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.

Epidemiological profile of bacterial meningitis in the state of São Paulo

Introduction: Meningitis is an inflammatory process of the meninges, which can be of infectious cause or not. Among the infectious, the bacterial is the most alarming for society, since it has a much higher rate of morbidity and mortality. Objectives: Analyze and describe the epidemiological profile of bacterial meningitis in the State of São Paulo. Methods: Descriptive epidemiological study of cases of bacterial meningitis in the State of São Paulo, carried out through the DATASUS platform, in the period from 2016 to 2020. Results: The State of São Paulo registered 4013 cases of bacterial meningitis, 67.1% of the cases in the Southeast (5977), being responsible for 53% of the cases of this disease in Brazil. The most affected age group in the State was 0 to 4 years, 33.7% of the total, while elderly people aged 80 and over were the least affected (2.3%). As for deaths, São Paulo recorded 862 and a mortality rate of 21.4%, higher than the country average (20.5%), representing 64% of deaths in the Southeast region. In addition, males were the most affected, registering 58.1% of the total, while females registered 41.8%. Conclusions: São Paulo has the majority of cases and deaths from bacterial meningitis in its region, with a mortality rate that exceeds Brazilian averages and which contributes to the Southeast having more than half of the cases of meningitis in Brazil. More active epidemiological surveillance and greater dissemination of information on meningitis and its signs and symptoms is necessary.

Ambulatory Care Preferences of Older People Age 80 and Over: A Systematic Review of Qualitative Studies

According to the United Nations, the number of people aged 80 and over is expected to treble by 2050 globally. But research on the preferences for care of this age group grows slowly. To achieve high-quality patient-centered care, we need to understand the oldest people’s specific living circumstances, care preferences and goals. The aim of the study was to synthesize findings about ambulatory care preferences, experiences and expectations of people aged 80 and over. We systematically searched Medline, CINAHL, PsycInfo, Web of Science Core Collection and Google Scholar for qualitative studies published until October 2019 and additionally conducted forward and backward citation search for included studies. Two independent reviewers assessed studies for eligibility criteria and quality. We performed a thematic synthesis of study findings as developed by Thomas and Harden using MAXQDA-20 content analysis software. Twenty-three studies were included. They were mainly conducted in Europe, used face-to-face interviews, reported on ambulatory home care and used qualitative content or thematic analysis. The meta-synthesis revealed two fundamental themes from the perspective of older people: feeling safe and feeling valued in their relationships with caregivers and in their care environment. This was shown, for instance, in preferences for coordinated care, high continuity of caregivers, personal attention and interactions based on trust and respect. In practice, the older persons’ preferences should be integrated into care planning and policies to ensure patient-centered care.