Factores de riesgo asociados al agravamiento clínico de los pacientes ingresados con enfermedad de Alzhéimer

Introducción: La principal causa de demencia degenerativa es la enfermedad de Alzhéimer. En la población cubana, una de cada cuatro personas de 65 años y más fallece por esta enfermedad u otra forma de demencia. Objetivo : Identificar los factores de riesgo asociados al agravamiento clínico de los pacientes ingresados con enfermedad de Alzhéimer en el Hospital Psiquiátrico Universitario Rene Vallejo Ortiz entre enero de 2013 y diciembre de 2022. Métodos: Se realizó un estudio observacional, descriptivo y transversal. El universo estuvo integrado por todos los pacientes ingresados en la mencionada institución asistencial y docente. La muestra no probabilística y a criterio de los autores la integraron 77 pacientes adultos con el diagnóstico de la enfermedad en el periodo de estudio señalado. Las historias clínicas fueron la fuente secundaria de información. Se utilizó estadística descriptiva e inferencial. La información se resumió en tablas y gráficos. Resultados: El 90,6 % presentaban más de 60 años y más de la mitad eran del sexo masculino (54,5 %). La mayoría de los pacientes presentaron diversos síntomas asociados. Lo trastornos de personalidad y orientación se constataron en el 75,3 % mientras que los de memoria en el 72,7 %. Conclusiones: El agravamiento clínico luego del ingreso hospitalario se acentuó en aquellos pacientes sin escolaridad, solteros, desocupados, con enfermedades cerebro vasculares y presencia de familias disfuncionales presentaron. Los pacientes anémicos o con signos de irritación cortical focal en región frontoparietal con generalización secundaria presentaron mayoritariamente un empeoramiento clínico.

Introduction: The main cause of degenerative dementia is Alzheimer's disease. In the Cuban population, one in four people aged 65 and over dies from this disease or another form of dementia. Objective: To identify the risk factors associated with the clinical worsening of patients admitted with Alzheimer's disease at the Rene Vallejo Ortiz University Psychiatric Hospital. Methods: An observational, descriptive and cross-sectional study was carried out. The universe was made up of all patients admitted to the aforementioned healthcare and teaching institution. The non-probabilistic sample and at the discretion of the authors was made up of 77 adult patients with the diagnosis of the disease in the indicated study period between January 2013 and December 2022. Medical records were the secondary source of information. Descriptive and inferential statistics were used. The information was summarized in tables and graphics. Results: 90.6% were over 60 years old and more than half were male (54.5%). Most patients presented various associated symptoms. Personality and orientation disorders were found in 75.3%, while memory disorders were found in 72.7%. Conclusions: The clinical worsening after hospital admission was accentuated in those patients without schooling, single, unemployed, with cerebrovascular diseases and presence of dysfunctional families. Anemic patients or patients with signs of focal cortical irritation in the frontoparietal region with secondary generalization mostly presented clinical worsening.

Higiene das mãos dos profissionais de saúde: perspectivas do estudante de enfermagem no papel de paciente/familiar / Higiene de manos de los profesionales de la salud: perspectiva de estudiantes de enfermería en el papel de paciente/familiar / Healthcare professionals' hand hygiene: perspectives of nursing student's in patients/relatives role

Resumo Objetivo Investigar as opiniões e atitudes dos estudantes de enfermagem no papel de pacientes ou familiares de pacientes, a respeito do comportamento de higiene das mãos dos profissionais de saúde e da participação dos pacientes na campanha de higiene das mãos. Métodos Estudo transversal prospectivo realizado entre 2021-2022 no Nursing Department, Faculty of Health Sciences, de duas universidades turcas. A amostra do estudo foi composta por 330 alunos. Os dados foram coletados por meio de questionário autoaplicável. A taxa de resposta do questionário foi de 89,43%. O teste qui-quadrado foi utilizado na análise dos dados. Resultados A média de idade dos estudantes foi de 19,80±1,30 anos, 76,1% eram do sexo feminino, 50,9% afirmaram ter recebido instrução sobre Infecções Associadas aos Cuidados de Saúde (IACS). Enquanto 30,1% dos estudantes relataram realizar a higiene das mãos "9 a 11 vezes" em sua vida diária, 54,6% relataram "12 a 15 vezes" no hospital, e 96,4% dos estudantes se perguntaram se os profissionais de saúde realizavam a higiene das mãos antes de fornecer cuidados durante as internações. De acordo com 30,5% dos estudantes, lembretes dos pacientes e seus familiares sobre a realização da higiene das mãos antes do contato com os pacientes os deixariam satisfeitos. Houve diferença estatisticamente significativa entre a instrução anterior dos estudantes sobre IACS e a higiene das mãos como cuidado importante a pacientes hospitalizados (p<0,05). Conclusão Os estudantes de enfermagem apresentaram conhecimento suficiente sobre a higiene das mãos e uma atitude positiva frente aos comportamentos de higiene das mãos dos profissionais de saúde. Estudantes de enfermagem como pacientes e familiares dos pacientes podem ser incluídos nas campanhas de higiene das mãos dos profissionais de saúde, desde que as etapas do programa sejam bem planejadas.

