1,721,763 research outputs found
The frail patient with heart disease: An emerging and challenging issue
No full textFrailty and cardiovascular disease (CVD) are two common conditions that may affect clinical outcomes in older people. Epidemiological studies suggest that CVD is one of the most important contributor to the development of frailty in the aged patient, and the latter can therefore be considered a potential CVD risk factor. Moreover, traditional CVD risk factors are also known to be important for developing frailty. This close relationship between CVD and frailty is due, in part, to the shared etiological factors, which include low-grade inflammation, cellular senescence, and endocrine dysregulation. Therefore, the early detection of frailty is important in the management of patients with CVD or in those who are at a high risk of developing CVD. In this regard, the use of a comprehensive geriatric assessment (CGA) may be considered in these patients. Unfortunately, the literature available for the use of CGA is only based on observational data, which may be biased; therefore, future studies are needed to understand the true role of CGA for detecting frailty in patients with CVD. In this article, an overview is provided of the current evidence regarding frailty, CVD, and their coexistence in terms of the underlying pathophysiology and their impact on clinical outcomes. © 2018 Les Laboratoires Seriver. All Rights Reserved
Reply to: "bio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: A double-blind multicenter randomized placebo controlled three-arm study"
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Highly purified chondroitin sulfate: a literature review on clinical efficacy and pharmacoeconomic aspects in osteoarthritis treatment
Full text linkOsteoarthritis (OA) is the most prevalent musculoskeletal disease and a major cause of negative relevant outcomes, associated with an ever-increasing societal burden. Pharmaceutical-grade chondroitin sulfate (CS) was repeatedly reported to reduce pain and improve function in patients with OA. This article aims to review the evidence for the role of highly purified (hp) CS (Condrosulf®, IBSA) in the treatment of OA. We collected and reported evidence concerning (1) efficacy of hpCS 800 mg/day in the treatment of OA affecting the knee, hand and hip; (2) efficacy and safety of hpCS 1200 mg/day also in the oral gel formulation; (3) the safety profile of hpCS; (4) the difference of hpCS and pharmaceutical-grade formulations versus food supplements; (5) pharmacoeconomic added value of hpCS. The data support that hpCS is an effective and safe treatment of OA, with its effect already evident at 30 days; in addition, its beneficial action is prolonged, being maintained for at least 3 months after the drug is discontinued. Full safety reports’ analyses confirm that CS is safe to use and has almost no side effects, in particular, it showed better gastrointestinal tolerance if compared with non-steroidal anti-inflammatory drugs (NSAIDs). Moreover, the therapeutic strategy has proved to be cost-effective: treatment with CS reduced the use of NSAIDs and their side effects. © 2020, The Author(s)
The Emergency Surgery Frailty Index (EmSFI) in Elderly Patients with Acute Appendicitis: An External Validation of Prognostic Score
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Frailty as Cardiovascular Risk Factor (and Vice Versa)
No full textThe prevalence of frailty seems to be higher in people with cardiovascular disease (CVD) compared to those without, but also the prevalence of CVD is higher in people with frailty compared to robust ones. In longitudinal studies and meta-analyses dealing with the role of frailty as potential risk factor for incident CVD, we have an increasing literature suggesting that frailty increases the risk of these conditions, particularly of fatal events, and independently from several potential confounding factors. Among the domains usually included in the definition of physical frailty, exhaustion, low physical activity, slow gait speed and weakness are significantly associated with the onset of CVD in older people. However, also CVD can be considered as potential risk factor for incident frailty even if the literature is more limited. In this chapter, I will therefore report and discuss the most recent and relevant findings in this topic, of extreme importance in actual geriatric medicine. © Springer Nature Switzerland AG 2020
Impaired magnesium status and depression
No full textMagnesium (Mg) is an element present in everyday dietary plan of regular meals, but it has been shown that a large part of the population presents a low Mg status. Mg has a wide range of physiologic and protective functions within energy regulation and cellular, included neuronal, homeostasis. It obstacles excessive calcium flow into the cells, preventing cells' death, has anti-inflammatory properties, antioxidant action, and interacts with serotonin, a central neurotransmitter involved in depression pathophysiology. Epidemiologic studies have shown that low Mg status is associated with increased frequency of depression, with both cross-sectional and longitudinal designs. Promising evidence has shown that Mg has antidepressant activity similar to imipramine, and that it can be a valid supplementation to antidepressants in treatment resistant depression. However, at the present state of the art too few and small studies have investigated the role of Mg among other therapeutic means in depression, and any conclusion about its utility in clinical practice cannot be drawn. Future research should shed a light on such an important field needing more evidence. © Springer Nature Switzerland AG 2019
Specific approaches to patients affected by dementia and covid-19 in nursing homes: the role of the geriatrician
No full textThe coronavirus disease 19 (COVID-19) is relevant in older people. Attention was given to the nursing homes in which frailer people are usually admitted. In this review, we discuss the approaches for daily problems found in nursing home as geriatricians and potentially new research directions. We start with the problem of the older people affected by dementia and Behavioral and Psychological Symptoms of Dementia for which also the execution of a simple diagnostic test (such as nasopharyngeal swab) could be problematic. Another important problem is the management of wandering patients for which the re-organization of the spaces and vaccination could be the solutions. The relationship with families is another important problem, also from a medico-legal point of view, that can be faced using video conferencing tools. Moreover, we discussed the importance of stratifying prognosis in older nursing home residents for the best management and therapeutically approach, including palliative care, also using telemedicine and the inclusion of prognostic tools in daily clinical practice. Finally, we approached the therapeutical issues in older people that suggests the necessity of future research for finding older-friendly medications. © 2021 Elsevier B.V
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