Whole body vibration can improve the muscle strength, balance and walking ability of elderly persons with sarcopenia / 中华物理医学与康复杂志

Objective:To observe any effect of alternate side whole body vibration on the muscle strength, balance and walking ability of persons with sarcopenia.Methods:Forty elderly persons with sarcopenia were randomly divided into an experimental group and a control group, each of 20. Both groups received conventional balance and lower-limb muscle strength training, but the experimental group also received 9-14Hz whole body vibration treatment with an amplitude of 2-3mm, 5 one-minute groups a day, 5 times a week. Before and after 8 weeks of treatment, both groups′ lower limb strength, 6m step speed, exercise ellipse area, exercise track length, and Up and Go test (TUGT) time were measured.Results:In the experimental group the average bilateral iliopsoas muscle strength and all the other measurements had improved significantly. In the control group, the exercise ellipse area with the eyes closed and the exercise track length with the eyes open and all the other measurements had improved significantly compared with before the training. But all of the experimental group′s outcomes were, on average, significantly better than those of the control group.Conclusion:Low frequency vibration training can better improve the muscle strength, balance and walking ability of elderly persons with sarcopenia. It can be used for prevention as well as treatment.

Research progress on the effective components of traditional Chinese medicine for improving AD-related cognitive impairment / 药学学报

Alzheimer's disease (AD) and other aging-related diseases have become an important public health issue in China. However, current clinical drugs have failed to reverse the pathological process of AD. The holistic approach of traditional Chinese medicine offers advantages in improving cognitive function in AD through multiple molecular pathways, and may have potential for preventing AD. This paper summarizes the effects of classical traditional Chinese medicine and its active components in the improvement of AD-related cognitive dysfunction and describes the functional targets and related molecular mechanisms. This may have significance for the prevention and treatment of AD through multi-target intervention.

O trabalho do psicopedagogo na reabilitação cognitiva do idoso / Psychopedagogue's work in cognitive rehabilitation of the elderly

O presente artigo busca evidenciar a possibilidade de atuação do psicopedagogo no campo da geriatria, especificamente na reabilitação cognitiva de idosos com prejuízos cognitivos decorrentes tanto do processo natural do envelhecimento quanto de doenças e/ou lesões cerebrais. A metodologia adotada para esta pesquisa é a da revisão bibliográfica narrativa e encontra-se ancorada em áreas do conhecimento como a neurociência, a psiquiatria, a neuropsicologia, a análise do comportamento e a neurologia. Conclui-se que o psicopedagogo, por possuir conhecimentos que o levam a ter afinidade com tais áreas e por ser um especialista em processos de aprendizagem, possui competência para colaborar em programas de reabilitação cognitiva de modo a atuar como facilitador na construção e reconstrução de saberes que promovam o restabelecimento da autonomia do idoso e sua plena reinserção ao convívio social.

This article aims to highlight the possibility of psychopedagogy in the field of geriatrics, specifically in the cognitive rehabilitation of the elderly with cognitive impairments arising both from the natural aging process and from brain diseases and/or injuries. The methodology adopted for this research is that of the bibliographic narrative review and is anchored in areas of knowledge such as neuroscience, psychiatry, neuropsychology, behavioral analysis and neurology. It is concluded that the psychopedagogue has the competence to collaborate in cognitive rehabilitation programs to act as a facilitator in the construction and reconstruction of knowledge that promote the restoration of the autonomy of the elderly and their full reintegration into social life. This conclusion is justified by the fact that he has sufficient knowledge in such areas and acts in learning processes.

Survey about Death Certificates of Senile Patients Who Died of Pneumonia as A Complication ~from A Survey on The Diagnosis of Senility~ / 日本プライマリ・ケア連合学会誌

Introduction: The purpose of this study was to investigate the immediate cause of death recorded by home medical care physicians on the death certificates of senile patients who died of pneumonia as a complication, and to examine physician-level factors related to selection of the cause of death.Methods: We used a mail questionnaire survey to conduct a cross-sectional study of members of the Japan Network of Home Care-Supporting Clinics.Results: In total, 470 valid responses were received (response rate: 51.8%). The immediate cause of death was recorded as pneumonia in cases of complication by pneumonia "always" by 95 physicians (20.2%), "often" by 131 (27.9%), "sometimes" by 134 (28.5%), "rarely" by 91 (19.4%), and "never" by 19 (4.0%). Multivariate analysis revealed that female physicians were significantly less likely to record the immediate cause of death as senility (OR: 0.10, 95%CI: 0.01-0.71).Conclusion: The immediate cause of death recorded on death certificates varied in cases of senile patients who died of pneumonia as a complication. The present study also suggested that selection of the cause of death was influenced by the gender of physicians.

