aging

Cervical cancer constitutes an issue in public health, becoming the leading cause of death by cancer in women between 20-40 years of age in Latin America. In Argentina 5000 new cases are diagnosed each year, where more than 56% are in advanced stages. The aim of the present current opinion or critical review article is to remark the importance of the prognostic significance of the Central Tumor Size in stages IIB and IIIB cervical cancer, as well as to propose a new FIGO Staging System for Cervical cancer and trying to find out a role for the different therapeutic strategies for those cases.

It is the dart that penetrates deep into my soul, every time I see with my own eyes how the incidence of cancer has grown in recent years. I am a pathologist. I am dedicated to diagnosing the disease from the cellular and tissue point of view. The answer to the question that haunts me may seem easy, simple, but I am not satisfied with knowing that advances in technology make it possible to diagnose a greater number of entities, many of them in early stages [1]. Of course, this statement is true. However, in recent years we have verified a greater number of cases with aggressive phenotypes, a fact that makes us ask ourselves certain questions. The first one is: Why? We know that cancer is a multifactorial disease in which genetics and different environmental factors participate. Are we witnessing the concurrence of factors that facilitate the greatest degree of neoplasms? Are habits the cause of this paradigm shift? On the table for debate is the therapeutic success of new strategies, of new drugs, of new algorithms, but the morphology is also changing. This change is exacerbated in the times of pandemic that we have lived through [2]. Pathologists attend a number of cancer diagnoses that have grown exponentially, as has the histological grade, not the staging, of it. And the initial question remains in the air, why? The fear of going to the hospital, the fear of self-exploration, the diversion of media attention to topics that arouse greater interest ... may be having a harmful effect on the health of patients [3]. I do not tell anything new, at least nothing that cannot be assumed by analyzing what happens every day in this new world, a world that will soon have to face, if not already, a cut in resources, research and other parameters that will negatively influence the answers to the eternal question: Why? In the era of personalized medicine, the same one that has reached or is close to reaching great milestones in the survival of once-deadly diseases, the microscope shows a parallel reality and allows, at least, to be pessimistic, or at least realistic: suffering…

Since the advent of antibiotics, lateral sinus thrombosis is an infrequent complication of otitis media. Lateral sinus thrombosis may occur by thrombophlebitis or penetration by offending pathogens through the dura of middle and posterior cranial fossae. We present a case of right-sided sigmoid and transverse venous sinus thrombosis as a rare complication of chronic suppurative otitis media in an adult. We discuss the patient’s imaging, management and relevant literature to offer clinical recommendations. A 39-year-old woman presented with headache, neck pain, vomiting, fever and photophobia with a tender right mastoid on examination. Computerised Tomography, Magnetic Resonance Imaging and Magnetic Resonance Venogram of the head revealed complete opacification of the right mastoid air cells and middle ear, with absent flow void in the right transverse and sigmoid sinus, consistent with thrombosis. After discussion with neurosurgery, she was commenced on anticoagulants. The patient was readmitted with right otalgia and otorrhea refractory to medical treatment, and ultimately underwent right mastoid exploration. Conclusion: Lateral sinus thrombosis may occur with other intracranial or extracranial complications of otitis media. Clinicians should approach any complication of otitis media with vigilance as antibiotics may mask some signs and symptoms of mastoiditis, which can progress to otogenic brain abscess.

The doctor-patient communication and the aging of the patients attended by the general practitioner are two important concepts that constantly impact medical consultations. This article raises some reflections and conceptualizations about the main psychological phenomena that have a special importance in the doctor-elderly patient communication and relationship: 1) Stereotypes and prejudices; 2) Regression; 3) Transference, countertransference and resistance; 4) Rapport; 5) Empathy; and 6) Paternalism. The GP must be alert about what affecting the communication with the old man and he should put the means to get a warm relationship. Consequently, to achieve effective communication with an older adult: The GP have to take it easy; to be patient; avoiding stereotypes and prejudices; allowing the patient to establish a benign regressive relationship, until if it is possible due to the biopsychosocial context of the elderly patient, he can begin the non-regressive relationship again; recognizing fact of transference, which put the doctor in another place, is inevitable, but taking into account that it greatly affects his relationship with the patients; avoiding countertransference; considering that the therapeutic alliance or rapport is particularly fragile in elderly patients with chronic diseases; giving greater importance to empathy; knowing that the elderly patient frequently accepts the authority of the doctor, but avoiding falling into an iatrogenic paternalism; and smile.

