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Increasing Age (increasing + age)
Selected AbstractsHeart Rate Variability Declines with Increasing Age and CTG Repeat Length in Patients with Myotonic Dystrophy Type 1ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2003Bradley A. Hardin Background: Cardiac myopathy manifesting as arrhythmias is common in the neurological disease, myotonic dystrophy type 1 (DM1). The purpose of the present study was to evaluate heart rate variability (HRV) in patients with DM1. Methods: In a multicenter study, history, ECG, and genetic testing were performed in DM1 patients. Results: In 289 patients in whom the diagnosis of DM1 was confirmed by a prolonged cytosine-thymine-guanine (CTG) repeat length the most common ambulatory ECG abnormality was frequent ventricular ectopy (16.3%). The 24-hour time domain parameters of SDNN (SD of the NN interval) and SDANN (SD of the mean NN, 5-minute interval) declined as age and CTG repeat length increased (SDNN: ,8.5 ms per decade, 95% confidence intervals [CI],12.9, ,4.2, ,8.7 ms per 500 CTG repeats, CI ,15.7, ,1.8, r = 0.24, P < 0.001; SDANN: ,8.1 ms per decade, CI ,12.4, ,3.8, ,8.8 ms per 500 CTG repeats, CI ,15.7, ,1.9, r = 0.23, P < 0.001). Short-term frequency domain parameters declined with age only (total power: ,658 ms2 per decade, CI: ,984, ,331, r = 0.23, P < 0.001; low frequency (LF) power ,287 ms2 per decade, CI: ,397, ,178, r = 0.30, P < 0.001; high frequency (HF) power: ,267 ms2 per decade, CI: ,386, ,144, r = 0.25, P < 0.001). The LF/HF ratio increased as the patient aged (0.5 per decade, CI: 0.1, 0.9, r = 0.13, P = 0.03). Conclusions: In DM1 patients a decline in HRV is observed as the patient ages and CTG repeat length increases. A.N.E. 2003; 8(3):227-232 [source] Quality of diabetes care in patients with schizophrenia and bipolar disorder: cross-sectional studyDIABETIC MEDICINE, Issue 12 2007S. Whyte Abstract Aims To determine whether patients with severe mental illness receive poorer health care for diabetes than patients without. Methods This population-based cross-sectional survey used electronic general practice records from 481 UK general practices contributing to the QRESEARCH database. The records of 11 043 patients with diabetes, drawn from a database population of over 9 million patients, were extracted. Unadjusted and adjusted odds ratios were calculated using unconditional logistic regression for each of 17 quality indicators for diabetes care from the new General Medical Services contract for general practitioners. Results The presence of severe mental illness did not reduce the quality of care received; the only significant difference between groups showed that such patients were more likely to have glycated haemoglobin < 7.5%[adjusted odds ratio = 1.45 (99% confidence interval 1.20,1.76)]. Increasing age was associated with better care [adjusted odds ratios from 1.06 (1.02,1.11) to 1.61 (1.52,1.70)], but other confounding variables had no consistent effect across indicators. Overall, performance against government targets was good. Conclusions The hypothesis of poorer diabetes care for those with severe mental illness is disproved, perhaps surprisingly, in the light of other recent UK studies showing inequalities in care for the mentally ill. The study does not reveal who is providing this good care (general practitioners, psychiatrists or diabetologists) or take account of the estimated 600 000 people in the UK with undiagnosed diabetes. [source] Needs assessment in dementiaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2005A. M. Meaney Abstract Background Resource allocation and service development traditionally focuses on diagnostic categories and consequent perceived need. Identification of the actual level of need in the elderly with dementia, and the degree to which it is unmet is necessary to plan services both individually and as a group. The aim of this study was to characterise the needs of a sample of community dwelling elderly patients with dementia who were referred to an old age psychiatry service in Ireland between July 2002 and July 2003. Methodology Eighty-two consecutively referred community dwelling patients with ICD-10 diagnosis of dementia were assessed on The Care Needs Assessment Pack for Dementia (CareNap-D). Data on needs across seven domains (health and mobility, self-care and toileting, social interaction, thinking and memory, behaviour and mental state, housecare, community living) is presented (Reynolds T et al., 1998). Results Subjects had a mean of 33 (range: 13,56) identified needs. Approximately 1/3 of these were unmet with a mean of 13 (range: 0,37) and a mean of 20 (range: 4,39) were met. High levels of unmet need was identified in the domains of behaviour and mental state (84% of those with agitation) and of social interaction (79% of those with ,partaking in activities' need). The specific item of repetitive questioning occurred in 68 individuals and was unmet in 88% of these cases. Increasing age, lower MMSE score, and living alone were associated with greater total levels of unmet need. Conclusion This data underlines the degree of unmet need in the community dwelling elderly with dementia and the importance of developing a spectrum of services on the basis of the actual needs identified. Copyright © 2005 John Wiley & Sons, Ltd. [source] Imputation of 10-year osteoporotic fracture rates from hip fractures: A clinical validation studyJOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2010William D Leslie Abstract The World Health Organization (WHO) fracture risk assessment system (FRAX) allows for calibration from country-specific fracture data. The objective of this study was to evaluate the method for imputation of osteoporotic fracture rates from hip fractures alone. A total of 38,784 women aged 47.5 years or older at the time of baseline femoral neck bone mineral density (BMD) measurement were identified in a database containing all clinical dual energy X-ray absorptiometry (DXA) results for the Province of Manitoba, Canada. Health service records were assessed for the presence of nontrauma osteoporotic fracture codes after BMD testing (431 hip, 787 forearm, 336 clinical vertebral, and 431 humerus fractures). Ten-year hip and osteoporotic fracture rates were estimated by the Kaplan-Meier method. The population was stratified by age (50 to 90 years, 5-year width strata) and again by femoral neck T -scores (,4.0 to 0.0, 0.5 SD width strata). Within each stratum, the ratio of hip to osteoporotic fractures was calculated and compared with the