Resumen Objetivo Investigar las opiniones y actitudes de los estudiantes de enfermería en el papel de pacientes o familiares de pacientes respecto al comportamiento de higiene de manos de los profesionales de la salud y de la participación de los pacientes en la campaña de higiene de manos. Métodos Estudio transversal prospectivo realizado entre 2021 y 2022 en el Nursing Department, Faculty of Health Sciences, de dos universidades turcas. La muestra del estudio estuvo compuesta por 330 alumnos. Los datos se recopilaron mediante cuestionario autoaplicado. El índice de respuesta del cuestionario fue de 89,43 %. Se utilizó la prueba ji cuadrado en el análisis de los datos. Resultados El promedio de edad de los estudiantes fue de 19,80±1,30 años, el 76,1 % era de sexo femenino, el 50,9 % afirmó haber recibido instrucción sobre infecciones asociadas a los cuidados de la salud (IACS). Mientras el 30,1 % de los estudiantes relató realizar la higiene de manos "9 a 11 veces" en su vida diaria, el 54,6 % relató "12 a 15 veces" en el hospital, el 96,4 % de los estudiantes se preguntó si los profesionales de la salud realizaban la higiene de manos antes de brindar cuidados durante las internaciones. El 30,5 % de los estudiantes estuvo satisfecho con los recordatorios de los pacientes y sus familiares sobre la realización de la higiene de manos antes del contacto con los pacientes. Hubo diferencia estadísticamente significativa entre la instrucción anterior de los estudiantes sobre IACS y la higiene de manos como cuidado importante en pacientes hospitalizados (p<0,05). Conclusión Los estudiantes de enfermería presentaron conocimientos suficientes sobre la higiene de manos y una actitud positiva frente a los comportamientos de higiene de manos de los profesionales de la salud. Puede incluirse a los estudiantes de enfermería como pacientes y familiares de los pacientes en las campañas de higiene de manos de los profesionales de la salud, siempre que las etapas del programa estén bien planificadas.

Abstract Objective To investigate the views and attitudes of nursing students, as patients or relatives, on healthcare professionals' hand hygiene behavior and patient participation hand hygiene campaign. Methods This prospective cross-sectional study was conducted in the nursing departments of the health and science faculties at two Turkish universities between 2021-2022. The study sample comprised 330 students. Data were collected using a self-administered questionnaire. The response rate of the questionnaire was 89.43%. Chi-square test was used in data analysis. Results The mean age of students was 19.80±1.30 years, 76.1% were female, 50.9% stated they had received education regarding healthcare-associated infections (HAI). While 30.1% of students reported they performed hand hygiene "9-11 times" in their daily lives, 54.6% reported performing "12-15 times" in the hospital, and 96.4% of students expressed wondering if healthcare professionals performed hand hygiene before offering care during hospitalizations. Among students, 30.5% stated that reminders from patients and their relatives about performing hand hygiene before contact with patients would make them happy. There was a statistically significant difference between students' previous training in HAIs and hand hygiene as an important inpatient care (p<0.05). Conclusion Nursing students had sufficient knowledge of hand hygiene and a positive attitude towards hand hygiene behaviors of healthcare professionals. Nursing students, such as patients and their relatives, can be included in hand hygiene campaigns for healthcare professionals, provided that the program steps are well planned.

Relação entre benefício e risco em interações medicamentosas nas prescrições médicas de um hospital universitário no estado de São Paulo / Benefit-risk relationship in drug interactions in prescriptions from a university hospital in the state of São Paulo / Relación beneficio-riesgo en interacciones medicamentosas en prescripciones de un hospital universitario del estado de São Paulo

Objetivo: Avaliar interações medicamentosas (IM), em que os riscos se so- brepõem aos benefícios (nível I) ou os benefícios se sobrepõem aos riscos (nível II); a partir da análise retrospectiva de prescrições médicas em um Hospital Universitário no estado de São Paulo, Brasil. Métodos: Foram analisadas 19762 prescrições médicas des- tinadas à farmácia do hospital, de janeiro a setembro de 2009; com o auxílio de programas sobre IM, para categorizar IM de nível I e II. Resultados: Na análise 26,53% apresentaram IM, em que 23,64% foram classificadas em nível I e 76,35% em nível II. Dentre as IM com maior frequência no nível I, estavam: ácido acetilsalicílico (AAS) e clopidogrel, AAS e heparina, captopril e espironolactona, digoxina e hidroclorotiazida. Houve uma redução em percentual de IM de nível I, comparando janeiro representado por 26,5% e setembro representado por 18,4%. Já nas IM de nível II, tem-se as seguintes associações com maior frequência: AAS e propranolol, AAS e insulina regular humana, AAS e ate- nolol, AAS e enalapril, AAS e carvedilol. Conclusão: A atuação dos farmacêuticos cola- borou à redução de IM de nível I, devido à intervenção por meio de comunicação estabe- lecida com os prescritores; sinalizando a importância da equipe interprofissional em saúde.

Objective: To evaluate drug interactions (MI), in which risks outweigh the benefits (level I) or benefits outweigh the risks (level II); from the retrospective analysis of medical prescriptions in a University Hospital in the state of São Paulo, Brazil. Methods: 19,762 prescriptions destined to the hospital pharmacy were analyzed, from January to September 2009; with the help of programs on MI, to categorize level I and II MI. Results: In the analysis 26.53% presented MI, in which 23.64% were classified in level I and 76.35% in level II. Among the most frequent level I MI were: acetylsalicylic acid (ASA) and clopidogrel, ASA and heparin, captopril and spironolactone, digoxin and hydrochlorothiazide. There was a reduction in the percentage of level I MI, comparing January, which accounted for 26.5%, and September, which accounted for 18.4%. As for level II MI, the following associations were more frequent: ASA and propranolol, ASA and regular human insulin, ASA and atenolol, ASA and enalapril, ASA and carvedilol. Conclusion: The role of pharmacists collaborated to the reduction of level I MI, due to the intervention by means of communication established with the prescribers; signaling the importance of the interprofessional health team.

Objetivo: Evaluar las interacciones medicamentosas (IM), en las que los riesgos superan a los beneficios (nivel I) o los beneficios superan a los riesgos (nivel II); a partir del análisis retrospectivo de las prescripciones médicas en un Hospital Universitario del estado de São Paulo, Brasil. Métodos: Se analizaron 19.762 prescripciones destinadas a la farmacia del hospital, de enero a septiembre de 2009; con la ayuda de programas sobre IM, para categorizar los IM de nivel I y II. Resultados: En el análisis el 26,53% presentaron IM, en el que el 23,64% se clasificaron en nivel I y el 76,35% en nivel II. Entre los IM de nivel I más frecuentes estaban: ácido acetilsalicílico (AAS) y clopidogrel, AAS y heparina, captopril y espironolactona, digoxina e hidroclorotiazida. Hubo una reducción del porcentaje de IM de nivel I, comparando enero, que supuso el 26,5%, y septiembre, que supuso el 18,4%. En cuanto a los IM de nivel II, fueron más frecuentes las siguientes asociaciones: AAS y propranolol, AAS e insulina humana regular, AAS y atenolol, AAS y enalapril, AAS y carvedilol. Conclusiones: El papel de los farmacéuticos colaboró a la reducción de las IM de nivel I, debido a la intervención mediante la comunicación establecida con los prescriptores; señalando la importancia del equipo sanitario interprofesional.

