The burgeoning geriatric population worldwide has resulted in an unprecedented challenge to the cardiology community. Cardiovascular disease is the major cause of morbidity and mortality in the elderly population, but...The burgeoning geriatric population worldwide has resulted in an unprecedented challenge to the cardiology community. Cardiovascular disease is the major cause of morbidity and mortality in the elderly population, but its recognition and management are characteristically confounded by substantial comorbidities, polypharmacy, and other complexities of care, not encountered in younger cardiac patients.展开更多
Objective The predictive value of the metabolic syndrome （MetS） for mortality from all-cause and cardiovascular disease （CVD） in the Chinese population is unclear. The aim of this present study was to compare MetS...Objective The predictive value of the metabolic syndrome （MetS） for mortality from all-cause and cardiovascular disease （CVD） in the Chinese population is unclear. The aim of this present study was to compare MetS with its individual components as predictors of mortality in Chinese elderly adults. Methods A cohort of 1,535 subjects （994 men and 541 women） aged 50 years or older was selected from employees of a machinery factory in 1994 and followed until 2009. Cox models were used to estimate the hazard ratios （HRs） predicted by MetS according to the harmonized defmition and by its individual components. Results The baseline prevalence of MetS was 28.0% in men and 48.4% in women. During a median follow-up of 15 years, 414 deaths occurred, of these, 153 participants died from CVD. Adjusted for age and gender, the HRs of mortality from all-cause and CVD in participants with MetS were 1.47 （95% confidence interval （CI）： 1.20-1.80） and 1.96 （95%CI： 1.42-2.72）, respectively, compared with those without MetS. Non-significant higher risk of CVD mortality was seen in those with one or two individual components （HR = 1.22, 95%CI： 0.59-2.50; fir = 1.82, 95%CI： 0.91-3.64, respectively）, while a substantially higher risk of CVD mortality only appeared in those with 3, 4, or 5 components （H_R = 2.81-3.72）, compared with those with no components. On evaluating the MetS components individually, we found that, independent of MetS, only hypertension and impaired glucose predicted higher mortality. Conclusions The number of positive MetS components seems no more informative than classifying （dichotomous） MetS for CVD risks assessment in this Chinese cohort.展开更多
Background Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined ef- fect on mortality in stages of hypertension according to updated clinical guidelines am...Background Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined ef- fect on mortality in stages of hypertension according to updated clinical guidelines among dderly population is unclear. Methods We fol- lowed a cohort of 6100 residents （2600 males and 3500 females） of Kangwha County, Korea, ranging from 55 to 99 year-olds as of March 1985, for all-cause and cardiovascular mortality for 20.8 years until December 31, 2005. Mortality data were collected through telephone calls and visits （to 1991）, and were confirmed by death record matching with the National Statistical Office （1992-2005）. Hazard ratios were calculated for all-cause and cardiovascular mortality by resting heart rate and hypertension defined by Eighth Joint National Committee crite- ria using the Cox proportional hazard model after controlling for confounding factors. Results The hazard ratios associated with resting heart rate 〉 80 beats/min were higher in hypertensive men compared with normotensives with heart rate of 61-79 beats/rain, with hazard ratios values of 1.43 （95% CI： 1.00-1.92） on all-cause mortality for prehypertension, 3.01 （95% CI： 1.07-8.28） on cardiovascular mortality for prehypertension, and 8.34 （95% CI： 2.52-28.19） for stage 2 hypertension. Increased risk （HR： 3.54, 95% CI： 1.16-9.21） was observed among those with both a resting heart rate 〉 80 beats/rain and prehypertension on cardiovascular mortality in women. Conclusions Indi- viduals with coexisting elevated resting heart rate and hypertension, even in prehypertension, have a greater risk for all-cause and cardiovas- cular mortality compared to those with elevated resting heart rate or hypertension alone. These findings suggest that elevated resting heart rate should not be regarded as a less serious risk factor in elderly hypertensive patients.展开更多
Aortic stenosis （AS） has become a leading cause of morbidity and mortality among a growing population of older adults. The number of elderly patients with severe symptomatic AS requiring aortic valve replacement has...Aortic stenosis （AS） has become a leading cause of morbidity and mortality among a growing population of older adults. The number of elderly patients with severe symptomatic AS requiring aortic valve replacement has been significantly increasing in recent years.展开更多
