Health services for the elderly through the eyes of the health councilors of the Metropolitan Region of São Paulo : 'who will take care of us in 2030?'

O estudo foi desenvolvido por meio de um recorte da pesquisa: 'Quem cuidará de nós em 2030?'. Sob a ótica dos conselheiros de saúde buscou-se compreender a percepção sobre os serviços oferecidos hoje e os que seriam necessários em 2030 para os idosos. Ao serem questionados sobre possíveis direcionamentos de ações para os dias de hoje e para 2030, a construção e aperfeiçoamento de espaços de convivência foram os mais citados pelos sujeitos. Há clara preferência por programas que propõem fortalecimento de vínculos familiares e comunitários com atividades sócio-ocupacionais e de lazer. Foi percebido que no campo das ações preventivas muito ainda deve ser articulado para garantir qualidade nos serviços.This study of an excerpt of the research 'Who will take care of us in 2030?'. From a health councilor standpoint, this study sough to understand the perception about the health services offered today and the ones expected in 2030 for the elderly. When questioned about possible directions for today and for 2030, the construction and improvement of living centers were always mentioned by the councilors. There is a clear preference for programs that strengthen family and community ties through leisure, social, and occupational activities. It was strongly perceived that large scale preventive actions are needed to guarantee the quality of the services provided

Acute and Chronic Effects of Endurance Running on Inflammatory Markers: A Systematic Review

[EN] In order to understand the effect of endurance running on inflammation, it is necessary to quantify the extent to which acute and chronic running affects inflammatory mediators. The aim of this study was to summarize the literature on the effects of endurance running on inflammation mediators. Electronic searches were conducted on PubMED and Science Direct with no limits of date and language of publication. Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) investigating the acute and chronic effects of running on inflammation markers in runners were reviewed by two researchers for eligibility. The modified Downs and Black checklist for the assesssments of the methodological quality of studies was subsequently used. Fifty-one studies were finally included. There were no studies with elite athletes. Only two studies were chronic interventions. Results revealed that acute and chronic endurance running may affect anti- and pro-inflammatory markers but methodological differences between studies do not allow comparisons or generalization of the results. The information provided in this systematic review would help practitioners for better designing further studies while providing reference values for a better understanding of inflammatory responses after different running events. Further longitudinal studies are needed to identify the influence of training load parameters on inflammatory markers in runners of different levels and training background.DN enjoys a PROSUP grant from CAPES. DB and JP enjoy a productivity research grant from CNPq.The first and second authors would like to thank the support of their families (Rita and Nicolas)

Tratamento ambulatorial dos transtornos do sono em pacientes com doença de Alzheimer

Os transtornos do sono são comuns nos pacientes com doença de Alzheimer e interferem na qualidade de vida do paciente e de seu cuidador. Apesar da alta prevalência desses transtornos, existe pouca evidência em relação ao seu tratamento. Nosso objetivo foi revisar a literatura em relação ao tratamento não farmacológico e farmacológico dos transtornos do sono nos idosos com doença de Alzheimer em comunidade. Os tratamentos incluídos consistiram na higiene do sono e/ou no uso da luz intensa, combinados ou não com o uso da melatonina, nos inibidores de acetilcolinesterases, antipsicóticos, hipnóticos ou antidepressivos. Para além das medidas não farmacológicas, há evidência de que o uso da trazodona é efetivo no tratamento dos transtornos do sono de pacientes com doença de Alzheimer. Mais estudos sobre as estratégias farmacológicas e não farmacológicas aqui revisadas ou outras são desejáveis.Sleep disorders are common in patients with Alzheimer dementia and affect the quality of life of patients and of their caregivers. Despite the rising number of studies in the area, almost all of them are about non-pharmacological treatment. Our objective was to review the literature concerning pharmacological and non-pharmacological approaches to treat sleep disorders of elderly patients with Alzheimer dementia in the ambulatory setting. The treatments revised consisted of sleep hygiene and/or use of intense light coupled or not with use of melatonin, cholinesterase inhibitors, antipsychotics, hypnotics or antidepressants. In addition to the non-pharmacological measures, there is evidence that the use of trazodone may aid the treatment of sleep disorders of older individuals with Alzheimer dementia. More studies are necessary to examine the non-pharmacological and pharmacological treatments revised herein

