Retrospective cohort study on the factors influencing poor prognosis in young and middle-aged patients with pulmonary tuberculosis / 公共卫生与预防医学

Objective To conduct a retrospective cohort study on the influencing factors of poor prognosis of young and middle-aged patients with pulmonary tuberculosis. Methods Selecting 426 young and middle-aged patients who were diagnosed with pulmonary tuberculosis in our hospital from January to December 2018 as the research subjects. Collecting the social demography information of all patients and the information of potential factors affecting the prognosis (allergy history, smoking history, drinking history, BMI level, disease information, treatment information, etc.) and discussing the factors affecting the prognosis of young and middle-aged pulmonary tuberculosis patients and their effects. Results The average age of 426 patients was (41.93±5.17) years old, the average BMI of them was (21.97±3.15) kg/m2, and an average course of disease of them was (2.76±0.99) years. There was no significant difference in the basic sexual information between men and women. In this study, a total of 128 patients with poor prognosis were retrospectively followed up, including 90 males and 38 females. The detection rate of males was significantly higher than that of females (χ2=16.976, P2=18.850, P2=38.924, P2=127.207, P2=32.566, P2=16.715, P2=17.315, P2=16.976，P1 and P1 and P<0.05; Regular treatment still showed potential protective factors, with an HR of 0.408, P<0.05. Conclusion: Male, emaciated body type, disease course ≥ 5 years, smoking history, number of lung field lesions ≥ 3, presence of pulmonary cavities and comorbidities are potential risk factors, while regular treatment suggests potential protective factors. Conclusion More targeted disease control and management should be implemented for middle-aged and young patients with pulmonary tuberculosis based on the aforementioned influencing factors to improve their prognosis.

Matriz analítica de vulnerabilidade da população adulta para Covid-19: uma revisão integrativa / Analytic Matrix of vulnerability to Covid-19 among the adult population: an integrative review

Resumo Sintetizar os elementos de vulnerabilidade da população adulta para a Covid-19. Método: Revisão integrativa, realizada entre agosto e novembro de 2020, com critérios definidos de inclusão, exclusão e recuperação dos estudos, de extração e síntese dos dados, pela análise temática categorial e sistematização pela vulnerabilidade. Resultados mais relevantes: De 2.247 artigos recuperados, foram selecionados e avaliados 70 estudos originais com leitura integral. Emergiram da análise temática quatro marcadores de vulnerabilidade: Condições crônicas de saúde; Experiências de vida e cotidiano; Inserção social; e Serviços e ações de saúde. Principais conclusões: Os marcadores de vulnerabilidade identificados poderão subsidiar os profissionais de saúde na identificação dos pacientes com menos autonomia e recursos para o autocuidado e proteção contra a Covid-19, além da adoção de intervenções em saúde e intersetoriais que as protejam mais contra a infecção por Covid-19, diminuindo as taxas de transmissão do SARS-Cov-2 dentro das comunidades e outros espaços, com a redução significativa do impacto do vírus sobre a sociedade.

Abstract Objective: To synthesize the elements of vulnerability to Covid-19 among the adult population. Method: Integrative review carried out between August and November 2020, with defined criteria of inclusion, exclusion and retrieving of studies. Data were extracted and synthesized by means of the categorical thematic analysis, and systematized by the vulnerability concept. Most relevant results: From 2247 articles retrieved, 70 original studies were selected, fully read and assessed. Four vulnerability markers emerged: Chronic Health Conditions; Daily Life Experiences; Social Insertion; and Health Services and Actions. Main conclusions: The identified vulnerability markers may support health professionals in the identification of patients with less autonomy and resources for self-care and protection against Covid-19. They may also foster the adoption of health and intersectoral interventions to protect patients against Covid-19, as well as the reduction of SARS-Cov-2 transmission rates within communities and other settings, with significant decline in the impact of the virus on society.

Percepção de pessoas idosas acerca da transição de cuidados prestados por uma equipe multiprofissional de atenção domiciliar / Aged people's perception about the transitional care provided by a multiprofessional home-based assistance team / Percepción de los adultos mayores sobre la transición del cuidado brindado por un equipo multiprofesional de atención domiciliaria

RESUMO Objetivo: compreender a percepção de pessoas idosas acerca da assistência prestada por uma Equipe Multiprofissional de Atenção Domiciliar do município de São Paulo - Brasil. Método: estudo qualitativo, com o emprego da história oral de vida. Coleta de dados entre agosto de 2020 até outubro de 2021, com entrevistas semiestruturadas. Amostra foi de nove idosas atendidas pela Equipe Multiprofissional de Atenção Domiciliar. Os dados foram tratados de acordo com a história oral de vida, apresentados na forma de narrativas e categorizados. Resultados: das narrativas emergiram sete categorias temáticas. A percepção dos participantes acerca da assistência à saúde prestada pela equipe, mostrou-se positiva e necessária, por sobretudo favorecer o acesso aos recursos disponibilizados pelo Sistema Único de Saúde. Conclusão: destaca-se a importância da atenção domiciliar para a continuidade do cuidado das pessoas idosas. Reforçou a necessidade de incluir o processo de finitude no planejamento nas ações de cuidado dos serviços de saúde.

