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ABSTRACT BACKGROUND: Environmental and population characteristics seem to influence the variation in cutoff points of the Short Physical Performance Battery (SPPB) for diagnosing frailty syndrome among older adults. OBJECTIVE: To verify the validity of the SPPB for screening for frailty syndrome among older adults in the Amazonian context. DESIGN AND SETTING: Cross-sectional population-based study on older adults in the urban area of Coari (AM), Brazil. METHODS: In total, 264 older adults (60 years of age or over) were included. Frailty syndrome was defined using the Fried phenotype criteria. The SPPB cutoff points were compared in relation to frailty and validity measurements were calculated for the test. RESULTS: A strong association between poor physical performance and frailty was identified (P < 0.001). The cutoff point of 6 demonstrated the best validity measurements for frailty in the sample studied (sensitivity: 0.28; specificity: 0.94; accuracy: 0.88; area under the receiver operating characteristic curve, AUC-ROC: 0.61; likelihood ratio, LR+: 4.44; LR-: 0.77; prevalence: 8.3%; post-test probability, PTP+: 0.32; PTP-: 0.07), with emphasis on high specificity and the positive likelihood ratio value. CONCLUSION: The SPPB was shown to be useful for screening frail older adults in the Amazon region. The score of 6 demonstrated the best cutoff point for this population. This could be used in healthcare services for diagnostic screening for frailty among older people within the Amazonian context.
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Humans , Middle Aged , Aged , Mass Screening , Frail Elderly , Frailty/diagnosis , Physical Functional Performance , Brazil , Cross-Sectional Studies , Reproducibility of ResultsABSTRACT
RESUMEN: Objetivo: Determinar las dimensiones de la cresta ósea vestibular de los incisivos maxilares con indicación de implantación inmediata. Pacientes y método: Un estudio transversal fue realizado en pacientes con necesidad de colocación de implantes inmediatos unitarios en la zona incisiva superior, durante el periodo de Enero-2015 a Diciembre-2017. Cortes tomográficos sagítales fueron utilizados para determinar la altura y el grosor de la cresta ósea alveolar vestibular. El punto de medición del grosor fue localizado a 4 mm apical a la linea amelocementaria. Un análisis T-student, fue utilizado para comparar las variables según la edad, el género y el grupo dentario, con un intervalo de confianza de 95%. Resultados: 298 imágenes fueron incluidas en la evaluación. El promedio de altura fue 10,68 mm, no hubo diferencias al comparar los grupos. El grosor promedio fue de 0,73 mm, diferencias de grosor, estadísticamente significativas, fueron observadas al comparar la edad y el género, no así en el grupo dentarlo. Conclusiones: La altura del hueso alveolar vestibular de incisivos superiores es suficiente para colocar implantes inmediatos dentro de un marco óseo. No obstante, el grosor observado, se traduciría en la necesidad de complementar la implantación con técnicas de regeneraciónn tisular guiada.
ABSTRACT: Objective : Determine the dimensions of the facial bone ridge of the maxillary incisors with indication of immediate implantation. Patients and method: A cross-sectional study was carried out in patients in need of single immediate implant placement in the upper incisor area, during the period from January-2015 to December-2017. Sagittal tomographic sections were used to determine the height and thickness of the vestibular alveolar bone ridge. The thickness measurement point was located 4 mm apical to the amelocementary junction. A T-student analysis was used to compare the variables according to age, gender, and dental group, with a 95% confidence interval. Results: 298 images were included in the evaluation. The mean height was 10.68 mm, there were no differences when comparing the groups. The mean thickness was 0.73 mm, statistically significant differences in thickness were observed when comparing age and gender, but not in the dental group. Conclusions: The height of the vestibular alveolar bone of the upper incisors could be sufficient to place immediate implants within a bone framework. However, the thickness observed would result in the need to complement the implantation with guided tissue regeneration techniques.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Therapeutics , Facial Bones , Incisor , Jaw , Cross-Sectional StudiesABSTRACT
Introduction: Outpatients health care service or ambulatory care is can support the most (80-85% of all) health services except the admission and emergency and intensive care of severe patients. WHO is offering the health care services provided to patients on an ambulatory basis, rather by admission to a hospital or other health care facility in developing countries. The outpatient health services quality may be diminished in my country since 1990 and also outpatient health care services did not expanded because of too much concerning about hospital admission. Goal of study: To evaluate the Achtan Elite Clinical Hospitals outpatient- policlinic health service in 2006-2007 years and to improve the outpatient- inpatient services correlation and management. Objectives: 1. To make analyses outpatient-policlinic health service result. 2. To find out outpatient areas workloads. Methodology of study: We prepared special questionnaire and tried to evaluate a daily normal workloads. We used Statistical SPSS-12 program is used for statistical analyses. Results of study: Achtan Clinical hospital served 3899-4364 inpatients for admition in hospital, 38327-39675 outpatients in 2006-2007 years. The most 30308- 35959 outpatients were for diagnostic visit for doctors and rest people visited for preventive care. If compare our workloads with state clinical hospitals, we provide 11.9%-14.3% health service of state hospitals workloads. Gastroenterology, cardiology and neurology cabinets workloads are always higher than other cabinets in 108% -124%. In contrast traditional medicine, pediatric, neurosurgery and psychiatrist cabinets did not perform (55-75%) their normal workloads. Discussion: According to ambulatory-outpatient health, services study shows that necessity of opening the family doctor centered local outpatient care in big cities like Ulaanbaatar. There will need 10-15 family doctors and 8-10 specialized doctors to serve 20000-25000 residencies or 4000-5000 families. Laboratory, rehabilitations, dispensary, health education department of preventing most infectious diseases including tuberculosis, psychiatric and traumatic disorders preventing programs will be able to maintain. When we change the policy of administration and management of outpatient health services than community, based prevention will be able to follow. Conclusion: 1. There is a necessity of expanding and management of renewing out and inpatient clinic. Which provide 80-85% of all the medical help and service. 2. The relationship of out and inpatient clinic and their activity risk and resource are need to determine. All these mentioned fi nding show that health administrative has to perform well-targeted study. 3. To fi nd out normal working load is main problem of health management. In our predictive study-shows in internal and neurological cabinets load can be 25 people per day, 15-20 for surgical and ophthalmological, 10-15 for urology and gynecology cabinets.
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Introduction: Biological aging is defined as a process or group processes that originate from progressive decrement of viability and increment of vulnerability of the organism with the passage of time. Biological age can be viewed as an objective measure for the assessment of ones biological vigor which is inevitably declined with advancing chronological age. Materials and methods: The individuals biological age scores (BAS) were estimated from 5 variables: forced expiratory volume in 1.0 sec (FEV1), systolic blood pressure (SBP), blood glucose, albumin, other proteins ratio and mean corpuscular hemoglobin (MCH). The study was composed on study design, based on E. Nakamuras developed method. Using above mentioned parameters was calculated biological age score (BAS), by which were assessed the aging rate of each individual. Results: We investigated a trend for the rate of aging changes in adults aged above 35. Variables used as a biomarkers of aging are significantly correlated with aging, where the systolic blood pressure was strongest one. Biological age score was calculated for every individual and it has strong correlation with chronological age (r=0.331, p=0.01). The rate at which ageing process relatively faster were 45-55 and 55-66 age intervals for females, against which aging rate of man was slower than women in above mentioned age groups. Conclusion: Variables used in calculation of BAS had significant cross sectional correlation with age and the aging rate was faster in man than in women in later age groups. In younger and older age groups (35-45 and above 65) individuals of both sexes had similar aging rate.