Made available in DSpace on 2015-04-14T13:53:50Z (GMT). No. of bitstreams: 1 443025.pdf: 11289589 bytes, checksum: 05cc051d121493a0aa28c429a097b2f6 (MD5) Previous issue date: 2012-08-23 / Introduction : Major depression is one of the most relevant mental disorders in elderly. Some authors propose that the distinction between cases of early-onset and late-onset major depression is justified by differences in etiology, clinical picture and comorbidities. Such differences are still not clarified enough, and some disagreement among studies does exist. Objectives : To investigate the distinctive characteristics between elderly with early-onset and late-onset major depression with respect to sociodemographic factors, self-perceived health, cardiovascular risk factors, cognitive deficit, family history of depression, depressive symptoms, melancholic features, suicide risk and alcohol abuse/dependence. Methods : Cross-sectional, descriptive and analytic study, with prospective data collection, in an aleatory sample of 348 elderly (≥60 years old) of the Health Family Strategy, of which were identified 90 cases of DSM-IV unipolar major depression; subjects were divided according to early or late (≥60) age at onset of depression. Results : The prevalence of major depression in the whole sample was 25,86%. Depressive subjects were mainly of early-onset (69,14%) and of female sex (74,4%); the mean age in years was higher in the late-onset major depression group (p= 0,028); the groups did not differ with respect to the other evaluated factors; after multivariate analysis there was a trend toward a negative association between suicide risk and late-onset depression. Conclusion : The early or late age at onset of depressive symptoms was not associated with distinctive profiles, neither with respect to clinical picture, nor with respect to the risk factors. The results of this paper give support to the hypothesis that early and late-onset major depressive disorders are clinically undistinguishable and do not represent distinct pathologies or subtypes. / Introdu??o : A depress?o maior ? um dos transtornos mentais mais relevantes em idosos. Alguns autores prop?em que a distin??o entre casos de depress?o maior de in?cio precoce e de in?cio tardio ? justificada por diferen?as na etiologia, quadro cl?nico e comorbidades. Tais diferen?as ainda n?o est?o bem esclarecidas, havendo discord?ncias entre os estudos. Objetivos : Investigar as caracter?sticas distintivas entre idosos com depress?o maior de in?cio precoce e de in?cio tardio quanto a fatores sociodemogr?ficos, autopercep??o de sa?de, fatores de risco cardiovascular, d?ficit cognitivo, hist?ria familiar de depress?o, sintomas depressivos, caracter?sticas melanc?licas, risco de suic?dio e abuso/depend?ncia de ?lcool. M?todos : Estudo transversal descritivo e anal?tico, de coleta prospectiva, em uma amostra aleat?ria de 348 idosos (≥60 anos de idade) da Estrat?gia Sa?de da Fam?lia, dos quais foram identificados 90 casos de depress?o maior segundo crit?rios do DSM-IV; os sujeitos foram divididos de acordo com a idade de in?cio precoce ou tardia (≥60 anos) da depress?o. Resultados : A preval?ncia de depress?o maior na amostra total foi de 25,86%. Sujeitos deprimidos na maioria dos casos foram do grupo de in?cio precoce (69,14%) e pertencentes ao sexo feminino (74,4%); a m?dia de idade em anos foi maior para o grupo com depress?o maior de in?cio tardio (p= 0,028); os grupos n?o diferiram quanto aos demais fatores avaliados; ap?s an?lise multivariada, houve uma tend?ncia de associa??o negativa entre risco de suic?dio e depress?o de in?cio tardio. Conclus?o : A idade de in?cio precoce ou tardio dos sintomas depressivos n?o esteve associada a perfis distintos, nem quanto ao quadro cl?nico, nem quanto a fatores de risco. Os resultados deste trabalho d?o suporte ? hip?tese de que a depress?o maior de in?cio precoce e a de in?cio tardio s?o indistingu?veis clinicamente e n?o representam patologias ou subtipos distintos.

Made available in DSpace on 2015-04-14T13:53:50Z (GMT). No. of bitstreams: 1 443857.pdf: 104654 bytes, checksum: d14d1ff631f377fd5683daa19fc320f5 (MD5) Previous issue date: 2012-08-30 / Introduction: The immune risk phenotype (IRP), as shown by increased CD8+ and low CD4+ T cell counts, and cognitive impairment have been associated with increased morbidity and mortality in very old subjects. Recent evidence suggests that persistent viral infections of the herpesviridae family such as cytomegalovirus (CMV) are likely to be involved with these specific T cell changes. This study aims to identify the IRP and investigate possible associations with viral infections, cognitive and functional states of elderly in Brazil. Material and Methods: 360 elders aged between 60-103 years were recruited from the public health care system in Porto Alegre, Brazil. Peripheral blood was collected and lymphocyte subsets (CD4+, CD8+, NK, NK T, B and CD8+CD28-) assessed by multi-color flow cytometry. CMV and Epstein-Barr virus (EBV) serologies were determined by ELISAs. Cognitive function was evaluated by the word list memory and constructional praxis from the standard neuropsychological battery of Consortium to Establish a Registry for Alzheimer s Disease and Mini