Decrease In Functional Capacity Research Articles

Type 2 diabetes mellitus negatively affects the functional performance of 6-min step test in chronic heart failure: a 3-year follow-up study

BackgroundType 2 diabetes mellitus (T2DM) and chronic heart failure (CHF) present a decrease in functional capacity due to the intrinsic nature of both pathologies. It is not known about the potential impact of T2DM on functional capacity when assessed by 6-min step test (6MST) and its effect as a prognostic marker for fatal and non-fatal events in patients with CHF.Objectiveto evaluate the coexistence of T2DM and CHF in functional capacity through 6MST when compared to CHF non-T2DM, as well as to investigate the different cardiovascular responses to 6MST and the risk of mortality, decompensation of CHF and acute myocardial infarction (AMI) over 36 months.MethodsThis is a prospective cohort study with 36 months of follow-up in individuals with T2DM and CHF. All participants completed a clinical assessment, followed by pulmonary function testing, echocardiography, and 6MST. The 6MST was performed on a 20 cm high step and cardiovascular responses were collected: heart rate, systemic blood pressure, oxygen saturation, BORG dyspnea and fatigue. The risk of mortality, acute myocardial infarction and decompensation of CHF was evaluated.ResultsEighty-six participants were included. The CHF-T2DM group had a significantly lower functional capacity than the CHF non-T2DM group (p < 0.05). Forced Expiratory Volume in one second (L), ejection fraction (%), gender and T2DM influence and are predictors of functional capacity (p < 0.05; adjusted R squared: 0.419). CHF-T2DM group presented a higher risk of mortality and acute myocardial infarction over the 36 months of follow-up (p < 0.05), but not to the risk of decompensation (p > 0.05).ConclusionT2DM negatively affects the functional performance of 6MST in patients with CHF. Gender, ejection fraction (%), FEV1 (L) and T2DM itself negatively influence exercise performance.

Physical functional capacity assessment in children with chronic kidney disease: A cross sectional observational study.

Chronic kidney disease (CKD) leads to reduced muscle mass and strength in children resulting in a decrease in functional capacity. The objectives of this cross-sectional observational study were to evaluate and compare the functional capacity and muscle strength in children with CKD stage I - V (group A), on dialysis (stage VD) (group B), and kidney transplant recipients (KTR) (group C) in Indian children. 60 children, 20 each in groups A, B, and C were enrolled. Children who could not do the tests and transplant recipients within 6 months of transplantation were excluded. Functional capacity and muscle strength were assessed by 6-minute walk distance (SMWD), timed floor-to-stand test (TFTS), and hand grip strength (HGS). The mean age of the group was 12.54 ± 2.96 years. Among groups A, B, and C, the SMWD in meters (465.90 ± 68.85, 381.45 ± 50.88, 509.05 ± 43.37), TFTS in seconds (9.93 ± 1.77, 10.36 ± 1.30, and 7.68 ± 0.76), and HGS in kg were (12.7 ± 3.85, 10.4 ± 3.02, 19.75 ± 4.45), respectively (p &lt; 0.001). Group C had the best physical functional capacity. The SMWD and HGS had a moderate positive correlation (r = 0.658, 0.658, respectively), and TFTS had a negative correlation (r = -0.605) with estimated glomerular filtration rate (eGFR). The mean HGS and TFTS were different between groups A, C, and B, C (p < 0.05) and not between A and B. The SMWT was however different between A, B, and C (p < 0.001). Muscle strength and functional capacity were most impaired in Indian children on hemodialysis and best preserved in KTR.