The influence of intense intermittent versus moderate continuous exercise on postprandial lipemia

INTRODUCTION: Postprandial lipemia is characterized by an increased concentration of circulating lipids after fat intake and is an independent risk factor for cardiovascular disease. Exercise is known to reduce postprandial lipemia and its negative clinical outcomes. OBJECTIVE: This study investigated the effect of intense intermittent versus moderate continuous exercise using the same energy expenditure in postprandial lipemia. MATERIALS AND METHODS: Twenty healthy men (aged 21.5 + 3.5 years) performed a random sequence of either rest or 500 Kcal tests separated by a minimum 48 h interval as follows: (a) no exercise (control), (b) intense intermittent exercise, or (c) moderate continuous exercise. Each test series was completed 30 min before ingestion of a high-fat meal (1 g fat/kg). Venous blood was collected before and at 1, 2, 3 and 4 hours after the high-fat meal. Postprandial lipemia was assessed using the area under the curve approach as well as a kinetic profile of mean lipid variables. Statistical significance was tested at the p<0.05 level. RESULTS: With both statistical approaches, intense intermittent and moderate continuous exercises were both effective in reducing postprandial triglycerides; however, only intense intermittent exercise reduced the levels of postprandial very low density lipoprotein. Intense intermittent and continuous exercise produced lower levels of insulinemia using the area under the curve analysis only. CONCLUSION: Intense intermittent or continuous exercise with an energy expenditure of 500 kcal completed 30 min before ingestion of high-fat meal reduced postprandial lipid levels to different levels in physically active men. Understanding these relevant differences will enable clinicians to provide the best exercise prescription for patients

Obesidade e capacidade funcional podem estar associadas com diversas comorbidades em idosos residentes em instituições de longa permanência

ResumoIntrodução: o envelhecimento é um processo complexo que geralmente ocorre concomitantemente com o declínio e a reformulação das diferentes funções do corpo, dentre as quais, destacam-se as mudanças antropométricas, funcionais e cognitivas, bem como o aparecimento de diversos problemas de saúde. Objetivo: analisar a correlação entre a obesidade e a capacidade funcional com o déficit cognitivo e outras comorbidades em idosos residentes em Instituições de Longa Permanência. Materiais e Métodos: estudo transversal descritivo realizado em 40 idosos de ambos os sexos residentes em Instituições de Longa Permanência. Foram mensurados dados antropométricos, cognitivos e funcionais. As comorbidades foram verificadas com base no prontuário médico. Os dados foram analisados por meio do teste T independente, Teste Qui-Quadrado e Correlação Linear de Pearson. Foi adotado o valor de p&lt;0,05 para apontar as diferenças significativas. O programa SPSS, 22.0 foi usado para realizar as análises. Resultado: o déficit cognitivo foi de 73% para mulheres e 48% para homens. A força de preensão palmar dominante foi de 11,6 ± 7,5 no sexo masculino e 6,2 ± 5,2 no sexo feminino, e não dominante 10,3 ± 6,5 e 5,3 ± 3,8 para masculino e feminino respectivamente. O IMC foi 25,9 ± 3,7 e 28,1 ± 5,0 para homens e mulheres respectivamente. Conclusão: a obesidade e o déficit cognitivo estão elevados entre os idosos institucionalizados. Houve associação do IMC e da força com as comorbidades, porém não com o desempenho cognitivo. Adicionalmente, os resultados dos testes funcionais se mostraram bastante comprometidos, uma vez que estão bastante inferiores aos valores encontrados em outros estudos. AbstractIntroduction: aging is a complex process that usually occurs concomitantly with the decline and the reformulation of the different body functions, among which, the anthropometric, functional and cognitive changes are distinguished, as well as the appearance of several health disorders. Objective: analyze the correlation between obesity and functional capacity with cognitive impairment and other comorbidities in the elderly living in long-stay institutions. Materials and Methods: descriptive cross-sectional study conducted in 40 elderly of both genders, who live in LSI. Anthropometric, cognitive and functional data were measured. Comorbidities were verified based in medical records. Data were analyzed using independent T test, chi-square test and Pearson’s linear correlation. It was adopted p value &lt;0.05 to point out the significant differences. Result: cognitive impairment was 73% for women and 48% for men. The strength of dominant handgrip was 11.6 ± 7.5 in males and 6.2 ± 5.2 in females, and non-dominant 10.3 ± 6.5 and 5.3 ± 3.8 for male and female respectively. BMI was 25.9 ± 3.7 and 28.1 ± 5.0 for men and women respectively. Conclusion: obesity and cognitive impairment are high among the institutionalized elderly. There was an association of BMI and strength with comorbidities, but not with cognitive performance. Additionally, the results of the functional tests showed much compromised, since they are well below than the values found in other studies. figshare DOI: 10.6084/m9.figshare.819860

