ABSTRACT
Objetivos: Avaliar a prevalência de síndrome metabólica em idosos assistidos na atenção terciária à saúde e a associação entre síndrome metabólica e saúde, capacidade funcional, estilo de vida e fatores demográficos e socioeconômicos. Métodos: Foi realizado um estudo transversal envolvendo idosos atendidos em um ambulatório de Clínica Médica de um hospital universitário localizado em Curitiba, capital do Paraná. A síndrome metabólica foi definida pelos critérios do National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). As variáveis avaliadas foram: síndrome metabólica e seus componentes; fatores demográficos e socioeconômicos (faixa etária, sexo, escolaridade, renda familiar); estilo de vida (tabagismo, etilismo, adesão à dieta, atividade física); perfil de saúde (doenças crônicas não transmissíveis, medicamentos de uso contínuo); e capacidade funcional, determinada através das escalas de Katz e de Lawton. Resultados: Participaram do estudo 133 idosos, com média de idade de 68,7±5,8 anos (60-85 anos), sendo a maioria do sexo feminino (66,9%). A prevalência de síndrome metabólica foi de 63,9%, sendo 71,8% entre mulheres e 28,2% entre os homens (p=0,16). Síndrome metabólica foi mais frequente nos indivíduos entre 60-69 anos em comparação com os acima dessa idade (64,7% versus 35,3%; p=0,03). Também houve associação de síndrome metabólica com relato de cinco ou mais doenças crônicas não transmissíveis (60,0% versus 29,2%, p<0,001) e com uso de sete ou mais medicamentos contínuos (36,5% versus 1,6%, p<0,001). Obesidade abdominal foi significativamente mais frequente entre as mulheres (98,4% versus 66,7%; p=0,001) e hiperglicemia mais frequente entre os homens (95,8% versus 75,4%; p=0,03). Apenas 7,1% dos idosos com síndrome metabólica eram considerados dependentes. Conclusões: A prevalência de síndrome metabólica foi elevada nesta amostra de idosos assistidos na atenção terciária à saúde. A distribuição de dois dos cinco componentes da síndrome metabólica foi diferenciada entre os sexos (obesidade central mais frequente em mulheres e hiperglicemia em homens). Idosos com síndrome metabólica tinham mais frequentemente menos de 70 anos, relatavam maior número de doenças crônicas e usavam maior número de medicações contínuas. Não se observou associação de síndrome metabólica com sexo, fatores socioeconômicos, estilo de vida e capacidade funcional.
Aims: To evaluate the prevalence of metabolic syndrome in elderly assisted in tertiary health care and the association between metabolic syndrome and health, functional capacity, life style, and demographic and socioeconomic factors. Methods: A cross-sectional study was conducted involving elderly assisted in an outpatient medical clinic of a university hospital in Curitiba, capital of Paraná State, Brazil. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). The variables evaluated were: metabolic syndrome and its components; demographic and socioeconomic factors (age, sex, education, family income); lifestyle (smoking, alcohol use, adherence to diet, physical activity); health profile (non-communicable diseases, continued use of medicines); and functional capacity, determined by Katz and Lawton scales. Results: The study included 133 elderly, with a mean age of 68.7±5.8 years (60-85 years), most of them women (66.9%). The prevalence of metabolic syndrome was 63.9%, being 71.8% in women and 28.2% in men (p=0.16). Metabolic syndrome was more frequent in individuals aged 60-69 years compared with those above that age (64.7% versus 35.3%; p=0.03). There was also association of metabolic syndrome with reporting five or more chronic diseases (60.0% versus 29.2%, p<0.001) and with using seven or more continuous medicines (36.5% versus 1.6%, p<0.001). Abdominal obesity was more frequent among women (98.4% versus 66.7%; p=0.001) and hyperglycemia was more frequent among men (95.8% versus 75.4%; p=0.03). Only 7.1% of the elderly with metabolic syndrome were considered dependent. Conclusions: Prevalence of metabolic syndrome was high in this sample of elderly assisted in tertiary health care setting. The distribution of two of the five components of metabolic syndrome was different between sexes (central obesity more frequent in women and hyperglycemia more frequent in men). Elderly people with metabolic syndrome were more often less than 70 years old, reported more chronic diseases and used more continuous medicines. There was no association of metabolic syndrome with sex, socioeconomic factors, lifestyle or functional capacity.