A Comparative Analysis of Vitamin D Status among Tuberculosis Patients and Healthy Household Contacts: A Case–Control Study from Central India

Background and Objectives: When it comes to the nature of the relationship between tuberculosis (TB) and Vitamin D, the available literature offers contradictory findings. The purpose of this study was to assess the relationship between Vitamin D and TB, as well as the relationship between Vitamin D and functional capacity in TB patients from Central India. Materials and Methods: This case–control study comprised 400 participants divided into two equal groups: cases (200 TB patients) and controls (200 healthy household contacts). The study involved subjecting participants to standard laboratory tests in accordance with the management guidelines implemented by the institute. Abbott Architect i1000SR PLUS was used to test the Vitamin D levels while the Karnofsky Performance Status Scale score was used for the functional capacity of cases. Vitamin D levels were categorized into deficient, insufficient, and sufficient for every participant. Information related to the study was noted down on a structured pro forma. Results: The difference in Vitamin D values between the two groups was statistically significant, with 62.5% of deficient patients in the case group compared to 15% in the control group (confidence interval = 95%, χ 2 = 173.97, P = 0.001). The relationship between Vitamin D concentration and Karnofsky scale categories was statistically significant ( r = 0.752, P = 0.01). Interpretation and Conclusions: Vitamin D deficiency is associated with TB and a decrease in functional capacity in the region of Bundelkhand, highlighting the vital role of Vitamin D for TB patients.

Pulmonary hemorrhage as a presentation of AL amyloidosis secondary to multiple myeloma: a case report

Abstract Background The convergence of pulmonary hemorrhage, pulmonary amyloidosis, and multiple myeloma is uncommon. Amyloidosis can affect the pulmonary parenchyma in a diffuse, tracheobronchial, or parenchymal pattern and may rarely be associated with pulmonary hemorrhage. Additionally, pulmonary amyloidosis is not a frequent manifestation of multiple myeloma. We present a case of a male patient with pulmonary hemorrhage as the initial manifestation of AL pulmonary amyloidosis, and ultimately, confirmation of multiple myeloma through bone marrow biopsy. Case presentation The clinical case involves a 60-year-old male with no significant medical history, who was admitted presenting a clinical picture evolving over 6 months characterized by hemoptoic cough, accompanied by dyspnea, a decrease in functional capacity, and constitutional symptoms. Thoracic CT images revealed multilobar ground-glass opacities with suspected alveolar hemorrhage. In response to this clinical presentation, bronchoalveolar lavage with cytology was performed, revealing the presence of hemosiderin-laden macrophages. Given the complexity of the case, further investigation included a wedge biopsy of the lung. The pathological report indicated an atypical lymphoplasmacytoid proliferation with deposits of eosinophilic amorphous material, suggestive of amyloidosis. Congo red staining confirmed the presence of amyloid material. Elevated Kappa light chains were detected in both serum and urine, with an increased K/L ratio. Immunoglobulins G and M were found to be decreased. As part of the comprehensive assessment, a bone marrow biopsy was conducted, confirming the diagnosis of multiple myeloma with 10% atypical plasma cells. In light of this diagnosis, appropriate treatment has been initiated to address this intricate medical condition effectively. Conclusion The present case report provides an illustrative perspective on an uncommon presentation of pulmonary amyloidosis secondary to multiple myeloma, with the initial manifestation being pulmonary hemorrhage. The findings from both the physical examination and laboratory tests were consistent with pulmonary amyloidosis, and definitive confirmation of the multiple myeloma diagnosis was achieved through bone marrow biopsy. This case highlights the significance of considering pulmonary amyloidosis as a potential cause of hemoptysis, especially in patients with associated risk factors for multiple myeloma. Early recognition of this clinical association is pivotal for precise diagnosis and prompt therapeutic intervention. The complexity of this case underscores the importance of a comprehensive diagnostic approach in unraveling intricate medical conditions.

