Objective: to evaluate the performance of the 4 ‘A’s Test (4AT) in screening for delirium in older patients. The 4AT is a new test for rapid screening of delirium in routine clinical practice. Design: prospective study of consecutively admitted elderly patients with independent 4AT and reference standard assessments. Setting: an acute geriatrics ward and a department of rehabilitation. Participants: two hundred and thirty-six patients (aged ≥70 years) consecutively admitted over a period of 4 months. Measurements: in each centre, the 4AT was administered by a geriatrician to eligible patients within 24 h of admission. Reference standard delirium diagnosis (DSM-IV-TR criteria) was obtained within 30 min by a different geriatrician who was blind to the 4AT score. The presence of dementia was assessed using the Alzheimer's Questionnaire and the informant section of the Clinical Dementia Rating scale. The main outcome measure was the accuracy of the 4AT in diagnosing delirium. Results: patients were 83.9 ± 6.1 years old, and the majority were women (64%). Delirium was detected in 12.3% (n = 29), dementia in 31.2% (n = 74) and a combination of both in 7.2% (n = 17). The 4AT had a sensitivity of 89.7% and specificity 84.1% for delirium. The areas under the receiver operating characteristic curves for delirium diagnosis were 0.93 in the whole population, 0.92 in patients without dementia and 0.89 in patients with dementia. Conclusions: the 4AT is a sensitive and specific method of screening for delirium in hospitalised older people. Its brevity and simplicity support its use in routine clinical practice.
The editors of <em>OBM Geriatrics </em>would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2025. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal's editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers can download a certificate of recognition directly from our submission system. Additionally, reviewers can sign up to the Web of Science Reviewer Recognition Service (formerly Publons) (<a href="https://webofscience.com/wos/">https://webofscience.com/wos/</a>) to receive recognition. Of course, in these initiatives we are careful not to compromise reviewer confidentiality. Many reviewers see their work as a voluntary and often unseen part of their role as researchers. We are grateful for the time reviewers donate to our journals and the contribution they make.
Abstract Background In recent years, the prevalence of AIDS has shown a high increase, which has become a major public health problem of international concern. According to research, the quality of life(QoL) of AIDS patients is often lower than that of patients with other chronic diseases, so how to improve the QoL of AIDS patients has become a problem that needs to be urgently focused on at present. The purpose of this study is to develop and validate the AIDS scale among the System of Quality of Life Instruments for Chronic Diseases(QLICD), name as QLICD-HIV V2.0. Methods QLICD-HIV V2.0 was developed using a programmed modular approach with multiple nominal and focus group discussions, in-depth interviews and quantitative statistical procedures. Pre-surveys and formal surveys were conducted on the preliminary version of the scale, thus completing the scale development and validation process. The reliability of the scale was analyzed using the correlation coefficient method, the variability method, and the Cronbach’s α coefficient method of classical test theory(CTT), the validity of the scale was analyzed using factor analysis and correlation analysis with the SF-36 as a criterion, and the responsiveness of the scale and of each domain/facet was assessed through paired t-tests of before and after admission scores, and calculation of the standardized response mean (SRM). Results QLICD-HIV V2.0 ultimately retained 43 items, resulting in a structure of 4 domains, subdivided into 12 facets. The scale was shown to have high reliability overall by several methods of CTT. The Cronbach’s α coefficient and test-retest reliability for the total scale were 0.90 and 0.88, respectively, with domain Cronbach’s α coefficient ranging from 0.74 to 0.85 and test-retest reliabilities ranging from 0.69 to 0.89. Factor analysis results showed KMO = 0.852, with three common factors extracted from 15 items of the specific module, accounting for 55.2% of the cumulative variance, and correlation and factor analyses confirmed good structural and criterion-related validity. Conclusions QLICD-HIV V2.0 was developed in a systematic and scientific way, and showed good reliability and validity after preliminary application, which can be further promoted and used as a new QoL scale for AIDS patients with Chinese characteristics.
Roger Antabe, Yujiro Sano, Emmanuel Kyeremeh
et al.
