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Introdução: A capacidade funcional é um importante componente da qualidade de vida e marcador de saúde, refletindo a condição geral do idoso. Juntamente com a avaliação da capacidade funcional, as avaliações nutricional e antropométrica também estimam a saúde dessa população. Observa-se associação entre esses parâmetros. Objetivo: Estudar a associação do estado nutricional com a capacidade funcional em idosos de instituição de longa permanência (ILP) da cidade de Botucatu/SP, analisando a relação entre os dados antropométricos e a capacidade funcional no indivíduo idoso. Materiais e métodos: Tipo de estudo: transversal. Foram avaliados 54 indivíduos, sendo mensurados dados antropométricos com cálculo do índice de massa corporal (IMC). Avaliou-se a capacidade funcional pelas Atividades Básicas de Vida Diária (ABVD) e Atividades Instrumentais de Vida Diária (AIVD). Foi analisada a associação entre dependência e as variáveis antropométricas obtidas. Resultados: Dos institucionalizados (19 do gênero masculino e 35 do feminino, com idade média de 76,1 ± 9,9 anos), 46,3% apresentaram IMC abaixo de 22 kg/m2. A dependência para as ABVD, em 33,3% dos casos, esteve diretamente relacionada ao baixo peso (IMC ≤ 22 kg/m2; p < 0,05). Conclusão: A maioria dos idosos da ILP apresentou baixo peso associado à capacidade funcional diminuída para as ABVD.

A American Academy of Family Physicians (AAFP) divulgou o resumo das “Recommendations for Clinical Preventive Services”. É uma publicação baseada nas “Recommendations for Clinical Preventive Services” editada pela United States Preventive Services Task Force (USPSTF). Essas recomendações são fornecidas apenas como um auxílio para os médicos na tomada de decisões clínicas quanto aos cuidados de seus pacientes. Refletem as referências clínicas existentes no momento da publicação. Porém, devem ser usadas com o claro entendimento de que a pesquisa continuada pode resultar em novos conhecimentos e consequentemente há a necessidade de atualizações. Algumas recomendações da USPSTF são importantes na prática clínica com o paciente idoso.

Em um cenário de envelhecimento populacional global, atingir idades superiores aos 100 anos não é mais fato isolado: no Brasil já foram contabilizados mais de 24 mil centenários, e em algumas nações esse segmento aumentará cerca de 700% até 2050, quando estimam-se aproximadamente 3 milhões de centenários no mundo. A despeito de representar um triunfo social, econômico e tecnológico, o crescimento dos centenários associa-se também a importantes desafios aos tradicionais modelos de seguridade e suporte social, bem como um gargalo para as políticas públicas de saúde. Neste manuscrito nos propusemos a apresentar nossas opiniões sobre a temática, revisar as implicações do aumento dos centenários para a saúde pública, destacando a importância de uma agenda nacional de pesquisa no Brasil envolvendo os centenários, além de discutir alternativas e modelos na reorientação das políticas públicas de saúde, com foco nesse segmento etário.

INTRODUCTION: Little is known about management and mitigation of COVID-19 in long-term care facilities (LTCF) for older adults in Latin America. OBJECTIVE: To describe how the management of LTCF in Hispanic American countries plan and adapt their routines for coping with COVID-19 and whether they have been able to fulfill recommendations published by the World Health Organization (WHO). METHODOLOGY: A cross-sectional study was conducted by online survey of managers of LTCF located in Hispanic American countries. A 46-item questionnaire (adopting the WHO principles) was sent to participants. Descriptive statistics were used to summarize the data. RESULTS: Twenty-three care home managers replied, responsible for a total of 874 older people (range: 5 - 270). One questionnaire was excluded because of missing responses. Fourteen LTCF (63.60%) were private, for-profit facilities. The rate of compliance with WHO recommendations exceeded 70% for the majority of items. Just over half of the institutions had developed a strategic management plan, or had identified strategies for dealing with deaths of suspected cases. Difficulty acquiring personal protective equipment (PPE) was reported by 59.10% of the LTCF surveyed. The homes' capacity for SARS-Cov-2 testing was limited (36.36% of the institutions did not have any tests). CONCLUSIONS: The rate of compliance with recommendations published by the WHO for dealing with COVID-19 was greater than 70% at the majority of the LTCF surveyed. More than half of the institutions had strategic management plans. Availability of PPE and SARS-Cov-2 testing capacity were very unsatisfactory.

