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Polypharmacy continues to be a topic of concern among older adults and puts patients at increased risk of potential drug-drug interactions (DDIs) and negative health outcomes. The objective of this study was to assess the prevalence of polypharmacy among older adults with cardiovascular disease (CVD) and to identify severe potential DDIs.

A retrospective chart review was conducted in a tertiary care center over a three-month period where we reviewed home medications of older adults upon hospital admission. Inclusion criteria were age ≥ 65 years, history of CVD, and admission to the cardiology service. Polypharmacy was defined as 5 or more medications taken concomitantly, hyper-polypharmacy was defined as 10 or more medications taken concomitantly, and severe potential DDIs were considered to be those belonging to category D or X using Lexicomp® Drug Information Handbook. Category D interaction states that modification of therapy should be considered while category X states that the combination should be aIs are very common in older adults with CVD. Clinicians should vigilantly review patients’ drug records and adjust therapy accordingly to prevent adverse drug reactions and negative health outcomes.

The proportion of older adults is increasing rapidly, and the majority are female. In 2050, the number of persons aged 60 years and over is estimated to reach 2.1 billion worldwide, constituting one-third of the total population of Europe. Long-term back pain is a disabling and common condition, primarily affecting older women. Although standardized functional evaluations are essential in the screening of older adults, self-rated activities of daily living capture a different aspect of the person’s ability in the context of his or her environment and social support system. This study aimed to describe how older women with or without long-term back pain self-rate their activities of daily living (ADL) and instrumental activities of daily living (IADL) in relation to their performance-based testing of physical function, including walking test, leg muscle strength, balance, and endurance.

This study is part of the Gothenburg H70 Birth Cohort Studies in Sweden (H70 studies) and uses data from the 1944 birth cback pain in municipal or emergency health-care settings.

Accurate characterization of small nodules in a cirrhotic liver is challenging. We aimed to determine the additive value of MRI-based radiomics analysis to Liver Imaging Reporting and Data System version 2018 (LI-RADS v 2018) algorithm in differentiating small (≤ 3cm) hepatocellular carcinomas (HCCs) from benign nodules in cirrhotic liver.

In this retrospective study, 150 cirrhosis patients with histopathologically confirmed small liver nodules (HCC, 112; benign nodules, 44) were evaluated from January 2013 to October 2018. Based on the LI-RADS algorithm, a LI-RADS category was assigned for each lesion. A radiomics signature was generated based on texture features extracted from T1-weighted, T2W, and apparent diffusion coefficient (ADC) images by using the least absolute shrinkage and selection operator regression model. A nomogram model was developed for the combined diagnosis. Diagnostic performance was assessed using receiver operating characteristic curve (ROC) analysis.

A radiomics signature consisting of eight features was significantly associated with the differentiation of HCCs from benign nodules. Both LI-RADS algorithm (area under ROC [A

] = 0.898) and the MRI-Based radiomics signature (A

 = 0.917) demonstrated good discrimination, and the nomogram model showed a superior classification performance (A

 = 0.975). Compared with LI-RADS alone, the combined approach significantly improved the specificity (97.7% vs 81.8%, p = 0.030) and positive predictive value (99.1% vs 92.9%, p = 0.031) and afforded comparable sensitivity (97.3% vs 93.8%, p = 0.215) and negative predictive value (93.5% vs 83.7%, p = 0.188).

MRI-based radiomics analysis showed additive value to the LI-RADS v 2018 algorithm for differentiating small HCCs from benign nodules in the cirrhotic liver.

MRI-based radiomics analysis showed additive value to the LI-RADS v 2018 algorithm for differentiating small HCCs from benign nodules in the cirrhotic liver.

Despite a notable decrease in acute rheumatic fever (ARF) incidence in the past few decades, there are still cases in our setting. PBIT purchase Sydenham chorea (SC) may be the initial manifestation for this condition in childhood in a significant proportion of children. We report two cases of choreoathetosis in children as the first manifestation of ARF.

A previously healthy 8-year-old boy presented with right hemichorea with a predominance in the brachial region, orofacial dyskinesias and speech difficulties for the past 2weeks. The only medical history of interest was a common catarrhal illness 3 weeks before and nonspecific bilateral tenosynovitis in both feet since a year prior. A brain computerized tomography was normal and the echocardiogram showed mild mitral and aortic regurgitation, meeting ARF criteria. He demonstrated clinical improvement with treatment based on prednisone and carbamazepine. The second patient was a 10-year-old girl with choreic movements of the right half of the body and repetitive right ee to the possibility of subclinical valve lesions. Good adherence to secondary prophylaxis is crucial to avoid chorea relapses and worsening valve disease.

SC should be the main diagnostic consideration in cases of hemichorea with normal neuroimaging in children. The cases reported highlight the need to maintain a high index of suspicion even in settings where incidende of ARF is low and the need to perform cardiological investigations in all patients with suspected SC, due to the possibility of subclinical valve lesions. Good adherence to secondary prophylaxis is crucial to avoid chorea relapses and worsening valve disease.

Based on a conceptual framework, Kuspinar and colleagues analysed life-space mobility in community-dwelling older adults. However, a number of earlier mobility studies that used the same framework remained undiscussed. This correspondence article addresses similarities and differences between these studies, as well as highlight issues that need to be addressed to improve our understanding of mobility determinants in older adults.

Despite differences in methodological approach as well as in detailed results, the studies share one important outcome regardless of the specific choice of potential mobility determinants, only a low to moderate proportion of mobility could be explained.

Our present understanding of the determinants of mobility in community-dwelling older adults is limited. A consistent terminology that takes into account the different aspects of mobility; the use of objective methods to assess real-life mobility; and monitoring changes in real-life mobility in response to interventions will contribute to furthering our understanding of mobility determinants.