Patrícia Dall'Agnol Bianchi

Efeito de uma sessão de hemodiálise sobre o estresse oxidativo sistêmico de pacientes renais crônicos terminais

OBJECTIVE: To assess the effect of a hemodialysis (HD) session on systemic oxidative stress of chronic renal patients. METHODS AND RESULTS: The study comprised 17 patients (10 women and 7 men with mean age of 39.9 ± 13.5 years) undergoing hemodialytic treatment at the Unit of Nephrology of Hospital de Clinicas de Porto Alegre, and a control group formed by 18 healthy individuals (4 women and 14 men with mean age of 34.8 ± 10.1 years). Renal patients had blood samples withdrawn before and after HD session. Means were analyzed by Student t test (p < 0.05). In red blood cells, the activity of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) was assessed. In plasma, the non-enzymatic antioxidant system was assessed by measuring the total reactive antioxidant potential (TRAP). No significant differences were observed between the values of SOD and CAT before and after HD. Comparison with the control group showed a significant reduction in the activity of those enzymes. After HD session, a significant reduction in TRAP was observed. Oxidative damage to membrane lipids was assessed through chemiluminescence (CL), and the damage to proteins through carbonyl assay. No significant difference was observed in the values of CL and carbonyls after HD. However, when compared with the control group, a significant difference was observed, indicating a greater damage to membrane lipids and proteins in renal patients. CONCLUSIONS: Chronic renal patients on HD treatment show a reduction in the activity of antioxidant enzymes SOD and CAT, in addition to an increase in oxidative damage, when compared with healthy individuals. One HD session does not change those levels.

Avaliação da resiliência do cuidador de idosos com Alzheimer

This observational study of the descriptive case study type aimed to evaluate the resilience of caregivers of demented elderly people with Alzheimer. A questionnaire was used to trace the profile of the caregivers; bipolar protocol to evaluate the fatigue subjective state; the SRQ - Self Report Questionnaire to evaluate the stress; the Zarit inventory to evaluate overload and protocol to evaluate resilience of the six caregivers who participated in this study. Quantitative variables were described as a function of their average and variance. For associations, the Pearson Correlation and the Chi-Square test were used. The significance level adopted was p < 0.05. Results indicated that 83.3% of caregivers were females and 16.7% males, four of which (66.7%) sons and two (33.3%), consorts. It was observed that the health status of four caregivers got worse, going from a regular to a bad state in a five-year period. One (16.7%) caregiver dedicated 20 hours of his time for caring, and for the others (83.3%) the requirement was of 24 hours. Two did not show any possibility of developing disturbances, while four showed possibilities of developing mental disturbances. 66.7% of the caregivers did not show overload, while 33.3% were under intense overload. Even though some demonstrated fatigue and overload, the majority (83.3%) presented a high disposition for resilience. There was significant association between resilience and age (p< 0.05), and this expressed that the older the caregiver the greater the resilience.

Malnutrition risk and hospitalization in elderly assisted in Primary Care

Abstract The aim of this study was to investigate the association of malnutrition risk and single items of the Mini Nutritional Assessment (MNA®) with hospitalization in the last 12 months in the elderly assisted in primary care. A cross-sectional study was conducted with the evaluation of 1229 elderly persons assisted in Family Health Strategies in seven cities of South Brazil. Malnutrition risk was evaluated using the MNA®, and hospitalization was determined by one question of the Probability of Repeated Admission (PRA) instrument. Most of the elderly were women (61.7%), with a mean age of 71.7 ± 7.7 years. The malnutrition risk rate was 23.3% and hospitalization was 32.9%. The frequency of malnutrition and risk of malnutrition was two times greater among the elderly who were hospitalized (36.8 versus 18.6% - P < 0.001). There was a significant association between hospitalization and 11 (64.7%) of the 17 items on the MNA® evaluated (P < 0.05). Of these, seven items were independently associated with hospitalization by multivariate analysis. We observed an association of malnutrition risk and most of the single MNA® items as well, with hospitalization in the elderly assisted in primary care.

Síndrome metabólica e estado nutricional de idosos cadastrados no HiperDia

Aims: To analyze the association of metabolic syndrome and its components with the nutritional status of elderly enrolled in the HiperDia system.Methods: This was a cross-sectional study with a sample of elderly enrolled in the HiperDia of Central Specialty Unit of Municipal Health Department from Cruz Alta, Rio Grande do Sul, whose records contained the information necessary for the study. Metabolic syndrome diagnosis was based on criteria established by the National Cholesterol Education Programs Adult Treatment Panel III (NCEP-ATP III) and recommended by the Brazilian Society of Cardiology in the I Brazilian Guidelines for Diagnosis and Treatment of Metabolic Syndrome. Nutritional status was assessed by body mass index, according to the classification of II Guidelines on Geriatric Cardiology of the Brazilian Society of Cardiology. In the statistical analysis, the Student t test and the chi-square test were used, with analysis of adjusted residuals.Results: At all 485 seniors met the inclusion criteria and were selected. The sample mean age was 68.9±6.8 years (range 60 to 94 years). Most participants were female (62.5%) had metabolic syndrome (61.2%), and overweight/obesity (59%). When analyzing the association between nutritional status and metabolic syndrome and its components, significant associations of obesity with metabolic syndrome, central obesity, hypertriglyceridemia, and presence of four/five components of the syndrome (p <0.001) were found. The most common metabolic syndrome component was high blood pressure (81.3%), and the less frequent was hypertriglyceridemia (48.2%). Regarding gender, the frequency of metabolic syndrome was significantly higher among women (p=0.004; 66.3% versus 52.7%).Conclusions: The frequency of metabolic syndrome and its components and its association with nutritional status of elderly enrolled in HiperDia provides evidence that metabolic syndrome and nutritional status should also be monitored through this system.

CONDIÇÕES DE SAÚDE E PERFIL DE IDOSOS DO MUNICÍPIO DE XV DE NOVEMBRO – RS

O objetivo foi conhecer o perfil e as condicoes de saude dos idosos do municipio de XV de Novembro-RS. Realizou-se estudo observacional descritivo. A amostra envolveu 10% dos idosos do municipio que frequentam as Unidades Basicas de Saude, atraves do programa ESF. Participaram 71 idosos (34 masculino; 37 feminino). Utilizou-se questionario de Boult el al.(1994), adaptado por Veras. Os resultados indicaram que ha grande percentual de idosos casados, vivendo em casa propria, com ensino fundamental incompleto. A principal profissao era agricultura. A faixa etaria prevalente foi dos 60 aos 79 anos e com reduzido numero de filhos. A percepcao de saude foi boa, sendo que a maioria nao precisou de internacao hospitalar nenhuma vez e realizaram de duas a tres consultas (ultimo ano). As cirurgias mais frequentes foram histerectomia, colecistectomia e apendicectomia e a doenca mais prevalente foi a hipertensao. Dentre as neoplasias prevaleceu o câncer de pele.