Introdução: O envelhecimento humano envolve transformações físicas, psicológicas, sociais e culturais, o que pode favorecer o surgimento de transtornos mentais (Costa, 2009). Os transtornos psiquiátricos têm grande contribuição em relação à redução da capacidade funcional e da qualidade de vida em idosos. Objetivo: Analisar o impacto da pandemia COVID-19 na saúde mental de idosos que vivem em instituições de longa permanência para idosos (ILPIs). Métodos: Revisão integrativa nas bases de dados PUBMED, Scielo e LILACS com os descritores: ILPI, idoso, saúde mental, depressão, transtornos de ansiedade e COVID-19. Resultados: A OMS recomendou estrito isolamento social na área geriátrica. Ao mesmo tempo que é essencial para combater a COVID-19, é sinal de alerta como importante causa da solidão, especialmente nas ILPIs. No Brasil, o Ministério da Saúde emitiu uma nota técnica que sugere suspensão de visitas presenciais a idosos que residem em ILPIs no período da pandemia, com o intuito de reduzir a transmissão da doença. Estudos recentes enfatizam a alta frequência de anormalidades mentais subsindrômicas na população em geral durante a pandemia, afetando até um terço dos indivíduos (Rajkumar, 2020). As manifestações podem ser representadas por aumento na autopercepção de estresse, maior prevalência de sintomas de ansiedade e depressão, queixas de sono e recaída de transtornos psiquiátricos pré-existentes (Pfefferbaum e North, 2020). Conclusão: Diante disso, verifica-se que as ILPIs devem buscar manter seus moradores interagindo de alguma forma com familiares e amigos, para que se reduza a incidência de transtornos psiquiátricos e obtenham melhora na qualidade de vida.

BACKGROUND AND AIMS Chronic kidney disease (CKD) can predispose individuals to multiple extrarenal manifestations, such as anemia, bone disease, heart disease and electrolyte disorders. In addition, some patients with CKD can present with gastrointestinal (GI) symptoms, but the pathogenesis of this condition is still unclear. Symptoms of gastroparesis include early satiety, pyrosis, epigastric pain, nausea and vomiting, which may lead to caloric and electrolyte deficiencies as well as significant weight loss. Therefore, the aim of this study was to analyze the association between CKD and gastroparesis. METHOD A systematic literature review was conducted following the PRISMA guidelines. Papers were selected searching PubMed/Medline, SciELO and LILACS databases using the terms (chronic kidney disease OR CKD) and (gastroparesis OR gastric emptying) in January 2022. The inclusion criterion was limited to observational studies that evaluated the association between CKD and gastroparesis. There were no language or publication date restrictions. RESULTS Among the 111 papers initially identified, 14 were eligible for this review after full texts were read. Dysmotility-like dyspeptic complaints and delayed gastric emptying can be prevalent in CKD patients. Gastric hypomotility appears to be an important factor in the generation of GI symptoms in patients with CKD. Different pathophysiological mechanisms, such as electrolyte imbalance, gastric mucosal edema and direct toxicity of uremic retention molecules can play a role in inducing gastroparesis in patients with CKD. Serum levels of several polypeptide hormones involved in the modulation of GI motility [e.g. gastrin, cholecystokinin (CCK) and neurotensin] and the regulation of hunger and satiety (e.g. glucagon, CCK) were significantly altered as a consequence of renal insufficiency and may play a major role in gastrointestinal dysmotility. Patients with CKD showed impaired gastric myoelectrical activity in response to food and high levels of GI hormones. Delayed gastric emptying contributes to malnutrition, which may potentially have a broad impact in the prevention and treatment of CKD and its complications. Gastric emptying tests are valuable in identifying occult gastroparesis in high-risk patients and may guide the selection of prokinetic therapy, which can significantly increase levels of serum albumin and improve general prognosis. Electrogastrography is an interesting noninvasive technique to evaluate gastric motility in patients with severe chronic renal failure. CONCLUSION The studies suggest that patients with CKD are at higher risk of developing gastroparesis and dysmotility-like dyspeptic complaints. Nevertheless, more studies are needed to provide high-quality evidence.

