Danielle Teles da Cruz

Prevalência de quedas e fatores associados em idosos

OBJECTIVE To estimate the prevalence of falls in elderly individuals and to analyze associated factors. METHODS Cross-sectional study with 420 elderly subjects (aged 60 years or older) living in the city of Juiz de Fora (Southeastern Brazil) in 2010. A household survey was conducted and the occurrence of falls in the 12 previous months was described. For the analysis of factors associated with the outcome, a theoretical determination model with three hierarchical blocks was built. The variables were adjusted among each other within each block; those with level of significance < 0.20 were included in the Poisson regression model and adjusted to the immediately higher level, with 5% significance level. RESULTS The prevalence of falls among the elderly was 32.1% (95%CI: 27.7; 36.9). Among those who experienced falls, 53% had a single fall and 19% had fractures as a consequence. Most of the falls (59%) occurred at the elderly persons home. The occurrence of falls was associated with old age, female sex, need of help for locomotion and self-reported diagnosis of osteoporosis. CONCLUSIONS Falls are frequent among the elderly. Knowledge of the factors associated with the occurrence of this event can aid the development of prevention strategies and adequate health services.OBJETIVO: Estimar la prevalencia de caidas en ancianos y analizar factores asociados. METODOS: Estudio transversal con 420 ancianos (60 anos o mas) residentes en Juiz de Fora, Sureste de Brasil, en 2010. Se realizo pesquisa domiciliaria y se describio la ocurrencia de caida en los ultimos 12 meses. Para analisis de los factores asociados al resultado, se construyo un modelo teorico de determinacion con tres bloques jerarquizados. Las variables fueron ajustadas entre si dentro de cada bloque; las que presentaron nivel de significancia < 0,20 fueron incluidas en el modelo de regresion de Poisson y ajustadas al nivel superior al de cada una, con el nivel de 5% de significancia. RESULTADOS: La prevalencia de caidas entre los ancianos fue de 32,1% (IC95% 27,7;36,9). Entre aquellos que sufrieron caida, 53% tuvieron una unica caida y 19% tuvieron fractura como consecuencia. La mayor parte de las caidas (59%) ocurrio en el domicilio del anciano. La ocurrencia de caidas se asocio con edad avanzada, sexo femenino, necesidad de auxilio para locomocion y diagnostico auto-referido de osteoporosis. CONCLUSIONES: Las caidas son frecuentes entre ancianos. El conocimiento de los factores asociados a la ocurrencia de este evento puede auxiliar en la elaboracion de estrategias de prevencion y servicios de salud adecuados.

Prevalence of falls and associated factors in elderly individuals

OBJECTIVE To estimate the prevalence of falls in elderly individuals and to analyze associated factors. METHODS Cross-sectional study with 420 elderly subjects (aged 60 years or older) living in the city of Juiz de Fora (Southeastern Brazil) in 2010. A household survey was conducted and the occurrence of falls in the 12 previous months was described. For the analysis of factors associated with the outcome, a theoretical determination model with three hierarchical blocks was built. The variables were adjusted among each other within each block; those with level of significance < 0.20 were included in the Poisson regression model and adjusted to the immediately higher level, with 5% significance level. RESULTS The prevalence of falls among the elderly was 32.1% (95%CI: 27.7; 36.9). Among those who experienced falls, 53% had a single fall and 19% had fractures as a consequence. Most of the falls (59%) occurred at the elderly persons home. The occurrence of falls was associated with old age, female sex, need of help for locomotion and self-reported diagnosis of osteoporosis. CONCLUSIONS Falls are frequent among the elderly. Knowledge of the factors associated with the occurrence of this event can aid the development of prevention strategies and adequate health services.OBJETIVO: Estimar la prevalencia de caidas en ancianos y analizar factores asociados. METODOS: Estudio transversal con 420 ancianos (60 anos o mas) residentes en Juiz de Fora, Sureste de Brasil, en 2010. Se realizo pesquisa domiciliaria y se describio la ocurrencia de caida en los ultimos 12 meses. Para analisis de los factores asociados al resultado, se construyo un modelo teorico de determinacion con tres bloques jerarquizados. Las variables fueron ajustadas entre si dentro de cada bloque; las que presentaron nivel de significancia < 0,20 fueron incluidas en el modelo de regresion de Poisson y ajustadas al nivel superior al de cada una, con el nivel de 5% de significancia. RESULTADOS: La prevalencia de caidas entre los ancianos fue de 32,1% (IC95% 27,7;36,9). Entre aquellos que sufrieron caida, 53% tuvieron una unica caida y 19% tuvieron fractura como consecuencia. La mayor parte de las caidas (59%) ocurrio en el domicilio del anciano. La ocurrencia de caidas se asocio con edad avanzada, sexo femenino, necesidad de auxilio para locomocion y diagnostico auto-referido de osteoporosis. CONCLUSIONES: Las caidas son frecuentes entre ancianos. El conocimiento de los factores asociados a la ocurrencia de este evento puede auxiliar en la elaboracion de estrategias de prevencion y servicios de salud adecuados.

