Nonalcoholic fatty liver disease(NAFLD) is common in the elderly, in whom it carries a more substantial burden of hepatic(nonalcoholic steatohepatitis, cirrhosis and hepatocellular carcinoma) and extra-hepatic manifes...Nonalcoholic fatty liver disease(NAFLD) is common in the elderly, in whom it carries a more substantial burden of hepatic(nonalcoholic steatohepatitis, cirrhosis and hepatocellular carcinoma) and extra-hepatic manifestations and complications(cardiovascular disease, extrahepatic neoplasms) than in younger age groups. Therefore, proper identification and management of this condition is a major task for clinical geriatricians and geriatric hepatologists. In this paper, the epidemiology and pathophysiology of this condition are reviewed, and a full discussion of the link between NAFLD and the aspects that are peculiar to elderly individuals is provided; these aspects include frailty, multimorbidity, polypharmacy and dementia. The proper treatment strategy will have to consider the peculiarities of geriatric patients, so a multidisciplinary approach is mandatory. Non-pharmacological treatment(diet and physical exercise) has to be tailored individually considering the physical limitations of most elderly people and the need for an adequate caloric supply. Similarly, the choice of drug treatment must carefully balance the benefits and risks in terms of adverse events and pharmacological interactions in the common context of both multiple health conditions and polypharmacy. In conclusion, further epidemiological and pathophysiological insight is warranted. More accurate understanding of the molecular mechanisms of geriatric NAFLD will help in identifying the most appropriate diagnostic and therapeutic approach for individual elderly patients.展开更多
核电厂反应堆截止闸阀具有批量小、造价高、维修检测成本大、试验仿真难度高的特点,在产品设计阶段常采用故障模式影响及危害性分析(Failure Modes,Effect and Criticality Analysis,FMECA)的方法对其可靠性进行评价。在传统FMECA方法...核电厂反应堆截止闸阀具有批量小、造价高、维修检测成本大、试验仿真难度高的特点,在产品设计阶段常采用故障模式影响及危害性分析(Failure Modes,Effect and Criticality Analysis,FMECA)的方法对其可靠性进行评价。在传统FMECA方法的基础上,结合闸阀产品特点,提出了一种基于模糊危害性矩阵的FMECA方法,改良了传统FMECA难以衡量分析人员主观不确定性的问题。针对一款在研的反应堆截止闸阀,对提出的方法进行了验证。与传统FMECA方法相比,文中提出的方法克服了危害性矩阵分析存在的缺陷,提高了分析结果可信度与合理性,为闸阀产品可靠性工作提供了理论支撑与实践验证。展开更多
文摘Nonalcoholic fatty liver disease(NAFLD) is common in the elderly, in whom it carries a more substantial burden of hepatic(nonalcoholic steatohepatitis, cirrhosis and hepatocellular carcinoma) and extra-hepatic manifestations and complications(cardiovascular disease, extrahepatic neoplasms) than in younger age groups. Therefore, proper identification and management of this condition is a major task for clinical geriatricians and geriatric hepatologists. In this paper, the epidemiology and pathophysiology of this condition are reviewed, and a full discussion of the link between NAFLD and the aspects that are peculiar to elderly individuals is provided; these aspects include frailty, multimorbidity, polypharmacy and dementia. The proper treatment strategy will have to consider the peculiarities of geriatric patients, so a multidisciplinary approach is mandatory. Non-pharmacological treatment(diet and physical exercise) has to be tailored individually considering the physical limitations of most elderly people and the need for an adequate caloric supply. Similarly, the choice of drug treatment must carefully balance the benefits and risks in terms of adverse events and pharmacological interactions in the common context of both multiple health conditions and polypharmacy. In conclusion, further epidemiological and pathophysiological insight is warranted. More accurate understanding of the molecular mechanisms of geriatric NAFLD will help in identifying the most appropriate diagnostic and therapeutic approach for individual elderly patients.
文摘核电厂反应堆截止闸阀具有批量小、造价高、维修检测成本大、试验仿真难度高的特点,在产品设计阶段常采用故障模式影响及危害性分析(Failure Modes,Effect and Criticality Analysis,FMECA)的方法对其可靠性进行评价。在传统FMECA方法的基础上,结合闸阀产品特点,提出了一种基于模糊危害性矩阵的FMECA方法,改良了传统FMECA难以衡量分析人员主观不确定性的问题。针对一款在研的反应堆截止闸阀,对提出的方法进行了验证。与传统FMECA方法相比,文中提出的方法克服了危害性矩阵分析存在的缺陷,提高了分析结果可信度与合理性,为闸阀产品可靠性工作提供了理论支撑与实践验证。
