Relative incidence of interstitial lung diseases in Brazil / Incidência relativa de doenças pulmonares intersticiais no Brasil

ABSTRACT Objective: To assess the relative frequency of incident cases of interstitial lung diseases (ILDs) in Brazil. Methods: This was a retrospective survey of new cases of ILD in six referral centers between January of 2013 and January of 2020. The diagnosis of ILD followed the criteria suggested by international bodies or was made through multidisciplinary discussion (MDD). The condition was characterized as unclassifiable ILD when there was no specific final diagnosis following MDD or when there was disagreement between clinical, radiological, or histological data. Results: The sample comprised 1,406 patients (mean age = 61 ± 14 years), and 764 (54%) were female. Of the 747 cases exposed to hypersensitivity pneumonitis (HP)-related antigens, 327 (44%) had a final diagnosis of HP. A family history of ILD was reported in 8% of cases. HRCT findings were indicative of fibrosis in 74% of cases, including honeycombing, in 21%. Relevant autoantibodies were detected in 33% of cases. Transbronchial biopsy was performed in 23% of patients, and surgical lung biopsy, in 17%. The final diagnoses were: connective tissue disease-associated ILD (in 27%), HP (in 23%), idiopathic pulmonary fibrosis (in 14%), unclassifiable ILD (in 10%), and sarcoidosis (in 6%). Diagnoses varied significantly among centers (c2 = 312.4; p < 0.001). Conclusions: Our findings show that connective tissue disease-associated ILD is the most common ILD in Brazil, followed by HP. These results highlight the need for close collaboration between pulmonologists and rheumatologists, the importance of detailed questioning of patients in regard with potential exposure to antigens, and the need for public health campaigns to stress the importance of avoiding such exposure.

RESUMO Objetivo: Avaliar a frequência relativa de casos incidentes de doenças pulmonares intersticiais (DPI) no Brasil. Métodos: Levantamento retrospectivo de casos novos de DPI em seis centros de referência entre janeiro de 2013 e janeiro de 2020. O diagnóstico de DPI seguiu os critérios sugeridos por órgãos internacionais ou foi feito por meio de discussão multidisciplinar (DMD). A condição foi caracterizada como DPI não classificável quando não houve um diagnóstico final específico após a DMD ou houve discordância entre dados clínicos, radiológicos ou histológicos. Resultados: A amostra foi composta por 1.406 pacientes (média de idade = 61 ± 14 anos), sendo 764 (54%) do sexo feminino. Dos 747 casos expostos a antígenos para pneumonite de hipersensibilidade (PH), 327 (44%) tiveram diagnóstico final de PH. Houve relato de história familiar de DPI em 8% dos casos. Os achados de TCAR foram indicativos de fibrose em 74% dos casos, incluindo faveolamento, em 21%. Autoanticorpos relevantes foram detectados em 33% dos casos. Biópsia transbrônquica foi realizada em 23% dos pacientes, e biópsia pulmonar cirúrgica, em 17%. Os diagnósticos finais foram: DPI associada à doença do tecido conjuntivo (em 27%), PH (em 23%), fibrose pulmonar idiopática (em 14%), DPI não classificável (em 10%) e sarcoidose (em 6%). Os diagnósticos variaram significativamente entre os centros (c2 = 312,4; p < 0,001). Conclusões: Nossos achados mostram que DPI associada à doença do tecido conjuntivo é a DPI mais comum no Brasil, seguida pela PH. Esses resultados destacam a necessidade de uma estreita colaboração entre pneumologistas e reumatologistas, a importância de fazer perguntas detalhadas aos pacientes a respeito da potencial exposição a antígenos e a necessidade de campanhas de saúde pública destinadas a enfatizar a importância de evitar essa exposição.

MOTIVOS INTRÍNSECOS, EXTRÍNSECOS Y EXPECTATIVAS PARA ELECCIÓN DE LA CARRERA, COMO PREDICTORES DE RENDIMIENTO ACADÉMICO EN ESTUDIANTES DE ENFERMERÍA / INTRINSIC AND EXTRINSIC MOTIVATIONS AND EXPECTATIONS FOR CAREER CHOICE, AS PREDICTORS OF ACADEMIC PERFORMANCE IN NURSING STUDENTS

[{"text": "INTRODUCCIÓN. El decantarse por una carrera universitaria, es una decisión que marca el futuro profesional de los jóvenes; en ella están envueltas motivaciones intrínsecas, extrínsecas y expectativas que pueden predecir el desempeño académico. OBJETIVO. Predecir el rendimiento académico de los estudiantes de una facultad de enfermería, a través de los motivos intrínsecos, extrínsecos y expectativas para la elección de la carrera. METODOLOGÍA. Estudio correlacional, longitudinal, analítico. La muestra estuvo constituida por 400 estudiantes de primer semestre. Se aplicó una cédula socio demográfica; Escala de Motivación en Educación (EME); Escala de Expectativas Para la Elección de la Carrera e Interés Hacia los Estudios (EEPECIHE); Escala de Seguimiento Cambios en las Expectativas, Grado de Interés y Satisfacción de los Estudiantes (ESCEGIS). Los datos se analizaron con el software SPSS versión 25 para iOS; el estudio contó con la aprobación del comité de bioética en investigación de la Facultad de Enfermería Culiacán. RESULTADOS. Existen diferencias significativas de las motivaciones, expectativas y rendimiento académico (p <.05) al inicio del semestre y al finalizar el semestre; las motivaciones y expectativas predicen el rendimiento académico, en 74.6%, (R2=0,747, Ajuste R2 = 0,746,

Adjacent proximal proper digital artery transposition for extrinsic perfusion pressure in treatment of avulsion and rupture of digit / 中华显微外科杂志

