Development and validation of a Sarcopenia Geriatric Scale (SARCO-GS): a new short scale for the screening of sarcopenia.

Introduction: Sarcopenia is a highly prevalent disease associated with adverse outcomes such as falls, disability, and death. The current international consensuses agree that muscle strength, muscle mass, and gait speed must be included in the definition. However, these proposed criteria require objective measurements that are not available for most populations. Since the timely identification of sarcopenia is a priority, several subjective screening scales have been developed; however, they have some limitations due to their low sensitivity. The objective of this work was to develop and validate SARCO-GS, a new short scale to screen sarcopenia that is affordable, easy, and accessible for all clinical care settings. Methods and materials: The development of the SARCO-GS included four stages: (1) Review and analysis of documentary sources, (2) Contextualization of the theoretical model of sarcopenia, (3) Scale conformation, and (4) Reliability and validity analyses. SARCO-GS was validated in the FraDySMex study, which is a longitudinal cohort of community-dwelling adults. Results: In the studied population (n=852), the average age was 68.9 years (SD 10.21) and 80.1% of the participants were women. SARCO-GS is a seven-item scale with an innovative structure that included five subjective questions (gait speed, muscular strength, muscle mass) and two measurements of muscular strength and muscle mass (Chair stand test and calf circumference). The results regarding criterion validity showed that the cut-off point ≥ 3 had good sensitivity (77.68%) versus the EWGSOP2 consensus, with an adequate Area Under the Receiver Operating Characteristic (AUC) (0.73), in addition to showing higher values of sensitivity and AUC than SARC-F and SARC-CalF using as reference the same consensus. Furthermore, SARCO-GS presented good predictive validity for functional dependence (HR=2.22, p=0.046) and acceptable correlation with other related measurements (construct validity). Regarding reliability, the scale showed acceptable internal reliability (correlation between items and total score: 0.50 to 0.70). After the validation analysis, the scale was adapted to English. Conclusions: The SARCO-GS is a novel scale to screen sarcopenia with high sensitivity, good construct, predictive validity, and internal reliability that may be useful for health professionals in different clinical settings and for clinical research.

Clinical interventions in osteosarcopenic obesity: nutrition, physical and psychological activity / Intervenciones clínicas en obesidad osteosarcopénica: alimentación, actividad física y psicológica

Osteosarcopenic obesity (OSO) is a condition associated with adverse outcomes in older adults. Since it is a condition which includes three tissues (obesity, sarcopenia and osteopenia/osteoporosis), it requires simultaneous and multidisciplinary clinical interventions to revert it. Until this moment, there have been published review articles only focused on nutrition or physical activity. However, we believe that assembling the existing evidence on potential treatments (nutritional intervention with micro- and macronutrients), physical activity, farmacological treatment for osteopenia/osteoporosis, possible farmacological treatment for sarcopenia, and, finally, psychological interventions focused on the treatment of psychiatric comorbidities (such as anxiety or depression) will help healthcare providers to improve the body composition of older adults.

La obesidad osteosarcopénica (OOS) es una condición que representa diversos desenlaces adversos en el adulto mayor. Al ser una condición que incluye tres tejidos (obesidad, sarcopenia y osteopenia/osteoporosis), se requiere de intervenciones clínicas simultáneas y multidisciplinarias para lograr revertirla. Hasta el momento, han sido publicados artículos de revisión enfocados solo a la nutrición y a la actividad física. Sin embargo, consideramos que es necesario reunir la evidencia del nivel nutricional (en cuanto a micro- y macronutrientes), de la actividad física habitual o personalizada, de los potenciales tratamientos farmacológicos para la sarcopenia, del actual tratamiento farmacológico para la osteopenia/osteoporosis y, por último, en torno a las posibles intervenciones psicológicas enfocadas a tratar la comorbilidad psiquiátrica (ansiedad o depresión) y directamente hacia la mejora de la composición corporal en adultos mayores.

[Herpes zoster and post-herpetic neuralgia in the elderly: Particularities in prevention, diagnosis, and treatment]. / Herpes zoster (HZ) y neuralgia posherpética (NPH) en el adulto mayor: particularidades en la prevención, el diagnóstico y el tratamiento.

Herpes zoster (HZ) results from the reactivation of the varicella zoster virus latent in the sensory ganglia when cell-mediated immunity is altered. It is a frequent condition in older adults, leading to undesirable adverse outcomes. Aging is its main risk factor and the elderly may have different clinical presentations: zoster sine herpete, and a higher incidence of post-herpetic neuralgia (15%) and ophthalmic herpes (7%). Both HZ and post-herpetic neuralgia may impact the quality of life, functional status, mental health, and social interaction in older adults. Clinical trials have demonstrated that the vaccine decreases the incidence of HZ and post-herpetic neuralgia by up to 51% and 67%, respectively. When treating older adults with multi-morbidity, practitioners should consider starting low-dose drugs so they can look for potential drug-drug and drug-disease interactions. The aim of this article was to review the particularities of the risk factors, clinical presentation, complications, and treatment of HZ and post-herpetic neuralgia.

