Physical and leisure activities and it’s impact on cognition in aging

Modelo de estudo: estudo de prevalência. Objetivos do estudo: Este estudo teve como objetivo investigar a prevalência de atividades físicas e de lazer entre um grupo de idosos com idade entre 70 e 75 anos. Além disso, foi investigado se a inserção nessas atividades pode exercer influência sobre a cognição. Metodologia: Participaram do estudo 45 idosos de ambos os sexos, com idade entre 70 e 75 anos, cadastrados em um Núcleo de Saúde da Família (NSF) na cidade de Ribeirão Preto (SP), sem doenças neurológicas (previamente diagnosticadas), não acamados e não asilados. Foram utilizados um questionário para levantamento de dados sociodemográficos e de saúde, hábitos de vida e rotina do idoso, formulado com questões de caracterização dos sujeitos, incluindo informações sobre a realização e características das atividades de lazer e físicas, e o Mini-Exame do Estado Mental – MEEM. Resultados: No grupo estudado, 52,3% referiram praticar atividade física, principalmente caminhada, sendo maior a participação entre os homens (69,2%) do que entre as mulheres (43,7%). Quanto às atividades de lazer, 80% relatou participar de alguma atividade (81,2% das mulheres e 76,9% dos homens), sendo que a maioria (66,6%) apontou como lazer o hábito de freqüentar igreja. Os idosos que praticavam atividades de lazer obtiveram escores no MEEM significativamente superiores àqueles que não praticavam, verificado pelo teste t (p<0,05). Não houve diferença significativa (p>0,05) de desempenho no MEEM quando comparados os indivíduos que praticavam atividade física e aqueles que não praticavam. Conclusões:  O estímulo às atividades de lazer deve também ser considerado quando se pensam em atividades de promoção à saúde, especialmente no que tange a aumentar as possibilidades de um envelhecimento físico e cognitivo saudável.  Paper design: prevalence study.Objective:The goal of this study was to investigate the prevalence of physical and leisure activities among a gruop of elderly with age of 70 to 75. Furthermore, it was investigated if those activities would have an influence in cognition. Methods: Participated in this study 45 elderly of both gender in the age of 70 to 75. They were non bedridden, non living in an asylum, had no neurolical diseases ( pre diagnosticated) and were cadastrated in a Núcleo de Saúde da Família (NSF) in the city of Ribeirão Preto, São Paulo, Brazil. Two questionnaire were used: one to gatter data of social and economic state, health, life habits and the elderly routine, formulated with questions to qualify the subjects including informations about leisure and physical activities ; and the other one was the Mini Exame of Mental Health. Results: In this studied group 52,3% reported the habit to praticate physical activities, especialy walk, and men refered doing it more (69,2%) then women (43,7%). About the leisure activities 80% reported doing it (81,2% of the women and 76,9% of the men). The most refered tipe was going to church (66,6%). The elderly who practiced leisure activities had a significative higher score, verified by the t test, on the Mini Exame then those who didn’t. Conclusions: The incentive to leisure activities should be considered when one thinks about health promotion, specialy when there is a possibility to upgrade the chances of a healthy physical and cognition aging

Deficit irrigation in grapevine improves water-use efficiency while controlling vigour and production quality

Grapevine irrigation is becoming an important practice to guarantee wine quality or even plant survival in regions affected by seasonal drought. Nevertheless, irrigation has to be controlled to optimise source to sink balance and avoid excessive vigour. The results we present here in two grapevine varieties (Moscatel and Castela ˜o) during 3 years, indicate thatwe can decrease the amount ofwater applied by 50%(as in deficit irrigation, DI, and in partial root drying, PRD) in relation to full crop’s evapotranspiration (ETc) [full irrigated (FI) vines] with no negative effects on production and even get some gains of quality (in the case of PRD).We report that in non-irrigated and in several cases in PRD vines exhibit higher concentrations of berry skin anthocyanins and total phenols than those presented by DI and FI vines.We showed that these effects on quality weremediated by a reduction in vigour, leading to an increase on light interception in the cluster zone. Because plant water status during most of the dates along the season was not significantly different between PRD and DI, and when different, PRD even exhibited a higher leaf water potential than DI vines, we conclude that growth inhibition in PRD was not a result of a hydraulic control. The gain in crop water use in DI and PRD was accompanied by an increase of the δ13 C values in the berries in DI and PRD as compared to FI, suggesting that we can use this methodology to assess the integrated water-use efficiency over the growing season