Knowledge, attitude, and practice toward mucormycosis among patients discharged from a COVID-19 care tertiary center in South India: A questionnaire-based survey

Purpose: To study the awareness of mucormycosis among discharged inpatients after receiving treatment for COVID?19 infection at a tertiary COVID care center in south India. Methods: This was a telephone?based survey conducted using a questionnaire consisting of 38 questions in five sections in the month of June–July 2021. COVID?positive inpatients who had been admitted, treated, and discharged from a government medical college were contacted via phones, and their responses were directly entered into the Google Forms platform. Results: A total of 222 participants were included in the study. Among all the participants, a cumulative 66% of participants had some knowledge of mucormycosis and 98/222 (44%) did not have any idea of mucormycosis in spite of being admitted to the hospital. More than 40% of them reported that their prime source of information was through mass communication. Around 81% of the respondents were aware that it can occur after COVID?19 infection. Among them, only 25 knew that systemic steroids were the main risk factor. Sixty?four out of 124 knew that diabetes is a major risk factor. Fifty percent agreed that a vaccine for COVID can prevent mucormycosis. Conclusion: Such knowledge, attitude, and practice (KAP) studies give us an idea of the impact of the measures taken for educating the public. In this study, a cumulative 66% of participants had some knowledge of mucormycosis and 34.7% were diabetics who had better knowledge and practice scores than non?diabetics. Sixty?six point nine percent felt that it was possible to prevent this condition

Valor pronóstico de la hipoglucemia hospitalaria / Prognostic value of hospital hypoglycemia

Resumen Introducción: La hipoglucemia hospitalaria (HH) es un problema importante ya que se vincula a muerte hospitalaria, estadía prolongada y mayores costos, en personas con y sin diabetes, en área crítica y sala general, sobre todo en los casos de hipoglucemia grave. El objetivo de nuestro trabajo fue comparar la mortalidad hospitalaria, pase a área crítica y tiempo de internación en adultos con HH, según la gravedad de la misma. Métodos: Se realizó un estudio de cohorte retrospectiva en pacientes adultos interna dos con hipoglucemia en el Hospital Italiano de Buenos Aires entre 2013 y 2018. Se definieron tres grupos de hipoglucemia: leve (glucemia entre 70 y 54 mg/dl), grave (glucemia < 54 mg/dl ≥ 40 mg/dl) y crítica (glucemia < 40mg/dl). Resultados: Un total de 5994 pacientes tuvieron HH, la mayoría presentó hipoglucemia leve (72%). La hipoglucemia grave y la crítica, comparadas con la hipoglucemia leve se asociaron a una mayor mortalidad: OR 2.6 (IC95% 2.2-3.1) y 4.2 (IC95% 3.5-5.0) respectivamente; y a mayor internación en áreas de cuidados críticos: OR 1.6 (IC95% 1.4-1.9) y 3.2 (IC95% 2.6-4.0) respectivamente. No hubo diferencias en el tiempo de internación. Discusión: Esta información aporta evidencia en nuestro país, sobre el valor pronóstico de la hipo glucemia, cuya mayor gravedad se asocia a mayor internación en áreas críticas y mayor mortalidad hospitalaria.

Abstract Background: Hospital hypoglycemia (HH) is an important problem since it is linked to hospital death, prolonged stay and higher costs, both in people with and without diabetes, in the critical area and general ward, especially in cases of severe hypoglycemia. The objective of our work was to compare hospital mortality, transfer to the critical area and hospitalization periods in adults with HH according to its severity. Methods: We conducted a retrospective cohort of adults hospitalized with hypoglycemia at the Hospital Italiano de Buenos Aires between 2013 and 2018. Three groups of hypoglycemia were defined: mild (glycemia between 70 and 54 mg/dl), severe (glycemia < 54 mg/dl and ≥ 40 mg/dl) and critical (glycemia<40mg/dl). Results: A total of 5994 patients had HH, the majority presented mild hypoglycemia (72%). Severe and critical hypoglycemia, compared with mild hypo glycemia, were associated with higher mortality: OR 2.6 (95%CI 2.2-3.1) and 4.2 (95%CI 3.5-5.0) respectively; and increased hospitalization in critical care areas: OR 1.6 (95%CI 1.4-1.9) and 3.2 (95%CI 2.6-4.0) respectively. There were no differences in length of stay. Discussion: This information provides, in our country, evidence on the prognostic value of hypoglycemia, whose greater severity is associated with increased hospitalization in critical areas and higher hospital mortality.

A segurança do paciente e a avaliação do risco de quedas / Patient safety and fall-risk assessment / Seguridad del paciente y evaluación de riesgo de caída

Objetivo: Avaliar os pacientes hospitalizados quanto ao risco de quedas. Métodos: Estudo transversal, realizado por meio da aplicação da escala de Morse e registros de prontuários. Realizou-se estatísticas descritivas e Teste Qui-quadrado de Pearson, adotando-se o nível de 5%. Resultados: Dos 244 participantes, 139 (57%) eram do sexo masculino, 86 (47,5%) idosos, 116 (47,5%) com companheiro, 112 (45,9%) pardos e 173 (70,9%) com baixa escolaridade. O risco de quedas foi associado ao histórico de quedas (p=0,000), diagnóstico secundário (p<0,001), deambulação (p=0,002), marcha (p<0,001) e estado mental (p<0,000). A maioria dos entrevistados 194 (79,5%) estão sob um risco moderado a alto de sofrer quedas da própria altura 37 (15,2%), ocorridas no quarto ou na enfermaria 38 (15,6%). Conclusão: Observou-se um risco moderado a alto para quedas nos pacientes hospitalizados, o que aponta para a necessidade de implementação de políticas de segurança do paciente para garantir a qualidade da assistência. (AU)

