Made available in DSpace on 2015-04-14T13:53:48Z (GMT). No. of bitstreams: 1 438935.pdf: 99331 bytes, checksum: a10c49a5ae5179d2b8918c80e01ae2e7 (MD5) Previous issue date: 2011-05-31 / The study, using a descriptive, exploratory design, was developed in a case study approach and performed in a quanti-qualitative methodology with an interventional analysis in a longitudinal perspective. Its main objective was to analyze the effect of an errorless learning methodology in a program of digital inclusion workshops for aged people trying to find, therefore, arguments to confirm the thesis that the errorless learning technique supports computer-related learning in digital inclusion workshops for elderly people. The sample consisted of 25 elderly people divided in two groups (14/11), named Group 1 and 2, with mean age of 68 years. Concerning to the education level, 11 of them were graduates. It was observed that 13 people participating of group 1 had a computer and 11 from group 2 did. During the development of the intentional intervention tasks, data were collected through participant observation, perceiving the progress and difficulties of each student at every meeting and describing it in evaluation forms. Each operation developed was requested the same number of times so it was possible to observe which computer-related activities were more and less successful. Quantitative data contained in the evaluation forms and socio-demographic data from groups 1 and 2 were subjected to descriptive statistics treatment, the tests with inferential statistics analysis (two-way ANOVA followed by Tukey post hoc test, when necessary, and categorical data with the Chi-Square Test). The effects of methodological approach in the digital inclusion workshops on the learning process showed by the aged people were analyzed according to the Student t test for independent samples. The effect of digital inclusion workshops on cognitive aspects of the aged people who participated in this study was analyzed with the Student t test for independent samples. The measures have been presented by mean ? standard error, p<0,05 and it was considered significative, which means the method was efficient. In order to complement, qualitative data were analyzed according to the Analysis of Content proposed by Bardin demonstrating that the aged people appreciated the method and they felt included because they could learn without the fear of making a mistake. Self esteem increase, joy and sharing between colleagues were also observed among the participants. / O estudo, de car?ter explorat?rio-descritivo, foi desenvolvido na abordagem de um Estudo de Caso, adotando uma metodologia quanti-qualitativa, com a Interven??o de cunho longitudinal. Teve como objetivo geral analisar o efeito de uma metodologia de aprendizagem sem erro em Oficinas de Inclus?o Digital para idosos buscando, assim, argumentos para a confirma??o da tese de que a t?cnica de aprendizado sem erro auxilia no ensino de Inform?tica em Oficinas de Inclus?o Digital de idosos. A amostra foi constitu?da por vinte e cinco idosos, divididos em dois grupos (14/11), nomeados por Grupos 1 e 2, apresentando m?dia de idade de sessenta e oito anos, sendo que onze possuem curso universit?rio completo. Em rela??o ? Inform?tica, foi observado que treze idosos do Grupo 1 possu?am computador e onze do Grupo 2. Durante o desenvolvimento das atividades de Interven??o intencional, os dados foram coletados por meio de observa??o participante, acompanhando os progressos e as dificuldades de cada um dos alunos e pontuando, a cada encontro, em uma Ficha de Avalia??o de Rendimento. Cada opera??o desenvolvida foi solicitada com o mesmo n?mero de vezes e, dessa forma, foi poss?vel observar quais atividades de ensino em Inform?tica foram as que tiveram maior ?xito e/ou d?ficits. Os dados quantitativos da Ficha Informativa com os dados s?cio-demogr?ficos dos Grupos 1 e 2 receberam tratamento de Estat?stica Descritiva, com os Testes com an?lise de Estat?stica Inferencial (ANOVA seguida do teste post hoc de Tukey, quando necess?rio, e os dados categ?ricos com teste Qui-quadrado.). Os efeitos (n?mero de erros nas situa??es de teste) da abordagem metodol?gica das Oficinas de Inclus?o Digital sobre o aprendizado dos idosos foram analisados pelo teste t de Student para amostras independentes. O efeito das Oficinas de Inclus?o Digital nos aspectos cognitivos dos idosos que participaram delas com Teste t de Student para amostras (IN)dependentes. Todos os resultados foram expressos com m?dia + erro padr?o, p<0,05, sendo considerado que houve uma diferen?a significativa, isto ?, o m?todo mostrou-se eficaz. Complementarmente, os qualitativos com An?lise de Conte?do de Bardin, revelando que apreciaram o m?todo, sentiram-se inclu?dos, aprenderam sem temor, foi mais prazeroso trabalhar sem erro, pois ficaram sem receio de errar, melhora na autoestima, sentimentos de alegria e partilha com colegas.

Made available in DSpace on 2015-04-14T13:53:49Z (GMT). No. of bitstreams: 1 440855.pdf: 1485245 bytes, checksum: ff2f2be9961e9b5370d1793ebde1d602 (MD5) Previous issue date: 2012-07-13 / Introduction: the growth of the elderly population worldwide presents a challenge for active aging with quality of life. As a consequence of increased life expectancy, several organs of the human body age, including the skin. Therefore, the aging population is also a challenge for dermatologists, since the demographic transition also increases skin diseases and changes which need to be managed. This study is justified by the scarceness of epidemiological studies among us, regarding the prevalence of skin manifestations that affect the elderly and their importance as a foundation for the care of geriatric patients. Objectives: To study dermatological problems in elderly residents at a Long Stay Institution (LSI) and in those seen at an Outpatient Clinic and in a ward of a Geriatric Center of Reference in Porto Alegre, state of Rio Grande do Sul (RS), Brazil. Methods: cross-sectional, descriptive and analitcs study performed between August/2010 and May/2011. The people invited to participate in the study were all the elderly residents of a long-stay institution of Porto Alegre from August/2010 to October/2010, all the elderly patients of the Geriatrics Ambulatory of Hospital S?o Lucas from October 2010 to May /2011, and all the elderly hospitalized at the Geriatrics Unit Care of Hospital S?o Lucas from December/2010 to May/2011, 60 years old or over. Data on age, sex, race, schooling, associated illnesses and medications used were surveyed in the patients files. The elderly person or their representative was asked about the family history of skin diseases, and the dermatological manifestations were collected by dermatological exam (inspection and palpation), complemented by the dermatoscopic and histopathological exams when necessary. The descriptive analysis of the data was done by frequencies, means, medians and standard deviations. The Chi-square test was used to compare the frequencies of dermatological manifestations to the frequencies of demographic characteristics and to the frequencies of co-morbidities. Results: Three hundred and twelve elderly people participated in the study, 30.1% male and 69.9% female. The age varied from 60 to 103 years, the mean was 78.4 years (SD=8.9), and the median 79 years. Out of the total number, 60.9% were white, 55.0% had not completed elementary school, 94.6% had associated co-morbidities, and 94.2% used some kind of medication. One hundred and twenty-eight dermatological manifestations were observed, comprising skin, nail and hair changes. The mean number of dermatological manifestation per person was calculated as 18.5 (SD=3.7) and the margin of variation was from 7 to 28 manifestations per elderly person surveyed. Solar melanosis, guttate hypomelanosis, cherry hemangioma, longitudinal striae on the nails, wrinkles, melanocytic nevi, seborrheic keratosis, male androgenetic alopecia, cutaneous xerosis, telangiectasias, absent lunula, interdigital intertrigo of the toes, skin atrophy and poichilodermia were present in over 50% of the participants in this study. Actinic keratosis, white hair, hirsurtism, rhomboid skin, supraciliary madarosis, onycholysis, purpura, onicodystrophy, stellar scar, ochre dermatitis, acrochordon, dermatosis papulosa nigra, comedo and keratosis of the elbows and knees were present in 30 to 50% of the subjects in this study. Dilated pores, female androgenetic alopecia, hypertrichosis of the ears, seborrheic eczema, milium cysts, melasma, plantar callosities, different types of scar, plantar calluses, leukonychia, folliculitis and sebaceous hyperplasia were found in 10 to 30% of the elderly who participated in this study. Solar melanosis was the most prevalent manifestation (97.8%). Seborrheic keratosis (75.0%) was less prevalent among blacks (P=0.006) and in the elderly with DPOC (P=0.047). Cutaneous xerosis was present in 70.8% of the people researched. Guttate hypomelanosis (82?.7%), poichilodermia (50.3%), dilated pores (26.6%) and melasma (15.4%) were less prevalent in LSI (Long Stay Institutions for the Elderly) (P<0.001), and purpura (38.1%) was more frequent in hospitalization (P<0.001). Interdigital intertrigo of the toes (52.6%) occurred more frequently in males (P=0.001), in the brown and black races (P=0.001) and in those with diabetes (P=0.011). Actinic keratosis (46.5%) was more prevalent in the white race (P<0.001) and its prevalence increased with the older age groups (P<0.001). Most frequent ungueal changes were longitudinal striae (81.2%), more prevalent in the LSI (P<0.001), in males ((P=0.003), in the brown race (P=0.,032) and in the older age groups (P<0.001). Supraciliary madarosis (40.1%) was more prevalent in hospitalized patients (P=0.036), in the older age groups (P=0.001) and in those vascular encephalic accident (P=0.011) and pneumonia (P=0.002). Seborrheic eczema (22.4%) was more frequent in males (P<0.001) and in those with dementia (P=0.020). Plantar callosities (12.8%) were less prevalent in hospitalization (P=0.058) and in diabetes (P=0.022). On the other hand, plantar callosities (14.7%) were more prevalent in the Outpatient Clinic (P<0.001). Folliculitis (11.2%) was more prevalent in men (P<0.001). Sebaceous hyperplasia(10.6%) was more prevalent in elderly cancer patients (P=0.030). Conclusion: the variety of dermatological manifestations found in this study reminds one of the need to include skin care in the broad geriatric assessment and in integral care of the elderly. The presence of manifestations secondary to skin aging, infectious lesions, both pre-malignant and malignant, that can be prevented justify measures of Education for Health of the Elderly, for the caregiver, the health teams and the young age groups of the population Considering the skin manifestations observed, the high prevalence of ungueal involvement and the association between sebaceous hyperplasia and cancer in our work, it is suggested that further research be done in this field. / Introdu??o: o aumento da popula??o de idosos em todo o mundo, traz o desafio do envelhecimento ativo com qualidade de vida. Como consequ?ncia ao aumento da expectativa de vida, v?rios ?rg?os do corpo humano envelhecem, inclusive a pele. Logo, o envelhecimento populacional ? um desafio tamb?m enfrentado pelos dermatologistas, pois a transi??o demogr?fica aumenta as doen?as e altera??es cut?neas que necessitam ser manejadas. A escassez de estudos epidemiol?gicos em nosso meio sobre a preval?ncia das manifesta??es cut?neas que acometem o idoso e a import?ncia destes para embasar o atendimento ao paciente geri?trico justificaram a realiza??o desta pesquisa. Objetivos: estudar as manifesta??es dermatol?gicas em idosos residentes em uma Institui??o de Longa Perman?ncia para Idosos (ILPI) e naqueles atendidos no Ambulat?rio e na Interna??o de um Centro de Refer?ncia em Geriatria de Porto Alegre RS. M?todos: estudo transversal, descritivo e anal?tico, realizado entre agosto/2010 e maio/2011. Foram convidados todos os idosos residentes em uma ILPI de Porto Alegre no per?odo de agosto/2010 a outubro/2010, todos os idosos internados no ambulat?rio de refer?ncia em geriatria do Hospital S?o Lucas no per?odo de outubro/2010 a maio/2011 e todos os idosos atendidos na enfermaria geri?trica do Hospital S?o Lucas no per?odo de dezembro/2010 a maio/2011, com 60 anos de idade ou mais. Dados referentes ? idade, ao sexo, ? ra?a, ? escolaridade, ?s doen?as associadas e medica??es em uso foram pesquisados nos prontu?rios dos pacientes. O hist?rico familiar de doen?as de pele foi indagado ao idoso ou seu representante e as manifesta??es dermatol?gicas foram coletadas atrav?s do exame dermatol?gico (inspe??o e palpa??o) complementado pelos exames dermatosc?pico e histopatol?gico, quando necess?rio. A an?lise descritiva dos dados foi feita atrav?s de frequ?ncias, m?dias, medianas e desvios padr?es. Para compara??o das frequ?ncias das manifesta??es dermatol?gicas, com as frequ?ncias das caracter?sticas demogr?ficas e com as frequ?ncias das comorbidades foi utilizado o teste do qui quadrado. A pesquisa iniciou ap?s aprova??o pelo Comit? de ?tica e Pesquisa e os idosos ingressaram no estudo ap?s concord?ncia e assinatura do Termo de Consentimento Livre e Esclarecido. Resultados: participaram da pesquisa 312 idosos (103 da ILPI, 104 do Ambulat?rio e 105 da Interna??o), 30,1% do sexo masculino e 69,9% do feminino. A idade variou dos 60 aos 103 anos, sendo a m?dia de 78,4 anos (DP=8,9) e a mediana de 79 anos. Do total, 60,9% eram brancos, 55,0% n?o haviam completado o n?vel fundamental, 94,6% apresentavam doen?as associadas e 94,2% usavam algum tipo de rem?dio. Foram observadas 128 manifesta??es dermatol?gicas, compreendendo altera??es de pele, unhas e pelos. Calculando-se a m?dia do n?mero de manifesta??es dermatol?gicas por idoso, seu valor foi de 18,5 (DP=3,7) e a margem de varia??o de 7 a 28 manifesta??es dermatol?gicas por idoso pesquisado. Melanose solar, hipomelanose gotata, nevo rubi, estrias longitudinais das unhas, rugas, nevos melanoc?ticos, ceratose seborreica, alopecia androgen?tica masculina, xerose cut?nea, telangiectasias, aus?ncia de l?nula, intertrigo interdigital dos podod?ctilos, atrofia cut?nea e poiquilodermia estiveram presentes em mais de 50% dos participantes deste trabalho. Ceratose act?nica, can?cie, hirsutismo, pele romboidal, madarose supraciliar, onic?lise, p?rpura, onicodistrofia, cicatriz estelar, dermatite ocre, acroc?rdon, dermatose papulosa nigra, comed?o e ceratose de cotovelos e joelhos estiveram presentes entre 30 e 50 % dos sujeitos deste estudo. Poros