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Einstein (Sao Paulo) ; 18: eRC5063, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553357


A 65-year-old male with a history of urinary tract trauma requiring cystotomy and chronic bladder catheterization, presenting with chronic and uninvestigated changes in the color of the urine bag system, with no urine color change, and positive urine culture for Proteus mirabilis . These characteristics refer to the purple urine bag syndrome, a not weel-known condition, with a benign course in most cases, and associated with urinary tract infection in patients with chronic bladder catheterization. Although it is characterized by marked changes, it is underdiagnosed by healthcare professionals.

Infecções Relacionadas a Cateter/microbiologia , Coletores de Urina/efeitos adversos , Infecções Urinárias/microbiologia , Idoso , Infecções Relacionadas a Cateter/patologia , Humanos , Masculino , Proteus mirabilis/isolamento & purificação , Fatores de Risco , Síndrome , Infecções Urinárias/patologia , Urina/microbiologia
Einstein (Sao Paulo) ; 18: eGS4913, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31531556


OBJECTIVE: To evaluate indications, results and strategy of retinal exams requested at Primary Care Units. METHODS: A retrospective study that analyzed the indications and results of retinal exams, in the modalities clinical dilated fundus exams and color fundus photographs. In the following situations, patients were considered eligible for color fundus photographs if visual acuity was normal and ocular symptoms were absent: diabetes mellitus and/or hypertension, in use of drugs with potential retinal toxicity, diagnosis or suspicion of glaucoma, stable and asymptomatic retinopathies, except myopia greater than -3.00 diopters. RESULTS: A total of 1,729 patients were evaluated (66% female, age 63.5±15.5 years), and 1,190 underwent clinical dilated fundus exam and 539 underwent color fundus photographs. Diabetes was present in 32.2%. The main indications were diabetes (23.7%) and glaucoma evaluation (23.5%). In 3.4% of patients there was no apparent indication. The main results were a large cup/disc ratio (30.7%) and diabetic retinopathy (13.2%). Exam was normal in 9.6%, detected peripheral changes in 7% and could not be performed in 1%. Considering patients eligible for fundus photographs (22.4%), more than half underwent clinical dilated fundus exams. CONCLUSION: Regarding exam modality, there were no important differences in the distribution of indications or diagnosis. Color fundus photograph is compatible with telemedicine and more cost-effective, and could be considered the strategy of choice in some scenarios. Since there are no clear guidelines for retinal exams indications or the modality of choice, this study may contribute to such standardization, in order to optimize public health resources.

Técnicas de Diagnóstico Oftalmológico , Atenção Primária à Saúde/estatística & dados numéricos , Retina , Doenças Retinianas/diagnóstico , Idoso , Retinopatia Diabética/diagnóstico , Técnicas de Diagnóstico Oftalmológico/economia , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Fotografação , Exame Físico , Estudos Retrospectivos , Telemedicina , Acuidade Visual
Acta Neurochir Suppl ; 127: 179-183, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31407082


From 2013 to 2017, at the Burdenko Institute of Neurosurgery, intra-arterial verapamil for treatment of cerebral vasospasm following intracranial hemorrhage after aneurysm rupture was administered to 35 patients (total 75 procedures). The age is from 8 to 77 years. All ruptured aneurysms were treated: in 26 cases with open approach-clipping-and in 9 cases with endovascular occlusion. The procedure was carried out from 0 to 11 days after the operation. Severity of spasm was assessed by angiography and TCDU. Efficacy of the administration was assessed by TCDU 1 h after the procedure and by clinical evaluation of the patient's condition. The dose of verapamil was 15-50 mg (on average 40 mg) per procedure/per carotid pool and depended on the data of TCDU and clinical and radiological picture. The procedure was performed repeatedly (1-5 times) according to the indications and depending on the patient's condition, with an interval of 24 h. The procedure was effective as a preventive measure for care of patients in the initial stage of cerebral ischemia and was ineffective with a formed focus of ischemia. Endovascular administration of verapamil for treatment of cerebral vasospasm is a safe technique which positively affects the overall recovery of such patients.

