67 resultados para Sistema cardiovascular Doenças Fatores de risco - Teses
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Estudar a incidncia e fatores de risco (tempo de doena e presena de hipertenso arterial sistmica) para retinopatia diabtica em 1002 pacientes encaminhados pelo Programa de Diabetes do Hospital Universitrio Onofre Lopes no perodo de 1992 1995. Mtodos: Estudo retrospectivo de pacientes com diagnstico de diabetes mellitus encaminhados ao Setor de Retina do Departamento de Oftalmologia pelo Programa de Diabetes do Hospital Universitrio e submetido, sob a superviso do autor, a exame oftalmolgico, incluindo medida da acuidade visual corrigida (tabela de Snellen), biomicroscopia do segmento anterior e posterior, tonometria de aplanao e oftalmoscopia binocular indireta sob midrase(tropicamida 1% + fenilefrina 10%). Foi realizada anlise dos pronturios referente ao tempo de doenças e diagnostico clnico de hipertenso arterial sistmica. Resultados: Dos 1002 diabticos examinados (em 24 deles a fundoscopia foi invivel), 978 foram separados em 4 grupos: sem retinopatia diabtica (SRD), 675 casos (69,01%); com retinopatia diabtica no proliferativa (RDNP), 207 casos (21,16%); com retinopatia diabtica proliferativa (RDP), 70 casos (7,15%); e pacientes j fotocoagulados (JFC), 26 casos (2,65%). Do total, 291 eram do sexo masculino (29%) e 711 do sexo feminino (71%). Os 4 grupos foram ainda avaliados quanto ao sexo, a faixa etria, a acuidade visual, tempo de doena, presena de catarata e hipertenso arterial sistmica e comparados entre si. Com relao ao tipo de diabetes, 95 eram do tipo I (9,4%), 870 pacientes eram do tipo II (86,8%), e em 37 casos(3,7%) o tipo de diabetes no foi determinado. Concluses: Comprovou-se que os pacientes com maior tempo de doena tinham maior probabilidade de desenvolver retinopatia diabtica, e que a hipertenso arterial sistmica no constituiu fator de risco em relao diminuio da acuidade visual nos pacientes hipertensos
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Alterations in the neuropsychomotor development of children are not rare and can manifest themselves with varying intensity at different stages of their development. In this context, maternal risk factors may contribute to the appearance of these alterations. A number of studies have reported that neuropsychomotor development diagnosis is not an easy task, especially in the basic public health network. Diagnosis requires effective, low-cost, and easy - to-apply procedures. The Denver Developmental Screening Test, first published in 1967, is currently used in several countries. It has been revised and renamed as the Denver II Test and meets the aforementioned criteria. Accordingly, the aim of this study was to apply the Denver II Test in order to verify the prevalence of suspected neuropsychomotor development delay in children between the ages of 0 and 12 months and correlate it with the following maternal risk factors: family income, schooling, age at pregnancy, drug use during pregnancy, gestational age, gestational problems, type of delivery and the desire to have children. For data collection, performed during the first 6 months of 2004, a clinical assessment was made of 398 children selected by pediatricians and the nursing team of each public health unit. Later, the parents or guardians were asked to complete a structured questionnaire to determine possible risk indicators of neuropsychomotor development delay. Finally the Denver II Developmental Screening Test (DDST) was applied. The data were analyzed together, using Statistical Package for Social Science (SPSS) software, version 6.1. The confidence interval was set at 95%. The Denver II Test yielded normal and questionable results. This suggests compromised neuropsychomotor development in the children examined and deserves further investigation. The correlation of the results with preestablished maternal risk variables (family income, mother s schooling, age at pregnancy, drug use during the pregnancy and gestational age) was strongly significant. The other maternal risk variables (gestational problems, type of delivery and desire to have children) were not significant. Using an adjusted logistic regression model, we obtained the estimate of the greater likelihood of a child having suspected neuropsychomotor development delay: a mother with _75 4 years of schooling, chronological age less than 20 years and a drug user during pregnancy. This study produced two manuscripts, one published in Acta Cirrgica Brasileira , in which an analysis was performed of children with suspected neuropsychomotor development delay in the city of Natal, Brazil. The other paper (to be published) analyzed the magnitude of the independent variable maternal schooling associated to