Respiratory sarcopenia screening in dialysis patients: cross-sectional and multicentre study protocol.

BACKGROUND: Respiratory sarcopenia is characterized by the weakness of respiratory muscles associated with sarcopenia due to aging or systemic diseases such as chronic kidney disease (CKD). Patients with CKD undergoing dialysis are particularly susceptible to respiratory muscle weakness caused by factors such as fluid overload and electrolyte imbalance. This weakness not only affects ventilation but also impairs oxygen uptake and delivery to muscle tissue, potentially leading to severe sarcopenia. Thus, the objective of this study is to conduct a respiratory sarcopenia screening in patients with CKD undergoing haemodialysis (HD) and peritoneal dialysis (PD). METHODS: This is an observational, cross-sectional and multicentre study conducted between March 2023 and March 2025. The study was approved by the Research Ethics Committee at two centres. Sarcopenia diagnosis is determined based on low handgrip strength and amount of appendicular skeletal muscle mass, assessed through bioelectrical impedance analysis. Respiratory sarcopenia is diagnosed in patients with sarcopenia who have low inspiratory muscle strength, evaluated through a manovacuometry test. The severity of sarcopenia and respiratory sarcopenia is defined, respectively, by low physical performance (measured using the Short Physical Performance Battery and Timed-Up and Go test) and pulmonary performance (measured through spirometry). Thus, this study will include 81 patients undergoing dialysis (41 on HD and 40 on PD) from three participating centres. DISCUSSION: The literature has been focused on respiratory function in CKD; however, the relationship with sarcopenia remains understudied. We believe that, similar to appendicular skeleton muscles, the axial skeleton muscles are also likely to weaken with the presence of chronic disease, such as CKD.

Green photocatalytic remediation of Fenthion using composites with natural red clay and non-toxic metal oxides with visible light irradiation.

In the present work, composites with non-toxic metal oxides, such as TiO2 and ZnO, and a natural red clay (taua) reach in hematite were used in the photocatalytic degradation of Fenthion. The composite TiO2/Taua (0.5:1 wt. ratio) and pure TiO2 were prepared by sol-gel method while ZnO/Taua (0.5:1 wt. ratio) and pure ZnO were prepared by Pechini method. The materials were characterized by XRD, SEM, EDX, and DRS. The anatase phase was formed in both pure TiO2 and TiO2/Taua, while the hexagonal phase was formed in pure ZnO and ZnO/Taua. The bandgap energies for the two composites were narrowed compared to the respective pure oxides as consequence of the hematite (α-Fe2O3, Eg = 2.1 eV) in the red clay, reaching 2.1 eV for TiO2/Taua and 2.0 eV for ZnO/Taua, while the bandgap energies for pure TiO2 and ZnO were 3.2 and 3.0 eV, respectively. Fenthion was not degraded in the dark, but the concentration droped 20% after 180 min under visible light irradiation without photocatalyst and 60% after 210 min in the presence of the pure red clay. Both TiO2/Taua and ZnO/Taua composites were also photocatalytic active to degrade Fenthion (λ > 420 nm), with degradation of 78% (in 180 min) and 85% (in 210 min) respectively. In the optimized conditions (pH 2, 100 mg L-1 of H2O2 and 30 mg L-1 of Fenthion), the ZnO/Taua composite was the most efficient, reaching 89% degradation in up to 30 min, with Fenthion sulfoxide as the degradation product.

Frailty as a predictor of adverse outcomes in hospitalized older adults: A systematic review and meta-analysis.

