Convívio de animais de estimação entre idosos: um estudo de base populacional no Sul do Brasil

During aging, living with pets can help the elderly to go through difficult situations, making pets a social support. The objective of this study was to know the prevalence of elderly people living with pets and its association with sociodemographic and health characteristics. Methods: Cross-sectional population-based study. Data collection took place through a household survey with elderly people aged 60 or over, living in the urban area of the municipality of Bagé, RS, in 2008. The dependent variable was living with pets and the independent ones included sociodemographic and health characteristics. Descriptive and bivariate analyzes were performed and, to verify associations, Fisher's exact test for heterogeneity was used. The level of statistical significance used was 5% for two-tailed tests. All analyzes were performed using the Stata version 14.0 program. The sample consisted of 1,593 elderly people. The general prevalence of living with pets was (69.0%; 95% CI: 66.6; 71.2). The variables associated with the outcome were: male gender (72.0%), younger age group (60 to 74 years - 72.9%), living with a partner (72.9%), not living alone, not receiving retirement (72.9%) and not having reported a drop in the last year (70.7%). There was a high prevalence of elderly people living with pets, however more studies are needed to better understand how living with animals is reflected in health improvements for the elderly population.Durante o envelhecimento a convivência com animais de estimação pode ajudar a pessoa idosa a atravessar situações difíceis, tornando os animais de estimação um suporte social. O objetivo do estudo foi conhecer a prevalência de idosos em convívio com animais de estimação e sua associação com características sociodemograficas e de saúde. Estudo transversal de base populacional. A coleta de dados ocorreu por meio de inquérito domiciliar com idosos de 60 anos ou mais, residentes na área urbana do município de Bagé, RS, no ano de 2008. A variável dependente foi convivência com animais de estimação e as independentes incluíram características sociodemograficas e de saúde. Foram realizadas análises descritivas e bivariadas, para verificar as associações foi utilizado o teste de exato de Fisher para heterogeneidade. O nível de significância estatístico utilizado foi de 5% para testes bicaudais. Todas análises foram realizadas no programa Stata versão 14.0. A amostra foi de 1.593 idosos. A prevalência geral de convívio com animais de estimação foi de (69,0%; IC 95%: 66,6; 71,2). As variáveis associadas com o desfecho foram: sexo masculino (72%), menor faixa etária (60 a 74 anos - 72,9%), viver com companheiro (72,9%), não morar sozinho, não receber aposentadoria (72,9%) e não ter referido queda no último ano (70,7%). Encontrou-se uma elevada prevalência de idosos em convívio com animais de estimação, contudo mais estudos são necessários para melhor compreender como a convivência com os animais se reflete em melhorias de saúde para a população idosa

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Convívio de animais de estimação entre idosos: um estudo de base populacional no Sul do Brasil

During aging, living with pets can help the elderly to go through difficult situations, making pets a social support. The objective of this study was to know the prevalence of elderly people living with pets and its association with sociodemographic and health characteristics. Methods: Cross-sectional population-based study. Data collection took place through a household survey with elderly people aged 60 or over, living in the urban area of the municipality of Bagé, RS, in 2008. The dependent variable was living with pets and the independent ones included sociodemographic and health characteristics. Descriptive and bivariate analyzes were performed and, to verify associations, Fisher's exact test for heterogeneity was used. The level of statistical significance used was 5% for two-tailed tests. All analyzes were performed using the Stata version 14.0 program. The sample consisted of 1,593 elderly people. The general prevalence of living with pets was (69.0%; 95% CI: 66.6; 71.2). The variables associated with the outcome were: male gender (72.0%), younger age group (60 to 74 years - 72.9%), living with a partner (72.9%), not living alone, not receiving retirement (72.9%) and not having reported a drop in the last year (70.7%). There was a high prevalence of elderly people living with pets, however more studies are needed to better understand how living with animals is reflected in health improvements for the elderly population.Durante o envelhecimento a convivência com animais de estimação pode ajudar a pessoa idosa a atravessar situações difíceis, tornando os animais de estimação um suporte social. O objetivo do estudo foi conhecer a prevalência de idosos em convívio com animais de estimação e sua associação com características sociodemograficas e de saúde. Estudo transversal de base populacional. A coleta de dados ocorreu por meio de inquérito domiciliar com idosos de 60 anos ou mais, residentes na área urbana do município de Bagé, RS, no ano de 2008. A variável dependente foi convivência com animais de estimação e as independentes incluíram características sociodemograficas e de saúde. Foram realizadas análises descritivas e bivariadas, para verificar as associações foi utilizado o teste de exato de Fisher para heterogeneidade. O nível de significância estatístico utilizado foi de 5% para testes bicaudais. Todas análises foram realizadas no programa Stata versão 14.0. A amostra foi de 1.593 idosos. A prevalência geral de convívio com animais de estimação foi de (69,0%; IC 95%: 66,6; 71,2). As variáveis associadas com o desfecho foram: sexo masculino (72%), menor faixa etária (60 a 74 anos - 72,9%), viver com companheiro (72,9%), não morar sozinho, não receber aposentadoria (72,9%) e não ter referido queda no último ano (70,7%). Encontrou-se uma elevada prevalência de idosos em convívio com animais de estimação, contudo mais estudos são necessários para melhor compreender como a convivência com os animais se reflete em melhorias de saúde para a população idosa

