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Alzheimer's disease (AD) is a complex neurodegenerative disorder and the most common type of dementia in the elderly. Although its cause is not completely known, several studies suggest that oxidative stress plays an important role in the etiology of this disease. The SIRT1 and SOD2 proteins are linked to pathways that may impair oxidative stress. In this study, we analyzed the association between polymorphisms in these genes and in the APOE gene, through RT-PCR, as well as between environmental factors and the risk of AD. Additionally, the thiobarbituric acid reactive substance assay was performed to estimate the plasma level of malondialdehyde (MDA), a biomarker of lipid peroxidation. Furthermore, some cytogenetic studies indicate that cells of AD patients show increased chromosomal damage; thus, we performed the micronucleus cytome assay to assess cytogenetic damage in AD patients. As expected, the APOE polymorphisms were found to be highly associated with AD. Additionally, the CT genotype of the SIRT1 gene showed a positive association with the disease. The frequencies of genomic damage (micronucleus, buds, nucleoplasmic bridges and binucleated cells), the presence of cell death biomarkers (condensed chromatin, karyorrhexis and pyknosis), and the plasma level of MDA were significantly greater in AD patients than in controls. Our results support the hypothesis that AD is a condition with increased oxidative stress and genomic instability, which may contribute to the neurodegeneration in AD.

INTRODUCTION: Delirium is an acute change in cognition and attention, common in the postoperative period in older patients, associated with increased costs and longer hospital stay. OBJECTIVE: To evaluate the frequency, risk factors, and influence of postoperative delirium in older patients submitted to elective noncardiac surgery. METHOD: This was a cross-sectional, observational study of older adults (65 years or older) hospitalized for elective noncardiac surgery. During the immediate preoperative period (24 hours), risk factors such as age, sex, cognition (MiniCog), functional status (Katz and Timed Up and Go), medications, and clinical aspects were evaluated. Delirium, in the immediate postoperative period (up to 72 hours), was evaluated using the Confusion Assessment Method (CAM). RESULTS: A total of 83 patients were included in the study. Of these, 44.6% (n = 37) had undergone orthopedic surgery, 42.16% (n = 35), general surgery, and 13.3% (n = 11), urological surgery. Most participants were men (53%), with a mean age of 73 (65–94) years. Overall, 9.6% (n = 8) had postoperative delirium: 6% of the hyperactive subtype (n = 5), 2.4% of the hypoactive subtype (n = 2), and 1.2% of the mixed subtype (n = 1). These patients were older (p = 0.02), had greater cognitive decline (p = 0.01), anemia (p = 0.04), and prolonged hospital stay (p = 0.001). CONCLUSION: Postoperative delirium was more commonly observed in the older old with cognitive decline and anemia, with an impact on hospital length of stay, highlighting the importance of a more comprehensive preventive evaluation in the preoperative period.

Estudos demonstram que pacientes com 80 anos ou mais de idade apresentam uma alta frequência de mortalidade durante internação em unidades de terapia intensiva. O objetivo foi avaliar pacientes com idade superior a 80 anos no ambiente de Unidade de Terapia Intensiva geral (UTI), analisando escores prognósticos APACHE II e SOFA e os dados clínicos-laboratoriais durante a internação na UTI e associá-los com mortalidade. Coorte histórica analítica e observacional, em uma amostra por conveniência de um hospital-escola. O estudo contou com um número de 173 pacientes, sendo destes 65,3% do sexo feminino com 86±4 (80-99) anos de idade. Durante a internação, observamos um total de 87 óbitos totais (50,3%), sendo 70,11% no período de permanência na UTI. O estudo evidenciou que os pacientes com 80 anos de idade ou mais, apresentam uma alta mortalidade em UTI geral, e os escores de prognóstico APACHE II e SOFA não apresentaram associação com mortalidade.

