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Peters S, Cosco TD, Mackey DC, Sarohia GS, Leong J, Wister A. Quantifying Physical Resilience in Ageing Using Measurement Instruments: A Scoping Review. Physiother Can 2022. [DOI: 10.3138/ptc-2020-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: The capacity to recover motor function with pathology or age-related decline is termed physical resilience. It is unknown what outcome domains are captured with existing measurement instruments. Thus, this scoping review aimed to identify measurement instruments for physical resilience, identify research gaps, and make recommendations for future research. Methods: Articles were included from the search when their subject matter included the term resilience in relation to the physical health of older adults. Data on physical resilience measurement instruments were extracted using the outcome domains: body function or structure, activity and participation, and societal impact. Results: The majority of the 33 included articles involved older adults with fractures, cardiac conditions, and cancer. Many measurement instruments quantified body function or structure, and some instruments captured activity and participation, and societal impact of physical resilience. Measurement instruments were pooled into 4 categories: psychological, physiological, motor function, and psychosocial scales. No studies combined all areas of measurement. Conclusions: A potential gap of a measurement instrument capturing social aspects of physical resilience was identified. Comprehensive measurement could identify which outcome domains could be targeted to foster resilience. This knowledge might be useful across many health disciplines and contribute to therapeutic decision-making and rehabilitation strategies.
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Affiliation(s)
- Sue Peters
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Theodore D. Cosco
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada
- Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
| | - Dawn C. Mackey
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Gurkaran S. Sarohia
- MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey Leong
- MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Wister
- Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
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2
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Meng LL, Cao L. Serum neopterin levels and their role in the prognosis of patients with ischemic stroke: A systematic review and meta-analysis. J Clin Neurosci 2021; 92:55-60. [PMID: 34509262 DOI: 10.1016/j.jocn.2021.07.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/20/2021] [Accepted: 07/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Neopterin is an inflammatory marker that is found to have prognostic value in cardiovascular diseases but its prognostic role in cerebrovascular diseases is not as clear. This study evaluates the prognostic role of neopterin in patients with ischemic stroke. METHOD Studies were identified after a literature search in electronic databases (Ovid, PubMed, Science Direct, and Wiley) and were selected based on precise eligibility criteria. Random-effects meta-analyses were performed to estimate mean difference in blood neopterin levels between ischemic stroke patients and healthy individuals or between severe and low/moderate ischemic stroke. Prognostic information contained in research articles of included studies was synthesized. RESULTS Fourteen studies (1823 ischemic stroke patients and 2189 healthy individuals) were included. Serum neopterin levels were 4.22 ng/ml [95% confidence interval (CI): 3.66, 4.77] in ischemic stroke patients and 1.80 ng/ml [95% CI: 1.13, 2.46] in normal individuals (mean difference 2.14 ng/ml [95% CI: 1.41, 2.87]; p < 0.00001). Neopterin levels were significantly higher in patients with severe than in low/moderate ischemic stroke (mean difference 1.36 ng/ml [95% CI: 0.58, 2.13]; p = 0.0006). In individual studies, higher serum neopterin levels were found to be predictive of secondary stroke, adverse clinical or functional outcomes, depression, and mortality. Neopterin levels correlated positively with high-sensitivity c reactive protein (hsCRP), National Institutes of Health Stroke Scale score, and infarct volume. CONCLUSION Blood neopterin levels are found significantly higher in ischemic stroke patients and correlated positively with hsCRP, disease severity, and infarct volume. Higher neopterin levels are associated with a worse prognosis of ischemic stroke.
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Affiliation(s)
- Lin-Lie Meng
- Department of Neurology, Nangang Branch, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150001, China
| | - Li Cao
- Department of Neurology, Nangang Branch, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150001, China.