Objective:To explore indications for replantation of proximal proper digital artery and establishing extrinsic arterial perfusion pressure in the treatment of special type of severed digits with avulsion over 12.0 hours of warm ischemia, and to analyse the factors that affected the survival rate of the replanted digits.Methods:From September 2014 to January 2022, 8 patients with severed digits and prolonged warm ischemia were treated by transposition of adjacent digital artery together with the technique of extrinsic arterial perfusion pressure in the Department of Wrist and Hand Surgery, the Orthopaedic Hospital in Sichuan Province. During the operation, the defected proximal proper digital artery was reconstructed and repaired with vein graft, one side of the digital artery was repaired with an inverted "Y" vein graft, and one side of "Y" vein was bridged and anastomosed to repair the original digital artery. On the other side, the adjacent proximal proper digital arteries were transpositioned and anastomosed to gain an extrinsic arterial perfusion pressure, which increased the distal haemodynamic and reconstituted the blood supply. Of the 8 patients (9 severed digits) : 1 had severed index and middle fingers, 2 had severed index fingers, 4 had severed thumbs and 1 had severed little finger. All the patients were males, aged 16-63 years old, at 37.6 years old in average. Warm ischemia time of the severed digits were 12.3-20.6 hours, with 17.4 hours in average. The survival rate of replanted digits was observed after surgery. Postoperative follow-ups were conducted through telephone or WeChat reviews.Results:Follow-up time was 6-26 months, at 8.3 months in average. Retrospective analysis was performed. Vascular compromises occurred in 3 patients 4 digits (arterial insufficiency in 1 digit, venous congestion in 3 digits), skin necrosis occurred in 1 patient (1 digit) and digit necrosis in 1 patient (1 digit). Overall, 8 of the 9 replanted digits survived. According to the Replantation Function Evaluation Standard of Hand Surgery Association of Chinese Medical Association, the digit function after replantation was evaluated at excellent in 6 digits, good in 1 digit and poor in 1 digit.Conclusion:For a severed digit with an ischemia time over 12.0 hours, the survival rate can be improved by transposition of an adjacent digital artery to provided extrinsic arterial perfusion pressure.

Sleep parameters in patients with chronic hypersensitivity pneumonitis: a case-control study / Parâmetros do sono em pacientes com pneumonite de hipersensibilidade crônica: estudo de caso-controle

ABSTRACT Objective: To compare patients with chronic hypersensitivity pneumonitis (cHP) and controls with normal spirometry in terms of their sleep characteristics, as well as to establish the prevalence of obstructive sleep apnea (OSA) and nocturnal hypoxemia. Secondary objectives were to identify factors associated with OSA and nocturnal hypoxemia; to correlate nocturnal hypoxemia with the apnea-hypopnea index (AHI) and lung function, as well as with resting SpO2, awake SpO2, and SpO2 during exercise; and to evaluate the discriminatory power of sleep questionnaires to predict OSA. Methods: A total of 40 patients with cHP (cases) were matched for sex, age, and BMI with 80 controls, the ratio of controls to cases therefore being = 2:1. The STOP-Bang questionnaire, the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index, the Berlin questionnaire and the Neck circumference, obesity, Snoring, Age, and Sex (NoSAS) score were applied to all cases, and both groups underwent full-night polysomnography. Results: The patients with cHP had longer sleep latency, lower sleep efficiency, a lower AHI, a lower respiratory disturbance index, fewer central apneas, fewer mixed apneas, and fewer hypopneas than did the controls. The patients with cHP had significantly lower nocturnal SpO2 values, the percentage of total sleep time spent below an SpO2 of 90% being higher than in controls (median = 4.2; IQR, 0.4-32.1 vs. median = 1.0; IQR, 0.1-5.8; p = 0.01). There were no significant differences between cases with and without OSA regarding the STOP-Bang questionnaire, NoSAS, and ESS scores. Conclusions: The prevalence of OSA in cHP patients (cases) was high, although not higher than that in controls with normal spirometry. In addition, cases had more hypoxemia during sleep than did controls. Our results suggest that sleep questionnaires do not have sufficient discriminatory power to identify OSA in cHP patients.

RESUMO Objetivo: Comparar pacientes com pneumonite de hipersensibilidade crônica (PHc) e controles com espirometria normal quanto às características do sono, bem como estabelecer a prevalência de apneia obstrutiva do sono (AOS) e hipoxemia noturna. Os objetivos secundários foram identificar fatores associados à AOS e hipoxemia noturna; correlacionar a hipoxemia noturna com o índice de apneias e hipopneias (IAH), função pulmonar, SpO2 em repouso, SpO2 em vigília e SpO2 durante o exercício; e avaliar o poder discriminatório de questionários do sono para predizer AOS. Métodos: Um total de 40 pacientes com PHc (casos) foram emparelhados por sexo, idade e IMC com 80 controles (2:1). O questionário STOP-Bang, a Escala de Sonolência de Epworth (ESE), o Índice de Qualidade do Sono de Pittsburgh, o questionário de Berlim e o escore Neck circumference, obesity, Snoring, Age, and Sex (NoSAS, circunferência do pescoço, obesidade, ronco, idade e sexo) foram aplicados a todos os casos, e ambos os grupos foram submetidos a polissonografia de noite inteira. Resultados: Os pacientes com PHc apresentaram maior latência do sono, menor eficiência do sono, menor IAH, menor índice de distúrbio respiratório, menos apneias centrais, menos apneias mistas e menos hipopneias do que os controles. Os pacientes com PHc apresentaram SpO2 noturna significativamente menor; a porcentagem do tempo total de sono com SpO2 < 90% foi maior que nos controles (mediana = 4,2; IIQ: 0,4-32,1 vs. mediana = 1,0; IIQ: 0,1-5,8; p = 0,01). Não houve diferenças significativas entre os casos com e sem AOS quanto à pontuação no questionário STOP-Bang, no NoSAS e na ESE. Conclusões: A prevalência de AOS em pacientes com PHc (casos) foi alta, embora não tenha sido maior que a observada em controles com espirometria normal. Além disso, os casos apresentaram mais hipoxemia durante o sono do que os controles. Nossos resultados sugerem que os questionários do sono não têm poder discriminatório suficiente para identificar AOS em pacientes com PHc.

Motives for physical activity participation among lebanese adults aged 18 to 50 years: a cross-sectional study / Motivos para participação de atividade física em libanes adultos de 18 a 50 anos: um estudo transversal

ABSTRACT Background: Sports participation motivations can be intrinsic, extrinsic, or even amotivational. Few studies on adult participation in PA have been found in the Lebanese context. This study aims to: a) investigate significant differences in sports participation motivation across gender, age, occupation, and time of practice, and b) investigate sports participation motives that discriminated the best between those variables. Material and methods: The Arabic version of the Sport Motivation Scale was collected electronically from 531 volunteers practicing regular PA for the last six months. Gender, occupation, marital status, and time of practice were all analyzed using Mann-Whitney U test and the Kruskal Wallis Test with 0.05 as level of significance. Results: Internal motivation subscales (particularly the intention to accomplish) were the most influential motives for both genders. A significant difference across gender was reported in the extrinsic motivation and amotivation subscales. Furthermore, age, occupation, marital status, and time of practice show significant differences in motivation factors either dependent or regardless of gender distribution (p<0.05). Conclusion: no significant differences in the intrinsic motivation for sports participation between genders. Other factors, on the other hand, had a substantial impact. Research contribution: these findings are intended to contribute to a better understanding of differences in motivation for participating in PA and to aid in its promotion among Lebanese adults