Late-onset Alzheimer's disease (LOAD) is a multifactorial neurodegenerative disorder that corresponds to most Alzheimer's disease (AD) cases. Inflammation is frequently related to AD, whereas microglial cells are the major phagocytes in the brain and mediate the removal of Aβ peptides. Microglial cell dsyregulation might contribute to the formation of amyloid plaques, a hallmark of AD. Genome-wide association studies have reported genetic loci associated with the inflammatory pathway involved in AD. Among them, rs3865444 CD33, rs3764650 ABCA7, rs6656401 CR1, and rs610932 MS4A6A variants in microglial genes are associated with LOAD. These variants are proposed to participate in the clearance of Aβ peptides. However, their association with LOAD was not validated in all case-control studies. Thus, the present work aimed to assess the involvement of CD33 (rs3865444), ABCA7 (rs3764650), CR1 (rs6656401), and MS4A6A (rs610932) with LOAD in a sample from southeastern Brazil. The genotype frequencies were assessed in 79 AD patients and 145 healthy elders matched for sex and age. We found that rs3865444 CD33 acts as a protective factor against LOAD. These results support a role for the inflammatory pathway in LOAD.

Alzheimer's disease (AD) is a complex neurodegenerative disorder and the most common type of dementia in the elderly. Although its cause is not completely known, several studies suggest that oxidative stress plays an important role in the etiology of this disease. The SIRT1 and SOD2 proteins are linked to pathways that may impair oxidative stress. In this study, we analyzed the association between polymorphisms in these genes and in the APOE gene, through RT-PCR, as well as between environmental factors and the risk of AD. Additionally, the thiobarbituric acid reactive substance assay was performed to estimate the plasma level of malondialdehyde (MDA), a biomarker of lipid peroxidation. Furthermore, some cytogenetic studies indicate that cells of AD patients show increased chromosomal damage; thus, we performed the micronucleus cytome assay to assess cytogenetic damage in AD patients. As expected, the APOE polymorphisms were found to be highly associated with AD. Additionally, the CT genotype of the SIRT1 gene showed a positive association with the disease. The frequencies of genomic damage (micronucleus, buds, nucleoplasmic bridges and binucleated cells), the presence of cell death biomarkers (condensed chromatin, karyorrhexis and pyknosis), and the plasma level of MDA were significantly greater in AD patients than in controls. Our results support the hypothesis that AD is a condition with increased oxidative stress and genomic instability, which may contribute to the neurodegeneration in AD.

Resumo Objetivo Avaliar a frequência de deficiência de vitamina B12 e fatores associados em idosos institucionalizados. Método Analisamos 65 idosos, com idade média de 80±9 anos (61-113), de uma instituição geriátrica filantrópica de longa permanência. A dosagem sérica de vitamina B12 foi analisada e classificada em: normal (≥299 pg/mL), limítrofe (200-298 pg/mL) e deficiência (

Genome-wide associations studies (GWAS) are detecting new variants associated with late-onset of Alzheimer’s disease (LOAD), a multifactorial neurodegenerative disorder. The variants rs744373 BIN1, rs11136000 CLU and rs3764650 ABCA7 uncovered by GWAS led to different AD pathways, such as metabolism, trafficking and endocytosis of lipids and inflammation. However, most of the association studies did not replicate these variants with significance. This could be due to a small power effect evident when these variants are tested independently with LOAD. Therefore, we aimed to investigate whether the combination of different variants would additively modify the risk of association with LOAD that is observed in GWAS. We performed an association study testing pairwise variants in metabolism, trafficking and endocytosis of lipid (rs429358 and rs7412 APOE, rs744373 BIN1, rs3764650 ABCA7 and rs11136000 CLU) pathways with LOAD in samples from southeastern Brazil. Our data suggest a risk effect for LOAD between APOE with CLU and APOE with BIN1 genes.

