[Polymedication in institutionalized elderly and its effect on vitamin B12, folate, and homocysteine levels]. / La polimedicación en mayores institucionalizados: su efecto sobre los niveles de vitamina B12, folato y homocisteína.

AIM: To determine drug consumption in institutionalized elderly living in the Region of Madrid (Spain) and to assess the relationship between drug intake and biochemical parameters for vitamin B12 (Cobalamin and Holotranscobalamin), serum folate (SF) and homocysteine (Hcy). METHODS: 167 subjects (32% men), mean age 83 ± 7 years, were classified according to biochemical parameter levels (in or out of reference range) and drugs were classified according to ATC system. The relationship between drug intake and biochemical levels was studied by means of the Fisher exact test. RESULTS: The daily mean drug intake was 5. Psicoleptic and antiacid drugs were the most consumed (both 53%). Cobalamin (median 158.2 pg/mL; 10.7% of individuals), SF (5.3 ng/mL; 52.1%) and holotranscobalamin (11.76 pmoL/L; 7.8%) deficiencies were observed. Hyperhomocysteinaemia (19.4 µmoL/L) was present in 65% of population. Antiaenemic drug intake normalized cobalamin, urologic drug and corticosteroids SF and psicoanaleptics holotranscobalamin levels. Drugs against pulmonar obstruction increased Hcy concentration (all p < 0.05). CONCLUSION: There is a high prevalence of SF deficiency and hyperhomocysteinaemia in the studied population. The elevated number of drugs taken simultaneously by each subject makes it difficult to analyze which drugs are responsible for those alterations.

Psychological effects of Tai Chi Chuan.

This article reviews the scientific studies which have been carried out at the international level on the psychological benefits that Tai Chi Chuan (TCC) brings to those who practice it. It analyzes the framework in which the research was performed, the real benefits that this activity achieves and their causes. The present article brings a new analytical perspective to the reviews carried out to date in regard to classifying and analyzing the psychological variables involved in the practice of TCC and offers a homogeneous framework within which to develop research in this field based on the model proposed by Spirduso et al. (2005).

La polimedicación en mayores institucionalizados; su efecto sobre los nivelesde vitamina B12, folato y homocisteína / Polymedication in institutionalized elderly and its effect on vitamin B12, folate, and homocysteine levels

Objetivo: Determinar qué tipo de medicamentos consume una población de ancianos institucionalizados en la Comunidad de Madrid y valorar la influencia de estos fármacos sobre las concentraciones de vitamina B12 (B12y holotranscobalamina), folato sérico (FS) y homocisteína (Hcy).Metodología: 167 individuos (32% varones), edad media 83 ± 7 años, fueron categorizados dependiendo de si la variable bioquímica estaba dentro o fuera del intervalo de normalidad. Los medicamentos fueron agrupados según la clasificación ATC. Mediante una prueba exacta de Fisher se estudió la relación entre el consumo de un determinado grupo de fármacos y la alteración de los niveles de las variables bioquímicas. Resultados: El consumo medio diario fue de 5 fármacos diferentes. Los más consumidos fueron psicolépticos y antiácidos (ambos 53%). Se observaron deficiencias deB12 (mediana 158,2 pg/mL; 10,7%), FS (5,3 ng/mL;52,1%), holotranscobalamina (11,76 pmoL/L; 7,8%) y un65,9% de hiperhomocisteinemia (19,4 μmoL/L). La toma de antianémicos normalizaba los valores de B12, los preparados urológicos y los corticosteroides los niveles de folato y los psicoanalépticos los de holotranscobalamina.La medicación contra obstrucciones pulmonares aumentaba los niveles de Hcy (todos p < 0,05).Conclusión: La población estudiada presentaba una alta prevalencia de déficit de FS e hyperhomocisteinemia.El número elevado de medicamentos tomados simultáneamente hace difícil determinar qué fármacos son responsables de estas alteraciones (AU)

