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At least 19 recordsLinked to original sources
PubMed2001

[Ischemic heart disease in the elderly. Special Conference of the 36th National Congress of the Spanish Society of Cardiology].

In the field of Cardiology, older patients are the most frequently seen in clinical practice. In the USA, 60% of the patients hospitalized with acute myocardial infarction are 65 or older, as are almost 80% of the patients with heart failure. Population in industrialized countries is aging progressively and this fact is particularly pronounced in Spain, where, as calculated, the population pyramid will be inverted in the next 50 years and people over 65 will be a majority group. We know that age is a determinant factor in the prognosis of illness. With age, comorbidity increases, sex distribution changes, mortal complications have a higher incidence, and there are structural and mechanical functional changes. The specific characteristics of this group of patients and their enormous impact in clinical practice have led us to reconsider the medical focus used to approach this very important aspect of public health. Many of the larger randomized clinical trials have included a narrow spectrum of older patients despite the great relevance that the study of this group might have. On the other hand, the extrapolation of the results obtained in younger patients to older patients implies that the average results of the study may be assigned to a heterogeneous population, not taking into consideration the specificities of each subgroup. Therefore, there is a need to create innovative strategies to optimize the results in the older patient group. Even though clinical trials are a very useful tool to establish the effectiveness of a therapy, from a methodological point of view, they should include a higher number of older patients, and the observational studies undertaken with a rigorous methodology should be more frequently used to generate new knowledge and put the established knowledge info practice. Furthermore, observational studies can be particularly important in the development of strategies that allow the translation of information from the clinical trials to daily clinical practice.

Adult↗
PubMedDate not supplied

American household structure in transition.

The number of U.S. households rose by 58 percent between 1960 and 1983, with nontraditional household types accounting for most of the increase. Whereas the number of households containing married couples with children younger than 18 rose by only four percent over the period, one-parent households increased by 175 percent; one-person households, by 173 percent; and households composed of unmarried couples, by 331 percent. In 1983, households maintained by married couples constituted six in 10 U.S. households; the second most common household type--adults living alone--accounted for about one-quarter of all households. Lone parents living with their children represent nearly one in 10 households. Almost all of these parents are women--of whom two-thirds are separated or divorced, one-quarter have never been married, and fewer than one in 10 are widows. Among adults living alone, women aged 45 and older predominate; but the rate at which the practice has been adopted since 1960 has been greatest among those under age 45. Most of the growth in the number of one-person households occurred during the 1970s. The increase in cohabitation--most of it also in the 1970s--has similarly been concentrated in the younger age-groups. The living arrangements of children younger than 18 have changed accordingly over the two decades. Since 1960, the number of children living with two parents has declined by nearly one-fifth, and the number living with one parent--generally the mother--has more than doubled.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Requirement and supply of dental services in Victoria.

The appropriateness of dental manpower has become a great uncertainty in the changing practice of dentistry. This paper presents research on the requirement for and supply of dental services in Victoria between 1984 and 1996. The requirement for dental services was found to be increasing due to population growth and higher per capita demand due to decreased endentulism. The supply of dental services was found to be mildly decreasing due to balanced supplementation and attrition processes and subtle sex ratio and age distribution changes among dentists. The resulting market excess, even after consideration of idle capacity and transfer of services supplied to dental therapists, provides a marked contrast to many, but not all, developed countries. It also offers an opportunity to shape occupational and specialty distribution to the advantage of dental professions and the public.

Age Factors↗
PubMed1992

[[Changes in the labor force in Taiwan: 1979-1990]].

"The purpose of this paper is to investigate the effect of age composition on labor force participation rate as well as the change in age-specific labor force participation rate for both males and females in Taiwan.... Data [are] obtained from the Taiwan Manpower Utilization Survey from 1979 to 1990. Results from the standardization analyses indicated that the age composition change from 1979 to 1990 has a leveling effect on the labor force participation rate (LFPR) for both males and females. During the period of time, rate of male labor force participation has...decreased while female labor force participation rate has...increased and then [leveled] off." (SUMMARY IN ENG)

Age Distribution↗
PubMed1982

Intravenous benzodiazepines as anaesthetic agents: pharmacokinetics and clinical consequences.

