Quality of life in elderly people after a hip fracture: a prospective study.

BACKGROUND: Hip fracture is an important social and medical problem due to its increasing prevalence, the consequences for health and the economic impact on the health care system, but there is no doubt that it also has repercussions on health-related quality of life (HRQoL). Hence the importance of understanding and determining the impact of the condition on everyday life from the perspective of the patient's physical, emotional and social well-being. PURPOSE: To determine the impact of hip fracture on HRQoL of people over the age of 65 1 month after surgery, related factors and the effects on functional ability and mood. METHODS: Prospective observational study conducted in the traumatology units of two university hospitals in the province of Cáceres with consecutive sampling of all patients over the age of 65 admitted for hip fracture surgery during the study period. Sociodemographic and clinical data were recorded at the time of admission and prospectively at the follow-up visit 1 month later. Clinical, social, quality of life (EQ-5D-), basic functional and instrumental capacity (Barthel Index (BI) and Lawton & Brody Scale), and geriatric depression (Yesavage) variables were collected. RESULTS: The study included 224 patients with a median age of 84.6 years (SD ± 6.1), 76.3% were female. Charlson's comorbidity was 5.3 (SD ± 1.2). The EQ-5D index decreased from 0.62 (SD ± 0.35) to 0.16 at 1 month follow up (SD ± 0.20) p <  0.001. The mean Visual Analog Scale (VAS) score of EQ-5D decreased from 72.8 (SD ±15.8) to 48.3 (SD ± 17.2) p <  0.001. All dimensions of EQ-5D showed a significant reduction from the time of pre-fracture status to 1 month after surgery. Independent factors associated with HRQoL 1 month after surgery were pre-fracture status Barthel Index score, Lawton and Brody scale, presence of depression, and type of surgery. CONCLUSIONS: After a hip fracture, patients experience considerable deterioration in their HRQoL, especially in self-care, daily activities, and mobility. There is also a significant decline in functional capacity for both the basic and instrumental activities of daily living. One month after surgery, HRQoL is a long way from pre-fracture levels.

Controlling Nutritional Status (CONUT) Score as a Predictor of All-Cause Mortality at 3 Months in Stroke Patients.

Malnutrition is frequently observed in patients after stroke and is associated with poor outcomes. Patients at risk of malnutrition may be identified with several nutrition screening tools, but no nutritional screening tool has been validated for use with stroke patients. The aim of this study was to explore the ability of the Controlling Nutritional Status (CONUT) score to predict 3-month mortality in stroke patients. METHOD: Patients were recruited from consecutive admissions at a hyperacute stroke unit and were screened for risk of malnutrition (light, moderate, or severe) using CONUT scores. At the next visit, 3-month outcomes were obtained. RESULTS: Of the 164 recruited patients, 51.2% were male. Mean patient age was 77.7 (SD = 7.0) years, and 85.8% of patients had an ischemic stroke. There was a significant difference in the survival rate (p < .001) at 3 months between patients with moderate risk for malnourishment compared to the other patients. The multivariate regression Cox model showed that moderate risk of malnourishment, according to the CONUT score, increased the risk for death at 3 months (hazard ratio = 1.086; 95% CI [1.057, 8.305]; p < .039). CONCLUSION: The CONUT score has predictive validity for all-cause mortality in stroke patients after 3 months, both in hospital and after discharge. Further prospective multicenter studies with larger samples are needed to clarify the usefulness of the CONUT score in the prognosis of all-cause mortality in stroke patients.

