Complicações Cardiovasculares Associadas à Infeção por COVID-19

Introduction: Reports of cardiovascular complications related to the COVID-19 infection have been frequent. Methods: Narrative review for relevant articles on the topic. The classic cardiovascular risk factors, like age, obesity, diabetes, and hypertension are associated with adverse outcomes in COVID-19 patients. Cardiovascular complications can have a diverse clinical presentation including silent myocardial injury, acute coronary syndromes, thromboembolism, cardiac arrhythmias, and heart failure. There are multiple mechanisms of cardiac injury that are not mutually exclusive. The approach to diagnosis and management should be carried out according to usual practice, while considering the particularities of COVID-19 infection. Conclusion: The interaction between SARS-CoV-2 and the heart is complex and is manifested in multiple ways. Regardless of the clinical presentation, cardiac complications convey a worse prognosis. Patients should be actively monitored and treated accordingly.info:eu-repo/semantics/publishedVersio

Cerebral Venous Thrombosis Imagiologic Features in a Pregnant Woman

A trombose venosa cerebral (TVC) é uma doença relativamente rara mas grave, potencialmente reversível com diagnóstico atempado e terapêutica médica adequada. A gravidez e o puerpério são um factor predisponente de TVC, que é responsável por 6% das causas de morte materna. As manifestações clínicas dependem da localização, extensão do trombo, bem como da rede de colaterais existente. Apresentamos o caso duma doente do sexo feminino, 33 anos, grávida de 13 semanas que recorreu ao serviço de urgência por quadro de cefaleias e cujo estudo por Ressonância Magnética revelou aspectos compatíveis com doença venosa oclusiva subtotal do seio longitudinal superior em fase aguda. A propósito deste caso discutimos as manifestações imagiológicas da trombose venosa dural na fase aguda

Elderly people with limited mobility: their families and the implications of their dependency

INTRODUCTION AND OBJECTIVES. The family has su'ered several changes throughout the times, leading to many elderly people living alone or with other elderly. In a family the situation of the elderly that depended on others can compromise the family’s relationships, which leads to little availability to motivate them to mobilization. The objective of the study was to understand the way the family functions in view of to the dependence of the elderly with limited mobility in a community context. METHODOLOGY. Descriptive study, exploratory of a quantitive character. The data was gathered through a questionnaire, including the Lawton & Brody (1969) scales, the lifestyle pro+le (Nahas, 2013) and the familiar APGAR (Smilkstein, 1978). Nonprobabilistic sample, composed by 1298 elderly with limited mobility, from 26 civil parishes from the municipality of Vila Nova de Famalicão. RESULTS AND DISCUSSION. Most of the people polled considered that his own family was a functional one (64.8%) and 49.6% were moderately dependent. By analysing the physical activity lifestyle pro+le and the familiar functionality one could conclude that 65.2% had a positive pro+le, presenting typical behaviours of an active lifestyle. We think that the fact that 73.1% are inserted in functional families had something to do with it. We have veri+ed a perfect association (p = 0.000) between dependency, lifestyle physical activity and familiar functionality – APGAR. CONCLUSIONS: The results show that the family determines the lifestyle physical activity and the elderly’s dependency. A functional family in<uences a positive physical activity pro+le, even in the elderly with limited mobility.info:eu-repo/semantics/publishedVersio

Terapia por caja espejo y autonomía en el autocuidado después de un accidente cerebrovascular: programa de intervención