The sundown syndrome is a complex neurobehavioral disorder in patients with dementia associated with high financial cost and significant caregiver burden. It is a multifactorial phenomenon with unclear pathophysiology, characterized by the presence of neuropsychiatric symptoms in the evening period. Objective: To analyze the main neuropsychiatric symptoms, their correlation with one another, with comorbidities, and with time of day of greatest symptom intensity in patients with Alzheimer’s disease dementia. Methods: This is a cross-sectional, observational and explanatory study in which caregivers/relatives of elderly patients with dementia were interviewed using a structured tool called the Neuropsychiatric Inventory (NPI). Results: The sample studied was composed of 38 patients, 60.5% female and 39.5% male, with mean age of 81±6 (67-94) years. A high frequency of neuropsychiatric symptoms in the evening period was observed, predominantly irritability (55.3%), nocturnal behavior (47.4%), and aggressiveness (42.1%). Only 36.8% of the family caregivers used non-pharmacological strategies. Conclusion: The frequency of neuropsychiatric symptoms was exacerbated in the evening among patients with Alzheimer’s disease, especially for those behavioral symptoms that had a positive correlation with one another. RESUMO A síndrome do entardecer ou “pôr do sol” - “sundown syndrome” - é uma alteração neurocomportamental complexa em pacientes portadores de demência que geram custos financeiros excessivos e desgaste importante a seus cuidadores. Trata-se de um fenômeno multifatorial com fisiopatologia incerta, que caracteriza-se pela presença de sintomas neuropsiquiátricos no período vespertino. Objetivo: Analisar os principais sintomas neuropsiquiátricos, sua correlação entre si, com comorbidades e o horário do dia de maior intensidade destes em pacientes portadores de demência da doença de Alzheimer. Métodos: Trata-se de um estudo analítico transversal, observacional e explanatório no qual foram entrevistados cuidadores/familiares de pacientes idosos portadores de demência utilizando uma ferramenta estruturada denominada Neuropsychiatric Inventory (NPI). Resultados: A amostra estudada foi de 38 pacientes, 60,5% feminino e 39,5% masculino, com 81±6 (67-94) anos de idade. Foi observada uma alta frequência de sintomas neuropsiquiátricos no período vespertino, principalmente irritabilidade (55,3%), comportamento noturno (47,4%), agressividade (42,1%). Apenas 36,8% dos cuidadores familiares empregavam estratégias não farmacológicas. Conclusão: A frequência dos sintomas neuropsiquiátricos são exacerbados ao entardecer em pacientes com doença de Alzheimer; principalmente os sintomas comportamentais com correlação positiva entre si.

Human longevity is a polygenic and multifactorial trait. Pathways related to lifespan are complex and involve molecular, cellular, and environmental processes. In this analytical observational study, we evaluated the relationship between environment factors, oxidative stress status, DNA integrity level, and the association of FOXO3 (rs2802292), SOD2 (rs4880), APOE (rs429358 and rs7412), and SIRT1 (rs2273773) polymorphisms with longevity in oldest-old individuals from southeastern Brazil. We found an association between the FOXO3 GG genotype and gender. While lifestyle, anthropometric, and biochemical characteristics showed significant results, DNA damage and oxidative stress were not related to lifespan. We found that long-lived individuals with FOXO3 GT genotype had low levels of triglycerides. This study is the first to demonstrate that FOXO3 could be a candidate gene for longevity in the Brazilian population. These results are important in terms of provisions of health care for age-related diseases and lifespan, and provide insight for further research on epigenetic, gene regulation, and expression in oldest-old individuals.

