Coagulation areas produced by cool-tip radiofrequency ablation and microwave ablation using a device to decrease back-heating effects: a prospective pilot study.

Purpose: To compare the ablation area produced by a single application of a microwave ablation (MWA) system, equipped with a miniaturized device on the tip of the antenna entrapping reflected microwaves, with that produced by an internally cooled radiofrequency ablation (RFA) system.

Materials And Methods: Forty patients with primary or secondary inoperable liver tumors, selected to undergo percutaneous thermal ablation, were randomly assigned to MWA or RFA procedure. The ablation areas produced by a single application of MWA (ablation time 10 min) or RFA (ablation time 12 min) energy were assessed by contrast-enhanced ultrasonography immediately after the end of the procedure.

Interventional approaches in VTE treatment (vena cava filters, catheter-guided thrombolysis, thrombosuction).

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most common cardiovascular pathology after coronary disease and cerebrovascular diseases and is responsible for significant morbidity and mortality in the general population. Full-dose anticoagulation is the standard therapy for VTE, both the acute phase and the prolonged treatment. The latest guidelines of the American College of Chest Physicians recommend treatment with a full-dose of unfractionated heparin (UFH), low-molecular-weight-heparin (LMWH), fondaparinux, vitamin K antagonist (VKA), or systemically administered thrombolytics for most of the patients with objectively confirmed VTE.

Predictive value of the Short Physical Performance Battery following hospitalization in older patients.

Background: Hospitalization represents a stressful and potentially hazardous event for older persons. We evaluated the value of the Short Physical Performance Battery (SPPB) in predicting rates of functional decline, rehospitalization, and death in older acutely ill patients in the year after discharge from the hospital.

Methods: Prospective cohort study of 87 patients aged 65 years and older who were able to walk and with a Mini-Mental State Examination score ≥ 18 and admitted to the hospital with a clinical diagnosis of congestive heart failure, pneumonia, chronic obstructive pulmonary disease, or minor stroke.

Potentially inappropriate drug prescriptions and risk of hospitalization among older, Italian, nursing home residents: the ULISSE project.

Background: Potentially inappropriate medications in older patients increase the risk of adverse drug events, which are an important cause of hospital admission and death among hospitalized patients. Little information is available about the prevalence of potentially inappropriate drug prescriptions (PIDPs) and the related health adverse outcomes among nursing home (NH) residents.

Objective: To estimate the prevalence of PIDPs and the association with adverse outcomes in NH residents.

Lipoprotein(a), inflammation, and peripheral arterial disease in a community-based sample of older men and women (the InCHIANTI study).

Lipoprotein(a) (Lp[a]) may represent an independent risk factor for peripheral arterial disease of the lower limbs (LL-PAD), but prospective data are scant. We estimated the association between baseline Lp(a) with prevalent and incident LL-PAD in older subjects from the InCHIANTI Study. LL-PAD, defined as an ankle-brachial index <0.

Type 2 diabetes and risk for functional decline and disability in older persons.

As older adults make up an increasingly lager proportion of the diabetic population, the spectrum of chronic diabetes complications will change and expand. Aside from the traditional long-term complications, diabetes has been associated with excess risk of a number of clinical conditions typical of the geriatric population, including functional decline, physical disability, falls, fractures, cognitive impairment, and depression. These conditions are common and profoundly affect the quality of life of older patients with diabetes.

Variability in the prescription of cardiovascular medications in older patients: correlates and potential explanations.

In western countries approximately a quarter of the population is 65 years and older. People in this age group often have several coexisting medical problems and take multiple drugs, and older people receive the greatest proportion of dispensed prescriptions. The prevalence of cardiovascular diseases, the leading cause of death and a major cause of physical and cognitive disability, increases steeply with increasing age.

Development of CRIteria to assess appropriate Medication use among Elderly complex patients (CRIME) project: rationale and methodology.

Pharmacological treatment of complex older adults with comorbidities, multiple impairments in function, cognition, social status and geriatric syndromes represents a challenge for prescribing physicians and often results in a high rate of iatrogenic illnesses. Clinical guidelines are commonly used to indicate appropriate prescription, but they are often based on the results of clinical trials that are conducted on young subjects with a low level of complexity. Therefore, the recommendations of clinical guidelines may be difficult to apply to older complex adults.

Moderate alcohol intake and risk of functional decline: the Health, Aging, and Body Composition study.

Objectives: To investigate the prospective relationship between alcohol consumption and incident mobility limitation.

Design: Cohort study.

Setting: The Health Aging and Body Composition study, conducted in Memphis, Tennessee, and Pittsburgh, Pennsylvania.

Performance-based functional assessment in older hospitalized patients: feasibility and clinical correlates.

Background: Functional evaluation is a cornerstone of multidimensional geriatric assessment; however, little is known of the clinical value of standardized performance-based assessment in the acute care setting. The aim of this study was to evaluate the clinical correlates and short-term predictive value of the Short Physical Performance Battery (SPPB) in older patients admitted to the hospital for an acute medical event.

