Elderly caregivers suffer physical and psychological consequences of the act of caring. The objective of this study was to characterize primary caregivers of elderly people in the community and identify the higher impacts of this activity on their life. We interviewed 127 caregivers about sociodemographic characteristics, presence of anxiety/depression (self-reporting questionnaire = SRQ), burden of care (caregiver burden scale = CBS); while their dependents were evaluated using sociodemographic questionnaires, health history, activities of daily living (ADL) scale and geriatric depression scale (GDS-15). The caregivers’ mean age was 55.1 ± 13.3 years; among them most were women and daughters with up to 4 years of education. The mean time as responsible for the elderly was 86.5 ± 96.3 months; 56% divided the caring responsibility and 28.2% had another occupation; 32.3% presented psychoemotional illness. There was a positive correlation between the CBS and the caregiver factors: psychoemotional disorders, time as responsible for the elderly and education level; as well as between the CBS and the elderly: number of activities with dependence, presence of depression and incontinences. The correlation between the elderly's personal income and number of visits received was negative. The identification of high impacts on the caregivers’ life would facilitate the professional approach. 相似文献
Introduction: We present our experience in the management of penetrating pancreatic injuries, focusing on factors related to complications and death.
Methods: Retrospective trauma registry-based analysis of 62 consecutive patients with penetrating pancreatic injuries during an 11-year period. Overall injury severity was assessed by the injury severity score (ISS) and the penetrating abdominal trauma index (PATI). Pancreatic injuries were graded according to the American Association for the Surgery of Trauma (AAST) Organ Injury Scaling (OIS). Complications were characterised using standardised definitions. Mortality was recorded as early (within 48 h after admission) and late (after 48 h).
Results: Thirty patients suffered gunshot wounds and 24 had grade I pancreatic injuries. Shotgun and gunshot wounds were more destructive than stab wounds (higher PATI, number of intraabdominal injuries and mortality). Seventeen patients died. Most deaths occurred within 1 h after admission due to massive bleeding and severe associated injuries. Only one death was potentially related to the pancreatic injury. Mortality rate also correlated with pancreatic injury grading. Sixty-one patients had associated intraabdominal injuries. Combined pancreaticoduodenal injuries were present in 13 patients, and five died. Simple drainage was the most common procedure performed. Pancreas-related complications were found in 12 out of 47 patients who survived more than 48 h; intraabdominal abscess (n=7) that was associated with colon injuries, and pancreatic fistula (n=5).
Conclusion: An approach based on injury grade and location is advised. Routine drainage is recommended; distal resection is indicated in the presence of main duct injury, and the management of severe injuries will be tailored according to the overall physiologic status, presence of associated injuries, and duodenal viability. Morbidity and mortality is mainly due to associated injuries. 相似文献
Mitochondrial dysfunction might have a central role in the pathophysiology of depression. Phenotypically, depression is characterized by lack of energy, concentration problems and fatigue. These symptoms might be partially explained by reduced availability of adenosine triphosphate (ATP) as a consequence of impaired mitochondrial functioning. This study investigated mitochondrial respiration in peripheral blood mononuclear cells (PBMCs), an established model to investigate the pathophysiology of depression. Mitochondrial respiration was assessed in intact PBMCs in 22 individuals with a diagnosis of major depression (MD) compared with 22 healthy age-matched controls using high-resolution respirometry. Individuals with MD showed significantly impaired mitochondrial functioning: routine and uncoupled respiration as well as spare respiratory capacity, coupling efficiency and ATP turnover-related respiration were significantly lower in the MD compared with the control group. Furthermore, mitochondrial respiration was significantly negatively correlated with the severity of depressive symptoms, in particular, with loss of energy, difficulties concentrating and fatigue. The results suggest that mitochondrial dysfunction contributes to the biomolecular pathophysiology of depressive symptoms. The decreased immune capability observed in MD leading to a higher risk of comorbidities could be attributable to impaired energy supply due to mitochondrial dysfunction. Thus mitochondrial respiration in PBMCs and its functional consequences might be an interesting target for new therapeutical approaches in the treatment of MD and immune-related comorbidities. 相似文献