Functionality after hip surgery: correlation between balance, age, independence, and depression among the elderly

Objective: To determine correlations between age and balance, independence, and depression among the elderly who suffered hip fractures following a fall. Method: The consecutive sample included elderly who had suffered hip fractures within the past 24 months. We evaluated 14 elderly patients (12 women and two men); with an average age of 78 ± 6.9 years old. A questionnaire was applied to obtain general data, Timed Up and Go (TUG test), Berg Balance Scale (BBS), Geriatric Depression Scale - Short form (GDS-S), Barthel Index (BI), and Waist-hip ratio (WHR). We used the one-way ANOVA, t-test, and Pearson correlation tests with a significance levels of 5%. Results: Mean tests: BBS (35.38 ± 33.06), the TUG test (28.40 ± 10.59), the pre-fall GDS-S 6.33 ± 1.52, the post-fall GDS-S 7.66 ± 1.52, and the WHR 1.05 ± 0.35 for men and 0.92 ± 0.12 for women. The Barthel Index pre-fall was 16.20 ± 5.4 and the Barthel Index post-fall was 15.12 ± 6.78. The greater the age, the longer the stay, but there was no correlation between age and function. There was a negative correlation between age and balance, but age was not related to the level of depression. Conclusion: A positive correlation was found between age and length of stay and a negative correlation was found between age and balance. There was a decrease in the BBS, and an increase in the length of the TUG test and WHR.Objetivo: Verificar correlações entre a idade e o equilíbrio, a independência, tempo de internação, e a depressão em idosos que sofreram fratura do quadril após quedas. Método: Amostra consecutiva incluiu idosos que sofreram fratura de quadril há até 24 meses. Foram avaliados 14 idosos (12 mulheres e dois homens), com idade média de 78 anos ± 6,9. Foi aplicado um questionário para obtenção de dados gerais, Time Up and Go (TUG test), Escala de Equilíbrio Berg (EEB), Escala de Depressão Geriátrica Abreviada (EDGA), Índice de Barthel e Razão cintura-quadril (RCQ). Foi aplicado ANOVA one-way, teste t e teste de correlação de Pearson com um nível de significância de 5%. Resultados: As médias dos testes: EEB (35,38 ± 33,06), o TUG test (28,40 ± 10,59); a EDGA pré-queda 6,33 ± 1,52; a EDGA pós-queda 7,66 ± 1,52; o RCQ 1,05 ± 0,35 para homens e 0,92 ± 0,12 para mulheres. O Índice de Barthel pré-queda 16, 20 ± 5,4 e o Índice de Barthel pós-queda 15,12 ± 6,78. Quanto maior a idade, maior é o tempo de internação e que não há correlação entre idade e função (IC: 0,643; valor p ≤ 0,013). Houve correlação negativa entre idade e equilíbrio, mas a idade não está relacionada ao nível de depressão (IC: -0,556; valor p ≤ 0,048). Conclusão: Foi verificada correlação positiva entre idade e tempo de internação e correlação negativa entre idade e equilíbrio. Houve a diminuição da pontuação de EEB, aumento do tempo do TUG Test e aumento da RQC

Obesidade em idosos do Município de São Carlos, SP e sua associação com diabetes melito e dor articular

The aim of this study was to assess prevalence of obesity and its association with diabetes mellitus (DM) and joint pain among elderly dwellers in the city of São Carlos, SP, Brazil. A total of 399 aged people - 227 women (mean age 69.6±6.8) and 172 men (mean age 69.4±6.7) - were assessed as to body mass index (BMI) and were questioned whether they had diabetes and joint pain. Data were statistically analysed. Results showed that 73.6% of the women and 66.9% of the men were overweight or obese; BMI values were higher in subjects aged under 75. Among women, associations were found between the obese condition, presence of diabetes, and foot, ankle and knee pain. In the male group, the obese condition presented association only with presence of diabetes. An association was hence found between obesity and DM. Prevalence of obesity was greater in elderly women, who also presented association between joint pain and high BMI values.Este estudo tem por objetivo verificar a prevalência de obesidade e sua associação com diabetes melito (DM) e dores articulares na população idosa residente em São Carlos, SP. Foram avaliadas 227 idosas (média de idade 69,6±6,8 anos) e 172 idosos (69,4±6,7 anos) quanto ao índice de massa corporal (IMC) e questionados quanto à presença de diabetes e dor articular. Os dados foram tratados estatisticamente. Os resultados mostram que 73,6% das idosas e 66,9% dos idosos apresentavam sobrepeso ou eram obesos. As médias de IMC foram maiores nos indivíduos com idade inferior a 75 anos. Entre as mulheres da amostra foi encontrada associação entre a presença de DM, dores no pé, tornozelo e joelho e a condição"obesa". No grupo masculino, a condição obeso só apresentou associação com a presença de DM. Foi pois constatada associação entre obesidade e presença de DM. Mulheres idosas apresentam maior prevalência de obesidade e associação entre dores articulares e excesso de peso corporal

