Creating knowledge and actions by promoting health in aged women with osteoporosis / Crear conocimientos y acciones promoviendo la salud de ancianas con osteoporosis / Construindo saberes e fazeres mediante a promoção da saúde de mulheres idosas com osteoporose

ABSTRACT Objective: to analyze how Paulo Freire's theoretical framework can contribute to understanding the awareness-raising process about aging, by promoting health and self-care in aged women with osteoporosis and considering the socioeconomic and environmental factors involved in this process. Method: a qualitative and descriptive study conducted by means of secondary analysis of data from a primary study carried out between December 2019 and February 2020, which included 25 aged women treated in a Rheumatology health unit of a university hospital. This analysis intended to return to a corpus of previously collected data, aiming to reexamine them from a new investigative angle, Paulo Freire's theoretical perspective, which served as theoretical-methodological framework. Results: the findings of this research enabled an approach to the reality of aged women with osteoporosis through a critical reflection on the practice and sensitization inherent to the human essence. This allowed revealing aspects that were hidden and driving the creation of concrete action proposals in relation to the participants' reality. Conclusion: nurses' crucial role in the assistance provided to aged women with osteoporosis was verified, as well as the efficiency of a dialogical approach that values their self-care choices and skills. As a dynamic process that involves actions, reflections and new actions, the health perception strengthens Freire's perspective in the Nursing practice as a strategy to develop diverse knowledge and actions along with aged women with osteoporosis, aiming to promote emancipating assistance based on the care ethics.

RESUMEN Objetivo: analizar de qué manera el referencial teórico de Paulo Freire puede ayudar a entender el proceso de concientización sobre el envejecimiento, promoviendo la salud y el autocuidado en ancianas con osteoporosis y considerando los factores socioeconómicos y ambientales implicados en este proceso. Método: estudio cualitativo y descriptivo realizado a través de análisis secundario de los datos obtenidos en un estudio primario llevado a cabo entre diciembre de 2019 y febrero de 2020 y que incluyó a 25 ancianas atendidas en una unidad de salud especializada en Reumatología de un hospital universitario. Este análisis pretendió retornar a un corpus de datos previamente recolectados, a fin de volver a examinarlos desde un nuevo ángulo de investigación, la perspectiva teórica de Paulo Freire, que sirvió como marco teórico-metodológico. Resultados: los hallazgos de este trabajo de investigación hicieron posible un acercamiento a la realidad de las ancianas con osteoporosis a través de una reflexión crítica sobre la praxis y la concientización inherentes a la esencia humana. Eso permitió revelar aspectos que estaban ocultos e impulsar la creación de propuestas concretas de acción en relación con la realidad de las participantes. Conclusión: se verificó el rol crucial de los profesionales de Enfermería en la asistencia provista a ancianas con osteoporosis, al igual que la eficiencia de una enfoque dialógico que valoriza sus elecciones y habilidades para el autocuidado. La percepción de la salud como un proceso dinámico que implica acciones reflexiones y nuevas acciones fortalece la efectividad de la perspectiva de Freire en la práctica de Enfermería como una estrategia para crear conocimientos y acciones junto con las ancianas que padecen osteoporosis, con el objetivo de promover una asistencia emancipadora basada en la ética de la atención.

RESUMO Objetivo: analisar como o referencial teórico de Paulo Freire pode contribuir para a compreensão do processo de conscientização sobre o envelhecimento, mediante a promoção da saúde e o cuidado de si de mulheres idosas com osteoporose, considerando os fatores socioeconômicos e ambientais implicados nesse processo. Método: estudo qualitativo descritivo realizado através da análise secundária de dados de um estudo primário conduzido entre dezembro de 2019 e fevereiro de 2020, que contou com 25 idosas atendidas em uma unidade de saúde de reumatologia em um hospital universitário. Esta análise ensejou o retorno a um corpus de dados previamente coletados, visando reexaminá-los sob um novo prisma investigativo, a perspectiva teórica de Paulo Freire, que atuou como arcabouço teórico-metodológico. Resultados: os achados desta pesquisa possibilitaram uma aproximação da realidade das idosas com osteoporose através de uma reflexão crítica sobre a práxis e conscientização inerentes à essência humana. Isso permitiu revelar aspectos que estavam ocultos e impulsionar a criação de propostas concretas de ação em relação à realidade das participantes. Conclusão: verificou-se o papel crucial do enfermeiro na assistência às idosas com osteoporose e a eficiência de uma abordagem dialógica que valoriza suas escolhas e habilidades para o cuidado de si. A percepção da saúde como um processo dinâmico, que envolve ações, reflexões e novas ações, fortalece a efetividade da perspectiva freiriana na prática de enfermagem como uma estratégia para construir saberes e fazeres em conjunto com as idosas com osteoporose, com o objetivo de promover uma assistência emancipadora baseada na ética do cuidado.

Transtornos alimentares: vivências de mulheres acima de 30 anos / Eating disorders: experiences of women aged over 30 years / Trastornos alimentarios: experiencias de mujeres de más de 30 años

O objetivo deste estudo foi compreender como mulheres adultas (acima de 30 anos) diagnosticadas com transtornos alimentares (TAs) vivenciam o adoecer. Trata-se de um estudo qualitativo, descritivo e exploratório, desenvolvido com base no referencial teórico-metodológico da Análise Fenomenológica Interpretativa (AFI). Participaram seis mulheres, com idades entre 34 e 65 anos, atendidas em um serviço especializado. Os dados foram coletados por meio de entrevista aberta, de inspiração fenomenológica, na modalidade remota. As entrevistas foram audiogravadas, transcritas e analisadas seguindo os passos da AFI. Duas categorias temáticas foram identificadas: "Vivendo antes do adoecer" e "Encontrando-se doente." Constatou-se que os sintomas tiveram início anteriormente à vida adulta e que houve dificuldade na confirmação do diagnóstico. Na perspectiva das participantes, conviver com a sintomatologia ficou mais complicado em função de particularidades de manejo dos sintomas na vida adulta, e a idade é percebida como um fator que impacta e dificulta ainda mais a recuperação. As participantes relataram desesperança em relação ao futuro, apesar de a maioria reconhecer melhoras no quadro clínico ao longo do tempo e de valorizar a relação de confiança estabelecida com a equipe multiprofissional.(AU)

This study aimed to understand the experience of illness of adult women (over 30 years) diagnosed with eating disorders (ED). This is a qualitative, descriptive, and exploratory study, using Interpretative Phenomenological Analysis (IPA) as theoretical and methodological framework. A sample of six women aged 34-64 years, assisted in a specialized service, were recruited to complete a phenomenological in-depth open interview. The data were remotely collected. Interviews were audio-recorded, transcribed and analyzed following the IPA. Two thematic categories were identified: "Living before the illness" and "Finding about the illness." It was found that the symptoms started before adulthood and that there was difficulty establishing the diagnosis. Living with the symptoms became more complicated due to particularities of symptom management in adulthood and age is perceived as a factor that impacts recovery and makes it even more difficult. The participants reported hopelessness about the future, although most recognized improvements in the clinical condition over time and valued the trusting relationship they established with the multiprofessional team.(AU)

El objetivo de este estudio fue comprender las experiencias de las mujeres adultas (mayores de 30 años) diagnosticadas con trastornos alimentarios (TA) respecto a la enfermedad. Se trata de un estudio cualitativo, descriptivo y exploratorio, desarrollado a partir del marco teórico y metodológico del Análisis Fenomenológico Interpretativo (AFI). Participaron seis mujeres, con edades de entre 34 y 65 años, atendidas en un servicio especializado. Los datos se recogieron mediante entrevistas abiertas, de inspiración fenomenológica, en la modalidad a distancia. Las entrevistas fueron grabadas en audio, transcritas y analizadas siguiendo los pasos del AFI. Se identificaron dos categorías temáticas: "Vivir antes de enfermar" y "Encontrarse enfermo." Se constató que los síntomas comenzaron antes de la edad adulta y que hubo dificultades de establecer el diagnóstico. La convivencia con síntomas se complicó debido a las particularidades del manejo de los síntomas en la vida adulta y la edad se percibe como un factor que influye y dificulta aún más la recuperación. Los participantes manifestaron desesperanza sobre el futuro, aunque reconocieron mejoras en el cuadro clínico con el paso del tiempo y valoraron la relación de confianza establecida con el equipo multiprofesional.(AU)

Efectos del ejercicio físico sobre la calidad de vida en personas mayores. Revisión de la literatura

RESUMEN El objetivo de esta revisión fue determinar cuál es la dosis óptima necesaria de ejercicio físico que debe realizar una persona mayor para generar efectos en la Calidad de Vida. Se realizó una búsqueda en bases de datos electrónicas entre 2015-2020. Como resultado, 9 de 33 artículos cumplieron con criterios de inclusión. La prescripción de ejercicio físico más utilizada en términos de FITT o FITT-VP fue: tipo, fuerza muscular a intensidad moderada a intensa, y/o ejercicio físico aeróbico a intensidad moderada; tiempo de sesión de 60 minutos; frecuencia 3 veces por semana; y tiempo de intervención mínimo 3 meses. En cuanto al volumen y progresión, la información fue limitada y justifica más estudios. Los efectos del ejercicio físico sobre la Calidad de Vida de las personas mayores se producirán cuando exista una programación basada como mínimo según FITT, se consideren los objetivos de la persona mayor, y la práctica sea regular.

ABSTRACT The objective of this review was to determine the optimal dose of physical exercise that an elderly person should perform to generate effects on Quality of Life. A search was carried out in electronic databases between 2015-2020. As a result, 9 of 33 articles met the inclusion criteria. The most used physical exercise prescription in terms of FITT or FITT-VP was: type, muscular strength at moderate to intense intensity, and / or aerobic physical exercise at moderate intensity; 60-minute session time; frequency 3 times a week; and intervention time at least 3 months. In terms of volume and progression, the information was limited and needs further studies. The effects of physical exercise on the Quality of Life of the elderly will occur when there is a schedule based at least according to FITT, the objectives of the elderly person are considered, and the practice is regular.

