Este estudo teve por objetivo identificar os aspectos epidemiológicos, clínicos e evolutivos de idosos com síndrome daimunodeficiência adquirida (aids) atendidos em um centro de referência sorológico em Sobral (CE). Sua amostra foi compostapor indivíduos com ≥ 59 anos com caso notificado de aids no Centro de Orientação e Atendimento Sorológico (Coas), de janeirode 2007 a dezembro de 2016. As informações foram coletadas em prontuários médicos e no Sistema Nacional de Agravos deNotificação (Sinan). Dos 72 prontuários selecionados, 61,11% eram de indivíduos do gênero masculino, 54,17% tinham entre 65 e74 anos, 31,94% estudaram até o Ensino Fundamental, 70,8% eram heterossexuais, 44,44% relataram prática sexual desprotegida,62,5% eram procedentes de outros municípios e 55,4% apresentavam contagem de linfócitos T CD4+ < 350 cel/mm3 no momento dodiagnóstico. Os principais sinais e sintomas que levaram os indivíduos a buscar o serviço de saúde, culminando com o diagnóstico,foram: perda de peso, diarreia, febre, leucoplasia pilosa e tosse persistente. Constatou-se a necessidade de intervenções voltadasà prevenção e à identificação de casos de doenças sexualmente transmissíveis (DST), para reduzir a incidência de casos de aids,tendo em vista sua elevada morbimortalidade na população idosa.

Objective: To correlate the presence of anemia with mortality in hospitalized patients with decompensated HF (heart failure). Methods: A total of 148 patients hospitalized for HF compensation were analyzed from April 1 to December 31, 2017 in a tertiary referral hospital for cardiovascular diseases. The diagnosis of anemia was established according to the Brazilian Ministry of Health criteria, considering a serum hemoglobin value of < 13 g/dL for men and < 12 g/dL for women. Data were collected through medical and physical attendance records. Statistical analysis was performed using the Epi Info program, version 7.0 for Windows, with Student's t test for unpaired variables, Chi-square test and Fischer test. The significance of p < 0.05 was considered. Results: Of the 148 selected patients, 63.5% were male, 60.1% were over 65 years old, 50.74% were enrolled in the first grade, and 93.2% were self-declared white. The prevalence of anemia observed in the study population was 72 (56.25%), of which 49 (68%) were male and 23 (32%) were female. The mortality rate of the anemic patients was 19.4%, a total of 14 patients, whereas the non-anemic patients rate was 7.9%. It was observed that patients with worse outcome had hemoglobin < 12mg/dL (p = 0.045) and Functional Class (FC IV) by the New York Heart Association (NYHA) (p = 0.0001) at hospital admission. Conclusions: It is noticed that anemia is a frequent finding in patients with HF and that it interferes in the clinical manifestations, with worsening of the prognosis. Anemia treatment is not yet standarized in the HF approach, but patients without anemia appear to evolve with more favorable outcomes than anemia.

Systemic lupus erythematosus (SLE) is a pathology capable of affecting several organs and systems of the human body, including the central nervous system. The most common psychiatric manifestations addressed in studies are acute confusional state, mood disorders, cognitive dysfunction, psychosis, among others. However, there are few documented case reports associating lupus with an episode of mania, mainly because this neuropsychiatric symptom usually precedes the onset of typical SLE symptoms, such as malar rash or arthralgias. The objective of this study is to describe the case of a patient hospitalized for diagnostic investigation of SLE who presented with mania.

Introdução: no Brasil, a expectativa de vida aumentou no último meio século, proporcionando uma explosão demográfica de idosos no país. Concomitantemente, houve um aumento na prevalência de doenças crônico-degenerativas, uma vez que o próprio processo do envelhecimento é fator de risco para morbidades. Objetivo: Descrever o perfil de idosos cadastrados em um projeto de convivência e lazer na periferia de Fortaleza/CE. Metodologia: Estudo descritivo, transversal e com abordagem quantitativa, que descreve o perfil epidemiológico e socioeconômico de idosos cadastrados em um projeto de convivência e lazer localizado no bairro Canindezinho na cidade de Fortaleza-CE-Brasil. Foram entrevistados 24 idosos de agosto a outubro de 2013, para isso utilizou-se de um instrumento modificado do padrão original Brazil Old Age Schedule -BOAS. Os dados encontrados foram processados e analisados mediante a utilização de estatística descritiva. Resultados e Discussão: Os resultados revelaram que 87,5% são do gênero feminino; 89% são aposentados; 83,3% possuem baixo poder aquisitivo; 58,3 têm baixo nível de escolaridade; 75% têm renda mensal entre um a dois salários mínimos; 79% tem uma percepção positiva da sua saúde geral; 91,7% apresentam algum tipo de doença e fazem uso de medicamento diariamente. Além disso, todos os entrevistados apresentaram alto grau de autonomia e independência. Conclusão: o conhecimento das características dos idosos é fundamental para o estabelecimento de políticas públicas de promoção à saúde, favorecendo o cuidado integral, individualizado e preventivo. Além disso, pode haver variações nas ações de enfrentamento, quando a população encontra-se em situação social distinta.

BACKGROUNDSystemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by periods of exacerbations, interspersed with remissions. It has variable manifestations which can affect different systems of the human body. Regarding cardiac involvement, the most classic manifestations consist of pericarditis, myocarditis, cardiac block and endocarditis. However, it is observed that cardiac tamponade (CT), although rarer, is potentially fatal in patients with SLE. CASE REPORTA 22-year-old female diagnosed 1 year ago with SLE with cutaneous-articular involvement, without follow-up, using prednisone 40 mg/day for 8 months. She was hospitalized with dyspnea at rest, oliguria and foamy urine for 5 days. She also had fever and arthralgia of her wrists and elbows for 15 days. Physical examination: blood pressure 101/69 mmHg, heart rate 133 bpm, systolic murmur in the mitral focus (4+/6+) and aortic (4+/6+), turgid jugular, bilateral basal crackles and positive Skoda's sign . Laboratory showed hemoglobin 6.8g/dL; creatinine 4.8 mg/dL; urea 178 mg/dL; albumin 2.2 g/dL, hypocomplementemia; urine with 3+ proteinuria, 2+ erythrocytes; 24-h urine with 1.8 g protein/day, characterizing nephritis lupus. Radiography showed bilateral pleural effusion with significant cardiomegaly. The patient developed acute hypervolemic pulmonary edema, indicating dialysis therapy. After 23 days, she presented hypotension, muffled heart sounds and worsening of jugular turgescence, pericardiocentesis was performed with the output of 460 mL of blood fluid, increased cellularity, predominance of neutrophils and glucose consumed. Five days later, she presented Beck's triad again, and a pericardial pleural window with pericardial biopsy was performed. Absence of vegetation ruled out infectious endocarditis. Empirical treatment with COXCIP-4 was initiated due to the possibility of pericardial tuberculosis, subsequently suspended due to lack of clinical response and signs of drug induced hepatitis. In addition, the patient had a tonic-clonic seizure, treated with pulse therapy with immunoglobulin for 5 days and pulse therapy with cyclophosphamide due to compatible neurolupus. After being hospitalized for 3 months, she was discharged with established renal and cyclophosphamide pulse therapy planned for another 6 months. CONCLUSIONIn SLE, CT has a prevalence of only 1%. Also, there are few cases in the literature of patients with this condition. However, this report reinforces the importance of CT being remembered as a possible differential diagnosis of complications in patients with SLE. In addition, our case emphasizes the importance of early diagnosis and treatment, aiming to avoid dramatic cases like this.