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Validation of the Nottingham Hip Fracture Score (NHFS) to predict 30-day mortality following hip fracture in a Mexican population 诺丁汉髋部骨折评分(NHFS)预测墨西哥人群髋部骨折后30天死亡率的验证。
Q3 Medicine Pub Date : 2024-12-24 DOI: 10.1016/j.regg.2024.101610
Mayra Arely Serrano-Lugo , Iván Luján-Hernández , Ma. Elena Ledesma-González , Quitzia Libertad Torres-Salazar

Introduction

Hip fractures in the elderly pose a significant clinical challenge, with high short-term mortality rates. The Nottingham Hip Fracture Score (NHFS) has proven useful in predicting 30-day mortality in European and Asian populations, but its validity in the Mexican population has not been widely assessed.

General objective

To validate the NHFS in predicting 30-day mortality following hip fracture in a Mexican population.

Methodology

An observational, longitudinal, and prospective study was conducted with 143 patients over 60 years of age with hip fractures treated surgically at Hospital General de Zona No. 16 of IMSS. NHFS was applied upon admission, and health status was verified 30 days post-surgery. The area under the ROC curve (AUC), sensitivity, specificity, and model calibration were calculated.

Results

The 30-day mortality rate was 14.7%. The NHFS had an AUC of 0.72, indicating moderate predictive capacity. A cutoff score of 3.5 yielded 85.7% sensitivity and 24% specificity. A higher cutoff of 4.5 improved specificity (45%) but reduced sensitivity (81%).

Conclusions

The NHFS is a useful tool for predicting 30-day mortality in the Mexican population with hip fractures, though its discriminative ability is moderate. A 3.5 cutoff is recommended when prioritizing sensitivity in clinical settings.
老年人髋部骨折具有很高的短期死亡率,是一个重大的临床挑战。诺丁汉髋部骨折评分(NHFS)在预测欧洲和亚洲人群的30天死亡率方面已被证明是有用的,但其在墨西哥人群中的有效性尚未得到广泛评估。总体目的:验证NHFS在预测墨西哥人群髋部骨折后30天死亡率中的作用。方法:对143例60岁以上髋部骨折患者在IMSS第16总医院进行了一项观察性、纵向和前瞻性研究。入院时进行NHFS,术后30天进行健康状况验证。计算ROC曲线下面积(AUC)、灵敏度、特异度和模型校准。结果:30天死亡率为14.7%。NHFS的AUC为0.72,预测能力中等。临界值为3.5,敏感性为85.7%,特异性为24%。4.5的较高临界值提高了特异性(45%),但降低了敏感性(81%)。结论:NHFS是预测墨西哥髋部骨折患者30天死亡率的有用工具,但其判别能力较弱。在临床环境中对敏感性进行优先排序时,推荐3.5的临界值。
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引用次数: 0
Impact of malnutrition on the clinical evolution in a cohort of older patients undergoing emergency surgery for abdominal pathology 营养不良对一组接受腹部病理急诊手术的老年患者临床演变的影响。
Q3 Medicine Pub Date : 2024-12-24 DOI: 10.1016/j.regg.2024.101609
María Villajos-Guijarro , Raquel Ramírez-Martín , Coro Mauleón-Ladrero , Victoria Déniz González , Alexander Forero Torres , Francisca Garcia-Moreno Nisa , Juan Ignacio González-Montalvo

Purpose

Analyse the influence of the nutritional status of older patients undergoing emergency abdominal surgery on postoperative complications, mortality and mean length of hospital stay.

Methods

We performed a longitudinal observational study including patients older than 80 years who underwent emergency surgery by the general surgery service for abdominal pathology, who were followed by the geriatrics service between September 2018 and May 2021. Malnutrition was diagnosed using Global Leadership Initiative on Malnutrition (GLIM) criteria, classifying patients as malnourished and normonourished. A comprehensive geriatric assessment was performed on patients, and postoperative complications, mean length of hospital stay and mortality in-hospital were recorded.

Results

131 patients were included, 84 of them were malnourished and 47 normonourished. Mean age was 86 ± 4.7 years. Malnourished patients had higher incidence of new-onset atrial fibrillation (odds ratio [OR]: 6.1, 95% confidence interval [CI]: 1.33–27.6, p < 0.05), urinary tract infection (OR 4.72, 95% CI: 1.02–21.95, p < 0.05) and bacteraemia (OR 3.51, 95% CI: 1.14–11.1, p < 0.05), compared with normonourished patients. Surgical complications were more frequent in malnourished patients (OR 3.34, 95% CI: 1.5–7.44, p < 0.05). Mean length of hospital stay in malnourished patients was longer (22.6 (±14.1)) compared with normonourished patients (15.3 (±11.9)) (p < 0.005).

