F. Rengo

Frailty predicts long-term mortality in elderly subjects with chronic heart failure.

Backgroundu2002 The elderly are characterized by a high prevalence of chronic heart failure (CHF) and frailty, which is a complex interaction of physical, psychological and social impairment. This study aimed to examine the predictive role of frailty on long‐term mortality in elderly subjects with CHF.

Diagnosis and Characteristics of Syncope in Older Patients Referred to Geriatric Departments

OBJECTIVES: To test the applicability and safety of a standardized diagnostic algorithm in geriatric departments and to define the prevalence of different causes of syncope in older patients.

Tandem action of exercise training and food restriction completely preserves ischemic preconditioning in the aging heart

Ischemic preconditioning (IP) has been proposed as an endogenous form of protection against ischemia reperfusion injury. IP, however, does not prevent post-ischemic dysfunction in the aging heart but may be partially corrected by exercise training and food restriction. We investigated the role of exercise training combined with food restriction on restoring IP in the aging heart. Effects of IP against ischemia-reperfusion injury in isolated hearts from adult (A, 6 months old), sedentary ad libitum fed (SL), trained ad libitum fed (TL), sedentary food-restricted (SR), trained- and food-restricted senescent rats (TR) (24 months old) were investigated. Norepinephrine release in coronary effluent was determined by high performance liquid cromatography. IP significantly improved final recovery of percent developed pressure in hearts from A (p<0.01) but not in those from SL (p=NS) vs unconditioned controls. Developed pressure recovery was partial in hearts from TL and SR (64.3 and 67.3%, respectively; p<0.05 vs controls) but it was total in those from TR (82.3%, p=NS vs A; p<0.05 vs hearts from TL and SR). Similarly, IP determined a similar increase of norepinephrine release in A (p<0.001) and in TR (p<0.001, p=NS vs adult). IP was abolished by depletion of myocardial norepinephrine stores by reserpine in all groups. Thus, IP reduces post-ischemic dysfunction in A but not in SL. Moreover, IP was preserved partially in TR and SR and totally in TR. Complete IP maybe due to full restoration of norepinephrine release in response to IP stimulus.

Moderate alcohol consumption predicts long-term mortality in elderly subjects with chronic heart failure

ObjectiveModerate alcohol consumption is related to a reduction of mortality. However, this phenomenon is not well established in the elderly, especially in the presence of chronic heart failure (CHF). The aim of the study was to verify the effect of moderate alcohol consumption on 12-year mortality in elderly community-dwelling with and without CHF.Settingscommunity-dwelling from 5 regions of Italy.ParticipantsA cohort of 1332 subjects aged 65 and older.MeasurementMortality after 12-year follow-up in elderly subjects (≥65 years old) with and without CHF was studied. Moderate alcohol consumption was considered ≤250 ml/day (drinkers).ResultsIn the absence of CHF (n=947), mortality was 42.2% in drinkers vs. 53.7% in non-drinker elderly subjects (p=0.021). In contrast, in the presence of CHF (n=117), mortality was 86.5% in drinkers vs. 69.7% in non-drinker elderly subjects (p=0.004). Accordingly, Cox regression analysis shows that a moderate alcohol consumption is protective of mortality in the absence (HR=0.79; CI 95% 0.66–0.95; p<0.01) but it is predictive of mortality in the presence of CHF (HR=1.29; CI 95% 1.05–1.97; p<0.05).ConclusionsOur data demonstrates that moderate alcohol consumption is associated with an increased long-term mortality risk in the elderly in the presence of CHF.

Use of antibiotics in elderly patients with exacerbated COPD: The OLD-chronic obstructive pulmonary disease study

OBJECTIVES: To verify how frequently geriatric patients hospitalized for exacerbated chronic obstructive pulmonary disorder (COPD) had not been given antibiotics at home and to identify the relationship between the patients condition and the prescribing practice.

Mild Stress in the Aging Heart: Role of Ischemic Preconditioning

Hormetic effects have been documented in diverse combinations of stressors and recipient organism. Such sublethal stress pre-treatments have been shown to increase stress resistance and life expectancy in several animal organisms. Stressors reported to increase subsequent stress resistance include heat, cold, hypergravity, and pesticides. Increased life span has been reported after a similarly diverse number of hormetic treatments including heat, cold, hypergravity, ionizing radiation, exercise, electric shock, and wounding accompanied by regrowth (Martinez 1996; Minois 2000). Khazaeli et al. (1997) have demonstrated that heat induced longevity extension in Drosophila and, similarly, Michalski et al. increased longevity in Caenorhabditis elegans by heating stress (2001). Resistance to the paradoxical effects of hormesis necessitated the extended and exhaustive documentation of the phenomenon, an effort led primarily by Edward Calabrese (Kaiser 2003). Those efforts produced both practical and theoretical benefits. The practical benefit was an additional set of tools useful in studying survival, following the application of mild stress. The theoretical aspect was further support for the inverse correlation observed between stress resistance generally and improved survival. The biological mechanisms underlying hormesis are unclear. Transcription, translation, and/or post-translational protein medication, such as phosphorylation may represent the hormetic response. Calabrese and Baldwin (1986) have suggested

PUFA for human health: diet or supplementation?

Large doses of omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are used to treat several diseases including hypertriglyceridemia in humans. Modest levels of EPA and DHA may be obtained from food, particularly from fatty fish. This review presents the literature examining the differences between omega-3 fatty acid dietary supplementation and prescribed omega-3-acid ethyl esters (P-OM3). Reports published between 1995 and 2007 containing sources, recommended intake, and differences in the various formulations of omega-3 fatty acids were sought in PubMed and the Food and Drug Administration (FDA) Websites. However, lack of head-to-head clinical trials using both P-OM3 and dietary-supplement omega-3 fatty acids is the greatest limitation of this review. Although many kinds of omega-3 fatty acid dietary supplements are available, the efficacy, quality, and safety of these products are questionable because they are beyond any pharmaceutical control. Thus, P-OM3 is the only FDA approved omega-3 fatty acid product which is available in the United States as an adjunct to diet to improve human health.

Corrigendum to “Tandem action of exercise training and food restriction completely preserves ischemic preconditioning in the aging heart” [Experimental Gerontology 40/1–2 (2005) 43–50]

Cattedra di Geriatria, Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Universita degli Studi di Napoli ‘Federico II’, Naples, Italy Cattedra di Medicina Interna, Dipartimento di Scienze Animali, Vegetali ed Ambientali, Universita del Molise, Campobasso, Italy Istituto Scientifico di Campoli/Telese, Fondazione Salvatore Maugeri, IRCCS, Benevento, Italy Department of Clinical Pathology and Laboratory Medicine, II University of Naples, Naples, Italy Department of Medicine, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA