Fatores associados à qualidade de vida percebida em adultos mais velhos: ELSI-Brasil

OBJETIVO: Identificar fatores associados à qualidade de vida percebida em amostra nacional representativa da população com 50 anos ou mais. MÉTODOS: Foram utilizados dados de 7.651 participantes da linha de base do ELSI-Brasil, conduzida entre 2015 e 2016. A qualidade de vida percebida foi aferida pela escala CASP-19, considerando-se como boa qualidade de vida percebida o tercil mais alto. As variáveis independentes incluíram características sociodemográficas, mobilidade, solidão, redes sociais, apoio social e participação social. As associações foram testadas por meio de regressão de Poisson multivariada. RESULTADOS: A melhor qualidade de vida percebida apresentou associação positiva e independente com a frequência de encontros com amigos (RP = 1,25 para pelo menos uma vez a cada 2–3 meses e RP = 1,36 para pelo menos uma vez por semana), suporte instrumental dentro de casa, de cônjuge ou companheiro (RP = 1,69) e suporte emocional de outros parentes (RP = 1,45), de filho, nora ou genro (RP = 1,41) e do cônjuge ou companheiro(a) (RP = 1,33). Associações negativas foram observadas para idade igual ou superior a 80 anos (RP = 0,77), escolaridade igual a 4–7 e 8 anos ou mais (RP = 0,78 e 0,75, respectivamente) e dificuldade na mobilidade (RP = 0,83). CONCLUSÕES: Além da idade e da escolaridade, a mobilidade, a sociabilidade e o suporte instrumental e emocional estão associados à qualidade de vida percebida entre adultos mais velhos brasileiros. Essas características devem ser consideradas nas ações visando à promoção da qualidade de vida dessa população.OBJECTIVE: To identify factors associated with perceived quality of life in a representative national sample of the population aged 50 or over. METHODS: Data from 7,651 participants of the baseline ELSI-Brazil (Brazilian Longitudinal Study of Aging), conducted between 2015 and 2016, were used. The perceived quality of life was measured by the CASP-19 scale - (CASP - control, autonomy, self-fulfillment and pleasure), considering the highest tertile as good quality of life. The independent variables included socio-demographic characteristics, mobility, loneliness, and indicators of sociability (social network, social support and social participation). The associations were tested using multivariate Poisson regression. RESULTS: The best perceived quality of life showed a positive and independent association with the frequency of contacts with friends (PR = 1.25 for at least once every 2–3 months and PR = 1.36 for at least once a week), instrumental support from spouse or partner in the household (PR = 1.69), and emotional support from other relatives (PR = 1.45), children or children in law (PR = 1.41) and spouse or partner (PR = 1.33). Negative associations were observed for participants aged 80 and over (RP = 0.77), with 4 to 7 or 8 or more years of schooling (PR = 0.78 and 0.75, respectively) and with difficulty in mobility (PR = 0.83). CONCLUSIONS: In addition to age and schooling, mobility, sociability and instrumental and emotional support are associated with perceived quality of life among older Brazilian adults. These characteristics must be considered when actions are taken, aiming to promote quality of life in this population

Social roles and aging from a life-span perspective

Este trabalho investigou os papéis sociais e as tarefas evolutivas desempenhados por adultos. O local escolhido para investigação foi um assentamento de famílias de baixa renda do Distrito Federal criado em 1989. Utilizou-se um questionário contendo 17 questões abertas e 15 questões fechadas, preenchido pela primeira autora durante uma visita domiciliar. Participaram 98 respondentes (73 F e 25 M), sendo 51 entre 50 e 59 anos e 47 a partir de 60 anos. Os resultados apontaram que este grupo é heterogêneo e que seus papéis sociais são influenciados pelas variáveis demográficas (idade, sexo, escolaridade, ocupação, naturalidade e estado civil) e também pelas variáveis relativas à moradia atual. Concluiu-se também que as expectativas sociais, o suporte social e a escolarização são fatores de suma importância para oferecer recursos para a otimização e compensação necessárias a um envelhecimento bem sucedido. __________________________________________________________________________________________________________ ABSTRACTThis study investigated the social roles and developmental tasks of adults. The study took place in a settlement of low-income families, created in The Federal District in 1989. Data were collected through a questionnaire composed of 17 open and 15 closed questions, administered by the first author during a home visit. There were 98 respondents, 73 female and 25 male, being 51 between 50 to 59 years old and 47 elders above the age of 60. The result indicated that this group is heterogeneous and that its social roles are influenced by the demographic variables - age, sex, educational level, work, place of the birth and marital status, as well for the relative variables to current residence. The data allow the conclusion that social expectations, social support and the educational level are important resources for the optimization and necessary compensation to successful aging

