesized that implicit ageism would be associated with younger subjective age and that this association would be only evident among older adults with lower emotional empathy. Implicit ageism was not associated with younger subjective age. As expected, hierarchical linear regression showed that the connection between higher implicit ageism and a younger subjective age remains significant (p = 0.012) only among participants with lower emotional empathy (∆R2 = 0.022, β = 0.156). Higher emotional empathy was associated with younger subjective age. For older adults who are equipped with the ability to feel others' emotions, the defensive dissociation between self and other perceptions of aging might be unnecessary. Theoretical and methodological implications are discussed.

A nomogram prediction model for postoperative seroma/hematoma in elderly subjects after TAPP.

Formation of seroma/hematoma is one of the most common postoperative complications following laparoscopic inguinal hernia repair. This study aimed to identify risk factors associated with seroma/hematoma and construct a prediction model. Elderly subjects undergoing laparoscopic Transabdominal preperitoneal Patch Plasty (TAPP) were included in this study. The observation endpoint was set as the occurrence of seroma/hematoma within 3 months after TAPP surgery. Independent risk factors were identified through preliminary univariate screening and binary logistic regression analysis. These risk factors were then used to construct a nomogram predictive model using R software. A total of 330 patients were included in the analysis, of which 51 developed seroma/hematoma, resulting in an incidence rate of 15.5%. Obesity (OR: 3.54, 95%CI: 1.45-8.66, P = 0.006), antithrombotic drug use (OR: 2.73, 95%CI: 1.06-7.03, P = 0.037), C-reactive protein (CRP) ≥ 8 (OR: 2.72, 95%CI: 1.04-7.10, P = 0.041, albumin/fibrinogen ratio (AFR) < 7.85 (OR: 2.99, 95%CI: 1.28-7.00, P = 0.012), and lymphocyte/monocyte ratio (LMR) < 4.05 (OR: 12.62, 95%CI: 5.69-28.01, P < 0.001) were five independent risk factors for seroma/hematoma. The nomogram model has well predictive value for seroma/hematoma, with an AUC of 0.879. The nomogram model based on obesity, antithrombotic drug, CRP, AFR, and LMR has a proved good predictive value and it has potential in clinical practice.

Predictors of Posture Induced Intraocular Pressure Variations in Normal Subjects and Glaucoma Patients. Evidence from Abakaliki

Background: Intraocular pressure (IOP) is affected by factors like age, gender, body mass index (BMI), and blood pressure among others. Studies have investigated the relationship between IOP and age, gender, BMI, and refractive error (3-5). There has been conflicting results as some studies have reported a correlation between IOP and age, gender, BMI, and refractive error while results from other studies found no such association. Aim: The aim of this study was to determine the relationship between IOP and age, gender, body mass index and refractive status in the primary open angle glaucoma (POAG) and non-glaucomatous eyes. Methods: A case controlled study involving consecutive newly diagnosed POAG and non-glaucomatous patients conducted in the eye clinic of Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Demographic data included age, gender, and occupation. Height and weight were measured using a Standing Scale with calibrated metal rule. BMI was calculated as Weight (kg) / [Height (m)] 2). IOP was measured with Perkins hand-held applanation tonometer. Correlation and regression analysis was used to determine the relationship between IOP and age, gender, BMI and refractive status. Results: There was a direct relationship between age and IOP in non-glaucomatous subjects which was statistically significant (P &lt; 0.001; r = 0.8). Intraocular pressure also increased with increasing age in POAG but this was not statistically significant (P = 0.18; r =0.3). There was no statistically significant difference between mean IOP in males and females of both POAG and non-glaucoma patients, with P = 0.72 and P = 0.50 respectively. BMI had a linear relationship with intraocular pressure which was statistically significant in POAG (P = 0.01; r value = 0.3) but showed no such relationship in non-glaucomatous patients (P = 0.38; r value = 0.1). The relationship between mean IOP and refractive status was not statistically significant in non-glaucomatous (P = 0.19; r = 0.2) and POAG patients (P = 0.5; r = 0.09) respectively. Conclusion: IOP has linear correlation with increasing age in both non-glaucomatous patients and POAG. A statistically significant relationship was found between IOP and BMI in POAG but not in non-glaucomatous eyes. There was no relationship between either the gender, or refractive status and IOP in non-glaucoma and POAG subjects respectively.

