The elderly, medicines and robust evidence from randomised control trials

1998 ◽  
Vol 3 (3) ◽  
pp. 105-111 ◽  
Author(s):  
Alan Earl‐Slater
Keyword(s):  
The Elderly ◽  
Randomised Control Trials ◽  
Robust Evidence

Lumbar Facet Arthropathy

2018 ◽  
Author(s):  
Leonardo Kapural ◽  
Harish Badhey ◽  
Suneil Jolly
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
The Elderly ◽  
Evidence Base ◽  
Low Back ◽  
Common Cause ◽  
Anatomic Basis ◽  
Facet Arthropathy ◽  
Lumbar Facet ◽  
Robust Evidence

Lumbar facet dysfunction is a common cause of low back pain. This syndrome appears to involve anatomic and pathophysiologic degeneration, and the elderly are more commonly affected. This chapter examines the incidence of low back pain related to facet dysfunction. It describes the anatomic and pathophysiologic basis of pain mediated by the lumbar facet. It discusses the anatomic basis for the treatment of lumbar facet pain, with an emphasis on therapies that have a robust evidence base.

Stimulation of Leydig and Sertoli cellular secretory function by anti-oestrogens: Tamoxifen

2020 ◽  
Vol 26 ◽  
Author(s):  
A. Dimakopoulou ◽  
D. Foran ◽  
C.N. Jayasena ◽  
S. Minhas
Keyword(s):  
Pregnancy Rates ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Hpg Axis ◽  
Receptor Modulator ◽  
Ovid Medline ◽  
Gonadotrophin Secretion ◽  
Randomised Control Trials ◽  
Robust Evidence ◽  
Selective Oestrogen Receptor Modulator

Tamoxifen is a selective oestrogen receptor modulator (SERM). SERMs act on oestrogen receptors to inhibit oestradiol mediated negative feedback on the hypothalamic-pituitary-gonadal (HPG) axis, thereby upregulating gonadotrophin secretion and release from the pituitary. Hence, Tamoxifen is used to upregulate activation of the HPG axis in the treatment of male-factor infertility. However, due to a lack of robust evidence, Tamoxifen has not been FDA approved for use in male-factor infertility and so its use is currently off-label. In this study, we performed a literature search of the OVID medline database and identified 37 studies describing the effects of tamoxifen which we then reviewed. Evidence suggests Tamoxifen effectively increases androgen levels and sperm concentrations in males with idiopathic oligozoospermia. Evidence for increased motility and pregnancy rates in these patients is less conclusive. Further randomised control trials are needed to elucidate the safety of Tamoxifen combination therapies and their efficacy in improving pregnancy rates.

Pathophysiology and management of thyroid disorders in the critically ill

2016 ◽  
Author(s):  
Michael O’Dwyer ◽  
David Watson
Keyword(s):  
Thyroid Hormones ◽  
Critically Ill ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Thyroid Storm ◽  
Admission Diagnosis ◽  
Therapeutic Approaches ◽  
Diagnostic Dilemma ◽  
Effect Of Treatment ◽  
Robust Evidence

Although overt thyroid disease as a primary admission diagnosis to an intensive care unit is uncommon, failure to recognize and adequately manage this condition can have fatal consequences. Hyperthyroidism is usually manifested by signs and symptoms of an exaggerated sympathomimetic response. In its most severe forms, a thyroid storm will necessitate a multimodal treatment. Although robust evidence is lacking, radiographic contrast dyes containing iodine are becoming popular as a first-line treatment. Hypothyroidism can similarly present as a diagnostic dilemma, particularly in the elderly. Management is difficult with little consensus as to the optimal pharmacological approach. Treatment should be individually tailored, while remaining vigilant for the unwanted side effect of treatment with thyroid hormones. In contrast, sick euthyroid syndrome is commonly observed in the critically ill. A sound understanding of the action of thyroid hormones in health and in the critically ill will benefit clinicians in recognizing these disorders and also in guiding their management in an area where significant variability remains in therapeutic approaches.

scholarly journals Assessment in the Supine-To-Stand Task and Functional Health from Youth to Old Age: A Systematic Review

2020 ◽  
Vol 17 (16) ◽  
pp. 5794 ◽  
Author(s):  
Maria Teresa Cattuzzo ◽  
Frederico Santos de Santana ◽  
Marisete Peralta Safons ◽  
Alessandro Hervaldo Nicolai Ré ◽  
Danielle Rene Nesbitt ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Weight ◽  
Weight Status ◽  
Web Of Science ◽  
The Elderly ◽  
Risk Of Bias ◽  
Functional Health ◽  
Moderate Risk ◽  
Body Weight Status ◽  
Robust Evidence

