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Contrasting clinical and care features in British and Spanish Acute Geriatric Units (AGUs) 对比英国和西班牙急性老年病房(AGUs)的临床和护理特点
Q3 Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.regg.2025.101635
Gemma Cuesta Castellón , Francisco Javier Gómez Pavón , Joan Espaulella Panicot , Arturo Vilches-Moraga

Purpose

Compare service delivery and clinical outcomes in Acute Geriatric Units (AGUs) between the United Kingdom and Spain.

Methods

Prospective observational study of consecutive patients admitted to AGU in two English and four Spanish hospitals 15th September to 15th November 2022.

Results

650 patients (476 from SP and 174 from the UK) with an average age of 85.4 years in Spanish hospitals and 83.5 years in British hospitals. Similar frailty prevalence (73.1% Spain, 77.7% UK) but differences in medication, pressure ulcers, antipsychotic use, and therapy evaluations. Spain had shorter average stay (8.3 days) and higher mortality (14% vs 7.6% UK). No significant differences in advance care planning.

Conclusions

UK patients were younger, more independent, with fewer health issues. UK hospitals provided more therapy, fewer antipsychotics, and lower mortality despite longer stays. Calls for further research, including cost-effectiveness analysis and long-term studies.
目的比较英国和西班牙急性老年病房(agu)的服务提供和临床结果。方法对2022年9月15日至11月15日在两家英国医院和四家西班牙医院连续住院的AGU患者进行前瞻性观察研究。结果650例患者(西班牙476例,英国174例),西班牙平均年龄85.4岁,英国平均年龄83.5岁。相似的虚弱患病率(西班牙73.1%,英国77.7%),但在用药、压疮、抗精神病药物使用和治疗评估方面存在差异。西班牙的平均住院时间较短(8.3天),死亡率较高(14%比英国的7.6%)。在预先护理计划方面无显著差异。结论suk患者更年轻,更独立,健康问题较少。英国医院提供更多的治疗,更少的抗精神病药物,尽管住院时间更长,但死亡率更低。呼吁进一步研究,包括成本效益分析和长期研究。
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引用次数: 0
Envejecer en el país de acogida [东道国的老龄化]
Q3 Medicine Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1016/j.regg.2024.101555
Oriol Turró Garriga , Glòria Pla Comas , Sandra Devesa Fàbrega , Mariona Gifre Monreal , Roger López Guirao , Pere Plaja Roman , Pilar Monreal Bosch

Objective

To explore the perceptions of elderly people from diverse cultures regarding the factors relevant to aging, identifying similarities and differences, and describing elements that facilitate or hinder this process, with a focus on the impact of care services.

Method

Qualitative study with 48 participants over 50 years old, residing in the Alt Empordà region, Catalonia. Seven focus groups were conducted, including one exploratory multicultural group and six stratified by origin: native, Western Europe, Eastern Europe, Latin America, North Africa, and West Africa.

Results

All groups valued health and the desire to remain in their homes or communities for as long as possible. African groups emphasized the importance of free health services, while the Latin American group valued personalized end-of-life care. The native group pointed out deficiencies in home care and residential care services. Western European participants mentioned language barriers and challenges with digitalization as the only means of accessing information, and Eastern European participants highlighted the need for empowerment and social participation. Additionally, the importance of new family models, restrictions on non-Catholic funeral practices, and the need for community integration were mentioned.