neuropsychomotor development delay, every 3 months during the first twelve months of life of the children selected.. The results of the present study reinforce the multifactorial characteristic of development and the cumulative effect of maternal risk factors, and show the need for a regional policy that promotes low-cost programs for the community, involving children at risk of neuropsychomotor development delay. Moreover, they suggest the need for better qualified health professionals in terms of monitoring child development. This was an inter- and multidisciplinary study with the integrated participation of doctors, nurses, nursing assistants and professionals from other areas, such as statisticians and information technology professionals, who met all the requirements of the Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte
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Body image is the figure of our bodies built in our minds and the degree of dissatisfaction is often associated with risk factors identified by anthropometric measures. The purpose of this descriptive study was to evaluate the risk factors associated to morphological and functional variables associate to the perception of auto-image in middle-aged walkers of the south zone of the city of Natal. A hundred and thirty volunteers had been evaluated in four groups in function of the gender and age group. As measurement evaluations were used an auto-image perception questionnaire proposed by Stunkart of nine silhouettes numbered for both gender was applied; a weighing machine equipped with stadiometer for the body mass (kg) and stature (m) and the body mass index (kg/m2) that was calculated with base in measures of the body weight and stature and classified according to norms of the National Institute of Health (2000) as well as the systolic and diastolic blood pressure by a electronic digital device (DIGITRONIC). A metal anthropometric tape was used for the waist to hip ratio (WHR). It was used Analyses of variance (ANOVA) one-way, post hoc of Tukey and correlation of Spearman for the nonparametric data adopting the level of ρ≤ 0,05 for rejection of the null hypothesis. The body mass index indicated high factors of risk in the consisting groups. In all the groups were registered the desire to reduce their silhouettes. The body weight shows reduced when compared with the younger group in the male group of superior age group, while in the female group the inverse one occurs. The autoimage perception is associated with the classification of the waist to hip ratio in the female gender in the age group of the 50 to the 59 years and in the classification of the body mass index of all constituted groups. Significant associations had not been found for classification of the systolic and diastolic blood pressure in relation to the auto-image 41 perception. This thesis presents relation of interdisciplinarity and its contents have application in the fields of Physical Education, Medicine, Physiotherapy and Nursing
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Preeclampsia is a spectral disease, with different clinical forms which can evolve with severe multisystemic complications. This present study aimed to determine the risk factors associated with preeclampsia (PE); to validate the existence of aggregation of hypertensive disease in families of women with preeclampsia and verify the existence of association between polymorphisms in the VEGF gene and level of VEGF and its soluble receptor (sFlt1). A case-control study was performed (n = 851). Genotyping of VEGF was performed and serum levels of VEGF and sFlt1 were measured by ELISA. It was observed that 38% of mothers (173, 455) of a case of preeclampsia and 30.8% (78 of 361) of controls had history of hypertension (p <0.0001). Similarly, when examining the history of maternal preeclampsia, we observed that 14.6% (48 of 328) of mothers of women with preeclampsia and 9.6% (12 of 294) of mothers of controls had a history of preeclampsia (p = 0.0001). As for maternal history of preeclampsia, we found that 5.1% (15 of 295) of cases and 3.6% (7 of 314) of controls had a history of preeclampsia (p = 0.0568). Sisters of women with preeclampsia also had a history of hypertensive disease in 9% (41 of 455) versus 6.6% (13 of 361), p = 0.002. Similarly when examining the history of preeclampsia in sisters, it was observed that 22.7% (57 of 251) of a sister of case versus 11.4% (26 of 228) of controls had a history of preeclampsia (P = 0.0011). We observed a decrease in free VEGF in the serum of patients (P <0.05) and increased soluble VEGF receptor. There was no association between polymorphisms in the VEGF gene and preeclampsia. The data obtained in this work validate that hypertensive disease in mothers and sisters with preeclampsia are risk factors for preeclampsia. The risk of illness in the family is higher according to disease severity. High incidence of preeclampsia can be assumed by the high incidence of this disease among the controls. Significant differences between the frequency of preeclampsia in mothers of cases and controls indicate familial factors. Work is being conducted with the to eventually perform genome wide association studies to identify susceptibility loci
