Effect of COVID-19 on quality of life of persons aged >70 years with adult spinal deformity: A cross-sectional case-control study.

This observational, cross-sectional case-control study evaluates the impact of coronavirus disease 2019 (COVID-19) on health-related quality of life (HRQoL) in elderly persons who have undergone surgery for adult spinal deformity (ASD). On December 31, 2019, the Chinese authorities first reported severe acute respiratory syndrome coronavirus 2, and on March 11, 2020, it was declared a pandemic. The pandemic seems to have had a negative effect on elderly patients who underwent ASD, in terms of functional and psychological quality of life. We selected patients with ASD aged > 70 years who had undergone surgery between 2010 and 2015 and compared them with age- and sex-matched patients who did not have ASD. We recorded sociodemographic variables, type of surgery, levels of spinal fusion, HRQoL (Scoliosis Research Society-22, Short Form 12 Health Survey, EuroQol-5D [EQ-5], Geriatric Depression Scale [Yesavage] [GDS], Modified Frailty Index-11, and Barthel index), fear of visiting a health center, fear of leaving one's house, and adherence to preventive measures. The study population comprised 174 patients (mean [standard deviation] age, 77.3 [5.9] years; 86% women), of whom 87 had undergone surgery for ASD. The incidence of COVID-19 was higher in patients aged > 85 years (P = .041), urban areas (P = .047), and in patients in long-term care (P = .03). Similarly, no differences were observed for the ability to cope with the pandemic (P > .05). Patients who underwent surgery also had a higher risk of depression (GDS, 6.7 [P = .02]), a lower EQ-5 score (P = .001), a higher body mass index (P = .004), greater consumption of drugs (P < .001), especially opiates (P < .001). Patients who underwent surgery constitute a vulnerable population during the COVID-19 pandemic, with poorer quality of life and had a much higher risk of depression. They are also polymedicated and prefrail, adhere well to COVID-19 preventive measures, and do not seem to fear visiting health centers.

A Public Mental Health Study Among Iraqi Refugees in Sweden: Social Determinants, Resilience, Gender, and Cultural Context.

This public mental health study highlights the interactions among social determinants and resilience on mental health, PTSD and acculturation among Iraqi refugees in Sweden 2012-2013. Objectives: The study aims to understand participants' health, resilience and acculturation, paying specific attention to gender differences. Design: The study, using a convenience sampling survey design (N = 4010, 53.2% men), included measures on social determinants, general health, coping, CD-RISC, selected questions from the EMIC, PC-PTSD, and acculturation. Results: Gender differences and reported differences between life experiences in Iraq and Sweden were strong. In Sweden, religious activity was more widespread among women, whereas activity reflecting religion and spirituality as a coping mechanism decreased significantly among men. A sense of belonging both to a Swedish and an Iraqi ethnic identity was frequent. Positive self-evaluation in personal and social areas and goals in life was strong. The strongest perceived source of social support was from parents and siblings, while support from authorities generally was perceived as low. Self-rated health was high and the incidence of PTSD was low. A clear majority identified multiple social determinants contributing to mental health problems. Social or situational and emotional or developmental explanations were the most common. In general, resilience (as measured with CD-RISC) was low, with women's scores lower than that of men. Conclusions: Vulnerability manifested itself in unemployment after a long period in Sweden, weak social networks outside the family, unsupportive authorities, gender differences in acculturation, and women showing more mental health problems. Though low socially determined personal scores of resilience were found, we also identified a strong level of resilience, when using a culture-sensitive approach and appraising resilience as expressed in coping, meaning, and goals in life. Clinicians need to be aware of the risks of poorer mental health among refugees in general and women in particular, although mental health problems should not be presumed in the individual patient. Instead clinicians need to find ways of exploring the cultural and social worlds and needs of refugee patients. Authorities need to address the described post-migration problems and unmet needs of social support, together comprising the well-established area of the social determinants of health.

Evaluation of Dram Score as a Predictor of Poor Postoperative Outcome in Spine Surgery.

