Diabetes em idosos e longevos : dados da Pesquisa Nacional de Saúde

Introdução: Nos últimos anos o Brasil vem passando por um acelerado e progressivo envelhecimento da população. A expectativa de vida é diretamente proporcional à prevalência de doenças crônicas não transmissíveis, perdas da independência funcional e autonomia. O Diabetes nos idosos está relacionado a um risco maior de morte prematura e maior associação com outras comorbidades. Objetivo: Descrever o conhecimento e práticas realizadas para o tratamento do diabetes em idosos e longevos Metodologia: Estudo descritivo com dados da Pesquisa Nacional de Saúde de 2013, com idosos (60 a 79 anos) e longevos (80 anos ou mais) que possuem diabetes (auto referido). Resultados: O número de idosos e longevos que referiram diagnóstico de diabetes na amostra foi de 1896, sendo 1648 idosos (60 a 79 anos) e 248 longevos (acima de 80 anos). Foi identificado que em média dos idosos diabéticos 89% manifestaram alguma complicação advinda da doença e 36% destes referiram que as complicações do diabetes limitam de pouco a muito intensamente as suas atividades habituais. Hábitos de vida saudáveis são a base do tratamento do diabetes em idosos, sobre a qual pode ser acrescido ou não o tratamento farmacológico. Conclusão: O acompanhamento e avaliação nutricional são imprescindíveis desde o início da doença para prevenir e/ou retardar as manifestações das complicações do diabetes, assim melhorando a qualidade de vida desses indivíduos em idade avançada.Introduction: Recently, Brazil has been experiencing an accelerated and progressive population’s aging. Life expectancy is directly proportional to the prevalence of chronic diseases, loss of functional independence and autonomy. DM in the elderly is related to an increased risk of premature death, a greater association with other comorbidities. Objective: It is to analyze health data on diabetes in the elderly and long-lived in the Pesquisa Nacional de Saúde (in free translation: National Health Survey). Methodology: This is a descriptive study based on secondary data. The analyzes were performed with a sample of elderly (60 to 79 years) and long-lived (80 years or older) who have diabetes (self-reported). Results: The number of elderly and long-lived patients who reported a diagnosis of diabetes in this sample was 1896, 1648 elderly (60 to 79 years) and 248 elderly (over 80 years). Among the main results were identified that, on average, 89% of the diabetic elderly showed some complication from the disease and 36% of those reported that the complications from diabetes limit their everyday activities by a little or very intensely. Healthy life habits are the basis for the treatment of diabetes on elderly, on which could be added or not a pharmacological treatment. Conclusion: Nutritional monitoring and evaluation are essential since the beginning of the disease to prevent and/or delay manifestations of diabetes complications, as well as improving the life’s quality of people

Association of Subjective Global Assessment and adductor pollicis muscle thickness with the Sarcopenia in older patients with type 2 diabetes

Background and Aim: Sarcopenia is prevalent in older patients and increases the risk for negative outcomes during hospitalization and after hospital discharge. In patients with type 2 diabetes (T2D) this association may be even worse. Upon hospital admission, it is often difficult to identify sarcopenia, so the objective of this study was to assess whether the subjective global assessment (SGA), the European Society for Clinical Nutrition and Metabolism (ESPEN) and Global Leadership Initiative on Malnutrition (GLIM) criteria and/or usual anthropometric measures can predict sarcopenia. A secondary objective, to evaluate the accuracy of variables in the prediction of sarcopenia. Methodology: Patients 60 years old and with T2D were included. Malnutrition was evaluated in accordance with the guidelines of ESPEN and GLIM, and SGA. Anthropometric measurements were performed by Mid-arm circumference (MAC), mid-upper arm muscle circumference (MUAMC), and adductor pollicis muscle thickness (APMT) was performed. The sarcopenia was evaluated by handgrip strength, timed Up and Go (TUG) test and muscle mass by measuring the calf circumference (CC). Logistic regression was performed to assess the association of variables with Sarcopenia. Results: A total of 311 patients were included. The prevalence of malnutrition in accordance to ESPEN, GLIM and SGA was 18 (5.8%), 65 (21%) and 15 (4%), respectively. The MAC and MUAMC showed a negative relationship with sarcopenia (HR: 0.92 CI95% 0.85-0.99). However, patients with overweight had a 66% reduction in the risk of sarcopenia (HR: 0.34 CI95% 0.19-0.59). After adjustments, malnourished patients according to the SGA had a risk of HR: 5.65 (CI95% 1.64-19.38) of sarcopenia, similarly to patients with APMT <5 th HR: 2.81 (CI95% 1.53-5.13), ESPEN and GLIM criteria presented HR:3.10 (CI95%1.12-8.22) and HR:2.94 (CI95%1.64-5.27), respectively. The interaction between SGA and APMT after adjusting the model has been significant (HR: 7.23 CI95% 2.98-17.67). In the area under the curve (ROC), only SGA and APMT showed greater accuracy in the prediction of sarcopenia (AUC: 0.713 CI95% 0.650-0.803). Conclusion: In our sample, it was possible to predict sarcopenia through the malnutrition criteria of ESPEN and GLIM, SGA, MAC and APMT. Measures such as APMT associated with the SGA tool seem to better predict sarcopenia in older patients with T2D