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Resilience consists of a capacity to adapt and overcome situations of risk, from the aid of protective factors. This construct constitutes a process of preventive and multidimensional present in all stages of human development. During this development, it has been immersed in the elderly biopsychosocial changes resulting from the aging process. In this sense, there was a need for a multidisciplinary study, combining psychology, medicine, nursing, social work and gerontology in order to check the resilience, its risk factors, such as life events and health, and protection, such as self-esteem and social support. For this, we performed a descriptive exploratory study of cross-sectional nature, along with a convenience sample consisting of 65 elderly users of the public health of the district east of the city of Natal/RN, Brazil. This research allowed the collection of socio-demographic, economic, relational, physical, biological and psychological in understanding the aging process. It is observed that the studied sample socio-economic status and chronic health conditions in their own lives and their families, that demand for care and attention every day, are resilient, have faced significant losses, have positive self-esteem and social support perceived as external satisfactory. Given this multidimensional nature, the aging process deserves the attention of many professionals and health policies, seeking provide to the elderly a better living conditions and mechanisms that promote well-being and health
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The pressure ulcers (PU), also known as decubitus ulcers, are defined as injuries caused by the constant pressure exerted on a particular point of the body, causing impairment of blood supply with a decrease or interruption of tissue irrigation, causing occlusion of blood vessels and capillaries, ischemia and cell death. This is a descriptive study with longitudinal design, and panel type, with quantitative approach that aimed to examine the association between predisposing conditions (PC), intrinsic factors (IF) and extrinsic factors (EF) with the occurrence of PU, in hospitalized patients in the Intensive Care Unit (ICU), pain clinical, surgical clinical and neurology wards of a university hospital. The study population was composed of all patients who were restricted to bed during the period from December 2007 to February 2008. The study was approved by the Ethics Committee of HUOL / UFRN (No 135/07). The data-collection took place through a structured formulary of observation, data from medical records and physical examination of patients skins. The results were organized in SPSS 15.0 software, tabulated, categorized and analyzed by descriptive and inferential statistics. Of the 30 patients studied, 43.3% had been hospitalized in the pain clinical and surgical clinic wards, 20.0% in the ICU, 20.0% in the ICU / ward and 16.7% in neurology, being the length of hospitalization in those units of 7 to 18 days (63.3%) and from 19 to 30 days (36.7%), predominantly female and aged ≥ 60 years (60.0%). 19 PU were diagnosed in 43.3% of patients monitored, being 38.5% with one PU between 7 to 18 days and 46.2% with two or more between 19 to 30 days of hospitalization, showing significant relationship (ρ-value = 0029) between length of hospital stay and the number of PU. Was found an association of 35.7% of the PC (cardio-respiratory, hematological, metabolic and psychogenic), IF (age group, oedema, skin changes in humidity and change of body temperature) and EF (type of mattress and strength of body pressure) for all patients studied, statistically significant (ρ-value = 0001), between the average scores in patients with and without PU, with reason chance to 12.0 for the development of PU and there was moderate correlation ( r = 0618) in the presence of this association. Results show the influence of the multiplicity of factors and conditions on the occurrence of PU, which brings us to reflect on the assistance focused on prevention and reduction of these injuries which will encourage the reduction of hospitalization length, physical and psychological suffering, and the possibility of improving the clinical condition of the patient.