Objective: Assess hospitalized patients for the risk of falls. Methods: Cross-sectional study, carried out through the application of the Morse scale and medical records. Descriptive statistics and Pearson's Chi-square test were performed, adopting the 5% level. Results: Of the 244 participants, 139 (57%) were male, 86 (47.5%) elderly, 116 (47.5%) with a partner, 112 (45.9%) brown and 173 (70.9%) with low education level. The risk of falls was associated with a history of falls (p = 0.000), secondary diagnosis (p <0.001), walking (p = 0.002), gait (p <0.001) and mental status (p <0.000). Most respondents 194 (79.5%) are at moderate to high risk of suffering falls from their own height 37 (15.2%), in their bedroom or in the ward 38 (15.6%). Conclusion: There was a moderate to high risk for falls in hospitalized patients, which points to the need of implementing patient safety policies in order to guarantee quality of care. (AU)

Objetivo: Evaluar a los pacientes hospitalizados por el riesgo de caídas. Métodos: Estudio transversal, realizado a través de la aplicación de la escala Morse y registros médicos. Se realizaron estadísticas descriptivas y la prueba de Chi-cuadrado de Pearson, adoptando el nivel del 5%. Resultados: De los 244 participantes, 139 (57%) eran hombres, 86 (47.5%) ancianos, 116 (47.5%) con una pareja, 112 (45.9%) marrones y 173 (70.9%) con baja educacion. El riesgo de caídas se asoció con antecedentes de caídas (p = 0.000), diagnóstico secundario (p <0.001), caminar (p = 0.002), marcha (p <0.001) y estado mental (p <0.000). La mayoría de los encuestados 194 (79.5%) tienen un riesgo moderado a alto de sufrir caídas desde su propia altura 37 (15.2%), ocurriendo en el dormitorio o en la sala 38 (15.6%). Conclusión: Hubo un riesgo moderado a alto de caídas en pacientes hospitalizados, lo que apunta a la necesidad de implementar políticas de seguridad del paciente para garantizar la calidad de la atención. (AU)

Contenido de sodio en antimicrobianos parenterales: Una fuente extra de sodio a considerarse en pacientes hospitalizados

Los antimicrobianos parenterales son esenciales en el tratamiento de infecciones intrahospitalarias, sin embargo, es importante considerar la carga de sodio y volumen que pueden aportar, especialmente, en pacientes con restricción sódica. En el presente estudio se identificaron los antimicrobianos parenterales usados en uno de los hospitales más grandes del Perú. Se revisó la cantidad de sodio intrínseco y se calculó la cantidad de sodio total por día de tratamiento según el régimen frecuentemente usado en adultos. Como resultado, se encontró que 22% de las terapias antimicrobianas superaban el requerimiento de sodio diario, lo que podría ser perjudicial para pacientes con insuficiencia cardiaca, enfermedad renal crónica, con cirrosis hepática, entre otros.

Parenteral antibiotics are essential in the treatment of nosocomial infections; however, their sodium load and volume should be considered as an extra source, especially, in patients with sodium restriction. In this study, we identified the parental antibiotics used in one of the largest hospitals in Peru. We reviewed the amount of intrinsic sodium and we calculated the sodium load per day of treatment according to the commonly used regimen in adults. As a result, we found that 22% of the antibiotic treatment regimens exceed the daily sodium requirement, which could be harmful for patients with heart failure, chronic kidney disease, liver cirrhosis, among others.

Quedas entre pacientes internados em um hospital público e de ensino: uma análise das notificações / Falls of patients admitted to a public and teaching hospital: an analysis of notifications / Caídas en pacientes ingresados en un hospital público y docente: análisis de las no-tificaciones

Objetivo: descrever o perfil das quedas notificadas de pacientes internados em um hospital público e de ensino. Método: estudo descritivo e retrospectivo, com análise estatística descritiva, inferencial e de correspondência múltipla dos dados de notificações do aplicativo Vigilância em Saúde e Gestão de Riscos Assistenciais Hospitalares sobre quedas de pacientes internados entre 2017 e 2019. Resultados: predominaram, dentre 153 notificações de quedas no período, as ocorridas no quarto, em unidades de atendimento cirúrgico, emergencial e clínico, sofridas por pacientes do sexo masculino, na faixa etária entre 20 e 59 anos. Nesta, destacaram-se os idosos. A abrasão foi o dano mais relatado. A análise de correspondência múltipla não apresentou significância. Conclusão: a análise dos eventos notificados contribuiu para o planejamento e a implantação do Programa Fall Tailoring Interventions for Patient Safety Brasil para aprimoramento da gestão dos riscos relacionados.(AU)

Objective: to describe the profile of reported falls of patients admitted to a public and teaching hospital. Method: descriptive and retrospective study, with descriptive, inferential, and multiple correspondence statistical analysis of notification data from the Health Surveillance and Hospital Care Risk Management app on falls of hospitalized patients between 2017 and 2019. Results: predominated, among 153 notifications of falls in the period, those occurring in the ward, in surgical, emergency, and clinical care units, suffered by male patients, aged between 20 and 59 years. In this, the elderly stood out. Abrasion was the most reported harm. Multiple correspondence analysis did not show significance. Conclusion: the analysis of reported events contributed to the planning and implementation of the Fall Tailoring Interventions for Patient Safety Program in Brazil to improve the management of related risks.(AU)

Objetivo: describir el perfil de las caídas de pacientes internados reportadas en un hospital público y de enseñanza. Método: estudio descriptivo y retrospectivo, con análisis estadístico descriptivo, inferencial y análisis de correspondencias múltiples de datos de notificación de la aplicación Vigilancia en Salud y Gestión de Riesgos de Atención Hospitalaria sobre caídas de pacientes hospitalizados entre 2017 y 2019. Resultados: predominó, entre 153 notificaciones de caídas en el período, las ocurridas en el dormitorio, en unidades quirúrgicas, de emergencia y de atención clínica, sufridos por pacientes del sexo masculino, con edades entre 20 y 59 años. En este último, se destacaron los adultos mayores. La abrasión fue el daño más reportado. El análisis de correspondencia múltiple no mostró significación. Conclusión: el análisis de los eventos notificados contribuyó para la planificación e implementación del Programa Fall Tailoring Interventions for Patient Safety en Brasil para mejorar la gestión de sus riesgos re-lacionados.(AU

