The role of inflammation in the development of post-stroke depression in elderly patients

Цель исследования - изучение роли цитокинов, соотношения нейтрофилов и лимфоцитов в развитии постинсультной депрессии (ПД) у больных пожилого возраста. В исследование были включены 110 больных с острым ишемическим инсультом, из них 60 человек среднего возраста (52±5 лет) и 50 - пожилого возраста (66±4 года). Контрольную группу составили 20 человек среднего возраста без инсульта в анамнезе. Через 3 мес наблюдения ПД в пожилом возрасте развилась у 28 (56 %) больных, в среднем возрасте - у 26 (43,3 %). Больные пожилого возраста с ишемическим инсультом, у которых развилась ПД, были достоверно старше (7,9 %, р<0,05), чаще имели артериальную гипертензию (12,4 %, р<0,05), уровень гликемии выше на 16,1 % (р<0,05), триглицеридов - на 14 % (р<0,05), ЛПНП - на 12,8 % (р<0,05). Больные среднего возраста с ПД имели ИМТ выше на 8,1 % (р<0,05), уровень гликемии - на 9,6 % (р<0,05), триглицеридов - на 10,9 % (р<0,05), ЛПНП - на 9,7 % (р<0,05), чем больные без депрессии. Пожилые больные с ишемическим инсультом и ПД имели более высокий уровень цитокинов - IL-1β был выше на 35,4 % (р<0,01), TNF-α - на 27 % (р<0,01), INF-γ - на 18 % (р<0,01), чем у больных без ПД. У больных пожилого возраста с ПД соотношение нейтрофилов и лимфоцитов (Н/Л) было на 46 % (p<0,001) выше, чем у больных без ПД. В группе больных пожилого возраста при наличии ПД соотношение Н/Л было на 50 % (p<0,001) выше, чем в аналогичной группе среднего возраста. Таким образом, у пожилых больных с ишемическим инсультом уровень маркеров воспаления может иметь прогностическое значение в развитии постинсультной депрессии. The aim of the study was to study the role of cytokines, the ratio of neutrophils and lymphocytes in the development of post-stroke depression in elderly patients. The study included 110 patients with acute ischemic stroke, including 60 middle-aged people (52±5 years) and 50 elderly people (66±4 years). The control group consisted of 20 middle-aged people without a history of stroke. After 3 months of follow-up, post-stroke depression (PSD) developed in the elderly in 28 patients (56 %), in the middle age in 26 patients (43,3 %). Patients with ischemic stroke in the elderly who developed PSD were significantly older (7,9 %, p<0,05), more often had arterial hypertension (12,4 %, p<0,05), the level of glucose was 16,1 % higher (p<0,05), triglycerides by 14 % (p<0,05), LDL-C by 12,8 % (p<0,05). In middle age, patients with post-stroke depression had a body mass index higher by 8,1 % (p<0,05), a glucose level by 9,6 % (p<0,05), triglycerides by 10,9 % (p<0,05), LDL-C by 9,7 % (p<0,05) than patients without PSD. Elderly patients with ischemic stroke and PSD had higher levels of cytokines - IL-1β was 35,4 % higher (p<0,01), TNF-α by 27 % (p<0,01), INF-γ by 18 % (p<0,01) than in patients without PSD. In elderly patients with PSD, the ratio of neutrophils and lymphocytes (N/L) is 46 % (p<0,001) higher than in patients without PSD. In the elderly, in the presence of PSD, the N/L ratio was 50 % (p<0,001) higher than in the same middle-aged group. Thus, in elderly patients with ischemic stroke, the level of inflammatory markers may have a prognostic value in the development of post-stroke depression.

Grateful Expectations: Cultural Differences in the Curvilinear Association between Age and Gratitude

Recent research suggests that the association between age and gratitude might be curvilinear—despite gratitude ostensibly being higher in middle-age, it might be lower in older adulthood. It is unclear if this curvilinear pattern of age differences in gratitude is found in other samples and whether its manifestation depends on contextual (i.e., national/cultural) characteristics. The current study examined cultural variation in the curvilinear effect of age on gratitude in a sample of over 4.5 million participants from 88 countries. Participants from countries with lower levels of human development, a shorter-term orientation, and higher levels of indulgence reported higher levels of gratitude. Cultural moderation effects were very small, suggesting that curvilinear effects of age on gratitude may be relatively comparable across cultures.