Frailty syndrome is prevalent among hospitalized older adults as are the occurrence of adverse outcomes. This systematic review and meta-analysis investigated whether frailty in older adults at hospital admission predicts adverse outcomes. Manual (ProQuest, conferences annals and references) and electronic searches (PUBMED, EMBASE, Web of Science, Lilacs, CINAHL, PsycINFO and Google Scholar) were performed. We included prospective studies of hospitalized older adults. Primary outcomes were functional decline at hospital discharge and mortality after discharge. Other data were considered secondary outcomes. Methodological quality was evaluated by the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Twenty-eight papers were included, corresponding to 19 cohorts (5 cohorts for functional decline and 16 for mortality), with moderate to good methodological quality. Being frail [RR: 1.32 (95%CI: 1.04; 1.67)] and pre-frail [RR: 1.51 (95%CI: 1.05; 2.17)] are risk factors for functional decline compared with being nonfrail. Frail individuals had a relative risk for in-hospital mortality and mortality in medium- and long-term compared to nonfrail (in-hospital RR: 8.20, medium RR: 9.49 and long RR: 7.94) and pre-frail (in-hospital RR: 3.19, medium RR: 3.31 and long RR: 3.72). The overall mortality risk in frail individuals is 3.49 and 2.14 times compared to nonfrail and pre-frail, respectively. Length of hospital stay was higher for frail older adults (13.5 days) compared with pre-frail (10.5 days) and nonfrail (8.3 days). Therefore, being frail at hospital admission is a risk factor for in-hospital mortality, long hospital stay, functional decline at hospital discharge, and mortality in the medium- and long-term.

Correlation between functional mobility and cognitive performance in older adults with cognitive impairment.

Association between cognitive impairment and gait performance occurs in mild cognitive impairment (MCI) and Alzheimer's disease (AD), particularly under "divided attention" conditions, leading to a greater risk of falls. We studied 36 controls, 42 MCI, and 26 mild AD patients, using the Timed Up-and-Go test (TUG) under four conditions: TUG single - TUG1; TUG cognitive - TUG2; TUG manual -TUG3; TUG cognitive and manual - TUG4. Cognition was assessed using the MMSE, SKT, Exit25, and TMT (A and B). We found significant correlations between cognitive scores and TUG2 [r values (MMSE: -0.383, TMT-A: 0.430, TMT-B: 0.386, Exit25: 0.455, SKT: 0.563)] and TUG4 [(MMSE: -0.398, TMT-A: 0.384, TMT-B: 0.352,Exit25: 0.466, SKT: 0.525)] in the AD group, and between all TUG modalities and SKT in MCI and AD. Our results revealed that functional mobility impairment in cognitive dual tasks correlated to cognitive decline in AD patients and to attention and memory impairment in MCI.

[Evaluation of implementation of the protocol for managing tuberculosis/ human immunodeficiency virus coinfection in specialized care services in ceará state]. / Evaluación de la implementación del protocolo de manejo de coinfección de tuberculosis y virus de inmunodeficiencia humana en los servicios de asistencia especializada del estado de Ceará.

OBJECTIVES: Identify barriers and strategies for implementation of the protocol for managing tuberculosis/ human immunodeficiency virus (TB/HIV) coinfection in specialized care services in Ceará state, through evaluation research. METHODS: The study followed iPIER methodology, a new initiative to help improve the implementation of health programs through the use of research that is conducted as a part of the implementation process. Data were collected on the structure and processes of 22 services and barriers were explored in four focus groups with 28 participants, from the standpoint of the health team, administrators, and users. The discussions were transcribed and interpreted with regard to the objectives of the study. RESULTS: The information on structure and process revealed that six services manage TB/HIV coinfection and 16 do not. The barriers were: team members were unaware of the protocol; lack of clinical practice guidelines in the services; specialized care services working at all three levels of the health system; inadequate spaces for treatment of airborne diseases; and lack of communication with primary health care sectors for patient transfers. The results were discussed with teams and administrators in seminars held in the services and with program managers for sexually transmitted infections, human immunodeficiency virus, AIDS, hepatitis, and tuberculosis. CONCLUSIONS: Direct dialogue between administrators, implementers, users, and researchers generated knowledge about the services and led to joint preparation of modifications in workflow aimed at acceptance and use of the protocol; however, users continue to resist adherence to treatment.

