INTRODUCTION: This article is part of a special series designed to help authors in the process of scientific writing.
OBJECTIVE: To address common mistakes that researchers commit while writing a manuscript, in order to understand and optimize the process of writing a new research paper.
METHODS: The authors made a nonsystematic search in the current literature (PubMed) to retrieve papers that address the most frequent mistakes found by editors, peer reviewers, journals and authors.
RESULTS: According to the search results, key findings about the most common mistakes for each section of a manuscript were described (introduction section, methods section, results section, discussion section, conclusion section, references, title and abstract).
CONCLUSION: There is a great amount of avoidable mistakes in each section of a scientific manuscript. Overall, among the most common mistakes are missing data, incomplete sections, excessive report of current literature or reporting data in an inadequate section.
Keywords: manuscripts; editorial; journal article; medical writing.
OBJECTIVES: To evaluate the consumption of fruits based on the habitual consumption in elderly.
METHODS: Crosssectional study in non-probabilistic sample of 295 elderly people, from the research "Food Consumption Assessment in Elderly in São Caetano do Sul, São Paulo, Brazil". Information on fruits intake was obtained from the previously validated Food Frequency Questionnaire, and the consumption of energy and nutrients was assessed by two 24-hour dietary recall, using the Multiple Source Method Program (MSM). A logistic regression was applied to verify socio-demographic factors and lifestyle associated with fruits intake, and the Mann-Whitney test was used to evaluate the differences among the consumption of fruits, energy, macro and micronutrients.
RESULTS: More than half of the sample (58%) consumed three or more fruit daily. The fruit intake was positively associated with female gender (OR = 2.00; 95%CI 1.02 - 3.91; p = 0.04) andliving alone (OR = 1.86; 95%CI 1.04 - 3.30; p = 0.03); and negatively associated with malnutrition (OR = 0.36; 95%CI 0.17 - 0.76; p = 0.01). Among seniors who have adequate consumption of fruit it was observed an increased intake of fibers (p = 0.03), vitamin A (p < 0.01), vitamin C (p < 0.01), potassium (p < 0.01) and magnesium (p < 0.01). Although, there was no significant association between energy and macronutrients (p > 0.05).
CONCLUSION: The consumption of fruit was influenced by socio-demographic factors and nutritional status, affecting the higher consumption of fiber, vitamin A and C, minerals like potassium and magnesium. Public policies that increased fruit consumption by the elderly could influence the health and quality of life of older people.
Keywords: fruit; aging; food consumption; elderly nutrition; nutrients.
BACKGROUND: There are different types of exercises, but the circuit weight training is less prescribed for the elderly in order to corroborate the control of glycaemia and hypertension.
OBJECTIVE: To compare the acute and chronic effects of circuit weight training or walking exercises on capillary glucose, physical fitness, and arterial blood pressure of the elderly women.
METHODS: Twelve weeks of circuit weight (n = 14) or walking (n = 9) were performed 3 times a week at the intensity of 40 to 60% heart rate, 11 to 13 in the Borg Scale. The elderly patients with medicated hypertension and diabetes (users of β-blockers, angiotensin-converting enzyme inhibitors and oral hypoglycemic) were selected.
RESULTS: The capillary glucose decreased in both groups in acute and chronic effects of exercise (p < 0.05). The systolic blood pressure increased in acute moment only in the circuit weight (+6 mmHg, p < 0.05) without differences in the diastolic blood pressure. The right handgrip, the balance of right and left legs, the sitting and standing test were improved in walking (p < 0.05), and flexibility in circuit weight (p < 0.05). There was no statistically significant difference in the left handgrip, subscapularis, lumbar back, and abdominal circumference, three-meters walking under line. There was no difference in the comparison between groups.
CONCLUSION: The two types of exercises improve metabolic rehabilitation. Only 12 weeks of the circuit weight training seems to be a short period to induce higher physical performance in elderly women.
Keywords: aging; blood glucose; physical fitness; rehabilitation.
OBJECTIVE: Gastric cancer (GC) is one of the most common cancers, and its incidence increases with age. The objective of the study was to evaluate the response rate (RR), overall survival (OS), and toxicity in patients aged over 60 years, with metastatic GC and who were undergoing chemotherapy.
METHODS: This is a retrospective study developed in a university hospital. Medical records of patients treated in the last 4 years were analyzed.
