Impact of Physical Activity on Frailty Status and How to Start a Semiological Approach to Muscular System

Introduction: The world population is aging, and this demographic fact is associated with an increased prevalence of sedentary lifestyles, sarcopenia and frailty; all of them with impact on health status. Biologic reserve determination in the elderly with comorbidity poses a challenge for medical activities. Frailty is an increasingly used concept in the geriatric medicine literature, which refers to an impairment in biologic reserve. There is a close and multidirectional relationship between physical activity, the muscular system function, and a fit status; decline in this dimensions is associated with poor outcomes. The aim of this article is to make a narrative review on the relationship between physical activity, sarcopenia and frailty syndrome. Results: The low level of physical activity, sarcopenia and frailty, are important predictors for development of disability, poor quality of life, falls, hospitalizations and all causes mortality. For clinical practice we propose a semiological approach based on measurement of muscle performance, mass and also level of physical activity, as a feasible way to determine the biologic reserve. This evidence shows us that the evaluation of muscle mass and performance, provides important prognostic information because the deterioration of these variables is associated with poor clinical outcomes in older adults followed up in multiple cohorts. Conclusions: Low activity is a mechanism and at the same time part of the frailty syndrome. The determination of biologic reserve is important because it allows the prognostic stratification of the patient and constitutes an opportunity for intervention. The clinician should be aware of the clinical tools that evaluate muscular system and level of physical activity, because they place us closer to the knowledge of health status

Institutional Registry of Elderly Patients With Hip Fracture in a Community-Based Tertiary Care Hospital in Argentina (RIAFC)

Background: A clinical registry encompasses a selective set of rigorously collected and stored clinical data focused on a specific condition. Hip fracture is a common complication of osteoporosis in elderly patients. Hip fracture substantially increases the risk of death and major morbidity in the elderly patients. Limited data regarding hip fracture are available from Latin America and Argentina. The purpose of this project is to create an institutional registry of elderly patients with hip fracture in order to obtain data that reveal the impact of this disease in our environment, allowing us to evaluate different strategies of patient’s care and clinical outcomes. Objective: To describe the implementation of an institutional registry of elderly patients with hip fracture in Argentina. Methods: In this article, we described the creation, implementation, and data management of a prospective registry of elderly patients with hip fracture. The registry contains information on baseline demographics, comorbidities, laboratory, and radiological data. Follow-up at 3 and 12 months postfracture is done by phone interview to assess physical function, readmissions, and morbi-mortality. Clinical Trials registry number NCT02279550. Conclusion: In this project, we have created a hip fracture registry. We hope that this registry will provide valuable data that can lead us to new lines of research, addressed to answer questions raised in clinical practice

COVID-19 vaccines reduce mortality in hospitalized patients with oxygen requirements: Differences between vaccine subtypes: A multicontinental cohort study

The aim of this study was to analyze whether the coronavirus disease 2019 (COVID-19) vaccine reduces mortality in patients with moderate or severe COVID-19 disease requiring oxygen therapy. A retrospective cohort study, with data from 148 hospitals in both Spain (111 hospitals) and Argentina (37 hospitals), was conducted. We evaluated hospitalized patients for COVID-19 older than 18 years with oxygen requirements. Vaccine protection against death was assessed through a multivariable logistic regression and propensity score matching. We also performed a subgroup analysis according to vaccine type. The adjusted model was used to determine the population attributable risk. Between January 2020 and May 2022, we evaluated 21,479 COVID-19 hospitalized patients with oxygen requirements. Of these, 338 (1.5%) patients received a single dose of the COVID-19 vaccine and 379 (1.8%) were fully vaccinated. In vaccinated patients, mortality was 20.9% (95% confidence interval [CI]: 17.9–24), compared to 19.5% (95% CI: 19–20) in unvaccinated patients, resulting in a crude odds ratio (OR) of 1.07 (95% CI: 0.89–1.29; p = 0.41). However, after considering the multiple comorbidities in the vaccinated group, the adjusted OR was 0.73 (95% CI: 0.56–0.95; p = 0.02) with a population attributable risk reduction of 4.3% (95% CI: 1–5). The higher risk reduction for mortality was with messenger RNA (mRNA) BNT162b2 (Pfizer) (OR 0.37; 95% CI: 0.23–0.59; p < 0.01), ChAdOx1 nCoV-19 (AstraZeneca) (OR 0.42; 95% CI: 0.20–0.86; p = 0.02), and mRNA-1273 (Moderna) (OR 0.68; 95% CI: 0.41–1.12; p = 0.13), and lower with Gam-COVID-Vac (Sputnik) (OR 0.93; 95% CI: 0.6–1.45; p = 0.76). COVID-19 vaccines significantly reduce the probability of death in patients suffering from a moderate or severe disease (oxygen therapy).Fil: Huespe, Ivan. Hospital Italiano. Instituto Universitario. Escuela de Medicina; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Ferraris, Augusto. Hospital Italiano. Instituto Universitario. Escuela de Medicina; ArgentinaFil: Lalueza, Antonio. 12 de Octubre University Hospital; EspañaFil: Valdez, Pascual. Hospital General de Agudos Dalmacio Velez Sarsfield ; Gobierno de la Ciudad Autonoma de Buenos Aires;Fil: Peroni, María Leticia. Hospital Italiano. Instituto Universitario. Escuela de Medicina; ArgentinaFil: Cayetti, Luis A.. Hospital Italiano. Instituto Universitario. Escuela de Medicina; ArgentinaFil: Mirofsky, Matias A.. Hospital Municipal Doctor Leónidas Lucero; ArgentinaFil: Boietti, Bruno Rafael. Hospital Italiano. Instituto Universitario. Escuela de Medicina; ArgentinaFil: Gómez Huelgas, Ricardo. Universidad de Málaga; EspañaFil: Casas Rojo, José M.. Infanta Cristina University Hospital; EspañaFil: Antón Santos, Juan M.. Infanta Cristina University Hospital; EspañaFil: Núñez Cortés, Jesús M.. Hospital General Universitario Gregorio Marañón (hosp Gral Univ G. Marañón); EspañaFil: Lumbreras, Carlos. 12 de Octubre University Hospital; España. Universidad Complutense de Madrid; EspañaFil: Ramos Rincón, Jose Manuel. Universidad de Miguel Hernández; EspañaFil: Barrio, Noelia G.. 12 de Octubre University Hospital; España. Universidad Complutense de Madrid; EspañaFil: Pedrera Jiménez, Miguel. 12 de Octubre University Hospital; España. Universidad Complutense de Madrid; EspañaFil: Martin Escalante, María D.. Costa del Sol Hospital; EspañaFil: Ruiz, Francisco R.. Costa del Sol Hospital; EspañaFil: Onieva García, María Á.. Costa del Sol Hospital; EspañaFil: Toso, Carlos R.. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Risk, Marcelo. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Hospital Italiano. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional E Ingenieria Biomedica.; ArgentinaFil: Klén, Riku. University of Turku; FinlandiaFil: Pollán, Javier A.. Hospital Italiano. Instituto Universitario. Escuela de Medicina; ArgentinaFil: Gómez Varela, David. Universidad de Viena; Austri