Factors related to the discontinuation and mortality rates of a cardiac rehabilitation programme in patients with Chagas disease: a 6-year experience in a Brazilian tertiary centre.

OBJECTIVES: To describe the clinical and sociodemographic characteristics of participants as well as discontinuation and mortality rates in a cardiac rehabilitation programme (CRP) tailored to Chagas disease (CD). METHODS: Participants underwent functional capacity, anthropometry and cardiac function evaluations before beginning a CRP. Univariate and multivariate Cox proportional hazards models were performed to investigate the associations between clinical and sociodemographic characteristics at baseline with discontinuation rates and deaths. RESULTS: Forty-two patients were enrolled in the CRP (61.9% men, mean age of 58.1 ± 11.8 years). During a median follow-up period of 10.8 months, 74% discontinued and 14% died while enrolled in CRP. 34% of the patients who discontinued CRP died during follow-up. White race (HR = 0.09; 95% CI 0.01-1.00), right ventricular systolic dysfunction (HR = 10.54; 95% CI 1.24-89.50) and oxygen pulse (HR = 0.69; 95% CI 0.48-0.99) were independently associated with death while enrolled in CRP. Married status (HR = 0.44; 95% CI 0.21-0.95) was independently associated with discontinuation rates from CRP. VO2 peak (HR = 0.85; 95% CI 0.74-0.98) and CRP discontinuation due to CD-related reasons (HR = 8.33; 95% CI 1.91-36.27) were the variables independently associated with death after discontinuation of CRP. CONCLUSION: In this population, sociodemographic aspects and severity of CD were important determinants of CRP discontinuation and mortality.

OBJECTIFS: Décrire les caractéristiques cliniques et sociodémographiques des participants ainsi que les taux d'abandon et de décès dans un programme de réadaptation cardiaque (PRC) adapté à la maladie de Chagas (MC). MÉTHODES: Les participants ont subi des évaluations de la capacité fonctionnelle, de l'anthropométrie et de la fonction cardiaque avant de commencer un PRC. Des modèles de risques proportionnels de Cox univariés et multivariés ont été appliqués pour étudier les associations entre les caractéristiques cliniques et sociodémographiques au départ avec les taux d'abandon et les décès. RÉSULTATS: 42 patients ont été enrôlés dans le PRC (61,9% d'hommes, âge moyen de 58,1 ± 11,8 ans). Au cours d'une période médiane de suivi de 10,8 mois, 74% ont abandonné et 14% sont décédés durant leur enrôlement au PRC. 34% des patients qui ont arrêté le PRC sont décédés au cours du suivi. La race blanche (HR = 0,09; IC95%: 0,01-1,00), le dysfonctionnement systolique ventriculaire droite (HR = 10,54; IC95%: 1,24-89,50) et le pouls d'oxygène (HR = 0,69; IC95%: 0,48-0,99) étaient indépendamment associés avec le décès lors de l'enrôlement au PRC. Le statut marié (HR = 0,44; IC95%: 0,21-0,95) était indépendamment associé aux taux d'abandon de la CRP. Le pic de VO2 (HR = 0,85; IC95%: 0,74-0,98) et l'arrêt du PRC pour des raisons liées à la MC (HR = 8,33; IC95%: 1,91 à 36,27) étaient les variables indépendamment associées au décès après l'arrêt du PRC. CONCLUSION: Dans cette population, les aspects sociodémographiques et la sévérité de la MC étaient des déterminants importants de l'arrêt du PRC et du décès.

Inducible Nitric Oxide Synthase Polymorphisms and Nitric Oxide Levels in Individuals with Chronic Periodontitis.

