Foot Anatomical Structural Variations Increase the Risk of Falls in Older Adults

Falls are common among older adults. The purpose of this study was to demonstrate the relationship between foot anatomical structural variations and balance in older adults and quantify foot posture and stabilometry as predictors of fall risk. This case-control study of older adults classified cases or controls according to falls in the last five years. All subjects were healthy women and men > 65 years old (n = 164), who were divided into two groups: 83 individuals who had suffered from a fall in the previous five years (case group) and 81 individuals who had not suffered from a fall (control group). Hallux abductus valgus (HAV) and tailor’s bunion are stability-determining factors. Women have a higher probability of falling. HAV (p = 0.042) and tailor’s bunion (p = 0.069) also increased the fall probability. Morphological foot variations (HAV and tailor’s bunion) linked to gender and age increase fall risk among older adults. In women fallers with HAV, there was a higher possibility of falling (63.9%). According to age, in older adults with HAV, the percentage of falls is high (62%). Fallers with tailor’s bunion (60.7%) are more numerous than fallers without this pathology. Older adults with HAV and tailor´s bunion had twice the probability of suffering a fall than older people without foot anatomical structural. Foot morphology is decisive in falling risk

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Valores baropodométricos y estabilométricos para la detección del riesgo de caídas en población adulta mayor

