RESUMEN

Previous mental health trajectory studies were mostly limited to the months before access to vaccination. They are not informing on whether public mental health has adapted to the pandemic. The aim of this analysis was to 1) investigate trajectories of monthly reported depressive symptoms from July 2020 to December 2021 in Switzerland, 2) compare average growth trajectories across regions with different stringency phases, and 3) explore the relative impact of self-reported worries related to health, economic and social domains as well as socio-economic indicators on growth trajectories. As part of the population-based Corona Immunitas program of regional, but harmonized, adult cohorts studying the pandemic course and impact, participants repeatedly reported online to the DASS-21 instrument on depressive symptomatology. Trajectories of depressive symptoms were estimated using a latent growth model, specified as a generalised linear mixed model. The time effect was modelled parametrically through a polynomial allowing to estimate trajectories for participants' missing time points. In all regions level and shape of the trajectories mirrored those of the KOF Stringency-Plus Index, which quantifies regional Covid-19 policy stringency. The higher level of average depression in trajectories of those expressing specific worries was most noticeable for the social domain. Younger age, female gender, and low household income went along with higher mean depression score trajectories throughout follow-up. Interventions to promote long-term resilience are an important part of pandemic preparedness, given the observed lack of an adaptation in mental health response to the pandemic even after the availability of vaccines in this high-income context.

Asunto(s)

RESUMEN

BACKGROUND: Frailty is a geriatric syndrome associated with multiple negative health outcomes. However, its prevalence varies by population and instrument used. We investigated frailty and pre-frailty prevalence by 5 instruments in community-dwelling older adults enrolled to a randomized-controlled trial in 5 European countries. METHODS: Cross-sectional baseline analysis in 2,144 DO-HEALTH participants recruited from Switzerland, Austria, France, Germany, and Portugal with complete data for frailty. Frailty status was assessed by the Physical Frailty Phenotype [PFP], SOF-Frailty Index [SOF-FI], FRAIL-Scale, SHARE-Frailty Instrument [SHARE-FI], and a modified SHARE-FI, and compared by country, age, and gender. Logistic regression was used to determine relevant factors associated with frailty and pre-frailty. RESULTS: Mean age was 74.9 (±4.4) years, 61.6% were women. Based on the PFP, overall frailty and pre-frailty prevalence was 3.0% and 43.0%. By country, frailty prevalence was highest in Portugal (13.7%) and lowest in Austria (0%), and pre-frailty prevalence was highest in Portugal (57.3%) and lowest in Germany (37.1%). By instrument and overall, frailty and pre-frailty prevalence was highest based on SHARE-FI (7.0% / 43.7%) and lowest based on SOF-FI (1.0% / 25.9%). Frailty associated factors were residing in Coimbra (Portugal) [OR 12.0, CI 5.30-27.21], age above 75 years [OR 2.0, CI 1.17-3.45], and female gender [OR 2.8, CI 1.48-5.44]. The same three factors predicted pre-frailty. CONCLUSIONS: Among relatively healthy adults age 70 and older enroled to DO-HEALTH, prevalence of frailty and pre-frailty differed significantly by instrument, country, gender, and age. Among instruments, the highest prevalence of frailty and pre-frailty was documented by the SHARE-FI and the lowest by the SOF-FI.

Asunto(s)