This study aimed to investigate whether the -1026(A>C)(rs2779249) and +2087(A>G)(2297518) polymorphisms in the NOS2 gene were associated with chronic periodontitis (CP) and with salivary levels of nitrite (NO2-) and/or nitrate + nitrite (NOx). A group of 113 mixed-race patients were subjected to periodontal, genetic, and biochemical evaluations (65 CP/48 periodontally healthy subjects). DNA was extracted from oral epithelial cells and used for genotyping by polymerase chain reaction (real-time). Salivary NOx concentrations were determined using an ozone-based chemiluminescence assay. Association of CP with alleles and genotypes of the -1026(A>C) polymorphism was found (X² test, p = 0.0075; 0.0308), but this was not maintained after multiple logistic regression, performed to estimate the effect of covariates and polymorphisms in CP. This analysis demonstrated, after correction for multiple comparisons, that only the female gender was significantly associated with CP. Polymorphisms analyzed as haplotypes were not associated with CP. NOx levels were significantly higher in the control group of heterozygous individuals for both polymorphisms. In conclusion, the female gender was significantly associated with CP, and higher levels of salivary NOx were found in control subjects and associated with the heterozygous state of the NOS2 polymorphisms, reinforcing the potential of NO metabolites as markers of periodontitis status.

Comparative effects of a cardiovascular rehabilitation program on functional capacity in patients with chronic chagasic cardiomyopathy with or without heart failure.

PURPOSE: The aim of the present study was to evaluate the effects of cardiovascular rehabilitation (CR) on functional capacity of patients with chronic chagasic cardiomyopathy (CCC) and to compare the responses between CCC patients without and with heart failure (HF). MATERIALS AND METHODS: A longitudinal observational retrospective study was carried out including 36 patients with CCC without HF (stage B2 [n = 7]) and with HF (stage C [n = 29]), who participated in a CR program. Functional capacity was assessed by a maximal progressive cardiopulmonary exercise test performed on a treadmill. The longitudinal effects of the CR on functional capacity were determined by linear mixed models that included an interaction term to evaluate the differential responses between patients without and with HF. RESULTS: Significant improvements in peak oxygen consumption, resting heart rate and blood pressure, and maximum pulmonary ventilation were observed for the overall study sample, with no apparent differential effects according to the presence of HF. CONCLUSIONS: CR significantly improved functional capacity of patients with CCC. The responses to CR appear to be similar among patients without and with HF, reinforcing the need for its inclusion as a standard treatment strategy of CCC.Implications for rehabilitationExercise-based cardiovascular rehabilitation (CR) is a safe strategy that improves functional capacity, cardiac function, and quality of life in patients with several cardiovascular diseases, and recent studies also suggested a potential beneficial effect of CR in chronic chagasic cardiomyopathy (CCC).In this observational study, CR seems to equally improve exercise capacity, resting heart rate, resting blood pressure, and maximum pulmonary ventilation in patients with CCC without (stage B2) and with heart failure (stage C).Cardiovascular rehabilitation should be included as a standard treatment strategy for patients with CCC, regardless the severity of cardiomyopathy.

[Cognitive alterations of the elderly in home settings and the attitudes of children towards aging]. / Alterações cognitivas de idosos no contexto domiciliar e atitudes de crianças em relação à velhice.

Children develop attitudes towards aging from birth and are influenced by everyday factors. The objective of this study was to evaluate attitudes towards aging of children living with elderly individuals with and without cognitive changes. Home interviews were performed with 54 children from five Family Health Units, 25 of whom lived with seniors with cognitive changes (group 1), and 29 living with seniors without cognitive changes (group 2). All ethical precautions were observed. The Scale for Children's Attitudes Towards Aging was used. The mean scores obtained were 1.66 (group 1) and 1.52 (group 2). One point represented the most positive possible score, and three points the most negative. The comparison between groups, cognition domains, and social relationships presented significant rates, showing that children living with seniors with cognitive changes have more negative attitudes in these domains. Primary healthcare professionals should pay close attention to multigenerational families and invest in their education.

Variation in the CXCR1 gene (IL8RA) is not associated with susceptibility to chronic periodontitis.