Despite extensive and numerous pharmacokinetic studies on benzodiazepines, the published pharmacokinetic data do not adequately explain the clinical differences found between different benzodiazepine derivatives after intravenous administration. Especially, correlations between initial drug responses and distributional changes of the benzodiazepines are limited. However, during the elimination phase some relationships exist between the kinetic and dynamic phenomena. Age, sex, diseases and concomitantly given drugs cause clinically important alterations in the pharmacokinetics of benzodiazepines. Generally these anxiolytics and sedatives should be considered as adjuvants to general anaesthesia, but not primarily as routine induction agents. The major reasons for this limitation are a high variability in drug response, a relatively slow onset of action and long-lasting residual effects. However, benzodiazepines have many important advantages (see Table 5) when used as intravenous inducing agents of general anaesthesia.

Adult↗
PubMed1993

Distribution of fluoride in cortical bone of human rib.

We describe a detailed study of fluoride distribution with age in the human cortical rib bone. Human ribs were obtained from 110 subjects (M:68, F;42) aged 20-93 years. The fluoride distribution from the periosteal to endosteal surfaces of the ribs was determined by sampling each specimen using an abrasive micro-sampling technique, and the samples were analyzed using the fluoride electrode, as described by Weatherell et al. [1]. The concentration of fluoride was highest in the periosteal region, decreased gradually towards the interior of the tissue where the concentration of fluoride tended toward the plateau, and then rose again towards the endosteal surface. Patterns of fluoride distribution changed with age, and the difference between periosteal and endosteal fluoride levels increased with age. Although average fluoride concentrations increased with age in both sexes, there was a significant difference between males and females at the age of about 55 years (P < 0.05).

Adult↗
PubMed1987

Demographic aspects of population aging in developed countries.

There has been a dramatic growth of the elderly (aged 60+) population in the developed countries since 1950. By the year 2000, roughly 20% of the population in these countries will belong to the aged. Women far outnumber men among the elderly due to differential mortality trends between the sexes. Male life expectancy at age 60 varies from 19.1 years in Japan to 14.6 years in Hungary. Among females, the range is from 23.2 years (Canada) to 18.4 years (Romania). Mortality rates have declined dramatically in several countries since 1970 due primarily to declines in death rates from ischaemic heart disease and stroke.

Aged↗
PubMed2001

Highly active antiretroviral-treated HIV-infected children show fat distribution changes even in absence of lipodystrophy.

BACKGROUND: Combined use of dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI) allows a precise estimate of regional body composition and intra-abdominal adipose tissue (IAT). Data on body composition in HIV-infected children (HIV+) receiving highly active antiretroviral therapy (HAART) with (LD+) and without (LD-) lipodystrophy are lacking. METHODS: DXA scans were performed in 34 HIV+: six LD+, 28 LD- and 34 pair-matched (age, sex and body mass index) healthy controls (HC): six for LD+ (HC+) and 28 for LD- (HC-). MRI scans were performed in 16 HIV+: six LD+, 10 LD- and 16 pair-matched (age and sex) HC. Data were analysed by analysis of variance, post hoc Fisher test and Mann-Whitney test. RESULTS: LD+ and LD- were similar for: previous exposure to zidovudine/zidovudine + didanosine, months on HAART (stavudine + lamuvidine + one protease inhibitor), CD4+ cells, patients with HIV-RNA < 50 copies/ml. In HIV+ and HC, fat mass and distribution were significantly different, whereas lean mass was comparable. Thus, LD+ and LD- as compared to HC+ and HC- respectively showed: (1) reduced fat amount and percentage; (2) lower truncal fat mass; (3) markedly reduced limbs fat mass. Within the HIV+ group, (4) LD+ showed higher fat trunk/fat total (P = 0.04) and lower fat limbs/ fat total ratios (P = 0.009) than LD-; (5) LD+ showed larger IAT areas than LD- and HC (P < 0.0003). CONCLUSIONS: Increased central fat and peripheral lipoatrophy are distinctive features of all HAART-treated children. Changes in body fat composition are detectable by DXA even in the absence of signs of Lipodystrophy. Only LD+ show true central obesity.