Enquadramento: Nos doentes com acidente vascular cerebral (AVC) da artéria cerebral média (ACM), a alteração da função do membro superior conduz à dependência no autocuidado. No processo de reconstrução da autonomia/independência, existe evidência da efetividade dos métodos com estímulos sensoriais na recuperação motora após o AVC. Objetivo: Avaliar o contributo da terapia por caixa de espelho para a autonomia no autocuidado nos doentes com hemiplegia/hemiparesia, por AVC da ACM. Metodologia: Estudo transversal, quase-experimental, com abordagem quantitativa, desenho pré-programa/pós- -programa com grupo controlo não equivalente. Amostra não probabilística de 30 participantes. Resultados: Verificaram-se ganhos na força de preensão, amplitude articular e destreza manual do membro superior, mais expressivos no grupo experimental mas sem diferenças estatisticamente significativas entre grupos. Conclusão: Apesar da evolução mais expressiva do grupo experimental, a terapia por caixa de espelho não se revelou efetiva na recuperação motora do membro superior, pelo que, é necessário continuar a investigação nesta área com desenhos randomizados, amostras maiores e direcionada para o autocuidado.Background: In patients with middle cerebral artery (MCA) stroke, changes in upper limb function lead to dependence on others for self-care. In the process of recovering autonomy/independence, there is evidence on the effectiveness of sensory stimulation techniques in the motor recovery after stroke. Objective: To assess the effect of mirror therapy on the self-care autonomy of patients with hemiplegia/hemiparesis due to MCA stroke. Methodology: Cross-sectional and quasi-experimental study with a quantitative approach, a before-and-after design, and a non-equivalent control group. A nonprobability sample of 30 participants was selected. Results: Gains in grip strength, joint range of motion, and manual dexterity of the upper limb were more significant in the experimental group but without statistically significant differences between groups. Conclusion: Despite the more significant evolution of the experimental group, mirror therapy was not effective in the motor recovery of the upper limb. Further studies are needed in this area using randomized designs, larger samples, and focused on self-care.Marco contextual: En los pacientes que han sufrido un accidente cerebrovascular (ACV) en la arteria cerebral media (ACM), la alteración de la función del miembro superior lleva a ser dependientes en el autocuidado. En el proceso de reconstrucción de la autonomía/independencia, existen pruebas de la efectividad de los métodos con estímulos sensoriales en la recuperación motora después del ACV. Objetivo: Evaluar la contribución de la terapia por caja espejo para la autonomía en el autocuidado en los pacientes con hemiplejia/hemiparesia por ACV de la ACM. Metodología: Estudio basado en el paradigma cuantitativo, de naturaleza transversal y carácter cuasiexperimental, con un diseño preprograma/posprograma con un grupo de control no equivalente. Muestra de 30 participantes sin repartir aleatoriamente. Resultados: Se observaron beneficios en la fuerza de prensión, amplitud articular y destreza manual del miembro superior, más llamativos en el grupo experimental pero sin diferencias estadísticamente significativas entre grupos. Conclusión: A pesar de la evolución más llamativa del grupo experimental, la terapia por caja espejo no se mostró efectiva en la recuperación motora del miembro superior, por lo que es necesario continuar la investigación en esta área con diseños aleatorizados, muestras mayores y dirigida al autocuidado.info:eu-repo/semantics/publishedVersio

Violence Against the Elderly: Social Representations of Portuguese and Brazilian Caregivers

The increase in life expectancy and elderly people in society, coupled with changes in family structure, have highlighted the importance of formal and informal caregivers of elderly people. Objective: To analyse the social representations of violence against the elderly, of two groups of formal and informal caregivers. Methods: Exploratory, quantitative and qualitative research, supported by the theoretical-methodological reference of the Social Representations Theory and in the context of this, the Central Core Theory. The sample was participated in by 81 formal caregivers from the project “Aging in Safety in the Alentejo - Understanding to Act, of the University of Évora” and 20 informal caregivers from the project “Qualification of caregivers and aspects related to the quality of life of the elderly people dependent on primary and tertiary care: Implementation and protocol evaluation, of the State University of Southwest of Bahia”. We used the Free Word Association Technique. The data was analysed by prototypical analysis based on two matrices by the software IRAMUTEQ (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) 0.7 alpha 2. Results: In Portugal, the elements “bad, mistreatment, I will be, sad, anger, patience, physical, injustice, irritation and meanness” stood out in the central core. In Brazil the mention of “hitting” was emphasized. Conclusions: In both Portugal and Brazil, physical violence takes on particular significance in the social representations of caregivers, rather than verbal and psychological violence, which is not present in the central core of social representations of violence against the elderly in either of the countries

Non-Vitamin K Oral Anticoagulants Assessment in High Risk of Bleeding Patients with Non-Valvular Atrial Fibrillation

Atrial fibrillation (AF) is commonly associated with advanced age and the presence of multiple, concomitant acute and chronic health conditions, placing this population at high risk for serious therapeutic side effects. Nonvitamin K antagonist oral anticoagulants (NOACs) are increasingly used for stroke prevention in patients with atrial fibrillation. The purpose of this study was to investigate the effectiveness and safety of NOAC in a group at high risk of bleeding complications, in a real-world setting. We conducted a retrospective analysis of a high-risk cohort of 418 patients (pts) followed-up in our anticoagulation unit; data on patient characteristics, anticoagulation treatment, and bleeding and thrombotic complications were evaluated. The population had a median age of 77.8 ± 10.3 years and the mean CHA2DS2-VASc score was 3.85 (SD ± 1.4). Overall, 289 (69.1%) were ≥75 years old. During a mean follow-up time of 51.2 ± 35.7 months, we observed a rate of any bleeding of 7, a clinically relevant non-major bleeding rate of 4.8, a major bleeding rate of 2.2, a stroke rate of 1.6, and a rate of thrombotic events of 0.28 per 100 patient-years. There were 59 hospitalizations due to any cause (14.1%) and 36 (8.6%) deaths (one due to ischemic stroke). A structured follow-up, with judicious prescribing and drug compliance, may contribute to preventing potential complicationsinfo:eu-repo/semantics/publishedVersio