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The role of invasive therapies in elderly patients with acute myocardial infarction

NICOLAU, José C.; LEMOS, Pedro A.; WAJNGARTEN, Maurício; GIRALDEZ, Roberto R.; SERRANO JR., Carlos V.; MARTINEZ, Eulógio E.; BARACIOLI, Luciano M.; KALIL, Roberto; JATENE, Fábio B.; DALLAN, Luis A.; PUIG, Luis B.; STOLF, Noedir A.
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
45.83%
INTRODUCTION: In elderly patients with acute myocardial infarction, very little is known about the role of surgical myocardial revascularization and percutaneous coronary intervention (invasive therapies - IT), especially in the context of long-term outcomes after hospital discharge. METHODS: We analyzed 1588 patients with MI who had been included prospectively in a databank and followed for up to 7.5 years. In this population, 548 patients were >70 years old (elderly group - EG), and 1040 were <70 years of age (younger group - YG); 1088 underwent IT during hospitalization, and the remaining 500 were treated medically (conservative therapy - CT). Patients were monitored either by visit or by phone at least once a year. A standard questionnaire was administered to all patients. The impact of IT was analyzed with both non-adjusted and adjusted models. RESULTS: By the end of the follow-up period, the survival rates for the IT and CT groups were, respectively, 71.9% versus 47.2% in the global population (hazard ratio=0.55, P<0.001), 81.5% versus 66.6% in the YG (hazard ratio=0.68, P=0.018) and 48.8% versus 20.3% in the EG (hazard ratio=0.58, P<0.001). In the adjusted models, the hazard ratios were 0.62 (P<0.001) in the global population...

Estudo dos fatores preditores de envelhecimento sem incapacidade funcional entre os idosos em velhice avançada no município de São Paulo; Predict factors´ study for aging without disability among very old people in Sao Paulo city

Francisco, Célia Maria
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 27/11/2006 PT
Relevância na Pesquisa
66.13%
O envelhecimento é um fenômeno mundial, resultado da diminuição progressiva das taxas de fecundidade e mortalidade e do aumento da expectativa de vida. O grupo de idosos, no Brasil e em países em desenvolvimento, segundo a OMS, é constituído por pessoas a partir dos 60 anos. Dentre desse grupo, a população que mais rapidamente cresce são os denominados idosos em velhice avançada (80 anos e mais) cujas demandas específicas ainda são desconhecidas em nosso meio. O envelhecimento pode ser acompanhado por um declínio funcional progressivo que pode estar associado a quadros de dependência responsáveis por demandas assistenciais específicas. A dependência em si constitui o maior temor dos idosos. Assim, conhecer os fatores preditores do alcance das idades mais longevas com independência funcional torna-se primordial e constitui o objetivo desse estudo que é parte do Estudo SABE - Saúde Bem-estar e Envelhecimento na América Latina e Caribe. Esse estudo, realizado no ano 2000, foi coordenado pela Organização Pan-Americana de Saúde (OPAS) e desenvolvido simultaneamente em sete países da dessa região com o objetivo de traçar as condições de vida e saúde dos idosos aí residentes. No Brasil, foi desenvolvido na zona urbana do Município de São Paulo com uma amostra de 2.143 idosos representativa da população residente na região no período. Para o desenvolvimento desse estudo...

Estilo de vida e sua associação com a longevidade de idosos muito velhos de Aracaju, SE; Lifestyle and its association to longevity of very old elderly of Aracaju, SE

Lima, Wilma Resende
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 25/04/2014 PT
Relevância na Pesquisa
96.2%
A longevidade é um processo inevitável, irreversível e de extrema importância para a civilização. A população de idosos de 80 anos ou mais tem aumentado, demandando atenção e compromisso por parte dos profissionais de saúde. Conhecer o processo de envelhecimento envolve o estudo de vários fatores, dentre eles, o estilo de vida que pode estar relacionado a maior longevidade desses idosos muito velhos. Portanto, o objetivo geral deste estudo foi avaliar o estilo de vida e sua associação com a longevidade de idosos muito velhos do município de Aracaju-SE. Metodologia: estudo descritivo-exploratório, transversal, com abordagem quantitativa. O cenário de estudo foi o município de Aracaju, uma das capitais do nordeste que apresentou crescimento acelerado do número de idosos nos últimos 40 anos. Os critérios de inclusão para a população foram: idosos cadastrados nas Unidades de Saúde da Família, de ambos os sexos, com 80 anos ou mais, que deveriam atingir o mínimo de 19 pontos no Mini-Exame do Estado Mental (MEEM). Foram realizadas entrevistas estruturadas por meio de três formulários: um com dados do MEEM; outro com dados socioeconômico e demográfico, de saúde, de nutrição e de longevidade e o terceiro com dados do Perfil do Estilo de Vida Individual (PEVI)-Pentáculo do Bem-Estar. Para a análise dos dados...

