Maxillofacial infections of dental origin: risk factors for hospital admission

Aim: to evaluate the occurrence of maxillofacial infection cases, which were treated at local hospital, identifying the main risk factors that determine the need for hospitalization of patients and the factors associated with staying length. Methods: A retrospective review of 191 records of patients with maxillofacial infection of odontogenic origin was performed, statistically evaluated by frequency and percentage of involvement, p values (based on the chi-square test) and odds ratio with a 95% confidence interval. A p-value <0.05 was considered statistically significant. Results: Among all the 191 patients, 31 had some harmful habits, such as smokers (13%) and alcoholics (1%). In addition, 39 patients reported some general health problem, such as systemic arterial hypertension (8.3%), depression (6.8%), diabetes (3.6%) and some immunosuppression (1.57%). Involvement of infection in deep facial spaces was present, with 119 patients presenting a deeper infection (62.3%) and 72 patients a superficial infection (37.7%). The most prevalent clinical signs and symptoms in the initial evaluation were pain (91.1%) and edema (90.1%), followed by erythema/hyperemia (44.5%), trismus (37.7%), abscess (30.9%), cellulitis (27.7%), f istula (16.8%), fever (16.8%), dysphagia (11%), dehydration (9.9%), odynophagia (7.9% ) and dyspnea (3.7%). Pulp necrosis was considered a risk factor for treatment in a hospital environment (0.032) and root canal treatment decreases the risk of hospitalization (p=0.002). Considering the evaluated patients, 146 (76.4%) were admitted and 45 (37.7%) were not admitted for hospitalization after initial clinical evaluation. Conclusion: there is a high occurrence of maxillofacial infection cases of dental origin, considering that involvement of infection in deeper facial spaces, as well as presence of pain, edema, erythema/hyperemia, trismus, abscess, cellulitis and pulp necrosis, represent the main risk factors for hospitalization and staying length

Cenário das políticas públicas para hemocromatose hereditária no Brasil / Public policy scenario for hereditary hemochromatosis in Brazil

Resumo Hemocromatose hereditária (HH) é a doença genética mais comum em descendentes de europeus e sua epidemiologia em nosso país é incerta. Considerando o cenário das políticas públicas em HH no mundo contemporâneo, este artigo propõe uma reflexão sobre o tema, com objetivo de fazer uma revisão bibliográfica narrativa sobre a abordagem adotada para essa doença em países desenvolvidos e a nível nacional. Além disso, discute sobre o custo-benefício da incorporação do índice de saturação da transferrina (ST) e ferritina sérica (FS) no nosso sistema de saúde, com a finalidade de identificar a HH antes que surjam suas complicações, bem como seu rastreio em campanhas nacionais de prevenção. O valor gasto para o screening da HH com dosagem de ST e FS pelo Sistema Único de Saúde (SUS) é muito menor do que os custos gerados quando o dano por excesso de ferro já está estabelecido. Nos casos suspeitos de HH, deveria ser viabilizada pelo SUS a pesquisa da mutação genética para o gene HFE, que atualmente só está disponível de forma privada. Com essas medidas, modifica-se a história natural da doença, reduzindo a morbimortalidade dos portadores e custos ao sistema público de saúde.

Abstract Hereditary hemochromatosis (HH) is the most common genetic disease among European descendants and its epidemiology in Brazil is unclear. Considering the contemporary public policy scenario aimed at HH, this narrative bibliographic review reflects on the approach adopted for this disease at the national level in developed countries. It also discusses the cost-effectiveness of incorporating transferrin saturation (TS) and serum ferritin (SF) indexes in the Brazilian healthcare system for early HH identification, as well as its screening in national prevention campaigns. The amount spent on ST- and FS-based HH screening by the Brazilian National Health System (SUS) is much lower than the costs generated by the already established iron overload. In suspected cases, genetic mutation research of the HFE gene, which is currently only performed privately, should be made available by the SUS. These measures can modify the natural history, reducing HH morbidity and mortality and its costs to the public health system.

Absenteísmo e bem-estar no trabalho para os profissionais de enfermagem / Absenteeism and well-being at work for nursing professionals

O absenteísmo e o bem-estar no trabalho (isto é, a síndrome de burnout e o work engagement) são duas realidades distintas que têm caracterizado a categoria dos profissionais da enfermagem e as organizações de saúde em nível mundial. Este artigo tem como objetivo analisar a relação entre o bem-estar no trabalho e o absenteísmo nos profissionais de enfermagem que atuam em ambiente hospitalar. O estudo de corte transversal foi realizado com profissionais da categoria de enfermagem, que trabalham em três hospitais no município de Passo Fundo (RS), Brasil. Trata-se de uma pesquisa de abordagem quantitativa que contou com a participação de 201 profissionais da enfermagem, absenteístas e não absenteístas. O bem-estar foi mensurado por meio de questionário derivado do Maslach Burnout Inventory que mediu duas dimensões core do burnout (cinismo e exaustão) e o work engagement foi medido por meio da Utrecht Work Engagement Scale. Os resultados, nesta amostra, apontaram um alto nível de engagement e um baixo nível de burnout, não sendo registradas diferenças significativas entre os dois grupos de profissionais de enfermagem, absenteístas e não absenteístas.

Streptococcus gallolyticus bacteremia detected in apheresis platelets and its link to colonic neoplasms

Introduction: Streptococcus gallolyticus belongs to theStreptococcus bovis complex, and it is a common bacterium colonizing the gastrointestinal tract. Its presence in the blood may suggest an underlying pathology such as a colonic neoplasm. We report herein a case of S. bovis bacteremia in an apheresis platelet donor, review similar cases in the literature, and suggest a flowchart for the management of similar cases in other blood donation centers. Case Presentation: A 61-year-old subject presented to a Hemotherapy Service to make an apheresis platelet donation. On quality control testing, S. gallolyticus was identified in hemoculture, and the donor was called back for follow-up. At first, a new hemoculture was requested, and the patient was referred to the outpatient department of infectious diseases to further investigate pathologies associated with S. gallolyticus. A subsequent colonoscopy investigation evidenced a polypoid structure in the ascending colon. Pathology reported the resected specimen as a low-grade tubular adenoma. Conclusion: Isolation of S. bovis in blood products requires further investigation and should be managed with precision by Hemotherapy Services. A standard protocol for the management of asymptomatic patients with S. bovis positive hemoculture, with the requests of a new blood culture, a colonoscopy, and an echocardiogram is crucial, as it may ensure early diagnosis and reduce morbidity and mortality. (AU)

Effectiveness of topical ozonated oil in severe osteoarthritis: A randomised, triple-blinded, placebo-controlled study.

BACKGROUND: Osteoarthritis is highly prevalent and a common locomotory disorder in the elderly. The treatments aim improves the quality of life. We aimed to evaluate the effectiveness of topical ozonated oil in relieving pain in patients with osteoarthritis. DESIGN: A placebo-controlled, triple-blind, randomised controlled trial including osteoarthritis patients older than 50 years. INTERVENTIONS: Eighty patients were randomly divided into two groups: treatment (ozonated oil) and placebo (non-ozonated oil). The oils were used twice a day for 60 days. Evaluations were performed using WOMAC (Western Ontario and McMaster Universities) and VAS (visual analogue scale) and laboratory analysis. RESULTS: Pain relief was observed in all groups except in the placebo group where patients are diagnosed with severe osteoarthritis (degree 4) (p-value treatment and placebo group: 0.021 and 0.345, respectively). CONCLUSIONS: For the first time, the pain relief in patients with severe osteoarthritis was demonstrated by the use of topical ozonated oil.

A Bowling Exergame to Improve Functional Capacity in Older Adults: Co-Design, Development, and Testing to Compare the Progress of Playing Alone Versus Playing With Peers.

BACKGROUND: Older people often do not meet the recommended levels of exercise required to reduce functional decline. Social interaction is mentioned by this cohort as a reason for joining group-based exercises, which does not occur when exercising alone. This perspective shows that exergames can be used as motivational resources. However, most available exergames are generic, obtained from commercial sources, and usually not specifically designed or adapted for older people. OBJECTIVE: In this study, we aim to co-design and develop a new exergame alongside older participants to (1) tailor the game mechanics and optimize participants' adherence to and enjoyment of exercise; (2) test the participants' functional capacity, motivation, and adherence to the exergaming program; and (3) compare these scores between those who played alone and those who played with peers. METHODS: We conducted a co-design process to develop a new exergame adapted to older people. For user testing, 23 participants were divided into 2 groups to play individually (alone group) or to compete in pairs (with peers group). They played the game twice a week, resulting in 21 exergaming sessions. We assessed the participants' General Physical Fitness Index (GPFI) before and after the user testing. We also administered questionnaires about the gaming experience and exercise adherence with its motivators and barriers. RESULTS: We introduced a new bowling exergame for Xbox with a Kinect motion sensor that can be played in single or multiplayer mode. For the GPFI measurements, the sample was homogeneous in the pretest (with peers group: mean 40.5 [SD 9.6], alone group: mean 33.9 [SD 7.8]; P=.11). After the exergame testing sessions, both groups had significant gains (with peers group: mean 57.5 [SD 8.7], P=.005; alone group: mean 44.7 [SD 10.6]; P=.02). Comparing the posttest between groups, it was found that the group in which participants played with peers had better outcomes than the group in which participants played alone (P=.02). Regarding the gaming experience and exercise adherence, both groups recognized the benefits and expressed enthusiasm toward the exergame. CONCLUSIONS: The findings suggest that the developed exergame helps in improving the functional capacity and adherence to physical exercise among older people, with even better results for those who played with peers. In addition to leading to more appropriate products, a co-design approach may positively influence the motivation and adherence of participants.

Association of positive direct antiglobulin test (DAT) with nonreactive eluate and drug-induced immune hemolytic anemia (DIHA).