Repercusión de los dispositivos móviles en la atención de enfermería a usuarios en estado crítico / Repercussion of mobile devices on nursing care for users in critical state

Introducción: actualmente en los hospitales de México, especialmente en las áreas de cuidados críticos, se ha incrementado el uso de dispositivos móviles de comunicación, repercutiendo en el cuidado del paciente; esto pudiera representar no solamente un distractor, sino una fuente portadora de gérmenes. Objetivo: evaluar la repercusión de los dispositivos móviles en la atención de enfermería a usuarios en estado crítico. Métodos: estudio descriptivo, trasversal; donde fueron medidos los tiempos de interrupción del cuidado de enfermería en el uso de dispositivos móviles de comunicación; se describió la exposición de estos artefactos con los equipos biomédicos por medio de una guía observacional, además se tomó muestra de los dispositivos móviles para su cultivo en agar nutritivo. Resultados: el 75,00 por ciento de los enfermeros estudiados hacían uso de los dispositivos móviles dentro de su jornada laboral; el 68,00 por ciento hizo uso de algún dispositivo móvil mientras realizaba alguna actividad con el paciente; el 64,00 por ciento tenía contacto con equipo biomédico; el 100,00 por ciento no se lavaba las manos antes y después de usarlos; en el 100,00 por ciento de las muestras tomadas y cultivadas hubo crecimiento Unidades Formadoras de Colonias a las 48 horas. Conclusiones: los dispositivos móviles son distractores, adictivos y cuentan con carga bacteriológica, esto afecta en la atención directa al paciente, su uso aún no está regulado; por esta razón sería importante considerar limitar el uso en las unidades de cuidados críticos, esto ayudara a brindar una mejor atención viéndose reflejado en la seguridad del paciente(AU)

Introduction: In Mexico hospitals today, especially in critical care areas, the use of mobile devices of communication has increased, which has had a repercussion on the care for the patient; this could represent not only a distracting aspect, but a germ-bearing source. Objective: Assess the repercussion of mobile devices on nursing care for user in critical state. Methods: cross-sectional, descriptive study in which we measured the interruption times for nursing care in the use of mobile devices of communication; we described the exposition of this artifacts with biomedical equipment by means of an observational guide, we also took sample of mobile devices for their culture in a nutrient agar. Results: 75.00 percentof the studied nurses used mobile devices within their working day; 68.00 percent used any mobile device while doing any activity with the patient; 64.00 percent had contact with biomedical equipment; 100.00 percent did not wash their hands before or after using them; in the 100.00 percent of the samples taken and cultured there were colonies growing after 48 hours. Conclusions: Mobile devices are distracting, addictive and have bacteriologic charge, which affects the direct care for the patient, their use is not regulated; therefore, it would be important to consider limiting their use in critical care units, which will help provide better attention reflected on the patient's safety(AU)

Repercusión de los dispositivos móviles en la atención de enfermería a usuarios en estado crítico / Repercussion of mobile devices on nursing care for users in critical state

Introducción: actualmente en los hospitales de México, especialmente en las áreas de cuidados críticos, se ha incrementado el uso de dispositivos móviles de comunicación, repercutiendo en el cuidado del paciente; esto pudiera representar no solamente un distractor, sino una fuente portadora de gérmenes. Objetivo: evaluar la repercusión de los dispositivos móviles en la atención de enfermería a usuarios en estado crítico. Métodos: estudio descriptivo, trasversal; donde fueron medidos los tiempos de interrupción del cuidado de enfermería en el uso de dispositivos móviles de comunicación; se describió la exposición de estos artefactos con los equipos biomédicos por medio de una guía observacional, además se tomó muestra de los dispositivos móviles para su cultivo en agar nutritivo. Resultados: el 75,00 por ciento de los enfermeros estudiados hacían uso de los dispositivos móviles dentro de su jornada laboral; el 68,00 por ciento hizo uso de algún dispositivo móvil mientras realizaba alguna actividad con el paciente; el 64,00 por ciento tenía contacto con equipo biomédico; el 100,00 por ciento no se lavaba las manos antes y después de usarlos; en el 100,00 por ciento de las muestras tomadas y cultivadas hubo crecimiento Unidades Formadoras de Colonias a las 48 horas. Conclusiones: los dispositivos móviles son distractores, adictivos y cuentan con carga bacteriológica, esto afecta en la atención directa al paciente, su uso aún no está regulado; por esta razón sería importante considerar limitar el uso en las unidades de cuidados críticos, esto ayudara a brindar una mejor atención viéndose reflejado en la seguridad del paciente(AU)