BACKGROUND: The chemokine receptor 1 CXCR-1 (or IL8R-alpha) is a specific receptor for the interleukin 8 (IL-8), which is chemoattractant for neutrophils and has an important role in the inflammatory response. The polymorphism rs2234671 at position Ex2+860G>C of the CXCR1 gene causes a conservative amino acid substitution (S276T). This single nucleotide polymorphism (SNP) seemed to be functional as it was associated with decreased lung cancer risk. Previous studies of our group found association of haplotypes in the IL8 and in the CXCR2 genes with the multifactorial disease chronic periodontitis. In this study we investigated the polymorphism rs2234671 in 395 Brazilian subjects with and without chronic periodontitis. FINDINGS: Similar distribution of the allelic and genotypic frequencies were observed between the groups (p>0.05). CONCLUSIONS: The polymorphism rs2234671 in the CXCR1 gene was not associated with the susceptibility to chronic periodontitis in the studied Brazilian population.

Haplotypes in the interleukin 8 gene and their association with chronic periodontitis susceptibility.

Interleukin-8 (IL-8), which is responsible for the migration and activation of neutrophils, is an important inflammatory mediator involved in the initiation and amplification of acute inflammatory reactions and chronic inflammatory processes. IL-8 plays an important role in periodontitis, an inflammatory disease characterized by the loss of connective tissue and alveolar bone. The aim of this study was to investigate whether the SNPs rs2227307 (+396) and rs2227306 (+781), and the haplotypes they formed together with the previously investigated rs4073 (-251), were associated with chronic periodontitis susceptibility. Clinical periodontal exams were performed and DNA samples were collected from 493 individuals (223 with periodontitis and 270 controls). Associations between SNPs, haplotypes, and subject phenotypes were analyzed using the χ(2) test followed by multivariate logistic regression modeling. We conclude that the +396TT genotype and the haplotypes ATC/TTC and AGT/TGC were significantly associated with chronic periodontitis susceptibility in Brazilians.

Disasters and the historical recurrence of tragedies: implications for the health and aging process. / Desastres e o ciclo histórico de repetição de tragédias: implicações ao processo de saúde e envelhecimento.

In a context of disaster recurrence, naturalization or demotion of the concept to tragedy does not include all the dynamics and processes involved in affecting the communities and population groups most vulnerable to death and illness, such as the older adults. This paper aims to describe and analyze the socioeconomic, environmental, and health context of impact on older adults in four municipalities in the states of Santa Catarina and Rio de Janeiro. We carried out documentary research and open data survey of sociodemographic, environmental, economic, and health aspects of these locations and population groups. Also, descriptive, interrupted time series and documentary analyses were integrated. Among the results, collected documents and data point to the lack of preventive or mitigating actions for priority groups. Significant changes in hospital admissions for older adults were observed for some groups of causes. We conclude that institutional learning based on collective construction is required to corroborate the disruption of the disaster repetitive cycle.

Em um contexto de recorrência de desastres, a naturalização ou rebaixamento destes à tragédia invisibiliza as dinâmicas e os processos envolvidos na afetação das comunidades e grupos populacionais mais vulneráveis a óbito e adoecimentos, como os idosos. Objetiva-se neste artigo descrever e analisar o contexto socioeconômico, ambiental e de saúde da afetação de idosos em quatro municípios dos estados de Santa Catarina e Rio de Janeiro. Para isto, realizou-se pesquisa documental, levantamento de dados abertos sociodemográficos, ambientais, econômicos e de saúde destas localidades e grupo populacional. Integraram-se as análises descritivas, de série temporal interrompida e documental. Dentre os resultados, observou-se nos documentos e dados levantados carência de previsão de ações preventivas ou mitigatórias voltadas a grupos prioritários. Para alguns grupos de causas, houve mudanças significativas no comportamento das internações hospitalares de idosos no período estudado. Conclui-se que o aprendizado institucional pautado na construção coletiva precisa ocorrer para corroborar com o rompimento do ciclo de repetição de desastres.

Comparison of friction of metallic and ceramic brackets during sliding mechanics after prophylaxis with sodium bicarbonate jet: An in vitro study.

