Lo que natura no da : ¿La filosofía lo presta? 'Disposiciones naturales' en IV Macabeos

Múltiples y variadas tendencias han encontrado sitio dentro del conjunto de propuestas que fueron postuladas por los estudiosos para encuadrar el contenido filosófico del Libro IV de los Macabeos. En efecto, se ha afirmado desde que sus planteos no pueden ser asignados a ninguna escuela en particular (Breitenstein 1978:665-6) hasta los que creen que su influencia mayoritaria es platónica (Hadas 1953:205) o estoica (Heinemann:1928). Estas posiciones fueron parcialmente explicitadas y aclaradas por Renehan (1972:227; que es quien cita a los anteriores) en forma de una koiné filosófica permeada particularmente de estoicismo, lectura que siguieron en su mayoría los demás estudiosos (inter alia Collins 2000:205; Piñero 2007:70 y Frenkel 2011a:67 y nota ad loc). Creemos que tales acercamientos hallan sustento en los argumentos enfrentados que esgrimen tanto Antíoco IV Epifanes como el anciano sacerdote Eleazar. Cada uno de ellos, en busca de una eficaz defensa de sus argumentos, demuestra un gran conocimiento de las líneas de pensamiento imperantes en sus marcos culturales correspondientes. De ese modo, la contienda verbal se articulará ya no sobre estos saberes sino sobre la postura que cada uno de ellos sostiene acerca de lo considerado "natural". Creemos que es este punto lo que agudizará la pugna entre ellos de modo de llevar al anciano a la muerte. Intentaremos demostrarlo mediante el rastreo de uso del término naturaleza y sus derivados en sus respectivos contextos de uso. De ese modo, creemos, podremos adscribir las peroraciones a sendas corrientes de pensamiento que, si bien no taxativamente categoriales, sustentarán la visión de mundo que defienden. Finalmente, estas concepciones serían las que articularán la totalidad del texto y lo llevarán a demostrar y defender la veracidad de la tesis expresada en su primer capítulo, que tiene en cuenta las disposiciones consideradas ?naturales? por el autor del tratado.

Lo que natura no da : ¿La filosofía lo presta? 'Disposiciones naturales' en IV Macabeos

Múltiples y variadas tendencias han encontrado sitio dentro del conjunto de propuestas que fueron postuladas por los estudiosos para encuadrar el contenido filosófico del Libro IV de los Macabeos. En efecto, se ha afirmado desde que sus planteos no pueden ser asignados a ninguna escuela en particular (Breitenstein 1978:665-6) hasta los que creen que su influencia mayoritaria es platónica (Hadas 1953:205) o estoica (Heinemann:1928). Estas posiciones fueron parcialmente explicitadas y aclaradas por Renehan (1972:227; que es quien cita a los anteriores) en forma de una koiné filosófica permeada particularmente de estoicismo, lectura que siguieron en su mayoría los demás estudiosos (inter alia Collins 2000:205; Piñero 2007:70 y Frenkel 2011a:67 y nota ad loc). Creemos que tales acercamientos hallan sustento en los argumentos enfrentados que esgrimen tanto Antíoco IV Epifanes como el anciano sacerdote Eleazar. Cada uno de ellos, en busca de una eficaz defensa de sus argumentos, demuestra un gran conocimiento de las líneas de pensamiento imperantes en sus marcos culturales correspondientes. De ese modo, la contienda verbal se articulará ya no sobre estos saberes sino sobre la postura que cada uno de ellos sostiene acerca de lo considerado "natural". Creemos que es este punto lo que agudizará la pugna entre ellos de modo de llevar al anciano a la muerte. Intentaremos demostrarlo mediante el rastreo de uso del término naturaleza y sus derivados en sus respectivos contextos de uso. De ese modo, creemos, podremos adscribir las peroraciones a sendas corrientes de pensamiento que, si bien no taxativamente categoriales, sustentarán la visión de mundo que defienden. Finalmente, estas concepciones serían las que articularán la totalidad del texto y lo llevarán a demostrar y defender la veracidad de la tesis expresada en su primer capítulo, que tiene en cuenta las disposiciones consideradas ?naturales? por el autor del tratado.

Grip strength and functional recovery after hip fracture: An observational study in elderly population

Muscle strength is a common issue in fragility syndrome and sarcopenia, both of them involved in the pathogenesis of falls and fractures. The objective is to study the relationship between hand grip strength and functional recovery after hip fracture surgery. This prospective observational study included patients aged 65. years and older who were admitted to hospital for hip fracture surgery during a 12 month period. Functional status (Barthel Index), mental status (Cruz Roja Index), hand grip strength, 25/OH-Vitamin D plasmatic levels were evaluated at admission. Follow-up was performed 3. months after discharge to assess functional status and survival. Correlations between hand grip strength and the rest of variables were evaluated. Univariate and multivariate analyses were further applied. Mean age of subjects was 85.1. ±. 0.63 years. Out of 127 subjects, 103 were women and 24 were men. Hand grip strength was obtained in 85 patients (76.5%) and, values were between 3.3 and 24.8. kg and 81 patients (95.2%) had values below cut-point of sarcopenia considering European Working Group of Sarcopenia criteria. Hand grip strength at admission shows significant association to Barthel index at three months and functional recovery. It is also associated with age (P <. 0.001) (r = 0.81), sex (P = 0.001), cognitive status by Cruz Roja Index (P <. 0.001) and functional status measured at admission by Barthel Index (P <. 0.01) (r = -0.22). Multivariate analysis confirmed that variables were independently associated to grip strength. Hand grip strength measured at admission in Orthogeriatric Unit after hip fracture is directly related to functional recovery in elderly patients.

