ABSTRACT
BACKGROUND: Elderly people are exposed to an increased load of stressful events and neuro-hormonal stimulation is a key finding in metabolic syndrome and its related disorders. AIMS: To determine the role of cortisol in elderly subjects, with or without metabolic syndrome (MetS), by means of a national multicentre observational study, AGICO (AGIng and Cortisol). METHODS: From 2012 to 2017, the AGICO study enrolled n.339 subjects (aged > 65), after obtaining their informed consent. The investigators assessed a cardio-metabolic panel (including electrocardiogram, carotid ultrasonography and echocardiography), the presence of MetS (on Adult Treatment Panel III criteria), a neurological examination (including brain imaging), and cortisol activity (using a consecutive collection of diurnal and nocturnal urine). RESULTS: In the patients presenting with MetS, the standardized diurnal and nocturnal cortisol excretion rates were 210.7 ± 145.5 and 173.7 ± 118.1 (mean ± standard deviation) µg/g creatinine/12 h; in those without MetS, the standardized diurnal and nocturnal cortisol excretion rates were 188.7 ± 92.7 and 144.1 ± 82.3 µg/g creatinine/12 h, respectively (nocturnal urinary cortisol in patients with MetS versus those without MetS p = 0.05, female patients with MetS vs female patients without MetS, p < 0.025). A significant positive correlation was found between the CRP levels and both the diurnal and nocturnal urinary cortisol levels with r = 0.187 (p < 0.025) and r = 0.411 (p < 0.00000001), respectively. DISCUSSION: The elderly patients with MetS showed a trend towards increased standardized nocturnal cortisol excretions, with particular regard to the female subjects. CONCLUSION: The positive correlation between cortisol excretion and low-grade inflammation suggests a common mechanism driving both hormonal and inflammatory changes.
Subject(s)
Hydrocortisone/metabolism , Inflammation/metabolism , Metabolic Syndrome/metabolism , Aged , Aged, 80 and over , Echocardiography , Female , Humans , Inflammation/complications , Male , Metabolic Syndrome/complicationsABSTRACT
PURPOSE: To compare ocular surface temperature (OST) measures in patients with central retinal vein occlusion (CRVO) and controls. METHODS: Thirty-six patients with unilateral CRVO and 54 healthy volunteers were included in the study. OST was evaluated by infrared thermography. RESULTS: In CRVO eyes and in fellow, nonaffected eyes, OST values were lower than in controls (p<0.05). Ischemic CRVO eyes showed lower temperatures than nonischemic ones. CONCLUSIONS: Infrared thermography may be helpful in the management of patients with CRVO.
Subject(s)
Body Temperature/physiology , Eye/physiopathology , Retinal Vein Occlusion/physiopathology , Aged , Female , Humans , Male , Middle Aged , Prognosis , ThermographyABSTRACT
Over a 25-year period, 58 patients underwent evaluation or surgical treatment of coronary artery fistulas, or both, at our institution. Twenty-one patients had major associated cardiac defects, either congenital or acquired, and 9 had multiple fistulas. Fistulas to the left heart were unusual. Exertional angina and dyspnea were the most common presenting symptoms, but most young patients were asymptomatic. Seventy percent had audible heart murmurs. No operative deaths occurred in patients with isolated fistulas. Coronary artery fistulas cause symptoms due to "coronary steal" with resulting myocardial ischemia and, more rarely, marked left-to-right or left-to-left shunting. Definitive surgical correction is safe and effective, with good long-term results.
