ABSTRACT
BACKGROUND: Physical frailty is well known to be strongly associated with malnutrition, but the combined impact of physical frailty and cognitive impairment among non-demented older persons (cognitive frailty) on malnutrition prevalence is not well documented. DESIGN: Cross-sectional cohort study. SETTING AND PARTICIPANTS: Community-dwelling older Singaporeans aged ≥55y (n=5414) without dementia in the Singapore Longitudinal Ageing Study (SLAS-1 and SLAS-2). MEASUREMENTS: The Mini Nutritional Assessment - short form (MNA-SF) and Nutrition Screening Initiative (NSI) Determine Checklist were used to determine their nutritional status. Participants were categorized as cognitive normal (CN) or cognitive impaired (CI) by Mini Mental State Examination (MMSE<=23), as pre-frail (PF) (score=1-2) or frail (F) (score=3-5) using Fried's criteria, and as cognitive pre-frail (PF+CI) or cognitive frail (F+CI). RESULTS: The prevalence of cognitive frailty was 1.6%, and cognitive pre-frailty was 5.5% (total, 7.1%). The prevalence of MNA malnutrition was 2.4%, and NSI high nutritional risk was 6.3%. The prevalence of MNA malnutrition was lowest among Robust-CN and highest among Frail-CI (0.5% in Robust-CN, 0.6% in Robust-CI, 2.8% in Pre-frail-CN, 7.3% in Pre-frail-CI, 15.4% in Frail-CN, and 23.1% in Frail-CI). Similarly, the prevalence of NSI high nutritional risk was lowest in Robust-CN (3.7%) and highest in Frail-CI (13.6%). Adjusted for sociodemographic and health status, pre-frailty/frailty-CI versus Robust-CN was associated with the highest odds ratio of association with MNA malnutrition (OR=8.16, p<0.001), although not the highest with NSI high nutritional risk (OR=1.48, p=0.017). CONCLUSIONS: An extraordinary high prevalence of malnutrition was observed among older adults with cognitive frailty who should be specially targeted for active intervention.
Subject(s)
Aging/metabolism , Aging/psychology , Cognitive Dysfunction/epidemiology , Frail Elderly/psychology , Frail Elderly/statistics & numerical data , Malnutrition/epidemiology , Aged , Aged, 80 and over , Case-Control Studies , Comorbidity , Cross-Sectional Studies , Female , Geriatric Assessment , Humans , Longitudinal Studies , Male , Mental Status and Dementia Tests , Middle Aged , Nutrition Assessment , Nutritional Status , Prevalence , Singapore/epidemiologyABSTRACT
This study aimed to assess the difference in blood pressure readings between the standard and large cuff and to determine if such a difference applies over a range of arm circumferences (ACs) in pregnancy. We measured blood pressure on 219 antenatal women. Six blood pressure readings were taken, three with a standard 'adult' and three with a 'large' cuff, in random order. A random zero sphygmomanometer was used by a trained observer. Women with an AC >33 cm were similar in age, gestational age and parity but were heavier and had more hypertension than those with AC ≤33 cm. There was a systematic difference between the standard and large cuff of 5-7 mmHg with little effect due to AC. We were unable to demonstrate an association between the standard and large cuff blood pressure difference and increasing blood pressure. Our study has shown that both systolic and diastolic blood pressure measurements are more dependent on the cuff size used than AC and for the individual it is difficult to predict the magnitude of effect the different cuff sizes will have on blood pressure measurements. This study has shown the presence of an average difference in blood pressure measurement between standard and large cuffs in pregnancy, and does not support the arbitrary 33 cm 'cut-off' recommended in guidelines for the use of a large cuff in pregnancy.
ABSTRACT
Disinfectant solutions with high concentrations of alcohol are used in many operating theatres as skin preparation. We present two cases of burns as a result of accidental ignition of the solution and list precautionary measures for the use of these solutions.
Subject(s)
Alcohols/administration & dosage , Burns/etiology , Diathermy/adverse effects , Disinfectants/administration & dosage , Fires/prevention & control , Abscess/therapy , Administration, Cutaneous , Adult , Alcohols/analysis , Axilla , Disinfectants/adverse effects , Disinfectants/analysis , Female , Follow-Up Studies , Humans , Incontinence Pads , Perineum , Risk AssessmentABSTRACT
A case of Pantopaque pulmonary embolism during myelography is presented. All reported cases of venous intravasation of Pantopaque have been associated with traumatic lumbar tap, and a mechanism whereby a bloody lumbar tap causes venous intravasation and hence Pantopaque pulmonary embolism during myelography is postulated.