Genome-wide association study (GWAS) has identified several novel genes associated with the risk of Alzheimer's disease (AD), which is a progressive neurodegenerative disease in elders. However, most of the novel genes have not been validated through replication in separated populations. Among them, the BIN1 gene is involved in endocytosis and intracellular trafficking as well as in the formation of β amyloid plaques and neurofibrillary tangles, which are the main pathological hallmarks of AD. The IL-6 gene has also been frequently associated with AD; however, consistent results have not been found. IL-6, a cytokine from the immune system, is implicated in the pathogenesis of several degenerative diseases. Similar to BIN1, it is suggested that IL-6 is also involved in the formation of β amyloid plaques. In this case-control study, we aimed to investigate whether single nucleotide polymorphisms in the BIN1 (rs744373) and IL-6 (rs1800795) genes are associated with AD. Genotype frequencies were evaluated via PCR-RFLP in 82 late-onset AD patients and 159 elderly healthy controls, who were matched by age and gender. In this study, no association was found for either polymorphism, suggesting that these genes are not implicated in the aetiology of AD in all populations.

OBJECTIVES: The objective of this study was to evaluate the frequency of long QT syndrome (LQTS) in the electrocardiographic tracing of elderly people and the concomitant use of drugs that can aggravate this condition. METHODS: This is a crosssectional, observational study of elderly patients in outpatient services at Hospital Santa Casa de Misericórdia de Vitória, over a six-month period. RESULTS: A total of 163 patients with 75 ± 8 (60–94) years of age, 60.7% (n = 99) of whom were female, participated in the study. Of the total number of patients, 33.1% (n = 54) were regularly taking at least one pharmaceutical that increased the risk of QTc prolongation; 34 patients (20.9%) had prolonged QTc and 15 (9,2%) had at-risk QTc. Of these patients with at-risk QTc, 4 (23.4%) were using at least 1 1 pharmaceutical that increases the risk of QT prolongation (p = 0.07). CONCLUSION: In this sample, a high frequency of LQTS was observed, as well as the use of pharmaceuticals that potentially cause LQTS and arrhythmias.

Objective: The aim of the present study was to estimate the prevalence of disability and associated factors in elderly stroke survivors. Methods: A cross-sectional study of 230 elderly persons was conducted in the 22 territories of the Estratégia de Saúde da Família (the Family Health Strategy) of Vitória, in the state of Espirito Santo. Patients were assessed using the modified Rankin Scale. Poisson regression with robust variance in crude and adjusted analyses was employed. Results: The majority of subjects were men (52.1%) aged between 60 to 98 years, with a mean age of 75.8 (sd±9.2). The prevalence of disability was 66%. Age ≥80 years, self-perceived limitations in bodily function, considering the physical structure of the street to be a barrier to leaving home and believing street lighting to be insufficient were positively associated with functional disability. Possessing 12 or more years of schooling was inversely associated with the outcome. Conclusions: The high prevalence of disability and associated factors in elderly stroke survivors reinforce the need for a health system that operates continuously and proactively, promoting active aging. Resumo Objetivo: Estimar a prevalência da incapacidade funcional e os fatores associados em idosos que sofreram o Acidente Vascular Cerebral (AVC). Método: Estudo transversal, realizado nos vinte e dois territórios da Estratégia de Saúde da Família no município de Vitória, ES. Participaram 230 indivíduos com idade igual ou superior a 60 anos. Os dados foram coletados em entrevistas domiciliares e a incapacidade funcional foi avaliada por meio da Escala de Rankin modificada. Empregou-se a regressão de Poisson com variância robusta nas análises bruta e ajustada. Resultado: A maioria dos participantes eram homens (52,1%) entre 60 a 98 anos, a média de idade foi de 75,8, com desvio padrão de 9,2. A prevalência da incapacidade funcional foi de 66%. Na análise ajustada, uma maior prevalência da incapacidade associou-se a ter 80 anos ou mais de idade, autoperceber limitações em funções do corpo, perceber a estrutura física da rua como barreira e achar a sinalização das vias insuficiente. Já ter 12 anos ou mais de estudo, associou-se a uma menor prevalência do desfecho. Conclusão: A alta prevalência da incapacidade funcional nos idosos após o AVC, bem como a identificação dos seus fatores associados reforçam a necessidade de um sistema de saúde que atue de forma contínua e proativa investindo em práticas que promovam o envelhecimento ativo.

