Percepciones sobre la institucionalización de la persona adulta mayor en Barranquilla, Colombia / Perceptions about the Institutionalization of the Elderly in Barranquilla, Colombia

Resumen Introducción: El crecimiento demográfico global observado en personas adultas mayores plantea múltiples retos para el diseño de políticas de bienestar y salud pública, los cuales requieren introducir mejoras para su calidad de vida, la de la familia y la comunidad. El presente estudio resultado de investigación recoge las percepciones relacionadas con la disyuntiva entre vivir la vida en familia o la institucionalización de las personas adultas mayores en la ciudad de Barranquilla. Objetivo: Determinar la percepción que se tiene sobre la institucionalización de las personas adultas mayores desde la perspectiva del sujeto y la familia vinculados a los hogares geriátricos/gerontológicos y grupos de la tercera edad en la ciudad. Método: La investigación se realizó desde un enfoque hermenéutico, aplicando entrevistas semiestructuradas a las personas adultas mayores y las familias. Resultado: En la ciudad existe una heterogeneidad en relación con las percepciones sobre la forma de vivir esta etapa del desarrollo humano y que se encuentra estrechamente relacionada con aspectos como la salud, la economía, la funcionalidad familiar y el cuidado subrogado como un fenómeno social vinculado a la migración de las familias. Conclusión: El tema plantea desafíos que hay que enfrentar en Colombia y el mundo ante el envejecimiento, especialmente en el contexto de la pobreza, disfuncionalidad familiar y desigualdad. Se definen las causas y consecuencias de la institucionalización de las personas adultas mayores, así como las alternativas de cuidado familiar y social, explorando las características culturales y demográficas que influyen en la situación de las personas adultas mayores en el país.

Abstract Introduction: The global demographic growth observed in the segment of older adults poses multiple challenges for the design of well-being and public health policies in the countries, which requires introducing improvements that positively impact the quality of life of the older adult, the family and the community. The present study, a result of descriptive research, collects the perceptions related to the dilemma between living life as a family or the institutionalization of the elderly in the city of Barranquilla. Objective: To determine the perception of the institutionalization of the elderly from the perspective of the subject and the family linked to geriatric/gerontological homes and groups of the elderly in the city. Method: The research was carried out from a hermeneutic approach, applying semi-structured interviews to older adults and families. Result: There is heterogeneity in the city in relation to perceptions about the way of living this stage of human development and that it is closely related to aspects such as health, economy, family functionality, and the surrogate care as a social phenomenon linked to family migration. Conclusion: The topic raises challenges to be faced in Colombia and the world when it comes to aging, especially in the context of poverty, family dysfunction and inequality. The causes and consequences of the institutionalization of the elderly are defined, as well as the alternatives of family and social care, exploring the cultural and demographic characteristics that influence the situation of the elderly in the country.

Prevalencia del síndrome metabólico y factores de riesgo cardiovascular asociados en una comunidad urbana de San Luis, Argentina / Prevalence of metabolic syndrome and associated cardiovascular risk factors in an urban community of San Luis, Argentina / Prevalência da síndrome metabólica e fatores de risco cardiovascular associados em uma comunidade urbana de San Luis, Argentina

Resumen El síndrome metabólico (SM) se asocia con alteraciones metabólicas e inflamatorias que imprimen un mayor riesgo de desarrollar diabetes y enfermedades cardiovasculares y tiene como base la resistencia insulínica. La alimentación, sedentarismo, educación y distribución del ingreso pueden influir en la aparición del SM. El objetivo del estudio fue conocer la prevalencia del SM y los factores de riesgo cardiovascular asociados en una población vulnerable, adulta y urbana, que acudió voluntariamente luego de una campaña de difusión, a un hospital de atención primaria en la ciudad de San Luis, Argentina. En 451 sujetos, 205 hombres y 246 mujeres (45,5±12,4 años) se analizaron datos personales, antropométricos y biomarcadores: colesterol total, colesterol HDL (c-HDL), colesterol LDL, triglicéridos, glucosa, insulina, proteína C reactiva ultrasensible (PCRus), apolipoproteínas A y B, ácido úrico e índices subrogados de insulina. El SM se estableció empleando la definición armonizada de SM (2009). El 80% de la población no completó la educación formal. Los hombres estaban desempleados o con trabajo informal (70%). El 51,4% de la población cumplía con el criterio de SM (50,0% mujeres y 53,1% hombres). Entre los componentes del SM, la tríada más frecuente en mujeres y hombres, fue: c-HDL disminuido, circunferencia de cintura elevada e hipertrigliceridemia. El SM aumentó con la edad en los hombres. Las mujeres con SM presentaron niveles altos de PCRus. El conocimiento de la prevalencia local, tanto de la obesidad como del SM, permite valorar la magnitud del problema en cada comunidad, establecer medidas de prevención, control y compararlo con otras realidades epidemiológicas.

Abstract Metabolic syndrome (MS) is associated with metabolic and inflammatory alterations that increase the risk of developing diabetes and cardiovascular diseases, based on insulin resistance. Diet, sedentary lifestyle, education and income distribution can influence the appearance of MS. The objective of the study was to know the prevalence of MS and associated cardiovascular risk factors in a vulnerable, adult and urban population, that voluntarily attends after diffusion campaign, to a primary care hospital in the city of San Luis, Argentina. In 451 subjects, 205 men and 246 women (45.5±12.4 years), personal, anthropometric and biomarker data were analysed: total cholesterol HDL cholesterol (HDL-c), LDL cholesterol, triglycerides, glucose, insulin, ultrasensitive C-reactive protein (usCRP), apolipoproteins A and B, uric acid and insulin surrogate indices. The MS was established using the harmonised definition of MS (2009). Eighty percent of the population did not complete formal education. Men were unemployed or in informal work (70%). A total of 51.4% of the population had the MS criteria (50.0% women and 53.1% men). Among the components of MS, the most frequent triad in women and men, were: decreased HDL-c, elevated waist circumference and hypertriglyceridemia. The prevalence of MS increased with age in men. Women with MS presented high levels of usCRP. Knowledge of the local prevalence of both obesity and MS would allow enable the assessment of the magnitude of the problem in each community, establish prevention and control measures, and compare it with other epidemiological realities.

