Morbi-mortalidade e gastos hospitalares com idosos de Minas Gerais, Brasil / Morbis-mortality and hospital costs with elderly people from Minas Gerais, Brazil / Morbi-mortalidad y gasto hospitalario en ancianos de Minas Gerais, Brasil

Introdução: O envelhecimento populacional é uma realidade em todo o mundo, representando um desafio significativo para os sistemas de saúde. Objetivo: Descrever o perfil de morbidades e os gastos relacionados a internações de idosos em comparação aos adultos registradas no estado de Minas Gerais, Brasil, entre 2008 e 2017. Métodos: Estudo descritivo, de corte transversal, com dados do DATASUS e com base na CID-10. Resultados: Embora o maior número de internações esteja na faixa etária adulta, a proporção de gastos é maior com os idosos, com maior prevalência entre doenças mentais e comportamentais, osteomusculares e do tecido conjuntivo, seguidos das doenças de causas externas e do aparelho circulatório. Conclusão: Sugere-se a adoção de políticas mais abrangentes e maior investimento em ações de promoção da saúde, prevenção de agravos e tratamento oportuno e adequado para as doenças mais prevalentes nos idosos, em especial na atenção primária à saúde.

Introduction: Population aging is a reality around the world, representing a significant challenge for health systems. Objective: To describe the profile of morbidities and spending related to hospitalizations of elderly in comparison to adults registered in the state of Minas Gerais, Brazil, between 2008 and 2017. Methods: Descriptive, cross-sectional study with data from DATASUS and based on ICD-10. Results: Although the highest number of hospitalizations is in the adult age group, the proportion of expenditures is higher with the elderly, with a higher prevalence among mental and behavioral diseases, osteomuscular diseases and connective tissue, followed by diseases of external causes and the circulatory system. Conclusion: It is suggested to adopt more comprehensive policies and to invest more in actions to promote health, prevention of diseases and timely and adequate treatment for the most prevalent diseases in the elderly, especially in primary health care.

Introducción: El envejecimiento de la población es una realidad mundial, que representa un importante desafío para los sistemas de salud. Objetivo: Describir el perfil de morbilidad y los gastos relacionados con las internaciones de los ancianos en comparación con los adultos registrados en el estado de Minas Gerais (Brasil) entre 2008 y 2017. Métodos: estudio descriptivo, transversal con datos DATASUS y basado en CID-10. Resultados: Aunque el mayor número de internaciones se encuentra en el grupo de edad adulta, la proporción de gastos es mayor con los ancianos, con una mayor prevalencia entre las enfermedades mentales y conductuales, las enfermedades osteomusculares y el tejido conjuntivo, seguidas de enfermedades de causas externas y el aparato circulatorio. Conclusión: Se sugiere adoptar políticas más amplias e invertir más en acciones para promover la salud, prevenir las agravaciones y el tratamiento oportuno y adecuado de las enfermedades más prevalentes en las personas de edad, especialmente en la atención primaria de la salud.

Avós cuidadores de netos: análise do perfil e intensidade dos cuidados / Grandparents that take care of granchildren: analysis of the care profile and intensity / Abuelos cuidadores de nietos: análisis del perfil e intensidad del cuidado

RESUMO Objetivo: identificar o perfil e a intensidade de cuidado dos avós para com os netos. Método: estudo descritivo, transversal, por amostra aleatória sistematizada, utilizado questionário semiestruturado e empreendida análise exploratória descritiva. Realizado no município do Triângulo Mineiro - Brasil, 2019. Resultados: entrevistados 392 avós cuidadores de netos, maioria mulheres (87,5%), aposentadas (67,3%), ensino fundamental incompleto (52,8%), hipertensas (71,9%) e problemas visuais (69,4%). O motivo principal de cuidado foi pelos pais trabalharem e a intensidade de cuidado junto aos netos foi intensiva. Conclusão: considera-se que a relação de cuidado entre avos e netos é um aspecto invisível à produção científica e na estruturação de programas de saúde, apesar de seus impactos à condição de saúde dos idosos. O estudo amplia a visão aos mesmos sendo necessário o desvelar deste tema para que se possa efetivamente integrá-los e fortalecer políticas públicas e sociais, notadamente no setor saúde, dado ser um fenômeno emergente.

