Poor Muscle Strength and Low Physical Activity Are the Most Prevalent Frailty Components in Community-Dwelling Older Adults.

OBJECTIVE: To determine the prevalence of five physical frailty phenotype components and to assess the relationship between them and other clinical factors. METHOD: A population-based cross-sectional study was performed. Subjects 75 years and older were randomly selected from primary care databases (with sampling stratified by gender). Physical frailty phenotypes were assessed using Fried's criteria. Sociodemographic data, comorbidities, nutritional status, and functional capacity were assessed. RESULTS: 126 subjects were recruited (47% women). Prevalence rates were poor muscle strength: 50%; low physical activity: 29%; slow gait: 28%; exhaustion: 27%; and weight loss: 5%. Prefrailty and frailty prevalence rates were 35.7% and 29.4%, respectively. Poor muscle strength and low physical activity showed a close relationship and concordance (kappa = 0.92). Most frailty components were associated with outdoor activity, hours walked daily, and certain comorbidities. CONCLUSIONS: Poor muscle strength was the most prevalent frailty component and was closely associated with physical activity, suggesting that training programs may revert or prevent the frailty process.

Tratamiento conservador de un caso de placenta increta con metotrexato / Conservative management with methotrexate in a case of placenta increta

Las anomalías de la adhesión placentaria son una de las causas más frecuentes de histerectomía posparto de urgencia. El tratamiento conservador con metotrexato permite la posibilidad de conservar la capacidad reproductiva de la paciente, evitando además las posibles complicaciones de la cirugía. Presentamos un caso de placenta increta que, tras su diagnóstico, fue dejada in situ y tratada con éxito con metotrexato. Se presenta además una revisión de la bibliografía más reciente relacionada con el caso y se hace mención a otras alternativas terapéuticas conservadoras

Abnormal placentation is one of most common causes of emergency postpartum hysterectomy. Conservative management with methotrexate allows fertility to be conserved and avoids surgical morbidity. We describe a case of placenta increta that was left in situ and successfully treated with methotrexate. We also review recent publications on placenta increta and discuss other alternatives in the conservative management of this entity

Prerigor injection using glycolytic inhibitors in low-quality beef muscles.

The objective of this experiment was to determine the effect of prerigor injection of several glycolytic inhibitors on pH, color, tenderness, and related traits of low-value beef cuts. The semimembranosus, triceps brachii, and supraspinatus muscles from each of 10 steer carcasses were removed 1 h postmortem. Control samples remained in the carcass at 2 degrees C for 24 h. Prerigor muscles were injected and tumbled with 10% (by weight) of one of four solutions: sodium citrate (NaC; 200 mM), sodium fluoride (NaF; 200 mM), sodium acetate (NaA; 200 mM), and calcium chloride (CaCl2; 300 mM). All muscles treated with NaC and NaF showed the highest pH and glycogen content (P < 0.05), indicating that glycolysis was inhibited. Injection of NaC in semimembranosus and supraspinatus produced the tenderest meat (P < 0.05), showing a greater increase in tenderization at 3 d than at 7 d postmortem. Treatment did not affect color or oxidation-reduction potential, but all treated muscles tended to be more oxidative (higher oxidation-reduction potential). Sodium citrate was identified as a potential compound to enhance tenderness of prerigor muscle without altering color. Further studies are required to investigate its effect on palatability traits and to provide a basis for commercial application of the process.

Educación en pacientes con artritis reumatoidea: evaluación de una encuesta de intereses / Education of patients with rheumatoid arthritis: assessment of a survey of interests

Background: The congruence of interests between health care providers and clients is essential if subjects with chronic diseases will be educated. Aim: To assess, in patients with rheumatoid arthritis, those fields in which they would like to receive education. Patients and methods: Eighty eight patients with rheumatoid arthritis were surveyed about the topics in whicb they would like to be educated. The inquiry included medical aspects, handicap overcoming, social issues and labor aspects. Results: Eighty two percent of Patients were interested in medical aspects, 77 percent in social issues and 71 percent in handicap overcoming. Eighty three percent of Patients with greater handicaps preferred handicap overcoming, 75 percent social aspects and 74 percent medical aspects. Younger patients had a greater interest in labor aspects, those with a recently diagnosed disease were interested in legal rights and those with a prolonged disease wanted information about self help groups. Conclusions: The greater educational interests of patients with rheumatoid arthritis were on medical aspects. However, those impaired by the disease were interested in handicap overcoming. Age and duration of the disease also influenced the educational interests of patients. Thus, education in these patients must be individualized

Efecto de un manual educativo sobre conocimientos y actitudes en pacientes reumáticos y personal de salud / Impact of an educational handbook on knowledge and attitudes of rheumatic patients and health workers

To assess the impact of the educational manual Aches and Pain, on knowledge and attitudes of patients with chronic rheumatism and paramedics, using an instrument with 40 aseverations extracted from the manual, 77 patients and 42 paramedics were studied. The assessment instrument was responded before and after reading chapters of the manual, selected by the authors. Knowledge was quantified according to the number of correct answers. Adaptation to disease, optimism and self help capacity were the evalauted attitudes, using a five point scale. The study was completed by 48 patients and 42 paramedics. Knowledge improved from 19,9ñ5,3 to 25,6ñ6,15 correct answers in the former and from 23,6ñ4,9 to 30,3ñ5,5 in the latter (p<0,001), In patients there were improvements in the degree of adaptation to disease from 3,3ñ0,9 to 4,0ñ0,8 and in selfhelp capacity from 4,0ñ0,8 to 4,3ñ0,8; optimism did not improve significantly. In conclusion, the eductinal manual had an impact on knowledge and improved rheumatic patient's attitudes towards the disease