For a comprehensive risk assessment in geriatric patients, the organ-specific risk stratification is insufficient. Assessment instruments that reflect the idiosyncrasies of multidimensional disease in geriatric patients can complement risk stratification. These should include the assessment of multimorbidity, frailty, nutrition, activities of daily living, and cognition. In addition to risk prediction, geriatric assessment has the major advantage of providing both a diagnostic and a planning perspective. This allows the implementation of supporting measures for optimal perioperative care, which is the goal of any risk stratification. Risk scores provide a global assessment, but they have their limitations in predicting individual patient risk.
The excision repair deficient mei-9L1-embryos of Drosophila melanogaster are up to four times more radiosensitive than normal +/+ embryos. The lack of oxygen-effect in the repair deficient 4-h-embryos and the reduced O2-effect in the 13/4-h embryos suggest an interpretation of the oxygen effect as a modification of the ability to repair. The conversion of the early death (heavy damage) to late death (slight damage) by irradiation of normal embryos in N2 supports this interpretation. This theory can also explain the dependence of O2-effect on LET. The spontaneous lethality and the increase in radiosensitivity depend in heterozygous mei-9L1-embryos strictly upon the genotype of the mother, thus representing a maternal effect.
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