Falls in Older Adults With Cancer: Evaluation by Oncology Providers

Falls in older adults are common. Screening for falls is quick, simple, and important because falls increase the risk of morbidity and mortality in older patients with cancer. The aim of this study was to evaluate oncology providers' recognition of and response to falls in older patients with cancer

Geriatric assessment as an aide to understanding falls in older adults with cancer

In older adults, falls are a common cause of functional decline, institutionalization, and reduced quality of life. This study (1) investigates the prevalence of falls in a large sample of community-dwelling older adults with a cancer diagnosis and (2) evaluates the association of falls with domains of comprehensive geriatric assessment (CGA) that pertain to falls risk

Effect of Cytotoxic Chemotherapy on Markers of Molecular Age in Patients With Breast Cancer

Senescent cells, which express p16 INK4a, accumulate with aging and contribute to age-related pathology. To understand whether cytotoxic agents promote molecular aging, we measured expression of p16 INK4a and other senescence markers in breast cancer patients treated with adjuvant chemotherapy

Case Studies in Nanocluster Synthesis and Characterization: Challenges and Opportunities.

Atomically precise nanoclusters (APNCs) are an emerging area of nanoscience. Their monodispersity and well-defined arrangement of capping ligands facilitates the interrogation of their fundamental physical properties, allowing for the development of structure-function relationships, as well as their optimization for a variety of applications, including quantum computing, solid-state memory, catalysis, sensing, and imaging. However, APNCs present several unique synthetic and characterization challenges. For example, nanocluster syntheses are infamously low yielding and often generate complicated mixtures. This combination of factors makes nanocluster purification and characterization more difficult than that of typical inorganic or organometallic complexes. Yet, while this fact is undoubtedly true, the past lessons learned from the characterization of inorganic complexes are still useful today. In this Account, we discuss six case studies taken from the recent literature in an attempt to identify common challenges and pitfalls encountered in APNC synthesis and characterization. For example, we show that several reducing agents employed in APNC synthesis, including the commonly used reagent NaBH4, do not always behave as anticipated. Indeed, we highlight one case where NaBH4 reduces the ligand and not the metal center, and other cases where NaBH4 acts as a Brønstead base instead of a reducing agent. In addition, we have identified several instances where the use of phase transfer agents, which were added to mediate APNC formation, played no role in the nanocluster synthesis, and likely made the isolation of pure material more difficult. We have also identified several cases of cluster misidentification driven by spurious or ambiguous characterization data, most commonly collected by mass spectrometry. To address these challenges, we propose that the nanocluster community adopt a standard protocol of characterization, similar to those used by the organometallic and coordination chemistry communities. This protocol requires that many complementary techniques be used in concert to confirm formulation, structure, and analytical purity of APNC samples. Two techniques that are underutilized in this regard are combustion analysis and NMR spectroscopy. NMR spectroscopy, in particular, can provide information on purity and formulation that are difficult to collect with any other technique. X-ray absorption spectroscopy is another powerful method of nanocluster characterization, especially in cases where single crystals for X-ray diffraction are not forthcoming. Chromatographic techniques can also be extremely valuable for assessing purity, but are rarely used during APNC characterization. Our goal with this Account is to begin a discussion with respect to the best protocols for nanocluster synthesis and characterization. We believe that embracing a standard characterization protocol would make APNC synthesis more reliable, thereby accelerating their integration into a variety of technologies

Geriatric Assessment‐Identified Deficits in Older Cancer Patients With Normal Performance Status

BACKGROUND. We investigated whether a brief geriatric assessment (GA) would identify important patient deficits that could affect treatment tolerance and care outcomes within a sample of older cancer patients rated as functionally normal (80%–100%) on the Karnofsky performance status (KPS) scale. METHODS. Cancer patients aged ≥65 years were assessed using a brief GA that included both professionally and patient-scored KPS and measures of comorbidity, polypharmacy, cognition, function, nutrition, and psychosocial status. Data were analyzed using descriptive statistics and multivariable logistic regression. RESULTS. The sample included 984 patients: mean age was 73 years (range: 65–99 years), 74% were female, and 89% were white. GA was conducted before (23%), during (41%), or after (36%) treatment. Overall, 54% had a breast cancer diagnosis (n = 528), and 46% (n = 456) had cancers at other sites. Moreover, 81% of participants (n = 796) had both professionally and self-rated KPS ≥80, defined as functionally normal, and those patients are the focus of analysis. In this subsample, 550 (69%) had at least 1 GA-identified deficit, 222 (28%) had 1 deficit, 140 (18%) had 2 deficits, and 188 (24%) had ≥3 deficits. Specifically, 43% reported taking ≥9 medications daily, 28% had decreased social activity, 25% had ≥4 comorbidities, 23% had ≥1 impairment in instrumental activities of daily living, 18% had a Timed Up and Go time ≥14 seconds, 18% had ≥5% unintentional weight loss, and 12% had a Mental Health Index score ≤76. CONCLUSION. Within this sample of older cancer patients who were rated as functionally normal by KPS, GA identified important deficits that could affect treatment tolerance and outcomes