The pathogenesis and antioxidant treatment of age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

@#Aged-related macular degeneration(ARMD)is prone to occur in the people who aged 50a or older. The disease can lead to partial or even complete loss of sight in single or both eyes progressively. The pathogenesis of ARMD is still unclear, but the previous studies have shown that oxidative stress plays an important role. The mechanism of antioxidants on ARMD has gradually become a hotspot in recent years. In this paper, we briefly reviewed the mechanism of ARMD caused by oxidative stress and the application of antioxidants on ARMD.

Clinical Efficacy by Kidney Tonifying and Essence Strengthening Method in Regulating Pulse Wave Velocity to Delay Physiological Vascular Aging / 中国实验方剂学杂志

Objective: To observe the clinical efficacy of kidney tonifying and essence strengthening method in delaying physiological vascular aging. Method: Sixty-two subjects who completed the study were randomly divided into experimental group (31 cases) and control group (31 cases) with the matching research method. The experimental group was treated with kidney tonifying and essence strengthening recipe orally for 24 weeks, while the control group was not interfered with traditional Chinese medicine (TCM). Score of TCM syndrome in kidney deficiency syndrome, pulse wave velocity, intima-media thickness, plasma homocysteine level and serum superoxide dismutase level were evaluated before and after treatment. Result: Compared with before treatment period, the score of TCM syndrome in kidney deficiency syndrome, pulse wave velocity and plasma homocystenine level decreased, while the serum superoxide dismutase level increased in the experimental group after treatment (PPPPPConclusion: The kidney tonifying and essence strengthening method may delay the aging of physiological blood vessels caused by aging.

Brain parenchymal changes during normal aging in domestic cats / Alterações do parênquima cerebral durante a senilidade em gatos domésticos

This study aimed to identify changes related to brain parenchyma as advancing age in healthy domestic cats. Our hypothesis is that cats suffer cerebral and cerebellar atrophy and show focal changes in signal intensity of the brain parenchyma in accordance with the progression of age. Twelve adult (1 to 6 years), eleven mature (7 to11 years) and ten geriatric non-brachycephalic cats (12 years or more of age) underwent brain magnetic resonance imaging (MRI). There were no changes in signal intensity and contrast uptake in brain parenchyma of the cats. Geriatric animals showed significantly lower average thickness of the interthalamic adhesion and percentage of the cerebral parenchyma volume in relation to intracranial volume than those found in the adult group. No significant differences were found between groups for cerebral volume, cerebellar volume and percentage of cerebellar volume in relation to intracranial volume. The results of this study indicate that atrophy of the cerebral parenchyma, including the interthalamic adhesion, occurs with age in domestic cats, confirming the hypothesis of the study. However, the results did not corroborate the hypothesis that cats show cerebellar atrophy and focal changes in signal intensity of the brain parenchyma with advancing age.(AU)

Este estudo objetivou a identificação de alterações no parênquima cerebral relacionadas ao avanço da idade em gatos domésticos saudáveis. Nossa hipótese é de que os gatos sofrem atrofia cerebral e cerebelar, além de alterações focais na intensidade do sinal do parênquima cerebral, de acordo com a progressão da idade. Doze gatos não braquicéfalos adultos (1 a 6 anos), onze maduros (7 a 11 anos) e dez geriátricos (12 anos ou mais) foram submetidos à ressonância magnética encefálica. Não foram observadas alterações na intensidade do sinal e na captação de contraste do parênquima encefálico nos gatos. Os animais geriátricos apresentaram médias da espessura da adesão intertalâmica e porcentagem do volume do parênquima cerebral, em relação ao volume intracraniano, significativamente menores a aquelas encontradas no grupo dos adultos. Não foram encontradas diferenças significativas entre os grupos para volume cerebral, volume cerebelar e porcentagem de volume cerebelar em relação ao volume intracraniano. Os resultados deste estudo indicam que a atrofia do parênquima cerebral, incluindo a adesão intertalâmica, ocorre com o avanço da idade em gatos domésticos, confirmando a hipótese do estudo. No entanto, os resultados não corroboraram a hipótese de que os gatos apresentam atrofia cerebelar e alterações focais na intensidade do sinal do parênquima encefálico com a progressão da idade.(AU)

Discussion on Strategies for Prevention and Treatment of Senile Encephalopathy from Kidney / 世界科学技术-中医药现代化

The principles and methods of prevention and treatment of Chinese medicine for senile encephalopathy are diverse, reflecting the flexibility of syndrome differentiation and treatment. Kidney essence deficiency is one of the main pathogenesis of senile encephalopathy. According to the correlation between brain and kidney, this paper systematically analyzed the strategy of preventing and treating senile encephalopathy based on the theory of "kidney visceral manifestation", in order to provide theoretical basis for guiding clinical treatment.

Survey on the Diagnosis of Senility as the Cause of Death in Home Medical Care / 日本プライマリ・ケア連合学会誌

Introduction: Although the number of deaths following a diagnosis of senility is increasing in Japan, the criteria of senility are unclear. Therefore, the purpose of this study was to investigate methods to diagnose senility in home medical care.Methods: We mailed questionnaires to 908 members of the Japan Network of Home Care-Supporting Clinics.Results: In total, 535 members (58.9%) responded. Responses of 501 members who selected senility as the cause of death were analyzed. Most doctors considered "continuous care of the patient", "the patient's ADL and gradual decline in oral intake", and "the absence of other critical diseases" to be important when diagnosing senility. The items affecting a diagnosis of senility were "the family's understanding and opinions", "other diseases being medically excluded", and "contribution to the patient's QOL".Conclusion: In home medical care, many doctors consider continuity of care, gradual decline, and the absence of other critical diseases to be important when diagnosing senility. Non-medical aspects, such as the family's opinions and patient's QOL, affected the diagnosis.

Avaliação diagnóstica na síndrome disfunção cognitiva canina / Diagnostic Evaluation of Canine Cognitive Dysfunction Syndrome

O objetivo do presente estudo foi avaliar o questionário observacional e os testes de reatividade como forma de triagem e diagnóstico da disfunção cognitiva em cães idosos. Foram estudados 10 cães acima de sete anos, que apresentavam queixas comportamentais. Foi utilizado questionário que abordava questões comportamentais, como desorientação, atividade, interação socioambiental, alterações no padrão do sono e casa-sujidade. As respostas foram convertidas em pontuações, cujo somatório classificou o cão com disfunção cognitiva canina (DCC), ou borderline (BL), ou sem alterações comportamentais (SAC). Logo depois, foram realizados, em todos os cães, os seguintes testes cognitivos: open field, curiosidade, interação com humano e com espelho. Pela avaliação do questionário, foi determinado que dois cães tinham DCC, três eram BL, cinco eram SAC. Os cães classificados com DCC tinham idade superior aos demais e apresentaram alterações em todos os testes de reatividade, enquanto os cães BL apresentaram alterações em dois testes de reatividade e os SAC não apresentaram alterações. Conclui-se que, com o aumento da expectativa de vida canina, o questionário observacional foi um instrumento de triagem para a identificação dos cães classificados com DCC, BL e SAC, e os testes de reatividade como um método inovador para identificar o verdadeiro estado cognitivo dos pacientes idosos.(AU)

The objective was to evaluate the observational questionnaire and the reactivity tests as a way of screening and diagnosis of cognitive dysfunction in elderly dogs. Ten dogs over seven years of age, with behavioral complaints, were studied. A questionnaire was used that addressed behavioral issues such as disorientation, activity, socioenvironmental interaction, changes in sleep pattern, and house-dirtiness. Responses were converted into scores, which summed the dog with canine cognitive dysfunction (DCC), or Borderline (BL) or without behavioral changes (SAC). Soon after, the following cognitive tests were performed on all dogs: open field, curiosity, interaction with human and with mirror. Through questionnaire evaluation, two dogs had CHD, three were BL, and five were SAC. The dogs classified with DCC were older than the others and presented alterations in all reactivity tests, while the BL dogs presented changes in two reactivity tests and CAD showed no alterations. With the increase in canine life expectancy, the observational questionnaire was a screening instrument for the identification of dogs classified with DCC, BL and SAC and the reactivity tests as an innovative method to identify the true cognitive status of the dogs elderly patients.(AU)