Methods: We enrolled 92 women and men 65 years old or older who were able to walk, who had a Mini-Mental State Examination (MMSE) score > or =18, and who were admitted to the hospital with a clinical diagnosis of congestive heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), or minor stroke.

Physical function, physical activity and recent falls. Results from the "Invecchiamento e Longevità nel Sirente (ilSIRENTE)" Study.

Background And Aims: A fall is a common and traumatic event in the life of older persons. This study aims: 1) to explore the relationship between recent falls and measures of physical function in elders, and 2) to examine the role played by habitual physical activity in the relationship between recent falls and physical function.

Methods: We used baseline data from 361 community-dwelling persons aged > or = 80 years (mean age 85.

Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons: the health, aging, and body composition study.

Background: Cross-sectional studies find an elevated prevalence of depression among subjects with diabetes mellitus (DM). The causal mechanisms and temporal sequence of this association have not been clearly delineated. This study investigated the prospective relationship between DM and depressive symptoms.

Characteristics of nondisabled older patients developing new disability associated with medical illnesses and hospitalization.

Objective: To identify demographic, clinical, and biological characteristics of older nondisabled patients who develop new disability in basic activities of daily living (BADL) during medical illnesses requiring hospitalization.

Design: Longitudinal observational study.

Setting: Geriatric and Internal Medicine acute care units.

Association between anemia and physical disability in older patients: role of comorbidity.

Background And Aims: In older persons, anemia is a common medical disorder and is often associated with comorbidity and poor health outcomes. We evaluated the relationship between anemia and physical disability in a sample of older hospitalized patients, taking into account the role of comorbidity.

Methods: Cross-sectional analysis of the baseline data of the Italian Group of Pharmacoepidemiology in the Elderly Study.

Physical exercise and comorbidity. Results from the Fitness and Arthritis in Seniors Trial (FAST).

Background And Aims: Physical exercise is associated with a lower risk of disability. The impact of comorbidity on the benefits from physical exercise has not been clearly investigated. Elders with comorbidity may benefit from physical exercise to preserve physical function.

Effects of a physical activity intervention on measures of physical performance: Results of the lifestyle interventions and independence for Elders Pilot (LIFE-P) study.

Background: The Short Physical Performance Battery (SPPB), which includes walking, balance, and chair stands tests, independently predicts mobility disability and activities of daily living disability. To date, however, there is no definitive evidence from randomized controlled trials that SPPB scores can be improved. Our objective was to assess the effect of a comprehensive physical activity (PA) intervention on the SPPB and other physical performance measures.

Anemia, physical disability, and survival in older patients with heart failure.

Background: Anemia is common in congestive heart failure, and it has been associated with poor prognosis. The effect of anemia on functional ability in heart failure has not been described. We evaluated the relationship of anemia, physical disability, and survival in patients with heart failure.

Total serum cholesterol and recovery from disability among hospitalized older adults.

Background: The association between total serum cholesterol and health outcomes among older adults is controversial. The objective of the present study was to determine within a cohort of acutely hospitalized disabled elderly patients whether total cholesterol predicts recovery from disability in basic activities of daily living (ADL).

Methods: Patients (3150) 65 years old or older admitted to 81 acute care units in Italy and presenting with ADL disability at hospital admission were included in this study.

Impact of inflammation on the relationship among alcohol consumption, mortality, and cardiac events: the health, aging, and body composition study.

Background: Uncertainty remains about the overall survival benefit of alcohol consumption and the mechanisms underlying the cardioprotective effect of light to moderate alcohol intake. Recent evidence suggests an anti-inflammatory effect of light to moderate alcohol consumption. We investigated the relationship of alcohol intake with all-cause mortality and cardiac events and evaluated whether this relationship is mediated or modified by inflammatory markers.

Anemia and cognitive performance in hospitalized older patients: results from the GIFA study.

Background: Anemia represents a major risk factor for adverse health-related events in older persons. The aim of this study was to evaluate the association between hemoglobin levels/anemia and cognitive function in hospitalized older persons.

Method: Data are from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study.

Anemia and recovery from disability in activities of daily living in hospitalized older persons.

Objectives: To evaluate the predictive value of hemoglobin levels upon hospital admission on recovery from activity of daily living (ADL) disability during hospital stay in older patients.

Design: Longitudinal observational study.

Setting: Geriatric and internal medicine acute care units.

Frailty syndrome and skeletal muscle: results from the Invecchiare in Chianti study.

Background: Frailty is a common condition in elders and identifies a state of vulnerability for adverse health outcomes.

Objective: Our objective was to provide a biological face validity to the well-established definition of frailty proposed by Fried et al.

Design: Data are from the baseline evaluation of 923 participants aged > or =65 y enrolled in the Invecchiare in Chianti study.

Executive function correlates with walking speed in older persons: the InCHIANTI study.

Objectives: To study the association between performance on psychological tests of executive function and performance on lower extremity tasks with different attentional demands in a large sample of nondemented, older adults.

Design: Cross-sectional study.

Setting: Community-based.