Social determinants of health and metabolic syndrome in Colombian older adults.

BACKGROUND AND AIMS: Social determinants of health (SDH) are critical in health outcomes. More insight is needed on the correlation between SDH and metabolic syndrome (MetS) in the aging population. This study assessed the association between SDH and MetS scores among older adults in Colombia. METHODS AND RESULTS: This cross-sectional country-wide study includes a sample of 4085 adults aged ≥60 from the SABE Colombia Survey. MetS measurements were central obesity, hyperglycemia or diabetes, hypertriglyceridemia, arterial hypertension, and low HDL cholesterol (MetS score 0-5). SDH includes four levels: 1- general socioeconomic and environmental conditions; 2-social and community networks; 3- individual lifestyle; and 4-constitutional factors. In multivariate linear regression analysis, the SDH factors with greater effect sizes, calculated by Eta Squared, predicting higher MetS mean scores were women followed by low education, no alcohol intake, urban origin, and residing in unsafe neighborhoods. Two interactions: men, but not women, have lower MetS in safe neighborhoods compared to unsafe, and men, but not women, have lower MetS when having low education (0-5 years) compared to high (≥6). CONCLUSION: Gender, education, alcohol intake, and origin have the greatest effect sizes on MetS. Education level and neighborhood safety modified the relationship between gender and MetS. Low-educated men or those residing in safe neighborhoods have lower MetS. Neighborhood environments and educational differences influencing MetS should be considered in future studies.

Racial Discrimination and Multimorbidity Among Older Adults in Colombia: A National Data Analysis.

INTRODUCTION: Multimorbidity is a prevalent worldwide problem among older adults. Our objective was to assess the association between life-course racial discrimination and multimorbidity among older adults in Colombia. METHODS: We used data from the SABE (Salud, Bienestar y Envejecimiento) Colombia Study in 2015 (N = 18,873), a national cross-sectional survey among adults aged 60 years or older. The outcome was multimorbidity, defined as having 2 or more chronic conditions. The main independent variables were 3 racial discrimination measures: 1) everyday racial discrimination (yes or no), 2) childhood racial discrimination score (scored from 0 [never] to 3 [many times]), and 3) situations of racial discrimination in the last 5 years (scored from 0 to 4 as a sum of the number of situations [group activities, public places, inside the family, health centers]). Other variables were sociodemographic characteristics, diseases, economic or health adversity during childhood, and functional status. We used weighted logistic regression analyses to adjust for differences between groups. RESULTS: Multivariate logistic regression models showed that multimorbidity was significantly associated with experiencing everyday racial discrimination (OR, 2.21; 95% CI, 1.62-3.02), childhood racial discrimination (OR, 1.27; 95% CI, 1.10-1.47), and the number of situations of racial discrimination (OR= 1.56; 95% CI, 1.22-2.00). Multimorbidity was also independently associated with multimorbidity during childhood. CONCLUSION: Racial discrimination experiences were associated with higher odds of multimorbidity among older adults in Colombia. Strategies to decrease life course experiences of racial discrimination may improve the health of older adults.

Revealing the Reactivity of Individual Chemical Entities in Complex Mixtures: the Chemistry Behind Bio-Oil Upgrading.

Bio-oils are precursors for biofuels but are highly corrosive necessitating further upgrading. Furthermore, bio-oil samples are highly complex and represent a broad range of chemistries. They are complex mixtures not simply because of the large number of poly-oxygenated compounds but because each composition can comprise many isomers with multiple functional groups. The use of hyphenated ultrahigh-resolution mass spectrometry affords the ability to separate isomeric species of complex mixtures. Here, we present for the first time, the use of this powerful analytical technique combined with chemical reactivity to gain greater insights into the reactivity of the individual isomeric species of bio-oils. A pyrolysis bio-oils and its esterified bio-oil were analyzed using gas chromatography coupled to Fourier transform ion cyclotron resonance mass spectrometry, and in-house software (KairosMS) was used for fast comparison of the hyphenated data sets. The data revealed a total of 10,368 isomers in the pyrolysis bio-oil and an increase to 18,827 isomers after esterification conditions. Furthermore, the comparison of the isomeric distribution before and after esterification provide new light on the reactivities within these complex mixtures; these reactivities would be expected to correspond with carboxylic acid, aldehyde, and ketone functional groups. Using this approach, it was possible to reveal the increased chemical complexity of bio-oils after upgrading and target detection of valuable compounds within the bio-oils. The combination of chemical reactions alongside with in-depth molecular characterization opens a new window for the understanding of the chemistry and reactivity of complex mixtures.

