Articles: middle-aged.
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The opioid crisis in the USA and in other developed countries can potentially affect low- and middle-income countries (LMICs). The licit medical use of opioids has two sides. The USA and high-income countries maintain abundant supply for medical prescription. ⋯ Physicians and nurses in Asia and Africa engaged in cancer pain relief and palliative care face a constant paucity of opioids. Millions of patients in LMICs, suffering from life-modifying cancer pain, do not have access to morphine and other essential opioids, due to restrictive opioid policies. Attention will be needed to improve opioid availability in large parts of the world, even though the opioid crisis has led to control the licit medical use in the USA.
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To investigate the normal diameter of the abdominal aorta and common iliac arteries of the middle-aged and elderly people in China and the relationship of the diameters with age, sex, height, weight, body mass index (BMI), and body surface area (BSA). This retrospective study enrolled 625 patients including 380 males and 245 females aged 60.00 years (interquartile range 13.00 years). All clinical data and the diameters of the abdominal aorta and common iliac arteries were analyzed. ⋯ The diameter of the abdominal aorta at the proximal, middle, and distal segment as well as the diameter of the left and right common iliac artery at the distal segment were significantly (P < .05) increased with age. The normal values of the diameter of the abdominal aorta and common iliac arteries are suggested for the middle-aged and elderly Chinese people for clinical reference. The diameters are gender related and significantly positively correlated with BSA, height, weight, and BMI, which is beneficial for the diagnosis and treatment planning of relevant vascular diseases.
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We aimed to investigate the impact of common diseases and habits on daytime sleepiness in adults. We retrospectively collected the clinical and overnight polysomnographic data of 2829 adults. The impact of common diseases and habits on the Epworth Sleepiness Scale (ESS) score was analyzed by univariate and multivariate linear regression analyses. ⋯ AMI had a significantly positive association with ESS scores, but chronic kidney disease had a significantly negative association with ESS scores in middle-aged adults. Furthermore, dyslipidemia, chronic kidney disease, and cancers had a significantly positive association with ESS scores in older adults. Dyslipidemia, AMI, liver cirrhosis, alcohol drinking, and tea consumption had a significantly positive association with daytime sleepiness in adults but differed by sex and age.
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Hepatic sarcomatoid carcinoma is a rare liver malignancy with atypical clinical symptoms and a high degree of malignancy. To improve the understanding of this disease, we collected the clinical and pathological data of 14 patients with hepatic sarcomatoid carcinoma admitted to the First Affiliated Hospital and Second Affiliated Hospital of Bengbu Medical College from 2011 to 2021 and reviewed the relevant literature. The clinical and pathological data of 14 patients with hepatic sarcomatoid carcinoma were collected from the electronic medical record system of the 2 hospitals. ⋯ Hepatic sarcomatoid carcinoma is more common in middle-aged and elderly patients, especially men, and has no characteristic clinical manifestations. Imaging examination and B-ultrasound-guided liver biopsy + immunohistochemistry can help diagnose. Radical surgery is the preferred method for hepatic sarcomatoid carcinoma, and postoperative adjuvant chemotherapy is expected to prolong patient survival.
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Postoperative ischemic stroke in middle-aged and elderly patients with hip or knee arthroplasty remains a major postoperative challenge, little is known about its incidence and risk factors. This study sought to create a nomogram for precise prediction of ischemic stroke after hip or knee arthroplasty. Discharge data of all middle-aged and elderly patients undergoing primary hip or knee arthroplasty from May 2013 to October 2020 were queried. ⋯ The calibration curves for the probability of ischemic stroke showed optimal agreement between the probability as predicted by the nomogram and the actual probability (Hosmer-Lemeshow test: P = .818). We developed a practical nomogram that can predict the risk of ischemic stroke for middle-aged and elderly patients with hip or knee arthroplasty. This model has the potential to assist clinicians in making treatment recommendations.