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[PMID]:29216957
[Au] Autor:Zhang XS; Liu YH; Zhang Y; Xu Q; Yu XM; Yang XY; Liu Z; Li HZ; Li F; Xue CY
[Ad] Endereço:Department of Nutrition, Chinese PLA General Hospital, Beijing 100853, China.
[Ti] Título:Handgrip Strength as a Predictor of Nutritional Status in Chinese Elderly Inpatients at Hospital Admission.
[So] Source:Biomed Environ Sci;30(11):802-810, 2017 Nov.
[Is] ISSN:0895-3988
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess nutritional status and define gender- and age-specific handgrip strength (HGS) cut-point values for malnutrition or nutritional risk in elderly inpatients. METHODS: A cross-sectional study of 1,343 elderly inpatients was conducted in the Chinese PLA General Hospital. Nutrition Risk Screening (NRS 2002) and Subjective Global Assessment (SGA) were administered. Anthropometric measurements and blood biochemical indicators were obtained using standard techniques. The gender- and age-specific receiver operating characteristic (ROC) curves were constructed to evaluate the HGS for nutritional status by SGA and NRS 2002. Sensitivity, specificity, and areas under the curves (AUCs) were calculated. RESULTS: According to NRS 2002 and SGA, 63.81% of elderly inpatients were at nutritional risk and 28.22% were malnourished. Patients with higher HGS had an independently decreased risk of malnutrition and nutritional risk. The AUCs varied between 0.670 and 0.761. According to NRS 2002, the optimal HGS cut-points were 27.5 kg (65-74 years) and 21.0 kg (75-90 years) for men and 17.0 kg (65-74 years) and 14.6 kg (75-90 years) for women. According to SGA, the optimal HGS cut-points were 24.9 kg (65-74 years) and 20.8 kg (75-90 years) for men and 15.2 kg (65-74 years) and 13.5 kg (75-90 years) for women. CONCLUSION: Elderly inpatients had increased incidence of malnutrition or nutritional risk. HGS cut-points can be used for assessing nutritional status in elderly inpatients at hospital admission in China.
[Mh] Termos MeSH primário: Grupo com Ancestrais do Continente Asiático
Força da Mão/fisiologia
Pacientes Internados
Estado Nutricional/fisiologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.3967/bes2017.108


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[PMID]:28463817
[Au] Autor:Zheng C; Zhu Y; Zhu D; Lu F; Xia X; Jiang J; Ma X
[Ad] Endereço:Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China.
[Ti] Título:Motor unit number estimation in the quantitative assessment of severity and progression of motor unit loss in Hirayama disease.
[So] Source:Clin Neurophysiol;128(6):1008-1014, 2017 06.
[Is] ISSN:1872-8952
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate motor unit number estimation (MUNE) as a method to quantitatively evaluate severity and progression of motor unit loss in Hirayama disease (HD). METHODS: Multipoint incremental MUNE was performed bilaterally on both abductor digiti minimi and abductor pollicis brevis muscles in 46 patients with HD and 32 controls, along with handgrip strength examination. MUNE was re-evaluated approximately 1year after initial examination in 17 patients with HD. RESULTS: The MUNE values were significantly lower in all the tested muscles in the HD group (P<0.05). Despite abnormally low MUNE values, 54.3% (25/46) of patients with HD had normal ipsilateral grip power. There was a significant inverse correlation between MUNE values and disease duration (P<0.05). A longitudinal follow-up MUNE analysis demonstrated slow progression of motor unit loss in patients with HD within approximately 1year (P<0.05), even in patients with an illness duration >4years. CONCLUSIONS: A reduction in the functioning motor units was found in patients with HD compared with that in controls, even in the early asymptomatic stages. Moreover, the motor unit loss in HD progresses gradually as the disease advances. SIGNIFICANCE: These results have provided evidence for the application of MUNE in estimating the reduction of motor unit in HD and confirming the validity of MUNE for tracking the progression of HD in a clinical setting.