RESUMO Contexto: As motivações para a participação desportiva podem ser intrínsecas, extrínsecas ou mesmo amotivacionais. Poucos estudos sobre a participação de adultos em AF foram encontrados no contexto libanês. Este estudo tem como objetivos: a) investigar diferenças significativas na motivação para a prática desportiva em função do género, idade, profissão e tempo de prática, e b) investigar os motivos da prática desportiva que melhor discriminaram entre essas variáveis. Material e métodos: A versão árabe da Sport Motivation Scale foi coletada eletronicamente de 531 voluntários praticantes regulares de AF nos últimos seis meses. Gênero, ocupação, estado civil e tempo de atuação foram analisados por meio do teste U de Mann-Whitney e do teste de Kruskal Wallis com nível de significância de 0,05. Resultados: As subescalas de motivação interna (particularmente a intenção de realizar) foram os motivos mais influentes para ambos os sexos. Uma diferença significativa entre os gêneros foi relatada nas subescalas de motivação extrínseca e amotivação. Além disso, idade, ocupação, estado civil e tempo de prática mostram diferenças significativas nos fatores de motivação dependentes ou independentes da distribuição por gênero (p<0,05). Conclusão: não houve diferenças significativas na motivação intrínseca para a prática desportiva entre os sexos. Outros fatores, por outro lado, tiveram um impacto substancial. Contribuição da pesquisa: esses achados pretendem contribuir para uma melhor compreensão das diferenças na motivação para participar da AF e auxiliar na sua promoção entre adultos libaneses.

Factors that cause women with osteoporosis to fall

ABSTRACT Objectives: To analyze and compare intrinsic and extrinsic factors that cause falls among women receiving treatment for osteoporosis. Subjects and methods: A cross-sectional study of women ≥50 years receiving treatment for osteoporosis. Participants filled out questionnaires (demographic characteristics), and researchers took anthropometric measurements of bone mineral density, handgrip strength (HGS), ankle range of motion (ROM), and gait speed (GS). We also evaluated the Timed Up and Go Test (TUGT), Five Times Sit-to-Stand Test (SST), and Falls Efficacy Scale-International (FES-I) and investigated the extrinsic factors for falls. Results: We included 144 participants (71.6 [8.3 years]), who reported 133 falls. We classified participants into a non-faller group (NFG; 0 falls, n = 71, 49.5%), a faller group (FG; 1 fall, n = 42, 28.9%), and a recurrent-faller group (RFG; more than 1 fall, n = 31, 21.5%). Most patients had an increased risk of falling according to the TUGT, SST, reduced ankle ROM, and GS (P < .005 for all). FES-I was associated with sporadic and recurrent falls. For the multivariate analysis, the number of falls was influenced by the presence of ramps (RR 0.48, 95% CI, 0.26-0.87, P = .015), uneven surfaces (RR 1.6, 95% CI. 1.05-2.43, P = .028), and antislippery adhesive on stairs (RR 2.75, 95% CI, 1.77-4.28, P < .001). Conclusion: Patients receiving treatment for osteoporosis are influenced by intrinsic and extrinsic factors that cause falls. Lower-limb strength and power-discriminated participants at a higher risk of falls, but extrinsic factors varied. Only uneven floors and antislippery adhesives on stairs were associated with increased frequency of falls.

Progressive fibrotic interstitial lung disease / Doença pulmonar intersticial fibrosante progressiva

ABSTRACT Many interstitial lung diseases (ILDs) share mechanisms that result in a progressive fibrosing phenotype. In Brazil, the most common progressive fibrosing interstitial lung diseases (PF-ILDs) are chronic hypersensitivity pneumonitis, idiopathic pulmonary fibrosis, unclassified ILD, and connective tissue diseases. PF-ILD is seen in approximately 30% of patients with ILD. Because PF-ILD is characterized by disease progression after initiation of appropriate treatment, a diagnosis of the disease resulting in fibrosis is critical. Different criteria have been proposed to define progressive disease, including worsening respiratory symptoms, lung function decline, and radiological evidence of disease progression. Although the time elapsed between diagnosis and progression varies, progression can occur at any time after diagnosis. Several factors indicate an increased risk of progression and death. In the last few years, antifibrotic drugs used in patients with idiopathic pulmonary fibrosis have been tested in patients with PF-ILD. The effects of nintedanib and placebo have been compared in patients with PF-ILD, a mean difference of 107.0 mL/year being observed, favoring nintedanib. The U.S. Food and Drug Administration and the Brazilian Health Regulatory Agency have approved the use of nintedanib in such patients on the basis of this finding. Pirfenidone has been evaluated in patients with unclassified ILD and in patients with other ILDs, the results being similar to those for nintedanib. More studies are needed in order to identify markers of increased risk of progression in patients with ILD and determine the likelihood of response to treatment with standard or new drugs.

RESUMO Muitas doenças pulmonares intersticiais (DPI) compartilham mecanismos que resultam em um fenótipo fibrosante progressivo. No Brasil, as doenças pulmonares intersticiais fibrosantes progressivas (DPI-FP) mais comuns são a pneumonite de hipersensibilidade crônica, a fibrose pulmonar idiopática, a DPI não classificada e as doenças do tecido conjuntivo. A DPI-FP é observada em aproximadamente 30% dos pacientes com DPI. Como a DPI-FP é caracterizada pela progressão da doença após o início do tratamento adequado, é fundamental diagnosticar a doença que resulta em fibrose. Diferentes critérios foram propostos para definir doença progressiva, incluindo piora dos sintomas respiratórios, declínio da função pulmonar e evidências radiológicas de progressão da doença. Embora o tempo decorrido entre o diagnóstico e a progressão varie, a progressão pode ocorrer a qualquer momento após o diagnóstico. Vários fatores indicam risco aumentado de progressão e morte. Nos últimos anos, antifibróticos usados em pacientes com fibrose pulmonar idiopática foram testados em pacientes com DPI-FP. Os efeitos do nintedanibe e placebo foram comparados em pacientes com DPI-FP, com diferença média de 107,0 mL/ano a favor do nintedanibe. A Food and Drug Administration (EUA) e a Agência Nacional de Vigilância Sanitária aprovaram o uso do nintedanibe em tais pacientes com base nesse achado. A pirfenidona foi avaliada em pacientes com DPI não classificada e em pacientes com outras DPI, e os resultados foram semelhantes aos do nintedanibe. Mais estudos são necessários para identificar marcadores de risco aumentado de progressão em pacientes com DPI e determinar a probabilidade de resposta ao tratamento com medicamentos-padrão ou novos.

