Ausência De Expectativa De Suporte Para O Cuidado Aos Idosos Da Comunidade

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Combined Effect of Dynapenia (Muscle Weakness) and Low Vitamin D Status on Incident Disability

BACKGROUND AND OBJECTIVE: There is little epidemiologic evidence considering the combined effect of dynapenia and low 25-hydroxyvitamin D [25 (OH) D] on incident disability. Our aim was to investigate whether the combination of dynapenia and low 25 (OH) D serum levels increases the risk of activities of daily living (ADL) incident disability. DESIGN: Prospective cohort study. SETTINGS: English Longitudinal Study of Aging. PARTICIPANTS: A total of 4630 community-dwelling adults aged 50 years and older without ADL disability at baseline. MEASUREMENTS: The baseline sample was categorized into 4 groups (ie, nondynapenic/normal 25 (OH) D, low 25 (OH) D only, dynapenic only, and dynapenic/low 25 (OH) D according to their handgrip strength (<26 kg for men and <16 kg for women) and 25 (OH) D (≤50 nmol/L). The outcome was the presence of any ADL disability 2 years after baseline according to the modified Katz Index. Incidence rate ratios (IRRs) adjusted by sociodemographic, behavioral, and clinical characteristics were estimated using Poisson regression. RESULTS: The fully adjusted model showed that older adults with dynapenia only and those with lower serum levels of 25 (OH) D combined with dynapenia had higher incident ADL disability risk compared with nondynapenic and those with normal serum levels of 25 (OH) D. The IRRs for lower 25 (OH) D serum levels combined with dynapenia were higher than for dynapenia only, however, the confidence intervals (CIs) showed similar effect for these 2 groups. The IRRs were 1.31 for low 25(OH) D only (95% CI 0.99-1.74), 1.77 for dynapenia only (95% CI 1.08-2.88), and 1.94 for combined dynapenia and low 25(OH)D (95% CI 1.28-2.94). CONCLUSIONS: Dynapenia only and dynapenia combined with low 25 (OH) D serum levels were important risk factors for ADL disability in middle-aged individuals and older adults in 2 years of follow-up

Percepção de idosos sobre o papel do psicólogo em instituições de longa permanência

Este trabalho se propôs a descrever a percepção de idosos institucionalizados sobre o papel do profissional psicólogo junto à população abrigada das Instituições de Longa Permanência para Idosos (ILPI) da cidade de Juiz de Fora-MG. O universo da pesquisa abrangeu as instituições cuidadoras e cadastradas junto ao Conselho Municipal do Idoso da referida localidade. Quanto à metodologia, procedeu-se a estudo qualitativo exploratório utilizando a Análise de Conteúdo na perspectiva de Bardin como ferramenta para o tratamento dos dados. Os critérios de inclusão utilizados foram: 1) ser residente em ILPI; 2) ter 60 ou mais anos de idade; 3) aceitar participar; e 4) ser capaz de responder às perguntas formuladas. Constitui-se amostra por conveniência de 34 idosos que apresentaram as seguintes representações acerca do papel do psicólogo: relevância e pertinência de seu trabalho, não percebendo a presença de pontos negativos no trabalho deste profissional nas ILPIs. Identificou-se ainda que as áreas de atuação psicológica mais apontadas foram as relacionadas à prevenção, diagnóstico e tratamento dos residentes naqueles locais

Determination of para-Phenylenediamine (PPD) in Henna in the United Arab Emirates

Henna is very popular in the United Arab Emirates (UAE); it is part of the culture and traditions. Allergy to natural henna is not usual; however the addition of para-phenylenediamine (PPD) to the natural henna increases the risk of allergic contact dermatitis. The objectives of the study were to identify the presence and concentration of PPD in henna available in UAE. Fifteen henna salons were selected randomly from three cities in UAE. Twenty five henna samples were acquired from these selected salons. The presence of PPD in henna samples was determined qualitatively and quantitatively using High Performance Liquid Chromatography (HPLC). The study showed that PPD was present in all of the black henna samples at concentrations ranging between 0.4% and 29.5% and higher than that recommended for hair dyes in most of the black henna samples. The presence of PPD in the black henna increases the risk of allergic contact dermatitis among users of black henna and a number of cases have already been reported in UAE