[Mh] Termos MeSH primário: Força da Mão
Nervo Mediano/fisiopatologia
Músculo Esquelético/fisiopatologia
Atrofias Musculares Espinais da Infância/fisiopatologia
Nervo Ulnar/fisiopatologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos de Casos e Controles
Progressão da Doença
Eletromiografia/métodos
Seres Humanos
Músculo Esquelético/inervação
Atrofias Musculares Espinais da Infância/diagnóstico
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:29380887
[Au] Autor:Young JW; Shapiro LJ
[Ad] Endereço:Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, Ohio, 44272.
[Ti] Título:Developments in development: What have we learned from primate locomotor ontogeny?
[So] Source:Am J Phys Anthropol;165 Suppl 65:37-71, 2018 01.
[Is] ISSN:1096-8644
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The importance of locomotion to evolutionary fitness has led to extensive study of primate locomotor behavior, morphology and ecology. Most previous research has focused on adult primates, but in the last few decades, increased attention to locomotor development has provided new insights toward our broader understanding of primate adaptation and evolution. Here, we review the contributions of this body of work from three basic perspectives. First, we assess possible determinants on the timing of locomotor independence, an important life history event. Significant influences on timing of locomotor independence include adult female body mass, age at weaning, and especially relative brain size, a significant predictor of other primate life history variables. Additionally, we found significant phylogenetic differences in the timing of locomotor independence, even accounting for these influences. Second, we discuss how structural aspects of primate growth may enhance the locomotor performance and safety of young primates, despite their inherent neuromotor and musculoskeletal limitations. For example, compared to adults, growing primates have greater muscle mechanical advantage, greater bone robusticity, and larger extremities with relatively long digits. Third, focusing on primate quadrupedalism, we provide examples that illustrate how ontogenetic transitions in morphology and locomotion can serve as a model system for testing broader principles underlying primate locomotor biomechanics. This approach has led to a better understanding of the key features that contribute to primates' stride characteristics, gait patterns, limb force distribution, and limb postures. We have learned a great deal from the study of locomotor ontogeny, but there is much left to explore. We conclude by offering guidelines for future research, both in the laboratory and the field.
[Mh] Termos MeSH primário: Fenômenos Biomecânicos/fisiologia
Marcha/fisiologia
Locomoção/fisiologia
Primatas/fisiologia
[Mh] Termos MeSH secundário: Animais
Antropologia Física
Osso e Ossos/fisiologia
Feminino
Força da Mão/fisiologia
Seres Humanos
Masculino
Filogenia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1002/ajpa.23388


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[PMID]:28406361
[Au] Autor:Novak AR; Bennett KJM; Fransen J; Dascombe BJ
[Ad] Endereço:a Applied Sports Science and Exercise Testing Laboratory, School of Environmental and LifeSciences, Faculty of Science and Information Technology , University of Newcastle , Ourimbah , Australia.
[Ti] Título:Predictors of performance in a 4-h mountain-bike race.
[So] Source:J Sports Sci;36(4):462-468, 2018 Feb.
[Is] ISSN:1466-447X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This study aimed to cross validate previously developed predictive models of mountain biking performance in a new cohort of mountain bikers during a 4-h event (XC4H). Eight amateur XC4H cyclists completed a multidimensional assessment battery including a power profile assessment that consisted of maximal efforts between 6 and 600 s, maximal hand grip strength assessments, a video-based decision-making test as well as a XC4H race. A multiple linear regression model was found to predict XC4H performance with good accuracy (R = 0.99; P < 0.01). This model consisted of [Formula: see text] relative to total cycling mass (body mass including competition clothing and bicycle mass), maximum power output sustained over 60 s relative to total cycling mass, peak left hand grip strength and two-line decision-making score. Previous models for Olympic distance MTB performance demonstrated merit (R = 0.93; P > 0.05) although subtle changes improved the fit, significance and normal distribution of residuals within the model (R = 0.99; P < 0.01), highlighting differences between the disciplines. The high level of predictive accuracy of the new XC4H model further supports the use of a multidimensional approach in predicting MTB performance. The difference between the new, XC4H and previous Olympic MTB predictive models demonstrates subtle differences in physiological requirements and performance predictors between the two MTB disciplines.
