Perfil de pacientes com sepse e choque séptico em um hospital de trauma: estudo transversal / Profile of patients with sepsis and septic shock in a trauma hospital: cross-sectional study / Perfil de pacientes con sepsis y shock séptico en un hospital de trauma: estudio transversal

Objetivo: Avaliar o perfil e o desfecho clínico de pacientes com sepse e choque séptico em um hospital de trauma de Belo Horizonte. Métodos: Trata-se de estudo transversal, retrospectivo e descritivo dos casos de sepse e choque séptico. Resultados: Constatou-se que 97 (73%) pacientes eram do sexo masculino, com idade entre 19 e 59 anos, 87 (65%) previamente hígidos. Principal motivo de internação foi queda da própria altura com 23 (17%) casos e 37 (28%) diagnósticos de trauma crânio encefálico. Oitenta e seis (65%) pacientes tiveram diagnóstico de sepse e 47 (35%) choque séptico, o principal foco de infecção foi pulmonar 83 (62%). Obtivemos 88 (66%) resultados de hemoculturas negativas e 45 (34%) positivas, 64 (48%) pacientes receberam antibiótico em até 60 minutos após o diagnóstico e o tempo de internação mais prevalente após o evento séptico foi de 7 dias, representado por 31 (46%) pacientes que já estavam internados em uma Unidade de Terapia Intensiva (UTI). Mortalidade de 37 (28%) e 96 (72%) sobreviventes da população estudada. Conclusão: O evento séptico é um problema de saúde pública e tem alta letalidade em pacientes traumatizados. (AU)

Objective: To evaluate the profile and clinical outcome of patients with sepsis and septic shock in a trauma hospital in Belo Horizonte. Methods: This is a cross-sectional, retrospective and descriptive study of cases of sepsis and septic shock. Results: It was found that 97 (73%) patients were male, aged 19 to 59 years, 87 (65%) were previously healthy. Main reason for hospitalization was a fall from one's own height with 23 (17%) cases and 37 (28%) diagnosis of traumatic brain injury. Eighty-six (65%) patients were diagnosed with sepsis and 47 (35%) septic shock, the main focus of infection was pulmonary 83 (62%). We got 88 (66%) negative blood culture results and 45 (34%) positive, 64 (48%) patients received antibiotics within 60 minutes after diagnosis and the most prevalent hospital stay after septic event was 7 days, represented by 31 (46%) patients who were already hospitalized in an Intensive Care Unit (ICU). Mortality of 37 (28%) and 96 (72%) survivors of the population studied. Conclusion: Septic event is a public health problem and has high lethality in traumatized patients. (AU)

Objetivo: Evaluar el perfil y el resultado clínico de los pacientes con sepsis y shock séptico en un hospital de trauma en Belo Horizonte. Métodos: Este es un estudio transversal, retrospectivo y descriptivo de casos de sepsis y shock séptico. Resultados: Se encontró que 97 (73%) pacientes eran hombres, de 19 a 59 años, 87 (65%) antes estaban sanos. La razón principal de la hospitalización fue una caída desde la propia altura con 23 (17%) casos y 37 (28%) diagnóstico de lesión cerebral traumática. Ochenta y seis (65%) pacientes fueron diagnosticados con sepsis y 47 (35%) shock séptico, el foco principal de infección fue pulmonar 83 (62%). Tenemos 88 (66%) resultados negativos del cultivo sanguíneo y 45 (34%) positivo, 64 (48%) los pacientes recibieron antibióticos dentro de los 60 minutos posteriores al diagnóstico y la estancia hospitalaria más frecuente después del evento séptico fue de 7 días, representados por 31 (46%) pacientes que ya estaban hospitalizados en una Unidad de Cuidados Intensivos (UCI). Mortalidad de 37 (28%) y 96 (72%) sobrevivientes de la población estudiada. Conclusión: El evento séptico es un problema de salud pública y tiene alta letalidad en pacientes traumatizados. (AU)

Factores estresantes percibidos por pacientes en unidades de cuidados intensivos en una institución de Bogotá / Stressors perceived by patients in intensive care units in an institution in Bogotá