OBJECTIVE: An in vitro experimental study was carried out with the objective to compare the friction in aesthetic and metallic brackets after prophylaxis with sodium bicarbonate jet during sliding mechanics. MATERIAL AND METHODS: Aesthetic monocrystalline (n=24) and polycrystalline (n=24) and metallic brackets (n=24) were used. Each group of brackets was divided into two groups, as follows: the first group received prophylaxis with a bicarbonate jet, while the second group did not. An acrylic plate was attached to the base fixature of the Instron 4411 universal testing machine, simulating the retraction movement of the canine during sliding mechanics. The bracket was pulled at a speed of 0.5mm/minute over a distance of 0.5mm. The data were analysed by analysis of variance (ANOVA) and Tukey test. RESULTS: After the sodium bicarbonate jet, conventional metal brackets showed less friction (P<0.05). While the aesthetic brackets did not show significant difference in friction between the exposed and non-exposed groups with the sodium bicarbonate jet (P>0.05), the polycrystalline brackets showed greater friction when compared to the other groups of brackets. CONCLUSIONS: It was concluded that prophylaxis with sodium bicarbonate jet did not influence the resistance to friction in aesthetic brackets; however, metal brackets showed a significant decrease in friction after prophylaxis with sodium bicarbonate jet. Our results suggest that the abrasion of the sodium bicarbonate particles can cause micromorphological changes, which may influence the friction; however, studies with scanning electron microscopy are necessary.

Rural Older Adults in Disasters: A Study of Recovery From Hurricane Michael.

OBJECTIVE: This study aims for a greater understanding of how older adults (age 65 and older) in Jackson County, Florida, are prepared for and cope with the effects of a natural disaster. METHODS: A multidisciplinary, international research team developed a survey examining: (1) resources available to individuals aged 65+ in rural communities for preparing for a disaster; (2) challenges they face when experiencing a disaster; and (3) their physical, social, emotional, and financial needs when it strikes. The survey was administered with older adults (65+) in Jackson County, Florida, following Hurricane Michael in 2018. The descriptive, multivariate logistic, and linear regression analyses were performed to examine the relationship between respondents' demographic information and needs, concerns, and consequences of disaster. RESULTS: Results indicated (n = 139) rural community-dwelling older adults rely on social support, community organizations, and trusted disaster relief agencies to prepare for and recover from disaster-related events. CONCLUSIONS: Such findings can be used to inform the development of new interventions, programs, policies, practices, and tools for emergency management and social service agencies to improve disaster preparedness and resiliency among older populations in rural communities.

Desastres e o ciclo histórico de repetição de tragédias: implicações ao processo de saúde e envelhecimento / Disasters and the historical recurrence of tragedies: implications for the health and aging process

Resumo Em um contexto de recorrência de desastres, a naturalização ou rebaixamento destes à tragédia invisibiliza as dinâmicas e os processos envolvidos na afetação das comunidades e grupos populacionais mais vulneráveis a óbito e adoecimentos, como os idosos. Objetiva-se neste artigo descrever e analisar o contexto socioeconômico, ambiental e de saúde da afetação de idosos em quatro municípios dos estados de Santa Catarina e Rio de Janeiro. Para isto, realizou-se pesquisa documental, levantamento de dados abertos sociodemográficos, ambientais, econômicos e de saúde destas localidades e grupo populacional. Integraram-se as análises descritivas, de série temporal interrompida e documental. Dentre os resultados, observou-se nos documentos e dados levantados carência de previsão de ações preventivas ou mitigatórias voltadas a grupos prioritários. Para alguns grupos de causas, houve mudanças significativas no comportamento das internações hospitalares de idosos no período estudado. Conclui-se que o aprendizado institucional pautado na construção coletiva precisa ocorrer para corroborar com o rompimento do ciclo de repetição de desastres.