[Mh] Termos MeSH primário: Ciclismo/fisiologia
Destreza Motora/fisiologia
Resistência Física/fisiologia
[Mh] Termos MeSH secundário: Adulto
Índice de Massa Corporal
Tomada de Decisões
Força da Mão/fisiologia
Seres Humanos
Modelos Lineares
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE
[do] DOI:10.1080/02640414.2017.1313999


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[PMID]:29364939
[Au] Autor:Mishra S; Goldman JD; Sahyoun NR; Moshfegh AJ
[Ad] Endereço:Department of Nutrition and Food Science, University of Maryland, College Park, Maryland, United States of America.
[Ti] Título:Association between dietary protein intake and grip strength among adults aged 51 years and over: What We Eat in America, National Health and Nutrition Examination Survey 2011-2014.
[So] Source:PLoS One;13(1):e0191368, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Distributing daily protein intake evenly across meals (∼25-30g/meal) has been suggested to improve muscle mass. The aim of this research is to examine the association between grip strength, total protein intake and its distribution across day's meals in older adults. METHODS: Nationally representative dietary intake data of adults aged 51 years and older (n = 4,123) who participated in What We Eat in America, NHANES 2011-2014 were analyzed. Protein intake per day and per eating occasion (breakfast, lunch, dinner, and snack) were determined. Combined grip strength was calculated and expressed in kilograms. Grip strength of individuals consuming ≥25g protein at 1 eating occasion was compared with those consuming same level of protein at 2 and 3 or more eating occasions. Grip strength of individuals in quartile 1 of daily protein intake was compared to those in the other quartiles. All associations were examined without and with adjustment for age, race/ethnicity, physical activity, health status, and smoking status. The comparison involving eating occasions and protein intake quartiles were further adjusted for daily protein intake and energy intake, respectively. RESULTS: Only 33% of men and 19% of women had protein intake of ≥25g at 2 or more eating occasions. These individuals also had higher grip strength and daily protein intake. Grip strength was positively associated with consumption of ≥25g protein at 2 eating occasions as compared to consumption of same level of protein at 1 eating occasion (p<0.05) in unadjusted model, but not when adjusted. Grip strength was positively associated with daily protein intake among women in quartiles 3 and 4 (p<0.05) of protein intake in both unadjusted and adjusted models compared to lowest protein intake. Among men, grip strength was associated with daily protein intake in quartiles 3 and 4 (p<0.05) in the unadjusted model, but not when adjusted. CONCLUSION: In a nationally representative sample of older adults, consuming ≥25g protein at 2 or more eating occasions was not associated with grip strength. However, higher daily protein intake was positively associated with grip strength in women.
[Mh] Termos MeSH primário: Proteínas na Dieta/administração & dosagem
Força da Mão/fisiologia
[Mh] Termos MeSH secundário: Idoso
Ingestão de Alimentos
Feminino
Seres Humanos
Masculino
Meia-Idade
Inquéritos Nutricionais
Fatores Sexuais
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Dietary Proteins)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191368


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[PMID]:29309417
[Au] Autor:Seegelke C; Weigelt M
[Ad] Endereço:Biopsychology and Cognitive Neuroscience, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany.
[Ti] Título:Anticipating different grips reduces bimanual end-state comfort: A tradeoff between goal-related and means-related planning processes.
