86 research outputs found
Age-related physiologic changes and perioperative management of elderly patients
No full textAging itself only minimally increases operative risk, but with aging, there is an increase of the prevalence of chronic diseases and a progressive deterioration of organ function. Aging is associated with a progressive decrease in heart, lung and kidney performance. Under normal conditions, these physiologic changes do not produce any problems for the elderly, but when these patients are subjected to the stress of surgery or its complications, there may be inadequate functional reserve. It is very important to know age-related patho-physiological changes in order to be able to better evaluate elderly patients undergoing surgery, and to prevent and manage preoperative complications. In this review we try to identify and to describe the most frequent physiological changes in the elderly, how those impact pharmacodynamic and pharmacokinetic parameters, and how to assess and manage them
Assessment and treatment of elderly patients with cancer
No full textIn the US, the total projected cancer incidence will increase by 45% yearly from 2010 to 2030. The majority of these neoplasms will affect the elderly. The National Institute on Aging has characterised the aging of our society as a "silver tsunami". Thus, the management of cancer in the older aged person represents a priority for health care delivery in the immediate future. Aging, age-related changes, frailty, prolongation of active life expectancy, prevention of Adverse Drugs Reactions (ADRs), Comprehensive Geriatric Assessment (CGA), and individualised treatment in the future will become the most widely used concepts in the management of cancer patients
The role of Mediterranean diet in cancer incidence and mortality in the older adults
No full textThe magnitude of benefit of Mediterranean diet in cancer prevention and mortality in older adults is still unclear, therefore we conducted a systematic review and meta-analysis. Outcomes considered were cancer incidence and cancer mortality. In studies evaluating cancer incidence as a time-to-event endpoint and adherence as quantiles, HR was 0.885 (95% CI 0.773–1.013, I2 = 44%). Including ORs, exploratory pooled effect size was 0.876 (0.794–0.966, I2 = 34%), consistently with results of studies evaluating ORs for adherence as one-point increase (OR 0.744, 0.570–0.972, I2 = 90%). No clear benefit was observed on cancer mortality, with pooled HR of 0.935 (0.800–1.093, I2 = 0%). Significant differences were observed for ORs according to cancer type but not between medium and high adherence for both outcomes. Certainty of evidence was low. Our findings suggest that MD could play a protective role in cancer incidence in advanced age, but no clear effect on cancer mortality was observed
Sarcopenia (and sarcopenic obesity) in older patients with gynecological malignancies
No full text: Cancer is often complicated by the deterioration of both muscle mass and function, which may be more pronounced in older people. The prevalence of sarcopenia varies according to tumour type, stage and sarcopenia definition; in gynaecologic malignancies it ranges from 25 to 50%. Unfortunately, sarcopenia is often underdiagnosed especially in overweight and obese patients. The consequences of sarcopenia are serious: shorter time of tumour progression, increased chemotherapy-related toxicity, post-operative complications, poor functional status, hospitalisation, increased length of hospital stay, high 30-day readmission rate and mortality. Therefore, its precocious recognition and treatment is of paramount importance. We demonstrated that obesity can mask sarcopenia, taking into consideration a sample of older patient with cancer, unless body composition evaluation and comprehensive geriatric assessment, including measures of muscle strength and performance, is executed. Our work underlines the importance of a multidisciplinary approach to older patients with cancer to optimize their management
Intradialytic hypotension is associated with dialytic age in patients on chronic hemodialysis
No full textIntradialytic hypotension (IDH) is common in patients on chronic hemodialysis, but knowledge on determinants is still unclear. The present study aims at evaluating the association between IDH and dialytic age (DA) in patients on chronic hemodialysis
Efficacy of an eye movement desensitization and reprocessing (EMDR) intervention for a head and neck cancer patient with intolerable anxiety undergoing radiotherapy
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Ovarian cancer management in the oldest old: Improving outcomes and tailoring treatments
No full textOvarian cancer is the most common cause of death from gynecological cancers in developed countries. It is a common disease of older women at or above 63 years upon diagnosis. Thanks to advance in new treatments, mortality from ovarian cancer has declined in developed countries in the last decade. This decline in mortality rate is unevenly distributed across the age-spectrum. While mortality in younger women has decreased 21.7%, for elderly women it has declined only 2.2%. Even if ovarian cancer is clearly a disease of the elderly, older women are underrepresented in clinical trials, and scant evidence exists for the treatment of women older than 80 years. Moreover, older women are frequently undertreated, receive less chemotherapy and less combination of surgery and chemotherapy, despite the fact that this is considered the optimal treatment modality. This may be mainly due to the lack of evidence and physician's confidence in the management of elderly women with ovarian cancer. In this review, we focus on the management of older women with ovarian cancer, considering geriatric features tied to this population
Prevalence of the seven cardiovascular health metrics in a Mediterranean country: results from a cross-sectional study
No full textPrimordial prevention is essential for reaching cardiovascular (CV) health. This is defined by seven health metrics identified by the American Heart Association. Aim of the present study was to assess prevalence and distribution of these seven CV health metrics within an unselected population
Erratum to "Muscoloskeletal aging, sarcopenia and cancer" [Journal of Geriatric Oncology, Volume 10, Issue 3, May 2019, Pages 504-509]
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