Resumo A síndrome metabólica (SM) está associada a alterações metabólicas e inflamatórias que aumentam o risco de desenvolvimento de diabetes e doenças cardiovasculares, considerando a resistência à insulina. A alimentação, o sedentarismo, a escolaridade e a distribuição de renda podem influenciar o aparecimento da SM. O objetivo do estudo foi conhecer a prevalência da SM e os fatores de risco cardiovascular associados em uma população vulnerável, adulta e urbana, que compareceu voluntariamente a um hospital de atenção primária na cidade de San Luis, Argentina, após uma campanha de divulgação. Em 451 indivíduos, 205 homens e 246 mulheres (45,5±12,4 anos), foram analisados dados pessoais, antropométricos e de biomarcadores: colesterol total, colesterol HDL (c-HDL), colesterol LDL, triglicerídeos, glicose, insulina, proteína C reativa ultrassensível (PCRus), apolipoproteínas A e B, ácido úrico e índices substitutos de insulina. A SM foi estabelecida utilizando a definição harmonizada de SM (2009). Oitenta por cento da população não concluiu a educação formal. Os homens estavam desempregados ou em trabalho informal (70%). 51,4% da população atendia os critérios da SM (50,0% mulheres e 53,1% homens). Dentre os componentes da SM, a tríade mais frequente em mulheres e homens: c-HDL diminuído, circunferência abdominal elevada e hipertrigliceridemia. SM aumentou com a idade nos homens. Mulheres com SM apresentaram níveis elevados de PCRus. O conhecimento da prevalência local da obesidade quanto da SM permite avaliar a magnitude do problema em cada comunidade, estabelecer medidas de prevenção e controle e compará-lo com outras realidades epidemiológicas.

Laparoscopic cholecystectomy in an adult patient with a ventriculoperitoneal shunt system

Adult patients with a ventriculoperitoneal shunt valve (VDVP) are not exempt from suffering from gastrointestinal diseases. Nowadays, with technological advances, it would be contradictory not to offer them the benefits of minimally invasive surgery. The case of a laparoscopic cholecystectomy of a 40-year-old male patient with VDVP who presented clinical signs of cholecystitis is presented. The patient's evolution was satisfactory and he was discharged home 72 hours after surgery. Currently, there are significant studies that demonstrate the benefit of minimally invasive surgery in patients with VDVP as a treatment for abdominal surgical pathologies, including biliary pathology. Therefore, in our experience and with the published cases, we conclude that patients with VDVP do benefit from minimally invasive surgery for any abdominal surgical pathology, including pathology of biliary origin.

Pyloric hypertrophy in adults: case report

Pyloric hypertrophy is a benign condition characterized by narrowing of the pyloric canal, which may be associated with other pathologies. It is believed to manifest as a mild form of hypertrophy from childhood into adulthood. Symptoms can be nonspecific, such as nausea, vomiting, oral intolerance, and weight loss. Diagnosis can be challenging for physicians, and accurate reporting of cases is difficult due to some patients remaining asymptomatic.

Medicación potencialmente inapropiada en adultos mayores con necesidades paliativas en domicilio / Potentially inappropriate medication in older adults with palliative care at home

Resumen Introducción : Los adultos mayores con enfermedades crónicas avanzadas y necesidad de cuidados paliativos están más expuestos a la polifarmacia y a consumir medicación potencialmente inapropiada, la cual genera un alto riesgo de eventos adversos y alteración de la calidad de vida. El objetivo de este estudio fue describir la frecuencia de consumo de medicación potencialmente inapropiada de adultos mayores con necesidad de cuida dos paliativos que ingresaron a cuidados domiciliarios luego de una hospitalización. Métodos : Estudio de corte transversal observacional de registros de dispensación e historias clínicas electró nicas, de adultos mayores en un sistema de cuidados domiciliarios y con necesidades de cuidados paliativos según el rastreo con la herramienta NECPAL, los índices PROFUND y/o PALIAR. Se analizó el consumo de fárma cos durante los 180 días posteriores al ingreso a cuidados domiciliarios. Se clasificaron los fármacos como poten cialmente inapropiados según criterios de LESS-CHRON. Resultados : Se incluyeron 176 pacientes, edad prome dio 87.4 años, 67% mujeres; 78% eran pluripatológicos y 22% presentaban una enfermedad única crónica progre siva. La mortalidad a los 6 meses fue 73%. La mediana de consumo de fármacos por paciente fue 9.1 (RIC = 4-9.7). El 87% consumía medicación potencialmente inapropia da, principalmente antihipertensivos, benzodiacepinas y antipsicóticos. Conclusión : Este estudio observó que los adultos ma yores, con necesidad de cuidados paliativos en cuidados domiciliarios, tienen un alto consumo de medicación potencialmente inapropiada. Esto refuerza la necesidad de implementar intervenciones efectivas centradas en el paciente, para prevenir la prescripción inadecuada y estimular la de-prescripción.