Factores extrínsecos implicados en la pigmentación de las resinas compuestas dentales / Extrinsic factors involved in the pigmentation of dental composite resins

RESUMEN Las resinas compuestas dentales fueron introducidas en la primera mitad del siglo XX como una avance mecánico- estético en el campo de la odontología restauradora, en respuesta a los silicatos, que hasta aquel entonces era el material restaurador de primera elección, dentro de su composición, posee una matriz orgánica formada por Bis- GMA y otros monómeros de dimetacrilato (TEGMA, UDMA, siloranos), que son susceptibles a la pigmentación de sustancias extrínsecas, en diferente grado , las bebidas más comunes como vino tinto, té, café y bebidas azucaradas Objetivo: Revisar y analizar la literatura disponible que responda a la pregunta ¿Cuáles son los factores extrínsecos más comunes que causan pigmentación de las resinas compuestas?

ABSTRACT Dental composite resins were introduced in the first half of the 20th century as a mechanical-aesthetic advance in the field of restorative dentistry, as a response to silicates, which at that time was the first choice restorative material, composite resin contains a matrix of organic made up of Bis-GMA and other dimethacrylate monomers (TEGMA, UDMA, silorans) doing them susceptible to pigmentation with extrinsic substances, in this case drinks, such as red wine, tea and coffee are the main cause of the pigmentation of resins. Objective: To Review and analyze the available literature that answers the question: what are the most common extrinsic factors that cause pigmentation of composite resins?

Motivação de atletas amadores e profissionais para a prática do triathlon: uma investigação qualitativa / Motivation of amateur and professional athletes for the practice of triathlon: a qualitative investigation / Motivación de atletas amateurs y profesionales para la práctica del triatlón: una investigación cualitativa

O objetivo dessa investigação foi verificar as motivações para a prática esportiva de triatletas amadores e profissionais. Participaram desse estudo 12 triatletas, sendo 7 atletas profissionais (4 homens e 3 mulheres) e 5 atletas amadores (2 homens e 3 mulheres), com idades entre 19 e 67 anos. Utilizouse como instrumento de pesquisa uma entrevista semiestruturada a partir de um roteiro de questões previamente elaborado pelas pesquisadoras responsáveis, considerando as principais dimensões da motivação. Os dados foram analisados através da análise de conteúdo temática. Como resultado, triatletas são motivados por razões distintas, tanto de forma intrínseca (aptidão física, emoção, competência técnica e diversão), como extrínseca (reconhecimento social, atividades de grupo, competição e afiliação). Concluiu-se que condições como status social, preocupação com a forma física, intensa dedicação a modalidade e presença de motivações ora intrínsecas, ora extrínsecas, parecem ser motivos determinantes para ingresso e permanência de triatletas na modalidade.

The objective of this investigation was to verify the motivations for the sport practice of amateur and professional triathletes. Twelve triathletes participated in this study, 7 professional athletes (4 men and 3 women) and 5 amateur athletes (2 men and 3 women), aged between 19 and 67 years. A semistructured interview was used as a research instrument based on a script of questions previously prepared by the responsible researchers, considering the main dimensions of motivation. Data were analyzed through thematic content analysis. As a result, triathletes are motivated by different reasons, both intrinsically (physical fitness, emotion, technical competence and fun) and extrinsically (social recognition, group activities, competition and affiliation). It was concluded that conditions such as social status, concern with physical shape, intense dedication to the modality and the presence of either intrinsic or extrinsic motivations, seem to be determining reasons for entry and permanence of triathletes in the modality.

El objetivo de esta investigación fue verificar las motivaciones para la práctica deportiva de triatletas aficionados y profesionales. Doce triatletas participaron en este estudio, 7 atletas profesionales (4 hombres y 3 mujeres) y 5 atletas aficionados (2 hombres y 3 mujeres), con edades entre 19 y 67 años. Se utilizó como instrumento de investigación una entrevista semiestructurada a partir de un guión de preguntas previamente elaborado por los investigadores responsables, considerando las principales dimensiones de la motivación. Los datos fueron analizados a través del análisis de contenido temático. Como resultado, los triatletas están motivados por diferentes motivos, tanto intrínsecos (aptitud física, emoción, competencia técnica y diversión) como extrínsecos (reconocimiento social, actividades grupales, competencia y afiliación). Se concluyó que condiciones como el estatus social, la preocupación por la forma física, la intensa dedicación a la modalidad y la presencia de motivaciones intrínsecas o extrínsecas, parecen ser motivos determinantes para el ingreso y permanencia de los triatletas en la modalidad.

Emotional interdependence: the key to studying extrinsic emotion regulation

The literature on extrinsic emotion regulation or the intention to modify other people's emotions has grown in recent years, accompanied by proposals in which its definition is made more precise, the way to understand it in relation to other related processes is delimited, and the consequences of its use in the quality of close relationships are evidenced. Conceptual reviews on this topic recognize the importance of examining the affect and dyadic dynamics that arise between those who regulate each other extrinsically. This dynamic refers to emotional interdependence, the potential of the members of a dyad to shape each other's emotions reciprocally, particularly in those who share a close bond, such as that of a romantic couple. There is little theoretical development regarding the relevance of this characteristic in relation to EER. This article has two objectives: (1) to make a narrative synthesis of the characteristics that define EER and (2) to expand and complexify the existing model by including the emotional interdependence as a vital component in the understanding of the functioning of EER. Lastly, the role of emotional interdependence in the emergence, maintenance, and satisfaction concerning couple relationships is made explicit through phenomena such as shared reality. (AU)

Desorientación intrínseca y extrínseca en la atención nefrológica / Intrinsic and extrinsic disorientation in nephrological care

Resumen En este ensayo se muestra que el desarrollo de la nefrología en los últimos lustros ha sido básicamente en la diálisis y el trasplante renal, pero es insuficiente y limitado el acceso a toda la población que los requieren, lo cual es un fenómeno universal. Además, se ha generado la fragmentación de la especialidad en otras subespecialidades. Entre otros motivos que impiden que los tomadores de decisiones se decidan por ampliar la atención nefrológica terciaria a mayor población se identifican 12 factores intrínsecos y cuatro extrínsecos, aunado a limitados recursos destinados a la investigación, por lo que se invita a que las sociedades nacionales de nefrología actúen y traten de modificar esos factores que son obstáculos para el desarrollo de la especialidad y la ampliación de la atención nefrológica.