Abstract In a context of disaster recurrence, naturalization or demotion of the concept to tragedy does not include all the dynamics and processes involved in affecting the communities and population groups most vulnerable to death and illness, such as the older adults. This paper aims to describe and analyze the socioeconomic, environmental, and health context of impact on older adults in four municipalities in the states of Santa Catarina and Rio de Janeiro. We carried out documentary research and open data survey of sociodemographic, environmental, economic, and health aspects of these locations and population groups. Also, descriptive, interrupted time series and documentary analyses were integrated. Among the results, collected documents and data point to the lack of preventive or mitigating actions for priority groups. Significant changes in hospital admissions for older adults were observed for some groups of causes. We conclude that institutional learning based on collective construction is required to corroborate the disruption of the disaster repetitive cycle.

Factors associated with number of erupted primary teeth in Brazilian children: a cross-sectional study.

PURPOSE: The purpose of this study was to determine whether nutritional status, gender, weight, and height affected the number of erupted primary teeth in six- to 30 month-old children. METHODS: A cross-sectional study was carried out involving an oral clinical examination, and weight and height measurements of 232 children, as well as a questionnaire filled out by their parents. Statistical analysis involved descriptive data, Spearman's correlation coefficient, Kruskall-Wallis test, and multiple linear regression in two sets, using the enter method to control the confounding factor (age) and the stepwise method for gender, weight, and height ( P<.05). The calculation of effect size proposed by Cohen was used to test the clinical significance of the findings. RESULTS: The number of erupted teeth was not significantly influenced by nutritional status ( P<.58; Kruskal-Wallis test) or gender ( P=.95; Mann-Whitney test). Body weight had a statistically significant association with the number of erupted primary teeth ( P<.001), and height showed a positive correlation with this variable, both independently of the child's age. CONCLUSION: The number of erupted primary teeth was affected by weight in children of the same age.

Association of haplotypes in the CXCR2 gene with periodontitis in a Brazilian population.

CXCR-2 is a receptor of interleukin-8, which is involved in acute and chronic inflammatory processes. Polymorphisms in the CXCR2 gene have been associated with chronic inflammatory conditions. The aim of this study was to investigate whether the +785(C/T), +1208(T/C), and +1440(G/A) single-nucleotide polymorphisms (SNPs) in the CXCR2 gene, as well as their haplotypes, are associated with susceptibility to periodontitis in Brazilians. DNA was extracted from the buccal epithelial cells of 487 individuals (control = 215; periodontitis = 272). The SNPs were investigated using the sequence-specific primer-polymerase chain reaction method. Associations between the polymorphisms and subject phenotypes were analyzed using the chi-squared statistical test, followed by univariate and multivariate logistic regression modeling. Haplotypes were reconstructed using the expectation-maximization algorithm, and differences in haplotype distribution between the groups were analyzed to estimate genetic susceptibility for periodontitis development. Univariate and multivariate analysis revealed that age, skin color, and smoking status were associated with periodontitis. The +1440 GG genotype was shown to be protective against periodontitis in both univariate and multivariate analysis (odds ratio [OR](adjusted) = 0.42; 95% confidence interval [CI] = 0.19, 0.96). A similar relevant result for the +1440 GG was obtained in an alternative analysis considering a subgroup containing only white nonsmokers (OR = 0.37; 95% CI = 0.15, 0.92). White nonsmokers with the CTG/TCG haplotype appeared to be genetically protected against the development of periodontitis (OR = 0.29; 95% CI = 0.09, 0.89), while those carrying the CTG/TCA haplotype were more susceptible to the development of periodontitis (OR = 2.08; 95% CI = 1.24, 3.51). In conclusion, the +1440 SNP and some haplotypes are associated with periodontitis in Brazilian individuals.

Polymorphisms and haplotypes in the interleukin-4 gene are associated with chronic periodontitis in a Brazilian population.