Absorptiometry, Photon↗
PubMed1999

Changes of regional distribution of bone mineral according to age, gender, and activity.

To assess the pattern of bone mineral distribution over various parts of the skeletal system depending on age, gender, and level of activity, bone mineral content of the head, arms, trunk, and legs was measured and expressed as percentage of the whole-body mineral content (H%, A%, T%, and L%) by a QDR-4,500 (Hologic) in 814 subjects between ages of 20 and 99, 205 men and 609 women. In ambulant, self-supporting subjects classified as ADL 1, women had higher H%, lower A%, and lower L% at each age group than in men. In subjects older than 60 years of age, H% increased and L% decreased markedly in women, whereas these changes were milder in men. Women, but not men, showed definite fall of L% and rise of H% along with the decrease of the level of activity. In hospitalized female subjects with a lower level of activity, but not in ambulatory female subjects, fall of L% and rise of H% was noted after 1 year, unlike the results in their male counterparts. Mineral distribution changes over the whole body characterized by age, gender, and activity may serve as new indices for evaluation of skeletal changes caused by aging, lifestyle, and disease.

Activities of Daily Living↗
PubMed1998

Age- and gender-related elastin distribution changes in human vocal folds.

The composition of the lamina propria in human vocal folds has been shown to affect vocal performance. Elastin plays a significant role in the biomechanical effects of the lamina propria. We obtained 19 larynges from the state medical examiner from subjects whose cause of death was unrelated to the trachea and laryngeal regions. The sample contained male and female subjects in the infant, adult, and geriatric age groups. We stained the vocal folds for elastin with Verhoeff's elastic tissue stain and studied them with use of an image analysis system configured for light microscopy. Distributions of elastin were measured from superficial to deep within the lamina propria (from epithelium to vocal muscle). These elastin distributions were then compared with the use of statistical software. The data showed that there was an increase in elastin content from the infant through geriatric stages. No gender-related differences were found. Infant folds had about 23% of the elastin found in adults, and geriatric subjects had about 879% of the elastin found in adults. Both of these results were statistically significant (p < 0.05). The distributions were consistent with previous observations that the lamina propria is a layered structure with most of the elastin present in the intermediate layer. This layer was larger in geriatric subjects than in adult and pediatric subjects. We observed that the fiber diameter appeared to be larger in geriatric subjects (this observation is currently being verified with electron microscopy) whereas smaller, spiraled fibers appeared in pediatric subjects.

Actin Cytoskeleton↗
PubMed1992

Oxytocin receptor distribution reflects social organization in monogamous and polygamous voles.

The neuropeptide oxytocin has been implicated in the mediation of several forms of affiliative behavior including parental care, grooming, and sex behavior. Here we demonstrate that species from the genus Microtus (voles) selected for differences in social affiliation show contrasting patterns of oxytocin receptor expression in brain. By in vitro receptor autoradiography with an iodinated oxytocin analogue, specific binding to brain oxytocin receptors was observed in both the monogamous prairie vole (Microtus ochrogaster) and the polygamous montane vole (Microtus montanus). In the prairie vole, oxytocin receptor density was highest in the prelimbic cortex, bed nucleus of the stria terminalis, nucleus accumbens, midline nuclei of the thalamus, and the lateral aspects of the amygdala. These brain areas showed little binding in the montane vole, in which oxytocin receptors were localized to the lateral septum, ventromedial nucleus of the hypothalamus, and cortical nucleus of the amygdala. Similar differences in brain oxytocin receptor distribution were observed in two additional species, the monogamous pine vole (Microtus pinetorum) and the polygamous meadow vole (Microtus pennsylvanicus). Receptor distributions for two other neurotransmitter systems implicated in the mediation of social behavior, benzodiazepines, and mu opioids did not show comparable species differences. Furthermore, in the montane vole, which shows little affiliative behavior except during the postpartum period, brain oxytocin receptor distribution changed within 24 hr of parturition, concurrent with the onset of maternal behavior. We suggest that variable expression of the oxytocin receptor in brain may be an important mechanism in evolution of species-typical differences in social bonding and affiliative behavior.