Efeitos de um programa de ginástica orientada sobre os níveis de flexibilidade de idosos / Effects of a monitored gym program on flexibilit y levels in elderly people

Envelhecer representa ao indivíduo idoso um desgaste das suas capacidades fisiológicas globais, seja de um modo progressivo discreto ou grave. Portanto, a prática de atividades físicas na terceira idade associada à ginástica orientada pode ocasionar melhora nos níveis de flexibilidade do idoso, consequentemente, melhorando a sua qualidade de vida. Objetivo: Analisar os efeitos de um programa de ginástica orientada sobre os níveis de flexibilidade de idosos. Métodos: Trata-se de um estudo experimental, de cunho qualitativo, em que 30 idosos foram submetidos a 12 semanas de treinamento de ginástica orientada, duas vezes por semana. Resultados: No presente estudo, constatou-se que todos os indivíduos apresentaram melhoras significativas na flexibilidade, da ordem de 21,12 (DP= 7,7) graus para 23,17 (DP= 7,2). Conclusão: Os resultados permitem concluir que houve um ganho significativo na flexibilidade dos participantes de ginástica orientada, evidenciando que a realização de exercícios do programa de alongamento reflete em benefícios à amplitude angular de indivíduos idosos.

Aging is a wear in the physiological capacities of the elderly, either at a discretely or at a seriously progressive rate. Physical activities in the elderly associated with gym activities may help improve the elderly´s flexibility levels and thus their life quality. Current paper analyzes the effects of a gym program for flexibility levels in elderly people. Current experimental and qualitative study involved 30 elderly people who underwent 12 weeks of gym training, twice a week. Results showed that all elderly people significantly improved their flexibility from 21.12 (DP= 7.722) degrees to 23.17 (DP= 7.223). Results show that significant flexibility occurred in the elderly with monitored gym exercises and reflects the benefits to their angular amplitude.

Effect of selective fenestration decompression for elderly patients with lumbar spinal canal stenosis / 局解手术学杂志

Objective To evaluate the curative effect of selective window decompression surgery for over 80-year-old patients with mul-tiple segment lumbar spinal stenosis. Methods The patients received the operation through posterior median approach. The location of le-sions were determined according to patients' symptom,physical examination and imaging examination,the selective window decompression sur-gery was performed in patients,JOA scoring method was used to evaluating the effect of surgery. Results In the recent follow-up of first 6 months after surgery,the response rate of 52 patients with follow-up was 100%. During the mid-term follow-up after 24~36 months,the re-sponse rate of 47 patients with follow-up is 90. 4%,the average follow-up time was 30. 4 months. The preoperative JOA score and postopera-tive score were (6. 93 +0. 52) and (11. 98 +0. 72) respectively,of which 40 cases achieved optimal standard (76. 9%),10 cases (19. 2%) achieved a good standard,2 cases reached the standard (3. 9%),the excellent rate was 96. 1%. The JOA score of mid-term fol-low-up was (12. 06 +0. 46),of which 36 cases reached optimal standard (76. 6%),10 cases achieved a good standard (21. 3%), but standard was in 1 case (2. 1%),the excellent rate was 97. 9%. The difference of JOA scores was statistically significant (P<0. 01). Con-clusion Selective windowing decompression has the advantages of small trauma,short recovery time and satisfied curative effect,which is suitable for elderly patients with lumbar spinal stenosis.

