Preoperative geriatric assessment of urological patients: a narrative review.

Purpose Of Review: The proportion of older people is increasing disproportionately. The age between 60 and 65 years is seen as the transition to 'old age'. Frailty is a risk factor for morbidity, mortality, and complications in the context of medical interventions or adverse effects of drug therapies.

[Coronavirus disease 2019 and frailty].

The course of coronavirus disease 2019 (COVID-19) varies from individual to individual. People of advanced age with comorbidities have been identified as having a higher risk for severe disease or to die from COVID-19. Frailty is an essential risk factor in this respect.

Sarcopenia-a geriatric pandemic : A narrative review.

With growing life expectancy, the prevalence of frailty and sarcopenia will continuously increase during the next decades. Geographical differences have been described, and depending on the population studied, sarcopenia is evident in 10% of community-dwelling people, increasing up to 40 to 50% among those living in nursing homes. Sarcopenia is a complex age-related process of multifactorial pathogenesis, influenced by lifestyle, nutrition, biological processes during aging, and also immunological and endocrine mechanisms.

Evaluation of thoracic impedance trends for implant-based remote monitoring in heart failure patients - Results from the (J-)HomeCARE-II Study.

Aims: Remote monitoring by implantable devices substantially improves management of heart failure (HF) patients by providing diagnostic day-to-day data. The use of thoracic impedance (TI) as a surrogate measure of fluid accumulation is still strongly debated. The multicenter HomeCARE-II study evaluated clinically apparent HF events in the context of remote device diagnostics, focusing on the controversial role of TI.

Challenge of cancer in the elderly.

Despite the sustained trend of decreasing overall cancer incidence, the number of elderly patients with cancer will considerably increase in the coming years, as the incidence of cancer is elevated 11-fold after the age of 65 years compared to adults up to 65 years. This soon-to-erupt tsunami of elderly patients with cancer requires adequate treatment, for which guidelines and evidence-based data are still scarce, given the longlasting under-representation of elderly patients with cancer in cancer trials. Older adults present not only with the physiological decreases of organ functions related to age, but also with an individual burden of comorbidities, other impairments and social factors that might impact on their potential for undergoing cancer care.

[Guidelines for vaccination of immunocompromised individuals].

Immunosuppression of various origins is associated with an increased risk of infection; therefore the prevention of infectious diseases by vaccination is especially important in immunocompromised patients. However, the response to vaccinations is often reduced in these risk groups and the application of live vaccines is contraindicated during immunosuppression.In the following expert statement, recommendations for vaccination were created on the basis of current evidence and theoretical/immunological considerations.

Recurrence of paroxysmal atrial fibrillation after cryoisolation of the pulmonary veins. Is a "redo" procedure using the cryoballoon useful?

Background: Pulmonary vein (PV) isolation with the cryoballoon technique is an effective and safe method to treat patients with paroxysmal atrial fibrillation (AF). However, the optimal treatment strategy for patients with recurrences after this ablation is unclear.

Aims: The aim of this single centre study was to evaluate the efficacy and safety of a "redo" procedure using the cryoballoon in this patient cohort.

Rheumatoid arthritis and falls: the influence of disease activity.

Objective: To examine the correlation between disease activity of RA and the risk of falling.

Methods: Seventy-eight patients were tested. Disease activity was measured with acute-phase reactants, autoantibodies, swollen and tender joint count (SJC28, TJC28), pain on a visual analogue scale (VAS pain), patient and evaluator global assessment of disease activity (PGA, EGA), HAQ disability index (HAQ-DI), 28-joint DAS (DAS-28) and the clinical and simple disease activity indexes (CDAI, SDAI).

Response of elderly patients with rheumatoid arthritis to methotrexate or TNF inhibitors compared with younger patients.

Objective: To compare the efficacy of MTX and MTX+TNF inhibitors (TNFis) in elderly patients with RA with that in patients of younger age.

Methods: Data from two large, randomized, controlled, double-blind trials in patients with early RA using adalimumab or infliximab+MTX or MTX alone were obtained and pooled. Composite disease activity indices were calculated at baseline and 1 year of treatment, and compared in groups of patients classified by quartiles of age with the highest age group comprising 61-82 years using analysis of variance or Kruskal-Wallis test.

Cryoballoon ablation of paroxysmal atrial fibrillation within the dilated coronary sinus in a case of persistent left superior vena cava.

