Book chapters will be unavailable on Saturday 24th August between 8am-12pm BST. This is for essential maintenance which will provide improved performance going forwards. Please accept our apologies for any inconvenience caused.
To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The risk of cancer increases with age, and the number of older adults seeking treatment is increasing dramatically in line with the aging population. The care of older patients differs from that of younger adults because of differences in the biology of the tumor, age-related differences in host physiology, comorbidity burden and psychosocial issues, which might impact the efficacy and side effects of cancer therapy. Practical Geriatric Oncology is a comprehensive, evidence-based text that synthesizes the growing literature in this field and provides practical guidelines to the care of older adults with cancer. Coverage includes patient assessment, management of solid tumors and hematologic malignancies, the impact of age on the pharmacology of cancer therapy, surgical oncology and radiation oncology in the older adult, symptom management and supportive care. In addition to serving as core reading for oncologists and hematologists, the book will also be a useful work for other healthcare professionals who provide oncology care, including surgeons, radiation oncologists, palliative care doctors, primary care providers, geriatricians and nurses.
Monoclonal gammopathy of unknown significance (MGUS) affects up to 2% of persons aged 50 years or over, and about 3% of those older than 70 years. The aim of this chapter is to highlight some of the features of this disease process and its relationship to aging. It will focus on (1) epidemiology, (2) biology of MGUS and the role of various cytokines in the pathophysiology, (3) correlation of the biology of MGUS with aging, (4) diagnosis and follow-up of patients with MGUS, and (5) natural history and predictors of progression in patients with MGUS.
The monoclonal gammopathies are a group of disorders associated with proliferation of a single clone (monoclonal) of plasma cells. They are characterized by the secretion of an immunologically homogenous monoclonal protein (M-protein, M-component, M-spike, or paraprotein). Each M-protein consists of two heavy (H) polypeptide chains of the same class and subclass, and two light (L) chains of the same type. The heavy chains are IgG, IgM, IgA, IgD, and IgE, while the light-chain types are kappa (κ), and lambda (λ). In contrast, a polyclonal gammopathy is characterized by an increase in one or more heavy chains, and in both types of light chains, and is usually associated with an inflammatory or reactive process.
The fluid recommendation for adults aged 70+ years has been criticised on the basis of a low prevalence of dehydration in community-dwelling older adults. This study explores whether the low prevalence might reflect limitations of individual dehydration indices.
Cross-sectional data on plasma sodium, blood urea nitrogen (BUN), creatinine, glucose and potassium were used to classify 1737 participants of the 1992 Established Populations for Epidemiologic Studies of the Elderly (EPESE) (70+ years) according to multiple dehydration indices. Associations between dehydration indices, health and functional status were evaluated.
Depending on the indicator used, the prevalence of dehydration ranged from 0.5% for hypotonic hypovolaemia only (plasma tonicity <285 mOsm l−1 with orthostatic hypotension) to 60% with dehydration defined as either plasma sodium ≥145 mEq l−1, BUN/creatinine ratio ≥20, tonicity ≥295 mOsm l−1, or hypotonic hypovolaemia. Elevated tonicity and BUN/creatinine ratio were respectively associated with chronic disease and functional impairment.
The true prevalence of dehydration among community-dwelling adults may be low or high, depending on the indicator(s) used to define dehydration. Before we can pinpoint a generalisable prevalence of dehydration for community-dwelling seniors and draw conclusions about fluid recommendations, validation studies of dehydration indices and longitudinal studies of dehydration, health and functional status are needed.
Email your librarian or administrator to recommend adding this to your organisation's collection.