Effects of 6 weeks of traditional resistance training or high intensity interval resistance training on body composition, aerobic power and strength in healthy young subjects: A randomized parallel trial

Consistent practice of physical activity has well known positive effects on general health; however, time for exercise remains one major barrier for many. An acute bout of high intensity interval resistance training (HIIRT) increases acute resting energy expenditure (REE) and decreases respiratory ratio (RR), suggesting its potential role on weight loss and increased fatty acid oxidation. The aim of this study was to test the long-term effect of HIIRT on body composition, lipid profile and muscle strength using a randomized parallel trial. Twenty healthy young adults (22.15 ± 1.95 years) were randomized to perform either a HIIRT (N = 11) protocol, consisting of three sets of 6 repetitions at 6 repetition maximum (RM) and then 20 seconds of rest between repetitions until exhaustion repeated for 3 times with 2’30″ rest between sets or a traditional training (TRT, N = 9) protocol of 3 sets of 15 reps with 75 sec of rest between sets. Body composition, resting energy metabolism, aerobic capacity, muscle strength and blood measurements were taken before and after 8 weeks of training. Both protocols enhanced muscle strength, but only HIIRT improved endurance strength performance (+22.07%, p < 0.05) and lean body mass (+2.82%, p < 0.05). REE and RR were unaltered as lipid profile. HIIRT represents a valid training method to improve muscle strength and mass, but its role on body weight control was not confirmed

Tophaceous gout in the elderly: a clinical case review

Gout is the most common cause of arthritis in the elderly. Its incidence among older people has risen worldwide due to an increase in risk factors such as renal diseases, metabolic syndrome, and a diet rich in purines. In older age, tophaceous gout may affect different joints from its classical presentation, due to other concomitant musculoskeletal diseases, but specific data on its epidemiology and clinical aspects in the elderly are limited to a few case reports. The present review focuses on the distinctive aspects of tophaceous gout in the elderly, revisiting all our clinical cases seen from 1990 to December 2011. Our findings indicate that: tophaceous gout can affect several joints in the elderly, including some unusual sites; its incidence is similar in both genders in the elderly even if the latency period between its initial diagnosis and the onset of tophi is higher in men; and vertebral localizations are rising and often solitary. The components of metabolic syndrome are the most common medical conditions associated with tophaceous gout. In conclusion, tophaceous gout in the elderly may be a growing medical problem and cause of disability in years, partly because of the new sites involve

A rare case of sepsis due to Corynebacterium macginleyi from central venous catheter in an elderly woman

Corynebacterium macginleyi is a gram positive rod that causes especially ocular infections: since now only six elderly cases of extraocular infection are described. A 76 years old bedridden woman with a central venous catheter was hospitalized for 10 days of persistent fever. She was treated before with vancomicin and then with imipenem. The clinical conditions improved and the patient was discharged after two weeks of hospitalization. Among recognised risk factors for this infection the advanced age, indwelling devices and immunosuppression seem the most important. On the other hand, the antibiotics of choice are glycopeptides while the association of another antibiotic is recommended in our opinion only in severe clinical manifestatio

The Potential Role of miRNAs in Cognitive Frailty

Frailty is an aging related condition, which has been defined as a state of enhanced vulnerability to stressors, leading to a limited capacity to meet homeostatic demands. Cognitive impairment is also frequent in older people, often accompanying frailty. Age is the main independent risk factor for both frailty and cognitive impairment, and compelling evidence suggests that similar age-associated mechanisms could underlie both clinical conditions. Accordingly, it has been suggested that frailty and cognitive impairment share common pathways, and some authors proposed “cognitive frailty” as a single complex phenotype. Nevertheless, so far, no clear common underlying pathways have been discovered for both conditions. microRNAs (miRNAs) have emerged as key fine-tuning regulators in most physiological processes, as well as pathological conditions. Importantly, miRNAs have been proposed as both peripheral biomarkers and potential molecular factors involved in physiological and pathological aging. In this review, we discuss the evidence linking changes of selected miRNAs expression with frailty and cognitive impairment. Overall, miR-92a-5p and miR-532-5p, as well as other miRNAs implicated in pathological aging, should be investigated as potential biomarkers (and putative molecular effectors) of cognitive frailty

Relationship between increased endogenous parathormone levels and bone density in postmenopausal women treated with bisphosphonates

Bisphosphonates increase bone mineral density (BMD) and also increase parathyroid hormone (PTH): the rule of increased PTH on BMD is not well known. The aim of our study was to assess the relationship between endogenous PTH levels and BMD after 18 months of antiresorptive therapy in a group of post-menopausal women with normal baseline PTH levels. A retrospective study was conducted on 62 women with normal baseline PTH levels (mean age 62.7 +/- 8.6 years) who underwent dual-energy X-ray absorptiometry, thoraciclumbar radiography, and blood and urine sampling at the baseline and after 18 months. All patients were treated with bisphosphonates and received calcium and vitamin D3 supplementation. In the whole group, after 18 months, mean BMD improved both at lumbar spine (0.53 +/- 0.09 vs. 0.49 +/- 0.09 g/cm(2); P0 or 50), the group with Delta PTH>0 had higher percentage increase of BMD at spine (8.0 +/- 9% vs. 4 +/- 7.5 %; P<0.001) and at total hip (3 +/- 9% vs. 0.49 +/- 8.9%; P<0.001) while the bone alkaline phosphatase significantly decreased (-11.80 +/- 2.19 vs. -4.05 +/- 3.08 ug/L; P<0.001) than the other group. Increased endogenous PTH levels seems to be associated with a higher BMD increase in patients treated with bisphosphonates for postmenopausal osteoporosis. The increase of PTH must be clarified by further investigation