Background: Tongue swelling often presents as an acute upper airway obstruction. Aim: To present a case series of patients presenting with an acute tongue swelling sharing our experience in managing these patients. Subjects and methods: A retrospective analysis of consecutive patients presenting acutely to the emergency department (ED) at two institutions in Scotland. All patients were evaluated by an otolaryngologist for probable causes of tongue swelling. Data were collected on demographics, co-morbidities, clinical history, examination findings, acute airway management and subsequent care the patients needed. Results: A total of 32 patients (mean age ± STD, 61.6 ± 18.8; 65% male) were included in the study from two teaching hospitals. The most common presenting symptoms were difficulty in speaking (30/32, 94%) and dysphagia (27/32, 84%). Breathing difficulty was only observed in 8 of 32 patients (25%). Angiotensin converting enzyme (ACE) inhibitor’s induced angioedema was the most common cause (45%) for acute tongue swelling. Three (9.4%) patients required intubation; 2 (6.3%) on initial presentation. Two patients had emergency tracheostomy for breathing difficulties due to supraglottic swelling on flexible pharyngolaryngoscopy. Conclusion: Acute tongue swelling is a life-threatening condition. The patients on ACE inhibitors would appear to be at higher risk of developing acute tongue swelling. Such patients with potentially compromised airway need to be treated in a facility where emergency intubation and tracheostomy can be performed at a short notice.

Coronavirus disease 2019 (covid-19) pandemic gives rise to a significant number of psychological consequences and health problems. The GP must recognize the feelings generated in their patients and address them. This task includes 4 areas: 1. Knowing and managing the epidemic of anxiety and fear in patients; 2. Assessing possible de-compensation of patients with previous mental problems; 3. Knowing and managing effects of quarantine and social distancing; and 4. Knowing and managing possible truncated mourning. The recommendations for GPs intervention are: 1) In the clinical interview (identify maladaptive thoughts and emotions; comprehensive health); 2) Health information (clear, evidence-based communication); 3) Health education (healthy behaviors); 4) Telecare (support, monitoring and attention over the phone, via WhatsApp or video calls); 5) Crisis interventions (psycho education, cognitive behavioral techniques or referral to specialist); 6) Bibliotherapy (free electronic copies for the public); 7) Special efforts directed at vulnerable populations (infected and sick patients, the elderly, with a compromised immune function and those living or receiving care in congregated settings and people with adverse medical, psychiatric or with substance use problems, their families and caregivers); 8) Psychosocial monitoring (stressors related to COVID-19: exposures to infected sources, infected family members, loss of loved ones and physical distancing, secondary adversities such as economic loss, psychosocial effects such as depression, anxiety, psychosomatic concerns, insomnia, increased use of substances and domestic violence, and vulnerability indicators such as pre-existing physical or psychological conditions); and 9) Follow-up of the “complicated” mourning (“accompaniment” and transmit compassion, love and affection).

Background: Corneal injuries are significant contributors to blindness. Cornea being the most anterior structure of eye is exposed to various hazards like airborne debris and blunt trauma. By understanding different types of injuries to which cornea is exposed, the practitioner maybe more capable in managing injuries to minimise structural and visual sequelae. Objectives: To study various patterns of corneal injuries and its visual outcome among patients of ocular trauma in a tertiary care hospital. Methods: Study of 100 cases of corneal injuries wherein patients were treated according to injury type and followed up for 4 months. Results: Majority of patients belonged to working population between age groups 21-65 years. Most patients suffered from corneal abrasions while the least common were perforating and lacerating injuries. Alkali injuries were more common than acid injuries. Most patient presented within 24 hours and had only epithelial defects. Therefore, the number of patients receiving conservative management was higher than those receiving surgical intervention. Conclusion: Most common causes of blindness and low vision in our study was full thickness corneal laceration and corneal abrasions, foreign body injuries affecting the pupillary area and involving anterior or mid stroma causing nebular or macular grade opacities hampering vision.

