The exchange of emotional support with age and its relationship with emotional well-being by age

This study tested three hypotheses derived from the application of socioemotional selectivity theory and exchange theory to the exchange of emotional support with age and its relationship with positive and negative affect by age. Data are from the Midlife in the United States study of 3,032 U.S. adults between the ages of 25 and 74. The social contact hypothesis predicts that hours of emotional support given and received should decrease with age. The exchange hypothesis predicts that the discrepancy between the hours of emotional support given and received should decrease with age to reflect more balanced exchanges with age. The goal hypothesis predicts that unequal exchanges of support should predict higher negative and lower positive affect with age. Findings supported each hypothesis. Hours of emotional support given and received decreased as chronological age increased. Although adults of all ages gave more support than they received, the discrepancy between hours of emotional support given and received became more balanced with age. Compared with equal exchanges, unequal exchanges predicted worse emotional well-being profiles only among the oldest adults in this study (i.e., those aged 55-64 and 65-74). Findings contribute to the growing literature on the changing nature of the quantity and quality of interpersonal exchanges with age.     

Adiponectin isoform distribution in women—relationship to female sex steroids and insulin sensitivity

Little is known about the associations between adiponectin and its oligomeric isoforms with female sex steroids, and the relevance of these relationships to insulin sensitivity in women. In a cross-sectional study of 32 healthy women (12 premenopausal, 10 postmenopausal, and 10 early pregnant), we investigated the correlations of total adiponectin and the high-, medium-, and low-molecular weight oligomers (HMW, MMW, and LMW, respectively) with estrogen, progesterone, adiposity, and insulin resistance. Fat mass and serum concentrations of estradiol, progesterone, insulin, glucose, and total and isoform adiponectin were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Serum concentrations of total and HMW adiponectin were highest in postmenopausal women and lowest in pregnant women. Concentrations of the MMW and LMW isoforms were not significantly different between the 3 groups. Total adiponectin, HMW adiponectin, and MMW adiponectin were negatively associated with estradiol and progesterone; but no associations between the LMW isoform and female sex steroids were observed. Fat mass and HOMA-IR were highest in pregnant women and lowest in premenopausal women. The HOMA-IR was positively associated with fat mass, estradiol, and progesterone, and negatively associated with total, HMW, and MMW adiponectin. Multivariate stepwise regression analysis revealed that fat mass explained 34% of the variance in HOMA-IR and that total and isoform adiponectin contributed an additional 10% to 15%. In the multivariate linear regression analysis, there were significant interactions of estradiol and progesterone with adiponectin or fat mass in the associations with HOMA-IR. In conclusion, there are strong negative associations of serum adiponectin and some of its isoforms with estradiol and progesterone. Female sex steroids are likely to affect insulin sensitivity through modulation of adiponectin and body fat.     

严重脓毒症早期性激素水平与器官损伤的相关性及对预后的影响

目的:探讨严重脓毒症患者早期血清性激素水平与器官损伤之间的相关性及对预后的影响。方法:回顾性分析53例男性严重脓毒症患者的临床资料,收集患者72 h内血清睾酮(T)、雌二醇(E2)和催乳素(PRL)水平,并进行Marshall和APACHEⅡ评分,4周后根据存活情况分为存活组和死亡组,另外选择同期20例男性健康体检者作为对照组。结果:存活组32例,死亡组21例;存活组的血清T低于死亡组和对照组(均P0.01),血清E2和PRL水平高于死亡组和对照组(均P0.05),Marshall和APACHEⅡ评分均低于死亡组(均P0.01);死亡组血清E2显著低于对照组(P0.01),血清T和PRL与对照组无显著差异(P0.05),但呈降低趋势;生存组和死亡组Marshall评分与血清T呈正相关(r=0.637),与血清E2和PRL呈负相关(r分别为-0.732和-0.654,均P0.05)。结论:严重脓毒症早期患者血清T、E2和PRL水平与器官功能的损伤程度密切相关,血清高E2、PRL和低T水平可能具有保护器官的作用。     

Bone mass and its relationship to age and the menopause

To examine the influence of age and the menopause on bone loss we studied 178 healthy women, aged 29-78 yr. Bone mass was measured at 2 forearm sites, in the total spine, in the lumbar spine, and in the whole body by single and dual photon absorptiometry. Women of the same age but different menopausal status had significantly different bone masses, whereas a 5-yr difference in age had no effect on bone mass in women with the same menopausal status. At the menopause the hormone changes (low serum estrogen and high serum gonadotropin levels) occurred simultaneously with the appearance of biochemical indices of increased bone turnover. Neither biochemical values nor bone measurements indicated significant bone loss before the menopause. We conclude that the menopause has a greater effect on bone loss than does chronological age.     