Animals↗
PubMedDate not supplied

Use of condoms by heterosexually active drug abusers before and after AIDS education.

This study identified variables associated with increased condom use among drug abusers in a randomized trial of three AIDS educational programs in a short-term inpatient detoxification program. Participants (n = 301) completed baseline and follow-up interviews and were heterosexually active on both occasions. At baseline, 10% always, 24% sometimes, and 66% never used condoms, and this distribution changed only slightly at follow-up. Among the latter two groups, 21% increased their use. There was no differential intervention effect on changes in condom use. Women, but not men, were more likely to initiate condom use than to increase to consistent use with all partners, and to initiate use if they had multiple partners. Although beneficial attitudes and beliefs about condoms were more common among women at baseline, positive changes in these attitudes/beliefs were associated with increased condom use among men only. Among men, personal attitudes and beliefs were associated with increased condom use, while among women, perceptions of the attitudes of sexual partners were more important.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Age- and gender-related changes in the distribution of osteocalcin in the extracellular matrix of normal male and female bone. Possible involvement of osteocalcin in bone remodeling.

With increasing age, bone undergoes changes in remodeling that ultimately compromise the structural integrity of the skeleton. The presence of osteocalcin in bone matrix may alter bone remodeling by promoting osteoclast activity. Whether age- and/or gender-related differences exist in the distribution of osteocalcin within individual bone remodeling units is not known. In this study, we determined the immunohistochemical distribution of osteocalcin in the extracellular matrix of iliac crest bone biopsies obtained from normal male and female volunteers, 20-80 yr old. Four different distribution patterns of osteocalcin within individual osteons were arbitrarily defined as types I, II, III, or IV. The frequency of appearance of each osteon type was determined as a percent of the total osteons per histologic section. The proportion of osteons that stained homogeneously throughout the concentric lamellae (type I) decreased in females and males with increasing age. The proportion of osteons that lack osteocalcin in the matrix immediately adjacent to Haversian canals (type III) increased in females and males with age. Osteons staining intensely in the matrix adjacent to Haversian canals (type II) increased in females and was unchanged in aging males. Osteons that contained osteocalcin-positive resting lines (type IV) increased in bone obtained from males with increasing age but were unchanged in females. Sections of bone immunostained for osteopontin (SPP-I), osteonectin, and decorin did not reveal multiple patterns or alterations in staining with gender or increasing age. We suggest that the morphology of individual bone remodeling units is heterogeneous and the particular morphologic pattern of osteocalcin distribution changes with age and gender. These results suggest that differences in the distribution of osteocalcin in bone matrix may be responsible, in part, for the altered remodeling of bone associated with gender and aging.

Adult↗
PubMed2000

Efficacy of troglitazone on body fat distribution in type 2 diabetes.