Mental Status Examination (MMSE) inventory. PFEFFER Functional Activities Questionnaire was used to determine activities of daily living. Results: 59 individuals were defined with IRP (CD4/CD8 ratio < 1). Increased IgG titers to CMV (p<0.01) but not to EBV were found in the IRP+ group as compared to non-IRP. The IRP+ elders had a greater late-memory deficit (p<0.05) and more functional disability and dependency (p=0.01) when compared with the non-IRP group. Subjects with both IRP and cognitive impairment did not show synergist effects upon lymphocytes or viral serologies. Conclusions: The IRP was identified in 16% of the Brazilian community dwellers. Our data further indicate the association of CMV with IRP and both cognitive and functional disability/dependency during aging. / Introdu??o: O fen?tipo risco imunol?gico (IRP) tem sido demonstrado pelo aumento de c?lulas T CD8+ e baixa contagem de T CD4+, e o comprometimento cognitivo t?m sido associado com aumento da morbidade e mortalidade em idiv?duos muito velhos. Evid?ncias recentes sugerem que infec??es virais persistentes da fam?lia Herpesviridae como o citomegalov?rus (CMV) s?o mais propensos a desenvolverem estas altera??es nas c?lulas T espec?ficas. Este estudo visa identificar o IRP e investigar poss?veis associa??es com infec??es virais, e com o estado cognitivo e funcional em idosos do Brasil. Material e M?todos: 360 idosos com idades entre 60-103 anos foram recrutados a partir do sistema p?blico de sa?de em Porto Alegre, Brasil. O sangue perif?rico foi recolhido e os subconjuntos de linf?citos (c?lulas T CD4 +, CD8 +, c?lulas NK, NK T, B e CD8+CD28-) foram avaliados por citometria de fluxo. A sorologias para CMV e para o v?rus de Epstein-Barr (EBV) foram determinadas por ELISA. A fun??o cognitiva foi avaliada atrav?s da lista de palavras e praxia construtiva do Consortium to Establish a Registry for Alzheimer s Disease (CERAD), do teste de mem?ria verbal e l?gica de Wechesler, e do Mini Exame de Estado Mental (MEEM). O question?rio de Atividade Funcionais PFEFFER foi utilizado para determinar as atividades da vida di?ria. Resultados: 59 indiv?duos foram definidos com IRP. T?tulos aumentados de IgG para CMV (p <0,01), mas n?o para o EBV foram encontrados no grupo IRP+ grupo quando comparados ao grupo Non-IRP. Idosos com IRP+ apresentaram um maior d?ficit de mem?ria tardia (p <0,05) e maior depend?ncia e incapacidade funcional (p = 0,01) em rela??o ao grupo Non-IRP. Indiv?duos com IRP e com d?ficit cognitivo n?o demonstraram efeitos sin?rgicos sobre as popula??es de linf?citos ou sorologias virais. Conclus?es: O IRP foi identificado em 16% dos moradores de comunidades brasileira. Nossos dados ainda indicam uma importante associa??o do CMV com IRP e ambos com o estado cognitivo e funcional defici?ncia/depend?ncia durante o envelhecimento.

Made available in DSpace on 2015-04-14T13:53:51Z (GMT). No. of bitstreams: 1 443880.pdf: 7695566 bytes, checksum: a3397252a1694c7b91b7cd9a54df25b4 (MD5) Previous issue date: 2012-08-17 / HMGA overexpression, other than to be a feature of human malignant neoplasias, has a causal role in cell transformation. Then, the aim of our study has been to investigate the miRNAs regulated by the HMGA proteins in the process of cell transformation analyzing the miRNA expression profile of v-ras-ki oncogenetransformed thyroid cells expressing or not HMGA proteins. We demonstrate that, among the miRNAs regulated by cell transformation, there are miR-10b, miR-21, miR-125b, miR-221 and miR-222 that are positively and miR-34a and miR-603 that are negatively regulated, by HMGA expression. Then, we focused our attention on the miR-10b and miR-603 whose expression appeared to be dependent on the presence of the HMGA proteins also in other cell systems. We found that miR-10b is able to target the PTEN gene, whereas miR-603 targets CCND1 and CCND2 genes. Moreover, functional studies showed that miR-10b and miR-603 were able to regulate positively and negatively, respectively, cell proliferation and migration suggesting a role of their deregulation in thyroid cell transformation. / A super express?o das prote?nas HMGA (High Mobility Group A) al?m de ser uma caracter?stica de neoplasias humanas malignas tem uma papel essencial na transforma??o celular. O objetivo deste trabalho foi identificar os miRNAs associados as prote?nas HMGA no processo de transforma??o celular, analisando perfil de express?o de microRNAs (miRNAs) em c?lulas da tire?ide transformadas com o oncogene v-ras-ki, expressando ou n?o as prote?nas HMGA. Entre os miRNAs regulados pela transforma??o celular, observou-se que o miR-10b, miR-21, miR- 125b, miR-221 e o miR-222 s?o positivamente e o miR-34a and miR-603 s?o negativamente regulados pela express?o das prote?nas HMGA. Assim focamos nossa atencao no miR-10b e no miR-603 cuja express?o parece ser dependente da presen?a das prote?nas HMGA tamb?m em outros sistemas celulares. Igualmente, foi demonstrado que CCND1 e CCND2 s?o alvos do miR-603, e PTEN alvo do miR- 10b. Al?m disso, os estudos funcionais demonstraram que o miR-10b e o miR-603 s?o capazes de regular positiva e negativamente a prolifera??o celular e migra??o, sugerindo um papel da sua desregula??o na transforma??o de c?lulas da tire?ide.