ABSTRACT Objective: to identify the profile and intensity of the care provided by grandparents to grandchildren. Method: a descriptive and cross-sectional study by means of systematized random sampling, with application of a semi-structured questionnaire and execution of descriptive exploratory analysis. It was conducted in 2019 in the municipality of Triângulo Mineiro - Brazil. Results: a total of 392 grandparents caring for grandchildren were interviewed, mostly women (87.5%), retired (67.3%), with incomplete Elementary School (52.8%), hypertensive (71.9%) and with vision problems (69.4%). The main reason for the caregiver role was the fact that the parents had to work, and intensity of the care provided to the grandchildren was high. Conclusion: it is considered that the care relationship between grandparents and grandchildren is an invisible aspect to the scientific production and in the structuring of health programs, despite its impacts on older adults' health status. The study broadens their visibility, with the need to unveil this topic so that it is possible to integrate them and strengthen public and social policies, especially in the health sector, given that it is an emerging phenomenon.

RESUMEN Objetivo: identificar el perfil y la intensidad del cuidado que realizan los abuelos de sus nietos. Método: estudio descriptivo, transversal, con muestreo aleatorio sistemático, mediante cuestionario semiestructurado y análisis descriptivo exploratorio. Realizado en el municipio del Triángulo Minero - Brasil, 2019. Resultados: se entrevistó a 392 abuelos que cuidaban a sus nietos, la mayoría eran mujeres (87,5 %), jubiladas (67,3 %), con primaria incompleta (52,8 %), hipertensión (71,9 %) y problemas visuales (69,4 %). La principal razón para que cuiden de ellos era que los padres trabajaban y la intensidad del cuidado de los nietos era intensiva. Conclusión: se considera que la relación de cuidado entre abuelos y nietos es un aspecto invisible en la producción científica y en la estructuración de programas de salud, a pesar de los impactos que tiene en la condición de salud de los adultos mayores. El estudio amplía la visión sobre los mismos dado que es necesario dilucidar este tema para que puedan ser efectivamente integrados y fortalecer las políticas públicas y sociales, especialmente en el sector salud, dado que se trata de un fenómeno emergente.

Covid-19: processo de trabalho da equipe de enfermagem em Unidade de Terapia Intensiva / Covid-19: work process of the nursing team in an Intensive Care Unit

O objetivo deste estudo foi compreender o processo de trabalho da equipe de enfermagem atuante em Unidade de Terapia Intensiva para atendimento de pacientes com covid-19. Tratou-se de uma pesquisa descritiva, de abordagem qualitativa. A coleta de dados ocorreu por meio de entrevista semiestruturada e audiogravada, e a interpretação foi realizada a partir da análise temática indutiva. Participaram 28 profissionais de enfermagem, sendo oito enfermeiros gerentes, sete enfermeiros assistenciais e 13 técnicos de enfermagem, todos atuantes na Unidade de Terapia Intensiva de um hospital público no interior de Minas Gerais. O processo de trabalho esteve relacionado à sobrecarga, pressões, sofrimento e impacto dos óbitos. Foram relatadas, positivamente, oportunidades de aprendizado técnico-científico e de inserção no mercado de trabalho. A vacinação proporcionou maior segurança, e os profissionais também refletiram sobre a vida e o seu real valor. Logo, conceder o reconhecimento a esses profissionais diante do trabalho vivenciado e desempenhado denota compromisso social e valorização para com aqueles que fizeram a diferença em uma das maiores pandemias da história

The objective of this study was to understand the work process of the nursing team working in Intensive Care Unit for the care of patients with COVID-19. It was a descriptive research, with a qualitative approach. Data collection took place with semi-structured and audio-recorded interviews, and interpretation was performed based on inductive thematic analysis. A total of 28 nursing professionals participated, with eight manager nurses, seven assistant nurses, and 13 nursing technicians, all working in the Intensive Care Unit sector of a public hospital in the interior of Minas Gerais. The work process was related to overload, pressure, suffering, and the impact of deaths. Opportunities for technical-scientific learning and insertion in the job market were positively reported. Vaccination provided more safely, and professionals also reflect on life and its real value. Therefore, granting recognition to these professionals in view of the work experienced and performed denotes social commitment and appreciation for those who made a difference in one of the greatest pandemics in history

Repairing left ventricular outflow after aortic composite graft pseudoaneurysm: case report.