ABSTRACT Objective: to understand the aged people's perception about the care provided by a Multiprofessional Home-based Assistance Team in the city of São Paulo - Brazil. Method: a qualitative study using oral life stories. The data were collected between August 2020 and October 2021 by means of semi-structured interviews. The sample consisted of nine aged women assisted by the Multidisciplinary Home-based Assistance Team. The data were treated according to oral life stories, presented in the form of narratives and categorized. Results: seven thematic categories emerged from the narratives. The participants' perception of the health care provided by the team was positive and necessary, mainly because it favored access to the resources provided by the Unified Health System. Conclusion: the importance of home-based care for care continuity for aged people is highlighted. The study reinforced the need to include the finitude process in the planning of care actions in health services.

RESUMEN Objetivo: comprender la percepción de los adultos mayores sobre la asistencia prestada por un Equipo Multiprofesional de Atención Domiciliaria en la ciudad de San Pablo, Brasil. Método: estudio cualitativo, que usa la historia oral de vida. Recolección de datos entre agosto de 2020 y octubre de 2021, con entrevistas semiestructuradas. La muestra estuvo compuesta por nueve mujeres de tercera edad que atendidas por el Equipo Multidisciplinario de Atención Domiciliaria. Los datos fueron tratados como historia oral de vida, presentados en forma de narraciones y categorizados. Resultados: siete categorías temáticas surgieron de las narrativas. La percepción de los participantes sobre la asistencia sanitaria que prestó el equipo fue que era positiva y necesaria, principalmente porque favoreció el acceso a los recursos que brinda el Sistema Único de Salud. Conclusión: se destaca la importancia de la atención domiciliaria para la continuidad del cuidado del adulto mayor. Reforzó la necesidad de incluir el proceso de finitud en la planificación de las acciones de cuidado en los servicios de salud.

Lifestyle and mild cognitive impairment in aged people: Inhibitory effect of modifiable lifestyle in the progression of impairment

The process of aging usually accompanied with deterioration of physical and mental abilities resulting in gradual decline in cognitive function and increased risk of cognitive impairment. People experience age related dysfunctions, which is termed as Mild Cognitive Impairment. The values and attitudes exhibited as an impact of social, cultural, economic and environmental conditions and a set of health pertinent behaviour are collectively termed as Lifestyle. Modifiable lifestyle factors are those factors, which inhibit the progression of cognitive decline and can act as an aid to stabilize cognitive health and improve cognitive functioning. The present paper intends to review the inhibitory effect of modifiable lifestyle in cognitive impairment in aged people. An integrated review of literature of about 30 papers ranging from 2004 to 2020 performed from different sources namely Publish or Perish 7, Academia, Research Gate, PubMed, NIH- PA, Science Direct, PloS Medicine etc. Findings of the present review suggest that modifiable lifestyle factors, level of education, leisure activity, and appropriate sleep duration are some important factors that influence cognitive health in later life and reduces the risk of cognitive decline. Further, social isolation, depression, alcohol consumption, and smoking are some factors that act as risk factors and may enhance the progression of MCI. Professionals can intervene with elderly individuals or in a geriatric community by implementing some modifications in lifestyle that in turn may inhibit or delay the progression of cognitive decline. Geriatric health policy can be developed by policy makers considering the modifiable risk factors to manage the problem of cognitive impairment

Fatores de risco associados ao delirium em idosos hospitalizados para tratamento clínico: revisão integrativa / Factores de riesgo asociados al delirio en adultos mayores hospitalizados para tratamiento clínico: revisión integradora / Risk factors associated with delirium in aged people hospitalized for clinical treatment: an integrative review

RESUMO Objetivo: identificar fatores de risco associados ao desenvolvimento de delirium em pessoas idosas hospitalizadas para tratamento clínico. Método: revisão integrativa da literatura. Busca realizada em fevereiro de 2022 através da aplicação de estratégia de busca em portais e bases de dados eletrônicas, como a Biblioteca Virtual em Saúde, o PubMed/MEDLINE e o Web of Science. Resultados: a busca resultou em 965 artigos. Após retirada de duplicatas, 583 tiveram títulos e resumos lidos. Respeitados critérios de elegibilidade, chegou-se a 127 estudos para leitura completa, dos quais 110 foram excluídos e 17 analisados, totalizando amostra de 6.170 pacientes. Foram incluídos estudos com pacientes ≥ 60 anos de idade, tratamento clínico, avaliação de fatores de risco para delirium; e excluídos estudos que utilizaram instrumentos não validados, relatos de casos, teses, monografias, artigos de revisão ou que não responderam à questão de pesquisa. Os fatores de risco mais encontrados foram a presença de déficit cognitivo e demência. Outros fatores também encontrados foram: idade avançada, presença de febre/infecção, desidratação, déficit funcional, uso de psicotrópicos antes do internamento, severidade das doenças de base, polifarmácia, déficit visual, dor ao repouso, presença de diabetes mellitus , fragilidade e tempo de internamento na emergência. Conclusões: os estudos apontam diversos fatores de risco associados ao delirium e destacam a relevância do reconhecimento do delirium pela equipe assistencial. Ação rápida e eficaz na prevenção do delirium em idosos depende da sua identificação. A equipe de saúde deve estar atenta durante o cuidado de populações vulneráveis para que o rastreio de sinais, muitas vezes flutuantes, seja facilitado.