El presente estudio, es de tipo descriptivo y tiene como objetivo, determinar cuáles son los factores estresantes percibidos por los pacientes adultos en las UCI (UCI Cardiovascular y UCI Medica) y comparar sus resultados en una institución de cuarto nivel de complejidad en la ciudad de Bogotá. La muestra correspondió a 210 pacientes que cumplieron con los criterios de inclusión establecidos. S realizo una entrevista a cada paciente y se aplicó el instrumento IFEPP-UCI y un formato de variables clínicas y sociodemográficas. En los resultados se pudo determinar que cuanto, a los factores de estrés evaluados, en la gran mayoría existe una proporción mayor de pacientes que reporta sentirlos en la UCI Médica en comparación con la UCI Cardiovascular, evidenciando que los pacientes de UCI Cardiovascular tienen en general una menor cantidad de factores de estrés asociados a su condición y diagnóstico. Los principales factores estresantes percibidos por los pacientes adultos en las UCI (UCI Cardiovascular y UCI Medica) fueron: la imposibilidad de movilización, tener sed, permanecer en la misma posición, no poder comunicarse, tener dolor, el ruido, no saber el día ni la hora, la iluminación, y no poder dormir. Para concluir Los resultados obtenidos en los análisis descriptivo y multivariado permiten identificar factores relevantes estresantes que perciben los pacientes en las UCI, los cuales orientan al profesional de enfermería para el desarrollo de intervenciones que permitan mejorar la percepción del paciente durante su estancia en UCI y así facilitar su recuperación

The present study is descriptive, and its objective is to determine which are the stressors perceived by adult patients in the ICU (Cardiovascular ICU and Medical ICU) and to compare their results in an institution of fourth level of complexity in the city of Bogota. The sample corresponded to 210 patients who met the established inclusion criteria. An interview was carried out with each patient and the IFEPP-UCI instrument and a format of clinical and sociodemographic variables were applied. In the results it was possible to determine that regarding the stress factors evaluated, in the vast majority there is a greater proportion of patients who report feeling them in the Medical ICU compared to the Cardiovascular ICU, showing that Cardiovascular ICU patients generally have fewer stressors associated with your condition and diagnosis. The main stressors perceived by adult patients in ICUs (Cardiovascular ICU and Medical ICU) were inability to move, being thirsty, staying in the same position, not being able to communicate, having pain, noise, not knowing the day or the time, the lighting, and not being able to sleep. To conclude, the results obtained in the descriptive and multivariate analyzes allow identifying relevant stressful factors perceived by patients in the ICU, which guide the nursing professional to develop interventions that improve the perception of the patient during their stay in the ICU and thus facilitate your recovery

Effect of “lumbar three needles” on expression of oxidative stress factors in rats with multifidus muscles injury / 中国组织工程研究

BACKGROUND: Posterior lumbar spine surgery is currently the main surgical approach for many surgical operations such as discectomy and spinal canal decompression. However, 10%-40% of patients with posterior lumbar spine surgery can have low back pain and related dysfunctions soon after surgery, which is related to excessive stretching or blunt injury to the paraspinal muscles such as the multifidus muscle during the operation. OBJECTIVE: To explore the effect of “Lumbar Three Needles” on the expression of oxidative stress factors, including malondialdehyde, reactive oxygen species, superoxide dismutase, glutathione peroxidase and phosphorylated protein kinase B, in rats with multifidus muscles injury. METHODS: Twenty-four male Sprague-Dawley rats were randomly divided into control group, model group and “Lumbar Three Needles” group, with 8 rats in each group. An animal model of multifidus muscles injury was made by intramuscular injection of 0.5% bupivacaine hydrochloride in the model and treatment groups in control and “Lumbar Three Needles” group, while normal saline was injected in the control group. No acupuncture intervention was given in the control group and model group, while Dachangshu, Shenshu and Weizhong acupoints were electroacupunctured in the “Lumbar Three Needles” group. Needles were then stimulated electrically using a Han's Acupoint Nerve Stimulator with density wave, frequency of 2 Hz/10 Hz and continuous current of 1 mA for 20 minutes, once daily for 7 days in total. The multifidus muscle was stained with hematoxylin-eosin staining to observe morphological changes, and kits were used to observe the expression of malondialdehyde, reactive oxygen species, superoxide dismutase, and glutathione peroxidase, while western blot was applied to observe the expression of phosphorylated protein kinase B. The study protocol was approved by the Animal Ethic Committee of Guangdong Second Traditional Chinese Medicine Hospital with an approval No. 048617. RESULTS AND CONCLUSION: Hematoxylin-eosin staining results indicated that the muscle fibers were partially fixed in the model group and there were still a lot of macrophages after 7 days of intervention. Compared with the model group, more newborn muscle fibers and fewer macrophages could be seen in the “Lumbar Three Needles” group. After intervention, the cross-sectional area of the multifidus muscles in the “Lumbar Three Needles” group was significantly bigger than that in the model group (P < 0.01). The expression levels of malondialdehyde and reactive oxygen species in the model group were significantly increased compared with the control group (P < 0.01) and “Lumbar Three Needles” group (P < 0.01). The expression of superoxide dismutase, glutathione peroxidase and phosphorylated protein kinase B in the “Lumbar Three Needles” group was significantly higher than that in the model group (P < 0.01 or P < 0.05). Therefore, “Lumbar Three Needles” can significantly decrease the oxidative stress level after multifidus muscle injury, which may be related to the improvement of phosphorylated protein kinase B.