Interatrial block and atrial arrhythmias in centenarians: Prevalence, associations, and clinical implications

Data are lacking on the characteristics of atrial activity in centenarians, including interatrial block (IAB). The aim of this study was to describe the prevalence of IAB and auricular arrhythmias in subjects older than 100 years and to elucidate their clinical implications. We studied 80 centenarians (mean age 101.4 ± 1.5 years; 21 men) with follow-ups of 6–34 months. Of these 80 centenarians, 71 subjects (88.8%) underwent echocardiography. The control group comprised 269 septuagenarians. A total of 23 subjects (28.8%) had normal P wave, 16 (20%) had partial IAB, 21 (26%) had advanced IAB, and 20 (25.0%) had atrial fibrillation/flutter. The IAB groups exhibited premature atrial beats more frequently than did the normal P wave group (35.1% vs 17.4%; P < .001); also, other measurements in the IAB groups frequently fell between values observed in the normal P wave and the atrial fibrillation/flutter groups. These measurements included sex preponderance, mental status and dementia, perceived health status, significant mitral regurgitation, and mortality. The IAB group had a higher previous stroke rate (24.3%) than did other groups. Compared with septuagenarians, centenarians less frequently presented a normal P wave (28.8% vs 53.5%) and more frequently presented advanced IAB (26.3% vs 8.2%), atrial fibrillation/flutter (25.0% vs 10.0%), and premature atrial beats (28.3 vs 7.0%) (P < .01). Relatively few centenarians (<30%) had a normal P wave, and nearly half had IAB. Our data suggested that IAB, particularly advanced IAB, is a pre–atrial fibrillation condition associated with premature atrial beats. Atrial arrhythmias and IAB occurred more frequently in centenarians than in septuagenarians.

Sex-related differences in centenarians and their hearts

Sociedad Española de Cardiología. Proyecto de Registro Clínico de la Sección de Cardiología Clínica 2013

Conservative management in very elderly patients with severe aortic stenosis: Time to change?

Despite current recommendations, a high percentage of patients with severe symptomatic aortic stenosis are managed conservatively. The aim of this study was to study symptomatic patients undergoing conservative management from the IDEAS registry, describing their baseline clinical characteristics, mortality, and the causes according to the reason for conservative management. Consecutive patients with severe aortic stenosis diagnosed at 48 centers during January 2014 were included. Baseline clinical characteristics, echocardiographic data, Charlson index, and EuroSCORE-II were registered, including vital status and performance of valve intervention during one-year follow-up. For the purpose of this substudy we assessed symptomatic patients undergoing conservative management, including them in 5 groups according to the reason for performing conservative management [I: comorbidity/frailty (128, 43.8%); II: dementia 18 (6.2%); III: advanced age 34 (11.6%); IV: patients’ refusal 62 (21.2%); and V: other reasons 50 (17.1%)]. We included 292 patients aged 81.5 ± 9 years. Patients from group I had higher Charlson index (4 ± 2.3), higher EuroSCORE-II (7.5 ± 6), and a higher overall (42.2%) and non-cardiac mortality (16.4%) than the other groups. In contrast, patients from group III had fewer comorbidities, lower EuroSCORE-II (4 ± 2.5), and low overall (20.6%) and non-cardiac mortality (5.9%). Patients with severe symptomatic aortic stenosis managed conservatively have different baseline characteristics and clinical course according to the reason for performing conservative management. A prospective assessment of comorbidity and other geriatric syndromes might contribute to improve therapeutic strategy in this clinical setting.

Implications of obesity in exceptional longevity

Fondo de Investigaciones Sanitarias (PI15/00558)

Muscle-related polymorphisms (MSTN rs1805086 and ACTN3 rs1815739) are not associated with exceptional longevity in Japanese centenarians

Myostatin (MSTN) and α-actinin-3 (ACTN3) genes are potentially associated with preservation of muscle mass and oxidative capacity, respectively. To explore the possible role of these genes in exceptional longevity (EL), the allele/genotype frequency distribution of two polymorphisms in MSTN (rs1805086, K153R) and ACTN3 (rs1815739, R577X) was studied in Japanese centenarians of both sexes (n = 742) and healthy controls (n = 814). The rs1805086 R-allele (theoretically associated with muscle mass preservation at the expense of oxidative capacity) was virtually absent in the two groups, where genotype distributions were virtually identical. Likewise, no differences in allele (p = 0.838 (women); p = 0.193 (men); p = 0.587 (both sexes)) or genotype distribution were found between groups for ACTN3 rs1815739 (p = 0.975 (women), p = 0.136 (men), p = 0.752 (both sexes)). Of note, however, the frequency of the rs1805086 R-allele observed here is the lowest been reported to date whereas that of the 'highly oxidative/efficient' rs1815739 XX genotype in Japanese male centenarians (33.3%) or supercentenarians of both sexes (≥110 years) are the highest (32.6%), for a non-American population. No definite conclusions can be inferred in relation to EL owing to its lack of association with both rs1815739 and rs1805086. However, it cannot be excluded that these gene variants could eventually be related to a "healthy" metabolic phenotype in the Japanese population. Further research might determine if such metabolic profile is among the factors that can potentially predispose these individuals to live longer than Caucasians and what genetic variants might be actually involved.