Aim: To determine drug consumption in institutionalized elderly living in the Region of Madrid (Spain) and to assess the relationship between drug intake and biochemical parameters for vitamin B12 (Cobalamin and Holotranscobalamin), serum folate (SF) and homocysteine(Hcy).Methods: 167 subjects (32% men), mean age 83±7years, were classified according to biochemical parameter levels (in or out of reference range) and drugs were classified according to ATC system. The relationship between drug intake and biochemical levels was studied by means of the Fisher exact test. Results: The daily mean drug intake was 5. Psicoleptic and antiacid drugs were the most consumed (both 53%).Cobalamin (median 158.2 pg/mL; 10.7% of individuals),SF (5.3 ng/mL; 52.1%) and holotranscobalamin (11.76pmoL/L; 7.8%) deficiencies were observed. Hyperhomocysteinaemia (19.4 μmoL/L) was present in 65% of population. Antiaenemic drug intake normalized cobalamin, urologic drug and corticosteroids SF and psicoanaleptics holotranscobalamin levels. Drugs against pulmonar obs -truction increased Hcy concentration (all p < 0.05).Conclusion: There is a high prevalence of SF deficiency and hyperhomocysteinaemia in the studied population. The elevated number of drugs taken simultaneously by each subject makes it difficult to analyze which drugs are responsible for those alterations (AU)

Lipid, lipoprotein and apolipoprotein profiles in European adolescents and its associations with gender, biological maturity and body fat--the HELENA Study.

BACKGROUND/OBJECTIVES: To provide a detailed lipid profile of a European adolescent population considering age, gender, biological maturity, body mass index (BMI), fat mass (FM) and percentage body fat (BF). SUBJECTS/METHODS: Within Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA), a cross-sectional study was conducted to determine fasting serum concentrations of lipids, lipoproteins and apolipoproteins in 1076 adolescents aged 12.5-17.49 years from ten European centres. RESULTS: All serum lipid concentrations were significantly higher in girls than in boys. In boys, age was negatively correlated with high-density lipoprotein (HDL)-cholesterol and total cholesterol (TC), and positively associated with triacylglycerides (TAG) (P < 0.01) whereas no significant associations were observed in girls. Biological maturity was negatively associated with TC, HDL-, low-density lipoprotein (LDL)- and non-HDL cholesterol in boys (all P<0.05) and negatively correlated with HDL-cholesterol in girls (P<0.05). BMI, FM and BF were significantly correlated with HDL-cholesterol, LDL-cholesterol, non-HDL cholesterol, apolipoprotein (apo) A1, apoB and TAG in both boys and girls. CONCLUSIONS: The lipid profile in adolescents is strongly determined by gender. Biological maturity, FM and percentage BF contribute to the variance in lipid concentrations and should be considered in future evaluations of lipid status.

Prevalence of overweight and obesity in non-institutionalized people aged 65 or over from Spain: the elderly EXERNET multi-centre study.

Coupled with the growth of the older population, an increase in the prevalence of overweight and obesity in this age group has occurred in the last decades. The main aims of the present study were (i) to provide an updated prevalence of overweight and obesity in a representative sample of the Spanish elderly population; (ii) to calculate the prevalence of sarcopenic obesity (SO) and (iii) to analyse the relationships between adiposity measurements and lifestyle. A cross-sectional study was carried out in a sample of 3136 persons representative of the non-institutionalized population ≥65 years of age. Anthropometric measurements were obtained using standardized techniques and equipment. Overall, 84% of the population can be categorized as overweight and/or obese. The present study indicates that 67% of the Spanish elderly population has an increased percentage of fat mass and more than 56% suffer from central obesity. Moreover, SO is present in 15% of the Spanish elderly population. Finally, a strong relationship between both physically active and sedentary lifestyles and the level of adiposity was found. Prevalence of overweight and obesity among elderly people in Spain is very high and is still increasing. Lifestyle seems to be a determinant factor in the development of obesity among elderly people.