predicted ratio from FRAX. Increasing age was associated with greater predicted hip-to-osteoporotic ratios (youngest 0.07 versua oldest 0.41) and observed ratios (youngest 0.10 versus oldest 0.48). Lower T -scores were associated with greater predicted (highest 0.04 versus lowest 0.71) and observed ratios (highest 0.06 versus lowest 0.44). There was a strong positive correlation between predicted and observed ratios (Spearman r,=,0.90,0.97, p,<,.001). For 14 of the 18 strata, the predicted ratio was within the observed 95% confidence interval (CI). Since collection of population-based hip fracture data is considerably easier than collection of non,hip fracture data, this study supports the current emphasis on using hip fractures as the preferred site for FRAX model calibration. © 2010 American Society for Bone and Mineral Research [source] Tinea pedis in European marathon runnersJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2002C Lacroix Abstract Background Epidemiological studies suggest that 15% of the population in industrial countries suffer from tinea pedis (athlete's foot) and that persons who do sports are a high-risk population. Objective To investigate the responsibility of dermatophytes in interdigital lesions of the feet in European marathon runners and to identify associated risk factors. Subjects and methods Runners of the 14th Médoc Marathon (n = 147) were interviewed on risk factors for tinea pedis and underwent physical and mycological examinations. Results Interdigital lesions of the feet were found in 66 runners (45%). A dermatophyte was isolated in 45 runners (31%), 12 of whom were asymptomatic. Trichophyton interdigitale and T. rubrum accounted for 49% and 35.5%, respectively, of the cases of tinea pedis. Thirty-three (22%) of the 102 runners free of dermatophyte infection had lesions resembling those of tinea pedis. Increasing age and use of communal bathing facilities were predictive of T. rubrum culture. Conclusions Marathon runners are at high risk for tinea pedis, but dermatophytes are responsible for only half of the foot lesions found in runners. The existence of asymptomatic carriers calls for prophylactic measures. [source] Disrupted myelin and axon loss in the anterior commissure of the aged rhesus monkeyTHE JOURNAL OF COMPARATIVE NEUROLOGY, Issue 1 2003Julie H. Sandell Abstract This study assesses the effects of age on the composition of the anterior commissure of the rhesus monkey. The anterior commissures of nine young (5,10 years), five middle-aged (15,20 years), and eight old (25,35 years) monkeys were examined by light and electron microscopy. In all, 90,95% of the nerve fibers in the anterior commissure are myelinated. With age, the structure of the myelin sheaths of some nerve fibers is altered. Some of the axons also show signs of degeneration and this leads to a loss of nerve fibers. Thus, in young and the middle-aged monkeys the mean number of myelinated nerve fibers in the anterior commissure is 2.2 × 106, while in the old monkeys the mean is 1.2 × 106. Increasing age is correlated with a reduction in the number of myelinated nerve fibers in the anterior commissure, an increase in the frequency of structural alterations in myelin sheaths, and an increase in the frequency of occurrence of degenerating axons. However, the number of myelinated nerve fibers is the only variable that correlates with cognition: in monkeys 5,20 years of age the fewer the number of nerve fibers the poorer the cognitive performance, as measured by our Cognitive Impairment Index (CII). The most common neuroglial cells in the anterior commissure are oligodendrocytes. They account for 86% of all neuroglial cell profiles, while astrocytes account for 9%, and microglial cells for 5% of profiles. There is no apparent change with age in the total numbers of neuroglial cells, although as they age each of the neuroglial cell types acquires some inclusions in their cytoplasm. The data, together with those from previous studies, support the concept that in aging there is a ubiquitous loss of myelinated nerve fibers from the brain and that fiber loss is preceded by alterations in the structure of many of the myelin sheaths. J. Comp. Neurol. 466:14,30, 2003. © 2003 Wiley-Liss, Inc. [source] Epidemiology of gout in women: Fifty-two,year followup of a prospective cohortARTHRITIS & RHEUMATISM, Issue 4 2010Vidula Bhole Objective Despite the recent doubling of the incidence of gout among women and its substantial prevalence particularly in the aging female population, the risk factors for gout among women remain unknown. We undertook this study to evaluate purported risk factors for incident gout among women and to compare them with those among men. Methods Using prospective data from the Framingham Heart Study, we examined over a 52-year period (1950,2002) the relationship between purported risk factors and the incidence of gout in 2,476 women and 1,951 men. Results We documented 304 incident cases of gout, 104 of them among women. The incidence rates of gout for women per 1,000 person-years according to serum uric acid levels of <5.0, 5.0,5.9, 6.0,6.9, 7.0,7.9, and ,8.0 mg/dl were 0.8, 2.5, 4.2, 13.1, and 27.3, respectively (P for trend < 0.0001). The magnitude of this association was lower than that among men (P for interaction = 0.0002). Multivariate relative risks conferred by increasing age (per 5 years), obesity (body mass index ,30 kg/m2), alcohol intake (,7 ounces of pure alcohol/week), hypertension, and diuretic use were 1.24, 2.74, 3.10, 1.82, and 2.39, respectively (all P < 0.05), for women. Conclusion These prospective data with long-term followup provide evidence that higher levels of serum uric acid increase the risk of gout in a graded manner among women, but the rate of increase is lower than that among men. Increasing age, obesity, alcohol consumption, hypertension, and diuretic use were associated with the risk of incident gout among women. [source] Why do women have voiding dysfunction and de novo detrusor instability after colposuspension?BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2002L. Bombieri Objective To investigate the causes of voiding dysfunction and new detrusor instability after colposuspension. Design Prospective, observational study. Setting Urogynaecology unit, district general hospital. Population Seventy-seven women undergoing colposuspension for genuine stress incontinence. Methods The following factors were investigated: 1. bladder neck elevation by magnetic resonance imaging before and after surgery; 2. urethral compression by measuring bladder