Implicações da técnica Homeostase Quântica Informacional sobre a saúde física e emocional / Implications of the Quantum Information Homeostasis technique for physical and emotional health / Implicaciones de la técnica Homeostasis Quántica Informacional sobre la salud física y emocional

Objetivo: Avaliar os benefícios da técnica Homeostase Quântica Informacional (HQI) sobre a saúde física e emocional de pessoas adultas. Métodos: Estudo experimentalrandomizado quali-quantitativo com grupo controle, com pré-teste e pós-teste, realizado na cidade de Campinas, São Paulo, Brasil. Obtiveram-se os dados entre julho e setembro de 2018 com 50 adultos na faixa etária de 45 a 60 anos, e os instrumentos utilizados avaliaram variáveis de natureza sociodemográfica, de saúde física e emocional. Para análise dos dados utilizou-se o teste qui-quadrado ou o teste exato de Fisher. Para comparação das variáveis numéricas entre os dois grupos utilizou-se o teste de Mann-Whitney e para comparação das variáveis categóricas utilizou-se o teste de Cochran seguido do teste de McNemar. O nível de significância adotado para os testes estatísticos ficou ajustado em p<0,05 e para os dados qualitativos utilizou-se a análise de conteúdo. Resultados: Os resultados mostraram ganhos estatisticamente significantes nos indivíduos do Grupo 1, que receberam o tratamento de HQI, nas avaliações para atividade física (p=0,046), escore de ansiedade (p=0,013), de sofrimento emocional (p=0,008 e p=0,019) e de tontura (p=0,021), quando comparados com o Grupo 2, controle. Conclusão: Os dados obtidos permitem afirmar que a HQI proporciona benefícios para a saúde física e emocional de pessoas adultas. Bem como o seu emprego poderia tornar melhor o dia a dia das pessoas, diminuindo o custo de tratamentos prolongados e onerosos.

Objective: To assess the benefits of the Quantum Information Homeostasis (QIH) technique for the physical and emotional health of adults. Methods: A qualitative and quantitative randomized experimental study with a control group, pre-test and posttest was carried out in the city of Campinas, São Paulo. Data were collected between July and September 2018 from 50 adults aged 45 to 60 years, and the instruments used assessed sociodemographic and physical and emotional health variables. For data analysis, we used either the chi-square test or the Fisher's exact test. To compare the numerical variables between the two groups, the Mann-Whitney test was used, and to compare thecategoricalvariables, the Cochran test followed by the McNemar est was used. The level of significance adopted for the statistical tests was adjusted to p<0.05 and content analysis was used for qualitative data. Results: The results showed statistically significant gains in individuals in group 1, who received the QIH treatment, in the assessments for physical activity (p=0.046), anxiety score (p=0.013), emotional distress (p=0.008 and p= 0.019) and dizziness (p=0.021), when compared to group 2, controls. Conclusion: The data obtained allow us to state that QIH provides benefits for the physical and emotional health of adults. Also, its use could make people's daily lives better, reducing the cost of long and expensive treatments

Objetivo: Evaluar los beneficios de la técnica Homeostasis Quántica Informacional (HQI) sobre la salud física y emocional de personas adultas. Métodos: Estudio experimental randomizado cuali-cuantitativo con grupo control, pre y postest realizado en la ciudad de Campinas, São Paulo, Brasil. Se ha recogido los datos entre julio y septiembre de 2018 con 50 adultos en la franja de edad entre 45 y 60 años. Los instrumentos utilizados evaluaron las variables de naturaleza sociodemográfica, salud física y emocional. Se utilizó la prueba chi-cuadrado o exacto de Fisher para el análisis de los datos. Para la comparación de las variables numéricas entre los grupos se utilizó la prueba de Mann-Whitney y para la comparación de las variables categóricas se utilizó la prueba de Cochran seguida de la prueba de McNemar. El nivel de significancia adoptado para las pruebas estadísticas fue de p<0,05 y para los datos cualitativos se utilizó el análisis de contenido. Resultados: Los resultados mostraron ganancias estadísticamente significantes para los individuos del Grupo 1, que han sido tratados con la HQI, en las evaluaciones de actividad física (p=0,046), la puntuación de ansiedad (p=0,013), el sufrimiento emocional (p=0,008 e p=0,019) y de vértigo (p=0,021) comparados con el Grupo 2, el control. Conclusión: Los datos permiten afirmar que la HQI proporciona beneficios para la salud física y emocional de personas adultas, así como su utilización podría mejorar el día a día de las personas disminuyendo el coste de los tratamientos a largo plazo y costosos.

