Introduction: Frailty syndrome is characterized by reduced physical and cognitive reserves, making older people vulnerable to adverse events. This study describes a prototype sensor system developed for assessing frailty through physiological parameters and frailty markers. Methods: A prototype combining four sensors in network and a software package was developed and tested in four long-term care facility senior residents of both sexes, aged 60 and older, showing no locomotive syndrome or severe cognitive impairment. Three of them were frail and able to walk without aid (P1), holding onto the wall (P2) or with a cane (P3), and a non-frail participant (P4) walked without aid. Results: Regarding mean acceleration, P1 and P4 showed the lowest and highest values, respectively, on the antero-posterior axis; P4 had the lowest value on the medio-lateral axis; and P3 presented the highest value on the vertical axis. All participants showed similar roll angular velocity; P4 presented the lowest pitch angular velocity; and P1 and P4 had the highest mean yaw angular velocity. A sarcopenic participant (P2) exhibited the lowest force of muscle contraction. Conclusion: The device has potential to detect frailty markers for adverse outcomes in older people, such as postural instability and increased risk of falls.
Infective endocarditis is a disease caused by the adherence of infectious agents to the endocardial surface, resulting in inflammation and damage, especially to the heart valves. Endocarditis may be diagnosed in up to 5% of patients with prolonged febrile syndrome. The incidence of endocarditis affecting the right heart chambers ranges from 5% to 10% with predominant involvement of the tricuspid valve. Pulmonary valve involvement is rare and usually associated with immunosuppressive conditions or structurally abnormal hearts. Pulmonary valve endocarditis may present atypically with recurrent respiratory symptoms, so that echocardiography should be considered to assess the presence of right heart lesions, which may be a challenge for suspicion and diagnosis, especially in patients without risk factors. In this study, the authors report a case of isolated infective endocarditis in the pulmonary valve due to Staphylococcus aureus in a young man with recurrent pneumonia episodes and without traditional risk factors. Although technological advances contribute to the diagnosis of complex cases, the clinical approach was the best way to determine the appropriate tests and examinations, and for choosing or developing interventions. Despite the availability of resources and diagnostic tools, many diseases associated with high morbidity and mortality may be misdiagnosed and mistreated, including infective endocarditis. A comprehensive patient assessment is essential for the correct diagnosis, as many signs and symptoms are common to different diseases.
Introdução: A manutenção da qualidade de vida aos idosos apresenta diversos desafios, em destaque a fragilidade. Esse processo decorrente de alterações metabólicas e fisiológicas é avaliado atualmente por diferentes parâmetros, desde a sarcopenia a incapacidade funcional. Objetivo: Buscou-se avaliar os estudos presentes na literatura acerca da repercussão da fragilidade, bem como compreender os instrumentos para sua definição e o impacto na vida dos indivíduos, analisando meios de prevenção dessas implicações e preservação da saúde. Metodologia: Realizou-se uma revisão de literatura narrativa com análise descritiva, com a utilização dos descritores qualidade de vida; idoso; sarcopenia; atividades diárias; avaliação geriátrica. Resultados: Foram analisados 60 artigos, separados e tabelados conforme o desenho do estudo. Observou-se que através dos diversos critérios existentes para definição da fragilidade, há correlação positiva entre essa síndrome e a qualidade de vida em idosos. Conclusão: Foi demonstrado que através dos protocolos de saúde auxilia no direcionamento e na conduta adequada das pessoas com fragilidade, possibilitando mais bem-estar ao envelhecimento.
A púrpura de Henoch-Schönlein (PHS) é uma vasculite caracterizada pelo depósito de imunoglobulina A (IgA) provocando reação leucocitoclástica. A etiologia não está totalmente esclarecida. Afeta principalmente crianças e o acometimento em adultos costuma ser mais raro e com pior prognóstico. Os locais mais afetados compõem uma tétrade: pele, articulações, trato gastrointestinal e rins. O diagnóstico é clinico, sendo que a maioria dos pacientes apresenta elevação sérica de IgA e a biopsia cutânea revela uma vasculite leucocitoclástica. Costuma ser uma doença benigna e autolimitada, a terapia de suporte base do tratamento é realizada com repouso e analgesia, além do uso de corticoide em casos mais intensos. Esse artigo reporta o caso da doença em um homem de 46 anos admitido com púrpura palpável, proteinúria, aumento do nível sérico de IgA e vasculite leucocitoclástica à biópsia cutânea. Foi tratado com corticoterapia, evoluindo com melhora expressiva do quadro.
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