RESULTS: Twenty-one patients were included; the average age was 69.6 ± 7.6 years, 76.2% men, 61.9% Karnofsky Performance Status (KPS) > 70, 85.7% had weight loss > 10% in 6 months, 28.6% had at least 2 sites of metastasis, and 42.9% had unfavorable histology (diffuse). Most of the patients (85.7%) were treated with combination regimens (4.6 cycles on average). Patients with better nutritional status had a non-statistically significant better tolerance to the treatment (p = 0.17). The median progression-free survival (PFS) was 9.0 months and the median OS was 13.8 months. Toxicity grade 1-2 was observed in 61.9%, and grade 3-4, in 14.3%. Less than two sites of metastasis (hazard ratio [HR] = 0.15; CI95% 0.02 - 0.93), absence of metastasis to non-regional lymph nodes (HR = 0.04; CI95% < 0.01 - 0.44), higher number of chemotherapy cycles (HR = 0.72; CI95% 0.53 - 0.97), objective response (HR = 0.06; CI95% 0.01 - 0.69) were associated with higher OS. Higher body mass index (BMI) was related with a not statistically significant better OS (HR = 0.84; CI95% 0.64 - 1.10).
CONCLUSIONS: Patients treated in our hospital showed results compatible with literature. The doublet chemotherapy is feasible in elderly individuals with manageable toxicity.
Keywords: stomach neoplasms; drug therapy; palliative care; cachexia; drug-related side effects and adverse reactions.
OBJECTIVE: To evaluate the use of calf circumference measurement in the diagnosis of nutritional status of elderly in a geriatric hospitalization unit and check whether a calf circumference measurement lower than 31 cm indicates poor clinical outcome in these patients.
METHODS: A retrospective cross-sectional study with 548 elderly people. An association was found between calf circumference measurement and length of hospital stay, clinical outcome, Body Mass Index, nutritional risk and malnutrition. The Mann-Whitney test, the Pearson's χ2 test, the Kruskal-Wallis test, the ANOVA test and the logistic regression were conducted.
RESULTS: Inferential analysis showed longer hospital stay (11 versus 9 days; p = 0.028), more deaths (22.4 versus 11.4%; p = 0.001), patients with lower body mass index (19.0 versus 26.5 kg/m2; p < 0.001), higher nutritional risk (99.3 versus 88.6%; p < 0.001), and a higher degree of malnutrition (69.6 versus 8.6%; p < 0.001) in the group with a calf circumference < 31 cm. The average values of calf circumference of the group of patients who passed away (p < 0.001), who were underweight (p < 0.001), who showed nutritional risk (p < 0.001) and who were malnourished (p < 0.001) were significantly lower. In addition, the elderly with calf circumference < 31 cm showed 2.24 times higher chance of death (95%CI 1.40 - 3.66).
CONCLUSION: Calf circumference is a good indicator of nutritional status and was associated with poorer clinical outcome in hospitalized elderly patients, justifying thus its routine use in the nutritional evaluation of these patients, especially those bedridden.
Keywords: aged; nutrition assessment; malnutrition; body composition.
OBJECTIVE: In this descriptive epidemiological study, we sought to trace the profile of socio-demographic and health conditions of elders residing in long-term institutions in cities in the Southeast and Midwest regions of Brazil.
METHODS: We used descriptive statistical methods to characterize and compare the profile of the elders in each city and the statistical significance of the observed differences was tested by the χ2 test, considering p < 0.05.
RESULTS: In total, 760 individuals were interviewed, of whom more than half were men (52.6%) and almost 40.0% were 80 years or older. The majority presented dependence in instrumental activities of daily living (81.2%) and cognitive impairment (73.3%). The major part of socio-demographic and health characteristics of these individuals differed among the suited cities.
CONCLUSION: This heterogeneity may be related to the different socio-cultural contexts of each city that, in a sense, influence the health conditions and the reasons leading to the institutionalization of elders in Brazil.
Keywords: health of the elderly, homes for the aged, Brazil.
INTRODUCTION: Vitamin D deficiency is frequently noticed in the elderly. However, there are still doubts about the supplementation levels required to achieve the normalization of such deficiency.
OBJECTIVE: To evaluate the efficacy of vitamin D replacement with weekly oral doses of 50,000 IU in community elders of the Federal District, Brazil.
METHODS: Clinical, interventional, quasi-experimental study with 89 community volunteers, aged 60 and older, living in the Federal District, 15°S. Variables on habits, medication use, dosage (chemiluminescence) of serum 25 (OH) D, parathyroid hormone (PTH), calcium, and phosphorus were analyzed. Supplementation with vitamin D3 was performed in 24 volunteers with sufficient 25-OH VITD (> 30 ng/mL) at a dose of 800 IU per day; in 20 subjects with deficiency of 25-OH VITD (< 20 ng/mL), and in 45 subjects with insufficiency of 25-OH VITD (20 to 29 ng/mL) a dose of 50,000 IU per week for 8 weeks was used.