Distanciamento social pela covid-19: rede de apoio social, atividades e sentimentos de idosos que moram só / Social distancing due to covid-19: social support network, activities and feelings of aged individuals who live alone / Distanciamiento social debido al covid-19: red de apoyo social, actividades y sentimientos de ancianos que viven solos

RESUMO Objetivo: to analyze the social support network, the activities performed, and the factors associated with the presence of negative feelings of aged individuals who live alone during social distancing due to COVID-19. Método: a cross-sectional study conducted with 119 aged individuals who live alone in the Macro-region of Triângulo Sul, Minas Gerais, Brazil. The data were collected at the homes and with instruments validated in the country. Descriptive and multiple binary regression analyses were performed (p<0.05). Resultados: 97.5% had a social support network for health needs and for maintaining social distancing (79.8%). The activity most frequently performed was household chores (77.3%). The presence of negative feelings was associated with the female gender (p<0.001) and with fewer activities (p=0.012). Conclusão: the data contribute to the development of health actions, revealing situations in the daily life of aged individuals that are exacerbated during the COVID-19 pandemic, as well as aspects related to the negative feelings experienced by aged individuals who live alone.

ABSTRACT Objective: to identify the sociodemographic profile of interpersonal violence associated with alcohol consumption in São Paulo-SP, Brazil. Method: a cross-sectional study carried out through notifications of suspected or confirmed cases of interpersonal violence from the Notifiable Diseases Information System submitted between 2016 and 2019. Collection took place between March and June 2020. Chi-square or Fisher's exact tests were performed in the statistical analysis. Results: 27,775 notifications were obtained, whose prevalent profile was female victims (60.6%), aged between 20 and 34 years old (41.4%), brown- or black-skinned (51%), and with complete high school (18.8%). Physical violence was more frequent (81.9%), perpetrated by an intimate partner (20.3%), motivated by sexism (9.9%) and generational conflict (11.2%). In sexual violence, rape prevailed with 69.4% and there was a low supply of emergency contraception methods (14.7%). Conclusion: the study contributes to reflections and subsidies in the planning of public policies to control the problem.

RESUMEN Objetivo: analizar la red de apoyo social, las actividades realizadas y los factores asociados a la presencia de sentimientos negativos de ancianos que viven solos durante el distanciamiento social debido al COVID-19. Método: estudio transversal realizado con 119 ancianos que viven solos en la Macro-región de Triângulo Sul, Minas Gerais, Brasil. Los datos se recolectaron en los domicilios y con instrumentos validados en el país. Se realizaron análisis descriptivos y de regresión binaria múltiple (p<0,05). Resultados: El 97,5% contaba con una red de apoyo social para necesidades de salud y para mantener el distanciamiento social (79.8%). La actividad más frecuente fue la de tareas domésticas (77,3%). La presencia de sentimientos negativos se asoció al sexo femenino (p<0,001) y a una menor cantidad de actividades realizadas (p=0,012). Conclusión: los datos contribuyen en la elaboración de acciones de salud, evidenciando situaciones en la vida diaria de los ancianos que se vieron agravadas durante la pandemia de COVID-19, como ser los aspectos relacionados a los sentimientos negativos experimentados por los ancianos que viven solos.

Prevalence of rotator cuff diseases in adults older than 40 years in or near Chuncheon city, Korea.

BACKGROUND: To determine the prevalence of rotator cuff diseases in a population older than 40 years in or nearby Chuncheon city, Republic of Korea. METHODS: Sixty shoulders of 30 people older than 40 years who participated in a health lecture were examined for free by an orthopedic surgeon. Visual analog scale of pain and American Shoulder and Elbow Surgeons scores were assigned, and routine physical examination was performed. Ultrasonography was performed on the shoulder. RESULTS: On ultrasonographic examination, there were one shoulder with full thickness rotator cuff tear, 20 of 60 (33%) with partial thickness rotator cuff tear, five of 60 (8%) with calcific tendinitis, one of 60 (2%) with tear of the long head of the biceps, and five of 60 (8%) with tendinitis of the long head of the biceps. Participants older than 60 years showed significantly high proportions of lesion of the long head of the biceps and rotator cuff diseases (P=0.019 and P=0.015, respectively). Participants who performed physical labor had high proportions of rotator cuff tear and rotator cuff disease (P=0.001 and P<0.001, respectively). CONCLUSIONS: Rotator cuff diseases showed a high prevalence in aged persons and resulted in a decrease in shoulder function.

[Predictive capacities at the end of hospitalisation in geriatrics of the modified SEGA frailty score: a 6-month prospective study]. / Capacités prédictives du score de fragilité de la grille SEGA modifiée en sortie d'hospitalisation de gériatrie : étude prospective à 6 mois.

The aim of this study was to describe the predictive role of the modified SEGA fragility score on nursing home admission, rehospitalization, falls and mortality. MATERIAL AND METHODS: We performed a prospective, single-center cohort study in patients leaving geriatric hospitalization between July 2016 and February 2017, with follow-up at 6 months. Patients 65 years of age and over, returning home, were included. The primary outcome measure was admission to an institution at 6 months. We realized a Cox model to explore the predictive character of the variables. RESULTS: Thirty-three patients (18.4%), mean age 80.9 years (± 6.5), were not very fragile. At 6 months, 13.5% of the fragile or very fragile patients and 1.2% of the patients who were not very fragile had entered the institution (p = 0.169). Fragility status was statistically significantly associated with rehospitalization at 3 months (p = 0.026) and single or multiple drop at 6 months) month (p = 0.003). CONCLUSION: The SEGAm grid would predict the occurrence of derogatory events and improve return home.