BACKGROUND: We present a technique for aortic composite graft implantation after left ventricular outflow tract destruction due to its proximal dehiscence. CASE PRESENTATION: A 53-year-old gentleman with rheumatoid arthritis and history of Bentall procedure, presented with heart failure symptoms for the past month. Transthoracic echocardiogram identified prosthetic valve dysfunction, and transesophageal echocardiogram detected that its mechanism was by dehiscence. After excluding infectious etiology, it was hypothesized that the cause was the absence of endothelialization, owing to immunosuppressive therapy. Repair surgery was successful, and 2 years later, the patient is fully asymptomatic. CONCLUSIONS: Immunosuppressive drugs are a rare cause of aortic composite graft dehiscence. Left ventricular outflow tract surgical reconstruction remains an extremely complex and high-risk intervention, with the need for reentry into cardiopulmonary bypass and graft proximal segment implantation in a lower position.

Fatores relacionados à autopercepção sobre o envelhecimento de idosos cadastrados em uma Unidade de Atenção ao Idoso / Factors related to self-perception of aging in elderly people registered in an Elderly Care Unit

Este estudo teve o objetivo de identificar a percepção sobre o envelhecimento dos idosos usuários de uma Unidade de Atenção ao Idoso de um município brasileiro e avaliar a relação entre características sociodemográficas e de autopercepção sobre o envelhecimento. Estudo de caráter quantitativo, analítico, observacional e transversal realizado com 228 idosos. Foram utilizados os seguintes instrumentos: questionário sociodemográfico, Mini Exame do Estado Mental, APQ (Aging Perception Questionnaire), WHOQOL-Bref, WHOQOL OLD e ASKAS. Foram realizadas análises bivariada e multivariada. Encontrou-se predomínio do sexo feminino, com média de idade de 78,86 anos. A autopercepção sobre o envelhecimento foi moderada. Idosos do sexo feminino e aqueles que residem com filhos demonstraram maior autopercepção do envelhecimento.

This study aimed to identify the perception of aging of elderly users of an Elderly Care Unit in a Brazilian city and to evaluate the relationship between sociodemographic characteristics and self-perception of aging. An observational and descriptive, cross-sectional study with 228 elderly people. The following instruments were used: sociodemographic questionnaire, Mini Mental State Examination, APQ (Aging Perception Questionnaire), WHOQOL-Bref, WHOQOL OLD and ASKAS. Bivariate and multivariate analyzes were performed. There was a predominance of females, with a mean age of 78.86 years. Self-perception of aging was moderate. Elderly females and those who live with children have greater self-perception of aging.

Early differentiated CD28+ CD27+ T lymphocytes as a biomarker for short and long-term outcomes in older patients with pneumonia.

This study tested the hypothesis that a more senescent immune system would predict a worse outcome in older patients hospitalized for community-acquired pneumonia (CAP). CAP has long been responsible for high rates of mortality and readmissions among older people. Although immunosenescence is a key factor in the increased susceptibility to infections, there are no related biomarkers currently available in clinical practice. In this context, the aim of this prospective study was to identify immunosenescence-related biomarkers to predict outcomes in patients older than 65 years hospitalized for CAP. We evaluated 97 patients admitted to our hospital for CAP in 2019 and 2020. All patients were followed for 1 year. Our findings showed that elevated levels of early differentiated CD28+ CD27+ T cells at admission were associated with better short (2 months) and long-term (1 year) outcomes in terms of mortality and readmissions. Early differentiated CD28+ CD27+ CD4+ T cell counts were even better long-term predictors. In conclusion, early differentiated CD28+ CD27+ T cells could be useful biomarkers to identify high-risk older patients with CAP, helping clinicians with risk stratification and follow-up.

HYBRID AORTIC ARCH SURGERY TO CREATE A LANDING ZONE IN THE ASCENDING AORTA.

INTRODUCTION: Thoracic Endovascular Aortic Repair (TEVAR) has enabled the treatment of aortic pathology that previously required open surgery, with higher morbidity and mortality. The need for a favorable landing zone (Lz), without compromising the patency of the supra-aortic vessels meant that Ishimaru Lz 2 was the most proximal technically feasible Lz. We developed a hybrid technique for the creation of a more proximal Lz in high risk patients - in the first stage, debranching/ rerouting of the supra-aortic vessels, with or without ascending aorta replacement, was performed; a few weeks later, a TEVAR with a LZ in the distal ascending aorta was performed. This technique allowed the avoidance of the more aggressive total arch and proximal descending aorta replacement (Elephant Trunk or Frozen Elephant Trunk - FET) in high risk patients. We reviewed all patients who underwent hybrid arch surgery in our Department to create a more proximal Lz that allowed safe TEVAR stent placement. From November 2007 to October 2019, 15 patients required hybrid surgery to achieve treatment - 9 by replacing the ascending aorta and debranching supra-aortic vessels and 6 by debranching and re-routing supra-aortic vessels to the native ascending aorta. All underwent computed tomography angiography within 30 days of surgery and had follow-up with annual appointments and imaging control. Patients average age was 65.5 (+/- 11.5) years, 73.3% being male. Average follow-up was 54.7 (+/- 46.2) months. The most common diagnosis was thoracic aortic aneurysm (66.7%), followed by chronic type B aortic dissection (20.0%), pen- etrating atherosclerotic ulcer (6.7%) and reintervention due to endoleak (EL, 6.7%). No in-hospital mortality was registered. ICU and hospital stay was 1.3 (0.8) days and 9.8 (10.3) days, respectively. Survival at 1- and 5- years was 84.6% and 65.8%, respectively. No EL was detected in 66.7% (n=10) of patients. Incidence of early EL was 20.0% (n=3), of which two-thirds had spontaneous resolution, and late EL was 13.3% (n=2). Endovascular reintervention was required in one patient. TEVAR in the context of hybrid surgery is associated with low morbidity and mortality, with a low incidence of EL and good early and long term survival.

ATLANTIC ANTS: a data set of ants in Atlantic Forests of South America.

Ants, an ecologically successful and numerically dominant group of animals, play key ecological roles as soil engineers, predators, nutrient recyclers, and regulators of plant growth and reproduction in most terrestrial ecosystems. Further, ants are widely used as bioindicators of the ecological impact of land use. We gathered information of ant species in the Atlantic Forest of South America. The ATLANTIC ANTS data set, which is part of the ATLANTIC SERIES data papers, is a compilation of ant records from collections (18,713 records), unpublished data (29,651 records), and published sources (106,910 records; 1,059 references), including papers, theses, dissertations, and book chapters published from 1886 to 2020. In total, the data set contains 153,818 ant records from 7,636 study locations in the Atlantic Forest, representing 10 subfamilies, 99 genera, 1,114 ant species identified with updated taxonomic certainty, and 2,235 morphospecies codes. Our data set reflects the heterogeneity in ant records, which include ants sampled at the beginning of the taxonomic history of myrmecology (the 19th and 20th centuries) and more recent ant surveys designed to address specific questions in ecology and biology. The data set can be used by researchers to develop strategies to deal with different macroecological and region-wide questions, focusing on assemblages, species occurrences, and distribution patterns. Furthermore, the data can be used to assess the consequences of changes in land use in the Atlantic Forest on different ecological processes. No copyright restrictions apply to the use of this data set, but we request that authors cite this data paper when using these data in publications or teaching events.

First record of Cryptophion Viereck, 1913 (Ichneumonidae: Campopleginae) from Colombia, with description of a new species.

The genus Cryptophion Viereck, 1913 includes eight Neotropical species distributed in Central and South America. Herein the genus is recorded for the first time in Colombia and a new species, Cryptophion flavonigrovittatus Santos, Onody & Palacio sp. nov. is described. In addition, Cryptophion spinozai and Cryptophion guilhermoi are reported for the first time for Colombia. An identification key is also provided for all species of the genus.

Factor investing: A stock selection methodology for the European equity market.

This paper uses European high capitalization corporate data for the 1991-2019 period to demonstrate that a systematic active management portfolio based on the identification of value, profitability, and momentum factors can outperform competing benchmark strategies. Factor investment methodologies received significant attention in the literature in the U.S. market but their application to European corporates is more limited. The authors construct several systematic investment strategies combining different metrics measuring the three factors. Reported results show that a) combined (mixed/conditional) strategies deliver positive alphas and significantly outperform their pure strategy counterparts and b) while there exists a time changing performance of selected metrics the iterative combination of factors delivers the highest performance with average annualized compounded returns of up to about 17%. Three Key Takeaways:  1. This paper documents the existence of alpha-generating factor strategies based on a combination of value, profitability, and momentum metrics. Combined (mixed/conditional) portfolios significantly outperform their pure strategy counterparts.  2. The iterative combination of factors delivers the highest performance with annualized compounded returns of up to 17%.  3. In line with the recent literature, we find decaying returns to factor strategies.

A striking new species of Dolichomitus Smith, 1877 (Hymenoptera: Ichneumonidae; Pimplinae) from South America.

BACKGROUND: Dolichomitus Smith, 1877 is a genus of Darwin wasps characterised by their large bodies and long ovipositors, that includes more than 75 species worldwide, 20 of which occur in the Neotropical Region. Due to recent efforts, the number of species of this genus continues to increase in South America. NEW INFORMATION: A new iridescent species of Pimplinae, Dolichomitus meii sp. nov., is described and illustrated. It was discovered from the biological station of Yanayacu located in the north-eastern slopes of the tropical Andes. It may be separated from all other species of Dolichomitus Smith by the striking colour pattern and apically strongly decurved ovipositor.

Nurse knowledge about potentially inappropriate medications for elderly

Due to the consequences of changes in fertility and mortality rates, there is an increase in population aging. In this context, the use of potentially inappropriate medications in this population makes nurses important agents in the identification of adverse reactions, requiring their knowledge about these drugs and their effects. The study aimed to verify nurses knowledge about the 2015 AGS BeersCriteria, regarding the potentially inappropriate medications for the elderly, and their adverse effects. It is a cross-sectional, descriptive, and analytical study with a quantitative and qualitative approach performed in a teaching hospital in the Triângulo Mineiro, Minas Gerais. Of the 80 professionals, 74.1% reported attending the elderly frequently, and only 3.8% had a specialization course in elderly health. Only 13.8% reported knowing the Beers Criteria. And 69% believe that adverse drug reactions can be confused as a new symptom and because of this, new drugs can be inserted into the therapeutic plan. Three categories emerged: The importance of assertive knowledge about PIMs, The nurse as a fundamental character in ADR, and Knowledge as a reinforcer of care. There is evidence of the need to train nurses to better identify adverse drug reactions so that they can act on these events avoiding the worsening of the individual.

Hospitalization of elderly people for conditions sensitive to primary health care in a city in the Triângulo Mineiro

This study aimed to analyze the profile of hospitalizations sensitive to primary care in the elderly according to age and sex. This is an ecological study with description of sensitive hospitalizations of elderly residents in the city of Uberaba - MG from 2009 to 2018. The proportion of hospitalizations for sensitive conditions compared to the total number of hospitalizations and the rates of sensitive hospitalizations were analyzed. For the other analyzes, the causes of hospitalization by age and sex were analyzed, and descriptive analyzes were carried out in terms of frequency and percentage. The proportion of sensitive hospitalizations decreased in the period between 2009 and 2016, with the most expressive groups of causes related to the cardiovascular system (heart failure, angina, and cerebrovascular diseases), elderly people aged 80 years and over and male. Ecological studies with public domain data are of fundamental importance in the analysis of the health conditions of the populations and in the direction of the health actions undertaken, especially those carried out by Primary Health Care (PHC).

Morphophysiological characterization of Ceratocystis fimbriata isolates from yerba mate / Caracterização morfofisiológica de isolados de Ceratocystis fimbriata de erva-mate

ABSTRACT: This study aimed to morphologically characterize the isolates of Ceratocystis fimbriata from yerba mate and to evaluate the effect of culture medium and temperature on mycelial growth and sporulation of C. fimbriata. For the morphological characterization of the 11 monosporic isolates of the fungus, slides were prepared to determine the dimensions of the sexual and asexual structures of the fungus. Four experiments were conducted to evaluate the mycelial growth and to evaluate the sporulation of C. fimbriata in different culture mediums and temperatures. The isolates of C. fimbriata from yerba mate showed perithecia with brown to black necks, divergent ostiolar hyphae, hatshaped hyaline ascospores, single-celled, cylindrical endoconidia, and globular to ovoid aleurioconidia. PDA and V8-agar media showed the highest mycelial growth. The average optimum temperature for mycelial growth and sporulation of isolates of C. fimbriata of yerba mate were 22.5 and 22.4 ºC, respectively.

