Search Results (5,699)

This study investigated colostrum source impact on passive immunity transfer and humoral immune development in Polypay lambs. Newborn lambs (4.80 ± 0.33 kg BW) were assigned to four groups: fresh ewe colostrum (FrC; n = 10), frozen ewe colostrum (FZ; n = 11), frozen cattle colostrum (CC; n = 11), or artificial cattle colostrum (AC; n = 11). Lambs received 65 mL/kg colostrum within 4 h post-parturition and were raised on milk replacer, creep feed, and hay until weaned (28 days of age [d]). Immunoglobulin G concentrations were measured at birth and then weekly until 28 d. Lambs were immunized with 1 mL ovalbumin (2 mg/mL PBS) at 35 and 63 d. Ovalbumin-specific antibodies were quantified. A tendency (p = 0.06) suggested FrC yielded higher relative IgG at later time points (7, 14, 21, and 28 d) compared to FZ. Frozen cattle colostrum resulted in significantly (p = 0.02) higher IgG concentrations than AC at 24 h, 7, 14, and 21 d. Fresh ewe colostrum and AC showed a faster (1 week-post-immunization) and more robust (>175%; p ≤ 0.07) ovalbumin humoral response compared to CC lambs 2 to 8 weeks-post-immunization. Fresh ewe colostrum seems to provide the best passive and adaptive immunity compared to other colostrum sources. Moreover, our results suggest that the best colostrum alternative for newborn lambs is frozen ewe colostrum. Full article

Background: The purpose of this study was to evaluate the effects of a structured barefoot walking program on menopausal symptoms, sleep quality, stress, and quality of life in middle-aged women experiencing menopausal symptoms. Methods: A quasi-experimental design with a nonequivalent control group and pretest-posttest was used. Community-dwelling women aged 45 to 65 years residing in Wonju, Republic of Korea, were recruited and assigned to either an experimental (n = 29) or control group (n = 31). The intervention consisted of 12 weeks of barefoot walking (three times per week, 60 min per session). Outcome measures included the Menopause Rating Scale (MRS), Verran and Snyder–Halpern Sleep Scale, Stress Response Inventory, and WHOQOL-BREF. In addition, changes in participants’ body composition before and after the intervention were assessed using a bioelectrical impedance analyzer (InBody 770). Data were analyzed using the Mann–Whitney U test, repeated measures ANOVA, ANCOVA, and other relevant statistical methods, with the level of significance set at p < 0.05. Results: Compared with the control group, the experimental group showed significant improvements in menopausal symptoms (z = −5.59, p < 0.001), stress (z = −3.58, p < 0.001), and quality of life (z = −3.47, p = 0.001). A significant time-by-group interaction effect was observed for sleep quality (F = 7.53, p = 0.008). No significant changes were found in body composition. Conclusion: Barefoot walking represents a promising, low-cost, community-based intervention for alleviating menopausal symptoms, enhancing sleep quality, reducing stress and improving quality of life in middle-aged women experiencing menopausal symptoms. Further randomized controlled trials are warranted to confirm these findings. Full article

