São Paulo medical journal = Revista paulista de medicina
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Frailty among elderly people is associated with negative health outcomes. Through gaining better understanding of this syndrome over different time periods, healthcare actions that take predictive factors into consideration may be facilitated. ⋯ Age over 80 years was predictive of pre-frailty and frailty, while dependency in basic activities of daily living and poor physical performance predicted frailty. A one-unit increased score for advanced activities of daily living decreased the frailty rate by 15%.
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Management of rectal cancer has become more complex with multimodality therapy (neoadjuvant chemoradiotherapy and surgery) and this has led to the need to organize multidisciplinary teams. The aim of this study was to report on the planning, implementation and evaluation of an integrated care pathway for neoadjuvant treatment of middle and lower rectal cancer. ⋯ The logic model was useful for evaluating the implementation of the integrated care pathways and for identifying measurements to be made in future outcome studies.
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Osteosarcoma is the most prevalent malignant bone tumor in children and adolescents. Lung metastases are associated with poor prognosis. ⋯ The factors revealed here may guide lung metastasis screening and prophylactic treatment for osteosarcoma patients. A primary tumor in an axial location, greater primary tumor size, higher lymph node stage and presence of bone or brain metastases were significantly correlated with lung metastases. The elderly group (≥ 60 years) showed significant correlation with poor overall survival. For improved survival among high-grade osteosarcoma patients with lung metastases, aggressive surgery on the primary tumor site should be encouraged.
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Package leaflets of medicines need to be intelligible, but tools for their evaluation are scarce. ⋯ LiS-RPL is a validated tool for evaluating subjects' satisfaction with medicine package leaflets.
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Falls among the elderly are one of the main public health problems that have direct consequences for their health. They reduce these individuals' autonomy and functional independence. ⋯ Higher occurrence of falls was observed among female elderly individuals who suffered recurrent falls, had had low levels of schooling, presented comorbidities, had comorbidities and made use of drugs. These conditions predisposed these individuals to greater vulnerability to the risk of falls.