Susceptibility of Flordaguard peach rootstock to a resistant-breaking population of Meloidogyne floridensis and two populations of Meloidogyne arenaria.

Cultivar Flordaguard is suggested as a root-knot nematode (RKN) resistant rootstock for Florida peaches, however, RKN disease has been observed on this rootstock in peach orchards. Our goal was to confirm whether the RKN resistance breaking isolates of M. floridensis and M. arenaria indeed could infect and reproduce on the peach rootstock cv. Flordaguard in both laboratory and field studies. Root galling occurred on all peach cultivars evaluated including Flordaguard, Flordaglo, Okinawa, and Lovell, in the presence of the RKN resistance-breaking isolates of M. floridensis (MfGnv14) and two M. arenaria isolates (Ma1 and Ma2). These rootstocks showed varying degrees of susceptibility (to a lesser extent in Okinawa) to these three RKN resistance-breaking isolates. The importance of nematode inoculum concentrations in differentiating between resistance and susceptible plants was demonstrated, and thus are an important factor to consider in nematode resistance breeding programs. In host differential tests the peach-originated isolates of M. floridensis and M. arenaria behaved similarly with the vegetable-originated isolates of M. floridensis on tomato, peanut, watermelon, and tobacco, but showed variable host responses on cotton and pepper. The two M. arenaria isolates from peach reproduced on pepper but not on peanut. To our knowledge this is the first report of M. arenaria race 3 infecting Flordaguard and pepper in Florida. Soil and root samples collected from cv. Flordaguard infected trees at two commercial peach orchards showed that M. floridensis and M. arenaria were established on the rootstock.

Dissection of transcriptional events in graft incompatible reactions of "Bearss" lemon (Citrus limon) and "Valencia" sweet orange (C. sinensis) on a novel citrandarin (C. reticulata × Poncirus trifoliata) rootstock.

Citrus is commercially propagated via grafting, which ensures trees have consistent fruit traits combined with favorable traits from the rootstock such as soil adaptability, vigor, and resistance to soil pathogens. Graft incompatibility can occur when the scion and rootstock are not able to form a permanent, healthy union. Understanding and preventing graft incompatibility is of great importance in the breeding of new fruit cultivars and in the choice of scion and rootstock by growers. The rootstock US-1283, a citrandarin generated from a cross of "Ninkat" mandarin (Citrus reticulata) and "Gotha Road" #6 trifoliate orange (Poncirus trifoliata), was released after years of field evaluation because of its superior productivity and good fruit quality on "Hamlin" sweet orange (C. sinensis) under Florida's growing conditions. Subsequently, it was observed that trees of "Bearss" lemon (C. limon) and "Valencia" sweet orange (C. sinensis) grafted onto US-1283 exhibited unhealthy growth near the graft union. The incompatibility manifested as stem grooving and necrosis underneath the bark on the rootstock side of the graft. Another citrandarin rootstock, US-812 (C. reticulata "Sunki" × P. trifoliata "Benecke"), is fully graft compatible with the same scions. Transcriptome analysis was performed on the vascular tissues above and below the graft union of US-812 and US-1283 graft combinations with "Bearss" and "Valencia" to identify expression networks associated with incompatibility and help understand the processes and potential causes of incompatibility. Transcriptional reprogramming was stronger in the incompatible rootstock than in the grafted scions. Differentially expressed genes (DEGs) in US-1283, but not the scions, were associated with oxidative stress and plant defense, among others, similar to a pathogen-induced immune response localized to the rootstock; however, no pathogen infection was detected. Therefore, it is hypothesized that this response could have been triggered by signaling miscommunications between rootstock and scion either through (1) unknown molecules from the scion that were perceived as danger signals by the rootstock, (2) missing signals from the scion or missing receptors in the rootstock necessary for the formation of a healthy graft union, (3) the overall perception of the scion by the rootstock as non-self, or (4) a combination of the above.