Made available in DSpace on 2015-04-14T13:53:53Z (GMT). No. of bitstreams: 1 445300.pdf: 610047 bytes, checksum: b17944cdf4b2eeba31164303e8b9746a (MD5) Previous issue date: 2012-10-29 / Background : Physiological changes related to aging leads to nutritional deficiencies that may be aggravated by inadequate intake of nutrients in the diet and polypharmacy. Objectives : The paper 1 had the objective of analyzing the potential pharmacological interactions among drugs taken by elderly patients. The paper 2 aimed to determine the profile of nutrients consumption and the paper 3 proposed to associate the inadequate intake with nutrient depletion caused by drugs. Methods : A cross-sectional observational population based study was performed by the Institute of Geriatrics and Gerontology (IGG), PUCRS. We retrospectively analyzed the database provided by IGG composed of 512 elderly persons and epidemiologic indicators. In paper 1, drugs were classified using the Anatomical Therapeutic and Chemical Classification System (ATC). Drug-durg interactions and their severity were assessed using the software Micromedex? Healthcare Series. In the paper 2 dietary intake was assessed by the 24-hour food recall Survey and the Research Dietetic History. Nutritional composition of daily diet was calculated using the Nutwin software. In the paper 3 the amount of nutrients intake in daily diet was compared to Dietary Reference Intake (DRIs) for inadequate consumption analyses and it was considered inadequate values below the EAR (Estimated Average Requirement) and above the UL (tolerable Upper Intake Level). Drugs used were associated with inadequate intake nutrients depleted by such drugs. Results : Paper 1 showed a high prevalence of use of drugs by elderly with significant statistical difference between genders. Age group between 70 and 79 years old use more drugs than others. Paper 2 showed that men consumed more calories, protein, fiber, minerals and vitamins. Carbohydrate and calcium intake increase with advancing age, as well decreases zinc intake. Physical exercise has increased intake of calorie, magnesium, potassium and phosphorus. The higher education and family income increased intake of vitamins B complex. Paper 3 pointed that acetylsalicylic acid, hydrochlorothiazide and proton pump inhibitors are responsible for the most number of nutrients depletion. Furthermore, 97% of users of hypolipidemic enzyme inhibitor hydroxymethyl-glutaryl coenzyme A reductase have inadequate intake of vitamin E, 90% of potassium-sparing diuretic users have inadequate intake of magnesium, 83.3% of digoxin users have inadequate consumption of magnesium and 58.3% of inadequate for calcium and potassium; People that has used anti-ulcers H2 antagonists have 83.3% of inadequate of folate consumption. The analyses of hidroclorothiazide, acetylsalicylic acid and furosemide pointed 83.2%, 82.1% and 80% of respectively inadequate intake of potassium. Conclusions : The number of drugs used by elderly increases with age. Women are the largest users of drugs, as well as pointed higher number of nutrient deficiencies in daily diet. Drugs most commonly used are also involved in drug interactions and responsible for depletion of several micronutrients that showed a high prevalence of inadequate intake by elderly / Introdu??o : Altera??es fisiol?gicas decorrentes do envelhecimento levam o idoso a defici?ncias nutricionais que podem ser agravadas pelo consumo inadequado de nutrientes na dieta e pela polifarm?cia. Objetivos : O artigo 1 prop?s analisar as potenciais intera??es farmacol?gicas entre os f?rmacos utilizados por idosos. O artigo 2 objetivou tra?ar o perfil de consumo de nutrientes nesses indiv?duos e o artigo 3 prop?s associar a inadequa??o de consumo de nutrientes da dieta com a deple??o de nutrientes causada pelo uso de f?rmacos. M?todos : Foi realizado um estudo observacional transversal, de base populacional pelo Instituto de Geriatria e Gerontologia (IGG), PUCRS. Foi realizada uma an?lise retrospectiva da base de dados do IGG, composta por 512 idosos e diversos indicadores epidemiol?gicos. No artigo 1 foi utilizado o sistema de classifica??o de f?rmacos denominado Anatomical Therapeutic and Chemical Classification System (ATC). As intera??es farmacol?gicas foram analisadas atrav?s do programa Micromedex? Healthcare Series. No artigo 2, foi avaliado o consumo alimentar, utilizando-se o Inqu?rito Recordat?rio de 24 Horas e Investiga??o da Hist?ria Diet?tica. Foi calculada a composi??o nutricional da dieta com o aux?lio do software Nutwin. No artigo 3 a quantidade de nutrientes na dieta habitual foi comparada com as Dietary Reference Intake (DRIs) para avalia??o da inadequa??o de consumo. Foi considerado inadequado o consumo abaixo da EAR (Estimated Average Requirement) e acima da UL (Tolerable Upper Intake Level). Os principais f?rmacos utilizados foram associados ? inadequa??o de consumo dos nutrientes depletados pelos f?rmacos. Resultados : O artigo 1 mostrou alta preval?ncia de uso de medicamentos por idosos, sendo a diferen?a estatisticamente significativa entre os sexos. Os idosos entre 70 e 79 anos utilizam mais medicamentos do que as demais faixas et?rias. O artigo 2 mostrou que os homens consomem mais prote?nas, fibras, minerais e vitaminas. O consumo de carboidrato e c?lcio aumentou e o consumo de zinco diminuiu conforme o avan?o da idade. A pr?tica de exerc?cio f?sico elevou o consumo de calorias, magn?sio, pot?ssio e f?sforo. Maior escolaridade e renda familiar elevaram o consumo de vitaminas do complexo B. O artigo 3 mostrou que AAS, hidroclorotiazida e inibidores das bombas de pr?tons s?o os f?rmacos que depletam maior n?mero de nutrientes. Al?m disso, 97% dos usu?rios de Inibidores da HMG-CoA redutase possuem inadequa??o de consumo de vitamina E; dos usu?rios de diur?ticos poupadores de pot?ssio, 90,0% possui inadequa??o de consumo de magn?sio; dos usu?rios de digoxina, 83,3% possui inadequa??o para o magn?sio e 58,3% para c?lcio e pot?ssio. Entre os usu?rios de antiulcerosos antagonistas H2, 83,3% deles possui inadequa??o de consumo de folato. A an?lise da hidroclorotiazida, AAS e furosemida apontou respectivamente 83,2%, 82,1% e 80,0% de inadequa??o de consumo de pot?ssio. Conclus?es : O uso de medicamentos por idosos aumenta com a idade, sendo as mulheres s?o as maiores usu?rias e entre elas h? maior defici?ncia de nutrientes na alimenta??o di?ria. Os f?rmacos mais utilizados s?o tamb?m os mais envolvidos em intera??es farmacol?gicas e respons?veis pela deple??o de micronutrientes que mostraram alta preval?ncia de inadequa??o de consumo por idosos

