Objective: To investigate the occurrence of frailty and analyze the functional capacity and quality of life in the elderly in a department of geriatrics and gerontology in Belém-PA. Method: Cross-sectional, descriptive and analytical study.103 elderly people were assessed as the socio-demographic and clinical aspects, frailty, according to the phenotype of Fried, history of falls, self-perceived health, functional capacity (FC) and quality of life (QOL). The elderly were classified as frail (FR), pre-frail (PF) and non-frail (NF). The groups were compared using the binomial test, Kruskal-Wallis test and ANOVA test, and the relationship between FC and QOL through Pearson correlation. Results: The mean age was 73.39(±6.42) years; 23.0% of the elderly were FR, 57.0%were PF and 20.0% were NF. The highest criteria of phenotype were muscle weakness and physical inactivity. Was no difference in FC between FR and PF ( p<0.01) and FR and NF ( p<0.01). The FR elderly had lower QOL and the highest scores were intimacy (15.33±2.26) and death and dying (14.88±3.26). There were correlation between FC and QOL in groups PF ( p=0.0273) and NF ( p=0.0017). 62.1% of seniors pointed to health as regular and 34.0% had a history of falling. Conclusion: Muscle weakness and physical inactivity were most striking in the development of frailty, which was associated with worse QOL and FC, despite most seniors be independent. These data are important for early detection of determinants of frailty, since the criteria discussed here are reversible.

Objetivo: Identificar a funcionalidade global de idosos submetidos a internação, correlacionando o desempenho para as atividades de vida diária básicas (ABVD) e instrumentais (AIVD) com os principais sistemas funcionais (cognição, humor, mobilidade e comunicação). Métodos: Trata-se de estudo observacional transversal e analítico com a participação de 94 idosos internados em uma clínica médica. Os instrumentos utilizados foram: Escala de Katz, Escala de Lawton & Brody, Miniexame do Estado Mental (MEEM), Escala de Depressão Geriátrica 15 (GDS-15), Teste Timed Up and Go (TUG) e a Avaliação Funcional das Habilidades de Comunicação da Associação Americana de Fonoaudiologia (ASHA FACS). Resultados: Foram avaliados 94 idosos, cuja maioria apresentava algum grau de dependência para ABVD (61,71%) e para AIVD (52,13%). Nos sistemas funcionais, a autonomia mostrou-se preservada, com desempenho médio de 18,14 pontos no MEEM, e de 4,43 pontos na GDS-15; e a independência, alterada, por desempenho médio de 21,82 segundos no TUG, classificando-os com uma mobilidade regular, e de 5,27 pontos na ASHA FACS, considerando-os com a necessidade de auxílio moderado nessa função. Evidenciou-se moderada e significativa associação entre o desempenho para as ABVDs e AIVDs com quase todos os sistemas funcionais. Conclusão: A população estudada apresentou funcionalidade global alterada, devido a algum grau de dependência para as ABVDs e AIVDs, com autonomia preservada e independência prejudicada. As correlações evidenciaram que com o decréscimo dos principais sistemas funcionais, ocorreu declínio da funcionalidade global.

OBJECTIVE To analyze the prevalence and factors associated with smoking abstinence among patients who were treated in a reference unit for smoking cessation.METHODS This cross-sectional study examined the medical records of 532 patients treated in a reference unit for smoking cessation in Belém, PA, Northern Brazil, between January 2010 and June 2012. Sociodemographic variables and those related to smoking history and treatment were analyzed. Statistical significance was set at p < 0.05.RESULTS The mean age of the participants was 50 years; 57.0% of the patients were women. The mean tobacco load was 30 packs/year, and the mean smoking duration was approximately 32 years. Most patients remained in treatment for four months. The rate of smoking abstinence was 75.0%. Regression analysis indicated that maintenance therapy, absence of relapse triggers, and lower chemical dependence were significantly associated with smoking cessation.CONCLUSIONS The smoking abstinence rate observed was 75.0%. The cessation process was associated with several aspects, including the degree of chemical dependence, symptoms of withdrawal, and period of patient follow-up in a multidisciplinary treatment program. Studies of this nature contribute to the collection of consistent epidemiological data and are essential for the implementation of effective smoking prevention and cessation strategies.