RESUMO: Este estudo teve como objetivo caracterizar morfologicamente os isolados de Ceratocystis fimbriata e avaliar o efeito do meio de cultura e da temperatura no crescimento micelial e na esporulação de C. fimbriata. Para a caracterização morfológica dos 11 isolados monospóricos do fungo foram preparadas lâminas para determinar as dimensões das estruturas sexuadas e assexuadas do fungo. Quatro experimentos foram conduzidos para avaliar o crescimento micelial e esporulação of C. fimbriata em diferentes meios de culturae temperaturas. Os isolados de C. fimbriata de erva-mate apresentaram peritécios com pescoço de marrom a preto, hifa ostiolar divergente, ascósporos hialinos em formato de chapéu, endoconídios unicelulares, cilíndricos, e aleuroconídios com formato globoso a ovoide. Os meios de cultura PDA e V8-ágar apresentaram os maiores crescimentos miceliais. A temperatura ótima média para crescimento micelial e esporulação dos isolados de C. fimbriata de erva-mate foram de 22,5 e 22,4 ºC, respectivamente.

Influence of pulmonary rehabilitation in patients with Chronic Obstructive Pulmonary Disease exacerbator phenotype. / Influência da reabilitação pulmonar no paciente com Doença Pulmonar Obstrutiva Crônica fenótipo exacerbador.

Objective To verify if there are differences in Chronic Obstructive Pulmonary Disease (COPD) patient exacerbator and non-exacerbator phenotypes undergoing a Pulmonary Rehabilitation Program (PRP). Methods A real life retrospective study included outpatients with COPD from public primary care who completed a 12-weeks PRP, three times a week. All were assessed before and after PRP using the six-minute walk test (6MWT), the modified Medical Research Council (mMRC) dyspnea index, quality of life and Body-mass Index, airflow Obstruction, Dyspnea and Exercise (BODE index). Results A total of 151 patients were analyzed and mean age was 65.0 ± 8.1 years and mean Forced Expiratory Volume (FEV) 1% of predicted was 39.8 ± 15.9. The predominant gender was male (66.9%). Of these patients 31 (20.5%) were exacerbator phenotype There was a significant improvement in the mean distance in the 6MWT in both groups, with the largest change observed in the exacerbator group [mΔ (95% CI): 84.9 (57.1-112.6) vs. 48.6 (37-60.2) p= 0.018]. Significant reduction in dyspnea on the mMRC scale occurred in both groups, with the highest intensity in the exacerbator group [mΔ (95% CI): - 0.8 (-1.11 to 0.51) vs. -1.6 (-2.20 to -1.13) p = 0.006]. Improvement in the BODE index occurred in both groups, but the mean variation was also significantly greater in the exacerbator group [mΔ (95% CI): -1.44 (-2.17 to -0.70) p= 0.045]. Conclusion Patients with COPD exacerbator phenotype had a greater magnitude of response to PRP (36 meters) when compared to non-exacerbator phenotype regardless the severity of airflow obstruction, also showing improvement in prognosis measured by the BODE index.

Self-efficacy in elderly with type 2 Diabetes Mellitus.

OBJECTIVE: to analyze the self-efficacy of elderly with type 2 diabetes mellitus and the relationship with sociodemographic, clinical, knowledge, and attitude variables. METHOD: a cross-sectional quantitative study conducted with 256 elderly people enrolled in Family Health Strategies. Data were obtained through interviews. Descriptive statistical analysis and multiple linear regression model were performed (p <0.05). RESULTS: female, 69.95-year mean age, white skin color, 4-7 years of schooling, living with a partner, retirees, low individual monthly income, 6 to 15 years of illness, Catholics, living with children (with or without spouse). The elderly's low knowledge and negative attitude prevailed. Self-efficacy was associated with attitude and knowledge in the domains "General and Specific Diet", "Physical Exercise" and "Blood Glucose". CONCLUSION: self-efficacy investigations in type 2 Diabetes Mellitus management in the elderly are important and encourage treatment adherence.

Results of frozen elephant trunk from the international E-vita Open registry.