BACKGROUND AND OBJECTIVES: Drug-induced immune hemolytic anemia is a rare condition that occurs primarily because of drug-induced antibodies, either dependent or independent and positive direct antiglobulin test. Our aim was to evaluate the association of positive DAT with nonreactive eluate and DIHA. MATERIALS AND METHODS: From 2014-2018, we evaluated 159 patients who presented positive DAT with a nonreactive eluate. Laboratory and clinical analyses were performed including HIV, HBV and HCV testing. All patients were exposed to the following drugs: Dipyrone in 63.5 %, Furosemide in 28.9 %, Metoclopramide in 34.6 % and Ondansetron in 41.5 %. RESULTS: Results of DAT showed IgG in 125 (78.4 %) patients and C3d in 24 (15.1 %) with reactions varying from 1+ to 4+. HIV test was positive in 10 (16.1 %) patients, HBV was positive in 3 (4.7 %) and HCV was positive in, 1 (1.5 %). There was no clinical significance when the parameters of hemoglobin, hematocrit, reticulocytes and LDH were evaluated, only a slight increase in bilirubin, especially, in patients with positive DAT reacting 3+/4+ due to IgG and C3d sensitization. Clinical evaluations showed that all patients were asymptomatic. CONCLUSIONS: The association of drugs with positive DAT can be a challenge to transfusion services and immunohematology reference laboratories. There was no evidence of any case of severe hemolysis with clinical repercussion through the clinical and laboratory findings analyzed with the drugs associated with positive DAT. Dipyrone and Furosemide have already been associated with DIHA but there are no studies reporting the association of Metoclopramide and Ondansetron with DIHA.

Perfil Epidemiológico de Pacientes Diagnosticados com Carcinoma Epidermoide Oral em Passo Fundo, Brasil / Epidemiological Profile of Patients Diagnosed with Oral Squamous Cell Carcinoma in Passo Fundo, Brazil / Perfil Epidemiológico de Pacientes Diagnosticados con Carcinoma Epidermoide Oral en Passo Fundo, Brasil

Introdução: O carcinoma epidermoide é uma patologia que corresponde a 90% dos tumores malignos da cavidade oral. Objetivo: Avaliar o perfil epidemiológico, o tratamento e a sobrevida dos pacientes diagnosticados com carcinoma epidermoide oral em um hospital referência na Região Norte do Estado do Rio Grande do Sul, Brasil. Método: Estudo observacional retrospectivo, com análise dos prontuários dos pacientes com diagnóstico dessa patologia, no período de 1993 a 2008, no banco de dados desse hospital. Os dados foram analisados pelo programa estatístico SPSS versão 18 utilizando testes paramétricos e não paramétricos. Resultados: Foram coletados e analisados dados de 303 prontuários que revelaram que 88,4% eram homens, leucodermas, com maior incidência na faixa etária entre 51 e 60 anos. A associação de álcool e tabaco foi observada em 84,7% dos pacientes. O local mais afetado foi a língua (45,5%) e a maioria dos casos apresentou estádios tardios III e IV com uma sobrevida de 17,83 meses. Embora o tratamento cirúrgico tenha sido o mais realizado (55,9%) e apresentado a maior sobrevida, não foi observada significância estatística deste com relação aos demais tratamentos (p=0,185). Conclusão: O perfil epidemiológico dos pacientes é muito semelhante aos registros de vários países. Neste caso, o diagnóstico tardio diminuiu significativamente a expectativa de vida dos pacientes (2,5x), e o tratamento executado bem como o local inicial da lesão não tiveram influência significativa na sobrevida

Introduction: The squamous cell carcinoma is a pathology accounting for 90% of all the malignant tumors found in the oral cavity. Objective: This study aimed to assess the epidemiological profile, treatment, and survival of patients diagnosed with oral squamous cell carcinoma at a reference hospital of the northern region of the state of Rio Grande do Sul, Brazil. Method: Retrospective observational study with analysis of the patients' charts diagnosed with this condition from 1993 to 2008 at this hospital database. The data collected were analyzed using the statistical program SPSS version 18 using parametric and non-parametric tests. Results: From the 303 charts analyzed, 88.4% were men, Caucasian, leukoderma, with higher incidence in the age range between 51 to 60 years old. The association of alcohol with tobacco was detected in 84.7% of the patients. The most affected site was the tongue (45.5%), and most of the cases were diagnosed in late stage III and IV, with survival of 17.83 months. Although surgical treatment has been performed more frequently (55.9%) and presented higher survival rates, its statistical significance in comparison with other treatments was not demonstrated (p=0.185). Conclusion: The epidemiological profile of patients is very similar to the charts of several countries. In the present case, the late diagnosis significantly decreased life expectancy of patients (2.5-fold), and that the treatment, and the initial site of the lesion had no significant influence on survival

