The Alusti Test, a Functional Assessment Scale Applicable to the Geriatric Population.

INTRODUCTION: Decreases in functional ability generate dependence, limiting people's quality of life. Assessment tools are needed to evaluate functional abilities of the older adults that can objectively and accurately assess any type of user. Such proper or adapted tools are not always available. The aim of this study was to demonstrate the usefulness and universal application of the Alusti Test, a functional assessment scale, in the older population and to evaluate the sensitivity to change of the Alusti Test short version (Alusti-S) in a psychogeriatric hospitalized population. METHODS: Longitudinal study was conducted in a psychogeriatric clinic in Navarra, Spain. The study sample comprised 539 persons of 65 years and older hospitalized at a psychogeriatric clinic (mean age 82.8 ± 7.3 years). The sensitivity to change was assessed upon admission and discharge through the application of three tests: Barthel Index, Complete Alusti Test, and Alusti-S. RESULTS: We verified sensitivity to change, as illustrated by an improvement of 24.7%, 13.8%, and 16.0%, respectively. Due to the greater functional deterioration upon admission, the improvement margin in the three tests was higher in patients over 85 years of age and in women. CONCLUSION: We consider the Alusti Test an innovative functional assessment tool due to its simplicity, sensitivity, and suitability to universal application in psychogeriatric populations. Correlating recommended physical activity based on the functional ability of the person, based on the Alusti Test, is a pending task that could be of interest for the sake of efficient interventions.

[Alusti test as a premonitory variable of adverse health events in a nursing home. Two-years follow-up]. / Test Alusti como variable premonitoria de procesos adversos de salud en una residencia de mayores. Seguimiento a 2 años.

INTRODUCTION: Functional capacity is a good indicator of health, quality of life, and a good predictor of morbimortality. It is a priority to functionally assess the geriatric population through objective, precise, and simple instruments. The Alusti Test in its two versions, complete (TA) and abbreviated (TAA), is a scale that meets these criteria. OBJECTIVE: To determine the usefulness of the Alusti Test as a predictor of adverse health events: falls, hospitalizations, cognitive deterioration, and mortality in the elderly institutionalized population, with a two-year follow-up. MATERIAL AND METHODS: This observational study's sample included 176 persons admitted to a nursing home for 32months, with a mean age of 85.5years. The TA was performed on 138 and the TAA on 38. RESULTS: The ratio of falls is much higher in residents with mild dependence than in those with total dependence (P<.001). Hospitalizations increase as the results of the Alusti Test are more favorable. The risk of hospitalization in dependent patients is 50% lower (P<.001) than in those with preserved mobility. Cognitive impairment is similar in all the populations with some mild-moderate level of functional dependence and decreases in the population with preserved mobility. Categorization as total and mild/severe dependence is related to a 3-4times higher mortality at six months follow-up. CONCLUSIONS: A higher mild-moderate level of dependence on the AT correlates with a lower risk of falls, a lower rate of hospitalization, and a higher risk of mortality at six months.

Case-control study of arsenic in drinking water and kidney cancer in uniquely exposed Northern Chile.

Millions of people worldwide are exposed to arsenic in drinking water. The International Agency for Research on Cancer has concluded that ingested arsenic causes lung, bladder, and skin cancer. However, a similar conclusion was not made for kidney cancer because of a lack of research with individual data on exposure and dose-response. With its unusual geology, high exposures, and good information on past arsenic water concentrations, northern Chile is one of the best places in the world to investigate the carcinogenicity of arsenic. We performed a case-control study in 2007-2010 of 122 kidney cancer cases and 640 population-based controls with individual data on exposure and potential confounders. Cases included 76 renal cell, 24 transitional cell renal pelvis and ureter, and 22 other kidney cancers. For renal pelvis and ureter cancers, the adjusted odds ratios by average arsenic intakes of <400, 400-1,000, and >1,000 µg/day (median water concentrations of 60, 300, and 860 µg/L) were 1.00, 5.71 (95% confidence interval: 1.65, 19.82), and 11.09 (95% confidence interval: 3.60, 34.16) (Ptrend < 0.001), respectively. Odds ratios were not elevated for renal cell cancer. With these new findings, including evidence of dose-response, we believe there is now sufficient evidence in humans that drinking-water arsenic causes renal pelvis and ureter cancer.

