[Characteristics of the sexual sphere in elderly patients]. / Características de la esfera sexual en pacientes adultos mayores.

OBJECTIVE: Sexuality plays a fundamental role in our lives, but there is little research on this subject with representative samples. This study aims to analyse the knowledge and characteristics of sexual function in people over 60 years of age. MATERIAL AND METHODS: An observational cross-sectional study was carried out. The sample consisted of people over 60 years of age who voluntarily attended health education talks on sexuality held in urban centres for the elderly. Before the talk, they were given a questionnaire to assess their sexual habits and practices. The talk on sexuality was given, and a questionnaire related to the concepts mentioned while the talk was delivered. The data from the questionnaires were collected on spreadsheets in Microsoft Office Excel for Windows, and the statistical analysis was performed with the statistical package SPSS. RESULTS: The results show that sexual activity is important in those over sixty years, with 52.53% of respondents having relationships. More than 70% of adults over 60 refer to being sexually attractive for their age. There were concepts about sexuality that were not clear after the talk. CONCLUSION: Our society is experiencing progressive aging involving the elderly groups in sex education, emphasising the changes at the sexual level implied by age. It is important to start training sessions on health education with content on sexuality and body image reinforcement in the elderly population.

[Tele-medicine consultation as a tool to improve the demand for consultation in Primary Care]. / La consulta no presencial como herramienta de mejora de la consulta a demanda en atención primaria.

OBJECTIVE: Currently, there is a strong healthcare pressure on resources in Primary Care clinics. This significantly compromises the accessibility and the time dedicated to the patient. This paper analyses the implementation of a tele-medicine service using telephone and e-mail consultations. MATERIALS AND METHODS: The telephone and e-mail consultations carried out during one year were reviewed retrospectively. The patient profile, the type of consultation carried out, the need for a face-to-face visit, and the receipt of attached documentation were analysed. RESULTS: A total of 884 distance consultations were received in a 12month period. The distance consultation accounted for 13.56% of consultations on demand. The mean age of the patient was 54 (SD: 17) years old. The large majority (87.7%) of the consultations were made by the patients and the rest by relatives or caregivers. The time spent per patient in the face-to-face consultation was 10.24minutes and the waiting list was less than 48hours on 97% of the days of the year. The patient had to go in person on 24 (2.71%) occasions. CONCLUSIONS: Distance consultation is a useful resource for improving accessibility, as well as leading to more physical consultation time. It has also demonstrated that it is capable of solving problems of different kinds and in different age groups.

A comprehensive profiling of sulfatides in myelin from mouse brain using liquid chromatography coupled to high-resolution accurate tandem mass spectrometry.

Sulfatides are sulfoglycolipids found in the myelin sheath. The composition ratio of sulfatide molecular species changes with age, and it has also been associated with the pathogenesis of various human central nervous system diseases. However, profiling sulfatides in biological samples is difficult, due to the great variety of molecular species. In this work, a new, easy and reliable liquid chromatography-electrospray tandem mass spectrometry (LC-ESI(+)-MS/MS) method has been developed to profile sulfatide content in biological samples of myelin. The 'wrong-way-round' ionization effect has been described for this type of molecules for the first time, making it possible to correctly identify as many as 37 different sulfatides in mouse brain myelin samples, including molecules with different fatty acid chain lengths and varying degrees of unsaturation and hydroxylation. A chemometric analysis of their relative abundances showed that the main difference among individuals of different ages was the content of sulfatides with odd-numbered fatty acid chains, in addition to hydroxylated species.

Apolipoprotein E genotype is not associated with cardiovascular disease in heterozygous subjects with familial hypercholesterolemia.

BACKGROUND: Familial hypercholesterolemia (FH) is a genetic disorder characterized by high low-density lipoprotein cholesterol levels and premature cardiovascular disease (CVD). There are important differences in the presence of CVD among heterozygous subjects with FH. Some of this variability can be explained by genetic factors, and the apolipoprotein (apo) E genotype has been proposed as a useful marker. METHODS: We analyzed the apo E genotype in 706 non-related subjects who were heterozygous for FH from Spain. CVD was present in 198 subjects (28%), 132 men (41%) and 66 women (17%). RESULTS: Apo E allele frequencies for the epsilon 3, epsilon 4, and epsilon 2 alleles were 0.89, 0.09, and 0.02 respectively. Age, body mass index, smoking status, high blood pressure, diabetes mellitus, presence of tendon xanthomas, total cholesterol level, triglyceride levels, high-density lipoprotein cholesterol level, low-density lipoprotein cholesterol level, and Lp(a) did not differ among genotypes. The incidence of CVD and the age of onset of CVD did not differ among genotypes either. In the multivariant analysis, apo E genotype did not contribute significantly to CVD. CONCLUSIONS: Heterozygous men with FH have a very high risk of coronary disease in a Mediterranean country, and the apo E genotype in this large group of adults with FH is not associated either with CVD or lipid values, in contrast with the established effect in the general population.