Elderly care: performance of interventions carried out by More Doctors Program professionals

ABSTRACT In order to assess coverage and quality of elderly care, a cross-sectional study of 204 interventions of Family Health Specialization students of UFPel was conducted, both connected and not connected to the More Doctors Program (PMM). The coverage difference between the third and first months of intervention and the percentage at the end of the third month were calculated in order to obtain quality indicators. An average increase in coverage of 35.7 percentage points (pp) (32.9, 38.6) was found: 42.1 pp (38.6, 45.7) and 26.1 pp (22.3, 30) were, respectively, related and not related to PMM. Brief Multidimensional Assessment (AMR), up-to-date clinical examination and assessment of the need for dental treatment showed better results in interventions conducted by PMM professionals. The interventions were effective regardless of supply and nationality, obtaining significantly better results those conducted by PMM professionals, especially Cubans

Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration

Insegurança alimentar no Nordeste e Sul do Brasil: magnitude, fatores associados e padrões de renda per capita para redução das iniquidades

O artigo analisa a insegurança alimentar em domicílios urbanos com crianças menores de sete anos de idade. Por meio de estudo transversal localizou-se, nas áreas de abrangência de unidades básicas de saúde, 5.419 domicílios na Região Nordeste e 5.081 na Região Sul do Brasil. A insegurança alimentar foi avaliada usando-se a Escala Brasileira de Insegurança Alimentar. A prevalência de insegurança alimentar moderada ou grave foi 22,9% no Nordeste e 7,5% no Sul. Em ambas as regiões, na análise ajustada, a maior probabilidade de insegurança alimentar moderada e grave foi identificada em domicílios chefiados por mulheres, com cor da pele materna preta e parda/mestiça, com menor escolaridade materna, menor renda familiar per capita e beneficiários do Bolsa Família. A insegurança alimentar moderada ou grave seria reduzida em 59,5% no Nordeste e em 45,4% no Sul, com uma renda familiar per capita mínima de R$ 175,00 ao mês. O aumento da renda familiar dos mais pobres e a melhor focalização do Bolsa Família são essenciais para a diminuição da insegurança alimentar no país

Interactive mobile application for Parkinson?s disease deep brain stimulation (MAP DBS): An open-label, multicenter, randomized, controlled clinical trial

Introduction: Deep brain stimulation (DBS) is an effective treatment for Parkinson's disease (PD), but its efficacy is tied to DBS programming, which is often time consuming and burdensome for patients, caregivers, and clinicians. Our aim is to test whether the Mobile Application for PD DBS (MAP DBS), a clinical decision support system, can improve programming.Methods: We conducted an open-label, 1:1 randomized, controlled, multicenter clinical trial comparing six months of SOC standard of care (SOC) to six months of MAP DBS-aided programming. We enrolled patients between 30 and 80 years old who received DBS to treat idiopathic PD at six expert centers across the United States. The primary outcome was time spent DBS programming and secondary outcomes measured changes in motor symptoms, caregiver strain and medication requirements.Results: We found a significant reduction in initial visit time (SOC: 43.8 +/- 28.9 min n = 37, MAP DBS: 27.4 +/- 13.0 min n = 35, p = 0.001). We did not find a significant difference in total programming time between the groups over the 6-month study duration. MAP DBS-aided patients experienced a significantly larger reduction in UPDRS III on-medication scores (-7.0 +/- 7.9) compared to SOC (-2.7 +/- 6.9, p = 0.01) at six months.Conclusion: MAP DBS was well tolerated and improves key aspects of DBS programming time and clinical efficacy