Abstract This essay shows that the development of nephrology in recent years has been basically in dialysis and kidney transplantation, but access to the entire population that requires it is insufficient and limited, which is a universal phenomenon. In addition, the fragmentation of the specialty into other subspecialities has been generated. Among other reasons that prevent decision makers from deciding to expand tertiary nephrology care to a larger population, 12 intrinsic factors and four extrinsic factors are identified, together with limited resources dedicated to research; therefore, national societies of nephrology are encouraged to act and try to modify those factors that are obstacles to the development of the specialty and the expansion of nephrological care.

Motivaciones de los estudiantes de fisioterapia para practicar actividad físico-deportiva / Motivations of physiotherapy students to practice sports and physical activity

Introducción. El sedentarismo es un problema de salud pública, siendo un riesgo latente para las enfermedades crónicas no trasmisibles. En un estudio previo en la Fundación Universitaria María Cano se encontró sedentarismo de 97% en estudiantes. El propósito del estudio es contribuir a la comprensión del comportamiento sedentario en estudiantes de fisioterapia, información clave para que la institución genere estrategias efectivas que incentiven la práctica físico-deportiva, considerando las motivaciones de los estudiantes. Metodología. Estudio de enfoque cuantitativo, diseño no experimental, de corte transversal. Participaron 178 estudiantes de Fisioterapia (I a VII semestre). Se aplicó un cuestionario sociodemográfico y el CAMIAF (Cuestionario de Actitudes, Motivaciones e Intereses hacia las Actividades Físico-deportivas). Resultados. Población joven, en su mayoría mujeres (77,5%), con edades entre 16 y 36 años, y media de 21,3 (DE: ±3,244). El 64% manifiesta no practicar deporte o actividad física (AF) de manera habitual. Se encuentra asociación significativa de la edad con los factores competencia (todas las variables), capacidad personal (por superarse), aventura (relacionarme y conocer gente), hedonismo (porque quiero ser celebre y popular) y forma física (para mejorar mi imagen y aspecto físico). El 92,2% de los participantes manifiestan que la Universidad motiva la práctica de AF con jornadas físicas permanentes (34,9%) y el incentivo académico (28,6%) Conclusiones. Entre las motivaciones para la práctica de AF predomina, en su orden, el factor competencia, social y recreativo, y el estético. El que genera menor motivación es el emocional. Limitaciones. El constructo motivacional es multidimensional; un abordaje cualitativo adicional podría mejorar la comprensión de los hallazgos.

Introduction. Sedentary lifestyle is a public health problem, being a latent risk for chronic non-communicable diseases. In a previous study at Fundación Universitaria María Cano, a sedentary lifestyle of 97% was found in students. The purpose of the study is to contribute to the understanding of sedentary behavior in physical therapy students, which is a key information for the institution to generate effective strategies to encourage sports and physical practice, considering the students' motivations. Methodology. A quantitative approach study, with a non-experimental and cross-sectional design. 178 physiotherapy students (1st to 7th semester) participated. A sociodemographic questionnaire and the CAMIAF (Questionnaire of Attitudes, Motivations, and Interests towards Physical-Sports Activities) were applied. Results. Young population, mostly women (77.5%), aged between 16 and 36, with an average of 21.3 (SD: ±3.244). Sixty-four percent stated that they did not practice sport or physical activity (PA) on a regular basis. A significant association was found between age and the following factors: competence (all variables), personal capacity (for self-im-provement), adventure (to socialize and meet people), hedonism (because I want to be famous and popular), and physical fitness (to improve my image and physical appear-ance). 92.2% of the participants state that the University motivates the practice of PA with permanent physical sessions (34.9%) and academic incentive (28.6%). Conclusions. Among the motivations for the practice of PA, the following factors predominate in this order: competition, social and recreational, and aesthetic. The least motivating factor was the emotional one.Limitations. The motivational construct is multidimensional; an additional quali-tative approach could improve the understanding of the findings.

Efectividad del feedback aumentado en el desempeño de destrezas motrices: un meta-análisis / Effectiveness of Augmented Feedback on Motor Skills Performance: A Meta-Analysis

Resumen El propósito del presente estudio fue examinar la efectividad del feedback aumentado (FA) en el desempeño y aprendizaje de destrezas motrices. La búsqueda de los estudios se realizó en bases de datos digitales, revisando referencias y consultando a personal experto del área. La selección de los estudios y la extracción de los datos fue realizada por las tres autoras de forma independiente. La calidad de los estudios se evaluó utilizando una modificación de la escala TESTEX. Con el modelo de efectos aleatorios se calculó el tamaño de efecto (TE) de la diferencia de medias estandarizada. Se examinó la heterogeneidad con la Q estadística y la consistencia con I 2 . Veinte estudios cumplieron los criterios de inclusión. Un total de 95 TE fueron calculados, lo cual representa a 949 participantes. El uso de FA durante la práctica física aumentó el desempeño significativamente entre el pretest y la adquisición (TE = 0.87; IC95% = 0.65, 1.10; n = 47; Q = 183.6, I 2 = 74.41%; p < 0.01); mientras que el desempeño disminuyó significativamente entre la prueba de adquisición y la retención, después de que el FA fue suspendido (TE = -0.74, IC95% = -1.04, -0.44; n = 45; Q = 377.45, I 2 . = 88.34%; p < 0.01). Se analizaron la edad y el nivel de habilidad de los sujetos participantes, el tipo de destreza y las características de la práctica y el tipo de FA como posibles variables moderadoras. Los resultados sugieren que el desempeño mejora en la adquisición al recibir FA durante la práctica física, y disminuye en la retención, una vez que no está disponible; no obstante, el uso de FA promueve significativamente el aprendizaje de destrezas motrices.