Características de la esfera sexual en pacientes adultos mayores / Characteristics of the sexual sphere in elderly patients

OBJETIVO: La sexualidad desempeña un papel fundamental en nuestras vidas pero hay pocas investigaciones sobre este tema con muestras representativas. Nuestro estudio persigue analizar los conocimientos y las características sobre la función sexual en personas mayores de 60 años. MATERIAL Y MÉTODOS: Se realizó estudio observacional de tipo transversal. La muestra estuvo formada por mayores de 60 años que acudieron de manera voluntaria a charlas de educación para la salud sobre sexualidad celebradas en centros de mayores de ámbito urbano. Antes de la charla se les entregó una encuesta para valorar sus hábitos y prácticas sexuales. Se impartió la charla sobre sexualidad y posteriormente se entregó una encuesta relacionada con conceptos tratados durante la charla. Los datos de las encuestas se recogieron en hojas de cálculo en Microsoft Office Excel para Windows y el análisis estadístico fue realizado con el paquete estadístico SPSS. RESULTADOS: Los resultados muestran que la actividad sexual es importante en los mayores de 60 años, un 52,53% de los encuestados mantienen relaciones. Más del 70% de los adultos mayores de 60 años refieren tener atractivo sexual a su edad. Hubo conceptos sobre sexualidad que no quedaron claros tras la charla. CONCLUSIÓN: Nuestra sociedad sufre un envejecimiento progresivo implicando a los grupos de edad avanzada en la educación sexual, haciendo hincapié en los cambios a nivel sexual que implica la edad. Es importante la puesta en marcha de sesiones formativas de educación para la salud con contenido sobre sexualidad y refuerzo de imagen corporal en población adulta mayor

OBJECTIVE: Sexuality plays a fundamental role in our lives, but there is little research on this subject with representative samples. This study aims to analyse the knowledge and characteristics of sexual function in people over 60 years of age. MATERIAL AND METHODS: An observational cross-sectional study was carried out. The sample consisted of people over 60 years of age who voluntarily attended health education talks on sexuality held in urban centres for the elderly. Before the talk, they were given a questionnaire to assess their sexual habits and practices. The talk on sexuality was given, and a questionnaire related to the concepts mentioned while the talk was delivered. The data from the questionnaires were collected on spreadsheets in Microsoft Office Excel for Windows, and the statistical analysis was performed with the statistical package SPSS. RESULTS: The results show that sexual activity is important in those over sixty years, with 52.53% of respondents having relationships. More than 70% of adults over 60 refer to being sexually attractive for their age. There were concepts about sexuality that were not clear after the talk. CONCLUSION: Our society is experiencing progressive aging involving the elderly groups in sex education, emphasising the changes at the sexual level implied by age. It is important to start training sessions on health education with content on sexuality and body image reinforcement in the elderly population

La consulta no presencial como herramienta de mejora de la consulta a demanda en atención primaria / Tele-medicine consultation as a tool to improve the demand for consultation in Primary Care

Objetivo: Existe en el momento actual una fuerte presión asistencial en las consultas de atención primaria, y esto compromete de forma importante la accesibilidad y el tiempo dedicado al paciente. Este trabajo analiza la puesta en marcha de un servicio de consulta no presencial mediante consulta telefónica y correo electrónico. Materiales y métodos: Se revisaron retrospectivamente las consultas telefónicas y de correo electrónico realizadas durante un año. Se analizó el perfil de pacientes, tipo de consulta realizada, necesidad de visita presencial y recepción de documentación adjunta. Resultados: Se recibieron 884 consultas no presenciales en 12meses. La consulta no presencial supuso un 13,56% de las consultas a demanda. La edad media fue de 54años (DE: 17). El 87,7% de las consultas fueron realizadas por los pacientes y el resto por familiares o cuidadores. El tiempo dedicado por paciente en consulta a demanda presencial fue de 10,24min y la lista de espera menor de 48h fue del 97% de los días del año. En 24 ocasiones (2,71%) el paciente tuvo que acudir de forma presencial. Conclusiones: La consulta no presencial proporciona un recurso útil para la mejora de la accesibilidad y para generar más tiempo de consulta presencial. Además, ha demostrado que es capaz de resolver problemas de diversa clase y en distintos grupos de edad