Analysis of SARS-CoV-2 Infection Among Inpatients in a Tertiary Hospital in Guangzhou During the Covid-19 Pandemic / 中山大学学报(医学科学版)

ObjectiveAt the end of November 2022， Guangzhou implemented the latest Covid-19 epidemic prevention policy and began to gradually lift the lockdown. However， under the new epidemic prevention situation， the situation of SARS-CoV-2 infection in hospitalized patients in China is still unclear. Accordingly， this paper aims to study the SARS-CoV-2 infection of hospitalized patients in Guangzhou under the new epidemic prevention and control situation. MethodsThe results of SARS-CoV-2 nucleic acid tests in our hospital from the end of November 2022 to the beginning of February 2023 were retrospectively analyzed. The positive rate of SARS-CoV-2 nucleic acid tests in outpatients and inpatients under the new epidemic prevention situation， and the nosocomial infection of SARS-CoV-2 in inpatients were statistically analyzed. ResultsThis study retrospectively analyzed the SARS-CoV-2 nucleic acid test results of 13 959 patients， including 6 966 outpatients and 6 993 inpatients. On November 30， 2022， the SARS-CoV-2 nucleic acid test results of outpatients began to be positive， indicating that the outbreak of the SARS-CoV-2 infection had begun. On December 7， one case of SARS-CoV-2 nucleic acid test results of hospitalized patients was positive， and nosocomial infections began to break out. On December 15， the positive rate of SARS-CoV-2 nucleic acid test among patients exceeded 40 %， and the epidemic entered its peak period. After the end of December， the test positive rate gradually decreased， but the positive rate of inpatients was always higher than that of outpatients. Compared with December 2022， the positive rate of SARS-CoV-2 nucleic acid test of patients in many departments in January 2023 decreased， but the positive rate of SARS-CoV-2 nucleic acid test of inpatients in the oncology department increased significantly （P < 0.001）. Further analysis found that the nosocomial infection rate of SARS-CoV-2 in inpatients was 86.57 % （329/380）. However， the nosocomial infection rate in lymphoma patients ［58.33 % （14/24）］ was significantly lower than that of the hospitalized patients with other disease types （P < 0.001）. ConclusionThe positive rate of SARS-CoV-2 nucleic acid testing among patients reached its peak in mid-December 2022. In January 2023， the positive rate of SARS-CoV-2 nucleic acid testing gradually decreased， while the number or positive rate of SARS-CoV-2 nucleic acid testing positive patients in some departments increased. The nosocomial infection rate among hospitalized patients is as high as 90 %. There are differences in the nosocomial infection rate of SARS-CoV-2 among inpatients with different disease types. In summary， this study provides preliminary data on the epidemiological characteristics of SARS-CoV-2 infection among hospitalized patients in Guangzhou， as well as the protection against infection among hospitalized patients and cross-infection between medical staffs and patients.

Establishment and verification of a diagnostic prediction model for non-suicidal self-injury behaviors in adolescents with depressive disorder / 四川精神卫生

ObjectiveTo establish a diagnostic prediction model for non-suicidal self-injury （NSSI） behaviors in adolescents with depressive disorder， in order to provide references for early identification of NSSI behaviors in them. MethodsRetrospective analysis was performed on the clinical data of adolescents with depressive disorder （n=366） who were admitted to the Pediatric Department of Shenzhen Kangning Hospital from January 1 to December 31， 2021. According to the Diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria for NSSI， the patients were divided into comorbid NSSI group （n=289） and non-NSSI group （n=77）. The selected adolescents were randomly divided into a training set （n=258） and a verification set （n=108） in a 7∶3 ratio. Logistic regression analysis was used to screen the independent risk factors for NSSI behaviors in adolescents with depressive disorder， which served as the basis for prediction model. Finally， the receiver operating characteristic （ROC） curve was established and the area under curve （AUC） was calculated to evaluate the discrimination in the training set and validation set. Calibration curve was applied to evaluate the calibration degree of the model. The Homser-Lemeshow （HL） test was conducted to evaluate the goodness of fit of the model. And decision curve analysis （DCA） was performed to evaluate the clinical benefit of the model. ResultsGender （β=1.734， OR=5.561， 95% CI： 2.678~11.964）， education level （β=0.864， OR=2.737， 95% CI： 1.174~4.795）， history of suicide attempts （β=0.932， OR=2.539， 95% CI： 1.253~5.144）， being an only child （β=0.745， OR=2.106， 95% CI： 1.029~4.311） and depression severity （β=0.056， OR=1.058， 95% CI： 1.025~1.092） were independent risk factors related to NSSI behaviors in adolescents with depressive disorder （P<0.05 or 0.01）. The AUC was 0.808 （95% CI： 0.746~0.870） in the training set， and was 0.722 （95% CI： 0.581~0.864） in the validation set. The prediction model showed good calibration with the HL test （P=0.561）. ConclusionGender， education level， suicide attempt history， being an only child and depression severity are independent risk factors for NSSI behaviors in adolescents with depressive disorder， furthermore， the diagnostic clinical prediction model constructed using above factors for NSSI behaviors in adolescents with depressive disorder has displayed good sensitivity and specificity.