Increased physical activity and fitness above the 50th percentile prevents the institutionalization of elderly people: a cross-sectional pilot study.

Pereira, Catarina; Fernandes, Jorge; Raimundo, Armando; Biehl-Printes, Clarissa; Marmeleira, Jose; Tomas-Carus, Pablo
Fonte: Abstracts book of the Cidesd 2014 Publicador: Abstracts book of the Cidesd 2014
Tipo: Aula
ENG
Relevância na Pesquisa
45.91%
Introduction Institutionalization in a nursing home restricts autonomy, most notably free will, free choice, and free action. Decreased physical activity and fitness are predictive of disability and dependence (Rikli & Jones, 2013; Tak, Kuiper, Chorus, & Hopman-Rock, 2014); however little is known about the impact of these factors on institutionalization. Thus, this study aimed to analyze the impact of physical activity and fitness and on the risk of elderly people without cognitive impairment become institutionalized. Methods This cross-sectional study involved 195 non-institutionalized (80.14.4yrs) and 186 institutionalized (83.85.2yrs) participants. Cognitive impairment was assessed using Mini-Mental State Examination, physical activity was assessed using the International Physical Activity Questionnaire, and measures of physical fitness were determined by the Senior Fitness Test. Results: Multivariate binary logistic analysis selected 4 main predictors of institutionalization in both genders. The likelihood of becoming institutionalized increased by +18.6% for each additional year of age, while it decreased by -24.8% by each fewer kg/m2 in BMI, by -0.9% for each additional meter performed in the aerobic endurance test and by -2.0% for each additional 100MET-min/wk of physical activity expenditure (p<0.05). Values ≤50th percentile (age ≥81yrs...

Increased physical activity and fitness above the 50th percentile prevents the institutionalization of elderly people: a cross-sectional pilot study.

Pereira, Catarina; Fernandes, Jorge; Raimundo, Armando; Biehl-Printes, Clarissa; Marmeleira, José; Tomas-Carus, Pablo
Fonte: Universidade de Évora Publicador: Universidade de Évora
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
45.91%
Introduction Institutionalization in a nursing home restricts autonomy, most notably free will, free choice, and free action. Decreased physical activity and fitness are predictive of disability and dependence (Rikli & Jones, 2013; Tak, Kuiper, Chorus, & Hopman-Rock, 2014); however little is known about the impact of these factors on institutionalization. Thus, this study aimed to analyze the impact of physical activity and fitness and on the risk of elderly people without cognitive impairment become institutionalized. Methods This cross-sectional study involved 195 non-institutionalized (80.14.4yrs) and 186 institutionalized (83.85.2yrs) participants. Cognitive impairment was assessed using Mini-Mental State Examination, physical activity was assessed using the International Physical Activity Questionnaire, and measures of physical fitness were determined by the Senior Fitness Test. Results: Multivariate binary logistic analysis selected 4 main predictors of institutionalization in both genders. The likelihood of becoming institutionalized increased by +18.6% for each additional year of age, while it decreased by -24.8% by each fewer kg/m2 in BMI, by -0.9% for each additional meter performed in the aerobic endurance test and by -2.0% for each additional 100MET-min/wk of physical activity expenditure (p<0.05). Values ≤50th percentile (age ≥81yrs...