Aneurisma Roto , Hemorragia Subaracnóidea , Vasodilatadores , Vasoespasmo Intracraniano , Verapamil , Adolescente , Adulto , Idoso , Criança , Humanos , Pessoa de Meia-Idade , Hemorragia Subaracnóidea/tratamento farmacológico , Hemorragia Subaracnóidea/prevenção & controle , Resultado do Tratamento , Vasodilatadores/uso terapêutico , Vasoespasmo Intracraniano/tratamento farmacológico , Verapamil/uso terapêutico , Adulto Jovem
N Engl J Med ; 382(2)2020 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-31733181


BACKGROUND: The timing and indications for surgical intervention in asymptomatic patients with severe aortic stenosis remain controversial. METHODS: In a multicenter trial, we randomly assigned 145 asymptomatic patients with very severe aortic stenosis (defined as an aortic-valve area of ≤0.75 cm2 with either an aortic jet velocity of ≥4.5 m per second or a mean transaortic gradient of ≥50 mm Hg) to early surgery or to conservative care according to the recommendations of current guidelines. The primary end point was a composite of death during or within 30 days after surgery (often called operative mortality) or death from cardiovascular causes during the entire follow-up period. The major secondary end point was death from any cause during follow-up. RESULTS: In the early-surgery group, 69 of 73 patients (95%) underwent surgery within 2 months after randomization, and there was no operative mortality. In an intention-to-treat analysis, a primary end-point event occurred in 1 patient in the early-surgery group (1%) and in 11 of 72 patients in the conservative-care group (15%) (hazard ratio, 0.09; 95% confidence interval [CI], 0.01 to 0.67; P = 0.003). Death from any cause occurred in 5 patients in the early-surgery group (7%) and in 15 patients in the conservative-care group (21%) (hazard ratio, 0.33; 95% CI, 0.12 to 0.90). In the conservative-care group, the cumulative incidence of sudden death was 4% at 4 years and 14% at 8 years. CONCLUSIONS: Among asymptomatic patients with very severe aortic stenosis, the incidence of the composite of operative mortality or death from cardiovascular causes during the follow-up period was significantly lower among those who underwent early aortic-valve replacement surgery than among those who received conservative care. (Funded by the Korean Institute of Medicine; RECOVERY number, NCT01161732.).

Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Tratamento Conservador , Idoso , Estenose da Valva Aórtica/mortalidade , Estenose da Valva Aórtica/terapia , Doenças Assintomáticas/terapia , Doenças Cardiovasculares/mortalidade , Feminino , Seguimentos , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Gravidade do Paciente , Complicações Pós-Operatórias/mortalidade
Orthop Clin North Am ; 51(1): 13-26, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739876


Open reduction and internal fixation of displaced acetabular fractures has been the gold standard for treatment of these complex injuries. The subset of older patients with dome impaction, femoral head impaction, or a posterior wall component are considered for treatment with concomitant open reduction and internal fixation and total hip arthroplasty. Little has been written on the surgical techniques to perform concomitant open reduction and internal fixation plus total hip arthroplasty safely. This article describes the important intrinsic factors for acetabular component stability, choice of surgical approach for management of these injuries, and surgical technique for anterior and posterior approaches.

Acetábulo/cirurgia , Cabeça do Fêmur/cirurgia , Fixação Interna de Fraturas/métodos , Redução Aberta/métodos , Acetábulo/lesões , Idoso , Artroplastia de Quadril/métodos , Cadáver , Cabeça do Fêmur/lesões , Fixação Interna de Fraturas/normas , Fraturas Ósseas/cirurgia , Fraturas do Quadril/cirurgia , Humanos , Redução Aberta/normas , Cuidados Pós-Operatórios , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Resultado do Tratamento
Orthop Clin North Am ; 51(1): 27-36, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739877


Distal femoral replacement (DFR) is a reasonable treatment option when used for select indications. In the setting of comminuted intra-articular distal femoral fractures, distal femoral arthroplasty should be considered in low-demand patients with poor bone quality. This article summarizes the existing literature plus the authors' personal experience with DFR use for distal femoral fractures of the native knee.

Fraturas do Fêmur/cirurgia , Fêmur/cirurgia , Fraturas Cominutivas/cirurgia , Articulação do Joelho/cirurgia , Idoso , Humanos , Fraturas Intra-Articulares/cirurgia , Pessoa de Meia-Idade , Cuidados Pós-Operatórios , Implantação de Prótese/métodos , Reoperação/métodos , Reoperação/estatística & dados numéricos , Reimplante/métodos , Reimplante/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento
Emerg Med Clin North Am ; 38(1): 15-29, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31757248


Appropriate recognition of the physiologic, psychological, and clinical differences among geriatric patients, with respect to orthopedic injury and disease, is paramount for all emergency medicine providers to ensure they are providing high-value care for this vulnerable population.

