O projeto SABE (Saúde, bem-estar e envelhecimento) foi coordenado pela Organização Pan-Americana de Saúde com o objetivo de coletar informações sobre as condições de vida dos idosos (60 anos e mais) residentes em áreas urbanas de metrópoles de sete países da América Latina e Caribe - entre elas, o Município de São Paulo - e avaliar diferenciais de coorte, gênero e socioeconômicos com relação ao estado de saúde, acesso e utilização de cuidados de saúde. Por meio de questionário e processo amostral padronizados foram entrevistadas 2.143 pessoas. Encontrou-se que as mulheres são maioria, os imigrantes eram 8,7%, 62,6% viveram por cinco anos ou mais na área rural até os quinze anos de vida. Dos idosos, 13,2% viviam sós, sendo que esse valor aumentou com a idade e no sexo feminino. Em relação ao estado mental, encontrou-se, pelo Mini Exame do Estado Mental (MEEM), 6,9% de deterioração cognitiva e 18,1% de depressão, segundo a Escala de Depressão Geriátrica. As auto-avaliações de saúde mostram que 53,8% dos entrevistados consideraram a sua saúde regular ou má. Dentre as doenças mais freqüentes estavam a hipertensão (53,3%); artrite/artrose/reumatismo, 31,7%; e diabetes, 17,9%. A grande maioria dos idosos não apresentou dificuldades nas atividades básicas de vida diária (80,7%), e entre aqueles que apresentaram, a maioria tinha dificuldades em uma ou duas atividades. Foram apresentados dados dos arranjos domiciliares encontrados, do acesso e utilização de serviços de saúde, e relativos à renda e condição de trabalho. Conclui-se que as condições de saúde são preocupantes, assim como a insuficiência do sistema de seguridade social.

The SABE project (health, well-being and aging) was coordinated by the Pan American Health Organization and aimed to collect information about the living conditions of the elderly population (aged 60 and older) in urban metropolitan areas in seven Latin American countries, including the city of São Paulo, and to investigate cohort, socioeconomic and gender differences in relation to health status, as well as use and access to heath care. A questionnaire and a standardized sampling process were used to interview 2,143 people. The results show that most of the elderly are women, with a ratio of 142 women to 100 men. 8.7% were immigrants, and 62.6% lived for five or more years in the rural area until the age of fifteen. 13.2% of the elderly lived alone, a percentage that was greater for women and as age increased. For those aged 80 and over, the percentage of living alone was found to be 21.5%; among very old women, that percentage was 17.1%. The Mini Mental State Examination (MMSE) was used to assess cognitive mental functioning. The results show that 6.9% of the elderly suffered mental impairment. Besides, the older they were, the greater the mental impairment was. However, when the MMSE was associated with the Pfeffer questionnaire, the prevalence dropped to 3.4%. The Geriatric Depression Scale (GDS) revealed that 18.1% of the elderly suffered from depression and only a small number of them took antidepressants. Their health self assessment data shows that 53.8% of the interviewees considered their health to be regular or poor, and this assessment differs when variables such as age, sex, years of education, and disability are considered. Among the most frequent illnesses, we found: hypertension (53.3%) - 80.6% took some kind of medicine; arthritis/rheumatism (31.7%) - 62.6 had some kind of disability, and diabetes (17.9%). The prevalence of elderly falls was 28.6%. The great majority of the elderly did not have any difficulties in their activities of daily living (ADL) (80,7%). Those who had problems usually had difficulties in performing one or two ADLs. Data on their living arrangements and help received according to family support was also presented, and we found that little support was given to ADLs. Income was low - 2.1 minimum wages. We conclude that health status and the inefficiency of the social security system are worrying issues in this elderly population, as a significant number of them are not financially independent and continue to work.

O projeto SABE (Saúde, bem-estar e envelhecimento) foi coordenado pela Organização Pan-Americana de Saúde com o objetivo de coletar informações sobre as condições de vida dos idosos (60 anos e mais) residentes em áreas urbanas de metrópoles de sete países da América Latina e Caribe - entre elas, o Município de São Paulo - e avaliar diferenciais de coorte, gênero e socioeconômicos com relação ao estado de saúde, acesso e utilização de cuidados de saúde. Por meio de questionário e processo amostral padronizados foram entrevistadas 2.143 pessoas. Encontrou-se que as mulheres são maioria, os imigrantes eram 8,7%, 62,6% viveram por cinco anos ou mais na área rural até os quinze anos de vida. Dos idosos, 13,2% viviam sós, sendo que esse valor aumentou com a idade e no sexo feminino. Em relação ao estado mental, encontrou-se, pelo Mini Exame do Estado Mental (MEEM), 6,9% de deterioração cognitiva e 18,1% de depressão, segundo a Escala de Depressão Geriátrica. As auto-avaliações de saúde mostram que 53,8% dos entrevistados consideraram a sua saúde regular ou má. Dentre as doenças mais freqüentes estavam a hipertensão (53,3%); artrite/artrose/reumatismo, 31,7%; e diabetes, 17,9%. A grande maioria dos idosos não apresentou dificuldades nas atividades básicas de vida diária (80,7%), e entre aqueles que apresentaram, a maioria tinha dificuldades em uma ou duas atividades. Foram apresentados dados dos arranjos domiciliares encontrados, do acesso e utilização de serviços de saúde, e relativos à renda e condição de trabalho. Conclui-se que as condições de saúde são preocupantes, assim como a insuficiência do sistema de seguridade social.

