Global Sex Disparity Of Covid-19: A Descriptive Review Of Sex Hormones And Consideration For The Potential Therapeutic Use Of Hormone Replacement Therapy In Older Adults

The 2019-2020 SARS-related coronavirus-2 (SARS-CoV-2) pandemic has brought unprecedented challenges to healthcare sectors around the world. As of November 2020, there have been over 64 million confirmed cases and approaching 2 million deaths globally. Despite the large number of positive cases, there are very limited established standards of care and therapeutic options available. To date, there is still no Food and Drug Administration (FDA) approved vaccine for COVID-19, although there are several options in various clinical trial stages. Herein, we have performed a global review evaluating the roles of age and sex on COVID-19 hospitalizations, ICU admissions, deaths in hospitals, and deaths in nursing homes. We have identified a trend in which elderly and male patients are significantly affected by adverse outcomes. There is evidence suggesting that sex hormone levels can influence immune system function against SARS-CoV-2 infection, thus reducing the adverse effects of COVID-19. Since older adults have lower levels of these sex hormones, we therefore speculate, within rational scientific context, that sex steroids, such as estrogen and progesterone, needs further consideration for use as alternative therapeutic option for treating COVID-19 elderly patients. To our knowledge, this is the first comprehensive article evaluating the significance of sex hormones in COVID-19 outcomes in older adults

Quality of Life as an outcome in Alzheimer's disease and other dementias- obstacles and goals

<p>Abstract</p> <p>Background</p> <p>The number of individuals at risk for dementia will probably increase in ageing societies as will the array of preventive and therapeutic options, both however within limited economic resources. For economic and medical purposes valid instruments are required to assess disease processes and the efficacy of therapeutic interventions for different forms and stages of illness. In principal, the impact of illness and success of an intervention can be assessed with biomedical variables, e.g. severity of symptoms or frequency of complications of a disease. However, this does not allow clear judgement on clinical relevance or comparison across different diseases.</p> <p>Discussion</p> <p>Outcome model variables such as quality of life (QoL) or health care resource utilization require the patient to appraise their own well-being or third parties to set preferences. In Alzheimer's disease and other dementias the evaluation process performed by the patient is subject to the disease process itself because over progress of the disease neuroanatomical structures are affected that mediate evaluation processes.</p> <p>Summary</p> <p>Published research and methodological considerations thus lead to the conclusion that current QoL-instruments, which have been useful in other contexts, are ill-suited and insufficiently validated to play a major role in dementia research, decision making and resource allocation. New models integrating biomedical and outcome variables need to be developed in order to meet the upcoming medical and economic challenges.</p

Thallium concentration levels in hair, urine and saliva in a contaminated population in the Northwest of Italy

Water-soluble thallium (Tl) compounds are highly toxic for most living organisms. Tl toxicity to mammals is higher than that of Hg(II), Cd(II) and Pb(II), because it chemically behaves as a heavy metal and because, due to its charge and size, it is an analogous of potassium. Thus, it has been notified as an important EPA priority pollutant. Thallium maximum contaminant level (MCL) in drinking water defined by EPA is 2 μg/L and 0.1 μg/L in China (CNS 2006) [1]. A recent study showed the presence of Tl at high concentrations (up to 9000 μg/L) in groundwater near Valdicastello Carducci (Italy). The contamination is supposedly due to acid drainage from abandoned mining areas. In September 2014 Tl contamination was also found in water intended for human consumption distributed in the same area. We report here the preliminary results of a non-invasive population-based study that aimed to quantify the Tl levels in about 100 urine and 330 hair samples from the population of Valdicastello Carducci and Pietrasanta, Italy. Several saliva samples were also collected in order to explore this matrix as exposure indicator. All samples were analyzed by ICP-MS. Tl values found in urine and hair samples were correlated with Tl concentration levels found in tap water in the living area of each citizen and with his/her habits (use of tap water both to drink and to cook or only to cook). The kinetics of decay of Tl concentration in urine samples was also investigated. About 50% of urine samples had a Tl concentration value above 0,5 microgram/L; about 70% of hair samples had a Tl concentration > 10 ng/g (2 ±1 ng/g is the value of not exposed people). The high values of thallium found in hair samples suggest a long-term exposure

