Vólvulo vesicular: un hallazgo quirúrgico / Vesicular volvulus: a surgical finding

Se describe el caso clínico de una paciente de 95 años de edad, quien acudió al Cuerpo de Guardia del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba por presentar dolor abdominal difuso, de comienzo súbito con 48 horas de evolución, acompañado de náuseas y vómitos de escasa cuantía y de coloración oscura, así como ligera distención abdominal, sin expulsión de heces ni gases. Se decidió su ingreso para tratamiento quirúrgico urgente, con el diagnóstico presuntivo de oclusión intestinal. Durante la cirugía se encontró la vesícula distendida con su pedículo torcido. Se realizó colecistectomía típica. La paciente evolucionó satisfactoriamente y no presentó complicaciones posoperatorias.

The case report of a 95 years patient is described, she went to the emergency department of Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba due to a diffuse abdominal pain, of sudden beginning with 48 hours of clinical course, accompanied by nauseas and vomits of scarce quantity and dark color, as well as slight abdominal distention, without expulsion of stools neither gases. Her admission was decided for emergency surgical treatment, with the presumptive diagnosis of intestinal occlusion. During the surgery the distended gallbladder with bent pedicle was found. A typical cholecystectomy was carried out. The patient had a favorable clinical course and she didn't present postoperative complications.

Impacto de la obesidad en la salud de la mujer adulta mayor

La población mundial ha envejecido y se está haciendo más femenina. La mujer adulta mayor sufre el impacto negativo del envejecimiento y la falla ovárica, con niveles bajos de estrógenos por la menopausia. Incrementa hasta en 33% de ellas el peso corporal, en rango de sobrepeso u obesidad, con redistribución de la grasa en la región visceral y disminución de la masa magra. Ello la predispone a todas las comorbilidades asociadas con la obesidad así como las enfermedades metabólicas y cardiovasculares, además de mortalidad a edad más temprana que sus pares que cursan con peso normal. Se ha incrementado la esperanza de vida. Por tanto sería ideal añadir a estos años calidad, viviendo libre de enfermedades crónicas e invalidantes y hasta donde sea posible lograr que ellas sean autosuficientes e independientes. Hay que intervenir para buscar la pérdida de peso intencional en aquellas que lo tienen incrementado y así reducir la morbimortalidad que se aumenta con la obesidad.

The world's population has aged and is becoming more feminine. The adult women suffer the negative impact of ageing and ovarian failure, with low levels of estrogen in the menopause. In up to 33% of them the body weight increases in range of overweight or obesity, with redistribution of fat in the visceral region and reduction of lean mass. This predisposes it to all comorbidities associated with obesity as well as metabolic and cardiovascular diseases and mortality at younger age than their peers with normal weight. Life expectancy has increased. Therefore it would be ideal to add to these quality years, living free of chronic and disabling illnesses and as much as possible to make them self-sufficient and independent. We should intervene to find intentional weight loss in those who have it increased, reducing mortality and morbidity that increase with obesity.

Reconstrucción labial por mordedura canina en una anciana / Labial reconstruction due to a dog bite in an elderly woman

Se presenta el caso clínico de una anciana de 80 años de edad con antecedentes de demencia senil, quien acudió acompañada de sus hijos a la consulta de Emergencia del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres por presentar mordedura de un perro en la región labial. A la paciente se le realizó lavado de la herida, desbridamiento y profilaxis, seguidos de la confección de colgajos locales combinados y sutura inmediata. Los resultados cosméticos y funcionales fueron catalogados como favorables.

The case report of an 80 years elderly woman with history of Alzheimer´s is presented, who went along with her children to the Emergency Service of Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital due to a dog bite in the labial region. The wound cleaning, debridement and prophylaxis was carried out to the patient, followed by making combined local flaps and immediate suture. The cosmetic and functional results were classified as favorable.

Safety of laparoscopic surgery in diagnosis and treatment of gynecologic diseases in elderly women / 上海交通大学学报（医学版）

Objective·To investigate safety of laparoscopic surgery in diagnosis and treatment of gynecologic diseases in elderly women over 70 years old. Methods·A total of 420 cases of elderly patients over 70 years old from January 2009 to December 2016 were retrospectively analyzed in Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. According to ages, the patients were divided into elderly group (70-80 years old,including 70 years old) and advanced age group (80 years old and above); according to surgical methods, the patients were divided into laparoscopy group and laparotomy group. The ages, American Society of Anesthesiology (ASA) classifications, body mass indexes (BMI), preoperative complications, surgical methods, intraoperative circumstances, postoperative pathology results and postoperative complications were analyzed. Results·There were no significant differences in age, ASA classification and BMI between laparoscopy group and laparotomy group in the same age group (P<0.05). Most patients had various chronic diseases before operations. Taking total hysterectomy as an example, laparoscopy groups in the two age groups were superior to laparotomy groups in the comparison of surgical time, bleeding volume, anal evacuation time and length of hospital stay (P<0.05). In the two age groups,laparoscopic malignant tumor radical surgery took less time, less bleeding and shorter anal evacuation time than laparotomy (P<0.05). Elderly laparoscopy group had less poor wound healing cases than elderly laparotomy group (P<0.05), while there was no statistical difference in other postoperative complications (P>0.05). All the patients completed the surgeries without perioperative deaths. Conclusion·Laparoscopy is safe in the diagnosis and treatment of gynecological benign and malignant diseases in elderly women with shorter operation time, less bleeding and faster postoperative recovery compared with laparotomy.