Background
Canada is undergoing a demographic shift, with projections indicating that over 25% of the country’s population will be 65 years or older by 2063. While this has raised critical concerns about Canada’s preparedness to meet the social and health-care needs of an aging population, the increasing incidence of food insecurity is particularly affecting vulnerable groups, such as older Canadians, with implications for their health-care service utilization. Despite this observation, there are nascent studies examining the role of household food insecurity status on unmet health-care needs among older people in Canada. The main objective of our study is to assess the association between household food insecurity and unmet health-care needs among older Canadians.
Methods
We used data from a selected sample of 21,178 participants as part of the 2017–18 Canadian Community Health Survey and applied logistic regression analysis.
Results
Our findings indicate that older people experiencing any type of food insecurity, that is, either moderate (OR=3.07, p<.01) or severe (OR=4.09, p<.01) were more likely to have reported unmet health-care needs compared to their counterparts in food secure households, even after controlling for a range of demographic, socioeconomic, and health and health-care variables. Our finding is concerning, considering that older people in Canada who are in most need of health-care services due to their food insecurity status are instead reporting unmet health-care needs.
Conclusion
This revelation calls for urgent policy attention to reduce the episodes of household food insecurity among older people in Canada. Specifically, to improve their access to health-care services, providing them with periodic grocery rebates as part of the social protection package for seniors in Canada would help mitigate the problem of food insecurity among them.
Xiaoyu Zhou,1– 3 Fei Du,1– 3 Wei Peng,4 Li Bai,5 Leyi Peng,1– 3 Xiaorong Hou1– 3 1College of Medical Informatics, Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 2Medical Data Science Academy, Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 3Chongqing Engineering Research Center for Clinical Big Data and Drug Evaluation, Chongqing, 400016, People’s Republic of China; 4The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400042, People’s Republic of China; 5Hospital of Zigong Mental Health Central, Sichuan, 643021, People’s Republic of ChinaCorrespondence: Xiaorong Hou, Chongqing Medical University, No. 1, Medical College Road, Yuzhong District, Chongqing, 400016, People’s Republic of China, Email xiaoronghou@cqmu.edu.cnPurpose: Long-term care facilities are increasingly challenged with meeting the diverse healthcare needs of the elderly population, particularly concerning medication management. Understanding medication information literacy and behavior among this demographic is imperative. Therefore, this qualitative study aims to explore medication information literacy and develop distinct medication profiles among elderly long-term care residents.Material and Methods: In this study, we conducted in-depth semi-structured interviews with 32 participants aged 65 or older residing in a long-term care facility. The interviews were designed to explore participants’ understanding of medication information, medication management practices, and experiences with healthcare providers. Thematic analysis was employed to analyze the interview data, allowing for the identification of common patterns and themes related to medication-taking behavior among the elderly residents.Results: The thematic analysis revealed four distinct medication behavior profiles among the elderly long-term care residents: (1) Proactive Health Self-Managers, (2) Medication Information Adherents, (3) Experience-Based Medication Users, and (4) Nonadherent Medication Users. These findings provide valuable insights into the diverse approaches to medication management within long-term care facilities and underscore the importance of tailored interventions to support the specific needs of each profile.Conclusion: This study highlights the necessity for tailored medication education and support to optimize medication management for the elderly. With the aging population expansion, addressing the unique medication challenges within long-term care facilities becomes increasingly critical. This research contributes to ongoing endeavors to enhance healthcare services for the elderly, striving for safer and more effective medication-taking behavior.Keywords: medication information literacy, medication profile, long-term care facility, qualitative study, elderly
The editors of <em>OBM Geriatrics</em> would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2022. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal's editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers receive a voucher entitling them to a discount on their next LIDSEN publication and can download a certificate of recognition directly from our submission system. Additionally, reviewers can sign up to the service Publons (<a href="https://publons.com">https://publons.com</a>) to receive recognition. Of course, in these initiatives we are careful not to compromise reviewer confidentiality. Many reviewers see their work as a voluntary and often unseen part of their role as researchers. We are grateful to the time reviewers donate to our journals and the contribution they make.
