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  • ISSN: 2378-9409
    Volume 2, Issue 2
    Research Article
    Jonathen Venkatachalam, John Abisheganaden, Shuyu Chen, Albert YH Lim, Dessmon YH Tai, Soon Keng Goh, Ai Ching Kor and Akash Verma*
    Abstract:
    Aim: Evaluate the clinical, radiological, and prognostic features in lung cancer amongst elderly patients.
    Method: A retrospective study of patients diagnosed with lung cancer between January 2011 and December 2013, looking at demographics, CT findings, histopathology results, therapy, and survival was done. Features among young (=60 years), and octogenarians (=80 years) were compared.
    Result: 177 patients were diagnosed with lung cancer out of which 51 were = 60 years old, and 27 were = 80 years old. These were analysed (n=78). 70 (89.7%) presented with advanced and 8 (10.2%) with early stage cancer. Octogenarians were significantly different from younger patients in terms of male predominance 21 (78%) vs. 26 (51%) in younger patients, p=0.02. Greater proportion of patients had fibrotic changes 3 (11%), scarring 9 (33%), peripherally located lung cancer 17 (63%) and past history of tuberculosis 6 (22%) in octogenarians as compared to young patients, p=0.03& p=0.01. Octogenarians 3 (11%) were treated with chemotherapy less frequently than the younger patients 29 (57%), p=0.0001, however no difference in survival was seen. Among octogenarians, 4(14.8%) survived >2 years, 7(26%) 1-2 years, &13(48.1%) survived <1 year. Features of peripheral tumour, left lower lobe involvement, early stage, and radiotherapy correlated with survival of = 2 years in this group.
    Conclusion: Lung cancer presents peripherally in octogenarians making the service of transthoracic needle aspiration an essential pre-requisite for all hospitals managing such patients. Fibrotic changes, scarring, and past tuberculosis correlated with lung cancer in this population. There was no difference in survival between octogenarians & younger patients. This helps to dispel nihilism surrounding the treatment of lung cancer in the elderly. Peripheral tumour, left lower lobe involvement, early stage, and radiotherapy correlated with better survival.
    Flávia Wanderley1*, André Moreira2, Oksana Sokhatska2, Carmo Palmares2, José Oliveira3 and Joana Carvalho3
    Abstract: In this study we aimed to verify the effects of training on cardiovascular function, body composition, high-sensitive C - reactive protein (hs-CRP), and physical fitness of older adults. Fifty-four subjects were randomly allocated into Aerobic Training (AT), Strength Training (ST), or Waiting List (WL). Heart Rate Variability (HRV), Blood Pressure (BP), body composition (DXA), hs-CRP, and fitness (6MWT) were assessed at baseline and after a four-month intervention. To detect changes within groups (before vs. after) the paired t-test was employed. General linear models were used with time (before and after interventions/observation) as a within-subject factor, Group (ST, AT and WL) as a between-subjects factor, and gender as a covariate (P<0.05). After intervention, AT and ST demonstrated a better performance in 6MWT (+43.3m; +31.5m) and lower body fat (-1.5%; -1.2%), trunk fat (-0.9kg; -0.8kg), and systolic BP (-13.1mmHg; -8.7mmHg), additionally, AT lowered diastolic BP (-3.7mmHg). Excluding systolic and diastolic BP (-6.4mmHg; -3.1mmHg), no differences were observed in WL. These data suggest that four months of AT or ST can reduce total and trunk fat content and improve aerobic fitness in older adults. However, training has no effect on HRrest, HRV, and hs-CRP.
    Review Article
    Stavros P. Kiriakidis*
    Abstract:
    Suicide is a serious problem concerning mental health professionals. In the present paper we will attempt a review of the evidence about the risk factors associated with suicidality among the elderly, mainly factors related with mental health illnesses and mainly depression, somatic illnesses, chronic pain and psychosocial factors, like social isolation, bereavement and financial problems. In addition, issues regarding interventions, at the individual or group level, to prevent suicide are reviewed, including contracting, medication, screening, reducing social isolation, restriction of access to lethal means, community education programs and the role of the general practitioners in detecting proneness to suicide. In addition, we will focus on useful improvements of interventions aiming at reducing suicide rates from a social policy and prevention perspective.
    Letter to Editor
    Ashok K. Vijh*
    Based on our recent brief comments [1], we wish to elaborate the theme of healthy aging based on the current scientific understanding of this subject. Some aspects of this problem are dealt with below.
    Short Communications
    Jeannine Skinner, Hector Hernandez-Saucedo, Gayle Robinson, Darla Chapman, Angela J. Hanson, James Leverenz, Consuelo H. Wilkins, Charles W Wilkinson, Suzanne Craft and Laura D Baker
    Abstract:
    Background: Pre-diabetes has deleterious effects on cognitive and physical health, yet responds favorably to exercise. Little is known about how exercise affects health in African Americans, a group disproportionately affected by pre-diabetes and type 2 diabetes. The objective of this pilot study was to evaluate the effects of an aerobic training (AT) versus resistance training (RT) program on cognitive function and biomarkers of type 2 diabetes (T2D) and Alzheimer's disease (AD) in African American elders with pre-diabetes.
    Methods: Fifteen African Americans aged 50 years and older with pre-diabetes were randomly assigned to a 6-month AT or RT protocol. Pre- and post-intervention, participants were administered cognitive tests. Blood biomarkers of T2D and AD were also examined.
    Results: Group differences in cognitive test performance or biomarkers failed to reach statistical significance (all p-values>0.05). Exploratory within group analyses to examine change over time indicated an improvement in verbal memory in the AT group (p=0.03), and an increase in high-density lipoprotein levels (p=0.01) and a trend decrease in plasma levels of Aß42 (p=0.10) in the RT group.
    Conclusion: Although there were no overall group differences in cognitive or biomarker outcomes in this small pilot study, within group differences point to a potential benefit of AT on verbal memory and RT on lipid profiles in older African Americans with pre-diabetes. Larger exercise trials in African Americans are needed to advance our understanding of how different exercise modalities affect cognitive and cardiovascular health in older African Americans, a group at high risk for cognitive decline.
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