RESUMEN Objetivo: identificar los factores de riesgo asociados al desarrollo de delirium en personas mayores hospitalizadas para tratamiento clínico. Método: revisión bibliográfica integradora. Búsqueda realizada en febrero de 2022 aplicando una estrategia de búsqueda en portales y bases de datos electrónicas Biblioteca Virtual em Saúde, PubMed/MEDLINE y Web of Science. Resultados: la búsqueda dio lugar a 965 artículos. Tras eliminar los duplicados, se leyeron 583 títulos y resúmenes. Se respetaron los criterios de elegibilidad, lo que dio lugar a 127 estudios para su lectura completa, tras lo cual se excluyeron 110 y se analizaron 17, totalizando una muestra de 6.170 pacientes. Se incluyeron estudios con pacientes ≥ 60 años, tratamiento clínico, evaluación de factores de riesgo de delirio; se excluyeron los estudios que utilizaron instrumentos no validados, informes de casos, tesis, monografías, artículos de revisión o que no respondían a la pregunta de investigación. Los factores de riesgo hallados con mayor frecuencia fueron la presencia de déficit cognitivo y demencia. Otros factores: edad avanzada, presencia de fiebre/infección, deshidratación, déficit funcional, uso de psicofármacos antes de la hospitalización, gravedad de las enfermedades subyacentes, polifarmacia, déficit visual, dolor en reposo, presencia de diabetes mellitus, fragilidad y duración de la estancia en urgencias. Conclusiones: los estudios señalan varios factores de riesgo asociados al delirio y destacan la importancia de que el equipo asistencial reconozca la presencia de delirio. Una acción rápida y eficaz para prevenir el delirio en los ancianos depende de su identificación. El equipo sanitario debe estar atento durante la atención a las poblaciones vulnerables para que se facilite el seguimiento de los signos, a menudo fluctuantes.

ABSTRACT Objective: to identify risk factors associated with development of delirium in aged people hospitalized for clinical treatment. Method: an integrative literature review. The search was conducted in February 2022 by applying the search strategy in electronic portals and databases, such as Biblioteca Virtual em Saúde, PubMed/MEDLINE and Web of Science. Results: the search yielded 965 articles. After removing duplicates, 583 had their titles and abstracts read. After applying the eligibility criteria, 127 studies were submitted to full reading, with exclusion of 110 and analysis of 17, totaling a sample comprised by 6,170 patients The studies included were those conducted with patients ≥ 60 years of age, clinical treatment, assessment of risk factors for delirium; and the excluded studies were those that used non-validated instruments, case reports, theses, monographs, review articles or that did not answer the research question. The most frequently found risk factors were presence of cognitive deficit and dementia. Other factors also found were as follows: advanced age, presence of fever/infection, dehydration, functional deficit, use of psychotropic drugs before hospitalization, severity of underlying diseases, polypharmacy, visual impairment, pain at rest, presence of diabetes mellitus, frailty and hospitalization time in the emergency sector. Conclusions: the studies point to various risk factors associated with delirium and highlight the relevance of the care team recognizing this condition. Fast and effective actions to prevent delirium in aged people depends on its identification. The health team should be alert during the care provided to vulnerable populations so that the screening of sings, which are often fluctuating, is facilitated.

Personas mayores ¿población en riesgo en tiempos de pandemia? Un estudio cualitativo sobre narrativas de afrontamiento que favorecen la resiliencia en las personas mayores

Introducción: La Organización Mundial de la Salud, menciona que el estrés que el COVID-19 desencadena y el confinamiento están causando un fuerte impacto psicológico en las sociedades, por la relación que se hace del binomio: pandemia-muerte. Lo anterior, expone el escenario político del COVID-19 para el adulto mayor que de nuevo exhibe la imagen del adulto mayor como un ser frágil, incapaz de pensar y decidir por sí mismo, al que se debe enclaustrar y aislar. Sin embargo, a pesar de las evidencias empíricas que muestran a una población vulnerable y en riesgo en el marco de la actual pandemia, existen otras miradas teóricas que difieren, y enfatizan en las fortalezas que en esta etapa de vida se manifiestan. Objetivo: comprender la construcción narrativa y sus procesos resilientes que la población adulto mayor ha experimentado respecto al COVID-19. Se puso especial atención al discurso sobre consecuencias psicoemocionales, creencias sociales alrededor de la vejez, la discriminación, así como las omisiones a los derechos humanos y dignidad del adulto mayor. Método: diseño cualitativo descriptivo transversal, etnometodológico, con una muestra de inclusión continua, correspondiente a 15 participantes, entre 64 y 85 años radicados en México. Resultados: se identificó que los adultos mayores participantes, cuentan con suficientes recursos psicoemocionales de afrontamiento, por la eficacia de la regulación entre los sentimientos experimentados. Sin embargo, aun influye la percepción social de estereotipos y estigmatización. Conclusiones: Los resultados coinciden con los postulados de la psicología positiva y la psicogerontología respecto al desarrollo de capacidades y potencialidades como un continuo proceso, y que en la edad adulta mayor se hacen presentes, gracias a la acumulación de experiencias, individuales y colectivas. Lo que subraya la importancia de incluir otras formas en que se vive y estudia a la vejez y por ende a las metodologías y propuestas de intervención.