BACKGROUND: Over the years, frozen elephant trunk (FET) has become the treatment of choice for multisegmental thoracic aortic disease. This multicenter study presents the evolution of FET results using the E-vita Open hybrid graft with respect to institutional experience and time. METHODS: The data of International E-vita Open registry were studied according to the institutional experience of the participating centers (high- versus low-volume centers) and according to the evolution of FET treatment during time (1st period, 2005-2011 versus 2nd period, 2012-2018). Overall, 1,165 patients were enrolled in the study with a wide variety of multisegmental thoracic aortic pathologies and aortic emergencies. Participating centers determined their own surgical protocol. RESULTS: The overall 30-day mortality was 12%. Short- and long-term survival were higher in high- versus low-volume centers (P=0.048 and P=0.013, respectively). In the 2nd time period, cerebral complications were reduced significantly (P=0.015). Incidence of permanent spinal cord-related symptoms was reduced to 3% in the 2nd time period, but did not reach statistical significance. Hypothermic circulatory arrest time (P<0.001) and incidence of postoperative temporary renal replacement therapy (P=0.008) were significantly reduced in the 2nd time period. Ten-year survival and freedom from aortic-related death rates were 46.6% and 85.7%, respectively, for the entire group. The freedom from distal aortic re-interventions for a new or progressive residual aortic disease was 76.0%. CONCLUSIONS: Evolution of FET arch repair techniques with the E-vita Open graft and increasing institutional experience were associated with improved results. Progression of residual aortic disease makes close follow-up with aortic imaging mandatory in such patients.

Quality of life of elders in the primary health care in Uberaba, MG / Qualidade de vida de idosos da atenção primária à saúde em Uberaba, MG

This study aimed to evaluate social and economic predictors, as well social behavior and its influence on the quality of life of elders who use the primary health care network of Uberaba, Minas Gerais. Methods: Descriptive, exploratory, cross-sectional and quantitative study, conducted with 248 60 year old or older subjects, from November 2016 to May 2017. A structured questionnaire was applied to evaluate sociodemographic data, health conditions and life habits as well the WHOQOL-Bref and the WHOQOL-Old. The analysis were conducted through relative frequencies and t-test as well multiple linear regression were used to associate variables. The study was approved by the Committee of Ethics in Researches with Human Beings of the Federal University of the Triângulo Mineiro (CEP/UFTM). Results: Most elders were women, catholic, with 4 years or more of formal education, had partners, a sexually inactive life, and were retired. The linear regression analysis, found a positive and light or moderate association between sexual life and the physical, social, and environmental domains, and the past, present and future activities facet. The educational level variable had a positive and light association with the psychological domain, whereas the variable occupation had a negative and light association with the death and dying facet. Conclusions: The results found show an important social impact regarding the studied population, making it clear that public policies should be created and executed as to offer subsidies for actions which are specifically targeted at the QoL of elders.

Este estudo teve como objetivo avaliar os preditores sociais e econômicos, bem como o comportamento social e sua influência na qualidade de vida dos idosos que utilizam a rede de Atenção Primária à Saúde de Uberaba, Minas Gerais. Métodos: Estudo descritivo, exploratório, transversal e quantitativo, realizado com 248 pessoas de 60 anos ou mais, entre novembro de 2016 a maio de 2017. Foi aplicado um questionário estruturado para avaliar os dados sociodemográficos, condições de saúde e hábitos de vida, bem como o WHOQOL-Bref e o WHOQOL-Old. A análise foi realizada através de freqüências relativas e teste t, bem como regressão linear múltipla foram utilizadas para associar variáveis. O estudo foi aprovado pelo Comitê de Ética em Pesquisa com Seres Humanos da Universidade Federal do Triângulo Mineiro (CEP / UFTM). Resultados: A maioria dos idosos eram mulheres, católicas, com 4 anos ou mais de educação formal, tinham parceiros, uma vida sexualmente inativa e eram aposentadas. A análise de regressão linear, encontrou uma associação positiva leve ou moderada entre a vida sexual e os domínios físico, social e ambiental, e facetas de atividades passadas, presentes e futuras. A variável nível educacional teve uma associação positiva e leve com o domínio psicológico, enquanto que a variável ocupação teve uma associação negativa e leve com a faceta de morte e morrer. Conclusões: Os resultados encontrados mostram um impacto social importante em relação à população estudada, deixando claro que as políticas públicas devem ser criadas e executadas de forma a oferecer subsídios para ações especificamente voltadas para a QV dos idosos.