Biomechanical gait pattern changes associated with functional fitness levels and falls in the elderly

Silva, Vera Moniz Pereira da
Fonte: Universidade Técnica de Lisboa Publicador: Universidade Técnica de Lisboa
Tipo: Tese de Doutorado
Publicado em //2014 ENG
Relevância na Pesquisa
45.81%
Doutoramento em Motricidade Humana na especialidade de Biomecânica; This thesis aimed to provide a better understanding on the determinant factors for falling in Portuguese older adults, with a special emphasis on the biomechanical changes in gait patterns associated with the functional fitness decline in this population. Our methodological approach to this problem encompassed two different levels of analysis: in the first part two epidemiological studies were conducted in order to establish the determinant factors for falling within the Portuguese older adults; in the second part three laboratory-based studies were performed in order to determine the influence of functional fitness levels on elderly gait patterns. Falls were shown to result from the interaction of many risk factors. Within these, gender, functional fitness level and health parameters were found to be the strongest fall determinants. Interestingly, age was not a determinant factor for falling, even within very old individuals (≥75 years or ≥80 years). Therefore, in the subsequent studies, the gait patterns of a subgroup of older adults, who had participated in the epidemiological studies, were characterized according with their functional fitness levels. The results showed that older subjects with a lower functional fitness level score...

Atrial fibrillation in very old patients

Vasconcelos, P; Luz, I; Heitor, S; Bragança, N
Fonte: European Federation of Internal Medicine (EFIM), Spanish Society of Internal Medicine (SEMI) Publicador: European Federation of Internal Medicine (EFIM), Spanish Society of Internal Medicine (SEMI)
Tipo: Conferência ou Objeto de Conferência
Publicado em //2012 ENG
Relevância na Pesquisa
56.08%
OBJECTIVES Atrial Fibrillation (AF) is the arrhythmia most often observed in elderly patients and is an important cause of morbidity and mortality in this age group. Anticoagulation to reduce the thromboembolic risk is an essential part of the approach of this pathology. In this context, our aim is to assess the prevalence of AF and its treatment in very old patients admitted to our medicine ward. MATERIAL AND METHOD We analyzed the clinical files of very old patients (VOP - very old people - age > or = life expectancy + 5 years for both sexes - 76 + 5 years for males and 82 + 5 years for females) admitted to our department from 01/01/2011 to 31/12/2011. The average of in ward days and death rate was calculated. We analyzed the electrocardiograms performed at baseline and assessed outpatient medication. RESULTS In 2011 we recorded 996 admissions, of which 189 (19%) were VOP. Of these, 26 (13.76%) died. The average hospitalization was found to be 15 days. We identified 61 cases (32%) with AF. No differences were found between genders. The majority (74%) had a CHADS2 score >2. Only 1/10 of patients were treated with oral anticoagulants. CONCLUSIONS The prevalence of AF in our sample is relatively high compared to that described in other epidemiological studies. Despite the higher risk of stroke in elderly patients...

Emergency Hartmann´s procedure: short term outcomes in the old and the very old

Rocha, R; Gomes, A; Marinho, R; Sousa, M; Carneiro, C; Nunes, V
Fonte: European Society of Coloproctology Publicador: European Society of Coloproctology
Tipo: Conferência ou Objeto de Conferência
Publicado em //2013 ENG
Relevância na Pesquisa
56.04%
Objectives: Emergency Hartmann´s procedure is associated with significant morbidity and mortality, particularly in the elderly populations. Our aim is to compare the short term outcomes of old [65-80 years old[ and very old patients (80 or more) submitted to this procedure. Materials: Between January 2008 and December 2012 we submitted to emergency Hartmann´s procedure 105 patients: 65 old and 40 very old. We retrospectively reviewed patient charts and comparatively analysed demographic data, indications to surgery, P-POSSUM, ASA, intensive care unit stay, medical and surgical morbidity and 30-day mortality and performed univariate and multivariate logistic regression analysis. Results: x female, years . Comparing the Old and Very Old groups - Neoplasia (41% vs 47,5%), Acute Diverticulitis (31% vs 22,5%); 30-day mortality rate of 10% vs 45% (p value<0,05). Conclusions: Very old age was an independent factor of morbidity and mortality in emergency Hartmann´s procedure in our patients.