neck approximation to the pubis with magnetic resonance imaging after surgery (anterior compression) and the distance between the medial stitches during surgery (lateral compression); 3. clinical and urodynamic factors. Main outcome measures 1. Post-operative voiding function (i.e. first day of voiding and day of catheter removal); 2. objective evidence of detrusor instability three months post-operatively. Results Pre-operative peak flow rate (P= 0.004), straining during voiding (P= 0.005), increasing age (P< 0.001), operative elevation (P< 0.001) and anterior urethral compression (P= 0.001) were associated with the number of days of post-operative catheterisation. Increasing age (P= 0.02), previous bladder neck surgery (P= 0.04), operative elevation (P= 0.049) and anterior urethral compression (P< 0.001) were associated with detrusor instability at three months. Conclusion Surgical factors (bladder neck elevation and compression) are associated with voiding dysfunction and detrusor instability after colposuspension. These findings have implications for prevention. [source] Functioning and disability 6,15 years after traumatic brain injuries in northern SwedenACTA NEUROLOGICA SCANDINAVICA, Issue 6 2009L. J. Jacobsson Objectives,, To assess long-term functioning and disability after traumatic brain injury (TBI). Material and methods,, Individuals (n = 88) in Norrbotten, northern Sweden, who had been transferred for neurosurgical care were assessed with internationally established TBI outcome measures 6,15 years post-injury. Results,, There was an improvement in overall outcome from discharge from inpatient rehabilitation to follow-up. Many individuals had a high degree of motor and cognitive functioning, which enabled them to live independently in their own home without assistance, but there remained a disability related to community reintegration and social participation. This affected their productivity and to some degree their marital stability. The remaining disability and reduced productivity were related to the age at injury and the injury severity. Conclusions,, Our data showed that individuals with a TBI can achieve and maintain a high degree of functioning many years after the injury. Increasing age and a greater injury severity contributed to their long-term disability. [source] Older age predicts a decline in adjuvant chemotherapy recommendations for patients with breast carcinomaCANCER, Issue 9 2003Evidence from a tertiary care cohort of chemotherapy-eligible patients Abstract BACKGROUND The appropriate use of adjuvant chemotherapy for elderly women with breast carcinoma remains controversial. Efficacy data in women age , 70 years are scarce, resulting in a lack of clear guidelines for patients in this age group. Although several studies have demonstrated decreasing use of chemotherapy with age, none specifically examined its use in an elderly cohort of patients who were deemed eligible for such therapy based on consensus guidelines, simultaneously examining the impact of comorbidity and previous history of malignant disease on these recommendations. METHODS The authors examined adjuvant chemotherapy use among chemotherapy-eligible patients age , 50 years who were evaluated in a tertiary care cancer center. Associations between patient age and 1) physician recommendation for adjuvant chemotherapy, 2) recommended treatment regimen, and 3) patient acceptance of the treatment plan recommended were examined, adjusting for the impact of aggressive tumor characteristics, medical comorbidity, previous history of malignant disease, and features of the treatment setting. RESULTS Of the 208 chemotherapy-eligible patients who were studied, 74% overall were recommended chemotherapy. Chemotherapy was recommended to 92% of women age 50,59 years compared with 77% of women age 60,69 years and 23% of women age , 70 years. Increasing age was associated strongly with a decreasing likelihood of receiving a recommendation in favor of chemotherapy. After adjusting for estrogen receptor status, previous history of malignant disease, comorbidity score, and prognostic group, the odds of receiving a recommendation in favor of chemotherapy fell by 22% per year or 91% per 10-year interval, and the rate of decline did not change significantly at age , 70 years. We found no age-related differences in either the drug regimens recommended or patient acceptance rates for adjuvant therapy. CONCLUSIONS Age was associated strongly and independently with physician recommendation for adjuvant chemotherapy among a group of older women who were eligible specifically for such therapy. Medical comorbidity and a history of previous malignant disease did not alter this correlation significantly, although the latter was a significant predictor of chemotherapy use. Further studies clearly are needed to determine the underlying reasons for this strong age effect and to explore strategies that will optimize the utilization of this potentially curative therapy in the elderly. Cancer 2003;97:2150,9. © 2003 American Cancer Society. DOI 10.1002/cncr.11338 [source] Prevalence of idiopathic macular hole in adult rural and urban south Indian populationCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2008Parveen Sen MS Abstract Background:, This study was undertaken to evaluate the prevalence of idiopathic macular hole in a defined community in Southern India. Methods:, In all, 7774 of the 9546 enumerated (81.43%) subjects availed themselves for an ophthalmic assessment which included a detailed ophthalmic examination and fundus photography. All data were entered and stored in a secure computerized database and statistical analysis was performed using spss for Windows. Results:, Thirteen subjects comprising six males and seven females were diagnosed with macular holes equating to a risk of 0.17%. Bilateral macular holes were found in two subjects. The mean age of subjects with a macular hole was 67 years. Increasing age and history of cataract surgery was strongly associated with an increased prevalence of macular holes (P < 0.0001). There was no difference in the prevalence of macular hole between the rural and urban communities. The mean logMAR visual acuity of subjects in the eye with a macular hole was 1.31 ± 0.45 whereas the acuity in the unaffected fellow eye was 0.70 ± 0.51. The mean spherical equivalent in the subjects with macular hole was ,0.56 ± 1.92 (,4.25 to +1.00). Conclusion:, Prevalence rate of idiopathic macular hole in South India appears to be comparable to that seen worldwide. [source] Basal cell carcinoma mistaken for