Evaluation High-Resolution Computed Tomography (HRCT) Of Temporal Bone In Cholesteatoma Of Middle Ear In Comparison With Histopathological Findings: A Prospective Study

Background: Cholesteatoma is relatively common and potentially dangerous disease of the ear. It is characterised by local destruction and osseous erosion leading to complications. Pre-operative assessment of middle ear cholesteatoma is a must for assessing the disease's location, extent, and complication. High resolution computed tomography (HRCT) is the imaging modality of choice for evaluation of middle ear structures and pathology. Therefore, in the present study we aimed to evaluate HRCT of temporal bone in cholesteatoma of middle ear cleft in comparison with histopathological results. Materials and Methods: This is a prospective study carried out on total of 30 patients who were undergoing HRCT of temporal bone for middle ear cleft pathology and found to have imaging evidence of chronic otomastoiditis on HRCT, subsequently undergoing surgery and histopathological validation. Results: The mean age of study subjects was found to be 23.97 ± 11.30 years. Majority of the study subjects were belonged to age group of 11-40 years (40%) with female predominance (53.3%) as compared to male (46.7%). Majority of the patients i.e., 60% showed signs of loss of aeration and sclerosis of mastoid air cells followed by soft tissue density lesions (43.3%), bony erosions (26.7%), and bony expansions (6.7%). Surgical findings and histopathological reports were correlated with pre-operative HRCT scans analyses with 95.88% accuracy. Conclusion: Compared to histopathological findings, HRCT offers a diagnostic capacity that is remarkably sensitive and specific in identifying cholesteatoma and the condition of the bone structures in the temporal bone

Parathyroidectomy Reduces Inflammatory Cytokines and Increases Vitamin D Metabolites in Patients With Primary Hyperparathyroidism

ContextPrimary hyperparathyroidism (PHPT) is accompanied by a decreased 25-hydroxyvitamin D (25OHD) and vitamin D binding protein (DBP). High parathyroid hormone (PTH) is associated with elevated interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1), yet the effect of parathyroidectomy (PTX) on DBP and cytokines is not clear. ObjectiveTo prospectively evaluate the effect of PTX on inflammatory profiles, total and free 25OHD, and DBP in patients with PHPT. MethodsNewly diagnosed patients with PHPT were recruited for the study (n = 70). Twenty-eight patients returned after PTX, 3 months later. Biochemical markers were measured before and after PTX. A group of age and body mass index-matched healthy subjects were included as controls (n = 70). ResultsBefore PTX, patients had lower serum DBP (37.5 ± 6.0 vs 41.5 ± 6.1 mg/dL, P < .001) and total 25OHD (30.1 ± 9.5 vs 33.3 ± 7.9 ng/mL, P < .05) but similar free 25OHD when compared to controls. Serum IL-6, C-reactive protein, and MCP-1 were higher in patients with PHPT (P < .05), whereas interleukin-10 was similar to that in controls. PTX increased total and free 25OHD and DBP (P < .001) and decreased serum IL-6 and MCP-1 (P < .05), but not C-reactive protein and interleukin-10. Multiple regression analysis indicated that the preoperative PTH explained a significant portion of the variance of IL-6 and MCP-1 (P < .05). ConclusionThese findings suggest that PTH may upregulate the production of MCP-1 and IL-6 and downregulate circulating DBP in patients with PHPT that are normalized by PTX. The exact mechanism of IL-6 and MCP-1 on DBP, vitamin D metabolites, and clinical outcomes in patients with PHPT is an area requiring further study.

High-altitude cerebral oxygen saturation detection using wireless wearable cerebral oximeter.

