Indicadores de depressão e de declínio cognitivo em idosos institucionalizados: um estudo de caso

This case study objectified investigating the symptomatology prevalence for depression (DP) and cognitive decline (CD) on institutionalized elderly’s; verifying the existence of correlations between DP and CD with age, gender and scholarity; and analyzing the possible correlations between symptomatology for DP and CD. For the realization of this research were selected, in two Elderly’s Long-Permanence Institutions (ELPIs), 24 subjects, which were classified according to gender, scholarity and age group. To verify the occurrence of CD, the Mini Mental State Examination (MMSE) was applied and, for the incidence of DP, the Geriatric Depression Scale (GDS) was applied. The data were tabulated and descriptively analyzed. For the study of the relations between quantitative variables, the Pearson correlation test was utilized and also the Spearmann test when necessary; for the comparison between two independent groups, the Student's t-test was utilized; for the verification of the association between gender, scholarity, DP and CD indicatives, the Pearson's X2 test and, due to theoretical restriction, the Fisher's exact test were utilized. The level of 5% probability was adopted for the rejection of nullity's hypothesis on all the tests. The research demonstrated that 50% of the research' subjects presented DP indicatives and 54.2% presented CD indicatives. Associations between: gender and DP (p = 0.414), gender and CD (p = 0.219), scholarity and CD (p = 0.527) were not observed. Positive regular correlation was verified between age and DP (r = 0.557; p = 0.005) and negative regular correlation was verified between DP and CD (r = -0.406; p = 0.049). The data suggest that DP might be a reaction to CD perceived by the subject. However, the hypothesis that indicates DP as a risk factor for CD and DM cannot be overruled, which suggests the importance of monitoring and treating depressive episodes on elderly populations.

Estudo epidemiológico do perfil do idoso institucionalizado do interior paulista

The increase in the elderly population is a worldwide phenomenon and has different consequences not only in terms of health, but also in terms of economy. One of those consequences is the institutionalization. The understanding of this process, as well as of the reality of the institutionalized elderly is essential to develop policies of care. Goals: a) present the epidemiological profile of institutionalized elderly who live in institutions in the countryside of São PauloState and describe the development of an extension project implemented in two elderly-care institutions (IRLPI’s). Methods and procedures: data were collected in three forms, from which it was possible to verify: a) institutional data; b) social data and c) data about general and mental health. The data related to health were collected from the medication of continuous use. All data were launched into the database (Access) and subjected to the descriptive statistical analysis. Data related to mental health were confirmed from the application of clinical trials (Geriatric Depression Scale – GDS and Mini Mental State Examination: MMSE).

Efeito da injeção de adrenomedulina combinada ou não com glutamato no bulbo rostroventrolateral de ratos normotensos e espontaneamente hipertensos não anestesiados

O bulbo rostroventrolateral (RVL) é uma estrutura importante para o controle cardiovascular. Em ratos espontaneamente hipertensos (SHR), há evidências de que a transmissão glutamatérgica descendente do RVL aos neurônios pré-ganglionares simpáticos é maior quando comparada com os ratos Wistar Kyoto (WKY). A adrenomedulina (ADM) é um peptídeo de 52 aminoácidos que tem como funções: vasodilatação, broncodilatação e neurotransmissão no sistema nervoso central (SNC). Dados da literatura têm demonstrado que a ADM quando microinjetada no RVL de ratos normotensos anestesiados ou normotensos não anestesiados promove aumento da pressão arterial. Ademais, também já foi demonstrado que a microinjeção bilateral no RVL do antagonista de ADM (adrenomedulina 22-52) em SHR anestesiados foi capaz de reduzir significantemente a pressão arterial, enquanto que não foi observado alterações da pressão arterial em ratos normotensos. Uma vez que foi descrito que em SHR há um maior número de receptores de ADM no RVL quando comparado com ratos normotensos, esses dados obtidos são convergentes com a idéia de que maior número de receptores de ADM no RVL de SHR possam ser um dos fatores responsáveis pela hipertensão nestes animais. Entretanto, até o momento, não sabemos os efeitos da ADM no RVL de SHR não anestesiados, uma vez que a anestesia pode interferir com a resposta cardiovascular. Estudos anteriores demonstraram que o efeito pressor da ADM no RVL são dependentes de receptores glutamatérgicos, sugerindo uma interação entre a ADM e o glutamato (GLU). Assim, seria interessante estudar a interação entre ADM e a neurotransmissão glutamatérgica no RVL. Por isso, o presente estudo teve como objetivo estudar os efeitos da microinjeção de ADM no RVL e seu efeito sobre a resposta pressora do GLU em ratos normotensos e SHR conscientes... (Resumo completo, clicar acesso eletrônico abaixo)

Uso da morfina na analgesia de equinos

Pain control is an important aspect of equine medicine. Musculoskeletal and gastrointestinal diseases are the most important clinical and surgical painful situations in this specie. In these cases, opioids have been used successfully for the treatment of pain, administered both local (intra-articular and epidural) and systemically. Otherwise, opioids, specially mu agonists like morphine, present important side effects in horses. Amongst these effects, CNS stimulation with increased motor activity and impairment of intestinal motility are observed in several cases. Therefore, adequate dosing of administration are essential for the safe use of opioids in horses