Introducción: El carcinoma de células escamosas es una patología que corresponde aproximadamente a 90% de los tumores malignos de la cavidad bucal. Objetivo: Evaluar el perfil epidemiológico, el tratamiento y la sobrevida de los pacientes diagnosticados con carcinoma epidermoide oral en un hospital referencia en la región norte del estado de Rio Grande do Sul, Brasil. Método: Estudio observacional retrospectivo con los prontuarios de los pacientes con el diagnóstico de esa patología en el período de 1993 a 2008, en el banco de datos de este hospital usando el programa estadístico SPSS versión 18 usando pruebas paramétricas y no paramétricas Resultados: Se recogieron y analizaron datos de 303 prontuarios, que revelaron que 88,4% eran hombres, leucodermas, entre 51 a 60 años. La asociación de alcohol y tabaco fue observada en el 84,7% de los pacientes. El local más afectado fue la lengua (45,5%) y la mayoría de los casos ha presentado estadios tardíos III y IV con una sobrevida de 17,83 meses. Aunque el tratamiento quirúrgico fue el más realizado (55,9%) y presentado la mayor sobrevida, no se observó la significancia estadística de éste con relación a los demás tratamientos (p=0,185). Conclusión: El perfil epidemiológico de los pacientes es muy similar a los registros de varios países. En este caso, el diagnóstico tardío disminuyó significativamente la expectativa de vida de los pacientes (2,5x) y el tratamiento realizado, así como el lugar inicial de la lesión no tuvieron influencia significativa en la sobrevida

"Hey assistant, how can I become a donor?" The case of a conversational agent designed to engage people in blood donation.

BACKGROUND: People have insufficient knowledge and many misconceptions about the blood donation process, which hampers donors recruitment. Therefore, novel strategies and resources are needed to provide information and improve these circumstances. OBJECTIVE: We aimed at an interactive conversational agent to explain about blood donation. METHODS: We used the Dialogflow framework to develop a conversational agent and deployed it publicly. Afterward, we conducted an assessment of user experience (UX) with 50 participants who interacted with the agent. We analyzed participants' opinions, the different UX scales, and their association with participants' demographic variables. RESULTS: The conversational agent is available on the Google Assistant platform in Brazil. It is capable of responding to utterances related to 30 common questions and concerns about donating blood. The user can interact and explore freely and in any order by typing, speaking and selecting interface elements. The agent responds by speaking and displaying visual information, some multimedia content, and suggestions for continuing the dialogue. It enables a conversational sequence in which knowledge is imparted to the user in stages as the dialogue evolves. The overall UX assessed was very satisfactory, and people with specific demographic characteristics were more likely to have better UX. All participants had positive opinions and attitudes towards the conversational agent. CONCLUSIONS: A conversational agent is a creative and captivating strategy of imparting knowledge and engage people regarding blood donation. The findings reaffirm the potential of using this technology for information outreach, especially for socially relevant purposes.

Identification of rare blood types in southern Brazil: impact on transfusion support.

CONCLUSIONS: The prevalence of blood group antigens and phenotypes varies significantly in Brazil. To ensure a proper rare blood supply, it is essential to establish a local and regional database of rare donors connected to the national registry. The objective of this study was to create a database of rare blood donors in the northern region of southern Brazil. From November 2011 to December 2018, red blood cell (RBC) phenotyping and genotyping were performed on common and high-prevalence antigens in donors and patients in southern Brazil. During this study period, 17 patients and 33 blood donors with rare phenotypes were identified. Six patients had already been alloimmunized to clinically significant antigens. Patients with the following phenotypes (i.e., negative for highprevalence antigens) were found: Yt(a-), Jk(a-b-), Lu(a-b-), Oh (Bombay), Tc(a-), k-, and Fy(a-b-). Among the donors, Kp(a+b-), Fy(a-b-), Lu(a-b-), and k- phenotypes were identified. We also found four donors with the weak D type 18 phenotype. In conclusion, we observed that the prevalence of rare blood phenotypes in our region corresponds more to the prevalence found in the Caucasian population when compared with other regions in Brazil. Our results show the importance of continuous screening for rare donors in different regions of the country and the creation of a local database to support RBC transfusions in patients who need rare blood.

Cuidado ao idoso institucionalizado não se relaciona ao processo de comunicação adotado pelo profissional de saúde / Caring for elderly people is not related with process of communication by healthcare professionals

Introdução: a comunicação é um instrumento importante para o processo do cuidado de pessoa idosa institucionalizada. O uso das tecnologias assistivas pode estabelecer a comunicação entre a equipe interdisciplinar de saúde e a pessoa idosa. Objetivo: avaliar o conhecimento dos profissionais de saúde sobre o uso de tecnologia assistiva para comunicação alternativa. Método: estudo misto de cunho descritivo-analítico. Participaram 178 profissionais que compõem as equipes interdisciplinares de saúde de 19 instituições de longa permanência para idosos. A comunicação não verbal foi avaliada a partir do processo de cuidado, da percepção sobre saúde e conhecimento sobre geriatria e gerontologia. Resultados: o constructo de comunicação não verbal e cuidado contemplou os componentes de conscienciosidade, viver e envelhecer, formação e atuação da equipe interdisciplinar. O processo de comunicação não verbal efetuado por meio da tecnologia assistiva se relacionou ao grau de conhecimento de geriatria e gerontologia constituído pela equipe interdisciplinar. Conclusão: o cuidado humanizado ao idoso residente em instituição de longa permanência não se relaciona ao processo de comunicação não verbal efetuado pela equipe interdisciplinar. O profissional busca alternativas para efetuar a comunicação não verbal com o idoso institucionalizado se ocorrer a integralização de um conjunto de fatores.(AU)

