Health Conditions in Older Adults Suspected of Being Maltreated: A 20-Year Real-World Study.

Older adult maltreatment (OAM) is a global problem that has attracted increasing attention due to the ageing population and its severe impact on victim health. Thus, this study aims to analyse the prevalence of certain health conditions in people ≥ 60 years old whom physicians from a local healthcare unit suspected to be victims of maltreatment. The specific objectives are to determine the prevalence rates of health-related risk factors, traumatic injuries and intoxications, mental disorders, and physical disorders. We conducted a real-world, retrospective, observational, and cross-sectional study based on secondary data analyses of electronic health records and healthcare registers of patients at the Local Healthcare Unit of Matosinhos (2001-2021). Information was obtained based on codes from the International Classification of Diseases, codes from the International Classification of Primary Care, and clinical notes (according to previously defined keywords). We identified 3092 suspected victims of OAM, representing 4.5% of the total population analysed. This prevalence is lower than the known rates. We also found that some health risk factors, traumatic injuries and intoxications, mental health disorders, and physical disorders presented higher rates in the suspected victims than among the total population. In this age group, we cannot assume that these health problems are only related to a possible current victimisation process; they could also be associated with adverse childhood experiences or intimate partner violence, among other forms of violence, all of which can lead to cumulative effects on the victim's health. This evidence increases healthcare providers' responsibility in detecting and reporting all cases of suspected maltreatment.

Ciprofloxacin, diclofenac, ibuprofen and 17α-ethinylestradiol differentially affect the activity of acetogens and methanogens in anaerobic communities.

Pharmaceutical compounds end up in wastewater treatment plants but little is known on their effect towards the different microbial groups in anaerobic communities. In this work, the effect of the antibiotic Ciprofloxacin (CIP), the non-steroidal anti-inflammatory drugs Diclofenac (DCF) and Ibuprofen (IBP), and the hormone 17α-ethinylestradiol (EE2), on the activity of acetogens and methanogens in anaerobic communities, was investigated. Microbial communities were more affected by CIP, followed by EE2, DCF and IBP, but the response of the different microbial groups was dissimilar. For concentrations of 0.01 to 0.1 mg/L, the specific methanogenic activity was not affected. Acetogenic bacteria were sensitive to CIP concentrations above 1 mg/L, while DCF and EE2 toxicity was only detected for concentrations higher than 10 mg/L, and IBP had no effect in all concentrations tested. Acetoclastic methanogens showed higher sensitivity to the presence of these micropollutants, being affect by all the tested pharmaceutical compounds although at different degrees. Hydrogenotrophic methanogens were not affected by any concentration, indicating their lower sensitivity to these compounds when compared to acetoclasts and acetogens.

Análise da eficácia do óleo de hortelã pimenta (Mentha piperita L) na síndrome do intestino irritável: revisão baseada em evidência / Analysis of the efficacy of the peppermint oil (Mentha piperita L) on irritable bowel syndrome: an evidence-based review / Análisis de la eficacia del aceite de menta (Mentha piperita L) sobre el síndrome del intestino irritable: revisión basada en evidencia

Objetivo: Avaliar a eficácia do óleo de hortelã-pimenta (Mentha piperita L) no tratamento de indivíduos com síndrome do intestino irritável (SII), analisando a melhora dos sintomas e da qualidade de vida. Métodos: Foram realizadas pesquisas nas bases de dados Trip database, National Guideline Clearinghouse, Guidelines finder, Cochrane Library, Dare, Bandolier e Medline utilizando os termos MeSH Irritable bowel syndrome e peppermint oil. Foram incluídas normas de orientação clínica (NOC), revisões sistemáticas e metanálises e ensaios clínicos aleatorizados e controlados (ECAC) que avaliassem a eficácia do óleo de hortelã-pimenta (OHP) no alívio sintomático ou melhoria da qualidade de vida de indivíduos com SII, quando comparado com placebo ou outra terapêutica validada. Resultados e Discussão: Foram selecionados 8 artigos (5 NOC, 3 revisões sistemáticas/metanálises). A evidência sugere que o OHP é eficaz no alívio sintomático global da SII, especialmente quando existe dor abdominal, verificando-se a sua superioridade em relação ao placebo na maioria dos estudos avaliados ­ com odds ratio favorecendo o óleo de hortelã-pimenta atingindo 2,7 (IC de 95% de 1,6 a 4,8) e NNT de 3. Existe também evidência de melhoria da qualidade de vida com o OHP, em comparação com o placebo (p<0,001). Conclusão: A evidência demonstra eficácia do OHP na SII, especialmente quando existe um componente de dor abdominal, quando comparado com o placebo (força de recomendação B). São necessários mais estudos com qualidade metodológica que avaliem eficácia e segurança a longo prazo do OHP no alívio sintomático da SII.

Objective: To evaluate the efficacy of peppermint oil (Mentha piperita L.) on individuals diagnosed with irritable bowel syndrome (IBS) regarding symptom improvement and quality of life enhancement. Methods: Literature search was conducted according to evidence based on methodology review at Trip database, National Guideline Clearinghouse, Guidelines finder, Cochrane Library, Dare, Bandolier and Medline, as well as using the MeSH index terms "Irritable bowel syndrome" and "peppermint oil". We selected practice guidelines, systematic reviews, meta-analysis and randomized controlled trials that evaluated peppermint oil (PO) efficacy in improving symptoms and/or quality of life when compared to placebo or other approved therapy for IBS. Results and Discussion: A total of eight articles were selected including five practice guidelines and three systematic reviews/ meta-analysis. Existing evidence suggests that there are enough data to support the use of peppermint oil in IBS for overall symptomatic relief, especially when abdominal pain is the dominant symptom, when compared to placebo (with an odds ratio of 2.7; CI 95%, 1.6 to 4.8 and NNT of 3). There is also evidence regarding overall quality of life improvement when using PO compared to placebo (p<0.001). Conclusion: So far, evidence suggests that PO should be considered for IBS patients, especially in the presence of abdominal pain (Strength of recommendation B). However, more high methodological quality studies that evaluate long-term efficacy and security of PO are needed.

Objetivo: Evaluar la eficacia del aceite de menta (Mentha piperita L.) en el tratamiento de pacientes con síndrome del intestino irritable (SII) y analizar el alivio de sus síntomas y la mejora en su calidad de vida. Métodos: Se realizaron búsquedas en las bases de datos Trip database, National Guideline Clearinghouse, Guidelines finder, Cochrane Library, Dare, Bandolier y Medline usando los términos MeSH "Irritable bowel syndrome" y "peppermint oil". Se incluyeron las normas de orientación clínica (NOC), revisiones sistemáticas y meta-análisis y ensayos clínicos controlados aleatorizados (ECAC) para evaluar la eficacia del aceite de menta (AM) en el alivio sintomático y mejora de la calidad de vida de las personas con SII en comparación con el placebo u otra terapia validada. Resultados y Discusión: Se seleccionaron ocho estudios (cinco NOC y tres revisiones sistemáticas/meta-análisis). La evidencia sugiere que el AM es eficaz en el alivio de los síntomas generales del SII, en particular si había dolor abdominal, verificandose su superioridad sobre el placebo en la mayoría de los estudios evaluados (odds ratio de 2,7; IC 95% de 1,6 a 4,8 y NNT de 3). Hubo también evidencia de mejora en la calidad de vida en los pacientes tratados con AM, en comparación con el placebo (p <0,001). Conclusión: Las pruebas demuestran la eficacia del AM en el SII, especialmente en presencia de dolor abdominal, en comparación con el placebo (fuerza de recomendación B). Se necesitan más estudios con buena calidad metodológica que evalúen la eficacia y la seguridad a largo plazo del AM en el alivio de los síntomas del SII.