Tabagismo em idosos

Introdução: o tabagismo é um grave problema de saúde pública em âmbito mundial que afeta a todas as faixas etárias, causando altas taxas de morbimortalidade evitáveis.Objetivo: descrever o que vem sendo publicado sobre o tabagismo na população idosa nos últimos cinco anos na esfera internacional.Metodologia: trata-se de uma revisão integrativa da literatura, onde foram realizadas buscas de artigos nas seguintes bases de dados: PUBMED/MEDLINE, BVS/LILACS, SCOPUS e SCIELO, utilizando os seguintes Descritores em Ciências da Saúde em inglês: “Tobacco Use Cessation” OR “Tobacco Use Disorder” AND “Health of the Elderly” OR “Aged” OR “Aged, 80 and over”. O recorte temporal foi de 2016 a 2020.Resultados: dos 1.642 trabalhos recuperados das bases, houve o afunilamento para um número total de 18 artigos, com a seguinte categorização: mortalidade e outros desfechos clínicos negativos (5); o tabagismo, as síndromes geriátricas e outras patologias (4); políticas públicas para o controle do tabaco (3); qualidade de vida e tabagismo (3); e fatores preditores para cessação tabágica (3).Conclusões: apenas um estudo selecionado foi realizado no Brasil, ressaltando a necessidade de mais estudos brasileiros envolvendo o tabagismo na população idosa objetivando uma melhor compreensão dos aspectos envolvidos e futuras capacitações e otimização de políticas públicas específicas.

An overview on the treatment and outcome factors of ankle fractures in elderly men and women aged 80 and over: a systematic review

Introduction This article is a systematic review of the literature on elderly aged 80 and over with an ankle fracture. Low energy trauma fractures are a major public health burden in developed countries that have aged populations. Ankle fractures are the third most common fractures after hip and wrist fractures. The purpose of this review is to provide an overview of the treatments and the used outcome factors. Methods PubMed, Embase, Cochrane Library, and CINAHL were searched to retrieve relevant studies. Studies published in English or Dutch concerning the treatment of ankle fractures in patients aged 80 and over were included. Results Initially 2054 studies were found in the databases. After removing duplicate entries, 1182 remained. Finally, after screening six studies were included, of which three cohorts studies and three case series. Six different treatments were identified and described; ORIF, transarticular Steinmann pin, plaster cast with or without weight-bearing, Gallagher nail and the TCC nail. Furthermore, 32 outcome factors were identified. Discussion The various studies show that practitioners are careful with early weight-bearing. However, if we look closely to the results and other literature, this seems not necessary and it could potentially be of great value to implement early weight-bearing in the treatment. Furthermore, quality of life seems underreported in this research field. Conclusions ORIF with plaster cast and permissive weight-bearing should be considered for this population since it seems to be a safe possibility for a majority of the relatively healthy patients aged 80 and over. In cases where surgery is contra-indicated and a plaster cast is the choice of treatment, early weight-bearing seems to have a positive influence on the outcome in the very old patient.

What matters to people aged 80 and over regarding ambulatory care? A systematic review and meta-synthesis of qualitative studies

The growing percentage of the population aged 80 and over is challenging for healthcare systems, as frailty and other complex health issues are common in this age group. In order to provide patient-centered ambulatory healthcare, their preferences and expectations need to be explored. Therefore, the aim of this study was to systematically search for and synthesize qualitative evidence on how people aged 80 and over believe ambulatory healthcare (medical and nursing care) should be delivered to them. Medline, PsycINFO, CINAHL, Web of Science Core Collection and Google Scholar were searched for full research reports of qualitative studies focusing on the preferences, wishes, needs, expectations and experiences of people aged 80 and over regarding ambulatory medical and nursing care. The results were screened by two independent reviewers using a two-step approach. The included studies were meta-synthesized using Thomas and Harden’s ‘thematic synthesis’ approach in order to gain a new, second-order interpretation of the findings of the primary studies. In the intermediate synthesis step, 14 aspects of healthcare structures and care relationships were identified as relevant. Based on these, three underlying wishes were found: feeling safe, feeling like a meaningful human being, and maintaining control and independence. The results of this review are in line with other research, such as reviews focusing on the preferences of the younger age group (65–80). However, the importance of aspects of care relationships as an integral part of favorable ambulatory healthcare and the wish to be strengthened as a meaningful human being are emphasized more strongly.