Conclusion

While there are differences in perceptions of aging among the different groups, common factors were identified that either facilitate or hinder this process, regardless of whether there is a migration background.
目的:探讨不同文化背景的老年人对老龄化相关因素的看法:探讨来自不同文化背景的老年人对老龄化相关因素的看法,找出异同点,并描述促进或阻碍老龄化进程的因素,重点关注护理服务的影响:定性研究:48 位居住在加泰罗尼亚 Alt Empordà 地区的 50 岁以上的参与者。进行了七个焦点小组讨论,包括一个探索性多元文化小组和六个按原籍分层的小组:本地、西欧、东欧、拉丁美洲、北非和西非:所有小组都重视健康,并希望尽可能长时间地留在自己的家中或社区。非洲群体强调免费医疗服务的重要性,而拉丁美洲群体则重视个性化的临终关怀。土著群体指出了家庭护理和寄宿护理服务的不足。西欧与会者提到了语言障碍和数字化作为获取信息的唯一手段所带来的挑战,而东欧与会者则强调了赋权和社会参与的必要性。此外,与会者还提到了新家庭模式的重要性、对非天主教葬礼习俗的限制以及社区融合的必要性:虽然不同群体对老龄化的看法存在差异,但无论是否有移民背景,都发现了一些促进或阻碍老龄化进程的共同因素。
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引用次数: 0
Organización y planificación de cuidados. La Atención Intermedia [护理的组织与规划。 中级护理]。
Q3 Medicine Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1016/j.regg.2024.101568
Benito J. Fontecha Gómez
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引用次数: 0
Artritis séptica relacionada con Lactobacillus sakei: a propósito de un caso [与清酒乳杆菌有关的化脓性关节炎:病例报告]。
Q3 Medicine Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1016/j.regg.2024.101562
Viridiana Cabrera Romero , Raquel Ramírez-Martín , Cecilia Daniella Palacios Revilla , María Inmaculada Quiles Melero , Alicia Rico Nieto
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引用次数: 0
Justification and design of the BOCADOS-IC study: Nutritional management in adults followed in Spanish hospitals for heart failure BOCADOS-IC 研究的理由和设计:在西班牙医院接受随访的心力衰竭成人的营养管理。
Q3 Medicine Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1016/j.regg.2024.101566
Alberto Esteban-Fernández , Juan Luis Bonilla-Palomas , Ana Ayesta-López , José Ángel Pérez-Rivera , on behalf of the BOCADOS-IC study researchers

Introduction and objectives

Malnutrition is common in patients with heart failure (HF) and is associated with increased mortality and hospital admissions. There is evidence that nutritional intervention in the inpatient setting improves the prognosis, but evidence in the outpatient setting is limited. This study aims to assess whether a nutritional intervention in outpatients with HF and malnutrition produces a benefit in their morbidity and mortality.

Methods

BOCADOS-IC (Nutritional Assessment in Adults followed in Spanish hospitals for Heart Failure) is a randomised, controlled, masked, prospective, multicentre, clinical trial that includes patients with HF followed on an outpatient basis and who present malnutrition by the screening Mini Nutritional Assessment-Short Form (MNA-SF) scale. Patients are randomised to a control group (standard follow-up) or the intervention group (multifactorial nutritional intervention). A sample size of 266 patients has been estimated, with a follow-up of 6 months. The primary endpoint is time to death from any cause or admission for HF. The analysis is performed on an intention-to-treat basis.