Avaliação da eficácia da analgesia com acupuntura pela análise imuno-histoquimica da expressão de proteína C-Fos: estudo em modelo experimental de dor aguda em ratos

The behavior and experience of pain are characterized by alertness and anxiety, which disappear soon after the healing process begins. Based on this area, the present study aimed to quantify the expression of c-fos in segments of the brain of rats after surgical stimulation in one rear hind paw (analgesia), using anesthesia with sodium thiopental and practices of acupuncture pre and post operative. The animals were stimulated with intraperitoneal injections of solution (NaCl) 0.2% (2ml), and divided into three groups, control, preoperative and postoperative. Each treatment was divided in manual acupuncture (AM) and electroacupuncture (EA). The animals were randomly distributed in each group. The c-fos expression was quantitated using immunohistochemistry for all situations. The results showed a great efficiency of all treatment compared to the control group (p <0.001), thus reenforcing data in the literature on the potential of acupuncture analgesia. There were no statistical differences among the different treatments, although there was a trend of EA being more efficient than AM

Considerações anestésicas para realização da cirurgia de facoemulsificação em cães

Cataract is the leading cause of blindness in dogs. It is defined as an opacity in the lens and is independent of resulting visual deficit. Although there are a growing number of studies related to drug therapy of cataract, the treatment is still considered exclusively surgical. Among the techniques used to remove cataract, phacoemulsification is the best performer. Anesthesia in intraocular surgery has several peculiarities, which are essential to successfully conduct phacoemulsification in dogs. In these patients, a safe and effective anesthesia requires the maintenance of intraocular pressure close to normal, preventing the activation of the oculo-cardiac reflex and complete immobilization of the eye. The appropriate conditions for such surgical procedures can be established through the use of drugs from different pharmacological groups for premedication, induction and maintenance of anesthesia, making a balanced anesthesia. This work was compiled from a careful review of the literature on anesthesia in cataract surgery. Considerations on the pre-medication, induction and maintenance of anesthesia are discussed, aiming to contribute to the phacoemulsification becomes more safe and suitable for the anesthesiologist and the surgeon as well as comfortable for dogs undergoing surgery

Comparando a eficácia da manta térmica com método de aquecimento passivo na prevenção de hipotermia

Hypothermia is a common phenomenon in the perioperative period, and it affects 60 to 90% of patients submitted to anesthetic-surgical procedures. In order to minimize its incidence, warming methods are used. Such methods can be passive, such as orthopedic cotton, sheets and blankets, or active, such as warm-air blankets and thermal mattresses. In this scenario, the present study aimed at comparing two warming methods used in the intraoperative period. Patients submitted to abdominal surgery in the specialties of gynecology and gastric surgery from August to September 2010 were included in the study. After randomization, they were divided into two groups: one using a thermal blanket (group I) and one using orthopedic cotton (group II). At last, 9 patients were included. The variables for each question were considered according to occurrence frequency. Comparison between groups was performed by Student’s t test. With the purpose to analyze whether there was an association, the chi-square test or Fisher’s Exact test was used. Whenever it was applicable for multiple comparisons, Tukey’s test was utilized; p values < 0.05 were considered to be statistically significant for analysis. The sample comprised 6 males and 3 females submitted to gynecological and gastric surgeries. Their mean age was 48 years for group I and 46.2 years for group II. A predominance of general anesthesia was observed. The time of permanence in the operating room ranged from 80 to 360 minutes. With regard to warming parenteral solutions, the procedure was performed on 5 patients, and infusion of warm solution into the abdominal cavity was performed on 50% of the sample. Concerning the warming method used, 5 patients used a thermal blanket. In view of the results presented, it was not possible to conclude which warming method should be used due to sample size

A interferência do estado de humor na melhora dos componentes da capacidade funcional em idosos

Mood States are feelings auto regulation deliver to individual better quality of life and healthy aging. The declines of the aging process can be minimized with the regular practice of physical activity and systematized. The objective of this study was to evaluate the effects of a dance program in mood states, depressive symptoms and functional capacity in elderly participants of PROFIT. METHOD: The sample was composed of 20 elderly people. The Training Group was formed by 15 elders who participated in a protocol of dance with duration of 1 hour, three times per week, for 12 weeks and the Control Group, composed of 5 elderly, did not attend any program of physical activity. The participants were evaluated by the List of States of Mind Reduced and Illustrated, Geriatric Depression Scale and the battery of tests of AAHPERD. For the mood states was used non-parametric analysis, according to the technique of Binomial Analysis. To compare the components of functional capacity between the groups was used analysis of variance for repeated measures two-way ANOVA and the level of significance was set at 5 %. RESULTS: The functional components remained favorable, highlighting Agility (pre = 21.03 ± 1.64 sec./ post = 18.63 ± 2.26 sec.) And aerobic endurance (pre = 495.94 ± 46.48 sec. / post = 448.01 ± 12.27 sec.). In the comparison between positive and negative functional levels and mood states showed no relationship between these variables, dealing with different aspects and has influence one another. The state post-dancing sessions mood in GT were more positive even for elderly patients with depressive symptoms even unproven statistically, depressive symptoms were maintained or reduced mostly. CONCLUSION: The dance practice maintains the functionality of components; modifies mood states to positive levels and reduces or prevents the onset of depressive symptoms and complications in elderly

Efeitos do Square Stepping Exercise nas capacidades funcionais e funções executivas em frequentadores do Centro do Idoso de Rio Claro - SP

With aging process, there is a natural biological decline that eventually may lead to a functional and cognitive decrease. It is important that older people preserve these functions so they can live an independent life. Some declines in old people who attend Geriatric Day-Care tend to be more severe and recurrent. The Square Stepping Exercise (SSE) is a program created by Shigematsu & Okura (2006), in order to improve the balance of its practitioners, thereby decreasing the risk of falls. It is also believed that the SSE stimulates cognition, and thus, executive functions. The present study, with a longitudinal design, evaluated the effects of SSE in balance performance and executive functions of elderly from the “Centro-Dia do Idoso Padre Casagrande” from Rio Claro – SP. A group of 15 people (GT, n = 15), which performed a four month SSE intervention, and a control group (GC; n = 17) answered the following evaluations.: Questionnaire Registration Data and Anamnesis, Questionnaire Baeck Modified for Elderly, Mini-Mental State Examination, Modified Card Sorting Test, Geriatric Depressive Scale, Questionnaire Pfeffer for Instrumental Activities, Berg Balance Scale and Time Up and Go Test. Although significant improvements have not been observed in GT, the results showed a decline in instrumental activities performance in GC, as well as maintenance in executive functions and balance, and also an improvement in depressive symptoms in GT. This way, Square Stepping Exercise can be considered an activity that helps maintaining functional capacity, among them balance, and executive function in elderly people.

Mensuração e análise do ph salivar em pacientes com hiperidrose submetidos a cirurgia de simpatectomia videotoracoscópica

The study was performed to verify if there are changes in salivary pH in patients with hyperhidrosis who were treated by Videothoracoscopic Sympathectomy. Twelve patients underwent sympathectomy with clamping the sympathetic chain along the vertebrae T2, T3 and T4, under inhalation and intravenous general anesthesia and with drainage of pneumothorax through probe N° 16. These patients had their saliva collected 1 day before and 7 days after surgery for measurement of pH by the colorimetric method with indicator paper. All patients showed no sign or symptom of hyperhidrosis in the immediate postoperative period, which demonstrates the success of sympathetic denervation on these levels. No patient had compensatory sweating and there was no post-operatively surgical complication. No drug or substance has been administered to patients for the study. The pH results obtained were analyzed using test ´´t´´ Student. Although the average pH in samples obtained after surgery was lower than the preoperative, the test revealed no statistically significant difference (p = 0.181). It is concluded that sympathectomy, an excellent therapeutic and definitive method for hyperhidrosis, does not alter the salivary pH, and so, did not influence the cariogenic process

Associações neuroleptoanalgésicas em equinos

The equine anesthesia is proven to be a high risk procedure, for both patient and anesthetist, compared to other animal species. In these conditions, a good anesthetic protocol that can deliver sedation, making access and manipulation easier, analgesia fair enough to realize cirurgical procedures, and minimal physiologic changes would be ideal. Since there aren’t any drugs suporting all these qualities, the Neuroleptoanalgesic Associations show themselves as a valuable technique to provide anesthetic quality and safety, possibly diminishing our drug of choice’s doses, therefore offering less fisiological changes and easier monetary access in some cases. This paper objective was to list all these associations found in literature, evaluating their advantages and practical applications

Avaliação das impedâncias em pontos de acupuntura

An experimental study in dogs was accomplished to evaluate impedances at the acupuncture points and the relative false points. According to the physics concepts and the Ohm’ Law, an electrical circuit was set up to determine the impedance. This circuit was introduced into three experiments in anesthetized dogs with needles at selected points. In the first two experiments, was applied an alternating tension with 200Hz frequency in the circuit and, in the last experiment, the frequency was increased to 10kHz, the tensions and electrical currents were measured between every pair of points for the all experiments. The impedances were calculated with the values obtained by experiments. The analysis of impedance values indicated that there is a coherent relation between the results and the applied frequencies in circuit, so just at high frequency condition admits the correct measurement of total impedance, therefore the last experiment gave the result which agreed with the theory, that the impedances at acupuncture points are lower than the impedances at false points

Alterações hepáticas em cães intoxicados experimentalmente por sementes de Crotalaria spectabilis

Pós-graduação em Medicina Veterinária - FCAV

Avaliação da viabilidade de cateter epidural totalmente implantado em equídeos

Pós-graduação em Cirurgia Veterinária - FCAV

Exercício físico, marcadores inflamatórios e genótipo da APOE em idosos com comprometimento cognitivo leve e idosos cognitivamente preservados

Pós-graduação em Ciências da Motricidade - IBRC