Background: The World Health Organization mentions that the stress that COVID-19 triggers and confinement are causing a strong psychological impact on societies, due to the relationship made of the binomial pandemic and death. The above exposes the political scenario of COVID-19 for the elderly that once again exhibits the image of the elderly as fragile beings, incapable of thinking and deciding for themselves, who must be cloistered and isolated. However, despite the empirical evidence that shows a vulnerable and at-risk population in the context of the current pandemic, other theoretical views differ and emphasize the strengths that are manifested in this stage of life. Objective: To understand the narrative construction and resilient processes that the older adult population has experienced concerning COVID-19. Special attention was paid to the discourse on psycho-emotional consequences, social beliefs about old age, discrimination, as well as the omissions of human rights and dignity of the elderly. Method: qualitative descriptive cross-sectional ethnomethodological design, with a continuous inclusion sample, corresponding to 15 participants, between 64 and 85 years old, living in Mexico. Results: It was identified that the participating older adults have sufficient psycho-emotional coping resources, due to the efficacy of the regulation of the feelings experienced. However, it is still influenced by the social perception of stereotypes and stigmatization. Conclusions: The results coincide with the postulates of positive psychology and psycho-gerontology regarding the development of capacities and potentialities as a continuous process, and that in older adulthood they become present, thanks to the accumulation of experiences, individual and collective. This underlines the importance of including other ways in which old age is lived and studied, and therefore in the methodologies and proposals for intervention.

Application of fluorouracil and adjustable suture on surgery treatment for acute attack of primary angle-closure glaucoma in middle-aged patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effect of combined application of fluorouracil and adjustable suture in trabeculectomy for acute attack of primary angle-closure glaucoma in middle-aged patients. <p>METHODS: This was a prospective study. 60 patients(60 eyes)with primary angle-closure glaucoma in middle-aged patients were selected in our hospital from October 2016 to March 2019. Patients were randomly divided into suture group, 5-FU group and combined group, with 20 cases(20 eyes)in each group. Followed up for 6mo postoperatively, the patient's vision, visual field, intraocular pressure, adjuvant therapy and quality of life were observed.<p>RESULTS:The best corrected visual acuity among the three groups in the first week after operation was higher than that before surgery(<i>P</i><0.05). The intraocular pressure of the three groups at one week, one month and six months after operation were lower than that before operation(all<i> P</i><0.05). The intraocular pressure in the combined group were significantly lower than that in the suture group and the 5-FU group at 1mo and 6mo after operation(all <i>P</i><0.05). The number of eyes with anti-glaucoma drugs(2 eyes)and the number of anti-glaucoma drugs(0.20±0.016)in the combined group after operation were significantly lower than those in the suture group(11 eyes, 0.90±0.068)and the 5-FU group(12 eyes, 0.95±0.045)(all <i>P</i><0.05). There was no significant differences in preoperative CLVQOL scores among the three groups(<i>P</i>>0.05). The CLVQOL scores of the combined group(110.60±2.44)was higher than that of the suture group(101.50±2.61)and the FU group(98.55±2.50)at 6mo after operation(<i>P</i><0.05). The increase of CLVQOL scores(34.50±4.36)in the combined group before and after operation was significantly higher than that in the suture group(25.80±3.59)and the FU group(23.05±5.44)(<i>P</i><0.05). <p>CONCLUSION: Combined use of 5-FU and adjustable suture in trabeculectomy for the treatment of acute attack of middle-aged primary acute angle-closure glaucoma patients is safe and effective, which can improve the quality of life.

Health Behaviors and Lifestyle Patterns of Elderly Living Alone in Korea

BACKGROUND: Korea's population is aging rapidly. Aged people who lead a solitary life are in a state of social isolation and face a greater risk of lower quality of life. The purpose of this study was to analyze the health behaviors and lifestyle patterns of aged people who lead a solitary life in Korea.METHODS: We analyzed 4,471 subjects (1,933 men and 2,538 women)-aged people aged 65 or above-based on data from the Korea National Health and Nutrition Examination Survey VI (2013–2015). The odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed using multivariate logistic regression analysis adjusted with age, household income level, occupational status, and geographical region.RESULTS: Socioeconomic status was lower in aged people who lead a solitary life than in those living with family. The ORs for frequent eating out alone (OR=2.93; 95% CI 1.83–4.38), daily eating out alone (OR=2.40; 95% CI 1.25–4.60), smoking (OR=1.57; 95% CI 1.06–2.32), feeling sick or uncomfortable (OR=1.59; 95% CI 1.08–2.36), feeling depressed (OR=4.10; 95% CI 2.53–6.65), and suicide ideation (OR=2.06; 95% CI 1.21–3.51) were significantly higher in male subjects who lead a solitary life. The ORs for frequent eating out alone (OR=1.57; 95% CI 1.10–2.24) and inadequate sleep duration (OR=1.29; 95% CI 1.03–1.61) were significantly higher in female subjects who lead a solitary life.CONCLUSION: Aged people who lead a solitary life exhibited unhealthy behaviors and poor mental health. The elderly men who lead a solitary life faced higher risk of poor health than the women. Integrated management of lifestyle behaviors is required to improve the quality of health in aged people who lead a solitary life.