Organização dos serviços na atenção à saúde da idosa: percepção de usuárias / Organization of healthcare services for elderly women: users’ perceptions / Organización de los servicios en la atención de la salud de la mujer anciana: percepción de usuarias

Objetiva-se apreender os aspectos que interatuam na assistência à mulher idosa no município de Mossoró-RN, Brasil, a partir da perspectiva das usuárias. Pesquisa de natureza descritiva e abordagem qualitativa, realizada com mulheres na faixa etária dos sessenta anos ou mais, que utilizam os serviços de atenção básica selecionados para o estudo. Após a análise dos depoimentos, emergiram três categorias: motivos que estimulam a procura do serviço; orientações recebidas nos serviços de saúde, e problemáticas cotidianamente vivenciadas na procura do serviço. A qualidade da atenção à mulher idosa requer trabalhadores capacitados; diminuição dos entraves burocráticos; ações e práticas articuladas e contínuas, contemplando anseios e expectativas da idosa...

The aim of this study was to ascertain the factors that interact in care for elderly women in the municipality of Mossoró, Rio Grande do Norte, Brazil, from the users’ perspective. This study took a descriptive and qualitative approach and was carried out among women aged 60 years or over who used the primary care services selected for this study. From analysis on testimonies, three categories emerged: reasons for seeking the healthcare service; medical guidance received from the healthcare service and everyday problems faced on seeking services. Quality of care for elderly women requires trained workers, reduction of bureaucratic obstacles and continuous linked-up actions and practices that take into account elderly women’s desires and expectations...

Su objetivo es percibir los aspectos que interactúan en la asistencia a la mujer anciana en el municipio de Mossoró-Estado de Río Grande do Norte, Brasil, a partir de la perspectiva de las usuarias. Encuesta de naturaleza descriptiva y abordaje cualitativo, realizado con mujeres en el rango de edad de sesenta años o más que utilizan los servicios de atención básica seleccionados para el estudio. Después del análisis de las declaraciones, surgieron tres categorías: motivos que incentivan la búsqueda del servicio, orientaciones recibidas en los servicios de salud y problemáticas vividas cotidianamente en la búsqueda del servicio. La calidad de la atención a la mujer mayor requiere trabajadores capacitados; disminución de los obstáculos burocráticos, acciones y prácticas articuladas y continuas, incluyendo anhelos y expectativas de la mujer anciana...

Efeitos de diferentes tipos de treinamento de força no desempenho de capacidades funcionais em mulheres idosas / Effects of different types of strength training on the functional capacity performance in elderly women

Os diferentes tipos de treinamento de força (TF) apresentam distintasadaptações do tecido muscular como o desenvolvimento de forçamáxima, potência e/ou força reativa muscular. Dentre estes tipos deTF, estão os treinamentos de força tradicional (TFT), potência (TP) ede força reativa, em que está presente o ciclo-alongamento-encurtamento(CAE) (TR). A habilidade de produzir força rapidamenterequer a participação intensa das fibras do tipo IIX, condição esta frequentemente reduzida em mulheres idosas. A força rápida tem importânciasignificativa, para homens e mulheres de todas as idades,destacando-se ainda mais em mulheres idosas. A prescrição de umtipo de TF que melhor desenvolva as atividades de vida diária (AVD)é primordial para a manutenção da independência física e qualidadede vida de idosas. A metodologia embasou-se em pesqui sabibliográfica, utilizando artigos atuais e clássicos da literatura sobreTF em mulheres idosas (publicados a partir de 2000) selecionadosnas bases de dados Pubmed e Sportdiscus, que compa rasseme analisassem pelo menos dois tipos específicos de TF (TFT, TPe TR). Sendo assim, o objetivo do presente estudo de revisão foicomparar os efeitos de três diferentes tipos de TF no desempenhode capacidades funcionais em mulheres idosas. Como resultadosos artigos consultados apresentam um consenso de que o TP e TRdesenvolvam de forma mais eficaz as capacidades funcionais demulheres idosas e que o TR é mais efetivo no desenvolvimento daforça reativa muscular que o TP. Dessa forma, conclui-se que o TRé mais efetivo para o desenvolvimento da produção de força rápidado músculo que os outros tipos específicos de treinamento de forçae por consequência disto, melhor desenvolve as capacidades funcionaisde mulheres idosas.