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3
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Chauvin M, Larsen M, Quirant B, Quentric P, Dorgham K, Royer L, Vallet H, Guihot A, Combadière B, Combadière C, Barallat J, Mayaux J, Luyt CE, Mathian A, Amoura Z, Boddaert J, Armestar F, Gorochov G, Martinez-Caceres E, Sauce D. Elevated Neopterin Levels Predict Fatal Outcome in SARS-CoV-2-Infected Patients. Front Cell Infect Microbiol 2021; 11:709893. [PMID: 34497777 PMCID: PMC8419218 DOI: 10.3389/fcimb.2021.709893] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/31/2021] [Indexed: 01/14/2023] Open
Abstract
Highlights Innate immune activation during Covid-19 infection is associated with pernicious clinical outcome. Background Coronavirus disease 2019 (Covid-19) is a worldwide threat that has already caused more than 3 000 000 deaths. It is characterized by different patterns of disease evolution depending on host factors among which old-age and pre-existing comorbidities play a detrimental role. Previous coronavirus epidemics, notably SARS-CoV, were associated with increased serum neopterin levels, which can be interpreted as a sign of acute innate immunity in response to viral infection. Here we hypothesize that neopterin may serve as a biomarker of SARS-CoV-2 viral infection and Covid-19 disease severity. Methods We measured neopterin blood levels by ELISA. Seric concentration was quantified from 256 healthy donors and 374 Covid-19 patients at hospital admission. Enrolled Covid-19 patients were all symptomatic and displayed a large spectrum of comorbidities. Patients were followed until disease resolution or death. Results Severe and critically ill SARS-CoV-2 infected patients were characterized by a profound exacerbation of immune activation characterized by elevated neopterin blood levels. Systemic neopterin levels above 19nM stratified healthy individuals from Covid-19 patients with 87% specificity and 100% sensitivity. Moreover, systemic neopterin levels above 53nM differentiated non-survivors from survivors with 64% specificity and 100% sensitivity. Conclusion We propose that neopterin concentration measured at arrival to hospital is a hallmark of severe Covid-19 and identifies a high-risk population of pernicious clinical outcome with a need for special medical care.
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Affiliation(s)
- Manon Chauvin
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France
| | - Martin Larsen
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France
| | - Bibiana Quirant
- Division of Immunology, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Spain.,Department of Cellular Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Paul Quentric
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France
| | - Karim Dorgham
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France
| | - Luca Royer
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France
| | - Hélène Vallet
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Unité de Gériatrie Aigue, Paris, France
| | - Amelie Guihot
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Département d'Immunologie, Paris, France
| | - Béhazine Combadière
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France
| | - Christophe Combadière
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France
| | - Jaume Barallat
- Biochemistry Department, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Julien Mayaux
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Service de Médecine Intensive-Réanimation et Pneumologie, Paris, France
| | - Charles-Edouard Luyt
- Service de Médecine Intensive Réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris (APHP), Sorbonne-Université, Service de Médecine Intensive-Réanimation et Pneumologie, Paris, France
| | - Alexis Mathian
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France.,Service de Médecine Interne 2, Institut E3M, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Paris, France
| | - Zahir Amoura
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France.,Service de Médecine Interne 2, Institut E3M, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Paris, France
| | - Jacques Boddaert
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris (APHP), Sorbonne-Université, Hôpital Pitié-Salpêtrière, Département de Gériatrie, Paris, France
| | - Fernando Armestar
- Critical Care Department, Germans Trias i Pujol University Hospital, Badalona, Spain.,Department of Medicine Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Guy Gorochov
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Département d'Immunologie, Paris, France
| | - Eva Martinez-Caceres
- Division of Immunology, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Spain.,Department of Cellular Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Delphine Sauce
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France
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4
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Bermejo-Bescós P, Martín-Aragón S, Cruz-Jentoft AJ, Merello de Miguel A, Vaquero-Pinto MN, Sánchez-Castellano C. Peripheral IL-6 Levels but not Sarcopenia Are Predictive of 1-Year Mortality After Hip Fracture in Older Patients. J Gerontol A Biol Sci Med Sci 2021; 75:e130-e137. [PMID: 32585691 DOI: 10.1093/gerona/glaa154] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sarcopenic patients may have an increased risk of poor outcomes after a hip fracture. The objective of this study was to determine whether sarcopenia and a set of biomarkers were potential predictors of 1-year-mortality in older patients after a hip fracture. METHODS About 150 patients at least 80 years old were hospitalized for the surgical treatment of a hip fracture. The primary outcome measure was the death in the first year after the hip fracture. Sarcopenia was defined at baseline by having both low muscle mass (bioimpedance analysis) and handgrip and using the updated European Working Group on Sarcopenia in Older People (EWGSOP2) definition of probable sarcopenia. Janssen's (J) and Masanés (M) cutoff points were used to define low muscle mass. RESULTS Mortality 1 year after the hip fracture was 11.5%. In univariate analyses, baseline sarcopenia was not associated with mortality, using neither of the muscle mass cutoff points: 5.9% in sarcopenic (J) versus 12.4% in non-sarcopenic participants (p = .694) and 16% in sarcopenic (M) versus 9.6% in non-sarcopenic participants (p = .285). Probable sarcopenia (EWGSOP2) was not associated with mortality. Peripheral levels of IL-6 at baseline were significantly higher in the group of participants who died in the year after the hip fracture (17.14 ± 16.74 vs 11.42 ± 7.99 pg/mL, p = .026). TNF-α peripheral levels had a nonsignificant trend to be higher in participants who died. No other biomarker was associated with mortality. CONCLUSIONS Sarcopenia at baseline was not a predictor of 1-year mortality in older patients after a hip fracture. IL-6 was associated with a higher risk of mortality in these patients, regardless of sarcopenia status.
