1.Multidomain Geriatric Screen and Physical Fitness Assessment Identify Prefrailty/Frailty and Potentially Modifiable Risk Factors in Community-Dwelling Older Adults.
Laura Bg TAY ; Melvin Pw CHUA ; Ee Ling TAY ; Hiu Nam CHAN ; Shi Min MAH ; Aisyah LATIB ; Cheryl Qy WONG ; Yee Sien NG
Annals of the Academy of Medicine, Singapore 2019;48(6):171-180
INTRODUCTION:
Frailty begins in middle life and manifests as a decline in functional fitness. We described a model for community frailty screening and factors associated with prefrailty and frailty and fitness measures to distinguish prefrail/frail from robust older adults. We also compared the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight (FRAIL) scale against Fried frailty phenotype and Frailty Index (FI).
MATERIALS AND METHODS:
Community-dwelling adults ≥55 years old were designated robust, prefrail or frail using FRAIL. The multidomain geriatric screen included social profiling and cognitive, psychological and nutritional assessments. Physical fitness assessments included flexibility, grip strength, upper limb dexterity, lower body strength and power, tandem and dynamic balance and cardiorespiratory endurance.
RESULTS:
In 135 subjects, 99 (73.3%) were robust, 34 (25.2%) were prefrail and 2 (1.5%) were frail. After adjusting for age and sex, depression (odds ratio [OR], 2.90; 95% confidence interval [CI], 1.05-7.90; = 0.040) and malnutrition (OR, 6.07; 95% CI, 2.52-14.64; <0.001) were independently associated with prefrailty/frailty. Prefrail/frail participants had significantly poorer performance in upper limb dexterity ( = 0.030), lower limb power ( = 0.003), tandem and dynamic balance ( = 0.031) and endurance ( = 0.006). Except for balance and flexibility, all fitness measures differentiated prefrail/frail from robust women. In men, only lower body strength was significantly associated with frailty. Area under receiver operating characteristic curves for FRAIL against FI and Fried were 0.808 (0.688-0.927, <0.001) and 0.645 (0.546-0.744, = 0.005), respectively.
CONCLUSION
Mood and nutrition are targets in frailty prevention. Physical fitness declines early in frailty and manifests differentially in both genders.
2.Comparison of HRCT imaging features of ground glass opacity of COVID-19 and early-stage lung carcinoma
Guojun GENG ; Xiaolei ZHU ; Yanjun MI ; Wei XIONG ; Fan OU ; Ning LI ; Hongming LIU ; Mengkun CAO ; Chengqing DENG ; Sien SHI ; Xiuyi YU ; Jie JIANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2020;36(7):393-396
Objective:To investigate the difference of HRCT imaging features between COVID-19 and the ground-glass opacity(GGO) lesion of early-stage lung carcinoma, standardize the diagnosis and treatment process of ground-glass opacity(GGO) degeneration during the epidemic.Methods:A total of 34 patients with diagnosed COVID-19 who confirmed by positive results of the new coronavirus nucleic acid test were collected as observation group 40 patients with pathologically diagnosed early-stage lung carcinoma whose preoperative HRCT examination showed pure ground glass lesions and received surgical intervention were recruited from the Department of Thoracic Surgery (The First Affiliated Hospital of Xiamen University) from January 2018 to December 2019 as the control group. The HRCT imaging features of these two groups of patients were compared and statistically analyzed.Results:The HRCT imaging features of the new type of COVID-19 showed significant difference by characteristics of multiple lesions, lesion rapid variation within 3 days, reticular pattern, vacuolar sign and clear boundary compared to the GGO lesion of early-stage lung carcinoma( P<0.05). The chinical and imaging characteristic the sex, age, with pleural effusion or not and the lesion location showed no significant difference between these 2 groups ( P>0.05). Conclusion:Contrast with inert early lung carcinoma lesions, COVID-19 disease developed rapidly. Imaging dynamic examination can provide evidences to distinguish Novel Coronavirus Pneumonia and early-stage lung carcinoma.
3.Accuracy and technical feasibility of mutual corroboration in the diagnosis of pulmonary nodule: A report of 1 368 cases
Guojun GENG ; Yanjun MI ; Xiaolei ZHU ; Guang ZHAO ; Ning LI ; Hongming LIU ; Weixi GUO ; Sien SHI ; Liangliang WANG ; Pan YIN ; Jie MA ; Xiuyi YU ; Jie JIANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2020;27(06):669-674
Objective By applying the mutual corroboration in the diagnosis, we aimed to improve the accuracy of preoperative imaging diagnosis, select the appropriate timing of operation and guide the follow-up time for patients with pulmonary nodules. Methods Clinical data of 1 368 patients with pulmonary nodules undergoing surgical treatment in our department from July 2016 to October 2019 were summarized. There were 531 males and 837 females at age of 44 (21-67) years. The intraoperative findings, images and pathology were classified and analyzed. The imaging pathology and pathological changes of pulmonary nodules were shown as a dynamic process through mutual collaboration and interaction. Results Of 1 368 patients with pulmonary nodules, 376 (27.5%) were pure ground-glass nodules, 729 (53.3%) were mixed ground-glass nodules and 263 (19.2%) were solid nodules. Among the pure ground-glass nodules, adenocarcinoma in situ (AIS) accounted for the highest proportion (156 patients), followed by microinvasive adenocarcinoma (MIA, 90 patients), atypical adenomatous hyperplasia (AAH, 85 patients), and benign tumors (20 patients). Among mixed ground-glass nodules, 495 patients were invasive adenocarcinoma (IA) and 207 patients of MIA. no patient was featured by AAH, AIS or MIA. Conclusion The mutual collaboration and interaction can improve the accuracy of preoperative diagnosis of pulmonary nodules, and it supports the choice of operation timing and the judgment of follow-up time.