Clinical and functional evaluation of the joint status of hemophiliac adults at a Brazilian blood center

Background Hemophilia is a potentially disabling condition as hemophilic arthropathy develops early in life and is progressive, especially in patients treated in an on-demand regime. Objective This study aimed to describe the structural joint status and the functional independence score of hemophiliac adults and correlate structural damage with the functional deficits found in these patients. Methods Hemophiliacs at the Juiz de Fora Regional Blood Center - HEMOMINAS Foundation, aged 18 years and over and treated in an on-demand regime, were clinically evaluated in respect to structural joint damage using the World Federation of Hemophilia Physical Examination Scale (WFH-PE) and functional deficits using the Functional Independence Score in Hemophilia (FISH). The Spearman rank test was used to evaluate the correlation between the two scores. Results Thirty-nine patients were evaluated. The mean age was 36.8 years. Target joints were detected in 69.2% of patients studied. The mean Physical Examination Scale and Functional Independence Score were 16.87 and 25.64, respectively. Patients with mild hemophilia showed no significant joint involvement. Patients with severe or moderate hemophilia had similar results regarding structural damage (p-value < 0.001) and functional deficits (p-value = 0.001). There was statistical significance in the correlation between the two scores (r = -0.850; p-value = 0.01). Conclusions The World Federation of Hemophilia Physical Examination Scale and Functional Independence Score in Hemophilia may be useful to clinically assess structural joint damage and functional deficits in hemophiliacs as the tools are inexpensive and easy to administer and may be able to detect hemophilic arthropathy, which results from recurrent hemarthrosis and is common in the population studied.

O lugar ocupado pela assistência fisioterapêutica: representações sociais de trabalhadores com DORT

INTRODUCAO: Os disturbios osteomusculares relacionados ao trabalho (DORT) articulam-se diretamente a realizacao de atividades ocupacionais e as condicoes de trabalho. OBJETIVO: O artigo origina-se de uma pesquisa qualitativa que analisou as representacoes sociais da assistencia fisioterapeutica entre trabalhadores portadores de Disturbios Osteomusculares Relacionados ao Trabalho (DORT), frequentadores do Centro de Referencia em Saude do Trabalhador (CEREST), pelo Departamento de Saude do Trabalhador (DSAT), Juiz de Fora (MG). MATERIAIS E METODOS: O recurso de apreensao das informacoes foi a entrevista semiestruturada, realizada com 12 trabalhadoras com idades entre 29 e 55 anos. RESULTADOS: As informacoes submetidas a analise tematica apontaram que a assistencia fisioterapeutica recebida repercute em periodos longos de tratamento e na insatisfacao dos resultados, por meio de uma pratica curativista, segmentada e pouco resolutiva, na qual prevalece a utilizacao de equipamentos em detrimento das manobras corporais e holisticas. CONCLUSAO: Diante dos relatos, verificamos a necessidade de uma atencao humanizada, integral e equânime com responsabilizacao e vinculo, alem da valorizacao dos trabalhadores e usuarios, promovendo melhor qualidade de vida. E imprescindivel a realizacao de novos estudos que possibilitem melhor compreensao e aprofundamento teorico e pratico da relacao entre a atuacao do fisioterapeuta e as representacoes sociais envolvidas.