Hypobaric hypoxic conditions encountered at high altitudes can significantly impact the physiological functions of human body. Therefore, accurate and real-time monitoring of physiological characteristics is crucial for the prevention of brain injuries in individuals with acute and chronic high-altitude exposure. In this study, a wireless wearable cerebral oximeter (WORTH band) was used for the continuous, real-time monitoring of physiological parameters, including regional cerebral oxygen saturation (rSO2) and heart rate (HR), among subjects with high-altitude exposure. During the high-altitude (from 46 m to 4300 m) expedition task, there was a significant decrease in rSO2 accompanied by a corresponding increase in heart rate as the altitude increased. Additionally, during the long-term (52 days) high-altitude (from 356 m to 4658 m) cycling task, the altitudes were significantly correlated with the rSO2 and SpO2 in the elderly subjects. The current findings indicate that the WORTH band oximeter can serve as a promising instrument for measuring rSO2 at high altitudes. We hope that the insights derived from this study could contribute to the management of cerebral oxygenation for individuals with high-altitude exposure and further expand the existing understanding of brain functional detection at high altitudes.

Measures of spatial memory, peripheral inflammation and negative emotional state predict social-cognitive skills in healthy aging cats

Aging is a complex, multidimensional process. Normative aging is typically accompanied by declines in several cognitive domains, including memory and social cognition. As aging progresses, the often-overlooked early manifestations of cognitive decline can advance, leading to an inability to adapt to new situations and environments. Potential mechanisms influencing cognitive decline remain elusive, but, among other mechanisms, inflammaging, an age-related increase in the chronic production of pro-inflammatory mediators, and emotional stress are implicated. Cognitive function in cats is under-researched, with no studies on the link between potential risk factors and cognitive signs in aging subjects. Understanding this link is essential as it may facilitate the early identification of cognitive decline and encourage preventative, individualized interventions. We carried out a citizen science study to investigate, for the first time, the relationship between cognitive functions, stress, and the inflammatory markers interleukin (IL)-1β and IL-10 in 44 healthy, privately owned pet cats (7–14 years of age), who underwent standardized testing in their home environment. A task was employed to test spatial memory, requiring the cat to recall the location of a food-baited container. An unsolvable task was used to assess cats' social cognition and cognitive flexibility by measuring how they used referential communication (i.e., gaze alternation between the apparatus and the caregivers) compared to their persistence in trying to obtain food which was out of reach. Generalized linear regression analysis, conducted while adjusting for demographic factors and stress behaviors, revealed: 1) a predictive positive relationship connecting spatial memory and the use of social referencing with the caregiver (more gaze alternation) in the unsolvable task, highlighting the importance of the interplay between cognitive domains in sustaining complex behaviors, and 2) a reduced engagement in social referencing toward caregivers (less gaze alternation) in the presence of higher serum levels of IL-1β in the unsolvable task, especially as cats get older. A cat’s social cognitive performance was also negatively predicted by stress-related behaviors, which is not surprising given that cats are sentient creatures whose everyday behavior is also influenced by emotional states. These findings provide new insights into the crosstalk between different cognitive domains during aging and the potential contributions of emotions and inflammation to cognitive changes in healthy aging cats. Further research using this multidimensional approach will help explore these mechanisms of cognitive aging and potential markers for early detection of cognitive changes in older cats, which is critical for timely interventions.

Affecting Factors on Police Body-Worn Camera

Previous studies related to police body-worn cameras have discussed legal and institutional problems and issues that may cause when police officers use them at the scene. In recent years, there has been a possibility that their use will be further expanded due to the revision of related laws after the test project of the police body-worn cameras is closed. This study empirically analyzes the differences among the socio-demographic characteristics of field police officers' perceptions of police body-worn cameras using two variables: citizen/resident reaction and general perception. As a result of the research, differences are identified in the variables of citizens/residents reaction according to the socio-demographic characteristics such as age and rank of the survey subjects. On the other hand, there is no difference in general perception variables according to the socio-demographic characteristics. Based on the results of the study, domestic and international research results are different on citizen/resident reactions, and this study also suggests future discussion directions in that they differ from some socio-demographic characteristics of citizen/resident reactions. This study also differs from existing studies in that no difference is identified in general perception by the socio-demographic characteristics. Through these findings, this study suggests the expansion of empirical research related to police body-worn cameras.