Dificuldades encontradas pela enfermagem para implementar a humanização na unidade de terapia intensiva / Difficulties found by nursing to implement humanization in the intensive therapy unit

Objetivo: analisar artigos referentes a humanização em Unidade de Terapia Intensiva proporcionadas pela equipe de enfermagem. Metodologia: trata-se de um estudo de revisão integrativa da literatura, onde foi realizado busca online nas bases de dados SciELO, LILACS, BDENF, MEDLINE. Para esta pesquisa usou-se 11 artigos publicados entre os anos de 2009 a 2016 e disponíveis na integra. Resultados: são varias a formas de se proporcionar o cuidado humanizado ao pacientem em Unidade de Terapia Intensiva, se destacando de acordo com as mais novas publicações, o apoio a família dos pacientes. Porém, algumas dificuldades foram relatados nos estudos, tais como: a presença cada vez maior da tecnologia na Unidade de Terapia Intensiva e sua complexidade manusear, a falta de autonomia, a sobrecarga de trabalho, a falta de melhores condições de trabalho etc. Conclusão: não basta pensar em humanização com enfoque apenas ao paciente. Deve-se também enfatizar os familiares e profissionais de saúde, pois a humanização só será possível se em conjunto com os profissionais que prestam os cuidados, de modo que estes internalizarem a importância e se sentirem protagonistas desse processo na Unidade de Terapia Intensiva.

Objective: to analyze articles related to humanization in ICU provided by the nursing team. Methodology: it is a study of integrative review of literature, where the study was conducted online search in SciELO, LILACS, BDENF, MEDLINE. For this study, we used 11 articles published between the years of 2009 to 2016 and available on integra. Results: there are several ways to provide humanized care to the patient in the ICU, highlighting according to the newest publications, support to the patient's family. However, some difficulties were reported in the studies, such as: the increasing presence of technology in the ICU and its complexity handling, lack of autonomy, work overload, lack of better working conditions, etc. Conclusion: it is not enough to think about humanization with a focus on the patient alone. It is also important to emphasize family members and health professionals, since humanization will only be possible if together with care professionals, so that they internalize the importance and feel the protagonists of this process in the ICU.

Evaluación de la implementación del protocolo de manejo de coinfección de tuberculosis y VIH en los servicios de asistencia especializada del estado de Ceará, Brasil / Evaluation of implementation of the protocol for managing tuberculosis/ HIV coinfection in specialized care services in the state of Ceará, Brasil

Objetivos. Identificar barreras y estrategias para la implementación del protocolo “Manejo de coinfección por tuberculosis y virus de inmunodeficiencia humana (TBC/VIH)” en los servicios de asistencia especializada (SAE) de Ceará, mediante investigación evaluativa. Métodos. Estudio desarrollado siguiendo la metodología iPIER, una nueva iniciativa con el propósito de apoyar mejoras en la ejecución de programas de salud a través de investigaciones integradas en ellos acerca de su ejecución. Se recogieron datos de estructura y procesos de 22 servicios y se exploraron las barreras mediante cuatro grupos focales, con 28 participantes, desde el punto de vista del equipo de salud, los administradores y los usuarios. Las discusiones fueron transcritas e interpretadas según los objetivos del estudio. Resultados. Los datos de estructura y procesos revelaron que seis servicios realizan acciones de manejo de coinfección TB/VIH y 16, no lo hacen. Las barreras fueron: desconocimiento del protocolo en los equipos, ausencia de guías de práctica clínica en los servicios, inserción de los SAE en los tres niveles del sistema de salud, espacios inadecuados para tratar enfermedades de transmisión aérea y falta de comunicación con los sectores de atención primaria de salud para los traslados. Se discutieron los resultados con equipos y administradores en seminarios en los servicios y con los responsables de los programas de enfermedades de transmisión sexual, virus de inmunodeficiencia humana, sida, hepatitis y tuberculosis. Conclusiones. El diálogo directo entre administradores, ejecutores, usuarios e investigadores generó conocimiento sobre los servicios y elaboración conjunta de modificaciones de flujos para la aceptación y utilización del protocolo; sin embargo, entre los usuarios persiste la resistencia para adherirse al tratamiento.