Objectives: Our study aims to evaluate developments in vaccine uptake and digital proximity tracing app use in a localized context of the SARS-CoV-2 pandemic.Methods: We report findings from two population-based longitudinal cohorts in Switzerland from January to December 2021. Failure time analyses and Cox proportional hazards regression models were conducted to assess vaccine uptake and digital proximity tracing app (SwissCovid) uninstalling outcomes.Results: We observed a dichotomy of individuals who did not use the SwissCovid app and did not get vaccinated, and who used the SwissCovid app and got vaccinated during the study period. Increased vaccine uptake was observed with SwissCovid app use (aHR, 1.51; 95% CI: 1.40–1.62 [CI-DFU]; aHR, 1.79; 95% CI: 1.62–1.99 [CSM]) compared to SwissCovid app non-use. Decreased SwissCovid uninstallation risk was observed for participants who got vaccinated (aHR, 0.55; 95% CI: 0.38–0.81 [CI-DFU]; aHR, 0.45; 95% CI: 0.27–0.78 [CSM]) compared to participants who did not get vaccinated.Conclusion: In evolving epidemic contexts, these findings underscore the need for communication strategies as well as flexible digital proximity tracing app adjustments that accommodate different preventive measures and their anticipated interactions.
ObjectiveThe present study aimed to explore the combined associations of depression and cognitive impairment with functional disability and mortality, and whether the joint effects of depression and cognitive impairment on mortality were influenced by functional disability.MethodsA total of 2,345 participants aged 60 and above from the 2011–2014 cycle of the National Health and Nutrition Examination Survey (NHANES) were included in the analyses. Questionnaires were used to evaluated depression, global cognitive function and functional disability (including disability in activities of daily living (ADLs), instrumental activities of daily living (IADLs), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activity (GPA)). Mortality status was ascertained up to December 31, 2019. Multivariable logistic regression was performed to investigate the associations of depression and low global cognition with functional disability. Cox proportional hazards regression models were conducted to evaluate the effect of depression and low global cognition on mortality.ResultsInteractions between depression and low global cognition were observed when exploring associations of depression and low global cognition with IADLs disability, LEM disability, and cardiovascular mortality. Compared with normal participants, participants with both depression and low global cognition had the highest odds ratios of disability in ADLs, IADLs, LSA, LEM, and GPA. Besides, participants with both depression and low global cognition also had the highest hazard ratios of all-cause mortality and cardiovascular mortality, and these associations remained after adjusting for disability in ADLs, IADLs, LSA, LEM, and GPA.ConclusionOlder adults with both depression and low global cognition were more likely to have functional disability, and had the highest risk of all-cause mortality and cardiovascular mortality.
Abstract Background Since angiogenesis occurs as the pathological process following myocardial infarction to alleviate ischemia, therapeutic angiogenesis has been proposed to be a cardioprotective strategy. CD44 has been implicated in endothelial cell functions and its role has been well established in angiogenesis for years. Although recent studies indicate the close correlation between CD44 and exosome, as well as the two being implicated in myocardial ischemia pathological processes, the effect and the underlying mechanism of CD44 and its regulated plasma exosome in pathological angiogenesis post-myocardial infarction have not been fully elucidated. Methods In this study, we used CD44 knockout mice to study the in vivo impacts of CD44 on ischemic angiogenesis in myocardial infarction. Mouse cardiac function was measured by echocardiography, histological changes were observed by Evans Blue and TTC-double staining and Masson’s trichrome staining, and molecular changes were detected by immunofluorescence. In the in vitro study, CD44 knockout HUVECs were generated and CD44 inhibitor was used to study the mechanism of CD44 on angiogenesis. We performed the immunoprecipitation, proximity ligation assay, and super-resolution imaging to study the mechanistic regulation of FGFR2 signaling transduction by CD44. Importantly, we also isolated plasma exosomes from myocardial infarction model mice and studied the effect of plasma exosomes on the activation of the FGFR2 signaling pathway and the related phenotypic alterations, including exosomes uptake and angiogenic function in primary mouse microvascular endothelial cells, and further discovered the regulation mechanism of exosomal miRNAs. Results We observed that the expression of CD44 in the border zone of the infarcted heart was tightly related to pathological angiogenesis following myocardial ischemia. The depletion of CD44 impaired angiogenesis and impacts biogenesis and proangiogenic function of plasma exosomes. Subsequently, we found that CD44 mediated the activation of the FGFR2 signaling pathway as well as the caveolin 1-dependent uptake of exosomes in vascular endothelial cells. Most importantly, the proangiogenic therapeutic effect of plasma exosomal miRNAs depended upon the participation of CD44/FGFR2 signaling transduction in vascular endothelial cells. Conclusion CD44 and its regulated plasma exosomes have crucial potent angiogenic activity. Our studies elucidate that CD44 plays a key role in plasma exosomal miRNA-enhanced angiogenic FGFR2 singling transduction and ischemic angiogenesis in the early stage of myocardial infarction.