Abstract Introduction : Older adults with advanced chronic diseases and palliative care needs are more exposed to polypharmacy and use of potentially inappropriate medication, which generates a high risk of adverse events and impaired quality of life. The objective of this study was to describe the frequency of potentially inappropriate medication use among older adults with palliative care needs receiving home care services after hospital discharge. Methods : Observational cross-sectional study of pharmacy dispensing and electronic health records, of older adults in a home care system and with palliative care needs according to the screening with the NECPAL tool or the PROFUND and/or PALIAR indexes. Dispensed medications during 180 days after admission to home care were analyzed. Medications were classified as po tentially inappropriate according to the LESS-CHRON criteria. Results : We included 176 patients, mean age 87.4 years, 67% were women; 73% were pluripathologic pa tients and 22% had one chronic progressive disease. Mortality at 6 months was 73%. Median frequency of dispensed medications per patient was 9.1 (IQR = 4-9.7). The frequency of potentially inappropriate medication dispensation among patients was 87%, mainly antihy pertensives, benzodiazepines and antipsychotics. Conclusion : This study observed that dispensation of potentially inappropriate medication among older adults with palliative care needs and home care services is very high. This emphasizes the need for effective patient-centered interventions to prevent inadequate prescription and stimulate de-prescription.

ARGEN-IAM-ST: adultos mayores con infarto, ¿son todos iguales? / ARGEN-IAM-ST Registry: older adults with infarction: Are they all the same?

Resumen Introducción : Actualmente se define al paciente como adulto mayor (AM) si su edad es al menos de 60 años. Dada la expectativa de vida prolongada resulta intere sante evaluar si todos los AM con infarto agudo de mio cardio (IAM) son iguales. Los objetivos fueron conocer la prevalencia de AM en el IAM y dentro de ellos, la de los ≥75 años y analizar características, tratamientos de reperfusión y mortalidad intrahospitalaria de acuerdo a si son < o ≥ 75 años. Métodos : Se analizaron los pacientes AM ingresados en el Registro Nacional de Infarto con supra desnivel del segmento ST (ARGEN-IAM-ST). Se los dividió en grupo 1: 60-74 años y grupo 2: ≥ 75 años y se compararon entre sí. Resultados : AM 3626, 75.92% del Grupo 1, el resto del Grupo 2. En el grupo 2 hubo más mujeres, hipertensos y con antecedentes coronarios. Hubo similar porcentaje de diabetes y dislipidemia, pero menos de tabaquistas. En el Grupo 2 se empleó menos tratamiento de reperfusión (aunque más angioplastia primaria), con similar tiempo puerta-balón. Los pacientes del Grupo 2 recibieron me nos medicamentos de probada eficacia y en la evolución hospitalaria, más sangrado (aunque no mayor), más insuficiencia cardíaca y más mortalidad: 18.3% vs 9.4%, p<0.001. La edad ≥75 años fue predictor independiente de mortalidad. Conclusiones : Uno de cada cuatro AM con IAM tiene más de 75 años; estos pacientes reciben menos reper fusión, presentan más insuficiencia cardíaca y sangrado y tienen el doble de mortalidad que los pacientes de entre 60 y 74 años.

Abstract Introduction : Currently the patient is defined as an older adult (OA) when the age is at least 60 years. Given the long life expectancy, it is interesting to evaluate whether all OAs with acute myocardial infarction (AMI) are equal. The objectives were to know the prevalence of OA in AMI and within them, that of those ≥75 years of age and to analyze characteristics, reperfusion treat ments and in-hospital mortality according to whether they are < or ≥ 75 years of age. Methods : OA patients admitted to the National Reg istry of Infarction with ST segment elevation (ARGEN-IAM-ST) were analyzed. They were divided into group 1: 60-74 years old and group 2: ≥ 75 years old and compared with each other. Results : 3626 AM, 75.9% from Group 1, the rest from Group 2. In group 2 there were more women, hyperten sive and with a history of coronary arteries. There was a similar percentage of diabetes and dyslipidemia, but fewer of smokers. In Group 2, less reperfusion treat ment was used (although more primary angioplasty), with similar door-to-balloon time. Patients in Group 2 received fewer medications of proven efficacy and in the hospital course, they had more bleeding (although not major), more heart failure and more mortality: 18.3% vs. 9.4%, p<0.001. Age ≥75 years was an independent predictor of mortality. Conclusions : one in four patients with AMI is over 75 years old; they receive less reperfusion, have more heart failure, bleeding and twice the mortality rate than patients between 60 and 74 years.

Acute coronary syndrome in very young adults (<35 years of age) - time to awake and act! A prospective analytical study from South India

Background: Acute coronary syndrome in very young adults (<35 yrs) was considered as an uncommon entity, recently shows rising incidence especially in India. Hence we planned this study with the aim, to investigate the incidence, clinical, angiographic profile and outcome of ACS in this population. Methods: This is a prospective analytical study included patient <35 yrs with ACS admitted to cardiology department in a tertiary hospital of South India. Risk factors, clinical, angiographic profile and follow up data were recorded and analyzed. Results: Among the total 2180 patients with ACS, 5.8% (n=127) were very young adults. Youngest one was 11 yrs old with coronary anomaly. Median age was 30yrs (SD� and only 8.6% (n=10) were obese. Smoking, male sex were the major conventional risk factors followed by low HDL (52%). Family history of premature coronary event seen in 12.9%, hyperhomocysteinemia, elevated LPA and high fibrinogen were observed in 15%, 20% and 3.5% respectively. Anterior wall MI with LAD occlusion was the commonest type (66.3%). Angiographically 31.4% (36/116) had recanalised vessels, coronary anomaly was seen in 3 (2.5%) patients and pure ectasia in 4 (3.4%) patients. Only 2 were undergone primary PCI (1.7%), 61% (n=71) received thrombolytic therapy. Median delay for angiogram was 72 hrs (3 days). In-hospital mortality was 3.4% and 4.5% (n=5) during follow up. Conclusions: The incidence of ACS among very young adults is on the rising trend (5.8%). Obstructive CAD in 56.9% patients implies the rapid progression of atherosclerosis. With little contribution of novel risk markers of atherosclerosis, smoking and dyslipidemia accelerate the process of premature vascular aging in Indian subcontinent.