The Distress Risk Assessment Method (DRAM) was presented by Main, Wood and Hillis in 1992 as a simple means of assessing the risk of failure due to psychosocial factors in spine surgery. To our knowledge, it has not been used in our setting. The aim of this study was to analyse the usefulness of the Spanish translation of this instrument to predict poor outcomes. METHODS: A prospective blind study was conducted including 65 patients undergoing spine surgery. We created two groups of patients based on DRAM score: not distressed (NDRAM) or distressed (DDRAM). A visual analogue scale for pain and the 12-Item Short Form Health Survey (SF-12) were used at baseline, 6 weeks and 6 months. RESULTS: 24 patients were classified as DDRAM and 38 as NDRAM, with 3 patients not completing the questionnaires. The analysis found no significant differences in the demographic or clinical variables at baseline. At 6 weeks and 6 months, the NDRAM group showed improvements in low back pain (p < 0.001; p = 0.005), leg pain (p < 0.001; p = 0.017), physical health (p = 0.031; p = 0.003) and mental health (p = 0.137; p = 0.049). In contrast, in the DDRAM group, though leg pain score improved (p < 0.001; p = 0.002), there was no improvement at 6 weeks or 6 months in low back pain (p = 0.108; p = 0.287), physical health (p = 0.620; p = 0.263) or mental health (p = 0.185; p = 0.329). CONCLUSIONS: In our setting, the DRAM is a useful screening tool, and it has allowed the creation of a program between psychiatry and spine surgery.

Spinal fusion achieves similar two-year improvement in HRQoL as total hip and total knee replacement. A prospective, multicentric and observational study.

INTRODUCTION: Total hip and knee arthroplasty (THA/TKA) are surgical procedures with proven benefits. Although the literature reports outcomes of fusion of the lumbar spine comparable to those of THA/TKA in general health-related quality-of-life (HRQoL) questionnaires, functional assessment is nevertheless needed for these results to be of use in clinical practice and management. Aim of our study was to prove that lumbar spinal fusion has similar if not better outcomes than THA/TKA using intervention-specific HRQoL questionnaires and functional assessment questionnaires. MATERIALS AND METHODS: Observational, ambispective, multicentre study of three cohorts undergoing lumbar spinal fusion (n = 115), THA (n = 119) and TKA (n = 253). Patients were evaluated using the Short-Form-12 (SF-12), Harris-Hip-Score, Hospital for Special Surgery Scale (HSS) and Oswestry Low Back Pain Disability questionnaires. A minimum follow-up of two years was conducted. RESULTS: The SF-12 showed significant improvement in all groups. The SF-12 physical component summary score indicated a more severe pre-operative status (p = 0.031) in the THA cohort. The mental component summary score indicated a less severe pre-operative status in the TKA cohort (p = 0.008) and greater post-operative improvement in the TKA and THA cohorts across follow-up (six months p = 0.021; one year p = 0.012; two years p = 0.042). Functional assessment indicated greater pre-operative disability in the THA group. At two years of follow-up, functional improvement according to the Harris, HSS and Oswestry questionnaires were 152.01%, 50.07% and 41.14% respectively. CONCLUSIONS: This study demonstrates that lumbar spinal fusion and total knee and hip arthroplasty are comparable in terms of functional improvement when thoroughly studied with health, quality-of-life and functional assessment questionnaires.

Comparative study on the treatment of disc herniations / Estudio comparativo del tratamiento de las hernias discales / Estudo comparativo de tratamento de hérnias de disco

ABSTRACT Objective: To compare the results of treatment of patients with low back pain and radiculalgia resulting from disc herniation associated with disc degeneration through instrumentation with pedicle screws and dynamic rod, with root release and without diskectomy compared with other non-instrumented techniques (microdiskectomy with or without foraminotomy). Methods: This is a retrospective descriptive study of interventions for patients with herniated discs in the Traumatology and Neurosurgery that used the following variables: age, sex, type of technique, surgical time, time of evolution, degree of satisfaction, and complications. Two groups were formed: instrumentation with dynamic rods and non-instrumented techniques, comparing the results of each group. The software used was the SPSS v20.0. Results: We presented 142 interventions carried out between 2009 and 2012, 86 with dynamic instrumentation and 56 by other decompression techniques without instrumentation. No statistically significant differences were observed between age and sex groups and time elapsed until intervention. We found statistically significant differences (p=0.001) in surgical time, which was lower in the instrumented technique. No significant differences were found in complications between the techniques in both re-operations and in infections. Conclusions: In this study, we found no significant differences between the use of instrumentation with dynamic rods with respect to other non-instrumented surgical techniques in the treatment of herniated discs over 6 months of evolution or the complications and the degree of the patients' satisfaction.