actinic keratosisCLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 3 2006Robert J Jacobs PhD MSc(Optom) LOSc FAAO FVCO Increasing age and UV exposure are well-known associations with precancerous and cancerous skin lesions, including actinic (solar) keratosis, and squamous and basal cell carcinomata. This report describes a patient with a facial skin lesion close to an eye that was initially believed to be actinic (solar) keratosis but was subsequently diagnosed as a basal cell carcinoma (BCC). The diagnosis of BCC was helped pre-operatively by manipulation of the surrounding facial skin, which revealed the characteristic rolled edges and telangiectasis. Referral to his general medical practitioner (GP) resulted in surgical excision of the lesion. This procedure was performed inexpensively by the local GP as the lesion was not large and was in an accessible position. The lesion and the course of recovery over four weeks were documented photographically. The lesion was surgically excised and the diagnosis of basal cell carcinoma was confirmed by pathological examination. The wound healed well and the final cosmetic result was excellent. This patient illustrates the importance of careful observation and photo-documentation of suspicious skin lesions. A review of the treatment options for these lesions is included in this report. [source] Delayed Wound Healing After Three Different Treatments for Widespread Actinic Keratosis on the Atrophic Bald ScalpDERMATOLOGIC SURGERY, Issue 10 2003Patricia J. F. Quaedvlieg MD Background. Actinic keratosis is an exceedingly common premalignant lesion that can develop into squamous cell carcinoma. There is an increasing prevalence of actinic keratosis with increasing age. Numerous treatment options are available for the treatment of actinic keratosis on the scalp. Although we know that atrophic skin heals slowly, one should be careful but should not hesitate to treat. Objective. We present three patients with widespread actinic keratotic lesions on the atrophic bald scalp who received different treatments. Methods. Patient 1 was treated with medium-depth chemical peel, patient 2 with cryopeel, and patient 3 with CO2 laser resurfacing. In all patients, the entire surface area was treated. Results. Despite the different treatment methods used, all three patients had severly delayed wound healing as a complication. Remarkably, all patients had a prolonged period of re-epithelialization. Conclusion. Care has to be taken in patients with widespread actinic keratosis on the atrophic bald scalp when treating the entire surface area regardless the treatment modality. [source] The development of "roughness" in the play fighting of rats: A Laban Movement Analysis perspectiveDEVELOPMENTAL PSYCHOBIOLOGY, Issue 1 2003Afra Foroud Abstract With increasing age, rats, when play fighting, become rougher. In part, this change can be accounted for by the increasing likelihood of using adult-typical fighting tactics. However, even when using the same tactics, adults appear rougher than juveniles in their play. In this study, videotaped sequences of play fighting in rats from the juvenile (30 days) to the post-pubertal (70 days) period were analyzed using Laban Movement Analysis (LMA). Movement qualities called Effort Factors in LMA captured the character of some of this change. Juveniles tended to use Indulging Efforts, whereas older rats tended to use Condensing Efforts. The latter are related to performing movements that are more controlled. This greater level of control was also evident in the way older rats maintained postural support during play fights. When standing over supine partners, juveniles are more likely to stand on the partner with all four paws, reducing their postural stability, and hence ability to control their partner's movements. Older rats are more likely to place their hind paws on the ground, thus providing a firmer anchor for movements with their upper bodies and forepaws. These age-related changes in behavior were found for both males and females. The findings lend support to a growing body of evidence that play fighting in the juvenile phase of rats is not just a more frequently occurring version of that present in adults, but rather, has unique organizational properties. © 2003 Wiley Periodicals, Inc. Dev Psychobiol 42: 35,43, 2003. [source] Age-related changes in transient and oscillatory brain responses to auditory stimulation during early adolescenceDEVELOPMENTAL SCIENCE, Issue 2 2009Catherine Poulsen Maturational changes in the capacity to process quickly the temporal envelope of sound have been linked to language abilities in typically developing individuals. As part of a longitudinal study of brain maturation and cognitive development during adolescence, we employed dense-array EEG and spatiotemporal source analysis to characterize maturational changes in the timing of brain responses to temporal variations in sound. We found significant changes in the brain responses compared longitudinally at two time points in early adolescence, namely 10 years (65 subjects) and 11.5 years (60 of the 65 subjects), as well as large differences between adults, studied with the same protocol (Poulsen, Picton & Paus, 2007), and the children at 10 and 11.5 years of age. The transient auditory evoked potential to tone onset showed decreases in the latency of vertex and T-complex components, and a highly significant increase in the amplitude of the N1 wave with increasing age. The auditory steady state response to a 40-Hz frequency-modulated tone increased in amplitude with increasing age. The peak frequency of the envelope-following response to sweeps of amplitude-modulated white noise also increased significantly with increasing age. These results indicate persistent maturation of the cortical mechanisms for auditory processing from childhood into middle adulthood. [source] Maturation of action monitoring from adolescence to adulthood: an ERP studyDEVELOPMENTAL SCIENCE, Issue 6 2005Alexandra M. Hogan This study investigated the development of the frontal lobe action-monitoring system from late childhood and adolescence to early adulthood using ERP markers of error processing. Error negativity (ERN) and correct response negativity (CRN) potentials were recorded while adolescents and adults (aged 12,22 years, n = 23) performed two forced-choice visual reaction time tasks of differing complexity. Significant age differences were seen for behavioural and ERP responses to complex (infrequent, incompatible) trials: adolescents elicited an error negativity of reduced magnitude