Urinary excretion of 6-sulphatoxymelatonin in normal subjects: statistical approach to the influence of age and sex

A radioimmunoassay of urinary 6-sulphatoxymelatonin (a-MT6s) was performed in 90 normal subjects: 44 males and 46 females (17-67 years). Patients treated with betablokers or antidepressants were not included in this study. Urine samples were collected over three periods of time: 7 to 11 p.m., 11 p.m. to 7 a.m., and 7 to 11 a.m. Between 11 p.m. and 7 a.m., the subjects slept in their normal environment and had not ingested alcohol for 24 hours. We searched for a possible relation between urinary a-MT6s excretion (expressed in ng/l/h) and age. From 7 to 11 p.m. and from 7 to 11 a.m. no significant relation could be found. On the contrary, between 11 p.m. and 7 a.m. there was a significant relation indicating decrease of a-MT6s secretion with increasing age. Several linear or non-linear curve patters were tested: Boltzmann sigmoid (1(st), 2(nd), and 3(rd) degree), polynomial curves. The Boltzmann sigmoid showed the best fit judging by the r-squared value (0.152) and the runs test (p=0.64). On this curve the inflection point was located at 53 4 years (SDM, standard deviation of the mean). From 19 to 45 years, the upper sigmoid plateau was located at 1381 91 ng/l/h (SDM). The decrease was found between 45 and 60 years and the lower sigmoid plateau then stabilized at 467 370 ng/l/h (\SDM). In the study group, there was no significant difference between men and women according to the Mann-Withney test. Finally, use of oral contraceptives did not affect urinary a-MT6s (Mann-Withney).     

Portal vein thrombosis in hepatocellular carcinoma: age and sex distribution in an autopsy study

The purpose of this work was to investigate the prevalence, associated features and effect on survival of portal vein thrombosis (PVT) complicating hepatocellular carcinoma (HCC). The autopsy data of a series of 72 consecutive patients (57 male, 15 female) with HCC were reviewed. PVT was found in 32/72 patients (44%), and tended to be more common in female patients (10/15 versus 22/57, P = 0.052). Stratifying the data according to gender, it appeared that the mean age of patients with PVT compared to those without was greater in woman (71.9 ± 5.9 versus 63.2 ± 6.9 years, P = 0.024) and younger in men (58.8 ± 8.9 versus 66.0 ± 9.9 years, P = 0.007). When PVT was present, it was more likely that a definite diagnosis of HCC had been obtained before autopsy (P = 0.0001) and that death had been caused by bleeding complications (P = 0.007). Median survival times were similar, irrespective of the presence of PVT. During the natural history of HCC, PVT occurs in a substantial proportion of patients. Hormonal factors may have a permissive role in thrombus formation or neoplastic vascular invasion. Although in the presence of PVT a diagnosis of HCC is rarely missed and bleeding complications are likely to occur, patient survival does not seem to be significantly affected. Received: 30 September 1997 / Accepted: 4 April 1998     

支气管哮喘患者生活质量与性别、年龄、病程的相关关系

目的探讨支气管哮喘患者生活质量与性别、年龄、病程的相关关系。方法按性别分为两组,将生活质量总得分及其构成生活质量的5个因素（活动受限、哮喘症状、心理状况、对刺激原的反应、对自身健康的关心）进行组间比较和t检验;另将全部患者上述得分数据与年龄和病程进行相关性分析。结果男女组间比较仅对刺激原的反应差异有显著性（P〈0．05）;仅有哮喘症状与病程呈正帽关关系（r=0．103,P〈0．05）;对刺激原的反应与年龄（r=-0．123,P〈0．01）和活动受限与病程：r=-0．133,P〈0．01）呈负相关关系。结论哮喘患者生存质量评分中,女性对刺激原的反应较玛性强烈;患者对刺激原的反应随年龄增加而下降;患者的症状与病程呈正相关关系,而活动受限与病程呈负相关关系。     

A post-mortem study of gastric and duodenal peptic lesions: Part I Frequency and distribution by age and sex

The overall incidence of peptic lesions in the reported series was 24·3%. Chronic peptic lesions were much higher in males (22·9%) than in females (12·2%). The incidence in males increased gradually from 19·6% in 1940-43 to 26·5% in 1956-58; in females there was an increase in the last few years only. Acute peptic lesions were approximately of the same incidence in males (6·3%) and in females (5·6%). In both sexes there was a sudden increase in frequency after 1949. Correlations have been demonstrated between acute peptic lesions and acute pathological conditions of the central nervous system, and between both acute and chronic lesions and chronic pulmonary diseases.     

