[Quality of life after a social-physical activity community intervention in elderly people with social risk. Clinical trial]. / Calidad de vida tras una intervención comunitaria sociomotriz en mayores con riesgo social. Ensayo clínico.

OBJECTIVE: To assess the effectiveness of a social-physical activity program to improve the health-related quality of life of patients over 65years old with social risk. MATERIAL AND METHODS: Randomized clinical trial. SETTING: Community; primary care and public schools. SUBJECTS: patients over 65years old with social risk, who went to the health center during the study period and met the inclusion criteria, n=102. INTERVENTIONS: Subjects were randomized into two groups. The intervention group conducted two weekly sessions of 1hour of physical exercise, for 4months; monthly sessions on healthy habits and three days of social activities. The control group received the usual advice. Quality of life was assessed using the SF-36 questionnaire; previously and at the end of the program. RESULTS: The study was completed by 80 subjects (mean age 71.5±5 years; 91.3% women). Baseline, there were no significant differences between groups, and their standardized physical and mental summary components of the SF-36 were below the population reference values (P<.01). After the program, the intervention group improved significantly, compared to the control group, in the 8 scales of the SF-36 and in the summary components, with a greater increase of 4points (P<.01) in the physical component, and 10 points in the mental component (p<0.01). CONCLUSIONS: The community program of social-physical activity intervention improves the health-related quality of life in older people at social risk.

[Functional physical condition after a multi-component community intervention of active aging: Pragmatic clinical trial]. / Condición física funcional tras una intervención comunitaria multicomponente de envejecimiento activo. Ensayo clínico pragmático.

OBJECTIVE: The objective is to assess the effectiveness of a multicomponent program of active aging in the improvement of the functional physical condition of patients older than 65years old with social risk. MATERIAL AND METHODS: Pragmatic clinical trial non-blinded. SETTING: Community activity; primary care and public education center. PARTICIPANTS: Patients older than 65years and diagnosed with social risk. The patients who attended at the health center and fulfilled the inclusion criteria were selected consecutively (n=102). INTERVENTIONS: The patients were randomized into the intervention group or to the control group. The intervention included two weekly sessions of 1h of exercise during 4months, monthly health education sessions, and three days of social activities. The control group received the regular tips. The physical conditions were evaluated before and at the end the study. RESULTS: Eighty of the patients completed the study. Their middle age was 71.5±5 years old, and 91.3% of them were women. There was no significant differences between both groups. After the intervention, all the test for physical qualities improved in the intervention group; in the 6-minutes walk test the patients improved their mark in a 98% from the baseline marks, with an average increase of 65±35m. Flexibility improved in the 60% of the patients (95%CI: 50-70); strength increased an 84% (95%CI: 76-92), and dynamic balance increased a 79% (95%CI: 70-88). In control group improve some test marks but it had no statistical significance. CONCLUSIONS: The socio-motor intervention program coordinated between health services and educational centers improves the functional physical condition of the elderly with social risk.

[Aortic dissection: 2 cases of atypical presentation]. / Disección aórtica: 2 casos de presentación atípica.

Aortic dissection is an uncommon disease with high mortality. The typical clinical picture is characterised by sudden pain in the retrosternal or interscapular region radiating to the back and abdomen. There can be several signs, depending on the arterial branches involved (stroke, renal or mesenteric ischaemia), and even the absence of pain. Two cases with unusual presentations are discussed; one with sudden paresis and ischaemia of both legs with involvement of spinal and iliac branches, and the other began as a syncope and right hemiparesis with carotid involvement.

Disección aórtica: 2 casos de presentación atípica / Aortic dissection: 2 cases of atypical presentation

La disección aórtica es un proceso patológico poco frecuente con una gran mortalidad. De forma típica la sintomatología se caracteriza por un dolor súbito en la región retroesternal o interescapular que se irradia a la espalda y el abdomen. Pueden existir diversas formas de manifestación dependiendo de la afectación de ramas arteriales (accidente vascular cerebral, isquemia renal o mesentérica) e incluso ausencia de dolor. Se describen 2 casos con presentaciones poco frecuentes, uno con paresia e isquemia brusca de miembros inferiores por afectación de ilíacas y ramas medulares, y otro que se inició como un síncope y con hemiparesia derecha por afectación carotídea (AU)

Two cases with unusual presentations are discussed; one with sudden paresis and ischaemia of both legs with involvement of spinal and iliac branches, and the other began as a syncope and right hemiparesis with carotid involvement. Aortic dissection is an uncommon disease with high mortality. The typical clinical picture is characterised by sudden pain in the retrosternal or interscapular region radiating to the back and abdomen. There can be several signs, depending on the arterial branches involved (stroke, renal or mesenteric ischaemia), and even the absence of pain (AU)

Efectividad de un programa de intervención socio-motriz en población mayor con riesgo social / Effectiveness of a social-physical activity intervention program in an elderly social risk population