Distinct adaptations of muscle tissue as the development of maximumstrength, power and/or reactive muscle strength seems to beassociated with different programs of strength training (ST). Amongthese several programs, there are the traditional strength training(TST), the power training (PT) and the reactive force, in which is presentthe stretch-shortening cycle (SSC) (RT). The ability to produceforce rapidly requires intense participation of the type IIX fibers. Thiscondition is often reduced in older women. However, this kind offorce adaptation is very important for the elderly women functionalcapacity. Consequently, the prescription of one type of ST that bestcarries out the activities of daily living (ADL) is essential for maintainingphysical independence and quality of life of elderly women.Therefore, the aim of this review study was to compare the effects ofthree different programs of ST in the performance of functional abilitiesin older women throughout a research on the current and classicpapers (published since 2000) selected from the Pubmed andSPORTDiscus databases, that compare and analyze at least twospecific types of ST (i.e. TST, PT and RT). The results of our reviewshowed that the PT and RT are more effective for the developmentof functional capacities for older women than the other programsstudied. Furthermore, the RT is more effective in developing reactivemuscular strength exercises with the use of SSC than PT. The conclusionof the present study was that RT is more effective than theothers specific programs studied of strength training for the developmentof rapid force. as well as, it was the best program associatedwith the development of the functional capacity for older women.

The Experience of Health Behavior in Elderly Woman / 성인간호학회지

PURPOSE: The aim of this study is to understand the experience of health behavior among elderly women. METHOD: Participants of this study were 8 healthy elderly women over 65, who live in city and town. The data were collected through in-depth interview and participant observation, analyzed by the Colaizzi (1978)'s phenomenal research method was adopted. The data collection period was from March to May of 2003. RESULT: The essential themes were 'desiring to keep oneself in good health even with aging body', 'receiving and living with illness', 'maintaining ones health with body activity', 'getting along with peace of mind' CONCLUSION: The study is significant because it provides viewpoints for understanding elderly women's experience of health behavior in the context of Korean culture. And also it provides guideline for elderly nursing intervention.

Antropometric and Health Status of the Elderly Women Attending a Health Promotion Program in an Urban Community / 대한지역사회영양학회지

This study was conducted to evaluate the health status of elderly women who attended in a Health Promotion Program of the Seo-gu Health Center in Daegu. The study subjects were 158 elderly women (over 65 years) in an urban community. The subjects were investigated by means of individual interviews using a questionnaire, Blood tests for analyzing their biochemical status were carried out. The average age of the study subjects was 70.9 +/- 2.3 years. Of the subject group 79.1% ranged in age from 65 to 74 year and 20.9% were over 75 years. With respect to health related factors, 23.4% of subjects drank alcoholic beverages and 15.2% of sujects currently smoker. The prevalence with chronic diseases was 51.9%, and 26.6% of the subjects were healthy. The diseases most frequently reported as having been or being treated were arthritis (38.1%), hypertension (21.4%), and diabetes (17.9%). The average height of subjects was below the standard established in the Korean Recommended Dietary Allowances, while the average weight was close to the standard. The means of systolic and diastolic blood pressure were 130.2 mmHg and 71.9 mmHg, respectively. The mean serum albumin level was 4.5 mg/dl, and the value of hemoglobin and hematocrit was 12.5 mg/dl and 0.7%, respectively. The mean serum cholesterol level was 207.1 mg/dl and the mean triglyceride level was 187.7 mg/dl. The serum lipid levels were higher then in those reported in research. The serum cholesterol levels of 71.5%of subjects were within the normal range. The GOT and GTP levels were within the moderate range. In conclusion, the health status of the elderly who attended the Health Promotion Program in the Seo-gu Health Center were very average. However, it was necessary to prepare a health management program to deal with the serum lipids so as to establish and maintain good health. When we carry out the health promotion program in a community, individual program of adequate to health status should be developed more.

Preferred place of death of elderly women in seoul

BACKGROUND: The present it is getting to be on aged society there is increasing that hospital has higher rate for place of death than home. Because we can expect that many patients who are faced with death come to hospital or hospice in the future, we have studied preferred place of death with an old women in seoul to have essential material of plan to understand asking for medical service of death, to divide medical manpowers and equipments and to supplement and to revise of medical educations. METHODS: Through the internet, 71 schools for the elderly. Of 277 an old woman who attending the schools out of 7 schools. We research into preferred place of death by self answering way through the June to July in 2000. RESULTS: The average age was 72.4 years. Of 277 respondents, 87 respondents(32.46%) reply their homes as a place of death and 166(61.94%) reply hospital, 15(5.6%) reply hospice, missing is 9. Statistical significance has connections with only level of education. The highest reason(47.5%) why respondents choose the hospital or hospice is only to reduce their children's burdens. Unlike respondents that education attending period is below 6 year, the relative risk of choosing the hospital or hospice between respondents who are 6 9year and above 9 year is each of 3.66, 5.58. CONCLUSION: This research shows that an elderly women in seoul prefer hospitals or hospice to homes as their place of death.