Accuracy of the Timed Up and Go test for predicting sarcopenia in elderly hospitalized patients

OBJECTIVES: The ability of the Timed Up and Go test to predict sarcopenia has not been evaluated previously. The objective of this study was to evaluate the accuracy of the Timed Up and Go test for predicting sarcopenia in elderly hospitalized patients. METHODS: This cross-sectional study analyzed 68 elderly patients (≥60 years of age) in a private hospital in the city of Salvador-BA, Brazil, between the 1st and 5th day of hospitalization. The predictive variable was the Timed Up and Go test score, and the outcome of interest was the presence of sarcopenia (reduced muscle mass associated with a reduction in handgrip strength and/or weak physical performance in a 6-m gait-speed test). After the descriptive data analyses, the sensitivity, specificity and accuracy of a test using the predictive variable to predict the presence of sarcopenia were calculated. RESULTS: In total, 68 elderly individuals, with a mean age 70.4±7.7 years, were evaluated. The subjects had a Charlson Comorbidity Index score of 5.35±1.97. Most (64.7%) of the subjects had a clinical admission profile; the main reasons for hospitalization were cardiovascular disorders (22.1%), pneumonia (19.1%) and abdominal disorders (10.2%). The frequency of sarcopenia in the sample was 22.1%, and the mean length of time spent performing the Timed Up and Go test was 10.02±5.38 s. A time longer than or equal to a cutoff of 10.85 s on the Timed Up and Go test predicted sarcopenia with a sensitivity of 67% and a specificity of 88.7%. The accuracy of this cutoff for the Timed Up and Go test was good (0.80; IC=0.66-0.94; p=0.002). CONCLUSION: The Timed Up and Go test was shown to be a predictor of sarcopenia in elderly hospitalized patients

PREVENÇÃO DE RISCOS E AGRAVOS À SAÚDE DO HOMEM: CONTRIBUIÇÕES PARA A PRÁTICA ASSISTENCIAL NO NÍVEL TÉCNICO EM ENFERMAGEM

Os objetivos deste estudo são determinar o nível de conhecimento da comunidade do Centro Federal de Educação Tecnológica Celso Suckow da Fonseca (CEFET/RJ) sobre a Saúde do Homem. Estudo transversal, quantitativo em que foram entrevistados 103 indivíduos de ambos os sexos, aos quais foi aplicado um questionário formulado pela equipe do projeto, com questões abertas e fechadas Foram selecionados 88 questionários, 14 foram descartados por terem sido preenchidos incorretamente e 01 entrevistado recusou-se responder e participar da pesquisa, sendo respeitados os preceitos da Resolução 466/2012. Dentre os participantes do estudo predominância feminina (55,6% - n= 49), a faixa etária de 15 a 59 anos, a média etária ficou em 20,2 e a mediana 24 anos, 69% tinham conhecimento de que morrem mais homens que mulheres em acidentes/violência, esse mesmo percentual desconheciam a existência da PNAISH e 72% (n= 63) afirmaram que nunca tinha ouvido um homem falar que iria fazer exames preventivos para a sua saúde e que possuem conhecimento insuficiente sobre à saúde do homem. Foi evidenciado baixo nível de conhecimento sobre a Política Nacional de Atenção Integral à saúde do homem (PNAISH) na comunidade e os discentes extensionistas do Curso Técnico em Enfermagem vivenciaram situações presentes em nosso cotidiano acerca da prevenção de riscos e agravos à saúde da população, sobretudo à população masculina

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Structural and thermal performance of low-cost house buildings in Maceió, Northeastern Brazil : analysis of construction walls made of blocks using recycled aggregates

Paper presented at the XXXIII IAHS World Congress on Housing, 27-30 September 2005,"Transforming Housing Environments through Design", University of Pretoria.An important issue in Brazil nowadays is the lack of appropriate low-cost housing however, construction and demolition residues present appropriated physical and chemical properties in case of employment as construction material. With regard to the quality and performance of dwellings, this paper shows the results of structural and thermal performance evaluation of a building prototype of approximately 40m2 made of concrete blocks which were produced with recycled construction and demolition aggregates, according to government exigencies in Maceió, a tropical humid city in Northeastern Brazil. The blocks were developed in the Federal University of Alagoas Technological Research Center and made in a precast concrete factory called INDARC and their strucktural performance was analyzed after experimental tests. The bedding mortar was produced with recycled aggregates and its influence in the masonry was analyzed. The thermal performance monitoring period was summer time in Maceió. Outdoor and indoor measurements were carried out with HOBO data-loggers and superficial temperatures with infrared thermometers. Final results were compared to outdoor conditions, with regard to daily temperature swings and comfort levels. Some improvements were suggested regarding the thermal performance. Experiments indicate the application viability of that construction system in order to obtain improvement of low-cost housing politics, emphasizing the importance of aspects to be considered in building design, such as user’s well fare and comfort and energy savings. This research can also empower the production, in large scale, of low-cost and sustainable building components.Authors of papers in the proceedings and CD-ROM ceded copyright to the IAHS and UP. Authors furthermore declare that papers are their original work, not previously published and take responsibility for copyrighted excerpts from other works, included in their papers with due acknowledgment in the written manuscript. Furthermore, that papers describe genuine research or review work, contain no defamatory or unlawful statements and do not infringe the rights of others. The IAHS and UP may assign any or all of its rights and obligations under this agreement