The effect of intense exercise on muscle power and functional abilities of obese people

BACKGROUND: Obesity, expressed as a high body mass index (BMI), is associated with a risk of decrease in functional capacity and muscle strength, in particular in weight-bearing joints, but so far, no study has been able to show a sufficiently strong relationship between these factors. two options in conclusion.AIM: This study was conducted to quantify the effect of intense exercise on the functional capacity and muscle power of obese individuals and the risk of knee osteoarthritis.MATERIALS AND METHODS: The present research project is characterized as a clinical trial, cross-sectional, and uncontrolled research. All participants had a body mass index from 30.6 kg/m² to 34.9 kg/m² and reported not working out in the last 3 months prior to this experiment. Before their involvement, all participants were informed during an initial interview about the experimental procedure, the nature of the research, and the test protocols. They gave their written and signed informed consent to voluntarily participate in this research and completed two questionnaires. Participants in our study were recruited from sports centers, social clubs, and word of mouth. A total of 78 participants responded to the call articipated in our training protocol which was composed of two main parts. The first one is the «Anthropometric measurements tests» and the second one is the «Functional capacity tests» that were done in a gym. The participants were divided randomly into two experimental. After the end of every phase of the experiment, some members of each group were moved randomly to the other group.RESULTS: The final results of the intra-class correlation coefficient measurements for a set of tests showed strong reliability among members of each examined group. For the handgrip strength tests of the right and left hands, the results were 0.850 and 0.892, respectively. For the squat jump and countermovement jump tests, the results were 0.966 and 0.932, respectively. The results were 0.896 and 0.945 for walking 6 meters with or without double tasks. Finally, for the TUG and TUP-DT tests, the results were 0.520 and 0.663, respectively. After analyzing and interpreting the data for the functional capacity tests, the following results were obtained: For the 5 sit-stand test, the result was (F (3.87)=4.22; p=0.008, ηp2=0.127). For the Time up and go test, the result was (F (3.87)=4.56; p=0.019, ηp2=0.136), and for the 6 m walk, the result was (F (3.87)=3.81; p=0.013, ηp2=0.116). Finally, the 5X sit-to-stand test at 48 hours was lower than the base value (p=0.024), while the TUG immediately after the post was lower than the base value.CONCLUSION: In conclusion, the results of this study demonstrate the positive impact of intense exercise on muscle power and functional capacity in obese individuals. These findings suggest that high-intensity physical activity may be an effective means of improving the health and quality of life of obese individuals. Therefore, it is recommended that obese individuals include high-intensity exercise in their regular exercise program to reap these health benefits. However, it is important to emphasize the importance of consulting a healthcare professional before starting a high-intensity exercise program to avoid the risk of injury or health complications.

Functional Capacity of Noninstitutionalized Older Adults from Northwest Mexico: Reference Values.

Physical capacity (PC) is a strong determinant of health, quality of life, and functional independence in older adults. Having reference values for PC specific to a particular region allows for a contextual interpretation of an individual's level. The objectives of this study were to describe the evolution of key aspects of PC during the aging process and provide reference values for the major components of health-related PC for the older adult population in Northwest Mexico. A total of 550 independent older adults (60-84 years, 70% women) from the city of Hermosillo (Sonora, Mexico) were included between January and June 2019. PC was assessed using the Senior Fitness Test Battery (SFTB) and grip-strength test. Reference values were established for 5-year age groups, providing percentile values at 10, 25, 50, 75, and 90. The percentage decrease in functional capacity with aging was determined via a linear regression analysis of age against the percentage value of each subject relative to the average value of 60-year-old individuals of the same sex. Statistically significant differences in the results between men and women within the same age group were few and inconsistent, except for handgrip strength, which was lower in women across all age groups. The functional level, with respect to reference values for each age and sex group, was similar between men and women. The most pronounced functional decline during the aging period occurs between 70 and 80 years of age. The various tests generally show an annual percentage loss of approximately 1% from 60 years of age. This is the first study in Mexico that provides reference values for physical capacity using the Senior Fitness Test Battery. In general, older adults-both men and women-show similar functional levels with respect to their respective reference values. In general, an annual decline of 1% from the age of 60 years occurs.

Effect of Exercise Training on Functional Capacity Head and Neck Cancer Patients Receiving Various Anticancer Therapies: An Interventional Study.