Association of Frailty Status and Functional Disability among Community-Dwelling People Aged 80 and Older in Vietnam

Objectives. This study investigated associations between frailty and functional disability in elder suburban Vietnamese. Method. Cross-sectional analysis was carried out on 251 participants aged 80 and over in Soc Son district. We used the Instrumental Activities of Daily Living (IADL) scale including 8 items, and functional disability was defined as ≥3 IADL impairment. We defined frail as ≥3 out of 5 frailty components including weight loss > 5 % , weak grip, exhaustion, low walking speed, and low physical activity. Results. Of 251 participants with a mean age of 84.6, 11.2% was classified as frail and 64.5% had ≥3 IADLs. Among the frailty components, low walking speed and low physical activity were significantly associated with increased odds of having ≥3 IADLs: ORs (95% CI) were 4.2 (2.3-7.9) and 3.7 (1.7-8.2). Conclusion. Frailty is associated with the higher likelihood of having functional disability. Further longitudinal studies are needed to examine the causal this relationship.

En Bloc Resection of Bladder Tumor—Is It the Way Forward?

Transurethral resection of bladder tumors (TURBT) represents the cornerstone in diagnosis and treatment of bladder cancer but recurrence is observed in up to 80% and over- or understaging with TURBT is common. A more recent development to overcome these limitations represents en-bloc resection of bladder tumors (ERBT) which offers several advantages over TURBT. In this report, we briefly review studies assessing outcomes of bladder cancer patients undergoing ERBT. Most randomized and non-randomized trial demonstrate improvement in clinical outcomes for ERBT over TURBT, however more pathological and translational studies are warranted.

Global Kelp Forest Restoration: Past lessons, status, and future goals

Kelp forest ecosystems and their associated ecosystem services are declining around the world. In response, marine managers are working to restore and counteract these declines. Kelp restoration first started in the 1700s in Japan and since then has spread across the globe. Restoration efforts, however, have been largely disconnected, with varying methodologies trialled by different actors in different countries. To distil lessons learned over the last 60 years of kelp restoration, we synthesize the results of nearly 200 projects spanning 1957 to 2020, across 16 countries, five languages, and user groups. Our results show that kelp restoration projects have increased in frequency, have employed 12 different main methodologies, and targeted 17 different kelp genera. Of these projects, the majority have been led by academics (62%), have been conducted at sizes of less than 1 hectare (80%) and over time spans of less than 2 years. We show that projects are most successful when they are located near existing healthy kelp forests. Disturbance events such as sea-urchin grazing are identified as regular causes of project failure. Costs for restoration are historically high, averaging hundreds of thousands of dollars per hectare, but we explore avenues to reduce these costs and suggest pathways for scaling-up future restoration efforts. One key suggestion is the creation of a living database which serves as a platform for recording restoration projects, showcasing and/or re-analyzing the data, and providing updated information. In this way, our work establishes the groundwork to provide adaptive and relevant recommendations on best practices for kelp restoration projects today and into the future.

Alzheimer in Brazil, epidemiology of the last 5 years

Introduction: Alzheimer’s disease (AD) is the most frequent neurodegenerative pathology associated with age, being progressive, insidious and irreversible, whose cognitive and neuropsychiatric manifestations result in an eventual disability. Thus, the interest in evaluating the epidemiological profile of hospitalizations in Brazil, according to age and sex in the period of 5 years. Methods: Ecological and descriptive study. The data collection for this study was based on results obtained through the Health Information (TABNET) and the SUS Hospital Information System (SIH / SUS) in the period from 2016 to 2020. Results: In the period of 5 years, 7,431 admissions for Alzheimer’s were registered, with the highest prevalence in the Southeast, with 4,192 cases (56.41% of total admissions), followed by the South, with 1,727 cases (23.24%). The least incident region was in the North, with 199 cases. There was a predominance of females, with 4,842 cases (65.15%). The most affected age group was between 80 and over, with 4,398 cases, followed by between 70 and 79, with 2,117. From 2016 to 2020, there was a decrease of 19.25% in the number of hospitalizations, however it had a progressive increase until 2019, being the most incident year. Conclusion: The profile was given by a female figure over 80 years old, from the Southeast. As for the progressive increase until 2019, it is necessary to implement measures and policies guiding and welcoming these patients and their families, promoting a better quality of life for the affected population.