RELATION BETWEEN MATERNAL THROMBOPHILIA AND STILLBIRTH ACCORDING TO CAUSES/ASSOCIATED CONDITIONS OF DEATH

OBJECTIVE: To investigate maternal thrombophilia in cases of Stillbirth (SB), also an uncertain topic because most case series were not characterised for cause/associated conditions of death. STUDY DESIGN: In a consecutive, prospective, multicentre design, maternal DNA was obtained in 171 cases of antenatal SB and 326 controls (uneventful pregnancy at term, 1:2 ratio). Diagnostic work-up of SB included obstetric history, neonatologist inspection, placenta histology, autopsy, microbiology/chromosome evaluations. Results audited in each centre were classified by two of us by using CoDAC. Cases were subdivided into explained SB where a cause of death was identified and although no defined cause was detected in the remnants, 64 cases found conditions associated with placenta-vascular disorders (including preeclampsia, growth restriction and placenta abruption - PVD). In the remnant 79 cases, no cause of death or associated condition was found. Antithrombin activity, Factor V Leiden, G20210A Prothrombin mutation (FII mutation) and acquired thrombophilia were analysed. RESULTS: Overall, the presence of a thrombophilic defect was significantly more prevalent in mothers with SBs compared to controls. In particular, SB mothers showed an increased risk of carrying Factor II mutation (OR=3.2, 95\% CI: 1.3-8.3, p=0.01), namely in unexplained cases. Such mutation was significantly associated also with previous SB (OR=8.9, 95\%CI 1.2-70.5). At multiple logistic regression, Factor II mutation was the only significantly associated variable with SB (adj OR=3.8, 95\% CI: 1.3-13.5). CONCLUSION: These data suggest that Factor II mutation is the only condition specifically associated with unexplained SB and could represents a risk of recurrence. PVD-associated condition is unrelated to thrombophilia

Prevalence of Neuroradiological Abnormalities in First-Episode Psychosis: A Systematic Review and Meta-analysis

IMPORTANCE: Individuals presenting with first-episode psychosis (FEP) may have a secondary ("organic") etiology to their symptoms that can be identified using neuroimaging. Because failure to detect such cases at an early stage can have serious clinical consequences, it has been suggested that brain magnetic resonance imaging (MRI) should be mandatory for all patients presenting with FEP. However, this remains a controversial issue, partly because the prevalence of clinically relevant MRI abnormalities in this group is unclear. OBJECTIVE: To derive a meta-analytic estimate of the prevalence of clinically relevant neuroradiological abnormalities in FEP. DATA SOURCES: Electronic databases Ovid, MEDLINE, PubMed, Embase, PsychINFO, and Global Health were searched up to July 2021. References and citations of included articles and review articles were also searched. STUDY SELECTION: Magnetic resonance imaging studies of patients with FEP were included if they reported the frequency of intracranial radiological abnormalities. DATA EXTRACTION AND SYNTHESIS: Independent extraction was undertaken by 3 researchers and a random-effects meta-analysis of pooled proportions was calculated. Moderators were tested using subgroup and meta-regression analyses. Heterogeneity was evaluated using the I2 index. The robustness of results was evaluated using sensitivity analyses. Publication bias was assessed using funnel plots and Egger tests. MAIN OUTCOMES AND MEASURES: Proportion of patients with a clinically relevant radiological abnormality (defined as a change in clinical management or diagnosis); number of patients needed to scan to detect 1 such abnormality (number needed to assess [NNA]). RESULTS: Twelve independent studies (13 samples) comprising 1613 patients with FEP were included. Of these patients, 26.4% (95% CI, 16.3%-37.9%; NNA of 4) had an intracranial radiological abnormality, and 5.9% (95% CI, 3.2%-9.0%) had a clinically relevant abnormality, yielding an NNA of 18. There were high degrees of heterogeneity among the studies for these outcomes, 95% to 73%, respectively. The most common type of clinically relevant finding was white matter abnormalities, with a prevalence of 0.9% (95% CI, 0%-2.8%), followed by cysts, with a prevalence of 0.5% (95% CI, 0%-1.4%). CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis found that 5.9% of patients presenting with a first episode of psychosis had a clinically relevant finding on MRI. Because the consequences of not detecting these abnormalities can be serious, these findings support the use of MRI as part of the initial clinical assessment of all patients with FEP