Performance in the supine-to-stand (STS) task is an important functional and health marker throughout life, but the evaluation methods and some correlates can impact it. This article aims to examine the studies that assessed the performance of the STS task of young people, adults and the elderly. Evidence of the association between the STS task and body weight status, musculoskeletal fitness and physical activity was investigated, and a general protocol was proposed. MEDLINE/Pubmed and Web of Science databases were accessed for searching studies measuring the STS task directly; identification, objective, design, sample, protocols and results data were extracted; the risk of bias was assessed (PROSPERO CRD42017055693). From 13,155 studies, 37 were included, and all demonstrated a low to moderate risk of bias. The STS task was applied in all world, but the protocols varied across studies, and they lacked detail; robust evidence demonstrating the association between STS task and musculoskeletal fitness was found; there was limited research examining body weight status, physical activity and the STS task performance. In conclusion, the STS task seems to be a universal tool to track motor functional competence and musculoskeletal fitness throughout life for clinical or research purposes.

scholarly journals Amphetamine Use in the Elderly: A Systematic Review of the Literature

2020 ◽  
Vol 18 (2) ◽  
pp. 126-135
Author(s):  
Karina Lúcia Moreira Sassi ◽  
Natalia Pessoa Rocha ◽  
Gabriela Delevati Colpo ◽  
Vineeth John ◽  
Antonio Lucio Teixeira
Keyword(s):  
Systematic Review ◽  
Clinical Improvement ◽  
Elderly Population ◽  
The Elderly ◽  
Therapeutic Use ◽  
Review Of The Literature ◽  
Eligibility Criteria ◽  
Effective Strategies ◽  
Amphetamine Use ◽  
Robust Evidence

Objective: To systematically review the literature on the therapeutic use of amphetamine, lisdexamfetamine and methylphenidate in elderly population with and without dementia. Methods: We conducted two researches on the PubMed, Scopus and Embase using the keywords (“elderly”) AND (“amphetamine” OR “methylphenidate” OR “lisdexamfetamine”) and then (“Alzheimer” OR “dementia”) AND (“amphetamine” OR “methylphenidate” OR “lisdexamfetamine”). Results: Twenty-nine papers met all the eligibility criteria. The results are encouraging as 81.5% of the studies showed clinical improvement of the investigated condition. Conclusion: Amphetamines and methylphenidate are probably effective strategies for different conditions in the elderly population. However, further studies are needed to provide more robust evidence on efficacy, dosage and safety for this population.

Cell surface changes during aging of human bladder epithelium examined by lectin probes and SEM

1990 ◽  
Vol 48 (3) ◽  
pp. 966-967
Author(s):  
J. Jacob ◽  
M.F.M. Ismail
Keyword(s):  
The Elderly ◽  
Ultrastructural Changes ◽  
Pokeweed Mitogen ◽  
Asymmetric Structure ◽  
Luminal Surface ◽  
Bladder Epithelium ◽  
Aldehyde Groups ◽  
Cell Surface Changes ◽  
Phosphate Buffered Saline ◽  
Surface Changes

Ultrastructural changes have been shown to occur in the urinary bladder epithelium (urothelium) during the life span of humans. With increasing age, the luminal surface becomes more flexible and develops simple microvilli-like processes. Furthermore, the specialised asymmetric structure of the luminal plasma membrane is relatively more prominent in the young than in the elderly. The nature of the changes at the luminal surface is now explored by lectin-mediated adsorption visualised by scanning electron microscopy (SEM).Samples of young adult (21-31 y old) and elderly (58-82 y old) urothelia were fixed in buffered 2% glutaraldehyde for 10 m and washed with phosphate buffered saline (PBS) containing Ca++ and Mg++ at room temperature. They were incubated overnight at 4°C in 0.1 M ammonium chloride in PBS to block any remaining aldehyde groups. The samples were then allowed to stand in PBS at 37°C for 2 h before incubation at 37°C for 30 m with lectins. The lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) at a concentration of 500 mg/ml in PBS at pH 7.A.

The effect of dental geriatric curricula on attitudes toward the elderly

1988 ◽  
Vol 52 (9) ◽  
pp. 516-518 ◽  
Author(s):  
J Mann ◽  
TJ Bomberg ◽  
JM Holtzman ◽  
DB Berkey
Keyword(s):  
The Elderly

Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

2015 ◽  
Vol 25 (2) ◽  
pp. 61-69
Author(s):  
Angel L. Ball ◽  
Adina S. Gray
Keyword(s):  
Depressive Symptoms ◽  
The Elderly ◽  
Environmental Communication ◽  
Pharmacological Intervention ◽  
Team Approach ◽  
Discussion Paper ◽  
Term Care ◽  
Anticholinergic Medications ◽  
Inappropriate Treatment ◽  
Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

Acquired haemophilia in the elderly is a severe disease: report of five new cases

Haemophilia ◽  
2001 ◽  
Vol 7 (4) ◽  
pp. 428-432 ◽  
Author(s):  
S. Godreuil ◽  
R. Navarro ◽  
P. Quittet ◽  
L. Landreau ◽  
J-F. Schved ◽  
...  
Keyword(s):  
Severe Disease ◽  
The Elderly ◽  
Acquired Haemophilia
Sign in / Sign up

Export Citation Format

Share Document