Evolução da nefrite lúpica em pacientes tratados com ciclofosfamida de acordo com variáveis prognósticas : a influência da etnia e da hipertensão arterial sistêmica

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Efeitos do sildenafil na capacidade funcional, hipertensão pulmonar e função endotelial em pacientes com insuficiência cardíaca

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Representações sociais de velhice em contexto de prestação formal de cuidados

Universidade da Madeira. Centro de Ciência e Tecnologia da Madeira

Perfil das condições de seguimento terapêutico em portadores de hipertensão arterial

A proposta foi investigar os aspectos comportamentais referentes ao seguimento da terapêutica farmacológica e não farmacológica e o grau de adesão ao tratamento anti-hipertensivo de um grupo específico. Estudo observacional descritivo com análise quantitativa, realizado no Centro de Referência da Assistência Social em Fortaleza-CE, de agosto/2008 a maio/2009. Dados obtidos de 49 indivíduos por entrevista e exame físico. Mais de 50% dos participantes seguiam as terapêuticas não farmacológicas. Prevaleceram a terapia combinada (53%) e as classes medicamentosas de diuréticos (72%) e inibidores da enzima conversora de angiotensina (55%). Muitos participantes (49%) referiram reações adversas. Destas, as mais citadas foram poliúria e tontura (29%). Quanto ao grau de adesão, a média correspondeu ao conceito não adesão leve. A avaliação dos comportamentos de seguimento terapêutico e a caracterização clínico-epidemiológica são necessárias para o enfermeiro planejar estratégias educativas. Ambas possibilitam ajustes no planejamento das intervenções, contribuindo para a melhor adesão terapêutica dos indivíduos

Corpo e Velhice: um estudo da qualidade de vida de idosos da Vila Vicentina Júlia Freire em João Pessoa

The aim of this study was to follow the daily routine of elderly individuals residing at the Vila Vicentina Júlia Freire (VVJF) nursing home in João Pessoa, Brazil, observing and analyzing as much as possible, the way in which they live in a group and how they deal, through personal experiences, with their own body image and with that of others. The results were obtained from information considered relevant, according to the perspectives of the residents themselves, contained in narratives of their history and related to their quality of life. Our interest lays in how they coped with changes in their bodies at old age and adapted to the challenges of this new phase. To obtain this information, with significant expressions, we used the Narrative Interview (NI) as a research tool in order to redeem their life experience and develop an understanding of their impressions about the life experience at the current nursing home. We selected, among the housed, ten subjects - actors - to appear as a sample of the group together. The design of our sample had a hybrid model, combining two types: random sample (probability) and an intentional sample (not probability). After recording transcripts and ensuring that all the subjects showed common interests that were relevant to the group, we chose three categories for analysis as follows: a. the elderly as seen by themselves and by others; b. religiosity as a moral factor; c. intimacy and relationships. Our choice was based on the importance of the theme as a multidisciplinary topic in the quality of life of populations. The subjects, chosen as spokespersons for the VVJF, spoke, among other things, about the way in which they viewed the world, their own body and how they experienced the environment and their fellow residents, in an attitude of reflection and criticism that confirms the lucidity of an old age conditioned to an elderly institution. The method allowed us to investigate our subjects from a multidisciplinary point of view. We suggest other studies in assorted areas of the human sciences, having as principle, man at the center of all our scientific questionings. The paradigm that the elder is, necessarily, unhappy in his sheltered has been, in this job, broken through the testimonies collected, establishing multiple perspectives of the analyzed subjects by their respective narrative records. Involving the participation of researchers with major in Administration, Communication and Law, this study filled, in this aspect, the requirements of the multidisciplinarity of the Program of Pos-Graduation in Health Science

Resiliência e velhice: um estudo de fatores de risco e de proteção na saúde do idoso

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

Análise das manifestações auditivas em individuos com hipertensão arterial sistêmica