Grateful expectations: Cultural differences in the curvilinear association between age and gratitude

Recent research suggests that the association between age and gratitude might be curvilinear—despite gratitude ostensibly being higher in middle-age, it might be lower in older adulthood. It is unclear if this curvilinear pattern of age differences in gratitude is found in other samples and whether its manifestation depends on contextual (i.e., national/cultural) characteristics. The current study examined cultural variation in the curvilinear effect of age on gratitude in a sample of over 4.5 million participants from 88 countries. Participants from countries with lower levels of human development, a shorter-term orientation, and higher levels of indulgence reported higher levels of gratitude. Cultural moderation effects were very small, suggesting that curvilinear effects of age on gratitude may be relatively comparable across cultures.

A Retrospective Study of Lacunar Stroke Cases in University Malaya Medical Centre (UMMC) According to Age and Gender

Worldwide, stroke was ranked as the second commonest cause of death and the third most common cause of disability-adjusted life-years. Lacunar stroke is one type of stroke. The aim of this study is to determine the dependability of gender differences in lacunar stroke epidemiology on patient age as the influence of gender on stroke risk and outcome changes across the lifespan. Thus, this study was to identify age, and gender differences among lacunar stroke patients at University Malaya Medical Centre (UMMC). This study was conducted retrospectively from January 2016 to December 2019 in UMMC. Patients were selected based on inclusion and exclusion criteria. The inclusion criteria include a clinical diagnosis of lacunar stroke, age categories of middle age (40 – 59 years old) and older age (60 years and above), as well as undergo CT examination. The exclusion criterion is other than lacunar stroke patients. Patient’s data on gender and age were retrieved from the database PACS of UMMC. The analyzation includes cross tabulation of categorical data and independent t-test. Among 94 cases, higher cases of lacunar stroke are found to occur in men (58.51%). Furthermore, both middle age (13.83%) and older age (44.68%) among male patient shows higher percentage of lacunar incidence compared to female patients. Moreover, old age patients (76.60%) for each gender shows higher percentage of lacunar incidence compared to middle-aged patients (23.30%). Meanwhile the independent t-test result demonstrated that the mean age of female patients (67.79) diagnosed with lacunar stroke is not statistically different from the mean age of male patients (68.47). The study indicated that lacunar stroke is most likely to occur in men either at age 40 or 60 and above. Higher cases were recorded in older category which is at age 60 and above for both genders.

Salutogenesis and the Sense of Coherence in Middle Adulthood

In this chapter, the authors focus on the transition from middle to late adulthood. The questions of when and how past transitions affect subsequent ageing is discussed. Whilst middle age was long considered undramatic, the authors state that it is increasingly gaining profile. They focus on a phase typically observed in the sixth decade of life, characterized by the initiation of the transition to de-professionalization and change of responsibilities within the family when crisis and chronic situations can lead to the need for help from health professionals.The authors deliberate on how a dialogue between middle-aged adults and professionals can contribute positively to the naming, modification, design and further development of health goals, linking physiological and unconscious processes to the theory of salutogenesis.Notably, the authors frame illness processes from the perspective of salutogenic resources, also discussing the benefits of crises experienced in middle adulthood.The authors’ novel ideas about a salutogenic perspective on life in middle adulthood will inspire researchers and practitioners to a more innovative approach to this large segment of society.

Identification of gender by radiographic analysis of mental foramen in a sample of Iraqi patients

Objective: The mandible is the strongest bone in the human skeleton. The uses of the morphological characters of such jawbone is a predominantly used approach in forensic dentistry to determine the gender of a severely damaged cadaver. Distinguishing sex, race and personal stamp of the unknown skeleton still has been the most challenging job in forensic dentistry. This research aimed to clarify the gender of Babylon population by mental foramen (MF) assessment using Orthopantomography (OPG). Method: The present retrospective study was conducted on 120 digital panoramic radiographs. The radiographs were of 60 male and 60 female dentate patients aged between 18-62 years. Morphometric analysis was performed on bilateral mental foramina. Lines were drawn from superior (S) and inferior (I) borders of the foramen and perpendiculars to the lower (L) border of the mandible (S-L and I-L lines respectively). Data were distributed and subjected to statistical analysis using the Independent-Samples T test. Results: The average values of S-L and I-L were significantly higher in males than in females (p<0.05). Conclusion: The distance from the MF to the lower border of the lower jaw reveals gender differences in Babylon city population. Findings also suggest that OPG could be a useful technique for gender identification from the remnants of the human body skeleton. There was a statistical significant difference in the average S-L distance and average I-L distance between males and females at 3 different age groups (young adult, middle age and old age groups), except in the average I-L distance at the middle age group (p<0.05). Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 79-83