Masa ósea en mujeres de edad mediana del Policlínico 19 de abril / Bone Mass in Middle-Aged Women from Policlínico 19 de Abril of Havana

Introducción: La osteoporosis es una enfermedad esquelética difusa caracterizada por una disminución generalizada de la resistencia ósea, que predispone a un mayor riesgo de fracturas por fragilidad y está reconocida como un grave problema de salud. Objetivo: Determinar la masa ósea en mujeres de edad mediana y algunos factores relacionados con ella. Métodos: Se realizó un estudio descriptivo transversal en mujeres de edad mediana del Policlínico 19 de abril. De la planilla de recolección de datos se extrajeron: edad, color de la piel, etapa climatérica, número de partos, meses de lactancia, resultados hormonales. Se realizó densitometría para determinar mujeres con hueso normal, baja masa ósea u osteopenia y osteoporosis, y se asociaron con algunos factores de riesgo. Resultados: Se estudiaron 82 mujeres. El 67,07 por ciento tuvo masa ósea normal en la columna lumbar, un 19,51 por ciento baja masa ósea u osteopenia y un 13,42 por ciento osteoporosis. En la cadera izquierda la mayoría (91,46 por ciento) presentó masa ósea normal. De las perimenopáusicas, una entre 50 y 54 años presentó baja masa ósea; en posmenopáusicas predominó la osteoporosis en el grupo de 50-54 (50 por ciento), en las de 55-59, las que tenían hueso normal y osteopenia (41,2 por ciento cada una). En las posmenopáusicas, las que tenían la piel blanca fueron las que presentaron mayor afectación de la masa ósea. A mayor tiempo de posmenopausia menor masa ósea (p= 0,031*), a niveles más elevados de hormona luteinizante (p= 0,000) y foliculoestimulante (p= 0,000), menor densidad mineral ósea en la columna lumbar y cadera izquierda; a niveles más elevados de estradiol (p= 0,000), mayor densidad mineral ósea en ambas localizaciones. Conclusiones: Se concluye que la mayoría de las mujeres de edad mediana del policlínico 19 de abril tenían hueso normal; la osteoporosis predominó en los grupos de mayor edad y el color de la piel blanca. Mayor tiempo de posmenopausia y niveles elevados de hormona luteinizante y foliculoestimulante se asociaron con mala masa ósea; niveles elevados de estradiol con mejor masa ósea(AU)

Introduction: Osteoporosis is a diffuse skeletal disease characterized by a generalized decrease in bone resistance, which predisposes patients to an increased risk of fragility fractures and is recognized as a serious health problem. Objective: To determine bone mass in middle-aged women and some factors related to it. Methods: A descriptive and cross-sectional study was carried out in middle-aged women from the Policlínico 19 de Abril. The following data were extracted from the data collection form: age, skin color, climacteric stage, number of deliveries, breastfeeding months, hormonal results. Densitometry was performed to determine women with normal bone, low bone mass or osteopenia and osteoporosis, and these were associated with some risk factors. Results: A group of 82 women were studied. Of them, 67.07percent had normal bone mass in the lumbar spine, 19.51percent had low bone mass or osteopenia, and 13.42percent ad osteoporosis. On the left hip, the majority (91.46percent) had normal bone mass. Of the perimenopausal women, one aged 50-54 years had low bone mass; among postmenopausal women, osteoporosis predominated in the 50-54 age group (50percent), as well as in those aged 55-59, those with normal bone mass and osteopenia (41.2percent for each condition). In the postmenopausal women, those with white skin were the most affected in bone mass. The longer the postmenopausal period, the lower the bone mass (p = 0.031*); the higher the levels of luteinizing hormone (p = 0.000) and the follicle stimulating hormone (p = 0.000), the lower bone mineral density on the lumbar spine and left hip; the higher the levels of estradiol (p = 0.000), the higher bone mineral density on both locations. Conclusions: Most middle-aged women from the Policlínico April 19 were concluded to have normal bone; osteoporosis predominated in older age groups and white skin color. Longer postmenopausal time and higher levels of luteinizing hormone and the follicle stimulating hormone were associated with poor bone mass; high levels of estradiol were associated with better bone mass(AU)

Effect of aerobic exercise associated with resistance training on body composition of middle-aged and elderly women / Efeito do exercício aeróbio associado ao treinamento de força sobre a composição corporal de mulheres de meia-idade e idosas / Efecto del ejercicio aeróbico asociado al entrenamiento de fuerza sobre la composición corporal de mujeres de mediana edad y ancianas

ABSTRACT Introduction: Lack of exercise negatively impacts physical condition and quality of life among middle-aged and elderly women. Objective: Study the effects of aerobic exercise combined with strength training on the body composition of middle-aged and elderly women. Methods: The exercise was performed once every other day from 5 pm to 6 pm. 20 middle-aged and elderly women formed an experimental group. The exercise consisted of aerobic exercise combined with strength training, while the control group practiced aerobic walking. The entire experiment lasted two months, having a total of 30 sessions. Results: Body fat percentage in the experimental group decreased from 35.10±3.436% to 30.07±3.104 %; BMI decreased from 24.98±2.870 kg/m² to 24.25±3.251 kg/m²; the mean bone mineral density increased from 1.20±0.284 g/cm3 to 1.21±0.278 g/cm3. Conclusion: Aerobic exercise and resistance training can improve physical function in middle-aged and elderly women. It may also improve bone density, optimize sports practice, and promote women's physical health. Level of evidence II; Therapeutic studies - investigating treatment outcomes.

RESUMO Introdução: A inobservância do exercício tem um impacto negativo sobre a condição física e a qualidade de vida entre as mulheres de meia-idade e idosas. Objetivo: Estudar os efeitos do exercício aeróbico combinado ao treinamento de força sobre a composição corporal de mulheres de meia-idade e idosas. Métodos: O exercício físico foi realizado uma vez a cada dois dias das 17h às 18h, 20 mulheres de meia-idade e idosas formaram um grupo experimental. O conteúdo do exercício consistia em exercício aeróbico combinado ao treinamento de força, enquanto o grupo de controle praticava caminhada aeróbica. Todo o experimento durou dois meses, com um total de 30 sessões. Resultados: A porcentagem de gordura corporal no grupo experimental diminuiu de 35,10±3,436 % para 30,07±3,104 %; o IMC reduziu de 24,98±2,870 kg/m² para 24,25±3,251 kg/m²; a densidade mineral óssea média aumentou de 1,20±0,284 g/cm3 para 1,21±0,278 g/cm3. Conclusão: O exercício aeróbico combinado com o treinamento de resistência pode melhorar a função física nas mulheres de meia-idade e idosas. Também pode melhorar a densidade óssea, otimizar a prática esportiva, promovendo a saúde física da mulher. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La inobservancia del ejercicio repercute negativamente en la condición física y la calidad de vida de las mujeres de mediana y avanzada edad. Objetivo: Estudiar los efectos del ejercicio aeróbico combinado con entrenamiento de fuerza sobre la composición corporal de mujeres de mediana edad y ancianas. Métodos: El ejercicio físico se realizó una vez cada dos días de 17:00 a 18:00, 20 mujeres de mediana edad y ancianas formaron un grupo experimental. El contenido del ejercicio consistió en ejercicio aeróbico combinado con entrenamiento de fuerza, mientras que el grupo de control practicó marcha aeróbica. El experimento duró dos meses, con un total de 30 sesiones. Resultados: El porcentaje de grasa corporal en el grupo experimental disminuyó de 35,10±3,436 % a 30,07±3,104 %; el IMC se redujo de 24,98±2,870 kg/m² a 24,25±3,251 kg/m²; la densidad mineral ósea media aumentó de 1,20±0,284 g/cm3 a 1,21±0,278 g/cm3. Conclusión: El ejercicio aeróbico combinado con el entrenamiento de resistencia puede mejorar la función física en mujeres de mediana y avanzada edad. También puede mejorar la densidad ósea, optimizar la práctica deportiva y promover la salud física de las mujeres. Nivel de evidencia II; Estudios terapéuticos -investigación de los resultados del tratamiento.