Objective: Obesity increases the risk of endometrial cancer (EC). In this study, we aimed to investigate the prognostic effect of sarcopenia, sarcopenic obesity and sarcopenic visceral obesity, calculated with the help of cross-sectional imaging methods of muscle and visceral adipose tissue from body composition parameters, in EC. Methods: Patients diagnosed with EC were identified between January 2014 and June 2024. The combination of radiological markers and patient outcomes can predict prognosis. The skeletal muscle index (SMI) and visceral fat index (VFI) were calculated from computed tomography (CT) and/or abdominal magnetic resonance (MR) scans taken at the time of diagnosis at the Lumbal 3 (L3) vertebra level. The findings of these analyses demonstrate the strongest correlation with the ratio of muscle and visceral fat tissue throughout the body. The loss of muscle and fat is an unfavourable indicator in patients with EC. The present study analysed the prognostic values of sarcopenia, sarcopenic obesity, sarcopenic visceral obesity, and the visceral fat index in EC. The total skeletal muscle area was calculated in square centimetres. Body surface area (m²) was calculated using the Mosteller formula: ((height (cm) × weight (kg))/3600)^1/2. To normalize body composition components, the skeletal muscle index was calculated as cm²/m². Results: The study comprised a total of 236 EC patients. The prevalence of sarcopenia, sarcopenic obesity, and sarcopenic visceral obesity were found to be 48.31%, 33.47%, and 22.88%, respectively. The presence of sarcopenia, high VFI levels, sarcopenic obesity, and sarcopenic visceral obesity did not demonstrate statistical significance in the survival analysis. However, stage increase (p = 0.001), primary tumour localization in the lower uterine segment (p = 0.001), serous carcinoma (p = 0.001), increased grade in endometrioid carcinoma (p = 0.023), and lymphovascular invasion (p = 0.001) were significantly associated with increased mortality risk. The presence of sarcopenia was found to be significant in patients with obesity (p = 0.008) and those aged ≥ 65 years (p = 0.001). Conclusions: In EC survival, established prognostic factors such as serous histopathology, LVI positivity, and the extent of surgical staging are prioritised. The presence of these well-established markers means the potential effect of BMI-based observations, such as the ‘obesity paradox’, and even body composition measurements, such as sarcopenic obesity, are now statistically insignificant. Our findings suggest that aggressive tumour biology (serous type, LVI) and surgery, rather than metabolic variables such as sarcopenia, sarcopenic obesity and sarcopenic visceral obesity, are the direct reason for the survival difference. This is due to the tumour’s aggressive nature and clinical characteristics (e.g., age at diagnosis, operability, stage, primary tumour localization in the lower uterine segment, serous carcinoma, grade, and LVI positivity) rather than metabolic variables. Full article

Nontuberculous mycobacteria (NTM) represent a heterogeneous group of environmental opportunistic pathogens that have emerged particularly in immunocompromised individuals and patients with underlying pulmonary disorders. NTM infections primarily affect the lungs, but can also manifest as lymphadenitis, skin and soft tissue infections, and disseminated disease. This retrospective study took into consideration 425 NTM-positive samples collected between May 2011 and December 2023, analyzed by sample type, sex, and age group (0–17, 18–49, 50–65, >65 years). Antimicrobial susceptibility analysis was performed on the 223 NTM strains with greater pathogenic power and most frequently isolated, from 2016 to 2023. Pulmonary NTM disease (NTM-PD) infections were most prevalent in patients over 65 years (52.1%), while extrapulmonary NTM disease (NTM-EPD) occurred most frequently in the 0–17 age group (56.4%). Women were slightly more affected (54.4%) than men (45.6%), with the highest incidence in female individuals over 65 years old. The most frequently isolated NTM species was the Mycobacterium avium complex (MAC) (47% of isolates). Antimicrobial susceptibility testing of 223 isolates from 2016 to 2023 revealed species-specific resistance patterns, with high susceptibility to clarithromycin in MAC (94.7%) and Mycobacterium chelonae (100%), but notable resistance in Mycobacterium abscessus complex (MABC). The increasing incidence of NTM infections underscores the need for improved diagnostic techniques and targeted treatment strategies. Full article

Background: Enzymatic debridement with Nexobrid (NXB) is established for burn care, but specific outcomes in the elderly remain poorly characterized. This study evaluates the safety, efficacy, and clinical outcomes of NXB in patients aged ≥65 years. Methods: A retrospective case-series of 43 consecutive elderly patients (mean age 74.5 years) with deep partial- to full-thickness burns treated with NXB at a single burn center. Data on demographics, burn characteristics, treatment chronology, and complications were analyzed. Results: The median total burn surface area (TBSA) was 11%. NXB was applied selectively, with a mean debrided area of 7.41% TBSA, primarily on limbs and hands. While 76.7% of patients ultimately required surgical autografting, no patient required an escharotomy in NXB-treated areas. The mortality rate was 25.6%, which was lower than expected for a median revised Baux score of 90, which is expected to be more than 50%. Hypertrophic scarring occurred in 28.1% of survivors, associated with a prolonged median healing time of 63 days. Conclusions: In elderly burn patients, NXB facilitates precise eschar removal and reliably prevents compartment syndrome, demonstrating a strong safety profile even in high-risk individuals. Its primary benefit shifts from reducing surgical incidence to optimizing the wound bed for grafting. These findings support the use of NXB in the elderly, with the understanding that subsequent grafting is often still required due to age-related delayed healing. Full article

