Uso de Tai Chi para la salud del adulto mayor: revisión bibliográfica / Use of Tai Chi for the health of the elderly: A bibliographic review / Uso do Tai Chi para a saúde de idosos: uma revisão bibliográfica

RESUMEN Introducción: La población de adultos mayores está incrementando y se observa la necesidad emergente de implementar estrategias dirigidas a recuperar o conservar su salud para que puedan gozar de una vejez plena. Técnicas como el Tai Chi podrían contribuir, ya que han mostrado tener múltiples beneficios para quien la práctica, tales como mejoras en la concentración, memoria, marcha, equilibrio, reducción del riesgo de caídas, fortalecimiento del sistema cardiovascular, reducción del estrés y la depresión, entre otros beneficios. Objetivo: Analizar la evidencia científica del uso del Tai Chi para conservar la salud del adulto mayor. Desarrollo: Revisión bibliográfica realizada durante el periodo 2013-2019 en distintas bases de datos como: Pubmed, Dialnet, SciELO, LILACS, ScienceDirect y Google Académico. Se utilizaron las palabras Tai Chi Chuan, Tai Ji Quan, Tai Chi. Aplicando los criterios de elegibilidad se seleccionaron 29 artículos. Resultados: Gran porcentaje de los artículos revisados estudian la atención de síntomas físicos que deterioran la movilidad del adulto mayor, sin embargo, también se encontraron investigaciones dirigidas a la parte psicológica, como el estrés, la ansiedad, el insomnio, la depresión y el enfado-tensión, en las cuales la práctica del Tai Chi demostró mejoría. Conclusiones: El Tai Chi es una terapia alternativa para prevenir y conservar la salud del adulto mayor, fácil de aprender y de bajo costo. En la revisión bibliográfica realizada no se reportan reacciones adversas durante ni después de la práctica de la técnica; el profesional de enfermería puede recomendarla ampliamente para ser implementada como un cuidado dirigido al adulto mayor.

ABSTRACT Introduction: The population of older adults is increasing and an emergent need to implement strategies aimed at recovering or maintaining their health is observed. In this sense, techniques such as Tai Chi could contribute because they have demonstrated bringing diverse benefits for those who practice them, including improvements in the concentration, memory, gait, and equilibrium, a reduction in the risk of falls, a strengthening of the cardiovascular system, and a reduction of stress and depression, among other benefits. Objective: To analyze the scientific evidence on the use of Tai Chi as a health promoter and preserver among older adults. Development: This bibliographic review was conducted during 2013-2019 on the Pubmed, Dialnet, SciELO, LILACS, ScienceDirect and Academic Google databases. The keywords used were Tai Chi Chuan, Tai Ji Quan, and Tai Chi. After filtering through the eligibility criteria, 29 articles were selected for the review. Results: An important percentage of the articles were focused on the attention to physical symptoms which impair the mobility of older adults; nevertheless, some studies addressed psychological issues such as stress, anxiety, sleep disorders, depression, and anger-tension, as well. In these studies, the practice of Tai Chi was associated with health improvements among older adults. Conclusions: Tai Chi is an alternative therapy to promote and maintain health among older adults. This technique is easy to learn, and its practice is not expensive. No adverse reactions during or after the practice of this technique were reported in the studies of this literature review. Therefore, the nursing professional can recommend Tai Chi practice to be implemented as a complementary healthcare measure for older adults.

RESUMO Introdução: A população de idosos está aumentando e observa-se a necessidade emergente de implementação de estratégias que visem a recuperação ou preservação da saúde para que possam desfrutar de uma velhice plena. Técnicas como o Tai Chi podem contribuir, dado que têm se mostrado múltiplos benefícios para quem o pratica, tais como melhora na concentração, memória, marcha, equilíbrio, redução do risco de quedas, fortalecimento do sistema cardiovascular, redução de estresse e depressão, entre outros benefícios. Objetivo: Analisar a evidência científica do uso do Tai Chi na preservação da saúde de idosos. Desenvolvimento: Revisão bibliográfica realizada no período 2013-2019 em diferentes bases de dados como: Pubmed, Dialnet, SciELO, LILACS, ScienceDirect e Google Academic. Foram utilizadas as palavras Tai Chi Chuan, Tai Ji Quan, Tai Chi. Aplicando os critérios de elegibilidade, foram selecionados 29 artigos. Resultados: Grande porcentagem dos artigos revisados estuda a atenção aos sintomas físicos que prejudicam a mobilidade do idoso, porém, as pesquisas também foram direcionadas à parte psicológica, como estresse, ansiedade, insônia, depressão e raiva-tensão, em que a prática do Tai Chi demonstrou melhora. Conclusões: O Tai Chi é uma terapia alternativa para prevenir e preservar a saúde do idoso, de fácil aprendizado e de baixo custo. Na revisão bibliográfica realizada, não foram relatadas reações adversas durante ou após a prática da técnica; o profissional de enfermagem pode recomendar veementemente que seja implementada como cuidado ao idoso.