OBJECTIVE: To describe infection and mortality rates associated with COVID-19 in older people living in Brazilian care homes. METHODS: A descriptive cross-sectional study was conducted using primary and secondary data sources. Nationwide care home administrators were invited to report, via an online questionnaire, the occurrence of infection and mortality associated with COVID-19 from April to August 2020. State Public Prosecutor Offices, State Health Departments, and the Unified Social Security System were also contacted for information. Data were analyzed using descriptive statistics. RESULTS: Data were collected from 2154 care homes located in 14 states, covering 59 878 older residents. The incidence rate of COVID-19 was 6.57%, and 883 deaths were recorded in the period, with a case-fatality rate of 22.44%. CONCLUSIONS: The incidence and mortality rates observed in this study were lower than those observed in other (high-income) countries. Data sources related to COVID-19 outbreaks in Brazilian care homes are currently limited to self-report. Structuring and systematizing data recording and reporting in these settings is essential to better understand the spread of the virus and to protect care home residents in Brazil.

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Introduction: The World Health Organization (WHO) has proposed to monitor intrinsic capacity (IC) in the older population as a public health strategy through the Integrated Care for Older People (ICOPE) program. Although the program has been developed based on solid concepts, scientific evidence on its practical applicability is still scarce. Objectives: To evaluate IC in Brazilian older adults, its progress over time, and its association with sociodemographic and health factors and outcomes. To evaluate the psychometric properties of the WHO/ICOPE screening tool. Methods: This is a prospective multicenter cohort study with a 36-month follow-up. We will recruit 3838 people aged ≥ 60 years, registered in the health care units included in the study by the participating centers. We will collect sociodemographic and health data and will administer tools to assess IC domains, both those provided for in the ICOPE screening tool and the sequence of confirmatory assessments provided for in the program. Participants will be reassessed every 6 months for 36 months. Expected results: To establish the profile of IC in the study population and to understand its progress and the variables associated with the clinical outcomes of interest. To reveal the diagnostic and psychometric properties of the WHO/ICOPE screening tool. The project is funded by the Brazilian National Council for Scientific and Technological Development (CNPq). Relevance: Understanding the potential use of the ICOPE public health strategy proposed by the WHO within the scope of the Brazilian Unified Health System (SUS) by integrating several research centers in the field of Geriatrics and Gerontology throughout Brazil.

Abstract Background National and international guidelines on frailty assessment and management recommend frailty screening in older people. This study aimed to determine how Brazilian healthcare professionals (HCPs) identify and manage frailty in practice. Methods An anonymous online survey on the assessment and management of frailty was circulated virtually through HCPs across Brazil. Results Most of the respondants used non-specific criteria such as gait speed (45%), handgrip strength (37.6%), and comprehensive geriatric assessment (33.2%). The use of frailty-specific criteria was lower than 50%. The most frequently used criteria were the Frailty Index (19.1%), Frailty Phenotype (13.2%), and FRAIL (12.5%). Only 43.5% felt confident, and 40% had a plan to manage frailty. In the multivariate-adjusted models, training was the most crucial factor associated with assessing frailty, confidence, and having a management plan (p

