ABSTRACT
Chronic pain is defined as pain lasting longer than six weeks and is one of the main complaints in elderly subjects. Frailty is a pathological condition that increases an individual's vulnerability by diminishing their homeostatic reserve, and it is considered a mortality risk factor. We examined the association between chronic pain and frailty in subjects who were recruited from a check-up clinic in Mexico City. Chronic pain and frailty were evaluated in 131 subjects through validated questionnaires. Descriptive and analytical statistics were performed. Of the participants, 41.9% presented with chronic pain, and 12.2% were frail. The unadjusted OR for the presence of frailty in subjects with chronic pain was 14.3 (95%CI 3.0-67.8), and the phi coefficient showed a weak positive correlation between the variables (Φ=0.352, p<0.001). In conclusion, chronic pain is associated with a higher risk of frailty. Well-timed diagnosis and treatment of chronic pain can help prevent dependency in these individuals.
Subject(s)
Activities of Daily Living , Chronic Pain , Frail Elderly/statistics & numerical data , Aged , Chronic Pain/complications , Chronic Pain/diagnosis , Chronic Pain/epidemiology , Chronic Pain/therapy , Cross-Sectional Studies , Early Medical Intervention/methods , Female , Geriatric Assessment/methods , Humans , Male , Mexico/epidemiology , Middle Aged , Risk Factors , Statistics as TopicABSTRACT
Objetivo Comparar la discriminación y calibración de la escala modificada de Bruselas con el sistema Simplified Acute Physiology Score version 3 (SAPS-3) como predictor de mortalidad. Diseño Cohorte prospectiva. Ámbito Unidad de Cuidados Intensivos Respiratorios (UCIR) del Hospital General de México. Pacientes De 285 ingresos en la UCIR en 2012, se incluyeron 251 pacientes, con una edad media de 48,4±17,1 años; de ellos, 132 fueron hombres (52,8%).Intervenciones Ninguna. Variables de interés Demográficas, SAPS-3 y escala modificada de Bruselas del primer día de estancia en UCIR. Resultados El valor de la escala de Bruselas modificada del día 1 fue 4,7±3,8, y de SAPS-3, 54,7±17,8. El área ROC para la escala de Bruselas modificada del día 1 fue 0,837±0,025 (IC 95% 0,787 a 0,887), y para SAPS-3, de 0,813±0,027 (IC 95% 0,761 a 0,865), con prueba de bondad de ajuste de Hosmer-Lemeshow de 5.885 (p=0,660) y 4.026 (p=0,855), respectivamente. Conclusiones La escala modificada de Bruselas en el día 1 tiene una discriminación y calibración excelentes para predecir la mortalidad de los pacientes en la UCIR, comparables a las del modelo SAPS-3 (AU)
Purpose To compare discrimination and calibration of the modified Brussels score with the Simplified Acute Physiology Score version 3 (SAPS-3) in predicting mortality. Design A prospective cohort study was carried out. Setting The Respiratory Intensive Care Unit (RICU) of Mexico General Hospital. Patients A total of 251 patients out of 285 admissions to the RICU in 2012 were included. The mean age was 48.4±17.1 years, and 132 of the patients were men (52.8%). Interventions None. Variables of interest Demographic data, SAPS-3 score upon admission and the modified Brussels score on the day 1 of stay in the RICU. Results On day 1, the modified Brussels and SAPS-3 scores were 4.7±3.8 and 54.7±17.8, respectively. Areas under the ROC curve for the modified Brussels score on day 1 and the SAPS-3 were 0.837±0.025 (95% CI 0.787-0.887) and 0.813±0.027 (95% CI 0.761-0.865), respectively. Hosmer-Lemeshow goodness-of-fit values were 5,885 (P=.660) and 4,026 (P=.855), respectively. Conclusions The modified Brussels score on day 1 offers excellent discrimination and calibration in predicting mortality in the RICU, comparable to that of the SAPS-3 (AU)
Subject(s)
Intensive Care Units/statistics & numerical data , Multiple Organ Failure/mortality , Severity of Illness Index , Risk Factors , Hospital Mortality , Risk Adjustment/methods , Prospective Studies , Reproducibility of ResultsABSTRACT
PURPOSE: To compare discrimination and calibration of the modified Brussels score with the Simplified Acute Physiology Score version 3 (SAPS-3) in predicting mortality. DESIGN: A prospective cohort study was carried out. SETTING: The Respiratory Intensive Care Unit (RICU) of Mexico General Hospital. PATIENTS: A total of 251 patients out of 285 admissions to the RICU in 2012 were included. The mean age was 48.4±17.1 years, and 132 of the patients were men (52.8%). INTERVENTIONS: None. VARIABLES OF INTEREST: Demographic data, SAPS-3 score upon admission and the modified Brussels score on the day 1 of stay in the RICU. RESULTS: On day 1, the modified Brussels and SAPS-3 scores were 4.7 ± 3.8 and 54.7 ± 17.8, respectively. Areas under the ROC curve for the modified Brussels score on day 1 and the SAPS-3 were 0.837 ± 0.025 (95% CI 0.787-0.887) and 0.813 ± 0.027 (95% CI 0.761-0.865), respectively. Hosmer-Lemeshow goodness-of-fit values were 5,885 (P=.660) and 4,026 (P=.855), respectively. CONCLUSIONS: The modified Brussels score on day 1 offers excellent discrimination and calibration in predicting mortality in the RICU, comparable to that of the SAPS-3.
Subject(s)
Hospital Mortality , Intensive Care Units , Severity of Illness Index , Adult , Area Under Curve , Calibration , Female , Humans , Male , Middle Aged , Prognosis , Prospective Studies , ROC Curve , SpainABSTRACT
Aeromonas hydrophila is considered to be an emergent food-related bacterium. Phosphates are used as additives, mainly in meat products, to improve the quality of these foods. The antibacterial properties of phosphates are also well known. In this work, two A. hydrophila strains in early exponential phase were used: (A) A. hydrophila ATCC 7965 and (B) A. hydrophila derived from food, isolated in our laboratory. MIC and MBC studies were performed to assess the antibacterial effects of four phosphates assayed in brain heart infusion broth (BHI) and modified complete defined synthetic medium (mCDS) as compared to cooked ground meat medium (CM). The MBC values of the phosphates in CM were significantly higher than MIC values in BHI broth and mCDS medium (P < 0.05). In the two latter media, the growth of both A. hydrophila strains was totally inhibited by concentrations between 0.5 and 3.0%. Although all the assayed phosphates proved to have bactericidal effects on A. hydrophila, 0.5% sodium acid pyrophosphate (SAPP) exhibited greater effects in both strains and was selected for subsequent experiments. The bacteriolytic effect of SAPP was spectrophotometrically determined (260 nm of absorbance) by means of the leakage of intracellular nucleotides and microscopically confirmed by the presence of massive gelatinous aggregates. These were identified by enzymes (RNase, DNase, and proteinase) that hydrolyzed the nucleotides and proteins released during cellular lysis in the presence of SAPP. It was concluded that 0.5% SAPP can have bactericidal and bacteriolytic effects in early exponential phase A. hydrophila cells.