Comparison of blood lipid levels and influencing factors among normotensive young and middle-aged people with different brachial ankle pulse wave velocity / 中国综合临床

Objective To compare the blood lipid levels of different brachial-ankle pulse wave velocity (baPWV) in young and middle-aged people with normal blood pressure and to explore the related factors affecting baPWV.Methods From January 2014 to December 2017,the clinical data of one thousand two hundred and sixty-eight middle-aged and young people with normal blood pressure who underwent physical examination in Dongying People's Hospital were retrospectively analyzed.Using baPWV＜ 1 400 cm/s as the standard of normal arterial stiffness,the patients were divided into normal arterial stiffness group (normal group,1 128 cases),abnormal arterial stiffness group (abnormal group,baPWV ≥ 1 400 cm/s,140 cases).The blood lipid indexes of the two groups were analyzed and compared.Logistic regression analysis was used for multivariate analysis and linear correlation analysis was used for linear correlation analysis.Pearson correlation analysis was used.Results Compared with the normal group,TC ((4.99 ± 1.10) mmol/L vs.(4.48 ± 1.03) mmoL/L,t =5.830),TG ((1.62 ± 0.27) mmol/L vs.(1.49 ± 0.23) mmol/L,t=5.102),LDL-C[(3.25±0.23) mmol/L vs.(3.11±0.16) mmol/L,t =4.712),Apo B((0.96 ±0.07) g/L vs.(0.87±0.08) g/L,t =4.297)in abnormal group all increased,and HDL-C((1.15±0.09) mmol/L vs.(1.27±0.07) mmol/L,t =4.712) decreased,and the differences were statistically significant (P＜0.05).Smoking,high FPG,high LDL-C,high Apo B,low HDL-C were the independent factors affecting baPWV abnormality (P＜ 0.05).TC,TG,LDL-C,Apo B and baPWV in abnormal group were positively correlated(P＜0.05),and HDL-C and baPWV were negatively correlated(P＜0.05).There was a linear regression relationship between LDL-C,Apo B and baPWV (P＜0.05).Conclusion The increase of LDL-C and Apo B are closely related to early arterial disease in the low-risk populations of normotensive young and middle-aged people,even the risk of blood lipid may already exist within the normal range.

Fontes de sentido de vida para idosas longevas / Sources of meaning for the elderly / Fuentes de sentido de la vida para las personas de edad avanzada

No Brasil, o número de idosos longevos está crescendo de forma significativa. Compreender as fontes de sentido de vida para essa população pode auxiliar nas reflexões da comunidade acadêmica para melhor atendê-la. Oito idosas longevas foram entrevistadas e, através da perspectiva de análise fenomenológica, buscou-se compreender quais as fontes de sentido das suas vidas. A família e a fé aparecem como aspectos centrais, ratificando-se o que existe na literatura.

In Brazil, the number of aged people is growing significantly. Understanding the sources of meaning of life for this population can help reflections of the academic community to better serve it. Eight elderly women were interviewed and, through the perspective of phenomenological analysis, they sought to understand the sources of meaning in their lives. Family and faith appear as central aspects, confirming what exists in literature.

En Brasil, el número de ancianos longevos está creciendo de forma significativa. Comprender las fuentes de sentido de vida para esa población puede auxiliar en las reflexiones de la comunidad académica para mejor atenderla. Ocho ancianas longevas fueron entrevistadas y, a través de la perspectiva de análisis fenomenológico, se buscó comprender cuáles las fuentes de sentido de sus vidas. La familia y la fe aparecen como aspectos centrales, ratificando lo que existe en la literatura.

Predictive value of serum glycosylated hemoglobin for the onset of nonalcoholic fatty liver disease / 中华肝脏病杂志

Objective@#To discuss the affect of glycosylated hemoglobin (HbA1c) level for the onset of nonalcoholic fatty liver disease (NAFLD) in cohort population.@*Methods@#An epidemiological survey of the relationship between HbA1c and NAFLD conducted in 2012 was based at cohort baseline, and three follow-up sessions conducted in 2013, 2014 and 2015. In total 2 811 subjects were included in the study after exclusion of NAFLD patients at baseline and those who lost their lives due to relocation, and death. The Cox proportional hazard model was used to analyze the relationship between glycosylated hemoglobin and other risk factors of NAFLD. Continuous variables were compared using the t-test or the Mann-Whitney test. χ 2-test was used for the measurement of categorical data.@*Results@#A total of 2 811 subjects with mean age of 59 (58.2±9.8) years old, including 1 664 males and 1 147 females. Age, waist circumference, body mass index, systolic blood pressure, γ-glutamyltransferase and fasting blood glucose level of HbA1c abnormal group were higher than normal group. The incidence of NAFLD in the abnormal HbA1c level group (25.4%) was higher than normal group (14.9 %), and diastolic blood pressure, high-density lipoprotein cholesterol was lower than normal group and the differences were statistically significant. During the three follow-up intervals, there were 440 new cases of NAFLD, consisting 285 males and 155 females with cumulative incidence of 15.7% (440/2 811). Multivariate Cox regression analysis showed that patients with elevated HbA1c had a higher risk of developing NAFLD (HR 1.796; 95% CI 1.335~2.418; P < 0.01), and the increased HbA1c level after adjustment for gender, age, and metabolic syndrome-related factors remained an independent risk factors for NAFLD (HR 1.580; 95.0% CI 1.161-2.152; P < 0.01).@*Conclusion@#An elevated HbA1c levels have a positive predictive value for the onset of NAFLD.

