ABSTRACT
OBJECTIVES: Our goal was to evaluate the proportion of community-dwelling elderly people at risk for malnutrition and the effect of different socioeconomic status (SES) indicators as well as social, physical and leisure activities in late life on the risk for malnutrition. DESIGN: A cross-sectional population-based study. SETTING: A sub-urban area in Northern Italy. PARTICIPANTS: 698 community-dwelling older persons. MEASUREMENTS: The nutritional status of participants was assessed through the Mini Nutritional Assessment-Short Form (MNA-SF). SES was defined by means of early-life education, longest occupation, and late-life financial conditions. The following indicators were also evaluated: social contacts, and performing mental, physical and leisure activities during late-life. Chronic diseases, functional, cognitive and affective status were considered as potential confounders when examining the risk for malnutrition by logistic regression models. RESULTS: 8% of the participants (average age 75.6 years, 408 women) were at risk for malnutrition (MNA-SF ≤ 11). Low education, poor financial condition, and lack of physical and leisure activities showed a crude association with risk for malnutrition. Multi-adjusted logistic regression models showed that only low education (OR=2.9; 95% CI=1.2-6.8) and lack of physical activity (OR=4.4;95%CI=2.0-9.7) were independently associated with the risk for malnutrition. CONCLUSIONS: Low education and lack of physical activity in late-life may affect the risk for malnutrition in the elderly. Further studies are needed to clarify the cause-effect relationship between lack of physical activity and malnutrition.
Subject(s)
Educational Status , Leisure Activities , Malnutrition/epidemiology , Self Disclosure , Social Class , Aged , Cross-Sectional Studies , Female , Humans , Italy/epidemiology , Logistic Models , Male , Nutritional Status , Risk Factors , Socioeconomic FactorsSubject(s)
Antibiotics, Antineoplastic/adverse effects , Epirubicin/adverse effects , Heart/drug effects , Ventricular Dysfunction, Left/chemically induced , Antibiotics, Antineoplastic/therapeutic use , Breast Neoplasms/blood , Breast Neoplasms/drug therapy , Epirubicin/therapeutic use , Female , Humans , Middle Aged , Natriuretic Peptide, Brain/blood , Prospective Studies , Radionuclide Ventriculography , Ultrasonography , Ventricular Dysfunction, Left/blood , Ventricular Dysfunction, Left/diagnostic imagingABSTRACT
To define a vegetative state (VS) as permanent is to declare its irreversibility. In 1994 a North-American multidisciplinary task force, by extensively analysing the literature, concluded that the recovery of consciousness from a post-traumatic or non-traumatic VS is unlikely after 12 and 3 months respectively. These conclusions did not obtain unanimous consent. The term permanent was in fact inappropriately used to define either the loss of consciousness or of function. Furthermore, patients with traumatic brain injury have been shown to recover the consciousness in a substantial greater percentage (6-7%) than previously appreciated (1.6%). This is hardly compatible with the peremptoriness of the term permanent, which should be used only in case of certainty. Ancillary tests are important in defining the prognosis. Patients in deep coma after an anoxic brain injury can be predicted as having a poor prognosis (death or permanent VS) with 100% specificity within one week of the insult. Magnetic resonance of the brain can predict patients at high risk of permanent VS within 6-8 weeks of a traumatic brain injury. In conclusion, the available evidence does not permit to define with certainty the patients who have irremediably lost their consciousness after a devasting brain insult. However, it seems possible to reliably define the risk of severe disability. Whether or not this knowledge might or should be used to titrate the intensity of therapeutic approach is to be defined. In this respect, it is central the definition of what an "acceptable outcome" is, certainly not an exclusive medical attribution.
Subject(s)
Persistent Vegetative State/physiopathology , Humans , Persistent Vegetative State/rehabilitation , PrognosisSubject(s)
Antimetabolites, Antineoplastic/adverse effects , Deoxycytidine/analogs & derivatives , Respiratory Distress Syndrome/chemically induced , Ventricular Fibrillation/chemically induced , Adenocarcinoma/drug therapy , Adenocarcinoma/secondary , Aged , Antimetabolites, Antineoplastic/administration & dosage , Deoxycytidine/adverse effects , Deoxycytidine/therapeutic use , Fatal Outcome , Heart/drug effects , Humans , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Lung/drug effects , Male , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/pathology , Respiratory Distress Syndrome/therapy , Ventricular Fibrillation/therapy , GemcitabineABSTRACT
The aim of this study was to identify the specific somatostatin receptors expressed by several tumors, utilizing 111In-octreotide, a long acting somatostatin analogue. We studied two different groups of patients: the first group was composed of 21 patients suffering from different pituitary adenomas, while the second group consisted of 12 patients affected by several different neoplasms. In vivo scintigraphy showed pentetreotide receptors only in large GH-secreting adenomas and several macroadenomas. Concerning the endocrine activity of the adenomas, 111In-octreotide showed a good sensibility in detecting GH-secreting tumors. In the second group, 111In-octeotride proved to be a good diagnostic tool to show carcinoid lesions which were missed by other complementary methodologies.