Made available in DSpace on 2015-04-14T13:53:53Z (GMT). No. of bitstreams: 1 445468.pdf: 870967 bytes, checksum: aa47d758bcd94b29ce99cd60ca07b045 (MD5) Previous issue date: 2012-03-26 / Introduction : New epidemiological studies show an increase in elderly population in Brazil, which makes the likelihood of chronic degenerative osteoarticular diseases take root among this osteoarthritis is one of the most prevalent diseases in elderly, and affects more woman individuals, affecting considerably the knee joint. The technologies are identified as a new way to promote health activities, since the functional capacity and well-being are essential when thinking about aging with quality of life. Virtual reality uses multi-sensory channels and allows the user immersion, navigation and interaction in a three-dimensional synthetic environment generated by computer. Physical therapy intervention conventional, there is today a new ally in intervention programs, through wiiterapia. Wiiterapia is the name that is the new feature that combines physical therapy through the video game Nintendo Wii?, which can also be associated with WiiFit platform. This feature is part of this kind of reality, and that increasing the physiotherapy programs, bringing benefits in a playful and more participatory on the part of individuals. Objectives : This study evaluated the effects of conventional physiotherapy and wiiterapia in elderly women with knee osteoarthritis. Method : The research is a longitudinal study, interventionist and was held in Passo Fundo - RS. Were 71 elderly women aged more than sixty years, the study subjects, suffering from knee osteoarthritis, who were divided into two groups (GI = 33 and GII = 38), the group I underwent an intervention program based in physiotherapy and II with wiiterapia. Both greater 20 sessions of intervention three times a week, for approximately 3 months. Results : The elderly women who underwent conventional therapy (group I) showed a significant improvement in the field stiffness (14.39 ? 17.43) compared to wiiterapia (group II, 25.13 ? 15.99) in the post-intervention ( p = 0.00). No differences were observed between groups in the domains of pain, disability and balance in intervention post. When is compared with conventional physiotherapy, the wiiterapia we found no statistically significant results in muscle strength. Conclusion : The intervention program of physiotherapy was effective in improving the stiffness in elderly women with osteoarthritis, of the knee flexor muscles are weaker in the older group who performed physiotherapy, and the flexor muscles are weaker than the extensors in both study groups and the higher speed, lower peak torque in the extensor muscles. However, although the peak torque wiiterapia be higher in the group that underwent conventional physiotherapy had a higher percentage of increase in muscle strength in both flexors and extensors in post-intervention. / Introdu??o : Novos estudos epidemiol?gicos mostram o aumento da popula??o idosa no Brasil, o que faz com que a probabilidade de doen?as cr?nico-degenerativas osteoarticulares se instalem, dentre estas a osteoartrite que ? uma das doen?as mais prevalentes em idosos, e acomete mais os indiv?duos do sexo feminino afetando consideravelmente a articula??o do joelho. As tecnologias s?o apontadas como uma nova forma de promover a??es de sa?de j? que a capacidade funcional e o bem-estar s?o fundamentais quando se pensa em envelhecimento com qualidade de vida. A realidade Virtual, utiliza-se de canais multi-sensoriais e possibilita ao usu?rio a imers?o, a navega??o e a intera??o em um ambiente sint?tico tridimensional gerado pelo computador. A interven??o fisioterap?utica convencional, ganha hoje um novo aliado nos programas de interven??o. Wiiterapia ? o nome que se da a este novo recurso que associa a fisioterapia atrav?s do videogame Nintendo Wii?, onde tamb?m pode ser associado a plataforma WiiFit. Este recurso faz parte deste tipo de realidade e esta incrementando os programas de Fisioterapia, trazendo benef?cios de forma l?dica e mais participativa por parte dos indiv?duos. Objetivos : O presente estudo avaliou os efeitos da fisioterapia convencional e da wiiterapia em mulheres idosas com osteoartrite de joelho. M?todo : A pesquisa ? um estudo longitudinal, intervencionista e foi realizada na cidade de Passo Fundo RS. Os sujeitos pesquisados foram 71 mulheres idosas, com idade igual ou maior de sessenta anos, portadoras de osteoartrite de joelho, que foram divididas em dois grupos (GI=33 e GII=38), o grupo I foi submetido a um programa de interven??o baseado em fisioterapia convencional e o II em wiiterapia. Ambos realizaram 20 sess?es de interven??o 3 vezes por semana com dura??o de aproximadamente 3 meses. Resultados : As idosas submetidas ? fisioterapia convencional (grupo I) apresentaram uma melhora significativa no dom?nio rigidez (14,39?17,43) em rela??o ? wiiterapia (grupo II; 25,13?15,99) na p?s-interven??o (p=0,00). N?o foram observadas diferen?as entre os grupos nos dom?nios dor, incapacidade e equil?brio na p?s-interven??o.Quando se compara a fisioterapia convencional com a wiiterapia, n?o encontramos resultados estatisticamente significativos na for?a muscular. Conclus?o : O programa de interven??o da fisioterapia convencional foi eficaz na melhora da rigidez em idosas portadoras de osteoartrite de joelho, os m?sculos flexores s?o mais fracos no grupo de idosas que realizou fisioterapia convencional, os m?sculos flexores s?o mais fracos que os extensores em ambos os grupos avaliados e quanto maior a velocidade, menor o pico de torque nos m?sculos extensores. No entanto, apesar dos picos de torque serem maiores no grupo wiiterapia, o grupo que realizou fisioterapia convencional apresentou um percentual maior de aumento na for?a muscular, tanto em m?sculos flexores quanto em extensores p?s-interven??o.

