IL-10 and IL-1ß Serum Levels, Genetic Variants, and Metabolic Syndrome: Insights into Older Adults' Clinical Characteristics.

Populational aging is marked by chronic noncommunicable diseases, such as metabolic syndrome (MetS). IL-10 and IL-1ß are pleiotropic cytokines with multiple biological effects linked to metabolic disorders. This cross-sectional study assessed 193 participants' IL-10 and IL-1ß serum levels regarding their role in developing MetS, clinical characteristics, and their IL1B rs1143627 and IL10 rs1800890 variants' genotype frequencies in a population over 60. IL-10 levels correlated weakly with HDL levels and fat mass and inversely with triglycerides, glucose, glycated hemoglobin, and estimated average blood glucose levels. IL-10 levels were also indirectly influenced by the patient's T2DM duration, lean mass amount, and bone mineral content. Participants with altered HDL, elevated serum glucose, raised HbA1c levels, or those over 80 had reduced serum IL-10 levels compared to those with normal levels or other age groups, respectively. Women also had higher serum IL-10 levels than men. Dissimilarly, IL-1ß levels correlated directly only with the number of total leukocytes and segmented neutrophils, showing only significant variations with self-reported alcohol consumption. Our study also found that those with the IL10 AA genotype (lower IL-10 levels) had a significantly higher risk of developing MetS. These findings may help direct future research and more targeted therapeutic approaches in older adults.

Predictive Models of Muscle Strength in Older People with Type 2 Diabetes Mellitus.

Purpose: To propose predictive models for absolute muscle strength (AMS) of elderly people with type 2 Diabetes Mellitus (DM2) in primary health care. Patients and Methods: The cross-sectional study was conducted with 138 elderly diabetics. The AMS was measured by a JAMAR® hydraulic handgrip dynamometer, determined by the sum of both hands. The following indices were evaluated: waist-to-height ratio (WHtR), body mass index (BMI), Lipid Accumulation Product (LAP), Triglyceride/High Density Lipoprotein (TG/HDL) ratio and platelet/lymphocyte ratio (PLR). Multiple linear regression was used in the statistical analysis. Results: The final regression model indicated 66.4% (R²=0.66) of the variation in AMS. WHtR decreased AMS by 41.1% (ß = -0.19; t = -3.70; p < 0.001), while PLR by 11.3% (ß = -0.12; t = -2.36; p = 0.020). Male sex increased AMS by 10.6% (ß = 0.32; t = 4.16; p < 0.001), and lean mass (LM) by 0.89% (ß = 0.46; t = 6.03; p < 0.001). Conclusion: WHtR and PLR predicted a decrease, while male sex and LM predicted an increase in AMS. It is suggested that these markers be used as screening measures for variation in AMS in older adults with DM2. These results have relevant practical application in primary health care since the markers are easy to use.

MAOA uVNTR Polymorphism Influence on Older Adults Diagnosed with Diabetes Mellitus/Systemic Arterial Hypertension.

Background: Monoamine oxidase (MAO) is involved in several biological processes associated with well-being and mental health, and alterations in its function might directly impact various mental disorders. Some mental disorders concomitantly occur in individuals with clinical characteristics, such as substance abuse and diabetes. Objective: To analyze the functional MAOA uVNTR polymorphism genotype frequency in an older adult population with diabetes mellitus/arterial hypertension and associate this frequency with clinical characteristics impacting daily life. Methodology. Older adults diagnosed with diabetes mellitus, systemic arterial hypertension, or both (DM/SAH) were selected and had their MAOA gene genotyped for uVNTR polymorphism. The revised Beck Depression Inventory (BDI) and a questionnaire were also applied to determine their mental health and clinical characteristics. Results: The allelic variants detected among the participants were the 2R, 3R, 4R, and 3R/4R heterozygous genotypes. Genotypes solely containing the 3R allele had patients who marked yes for smoking and alcoholism, and only those with the 3R genotypes (female 3R/3R homozygote or male 3R∗ hemizygote) were significant. Although not statistically significant, only 3R and 3R/4R genotypes presented cases of severe depression per the revised BDI interpretations. Conclusion: The MAOA uVNTR polymorphism's low-activity 3R allele presence in an older adult population diagnosed with DM/SAH may represent a risk for developing substance use (alcohol and smoking) dependence.

Impact of Metabolic Syndrome Components in High-Risk Cardiovascular Disease Development in Older Adults.

OBJECTIVE: Analyze the influence between the components of metabolic syndrome and the independent risk for cardiovascular disease (CVD) in the elderly. METHODS: A descriptive cross-sectional study was carried out with 205 older adults from a primary healthcare unit of the Federal District, Brazil. The cardiovascular risk was determined by the Framingham Risk Score (FRS). The National Cholesterol Evaluation Program for Adult Treatment Panel III 2001 (NCEP-ATP III) criteria were considered to analyze metabolic syndrome (MS) diagnoses. RESULTS: There was a strong association between MS and high cardiovascular risk (OR = 8.86). The univariate analysis main findings revealed that male gender, diabetes, smoking habit, systolic blood pressure, HDL level, high blood glucose, glycated hemoglobin, and LDL level were associated with high cardiovascular risk. FRS increases significantly with the presence of four or more MS components (by 30%, if 4 components are present, and by 40%, if 5 components) when compared with the presence of three or fewer components (P <0.001). A logistic regression analysis of high-risk predictors was described to reduce the effects of confounding and bias factors. CONCLUSION: The identification of MS associated with high FRS values represents a cascading of adverse effects on the population's aging process.

Interrupções no trabalho da enfermagem como fator de risco para erros de medicação / Interruptions in the work of nursing as a risk factor for medication errors

Resumo Objetivo: Verificar a associação entre as interrupções e os erros de medicação nas doses preparadas e administradas por profissionais de enfermagem das unidades de internação de clínica médica de dois hospitais públicos localizados no Distrito Federal, Brasil. Metodologia: Estudo exploratório, de delineamento transversal e caráter quantitativo realizado em dois hospitais públicos no Distrito Federal, Brasil. A amostra foi de conveniência, sendo 8 profissionais do Hospital 1 e 18 profissionais do Hospital 2. Os dados foram coletados a partir de observação direta e aplicação de questionário e instrumento para identificação dos fatores de risco para erros de medicação. Foram considerados significativos os resultados com valores de p < 0,05 e o índice de confiança estabelecido foi de 95 %. Resultados: Em ambos os hospitais verificou-se um perfil majoritariamente de técnicos de enfermagem (H1 = 100 %; H2 = 94,4 %), do sexo feminino (H1 = 75,0 %; H2 = 88,1 %), com idade superior aos 30 anos (H1 = 75,0 %; H2 = 61,0 %). Foram observadas 899 doses no Hospital 1 e Hospital 2, que resultaram em 921 e 648 erros respectivamente, dos quais 464 (53,6 %) no Hospital 1 e 118 (24,4 %) no Hospital 2 estiveram diretamente relacionados à presença de interrupções no trabalho. Cada dose observada sofreu aproximadamente 1,7 erros e percebeu-se uma frequência de aproximadamente 26 (H1) e 16,2 (H2) erros por hora. Conclusões: Verifica-se uma forte associação entre as interrupções no trabalho da equipe de enfermagem e os erros de medicação nas unidades de internação estudadas, caracterizando as interrupções como importante fator de risco.

Resumen Objetivo: Verificar la asociación entre las interrupciones y los errores de medicación en dosis preparadas y administradas por profesionales de enfermería en unidades de internación de clínica médica de dos hospitales públicos en el Distrito Federal, Brasil. Metodología: Estudio exploratorio, de delineamiento transversal y carácter cuantitativo realizado en dos hospitales públicos en el Distrito Federal, Brasil. La muestra fue por conveniencia, siendo ocho profesionales en el Hospital 1 y 18 profesionales en el Hospital 2. Los datos fueron recolectados a partir de observación directa y aplicación de cuestionario e instrumento para identificación de los factores de riesgo para errores de medicación. Fueron considerados significativos los resultados con valores de p < 0,05 y el índice de confianza establecido fue del 95%. Resultados: En ambos hospitales se verificó un perfil mayoritariamente de técnicos de enfermería (H1=-100%, H2 = 94,4 %), de sexo femenino (H1 = 75,0 %, H2 = 88,1 %) y edad superior a los 30 años (H1 = 75,0 %, H2 = 61,0 %). Se observaron 899 dosis en H1 y H2, que resultaron en 921 y 648 errores respectivamente, de los cuales 464 (53,6 %) en el H1 y 118 (24,4 %) en el H2 estuvieron directamente relacionados con interrupciones en el trabajo. Cada dosis observada sufrió aproximadamente 1,7 errores y se verificó cerca de 26 (H1) y 16,2 (H2) errores por hora. Conclusiones: Se observa una fuerte asociación entre las interrupciones en el trabajo del equipo de enfermería y los errores de medicación en las unidades de internación estudiadas, caracterizando las interrupciones como importante factor de riesgo.

Abstract Objective: To verify the association between interruptions and errors of medication in doses prepared and administered by nursing professionals in inpatient units of medical clinic of two public hospitals in Distrito Federal, Brazil. Methodology: Exploratory study, of transverse delineation and quantitative character, performed in two public hospitals in Distrito Federal, Brazil. The sample was by convenience, being eight professionals at the Hospital 1 and eighteen professionals at the Hospital 2. Data were collected from direct observation and application of questionnaire and instrument for identifying the factors of risk for medication errors. There were considered significant results with values of p < 0.05 and established confidence index was 95 %. Results: In both hospitals it was verified a profile mostly of nursing technicians (H1 = 100 %; H2 = 94.4 %), female (H1 = 75 %; H2 = 88.1 %) and older than 30 years old (H1 = 75 %; H2 = 61 %). There were observed 899 dose in H1 and H2, resulting in 921 and 648 errors respectively, of which 464 (53.6 %) in the H1 and 118 (24.4 %) in the H2 were directly related to interruptions at work. Each observed dose suffered approximately 1,7 errors and there were about 26 (H1) and 16.2 (H2) errors per hour. Conclusion: There is a strong association between interruptions in the work of the nursing team and errors of medication in the inpatient units studied, characterizing the interruptions as an important factor of risk.