Amanda Hammer, Katarina Ljungberg, Tony Bohman
et al.
Abstract Background Hip fractures are a global problem, and it will probably increase. Hip fractures impair health aspects which creates demands on postoperative care. This study describes and compares patients with hip fracture in 2008 and in 2018. An increased knowledge of this group could be a basis how to optimize aftercare and dimension rehabilitation. Methods Using a comparative cross-sectional study to describe and compare patients with hip fracture from 2018 and 2008 at Örebro University Hospital regarding age, sex, multimorbidity, fracture type, surgical materials, surgery within 24 hours, length of stay, postoperative walking ability, physical activity level and hand grip strength. Data was collected from 76 patients with hip fracture from 2018 and 78 patients from 2008. Outcome measures considering functioning were walking ability (Functional Ambulation Categories), physical activity level (Classification system of physical activity) and hand grip strength (Jamar hand dynamometer). Statistical analyses used were hypothesis tests and regressions analysis. Results No differences in age, sex, fracture type, proportion of surgery within 24 hours or length of stay between the cohorts. The cohort 2018 had more multimorbidity in number of diagnoses and ASA-classification preoperatively. In 2018 70% of the participants were dependent in walking ability (physical human support) compared to 43% 2008 (p = 0.007). Proportion of physically inactive was 9% in 2018 compared to 21% 2008 (p = 0.047). Hand grip strength was 5.1 kg better in 2018 (p = 0.011). Adjusted for age, sex, ASA-classification (American Society of Anaesthesiologists Classification System), surgical materials and number of days between surgery and testing the cohort of 2018 had a lower odds to have independent walking ability and higher odds to be physical active. Differences in hand grip strength decreased to 4.7 kg. Participants in 2018 suffered significantly more multimorbidity. Conclusions Study indicated differences in patients’ postoperative functioning between 2018 and 2008 with more impaired walking ability, more multimorbidity, higher proportion of physically active and better hand grip strength 2018. The results are important for future reasoning regarding care needs of patients with hip fracture.
M. D’ascanio, M. Innammorato, L. Pasquariello
et al.
Abstract Background The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the outcome of the disease in this group of patients, admitted to our Hospital in Rome. Methods This is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to May 2020, divided in two groups according to their age (Elderly: 65–80 years old; Very Elderly > 80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding. The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. To assess significance among multiple groups of factors, we used the Bonferroni correction. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariate and Multivariate logistic regression were performed to estimate associations between age, comorbidities, provenance from long-stay residential care homes (LSRCH) s and clinical outcomes. Results We found that Very Elderly patients had an increased mortality rate, also due to the frequent occurrence of multiple comorbidities. Moreover, we found that patients coming from LSRCHs appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease. Conclusion We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes. To establish a correct risk stratification, comorbidities and information about provenience from LSRCHs should be considered.
Background: Excessive copper (Cu) has risky effect on insulin resistance (IR), oxidative stress and inflammation. Instead, some studies reported serum Cu to be protective for non-alcoholic fatty liver disease (NAFLD). The aim of this study was to reevaluate the evidence for a potential risky correlation of serum Cu to NAFLD in large-scale and non-institutionalized American subjects. Methods: A cross-sectional study of 3211 subjects was from the National Health and Nutrition Examination Survey (NHANES). Logistic regression and cubic spline-based curve-fitting analyses were used to estimate the independent risky effect of Cu to hepatic steatosis index (HSI), US fatty liver index (USFLI) and NAFLD and their dose-effect relationship. Moreover, this association was analyzed in stratification of HOMA-IR, Metabolic syndrome (MetS) and severity of NAFLD, besides age and gender. Results: The average level of serum Cu was 18.67 μmol/L and the prevalence of NAFLD was 54.53% and 32.60%, respectively defined by HSI and USFLI. Generally, the level of Cu was higher in females than males. Serum Cu was positively associated with higher HSI, USFLI index and risk of NAFLD. In fully adjusted models, compared with the lowest quartile, the risk of NAFLD increased 97% in the highest quartile of Cu. Interestingly, stratified analysis showed that the risky effect of Cu to NAFLD was more prominent in the middle-aged, females and subjects with improved status of IR (lower HOMA-IR and non-Mets) compared with their counterparts. Moreover, we further found that circulating copper was correlated to severity of NAFLD only in males. Conclusion: Excess serum Cu is significantly associated with risk of NAFLD, which is prominent in females, middle-aged and subjects with improved status of IR, and seems to be related to the severity of NAFLD, additionally. It is necessary to be cautious of the toxic effect of Cu and prospective cohort and mechanism studies are needed to verify the causal effect of Cu to NAFLD.
