摘要:

Asthma is common in old age and carries significant morbidity and mortality. Most deaths due to asthma occur in old people. Often the diagnosis of asthma is overshadowed by other medical problems such as heart failure and emphysema, and thus elderly people may not receive optimal treatment. The treatment of an elderly patient with asthma is further complicated by concomitant disease and pharmacological interactions.

ISSN:0304-324X    

DOI:10.1159/000213774

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

In this study, the changes in some of the cellular components of the immune system and the activity of the cytokine interleukin 2, important for immune activation and lymphocyte proliferation, were measured in a large cross-sectional study of all age groups including octogenarian and nonagenarian subjects. In 206 apparently well community-living subjects, the absolute lymphocyte count and T and B cell numbers fell a little in old and very old subjects. Within the T cell compartment, helper/inducer CD4+ T cells, together with their subsets identified as ‘naive’ (CD4+/CD45RA+) and ‘memory’ (CD4+/CD45RO+) cells, also showed a decline with increased age. The suppressor/cytotoxic CD8+ subset showed no age-related change. The levels of the cytokine interleukin 2 were very low in octogenarian and nonagenarian subjects, while the soluble interleukin 2 receptor levels increased with increasing age. The interleukin 2 levels were associated with number and percentage of the ‘memory’ (CD4+/CD45RO+) subset of T cells which mediates the host response to previously met antigens. Since the interleukin 2 values were very low in the oldest groups and were associated with a reduced ‘memory’ (CD4+/CD45RO+) compartment, this suggests a possible mechanism of why the very elderly subject is more susceptible to morbidity and mortality from infectious

ISSN:0304-324X    

DOI:10.1159/000213775

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The effects of aging on the secretion of and renal sensitivity to atrial natriuretic factor (ANF) were studied concomitantly in both senescent (25- to 34-month-old) and in adult (7- to 13-month-old) female and male Long-Evans rats. The plasma concentrations of ANF, measured in response to either a mild stimulation induced by a hypertonic volume expansion (i.e., 20 min after the onset of a continuous infusion during 15 min of a 2.5% NaCl solution; n = 18 old and 23 adult rats) or an intense stimulation produced by morphine injection (i.e., 30 min after an intraperitoneal injection of 5 mg morphine/100 g body weight; n = 11 old and 12 adult rats), were significantly lower (approximately -34 and -80%, respectively) in old as compared with adult animals. Acute intravenous injection of exogenous rat ANF (0.10 and 0.40μg/l00g body weight) induced similar natriuretic, diuretic, and kaliuretic effects in aged (n = 18) and in adult (n = 23) rats. The present data suggest that the significantly reduced (about -20%) natriuretic and kaliuretic responses of the aged rat, observed 20 min after the onset of hypertonic volume expansion, could be partly due to a primary defect in cardiac production and/or release of ANF rather than to a reduction of renal responsivity to ANF

ISSN:0304-324X    

DOI:10.1159/000213776

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

This contribution makes an attempt to critically reassess the impressive carreer of melatonin from a stepchild of hormone research to a best-seller of drug marketing. Melatonin is an extremely interesting hormone. It is involved in the regulation of seasonal and circadian fluctuations of other hormones and in the synchronization of many different aspects of circadian rhythmicity to the light-dark cycle. In addition to these receptor-mediated functions, melatonin may act as a modulator of intracellular signal transduction to enhance or suppress the responses of many different cells to other incoming signals. Melatonin is also a potent scavenger of reactive oxygen species and may thus protect cells and tissues against radical-mediated damage. The production of melatonin declines with increasing age, and circulating melatonin levels are affected by certain pharmacological or physiological manipulations, notably food restriction which increases melatonin levels and prevents its age-related decline. Animal and cell culture experiments suggest that melatonin may have beneficial effects on certain aspects of aging and age-associated diseases. Of particular interest in this respect are reports on the influence of melatonin on the brain and the immune system. More research data are urgently needed in order to more clearly define the possible sites and mechanisms of these actions. Clinical studies need to be performed in order to identify possible side effects of long-term melatonin treatment, especially in elderly and diseased subjects. Serious concerns are rised about the use of uncontrolled, impure, or partially degraded melatonin preparations.