How multimorbidity relates to road traffic accident among older adults and elderly population: insights from longitudinal aging study in India (1st wave)

Background: Multimorbidity and road traffic accidents increase with increasing age. Supplemented with increasing life expectancy at birth, both multimorbidity and RTAs will contribute significantly to the growing disease burden of the country. The objective of the study was to determine the association between multimorbidity and RTAs among older adults (above 45 years) and the elderly (above 60 years) population in India. Methods: A secondary data analysis was conducted using the Longitudinal Ageing Study in India (LASI)-1st wave data (April 2017 to December 2018). Participants having at least two chronic health conditions were described as multimorbidity. Road traffic accidents (RTAs) was taken as the outcome variable. Univariate followed by multivariable logistic regression was conducted between the outcome variable and each explanatory variable. Results: Data extracted consisted of 34704 (51.1%) older adults and 31902 (47.9%) elderly. Multimorbidity was present in 25054 (37.6%) individuals. Among the RTA group, 325 (26.5%) individuals had multimorbidity. The elderly with multimorbidity (at least two) were associated with the RTA with an adjusted odds ratio (CI) of 0.55 (0.45-0.67) and p value of <0.001 in comparison to older adults. Clerical and skilled individuals with multimorbidity were associated with RTA in comparison to unemployed individuals with multimorbidity with an adjusted odds ratio (CI) of 1.40 (1.10-1.79) and p value of 0.007. Conclusions: The RTA was evident among males aged 45-60 years with multimorbidity. Clerical and skilled individuals with multimorbidity were more prone to RTA. These individuals should be encouraged to take necessary measures to promote healthy living and adhere to them.

Perfil das doenças metabólicas na perda auditiva ocupacional / Profile of metabolic damages in occupational hearing loss / Perfil de enfermedades metabólicas en la pérdida auditiva ocupacional

Introdução: O diagnóstico precoce quanto às perdas auditivas é essencial para minimização do impacto social em relação à rotina laboral e na qualidade de vida. Objetivo: Caracterizar a associação entre a perda auditiva em trabalhadores com doenças metabólicas. Método: Estudo transversal retrospectivo de dados secundários de prontuário com o tratamento das doenças metabólicas, os dados foram coletados em duas clínicas de saúde ocupacional (C1 e C2) em Florianópolis - Santa Catarina (Brasil), no período de janeiro de 2020 a dezembro de 2022, considerando exames referenciais a partir do ano de 2005. Os dados foram organizados em planilhas do programa Microsoft Excel® e, posteriormente, exportados e analisados no software MedCalc® Statistical Software versão 22.006. Resultados: Foram analisados dados de 97 pacientes (71 homens e 26 mulheres), expostos ao ruído ocupacional (p = 0,0047), com diagnóstico de ao menos uma doença metabólica (41,20%) e prevalência de medicamentos da classe ATC H (p = 0,0465) e Losartana® (OR = 1,6976). Conclusão: O ruído ocupacional é o principal fator de risco auditivo nas empresas analisadas, e a presença de doença metabólica poderá influenciar em alterações dos limiares auditivos. Para reduzir a vulnerabilidade dessa população, é necessário a promoção, educação e conscientização dos trabalhadores nos aspectos de saúde. (AU)

Introduction: Early diagnosis of hearing loss is essential to minimize the social impact in relation to work routine and quality of life. Objective: Analyze the association between hearing loss in workers and metabolic diseases. Method: Retrospective cross-sectional study of secondary data on the use of medications in metabolic diseases, the data were collected in two occupational health clinics (C1 and C2) in Florianópolis - Santa Catarina (Brazil), from January 2020 to December 2022, considering references from exams from the year 2005. The data were organized in Microsoft Excel® spreadsheets and subsequently exported and analyzed using the MedCalc® statistical software version 22.006. Results: The data of 97 patients (71 men and 26 women) exposed to occupational noise (p = 0.0047), diagnosed with at least one metabolic disease (41.20%) and prevalence of ATC H class medications (p = 0.0465) and Losartan® (OR = 1.6976). Discussion andConclusion: Occupational noise is the main auditory risk factor, and the presence of metabolic disease can influence hearing thresholds. To reduce the vulnerability of this population, it is necessary to promote, raise awareness and educate, using approaches related to health aspects at work. (AU)

Introducción: El diagnóstico precoz de la pérdida auditiva es fundamental para minimizar el impacto social en la rutina laboral y la calidad de vida. Propósito: Analizar la asociación entre pérdida auditiva en trabajadores y enfermedades metabólicas. Metodología: Estudio transversal retrospectivo de datos secundarios sobre el uso de medicamentos en enfermedades metabólicas; Los datos fueron recolectados en dos clínicas de salud ocupacional (C1 y C2) en en Florianópolis - Santa Catarina (Brasil), de enero de 2020 a diciembre de 2022, considerando referencias de exámenes del año 2005. Los datos fueron organizados en hojas de cálculo Microsoft Excel®. y posteriormente exportados y analizados. utilizando el software estadístico MedCalc® versión 22.006. Resultados: Se analizaron los datos de 97 pacientes (71 hombres y 26 mujeres) expuestos a ruido ocupacional (p = 0,0047), diagnosticados con al menos una enfermedad metabólica (41,20%) y prevalencia de medicamentos clase ATC H (p = 0,0465). y Losartan® (OR = 1,6976). Discusión y Conclusión: El ruido ocupacional es el principal factor de riesgo auditivo y la presencia de enfermedad metabólica puede influir en los umbrales auditivos. Para reducir la vulnerabilidad de esta población es necesario promover, sensibilizar y educar utilizando enfoques relacionados con aspectos de salud en el trabajo. (AU)

Body Typology of Lebanese Adults: Initial Cluster Cross-Selection Study / Tipología Corporal de Adultos Libaneses: Estudio Inicial de Selección Cruzada de Grupos