Objective: To determine the prevalence of auditory manifestations in individuals with hypertension and analyze the association between hearing loss, systemic hypertension and quality of life in hypertensive patients. Method: This was a prospective, observational, case-control study, carried out from June 2010 to December 2013 at the University Hospital Onofre Lopes, in Natal, Brazil, which involved 120 patients of both sexes were analyzed with a diagnosis of hypertension and 120 patients without a diagnosis of hypertension. The audiological function was assessed by tonal and vocal audiometry. The quality of life was defines by the MINICHAL BRASIL questionnaire. Results: The prevalence of hearing loss was high in both groups (82.5 % and 75.8 %, in hypertension group and control, respectively, p=0.003). The sensorineural was the most common type of hearing loss (48.5 %) in hypertension group while conductive hearing loss was predominant (61.5 %) in the control group. There were no difference in the intensity of hearing loss between the groups (p=0,21). The main hearing complaint was hearing loss (51 %), followed by ear pain (14 %). There was worse quality of life in hypertensive individuals with hearing loss (p= 0.0001). Conclusion: Hypertensive individuals showed higher prevalence of auditory events, including hearing loss, sensorineural hearing loss is predominant . Hearing loss is associated with worse quality of life of hypertensive individuals even when these pressure values are within normal limits

Histórias de idosos: sementes para cultivarmos uam educação para uma velhice bem-sucedida

We understand that the successful old age is not confined only in the analysis of quantitative aspects concerning the economic situation of the subject that gets old, but this special way of aging is related to other values, such as dignity, happiness, self-esteem, willingness, autonomy, independence, social involvement with family and friends, among others. Thus, this study aimed to investigate the human aging process, considering the history of life of ten seniors who fit the profile of successful old age, seeking to identify elements that contribute to educational thinking in order to get a successful aging. In this perspective, we argue in this study, the idea that we need to learn to engage in experiences that more than providing satisfaction and well-being in the moment in which we conducted, serve as a potentiating to a successful old age. Thus, throughout this thesis we question: what are the present indicative in the histories of life of elderly people, considered successful, which may contribute to an education that people experiencing their age more satisfactorily. This is a qualitative study, that took as universe a methodological oral history, in which we used as a technique of research a semistructured interview as a part of their life history, with emphasis on consideration of the following categories: diary routine, with emphasis on social harmony in the family, at work and in friendship groups of leisure and physical activity, self-knowledge and the learning experiences throughout life. To get the objectives outlined, as well as lectured on the categories analyzed, we support our reflection on the theory of the course of life, which includes human aging as a historical and cultural contextual reality. Our research revealed, among other things, that successful aging is coupled to an active lifestyle, where the involvement in physical activities, recreational and social experiences throughout life is important for increasing self-esteem, autonomy and joy of living, conditions that enable successful old age. Our study also revealed that the educationfor successful old age is linked with the consumption along the life, educational activities which broaden the possibilities of social interaction between people, even among different generations, since the interaction is important to learn and accept our possibilities and limits.

Hipertensão arterial e fatores de risco em servidores atendidos pelo departamento de assistência da Universidade Federal do Rio Grande do Norte

