Depression and Cognitive Decline: Factors Related to Demographics and Psycho Pharmacotherapy on Elderly in Nursing Homes

Objectives: To identify the prevalence of neuropsychiatric disorders, especially DP and CD, on a sample of nursing home residents, relating this prevalence with some aspects of the demographics and psycho pharmacotherapy. Methods: 48 elders from two different nursing homes were selected. The collection of demographic and pharmacological data was made utilizing medical records. The medication was classified according to the Anatomical Therapeutic Chemical Code (ATC) criteria. The Geriatric Depression Scale (GDS 30) and the Mini Mental State Examination (MMSE) tests were utilized to determine the prevalence of DP and CD. Results: It was observed in the sample a high incidence of DP and CD among the researched elders. More schooling individuals tend to present less CD. Individuals with less CD indicatives present less symptomatology for DP. Of all the researched elders, 54,2% are submitted to psycho pharmacotherapy. Of all the consumed medicine, 16,5% belonged to the class of neuropsychiatric medicine. The medicated elders present, in average, a larger symptomatology for DP (12 points/average/GDS) than the non-medicated elders (9,9 points/average/GDS). The inverse occurs in relation to the CD indicatives. The use of psychotropics, especially in association, can have negative effects related to depression and cognition. Discussion: The pharmacotherapy, characterized for the polymedication and chronicity, especially of neuropsychiatric medicines, deserves special attention among elders, because the data suggest a significant relation between the utilization of medicines, singly or in association, and the increase of CD and DP. In addition, the data suggest that DP is a risk factor for CD and DM.

Proinflammatory profile of in vitro monocytes in the ageing is affected by lymphocytes presence

Background: Aging is associated with complex and constant remodeling of the immune function, resulting in an increasing susceptibility to infection and others diseases. The infections caused by Gram-negative microorganisms, present in nursing homes and hospitals, constitute one of the most common infections in the elderly, and are mainly combated by innate immune cells. Although the functions of innate immunity seem more preserved during aging than of adaptive immune mechanisms, two systems operate in an integrated way in the body, so that injury in one part of the immune system inevitably affects the other as they are part of a defensive network. The aim of this study was to investigate the in vitro production of proinflammatory (TNF-α, IL-6, IL-1β, CXCL-8 and MCP-1) and anti-inflammatory (TGF-β and IL-10) cytokines by monocytes, stimulated or not (basal) with lipopolysaccharide, from healthy young and elderly subjects. By means of PBMCs, we also studied if cytokine profile is altered in these different patient groups, in the presence of lymphocytes, under the same experimental conditions.Results: The monocytes from elderly presented higher basal production of TNF-α, MCP-1 and lower of TGF-β than young monocytes. PBMC showed similar cytokines production, irrespective age or stimulation presence. In the presence of lymphocytes, the spontaneous production of IL-10 was higher and of TGF-β was lower than monocytes, regardless of age. After LPS-stimulation, the presence of lymphocytes resulted in increased IL-6, IL-1β, MCP-1 and IL-10 and decreased CXCL-8 and TGF-β in comparison to pure culture of monocytes from young patients. With age, the same differences were observed, except for CXCL-8 and TGF-β which production was the same between monocytes and PBMC stimulated with LPS.Conclusion: These findings reinforce the systemic state of inflamm-aging frequently reported in elderly and considered a factor of susceptibility to numerous diseases. Still, the cytokine production from just monocytes of the elderly showed alterations, while in the lymphocyte presence not, suggesting an immunomodulator role of lymphocytes on monocytes. In addition, the differences between the production patterns by LPS-stimulated PBMC between young and elderly volunteers can be related with an imbalance in response against Gram-negative bacteria in throughout life. © 2013 Pinke et al.; licensee BioMed Central Ltd.

Prevalência e fatores de risco para carreamento de Staphylococcus aureus resistente à meticilina em idosos institucionalizados na cidade de Bauru-SP

Pós-graduação em Doenças Tropicais - FMB

Content Validation of the Operational Definitions of the Nursing Diagnoses of Activity Intolerance, Excess Fluid Volume, and Decreased Cardiac Output in Patients With Heart Failure

Objectives To consensually validate the operational definitions of the nursing diagnoses activity intolerance, excessive fluid volume, and decreased cardiac output in patients with decompensated heart failure. Method Consensual validation was performed in two stages: analogy by similarity of defining characteristics, and development of operational definitions and validation with experts. Results A total of 38 defining characteristics were found. Operational definitions were developed and content-validated. One hundred percent of agreement was achieved among the seven experts after five rounds. Ascites was added in the nursing diagnosis excessive fluid volume. Conclusion The consensual validation improves interpretation of human response, grounding the selection of nursing interventions and contributing to improved nursing outcomes. Implications for Practice Support the assessment of patients with decompensated heart failure. Objetivos Realizar a validacAo consensual das definicoes operacionais dos diagnosticos de enfermagem Intolerancia a atividade, Volume de liquidos excessivo e Debito cardiaco diminuido em pacientes com insuficiencia cardiaca descompensada. Metodo ValidacAo consensual em duas etapas: Analogia de semelhanca das caracteristicas definidoras e desenvolvimento de definicoes operacionais e validacAo com expertst. Resultados Foram encontradas 38 caracteristicas definidoras para os diagnosticos de enfermagem. Suas definicoes operacionais foram desenvolvidas e seu conteudo validado. Os resultados mostram que houve 100% de concordancia entre os sete experts apos cinco rodada. As definicoes operacionais foram classificadas com base no nivel de concordanica. Ascite foi acrescentada ao diagnostico Volume de liquidos excessivo. ConclusAo A validacAo consensual melhora a interpretacAo das respostas humanas, embasando a selecAo de intervencoes de enfermagem e contribuindo para melhorar os resultados. Implicacoes Para A Pratica Apoio a avaliacAo dos pacientes com insuficiencia cardiaca descompensada.