Abstract Background Oxidative stress is a common cause of neurodegeneration and plays a central role in retinal degenerative diseases. Heme oxygenase-1 (HMOX1) is a redox-regulated enzyme that is induced in neurodegenerative diseases and acts against oxidative stress but can also promote cell death, a phenomenon that is still unexplained in molecular terms. Here, we test whether HMOX1 has opposing effects during retinal degeneration and investigate the molecular mechanisms behind its pro-apoptotic role. Methods Basal and induced levels of HMOX1 in retinas are examined during light-induced retinal degeneration in mice. Light damage-independent HMOX1 induction at two different expression levels is achieved by intraocular injection of different doses of an adeno-associated virus vector expressing HMOX1. Activation of Müller glial cells, retinal morphology and photoreceptor cell death are examined using hematoxylin-eosin staining, TUNEL assays, immunostaining and retinal function are evaluated with electroretinograms. Downstream gene expression of HMOX1 is analyzed by RNA-seq, qPCR examination and western blotting. The role of one of these genes, the pro-apoptotic DNA damage inducible transcript 3 (Ddit3), is analyzed in a line of knockout mice. Results Light-induced retinal degeneration leads to photoreceptor degeneration and concomitant HMOX1 induction. HMOX1 expression at low levels before light exposure prevents photoreceptor degeneration but expression at high levels directly induces photoreceptor degeneration even without light stress. Photoreceptor degeneration following high level expression of HMOX1 is associated with a mislocalization of rhodopsin in photoreceptors and an increase in the expression of DDIT3. Genetic deletion of Ddit3 in knockout mice prevents photoreceptor cell degeneration normally resulting from high level HMOX1 expression. Conclusion The results reveal that the expression levels determine whether HMOX1 is protective or deleterious in the retina. Furthermore, in contrast to the protective low dose of HMOX1, the deleterious high dose is associated with induction of DDIT3 and endoplasmic reticulum stress as manifested, for instance, in rhodopsin mislocalization. Hence, future applications of HMOX1 or its regulated targets in gene therapy approaches should carefully consider expression levels in order to avoid potentially devastating effects.
Neurology. Diseases of the nervous system, Geriatrics
Naomi Turner MD, Jennifer M. Dinh MPH, Jennah Durham MD
et al.
Background: Patient reported outcome measures (PROMs) are becoming well recognized as an important component of health care outcomes and determinants of value in patient-centered care. Yet, there is emerging recognition that guidance is lacking in the utilization of PROMs in hip fracture patients. The aim of this study was to collect input from hip fracture patients and their health care advocates as proxies to identify outcomes that are important and to gain insight into which ones are of greatest importance. Methods: A cross-section of patients aged 65 and older treated for hip fractures at a single level 1 trauma center within the previous 3 to 9 months was identified. Semistructured telephone interviews of patients and/or health care proxies were performed in 2 phases: (1) concept identification and conceptual framework development and (2) item generation and assessment of relative importance of health care outcomes. Each phase was completed by separate patient cohorts. Results: Sixty-four interviews were completed. Eighteen interviews with 13 patients and 5 proxies were completed for framework development . Forty-six interviews with 33 patients and 13 proxies were completed for the assessment of relative importance . Care team and communication were reported as important in hip fracture patients. Physical outcomes were ranked as most important by only 9% of respondents. “Having confidence that I/my loved one received the best care possible” was perceived as very important by 98% of respondents and “Having access to the surgeon” was perceived as very important by 76% of the respondents. Conclusions: In our study, communication between patients and care providers as well as collaboration among patients’ care providers ranked as the most important postoperative preferences in our cohort. Notably, physical outcomes were ranked as most important by only 9% of respondents.
Tahir Belice, Mustafa Ubay, Fatma O Gozubuyuk
et al.