The role of the NIS (SLC5A5) gene in Papillary thyroid cancer : a systematic review

Papillary thyroid cancer (PTC) is the most common thyroid malignancy. Genetic and epigenetic alterations play a decisive role in the onset of several human neoplasms. Mutations and polymorphisms are two frequent genetic alterations. Located on chromosome 19 (19p13.11), the NIS SLC5A5 (solute carrier family 5 member 5) gene encodes a highly specialized and efficient 80–90 kDa transmembrane glycoprotein that mediates active transport of iodide from the bloodstream into the follicular cells. Given the highly significant role of NIS in the physiology and the cancer pathogenesis process, this paper’s objective is to provide a comprehensive assessment of the associations between NIS gene and protein with papillary thyroid cancer

Panoramic snapshot of serum soluble mediator interplay in pregnant women with convalescent COVID-19: an exploratory study

IntroductionSARS-CoV-2 infection during pregnancy can induce changes in the maternal immune response, with effects on pregnancy outcome and offspring. This is a cross-sectional observational study designed to characterize the immunological status of pregnant women with convalescent COVID-19 at distinct pregnancy trimesters. The study focused on providing a clear snapshot of the interplay among serum soluble mediators.MethodsA sample of 141 pregnant women from all prenatal periods (1st, 2nd and 3rd trimesters) comprised patients with convalescent SARS-CoV-2 infection at 3-20 weeks after symptoms onset (COVID, n=89) and a control group of pre-pandemic non-infected pregnant women (HC, n=52). Chemokine, pro-inflammatory/regulatory cytokine and growth factor levels were quantified by a high-throughput microbeads array.ResultsIn the HC group, most serum soluble mediators progressively decreased towards the 2nd and 3rd trimesters of pregnancy, while higher chemokine, cytokine and growth factor levels were observed in the COVID patient group. Serum soluble mediator signatures and heatmap analysis pointed out that the major increase observed in the COVID group related to pro-inflammatory cytokines (IL-6, TNF-α, IL-12, IFN-γ and IL-17). A larger set of biomarkers displayed an increased COVID/HC ratio towards the 2nd (3x increase) and the 3rd (3x to 15x increase) trimesters. Integrative network analysis demonstrated that HC pregnancy evolves with decreasing connectivity between pairs of serum soluble mediators towards the 3rd trimester. Although the COVID group exhibited a similar profile, the number of connections was remarkably lower throughout the pregnancy. Meanwhile, IL-1Ra, IL-10 and GM-CSF presented a preserved number of correlations (≥5 strong correlations in HC and COVID), IL-17, FGF-basic and VEGF lost connectivity throughout the pregnancy. IL-6 and CXCL8 were included in a set of acquired attributes, named COVID-selective (≥5 strong correlations in COVID and &lt;5 in HC) observed at the 3rd pregnancy trimester.Discussion and conclusionFrom an overall perspective, a pronounced increase in serum levels of soluble mediators with decreased network interplay between them demonstrated an imbalanced immune response in convalescent COVID-19 infection during pregnancy that may contribute to the management of, or indeed recovery from, late complications in the post-symptomatic phase of the SARS-CoV-2 infection in pregnant women