Gait speed according to cognitive status in older adults: a cross-sectional study in a resource-limited country.

OBJECTIVE: We aimed to investigate the association between gait speed and cognitive status in outpatient older adults from a resource-limited setting in Peru. METHODS: We performed a cross-sectional study including older adults aged ≥60 years attending a geriatrics outpatient clinic between July 2017 and February 2020. Gait speed was measured over a 10-meters distance without considering the first and last meter traveled. Cognitive status was assessed through the Short Portable Mental Status Questionnaire (SPMSQ) and the Mini-Mental State Examination (MMSE). We used a multivariate binomial logistic regression to conduct both an epidemiological and fully adjusted models. RESULTS: We included 519 older adults (mean age: 75 years; IQR = 10), of whom 95 (18.3%) and 151 (31.5%) were cognitively impaired according to the SPMSQ and MMSE, respectively. Gait speed was slower among patients with poorer cognitive status as assessed by both tools (p < 0.001). Malnutrition (PR: 1.74; CI: 1.45-2.08) and functional dependency (PR: 4.35; CI: 2.68-7.08) were associated with a greater prevalence of cognitive impairment according to the SPMSQ, whereas a faster gait speed (PR: 0.27, CI: 0.14-0.52) and longer years of education (PR: 0.83, CI: 0.77-0.88) were associated with a less prevalence. CONCLUSIONS: Slower gait speed was associated with poorer cognitive status in outpatient older adults. Gait speed may be a complementary tool in the cognitive assessment of older adults from resource-limited settings.

Neck circumference in Latin America and the Caribbean: A systematic review and meta-analysis.

Background: High neck circumference (NC) is associated with high burden diseases in Latin American and the Caribbean (LAC). NC complements established anthropometric measurements for early identification of cardio-metabolic and other illnesses. However, evidence about NC has not been systematically studied in LAC. We aimed to estimate the mean NC and the prevalence of high NC in LAC. Methods: We conducted a systematic review in MEDLINE, Embase, Global Health and LILACS. Search results were screened and studied by two reviewers independently. To assess risk of bias of individual studies, we used the Hoy et al. scale and the Newcastle-Ottawa scale. We conducted a random-effects meta-analysis. Results: In total, 182 abstracts were screened, 96 manuscripts were reviewed and 85 studies (n= 51,978) were summarized. From all the summarized studies, 14 were conducted in a sample of the general population, 23 were conducted with captive populations and 49 studies were conducted with patients. The pooled mean NC in the general population was 35.69 cm (95% IC: 34.85cm-36.53cm; I²: 99.6%). In our patient populations, the pooled mean NC in the obesity group was 42.56cm (95% CI 41.70cm-43.42cm; I²: 92.40%). Across all studied populations, there were several definitions of high NC; thus, prevalence estimates were not comparable. The prevalence of high NC ranged between 37.00% and 57.69% in the general population. The methodology to measure NC was not consistently reported. Conclusions: Mean NC in LAC appears to be in the range of estimates from other world regions. Inconsistent methods and definitions hamper cross-country comparisons and time trend analyses. There is a need for consistent and comparable definitions of NC so that it can be incorporated as a standard anthropometric indicator in surveys and epidemiological studies.

Prescrição e dispensação de benzodiazepínicos em tempos de pandemia da covid-19 no Brasil / Prescription and Dispensing of Benzodiazepines in Times of the Covid-19 Pandemic in Brazil / Prescripción y Dispensación de Benzodiazepinas en Tiempos de la Pandemia Covid-19 en Brasil

Objetivo: teve como objetivo analisar a prevalência da prescrição e dispensação de benzodiazepínicos nas capitais brasileiras, nos 1°s trimestres de 2020 e 2021, considerando a pandemia da Coronavirus desease-2019 (COVID-19). Método: é um estudo epidemiológico, exploratório, quantitativo, documental e retrospectivo que investigou dados do Sistema Nacional de Gerenciamento de Protocolos Controlados. Utilizou-se da estatística descritiva e testes de associação para as análises dos dados, pelo programa Software Statistical Package for the Social Sciences. Além disso, foi realizado o cálculo da prevalência da dispensação. Resultados:a dispensação de alprazolam e clonazepam tem maior prevalência. A região Sudeste apresenta maior prevalência de dispensação (1° trimestre de 2020 n = 7098,74; 1° trimestre de 2021 n =6849,77), seguida do Sul (1° trimestre de 2020 n = 5939,6; 1° trimestre de 2021 n=5616,16). Conclusão: sendo assim, não houve aumento significativo para dizer que há prescrição e dispensação de benzodiazepínicos entre os anos analisados