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Affiliation(s)
- Paloma Bermejo-Bescós
- Departamento de Farmacología, Farmacognosia y Botánica, Facultad de Farmacia, Universidad Complutense de Madrid (UCM), Spain
| | - Sagrario Martín-Aragón
- Departamento de Farmacología, Farmacognosia y Botánica, Facultad de Farmacia, Universidad Complutense de Madrid (UCM), Spain
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Duong L, Radley HG, Lee B, Dye DE, Pixley FJ, Grounds MD, Nelson DJ, Jackaman C. Macrophage function in the elderly and impact on injury repair and cancer. IMMUNITY & AGEING 2021; 18:4. [PMID: 33441138 PMCID: PMC7805172 DOI: 10.1186/s12979-021-00215-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/01/2021] [Indexed: 02/07/2023]
Abstract
Older age is associated with deteriorating health, including escalating risk of diseases such as cancer, and a diminished ability to repair following injury. This rise in age-related diseases/co-morbidities is associated with changes to immune function, including in myeloid cells, and is related to immunosenescence. Immunosenescence reflects age-related changes associated with immune dysfunction and is accompanied by low-grade chronic inflammation or inflammageing. This is characterised by increased levels of circulating pro-inflammatory cytokines such as tumor necrosis factor (TNF), interleukin (IL)-1β and IL-6. However, in healthy ageing, there is a concomitant age-related escalation in anti-inflammatory cytokines such as transforming growth factor-β1 (TGF-β1) and IL-10, which may overcompensate to regulate the pro-inflammatory state. Key inflammatory cells, macrophages, play a role in cancer development and injury repair in young hosts, and we propose that their role in ageing in these scenarios may be more profound. Imbalanced pro- and anti-inflammatory factors during ageing may also have a significant influence on macrophage function and further impact the severity of age-related diseases in which macrophages are known to play a key role. In this brief review we summarise studies describing changes to inflammatory function of macrophages (from various tissues and across sexes) during healthy ageing. We also describe age-related diseases/co-morbidities where macrophages are known to play a key role, focussed on injury repair processes and cancer, plus comment briefly on strategies to correct for these age-related changes.
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Affiliation(s)
- L Duong
- Curtin Medical School, Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Kent Street, 6102, Bentley, Western Australia, Australia
| | - H G Radley
- Curtin Medical School, Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Kent Street, 6102, Bentley, Western Australia, Australia
| | - B Lee
- Curtin Medical School, Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Kent Street, 6102, Bentley, Western Australia, Australia
| | - D E Dye
- Curtin Medical School, Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Kent Street, 6102, Bentley, Western Australia, Australia
| | - F J Pixley
- School of Biomedical Sciences, University of Western Australia, 6009, Nedlands, Western Australia, Australia
| | - M D Grounds
- School of Human Sciences, University of Western Australia, 6009, Nedlands, Western Australia, Australia
| | - D J Nelson
- Curtin Medical School, Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Kent Street, 6102, Bentley, Western Australia, Australia
| | - C Jackaman
- Curtin Medical School, Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Kent Street, 6102, Bentley, Western Australia, Australia.
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6
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Vallet H, Bayard C, Lepetitcorps H, O'Hana J, Fastenackels S, Fali T, Cohen-Bittan J, Khiami F, Boddaert J, Sauce D. Hip Fracture Leads to Transitory Immune Imprint in Older Patients. Front Immunol 2020; 11:571759. [PMID: 33072114 PMCID: PMC7533556 DOI: 10.3389/fimmu.2020.571759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/13/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Hip fracture (HF) is common in the geriatric population and is associated with a poor vital and functional prognosis which could be impacted by immunological changes. The objective here is to decipher immune changes occurring in the 1st days following HF and determine how phenotype, function, and regulation of innate and adaptive compartments adapt during acute stress event. Methods: We included HF patients, aged over 75 years. For each patient, blood samples were taken at five different timepoints: four in the perioperative period (day 0 to hospital discharge) and one at long term (6–12 months). Phenotypical and functional analysis were performed longitudinally on fresh blood or cryopreserved PBMCs. Clinical data were prospectively collected. Results: One-hundred HF patients and 60 age-matched controls were included. Innate compartment exhibits pro-inflammatory phenotypes (hyperleukocytosis, increase of CD14+ CD16+ proportion and CCR2 expression), maintaining its ability to produce pro-inflammatory cytokines. Adaptive compartment extends toward a transitory immunosuppressive profile (leucopenia) associated with an active T-cell proliferation. Furthermore, increases of LAG-3 and PD-1 and a decrease of 2-B4 expression are observed on T-cells, reinforcing their transitory suppressive status. Of note, these immune changes are transitory and sequential but may participate to a regulation loop necessary for homeostatic immune control at long term. Conclusion: HF is associated with several transitory immunological changes including pro-inflammatory phenotype in innate compartment and immunosuppressive profile in adaptive compartment. A comprehensive assessment of immune mechanisms implicated in the patient's prognosis after HF could pave the way to develop new immune therapeutics strategies.