Gimnasia laboral para profesionales de la salud: una revisión sistemática

This aimed to systematically review randomizedcontrolled trials and compare the effectiveness of laborgymnastics with that of no intervention, minimal interventionor other types of intervention in healthcare workers,in relation to musculoskeletal pain, stress, physical disability,and absence from work. A search was carried out in thePUBMED, Pedro, EMBASE, CENTRAL, CINAHAL, PSYCHINFO,NIOSHTIC-2, SPORT DICUS, SCIELO, and LILACS databases.In total, 3,598 articles were found, seven of which wereeligible for the study. There was a statistical difference inmusculoskeletal pain in favor of labor gymnastics after 5,10 and 12 weeks (MD: −0.63; 95%, CI: −1.17; −0.08) and 6,9 and 12 months of intervention (MD: −0.74; 95% CI: −1.43;−0.05). There was also a statistical difference in favor of laborgymnastics in terms of time off work (MD: −3.26; 95% CI:−6.28; −0.25) and stress (SMD: −0.35; 95% CI: −0.67; −0.03)in studies in which interventions were carried out for 5 and10 weeks. Labor gymnastics can contribute to the physicaland mental health of healthcare professionals. However,more randomized controlled studies with a larger samplesize and aimed at this professional category are neededEste estudo tem como objetivo revisarsistematicamente ensaios randomizados controlados ecomparar a eficácia da ginástica laboral com nenhumaintervenção, intervenção mínima ou outros tipos deintervenção em trabalhadores de saúde, em relação àdor musculoesquelética, estresse, incapacidade física eafastamento do trabalho. Foram realizadas buscas nasbases de dados PUBMED, PEDro, EMBASE, CENTRAL,CINAHAL, PsycINFO, NIOSHTIC-2, SPORTDicus, SCIELOe LILACS. Foram encontrados 3598 artigos, sendosete elegíveis. Houve diferença estatística para dormusculoesquelética a favor da ginástica laboral após 5,10 e 12 semanas (MD: −0,63; 95%, CI: −1,17; −0,08) e 6,9 e12 meses de intervenção (MD: −0,74; 95% CI: −1,43; −0,05).Também foi verificada diferença estatística a favor daginástica laboral para o afastamento no trabalho (MD:−3,26; 95% IC: −6,28; −0,25) e para redução do estresse(SMD: −0.35; 95% IC: −0,67; −0.03) nos estudos querealizaram intervenção por 5 e 10 semanas. A ginásticalaboral pode contribuir para a saúde física e mentaldo profissional de saúde, no entanto, mais estudosrandomizados controlados voltados para essa categoriaprofissional, e com maior valor amostral, são necessáriospara confirmação dessa hipóteseEste estudio tuvo por objetivo realizaruna revisión sistemática de los ensayos aleatorizados controlados y comparar la efectividad de la gimnasia laboralcon ninguna intervención, con intervención mínima u otros tiposde intervención en los profesionales de la salud con relacióna dolor musculoesquelético, estrés, incapacidad física y bajalaboral. Se realizaron búsquedas en las bases de datos PUBMED,PEDro, EMBASE, CENTRAL, CINAHAL, PsycINFO, NIOSHTIC-2,SPORTDicus, SciELO y LILACS. Se encontraron 3.598 artículos,de los cuales siete fueron elegibles. Hubo una diferencia estadísticapara el dolor musculoesquelético a favor de la gimnasia laboraldespués de 5, 10 y 12 semanas (MD: −0,63; 95% CI: −1,17; −0,08) y6,9 y 12 meses de intervención (MD: −0,74; 95% CI: −1,43; −0,05).También hubo una diferencia estadística a favor de la gimnasialaboral para el tiempo de baja laboral (MD: −3,26; 95% IC: −6,28;−0,25) y la reducción del estrés (SMD: −0,35; 95% IC: −0,67;−0,03) en los estudios que realizaron la intervención entre cincoy diez semanas. La gimnasia laboral puede contribuir a la saludfísica y mental de los profesionales de la salud, sin embargo,son necesarios más estudios aleatorizados controlados dirigidosa esta categoría profesional y con un mayor tamaño muestralpara confirmar esta hipótesi

High prevalence of hepatitis B virus and low vaccine response in children and adolescents in Northeastern Brazil

