Articles

<b>Background:</b> Tuberculosis (TB) in the elderly poses significant diagnostic and therapeutic challenges due to immunosenescence, comorbidities, and atypical clinical presentation. This study evaluates the epidemiological and clinical characteristics of TB in patients aged ≥65 years. <b>Methods:</b> A retrospective descriptive study was conducted including all TB cases reported between 2020 and 2024. Data from the National Tuberculosis Program were analyzed for demographic characteristics, clinical form, bacteriological confirmation, comorbidities, and treatment outcomes. <b>Results:</b> Of 1,335 TB cases, 352 (26.4%) occurred in individuals aged ≥65 years. Pulmonary TB accounted for 80.7% of cases. Men represented 63.4% of patients, and 56.8% lived in urban areas. Bacteriological confirmation was achieved in 82% of pulmonary cases, and treatment success exceeded 85%. Diabetes mellitus (26.5%) and arterial hypertension (31%) were the most common comorbidities. An increase in TB cases was observed in the post-COVID-19 period. A significant association was found between age and clinical form of TB (p < 0.001). <b>Conclusions:</b> Elderly individuals constitute a substantial proportion of TB cases and frequently present with chronic comorbidities. Despite diagnostic challenges, favorable treatment outcomes were achieved, highlighting the need for integrated and early management strategies in this population.

This paper describes the current status of research on disease distress in elderly type 2 diabetic patients at home and abroad, with a view to developing targeted interventions for diabetic patients, improving self-management behavioral ability and quality of life in elderly type 2 diabetic patients, and improving patients' glycemic control.

<b>Background:</b><b> </b>High educational attainment is a well-recognized protective factor against health problems such as diabetes. However, the theory of Minorities' Diminished Returns (MDRs) suggests that this protective effect is weaker for ethnic minorities compared to non-Latino Whites. This diminished effect is thought to result from structural inequalities, such as lower-quality education and fewer occupational opportunities, faced by ethnic minorities. <b>Objective:</b><b> </b>This study examined the protective effect of years of schooling—used as a proxy for educational attainment—on diabetes mellitus (DM), overall and by ethnicity. Based on the MDRs framework, we hypothesized that the protective effect of education would be weaker for Latino individuals compared to non-Latinos. <b>Methods:</b><b> </b>Data were drawn from the 2012 wave of the Understanding America Study (UAS), a nationally representative, internet-based panel. The outcome of interest was self-reported doctor diagnosis of DM. Logistic regression models were used to assess the association between educational attainment and DM, with an interaction term to explore differences between Latino and non-Latino individuals. Models were adjusted for age, sex, employment, immigration status, and marital status. Findings were presented as adjusted odds ratios (OR), p-values, and 95% confidence intervals (CIs). <b>Results:</b><b> </b>Higher educational attainment was associated with lower odds of DM in both Latino and non-Latino individuals (p < 0.001). An interaction between education and ethnicity (p < 0.05) indicated that the protective effect of education was weaker for Latino individuals compared to non-Latinos. <b>Conclusion:</b><b> </b>The findings align with the MDRs framework, which suggests that the health benefits of education are not equally distributed across ethnic groups. For Latino individuals, structural barriers such as lower educational quality and labor market discrimination may limit the protective effect of education against DM. While education is a key determinant of health, its unequal returns contribute to ethnic health disparities. Policymakers must address structural inequalities in education and employment that disproportionately affect ethnic minorities. Tackling these disparities through multi-sector policy interventions will require bipartisan political support.

<b>Background</b>: Type 2 Diabetes Mellitus (T2DM) and Alzheimer’s Disease (AD) are increasingly linked through shared pathophysiological mechanisms, giving rise to the concept of Type 3 Diabetes Mellitus (T3DM). Brain insulin resistance, oxidative stress, and neuroinflammation are central to both conditions, contributing to cognitive decline and AD progression. <b>Aim:</b> This review aims to explore this emerging relationship and its implications for prevention and management. <b>Methods</b>: Using an integrative review, 21 studies were systematically analyzed. The review focused on identifying demographic, genetic, and lifestyle factors contributing to T2DM and AD and examined shared molecular pathways such as insulin dysregulation and amyloid-beta accumulation. <b>Results</b>: The findings reveal that T3DM shares key features with T2DM and AD, including insulin resistance and chronic inflammation. Lifestyle interventions, such as diet and exercise, alongside routine cognitive and metabolic screenings, are critical in mitigating progression. <b>Conclusions</b>: Further research into diagnostic biomarkers and targeted therapies is essential to manage T3DM and its impact on AD. The role of nursing professionals in early detection, education, and holistic management is emphasized as vital in addressing this dual disease burden. This review offers actionable insights into integrated strategies for addressing these interconnected conditions.

