Objective: To describe the demographic characteristics, everyday habits, socio-economic conditions, clinico-epidemiological profiles and access to health care services among the elderly patients with tuberculosis diagnosed and treated in the city of Recife, Brazil, comparing them to those observed in young adults with tuberculosis. Methods: A case-control type strategy was used to evaluate a cohort of patients with tuberculosis, all of whom were treated in public health care facilities in (cases) and 991 young adults (controls). In both groups, males predominated, and the most common form of tuberculosis was the pulmonary form. Alcoholism was more common in the control group, whereas illiteracy was more common in the case group. There were fewer complaints of cough, sweats and chest pain among the patients in the case group than among those in the control group. Serological testing for the human immunodeficiency virus was performed in only 29 patients (2.6%). The percentage of positive sputum smear microscopy results, as well as that of positive cultures, was higher in the controls. Prior to being diagnosed with the disease, patients in both groups had sought treatment at more than two health care facilities and had waited more than two months (after first seeking treatment). The elderly patients presented higher indices of cure and were more often compliant with the treatment regimen, yet presented higher mortality rates. Conclusion:In the population studied, the elderly presented less cough, fewer episodes of night sweats and less chest pain, as well as less often presenting positivity on complementary exams. Nevertheless, the mortality rate was higher among the elderly patients than among the young adult patients. Elderly patients with tuberculosis constitute a population that should be given special attention in public health care facilities.

Objective: To evaluate the frequency of pressure injuries and associated factors in the older pacients with gastrointestinal cancer. Methods: Cross-sectional study of 212 individuals aged 60 years and older and diagnosed with untreated gastrointestinal cancer confirmed by histology, cytology or immunohistochemistry. Patients who had undergone previous cancer treatment, except surgical ones, were excluded. The variables studied were: pressure injury, nutritional status, weight loss in the three months prior to the assessment, functionality, level of physical activity, presence of comorbidities and laboratory variables. For media comparisons, Student's test and categorical variables or square test or Fisher's exact test were used. In the multivariate analysis using logistic regression, the Wald test was used to evaluate the independent effects of factors with p <0.20 and applied to the Hosmer-Lemesho test. Results: The frequency of LP was 68/212 (32.1%). In the multivariate analysis, variables that may remain associated with the presence of LP were: hypertension and cerebrovascular disease. The final model presents an adequate fit to the data (Hosmer-Lemeshow test (p = 0.736). Conclusion: these findings can guide future research and can serve as a guide in health care services decisions about the use of pressure injury prevention strategies.

Objectives: to develop a flow to ensure care for all people with severe acute respiratory syndrome Coronavirus 2, offering from intensive care to palliative care, in an equitable and fair manner. Methods: the modified Delphi methodology was used to reach consensus on a flow and a prioritization index among specialists, the regional council of medicine, members of the healthcare system and the local judicial sector. Results: the score was incorporated into the flow as the final phase for building the list of patients who will be referred to intensive care, whenever a ventilator is available. Patients with lower scores should have priority access to the ICU. Patients with higher scores should receive palliative care associated with available curative measures. However, curative measures must be proportionate to the severity of the overall clinical situation and the prognosis. Conclusions: this tool could and will prevent patients from being excluded from access to the necessary health care so that their demands are assessed, their suffering is reduced, and their illnesses are cured, when possible.

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To determine risk factors for early death identified the Comprehensive Geriatric Assessment (CGA) in elderly patients with gynecological cancer (EPGC) Methods:

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e21533 Background: To determine if the nutritional risk according Mini Nutritional Assessment Short-Form (MNA®-SF) is an independent factor for short-term outcomes (infection, un programmed hospitalization and premature death) within the first six months after study entry. Methods:Prospective cohort study of elderly patients (≥ 60 years) with a recent diagnosis of cancer admitted to an outpatient oncology unit. At baseline sociodemographic and clinical variables were determined and comprehensive geriatric assessment (CGA) was conducted including MNA-SF. The outcomes were first Healthcare-associated Infection, un programmed hospitalization and death. Data were analyzed using multivariate Cox proportional hazards models; overall survival was estimated using the Kaplan–Meier method and survival curves were compared using the Log rank test. Results:The cohort consisted of 608 elderly patients followed for 180 days or until the censured data. Mean age was 71.9 years (range: 60‒96), 305 (50.2%) participants were at risk of malnutrition. During this period, 216 (35.5%) participants were hospitalized, 179 (29.4%) HAI and 100 (16.4%) died. After adjustment for age, site of cancer and cancer stage the multivariate regression Cox model showed that being undernourished was an independent predictor of infection (HR = 1.88, 95%CI 1.32-2.67, p < 0.001) hospitalization (HR = 1.5, 95% CI:1.10- 2.06, p = 0.012) and death (HR = 3.12, 95% CI: 1.74‒ 5.78, p < 0.001) Conclusions:Nutritional risk at admission was identified as a significant predictor of risk for premature death, infection, and need for hospitalization in elderly cancer patients. The use of MNA-SF should be incorporated into regular geriatric assessment of older patients with cancer