dilatados, alopecia androgen?tica feminina, hipertricose das orelhas, eczema seborreico, cistos de millium, melasma, calosidades plantares, diferentes tipos de cicatrizes, calos plantares, leucon?quia, foliculite e hiperplasia seb?cea foram constatadas entre 10 e 30 % dos idosos que fizeram parte desta pesquisa. Melanose solar foi a manifesta??o mais prevalente (97,8%). Ceratose seborreica (75,0%) foi menos prevalente na ra?a negra (P=0,006) e nos idosos com DPOC (P=0,047). Xerose cut?nea esteve presente em 70,8% dos pesquisados. Hipomelanose gotata (82,7%), poiquilodermia (50,3%), poros dilatados (26,6%) e melasma (15,4%) foram menos prevalentes na ILPI (P<0,001) e a p?rpura (38,1%) foi mais frequente na Interna??o (P<0,001). Intertrigo dos podod?ctilos (52,6%) foi mais frequente nos homens (P=0,001), nas ra?as parda e negra (P=0,001) e naqueles com diabetes (P=0,011). Ceratose act?nica (46,5%) foi mais prevalente na ra?a branca (P<0,001) e aumentou sua preval?ncia de acordo com o aumento das faixas et?rias (P<0,001). As altera??es ungueais mais frequentes foram as estrias longitudinais (81,2%), mais prevalentes na ILPI (P<0,001), no sexo masculino ((P=0,003), na ra?a parda (P=0,032) e nas faixas et?rias mais altas (P<0,001). Madarose supraciliar (40,1%) foi mais prevalente na interna??o (P=0,036), nas faixas et?rias mais altas (P=0,001) e naqueles com AVE (P=0,011) e pneumonia (P=0,002). Eczema seborreico (22,4%) foi mais frequente no sexo masculino (P<0,001) e naqueles com dem?ncia (P=0,020). Calo plantar (12,8%) foi menos prevalente na Interna??o (P=0,058) e no diabetes (P=0,022), j? a calosidade plantar (14,7%) foi mais prevalente no Ambulat?rio (P<0,001). Foliculite (11,2%) apresentou maior preval?ncia nos homens (P<0,001). A hiperplasia seb?cea (10,6%) foi mais prevalente nos idosos com c?ncer (P=0,030). Conclus?o: a variedade de manifesta??es dermatol?gicas presentes nesta pesquisa remete ? necessidade de inserir o cuidado com a pele na avalia??o geri?trica ampla e no atendimento integral ? sa?de do idoso. A presen?a de manifesta??es secund?rias ao envelhecimento cut?neo, les?es infecciosas, pr?-malignas e malignas pass?veis de preven??o justificam medidas de Educa??o para a Sa?de ao idoso, ao cuidador, ?s equipes de sa?de e ?s faixas et?rias mais jovens da popula??o. Face ?s manifesta??es dermatol?gicas observadas, ? elevada preval?ncia de acometimento ungueal e ? associa??o entre hiperplasia seb?cea e c?ncer em nosso trabalho, sugere-se a realiza??o de futuras pesquisas nesta ?rea.

Made available in DSpace on 2015-04-14T13:53:54Z (GMT). No. of bitstreams: 1 447324.pdf: 2395700 bytes, checksum: bd85bcda4b76779315b4d5d7fb97f4f1 (MD5) Previous issue date: 2013-01-11 / The prevalence of metabolic syndrome (MS) has a wide range depending on the population and the diagnostic criteria used. MS is characterized by alterations in glucose metabolism, obesity, hypertension and dyslipidemia. Regarding bone mass, the higher the peak reached by the individual, the greater your reservation calcium for the period of aging and lower your susceptibility to fractures. This study aimed to describe bone mass and assess its relationship with the metabolic syndrome and vitamin D levels in indigenous middle-aged and elderly in rural areas of southern Brazil. This is a cohort study, cross-sectional, descriptive and analytical. Participated in the study, 73 Indians aged 40 or older in the municipality of Nonoai, RS, Brazil. The prevalence of MS was estimated by applying the diagnostic criteria recommended by the National Cholesterol Education Program - Adult Treatment Panel III. Biochemical tests were performed to determine the levels of total cholesterol, HDL cholesterol, blood glucose and TGL and vitamin D. Were also obtained anthropometric data and dietary data through a questionnaire frequency of food intake. The evaluation of bone densitometry was performed by the regions of the spine and femur. The prevalence of MS was 56 (76.7%) being more prevalent in females. Regarding bone mass observed that the major changes were located in Column 46 (63%). With respect to the femur bone, only 19% of subjects analyzed had abnormal. With respect to serum levels of vitamin D found that 49 (67.1%) were altered When the criteria for SM were compared with changes in bone mass was not significant, however HDL values were related to reductions in the levels of Vitamin D. Regarding food frequency, there was an association between bone mass, SM and serum vitamin D in thier adding salt to food. We observed a significant relationship between intake of fatty foods and meat with SM and altered levels of vitamin D. It is believed that the health education of individuals with bone changes associated with MS is the best way to control this problem, since it promotes its suitability for Indian culture and motivation to change habits in order to improve quality of life. / A preval?ncia da s?ndrome metab?lica (SM) tem ampla varia??o dependendo da popula??o e do crit?rio de diagn?stico utilizado. A SM ? caracterizada por altera??es no metabolismo glic?dico, obesidade, hipertens?o e dislipidemia. Em rela??o ? massa ?ssea, quanto maior o pico atingido pelo indiv?duo, maior ser? a sua reserva de c?lcio para o per?odo do envelhecimento e menor ser? a sua suscetibilidade a fraturas. A presente pesquisa teve por objetivo descrever a massa ?ssea e a avaliar sua rela??o com a S?ndrome Metab?lica e n?veis de vitamina D em ind?genas de meia idade e idosos do meio rural do sul do Brasil. Este ? um estudo transversal, descritivo e anal?tico. Participaram do estudo, 73 ind?genas com 40 anos de idade ou mais do munic?pio de Nonoai, RS, Brasil. A preval?ncia da SM foi estimada aplicando-se os crit?rios diagn?sticos preconizados pelo National Cholesterol Education Program - Adult Treatment Panel III. Foram realizados testes bioqu?micos para determina??o dos n?veis de colesterol total, colesterol HDL, glicemia e triglicer?deos e vitamina D. Foram tamb?m obtidos dados antropom?tricos e dados da dieta por meio da aplica??o de um question?rio de freq??ncia de ingest?o de alimentos. A avalia??o da massa ?ssea foi realizada por densitometria das regi?es da coluna e f?mur. A preval?ncia da SM foi em 56 (76,7%) sendo mais prevalente no sexo feminino. Em rela??o ? massa ?ssea, observou-se que as principais altera??es localizavam-se na coluna 46 (63%). Com rela??o ? massa ?ssea do f?mur, apenas 19% dos indiv?duos analisados apresentavam altera??es. Em rela??o aos n?veis s?ricos de vitamina D, observou-se que 49 (67,1%) estavam alterados Quando os crit?rios para SM foram comparados com altera??o de massa ?ssea n?o houve signific?ncia, entretanto os valores de HDL estavam relacionados com redu??es nos n?veis de vitamina D. Em rela??o ? freq??ncia alimentar, houve uma associa??o entre massa ?ssea, SM e n?veis s?ricos de vitamina D em rela??o ? adi??o de sal nos alimentos. Observou-se rela??o significativa entre a ingest?o de alimentos gordurosos e carne com a SM e com n?veis alterados de vitamina D. Acredita-se que a educa??o para a sa?de dos indiv?duos portadores de altera??o de massa ?ssea associada a SM seja o melhor caminho para o controle desse problema, desde que se promova a sua adequa??o para a cultura ind?gena e a motiva??o para mudan?as de h?bitos visando ? melhora da qualidade de vida.