Anticancer therapies causes decreased respiratory function, quality of life and functional capacity in head and neck cancer patients. Patients receiving these cancer therapies suffer from fatigue which causes decrease in functional capacity and quality of life. The objective of this present study was to determine and compare the effect of exercise training on fatigue, functional capacity and quality of life in head and neck cancer patients receiving various anticancer therapies. A total of 45 subjects were included based on inclusion and exclusion criteria. 6-minute walk test, brief fatigue inventory (BFI) and functional assessment of cancer therapy- general (FACT-G) was used to measure the functional capacity, fatigue and quality of life respectively at baseline and post intervention. Participants received exercise intervention for six weeks (three days a week) for 40 min. Exercise intervention is delivered by a qualified physiotherapist from the Department of Physiotherapy. The result of this study shows that there was highly significant improvement in six-minute walk distance pre and post intervention in chemotherapy (33.75+21.55, p=0.000), radiation therapy (39.69+25.46, p=0.000) and chemoradiotherapy (32.06+16.49, p=0.000) within the group. Similarly, significant improvement was also seen in quality of life within the groups, chemotherapy (2.92+2.43, p=0.002), radiation therapy (6.06+3.13, p=0.000) and chemo radiotherapy (5.65+6.93, p=0.004). There was significant reduction in fatigue in chemotherapy (6.92+11.07, p=0.045), radiation therapy (12.38+7.28, p=0.000) and chemo radiotherapy (11.47+8.89, p=0.000). No significant improvement was noted between the groups for six- minute walk distance (p=0.784), quality of life (p= 0.058) and reduction in fatigue (p=0.065). This study concluded that exercise training is effective in improving functional capacity, quality of life and reducing fatigue in head and neck cancer patients receiving various anticancer therapies.

Effects of COVID-19 Lockdown on Nutritional, Functional and Frailty Biomarkers of People Living in Nursing Homes. A Prospective Study.

Nursing home residences suffered a lockdown from the beginning of the COVID-19 pandemic. The present study prospectively evaluates the frailty, functional, and nutritional statuses of nursing home residents. Three hundred and one residents from three nursing homes took part in the study. Frailty status was measured using the FRAIL scale. Functional status was evaluated using the Barthel Index. Additionally, Short Physical Performance Batter (SPPB), SARC-F, hand-grip strength, and gait speed were also evaluated. Nutritional status was determined using the mini nutritional assessment test (MNA) and several anthropometrical and biochemical markers. Mini Nutritional Assessment test scores decreased in 20% throughout the confinement (p < .001). Barthel index, SPPB and SARC-F scores also decreased, although to a lesser extent, reflecting a decrease in functional capacity. However, both anthropometric parameters, hand grip strength and gait speed, remained stable throughout confinement (p > .050 in all cases). Morning cortisol secretion significantly decreased by 40% from baseline to post-confinement. A significant reduction in daily cortisol variability was observed, which may suggest increased distress. Fifty-six residents died during the period of confinement (81.4% survival rate). Sex, FRAIL and Barthel Index scores were significant predictors of resident survival. After the first COVID-19 blockade, several alterations in residents' frailty markers were observed, which were small and potentially reversible. However, many of the residents were pre-frail after the lockdown. This fact highlights the need for preventive strategies to reduce the impact of future social and physical stressors on these vulnerable individuals.

Effectiveness of a Multicomponent Training Program on Physical Performance and Muscle Quality in Older Adults: A Quasi-Experimental Study.