BACKGROUND: Some haplotypes in the interleukin-4 (IL4) gene were reported to influence IL-4 cytokine production and were associated with inflammatory diseases. Association studies focusing on IL4 gene polymorphisms and periodontal disease provided conflicting results. The aim of this study is to investigate whether IL4 gene polymorphisms and haplotypes were related to chronic periodontitis in a Brazilian population. METHODS: The polymorphisms -590(C/T) and +33(C/T) in the IL4 gene were identified by polymerase chain reaction (PCR) and restriction fragment-length polymorphism methods; the variable number of tandem repeats (VNTR) was identified by PCR. To assess the differences between the periodontitis group (n = 125) and control group (n = 125), the chi(2) test was used to assess genotype and allele distributions of individual polymorphisms. For haplotypes reconstructed by an expectation-maximization algorithm, the CLUMP program and Fisher exact test were used. Multivariate logistic regression modeling was used to assess the association of age, gender, smoking status, and polymorphism/haplotype with periodontitis. RESULTS: The -590(T), +33(C), and insertion (I) of 70-base pair (bp) alleles and genotypes were more prevalent in the periodontitis group, even after adjusting for covariates. The -590, +33, and insertion (TCI) haplotype was associated with a susceptibility to periodontitis (adjusted odds ratio [OR(adjusted)] = 2.68; 95% confidence interval [CI] = 1.50 to 4.80) as was the genotype TCI/CCI (OR(adjusted) = 5.27; 95% CI = 2.28 to 12.18), whereas the TTD (OR(adjusted) = 0.48; 95% CI = 0.26 to 0.91), CTI (OR(adjusted) = 0.28, 95% CI = 0.11 to 0.70), and TTD/CTI (OR(adjusted) = 0.29; 95% CI = 0.08 to 1.13) genotypes were a associated with protection against the development of chronic periodontitis. CONCLUSION: Significant associations between alleles, genotypes, and haplotypes of polymorphisms in the IL4 gene and chronic periodontitis were verified in Brazilian individuals.

Association of haplotypes in the IL8 gene with susceptibility to chronic periodontitis in a Brazilian population.

BACKGROUND: Interleukin 8 (IL-8) is a chemokine related to the initiation and amplification of acute and chronic inflammatory processes. Polymorphisms in the IL8 gene have been associated with inflammatory diseases. We investigated whether the -845(T/C) and -738(T/A) single nucleotide polymorphisms (SNPs) in the IL8 gene, as well as the haplotypes they form together with the previously investigated -353(A/T), are associated with susceptibility to chronic periodontitis. METHODS: DNA was extracted from buccal epithelial cells of 400 Brazilian individuals (control n=182, periodontitis n=218). SNPs were genotyped by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Disease associations were analyzed by the chi(2) test, Exact Fisher test and Clump program. Haplotypes were reconstructed using the expectation-maximization algorithm and differences in haplotype distribution between the groups were analyzed to estimate genetic susceptibility for chronic periodontitis development. RESULTS: When analyzed individually, no SNPs showed different distributions between the control and chronic periodontitis groups. Although, nonsmokers carrying the TTA/CAT (OR=2.35, 95% CI=1.03-5.36) and TAT/CTA (OR=6.05, 95% CI=1.32-27.7) haplotypes were genetically susceptible to chronic periodontitis. The TTT/TAA haplotype was associated with protection against the development of periodontitis (for nonsmokers OR=0.22, 95% CI=0.10-0.46). CONCLUSION: Although none of the investigated SNPs in the IL8 gene was individually associated with periodontitis, some haplotypes showed significant association with susceptibility to, or protection against, chronic periodontitis in a Brazilian population.

O ensino da avaliação cognitiva na graduação em Gerontologia / The teaching of cognitive assessment in undergraduate Gerontology courses

Saber avaliar adequadamente as alterações cognitivas é uma habilidade importante na formação de profissionais na área de saúde. Na graduação em Gerontologia na América Latina e Portugal, os protocolos de avaliação clínica incluem a necessidade de aplicação de instrumentos de rastreio cognitivo. Este estudo objetivou, nesse sentido, auxiliar no ensino de graduandos da área, por meio da elaboração de vídeos educacionais e um manual sobre a aplicação dos instrumentos mais utilizados na graduação em Gerontologia.

