Prevalence and clinical correlates of sarcopenia in institutionalized older people: Cross-sectional study of a nursing home population

Background & aims. Sarcopenia is a common condition among institutionalized older people which leads to increased risk of adverse outcomes such as disability and death. We investigated the prevalence and clinical correlates of sarcopenia in older institutionalized adults in Italy, while also evaluating the interchangeability and adequacy of two definitions of sarcopenia (EWGSOP and FNIH) for this geriatric setting. Methods. Cross-sectional analysis of 97 participants enrolled in a nursing home facility in Italy. Since 97% of the study subjects resulted either unable to walk or “slow walkers”, we assessed sarcopenia presence ignoring the walking speed criterion: sarcopenia was assessed as low appendicular skeletal mass index plus low grip strength (EWGSOP criteria) and as weakness plus low lean mass (FNIH criteria). Skeletal muscle mass was estimated using bioimpendance analysis. Results. In this population of 97 institutionalized older people (age 83.2 ± 9.4 years, women 73.2%), according to both EWGSOP and FNIH criteria 13 participants (13.4%) were identified as affected by sarcopenia; however, only 5 subjects were identified as sarcopenic according to both definitions simultaneously. The prevalence of sarcopenia was directly correlated with male sex and comorbidity level, while being inversely correlated with Body Mass Index. Conclusions. According to EWGSOP and FNIH criteria, prevalence of sarcopenia is significant among institutionalized older people, and it’s strongly related to male sex, BMI and comorbidity level. EWGSOP and FNIH criteria identified as sarcopenic different individuals and therefore cannot be used interchangeably. Assessment of walking speed might be unfeasible in institutionalized older subjects

Geotecnologias para avaliação e análise da dinâmica espaço temporal do parque cafeeiro da região de Três Pontas - MG.

A região de Três Pontas é uma das regiões cafeeiras mais importantes do Brasil e do mundo. O município é considerado o maior produtor mundial de café. Por esse motivo, conhecer a extensão e a localização desse parque cafeeiro torna-se de extrema importância. O objetivo desse trabalho foi analisar a evolução deste parque cafeeiro no tempo e no espaço, por meio de geotecnologias. No trabalho foram utilizadas imagens TM/Landsat do ano de 2000 e do ano de 2010. Foram confeccionados os mapas de uso da terra para o ano de 2000 e para o ano de 2010. Por meio de ferramentas de análise espacial do sistema de informação geográfica SPRING, conclui-se que, durante esse período, o parque cresceu 7%. As áreas de café em produção aumentaram 11%, o que provavelmente elevou a produtividade da região. Não foram encontrados padrões de mudança no crescimento do parque

Strategies and Tools for Supporting the Appropriateness of Drug Use in Older People

Through this structured review of the published literature, we aimed to provide an up-to-date description of strategies (human-related) and tools (mainly from the digital field) facilitating the appropriateness of drug use in older adults. The evidence of each strategy and tool’s effectiveness and sustainability largely derives from local and heterogeneous experiences, with contrasting results. As a general framework, three main steps should be considered in implementing measures to improve appropriateness: prescription, acceptance by the patient, and continuous monitoring of adherence and risk-benefit profile. Each step needs efforts from specific actors (physicians, patients, caregivers, healthcare professionals) and dedicated supporting tools. Moreover, how to support the appropriateness also strictly depends on the particular setting of care (hospital, ambulatory or primary care, nursing home, long-term care) and available economic resources. Therefore, it is urgent assigning to each approach proposed in the literature the following characteristics: level of effectiveness, strength of evidence, setting of implementation, needed resources, and issues for its sustainability

Determinantal Characterization of Canonical Curves and Combinatorial Theta Identities

We characterize genus g canonical curves by the vanishing of combinatorial products of g+1 determinants of Brill-Noether matrices. This also implies the characterization of canonical curves in terms of (g-2)(g-3)/2 theta identities. A remarkable mechanism, based on a basis of H^0(K_C) expressed in terms of Szego kernels, reduces such identities to a simple rank condition for matrices whose entries are logarithmic derivatives of theta functions. Such a basis, together with the Fay trisecant identity, also leads to the solution of the question of expressing the determinant of Brill-Noether matrices in terms of theta functions, without using the problematic Klein-Fay section sigma.Comment: 35 pages. New results, presentation improved, clarifications added. Accepted for publication in Math. An