Impaired sensitivity to thyroid hormones is associated with ischemic stroke in young and middle-aged euthyroid population / 西安交通大学学报(医学版)

【Objective】 To investigate the association of thyroid indices with the prevalence of ischemic stroke in young and middle-aged euthyroid population. 【Methods】 For this retrospective study, 620 euthyroid patients aged from 18 to 65 years were divided into ischemic stroke group (n=308) and non-ischemic stroke group (n=312). The characteristics of the study population; serum thyroid indices, i.e., free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH), were collected from biochemical test results. Multivariate conditional logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for thyroid indices and ischemic stroke. 【Results】 Compared with non-ischemic stroke group, significant differences were observed in age, gender, weight, smoking status, drinking status, history of hypertension and diabetes, SBP, DBP, FBG, TC, HDL-C, LDL-C, FT3, FT4, FT3/FT4, TFQI, and PTFQI in ischemic stroke patients (all P0.05). Logistic regression analysis revealed that lower FT3 [OR (95% CI) =0.722 (0.547~0.955) , P=0.022] and FT3/FT4 ratio [OR (95% CI) =0.723 (0.600~0.870) , P=0.001] , FT4 [OR (95% CI) =1.099 (1.011~1.194) , P=0.026] were significantly associated with an increased risk of ischemic stroke. After stratified analysis by hypertension, FT4 [OR (95% CI) =1.133 (1.021~1.257) , P=0.019] , lower FT3/FT4 ratio [OR (95% CI) =0.723 (0.600~0.870) , P=0.003] , TFQI [ OR (95% CI) =1.854 (1.026~3.350) , P=0.041] , and PTFQI [OR (95% CI) =1.871 (1.065~3.288) , P=0.029] were significantly associated with an increased risk of ischemic stroke in patients combined with hypertension, while after stratified analysis by diabetes, we only found that lower FT3/FT4 ratio [OR (95% CI) =0.730 (0.559~0.953) , 0.704 (0.536~0.944) , P=0.021] and FT4 [OR (95% CI) =1.170 (1.025~1.335) , P=0.026] were significantly associated with an increased risk of ischemic stroke in patients combined with diabetes. 【Conclusion】 FT3, FT4, and FT3/FT4 ratio are associated with an increased risk for ischemic stroke in young and middle-aged euthyroid population; TFQI and PTFQ are associated with an increased risk for ischemic stroke in patients combined with hypertension.

The status and influencing factors of the dyadic coping in spouses of young and middle-age cervical cancer patients undergoing synchronous radiotherapy and chemotherapy / 中国实用护理杂志

Objective:To analyze the status of the dyadic coping in spouses of young and middle-age cervical cancer patients undergoing synchronous radiotherapy and chemotherapy, and to explore the influencing factors in bi-directional of patients and their spouses.Methods:With the convenience sampling method, a total of 150 cervical cancer patients undergoing synchronous radiotherapy and chemotherapy who were hospitalized in the Radiotherapy Department of Tianjin Medical University Cancer Institute and Hospital from March 2021 to February 2022 and their spouses were selected. A cross-sectional study was conducted by the Dyadic Coping Inventory, the Lock-Wallace Marital Adjustment Test, the General Self-Efficacy Scale, the Hospital Anxiety and Depression Scale, etc. Besides, multiple linear regression was used to identify predictors of the dyadic coping in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy.Results:The total score of dyadic coping, marital quality, general self-efficacy, anxiety and depression in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy were (121.69 ± 19.67), (97.23 ± 25.05), (25.13 ± 5.19), (9.98 ± 3.46), (8.19 ± 4.06) points. The scores of anxiety and depression of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy were (10.57 ± 3.60), (9.10 ± 4.12) points. Multiple linear regression analysis showed that factors of the patients′ anxiety and depression, spouse′s perception of marital quality, spouse′s general self-efficacy, changes in family relationship, family income, and period of radiotherapy were the main influencing factors ( P<0.01), which accounted for 55.7% of total variation. Conclusions:The level of dyadic coping in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy was medium, the marriage quality remains to be further improved,and its influence factors involved in the bi-directional of patient and spouse, including patients′ anxiety and depression, the changes of the family relationship, period of radiotherapy, spouses perception of marital quality and self-efficacy and family income. Clinical medical staff can improve the level of dyadic coping in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy by improving their cognition of disease, reducing the incongruence of dyadic illness appraisals, and taking multiple measures to reduce the economic burden felt of the spouses.

The mediating effect of social support between adult attachment and family resilience in young and middle-aged patients undergoing peritoneal dialysis / 中国实用护理杂志

Objective:To explore the mediating effect of social support between adult attachment and family resilience in young and middle-aged patients undergoing peritoneal dialysis, and to provide reference for psychological health care of young and middle-aged peritoneal dialysis patients.Methods:From September 2019 to February 2022, the prospective research method was adopted to investigate a total of 100 young and middle-aged patients undergoing peritoneal dialysis by general information questionnaire, Experiences in Close Relationship Scale-short form, Social Support Rating Scale, Family Resilience Scale, respectively. Multiple linear regression and structural equation model was used to evaluate the mediating effect of social support on adult attachment and family resilience.Results:The scores of attachment avoidance and attachment anxiety in Experiences in Close Relationship Scale-short form were (46.47 ± 10.23) points and (63.67 ± 10.37) points; Social Support Rating Scale scores were (36.40 ± 7.27) points; Family Resilience Scale scores were (94.21 ± 11.40) points. There was a negative correlation of attachment anxiety and attachment avoidance with total score and each dimension score of Social Support Rating Scale and total score and each dimension score of Family Resilience Scale ( r values were -0.844--0.373, all P<0.05). Attachment anxiety and attachment avoidance had a significantly indirect effect on the family resilience of young and middle-aged peritoneal dialysis patients through social support, which showed that the mediating effect of social support accounts for 41.6% and 48.8% of the total effect. Conclusions:Social support plays a mediating role in the relationship between adult attachment and family resilience in young and middle-aged peritoneal dialysis patients, nurses can focus on social support to reduce the adverse effects of adult attachment on family resilience.

