[Prevalence and relations of orthostatic hypotension in patients 80 years old and over from a primary care unit]. / Prevalencia y relaciones de la hipotensión ortostática en los pacientes de 80 o más años de edad de una unidad de atención primaria.

OBJECTIVE: To estimate the prevalence of orthostatic hypotension (OH) in patients 80 years old and over attending a primary care unit. To relate OH to the most prevalent pathologies and to the most used drugs. DESIGN: Transversal observational study. LOCATION: Primary care unit, Santiago de Compostela. PARTICIPANTS: Eighty one patients 80 years old or over representative of a primary care unit were recruited. Ten patients were excluded. MAIN MEASUREMENTS: Blood pressure was measured in decubitus and later in erect position first immediately after standing and then after 3 minutes. Diagnoses and active treatments were reviewed in the electronic clinical history and through an interview with the patient and caregiver. RESULTS: In 26.76% of patients the systolic blood pressure fell by 20mmHg or more and/or the diastolic blood pressure fell by 10mmHg in the instant following the postural shift. In 16.90% of patients the drop persisted after 3 minutes of standing from decubitus position. None of the patients was diagnosed with OH. The highest prevalence ratio was observed for diabetes mellitus (1.6; P=.412), not existing differences for arterial hypertension (P=.881). OH related in a statistically meaningful way to the use of renin angiotensin aldosterone system inhibitors (OR: 8.174, CI95%: 1.182-56.536); P=.033] and benzodiazepines (OR: 5.938, CI95%: 1.242-28.397; P=.026)]. CONCLUSION: OH had a prevalence of 16.90% among the elderly patients who had a consultation. Its connection with some drugs (renin angiotensin aldosterone system inhibitors and benzodiazepines) must be considered.

High incidence of hypoglycemia in stable insulin-treated type 2 diabetes mellitus: continuous glucose monitoring vs. self-monitored blood glucose. Observational prospective study.

OBJECTIVES: Hypoglycemia is a limiting factor in the achievement of strict glycemic control. The primary objective of this 9-week study was to determine the frequency of hypoglycemia in patients with stable insulin-treated type 2 diabetes mellitus by comparing self-monitored blood glucose (SMBG) measurement with continuous glucose monitoring (CGM). METHODS: This was an observational prospective study. Included in the study were 63 stable, insulin-treated patients with type 2 diabetes. They were instructed to record 2 daily capillary blood glucose readings, pre- and/or postprandial, in a sequential way during 8 consecutive weeks. A CGM system was worn during an additional week. We evaluated the frequency of hypoglycemia using the 8-week SMBG profile and the 1 CGM week. RESULTS: SMBG revealed that 50% of the patients had experienced hypoglycemia. CGM found hypoglycemia in 59% of patients. Significantly higher percentages of hyperglycemic and hypoglycemic episodes were detected by CGM than by capillary blood glucose measurements (61.1% vs. 50.8%; p=0.047) and (3.8% vs. 1.7%; p=0.016); 33% of patients experienced nocturnal hypoglycemia, and 19% of patients who had no data concerning hypoglycemia recorded in the capillary blood glucose diary had experienced hypoglycemia as measured by CGM, and the hypoglycemia occurred mainly during the nocturnal period. CONCLUSIONS: In stable well-controlled, insulin-treated patients with type 2 diabetes, CGM showed higher numbers of hypoglycemic events than did SMBG, especially at night. CGM is a useful tool that provides clinically valuable information about glucose control in these patients.

Incidence and characteristics of myelodysplastic syndromes in Ourense (Spain) between 1994-1998.

The very few reference epidemiological studies on myelodysplastic syndromes (MDS) have been carried out in Europe: Germany, France, UK and Sweden. We present the first Spanish study on the incidence and characteristics of MDS. The incidence rates, distribution by FAB subtypes, sex and age groups are within the ranges established by the reference studies with minimal differences which we point out and attempt to explain.

Influencia de los programas colectivos en la condición física de mujeres mayores / Influence of Collective Programs in the Physical Condition of Elderly Women / Influência dos programas coletivos na condição física de mulheres idosas