Perceived Ageism is Associated With Recurrent Falling Among Older Colombian Adults.

Literature on the association between ageism and falling among older adults is limited. Using data from the nationwide cross-sectional SABE (Salud, Bienestar y Envejecimiento) Colombia Survey in 2015 with 18,875 participants aged ≥60 years living in the communities, the study aims to evaluate the association between perceived ageism within the family, neighborhood, health services, and public services, and recurrent falling. Participants had a mean age of 69.2 ± 7.1; 56.1% were female. Recurrent falling prevalence was 15%, and experiencing any ageism was 10%. Multivariable logistic regression analyses showed higher odds of recurrent falling for any ageism (OR = 1.81, 95% CI 1.61-2.02, p < .0001). High depressive symptoms mediated 10.1% of the association between any ageism and recurrent falling, followed by low instrumental activities of daily living (9.7%) and multimorbidity (9.3%). Current findings open new areas of gerontological research by expanding the risk factors for falling among older adults to include ageism perceptions.

Variation in the Root System Architecture of Peach × (Peach × Almond) Backcrosses.

The spatial arrangement and growth pattern of root systems, defined by the root system architecture (RSA), influences plant productivity and adaptation to soil environments, playing an important role in sustainable horticulture. Florida's peach production area covers contrasting soil types, making it necessary to identify rootstocks that exhibit soil-type-specific advantageous root traits. In this sense, the wide genetic diversity of the Prunus genus allows the breeding of rootstock genotypes with contrasting root traits. The evaluation of root traits expressed in young seedlings and plantlets facilitates the early selection of desirable phenotypes in rootstock breeding. Plantlets from three peach × (peach × almond) backcross populations were vegetatively propagated and grown in rhizoboxes. These backcross populations were identified as BC1251, BC1256, and BC1260 and studied in a completely randomized design. Scanned images of the entire root systems of the plantlets were analyzed for total root length distribution by diameter classes, root dry weight by depth horizons, root morphological components, structural root parameters, and root spreading angles. The BC1260 progeny presented a shallower root system and lower root growth. Backcross BC1251 progeny exhibited a more vigorous and deeper root system at narrower root angles, potentially allowing it to explore and exploit water and nutrients in deep sandy entisols from the Florida central ridge.

Serum proteomic changes in adults with obstructive sleep apnoea.

To examine whether differentially expressed proteins are present in the serum of patients with obstructive sleep apnoea (OSA), iTRAQ techniques (isobaric tags for relative and absolute quantification) were employed in a prospective study. Individuals were assigned to either a non-OSA control group (apnoea-hypopnoea index, AHI <5) or an OSA group (AHI ≥5). Blood samples were collected, aliquoted and frozen at -80 °C. Protein digestion and tagging with iTRAQ4plex® and mass spectrometry analysis was then performed (MALDI TOF/TOF). Ten male subjects were included in the control group (age = 45 ± 9.7 years) and 30 male patients in the OSA group (age = 45 ± 10.7 years), the latter being then subdivided into three severity groups. A total of 103 proteins were identified with differential levels between patients with OSA and controls. Of these, 11 proteins were underexpressed and 19 were overexpressed in patients with OSA. C4BPA and thrombospondin were underexpressed in all three OSA severity groups. Among the overexpressed proteins, 13 were overexpressed in the mild OSA group, seven in the moderate group and five in the severe group. Analysis of interactions between the identified proteins revealed that protein alterations in OSA are primarily associated with derangements in lipid and vascular metabolic pathways. This study provides initial evidence that differential protein expression occurs in adults with OSA, and that such proteins change according to disease severity, and appear to primarily involve lipid and vascular metabolic pathways.