ISSN:0304-324X    

DOI:10.1159/000213777

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Helicobacter pylori (Hp) is associated with gastritis and peptic ulcers. It may also induce gastric atrophy (GA) and intestinal metaplasia (IM), and these changes may be the precursors of gastric carcinoma. The aim of this study was to determine if GA or IM is associated with Hp infection in elderly patients. Consecutive patients admitted for gastroscopy were recruited. Multiple biopsies were taken for histology and rapid urease (CLO) tests along with IgG enzyme-linked immunosorbent assay antibodies and 13C-urea breath tests. Statistical analysis was by χ2 tests. 114 patients were recruited, the average age was 78.9 ± 5.4 years. Histology was available on 105 patients, 80 (76.2%) had gastritis, and 61/80 (76.25%) had evidence of definite current Hp infection. Seven patients had reflux gastritis, and these were excluded from the analysis described below. 20 patients had GA and 24 IM. The relationship between Hp and GA or IM was investigated by dividing patients into four groups: Group 1 patients (n = 57) were taken to be definitely currently infected (GA 7 patients, IM 11, both 1). Group 2 patients (n = 18) had old infection (GA 2, IM 4, both 3). Group 3 patients (n = 16) have never been infected previously (GA 1, IM 1, both 3). Group 4 patients (n = 4) had a poor immunological response to Hp (GA 1, IM 1, both 0). There were no significant differences in the numbers of patients with GA or IM in any group as compared with any other, with the exception of less patients with histological evidence of combined GA and IM among patients with definite current infection as compared with those with either previous infection (p = 0.04) or ‘never’ infection (p = 0.03). We conclude that the mucosal changes of GA or IM are not consistently associated with Hp infection in the el

ISSN:0304-324X    

DOI:10.1159/000213778

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Falls occurring in elderly in-patients during periods of hospitalization are common, and attempts have been made to predict and prevent them based on risk factor analysis. These have not looked extensively at specific elderly care wards. We have investigated in-patient falls in mixed acute and rehabilitation elderly care wards in a case-controlled study. Fifty fallers were paired with fifty non-fallers, and their risk factors for falling evaluated. Only three risk factors were significantly more common in the fallers. These were: a previous history of falls; the presence of confusion/disorientation, and needing help to toilet/incontinence/diarrhoea. Prediction of falls based on the presence of the first two of these risk factors gives a sensitivity of 68% and a specificity of 88%. A risk factor approach to the prediction of falls in an in-patient elderly care setting seems to be less practical than was previously hoped.

ISSN:0304-324X    

DOI:10.1159/000213779

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

In this study, 97 patients with senile dementia of the Alzheimer type (SDAT) in a nursing home were followed over a period of 2 years, and the relationship between falls and gait function was examined. The findings indicated that the number of fallers was significantly higher in moderate-stage SDAT patients than in the mild-stage patients. In the moderate-stage SDAT patients, walking speed and stride length, measured as indices to evaluate gait function, were significantly lower, and the stride length variability was significantly higher than in mild-stage patients. When comparing the gait indices of fallers and non-fallers by the severity of dementia, a significant difference was observed only in stride length variability. The gait abnormality associated with advanced severity in dementia is believed to be a factor affecting falling. In particular, stride length variability appeared to be an effective predictor of falling.

ISSN:0304-324X    

DOI:10.1159/000213780

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The purpose of this study was to determine the effects of a maximal isokinetic training program on strength and muscle mass in a group of untrained men 73 ± 7.3 (range 68-82) years of age. Testing and training were conducted on an isokinetic dynamometer. Training consisted of one set of six maximal knee flexion and extension movements at 60 deg·s-1 performed three times per week for 12 weeks. The subjects trained the right leg only, the left leg serving as a within-subject control. Trained leg peak torque increased by 18.1% for knee extension (from 107.2 ± 42.9 to 126.6 ± 44.6 Nm; p < 0.05) and by 18.2% for knee flexion (from 85.1 ± 21.1 to 100.4 ± 25.5 Nm; p < 0.05). Urinary creatinine levels increased by 24.3% (NS). We conclude that maximal isokinetic training at 60 deg·s-1 increases strength and a urinary index of muscle mass in a group of aged untrain

ISSN:0304-324X    

DOI:10.1159/000213781

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:0304-324X    

DOI:10.1159/000213782

出版商:S. Karger AG    

年代:1996

数据来源: Karger