This study showed that several preoperative CT features of PanNETs are associated with the ALT phenotype, which is known to predict poor prognosis. Additionally, CT findings of intratumoral calcifications and metastases predicted poor survival independent of the ALT status.

Background To describe covariates and patterns of late-life analgesic use in the rural, population-based MoVIES cohort from 1989 to 2002. Methods Secondary analysis of epidemiologic survey of elderly people conducted over six biennial assessment waves. Potential covariates of analgesic use included age, gender, depression, sleep, arthritis, smoking, alcohol, and general health status. Of the original cohort of 1,681, this sample comprised 1,109 individuals with complete data on all assessments. Using trajectory analysis, participants were characterized as chronic or non-chronic users of opioid and non-opioid analgesics. Multivariable regression was used to model predictors of chronic analgesic use. Results The cohort was followed for mean (SD) 7.3 (2.7) years. Chronic use of opioid analgesics was reported by 7.2%, while non-opioid use was reported by 46.1%. In the multivariable model, predictors of chronic use of both opioid and non-opioid analgesics included female sex, taking ≥2 prescription medications, and “arthritis” diagnoses. Chronic opioid use was also associated with age 75–84 years; chronic non-opioid use was also associated with sleep continuity disturbance. Conclusions These epidemiological data confirm clinical observations and generate hypotheses for further testing. Future studies should investigate whether addressing sleep problems might lead to decreased use of non-opioid analgesics and possibly enhanced pain management.

Aim:To improve selection of older lumbar surgical candidates, we surveyed correlates of functioning and satisfaction with surgery. Materials & methods: Prospective sample at lumbar spine surgery clinic. Patients (n = 48) were evaluated before surgery and after 3 months. Dependent variables were functioning and surgical satisfaction. Results: Baseline variables associated with disability at 3 months included cognitive status and widespread pain. There was clinically significant improvement with moderate effects sizes for anxiety and depression at follow-up. Patients with at least a 30% improvement in disability had better physical health-related quality of life and were less likely to report widespread pain before surgery. Conclusion: Although preliminary, two novel potential predictors of lumbar surgery outcome include diminished cognitive functioning and widespread pain. Further study of these variables on post-surgical functioning and satisfaction may improve patient selection. Summary points• In late life, low back pain with and without leg pain is frequently associated with functional disability, psychosocial impairment, poor sleep quality and depression.• A substantial body of literature has identified comorbidities that predict suboptimal spine surgery outcome, including musculoskeletal conditions, impaired gait, cardiovascular disease, and mood and anxiety disorders.• We observed that mild cognitive impairment and the presence of widespread pain may be two potential predictors of satisfaction and disability following lumbar surgery. Given the relatively high frequency at which these two conditions occur in older adults in clinical settings, future projects are warranted to understand their potential impact on surgical outcome, functioning and satisfaction.• Patients with at least a 30% improvement in disability had better physical health-related quality of life and were less likely to report widespread pain before surgery.• Depression and anxiety both improved at the 3-month follow-up with moderate effect sizes for both.For reprint orders, please contact: reprints@futuremedicine.com