Blood pressure variability and circadian rhythms in young and middle-aged people with H-type primary hypertension / 重庆医学

Objective To investigate the blood pressure variability(BPV) and circadian rhythms in young and middle-aged people with H-type hypertension.Methods The ambulatory blood pressure monitoring data from 89 young and middle-aged patients with mild-to-moderate hypertension were retrospectively analyzed.All cases were divided into the H-type hypertension group (n=56) and non-H-type hypertension group(n=33) according to plasma homocysteine(Hcy) level.Blood pressure in different time periods(including 24hSBP/24hDBP,dSBP/dDBP,nSBP/nDBP,mSBP/mDBP,mnSBP/mnDBP),variability(including 24hSBPV/24hDBPV,dSBPV/dDBPV,nSBPV/nDBPV,mSBPV/mDBPV,mnSBPV/mnDBPV),day and night average heart rate,dipper ratio of SBP/DBP and morning blood pressure surge were compared between the two group.Results 24hSBP,dSBP,nSBP and mSBP in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group,while 24hDBP,dDBP,nDBP and mDBP were significantly lower than those in the non-H-type group,the differences were statistically significant(P＜0.01).24hSBPV,24hDBPV,dSBPV,nDBPV and mSBPV had statistically significantly difference between the H-type hypertension group and non-H-type hypertension group(P＜0.05).The dipper ratio of SBP and mean MBPS in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group(P＜0.01).Conclusion Blood pressure variability is increased within a certain range in young and middle-aged patients with H-type hypertension,which is correlated to circadian rhythm changes.

Fatores associados à ótima capacidade para o trabalho em servidores idosos de uma universidade no Sul do Brasil / Factors associated to excellent work ability of aged public servants from a university in southern Brazil

Resumo Objetivo: investigar a associação entre o índice de capacidade para o trabalho e os fatores sociodemográficos, ocupacionais, estilo de vida e saúde em idosos. Métodos: estudo transversal, com amostra de servidores idosos de uma instituição de ensino superior. Foram coletadas informações sociodemográficas e dados referentes a comportamento social, saúde, e trabalho. Utilizou-se análise uni e multivariada pelo Modelo de Regressão Logística para determinar os fatores associados à ótima capacidade para o trabalho. Resultados: na amostra prevaleceram os homens (57,8%), entre 60 e 64 anos (75,6%), com ensino superior (57,8%). A maioria declarou ser sedentária (89,1%) e com exigência mental de trabalho (62,8%). Mais da metade da amostra era de idosos em sobrepeso (53%), que relataram quedas (21,3%) e uso regular de múltiplos medicamentos (25,6%). As variáveis associadas à menor chance de ótima capacidade para o trabalho foram sexo feminino (OR=0,39; IC95%=0,18-0,83); cor não branca (OR=0,37; IC95%=0,16-0,84); exigência física para o trabalho (OR=0,40; IC95%=0,17-0,97); hospitalização (OR=0,14; IC95%=0,03-0,57); dificuldades no sono (OR=0,12; IC95%=0,04-0,43); autopercepção de saúde ruim (OR=0,22; IC95%=0,09-0,54); queixas de sintomas osteomusculares nos últimos 7 dias (OR=0,29, IC95%=0,10-0,87); e sintomas que comprometem o trabalho (OR=0,25; IC95%=0,08-0,82). Conclusão: fatores sociodemográficos, ocupacionais e condição de saúde comprometeram a ótima capacidade para o trabalho em idosos.

Abstract Objective: to investigate the association between work ability index and socio-demographic, occupational, lifestyle and health factors in aged people. Methods: cross-sectional study, with aged public servants from a higher education institution. Sociodemographic information and data on social behavior, health, and work were collected. Uni and multivariate analysis according to the logistic regression model was used to determine the factors associated with excellent work ability. Results: the sample showed a prevalence of men (57.8%), between 60 and 64 years (75.6%), with higher education (57.8%). Most claimed being sedentary (89.1%) and having mental work demands (62.8%). More than half of the sample was of overweight aged people (53%) who reported falls (21.3%) and regular use of multiple medications (25.6%). The variables associated with less chance of excellent work ability were female (OR=0.39; CI95%=0.18-0.83); non-white color (OR=0.37; CI95%=0.16-0.84); physical demand for the job (OR=0.40; CI95%=0.17-0.97); hospitalization (OR=0.14; CI95%=0.03-0.57); sleep difficulties (OR=0.12; CI95%=0.04-0.43); self-perception of poor health (OR=0.22; CI95%=0.09-0.54); complaints of musculoskeletal symptoms in the last 7 days (OR=0.29, CI95%=0.10-0.87); and symptoms that affect work (OR=0.25; CI95%=0.08-0.82). Conclusion: sociodemographic and occupational factors, as well as health conditions jeopardize aged people's excellent work ability.

