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Elderly patients diagnosed with acute coronary syndromes (ACS) represent a growing demographic population. These patients typically present more comorbidities and experience poorer outcomes compared to younger patients. Furthermore, they are less frequently subjected to revascularization procedures and are less likely to receive evidence-based medications in both the short and long-term periods. Assessing frailty is crucial in elderly patients with ACS because it can influence management decisions, as well as risk stratification and prognosis. Indeed, treatment decisions should consider geriatric syndromes, frailty, polypharmacy, sarcopenia, nutritional deficits, prevalence of comorbidities, thrombotic risk, and, at the same time, an increased risk of bleeding. Rigorous clinical assessments, clear revascularization criteria, and tailored approaches to antithrombotic therapy are essential for guiding personalized treatment decisions in these individuals. Assessing frailty helps healthcare providers identify patients who may benefit from targeted interventions to improve their outcomes and quality of life. Elderly individuals who experience ACS remain significantly underrepresented and understudied in randomized controlled trials. For this reason, the occurrence of ACS in the elderly continues to be a particularly complex issue in clinical practice, and one that clinicians increasingly have to address, given the general ageing of populations. This review aims to address the complex aspects of elderly patients with ACS to help clinicians make therapeutic decisions when faced with such situations. [ABSTRACT FROM AUTHOR]

Adverse drug reactions (ADRs) are frequent and represent a significant healthcare burden. ADRs are a potentially avoidable contributor to excess unscheduled hospital admissions, higher morbidity, mortality, and healthcare costs. The objective of this review is to examine the epidemiology of ADRs in older multimorbid adults and to explore strategies for ADR prevention. ADRs in this population are often linked to commonly prescribed medications, including anticoagulants, antiplatelet agents, insulin, and non-steroidal anti-inflammatory drugs, but ADRs and adverse drug events (ADEs) in fact encompass a much broader range of culprit drugs. Age-related factors such as changes in pharmacokinetics and pharmacodynamics, multimorbidity, polypharmacy, and frailty have been associated with ADR occurrences. Various strategies have been proposed to prevent ADRs in different clinical settings, such as structured routine medication review and the use of bespoke software applications to identify potentially inappropriate prescriptions and drug interactions. Although these approaches have demonstrated some improvement in the quality of prescribing, there is still a lack of consistent evidence regarding their effectiveness in preventing ADRs. The nuanced and often intricate complexities associated with older patients' pharmacotherapy necessitate a comprehensive approach to attenuate the impact of ADRs within this growing section of most populations globally. [ABSTRACT FROM AUTHOR]

This study investigates the importance of convective systems for extreme rainfall along the northern coast of the Gulf of Guinea (GG) and their relationship with atmospheric and oceanic conditions. Convective system data (MCSs), daily precipitation, sea surface temperature (SST) and moisture flux anomalies from June to September 2007–2016 are used. The results show that 2/3 of MCSs crossing Abidjan are produced in June, which is the core of the major rainy season. Likewise, 2/3 of MCSs originate from continental areas, while 1/3 come from the ocean. Oceanic MCSs are mostly initiated close to the coast, which also corresponds to the Marine Heat Waves region. Continental MCSs are mostly initiated inland. The results also highlight the moisture flux contribution of three zones which have an impact on the onset and the sustaining of MCSs: (i) the seasonal migration of the intertropical convergence zone (ITCZ), (ii) the GG across the northern coastline, and finally (iii) the continent. These contributions of moisture fluxes coincide with oceanic warming off Northeast Brazil and the northern coast of the GG both two days before and the day of extreme rainfall events. The ocean contributes to moisten the atmosphere, and therefore to supply and sustain the MCSs during their lifecycle. [ABSTRACT FROM AUTHOR]