The impact of loneliness and social isolation on the benefits of an exercise program with hospitalised older adults.

OBJECTIVES: This study aimed to assess the prevalence and impact of loneliness (De Jong Gierveld scale) and isolation (Lubben scale) on the effects of a hospital-based exercise programme. DESIGN: Secondary analysis of a randomised clinical trial. SETTING: Acute Geriatric Unit of a tertiary hospital in Spain. PARTICIPANTS: 103 hospitalised older adults. INTERVENTION: Individualised multicomponent exercise program (20-minute sessions twice a day for 3 consecutive days). RESULTS: Among the 103 randomised patients included in the analysis (both arms included), 58.3% were male, and their mean age was 87.3 (4.5) years. According to the Lubben scale, 15.8% of patients were at risk of isolation, while 62.7% were in a situation of severe or moderate loneliness according to the De Jong Gierveld scale. In the non-isolated group, training showed a substantial positive impact on Geriatric Depression Scale (B = -1.25, 95% CI = -0.24 to -0.27). In the isolated group, all outcomes improved, but only the Quality of Life showed significant changes (B = 35, 95% CI = 4.96-35.8). The SPPB test (B = 1.62, 95% CI = 0.19-3.04) and Quality of Life, (B = 17.1, 95% CI = 1.84-32.3) showed a significant improvement in the non-loneliness exercise group while no differences were found in the loneliness group. CONCLUSION: Despite the high prevalence of loneliness and social isolation, individualised exercise programs provide significant benefits to hospitalised patients, especially in quality of life.

Synthesis and characterization of sol-gel silica films doped with size-selected gold nanoparticles.

Homogeneous nanocomposite silica films uniformly doped with size-selected gold nanoparticles (AuNPs) have been prepared by a combined use of colloidal chemistry and the sol-gel process. For this purpose, stable thiol-functionalized AuNPs (DDT-AuNPs) were first synthesized by a two-phase aqueous/organic system and, subsequently, dispersed in an acid-catalysed sol-gel silica solution. The microstructural morphology of the samples was investigated by x-ray diffraction and field emission scanning electron microscopy. X-ray photoelectron spectroscopy (XPS) and UV-vis optical spectrophotometry were instead employed to investigate the elemental chemical behaviour and the evolution of the surface plasmon resonance (SPR) band of the AuNPs from their synthesis up to the formation of the Au-doped silica films. The results show that the size, shape and crystalline domains of the AuNPs remain unchanged during the entire preparation process, indicating that their aggregation or decomposition was prevented. XPS results show that the DDT-AuNPs lose the capping shells and oxidize themselves when dispersed in acid-catalysed sol-gel solutions, and that bare AuNPs are embedded in the SiO(2) films. A large broadening of the SPR band, observed for systems with DDT-AuNPs, suggests the presence of interface effects which cause a surface electron density lowering. Thiol chain detachment from the AuNPs determines an increase of the SPR peak intensity while the oxidation of the Au surfaces causes a red shift of its position. The latter is no longer observed in doped films, suggesting that no interfacial effects between bare AuNPs and the host medium are present.

Deposition of SiO2 films with high laser damage thresholds by ion-assisted electron-beam evaporation.

SiO(2) thin films (approximately 100 nm thick) with transmittivity and a laser damage threshold nearly equal to those of bulk material are deposited on silica substrates by the technique of ion-assisted electron-beam evaporation. The influence of film packing density on the laser damage threshold is investigated by the technique of photoacoustic probe beam deflection. It is shown that films with lower packing density may have a higher laser damage threshold and as a consequence better heat dissipation.

[Electrocardiographic diagnosis of ventricular tachycardia in patients with previous myocardial infarct: frequency and significance of diverse diagnostic criteria]. / Diagnosi elettrocardiografica di tachicardia ventricolare in pazienti con pregresso infarto miocardico: frequenza e significato dei diversi criteri diagnostici.

Electrocardiographic tracings of ventricular tachycardia were recorded from 34 patients with old myocardial infarction. The diagnostic criteria of ventricular tachycardia were carefully assessed in each tracing. The most commonly observed signs were: 1) QRS duration greater than 140 msec; 2) a prevalent negative deflection in Lead V6; 3) an interval from the beginning of the QRS complex to the S wave nadir greater than 100 msec in at least one precordial lead. The cases were subdivided into two groups on the basis of a predominant positive or negative deflection in Lead V1 (Group 1 and 2, respectively). The most common signs in Group 1 were a monophasic R wave configuration of the QRS complex in Lead V1, and a QS configuration in Lead V6. On the other hand, the most frequent criteria in Group 2 were an interval between the beginning of the QRS complex and the S wave nadir greater than 60 msec in Lead V1, and a QS configuration in Lead V6. Furthermore, none of the cases reflected a normal frontal plane QRS axis, but an axis deviation was evident in all 29 cases where axis could be calculated.

Longitudinal dissociation within the reentry pathway of ventricular tachycardia.

Two cases of nonsustained, repetitive ventricular tachycardia are analyzed. In both, the episodes of tachycardia do not contain random numbers of beats, but the complexes in each phase of tachycardia are either always in even numbers (case 1) or always in odd numbers (case 2). This indicates longitudinal dissociation within the reentry circuit: i.e., there are two functionally separate pathways in some part of the reentry circuit, and the reciprocating impulse runs alternatively through the two pathways. Tachycardia ends due to block of the impulse always in the same pathway, thus, the number of beats in each episode of tachycardia is always either in odd or even numbers.

[A-V conduction in atrial flutter. Electrocardiographic study]. / La conduzione A-V nel flutter atriale. Studio elettrocardiografico.

One hundred and twenty-nine cases of atrial flutter were analyzed to assess the A-V conduction. The R-R intervals, the A-V conduction ratio, and the F-R intervals were measured in each case. Conduction in atrial flutter was defined either as constant or as variable depending on whether the A-V conduction ratio was fixed or variable. Furthermore, atrial flutter was defined as regular whenever the R-R intervals were mathematically related to each other, any interval being a multiple of the F-F cycle. On the other hand, atrial flutter was defined as irregular when the R-R cycles did not reflect a precise mathematical relationship. The R-R intervals in irregular atrial flutter were not exactly multiples of the F-F cycle. This was because the F-R intervals were variable. Sixty-five cases of atrial flutter had constant A-V conduction, whereas 64 cases were associated with variable A-V conduction. Eighty-eight per cent of cases with constant conduction were regular. On the contrary, 91% of cases with variable A-V conduction were irregular. These data reflect a relationship between the constancy of the A-V conduction ratio and the regularity of the R-R intervals. Several mechanisms were identified as being responsible for atrial flutter irregularity. Alternation of the F-R intervals was the most frequent mechanism leading to irregularity of atrial flutter with constant A-V conduction. Alternating Wenckebach periodicity was the most common cause of irregularity in atrial flutter with variable conduction ratio. Concealed conduction of blocked impulses was also frequently involved in determining atrial flutter irregularity.

[Acquired immunodeficiency syndrome. Review of the literature. Apropos of a pre-AIDS case in a heroin addict]. / La sindrome da immunodeficienza acquisita. Rassegna della letteratura. A proposito di un caso di pre-AIDS in tossicodipendente da eroina.

The Authors, after a review of the latest reports on ethiology, pathology and clinical aspects of acquired immunodeficiency syndrome (AIDS) and of linphadenopathyc syndrome (LAS or pre-AIDS), describe a case of pre-AIDS syndrome in a heroin addict characterized by typical symptoms, histological, serological and immunological patterns.