The influence of aging on the renin-angiotensin-aldosterone system was evaluated by comparing young (20 to 30 yr) with elderly (62 to 70 yr) healthy subjects. Despite comparable body sodium-fluid balance in the two age groups, serum renin concentration, plasma renin activity and aldosterone concentrations were lower in the elderly. The age-related decreases in circulating renin and aldosterone concentrations were slight while subjects were supine and receiving normal sodium intake; when upright and during sodium depletion, they were more pronounced. Inverse renin-blood pressure interrelations were noted during two of four study conditions involving normal sodium intake or mild sodium depletion (r = --0.44 and --0.47, respectively), but not during progressive sodium depletion. Plasma renin levels were decreased in the elderly regardless of the presence or absence of an inverse relationship with blood pressure. Aldosterone and cortisol responses to corticotropin infusion were unaltered in the elderly. It is concluded that aging may cause a decrease in circulating renin, with parallel lowering of plasma aldosterone concentrations.

Control of aldosterone responsiveness in terminal renal failure. Plasma aldosterone concentration in 30 hemodialysis patients correlated closely with renin concentration, renin activity or renin and potassium concentrations combined (r is greater than or equal to 0.62; P is less than 0.01), and increased consistently in response to upright posture or corticotropin administration. Aldosterone response to hemodialysis was variable. Significant correlations (r is greater than or equal to 0.65; P is less than 0.01) were demonstrated between postural plasma aldosterone and renin responses, between aldosterone responses to corticotropin and basal plasma aldosterone or renin and potassium values, between hemodialysis-induced changes in plasma aldosterone and those in potassium or renin; but not between various indexes of heparin treatment and aldosterone activity. Bilateral nephrectomy reduced basal plasma renin and aldosterone concentrations and aldosterone responsiveness in five preoperatively normoreninemic or hyperreninemic patients, but not in a hyporeninemic patient. These results demonstrate the complementary roles of circulating renin and potassium in the control of aldosterone release under basal and stimulatory conditions in patients with terminal renal failure. Administration of heparin in dosages used during long-term hemodialysis does not appear to significantly interfere with aldosterone control.

Rigorous control of water quality in hemodialysis services is extremely important in order to guarantee a better quality of life of the patients submitted to this treatment. The lack of adequate water monitoring has caused the death of various patients in the past. The objective of the present study was to determine the physicochemical and bacteriological characteristics of water used by hemodialysis services in hospitals of the city of São Luís, Maranhão, Brazil. Bacteriological analyses included the membrane filter method for the determination of total coliform bacteria, the Cult-Dipcombi-TTC-agar method for heterotrophic bacteria and the limulus amebocyte lysate method for the determination of endotoxins. Eighteen water samples obtained from three hospital units, six samples per hemodialysis service, collected directly at the pre-and posttreatment points, were analyzed. Microorganisms were detected in the water used by the hemodialysis services in two of the three hospital units (B and C) studied. No contamination with heterotrophic bacteria was observed in pretreatment samples, while endotoxin production was detected in 100% of the samples. In post-treatment samples, heterotrophic bacteria were detected in 66.6% of the samples and endotoxins in 33.3%. The microorganisms identified in unit B were Burkholderia cepacia, Alcaligenes xylosoxidans, Pseudomonas aeruginosa and Stenotrophomonas maltophilia. In unit C Flavimonas oryzihabitans, Ralstonia pickettii and Burkholderia cepacia were identified. A significant correlation was observed between the presence of endotoxins and the physicochemical characteristics of water such as turbidity and conductivity. These data indicate that two of the three hospital units studied should revise the control of their hemodialysis water system.

SummaryBackground: Metabolic Syndrome (MS) is often linked to overweight/obesity and can improve after weight loss, such improvement is expected to be proportional to the intensity of weight loss.

The human T cell lymphotropic virus (HTLV) has a worldwide distribution. HTLV is endemic in some states in the northeastern region of Brazil. This study investigated the prevalence of HTLV-1/2 in 713 pregnant women attended at the Central Laboratory of Public Health of Maranhão (LACEN-MA) between February 2015 and May 2017. Serological screening was performed by chemiluminescent microparticle immunoassay (CMIA), and reactive sera were subsequently confirmed by Western blot (WB) analysis. Five samples were determined to be HTLV-1/2-reactive by CMIA analysis, while in the WB analysis, three sera were positive for HTLV-1, and two were indeterminate. The polymerase chain reaction (PCR) analysis used to detect HTLV-1 proviral DNA showed a specific 336 base pair fragment for HTLV-1 in all CMIA-reactive serum samples. PCR products were purified and sequenced. We observed a 0.7% molecular prevalence of HTLV-1 infection. The average age of the HTLV-1-positive pregnant women was 25.6 ± 8.2 years, and the average age of the HTLV-1-negative pregnant women was 24.3 ± 6.2 (p = 0.60). We observed that there was no association of HTLV-1 infection with age, ethnicity, marital status, educational level, family income, age of first sexual intercourse, previous pregnancy, breastfeeding, intravenous drug use by partner, history of blood transfusions, or use of condoms. The prevalence of HTLV-1 observed in pregnant women demonstrated the need to implement public health policies for the screening of HTLV-1/2 in prenatal care and counseling to avoid breastfeeding by infected women; this approach could control vertical transmission and reduce the spread of this virus in the population.

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ResumoO envelhecimento é considerado um processo natural e irreversível. O crescimento acelerado da população idosa leva à maior demanda pelos serviços de saúde. Sendo assim, se faz importante conhecer a satisfação de idosos hospitalizados com os cuidados de Enfermagem. Estudo descritivo, exploratório, com corte transversal e abordagem quantitativa no município de São Luís, participaram 102 idosos hospitalizados, internados em um período mínimo de 5 dias, no Hospital Universitário Presidente Dutra. Maioria homens, idade entre 60 e 69 anos, casados, possuíam até cinco anos de estudo, católicos, renda familiar entre 01 e 03 salários mínimos. Os resultados obtidos apontaram bom nível de satisfação dos idosos com os cuidados de enfermagem, sendo a maior média relacionada ao domínio da confiança. Após concluída a pesquisa percebeu-se que os idosos do Hospital Universitário Presidente Dutra estão satisfeitos com os cuidados ofertados pela Enfermagem, sendo assim os idosos avaliaram positivamente os cuidados recebido demonstrando uma relação de confiança com a Enfermagem.Palavras-Chave: Enfermagem. Idoso. Hospitalização. Satisfação do Paciente. Cuidado de Enfermagem. AbstractAging is considered a natural and irreversible process. The rapid growth of the elderly population leads to increased demand for health services. Therefore, it is important to know the satisfaction of hospitalized elderly with nursing care. It was a descriptive, exploratory, cross-sectional and quantitative approach in São Luis. One hundred and two hospitalized elderly participated. They were hospitalized in a minimum period of five days at the President Dutra University Hospital. Most men, aged between 60 and 69 years old, married, had up to five years of study, Catholic, family income between 01 and 03 the minimum wage. The results showed good level of satisfaction of elderly with nursing care, with the highest average related to the field of trust. After the conclusion of the research it was noticed that the elderly of the president Dutra University Hospital are satisfied with the care offered by nursing, so the elderly positively evaluated the care received showing a relationship of trust with nursing.

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