Sampling and processing of fresh blood samples within a European multicenter nutritional study: evaluation of biomarker stability during transport and storage.

INTRODUCTION: Analysis of several biological markers improves the quality and physiologic comprehension of data obtained in epidemiological nutritional studies. AIM: To develop a methodology that guarantees the centralized analysis and quality assurance of the most relevant blood parameters from fresh blood samples in adolescents in a European multicenter study. MATERIALS AND METHODS: Stability of selected nutrients and biomarkers (vitamins, fatty acids, iron metabolism and immunological parameters) chosen with respect to time and temperature of sample transport and storage was evaluated as part of the pilot study of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) project. RESULTS: Routine biochemistry and iron status parameters included in the HELENA Cross-Sectional Study (CSS) protocol could be analyzed within 24 h from fresh blood samples without any stability problems (coefficient of variation (CV)<5%, P<0.05). However, stability tests for lymphocyte subpopulations, vitamin C and fatty acids showed that they are very unstable at room temperature without any treatment. Therefore, a special handling for these samples was developed. Vitamin C was stabilized with metaphosphoric acid and transported under cooled conditions (CV 4.4%, recovery rate >93%, P>0.05). According to the results, a specific methodology and transport system were developed to collect blood samples at schools in 10 European cities and to send them to the centralized laboratory (IEL, Bonn, Germany). To guarantee good clinical practice, the field workers were instructed in a training workshop and a manual of operation was developed. CONCLUSION: The handling and transport system for fresh blood samples developed for the European multicenter study HELENA is adequate for the final part of the HELENA-CSS and will provide, for the first time, reference values for several biological markers in European adolescents.

[Replacement of the long extensor tendon of the thumb by transposition of the index finger extensor tendon]. / Ersatz der langen Daumenstrecksehne durch Umlagerung des Zeigefingerstreckers.

Transposition of the extensor indicis seems to be the most common procedure for reconstruction of the ruptured or severed extensor pollicis longus (EPL) tendon. From 1959 to 1988, we performed 115 extensor indicis transpositions in 34 open EPL injuries and 81 subcutaneous EPL ruptures. The open injuries involved failed primary repair (n = 6) or untreated tendon injuries (n = 19). The subcutaneous ruptures occurred after distal radius fractures or other closed injuries of the wrist (n = 62), arthrosis or rheumatoid synovialitis (n = 8). Forty-seven patients returned for follow-up examination six months to 18 years after operation. The evaluation included twelve parameters involving thumb, index finger and overall hand function as well as subjective patient assessment. We found significant loss of motion and strength only in two cases, where the tension of the transposed tendon was obviously inadequate. A certain loss of independent index extension was without functional impairment. Although several authors prefer EPL reconstruction with an intercalated tendon graft, we recommend the extensor indicis transposition as a simple procedure with predictable satisfactory results.

[Surgical indications status in ileus using a simple clinical index]. / Indikationsstellung beim Ileus mit Hilfe eines einfachen klinischen Index.

Based on a retrospective analysis of a group of patients with ileus disease in regard of the indication for operative intervention an "ileus index" was created which is derived from simple clinical and radiological findings and laboratory data. Prospective evaluation of this index showed its effectiveness in separating patients who had to undergo an emergency operation from those who could be operated electively after preceding diagnostic procedures or could be treated conservatively.

[Functional pathomechanisms of anal fissure]. / Funktionelle Pathomechanismen der Analfissur.

In a prospective consecutive study of 40 patients with anal fissure we analysed the anal sphincter function at rest and rectal distension. Healthy persons with comparable age and sex distribution were controls. The anal pressures were registered with thin water perfused catheters (2 ml/min). Our patients with anal fissure showed significant elevation of anal pressures at rest along the whole length of anal canal. During rectal distension only the distal part of anal sphincter (up to a level of 2 cm from the anocutaneous line) showed a spasm with reduced relaxation. Our results are useful for operative therapy, since lateral internal sphincterotomy corresponds very well to functional pathomechanism of anal fissure.