[A case of angioedema with dysarthria mimicking transient ischemic attack].

An 85-year-old woman was transported to our emergency room by ambulance with a complaint of slurred speech. Neurological examination revealed dysarthria only. We considered that lingual edema identified on physical examination might have influenced dysarthria. However, we were unable to perform sufficient evaluation, since she could not open her mouth widely or push the tongue out beyond the lips. We considered the incidence of acute cerebrovascular disease because of the acute onset, and performed emergency brain MRI. Imaging revealed that although no abnormality was present in the brain parenchyma, edema of the tongue and soft palate was evident on T2-weighted sagittal imaging. We confirmed the dysarthria was caused by tongue edema due to angioedema. In addition, we diagnosed angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema, because ACEI had been started 2 months earlier as pharmacotherapy for hypertension. Tongue swelling due to angioedema should be considered when examining patients with dysarthria.

Fibrous dysplasia of the anterior mandible: A rare case report.

Fibrous dysplasia (FD) is a rare bony disorder in which normal bone is replaced by abnormal fibro-osseous tissue. It often involves the long bones, craniofacial bones, ribs, and pelvis. Approximately 30% of monostotic FD (MFD) lesions are found in the cranial or facial bones. In general, FD is found in teenagers, and it usually becomes static after adulthood. FD involves the maxilla almost two times more often than the mandible. It frequently appears in the posterior region of the jaw bone and is usually unilateral. Here, we present an unusual case of symptomatic MFD affecting the anterior region of the mandible in a 43-year-old female with the clinical, radiographical, and histopathological features. The clinical examination showed both the labial and lingual bone expansion in the anterior mandible. The radiographic examination revealed a lesion with both radiopaque and radiolucent features showing a "ground-glass" appearance. The diagnosis was obtained after confirmatory intrabony biopsy with the histopathological examination, and it was diagnosed with benign FD. The patient preferred regular follow-up of MFD after discussion. During the regular follow-up, MFD lesion showed no obvious signs of progression or malignancy features.

Cellulitis in aged persons: a neglected infection in the literature.

Cellulitis is a frequent soft tissue and skin infection. The lower limbs are affected in 70 to 80% of cases. Cellulitis in aged persons is not yet well described in literature. A retrospective descriptive study conducted in the Internal Medicine Department of Sahloul hospital in Sousse in Tunisia. It included patients whose age was up to 65 years old admitted into hospital for cellulitis of the legs, the arms or the face. One hundred fifty eight patients with a mean age of 73 years old (range: 65 to 94 years old) were included. Female to male sex ratio was 0.68. Among them, we noted diabetes mellitus in 81 cases (50.6%). The infection was located in the lower limbs in 155 cases (98%), in the face in two cases (1.3%) and in the upper limb in one case (0.7%). Twenty one patients (13.3%) presented with severe cellulitis and one presented with necrotizing fasciitis. All patients received intra venous antibiotic therapy. Surgical treatment was indicated in 14 cases. Cefazolin was prescribed in 77 cases (48%). Favorable evolution was noted in 144 patients (91.1%). Forty four patients (27.8%) received prophylactic antibiotics. Prevention of skin and soft tissue infection is a crucial step to preserve health in aged persons.

Survey of “Rural type solitary death” through Postmortem Examination / 日本プライマリ・ケア連合学会誌

<b>Purpose</b>: To analyze “solitary deaths” in Hitachiomiya city through postmortem examination results, and contribute to formulation of preventative measures.<br><b>Methods</b>: The author surveyed 149 cases of elderly individuals found deceased in their house during the period between January 2008 and December 2014. All had lived alone or almost alone in social isolated conditions.<br><b>Results</b>: There were more males than females. Men were in a wide range of ages, while women were predominantly in their 80's and 90's. Nearly all cases were found within 2 days following death and deaths occurred more frequently in the winter and spring. Cardinal causes of death, were acute cardiac disorders and cerebrovascular diseases. Malignancy and pneumonia were less frequent. More than 90% of the corpses were found by their family members or relatives, and others by nursing service providers or neighbors.<br><b>Conclusion</b>: This analysis of “solitary deaths” in Hitachiomiya city showed predominance of men and shorter intervals between death and being found than those of metropolis after death.

Qualidade de vida do cuidador do portador de Doença de Alzheimer / Quality of life of Alzheimer patients’ caregivers / Calidad de vida de quien cuida del portador de Enfermedad de Alzheimer

O objetivo do estudo foi avaliar a qualidade de vida do cuidador do portador da Doença de Alzheimere sua relação com o nível de independência funcional do portador. O estudo quantitativo foi realizado no Centro de Referência ao Idoso de Jundiaí, entre os meses de maio e agosto de 2011, com 66 cuidadores, e para a coleta foram utilizados os instrumentos World Health Organization Quality of Life – Bref e a Medida da Independência Funcional. A qualidade de vida resultou em uma média de 65,2 pontos para o domínio físico; 57,1 para o psicológico; 62,6 para as relações sociais; 54,6 para o meio ambiente; 64 para a questão geral de qualidade de vida e 58,7 para a avaliação global da saúde. Não foi encontrada correlação significante entre os instrumentos. A avaliação da qualidade de vida pode contribuir para a diminuição do processo de adoecimento do cuidador, através de elaboração de estratégias pelos profissionais.