Background/Objectives: Individuals with autism spectrum disorder (ASD) often experience high anxiety and low physical activity (PA). While the influence of parenting styles on these outcomes is well-documented in typically developing children, their role in autistic youth remains underexplored. The study examines how parenting style and parental encouragement of physical activity relate to anxiety and activity levels in ASD youth. Methods: The sample consisted of 76 parents of school-aged children diagnosed with ASD, including 54 parents of boys and 22 parents of girls (Aged 6–18; Mage = 10.75, SD = 3.67). The parents’ ages ranged from 23 to 65 years (M = 42.96, SD = 7.01). Results: Using a path model analysis, we found that authoritarian and permissive parenting were directly associated with elevated child anxiety. Authoritative and permissive parenting were inversely associated with child anxiety indirectly via parental encouragement of PA. Furthermore, authoritative and permissive parenting were inversely associated with the child’s PA score via encouragement of PA. Conclusions: The study establishes links between parenting styles and anxiety and physical activity in ASD children and adolescents, while identifying a specific mechanism that partially explains these associations. Full article

Heart failure with preserved ejection fraction (HFpEF) currently accounts for half of the heart failure (HF) cases world-wide, affecting nearly 32 million people. HFpEF has a skewed prevalence toward females and those older than 65 years old. The pathophysiology of HFpEF is suggestive of a conglomerate of inflammatory, hypertensive, as well as metabolic dysfunction, giving rise to the syndrome. Disruptions in ceramide metabolism do occur in heart failure as well as within the HFpEF-associated risk factors, both modifiable inflammation, obesity, hypertension, diabetes, and non-modifiable-aging, and female sex. The focus of this review is to draw attention to the links between changes in female biophysiology, such as pregnancy, menopause and aging, in which ceramide is dysregulated and consequently gives rise to the same pathologies that are labeled as risk factors for HFpEF. Our objective is to highlight ceramides as potential biomarkers for prevention and initial diagnostic tools for HFpEF, especially for women later in life. Full article

Background: Androgenetic alopecia, also known as male pattern baldness (MPB), is a common hair loss disorder among middle-aged men. MPB shares similar risk factors with prostate cancer (PrCa), including advancing age, family history, and sex hormones. Several studies have examined the associations between MPB and PrCa; however, the evidence remains unclear. We carried out an updated meta-analysis of epidemiological studies that examined the relationship between age at onset and patterns of MPB (either frontal, vertex, or both) and their associations with risks of total and aggressive PrCa. Methods: A literature search was performed using PubMed and Web of Science databases for epidemiological studies published between 1 January 2000 and 31 December 2024 that examined the associations between MPB and PrCa. From each eligible study, relevant data were extracted on study design and population, sample size, prevalence of MPB at various ages, and their association with PrCa. Pooled relative risks (RR) and corresponding 95% confidence intervals (CI) were calculated using the Der-Simonian and Laird random-effects models. Heterogeneity across studies was assessed by I² statistics, while the quality of studies was evaluated using the Newcastle–Ottawa Scale. Results: A total of 19 observational studies, including 17,810 cases and 146,806 controls/non-cases, were analyzed. The prevalence of MPB increased from 5% to 65% with aging and varied across the studies. Both frontal and vertex MPB were associated with a pooled RR of 1.08 (95% CI 1.02–1.14) for total PrCa, but there was no association with frontal-only MPB. Younger-onset MPB (<40 years old) was also associated with an RR = 1.13 (95% CI 0.96–1.31) for PrCa, although results were not statistically significant. Vertex-only MPB was associated with more aggressive PrCa (pooled RR = 1.14; 95% CI 1.02–1.25); however, there was substantial heterogeneity in the definition of aggressive PrCa across the studies. Conclusions: Men with both frontal and vertex MPB have a modestly elevated risk of PrCa. However, most studies were conducted in Caucasian men and they did not evaluate effect modifications by genetic variations in androgen metabolism pathway genes or changes in serum levels of androgens with aging. Large prospective cohort studies with more accurate longitudinal assessment of hair loss patterns are needed to better understand the complex relationship between genetic susceptibility, endogenous hormones, MPB, and subsequent risk of PrCa. Full article