The anti-aging effect of lycium barbarum polysaccharide on human retinal pigment epithelial cell / 中华实验眼科杂志

Background The pathogenesiof age-related maculadegeneration (AMD) iassociated with the senility of human retinal pigmenepithelium (RPE) cells.Seeking drug to arresRPE cell senility iof significance fothe prevention and treatmenof AMD.Research showed thathe lycium barbarum polysaccharide (LBP) can delay senility,buitinfluence on RPE cell aging iunclear.Objective Thistudy wato discusthe protective effecand mechanism of LBP on RPE cell aging.MethodPorcine retinal neural epithelial layewaisolated,and photoreceptooutesegmen(POS) waextracted by density gradiencentrifugation and marked by FITC.The POwathen co-cultured with RPE cellin the medium containing 0.01,0.10 and 1.00 g/L LBP fo24 hours.The areof fluorescence,representing the amounof POphagocytosed by RPE cells,wameasured undethe fluorescenmicroscope to evaluate the influence of LBP on the phagocytifunction of RPE cells.The POS-induced RPE lipofuscin-uptake cell model waestablished by co-culturing human RPE cellwith porcine POfo3 weeks.The RPE-POco-culture cell model waincubated in medium containing 0.01,0.10 o1.00 g/L LBP,and the autofluorescence caused by lipofuscin up-taken into RPE cellwadetected with flow cytometry.cell counting kiwaused to assescell proliferation and viability (value) 24,48 and 72 hourafteculturing.ResultPorcine POpresented athin rodundethe lighmicroscope and appeared abilayedisc-like structureundethe transmission electron microscope,and itFITC-labeled yellow-green autofluorescence waobserved undethe fluorescenmicroscope.No POwaup-taken into the RPE cellin the normal control group,buthe areof POphagocytosed by RPE cellwagradually enlarged with increasing doseof LBP,showing significandifference among the group(F =21.425,P =0.006).Compared with the POcontrol group,the phagocytosed areincreased avariouconcentrationof LBP+POgroup(P＜0.01).Flow cytometry showed thathe autofluorescence value in the POcontrol group wamore highethan thaof the normal control group.Athe LBP dose increased,the autofluorescence value in the RPE celldeclined gradually and iwaneathe normal value in the 1.00 g/L LBP+ POgroup.The rate of proliferation of the lipofuscin RPE cellvaried with the increase of doseof LBP with the maximal value in the normal RPE group and minimal value in the lipofuscin RPE group,and the rate of proliferation of the lipofuscin RPE cellascended with increasing doseof LBP until neathe normal value in the 1.00 g/L LBP + lipofuscin RPE cellgroup (P＞0.05).ConclusionLBP enhance the anti-aging effecof human RPE cellby strengthening the phagocytiability to POand the ability to remove lipofuscin and by heightening the proliferation of human RPE cells.

Fall risk estimation for senile patients / 中华物理医学与康复杂志

Objective To investigate the discriminant validity and relativity of three scales applied in fall risk estimation for senile patients.Methods The timed up and go test (TUGT),the Morse Fall Scale (MFS) and the Berg Balance Scale (BBS) were used by two trained testers to evaluate the fall risk of 161 senile in-patients.The patients were divided into a falling group and a no-fall group based on their history of falling in the previous one year.Student's t-test was applied to compare the discriminant validity of the TUGT,MFS and BBS.Spearman's correlation coefficient was calculated to analyze the correlation among the three scales.Results The scores of patients in the falling group on the three scales were significantly different from those of the no-falls group.The correlation coefficients among the three scales were in the range 0.680-0.888.Conclusion The TUGT,MFS and BBS all showed high sensitivity and good discrimination in fall risks estimation for senile patients.The results with the three scales were highly correlated.Because the emphasis of these three scales is different,a suitable scale should be selected in clinical practice according to the characteristics of the senile patient.

Aging is not senescence: a short computer demonstration and implications for medical practice

INTRODUCTION: The discussion regarding the evolution of aging is almost as old as Darwinian Evolution Theory, but to date, it has remained one of biology's unresolved problems. One issue is how to reconcile natural selection, which is understood as a process that purges deleterious characteristics, with senescence, which seems to offer no advantages to the individual. METHOD: A computer simulation that illustrates an evolutionary mechanism for the development of senescence in populations is presented. DISCUSSION: In this article, we debate that two popular explanations for the existence of senescence, namely, (1) the removal of elders for the benefit of the species and (2) the progressive deterioration of the organic machine due to continuous use, are not correct. While human populations continue to age, it is important that the physician understands that senescence, here defined as the progressive impairment of an organism, does not necessarily accompany aging, which we here define as the mere passage of time. As such, we argue that certain processes that were originally assumed to be part of aging should have their status changed because they are actually diseases. Physicians often encounter situations that depend on a better understanding of what limitations senescence imposes on most living species. The concepts of aging (the unavoidable passage of time), senescence (progressive physiologic impairment), and senility (the pathological development of diseases), are discussed.