Application of Assistive Technology in Rehabilitation of Aged People / 中国康复理论与实践

According to the United Nations' definition of a three-stage aging society, China has entered into the aging society since 2000. As for the reason resulting in dysfunction of aged people, this paper points out that the majority is due to degenerative changes of the organs to cause the ability a gradual decline, besides the reason resulted from old-age disease. They are neither patients caused by diseases, nor people with disablities reaching the threshold on the continuum of disability;they might be called as aged people with disability. The re-habilitation of the aged people mainly relies on assistive technologies to improve the ability of activity and participation. The needs of assis-tive technology for old people as well as the role and selection principles of assistive technologies in rehabilitation of aged people are intro-duced in the paper. Finally, an overview of assistive technology for aged people is introduced in the paper.

Correlation between Body Mass Index and Frailty for Community Aged People in Zhengzhou, Henan, China / 中国康复理论与实践

Objective To explore the relationship between body mass index (BMI) and frailty among community aged people. Methods A total of 1571 aged people in two communities in Zhengzhou, Henan, China were recruited by convenience sampling method. They were divided into normal group, overweight group and obesity group according to BMI, and were assessed with Fried Frailty Criteria. Results The rates of overweight and obesity were 38.6%and 10.9%, respectively. There was significant difference in the level of frailty among dif-ferent groups (χ2=86.659, P<0.001). Multivariate Logistic regression analysis showed that overweight and obesity were independent risk fac-tors of pre-frailty (P<0.05), and obesity was the independent risk factor of frailty (P<0.05). Conclusion The prevalence of overweight and obesity was higher in community aged people in Zhengzhou, and normal BMI was important to postpone the process of frailty.

Assessments of Physical Function and Related Factors among Community-dwelling Aged People / 中国康复理论与实践

Objective To evaluate the physical functions of community-dwelling older adults, and analyze the related factors. Methods From September to October, 2016, 80 adults over 55-year-old in one community in Wuhan, Hubei, China were selected with convenience sampling. General situation was collected through questionnaires. Physical functions were measured by tests of grip strength, Five-Times-Sit-to-Stand Test (FTSST), modified Clinical Test of Sensory Interaction and Balance (mCTSIB) and TimedUp and GoTest (TUGT). Their correlation was analyzed. Results The average grip strength of the participants was (27.46 ± 9.66) kg; the average time of FTSST was (11.58 ± 4.03) s;there was only one (1.25%) participant observed with an impairment in mCTSIB;the average time of TUGT was (9.05±3.47) s. Grip strength was correlated with gender (r=-0.669), education level (r=0.238), the score of Mini-Mental State Examina-tion (MMSE) (r=-0.302) and activities of daily living (ADL) (r=-0.344) (P<0.05). The time of FTSST was correlated to gender (r=0.274), the score of MMSE (r=0.243) and ADL (r=0.321) (P<0.05). The time of TUGT was correlated to gender (r=0.255), education level (r=-0.362), income level (r=-0.245), the score of Self-rating Depression Scale (r=0.223), the score of MMSE (r=0.328) and ADL (r=0.354) (P<0.05). Conclusion The levels of grip strength, FTSST and TUGT are related to the demographic characters in community-dwell-ing older adults. Little abnormity has been found in mCTSIB.

Reliability and Validity of Chinese Version of Comprehensive Frailty Assessment Instrument / 中国康复理论与实践

Objective To translate the English version of Comprehensive Frailty Assessment Instrument (CFAI) into Chinese and evalu-ate its reliability and validity. Methods CFAI was translated into Chinese with the Brislin's translation mode. From May to July, 2015, 200 community aged people in Shijiazhuang, China were assessed with the Chinese version of CFAI and World Health Organization Quality of Life-BREF (WHOQOL-BREF), and 30 of them were assessed with CFAI again after a week. The content validity was rated by six experts of gereology. The total scores of CFAI and WHOQOL-BREF were analyzed with Pearson's correlation, as well as the scores of CFAI test and retest. The CFAI were analyzed with Factor Analysis. The Cronbach's α was tested. Results There were 23 items in 4 dimensions. The content validity index was 0.782. Six factors were extracted by Factor Analysis and the cumulated variance was 64.05%. The total score of CFAI correlated with the score of WHOQOL-BREF (r=-0.764, P<0.001). The Cronbach's α was 0.704~0.897 in dimensions (P<0.001), and the r= 0.604~0.941 (P<0.001) between test and retest. Conclusion The Chinese version of CFAI is reliable and valid, that can be applied to evaluate frailty in community aged people.