Rhizoboxes as Rapid Tools for the Study of Root Systems of Prunus Seedlings.

Rootstocks are fundamental for peach production, and their architectural root traits determine their performance. Root-system architecture (RSA) analysis is one of the key factors involved in rootstock selection. However, there are few RSA studies on Prunus spp., mostly due to the tedious and time-consuming labor of measuring below-ground roots. A root-phenotyping experiment was developed to analyze the RSA of seedlings from 'Okinawa' and 'Guardian'™ peach rootstocks. The seedlings were established in rhizoboxes and their root systems scanned and architecturally analyzed. The root-system depth:width ratio (D:W) throughout the experiment, as well as the root morphological parameters, the depth rooting parameters, and the root angular spread were estimated. The 'Okinawa' exhibited greater root morphological traits, as well as the other parameters, confirming the relevance of the spatial disposition and growth pattern of the root system.

Sarcopenic Dysphagia Is Associated With Mortality in Institutionalized Older Adults.

OBJECTIVE: To estimate mortality associated with sarcopenic dysphagia. DESIGN: A 3-year follow-up cohort. SETTING AND PARTICIPANTS: Ninety-five nursing home residents were evaluated to determine the baseline presence or absence of oropharyngeal dysphagia and followed up for 3 years. METHODS: The primary outcome was the risk of death. Dysphagia was assessed using a volume-viscosity swallow test. We used an algorithm to determine sarcopenic dysphagia based on grip strength, walking speed, calf circumference, and exclusion of neurologic or structural causes of dysphagia. We constructed 3 subgroups: without dysphagia, nonsarcopenic dysphagia, and sarcopenic dysphagia. Cox proportional regression analyses were used to predict the risk of death. RESULTS: Thirty-five percent of participants had no dysphagia, 20% nonsarcopenic dysphagia, and 45% sarcopenic dysphagia. Sarcopenic dysphagia was independently associated with a higher risk of death [hazard ratio (HR) 2.44, 95% CI 1.02-5.80, P = .043] than without dysphagia. In addition, a higher Charlson Comorbidity Index score was associated with a higher risk of death (HR 1.33, 95% CI 1.01-1.75, P = .040). CONCLUSIONS AND IMPLICATIONS: This study shows that sarcopenic dysphagia was associated with increased mortality among institutionalized older adults. These deaths could be potentially preventable.

The Association Between Discrimination and Falling. A National Sample of Older Adults.

OBJECTIVE: To assess the relationship between discrimination and falling among older people. METHODS: A cross-sectional nationwide population-based face-to-face survey, 2015. The SABE (Salud, Bienestar y Envejecimiento) Colombia Study, 19,004 community-dwelling adults aged ≥60 years. Recurrent falling was defined as ≥2 falls during the prior year. Main independent variable was discrimination. RESULTS: Multivariate logistic regression models showed that recurrent falling was significantly associated with a number of reasons for experiences of everyday discrimination (due to racial, socioeconomic status, gender, age, religion, sexual orientation, or disability) (OR = 1.27, 95% CI 1.21-1.33), childhood discrimination score (never = 0 to many times = 3) (OR = 1.23, 95% CI 1.13-1.33), and number of situations for discrimination during the last 5 years due to skin color (group activities, public places, inside the family, or health centers) (OR = 1.12, 95% CI 1.08-1.17). DISCUSSION: Discrimination experiences were associated with higher odds of recurrent falling.

Engineering a Plant-Derived Astaxanthin Synthetic Pathway Into Nicotiana benthamiana.