Cluster-analysis of human pulse wave by self-organizing Cohonen maps to identify markers of age groups

The present study is methodological in nature and describes an approach to the study of the human cardiovascular system. The assessment of biological age is important for the management of the human aging process. Regular monitoring of this indicator makes it possible to take preventive measures to reduce the likelihood of cardiovascular disasters. The aim of the study is to determine the age groups based on the pulse waves of the subjects using Kohonen neural networks. In this study, Kohonen self-organizing maps were used to cluster pulse waves of people of different ages by observing the dy-namic change of the pulse wave with the selection of parameters of the neural network self-organization algorithm. A data set of different age groups was used. Each group con-tained files of subjects of the same age, each file – pulse waves of these subjects. As a result of experiments with neural network configurations, cluster structures were obtained and geometric characteristics of pulse waves corresponding to age groups were estab-lished. The clustering algorithm used broke the pulse waves into clusters, the reliability of which in some cases reached 91–96 %. The software implementation of the trained neural network and the portability of the pulse wave measuring device allow the proposed tech-nique to be used to monitor the state of the cardiovascular system in people at risk of cardiovascular disasters, as well as people associated with dangerous professions, ath-letes, office workers, etc. Registration of changes in biological age contributes to the adoption of timely preventive measures, decisions on the modification of nutrition, life-style and physical activity. The resulting network can be used in diagnostic systems to support medical decision-making.

Lipid profile in elderly and centenarian subjects in Kazakhstan: a case-control study

Introduction. The health of centenarians is a major focus in global studies. Dyslipidemia is directly linked to the risk of cardiovascular diseases, which pose a growing burden on healthcare due to the increasing elderly population. Studying the lipid profiles of centenarians is important for preventing circulatory system diseases and promoting healthy aging. This research aims to compare the prevalence of dyslipidemia in centenarians (median age 96 [95-97]) with elderly individuals (median age was 69 [64 – 74]) in the Republic of Kazakhstan and examine potential predictors of dyslipidemia in the centenarian group. Methods. The study involved 46 centenarians (study group) and 82 elderly individuals (control group). Statistical analysis was used to process the data, including blood markers and demographic variables, to identify factors contributing to dyslipidemia. Results and conclusion. The prevalence of hypercholesterolemia in centenarians was 32.6% (15 people - 3 men; 12 women), with elevated LDL levels in 4.3% (2 women). In the control group, hypercholesterolemia prevalence was 29.3% (24 people - 6 men; 18 women) and elevated triglycerides in 6.1% (3 women; 2 men). The study and control groups were compared based on their lipid profile characteristics, which showed similarities as indicated by all p-values being above 0.05: Cholesterol (p=0.348), HDL (p=0.975), LDL (p=0.161), and Triglycerides (p=0.159). Decreased physical activity was a predictor of dyslipidemia in centenarians. Excessive cholesterol levels were significantly higher among women than men in both groups. The primary factor for dyslipidemia was low physical activity, with other predictors having no significant impact on the lipid profiles of centenarians. This factor should be considered when assessing cardiovascular disease risks and all-cause mortality.

The Performance and Associated Risks of the Criteria for Sarcopenic Obesity Proposed by the European Association for the Study of Obesity in a Geriatric Population

Background: There is no gold standard definition of sarcopenic obesity (SO). Our objective is to evaluate the benefit of using the new definition proposed by the European Association for the Study of Obesity (EASO) in older people. Methods: Data from the Toledo Study of Healthy Aging, a study based on a cohort of community-dwelling older adults, were used. SO was defined according to the EASO and by a composite of the Foundation for the National Institute of Health (FNIH) for the diagnosis of sarcopenia and the WHO’s criteria for obesity (Body Mass Index, BMI ≥ 30 kg/m2; waist circumference, &gt;88 cm for women and &gt;102 cm for men). Frailty [Frailty Phenotype (FFP) and Frailty Trait Scale-5 (FTS5)] and disability (Katz Index) statuses were assessed at baseline and at the follow-up (median 2.99 years). Mortality at a 5-year follow-up was also assessed. The Logistic and Cox regression models were used to assess the associations. Results: Of the 1559 subjects (age 74.79 ± 5.76 years; 45.54% men), 30.15% (EASO/ESPEN) vs. 16.36% (FNIH) met the SO criteria (Kappa = 0.42). SO was associated with the prevalence of frailty by both the EASO’s [OR(95%CI): FFP: 1.70 (1.33–2.16); FTS-5 binary: 2.29 (1.60–3.27); β(95%CI): FTS-5 continuous 3.63 (3.00–4.27)] and FNIH+WHO’s criteria [OR (95%CI): 2.20 (1.61, 3.00)]. The FNIH + WHO’s criteria were cross-sectionally associated with disability [OR: 1.52 (1.07, 2.16); p-value 0.018], while the EASO’s criteria were not. The EASO’s criteria did not show any association at the follow-up, while the FNIH + WHO’s criteria were associated with incident frailty. Conclusions: The EASO’s new criteria for sarcopenic obesity demonstrate moderate agreement with the traditional definition and are cross-sectionally associated with adverse events, but they do not effectively predict the outcomes generally associated with sarcopenic obesity in older adults. Therefore, the performance of the EASO’s criteria in older people raises the need for refinement before recommending it for generalized use in this population.