Made available in DSpace on 2015-04-14T13:53:54Z (GMT). No. of bitstreams: 1 447317.pdf: 114787 bytes, checksum: 8e1f0f8c0990d63c2a83d55f53ceb084 (MD5) Previous issue date: 2012-11-30 / Introduction: the Frailty syndrome (FS) increases the risk of institutionalization, disability and death in the elderly. The concept of fragility evolved into propositions that are no longer limited only to physical and functional aspects. Several authors have studied other dimensions such as psychological and social support structure. However, few studies focused on primary health care.Objective: Develop and validate a multidimensional instrument for frailty screening in elderly patients in primary care.Materials and methods: Cross-sectional, observational, descriptive and analytical, conducted in a random sample of 355 elderly participants Multidimensional Study of the Elderly in Porto Alegre (EMISUS), from 27 different Family Health Strategies of the municipality of Porto Alegre. The elderly were evaluated by an interdisciplinary team. The clinical criteria for determining the phenotype of FS was modified Fried (unintentional weight loss, decreased grip strength, exhaustion and slow walking time - individuals with 0 points were not considered fragile, with 1 point were considered prefrail and those with 2 or more frail).Results: For the development of the instrument, 10 dimensions were initially selected (social (living alone), age (&#8805;80 years old), sensorial (vision, audition and speech), depressed mood, cognition (remembering three words mentioned), medication (5 or more), Daily Life Activities (DLA) / Instrumental activities of daily living (IADL), balance, urinary incontinence and nutrition) categorized as present or not. In the analysis of the degree of concordance between the instrument and the modified Fried phenotype showed low statistical power (degree of concordance = 0.267). It was then performed the multiple logistic regression method Forward Stepwise and five models were generated. The independent predictive variables with greater odds ratio, included in the model 5 where the dimensions were included nutrition (P = 0.019), polypharmacy ( P = 0.005), dependence in DAL / IADL (P = 0.052), urinary incontinence (P = 0.010) and balance (P <0.001). Additionally, it was performed a ROC curve and established a cutoff point of 1/2 to discriminate between individuals of pre-frail/frail not fragile. The instrument sensitivity was 0.759 and specificity was 0.563. The positive predictive value was 0.583 and the negative predictive value was 0.745. The agreement with the IMSIFI Fried phenotype was considered good . By the criteria of Fried, the phenotype was more common non frail (44.5%) following the pre-frail (32.4%). At IMSIFI, most elderly was considered prefrail/ frail (72.9%). It was observed an association between both instruments (Fried and IMSIFI) with functional capacity (DAL / IADL).Conclusion: The instrument developed is objective and of rapid implementation for the context of primary health care. However, longitudinal studies are needed to to compare the IMSIFI with the complete Fried phenotype and other multidimensional instruments, as well as longitudinal studies, are required to prove the role of the IMSIFI in the screening FS / Introdu??o: A S?ndrome da Fragilidade (SF) aumenta o risco de institucionaliza??o, incapacidade e morte em idosos. O conceito de fragilidade evoluiu para proposi??es de natureza que n?o se limitam mais somente aos aspectos f?sicos e funcionais. Diversos autores t?m estudado outras dimens?es como a psicol?gica e a estrutura de apoio social. Por?m poucos estudos s?o voltados para a aten??o b?sica de sa?de.Objetivo: Elaborar e validar um instrumento multidimensional de rastreio de S?ndrome da Fragilidade em idosos atendidos na aten??o b?sica.Materiais e m?todos: Trata-se de um estudo transversal, observacional, descritivo e anal?tico, realizado em uma amostra aleat?ria de 355 idosos participantes do Estudo Multidimensional dos Idosos de Porto Alegre (EMISUS), provenientes de 27 diferentes Estrat?gias Sa?de da Fam?lia. Os idosos foram avaliados por uma equipe interdisciplinar. O crit?rio cl?nico para determina??o da SF foi o fen?tipo de Fried modificado (diminui??o de peso involunt?ria, for?a de preens?o palmar diminu?da, exaust?o e lentid?o do tempo de caminhada indiv?duos com 0 pontos foram considerados n?o fr?geis, com 1 ponto foram considerados pr?fr?geis e os com 2 pontos ou mais, fr?geis).Resultados: Para elabora??o do instrumento, foram selecionados, inicialmente 10 dimens?es [social (vive sozinho), idade (&#8805;80 anos), sensorial (vis?o, audi??o e fala), humor depressivo, cogni??o (lembrar as tr?s palavras ditas), medicamentos (uso de 5 ou mais medicamentos), depend?ncia (AVD/AIVD), equil?brio (quest?o espec?fica), contin?ncia urin?ria (quest?o espec?fica) e nutri??o (IMC)] categorizados como presente ou n?o. Na an?lise do grau de concord?ncia entre o instrumento e o fen?tipo de Fried modificado, observou-se um grau fraco (P=0,267). Foi, ent?o, realizada uma regress?o log?stica m?ltipla pelo m?todo Forward Stepwise e cinco modelos foram gerados, sendo o modelo com as vari?veis preditivas de SF independentes com maior raz?o de chance (OR), as do modelo 5 [desnutri??o (P=0,019; OR=2,661), polifarm?cia, (P=0,005; OR=1,921), depend?ncia AVD/AIVD (P=0,052; P=4,584), incontin?ncia urin?ria (P=0,010; OR=1,876) e desequil?brio, (P<0,001; OR=3,316)]. Adicionalmente, foi realizada uma curva ROC e estabelecido o ponto de corte de 1/2 para discriminar os indiv?duos n?o fr?geis dos pr?fr?geis/ fr?geis. A sensibilidade do instrumento foi de 0,759 e a especificidade foi de 0,563. O valor preditivo positivo foi de 0,583 e o valor preditivo negativo foi de 0,745. A concord?ncia do instrumento multidimensional de rastreio de S?ndrome da Fragilidade (IMSIFI) com o fen?tipo de Fried foi considerada de grau bom (?rea abaixo da curva=0,720). Pelos crit?rios de Fried, 44,5% dos idosos foram considerados n?o fr?geis, 32,4% pr?-fr?geis e 23,1% fr?geis. Pelo IMSIFI, 27,1% foram considerados n?o fr?geis e 72,9% pr?-fr?gil/fr?gil. Observou-se associa??o de ambos instrumentos (fen?tipo de Fried modificado e IMSIFI) com depend?ncia.Conclus?o: Elaborou-se um instrumento objetivo e de r?pida aplica??o para o contexto da aten??o b?sica. Contudo, estudos adicionais comparando o IMSIFI com o fen?tipo completo de Fried e outros instrumentos multidimensionais, al?m de estudos longitudinais, s?o necess?rios para comprovar o papel do IMSIFI no rastreio de SF.