Gerenciamento Clínico , Avaliação Geriátrica , Geriatria/métodos , Procedimentos Ortopédicos/métodos , Ortopedia/métodos , Ferimentos e Lesões/terapia , Idoso , Humanos , Ferimentos e Lesões/diagnóstico
Gene ; 722: 144127, 2020 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-31525397


Complement factor H (CFH) serves as a major down-regulator in the complement system, often utilized by bacterial pathogens to evade complement attack. Yet, little is currently known about the genetic correlation of CFH polymorphisms with sepsis due to various microbial infections. A case-control method (488 septic patients and 527 healthy individuals) was carried out in this study to investigate the genetic relationship between CFH polymorphisms (rs3753394 C/T, rs1065489 G/T and rs1061170 C/T) and susceptibility to sepsis caused by bacterial infections in Chinese Han populations. Our findings indicated that the frequency of rs3753394 CT/TT genotype in the septic patients with P. aeruginosa was significantly higher than that in the control individuals (P = 0.033, OR = 2.668, 95%CI = 1.072-6.334). The rs3753394 T allele frequency in the P. aeruginosa-infected patients was significantly increased, compared to that in the healthy controls (P = 0.014, OR = 1.68, 95%CI = 1.118-2.538). Moreover, these significant differences of rs3753394 genotype and allele frequencies remained after multiple testing corrections [P (corr.) = 0.033 for genotype; P (corr.) = 0.033 for allele]. The current study highlighted the significance of CFH polymorphism rs3753394 as a potential biomarker for targeting P. aeruginosa infection in critically ill patients.

Predisposição Genética para Doença , Infecções por Pseudomonas/genética , Pseudomonas aeruginosa , Sepse/genética , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , China/etnologia , Fator H do Complemento/genética , Frequência do Gene , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Pseudomonas/diagnóstico , Infecções por Pseudomonas/etnologia , Sepse/diagnóstico , Sepse/etnologia , Sepse/microbiologia
Dent Clin North Am ; 64(1): 209-228, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31735227


Poor oral health in the geriatric population is being framed as a potentially new geriatric syndrome; an oral and maxillofacial geriatric syndrome. As such, the treatment of oral diseases will require a comprehensive approach that considers the multimorbidity of disease, and polypharmacy that is precipitated/exacerbated by oral and maxillofacial dysfunction. This is challenging because oral diseases are not 1 discrete systemic illness but a combination of many with common causes. This article presents a roadmap approach to evaluate symptoms and apply therapeutic strategies for 5 common oral and maxillofacial dysfunctions seen in the elderly.

Avaliação Geriátrica , Saúde Bucal , Idoso , Humanos , Polimedicação
Einstein (Sao Paulo) ; 18: eAO4739, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553355


OBJECTIVE: To use magnetic resonance imaging to assess the prevalence of foot and ankle ligament injuries and fractures associated with ankle sprain and not diagnosed by x-ray. METHODS: We included 180 consecutive patients with a history of ankle sprain, assessed at a primary care service in a 12-month period. Magnetic resonance imaging findings were recorded and described. RESULTS: Approximately 92% of patients had some type of injury shown on the magnetic resonance imaging. We found 379 ligament injuries, 9 osteochondral injuries, 19 tendinous injuries and 51 fractures. Only 14 magnetic resonance imaging tests (7.8%) did not show any sort of injury. We observed a positive relation between injuries of the lateral complex, syndesmosis and medial ligaments. However, there was a negative correlation between ankle ligament injuries and midfoot injuries. CONCLUSION: There was a high rate of injuries secondary to ankle sprains. We found correlation between lateral ligament injuries and syndesmosis and deltoid injuries. We did not observe a relation between deltoid and syndesmosis injuries or between lateral ligamentous and subtalar injuries. Similarly, no relation was found between ankle and midfoot injuries.

Traumatismos do Tornozelo/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Traumatismos do Tornozelo/diagnóstico por imagem , Brasil/epidemiologia , Cartilagem Articular/lesões , Criança , Feminino , Humanos , Ligamentos Laterais do Tornozelo/lesões , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
Gene ; 7242020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30898706


AIM: The long noncoding RNAs (lncRNAs) have gradually been reported to be an important class of RNAs with pivotal roles in the development and progression of myocardial infarction (MI). In this study, we hypothesized that genetic variant of cyclin-dependent kinase inhibitor 2B antisense RNA (ANRIL) and metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) may affect the prognosis of MI patients. METHODS: The study included 401 Han Chinese MI patients and 409 controls. Four lncRNA tag single nucleotide polymorphisms (SNPs)-ANRIL rs9632884 and rs1537373, MALAT1 rs619586 and rs3200401-were selected. SNP genotyping was performed by an improved multiplex ligation detection reaction assay. RESULTS: rs9632884 and rs3200401 SNPs were significantly associated with lipid levels in both controls and MI patients (P < 0.003-0.046). Several SNPs interacted with sex and age to modify total cholesterol, low-density lipoprotein cholesterol, and creatinine levels to modify the risk of MI. No association between the lncRNAs SNPs and susceptibility to MI was found (P > 0.05 for all). CONCLUSIONS: Taken together, this study provides additional evidence that genetic variation of the ANRIL rs9632884 and MALAT1 rs3200401 can mediate lipid levels in MI patients.

