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- ItemSomente Metadadados25(oh)vitamina d como preditor de desfechos e óbito em idosos longevos(Universidade Federal de São Paulo (UNIFESP), 2016-10-26) Pontes, Tatiana Elias de [UNIFESP]; Cendoroglo, Maysa Seabra Cendoroglo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)25(OH) Vitamin D as Predictor of Outcomes and Death in Oldest Old One of the greatest cultural achievements of a people in their humanization process is the aging of its population, reflecting the improvement of living conditions. Some factors that contribute to active aging can benefit the raising number of oldest old people. Vitamin D and life style have shown impact on functionality and mortality. That context, this study has aimed to evaluate the relationship between serum levels of 25(OH) Vit D, outdoor activity, poor outcomes and death in independent oldest old. We selected 258 community-dwelling and independent elderly people with 80 years old or more, accompanied the Geriatrics and Gerontology Division, Federal University of São Paulo. We dose serum levels of 25(OH)D and apply a questionnaire on skin type, sun exposure and falls. We evaluated the mortality through the death certificate or register in medical records from April 2010 to March 2016. During the survival analysis, we have used the models of Kaplan-Meier and Cox. Around 70.5% were women between 80 to 89 years old (80.2%), 38.8% had daily sunlight exposure > 15 minutes and 20.1% were chronic fallers. Regarding 25(OH)D, 9.3% had serum levels < 10 ng/mL, while 76.4% between 10-30 ng/mL and 14.3% showed values > 30 ng/mL. During the observational period, 65.9% of the old oldest have stayed independent, and 17.1% have deceased. The analysis of survival time have shown that men (HR=2.7, p=0.003), over 90 years old (HR= 4.12, p < 0.001), with levels of 25(OH)VitD < 10 ng/mL (HR=3.2, p=0.004) and chronic fallers (HR=1.97, p=0.042) have shown a lower survival in comparison to the other oldest old; while women, aged 80-89 years, with a level of 25(OH) VitD > 10ng/mL and not chronic fallers, have characterized the lower risk group. Thus, we have identified that insufficient levels of 25(OH) VitD contribute to increased risk of death in the oldest old.
- ItemAcesso aberto (Open Access)Avaliação de fatores clínicos, laboratoriais e ultrassonográficos preditores de malignidade em nódulos tiroidianos(Sociedade Brasileira de Endocrinologia e Metabologia, 2011-02-01) Rio, Ana Luiza Silva [UNIFESP]; Biscolla, Rosa Paula Mello [UNIFESP]; Andreoni, Danielle Macellaro [UNIFESP]; Camacho, Cléber Pinto [UNIFESP]; Nakabashi, Cláudia Cristina Doimo [UNIFESP]; Mamone, Maria da Conceição de Oliveira Carneiro [UNIFESP]; Ikejiri, Elza Setsuku [UNIFESP]; Matsumura, Luiza Kimiko [UNIFESP]; Hidal, Jairo Tabacow [UNIFESP]; Maciel, Rui Monteiro de Barros [UNIFESP]; Furlanetto, Reinaldo Perrone [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Instituto Israelita de Ensino e Pesquisa Albert Einstein Centro de Doenças Tiroidianas; Fleury Medicina e SaúdeOBJECTIVE: To evaluate the risk of malignancy in thyroid nodules through clinical, laboratory, ultrasonographic and cytological aspects. PATIENTS AND METHODS: 741 nodules of 407 patients. RESULTS: The cytology was benign (60,5%), indeterminate (23,3%), malignant (8,3%) or nondiagnostic (7,6%). The prevalence of cancer in indeterminate citology was 18,5% (16% in follicular lesions, 44% in suspicious). The diagnosis of malignancy was 17,2% (n = 70). The frequency of cancer in women (15,2%) was lower than in men (27,9%). There was an inverse relation between age and cancer risk. There was no statistical significance in the prevalence of cancer according to number, size of nodules or TSH levels. Hypoechogenicity and microcalcifications on ultrasound were risk factors. CONCLUSION: The risk of malignancy was higher in men, hypoechoic nodules, with microcalcifications and was inversely related to age. The TSH level was not an independent factor predictive of malignancy.