This research aimed at evaluating the quality of life of Alzheimer patients’ caregivers and his-her relationship with patient’s level of functional independence. The quantitative study was conducted with 66 caregivers, at the Support Center for Aged People in Jundiaí, São Paulo, Brazil, from May to August, 2011. Data collection was conducted on the basis of World Health Organization Quality of Life – Bref and Functional Independence Measure. Quality of life resulted in an average of 65.2 points for physical domain; 57.1 for psychological domain; 62.6 for socialrelations; 54.6 for environment; 65 for quality of life as a whole; and 58.7 for general health evaluation. No significant correlation was found out among the tools. Quality of life evaluation and development of professional strategies can help decrease caregivers’ health deterioration process.

El objetivo del estudio fue evaluar la calidad de vida del cuidador dedicado al portador de la Enfermedad de Alzheimer y su relación con el nivel de independencia funcional del portador. El estudio cuantitativo fue realizado con 66 cuidadores, en el Centro de Referencia del Anciano de Jundiaí-SP-Brasil, entre los meses de mayo y agosto de 2011, y para la recolección se utilizaron los instrumentos Calidad de Vida – Bref, creado por la Organización Mundialde la Salud, y la Medida de Independencia Funcional. La calidad de vida resultó en un promedio de 65,2 puntos para el dominio físico; 57,1 para el psicológico; 62,6 para las relaciones sociales; 54,6 para el medio ambiente; 64 para la cuestión general de calidad de vida, y 58,7 para la evaluación global de la salud. No se encontró correlación significativa entre los instrumentos. La evaluación de la calidad de vida puede contribuir para la disminución del proceso referente a que el cuidador contraiga enfermedades, haciéndose esto mediante la elaboración de estrategias por los profesionales.

Evaluación de los estados funcional y afectivo en la población geriátrica del área de salud "28 de Septiembre" / Evaluation of the functional and affective states in the geriatric population of "28 de septiembre" health area

Se realizó un estudio descriptivo y transversal de 108 ancianos con 60 años y más, pertenecientes al Policlínico Universitario "28 de Septiembre" de Santiago de Cuba, desde abril hasta octubre del 2011, a fin de evaluar los estados funcional y afectivo en esta población geriátrica. En la casuística prevalecieron las edades de 70-79 años (35,2 %), el sexo femenino (60,2 %) y las que tenían dependencia funcional en la realización de 1 o 2 tareas básicas de la vida diaria, así como en 3 o 4 actividades instrumentadas. También primaron los trastornos afectivos con predominio de la depresión y la ansiedad.

A descriptive and cross-sectional study of 108 aged patients with 60 years and over, belonging to "28 de Septiember" University Polyclinic in Santiago de Cuba , was carried out from April to October, 2011, in order to evaluate the functional and affective states in this geriatric population. Ages from 70-79 years (35.2 %), the female sex (60.2 %) and those who had functional dependence in carrying out 1 or 2 basic tasks of the daily life activity, as well as in 3 or 4 instrumental activities, prevailed in the case material. The affective disorders also prevailed with a prevalence of depression and anxiety.

Factores de riesgo coronarios asociados al infarto agudo del miocardio en el adulto mayor / Coronary risk factors associated with the acute myocardial infarction in the elderly

Se realizó un estudio observacional, analítico y retrospectivo, de tipo caso-control, de los adultos mayores con infarto agudo del miocardio, pertenecientes al área de salud Municipal de Santiago de Cuba, desde enero de 2006 hasta diciembre de 2011, a fin de identificar los factores de riesgo coronarios asociados al mismo. Se seleccionaron 33 casos y 2 controles por cada uno de ellos. Se calcularon el riesgo relativo a través de la razón de productos cruzados y el riesgo atribuible en expuestos porcentual como medida de impacto. El sedentarismo y la hipertensión arterial tuvieron una acentuada relación significativa de causalidad con el infarto agudo del miocardio y de forma moderada con el tabaquismo, no así los antecedentes familiares ni personales de cardiopatía isquémica, sexo, obesidad y diabetes mellitus

An observational, analytic and retrospective study of case-control type, of aged patients with acute myocardial infarction, belonging to the health Municipal area of Santiago de Cuba was carried out from January, 2006 to December, 2011, in order to identify the coronary risk factors associated with it. Thirty three cases and two controls for each were selected. The relative risk through the odds ratio and the attributable risk in percentage exposed as impact measure were calculated. Sedentarism and hypertension had a considerable significant causative relationship with acute myocardial infarction and in a moderate way with smoking habit. Family or personal history of ischemic cardiopathy, sex, obesity or diabetes mellitus had no relation with it

Co-Occurrence of Syringomyelia and Hydrocephalus in a Patient Without Chiari Malformation in Her 50's

Syringomyelia rarely accompanies hydrocephalus in the aged person except for the cases with a typical Chiari malformation. A 59-year-old woman developed progressive generalized weakness and gait disturbance for 9 years. MRI demonstrated marked enlargement of the cerebral ventricles and the longitudinal dilatation of central canal involving the entire spinal cord, whereas a typical Chiari malformation was absent. She was successfully treated by ventriculoperitoneal shunting. We report a hydrocephalic patient in her 50's accompanied by syringomyelia without a typical Chiari malformation.

