Marcadores nutricionais e inflamatórios e sua associação com a morbimortalidade em hemodiálise

Background: Malnutrition, inflammation and comorbidities are frequent in patients with chronic renal failure in hemodialysis (HD), contributing for morbidity and mortality. Aims: To evaluate the correlation between anthropometric, laboratory parameters, bioelectrical impedance (BIA) and inflammatory markers with the morbidity and mortality of patients in HD, as well as the impact of its alterations throughout 12 months. Methods: 143 patients of a dialysis facility in Northeast Brazil were evaluated throughout 18 months. Patients with more than 3 months on dialysis, older than 18 years, without amputation of hands and feet, were included in the study. We performed a clinical (subjective global assessment - SGA), anthropometric (BMI, percent of ideal weight, MAC, MAMC, MAMA, percent of fat mass and TSF), laboratory (albumin, creatinine, lymphocyte count as nutritional markers and CRP, IL-6 and TNF- as inflammatory markers) evaluation and BIA (reactance, phase angle and percent of body cell mass) at the beginning of study and after 3, 6 and 12 months of follow-up. The association between study variables and deaths and hospitalizations in 6 and 12 months was investigated. The variable with significance < 10% in the univariate analysis had been enclosed in a multivariate logistic regression analysis. We also investigated the risk of mortality and hospitalization associated with differences in measurements of the variables at baseline and six months later. Results: Patients were aged 52.2 ± 16.6 years on the average, 58% were male, and mean dialysis vintage was 5.27 ± 5.12 years. The prevalence of malnutrition varied from 7.7-63.6%, according to the nutritional marker. The variables associated with morbidity and mortality in 6 and 12 months had been creatinine ≤ 9.45 mg/dl, phase angle ≤ 4.57 degrees, BMI ≤ 23 kg/m2, age ≤ 64.9 years, reactance ≤ 51.7 ohms; Charlson´s index ≥ 4 and socioeconomic status ≤ 7. During six months of follow up, decrease in albumin was associated with significantly higher mortality risk. Conclusions: This study detected that the best predictors of morbidity and mortality between nutritional and inflammatory markers are phase angle, reactance, creatinine and BMI and that changes in albumin values over six 107 months provide additional prognostic information. The authors believe that parameters of BIA may detect early changes in nutritional status and emphasize that longitudinal studies with larger number of patients are necessary to confirm these data and to recommend BIA as a routine nutritional evaluation in HD patients

"Antes que eu esqueça : trajetórias, laços e memórias produzidas por sujeitos da terceira idade na interação em territórios de sociabilidades

Currently the number of elderly in the world and Brazil is growing increasingly. However, old age is still presented as a complex issue that needs more depth. It is extremely important that society should create a discourse committed to reviewing negative stereotypes of old age as well as studies that allow the construction of new looks inclusive , as well as the creation of public policies that favor the elderly category, such as the National Policy and Elderly Statute established recently. The aim of this study is to analyze the spaces of sociability for the elderly Mossley and understand how the collective experiences in these environments influence the quality of life and influence in their depictions of the elderly subjects. To collect data observations were made, semi-structured interviews and wheels conversations with men and women aged 65 to 80 years old, retired, mostly widows, neighborhood residents Abolition in Mossley, participants (CCI) Coexistence Center Seniors Jose Sarney and (CRAS) Reference Center and Welfare. Thus, the spaces facing the elderly are presented as a good alternative for the rehabilitation, the fun and preserve their memories, while the agents posing as productive, active, and transformers of their reality

Desenpenho aeróbio e controle autonômico cardíaco em idosas praticantes de tai chi chuan e sedentárias

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Validade e reprodutibilidade do Wii Balance Board para avaliação do equilíbrio vertical estático: um novo método de avaliação.

The Wii Balance Board (WBB) began to be investigated as a low-cost alternative for assessing static balance in vertical posture. However, studies employed methodological procedures that did not eliminate result variability between the tests and equipment used. Objective: Determine the validity and reproducibility of the WBB as an instrument for assessing static balance in the vertical position, using simultaneous data analysis and superimposed equipment. Methods: This is an accuracy study of 29 healthy young individuals of both sexes aged 18 to 30 years. Subjects were assessed 24h apart (test-retest), using unipodal and bipodal support tests, with eyes closed and open. To that end the WBB was placed on top of a force platform (FP) and data (postural sway) were collected simultaneously on both devices. Validity and reproducibility were analyzed using the interclass correlation coefficient (ICC). Finally, Bland-Altman analysis was applied to assess agreement. Results: The sample was composed of 23 women and 6 men, with mean age of 24.2±6.3 years, 60.7±6.3 kg and 1.64±4.2 m. The validity of the WBB compared to the FP was excellent for all 4 tasks proposed (ICC = 0.93 0.98). The reproducibility analyzed by test-retest was excellent for the bipodal support tasks (ICC = 0.93-0.98) and only moderate for the unipodal support tests (ICC = 0.46 0.70). Graphic analysis exhibited good agreement between the devices, since most of the measures were within the limits of agreement. Conclusion: this study proved the validity and reproducibility of the Wii Balance Board as an instrument for assessing static balance in vertical posture, using simultaneous analysis with superimposed equipment. Thus, the WBB has been increasingly used by physical therapists and other health professionals in their clinical practice, as both a rehabilitation and assessment tool

