Resultados quirúrgicos de la herniorrafia inguinal en los pacientes mayores de 80 años: Revisión sistemática y metaanálisis / Surgical outcomes of inguinal herniorrhaphy in patients over 80 yearsof age: Systematic review and meta-analysis

Introducción. Los pacientes octogenarios y nonagenarios conforman un grupo etario en progresivo crecimiento. La hernia inguinal es una patología que aumenta progresivamente con la edad. Este trabajo tuvo como objetivo conocer los resultados quirúrgicos de los pacientes mayores de 80 años a quienes se les realizó herniorrafía inguinal. Métodos. De acuerdo con las guías PRISMA, se realizó una revisión sistemática de PubMed, Embase y Google Scholar. Se incluyeron estudios que reportaron la incidencia de complicaciones y mortalidad después de una herniorrafía inguinal en los pacientes octogenarios y nonagenarios. Se calculó la proporción de pacientes con complicaciones después de una herniorrafía inguinal según los datos presentados, con su respectivo intervalo de confianza del 95 %. Resultados. Catorce estudios reportaron un total de 19.290 pacientes, entre quienes se encontró una incidencia acumulada de infección del sitio operatorio de 0,5 % (IC95% 0,460 - 0,678), seroma de 8,7 % (IC95% 6,212 - 11,842), hematoma de 2,6 % (IC95% 2,397 - 2,893), dolor crónico de 2,1 % (IC95% 0,778 - 4,090) y recidiva de 1,2 % (IC95%0,425 - 2,284), para una morbilidad de 14,7 % (IC95% 9,525 - 20,833). Conclusión. Las complicaciones de la herida quirúrgica, el dolor crónico y la recidiva en los pacientes mayores de 80 años a quienes se les realiza herniorrafia inguinal son comparables con las de la población general.

Introduction. Octogenarian and nonagenarian patients constitute a progressively growing age group. Inguinal hernia is a pathology that increases with age. This study aims to understand the surgical outcomes of inguinal herniorrhaphy in patients over 80 years of age. Methods. A systematic review of PubMed, Embase, and Google Scholar was conducted following PRISMA guidelines. Studies reporting the incidence of complications and mortality after inguinal herniorrhaphy in octogenarian and nonagenarian patients were included. The proportion of patients with complications after inguinal herniorrhaphy was calculated based on the data presented, with its respective 95% confidence interval. Results. Fourteen studies reported a total of 19,290 patients, among whom a cumulative incidence of surgical site infection of 0.5 (95% CI 0.460 ­ 0.678), seroma of 8.7% (95% CI 6.212 ­ 11.842), hematoma of 2.6% (95% CI 2.397 ­ 2.893), chronic pain 2.1% (95% CI 0.778 ­ 4.090), recurrence 1.2% (95% CI 0.425 ­ 2.284), and morbidity 14.7% (95% CI 9.525 ­ 20.833) were found. Conclusion. Surgical wound complications, chronic pain, and recurrence in patients over 80 years of age undergoing inguinal herniorrhaphy are comparable to those in the general population.

Perfil e capacidade funcional de pessoas longevas: revisão integrativa / Profile and functional capacity of long-lived people: integrative review / Perfil y capacidad funcional de personas longevas: revisión integradora

Objetivo: descrever o perfil e a capacidade funcional de pessoas longevas encontradas na literatura científica. Método: revisão integrativa realizada em março de 2021, nas bases de dados CINAHL, MEDLINE, LILACS, BDENF, SCOPUS e WEB OF SCIENCE, incluindo estudos realizados com idosos de 80 anos ou mais, institucionalizados ou da comunidade, que utilizassem as escalas Barthel, Lawton e Brody ou Katz, sem delimitação de período ou idioma. A análise ocorreu de maneira descritiva. Resultados: selecionaram-se 16 artigos, a maioria publicada em 2020, no idioma inglês, desenvolvidos por médicos e em países europeus. Predominaram longevos da comunidade, do sexo feminino e com comorbidades. A escala de Katz foi a mais utilizada para avaliar a capacidade funcional dos longevos e estes possuíam algum grau de dependência nas atividades diárias e instrumentais. Conclusão: os longevos são, em sua maioria, da comunidade, mulheres, com comorbidades, principalmente hipertensão arterial, e apresentam maior grau de dependência nas atividades instrumentais.

Objective: to describe the profile and functional capacity of long-lived persons found in the scientific literature. Method: this integrative review was carried out in March 2021 in the CINAHL, MEDLINE, LILACS, BDENF, SCOPUS and WEB OF SCIENCE databases, including studies conducted with people aged 80 years or more, institutionalized or in the community, using the Barthel, Lawton & Brody or Katz scales, with no time or language limits. The analysis was descriptive. Results: 16 articles were selected, most of them published in 2020, in English, by doctors, and in European countries. The long-lived persons were predominantly in the community, female and had comorbidities. The Katz scale was the most used to assess functional capacity in the long-lived persons, who displayed some degree of dependence in daily and instrumental activities. Conclusion: the longlived persons were mostly in the community, women, with comorbidities, especially arterial hypertension, and were more dependent in instrumental activities.

Objetivo: describir el perfil y capacidad funcional de personas longevas que se encuentran en la literatura científica. Métodos: revisión integradora realizada en marzo de 2021, en las bases de datos CINAHL, MEDLINE, LILACS, BDENF, SCOPUS y WEB OF SCIENCE, incluyendo estudios realizados junto a personas mayores de 80 años internados o en la comunidad, utilizando las escalas Barthel, Lawton y Brody o Katz, sin límites de tiempo ni de idioma. El análisis se realizó de forma descriptiva. Resultados: Se seleccionaron 16 artículos, la mayoría publicados en 2020, en inglés, desarrollados por médicos y en países europeos. Predominaron longevos de la comunidad, del sexo femenino y con comorbilidades. La escala de Katz fue la más utilizada para evaluar la capacidad funcional de esos longevos y se vio que estos tenían cierto grado de dependencia en las actividades cotidianas e instrumentales. Conclusión: los longevos son, en su mayoría, de la comunidad, mujeres, con comorbilidades, especialmente hipertensión arterial y tienen un mayor grado de dependencia en las actividades instrumentales.

