Anul 2012 - anul longevităţii active la aniversarea a 60 de ani de geriatrie şi gerontologie în România

Institutul Naţional de Geriatrie şi Gerontologie „Ana Aslan” Bucureşti, UMF „Carol Davila” Bucureşti, I-a Conferinţă Internaţională de Geriatrie şi Gerontologie din Republica Moldova 21 septembrie 201

Psychological characteristics of elderly patients with oral diseases

The proportion of older people continues to grow worldwide. This, along with an increase in the prevalence of oral diseases, will significantly challenge health and social policy planners. Oral health is often neglected in the elderly and oral diseases associated with aging are complex, adversely affecting the quality of life. Identifying the psychopathology or the type of deviation from normality in the elderly, involves the assessment of psychological health and the operation with the psychological health major symptomatology. One of the dentist’s difficulties may be the recognition of a particular disorder in the case of an individual who is accusing a suffering state. The communication between the doctor and the elderly patient, which is the key in geriatric practice, is not optional, because it helps to achieve an efficient medical act in an appropriate, relevant and satisfactory manner for the care of the elderly patient. Discussion with the patient should be appropriate to the level of understanding of the individual elderly person. The patient’s cooperation is essential for any type of dental treatment. The biopsychosocial concept is fundamental to find an optimal treatment for oral diseases. The oral health influences the mental health of patients, changing their self-esteem, mood and satisfaction, even influencing their social life and quality of life. This is an important factor that has a direct influence on the general health and quality of life of older people, fundamental factors for “healthy aging”

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Receptor of advanced glycation end products and cardiovascular risk in elderly with type 2 diabetes mellitus

The interaction of Advanced Glycation End products (AGEs) and their specific receptor, Receptor for Advanced Glycation End products (RAGE) play an important role in diabetes and vascular complications. Engagement of RAGE by AGEs leads to activation of cellular signaling pathways and vascular dysfunction. The soluble RAGE (sRAGE) acts as a decoy receptor for AGEs. The aim of this study was to evaluate the soluble RAGE in elderly subjects with T2DM and its relationships with glycoxidative, inflammatory and cardiovascular risk markers. The serum AGEs, sRAGE, interleukine- 6 (IL-6), lipid profile, glycemic status, uric acid, creatinine and cardiovascular risk markers were determined in elderly subjects with type 2 diabetes mellitus (T2DM, N=72, 75±4 years old) and aged-match healthy subjects (N=15, 76±3 years old). Significant higher levels of AGEs and AGEs/sRAGE ratio concomitantly with significant lower levels of sRAGE were pointed out in elderly subjects with T2DM as compared to control. The values of AGEs/sRAGE ratio were significantly positively associated (P<0.05) with atherogenic, inflammatory and cardiovascular risk markers and significantly negatively with anti-atherogenic lipoproteins (P<0.05). The multivariate regression analyses showed that atherogenic index was an independent predictor of sRAGE levels and AGEs/sRAGE ratio values. The associations of soluble RAGE and the AGEs/sRAGE ratio with atherogenic and inflammatory markers could reflect the protective role of soluble variants of RAGE in atherosclerosis and diabetes vascular complications

Effects of health risk assessment and counselling on physical activity in older people: A pragmatic randomised trial

<div><p>Background</p><p>Interventions to increase physical activity (PA) among older community-dwelling adults may be enhanced by using multidimensional health risk assessment (HRA) as a basis for PA counselling.</p><p>Methods</p><p>The study was conducted among nondisabled but mostly frail persons 65 years of age and older at an ambulatory geriatric clinic in Bucharest, Romania. From May to July 2014, 200 participants were randomly allocated to intervention and control groups. Intervention group participants completed an initial HRA questionnaire and then had monthly counselling sessions with a geriatrician over a period of six months that were aimed at increasing low or maintaining higher PA. Counselling also addressed the older persons’ concomitant health risks and problems. The primary outcome was PA at six months (November 2014 to February 2015) evaluated with the International Physical Activity Questionnaire.</p><p>Results</p><p>At baseline, PA levels were similar in intervention and control groups (median 1089.0, and 1053.0 MET [metabolic equivalent of task] minutes per week, interquartile ranges 606.0–1401.7, and 544.5–1512.7 MET minutes per week, respectively). Persons in the intervention group had an average of 11.2 concomitant health problems and risks (e.g., pain, depressive mood, hypertension). At six months, PA increased in the intervention group by a median of 180.0 MET minutes per week (95% confidence interval (CI) 43.4–316.6, p = 0.01) to 1248.8 MET minutes per week. In the control group, PA decreased by a median of 346.5 MET minutes per week (95% CI 178.4–514.6, p<0.001) to 693.0 MET minutes per week due to a seasonal effect, resulting in a difference of 420.0 MET minutes per week (95% CI 212.7–627.3, p< 0.001) between groups.</p><p>Conclusion</p><p>The use of HRA to inform individualized PA counselling is a promising method for achieving improvements in PA, and ultimately health and longevity among large groups of community-dwelling older persons.</p><p>Trial registration</p><p>International Standard Randomized Controlled Trial Number: <a target="_blank">ISRCTN11166046</a></p></div

Distinctive Under-Expression Profile of Inflammatory and Redox Genes in the Blood of Elderly Patients with Cardiovascular Disease

Purpose: Chronic low-grade inflammation and oxidative stress are present in most of the pathologic mechanisms underlying non-communicable diseases. Inflammation and redox biomarkers might therefore have a value in disease prognosis and therapy response. In this context, we performed a case–control study for assessing in whole blood the expression profile of inflammation and redox-related genes in elderly subjects with various comorbidities. Patients and Methods: In the blood of 130 elderly subjects with various pathologies (cardiovascular disease, hypertension, dyslipidemia including hypercholesterolemia, type 2 diabetes mellitus), kept under control by polyvalent disease-specific medication, we investigated by pathway-focused qRT-PCR a panel comprising 84 inflammation-related and 84 redox-related genes. Results: The study highlights a distinctive expression profile of genes critically involved in NF-κB-mediated inflammation and redox signaling in the blood of patients with cardiovascular disease, characterized by significant down-regulation of the genes NFKB2, NFKBIA, RELA, RELB, AKT1, IRF1, STAT1, CD40, LTA, TRAF2, PTGS1, ALOX12, DUOX1, DUOX2, MPO, GSR, TXNRD2, HSPA1A, MSRA, and PDLIM1. This gene expression profile defines the transcriptional status of blood leukocytes in stable disease under medication control, without discriminating between disease- and therapy-related changes. Conclusion: The study brings preliminary proof on a minimally invasive strategy for monitoring disease in patients with cardiovascular pathology, from the point of view of inflammation or redox dysregulation in whole blood.Research and publication of the present study was funded by the Romanian Ministry of Education and Research through the European Regional Development Fund, Competitiveness Operational Program 2014–2020 [the REDBRAIN project, ID: P_37_732] and through Programme 1 – Development of the national researchdevelopment system [grant 7PFE/2018

Study group characteristics at baseline.

<p>Study group characteristics at baseline.</p

Study CONSORT flow diagram.

<p>Study CONSORT flow diagram.</p

Self-reported reasons for not increasing physical activity among the subgroup of participants with no intention to increase physical activity at baseline.

<p>Self-reported reasons for not increasing physical activity among the subgroup of participants with no intention to increase physical activity at baseline.</p