[So] Source:PLoS One;13(1):e0190586, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The present study explored the sensitivity towards bimanual end-state comfort in a task that required anticipating different final grips. Participants simultaneously reached and grasped two objects with either a whole-hand grip (WHG) or a precision grip (PG), and placed them at two target locations by transporting them either over or under an obstacle. The transport path was varied such that it could be either congruent (i.e., both objects over or under) or incongruent (i.e., one object over and the other object under). In the congruent conditions, participants satisfied bimanual end-state comfort (and identical initial grips) on the majority of trials. That is, participants adopted a PG for either hand when the objects were transported over the obstacle and a WHG for either hand when the objects were transported under the obstacle. In contrast, in the incongruent conditions, bimanual end-state comfort was significantly reduced, indicating the presence of intermanual inference. The results indicate that goal-related planning constraints (i.e., bimanual end-state comfort) do not strictly take precedence over means-related constraints (i.e., identical initial grips) if this requires anticipating different final grips. Thus, bimanual end-state comfort per se does not provide a predominant constraint in action selection, by which sensorimotor interference can be reduced. In line with the proposal that bimanual grip planning relies on a flexible constraint hierarchy, a simple formal model that considers bimanual grip posture planning as a tradeoff between goal-related and means-related planning processes can explain our results reasonably well.
[Mh] Termos MeSH primário: Força da Mão
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
Desempenho Psicomotor
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180109
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190586


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[PMID]:29293615
[Au] Autor:Clark AP; Howard KL; Woods AT; Penton-Voak IS; Neumann C
[Ad] Endereço:Brunel University London, Uxbridge, United Kingdom.
[Ti] Título:Why rate when you could compare? Using the "EloChoice" package to assess pairwise comparisons of perceived physical strength.
[So] Source:PLoS One;13(1):e0190393, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We introduce "EloChoice", a package for R which uses Elo rating to assess pairwise comparisons between stimuli in order to measure perceived stimulus characteristics. To demonstrate the package and compare results from forced choice pairwise comparisons to those from more standard single stimulus rating tasks using Likert (or Likert-type) items, we investigated perceptions of physical strength from images of male bodies. The stimulus set comprised images of 82 men standing on a raised platform with minimal clothing. Strength-related anthropometrics and grip strength measurements were available for each man in the set. UK laboratory participants (Study 1) and US online participants (Study 2) viewed all images in both a Likert rating task, to collect mean Likert scores, and a pairwise comparison task, to calculate Elo, mean Elo (mElo), and Bradley-Terry scores. Within both studies, Likert, Elo and Bradley-Terry scores were closely correlated to mElo scores (all rs > 0.95), and all measures were correlated with stimulus grip strength (all rs > 0.38) and body size (all rs > 0.59). However, mElo scores were less variable than Elo scores and were hundreds of times quicker to compute than Bradley-Terry scores. Responses in pairwise comparison trials were 2/3 quicker than in Likert tasks, indicating that participants found pairwise comparisons to be easier. In addition, mElo scores generated from a data set with half the participants randomly excluded produced very comparable results to those produced with Likert scores from the full participant set, indicating that researchers require fewer participants when using pairwise comparisons.
[Mh] Termos MeSH primário: Vestuário
Força Muscular
Percepção
[Mh] Termos MeSH secundário: Adolescente
Força da Mão
Seres Humanos
Masculino
Probabilidade
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190393


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[PMID]:28103737
[Au] Autor:Novak AR; Bennett KJM; Fransen J; Dascombe BJ
[Ad] Endereço:a Applied Sports Science and Exercise Testing Laboratory, School of Environmental and Life Sciences, Faculty of Science and Information Technology , University of Newcastle , Ourimbah , Australia.
[Ti] Título:A multidimensional approach to performance prediction in Olympic distance cross-country mountain bikers.
[So] Source:J Sports Sci;36(1):71-78, 2018 Jan.