Condição de saúde bucal autopercebida, capacidade mastigatória e longevidade em idosos / Self-perceived oral health status, chewing ability and longevity in the elderly

Resumo O objetivo deste artigo é verificar a condição bucal e a capacidade mastigatória autopercebidas em idosos longevos (≥ 80 anos). Foram utilizados dados do estudo multicêntrico FIBRA. A amostra foi composta por 2.341 indivíduos com ausência de déficit cognitivo, com idade ≥ 65 anos, no período entre 2008 e 2009, quando os idosos foram submetidos à coleta de dados. Quanto ao desfecho, a idade foi dicotomizada em 65-79 e 80 anos ou mais. A associação entre longevidade e as variáveis sociodemográficas, comportamentais, de saúde geral e bucal e a capacidade mastigatória autopercebida foram avaliadas pela regressão de Poisson. Dados completos disponíveis para 2.126 idosos. A idade média foi 70,91 (DP = ±4,11) anos entre os idosos jovens e 82,70 (DP = ±2,61) entre os longevos. A amostra de idosos com idade ≥ 80 anos foi de 11,7%. Baixa escolaridade, estado civil solteiro e ausência de trabalho estiveram associados à longevidade, assim como autorrelato de não possuir dentes naturais e dificuldade ou dor ao mastigar alimentos duros. Os resultados sugerem a associação entre longevidade com características sociodemográficas e de saúde bucal.

Abstract The scope of this article is to assess the oral health conditions and self-perceived chewing ability among the elderly seniors (≥ 80 years). Data from the FIBRA multicentric study were used. The sample consisted of 2,341 individuals with no cognitive impairment, aged ≥ 65 years, between 2008 and 2009, where the elderly were subjected to data collection. Regarding the outcome, age was dichotomized into 65-79 and 80 and over. The association between longevity and the socio-demographic and behavioral variables, general and oral health and self-perceived chewing ability was assessed by Poisson regression. Complete data are now available for 2,126 seniors. The mean age was 70.91 (SD =± 4.11) years among the young elderly and 82.70 (SD =± 2.61) among the elderly seniors. The sample of individuals aged ≥ 80 years was 11.7%. Low education, single marital status and lack of work were associated with longevity, as well as self-reporting of having no natural teeth and difficulty or pain when chewing hard foods. The results suggest an association between longevity with sociodemographic characteristics and oral health.

Idosos longevos: avaliação da qualidade de vida no domínio da espiritualidade, da religiosidade e de crenças pessoais / Long-lived elderly: assessment of quality of life in the field of spirituality, religiousness and personal beliefs

RESUMO Este estudo tem como objetivo avaliar a qualidade de vida no domínio da espiritualidade, da religiosidade, de crenças pessoais e fatores associados em idosos longevos. Para isso, foi utilizado o questionário World Health Organization Quality of Life - Spirituality, Religiousness and Personal Beliefs, através de um estudo descritivo, transversal, com a participação de 100 idosos. Verificou-se que provavelmente a qualidade de vida esteja relacionada com a autoestima e com o bem-estar pessoal/espiritual. Neste âmbito, profissionais de saúde precisam estar engajados e incorporar este conhecimento, principalmente aqueles atrelados aos serviços de Atenção Primária à Saúde.

ABSTRACT This study aims to evaluate the quality of life in the field of spirituality, religiousness, personal beliefs and associated factors in long-lived elderly. For this purpose, the World Health Organization Quality of Life - Spirituality, Religiousness and Personal Beliefs questionnaire was used, through a descriptive, cross-sectional study, with the participation of 100 elderly people. It has been found that quality of life is probably related to self-esteem and personal/spiritual well-being. In this context, health professionals need to be engaged and incorporate this knowledge, especially those linked to Primary Health Care services.

Analysis of the pathogenic causes and treatment outcomes of acute kidney injury in 39 very old patients / 中华老年医学杂志

Objective To investigate the clinical characteristics,pathogenic causes and treatment outcomes of acute kidney injury (AKI) in very old patients in order to improving the diagnosis and treatment.Methods 39 AKI patients aged ≥80 years in the department of geriatric medicine of our hospital were enrolled and followed up for 3 months.Clinical and laboratory data were analyzed and the pathogenic causes as well as the treatment outcomes were summarized.Results Among the 39 very old patients,31(79.5％) were male,8(20.5％) were female,and the mean age was (93.5±4.6) years.33 (84.6％)patients had chronic kidney diseases.The pathogenic causes of AKI were mainly as follows:urological infections (71.8％),blood volume deficiency (48.7％),cardiac dysfunction (23.1％) and hypotension (15.4％).2 to 4 pathogenic causes were co present in 64.1％ patients.Renal function was improved and recovered in 69.2 ％ patients and the death rate was 25.6％ after treatment.The main causes of death were septic shock (30.0％),multiple organ failure (20.0％),massive gastrointestinal hemorrhage (20.0％) et al.Conclusions Most of the very old patients may suffer from AKI on the basis of chronic kidney disease.AKI is often induced by multiple pathogenic causes.The main factors leading to AKI are urological infections,followed by blood volume deficiency and cardiac dysfunction.Most patients with AKI can recover after the precipitating factors are removed and supportive treatments are administered in time.Septic shock is the main cause of death.