Colesterol/sangue , Infarto do Miocárdio/genética , RNA Longo não Codificante/genética , Triglicerídeos/sangue , Idoso , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , Colesterol/genética , Doença da Artéria Coronariana/genética , Feminino , Frequência do Gene , Predisposição Genética para Doença , Humanos , Hipertensão/genética , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Polimorfismo de Nucleotídeo Único , Fumar/genética , Triglicerídeos/genética
Toxicol Lett ; 318: 65-73, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31654803


OBJECTIVE: The optimal measuring timing of serum/plasma Cystatin C (CysC) for early detection of contrast-induced acute kidney injury (CIAKI) remains un-studied. We elucidated further on this issue. METHODS: We searched PubMed, MEDLINE, and Embase from inception until March 2018 for studies evaluating diagnostic accuracy of CysC for detecting CIAKI in patients exposed to contrast agents during diagnostic examinations or cardiac/peripheral catheterizations. RESULTS: A total of 10 relevant studies, comprising 2554 patients, were included and divided into the <24 -h and 24 -h groups based on CysC measuring timing (i.e., hours after contrast agent exposure). Compared with creatinine, pooled diagnostic odds ratio of CysC for detecting CIAKI of the <24 -h and 24 -h groups was 7.59 (95 % confidence interval [CI]: 1.31-44.08) and 53.81 (95 % CI: 13.57-213.26). Pooled sensitivity of the <24 -h and 24 -h groups was 0.81 and 0.88. Pooled specificity of the <24 -h and 24 -h groups was 0.64 and 0.88, respectively. Area under the hierarchical summary receiver operating characteristic curve of the <24 -h and 24 -h groups was 0.75 and 0.93. CONCLUSIONS: Measuring CysC at 24 h after contrast agent exposure shows higher diagnostic accuracy for early detection of CIAKI than measuring CysC at <24 h after contrast agent exposure.

Lesão Renal Aguda/diagnóstico , Meios de Contraste/efeitos adversos , Cistatina C/sangue , Lesão Renal Aguda/sangue , Lesão Renal Aguda/induzido quimicamente , Idoso , Biomarcadores/sangue , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Fatores de Tempo
Gene ; 723: 144120, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31589964


PURPOSE: Matrix Gla protein (MGP) is a vitamin K-dependent, γ-carboxylated protein that was initially found to be a physiological inhibitor of ectopic calcifications affecting mainly cartilage and the vascular system. Mutations in the MGP gene were found to be responsible for a human pathology, the Keutel syndrome, characterized by abnormal calcifications in cartilage, lungs, brain and vascular system. MGP was recently implicated in tumorigenic processes such as angiogenesis and shown to be abnormally regulated in several tumors, including cervical, ovarian, urogenital and breast. This fact has triggered our interest in analyzing the expression of MGP and of its regulator, the transcription factor runt related transcription factor 2 (RUNX2), in colorectal cancer (CRC). METHODS: MGP and RUNX2 expression were analyzed in cancer and non-tumor biopsies samples from 33 CRC patients and 9 healthy controls by RT-qPCR. Consequently, statistical analyses were performed to evaluate the clinical-pathological significance of MGP and RUNX2 in CRC. MGP protein was also detected by immunohistochemical analysis. RESULTS: Showed an overall overexpression of MGP in the tumor mucosa of patients at mRNA level when compared to adjacent normal mucosa and healthy control tissues. In addition, analysis of the expression of RUNX2 mRNA demonstrated an overexpression in CRC tissue samples and a positive correlation with MGP expression (Pearson correlation coefficient 0.636; p ≤ 0.01) in tumor mucosa. However correlations between MGP gene expression and clinical-pathological characteristics, such as gender, age and pathology classification did not provide relevant information that may shed light towards the differences of MGP expression observed between normal and malignant tissue. CONCLUSIONS: We were able to associate the high levels of MGP mRNA expression with a worse prognosis and survival rate lower than five years. These results contributed to improve our understanding of the molecular mechanism underlying MGP deregulation in cancer.

Proteínas de Ligação ao Cálcio/genética , Proteínas de Ligação ao Cálcio/metabolismo , Neoplasias Colorretais/patologia , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Proteínas da Matriz Extracelular/genética , Proteínas da Matriz Extracelular/metabolismo , Regulação para Cima , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/genética , Neoplasias Colorretais/metabolismo , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Análise de Sobrevida
Rev. Esc. Enferm. USP ; 53: e03466, Jan.-Dez. 2019.
Artigo em Inglês, Espanhol | LILACS, BDENF - Enfermagem | ID: biblio-1020391