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The purpose of this study was to investigate the risk factors to the functional edentulism in adults aged 35 a 44 years old of Natal-RN, 278 adults took part in the study. They were all selected from a previous dental loss prevalence study thus being complemented by an active research. The study was a case-control based and data collection was made though a survey as well as with a clinical examination. The cases were identified through individuals with 20 or more teeth. Age and gender were used as variables of pairing off. The data was analyzed through chi-square, significant level of 95% to the checking of its force associations. The independent variables were grouped in three levels. The first one, more macro, is related to the region where the individual lives, which was also related to the second level, the family-based one, linked with a third level, at this low socio-economical level, where the domiciliary density was favorable, living in capital cities, regions with prime sanitary condicitions, with predominant possibility of accessing the public dental service, but in despite of this, only looking for this service when tooth ache is felt, where preferentially an aid dressing treatment is executed in detriment of preventive procedures. From all the samples, less than 25% of the individuals make use of tobacco and alcoholic beverages for quite a number of years. There was an association of functional edentulism with all the studied variables in a regional method. In the family-based with Critrio Brasil (OR=4,45) and monthly wages (OR=9,62) and to an to an individual level, the associations took place with the current use of kind of attendance (OR=1,78), looks for dressing treatment (OR=2,51), does not look for preventive treatment (OR=3,31), pain as the main cause of demand (OR=1,92), previous treatment as the demanding reason for dental service (OR+0,28), interval of the last visit to the dental service (OR=1,35) and when advise was received (OR=1,66). It was noticed from the results that the functional edentulism is much more expressive in those families which live in environments with precarious social economical sanitary conditions. Such conditions seem to have a direct influence upon the family social economical conditions which are also shown in detriment to functional edentulism. In the same way, the collection of variants influence the social economical conditions of the individual, as well as the kind of dental service searched by them, the reason of the search and the interval of the last visit to the dental service were strong determiners to the functional edentulism. Beyond that, individual habits like the use of tobacco and its frequency on its previous use influenced in a significant way the existence of functional edentulism in the studied population
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Coordenao de Aperfeioamento de Pessoal de Nvel Superior
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Literature has demonstrated to the narrow relation between deleterious habits and the occurrence of malocclusion in minors of 5 years. The existence of these habits, however, already considered as risk factors, having also, its determinative ones, which present cultural dimensions and economic social, many of them related to the parents of the child, having in account that such habits if develop in phases in which the child establish a narrow relation of dependence. This study it had an objective to investigate the prevalence of deleterious buccal habits in children and its relation with the economic social and characteristics of the parents. It was developed an epidemiologist study of transversal character with interview, through daily pay-tested form, with 218 parents in the day of the National Campaign of Vaccination. In the cast of the variable that had composed the study, they had been used, as changeable dependents, the use of the baby's bottle, bottle and the digital suction, being considered as outcomes of the research. Amongst the independent variable, the economic social factors (type of occupation, number of children, civil state, sort, schooling and age) and staffs of the parents (self perception in oral health) had entered as the variable to be analyzed in the problems of the infantile odontology. The collected data had been submitted to the analysis descriptive and inferential statistics, being used the test qui-square and the analysis of the possibility reasons. As main results, it was found that breast feeding before the six months if presents as one of the main factors of risk for the use of baby's bottle (p< 0.001, OR= 2.8, I.C= 1.589 4.906), bottle (p< 0.001, OR= 3.7, I.C.= 2.076 6.624) and digital suction (p< 0.014, OR= 3.5, I.C.= 1.225 10.181). From the data found, one concludes that breast-feeding is considered a primordial factor for not the installation of deleterious oral habits and that the economic social and cultural factors can reflect in central way in the performance of this act