Tesis inédita presentada en la Universidad Europea de Madrid. Escuela de Doctorado e Investigación. Programa de Doctorado en Biomedicina y Ciencias de la SaludINTRODUCCIÓN Las caídas son la segunda causa de muerte no accidental. Además, cada vez son Tás frecuentes la población adulta mayor. En la última década, la población anciana ha ido aumentando progresivamente debido a una mayor esperanza de vida. Las caidas son un Importante indicador de fragilidad en genatria y; son causa de fracturas, incapacidad e incluso la muerte. Las alteraciones estructurales de los la postura, el género, la edad, el índice de masa corporal (IMC) y la actividad fisica han sido prcpuestos como factores predisponentes de las caidas. OBJETIVO Estudiar los valores baropodométricos y estabilométricos en la población adulta según el riesgo de caídas. MATERIALES Y MÉTODOS Estudio descriptivo observacional de casos y controles para la comparación de los factores de ries20 que influyen en la estabilidad en los pacientes adultos mayores- Un total de 164 sujetos años, y el 60,74% muQ%es) son personas mayores de 65 años sin antecedentes de alteraciones cognitivas ni qui:ügicas previas que afecten a la bipedestación o compresión del estudio- Fueron divididos en dos grupos según sus antecedentes de caídas de los últimos cinco años: grupo casos (N=S3) y grupo controles (N=81). Se recogieron las variables antropométricas de cada paciente, las alteraciones estructurales del pie, la postura del pie, el nivel de actividad y el análisis baropodométrico y estabilométrico. Se realiza un análisis de normalidad de las variables cuantitativas del estudio mediante la prueba de Shapiro-Wilk, siendo p mayor o igual que 0,05. RESULTADOS La altura de los pacientes se asoció inversamente al riesgo de sufrrr caídas, siendo la mediana de los sujetos que sufieron caídas de 162 cm (OR=0,97, p=0,033). Las consecuencias más frecuentes de las caídas frieron las lesiones leves siendo un 65.()6%. Un 87.200/0 de la muestra sufrió alguna patología estructural de los pies, siendo la más frecuente los dedos en garra (73, 17%, p=0,256), seguido de Tlallux Abductus Valgus (HAV) (59,15%, p=0,030). Los pacientes que sufrieron caídas mostraron más HAV (57,73%, OR=2,01, p=0,030) que los controles (42.27%), predominando la presencia de HAV en el género femenino (72,73%, OR=2,96, p=0,019). En los los sujetos mayores de 70 años con HAV el porcentaje de caídas file del 62% (OR=4,07, p=0,006) respecto a los sujetos de la misma edad con HAV que no han sufrido caídas. El 53,33% (OR=I ,50, p=0,256) de los pacientes con dedos en garra han sufrido caídas, predominando esta alteración en las mujeres (74,75%, p=0,330). Respecto a la postura del pie, las caídas en los sujetos con el pie pronado es mayor (63,04%) respecto al porcentaje de caídas en los pies muy pronados (31,25%, OR=3,66, p=0,007). Los pacientes que realizan actividad fisica a menudo (5 a 7 días por semana) (3(),43%, p=(),040), tienen un 62% menos de riesgo de sufrir una caída que los pacientes que no realizan actividad fisica (53,90%). El modelo de regresión logística para valorar la influencia de las diferentes variables analizadas demostró que, el aumento de IMC, la presencia de HAv la presencia de dedos en garra, el género femenino y la ausencia de actividad fisica aumenta la probabilidad de sufrir caídas. CONCLUSIONES Las principales consecuencias de las caídas en adultos mayores son los hematomas y las contusiones. La mayor edad del paciente, el género femenino, un mayor IMC, la presencia de HAV y de dedos en garra, la postura del pie y un menor nivel de actividad física son factores influyentes en la probabilidad depara sufrir caídas.INTRODUCTION Falls are the second leading cause of non-accidental death. In addition, they are becoming more frequent in the older adult population. In the last decade, the elderly population has been increasing progressively due to a longer life expectancy. Falls are an important Indicator of frailty in geriatrics and; They are the cause of fractures, disability and even death. Structural alterations of the feet, posture, gender, age, body mass index (BMI) and physical activity have been proposed as predisposing factors for falls. TARGET To study the baropodometric and stabilometric values in the elderly population according to the risk of falls. MATERIALS AND METHODS Observational descriptive study of cases and controls for the comparison of risk factors that influence stability in elderly patients. A total of 164 subjects (70,89±5,27 years, 60,74% women) are people over 65 years of age with no history of visual, cognitive or previous surgical alterations that affect standing or compression or the study. They were divided into two groups according to their history of falls in the last five years: case group (N=83) and control group (N=81). The anthropometric variables of each patient, the structural alterations of the foot, the foot posture, the level of activity and the baropodometric and stabilometric analysis were collected. An analysis of normality of the quantitative variables of the study is performed using the Shapiro-Wilk test, with p being greater than or equal to 0.05. RESULTS The height of the patients was inversely associated with subjects who suffered falls being 162 The frequent consequences were minor injuries, being 65.06%. 8720% of the sufTered some structural pathology feet the most frequent being claw toes (73,17%, p=0,256), followed by I-Iallux Abductus VaIgus (HAY) (59, 15%, p=0,03()). The patients who suffered falls showed Inore I-IAV (57, 73%, than the controls (42,27%), with the presence of HAV predominating in the female gender (72,730/ OR-2,96, p In subjects older than 70 years with HAV, the percentage of falls was (OR=4,07, p=0,006) compared to subjects of the same age with HAV who had not suffered falls. 53 330/ (OR=l,50, p=0,256) of patients with claw toes have suffered falls, this alteration Predominating in women (74, 75%, p=0,330). Regarding the foot posture, the falls in the subjects with the pronated foot is greater (63,04%) compared to the percentage of falls in the very pronated feet (31,25%). Patients who perform physical activity often (5 to 7 days per week) (30, 3%, p=0,040), have a 62% lower risk of falling than patients who do not perform physical activity (53.,90%). The logistic regression model to assess the influence of the different variables analyzed showed that an increase in BMI, the presence ofHAV, the presence of claw toes, female gender and the absence of physical activity increase the probability of falling. CONCLUSIONS The main consequences of falls in older adults are bruises and contusions. The patient's older age, female gender, higher BMI, the presence of HAV and claw toes, foot posture and a lower level of physical activity are influential factors in the probability of suffering falls.No data 2022UE

Foot Anatomical Structural Variations Increase the Risk of Falls in Older Adults

Falls are common among older adults. The purpose of this study was to demonstrate the relationship between foot anatomical structural variations and balance in older adults and quantify foot posture and stabilometry as predictors of fall risk. This case-control study of older adults classified cases or controls according to falls in the last five years. All subjects were healthy women and men &gt; 65 years old (n = 164), who were divided into two groups: 83 individuals who had suffered from a fall in the previous five years (case group) and 81 individuals who had not suffered from a fall (control group). Hallux abductus valgus (HAV) and tailor&rsquo;s bunion are stability-determining factors. Women have a higher probability of falling. HAV (p = 0.042) and tailor&rsquo;s bunion (p = 0.069) also increased the fall probability. Morphological foot variations (HAV and tailor&rsquo;s bunion) linked to gender and age increase fall risk among older adults. In women fallers with HAV, there was a higher possibility of falling (63.9%). According to age, in older adults with HAV, the percentage of falls is high (62%). Fallers with tailor&rsquo;s bunion (60.7%) are more numerous than fallers without this pathology. Older adults with HAV and tailor&acute;s bunion had twice the probability of suffering a fall than older people without foot anatomical structural. Foot morphology is decisive in falling risk