The SABE project (health, well-being and aging) was coordinated by the Pan American Health Organization and aimed to collect information about the living conditions of the elderly population (aged 60 and older) in urban metropolitan areas in seven Latin American countries, including the city of São Paulo, and to investigate cohort, socioeconomic and gender differences in relation to health status, as well as use and access to heath care. A questionnaire and a standardized sampling process were used to interview 2,143 people. The results show that most of the elderly are women, with a ratio of 142 women to 100 men. 8.7% were immigrants, and 62.6% lived for five or more years in the rural area until the age of fifteen. 13.2% of the elderly lived alone, a percentage that was greater for women and as age increased. For those aged 80 and over, the percentage of living alone was found to be 21.5%; among very old women, that percentage was 17.1%. The Mini Mental State Examination (MMSE) was used to assess cognitive mental functioning. The results show that 6.9% of the elderly suffered mental impairment. Besides, the older they were, the greater the mental impairment was. However, when the MMSE was associated with the Pfeffer questionnaire, the prevalence dropped to 3.4%. The Geriatric Depression Scale (GDS) revealed that 18.1% of the elderly suffered from depression and only a small number of them took antidepressants. Their health self assessment data shows that 53.8% of the interviewees considered their health to be regular or poor, and this assessment differs when variables such as age, sex, years of education, and disability are considered. Among the most frequent illnesses, we found: hypertension (53.3%) - 80.6% took some kind of medicine; arthritis/rheumatism (31.7%) - 62.6 had some kind of disability, and diabetes (17.9%). The prevalence of elderly falls was 28.6%. The great majority of the elderly did not have any difficulties in their activities of daily living (ADL) (80,7%). Those who had problems usually had difficulties in performing one or two ADLs. Data on their living arrangements and help received according to family support was also presented, and we found that little support was given to ADLs. Income was low - 2.1 minimum wages. We conclude that health status and the inefficiency of the social security system are worrying issues in this elderly population, as a significant number of them are not financially independent and continue to work.

Recentemente, foco de leishmaniose visceral canina (CVL) foi descrito na região noroeste do Estado de São Paulo - Brasil. O Hospital Veterinário - UNESP - Araçatuba, no ano de 2.000, desenvolveu 60 testes citopatológicos de casos suspeitos de leishmaniose usando aspirado por agulha fina (FNA). Os esfregaços de linfonodo foram corados pelo método de Romanowsky (Diff-Quik®) e observados em microscopia de luz. Os casos positivos mostraram formas amastigotas típicas de Leishmania livres ou em vacúolos de macrófagos. Sinais citopatológicos de reatividade do sistema linfo-histiocitário com ausência de parasitos foram também observados. Com o objetivo de implementar o diagnóstico da CVL, detectando parasitos e material antigênico nos esfregaços, aplicou-se a reação de imunofluorescência direta (IFD) usando anticorpo policlonal anti-Leishmania produzido em camundongo. Comparamos o método de IFD com a pesquisa direta do parasito em esfregaços corados pelo método de Romanowsky. Dos 60 cães com sinais clínicos da doença, o exame direto foi positivo em 50% (n=30), duvidoso em 36,7% (n=22) e negativo com reatividade do linfonodo em 13,3% (n=8). Quando os linfonodos foram submetidos a reação de IFD observamos reação positiva em 93,3% (n=56) e reação negativa em 6,7% (n=4). Nossos resultados mostraram que a reação de IFD apresentou alta sensibilidade quando comparada a pesquisa direta do parasito pela coloração de Romanowsky. A reação de IFD pode ser um método útil para confirmar os casos duvidosos da doença, onde as formas amastigotas não são identificadas com facilidade.

Recently, canine visceral leishmaniasis (CVL) was detected in the northwest of São Paulo State - Brazil. The Veterinary Hospital - UNESP - Araçatuba, in 2.000, carried out 60 cytopathological test of suspected cases of leishmaniasis using the fine-needle aspiration (FNA). The smears of the FNA popliteal lymph nodes were stained by the Romanowsky stain (Diff-Quik®) and observed using a light microscope. The positive cases showed typical amastigotes forms of Leishmania either free or in macrophage vacuoles. Cytopathological signs of reactivity of the lymph-hystiocitary system with the absence of parasites were also detected. In order to improve the diagnosis of CVL, looking for parasites and antigenic material detection in smears, we standardized the direct immunofluorescence assay (IFD) using mouse anti-Leishmania policlonal antibodies. We compared the IFD assay with the direct search of parasites in smears stained by Romanowsky stain. From the 60 dogs with clinical signs of the disease, the direct exam was positive in 50% (n=30), uncertain in 36,7% (n=22) and negative with lymph node reativity in 13,3% (n=8). When the lymph node smears were submitted to IFD assay we observed positive reaction in 93,3% (n=56) and negative reaction in 6,7% (n=4). Our results showed that IFD assay presented a high sensibility compared to parasite direct search by Romanowsky stain. The IFD assay could be useful method to confirm the uncertain cases of the disease, where amastigotes forms were not clearly identified.