Abstract-Aortic pulse wave velocity (PWV) is a significant and independent predictor of cardiovascular mortality in subjects with essential hypertension and in patients with end-stage renal disease. Its contribution to cardiovascular risk in subjects 70 to 100 years old has never been tested. A cohort of 141 subjects (meanϮSD age, 87.1Ϯ6.6 years) was studied in 3 geriatrics departments in a Paris suburb. Together with sphygmomanometric blood pressure measurements, aortic PWV was measured with a validated automatic device. During the 30-month follow-up, 56 patients died (27 from cardiovascular events). Logistic regressions indicated that age (Pϭ0.005) and a loss of autonomy (Pϭ0.01) were the best predictors of overall mortality. For cardiovascular mortality, aortic PWV was the major risk predictor (Pϭ0.016). The odds ratio was 1.19 (95% confidence interval, 1.03 to 1.37). Antihypertensive drug treatment and blood pressure, including systolic and pulse pressure, had no additive role. In subjects 70 to 100 years old, aortic PWV is a strong, independent predictor of cardiovascular death, whereas systolic or pulse pressure was not. This prospective result will need to be confirmed in an intervention trial. Key Words: very old (Ͼ70 years) subjects Ⅲ aortic pulse wave velocity Ⅲ cardiovascular mortality Ⅲ drug treatment of hypertension Ⅲ pulse pressure W ith increasing age, there is a gradual shift from diastolic blood pressure (DBP) to systolic blood pressure (SBP) and then to pulse pressure (PP) as predictors of cardiovascular (CV) risk, mainly from coronary heart disease. In patients Ͻ50 years of age, DBP is the strongest CV predictor. The age range of 50 to 59 years is a transition period when all 3 BP indexes are comparable predictors, and, from 60 years of age, PP becomes superior to both SBP and DBP to predict myocardial infarction. 1-3 In addition, because for a given ventricular ejection aortic stiffness is the major determinant of PP, increased aortic pulse wave velocity (PWV), a classic marker of arterial rigidity, has also been identified as an independent predictor of CV risk in subjects with hypertension, whether in the presence of end-stage renal disease or with preserved renal function. 4 -6 However, these epidemiological findings are limited to cohorts between 50 and 75 years of age.BP increases with age. However, this influence of age differs markedly for SBP and DBP. 7,8 Whereas SBP increases substantially with age, particularly in women after menopause, the increase of DBP with age is less pronounced. Indeed, DBP even tends to fall after 55 years of age. In the elderly, the hemodynamic pattern associating an increase in SBP and a low DBP is a characteristic feature, usually attributed to an age-related increase of arterial stiffness. 7 In elderly populations, SBP and PP are usually considered the major markers of CV risk. 1 However, there is no study in subjects Ͼ70 years old that would indicate whether an increase in PWV could be, in place of SBP and PP, the best independent predictor of CV mortal...

Hypertrophic scars and keloids can be aesthetically displeasing and lead to severe psychosocial impairment. Many invasive and non-invasive options are available for the plastic (and any other) surgeon both to prevent and to treat abnormal scar formation. Recently, an updated set of practical evidence-based guidelines for the management of hypertrophic scars and keloids was developed by an international group of 24 experts from a wide range of specialities. An initial set of strategies to minimize the risk of scar formation is applicable to all types of scars and is indicated before, during and immediately after surgery. In addition to optimal surgical management, this includes measures to reduce skin tension, and to provide taping, hydration and ultraviolet (UV) protection of the early scar tissue. Silicone sheeting or gel is universally considered as the first-line prophylactic and treatment option for hypertrophic scars and keloids. The efficacy and safety of this gold-standard, non-invasive therapy has been demonstrated in many clinical studies. Other (more specialized) scar treatment options are available for high-risk patients and/or scars. Pressure garments may be indicated for more widespread scarring, especially after burns. At a later stage, more invasive or surgical procedures may be necessary for the correction of permanent unaesthetic scars and can be combined with adjuvant measures to achieve optimal outcomes. The choice of scar management measures for a particular patient should be based on the newly updated evidence-based recommendations taking individual patient and wound characteristics into consideration.

Background: How well the motor symptoms assessed by the motor section of the Unified Parkinson Disease Rating Scale (UPDRS3) reflect the neuronal loss observed in the substantia nigra is not known. Objective: To study the relationships among the motor symptoms assessed by the UPDRS3, Lewy bodyassociated neuronal loss in the substantia nigra, and duration of disease.