Conclusions

The BOCADOS-IC trial aims to evaluate the impact of nutritional intervention in malnourished patients with HF in the outpatient setting.
导言和目标:营养不良是心力衰竭(HF)患者的常见病,与死亡率和住院率的增加有关。有证据表明,住院病人的营养干预可改善预后,但门诊病人的证据却很有限。本研究旨在评估对患有高血压和营养不良的门诊患者进行营养干预是否能降低其发病率和死亡率:BOCADOS-IC(西班牙医院随访的心力衰竭成人营养评估)是一项随机、对照、蒙面、前瞻性、多中心临床试验,对象包括门诊随访的心力衰竭患者,这些患者通过迷你营养评估-简表(MNA-SF)量表筛查发现营养不良。患者被随机分配到对照组(标准随访)或干预组(多因素营养干预)。估计样本量为 266 名患者,随访时间为 6 个月。主要终点是患者死于任何原因或因高血压入院的时间。分析以意向治疗为基础:BOCADOS-IC试验旨在评估营养干预对门诊高血压营养不良患者的影响。
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引用次数: 0
Update on vaccines against respiratory syncytial virus (RSV): A narrative review 呼吸道合胞病毒(RSV)疫苗的最新进展:述评
Q3 Medicine Pub Date : 2025-03-01 Epub Date: 2025-02-11 DOI: 10.1016/j.regg.2025.101630
José Gutierrez-Rodriguez , Jaime Rodríguez-Salazar , Francisco José Tarazona-Santabalbina
Respiratory syncytial virus (RSV) infections pose a significant challenge to healthcare systems due to their impact on older adults, particularly those who are frail. Implementing an appropriate vaccination policy for these patients could help reduce healthcare resource utilization and costs while enhancing the quality of life for elderly individuals and their families. This narrative review aims to present the latest evidence on RSV and the available vaccines. Of the five vaccines evaluated, three have demonstrated significant efficacy in individuals over 60 years of age. Based on the current evidence, it is recommended that individuals over 75 be offered RSV vaccination, with priority given to those with chronic heart or lung conditions, frailty, or who reside in long-term care facilities.
呼吸道合胞病毒(RSV)感染对老年人,特别是体弱多病者的影响,对卫生保健系统构成重大挑战。对这些患者实施适当的疫苗接种政策可以帮助减少医疗资源的利用和成本,同时提高老年人及其家庭的生活质量。本综述旨在介绍关于呼吸道合胞病毒和现有疫苗的最新证据。在评估的五种疫苗中,有三种已证明对60岁以上的人有显著效力。根据目前的证据,建议为75岁以上的个体提供RSV疫苗接种,优先考虑患有慢性心肺疾病、虚弱或居住在长期护理机构的人。
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引用次数: 0
Síndrome poliglandular autoinmune tipo 2: reporte de un caso [自身免疫性多腺体综合征 2 型:病例报告]。
Q3 Medicine Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1016/j.regg.2024.101541
Myrian González Álvarez , Beatriz Suárez Rodríguez , Patricia Dieguez Pena
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引用次数: 0
Puesta en marcha de una unidad de fragilidad en Osakidetza-Servicio Vasco de Salud [在Osakidetza--巴斯克医疗服务机构设立虚弱科]。
Q3 Medicine Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1016/j.regg.2024.101542
Laura García Ortiz de Uriarte, Nancy Janette Gonzales Montejo, Nerea Lorente del Rio, Aitor Garcia Rodriguez
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引用次数: 0
Efectos de la intergeneracionalidad (relaciones, contactos y programas) en la reducción del edadismo: una revisión sistemática (2013-2023) ["代际关系(关系、联系和计划)对减少老龄歧视的影响:系统回顾(2013-2023 年)"]。
Q3 Medicine Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1016/j.regg.2024.101540
Esther Sánchez Sánchez, Inmaculada Montero García
Discrimination against people on the basis of age, ageism, is one of the most latent forms of discrimination in today's society. In this systematic review we analysed the impact of intergenerationality (relationships, contacts and programmes) on reducing ageism. Eighteen articles were selected following the PRISMA protocol, searching three major databases (Scopus, WoS and ERIC). The results of the studies highlight how intergenerational interventions reduce ageism by fostering understanding and contact between generations, with an emphasis on technology and youth programmes. Shared housing and the duration of interventions are also key factors. As a proposal, an approach to ageism from a socio-educational perspective is proposed that favours the creation of inclusive environments, creating synergies to break the stigma of chronological age.
对人的年龄歧视,即年龄歧视,是当今社会最隐蔽的歧视形式之一。在这篇系统性综述中,我们分析了代际关系(关系、联系和计划)对减少年龄歧视的影响。我们按照 PRISMA 协议,搜索了三个主要数据库(Scopus、WoS 和 ERIC),筛选出 18 篇文章。研究结果强调了代际干预如何通过促进代际之间的理解和接触来减少老龄歧视,重点是技术和青年计划。共用住房和干预措施的持续时间也是关键因素。作为一项建议,提出了一种从社会教育角度解决老龄歧视问题的方法,这种方法有利于创造包容性的环境,产生协同作用,打破按时间计算的年龄所带来的耻辱感。
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引用次数: 0
Beneficios de un programa ambulatorio de ejercicio multicomponente unido a la valoración geriátrica integral para pacientes mayores de la comunidad con fragilidad física 多组分运动门诊方案与对社区中身体虚弱的老年患者进行综合老年病学评估相结合的益处
Q3 Medicine Pub Date : 2025-03-01 Epub Date: 2025-02-12 DOI: 10.1016/j.regg.2025.101625
Ruth Aguado Ortego, Lucía Gómez González, Montserrat Gómez Rubiano, Esperanza Fernández Rodriguez, Juan José Baztán Cortés, Javier Gómez-Pavón