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Affiliation(s)
- Héléne Vallet
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), Paris, France.,Assistance Publique Hôpitaux de Paris (APHP), Hôpital Saint Antoine, Department of Geriatrics, Paris, France
| | - Charles Bayard
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), Paris, France
| | - Héléne Lepetitcorps
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), Paris, France
| | - Jessica O'Hana
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), Paris, France
| | - Soléne Fastenackels
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), Paris, France
| | - Tinhinane Fali
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), Paris, France
| | - Judith Cohen-Bittan
- Assistance Publique Hôpitaux de Paris (APHP), Hôpital Pitié-Salpétrière, Department of Geriatrics, Paris, France
| | - Frédéric Khiami
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), Paris, France.,APHP, Hôpital Pitié-Salpétrière, Department of Orthopedic Surgery, Paris, France
| | - Jacques Boddaert
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), Paris, France.,Assistance Publique Hôpitaux de Paris (APHP), Hôpital Pitié-Salpétrière, Department of Geriatrics, Paris, France
| | - Delphine Sauce
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), Paris, France
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Attributable Mortality of Hip Fracture in Older Patients: A Retrospective Observational Study. J Clin Med 2020; 9:jcm9082370. [PMID: 32722204 PMCID: PMC7465479 DOI: 10.3390/jcm9082370] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 11/26/2022] Open
Abstract
Hip fracture (HF) in older patients is associated with a high six-month mortality rate. Several clinical conditions may affect outcome, including baseline characteristics, co-existing acute illnesses, perioperative factors, and postoperative complications. Our primary objective was to estimate the respective effect of these four domains on six-month mortality after HF. A retrospective observational study using a monocentric cohort of older patients was conducted. All patients ≥ 70 years old admitted to the emergency department for HF and hospitalized in our perioperative geriatric care unit from June 2009 to September 2018 were included. Among 1015 included patients, five (0.5%) were lost to follow-up, and 1010 were retained in the final analysis (mean age 86 ± 6 years). The six-month mortality rate was 14.8%. The six-month attributable mortality estimates were as follows: baseline characteristics (including age, gender, comorbidities, autonomy, type of fracture): 62.4%; co-existing acute illnesses (including acute events present before surgery that could result from the fracture or cause it): 0% (not significantly associated with six-month mortality); perioperative factors (including blood transfusion and delayed surgery): 12.3%; severe postoperative complications: 11.9%. Baseline characteristics explained less than two-thirds of the six-month mortality after HF. Optimizing patients care by improving management of perioperative factors and thus decreasing postoperative complications, could reduce by a maximum of one quarter of the six-month mortality rate after HF.
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Pterins as Diagnostic Markers of Mechanical and Impact-Induced Trauma: A Systematic Review. J Clin Med 2019; 8:jcm8091383. [PMID: 31484468 PMCID: PMC6780259 DOI: 10.3390/jcm8091383] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 12/18/2022] Open
Abstract
We performed a systematic review of the literature to evaluate pterins as biomarkers of mechanical and impact-induced trauma. MEDLINE and Scopus were searched in March 2019. We included in vivo human studies that measured a pterin in response to mechanical or impact-induced trauma with no underlying prior disease or complication. We included 40 studies with a total of 3829 subjects. Seventy-seven percent of studies measured a significant increase in a pterin, primarily neopterin or total neopterin (neopterin + 7,8-dihydroneopterin). Fifty-one percent of studies measured an increase within 24 h of trauma, while 46% measured increases beyond 48 h. Pterins also showed promise as predictors of post-trauma complications such as sepsis, multi-organ failure and mortality. Exercise-induced trauma and traumatic brain injury caused an immediate increase in neopterin or total neopterin, while patients of multiple trauma had elevated pterin levels that remained above baseline for several days. Pterin concentration changes in response to surgery were variable with patients undergoing cardiac surgery having immediate and sustained pterin increases, while gastrectomy, liver resection or hysterectomy showed no change. This review provides systematic evidence that pterins, in particular neopterin and total neopterin, increase in response to multiple forms of mechanical or impact-induced trauma.
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9
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Impact of stress on aged immune system compartments: Overview from fundamental to clinical data. Exp Gerontol 2018; 105:19-26. [DOI: 10.1016/j.exger.2018.02.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/03/2018] [Accepted: 02/05/2018] [Indexed: 12/12/2022]
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