Abstract The purpose of this study was to use the meta-analytic approach to assess the effectiveness of augmented feedback (AF) on performance and learning of motor skills. Studies were retrieved by searching electronic databases, cross refereeing, and expert criteria. Studies were selected and data was extracted by the three authors independently. The quality of the studies was measured by a modify TEXTEX scale. Random effects models using the standardized mean difference effect size (ES) were used to pool results. Risk of bias, heterogeneity, and inconsistency was examined. Twenty studies met the inclusion criteria. A total of 95 ESs were calculated, representing 949 participants. During physical practice, performance increases from pretest to acquisition when receiving AF (ES = 0.87; 95%CI = 0.65, 1.10; n = 47; I 2 . = 74.41; Q= 183,6; p < 0.01); while performance significantly decrease between the acquisition and retention phase after AF was removed (ES = -0.74; 95%CI = -1.04, -0.44; n = 45; I 2 . = 88.34; Q = 377.45; p < 0.01). Age and skill level ability of the participants, type of task, and practice characteristics, and type of feedback were analyzed as potentially moderator variables. Results suggest that AF increases performance in motor skills during physical practice, but performance decreases after removing AF in retention; all due, AF enhances learning of motor skills.

Resumo O objetivo do presente estudo foi examinar a eficácia do aumento do feedback (AF) sobre o desempenho e a aprendizagem das habilidades motoras. Foram pesquisados estudos em bancos de dados digitais, verificando referências e consultando especialistas na área. A seleção do estudo e a extração de dados foi feita pelos três autores independentemente. A qualidade dos estudos foi avaliada utilizando uma modificação da escala TESTEX. Sob o modelo de efeitos aleatórios, foi calculado o tamanho do efeito (TE) da diferença média padronizada. A heterogeneidade foi examinada usando o Q estatístico e a consistência usando o I2. Vinte estudos preencheram os critérios de inclusão. Um total de 95 TE's foi calculado, representando 949 participantes. O uso de AF durante a prática física aumentou significativamente o desempenho entre o pré-teste e a aquisição (ET = 0,87; CI95% = 0,65, 1,10; n = 47; Q = 183,6, I2 = 74,41%; p < 0. 01); enquanto o desempenho diminuiu significativamente entre o teste de aquisição e a retenção, depois que o AF foi suspenso (SD = -0,74, 95% CI = -1,04, -0,44; n = 45; Q = 377,45, I2. = 88,34%; p < 0,01). A idade e o nível de habilidade dos participantes, tipo de habilidade e características de prática, e tipo de AF foram analisados como possíveis variáveis moderadoras. Os resultados sugerem que o desempenho melhora na aquisição ao receber AF durante a prática física, e diminui na retenção, uma vez que ela não está disponível; entretanto, o uso de AF promove significativamente o aprendizado das habilidades motoras.

Morphological description of extrinsic muscles of the thoracic limb in a specimen of pudu (Pudu puda) / Descripción morfológica de la musculatura extrínseca del miembro torácico de un espécimen de pudú (Pudu puda)

SUMMARY: The pudu (Pudu puda) is classified as an artiodactyl of the Cervidae family. It is a native species found in Argentina and Chile. It is estimated that its population has been substantially reduced due to several causes, such as loss of forests, predation, hunting, and vehicle accident. Therefore, this species is protected due to its vulnerable conservation status. The extrinsic muscles of the thoracic limb have great importance in the biomechanical functionality of the suspension of the limb, neck, and head, as well as participating in the movement of the thoracic wall and thoracic limb. The objective of the present study is to describe the extrinsic musculature of the thoracic limb of a specimen of pudu, comparing the results with those described for domestic ruminants in the classical anatomical bibliography. Basic procedures: All extrinsic muscles were analyzed, describing shape, distribution, origin, and insertion. The results indicate that the pudu specimen has anatomical characteristics similar to domestic ruminants; however, some differences should be considered. Main findings: The brachiocephalicus muscle has an evident clavicular intersection that separates it into cleidobrachialis, cervicalis, and mastoideus pars. The pectoralis superficialis muscle has two distinct and independent pars, and the pectoralis profundus muscle has a partial fusion with the latissimus dorsi and cutaneous trunci muscles. The subclavius muscle is small and has an elongated shape and goes deep into the cephalic vein, just at the point it is a tributary of the external jugular vein. The results of this study present specific anatomical features of Pudu puda providing novel reference information and expanding scientific knowledge of this scarcely studied wild species.

RESUMEN: El pudu (Pudu puda) se clasifica como un artiodáctilo de la familia Cervidae. Es una especie nativa que se encuentra en Argentina y Chile y se estima que su población se ha reducido sustancialmente debido a varias causas, tal como la pérdida de bosques, depredación, caza y accidentes de vehículo. Debido a lo anterior esta especie está protegida por su estado de conservación vulnerable. Los músculos extrínsecos del miembro torácico tienen gran importancia en la funcionalidad biomecánica de la suspensión del miembro, el cuello y la cabeza, además de participar en el movimiento de la pared torácica y el miembro torácico. El objetivo del presente estudio es describir la musculatura extrínseca del miembro torácico de un ejemplar de pudu, comparando los resultados con los descritos para rumiantes domésticos en la bibliografía anatómica clásica. Se analizaron todos los músculos extrínsecos, describiendo la forma, distribución, origen e inserción. Los resultados indican que el espécimen de pudu tiene características anatómicas similares a las de los rumiantes domésticos; sin embargo, deben tenerse en cuenta algunas diferencias. Hallazgos principales: El músculo braquiocefálico tiene una interección clavicular evidente que lo separa en pars cleidobraquial, cervical y mastoideo. El músculo pectoral superficial tiene dos porciones distintas e independientes, y el músculo pectoral profundo tiene una fusión parcial con los músculos latissimus dorsi y cutáneo del tronco. El músculo subclavio es pequeño y tiene una forma alargada y se ubica profundamente a la vena cefálica, justo en el punto en el que es un afluente de la vena yugular externa. Los resultados de este estudio presentan características anatómicas específicas de Pudu puda proporcionando información de referencia novedosa y ampliando el conocimiento científico de esta especie silvestre escasamente estudiada.