RESUMEN Objetivo Describir la experiencia del cuidado familiar a la mujer con cáncer de mama durante el tratamiento, desde la perspectiva de los cuidadores en el contexto mexicano. Método Estudio cualitativo fenomenológico. Fueron realizadas entrevistas en profundidad con cuidadores de mujeres sobrevivientes de cáncer de mama seleccionados mediante muestreo intencional, acumulativo y secuencial. Se llevó a cabo un análisis de contenido convencional. Resultados Participaron siete cuidadores. Los cuidadores refieren sus experiencias positivas y negativas al asumir su rol de cuidadores informales en el contexto familiar. Sobre la fortaleza de la reciprocidad del cuidado y su recompensa, prevalecen los momentos críticos, los sentimientos negativos y la falta de recursos de apoyo durante la experiencia. Ello permite entender el vínculo del cuidado informal para potenciarlo con estrategias de afrontamiento y orientación especifica por parte del personal de enfermería. Conclusión Los participantes experimentaron una transformación en su identidad como cuidadores y al ser conscientes de su experiencia, fueron capaces de describir sus cualidades lo que incrementa sus estrategias de afrontamiento tanto de la enfermedad como de los desafíos del cuidado.

RESUMO Objetivo Descrever a experiência do cuidado familiar com a mulher com câncer de mama durante o tratamento, do ponto de vista dos cuidadores no contexto mexicano. Método Estudo qualitativo fenomenológico. Foram realizadas entrevistas em profundidade com cuidadores de mulheres sobreviventes ao câncer de mama selecionados por meio de amostragem intencional, acumulativa e sequencial. Foi realizada uma análise de conteúdo convencional. Resultados Participaram sete cuidadores. Os cuidadores relatam suas experiências positivas e negativas ao assumir seu papel de cuidadores informais no contexto familiar. Sobre a força da reciprocidade do cuidado e sua recompensa, prevalecem os momentos críticos, os sentimentos negativos e a falta de recursos de apoio durante a experiência. Isso permite entender o vínculo do cuidado informal para potencializá-lo com estratégias de enfrentamento e orientação específica por parte do pessoal de enfermagem. Conclusão Os participantes experimentaram uma transformação na sua identidade como cuidadores e, ao ser conscientes da sua experiência, foram capazes de descrever suas qualidades, o que aumenta suas estratégias de enfrentamento tanto da doença quanto dos desafios do cuidado.

ABSTRACT Objective To describe the experience of family care to women with breast cancer during treatment from the perspective of caregivers in the Mexican context. Method Qualitative phenomenological study. In-depth interviews were conducted with caregivers of women who survived breast cancer. Participants were selected by intentional, cumulative and sequential sampling. A conventional content analysis was performed. Results Participation of seven caregivers, who reported their positive and negative experiences when assuming their role as informal caregivers in the family context. On the strength of the reciprocity of care and its reward, prevailed critical moments, negative feelings, and lack of support resources during the experience. This enables the understanding of the informal care bond in order to enhance it with coping strategies and specific guidance from the nursing staff. Conclusion Participants experienced a transformation in their identity as caregivers and by being aware of their experience, they could describe their qualities, which increased their coping strategies with the disease and the care challenges.

Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Mama/terapia , Família , Cuidadores/psicologia , Enfermagem Oncológica , Entrevista , Pesquisa Qualitativa
Rev. Esc. Enferm. USP ; 53: e03512, Jan.-Dez. 2019. graf
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1020387


OBJETIVO: Desvelar as práticas de Educação Permanente em Saúde desenvolvidas pelo Núcleo de Apoio à Saúde da Família na atenção ao idoso. MÉTODO: Estudo qualitativo e exploratório-descritivo, desenvolvido em um município do estado do Paraná, com profissionais do Núcleo de Apoio à Saúde da Família. Os dados foram obtidos pela técnica de Grupo Focal e submetidos à Classificação Hierárquica Descendente utilizando o software IRaMuTeQ. Os referenciais teórico-analíticos foram a Política Nacional de Educação Permanente em Saúde e a Teoria Dialógica. RESULTADOS: Participaram 46 profissionais. Surgiram cinco classes que permitiram desvelar que as práticas de educação permanente na atenção ao idoso ocorrem durante os momentos de discussão de casos, no matriciamento, nas visitas domiciliares, nos grupos operativos e no cotidiano do trabalho de modo informal. CONCLUSÃO: As práticas de educação permanente desenvolvidas pelos profissionais na atenção ao idoso ocorrem em distintos momentos da atuação profissional e são permeadas pela prática