Disparidades de acesso à cirurgia de correção de hérnias inguinais no Brasil

A hernioplastia inguinal é frequente na Cirurgia Geral e pode ser utilizada como indicador de qualidade cirúrgica no Brasil, país com múltiplas desigualdades. Foram coletados dados sobre 722.140 correções cirúrgicas de hérnias inguinais, realizadas de 2017 a 2022, no DATASUS, por região geográfica. A análise geoespacial foi realizada com o Índice de Moran. O número total de hernioplastia inguinal bilateral ressaltou diferenças regionais - 48,45% no Sudeste (45.037), 23,49% no Nordeste (21.835), 10,92% no Sul (10.150), 9,48% no Norte (8.814) e 7,67% no Centro-Oeste (7.128). O número de hernioplastia inguinal por videolaparoscopia por 100.000 habitantes apresentou significativo predomínio no Sul (0,58 - 1,59%), maior porcentagem geral em 2022 e menor em 2020 e 2021. A taxa de mortalidade por hérnia inguinal tem relevância regional, com maior amplitude no Centro-Oeste (0,12 - 0,41) e menores marcadores no Norte (0,09 - 0,25). Observou-se uma queda total na realização de hernioplastias inguinais entre 2020 e 2021 atribuída às limitações da pandemia da COVID-19. Fatores econômicos e geográficos, como a dificuldade e desigualdade no acesso ao cuidado cirúrgico, culminaram em diagnósticos tardios e complicações que explicam as amplas e díspares taxas de mortalidade encontradas. O uso da via laparoscópica apresenta uma concentração no Sul e Sudeste, refletindo a desigualdade na distribuição de tecnologia médica no país. É fundamental investir no desenvolvimento de técnicas reprodutíveis, seguras e economicamente viáveis para garantir o acesso igualitário ao cuidado cirúrgico. As disparidades geográficas na realização da hernioplastia inguinal devem ser combatidas e a Cirurgia Global priorizada

Autologous anti-GD2 CAR T cells efficiently target primary human glioblastoma

Glioblastoma (GBM) remains a deadly tumor. Treatment with chemo-radiotherapy and corticosteroids is known to impair the functionality of lymphocytes, potentially compromising the development of autologous CAR T cell therapies. We here generated pre-clinical investigations of autologous anti-GD2 CAR T cells tested against 2D and 3D models of GBM primary cells. We detected a robust antitumor effect, highlighting the feasibility of developing an autologous anti-GD2 CAR T cell-based therapy for GBM patients

Marine phycotoxin levels in shellfish-14 years of data gathered along the Italian coast

Along the Italian coasts, toxins of algal origin in wild and cultivated shellfish have been reported since the 1970s. In this study, we used data gathered by the Veterinary Public Health Institutes (IZS) and the Italian Environmental Health Protection Agencies (ARPA) from 2006 to 2019 to investigate toxicity events along the Italian coasts and relate them to the distribution of potentially toxic species. Among the detected toxins (OA and analogs, YTXs, PTXs, STXs, DAs, AZAs), OA and YTX were those most frequently reported. Levels exceeding regulatory limits in the case of OA (≤2,448 μg equivalent kg-1) were associated with high abundances of Dinophysis spp., and in the case of YTXs (≤22 mg equivalent kg-1) with blooms of Gonyaulax spinifera, Lingulodinium polyedra, and Protoceratium reticulatum. Seasonal blooms of Pseudo-nitzschia spp. occur all along the Italian coast, but DA has only occasionally been detected in shellfish at concentrations always below the regulatory limit (≤18 mg kg-1). Alexandrium spp. were recorded in several areas, although STXs (≤13,782 μg equivalent kg-1) rarely and only in few sites exceeded the regulatory limit in shellfish. Azadinium spp. have been sporadically recorded, and AZAs have been sometimes detected but always in low concentrations (≤7 μg equivalent kg-1). Among the emerging toxins, PLTX-like toxins (≤971 μg kg-1 OVTX-a) have often been detected mainly in wild mussels and sea urchins from rocky shores due to the presence of Ostreopsis cf. ovata. Overall, Italian coastal waters harbour a high number of potentially toxic species, with a few HAB hotspots mainly related to DSP toxins. Nevertheless, rare cases of intoxications have occurred so far, reflecting the whole Mediterranean Sea conditions

Influence of Antisynthetase Antibodies Specificities on Antisynthetase Syndrome Clinical Spectrum TimeCourse

Introduction: Increased cardiovascular (CV) morbidity and mortality is observed in inflammatory joint diseases (IJDs) such as rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. However, the management of CV disease in these conditions is far from being well established.Areas covered: This review summarizes the main epidemiologic, pathophysiological, and clinical risk factors of CV disease associated with IJDs. Less common aspects on early diagnosis and risk stratification of the CV disease in these conditions are also discussed. In Europe, the most commonly used risk algorithm in patients with IJDs is the modified SCORE index based on the revised recommendations proposed by the EULAR task force in 2017.Expert opinion: Early identification of IJD patients at high risk of CV disease is essential. It should include the use of complementary noninvasive imaging techniques. A multidisciplinary approach aimed to improve heart-healthy habits, including strict control of classic CV risk factors is crucial. Adequate management of the underlying IJD is also of main importance since the reduction of disease activity decreases the risk of CV events. Non-steroidal anti-inflammatory drugs may have a lesser harmful effect in IJD than in the general population, due to their anti-inflammatory effects along with other potential beneficial effects.This research was partially funded by FOREUM—Foundation for Research in Rheumatolog