[Evaluation and impact on the use of information and communication technology in the clinical management and agreed shared monitoring of pressure ulcers]. / Evaluación e impacto del uso de las tecnologías de la información y comunicación para la gestión clínica y seguimiento compartido y consensuado de las úlceras por presión.

OBJECTIVE: Tackling the huge problem of Pressure Ulcers (PU), involves looking for new recording methods and strategies, as well as the standardization of the assessment and intervention criteria. In this context, a specific software application for PU management has been developed and was used for assessing its acceptability, usefulness and applicability by professional nurses from three residential homes for the elderly over a period of one year. MATERIAL AND METHODS: A software application is designed and evaluated. This software application allows health professionals to: Manage and monitor PUs.; to determine the risk of PUs; and perform a nutritional status screen, based on a comprehensive data collection, processing and interpretation. It also allows health professionals to exchange data between themselves and at different care levels, which could provide a new approach based on the use of ICT as a tool for an agreement to shared care. This approach has an important journey ahead in terms of its assessment, to which we attempt to contribute through this article. RESULTS: Three centres and 69 residents are taking part in this project. During these processes, 27 nutritional status screens and 22 PU risk assessments, as well as the monitoring of 230 PUs have been performed. CONCLUSIONS: Nurses professionals think that the system is useful, easy to use, and perceive that it improves patient monitoring, but not relationship between professionals. Moreover, they would like to makethe web a more powerful part of the application and to speed up the procedures.

Respiratory disease and particulate air pollution in Santiago Chile: contribution of erosion particles from fine sediments.

Air pollution in Santiago is a serious problem every winter, causing thousands of cases of breathing problems within the population. With more than 6 million people and almost two million vehicles, this large city receives rainfall only during winters. Depending on the frequency of storms, statistics show that every time it rains, air quality improves for a couple of days, followed by extreme levels of air pollution. Current regulations focus mostly on PM10 and PM2.5, due to its strong influence on respiratory diseases. Though more than 50% of the ambient PM10s in Santiago is represented by soil particles, most of the efforts have been focused on the remaining 50%, i.e. particulate material originating from fossil and wood fuel combustion, among others. This document emphasizes the need for the creation of erosion/sediment control regulations in Chile, to decrease respiratory diseases on Chilean polluted cities.

[Falls in nursing homes and institutions: update by the Osteoporosis, Falls and Fractures Working Group of the Spanish Society of Geriatrics and Gerontology (GCOF-SEGG)]. / El fenómeno de las caídas en residencias e instituciones: revisión del Grupo de Trabajo de Osteoporosis, Caídas y Fracturas de la Sociedad Española de Geriatría y Gerontología (GCOF-SEGG).

The Workshop on Osteoporosis, Falls and Fractures (GCOF) of The Spanish Geriatrics and Gerontology Society (SEGG) formed a committee in order to review the state of the art on the detection, risk factors and assessment tools for falls, and intervention protocols when falls occurs in nursing homes, long-term hospitals or medium-stay units. The different patient profiles are described in order to make a comprehensive approach to this heterogeneous topic and population, offering a risk classification and specific advice according to these categories.

Infarto cerebral: localización anatómica, manifestaciones clínicas y evolución / Cerebral infarct: anatomical location, clinical manifestations and evolution

Expone que el infarto cerebral es una entidad patológica muy frecuente y que genera un gran número de sujetos discapacitados a nivel mundial. El presente es un estudio de caos en serie en el que se revisan el sexo, las manifestaciones clínicas, la patología de base, la ubicación de la lesión y la evolución de los 442 pacientes que egresaron del Servicio de Neurología del Hospital Dr. Teodoro Maldonado Carbo con diagnóstico definitivo de Infarto Cerebral, durante el período comprendido desde el 1 de ene. 1991 hasta el 31 de dic. 1995. Se concluyó que el infarto cerebral es una patología frecuente, que en su mayoría es secundaria a hipertensión arterial y que genera un elevado índice de discapacidad.