Investigating the effect of intracameral cefuroxime on oxidative stress and apoptosis in the rat cornea / Investigando o efeito de cefuroxima intracameral sobre o estresse oxidativo e a apoptose na córnea de ratos

ABSTRACT PURPOSE: We examined the effect of intracameral administration of cefuroxime on oxidative stress and endothelial apoptosis in rat corneal tissue. METHODS: In total, 30 rats were divided into 3 groups of 10 rats each (intracameral administration of cefuroxime 0.1 mg/0.01 mL (cefuroxime group); intracameral administration of balanced salt solution 0.01 mL (control group); or absence of intracameral injection (sham group). Corneal endothelial apoptosis was assessed by immunohistochemical analysis using caspase-3 and caspase-8. Total oxidant status, total antioxidant status, oxidative stress index, and paraoxonase and arylesterase levels were examined in corneal endothelial tissue and serum. RESULTS: Paraoxonase levels in the serum were significantly different between the sham and cefuroxime groups (p=0.027). A significant difference was also observed in total oxidant status levels between the cefuroxime and balanced salt solution groups (p=0.023). In addition, there were significant differences in total antioxidant status levels in corneal tissue between the cefuroxime and sham groups (p<0.001) and between the cefuroxime and balanced salt solution groups (p<0.001). Furthermore, significant differences were also observed in oxidative stress index levels between the cefuroxime and balanced salt solution groups (p=0.001) and between the cefuroxime and sham groups (p=0.026). According to the immunohistochemical staining results, a significant association with caspase-3 activity existed between the cefuroxime and balanced salt solution groups (p=0.007), while no significant difference was found with caspase-8 activity (p=0.541). Caspase-3 activity exhibited a significant relationship between the sham and balanced salt solution groups (p=0.018), but no relationship was found with caspase-8 activity (p=0.623). CONCLUSION: Immunohistochemical examination revealed that intracameral cefuroxime increased apoptosis when compared to the sham and balanced salt solution groups. Moreover, intracameral cefuroxime increased oxidative stress in the cornea and simultaneously induced apoptosis.

RESUMO OBJETIVO: Examinamos o efeito da administração intracameral da cefuroxima sobre o estresse oxidativo e a apoptose endotelial no tecido corneano de ratos. MÉTODOS: No total, 30 ratos foram divididos em 3 grupos de 10 ratos cada (administração intracameral de cefuroxima 0,1 mg/0,01 mL (grupo cefuroxima), administração intracameral de solução salina balanceada 0,01 mL (grupo controle) ou ausência de injeção intracameral (grupo sham)). A apoptose endotelial da córnea foi avaliada por análise imuno-histoquimica usando caspase-3 e -8. O status oxidante total, o status antioxidante total, o índice de estresse oxidativo e os níveis de a paraoxonase e arilesterase foram investigados no tecido endotelial da córnea e no soro. RESULTADOS: Os níveis de paraoxonase no soro foram significativamente diferentes entre os grupos sham e cefuroxima (p=0,027). Foi também observada uma diferença significativa nos níveis de estado oxidante total entre os grupos cefuroxima e solução salina balanceada (p=0,023). Além disso, houve diferenças significativas nos níveis de status antioxidante total no tecido da córnea entre os grupos cefuroxima e sham (p<0,001) e entre os grupos cefuroxima e solução salina balanceada (p<0,001). Diferenças significativas também foram observadas nos níveis do índice de estresse oxidativo entre os grupos cefuroxima e solução salina balanceada (p=0,001) e entre os grupos cefuroxima e sham (p=0,026). De acordo com os resultados de coloração imuno-histoquimica, houve associação significativa com a atividade da caspase-3 entre os grupos cefuroxima e solução salina balanceada (p=0,007), enquanto não houve diferença significativa com a atividade da caspase-8 (p=0,541). A atividade da caspase-3 exibiu uma relação significativa entre os grupos sham e solução salina balanceada (p=0,018), mas nenhuma relação foi encontrada com a atividade da caspase-8 (p=0,623). CONCLUSÃO: O exame imuno-histoquímico revelou que a cefuroxima intracameral aumentou a apoptose quando comparada com os grupos sham e solução salina balanceada. Além disso, a cefuroxima intracameral aumentou o estresse oxidativo na córnea e induziu simultaneamente a apoptose.

Effects of occupational stress factors on the function of thyroid and liver among petroleum refining and petrochemical workers / 中华劳动卫生职业病杂志

Objective@#To investigate the association between occupational stress factors and the level of thyroid function and liver function in petroleum refining and petrochemical workers. @*Methods@#A total of 353 petroleum refining workers were investigated by occupational stress indicator question-naire (OSI-R) , and their level of thyroid and liver function were measured. @*Results@#With the incre-ase of task control, decision control, environmental control, resource control and technology utilization score, the TT4 concentration level decreased (P<0.05) . The TT4 concentration level increased with the increase of the quantiontive load, load changes, job hazards, job prospects, promation opportunities and participaction decision rating (P<0.05) . The total protein concentration level decreased with the increase of task control, decision control, environmental control, resource control, quantitative load, load change, promotion opportunity and participation decision value (P<0.05) , increased with the use degree of technology, work risk, job monotonous, work prospects score rised (P<0.05) . And there were statistically significant differences in the job requirements and job control scores between the low, middle and high levels of occupational factors (P<0.05) . @*Conclusion@#Occupational stress factors of petroleum refining workers have certain influence on the level of thyroid and liver function index.

Comparison of Vocational Exhaustion Positive Rate among Different Occupational Stress Groups / 中华劳动卫生职业病杂志

Objective@#To explore the statistical differences of the vocational exhaustion positive rate among various occupational stress factors, occupational stress reaction, personality characteristics and relieving factors, to lay a foundation for reducing occupational stress of the medical staffs. @*Methods@#656 medical staffs in Yangzhong and Chifeng hospitals were included to conduct the evaluation of the occupational stress and job burnout, analyze the differences among the various factors by comparing them. @*Results@#Various levels of vocational exhaustion positive rate among different occupational stress factors, occupational stress reaction, personality characteristics and relieving factors show statistical difference (P<0.05) . Among occupational stress factors, the vocational exhaustion positive rate of high level groups of conflict in groups was the highest (73.4%) , among occupational stress reaction, the vocational exhaustion positive rate of high level groups of body complain was the highest (80.4%) , among personality characteristics, the vocational exhaustion positive rate of low level groups of self-esteem was the highest (74.4%) , among relieving factors, the vocational exhaustion positive rate of high level groups of family support was the highest (76.4%) . @*Conclusion@#The vocational exhaustion rate of medical staffs show very high in the profession, comprehensive factors should be considered to create harmonious working atmosphere and to reduce vocational exhaustion positive rate of the medical staffs, to reduce the positive rate of vocational exhanstion in medical staffs.