The role of invasive therapies in elderly patients with acute myocardial infarction

Nicolau,José C.; Lemos,Pedro A.; Wajngarten,Maurício; Giraldez,Roberto R.; Serrano Jr.,Carlos V.; Martinez,Eulógio E.; Baracioli,Luciano M.; Kalil,Roberto; Jatene,Fábio B.; Dallan,Luis A.; Puig,Luis B.; Stolf,Noedir A.
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2009 EN
Relevância na Pesquisa
45.83%
INTRODUCTION: In elderly patients with acute myocardial infarction, very little is known about the role of surgical myocardial revascularization and percutaneous coronary intervention (invasive therapies - IT), especially in the context of long-term outcomes after hospital discharge. METHODS: We analyzed 1588 patients with MI who had been included prospectively in a databank and followed for up to 7.5 years. In this population, 548 patients were >70 years old (elderly group - EG), and 1040 were <70 years of age (younger group - YG); 1088 underwent IT during hospitalization, and the remaining 500 were treated medically (conservative therapy - CT). Patients were monitored either by visit or by phone at least once a year. A standard questionnaire was administered to all patients. The impact of IT was analyzed with both non-adjusted and adjusted models. RESULTS: By the end of the follow-up period, the survival rates for the IT and CT groups were, respectively, 71.9% versus 47.2% in the global population (hazard ratio=0.55, P<0.001), 81.5% versus 66.6% in the YG (hazard ratio=0.68, P=0.018) and 48.8% versus 20.3% in the EG (hazard ratio=0.58, P<0.001). In the adjusted models, the hazard ratios were 0.62 (P<0.001) in the global population...

Levels of customary physical activity among the old and the very old living at home.

Dallosso, H M; Morgan, K; Bassey, E J; Ebrahim, S B; Fentem, P H; Arie, T H
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1988 EN
Relevância na Pesquisa
45.88%
With an activity inventory designed specifically for use among elderly people, detailed profiles of customary physical activity were obtained from 507 old (aged 65-74 years) and 535 very old (aged 75 years and over) individuals randomly sampled from the community. Participation in four categories of activity was assessed: outdoor productive activities; indoor productive activities; leisure activities; and walking. Customary engagement in many activities was found to be low, age (old versus very old) and sex being among the most important determinants of participation. The method of assessment is described, and activity profiles normative for older age groups are presented.

Zinc-bound metallothioneins and immune plasticity: lessons from very old mice and humans

Mocchegiani, Eugenio; Giacconi, Robertina; Muti, Elisa; Cipriano, Catia; Costarelli, Laura; Tesei, Silvia; Gasparini, Nazzarena; Malavolta, Marco
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 29/09/2007 EN
Relevância na Pesquisa
45.8%
The capacity of the remodelling immune responses during stress (named immune plasticity) is fundamental to reach successful ageing. We herein report two pivotal experimental models in order to demonstrate the relevance of the immune plasticity in ageing and successful ageing. These two experimental models will be compared with the capacity in remodelling the immune response in human centenarians. With regard to experimental models, one model is represented by the circadian rhythms of immune responses, the other one is the immune responses during partial hepatectomy/liver regeneration (pHx). The latter is suggestive because it mimics the immunosenescence and chronic inflammation 48 h after partial hepatectomy in the young through the continuous production of IL-6, which is the main cause of immune plasticity lack in ageing. The constant production of IL-6 leads to abnormal increments of zinc-bound Metallothionein (MT), which is in turn unable in zinc release in ageing. As a consequence, low zinc ion bioavailability appears for thymic and extrathymic immune efficiency, in particular of liver NKT cells bearing TCR γδ. The remodelling during the circadian cycle and during pHx of zinc-bound MT confers the immune plasticity of liver NKT γδ cells and NK cells in young and very old mice...

Dietary source of vitamin B12 intake and vitamin B12 status in female elderly Koreans aged 85 and older living in rural area

