Anemia prevalence and its determinants in Brazilian institutionalized elderly

ObjectiveTo estimate the prevalence of anemia and analyze the factors associated with anemia in elderly residents of long-term care institutions.MethodsThis cross-sectional study was performed in male and female elderly volunteers selected in a two-stage random sampling from long-term care institutions in the city of Maringá, Brazil (2008). A diagnosis of anemia was based on the plasma hemoglobin concentration. The independent variables analyzed were gender, age, time of residence at an institution, body mass index, and serum iron and albumin concentrations. The association between anemia and the variables was assessed using the Poisson regression with robust variance in unadjusted and adjusted analyses, considering a complex sample and a significance level of 5%.ResultsThe sample included 124 adults older than 60 y residing in long-term care institutions (53.0% female). The prevalence of anemia was 29% and was not significantly associated with gender, serum iron concentration, time of residence at an institution, or body mass index. Conversely, hypoalbuminemia was considered a risk factor for anemia.ConclusionThere is a high prevalence of anemia in the institutionalized elderly and hypoalbuminemia is a factor associated with this outcome. Interventions are necessary to promote improvements in the health and welfare of this population.     

Volume management in critically ill patients: New insights

In order to turn a fluid challenge into a significant increase in stroke volume and cardiac output, 2 conditions must be met: 1) fluid infusion has to significantly increase cardiac preload and 2) the increase in cardiac preload has to induce a significant increase in stroke volume. In other words, a patient can be nonresponder to a fluid challenge because preload does not increase during fluid infusion or/and because the heart (more precisely, at least 1 of the ventricles) is operating on the flat portion of the Frank-Starling curve. Volumetric markers of cardiac preload are therefore useful for checking whether cardiac preload effectively increases during fluid infusion. If this is not the case, giving more fluid, using a venoconstricting agent (to avoid venous pooling), or reducing the intrathoracic pressure (to facilitate the increase in intrathoracic blood volume) may be useful for achieving increased cardiac preload. Arterial pulse pressure variation is useful for determining whether stroke volume can/will increase when preload does increase. If this is not the case, only an inotropic drug can improve cardiac output. Therefore, the best option for determining the usefulness of, and monitoring fluid therapy in critically ill patients is the combination of information provided by the static indicators of cardiac preload and arterial pulse pressure variation.     

Untersuchungen am Mäuseascitescarcinom

Ohne ZusammenfassungMit 8 Textabbildungen.     

Über Tumoren des Hundes

Ohne ZusammenfassungMit 30 Textabbildungen     

Über den Eisengehalt des Magen- und Darmtractus bei normalen und tumorkranken Ratten und Mäusen

Ohne ZusammenfassungMit 1 Textabbildung     

Creative Grandparenting Bonding the Generations

Grandparents are a vital link for young families. The support grandparents can provide to the new family is now more important than ever. A creative grandparenting program can increase the likelihood that grandparent support is effective and welcomed. This article includes a discussion of such a program, suggested content areas to include, and the development of appropriate teaching strategies.     

Physical, subjective, and social availability: their relationship to alcohol consumption in rural and urban areas

The alcohol availability literature indicates that under some conditions, physical availability is positively associated with per capita alcohol consumption. Smart (1980) suggested that at the individual level, subjective and social aspects of availability may mediate and outweigh the influence of physical availability. The study described here examined the simultaneous effects of physical, subjective, and social availability on alcohol consumption. Standardized telephone interviews were conducted with 781 adult drinkers. As hypothesized, physical availability was not a significant multivariate predictor of alcohol consumption for residents of high, medium, and low alcohol outlet density counties in Michigan (USA). Subjective and social availability indicators were significant predictors of alcohol consumption. Similar patterns of results were found in multiple regression analyses for blacks and whites and women and men, although blacks and women consumed less alcohol than did whites and men. The theoretical and practical implications of these results are discussed.