RESUMEN
OBJECTIVE: To determine the effectiveness of a multifactorial intervention program to prevent falls among older adults as compared with a brief intervention. DESIGN: Randomized controlled trial. SETTING: Eleven health centers located in Córdoba, Spain. PARTICIPANTS: People over 70 years old (N=404), who are residents in the community. INTERVENTIONS: The centers were randomized to either 1 of the 2 groups: intervention group (IG), of a multifactorial nature (individual advice, information leaflet, physical exercise workshop, and home visits), or control group (CG) (brief individual advice and information leaflet). MAIN OUTCOME MEASURES: Fall rates and time until the fall; estimates of the relative and absolute risk of falls; and survival analysis and Cox regression. RESULTS: Of the patients recruited, 133 were in the IG and 271 were in the CG. Around 33% in the IG and 30.25% in the CG had had a fall in the previous year (P=.56). After 12 months, the fall incidence rate was 17.29% in the IG and 23.61% in the CG (relative risk=0.73; 95% confidence interval [CI], 0.48-1.12; P=.146). Around 60% of the IG patients said they had increased the time spent on physical activity. In the IG, the incidence of falls at home was 27.5% compared with 49.3% in the CG (P=.04). Being a woman (odds ratio [OR]=1.62; 95% CI, 1.03-2.54), having a history of falls (OR=1.15; 95% CI, 1.05-1.26), suffering acute health problems (OR=2.19; 95% CI, 1.09-4.40), and doing moderate exercise (OR=1.91; 95% CI, 1.08-3.38) were found as factors associated with a higher risk of falls. CONCLUSIONS: Although the reduction of falls in the IG was nearly halved, and after the intervention there was a significant reduction in the number of falls at these patients' homes, the multifactorial intervention program is no more effective than the brief intervention to reduce the overall risk of falls.
Asunto(s)
Prevención de Accidentes/métodos , Accidentes por Caídas/prevención & control , Accidentes Domésticos/prevención & control , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Distribución de Chi-Cuadrado , Ejercicio Físico , Femenino , Humanos , Masculino , Modelos de Riesgos Proporcionales , Factores de Riesgo , España , Encuestas y CuestionariosRESUMEN
As part of a routine screening for the possible presence of the necrotic strains of potato virus Y affecting potatoes in Mexico, five PVY isolates were submitted to biological and molecular analysis. Considering their serological properties, two belong to the common strain (O) and three to the necrotic strain (N). All the isolates induced vein necrosis in Nicotiana tabacum. To characterize the isolates, 5' NTR and P1 genes were sequenced and compared with sequences from GenBank database. Nucleotide sequence similarity ranged from 47-100% in the 5' NTR and from 63-100% in the P1 coding region. The lowest amino acid similarity between sequences of P1 gene was 55%. In phylogenetic trees of 5'NTR analysis, two PVY(O) Mexican isolates clustered with other PVY(O) isolates. In turn, the three PVY(N) isolates grouped with PVY(N-NTN) isolates. The phylogenetic analysis of P1 sequences (nucleotide and amino acid) showed two PVY(O) isolates grouping next to N-NTN cluster. A detailed analysis of the PVY(O) isolates showed two potential recombination regions in the P1 gene, in contrast to 5'NTR where no recombination was detected.
Asunto(s)
Potyvirus/genética , Potyvirus/aislamiento & purificación , Solanum tuberosum/virología , Regiones no Traducidas 5' , Análisis por Conglomerados , México , Datos de Secuencia Molecular , Filogenia , Enfermedades de las Plantas/virología , Potyvirus/clasificación , ARN Viral/genética , Análisis de Secuencia de ADN , Homología de Secuencia , Serotipificación , Nicotiana/virología , Proteínas Virales/genéticaRESUMEN
Con el cambio en el estilo de vida de la mujer se ha incrementado el tabaquismo, el consumo de bebidas con cafeína y el sedentarismo, por lo cual se intensifican los factores de riesgo y se favorece la descalcificación, constituyendo un problema de salud pública por el aumento en la incidencia de fracturas osteoporóticas conforme avanza la edad, sobre todo en la mujer posmenopáusica, la cual lleva a una mayor morbimortalidad secundaria a esta entidad, siendo una causa importante de discapacidad física, afectando en forma directa el bienestar psicoemocional de la mujer. Con el desarrollo de la tecnología, cada vez se cuenta con equipos de diagnóstico más sensibles y específicos para detectar la descalcificación en estas mujeres; se utilizaron dos métodos de osteodensitometría, uno a través de rayos X, y otro a través de ultrasonido en 138 mujeres en la etapa de la posmenopausia con un promedio de índice de masa corporal de 29. Se compararon ambos resultados de densidad ósea, puntuación de T, con osteopenia y osteoporosis. Se realizó doble densitometría a las 138 pacientes de columna lumbar con equipo DEXA, y de calcáneo con equipo DTU-one, por el mismo técnico, calculando la diferencia del puntaje de T en el doble estudio.