Kwak, Chung Shil; Lee, Mee Sook; Lee, Hae Jeung; Whang, Jin Yong; Park, Sang Chul
Fonte: The Korean Nutrition Society and the Korean Society of Community Nutrition Publicador: The Korean Nutrition Society and the Korean Society of Community Nutrition
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.01%
Recently, we found and analyzed vitamin B12 in some Korean traditional plant foods which had not reported, yet. This study was to investigate vitamin B12 intake and its dietary sources and the vitamin B12 status in the very old elderly Koreans. We measured serum vitamin B12 level and estimated the amounts of vitamin B12 intake from different dietary sources in female elderly Koreans aged 85 and over who had consumed a relatively low animal traditional diet for the whole life. The average age of the subjects (n = 127) was 98.0 years (85-108 years). The assessment on energy and nutrient intake involved a one-day 24-hour recall, and serum vitamin B12 concentration was measured by radioimmunoassay. Overall diet pattern was not different between the 85-99 yr-old group and centenarians, except centenarians were taking more dairy product. The average ratio of plant food to animal food consumption was 87.5:12.5 in weight. The average vitamin B12 intake of our subjects was 3.2 µg/day, and 52.7% of subjects consumed under estimated average requirement, 2.0 µg/day. On dietary source, 67.3% of dietary vitamin B12 was from meat, eggs and fishes and 30.6% was from plant foods, such as soybean-fermented foods, seaweeds, and kimchi. The average serum vitamin B12 concentration was 450.5 pg/mL...

Protective neighborhoods: Neighborhood proportion Mexican American and depressive symptoms among very old Mexican Americans

Gerst, Kerstin; Miranda, Patricia Y.; Eschbach, Karl; Sheffield, Kristin M.; Peek, M. Kristen; Markides, Kyriakos S.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /02/2011 EN
Relevância na Pesquisa
45.88%
Research indicates that neighborhood context can have a significant effect on the health of elders. The evidence suggests that there may be physical health benefits afforded to Mexican Americans living in ethnically homogenous neighborhoods, despite the relatively high economic risk in such neighborhoods. However, few studies have considered the impact of neighborhood ethnic density on mental health outcomes in older adults. This study evaluates the association between neighborhoods with a high proportion of Mexican Americans and depressive symptoms among very old Mexican Americans. Hierarchical linear modeling was used to examine data from Wave 5 (2004–2005) of the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE). Subjects included 1,875 community-dwelling Mexican Americans aged 75 and older living in 386 neighborhoods across five states in the Southwestern United States (Arizona, California, Colorado, New Mexico, Texas). Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D, α =0.88). Results showed that among very old men, there was a significant negative association between percent Mexican Americans in the neighborhood and depressive symptoms (P=.011). Although among women the direction of the association was the same...

Associations between White Matter Microstructure and Cognitive Performance in Old and Very Old Age

Laukka, Erika J.; Lövdén, Martin; Kalpouzos, Grégoria; Li, Tie-Qiang; Jonsson, Tomas; Wahlund, Lars-Olof; Fratiglioni, Laura; Bäckman, Lars
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 25/11/2013 EN
Relevância na Pesquisa
45.94%
Increasing age is associated with deficits in a wide range of cognitive domains as well as with structural brain changes. Recent studies using diffusion tensor imaging (DTI) have shown that microstructural integrity of white matter is associated with cognitive performance in elderly persons, especially on tests that rely on perceptual speed. We used structural equation modeling to investigate associations between white matter microstructure and cognitive functions in a population-based sample of elderly persons (age ≥ 60 years), free of dementia, stroke, and neurological disorders (n = 253). Participants underwent a magnetic resonance imaging scan, from which mean fractional anisotropy (FA) and mean diffusivity (MD) of seven white matter tracts were quantified. Cognitive functioning was analyzed according to performance in five task domains (perceptual speed, episodic memory, semantic memory, letter fluency, and category fluency). After controlling for age, FA and MD were exclusively related to perceptual speed. When further stratifying the sample into two age groups, the associations were reliable in the old-old (≥78 years) only. This relationship between white matter microstructure and perceptual speed remained significant after excluding persons in a preclinical dementia phase. The observed pattern of results suggests that microstructural white matter integrity may be especially important to perceptual speed among very old adults.

Effects of zinc-fortified drinking skim milk (as functional food) on cytokine release and thymic hormone activity in very old persons: a pilot study