Critérios relacionados à alta hospitalar segura do recém-nascido: Uma revisão integrativa

Objective: To identify the main criteria evidenced by the literature published on newborns’ hospital discharge. Method: This is an integrative literature review, carried out in December 2021 in the PubMed/Medline, BVS, Scopus and LILACS databases, using the “patient discharge summaries” OR “patient discharge” AND “newborn” descriptors. The study was based on PRISMA methodological procedures, eligibility criteria were adopted, and the inclusion criteria were as follows: articles available in full, published in the last 5 years in English, Spanish and Portuguese and dealing with newborn care, hospital discharge or neonatal patient discharge. All articles that did not meet the research objective and/or were not related to the topic under study were excluded. Results: Of the 94 articles identified between 2017 and 2021, 12 studies were included, most from Brazil and with a qualitative approach. Three thematic analysis categories were established: 1) Biophysiological parameters; 2) Communication and guidelines for parents: weaknesses and strengths of the family; and 3) Post-discharge care: network follow-up. Conclusion: According to the selected bibliography, it is concluded that newborns’ safe hospital discharge requires attention to the physiological, communication with the family and intersectoral aspects for network follow-up.Objetivo: Identificar los principales criterios evidenciados por la literatura científica involucrados en el alta hospitalaria segura del recién nacido. Método: Revisión integrativa de la literatura, realizada en diciembre de 2021 en las bases de datos Pubmed/Medline, BVS, Scopus, Lilacs, utilizando los descriptores “patient high summaries” OR “patient high” AND “newborn”. El estudio se basó en los procedimientos metodológicos PRISMA, se adoptaron criterios de elegibilidad y criterios de inclusión: artículos disponibles en su totalidad, publicados en los últimos 5 años, en inglés, español y portugués que versan sobre la atención del recién nacidos, el alta hospitalaria o el alta del paciente neonatal. Se excluyeron todos los artículos que no cumplieran con el objetivo de la investigación y/o no tuvieran relación con el tema en estudio. Resultados: De los 94 artículos identificados entre 2017 y 2021, se incluyeron 12 estudios, la mayoría de Brasil y con abordaje cualitativo. Se establecieron tres categorías temáticas de análisis: 1) Parámetros biofisiológicos; 2) Comunicación y orientación a los padres: fragilidades y potencialidades de la familia; y 3) Atención posterior al alta y seguimiento en red. Conclusión: Según a la bibliografía seleccionada, se concluye que el alta hospitalaria segura de los recién nacidos requiere atención a aspectos fisiológicos, de comunicación con la familia e intersectoriales para el seguimiento en red.Objetivo: Identificar os principais critérios evidenciados pela literatura científica envolvidos na alta hospitalar segura do recém-nascido. Método: Trata-se de uma revisão integrativa da literatura, realizada em dezembro de 2021 nas bases de dados Pubmed/ Medline, BVS, Scopus, Lilacs, utilizando-se os descritores “patient discharge summaries" OR “patient discharge” AND “newborn”. O estudo foi fundamentado pelos procedimentos metodológicos PRISMA, foram adotados critérios de elegibilidade, critérios de inclusão: artigos disponíveis na íntegra, publicados nos últimos 5 anos, nos idiomas inglês, espanhol e português que versassem sobre cuidados ao recém-nascido, alta hospitalar ou alta do paciente neonatal. E de exclusão: todos os artigos que não atendiam ao objetivo da pesquisa e ou não possuíam relação com o tema em estudo. Resultados: Dos 94 artigos identificados entre 2017 e 2021 foram incluídos 12 estudos, sendo a maioria do Brasil e de abordagem qualitativa. Foram estabelecidas três categorias temáticas de análise: 1) Parâmetros biofisiológicos; 2) Comunicação e orientação aos pais: fragilidades e potencialidades da família; e 3) Cuidados pós alta e seguimento de rede. Conclusão: De acordo com a bibliografia selecionada está concluído que a alta hospitalar segura de recém-nascidos requer atenção aos aspectos fisiológicos, de comunicação com a família e intersetorial para seguimento de rede