Carbohydrate antigen 15-3 as a marker of disease severity in patients with chronic hypersensitivity pneumonitis* / Antígeno carboidrato 15-3 como marcador de gravidade da doença em pacientes com pneumonite de hipersensibilidade crônica

ABSTRACT Objective: Biomarkers associated with mucin 1, such as Krebs von den Lungen-6 and carbohydrate antigen (CA) 15-3, are increased in various interstitial lung diseases. Our aim was to determine whether CA 15-3 could be considered a biomarker of disease severity in patients with chronic hypersensitivity pneumonitis (cHP). Methods: This was a prospective observational study involving adult patients with cHP. Serum levels of CA 15-3 were measured and were correlated with variables related to disease severity and extension. HRCT scans were quantitatively analyzed using a computational platform and an image analysis tool (Computer Aided Lung Informatics for Pathology Evaluation and Rating). CA 15-3 levels were normalized by logarithmic transformation. Results: The sample comprised 41 patients. The mean age of the patients was 60.1 ± 11.6 years. The mean FVC in % of predicted was 70.3% ± 17.3%, and the median of the serum level of CA 15-3 was 48.1 U/mL. CA 15-3 levels inversely correlated with FVC in % of predicted (r = −0,30; p = 0,05), DLCO in % of predicted (r = −0,54; p < 0,01), and SpO2 at the end of a 4-min step test (r = −0,59; p < 0,01), but they directly correlated with total quantitative HRCT scores (r = 0,47; p = 0,004), especially regarding ground-glass opacities (r = 0.58; p < 0,001). Conclusions: CA 15-3 is likely to be a biomarker of disease severity of patients with cHP, particularly regarding gas exchange abnormalities.

RESUMO Objetivo: Biomarcadores associados à mucina-1, tais como Krebs von den Lungen-6 e carbohydrate antigen (CA, antígeno carboidrato) 15-3, encontram-se aumentados em diversas doenças pulmonares intersticiais. Nosso objetivo foi determinar se CA 15-3 poderia ser considerado um biomarcador de gravidade de doença em pacientes com pneumonite de hipersensibilidade crônica (PHc). Métodos: Estudo prospectivo observacional envolvendo pacientes adultos com PHc. Os níveis séricos de CA 15-3 foram medidos e correlacionados com variáveis relacionadas à gravidade e extensão da doença. As imagens de TCAR foram analisadas quantitativamente utilizando uma plataforma computacional e uma ferramenta de análise de imagem (Computer-Aided Lung Informatics for Pathology Evaluation and Rating). Os níveis de CA 15-3 foram normalizados por transformação logarítmica. Resultados: A amostra foi composta por 41 pacientes. A média de idade dos pacientes foi de 60,1 ± 11,6 anos. A média da CVF em % do previsto foi de 70,3% ± 17,3%, e a mediana do nível sérico de CA 15-3 foi de 48,1 U/mL. Os níveis de CA 15-3 se correlacionaram inversamente com CVF em % do previsto (r = −0,30; p = 0,05), DLCO em % do previsto (r = −0,54; p < 0,01) e SpO2 ao final de um teste de degrau de 4 minutos (r = −0,59; p < 0,01), mas se correlacionaram diretamente com a pontuação quantitativa total da TCAR (r = 0,47; p = 0,004), especialmente quanto a opacidades em vidro fosco (r = 0,58; p < 0,001). Conclusões: É provável que o CA 15-3 seja um biomarcador de gravidade de doença em pacientes com PHc, particularmente quanto a anormalidades nas trocas gasosas.

Caracterización clínico epidemiológica de pacientes con discromía dental / Clinical epidemiological characterization of patients with dental dyschromia

Introducción: La odontología conservadora ha afrontado un problema conocido como discromía, la cual ocurre cuando el diente sufre un cambio de color. No es grave en cuanto a la repercusión para la salud, pero es una condición desagradable que afecta la estética del paciente y su estado psíquico. Algunos estudios evidencian un aumento en cuanto a la discromía dental, como motivo de consulta de los pacientes, quienes en ocasiones solicitan la avulsión dentaria. Objetivo: Describir las características clínicas y epidemiológicas de pacientes con discromía. Método: Se realizó una investigación observacional, descriptiva transversal, en pacientes que acudieron a consulta en la clínica estomatológica docente del Hospital Militar Central Dr. Carlos J. Finlay, en el período comprendido entre febrero de 2016 a octubre de 2019, con un universo de 349 pacientes. Resultados: Los pacientes menos afectados fueron los menores de 19 años con un 4,3 por ciento, el sexo masculino representó un 65,9 por ciento. Predominaron las tinciones por bacterias cromógenas tanto para el sexo masculino como el femenino, con un 27,3 por ciento y 15,9 por ciento respectivamente, el grupo de edad de 35-59 años fue el más afectado con un 44,1 por ciento; las tinciones por descomposición aparecieron en el 48,4 por ciento de los pacientes. Conclusiones: Los pacientes más afectados por discromía dental fueron del sexo masculino, del rango de edad entre 35-59 años y causas extrínsecas(AU)

Introduction: Conservative dentistry has faced a problem known as dyschromia, which occurs when the tooth undergoes a color change. It is not serious in terms of consequences for health, but it is an unpleasant condition that affects the aesthetics of the patient and her psychic state. Some studies show an increase in terms of dental dyschromia, as a reason for consulting patients, who sometimes request dental avulsion. Objective: To describe the clinical and epidemiological characteristics of patients with dyschromia. Method: An observational, descriptive cross-sectional investigation was carried out in patients who came to the clinic at the teaching dental clinic of the Central Military Hospital Dr. Carlos J. Finlay, in the period from February 2016 to October 2019, with a universe of 349 patients. Results: The least affected patients were under 19 years old with 4.3 percent, the male sex represented 65.9 percent. Staining by chromogenic bacteria predominated for both the male and female sex, with 27.3 percent and 15.9 percent respectively, the age group of 35-59 years was the most affected with 44.1 percent; decomposition stains appeared in 48.4 percent of patients. Conclusions: The patients most affected by dental dyschromia were male, with an age range between 35-59 years and extrinsic causes(AU)

Relationship between sleep disturbances, lipid profile and insulin sensitivity in type 1 diabetic patients: a cross-sectional study

ABSTRACT Objective The consequences of sleep deprivation in type 1 diabetes (T1D) patients are poorly understood. Our aim was to determine how sleep disorders influence lipid profile and insulin sensitivity in T1D patients. Materials and methods This was a cross-sectional study at a public university hospital. Demographic information and medical histories were obtained during regular scheduled visit of T1D patients to the outpatient clinic. Insulin sensitivity was obtained using the estimated glucose disposal rate (eGDR) formula. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Berlin Questionnaire. Results The adult participants (n = 66, 62% women) had a median age of 28.0 years (interquartile range 21.8-33.0). Six patients (9%) had metabolic syndrome according to the International Diabetes Federation criteria. Thirty patients (46%) were considered poor sleepers according to the Pittsburgh Sleep Quality Index. The LDL-c and total cholesterol levels of poor sleepers were higher than those of good sleepers (103 v. 81; p = 0.003 and 178.0 v. 159.5 mg/dL; p = 0.009, respectively). Three patients (4%) were at high risk of obstructive sleep apnea syndrome (OSAS) according to the Berlin Questionnaire. The eGDR was lower in the group of patients with high probability of having OSAS (6.0 v. 9.1 mg.kg-1.min-1;p = .03). Conclusions Poor subjective quality of sleep and higher risk of OSAS were correlated with a worsened lipid profile and decreased insulin sensitivity, respectively. Therefore, T1D patients with sleep disturbances might have an increased cardiovascular risk in the future.