compared with adults. Furthermore, in contrast to adults, adolescents showed a non-significant differentiation between response-locked ERP components elicited by correct (CRN) and error responses (ERN). Behaviourally, adolescents corrected fewer errors in incompatible trials, and with increasing age there was greater post-error slowing. In conclusion, the neural systems underlying action-monitoring continue to mature throughout the second decade of life, and are associated with increased efficiency for fast error detection and correction during complex tasks. [source] Treatment of isolated systolic hypertension in diabetes mellitus type 2DIABETES OBESITY & METABOLISM, Issue 4 2006Ingrid Os Age-related arterial stiffness is more pronounced in diabetics compared to non-diabetics, which could explain the prevalence of isolated systolic hypertension (ISH, systolic blood pressure ,140 mmHg and diastolic blood pressure <90 mmHg) being approximately twice that of the general population without diabetes. Large-scale interventional outcome trials have also shown that diabetics usually have higher pulse pressure and higher systolic blood pressure than non-diabetics. Advanced glycation end-product formation has been implicated in vascular and cardiac complications of diabetes including loss of arterial elasticity, suggesting possibilities for new therapeutic options. With increasing age, there is a shift to from diastolic to systolic blood pressure and pulse pressure as predictors of cardiovascular disease. This may affect drug treatment as different antihypertensive drugs may have differential effects on arterial stiffness that can be dissociated from their effects on blood pressure. While thiazide diuretics are associated with little or no change in arterial stiffness despite a robust antihypertensive effect, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers and calcium-channel blockers have been shown to reduce arterial stiffness. However, combination therapy is nearly always necessary to obtain adequate blood pressure control in diabetics. There are no randomized controlled trials looking specifically at treatment of ISH in diabetics. Recommendations regarding treatment of ISH in diabetes mellitus type 2 are based on extrapolation from studies in non-diabetics, post-hoc analyses and prespecified subgroup analysis in large-scale studies, and metaanalysis. These analyses have clearly demonstrated that blood pressure lowering in ISH confers improved prognosis and reduced cardiovascular and renal outcomes in both diabetics and non-diabetics. [source] Relationship of glucose concentrations with PAI-1 and t-PA in subjects with normal glucose toleranceDIABETIC MEDICINE, Issue 8 2006P. E. Heldgaard Abstract Aims To study metabolic risk factors for the development of cardiovascular disease (CVD), including markers of the fibrinolytic system in relation to blood glucose levels in subjects with normal glucose tolerance and fasting blood glucose levels below 5.6 mmol/l. Methods Cross-sectional, community-based study from a primary health-care centre of adult subjects with normal glucose tolerance. Analysis of fasting and 2-h post-load blood glucose concentrations were centralized and related to anthropometric characteristics, metabolic variables, inflammatory markers, and coagulation and fibrinolytic variables. Results Increasing fasting blood glucose concentrations within the normal range in subjects with normal glucose tolerance were associated with increasing age, body mass index, and waist circumference, and with increasing concentrations of metabolic risk factors for development of CVD. After adjustment for gender, age, body mass index (BMI), and fasting insulin, levels of plasmin activator inhibitor (PAI-1) and tissue type plasminogen activator (t-PA) increased significantly with increasing levels of fasting glucose within the normal range (P = 0.012 and P < 0.0001, respectively). Conclusions We found risk factors for CVD, specifically key components of the fibrinolytic system, PAI-1 and t-PA, increased with increasing fasting glucose levels even in subjects with normal glucose tolerance. This observation may help to explain the increased risk of CVD with increasing values of fasting glucose in the normal range. [source] The metabolic syndrome and changing relationship between blood pressure and insulin with age, as observed in Aboriginal and Torres Strait Islander peoplesDIABETIC MEDICINE, Issue 11 2005A. E. Schutte Abstract Aims To determine the prevalence of the metabolic syndrome (MS) among Aboriginal and Torres Strait Islander peoples. A further objective was to investigate the relationships between fasting insulin and blood pressure (BP) within these groups with increasing age. Methods A cross-sectional population-based study included 369 Torres Strait Islanders (residing in Torres Strait and Far North Queensland), and 675 Aborigines from central Australia. Data necessary for classification of MS was collected, including fasting and 2-h glucose and insulin, urinary albumin and creatinine, anthropometric measurements, BP, serum lipids. Results The ATPIII criteria classified 43% of Torres Strait Islanders and 44% of Aborigines with MS, whereas 32 and 28%, respectively, had the MS according to WHO criteria. Agreement between the two criteria was only modest (kappa coefficient from 0.28 to 0.57). Factor analyses indicated no cluster including both insulin and BP in either population. Significant correlations (P < 0.05) [adjusted for gender, body mass index (BMI) and waist circumference] were observed between BP and fasting insulin: a positive correlation for Torres Strait Islanders aged 15,29 years, and an inverse correlation for Aborigines aged 40 years and older. Conclusion Torres Strait Islanders and Aborigines had very high prevalences of the MS. Specific population characteristics (high prevalences of central obesity, dyslipidaemia, renal disease) may make the WHO definition preferable to the ATPIII definition in these population groups. The poor agreement between criteria suggests a more precise definition of the metabolic syndrome that is applicable across populations is required. This study showed an inverse relationship with age for the correlation of BP and fasting insulin. [source] Results of longterm hospital based cytological screening in asymptomatic womenDIAGNOSTIC CYTOPATHOLOGY, Issue 3 2006Jata S. Misra Ph.D., M.I.A.C. Abstract Routine cytological screening has been carried out in 27,062 asymptomatic women attending Gynaec and Family Planning O.P.D. of Queen Mary's Hospital, Lucknow, India (April 1971,December 2004). Incidence of squamous intraepithelial lesion (SIL) was found to be 5.9% in the series, while cervical malignancy was seen in 0.6% of cases. The study highlighted the immense utility of cytological screening in minimizing the incidence of carcinoma cervix in the segment of the urban population screened, as the incidence dropped down to 0.5% in the second half from 1.1% noticed in the first half of the screening period. The study also emphasized the utility of clinically downstaging the cervical cancer as 7,316 women showing clinical lesions of cervix were found to harbor SIL in 15.3% and carcinoma cervix in 1.3% of cases as against the incidence of 2.5% for SIL and 0.6% for frank cancer in women with normal cervix. The investigation into different risk factors involved in cervical carcinogenesis revealed that the incidence of SIL and cancer cervix showed a rise with increasing age and parity and prolonged sexual period. The incidences of both cervical cytopathologies were also higher in women of low socio-economic status while religion was found to have no bearing on the occurrence of the disease. Among the four sexually transmitted diseases (STDs) diagnosed in the cervical smears, Trichomonas vaginalis was found to be more prevalent (2.6%), while human papillomavirus (HPV) and Herpes simplex was seen in 0.4 and 0.2% of cases, respectively Herpes simplex was found to have strong affinity with both SIL and carcinoma cervix, while only SIL incidence was high with HPV infection. The study emphasizes need of proper education to women of low socio-economic class for creating awareness regarding hazards and risk factors of cervical cancer as well as management and cure of the disease. Diagn. Cytopathol. 2006;34: 184,187. © 2006 Wiley-Liss, Inc. [source] C-Reactive Protein and Aortic Stiffness in Patients with Idiopathic Dilated CardiomyopathyECHOCARDIOGRAPHY, Issue 1 2007Feridun Kosar M.D. Background: Previous studies have shown an association between C-reactive protein (CRP)and arterial stiffness in most cardiovascular diseases. Increased CRP levels and arterial stiffness have been considered independent predictors of cardiovascular mortality in cardiovascular disease and even in the general population. Objective: The aim of this study was to investigate the relationship between CRP, a marker of systemic inflammation and aortic stiffness in patients with idiopathic dilated cardiomyopathy (DCMP). Methods: Serum CRP levels and aortic stiffness parameters were measured in DCMP patients (n= 37) and age- and gender-matched control subjects (n= 30). High-sensitivity CRP levels were determined by an immunonephelometry assay. Aortic strain (AS) and aortic distensibility (AD) were calculated from the aortic diameters measured using M-mode echocardiography and blood pressure obtained by sphygmomanometry. Results: Serum levels of CRP in DCMP patients were higher than in the control subjects (5.47 ± 2.06 mg/L and 2.35 ± 0.47 mg/L, P < 0.001, respectively). AS and AD were significantly decreased in DCMP patients compared to the controls (P < 0.001 and P < 0.001, respectively). There were positive correlations between CRP, and (r = 0.3.64, P = 0.027) smoking (r = 0.3.56, P = 0.024), and increasing age (r = 0.587, P < 0.001), and negative correlations between CRP, and DBP (r =,0.485, P < 0.001), diameter change (DC; r =,0.493, P < 0.001), AS (r =,0.526, P < 0.001), and AD (r =,0.626, P < 0.001). Conclusion: We have shown that there is a significant relation between high serum CRP levels and impaired aortic stiffness in patients with idiopathic DCMP. These findings may indicate an important role of CRP in the pathogenesis of impaired aortic stiffness in idiopathic DCMP. [source] Gender and alcohol consumption: patterns from the multinational GENACIS projectADDICTION, Issue 9 2009Richard W. Wilsnack ABSTRACT Aims To evaluate multinational patterns of gender- and age-specific alcohol consumption. Design and participants Large general-population surveys of men's and women's drinking behavior (n's > 900) in 35 countries in 1997,2007 used a standardized questionnaire (25 countries) or measures comparable to those in the standardized questionnaire. Measurements Data from men and women in three age groups (18,34, 35,49, 50,65) showed the prevalence of drinkers, former drinkers, and lifetime abstainers; and the prevalence of high-frequency, high-volume, and heavy episodic drinking among current drinkers. Analyses examined gender ratios for prevalence rates and the direction of changes in prevalence rates across age groups. Findings Drinking per se and high-volume drinking were consistently more prevalent among men than among women, but lifetime abstention from alcohol was consistently more prevalent among women. Among respondents who had ever been drinkers, women in all age groups were consistently more likely to have stopped drinking than men were. Among drinkers, the prevalence of high-frequency drinking was consistently greatest in the oldest age group, particularly among men. Unexpectedly, the prevalence of drinking per se did not decline consistently with increasing age, and declines in high-volume and heavy episodic drinking with increasing age were more typical in Europe and English-speaking countries. Conclusions As expected, men still exceed women in drinking and high-volume drinking, although gender ratios vary. Better explanations are needed for why more women than men quit drinking, and why aging does not consistently reduce drinking and heavy drinking outside Europe and English-speaking countries. [source] DNA sequence analysis of interlocus recombination between the human T-cell receptor gamma variable (GV) and beta diversity-joining (BD/BJ) sequences on chromosome 7 (inversion 7)ENVIRONMENTAL AND MOLECULAR MUTAGENESIS, Issue 2 2002Scott W. Ballinger Abstract V(D)J recombinase-mediated recombination between the T-cell receptor (TCR) gamma variable (GV) genes at chromosome 7p15 and the TCR beta joining (BJ) genes at 7q35 leads to the formation of a hybrid TCR gene. These TCR gamma/beta interlocus rearrangements occur at classic V(D)J recombination signal sequences (RSS) and, because the loci are in an inverted orientation, result in inversion events that are detectable in the chromosome structure as inv(7)(p15;q35). Similar rearrangements involving oncogenes and either TCR or immunoglobulin genes mediated by the V(D)J recombinase are found in lymphoid malignancies. Oligonucleotide primers that allow polymerase chain reaction (PCR) amplification across the inv(7) genomic recombination