RESUMONo Brasil, estima-se que 60% dos pacientes oncológicos tenham mais de 65 anos de idade, o que obriga uma ação integrada entre a oncologia e a geriatria. Essa nova abordagem evidencia a capacidade funcional como um preditor de saúde. O presente estudo tem como objetivo avaliar a capacidade funcional e o desempenho dos sistemas funcionais de idosos com diagnóstico de câncer. Trata-se de um estudo descritivo e analítico transversal, com idosos, que apresentam diagnóstico de câncer, internados na clínica médica do Hospital Universitário João de Barros Barreto, em Belém, Estado do Pará, Brasil. Os instrumentos utilizados foram: a escala Performance Status do Eastern Cooperative Oncology Group (PS-ECOG), a escala de Katz (ABVD), escala de Lawton (AIVD), miniexame do estado mental (MEEM), escala de depressão geriátrica 15 (GDS-15), teste Timed Up and Go (TUG), teste de Tinetti e a avaliação funcional das habilidades de comunicação da Associação Americana de Fonoaudiologia (ASHA FACS). Foram avaliados sete idosos (amostra por conveniência), com a capacidade funcional classificada entre 2 e 4 na escala PS-ECOG, e desempenho médio de 10,4 pontos para as ABVD e de 17,6 para as AIVD. O perfil dos sistemas funcionais evidenciou desempenho médio de 14,9 pontos no MEEM; 3,3 na escala GDS-15; 5,5 na ASHA FACS; 12,2 segundos no TUG e de 18,5 pontos no teste de Tinetti, revelando alterações na autonomia e na independência. A maioria dos indivíduos estudados apresentou sua capacidade funcional alterada, devido à semidependência para as atividades de vida diária, justificada por desempenhos anormais na cognição, mobilidade e comunicação. A capacidade funcional é definida como a capacidade de gerir a própria vida ou cuidar de si mesmo, e é influenciada pelo grau de autonomia e ARTIGO ORIGINAL | ORIGINAL ARTICLE | ARTÍCULO ORIGINAL

Pseudomonas aeruginosa is an opportunistic pathogen causing different types of infections, particularly in intensive care unit patients. Characteristics that favor its persistence artificial environments are related to its high adaptability, wide arsenal of virulence factors and resistance to several antimicrobial classes. Among the several virulence determinants, T3SS stands as the most important due to the clinical impact of exoS and exoU genes in patient's outcome. The molecular characterization of P. aeruginosa isolates helps in the comprehension of transmission dynamics and enhance knowledge of virulence and resistance roles in infection process. In the present study, we investigated virulence and resistance properties and the genetic background of P. aeruginosa isolated from ICUs patients at a referral hospital in Brazilian Amazon. A total of 54 P. aeruginosa isolates were characterized by detecting 19 virulence-related genes, antimicrobial susceptibility testing, molecular detection of β-lactamase-encoding genes and genotyping by MLST and rep-PCR. Our findings showed high prevalence of virulence-related markers, where 53.7% of the isolates presented at least 17 genes among the 19 investigated (P = 0.01). The rare exoS + /exoU + cytotoxic virulotype was detected in 55.6% of isolates. Antimicrobial susceptibility testing revealed percentages of antibiotic resistance above 50% to carbapenems, cephalosporins and fluoroquinolones associated to MDR/XDR isolates. Isolates harboring both bla SPM-1 and bla OXA genes were also detected. Genotyping methods demonstrated a wide genetic diversity of strains spread among the different intensive care units, circulation of international MDR/XDR high-risk clones (ST111, ST235, ST244 and ST277) and emergence of seven novel MLST lineages. Finally, our findings highlight the circulation of strains with high virulence potential and resistance to antimicrobials and may be useful on comprehension of pathogenicity process,