Objective: To analyze the impact of intrinsic capacity on 30-month mortality among older adults living in long-term care facilities (LTCFs). Methods: Prospective cohort study with survival analysis conducted from July 2020 to December 2022 among older adults living in Brazilian LTCFs. At baseline (T0), 209 older residents were evaluated for demographic profile, clinical data (diagnosed diseases and current medications), intrinsic capacity according to ICOPE (cognitive capacity, psychological capacity, hearing capacity, visual capacity, vitality, and locomotor capacity domains), functional capacity (Katz Index of Independence in Activities of Daily Living), and frailty (FRAIL scale). At 30 months, mortality in the sample was assessed. Results: At T0, the mean age of residents was 82 (SD, 11.21) years; 65.07% were female, 94.26% were white, and 88.04% had multimorbidity. Overall, 54.07% (n = 113) of residents exhibited changes in four or more domains of intrinsic capacity, with locomotor capacity being the most commonly impaired domain (82.78%); 43.54% were completely dependent for basic activities of daily living, and 42.58% were frail. At 30-month follow-up, 33.49% (n = 70) of residents had died. Survival analysis revealed a statistically significant association between death and impairment in four or more domains of intrinsic capacity (p = 0.044). Conclusions: Impairment in four or more domains of intrinsic capacity is associated with death in LTCF residents.

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RESUMO Introdução: A Universidade Estadual Paulista (Unesp) implantou o sistema de cotas (ações afirmativas) para ingressantes em 2014, por meio do sistema de reserva de vagas destinada a alunos oriundos de escolas públicas. As principais ressalvas quanto ao sistema de cotas dizem respeito às dificuldades de adaptação desses alunos ao meio acadêmico universitário, que poderiam interferir em seu desempenho durante a graduação. Por isso, é necessário conhecer o desempenho desses alunos para poder propor alternativas viáveis para suas necessidades. Objetivo: Este estudo teve como objetivo avaliar o desempenho acadêmico pelo coeficiente de rendimento (CR) escolar dos egressos do curso de Medicina da Faculdade de Medicina de Botucatu (FMB) da Unesp segundo forma de ingresso no vestibular. Método: Foram avaliados os CR finais dos alunos que finalizaram o curso de Medicina nos anos de 2019, 2020 e 2021. Os dados foram obtidos na Seção de Graduação da FMB. Realizaram-se comparações das médias do CR entre os grupos (ingresso universal - IU e ação afirmativa - AA). Resultado: No período de 2019 a 2021, graduaram-se 252 alunos: 184 do IU (73%) e 68 (27%) de AA. A média geral do CR foi de 8,41 + 0,61. As médias do CR dos alunos do IU foram de 8,45 + 0,61 e de AA de 8,31 + 0,60 (p = 0,414). Conclusão: A análise do CR dos formados em três anos do curso de Medicina da FMB revela que o desempenho dos ingressantes por AA e IU é semelhante.

The use of Generative Pretrained Transformer (ChatGPT), an artificial intelligence tool, for writing scientific articles has been reason for discussion by the academic community ever since its launch in late 2022. This artificial intelligence technology is becoming capable of generating fluent language, and distinguishing between text produced by ChatGPT and that written by people is becoming increasingly difficult. Here, we will present some topics to be discussed: (1) ensuring human verification; (2) establishing accountability rules; (3) avoiding the automatization of scientific production; (4) favoring truly open-source large language models (LLMs); (5) embracing the benefits of artificial intelligence; and (6) broadening the debate. With the emergence of these technologies, it is crucial to regulate, with continuous updates, the development and responsible use of LLMs with integrity, transparency, and honesty in research, along with scientists from various areas of knowledge, technology companies, large research funding bodies, science academies and universities, editors, non-governmental organizations, and law experts.

To catalyze the discussion and implementation of state policies for an integrated continuum of long-term care (LTC), it is imperative to assemble strategic actions involving the public and private sectors, civil society, international agencies, professionals, academia, and the media, considering clear objectives for improving the lives of older adults, their families, and the communities where they live. Care may be provided at home, in the community, or at LTC facilities (LTCFs) for older adults. In this essay, we focused on institutional care. Tensions between advocates of different models of care for older people should include space for dialogue, convergence, and intersectoral actions, regardless of where LTC is provided. Conditions for LTCFs not to be perceived as the “last and undesirable alternative” should exist or be created so that these institutions are seen instead as welcoming, productive, and inclusive environments that are integrated to the community and its social, recreational, and health systems. The aim of this essay was to reflect on the urgency of developing an integrated continuum of LTC for older adults in Brazil that considers care as a right along with its modalities of delivery, flow, services, and activities, as well as sustainable financing alternatives and legal and governance directives. This work was divided into four sections: (1) aging as a social achievement and care as a right; (2) models of LTC and panorama of the sector in Brazil; (3) change in paradigms for conceiving LTCFs and LTC; and (4) framework for achieving an integrated continuum of LTC.