Habermas e a Sociologia Médica: saúde, Estado e direito

Opresente estudo busca examinar as principais contribuições do pensamento de Habermas à sociologia médica ou sociologia da saúde e doença. Embora Habermas tenha se devotado em várias oportunidades a temas da filosofia da medicina ou bioética, apesar de ser considerado uma figura de primeira grandeza dentro do campo da sociologia, não tem se manifestado acerca da sociologia médica. Contudo, alguns estudos recentes têm buscado aplicar as construções teóricas de Habermas a esse campo e tentado mostrar seu potencial explicativo e crítico

Avaliação de classificadores automáticos no mapeamento de áreas cafeeiras da Região de Guaxupé, Minas Gerais.

O mapeamento da ocupação da terra constitui uma das mais importantes atividades de geração de dados para gerenciamento e monitoramento de ambientes agrícolas. Pretendeu-se neste trabalho avaliar a exatidão da interpretação visual de uma imagem SPOT 5 no mapeamento do café na região de Guaxupé, tendo como referência dados obtidos em campo, bem como comparar o desempenho de técnicas de mapeamento automático da mesma área em comparação com a interpretação visual,visando a avaliação da viabilidade de aplicação destas técnicas para agilizar o mapeamento do parque cafeeiro na região.Foram trabalhadas imagens SPOT 5 com resolução espacial de 10 metros e de 2,5 metros. A cena foi submetida ao processamento por diferentes métodos de classificação automática para a imagem com resolução de 10 metros e por interpretação visual para a imagem com resolução de 2,5 metros. Dados obtidos em campo foram tomados como referência para obtenção de índices de exatidão do mapeamento. Foram estratificadas as classes café, mata e outros usos, sendo esta última oriunda do agrupamento dos demais tipos de vegetação como culturas anuais, pastagens, solo exposto, áreas urbanas, etc. Os índices utilizados foram calculados de maneira a permitir a avaliação da exatidão global da classificação e também individualmente para a classe café

Ocupação da cafeicultura em relação às classes de solos da região de Machado-MG.

O objetivo desse trabalho foi realizar uma análise espacial do parque cafeeiro da região de Machado no ano de 2009 e sua relação com o mapa de solos da região, utilizando geotecnologias

Short- and long-term reproductive effects of prenatal and lactational growth restriction caused by maternal diabetes in male rats

Background: A suboptimal intrauterine environment may have a detrimental effect on gonadal development and thereby increases the risk for reproductive disorders and infertility in adult life. Here, we used uncontrolled maternal diabetes as a model to provoke pre- and perinatal growth restriction and evaluate the sexual development of rat male offspring.Methods: Maternal diabetes was induced in the dams through administration of a single i.v. dose of 40 mg/kg streptozotocin, 7 days before mating. Female rats presenting glycemic levels above 200 mg/dL after the induction were selected for the experiment. The male offspring was analyzed at different phases of sexual development, i.e., peripuberty, postpuberty and adulthood.Results: Body weight and blood glucose levels of pups, on the third postnatal day, were lower in the offspring of diabetic dams compared to controls. Maternal diabetes also provoked delayed testicular descent and preputial separation. In the offspring of diabetic dams the weight of reproductive organs at 40, 60 and 90 days-old was lower, as well as sperm reserves and sperm transit time through the epididymis. However the plasma testosterone levels were not different among experimental groups.Conclusions: It is difficult to isolate the effects directly from diabetes and those from IUGR. Although the exposure to hyperglycemic environment during prenatal life and lactation delayed the onset of puberty in male rats, the IUGR, in the studied model, did not influenced the structural organization of the male gonads of the offspring at any point during sexual development. However the decrease in sperm reserves in epididymal cauda and the acceleration in sperm transit time in this portion of epididymis may lead to an impairment of sperm quality and fertility potential in these animals. Additional studies are needed in attempt to investigate the fertility of animals with intrauterine growth restriction by maternal diabetes and possible multigenerational effects