Características sociodemográficas y de salud de los adultos mayores en situación de calle en Lima, Perú / Socio-demographics characteristics and health conditions of older homeless persons of Lima, Peru

Describir las características sociodemográficas y de salud de las personas adultas mayores en situación de calle (PAMSC). Materiales y métodos. Estudio de tipo transversal, se identificaron variables sociodemográficas y de salud de las PAMSC al momento del ingreso al Programa Nacional Vida Digna (PNVD) del Ministerio de la Mujer y Poblaciones Vulnerables del Perú. Se realizó un análisis descriptivo de las variables sociodemográficas y de las condiciones de salud, además se determinó la probabilidad de dependencia funcional según edad y estratificada por sexo y estado mental, usando un modelo de regresión logística. Resultados. Las PAMSC fueron, en su mayoría, hombres, solteros y con grado de instrucción primaria o menor. El 66,2% de las PAMSC presentaron algún tipo de enfermedad crónica y 27,8 algún tipo de enfermedad mental. El 50% presentaron algún grado de dependencia funcional, y casi el 70% presentó algún grado de deterioro cognitivo. La probabilidad de dependencia funcional parcial se incrementó con la edad, siendo más alta en mujeres, además, se incrementó a mayor grado de deterioro cognitivo. Conclusiones. Las PAMSC son una población altamente vulnerable no solo por el hecho de vivir a la intemperie, con necesidades básicas insatisfechas, sino también por su alta frecuencia de enfermedades crónicas y mentales, además de su alto grado de dependencia funcional y deterioro mental, que hace difícil que puedan valerse por sí mismas y requieren de cuidados especiales para superar esta situación de abandono...

Determine the socio-demographics characteristics and health conditions of older homeless persons at the time of enrollment into the National Program ôVida Dignaõ and the probability of functional dependency by age, and stratified by gender and cognitive impairment. Materials ande methods. We performed a cross sectional study, reviewing all registration forms of the program in order to identify socio-demographic variables and health conditions of older homeless persons at the time of enrollment in the program. We did a descriptive analysis of the socio-demographic variables and we also determined the frequency of health conditions. Furthermore, we determined the probability of functional dependency by age, and stratified by gender and cognitive impairment through a logistic regression model. Results. The older homeless persons at the time of enrollment in the program were mostly single men, with a primary education or no education. The study subjects had a high frequency of chronic and mental diseases. 50% of them had certain level of functional impairment and roughly 70% had a certain level of cognitive impairment. The probability of functional dependency increased by age, and it was higher in women than in men. This probability increased according to the level of cognitive impairment. Conclusions. This study shows that older homeless persons are a vulnerable population not only because they live outdoors but also because they a have also for the high prevalence of chronic and mental diseases. These diseases prevent the homeless persons from living by themselves special care to overcome their situations...

Logoaudiometria convencional y sensibilizada (S/R) en la discriminación del habla en profesores de educación básica / Conventional and sensitized logo audiometry (s/r) in the discrimination of speach in teachers of basic education

El presente estudio de tipo descriptivo se realizó con el objetivo de comparar los resultados obtenidos entre la logoaudiometría convencional y la sensibilizada (S/R) en relación con la discriminación del habla en profesores de educación básica. La población estudiada fue de 40 sujetos normooyentes con edades comprendidas entre los 25 y 46 años, 30 mujeres y 10 hombres con mínimo 5 años de experiencia docente. Se realizó audiometría tonal, se aplicó la logoaudiometría convencional y la sensibiliza (S/R) encontrando los siguientes resultados: todos los sujetos evaluados discriminaron el 100% en la audiometría convencional considerándose dentro de los parámetros de normalidad. En la audiometría sensibilizada (S/R) con ruido competente contralateral α – 10dB se encontró un promedio de discriminación del 100%, α 0dB un promedio de discriminación del 96% y α+10dB un promedio de discriminación del 91%. Con ruido competente ipsilateral α-10dB se encontró un promedio de discriminación de 89%, α 0dB un promedio de discriminación del 49% y α+10dB un promedio de discriminación del 13%. Se concluyó que a los sujetos evaluados se les facilita discriminar el habla cuando no hay ruido competente, mientras que si hay un ruido en competencia contralateral e ipsilateral, la discriminación disminuye, por lo cual se plantea la opción integrar la logoaudiometría sensibilizada (S/R), prueba tamiz, dentro de la batería audiológica básica para el diagnostico de pacientes expuestos, para la detección de diferentes patologías y en la adaptación de audífonos.