Comparison of four criteria for potentially inappropriate medications in Brazilian community-dwelling older adults: Potentially inappropriate medications

To compare four potentially inappropriate medication (PIM) criteria from different regions of the world in terms of their characteristics, concordance, sensitivity, specificity and predictive values in a community‐dwelling sample.

Associação entre capacidade cognitiva e ocorrência de quedas em idosos

Introduction Cognitive changes due to human aging process represent important conditions as they directly affect functionality and predispose subjects to falls. Objective To investigate the association between cognitive ability and falls in an elderly population and to characterize their profile. Methodology Cross-sectional study from the Health Survey project at Juiz de Fora, MG. The analyzed variables were calculated by applying the Mini-Mental State Examination (MMSE) and a semi-structured questionnaire containing questions on sociodemographic and falls occurence. We estimated the absolute and relative frequencies and used the chi-square (c2) to investigate the association between cognitive ability indicated by MMSE and falls, the significance level was 5%. Results 462 elderly, mean age 71.03 (SD = 7.79) and 3.64 years of schooling (SD = 3.26), 64.8% female and 28.14% showed cognitive decline; frequency of falls in the group with cognitive impairment was 42% and there was an association between cognitive ability and falls (p = 0.043). Conclusion Elderly patients with cognitive impairment had a higher frequency of falls compared with general elderly population. This finding together with the association between cognitive impairment and falls, reinforce the need for preventive measures and new health practices with an emphasis on healthy aging.

Perfil dos pacientes e características do tratamento fisioterapêutico aplicado aos trabalhadores com LER/DORT em Juiz de Fora, MG

INTRODUCTION: The restructuring of the production process in recent decades resulted in direct changes in the workers health, changing the profile of illness and suffering of these individuals. Within this context, there is a significant increase in cases of Repetitive Strain Injury (RSI) and Work-Related Musculoskeletal Disorders (WRMD). OBJECTIVE: To know the profile of workers with RSI/WRMD and physical therapy to be undergone. METHODS: By applying a structured questionnaire, 80 employees were interviewed, users of the SUS (public health system of Brazil), included in the Physical Rehabilitation Program of the Reference Center for Occupational Health (Cerest - Centro de Referencia em Saude do Trabalhador), through the Department of Occupational Health (DSAT - Departamento de Saude do Trabalhador), City Hall of Juiz de Fora, Department of Health (SS - Secretaria de Saude). RESULTS:There is a predominance of cases of WRMD in females, and 83.8% of the cases personal income is only a minimum wage. Within the occupations found, 76 (95%) were related to manual labor, and the average time working on the same function was of 16 years. Seventy-eight (97.5%) of workers claimed impossibilities in carrying out activities of daily living (ADL). In the physical therapy, 30 (37.6%) reported that they had some kind of kinesiotherapy. CONCLUSION: The strictly pathophysiological vision based on the unidirectional and curative model, does not shown satisfactory and effective results. This fact implies no resolution in pain conditions, favoring extended periods of physical therapy, the overload of public system of health and impact on the emotional and socio-economic development of these workers.