Efeitos adversos a medicamentos em hospital público: estudo piloto

The results from implementing a strategy for monitoring adverse effects from drugs in a public hospital in the municipality of Rio de Janeiro, Southeastern Brazil, in 2007, were analyzed. Based on retrospective analysis of 32 medical files, adverse effects were found in 16%. To identify these effects, 38 tracking criteria were needed. Among these, the main ones were the use of antiemetics, abrupt cessation of medication and over-sedation. Despite the difficulties, especially in relation to access to information and the record quality, application of these tracking criteria seems to be viable. To improve the implementation of the method, it is suggested that the data collection should be computerized and risk adjustment indicators should be sought.Fueron analizados los resultados de la implantación de estrategia de monitoreo de efectos adversos a los medicamentos en hospital público en Rio de Janeiro, Sureste de Brasil, en 2007. Con base en análisis retrospectivo de 32 prontuarios fueron encontrados efectos adversos en 16%. Para identificarlos, fueron necesarios 38 criterios rastreadores, de los cuales los principales fueron: uso de antieméticos, interrupción abrupta de medicamentos y sedación excesiva. A pesar de las dificultades, sobre todo relacionadas con el acceso a las informaciones y a la calidad de los registros, la aplicación de los criterios rastreadores parece ser viable. Para perfeccionar la implantación del método, se sugiere informatizar la colecta de datos y buscar indicadores de ajuste del riesgo.Foram analisados os resultados da implantação de estratégia de monitoramento de efeitos adversos aos medicamentos em hospital público no Rio de Janeiro, RJ, em 2007. Com base em análise retrospectiva de 32 prontuários foram encontrados efeitos adversos em 16%. Para identificá-los, foram precisos 38 critérios rastreadores, dos quais os principais foram: uso de antieméticos, interrupção abrupta de medicamentos e sedação excessiva. Apesar das dificuldades, sobretudo relacionadas ao acesso às informações e à qualidade dos registros, a aplicação dos critérios rastreadores parece ser viável. Para aprimorar a implantação do método, sugere-se informatizar a coleta de informações e buscar indicadores de ajuste de risco

Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment

Background Previous studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment. Methods This study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100). Results A total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001). Conclusions Adherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.info:eu-repo/semantics/publishedVersio

Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial

<p>Abstract</p> <p>Background</p> <p>Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage.</p> <p>Methods</p> <p>This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution.</p> <p>Discussion</p> <p>The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe in a population-based perspective, it could be the basis for an innovative public health program to prevent hypertension in Brazil.</p> <p>Trial Registration</p> <p>Clinical Trials <a href="http://www.clinicaltrials.gov/ct2/show/NCT00970931">NCT00970931</a>.</p

ERBB2 in Cat Mammary Neoplasias Disclosed a Positive Correlation between RNA and Protein Low Expression Levels: A Model for erbB-2 Negative Human Breast Cancer