Costarelli, Laura; Giacconi, Robertina; Malavolta, Marco; Basso, Andrea; Piacenza, Francesco; DeMartiis, MariLuisa; Giannandrea, Elvio; Renieri, Carlo; Busco, Franco; Galeazzi, Roberta; Mocchegiani, Eugenio
Fonte: Springer Netherlands Publicador: Springer Netherlands
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.12%
Zinc is a relevant nutritional factor for the whole life of an organism because it affects the inflammatory/immune response and antioxidant activity, leading to a healthy state. Despite its important function, the dietary intake of zinc is inadequate in elderly. Possible interventions include food fortification because it does not require changes in dietary patterns, the cost is low and it can reach a large portion of the elderly population, including very old subjects. Studies evaluating the impact of Zn-fortified foods on functional parameters in elderly, in particular, in very old individuals, are missing. The objective of this study was to evaluate the efficacy of consumption of a zinc-fortified drinking skim milk (Zn-FMilk) for a period of 2 months in comparison to standard non-fortified milk (No-FMilk) on some biochemical parameters, zinc status, inflammatory/immune response and on a key parameter of the T cell-mediated immunity (thymulin hormone) in healthy very old subjects. The treatment with zinc-fortified milk (Zn-FMilk) is a good omen to increase the cell-mediated immunity in very old age represented by thymulin activity and some cytokine (IL-12p70, IFN-γ) release. At clinical level, a good healthy state occurs in 70 % of the subjects with no hospitalization after 1 year of the follow-up in comparison to very old control subjects that did not participate to crossover design. In conclusion...

In patients with chronic stable angina, secondary prevention appears better in the very old compared to younger patients: The coronary artery disease in gENeral practiCE (CADENCE) substudy

Rajendran, S.; Visvanathan, R.; Tavella, R.; Weekes, A.; Morgan, C.; Beltrame, J.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
46.16%
BACKGROUND: With our aging communities and the increased prevalence of coronary heart disease (CAD) with age, the impact of this disease in the very old warrants further investigation. OBJECTIVE: To assess health outcomes and the attainment of guideline-based secondary prevention targets in the very old (>80 years, n=482) as compared to young (<65 years, n=582) and elderly (between 65 and 80 years, n=932) patients, all of whom had chronic stable angina. DESIGN: The coronary artery disease in general practice (CADENCE) study was a cluster-stratified cross-sectional survey. This study reports on health outcomes quantitated using the Seattle Angina Questionnaire and guideline targets achieved for blood pressure, smoking, lipids, diabetic control and body habitus. SETTINGS AND PARTICIPANTS: 2031 stable angina patients were recruited from 207 primary care practices. RESULTS: Despite similar angina frequency scores, the very old were more physically impaired by their angina than both the young and elderly [76±25 (Young) vs. 70±26 (Elderly) vs. 63±28 (Very old), p<0.05 for both comparisons]. However, the very old had better quality of life scores than young stable angina patients [72±24 vs. 65±25, p<0.05] and were similar to the elderly [72±24 vs. 72±23...

Dor crônica em idosos: estudo populacional em uma metrópole da região centro-oeste do Brasil; Chronic pain in the elderly: a study population in a metropolis of the west central region of Brazil

Vasconcelos, Patrícia Pereira de
Fonte: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Enfermagem (FEN); Faculdade de Enfermagem - FEN (RG) Publicador: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Enfermagem (FEN); Faculdade de Enfermagem - FEN (RG)
Tipo: Dissertação Formato: application/pdf
POR
Relevância na Pesquisa
46.08%
Chronic pain is an unpleasant experience that reaches much of the world's population; however, population studies with the elderly are rare. The aim of this study was to assess chronic pain and self-rated health among community elders. Study population-based cross-sectional, in Goiania, Goias, December/2009 between April 2010 and. For this cut, we excluded those who reached  13 on the MEEM scores, and needed help for the answers. The random sample consisted of 872 participants. Chronic pain was considered as existing for six months or more. Pain intensity was measured by using a numeric scale (0-10: zero=no pain, 1,2,3,4=mild, 5.6=moderate, and strong=7,8,9, and 10=worst pain possible) the location investigated through body diagrams, and self-rated health assessed by the scale of verbal descriptors ("very good", "good," "regular," "bad," "worst"). The project was approved by the CEP/UFG (Protocol 050/2009) and seniors signed the Informed Consent. The data were analyzed using Stata version 8.0 and operated by means of absolute and relative frequency and Confidence Interval (95%). Of the 872 elderly, 460 (52.7%: 95% CI: 49.4% -56.1%) reported chronic pain. By age, the prevalence was 52.4, 53.1 and 53.0%, respectively...