SUMMARY: This study aims to investigate body typologies based on a combination of basic anthropo-morphological characteristics and body composition measured by multichannel bioimpedance in a sample from the adult population of Lebanon. A total of 302 subjects (173 males and 129 females) without acute or chronic health disorders were included in the study. Body composition was measured by the multichannel bioelectrical impedance (BIA) method, using the i30 device (MEDIANA, Korea). The research used 10 variables, including three basic anthropo-morphological variables, three for assessing fat, three for assessing the muscle component, and one index variable. K-means cluster analysis was used to define five specific clusters (5D) of body types based on sex. In light of the results, the study established five distinct clusters representing five different body typologies among Lebanese adults, categorized by sex: Male sample, Group 1 - Obese Endomorph (15.61 %), Group 2 - Balanced Mesomorph (16.76 %), Group 3 - Short Endomorph (30.06 %), Group 4 - Short Mesomorph (34.10 %), and Group 5 - Pathological Obese Endomorph (3.47 %); Female sample, Group 1- Obese Endomorph (2.33 %), Group 2 - Short Endo/Mesomorph (28.68 %), Group 3 - Short Ectomorph (32.56 %), Group 4 - Endomorph (22.48 %), and Group 5 - Balanced Mesomorph (13.95 %). Furthermore, the results indicated that the primary factor contributing to the distinctions among the identified clusters in terms of sex is fat tissue. This leads to the conclusion that eating habits cause the given differences, rather than the level of physical activity, regardless of sex.

Este estudio ttuvo como objetivo investigar tipologías corporales basadas en una combinación de características antropomorfológicas básicas y composición corporal, medidas por bioimpedancia multicanal, en una muestra de la población adulta del Líbano. Se incluyeron en el estudio un total de 302 sujetos (173 hombres y 129 mujeres) sin trastornos de salud agudos o crónicos. La composición corporal se midió mediante el método de impedancia bioeléctrica multicanal (BIA), utilizando el dispositivo i30 (MEDIANA, Corea). La investigación utilizó 10 variables, incluidas tres variables antropomorfológicas básicas, tres para evaluar la grasa, tres para evaluar el componente muscular y una variable índice. Se utilizó el análisis de conglomerados de K-medias para definir cinco conglomerados específicos (5D) de tipos de cuerpo según el sexo. En base a los resultados, el estudio estableció cinco grupos distintos que representan cinco tipologías corporales diferentes entre los adultos libaneses, categorizados por sexo: muestra masculina, grupo 1: endomorfo obeso (15,61 %), grupo 2: mesomorfo equilibrado (16,76 %), grupo 3 - Endomorfo Corto (30,06 %), Grupo 4 - Mesomorfo Corto (34,10 %), y Grupo 5 - Endomorfo Obeso Patológico (3,47 %); Muestra femenina, Grupo 1: Endomorfo obeso (2,33 %), Grupo 2: Endo/mesomorfo corto (28,68 %), Grupo 3: Ectomorfo corto (32,56 %), Grupo 4: Endomorfo (22,48 %) y Grupo 5: Mesomorfo equilibrado (13,95 %). Además, los resultados indicaron que el factor principal que contribuye a las distinciones entre los grupos identificados en términos de sexo es el tejido adiposo. Esto lleva a la conclusión de que las diferencias dadas son causadas por los hábitos alimentarios, más que por el nivel de actividad física, independientemente del sexo.

Experiencia en la transición de adolescentes con enfermedad neuromuscular en el Hospital Garrahan / Experience in the transition of adolescents with neuromuscular disease at Garrahan Hospital

El desarrollo de nuevos abordajes terapéuticos ha generado un aumento en la esperanza de vida de los pacientes con enfermedades neuromusculares (ENM). Se trata de un grupo de enfermedades heterogéneas desde la clínica y los posibles tratamientos. La transición en los pacientes con ENM, implica un gran desafío por presentar niveles intelectuales dentro de rangos promedio, compromisos motor, respiratorio y cardiológico progresivos que resulta en aumento de la dependencia física conforme aumenta la necesidad de autonomía emocional del adolescente. La descripción de transiciones exitosas en ENM incluye intervenciones psicosociales individuales o grupales con un enfoque multidimensional e interdisciplinario, que contemple la participación de la familia para reducir la ansiedad y la preocupación sobre sus hijos. En el Hospital Garrahan los pacientes con ENM son atendidos dentro del Programa de Atención, Docencia e Investigación de Pacientes con Enfermedad Neuromuscular desde 2008. En este trabajo nos proponemos describir la experiencia en transición pre y post pandemia, de los adolescentes con ENM en seguimiento en el Hospital de Pediatría Garrahan (AU)

The development of new care and therapeutic approaches has generated an increase in the life expectancy of patients with neuromuscular diseases (NMD), a group of heterogeneous diseases from a clinical point of view. The transition in patients with MND involves a great challenge due to progressive motor, respiratory and cardiological compromises that result in an increase in physical dependence as the adolescent needs emotional autonomy. The description of successful transitions in patients with MND includes individual and psychosocial interventions with a multidimensional and interdisciplinary approach with family participation. Since 2008, we developed a Care, Teaching and Research Program for Patients with NMD Disease at the Garrahan Hospital. The objective of this work is to describe the pre- and post-pandemic transition experience of adolescents with NMD follow-up in our hospital (AU)

Transición y transferencia del adolescente con cardiopatía congénita / Transition and transfer of the adolescent with congenital heart disease

En las últimas décadas los avances médicos han permitido la sobrevida de los niños con cardiopatías congénitas hacia la adolescencia y adultez. Un número sustancial de pacientes tienen lesiones persistentes o residuales que requerirán asistencia durante toda la vida. El manejo exitoso durante el proceso de transición en pacientes con cardiopatía congénita (CC) requiere un enfoque integral y colaborativo. Es fundamental desarrollar un programa de transición planificado que incorpore educación y autocontrol. La educación continua y la participación activa de pacientes y familias son esenciales. La formación de especialistas y la creación de unidades de atención de Adolescentes y Adultos con cardiopatía congénita (AACC) garantizarán una mayor supervivencia y calidad de vida en esta creciente población de pacientes en Argentina. La investigación continua y la implementación de mejores prácticas, con el apoyo de políticas sanitarias, son clave para abordar los desafíos y controversias en la gestión de la transición y transferencia (AU)