RESULTS: Hypovitaminosis D was identified in 70.9% being deficient in 24.3% and insufficient in 46.6% of the subjects. Supplementation for 8 weeks resulted in an average gain of 8.27 ng/mL. In the group with D hypovitaminosis, there was a persistent insufficiency in 49.2% of volunteers, adequacy in 46.1% and deficiency only in 4.6%. In the group with deficiency the average gain were 12.90 ng/mL (92.5% gain), being 7.80 ng/mL (33.0% gain) in the deficiency group and 5.25 ng/mL (16.0% gain) for the group with no vitamin D deficiency. There was no evidence connecting the gains to gender and age group. Patients treated with antipsychotics and bisphosphonates had lower gains compared to the average.
CONCLUSIONS: Despite the statistically significant gain — mean 8.2 ng/mL — in volunteers who received a dose of 50,000 IU of vitamin D3 weekly, results show that after the treatment of vitamin D deficiency, 58.3% of pacients with hyposufficiency did not reach normal concentrations in the period of 8 weeks. Volunteers taking antipsychotics and bisphosphonates had significant smaller gains in vitamin D concentrations with the supplementation.
Keywords: vitamin D; vitamin D deficiency; aged; therapeutics.
INTRODUCTION: A core value for those facing the problem associated with life-threatening illness is to allow them to make their choices about end-of-life care.
OBJECTIVE: To culturally adapt the Portuguese version (Portugal) of the questionnaire about preferences and priorities for end-of-life care (PRISMA) for Brazil.
METHODS: Cultural adaptation involved the following phases: linguistic adaptation; synthesis of linguistic adaptations; back translation; intercultural equivalence; and pre-test of the final version, with the participation of 60 participants aged > 60 years, who were native speakers of Portuguese in Brazil and who lived in the city of Belo Horizonte, Minas Gerais.
RESULTS: Slight differences between the two versions were observed and few adjustments were made. The changes were considered of semantic nature. There were no negative comments from participants about the version of PRISMA questionnaire applied in the pre-test. It was observed that many participants needed significant time for reflection and to provide answers because the subject addressed in the questionnaire is sensitive and little discussed in the Brazilian society.
CONCLUSION: The tested questionnaire was accepted for use in studies of the elderly Brazilian population.
Keywords: palliative care; advance care planning; aged; validation studies; surveys and questionnaires.
INTRODUCTION: Tuberculosis is a disease of great global impact, due to its high morbidity and mortality. Among the extrapulmonary manifestations, tuberculous meningitis stands out as the most severe form. His initial presentation is very varied atypical, especially in the elderly, when the delirium may be the only manifestation. In this phase it is common to misdiagnosis and treatment delay, including iatrogenic potential. This paper reports an early MTB event in an old previously healthy, with discussion of the characteristics of the initial onset of this condition.
CASE REPORT: A female patient, 72 years old, autonomous and independent, sought urgent care complaining of nonspecific abdominal pain started a few hours before, and who developed delirium two days later. After extensive investigation there was no definitive diagnosis, when we opted for the Cerebrospinal fluid study showed a pattern compatible with MTB likely. After 48 hours of specific treatment there was resolution of fever, with significant improvement of the confusional picture on the seventh day of treatment, was discharged.
Keywords: Tuberculosis; Tuberculosis, Meningeal; Delirium; Health of the Elderly:
To investigate the prevalence and the factors associated with frailty syndrome in institutionalized elderly, residents in the city of Recife/PE, a descriptive, cross-sectional, quantitative study was performed in nine public or philanthropic Homes for the Aged, between January and May 2013. We included 214 seniors, assuming as independent variables, the sociodemographic and health conditions, self-reported or obtained from elderly records, and the degree of elderly fragility, as dependent variable, assessed by Edmonton Fragility Scale. The mean age equaled to 76.42 ± 0.66 years (95%CI 75.12 – 77.71). We found a predominance of females (69.6%), unmarried (53.7%), with study time ranging from one to four years (54.4%). More frequently they referred perception of income (86.4%) up to one minimum salary (73.4%) and the residence time was less than a year to 29.4% of elderly. Regarding cognition, 79.4% of respondents were disapproved by significant errors. The frailty syndrome was identified in 70.1% of the elderly. All factors included in elderly frailty scale reached statistical significance, associated with increased frailty prevalence, as well as education, with a prevalence equal to 3.0 (95%CI 1.3 – 6.6) for its absence, and 2.5 (95%CI 1.2 – 5.3), for a four-year study. The absence of personal income increased at twice the prevalence (95%CI 1.0 – 4.0). In multivariate analysis, the factors that most contributed to the prevalence were impaired cognition, functional independence, self-evaluation of health, frequency of social support, perceived weight loss and feeling of sadness/depression.
Keywords: aged; homes for the aged; frail elderly; health of institutionalized elderly.