To discern if physical function test are better mortality predictors than muscle mass in elderly hospitalized patients, we analyzed the prognostic value of muscle mass malnutrition and compared it with physical muscle function tests, including the six-minute walking test (6MWT) and hand grip strength. We included the ankle brachial index (ABI) to assess arterial disease, related to muscle atrophy due to hypoperfusion. We also analyzed the relationship of ABI with malnutrition, physical function tests and survival. We studied 310 hospitalized patients older than 60 years. To assess nutritional status, we determined BMI, triceps skinfold and mid-arm muscle area; we performed a subjective nutritional assessment; and evaluated the degree of inflammatory stress. We assessed physical function by hand grip strength and 6MWT. We evaluated arterial disease by ABI. Forty-one patients died during hospitalization; 269 were discharged and followed for a mean 808 days, reaching a mortality of 49%. Muscle malnutrition was frequent and was related to mortality, but the best predictors were physical function tests: inability to perform the 6MWT and low handgrip strength. Function tests were closely related to each other and correlated with nutritional data. Reduced ABI was related to impaired nutritional status, physical function tests and mortality.
Prevalent fractures are common among heavy alcoholics. Their presence is related more closely to nutritional status, lean mass and vitamin D levels than to BMD. Lean mass is more reduced, nutritional status is more impaired and there is a trend to more altered eating habits among patients with rib fractures, whereas multiple fractures depend more heavily on advanced liver disease.
Aortic stenosis is the most common valvulopathy in the Western world. Its prevalence has increased significantly in recent years due to population aging; hence, up to 8% of westerners above the age of 84 now have severe aortic stenosis (Lindroos et al., 1993). This causes increased morbidity and mortality and therein lies the importance of adequate diagnosis and stratification of the degree of severity which allows planning the best therapeutic option in each case. Long understood as a passive age-related degenerative process, it is now considered a rather more complex entity involving mechanisms and factors similar to those of atherosclerosis (Stewart et al., 1997). In this review, we summarize the pathophysiological mechanisms underlying the onset and progression of the disease and analyze the current role of cardiac imaging techniques for diagnosis.
Interatrial block (IAB) is due to disruption in the Bachmann region (BR). According to whether interatrial electrical conduction is delayed or completely blocked through the BR, it can be classified as IAB of first, second or third degree. On the surface electrocardiogram, a P wave ≥ 120 ms (partial IAB) is observed or associated to the prolongation of the P wave with a biphasic (positive / negative) morphology in the inferior leads (advanced IAB). Bayes syndrome is defined as an advanced IAB associated with atrial arrhythmia, more specifically atrial fibrillation. Objective and Conclusion: The purpose of this review is to describe the latest evidence about an entity considered an anatomical and electrical substrate with its own name, which may be a predictor of supraventricular arrhythmia and cardioembolic cerebrovascular accidents, as well as the role of new imaging techniques, such as echocardiographic strain and cardiac magnetic resonance imaging, in characterizing atrial alterations associated with this syndrome and generally in the study of anatomy and atrial function.
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