Background: Creutzfeldt-Jakob disease (CJD) is a progressive, rare, fatal and rapid human neurodegenerative disease that occurs in the etiologies: sporadic (CJD), familial, iatrogenic (CJD) and CJD variant (CJV) in which cell prion protein (PrP) can be transmitted through animals. Objectives: Literature review about Creutzfeldt-Jakob diseaseDesign and setting: Literature review development in the Centro Universitário de Volta Redonda, Rio de Janeiro, Brazil. Methods: The Creutzfeldt-Jakob disease, infectious diseases and neuroinfection indexes were used in the PUBMED and Scielo databases. Results:CJD has different etiologies with different clinical and pathological phenotypes. CJDV shows psychiatric behaviors and symptoms followed by abnormalities, ataxia and dementia. The sporadic form is the most common, with a progressive clinical course with generalized brain deposition of abnormal prion protein aggregates (PrPTSE) that leads to spongiform change, gliosis and neuronal loss. CJD progresses to dementia and two or more symptoms: cerebellar or visual impairments; pyramidal or extrapyramidal signs; myoclonus; and akinetic mutism. Complex periods of acute wave in the electroencephalogram (EEG) are strongly suggestive of prionic diseases. Rapidly evolving field neuroimmune disorders have shown an increasing in autoantibody testing; attempt to diagnose a range of immune-mediated conditions. Evidence indicates that diffusion-weighted magnetic resonance imaging (DWI) is more sensitive for detecting signal abnormalities. Conclusion: The disease progresses to dementia, accompanied by myoclonus, pyramidal signs and characteristic EEG. It is a complex pathology, which has only symptomatic treatment and requires strict control of reservoirs and risk of contamination.

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BACKGROUND AND AIMS Coronavirus disease 2019 (COVID-19) is mainly an infectious disease of the respiratory system transmitted through air droplets, and pulmonary symptoms constitute the main presentations of this disease [1]. The first cases of the disease were identified in Wuhan, China, which occurred in early December 2019. Initially, it was called pneumonia of unknown origin, severe acute (SARS-CoV-2) [2]. In addition to being a target of the virus, the kidney also seems to have a substantial influence on the outcomes of the disease [3]. Underlying kidney disease is an emerging risk factor for more severe coronavirus disease 2019 (COVID-19) illness [4]. Identifying patients who require a palliative care approach is challenging for family physicians, even though several identification tools have been developed for this purpose. The Supportive and Palliative Care Indicators Tool (SPICT™) aims at facilitating this identification [5]. The aim of this study is to compare the outcomes presented between patients with nephropathy and lung disease in the first wave of COVID-19 assisted by a reference center in Brazil. METHOD This study is a data analysis from patients assisted by a reference center in São Paulo, Brazil, which includes 2013 patients from March to July of 2020. This period consists on the first wave of COVID-19 infection in this country. In addition, a literature review was conducted, papers were selected searching PubMed/Medline, SciELO and LILACS databases using the terms (COVID-19) AND (nephropathy) AND (pneumopathy) AND (outcomes) in January 2022. There were no language or publication date restrictions. Also, we used the (SPICT™ to classify the patients for treatment with palliative care. RESULTS Among 2013 patients included in our study, 223 had nephropathy, 127 males and 96 females. As for pulmonary disease, there were 155 patients, 93 males and 62 females. Furthermore, among pneumopathy patients, 65% were >60 years old, and, among renal patients, 47% approximately were >60 years old. In addition, the mean age of the renal patients’ group was lower than the group of patients with lung disease. The outcomes in the nephropathy group consisted in 109 discharges and 114 deaths. In the group of pulmonary patients, 90 were discharged and 59 died; the other patients were transferred to specialized services. Renal patients presented worse outcomes than pulmonary patients, even though COVID-19 mainly affects the lung, our patients had substantial impact of its infection. Despite the fact that SPICTTM identified 41 renal patients eligible for palliative care, only 31 were referred to this service at the hospital where the study was conducted. When compared with the total population of this study, the renal patient's group was the third with the highest number of hospitalizations due to COVID-19. CONCLUSION Renal patients had a worse prognosis when compared with patients with lung disease and the total population. The outcomes could have been different if all renal patients had been referred and treated with palliative care.