阿托品试验阳性率与年龄分布关系106例临床分析

目的探讨阿托品试验阳性率与年龄分布的关系。方法追踪因非心脏疾病住院行阿托品试验检查的106例患者,按年龄段分为40岁组24例,40~59岁组37例,59岁组45例。观察阿托品试验阳性率与患者年龄分布的关系。结果 40岁组、40~59岁组、59岁组阿托品试验阳性率分别为4.17%、32.43%和57.78%,三组差异均有统计学意义(P0.05)。结论阿托品试验阳性率随年龄增高而增加;60岁以上的老年人较易存在窦房结功能低下的问题,应及早发现,对症处理,以预防心源性猝死的发生。     

Menopause-related blood pressure increase and its relationship to age and body mass index: the SIMONA epidemiological study

BACKGROUND: Menopause is commonly associated with some blood pressure (BP) rise, but cross-sectional or longitudinal studies completed so far were often too small and were unable to indicate whether this BP increase is really dependent on menopause, or was caused by age or changes in body mass index (BMI). METHODS AND RESULTS: The SIMONA study (Study on Hypertension Prevalence in Menopause in the Italian population) was a large cross-sectional study on 18 326 women of age range 46-59 years, consecutively seen by 302 practitioners all over Italy, and representing 60% of the women of that age in the National Health care list of those doctors. BP was measured three times in the seated position by the same automatic machine, and demographic and clinical data were taken. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were slightly but significantly higher in postmenopausal than premenopausal and perimenopausal women, but so were age and BMI. Within seven biannual strata, differences in age and BMI were minimized, but SBP/DBP remained significantly higher (by 3.4/3.1 mmHg) in postmenopausal than in premenopausal subjects in the youngest stratum (46-47 years), and was also significantly higher in the stratum 48-49 years. The differences remained significant after the exclusion of 1809 women with surgical menopause or 695 women with cardiovascular disease. Even when the confounding effects of age, BMI, smoking and contraceptive or replacement therapies were excluded by analysis of covariance, menopause was significantly and positively associated with SBP and DBP (approximately 2 mmHg difference in the age range 46-49 years). CONCLUSION: Menopause is associated with a slightly but significantly higher BP, even after adjustment for age and BMI, as well as other confounding factors, but the association is evident only in the younger end of the age range related to menopause.     

The relationship of allergy to the collagen diseases

The collagen diseases appear to be a varied group of abnormal states showing no evidence of a common pathogenesis, although several appear to exhibit immunologic features. Even the various types of polyarteritides appear to involve several different mechanisms. In general, more detailed immunologic investigations of the various collagen diseases tend to bring out differences rather than similarities. The only diseases of the group in which specific causative agents have been found are rheumatic fever and certain cases of hypersensitivity angiitis. Autosensitization appears to be a probable pathogenetic factor in lupus erythematosus, and possibly in rheumatoid arthritis, but the immunologic mechanisms of both are only partially understood. The term “collagen disease” appears to have outlived its usefulness as a pathogenetic classification. The etiology of each disease of the group must be considered separately.     

Anatomic distribution of cancers and colorectal adenomas according to age and sex and relationship between proximal and distal neoplasms in an i-FOBT-positive average-risk Italian screening cohort

Background and aims

Subsite-specific incidence rates of colorectal cancer (CRC) and adenomas may vary considerably by race, sex and age as well as due to different screening strategies. We assessed variations in the anatomical distribution of adenomas according to age and sex in an average-risk screening cohort testing positive at immunological faecal occult blood test (i-FOBT) in northern Italy.

Methods

Data from 2,281 consecutive asymptomatic i-FOBT-positive subjects ageing 50–70 years undergone colonoscopy were reviewed. Size, number, macroscopic and histological features of all adenomas found as well as their proximal or distal location in relation to the splenic flexure were examined. Odds ratios (OR) of proximal neoplasms, according to the presence of distal neoplasms and other selected covariates were assessed by multiple logistic regression analysis.

Results

A total of 2,599 neoplasms were found in 1,396 patients. Of these, 116 (5 %) were colorectal cancers, diagnosed in 106 patients. Out of 2,483 adenomas found, 1,564 (63 %) were sessile, 795 (32 %) were peduncolated and 124 (5 %) were flat-type; 54 % of all adenomas were tubular, 36 % were tubulovillous or villous, and 10 % were serrated adenomas. The majority of neoplasms (66 %) were located in the distal colon. Tumour subsite distribution was consistent in both sexes, whereas significant proximal migration of neoplasms occurred in the older age cohort. Indeed, the rate of proximal neoplasms in patients aged ≥60 years was 37 % as compared with 29 % in those ageing 50–59 years. Male gender (OR 1.84), age of 60 years or older (OR 1.44), having a family history of colorectal neoplasms (OR 1.47) and presence of at least 1 distal advanced adenoma (OR 1.63) were all significant predictors of advanced proximal neoplasms.

Conclusions

A left to right shift of colorectal adenomas with increasing age is evident in northern Italian asymptomatic i-FOBT-positive population. Advanced proximal neoplasms are not uncommon in subjects with or without distal adenomas, especially after 60 years of age. This should be carefully considered when implementing public screening strategies for CRC since the use of flexible sigmoidoscopy as a screening tool, particularly in older age groups, appears to be less effective.