Introduction: communication is an important instrument for the institutionalized elderly care process. The use of assistive technologies can establish communication between the interdisciplinary healt team and the elderly. Objective: to evaluate the knowledge of health professionals about the use of assistive technology for alternative communication. Method: mixed study of descriptive-analytical nature. 178 professionals from the interdisciplinary health teams of 19 long- -term care institutions for the elderly participated. Non-verbal communication was assessed from the care process, health perception and knowledge about geriatrics and gerontology. Results: the construct of non-verbal communication and care contemplated the components of conscientiousness, living and aging, formation and performance of the interdisciplinary team. The non-verbal communication process performed through assistive technology was related to the degree of knowledge of geriatrics and gerontology constituted by the interdisci- plinary team. Conclusion: humanized care for the elderly resident in a long-term care institution is not related to the non-verbal communication process performed by the interdisciplinary team. The professional searches for alternatives to make non-verbal communication with the institutionalized elderly if a set of factors occurs.(AU)

The Use of Digital Microscopy to Compare the Thicknesses of Normal Corneas and Ex Vivo Rejected Corneal Grafts with a Focus on the Descemet's Membrane.

OBJECTIVE: To compare the thickness of corneal layers, specifically the Descemet's membrane (DM), in normal corneas and in failed grafts due to rejection (FGRs) using the digital histopathology and to propose a model for the measurement of corneal layers using this method. METHODS: This is a prospective, cross-sectional study performed at the MUHC-McGill University Ocular Pathology & Translational Research Laboratory (McGill University, Montreal, Canada). Histopathological sections of 25 normal human corneas and 40 FGRs were fully digitalized and examined. Inclusion criteria: samples diagnosed as normal corneas or FGRs, from patients older than 18 years of age. Exclusion criteria: histopathological sections without adequate tissue or missing epidemiological information. For each sample, the thicknesses of the epithelium, stroma, and DM were acquired. From a perpendicular plane of reference, two central measurements and two nasal and two temporal peripheral measurements were obtained. RESULTS: There were differences between the normal and FGR groups in the mean central thickness of the epithelium (p < 0.001), the nasal and temporal stromal regions (p < 0.001), and of the DM in the nasal and temporal regions (p < 0.001). Compared with the extremities of the sample (nasal and temporal), the mean thickness of the DM in normal corneas was lower in the central region (p < 0.001), and this difference was not found in the FGR group. CONCLUSIONS: Normal corneas have a thinner epithelium in the central region than the FGR group. In addition, the stroma and DM thicknesses of the nasal and temporal periphery were significantly higher in normal corneas than in those from the FGR group. The digital microscopy protocol applied in this study may be useful for further research studies regarding cornea and other tissues.

A Idade como Diferencial no Engagement dos Profissionais de Enfermagem / The Age as a Differential in The Engagement of Nursing Professionals

Resumo O engajamento no trabalho é definido pelo equilíbrio entre funções cognitiva e afetiva do profissional. O estudo objetiva identificar a relação entre o engajamento e a idade dos profissionais de enfermagem, em termos de vigor, dedicação e absorção, atuantes em diferentes organizações de saúde. Com corte transversal, nível de complexidade descritiva, abordagem quantitativa, contempla 900 profissionais da enfermagem inscritos no Coren-RS, Brasil. O instrumento de pesquisa abrange questões sociodemográficas e o questionário breve de engajamento no trabalho de Utrecht. Os resultados apontam um nível médio de engajamento, especialmente no atributo relacionado à dedicação. Níveis mais elevados de engajamento foram identificados em profissionais com até 34 anos e com mais de 40 anos de idade.

Abstract Work engagement is defined by a balance between the cognitive and affective part of the professional. This study aims to identify the relationship between the engagement and the age of nursing professionals, in terms of vigor, dedication and absorption, acting in different health organizations. The cross-sectional study, with descriptive complexity level, quantitative approach, includes 900 nursing professionals enrolled in the Coren-RS, Brazil. The research instrument covers sociodemographic issues and the brief engagement questionnaire in Utrecht's work. The results indicate an average level of engagement, specially for the attribute related to dedication. Higher engagement levels were identified in professionals up to 34 years and over 40 years of age.