Total thyroidectomy versus hemithyroidectomy for patients with follicular neoplasm. A cost-utility analysis.

INTRODUCTION: Thyroid nodules are a common condition. Overall, 20% of the nodules assessed with FNAB correspond to the follicular pattern. A partial thyroidectomy is the minimal procedure that should be performed to determine the nature of these nodules. Some authors have suggested performing a total thyroidectomy based on the elimination of reoperation and ultrasound follow-up. The aim of this study was to evaluate the most cost-useful surgical strategy in a patient with an undetermined nodule, assessing complications, reoperation, recurrence and costs. MATERIAL AND METHODS: A cost-utility study was designed to compare hemithyroidectomy and total thyroidectomy. The outcomes were complications (definitive RLN palsy, permanent hypoparathyroidism, reoperation for cancer, and recurrence of the disease), direct costs and utility. We used the payer perspective at 5 years. A deterministic and probabilistic sensitivity analysis was completed. RESULTS: In a deterministic analysis, the cost, utility and cost-utility ratio was COP $12.981.801, 44.5 and COP $291.310 for total thyroidectomy and COP $14.309.889, 42.0 and $340.044 for partial thyroidectomy, respectively. The incremental cost-utility ratio was -$535.302 favoring total thyroidectomy. Partial thyroidectomy was more cost-effective when the risks of RLN injury and definitive hypoparathyroidism were greater than 8% and 9% in total thyroidectomy, respectively. In total, 46.8% of the simulations for partial thyroidectomy were located in the quadrant of more costly and less effective. CONCLUSION: Under a common range of complications, and considering the patient's preference and costs, total thyroidectomy should be selected as the most cost-effective treatment for patients with thyroid nodules and follicular patterns.

In vitro and in vivo biocompatibility of apatite-coated magnetite nanoparticles for cancer therapy.

The aim of this study was to determine the biocompatibility and potential toxicity of apatite-coated magnetite nanoparticles. The in vitro biocompatibility with human red blood cells was evaluated, not hemolytic effects were found at concentrations lower than 3 mg/ml. For the in vivo study, Balb/c mice were used. The animals were injected intravenously or intraperitoneally, the doses ranged from 100 to 2,500 mg/Kg. All the injected animals showed normal kidney and liver function. No significant changes were found in the body weight, the organs weight and the iron levels in liver due to the administration. In conclusion, apatite-coated magnetite nanoparticles did not induce any abnormal clinical signs in the laboratory animals. The results demonstrated that apatite-coated magnetite nanoparticles of 8 ± 2 nm in size did not have hemolytic effect in human erythrocytes and did not cause apparent toxicity in Balb/c mice under the experimental conditions of this study.

Manejo quirúrgico de un escolar con un traumatismo penetrante de tórax / Surgery management of the schoolboy with penetranting chest trauma

El traumatismo en niños constituye una elevada causa de morbimortalidad, especialmente el trauma penetrante, que aunque menos frecuente que el no penetrante, requiere cirugía con mayor frecuencia. A pesar de que el espectro de presentación de esta patología es muy variable y es de suma importancia el diagnóstico y tratamiento, las publicaciones sobre trauma torácico en niños son limitadas. Presentamos el caso de un escolar que se produjo una herida con una estaca al penetrarle todo el hemitórax derecho, en sentido anteroposterior, requiriendo cirugía de urgencia. Aunque la evolución inicial fue complicada, posteriormente el paciente se recuperó satisfactoriamente

Manejo quirúrgico de un escolar con traumatismo penetrante de tórax / Surgical handle of a school with penetrating thoracic injuries

El traumatismo en niños constituye una elevada causa de morbimortalidad, especialmente el trauma penetrante, que aunque menos frecuente que el no penetrante, requiere cirugía con mayor frecuencia. A pesar de que el espectro de presentación de esta patología es muy variable y es de suma importancia el diagnóstico y tratamiento, las publicaciones sobre trauma torácico en niños son limitadas. Presentamos el caso de un escolar que se produjo una herida con una estaca al penetrarle todo el hemitórax derecho, en sentido anteroposterior, requiriendo cirugía de urgencia. Aunque la evolución inicial fue complicada, posteriormente el paciente se recuperó satisfactoriamente