Prevalence of and factors associated with benzodiazepine use in community-resident elderly persons

Objetivo: avaliar a prevalencia e os fatores associados ao uso de benzodiazepinicos em idosos da comunidade. Metodo: Estudo transversal, realizado por meio de inquerito domiciliar, com 423 idosos de Juiz de Fora, MG, Brasil. Para analise dos fatores associados ao desfecho, foi utilizado o modelo de regressao de Poisson, baseado no modelo teorico de determinacao com blocos hierarquizados. As variaveis foram ajustadas dentro de cada bloco, permanecendo no modelo final aquelas com nivel de significância de 5%. Resultado: A prevalencia de uso de benzodiazepinicos foi de 18,3% (IC95% 15,2-21,6). A maioria dos benzodiazepinicos utilizados possui meia vida de eliminacao longa (59,2%) e o tempo de uso foi considerado prolongado em 85,5% dos usuarios. Dentre os usuarios de benzodiazepinicos, 38,4% tambem utilizavam antidepressivos. O uso de desses farmacos se mostrou associado a presenca de transtornos mentais e comportamentais autorrelatados, polifarmacia e realizacao de consulta medica nos ultimos tres meses. Conclusao: O uso de benzodiazepinicos foi considerado elevado entre idosos. A reducao da prescricao deve ser avaliada de forma individualizada, considerando as alteracoes fisiologicas dos idosos e os efeitos adversos dos medicamentos, a fim de minimizar prescricoes inadequadas.

Prevalência do medo de cair em uma população de idosos da comunidade

Objectives: To investigate the prevalence of fear of falling among a sample of elderly persons in the community, and to analyze its correlation with age, self-perceived health, difficulty walking, use of an assistive device for walking, history of falls, and functional capacity. Method: A cross-sectional study of 314 non-institutionalized elderly individuals, living in the city of Juiz de Fora in the state of Minas Gerais) in 2015, was carried out. A household survey was conducted and fear of falling was assessed using the Falls Palavras-chave: Saúde do idoso. Envelhecimento. Medo. Acidentes por Queda. Estudos Transversais. http://dx.doi.org/10.1590/1981-22562017020.160176Objetivos: Verificar a prevalencia do medo de cair em uma populacao de idosos da comunidade e analisar a sua correlacao com idade, autopercepcao de saude, dificuldade para andar, uso de dispositivo auxiliar, historico de quedas e capacidade funcional. Metodo: Estudo transversal com 314 idosos, nao institucionalizados, residentes na cidade de Juiz de Fora, MG, em 2015. Foi realizado inquerito domiciliar e o medo de cair foi avaliado usando Falls Efficacy Scale Internacional - Brasil (FES-I-BRASIL). Para verificar a correlacao das variaveis independentes com o medo de cair, foi utilizada correlacao de Spearman. Nivel de significância do estudo foi de 5%. Resultados: A prevalencia do medo de cair entre os idosos foi de 95,2% (IC95%=92,3; 97,3). O medo de cair correlacionou-se significativamente com todas as variaveis analisadas: idade (r=0,199), autopercepcao de saude (r=0,299), dificuldade para andar (r=-0,480), uso de dispositivo auxiliar da marcha (r=0,337), historico de quedas (r=-0,177) e capacidade funcional (r=-0,476). Conclusoes: Foi verificada alta prevalencia do medo de cair e correlacao significativa entre o desfecho e as variaveis estudadas. Esses achados apontam para a necessidade de estrategias de reabilitacao, prevencao e promocao a saude que possibilitem o envelhecimento saudavel.

Prevalence and factors associated with alcohol and tobacco use among non-institutionalized elderly persons

Objective: The present study aims to evaluate the prevalence of and factors associated with the use of tobacco and alcohol among elderly people living in the northern part of the city of Juiz de Fora, Minas Gerais, Brazil. Method: A cross-sectional study conducted through a home survey was performed with a sample of 423 elderly citizens. Interviews were conducted through a questionnaire including the Fagerström and Audit-C tests. The data were subjected to descriptive statistical analysis and multinomial regression. Palavras-chave: Envelhecimento Populacional. Saúde do Idoso. Alcoolismo. Tabagismo. http://dx.doi.org/10.1590/1981-22562018021.170185