Government agencies perform health technology assessment when evaluating requests to incorporate technologies in public health systems. To promote participation in this decision-making process, the National Commission for the Incorporation of Technologies in the Unified Health System (CONITEC) makes its recommendations available for public consultation for 20 days, which may occasionally be reduced or extended. Recently, CONITEC published its recommendations about the use of cost-effectiveness thresholds in health care decision-making. When reviewing the criteria for alternative cost-effectiveness thresholds, given that they promote innovation and equity in the Brazilian Unified Health System, we realized that the criterion “diseases affecting individuals at the end of life” was excluded from the list. This viewpoint article is a request for CONITEC to reconsider this position. The report disregards technical aspects related to the use of quality-adjusted life years as a metric in patients with low life expectancy, indicating the potential to discriminate against older adults and ignore the practical considerations of international organizations on this topic.

OBJECTIVES: To map the number and geospatial distribution of Brazilian long-term care facilities (LTCFs) for older adults. Additionally, we sought to highlight the relationship between these findings and the number of older people in the country's 27 Federation Units, demonstrating the growth of these facilities in the last decade. METHODS: This is a descriptive observational study, using secondary data, which was performed in 3 stages: 1) searching and consolidating national and subnational data from different sources and mapping LTCFs; 2) preparing a geospatial map using Brazilian postal codes; and 3) triangulating the number of facilities and of older people in each state and all 5 Brazilian regions. RESULTS: We found 7029 LTCFs in the country, mostly in the Southeast and South regions: São Paulo, Minas Gerais and Rio Grande do Sul had the highest numbers of facilities while states in the North region represented only 1.12% of Brazilian LTCFs. Geospatial mapping highlighted that 64% of the 5 570 Brazilian municipalities did not have any LTCFs for older adults. CONCLUSIONS: We observed a large difference between Brazilian regions regarding the provision of long-term care.

OBJECTIVES: To investigate the effect of frailty on 1-year mortality in long term-care facility (LTCF) residents. METHODS: This was a prospective cohort study with survival analysis of 209 participants living in 15 Brazilian LTCFs. Data on chronic diseases, age, sex, medication use, dependence in activities of daily living (ADLs; Katz index), and frailty (FRAIL scale) were collected at baseline, and death after 1 year was the outcome measure. Kaplan-Meier estimate and log-rank test were used to analyze the survival of residents. RESULTS: In the initial assessment, 65.07 of the residents were women, and the median age was 82 (interquartile range, 71–88) years, with 55% being over 80 years old. Overall, 88% had 2 or more diseases, 59.81% were using 5 or more medications, 42.11% were considered frail, 34.92% pre-frail, and 22.97% robust, and 69.94% were dependent in 3 or more ADLs. During the 12-month follow-up, 19.61% of the residents (n = 41) died. In the survival analysis for death, there was a statistically significant association with frailty (p = 0.03) and dependence in ADLs (p = 0.04). CONCLUSIONS: In this population of LTCF residents, frailty and functional dependence were associated with death.

This paper presents a novel policy framework to support government responses to COVID-19 in long-term care facilities (LTCFs) in low and middle-income countries. It focuses on issues that are of specific relevance to Brazilian policy-settings, including examples of its local implementation. The CIAT Framework combines and summarizes broad elements for an emergency strategy to address the potential effects of COVID-19. The 4 steps of the Framework entail policies to coordinate, identify, assess, and target support. Those policies can be applied immediately to mitigate the impact of the COVID-19 pandemic in LTCFs. It is, however, essential to situate these responses within a more comprehensive and permanent strategy. Intersectoral collaboration must evolve into a fully institutionalized system.

ABSTRACT Background: Alzheimer's disease (AD) is the leading cause of dementia worldwide. Despite alarming evidence on dementia prevalence, the condition is still underdiagnosed by general practitioners (GPs) in primary care. Early detection of the disease is beneficial for patients and relatives, who should be provided comprehensive guidance on dealing with dementia complications, covering medical, family and social aspects, thereby providing an opportunity to plan for the future. Objective: The objective of this study was to assess the knowledge of and attitudes toward dementia held by GPs from a city in the interior of São Paulo State, Brazil. Methods: A non-randomized intervention study was conducted involving six lectures about dementia. Before and after the intervention, the participating physicians completed two quizzes about knowledge of and attitudes towards dementia. The study was carried out in the primary care services of the town and a total of 34 GPs participated in the study. Results: The mean age of the sample was 33.9 (±10.2) years and the majority (76.5%) of the sample had not undertaken medical residency training. The mean number of correct answers on the Knowledge Quiz about dementia before and after the training intervention was 59.6 and 71.2% (p

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Abstract Objective: To verify the trajectory of the functional capacity of elderly persons hospitalized due to clinical conditions in a university hospital. Method: A descriptive, prospective cohort study was conducted between 2015 and 2016. Elderly patients admitted to the Hospital das Clínicas of Botucatu Medical School (Unesp), Brazil, were evaluated for the functional assessment of basic activities of daily living (BADL) using the Katz scale, nutritional status (body mass index (BMI)) and presence of the Frailty Syndrome (FS) (Fried criteria). A description of the trajectory of functional capacity was carried out at four times: 15 days before admission (T0), at admission (T1), at hospital discharge (T2) and 30 days after discharge (T3). Results: 99 elderly people with a mean age of 74 (+7.35) years, 59.6% of whom were male, were evaluated. Of these, 81.8% presented functional independence at T0, 45.5% at T1, 57.6% at T2 and 72.8% at T3. According to their functional trajectories, 28.2% of the elderly lost functional capacity between T0 and T3. There was an association between worsening of functional capacity between T0 and T3 and the FS (RR 4.56; 95% CI 1.70-12.26, p=0.003). Conclusion: Elderly patients have worse functional capacity at hospital discharge than before hospitalization. About 28.0% of the elderly had worse functional capacity 30 days after discharge than 15 days before admission. The elderly with Frailty Syndrome have a greater risk for worse functional capacity results 30 days after discharge.

B type natriuretic peptide (BNP) and its precursor, the inactive form of NT-pro-BNP, are currently the most studied laboratory parameters in the heart disease spectrum. The assessment of their blood concentrations provides invaluable information on the likelihood, severity and prognosis of the disease. The present review aims to describe the biological determinants, the factors that influence these peptide concentrations, the suggested cutoff values for the diagnosis of heart failure and the use of this biomarker in the assessment of cardiac function.

Previous studies have reported a controversial relationship between inadequate blood pressure control and predictor variables. Current prospective cohort study analyzes the interference of age, gender, diabetes and medication adherence in the control of blood pressure of hypertensive outpatients. Patients were interviewed under blind conditions to determine medication adherence, and clinical variables assessment were standardized. Univariate analysis of variance identified the variables correlated to blood pressure control at the end of the follow-up period. Missing data were excluded from analysis. After adjusting for confounders with univariate analysis, the association between the outcome (BP control rate) with significant factors and the calculated adjusted odds ratios (OR) and their 95% CI was analyzed by logistic regression. No interference by age or medication adherence in blood pressure control was reported. In fact, the higher the number of medications in use, the greater were the chances of having blood pressure control in disorder. Females are associated with a 3.1 increase in odds ratio of poor blood pressure control. Compared with non-diabetic hypertensive patients, hypertensive diabetic ones had a lower chance of poor blood pressure control.