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Objetivos: Estimar a prevalncia de alteraes do filme lacrimal e da doena do olho seco (DOS), comparar as mudanas na presso intraocular (PIO) e comparar as espessuras macular e da camada de fibras nervosas da retina (CFNR), entre mulheres com sndrome dos ovrios policsticos (SOP) e mulheres saudveis, estratificando-as em condies clnicas, metablicas e inflamatrias. Metodologia: O estudo incluiu 45 mulheres com SOP e 47 mulheres saudveis ovulatrias submetidas a avaliaes clnico-ginecolgicas e oftalmolgicas, incluindo propeduticas para a avaliao do filme lacrimal e medida da PIO, e medio da espessura macular, da CFNR e parmetros do disco ptico usando tomografia de coerncia ptica. Resultados: Tempo de ruptura do filme lacrimal (TRFL; p=0.001) e impregnao por fluorescena (p=0.006) apresentaram diferenas estatisticamente significantes entre os grupos estudados. A prevalncia de DOS foi de 44,4% nas portadoras de SOP. Houve reduo estatisticamente significativa do TRFL na presena de SOP (p=0.001). Alm disso, houve efeito estatisticamente significativo de intolerncia glicose e sndrome metablica/inflamao na impregnao por fluoresceina (p=0.004; p=0.015, respectivamente). A PIO encontrou-se estatisticamente mais elevada no grupo SOP que no grupo controle (p=0.011). Houve um aumento na mdia do IPC (ndice presso-crnea) com a associao entre SOP e da sndrome metablica (p = 0.005); A mdia da espessura da CNFR superior ao redor do nervo ptico foi estatisticamente mais espessa nas voluntrias com SOP que nas voluntrias saudveis (p=0.036); Aps estratificao pela presena de resistncia insulnica, as mdias dos subcampos das espessuras maculares macular interno temporal, macular interno inferior, macular interno nasal e macular externo nasal, foram mais espessas no grupo SOP que no grupo controle (p<0.05); Houve associao significativa entre obesidade e resistncia insulnica (p=0.037), e intolerncia glicose (p=0.001), com aumento mdio do componente principal 1 (CP1), e, na presena de sndrome metablica (p<0.0001), com aumento mdio do componente principal 2 (CP2), respectivamente, em relao espessura macular total. Na presena de obesidade e inflamao, houve reduo no escore mdio da CP2 (p=0.034), em relao espessura da CFNR na mcula. xviii Concluses: H uma associao da SOP, suas alteraes metablicas e inflamatrias com alteraes do filme lacrimal e com mudanas na PIO. A diminuio na espessura da CFNR macular e aumento da espessura total macular esto possivelmente associadas s alteraes metablicas, e, o aumento na espessura da CFNR ao redor do nervo ptico esto provavelmente associadas s alteraes hormonais, inerentes SOP.
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The metabolic syndrome (MetS) involves a group of risk factors and is associated with a significantly higher risk of developing cardiovascular diseases (CVD) and type 2 diabetes. Recent studies have shown the importance of preventing CVD through early diagnosis and treatment of patients with MetS. The objective of our study was to determine the prevalence of MetS by different diagnostic criteria in postmenopausal women and analyze the influence of socioeconomic factors on cardiovascular risk in this sample of the population. A cross-sectional study involving 127 postmenopausal women (45 to 64 years) from Natal and Mossor, Brazil. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte. The experimental protocol consisted of applying structured interview, clinical examination and implementation of dosages blood. The diagnosis of MetS was based on NCEP-ATP III (National Cholesterol Education Program-Adult Treatment Panel III) and IDF (International Diabetes Federation) criteria. The research was accomplished with the participation of an interdisciplinary team in their several phases. The result of the sample studied had mean age of 53.9 4.6 years and per capita income of 54.5 dollars. The prevalence of MetS, according to NCEP-ATP III and IDF criteria, was 52.8% and 61.4$, respectively. The agreement rate between NCEP-ATP III and IDF criteria was 81.9%, with a kappa value of 0.63 (CI 95%, 0.49-0.76), indicating good agreement between the two definitions. The most prevalent cardiovascular risk factor was HDL < 50 mg/dl, observed in 96.1% of the women analyzed, followed by increased waist circumference (≥ 80 cm) in 78.0%, elevated blood pressure in 51.2%, triglycerides ≥ 150 mg/dl in 40.9% and glycemia ≥ 100 mg/dl in 37.0% of the women. The occurrence of MetS was significantly associated with schooling and body mass index (BMI). High blood pressure was significantly associated with low family income, low schooling and weight gain. There was no significant association between the intensity of climacteric symptomatology and the occurrence of MetS. The conclusions of the research were that MetS and its individual components show a high prevalence in postmenopausal Brazilian women, and significant associations with weight gain and low socioeconomic indicators. The data point to the need for an interdisciplinary approach at the basic health care level, directed toward the early identification of risk factors and the promotion of cardiovascular health of climacteric women.
