Perfil e estilo de vida dos idosos cadastrados no sis-hiperdia da esf São Geraldo - São Gotardo/MG

Objetivo: Identificar os fatores de risco modificáveis e as sequelas prevalentes nos idosos cadastrados no SIS-HIPERDIA da ESF São Geraldo do Município de São Gotardo/MG. Métodos: estudo epidemiológico transversal de estatística descritiva através da ficha de cadastro de SIS-HIPERDIA da Unidade de Saúde da Família São Geraldo, no período de 2009 a 2010, no município de São Gotardo. Resultados: 164 idosos compõem esse universo, com predominância do sexo feminino, à semelhança de outros estudos realizados com idosos; é a feminização do envelhecimento. No que dizem respeito à faixa etária, os idosos apresentaram de 60 a 93 anos, sendo a média de 73,3 anos, a moda de 63 anos, a mediana de 73 anos e o desvio-padrão de 9 anos. Revelou também sobrepeso de 14,0 e obesidade de 24,4; 9,8 de tabagismo anterior (deixaram o vício) e continuam fumando 3,0; 1,2 de etilismo; 51,2 de sedentarismo. Conclusão: a realização deste estudo forneceu indicadores para o planejamento de adoção de hábitos e estilos de vida saudáveis, prevenindo complicações e proporcionando melhoria da qualidade de vida dos idosos.

Perfil do cuidador de idosos no universo familiar

Os avanços tecnológicos e medicinais vêm promovendo o aumento na expectativa de vida. Neste sentido o número de idosos vem crescendo abruptamente nas duas últimas décadas e destes, grande parte não possui autonomia de realizar suas atividades básicas da vida diária necessitando assim de cuidadores. Neste sentido, o presente estudo teve como objetivo traçar o perfil dos cuidadores de idosos no universo familiar. Para tanto, buscou-se dados relativos à saúde do idoso, aspectos socioeconômicos e culturais, bem como identificar características dos cuidadores. Trata-se de uma revisão literária que teve como descritores as palavras saúde do idoso, idoso, visitadores domiciliares. Discutir o papel e o perfil do cuidador de idosos no Brasil é uma tarefa que se mistura com a realidade desta população em nosso país, onde os resultados demonstraram que estes idosos através de sua aposentadoria são ainda em grande parte, responsáveis financeiros e que os cuidadores em sua maioria são familiares, principalmente filhas, que se desdobram em cuidar dos filhos e dos pais, e muitas vezes não possuem conhecimentos suficientes para lidar adequadamente com o idoso. Buscar compreender o perfil do cuidador de idosos é o primeiro passo para criarmos ações de saúde coletiva para esta parcela da população que necessita de políticas públicas efetivas que contribuam para a melhoria da qualidade de vida. Neste sentido, as ESF (Equipes de Saúde da Família) possui um papel fundamental, pois a partir da realidade encontrada pode-se traçar metodologias que vão melhorar o quadro atual, que é apresentado por falta de preparo destes cuidadores que deveriam ser capacitados e orientados, promovendo assim um melhor cuidado para os idosos dependentes.

Intervenção educativa da hipertensão arterial em PSF Miguel Sabino de Freitas. Município Pitangui - Minas Gerais