The transition to old age involves a series of events, including those that are objectively defined and others that individuals evaluate subjectively. The aim of this review study is the investigation, highlighting an...The transition to old age involves a series of events, including those that are objectively defined and others that individuals evaluate subjectively. The aim of this review study is the investigation, highlighting and information about the multiple effects of cancer on the elderly. An extensive review of the relevant literature was performed via electronic databases （Medline, PubMed, CINAHL and Google scholar） and Greek and international journals. The exclusion criterion for the articles was the language other than Greek and English. The risk of cancer increases with age, resulting in an increased number of older people seeking treatment. Caring for elderly people with cancer differs from that of adults because of the biological differences in tumor, coexistence of morbidity, as well as various psychosocial issues that can affect the effectiveness of treatment. Despite the reduction in the mortality rate of cancer, the aging of the population is accompanied by a significant increase in the overall number of cancer patients. The main nursing care goal is the limitation of biological and atomic forces and characteristics＇ loss and the adjustment of the elderly to the different phases of the disease. Finally, in the later stages of the disease, the nurse often provides just palliative care.展开更多
Ticks are important vectors for the transmission of pathogens including viruses.The viruses carried by ticks also known as tick-borne viruses(TBVs),contain a large group of viruses with diverse genetic properties and ...Ticks are important vectors for the transmission of pathogens including viruses.The viruses carried by ticks also known as tick-borne viruses(TBVs),contain a large group of viruses with diverse genetic properties and are concluded in two orders,nine families,and at least 12 genera.Some members of the TBVs are notorious agents causing severe diseases with high mortality rates in humans and livestock,while some others may pose risks to public health that are still unclear to us.Herein,we review the current knowledge of TBVs with emphases on the history of virus isolation and identification,tick vectors,and potential pathogenicity to humans and animals,including assigned species as well as the recently discovered and unassigned species.All these will promote our understanding of the diversity of TBVs,and will facilitate the further investigation of TBVs in association with both ticks and vertebrate hosts.展开更多
Objective： To evaluate the role of high risk factors in octogenarians and nonagenarians with hip trauma, which may lead to excessive mortality and morbidity postoperatively. Methods： Fifty-four octogenarians and non...Objective： To evaluate the role of high risk factors in octogenarians and nonagenarians with hip trauma, which may lead to excessive mortality and morbidity postoperatively. Methods： Fifty-four octogenarians and nonagenarians patients were enrolled in the study, receiving surgical repair of hip fracture in our hospital from January 2006 to January 2010. High risk factors were recorded preoperatively in detail. Complications and survival state were followed up by telephone for 2 years postoperatively. All the data were analyzed by Chi-square test with SPSS 13.0. Results： Twenty-six males （48.1%）, aged from 80 to 94 years with a mean age of 84.2 years, and twenty-eight females （51.9%）, aged from 80 to 95 years with a mean age of 83.4 years, were presented in the cohort study. The hip traumas were caused by daily slight injuries （52 cases） and car accidents （2 cases）, respectively. Twenty-eight patients （51.9%） with femoral neck fracture while 26 patients （48.1%） with intertrochanteric fracture were diagnosed through an anterior-posterior pelvic radiophotograph. In this series, 39 patients （72.2%） suffered from one or more comorbidities preoperatively. The morbidity was 48.1% and the major cause was urinary tract infection, while a significant difference was noted between females and males. The mortality was 20.4% with a predominant cause of acute renal failure. Conclusions： The gender should be considered as a critical high risk factor in octogenarians and nonagenarians with hip trauma postoperatively. Females are more likely to suffer complications postoperatively, which is especially obvious in senile patients over 80 years （P〈0.05）. Urinary tract infection is the most frequent complication after hip surgery, followed by low limb embolism and malnutrition. The mortality is dramatically greater in patients over 80 years old than those below, and major causes are acute renal failure, multiple organ dysfunction syndrome and mental deterioration. Multidisciplinary consultations and mental assessment are encouraged in patients over 80 years old after hip trauma and surgery. Hip fractures in octogenarians and nonagenarians deserve special attention because of their advanced age and comorbidities.展开更多
文摘The burgeoning geriatric population worldwide has resulted in an unprecedented challenge to the cardiology community. Cardiovascular disease is the major cause of morbidity and mortality in the elderly population, but its recognition and management are characteristically confounded by substantial comorbidities, polypharmacy, and other complexities of care, not encountered in younger cardiac patients.