In recent decades, medical advances have allowed children with congenital heart disease (CHD) to survive into adolescence and adulthood. A substantial number of these patients have persistent or residual lesions that require lifelong care. Successful management during the transition process for patients with CHD requires a comprehensive and collaborative approach. It is critical to develop a planned transition program that incorporates education and self-management. Continuing education and the active participation of patients and families are essential. The training of specialists and the creation of Adolescent and Adult Congenital Heart Disease (AACHD) care units will ensure greater survival and quality of life for this growing patient population in Argentina. Continued research and implementation of best practices, supported by health policies, are key to addressing the challenges and controversies in transition and transfer management (AU)

Validez y confiabilidad de las Escalas de siluetas de fatiga, caras de dolor revisada y catastrofización del dolor en adultos mayores / Validity and reliability of the Fatigue Silhouette, Revised Pain Faces, and Pain Catastrophizing Scales in older adults

Resumen Durante el proceso de envejecimiento aparece el dolor como uno de los síntomas más comunes y al que menos se le presta atención, este puede generar un impacto negativo en la calidad de vida de las personas mayores. También, la fatiga se manifiesta frecuentemente, pero no se suele evaluar o exteriorizar en consulta. Por esto, la presente investigación tuvo como propósito estudiar la validez y fiabilidad de las escalas Siluetas de Fatiga, Caras de Dolor Revisada y Catastrofización del Dolor en una muestra de adultos mayores del área metropolitana de Bucaramanga. La muestra estuvo conformada por 131 adultos mayores tanto institucionalizados como no institucionalizados. Los resultados evidenciaron altos valores de fiabilidad en las tres escalas y se revisan las evidencias de validez con el análisis factorial exploratorio. En conclusión, las escalas contribuyen a la medición del dolor en adultos mayores colombianos, brindando a los profesionales de la salud instrumentos confiables. Se sugiere ampliar la muestra con estudios en otras regiones del país.

Abstract Throughout the ageing process, pain arises as one of the most prevalent symptoms which regularly receives the least attention. As a result, pain can negatively impact the quality of life of older people. Fatigue is often present in older adults, yet it is frequently overlooked during consultations. Therefore, the aim of this study was to assess the reliability and validity of the Fatigue Silhouettes, Pain Faces Revised, and Pain Catastrophizing scales in a sample of older adults from the metropolitan area of Bucaramanga. The study included 131 older adults, both institutionalized and non-institutionalized. The results yielded high levels of reliability across all three scales. Moreover, the evidence of validity was assessed through exploratory factor analysis. Overall, these measuring scales provide reliable instruments to healthcare professionals evaluating pain in older adults in Colombia. Future research should expand the sample to other regions of the country.

Evidencias psicométricas de la Escala de Bienestar Psicológico (BIEPS-A) en una muestra de adultos mayores peruanos / Psychometric Evidence of the Psychological Well-Being Scale (BIEPS-A) in a Sample of Peruvian Older Adults

Resumen El bienestar psicológico es un importante factor protector de la salud mental, particularmente en población vulnerable como los adultos mayores. Por lo tanto, es necesario contar con instrumentos de medición válidos, confiables e invariantes para su adecuado uso, con fines de evaluación e intervención psicológica. Este estudio se propuso analizar las evidencias de validez, confiabilidad e invarianza factorial de la Escala de Bienestar Psicológico (BIEPS-A) en una muestra de adultos mayores peruanos. Participaron 522 adultos mayores, de 60 a 93 años (M = 70.81, DE = 7.62), quienes respondieron la Escala BIEPS-A. Se encontraron adecuados índices de ajuste para un modelo de tres factores correlacionados: x2/gl = 1.631, CFI = .988, TLI = .984, SRMR = .0470, y RMSEA = .0350. También se halló relación entre las puntuaciones de la BIESP-A y el WHO-5 (r = .504), lo que es evidencia de validez convergente. Así mismo, se halló evidencia de confiabilidad de las puntuaciones con los coeficientes alfa (α) y omega (ω) (> .80). Finalmente, se encontró evidencia parcial de invarianza factorial en función al sexo (ΔCFI < .010, ΔRMSEA < .015). Se concluyó que la escala BIEPS-A reúne evidencias de validez, confiabilidad e invarianza parcial respecto al sexo para su correcto uso en adultos mayores peruanos.

Abstract Psychological well-being is an important protective factor for mental health, particularly in vulnerable populations such as the elderly. Therefore, it is necessary to have valid, reliable, and invariant measurement instruments for their proper use for psychological assessment and intervention purposes. This study aimed to analyze the evidence of validity, reliability, and factor invariance of the Psychological Well-Being Scale (BIEPS-A) in a sample of older Peruvian adults. Participants were 522 older adults, from 60 to 93 years old (M = 70.81, SD = 7.62), who answered the BIEPS-A Scale. Adequate fit indices were found for a model of three correlated factors: x2/gl = 1.631, CFI = .988, TLI = .984, SRMR = .0470, and RMSEA = .0350. A relationship was also found between the scores of the BIESP-A and the WHO-5 (r = .504, r2 = .254), which is evidence of convergent validity. Likewise, evidence of reliability of the scores with the alpha (α) and omega (ω) coefficients (> .80) was found. Finally, partial evidence of factor invariance based on gender was found (ΔCFI < .010, ΔRMSEA < .015). It was concluded that the BIEPS-A scale gathers evidence of validity, reliability and partial invariance with respect to sex for its correct use in older Peruvian adults.