Summary Osteoporosis is a disease of ascending character in the world population; in this context, bone biomarkers are being increasingly studied in order to aid in the diagnosis and monitoring of these patients. The main objective of this study was a literature review of articles whose main theme was the use of biomarkers for bone formation and degradation, and to evaluate their possible applicability in clinical practice. Literature review was performed through articles indexed and published in the last five years in the PubMed database. The findings of this study showed that most of the previously selected articles were published in the last two years, and the most cited markers were bone resorption, C-terminal collagen telopeptide (CTX), showing the highest correlation with the dynamics of bone, and the biomarker of bone formation, bone-specific alkaline phosphatase (BAP), which is increased in the event of fracture or may suggest another bone disease. There was an increase in published articles, associating different bone biomarkers and their clinical applicability, especially for treatment control. Our findings suggest that in recent years there has been significant increase in publications evaluating the use of bone turnover biomarkers for bone formation and resorption and their possible clinical applicability, especially in the monitoring of treatment. Still, we believe that further studies need to be conducted to confirm these findings, given the advantages that bone biomarkers can deliver in the clinical management of the disease.

Although several alleles of susceptibility to Alzheimer’s disease (AD) have been studied in the last decades, few polymorphisms have been considered as risk factors for the disease. Among them, the APOE-e4 allele appears to be the major genetic risk factor for the onset of the disease. However, it is important to confirm the potential susceptibility of these genetic variants in dif ferent populations in order to establish a genetic profile for the disease in specific communities. This study analyzed the APOE polymorphisms regarding susceptibility to AD in a sample of 264 individuals (primarily Caucasians; 82 cases and 182 controls) in the population from Vitoria, ES, Brazil, by PCR restriction fragment length polymorphism (PCR-RFLP) methods. The patients were selected according to clinical criteria for probable AD. Whereas the e4 allele showed statistically significant positive association with susceptibility to AD (OR = 3.01, 95%CI = 1.96-4.61; P < 0.0001), the e2 allele did not. The results of the e4 allele confirm the role of this polymorphism as a risk factor for AD in the sample studied as observed in other populations. Although the e3 allele has been considered neutral in several studies, our results suggest that it acts as a protective factor against AD in the population studied (OR = 0.46, 95%CI = 0.30-0.67; P < 0.0001). This study may provide a new insight into the role of the APOE-e3 allele in the etiology of AD and might help to estabilish a profile of risk for AD in the population from Vitoria, ES.

O enrijecimento arterial é um fator de risco independente para doença cardiovascular, podendo se agravar com a idade e sendo atenuado pelo exercício físico principalmenteem idosos. O objetivo deste estudo foi correlacionar à capacidade física de indivíduos idosos com a Velocidade de Onda de Pulso (VOP). Para tanto, foi avaliada a complacência dos grandes vasos de pacientes do sexo masculino obtido através da medida da VOP com o aparelho COMPLIOR II. O nível de capacidade física foi obtido com o teste de esforço submáximo (teste de caminhada de 6 minutos). Nossos dados sugerem que a rigidez arterial aumenta com aidade, que esta rigidez esta intimamente ligada ao nível de aptidão cardiorrespiratória e que este pode sugestivamente influenciar na prevenção do enrijecimento arterial.