Analysis of the phagocytic function and spleen regeneration after subtotal splenectomy and splenic autotransplantation in senile rats

Objective. Compare the fagocitary function and the splenic regeneration of senile rats submitted to subtotal splenectomy or total splenectomy followed by splenic autotransplantation. Methods. Thirty Wistar rats have been ramdomly distributed into two groups with fifiteen animals each. One group named subtotal splenectomy (SS) have been submitted to a subtotal splenectomy surgery and the other group, autoimplant (AT) have been submitted to total splenectomy followed by autotransplantation. The animals from SS group have been redistributed again into three subgroups (n = 5) SS-1, SS-2 and SS-3 and submitted to reoperation and euthanasia on the 15th, 30th and 60th days respectively. In reoperation, the remaining spleen from SE group and the autotransplantation fragments from the AT animals group have been removed and histologically analised observing and classifying the degree of spleen regeneration into absent (0), discrete (1), moderate (2) and intense (3) and also counting the carbon colloidal marked macrophages. Results. All the rats submited to subtotal splenectomy was sacrificed with 15, 30, and 60 days and presented na intense splenic regeneration. In another group 80 % of the rats does not presented a splenic regeneration, but with 30 and 60 days, 60% of the rats had a moderate regeneration. Regeneration level considered as important and 300 or more macrophages were found in samples of all animals from subgroups SS-1, SS-2 and SS-3. In samples of animalsfrom subgroups AT-1, AT-2 and AT-3, regeneration level from absent to moderate and less than 200 macrophages were found. Conclusion. Under the conditions that this study was performed, the splenic regeneration and the fagocitary function of senile rats after subtotal splenectomy were more evident than those of autotransplantation.

Objetivo. Comparar a função fagocitária e a regeneração esplênica de ratos senis submetidos a esplenectomia subtotal ou a esplenectomia total seguida de autoimplante esplênico. Métodos. Trinta ratos Wistar foram separados aleatoriamente em dois grupos com quinze animais em cada, a saber: grupo esplenectomia subtotal (SS) que foram submetidos a esplenectomia subtotal e o grupo do autoimplante (AT) que foram submetidos a esplenectomia total seguida de autoimplante. Os animais do grupo SS foram redistribuídos aleatoriamente em três subgrupos (n = 5) SS-1, SS-2 e SS-3 e submetidos a reoperação e eutanásia após 15, 30 e 60 dias respectivamente. Três horas antes da reoperação, todos os animais receberam uma única dose intravenosa de carbono coloidal. Os animais do grupo AT também foram redistribuídos aleatoriamente em três subgrupos com cinco animais cada, AT-1, AT-2 e AT-3 e submetidos a reoperação e eutanásia após 15, 30 e 60 dias respectivamente. Na reoperação, o baço remanescente do grupo SS e os fragmentos autoimplantandos nos animais do grupo AT foram removidos e analisados histologicamente quanto ao grau de regeneração esplênica classificada em ausente (0), discreta (1), moderada (2) intensa (3) e contagem dos macrófagos marcados com carbono coloidal. Resultados. Todos os ratos submetidos à esplenectomia subtotal sacrificados com 15, 30 e 60 dias tiveram regeneração intensa do baço. No grupo submetido à esplenectomia e autoimplante, quinze dias após o procedimento, 80% dos ratos não apresentaram regeneração do baço. Porém, com trinta dias, 60% apresentaram regeneração moderada. O mesmo resultado foi observado após sessenta dias. O nível de regeneração foi considerado importante e 300 ou mais macrófagos foram encontrados em todos os animais dos grupos SS-1, SS-2 e SS-3. No grupo correspondente a AT-1, AT-2 e AT-3, o nível de regeneração encontrado foi ausente ou moderado e sempre menos de 200 macrófagos por campo foram identificados. Conclusão. Nas condições...