Aging is associated with a decrease in functional capacity, manifested by a loss of strength, physical performance and muscle quality. Multicomponent training (MCT), characterized by the combination of at least three types of training, could be a good strategy to counteract these changes. To date there are no studies evaluating the effectiveness of MCT in improving both physical performance and muscle quality simultaneously. The aim of this study is to evaluate the changes produced by an MCT program on both physical performance and muscle quality in a population of healthy older adults. Sixteen healthy older adults were recruited to perform a 15-session multicomponent training intervention. Physical performance was assessed by different functional tests, and muscle quality was assessed by tensiomyography and myotonometry. The main results of this study show some improvement in functional tests, but not in muscle quality parameters, except for vastus lateralis stiffness. MCT is able to generate improvements in the physical performance of older adults, but these improvements are not reflected in muscle quality parameters measured by tensiomyography and myotonometry.

Bimekizumab in psoriatic arthritis: a great leap forward?

Psoriatic arthritis is a chronic inflammatory arthritis that can affect up to a third of patients with psoriasis. Psoriatic arthritis can cause enthesosynovial inflammation and structural damage, which translates into a substantial decrease in functional capacity and an impact on quality of life.1 Treatment options for psoriatic arthritis are varied; however, a substantial number of patients do not reach their treatment goals. Therefore, the search for new approaches to treating the disease and for new therapeutic molecules continues to be essential.

Comparative effect of incentive spirometry and diaphragm breathing to functional capacity in COVID-19 patient in an isolated ward

Background: COVID-19 affects the multiorgan system, mostly the respiratory system. Symptoms might vary from upper respiratory manifestation to acute respiratory distress syndrome, with the main feature being impairment of gas exchange. This pulmonary impairment might lead to a decrease in functional capacity, which cause activity limitation. Thus, COVID-19 patient requires the right pulmonary rehabilitation strategy to improve pulmonary function and prevent further pulmonary complications. This study aimed to compare the effectiveness of incentive spirometry and diaphragm breathing exercise on cardiorespiratory functional capacity in COVID-19 patients. Methods: Subjects were divided into two groups of breathing exercises, the incentive spirometry group and the diaphragm breathing exercise group. They performed breathing exercises for 5 days, and the functional capacity was measured by a test named 4-meter gait time test (4MGT) and 30 sit-to-stand test (30STS). The test was taken before and after performing breathing exercises. Results: These two respiratory exercises significantly affected the functional capacity in a good manner (p &lt; 0.05). The incentive spirometry had improved 30STS (P = 0.763) and 4MGT results (P = 0.674), as well as diaphragm breathing exercise did to 30STS (P = 0.456) and 4MGS (P = 0.441). Conclusion: In conclusion, diaphragm breathing exercises and incentive spirometry improved the functional capacity of COVID-19 patients. However, incentive spirometry showed a larger effect on 30STS and 4MGT compared to diaphragm breathing exercises.

Prevalence of Emergence Delirium and Associated Factors among Older Patients Who Underwent Elective Surgery: A Multicenter Observational Study.

Background Emergence delirium is a common and serious postoperative complication in older surgical patients. It occurs at any time in the perioperative period, during or immediately following emergence from general anesthesia. Unfortunately, it is highly associated with postoperative complications such as a decrease in functional capacity, prolonged hospital stay, an increase in health care costs, and morbidity and mortality. The goal of this study was to determine the prevalence of emergence delirium and associated factors among older patients who underwent elective surgery in the teaching hospitals of Ethiopia at the postanesthesia care unit in 2021. Methods A multicenter prospective observational study was conducted at the postanesthetic care unit in the four teaching hospitals of Ethiopia. Older surgical patients admitted to the postanesthesia care unit who underwent elective surgery in the four teaching hospitals of Ethiopia were selected by using simple random sampling. Pretested structured questionnaire was used to collect data. Data were entered into EpiData (version 4.6) and exported to the SPSS (version 25.0). Binary logistic regression was used to identify factors independently associated with the emergence delirium. Results Out of 384 older patients included in the study, the prevalence of emergence delirium was 27.6%. Preoperative low hemoglobin levels (AOR: 2.0, 95% CI; 1.77–3.46), opioid (AOR: 8.0, 95% CI; 3.22–27.8), anticholinergic premedications (AOR: 8.5, 95% CI; 6.85–17.35), and postoperative pain (AOR: 3.10, 95 CI; 2.07–9.84) at PACU were independently associated with emergence delirium. Conclusion The prevalence of emergence delirium was high among older patients who underwent elective surgery. Opioid and anticholinergic premedication, low preoperative hemoglobin, and the presence of postoperative pain were independently associated with the emergence delirium. Adequate preoperative optimization and postoperative analgesia may reduce the prevalence of emergence delirium.