Análise do consumo de alimentos fontes de ômega 3 por participantes de grupos de convivências / Analysis of consumption of omega 3 source foods by participants of social groups

OBJETIVO: verificar o consumo de alimentos fontes de ômega 3 por participantes de grupos de convivências. MÉTODO: A pesquisa é do tipo transversal, descritivo/analítico, realizada com 850 idosos, participantes de grupos de convivência da Coordenadoria de Atenção ao Idoso (DATI), de uma cidade no estado do Rio Grande do Sul, Brasil, por meio de um questionário contendo variáveis sociodemográficas e consumo de alimentos fontes de ômega 3. Os dados foram analisados por meio da linguagem R 2.15.1, utilizando testes de qui-quadrado de Pearson e exato de Fisher. O nível de significância utilizado nos testes foi p≤0,05. RESULTADO:Os resultados do estudo demonstraram que as mulheres idosas possuem o hábito de utilizar mais alimentos fontes de ômega 3 do que os homens, como óleos, vegetais escuros, sementes, peixes e nozes e as pessoas com maior poder aquisitivo consomem mais produtos com ômega 3. CONCLUSÃO: Famílias com maior poder aquisitivo utilizaram fontes mais caras do ácido graxo ômega 3 e o consumo desses produtos não diferiu significativamente em relação a idade, IMC, estado marital e viver só ou com alguém. AU

OBJECTIVE: To verify the consumption of omega 3 source foods by participants of social groups. METHOD: a cross-sectional, descriptive analytical study was carried out with 850 older participants of social groups of the Older Adult Care Coordination (or DATI) in a city in the state of Rio Grande do Sul, Brazil, through a questionnaire containing sociodemographic variables and the consumption of omega 3 source foods. Data were analyzed using the R 2.15.1 language and using the Chi-square and Fisher's exact tests. The level of significance used in the tests was p≤0.05. RESULT: The results showed that older women have a habit of consuming more omega 3 source foods than men, such as oils, dark green vegetables, seeds, fish and nuts, and people with greater purchasing power consume more products with omega 3. CONCLUSION: Families with greater purchasing power used more expensive sources of omega 3 fatty acid, and the consumption of these products did not differ significantly in terms of age, BMI, marital status and whether the individual lived alone or with others. AU

Anxiety and depression symptoms in in post-percutaneous coronary adults and elderly intervention / Sintomas de ansiedade e depressão em adultos e idosos na pós-intervenção coronária percutânea / Síntomas de ansiedad y depresión en adultos y ancianos en la post-intervención coronaria percutánea

Abstract Cardiovascular diseases are among the leading causes of disability and death. One of the forms of treatment for them is the percutaneous coronary intervention (PCI). After a diagnosis or cardiac procedure, patients have psychological symptoms that often go unnoticed and interfere with their health condition. The aim of this article was to evaluate the intensity of anxiety and depression symptoms in adult and elderly patients hospitalized after PCI. The design of the study was cross-sectional, analytical, correlational and comparative. Participants were 266 patients who had undergone PCI. Their average age was 64.5 years (SD =8.9 years) and most of them were men (68%) with a diagnosis of acute myocardial infarction (AMI) (64.3%). The research instruments used were the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory - Second Edition (BDI-II). Data collection was performed during the patients' hospitalization and statistical analysis was carried out by means of the Chi-SquareTest, the Kolmogorov -Smirnov Test and ANOVA. The level of significance used wasp < .05. Results showed that the majority of patients presented severe symptoms of anxiety (29.7%) and minimum intensity depressive symptoms (51.9%). The study highlights the importance of assessing and treating psychological symptoms after PCI as these interfere with the patient's adherence to treatment and with their quality of life.

Resumo As doenças cardiovasculares estão entre as principais causas de incapacidade e mortalidade no mundo. Um dos tratamentos indicados é a intervenção coronária percutânea (ICP). Após um diagnóstico ou procedimento cardíaco, os pacientes apresentam sintomas psicológicos que costumam passar despercebidos e interferem na sua condição de saúde. O objetivo do presente artigo foi avaliar a intensidade dos sintomas de ansiedade e depressão em pacientes adultos e idosos hospitalizados depois de uma ICP. Trata-se de um estudo transversal, analítico, correlacional e comparativo. Participaram 266 pacientes que realizaram ICP. A média de idade dos pacientes foi de 64.5 anos (DP = 8.9), 68% eram homens e 64.3% apresentavam diagnóstico de infarto agudo do miocárdio (IAM). Utilizou-se o Inventário de Ansiedade de Beck (BAI) e o Inventário de Depressão de Beck - Segunda Edição (BDI-II) como instrumentos de pesquisa e a coleta de dados foi realizada durante a hospitalização do paciente. A análise de dados foi realizada por meio dos testes Qui-Quadrado, Kolmogorov-Smirnov e ANOVA, com um nível de significância dep < .05. Os resultados mostram que a maioria dos pacientes apresentou sintomas de ansiedade graves (29.7%) e sintomas depressivos de intensidade mínima (51.9%). Esses resultados destacam a importância de avaliar e tratar os sintomas psicológicos pós-ICP, uma vez que interferem na adesão ao tratamento e na qualidade de vida do paciente.