Human ERBB2 is a proto-oncogene that codes for the erbB-2 epithelial growth factor receptor. In human breast cancer (HBC), erbB-2 protein overexpression has been repeatedly correlated with poor prognosis. In more recent works, underexpression of this gene has been described in HBC. Moreover, it is also recognised that oncogenes that are commonly amplified or deleted encompass point mutations, and some of these are associated with HBC. In cat mammary lesions (CMLs), the overexpression of ERBB2 (27%–59.6%) has also been described, mostly at the protein level and although cat mammary neoplasias are considered to be a natural model of HBC, molecular information is still scarce. In the present work, a cat ERBB2 fragment, comprising exons 10 to 15 (ERBB2_10–15) was achieved for the first time. Allelic variants and genomic haplotype analyses were also performed, and differences between normal and CML populations were observed. Three amino acid changes, corresponding to 3 non-synonymous genomic sequence variants that were only detected in CMLs, were proposed to damage the 3D structure of the protein. We analysed the cat ERBB2 gene at the DNA (copy number determination), mRNA (expression levels assessment) and protein levels (in extra- and intra protein domains) in CML samples and correlated the last two evaluations with clinicopathological features. We found a positive correlation between the expression levels of the ERBB2 RNA and erbB-2 protein, corresponding to the intracellular region. Additionally, we detected a positive correlation between higher mRNA expression and better clinical outcome. Our results suggest that the ERBB2 gene is post-transcriptionally regulated and that proteins with truncations and single point mutations are present in cat mammary neoplastic lesions. We would like to emphasise that the recurrent occurrence of low erbB-2 expression levels in cat mammary tumours, suggests the cat mammary neoplasias as a valuable model for erbB-2 negative HBC.POCI/CVT/62940/2004 and by the PhD grants (SFRH/BD/23406/2005 and SFRH/BD/31754/2006, of the Science and Technology Foundation (FCT) from Portugal

Evaluation of Mini-Mental State Examination scores according to different age and education strata, and sex, in a large Brazilian healthy sample

Abstract Until better measures have been accepted for wider use, the Mini-Mental State Examination (MMSE) will continue to be utilized. In this context, knowledge on characteristics and determinants of its distribution for the Brazilian population are particularly valuable. The present study aimed to evaluate, based on multivariate analysis, the independent effect of age, educational level and sex, and their interactions, on MMSE scores in a healthy sample. Methods: Demographic data and scores on the MMSE of 1,553 healthy individuals were analyzed. The sample was grouped according to age and education. Results: The sample was composed of 963 females (62%), mean age ±SD was 49.6±20.7 yrs (range 20 to 92 yrs). The mean years of education ±SD was 8.9±5.5 yrs (range 0 to 28 yrs). The mean score ±SD on the MMSE was 27.3±2.7 (range 15 to 30). A significant effect of the interaction between education and sex (p=0.011), and also between education and age was observed (p=0.003). An independent effect of education (p<0.001) and age (p<0.001) was found. Participants from the higher educated group presented higher MMSE scores than the other groups. Younger adults presented higher MMSE scores than the other age groups. Conclusions: We observed an effect of education and age on MMSE scores. Younger individuals and higher educated participants presented higher scores

Neuropsychiatric symptoms as the main determinant of caregiver burden in Alzheimer's disease

Abstract Caregiver burden is common in Alzheimer's disease (AD), decreasing the quality of life among caregivers and patients. Projections of aging and aging-related diseases such as AD in developing countries justify additional data about this issue because people living in these countries have shown similarly high levels of caregiver strain as in the developed world. Objective: The aim of this study was to analyze the association of AD caregivers' burden with patients' neuropsychiatric symptoms (NPS), cognitive status, severity of dementia, functional capacity, caregiver sociodemographic characteristics, and the characteristics of care provided by caregivers. Methods: A cross-sectional study was conducted in a sample of 39 consecutive AD patients and their primary caregivers. NPS were evaluated using the Neuropsychiatric Inventory (NPI). Severity of dementia was assessed with the Clinical Dementia Rating (CDR) scale. Functional capacity was assessed using the Katz and Lawton scales. The burden level was rated using the Burden Interview (BI). Sociodemographic characteristics of caregivers and the characteristics of care provided by them were evaluated. The Mann-Whitney U-test, Kruskal-Wallis test and Spearman's rho coefficient were performed. Results: The BI had a moderate correlation with NPI intensity (rho=0.563), p<001. Female caregivers reported a greater level of burden (p=0.031) than male caregivers. The other variables were not significantly associated to caregiver burden. Conclusion: NPS were the main determinant of burden in primary caregivers of AD patients. This result underscores the need for prevention and treatment of these symptoms. Sex also had an effect on caregiver burden, but the small male sample in this study precludes the generalization of this finding