Articles: middle-aged.
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JNMA J Nepal Med Assoc · Jan 2024
Case ReportsPrimary Sjogren's Syndrome with Bicytopenia: A Case Report.
Sjogren's syndrome is a chronic multisystem autoimmune disease presenting a wide variety of clinical manifestations ranging from mild sicca symptoms to severe systemic symptoms involving pulmonary, renal, musculoskeletal, cutaneous, and haematological diseases. These symptomatic diversities can delay the correct diagnosis of Sjogren's Syndrome for a long time. Here, we report the case of a 59-year-old woman with fatigue and weakness in whom bicytopenia was documented. A thorough bicytopenia workup brought us to the final diagnosis of Sjogren's syndrome. Hydroxychloroquine was started which normalized the patient's blood parameters and clinical symptoms. The haematological alterations in Sjogren's syndrome are not pathognomonic. However, only bicytopenia can be the initial presentation of Sjogren's syndrome as in our patient. Therefore, inexplicable bicytopenia in a middle-aged female may alert the clinician about the possibility of Sjogren's syndrome. ⋯ autoimmune diseases; case reports; cytopenia; sjogren's syndrome.
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Chinese medical journal · Nov 2022
Changes of human immunodeficiency virus (HIV) burden globally and in China over three decades: a secondary analysis of global HIV statistics.
A more comprehensive understanding of the trends of incidence, prevalence, and mortality in human immunodeficiency virus (HIV), and their complex interrelationships, may provide important evidence for decision-making related to HIV prevention and control. The variances in these indices between different population groups, genders, and ages are critical to decipher evolving patterns of the HIV epidemic in specific populations. ⋯ Prevalence and mortality rates of HIV/AIDS have increased between 1990 and 2019 globally and in China. While the incidence rate and MPR have declined globally over the past three decades, these two indicators are observed to present an increasing trend in China. There is a high HIV burden among young and middle-aged adults globally; however, the elderly have a high HIV burden in China. HIV screening at older age should be scaled up, and patients with advanced HIV disease should be provided early with additional care and health resources.
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Observational Study
Observational study on obesity: Insights from middle-aged and elderly college staff in Beijing.
Obesity poses a serious global public health challenge, particularly among middle-aged, and elderly college staff. This study aims to explore the associated factors of obesity by analyzing the metabolic indicators of 1756 university staff from Minzu University of China, Beijing. ⋯ Multiple linear regression analysis revealed that BMI values increase with age (B = 0.074, P < .001), uric acid (B = 0.008, P < .001), alanine transaminase (B = 0.043, P < .001), low-density lipoprotein (B = 1.941, P < .001), triglycerides (B = 0.544, P < .001), total cholesterol (TC, B = -1.582, P < .001), and other factors, while decreasing with the increase of high-density lipoprotein (B = -1.493, P < .001). In light of these findings, it is recommended that middle-aged and elderly college staff undergo regular blood indicator checks and enhance weight management to mitigate the risk of obesity and promote their overall health.
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Higher body mass and obesity are associated with bodily pain, and rates of chronic pain increase among older adults. Most past studies are cross-sectional, precluding determination of the temporal relationship between body mass and pain. A longitudinal study of body mass and pain among middle-aged adults found that higher body mass index (BMI) led to greater lower back pain. ⋯ In addition, the relationship changed with age, until approximately age 80 years, increasing joint pain contributed to higher BMI, but after that time increasing joint pain contributed to lower BMI. In addition, sex differences in the relationship between BMI and pain appeared after age 70 years. Thus, joint pain contributes to changes in BMI among middle-aged and older adults, but the relationship may change by age and sex.
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Cochrane Db Syst Rev · Mar 2022
ReviewOral dextrose gel for the treatment of hypoglycaemia in newborn infants.
Neonatal hypoglycaemia, a common condition, can be associated with brain injury. It is frequently managed by providing infants with an alternative source of glucose, often given enterally with milk-feeding or intravenously with dextrose solution, which may decrease breastfeeding success. Intravenous dextrose also often requires that mother and baby are cared for in separate environments. Oral dextrose gel is simple and inexpensive, and can be administered directly to the buccal mucosa for rapid correction of hypoglycaemia, in association with continued breastfeeding and maternal care. This is an update of a previous review published in 2016. ⋯ We included two studies conducted in high-income countries, involving 312 late preterm and at-risk term infants and comparing oral dextrose gel (40% concentration) to placebo gel. One study was at low risk of bias, and the other (an abstract) was at unclear to high risk of bias. Oral dextrose gel compared with placebo gel probably increases correction of hypoglycaemic events (rate ratio 1.08, 95% confidence interval (CI) 0.98 to 1.20; rate difference 66 more per 1000, 95% CI 17 fewer to 166 more; 1 study; 237 infants; moderate-certainty evidence), and may result in a slight reduction in the risk of major neurological disability at age two years or older, but the evidence is uncertain (risk ratio (RR) 0.46, 95% CI 0.09 to 2.47; risk difference (RD) 24 fewer per 1000, 95% CI 41 fewer to 66 more; 1 study, 185 children; low-certainty evidence). The evidence is very uncertain about the effect of oral dextrose gel compared with placebo gel or no gel on the need for intravenous treatment for hypoglycaemia (RR 0.78, 95% CI 0.46 to 1.32; RD 37 fewer per 1000, 95% CI 91 fewer to 54 more; 2 studies, 312 infants; very low-certainty evidence). Investigators in one study of 237 infants reported no adverse events (e.g. choking or vomiting at the time of administration) in the oral dextrose gel or placebo gel group (low-certainty evidence). Oral dextrose gel compared with placebo gel probably reduces the incidence of separation from the mother for treatment of hypoglycaemia (RR 0.54, 95% CI 0.31 to 0.93; RD 116 fewer per 1000, 95% CI 174 fewer to 18 fewer; 1 study, 237 infants; moderate-certainty evidence), and increases the likelihood of exclusive breastfeeding after discharge (RR 1.10, 95% CI 1.01 to 1.18; RD 87 more per 1000, 95% CI 9 more to 157 more; 1 study, 237 infants; moderate-certainty evidence). AUTHORS' CONCLUSIONS: Oral dextrose gel (specifically 40% dextrose concentration) used to treat hypoglycaemia in newborn infants (specifically at-risk late preterm and term infants) probably increases correction of hypoglycaemic events, and may result in a slight reduction in the risk of major neurological disability at age two years or older. Oral dextrose gel treatment probably reduces the incidence of separation from the mother for treatment and increases the likelihood of exclusive breastfeeding after discharge. No adverse events have been reported. Oral dextrose gel is probably an effective and safe first-line treatment for infants with neonatal hypoglycaemia in high-income settings. More evidence is needed about the effects of oral dextrose gel treatment on later neurological disability and the need for other treatments for hypoglycaemia. Future studies should be conducted in low-and middle-income settings, in extremely and moderately preterm infants, and compare oral dextrose gel with other therapies such as intravenous dextrose. There are two ongoing studies that may alter the conclusions of this review when published.