Analysis of the feasibility of early hospital discharge after autologous hematopoietic stem cell transplantation and the implications to nursing care

Autologous hematopoietic stem cell transplantation is a conduct used to treat some hematologic diseases and to consolidate the treatment of others. In the field of nursing, the few published scientific studies on nursing care and early hospital discharge of transplant patients are deficient. Knowledge about the diseases treated using hematopoietic stem cell transplantation, providing guidance to patients and caregivers and patient monitoring are important nursing activities in this process. Guidance may contribute to long-term goals through patients' short-term needs. To analyze the results of early hospital discharge on the treatment of patients submitted to autologous transplantation and the influence of nursing care on this conduct. A retrospective, quantitative, descriptive and transversal study was conducted. The hospital records of 112 consecutive patients submitted to autologous transplantation in the period from January to December 2009 were revisited. Of these, 12 patients, who remained in hospital for more than ten days after transplantation, were excluded from the study. The medical records of 100 patients with a median age of 48.5 years (19-69 years) were analyzed. All patients were mobilized and hematopoietic stem cells were collected by leukapheresis. The most common conditioning regimes were BU12Mel100 and BEAM 400. Toxicity during conditioning was easily managed in the outpatient clinic. Gastrointestinal toxicity, mostly Grades I and II, was seen in 69% of the patients, 62% of patients had diarrhea, 61% of the patients had nausea and vomiting and 58% had Grade I and II mucositis. Ten patients required hospitalization due to the conditioning regimen. Febrile neutropenia was seen in 58% of patients. Two patients died before Day +60 due to infections, one with aplasia. The median times to granulocyte and platelet engraftment were 12 days and 15 days, respectively, with median red blood cell and platelet transfusions until discharge of three and four units, respectively. Twenty-three patients required rehospitalization before being discharged from the outpatient clinic. The median time to granulocyte engraftment was 12 days and during the aplasia phase few patients were hospitalized or suffered infections. The toxicity of the conditioning was the leading cause of rehospitalization. The nursing staff participated by providing guidance to patients and during the mobilization, transplant and outpatient follow-up phases, thus helping to successfully manage toxicity.

Características sociodemográficas e clínicas que afetam a qualidade de vida em pacientes estomizados intestinais

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Suckling and allosuckling in river buffalo calves and its relation with weight gain

The aim of the present study was to investigate if river buffalo calves (Bubalus bubalis) have equal access to all cows and if milk is thus equally available to all of them. We recorded suckling/allosuckling behaviour and weight gain (WG) of 29 calves (14 males and 15 females), with special consideration to their sex, birth order (BO) and age. Cows' nursing behaviour and milli production (MP) were also considered. While males tended to be born earlier than females during this study, this was not the trend in the overall herd records. The cows' MP was not effected by the calves' sex. However, bull-calves presented greater mean WG, and mean times spent in individual filial (IF) and in communal nonfilial (CNF) suckling than heifer-calves, which showed greater communal filial (CF) suckling than the former during the first 4 months of life. The WG was associated with IF for bull-calves (r = 0.680 and 0.765, respectively, for the periods from birth to 4th and 8th months of age), and to CNF for heifer-calves (r = 0.628, for the period from birth to 8th month). Results from multiple regression analysis showed independent effects of each suckling category on the calf WG, and such effects were variable according to the calf's sex. BO was negatively correlated to calves' WG (bull-calves: r(s) = - 0.873 and - 0.799, from birth to 4th and gth months, respectively; heifer-calves: r(s) = - 0.531 from birth to 4th month). Specifically for bull-calves, there was a positive correlation between BO and MP (r(s) = 0.528 and 0.633, from birth to 4th and 8th months of age, respectively). The correlation between BO and IF was negative in both sexes, indicating that calves that were born early had more opportunities to suckle individually from their mothers. For heifer-calves, BO was positively correlated with CF (two periods), and negatively with CNF (from birth to 8th month of age), suggesting that heifer-calves were most often accompanied by other calves during suckling when they were born later. The data taken together indicate that sex and/or BO influenced decisively social interactions during suckling, promoting differential development among the calves. In animal husbandry, if a homogenous WG is desired, these factors have to be taken into consideration. (C) 2000 Elsevier B.V. B.V. All rights reserved.

