Expresión sexual y regulación de la sexualidad en residencias de personas mayores

Objectives

The study had three objectives: (a) To determine how staff perceives the frequency of different sexual expressions in long-term care facilities for older people; (2) to quantify policies aimed at guaranteeing residents’ sexual rights in such institutions, and (3) to determine factors influencing the presence of these kind of policies.

Anciano y anemia: revisión crítica de su definición y prevalencia

Background and objectivesThe prevalence of anaemia is an important health indicator, although there is little rigorous information gathered on the elderly population, particularly in those over 80 years old. The same criteria that are used in the general population are often used to define anaemia in the elderly. The epidemiological data collected by the WHO in 1968 (that have been used to generalise this criteria), did not include the population over 65 years-old.Two objectives are established, which includes a critical review of the available evidence on whether the criteria used to define anaemia in the adult population can be extrapolated to the elderly, and a review of publications on the prevalence of anaemia in the elderly over 80 years-old.Material and methodsA systematic bibliographic search was performed on the established objectives.ResultsAlthough the WHO criteria, based on data from 1968, are widely used, other possible cut-off points have been proposed for elderly people. A total of 20 studies were found that were conducted in North America and Europe, with only 70,000 patients, and different age criteria. The prevalence of anaemia ranges between 3% and 63%, depending on the diagnostic criteria, age, and whether they were institutionalised or not.ConclusionsAnaemia is a very prevalent disease in elderly patients. The collection of large databases is necessary to determine more adequate diagnostic criteria.     

Bocio,función tiroidea y excreción de yodo en gestantes de la zona de El Bierzo

Estudios publicados en el año 1993 demuestran alta incidencia de bocio en escolares de la zona de El Bierzo.Hemos valorado mediante encuesta el consumo de sal yodada, la presencia de bocio mediante palpación y ecografía, la función tiroidea midiendo concentraciones hormonales en plasma y la excreción de yodo en orina y leche mediante el método de Benotti, en un grupo de mujeres embarazadas de la zona, en los tres trimestres de la gestación y en el posparto.Nuestros resultados demuestran escaso consumo de sal yodada, endemia bociosa grave, hipotiroxinemia materna, pobre excreción de yodo en orina en las gestantes y escasa presencia de yodo en la leche materna. Todo ello indica la necesidad de campañas institucionales para remediar la situación.     

Genotipificación de aislamientos clínicos de Aspergillus flavus y su relación con aislamientos ambientales de un centro oncohematológico

BackgroundDuring 4 months, and while conducting an environmental sampling of air, 2 cases of aspergillosis by Aspergillus flavus (A. flavus) were diagnosed at an oncohematological center in Buenos Aires, Argentina.AimsThe aim of this study was to know the variability and the genetic relationship between the clinical and environmental isolates, obtained in the oncohematological center.MethodsTwo genotyping techniques of different discriminatory power (RAPD and AFLP) were used. A genetic similarity matrix was calculated using Jaccard method and was the basis for the construction of a dendrogram by UPGMA. The level of genetic variability was assessed by measuring the percentage of polymorphic loci, number of effective allele, expected heterocygozity and association index test (I_A).ResultsThe dendrogram reveals that the A. flavus isolates recovered from the patients were not genetically related to those gotten from the rooms occupied by the patients. The environmental isolates had higher values of genetic diversity than the clinical isolates. The I_A estimated for all the isolates suggest that recombination events occurred.ConclusionsPatients 1 and 2 were not infected with isolates from the nosocomial environment. Clinical and environmental isolates of A. flavus showed high genetic variability among them.     

