Causas e consequências de quedas de idosos atendidos em hospital público

Objetivo: Identificar os fatores de riscos e consequências associadas a quedas em idosos atendidos em um hospital do interior do Maranhão. Métodos: Estudo descritivo, exploratório com abordagem quantitativa realizado com idosos vítimas de quedas, em atendimento em um hospital público na cidade de Caxias (MA). A coleta de dados ocorreu por meio de um questionário semiestruturado. Resultados: Participaram do estudo 20 idosos vítimas de quedas. Houve predominância do gênero feminino (60%); idade entre 70 e 75 anos (45%); casados (45%) e com baixa escolaridade. As causas das quedas relacionavam-se à perda de tônus muscular e força, tontura ou falta de iluminação do ambiente. As principais consequências sofridas foram o medo de cair novamente, fraturas e dor. Conclusão: As causas das quedas são multifatoriais, indo desde pisos irregulares à perda de tônus muscular. Quanto as consequências destacam-se fraturas, internações, dores e medo de cair novamente

A Patient with Erythema Nodosus Leprosum and Chagas Cardiopathy: Challenges in Patient Management and Review of the Literature

We report a patient with severe multi-bacillary leprosy complicated by recurrent episodes of erythema nodosum necrotisans that required thalidomide and/or corticosteroids during follow-up. Although the patient was from an area to which Chagas disease is endemic, this diagnosis was initially missed and was only investigated when heart failure developed in the patient. The difficulties of managing erythema nodosum necrotisans and heart failure concomitantly and those involved in excluding the diagnosis of acute myocarditis caused by reactivation of Chagas disease secondary to the immunosuppressive regimen are discussed. Other potential causes for the heart failure and possible interactions between the two diseases and their treatments are discussed. We also reviewed the literature for the association between leprosy and Chagas disease, both of which are highly endemic in Brazil. This case emphasizes the importance of searching for subclinical co-infections in leprosy patients because reactions frequently develop during specific treatment in these patients, and these reactions require prolonged therapy with immunosuppressive drugs