Assessing diastolic function using CMR as an alternative to echocardiography: age- and gender-related normal reference values.

Impaired diastolic function is associated with a variety of diseases such as myocarditis or dilated cardiomyopathy. Currently, echocardiography is the standard method for assessing diastolic function. Recently, it has been postulated that cardiovascular magnetic resonance (CMR) is an at least equivalent or superior alternative to echocardiography. To assess CMR-based age- and gender-dependent diastolic functional normal reference values, pulmonary venous and transmitral blood-flow parameters were examined in heart-healthy test persons. Flow-sensitive phase-contrast CMR imaging was performed in the right upper pulmonary vein (RUPV) and at the level of the mitral valve (MV) in 183 healthy subjects (age 10-70years; 97 women, 86 men). The data wasdistributed as evenly as possible across all groups. Strong age-dependence was observed for PV S/D; r = 0.718, p < 0.001 (Pearson product-moment correlation) and for transmitral MV E/A; ρ = -0.736, p < 0.001 (Spearman's Rho correlation). Moderate age-dependence was found for PV slope D-wave; r = 0.394, p < 0.001. Except for MV slope E-wave (male -292cm/s2 interquartile range (IQR) {-338; -243} vs. female -319 ± 82cm/s2; p = 0.047), no gender-related differences were observed. In a subgroup (N = 100), CMR data were compared with echocardiographic data. Strong correlation was found between CMR and echocardiography for PV S/D; r = 0.545, p < 0.001 and MV E/A; ρ = 0.692, p < 0.001. Diastolic functional parameters change with age, while gender-differences are small. CMR and echocardiography showed similar PV S/D and MV E/A ratios, making CMR a promising alternative for assessing diastolic function.

Increased nocturnal urinary cortisol levels in the elderly patients with depression, coexisting major geriatric syndromes and combined pathogenetic mechanisms

BackgroundThe mechanisms at the basis of depression are still matter of debate, but several studies in the literature suggest common pathways with dementia (genetic predispositions, metabolic and inflammatory mechanisms, neuropathological changes) and other geriatric syndromes.AimsTo evaluate the role of cortisol (as marker of the HPA, hypothalamus–pituitary–adrenal axis hyperactivity) in elderly subjects with depressive symptoms (by the means of the AGICO, AGIng and COrtisol, study), in relationship to the presence of the major geriatric syndromes.MethodsThe AGICO study enrolled patients from ten Geriatric Units in Italy. Every subject received a comprehensive geriatric assessment or CGA (including the Mini Mental State Examination or MMSE, Geriatric Depression Scale or GDS and Cornell Scale for Depression in Dementia or CSDD), the neurological examination (with a computed tomography scan or magnetic resonance imaging of the brain), the assessment of the metabolic syndrome (MetS), the evaluation of the cortisol activity by two consecutive urine collections (diurnal and nocturnal), a CGA-derived frailty index (FI) and a modified measure of allostatic load (AL).ResultsThe MMSE scores were significantly and inversely related to the values of GDS (p < 0.001) and CSDD (p < 0.05), respectively. The patients with depressive symptoms (GDS/CSDD > 8) showed significantly increased disability, MetS, inflammation, FI and AL and significantly reduced MMSE and renal function.The diurnal and nocturnal urinary cortisol levels in the patients with depressive symptoms (GDS/CSDD > 8) were higher with respects to controls (p < 0.05 for nocturnal difference).DiscussionThe AGICO study showed that the stress response is activated in the patients with depression.ConclusionThe depression in elderly patient should be reconsidered as a systemic disease, with coexisting major geriatric syndromes (disability, dementia, frailty) and combined pathogenetic mechanisms (metabolic syndrome, impaired renal function, low-grade inflammation, and allostatic load). Cortisol confirmed its role as principal mediator of the aging process in both dementia and metabolic syndrome.