Made available in DSpace on 2015-04-14T13:53:56Z (GMT). No. of bitstreams: 1 447890.pdf: 8825285 bytes, checksum: 2f13c7fbfd2c35d22260ef80079c2bf9 (MD5) Previous issue date: 2013-02-26 / Population aging is a global phenomenon that occurs more rapidly in developing countries like Brazil. As a consequence, there is the increased frequency of health problems characteristic of the elderly, including mental disorders. Depression is the most common psychiatric illness among the elderly. This pathology can achieve different levels of severity, from mild to the most severe and associated with suicide. Older individuals are at higher risk of suicide than any other population. The aim of this study is to evaluate ideation, attempts and risks of suicide in a random sample of the elderly attended by the Family Health Program of Porto Alegre. A prospective cross-sectional study was conducted. The sample consisted of 530 randomly selected older people from 27 Family Health Teams in the city of Porto Alegre (FHT/POA) drawn in a stratified manner by the "Health Districs". Diagnosis was made by psychiatrists experienced in evaluating the elderly and using the Brazilian version of the Mini International Neuropsychiatric Interview (M.I.N.I 5.0.0 plus). The results showed a total of 15.7% (n=83) of the elderly sample presented a risk of suicide. Of this total 10% (n = 53) had low risk, 0.8% (n = 4) moderate risk, and 4.9% (n = 26) high risk. Among the subjects who were at risk for suicide a few significant associations can be highlighted: female (19.5%, P <0.001), not having income (34.1%, P = 0.022) and loss of one or more children (22.6%, P = 0.007). Regarding the mood it was found that 59.2% (n=45) of those individuals with current unipolar depression presented a suicide risk, whilst 62.5% (n=5) with current bipolar disorder and 33.3% (n=8) with a past history of this disease also presented a risk of suicide. A high rate of suicide risk was found by this study in the elderly population living in the community of Porto Alegre. Increased mental distress was noted in the evaluated individuals and it was possible to identify predictive factors for suicide risk through the analyses performed. The findings of this study are worrying, being necessary to be replicated in other localities and samples. Even so, the results cited clamor for urgency in promoting the treatment of mental disorders and suicide risk, especially those specializing in the elderly. / O envelhecimento populacional ? um fen?meno mundial que ocorre de forma mais acelerada em pa?ses em desenvolvimento como o Brasil. Em consequ?ncia disso h? um aumento da frequ?ncia de problemas de sa?de caracter?sticos do idoso, entre eles os transtornos mentais. A depress?o ? a doen?a psiqui?trica mais frequente entre idosos. Esta patologia pode alcan?ar diferentes n?veis de gravidade, desde o leve at? o mais severo e associado ao suic?dio. Pessoas idosas t?m risco mais alto para suic?dio do que qualquer faixa et?ria. O objetivo do presente estudo ? avaliar idea??o, tentativa e risco de suic?dio em uma amostra aleat?ria de idosos atendidos pela Estrat?gia Sa?de da Fam?lia de Porto Alegre. O estudo ? do tipo transversal com coleta prospectiva. A amostra constituiu-se de 530 idosos randomicamente selecionados de 27 Equipes de Sa?de da Fam?lia do Munic?pio de Porto Alegre (ESF/POA) sorteadas de modo estratificado por Ger?ncia Distrital. Para os diagn?sticos, psiquiatras com experi?ncia na avalia??o de idosos utilizaram a vers?o brasileira do Mini International Neuropsychiatric Interview 5.0.0 plus (M.I.N.I. 5.0.0 plus). Em rela??o aos resultados: um total de 15,7% (n=83) dos idosos da amostra apresentaram risco de suic?dio. Desse total, 10% (n=53) obtiveram risco baixo de suic?dio, 0,8%(n=4) risco moderado e 4,9%(n=26) risco alto. Dentre os idosos que estavam com risco de suic?dio algumas associa??es significativas podem ser destacadas: sexo feminino (19,5%; P<0,001), n?o ter renda (34,1%; P=0,022) e perda de um ou mais filhos (22,6%; P=0,007). Com rela??o ao humor, verificou-se que 59,2% (n=45) dos indiv?duos com depress?o unipolar atual apresentaram risco de suic?dio. 62,5% (n=5) com transtorno bipolar atual estavam com risco de suic?dio assim como 33,3% (n=8) dos indiv?duos com transtorno bipolar no passado. Neste estudo foi encontrado uma alta taxa de risco de suic?dio em idosos que vivem na comunidade de Porto Alegre. Notou-se elevado sofrimento mental nestes indiv?duos avaliados e foi poss?vel identificar fatores preditores do risco de suic?dio atrav?s das an?lises realizadas. Os achados do presente trabalho s?o preocupantes, sendo necess?rio serem reproduzidos em outras localidades e amostras. Mesmo assim, os resultados citados clamam pela urg?ncia na promo??o do tratamento de transtornos mentais e do risco de suic?dio, em especial, aquele especializado em idosos.

