Antithrombotic Therapy in Elderly Patients with Acute Coronary Syndromes.

The treatment of acute coronary syndrome (ACS) in elderly patients continues to be a challenge because of the characteS.G.B.ristics of this population and the lack of data and specific recommendations. This review summarizes the current evidence about critical points of oral antithrombotic therapy in elderly patients. To this end, we discuss the peculiarities and differences reported referring to dual antiplatelet therapy (DAPT) in ACS management in elderly patients and what might be the best option considering these population characteristics. Furthermore, we analyze antithrombotic strategies in patients with atrial fibrillation (AF), with a particular focus on those cases that also present coronary artery disease (CAD). It is imperative to deepen our knowledge regarding the management of these challenging patients through real-world data and specifically designed geriatric studies to help resolve the questions remaining in their disease management.

Cognitive Functioning, Life Satisfaction, and Their Relationship with the Financial Attitudes of Older Individuals Who Participate in an Active Aging Program.

Life expectancy has increased in many countries throughout the world over recent years, leading to new challenges related to aging. A large part of the population is over 60 years old, and therefore studies that focus on financial autonomy and active aging are necessary. In this paper, we analyze the relationship between cognitive functioning and life satisfaction in relation to financial attitudes in a sample of 251 elderly adults (71% women) participating in an active aging program (M = 67.5, SD = 4.5). We used the Mini-Mental State Examination, the Satisfaction with Life scale, and a questionnaire about financial attitudes to gather data. Our results show that cognitive functioning and life satisfaction are related to certain financial attitudes. We also observed differences associated with gender, education level, and financial independence. According to our findings, life satisfaction should be taken into account when the financial attitudes of older adults are evaluated. The importance of support groups for the elderly is highlighted as well as of all those recreation and health programs, since they constitute a means of promoting well-being.

Significado de bienestar subjetivo e inclusión económica en adultos mayores líderes de asociaciones en el sur de Chile / Meaning of subjective well-being and economic inclusion in older adults leaders of associations in southern Chile

Resumen Chile es uno de los países con mayor esperanza de vida en Latinoamérica, así como con mayor porcentaje de personas mayores de 60 años. Este grupo etario es considerado como grupo vulnerable en procesos de inclusión económica. A esto se suma que muchos adultos mayores deben trabajar hasta edades avanzadas debido a las bajas pensiones y escasos recursos económicos, lo cual impacta su bienestar. Atendiendo a los antecedentes y desde la psicología económica, el objetivo de este estudio es conocer el significado del bienestar subjetivo y la inclusión económica en adultos mayores de entre 60-75 años, en zonas urbanas del sur de Chile. La metodología de investigación es cualitativa y se aplicaron entrevistas semiestructuradas, las cuales fueron analizadas con la técnica análisis de contenido y con el soporte del programa N-VIVO 11. Los participantes fueron 10 adultos mayores -3 hombres y 7 mujeres- todos líderes de clubes de adultos mayores. Los principales hallazgos muestran que los significados asociados al bienestar subjetivo se refieren a las fuentes de este, tales como familia, amigos y la participación en organizaciones de adultos mayores. Sin embargo, asocian sentimientos negativos relacionados con las dificultades que enfrentan por sus precarias condiciones económicas. En cuanto a los significados asociados a la inclusión económica, se refieren a habilidades tales como la capacidad de administración y distribución de los ingresos y la necesidad de aprender sobre el uso de herramientas tecnológicas que se requieren para sentirse incluidos en el sistema. Además, indican prácticas como el endeudamiento formal e informal y escaso ahorro.

Abstract Increasing life expectancy brings with it research challenges associated with the evidence of the psychosocial and economic implications of this fact in contemporary societies. At the same time, it is necessary to develop a field of study related to the quality of life and subjective well-being of this age group. Chile is one of the countries with the highest life expectancy in Latin America, as well as the highest percentage of people over 60. Faced with this panorama, it is necessary to know aspects that impact and take on meanings associated with subjective well-being in old age, as well as towards economic inclusion, considering that older adults, together with women heads of household and young people, are considered vulnerable socioeconomic groups in the processes of economic inclusion. Added to this is the fact that many older adults must continue to work into old age due to low pensions and scarce economic resources, which have an impact on their well-being. In this research, subjective well-being is considered to be composed of an affective and a cognitive dimension and is defined as the evaluation that people themselves make of their lives. On the other hand, economic inclusion is understood as a process of promoting affordable, timely and adequate access to a wide range of regulated financial products and services. Based on economic psychology, the objective of this study is to understand the meaning of subjective well-being and economic inclusion in older adults between the ages of 60-75 in urban areas of southern Chile. The study was realized in the Araucanía Region, the region with the highest poverty rate in this country. The research methodology is qualitative and semi-structured interviews were applied, which were analyzed with the content analysis technique and with the support of the N-VIVO 11 program. The participants were 10 older adults, 3 men and 7 women, leaders of older adult clubs. The research's ethical safeguards included the approval of the University of La Frontera Ethics Committee, incorporating the use of informed consent and authorization for the recording of interviews. The main findings show that the meanings associated with subjective well-being refer to its sources, such as family, friends and participation in organizations of older adults, declare positive feelings associated with happiness and satisfaction with life; however, they associate some negative feelings related to the difficulties they face due to precarious economic conditions that prevent them from satisfying basic needs (for example, health and food). As for the meanings associated with financial inclusion, they refer to skills such as the ability to manage and distribute income and the need to learn about the use of technological tools required to feel included in the system. In addition, they indicate practices associated with financial inclusion, highlighting formal and informal indebtedness and scarce savings. The results are discussed in light of the emerging categories of study population and theoretical background. It is suggested that financial capacities, as mechanisms that contribute to economic inclusion, are a dimension that should be highlighted in research and intervention, based on plans and programs aimed at the active ageing of older adults in Chile.

Tratamiento laparoscópico de litiasis biliar / Laparoscopic cholecystectomy

Los autores analizan en forma retrospectiva 154 colecistectomías laparoscópicas realizadas en la Clínica Quirúrgica 3 del Hospital Maciel en el período comprendido entre setiembre de 1996 y setiembre de 1998. El 96,7 por ciento correspondieron al sexo femenino y sólo el 3.3 por ciento al masculino. El promedio de edad fue 45 años con una mínima de 14 y una máxima de 77 años. Todos los pacientes se operaron de coordinación. Veinticinco pacientes tenían colecistitis aguda y siete subaguda. Cuatro tenían litiasis coledociana. La colecistectomía se realizó con la técnica americana en todos los pacientes. La colangiografía transcística se efectuó selectivamente en 15 casos, cuando hubo sospecha de litiasis coledociana. La mayoría de los procedimientos (60,3 por ciento fueron) realizados por asistentes de Clínica Quirúrgica. La conversión a cirugía abierta se hizo en 7 pacientes (4,5 por ciento). Hubo dos lesiones de la vía biliar principal (1,2 por ciento). La mortalidad de la serie fue nula. Se reoperaron 4 pacientes (2,5 por ciento en el posoperatorio inmediato y en un solo caso alejado. Se concluye que en base a la experiencia realizada en nuestro Servicio, la colecistectomía laparoscópica es un procedimiento seguro en la gran mayoría de los pacientes portadores de litiasis de la vía biliar accesoria