Background: 188Re-liposome has been used for evaluating the theranostic efficacy on human head and neck squamous cell carcinoma (HNSCC) at preclinical stages. Here we furthercompared the microRNA expressive profile in orthtopic HNSCC tumor model exposed to 188Re-liposome. Methods: A single dose or dual doses of 188Re-liposome was intravenously injected into tumor-bearing mice followed by the Cerenkov luminescent imaging (CLI) for monitoring the accumulation of 188Re-liposome in tumors. The microRNA expressive profile was generated using the Taqman® OpenArray® Human MicroRNA Panel followed by the DIANA mirPath analysis, KEGG signaling pathways prediction, and Kaplan-Meier survival analysis for predicting the prognostic role of 188Re-liposome affected microRNAs. Results: Dual doses of 188Re-liposome exhibited a better tumor suppression than a single dose of 188Re-liposome, including reduced tumor size, Ki-67 proliferative marker, and epithelial-mesenchymal transition (EMT) related factors. The microRNA expressive profiles showed that 22 microRNAs and 19 microRNAs were up-regulated and down-regulated by dual doses of 188Re-liposome, respectively. Concomitantly, these two groups of microRNAs were inversely regulated by a single dose of 188Re-liposome accordingly. These microRNAs influenced most downstream genes involved in cancer related signaling pathways. Further, miR-520e and miR-522-3p were down-regulated whereas miR-186-5p and miR-543 were up-regulated by dual doses of 188Re-liposome, and they separately affected most of genes involved in their corresponding pathways with high significance. Additionally, high expressions of miR-520e and miR-522-3p were associated with lower survival rate of HNSCC patients. Conclusion: MicroRNA expression could be used to evaluate the therapeutic efficacy and regarded prognostic factors using different doses of 188Re-liposome.

Alzheimer’s Disease (AD) is a common dementia problem of the old population. The two main hallmarks of AD are tau protein and amyloid-beta protein. The relevant investigations on AD suggest that these proteins are also seen in the eye. There are many tests and imaging modalities are used for AD diagnosis. But these techniques are still unable to predict the disease effectively. In this regard, the lens of the eye may help in diagnosing AD. Therefore, a reliable technique for measuring the lens or retina must be selected. In this paper, we focus on the different types of retinal diseases occur in AD patients and the use of the Optical Coherence Tomography (OCT) technique is used for diagnosing AD. 

In the current study, we have investigated pros and cons controversy on molecular imaging and dynamics of double-standard DNA/RNA of human preserving stem cells-binding Nano molecules with Androgens/Anabolic Steroids (AAS) or Testosterone derivatives through tracking of Helium-4 nucleus (Alpha particle) using synchrotron radiation. In this regard, the enzymatic oxidation of double-standard DNA/RNA of human preserving stem cells-binding Nano molecules by haem peroxidases (or heme peroxidases) such as Horseradish Peroxidase (HPR), Chloroperoxidase (CPO), Lactoperoxidase (LPO) and Lignin Peroxidase (LiP) is an important process from both the synthetic and mechanistic point of view

At present Corona virus is the most burning topic across the world. At present there is no drug available to cure 100%. So many companies are trying to make it possible as soon as they can. The basic characteristics of the product is “Non-Toxic made of sugars Carbohydrates”. A Galectin is a protein that recognizes carbohydrates and modulates intracellular and extracellular interactions primarily related to the immune system. In some cases Galectins act as a glue bringing molecules together. The major focus of the research is on extracellular interactions.

Functional appliances used in correction of class II malocclusions are shown to modify the neuromuscular environment of dentition & associated bones. There are many studies related to the skeletal, dental and neuromuscular changes which are evaluated cephalometrically, clinically as well as with the recent diagnostic aids like MRI. The aim of this short communication was to highlight and discuss the different aspects of condylar modifications and its role in its growth. The Twin Block has higher effectiveness & comfort as compared to other removable functional appliances [1.2]. The action of Twin Block & Bionator is for 24 hours so effects are more with these appliances. Over the years, several theories have emerged attempting to shed light on condylar growth. One of the earliest theories, the genetic theory, suggests the condyle is under strong genetic control like an epiphysis that causes the entire mandible to grow downward and forward. Although this may be related more to development of the prenatal than postnatal condyle, the theory does indirectly question the effectiveness of orthopedic appliances in condylar growth as proposed by Brodie [3,4]. Several long-term investigations actually showed clinically insignificant condylar growth modification after continuous mandibular advancement with a reasonable retention period in human beings although the initial treatment results appeared encouraging. This leads to the conclusion that the general growth of the condyle appears relatively unalterable in long-term studies. A second hypothesis based on the earliest available acute and blind EMG monitoring technique, suggests that hyperactivity of the lateral pterygoid muscles (LPM) promotes condylar growth. Rees reported that other muscles and tendons, including those of the deep masseter and temporalis, also attach to the articular disk region. Attachments of the LPM to the condylar head or articular disk may be expected to cause condylar growth, but anatomic research has not found evidence that significant attachments actually exist [5,6]. The LPM tendon is observed attaching, however, to the anterior border of the fibrous capsule that in turn attaches to the fibrocartilage of the condylar head and neck anteriorly. At the same time, it is doubtful that initial hyperactivity could occur where the LPM muscle has been shortened by continuous mandibular displacement therapy. By using LPM myectomy in rats, which may have disrupted condylar blood supply, Whetten and Johnston found little evidence that LPM traction had any pronounced effect on condylar growth. More recently, permanently implanted longitudinal muscle monitoring techniques have found that the condylar growth is actually related to decrease postural and functional LPM activity. This notion was also supported in human studies by Auf der Maur, Pancherz and Anehus- Pancherz, and Ingervall and Bitsanis that reported decreased muscle activity. The LPM hyperactivity theory brought forward by Charlier et al. Petrovic, and later espoused by McNamara however, was important in prompting further investigations in muscle-bone interactions [7,8]. A third hypothesis, the functional matrix theory, postulates the principal control of bone growth is not the bone itself, but rather the growth of soft tissues directly associated with it. Although this was supported in part by investigations testing the different growth and developmental responses between the condyle and epiphysis, there has been no explanation as to exactly how condylar growth would be stimulated. Thus, this theory’s validity has been questioned. One of the reasons was that there was little explanation of the specific mechanism by which the condyle was stimulated to grow. Endow and Hans presented an excellent overall perspective suggesting that mandibular growth is a composite of regional forces and functional agents of growth control that interact in response to specific extra-condylar activating signals [9,10].