基金This study was supported by the National Natural Science Foundation of China，Ministry of Science and Technology of China，National Department Public Benefit Research Foundation by Ministry of Health of China
文摘Objective The predictive value of the metabolic syndrome （MetS） for mortality from all-cause and cardiovascular disease （CVD） in the Chinese population is unclear. The aim of this present study was to compare MetS with its individual components as predictors of mortality in Chinese elderly adults. Methods A cohort of 1,535 subjects （994 men and 541 women） aged 50 years or older was selected from employees of a machinery factory in 1994 and followed until 2009. Cox models were used to estimate the hazard ratios （HRs） predicted by MetS according to the harmonized defmition and by its individual components. Results The baseline prevalence of MetS was 28.0% in men and 48.4% in women. During a median follow-up of 15 years, 414 deaths occurred, of these, 153 participants died from CVD. Adjusted for age and gender, the HRs of mortality from all-cause and CVD in participants with MetS were 1.47 （95% confidence interval （CI）： 1.20-1.80） and 1.96 （95%CI： 1.42-2.72）, respectively, compared with those without MetS. Non-significant higher risk of CVD mortality was seen in those with one or two individual components （HR = 1.22, 95%CI： 0.59-2.50; fir = 1.82, 95%CI： 0.91-3.64, respectively）, while a substantially higher risk of CVD mortality only appeared in those with 3, 4, or 5 components （H_R = 2.81-3.72）, compared with those with no components. On evaluating the MetS components individually, we found that, independent of MetS, only hypertension and impaired glucose predicted higher mortality. Conclusions The number of positive MetS components seems no more informative than classifying （dichotomous） MetS for CVD risks assessment in this Chinese cohort.
文摘Background Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined ef- fect on mortality in stages of hypertension according to updated clinical guidelines among dderly population is unclear. Methods We fol- lowed a cohort of 6100 residents （2600 males and 3500 females） of Kangwha County, Korea, ranging from 55 to 99 year-olds as of March 1985, for all-cause and cardiovascular mortality for 20.8 years until December 31, 2005. Mortality data were collected through telephone calls and visits （to 1991）, and were confirmed by death record matching with the National Statistical Office （1992-2005）. Hazard ratios were calculated for all-cause and cardiovascular mortality by resting heart rate and hypertension defined by Eighth Joint National Committee crite- ria using the Cox proportional hazard model after controlling for confounding factors. Results The hazard ratios associated with resting heart rate 〉 80 beats/min were higher in hypertensive men compared with normotensives with heart rate of 61-79 beats/rain, with hazard ratios values of 1.43 （95% CI： 1.00-1.92） on all-cause mortality for prehypertension, 3.01 （95% CI： 1.07-8.28） on cardiovascular mortality for prehypertension, and 8.34 （95% CI： 2.52-28.19） for stage 2 hypertension. Increased risk （HR： 3.54, 95% CI： 1.16-9.21） was observed among those with both a resting heart rate 〉 80 beats/rain and prehypertension on cardiovascular mortality in women. Conclusions Indi- viduals with coexisting elevated resting heart rate and hypertension, even in prehypertension, have a greater risk for all-cause and cardiovas- cular mortality compared to those with elevated resting heart rate or hypertension alone. These findings suggest that elevated resting heart rate should not be regarded as a less serious risk factor in elderly hypertensive patients.
文摘Aortic stenosis （AS） has become a leading cause of morbidity and mortality among a growing population of older adults. The number of elderly patients with severe symptomatic AS requiring aortic valve replacement has been significantly increasing in recent years.
