Predictors of sarcopenia in young hospitalized patients living with HIV

ABSTRACT The prevalence of sarcopenia in hospitalized people living with HIV is underdiagnosed, as assessment instruments are not always available. This study aimed to identify factors related to sarcopenia, correlating their anthropometric and clinical markers in hospitalized people living with HIV. This was an observational cross-sectional clinical study, carried out from September 2018 through October 2019. Handgrip strength, muscle mass index, calf circumference and gait speed test were evaluated in recruited patients within three days of hospital admission. The sample consisted in 44 patients, mostly men (66%), black (68%), young adults (41.65 ± 12.18 years) and immunodeficient (CD4 cell count 165 cells/mm3 [34.25-295.5]). Sarcopenia was present in 25% of the sample. Calf circumference showed a significant correlation with CD4 cell count and viral load (p < 0.05) while handgrip strength and gait speed test did not. Calf circumference > 31 cm and gait speed test > 0.8 m/s reduced the chance of sarcopenia by 60% (OR = 0.396 [−1.67 to −0.18]; p < 0.05) and 98% (OR = 0.02 [−8.16 to 0.13]; p < 0.05) respectively. Calf circumference > 31 cm and gait speed test > 0.8 m/s are associated with a reduced chance of sarcopenia in hospitalized HIV patients.

O custo do absenteísmo do profissional de enfermagem numa instituição pública / The cost of absenteeism of the nursing professional in a public institution

Objetivo: Avaliar o custo e mensurar o impacto orçamentário pelo absenteísmo do profissional de enfermagem para uma instituição pública de saúde. Metodologia: Trata-se de análise de custo sobre o absenteísmo dos profissionais de enfermagem vinculados a uma instituição universitária realizada em 11 meses do ano de 2018. Resultados: Patologias psiquiátricas e osteomusculares foram prevalentes na etiologia dos afastamentos. O custo total da perda foi de R$ 288.615,45 e o médio R$ 11.544,62 por profissional o que representa o tamanho do impacto financeiro. Conclusão: O impacto orçamentário nas instituições de saúde é grande quando há absenteísmo dos profissionais de enfermagem por doenças advindas do trabalho. Acredita-se que o investimento em programas de prevenção possa representar impacto na redução destes custos e melhoria da qualidade assistencial. (AU)

Objective: To evaluate the cost and measure the budgetary impact of absenteeism of the nursing professional to a public health institution. Methodology: This is a cost analysis on the absenteeism of nursing professionals linked to a university institution held in 11 months of 2018. Results: Psychiatric and musculoskeletal pathologies were prevalent in the etiology of withdrawal. The total cost of loss was $ 288,615.45 and the average cost of $ 11,544.62 by professional representing the size of the financial impact. Conclusion: The budgetary impact on health institutions is great when there is absenteeism of nursing professionals due to work-related illnesses. It is believed that investing in prevention programs may have an impact in reducing these costs and improving the quality of care. (AU)

Objetivo: Evaluar el costo y medir el impacto presupuestario por el ausentismo del profesional de enfermería para una institución pública de salud. Metodología: Se trata de análisis de costo sobre el absentismo de los profesionales de enfermería vinculados a una institución universitaria realizada en 11 meses del año 2018. Resultados: Patologías psiquiátricas y osteomusculares fueron prevalentes en la etiología de los alejamientos. El costo total de la pérdida fue de $ 288.615,45 y el promedio $ 11.544,62 por profesional lo que representa el tamaño del impacto financiero. Conclusión: El impacto presupuestario en las instituciones de salud es grande cuando hay ausentismo de los profesionales de enfermería por enfermedades derivadas del trabajo. Se cree que la inversión en programas de prevención puede suponer un impacto en la reducción de estos costos y la mejora de la calidad asistencial. (AU)

Estado funcional de pacientes com quadro crônico de ciatalgia / Functional status of patients with chronic sciatica

Introdução: Dor lombar persistente e ciatalgia são queixas comuns na população geral. A dor lombar é amplamente estudada, porém o estado funcional de pacientes com quadro crônico de ciatalgia é pouco descrito. Objetivo: O objetivo deste estudo foi descrever o estado funcional de pacientes com ciatalgia. Métodos: Estudo transversal foi conduzido em 44 pacientes com ciatalgia. Os pacientes preencheram a Escala Numérica de Dor (END) e o questionário Oswestry Disability Index (ODI). Um exame físico foi realizado com avaliação clínica e os testes funcionais: teste de caminhada de 10 metros e a Síndrome de Disfunção de Movimento (SDM). Foi realizada a estatística descritiva e a correlação das variáveis. Resultados: A média de idade observada foi de 58,1 anos, com alta intensidade (END = 7,57) e duração (31,22 meses) de dor. A média de incapacidade autopercebida foi 32,79% e foi observada redução da velocidade de caminhada em 97,7% dos participantes. A intensidade da dor, levantar, ficar de pé e sentar foram os itens mais prejudicados. A SDM mais prevalente foi rotação com extensão (48,6%). O Índice de Massa Corporal e desempenho da caminhada se correlacionaram. Conclusão: A velocidade da caminhada e a capacidade funcional estão comprometidas nos pacientes com ciatalgia. (AU)

Introduction: Persistent back pain and sciatica are common complaint in the general population. Back pain is widely studied, but the functional status of sciatica patients is poorly described. Objective: The aim of this study was to describe the functional status of patients with sciatica. Methods: This cross-sectional study was conducted in 44 sciatica patients. The patients filled a Numeric Rating Pain Scale (NRPS) and the Oswestry Disability Index (ODI). A physical examination was performed with clinical examination and functional tests: ten meters walk test (TWT) and Lumbar Movement Impairment. A descriptive statistics and variables correlation was performed. Results: The mean age observed was 58.1 years, with a high intensity (NRPS = 7.57) and duration (31.22 months) of pain levels. Self-perceived disability average was 32.79% and lower walking speed was observed on 97.7% of the sample. Pain intensity, lifting, standing, and siting section were the most impaired sections. The most prevalent lumbar syndrome was rotation with extension (48.6%). Body mass index and gait performance were correlated. Conclusion: The walking speed and functional capacity are affected in patients with sciatica. (AU)

Is there an association between postural balance and pulmonary function in adults with asthma?

OBJECTIVE: Asthma may cause systemic repercussions due to its severity and the effects of treatment. Our objective was to compare posture, balance, functional capacity, and quality of life (QOL) according to the severity of disease, as assessed by pulmonary function levels. METHOD: This cross-sectional study evaluated fifty individuals with asthma. We compared two groups of adult individuals who were divided according to the median of the forced expiratory volume in one second (FEV1) as follows: group A  =  FEV1>74% predicted; group B  =  FEV1<74% predicted. All patients underwent the following tests: spirometry, whole-body plethysmography, diffusing capacity for carbon monoxide (DLco), respiratory muscle strength, posture assessment, stabilometry, six-minute walking distance (6MWD), and QOL. RESULTS: All pulmonary function variables exhibited statistically significant differences between the two groups, except for the DLco. The maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and 6MWD were lower in group B. The maximal mediolateral velocity and the mediolateral displacement were significantly different, while the postural changes and QOL were similar between the groups. CONCLUSIONS: In adult individuals with asthma, the pulmonary function is associated with balance control in the mediolateral direction but does not influence the postural changes or QOL. .