RESUMEN

In this prospective study, half of all falls resulted in injury. Pre-frail adults sustained more injuries, while more frail adults had injuries requiring hospitalization or fractures. Pre-frail adults fell more often when in movement compared with frail adults who fell more often when standing and in indoor public spaces. PURPOSE: To assess prospectively how fall environment and direction are related to injury among pre-frail and frail adults. METHODS: We included 200 community-dwelling adults with a prior fall (pre-frail, mean age 77 years) and 173 adults with acute hip fracture (frail, mean age 84 years; 77% community-dwelling). Falls were prospectively recorded using standardized protocols in monthly intervals, including date, time, fall direction and environment, and injury. We used logistic regression to assess the odds of injury adjusting for age, body mass index (BMI), and gender. RESULTS: We recorded 513 falls and 331 fall-related injuries (64.5%) among the 373 participants. While the fall rate was similar between groups, pre-frail adults had more injuries (71% among pre-frail vs. 56% among frail, p = 0.0004) but a lower incidence of major injuries (9% among pre-frail vs. 27% among frail, p = 0.003). Pre-frail adults fell more often while in movement (84% among pre-frail vs. 55% among frail, p < 0.0001), and frail adults fell more often while standing (26% vs. 15% respectively, p = 0.01). The odds of injury among frail adults was increased 3.3-fold when falling sideways (OR = 3.29, 95% CI = 1.68-6.45) and 2.4-fold when falling in an indoor public space (OR = 2.35, 95% CI = 1.00-5.53), and was reduced when falling at home (OR = 0.55, 95% CI = 0.31-0.98). The odds of injury among pre-frail adults was not influenced by environment and was 53% lower when falling backwards (OR = 0.47, 95% CI = 0.26-0.82). CONCLUSION: While pre-frail adults sustain more fall-related injuries, frail adults were more likely to sustain major injuries, especially when falling sideways or outside their home.

Asunto(s)

RESUMEN

BACKGROUND: Depression is common among senior adults, yet understudied among trauma patients. The purpose of this study was to assess the prevalence of depressive symptoms among seniors hospitalized in acute trauma care, to compare patients with depressive symptoms vs. those without, and to evaluate whether depression symptoms affects discharge destination. METHODS: This cross-sectional and prospective analysis was conducted among community-dwelling patients ≥70 years old, hospitalized at the Senior Trauma Center of the University Hospital Zurich, Switzerland. We used the Geriatric Depression Scale (GDS-15) to assess presence of depressive symptoms. Using a cutoff value of 5 points, we compared age- and gender-adjusted characteristics of patients with and without depressive symptoms. Multinomial logistic regression models were used to estimate the odds of returning home vs. not adjusting for age, gender, nutritional status, cognitive function and others. RESULTS: Of the 273 seniors enrolled, 104 (38.1%) were men and the mean age was 79.4 (SD = 6.5) years. We identified 52 (19.0%) patients with depressive symptoms. These patients were more likely to be older (p = 0.04), at risk for malnutrition (p<0.0001), at least pre-frail (p = 0.005), and have decreased cognitive function (p = 0.001). They were also more than twice as likely to be discharged to acute geriatric care compared to home (OR = 2.28 (CI = 1.12-4.68)). LIMITATIONS: Depressive symptoms were assessed during acute care without data before hospitalization. CONCLUSIONS: Senior trauma patients with depressive symptoms during acute care were more likely to be at higher risk of malnutrition, have cognitive decline and are more likely to receive additional geriatric care.

Asunto(s)

RESUMEN

BACKGROUND/OBJECTIVES: Malnutrition is an established risk factor for adverse clinical outcomes. Our aim was to assess nutritional status among geriatric trauma patients. SUBJECTS/METHODS: We enrolled 169 consecutive patients (⩾70 years) admitted to the Geriatric Traumatology Centre (University Hospital Zurich, Switzerland). On admission to acute care, nutritional status was assessed with the mini nutritional assessment (score<17=malnourished (M), ⩽23.5=at risk of malnutrition (ARM), >23.5=normal). At the same examination, we assessed mental (Geriatric Depression Scale; GDS) and cognitive function (Mini-Mental State Examination; MMSE), frailty status (Fried Scale), and number of comorbidities and medications. Further, discharge destination was documented. All analyses were adjusted for age and gender. RESULTS: A total of 7.1% of patients were malnourished and 49.1% were ARM. Patients with reduced mental health (GDS⩾5: 30.5 vs 11.5%; P=0.004), impaired cognitive function (MMSE⩽26: 23.6±0.5 vs 26.0±0.6; P=0.004), prevalent frailty (32.5 vs 8%; P<0.001), more comorbidities (2.3±0.1 vs 1.3±0.2; P<0.0001) and medications (5.6±0.3 vs 3.4±0.4; P<0.0001) were more likely to have an impaired nutritional status (M+ARM). Further, M+ARM patients were twice as likely to be discharged to destinations different to home (odds ratio=2.08; confidence interval 1.07-4.05). CONCLUSIONS: In this consecutive sample of geriatric trauma patients, 56.2% had an M+ARM upon admission to acute care, which was associated with indicators of worse physical, mental and cognitive health and predicted a more than twofold greater odds of being discharged to a destination other than home.