Canine atopic dermatitis (AD) is a chronic allergic skin disease in which various immunological markers have been investigated. While peripheral eosinophil counts, serum allergen-specific immunoglobulin E (IgE), and cytokines have each been evaluated in allergic disorders, their simultaneous assessment in dogs with AD has rarely been reported in Korea. This study aimed to evaluate the diagnostic and clinical utility of these parameters in affected dogs. A total of 93 dogs were included between August 2019 and February 2020, comprising 65 dogs diagnosed with AD and 28 healthy controls. Clinical information, peripheral blood eosinophil counts and ratios, serum allergen-specific IgE using a multiple allergen panel (60 allergens), and cytokines related to T helper 2 (Th2) and T regulatory (Treg) cells (IL-4, IL-13, IL-31, TGF-β1) were analyzed. The mean age of AD dogs was 6.34 ± 3.99 years, with a predominance of small breeds and males. Eosinophil counts and ratios showed no significant difference between groups. In contrast, allergen-specific IgE levels were significantly elevated for several allergens, including Dermatophagoides pteronyssinus, Acarus siro, Tyrophagus putrescentiae, alder/birch, hazel, oak, cladosporium, and selected dietary antigens (pea, soybean, pumpkin, apple) (p < 0.05). Sensitization rates were also higher for Acarus siro, Tyrophagus putrescentiae, oak, and sheep sorrel (p < 0.05). Th2-related cytokines tended to increase and TGF-β1 tended to decrease in AD dogs, though without statistical significance. These findings indicate that peripheral eosinophil counts have limited diagnostic value, whereas allergen-specific IgE testing provides clinically useful information for the diagnosis and management of canine AD. Further research stratifying disease stages and assessing local tissue cytokine expression is warranted. Full article

Background/Objectives: This exploratory systematic review aims to analyze the influence of isolated muscle flexibility training on the reduction of chronic pain symptoms in older adults aged 65 years or more. Articles were selected from the Web of Science, PubMed, and Scopus databases, using the EndNote software for reference management. The selection process followed the PICOS framework and the PRISMA 2020 guidelines, and the review protocol was registered in the PROSPERO database. Methods: The inclusion criteria comprised randomized controlled trials with participants aged 65 or older, evaluating the effect of flexibility training as a standalone intervention on chronic pain, and published in English or Portuguese. Studies were excluded if they involved multimodal training, did not specify participants’ ages, evaluated only acute or postoperative pain, or were not peer-reviewed articles. Results: From an initial pool of 1390 articles, only three met all criteria and were included in the final analysis. These studies—conducted in China (n = 2) and the United States (n = 1)—showed moderate methodological quality (PEDro score = 7/10). Two trials applied Proprioceptive Neuromuscular Facilitation (PNF) in participants with knee osteoarthritis, while the third compared a flexibility-based program to combined strength and aerobic training in a healthy elderly population. All studies reported significant reductions in chronic pain symptoms following flexibility training interventions. Conclusions: The reviewed evidence suggests that muscle flexibility training, particularly using techniques like PNF, may be a promising therapeutic strategy to mitigate specific chronic pain-related symptoms in older adults, particularly reductions in joint stiffness, movement discomfort, and pain intensity associated with osteoarthritis. However, the limited number of high-quality trials and heterogeneity in protocols and pain assessment tools highlight the need for further research. Full article