Objectives. Identify barriers and strategies for implementation of the protocol for managing tuberculosis/ human immunodeficiency virus (TB/HIV) coinfection in specialized care services in Ceará state, through evaluation research. Methods. The study followed iPIER methodology, a new initiative to help improve the implementation of health programs through the use of research that is conducted as a part of the implementation process. Data were collected on the structure and processes of 22 services and barriers were explored in four focus groups with 28 participants, from the standpoint of the health team, administrators, and users. The discussions were transcribed and interpreted with regard to the objectives of the study. Results. The information on structure and process revealed that six services manage TB/HIV coinfection and 16 do not. The barriers were: team members were unaware of the protocol; lack of clinical practice guidelines in the services; specialized care services working at all three levels of the health system; inadequate spaces for treatment of airborne diseases; and lack of communication with primary health care sectors for patient transfers. The results were discussed with teams and administrators in seminars held in the services and with program managers for sexually transmitted infections, human immunodeficiency virus, AIDS, hepatitis, and tuberculosis. Conclusions. Direct dialogue between administrators, implementers, users, and researchers generated knowledge about the services and led to joint preparation of modifications in workflow aimed at acceptance and use of the protocol; however, users continue to resist adherence to treatment.

Evaluación de la implementación del protocolo de manejo de coinfección de tuberculosis y virus de inmunodeficiencia humana en los servicios de asistencia especializada del estado de Ceará / Evaluation of implementation of the protocol for managing tuberculosis/ human immunodeficiency virus coinfection in specialized care services in ceará state

RESUMEN Objetivos Identificar barreras y estrategias para la implementación del protocolo “Manejo de coinfección por tuberculosis y virus de inmunodeficiencia humana (TBC/VIH)” en los servicios de asistencia especializada (SAE) de Ceará, mediante investigación evaluativa. Métodos Estudio desarrollado siguiendo la metodología iPIER, una nueva iniciativa con el propósito de apoyar mejoras en la ejecución de programas de salud a través de investigaciones integradas en ellos acerca de su ejecución. Se recogieron datos de estructura y procesos de 22 servicios y se exploraron las barreras mediante cuatro grupos focales, con 28 participantes, desde el punto de vista del equipo de salud, los administradores y los usuarios. Las discusiones fueron transcritas e interpretadas según los objetivos del estudio. Resultados Los datos de estructura y procesos revelaron que seis servicios realizan acciones de manejo de coinfección TB/VIH y 16, no lo hacen. Las barreras fueron: desconocimiento del protocolo en los equipos, ausencia de guías de práctica clínica en los servicios, inserción de los SAE en los tres niveles del sistema de salud, espacios inadecuados para tratar enfermedades de transmisión aérea y falta de comunicación con los sectores de atención primaria de salud para los traslados. Se discutieron los resultados con equipos y administradores en seminarios en los servicios y con los responsables de los programas de enfermedades de transmisión sexual, virus de inmunodeficiencia humana, sida, hepatitis y tuberculosis. Conclusiones El diálogo directo entre administradores, ejecutores, usuarios e investigadores generó conocimiento sobre los servicios y elaboración conjunta de modificaciones de flujos para la aceptación y utilización del protocolo; sin embargo, entre los usuarios persiste la resistencia para adherirse al tratamiento.