Assamese Cultural Narratives of Health, Illness and Healing

This present study was undertaken to understand the existing Assamese society beliefs and practices in relation to various illnesses such as jaundice and chicken pox. A purposive or judgmental sampling technique was adopted to select the subjects for the study. Data was collected from elderly subjects who had good knowledge about indigenous beliefs and practices of health and illnesses with the age group for the study considered at 50 and above for both genders. From the study, we find that most of the people strongly believed that health related issues can be cured with all the traditional form of practices or home remedies. The study found numerous believes and practices where some are safe and have scientific validation while some do not. We also find that these practices have been prevalent since time immemorial in the Assamese society, to the point that people tend to seek solutions from local ‘medicinemen’ rather than visit modern doctors. Though some practices have scientific validation, some are purely based on superstitious beliefs and might cause more harm than good if there are not enough interventions to remove ignorance among the people still adhering to such practices.

Environmental contaminants, sex hormones and SHBG in an elderly population

IntroductionEffects of environmental contaminants (ECs) on endocrine systems have been reported, but few studies assessed associations between ECs and sex hormones (SH) in elderly. Aim of this study was to investigate whether blood concentrations of four classes of ECs were associated with SH concentrations in elderly. MethodsSamples from participants of the cross-sectional population-based Prospective Investigation of the Vasculature in Uppsala Seniors study (PIVUS, 70-year-old men and women, n = 1016) were analyzed using validated mass spectrometry-based methods for SH (testosterone (T), dihydrotestosterone (DHT), estrone and estradiol (E2)); 23 persistent organic pollutants (POPs); 8 perfluoroalkyl substances (PFAS); 4 phthalates and 11 metals. SH binding globulin (SHBG) was analyzed using immunoassay. The measured concentrations were normalized, and the values converted to a z-scale. Linear regression analyses were conducted to assess association between concentration of the SH, SHBG and E2/T (aromatase enzyme index, AEI) with the ECs. Multiple linear regression analyses were performed to model the relationships. ResultsThe strongest associations were observed with the polychlorinated biphenyls (PCBs). In men, the strongest associations with concentrations of SH and SHBG were seen for PCBs containing >5 chlorine, monoethyl phthalate (MEP), Ni and Cd; and in women, with PCBs, MEP, several of the PFAS, Cd, Co, and Ni. Difference in the effect of ECs on AEI between men and women were observed. Area under the ROC curve for the models predicting abnormal values of SH and SHBG >0.75 due to the effects of ECs was observed for T, DHT, and E2 in men, and for E2 and SHBG in women. ConclusionsResults of this study suggest that in elderly subjects, concentrations of many ECs associated with concentrations of SH and SHBG, and AEI. Further studies are needed to confirm the findings and to assess effect of the pollutants on endocrine system function in elderly.

Exploring the Uncommon: A Series on Dermatofibrosarcoma Protuberans with Rare Locations, Unusual Sites of Metastasis, and Their Close Mimics

Abstract Dermatofibrosarcoma protuberans (DFSP) is an uncommon, slowly growing soft-tissue tumor that involves the dermis, subcutaneous fat and very rarely involves, muscle and deep fascia. It is locally aggressive and an intermediate-grade fibroblastic neoplasm that rarely metastasizes. It is important to know about this entity as it is locally aggressive and has a higher rate of transformation into fibrosarcoma which has an aggressive growth pattern and frequently metastasizes. Apart from this, there are diagnostic challenges, especially in small biopsies, where they resemble other spindle cell neoplasms. This article reviews the clinical and histological features of DFSP as well as possible pitfalls in their diagnosis and how to resolve them. Diagnosed cases of DFSP were retrieved from pathology archives. Their locations and histopathological features along with Immunohistochemistry (IHC) features were reviewed. Our study identified 26 cases of DFSP for 5 years from January 2019 to January 2024 in a tertiary care hospital. The age of study subjects was in the range of 11–70 years. Male:female ratio was 1.30:1. The most common site was shoulder (n = 5). Immunohistochemistry (HC) was performed in cases with diagnostic dilemmas and cases of high-grade transformation. The aim of this study was to perform a retrospective analysis of histopathological features of DFSP to distinguish it from other mimics and emphasize its local aggressiveness, reoccurrence, and rare site of metastasis, especially in cases with fibrosarcomatous transformation. The careful histomorphological examination particularly in smaller biopsies can be challenging, especially in peripheral laboratories and in resource-limited settings.