Algunos factores favorecedores de la depresión neurótica en longevos hospitalizados / Some favouring factors of the neurotic depression in hospitalized elderly

Se realizó un estudio descriptivo, retrospectivo y longitudinal de 81 pacientes atendidos en el servicio de psicogeriatría del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde enero hasta diciembre del 2010, a fin de identificar algunos factores favorecedores de la depresión neurótica en estos adultos mayores. Entre las variables analizadas figuraron: sexo, edad, nivel de escolaridad, situación económica, satisfacción con la vida actual, estado de soledad y severidad de la depresión. Para la recolección de la información se aplicó el test Escala de Depresión Geriátrica y se utilizó como medida de resumen el porcentaje. En la casuística los más afectados fueron el grupo etario de 60_69 años y el sexo femenino. Asimismo, tuvieron mayor riesgo de ideación suicida las féminas con nivel de escolaridad primario y predominó la situación económica mala, así como los gerontes que se sentían solos y no estaban satisfechos con la vida.

A descriptive, retrospective and longitudinal study of 81 patients assisted in the service of psychogeriatrics of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba was carried out from January to December 2010, in order to identify some favoring factors of neurotic depression in these aged persons. Among the analyzed variables there were: sex, age, school level, economic situation, and satisfaction with the current life, degree of loneliness and severity of the depression. For the gathering of the information the Scale of Geriatric Depression test was applied, and the percentage was used as summary measure. The most affected in the case material were the age group 60-69 year and the female sex. Also, the females with primary educational level had greater risk of suicidal ideas and the poor economic situation prevailed, as well as the aged who felt alone and who were not satisfied with life.

Factores de riesgo de carga en cuidadores informales de adultos mayores con demencia / Risk factors of burden in informal caregivers of older adults with dementia

Introducción: el fenómeno del envejecimiento de la población cubana es hoy una realidad que impone grandes retos a toda la sociedad y en particular a la familia, principal fuente de protección y apoyo para sus personas mayores. Objetivos: diagnosticar la carga e identificar sus factores de riesgo en los cuidadores informales de adultos mayores con demencia. Métodos: investigación analítica, de corte transversal, realizada en 192 cuidadores que acudieron a las consultas de los Equipos Multidisciplinarios de Atención Geriátrica del Centro Iberoamericano para la Tercera Edad y de áreas de salud de los municipios Playa y Plaza de la Revolución, de La Habana, durante el período 2003-2009. Se estudiaron variables del paciente, del cuidador y de la familia. La información se obtuvo a partir de la aplicación de diferentes instrumentos, entre ellos, cuestionario de caracterización del cuidador, escala de carga de Zarit y prueba de funcionamiento familiar. Para identificar los factores de riesgo de carga, se diseñó un estudio de casos y controles y el procedimiento estadístico empleado fue la regresión logística. Resultados: los cuidadores eran mayormente hijas de edad mediana con afectaciones de salud, elevado consumo de fármacos y limitaciones económicas; no tenían experiencia previa y no contaban con conocimientos acerca de la enfermedad y su manejo. Conclusiones: la carga se identifica en la mayoría de los cuidadores y sus factores de riesgo son, entre otros, grado de dependencia del enfermo, depresión del cuidador y el funcionamiento familiar. La edad del cuidador es ser un factor protector de carga(AU)

Introduction: aging of the Cuban population is considered to be an achievement; however, it is a present reality that brings big challenges to the whole society, particularly the family which is the main source of protection and support for elders. Objectives: to diagnose the burden and to identify its risk factors in the informal caregivers of old people with dementia. Methods: cross-sectional analytical research conducted in 192 caregivers, who went to the consultation service of the multidisciplinary geriatric care teams in the Ibero-American Institute for the Old Age and in the health areas located in Playa and Plaza municipalities from 2003 to 2009. The variables related to the patient, the caregiver and the family were studied. The collected information stemmed from the administration of different instruments such as caregiver characterization questionnaire, Zarit's burden scale and the family functioning test. A case-control study was designed and the logistic regression technique was used in order to identify the risk factors of burden. Results: the caregivers were mostly middle-aged daughters having health problems, high consumption of pharmaceuticals and economic restrictions. They were generally inexperienced and lacked appropriate knowledge about dementia and how to manage it. Conclusions: the burden is present in most of the caregivers and the main risk factors are degree of patient's dependence on the caregiver, depression and family functioning. The age of the caregiver is the protecting factor in terms of burden(AU)

