RESUMO
This study compared mirtazapine with megestrol in the management of cancer-related anorexia-cachexia syndrome in patients with advanced cancer. A randomized, double-blind, controlled clinical trial involving patients with advanced cancer and anorexia-cachexia syndrome was performed. Participants received mirtazapine 30 mg/day or megestrol 320 mg/day for eight weeks. The primary endpoint was the effect of mirtazapine on weight gain and the secondary endpoints were its effect on appetite, muscle strength, physical performance, body composition, adverse events, and medication adherence. Linear regression model with mixed effects was applied and a significance level of 5% was adopted. Fifty-two patients were randomized. Mean age was 65.8 ± 8.4 years. There was weight gain in 52% of the participants in the megestrol group and in 38% in the mirtazapine group after four weeks (p = 0.040). Appetite improved in 92% of the participants in the megestrol group and in 56% in the mirtazapine group after eight weeks (p = 0.007). In the sub-analysis by sex, women showed improvement in appetite (p < 0.001) and weight gain (p < 0.005) in the mirtazapine group, which was not observed in men. Mirtazapine appears to be inferior to megestrol in weight and appetite improvement. However, there may be a difference in the therapeutic response between sexes.
RESUMO
Resumo Objetivo analisar o conteúdo de documentos propostos por movimentos sociais e entidades de classe para orientar o cuidado em Instituições de Longa Permanência para Idosos (ILPI) durante a pandemia da COVID-19 no Brasil. Método Pesquisa documental, retrospectiva, descritiva e exploratória. Foram identificados quatro websites de movimentos sociais e entidades e analisados seus respectivos documentos para orientar o cuidado à pessoa idosa que vive em ILPI no contexto da pandemia no Brasil. A análise foi do tipo temática, com auxílio do software IRaMuTeQ Resultados Foram selecionados 28 textos para análise. O movimento social Frente Nacional de Fortalecimento à ILPI apresentou o maior quantitativo de produções. Na análise temática emergiram três classes: (1) O cuidado como estratégia de prevenção de contágio pela COVID-19 na ILPI; (2) O suporte dos gestores públicos enquanto direito da pessoa idosa que reside em ILPI; e (3) A preservação do vínculo sociofamiliar do residente da ILPI durante a pandemia. Conclusão Os movimentos sociais e entidades tiveram um lépido desempenho no suporte às ILPI no Brasil por meio da divulgação de documentos que contribuíram para nortear o cuidado à pessoa idosa institucionalizada em situação de vulnerabilidade. Faz-se necessário maior envolvimento dos gestores públicos na proteção e direito à vida dessa população idosa.
Abstract Objective To analyze the content of documents proposed by social movements and professional associations to guide care in Long-Term Care Institutions for the Elderly (LTCF) during a COVID-19 pandemic in Brazil. Method This is a documentary, retrospective, descriptive and exploratory research. It was found four websites and their respective documents were identified to guide the care of the older adultswho live in LTCF in the context of the pandemic in Brazil. Thematic analysis was performed using IRaMuTeQ software. Results 28 texts were selected for analysis. The social movement "National Front for Strengthening the LTCF" presented the highest number of productions. In the thematic analysis, three classes emerged: (1) Care as a contagion prevention strategy for COVID-19 at the LTCF; (2) The support of public managers as a right of the older adults living in the LTCF; and (3) The preservation of the social link of the LTCF residents during the pandemic. Conclusion Social movements and organizations had a quick performance in supporting the LTCF in Brazil through the dissemination of documents that guided the care of institutionalized older adults in situations of vulnerability. Greater involvement of public managers in the protection and the right to life of these older adults population is necessary.
