The study's objectives were to compare nursing workload among adults, elderly and very elderly patients, including in the analyses the interventions and evolution of the workload between admission and discharge. This prospective longitudinal study involved 600 adult patients in general ICU in four city hospitals in Sao Paulo. The results showed that, independent of the age, it had the similarity of the nursing workload in the admission, as well as in the evolution of the patients' care. Differences between the groups were observed in the NAS on ICU's discharge and the following instrument's items: Monitoring and titration and Hygiene procedures in admission, Respiratory support and Intravenous hyperalimentation in discharge and Mobilization and positioning in discharge and admission. In conclusion, the results evidenced that the age interfered only in specific aspects of the nursing workload required by patients in ICUs.

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Background and objectives To date, it is unclear whether antigen matching is effective in reducing antibody development and whether transfusing blood from non‐Caucasian donors reduces alloimmunization in sickle cell disease patients (SCP). This study was designed to evaluate the effectiveness of an antigen‐matching strategy supplied by a mixed donor population, in reducing alloimmunization in SCPs. Methods Eighty SCPs transfused with C‐, E‐ and K‐matched units and 2000 donors were genotyped for the most relevant RBC antigens, and resulting genotypic frequencies were compared. Also, alloantibodies specificity and clinical complications were evaluated in SCPs. Results A high alloimmunization rate was observed despite the prophylaxis protocol (62·1%). The main cause underlying lack of effectiveness was transfusion of non‐matched units in external hospitals. Even though our donor population was ethnically mixed, it still exhibited antigenic differences in relation to SCPs (C and Fya). Frequency of clinical complications was similar between alloimmunized and non‐alloimmunized patients. Conclusions Prospective antigen matching is an unattractive alloimmunization prophylaxis for SCPs if not associated with strategies to minimize the hazards related to transfusions at non‐index hospitals. Even in a highly mixed donor population, antigenic discrepancies in SCPs are high, increasing the risk of antibody development.

Resumo Ainda que a articulação entre corpo, saúde e contexto político-econômico seja extremamente complexa e mediada por processos heterogêneos, é possível problematizar o discurso produzido pela mídia sobre corpo e saúde. Este estudo teve por objetivo apresentar algumas reflexões sobre os discursos e práticas contemporâneos acerca da saúde, com enfoque nos aspectos corporais e na relação entre estética corporal e bem-estar do indivíduo. A linha argumentativa desenvolvida preconiza que, na rede discursiva que se propaga pelas grandes mídias, cria-se uma concepção de saúde intimamente atrelada ao mercado de consumo. Neste ensaio, alguns discursos midiáticos sobre saúde são analisados, tendo em vista compreender aspectos do mercado simbólico que se organiza calcado nos signos-saúde. A construção do “corpo saudável” é tematizada e problematizada por meio do percurso teórico empreendido. No novo ideal apolíneo emergente na contemporaneidade, o corpo é um objeto moldável a ser cultivado por meio de dietas e hábitos alimentares espartanos, educado em sessões exaustivas de exercícios físicos, modelado por substâncias anabolizantes, corrigido por cirurgias plásticas com finalidade estética e regulado por padrões socioculturais que almejam alcançar a imortalidade mascarada no mito da eterna juventude. Para aprimorar os cuidados em saúde, os profissionais devem compreender as transformações que incidem na imagem do corpo que tem sido valorizada na era contemporânea.

This study compared clinical outcomes among adult, elderly and very elderly patients admitted to Intensive Care Units (ICUs) located in São Paulo, Brazil. This retrospective, longitudinal and comparative study included 279 adult (≥18 and <60 years), 216 elderly (≥60 and <80 years) and 105 very elderly (≥80 years) patients. Adult patients differed from other groups regarding the unit to which they were referred and severity, according to the Simplified Acute Physiology Score II. Adults were most frequently sent to hospitalization wards; elderly and very elderly patients who survived hospitalization in critical units showed sharper improvement before discharge. There were differences in relation to mortality between adult and elderly patients, with a higher rate in the elderly group; however, the mortality rate of very elderly and adult patients was similar. In general, the results indicated that older age was not associated with undesirable outcomes in ICUs.Descriptors: Age Groups; Severity of Illness Index; Intensive Care Units; Aged; Aged, 80 and over. Evolución clínica de adultos, ancianos y muy ancianos internados en Unidades de Terapia IntensivaEl estudio comparó la evolución clínica de adultos, ancianos y muy ancianos internados en ancianos (≥60 y <80 años) y 105 muy ancianos (≥80 años). Los adultos difirieron de los otros grupos en relación a la unidad de destino y evolución de la gravedad, según Simplified Acute Physiology Score II. Fue más frecuente el encaminamiento de los adultos para unidades de internación, sin embargo los ancianos y muy ancianos sobrevivientes de la internación en la unidad crítica presentaron mejoría más acentuada antes del alta.Entre adultos y ancianos ocurrió diferencia en relación a la mortalidad, con mayor tasa en el grupo más viejo; entretanto, la mortalidad de los muy ancianos y adultos fue similar.En general, los resultados indicaron que la edad más avanzada no fue factor asociado a los resultados indeseables de la asistencia intensiva.

Soils from the orders Alfisol, Inceptisol, Mollisol, Ultisol, and Oxisol contained exchangeable K (neutral 1N NH4OAc) and boiling 1N HNO3 extractable K varying from 31 to 358 ppm and 62 to 652 ppm, respectively. Total K varied from 1,780 to 14,200 ppm. Quantities absorbed from each soil by 7 cuttings of perennial ryegrass (Lolium perenne) in the greenhouse ranged up to 13 times that of exchangeable K and up to 5 times that of HNO3‐extractable K. Total plant uptake represented 3.5 to 29.7% of total soil K. In no soil did K become limiting in the first four cuttings. However, except for the Mollisols, uptake decreased abruptly in the later cuttings, indicating very little “slowly” available K. Even though exchangeable K and K removed by strong acids were highly correlated with plant uptake (r = 0.744** to 0.881**), all extractants greatly underestimated actual plant‐available K under intensive cropping. Total soil K did not significantly correlate with plant uptake (r = 0.211).

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Cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) molecule is expressed on T-lymphocyte membrane and negatively influences the antigen-presenting process. Reduced expression of CTLA-4 due to gene polymorphisms is associated with increased risk of autoimmune disorders, whose physiopathology is similar to that of post-transfusion red blood cell (RBC) alloimmunization. Our goal was to evaluate if polymorphisms of CTLA-4 gene that affect protein expression are associated with RBC alloimmunization. This was a case-control study in which 134 sickle cell disease (SCD) patients and 253 non-SCD patients were included. All patients were genotyped for the polymorphisms 49A/G and -318C/T of CTLA-4 gene. The genotype frequency of -318C/T differed significantly between alloimmunized and nonalloimmunized SCD patients, irrespective of clinical confounders (p = .016). SCD patients heterozygous for -318T allele presented higher risk of alloantibody development (OR: 5.4, CI: 1.15-25.6). In conclusion, the polymorphism -318C/T of CTLA-4 gene is associated with RBC alloimmunization among SCD patients. This highlights the role played by CTLA-4 on post-transfusion alloantibody development.