The American journal of medicine
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Although elderly men, particularly patients with low-risk prostate cancer and a life expectancy less than 10 years, are unlikely to benefit from prostate cancer active therapy, treatment rates in this group are high. ⋯ Clinical factors play a limited role in treatment selection among elderly patients with localized prostate cancer.
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Several studies have suggested an increased risk of cardiovascular events, primarily acute myocardial infarction, around the time of hospital admission for pneumonia. Therefore, we examined cardiovascular events, including myocardial infarction, congestive heart failure, unstable angina, stroke, and serious cardiac arrhythmias, within 90 days after hospitalization for pneumonia. ⋯ A clinically important number of subjects in this cohort had a cardiovascular event within 90 days of hospital admission, suggesting that such events may have an important role in post-pneumonia mortality. Additional research is needed to determine whether interventions may reduce the number of cardiovascular events after pneumonia.
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Sarcopenia and weakness are known to precipitate risk for disability, comorbidity, and diminished independence among aging adults. Resistance exercise has been proposed as a viable intervention to elicit muscular adaptation and improve function. However, the reported prevalence of resistance exercise participation among US adults aged >50 years is very low. ⋯ Evidence reveals that not only is resistance exercise very effective for eliciting strength gain and increases in lean body mass, but that there is a dose-response relationship such that volume and intensity are strongly associated with adaptations. These findings reflect and support the viability of progression in resistance exercise dosage to accommodate optimal muscular adaptive response. Progressive resistance exercise should thus be encouraged among healthy adults to minimize degenerative muscular function associated with aging.
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Electroconvulsive therapy is used to treat patients with severe or resistant depression. Troponin elevations are associated with an adverse prognosis, and it is well known that central nervous system insults can cause biochemical evidence of cardiac injury. No study previously has studied this with electroconvulsive therapy. ⋯ Elevations of cTn occurred in 11.5% of patients treated with electroconvulsive therapy. Some of the elevations preceded therapy and some occurred during treatment. Given the adverse prognostic importance of cTn elevations in general, in addition to additional studies, an increased degree of medical scrutiny may be appropriate for this group of patients and for those receiving electroconvulsive therapy.