Resumen Las enfermedades cardiovasculares están entre las principales causas de incapacidad y mortalidad en el mundo, pero existe un modo de tratamiento para estas denominado intervención coronaria percutánea (ICP). Después de un diagnóstico o procedimiento cardiaco, los pacientes presentan síntomas psicológicos que a menudo pasan desapercibidos e interfieren con su condición de salud. El objetivo del presente artículo fue evaluar la intensidad de los síntomas de ansiedad y depresión en pacientes adultos y adultos mayores hospitalizados después de una ICP. Se utilizó un diseño transversal, analítico, correlacional y comparativo. En total, participaron 266 pacientes a quienes se les había realizado ICP, estos tenían un promedio de edad de 64.5 años (DE = 8.9), 68 % eran hombres y 64.3 % presentaban diagnóstico de infarto agudo de miocardio (IAM). Se utilizó el Inventario de Ansiedad de Beck (BAI) y el Inventario de Depresión de Beck - Segunda Edición (BDI-II) como instrumentos de investigación, y la recolección de datos se realizó durante la hospitalización del paciente. El análisis de datos se llevó a cabo por medio de las pruebas Chi-Cuadrado, Kolmogorov-Smirnov y ANOVA, con un nivel de significancia dep < .05. Los resultados muestran que la mayoría de los pacientes presentó síntomas de ansiedad graves (29.7 %) y síntomas depresivos de intensidad mínima (51.9 %). Estos resultados destacan la importancia de evaluar y tratar los síntomas psicológicos post ICP, debido a que estos interfieren en la adhesión al tratamiento y en la calidad de vida del paciente.

Social capital and Internet use in an age-comparative perspective with a focus on later life.

Older adults (aged 65+) are still less likely to adopt the Internet when compared to other age groups, although their usage is increasing. To explore the societal effects of Internet usage, scholars have been using social capital as an analytical tool. Social capital pertains to the resources that are potentially available in one's social ties. As the Internet becomes a prominent source of information, communication, and participation in industrialized countries, it is critical to study how it affects social resources from an age-comparative perspective. Research has found a positive association between Internet use and social capital, though limited attention has been paid to older adults. Studies have also found a positive association between social capital and wellbeing, health, sociability, and social support amongst older adults. However, little is known about how Internet usage or lack thereof relates to their social capital. To address this gap, we used a mixed-methods approach to examine the relationship between Internet usage and social capital and whether and how it differs by age. For this, we surveyed a representative sample of 417 adults (18+) living in Lisbon, Portugal, of which 118 are older adults. Social capital was measured through bonding, bridging, and specific resources, and analyzed with Latent Class Modeling and logistic regressions. Internet usage was measured through frequency and type of use. Fourteen follow-up semi-structured interviews helped contextualize the survey data. Our findings show that social capital decreased with age but varied for each type of Internet user. Older adults were less likely to have a high level of social capital; yet within this age group, frequent Internet users had higher levels than other users and non-users. On the one hand, the Internet seems to help maintain, accrue, and even mobilize social capital. On the other hand, it also seems to reinforce social inequality and accumulated advantage (known as the Matthew effect).

Indications and visual outcomes of intrastromal corneal ring segment implantation in a large patient series.

OBJECTIVES:: To describe the indications for and visual outcomes of intrastromal corneal ring segment implantation. METHODS:: A large retrospective case-series chart-review study was conducted using Sorocaba Ophthalmological Hospital medical records. This study included 1222 eyes (1196 patients) that were surgically treated between November 2009 and December 2012. The following preoperative data were collected: age, gender, type of medical care and funding source, surgical technique, best-corrected visual acuity, manifest sphere and cylinder refractive error, maximum and minimum central keratometry, and pachymetry measurements of the cornea at the thinnest point and at the ring channel. The postoperative best-corrected visual acuity and patient satisfaction were also determined. The cases were classified into six groups: four keratoconus groups (severe, advanced, moderate and mild), a pellucid marginal degeneration group and a post-graft irregular astigmatism group. This study was approved by the Brazilian Registry of Clinical Trials (UTN number 1111-1182-6181, TRIAL RBR-6S72RF). RESULTS:: The age (mean±standard deviation) of the patients was 31.0±10.0 years. The most prevalent pathology was keratoconus (1147 eyes, 93.8%). A correlation was found between ectasia severity and medical assistance (p<0.001), and the most serious cases was treated by the Brazilian public health system. No complications were found in a total of 1155 surgeries, and after surgery, 959 patients were satisfied. Among the 164 dissatisfied patients, the majority failed to show improved best-corrected visual acuity. CONCLUSION:: Patients in the public health system underwent surgical intervention for keratoconus later than those with private sources of funding. In the vast majority of operated cases, the patients reported improvements in vision.