A Hipertensão Arterial dentre as doenças crônicas, constitui um problema de saúde, sendo uma doença de caráter universal, com alto risco de complicações.Este é um projeto da intervenção educativo, na população de 35 até 50 anos no PSF Miguel Sabino de Freitas, com diagnóstico de Hipertensão Arterial, pertencente ao município de Pitangui, Minas Gerais. Foram selecionados de um universo de 472 pacientes hipertensos, 184 pacientes (n =184), deles 72 homens e 112 mulheres, entre 35 e 50 anos de idade, de acordo com critérios, com objetivo que conheçam a importância de um bom controle da pressão arterial, suas complicações, assim como promover mudanças no estilo de vida. O estudo foi no período compreendido entre março-setembro de 2014. Para o cumprimento dos objetivos foi necessário capacitar a equipe de trabalho e realizar práticas educativas, através de palestras, roda de discussão e formação de grupos de interesse. Demonstrou-se que no PSF Miguel Sabino de Freitas 13.9 da população é portadora da doença, os mais afetados são pessoas entre 35 e 50 anos, com predomínio do sexo feminino em 54.2 . A hipertensão arterial tem causa no contexto sociocultural e sua prevenção deve pautar em ações educacionais e serem direcionados para produzir mudança de vida. Os resultados do estudo foram positivos, determinam que as famílias melhorem a na compreensão da hipertensão, além de converter-se em uma campanha de prevenção contra doenças crônicas não transmissíveis

Avaliação do consumo de medicamentos psicotrópicos em adulto em uma Unidade Básica de Saúde de Girau do Ponciano - Alagoas

O uso excessivo e indiscriminado dos psicotrópicos tem sido considerado um grave problema por profissionais e autoridades sanitárias devido aos sérios prejuízos que esta prática causa à saúde mental das populações. O trabalho consiste numa proposta de intervenção no âmbito da Estratégia de Saúde da Família (ESF) de Canafístula ll, município de Girau do Ponciano, Alagoas. Foram analisados registros de 151 prontuários de usuários que fizeram uso de medicação controlada no período de janeiro a dezembro de 2014 com o objetivo de determinar a magnitude do consumo de medicamentos psicotrópicos entre os atendidos (5,1%) num universo de 2924 cadastrados na ESF, sendo 1439 (49,21%) eram do sexo masculino e 1485 (50,78) do feminino. Dos 151 que tomam medicação controlada, 93 são do sexo feminino e 58 masculinos. A partir da identificação do problema, propomos visitas domiciliares, rodas de conversa, trabalho em grupo, orientação individual e coletiva envolvendo a família e os profissionais de saúde da equipe multiprofissional ampliando o nível de comunicação e informação dos pacientes e familiares, estimulando a reorganização do serviço por meio da verificação da prescrição, motivo, frequência de uso, melhora dos sintomas, conhecimento acerca de efeitos adversos, interferência no convívio familiar, investigação de uso entre outras pessoas da família garantindo aos usuários acesso a informação e ao conhecimento dos efeitos colaterais do uso prolongado de psicofarmos, ampliando a capacidade de resposta das equipes de saúde com relação aos portadores de doenças crônicas psiquiátricas.

Proposta de intervenção com vistas a reduzir o número de hipertensos do município de Catuji - MG

Estudo descritivo e prospectivo, com o objetivo de elaborar uma proposta de intervenção com vistas a reduzir o número de hipertensos do Município de Catuji-Minas Gerais, no período compreendido desde Janeiro até Outubro de 2014. O universo populacional foi conformado por 1981 pacientes hipertensos do consultório cuja amostra foi formada por um total de 625 pacientes e constataram cifras tensionais de 140/90mmHgou mais, apresentando ou não antecedentes de hipertensos na família. A mostra foi agrupada segundo as variáveis utilizadas para essa investigação, cumprindo os critérios metodológicos e éticos para a mesma. Constata-se que o sexo feminino e a faixa etária de 50 - 59 anos foram predominantes. A maioria teve mais de um fator de risco, 47,2% só realizavam o tratamento higiênico dietético e 27,36% dos pacientes investigados apresentaram algumas complicações. Todo o dado estatístico da informação obtida foi através do sistema MICROSTAD. Os resultados se discutiram em quadros de três entradas (se expressaram em porcentagens) das diferentes variáveis dependentes e independentes contidas na operacionalização.