OBJETIVO: Determinar a prevalência de pneumonia nosocomial nas autópsias em um hospital público universitário; identificar os fatores de risco relacionados à pneumonia nosocomial e os potenciais fatores prognósticos relacionados à ocorrência de pneumonia nosocomial fatal; e correlacionar os achados anatomopatológicos com a ocorrência de pneumonia nosocomial e/ou pneumonia aspirativa. MÉTODOS: Estudo retrospectivo de 199 pacientes autopsiados, maiores de 1 ano de idade, internados no Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista entre 1999 e 2006, cuja causa de morte (causa básica ou associada) foi pneumonia nosocomial. Testou-se a associação dos dados demográficos, clínicos e anatomopatológicos com os desfechos pneumonia nosocomial fatal e pneumonia aspirativa fatal. As variáveis significativas entraram na análise multivariada. RESULTADOS: A idade média foi de 59 ± 19 anos. A prevalência de pneumonia nosocomial em autópsias foi 29%, e essa foi a causa mortis de 22,6% dos pacientes autopsiados. A pneumonia nosocomial fatal correlacionou-se com os achados anatomopatológicos de alterações estruturais tabágicas (OR = 3,23; IC95%: 1,26-2,95; p = 0,02) e acometimento pulmonar bilateral (OR = 3,23; IC95%: 1,26-8,30; p = 0,01). Não houve associações significativas entre as variáveis e pneumonia aspirativa fatal. CONCLUSÕES: Em nossa amostra, a pneumonia nosocomial teve prevalência elevada e foi responsável por quase 25% das mortes. A mortalidade é favorecida por alterações estruturais tabágicas e pneumonia bilateral. Esses achados corroboram os resultados de diversos estudos clínicos sobre pneumonia nosocomial.OBJECTIVE: To determine the prevalence of nosocomial pneumonia in autopsies at a public university hospital; to identify the risk factors for nosocomial pneumonia and the potential prognostic factors associated with fatal nosocomial pneumonia and with fatal aspiration pneumonia; and to determine whether anatomopathological findings correlate with nosocomial pneumonia or aspiration pneumonia. METHODS: A retrospective study involving 199 autopsied patients, older than 1 year of age, who had been admitted to the São Paulo State University Botucatu School of Medicine Hospital das Clínicas and died of nosocomial pneumonia (underlying or contributing cause), between 1999 and 2006. Demographic, clinical and anatomopathological variables were tested regarding their association with the outcomes (fatal nosocomial pneumonia and fatal aspiration pneumonia). The significant variables were analyzed using multivariate analysis. RESULTS: The mean age was 59 ± 19 years. The prevalence of nosocomial pneumonia in autopsies was 29%, and the disease was the cause of death in 22.6% of the autopsied patients. Fatal nosocomial pneumonia correlated with the following anatomopathological findings: tobacco-associated structural lesions (OR = 3.23; 95% CI: 1.26-2.95; p = 0.02) and bilateral pneumonia (OR = 3.23; 95% CI: 1.26-8.30; p = 0.01). None of the variables were found to be significantly associated with fatal aspiration pneumonia. CONCLUSIONS: In our sample, there was a high prevalence of nosocomial pneumonia, which was responsible for almost 25% of all of the deaths. Smoking-related structural lesions and bilateral pneumonia all favored mortality. These findings corroborate the results of various clinical studies on nosocomial pneumonia.

An estimated 61% of the 24.3 million people diagnosed with dementia worldwide live in underdeveloped countries, including Brazil, where a public healthcare system covers the majority of the population. This care is usually provided by General Practitioners (GP) and in Brazil many doctors recently graduated from medical school and residents of different medical specialties practice as GPs. Objective : The aim of this study was to describe the knowledge and attitudes about dementia in a sample of Brazilian medical residents from a university-hospital in São Paulo, Brazil. Methods : A total of 152 Brazilian medical residents participated in the study. Participants answered a "Knowledge Quiz" (KQ) and "Attitude Quiz" (AQ) about dementia issues, transculturally adapted for use in Brazilian physicians. A descriptive analysis of the correct answers on knowledge and of the attitude aspects was performed. Results : The medical residents showed poor knowledge (

ABSTRACT Patients with dementia are commonly admitted to inpatient sectors. The aim of this study was to describe the frequency of dementia among elderly inpatients admitted to the Geriatrics Sector of a Brazilian Tertiary University Hospital, and to identify associations between dementia and clinical and sociodemographic factors. Methods: All patients admitted to the Geriatrics Sector of a public Brazilian university-hospital from March 1st 2014 to January 31st 2015 were assessed by geriatricians. The patients were divided into groups "with or without diagnosis of dementia". Univariate analysis was performed between these two groups using the Chi-Square Test, Student's t-test or the Mann-Whitney Test. Results: One hundred and three elderly inpatients, with a mean age of 82 (±7.9) years, were assessed. Overall, 74.7% had low educational level (