Children have an increased likelihood of becoming carriers of the chronic hepatitis B virus. A total of 1,381 children and adolescents were assessed in five municipalities of Maranhao State, Brazil, for detection of anti-HBc, HBsAg and anti-HBs serologic markers and sociodemographic and behavioral features. Among those who were HBsAg negative and anti-HBc negative, the proportion of anti-HBs positives was calculated after the individuals had completed the vaccination schedule. The robust variance of the Poisson’s regression model was used in order to have adjusted tables and calculate the prevalence ratio. Multivariate analysis was performed to identify the factors associated with the prevalence of anti-HBc with or without HBsAg and the vaccine response. It was observed that 163 children were anti-HBc positive and nine individuals were HBsAg positive. The factors associated with the infection were: municipality of residence (residing in Morros municipality or Humberto de Campos municipality), residence in a rural area, aged between 13 and 15 years old, and illicit drug use. The percentage of individuals who were anti-HBc negative and received all three doses of the vaccine was 48.5%. Among these, only 276 (38.9%) had antibodies at protective concentrations. In an adjusted analysis, Morros municipality presented an increased positivity of vaccine response (p < 0.001), and the age ranging between 6 and 10 years old presented a reduced frequency of response. This study reveals a high prevalence of current and past HBV infection within the targeted age group which, in addition to the low vaccination coverage and serological responses, raises concerns about the management of prevention measures, especially the quality of vaccination in these locations

Inquérito sorológico da infecção pelos vírus da encefalomielite equina no estado de Minas Gerais, Brasil

The occurrence of Equine Eastern Encephalomyelitis (EEE), Equine Western Encephalomyelitis (WEE) and Equine Venezuelan Encephalomyelitis (VEE) virus infection was investigated in equids not vaccinated against these viruses. The animals were distributed  in ten regional districts of the state of Minas Gerais (Almenara, Bambuí, Curvelo, Governador Valadares, Montes Claros, Oliveira, São Gonçalo do Sapucaí, Teófilo Otoni, Unaí e Viçosa). Microplate serum neutralization test was used to detect antibodies against encephalitis virus. Two hundred and fifty animals (30.2%, 250/826) were EEE-seropositive, while 1.9% of them (16/826) were VEE-seropositive. No animals were found to be seropositive for WEE. In conclusion, either EEE or VEE viruses circulate in the equid population of the state of Minas Gerais.Foi investigada a ocorrência da infecção pelos vírus da Encelafalomielite Equina do Leste (EEE), Encefalomielite Equina do Oeste (WEE) e Encefalomielite Equina Venezuelana (VEE) em equídeos não vacinados contra tais agentes, criadosem dez Delegacias Regionaisdo Estado de Minas Gerais (Almenara, Bambuí, Curvelo, Governador Valadares, Montes Claros, Oliveira, São Gonçalo do Sapucaí, Teófilo Otoni, Unaí e Viçosa) empregando-se a técnica de soroneutralização em microplacas Dos 826 animais examinados, 30,2% (250/826) foram soropositivos para o EEE e 1,9% (16/826) para o VEE. Não foram detectados animais sororeagentes para o WEE. Conclui-se que tanto o vírus tipo leste como o venezuelano da Encelafalomielite Equina circulam na população equina do Estado de Minas Gerais

Joint Observation of the Galactic Center with MAGIC and CTA-LST-1

MAGIC is a system of two Imaging Atmospheric Cherenkov Telescopes (IACTs), designed to detect very-high-energy gamma rays, and is operating in stereoscopic mode since 2009 at the Observatorio del Roque de Los Muchachos in La Palma, Spain. In 2018, the prototype IACT of the Large-Sized Telescope (LST-1) for the Cherenkov Telescope Array, a next-generation ground-based gamma-ray observatory, was inaugurated at the same site, at a distance of approximately 100 meters from the MAGIC telescopes. Using joint observations between MAGIC and LST-1, we developed a dedicated analysis pipeline and established the threefold telescope system via software, achieving the highest sensitivity in the northern hemisphere. Based on this enhanced performance, MAGIC and LST-1 have been jointly and regularly observing the Galactic Center, a region of paramount importance and complexity for IACTs. In particular, the gamma-ray emission from the dynamical center of the Milky Way is under debate. Although previous measurements suggested that a supermassive black hole Sagittarius A* plays a primary role, its radiation mechanism remains unclear, mainly due to limited angular resolution and sensitivity. The enhanced sensitivity in our novel approach is thus expected to provide new insights into the question. We here present the current status of the data analysis for the Galactic Center joint MAGIC and LST-1 observations

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials