Resumo A inserção do cateter venoso central (CVC) para hemodiálise pode ser complicada em pacientes com anatomia anômala dos vasos. Nesses casos, o conhecimento detalhado da anatomia do vaso torácico é necessário para identificar a localização exata do cateter. A colocação venosa central sob controle de ultrassom tem reduzido significativamente as complicações associadas à punção às cegas e permite uma punção apropriada do vaso desejado, mas o CVC ainda pode ficar mal posicionado se seguir uma rota anômala. Aqui, relatamos um caso de cateter de diálise colocado em uma veia cava superior esquerda, apenas diagnosticado após estudo de tomografia computadorizada. (CVC vasos casos desejado Aqui esquerda computadorizada

Abstract Hemodialysis central venous catheter (CVC) insertion can be complicated in patients with anomalous vessel anatomy. In such cases detailed knowledge of thoracic vessel anatomy is necessary to identify the exact location of the catheter. Central venous placement under ultrasound control has significantly reduced the complications associated with blind puncture and allows an appropriate puncture of the desired vessel, but the CVC can still get misplaced if it follows an anomalous route. Herein, we report a case of dialysis catheter placed into a left sided superior vena cava, only diagnosed after CT scan study. (CVC route Herein cava study

Resumen: El bloqueo del plano del músculo erector espinal es una técnica ecoguiada que ha ganado popularidad como técnica analgésica perioperatoria debido a su perfil de seguridad y versatilidad. Se describe el caso de una anciana con cardiopatía isquémica y fibrilación auricular, a la que se le realizó colectomía segmentaria mediante laparotomía subcostal izquierda bajo anestesia general, para la escisión de un tumor de colon. Se colocó un catéter en el plano del músculo erector espinal al nivel T7 bajo guía ultrasónica y luego se utilizó para analgesia postoperatoria (ropivacaína 0.2% bolo + infusión a 8 mL/h) junto con paracetamol intravenoso y metamizol. Este régimen analgésico se mantuvo durante 72 horas, con excelente control del dolor, tras lo cual se retiró el catéter. La paciente permaneció con adecuada analgesia sin opioides de rescate hasta su alta a los siete días del postoperatorio. El bloqueo del plano del erector espinal torácico continuo fue una técnica eficaz para la analgesia postoperatoria en cirugía abdominal abierta, con bajo riesgo de complicaciones y evitando el uso de opioides.

Abstract: Erector spinae plane block is an ultrasound-guided technique who has seen a growing role as a perioperative analgesic technique due to its safety profile and versatility. We describe a case of an elderly female with a history of ischemic heart disease and atrial fibrillation, who underwent segmental colectomy by left subcostal laparotomy under general anesthesia, for removal of a colon tumor. An erector spinae plane catheter was placed at the T7 level under ultrasound guidance, and then used for postoperative analgesia. Ropivacaine 0.2% (initial bolus + infusion at 8 mL/h) was used through the catheter, together with intravenous paracetamol and metamizol. This analgesic regimen was maintained for 72 hours, with excellent pain control, after which the catheter was removed. The patient’s pain remained controlled and rescue analgesia was not required until her discharge at seven days postoperative. Continuous ESP block was an effective technique for postoperative analgesia in this case, allowing excellent pain control with a low risk of complications and avoiding the use of opioids.

ABSTRACT Systemic lupus erythematosus and ANCA-associated vasculitis overlap syndrome is rare and complex. Moreover, the mechanisms that explain the interaction between these two conditions are still unclear. The authors describe the case of a patient who had myeloperoxidase ANCA-associated vasculitis as the initial diagnosis, with biopsy-proven pauci-immune crescentic glomerulonephritis, attaining complete remission after immunosuppression. Five years later, Systemic Lupus Erythematosus was diagnosed and a second kidney biopsy showed a pattern of lupus nephritis class III. While on immunosuppression treatment, the patient developed a progressive elevation of liver enzymes and was later diagnosed with primary biliary cholangitis. It seems that in this case, the overlap of Systemic Lupus Erythematosus and ANCA-associated vasculitis may be part of a poliautoimmune syndrome suggested by association with a third autoimmune disease.

Os erros hereditários do metabolismo são um grupo de doenças heterogéneas e multissistémicas. Apesar de cada doença individualmente ser rara, no seu conjunto são relativamente comuns. O sistema nervoso central é habitualmente afetado. Os autores apresentam o caso de uma lactente de cinco meses de idade, filha de pais não consanguíneos, nascida de uma gravidez de termo e parto sem intercorrências. Aos cinco meses, iniciou um quadro de hipotonia e regressão do desenvolvimento, apresentando ao longo do tempo dismorfismo facial, hepatomegália, convulsões e cardiomiopatia dilatada. O diagnóstico de Gangliosidose tipo 1 foi confirmado por achados bioquímicos, enzimáticos e genéticos. Este caso clínico reforça a relevância de uma abordagem e seguimento multidisciplinares.

Inborn errors of metabolism are a heterogeneous class of multisystemic diseases which, although individually rare, are collectively quite common. Central nervous system is usually affected. The authors report the case of a five-month-old girl, daughter of non-consanguineous parents, born after an unremarkable full-term pregnancy and delivery. Hypotonia and neurodevelopmental regression were noted from the age of five months, along with progressive onset of facial dysmorphism, hepatomegaly, seizures, and dilated cardiomyopathy. Gangliosidosis type 1 diagnosis was confirmed by biochemical, enzymatic, and genetic findings. This report enhances the relevance of multidisciplinary approach and follow-up.

Purpose: The aim of this study is to characterize a Portuguese Intensive Care Unit experience in therapeutic plasma exchange in critically ill patients. Methods: We performed a retrospective analysis of the patients treated with therapeutic plasma exchange between 2000 and 2019. Data on patient characteristics, therapeutic plasma exchange prescription, adjuvant therapy used, adverse events and outcome under treatment were collected. Results: A total of 101 therapeutic plasma exchange procedures in 20 patients were studied. Mean number of therapeutic plasma exchange sessions per patient was 5.1±1.3. The most frequent indications to begin this treatment were myasthenia gravis (25.0%) and anti-neutrophil-cytoplasmic antibody-associated vasculitis (15.0%). There were 45.5% adverse events and the most frequent was hypotension (15.2%). 98% of the complications were mild-to-moderate. The outcome was favorable in 60.0% of patients. Conclusion: Therapeutic plasma exchange is an effective and safe therapy in many diseases that had high morbidity and mortality prior to the use of this technique.

Abstract: Carcinoid tumors are rare slow-growing neuroendocrine tissue neoplasms. Their ability to secrete bioactive substances to the systemic circulation is accountable for a clinical presentation known as carcinoid syndrome. Main symptoms include bronchoconstriction, flushing, diarrhea and hemodynamic instability. Octreotide, a somatostatin analogue, is the current mainstay for carcinoid syndrome treatment and perioperative management. However, no regimen has proven to be completely effective in preventing systemic manifestations and recent literature suggests that it might be an insufficient measure. We report a case of a 51-year-old male with a functioning small bowel neuroendocrine tumor and carcinoid syndrome presenting for a primary tumor resection, discussing possible pitfalls and key points in the care of these patients.

Resumen: Los tumores carcinoides son neoplasias de tejido neuroendocrino poco comunes y de crecimiento lento. Su capacidad para secretar sustancias bioactivas a la circulación sistémica es responsable por una presentación clínica conocida como síndrome carcinoide. Los principales síntomas incluyen broncoconstricción, enrojecimiento, diarrea e inestabilidad hemodinámica. Octreótido, un análogo de la somatostatina, es el pilar actual para el tratamiento del síndrome carcinoide y su manejo perioperatorio. Sin embargo, ningún tratamiento ha demostrado ser completamente eficaz para prevenir las manifestaciones sistémicas y estudios recientes indican que puede ser una medida insuficiente. Presentamos un caso de un varón de 51 años con un tumor neuroendocrino funcionante en el intestino delgado y un síndrome carcinoide, sometido a una resección del tumor primario, discutiendo posibles dificultades y puntos clave en la atención de estos pacientes.

ABSTRACT Objective: to analyze the prevalence of cognitive decline (CD) preventive practices among the elderly population and the associated socio-demographic and health factors. Methodology: a cross-sectional, analytical study, conducted with 557 older people assisted at family health units in the city of Tangará da Serra-MT. Data were obtained through interviews, using an instrument containing socio-demographic characteristics, health conditions and CD preventive practices performed by the older people and applying the abbreviated geriatric depression scale and the Barthel index. Bivariate analysis was performed between the independent variables and CD preventive practices to verify association (p <0.05) using Pearson's x2 test. Variables with an association with p <0.20 were selected for entry into the Poisson multiple regression model by the stepwise forward method. Results: the prevalence of CD preventive practices was 55.1%. An association was found between CD preventive practices and the variables education (p <0.001), occupational status (p <0.001), functional capacity (p = 0.017), gender (p <0.001) and self-rated health (p = 0.028). Conclusion: preventive practices of CD were performed in most participants and were not previously documented in other studies. Female, functionally independent, highly educated elderly women who are working and self-rated their health as regular performed more CD preventive practices. These results are important since they show the characteristics of this population that should be taken into consideration when planning actions to promote cognitive health.

RESUMEN Objetivo: analizar la prevalencia de prácticas preventivas del deterioro cognitivo (DC) entre ancianos y los factores sociodemográficos y de salud asociados. Metodología: estudio analítico transversal realizado con 557 personas mayores atendidas en unidades de salud familiar en la ciudad de Tangará da Serra-MT. Los datos se obtuvieron a través de entrevistas, con un instrumento que contenía características sociodemográficas, condiciones de salud y prácticas preventivas de DC realizadas por ancianos y aplicando la escala abreviada de depresión geriátrica y el índice de Barthel. Se realizó el análisis bivariado entre las variables independientes y las prácticas preventivas de DC para verificar la asociación (p <0,05) utilizando la prueba x2 de Pearson. Las variables con asociación p <0,20 se seleccionaron para ingresar en el modelo de regresión múltiple de Poisson mediante el método stepwise forward. Resultados: la prevalencia de prácticas preventivas de DC fue del 55,1%. Se encontró asociación entre las prácticas preventivas de DC y las variables educación (p <0.001), estado ocupacional (p <0.001), capacidad funcional (p = 0.017), género (p <0.001) y autoevaluación de la salud (p = 0,028). Conclusión: la mayoría de los participantes realizó prácticas preventivas de DC y no se documentaron previamente en otros estudios. Las mujeres mayores funcionalmente independientes, altamente educadas, que trabajan y autocalificaron su salud como regular realizaban más prácticas preventivas de DC. Estos resultados son importantes ya que muestran cuáles son las características que deben tenerse en cuenta al planificar acciones para promover la salud cognitiva de esta población.

RESUMO Objetivo: analisar a prevalência de práticas preventivas de declínio cognitivo (DC) entre idosos e os fatores sociodemográficos e de saúde associados. Metodologia: estudo transversal, analítico, desenvolvido com 557 idosos atendidos nas unidades de saúde da família do município de Tangará da Serra-MT. Os dados foram obtidos por meio de entrevista, com utilização de instrumento contendo características sociodemográficas, condições de saúde e práticas preventivas de DC realizadas por idosos e aplicação da escala de depressão geriátrica abreviada e do índice de Barthel. Foi realizada análise bivariada entre as variáveis independentes e práticas preventivas de DC para verificação de associação (p<0,05) por meio do teste x2 de Pearson. As variáveis que apresentaram associação com valor de p<0,20 foram selecionadas para a entrada no modelo de regressão múltipla de Poisson pelo método stepwise forward. Resultados: a prevalência de práticas preventivas de DC foi de 55,1%. Foi encontrada associação entre práticas preventivas de DC e as variáveis escolaridade (p<0,001), situação ocupacional (p<0,001), capacidade funcional (p=0,017), sexo (p<0,001) e autoavaliação de saúde (p=0,028). Conclusão: a realização de práticas preventivas de DC se deu na maioria dos participantes e não foi previamente documentada em outros estudos. Idosos do sexo feminino, funcionalmente independentes, com alto nível de escolaridade, que estão trabalhando e autoavaliaram sua saúde como regular realizaram mais práticas preventivas de DC. Esses resultados são importantes, uma vez que mostram quais são as características dessa população que devem ser levadas em consideração no planejamento de ações para a promoção da saúde cognitiva.

Objective: to evaluate the knowledge, attitudes and practices for the prevention of cognitive decline carried out by older adults. Method: a cross-sectional study was carried out with 557 older adults attended at the Family Health Units of a municipality of Mato Grosso from February to May of 2015. The data were collected through an interview using a structured questionnaire with questions on knowledge, attitudes and practices for the prevention of cognitive decline based on Knowledge, Attitude and Practice surveys. A bivariate analysis was performed between the variables knowledge, attitudes and practices for the prevention of cognitive decline, as well as Poisson multiple regression by the forward stepwise method. Results: 469 (84.2%) of the older adults presented unsatisfactory knowledge; 523 (93.9%) a favorable attitude; and 307 (55.1%) performed practices to prevent cognitive decline. An association was found between satisfactory knowledge and practices for the prevention of cognitive decline (p=0.027). Conclusion: These findings provide support for health actions that aim to increase the performance of preventive practices in this population.

Objetivo: evaluar el conocimiento, las actitudes y las prácticas preventivas del declive cognitivo que ocurre en ancianos. Método: estudio trasversal, desarrollado con 557 ancianos atendidos en las Unidades de Salud de la Familia de un municipio de Mato Grosso, en los meses de febrero a mayo de 2015. Se recogieron los datos por medio de entrevista, utilizándose cuestionario estructurado con preguntas acerca de conocimientos, actitudes y prácticas preventivas de declive cognitivo considerándose las investigaciones: Conocimiento, Actitud y Prácticas. Se realizó análisis bivariado entre las variables conocimiento, actitud y prácticas preventivas de declive cognitivo y regresión múltiple de Poisson por el método stepwise forward. Resultados: los ancianos con conocimiento insatisfactorio fueron 469 (84,2%); actitud favorable, 523 (93,9%); y desarrollan prácticas preventivas del declive cognitivo, 307 (55,1%). Hubo asociación entre conocimiento satisfactorio y prácticas preventivas de declive cognitivo (p=0,027). Conclusión: Esos hallazgos dan subsidios para acciones en salud y pueden elevar la realización de las prácticas preventivas en esa población.

Objetivo: avaliar o conhecimento, as atitudes e as práticas preventivas do declínio cognitivo realizadas pelos idosos. Método: estudo transversal, desenvolvido com 557 idosos atendidos nas Unidades de Saúde da Família de um município de Mato Grosso, nos meses de fevereiro a maio de 2015. Os dados foram coletados por meio de entrevista, utilizando questionário estruturado com perguntas sobre conhecimentos, atitudes e práticas preventivas de declínio cognitivo baseado nos inquéritos: Conhecimento, Atitude e Práticas. Realizou-se análise bivariada entre as variáveis conhecimento, atitude e práticas preventivas de declínio cognitivo e regressão múltipla de Poisson pelo método stepwise forward. Resultados: os idosos com conhecimento insatisfatório foram 469 (84,2%); atitude favorável, 523 (93,9%); e desenvolvem práticas preventivas do declínio cognitivo, 307 (55,1%). Foi encontrada associação entre conhecimento satisfatório e práticas preventivas de declínio cognitivo (p=0,027). Conclusão: Tais achados fornecem subsídios para ações em saúde, com a finalidade de elevar a realização das práticas preventivas nessa população.

Resumen Objetivo. Describir el desarrollo de la cobertura de celulosa bacteriana con antiinflamatorio Ibuprofeno (CB/Ibu) y evaluar el proceso de cicatrización en la utilización en pacientes con heridas crónicas de etiología venosa y diabética. Métodos. Estudio descriptivo longitudinal. La membrana de celulosa, cultivada con bacterias Gluconacetobacter xylinus y con incorporación del Ibuprofeno se utilizó en el tratamiento de pacientes con heridas crónicas en servicios de atención pública de un municipio brasileño. Se evaluaron características de cobertura ideal mediante pruebas físicas, químicas y de proliferación celular. Resultados. La muestra fue constituida por 14 pacientes (10 mujeres y 4 hombres): 8 con úlcera venosa, 5 con pie diabético y uno con herida mixta. Se redujo el área y el dolor en 9 lesiones; la cicatrización total de 3 heridas; y el debridamiento del tejido desvitalizado en 5 heridas con aumento del área. El uso de la membrana de celulosa disminuyó el dolor de la exudación y facilitó la realización del vendaje. Conclusión. La CB/Ibu favoreció el proceso de cicatrización de los pacientes con heridas crónicas vasculogénicas.

Abstract Objective. To describe the development of the bacterial cellulose coating with anti-inflammatory Ibuprofen (BC/Ibu) and to evaluate the cicatrization process with its use in patients with chronic wounds of venous and diabetic etiology. Methods. Longitudinal descriptive study. The cellulose membrane, cultivated with bacteria Gluconacetobacter xylinus and with incorporation of Ibuprofen, was used in the treatment of patients with chronic wounds in public health services in a Brazilian municipality. The ideal coverage characteristics were evaluated through physical, chemical and cell proliferation tests. Results. The sample consisted of 14 patients (10 women and 4 men), 8 with venous ulcer, 5 with diabetic foot and one with mixed wound. There was reduction of area and pain in 9 lesions; total healing of 3 wounds; and debridement of the devitalized tissue in 5 wounds with increased area. The use of the membrane was important in the reduction of pain, exudation and ease in the accomplishment of the curative. Conclusion. BC/Ibu favored the cicatrization process of patients with chronic vasculogenic wounds.

Resumo Objetivo. Descrever o desenvolvimento da cobertura de celulose bacteriana com anti-inflamatório Ibuprofeno (CB/Ibu) e avaliar o processo de cicatrização com a sua utilização em pacientes com feridas crônicas de etiologia venosa e diabética. Métodos. Estudo descritivo longitudinal. A membrana de celulose, cultivada com bactérias Gluconacetobacter xylinus e com incorporação do Ibuprofeno, foi utilizada no tratamento de pacientes com feridas crônicas em serviços de atendimento público de um município brasileiro. Foram avaliadas as características de cobertura ideal mediante testes físicos, químicos e de proliferação celular. Resultados. A amostra foi constituída por 14 pacientes (10 mulheres e 4 homens), sendo 8 com úlcera venosa, 5 com pé diabético e um com ferida mista. Houve redução da área e da dor em 9 lesões; cicatrização total de 3 feridas; e o debridamento do tecido desvitalizado em 5 feridas com aumento da área. O uso da membrana além da diminuição da dor, da exsudação e facilidade na realização do curativo. Conclusão. A CB/Ibu favoreceu o processo cicatrização dos pacientes com feridas crônicas vasculogênicas.

Antiphospholipid syndrome (APS) is a systemic autoimmune disease which can occur as a primary disease or in association with other autoimmune diseases, the most frequent being Systemic Lupus Erythematosus (SLE). Although renal manifestations of SLE are well known, antiphospholipid syndrome renal manifestations such as antiphospholipid syndrome nephropathy and glomerulopathies have yet to be better characterized. The authors present the case of a 39-year-old Caucasian woman with antiphospholipid syndrome diagnosis and a previous history of deep venous thrombosis and intermittent polyarthralgia, who was referred to a nephrology consultation for proteinuria and microscopic haematuria with preserved renal function. The renal biopsy showed a pattern of membranous glomerulopathy and thrombotic microangiopathy in association with antiphospholipid syndrome nephropathy. This case report illustrates a complex clinical and anatomopathological case of a 39- year-old woman with a previous antiphospholipid syndrome diagnosis who presented with unspecific manifestations such as proteinuria and microscopic haematuria and preserved renal function. The histological findings alert us to the range of possible renal manifestations of APS and the need to better characterize these patients by preforming renal biopsy.

Abstract Objective: To analyze the prevalence of fall prevention practices in older adults and the associated factors. Methods: A cross-sectional, analytical study with 557 older adults that were attending family health units. Data were collected using structured interviews. The dependent variable was the fall prevention practice. The associations were estimated through Poisson regression with robust variation. Results: The prevalence of fall prevention practices was 35.7%. After adjustments, the variables associated with the outcome were: gender (p = 0.003), very good/good self-assessment of health (p = 0.035), regular self-assessment of health (p = 0.012) and education (p = 0.039). Conclusion: The prevalence of fall prevention practices found was higher among older adult men with self-reported very good/good and regular health and with 5 or more years of study. This study contributes to assist the nurse in the planning of interventions to prevent falls in older adults.

Resumen Objetivo: Analizar la prevalencia de prácticas preventivas de caídas en ancianos, y los factores asociados. Métodos: Estudio transversal con 557 ancianos atendidos en las Unidades de Salud de la Familia. El muestreo fue probabilística estratificada proporcional. Los datos fueron colectados por medio de entrevista. La variable dependiente es la práctica preventiva de caída. Las asociaciones fueron estimadas por medio de la regresión de Poisson con variancia robusta. Resultados: La prevalencia de prácticas preventivas de caídas fue del 35,7%. Después de los ajustes, las variables que se asociaron al término fueron: género (p = 0,003); autoevaluación de salud excelente/buena (p = 0,035), regular (p = 0,012); y escolaridad (p = 0,039). Conclusión: La prevalencia de prácticas preventivas encontradas fue mayor entre los ancianos del sexo masculino, con autoevaluación de salud excelente/buena y regular, y con cinco años de estudio o más. Esta investigación contribuye en la planificación de intervenciones del enfermero para la prevención de caídas en los ancianos.

Resumo Objetivo: Analisar a prevalência de práticas preventivas de quedas em idosos e os fatores associados. Métodos: Estudo transversal com 557 idosos atendidos nas unidades de saúde da família. A amostragem foi probabilística estratificada proporcional. Os dados foram coletados por meio de entrevista estruturada. A variável dependente é a prática preventiva de queda. As associações foram esti madas por meio da regressão de Poisson com variância robusta. Resultados: A prevalência de práticas preventivas de quedas foi de 35,7%. Após os ajustes as variáveis que se associaram ao desfecho foram: sexo (p = 0,003), autoavaliação de saúde ótima/boa (p = 0,035), regular (p = 0,012) e escolaridade (p = 0,039). Conclusão: A prevalência de práticas preventivas encontrada foi maior entre os idosos do sexo masculino, com autoavaliação de saúde ótima/boa e regular e com 5 anos ou mais de estudo. Esta pesquisa contribui para auxiliar o enfermeiro no planejamento de intervenções para prevenção de quedas em idosos.

Systemic lupus erythematosus (SLE) is an autoimmune disease which can involve almost any organ, making its difficult therapeutic approach. Immune complex deposition can often activate complement, accounting for many of SLE clinical manifestations and laboratory findings. We present a case of a patient who presented with acute pancreatitis and acute kidney injury as onset manifestations of SLE, later developing neurological manifestations, who was successfully treated with rituximab, plasma exchange and steroids as induction therapy. Persistently low C3 level led to a genetic analysis of the complement system components. We found three polymorphisms in the alternative pathway of complement regulators (complement factor H c2669 G>T, p.Ser890Ile and c3019 G>T, p.Val1007Leu and complement factor I c.482+6 G>T), two of which have been correlated with atypical haemolytic uraemic syndrome and dense deposit disease and also complement factor H-related protein (CFHR1 and CFHR3) mutations by deletion. This raises the question whether these polymorphisms and mutations played any role in our patient’s clinical course

Resumo Objetivo: Analisar a prevalência de práticas preventivas de quedas em idosos e os fatores associados. Métodos: Estudo transversal com 557 idosos atendidos nas unidades de saúde da família. A amostragem foi probabilística estratificada proporcional. Os dados foram coletados por meio de entrevista estruturada. A variável dependente é a prática preventiva de queda. As associações foram esti madas por meio da regressão de Poisson com variância robusta. Resultados: A prevalência de práticas preventivas de quedas foi de 35,7%. Após os ajustes as variáveis que se associaram ao desfecho foram: sexo (p = 0,003), autoavaliação de saúde ótima/boa (p = 0,035), regular (p = 0,012) e escolaridade (p = 0,039). Conclusão: A prevalência de práticas preventivas encontrada foi maior entre os idosos do sexo masculino, com autoavaliação de saúde ótima/boa e regular e com 5 anos ou mais de estudo. Esta pesquisa contribui para auxiliar o enfermeiro no planejamento de intervenções para prevenção de quedas em idosos.

Abstract Objective: To analyze the prevalence of fall prevention practices in older adults and the associated factors. Methods: A cross-sectional, analytical study with 557 older adults that were attending family health units. Data were collected using structured interviews. The dependent variable was the fall prevention practice. The associations were estimated through Poisson regression with robust variation. Results: The prevalence of fall prevention practices was 35.7%. After adjustments, the variables associated with the outcome were: gender (p = 0.003), very good/good self-assessment of health (p = 0.035), regular self-assessment of health (p = 0.012) and education (p = 0.039). Conclusion: The prevalence of fall prevention practices found was higher among older adult men with self-reported very good/good and regular health and with 5 or more years of study. This study contributes to assist the nurse in the planning of interventions to prevent falls in older adults.

Resumen Objetivo: Analizar la prevalencia de prácticas preventivas de caídas en ancianos, y los factores asociados. Métodos: Estudio transversal con 557 ancianos atendidos en las Unidades de Salud de la Familia. El muestreo fue probabilística estratificada proporcional. Los datos fueron colectados por medio de entrevista. La variable dependiente es la práctica preventiva de caída. Las asociaciones fueron estimadas por medio de la regresión de Poisson con variancia robusta. Resultados: La prevalencia de prácticas preventivas de caídas fue del 35,7%. Después de los ajustes, las variables que se asociaron al término fueron: género (p = 0,003); autoevaluación de salud excelente/buena (p = 0,035), regular (p = 0,012); y escolaridad (p = 0,039). Conclusión: La prevalencia de prácticas preventivas encontradas fue mayor entre los ancianos del sexo masculino, con autoevaluación de salud excelente/buena y regular, y con cinco años de estudio o más. Esta investigación contribuye en la planificación de intervenciones del enfermero para la prevención de caídas en los ancianos.

This study was conducted to analyse the course and the outcome of the liver disease in the co-infected animals in order to evaluate a possible synergic effect of human parvovirus B19 (B19V) and hepatitis A virus (HAV) co-infection. Nine adult cynomolgus monkeys were inoculated with serum obtained from a fatal case of B19V infection and/or a faecal suspension of acute HAV. The presence of specific antibodies to HAV and B19V, liver enzyme levels, viraemia, haematological changes, and necroinflammatory liver lesions were used for monitoring the infections. Seroconversion was confirmed in all infected groups. A similar pattern of B19V infection to human disease was observed, which was characterised by high and persistent viraemia in association with reticulocytopenia and mild to moderate anaemia during the period of investigation (59 days). Additionally, the intranuclear inclusion bodies were observed in pro-erythroblast cell from an infected cynomolgus and B19V Ag in hepatocytes. The erythroid hypoplasia and decrease in lymphocyte counts were more evident in the co-infected group. The present results demonstrated, for the first time, the susceptibility of cynomolgus to B19V infection, but it did not show a worsening of liver histopathology in the co-infected group.