Age-related changes in EEG signal using triple correlation values.

The alpha rhythm in human electroencephalography (EEG) is known to decrease in frequency with age. Previous study has shown that elderly individuals with dementia exhibit higher S values (spatial variability) and SD values (temporal variability) in the triple correlation of the occipital region (P3, P4, Oz) compared to healthy elderly individuals. The objective of this research is to examine changes in S and SD values of the alpha band with aging in healthy individuals using triple correlation values from the frontal region. The subjects were 50 healthy elderly subjects (mean age 73.0 ± 5.1 years), 34 healthy younger subjects (mean age 28.1 ± 4.6 years), and 21 dementia patients (mean age 70.1 ± 9.1 years). The methodology involved recording EEG for 5 min during rest with closed eyes, and then calculating S and SD values of the alpha band (8-13 Hz) using three electrodes in the frontal region (F3, F4, Fpz). The findings indicated that the S values of young individuals were significantly higher than those of elderly individuals (p < 0.01), whereas the SD values of young individuals tended to be lower than those of elderly individuals. The elevated S values in young individuals imply greater spatial variability akin to individuals with dementia, whereas the reduced SD values in young individuals suggest lower temporal variability unlike individuals with dementia. The discrepancy between the S value and SD value in healthy young individuals suggests that the normal cortical dipole in the frontal regions might be more abundant in them compared to healthy elderly individuals.

Complications of Oral Corticosteroid Use in Otolaryngology.

Oral corticosteroids (OCS) are frequently prescribed by otolaryngologists. However, there are limited quantitative data on OCS-related adverse events (AEs) in otolaryngology. We sought to quantify OCS-related AEs in otolaryngology. All outpatient otolaryngology encounters in our healthcare system (2018-2023) at which an OCS was prescribed were identified via the electronic medical record. The diagnoses indicating OCS were categorized as sinonasal, otologic, pharyngo-laryngeal, and other. The medical record was subsequently examined to assess for OCS AEs during the 21-day period following the prescription. OCS AEs were grouped into (1) gastrointestinal, (2) metabolic, (3) bone/muscle, (4) ophthalmologic, and/or (5) psychiatric complications. The frequency and types of OCS related AEs were determined. A total of 20 746 otolaryngology encounters with OCS prescribed were examined. Seventy OCS courses had 1 or more AEs, implying a number needed to harm of 296.4 (240.2-386.8). There were 83 total OCS-related AEs, yielding an AE incidence rate of 4.0:1000 (95% CI, 3.0-5.0:1000) OCS prescriptions. The mean age of subjects with AEs (61.5 years) was significantly higher than those without (50.3 years; P < .001). Forty-seven (56.6%) of the complications were metabolic, with hyperglycemia and hypokalemia the most common, followed by gastrointestinal (26.5%), ophthalmologic (3.6%), psychiatric (2.4%), and musculoskeletal (2.4%). AEs related to OCS prescribed by otolaryngologists occur at a rate of once per 296 courses of treatment and older populations may be at increased risk for AEs. Otolaryngologists should balance AE rates against anticipated benefits of steroid therapy. 3.

Olfactory Bulb Volume and Asymmetry as Predictors of Executive Dysfunction in Adolescents with Congenital Heart Disease.