OBJECTIVE: The insulin-sensitizing action of troglitazone may be mediated through the activation of peroxisome proliferator-activated receptor-gamma (PPAR-gamma) and the promotion of preadipocyte differentiation in adipose tissue on which troglitazone has depot-specific effects. We investigated the relationship between efficacy of the drug and body fat distribution. Changes in body fat distribution were also investigated by long-term administration of the drug. RESEARCH DESIGN AND METHODS: Troglitazone was given at a dose of 400 mg/day to 20 patients with type 2 diabetes whose diet and sulfonylurea therapy produced unsatisfactory glycemic control (HbA(1c) >7.8%) and whose insulin secretory capacity was found to be preserved (postprandial C-peptide >3 ng/ml). HbA(1c) values, serum lipid levels, and body weight were measured monthly Body fat distribution was evaluated in subcutaneous (SC) and visceral fat using a computed tomography scan at umbilical levels before and after troglitazone therapy RESULTS: During the 1-year troglitazone treatment, HbA(1c) was significantly decreased (from 9.2 +/- 0.2 to 7.1 +/- 0.2%, P < 0.01), showing lowest values at 4-6 months, whereas body weight was significantly increased (BMI 24.6 +/- 0.6 to 25.7 +/- 0.6 kg/m2, P < 0.01). Reduction of HbA(1c) (deltaHbA(1c)) from the baseline value during treatment was significantly greater in obese patients (BMI >26 kg/m2) than in nonobese patients (-3.2 +/- 0.4 vs. -2.1 +/- 0.3%, P < 0.05) and was more significant in women than in men (-3.2 +/- 0.2 vs. - 1.4 +/- 0.2%, P < 0.01). The level of deltaHbA(1c) during treatment showed a significant negative correlation with SC fat area (r = -0.742, P < 0.01) but not with visceral fat area. Weight gain during troglitazone treatment resulted in increased accumulation of SC fat without a change in visceral fat area and, consequently. in a significant decrease in the visceral-to-SC fat ratio. CONCLUSIONS: Predominant accumulation of SC fat for the visceral fat tissue was an important predictor of the efficacy of troglitazone therapy in patients with type 2 diabetes. Greater efficacy of troglitazone was observed in women who were characterized by more accumulation of SC adipose tissue than men. Long-term administration of the drug resulted in weight gain with increased accumulation of SC adipose tissue, probably because of the activation of PPAR-gamma in the region.

Adipose Tissue↗
PubMed1995

The Harstad injury prevention study: hospital-based injury recording used for outcome evaluation of community-based prevention of bicyclist and pedestrian injury.

OBJECTIVE: To test the feasibility of a hospital-based injury recording for accident analysis and outcome evaluation of bicyclist and pedestrian injury prevention. DESIGN: Prospective injury recording lasting 7 1/2 years, using a quasi-experimental design. SETTING: The population of Harstad (22,000). INTERVENTION: Injury data were evaluated in an injury prevention group and used in planning a community-based intervention. Promotion of bicyclist helmet use and pedestrian safe behaviour was implemented by activating public and voluntary organizations and media. A traffic safety pamphlet containing local traffic injury data was distributed. Changes were made in the physical traffic environment. MAIN OUTCOME MEASURES: Injury rates for bicyclists and pedestrians. RESULTS: In 275 bicyclists upper extremity and head injuries were predominant 70% were below 16 years. In 137 pedestrians lower extremity injury was most frequent and children below 10 years had the highest injury rates. Significant injury rate reductions were observed after intervention for child bicyclists and pedestrians. CONCLUSION: A hospital-based injury recording is feasible for bicyclists and pedestrian accident analysis, planning injury prevention, and outcome evaluation of the programme. This study indicates that a significant injury rate reduction in children may have been the result of the intervention.

Accidents, Traffic↗
PubMed1982

Social-demographic development of Vologda Oblast during the intercensal period 1970-79.

"Demographic trends in Vologda Oblast are analyzed on the basis of 1979 census results as a case study of an oblast involved in the [development] program for the Nonchernozem Zone of the RSFSR. The trend in the 1970-79 intercensal period was for continuing growth of urban population, especially in the two major urban centers of Vologda and the iron and steel city of Cherepovets, and depopulation of rural areas. The age-sex structure is distinguished by a strong aging trend and sex imbalance, especially in rural areas. Despite the proclaimed aim of fostering abandonment of tiny rural places (with 25 residents or less), the number of places in that size class actually increased during the intercensal period (from 40% of all rural places in 1970 to 52 percent in 1979)."

Age Distribution↗