ABSTRACT Objectives Identify barriers and strategies for implementation of the protocol for managing tuberculosis/ human immunodeficiency virus (TB/HIV) coinfection in specialized care services in Ceará state, through evaluation research. Methods The study followed iPIER methodology, a new initiative to help improve the implementation of health programs through the use of research that is conducted as a part of the implementation process. Data were collected on the structure and processes of 22 services and barriers were explored in four focus groups with 28 participants, from the standpoint of the health team, administrators, and users. The discussions were transcribed and interpreted with regard to the objectives of the study. Results The information on structure and process revealed that six services manage TB/HIV coinfection and 16 do not. The barriers were: team members were unaware of the protocol; lack of clinical practice guidelines in the services; specialized care services working at all three levels of the health system; inadequate spaces for treatment of airborne diseases; and lack of communication with primary health care sectors for patient transfers. The results were discussed with teams and administrators in seminars held in the services and with program managers for sexually transmitted infections, human immunodeficiency virus, AIDS, hepatitis, and tuberculosis. Conclusions Direct dialogue between administrators, implementers, users, and researchers generated knowledge about the services and led to joint preparation of modifications in workflow aimed at acceptance and use of the protocol; however, users continue to resist adherence to treatment.

Percepção da funcionalidade nas fases leve e moderada da doença de Alzheimer: visão do paciente e seu cuidador / Perception of functionality in mild and moderate stages of Alzheimer's disease: vision of the patient and their caregiver

OBJETIVOS: Avaliar e comparar a percepção da funcionalidade de idosos com doença de Alzheimer (DA) em relação à percepção de seus cuidadores, bem como avaliar e comparar essa relação de acordo com o grau de comprometimento cognitivo desses idosos. MÉTODOS: Foi realizado estudo transversal em 20 idosos com DA e seus cuidadores, sendo aplicada a Medida de Independência Funcional (MIF) para avaliar a percepção da funcionalidade de acordo com o relato do idoso com DA e seu cuidador; foi aplicada a escala de avaliação clínica da demência (CDR) para avaliar o estadiamento clínico da demência, sendo considerados idosos com DA leve (CDR 1) e DA moderada (CDR 2). RESULTADOS: Comparada a percepção da funcionalidade da amostra total de idosos com DA e seus respectivos cuidadores, a média da MIF foi de 116,5 (dp=9,8) pontos, segundo a visão dos idosos, e a média foi de 88,5 (dp=19,0) pontos nas tarefas avaliadas pela MIF, de acordo com seus cuidadores (p<0,001). O mesmo padrão foi observado na comparação entre os idosos com DA leve e seus cuidadores, embora os itens "autocuidados" e "mobilidade da MIF" não tenham sido estatisticamente significativos. Já nos idosos com DA moderada, houve diferença significativa em todas as dimensões da MIF quando comparada a seus cuidadores. CONCLUSÃO: Idosos com DA subestimam suas dificuldades quando comparados com a percepção de seus cuidadores e, à medida que a gravidade da doença aumenta, há piora progressiva da percepção da sua funcionalidade.

OBJECTIVES: Evaluate and compare of the perception of functionality in elderly with Alzheimer´s disease (AD) with the functionality they present according with the perception of their caregivers, as well as evaluate this relationship according to the degree of cognitive problems in this population METHODS: Cross-sectional study in 20 older people with AD and their caregivers, applying the Functional Independence Measures (FIM) to evaluate the perception of functionality according to the report of the elderly with AD and their caregiver; it was used the Clinical Dementia Rating Scale (CDR) to evaluate the clinical staging of the dementia, considering elderly with mild AD (CDR 1) and moderate AD (CDR 2). RESULTS: When comparing the perception of the functionality of the total sample of older person with AD and their caregivers, the mean of FIM was 116.5 (sd=9.8) points, reported by patients with AD, and mean of 88.5 (sd=19.0) points according to their caregivers (p<0.001). The same pattern was observed in the comparison between the elderly with mild AD and their caregivers, although self-care and mobility FIM's items have not been statistically significant. In the elderly with moderate AD, there were significant differences in all dimensions of the FIM, when compared to their caregivers. CONCLUSION: Older patients with AD underestimate their difficulties as compared to the perception of their caregivers and this perception of functionality is worse according with progression of AD.