Factors associated with negative self-rated health of middle-aged women / Factores asociados a la autoevaluación de salud negativa de mujeres de media edad / Fatores associados à autoavaliação da saúde negativa de mulheres de meia-idade

ABSTRACT Objective: To evaluate factors associated with negative self-rated health among middle-aged women treated at a climacteric outpatient clinic. Method: This is a cross-sectional, analytical study conducted with 116 women assisted in the period between March 2015 and March 2020 at the climacteric outpatient clinic of a university hospital in Cuiabá, MT, Brazil. Data were collected through telephone interviews from October 2020 to January 2021, using a questionnaire containing questions about sociodemographic, health and psychosocial data. Self-rated health was checked by asking the subjects how they rated their health. The association measure used was the prevalence ratio and 95% confidence intervals (95%CI). Poisson's multiple regression was used in the multivariate analysis. Results: Most middle-aged women in this study (54.3%) had negative self-rated health. The factor associated with the outcome was menopausal symptoms (p< 0.001), identified in the severe menopausal symptoms category PR= 2.95 (95%CI 1.4-6.3). Conclusion: The higher prevalence of negative self-rated health among the women in this study is probably related to the life stage they are experiencing. Menopausal symptoms are associated with women's perception of health due to their discomfort and consequent impact on their lives.

RESUMEN Objetivo: Evaluar los factores asociados con la autopercepción de salud negativa entre mujeres de mediana edad atendidas en un ambulatorio de climaterio. Método: Estudio transversal, analítico, realizado con 116 mujeres atendidas en el período comprendido entre marzo de 2015 y marzo de 2020 en el ambulatorio de climaterio de un hospital universitario de Cuiabá-MT, Brasil. Los datos fueron recolectados a través de entrevistas telefónicas, de octubre de 2020 a enero de 2021, utilizando un cuestionario que contenía preguntas sobre datos sociodemográficos, de salud y psicosociales. La salud autoevaluada se verificó preguntando cómo calificaron su salud. La medida de asociación utilizada fue la razón de prevalencia e intervalos de confianza del 95% (IC 95%). En el análisis multivariante se utilizó la regresión múltiple de Poisson. Resultados: La mayoría de las mujeres de mediana edad en este estudio (54,3%) tenían una autoevaluación de salud negativa. El factor asociado al desenlace fueron los síntomas menopáusicos (p< 0,001), identificados en la categoría síntomas menopáusicos severos PR= 2,95 (IC 95% 1,4-6,3). Conclusión: La mayor prevalencia de autoevaluación de salud negativa entre las mujeres de este estudio probablemente esté relacionada con la etapa de la vida en la que se encuentran. Los síntomas de la menopausia están asociados a la percepción de salud de la mujer por su malestar y consecuente impacto en su vida.

RESUMO Objetivo: Avaliar os fatores associados à autoavaliação da saúde negativa de mulheres de meia-idade atendidas em um ambulatório de climatério. Metodo: Estudo transversal, analítico, desenvolvido com 116 mulheres atendidas no período entre março de 2015 e março de 2020 no ambulatório de climatério de um hospital universitário de Cuiabá-MT. Os dados foram coletados, por meio de entrevista por telefone, no período de outubro de 2020 a janeiro de 2021, utilizando-se questionário contendo perguntas sobre dados sociodemográficos, de saúde e psicossociais. A autoavaliação da saúde foi verificada perguntando como elas avaliavam sua saúde. A medida de associação utilizada foi a razão de prevalência e intervalos de confiança de 95% (IC 95%). Na análise multivariada utilizou-se a regressão múltipla de Poisson. Resultados: A maioria das mulheres de meia-idade deste estudo (54,3%) apresenta autoavaliação da saúde negativa. O fator que apresentou associação ao desfecho foi sintomas da menopausa (p< 0,001), identificado na categoria de sintomas severos da menopausa RP= 2,95 (IC 95% 1,4- 6,3). Conclusão: A maior prevalência de autoavaliação da saúde negativa das mulheres deste estudo, provavelmente, tem relação com a fase da vida em que estão vivenciando. Os sintomas da menopausa têm associação com a percepção de saúde das mulheres pelos seus desconfortos e consequente impacto em suas vidas.

Síndrome metabólico en personas mayores de 40 años del primer nivel de atención

RESUMEN Fundamento: el síndrome metabólico es una condición de creciente prevalencia, triplica el riesgo de desarrollar enfermedad cardiovascular ateroesclerótica, se asocia a la obesidad y a estilos de vida poco saludables. El diagnóstico precoz es imprescindible en el primer nivel de atención. Objetivo determinar el comportamiento del síndrome metabólico en personas mayores de 40 años del consultorio médico # 10, perteneciente al Policlínico Docente Mártires de Calabazar del municipio Boyeros. Métodos: se realizó un estudio descriptivo de corte transversal. El universo lo constituyeron 553 personas, de ellas se entrevistaron a 376 en el período de mayo del 2017 a mayo del 2018. Se siguieron los criterios del Adult Treatment Panel III para el diagnóstico de síndrome metabólico. Las variables descriptivas se expresaron en porcientos y para la comparación de variables en estudio se utilizó el método estadístico Chi cuadrado. Resultados: los resultados obtenidos mostraron un 14,63 % de personas con síndrome metabólico, predominaron los grupos de edad de 40 a 59 años con un 54,55 % y el sexo masculino con un 54,55 %. El 89,09 % tenían cifras de presión arterial ≥130/85 mmHg. El 100 % de las personas desconocían su enfermedad. Conclusiones: se encontró predominio en las personas con síndrome metabólico del sexo masculino y de los grupos de edad de 40 a 59 años. El diagnóstico en el primer nivel de atención es deficiente. Se asocia al riesgo cardiovascular global con el aumento de la edad y el sexo masculino.

ABSTRACT Background: metabolic syndrome is a condition of increasing prevalence, it triples the risk of developing atherosclerotic cardiovascular disease, and it is associated with obesity and unhealthy lifestyles. Early diagnosis is essential at the first level of care. Objective: to determine the metabolic syndrome behavior in people over 40 years of age from the medical office # 10, belonging to the Mártires de Calabazar Teaching Polyclinic in the Boyeros municipality. Methods: a descriptive cross-sectional study was carried out. The universe was made up of 553 people, of whom 376 were interviewed in the period from May 2017 to May 2018. The criteria of the Adult Treatment Panel III for the diagnosis of metabolic syndrome were followed. The descriptive variables were expressed in percentages and Chi square statistical method was used to compare the variables under study. Results: the results obtained showed 14.63 % of people with metabolic syndrome, predominating the age groups of 40 to 59 years old with 54.55 % and males with 54.55 %. The 89.09 % have blood pressure figures ≥130/85 mmHg. 100 % of the people were unaware of their illness. Conclusions: predominance was found in people with metabolic syndrome of the male sex and of the age groups of 40 to 59 years old. Diagnosis at the first level of care is poor. Global cardiovascular risk is associated with increasing age and male sex.