junction sequence have been described. Southern blot analysis has been primarily used to confirm the GV/BJ hybrid nature of the product, with limited information on the DNA sequence of these recombinations. We have modified this PCR method using total genomic DNA from the mononuclear cells in peripheral blood samples to increase specificity and to allow direct sequencing of the translocation junction that results from the recombination between the GV1 and BJ1 families of TCR genes in 25 examples from 11 individuals (three adults, one child, six newborns, and one ataxia telangiectasia (AT) patient). We focused on samples from newborns based on previous studies indicating that the predominant hypoxanthine-guanine phosphoribosyl transferase (HPRT) mutations in newborns are V(D)J recombinase-mediated deletion events and that the frequency of these mutations decreases with increasing age. Although the dilution series-based PCR assay utilized does not yield sharply defined quantitative endpoints, results of this study strongly suggest that inv(7) recombinations in newborns occur at equal or lower frequencies than those seen in adults. Consistent with the PCR primer pairs, all sequenced products contain a GV1 and a BJ1 segment and most also contain a BD1 segment. GV1s2 and 1s4 were the most frequently found GV1 genes (8 and 9 examples, respectively) and BJ1s5 and 1s6 were the most frequently found BJ1 genes (9 and 10 examples, respectively). These results demonstrate the effectiveness of this methodology for assessing GV/BJ interlocus rearrangements mediated by V(D)J recombinase. Environ. Mol. Mutagen. 40:85,92, 2002. © 2002 Wiley-Liss, Inc. [source] Surgery for temporal lobe epilepsy associated with mesial temporal sclerosis in the older patient: A long-term follow-upEPILEPSIA, Issue 6 2010Michael Murphy Summary Purpose:, To assess the outcomes from temporal lobectomy for hippocampal sclerosis in patients 50 years or older. Controversy exists as to the suitability of older patients for epilepsy surgery, with most of the previous studies demonstrating a correlation between increasing age and poor outcome. However, the inclusion of temporal lobe epilepsy of multiple etiologies has confounded many previous studies of this age group. Methods:, Twenty-one patients aged 50 years or older (mean 54.9 years) at the time of surgery were included in the study group. All patients had a pathologic diagnosis of hippocampal sclerosis. A retrospective analysis was performed comparing seizure outcomes following a standardized anterior temporal lobectomy with those from 103 patients younger than 50 (mean age 34.7 years) operated upon over the same time period. The mean follow-up period for the study was 9.57 years. Results:, Twenty of the 21 patients in the older group (95.2%) had a satisfactory seizure outcome (Engel classes I and II) compared with 90.3% of the younger patients. There was no statistically significant difference in the outcomes between the two groups (p = 0.719). Across both groups of patients combined, there was no significant difference between the mean age in the patients with a satisfactory seizure outcome compared to those with an unsatisfactory outcome (38.3 vs. 34.7 years, p = 0.213). Discussion:, Patients 50 years or older with intractable seizures from hippocampal sclerosis have seizure outcomes following temporal lobectomy that are comparable to young patients over the long term. Older patients should not be denied treatment on the basis of age. [source] Clinical dental examinations of 357 donkeys in the UK.EQUINE VETERINARY JOURNAL, Issue 4 2009Part 1: Prevalence of dental disorders Summary Reasons for performing study: Dental disorders have a high prevalence in older donkeys and horses, but the nature and pathogenesis of many of these disorders have yet to be established. Objectives: The identification and determination of the prevalence of important dental disorders in different age groups in a large single population of donkeys, to establish a better understanding of the nature and pathogenesis of these disorders. Methods: A prospective cross-sectional study was performed on the donkey population at The Donkey Sanctuary with detailed oral examinations of 357 donkeys within 7 different age groups (age range 2,53 years) recorded. Results: The prevalence of dental disease in all donkeys was 73%, increasing in prevalence from 28% in the youngest to 98% in the oldest age group. There was an increase in prevalence of commonly recognised dental disorders with increasing age, such as: diastemata (3.8% in youngest to 86% in oldest group); missing teeth (0,56%); overgrown teeth (15,86%); worn teeth (8,84%); displaced teeth (0,38%); and periodontal disease (0,28%). Conclusions: There was a significant increase in the prevalence of dental disorders with increasing age with the largest significant increase for most dental disorders occurring in the 15,20 year age group. Potential significance: Most dental disorders significantly increase in prevalence in the 15,20 year age group and, therefore, prophylactic geriatric dental treatment in donkeys should be commenced from age 15 years. [source] Changes In Rhesus Macaque ,Coo' Vocalizations during Early DevelopmentETHOLOGY, Issue 10 2000Kurt Hammerschmidt In order to test whether ,coo' calls of young rhesus macaques, Macaca mulatta, undergo some modifications during early development, and to explore which factors may influence these changes, we studied the ontogeny of their contact call, the ,coo' call. Vocalizations were recorded during brief periods of social separation. Infants were either raised with their mothers and other conspecifics, or separated from their mothers at birth and housed in a nursery with other infants. We recorded calls uttered in the separation context from 20 infants. We digitized the first 50 calls of a given series and subjected them to a Fourier transform. From each frequency,time spectrum, we extracted 65 acoustic parameters using a software program (LMA 5.9). We then used a cluster analysis to separate the ,coo' calls from other call types. With increasing age, the ,coos' dropped in pitch and became more even. The course of amplitude became more constant and the call duration increased slightly. Nevertheless, we found a high intra-individual variation throughout the 5 mo. Neither rearing condition nor sex had any apparent influence on age-related changes in ,coo' structure. With one exception, all parameters that correlated with age could be explained by variation in weight. Therefore, we conclude that growth is the main factor