Made available in DSpace on 2015-04-14T13:54:00Z (GMT). No. of bitstreams: 1 447976.pdf: 2294372 bytes, checksum: a52f283ed02e58ab228b1bcf5bd75ef1 (MD5) Previous issue date: 2013-03-27 / Population aging is a reality in all over the world, and aging increases the chance of developing urinary incontinence in women, so it is important to study effective therapeutic strategies and non-invasive for this growing population. The objectives of this study were: review the literature available regarding electrical stimulation and urinary incontinence, and examine the short-and long-term efficacy of transcutaneous tibial nerve electrical stimulation for the treatment of urge urinary incontinence in elderly women. We performed: a systematic review and a randomized clinical trial with 101 older women (> 60 years) with urge incontinence, followed by a cohort study with 50 who had improved after the initial therapy. The systematic review included 30 randomized studies that reported good results for intravaginal electrical stimulation for urge urinary incontinence, tibial nerve electrical stimulation and sacral stimulation in patients refractory; other therapies require further data. The 101 participants were treated with 12 weeks of bladder retraining and pelvic floor muscles training , and 51 were randomly selected to also receive electrical stimulation. The cases were evaluated by 3-day voiding diary, the Kings Health Questionnaire (KHQ) (scale of quality of life related to incontinence), the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and clinical data. The study population had a mean age of 69 years, clinical characteristics, the frequency of urinary incontinence and quality of life before treatment were similar between groups. Both groups showed significant improvement in ICIQ-SF in most KHQ domains, and clinical parameters. However, there was significantly improvement in the group treated with electrostimulation in all domains of the KHQ and ICIQ-SF. Throughout the follow-up, patients who relapsed in the group with electrostimulation, had good results in the repetition of therapy. Electrical stimulation techniques require more randomized trials to establish the benefit of each one for urinary incontinence. Our study showed that the tibial nerve transcutaneous electrical stimulation is safe, effective and durable in elderly patients with urge urinary incontinence. It should be considered the first line therapy to this group of patients. / O envelhecimento populacional ? uma realidade em quase todo o mundo, e, o avan?o da idade aumenta a chance de mulheres desenvolverem incontin?ncia urin?ria, portanto, ? muito importante o estudo de estrat?gias terap?uticas efetivas e n?o-invasivas para esta popula??o cada vez maior. Os objetivos deste estudo foram: revisar a literatura dispon?vel em rela??o a eletroestimula??o e incontin?ncia urin?ria, e; examinar a efic?cia a curto e longo prazo da eletroestimula??o transcut?nea do nervo tibial, para o tratamento de incontin?ncia urin?ria de urg?ncia em idosas. Foram realizadas: uma revis?o sistem?tica, e, um ensaio cl?nico randomizado, com 101 mulheres idosas (> 60 anos) com incontin?ncia urin?ria por urg?ncia, seguido de um estudo de coorte com as 50, que melhoraram com a terapia proposta. A revis?o sistem?tica incluiu 30 estudos randomizados, que relataram bons resultados da eletroestimula??o intravaginal para incontin?ncia urin?ria de urg?ncia, para eletroestimula??o do nervo tibial e, para estimula??o sacral em pacientes refrat?rias, as demais terapias carecem de mais informa??es. As 101 idosas foram tratadas com 12 semanas de retreinamento vesical e exerc?cios de refor?o da musculatura do assoalho p?lvico, sendo que 51 foram selecionadas aleatoriamente para receber tamb?m a estimula??o el?trica. Os casos foram avaliados por: di?rio miccional de 3 dias, Kings Health Questionnaire (KHQ) (escala de qualidade de vida relacionada a incontin?ncia), International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) e dados cl?nicos. A popula??o em estudo tinha uma idade m?dia de 69 anos, as caracter?sticas cl?nicas, o n?mero de perdas urin?rias e a qualidade de vida antes do tratamento foram semelhantes entre os grupos. Ambos os grupos apresentaram melhora significativa no ICIQ-SF, na maioria dos dom?nios do KHQ, e nos par?metros cl?nicos. No entanto, houve melhora significativamente superior no grupo tratado com eletroestimula??o em todos os dom?nios do KHQ e no ICIQ-SF. Ao longo do seguimento, as pacientes que recidivaram no grupo com eletroestimula??o, tiveram bom resultado na repeti??o da terapia. As t?cnicas de eletroestimula??o necessitam de mais estudos randomizados para estabelecer o benef?cio de cada uma delas frente a incontin?ncia urin?ria. Nosso estudo mostrou que, a eletroestimula??o transcut?nea do nervo tibial ? segura, efetiva e duradoura, em pacientes idosas com incontin?ncia urin?ria de urg?ncia, podendo ser usada como primeira linha terap?utica neste grupo de pacientes.

Made available in DSpace on 2015-04-14T13:54:03Z (GMT). No. of bitstreams: 1 448881.pdf: 903023 bytes, checksum: d34f4f43110110f455f9c35eeac2bcaa (MD5) Previous issue date: 2013-03-20 / Individuals with spine cord injury are more vulnerable to bone loss due to reduced physical activity and lower sun exposure, which may reflect the values of parathyroid hormone (PTH) and vitamin D. Objective : Measure serum PTH, calcium and vitamin D in patients with spinal cord injury by trauma. Methods : Cross-sectional study in men with spinal cord injury of the Associa??o dos Lesados Medulares do Rio Grande do Sul (LEME) and Associa??o Canoense de Deficientes F?sicos (ACADEF), Brazil. It was applied a questionnaire with socioeconomic and health data, and the measurement of PTH, calcium and vitamin D. For data analysis we used the linear correlation and chi-square. Were significant p values &#8804; 0.05. Results : The mean age of participants was 35.52 ? 9.78 years. The mean time lesion was 6.09 ? 5.55 years (6.07 ? 5.87 for paraplegia and 6.17 ? 4.55 years for tetraplegia). The mean concentration for vitamin D was 19.04 ? 6.98 ng / mL (20.13 ? 7.18 for paraplegia ng / mL and 15.27 ? 4.92 for tetraplegia ng / mL). The serum total calcium was 9.54 ? 0.52 mg / dL, with no variation between individuals with paraplegia and tetraplegia. Mean levels of parathyroid hormone was 34.81 ? 10.84 pg / mL (33.43 ? 8.61 for paraplegia pg / ml and 39.59 ? 16.19 for tetraplegia pg / dL). Individuals with sun exposure more than 2 hours per day of vitamin D had higher values than those who were exposed to an hour per day (p = 0.001) and subjects with longer lesions showed lower values of vitamin D (p = 0.029). Conclusion : Vitamin D showed higher in subjects with a time of sun exposure greater than 2 hours per day and lowest in those with longer duration of spinal cord injury. The average value of vitamin D is in the range rated poor. / Indiv?duos com les?o medular s?o mais vulner?veis ? perda de massa ?ssea, devido ? reduzida atividade f?sica e menor exposi??o solar, o que pode refletir nos valores do paratorm?nio (PTH) e vitamina D. Objetivo : Mensurar valores s?ricos de PTH, c?lcio e vitamina D em portadores de les?o medular por trauma. Metodologia : Estudo transversal em homens portadores de les?o medular por traumatismo da Associa??o dos lesados medulares do Rio Grande do Sul (LEME) e Associa??o Canoense de Deficientes F?sicos (ACADEF), Brasil. Foi aplicado um question?rio com dados socioecon?micos e de sa?de, al?m da mensura??o de PTH, c?lcio e vitamina D. Para a an?lise dos dados foi utilizada a correla??o linear e o teste do Qui-quadrado. Foram significativos os valores de p&#8804;0,05. Resultados : A idade m?dia dos participantes foi de 35,52?9,78 anos. O tempo m?dio de les?o foi de 6,09?5,55 anos (paraplegia de 6,07?5,87 e tetraplegia de 6,17?4,55 anos). A concentra??o m?dia de vitamina D foi 19,04?6,98 ng/mL (paraplegia de 20,13?7,18 ng/mL e tetraplegia de 15,27?4,92 ng/mL). A concentra??o s?rica de c?lcio total foi de 9,54?0,52 mg/dL, n?o tendo varia??o entre os indiv?duos com tetra e paraplegia. Os n?veis m?dios de paratorm?nio foram de 34,81?10,84 pg/mL (paraplegia de 33,43?8,61 pg/mL e tetraplegia de 39,59?16,19 pg/dL). Indiv?duos com exposi??o solar superior a 2 horas por dia apresentaram valores de vitamina D mais elevados em rela??o aos que se expunham at? uma hora por dia (p=0,001) e sujeitos com maior tempo de les?o apresentaram valores de vitamina D mais reduzidos (p=0,029). Conclus?o : A vitamina D se mostrou mais elevada nos sujeitos com um tempo de exposi??o solar superior a 2 horas por dia e mais reduzida naqueles com maior tempo de les?o medular. O valor m?dio de vitamina D est? classificado na faixa deficiente.

Made available in DSpace on 2015-04-14T13:54:07Z (GMT). No. of bitstreams: 1 457202.pdf: 1618194 bytes, checksum: d607b65d131e6da9ab8169e51d5b048b (MD5) Previous issue date: 2014-03-05 / The growing population aging has led to several changes in the needs of the society where we live, requiring a better understanding on topics ranging from epidemiological transition to financial issues related to how to defray the expenses of this longevity. It is known that changes in age structure and the consequences of population aging increase the prevalence of chronic degenerative diseases, a process that leads to an increase in costs for health systems. The main purpose of this study was to associate costs of elderly hospitalizations with mean per capita household income in elderly's municipality of residence. The method was a cross-sectional study that assessed hospitalizations of elderly people living in the municipalities of Alvorada, Ivoti and Porto Alegre, Southern Brazil, and admitted at hospitals in the state of Rio Grande do Sul in 2011, based on data collected from SIH/SUS-DATASUS, a database created by the Brazilian Ministry of Health. These municipalities were selected for this study because they showed the greatest disparity in mean per capita household income among the municipalities belonging to their Regional Health Department. Using the tabulation tool named TABWIN, the following analysis parameters were selected: total number, frequency and length of hospitalizations. Such data were associated with socioeconomic and demographic data of the municipalities under study. Considering the overall amount of hospitalizations of elderly people living in the three municipalities analyzed, it was observed that inhabitants of Porto Alegre showed the lowest frequency of hospitalizations (11.15%), whereas their hospitalizations had the highest mean cost (1.896,19 BRL [Brazilian reais]). Inhabitants of Ivoti showed the highest frequency of hospitalizations (18.53%), with the lowest mean cost (R$ 1,001.10 BRL), whereas inhabitants of Alvorada had an intermediate frequency of hospitalizations (16.57%), with a mean cost of R$ 1,483.66 BRL. As for the association between healthcare costs and mean household income, Porto Alegre showed the highest income (1,722.37 BRL) and the highest per capita gross internal product (GDP), Ivoti had intermediate income (1,019.75 BRL) and per capita GDP, and Alvorada presented a significantly lower income (587.84 BRL). However, although Porto Alegre showed the highest per capita cost with hospitalization of its inhabitants (31.78 BRL), it assigned only 0.1% of its GDP to cover these expenses, whereas Alvorada had a per capita cost of 22.08 BRL, assigning 0.29% of its per capita GDP, and Ivoti showed the lower cost per capita (18.94 BRL) for covering elderly hospitalizations and also the lowest portion of its GDP per capita for this purpose (0.08%). The combination of demographic, socioeconomic, epidemiological, and morbidity and mortality data provides a more solid, critical and endorsed view for the construction of favorable or unfavorable opinions regarding health actions and the use of public resources. Additionally, it is important to develop data analysis and collection skills among health professionals and managers, in order to potentiate care so that it meets the actual needs of each municipality or region during decision making processes. / O crescente envelhecimento da popula??o vem trazendo consigo modifica??es das necessidades na organiza??o social em que vivemos, exigindo desde uma melhor compreens?o desta transi??o epidemiol?gica at? as quest?es financeiras que envolvem o custeio desta longevidade. Entende-se que as mudan?as na estrutura et?ria e as consequ?ncias do envelhecimento populacional tornam mais significativa a preval?ncia de doen?as cr?nico-degenerativas, processo esse que desencadeia crescentes custos para os sistemas de sa?de. Este trabalho teve como objetivo relacionar custos de interna??es hospitalares de idosos com a renda m?dia domiciliar per capita de seus munic?pios de resid?ncia. Trata-se de um estudo transversal com an?lise a partir dos elementos colhidos no banco de dados do SIH/SUS-DATASUS, de interna??es hospitalares de idosos residentes dos munic?pios de Alvorada, Ivoti e Porto Alegre, internados no ano de 2011 em hospitais do Rio Grande do Sul, selecionados por representarem a maior disparidade de renda m?dia domiciliar per capita, dentre os munic?pios de sua Coordenadoria Regional de Sa?de. Atrav?s do TABWIN foram selecionados como par?metros para as an?lises o valor total, frequ?ncia e tempo de perman?ncia das interna??es hospitalares. Tais dados foram relacionados aos dados socioecon?micos e demogr?ficos dos munic?pios em estudo. Considerando o montante global de todas as interna??es dos idosos residentes dos tr?s munic?pios em an?lise, verificou-se que os mun?cipes de Porto Alegre apresentaram a menor frequ?ncia de interna??es (11,15%), ao passo que suas interna??es obtiveram o maior custo m?dio (R$ 1.896,19). Os mun?cipes de Ivoti apresentaram a maior frequ?ncia de interna??es, no valor de 18,53%, com o menor custo m?dio, de R$ 1.001,10, enquanto que os de Alvorada apresentaram interna??es em frequ?ncia intermedi?ria (16,57%), com custo m?dio de R$ 1.483,66. Quanto ? rela??o de custos em sa?de com renda m?dia domiciliar per capita, Porto Alegre apresentou a maior renda (R$ 1.722,37) e o maior PIB per capita, Ivoti apresentou renda R$ 1.019,75 e PIB intermedi?rios e Alvorada apresentou a renda significativamente menor (R$ 587,84). Entretanto, apesar de Porto Alegre ter apresentado o maior custo per capita com as interna??es de seus mun?cipes (R$ 31,78), empenhou apenas 0,1% de seu PIB para suprir estes custos, enquanto o munic?pio de Alvorada apresentou custo per capita de R$ 22,08, empenhando 0,29% de seu PIB per capita, e Ivoti apresentou o menor custo per capita (R$ 18,94) para a cobertura de interna??es de seus idosos e tamb?m teve o menor consumo de seu PIB per capita com este objetivo (0,08%). O cruzamento de dados demogr?ficos, socioecon?micos, epidemiol?gicos e de morbimortalidade proporciona uma vis?o mais s?lida, cr?tica e respaldada para a constru??o de pareceres favor?veis ou desfavor?veis ?s a??es de sa?de e ? utiliza??o dos recursos p?blicos. Tamb?m o maior desenvolvimento da habilidade de coleta e an?lise desses dados ? algo que merece ser disseminado entre os profissionais e gestores em sa?de, em prol da potencializa??o do atendimento ?s reais necessidades de cada munic?pio ou regi?o durante processos decis?rios.

Made available in DSpace on 2015-04-14T13:54:09Z (GMT). No. of bitstreams: 1 458725.pdf: 1572953 bytes, checksum: f2c104cd687cfb91cfa59d0110257630 (MD5) Previous issue date: 2013-03-27 / Physical activity has great influence in health, taking part on a successful aging through physiological mechanisms, some of them not well known. Objective: Evaluate the effects of heart rate and blood lactate from a protocol of exercises in and outside the water on physically active elder, that practice hydrogymnastics and adminisrated or not cardiovascular medicines. Methods: longitudinal, observational, analytic and prospective study on elderly women who are sixty years old or more with 6 months practice of hydrogymnastic on the swimming school from Parque Esportivo da Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Brazil and that administrated cardiovascular medicine,other medicines or none. It was applied a roll of exercises in two rounds. One of them inside the water and other outside, each of them contained the practice of 18 exercises set on 3 rounds of 6 exercises, in which each round had three exercises of small amplitude (running, side-running, back-running) and three exercises of high amplitude (front Kick, side kick and anthero posterior kick). They were set on a music rhythm of 120 bpm, during 10 minutes and 30 seconds (no interruption). For the analysis, the Exato de Fischer test, test t student, Wilcoxon and Mann- Whitney. The level of significance was of 5%. Results: There participated 14 elder women average age from 67,29?4,61 years old (8 of them under the administration of cardiovascular medicines an average age of 68,73 ? 4 years old, 3 of them under administration of other medicines and average age of 66,33 ? 46,62 years old and 3 with no use of medicines and average age of 64,67? 1,97 years old ). There was a reduction of blood lactate on the cardiovascular group inside and outside the water of 3,92?1,27 to 2,42?0,92, respectively (p=0,023). there was no difference in HR inside and outside water from different medicine groups. Conclusion: The comparison between heart rate and lactate among elder women wether using or not medicines from cardiovascular field has shown no significative difference, even in or outside the water. The elder women that practiced exercises outside the water showed a rise on the blood lactate level significantly higher in relation to those who practiced exercises inside the water, even in the group that uses or doesn't use cardiovascular medicines. / A atividade f?sica influencia de forma importante na sa?de do ser humano participando de um envelhecimento bem-sucedido atrav?s de mecanismos fisiol?gicos, alguns ainda n?o bem conhecidos. Objetivo: Analisar o efeito de um protocolo de exerc?cios dentro e fora da ?gua na frequ?ncia card?aca e nos n?veis de lactato sangu?neo em idosas fisicamente ativas, praticantes de hidrogin?stica e que usam ou n?o f?rmacos cardiovasculares. M?todos: Estudo longitudinal, observacional, anal?tico e prospectivo com idosas de 60 anos ou mais com pelo menos 6 meses de pr?tica de hidrogin?stica na Escola de Nata??o do Parque Esportivo da Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS), Brasil, e que utilizassem f?rmacos da classe cardiovascular, outros f?rmacos ou nenhuma medica??o.Foi aplicado protocolo de exerc?cios em duas sess?es, uma fora e outra dentro da ?gua, cada uma com a execu??o de 18 exerc?cios divididos em tr?s blocos de seis exerc?cios, onde cada bloco teve tr?s exerc?cios de pequena amplitude (corrida ? frente, corrida lateral e corrida para tr?s) e tr?s exerc?cios de grande amplitude (chute ? frente, chute lateral e ?ntero-posterior). Foram aplicados com ritmo de uma m?sica em 120 batimentos por minuto, durante 10 minutos e 30 segundos (sem intervalos). Para a an?lise foi utilizado o teste Exato de Fisher, teste t de Student, Wilcoxon eMann-Whitney. O n?vel de signific?ncia foi de 5%. Resultados: Participaram 14 idosas com idade m?dia de 67,29?4,61 anos (8 com uso de f?rmacos cardiovasculares e idade de 68,73 ? 4 anos, 3 com uso de outros f?rmacos e idade de 66,33 ? 46,62 anos e 3 sem uso de nenhum f?rmaco e idade de 64,67? 1,97 anos). Houve uma redu??o do lactato sangu?neo no grupo cardiovascular dentro e fora da ?gua de 3,92?1,27 para 2,42?0,92, respectivamente (p=0,023). N?o houve diferen?a da FC dentro e fora da ?gua nos diferentes grupos de f?rmacos. Conclus?o: A compara??o da frequ?ncia card?aca e do lactato entre as idosas que usam ou n?o f?rmacos da classe cardiovascular n?o mostrou diferen?a significativa, tanto dentro quanto fora da ?gua. As idosas que realizaram exerc?cios fora da ?gua mostraram um aumento nos n?veis de lactato sangu?neo significativamente maiores em rela??o ?s idosas que realizaram exerc?cios dentro da ?gua, tanto no grupo que usa como no grupo que n?o usa f?rmacos cardiovasculares.

Made available in DSpace on 2015-04-14T13:54:09Z (GMT). No. of bitstreams: 1 458730.pdf: 3302398 bytes, checksum: f9c8f99debefb7449116d63c80509bb8 (MD5) Previous issue date: 2014-03-28 / Introduction: the cognitive decline (DC) has a multifactorial etiology. Some studies have suggested that inflammation, oxidative stress and physical activity are associated with the DC. However, evidence of this issue are still controversial. Objective: to compare and verify the association of inflammatory, redox metabolism markers and caloric expenditure between older people with and without cognitive deficit assisted by the Family Health Strategy of the municipality of Porto Alegre. Methods: Cross-sectional study. The sample consisted of 424 older adults (224 with normal cognitive function and 220 with cognitive impairment) patients of the Family Health Program in Porto Alegre, Rio Grande do Sul, Brazil. The variables investigated were: sociodemografia, biochemical markers, inflammatory (CRP, IL - 6) and oxidation (TBARS, AOPP and FRAP), energy expenditure and cognitive function. The instruments used were the following: for the assessment of physical activity was used the Minnesota Leisure Time Physical Activity Questionnaire and the measurement of energy expenditure (METs) Compendium of physical activities was used: classification of energy costs of human physical activities, and used for final analysis of the converted values in Kcal. For the assessment of cognitive ability Bateira one of neuropsychiatric instruments was applied. Results: significant statistical differences were observed between the groups with respect to biochemical, (except to HDL-C, p=0,006) inflammatory, oxidative and antioxidant power markers investigated. Statistical differences were found in age (p=0,002), IL-6 (p=0,020) and time spent in physical activity (< 0.001) with respect to energy expenditure in the elderly. No association was found between caloric expenditure and cognition (p=0,282). To do so, when considering the statistical treatment using logistic regression, this study showed only association of cognitive impairment with age and HDL-C. Conclusions: the results suggest that biochemical (except to HDL-C), inflammatory, oxidative, antioxidant power markers and energy expenditure are not associated with