Introduction: In Mexico hospitals today, especially in critical care areas, the use of mobile devices of communication has increased, which has had a repercussion on the care for the patient; this could represent not only a distracting aspect, but a germ-bearing source. Objective: Assess the repercussion of mobile devices on nursing care for user in critical state. Methods: cross-sectional, descriptive study in which we measured the interruption times for nursing care in the use of mobile devices of communication; we described the exposition of this artifacts with biomedical equipment by means of an observational guide, we also took sample of mobile devices for their culture in a nutrient agar. Results: 75.00 percentof the studied nurses used mobile devices within their working day; 68.00 percent used any mobile device while doing any activity with the patient; 64.00 percent had contact with biomedical equipment; 100.00 percent did not wash their hands before or after using them; in the 100.00 percent of the samples taken and cultured there were colonies growing after 48 hours. Conclusions: Mobile devices are distracting, addictive and have bacteriologic charge, which affects the direct care for the patient, their use is not regulated; therefore, it would be important to consider limiting their use in critical care units, which will help provide better attention reflected on the patient's safety(AU)

Cross-Cultural Adaptation and Validation of the Spanish-Language Version of the SARC-F to Assess Sarcopenia in Mexican Community-Dwelling Older Adults.

OBJECTIVES: To cross-culturally adapt and validate the Spanish-language version of the SARC-F in Mexican community-dwelling older adults. DESIGN: Cross-sectional analysis of a prospective cohort. SETTING: The FraDySMex study, a 2-round evaluation of community-dwelling adults from 2 municipalities in Mexico City. PARTICIPANTS: Participants were 487 men and women older than 60 years, living in the designated area in Mexico City. MEASUREMENTS: Information from questionnaires regarding demographic characteristics, comorbidities, mental status, nutritional status, dependence in activities of daily living, frailty, and quality of life. Objective measurements of muscle mass, strength and function were as follows: skeletal muscle mass index (SMI) was taken using dual-energy x-ray, grip strength using a hand dynamometer, 6-meter gait speed using a GAIT Rite instrumented walkway, peak torque and power for knee extension using a isokinetic dynamometer, lower extremity functioning measured by the Short Physical Performance Battery (SPPB), and balance using evaluation on a foam surface, with closed eyes, in the Modified Clinical Test of Sensory Integration. The SARC-F scale translated to Spanish and the consensus panels' criteria from European, international, and Asian sarcopenia working groups were applied to evaluate sarcopenia. RESULTS: The Spanish language version of the SARC-F scale showed reliability (Cronbach alfa = 0.641. All items in the scale correlated to the scale's total score, rho = 0.43 to 0.76), temporal consistency evaluated by test-retest (CCI = 0.80), criterion validity when compared to the consensus panels' criteria (high specificity and negative predictive values). The scale was also correlated to other measures related to sarcopenia (such as age, quality of life, self-rated health status, cognition, dependence in activities of daily living, nutritional status, depression, gait speed, grip strength, peak torque and power for knee extension, SPPB, balance, SMI, and frailty). CONCLUSION: The SARC-F scale was successfully adapted to Spanish language and validated in community-dwelling Mexican older adults.

Cross-Cultural Adaptation and Validation of the FRAIL Scale to Assess Frailty in Mexican Adults.

OBJECTIVES: The objectives of this study were to cross-culturally adapt and validate the FRAIL scale in Mexican community-dwelling adults. DESIGN: Cross-sectional analysis of a prospective cohort. SETTING: The FraDysMex study, a 2-round evaluation of community-dwelling adults from 2 municipalities in Mexico City. PARTICIPANTS: Participants were 606 men and women living in the designated area in Mexico City. MEASUREMENTS: Interviewers obtained data regarding demographics, comorbidities, mental status, nutritional status, dependency in activities of daily living, quality of life, mobility, balance, and strength. The FRAIL scale translated to Spanish and the Fried criteria were applied to screen frailty. RESULTS: The Mexican Spanish version of the FRAIL scale showed internal consistency (4 of 5 items in the scale correlated to the scale's total score, rho = 0.41-0.74), external consistency (interrater correlation CCI = 0.82), known-group validity based on age (9.6% of frailty in persons ≥50 years × 3.2% in persons <50 years, P = .001), convergent validity with the Fried criteria (CCI = 0.63), and the scale was also correlated with other measures related to frailty (such as age, quality of life, self-rated health status, cognition, dependency, nutritional status, depression, and physical performance). CONCLUSION: The FRAIL scale was successfully adapted to Mexican Spanish and validated in community-dwelling Mexican adults.