OBJETIVO: Desvelar las prácticas de Educación Permanente en Salud desarrolladas por el Núcleo de Apoyo a la Salud de la Familia en la atención a la persona mayor. MÉTODO: Estudio cualitativo y exploratorio descriptivo, desarrollado en un municipio del Estado de Paraná, con profesionales del Núcleo de Apoyo a la Salud de la Familia. Los datos fueron obtenidos por la técnica de Grupo Focal y sometidos a la Clasificación Jerárquica Descendiente utilizando el software IRaMuTeQ. Los marcos de referencia teóricos analíticos fueron la Política Nacional de Educación Permanente en Salud y la Teoría Dialógica. RESULTADOS: Participaron 46 profesionales. Surgieron cinco clases que permitieron desvelar que las prácticas de educación permanente en la atención a la persona mayor ocurren durante los momentos de discusión de casos, en el matriciamiento, las visitas domiciliarias, los grupos operativos y el cotidiano del trabajo de modo informal. CONCLUSIÓN: Las prácticas de educación permanente desarrolladas por los profesionales en la atención a la persona mayor ocurren en distintos momentos de la actuación profesional y traen consigo la práctica

OBJECTIVE: To unveil the Permanent Education in Health practices developed by the Family Health Support Center in the care provided to older adults. METHOD: A qualitative and exploratory-descriptive study developed in a municipality in the state of Paraná with professionals from the Family Health Support Center. Data were obtained by the Focus Group technique and submitted to the Descending Hierarchical Classification using IRaMuTeQ software. The implemented theoretical-analytical references were the National Policy of Permanent Education in Healthcare and the Dialogical Theory. RESULTS: Forty-six (46) professionals participated. Five classes emerged which revealed that the practices of permanent education in care provided to older adults occur during the moments of discussion of cases, in collaborative care planning (matriciamento ), in the home visits, in the operative groups and in the daily life of the informal work. CONCLUSION: The permanent education practices developed by the professionals in the care provided to older adults occur at different moments of professional performance and are permeated by the practice

Humanos , Masculino , Feminino , Idoso , Atenção Primária à Saúde/normas , Educação Continuada/métodos , Enfermagem de Atenção Primária/normas , Serviços de Saúde para Idosos/normas , Pessoal de Saúde , Grupos Focais , Pesquisa Qualitativa
Acta colomb. psicol ; 22(2): 53-69, July-Dec. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1019276


Abstract Different studies with university students show the presence of a negative image about the elderly and an absence of positive stereotypes regarding this age group. With the increase of the older population, these stereotypes must disappear in order to work with aged people without a negative view of them. The aim of this paper was to identify the existence of negative stereotypes towards old age in students who are pursuing health-related and not related university degree courses. A total of 262 students were assessed with the CENVE questionnaire. In order to find out whether there were differences between students with respect to negative stereotypes, an ANOVA and a post-hoc comparison test were carried out. Results were significant at the 5% level. These show evidence of the existence of negative stereotypes about old age in students pursuing university degrees related and not related to the field of health. ANOVAs showed differences in total CENVE (F3 259 = 3.574; p = 0.015; r2 = 0.040), Social Motivation dimension (F3259 = 3.697; p = 0.012; rf = 0.042), and Personality dimension (F3259 = 5.157; p = 0.002; r2 = 0.057). The post-hoc tests show the existence of differences in stereotypes depending on the course that is being studied, where the health related courses show the lower level of negative stereotypes.

Resumo Diversos estudos sobre estereótipos com estudantes universitários mostram que as pessoas idosas são percebidas mais frequentemente a partir de uma imagem negativa do que com estereótipos positivos. Levando em consideração o crescente aumento da população idosa na atualidade e como o fim de trabalhar com pessoas mais velhas a partir de uma visão positiva de si mesmos, é preciso que esses estereótipos desapareçam. O objetivo deste trabalho foi determinar se existem estereótipos negativos com respeito à velhice em estudantes de cursos universitários relacionados e não relacionados com o campo da saúde. No total, 262 estudantes foram avaliados com o questionário CENVE e, para saber se existiam diferenças de estereótipos negativos entre os estudantes de acordo com sua habilitação, foi realizada uma análise ANOVA, além de comparações post hoc. Os resultados foram significativos com um nível de 5% e evidenciaram a existência de estereótipos negativos com respeito à velhice em estudantes de habilitações universitárias relacionadas e não relacionadas com o campo da saúde. Os ANOVA mostraram diferenças para o CENVE total (F3259 = 3.574; p = .015; n2 = .040), para a dimensão de motivação social (F3259 = 3.697; p = .012; n2 = .042) e para a dimensão de personalidade (F3259 = 5.157; p = .002; n2 = .057). As provas post hoc mostraram a existência de diferenças no grau de estereótipos negativos de acordo com as habilitações em curso, sendo que as habilitações de saúde mostraram menor grau em comparação com as demais.

