[Infeccious diseases as causes of death in autopsied elderly]

Blood pressure levels and adherence to treatment of hypertensive patients, users of a school pharmacy

Adherence to pharmacological treatment for hypertension is considered a key factor in guaranteeing successful therapy outcomes. Knowledge of the disease, its complications, as well as the need for changes in lifestyle, call for patient motivation and continuous interactive education. The evidence regarding the beneficial effects of changes in life style by hypertensive individuals in reducing the complications of the disease, as well as in its prevention are indisputable. However, the challenges posed by patient adherence to treatment prescribed by doctors remain. The aim of this study was to assess blood pressure levels together with degree of adherence to pharmacological treatment with Enalapril Maleate by means of the Morisky-Green Test, in hypertensive patients who were users of a School Pharmacy. Of the 102 patients interviewed, 65.7% had controlled blood pressure, but only 36.3% indicated total compliance with the pharmacological treatment. The Morisky-Green test proved ineffective in associating controlled blood pressure levels and positive attitudes toward taking antihypertensive medicines.

Estudo da mortalidade em população idosa de municipios do Rio Grande do Sul no período de 1996 a 2004

Estima-se que, no Brasil, a população com 60 anos ou mais será em torno de 34 milhões em 2025. O idoso vivencia em seu processo de envelhecimento uma série de alterações, que proporcionam o aparecimento de uma série de doenças que podem conduzi-lo ao óbito. Diante de tal realidade, o objetivo deste estudo foi analisar a evolução na taxa de mortalidade em idosos de municípios do interior do estado do Rio Grande do Sul, no período de 1996 a 2004, levando em consideração as faixas etárias e as diferenças entre os gêneros neste período, além de identificar as principais causas de óbitos. Dos resultados encontrados, podemos salientar que as doenças do aparelho circulatório apresentaram as taxas mais elevadas, seguidas pelas doenças do aparelho respiratório e neoplasias. Entre os gêneros, o diabetes mellitus apresenta maior prevalência entre as mulheres. Com relação à idade, as maiores taxas se encontram na população com mais de 80 anos.

A família no contexto do cuidado ao portador de nefropatia diabética: demanda e recursos

A doença renal crônica e o tratamento dialítico constituem um grande problema para a pessoa doente e sua família, modificando seus hábitos de vida. Essas mudanças exigem da família esforço, dedicação e adaptações na rotina de vida de seus membros. Objetivou-se neste estudo identificar as principais demandas e recursos da família no conviver e no cuidar de pessoas com nefropatia diabética. Trata-se de uma pesquisa qualitativa, conduzida pelos pressupostos do Modelo Calgary de Avaliação da Família (MCAF), desenvolvido com sete famílias em duas unidades de terapia renal substitutiva em Belo Horizonte/MG. Os resultados da pesquisa foram apresentados sob a forma de demandas e recursos, alicerçadas num conjunto de crenças e valores que interferem no enfrentamento da doença. Os dados obtidos sugerem que cada família pesquisada possui recursos mesmo em face de demandas de saúde, alertando para a necessidade de enxergamos a família como foco do cuidado de enfermagem.

Cysticercosis in the elderly

The immunosenescence, a peculiarity of the aging process, increases the susceptibility of elderly individuals to neoplasia, infections, and parasitosis, among them, cysticercosis. The aim of this study was to compare the epidemiological and anatomopathological characteristics of cysticercosis in elderly or nonelderly patients. We reviewed 72 autopsies, protocols and specimens, performed in the School Hospital of the Triangulo Mineiro Federal University. We selected 3 groups: elderly with cysticercosis, nonelderly with cysticercosis, and control group without cysticercosis. From the patients with cysticercosis, 27.8% were elderly. Of these, 80% presented with neurocysticercosis and 20% cardiac cysticercosis. In the elderly, the early stages of the parasitic development, vesicular and colloidal vesicular, prevailed (75%). In relationship with the causes of death, death in 40% of the elderly was by neoplasic and 35% by cardiovascular, whereas for the nonelderly, death in 63.5% was by cardiovascular and 25% by infectious. There was a significant difference between groups with relation to neoplasic and cardiovascular causes. Therefore, cysticercosis was frequent in elderly patients, and probably patients are continuously infected with cysticercosis as they age. Perhaps, decurrence of the immunosenescence associated with immunological alterations caused by cysticercosis form favorable conditions to the development of neoplasias in the elderly attacked by the parasitosis.

Thickness of the cervical epithelium of autopsied patients with acquired immunodeficiency syndrome

Several general pathologic processes that affect the uterine cervix have been described in Brazil and in the world. The aim of the current study was to evaluate morphometrically the cervical epithelium of autopsied patients with AIDS. This is a cross-sectional study of the cervix of 38 women autopsied from 1993 to 2003. We evaluated the cervix of women aged 20 to 40 years, 20 with AIDS (52.63%) and 18 without (47.37%). The inflammatory infiltrate found in the AIDS patients was more accentuated and predominantly composed of monocytes, which is characteristic of chronic inflammation. In addition, necrosis, fibrosis, and metaplasia were also more frequent in these patients. The cervical epithelium was considerably thinner in the AIDS patients. This hypotrophy occurred because of a significantly accentuated reduction in the number and surface area of cells (P < .01). There was still a significant correlation between the thickness of the epithelium and the nutritional status of AIDS patients. General pathologic processes, which affect the cervices of patients with AIDS, especially hypotrophy, could facilitate the penetration of other infectious agents. We suggest that the nutritional status of these patients and the adherence to antiretroviral therapy be routinely evaluated and the use of condoms stimulated even between HIV-positive partners to prevent possible increases in the viral load and reinfections that contribute to the aggravation of the disease.