Objective: Currently, there is a strong healthcare pressure on resources in Primary Care clinics. This significantly compromises the accessibility and the time dedicated to the patient. This paper analyses the implementation of a tele-medicine service using telephone and e-mail consultations. Materials and methods: The telephone and e-mail consultations carried out during one year were reviewed retrospectively. The patient profile, the type of consultation carried out, the need for a face-to-face visit, and the receipt of attached documentation were analysed. Results: A total of 884 distance consultations were received in a 12month period. The distance consultation accounted for 13.56% of consultations on demand. The mean age of the patient was 54 (SD: 17) years old. The large majority (87.7%) of the consultations were made by the patients and the rest by relatives or caregivers. The time spent per patient in the face-to-face consultation was 10.24minutes and the waiting list was less than 48hours on 97% of the days of the year. The patient had to go in person on 24 (2.71%) occasions. Conclusions: Distance consultation is a useful resource for improving accessibility, as well as leading to more physical consultation time. It has also demonstrated that it is capable of solving problems of different kinds and in different age groups

Risk factors for postoperative infections in patients with hip fracture treated by means of Thompson arthroplasty.

Specific conditions associated with surgery may predispose elderly people to septic complications after hip fracture surgery. This study investigated the risk factors predisposing infection in aged patients with subcapital hip fracture. We performed a prospective study of 290 patients with displaced subcapital hip fracture, operated by means of Thompson hip hemi-arthroplasty (83.5% fractures in women). The mean age was 85.42+/-6.06 years (ranging from 69 to 104). Follow-up was realized until death or at least for 2 years. The chi(2) test, analysis of variance, Kruskal-Wallis test, correlation analysis and the Spearman test were applied. Odds ratios (OR) were calculated. During the hospital stay, there were diagnosed 94 urinary tract infections, 25 pneumonias, 50 superficial wound infections, 11 deep wound infections. Transfusions were made in 120 patients (in average: 2.54+/-1.45 units of red cell concentrate/transfused patient). Transfusion appeared to be correlated with superficial wound infection (OR=1.96), urinary infection (OR=1.76) and pneumonia (OR=2.85). Higher number of days waiting for surgery were related significantly with pneumonia (9.8+/-7.44 days vs. 6.39+/-3.75), or urinary tract infection (7.76+/-4.39 days vs. 6.17+/-4.14). We concluded that the transfusion and longer waiting time for surgery have been associated with the septic complications in elderly patients treated surgically for hip fracture.

A study on partially biodegradable microparticles as carriers of active glycolipids.

This paper describes a study on the preparation and characterisation of partially biodegradable microparticles of poly(epsilon-caprolactone)/poly(ethyl methacrylate) (PCL/PEMA) as carriers of synthetic glycolipids with antimitotic activity against brain tumour cells. Microparticles prepared by suspension polymerisation of methacrylate in the presence of already polymerised PCL showed a predominantly spherical but complex morphology, with segregation of PCL micro/nano-domains towards the surface. Small diameter discs were prepared by compression moulding of blends of microparticles and the active principle under mild conditions. The in vitro behaviour of the discs and release of the glycolipid were studied in different simulated fluid models. Ingress of fluids increased with increasing hydrophobicity of the medium. Release of the glycolipid was sustained in all fluids, the most prolonged profile being in human synovial fluid and phosphate-buffered saline modified with 20 vol.% dioxane. Slow disintegration of the discs and partial degradation of the microparticles was evident in accelerated studies. The antimitotic activity of glycolipid released from the discs was proved against a human glioblastoma line. This activity, along with selectivity against human fibroblasts, could be controlled by the amount of drug charged in the disc.

Sustratos electrohilados de poli(hidroxibutirato-co-hidroxihexanoato) con glicósidos para reparación de la lesión medular / Glycosides-bearing electrospun poly(hydroxybutyrate-co-hydroxyhexanoate) substrates for the repair of injured spinal cord