Systemic arterial hypertension is a multifactorial disease that contributes to the country´s high cardiovascular morbi-mortality rates. Considering that hypertension affects individuals in their most productive age while facing work and living risk factors, it is important to investigate its occurrence and predisposing factors in different occupational segments. The objective of this study was to identify the prevalence of hypertension among workers attended to in a medical service of a public university, their hypertension levels, the risk factors present, and their knowledge of the factors that influence the arterial pressure. The epidemiologic study was conducted in the Health Department of the Federal University of Rio Grande do Norte with 102 workers that sought care in the medical clinic during the months of March to May 2009. Data were collected by means of a questionnaire and measurements of systolic and diastolic arterial pressure (SAP and DAP) that were classified in stages according to the Brazilian Society of Hypertension and the degree of risk for cardiovascular events according to the criteria of the Brazilian Society for Cardiology. Data were analyzed using descriptive statistics. The workers were, on average, 54 years of age; the majority (67%) was male and had primary or middle educational level; they worked mainly in supplemental units and deanship offices conducting different functions such as security guards, administrative assistants, health auxiliaries and constructions workers; 48 (47%) of the workers identified themselves as hypertensive for 8 years on average, with the majority executing hard labor and administrative functions. Among the workers with hypertension, the number of the pressure levels classified as pre-hypertensive, stage I and II were: (12% in the SAP and 20% in the DAP); (16% in the SAP and 9% in the DAP); and (15% in the SAP and 5% in the DAP), respectively. The workers that did not identify themselves as hypertensive presented classifications with greater frequencies were: normal (16% in the SAP and 30% in the DAP); and pre-hypertensive (21% in the SAP and 16% in the DAP). The risk factors identified in more than 50% of the workers were: tobacco smoking, alcohol consumption and indices of being overweight, although physical activities are also present. Of the 48 workers diagnosed as hypertensive, those that had 5 risk factors present and limitrophic pressure levels (12%), in stage I hypertension (16%) and stage II hypertension (15¨%) were categorized as being in high risk for vascular events. The number of workers that indicated they had knowledge of the factors that influence their hypertension was less than 39% for each factor. It is concluded that there is a high prevalence of systemic arterial hypertension in the university workers, even amongst those already under treatment. They constitute a population at risk considering their age group, their work functions, and their inadequate life habits. Health care of these hypertensive workers that seek attention in the Health Department is an important aspect of the internal workers health policy in the institution. Educational interventions are recommended for the improvement of quality of life and of work in these workers

Caminhos e descaminhos da adesão ao tratamento anti-hipertensivo :um estudo com usuários do Pacha (Programa de Assistência e Cuidado da Hipertensão Arterial) do Hospital Universitário Onofre Lopes

The high blood pressure is a multifactorial chronic disease which possesses emotional and social features in the illness appearance and evolution and in the adherence to the treatment which involves a decision-making through patient so that he or she process the necessary changes on harmful living habits. Adhesion, traditionally, it is referred to the patient to answer to the doctor orientations or of other health professional, about the appearance to the appointment with a doctor, about the use of medicine or lifestyle changes and maintaining this adhesion is the main problem to be overcame. It is expected the adhesion will ever be a continual, stable and satisfactory action, disregarding the complexity of subjectivity processes which permeate the sicken. This research aimed to investigate the difficulties which the person with high blood pressure has to adhere to the treatment, from the signification processes which give sense to the actions dealing with the adhesion. The study was carried out with 48 users of assistance program to the high blood pressure patient from Hospital Universitário from Natal RN, between 40-65 age. The answers were submitted to a double analysis process: 1) answer systematization in categories and codes and admission in statistical program SPSS (Statistical Package of Social Science), for generation of descriptive statistics; 2) Sense and signification analysis which permeated the deepener statement and interpretatively. The greater difficulties found are present on low-salt and law-calorie diets, in the dealing with everyday feeling and stress, being these factors cited as direct motive to the high blood pressure, regardless of interviewee s sex. It is observed there is not adhesion, but adhering, as an experienced everyday process. This work contributes with its results, assessing the used strategies by program with the aim of increasing the adhesion rates

Histórias de vida de mulheres idosas :um estudo sobre o bem-estar subjetivo na velhice