- ItemAcesso aberto (Open Access)Color doppler evaluation of the influence of type of delivery, sex, postnatal age and time post feeding on full term healthy newborns cerebral blood flow(Academia Brasileira de Neurologia - ABNEURO, 2009-06-01) Aranha, Carlos Alberto [UNIFESP]; Lederman, Henrique Manoel [UNIFESP]; Segre, Conceição A.m. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Israelita Albert EinsteinOBJECTIVE: The purpose of this study was to evaluate with Color Doppler the influence of type of delivery, sex, postnatal age and time post feeding on full term healthy newborns cerebral blood flow. METHOD: 50 newborns were studied. The Doppler parameters, peak-systolic velocity, end-diastolic velocity, mean velocity, pulsatility index and resistance index, were measured in the anterior cerebral artery, middle cerebral artery, posterior cerebral artery, and basilar artery. The data were compared and analyzed by statistical tests. Informed consent was obtained from all parents, and the study was approved by institutional ethical committee and review board. RESULTS: We observed not statistically significant differences on cerebral blood flow Doppler parameters in relation to type of delivery, sex, postnatal age and feeding in full term healthy newborns. CONCLUSION: We believe that the knowledge of these cerebral hemodynamic profile of newborns in the first days of life can contribute in an accurate interpretation of cranial Doppler abnormal findings when pathologic flow velocities are analyzed.
- ItemAcesso aberto (Open Access)Envolvimento religioso e fatores sociodemográficos: resultados de um levantamento nacional no Brasil(Faculdade de Medicina da Universidade de São Paulo, 2010-01-01) Moreira-Almeida, Alexander; Pinsky, Ilana [UNIFESP]; Zaleski, Marcos José Barreto [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Universidade Federal de Juiz de Fora Faculdade de Medicina; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: The relationship between religious involvement and health has been subject to an increasing interest. However, studies investigating religious involvement are scarce outside United States and Europe. OBJECTIVES: This study describes religious involvement in the Brazilian population and its relationship with sociodemographic variables. METHODS: In a Brazilian nationally probabilistic sample (n = 3,007), religious involvement variables and sociodemographic factors were assessed. RESULTS: Five percent of Brazilians reported having no religion, 83% considered religion very important in their lives, and 37% attended religious services at least once a week. The most frequent affiliations were Catholicism (68%), Protestant/Evangelicals (23%), and Kardecist Spiritism (2.5%). Ten percent reported attending more than one religion. In line with studies in other countries, older age and female gender were independently associated with higher levels of subjective and organizational religiousness after controlling for other sociodemographic factors. However, educational level, income and black race were not independently associated with religious involvement variables. DISCUSSION: This study shows high levels of religious involvement among Brazilians and suggests that religiousness may have different associations with other variables across different cultures. To better understand the influence of religion on health, it is necessary to expand this kind of survey to other cultures.
- ItemAcesso aberto (Open Access)Higher mortality rate is associated with advanced age and periodic lateralized epileptiform discharges in patients with refractory status epilepticus(Academia Brasileira de Neurologia - ABNEURO, 2013-03-01) Liberalesso, Paulo Breno Noronha; Garzon, Eliana [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Sakamoto, Américo Ceiki [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective To evaluate clinical data, electroencephalogram, etiology, classification, treatment, morbidity, and mortality in acute refractory status epilepticus. Methods Fifteen patients, mean age of 41.3 years-old, six males, with refractory status epilepticus, were retrospectively studied. All of them were followed by serial electroencephalogram or continuous electroencephalographic monitoring. Results The most common comorbidity was hypertension. Seven (46.7%) patients were diagnosed with previous symptomatic focal epilepsy. More than one etiology was identified in 40.0% of the cases. Status epilepticus partial complex was the most common (n=14, 93.3%), and discrete seizures were the most observed initial ictal pattern. Continuous intravenous midazolam was used in nine (60.0%) patients and continuous thiopental in three (20.0%). Nine (60.0%) participants died, one (6.6%) had neurological sequelae, and five (33.3%) presented no neurological sequelae. Conclusions Higher mortality rate was associated with advanced age and periodic lateralized epileptiform discharges. Midazolam proved to be a safe drug. The refractory status epilepticus is related to high mortality.
- ItemAcesso aberto (Open Access)Valores normais das velocidades de condução nervosa em um grupo de 101 pessoas(Academia Brasileira de Neurologia - ABNEURO, 1992-03-01) Grandini, Dalva Livramento [UNIFESP]; Nóbrega, J. A. Maciel [UNIFESP]; Juliano, Yara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Motor and sensory nerve conduction velocities were analysed in a group of 101 normal Brazilians. The normal values were obtained considering the group age, the distal and proximal segments of each nerve, the differences in the right and left side for each nerve. A significant decline in the conduction was found for the elderly aged group.