A Influência da Dança do Ventre nos sintomas depressivos em idosas da comunidade / The influence of Belly Dance in symptoms depressive in community-dwelling elderly women

Estudo do tipo ensaio clínico randomizado "cego" que avaliou a influência da dança do ventre (DV) nos sintomas depressivos em idosas da comunidade, sendo estas divididas em dois grupos: I-controle e II-intervenção; avaliadas antes (T0) e após (TI) a intervenção com DV. Utilizamos Escala Geriátrica de Depressão de Yesavage abreviada (EDG-15), sendo observada uma melhora significativa (p=0,019) apenas no grupo II na EDG-15 em relação a T0 (média: 6,45; DP=3,26) e T1 (Média: 3,33; DP=1,51).

The study the type randomized clinical trial "blind", evaluated the influence of belly dance (DV) on depressive symptoms in community elderly. The old were divided into two groups: control and I-II-intervention; assessed before and after the intervention. We used a sociodemographic questionnaire, health assessment and Geriatric Scale abbreviated Yesavage Depression (GDS-15). As a result, the group II showed significant improvement (p=0.019) in the GDS-15 in relation to T0 (mean: 6.45, SD=3.26) and T1 (Average: 3.33, SD=1.5) not being observed in group I.

Síndrome da fragilidade e sua relação com aspectos emocionais, cognitivos, físicos e funcionais em idosos institucionalizados / Frailty syndrome and your correlation with emotional, cognitive, physical and functional aspects in institutionalized elderly

O objetivo do estudo foi avaliar a fragilidade de idosos residentes em uma Instituição de Longa Permanência da cidade de Santos (SP) e correlacionar aspectos da síndrome manifesta com sintomas depressivos, desempenho cognitivo, físico e funcional nessa população. Foram avaliados 20 idosos institucionalizados, sendo estes na sua maioria (n=18; 90%), classificados como frágeis, e correlacionando-se com deficit cognitivo (r=-0,470; p=0,04), baixo desempenho físico (r=-0,437; p=0,05), e funcional (r=-0,529; p=0,02) na população estudada.

The objective of the study was to evaluate the frailty in elderly residents in a nursing home of the Santos city and correlate aspects of this syndrome with depressive symptoms, cognitive domain, physical and functional performance in this sample. Twenty institutionalized elderly were evaluated, which are mostly classified as frail (n = 18; 90%) and were correlated with cognitive impairment (r = -0.470; P = 0.04), low physical (r = -0.437; P= 0.05), and functional performance (r = -0.529; P = 0.02) in the study population.

Functional mobility in a divided attention task in older adults with cognitive impairment.

Motor disorders may occur in mild cognitive impairment (MCI) and at early stages of Alzheimer's disease (AD), particularly under divided attention conditions. We examined functional mobility in 104 older adults (42 with MCI, 26 with mild AD, and 36 cognitively healthy) using the Timed Up and Go test (TUG) under 4 experimental conditions: TUG single task, TUG plus a cognitive task, TUG plus a manual task, and TUG plus a cognitive and a manual task. Statistically significant differences in mean time of execution were found in all four experimental conditions when comparing MCI and controls (p < .001), and when comparing MCI and AD patients (p < .05). Receiver-operating characteristic curve analyses showed that all four testing conditions could differentiate the three groups (area under the curve > .8, p < .001 for MCI vs. controls; area under the curve > .7, p < .001 for MCI vs. AD). The authors conclude that functional motor deficits occurring in MCI can be assessed by the TUG test, in single or dual task modality.

Fear of falling and falls in older adults with mild cognitive impairment and Alzheimer's disease.

Cognitive impairment and fear of falling are risk factors for falls in older adults. Recurrent falls are more prevalent in older adults with cognitive impairment. We examined the number of previous falls, self-reported fear of falling, and the Falls Efficacy Scale-International (FES-I) in 104 older adults [26 with mild Alzheimer's disease (AD), 42 with mild cognitive impairment (MCI) and 36 cognitively healthy]. Older adults with AD and MCI had a higher number of falls (1.1 ± 1.2 and 1.5 ± 1.5, respectively) compared to the control group (0.3 ± 0.5, P < .001). Older adults with MCI more often reported fear of falling (74%) than patients with AD (31%) (P ≤ .002) and scored higher on the FES-I (29.7 and 23.8, respectively, P ≤ .01). The prevalence of falls in older adults with MCI and AD is higher than in subjects cognitively healthy. Older adults with MCI and AD differ in terms of reported fear of falling and falls self-efficacy.