Variation of the anal resting pressure induced by postexpiratory apnea effort in patients with constipation

CONTEXT: Intestinal constipation - a common symptom among the general population - is more frequent in women. It may be secondary to an improper diet or organic or functional disturbances, such as dyskinesia of the pelvic floor. This is basically characterized by the absence of relaxation or paradoxical contraction of the pelvic floor and anal sphincter during evacuation. OBJECTIVE: To analyze, by manometric data, the anal pressure variation at rest, during evacuation effort by using the Valsalva maneuver and forced post-expiratory apnea in subjects with secondary constipation. METHODS: Twenty-one patients (19 females - 90.4%) with a mean age of 47.5 years old (23-72) were studied. The diagnosis was performed using anorectal manometry, with a catheter containing eight channels disposed at the axial axis, measuring the proximal (1) and distal (2) portions of the anal orifice. The elevation of the pressure values in relation to the resting with the evacuation effort was present in all patients. The Agachan score was used for clinical evaluation of constipation. The variables studied were: mean anal pressure of the anal orifice for 20 seconds at rest, the effort of evacuation using Valsalva maneuver and the effort of evacuation during apnea after forced expiration, as well as the area under the curve of the manometric tracing at moments Valsalva and apnea. RESULTS: The analysis of the mean values of the anal pressure variation at rest evidenced difference between proximal and distal channels (P = 0.007), independent of the moment and tendency to differ during moments Valsalva and apnea (P = 0.06). The mean of values of the area under the manometric tracing curve showed differences between moments Valsalva and apnea (P = 0.0008), either at the proximal portion or at the distal portion of the anal orifice. CONCLUSION: The effort of evacuation associated with postexpiratory apnea, when compared with the effort associated with the Valsalva maneuver, provides lower elevation of anal pressure at rest by the parameter area under the curve.

Heterogeneidade do desempenho de alunos da Unicamp, do ingresso à conclusão

The aim of this work is to propose a methodology to evaluate the performance of students at Unicamp [São Paulo State University at Campinas] from admission to graduation. The sample consists of all students enrolled in Unicamp from 1997 to 2000, and the population corresponds to the universe of students throughout the existence of the university. The available database was gathered from socio-cultural questionnaires applied by the University Commission on College Entrance Examination at the time of enrollment for the examination (vestibular) and from academic information provided by the Unicamp Academic Studies Board. A methodology is proposed based on the relative gain variable suggested by Dachs and Maia (2006). This new methodology is based on the diversity measures proposed by Rao (1982) and on the use of U-statistics. Homogeneity tests have been proposed to assess whether there is a difference in performance among students from different groups.

Saúde dos adolescentes: um estudo de base populacional em Campinas, São Paulo, Brasil

We estimated the prevalence of chronic diseases and other health problems reported by adolescents in relation to social and demographic variables and nutritional status. This cross-sectional population-based survey analyzed data from the Health Survey in Campinas, São Paulo State, Brazil, 2008. We used descriptive statistics and associations between variables with the chisquare test. Prevalence of chronic diseases among adolescents was 19.17%, with asthma showing the highest prevalence (7.59%), followed by heart disease (1.96%), hypertension (1.07%), and diabetes 0.21%. Prevalence rates were 61.53% for health problems, 40.39% for allergy, and 24.83% for frequent headache or migraine. After multivariate analysis using Poisson regression, the factors associated with chronic disease were age 15 to 19 years (PR = 1.38), not attending school (PR = 1.46), having children (PR = 1.84), and obesity (PR = 1.54). Female gender (PR = 1.12) was statistically associated with health problems. The study illustrates that adolescence is a life stage in which chronic disease and health problems can occur.