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OBJECTIVE: Preeclampsia is a disease that can lead to a high maternal and infant morbidity. Worldwide, the incidence of this disease is highly variable and there is no data on this disorder in the Brazilian population. This study aimed at determining incidence and risk factors in the hypertensive disorders during pregnancy in a neighborhood of Natal, in addition to observing the evolution of these disorders one year and five years after delivery. METHODS: Prospective cohort study to assess the outcome of pregnancies of 242 women who became pregnant between 2004-2007 in the neighborhood of Bom Pastor in the city of Natal, state of RN, Brazil. Five years after delivery, there was an active search of thirty-nine (39) women who became pregnant and had a hypertensive disorder during pregnancy and/or pr-eclmpsia, out of the total of 242 participants in the initial study. We administered a structured questionnaire to obtain basic information about the current clinical situation of patients and occurrences of subsequent pregnancy and presence of hypertensive disorders during pregnancy. We also searched for information on the use of hypotensive drugs and contraceptives. The following characteristics were checked and recorded: a) current weight, b) blood pressure c) body mass index - BMI, and we collected biological samples (blood and urine) for measurement of biochemical parameters and evaluation of microalbuminria. Finally, we monitored the ambulatory blood pressure (ABP), which uses the method of automatic measurement of heart rate, systolic and diastolic blood pressure and an average of the two for the period of 24 hours. RESULTS: Out of 218 women who completed the study, the incidence of hypertensive disorders was of 16.9% (37 out of 218), while the incidence of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a BMI (body mass index) averaged of 25.3 ( 4.8) while this ratio in normotensive women was of 23.5 ( 3.7), p = 0.02. The risk of preeclampsia rises with age (OR 1084 p = 0.0034) and with a family history of hypertension (OR 2.6 p = 0.01). The follow-up one year after delivery revealed that 50% of women with hypertensive disorders in pregnancy remained hypertensive. High BMI was also observed after 5 years of delivery. CONCLUSIONS: an elevated BMI, age above 35 years and excessive weight gain during pregnancy were associated with hypertension in the long term in patients with prior preeclampsia. History of preeclampsia increases the risk of chronic hypertension
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Avaliar fatores de risco cardiovascular em mulheres brasileiras com sndrome dos ovrios policsticos (SOP), atravs da utilizao de mltiplos parmetros, incluindo a determinao da prevalncia de sndrome metablica e seus componentes e pesquisa de microalbuminria como marcador de um possvel dano renal precoce nessas pacientes. Mtodos: Foram avaliadas 102 mulheres de 20-34 anos de idade, com diagnstico de SOP pelo Consenso de Rotterdam, tendo sido analisados parmetros clnicos, antropomtricos, bioqumicos e hormonais. Para diagnstico de sndrome metablica, foram adotados critrios do National Cholesterol Education Program s Adult Treatment Panel III (NCEP-ATP III). Para avaliao da microalbuminria foi utilizada a relao albumina/creatinina (A/C), calculada a partir dos nveis de albumina e creatinina em amostra isolada de urina. Foram realizados testes estatsticos para avaliar associaes e correlaes entre variveis, bem como comparao de mdias ou medianas, adotando-se nvel de significncia de 5%. Resultados: A prevalncia de sndrome metablica foi de 28,4% (29 em 102 pacientes), estando associada ao aumento do ndice de massa corporal (IMC). Quanto anlise da prevalncia dos componentes