Common sequelae for patients with congenital heart disease (CHD) are neurodevelopmental disabilities including executive function, attention, and socio-emotional deficits. Although these are common diagnoses for patients with CHD, limited research has investigated the mechanistic underpinnings of these findings. Our previous research examined the association between abnormal respiratory ciliary motion and brain abnormalities in infants with CHD. Results suggested that abnormal ciliary motion correlated to a spectrum of subtle dysplasia, notably within the olfactory bulb (OB)1. Our current study investigates whether OB anomalies predict neurodevelopmental outcomes for pediatric patients with CHD. We hypothesize that adolescents with CHD who exhibit aberrant morphological measurements in the OB are more likely to suffer from executive functional deficits. A prospective, observational study of 54 CHD and 75 healthy subjects, ages 6-25 years old, was completed under the supervision of a senior pediatric neuroradiologist. T2 3D Space and T2 Blade 2MM MRI images were manually segmented to extract volumetric bilateral regions of the OB and cerebrospinal fluid (CSF) using ITK-SNAP. Imaging metrics were correlated to OB asymmetry, CSF to OB ratio, total CSF volume, total OB volume, and independent left and right CSF and OB volumes. Linear regression was used to evaluate MRI morphologic measurements with co-variates: CHD status, sex, MRI age, and segmenter. Executive function was determined by the Behavioral Rating Inventory of Executive Function (BRIEF) Parent Report and Delis-Kaplan Executive Function System (D-KEFS) for subjects ages 6-16. Cognition and olfactory function were measured with the NIH Toolbox Cognitive Battery and Odor Identification Test, respectively. No statistically significant results were reported between cohorts for asymmetry of OB, CSF to OB ratio, total CSF volume, total OB volume, nor between independent left and right CSF and OB volumes. Increased OB volume was associated with worse outcomes on the BRIEF Parent Report (p≤0.03). Asymmetry of OB predicted poorer executive functioning as reported by parents on the BRIEF (p≤0.05). Overall, the CHD cohort demonstrated worse scores on the BRIEF Parent Report compared to controls. Across groups, no significant association was reported for olfaction function measured by the NIH Toolbox Odor Identification Test on a limited subset of participants. As survival rates for CHD improve, there is an increased risk of long-term neurodevelopmental impairments. Our findings identify adolescents who are at risk for executive dysfunction, particularly those showing increased OB volume and/or asymmetry of the OB. This is particularly concerning for the CHD population with atypical OB morphology, who also exhibit significantly poorer outcomes on the BRIEF Parent Report and face a higher overall risk. Increased OB volume and OB asymmetry are olfactory-based biomarkers that may help identify at-risk CHD patients earlier, enabling more timely intervention and support.

Hepatitis C virus genotypes among population with reported risk factors in Assam, north-east India: Emergence of genotype-8.

Background & objectives Hepatitis C virus (HCV) exhibits extensive genetic diversity in infected hosts. There are few published reports of HCV genotype (GT) distribution from the north-east Indian States lying close to the 'Golden Triangle' known for illicit drug trafficking. Real-time knowledge of HCVGT distribution is important for studies on epidemiologic aspects and virus evolution and for the development of new target-specific, direct-acting antiviral drugs. This study aims to examine the distribution of HCVGTs and their subtypes in different risk groups from Assam, north-east India. Methods It is a hospital-based cross-sectional study. Plasma samples reactive for anti-HCV antibody in enzyme-linked immunosorbent assay (ELISA) were subjected to viral load test and genotyping by real-time Reverse Transcription-Polymerase Chain Reaction (RT-PCR) or characterization of non-structural protein NS5B region by nested PCR. Nucleotide sequences were subjected to phylogenetic analysis. Results The most common HCVGT detected was GT-3 (95.89%), followed by GT-1 (3.42%), GT-6xa (0.34%) and GT-8 (0.34%). The mean age of subjects was 30.24 yr, and males outnumbered females. The most commonly associated risk factor was injecting drug use (IDU) (74.31%), followed by tattooing and/or piercing (33.22%), transfusion of blood/blood products (10.27%), and haemodialysis (9.25%). Co-infection with human immunodeficiency virus (HIV) was found in 17.8 per cent, and with Hepatitis B virus (HBV) in 3.42 per cent of the cases. Interpretation & conclusions The detection of HCVGT-8 makes this the first report from Assam and the second from India as per the authors' knowledge. This may indicate strain's endemic nature in India. The increasing trend of HCV infection among young IDUs and HCV-HIV co-infection indicates the need for enhancing surveillance and intensified prevention efforts among young adults.