Effect of adding macro and micro minerals in pig feces fed diets with different levels of probiotic

O objetivo deste trabalho foi avaliar dietas contendo diferentes doses (0, 100, 200 e 300 ppm) de probiótico sobre a produção diária de fezes (PDF) e teor de macro e microminerais nas fezes de suínos, nas fases de creche e de crescimento e no período total. A PDF, como porcentagem do peso vivo, somente apresentou diferença estatística (P<0,05) na fase inicial 1. Os teores de macro e microminerais excretados nas fezes não apresentaram diferença (P>0,05) entre tratamentos, a exceção de cálcio e sódio na fase inicial 1 e cálcio, zinco e níquel no período total. A adição de um poliprobiótico às dietas, não afetou a produção de fezes dos suínos nas fases de creche e de crescimento. Entretanto, a presença de microrganismos, adicionados (níveis de 200 e 300 ppm) às dietas reduziu a excreção fecal de cálcio, zinco e níquel.

Ambrosia and bark beetles (Scolytidae : Coleoptera) in pine and eucalypt stands in southern Brazil

More than 95% of the reforested area in Brazil is covered by exotic Eucalyptus and Pinus plantations. Native Scolytidae, mostly ambrosia beetles, appear to be rapidly adapting to these exotic trees, and reports of economic damage are becoming frequent. The objectives of our research were to survey, characterize and compare the Scolytidae fauna present in a P. taeda and an E. grandis stand in Telemaco Borba, Parana state, Brazil. Beetles were caught in ethanol baited ESALQ-84 vane traps in weekly collections from July 1995 until July 1997. In all, 87 species were trapped, 62 in the pine and 75 in the eucalypt stand. The most abundant beetle species in the pines were Hypothenemus eruditus, Xyleborinus gracilis, Cryptocarenus sp. and Xylosandrus retusus, while the most frequent were H. eruditus, Cryptocarenus sp., H. obscurus, Ambrosiodmus obliquus, and X. gracilis. In the eucalypt stand, H. eruditus, X. retusus, H. obscurus, X. ferrugineus and Microcorthylus minimus were the most abundant species, and H. eruditus, H. obscurus and M. minimus were the most frequently trapped. The majority of the species, regardless of the forest community, were most active between August (end of winter) and October (mid-spring). Significantly more H. eruditus, X. gracilis, Cryptocarenus sp., Corthylus obliquus, Hypothenemus bolivianus, A. obliquus, Sampsonius dampfi and Xyleborus affinis were trapped in the pine stand, while X. retusus, H. obscurus, X. ferrugineus, Xyleborinus linearicollis, Corthylus sp, and Corthylus convexicauda were caught in higher numbers in the eucalypt stand. Approximately 50% of the species trapped were found in both communities. Morisita's similarity index indicates the composition of the two communities is very similar, suggesting that most of the beetles are polyphagous. (C) 2001 Elsevier B.V. B.V. All rights reserved.

Genotoxicity and antigenotoxicity assessment of shiitake (Lentinula edodes (Berkeley) Pegler) using the Comet assay

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Genetic identification of lamniform and carcharhiniform sharks using multiplex-PCR

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Karyotypic Data on 28 Species of Scinax (Amphibia: Anura: Hylidae): Diversity and Informative Variation

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A macro- and micromorphological survey of floral and extrafloral nectaries in the epiphytic cactus Rhipsalis teres (Cactoideae: Rhipsalideae)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Factors influencing psychotropic prescription by non-psychiatrist physicians in a nursing home for the elderly in Brazil

CONTEXTO E OBJETIVO: Embora os psicotrópicos sejam uma das classes de medicações mais prescritas em abrigos para idosos, os estudos avaliando o seu padrão de prescrição são limitados em número e escopo. Este estudo visou investigar os fatores associados ao uso de psicofármacos em um abrigo para idosos no Brasil. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo observacional realizado no Abrigo da Velhice de Rio Claro, Instituto de Biociências, Universidade Estadual Paulista. MÉTODOS: Dados sobre prescrições foram extraídos dos prontuários médicos dos 108 idosos moradores do abrigo. Sessenta e cinco sujeitos (idade média ± desvio padrão = 74,5 ± 9,4 anos), em uso regular de medicação, constituíram a amostra. Foram examinados os efeitos das variáveis sociodemográficas e clínicas sobre o padrão de prescrição de psicofármacos. RESULTADOS: As mulheres recebiam mais psicofármacos (p = 0.038); indivíduos em uso de medicações para doenças cardiovasculares recebiam menos psicofármacos (p = 0.001). Houve correlação negativa entre número de psicofármacos prescritos e, ambos, idade (p = 0.009) e número de medicações clínicas (p = 0.009). CONCLUSÃO: Embora preliminares, os resultados indicam as doenças cardiovasculares como a variável clínica que mais influenciou a prescrição de psicofármacos. Uma excessiva precaução por parte dos clínicos pode explicar parcialmente este resultado. Novas investigações, com amostras maiores e de diferentes regiões são desejáveis para confirmação destes dados.

Association of CSSM066 and ILSTS011 microsatellite markers and thyroglobulin gene SNP with backfat in Canchim cattle

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)