The prevalence and metabolic risk factors of nonalcoholic fatty liver disease among middle-aged and aged people / 实用医学杂志

Objective To investigate the prevalence of nonalcoholic fatty liver disease in a population of routine check-up,and analyze the correlation between non-alcoholic fatty liver disease and metabolic risk factors.Methods Physical examination data of 2 064 routine check-up (aged 45 or more) in the Third People's Hospital of Chengdu from January 2014 to December 2015 were randomly selected.HbA1c,fasting blood glucose,blood lipids and other indicators were measured to calculate the prevalence of NAFLD,and to analyze the correlation between NAFLD and metabolic risk factors.Results Among 2 064 cases underwent physical examination,the overall prevalence of NAFLD was 16.09％ (332/2 064).The male prevalence rate of NAFLD was significantly higher than that in female (18.51％ vs.12.87％;x2 =11.913,P =0.001).In four age groups (＜ 50 years old,50 to 59 years old,60 to 69 years old,≥ 70 years old),the NAFLD prevalence rate was 16.26％,15.63％,16.97％ and 14.72％ respectively.No statistical significance (x2 =0.900,P =0.826) was found in NAFLD prevalence rate difference in all age groups of has.In 50 ～ 59 years old and ≥70 years old group,the NAFLD prevalence rates in male were higher than that in female,the difference was statistically significant (both P ＜ 0.05).BMI,waist circumference,systolic blood pressure,diastolic blood pressure (DBP),HbA1c,fasting blood glucose,TC,TG,LDL-C,uric acid levels in NAFLD patients were higher than the normal population.HDL-C levels in patients with NAFLD is lower than that of the normal,and the difference is statistically significant (both P ＜ 0.05).Logistic regression analysis showed that BMI,hypertension,diabetes,and high TG were the independent risk factors of NAFLD;HDL-C and NAFLD were the protective factors.Conclusions In the Chengdu area of Sichuan Province,the prevalence rate of NAFLD was high,the incidence rate of NAFLD in male was higher than that in female.BMI,hypertension,diabetes mellitus and high TG were the independent risk factors of NAFLD,and HDL-C was the protective factor.

Prevalence characteristics of fatty liver and its risk factors analysis in young and middle-aged people / 中国综合临床

Objective To analyze the prevalence characteristics of fatty liver in young and middle-aged people,and to explore the risk factors of the disease,so as to provide clinical evidence for the prevention and treatment of fatty liver.Methods In 756 young and middle-aged healthy subjects with age≤50 years old,there were 197 fatty liver cases were diagnosed by ultrasonic test during 2015 year.The prevalence of different characteristics in young and middle-aged fatty liver was analyzed,the difference of blood biochemical index between fatty liver and non fatty liver group was compared,and risk factors of fatty liver was explored by binary logistic regression model.Results The total prevalence rate of fatty liver in young and middle-aged people was 26.1%(197/756),among which 33.1% (119/359) were male and 19.6%(78/397) were female,the prevalence rate of male was significantly higher than that of female(χ2=17.833,P<0.05).The prevalence rate of fatty liver increased with age(χ2=33.296,P<0.05),which in 40-50 years old was 37.1%(111/299) and significantly higher than that in 20 years-(15.0%)(24/160) and 30 years-(20.9%)(62/297).Logistic regression analysis on influencing factors of fatty liver prevalence showed that age,sex,body mass index(BMI),drinking,diabetes and fasting blood glucose(FPG),triglyceride(TG),total cholesterol(TC) were closely related to fatty liver(P<0.05),overweight,obesity,drinking,diabetes increased the risk of fatty liver disease.Biochemical indicators(FPG,TG,TC) in fatty liver group were higher than those in non fatty liver group((7.09±1.47) mmol/L vs.(5.14±1.71) mmol/L,(5.98±1.23) mmol/L vs.(4.95±1.42) mmol/L,(2.03±0.45) mmol/L vs.(1.23±0.67) mmol/L,t=271.905,98.866,278.255;P<0.05).Conclusion The prevalence rate of fatty liver in young and middle-aged people is high,and controlling body weight,give up drinking,active treating diabetes,reducing blood glucose and blood lipids can effectively decrease the prevalence of fatty liver in young and middle-aged people.

Um olhar sobre a deficiência visual e a prática de atividade física ao longo da vida / A look at visual impairment and lifelong physical activity / Una mirada a la discapacidad visual y la práctica de actividad física a lo largo de la vida

O presente estudo teve como objetivo relatar e enfocar a história de vida de uma deficiente visual congênita com sessenta e quatro anos, nascida no Norte de Portugal. Foi aplicada uma entrevista, com os dados sendo transcritos e analisados em categorias para reflexão sobre suas experiências: sensório-motoras, quedas, e lesões traumáticas durante a vida, dificuldades de orientação e mobilidade e a prática de atividade física. Os resultados sugerem a importância da realização de atividades adaptadas, de forma que um indivíduo seja capaz de obter êxito, estimulando sua progressão e autonomia ao longo da vida.

This study aimed to report the life story of a congenital blind sixty-four, born in northern Portugal. An interview was applied, the data were transcribed and analyzed in categories for reflection: sensorimotor experiences, falls and traumatic injuries throughout life, difficulties in orientation and mobility and physical activity. The results suggest the importance of conducting activities adapted so that the individual is able to succeed stimulating progression and autonomy throughout life.

Este estudio tuvo como objetivo informar y se centran en la historia de vida de un ciego congénito sesenta y cuatro años, nacido en el norte de Portugal. Se aplicó una entrevista, los datos fueron transcritas y analizadas en categorías para la reflexión: experiencias sensoriomotoras, las caídas y las lesiones traumáticas a lo largo de la vida, las dificultades en la orientación y la movilidad y la actividad física. Los resultados sugieren la importancia de realizar actividades adaptadas para que el individuo es capaz de tener éxito estimulando la progresión y la autonomía durante toda la vida.