文摘The transition to old age involves a series of events, including those that are objectively defined and others that individuals evaluate subjectively. The aim of this review study is the investigation, highlighting and information about the multiple effects of cancer on the elderly. An extensive review of the relevant literature was performed via electronic databases （Medline, PubMed, CINAHL and Google scholar） and Greek and international journals. The exclusion criterion for the articles was the language other than Greek and English. The risk of cancer increases with age, resulting in an increased number of older people seeking treatment. Caring for elderly people with cancer differs from that of adults because of the biological differences in tumor, coexistence of morbidity, as well as various psychosocial issues that can affect the effectiveness of treatment. Despite the reduction in the mortality rate of cancer, the aging of the population is accompanied by a significant increase in the overall number of cancer patients. The main nursing care goal is the limitation of biological and atomic forces and characteristics＇ loss and the adjustment of the elderly to the different phases of the disease. Finally, in the later stages of the disease, the nurse often provides just palliative care.
基金supported by Science and Technology Basic Work Program (2013FY113500) from the Ministry of Science and Technology of Chinathe European Union’s Horizon 2020 Research and Innovation Programme (No.653316)+1 种基金the Strategic Bio-resource Service Network Plan and Building the Biogenetic Resource Preserving Capacity Program from the Chinese Academy of Sciences (ZSSB-002)the Hubei Provincial program of scientific and technological condition platform establishment (2017BEC003)
文摘Ticks are important vectors for the transmission of pathogens including viruses.The viruses carried by ticks also known as tick-borne viruses(TBVs),contain a large group of viruses with diverse genetic properties and are concluded in two orders,nine families,and at least 12 genera.Some members of the TBVs are notorious agents causing severe diseases with high mortality rates in humans and livestock,while some others may pose risks to public health that are still unclear to us.Herein,we review the current knowledge of TBVs with emphases on the history of virus isolation and identification,tick vectors,and potential pathogenicity to humans and animals,including assigned species as well as the recently discovered and unassigned species.All these will promote our understanding of the diversity of TBVs,and will facilitate the further investigation of TBVs in association with both ticks and vertebrate hosts.
基金This study was supported by a grant from National Natural Science Foundation of China （No.10872078 and 10832012） and Development and Reform Commission of Jilin Province
文摘Objective： To evaluate the role of high risk factors in octogenarians and nonagenarians with hip trauma, which may lead to excessive mortality and morbidity postoperatively. Methods： Fifty-four octogenarians and nonagenarians patients were enrolled in the study, receiving surgical repair of hip fracture in our hospital from January 2006 to January 2010. High risk factors were recorded preoperatively in detail. Complications and survival state were followed up by telephone for 2 years postoperatively. All the data were analyzed by Chi-square test with SPSS 13.0. Results： Twenty-six males （48.1%）, aged from 80 to 94 years with a mean age of 84.2 years, and twenty-eight females （51.9%）, aged from 80 to 95 years with a mean age of 83.4 years, were presented in the cohort study. The hip traumas were caused by daily slight injuries （52 cases） and car accidents （2 cases）, respectively. Twenty-eight patients （51.9%） with femoral neck fracture while 26 patients （48.1%） with intertrochanteric fracture were diagnosed through an anterior-posterior pelvic radiophotograph. In this series, 39 patients （72.2%） suffered from one or more comorbidities preoperatively. The morbidity was 48.1% and the major cause was urinary tract infection, while a significant difference was noted between females and males. The mortality was 20.4% with a predominant cause of acute renal failure. Conclusions： The gender should be considered as a critical high risk factor in octogenarians and nonagenarians with hip trauma postoperatively. Females are more likely to suffer complications postoperatively, which is especially obvious in senile patients over 80 years （P〈0.05）. Urinary tract infection is the most frequent complication after hip surgery, followed by low limb embolism and malnutrition. The mortality is dramatically greater in patients over 80 years old than those below, and major causes are acute renal failure, multiple organ dysfunction syndrome and mental deterioration. Multidisciplinary consultations and mental assessment are encouraged in patients over 80 years old after hip trauma and surgery. Hip fractures in octogenarians and nonagenarians deserve special attention because of their advanced age and comorbidities.