Trigger sources of paroxysmal atrial fibrillation (PAF) are not limited to a pulmonary vein origin and may be achievable by cardiac vascular structures like the coronary sinus (CS), the vena cava superior and in some rare cases by a persistent left superior vena cava (LSVC). Cryoballoon ablation has been shown to be effective in pulmonary vein isolation. We report an unusual case of using this technique in the dilated CS in case of a persistent LSVC.

[Early arthritis: action desired - treatment required].

Rheumatoid Arthritis (RA) is the most prevalent inflammatory joint disease in adults and shows a destructive course in most cases. The outcome of the disease - functional decline and invalidity - necessitates an early therapy. Recent studies demonstrate that the initiation of the treatment with a disease modifying antirheumatic drug (DMARD) treatment within the first three months after the onset of symptoms is crucial for sustained improvement of prognosis as well as therapeutic success and outcome.

Automatic magnetic-guided electroanatomical mapping and remote-controlled ablation of atypical and typical atrial flutter.

Unlabelled: Two patients with inconclusive surface electrocardiogram patterns underwent nonfluoroscopy automatic mapping and remote-controlled ablation of nonisthmus and isthmus-dependent right atrial flutter.

Methods And Results: A 0.08 magnetic vector force and a motor drive enable a complex steering of a new 8-mm magnet tip electrode.

Dynamic mechanism for initiation of ventricular fibrillation in vivo.

Background: Dynamically induced heterogeneities of repolarization may lead to wave-front destabilizations and initiation of ventricular fibrillation (VF). In a computer modeling study, we demonstrated that specific sequences of premature stimuli maximized dynamically induced spatial dispersion of refractoriness and predisposed the heart to the development of conduction block. The purpose of this study was to determine whether the computer model results pertained to the initiation of VF in dogs in vivo.

Circumferential pulmonary vein isolation with the cryoballoon technique results from a prospective 3-center study.

Objectives: The purpose of this study was to investigate the efficacy safety of the novel cryoballoon device (Arctic Front, Cryocath, Quebec, Canada).

Background: Antral pulmonary vein (PV) ablation with radiofrequency energy is widely used as a strategy for catheter ablation of paroxysmal atrial fibrillation (PAF). A novel double lumen cryoballoon catheter was designed for circumferential pulmonary vein isolation (PVI) with the cryoablation technique.

Targeted therapy in rheumatoid arthritis.

Background: Rheumatoid arthritis (RA) is the most common inflammatory joint disease in adults leading to pain and disability. New drugs, called biologicals, have opened up new possibilities in the treatment of RA.

Objective: Targeting pro-inflammatory cytokines such as tumour necrosis factor-α (TNF-α) or interleukin-1 (IL-1) is well established in clinical care of RA patients.

Magnetic-guided percutaneous coronary intervention enabled by two-dimensional guidewire steering and three-dimensional virtual angioscopy: initial experiences in daily clinical practice.

Aims: Percutaneous coronary intervention (PCI) has been broadly established and often includes highly complex stenoses that require difficult navigation. The purpose of this study is to assess the feasibility of a new magnetic navigation system (MNS) to enable intracoronary guidewire deployment and PCI in daily clinical practice and to compare the 2D guidance to the virtual 3D angioscopy feature.

Methods And Results: We included 30 consecutive patients (pt) in whom 36 coronary arteries were PCI targets.

Abatacept: the evidence for its place in the treatment of rheumatoid arthritis.

Introduction: Rheumatoid arthritis (RA) is the most common inflammatory joint disease in adults with a prevalence of 0.5-1%. The development of targeted therapies, especially anti-TNF (tumor necrosis factor) treatment, has improved disease outcome during the last decade.

The public neglect of rheumatic diseases: insights from analyses of attendees in a musculoskeletal disease awareness activity.

Objectives: To obtain data on the care received by individuals counselled during a public health awareness campaign on painful musculoskeletal conditions (MSC).

Methods: Easy non-formal access to rheumatologists/pain specialists was offered using a mobile unit (Rheuma-Bus) at widely accessible sites. Clients were asked to assess their severity of pain using a 100 mm visual analogue scale (VAS).

Targeted therapy in rheumatoid arthritis.

The approach of targeting cytokines has dramatically improved the success in the treatment of rheumatoid arthritis (RA). The blocking of tumor necrosis factor (TNF)-alpha or interleukin (IL)-1 is well established in clinical practice, but a lack or loss of clinical response still occurs in up to 30% of RA patients. Therefore, enhanced efforts must be made to develop new strategies to disrupt the inflammatory process and to inhibit synovitis and joint destruction.