Indications and visual outcomes of intrastromal corneal ring segment implantation in a large patient series

OBJECTIVES: To describe the indications for and visual outcomes of intrastromal corneal ring segment implantation. METHODS: A large retrospective case-series chart-review study was conducted using Sorocaba Ophthalmological Hospital medical records. This study included 1222 eyes (1196 patients) that were surgically treated between November 2009 and December 2012. The following preoperative data were collected: age, gender, type of medical care and funding source, surgical technique, best-corrected visual acuity, manifest sphere and cylinder refractive error, maximum and minimum central keratometry, and pachymetry measurements of the cornea at the thinnest point and at the ring channel. The postoperative best-corrected visual acuity and patient satisfaction were also determined. The cases were classified into six groups: four keratoconus groups (severe, advanced, moderate and mild), a pellucid marginal degeneration group and a post-graft irregular astigmatism group. This study was approved by the Brazilian Registry of Clinical Trials (UTN number 1111-1182-6181, TRIAL RBR-6S72RF). RESULTS: The age (mean±standard deviation) of the patients was 31.0±10.0 years. The most prevalent pathology was keratoconus (1147 eyes, 93.8%). A correlation was found between ectasia severity and medical assistance (p<0.001), and the most serious cases was treated by the Brazilian public health system. No complications were found in a total of 1155 surgeries, and after surgery, 959 patients were satisfied. Among the 164 dissatisfied patients, the majority failed to show improved best-corrected visual acuity. CONCLUSION: Patients in the public health system underwent surgical intervention for keratoconus later than those with private sources of funding. In the vast majority of operated cases, the patients reported improvements in vision.

Methods of nutritional evaluation between patients in hemodialysis / Métodos de avaliação nutricional entre pacientes em hemodiálise

Chronic kidney disease is a public health problem. Characterizing the nutritional profile of these patients allows earlydiagnosis of possible nutritional risks. The objective was to evaluate the nutritional status and dietary intake of hemodialysispatients. A cross-sectional study was performed at a hemodialysis clinic from February to April 2016. Patients 18 yearsof age or older who underwent treatment for at least three months and were able to perform the Bioimpedance testwere included. Nutritional status was determined by Body Mass Index. The Palmar Grip Strength was measured bydynamometer and the Adductor Muscle Thickness of the Thumb was by an adipometer, food intake was analyzedthrough a 24-hour Food Recall. A Global Subjective Assessment was performed, adapted for kidney patients. Of the 33patients, 66.7% were males, with a mean age of 57.6 ± 14.2 years. According to the body mass index, eutrophy wasprevalent (54.5%). The thickness of the adductor muscle of the thumb showed severe depletion (66.7%). Palmar gripstrength ranked 72.7% of patients as malnourished. Body Fat, obtained through Bioimpedance, was high in 57.6%. TheGlobal Subjective Assessment ranked 87.9% of patients with mild malnutrition. According to the 24-hour food recall, thetotal caloric intake averaged 1493 ± 530 Kcal. The protein mean was 0.88 ± 0.4 g / kg. The study allowed to visualizenutritional alterations, food intake below the recommended amounts, and different classifications of the nutritional statedepending on the method used. Thus, a comprehensive nutritional assessment becomes important

A doença renal crônica constitui-se um problema de saúde pública. Caracterizar o perfil nutricional desses pacientes permite diagnosticar precocemente possíveis riscos nutricionais. O objetivo foi avaliar o estado nutricional e consumo alimentar de pacientes em hemodiálise. Estudo transversal, realizado em uma clínica de Hemodiálise, de fevereiro a abril de 2016. Foram incluídos pacientes com 18 anos ou mais, em tratamento por no mínimo três meses, capazes de responder a avaliação e que puderam realizar teste de Bioimpedância. O estado nutricional foi determinado pelo Índice de Massa Corporal. A força de Preensão Palmar foi mensurada por dinamômetro e a Espessura do Músculo Adutor do Polegar por adipômetro, ingestão alimentar foi analisada por meio de Recordatório Alimentar de 24 horas.Foi realizada Avaliação Subjetiva Global adaptada para pacientes renais. Dos 33 pacientes, 66,7% do sexo masculino,com média de idade de 57,6 ± 14,2 anos. Segundo o índice de massa corporal a eutrofia foi prevalente (54,5%). Já a espessura do músculo adutor do polegar mostrou depleção severa (66,7%). A força de preensão palmar classificou72,7% dos pacientes como desnutridos. A Gordura Corporal, obtida por meio da bioimpedância, mostrou-se alta em57,6%. A Avaliação Subjetiva Global classificou 87,9% dos pacientes com desnutrição leve. Segundo Recordatório Alimentar de 24 horas, o total calórico teve como média 1493 ± 530 Kcal. A média proteica foi de 0,88 ± 0,4 g/kg. O estudo permitiu visualizar alterações nutricionais, ingestão alimentar abaixo do recomendado e diferentes classificações do estado nutricional dependendo do método utilizado. Assim, torna-se importante uma avaliação nutricional ampla