Blood indexes of middle-aged and elderly persons with deep vein thrombosis of a lower extremity after a cerebral hemorrhage / 中华物理医学与康复杂志

Objective:To document the blood indexes of middle-aged and elderly intracerebral hemorrhage (ICH) patients complicated with deep vein thrombosis (DVT).Methods:A retrospective analysis was conducted of 77 hospitalized ICH patients using venous color Doppler ultrasonography within 3 days of admission. According to the results, they were divided into a DVT group (18 cases) and a non-DVT group (59 cases). The blood routine, biochemistry, coagulation, and D-dimer examinations were conducted on the 2nd day after admission. T-tests and rank sum tests tested the significance of any differences between the groups in average white blood cell counts, neutrophil percentages, platelets, albumin, globulin, fasting blood glucose, urea nitrogen, creatinine, uric acid, electrolytes, fibrinogen or D-dimer.Results:The average levels of albumin, uric acid and calcium in the DVT group were significantly lower than in the non-DVT group. The average levels of fasting blood glucose and D-dimer were significantly higher.Conclusions:Decreased serum uric acid, calcium and albumin levels, together with increased fasting blood glucose and D-dimer are related to the occurrence of DVT in ICH patients. To reduce the risk of DVT it is important to maintain normal levels of serum uric acid, calcium and albumin and to limit D-dimer and fasting blood glucose.

Investigation and analysis of muscle mass loss with obesity in 318 young and middle-aged weight loss patients / 中国医师杂志

Objective:To investigate the status of muscle mass loss with obesity among young and middle-aged weight loss patients in nutrition clinic, and to analyze the risk factors of muscle mass loss with obesity.Methods:318 cases of weight loss in the nutrition clinic of Changsha Central Hospital were investigated retrospectively. All subjects completed height and weight measurements, calculated body mass index (BMI), and measured skeletal muscle mass of limbs with Inbody 270 body composition analyzer. According to the muscle mass and body fat percentage, they can be divided into muscle mass loss combined with obesity group, simple obesity group, simple muscle mass loss group and normal group. The differences in body composition and the incidence of metabolic abnormalities between groups were compared, and the risk factors of muscle mass reduction combined with obesity were analyzed by logistic regression.Results:(1) The detection rate of muscle mass loss combined with obesity was 4.7%(15/318), including 5 males and 10 females. In addition, there were 269 cases of simple obesity, 34 cases of normal, no simple loss of muscle mass. (2) Compared with the muscle mass loss combined with obesity group, the simple obesity group had a higher proportion of family history of obesity, history of exercise and nonalcoholic fatty liver disease (NAFLD) (all P<0.05), and a lower proportion of sleep time ≥7 hours ( P<0.05). The proportion of patients with exercise history was higher in the normal group ( P<0.05). Compared with the simple obesity group, the normal group had a lower proportion of family history of obesity and NAFLD (all P<0.05), and a higher proportion of exercise history and sleep duration ≥7 hours (all P<0.05). (3) Compared with the muscle mass loss combined with obesity group, the body composition indexes of the simple obesity group were higher (all P<0.05); Compared with the muscle mass loss combined with obesity group, the height, body water, skeletal muscle mass, limb muscle mass and basal metabolism of the normal group were higher (all P<0.05), but the body fat, body fat percentage and visceral fat grade of the normal group were lower (all P<0.05). Compared with the simple obesity group, the normal group had lower body weight, body fat, body fat percentage, BMI and visceral fat grade (all P<0.05). (4) There were no significant difference in the incidence of abnormal blood pressure, blood glucose, blood lipid and uric acid levels among the three groups (all P>0.05). (5) Logistic regression analysis showed that exercise history was a protective factor for muscle mass loss ( OR=0.164, P=0.026). Conclusions:The prevalence of muscle mass loss with obesity was 4.7% in young and middle-aged overweight and obese people. These people tend to move less, sleep more. No higher incidence of metabolic abnormalities was found. Exercise was a protective factor against loss of muscle mass.

Modelo predictivo para el vaticinio de la baja calidad de vida relacionada con la salud en mujeres de edad mediana / A Predictive Model of Low Quality of Life Related to Health in Middle-Aged Women

Introducción: La calidad de vida ha sido una preocupación e interés para los investigadores, es definida como constructo social con limitaciones para su estudio, que se enmarcan en tres grupos de problemas: conceptuales, metodológicos e instrumentales. Objetivo: Desarrollar un modelo predictivo para el vaticinio de baja calidad de vida relacionada con la salud en mujeres de edad mediana. Métodos: Investigación de desarrollo tecnológico (I+D+I). Se estipuló un tamaño de muestra de 532 mujeres, para la validación del modelo, se escogieron por muestreo simple aleatorio a 200 mujeres de edad mediana. Variables utilizadas: edad, edad de la menopausia, apoyo familiar percibido, cantidad de enfermedades e intensidad del síndrome climatérico. Resultados: Se creó un modelo estadístico para el vaticinio de la baja calidad de vida relacionada con la salud, se presentan la aplicación de la regresión logística múltiple. En esta se aprecia el ajuste del modelo, evaluado por el estadígrafo X2 de Hosmer y Lemeshow (X2 Hosmer-Lemeshow = 8,656), que resultó significativo (p = 0,374). Conclusiones: El incremento de la edad en años, el apoyo familiar percibido y la intensidad del síndrome climatérico constituyen factores de riesgo de baja calidad de vida relacionada con la salud en las mujeres investigadas.El modelo estadístico es adecuado para su uso en el vaticinio de la baja calidad de vida relacionada con la salud en mujeres de edad mediana(AU)

Introduction: Quality of life has been a concern and interest for researchers. It is defined as a social construct with limitations for its study, which are framed into three groups of problems: conceptual, methodological and instrumental. Objective: To develop a predictive model of low quality of life related to health in middle-aged women. Methods: Technological development research (R+D+I). A sample size of 532 women was chosen. For the validation of the model, 200 middle-aged women were chosen by simple random sampling. The variables used were age, age at menopause, perceived family support, number of illnesses, and intensity of climacteric syndrome. Results: A statistical model was created for predicting low quality of life related to health. The application of multiple logistic regression is presented. This shows the fit of the model, evaluated by Hosmer and Lemeshow's X2 statistic (X2 Hosmer-Lemeshow=8.656), which was significant (P=0.374). Conclusions: Age increase in years, perceived family support and intensity of climacteric syndrome are risk factors for low quality of life related to health in the women investigated. The statistical model is suitable to be used for predicting low quality of life related to health in middle-aged women(AU)