Thallium determination in contaminated water and biological samples: a population-based case–control study in Valdicastello Carducci and Pietrasanta (Lucca, Italy)

Water-soluble thallium (Tl) compounds are highly toxic for most living organisms. Tl toxicity to mammals is higher than that of Hg(II), Cd(II) and Pb(II), because it chemically behaves as a heavy metal and because, due to its charge and size, it is an analogous of potassium. Thus, it has been notified as an important EPA priority pollutant. Thallium maximum contaminant level (MCL) in drinking water defined by EPA is 2 μg/L and 0.1 μg/L in China (CNS 2006) [1]. A recent study showed the presence of Tl at high concentrations (up to 9000 μg/L) in groundwater near Valdicastello Carducci (Italy). The contamination is supposedly due to acid drainage from abandoned mining areas. In September 2014 Tl contamination was also found in water intended for human consumption distributed in the same area. We report here the preliminary results of a non-invasive population-based study that aimed to quantify the Tl levels in about 100 urine and 330 hair samples from the population of Valdicastello Carducci and Pietrasanta, Italy. Several saliva samples were also collected in order to explore this matrix as exposure indicator. All samples were analyzed by ICP-MS. Quality assurance of the results was guaranteed analyzing two certified reference material (water and urine from NIST). Tl values found in urine and hair samples were correlated with Tl concentration levels found in tap water in the living area of each citizen and with his/her habits (use of tap water both to drink and to cook or only to cook). The kinetics of decay of Tl concentration in urine samples was also investigated. About 50% of samples had a Tl concentration value above 0,5 microgram/L; about 70% of hair samples had a Tl concentration > 10 ng/g (2 1 ng/g is the value of not exposed people). The high values of thallium found in hair samples suggest a long-term exposure

Atividade física e sintomas neuropsiquiátricos em pacientes com demência de Alzheimer Physical activity and neuropsychiatric symptoms in elderly with Alzheimer's dementia

Na demência de Alzheimer (DA) é comum a presença de sintomas neuropsiquiátricos resultantes de mudanças anatômicas e bioquímicas no cérebro. O objetivo deste estudo foi realizar uma revisão sistemática dos estudos que investigaram a relação entre atividade física e sintomas neuropsiquiátricos na DA. Efetuou-se uma pesquisa nas bases de dados: Academic Search Premier, Biological Abstracts, Medline, PsycINFO, Pubmed, Scielo, Science Direct, Sport Discus e Web of Science, utilizando-se as seguintes palavras - chave e operadores boleanos: (Neuropsychiatric disturbances OR Neuropsychiatric symptoms OR Neuropsychological disturbances OR Aberrant behavior OR Aberrant behaviour OR Behavior disturbances OR Behaviour disturbances OR Behavior management OR Behaviour management OR Disruptive behavior OR Disruptive behaviour) AND (Alzheimer) AND (Exercise OR Motor intervention OR training OR Physical activity OR fitness), além de referências cruzadas dos artigos selecionados. Foram encontrados oito estudos que preencheram os critérios de inclusão. Concluiu-se que bons resultados têm sido evidenciados para os distúrbios de agitação e sono de pacientes com DA. Entretanto então há um consenso de qual o melhor tipo de atividade para estes pacientes.<br>Is common the presence of neuropsychiatric symptoms in Alzheimer's disease (AD), this is resulted of anatomical and biochemical changes in the brain. The objective of present study was to look for papers relating physical activity and neuropsychiatric symptoms through a systematic review. The following data bases was accessed: Academic Search Premier, Biological Abstracts, Medline, PsycINFO, Pubmed, Scielo, Science direct on line, Sport Discus and Web of Science, using the following key-words: (Neuropsychiatric disturbances OR Neuropsychiatric symptoms OR Neuropsychological disturbances OR Aberrant behavior OR Aberrant behaviour OR Behavior disturbances OR Behaviour disturbances OR Behavior management OR Behaviour management OR Disruptive behavior OR Disruptive behaviour) AND (Alzheimer) AND (Exercise OR Motor intervention OR training OR Physical activity OR fitness), besides crossing the references in the selected articles. Eight studies had filled the inclusion criteria. It was possible to conclude there are evidences of positive results for agitation and sleep disturbances in patients with AD. However, there's no consensus of what kind of activity is better for these patients