Tendo como princípios orientadores a integralidade e a humanização do cuidado, a Faculdade de Medicina de Botucatu (FMB) - Unesp busca reorientar a formação dos profissionais de saúde com o desenvolvimento de pesquisas e educação permanente na Estratégia de Saúde da Família. Este artigo analisa o primeiro ano do PET-Saúde desenvolvido na FMB e Secretaria Municipal de Saúde de Botucatu (SP). Foram selecionados como temas de investigação: saúde bucal de gestante, criança e idoso; imunização do adolescente; saúde do adulto e do idoso; e saúde e meio ambiente. Realizaram-se oficinas com a metodologia da problematização, produzindo-se modelos de intervenção nos quais alunos, docentes e profissionais de saúde dos serviços locais de saúde são protagonistas. O programa é um desdobramento da disciplina Interação Universidade, Serviço e Comunidade, ministrada de modo integrado aos cursos de Medicina e Enfermagem. Há resistências no interior da universidade, reconhecendo-se a desvalorização da prática clínica extra-hospitalar e na Atenção Básica. Nesse processo, o PET-Saúde vem fortalecer a prática acadêmica que interliga a universidade, em suas atividades de ensino, pesquisa, serviço e extensão, com demandas da sociedade, de forma partilhada.

INTRODUÇÃO: Um dos projetos desenvolvidos pelo Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) da Faculdade de Medicina de Botucatu - Unesp é voltado à atenção integral à saúde do idoso: Acompanhamento Domiciliar (ACO). OBJETIVOS: Realizar ACO em idosos de USF, mensurando o impacto de medidas, e descrever a percepção de acadêmicos quanto ao ACO. METODOLOGIA: A equipe era composta por um tutor, três preceptores e 12 acadêmicos. Cada aluno realizou o acompanhamento de um idoso, aplicando a Avaliação Geriátrica Ampla, com ênfase na capacidade funcional. Após cada visita, eram realizadas discussões e propostos planos terapêuticos intervencionais não medicamentosos. RESULTADOS: Avaliaram-se 15 idosos e foram acompanhados 12, com média etária de 84,3 (± 2,6) anos, sendo 75% do sexo feminino. Tinham dependência para AVD (atividades de vida diária) 67% e para AIVD (atividades instrumentais de vida diária) 85%. Durante o ACO, nenhum idoso necessitou de internação. Os acadêmicos relataram melhor compreensão do envelhecimento populacional e a adequação do ACO como forma de atenção à saúde dos idosos. CONCLUSÕES: As atividades permitiram o estabelecimento de vínculo entre a equipe. O interesse do acadêmico na atenção à saúde do idoso foi atingido. A metodologia facilitou o processo de integração ensino-serviço.

ABSTRACT Objective: Our objective is to evaluate whether the use of guided growth with eight-plates is more effective than the use of Blount staples for the correction of the idiopathic genu varum or idiopathic genu valgum. Methods: A systematic review (SR) was carried out according to the appropriate methodology for randomized clinical trials (RCTs). We searched seven databases through a previously defined methodology, and we included RCTs, regardless of language, period of publication and status of publication. Results: Resulted in 6830 articles retrieved. Of theses, we identified 14 potential eligible studies. but just one RCT was included for the SR. The included RCT compares the eight-plate and the Blount staple and showed no statistically significant difference for the outcomes of time to correct the deformity, postoperative pain after 24 hours and postoperative pain after 72 hours. The study is of low or very low level of evidence to determine the most effective technique. We didn’t find a RCT that compared the correction of the genu varum. Conclusion: Good quality randomized clinical trials comparing Blount staples versus eight-plaque must be performed to determine which technique is superior for coronal plane corrections. Level of Evidence I, Systematic review of Level RCTs.