Leiomiomatosis vulvovaginal: reporte de un caso y revisión bibliográfica / Vulvo-Vaginal Leiomyomatosis: Case Report and Review of the Literature

Resumen ANTECEDENTES: Los leiomiomas son los tumores pélvicos más frecuentes en la mujer; sin embargo, su localización vaginal es excepcional. Suelen ser asintomáticos y encontrarse como un hallazgo clínico. En los últimos 20 años solo se han reportado 85 casos, y solo dos han sido recurrentes. OBJETIVO: Reportar un caso de miomatosis vaginal recurrente en una paciente histerectomizada y revisar la bibliografía al respecto. CASO CLÍNICO: Paciente de 58 años, histerectomizada, con una tumoración vaginal. El reporte histopatológico informó una proliferación fusocelular, debidamente delimitada, dispuesta en haces entrecruzados. Los núcleos eran alargados, monomorfos y de extremos romos. El estroma era escaso y colagénico. No se observaron atipias citonucleares ni necrosis. El estudio inmunohistoquímico de la lesión con actina de anticuerpos antimúsculo liso y desmina se reportó positivo. Se diagnosticó miomatosis vulvovaginal recurrente. Se trató mediante resección quirúrgica. CONCLUSIÓN: Los leiomiomas vulvovaginales son extremadamente raros y la bibliografía al respecto es poca; su recurrencia es verdaderamente excepcional. De ahí la importancia de la publicación de estos casos, que aporta información que pueden tomar en cuenta otros clínicos al momento del diagnóstico.

Abstract BACKGROUND: Leiomyomas are the most frequent pelvic tumors in women; however, their vaginal location is unusual. They are usually asymptomatic and present as a clinical finding. In the last 20 years only 85 cases have been reported, and only two have been recurrent. OBJECTIVE: To report a case of recurrent vaginal myomatosis in a hysterectomized patient and review the literature. CLINICAL CASE: A 58-year-old hysterectomized patient with a vaginal tumor. The histopathologic report reported a fusocellular proliferation, properly delimited, arranged in crisscross bundles. The nuclei were elongated, monomorphous and blunt ended. The stroma was sparse and collagenous. No cytonuclear atypia or necrosis were observed. Immunohistochemical study of the lesion with anti-smooth muscle antibody actin and desmin was reported positive. Recurrent vulvovaginal myomatosis was diagnosed. It was treated by surgical resection. CONCLUSION: Vulvovaginal leiomyomas are extremely rare, and the literature is sparse; their recurrence is truly exceptional. Hence the importance of publishing these cases, providing information to be considered by other clinicians at the time of diagnosis.

Analysis of traditional Chinese medical constitution status and its influencing factors of young and middle-aged residents / 中国实用护理杂志

Objective:To investigate the traditional Chinese medical (TCM) constitution status of young and middle-aged residents and to analyze related influencing factors.Methods:A cross-sectional study was conducted to obtain data of 1 082 young and middle-aged residents in China from April to May 2019. The general characteristic, habits, emotional status and TCM constitution types of young and middle-aged residents were been collected.Results:The number of normal constitution types was 415(38.35%, 415/1 082), and the number of biased constitution types was 667(61.65%, 667/1 082) which was dominated by qi-deficiency constitution (16.70%, 344/2 060), yang-deficiency constitution (16.17%, 333/2 060) and damp-heat constitution (15.97%, 329/2 060). The Logistic regression analysis showed that the dietary regularity, taking vigorous exercise and taking moderate exercise were the protective factors of the biased constitution types of young and middle-aged residents( OR values were 0.624, 0.704, 0.704, all P<0.05), while the female, meat-based diet, anxiety and depression were the risk factors of the biased constitution types of young and middle-aged residents( OR values were 2.009-2.568, all P<0.01). Conclusions:The biased constitution is common among young and middle-aged residents. The risk factors of biased constitution are unhealthy lifestyle, anxiety and depression,which suggest the community to develop actively interventions to adjust the lifestyle and strengthen the maintenance of mental health of young and middle-aged residents.

Factores de riesgo asociados a las complicaciones cardiovasculares en mujeres de edad mediana con diabetes mellitus tipo 2 / Risk Factors Associated with Cardiovascular Complications in Middle-Aged Women with Type 2 Diabetes Mellitus

RESUMEN Introducción: En la mujer con diabetes de edad mediana confluyen una serie de factores aterogénicos que favorecen la aparición de complicaciones cardiovasculares. Objetivo: Identificar los factores de riesgo asociados a las complicaciones cardiovasculares en mujeres con diabetes mellitus tipo 2 de edad mediana. Métodos: Se realizó un estudio analítico de tipo casos y controles con mujeres con diabetes tipo 2 en edad mediana (40-59 años) que ingresaron en el Centro de Atención al Diabético de Bayamo, Granma, desde el año 2010 al 2017. Se excluyeron las mujeres con menopausia artificial. El tamaño de la muestra quedó constituido por 375 pacientes, las que fueron escogidas por muestreo aleatorio simple: 125 con complicaciones cardiovasculares (casos) y 250 no complicadas (controles). Resultados: El número de mujeres con complicaciones cardiovasculares se incrementó con la menopausia y con el tiempo de haber ocurrido este evento (p = 0,0125). El análisis univariado expuso que siete factores incrementaron el riesgo de presentar complicaciones cardiovasculares, entre ellos, la menopausia (OR = 1,88, IC: 1,1- 3,0, p = 0,0077); mientras que el multivariado exhibió que solo tres de ellos lo hicieron de forma independiente, los cuales fueron: el tiempo de evolución de la diabetes mayor de 10 años (OR = 4,97, IC: 2,35-10,54, p = 0,000), la hipertensión arterial (OR = 3,58, IC: 1,71-7.48, p = 0,001) y el tabaquismo (OR = 2,605, IC: 1,47-4,59, p = 0,001). Conclusiones: Los principales factores de riesgo asociados a las complicaciones cardiovasculares en mujeres con diabetes mellitus tipo 2 de edad mediana fueron el tiempo de evolución de la diabetes mayor de 10 años, la hipertensión arterial y el tabaquismo(AU)