Introducción. El objetivo es evaluar la efectividad de un programa de intervención sociomotriz en la mejora de la calidad de vida relacionada con la salud y la condición física funcional de pacientes mayores de 65 años con riesgo social. Material y métodos. Estudio de intervención cuasi experimental (antes-después). Ámbito: actividad comunitaria; atención primaria y centro educativo público. Sujetos: 29 pacientes mayores de 65 años, atendidos en el centro de salud, con diagnóstico de riesgo social. El programa incluyó sesiones mensuales de educación para la salud, y 2 sesiones semanales de una hora de ejercicio físico durante 6 meses. Se realizaron mediciones previas y al finalizar el estudio. Las variables resultado fueron: calidad de vida valorada mediante el cuestionario SF-36 y condición física funcional mediante la batería Senior Fitness Test. Resultados. Tras la intervención mejoraron todos los tests para las cualidades físicas; en la marcha de 6min todos los sujetos mejoraron con respecto al valor basal, con un incremento medio de 62±36 m (IC 95%: 48-76). El cuestionario SF-36 mejoró en las 8 escalas y en el componente sumario mental, con un incremento mayor de 6 puntos (p<0,05). Conclusiones. El programa de intervención socio-motriz mejora la calidad de vida relacionada con la salud y la condición física funcional de los mayores con riesgo social. Este trabajo aporta resultados a favor de la implantación de actividades comunitarias socio-motrices, coordinadas entre los servicios de salud y los centros educativos, dirigidas a los mayores en riesgo (AU)

Introduction. The objective is to assess the effectiveness of a social-physical activity intervention program in the improvement of the health-related quality of life and functional physical condition of patients older than 65 years at social risk. Material and methods. Quasi-experimental intervention (pretest-posttest). Setting. Community activity; primary care and public education centres. Participants: Twenty-nine patients older than 65 years, seen at the health centre, with a diagnosis of social risk. The program included monthly health education sessions and two weekly sessions of one hour of exercise for 6 months. Measurements were taken before and at the end of the study. Outcome variables were: quality of life valued using the SF36 questionnaire and functional fitness through Senior Fitness Battery Test. Results. After intervention improved all tests for the physical qualities improved after the intervention; in the 6-minutes walk all subjects improved from baseline, with an average increase of 62±36 metres (95% CI: 48-76). The SF-36 questionnaire improved 8 scales and mental summary component with a further increase of 6 points (P<.05). Conclusions. Social-physical activity intervention program improved the health-related quality of life related and functional physical condition in older people at social risk. This paper provides evidence in favour of the implementation of social-physical community activities, coordinated between health services and education centres, aimed at the elderly at risk (AU)

[Effectiveness of a social-physical activity intervention program in an elderly social risk population]. / Efectividad de un programa de intervención socio-motriz en población mayor con riesgo social.

INTRODUCTION: The objective is to assess the effectiveness of a social-physical activity intervention program in the improvement of the health-related quality of life and functional physical condition of patients older than 65 years at social risk. MATERIAL AND METHODS: Quasi-experimental intervention (pretest-posttest). SETTING: Community activity; primary care and public education centres. PARTICIPANTS: Twenty-nine patients older than 65 years, seen at the health centre, with a diagnosis of social risk. The program included monthly health education sessions and two weekly sessions of one hour of exercise for 6 months. Measurements were taken before and at the end of the study. Outcome variables were: quality of life valued using the SF36 questionnaire and functional fitness through Senior Fitness Battery Test. RESULTS: After intervention improved all tests for the physical qualities improved after the intervention; in the 6-minutes walk all subjects improved from baseline, with an average increase of 62 +/- 36 metres (95% CI: 48-76). The SF-36 questionnaire improved 8 scales and mental summary component with a further increase of 6 points (P < .05). CONCLUSIONS: Social-physical activity intervention program improved the health-related quality of life related and functional physical condition in older people at social risk. This paper provides evidence in favour of the implementation of social-physical community activities, coordinated between health services and education centres, aimed at the elderly at risk.

Miocardiopatía hipertrófica: a propósito de un caso / Hypertrophyc cardiomyopathy: a case report

La miocadiopatía hipertrófica, es una afectación cardiaca caracterizada por una alteración de la función diastólica (dificultad en la fase de relajación y llenado ventricular) e incremento de la contractilidad, en ausencia de una causa desencadenante (hipertensión arterial, estenosis aórtica , etc.).Presentamos el caso de un paciente de 38 años de edad que tras ser diagnosticado de miocardiopatía hipertrófica no obstructiva, el estudio posterior logró descubrir un familiar afecto, asintomático (AU)

[Importance of health education in the practice of breastfeeding]. / Importancia de la educación para la salud en la práctica de la lactancia natural.

OBJECTIVES: To find if there is a connection between health education activities (HEA), and breast-feeding (BF) and the introduction of supplementary feeding. To assess the impact of post-delivery groups on BF. DESIGN: Crossover study. SETTING: Primary care. Trinidad-Jesús Cautivo Health Centre, Málaga. PATIENTS AND OTHER PARTICIPANTS: Of the 379 children born in the district between January 1992 and December 1993, the 240 children (63.3%) monitored under the healthy child programme up to at least 6 months of age were included. MEASUREMENTS AND MAIN RESULTS: Of the 240 mothers in the sample, 107 (44.6%) received HE classes. 81.3% of the mothers who had received HE breast-fed during the first month, against 66.9% of those who did not receive HE. This difference was maintained up to the sixth month of BF. The post-delivery groups were the HE activities with most influence on BF practice. Supplementary feeding was begun before the fifth month by 34.6% of those who had not received HE, versus 21.5% of those who had received it. CONCLUSIONS: Attendance at HE classes was significantly linked to BF up to six months and to starting supplementary feeding at a later date. Post-delivery groups were the basic factor in maintaining BF for six months; ante-natal education was an influence from the third month of pregnancy.