Uso de las redes sociales virtuales, percepción de soledad y habilidades sociales en jóvenes adultos españoles de la generación Z y la generación Y / Use of Virtual Social Networks and its Relationship with the Perception of Loneliness and Social Skills Among Spanish Young Adults of Generation Z and Y

Resumen Las redes sociales virtuales atraen a diferentes usuarios por las múltiples potencialidades e impactos característicos de esta sociedad tecnológica. El propósito de este estudio es identificar las redes sociales virtuales más usadas por los jóvenes, los motivos personales de uso y la relación de su utilización con la percepción de soledad y las habilidades de autoexpresión en escenarios sociales. En particular, se evalúan las diferencias de tales usos en función de la edad, el nivel de escolaridad y el género. En el estudio participaron 251 jóvenes adultos españoles con edades comprendidas entre los 18 y 40 años (X = 26.33, D.T. = 5-91) contactados a través de un muestreo no probabilístico por conveniencia. Se observó que el uso de las redes sociales virtuales se ve aumentado en los participantes con bajas habilidades sociales, altos niveles de soledad y más jóvenes. Destacan los motivos de aburrimiento y evasión o escape para usar los espacios digitales y se registra una tendencia en los jóvenes de la generación Z (18 a 28 años) a utilizar más las redes sociales virtuales, en comparación con los de la generación Y (29 a 40 años). Como conclusiones, se señala la conveniencia de controlar el uso problemático de las redes sociales virtuales y de entrenar las habilidades sociales para mejorar las relaciones interpersonales.

Abstract Virtual social networks are attracting different types of users thanks to the multiple potentialities and impacts characteristic of this technological society. The aim of this study is to identify the virtual social networks most used by young people, as well as the personal reasons for use and their negative effects in relation to the perception of loneliness and their self-expression skills in social settings. As specific objectives, it is proposed to determine the differences in such uses depending on age, level of education and gender. A non-probabilistic convenience sampling was carried out so that 251 young Spanish adults between the ages of 18 and 40 years old participated (X = 26.33, DT. = 5-91). It has been verified that the use of social networks is increased when presenting low social skills, having high levels of loneliness and the younger one is. The reasons for boredom and evasion or escape in the use of these digital spaces stand out, and a tendency is observed in the young people of Generation Z (young people between 18 and 28 years old) to use VSN more in comparison with the previous Generation Y (with a range of 29 to 40 years old). It emphasizes the convenience of controlling the problematic use of social networks, training social skills to improve interpersonal relationships and strengthening emotionally.

Propiedades psicométricas de la escala de resiliencia de Wagnild y Young en personas adultas mayores costarricenses / Psychometric Properties of The Wagnild and Young Resilience Scale in Costa Rican Older Adults / Propriedades psicométricas da escala de resiliência wagnild e young em pessoas idosas da Costa Rica

Resumen Objetivo: Analizar las propiedades psicométricas de la escala de resiliencia de Wagnild y Young, versión argentina, en un grupo de personas adultas mayores costarricenses. Materiales y métodos: Se contó con un grupo piloto (N = 40, X = 69.38) y otro para el análisis de las propiedades psicométricas (N = 100, X = 69.31). Se utilizó la escala de resiliencia de Wagnild y Young, versión argentina, de 25 ítems. Se efectuó un análisis por juicio de personas expertas y un estudio piloto, para establecer la escala por validar; posterior a esto, se realizó el estudio de validación completo. Se aplicaron análisis factoriales y alfa de Cronbach. Resultados: El análisis factorial extrajo dos factores denominados: a) "capacidad de autoeficacia" y b) "capacidad de propósito y sentido de vida". La consistencia interna en el nivel global fue 0.84 (21 ítems); para el primer factor, 0.81, y para el segundo factor, 0.74. Conclusiones: El instrumento es confiable y válido para valorar los niveles de resiliencia desde una óptica integral e interdisciplinaria, en una población de personas adultas mayores con las características similares a las de la muestra estudiada. A futuro, se recomienda realizar análisis cualitativos para delimitar mejor los constructos, con base en las características de la población.

Abstract Purpose: To analyze the psychometric characteristics of the Wagnild and Young Resilience Scale Argentine version in a Costa Rican elderly group. Materials and methods: The study had two groups, one for the pilot study (N = 40, X = 69.38), and another for the analysis of the psychometric properties (N = 100, X = 69.31). The 25-item Wagnild and Young Resilience Scale, Argentine version, was used. An analysis by expert judgment and a pilot study were carried out to establish the scale to be validated, after which, the complete validation study was carried out. Factor analyzes and Cronbach's alpha were applied. Results: They were obtained two factors named: a) "selfefficacy capacity", and b) "purpose in life capacity". The global internal consistency was 0.84, for the first factor was 0.81 and for the second factor was 0.74. Conclusions: The scale generated is reliable and valid to assess resilience in an elderly people with similar characteristics to the present study. In the future, it is recommended to carry out qualitative analyzes to better define the constructs based on the characteristics of the population.

Resumo Objetivo: Analisar as propriedades psicométricas da Escala de Resiliência Wagnild e Young, versão argentina, em um grupo de pessoas idosas costarriquenhas. Materiais e métodos: Um grupo piloto (N = 40, X = 69,38) e outro grupo para a análise das propriedades psicométricas (N = 100, X = 69,31) foram utilizados. A Escala de Resiliência Wagnild e Young, versão argentina, com 25 itens, foi utilizada. Para estabelecer a escala a ser validada, foi realizada uma análise de julgamento por especialistas e um estudo piloto, após o qual foi realizado o estudo de validação completo. A análise fatorial e o alfa de Cronbach foram aplicados. Resultados: A análise fatorial extraiu dois fatores: a) "capacidade de autoeficácia" e b) "capacidade de propósito e significado na vida". A consistência interna ao nível global foi de 0,84 (21 itens); para o primeiro fator foi de 0,81 e para o segundo fator foi de 0,74. Conclusões: O instrumento é confiável e válido para avaliar níveis de resiliência a partir de uma perspectiva holística e interdisciplinar em uma população de idosos com características semelhantes às da amostra estudada. Recomendam-se futuras análises qualitativas para melhor delimitar as construções com base nas características da população.