ABSTRACT Introduction: In middle-aged diabetic women, a series of atherogenic factors converge that favor the appearance of cardiovascular complications. Objective: To identify the risk factors associated with cardiovascular complications in middle-aged women with type 2 diabetes mellitus. Methods: An analytical case-control study was carried out with middle-aged (40-49 years old) women with type 2 diabetes and who were admitted to the Diabetic Care Center in Bayamo City, Granma, from 2010 to 2017. Women with artificial menopause were not part of the study. The sample was made up of 375 patients, who were selected by simple randomized sampling: 125 presented cardiovascular complications (cases) and 250 presented no complications (controls). Results: The number of women with cardiovascular complications was correspondingly higher with menopause and with the time after the occurrence of this event (p = 0.0125). Univariate analysis showed that seven factors increased the risk for presenting cardiovascular complications, among them menopause (OR = 1.88, CI: 1.1-3.0, p = 0.0077); while multivariate analysis showed that only three of them did so independently, which were time of evolution of diabetes over ten years (OR = 4.97, CI: 2.35-10.54, p = 0.000), arterial hypertension (OR = 3.58, CI: 1.71-7.48, p = 0.001), and smoking (OR=2.605, CI: 1.47-4.59, p = 0.001). Conclusions: The main risk factors associated with cardiovascular complications among middle-aged women with type 2 diabetes mellitus were time of evolution of diabetes over ten years, arterial hypertension, and smoking(AU)

Factores biológicos relacionados con la masa ósea en hombres de edad mediana / Biological Factors Associated to Bone Mass in Middle-Aged Men

RESUMEN Introducción: La osteoporosis masculina es una enfermedad clínica heterogénea y subdiagnosticada, con múltiples factores de riesgo. Requiere un proceso de diagnóstico en ocasiones más complejo que en las mujeres. Objetivo: Identificar factores biológicos relacionados con la masa ósea en hombres de edad mediana. Métodos: Se realizó estudio descriptivo, transversal, en 43 hombres de edad mediana (40-59 años) entre abril de 2017 y mayo de 2018, que fueron atendidos en el Policlínico Universitario Vedado. Se estudiaron los antecedentes patológicos familiares (APF) de osteoporosis masculina o fracturas por fragilidad, índice de masa corporal (IMC), circunferencia de la cintura (CC), presión arterial (PA), glucemia, colesterol, triglicéridos, creatinina, hormona luteinizante, folículo estimulante, estradiol, testosterona (T), prolactina y paratohormona (PTH) y densitometría dual de Rx (DXA). Según edad y resultado de la DXA, se crearon 4 grupos (de 40-49 y de 50-59 años, en L1-L4 y fémur). Se identificaron hombres con hueso normal y mala masa ósea (MMO). Se determinaron distribuciones de frecuencia (variables cualitativas), y mediana y rango (cuantitativas). Se empleó chi cuadrado para determinar relación entre variables cualitativas y Mann-Whitney para cuantitativas. Para establecer correlación entre variables cuantitativas, se calculó el test de Pearson. Resultados: En hombres de 50-59 años, con antecedentes patológicos familiares de fracturas por fragilidad, predominó la mala masa ósea (75 por ciento). La mediana del índice de masa corporal en hombres de 40-49 años fue mayor (26,7 Kg/m2sc) en los que tenían hueso normal en L1-L4; en los de 50-59 años con aumento de la circunferencia de la cintura predominó la mala masa ósea (3; 75 por ciento). La presión arterial sistólica y diastólica se correlacionaron positivamente con la densidad mineral ósea en L1-L4 ([r = 0,225; p = 0,009], [r = 0,263; p = 0,002]). Hubo correlación positiva entre colesterol y contenido mineral óseo en fémur (r = 0,164; p = 0,002). La testosterona resultó más baja en hombres con hueso normal (40-49 años: 15,3 nmol/L; 50-59 años: 12,5 nmol/L). Se observó correlación negativa entre paratohormona y contenido mineral óseo en fémur (r = -0,324; p = 0,000). Conclusiones: Se puede concluir que, de los factores biológicos estudiados en los hombres de edad mediana del Policlínico Universitario Vedado, los niveles más elevados de presión arterial y colesterol, y más bajos de paratohormona, se asociaron con mejor masa ósea(AU)

ABSTRACT Introduction: Male osteoporosis is a heterogeneous and underdiagnosed clinical condition and with multiple risk factors, which requires a diagnostic process that is sometimes more complex than for women. Objective: To identify biological factors related to bone mass in middle-aged men from "Vedado" University Polyclinic. Methods: A cross-sectional and descriptive study was carried out with 43 middle-aged (40-59 years old) men, between April 2017 and May 2018. The variables were family pathological history of osteoporosis or fragility fractures, body mass index, waist circumference, blood pressure, glycemia, cholesterol, triglycerides, creatinine, luteinizing hormone, stimulating follicle, estradiol, testosterone, prolactin and parathyroid hormone, and dual x-ray densitometry. According to age and results of the dual x-ray densitometry, four groups were created (40-49 and 50-59 years old, in L1-L4 and femur). The men with normal bone and poor bone mass were identified. Frequency distributions (qualitative variables), as well as median and range (quantitative variables) were determined. The chi-square test was used to determine the relationship between qualitative variables, and the Mann-Whitney test was used for quantitative variables. To establish correlation between quantitative variables, the Pearson test was used. Results: Among men aged 50-59 years and with a family pathological history of fragility fractures, poor bone mass prevailed (75 percent). The median body mass index among men aged 40-49 years was higher (26.7 kg/m2sc) in those with normal bone in L1-L4; among those aged 50-59 years and with increased waist circumference, poor bone mass predominated (3; 75 percent). Systolic and diastolic blood pressure were correlated positively with bone mineral density in L1-L4 [(r = 0.225, p = 0.009), (r = 0.263, p = 0.002)]. There was a positive correlation between cholesterol and bone mineral content in the femur (r = 0.164, p = 0.002). T was lower among men with normal bone (15.3 nmol/L for the group 40-49 years old, and 12.5 nmol/L for the group 50-59 years old). A negative correlation was observed between the parathyroid hormone and bone mineral content values in the femur (r = -0.324, p = 0.000). Conclusions: Among the biological factors studied in middle-aged men from "Vedado" University Polyclinic, higher levels of blood pressure and cholesterol, as well as lower levels of the parathyroid hormone were concluded to be associated with better bone mass(AU)

Middle-age Spread of Overweight and Obesity in Ghana; Myth or Reality? Evidence from WHO SAGE Wave 2 Data

Aims: The aim of this study is to describe the age-related risk of overweight/obesity among Ghanaians using data from the WHO Study on global AGEing and adult health (SAGE) Wave 2.Study Design:Cross sectional study.Place and Duration of Study:Ghana; 2014-2015. Methodology:Primary study variables were extracted onto Microsoft Excel 14.0 spreadsheet. Secondary variables were generated through grouping, recategorization and combination of primary variables. Descriptive statistics were calculated for age and BMI. Associations between respondents’ characteristics and BMI were evaluated with chi square(χ2) and odds ratio (OR) at 95% confidence level.Results:Data of 1322 respondents were included in data analysis. In all, 520 (39.3%) of the respondents were overweight/obese and nearly half (46.62%) were middle-aged adults. Middle-aged adults were nearly twice as likely to be overweight/obese compared with old adults (AOR=1.62; CI: 1.25-2.10) and the risk was higher for middle-aged females (AOR=2.38; CI: 1.84-3.09). Overall, beingmiddle-aged (OR=1.73; CI: 1.35-2.21); living in an urban community (OR=2.01; CI: 1.61-2.52); being a female (OR=2.69; CI: 2.1-3.44); not engaging in regular physical activity (OR=1.49; CI: 1.18-1.88); and being an occasional drinker of alcoholic beverage (OR=1.58; CI: 1,12-2.22) were significantly associated with overweight/obesity.Conclusion:Obesity/overweight are lifestyle driven phenomenon and can be controlled by risk modification. Public sensitization, imposition of special taxes on sugary beverages, promotion of healthy local staples and creation of enabling community environments to encourage physical activity may be useful approaches in controlling the epidemic