Evolución de la tentativa suicida atendida por los Servicios de Emergencias Médicas de Castilla-La Mancha tras la crisis económica / Attempted suicides attended by emergency services during the economic recession in Castile-La Mancha, Spain

Objetivo: Investigar la evolución de la tentativa suicida en Castilla La Mancha entre 2006 y 2015, y su correlación con factores sociodemográficos y económicos. Método: Estudio de una serie de casos incidentes de tentativa suicida atendidos por los Servicios de Emergencias Médicas de Castilla La Mancha entre 2006 y 2015. Se recogieron el número de incidentes y variables demográficas, sociales y económicas. Las tasas fueron estandarizadas de manera directa, tomando como referencia al total de población de la región. El impacto del cambio temporal de las tasas se estudió con modelos de Poisson segmentados. La correlación con los indicadores económicos se evaluó con el coeficiente de correlación de Pearson. Resultados: Se atendieron 1.308 incidentes de tentativa suicida, de los cuales 711 (55,8%) fueron en mujeres. La distribución global reveló máximos entre los años 2007 y 2013. Se obtuvo una razón de tasas estandarizadas un 23% mayor en las mujeres que en los hombres, un 10% más en Toledo que en Albacete, y un 20% mayor en 2007-2008 y un 30-40% mayor entre 2012-2015 que previamente a la crisis. La tasa fue mayor en las cohortes en edad laboral. La tasa se correlacionó principalmente con las tasas de hogares con dificultad para llegar a fin de mes (0,29 p < 0,01), riesgo de pobreza/exclusión regional (0,285, p<0,01) y paro regional (0,265, p<0,01). Conclusiones: La tasa de tentativa suicida se ha incrementado durante la crisis económica. La tasa muestra una correlación variable con indicadores socioeconómicos

Objective: To investigate changes in attempted suicide rates in Castile-La Mancha between 2006 and 2015 and the correlation with sociodemographic and economic indicators. Methods: Study of attempted suicides attended by the emergency medical services of Castile-La Mancha between 2006 and 2015. We obtained records of the number of incidents and recorded sociodemographic and economic variables. Rates were standardized by direct reference to regional population figures, and change over time was studied by means of segmented Poisson regression models. The correlation with economic indicators was assessed with the Pearson correlation coefficient. Results: A total of 1308 attempted suicides were attended; 711 (55.8%) were made by women. The years 2007 and 2013 saw the highest numbers of attempts. The population-standardized suicide rates were 23% higher in women than in men, 10% higher in Toledo than in Albacete, 20% higher in 2007-2008 and 30% to 40% higher between 2012 and 2015 than before the crisis began. Rates were higher in age brackets in which employment is usual. Rates correlated most strongly with economic strain (difficulty making it to the end of the monthly pay cycle) (r=0.29, P<.01), risk of poverty/exclusion in the region (r=0.285, P<.01), and the unemployment rate in the region (r=0.265, P<.01). Conclusions: Suicide rates rose during the economic recession. There were variable correlations between socioeconomic indicators and attempted suicide rates

Olive Oil Consumption and Bone Microarchitecture in Spanish Women.

Olive oil has been demonstrated to enhance various cardiometabolic risk factors. However, to our knowledge, the association between olive oil intake and cortical and trabecular bone microarchitecture has never been evaluated in Spanish women. We aimed to examine the association between olive oil intake and cortical and trabecular bone microarchitecture. We analyzed 523 women aged 50 (9) year, range (23⁻81) year. Participants underwent dual-energy X-ray absorptiometry and peripheral quantitative computed tomography scans. Dietary intake of calcium, vitamin D, energy and olive oil (g/day) were assessed by a self-administered food frequency questionnaire (FFQ). After adjustment for potential confounding factors (calcium (mg/day), vitamin D (µg/day) energy (Kcal/day), age, body mass index (BMI) (kg/m²), menopausal status, and osteoporotic diagnosis (normal, osteopenia, or osteoporosis)), there were significant increases in volumetric bone mineral density (vBMD) (mg/cm³) (p < 0.01) in the group with a higher intake of olive oil. Total, trabecular and cortical bone density were positively correlated with olive oil intake. The dietary intake of olive oil was significantly associated with vBMD in multiple regression analysis; total density: olive oil intake (g/day) standardized ß = 0.185 (p < 0.001), trabecular density: olive oil intake (g/day) standardized ß = 0.186 (p < 0.001) and cortical density olive oil intake (g/day) standardized ß = 0.114 (p = 0.008). We conclude that the dietary intake of olive oil is positively associated with a better vBMD in Spanish women.

