Medication management ability in older patients: Time for a reappraisal

Background. Adhering to drug regimens is a complex and multidimensional task. Elderly patients usually take an average of seven drugs but most fail to adhere to the prescribed regimen. Several performance-based instruments have been developed to assess a patient\u2019s capacity to manage drugs but with inconsistent results. Aims. The aim of the study was to assess the prevalence of impaired medical management capacity in a sample of the oldest old hospitalized elderly patients and the main clinical factors associated with potential unintentional non-adherence. Methods. Forty-six consecutive patients were enrolled in the geriatric transitional care unit of Ospedale Policlinico San Martino, Genoa, Italy. All patients received an abbreviated comprehensive geriatric assessment and a hand grip assessment for sarcopenia. Patients\u2019 medication management ability was assessed by administering the DRUGS tool 48-74 hours before hospital discharge. Results. The results showed a negative correlation between age and total medication management score. A positive correlation was detected between functional status, cognitive status, and medication management score. Hand grip strength < 9 kg correlated with a significant worsening of medical management capacity. In contrast, multiple morbidities and the mean number of drugs were not associated with the medical management score. Conclusions. This preliminary study indicated that drug management capacity mainly relies on frailty markers, such as functional status, sarcopenia, and cognitive performance. Further studies are warranted to identify a subset of medical parameters that can accurately predict impaired medical management ability early, particularly for highly vulnerable elderly patients

Behavioral disturbances in dementia and beyond: Time for a new conceptual frame?

Alzheimer\u2019s disease and vascular dementia are estimated to be the most common causes of dementia, although mixed dementia could represent the most prevalent form of dementia in older adults aged more than 80 years. Behavioral disturbances are common in the natural history of dementia. However, so far, there is a paucity of studies that investigated the causal association between behavioral psychological symptoms of dementia and dementia sub-types, due to the high heterogeneity of methodology, study design and type of clinical assessment. To understand the scant evidence on such a relevant clinical issue, it could be hypothesized that a new shifting paradigm could result in a better identification of the relationship between behavioral disturbances and dementia. This narrative review provides an update of evidence on the behavioral patterns associated with different dementia sub-types and offers a potential future perspective as common ground for the development of new translational studies in the field of behavioral disturbances in dementia and the appropriateness of psychoactive treatments

Resistin: A reappraisal

Abstract From a biological point of view, aging can be considered a progressive inability of an organism to react to stress, maintain homeostasis, and survive unfavourable changes during post-maturational life. The expression of several adipokines changes during aging and for some changes, a role in the onset of chronic disease and frailty has been proposed. Among adipokines, resistin was shown in recent studies to play a key role in aging. Resistin is a small secreted protein that regulates glucose metabolism in mammalians. High resistin levels induce insulin resistance and exert proinflammatory effects. Consistently, resistin has been shown to play a pivotal role in various metabolic, inflammatory, and autoimmune diseases. Herein, the role of resistin as a molecular link between aging and age-related conditions was reviewed and the clinical implications of this knowledge discussed

Thermodynamic analysis of adsorption models of phenol in liquid phase on different activated carbons

This paper studies the thermodynamic aspects of the processes of adsorption of phenol from dilute aqueous solutions on different commercial carbons, evaluating how to optimize the removal of this persistent contaminant. Two powdered activated carbons from two different companies were used: Tetrahedron Carbon (Andes Chemistry Lab., Mendoza, Argentina), and Norit (Norit Americas Inc., USA). Both specific surface areas were measured by means of the BET method. The adsorbate was high purity solid phenol (Fluka ® ≥ 99.5%). Experimental isotherms were determined at 293 K, 303 K and 313 K. The Freundlich and Sips theoretical models were used to fit the experimental data. Freundlich isotherm slightly diverges with the experimental results for higher equilibrium concentrations. Thermodynamic parameters were calculated and correlated with the adsorption behaviours. The values of the thermodynamic parameters obtained indicate an exothermic and spontaneous process for both carbons, and mainly for Norit. This is due to the fact that there might be chemically activated regions on the surface of the Norit carbon, which give rise to combined mechanisms of physisorption and chemisorption.Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicada

Thermodynamic analysis of adsorption models of phenol in liquid phase on different activated carbons

This paper studies the thermodynamic aspects of the processes of adsorption of phenol from dilute aqueous solutions on different commercial carbons, evaluating how to optimize the removal of this persistent contaminant. Two powdered activated carbons from two different companies were used: Tetrahedron Carbon (Andes Chemistry Lab., Mendoza, Argentina), and Norit (Norit Americas Inc., USA). Both specific surface areas were measured by means of the BET method. The adsorbate was high purity solid phenol (Fluka ® ≥ 99.5%). Experimental isotherms were determined at 293 K, 303 K and 313 K. The Freundlich and Sips theoretical models were used to fit the experimental data. Freundlich isotherm slightly diverges with the experimental results for higher equilibrium concentrations. Thermodynamic parameters were calculated and correlated with the adsorption behaviours. The values of the thermodynamic parameters obtained indicate an exothermic and spontaneous process for both carbons, and mainly for Norit. This is due to the fact that there might be chemically activated regions on the surface of the Norit carbon, which give rise to combined mechanisms of physisorption and chemisorption.Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicada

IgG4 related disease in elderly: A case report

IgG4-related systemic disease (IgG4-RSD) is an emerging autoimmune disorder that may affect several organs, with signs of organ fibrosis, storiform masses for hystopathological plasmacellular infiltration and plasmatic elevation of IgG4. This clinical condition frequently occurs in the sixth decade and may be considered an autoimmunity of the elderly; the disease may have a smouldering course with frequent misdiagnosis for the co-occurrence of comorbidity and clinical complexity. The present case report describes the clinical case of an 81 years old woman admitted to the geriatric ward for remittent fever and functional decline. The past clinical history reported an isolated CT scan suggestive of retroperitoneal fibrosis of unknown origin with and a drug regimen that included chronic corticosteroids (prednisone 5 mg oad). The in hospital diagnostic workout demonstrated the presence of a thoracic aneurysm. Several possible diagnoses among inflammatory, autoimmune (connective tissue disease, vasculitis, sarcoidosis, amyloidosis), infectious (mycotic) or neoplastic conditions were ruled out, as well as any drug association with higher risk of retroperitoneal fibrosis. Thus, the clinical hypothesis of an IgG4 chronic periaortitis was formulated due to the co-occurrence of all the three major components: the presence of a retroperitoneal fibrosis, IgG4 related abdominal aortitis and peryaneurysmal fibrosis. Patient\u2019s comorbidity did not allow performing the histological analysis. The present clinical case is original and adds knowledge to the 76 cases of thoracic aortitis due to IgG4 systemic disease out of the 3482 cases of disease reported so far. Further clinical investigation is needed to provide a homogeneous diagnostic workout for tailored early therapeutic intervention on the single geriatric patient. Moreover, a growing awareness of the disease is needed, especially in geriatrics, to providing a better standard of care and to improving the disease clinical knowledge and managemen

Preparación, caracterización y estudios texturales de carbones activados obtenidos a partir de yerba mate y su utilización para la remoción de fenol y Cr (III) en solución acuosa

Se sintetizaron carbones activados partiendo de yerba mate con distintos tratamientos químicos y físicos y se los estudió para la remoción de fenol y Cr(III) en soluciones acuosas. Se realizó la caracterización textural de los materiales carbonosos y se calculó área específica BET; volumen, tamaño y distribución tamaños de poros y posibles heterogeneidades de la superficie, empleandoteoría de funcionales de densidad (NL/QSDFT); tipoy cantidad de grupos oxigenados superficiales por el método de Boehm; punto de carga cero; microscopía electrónica de barrido y espectroscopia infrarroja por transformada de Fourier en celda de reflectancia difusa. Los datos experimentales de la adsorción de fenoly Cr(III) en solución acuosa fueron interpretados empleando modelo de Sips. El mayor área superficial corresponde a la muestra CYMFQ con 454 m2.g-1. CYMF resultó ser la más adecuada para la remoción de fenol, con capacidad máxima de 0.0040 mol.g-1. CYMFQ resultó ser la más adecuada para la remoción de cromo con capacidad máxima de 9.66 mg.g-1

Effects of competition on acute phase proteins and lymphocyte subpopulations - oxidative stress markers in eventing horses

The aim of the study was to evaluate markers of the acute phase response (APR) in eventing horses by measuring acute phase proteins (APP) (haptoglobin, Hp, and serum amyloid A, SAA), lysozyme, protein adducts such as pentosidine‐like adducts (PENT), malondialdehyde adducts (MDA), hydroxynonenal adducts (HNE) and total advanced glycation/glycoxidation end products (AGEs), complete blood count and lymphocyte subpopulations (CD4+, CD8+ and CD21+) both at rest and at the end of an eventing competition. Blood samples were collected from eight Warmblood horses (medium age 10 ± 3) during an official national 2‐day event competition at rest (R) and 10 min after the arrival of the cross‐country test on the second day. Exercise caused a significant increase in red blood cell number, haemoglobin, packed cell volume, neutrophils, white blood cell and lymphocyte number; however, these values remained within the normal range. The CD4+ and CD8+ cells significantly increased, whereas the CD21+ lymphocytes decreased; a significant increase in serum SAA, lysozyme and protein carbonyl derivates was also observed. Two‐day event causes significant changes in APR markers such as lysozyme, protein carbonyl derivates (HNE, AGEs, PENT) and lymphocyte subpopulations. The data support the hypothesis that 2‐day event may alter significantly APR markers. Limitations of the study were the relatively small sample size and sampling time conditioned by the official regulations of the event. Therefore, further studies are needed to investigate the time required for recovery to basal values in order to define the possible effects on the immune function of the athlete horse

Thermodynamic analysis of adsorption models of phenol in liquid phase on different activated carbons

This paper studies the thermodynamic aspects of the processes of adsorption of phenol from dilute aqueous solutions on different commercial carbons, evaluating how to optimize the removal of this persistent contaminant. Two powdered activated carbons from two different companies were used: Tetrahedron Carbon (Andes Chemistry Lab., Mendoza, Argentina), and Norit (Norit Americas Inc., USA). Both specific surface areas were measured by means of the BET method. The adsorbate was high purity solid phenol (Fluka ® ≥ 99.5%). Experimental isotherms were determined at 293 K, 303 K and 313 K. The Freundlich and Sips theoretical models were used to fit the experimental data. Freundlich isotherm slightly diverges with the experimental results for higher equilibrium concentrations. Thermodynamic parameters were calculated and correlated with the adsorption behaviours. The values of the thermodynamic parameters obtained indicate an exothermic and spontaneous process for both carbons, and mainly for Norit. This is due to the fact that there might be chemically activated regions on the surface of the Norit carbon, which give rise to combined mechanisms of physisorption and chemisorption.Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicada