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BACKGROUND: Aging increases the vulnerability to diseases and environmental changes such as the COVID-19 pandemic. Telehealth and tele-education are vital to prevent the deleterious effects of prolonged confinement, and to train the community, and constantly rotating medical students and health professionals. AIM: To assess the perception and impact of an online course about healthy aging aimed at the community and health care professionals. MATERIAL AND METHODS: An open online one-day course to promote healthy aging was carried out. A cross-sectional online survey about the course was answered by 386 attendants and a knowledge test was applied to 114 people. RESULTS: Seventy-five percent of respondents attended the course synchronously. Of these, 79% were women, 20% were older people and 53% were caregivers of an older person. All respondents acquired new knowledge and were willing to participate again. The frequency of interest about self-care is three times greater than about caring for another person, In an older person, the interest is 101 more times about self-care than caring for another person. Ninety five percent of respondents felt more active and 84% felt more accompanied. CONCLUSIONS: The course facilitated access to information on the promotion of active and healthy aging in the community with a favorable perception and a positive impact. The coverage for older people with a digital gap should be improved.
Assuntos
Estudantes de Medicina , Telemedicina , Humanos , Feminino , Idoso , Masculino , Pandemias/prevenção & controle , Estudos Transversais , ChileRESUMO
BACKGROUND: Up to 70% of hospitalized older people experience a deterioration of their functional capacity during the course of hospital stay. This change has a dismal effect of quality of life and prognosis. AIM: To assess the change in functional status of older people during the course of hospitalization in a geriatric unit. MATERIAL AND METHODS: Review of medical records of 83 patients with a mean age of 79 years (70% women), hospitalized in an acute geriatric unit of a clinical hospital, between 2007 and 2009. Functional capacity was assessed using Barthel and Lawthon scales in a basal period, on admission and on discharge. RESULTS: Mean hospital stay was nine days. Median scores of Barthel scale on the basal period, on admission and on discharge were 90, 50 and 80, respectively. The figures for Lawthon scale were 4,2 and 3 respectively. Seventy eight percent of patients lost functional capacity during hospital stay and 72% recovered their functional status on discharge. CONCLUSIONS: A great proportion of older people experience a loss of functional capacity during hospitalization. This deterioration can be reverted with an adequate geriatric management.
Assuntos
Atividades Cotidianas/psicologia , Avaliação Geriátrica/métodos , Hospitalização , Qualidade de Vida/psicologia , Idoso , Feminino , Humanos , Tempo de Internação , Masculino , Equipe de Assistência ao Paciente , Prognóstico , Estudos RetrospectivosRESUMO
BACKGROUND: Quality of Life assessment in oncologic patients evaluates the impact and sequels of the disease ana the adverse effects of available treatments. AIM: To validate in Chile the breast cancer specific-questionnaire (BR23) developed by the European Organization for Research and Treatment of Cancer (EORTC). PATIENTS AND METHODS: After performing a linguistic validation of the BR23 according to EORTC instructions, its psychometric properties were tested in 103 patients with breast cancer whose ages ranged from 34 to 83 years. Internal consistency of the scales was assessed using the Cronbach's alpha coefficient. The test-retest correlations of each scale (n = 83) were evaluated. The correlation of BR23 scales with SF36 version 2 and C30 version 3.0 scales was also assessed. The sensitivity and specificity of the instrument were analyzed using receiver operating characteristic curves (ROC). RESULTS: Alpha values showed acceptable levels of internal consistency, ranging between 0.702 and 0.917 in all scales of BR23. The statistical analysis revealed significant test-retest correlations in most scales of BR23. The correlations between BR23 and similar domains of C30 and SF36 questionnaires were also significant. The BR23 questionnaire demonstrated satisfactory levels of sensitivity and specificity when compared with the SF-36 scale. CONCLUSIONS: The BR23 questionnaire adapted for use in Chile is linguistically appropriate and psychometrically valid.
Assuntos
Neoplasias da Mama/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico , Chile , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Curva ROC , Sensibilidade e Especificidade , Inquéritos e QuestionáriosRESUMO
The Chilean census of 2017 reported that 11.4% of the local population are 65 years or older, and according to the National Institute of Statistics (INE) the current expectancy of life in Chile is 76 years for men and 81 years for women respectively. Cancer in Chile is a major public health problem. Aging is a significant risk factor for cancer development which added to the improved life expectancy, it increases the incidence of cancer. In 2040, new cancer cases will increase from 19.3 to 30.2 million worldwide. Older people are a heterogeneous group requiring specialized and individualized management. Chronological age does not necessarily correlate with physiological age. More than half of the geriatric patients with cancer have at least one comorbidity which is relevant when defining a cancer treatment. Likewise, polypharmacy is frequent and is an important issue to consider in people with cancer due to the risk associated with drug interactions. Oncogeriatric assessment consists of a comprehensive multidimensional evaluation, including functional and biopsychosocial issues, addressing aspects of the neoplastic disease such as the risk of toxicities due to systemic therapy and life expectancy. This tool has proven to be helpful in the diagnosis of conditions that are not evident in a routine oncological evaluation, such as geriatric syndromes, frailty, functional dependence, and cognitive impairment among others, which have an impact when deciding on therapy, predicting risks of treatment toxicity and mortality. In this article we aim to describe the current situation of Oncogeriatrics and to provide epidemiological information about cancer in the elderly population in Chile attempting to highlight the importance of the Oncogeriatrics units, within cancer departments, for a better decision taking in the elderly cancer patient.
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OBJECTIVE: The purpose of this study was to assess the parallel artery and vein sign at color Doppler breast ultrasound as a predictor of the benign nature of breast masses. SUBJECTS AND METHODS: A prospective study was performed to identify evidence of a parallel artery and vein in breast lesions consecutively biopsied with a 14-gauge needle under ultrasound guidance. Sensitivity, specificity, positive and negative predictive values, likelihood ratios, and 95% CIs for the parallel artery and vein sign were calculated. RESULTS: The parallel artery and vein sign was identified in 142 of the 1074 masses (13.2%). The specificity for benignity was 99.3% (CI 95%, 98.3-100.0%); sensitivity, 17.6% (CI 95%, 15.0-20.3%); positive predictive value, 99.0% (CI 95%, 96.7-100); negative predictive value, 30.0% (CI 95%, 27.0-32.9); positive likelihood ratio, 24.7 (CI 95%, 21.2-28.7); and negative likelihood ratio, 0.83 (CI 95%, 0.80-0.86). Among masses found to have the parallel artery and vein sign, all BI-RADS ultrasound category 3 and 95.1% of BI-RADS 4 lesions were determined to be benign. CONCLUSION: Although the parallel artery and vein sign is an uncommon finding, it has a significant association with benign pathologic results (96.5%) with a positive likelihood ratio of 24.7. The presence of this color Doppler ultrasound finding in breast masses in BI-RADS ultrasound categories 3 and 4 reinforces the benign nature and may allow follow-up rather than biopsy in the care of some patients.
Assuntos
Doenças Mamárias/diagnóstico por imagem , Mama/irrigação sanguínea , Ultrassonografia Doppler em Cores , Ultrassonografia Mamária , Adulto , Biópsia por Agulha , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama Masculina/diagnóstico por imagem , Distribuição de Qui-Quadrado , Diagnóstico Diferencial , Feminino , Humanos , Funções Verossimilhança , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , Ultrassonografia de IntervençãoRESUMO
Aging is a gradual and adaptive process that entails a series of changes, leading to reduced functional and physiological capacity. Each elderly person presents heterogeneous health conditions that must be considered by the interdisciplinary team responsible for their functional maintenance and overall health. This descriptive, cross-sectional study was conducted on elderly individuals with deficient removable dental prostheses, treated at the dental prosthetic rehabilitation centre of Hospital Del Salvador, in Santiago de Chile between the years 2021 and 2023. Instruments and indices were used to record and measure muscular conditions, such as the hand grip strength measurements, the Timed Up and Go test, and the calf circumference measurement. Information on educational levels, geriatric syndromes, chronic diseases, and medication consumption was collected. Of the participants, 58.9 % were female, and 41.1 % were male, with a mean age of 84.2 years for males and 80.4 years for females. 20.8 % had access to higher education, and 22.6 % lived alone. 78.5 % had lost all posterior support zones. 81.5 % had visual impairments; 36.3 % had auditory impairments, and 31.5 % had experienced one or more falls in the last 6 months. The mean sum of medications consumed per person was 4.32. The most prevalent morbidities were arterial hypertension (66.4 %) and type II diabetes (32.7 %). Means values for male/ female were: Hand Grip Strength 27.84 Kg/17.99 kg, Timed Up and Go 14.3 sec/14.9sec, BMI 27.16/ 26.44, and calf circumference 35.5 cm /35.2cm, values were within the normal range of values. The data collected is important to consider when treatment planning and implementing actions aimed at maintaining oral and general functionality. These aspects should be addressed from a multidimensional perspective, including risk factors, in both the diagnosis and dental treatments.
Envejecer es un proceso gradual y adaptativo que conlleva cambios, que reducen la capacidad funcional y fisiológica. Cada persona mayor presenta condiciones de salud heterogéneas que deben ser consideradas por el equipo interdisciplinario a cargo de su mantención funcional y estado de salud. Estudio descriptivo, corte transversal, en personas mayores portadoras de prótesis dentales removibles deficientes, del servicio dental de rehabilitación protésica del Hospital Del Salvador de Santiago de Chile, entre los años 2021-2023. Se emplearon instrumentos e índices para realizar registro y medición de condiciones musculares como fuerza de presión manual, prueba Timed Up and Go y medición del perímetro de pantorrilla. Se recolectó información asociada a nivel de escolaridad, síndromes geriátricos, enfermedades crónicas y cantidad de fármacos que consumen. Un 58,9 % eran mujeres, la edad media de hombres fue de 84,2 años y la de mujeres fue de 80,4 años. Un 20,8 % tuvo acceso a educación superior. El 22,6 % vive solo. Un 78,5 % ha perdido todas las zonas de soporte dentario posterior. Un 81.5 % tiene alteraciones visuales; un 36.3 % alteraciones auditivas; un 31.5 % ha tenido 1 o más caídas en los últimos 6 meses. La media de fármacos fue de 4.32 por persona. Las morbilidades más prevalentes fueron hipertensión arterial (66.4 %) y diabetes tipo II (32,7 %). Los valores promedios encontrados para hombres/mujeres en fuerza de prensión manual fueron 27,84 Kg/17,99 kg, Timed Up and Go fueron 14,3 sec / 14,9 sec, IMC 27,16/ 26,44 y perímetro de pantorrilla 35,5 cm / 35,2 cm. Todos los datos clasificaron en el rango de normalidad. Las características observadas son importantes a considerar al momento de planificar tratamientos e implementar medidas orientadas a mantener funcionalidad oral y general. Éstas deben ser abordadas desde una mirada multidimensional, incluyendo los factores de riesgo, tanto en el diagnóstico como su tratamiento odontológico.
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Background: Aging increases the vulnerability to diseases and environmental changes such as the COVID-19 pandemic. Telehealth and tele-education are vital to prevent the deleterious effects of prolonged confinement, and to train the community, and constantly rotating medical students and health professionals. Aim: To assess the perception and impact of an online course about healthy aging aimed at the community and health care professionals. Material and Methods: An open online one-day course to promote healthy aging was carried out. A cross-sectional online survey about the course was answered by 386 attendants and a knowledge test was applied to 114 people. Results: Seventy-five percent of respondents attended the course synchronously. Of these, 79% were women, 20% were older people and 53% were caregivers of an older person. All respondents acquired new knowledge and were willing to participate again. The frequency of interest about self-care is three times greater than about caring for another person, In an older person, the interest is 101 more times about self-care than caring for another person. Ninety five percent of respondents felt more active and 84% felt more accompanied. Conclusions: The course facilitated access to information on the promotion of active and healthy aging in the community with a favorable perception and a positive impact. The coverage for older people with a digital gap should be improved.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Estudantes de Medicina , Telemedicina , Educação a Distância , Envelhecimento Saudável , Autocuidado , Chile , Estudos Transversais , Inquéritos e Questionários , Pandemias/prevenção & controleRESUMO
RESUMEN Antecedentes: La incontinencia urinaria (IU) corresponde a la pérdida involuntaria de orina. En la medida en que la población envejece, aumenta su prevalencia y severidad. Objetivo: Describir el impacto de la incontinencia de orina en la población adulto mayor, así como conocer su fisiopatología e implicancias en la calidad de vida. Método: Revisión de la literatura disponible en PubMed, Embase y Medline utilizando los términos "urinary incontinence" y "elderly" entre los años 1990 y 2018. Resultados: La IU en el adulto mayor impacta negativamente en la calidad de vida de esta población, teniendo una multiplicidad de causas subyacentes que implican un tratamiento integral y multidisciplinario de esta patología. Conclusión: Dado el incremento de la edad en la población, conocer y manejar esta patología es importante para el clínico y el especialista para que de esta forma mejore la calidad de vida en este grupo etario.
ABSTRACT Background: Urinary incontinence (UI) is the involuntary loss of urine. The prevalence and severity of this condition increase as population ages. Objective: To describe the impact urinary incontinence in the elderly population, as well as to know its pathophysiology and implications in the quality of life. Method: Review of the literature available in PubMed, Embase and Medline using the keywords "urinary incontinence" and "elderly" between 1990 and 2018. Results: UI in the elderly has a negative impact on their quality of life, having a multiplicity of underlying causes that imply a comprehensive and multidisciplinary treatment of this pathology. Conclusion: Given the age increase in general population, knowing and managing this pathology is important for the clinician and the specialist to improve the quality of life in this age group.
Assuntos
Humanos , Idoso , Incontinência Urinária/diagnóstico , Incontinência Urinária/terapia , Qualidade de Vida , Incontinência Urinária/fisiopatologia , Diafragma da Pelve/fisiopatologiaRESUMO
En Diciembre 2019, surge una enfermedad emergente, COVID-19, que es debida a un coronavirus (SARS-CoV-2) que empieza en Wuhan, China y que se ha propagado rápidamente a nivel mundial. La Organización Mundial de la Salud (OMS) lo declara como pandemia el 12 de Marzo del 2020. En Chile, el día 14 de Marzo se decretó fase 3 y el 16 de Marzo se pasó a fase 4. Al 24 de Marzo del 2020, en Chile existen 922 casos confirmados de COVID-19, con una mediana de edad de 34 años, correspondiendo 51 casos (6%) a adultos mayores (AM).
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Background: Up to 70% of hospitalized older people experience a deterioration of their functional capacity during the course of hospital stay. This change has a dismal effect of quality oflife and prognosis. Aim: To assess the change in functional status of older people during the course of hospitalization in a geriatric unit. Material and Methods: Review of medical records of83 patients with a mean age of79years (70% women), hospitalized in an acute geriatric unit of a clinical hospital, between 2007 and 2009. Functional capacity was assessed using Barthel and Lawthon scales in a basal period, on admission and on discharge. Results: Mean hospital stay was nine days. Median scores of Barthel scale on the basal period, on admission and on discharge were 90, 50 and 80, respectively. The figures for Lawthon scale were 4,2 and 3 respectively. Seventy eight percent of patients lost functional capacity during hospital stay and 72% recovered their functional status on discharge. Conclusions: A great proportion of older people experience a loss of functional capacity during hospitalization. This deterioration can be reverted with an adequate geriatric management.
Assuntos
Idoso , Feminino , Humanos , Masculino , Atividades Cotidianas/psicologia , Avaliação Geriátrica/métodos , Hospitalização , Qualidade de Vida/psicologia , Tempo de Internação , Equipe de Assistência ao Paciente , Prognóstico , Estudos RetrospectivosRESUMO
Background: Quality of Life assessment in oncologic patients evaluates the impact ana sequels of the disease ana the adverse effects of available treatments. Aim: To validate in Chile the breast cáncer specific-questionnaire (BR23) developed by the European Organization for Research and Treatment of Cancer (EORTC). Patients and Methods: After performing a linguistic validation of the BR23 according to EORTC instructions, its psychometric properties were tested in 103 patients with breast cancer whose ages ranged from 34 to 83 years. Infernal consistency ofthe scales was assessed using the Cronbach's alpha coefficient. The test-retest correlations of each scale (n = 83) were evaluated. The correlation ofBR23 scales with SF36 version 2 and C30 version 3.0 scales was also assessed. The sensitivity and specificity of the instrument were analyzed using receiver operating characteristic curves (ROC). Results: Alpha values showed acceptable levels of internal consistency, ranging between 0.702 and 0.917 in all scales of BR23. The statistical analysis revealed significant test-retest correlations in most scales ofBR23. The correlations between BR23 and similar domains of C30 and SF36 questionnaires were also significant. The BR23 questionnaire demonstrated satisfactory levels of sensitivity and specificity when compared with the SF-36 scale. Conclusions: The BR23 questionnaire adapted for use in Chile is linguistically appropriate and psychometrically valid.