accounting for the observed changes. [source] A longitudinal study of the effects of adolescent cannabis use on high school completionADDICTION, Issue 5 2003Michael T. Lynskey ABSTRACT Objective ,To examine the extent to which weekly cannabis use during mid-adolescence may increase the risk of early school-leaving. Setting ,A prospective study of a general population sample of adolescents studied from ages 15,21 years in Melbourne, Australia. Method ,Computer-assisted self-completion questionnaires and telephone interviews conducted in six waves at ages 15,18 and again at age 21 in a sample of 1601 male and female school students. Results ,Weekly cannabis use, assessed prospectively, was associated with significantly increased risk of early school-leaving. This effect remained after adjustment for a range of prospectively assessed covariates including demographic characteristics, other substance use, psychiatric morbidity and antisocial behavior. There was suggestive evidence of an interaction between weekly cannabis use and age with the effects of weekly cannabis use on early school-leaving being strongest at the youngest ages and diminishing progressively with age. Conclusions ,Early regular cannabis use (weekly use at age 15) is associated with increased risk of early school-leaving. These effects of regular cannabis use may diminish with increasing age and are likely to operate through the social context within which cannabis is used and obtained. [source] Blockade of caspase-1 increases neurogenesis in the aged hippocampusEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 10 2007Carmelina Gemma Abstract Adult hippocampal neurogenesis dramatically decreases with increasing age, and it has been proposed that this decline contributes to age-related memory deficits. Central inflammation contributes significantly to the decrease in neurogenesis associated with ageing. Interleukin-1, is a proinflammatory cytokine initially synthesized as an inactive precursor that is cleaved by caspase-1 to generate the biologically active mature form. Whether IL-1, affects neurogenesis in the aged hippocampus is unknown. Here we analysed cells positive for 5-bromo-2-deoxyuridine (BrdU; 50 mg/kg) in animals in which cleavage of IL-1, was inhibited by the caspase-1 inhibitor Ac-YVAD-CMK (10 pmol). Aged (22 months) and young (4 months) rats received Ac-YVAD-CMK for 28 days intracerebroventricularly through a brain infusion cannula connected to an osmotic minipump. Starting on day 14, animals received a daily injection of BrdU for five consecutive days. Unbiased stereology analyses performed 10 days after the last injection of BrdU revealed that the total number of newborn cells generated over a 5-day period was higher in young rats than in aged rats. In addition, there was a 53% increase in the number of BrdU-labelled cells of the aged Ac-YVAD-CMK-treated rats compared to aged controls. Immunofluorescence studies were performed to identify the cellular phenotype of BrdU-labelled cells. The increase in BrdU-positive cells was not due to a change in the proportion of cells expressing neuronal or glial phenotypes in the subgranular zone. These findings demonstrate that the intracerebroventricular administration of Ac-YVAD-CMK reversed the decrease in hippocampal neurogenesis associated with ageing. [source] Mice transgenic for exon 1 of the Huntington's disease gene display reduced striatal sensitivity to neurotoxicity induced by dopamine and 6-hydroxydopamineEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 9 2001Ĺsa Petersén Abstract Huntington's disease is an autosomal dominant hereditary neurodegenerative disorder characterized by severe striatal cell loss. Dopamine (DA) has been suggested to play a role in the pathogenesis of the disease. We have previously reported that transgenic mice expressing exon 1 of the human Huntington gene (R6 lines) are resistant to quinolinic acid-induced striatal toxicity. In this study we show that with increasing age, R6/1 and R6/2 mice develop partial resistance to DA- and 6-hydroxydopamine-mediated toxicity in the striatum. Using electron microscopy, we found that the resistance is localized to the cell bodies and not to the neuropil. The reduction of dopamine and cAMP regulated phosphoprotein of a molecular weight of 32 kDa (DARPP-32) in R6/2 mice does not provide the resistance, as DA-induced striatal lesions are not reduced in size in DARPP-32 knockout mice. Neither DA receptor antagonists nor a N -methyl- d -aspartate (NMDA) receptor blocker reduce the size of DA-induced striatal lesions, suggesting that DA toxicity is not dependent upon DA- or NMDA receptor-mediated pathways. Moreover, superoxide dismutase-1 overexpression, monoamine oxidase inhibition and the treatment with the free radical scavenging spin-trap agent phenyl-butyl-tert-nitrone (PBN) also did not block DA toxicity. Levels of the antioxidant molecules, glutathione and ascorbate were not increased in R6/1 mice. Because damage to striatal neurons following intrastriatal injection of 6-hydroxydopamine was also reduced in R6 mice, a yet-to-be identified antioxidant mechanism may provide neuroprotection in these animals. We conclude that striatal neurons of R6 mice develop resistance to DA-induced toxicity with age. [source] Amino acids in Quaternary soil horizons from southwest PolandEUROPEAN JOURNAL OF SOIL SCIENCE, Issue 2 2003A. Szponar Summary Aminostratigraphy has proved to be a useful approach for dating fossils from the Quaternary. In these studies the amino acids in Quaternary soil formations were determined in an attempt to establish their stratigraphical relationships and relative ages. The sampling sites are in the southwest of Poland, in the Trzebnickie Hills. Three samples of fossil soils and two of recent soils were analysed. The absolute age of the soil samples was estimated by radiocarbon dating. We found that the total amount of amino acids decreased with the increasing age of soil. The smallest amounts of amino acids were found in the oldest fossil soil of Denekamp (Vistulian) age dated 29 600 ± 760 years bp. A sample of recent loess soil contained the most total amino acids, whereas the fossil soil of Lower Atlantic age, dated 3540 ± 230 years bp, was intermediate in respect of the total amount of amino acids, oxidation state and degree of biochemical transformation. Neutral amino acids formed a majority of all the amino acids studied. The method we describe could be useful in relative chronostratigraphical identification of fossil soils. [source] | ||||||||||||||||||||||||||||||||||||||||||||||