Analysis on the relationship between Occupational Stress Factors and Psychological Stress Reaction among Petrochemical Workers / 中华劳动卫生职业病杂志

Objective@#To explore the relationship between occupational stress factors and psychological stress reaction among petrochemical workers, detecting the effects caused by the occupational stress and putting forward solutions to reduce the occupational stress degree. @*Methods@#392 petrochemical workers in Oil refining enterprise were included to conduct the evaluation of the occupational stress, correlation analysis and ridge regression were used to analyze the relationship between occupational stress and five aspects of psychological stress reaction and to detect the influencing factors. @*Results@#Mission control, decision control, environmental control, resources control, promotion, and participation in decision making were positively correlated with job satisfaction (P<0.01) , technology utilization degree, work order tonality, job prospects were negatively correlated with job satisfaction (P<0.05) ; mission control, resource control, promotion, participation in decision-making were positively correlated with mental health (P<0.01) , work order tonality, job prospects were negatively correlated with mental health (P<0.05) ; load change risk, work, work order tonality, job prospects were positively correlated with depression (P<0.05) resource control, promotion opportunities were negatively correlated with depression (P<0.05) ; quantitative risk load, work, work order tonality, job prospects were positively correlated with anxiety (P<0.05) , the task control, promotion, and participation in decision-making were negatively correlated with anxiety (P<0.05) ; work, load change, work order tonality, risk scoring for job prospects were positively correlated with body complaint (P<0.01) , mission control, decision control, resource control were negatively correlated with body complaint (P<0.05) . @*Conclusion@#Different stress factors make different effects in different psychological stress reaction, the main predictors and predictive power of each psychological stress reaction were not the same.

COVID 19, Bolivia: Estado Emocional, Percepción, Acatamiento, Expectativas y Propuestas

Se describe la crisis de salud pública más impactante en la actualidad, donde se han generado medidas paliativas originadas en organismos internacionales, y se ha establecido la necesidad de que las ciencias sociales analicen el efecto de la pandemia en la salud mental. Para este fin, proponemos priorizar el análisis de las formas más efectivas de abordar el estado emocional y de proyectar una propuesta general para enfrentar situaciones similares en el futuro en el contexto del país.

The most shocking public health crisis today is described, where palliative measures originated in international organizations have been generated, and the need for the social sciences to analyze the specific impact of the pandemic on mental health has been established. To this end, we propose to prioritize the analysis of the most effective ways to address the affective state, and to project a general proposal to face similar situations in the future in the context of the country.

Sumario É descrevida a crise de saúde pública mais chocante da atualidade, onde medidas paliativas originadas em organizações internacionais foram geradas, assim como foi estabelecida a necessidade que as ciências sociais analisem o impacto específico da pandemía na saúde mental. Para esse efeito, é proposto priorizar a análise das formas mais eficazes de enfrentar o estado afetivo e projetar uma proposta geral para enfrentar no futuro situações semelhantes no contexto do país.

Factores generadores de estrés en el paciente adulto hospitalizado en la UCI: una revisión integrativa / Factors that generate stress in the adult patient hospitalized in the ICU: an integrative review

El presente trabajo tiene como objetivo realizar una revisión integrativa con el fin de identificar los factores estresores en el paciente critico adulto hospitalizado en la unidad de cuidado intensivo, tanto desde el reconocimiento a partir de la perspectiva personal así como la del profesional de enfermería. La búsqueda en diversas bases de datos con revistas indexadas comprendió un total de 22 artículos, que abordaran la temática relacionada bajo los términos claves en su búsqueda y contenido. Desde su análisis, se obtuvieron resultados acerca de los factores estresores en la UCI, a partir de perspectivas tanto del paciente como del profesional de enfermería, evidenciando el déficit de información, y el ambiente de la UCI como transversales; adicionalmente desde la perspectiva del paciente se encontró el déficit de sueño, desprendimiento de la realidad, la dificultad para entablar una comunicación efectiva y la interrupción de la cotidianidad. Se concluye que el profesional de enfermería debe considerar la gama de expresiones del paciente con el fin de formular una comprensión de la experiencia del individuo y reflexionar sobre su significado. La clasificación de experiencias y las sensaciones experimentadas permiten otorgar el carácter único de la percepción del paciente de manera singular y de esta manera acceder un plan de cuidado individualizado basado en la integralidad.

This work aims to carry out an integrative review in order to identify stressors critical factors in the adult patient hospitalized in the intensive care unit, both recognition from the personal perspective as well as professional nursing. Search multiple databases with journals indexed included a total of 22 articles, which addressed the topic under the key terms related to your search and content. From his analysis, results about stress factors were obtained in the ICU, from perspectives of both the patient and nurse, showing the information gap, and the ICU environment as cross; further from the patient's perspective sleep deficit, detachment from reality, the difficulty was found to engage in effective communication and disruption of everyday life. It is concluded that the nurse should consider the range of expressions of the patient in order to formulate an understanding of the individual's experience and reflect on its meaning. The classification of experiences and sensations experienced grant allow the uniqueness of the patient's perception uniquely and thus access individualized care plan based on comprehensiveness.