Resumen Introducción: los países más desarrollados del mundo están asistiendo a una regresión poblacional, lo que les supone un enorme costo en la atención sociosanitaria. Diversas investigaciones ponen en evidencia el envejecimiento, y muchos estudios demuestran la influencia de la actividad física en la salud de las personas, cuyo resultado dependerá de la forma de implementarla. Objetivo: El objetivo de este artículo es comparar los efectos en la salud física de dos programas de ejercicio físico supervisado para personas mayores. Materiales y métodos: se realizó un estudio de tipo cuasiexperimental, comparándose dos programas de ejercicio físico colectivo supervisado realizados por sendos grupos de mujeres mayores independientes entre 55 y 65 años. Se utilizó como control un programa sociomotriz existente, y se implementó un programa experimental, con contenidos complementarios, y más sesiones y actividades en el exterior. Se examinó la condición física, calculándose media y distribución de varianza. Resultados: los datos muestran que las mujeres mejoraron en el 90% de los indicadores de salud y percibieron mejor su aptitud física. El programa experimental, con mayor número de sesiones y actividades en el medio natural, se mostró significativamente efectivo en relación con el equilibrio y la fuerza de los miembros inferiores. Conclusiones: los programas de ejercicio físico colectivo supervisado son positivos para la salud física de las personas mayores, pero en especial aquellos que alcanzan una práctica semanal de tres días, que incluya un 30% de sesiones en el exterior.

Abstract Introduction: The more developed countries of the world are suffering a population regression, which suppose a high cost on socio-health care. There is a lot of evidence on aging, however, studies on the influence of physical activity on the health of people are insufficient, as it largely depends on its implementation. Objective: The objective is to compare the effects in physical health of two supervised physical exercise programs for seniors. Materials and methods: A quasi-experimental study was carried out, comparing two supervised collective physical exercise programs performed by groups of independent older women aged 55-65 years. An existing sociomotor program was used as control, and an experimental program was implemented, with additional contents, and more sessions and activities abroad. The physical condition was examined, and averaging and variance distribution was calculated. Results: The results showed that older women improved in 90% of physical fitness indicators and perceived their physical health better. In fact, the experimental program, with more sessions and activities in the natural environment was more effective in relation to balance and strength of the lower limbs. Conclusions: Supervised collective physical exercise programs are positive for the physical health of older people, but especially those who achieved three-day weekly practice, which includes 30% outdoor sessions.

Resumo Introdução: os países mais desenvolvidos do mundo estão assistindo a uma regressão populacional, o que lhes supõe um enorme custo na atenção sociossanitária. Existe muita evidência sobre o envelhecimento e estudos sobre a influência da atividade física na saúde das pessoas, cujo resultado dependerá da forma de implementá-la. Objetivo: o objetivo é comparar os efeitos na saúde física de dois programas de exercício físico supervisado para idosos. Materiais e métodos: se realizou um estudo de tipo quase-experimental, comparando-se dois programas de exercício físico coletivo supervisado, realizados pelos seus respetivos grupos de mulheres idosas independentes entre cinquenta e cinco e sessenta e cinco anos. Utilizou-se como controle um programa socio-motriz existente, e se implementou um programa experimental, com conteúdos complementários, e mais sessões e atividades no exterior. Se examinou a condição física, calculando-se média e distribuição de variância. Resultados: os dados mostram que as mulheres melhoraram no 90% dos indicadores de saúde e perceberam melhor a sua aptidão física. O programa experimental, com maior número de sessões e atividades no meio natural, se mostrou significativamente efetivo em relação com o equilíbrio e a força dos membros inferiores. Conclusões: os programas de exercícios físico coletivo supervisado sçao positivos para a saúde física dos idosos, mas particularmente aqueles que alcançam uma prática semanal de três dias, que inclua um 30% de sessões no exterior.

The influence of a cognitive stimulation program on the quality of life perception among the elderly.

There is an undeniable concern among the elderly about the mental changes they experience as they grow older. In general, the elderly tend to regard mental deterioration as a pathological condition, however these changes should be considered inherent in the aging process and in the last few years cognitive stimulation programs have been developed in order to address these concerns among the elderly. The purpose of this study is to analyze the influence of a cognitive training program on 53 subjects with age-related memory loss. The results of cognitive performance have been compared with a control group consisting of 51 subjects with no cognitive training. Moreover, this research analyses the relationship between cognitive changes and the variation in the perceived quality of life of the elderly people in both groups. The results show significant changes in the test group, demonstrating improved cognitive performance and quality of life perception.

Personal determinants of burnout in nursing staff at geriatric centers.

There is a high prevalence of stress in the workplace among nursing personnel at elderly care-centers. The general impression is that these high stress levels are related to conflict within the workplace. The purpose of this study is to evaluate whether personal factors (in particular personality and values), are related to burnout. For this reason we asked a sample of 42 nursing personnel from care-centers for the elderly to complete a self-administered questionnaire on conflict at work, stress at work, personality and motivational values for nursing professionals in elderly residences. Personality variables and motivational values were found to be significantly related to the appearance of stress in the workplace.