Objetivo: Obtención mediante electrohilado de fibras micro- y submicrométricas de poliésteres funcionalizadas con glicósidos que constituyen elementos estructurales de proteoglicanos, para su uso en la reparación del tejido medular. Material y métodos: Las fibras se prepararon a partir de disoluciones de poli(3-hidroxibutirato-co-3-hidroxihexanoato) con glicósidos sintéticos mediante electrohilado variando sistemáticamente las condiciones del proceso. La morfología de las fibras fue analizada mediante microscopía electrónica de barrido. Asimismo, se evaluó la estabilidad de la interacción entre el glicósido y la fibra en medio acuoso, y su toxicidad en cultivos de células neurales. Resultados: La morfología de las fibras obtenidas depende principalmente de los parámetros de la disolución. En medio acuoso, el glicósido sulfatado se liberó de las fibras más lentamente que el que no tenía dicho grupo funcional. La viabilidad de las células neurales no se vio afectada por los glicósidos. Conclusión: La preparación de microfibras alineadas de poliéster funcionalizadas con glicósidos es posible. La mayor parte del glicósido permanece retenido en las fibras sumergidas en agua después de varios días. El electrohilado es una técnica muy accesible y versátil para la fabricación de soportes en estrategias de terapia celular de lesiones medulares (AU)

Objective: Preparation of functionalized micro- and submicrofibers by electrospinning of polyesters with glycosides which are structural elements of proteoglycans, for application to the repair of spinal cord lesions. Material and methods: Solutions of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) with synthetic glycosides were prepared varying systematically the processing conditions. Fiber morphology assessed by scanning electron microscopy. The stability of the interaction between the glycoside and the polymer fiber was evaluated in aqueous medium, and their toxicity in cultures of neural cells. Results: The fiber morphology was altered mainly by the solution parameters. In aqueous medium, the glycoside with a sulfate group was released from fibers at slower rate than the non-sulfated glycoside. The viability of neural cells was not affected by the glycosides. Conclusion: It is possible to fabricate aligned polyester micro fibers with glycosides. Most of the glycoside present in the fibers remains in the substrate after extraction in water for several days. Electrospinning is a very accessible and versatile technique for application to strategies of cellular therapy in spinal cord injuries (AU)

Polymeric drugs based on bioactive glycosides for the treatment of brain tumours.

Polymeric drugs carrying glycolipids have been designed as target macromolecules for the treatment of brain tumours. A methacrylate derivative of oleyl 2-acetamido-2-deoxy-alpha-D-glucopyranoside (OAGMA) has been prepared and the corresponding glycopolymer obtained by free radical polymerisation. To modulate the hydrophobic character of the polymeric drug, the acrylic glycomonomer was copolymerised with vinyl pyrrolidone (VP). Reactivity ratios obtained by performing copolymerisation reactions inside the NMR apparatus were r(OAGMA)=5.94 and r(VP)=0.01, indicating the much higher reactivity of the glycomonomer. The hydrolytical release of oleyl 2-acetamido-2-deoxy-alpha-D-glucopyranoside (OAG) from the copolymeric drugs was produced in vitro by the ester enzymatic hydrolysis using enzyme/buffered solutions. The cytotoxicity of OAG and OAGMA tested against a human glioblastoma line and normal fibroblasts revealed a concentration dependent selectivity towards tumour cells versus fibroblasts. The antimitotic activity of the copolymeric drugs was also confirmed. The addition of the eluates of the copolymeric systems collected at 1 and 2 days produced a significant decrease in cellular viability of the glioblastoma cells without affecting that of normal fibroblasts. On the contrary, fibroblasts were able to adhere and proliferate onto the copolymeric systems showing normal morphology and revealing a good biocompatibility of the copolymeric drugs against healthy cells.

Estado inmunológico de ancianos candidatos a artroplastia tras fractura subcapital de cadera: estudio de su relación con la edad y con la morbimortalidad postoperatoria* / Immunological status of elderly patients eligible for arthroplasty after a femoral neck fracture: relationship between the patients' status, their age and postoperative morbimortality

Objetivo. Analizar la relación de la situación inmunológica preoperatoria tras fractura subcapital de cadera con las complicaciones postoperatorias. Material y método. Estudio prospectivo aleatorio de 94 pacientes (81 mujeres) con fractura subcapital de cadera Garden IV (edad media: 82,9 años (± 7,48), máximo: 100, mínimo: 64 años). Al ingreso se determinó en sangre venosa periférica: fórmula leucocitaria, inmunoglobulinas (IgG, IgA, IgM e IgE), CD19, CD3, CD4, CD8, niveles de transferrina, alfa-2-macroglobulina, ceruloplasmina, proteína transportadora de retinol, prealbúmina, albúmina, proteínas totales, colesterol total y triglicéridos. Se estudiaron las complicaciones postoperatorias. En la estadística se realizó análisis de la varianza y Chi cuadrado. Resultados. Se detectaron 12 casos de infección de la herida quirúrgica, 27 casos de infección de orina, 3 casos de neumonía y una infección periprotésica. Los pacientes con infección postoperatoria presentaron en el preoperatorio menores niveles de IgM (infección de orina y neumonía), de IgA (neumonía) y de IgE (infección de la herida), menor número de CD4 y CD8/mm3 (infección de orina y neumonía) y un menor porcentaje de CD19 (infección de herida). La albúmina, la prealbúmina, el colesterol total, los triglicéridos y la transferrina disminuyeron significativamente con la edad. Conclusiones. La IgM, la IgA, la IgE, el porcentaje de CD19 y el número de CD4 y CD8 podrían servir como indicadores de un mayor riesgo de desarrollar infecciones durante el postoperatorio de una fractura subcapital de cadera