Carotenoids have been shown to be essential for human nutrition. Consumption of carotenoid-rich fruits and vegetables can reduce the risk of many diseases. The ketocarotenoid astaxanthin has become a commercially valuable compound due to its powerful antioxidant properties compared to other carotenoids. It is naturally produced in certain algae, bacteria, and the flowers of some species of the genus Adonis, although it is produced in such small quantities in these organisms that it is costly to extract. Chemical synthesis of this compound has also shown limited success with a high proportion of esterified forms of astaxanthin being produced, which decreases antioxidant properties by the conversion of hydroxyl groups to esters. Previously, transgenic astaxanthin-producing plants have been created using a ß-carotene ketolase enzyme of either bacterial or algal origin. However, a novel astaxanthin pathway exists in the flowering plants of the genus Adonis which has not been utilized in the same manner. The pathway involves two unique enzymes, ß-ring-4-dehydrogenase and 4-hydroxy-ß-ring-4-dehydrogenase, which add the necessary hydroxyl and ketone groups to the rings of ß-carotene. In the present study, Nicotiana benthamiana plants were transformed with chimeric constructs coding for these two enzymes. The regenerated, transgenic plants accumulate astaxanthin and their growth (height and weight) was unaffected, when compared to non-transformed N. benthamiana and to plants transformed with the bacterial ß-carotene ketolase. The accumulation of astaxanthin also improved seedling survivability under harsh UV light, mitigated reactive oxygen accumulation, and provided a phenotype (color) that allowed the efficient identification and recovery of transgenic plants with and without selection.

Influence of rootstocks on fruit physical and chemical properties of peach cv. UFSun.

The subtropical peach cultivar UFSun grafted on five different rootstocks ('Flordaguard', 'Barton', 'MP-29', 'P-22', and 'Okinawa') was investigated in terms of the pomological and biochemical parameters of the fruit. Significant differences in fruit weight and size, soluble solids content, titratable acidity, and firmness were found among some rootstocks. The fruit length and diameter were different between the 'MP-29' and other rootstocks. It was also found that firmness of 'UFSun' fruit was affected by the rootstock. The highest firmness value was found when 'UFSun' was grafted on 'Flordaguard'.' 'MP-29' fruit had the highest soluble solids content, but there were no differences among the other rootstocks. 'UFSun' fruit from trees grafted on 'MP-29' were smaller and had the most intense color compared to 'UFSun' fruit from other rootstocks. Rootstock had a significant influence on total fruit phenolic compounds, anthocyanin content, and total antioxidant activity, with fruit from 'UFSun' on 'MP-29' having the highest values in all of them. A high correlation between fruit total antioxidant activity and total phenolic content was found. Overall, the results showed that 'MP-29' seems to induce the highest fruit quality, showing higher contents of total soluble solids, total titratable acidity, total phenolic compounds, total antioxidant activity, and total anthocyanin content. Selecting the right combination of the rootstock and cultivar is important for optimizing fruit quality parameters.

Effect of Propagation Systems and Indole-3-Butyric Acid Potassium Salt (K-IBA) Concentrations on the Propagation of Peach Rootstocks by Stem Cuttings.

Traditionally, peach rootstocks are propagated by seeds due to their high availability, low cost, and easy storage and handling. However, stem cuttings allow the propagation of interspecific hybrids and keep the genetic uniformity of heterozygous genotypes. This study compared the effect of four different concentrations of K-IBA (indole-3-butyric acid potassium salt) on softwood cuttings of three peach backcrosses (peach × (peach × almond)) for rootstock propagation in two propagation systems: aeroponics and germination trays. The four concentrations of K-IBA applied were: 0.0% (w/v) as a control, 0.1% (w/v), 0.2% (w/v), and 0.4% (w/v). Data were collected on the survival rate (%), rooting rate (%), and root growth parameters. The relevance of auxin for peach cuttings rooting was evidenced. K-IBA at 0.2% showed the best rooting effect for peach softwood cuttings, evidenced by its high rooting rate and higher survival rate. K-IBA at 0.4% and 0.2% produced the highest number of adventitious roots. The highest root growth parameters were obtained in germination trays, confirming the suitability of this system for root growth. However, aeroponics was demonstrated to be as efficient as the traditional germination trays for the rooting of peach cuttings, allowing for a more controlled environment with a better use of resources.