Elderly health: professional training and performance in primary health care

To identify the influences of the professional training process for action in the Family Health Strategy (FHS) related to the health of the elderly man. Exploratory descriptive research, carried out with 20 professionals, from a Brazilian Northeast municipality from October to December 2014. The data collection was performed through a questionnaire, following the statements were processed in the software IRaMuTeQ, analyzed by the Descending Hierarchical Classification. Three classes emerged: Influences of the professional training process on elderly health care; Health care for the elderly; Actions developed in the family health strategy in the implementation of the national policy of comprehensive health care for the elderly. The findings suggest improved knowledge, lack of resources and medical specialties, evidenced the complexity of the actions developed by health professionals

Criterios relacionados con el alta hospitalaria segura del recién nacido: Una revisión integrativa

Objetivo: Identificar los principales criterios evidenciados por la literatura científica involucrados en el alta hospitalaria segura del recién nacido. Método: Revisión integrativa de la literatura, realizada en diciembre de 2021 en las bases de datos Pubmed/Medline, BVS, Scopus, Lilacs, utilizando los descriptores “patient high summaries” OR “patient high” AND “newborn”. El estudio se basó en los procedimientos metodológicos PRISMA, se adoptaron criterios de elegibilidad y criterios de inclusión: artículos disponibles en su totalidad, publicados en los últimos 5 años, en inglés, español y portugués que versan sobre la atención del recién nacidos, el alta hospitalaria o el alta del paciente neonatal. Se excluyeron todos los artículos que no cumplieran con el objetivo de la investigación y/o no tuvieran relación con el tema en estudio. Resultados: De los 94 artículos identificados entre 2017 y 2021, se incluyeron 12 estudios, la mayoría de Brasil y con abordaje cualitativo. Se establecieron tres categorías temáticas de análisis: 1) Parámetros biofisiológicos; 2) Comunicación y orientación a los padres: fragilidades y potencialidades de la familia; y 3) Atención posterior al alta y seguimiento en red. Conclusión: Según a la bibliografía seleccionada, se concluye que el alta hospitalaria segura de los recién nacidos requiere atención a aspectos fisiológicos, de comunicación con la familia e intersectoriales para el seguimiento en red

ERUPTIVE SYRINGOMA IN A FORTUITOUS ASSOCIATION WITH LEPROSY - THE IMPORTANCE OF ACTIVE SEARCH

A Região Metropolitana do Rio de Janeiro concentra grande parte dos casos novos de hanseníase, sugerindo uma relação entre altas taxas de detecção com maior concentração populacional e com maior número de unidades de saúde descentralizadas. Para obter uma melhoria do acesso ao diagnóstico e tratamento é necessária capacitação na doença. Os autores apresentam um caso com associação fortuita entre hanseníase e siringoma eruptivo tratando de representação de área endêmica.The metropolitan area of Rio de Janeiro concentrates the most of new cases of leprosy, suggesting a relationship between high detection rates with higher population density and larger numbers of decentralized health units. For improved access to diagnosis and treatment is necessary training in disease. The authors present a case with casual link between leprosy and eruptive syringoma showing a representation of an endemic area

Epidemiological characteristics and temporal trends of new leprosy cases in Brazil: 2006 to 2017.

Our study aims to describe trends in new case detection rate (NCDR) of leprosy in Brazil from 2006 to 2017 overall and in subgroups, and to analyze the evolution of clinical and treatment characteristics of patients, with emphasis on cases diagnosed with grade 2 physical disabilities. We conducted a descriptive study to analyze new cases of leprosy registered in the Brazilian Information System for Notificable Diseases (SINAN), from 2006-2017. We calculated the leprosy NCDR per 100,000 inhabitants (overall and for individuals aged < 15 and ≥ 15 years) by sex, age, race/ethnicity, urban/rural areas, and Brazilian regions, and estimated the trends using the Mann-Kendall non-parametric test. We analyzed the distributions of cases according to relevant clinical characteristics over time. In Brazil, there was a sharp decrease in the overall NCDR from 23.4/100,000 in 2006 to 10.3/100,000 in 2017; among children < 15 years, from 6.94 to 3.20/100,000. The decline was consistent in all Brazilian regions and race/ethnicity categories. By 2017, 70.2% of the cases were multibacillary, 30.5% had grade 1 (G1D) or 2 (G2D) physical disabilities at diagnosis and 42.8% were not evaluated at treatment completion/discharge; cases with G2D at diagnosis were mostly detected in urban areas (80%) and 5% of cases died during the treatment (leprosy or other causes). Although the frequency of leprosy NCDR decreased in Brazil from 2006 to 2017 across all evaluated population groups, the large number of cases with multibacillary leprosy, physical disabilities or without adequate evaluation, and among children suggest the need to reinforce timely diagnosis and treatment to control leprosy in Brazil