Bolton freeware: aplicativo de avaliação de discrepância de massa dentária desenvolvido pelo programa de pós-graduação em odontologia/UFRN

The calculation of tooth mass discrepancy, essential for good planning and a proper orthodontic finishing, when performed manually, besides being laborious, requires considerable time consumption. The aim of this study was to develop and test Bolton Freeware, a software for analysis of the tooth mass discrepancy of Bolton, aiming to minimize the consumption of time in a less onerous way. The digital analysis of the software was done by means of two-dimensional scanning of plaster study models and compared to manual evaluation (gold standard), using 75 pairs of stone plaster study models divided into two groups according to the magnitude of the Curve of Spee (group I from 0 to 2 mm, group II greater than 2 to 3mm). All the models had permanent dentition and were in perfect condition. The manual evaluation was performed with a digital caliper and a calculator, and the time required to perform the analysis for both methods was recorded and compared. In addition, the software was evaluated by orthodontists regarding its use, by means of questionnaires developed specifically for this purpose. Calibration was performed prior to manual analysis, and excellent levels of inter-rater agreement were achieved, with ICC > 0.75 and r > 0.9 for total and anterior proportion. It was observed in the evaluation of error of the digital method that some teeth showed a significant systematic error, being the highest measured at 0.08 mm. The analysis of total tooth mass discrepancy performed by Bolton Freeware, for those cases in which the curve of Spee is mild and moderate, differ from manual analysis, on average, 0.09 mm and 0.07 mm respectively, for each tooth evaluated, with r> 0, 8 for total and anterior proportion. According to the specificity and sensitivity test, Bolton Freeware has an improved ability to detect true negatives, i.e. the presence of discrepancy. The Bolton analysis digitally performed was faster, with an average difference of time consumed to perform the analysis of Bolton between the two methods of approximately 6 minutes. Most experts interviewed (93%) approved the usability of the software

Tradução, adaptação cultural e propriedades psicométricas da versão brasileira do mobility assessment tool physical activity (MAT-PA) em idosos comunitários brasileiros

Objetivo: Traduzir e avaliar as propriedades psicométricas do Mobility Assessment Tool Physical Activity (MAT-PA) em idosos comunitários brasileiros. Métodos: Trata-se de um estudo tradução, adaptação cultural, e acurácia do instrumento MAT-PA, no qual foram avaliados 329 idosos, com idade mínima de 60 anos, residentes na comunidade. Os indivíduos submeteram-se a um formulário de avaliação composto por: questionário sócio-demográfico e de saúde percebida; avaliação física; Prova Cognitiva de Leganés (PCL); Center for Epidemiologic Studies Depression Scale (CES-D); International Physical Activity Questionnaire (IPAQ); Mobility Assessment Tool Physical Activity (MAT-PA). Dessa amostra total, 42 idosos utilizaram o acelerômetro durante 8 dias. Para verificar a confiabilidade teste-reteste do MAT-PA, reaplicou-se esse instrumento em 34 idosos 8 dias após a primeira avaliação. A análise estatística utilizada foi a correlação de Spearman, o Coeficiente de Correlação Intra-classe, o coeficiente α de Cronbach, o Bland-Altman e o teste T pareado. Resultados: As correlações dos dados IPAQ e acelerômetro versus o escore total do MAT-PA foram significativas e apresentaram um coeficiente de correlação de Spearman de 0,13 e 0,41, respectivamente. Analisou-se também a confiabilidade que apresentou as seguintes medidas: consistência interna, pelo coeficiente alfa de Cronbach (α= 0,70); Concordância teste-reteste, pelo coeficiente de correlação intra-classe (CCI=0,53; p<0,001). Conclusão: A versão brasileira do Mobility Assessment Tool Physical Activity (MAT-PA) como um instrumento de avaliação da atividade física de idosos, mostrou ser um método válido e confiável.