Introduction and objective

The greatest challenge in healthcare is maintaining the functional capacity of the elderly through prevention and reversal programs for situations of physical fragility before crossing the threshold of disability. The aim of this study is to describe the functional evolution of frail and pre-frail elderly people in the community, after a multifactorial intervention based on comprehensive geriatric assessment followed by an outpatient multicomponent exercise program.

Patients and methods

Longitudinal observational study, from May 27, 2021 to January 15, 2023, which included patients with physical frailty (Short Physical Performance Battery [SPPB] < 10) from the Frailty and Fall Prevention Clinic, to carry out an outpatient multicomponent exercise program for 12 weeks, supervised by a multidisciplinary team made up of geriatrics, physiotherapy and specialized nursing. The degree of frailty was assessed using the SPPB (10-12 points: robust, 7-9 points: pre-frail, 4-6 points: frail, 0-3 points: disability). The outcome variables were the pre- and post-intervention difference in SPPB, gait speed, grip strength and quality of life (EuroQoL EQ-5D), compared by Student's T test for paired samples.

Results

A total of 46 patients were included (82.3 years±5.47; 73.91% women). Before the intervention, 39.13% of the patients were categorized as frail and 60.87% as pre-frail. After the intervention, a gain of 3.56 points in the SPPB was achieved (P<.001), being 85.37% of the patients categorized as robust, 14.63% as pre-frail, and none of them as frail. Furthermore, the gait speed improved 0.38m/s (P<.001); the grip strength increased 2.84 kg in women (P<.05) and 3.91 kg in men (P<.05); and the EuroQoL score raised 29.15 points (P<.001).

Conclusion

Multicomponent exercise on an outpatient basis, combined with comprehensive geriatric assessment performed in a geriatric department by a multidisciplinary team, contributes to the reversal of frailty.
医疗保健的最大挑战是在跨越残疾门槛之前,通过预防和逆转方案来维持老年人的功能能力。本研究的目的是描述社区中体弱和体弱前老年人的功能演变,在综合老年评估的基础上进行多因素干预,然后进行门诊多成分锻炼计划。患者和方法:纵向观察研究,从2021年5月27日至2023年1月15日,包括身体虚弱的患者(Short physical Performance Battery [SPPB] <;10)在老年病学、物理治疗和专业护理组成的多学科团队的监督下,从虚弱和预防跌倒诊所,进行为期12周的门诊多成分锻炼计划。使用SPPB评估虚弱程度(10-12分:健壮,7-9分:虚弱前期,4-6分:虚弱,0-3分:残疾)。结果变量为干预前和干预后SPPB、步态速度、握力和生活质量(EuroQoL EQ-5D)的差异,采用配对样本的Student’s T检验比较。结果共纳入46例患者(82.3年±5.47年;73.91%的女性)。干预前,39.13%的患者体弱,60.87%的患者体弱前期。干预后,SPPB评分提高3.56分(P<.001), 85.37%的患者为健全型,14.63%的患者为体弱型,没有患者为体弱型。步态速度提高0.38m/s (P<.001);女性握力增加2.84 kg (p < 0.05),男性握力增加3.91 kg (p < 0.05);EuroQoL评分上升29.15分(P<.001)。结论在门诊基础上进行多组分锻炼,并结合由多学科团队在老年科进行的综合老年评估,有助于逆转虚弱。
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引用次数: 0
期刊
Revista Espanola de Geriatria y Gerontologia
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