Resumen Diversos estudios sobre estereotipos con estudiantes universitarios muestran que las personas mayores son percibidas más desde una imagen negativa que con estereotipos positivos. Teniendo en cuenta el creciente aumento de la población mayor en la actualidad, y con el fin de trabajar con personas mayores desde una visión positiva de sí mismos, es necesario que estos estereotipos desaparezcan. El objetivo de este trabajo fue determinar si existen estereotipos negativos hacia la vejez en estudiantes de carreras universitarias relacionadas y no relacionadas con el campo de la salud. En total, se evaluó a 262 estudiantes con el cuestionario CENVE, y, para saber si existían diferencias de estereotipos negativos entre los estudiantes según su titulación, se realizó un análisis ANOVA, además de comparaciones post hoc. Los resultados fueron significativos al nivel del 5 % y evidenciaron la existencia de estereotipos negativos hacia la vejez en estudiantes de títulos universitarios relacionados y no relacionados con el campo de la salud. Los ANOVA mostraron diferencias para el CENVE total (F3259 = 3.574; p = .015; η 2 = .040), para la dimensión de motivación social (F3259 = 3.697; p = .012; η2 = .042) y para la dimensión de personalidad (F3259 = 5.157; p = .002; η 2 = .057). Las pruebas post hoc mostraron la existencia de diferencias en el grado de estereotipos negativos según las titulaciones en curso, donde las titulaciones sanitarias mostraron menor grado en comparación con las demás.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Ageismo
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 375-379, Out.-Dez. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1024051


Introduction: Physical inactivity is an important risk factor for many aging-related symptoms. Studies suggest that physical activity may help to relieve tinnitus and headache. Objective: To investigate the presence of tinnitus and headache in elderly individuals by associating it with the lack of regular physical activity. Methods: A cross-sectional study including elderly individuals who live independently. The practice of physical activity and the complaints of headache and of tinnitus were checked by means of a questionnaire with objective questions. The statistical analysis was performed using the chi-squared test and relative risk, and a multiple logistic regression model was used to determine how well each factor predicted headache while controlling for each of the other factors. Results: Based on a sample of 494 subjects, it was found that 213 (43.11%) complained of tinnitus. Among the complainants, 97 (45.53%) practiced physical activity regularly. We have confirmed associations between headache with lack of physical activity among elderly individuals with tinnitus (p = 0.0440). It was also observed that certain factors, such as male gender and tinnitus, are independent factors for the complaint of headache. Conclusion: We have found that headache could be a symptom related to the lack of regular physical activity among elderly individuals with tinnitus. (AU)

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Zumbido , Exercício , Cefaleia , Envelhecimento , Distribuição de Qui-Quadrado , Modelos Logísticos , Estudos Transversais , Comportamento Sedentário , Atividade Motora
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 389-395, Out.-Dez. 2019. ilus, tab
Artigo em Inglês | LILACS | ID: biblio-1024150


Introduction: Agrochemicals, also known as pesticides, are widely used in agriculture and in public health. They are organic and inorganic chemical substances with a high level of toxicity not only for the environment, but also for human health. Objective: To verify findings on labyrinthine assessment in endemic disease control agents, and to recommend the inclusion of the vestibular exam in the set of tests for pesticide-exposed populations. Methods: Descriptive, prospective, cross-sectional study with a sample comprising 15 endemic disease control agents, males, mean age of 51.6 years old (standard deviation [SD] = 5.9). All of the participants were submitted to anamnesis, otorhinolaryngological screening, and vestibular assessment. Results: Regarding the most reported complaints, dizziness (73.4%), headache (60%), and tingling in the extremities (53.4%) were observed. The findings of the vestibular exams were normal in 53.3%, while 46.7% showed peripheral vestibular disorder, of which 26.7% were of deficitary type, and 20% of the irritative type. Conclusions: Alteration in the vestibular system was verified in 50% of the workers, with a greater prevalence in the caloric testing. Several disorders related to pesticides intoxication are scientifically known. Actions promoting knowledge and qualification of this population for the proper handling of chemicals are suggested, in addition to the elaboration and inclusion of protocols of vestibular assessment in hearing health programs for the prevention, diagnosis and treatment of vestibular disorders (AU)

Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Doenças Vestibulares/diagnóstico , Exposição Ocupacional , Exposição a Praguicidas , Doenças dos Trabalhadores Agrícolas/diagnóstico , Doenças Vestibulares/induzido quimicamente , Estudos Transversais , Estudos Prospectivos , Agroquímicos/efeitos adversos , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/induzido quimicamente
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 433-439, Out.-Dez. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1024413