Made available in DSpace on 2015-04-14T13:54:01Z (GMT). No. of bitstreams: 1 448876.pdf: 2695639 bytes, checksum: a3bbbe4d7e909726487f750267010636 (MD5) Previous issue date: 2013-03-29 / Introduction : In menopause occur a loss of bone mass sharper that is due to several factors, among them, low dietary intake of calcium. Proper nutrition is vital to preserve bone health and thus prevent falls and fractures. Objective : Evaluate food intake and calcium supplementation in women during the menopause and postmenopause. Methods : Cross-sectional study involving women during the climacteric and postmenopausal users of climacteric and menopause clinic of the Hospital S?o Lucas da PUC in Porto Alegre, Brazil. A structured questionnaire was applied with socioeconomic, anthropometric and health data. To assess dietary intake, we used the 24-hour food recall (R24) and the Food Frequency Questionnaire (FFQ). For the analysis we used the Mann-Whitney and Kruskal Wallys (post hoc Dunn). The significance level was 5%. Results : The sample consisted of 63 women aged 55.7 ? 7.2 years, where 49.2% are in group 50 to 59 years. Mean BMI was 29.6 ? 5.8 kg / m?. Menopause was present in 74.6%. The use of calcium supplements, with or without vitamin D has occurred in 25.4% of the sample. The average intake was higher in the group of women who consumed skimmed over those who did not (900.6 ? 245.4 mg and 587.5 ? 352.7 mg, p <0.001), semi skimmed milk (847 , 8 mg ? 459.8 and 618.3 ? 315.3 mg, p <0.05), yogurt (766.9 ? 377.2 mg and 566.7 ? 308.9 mg, p <0.05) mines and cheese (839.1 ? 354.3 mg and 537.7 ? 302.0 mg, p <0.001). There was no difference in the daily intake of calcium and age. Conclusion : Women consuming skimmed milk, semi skimmed milk, yogurt and cheese mines ingest more calcium daily than those who do not use. However, both groups ingest insufficient quantity of calcium recommended by Dietary Reference Intakes. / Introdu??o : Na menopausa ocorre uma perda mais acentuada da massa ?ssea a qual se deve a v?rios fatores, entre eles, a baixa ingest?o alimentar de c?lcio. A nutri??o adequada ? fundamental para preservar a sa?de ?ssea e consequentemente prevenir quedas e fraturas. Objetivo : Avaliar a ingest?o alimentar e a suplementa??o de c?lcio em mulheres no per?odo do climat?rio e p?s-menopausa. Metodologia : Estudo transversal envolvendo mulheres no per?odo do climat?rio e p?s-menopausa usu?rias do ambulat?rio de climat?rio e menopausa do Hospital S?o Lucas da PUC em Porto Alegre, Brasil. Foi aplicado question?rio estruturado com dados socioecon?micos, antropom?tricos e de sa?de. Para avaliar a ingest?o alimentar foi utilizado o Recordat?rio alimentar de 24 horas (R24) e o Question?rio de Frequ?ncia Alimentar (QFA). Para a an?lise foi utilizado o teste de Mann Whitney e Kruskal Wallys (post hoc Dunn). Foi adotado n?vel de signific?ncia de 5%. Resultados : A amostra foi de 63 mulheres com idade de 55,7?7,2 anos, onde 49,2% s?o do grupo de 50 a 59 anos. O IMC m?dio foi de 29,6?5,8 kg/m?. A menopausa estava presente em 74,6%. O uso de suplementa??o de c?lcio, com ou sem vitamina D, ocorreu em 25,4% da amostra. A m?dia de ingest?o foi mais elevada no grupo de mulheres que consumiu leite desnatado em rela??o aos que n?o utilizavam (900,6?245,4 mg e 587,5?352,7 mg; p<0,001), leite semi desnatado (847,8?459,8 mg e 618,3?315,3 mg; p<0,05), iogurte (766,9?377,2 mg e 566,7?308,9 mg; p<0,05) e queijo minas (839,1?354,3 mg e 537,7?302,0 mg; p<0,001). N?o houve diferen?a em rela??o ? quantidade ingerida de c?lcio di?rio e a faixa et?ria. Conclus?o : Mulheres consumidoras de leite desnatado, leite semi desnatado, iogurte e queijo minas ingerem mais c?lcio di?rio em rela??o ?s que n?o utilizam. No entanto, ambos os grupos ingerem quantidade insuficiente de c?lcio segundo as recomenda??es da Dietary Reference Intakes.