The normative reference value of the L test in older adults of age group 60 to 70 years of elderly adults: a cross-sectional study

Background: Walking speed assessments are thought to predict eventual health outcomes and patient quality of life when assessing the physical mobility of an individual. Such performance measurements are functional and objective which gives us accurate interpretation to anticipate future goals. The L-test is a feasible, easy administration in clinical setup would be quick and effortless for physiotherapist professionals. As there is no normative value of L- the test that could interpret the score of the test, our study focuses on finding the cut-off value in older adults aged 60-70 years. Methods: We conducted a cross-sectional study from January 2021 to June 2021 in Mumbai, India. A total of 200 participants were selected based on inclusion criteria. The study used an L-shaped path that is 20 meters long which goes 3 meters straight, then a right turn, followed by 7 meters straight. The subjects walked along the marked pathway and the test completion time was noted. Results: A notable difference was found between the male and female participants with a p value of 0.015 and the test duration for males was 19.15 (16.87-22.64) seconds and for females was 20.22 (18.03-23.94) seconds. A positive weak correlation was found between the body mass index (BMI) and duration. Also, a positive weak correlation was found statistically significant between the age and duration of the test. Conclusions: The study showed that there is an increased time duration of the L test with advancing age and BMI.

Bridging gaps in awareness of cancer associated lifestyle factors in adolescents and young adults: an interventional study in Chandigarh

Background: Cancer is a major public health concern and its incidence is growing worldwide. Adolescent and young adult (AYA) age group is a bridge between paediatric and adult age groups. AYAs have unique lifestyle patterns that may contribute to cancer risk. The study sought to assess the awareness and educate AYAs of Panjab University, Chandigarh about cancer risk associated lifestyle factors. Methods: This cross-sectional Interventional study was conducted from March -June 2023. A predesigned, pretested, validated questionnaire was used for data collection. Descriptive and analytical analysis was performed using SPSS, analytical analysis was conducted using Chi square test to find the relationship between different lifestyle factors and demographic characteristics such as age and gender. Results: The study included a total of 360 participants, consisting of 170 (47.2%) males and 190 (52.8%) females, aged between 15 and 39 years, of Panjab University, Chandigarh. Among them, 92.5% had awareness of smoking as risk factor for cancer. However, lower levels of awareness regarding lifestyle behaviours associated with cancer risk, including inadequate consumption of fruits and vegetables, regular intake of sweets and sugary drinks, following a high-fat diet (28.3%); insufficient physical activity (38.3%) and obesity (36.1%). Conclusions: The current study indicated a disparity in knowledge levels among adolescents and young adults (AYAs) of Panjab University. It is crucial to address the gaps in knowledge and promote healthy behaviours related to cancer prevention through targeted education campaigns among adolescents and young adults.

Profiles of childhood trauma: epidemiological survey results of an educated young community cohort

Background: Childhood trauma is a major threat to the welfare and prosperity of any society. Young adult population is vulnerable due to increasing adverse childhood experiences and the likelihood of serious implications in educational performance and mental health. This survey was aimed to observe the proportion of various types of childhood traumas and their association with different socio-demographic characteristics among young university students of Karachi, Pakistan. Methods: This cross-sectional study was conducted among 300 young university students, during August-December 2023. Initially, cluster sampling was done deemed to the epidemiological survey. Afterwards, from the selected clusters, students from different universities were approached using non-probability convenient sampling technique. Self-reported data were collected through a questionnaire comprising of socio-demographic characteristics along with the types of traumas experienced during their childhood. SPSS Version 26.0 was used to analyse data. Results: Of the 300 university students with a mean age of 22.14±2 years, 55.3% were females. Overall, 63.6% of the participants experienced trauma before 18 years age. The most common trauma types reported were physical/verbal abuse (81%), unlawful touch/sexual abuse (45%), parents separated/divorced (31%) abandoned by parents (20%), lived with an alcoholic/drug addict (18%) or with a mentally ill adult (14%). There were no statistically significant findings between childhood trauma experience and socio-demographic traits. Conclusions: Various profiles of childhood trauma were found prevalent in young university level individuals. Current research does suggest a way forward to prevent this public health issue that can have detrimental consequences on an individual’s mental and physical health and stress reactivity.

Normative values of neck muscle strength in adult population of Delhi NCR region

Background: The neck pain is common problem in the adult population. Neck muscles have the potential to regulate the neck movement and to maintain its physiological functions and hence should have a quantitative value for strength. The aim of this study was to evaluate the neck muscle strength which would be used as a reference in the analysis of neck pain. Further aim of this study was to analyze the effect of age, weight, height, gender, body mass index (BMI) on muscle strength. Methods: This study was an observational study conducted at physiotherapy department of I. T. S. Institute of Health and Allied Sciences from 23 September 2023 to 24 February 2024.The study comprised 1200 participants, both male and female, in the age group of 21 to 50 years old. Isometric strength measurements for several neck muscles were made using a handheld dynamometer after ethical approval. Normative strength values were calculated, and multivariate analysis was performed to conclude the effect of age, weight, height, gender and BMI on neck muscle strength. Data analysis was calculated using statistical package for the social sciences (SPSS) version 21.0. Results: Males are at lower risk than females to develop neck pain as males are having more strength than females in all age groups. Weight and age were positively associated with muscle strength (p<0.5). Height and BMI showed no significant correlation to muscle strength (p>0.5). Conclusions: This research provides the normative ranges of neck muscle strength in the adult population that will serve as a baseline and aid in prevention, maintenance and treatment of neck pain. It provides the standard for the clinician to compare the muscle strength of different age groups and unaffected.