Comparação entre a capacidade e desempenho: um estudo sobre a funcionalidade de idosos dependentes

OBJECTIVE: to compare the ability and performance of Basic Activities of Daily Living of dependent elderly individuals cared for in a geriatric healthcare center. METHOD: cross-sectional, observational study with quantitative approach. The Functional Independence Measure (FIM) was applied in 109 elderly individuals cared for in a geriatric healthcare center. Of these, 60 individuals were classified as dependent in the case of basic activities of daily living described according to the International Classification of Functionality, Disability and Health (ICF). The process of triangulation reinforced reliability of data, which included information provided by patients and caregivers and that contained in medical files and objective assessment. RESULTS: the average age was 81.0±7.1 with a predominance of women. The difference between ability and performance was statistically significant (pOBJETIVO: comparar a capacidade e o desempenho para a realização das Atividades Básicas de Vida Diária em idosos dependentes, atendidos pelo Centro de Referência do Idoso. MÉTODO: trata-se de estudo transversal, observacional, com abordagem quantitativa. A Medida de Independência Funcional foi aplicada em 109 idosos atendidos em um Centro de Referência do Idoso. Desses, 60 idosos foram classificados como dependentes para as Atividades Básicas de Vida Diária e descritos de acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde. O processo de triangulação reforçou a fidedignidade dos dados obtidos, no qual se consideram as informações de pacientes e acompanhantes, em conjunto com o prontuário e avaliação objetiva. RESULTADOS: a média de idade foi de 81,0±7,1, com predominância do sexo feminino. A diferença entre a capacidade e o desempenho foi estatisticamente significativa (pOBJETIVO: comparar la capacidad y el desempeño para la realización de las Actividades Básicas de la Vida Diaria en ancianos dependientes atendidos por el Centro de Referencia del Anciano. MÉTODO: se trata de un estudio transversal, observacional, con abordaje cuantitativo. La Medida de Independencia Funcional (MIF) fue aplicada en 109 ancianos atendidos en un Centro de Referencia del Anciano. De estos, 60 ancianos fueron clasificados como dependientes para las actividades básicas de la vida diaria y fueron descritos de acuerdo con la Clasificación Internacional de Funcionalidad Incapacidad y Salud (CIF). El proceso de triangulación reforzó la confiabilidad de los datos obtenidos, en el cual consideramos las informaciones de pacientes y acompañantes en conjunto con la ficha médica y evaluación objetiva. RESULTADOS: el promedio de edad fue de 81,0±7,1, con predominancia del género femenino. La diferencia entre la capacidad y el desempeño fue estadísticamente significativa (

Identification and treatment of osteoporosis among elderly patients with hip fractures

OBJECTIVE: To evaluate the profile of osteoporosis treatment among patients hospitalized due to hip fractures at a tertiary-level university hospital. To compare the impact of hospitalization on approaches toward treating bone mass losses. METHOD: The medical records of 123 hip fracture patients aged 60 years and over at the Institute of Orthopedics, Hospital das Clínicas, University of São Paulo School of Medicine, between 2004 and 2006 were reviewed and analyzed with respect to approaches towards investigating osteoporosis and treatments before and after fracture. RESULTS: The patients' mean age was 78 ± 8.3 years, and the majority were women (71.54%). The patients had a mean of 2.72 comorbidities and used 3.26 medications on average. Among these patients, 12.3% reported a previous diagnosis of osteoporosis, and 5.83% were on medication for this. The mean waiting time for surgery was 6.3 ± 7.54 days, and seven patients (5.7%) died during the hospitalization. There were no investigations using bone densitometry, no changes in osteoporosis therapy between admission and discharge (p = 0.375), and no reports of referrals for the patient to have access to treatment. CONCLUSIONS: Investigations and treatments of osteoporosis and strategies for preventing new fractures were not implemented during the hospitalization of these elderly patients with hip fractures, even though this is the most feared complication of osteoporosis. These data need to be disseminated so that professionals dealing with elderly patients are attentive to the need for primary and secondary prevention of osteoporosis because of the impact of fractures on these patients' quality of life, independence, morbidities, and mortality

Identification and Treatment of Osteoporosis among Elderly Patients with Hip Fractures