The role of invasive therapies in elderly patients with acute myocardial infarction

Nicolau, José C.; Lemos, Pedro A.; Wajngarten, Maurício; Giraldez, Roberto R.; Serrano Jr., Carlos V.; Martinez, Eulógio E.; Baracioli, Luciano M.; Kalil, Roberto; Jatene, Fábio B.; Dallan, Luis A.; Puig, Luis B.; Stolf, Noedir A.
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/06/2009 ENG
Relevância na Pesquisa
45.81%
INTRODUCTION: In elderly patients with acute myocardial infarction, very little is known about the role of surgical myocardial revascularization and percutaneous coronary intervention (invasive therapies - IT), especially in the context of long-term outcomes after hospital discharge. METHODS: We analyzed 1588 patients with MI who had been included prospectively in a databank and followed for up to 7.5 years. In this population, 548 patients were >;70 years old (elderly group - EG), and 1040 were

Preemptive kidney transplantation in elderly recipients with kidneys discarded of very old donors: a good alternative

Morales,Enrique; Gutiérrez,Eduardo; Hernández,Ana; Rojas-Rivera,Jorge; Gonzalez,Esther; Hernández,Eduardo; Polanco,Natalia; Praga,Manuel; Andrés,Amado
Fonte: Nefrología (Madrid) Publicador: Nefrología (Madrid)
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/01/2015 ENG
Relevância na Pesquisa
45.9%
Background: The shortage of organs is a major hurdle in kidney transplantation, and one solution to the problem is to extend the age of the donor. However, organs from older donors are often discarded due to the macroscopic appearance of the parenchyma or major vessels. On the other hand, a large number of elderly patients are potential candidates for kidney transplantation, while many kidneys from elderly deceased donors are discarded due to a lack of age-matched recipients. In addition, a large number are often discarded due to the lack of compatible recipients among elderly patients undergoing chronic dialysis. A possible solution to avoid this wastage of kidneys potentially suitable for transplantation could be the performance of preemptive kidney transplantation (PKT) in carefully selected elderly patients. PKT improves graft and patient survival compared to other renal replacement therapy options. There is no information about PKT in elderly patients receiving kidneys from elderly deceased donors. Methods: From 2007 to 2012, we performed a prospective observational study comparing 26 elderly patients receiving PKT with a control group of 26 elderly patients receiving a first transplant after prior dialysis. Results: Mean age of recipients was 74.3 ± 2.9 years and mean age of donors was 73.8 ± 4.1 years. Induction immunosuppression was similar in both groups. Death-censored graft survival was 96% in the PKT group and 68% in the control group (p = 0.02)...

Very elderly patients on haemodialysis: Evolution and its relation with comorbidities

Bento,Claudia; Fructuoso,Monica; Costa,Rui; Castro,Rui; Morgado,Teresa
Fonte: Sociedade Portuguesa de Nefrologia Publicador: Sociedade Portuguesa de Nefrologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2014 EN
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45.87%
Introduction: The population ageing has conditioned a progressive increase of very old patients on haemodialysis. These patients present multiple comorbidities that worsen the prognosis in dialysis and have an impact on their quality of life. Material and Methods: A retrospective observational study was performed, analysing all patients over 80 years of age that started regular haemodialysis between January 2004 and December 2011. The comorbidities were stratified using the Charlson score and correlated with mortality. Survival analysis was performed with Kaplan-Meier curves. Results: Fifty-nine patients were included, 35 females and 24 males, with a mean age of 84 ± 3 years. At the start of dialysis, the estimated glomerular filtration rate calculated using the modification of diet in renal disease (MDRD) formula was 10.8 ± 2.5 mL/min /1.73 m2. The initial Charlson score was 8 ± 3 and became higher at the end of follow-up (11.5 ± 2.9; p < 0.01). A Charlson score ≥ 8 was associated with more hospitalization days (878 vs. 360; p < 0.005). The survival rate was 56 % at 12 months and 31% at 24 months. The mortality rate at the end of follow-up (20.4 ± 15.7 months) was 55.9%, with a mortality rate of 27.3% at 3 months. The patients with early death presented a higher Charlson score (13.0 ± 1.7 vs. 6.4 ± 1.2; p < 0.01) at the beginning of dialysis. Conclusion: The benefits of dialysis in survival and quality of life in very elderly patients have been questioned. In our series...