Doença de Alzheimer / Alzheimer's disease

Descrita inicialmente em uma mulher com sintomas parecidos com demência, manifestando-se com idéias delirantes, graus de confusão mental, seguido de declínio cognitivo progressivo, evoluindo para a morte após quatro anos do surgimento da enfermidade. A doença de Alzheimer é a causa mais comum de demência senil e pré-senil. Raramente apresenta os sintomas antes dos 50 anos de idade. Acomete 5% a 10% dos pacientes acima de 65 anos e 20% a 40% daqueles acima de 85 anos. A maioria dos casos é de apresentação isolada, todavia, em 5% a 10% dos casos tem ocorrência familiar. Tem como fatores de risco a idade avançada e história familiar positiva. Sua manifestação é a perda lenta e gradual das funções cognitivas, entendido como o acometimento do aprendizado e realização de tarefas, abrangendo memória anterógrada, reconhecimento, linguagem, destreza, raciocínio e resolução de problemas. As bases histológica e fisiopatológica da enfermidade se fundamentam na depleção de acetilcolina (Ach), pela redução da colina-acetiltransferase e dos receptores nicotínicos de Ach. Outros neurotransmissores estão envolvidos, tanto na gênese quanto na apresentação clínica da doença, dentre eles se destacam a serotonina, a noradrelina e a dopamina. Acredita-se que a degeneração neuronal se deve ao acúmulo de placas senis (compostas por proteína Ab-amilóide) no interstício interneuronal e por novelos neurofibrilares no citoplasma celular. Embora o exame anatomopatológico do tecido cerebral permaneça essencial ao diagnóstico definitivo da doença, a combinação da avaliação clínica e dos métodos radiológicos modernos permite um diagnóstico preciso em 80% a 90% dos casos. O tratamento se baseia em drogas inibidoras da enzima acetilcolineterase responsável pela destruição do neurotransmissor acetilcolina na fenda sináptica. Recentes avanços no conhecimento genético e imunomodulador têm revelado esperanças no controle da doença. Resultados mais animadores são observados nas fases iniciais da...

Effect of Comprehensive Recuperatation on Hypertension in the Senility / 中国康复理论与实践

@#ObjectiveTo observe the effect of comprehensive recuperatation on hypertension in the senility.Methods92 old hypertension patient who accepted comprehensive recuperatation were analyzed retrospectively. The blood pressure, glucose and lipid in serum, and renal function were measured before and 2 months after recuperatation.ResultsTheir blood pressure, urea nitrogen, creatine and uric acid decreased (P<0.01 ), but the glucose, triglyceride and cholesterol remained no-change (P>0.05). ConclusionThe comprehensive recuperatation maybe effective on decrease of blood pressure, as well as protection of renal function in the senility.

Relationship between serum bilirubin and carotid atherosclerosis in aged patients with hypertension / 中国实用内科杂志

Objective To evaluate the relationship between serum bilirubin and carotid atberosclerosis in aged patients with hypertension.Methods 141 aged patients with hypertension were detected by ultrasound were divided into in- creased IMT group,atberoma group and narrow luminal diameter group.Their serum bilirubin levels were measured and compared.Results Those with lower serum total bilirubin,Serum direct bilirubin and serum indirect bilirubin showed more severe carotid atherosclerosis.There was significant statistical difference between threeg roups (P

Laparoscopic Repair of Incisional Hernia for Patients over Seventy Years Old(Report of 8 Cases) / 中国普外基础与临床杂志

Objective To investigate and summarize preliminarily the clinical experiences of laparoscopic incisional hernia repair with intraperitoneal patch placement for the patients over 70 years old.Methods From July 2005 to July 2008,laparoscopic incisional hernia repair with intraperitoneal onlay meshes were applied in 8 patients,and whose clinical data were studied retrospectively.Results The procedures were performed successfully in all patients except one converted to open because of severe adhesion.The mean operative time was 105 min(ranged from 50 min to 180 min).One postoperative hypercapnia was resolved through mechanic ventilation for 24 h.One seroma and 1 prolonged postoperative pain over 1 month occurred,which were cured with conservative therapy.Mean postoperative hospital stay was 9.5 d(ranged from 7 d to 14 d).There was no recurrence or local discomfort during 12-36 months(average 26.5 months)follow-up.Conclusions Laparoscopic incisional hernia repair with intraperitoneal onlay mesh for the patients over 70 years old is safe and feasible,which has some advantages such as less trauma and rapid recovery.The perioperative management and operative technique are very important for the success of operation.