Enfoque neuropsicológico de la memoria de trabajo en el climaterio / Neuropsychological approach to working memory in menopausal status

Introducción: Estudios multidisciplinarios que involucran mecanismos hormonales, neuronales, conductuales y de cognición contribuyen en las neurociencias. Los estrógenos localizados en el hipocampo y en la corteza prefrontal, pueden afectar la memoria de trabajo. Objetivo: evaluar neuropsicológicamente y comparar el desempeño en memoria de trabajo verbal y visual, durante la premenopausia, perimenopausia y postmenopausia. Se hipotetizó el peor desempeño en memoria de trabajo verbal en etapa de perimenopausia y, la mejor competencia en memoria de trabajo visual para mujeres en etapa de postmenopausia. Método: Estudio exploratorio, no experimental, transversal, con muestreo no probabilístico. 59 mujeres saludables de la población general en edad mediana. Variables clínicas y memoria de trabajo. Resultados: En la memoria de trabajo verbal no hubo diferencia significativa. En la memoria de trabajo visual, hubo diferencia significativa e importante (Ɛ2 R = .23, p = .001 y Ɛ2 R = .12, p = .047) en subpruebas que involucran la visoconstrucción, a diferencia de la subprueba de elección múltiple que no hubo diferencia significativa con el peor desempeño en la perimenopausia. Conclusiones: La memoria de trabajo se encuentra disociada, observando en la memoria de trabajo verbal el rendimiento en función del envejecimiento reproductivo y en la memoria de trabajo visual afectación por fluctuaciones hormonales, siendo una función sensible para detectar fallas cognoscitivas en forma temprana, que pudieran asociarse con enfermedades neurodegenerativas en la vejez. Es relevante considerar al momento de valorar a las mujeres, la etapa del climaterio que estén transitando, por la posible comorbilidad en el SNC.

Introduction: Multidisciplinary studies involving hormones, neurons, behavioral and cognitive functions promote neurosciences. Estrogens located in the hippocampus and the prefrontal cortex can affect working memory. Aim: Neuropsychological evaluation and comparison the efficiency in verbal and visual working memory in premenopausal, perimenopausal and postmenopausal stages. It was hypothesized the worst performance in verbal working memory in perimenopause stage, and the best competition in visual working memory in the postmenopausal stage. Method: Exploratory, non-experimental, cross-sectional study, with non-probability sampling. 59 healthy women from the general population. Study clinical, mental health and working memory. Results: There was no significant difference in verbal working memory. In visual working memory there was significant and relevant difference (Ɛ2 R = .23, p = .001 y Ɛ2 R = .12, p = .047) in the subtest involves visual construction; unlike the multiple-choice subtest there was no significant difference, finding the worst performance in perimenopause. Conclusions: Working memory is dissociated, verbal working memory observed performance based on reproductive aging and visual working memory supports the participation of hormonal fluctuations. It is considered a sensitive measure to detect cognitive failures early, which could be associated with neurodegenerative diseases in the aging. When evaluating middle-aged women, it is important to consider the stage of menopausal status that is transiting, due to the possible comorbidity in the CNS.

Preditores de dependência funcional em pessoas de 50 anos ou mais: estudo de seguimento de 4 anos / Predictors of functional dependence among individuals aged 50 years and older: a 4-year follow-up study

OBJECTIVE: To verify the effect of change and/or maintenance of poor sociodemographic factors, lifestyle and health conditions on the incidence of functional dependence for instrumental activities of daily living (IADLs) in people aged 50 years or older living in urban settings. METHODS: The relationship between IADLs and risk factors was analyzed in a prospective 4-year follow-up study involving 412 participants. Relative risk (RR) and 95% confidence intervals (95%CI) were calculated using Poisson regression models, adjusted for sex, age and education. RESULTS: The incidence of dependence for IADLs was 18.9%. Functional dependence was independently associated with lower socioeconomic status (RR = 2.03, 95%CI 1.24­3.32), lack of occupational activity (RR = 2.46, 95%CI 1.31­4.61), inadequate fruit and vegetable intake (RR = 1.90, 95%CI 1.06­3.38) and poor performance in the Mini Mental State Examination (RR = 2.52, 95%CI 1.53­4.17). The association between functional dependence and diabetes mellitus approached statistical significance (RR = 1.39, 95%CI 0.92­2.10). CONCLUSIONS: The results showed that worse socioeconomic conditions and chronic health issues were associated with the incidence of dependence for IADLs. These findings highlight the importance of comprehensive and interdisciplinary health care for populations with these characteristics.

OBJETIVO: Verificar o efeito de alterações de fatores sociodemográficos, estilo de vida e condições de saúde na incidência de dependência funcional para as atividades instrumentais de vida diária (AIVD) em pessoas de 50 anos ou mais em área urbana. MÉTODO: A relação entre AIVD e fatores de risco foi analisada em 412 indivíduos por meio de estudo longitudinal prospectivo com seguimento de quatro anos usando o cálculo do risco relativo (RR) e intervalo de confiança 95% (IC95%) em modelos de regressão de Poisson, ajustados por sexo, faixa etária e escolaridade. RESULTADO: A incidência de dependência de IAVD foi de 18,9% e estava associada de maneira independente a indivíduos com pior condição socioeconômica (RR = 2,03, IC95% 1,24­3,32), ausência de atividade laboral (RR = 2,46, IC95% 1,31­4,61), consumo irregular de frutas e vegetais (RR = 1,90, IC95% 1,06­ 3,38), e pior perfomance no miniexame do estado mental (RR = 2,52, IC95% 1,53­4,17). A diabetes apresentou uma tendência de associação com a incidência de dependência funcional (RR = 1,39, IC95% 0,92­2,10). CONCLUSÃO: Os resultados demonstram que piores condições socioeconômicas e de saúde estão associadas a maior incidência de dependência funcional por AIVD. Esses achados contribuem na elaboração de programas de promoção de saúde mais abrangentes e efetivos para esta população.

