Influence of personality and health behaviors on fatigue in late and very late life

There is limited understanding about variables associated with fatigue in late and very late life. The purpose of this study was to explore the longitudinal influences of personality and health behaviors on changes in fatigue. One hundred and seventy-eight participants of the Georgia Centenarian Study were part of this study. Multiple regression analyses were computed to assess the influence of personality, physical activity, stress management, and nutritional risk on fatigue after initial fatigue, self-reported health, and psychosocial variables were controlled for. Anxiety, physical activity, and nutritional risk had significant longitudinal effects on fatigue. Older adults who were anxious, less engaged in physical activity, and who had higher levels of nutritional risk were more likely to show increased fatigue levels. The results suggest that more clinical and research attention should be paid to changes of fatigue in older populations.     

Family functioning in late late life.

This study of 150 individuals, 85 years and older, focused on their families and social networks. Using both structured and open-ended questions, we explored the extent to which the family functions as a source of support for the oldest old. The findings indicate that those with children are significantly more active with all relatives, most likely because children link them to grandchildren, great-grandchildren, and their relatives by marriage. For the 30 percent who are childless and unmarried, other relatives are not usually active providers of support, a finding which suggests that the principle of substitution does not operate effectively for this age group. Case studies illustrate the variations in family functioning in the support of their oldest members.     

The conundrum of late and very late stent thrombosis following drug-eluting stent implantation

PURPOSE OF REVIEW: Drug-eluting stents reduce restenosis compared with bare metal stents, but there is growing concern that drug-eluting stents may lead to higher rates of late stent thrombosis, a rare and potentially catastrophic complication following stenting. RECENT FINDINGS: While the data on the risk of late stent thrombosis are not definitive, several general conclusions may be drawn from the available data. Late thrombosis, while associated with high mortality and morbidity, is an uncommon complication of both drug-eluting stents and bare metal stents. Randomized trials of approved drug-eluting stents versus bare metal stents have shown additional cases of late stent thrombosis in drug-eluting stents, but no significant difference in the cumulative incidence of stent thrombosis, myocardial infarction, or cardiac death at 4 years of follow-up. Observational studies suggest higher very late stent thrombosis incidence, but the relative risks of drug-eluting stents versus bare metal stents in specific high-risk groups require further study. Although the etiology of late stent thrombosis is multifactorial, premature discontinuation of clopidogrel appears to be the most important risk factor. SUMMARY: Long-term follow-up of patients after coronary stenting has identified stent thrombosis as a rare but serious event. Ongoing clinical trials in broader patient populations will be helpful to understand the risk of late stent thrombosis with greater certainty.     

Evaluation of predictive scores for late and very late recurrence after cryoballoon-based ablation of atrial fibrillation

Journal of Interventional Cardiac Electrophysiology - Studies on predictive scores for very late recurrence (VLR) (recurrence later than 12 months) after second-generation...     

Early and late pulmonary complications of botulism

Pulmonary complications of botulism were studied in an outbreak of 34 cases of type A botulism in New Mexico in 1978. Hospital record review, standardized questionnaires, and pulmonary function tests were used to define pulmonary complications during the acute illness and the patient's status one year later. Pulmonary involvement was documented in 81% of patients. Ventilatory failure occurred in 11, aspiration pneumonia in nine, and death in two patients. Difficulties in the diagnosis of ventilatory insufficiency were identified. At one year, most patients had residual symptoms, including easy fatigability in 68% and exertional dyspnea in 46%. However, only minor pulmonary function abnormalities were present. This study confirms the generally favorable prognosis of botulism and provides clinical guidance for the diagnosis and management of pulmonary complications in botulism.