Objective: the objective was the prevalence of prescription and dispensing of benzodiazepines in Brazilian capitals, in the first quarters of 2020 and 2021, considering the Coronavirus desease-2019 (COVID-19) pandemic. Methods: this is an epidemiological, exploratory, quantitative, documentary and retrospective study that investigated data from the National Controlled Protocol Management System. Descriptive statistics and association tests were used for data analysis, using the Software Statistical Package for Social Sciences program. In addition, the calculation of the prevalence of dispensation was performed. Results: dispensing of alprazolam and clonazepam is more prevalent. The Southeast region has the highest prevalence of dispensing (1st quarter of 2020 n = 7098.74; 1st quarter of 2021 n = 6849.77), followed by the South (1st quarter of 2020 n = 5939.6; 1st quarter of 2021 of 2021 n =5616.16). Conclusion: therefore, there was no significant increase to say that the prescription and dispensing of benzodiazepines between the years analyzed

Objetivo: el objetivo de este estudio fue analizar la prevalencia de la prescripción y dispensación de benzodiazepinas en capitales brasileñas en el 1er trimestre de 2020 y 2021, considerando la pandemia de Coronavirus desease-2019 (COVID-19). Método: se trata de un estudio epidemiológico, exploratorio, cuantitativo, documental y retrospectivo que investigó datos del Sistema Nacional de Gestión de Protocolos Controlados. Para el análisis de datos se utilizaron estadísticas descriptivas y pruebas de asociación, utilizando el programa Software Statistical Package for Social Sciences. Además, se realizó el cálculo de la prevalencia de dispensación. Resultados: la dispensación de alprazolam y clonazepam es más prevalente. La región Sureste tiene la mayor prevalencia de dispensación (1er trimestre de 2020 n = 7098.74; 1er trimestre de 2021 n = 6849.77), seguida por el Sur (1er trimestre de 2020 n = 5939.6; 1er trimestre de 2021 de 2021 n =5616.16). Conclusión: por lo tanto, no hubo un aumento significativo para decir que la prescripción y dispensación de benzodiazepinas entre los años analizados

Pestera cu Oase 2 and the cranial morphology of early modern Europeans.

Between 2003 and 2005, the Pestera cu Oase, Romania yielded a largely complete early modern human cranium, Oase 2, scattered on the surface of a Late Pleistocene hydraulically displaced bone bed containing principally the remains of Ursus spelaeus. Multiple lines of evidence indicate an age of approximately 40.5 thousand calendar years before the present (approximately 35 ka 14C B.P.). Morphological comparison of the adolescent Oase 2 cranium to relevant Late Pleistocene human samples documents a suite of derived modern human and/or non-Neandertal features, including absence of a supraorbital torus, subrectangular orbits, prominent canine fossae, narrow nasal aperture, level nasal floor, angled and anteriorly oriented zygomatic bones, a high neurocranium with prominent parietal bosses and marked sagittal parietal curvature, superiorly positioned temporal zygomatic root, vertical auditory porous, laterally bulbous mastoid processes, superiorly positioned posterior semicircular canal, absence of a nuchal torus and a suprainiac fossa, and a small occipital bun. However, these features are associated with an exceptionally flat frontal arc, a moderately large juxtamastoid eminence, extremely large molars that become progressively larger distally, complex occlusal morphology of the upper third molar, and relatively anteriorly positioned zygomatic arches. Moreover, the featureless occipital region and small mastoid process are at variance with the large facial skeleton and dentition. This unusual mosaic in Oase 2, some of which is paralleled in the Oase 1 mandible, indicates both complex population dynamics as modern humans dispersed into Europe and significant ongoing human evolution once modern humans were established within Europe.

An early modern human from the Pestera cu Oase, Romania.

The 2002 discovery of a robust modern human mandible in the Pestera cu Oase, southwestern Romania, provides evidence of early modern humans in the lower Danubian Corridor. Directly accelerator mass spectrometry radiocarbon (14C)-dated to 34,000-36,000 14C years B.P., the Oase 1 mandible is the oldest definite early modern human specimen in Europe and provides perspectives on the emergence and evolution of early modern humans in the northwestern Old World. The moderately long Oase 1 mandible exhibits a prominent tuber symphyseos and overall proportions that place it close to earlier Upper Paleolithic European specimens. Its symmetrical mandibular incisure, medially placed condyle, small superior medial pterygoid tubercle, mesial mental foramen, and narrow corpus place it closer to early modern humans among Late Pleistocene humans. However, its cross-sectional symphyseal orientation is intermediate between late archaic and early modern humans, the ramus is exceptionally wide, and the molars become progressively larger distally with exceptionally large third molars. The molar crowns lack derived Neandertal features but are otherwise morphologically undiagnostic. However, it has unilateral mandibular foramen lingular bridging, an apparently derived Neandertal feature. It therefore presents a mosaic of archaic, early modern human and possibly Neandertal morphological features, emphasizing both the complex population dynamics of modern human dispersal into Europe and the subsequent morphological evolution of European early modern humans.