OBJECTIVE: To evaluate the profile of osteoporosis treatment among patients hospitalized due to hip fractures at a tertiary-level university hospital. To compare the impact of hospitalization on approaches toward treating bone mass losses. METHOD: The medical records of 123 hip fracture patients aged 60 years and over at the Institute of Orthopedics, Hospital das Clínicas, University of São Paulo School of Medicine, between 2004 and 2006 were reviewed and analyzed with respect to approaches towards investigating osteoporosis and treatments before and after fracture. RESULTS: The patients' mean age was 78 ± 8.3 years, and the majority were women (71.54%). The patients had a mean of 2.72 comorbidities and used 3.26 medications on average. Among these patients, 12.3% reported a previous diagnosis of osteoporosis, and 5.83% were on medication for this. The mean waiting time for surgery was 6.3 ± 7.54 days, and seven patients (5.7%) died during the hospitalization. There were no investigations using bone densitometry, no changes in osteoporosis therapy between admission and discharge (p = 0.375), and no reports of referrals for the patient to have access to treatment. CONCLUSIONS: Investigations and treatments of osteoporosis and strategies for preventing new fractures were not implemented during the hospitalization of these elderly patients with hip fractures, even though this is the most feared complication of osteoporosis. These data need to be disseminated so that professionals dealing with elderly patients are attentive to the need for primary and secondary prevention of osteoporosis because of the impact of fractures on these patients' quality of life, independence, morbidities, and mortality

Prognostic Factors for Mortality Among Patients Above the 6th Decade Undergoing Non-Cardiac Surgery: (Cares – Clinical Assessment and Research in Elderly Surgical Patients)

PURPOSE: To ascertain perioperative morbimortality and identify prognostic factors for mortality among patients >55 years who undergo non-cardiac surgery. METHODS: A retrospective cohort of 403 patients relating to perioperative morbidity-mortality. Data were collected from a standardized protocol on gender, age, comorbidities, medications used, smoking, alcohol abuse, chronic use of benzodiazepine, nutritional status, presence of anemia, activities of daily living, American Society of Anesthesiology classification, Detsky's modified cardiac risk index - American College of Physicians, renal function evaluation, pulmonary risk according to the Torrington scale, risk of thromboembolic events, presence of malignant disease and complementary examinations. RESULTS: The mean age of the subjects was 70.8 ± 8.1 years. The "very old" (>80 years) represented 14%. The mortality rate was 8.2%, and the complication rate was 15.8%. Multiple logistic regression showed that a history of coronary heart disease (OR: 3.75; p=0.02) and/or valvular heart disease (OR: 31.79; p=0.006) were predictors of mortality. The American Society of Anesthesiology classification was shown to be the best scale to mark risk (OR: 3.01; p=0.016). Nutritional status was a protective factor, in which serum albumin increases of 1 mg/dl decreased risk by 63%. DISCUSSION: The results indicate that serum albumin, coronary heart disease, valvular heart disease and the American Society of Anesthesiology classification could be prognostic predictors for aged patients in a perioperative setting. In this sample, provided that pulmonary, cardiac and thromboembolic risks were properly controlled, they did not constitute risk factors for mortality. Furthermore, continuous effort to learn more about the preoperative assessment of elderly patients could yield intervention possibilities and minimize morbimortality

Quality of Life and Multimorbidity of Elderly Outpatients

INTRODUCTION: Substantial medical research has established an inverse relationship between quality of life and illness. However, there exists minimal evidence for such a connection in the context of stable and controlled diseases. OBJECTIVE: We wished to correlate multimorbidity with quality of life for elderly patients who suffer from stable chronic diseases. METHODS: We used a tool to evaluate quality of life, namely World Health Organization quality of life-BRIEF, together with a scale of multimorbidity known as the Cumulative Illness Rating Scale - Geriatric Version. Furthermore, the quality of life data were correlated with scores recorded on the Cumulative Illness Rating Scale - Geriatric Version, the number of drugs used, and individual perceptions of health and age. RESULTS: We studied 104 elderly patients who suffered from chronic diseases. The patients had exhibited neither acute events nor secondary complications, their cognition was intact, and they were functionally independent. The Cumulative Illness Rating Scale - Geriatric Version showed an inverse correlation with the physical domain (p= 0.008) and a tendency toward an inverse correlation with the psychological domain (p= 0.052). Self-perception of health showed a high correlation with the physical domain (p= 0.000), psychological domain (p= 0.000) and environmental domain (p= 0.000). The number of drugs used correlated only with the physical domain (p= 0.004). Age and social domain showed a tendency toward a positive correlation (p= 0.054). DISCUSSION: We uncovered an inverse relationship between quality of life and multimorbidity in a group of patients who suffered from stable chronic diseases, with no functional limitations, pain or complications. Our data suggest that a patient's knowledge that they have a certain clinical condition changes their subjective assessment of quality of life in the related domain. CONCLUSION: The perceived quality of life of the sample was affected by multimorbidity in the physical domain, with a tendency toward commensurate effects in the psychological domain

Advanced Glycation in macrophages induces intracellular accumulation of 7-ketocholesterol and total sterols by decreasing the expression of ABCA-1 and ABCG-1