Background: As we know that close contact is the main reason of the contagious diseases, caregivers are at higher risk for diseases that we can prevent by vaccines. In present study, we aim at revealing an example of clinical inertia in geriatrics, which shows us the status of vaccination both in a group of older patients and their caregivers. Materials and Methods: Both the caregivers and their dependent geriatric patients were included, and the selection of the participants was designed on a random and volunteer basis. We performed the study with a phenomenological design and asked the participants their vaccination status. For the participants that were not vaccinated, the reasons were questioned with a demographic form. Correlations between parameters were analyzed with an independent t-test and analysis of variance. SPSS (IBM SPSS for Windows, ver.24) was used to analyze the data, which were saved in excel files. Results: A total of 144 caregivers with 21 men (14.6%) and 123 female (85.4%) were included in the study. A total of 111(77.1%) caregivers had never been vaccinated before, while 21 (14.6%) caregivers were vaccinated occasionally, and finally, 12 (8.3%) caregivers were vaccinated on a regular base. The vaccination status of the older adults was as follows: 42 patients (29.2%) had never been vaccinated before, 60 (41.7%) had been vaccinated occasionally, and 42 (29.2%) patients had been vaccinated regularly. Conclusion: The vaccination rates of caregivers and older patients were lower than we expected, so primary-care providers need to plan more vaccination awareness studies in social media and communities. Clinical inertia might be an essential reason in the lower vaccination rates of the caregivers and older adults' population.
Schizophrenia and bipolar disorder share some common clinical features and are both characterized by aberrant resting-state functional connectivity (FC). However, little is known about the common and specific aberrant features of the dynamic FC patterns in these two disorders. In this study, we explored the differences in dynamic FC among schizophrenia patients (n = 66), type I bipolar disorder patients (n = 53), and healthy controls (n = 66), by comparing temporal variabilities of FC patterns involved in specific brain regions and large-scale brain networks. Compared with healthy controls, both patient groups showed significantly increased regional FC variabilities in subcortical areas including the thalamus and basal ganglia, as well as increased inter-network FC variability between the thalamus and sensorimotor areas. Specifically, more widespread changes were found in the schizophrenia group, involving increased FC variabilities in sensorimotor, visual, attention, limbic and subcortical areas at both regional and network levels, as well as decreased regional FC variabilities in the default-mode areas. The observed alterations shared by schizophrenia and bipolar disorder may help to explain their overlapped clinical features; meanwhile, the schizophrenia-specific abnormalities in a wider range may support that schizophrenia is associated with more severe functional brain deficits than bipolar disorder. Together, these findings highlight the potentials of using dynamic FC as an objective biomarker for the monitoring and diagnosis of either schizophrenia or bipolar disorder.
Jakub Husejko, Mateusz Porada, Daria Bieniek
et al.
Background: This article is devoted to the topic of breast cancer, which is a very important and overlooked problem by many women. This cancer is the most common malignancy in women in developed countries. It also creates an increasing problem in developing countries and causes high mortality. Early diagnoses of neoplastic lesions and rapid implementation of therapy in most cases allow for successful treatment its prognosis . Self-control is very important, women should examine their breasts by palpation. Further research to diagnose breast cancer are: mammography (MMG), ultrasonography (USG), magnetic resonance (MR), positron emission tomography (PET) and microscopic examination.
Material and Methods: In this article, it was analyzed by the latest literature on risk factors, epidemiology, diagnosis and treatment of breast cancer. Articles were searched from PubMed and Google Scholar.
Results: Breast cancer risk factors have been shown to be early menstruation, high women's height, high body mass (especially fat content) and hyperinsulinaemia. In addition, genetic factors play an important role. Research also confirms that highly-used cleaners, and at their head, DDP (dichlorodiphenyltrichloroethane) affect the formation of breast cancer. This is the third most common cause of death in women aged 60-85. In treatment, an individual approach to each patient is important. Older women individually discuss the methods of treatment with the doctor, because it gives beneficial results of therapy.
Conclusions: Breast cancer has become a very important medical and social problem in older women. Mass media are needed to disseminate knowledge, topics related to treatment and to support the sick. In older women, treatment is more aggressive, and in addition to radiotherapy, a partial mastectomy is performed. Breast cancer is a tought term for woman’s in all age. It is related with fear and loss of self—confidence.