Diaphragmatic Paraganglioma in an Adolescent Male.

Paragangliomas are an infrequent type of neuroendocrine tumor that commonly produces catecholamines. We describe a case of a 14-year-old male with a history of uncontrolled hypertension who presented to the emergency department with a headache, palpitations, and profuse sweating. Symptoms were explained by the presence of a catecholamine-producing paraganglioma located at the right diaphragm. One year after radical surgical resection, the patient remains normotensive and does not require hypertensive medications.

Sarcopenic dysphagia in institutionalised older adults. / Disfagia sarcopénica en adultos mayores institucionalizados.

INTRODUCTION: Sarcopenic dysphagia, defined as dysphagia caused by sarcopenia, is a swallowing disorder of great interest to the medical community. The objective of our study was to evaluate the prevalence and factors associated with sarcopenic dysphagia in institutionalised older adults. MATERIAL AND METHODS: An observational, analytical, cross-sectional study was conducted in a nursing home between September and December 2017, with 100 participants. The presence of dysphagia was assessed using the volume-viscosity clinical examination method, and the diagnostic algorithm for sarcopenic dysphagia was followed. The participants' grip strength, gait speed, calf circumference, nutritional assessment (Mini Nutritional Assessment), Barthel Index, cognitive assessment (Mini-Mental State Examination) and Charlson Comorbidity Index were evaluated. Bivariate and multivariate logistic regression analyses were performed. RESULTS: The median age was 84 years, and 55% were women; 48% had functional dependence, 49% had positive screening for malnutrition and 64% had some degree of dysphagia. The prevalence of sarcopenic dysphagia was 45%, and the main factors related to less sarcopenic dysphagia were a good nutritional status (OR 0.85, 95% CI, 0.72-0.99) and a better functional performance status (OR 0.98, 95% CI 0.97-0.98). CONCLUSION: Sarcopenic dysphagia has a high prevalence in institutionalised older adults; and functional dependence and poor nutritional status were associated with sarcopenic dysphagia.

Sarcopenic dysphagia in institutionalised older adults.

INTRODUCTION: Sarcopenic dysphagia, defined as dysphagia caused by sarcopenia, is a swallowing disorder of great interest to the medical community. The objective of our study was to evaluate the prevalence and factors associated with sarcopenic dysphagia in institutionalised older adults. MATERIAL AND METHODS: An observational, analytical, cross-sectional study was conducted in a nursing home between September and December 2017, with 100 participants. The presence of dysphagia was assessed using the volume-viscosity clinical examination method, and the diagnostic algorithm for sarcopenic dysphagia was followed. The participants' grip strength, gait speed, calf circumference, nutritional assessment (Mini Nutritional Assessment), Barthel Index, cognitive assessment (Mini-Mental State Examination) and Charlson Comorbidity Index were evaluated. Bivariate and multivariate logistic regression analyses were performed. RESULTS: The median age was 84 years, and 55% were women; 48% had functional dependence, 49% had positive screening for malnutrition and 64% had some degree of dysphagia. The prevalence of sarcopenic dysphagia was 45%, and the main factors related to less sarcopenic dysphagia were a good nutritional status (OR 0.85, 95% CI, 0.72-0.99) and a better functional performance status (OR 0.98, 95% CI 0.97-0.98). CONCLUSION: Sarcopenic dysphagia has a high prevalence in institutionalised older adults; and functional dependence and poor nutritional status were associated with sarcopenic dysphagia.