<b>Background</b><b>:</b> Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the poverty-to-income ratio (PIR), and CMD indicators—including obesity, diabetes, and cardiovascular disease (CVD)—among men and women using data from the National Health and Nutrition Examination Survey (NHANES). <b>Methods</b><b>:</b> This cross-sectional study utilized NHANES data (1999-2018), adjusting for race/ethnicity and age. SES was operationalized using PIR, with CMD outcomes (obesity, diabetes, and CVD) as dependent variables. Generalized linear models (GLM) were employed to evaluate the main effects of SES on CMD, with gender included as a moderator. <b>Results</b><b>:</b> Higher SES was associated with lower overall CMD risk. However, the protective effects of SES were more pronounced in women than in men for all outcomes. These findings suggest that gender-specific pathways may mediate the relationship between SES and CMD. Women may derive greater health benefits from higher SES due to factors such as reduced stress exposure, healthier behaviors, and increased healthcare utilization. Conversely, the weaker association observed in men may reflect differences in social hierarchy sensitivity, responses to unemployment, or other contextual factors. <b>Conclusion</b><b>:</b> The findings highlight the importance of gender-specific considerations when addressing SES-related disparities in CMD outcomes. Policies and interventions aimed at reducing CMD burden should account for these gender differences to promote equitable improvements in cardiometabolic health. Further research is needed to unravel the mechanisms driving these differences and to inform targeted strategies.

<b>Background:</b> Diabetes is a chronic global health issue that requires effective management to improve patient outcomes and quality of life. Nursing education plays a critical role in empowering diabetic patients with self-management skills. Aim This systematic review evaluates the impact of diabetes-focused nursing education on patient outcomes and quality of life. <b>Methods:</b> This study uses PRISMA guidelines and a systematic approach to identify and evaluate relevant literature. <b>Results and Discussion:</b> Among the 14 studies reviewed, eight emphasized self-management education, while four incorporated multidisciplinary approaches. Findings consistently demonstrated that structured nursing education programs significantly improved self-management behaviors, glycemic control, and patient knowledge. For instance, nurse-led self-management programs resulted in substantial enhancements in self-care skills and diabetes-related knowledge. Moreover, interventions that combined health education with psychological support were particularly effective, leading to better blood glucose control and increased adherence to treatment. Studies that examined quality of life reported reductions in anxiety, improved lifestyle habits, and better overall self-management. These findings highlight the multifaceted benefits of nursing education, suggesting that structured, supportive programs positively impact both clinical and psychological aspects of diabetes care. <b>Conclusion:</b> The review emphasizes the value of comprehensive nursing education that integrates both clinical guidance and psychological support for holistic diabetes management. <b>Implications</b>: Ongoing professional development and culturally sensitive education programs are recommended to address the diverse needs of diabetic patients. Future research should investigate the long-term effects of nursing education and explore innovative strategies to enhance diabetes management outcomes.

Digital therapeutics (DTx) play a transformative role in diabetes management by leveraging technology to provide personalized, data-driven medical interventions. These tools enhance self-management by offering continuous monitoring and real-time feedback on glucose levels, diet, and physical activity. This personalized approach helps patients adhere to treatment plans and make informed lifestyle changes, leading to improved clinical outcomes such as reduced HbA1c levels and better overall diabetes control. The importance of DTx lies in their ability to make diabetes care more accessible and convenient. Mobile apps and telemedicine platforms enable patients to receive support and guidance from anywhere, reducing the need for frequent in-person visits. Additionally, DTx often include behavioral support features like reminders, educational content, and motivational tools, which are crucial for maintaining healthy habits and managing stress. Currently, the dynamics of DTx in diabetes are rapidly evolving, with increasing integration of artificial intelligence and machine learning to further personalize and optimize care. As the adoption of these technologies grows, they hold the potential to significantly improve patient outcomes and revolutionize diabetes management on a global scale. This article will focus on the benefits of novel digital therapeutics for prevention and management of type II diabetes that are currently available in the market.