Aim and objective: Dentistry for children is not difficult but is different from what is practiced for adults. The children reacts to differently to people and places around them. Anxiety is an emotional state that helps normal individual defend themselves against a variety of threats and Dental anxiety refers to patients specific response towards dental suitation-associated stress. so the aim is to evaluate the anxiety related management of the children using intellectual mind game of the individual Study design: The background of the study is to evaluate and study the effectiveness of anxiety control of children using colour distraction between 5 and 12 yrs of age group as one part and the intellectual distraction of children between the same age group using buchanan facial imaging scale and intellectual coloured game chart Results and conclusion: lowering of anxiety was noticed in the children obtained the favorite colours in the dental environment and easy distraction can be achieved using intellectual gamings.

Spleen is one of the most important organ of the reticuloendothelial system and coordinates the immune response. Splenectomy is performed for hypersplenism, and staging of hematological malignancy. In conservatively followed patients, radiation therapy can be used to reduce hypersplenism symptoms. Splenectomy or palliative radiotherapy to spleen may probably cause an immune suppressive condition. This may probably local and systemic complications.

Gingival recession is defined as apical migration of the gingival epithelium leading to the exposure of root surface. There are many surgical procedures for treating gingival recessions and the main goal is to cover the exposed tooth surface by soft tissue augmentation. The surgical techniques performed for root coverage has their own advantages and limitations. The surgical technique used for managing the gingival recession is the major factor that determines the outcome and the long term result of the procedure. The most common surgical technique in treating the isolated gingival recession is the lateral pedicle graft and the surgical technique with highest percentage of root coverage is the connective tissue graft. This case report deals with the management of an isolated gingival recession with lateral pedicle and connective tissue graft. The outcome of the procedure was excellent having complete root coverage.

Objective: During aging, skin undergoes structural, cellular and molecular changes, which not only alter skin mechanical properties but also biological and physiological functions. Structurally the epidermis becomes thinner, the dermal epidermal junction flattens and the extra-cellular matrix component of the dermis is disorganized and degraded. The dermis is composed of two compartments: The Reticular dermis is the deepest and thickest part while the upper layer, the papillary dermis, which is much thinner and is in close contact with epidermis, plays an important role in the structure and function of the skin. We have recently shown that the papillary dermis was preferentially affected by skin aging because the activity of fibroblasts in this region was especially altered as a function of age. The purpose of this study was to investigate the capacity of a flax extract as anti-aging component. Method: We investigated the capacity of a flax extract to stimulate or restore the activity of papillary fibroblasts from young and old donors in cultured monolayers and in reconstructed skin. Several biological markers of extracellular matrix homeostasis and mechanical properties were investigated. Results: The tested flax extract seemed to improve parameters known to change with age: I/ In monolayers after treatment the number of aged fibroblasts increased II/ In reconstructed skin the flax extract appears to positively regulate some biological activities; particularly in aged fibroblasts where the deposition of laminin 5, fibrillin 1, procollagen I were increased in the dermis and the secretion of specific soluble factors like MMP1, MMP3 and KGF were regulated to levels similar to those observed in young fibroblasts III/ Mechanical properties were improved particularly for elastics parameters (R5, R2 and R7). Conclusion: The flax extract is a promising anti-aging compound. The treatment of aged papillary fibroblasts resulted in a return to a younger-like profile for some of the studied parameters.

