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'Scholarly peer reviewing': The art, the pleasures as well as issues.
BACKGROUND Cardiovascular disease (CVD) and thyroid dysfunction are common in older people, but little is known about how they affect health-related quality of life (HRQoL). METHODS We assessed HRQoL with the 15D instrument in 329 home-dwelling patients aged ≥ 75 years with stable CVD and compared the results to those of an age- and gender-matched general population (n = 103). We also studied the impact of age, BMI, number of medications, thyroid-stimulating hormone (TSH) concentration, levothyroxine (L-T4) substitution and Mini-Mental State Examination (MMSE) on HRQoL. RESULTS Overall HRQoL was impaired in older people with stable CVD (mean 15D score 0.777 vs 0.801, p = 0.001), and also on single dimensions of breathing, sleeping, discomfort and symptoms, distress, vitality (all p  less then  0.001), and depression (p = 0.016) compared to the age- and gender-matched general population. Furthermore, in the patients, L-T4 substitution associated with impaired sleeping (p = 0.018) and sexual activity (p = 0.030). Moreover, MMSE points, number of medications used, age (all p  less then  0.001) and BMI (p = 0.009) predicted impaired HRQoL. CONCLUSIONS Older people with stable CVD are characterized by impaired HRQoL compared to age- and gender-matched controls. We demonstrate that this is the consequence of impaired breathing, sleeping, discomfort and symptoms, distress, vitality, and depression. L-T4 substitution has a negative impact on HRQoL in old patients with stable CVD. MMSE score, number of medications, age and BMI predict worse HRQoL.BACKGROUND The purpose of this study was to examine whether impairments in sensorimotor peripheral nerve function are associated with a higher likelihood of swallowing impairment in older adults. METHODS Health, Aging and Body Composition participants (n = 607, age = 75.8 ± 2.7 years, 55.8% women, 32.3% black) underwent peripheral nerve testing at Year 4 and 11 with swallowing difficulty assessed at Year 4 and 15. Nerve conduction amplitude and velocity were measured at the peroneal motor nerve. Sensory nerve function was assessed with the vibration detection threshold and monofilament (1.4-g/10-g) testing at the big toe. Symptoms of lower extremity peripheral neuropathy and difficulty swallowing were collected by self-report. Data analysis was performed using a hierarchical approach. Odds ratios (ORs) were estimated using non-conditional logistic regression. RESULTS At Year 15 108 (17.8%) participants had swallowing impairments. In fully adjusted models, the peripheral nerve impairments associated with swallowing impairment were numbness (OR 4.67; 95%CI 2.24-9.75) and poor motor nerve conduction velocity (OR 2.26; 95%CI 1.08-4.70). Other peripheral nerve impairments were not related to swallowing. CONCLUSIONS The association between slow motor nerve conduction velocity and numbness and a higher likelihood of swallowing difficulties a decade later in our prospective study identifies an important area for further investigation in older adults.BACKGROUND There is a paucity of reliability data for walking speed tests in complex conditions to assess functioning in healthy older individuals. AIMS To evaluate the absolute intra- and intertest reliability of walking speed performed in basic and complex conditions in healthy older individuals. METHODS Fifty-two men and women of mean age 69.7 ± 3.2 years were tested for habitual and maximal walking speed. Maximal speed was also assessed under different conditions, including walking on a path of reduced width; picking up objects; stepping over hurdles; stepping over hurdles wearing sunglasses and finally, carrying a box. Two testing sessions (separated by 4 weeks) of two trials each were administered. Reliability was analysed by intra-class correlation coefficient (ICC), minimal detectable change (MDC) and Bland-Altman plots with limits of agreement (LOA). RESULTS Intrasession ICCs ranged from good to excellent (0.89-0.95) except for picking up objects (0.44). Intersession ICCs were moderate to good (0.60-0.78) and %MDCs were acceptable (14-24%). Bland-Altman plots suggested a good agreement between the two testing sessions at group level (mean differences from - 0.02 to - 0.11 m/s), and limited agreement between testing sessions at individual level (upper LOA from 0.13 to 0.37 m/s and lower LOA from - 0.29 to - 0.49 m/s). CONCLUSIONS Complex walking speed tests are generally reliable measures displaying good and moderate intra- and inter-session reliability. Such tests seem a more suitable functional assessment tool for heathy older subjects compared with simple walking. see more Some learning effect may be present and further reliability studies are needed.OBJECTIVES Liver is the most important and functional organ in the body to metabolize and detoxify endogenous compounds and xenobiotics. The major goal of the present narrative review is to assess the hepatoprotective properties of hesperidin against a variety of natural and chemical hepatotoxins via different mechanisms. EVIDENCE ACQUISITION Scientific databases such as Scopus, Medline, Web of Science and Google scholar were thoroughly searched, based on different keywords. RESULTS A variety of natural hepatotoxins such as lipopolysaccharide, concanavalin A and microcystins, and chemical hepatotoxins such as ethanol, acrylamide and carbon tetrachloride have been shown to damage hepatocytes as well as other liver cells. In addition to hepatocytes, ethanol can also damage liver hepatic stellate cells, Kupffer cells and sinusoidal endothelial cells. In this regard, the flavanone hesperidin, occur in the rind of citrus fruits, had been demonstrated to possess widespread pharmacological properties. Hesperidin exerts its hepatoprotective properties via different mechanisms including elevation in the activities of nuclear factor-like 2/antioxidant response element and heme oxygenase 1 as well as the levels of enzymatic and non-enzymatic antioxidants. Furthermore, reduction in the levels of high-mobility group box 1 protein, inhibitor of kappa B protein-alpha, matrix metalloproteinase-9 and C-reactive protein are some other important hesperidin-derived hepatoprotective mechanisms. CONCLUSION Based on several research papers, it could be concluded that hesperidin is able to protect against liver damage from inflammation and/or oxidative stress-mediated natural and chemical toxins.
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