The elderly population growth in Brazil and in the world is an incontestable reality, arising from a significant declining rate in mortality and fertility, resulting from the remarkable improvements in the quality of life of the people. Associated with the introduction of new technologies in the medical area, these issues have been highly contributing for the increase of the population longevity. The numbers of the elderly in Brazil and in the world show female population predominance within the aging segment, a phenomenon known as the feminisation of the old-age . Aging, therefore, is nowadays one of the primary issues and that has been mobilizing the Brazilian s society, since the development raised from this new reality brought with it enormous challenges and complex social implications which are already felt in the daily lives of the societies. My work experience among some age groups has shown that aging is a much differentiated process which has instigated my interest in understanding why aging has to face an overwhelming and painful experience for some people and enriched and full of signification for others. Overviewing, this research aimed to understand the aging development through the analysis of the processes of signification and production of meaning that permeate the aging and the subjective well-being of three aged women participants of the Project Health and Citizenship on Third Age /CEFET-RN, that evidenced attitudes and behaviors concerning the integration and the activity toward the elderly population. The methodological strategy used was History of Life, starting from collecting data based on deep interviews. The analysis of data evidenced that the elderly well-being is a unique and distinct meaningful experience for each person, concerning each story of their lives within differentiated social, cultural, economic context, from this perspective one can demystify the concept of that aging occurs in a homogeneous way for everyone, everywhere and with the same rhythm. The narratives presented in this research showed the human development as being a dialectic, discursive and interactionist process which extends throughout the adult life and continues to the aging life. The guarantee that development and aging are a parallel phenomenon always in interdependence on the preceding phases of live, are corroborated within the studies. This present study confirms that the elderly population can be a phase of growth, personal realization and continued development, without disrespecting the heterogeneous and the subjectivity of the person who ages. Notifying those healthy and well-succeeded aging experiences, this issue has the intention to contribute to demystify the concept of aging as a social problem, illness needed to be treated, and the stereotypy of the elderly being dependent and unproductive

Impacto da hipertensão arterial no remodelamento ventricular, em pacientes com estenose aórtica

FUNDAMENTO: A hipertrofia ventricular esquerda (HVE) é comum em pacientes com hipertensão arterial sistêmica (HAS) e estenose aórtica (EAo) e, com certa frequência, encontramos associação entre estas patologias. Mas, em tal situação, não está clara a importância de cada uma na HVE. OBJETIVO: 1 - Avaliar em pacientes portadores de EAo, submetidos previamente a estudo ecocardiográfico, a magnitude da HVE, nos casos de EAo isolada e associada à HAS; 2 - Avaliar o padrão de remodelamento geométrico nas duas situações. MÉTODOS: Estudo retrospectivo, observacional e transversal, incluindo 298 pacientes consecutivos, com EAo ao ecocardiograma. HVE foi considerada para massa miocárdica > 224g em homens e > 162g em mulheres. Os pacientes foram classificados como portadores de EAo leve (gradiente máximo < 30,0 mmHg), moderada (entre 30 e 50,0 mmHg) e grave (> 50,0 mmHg), além disso, foram separados em dois subgrupos: com e sem HAS. RESULTADOS: Nos três níveis de lesão aórtica, a massa ventricular esquerda foi maior na EAo associada à HAS do que na EAo isolada (EAo leve: 172 ± 45 vs 223 ± 73g, p < 0,0001; EAo moderada: 189 ± 77 vs 245 ± 81g, p = 0,0313; EAo grave: 200 ± 62 vs 252 ± 88g, p = 0,0372). Presença de HAS esteve associada a maior risco de HVE (OR = 2,1,IC95%:1,2-3,6; p = 0,012). Pacientes com EAo grave e HAS apresentaram predomínio de hipertrofia concêntrica, quando comparados com aqueles normotensos (p = 0,013). CONCLUSÃO: em pacientes com EAo, a presença de HAS foi um fator adicional de aumento da massa ventricular esquerda, interferindo também na geometria ventricular.

Comunicação da equipe multiprofissional e indivíduos portadores de hipertensão arterial

O presente estudo tem como objetivos levantar dados sobre o que os indivíduos portadores de hipertensão arterial pensam sobre a sua doença e verificar a ocorrência do processo de comunicação entre estes e os profissionais que atuam junto aos mesmos. Foram entrevistados 66 clientes, obtendo-se 73 narrativas, constatando-se que a maioria (69 narrativas) dos participantes da pesquisa faz correlação com o conceito de hipertensão arterial, ainda que de maneira pouco elaborada. Apesar de 95% dos clientes fazerem alguma referência à doença, não significa que as orientações recebidas anteriormente foram aprendidas. Espera-se que o enfermeiro por desempenhar um importante papel dentro da equipe multiprofissional, identifique as possíveis barreiras relativas ao processo de comunicação, havendo daí a intervenção junto aos elementos que podem estar dificultando ou impedindo a compreensão necessária para que o cliente assuma seu autocuidado.