Introduction Stroke is the most common cause of disability in Western countries, yet there is no consensus in the literature on how to measure and describe disability from stroke. Objective To conduct a systematic literature review on disability in stroke survivors. Method Observational studies published in the PubMed, LILACS and SciELO online databases were selected, to evaluate disability in adults and in the elderly after stroke in the period 2002–2012. The Downs and Black checklist for non-randomized studies was used to assess the quality of the articles. Results 212 articles were found from which 16 were selected to compose the study. The mean age of participants was 67 years, and disability affected 24% to 49% of the population evaluated. With regard to measurement instruments, 31% of the studies analyzed presented results of disability by means of the modified Rankin Scale; 19% by means of the World Health Organization’s International Classification of Functioning, Disability and Health; 19% by means of Katz’ Index of Independence in Activities of Daily Living; 12.5% by means of the London Handicap Scale; 12.5 % by means of the Barthel Index; and 6.25% by means of the Functional Independence Measure. Conclusion Literature is not uniform as regards means of measuring disability after stroke, but considering the preference of articles in assessing physical performance in activities of daily living, it can be concluded that a quarter to half of the population that survives stroke has some degree of disability. Introdução O acidente vascular cerebral (AVC) é a causa mais comum de incapacidade nos países ocidentais, e ainda não existe na literatura um consenso na forma de mensurar e descrever tal incapacidade. Objetivo Realizar uma revisão sistemática da literatura sobre a incapacidade nos sobreviventes do AVC. Métodos Foram selecionados estudos observacionais que avaliaram incapacidade na população adulta e idosa após AVC publicados na base de dados LILACS e nas bibliotecas virtuais PubMed e SciELO no período de 2002 a 2012. Para avaliação da qualidade dos artigos foi utilizado o critério de Downs e Black. Resultados Foram encontrados 212 artigos e selecionados 16 para compor o banco de dados. A média de idade dos participantes foi de 67 anos e a incapacidade atingiu de 24% a 49% da população avaliada. Com relação aos instrumentos de mensuração, 31% dos estudos analisados apresentaram os resultados de incapacidade por meio do Modified Rankin Scale, 19% por meio da Classificação Internacional de Funcionalidade, 19% por meio do Katz, 12,5% por meio do London Handicap Scale, 12,5% por meio do Barthel e 6,25% por meio da Medida de Independência Funcional. Conclusão A literatura não é uniforme quanto à forma de mensurar a incapacidade após AVC, mas considerando a preferência dos artigos em avaliar o desempenho físico nas atividades de vida diária, pode-se concluir que de um quarto à metade da população que sobrevive ao AVC apresenta algum grau de incapacidade.

INTRODUÇÃO: Sintomas neuropsiquiátricos ocorrem em 80-90% dos pacientes com demência, interferem significativamente na autonomia do paciente e ocasionam alta carga física, financeira e emocional ao núcleo familiar, resultando em institucionalização precoce. OBJETIVOS: Identificar sintomas neuropsiquiátricos mais frequentes e de maior gravidade nos pacientes portadores da doença de Alzheimer; especificar quais distúrbios são descritos como mais desgastantes pelo cuidador; e correlacionar os sintomas neuropsiquiátricos. MÉTODOS: Realizou-se estudo transversal, descritivo e exploratório, durante um ano, com idosos com provável doença de Alzheimer, atendidos no ambulatório de geriatria de uma instituição filantrópica de Vitória, que estavam acompanhados do principal cuidador. As duas subescalas brasileiras do Inventário Neuropsiquiátrico foram aplicadas ao acompanhante, e os sintomas foram correlacionados utilizando a correlação de Pearson e Spearman. RESULTADOS: Nos 50 pacientes analisados, o comportamento motor aberrante foi a manifestação mais frequente, enquanto a agitação apresentou maior gravidade entre os pacientes e foi relatada como o sintoma mais desgastante pelos cuidadores, que eram, predominantemente, filhas. Múltiplas correlações entre sintomas foram encontradas, sendo muito fortes: delírio e alucinação; delírio e ansiedade; delírio e disforia; agitação e irritabilidade. CONCLUSÃO: Os resultados reforçam a necessidade de estudos voltados para a abordagem das manifestações neuropsiquiátricas, dada sua alta prevalência e à presença de sintomas concomitantes que geram alto grau de desgaste no cuidador. INTRODUCTION: Neuropsychiatric symptoms occur in 80-90% of patients with dementia, interfere significantly in the patient's autonomy and cause high physical, financial and emotional tribulation to the family nucleus, leading to early institutionalization. OBJECTIVES: Identifying neuropsychiatric symptoms more frequent and more severe in patients who are Alzheimer's disease carriers; specifying which disturbs cause more anxiety on caregivers, and correlating neuropsychiatric symptoms. METHODS: Sectional, descriptive and exploratory study was conducted during one year, with elders who might have Alzheimer's disease and were attended as outpatients of a philanthropic institution in Vitoria city and were accompanied by the main caregiver. Two Brazilian subscales of the Neuropsychiatric Inventory were applied to the companions, and the symptoms were correlated using Pearson and Spearman's correlations. RESULTS: In the 50 patients analyzed, aberrant motor behavior was the most common manifestation, while agitation was more severe among patients and was reported as the worst symptom by caregivers, who were predominantly daughters. Multiple correlations were found between symptoms, being very strong: delirium and hallucination, delirium and anxiety, delirium and dysphoria, agitation and irritability. CONCLUSION: Results reinforce the need for studies aimed at approaching neuropsychiatric manifestations, due their high prevalence and the presence of concomitant symptoms that generate high degree of anxiety among caregivers.