Correlation between Physical Performance and Stabilometric Parameters in Older Adults.

Background and Objectives: Falls are a common and serious threat to the health and independence of older adults. The decrease in functional capacity during aging means an increased risk of falls. To date, it is not known whether there is a relationship between balance and functional tests. The aim of the study was to evaluate the correlation between eyes-open and eyes-closed static balance with different functional tests. Materials and Methods: A correlation study was designed with 52 healthy subjects over 65 years of age. Results: Regarding the open eyes stabilometric parameters, significant correlations observed between the surface and the functional tests were weak in all cases. The correlations observed between length and the functional tests performed were moderate, except for that of the Timed Up and Go test (TUG) which was weak. No significant correlation between TUG and surface was found. Regarding the closed eyes stabilometric parameters, statistically significant moderate correlations were found between the surface and the Short Physical Performance Battery (SPPB) and the Five Times Sit to Stand test (5XSST). In the case of the length with eyes closed, a statistically significant moderate correlation (rho = 0.40–0.69) was found with the SPPB and 5XSST variables, and weak correlations with the 4 m Walk Speed test (4WS) and TUG variables. Conclusions: There is a mild to moderate correlation between some functional tests and stabilometric parameters in adults over 65 years old.

Effect of kinesio taping™ on the balance in the elderly

BACKGROUND: It is known, among the elderly population, the decrease in functional capacity to perform daily free-living activities, with the occurrence of falls quite frequently. The muscular component must be prepared for a better performance in motor tasks, reason why the application of Kinesio Taping™ band appears as an intervention to consider, so the aim of this study is to analyze the effect of the Kinesio Taping™ method on the balance of a senior group. METHOD: A sample of 28 subjects was divided into 2 groups: a control group (CG) and an experimental group (EG). The balance was assessed using two scales: The Time-UP &amp; Go Test (TUG) and Berg Balance Scale (BBS). At first, individuals from both groups were assessed using both Scales. Subsequently, to the individuals belonging to EG, the Kinesio Taping™ method was applied (KT™), in the anterior tibial and peroneal in both lower limbs in CG KT™ was applied as a placebo. A day later, in a second visit, the performance of both groups was again evaluated using the mentioned scales. RESULTS: In CG, no statistically significant differences were observed in between testing days, (TUG day 1 vs TUG day 2: p = 0.842); (BBS day 1 vs BBS day 2: p = 0.157). On the other hand, statistically significant differences were observed in the experimental group, where TUG performance was faster after KT™ (p = 0.001) and BBS was higher (p = 0.002). CONCLUSION: The results demonstrate that the Kinesio Taping™ application had positive effects on balance and these results could help the prevention of falls in the elderly.

Impairments of social cognition significantly predict the progression of functional decline in Huntington’s disease: A 6-year follow-up study

This study sought to investigate if there was a significant difference between the Huntington’s Disease gene expansion carriers who were impaired on the cognitive domains, social cognition and executive functions. Also, it was investigated which of the cognitive domains could predict the decrease in total functional capacity over a 6-year follow-up period. Premanifest and motor-manifest Huntington’s Disease gene expansion carriers (N = 98), were examined with a neurological and neuropsychological examination at Time 1 (year 2012–2013). Regression-based normative data was used to classify impairments on the two cognitive domains. Follow-up participants (N = 80) had their functional capacity reexamined at Time 2 (year 2018–2020), to examine which cognitive domain could predict the decrease in functional capacity over the 6-year follow-up. More than 50% of the participants were impaired on the domain of social cognition. These participants were significantly different from the participants who were impaired on executive functions. The motor function and impairments on social cognition significantly predicted the decline in functional capacity. The Emotion Hexagon test was the only significant social cognitive task, that predicted the decline in functional capacity. Social cognition includes unique and separate functions in Huntington’s Disease, unaffected by executive functions. This study emphasizes the importance of regular assessment of social cognition in Huntington’s Disease and the clinical relevance of impaired social cognitive function.