RESUMEN Objetivo: Comparar los resultados del tratamiento de pacientes con lumbalgia y radiculalgia secundaria a hernia discal asociada a degeneración del disco, mediante la instrumentación con tornillos pediculares y barra dinámica, liberando la raíz sin discectomía frente a otras técnicas no instrumentadas (microdiscectomía con o sin foraminotomía). Métodos: Se ha realizado un estudio descriptivo retrospectivo de las intervenciones realizadas en pacientes con hernias discales por los servicios de Traumatología y Neurocirugía, recogiendo las siguientes variables: edad, sexo, tipo de técnica, tiempo de intervención, tiempo de evolución, grado de satisfacción y complicaciones. Se constituyeron dos grupos: instrumentación con barras dinámicas y técnicas no instrumentadas, comparando los resultados de cada grupo. Se utilizó el software SPSS v20.0. Resultados: Presentamos 142 intervenciones realizadas entre 2009 y 2012, 86 mediante instrumentación dinámica y 56 por técnicas de descompresión sin instrumentación. No se observaron diferencias estadísticamente significativas entre los grupos respecto a edad, sexo, ni tiempo de evolución hasta la intervención. Se observaron diferencias estadísticamente significativas (p = 0,001) en el tiempo de intervención, siendo menor en la técnica instrumentada. Respecto a las complicaciones de las técnicas no se hallaron diferencias significativas ni en las reintervenciones ni en las infecciones. Conclusiones: No encontramos diferencias significativas entre la utilización de instrumentación con barras dinámicas frente a otras técnicas quirúrgicas no instrumentadas en el tratamiento de las hernias discales de más de 6 meses de evolución, ni respecto a las complicaciones y ni al grado de satisfacción de los pacientes.

RESUMO Objetivo: Comparar os resultados do tratamento de pacientes com dor lombar e radiculalgia decorrente de hérnia de disco associada à degeneração do disco, por meio de instrumentação com parafusos pediculares e barra dinâmica com liberação da raiz sem discotomia em comparação com outras técnicas não instrumentadas (microdiscotomia com ou sem foraminotomia). Métodos: Foi realizado um estudo retrospectivo e descritivo de intervenções realizadas em pacientes com hérnia de disco nos serviços de Traumatologia e Neurocirurgia, empregando-se as seguintes variáveis: idade, sexo, tipo de técnica, tempo de cirurgia, tempo de evolução, grau de satisfação e complicações. Foram formados dois grupos: instrumentação com barras dinâmicas e técnicas não instrumentadas, comparando os resultados de cada grupo. O software utilizado foi o SPSS v20.0. Resultados: Apresentamos 142 intervenções realizadas entre 2009 e 2012, 86 por instrumentação dinâmica e 56 por técnicas de descompressão sem instrumentação. Não foram observadas diferenças estatisticamente significativas entre os grupos de idade, sexo e tempo de evolução até a intervenção. Constataram-se diferenças estatisticamente significativas quanto ao tempo cirúrgico (p = 0,001), sendo menor na técnica instrumentada. Com relação às complicações das técnicas, não houve diferença significativa nas re-operações nem nas infecções. Conclusões: Não foram encontradas diferenças significativas entre o uso de instrumentação com barras dinâmicas com respeito a outras técnicas cirúrgicas não instrumentadas no tratamento da hérnia de disco com mais de 6 meses de evolução nem a complicações e ao grau de satisfação dos pacientes.

Trastornos musculoesqueléticos en personal auxiliar de enfermería del Centro Polivalente de Recursos para Personas Mayores "Mixta" de Gijón - C.P.R.P.M. Mixta / Musculoskeletal disorders in nursing assistants from the Resource Polyvalent Centre for the Elderly "Mixta" Gijón - C.P.R.P.M. MIXTA

La elaboración de la Guía de Detección, Prevención e Intervención en Patologías Musculoesqueléticas ha puesto de relieve el desconocimiento que, hasta el momento, se tenía en el Centro Polivalente de Recursos para Personas Mayores Mixta de Gijón (CPR Mixta) acerca de la incidencia de trastornos musculoesqueléticos (TME) entre los trabajadores auxiliares de enfermería que desempeñan su labor profesional en este centro. Con el fin de realizar una breve y modesta aproximación a la situación actual de los TME entre los profesionales del CPR Mixta se ha llevado a cabo un cuestionario que, sin ser exhaustivo, pretende configurar el panorama actual y abrir la puerta a futuras investigaciones o estudios de las diversas categorías profesionales