Conclusion

Malnutrition in older patients (mean age 86 years old) undergoing emergency abdominal surgery is associated with a poorer clinical course; thus, it must be considered in the evaluation and follow-up of these patients.
目的:分析老年急诊腹部手术患者营养状况对术后并发症、死亡率及平均住院时间的影响。方法:我们进行了一项纵向观察研究,纳入了在2018年9月至2021年5月期间接受腹部病理普通外科急诊手术的80岁以上患者,并随访了老年科服务。根据营养不良全球领导倡议(GLIM)的标准诊断营养不良,将患者分为营养不良和营养不良。对患者进行全面的老年评估,并记录术后并发症、平均住院时间和住院死亡率。结果:纳入131例患者,其中营养不良84例,营养不良47例。平均年龄86±4.7岁。营养不良患者的新发房颤发生率较高(优势比[OR]: 6.1, 95%可信区间[CI]: 1.33-27.6)。结论:接受急诊腹部手术的老年患者(平均年龄86岁)营养不良与较差的临床病程相关;因此,在这些患者的评估和随访中必须考虑到这一点。
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引用次数: 0
Íleo biliar. ¿Cirugía o tratamiento conservador en paciente octogenario vulnerable? 胆石性肠梗阻。易受伤害的八旬老人手术还是保守治疗?]
Q3 Medicine Pub Date : 2024-12-24 DOI: 10.1016/j.regg.2024.101614
Paula Fernández García , María Teresa Madrid López , Alexander Forero Torres , Coro Mauleón-Ladrero , Raquel Ramírez Martín
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引用次数: 0
Beneficio del manejo en la Unidad de Ortogeriatría en una paciente centenaria con fractura pertrocantérea bilateral simultánea de fémur proximal. A propósito de un caso 矫形科治疗一例百岁高龄双侧股骨近端股骨粗隆后骨折的疗效分析。报道一个案件]。
Q3 Medicine Pub Date : 2024-12-24 DOI: 10.1016/j.regg.2024.101613
Nieves Fernández Letamendi , Miguel Sanz Sainz , Alberto Aso Vizán , Javier Domingo Cebollada
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引用次数: 0
Regenerative characteristics of the immortal jellyfish, Turritopsis dohrnii, and their potential implications for human aging 不死水母杜氏灯塔水母的再生特性及其对人类衰老的潜在影响。
Q3 Medicine Pub Date : 2024-12-23 DOI: 10.1016/j.regg.2024.101607
Valentina Velasco-Muñoz , Mateo Uribe-Gaviria , Santiago Andrés Suárez-Gómez , Antonio Villamizar-Romero , Andrés Ricaurte-Fajardo , Isabel Cristina Vásquez-Vélez , Carlos A. Cano-Gutiérrez
The jellyfish Turritopsis dohrnii (T. Nutricala) is a cnidarian of the Oceaniidae family that lives in the Mediterranean Sea. It is known as the immortal jellyfish since, through a process of cell development called transdifferentiation, it manages to return to a polyp state. The role of regeneration processes and their impact on aging have been studied in recent years for their potential applications in the development of more efficient pharmacology to address disorders related to aging. Reviewing the terms related to transdifferentiation in jellyfish and understanding the underlying mechanisms can help comprehend diverse processes such as aging, regeneration, and the molecular bases of diseases like cancer. This paper's purpose is to provide a description of the regenerative characteristics of the jellyfish T. dohrnii, investigate how its regenerative processes allow it to rejuvenate, and determine if these tissue restoration processes are also found in humans.
多氏灯塔水母(T. Nutricala)是生活在地中海的海洋生物科的一种刺胞动物。它之所以被称为不朽的水母,是因为它通过一种被称为转分化的细胞发育过程,成功地回到了水螅体状态。近年来,再生过程的作用及其对衰老的影响已被研究,以开发更有效的药理学来解决与衰老相关的疾病。回顾与水母转分化相关的术语,了解其潜在的机制,有助于理解衰老、再生等多种过程,以及癌症等疾病的分子基础。本文的目的是提供水母T. dohrnii再生特性的描述,研究其再生过程如何使其恢复活力,并确定这些组织恢复过程是否也存在于人类中。
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引用次数: 0
Manicura gualda, lo que esconden las uñas 黄色的指甲:指甲隐藏了什么。
Q3 Medicine Pub Date : 2024-12-23 DOI: 10.1016/j.regg.2024.101615
Sergio García-González, Sara Pilar Martínez-Cisneros, José González-Fernández, Victoria Lezcano-Biosca
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引用次数: 0