Viability of gait speed test in hospitalized elderly patients

ABSTRACT Objective: The gait speed test (GST) is a physical test that can predict falls and aid in the diagnosis of sarcopenia in the elderly. However, to our knowledge, there have been no studies evaluating its reproducibility in hospitalized elderly patients. The objective of this study was to evaluate the safety and reproducibility of the six-meter GST (6GST) in hospitalized elderly patients. Methods: This repeated measures study involved hospitalized elderly patients (≥ 60 years of age) who underwent the 6GST by the fifth day of hospitalization, were able to walk without assistance, and presented no signs of dyspnea or pain that would prevent them from performing the test. The 6GST was performed three times in sequence, with a rest period between each test, in a level corridor. Gait speed was measured in meters/second. Reproducibility was assessed by comparing the means, intraclass correlation coefficients (ICCs) and Bland-Altman plots. Results: We evaluated 110 elderly patients in a total of 330 tests. All participants completed all of the tests. The comparisons between the speeds obtained during the three tests showed high ICCs and a low mean bias (Bland-Altman plots). The correlation and accuracy were greatest when the mean maximum speed was compared with that obtained in the third test (1.26 ± 0.44 m/s vs. 1.22 ± 0.44 m/s; ICC = 0.99; p = 0.001; mean bias = 0.04; and limits of agreement = −0.27 to 0.15). Conclusions: The 6GST was proven to be safe and to have good reproducibility in this sample of hospitalized elderly patients. The third measurement seems to correspond to the maximum speed, since the first two measurements underestimated the actual performance

High-sugar diet intake, physical activity, and gut microbiota crosstalk: Implications for obesity in rats

This study aims to evaluate the effect of long-term high-sugar diet (HSD) intake and regular physical activity on gut microbiota as well as its health impact. Weaned male Wistar rats were fed with standard chow diet (SSD) or HSD ad libitum and subjected or not to regular swimming training with a workload (2% of body weight) for 15 weeks. Feces samples were used on microbiome analysis using 16S rRNA amplicon sequencing. HSD increased body mass, adipose cushions, and the serum levels of triglycerides and VLDL, also changed the bacteria taxons associated with metabolic disorders (increase taxons belonging to Proteobacteria phylum and decrease Pediococcus genus); the swim training reverted these changes. SSD intake increased the abundance of bacteria associated with metabolization of dietary fiber. Training in association with SSD consumption beneficially modulated the microbiota, increasing the Bacteroidetes, Bacteroidaceae, Porphyromonadaceae, Parabacteroides, and Lactobacillaceae, and decreasing the Firmicute/Bacteroidetes ratio; training was not able to maintain this profile in animals SHD-fed. Physical training modulates the gut microbiota reversing the obesogenic response caused by SHD. However, training itself is not efficient for up-regulating the probiotic bacteria in comparison to its association with a balanced diet

The Omicron Lineages BA.1 and BA.2 (<i>Betacoronavirus</i> SARS-CoV-2) Have Repeatedly Entered Brazil through a Single Dispersal Hub

Brazil currently ranks second in absolute deaths by COVID-19, even though most of its population has completed the vaccination protocol. With the introduction of Omicron in late 2021, the number of COVID-19 cases soared once again in the country. We investigated in this work how lineages BA.1 and BA.2 entered and spread in the country by sequencing 2173 new SARS-CoV-2 genomes collected between October 2021 and April 2022 and analyzing them in addition to more than 18,000 publicly available sequences with phylodynamic methods. We registered that Omicron was present in Brazil as early as 16 November 2021 and by January 2022 was already more than 99% of samples. More importantly, we detected that Omicron has been mostly imported through the state of São Paulo, which in turn dispersed the lineages to other states and regions of Brazil. This knowledge can be used to implement more efficient non-pharmaceutical interventions against the introduction of new SARS-CoV variants focused on surveillance of airports and ground transportation