Made available in DSpace on 2015-04-14T13:54:02Z (GMT). No. of bitstreams: 1 448872.pdf: 110185 bytes, checksum: f997b8351d65bf4ce2450d9331c8bf95 (MD5) Previous issue date: 2013-03-11 / Introduction : Physiological changes occur with aging. The effect of this process also affects sexuality, which is influenced by physical and mental health. Thus, the perception has their own sexuality in the elderly reflects on self-esteem and quality of life. Objective : Self-rated sexuality of older women attending the outpatient geriatric service at the Hospital S?o Lucas and Sociedade Porto Alegrense de Aux?lio aos Necessitados (SPAAN). Methods : Cross-sectional study, consisting of 78 women aged 60 years or more, divided in two groups of 39. We applied a questionnaire with socio-economic and age questions, self-perceived health status and use of drugs, knowledge about their sexuality, body image, importance and relevance of sexuality, sexual vision, family and femininity. We used the Student t test or analysis of variance (ANOVA) one-way chi-square test and Spearman correlation coefficient. The significance level was 5%. Results : The mean age of participants was 67.9 ? 6.6 years for the group PUCRS and 78.8 ? 8.1 years for the group SPAAN (p <0.001). Sexuality was important in 24 (61.5%) women PUCRS where 29 (76.3%) of this group consider themselves sexy. In group SPAAN 34 (85.5%) women do not think of sexuality (p = 0.002) and 11 (45.8%) of this group unmarried conceptualized sexuality as different levels of expression and affection, not just intercourse. Conclusion : The elderly PUCRS value her sexuality and consider themselves sexy, while women's SPAAN not think of sexuality, but the single valued expressions of affection and not just intercourse. / Introdu??o : Mudan?as fisiol?gicas ocorrem com o envelhecimento. O efeito deste processo tamb?m afeta a sexualidade, que ? influenciada pela sa?de f?sica e mental. Desta forma, a precep??o da pr?pria sexualidade no idoso reflete na auto-estima e qualidade de vida. Objetivo : Auto-avalia??o da sexualidade de mulheres idosas frequentadoras do ambulat?rio do servi?o de geriatria do Hospital S?o Lucas da PUCRS e institucionalizadas da Sociedade Porto Alegrense de Aux?lio aos Necessitados (SPAAN). Metodologia : Estudo transversal, formado por 78 mulheres com 60 anos ou mais, divididas em dois grupos de 39. Foi aplicado um question?rio contendo quest?es do perfil s?cio-econ?mico e et?rio, auto-percep??o de sa?de e uso de f?rmacos, conhecimento em rela??o ? sua sexualidade, como a imagem corporal, import?ncia e relev?ncia da sexualidade, vis?o sexual, familiar e feminilidade. Foi utilizado o teste t-student ou An?lise de Vari?ncia (ANOVA) oneway, teste qui-quadrado de Pearson e o coeficiente de correla??o de Spearman. O n?vel de signific?ncia foi de 5%. Resultados : A idade m?dia das participantes foi de 67,9?6,6 anos para o grupo PUCRS e 78,8?8,1 anos para o grupo da SPAAN (p<0,001). A sexualidade foi importante em 24 (61,5%) mulheres da PUCRS onde 29 (76,3%) deste grupo se consideram sensuais. No grupo SPAAN 34 (85,5%) mulheres n?o pensam em sexualidade (p=0,002) e 11 (45,8%) solteiras deste grupo conceituaram a sexualidade como v?rios n?veis de express?o e afeto e n?o apenas o coito. Conclus?o : As idosas da PUCRS valorizam a sexualidade e se consideram sensuais, enquanto que as mulheres da SPAAN n?o pensam na sexualidade, por?m as solteiras valorizam express?es de afeto e n?o apenas o coito.

Made available in DSpace on 2015-04-14T13:54:03Z (GMT). No. of bitstreams: 1 451173.pdf: 1812168 bytes, checksum: 8a896e7fcd7b000f80719ab791ec8cbc (MD5) Previous issue date: 2013-05-28 / Tooth loss is very common in the older people causing a need for a rehabilitative treatment by dental implants. The periimplant bone loss is one of the most important factors for the success of dental implants activated. Ageing, however, is associated with decreased bone metabolism; making can be a risk factor for the loss of these implants. It is known that bone loss can also be influenced by other factors such as gender, bruxism, diabetes, osteoporosis, heart disease, hypothyroidism, alcohol and smoking. This study aimed to monitor radiographic and clinically, for four years, the periimplant bone level from the installation of prostheses placed in dental implants. Were followed 18 patients, 57 patients with dental implants with their respective prosthesis installed, observing the periimplant bone height and systemic diseases present. The loss of periimplant bone height was significantly associated with a history of smoking and to be man, age was inversely associated with bone loss. Factors such as the presence of hypothyroidism, diabetes, hypertension, heart disease and osteoporosis were not associated with bone loss. There were no significant differences in nutritional parameters of patients followed. We conclude that age was a factor associated with height gain and bone that elderly male with a previous history of smoking are associated with loss of periimplant bone height. / A perda dent?ria ? muito comum no idoso fazendo com que exista a necessidade de um tratamento reabilitador por meio de implantes osseointegrados. A perda ?ssea periimplantar ? um dos fatores mais importantes para o sucesso dos implantes osseointegrados ativados. O envelhecimento, entretanto, est? associado ? diminui??o do metabolismo ?sseo, fazendo com que possa ser um fator de risco para a perda desses implantes. Sabe-se que a perda ?ssea pode tamb?m ser influenciada por outros fatores como sexo, bruxismo, diabetes, osteoporose, cardiopatias, hipotireoidismo, ?lcool e tabagismo. O presente trabalho teve como objetivo principal acompanhar radiogr?fica e clinicamente, durante quatro anos, o n?vel ?sseo periimplantar a partir da instala??o de pr?teses colocadas nos implantes osseointegrados. Foram acompanhados 18 pacientes, portadores de 57 implantes osseointegrados com suas respectivas pr?teses instalados, observando-se a altura ?ssea periimplantar e as doen?as sist?micas presentes. A perda da altura ?ssea periimplantar foi significativamente associada com hist?ria pr?via de tabagismo e sexo masculino, idade foi inversamente associada ? perda de massa ?ssea. Fatores como presen?a de hipotireoidismo, diabetes, hipertens?o, cardiopatia e osteoporose n?o foram associados ? perda ?ssea. N?o foram observadas diferen?as significativas nos par?metros nutricionais dos pacientes acompanhados. Conclui-se que idade foi um fator associado ao ganho de altura ?ssea e que idosos do sexo masculino e com hist?ria pr?via de tabagismo est?o associados ? perda de altura ?ssea periimplantar.