Asunto(s)

RESUMEN

We evaluated the perceived impact of physical activity on back pain in runners. Information from 777 runners participating in a half marathon was obtained with a questionnaire about basic data, features of the weekly training and the relationship between running activity and back pain. Half the runners (54.1%) reported a history of back pain. Among them, almost twice as many reported an improvement (49%) than a worsening (27%) of pain with running. No significant associations were found between perceived impact of running on back pain and other factors. In our study favorable effects were much more frequent than unfavorable ones. Further studies are needed to better understand these effects.

Asunto(s)

RESUMEN

La falta de conocimiento del potencial nocivo de los plaguicidas por parte de los trabajadores agrícolas puede ocasionar graves problemas en su salud y en la de los consumidores. Se determinó la residualidad de plaguicidas organoclorados (OCP, por sus siglas en inglés) en muestras de suero sanguíneo de trabajadores agrícolas de cultivos de café y plátano en el departamento del Quindío. Para la extracción de los analitos se implementó un método rápido, seguro, económico y eficiente de microextracción dispersiva en fase líquida (DLLME, por sus siglas en inglés) asistida por sonicación, logrando la extracción de 20 OCP de 200 µL de suero sanguíneo en un tiempo de 35 min con porcentajes de recuperación mayores al 87 %. Se empleó cromatografía de gases con detector de micro captura de electrones (GC-µECD) para el análisis de los OCP. Para cada analito, los coeficientes de correlación obtenidos a partir de las curvas de calibración interna fueron superiores a 0,9996, los límites de detección (LOD) se establecieron entre 0,02 a 0,04 ng/mL y los límites de cuantificación (LOQ) por debajo de 0,14 ng/mL. En el 55 % de las muestras analizadas (166) se evidenció la presencia de: 4,4-DDE, alfa y gamma BHC, endrin aldehído, endosulfan II, endosulfan sulfato, heptacloro y metoxicloro, compuestos que están prohibidos por la regulación nacional e internacional.

Lack of knowledge of the harmful potential of pesticides by agricultural workers can cause serious health problems for them and the consumer. The residual organochlorine pesticides (OCP) was determined in serum samples of coffee and banana crops farmworkers in the department of Quindio, Colombia. To extract analytes a fast, efficient, safe, and economic assisted dispersive liquid liquid microextraction (DLLME) method was implemented by sonication, achieving extraction of 20 OCP in 200 µL of blood serum in a time of 35 min with percentage recoveries higher than 87 %. OCP were analysed by gas chromatography with electron capture detector (GC-µECD). For each analyte, the correlation coefficients obtained from internal calibration curves were higher than 0.9996, the limits of detection (LOD) were established between 0.02 to 0.04 ng/mL and the limits of quantification (LOQ) below 0.14 ng/mL. A total of 55 % of the samples analyzed (166) showed the presence of 4,4-DDE, alpha and gamma BHC, endrin aldehyde, endosulfan II, endosulfan sulfate, heptachlor, and methoxychlor, compounds that are prohibited by both national and international regulation.

