Topic Review
Polypharmacy in Older Patients with COVID-19
Polypharmacy is the use of multiple and potentially inappropriate medications (PIMs) that lack sufficient evidence of benefits and/or increase the risks of adverse drug reactions. It is an increasing problem among older adults. The global polypharmacy prevalence is 34.6% in patients with COVID-19, and polypharmacy in COVID-19 increases with age. 
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  • 14 Mar 2024
Topic Review
Body Image, Body Composition, and Aging in Women
Sarcopenia, a condition of low muscle mass, is associated with aging, and sarcopenia in combination with excessive body fat causes sarcopenic obesity. Findings of improved health in people with a higher body mass index, known as the obesity paradox, are due to misclassifying healthy people as overweight according to height and body weight instead of according to fat mass and fat-free mass. Body fat infiltrates internal organs in aging adults as increasing levels of body fat are redistributed into the trunk, especially in the abdomen, while subcutaneous fat in the appendages decreases. Accuracy of body image perceptions can determine an individual’s control of body weight. Aging women can protect against sarcopenic obesity by increasing fat-free mass with resistance training and by lowering body fat levels with weight management knowledge and skills. Healthy dietary patterns are low in ultra-processed foods that stimulate excessive consumption of calories and increase body fat levels.
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  • 14 Mar 2024
Topic Review
Multiple Sclerosis and Sodium Toxicity
Salt intake is associated with multiple sclerosis; however, controversial findings that challenge this association rely primarily on methods that do not measure total sodium storage within the body, such as food surveys and urinary sodium excretion. In contrast, tissue sodium concentrations measured with sodium MRI confirm high sodium levels in multiple sclerosis, suggesting a role for sodium toxicity as a risk factor for the disease.
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  • 14 Mar 2024
Topic Review
Cancer Cachexia and Dysregulated Phosphate Metabolism
A diet high in phosphorus fed to mice deficient in klotho, a cofactor that regulates phosphate metabolism, accelerates aging, sarcopenia, general organ atrophy, kyphosis, and osteoporosis. Similar effects are seen in phenotypes of mutant p53 mice that overexpress the p53 tumor suppressor gene. Although mutant p53 mice do not develop tumors compared to wild-type mice, mutant p53 mice have shorter mean lifespans. Furthermore, tumorigenesis is associated with the sequestration of excessive inorganic phosphate, and dangerous levels of phosphate are released into circulation during tumor lysis syndrome. In total, this evidence implies that tumorigenesis may be a compensatory mechanism that provides protective effects against systemic exposure to dysregulated phosphate metabolism and phosphate toxicity related to cachexia in cancer. 
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  • 14 Mar 2024
Topic Review
Hypertension, Anxiety and Obstructive Sleep Apnea
Increased anxiety in these conditions may be linked to a high-salt diet through stimulation of the sympathetic nervous system, which increases blood pressure while releasing catecholamines, causing a “fight or flight” response. A rostral shift of fluid overload from the lower to the upper body occurs in obstructive sleep apnea associated with COVID-19 and cardiovascular disease, and may be related to sodium and fluid retention triggered by hypertonic dehydration. Chronic activation of the renin-angiotensin-aldosterone system responds to salt-induced dehydration by increasing reabsorption of sodium and fluid, potentially exacerbating fluid overload. Anxiety may also be related to angiotensin II that stimulates the sympathetic nervous system to release catecholamines. 
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  • 14 Mar 2024
Topic Review
SIDS, Pulmonary Edema, and Sodium Toxicity
Sudden Infant Death Syndrome (SIDS) occurs unexpectedly in an otherwise healthy infant with no identifiable cause of death following a thorough investigation. A general hypervolemic state has been identified in SIDS, and fluid in the lungs suggests the involvement of pulmonary edema and hypoxia as the cause of death.
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  • 14 Mar 2024
Topic Review
Calcium Phosphate and Mitochondrial Dysfunction in Parkinson’s Disease
Excessive phosphate is proposed to reduce Complex I function of the mitochondrial electron transport chain in Parkinson’s disease and is linked to opening of the mitochondrial permeability transition pore, resulting in increased reactive oxygen species, inflammation, DNA damage, mitochondrial membrane depolarization, and ATP depletion causing cell death. Parkinson’s disease is associated with α-synuclein and Lewy body dementia, a secondary tauopathy related to hyperphosphorylation of tau protein, and tauopathy is among several pathophysiological pathways shared between Parkinson’s disease and diabetes. Excessive phosphate is also associated with ectopic calcification, bone mineral disorders, and low levels of serum vitamin D in patients with Parkinson’s disease. Sarcopenia and cancer in Parkinson’s disease patients are also associated with phosphate toxicity. Additionally, Parkinson’s disease benefits are related to low dietary phosphate intake.
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  • 14 Mar 2024
Topic Review
Salt in Low Back Pain and Comorbid Conditions
Low back pain is the world’s leading disability, but the etiology of the majority of low back pain is non-specific with no known cause. Moreover, overuse of opioids to treat low back pain is a widespread problem. Many global populations consume excess sodium chloride, which can lead to fluid overload in hypervolemia, and cause swelling and temporary weight gain associated with low back pain. Numerous conditions comorbid with low back pain are also potentially mediated by excessive salt intake, including migraine headache, hypertension, cardiovascular disease, venous thromboembolism, liver disease, respiratory disorders, chronic kidney disease, pregnancy complications, and multiple sclerosis.
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  • 14 Mar 2024
Topic Review
Mucociliary Clearance and SARS-CoV-2 Infection
Ciliary beat frequency (CBF) within the ciliated epithelium of the nasal tract can be stimulated to a higher frequency and provide increased protection against transient exposure to airway irritants. Smokers as well as non-smokers exposed to secondhand tobacco smoke were found to have higher CBFs. However, with extended exposure to irritants, persistent upregulated CBF can damage and remodel the epithelial layer with fewer protective cilia. Additionally, mucociliary clearance (MCC), the innate defense mechanism of the respiratory system, traps particles and pathogens within the mucous layer of the epithelium and propels them out of the airways through ciliary activity. However, this mechanism becomes defective as disease progresses, increasing susceptibility to viral respiratory infections. 
  • 230
  • 14 Mar 2024
Topic Review
Phosphate Toxicity Associated with Tumorigenesis and Obesity
Phosphate toxicity, the accumulation of excess phosphate in the body from dysregulated phosphate metabolism, is associated with tumorigenesis. High levels of hormones that regulate phosphate metabolism, such as parathyroid hormone and fibroblast growth factor 23, are also associated with obesity, providing a potential link between obesity and phosphate toxicity. Increased dietary intake of inorganic phosphate is linked to excessive consumption of foods processed with phosphate additives, and consumption of ultra-processed foods is associated with an increase in the incidence of obesity.
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