Introduction: Studies have reported that although speech perception in noise was unaltered with and without digital noise reduction (DNR), the annoyance toward noise measured by acceptable noise level (ANL) was significantly improved by DNR with the range between 2.5 and 4.5 dB. It is unclear whether a similar improvement would be observed in those individuals who have an ANL ≥ 14 dB (predictive of poor hearing aid user) often rejects their aid because of annoyance toward noise. Objectives: (a) To determine the effect of activation of DNR on the improvement in the aided ANL from low- and high-ANL groups; and (b) to predict the change in ANL when DNR was activated. Method: Ten bilateral mild to severe sloping sensorineural hearing loss (SNHL) participants in each of the low- and high-ANL groups were involved. These participants were bilaterally fitted with receiver in canal (RIC) hearing aids (Oticon, Smorum, Egedal, Denmark) with a DNR processor. Both SNR-50% (Signal to noise ratio (in dB) required to achieve 50 % speech recognition) and ANL were assessed in DNR-on and DNR-off listening conditions. Results: Digital noise reduction has no effect on SNR-50 in each group. The annoyance level was significantly reduced in the DNR-on than DNR-off condition in the low-ANL group. In the high-ANL group, a strong negative correlation was observed between the ANL in DNR off and a change in ANL after DNR was employed in the hearing aid (benefit). The benefit of DNR on annoyance can be effectively predicted by baseline-aided ANL by linear regression. Conclusion: Digital noise reduction reduced the annoyance level in the high-ANL group, and the amount of improvement was related to the baseline-aided ANL value (AU)

Pessoa de Meia-Idade , Idoso , Limiar Auditivo/fisiologia , Percepção da Fala/fisiologia , Efeitos do Ruído , Auxiliares de Audição , Método Simples-Cego , Perda Auditiva Neurossensorial/fisiopatologia
Rev. cuba. angiol. cir. vasc ; 20(2)jul.-dic. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1003859


RESUMEN Introducción: la incorporación de la ecografía a los métodos diagnósticos de los aneurismas aórticos abdominales favorece su detección precoz. Objetivo: Describir las características de los pacientes a quienes se les detectó precozmente un aneurisma aórtico abdominal. Métodos: Estudio descriptivo de corte transversal en 243 pacientes pertenecientes al área de salud del Hospital Clinicoquirúrgico "General Freyre de Andrade", clasificados como población de riesgo (hombres > 50 años y mujeres > 60 años). El periodo de estudio: noviembre de 2016 a octubre de 2017. Resultados: Se realizó el diagnóstico de aneurisma aórtico abdominal en 2,1 % (n= 5); en estos pacientes prevaleció el grupo de edad de 70 a79 años (80 %) y el sexo masculino (60 %). Los factores de riesgo predominantes fueron el tabaquismo, la hipertensión arterial y la enfermedad arterial periférica, todos con igual porcentaje (100 %). El segmento aórtico más afectado fue el infrarrenal (100 %), los diámetros aórticos predominantes fueron: transversal (3-3,9 cm), longitudinal (5-10 cm) y antero-posterior (3-3,9 cm). La proteína C reactiva estuvo incrementada (mayor de 5 mg/L) en el 100 % de los casos. La claudicación intermitente fue la más frecuente. Conclusiones: A pesar de la baja prevalencia porcentual encontrada, destaca en todos los pacientes con aneurisma aórtico abdominal la presencia de factores de riesgo relevantes como es el tabaquismo, la hipertensión arterial y la enfermedad arterial periférica; incremento en la concentración de la proteína C reactiva, afectación en el segmento infrarrenal así como alto porcentaje con edades por encima de 70 años.

ABSTRACT Introduction: The incidence of abdominal aortic aneurysms in the population benefits from the incorporation of ultrasound to diagnostic methods due to the importance of their early detection. Objective: To describe the characteristics of patients who are early detected with an abdominal aortic aneurysm. Method: A descriptive, cross-sectional study was conducted in 243 patients belonging to the health area of "General Freyre de Andrade" Clinical- Surgical Hospital that were classified as a risk population (men > 50 years and women > 60 years). The study was conducted from November 2016 to October 2017. Results: The diagnosis of abdominal aortic aneurysm was performed in 2.1 % (n= 5); in these patients predominated the age group of 70 to 79 years (80 %), male sex (60 %) and white skin color (80 %). The predominant risk factors were smoking habit, arterial hypertension and peripheral arterial disease; all with equal percentage (100 %). The most affected aortic segment was the infrarenal (100 %), the predominant aortic diameters were: transversal (3-3.9 cm), longitudinal (5-10 cm) and anterior-posterior (3-3.9 cm). The C-reactive protein increased (greater than 5 mg/L) in 100 % of the cases. Intermittent claudication was the most frequent. Conclusions: Although the percentage prevalence of the disease was low, it was present in all the patients with abdominal aortic aneurysm, risk factors that are favorable to aneurysms, high concentrations of C-reactive protein, affectation in the infrarenal aortic segment, and high percentage of ages of more than 70 years.

Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/ultraestrutura , Ultrassonografia/métodos , Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Epidemiologia Descritiva , Estudos Transversais , Fatores de Risco