Non-invasive electrical stimulation in the form of neuromuscular electrical stimulation (NMES) and functional electrical stimulation (FES) has been documented as an optional assessment and treatment technology for decades. In contrast, translation of the robust clinical evidence supporting the effectiveness of FES’ enhancement of muscle force generation and adding to the recovery of motor control following damage to the brain appears limited. Furthermore, enabling many patients to regain locomotion ability though utilization of FES as a standard care option in rehabilitation medicine remains unmet. This perspective evolved over years of collaborative experience in clinical research, teaching, and patient care having a common goal of advancing patients’ rehabilitation outcomes. The clinical successes are supported by repeated evidence of FES utilization across the life span, from toddlers to elders, from hospitals’ critical care units to the home environment. The utilization include managing multiple deficits associated with the musculo-skeletal, neurological, cardio-pulmonary, or peripheral vascular systems. These successes were achieved in no small part because of the technological advancement leading to today’s wearable wireless FES systems that are being used throughout the continuum of rehabilitation care. However, failures to benefit from FES utilization are likewise numerous, collectively depriving most patients from using the technology to maximize their rehabilitation gains. The most critical failures are both clinical and technological. Whereas numerous barriers to NMES and FES utilization have been published, the focus of this perspective is on barriers not considered to date.

The etiology of abdominal obesity is multifactorial and has environmental factors as its most expressive risk factors. This study cross-sectional analyzed the association of abdominal fatness with physical inactivity and food inadequacy of 1,557 subjects, both genders, over 35yrs. old, enrolled in an ongoing epidemiological study. Waist circumference (WC) was the primary variable and demographic, social-economic, anthropometric and dietary intake data, were the co-variables. NCEP-ATP III, WHO, IPAQ-long (version 8) and Healthy Eating Index were used for functional definition of variables. Furthermore, longitudinal data from 50 subjects in an exercise protocol for 10 week receiving either regular diet (G1, n=22) or 30g fiber adequacy (G2; =28), were analyzed. The performed statistical analyses used software SAS for Windows, version 9.1 with p=0.05. In a predominantly female sample (74%), 76% aging 35-60yrs, 64% completed elementary school, 73% were living in a low income household, 77.5% overweight. The 62.5% presenting altered WC values were predominantly older, presented higher body fatness, and were consuming low variety-poor quality diet rich in fat (mainly saturated) and lower in fruit. WC correlated negatively with fruit intake and aerobic capacity (VO2max) but only carbohydrate (positive) and fruit intake (negative) were considered independent risk factors for abdominal obesity. In the longitudinal study, both G1 and G2 groups were similar at baseline and G1 maintained the anthropometry values throughout the experiment. Conversely, G2 decreased total body (4%) and WC (7%) fatness, reducing severe obesity by 16%, minimally affecting overweight and eutrophic rates. G2 presented 211% increase in fiber intake and 150% increase in plasma beta-carotene (colorful-fiber marker). Thus, in conclusion, recommended dietary fiber intake (increased fruit and low CHO intake) and physical activity would be the recommended changes against abdominal obesity and, by associating both physical exercises and dietary fiber there was indeed a decrease in abdominal fatness and obesity, predominantly at its higher grade.

Vestibular disorders and anxiety are closely related, probably because they share some neuronal pathways. Ageing and patient comorbidities are important facilitating factors, and multiple vascular risk factors could contribute to the onset of a vestibular syndrome called vascular vertigo. White matter lesions (WML) are often seen on magnetic resonance imaging (MRI) scans of elderly people and are related to various geriatric disorders, including dizziness. The cause of this correlation could be the disruption of neuronal networks that mediate higher vestibular cortical function. Numerous neuronal pathways link the vestibular network with limbic structures and the prefrontal cortex modulates anxiety through its connections to amygdala. The aim of the present work was to investigate the correlation between WML, amygdala and cognitive functions.

The main disturbing situation faced by any individual is obesity nowadays. Obesity occurs because of overweight and this has several reasons to gain weight like hereditary, diabetes, diet, aging, PCOS in women, stress, and tiredness. It is a major, sustaining, worsening condition of energy regulation with severe hereditary and early life natural causes. However, there are ways that we can treat obesity, but the complication emerges with the side effects. One way of treating obese by using lifestyle intervention involving exercise, maintaining a proper diet, and pharmacotherapy. Following this method does not affect much as mostly it includes lifestyle intervention. However, by using lifestyle intervention we could reduce weight to a certain extent only.