Polyvictimization and Recurrent Falling in Older Ecuadorian Adults: The Mediation Role of Depressive Symptoms.

Objective: To assess depressive symptoms as a mediator in the association between polyvictimization and recurrent falling. Methods: Using data from the Salud, Bienestar y Envejecimiento (Health, Well-being, and Aging) Ecuador Study, we analyzed community-dwelling adults 60 years and older (n = 5227). Recurrent falling was determined as ≥2 falls during the prior 12 months. Polyvictimization was determined as a history of ≥2 types of abuse. The mediator was depressive symptoms. Mediation analyses were based on the VanderWeele method. Results: Polyvictimization was significantly associated with higher odds of recurrent falling, and odds ratio (OR) = 1.45 (95% confidence intervals [CI] 1.20-1.76). Higher depressive symptoms increase the odds for recurrent falling (OR = 1.09 and 95% CI 1.07-1.11). Moreover, depressive symptoms were a significant mediator between polyvictimization and recurrent falling. The mediating effect was 28.4%. Discussion: Polyvictimization was associated with higher odds of recurrent falling, and this association was mediated by depressive symptoms.

Clinical and epidemiological characteristics, morbidity and treatment based on the registry of acromegalic patients in Colombia: RAPACO.

AIMS: Describe the local characteristics, methodology and results of the registry of acromegalic patients in Colombia (RAPACO). METHODS: Multicenter, retrospective study based on the registry of acromegalic patients in Colombia: RAPACO. The data collected included: demographics, diagnosis, approximate time of disease evolution, data on weight, height, body mass index (BMI), neck circumference (NC) abdominal circumference (AC) hip circumference (HC) and waist/hip ratio (WHR); clinical and biochemical data at the time of diagnosis, etiology, immunohistochemistry of the tumor and information related to types of treatment. Descriptive analytics were employed. RESULTS: A total of 201 patients (60% females) with an average age at registration of 49.5 ± 14.6 years and an average time of evolution of the disease of 6.96 ± 4.5 years. Average weight was 75.1 Kg ± 12.98, with an average BMI of 28.11 ± 4.33. The most frequent symptoms mentioned at the time of diagnosis were extremity enlargement and headache. The most frequent comorbidity was arterial hypertension in 50.3% of the cases. 78.6% of cases were caused by macroadenoma. 80.1% received surgical treatment, 77.6% were under medical treatment, of which 95.7% were receiving somatostatin analogues. 26.4% of patients were treated with radiation therapy. Of the patients who received any type of clinical treatment, only 2.5% reported biochemical control at registration. CONCLUSION: It is important to recognize the local epidemiological, clinical, biochemical and treatment characteristics in order to assist in further understanding this pathology to implement local measures to improve both the quality of life as well as the prognosis of the patients diagnosed.

Medical falls among older adults in Latin American cities.

OBJECTIVE: To estimate the prevalence and risk factors for falls requiring medical attention, referred as medical falls, in community-dwelling persons aged >60 years. Methods A cross-sectional analysis was conducted using information from the Health, Well-Being, and Aging ("SABE") Study in Latin America and the Caribbean (7 cities), as well as from the SABE Bogota study (pooled sample of 8 cities n=12,487). Falls that occurred during a past 12-month period were considered and then noted if required medical treatment because of the fall. RESULTS: The weighted prevalence of medical falls across the eight surveys ranged from 6.0% to 11.3%. In weighted multivariate logistic regression analyses, potentially modifiable risk factors for medical falls include urinary incontinence (OR=1.51 95% CI 1.18-1.92), high depressive symptomatology (OR=1.53 95% CI 1.24-1.91), poor self-rated health (OR=1.35 95% CI 1.10-1.66) and activities of daily living limitations (OR=1.48 95% CI 1.16-1.87). CONCLUSIONS: Based on our results, preventive measures targeting these risk factors may help to decrease the risk for medical falls among older adults in Latin America.