Perspectives of inpatient neurological rehabilitation in elderly patients
BALNEO RESEARCH JOURNAL
Authors: Muresan, Alexandru D.; Stanescu, Ioana C.; Bulboaca, Adriana E.; Fodor, Dana M.; Bulboaca, Alexandra Ina
Demographic data record an increasing number of people aged over 65 years, with specific health conditions and a high probability to suffer from chronic diseases, cognitive impairment or loss of autonomy, and with limited functional reserve. The prevalence of disability increases with age, affecting 33% of men and 42% of women aged over 85 years. Many neurodegenerative disorders increase in prevalence with age. Thus, the need for rehabilitation treatment in this segment of population is very high, loss of functioning being the most prominent condition for admitting elderly persons in rehabilitation facilities. Rehabilitation in the elderly is an important tool in regaining autonomy, associated with substantial reduction in the burden of health and social costs. Patients aged over 80 years need a comprehensive geriatric assessment (CGA) to establish the global capabilities of the person for inclusion in a coordinated therapy plan and a long term follow-up. CGA will identify patients with severe or complicated medical conditions and important disability who require a multidisciplinary team and a coordinated rehabilitation program, accessible only in rehabilitation hospitals. Rehabilitation treatment should start from the intensive care unit, and continues until the patient reaches a plateau of maximal functional improvement. The most useful therapeutic interventions in old people are physical and occupational therapy, and, for selected and stable patients, therapy in a balnear resort is an option to improve their quality of life.
The influence of green coffee bean extract supplementation on blood glucose levels: A systematic review and dose-response meta-analysis of randomized controlled trials
Authors: Chen, Yan; Zhao, Ying; Wang, Yanjun; Nazary-Vannani, Ali; Clark, Cain C. T.; Macit, Melahat Sedanur; Khani, Vahid; Zhang, Yong
Studies regarding the influence of green coffee extract (GCE) on blood glucose levels are conflicting. Thus, we sought to conduct a meta-analysis and systematic review of all available randomized controlled trials (RCTs) to quantify the effects of GCE and CGA intervention on blood glucose and insulin levels. We performed systematic online searches in Scopus, Web of science, and PubMed databases, from inception to July 2019. Data were combined analyzed using a random effects model (Der Simonian-Laird method) and reported as weighted mean differences (WMD). Ten trials reported the influences of GCE on FBS and insulin and were subsequently entered into the meta-analysis. Combined results highlighted that FBS was significantly altered after GCE consumption (WMD: -1.791 mg/dl, 95% CI -3.404, -0.177), with no significant heterogeneity among the studies (I-2= 35.0%,p= .128). However, overall results demonstrated that GCE administration did not result in any significant alteration in insulin levels (WMD: -0.925 mu U/ml, 95% CI:-1.915, 0.064), with significant heterogeneity found across studies (I-2= 87.9%). In sub-group analysis, insulin levels were significantly reduced when GCE was supplemented in dosages of >= 400 mg/day (WMD:-1.942 mg/dl, 95% CI:-1.184, -0.975;I-2= 0.0%). The results of present study support the use of GCE for the enhancement of blood glucose, while subgroup analysis highlighted significant improvements in insulin levels when GCE is supplemented in doses >= 400 mg/day.