Síndrome da fragilidade e sua relaçãocom aspectos emocionais, cognitivos, físicos e funcionais em idosos institucionalizados / Frailty syndrome and your correlation with emotional, cognitive, physical and functional aspects in institutionalized elderly

O objetivo do estudo foi avaliar a fragilidade de idosos residentes em uma Instituição de Longa Permanência da cidade de Santos (SP) e correlacionar aspectos da síndrome manifesta com sintomas depressivos, desempenho cognitivo, físico e funcional nessa população. Foram avaliados 20 idosos institucionalizados, sendo estes na sua maioria (n=18; 90%), classificados como frágeis, e correlacionando-se com deficit cognitivo (r=-0,470; p=0,04), baixo desempenho físico (r=-0,437; p=0,05), e funcional (r=-0,529; p=0,02).(AU)na população estudada.(AU)

The objective of the study was to evaluate the frailty in elderly residents in a nursing home of the Santos city and correlate aspects of this syndrome with depressive symptoms, cognitive domain, physical and functional performance in this sample. Twenty institutionalized elderly were evaluated, which are mostly classified as frail (n = 18; 90%) and were correlated with cognitive impairment (r = -0.470; P = 0.04), low physical (r = -0.437; P= 0.05), and functional performance (r = -0.529; P = 0.02) in the study population.(AU)

A Influência da Dança do Ventre nos sintomas depressivos em idosas da comunidade / The influence of Belly Dance in symptoms depressive in community-dwelling elderly women

Estudo do tipo ensaio clínico randomizado “cego” que avaliou a influência da dança do ventre (DV) nos sintomas depressivos em idosas da comunidade, sendo estas divididas em dois grupos: I-controle e II-intervenção; avaliadas antes (T0) e após (TI) a intervenção com DV. Utilizamos Escala Geriátrica de Depressão de Yesavageabreviada (EDG-15), sendo observada uma melhora significativa (p=0,019) apenas no grupo II na EDG-15 em relação a T0 (média: 6,45; DP=3,26) e T1 (Média: 3,33; DP=1,51).(AU)

The study the type randomized clinical trial "blind", evaluated the influence of belly dance (DV) on depressive symptoms in community elderly. The old were divided into two groups: control and I-II-intervention; assessed before and after the intervention. We used a sociodemographic questionnaire, health assessment and Geriatric Scale abbreviated Yesavage Depression (GDS-15). As a result, the group II showed significant improvement (p=0.019) in the GDS-15 in relation to T0 (mean: 6.45, SD=3.26) and T1 (Average: 3.33, SD=1.5) not being observed in group I.(AU)

Seasonal influence and cytotoxicity of extracts, fractions and major compounds from Allamanda schottii

The aim of this research was to evaluate the fractions obtained from the leaf, stem and roots of Allamanda schottii Pohl, Apocynaceae, responsible for the cytotoxicity, using several cell lines. Cytotoxicity was correlated with the season the part of the plant, and the major compounds were assessed. The ethanol extracts of leaves, stems and roots obtained at different seasons were evaluated in the human erythromyeloblastoid leukemia cell line (K562). Subsequently the ethanol extracts and dichloromethane fractions collected in winter were evaluated in mouse fibroblast cell line (Mus musculus) (L929), cervix adenocarcinoma (HeLa), human pre-B leukemia (Nalm6), as well as K562 cell line. The compounds plumericin, plumieride and ursolic acid isolated from ethanol extracts of the stems were evaluated in the same cell lines, as well as on breast adenocarcinoma cell line (MCF-7), and Mus musculus skin melanoma cell line (B16F10). The chromatographic profiles of the dichloromethane fractions were obtained by high performance liquid chromatography. The results revealed that the season during which A. schottii was collected, and the part of the plant analyzed, influence the cytotoxicity on the K562 cells tested. On the other hand the dichloromethane fractions, mainly from the stems and roots, are responsible for the cytoxicity on the cells tested. These results may be associated with the seasonal variation of plumericin in these parts of the plant. This information is in accordance with the HPLC analysis. The results clearly show the potential for the phytotherapeutic use of this species, and suggest that the cytotoxic activity observed may be due to the presence of plumericin, or to minor compounds not yet identified. The seasonal influence on the production of secondary metabolites was verified.