A falta de conhecimento do potencial nocivo dos pesticidas por trabalhadores agrícolas, pode causar sérios problemas de saúde e do consumidor. Os pesticidas organoclorados residuais (OCP) foi determinada em amostras de soro de trabalhadores rurais de café e plantações de banana, no departamento de Quindío. Para analitos extração método eficiente rápida e segura, econômica e assistida por dispersão de fase líquida microextração (DLLME) aplicado por ultra-som, a realização de extração OCP 20 200 uL de soro sanguíneo em um tempo de 35 min com porcentagens recuperação > 87%. Detector Foi realizada cromatografia gasosa com captura de elétrons micro (GC-AECD) para a análise da OCP. Para cada analito, os coeficientes de correlação obtidas a partir de curvas de calibração interna foram maiores do que 0,9996, foram estabelecidos os limites de detecção (LOD) entre 0,02-0,04 ng / mL e os limites de quantificação (LOQ) abaixo de 0,14 ng / mL. 55% das amostras analisadas (166) mostrou a presença de 4, 4-DDE, alfa e gama-BHC, aldeído endrina, endossulfão II, sulfato de endosulfan, heptacloro e metoxicloro, compostos que são proibidos pelo regulamento nacional e internacional.

RESUMEN

Los colirios contaminados representan una causa potencial de infección ocular prevenible. Como toda medicación terapéutica tópica, los colirios deben estar libres de agentes contaminantes. La frecuencia de contaminación varía entre 0,07% y 35,6% en los estudios publicados; no existiendo estudios publicados sobre este tema en nuestro país. Este estudio tiene como objetivo determinar la frecuencia de contaminación de las gotas oftálmicas utilizadas por pacientes que consultan en la Fundación Visión en Asunción, Paraguay. A todos los pacientes que acudieron a la consulta externa en el Servicio de Oftalmología de la Fundación Visión, de agosto de 2007 a julio de 2008 se les solicitó que entregaran sus envases de gotas oftálmicas que estuvieron utilizando por dos o más semanas, además se registraron sus datos demográficos y relacionados al uso del colirio. Los envases fueron enviados al Instituto de Investigaciones en Ciencias de la Salud (IICS), de manera que la medicación restante en el interior de los mismos fuera cultivada en los medios microbiológicos convencionales. De los 73 envases recolectados, 8 (11%) presentaron cultivos positivos, siendo los gérmenes aislados Estafilococo coagulasa negativo, Propionibacterium acnes, Serratia marcescens, Corynebacterium sp y Alcaligenes faecalis, además del hongo oportunista Aspergillus fumigatus. La contaminación de los colirios utilizados por estos pacientes es relevante. Estos resultados coinciden con reportes de otros países y señala la importancia de dar orientaciones a los pacientes en cuanto al modo de utilización, almacenamiento y tiempo de recambio de los colirios por parte de los oftalmólogos.

Asunto(s)

RESUMEN

We describe the case of an 81 year old woman that presented with jaundice, bile duct dilation, hepatic liver tests abnormalities and elevated levels of CA-19-9 (741 UI). Intestinal and pancreatic neoplasia were ruled out. Hepatic biopsy revealed chronic inflammation, cirrhosis and findings consistent with autoimmune hepatitis. The patient was given a course of corticoids and the disease as well as levels of CA-19-9 returned to normal levels.

Asunto(s)

RESUMEN

Describimos el caso de una mujer de 82 anos que se presento con ictericia, dilatación de colédoco, alteración de la bioquímica hepática y niveles elevados de CA-19.9 (741 UI). Se descartaron neoplasias pancreáticas e intestinales. La biopsia hepática mostróinflamación crónica, cirrosis y hallazgos consistentes con hepatitis autoinmune. La paciente recibió tratamiento con corticoides y tanto la enfermedad como los niveles de CA -19-9 regresaron a niveles normales.

We describe the case of an 81 year old woman that presented with jaundice, bile ductdilation, hepatic liver tests abnormalities and elevated levels of CA-19-9 (741 UI). Intestinaland pancreatic neoplasia were ruled out. Hepatic biopsy revealed chronic inflammation,cirrhosis and findings consistent with autoimmune hepatitis. The patient was given a courseof corticoids and the disease as well as levels of CA-19-9 returned to normal levels.

Asunto(s)