cognitive deficits in the older individuals. Only age and HDL-C were associated with cognitive impairment in this sample. / Introdu??o: o decl?nio cognitivo (DC) possui uma etiologia multifatorial. Alguns estudos t?m sugerido que a inflama??o, o estresse oxidativo e a atividade f?sica est?o associados ao DC. Todavia, as evid?ncias desta tem?tica ainda s?o controversas. Objetivo: comparar e verificar a associa??o de marcadores inflamat?rios, do metabolismo redox e gasto cal?rico entre idosos com e sem d?ficit cognitivo atendido pela Estrat?gia Sa?de da Fam?lia do Munic?pio de Porto Alegre. M?todos: estudo transversal. A amostragem foi composta de 424 idosos (224 com fun??o cognitiva normal e 220 com d?ficit cognitivo) pacientes da Estrat?gia de Sa?de da Fam?lia em Porto Alegre, Rio Grande do Sul, Brasil. As vari?veis investigadas foram: sociodemografia, marcadores bioqu?micos, inflamat?rios (PCR-us, IL-6) e oxidativos (TBARS, AOPP e FRAP), gasto energ?tico e fun??o cognitiva. Os instrumentos utilizados foram os seguintes: para a avalia??o de atividade f?sica foi utilizado o Minnesota Leisure Time Physical Activity Questionnaire e para a mensura??o de gasto cal?rico (METs) foi utilizado o Comp?ndio de atividades f?sicas: classifica??o de custos energ?ticos de atividades f?sicas humanas, sendo utilizados para an?lise final os valores convertidos em Kcal. Para a avalia??o de habilidade cognitiva foi aplicada uma bateira de instrumentos neuropsiqui?tricos. Resultados: diferen?as estat?sticas significativas n?o foram observadas entre os grupos com rela??o aos marcadores bioqu?micos (exceto para o HDL-C, p=0,006), inflamat?rios, oxidativos e poder antioxidante investigados. Foram encontradas diferen?as estat?sticas na idade (p=0,002), IL-6 (p=0,020) e tempo gasto em atividades f?sicas (< 0,001) com rela??o ao gasto cal?rico dos idosos. Nenhuma associa??o foi encontrada entre gasto cal?rico e cogni??o (p=0,282). Para tanto, quando considerado o tratamento estat?stico pela regress?o log?stica, este estudo evidenciou associa??o do d?ficit cognitivo apenas com idade e HDL-C. Conclus?es: os resultados sugerem que os marcadores bioqu?micos (exceto o HDL-C), inflamat?rios e oxidativos e o gasto cal?rico investigado n?o est?o associados com d?ficit cognitivo nos idosos. Somente a idade e o HDL-C foram associados ao d?ficit cognitivo nesta amostragem.

Made available in DSpace on 2015-04-14T13:54:10Z (GMT). No. of bitstreams: 1 459208.pdf: 2603710 bytes, checksum: 0d58cdef518906d2c275c3568d6b0dda (MD5) Previous issue date: 2014-03-28 / Introduction: With the increase of life expectation of individuals in Brazill and abroad, the number of elder in-patients also increases in hospital units and, consequently, in ICUs, the identification of risk factors being important to keep off compromising the elders who are assited in such units. Methods: The data collection was accomplished between December 2012 and June 2013, using the instrument constructed as from the pilot study and Katz scale. To analyse the data, we employed the SPSS programme, Pearson s chi-square test and Poisson s regression technique which estimates the relative risk, keeping the variables with p &#8804; 0.10 in the instrument and large biological plausibility. The death risk classification was elaborated throughout the use of the quartis analysis, confirmed by the ROC curve. The study was approved by CEP-PUCRS under the number 186.415. Results: Two hundred and five 74.6 mean-aged elders were included, with death rate being 59%. Out of the total sample and according to the scores, 16.6% of the elders had low risk, 23.9% showed moderate risk, 40% high risk and 19.5% of them showed very high risk. The predictive positive value of the instrument was 77% and the negative one was 67.5%, with concordance rate C = 0.78. The instrument cutoff point was &#8805; 9 points. Sensibility was 77.7% and specificity of 66.7%. For those individuals who remained in the ICU for up to 10 days, the survival rate was 69.8%, falling down to 46.6%, 22.4% and 10.7% for those who remained there for 20, 40 and 50 days respectively. Conclusion: The risk factors associated with the major death probability of elders kept in ICU were prior delirium, presence of neoplasies, use of vasoactive drugs, CF > 100beats/min, glycemia < 70mg/dl age band &#8805; 80 years, use of Venturi s mask or of mechanical ventilation as ventilating support, Glasgow comma scale, internment motive and ICU period of permanence > 6 days. The built-up instrument can be useful in the identification of aged individuals with risk factors who need better care, being therefore recommended to be applied in the ICUs. / Introdu??o: com o aumento da expectativa de vida dos indiv?duos no Brasil e no mundo, aumenta tamb?m o n?mero de interna??es de idosos em unidades hospitalares e, consequentemente, em UTIs, sendo importante a identifica??o dos fatores de riscos que podem comprometer o idoso que se interna nestas unidades. Objetivo: construir um instrumento de avalia??o progn?stica para idosos internados em unidade de terapia intensiva. M?todos: estudo de coorte, com coleta prospectiva, desenvolvido em quatro institui??es hospitalares da rede p?blica de sa?de do munic?pio de Jo?o Pessoa-Para?ba-Brasil, incluindo idosos com idade &#8805; a 60 anos. A coleta de dados foi realizada entre dezembro de 2012 e junho de 2013, utilizando-se o instrumento constru?do a partir do estudo piloto e a escala de Katz. Para a an?lise dos dados utilizou-se o programa SPSS, o teste qui-quadrado de Pearson e a t?cnica de regress?o de Poisson, que estima o risco relativo, mantendo-se no instrumento as vari?veis com p &#8804;0,10 e com grande plausibilidade biol?gica. Elaborou-se a classifica??o de risco de ?bito utilizando-se a an?lise dos quartis, confirmado pela curva ROC. O estudo foi aprovado pelo CEP-PUCRS, sob o n?mero 186.415. Resultados: foram inclu?dos 205 idosos, com m?dia de idade de 74,6 anos e mortalidade de 59%. Do total da amostra e de acordo com os escores, 16,6% dos idosos tinham risco baixo, 23,9% apresentaram risco moderado, 40% risco alto e 19,5% dos idosos, mostraram um risco muito alto. O valor preditivo positivo do instrumento foi de 77% e o negativo foi de 67,5%, com ?ndice de concord?ncia - C = 0,78. O ponto de corte do instrumento foi &#8805; 9 pontos. A sensibilidade foi de 77,7% e a especificidade de 66,7%. Para os indiv?duos que ficaram internados na UTI at? 10 dias, a taxa de sobreviv?ncia foi de 69,8%, caindo para 46,6%, 22,4% e 10,7%, para os que permanecem at? 20, 40 e 50 dias, respectivamente. Conclus?o: Os fatores de risco que se associaram ? maior probabilidade de ?bito em idosos internados em UTI foram: delirium anterior, presen?a de neoplasias, uso de drogas vasoativas, FC >100bat/min, glicemia <70mg/dl, faixa et?ria &#8805;80 anos, uso de m?scara de Venturi ou de ventila??o mec?nica invasiva como suporte ventilat?rio, escala de coma de Glasgow, motivo de interna??o e tempo de perman?ncia na UTI >6 dias. O instrumento constru?do pode ser ?til na identifica??o de indiv?duos idosos com fatores de risco que carecem de maiores cuidados, sendo, portanto, pass?vel de ser aplicado nas UTIs.