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Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Updated: Nov 15, 2025

Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
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Device Pocket Challenges in Elderly and Thin Individuals.

Ramil Goel1

  • 1Cardiovascular Disease, University of Florida, Gainesville, USA.

Cureus
|March 3, 2021
PubMed
Summary
This summary is machine-generated.

Aging reduces body fat, increasing risks for elderly patients needing cardiac implantable electronic devices (CIEDs). Subcutaneous tissue deficiency can cause device complications, necessitating strategies to manage soft tissue loss during implantation.

Keywords:
deficient soft tissueimplantable cardioverter defibrillatorpacemakerpocket reinforcementthin patients

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Area of Science:

  • Geriatric Medicine
  • Cardiology
  • Biomedical Engineering

Background:

  • Aging is associated with decreased subcutaneous fat and lean body mass.
  • Elderly individuals have a higher prevalence of cardiovascular disease, increasing the need for cardiac implantable electronic devices (CIEDs).
  • Current CIEDs are often implanted in a subcutaneous pocket, posing risks in patients with reduced soft tissue.

Purpose of the Study:

  • To review the challenges associated with implanting cardiac devices in patients with diminished subcutaneous tissue.
  • To discuss strategies for managing soft tissue deficiencies during CIED implantation in the elderly.

Main Methods:

  • Literature review of aging-related body composition changes.
  • Analysis of CIED implantation techniques and associated complications.
  • Exploration of potential mitigation strategies for soft tissue deficits.

Main Results:

  • Subcutaneous tissue loss in the elderly can lead to device protrusion and erosion.
  • These complications increase morbidity and mortality, particularly with device infection and extraction.
  • Various strategies exist to address soft tissue deficiency during device implantation.

Conclusions:

  • Addressing subcutaneous tissue loss is critical for safe and effective CIED implantation in aging populations.
  • Proactive management of soft tissue deficits can prevent serious complications.
  • Further research into optimized implantation techniques is warranted.