individuais da sndrome metablica, evidenciou-se: HDL-colesterol < 50 mg/dl em 69,6%, circunferncia da cintura ≥ 88 cm em 57,9%, triglicerdeos ≥150 mg/dl em 31,7%, presso arterial ≥130/85 mmHg em 18,6% e glicemia de jejum ≥110 mg/dl em 2,9%. Quando definida pelos limites convencionais para a relao A/C (3,5 35 mg/mmol), a microalbuminria esteve presente em apenas trs pacientes (3,3%). Entretanto, considerando diferentes limites de corte estabelecidos em recentes estudos que demonstraram aumento do risco cardiovascular associado a nveis muito baixos da relao A/C, a prevalncia em mulheres com SOP foi alta, variando de 17,7 a 43,3% (para valores ≥ 0,58 e ≥ 0,37 mg/mmol, respectivamente). Mulheres com intolerncia glucose apresentaram nvel significativamente mais elevado da relao A/C, quando comparadas s mulheres com normoglicemia. Os valores de microalbuminria no apresentaram correlao significativa com IMC, nveis pressricos, ndices de sensibilidade insulnica ou perfil lipdico. Concluses: Os dados evidenciam uma alta prevalncia de sndrome metablica e seus componentes individuais em mulheres brasileiras com SOP. Alm do mais, observou-se elevado percentual de mulheres com nveis de excreo urinria de albumina em faixas significativamente associadas com aumento do risco para eventos cardiovasculares. Em conjunto, esses dados alertam para a necessidade da abordagem interdisciplinar e multidisciplinar das pacientes com SOP, visando instituio de medidas voltadas para a preveno primria cardiovascular
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The aging process if characterizes for a complex events network, from multidimensional nature, that encloses biological, social, psychic and functional aspects. The alteration of one or more aspects can speed up the aging process, anticipating limitations and until the death in the aged. For an adjusted confrontation of this question is necessary an interdisciplinary vision, in which the some areas of the knowledge can interact and with this to intervenes of the best possible form. Then, information derived from studies of aspects related to incidence, morbidity-mortality and transition patterns, involved in the health-illness process can more accurately identify risk groups thereby establishing links between social factors, illness, incapacity and death. Thus, this study aimed to identify, by a multidimensional vision, the risk factors of mortality in a coorth of elderly in a city in the interior of the state of Rio Grande do Norte (RN), Brazil. A prospective study carried out in Santa Cruz RN, where 310 elderly were randomly selected to form a baseline. The follow-up was 53 months. The predictive variables were divided into sociodemographic, physical health, neuropsychiatric and functional capacity. The statistical analysis carried out by bivariate analysis, survival analysis, followed by binary logistic regression and Cox regression, in the multivariate analysis, considering significant levels p < 0.05 and confidence interval (CI) of 95%. A total of 60 (19.3%) elderly died during the follow-up, where cardiovascular disease was the main cause. The survival was approximately 24.8 months. The study of general survival showed, at 12, 24, 36, and 48 months of observation, a survival rate of 97%, 54%, 31%, and 5% respectively, with a statistical difference in survival only observed for the variables of cognitive function and Basic Activities of Daily Living. In the logistic regression analysis, the risk factors identified were cognitive deficits (OR = 8.74), poor perception of health (OR = 3.89) and dependence for Basic Activities of Daily Living (OR = 3.96). In the Cox analysis, as well as dependence for Basic Activities of Daily Living (HR = 3.17), cognitive deficit (HR = 4.30) and stroke (CVA) (HR = 3.49) continued as independent risk factors for death. The risk factors found in the study can be interpreted as the primary predictors for death among elderly members of the community. Therefore, improvements in health conditions, with actions towards sustaining an autonomous life with special attention for elderly with cognitive impairment, could mean additional healthy quality of life, resulting in the reduction of premature mortality in this population