Avaliação da qualidade de vida em pacientes idosos um ano após o tratamento cirúrgico de fraturas transtrocanterianas do fêmur

OBJECTIVE: Evaluate the impact that trochanteric hip fractures produce on life quality of elderly patients, treated surgically, during one year of monitoring. METHODS: Were selected 73 elderly with transtrochanteric femur fracture, aged equal or over than 65 years and of both sexes. All participants underwent a standardized questionnaire which obtained information on lifestyle habits, functionality, physical activity, ambulation and cognitive state. Were excluded patients who died, not walking, with neurological diseases and pathological fractures. RESULTS: The average age was 80.17 ± 7.2 years and 75% was female. When comparing the summation of activities of daily living (p = 0.04) and instrumental daily living (p = 0.004) obtained before and after fracture, the patients become more dependent after fracture. Activities of daily living that worsened after fracture were bathing (p = 0.04), toileting (p = 0.02) and dressing (p = 0.04). All instrumental activities of daily living showed a significant difference, with functional dependence after fracture, increased need for walking aid (p = 0.00002), aged (p = 0.01) and not doing housework (p = 0.01). The low score on the test Minimental was associated with a greater dependence to perform activities of daily living before (p = 0.00002) and after (p = 0.01) fracture. CONCLUSION: After a year, activities of daily living that depended on the lower limbs worsened significantly, all instrumental activities of daily living were significantly worse in more than 50% of patients and more than half of patients who walked without support lost this ability.

Gênero e estresse em trabalhadores de uma universidade pública do estado de São Paulo

The aim of this paper was to identify, according to gender, the indexes of Mental Health and the Psychosocial Risk Factors in workers at a state University. A sample of 400 was randomly selected, 253 female and 147 male. They were assessed by means of The Questionnaire SWS Survey (Self, Work and Social) (Ostermann & Gutiérrez, 1992), validated in Brazil by Guimarães and Macfadden (1999). Univariate, bivariate, multivariate statistics were assessed. Significant associations emerged from Mental Health and Gender, and Psychosocial Risk Factors and Gender. Women showed greater Psychosocial Risk Factors, Work and Social Stress, worst mental health than men (p < 0.05), which place them at greater risk for developing physical and/or mental illness.

Medo, ansiedade e controle relacionados ao tratamento odontológico

The aim of this study was to test fear, anxiety and control related to dental treatment. The subjects were 364 children with ages between 7 and 13 years. Three questionnaires with multiple choice questions were applied in groups of 10 children. The first instrument was the 15-item dental subscale from the Children’s Fear Survey Schedule9. The subjects rated their level of fear on a 5-point scale. The second survey instrument was the 20-item subscale from the State Trait Anxiety Inventory for Children16. This measure was used to capture how anxious the child was, in general. The third instrument was the Child Dental Control Assessment19. It contained 20 items to assess perceived control and 20 items to assess desired control. The results of the survey indicated that dental fear and anxiety were slightly higher for females when compared with male subjects (P < 0.05). Older children (11 to 13 years old) obtained higher fear scores than younger ones (7 to 9 years old). Concerning perceived control, the results indicate that younger children perceive more control than older ones. For desired control, the results indicate that younger children reported higher percentages than older ones. In this study, patients who had undergone anesthesia during treatment revealed higher fear scores when compared with those who had not. Dental fear etiology seems to be related to a procedure that may involve pain or lack of control.

Estudo comparativo dos métodos de estimativa da idade óssea de Greulich & Pyle e Tanner & Whitehouse

The purpose of this study was to verify whether the Greulich & Pyle (GP), Greulich & Pyle Visual (GPV) and Tanner & Whitehouse (TW) methods for estimating skeletal age could be applied in the Brazilian population, and which of these three methods could be considered more reliable when compared with the chronological age of the individuals. This study was based on one hundred and sixty volunteers (80 females and 80 males) with ages between 6 years and 10 months and 14 years and 9 months. The results showed that for the GP method, the correlations with chronological age were 0.95 for males and 0.97 for females. For the GPV method, the correlations were 0.96 and 0.97, respectively and for TW, 0.96 and 0.97. The results showed that the Greulich & Pyle, Greulich & Pyle Visual and Tanner & Whitehouse methods presented high correlation values when compared with the chronological age of the individuals. Corrective factors were established to make these methods applicable to the Brazilian population.