Background: Visual search supports action planning and target selection in daily life. Despite toileting being frequent yet high-risk in rehabilitation, gaze analyses specific to toileting remain limited. This study quantified visual search behavior during the approach phase of toileting. Methods: Twenty inpatients aged 65 years or older in a convalescent rehabilitation ward participated in the study. At the time of hospital admission, their gaze behavior from toilet room entry to arrival at the bowl was recorded using an eye tracker (Tobii Pro Glasses 2). Moreover, we evaluated a toilet-functional independence measure (toilet-FIM), comprising toileting, toilet transfer, and locomotion at discharge. Results: In multiple regression, a longer total gaze time directed towards the toilet seat was associated with a greater toilet-FIM independence (β = 0.446), whereas prolonged gaze to the toilet rim (β = −0.839) and to the right handrail (β = −0.621) were related to lower independence (adjusted R² = 0.715). Conclusions: A toilet seat-oriented gaze implies effective action planning for safe sit-down, whereas toilet rim- or handrail-oriented gazes may reflect responses to visual salience or compensatory visual strategies related to reduced independence. These observations could improve our understanding of older patients’ motor planning and spatial perception in toileting. Full article

Background/Objectives: Pseudoarthrosis continues to be a public health problem; however, in our country, information is scarce, particularly when talking about the clinical and sociodemographic characterization of the Mexican population with pseudoarthrosis. Methods: In this study, clinical and sociodemographic characteristics such as sex, age, educational level, nutritional status, comorbidities, affected bone, fracture characteristics, degree of exposure, and waiting time for the patient to undergo surgery were analyzed. Results: A total of 267 patients were included in the present study. A higher frequency of men (53.6%) was identified compared to women, and the main age group was 46–75 years (50.1%). The main comorbidities identified in our population were smoking (n = 141; 52.8%) and osteoporosis (n = 84; 31.5%). When evaluating the clinical characteristics of pseudoarthrosis, the tibia (n = 65; 24.3%) and radius (n = 54; 20.2%) were the main bones affected. Fracture exposure could be identified in 17.65% (n = 47) of the population, and the main grade of involvement was II (46.8%). Regarding the prevalence of the affected bone, the tibia was the main one, with 13.5% (9.38–17.58%) female patients, 12.7% (8.73–16.73%) with overweight, 18.0% (13.37–22.59%) with osteoporosis, and 14.2% (10.04–18.42%) with a history of smoking. Conclusions: In our cohort, we identified a high prevalence of the tibia as the affected bone, while overweight, obesity, osteoporosis, and smoking were the clinical and sociodemographic characteristics that characterized our population. The findings of this study lay the groundwork for understanding the clinical and sociodemographic context of a Mexican cohort with nonunion. Full article

Background and Objectives: Lateral osteotomies in rhinoplasty run adjacent to the lacrimal drainage system (LDS), risking postoperative tearing. Piezoelectric (piezo) devices enable precise bone cuts that may reduce LDS trauma. We compared the 1-month incidence of objective lacrimal dysfunction after piezo versus classic osteotomy. Materials and Methods: Retrospective, single-center controlled cohort (1 January 2024–1 January 2025) at a tertiary ENT clinic. Consecutive patients aged 19–45 with pre-operative paranasal sinus CT and no prior lacrimal disorder were grouped by osteotomy technique (piezo vs. classic; n = 65 per arm). Assessments were performed at postoperative day 7–10 and at 1, 3, and 6–12 months. The primary endpoint was 1-month objective lacrimal dysfunction, defined as fluorescein dye disappearance test (FDDT) grade ≥1 or reflux/resistance on irrigation plus symptoms (Munk ≥2). Pre-specified statistical tests were used. Results: Early tearing favored piezo. At week 1, epiphora occurred in 32.3% with piezo versus 46.1% with classic (p = 0.041); by month 6, rates were 4.6% versus 15.1% (p = 0.031). Differences at months 1 and 3 also favored piezo but were not statistically significant (p = 0.062 and p = 0.088). FDDT positivity was lower with piezo at week 1 (23.0% vs. 38.4%, p = 0.045) and month 6 (3.0% vs. 10.7%, p = 0.048). Irrigation obstruction was less frequent with piezo at week 1 (7.6% vs. 21.5%, p = 0.026), but groups converged by months 1 (15.4% vs. 12.3%, p = 0.80) and 3 (6.2% vs. 4.6%, p > 0.99). Punctum stenosis/occlusion remained uncommon in both groups without significant differences. Conclusions: Piezo-assisted lateral osteotomy is associated with less early lacrimal dysfunction and lower 6-month epiphora compared with the classic technique. Convergence of irrigation findings by 1–3 months suggests postoperative edema as the dominant transient mechanism. Given the retrospective, single-center design and low event rates, multicenter prospective studies powered for early LDS outcomes are warranted. Full article