Perceived overall self-efficacy and motivation to learn in high school teenagers / Autoeficacia general percibida y motivación para aprender en adolescentes de educación media / Autoeficácia geral percebida e motivação para aprender em adolescentes do Ensino Médio

Abstract Self-efficacy is the belief each one has about their performance abilities. Motivation to learn is considered an important construct that encourages individuals to perform their tasks. This study aimed to verify the correlation between self-efficacy and intrinsic and extrinsic motivation in teenagers, investigating potential differences related to gender and age - younger (14 to 16 years) and older (17 to 19 years) teenagers. 296 adolescents from 14 to 19 years old (M=16.03; SD=0.96) participated in the study, 57% female, 66% were students from public schools and 34% from private schools. The instruments used were: a sociodemographic data questionnaire, the Perceived General Self-Efficacy Scale and the Scale for Evaluation of Motivation to Learn for high school students. Descriptive analyses, Pearson correlation and Student's t-test for independent samples were performed. The results indicated a positive correlation between self-efficacy and intrinsic motivation, and a negative correlation between self-efficacy and extrinsic motivation. Girls showed higher averages in intrinsic motivation and boys higher averages in extrinsic motivation. Male participants achieve higher means of self-efficacy when compared to girls, and there was no statistically significant difference regarding age. The establishing of strategies in schools is important, once self-efficacy and motivation can interfere in the teenagers' learning process.

Resumen La autoeficacia se refiere a las creencias que cada individuo tiene acerca de sus propias capacidades para ejecutar una tarea, mientras que la motivación para aprender se considera un constructo de notoria importancia debido a que estimula al individuo a realizar sus tareas. Teniendo en cuenta estos dos conceptos, el objetivo de este estudio fue identificar la correlación entre la autoeficacia y la motivación intrínseca y extrínseca en adolescentes por medio de un análisis de las posibles diferencias en las medias por género y por franjas etarias -adolescentes de 14 a 16 años y de 17 a 19 años-. En total, participaron 296 adolescentes de 14 a 19 años (M = 16.03; DE = .96) -57 % de género femenino-, estudiantes de educación media de escuelas públicas (66 %) y privadas (34 %). Específicamente, se utilizó una ficha de datos sociodemográficos, la Escala de Autoeficacia General Percibida (EAGP) y la Escala de Motivación para Aprender (EMA-EM), instrumentos con los que se realizó un análisis de correlación de Pearson y el test t de Student para muestras independientes. Como resultados, se observó una correlación positiva entre la autoeficacia y la motivación intrínseca, una correlación negativa entre la autoeficacia y la motivación extrínseca, medias más altas para la motivación intrínseca en las mujeres y para la motivación extrínseca en los hombres, y medias más altas en autoeficacia en los hombres. No se encontraron diferencias estadísticamente significativas entre las franjas etarias. Con esto, resulta fundamental establecer estrategias para las escuelas que tengan en cuenta que la autoeficacia y la motivación pueden interferir en el proceso de aprendizaje de los adolescentes.

Resumo A autoeficácia diz respeito às crenças que cada indivíduo tem sobre suas capacidades de desempenho. Já a motivação para aprender é considerada um construto importante que estimula o indivíduo a realizar suas tarefas. Neste estudo, objetivou-se verificar a correlação entre autoeficácia e motivação intrínseca e extrínseca em adolescentes, investigando possíveis diferenças nas médias por gênero e faixas etárias distintas -adolescentes mais novos (de 14 a 16 anos) e mais velhos (de 17 a 19 anos). Participaram do estudo 296 adolescentes de 14 a 19 anos (M = 16.03; DP = 0.96), 57 % do gênero feminino, estudantes de Ensino Médio de escolas públicas (66 %) e privadas (34 %). Foram utilizadas uma ficha de dados sociodemográficos, a Escala de Autoeficácia Geral Percebida e a Escala de Motivação para Aprender. Análises descritivas, correlação de Pearson e teste t de Student para amostras independentes foram realizados. Houve correlação positiva entre autoeficácia e motivação intrínseca, e correlação negativa entre autoeficácia e motivação extrínseca, sendo que as meninas apresentaram médias mais altas na motivação intrínseca e os meninos médias mais altas na motivação extrínseca. Os adolescentes do gênero masculino obtiveram maiores médias de autoeficácia quando comparados com as meninas, e não houve diferença estatisticamente significativa quanto às faixas etárias dos adolescentes. Portanto, estabelecer estratégias nas escolas é fundamental, uma vez que a autoeficácia e a motivação podem interferir no processo de aprendizagem dos adolescentes.

Factors Associated With Falls among the Elderly Attending a Government Clinic in Kuala Lumpur

@#Falls among the elderly can be associated with serious complications such as fractures, injuries and death. This study aims to ascertain the factors associated with falls among the elderly patients attending a government clinic located in Kuala Lumpur. Method: This was a cross-sectional study using a convenience sampling method. Data collection in 2017 from 322 elderly who attended the above clinic. A modified assisted self-administered questionnaire was used that contained the socio-demographic data, falls profile as well as extrinsic and intrinsic factors associated with falls. Analysis was done with SPSS v20.0. Results: 120 (37.27%) elderly reported falls in the past one year. The majority who had falls were females (n=76, 41.8%) and between the age of 80-89 years old (n=29, 44.6%). Malay ethnicity group, reported more falls compared to other ethnicities (n=93,44.5%). Significant associations were found between age, ethnicity and history of falls with falling (p<0.001). Intrinsic factors such as gait or imbalance problem, vision problem, using visual aids, having medical co-morbidities such as stroke, diabetes, Parkinson’s Disease and osteoporosis, and being on antidiabetic drugs were also associated with increased risk of falling as well as extrinsic factors such as uneven floor, change in furniture position, poor lighting, lack of handrails, staircase, absence of railing at stairs and using walking aids (p<0.05). Conclusion: Factors founds to be associated with falls should be the primary intervention targets to help those who are at a heightened risk for falling such as visual problem and uneven floor, in order to reduce the negative impacts of falls.