[Is] ISSN:1466-447X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This study adopted a multidimensional approach to performance prediction within Olympic distance cross-country mountain biking (XCO-MTB). Twelve competitive XCO-MTB cyclists (VO max 60.8 ± 6.7 ml · kg · min ) completed an incremental cycling test, maximal hand grip strength test, cycling power profile (maximal efforts lasting 6-600 s), decision-making test and an individual XCO-MTB time-trial (34.25 km). A hierarchical approach using multiple linear regression analyses was used to develop predictive models of performance across 10 circuit subsections and the total time-trial. The strongest model to predict overall time-trial performance achieved prediction accuracy of 127.1 s across 6246.8 ± 452.0 s (adjusted R = 0.92; P < 0.01). This model included VO max relative to total cycling mass, maximal mean power across 5 and 30 s, peak left hand grip strength, and response time for correct decisions in the decision-making task. A range of factors contributed to the models for each individual subsection of the circuit with varying predictive strength (adjusted R : 0.62-0.97; P < 0.05). The high prediction accuracy for the total time-trial supports that a multidimensional approach should be taken to develop XCO-MTB performance. Additionally, individual models for circuit subsections may help guide training practices relative to the specific trail characteristics of various XCO-MTB circuits.
[Mh] Termos MeSH primário: Desempenho Atlético/fisiologia
Ciclismo/fisiologia
Teste de Esforço/métodos
[Mh] Termos MeSH secundário: Adulto
Antropometria
Tomada de Decisões
Força da Mão
Seres Humanos
Modelos Lineares
Masculino
Consumo de Oxigênio
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170121
[St] Status:MEDLINE
[do] DOI:10.1080/02640414.2017.1280611


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[PMID]:29437062
[Au] Autor:Gaspar MP; Pham PP; Pankiw CD; Jacoby SM; Shin EK; Osterman AL; Kane PM
[Ad] Endereço:Philadelphia Hand to Shoulder Center, Thomas Jefferson University, 834 Chestnut Street, The Franklin Building, Suite G114, Philadelphia, PA 19107, USA and Darden School of Business, University of Virginia, 100 Darden Boulevard, Charlottesville, Virginia 22903, USA.
[Ti] Título:Mid-term outcomes of routine proximal row carpectomy compared with proximal row carpectomy with dorsal capsular interposition arthroplasty for the treatment of late-stage arthropathy of the wrist.
[So] Source:Bone Joint J;100-B(2):197-204, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The aims of this study were to compare the mid-term outcomes of patients with late-stage arthritis of the wrist treated with proximal row carpectomy (PRC) and dorsal capsular interposition (DCI) arthroplasty with a matched cohort treated with routine PRC alone. PATIENTS AND METHODS: A total of 25 arthritic wrists (24 patients) with pre-existing degenerative changes of the proximal capitate and/or the lunate fossa of the radius were treated with PRC + DCI over a ten-year period. This group of patients were matched 1:2 with a group of 50 wrists (48 patients) without degenerative changes in the capitate or lunate fossa that were treated with a routine PRC alone during the same period. The mean age of the patients at the time of surgery was 56.8 years (25 to 81), and the demographics and baseline range of movement of the wrist, grip strength, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, and Patient-Rated Wrist Evaluation (PRWE) score were similar in both groups. RESULTS: At a mean follow-up of 5.9 years (1.8 to 11.8), significant improvements in mean grip strength, the flexion-extension arc of movement of the wrist, QuickDASH, and PRWE scores were seen in both groups. There was no diifference between the groups for any of the outcomes. One patient in the PRC + DCI group required additional surgery for a deep infection, while two in the PRC group had complications (one wound dehiscence requiring revision closure, one transient radial sensory neuritis). One patient in each group required total arthrodesis of the wrist for progressive degenerative radiocarpal changes. A total of 70 patients (93%) were satisfied with the outcomes. CONCLUSION: PRC with DCI is an effective form of treatment for late-stage arthritis of the wrist involving the capitolunate joint, with mid-term outcomes that are similar to those in patients without degenerative changes affecting the capitate or lunate fossa who are treated with a routine PRC alone. Cite this article: 2018;100-B:197-204.