Knowing to properly evaluate cognitive impairment is an important skill in training of healthcare professionals. In the undergraduate Gerontology in Latin America and Portugal, clinical assessment protocols include the necessity of using cognitive screening instruments. This study aimed, therefore, assists in education of undergraduate student from healthcare area, through the preparation of educational videos and a manual about the implementation of the most used instruments in Gerontology undergraduate courses.

Lack of association of a functional polymorphism in the interleukin 8 gene with susceptibility to periodontitis.

The important inflammatory mediator interleukin-8 (IL-8) is responsible for the migration and activation of neutrophils. The IL8 gene contains a functional single-nucleotide polymorphism (SNP) (rs4073) in its promoter region that may influence the expression of IL-8, and which has been associated with inflammatory diseases. The purpose of this study was to investigate the association of the SNP (rs4073) in the IL8 gene with susceptibility to periodontitis. DNA was extracted from the buccal epithelial cells of 500 individuals (control n = 224 and periodontitis n = 276). Individuals were genotyped for the SNP (rs4073) using sequence-specific primer polymerase chain reaction. Associations between the SNP (rs4073) and subject phenotypes were analyzed using the chi-squared test, followed by univariate and multivariate logistic regression modeling. The genotype distributions in both groups were consistent with Hardy-Weinberg equilibrium. Univariate and multivariate analysis showed that age, skin color, and smoking status were associated with periodontitis. No significant differences were found for sex and frequencies of alleles and genotypes between the control and periodontitis groups in the univariate analysis. These findings were replicated in the multivariate analysis. The SNP (rs4073) in the IL8 gene is not associated with susceptibility to periodontitis in Brazilian individuals, even after controlling for covariates.

A graduação em gerontologia na América Latina e Portugal: uma análise dos cursos e da oferta de disciplinas de avaliação gerontológica / The undergraduate degree in gerontology in Latin America and Portugal: an analysis of the degrees and of the offer of gerontological evaluation’s disciplines

O objetivo deste estudo é analisar a oferta de cursos de graduação em Gerontologia, na América Latina e Portugal. Foram localizados 22 cursos e analisados quanto ao início dos mesmos, objetivo, perfil profissional, carga horária e duração. Dos 22 cursos identificados, 45,4% oferecem disciplinas relacionadas à avaliação gerontológica. Conclui-se que há crescente preocupação dos países em formar profissionais aptos a lidar com uma população idosa em crescimento.

The objective of this study is to analyze the offer of undergraduate degrees in Gerontology in Latin America and Portugal. 22 courses were located and it was analyzed by the course’s beginning, goal, professional profile, work load and duration. Among the 22 identified courses, 45,4% offer gerontological evaluation’s disciplines. Concluding there are countries’ growing warring on create professionals up to deal with an elderly population in growing.

Low-grade chronic inflammation is not accompanied by structural arterial injury in polycystic ovary syndrome.

OBJECTIVE: To evaluate the presence of premature subclinical atherosclerosis, measured by examining carotid intima-media thickness (IMT) and to investigate whether the IMT may be linked to low-grade chronic inflammation, assessed by C-reactive protein (CRP), in young women with polycystic ovary syndrome (PCOS). METHODS: Fifty seven PCOS patients and 37 similarly aged and weight controls underwent B-mode ultrasonography of the carotid arteries for IMT measure. All these women were also screened for CRP and metabolic parameters including fasting insulin, glucose, lipid and androgen levels. Differences between means were analyzed by Student's unpaired t-test and analysis of correlations between parameters was performed by using Pearson's correlation. RESULTS: CRP was significantly higher in PCOS patients than in controls (3.1mg/dL vs. 1.4mg/dL; p=0.004). No difference was noted in IMT mean between PCOS cases and controls (0.52mm vs. 0.53mm; p=0.35). IMT did not correlate with CRP but exhibited a significant positive correlation with total testosterone (r=0.72, p=0.01). CONCLUSION: This study suggests that PCOS itself is not associated with structural arterial injury, carotid IMT is not linked to low-grade chronic inflammation and hyperandrogenism may be associated with subclinical atherosclerosis and cardiovascular risk in young women with PCOS. Additional research is needed to clarify these findings.