<p>Abstract</p> <p>Background</p> <p>Advanced glycation end products (AGE) alter lipid metabolism and reduce the macrophage expression of ABCA-1 and ABCG-1 which impairs the reverse cholesterol transport, a system that drives cholesterol from arterial wall macrophages to the liver, allowing its excretion into the bile and feces. Oxysterols favors lipid homeostasis in macrophages and drive the reverse cholesterol transport, although the accumulation of 7-ketocholesterol, 7alpha- hydroxycholesterol and 7beta- hydroxycholesterol is related to atherogenesis and cell death. We evaluated the effect of glycolaldehyde treatment (GAD; oxoaldehyde that induces a fast formation of intracellular AGE) in macrophages overloaded with oxidized LDL and incubated with HDL alone or HDL plus LXR agonist (T0901317) in: 1) the intracellular content of oxysterols and total sterols and 2) the contents of ABCA-1 and ABCG-1.</p> <p>Methods</p> <p>Total cholesterol and oxysterol subspecies were determined by gas chromatography/mass spectrometry and HDL receptors content by immunoblot.</p> <p>Results</p> <p>In control macrophages (C), incubation with HDL or HDL + T0901317 reduced the intracellular content of total sterols (total cholesterol + oxysterols), cholesterol and 7-ketocholesterol, which was not observed in GAD macrophages. In all experimental conditions no changes were found in the intracellular content of other oxysterol subspecies comparing C and GAD macrophages. GAD macrophages presented a 45% reduction in ABCA-1 protein level as compared to C cells, even after the addition of HDL or HDL + T0901317. The content of ABCG-1 was 36.6% reduced in GAD macrophages in the presence of HDL as compared to C macrophages.</p> <p>Conclusion</p> <p>In macrophages overloaded with oxidized LDL, glycolaldehyde treatment reduces the HDL-mediated cholesterol and 7-ketocholesterol efflux which is ascribed to the reduction in ABCA-1 and ABCG-1 protein level. This may contribute to atherosclerosis in diabetes mellitus.</p

Potentialities of the extraction technologies and use of bioactive compounds from winery by-products: a review from a circular bioeconomy perspective

Agro-industrial by-products and by-products from the wine industry (pomace, peels, leaves, stems, and seeds) represent a potential economic interest because they are usually relevant natural sources of bioactive compounds, which may present significant biological activities related to human health and well-being. This article aims to review wine and winery industry by-products as potential natural sources of antioxidant, antimicrobial, anti-inflammatory, antiaging, and anticancer compounds, as well as briefly highlighting the extraction methods used to obtain these bioactive compounds and explore their potential applications in the food, cosmetic, and packaging industries. Although there are some studies of wine industry by-products with different origins, this revision will be mainly focused on the Portuguese vineyard industry since it represents an import industrial sector as proof of the diversity of the bioactive compounds identified. Therefore, the recovery of these bioactive molecules that act as antioxidants and health-promoting agents may promote a variety of industries at the same time as the circular economy.info:eu-repo/semantics/publishedVersio

A roda de conversa como ferramenta de planejamento de ações:: relato de experiência

INTRODUÇÃO:&nbsp;As rodas de conversas são espaços coletivos usados para a discussão e reflexão sobre diversos temas, podendo ser utilizada para distintos fins inclusive para o planejamento de ações.&nbsp;OBJETIVO:&nbsp;Relatar a experiência vivenciada por enfermeiras a partir do uso da metodologia da roda de conversa com a comunidade no contexto do planejamento das ações em saúde.&nbsp;MATERIAIS E MÉTODOS:&nbsp;Trata-se de um relato de experiência acerca do uso da roda de conversa como ferramenta de atuação na comunidade. As rodas foram realizadas em equipamentos sociais do território de abrangência de uma Unidade Básica de Saúde da zona Leste do município de Teresina com finalidade de discutir o processo saúde-doença e participação popular no planejamento das ações que seriam desenvolvidas neste território.&nbsp;RESULTADOS:&nbsp;Neste estudo a roda de conversa foi utilizada como estratégia para participação popular no planejamento de ações. Inicialmente o facilitador lançou o questionamento “o que significa saúde para você?” e diversos conceitos foram expressos, alguns relataram que saúde é ter disposição pra trabalhar todos os dias, é não ter nenhum tipo de doença e estar em paz consigo. Alguns referiram que saúde é ter assistência hospitalar de qualidade, médico para atender a comunidade e medicação disponível. Em seguida o facilitador discutiu saúde como responsabilidade de todos, pactuando os eixos norteadores para o plano de trabalhado de acordo com as necessidades locais.&nbsp;CONCLUSÃO:&nbsp;Possibilitou a escuta e a participação popular no planejamento das ações de promoção da saúde. &nbsp