Cardiometabolic Disorders Are Important Correlates of Vulnerability in Hospitalized Older Adults.

With an increasingly aging population worldwide, the concept of multimorbidity has attracted growing interest over recent years, especially in terms of frailty, which leads to progressive multisystem decline and increased adverse clinical outcomes. The relative contribution of multiple disorders to overall frailty index in older populations has not been established so far. This study aimed to assess the association between the vulnerable elders survey-13 (VES-13) score, which is acknowledged to be one of the most widely used measures of frailty, and the most common accompanying diseases amongst hospitalized adults aged 60 years old and more. A total of 2860 participants with an average age of 83 years were included in this study. Multiple logistic regression with adjustment for age and nutritional status was used to assess the independent impact of every particular disease on vulnerability. Diabetes mellitus type 2, coronary artery disease, atrial fibrillation, heart failure, chronic kidney disease, osteoarthritis, fractures, eyes disorders, depression, dementia, pressure ulcers, and urinary incontinence were associated with higher scores of VES-13. Hospital admission of older subjects with those conditions should primarily draw attention to the risk of functional decline, especially while qualifying older patients for further treatment in surgery and oncology. At the same time, lipid disorders, gastrointestinal diseases, higher body mass index, and albumins level were related to a lower risk of being vulnerable, which may be attributed to a younger age and better nutritional status of those patients.

[Transabdominal chorionic villus sampling (CVS) for prenatal diagnosis of chromosomal disorders--own experiences]. / Przezbrzuszna biopsja kosmówki w prenatalnej diagnostyce zaburzen chromosomowych--doswiadczenia wlasne.

OBJECTIVE: To present the authors' own experiences on transabdominal Chorionic Villus Sampling (CVS) for prenatal diagnosis of genetic disorders. DESIGN: Descriptive study PATIENS AND METHODS: A total of 290 couples with request for prenatal diagnosis of various genetic disorders were studied. The most common indications were: fetal abnormalities suspected in an ultrasound scan and biochemistry positive family history on genetic disorders, maternal age. Transabdominal CVS was done under local anesthesia and ultrasound guidance. The genetic analysis was possible in 264 cases (241 with abnormal ultrasound scan and/or biochemistry 11 with positive family history 12 with maternal age). Results were recorded and analyzed for descriptive statistics. RESULT: A total of 290 CVSs were done in the outdoor Most procedures (76%) were done between 12 and 14 weeks (range 11-16 weeks). All placental positions including both anterior and posterior were approachable through the trans-abdominal route. The overall success rate was 100%. Abnormal fetal karyotype was diagnosed in 39% of cases. In 12.9% of cases inconclusive results were observed (due to placental mosaicism or maternal cells contamination). More aneuploidies were observed in group with abnormal first trimester screening (us scan and/or biochemistry) compared to any other indications. CONCLUSION: Transabdominal CVS is a useful outdoor procedure for prenatal diagnosis. However indications for the procedure should be carefully considered since some risk of inconclusive results occurred.

[Chorionic Villus Sampling in cytogenetic analysis--disadvantages and advantages]. / Analiza cytogenetyczna biopsji kosmówki--wady i zalety.

Chorionic villus sampling is used in prenatal diagnosis, enabling to detect fetal genetic abnormalities. Its advantages include the possibility of performing the procedure during the first trimester of pregnancy relatively fast result, risk of miscarriage comparable to that in case of amniocentesis. The disadvantages of this method are: difficult cytogenetic analysis, the possibility of contamination with maternal cells and the risk of mosaicism. There should always be a valid indication to perform the CVS procedure.

As Conferências Nacionais de Saúde na construçäo do SUS / The National Health Conferences in the construction of SUS

Pretende examinar o papel das Conferências Nacionais de Saúde na construçäo do Sistema Único de Saúde(SUS), concentrando-se em fontes documentais secundárias e em consultas a alguns dos atores partaicipantes. As primeiras sete conferências säo apresentadas brevemente, como antecedentes da 8a. CNS, que constitui o marco de transformaçäo desses fóruns. A análise restringe-se a cinco conferências - da 8a. à 12a. CNS.(AU)

A democratizaçäo da gestäo pública: as relaçöes entre gestor, inovaçäo e porte demográfico do município / The democratization of public management: the relationshio between the administrators, innovation, and the municipality's demographic size

Analisa alguns aspectos dos temas democracia e poder local. Conclui que o fato de o município ser pequeno não é necessariamente um obstáculo à inovação ou democratização da gestão.

Programa de Estudos e Pesquisas em Reforma do Estado e Governança: municipalizaçäo da saúde e poder local no Brasil: relatório de pesquisa / Health municipalization and local power in Brazil: research report

Procura averiguar que mudanças a política de descentralizaçäo tem implantado nos sistemas locais de saúde brasileiros (NMPM)