The polymorphism at codon 129 of the prion protein gene (PRNP) is a major risk factor for Creutzfeldt–Jakob disease (CJD). Several authors reported neuropathological and clinical overlapping between CJD and Alzheimer’s disease (AD), with a few association studies generating conflicting results. To investigate the distribution of this polymorphism in AD, we selected 58 patients with probable AD and 73 controls from a Brazilian population. There was no association between the PRNP polymorphism at codon 129 and AD. Our meta-analysis (performed using Alzgene; http://www.alzgene.org) along with previous studies conducted in Brazil demonstrated a negative association.

Alzheimer’s disease (AD) is a complex neurodegenerative disorder and the primary cause of dementia in the elderly and causes a decrease in cognition, functionality, and behaviour. Genetic risk factors play an important role in the pathogenesis of AD. In this case–control study, we aimed to investigate whether single nucleotide polymorphisms in MTHFR (rs1801133), PICALM (3851719), CLU (rs11136000), and CR1 (rs6701713) are associated with AD. Genotype frequencies were evaluated in 82 late-onset AD patients and 161 elderly healthy controls matched by age and gender. We detected a significant association of the MTHFR rs1801133 and PICALM rs3851179 polymorphisms with AD. The results of this study support the hypothesis that several genes are involved in the aetiology of AD.