<b>Background</b>: The increasing prevalence of Diabetes Mellitus (DM) is closely tied to complications, particularly diabetic foot ulcers, which significantly raise the risk of lower extremity amputations due to infected, non-healing ulcers. This study aimed to assess diabetic foot prevention knowledge, practices and associated factors among patients at the Edward Francis Small Teaching Hospital (EFSTH), Banjul. <b>Methods:</b> In this cross-sectional study, we employed a convenience sampling technique to enroll 357 diabetic patients, both inpatients and outpatients, who were under the care of EFSTH. Data on diabetic foot prevention were collected through semi-structured interviews conducted by trained interviewers. Statistical analyses were carried out using SPSS, encompassing descriptive analysis, chi-square, Fisher exact tests, and logistic regression. Statistical significance was set at p<0.05, with a 95% confidence interval. <b>Results: </b>The mean age of the respondents was 47.3 years (±10.5), with women comprising 55.2% of the study population and 94.4% were married. About 73% demonstrated good knowledge of diabetic foot care and prevention, while 25.8% exhibited fair knowledge. A significant association was observed in bivariate analysis with patients’ educational level (P = 0.032). Specifically, patients with Madarasa (Arabic) education had a 68% lower likelihood 【aOR: 0.320, 95% CI: (0.103, 0.992), p = 0.048】 of practicing diabetic foot care and prevention compared to those with tertiary education. <b>Conclusion</b>: The study revealed that participants’ knowledge of preventing diabetic foot was high. However, the practice was poor. Therefore, there is a need for more health education on the practices that would emphasize diabetes management among diabetes patients.

Novel corona virus disease (COVID-19) pandemic, which started in China's Hubei province in 2019, has caused a significant loss of human lives globally. This study describes the epidemiologic and clinical profiles of COVID-19 related deaths among patients admitted to treatment centers in Sidama region, Ethiopia. A cross-sectional study of 186 in hospital COVID-19 related deaths that occurred from July 2020 to December 2021 in Sidama region were analyzed. Data was extracted from regional emergency operation center death report. Data was entered using Epidata v3.1 and analysis was done using SPSS v.20. Categorical data was summarized using frequency and percentage while continuous data was summarized using median and interquartile range. Association between variables was assessed using chi-square test. More than two-third of the deceased patients were male (135; 72.6%) and median age at death was 60. The majority of deaths (151; 81.1%) occurred in 2021, while April 2021 had the highest death records. Cough and shortness of breath were the main presenting symptoms occurring in 89.2% and 85.5% of deceased patients respectively. Most of the COVID-19 related deaths (64.5%) had associated comorbidities. Diabetes (50%) and Hypertension (39.2%) were the most prevalent comorbidities. Significant proportion of patients (74.73%) presented on severe end of disease spectrum (critical/ severe). Of the deceased patients, around two-third required Intensive care unit (ICU) admission and 111 of them were put on mechanical ventilator. Moreover, the median ICU stay was 4 days. Around half of the death (48.4%) occurred in the first 5 days. The median survival time from symptom onset was 11.5 days with most (43.5%) of the deaths occurring within the first 14 days of symptom onset. Age category was significantly associated with the number of days from onset to death (p=0.006). The case fatality rate was 1.87% which is lower than national and global reports. Unlike previous studies, the prevalence of asthma among deceased patients was low and there were no patients with documented COPD.

<b>Background:</b> Psoriasis is extensively studied among middle-aged adults, but not many have studied psoriasis in older adults(geriatrics). OBJECTIVES: To analyze epidemiological, clinical, comorbidities and therapeutic profile of geriatric psoriasis(GP). METHODS: All consenting clinically diagnosed psoriatic patients ≥60 years were divided into two groups: Elderly psoriatic(EP)(60-75 years) and Ultra elderly psoriatic(UP)(>75 years). The dermatologist filled their clinical characteristics’ standardised questionnaire to determine comorbidities, drug interactions profile and compared with age-matched controls using Chi square test. RESULTS: Prevalence of GP is 14.5%(Average age:68 years; Sex ratio=2.5:1)among geriatrics attending dermatology OPD. Most common(49.9%) as well as initial site affected(39.3%) were Palms±Soles. Nummular plaque (90.2%) was most common type. Superficial fungal infection(26.9%) and pruritus(90.8%) were commonly associated cutaneous disease and symptom(p<0.05) respectively. Hypertension(49.7%),Diabetes Mellitus(22.8%), dyslipidemia(25.8%) and Metabolic syndrome(MS)(17.8%) were associated systemic comorbidities. Dyslipidemia and MS(p<0.0001) were more common among GP(163) than controls(963). Drug aggravated psoriasis could not be linked to polypharmacy. Although, topicals were mainstay, oral Methotrexate was most efficacious systemically. CONCLUSION: Our findings suggest a trimodal age of psoriasis onset at 68 years. As age advances, psoriasis severity decreases, unstable guttate lesions decrease; palms±soles commonly involved; infrequent familial occurrence with Polypharmacy not aggravating psoriasis. Active screening for cardiovascular comorbidities in all geriatric psoriasis patients is highly recommended.