Left Atrial Emptying Fraction as Precictor Parameter of Major Adverse Cardiovascular Events (MACE) and Decrease of Functional Capacity in Patients With STEMI treated by Primary Percutaneous Coronary Intervention

Background: HF is common following ST-elevated myocardial infarction (STEMI) and aasociated with morbidity and mortality. Echocardiography is routine examination and commonly utilized for risk stratification. In current guideline. Enlarged LA volume, doppler parameter, and tissue doppler imaging were used for diastolic dysfunction. However, they have several limitation. LAEF may be superior to LAVI, doppler parameter, or TDI as markers of cardiac function in acute phase after AMI. This study conducted to assess the LAEF in predicting death, rehospitalization of heart failure (HF), and decrease functional capacity after STEMI. Methods and Results: Between January 2018 and January 2021, 391 patients with STEMI who got primary percutaneous coronary intervention were included. After STEMI, patients had echocardiography within 48 hours. All of the patients were subjected to standardized 2-dimensional echocardiography procedures. The LAEF was determined by dividing the maximal LA volume by the minimal LA volume. The primary endpoint of this study was a Major Adverse Cardiovascular Events that consisting of all-cause death and rehospitalization because decompensation of heart failure within 12 months. The secondary end point was decline of functional capacity within 12 months. During the 12-month follow-up period, 162 individuals developed MACE. Only LAEF remained an independent predictor of MACE after adjusting for clinical, biochemical, and echocardiographic factors. (P = 0.000, Odds Ratio 15,46 (CI 95%: 9,264 – 26,409)). For secondary end point, there was a significant difference in the number of patients experiencing decreased functional capacity between the groups with LAEF ≥37.5% and LAEF &lt;37.5% (based on cut off value) in the 6-month range (p=0.000 ) and was consistent within 12 months (p=0.000). Conclusion: LAEF can be a predictor of MACE and decline functional capacity of STEMI patients who have undergone primary PCI within 12 months.

What is the Optimal Body Mass Index Range for Older Adults?

BackgroundObesity is pathophysiologically complex in older adults compared to that in young and middle-aged adults. The aim of the present study was to determine the appropriate body mass index (BMI) range based on geriatric evaluation parameters in which complications can be minimized in older adults. MethodsA total of 1,051 older adult patients who underwent comprehensive geriatric assessment were included. The patients’ demographic characteristics, comorbid diseases, number of drugs, BMI, basic and instrumental activities of daily living (BADL and IADL), Tinetti balance and walking scale, Mini Nutritional Assessment, Geriatric Depression Scale-15, Mini-Mental State Examination, Time Up and Go test, and handgrip strength measurement were extracted from patient records.ResultsOf the patients who took part, 73% were female, and the mean age was 77.22±7.10 years. The most negative results were observed in those with a BMI <25 kg/m2 and in those with a BMI >35 kg/m2. Receiver operating characteristic (ROC) analysis of the optimum BMI cutoff levels to detect the desirable values of geriatric assessment parameters was found to be 31–32 and 27–28 kg/m2 for female and male, respectively.ConclusionOlder adults with BMI <25 and >35 kg/m2 were at a higher risk of a decrease in functional capacity, and experienced gait and balance problems, fall risk, decrease in muscle strength, and malnutrition. Data from this study suggest that the optimum range of BMI levels for older adults is 31–32 and 27–28 kg/m2 for female and male, respectively.