The making of the Guide of Detection, Prevention and Intervention in Musculoskeletal Pathologies has shown the lack of knowledge that there's in the CPR Mixta about the incidence of musculoskeletal disorders among nursing assistants who perform their professional work in this center. In order to make a brief and modest approach to the current situation of MSDs among CPR Mixta professionals, this group has conducted a questionnaire which is intended to know the current outlook and open the door to future research or studies of the different professional categories

Sida prevención a través de la plástica / AIDS prevention through plastics

Se realizó un estudio analítico, prospectivo con los estudiantes de la academia de Artes Plásticas donde se exploraron sus conocimientos acerca del VIH _ SIDA, se les aplicó un formulario de encuesta, la cual arrojó que la edad promedio del grupo fue de 20-25 años, predominaron las encuestas evaluadas de regular y mal; lo que indicó poco conocimiento de la enfermedad, muchos encuestados desconocían que la placenta y los tatuajes son también vías de transmisión, no fue considerada la estabilidad de la pareja como aspecto importante en la prevención, hubo conocimiento con respecto a los grupos de riesgo, los estudiantes mantienen dudas sobre uso de la prueba del VIH, los encuestados no estaban conscientes de la necesidad de ayuda para evitar el contagio y diseminación del VIH. Se realizó una estrategia de intervención (conferencias, se videos, conversatorios, etc.), que logró incrementar los conocimientos de los alumnos y motivarlos a realizar mensajes de prevención a través de la plástica(AU)

An analytical prospective study with the students of the Academy of Arts the objective being to determine their knowledge of HIV/AIDS. The study was conducted by way of questionnaires, and the students being interviewed were on average, in the 20 25 age range. The majority of the questionnaires were evaluated as regular or bad. This indicated poor knowledge of that disease. Most of participants did not know that the disease can be transmitted via the placenta and also from tattoo application. An stable and faithful partner was not considered an important factor in the prevention of AIDS. The students were aware of “High risk” groups. They had doubts about the use of HIV test. Those questionnaires were not aware of the need for help in the fight to prevent the transmission and dissemination of HIV. Later an intervention strategy was employed (conferences, videos, conversations, etc). This helped to improve the student's knowledge and to motivate them to promote the message of prevention via the Arts(AU)

Utilización de residual aviar como fuente de nutrientes en cultivos de microalgas / Use of aviary residual as a source of nutrients in microalgas cultures

El residual aviar, como todos los desechos animales, es portador de variados elementos químicos, que tratados adecuadamente pueden ser utilizados como fuente de nutrientes para cultivos de microalgas. Se caracteriza con la determinación de la demanda química de oxígeno, demanda bioquímica de oxígeno, nitrógeno, fósforo, potasio y magnesio como parámetros de interés para la investigación. El residual se trabaja en 3 formas diferentes: excretas secas, excretas frescas, sobrenadante de una disolución de excretas secas y sobrenadante de una disolución de excretas frescas. Los resultados mostraron que la forma más adecuada para usar este residual como fuente de nutrientes para el cultivo de Chlorella vulgaris, es el sobrenadante de la disolución de excretas secas al 20 por ciento, por cuanto aporta los valores promedios siguientes: DQO: 979,84 mg/L; N total: 876,24; Mg: 74,25; K: 142,27 y P total: 733,12 mg/L. La biomasa resultante de la producción de biomasa de Chlorella vulgaris con este residual contenía: 39,8 por ciento de proteínas, 6,49 por ciento de grasa, 36,22 por ciento de carbohidratos, 5,27 por ciento de cenizas y 1,27 por ciento de fibra

Utilización de residual aviar como fuente de nutrientes en cultivos de microalgas / Use of aviary residual as a source of nutrients in microalgas cultures