Subject(s)
Geriatrics , Health of the Elderly , Metabolic SyndromeABSTRACT
PURPOSE: To investigate whether hospitalization influences serum prostate-specific antigen (PSA) values. MATERIALS AND METHODS: Transrectal ultrasound-guided prostate biopsies were performed for detecting prostate cancer in 2,017 patients between February 2001 and April 2011 at Ajou University Hospital. Of those patients, 416 patients who were hospitalized for prostate biopsies, whose serum PSA values were measured at the outpatient department within 1 month of admission and also just after admission, and who had negative prostate biopsy results were included in the present study. We retrospectively reviewed the data of the 416 patients and compared the serum PSA values measured in the outpatient department with those measured during hospitalization. RESULTS: Among all 416 patients, the interval between the two PSA measurements was 22.2 days (range, 3 to 30 days) and the prostate size measured by transrectal ultrasonography was 53.63 mL (range, 12.8 to 197.9 mL). Among all patients, mean serum PSA levels measured during hospitalization were significantly lower than those measured in the outpatient department (6.69 ng/mL vs. 8.01 ng/mL, p<0.001). When stratified according to age, the presence or absence of chronic prostatitis in the biopsy pathology, serum PSA levels, and prostate size, the serum PSA levels measured during hospitalization were significantly lower than those measured in the outpatient department in all subgroups, except in cases aged 20 to 39 years and those with PSA <4 ng/mL, in whom no significant differences were shown. CONCLUSIONS: Hospitalization decreases serum PSA values compared with those measured on an outpatient basis in patients with benign prostatic diseases. Therefore, serum PSA values should be checked on an outpatient basis for serial monitoring.
Subject(s)
Aged , Humans , Biopsy , Hospitalization , Outpatient Clinics, Hospital , Outpatients , Prostate , Prostate-Specific Antigen , Prostatic Diseases , Prostatic Neoplasms , Prostatitis , Retrospective StudiesABSTRACT
Objectives : To describe the pattern of adherence to Highly Active Antiretroviral therapy (HAART) and ascertain the factor(s) associated with nonadherence. Methods: This was a cross-sectional, two-site, hospital-based study. The study was undertaken in 2005; as a result of phased roll out of free HAART as part of National AIDS Control Program, patients at Lok Nayak Jai Prakash (LNJP) hospital were receiving free HAART, while patients at All India Institute of Medical Sciences (AIIMS) had to bear out-of-pocket expenses for HAART. Adherence was defined as not having missed even a single pill over the previous 4-day period on self-reporting. Results: Adherence at AIIMS was 47%, whereas it was 90% at LNJP. The difference was statistically significant. Multivariate analysis showed that nonadherence was associated with not having been told about the importance of HAART, having to pay out-of-pocket for HAART and reported continued risk behavior post HAART. Conclusion: With the provision of free HAART, adherence is likely to be high. Emphasis should be given on simultaneous recruitment of counselors, and physicians should be made aware about the need to inquire and counsel patients against continued risk behavior.
ABSTRACT
The "Assessment system for spiritual civilization development of service industries in Shanghai" is called into play to guide the survey of patients' satisfaction for service centers in hospital's outpatient clinics. Survey feedback recovered is analyzed with the key driving factors analysis model and the four-quadrant analysis. This practice identified the most critical areas to improve the satisfaction for such centers, providing theoretical references for constant quality improvement in hospitals, new insights for hospital branding, and guidelines for further health reforms.