Factores de riesgo de carga en cuidadores informales de adultos mayores con demencia / Risk factors of burden in informal caregivers of older adults with dementia

Introducción: el fenómeno del envejecimiento de la población cubana es hoy una realidad que impone grandes retos a toda la sociedad y en particular a la familia, principal fuente de protección y apoyo para sus personas mayores. Objetivos: diagnosticar la carga e identificar sus factores de riesgo en los cuidadores informales de adultos mayores con demencia. Métodos: investigación analítica, de corte transversal, realizada en 192 cuidadores que acudieron a las consultas de los Equipos Multidisciplinarios de Atención Geriátrica del Centro Iberoamericano para la Tercera Edad y de áreas de salud de los municipios Playa y Plaza de la Revolución, de La Habana, durante el período 2003-2009. Se estudiaron variables del paciente, del cuidador y de la familia. La información se obtuvo a partir de la aplicación de diferentes instrumentos, entre ellos, cuestionario de caracterización del cuidador, escala de carga de Zarit y prueba de funcionamiento familiar. Para identificar los factores de riesgo de carga, se diseñó un estudio de casos y controles y el procedimiento estadístico empleado fue la regresión logística. Resultados: los cuidadores eran mayormente hijas de edad mediana con afectaciones de salud, elevado consumo de fármacos y limitaciones económicas; no tenían experiencia previa y no contaban con conocimientos acerca de la enfermedad y su manejo. Conclusiones: la carga se identifica en la mayoría de los cuidadores y sus factores de riesgo son, entre otros, grado de dependencia del enfermo, depresión del cuidador y el funcionamiento familiar. La edad del cuidador es ser un factor protector de carga

Introduction: aging of the Cuban population is considered to be an achievement; however, it is a present reality that brings big challenges to the whole society, particularly the family which is the main source of protection and support for elders. Objectives: to diagnose the burden and to identify its risk factors in the informal caregivers of old people with dementia. Methods: cross-sectional analytical research conducted in 192 caregivers, who went to the consultation service of the multidisciplinary geriatric care teams in the Ibero-American Institute for the Old Age and in the health areas located in Playa and Plaza municipalities from 2003 to 2009. The variables related to the patient, the caregiver and the family were studied. The collected information stemmed from the administration of different instruments such as caregiver characterization questionnaire, Zarit's burden scale and the family functioning test. A case-control study was designed and the logistic regression technique was used in order to identify the risk factors of burden. Results: the caregivers were mostly middle-aged daughters having health problems, high consumption of pharmaceuticals and economic restrictions. They were generally inexperienced and lacked appropriate knowledge about dementia and how to manage it. Conclusions: the burden is present in most of the caregivers and the main risk factors are degree of patient's dependence on the caregiver, depression and family functioning. The age of the caregiver is the protecting factor in terms of burden

Metástasis en fosa nasal como primer síntoma de un carcinoma renal / Metastasis in nasal cavity as first symptom of a renal carcinoma

El carcinoma renal de células claras es el tipo histológico más frecuente. En el momento del diagnóstico, las metástasis están presentes en 25-30 % de los pacientes aproximadamente. La peculiar tendencia de dicho carcinoma a metastizar en localizaciones poco usuales, hace de este proceso oncológico un tumor primario a tener en cuenta en el diagnóstico diferencial de las metástasis como primera manifestación de neoplasia. Se presenta un caso poco frecuente, con tumor en fosa nasal izquierda y epistaxis recidivante, secundaria a metástasis de carcinoma renal como primer síntoma.

The renal carcinoma of clear cells is the most frequent histological type. Metastasis is present in approximately 25-30 % of the patients in the diagnosis. The peculiar tendency of this carcinoma to make metastasis in not very usual areas, makes of this oncological process a primary tumour to keep in mind in the differential diagnosis of metastases as the first neoplasia manifestation. A not very frequent case is presented, with tumour in the left nasal cavity and recurrent epistaxis, secondary to metastasis of renal carcinoma as first symptom.

Caña santa para el tratamiento de ancianos con hipertensión arterial / Lemongrass for treating aged persons with hypertension

Se efectuó una intervención educativa en 30 ancianos de la Casa de Abuelos del municipio de II Frente de la provincia de Santiago de Cuba, en el trimestre febrero-abril de 2009, a fin de que conocieran las ventajas de utilizar la caña santa para mantener controlada la hipertensión arterial. Se usaron el porcentaje como medida de resumen y la prueba de McNemar como validación estadística. Se logró elevar el nivel de conocimientos sobre el tema en la mayoría de los integrantes de la serie

An educational intervention was performed in 30 aged persons from the Grandparents' House of Segundo Frente Municipality in Santiago de Cuba, in the quarter February to April 2009, in order to make them know the advantages of using lemongrass to control hypertension. Percentage as summary measure and the McNemar test as statistical validation were used. It was possible to increase the level of knowledge on the topic in most of the people of the series