El residual aviar, como todos los desechos animales, es portador de variados elementos químicos, que tratados adecuadamente pueden ser utilizados como fuente de nutrientes para cultivos de microalgas. Se caracteriza con la determinación de la demanda química de oxígeno, demanda bioquímica de oxígeno, nitrógeno, fósforo, potasio y magnesio como parámetros de interés para la investigación. El residual se trabaja en 3 formas diferentes: excretas secas, excretas frescas, sobrenadante de una disolución de excretas secas y sobrenadante de una disolución de excretas frescas. Los resultados mostraron que la forma más adecuada para usar este residual como fuente de nutrientes para el cultivo de Chlorella vulgaris, es el sobrenadante de la disolución de excretas secas al 20 por ciento, por cuanto aporta los valores promedios siguientes: DQO: 979,84 mg/L; N total: 876,24; Mg: 74,25; K: 142,27 y P total: 733,12 mg/L. La biomasa resultante de la producción de biomasa de Chlorella vulgaris con este residual contenía: 39,8 por ciento de proteínas, 6,49 por ciento de grasa, 36,22 por ciento de carbohidratos, 5,27 por ciento de cenizas y 1,27 por ciento de fibra(AU)

Contenido de algunas vitaminas en cultivos de microalga Chlorella sp / Content of some vitamins in cultures of microalgae Cholrella sp

Se presentaron las posibilidades de la biomasa de microalga Chlorella sp. como fuente de vitaminas para el consumo humano y animal. Se emplearon métodos espectrofotométricos y cromatográficos, y se desarrolló además una técnica cromatográfica que permitió determinar simultáneamente varias vitaminas. El cultivo de microalga Chlorella sp. aporta una biomasa rica en vitaminas, utilizables en la alimentación humana y animal, y constituye una forma de depuración de residuales

Contenido de algunas vitaminas en cultivos de microalga Chlorella sp. / Content of some vitamins in cultures of microalgae Cholrella sp.

Se presentaron las posibilidades de la biomasa de microalga Chlorella sp. como fuente de vitaminas para el consumo humano y animal. Se emplearon métodos espectrofotométricos y cromatográficos, y se desarrolló además una técnica cromatográfica que permitió determinar simultáneamente varias vitaminas. El cultivo de microalga Chlorella sp. aporta una biomasa rica en vitaminas, utilizables en la alimentación humana y animal, y constituye una forma de depuración de residuales (AU)

Etiología bacteriana de la diarrea aguda en niños de 0 a 6 años

Se realizó coprocultivo a un total de 150 niños provenientes de dos sectores de distintos niveles socio-económicos, como son Gazcue y Los Mina. El período de estudio fue de mayo a julio de 1988. Los coprocultivos resultaron positivos en 65 casos (43.4%), siendo la Escherichia Coli el microorganismo más frecuentemente aislado. Eso nos confirma que las diarreas son causadas por bacterias con más frecuencia que lo estimado

Evaluación nutricional en los alumnos del Centro Escolar "26 de Julio" de Santiago de Cuba / Nutritional assessment of pupils at \"July 26\" School, Santiago de Cuba

Se presenta un estudio antropométrico en 480 alumnos de ambos sexos del Centro Escolar "26 de Julio" de la ciudad de Santiago de Cuba, seleccionados de forma aleatoria estratificada para evaluar su estado nutricional, se utilizaron para ello las tablas de Iowa y las cubanas, y se realizó una comparación con 2 estudios anteriores del mismo universo. En su análisis se emplearon varios estadígrafos, tales como: el chi-cuadrado, la t de Student, análisis de series cronológicas y de las tendencias seculares, se muestra una mejoría notable en el estado nutricional de los niños de 6 a 12 años, debido a una mayor disponibilidad de alimentos en la población de nuestra provincia

Evaluación nutricional en los alumnos del Centro Escolar "26 de Julio" de Santiago de Cuba / Nutritional assessment of pupils at "July 26" School, Santiago de Cuba

Se presenta un estudio antropométrico en 480 alumnos de ambos sexos del Centro Escolar "26 de Julio" de la ciudad de Santiago de Cuba, seleccionados de forma aleatoria estratificada para evaluar su estado nutricional, se utilizaron para ello las tablas de Iowa y las cubanas, y se realizó una comparación con 2 estudios anteriores del mismo universo. En su análisis se emplearon varios estadígrafos, tales como: el chi-cuadrado, la t de Student, análisis de series cronológicas y de las tendencias seculares, se muestra una mejoría notable en el estado nutricional de los niños de 6 a 12 años, debido a una mayor disponibilidad de alimentos en la población de nuestra provincia