Background: The average age and life expectancy of the population are increasing and so a growing number of elderly patients are being admitted to the intensive care unit Aim: To detect the accuracy of the physician view of endpoint on ICU admission and actual discha rge outcome Methods: A prospective cohort study conducted on140 elderly patients (60 years and above) admitted to medical ICU with acute illness, each patient was subjected to complete medical history, physical examination and assessment of medical comorbi dities, ICU mortality scores: (APACHE II, SAPS II, MPM II 0, MPM24) and calculation of the predicted mortality, establishment of intensivist point of view regarding the predicted outcome and establishment of end point of each patient (either discharge o r death). Conclusions: There is a highly significant association between physician view of end point of the patient on ICU admission and actual discharge of the patients in ICU
Background Body composition consists of fat and fat free mass muscle, bone, water and organs in the body 1. With advancing age, changes in body composition take place in the form of decline in skeletal muscle mass and increase in body fat with redistribution on fat in the body 2. Many physiological and pathological changes are responsible for these changes and the degree of these changes vary greatly among elderly population 3 Neuronal loss with age results in decrease in number of motor neurons with age and chronic denervation of muscle tissue with loss of muscle fibers and muscle mass. 4 Age related hormonal changes in the form of decrease in Growth Hormone, insulin like growth factor 1 and testosterone, increase in cortisol level and insulin resistance results in increase in body adiposity specially visceral fat, decrease in lean mass and bone mineral density 5 Also some inflammatory cytokines were observed to be increased in older adults such as tumor necrosis factor alpha, interleukin-6 , interleukin-1 and C-reactive protein. All of them induce inflammatory process which negatively affect muscle mass and strength. 6 Different methods used to assess body composition in elderly. Anthropometric measures such as Body mass index, waist circumference, waist hip ratio and skin fold thickness are all easy, inexpensive and portable measurements to evaluate body composition. Although they depend on skills of operator and their accuracy may vary between populations. 7 8 Dual Energy X-ray Absorpiometry DEXA , Computed Tomography CT and Magnetic Resonance Imaging MRI are all accurate validated methods to assess body composition. But all of them are expensive and nonportable methods using radiation and cannot be used in large population based studies. 9 10 11 Bioelecterical impedence analysis is a safe, portable, inexpensive and easy to use alternative that is suitable for evaluating large number of people. Results from
Background: The term "frailty" has been used clinically as a global concept to describe a condition, common in the old, of impaired strength, endurance, and balance, vulnerability to trauma and other stressors, and high risk for morbidity, disability, and mortality. A variety of factors may contribute to frailty or to one or more of its specific features. These include inflammatory, musculoskeletal, cardio respiratory, metabolic, hematologic, neurologic, immunologic and endocrine factors. Hormones important to the development of frailty that has been proposed include testosterone, luteinizing hormone (LH) and dehydroepiandrosterone (DHEA). Objective: to study the association between LH level and frailty among the elderly Method: A case control study was carried out. The case group included 80 Frail elderly subjects selected according to the American Geriatric Society Criteria; whereas 80 non-Frail elderly subjects were selected as the control group. Each participant was subjected to Comprehensive Geriatric Assessment and laboratory assessment of luteinizing hormone. Results: LH level was lower in frail subjects compared to non frail. Lower levels were significantly correlated with increased degree of dependency in both frail males and females. Conclusion: Luteinizing hormone level was lower among frail elderly. Further studies are needed to confirm such an association and to plan clinical practice accordingly.
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