Purpose. To analyze the relationship between a patient's immunological status prior to arthroplasty secondary to a femoral neck fracture and postoperative complications. Materials and methods. Prospective randomized study of 94 patients (81 of which female) with a Garden IV femoral neck fracture (mean age: 82.9 years (± 7.48), range: 100-64). On admission, the following parameters were evaluated in the patients' peripheral venous blood: differential leukocyte count; inmunoglobulin (IgG, IgA, IgM and IgE); percentage of CD19, CD3, CD4 and CD8; transferrin levels; alfa-2-macroglobulin; ceruloplasmin; retinol transport protein; prealbumin; albumin; total proteins; total cholesterol and triglycerides. Postoperative complications were studied. Statistics: Variance and chi square analysis. Results. There were twelve cases of surgical wound infection, 27 of urinary infection, 3 cases of pneumonia and one periprosthetic infection. Patients with a postoperative infection had lower preop levels of IgM (urinary infection and pneumonia), IgA (pneumonia) and IgE (wound infection), as well as a lower count of CD4 and CD8 per cubic mm (urinary infection and pneumonia) and a lower percentage of CD19 (wound infection). Albumin, prealbumin, total cholesterol, triglycerides and transferrin decreased significantly with age. Conclusions. The IgM, IgA, IgE, the CD19 percentage and CD4 and CD8 counts could be used indicators of a higher risk of developing infections after surgery for a femoral neck fracture (AU)

Perfil psicosocial de las personas mayores de una muestra de Valladolid / Profile psychosocial of grown-ups a sample of Valladolid

El tema central de nuestro estudio es analizar el perfil psicosocial de los mayores de una muestra de Valladolid para de esta forma ver qué tipo de ayudas tanto desde el punto de vista psicológico como social son necesarias para que en la medida de lo posible este colectivo tan numeroso y representativo de nuestra sociedad pueda alcanzar el mayor bienestar posible. Las personas mayores entrevistadas han proporcionado una información muy interesante sobre su estado de salud que, contrariamente a lo que en principio pudiera parecer, más de la mitad de los encuestados afirma encontrarse muy bien o bastante bien de salud, aunque es significativamente mayor el número de mayores institucionalizados que tienen problemas de salud. También mas de la mitad de los mayores afirman no necesitar ayuda para la realización de las actividades de la vida diaria, necesitando más ayuda las personas institucionalizadas. Las relaciones familiares en la mayoría de los mayores encuestados son buenas, no encontrándose diferencias significativas entre las relaciones familiares y la institucionalización. Casi la mitad de los mayores entrevistados no han cursado estudios, y si lo han hecho se trata de estudios primarios, solamente un porcentaje muy pequeño ha cursado estudios superiores. Pero lo más significativo y preocupante es el alto porcentaje de analfabetismo encontrado en nuestra muestra, sobre todo en mayores de 80 años, lo que indica que el nivel cultural va aumentando en los más jóvenes. El principal temor que muestran los mayores es la enfermedad, seguido de la soledad y la idea de ser una carga para los demás, y también es importante saber que hay un porcentaje considerable que no teme a nada. También observamos en nuestra muestra cómo al llegar a edades maduras se suele cambiar la escala de valores encontrando un sentido diferente a la existencia. Más de la mitad de los mayores encuestados consideran que viven por voluntad de Dios, siendo este porcentaje más elevado en personas institucionalizadas. Además, su principal problema es la soledad y no poder hacer vida familiar, seguido de la salud. La gran demanda del mayor es la acogida familiar; el deseo de más de la mitad de los mayores sería poder vivir con su familia en los últimos años de su vida. El resto de los problemas, como el económico, la edad, pasan a un segundo plano. Todos estos resultados obtenidos en nuestro trabajo son útiles para saber las necesidades, preocupaciones y problemas reales y prioritarios de los mayores en nuestra provincia (AU)