Cortisol diurnal patterns,associations with depressive symptoms,and the impact of intervention in older adults: Results using modern robust methods aimed at dealing with low power due to violations of standard assumptions

Advances in salivary bioscience enable the widespread integration of biological measures into the behavioral and social sciences. While theoretical integration has progressed, much less attention has focused on analytical strategies and tactics. The statistical literature warns that common methods for comparing groups and studying associations can have relatively poor power compared to more modern robust techniques. Here we illustrate, in secondary data analyses using the USC Well Elderly II study (n = 460, age 60–95, 66% female), that modern robust methods make a substantial difference when analyzing relations between salivary analyte and behavioral data. Analyses that deal with the diurnal pattern of cortisol and the association of the cortisol awakening response with depressive symptoms and physical well-being are reported. Non-significant results become significant when using improved methods for dealing with skewed distributions and outliers. Analytical strategies and tactics that employ modern robust methods have the potential to reduce the probability of both Type I and Type II errors in studies that compare salivary analytes between groups, across time, or examine associations with salivary analyte levels.     

老年气管插管患者下呼吸道感染细菌分布及 耐药性分析

目的研究老年气管插管患者下呼吸道感染的病原菌分布及耐药情况,为临床插管前预防性经验用药提供参考。方法回顾性分析2014-2016年上海市虹口区江湾医院老年气管插管患者的病原菌分布及耐药性情况。结果 560例标本中共检出177株致病菌,其中革兰阴性杆菌121株(68.36%),以肺炎克雷伯菌、铜绿假单胞菌为主;除鲍曼不动杆菌/溶血不动杆菌外,其他革兰阴性杆菌对亚胺培南、美罗培南敏感性均较高。革兰阳性球菌检出52株(29.38%),以金黄色葡萄球菌为主(其中MRSA 37株),对万古霉素敏感性较高。另外分离到真菌4株。结论气管插管患者下呼吸道感染致病菌以肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌为主。在临床应用中,应根据本地区、本医院的病原菌分布状况和细菌耐药情况,给予适当药物,预防感染。     

Inference of patient‐specific subpathway activities reveals a functional signature associated with the prognosis of patients with breast cancer

Breast cancer is one of the most deadly forms of cancer in women worldwide. Better prediction of breast cancer prognosis is essential for more personalized treatment. In this study, we aimed to infer patient‐specific subpathway activities to reveal a functional signature associated with the prognosis of patients with breast cancer. We integrated pathway structure with gene expression data to construct patient‐specific subpathway activity profiles using a greedy search algorithm. A four‐subpathway prognostic signature was developed in the training set using a random forest supervised classification algorithm and a prognostic score model with the activity profiles. According to the signature, patients were classified into high‐risk and low‐risk groups with significantly different overall survival in the training set (median survival of 65 vs 106 months, P = 1.82e‐13) and test set (median survival of 75 vs 101 months, P = 4.17e‐5). Our signature was then applied to five independent breast cancer data sets and showed similar prognostic values, confirming the accuracy and robustness of the subpathway signature. Stratified analysis suggested that the four‐subpathway signature had prognostic value within subtypes of breast cancer. Our results suggest that the four‐subpathway signature may be a useful biomarker for breast cancer prognosis.     

Frecuencia de envejecimiento exitoso y fragilidad. Factores de riesgo asociados

Objective

To determine the frequency of successful aging (SA) and its relationship with frailty in an elderly population.

Tratamiento de la diabetes mellitus tipo 2 en el paciente anciano

The prevalence of type 2 diabetes mellitus (DM2) increases markedly with age. Antidiabetic treatment and the objectives of glycaemic control in elderly patients with DM2 should be individualised according to their biopsychosocial characteristics. In elderly patients for whom the benefits of intensive antidiabetic treatment are limited, the basic objectives should be to improve the quality of life, preserve functionality and avoid adverse effects, especially hypoglycaemia.Treatment of DM2 in the elderly was the subject of a consensus document published in 2012 and endorsed by several Spanish scientific societies. Since then, new therapeutic groups and evidence have emerged that warrant an update to this consensus document. The present document focuses on the therapeutic aspects of DM2 in elderly patients, understood as being older than 75 years or frail.     

Fractura de cadera en el paciente anciano: factores pronóstico de mortalidad y recuperación funcional al año

Objective

The aim of this study is to identify the risks factors for mortality and functional recovery in elderly patients admitted to hospital with a hip fracture.

Actividades diarias evaluadas mediante monitor de actividad de alta precisión en adultos mayores: resultados preliminares del Estudio IMPACT65+

Introduction

Physical activity and physical inactivity patterns can affect health status. In the elderly people, their study is relevant given the importance that they have on the morbidity and mortality.

El significado de las relaciones sociales como mecanismo para mejorar la salud y calidad de vida de las personas mayores,desde una perspectiva interdisciplinar

Introduction

This study presents an analysis on the effects of positive social relationships as determining factors on the health status of the elderly, from an interdisciplinary point of view.

Velocidad de marcha y desarrollo de trastornos neurocognitivos en adultos mayores: resultados de una cohorte peruana

Introduction

The prevention and management of neurocognitive disorders (NCD) among older adults can be improved by early identification of risk factors such as walking speed. The objective of the study is to assess the association between gait speed and NCD onset in a population of Peruvian older adults.

Aspergilosis invasora en el paciente con enfermedad oncohematológica

Invasive aspergillosis is the most common invasive fungal infection in patients with acute hematological malignancies or treated with hematopoietic stem cell transplantation due to the marked alteration of the physiological mechanisms of antifungal immunity that takes place in these situations. For this reason, antifungal prophylaxis has a relevant role in these patients. The introduction of new antifungal agents has motivated the updating of recommendations for prophylaxis and treatment in different guidelines.The objectives of this chapter are a brief review of the mechanisms of immunity against fungi, the definition of risk for developing an invasive fungal infection and an update of the prophylaxis recommendations and treatment of invasive aspergillosis in the group of patients with hematological diseases.