Alterações de linguagem em pacientes pós lesão encefálica adquirida na fase aguda / Language changes in patients after brain injury acquired in the acute phase

Caracterizar as alterações de linguagem encontradas em pacientes com lesão encefálica adquirida em fase aguda Métodos: Trata-se de uma pesquisa observacional, descritiva do tipo transversal. A avaliação foi realizada nas enfermarias de um hospital de urgências, com pacientes de idade superior a 18 anos, diagnóstico de lesão encefálica adquirida e tempo de internação de até 60 dias. O protocolo utilizado incluiu avaliação das praxias orais, expressão, compreensão da linguagem oral e leitura. Ao final, foi possível apresentar as hipóteses diagnósticas de afasias fluentes e não fluentes, disartria e sem alteração de linguagem. A análise dos dados foi realizada por meio de estatística descritiva através da distribuição de frequência absoluta e frequência relativa Resultados: A amostra foi composta por 24 pacientes sendo a maioria do gênero masculino, com média de idade de 51 anos. O diagnóstico de maior frequência foi Acidente Vascular Cerebral. Dos pacientes avaliados, 79% tiveram alterações de fala/linguagem. As hipóteses diagnósticas fonoaudiológicas encontradas foram: afasia global, afasia de broca, afasia transcortical mista, afasia de condução, afasia transcortical motora, afasia transcortical sensorial e disartria. Conclusão: A afasia global foi o transtorno de linguagem de maior ocorrência entre os indivíduos, bem como o gênero masculino e o acidente vascular cerebral. A avaliação da linguagem de pacientes com lesões encefálicas adquiridas na fase aguda é pertinente, pois promove o levantamento de alterações desde as perceptíveis até as mais discretas

To characterize the language disorders found in patients with brain injury acquired in the acute phase Methods: This is an observational, descriptive cross-sectional study. The evaluation was carried out in the wards of an emergency hospital, with patients aged over 18 years, diagnosed with acquired brain injury and hospitalization time of up to 60 days. The protocol used included assessment of oral praxis, expression, comprehension of oral language and reading. In the end, it was possible to present the diagnostic hypotheses of fluent and non-fluent aphasias, dysarthria and without language alteration. Data analysis was performed using descriptive statistics through the distribution of absolute frequency and relative frequency. Results: The sample consisted of 24 patients, most of whom were male, with a mean age of 51 years. The most frequent diagnosis was Cerebral Vascular Accident. Of the evaluated patients, 79% had speech/language disorders. The speech-language diagnostic hypotheses found were: global aphasia, drill aphasia, mixed transcortical aphasia, conduction aphasia, motor transcortical aphasia, sensory transcortical aphasia and dysarthria. Conclusion: Global aphasia was the most frequent language disorder among individuals, as well as males and stroke. The evaluation of the language of patients with brain injuries acquired in the acute phase is relevant, as it promotes the survey of changes from the perceptible to the most discreet

Caracterización del dolor abdominal crónico en pacientes del Hospital Pediátrico Provincial Eduardo Agramonte Piña

Introducción: El dolor abdominal recurrente es un síntoma común en los niños y causa gran ansiedad a la familia. Representa hasta el 10 % de las consultas en pediatría, con frecuencia entre escolares y adolescentes, del 85 al 90 % de los casos la causa obedece a un trastorno de tipo funcional. Objetivo: Caracterizar el dolor abdominal recurrente en niños ingresados en el hospital pediátrico Eduardo Agramonte Piña de la provincia Camagüey. Métodos: Se realizó un estudio observacional, descriptivo, transversal, retrospectivo, cuyo universo de trabajo estuvo constituido por 122 pacientes ingresados con diagnóstico de dolor abdominal recurrente, durante el período de estudio. Para la obtención de la información se utilizó el análisis de documentos al revisar las historias clínicas del total de pacientes atendidos y los materiales bibliográficos. Resultados: De 122 pacientes estudiados el grupo más afectado correspondió al de 13-18 años de edad, seguido del grupo escolar de 7-12 años para un total de 73 y 45 casos, respectivamente. Entre los factores que aumentó la frecuencia estuvo la exposición mantenida a situaciones estresantes relacionadas con la disfunción del medio ambiente familiar y social del niño, expresados en los resultados, de 122 pacientes, 91 proceden de medios socio-ambientales disfuncionales, con predominio en las etapas escolares y de la adolescencia. Conclusiones: El número de pacientes con resultados de laboratorio negativos fue mayor que el de los positivos, por lo cual el dolor abdominal de origen funcional superó al de tipo orgánico.

Introduction: Recurrent abdominal pain (RAP) is a common symptom in children and causes great anxiety to the family. It represents up to 10% of pediatric consultations. It occurs frequently among schoolchildren and adolescents and in 85 to 90% of cases the cause is due to a functional disorder. Objective: To characterize the behavior of recurrent abdominal pain in children admitted to the Eduardo Agramonte Piña pediatric hospital in the province of Camagüey. Methods: An observational, descriptive, cross-sectional, retrospective study was carried out, whose universe of work consisted of 122 patients admitted with a diagnosis of recurrent abdominal pain, during the study period. To obtain the information, document analysis was used by reviewing the clinical histories of the total number of patients treated and the bibliographic materials. Results: Of a total of 122 patients studied, the most affected group corresponded to 13 to 18 years of age, followed by the school group of 7 to 12 years for a total of 73 and 45 cases, respectively. Among the factors that increased the frequency was sustained exposure to stressful situations related to the dysfunction of the child's family and social environment, expressed in the results: of 122 patients, 91 come from dysfunctional socio-environmental environments, with predominance in the schoolchildren and adolescents stages. Conclusions: The number of patients with negative laboratory results was greater than that of positive ones, that is why abdominal pain of functional origin exceeded that of organic origin.

Preditores de mortalidade e tempo médio de sobrevivência dos pacientes críticos / Predictores de mortalidad y tiempo promedio de supervivencia de los pacientes críticos / Predictors of mortality and median survival time of critically ill patients

Resumo Objetivo Analisar os preditores de mortalidade e o tempo médio de sobrevivência dos pacientes internados nas unidades de terapias intensivas. Métodos Coorte prospectiva, realizada no período de agosto de 2018 a julho de 2019, em quatro Unidades de Terapia Intensiva (UTI) de adultos, da rede pública e privada do Estado de Sergipe. Foram incluídos todos os pacientes adultos, desde que possuíssem o tempo de permanência mínima de 24 horas na unidade. O desfecho primário foi o óbito. Os desfechos secundários foram: diálise, lesão por pressão, lesão renal aguda, necessidade de ventilação mecânica invasiva por mais de 48 horas, infecção e o tempo de internação. Resultados Dos 432 pacientes, houve predomínio de óbito em pacientes do sexo masculino, com idade mais avançada e procedentes da unidade de emergência. A presença de insuficiência cardíaca, valores de creatinina >1,5 mg/dL na admissão, diabetes mellitus, doença hepática e tabagismo também tiveram associação com o desfecho óbito. Quanto aos demais preditores, destacaram-se o maior tempo de internação; maiores escores do Sequential Organ Failure Assessment (SOFA), Simplified Acute Phisiology (SAPS 3) e Nursing Activies Score (NAS), além do uso de noradrenalina. O uso do fentanil foi associado ao aumento do tempo de sobrevida e o tempo médio de sobrevivência geral foi 28 dias. Conclusão Os preditores de mortalidade dos pacientes internados em UTI de Sergipe foram o maior tempo de internação; os maiores escores de SOFA, SAPS-3 e NAS; creatinina >1,5mg/dl na admissão; uso de drogas vasopressoras e a necessidade de diálise.

Resumen Objetivo Analizar los predictores de mortalidad y el tiempo promedio de supervivencia de los pacientes internados en unidades de cuidados intensivos. Métodos Cohorte prospectivo, realizado durante el período de agosto de 2018 a julio de 2019, en cuatro Unidades de Cuidados Intensivos (UCI) de adultos, de la red pública y privada del estado de Sergipe. Se incluyeron todos los pacientes adultos, con tiempo de permanencia mínima de 24 horas en la unidad. El criterio principal de valoración fue la defunción. Los criterios secundarios fueron: diálisis, úlcera por presión, lesión renal aguda, necesidad de ventilación mecánica invasiva durante más de 48 horas, infección y el tiempo de internación. Resultados De los 432 pacientes, hubo un predominio de defunciones en pacientes del sexo masculino, con edad más avanzada y procedentes de la unidad de emergencia. La presencia de insuficiencia cardíaca, valores de creatinina >1,5 mg/dL en la admisión, diabetes mellitus, enfermedad hepática y tabaquismo también estuvieron asociados con el desenlace de defunción. Con relación a los demás predictores, se destacaron el mayor tiempo de internación; mayores puntuaciones del Sequential Organ Failure Assessment (SOFA), Simplified Acute Phisiology (SAPS 3) y Nursing Activies Score (NAS), además del uso de noradrenalina. El uso de fentanilo estuvo asociado con el aumento del tiempo de sobrevida y el tiempo promedio de supervivencia general fue de 28 días. Conclusión Los predictores de mortalidad de los pacientes internados en una UCI de Sergipe fueron: el mayor tiempo de internación; los puntajes más altos de SOFA, SAPS-3 y de NAS; creatinina >1,5mg/dl en la admisión; uso de drogas vasoactivas y la necesidad de diálisis.

Abstract Objective To analyze the predictors of mortality and the average survival time of patients hospitalized in Intensive Care Units. Methods This is a prospective cohort, carried out from August 2018 to July 2019, in four adult Intensive Care Units (ICU) from the public and private network of the State of Sergipe. All adult patients were included, provided they had a minimum length of stay of 24 hours in the unit. The primary outcome was death. Secondary outcomes were dialysis, pressure injury, Acute Kidney Injury, need for invasive mechanical ventilation for more than 48 hours, infection, and length of hospital stay. Results Of the 432 patients, there was a predominance of death in male patients, older and coming from the emergency unit. The presence of heart failure, creatinine values >1.5 mg/dL at admission, diabetes mellitus, liver disease and smoking were also associated with the death outcome. As for the other predictors, the longest hospital stay, higher Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology (SAPS 3) and Nursing Activities Score (NAS) scores, in addition to the use of noradrenaline, stand out. The use of fentanyl was associated with increased survival time and the overall median survival time was 28 days. Conclusion The mortality predictors of patients admitted to the ICU in Sergipe were longer length of stay; the highest SOFA, SAPS-3 and NAS scores; creatinine >1.5mg/dl on admission; use of vasopressor drugs and the need for dialysis.

Caracterización de pacientes con esquizofrenia en el Hospital Psiquiátrico Provincial de Sancti Spíritus

Introducción: Existe falta de consenso entre los expertos sobre la clínica y conceptualización de la esquizofrenia. La esquizofrenia es un trastorno mental severo que afecta al pensamiento, las emociones y el comportamiento. La causa de la enfermedad no está bien definida. Objetivo: Caracterizar los pacientes adultos esquizofrénicos internados en la institución. Métodos: Se realizó un estudio descriptivo para la caracterización del adulto con esquizofrenia hospitalizado se tuvo en cuenta, edad y sexo, independencia física, conducta, cognición, afectividad, síntomas positivos, negativos y nivel de rehabilitación. Se trabajó con una muestra intencional constituida por los adultos con diagnóstico de esquizofrenia ingresados en el hospital, en el periodo de 2018 al 2022, con un mínimo de seis meses de estadía hospitalaria, n=64. Resultados: El sexo predominante resultó el masculino 62,5 %, independencia física mínimo dependiente con un 51,57 %, la cognición estaba afectada en el 100 % de los estudiados, se destaca la desorganización del pensamiento y el embotamiento afectivo con el 100 y el 87,69 % respectivamente, con nivel de rehabilitación más preponderante el nivel cuatro para un 29,23 %. Conclusiones: La adecuada caracterización de los pacientes con esquizofrenia hospitalizados en el Hospital Psiquiátrico Docente Provincial de Sancti Spíritus, facilita el trabajo encaminado al fomento de las relaciones sociales a través de acciones que mejoran su estado de salud. Uno de cada siete pacientes con esquizofrenia puede alcanzar la recuperación funcional si dispone de una adecuada rehabilitación integral.