Factores relacionados con la masa ósea en hombres de edad mediana / Factors related to bone mass in middle-aged men

RESUMEN Introducción: La osteoporosis representa un problema de salud debido al impacto en la morbilidad, mortalidad, calidad de vida y altos costos. Los factores de riesgo asociados a la osteoporosis han sido poco abordados en hombres cubanos. Objetivo: Determinar la masa ósea y su posible relación con factores sociodemográficos y del estilo de vida en hombres de edad mediana del Policlínico Universitario "Vedado". Métodos: Se realizó un estudio descriptivo transversal que incluyó hombres de edad mediana. De la planilla de recolección de datos se extrajeron: sociodemográficos, estilo de vida y elementos del examen físico. Se realizó densitometría para determinar la masa ósea. Se crearon 4 grupos (de 40-49 y de 50-59 años en L1-L4 y fémur, solo se analizó L1-L4), se determinaron las personas con hueso normal y mala masa ósea (MMO) y se asociaron con los factores de riesgo. Resultados: En los hombres estudiados predominó el hueso normal: L1-L4 (27 = 62,8 por ciento) y fémur (38 = 88,4 por ciento). En los hombres entre 50-59 años, el 85,7 por ciento de los que tenían piel mestiza presentaron MMO, el 100 de los que tenían piel blanca y el 83,3 por ciento de los de piel negra, tuvieron hueso normal (p = 0,017). En los dos grupos, se observó un predominio del hueso normal, en los que tenían alimentación adecuada (100 por ciento) y aceptable (66,6 por ciento). En los de 40-49 años que realizaban actividad física, predominó el hueso normal; de 50-59 la mala masa ósea (6 = 60 por ciento). En ambos grupos, los que consumían bebidas alcohólicas y fumaban, predominaron en el grupo con hueso normal. Conclusiones: La mayoría de los hombres estudiados tenían masa ósea normal, la afectación fue mayor en L1-L4. La mayor edad y el color de piel mestiza, en hombres de 50-59 años, se asociaron con mayor daño óseo; factores del estilo de vida no se relacionaron con la masa ósea(AU)

ABSTRACT Introduction: Osteoporosis represents a health problem due to the impact on morbidity, mortality, quality of life and high costs. The risk factors associated with osteoporosis have been poorly addressed in Cuban men. Objective: To determine the bone mass and its possible relationship with sociodemographic and lifestyle factors in middle-aged men at Vedado University Polyclinic. Methods: A descriptive cross-sectional study was carried out in middle-aged men. From the data collection form were extracted sociodemographic, lifestyle and physical examination elements. Densitometry was performed to determine bone mass. Four groups (40-49 and 50-59 years in L1-L4 and femur were created, only L1-L4 was analyzed). People with normal bone and poor bone mass were identified and associated with risk factors. Results: Normal bone predominated in the studied men, L1-L4 (27 = 62.8 percent) and femur (38 = 88.4 percent). 85.7 percent between 50-99 years with meztizo skin color presented poor bone mass. Normal bone was evidenced in white and black skin subjects (100 and 83.3 percent) (p = 0.017). In both groups, predominance of normal bone was observed in those with adequate (100 percent) and acceptable diet (66.6 percent). In those 40-49 year-old subjects who had physical activity, normal bone predominated; but in those 50-59 year-old subjects, bad bone mass predominated (6 = 60 percent). In both groups, normal bone predominated in those who consumed alcoholic beverages and smoked in both groups. Conclusions: Most of the men studied had normal bone mass, the affectation was greater in L1-L4. Older age and mestizo skin color in 50-59 year-old men were associated with greater bone damage. Lifestyle factors were not related to bone mass(AU)

Alteración en la coordinación miccional: reporte de caso del síndrome de Fowler / Alteration in the micturition coordination: case report of Fowler's syndrome

Resumen ANTECEDENTES: El síndrome de Fowler es poco común, con predominio en mujeres jóvenes; se caracteriza por una actividad anormal, con contracciones repetidas en el esfínter uretral externo, en ausencia de enfermedad neurológica. CASO CLÍNICO: Paciente de 51 años, acudió a consulta por prolapso de órganos pélvicos con sensación de masa en la vagina y dificultad para orinar. En la videourodinamia se apreció una onda intermitente, con hipoactividad del detrusor y micción no coordinada, sin incontinencia, hallazgos característicos del síndrome de Fowler. Se le indicó terapia de aprendizaje de relajación del esfínter para coordinar la micción, posteriormente neuromodulación sacra. Durante el seguimiento se observó mejor coordinación y satisfacción después de orinar. CONCLUSIONES: La micción es un proceso complejo, que implica la integridad de la vía urinaria inferior y adecuado sinergismo con el sistema nervioso central, autónomo y somático. La falla en alguna de estas estructuras podría ocasionar un patrón miccional obstructivo.

Abstract BACKGROUND: Fowler's syndrome is a rare phenomenon mainly in young women in reproductive age with abnormal, repeated contractions in the external urethral sphincter without a neurological disease. CLINICAL CASE: 51-year-old woman with pelvic organ prolapse, symptoms of vaginal bulge and difficult micturition. A videourodynamic study was done showing intermittent waveform, detrusor hypoactivity and uncoordinated micturition without incontinence, suggestive of Fowler's syndrome. The patient underwent therapy for sphincter relaxation and sacral neuromodulation with good response. In the follow up with clinical improvement, referring being satisfied after micturition. CONCLUSIONS: Micturition is a complex process that needs integrity of the lower urinary tract and synergy between this and the central nervous system, autonomous and somatic. Failure in any of these structures can result in an obstructive pattern.

Presence of Metabolic Syndrome Components Is Associated with Tooth Loss in Middle-Aged Adults

PURPOSE: In general, the prevalence of metabolic syndrome (MS) and tooth loss increases with age. We investigated the relationship between the presence of MS, its elements, and tooth loss in middle-aged Korean adults. MATERIALS AND METHODS: This study included Korean adults between 30 and 64 years of age who resided in the capital area of Seoul. From January to June 2014, individuals interested in participating in the oral health survey among those who visited the university hospital's cardiovascular center and provided informed consent were selected. Among 748 subjects who responded to the oral health questionnaires, 30 were excluded due to unclear responses; therefore, a total of 718 were included in the final analysis. RESULTS: The crude odds ratio (OR) of ≥one MS component affecting tooth loss was 1.45 [95% confidence interval (CI), 1.06–2.00]. After adjusting for sex, age, education, income level, occupation, smoking status, kidney disease, chronic obstructive pulmonary disease, and rheumatic disease, the adjusted OR was 1.47 (95% CI, 1.06–2.05), which was statistically significant (p<0.05). The OR for tooth loss was higher in the presence of ≥one component of MS (50–64 years of age) in females. CONCLUSION: This study suggests that female aged 50–64 years may have higher likelihood of tooth loss upon the presence of at least one MS component. Prevention against MS among female of older age could contribute to maintenance of remaining teeth. Further well-designed studies are needed.