Erros de prescrição em uma farmácia básica do distrito federal / Errores de prescripción en una farmacia básica del distrito federal / Prescription errors in a basic pharmacy of the federal district

RESUMO Objetivo: Analisar prescrições eletrônicas e manuais quanto à ocorrência de polifarmácia e tipos potenciais de erros de medicação no contexto da atenção primária. Material e método: Estudo de caráter descritivo, transversal e retrospectivo, baseado na avaliação de prescrições manuais e eletrônicas arquivadas na farmácia da Unidade Básica de Saúde do Distrito Federal de Brasília (DF). Foram incluídas as segundas vias das prescrições para as doenças crônicas não transmissíveis. Resultados: 1500 prescrições foram analisadas. Apontaram a não totalidade dos critérios de avaliação proposto neste estudo, dentre eles: ilegibilidade (35,5%), abreviaturas (97,7%), forma farmacêutica (57,6%), concentração (32,4%). A polifarmácia foi identificada em 46% dos usuários e estava diretamente relacionada à idade do usuário. Conclusão: As prescrições apresentaram incompletude de informações em relação ao que estabelece a legislação, são necessárias estratégias que busquem melhorar a promoção de saúde na atenção básica, como trabalhos de educação permanente e que visem sensibilizar os prescritores e demais atores envolvidos neste processo sobre o ato de prescrever medicamentos.

ABSTRACT Objective: To analyze electronic and manual prescriptions regarding the occurrence of polypharmacy and potential types of medication errors in the context of primary care. Material and method: A descriptive, cross-sectional and retrospective study based on the evaluation of prescriptions filed at the pharmacy of a Basic Health Unit of the Federal District of Brazil. Copies of prescriptions for chronic non-communicable diseases were included. Results: 1500 prescriptions were analyzed according to evaluation criteria, such as illegibility (35.5 %), abbreviations (97.7%), dosage form (57.6%), and concentration (32.4%). Polypharmacy was identified in 46% of users and it was directly related to the age of the user. Conclusion: Prescriptions presented incomplete information regarding current legislation. Strategies that seek to improve health promotion in primary care, such as permanent education and more awareness from prescribers and other actors involved in the process of prescribing medications, are required.

RESUMEN Objetivo: Analizar prescripciones electrónicas y manuales en cuanto a la ocurrencia de polifarmacia y tipos potenciales de errores de medicación en el contexto de la atención primaria. Material y método: Estudio de carácter descriptivo, transversal y retrospectivo, basado en la evaluación de prescripciones manuales y electrónicas archivadas en la farmacia de la Unidad Básica de Salud (UBS) del Distrito Federal (Brasil). Se incluyeron los duplicados de las prescripciones para las enfermedades crónicas no transmisibles. Resultados: Se analizaron 1.500 prescripciones considerando la no totalidad de los criterios de evaluación propuestos en este estudio, entre ellos: ilegibilidad (35,5%), abreviaturas (97,7%), forma farmacéutica (57,6%), concentración (32,4%). Se identificó polifarmacia en el 46% de los usuarios y que estaba directamente relacionada a la edad del usuario. Conclusión: Las prescripciones presentaron información incompleta en relación a lo establecido por la legislación. Se requieren estrategias que busquen mejorar la promoción de salud en la atención básica, como educación permanente y sensibilización de los prescriptores y demás actores involucrados en el acto de prescribir medicamentos.

Medication errors in a public hospital in Brazil.

This article describes the analysis of the frequency, type and risk factors relating to errors in the preparation and administration of medications in patients admitted to a public hospital in Brasilia Federal District, Brazil, which serves a population of approximately 500,000 inhabitants. Patients are commonly affected and harmed by medication errors, almost half of which are preventable. This is a cross-sectional, descriptive and exploratory study conducted in a clinical medicine unit. Direct observations were made by eight nurse technicians. The type of error, the type of drug involved and associated risk factors were analysed. Relationships between the occurrence of errors and risk factors were studied with logistic regression models. Of the 484 observed doses, 69.5% errors occurred during drug administration, 69.6% during the preparation stage, 48.6% were timing errors, 1.7% were dose-related errors and 9.5% were errors of omission. More than one error was detected in 34.5% of occasions. Unlabelled drugs increased the risk of timing errors by a factor of 13.72. Interruptions in preparation increased the risk of errors by a factor of 3.75. Caring for a larger number of patients (8-9) increased the risk of timing errors by a factor of 8.27. The research shows the need to manage the risk of medication errors in their real-life contexts by interposing safety barriers between the hazards and potential errors.