El envejecimiento en poblaciones indígenas de la Amazonía peruana: una agenda pendiente de investigación [秘鲁亚马逊地区土著人口老龄化:一项未决的研究议程]。
Q3 Medicine Pub Date : 2024-12-17 DOI: 10.1016/j.regg.2024.101585
Dafne Lastra Landa , Oscar Flores-Flores , José F. Parodi
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引用次数: 0
Neumovejiga y Neumaturia secundarios a Infecciones Enfisematosas del Tracto Urinario, signos poco comunes [继发于肺气肿性尿路感染的肺膀胱和肺尿症,罕见体征]。
Q3 Medicine Pub Date : 2024-12-17 DOI: 10.1016/j.regg.2024.101578
José María Ortega Morente, Leopoldo Bárcena Goitiandia, Salvador Cuevas Durón, José Luter Llanque Callata, Juliana Zuluaga Gómez, Johanna Pamela Vázquez Grande
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引用次数: 0
Efficacy and safety of osteoporosis treatment in older adults. Approach for the secondary prevention of fractures in older populations. A proposal by SEFRAOS 老年人骨质疏松症治疗的有效性和安全性。老年人骨折的二级预防方法。SEFRAOS的提案。
Q3 Medicine Pub Date : 2024-12-17 DOI: 10.1016/j.regg.2024.101582
Leonor Cuadra-Llopart , Teresa Pareja Sierra , Pilar Sáez-López , Iñigo Etxebarria-Foronda , José R. Caeiro Rey
Osteoporosis is a systemic skeletal disease characterized by low bone mass and deterioration of the microarchitecture, resulting in bone fragility and risk of fractures.
As the life expectancy of the population increases, fragility fractures are expected to become more common. Indeed, the incidence rate for major fracture (hip, vertebra, pelvis, etc.) is highest among the population of adults aged 80 and over. Despite this, in Spain, three out of four patients who have experienced a fragility fracture do not receive drug treatment for the secondary prevention of new fractures. Therefore, it is crucial to raise awareness among healthcare professionals of the need to assess imminent fracture risk in older patients who have already sustained a fragility fracture and to initiate a rapid, appropriate, effective, and safe secondary fracture prevention strategy.
The various clinical guidelines on secondary prevention of fragility fractures published to date do not reflect the heterogeneity of older adults.
The aim of this paper is to provide a brief description of the available scientific evidence on the efficacy and safety of pharmacological treatments for osteoporosis in older adults and to submit a position paper proposed by the Spanish Society of Osteoporotic Fractures (SEFRAOS), which places greater emphasis on the specifics of the approach to and treatment of older adults who have sustained a fragility fracture.
骨质疏松症是一种全身性骨骼疾病,其特征是骨量低和微结构恶化,导致骨脆性和骨折风险。随着人口预期寿命的增加,脆性骨折预计将变得更加普遍。事实上,主要骨折(髋部、椎体、骨盆等)的发病率在80岁及以上的人群中最高。尽管如此,在西班牙,四分之三的易碎性骨折患者没有接受药物治疗以预防新发骨折。因此,提高医疗保健专业人员对已经发生脆性骨折的老年患者评估即将发生骨折风险的必要性的认识,并启动快速、适当、有效和安全的二级骨折预防策略是至关重要的。迄今为止发表的关于脆性骨折二级预防的各种临床指南并没有反映老年人的异质性。本文的目的是简要描述现有的关于老年人骨质疏松症药物治疗的有效性和安全性的科学证据,并提交一份由西班牙骨质疏松性骨折学会(SEFRAOS)提出的立场文件,该文件更加强调老年人脆性骨折的具体方法和治疗。
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引用次数: 0
Colitis colágena en una paciente octogenaria: a propósito de un caso 老年胶原性结肠炎1例。
Q3 Medicine Pub Date : 2024-12-17 DOI: 10.1016/j.regg.2024.101581
Constanza Sepúlveda Gallardo , Carlota Toapanta Gaibor , Emilio Sacanella Meseguer , Marta Arroyo-Huidobro
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引用次数: 0
期刊
Revista Espanola de Geriatria y Gerontologia
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