Phenotypic variability in a family with x-linked adrenoleukodystrophy caused by the p.Trp132Ter mutation

X-linked adrenoleukodystrophy (X-ALD) is an inherited disease with clinical heterogeneity varying from presymptomatic individuals to rapidly progressive cerebral ALD forms. This disease is characterized by increased concentration of very long chain fatty acids (VLCFAs) in plasma and in adrenal, testicular and nervous tissues. Affected individuals can be classified in different clinical settings, according to phenotypic expression and age at onset of initial symptoms. Molecular defects in X-ALD individuals usually result from ABCD1 gene mutations. In the present report we describe clinical data and the ABCD1 gene study in two boys affected with the childhood cerebral form that presented with different symptomatic manifestations at diagnosis. In addition, their maternal grandfather had been diagnosed with Addison's disease indicating phenotypic variation for X-ALD within this family. The mutation p.Trp132Ter was identified in both male patients; additionally, three females, out of eleven family members, were found to be heterozygous after screening for this mutation. In the present report, the molecular analysis was especially important since one of the heterozygous females was in first stages of pregnancy. Therefore, depending on the fetus outcome, if male and p.Trp132Ter carrier, storage of the umbilical cord blood should be recommended as hematopoietic stem cell transplantation could be considered as an option for treatment in the future.

Crescimento e composição corporal de uma coorte de crianças e adolescentes com diabetes tipo 1

OBJECTIVE: To evaluate the growth and body composition of children and adolescents with type 1 diabetes mellitus (T1DM). SUBJECTS AND METHODS: A cohort of 44 patients with T1DM were followed up for approximately four years and compared with a control group. Weight, height, body mass index (BMI), body fat percentage (BF%), fat mass index, waist circumference (WC) and waist-height ratio were determined. RESULTS: In females, in the first evaluation, BF% was lower in patients than in controls, while in the second evaluation, mean WC was higher in patients than in controls. In males, height of the patients was lower in the first evaluation, while body mass index (BMI) was higher in the second one. We did not find any differences among the changes in height, weight and BMI z-scores and BF% or in the distribution of those z-scores between the two evaluations, in both groups. Multiple regression analysis found differences in BMI and waist-height ratio in both sexes and also in WC in females. CONCLUSION: The patients had adequate growth but showed discrepancy in their body composition during the study.

Flicker perimetry in healthy subjects: influence of age and gender, learning effect and short-term fluctuation

PURPOSE: To determine the mean critical fusion frequency and the short-term fluctuation, to analyze the influence of age, gender, and the learning effect in healthy subjects undergoing flicker perimetry. METHODS: Study 1 - 95 healthy subjects underwent flicker perimetry once in one eye. Mean critical fusion frequency values were compared between genders, and the influence of age was evaluated using linear regression analysis. Study 2 - 20 healthy subjects underwent flicker perimetry 5 times in one eye. The first 3 sessions were separated by an interval of 1 to 30 days, whereas the last 3 sessions were performed within the same day. The first 3 sessions were used to investigate the presence of a learning effect, whereas the last 3 tests were used to calculate short-term fluctuation. RESULTS: Study 1 - Linear regression analysis demonstrated that mean global, foveal, central, and critical fusion frequency per quadrant significantly decreased with age (p<0.05).There were no statistically significant differences in mean critical fusion frequency values between males and females (p>0.05), with the exception of the central area and inferonasal quadrant (p=0.049 and p=0.011, respectively), where the values were lower in females. Study 2 - Mean global (p=0.014), central (p=0.008), and peripheral (p=0.03) critical fusion frequency were significantly lower in the first session compared to the second and third sessions. The mean global short-term fluctuation was 5.06±1.13 Hz, the mean interindividual and intraindividual variabilities were 11.2±2.8% and 6.4±1.5%, respectively. CONCLUSION: This study suggests that, in healthy subjects, critical fusion frequency decreases with age, that flicker perimetry is associated with a learning effect, and that a moderately high short-term fluctuation is expected.