Incorporación de la ecografía y la punción de tiroides a la actividad de endocrinología en una consulta de alta resolución

IntroductionFine-needle aspiration biopsy (FNAB) is considered the reference diagnostic procedure for thyroid nodules.Materials and methodsRoutine performance of thyroid ultrasound and ultrasound-guided FNAB by endocrinologists allows a more efficient approach in the setting of a high-resolution practice, thus reducing costs and the time elapsed until diagnosis.ResultsWe present our initial results of this procedure 2 years after its introduction, with a total of 286 biopsies performed. After a progressive learning curve over time and according to the endocrinologists’ previous experience, 72.72% samples were considered satisfactory for diagnosis. Greater difficulty was observed in obtaining optimal cytological specimens in smaller nodules. In conclusion, we have successfully incorporated thyroid ultrasound and ultrasound-guided FNAB into routine endocrine practice.ConclusionRoutine performance of thyroid ultrasound in endocrine practice will considerably aid the management of nodular thyroid disease.     

Evaluación de la utilización de las prestaciones específicas de los sistemas de infusión subcutánea de insulina y su relación con el control metabólico en pacientes con diabetes tipo 1

Background and objectivePatients with type 1 diabetes (T1DM) treated with continuous subcutaneous insulin infusion (CSII) have available several specific features of these devices. The aim of this study was to evaluate the relationship between real use of them and the degree of glycemic control in patients using this therapy.Patients and methodsForty-four T1DM patients on CSII therapy with or without real-time continuous glucose monitoring (CGM) were included. Data from 14 consecutive days were retrospectively collected using the therapy management software CareLink Personal/Pro^® and HbA1c measurement performed at that period. The relationship between the frequency of usie of specific features of insulin pumps (non-sensor augmented or sensor-augmented) and glycemic control was analyzed.ResultsMean HbA1c in the group was 7.5 ± .8%. Mean daily number of boluses administered was 5.1 ± 1.8, with 75.4% of them being bolus wizards (BW). Daily number of boluses was significantly greater in patients with HbA1c < 7.5% than in those with HbA1c > 7.5% (5.3 ± 1.6 vs. 4.3 ± 1.6, P = .056). There was a trend to greater use of BW in patients with better control (82.8 ± 21.4% vs. 69.9 ± 29.1%, P = .106). HbA1c was lower in patients using CGM (n = 8) as compared to those not using sensor-augmented pumps (7.6 ± .8 vs 7.1 ± .7, P = .067), but the difference was not statistically significant.ConclusionsMore frequent use of BW appears to be associated to better metabolic control in patients with T1DM using pump therapy. In standard clinical practice, augmentation of insulin pump with CGM may be associated to improved glycemic control.     

Repercusión de un sistema centralizado de ingresos sobre la eficacia y eficiencia de una unidad geriátrica de recuperación funcional

ObjectiveTo evaluate the influence of a change in the management of admissions on the activity and care outcomes of a Geriatric Functional Recovery Unit (GFRU).Material and methodsA retrospective observational study was conducted. Since 2000, the Hospital Central Cruz Roja GFRU has been collecting data grouped into periods of 4 years, except for the centralised admissions (September 2016-December 2018). The data collected on admission included the Red Cross Functional and Mental scales, the Barthel index, the main diagnosis of the functional decline (grouped into stroke, orthopaedic problem, and multifactorial immobility episodes), and comorbidity evaluated by the Charlson index. The following outcome variables were analysed: the overall and relative functional gain at discharge; length of hospital stay; the functional efficiency, discharges to nursing homes, and transfers to acute care units. An analysis was made of the relationship between the admissions from the centralised unit and the previous period (directly admission managed by GFRU), using multivariate analysis (linear regression for continuous outcome variables and logistic regression for the dichotomous ones), adjusted for admission variables.ResultsPatients admitted from the centralised unit showed a greater overall and relative functional gain (difference between both means: 3.49 points, 95% CI; 1.65-5.33, and 12.41%, 95% CI; 0.74-24.08, respectively), longer stay (12.92 days, 95% CI; 11.54-14.30) and lower efficiency (−0.36, 95% CI; −0.16 to −0.57), higher risk of institutionalisation (OR 1.61, 95% CI; 1.19-2.16), and transfers to acute care units (OR 3.16, 95% CI; 2.24-4.47).ConclusionsA centralised admissions system had an influence on the improvement of functional parameters in the patients, but with a longer length of hospital stay, and lower efficiency. Increases in institutionalisation at discharge and transfers to acute care units were also observed.