A Clinical Study of Androgenic Alopecia (VII) / 대한피부과학회지

BACKGROUND: Androgenic alopecia (AGA) is characterized by the local and gradual transformation of terminal scalp hair into vellus hair, which has a shorter and thinner shaft. It is the most common form of hair loss in people with a genetic predisposition for baldness. OBJECTIVE: The aim of this study was to evaluate the prevalence, AGA type, family history, co-morbidity diseases, stress factors and endocrine factors of AGA patients. METHODS: We examined a total of 432 male and female AGA patients who visited for two years at the Department of Dermatology, School of Medicine, Chung-Ang University. RESULTS: There were 2.06 times more men (291 patients) than women (141 patients) among the study subjects. Most of the men were in their twenties (108, 37.1%), however, most of the women were in their forties (42, 29.7%). In the 291 male patients, Norwood class IIIv was dominant (120 patients, 41.2%). In the 141 female patients, Ludwig class I was dominant (87 patients, 61.7%). 219 (75.2%) of the 291 male patients and 81 (73.6%) of the 141 female patients had a family history of AGA. 224 (76.9%) of the 291 male patients and 101 (53.4%) of the 141 female patients had a co-morbidity disorder. The most common among these disorders in both the male and female patients was seborrheic dermatitis. Stress factors were observed in 162 (55.6%) of the 291 male patients and in 78 (55.3%) of the 141 female patients. The most common stress factor in both the male and female patients was work tasks. The serum testosterone levels was increased in 51 (17.5%) of the 291 male patients and in 20 (14.1%) of the 141 female patients. CONCLUSION: Most of the study results are compatible with those of our previous study. Yet the following results were different: (1) the number of female AGA patients in their forties is increasing; and (2) stress was found to be associated with AGA in both the male and female patients.

A Clinical Study of Androgenic Alopecia (VII) / 대한피부과학회지

BACKGROUND: Androgenic alopecia (AGA) is characterized by the local and gradual transformation of terminal scalp hair into vellus hair, which has a shorter and thinner shaft. It is the most common form of hair loss in people with a genetic predisposition for baldness. OBJECTIVE: The aim of this study was to evaluate the prevalence, AGA type, family history, co-morbidity diseases, stress factors and endocrine factors of AGA patients. METHODS: We examined a total of 432 male and female AGA patients who visited for two years at the Department of Dermatology, School of Medicine, Chung-Ang University. RESULTS: There were 2.06 times more men (291 patients) than women (141 patients) among the study subjects. Most of the men were in their twenties (108, 37.1%), however, most of the women were in their forties (42, 29.7%). In the 291 male patients, Norwood class IIIv was dominant (120 patients, 41.2%). In the 141 female patients, Ludwig class I was dominant (87 patients, 61.7%). 219 (75.2%) of the 291 male patients and 81 (73.6%) of the 141 female patients had a family history of AGA. 224 (76.9%) of the 291 male patients and 101 (53.4%) of the 141 female patients had a co-morbidity disorder. The most common among these disorders in both the male and female patients was seborrheic dermatitis. Stress factors were observed in 162 (55.6%) of the 291 male patients and in 78 (55.3%) of the 141 female patients. The most common stress factor in both the male and female patients was work tasks. The serum testosterone levels was increased in 51 (17.5%) of the 291 male patients and in 20 (14.1%) of the 141 female patients. CONCLUSION: Most of the study results are compatible with those of our previous study. Yet the following results were different: (1) the number of female AGA patients in their forties is increasing; and (2) stress was found to be associated with AGA in both the male and female patients.

Cluster analysis on the job stress factors of drivers / 重庆医科大学学报

Objective:To study the job stress factors of drivers.Methods:Cluster analysis.Results:The job stress factors of drivers can be divided into six clusters,which are social support,negative state,job requiring,job control,stress level,and job busyness and monotony.Conclusion:Comprehensive measures should be used to reduce the job stress.