The herein descriptive study was done in order to compare results from the conventional logo audiometry and the sensitized one (S/R), in relation with the discrimination of speaking in teachers of basic education. The studied population were 40 normal hearing persons aged 25 to 46 years, 30 women and 10 men with minimum 5 years of teaching experience. A tonal audiometry was done, the conventional and sensitized logo audiometry was applied (S/R) with the following results: all assessed persons discriminated 100% in the conventional logo audiometry considered within normal parameters. In the sensitized logo audiometry (S/R) with contra lateral competent noise αt-10dB an average of discrimination of 100% was found, αt 0dB an average of discrimination of 96% and αt+10dB an average of discrimination of 91%. With competent ipsilateral noise αt-10dB an average of discrimination of 89% was found, αt 0dB an average of persons, the speaking discrimination is easy when there is not competent noise, while if there is noise in contra lateral and ipsilateral competence, the discrimination decreases, so the option to integrate the sensitized logo audiometry (S/R), tamis test, within the basic hearing battery for the diagnosis of exposed patients is stated, to detect different pathologies and with the adaptation to hearing aids.

Tenosinovitis por Mycobacterium chelonae: A propósito de un caso / Tenosinovitis caused by Mycobacterium chelonae: Report of a case

We report a patient with a diagnosis of synovial tenosynovitis who developed septic tenosinovitis with cold abscess on right hand, after a local punction. Mycobacterium chelonae a fast-growing mycobacteria, was isolated. We discuss aspects related to differential diagnosis, epidemiology, risk factors, diagnostic procedures and issues related to treatment of this nosocomial infection.

Efecto de la caseína en la absorción de d-xilosa medida mediante la prueba de H2 espirado / Effect of casein on d-xylose absorption measured by expired H2 test

Different experimental studies suggest that the presence of food in the alimentary tract, promote small intestinal absorption. The mechanism involved are not completely understood and might be related to motility changes or to humoral factors. Since studies have shown a decrease of small bowel motility after casein administration, the aim was to analyze the effect of this protein on small intestinal absorption and orocecal transit time. The hydrogen breath test was used to estimate d-xylose absorption. H2 production is dependent on the amount of this carbohydrate reaching the colon and therefore inversely proportional to d-xylose absorption. Six normal volunteers ingested 25 g d-xylose and 25 g de-xyllose + 30 g casein, and alveolar breath samples were obtained at 15 min intervals. Results: by adding casein to d-xylose solution a statistically significant decrease of maximal H2 concentration was observed from a mean of 40ñ11 ppm to a mean of 26ñ8 ppm. Similarly the area under the curve (which reflects the amount of xylose that was not absorbed) was also significantly decreased from a mean of 3281ñ1399 ppm to mean of 1394ñ700 ppm of H2. The orocecal transit time was significantly prolonged from 85.5ñ40 min to 112ñ38 min. Our results suggest that casein increased d-xylose absorption in normal subjects and that this effect might be related to a slower transit time

Cambios en los marcadores proteicos de repleción nutricional en pacientes desnutridos con nutrición enteral y su relación con los balances energético y nitrogenado / Changes in protein markers of nutritional repletion in undernurished patients with enteral nutrition and its relation with energetic and nitrogenous balance

Aim: to study the relation between tha changes in protein repletion indicators and calorie and nitrogen balance in undernurished patients receiving enteral nutrition. Patients and methods: fourteen patients (11 female, age range 55-85 years old) with an initial serum albumin below 3.5 g/dl or serum transferrin below 200 mg/dl, which receiving enteral nutrition, were studied. On days one and ten of nutritional support, indirect calorimetry, nitrogen balance and serum levels of albumin, transferrin, pre-albumin and total lymphocyte count were measured. Results: initial resting energy expenditure was 25.1ñ5 Kcal/kg/day (115.4ñ20 percent of that predicted by Harris Benedict equations) and urinary urea nitrogen 5.4ñ3.7 g/day. Initial and final nitrogen balances were 66.9ñ71 and 81.4ñ105.9 mg N/kg/day and mean energy balance throughout the study was +9.0ñ7.2 Kcal/kg/day. During the ten days of nutritional support, albumin improved significantly in 0.35ñ0.43 g/dl (15.2ñ19.8 percent). Transferrin, pre-albumin and total lymphocyte count did not change significantly. The changes in these last parameters did not correlate with nitrogen or calorie balance. Conclusions: probably other factors, besides nutritional balances, influence serum protein levels and these may not change despite an adequate nutritional repletion