Itraconazole vs. trimethoprim-sulfamethoxazole: A comparative cohort study of 200 patients with paracoccidioidomycosis.

Paracoccidioidomycosis (PCM) is a systemic mycosis endemic to Latin America. Brazil accounts for approximately 80% of cases, where it represents a major public health issue due to its disabling impact and the number of premature deaths it causes. We present a retrospective cohort study that was conducted in order to better understand factors that relate to cure of the infection in the treatment of 200 patients with PCM. We evaluated the influence of sociodemographic and clinical factors as well as therapeutic regimen (trimethoprim-sulfamethoxazole [TMP-SMX] and itraconazole) on the progress of PCM (cure and noncure). There was a higher incidence of cure (83%) among patients who regularly received treatment for their infections and completed the treatment protocol. Moreover, itraconazole (86.4%) was significantly superior to TMP-SMX (51.3%) in terms of cure rate and had a median treatment period that was significantly shorter (12 months) than that for TMP-SMX (23 months). A Cox proportional hazard regression model showed that use of itraconazole increased the hazard of cure, regardless of sex, age, education, clinical form, completion of treatment, and regularity. Although the results of this study show that itraconazole was the best treatment option for PCM patients, a double-blind, randomized, controlled trial is necessary to confirm this conclusion.

Quedas em idosos institucionalizados / Falls in institutionalized elderly people

O objetivo do presente estudo foi verificar a frequência de quedas em idosos institucionalizados, bem como descrever os fatores de risco para quedas dessa população. As informações foram obtidas por meio de análise de prontuários, de entrevistas e pelos testes Timed Up and Go, Short Physical Performance Battery, Mini-exame do Estado Mental, Medida de Independência Funcional e Escala de Depressão Geriátrica-15. A frequência de quedas foi de 22,2% e verificou-se que os fatores de risco são frequentes nessa população, mostrando, assim, um risco importante para quedas futuras.(AU)

The aim of this study was to determine the frequency of falls in institutionalized elderly people as well as to describe fall risk factors in this population. The information was obtained from reviewing medical records, conducting interviews and the tests Timed Up and Go, the Short Performance Physical Battery, the Mini Mental State Examination, the Functional Independence Measure and the Geriatric Depression Scale 15. The frequency of falls was at 22.2% and it was found that the risk factors are frequent in this cohort, thus evidencing a major risk for future falls.(AU)

Quedas em idosos institucionalizados / Falls in institutionalized elderly people

O objetivo do presente estudo foi verificar a frequência de quedas em idosos institucionalizados, bem como descrever os fatores de risco para quedas dessa população. As informações foram obtidas por meio de análise de prontuários, de entrevistas e pelos testes Timed Up and Go, Short Physical Performance Battery, Mini-exame do Estado Mental, Medida de Independência Funcional e Escala de Depressão Geriátrica-15. A frequência de quedas foi de 22,2% e verificou-se que os fatores de risco são frequentes nessa população, mostrando, assim, um risco importante para quedas futuras.

The aim of this study was to determine the frequency of falls in institutionalized elderly people as well as to describe fall risk factors in this population. The information was obtained from reviewing medical records, conducting interviews and the tests Timed Up and Go, the Short Performance Physical Battery, the Mini Mental State Examination, the Functional Independence Measure and the Geriatric Depression Scale 15. The frequency of falls was at 22.2% and it was found that the risk factors are frequent in this cohort, thus evidencing a major risk for future falls.