Made available in DSpace on 2015-04-14T13:54:04Z (GMT). No. of bitstreams: 1 452401.pdf: 4854044 bytes, checksum: 439bef327a415e56ee12df4b30684f1c (MD5) Previous issue date: 2013-08-23 / The international literature shows that population aging is a global phenomenon and is occurring more rapidly in developing countries like Brazil. Advancing age is a recognized risk factor for the development of dementia. Dementia is a disease associated with aging that lead more directly to physical disability, the continuous attention and a progressive burden to the healthcare system for the patients and their relatives. In our environment, prevalence of this disease is scarce, especially in populations with low education and income. We had the aims of diagnosing dementia and cognitive decline; estimate their prevalence, and examine their associations with socio-demographic and clinical profile among the elderly enrolled in the Family Health Strategy in Porto Alegre (FHS / POA). The study is cross-sectional design. The sample was composed of random individuals 60 years or older, enrolled in the FHS / POA. It presents the results of 459 individuals collected until December 2012 who completed the evaluation specialist at S?o Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul. In the final sample 59.5% were female, 30.1% had between 70 and 79 years and 7.8% were 80 years or older. Ages ranged from 60 to 103 years, with a mean of 68.6 and standard deviation of 7.1. The prevalence of dementia was 9.6% (95% CI = 6.9 to 12.3). The predictors of cognitive impairment were age, marital status, smoking history, history of bipolar disorder. The predictors of dementia were age, income, and history of cerebrovascular disease. A protective factor for cognitive deficits found in this study is subjective complaint of headache in the last year. Replicating findings of association and the pursuit of causal relationship in longitudinal studies are needed, especially for the most relevant findings associated with cognitive deficits found in this study: a positive association with bipolar disorder and negatively with the complaint of headache. / A literatura internacional evidencia que o envelhecimento populacional ? um fen?meno mundial e que est? ocorrendo de forma mais acelerada em pa?ses em desenvolvimento como o Brasil. A idade avan?ada ? um reconhecido fator de risco para o desenvolvimento de dem?ncia e d?ficit cognitivo. A dem?ncia ? uma das doen?as relacionadas ao envelhecimento que mais levam diretamente ? incapacidade f?sica, ? assist?ncia continuada de servi?os e a um ?nus progressivo, para o sistema de sa?de, para o paciente e para os seus familiares. Em nosso meio, estudo estimando preval?ncia desta enfermidade s?o escassos, especialmente em popula??es com a baixa escolaridade e renda. Tivemos como objetivos diagnosticar dem?ncia e d?ficit cognitivo; estimar suas preval?ncias, e examinar suas associa??es com dados s?cio-demogr?ficos e cl?nicos entre idosos cadastrados na Estrat?gia de Sa?de da Fam?lia no munic?pio de Porto Alegre (ESF/POA). O estudo tem desenho transversal. A amostra foi composta de forma aleat?ria por indiv?duos de 60 anos ou mais, cadastrados na ESF/POA. Apresenta os resultados de 459 indiv?duos coletada at? Dezembro de 2012 os quais completaram a avalia??o especializada no Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul. Na amostra final 59,5% eram do sexo feminino, 30,1% tinham entre 70 e 79 anos e 7,8% tinham 80 anos ou mais. A idade variou de 60 a 103 anos, com m?dia de 68,6 e desvio padr?o de 7,1. A preval?ncia de dem?ncia foi de 9,6% (IC95% = 6,9 12,3) e a de d?ficit cognitivo foi de 47,7% (IC95% = 42,9 52,5). As vari?veis associadas ao d?ficit cognitivo foram faixa et?ria, estado civil, hist?rico de tabagismo, hist?rico de transtorno do humor bipolar. As vari?veis associadas ? dem?ncia foram faixa et?ria, renda pessoal e hist?ria de doen?a c?rebro-vascular. Um achado protetor para d?ficit cognitivo e dem?ncia encontrada nesse estudo ? queixa subjetiva de dor de cabe?a no ?ltimo ano. A replica??o de achados de associa??o e a busca da rela??o causal s?o necess?rias em trabalhos longitudinais, especialmente para os achados de associa??o mais relevantes com o d?ficit cognitivo encontrados no presente estudo: a associa??o positiva com transtorno bipolar e negativa com a queixa de cefal?ia.