[Mh] Termos MeSH primário: Artroplastia/métodos
Ossos do Carpo/cirurgia
Osteoartrite/cirurgia
Articulação do Punho/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Avaliação da Deficiência
Feminino
Seguimentos
Força da Mão
Seres Humanos
Masculino
Meia-Idade
Satisfação do Paciente
Amplitude de Movimento Articular
Retalhos Cirúrgicos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0816.R2


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[PMID]:27779573
[Au] Autor:McAdams-DeMarco MA; Ying H; Olorundare I; King EA; Haugen C; Buta B; Gross AL; Kalyani R; Desai NM; Dagher NN; Lonze BE; Montgomery RA; Bandeen-Roche K; Walston JD; Segev DL
[Ad] Endereço:1 Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. 2 Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD. 3 Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. 4 Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD.
[Ti] Título:Individual Frailty Components and Mortality in Kidney Transplant Recipients.
[So] Source:Transplantation;101(9):2126-2132, 2017 09.
[Is] ISSN:1534-6080
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Frailty increases early hospital readmission and mortality risk among kidney transplantation (KT) recipients. Although frailty represents a high-risk state for this population, the correlates of frailty, the patterns of the 5 frailty components, and the risk associated with these patterns are unclear. METHODS: Six hundred sixty-three KT recipients were enrolled in a cohort study of frailty in transplantation (12/2008-8/2015). Frailty, activities of daily living (ADL)/instrumental ADL (IADL) disability, Centers for Epidemiologic Studies Depression Scale depression, education, and health-related quality of life (HRQOL) were measured. We used multinomial regression to identify frailty correlates. We identified which patterns of the 5 components were associated with mortality using adjusted Cox proportional hazards models. RESULTS: Frailty prevalence was 19.5%. Older recipients (adjusted prevalence ratio [PR], 2.22; 95% confidence interval [CI], 1.21-4.07) were more likely to be frail. The only other factors that were independently associated with frailty were IADL disability (PR, 3.22; 95% CI, 1.72-6.06), depressive symptoms (PR, 11.31; 95% CI, 4.02-31.82), less than a high school education (PR, 3.10; 95% CI, 1.30-7.36), and low HRQOL (fair/poor: PR, 3.71; 95% CI, 1.48-9.31). The most common pattern was poor grip strength, low physical activity, and slowed walk speed (19.4%). Only 2 patterns of the 5 components emerged as having an association with post-KT mortality. KT recipients with exhaustion and slowed walking speed (hazards ratio = 2.43; 95% CI, 1.17-5.03) and poor grip strength, exhaustion, and slowed walking speed (hazard ratio, 2.61; 95% CI, 1.14-5.97) were at increased mortality risk. CONCLUSIONS: Age was the only conventional factor associated with frailty among KT recipients; however, factors rarely measured as part of clinical practice, namely, HRQOL, IADL disability, and depressive symptoms, were significant correlates of frailty. Redefining the frailty phenotype may be needed to improve risk stratification for KT recipients.
[Mh] Termos MeSH primário: Idoso Fragilizado/psicologia
Nível de Saúde
Falência Renal Crônica/cirurgia
Transplante de Rim/mortalidade
Transplantados/psicologia
[Mh] Termos MeSH secundário: Atividades Cotidianas
Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Baltimore/epidemiologia
Depressão/diagnóstico
Depressão/mortalidade
Depressão/psicologia
Avaliação da Deficiência
Escolaridade
Tolerância ao Exercício
Feminino
Avaliação Geriátrica
Força da Mão
Seres Humanos
Falência Renal Crônica/diagnóstico
Falência Renal Crônica/mortalidade
Transplante de Rim/efeitos adversos
Masculino
Saúde Mental
Meia-Idade
Fenótipo
Valor Preditivo dos Testes
Prevalência
Estudos Prospectivos
Qualidade de Vida
Fatores de Risco
Inquéritos e Questionários
Fatores de Tempo
Resultado do Tratamento
Caminhada
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1097/TP.0000000000001546



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