Resumo:
Idosos apresentam prevalncia aumentada de Hipertenso Arterial Sistmica - HAS alm de multiplicidade de fatores de risco cardiovasculares adicionais relacionados a maus hbitos de vida. Este um estudo transversal que teve como objetivos comparar e correlacionar marcadores bioqumicos e antropomtricos e hbitos de vida indicadores de risco cardiovascular em idosos hipertensos e predominantemente saudveis, sedentrios e praticantes de atividade fsica. A amostra foi composta por 322 idosos, e distribuda em 2 grupos: G1: hipertensos e G2: predominatemente saudveis. A coleta de dados constou de anamnese e avaliaes bioqumica (perfil lipdico e Protena C-Reativa - PCR) e antropomtrica (ndice de Massa Corprea - IMC, Circunferncia da Cintura - CC, Circunferncia abdominal - CA e Relao Cintura- Quadril - RCQ). Na anlise dos dados utilizou-se estatstica descritiva, Teste t de Student, anlise de varincia (ANOVA One-Way) e correlao de Pearson. Os resultados mostram que no G1: 100% eram hipertensos, sendo que 31,55% eram diabticos e hipertensos e 0% era exclusivamente diabtico, no G2: 28,86% eram hipertensos, sendo que 13,40% eram diabticos e hipertensos, 5,15% eram exclusivamente diabticos e 65,99% no apresentam qualquer processo patolgico ativo. Com relao aos hbitos e estilo de vida, no G1: 58,22% eram sedentrios; 2,6% fumantes e 1,7% etilistas. No G2: 5,15% eram sedentrios; 7,21% fumantes e 8,24% etilistas. Com relao ao estado nutricional, verificou-se que no G1: 10,52% dos homens apresentaram Sobrepeso - SP e 14,03% Obesidade - OB, j entre as mulheres, 25,59% apresentaram SP e 20,23% OB. No G2: 6,06% dos homens apresentaram SP e 9,09% OB, e entre as mulheres, 15,87% apresentaram SP e 22,22% OB. Na anlise da RCQ, apresentaram valores acima dos recomendados: 24,56% dos homens e 82,14% das mulheres do G1 e 12,12% dos homens e 74,60% das mulheres do G2. Com relao a CC e CA, apresentaram valores indicativos de risco, respectivamente: no G1 (52,63% e 29,82% dos homens e 91,66% e 87,5% das mulheres) e no G2 (9,09% e 9,09% dos homens, e 80,95% e 55,55% das mulheres). Com relao idade, as freqncias de SP e OB no G1(n=225) foram: SP (A1=11,11%, A2=8%, A3=1,77%), OB (A1=8,44%, A2=8,88%, A3=1,33%), e no G2(n=97) foram: SP (A1= 5,15%, A2= 5,15%, A3= 2,06%) e OB (A1=9,27%, A2=7,21%, A3=0%). Na comparao entre G1 e G2 observou-se diferena estatsticamente significativa entre as seguintes mdias: IMC: [G1=27,23 e G2=23,26 x (p=0,0344)]; CA: [G1=99,09 e G2=89,51 (p<0,0001)]; CC: [G1=93,64 e G2=86,37 (p<0,0001)] e RCQ: [G1=93,64 e G2=86,37 (p<0,0001)]. Na correlao, verificou-se associao considerada como fraca positiva (p<0,05) entre PCR e as variveis antropomtricas e o perfil lipdico. Os resultados apontam para maior freqncia e intensidade de fatores de risco cardiovasculares adicionais a hipertenso em mulheres em relao aos homens, nas faixas etrias relativamente mais jovens, A1 e A2, em relao a mais velha, A3, e no grupo de idosos hipertensos, G1, em relao ao de idosos predominantemente saudveis, G2. Observou-se correlao, considerada fraca positiva (r>0,30), entre PCR, perfl lipdico e variveis antropomtrica (p<0,05). Esta tese apresenta uma relao de interface multidisciplinar, tendo o seu contedo uma aplicao nos campos da Fisioterapia, Educao Fsica, Medicina, Nutrio e da Bioqumica