OBJETIVO: Determinar as medidas ecocardiográficas de referência das cavidades cardíacas, da massa e dos índices de massa do ventrículo esquerdo (VE) em amostra da população adulta assintomática. MÉTODOS: Estudo observacional realizado em amostra aleatória da população da cidade de Vitória, Brasil. Foi realizado ecocardiograma transtorácico em 295 indivíduos voluntários (61,7% mulheres), sem história pregressa de doença cardiovascular. Os diâmetros dos ventrículos, a espessura do septo interventricular e da parede posterior do VE, a massa e os índices de massa VE e os diâmetros da aorta e do átrio esquerdo foram avaliados por ecocardiograma unidimensional. As medidas foram descritas por média e desvio padrão, por percentis, com intervalo de confiança de 95%. RESULTADOS: Sexo e idade influenciaram discretamente os valores ecocardiográficos. Em geral, os valores das medidas cardíacas foram maiores no sexo masculino. A espessura da parede posterior, os índices de massa corrigidos pela altura e o diâmetro diastólico foram influenciados pela idade. Os valores de percentil de 95% de septo interventricular e parede posterior do VE para homens foram 9,9 mm e 9,6 mm, respectivamente, e 9,3 mm para septo e parede posterior para mulheres. CONCLUSÃO: Os valores do percentil de 95% do septo interventricular e da parede posterior e, conseqüentemente, de massa ventricular esquerda absoluta e indexada encontrados em nosso estudo na população de Vitória são inferiores aos valores encontrados em estudos prévios. Nesse aspecto, os resultados deste estudo serão úteis como referência, pois estão de acordo com os novos limites sugeridos na literatura para o diagnóstico ecocardiográfico de hipertrofia ventricular esquerda. OBJECTIVE: To determine echocardiographic reference values for cardiac chambers, left ventricular mass, and left ventricular (LV) mass indexes in an asymptomatic adult population sample. METHODS: This was an observational study based on a randomly selected population sample from the city of Vitória, Brazil. Two hundred and ninety-five volunteers (61.7% women) with no past history of cardiovascular disease underwent transthoracic echocardiography. The following M-mode echocardiographic parameters were measured: ventricular diameters, interventricular septal thickness, LV posterior wall thickness, LV mass, left ventricular mass indexes, plus aortic and left atrial diameters. Values were expressed as mean and standard deviation and percentiles, with a 95% confidence interval. RESULTS: Echocardiographic values were slightly influenced by gender and age. Overall, cardiac measurements were higher in the male gender. LV posterior wall thickness, mass indexes corrected for height and diastolic diameter were influenced by age. The 95% percentiles of interventricular septum and LV posterior wall were 9.9 mm and 9.6 mm for men, respectively, and 9.3 mm for septum and posterior wall for women. CONCLUSION: The 95% percentile values of interventricular septum and posterior wall and, therefore, of both absolute and indexed left ventricular mass found in our study conducted in the Vitória population are lower than those reported in previous studies. In this framework, our results will be useful as a reference, since they are consistent with the new limits suggested in the literature for the echocardiographic diagnosis of left ventricular hypertrophy.

To determine echocardiographic reference values for cardiac chambers, left ventricular mass, and left ventricular (LV) mass indexes in an asymptomatic adult population sample.This was an observational study based on a randomly selected population sample from the city of Vitória, Brazil. Two hundred and ninety-five volunteers (61.7% women) with no past history of cardiovascular disease underwent transthoracic echocardiography. The following M-mode echocardiographic parameters were measured: ventricular diameters, interventricular septal thickness, LV posterior wall thickness, LV mass, left ventricular mass indexes, plus aortic and left atrial diameters. Values were expressed as mean and standard deviation and percentiles, with a 95% confidence interval.Echocardiographic values were slightly influenced by gender and age. Overall, cardiac measurements were higher in the male gender. LV posterior wall thickness, mass indexes corrected for height and diastolic diameter were influenced by age. The 95% percentiles of interventricular septum and LV posterior wall were 9.9 mm and 9.6 mm for men, respectively, and 9.3 mm for septum and posterior wall for women.The 95% percentile values of interventricular septum and posterior wall and, therefore, of both absolute and indexed left ventricular mass found in our study conducted in the Vitória population are lower than those reported in previous studies. In this framework, our results will be useful as a reference, since they are consistent with the new limits suggested in the literature for the echocardiographic diagnosis of left ventricular hypertrophy.

OBJETIVOS: Estimar a frequência da não adesão ao tratamento medicamentoso entre idosos acompanhados ambulatorialmente, bem como analisar seus fatores associados. METODOLOGIA: Foi conduzido estudo transversal com 263 idosos atendidos no ambulatório de especialidades médicas de um hospital filantrópico, localizado no município de Vitória-ES. Foi realizada entrevista utilizando roteiro estruturado em três blocos que contemplavam questões sociodemográficas, condições de saúde e estilo de vida e medicamentos em uso. Para verificar a não adesão ao tratamento medicamentoso, foi aplicado o instrumento de Medida de Adesão Terapêutica (MAT). Os dados foram analisados por meio do teste Qui-quadrado para variáveis categóricas. Foram consideradas significativas as variáveis com valor de p