Radiation Therapy Strategies in Geriatric Patients: A Literature Review

For humans, aging is defined as a universal biological process that manifests itself as a decrease in functional capacity and an increase in the risk of morbidity and mortality over time. Age is considered the single most significant risk factor for many chronic conditions including malignancies. Breast, lungs, prostate, colorectal, stomach, thyroid, pancreas, and ovarian cancers, as well as several types of leukemia, increase exponentially with age. Oncologists are often faced with difficulties when treat this population. Even though elderly and younger individuals seem to be able to get the same benefits result from a treatment, elderly are at greater risk of experiencing toxicity, serious side effects and death. A comprehensive multidisciplinary evaluation in elderly individuals with cancer can identify the risks and benefits of toxicity due to treatment plans including morbidity and mortality. Radiotherapy can be the solution in elderly with cancer, especially in patients at high risk for systemic therapy or surgery. Radiotherapy with modern techniques and fractionation adjustments (hypofractionation) can minimize the toxicity due to therapy and can be well tolerated by elderly individuals with cancer.

Prehabilitación en el paciente con sarcopenia candidato a procedimientos quirúrgicos

El envejecimiento es un proceso natural en el ser humano que trae consigo cambios fisiológicos, morfológicos, bioquímicos y psicológicos. A medida que van aumentando los años, estas modificaciones se traducen en una mayor vulnerabilidad para el desarrollo de enfermedades como la sarcopenia, que implican una disminución de la capacidad funcional, pérdida de masa y fuerza muscular, y mayor fragilidad. Los procedimientos quirúrgicos, cada vez más comunes en la población geriátrica, representan un gran desafío para el personal médico en la medida en que esta población requiere de cuidados individualizados y de una atención multidimensional enfocada en diferentes aspectos, que van desde la salud física y emocional hasta aspectos económicos, sociales y culturales. En los pacientes sarcopénicos candidatos a procedimientos quirúrgicos son necesarias intervenciones preoperatorias que optimicen su salud y aceleren su recuperación posoperatoria, y disminuyan el riesgo de complicaciones y mortalidad. Esta revisión examina cómo la prehabilitación representa una oportunidad para mejorar la capacidad funcional de los pacientes y para prepararlos para soportar un evento estresante como lo es una cirugía, haciendo más digno su curso posoperatorio y mejorando su calidad de vida a corto y largo plazo.

EFFECT OF MASTITIS ON MILK PRODUCTION IN DAIRY COWS IN KENYA

Purpose: Mastitis is an inflammatory disease condition of udder affecting milk production negatively and having a serious impact on the economy of dairy enterprises. It is considered to be the most costly disease of dairy animals and losses mainly occur through discarded milk, reduction in milk yield, premature culling of animals and replacements. It is usually caused due to the effects of infection by bacterial or mycotic pathogens. Pathological changes to milk-secreting epithelial cells due to the inflammatory processes often bring about a decrease in functional capacity. The general objective of the study is establish the effect of mastitis on milk production in dairy cows in Kenya&#x0D; Methodology: The paper used a desk study review methodology where relevant empirical literature was reviewed to identify main themes and to extract knowledge gaps.&#x0D; Findings: The study found out that mastitis significantly affect milk production and leads to losses due to discarded abnormal milk and withheld milk from cows treated with antibiotic. There is also lack of information on the economic impact of the disease in the majority of developing countries; lack of awareness among farmers concerning sub-clinical mastitis and the importance of udder health; and lack of specific national programmes to control mastitis in the majority of countries.&#x0D; Recommendations: The study recommends that government should create awareness, management and control measures to be developed for education at farmers’ level as udder health, hygiene and nutrition play an important role in the control of mastitis. The best practices for reducing the incidence of mastitis like teat dip after milking; not allowing the cows to sit for 30 minutes after milking should be propagated widely among the farming community through mass media. The government should provide provision adequate funds and infrastructure required to undertake research in this direction.