A risk score for predicting peripheral arterial disease in individuals 75 years or older

BACKGROUND: The prevalence of peripheral arterial disease (PAD) in the elderly is high. Most are asymptomatic and the sensitivity of the physical exam is low. In Brazil, little is known in regard to PAD risk factors in the elderly. OBJECTIVES: To identify risk factors for PAD among elderly individuals (> 75 years) in the community and to develop a prediction score. METHODS: Cross-sectional, prospective, community-based study nested within a cohort study (Epidoso). A total of 176 individuals were assessed. PAD was defined as an ankle-brachial index 18 points defined the high risk individuals and yielded sensitivity, specificity, positive predictive value and negative predictive value of 85.9%, 71.4%, 63.2% and 89.9%, respectively. Receiver-operator characteristic analysis yielded area under curve of 85%, indicating excellent discrimination and goodness-of-fit statistics indicated excellent calibration (p=0.639). CONCLUSION: Because of its good performance, the proposed score can become a simple and useful tool to identify elderly community residents at higher risk of PAD who should be considered for further investigation.FUNDAMENTO: A prevalência de doença arterial periférica (DAP) é elevada entre os idosos. A maioria é assintomática e o exame físico pouco sensível. No Brasil, os fatores associados à DAP em idosos são pouco conhecidos. OBEJETIVOS: Identificar os fatores associados à presença de doença arterial periférica (DAP) em idosos (> 75 anos) da comunidade e desenvolver um escore de predição da doença. MÉTODOS: Estudo transversal, aninhado em uma coorte prospectiva (Epidoso). Foram avaliados 176 idosos (> 75 anos) da comunidade. A presença de DAP foi definida por meio do índice tornozelo-braquial 75 anos) da comunidade com alto risco para DAP e que mereceriam investigação mais detalhada.Universidade Federal de São Paulo (UNIFESP)Hospital Israelita Albert EinsteinUNIFESPSciEL

Mild Systemic Oxidative Stress in the Subclinical Stage of Alzheimer's Disease

Alzheimer's disease (AD) is a late-onset, progressive degenerative disorder that affects mainly the judgment, emotional stability, and memory domains. AD is the outcome of a complex interaction among several factors which are not fully understood yet; nevertheless, it is clear that oxidative stress and inflammatory pathways are among these factors. 65 elderly subjects (42 cognitively intact and 23 with probable Alzheimer's disease) were selected for this study. We evaluated erythrocyte activities of superoxide dismutase, catalase, and glutathione peroxidase as well as plasma levels of total glutathione, alpha-tocopherol, beta-carotene, lycopene, and coenzyme Q10. These antioxidant parameters were confronted with plasmatic levels of protein and lipid oxidation products. Additionally, we measured basal expression of monocyte HLA-DR and CD-11b, as well as monocyte production of cytokines IL1-alpha, IL-6, and TNF-alpha. AD patients presented lower plasmatic levels of alpha-tocopherol when compared to control ones and also higher basal monocyte HLA-DR expression associated with higher IL-1 alpha production when stimulated by LPS. These findings support the inflammatory theory of AD and point out that this disease is associated with a higher basal activation of circulating monocytes that may be a result of alpha-tocopherol stock depletion.Univ São Paulo, Inst Quim, BR-05508900 São Paulo, BrazilUNIFESP, Inst Ciencias Ambientais Quim Farmaceut, BR-09972270 Diadema, SP, BrazilFMABC, Dept Hematol & Oncol, BR-09060650 Santo Andre, SP, BrazilUniversidade Federal de São Paulo, Dept Med, BR-04021001 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med Prevent, BR-04021001 São Paulo, BrazilUNIFESP, Inst Ciencias Ambientais Quim Farmaceut, BR-09972270 Diadema, SP, BrazilUniversidade Federal de São Paulo, Dept Med, BR-04021001 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med Prevent, BR-04021001 São Paulo, BrazilWeb of Scienc

Improving Strength and Fatigue Resistance in Post-Polio Syndrome Individuals with REAC Neurobiological Treatments

Post-Polio Syndrome (PPS) is a chronic condition characterized by the emergence of new symptoms and functional decline in individuals who previously had polio. Despite advances in medical understanding, management of PPS remains challenging. This study aimed to evaluate the use of neurobiological modulation treatments using Radio Electric Asymmetric Conveyer (REAC) technology on fatigue and muscle strength. An open-label study was conducted with 17 patients submitted to four neuromodulation protocols: Neuro Postural Optimization (NPO), Neuro Psycho Physical Optimization (NPPO), Neuro Psycho Physical Optimization—Cervico Brachial (NPPO-CB), and Neuromuscular Optimization (NMO). The Time Up and Go (TUG) test, Handgrip Strength Test, and Revised Piper Fatigue Scale (RPFS) were used to assess participants’ fatigue and muscle strength, being applied at the beginning and end of each protocol. The results obtained from the improvement in strength, physical endurance, and particularly the RPFS behavioral dimension, affective dimension, and psychological sensory dimension, through the utilization of REAC neurobiological modulation treatments, highlight this correlation. These results suggest that these treatments could be considered as a potential therapeutic approach for PPS