Attempted suicides attended by emergency services during the economic recession in Castile-La Mancha, Spain. / Evolución de la tentativa suicida atendida por los Servicios de Emergencias Médicas de Castilla-La Mancha tras la crisis económica.

OBJECTIVES: To investigate changes in attempted suicide rates in Castile-La Mancha between 2006 and 2015 and the correlation with sociodemographic and economic indicators. MATERIAL AND METHODS: Study of attempted suicides attended by the emergency medical services of Castile-La Mancha between 2006 and 2015.We obtained records of the number of incidents and recorded sociodemographic and economic variables. Rates were standardized by direct reference to regional population figures, and change over time was studied by means of segmented Poisson regression models. The correlation with economic indicators was assessed with the Pearson correlation coefficient. RESULTS: A total of 1308 attempted suicides were attended; 711 (55.8%) were made by women. The years 2007 and 2013 saw the highest numbers of attempts. The population-standardized suicide rates were 23% higher in women than in men, 10% higher in Toledo than in Albacete, 20% higher in 2007-2008 and 30% to 40% higher between 2012 and 2015 than before the crisis began. Rates were higher in age brackets in which employment is usual. Rates correlated most strongly with economic strain (difficulty making it to the end of the monthly pay cycle) (r=0.29, P<.01), risk of poverty/exclusion in the region (r=0.285, P<.01), and the unemployment rate in the region (r=0.265, P<.01). CONCLUSION: . Suicide rates rose during the economic recession. There were variable correlations between socioeconomic indicators and attempted suicide rates.

OBJETIVO: Investigar la evolución de la tentativa suicida en Castilla La Mancha entre 2006 y 2015, y su correlación con factores sociodemográficos y económicos. METODO: Estudio de una serie de casos incidentes de tentativa suicida atendidos por los Servicios de Emergencias Médicas de Castilla La Mancha entre 2006 y 2015. Se recogieron el número de incidentes y variables demográficas, sociales y económicas. Las tasas fueron estandarizadas de manera directa, tomando como referencia al total de población de la región. El impacto del cambio temporal de las tasas se estudió con modelos de Poisson segmentados. La correlación con los indicadores económicos se evaluó con el coeficiente de correlación de Pearson. RESULTADOS: . Se atendieron 1.308 incidentes de tentativa suicida, de los cuales 711 (55,8%) fueron en mujeres. La distribución global reveló máximos entre los años 2007 y 2013. Se obtuvo una razón de tasas estandarizadas un 23% mayor en las mujeres que en los hombres, un 10% más en Toledo que en Albacete, y un 20% mayor en 2007-2008 y un 30-40% mayor entre 2012-2015 que previamente a la crisis. La tasa fue mayor en las cohortes en edad laboral. La tasa se correlacionó principalmente con las tasas de hogares con dificultad para llegar a fin de mes (0,29 p < 0,01), riesgo de pobreza/exclusión regional (0,285, p < 0,01) y paro regional (0,265, p < 0,01). CONCLUSIONES: La tasa de tentativa suicida se ha incrementado durante la crisis económica. La tasa muestra una correlación variable con indicadores socioeconómicos.

Mechanical properties and ultrastructural characteristics of a glass fiber-reinforced composite.

PURPOSE: To examine the ultrastructural characteristics of a fiber-reinforced composite (FRC) and its behavior in vitro as a framework for fixed partial dentures (FPDs). METHODS: A total of 40 specimens were prepared using extracted teeth fixed in methacrylate blocks as supports for the FPD, then the specimens were divided into four groups depending on whether a retaining box was used to fix the FPD to the support teeth, and on whether a composite pontic was assembled on top of the fibers. Fracture testing was performed in a universal testing machine (1 mm/minute). Fracture strength values and failure types were statistically compared for each group. RESULTS: Using retaining boxes did not improve the mechanical behavior of the restorative system. The weakest element of the system was the composite tooth constructed on top of the FRC.