Background: Older adults (≥65 years) account for a substantial share of Emergency Medical Service (EMS) activations, yet differences between nursing homes (NHs) and the community are insufficiently defined. This study aimed to compare EMS responses for older adults inside and outside NHs. Methods: We conducted a retrospective observational study of all EMS activations involving patients ≥65 years in a rural German region from July 2020 to March 2025, based on fully anonymized prehospital patient care reports electronically documented on tablets. Prehospital patient care was assessed using the ABCDE approach, with additional analysis of feedback codes transmitted to the control center (response and on-scene times, physician dispatch, lights and sirens use, feedback codes, hospital destination, and admission urgency). Continuous variables were summarized as mean (SD) or median [IQR], categorical variables as n (%), and group comparisons performed using the Chi-Square test or Fisher’s exact test (categorical) and the t test or Mann–Whitney U test (continuous), as appropriate. Results: Among 46,598 EMS activations in adults aged ≥65 years, 28,749 EMS responses were included in the analysis after excluding non-emergency transports and duplicate physician records. Of these, 20% occurred in NHs (5707/28,749) and 80% in the community (23,042/28,749). Median age was 85 years (IQR 80–89) in NH patients and 80 years (IQR 73–86) in community patients (p < 0.001). Females accounted for 60% (3450/5705) of NH patients and 53% (12,223/23,036) of community patients (p < 0.001). Emergency physicians were dispatched in 7% of NH incidents (392/5707) and 10% of community incidents (2327/23,042; p < 0.001). In NHs, bronchitis/pneumonia was a leading feedback code (6%, 354/5707), whereas in community patients, acute coronary syndrome (ACS) was prominent (5%, 1249/23,042). Admission urgency categories also differed significantly, with NH residents classified as category 3 (outpatient evaluation) in 11% (621/5706) and category 0 (no admission) in 5% (280/5706), whereas community patients were more often classified as category 1 (immediate intervention) in 13% (2886/23,037) (all p < 0.001). Conclusions: NH residents were older, more often female, and presented with low-to-moderate acuity. Frequent diagnoses were closed extremity injuries and bronchitis/pneumonia. In contrast, ACS and other cardiovascular emergencies were more common in the community, particularly among men, consistent with international evidence on sex-specific incidence. NH residents were more often classified as non-urgent or outpatient and transported to nearby hospitals, whereas community patients more frequently required immediate intervention and referral to tertiary centers. In summary, EMS responses for older adults differed in clinical presentations, operational patterns, and hospital pathways. Full article

Background and Objectives: The mechanisms of traumatic brain injury (TBI), patient characteristics, and long-term outcomes in elderly patients differ from those in other age groups. This study aims to evaluate the effectiveness of the Elderly Traumatic Brain Injury (eTBI) Scoring System, recently described in the literature, in predicting mortality, prognosis, and surgical indication. Materials and Methods: Patients diagnosed with TBI over the age of 65 between January 2017 and December 2024 were retrospectively analyzed, and their eTBI scores were calculated. Statistical analyses were conducted to assess mortality, prognosis, and surgical indication or benefit from surgery across low-, medium-, and high-risk groups. Results: In this cohort of 236 patients, the mortality rate was higher in the high-risk group according to the eTBI scoring system, compared to the medium- and low-risk groups. However, the scoring system does not appear to be effective in determining surgical indications. While the medium-risk group was most predictive of mortality, the low-risk group demonstrated better accuracy in predicting prognosis. Conclusions: The eTBI scoring system appears to be an effective tool for assessing mortality risk and predicting prognosis in specific subgroups of elderly TBI patients. Full article