Prophylactic or therapeutic doses of heparins for COVID-19 infection? A retrospective study

Background: Coronavirus disease 19 (COVID-19) is a global outbreak. COVID-19 patients seem to have relevant coagulative abnormalities, even if they are not typical of disseminated intravascular coagulopathy (DIC) of the kind seen in septicaemia. Therefore, anticoagulant therapy with heparins is increasing in interest for a clinical approach to these patients, particularly if older. Studies comparing if prophylactic doses are more effective than therapeutic ones are still missing. Methods: Data were collected in the Geriatric Section of the Dolo Hospital, ULSS 3 \u201cSerenissima\u201d, Venice from 31st March to 01st May 2020. Heparins (calciparin, fondaparinux, enoxaparine) were divided into prophylactic or therapeutic doses. People previously treated with oral anticoagulants were removed. Vital status was assessed using administrative data. Cox\u2019s regression analysis, adjusted for potential confounders, was used for assessing the strength of the association between heparins and mortality. The data were reported as hazard ratio (HR) with 95% confidence intervals (CIs). Results: 81 older people (mean age 84.1&nbsp;years; females = 61.9%) were included. No significant differences in terms of demographic and clinical characteristics emerged between people treated with prophylactic or therapeutic doses, including age, gender, X-rays findings or severity of disease. Therapeutic doses were not associated to a better survival rate (HR 1.06; 95% CI 0.47\u20132.60; p = 0.89), even after adjusting for 15 confounders related to mortality (HR 0.89; 95% CI 0.30\u20132.71; p = 0.84). Conclusions: Our paper indicates that in older people affected by COVID-19 there is no justification for using therapeutic doses instead of prophylactic ones, having a similar impact on mortality risk. \ua9 2020, Springer Nature Switzerland AG

A case of naturally evolving gout in an elderly man

Gout is a common disorder in adults that can lead to severe organ decline, disability and impaired quality of life due to the formation of periarticular tophi. We report a case of massive tophaceous gout in a 78-year-old man with a 16-year-long history of untreated disease. The patient gradually became disabled, his renal function deteriorated, and he finally died of sepsis. Our case demonstrates that chronic gout not only affects the joints, but is also associated with organ function decline and can, even nowadays, lead to death

Influenza vaccination reduces dementia risk: A systematic review and meta-analysis

Animal models have indicated that influenza vaccination may prevent or delay the onset of dementia. However, the epidemiological evidence in human beings is still limited. Given this background, this systematic review and meta-analysis aimed to summarize the current state of the art of observational studies investigating the association between influenza vaccination and the risk of dementia. We searched Scopus and Pubmed/Medline until 24 September 2021 for studies investigating the risk of dementia by influenza vaccination status. After adjustment for potentially important confounding variables, data were reported as risk ratios (RRs) with 95% confidence intervals (CIs). Among 273 articles initially evaluated, five were included for a total of 292,157 older people free from dementia at baseline (mean age=75.5 ± 7.4 years; 46.8% females). All studies were of high quality. Over a mean follow-up of 9 years, influenza vaccination mitigated the risk of dementia (RR=0.97; 95%CI: 0.94–1.00; I2 =99%). This association held after adjustment for a mean of nine potential confounders (RR=0.71; 95%CI: 0.60–0.94; I2 =95.9%). In sensitivity analysis, removing one study from the adjusted analyses, the adjusted RR remained similar (RR= 0.67; 95%CI: 0.63–0.70), but the heterogeneity disappears (I2 =0%). In conclusion, influenza vaccination was associated with a significantly lower risk of dementia suggesting that the vaccination of older people against influenza may also aid in the prevention of dementia. © 2021 Elsevier B.V

The relationship between different settings of medical service and incident frailty

Background: Some studies have reported a potential association between usual source of health care and disability, but no one has explored the association with frailty, a state of early and potential reversible disability. We therefore aimed to explore the association between older persons' self-reported usual source of health care at baseline and the onset of frailty. Methods: Information regarding usual source of health care was captured through self-report and categorized as 1) private doctor's office, 2) public clinic, 3) Health Maintenance Organization (HMO), or 4) hospital clinic/emergency department (ED). Frailty was defined using the Study of Osteoporotic Fracture (SOF) index as the presence of at least two of the following criteria: (i) weight loss ≥5% between baseline and any subsequent follow-up visit; (ii) inability to do five chair stands; and (iii) low energy level according to the SOF definition. Multivariable Cox's regression analyses, calculating hazard ratios (HRs) with 95% confidence intervals (CIs), were undertaken. Results: Of the 4292 participants (mean age: 61.3), 58.7% were female. During the 8-year follow-up, 348 subjects (8.1% of the baseline population) developed frailty. Cox's regression analysis, adjusting for 14 potential confounders showed that, compared to those using a private doctor's office, people using a public clinic for their care had a significantly higher risk of developing frailty (HR = 1.56; 95%CI: 1.07–2.70), similar to those using HMO (HR = 1.48; 95%CI: 1.03–2.24) and those using a hospital/ED (HR = 1.76; 95%CI: 1.03–3.02). Conclusion: Participants receiving health care from sources other than private doctors are at increased risk of frailty, highlighting the need for screening for frailty in these health settings. © 2018 Elsevier Inc