Introduction: There is a lack of consensus among experts on the clinical symptoms and conceptualization of schizophrenia. Schizophrenia is a severe mental disorder that affects thinking, emotions, and behavior. The etiology of the disease is not well defined. Objective: To characterize adult schizophrenic patients admitted to the institution. Methods: Descriptive study was carried out for characterization of the hospitalized adult with schizophrenia taking into account age and sex, physical independence, behavior, cognition, affectivity, positive and negative symptoms and level of rehabilitation. It was worked with an intentional sample consisting of adults diagnosed with schizophrenia admitted to the hospital, in the period from 2018 to 2022, with a minimum of six months of hospital stay, n = 64. Results: The predominant sex was male 62.5%, minimum dependent physical independence with 51.57%, affected exponent with greater representativeness was cognition in 100%, disorganization of thought and affective blunting stand out with 100 and 87.69% respectively, with the most preponderant rehabilitation level being level 4 for 29.23%. Conclusions: The proper characterization of patients with schizophrenia hospitalized in the Provincial Teaching Psychiatric Hospital of Sancti Spíritus, facilitates the work aimed at promoting social relationships through actions that improve their health status. One in seven patients with schizophrenia can achieve functional recovery if adequate comprehensive rehabilitation is available.

Riesgo cardiovascular en pacientes ingresados en un Centro de Atención al diabético

Introducción: La diabetes mellitus constituye un importante problema de salud a nivel mundial. El riesgo cardiovascular en pacientes diabéticos es similar al que se observa en no diabéticos que han sufrido infarto del miocardio. Objetivo: Evaluar el riesgo cardiovascular en pacientes ingresados en el Centro de Atención al Diabético de Pinar del Río. Métodos: Se realizó un estudio observacional descriptivo de corte transversal en pacientes ingresados en el Centro de Atención al Diabético perteneciente al Hospital General Docente Abel Santamaría Cuadrado de la provincia Pinar del Río, en el período comprendido desde el 1ro enero de 2019 hasta el 31 diciembre de 2020. El universo de estudio quedó constituido por 689 pacientes con diagnóstico de diabetes mellitus y la muestra por 527, seleccionados a través de un muestreo probabilístico aleatorio simple, con una frecuencia esperada del 50 %, límite de confianza 5 % y nivel de confianza 95 %. Para el análisis de la información se utilizó el sistema estadístico, Statistical Package for Social Sciences, se aplicó análisis univariado de carácter descriptivo, se utilizaron estadígrafos descriptivos como la distribución de frecuencias absoluta y relativa. Se utilizó la prueba no paramétrica Chi cuadrado para datos cualitativos con un nivel de significación del 95 % (p<0,05). Resultados: En la serie predominó el sexo femenino (53,89 %), grupo etario de 60 a 69 años de edad (31,31 %) y afectados de piel blanca (75,9 %). Se observó preponderancia del sobrepeso/obesidad (74,75 %), seguido de la hipertensión arterial (73,62 %). Prevaleció el riesgo cardiovascular bajo (44,97 %). Conclusiones: La diabetes mellitus es una enfermedad crónica asociada a complicaciones cardiovasculares que produce aumento de riesgo cardiovascular y deterioro de la calidad de vida. Resulta fundamental instaurar estrategias de prevención primaria para detectar riesgos en forma temprana.

Introduction: Diabetes mellitus is a major health problem worldwide. The cardiovascular risk in diabetic patients is similar to that observed in non-diabetics who have suffered myocardial infarction. Objective: To evaluate the cardiovascular risk in patients admitted to the Diabetic Care Center of Pinar del Río. Methods: A cross-sectional descriptive observational study was carried out in patients admitted to the Diabetic Care Center belonging to the Abel Santamaría Cuadrado General Teaching Hospital in Pinar del Río province, in the period from January 1st, 2019 to December 31st, 2020. The universe of study was made up of 689 patients diagnosed with diabetes mellitus and the sample was 527, selected through simple random probabilistic sampling, with an expected frequency of 50 %, confidence limit 5 % and confidence level 95 %. For the analysis of the information, the statistical system, Statistical Package for Social Sciences, was applied, univariate analysis of a descriptive nature was applied, and descriptive statistics were used, such as the distribution of absolute and relative frequencies. The non-parametric Chi square test was used for qualitative data with a significance level of 95 % (p<0.05). Results : The female sex (53.89 %), age group 60 to 69 years of age (31.31 %) and white-skinned patients (75.9 %) predominated in the series. There was a preponderance of overweight/obesity (74.75 %), followed by arterial hypertension (73.62 %). Low cardiovascular risk prevailed (44.97 %). Conclusions: Diabetes Mellitus is a chronic disease associated with cardiovascular complications that causes increased cardiovascular risk and impaired quality of life. It is essential to establish primary prevention strategies to detect risks early.

Risco de quedas e seus fatores associados na pessoa idosa hospitalizada / Risk of falls and its associated factors in hospitalized older adults

Resumo Objetivo analisar o risco de queda e sua associação com as variáveis demográficas, clínicas, estado cognitivo, risco de sarcopenia e fragilidade da pessoa idosa hospitalizada em uma clínica médica de um hospital universitário. Método Estudo quantitativo, observacional, transversal e analítico realizado com 60 pessoas idosas hospitalizadas na clínica médica de um hospital universitário da cidade de São Paulo - SP, Brasil, com o uso dos seguintes questionários: perfil demográfico, dados clínicos, Mini Exame do Estado Mental, Escala de Morse, Escala SARC-F e Índice de Fragilidade Tilburg. Foram realizadas análises descritivas e teste de normalidade de Kolmogorov-Smirnov. Para as variáveis quantitativas foi utilizado o teste de correlação de Spearman e para categóricas, o teste U Mann-Whitney. Para identificar a associação, foi utilizada a regressão linear múltipla e adotado um nível de significância de 5%. Resultados Predomínio do sexo feminino, entre 60-79 anos e sem companheiro (a). Ademais, 80% apresentavam comprometimento cognitivo, 88,3% foram categorizados como frágeis, 60% apresentavam risco para sarcopenia e 75% possuíam alto risco de queda durante a hospitalização. Verificou-se associação do comprometimento cognitivo, ser frágil e ter risco de sarcopenia com o risco de queda na pessoa idosa hospitalizada. Conclusão o elevado risco de quedas em idosos hospitalizados está diretamente relacionado com a presença de deficit cognitivo, síndrome da fragilidade e o risco para sarcopenia, afirmando que esses fatores merecem atenção dos gestores e profissionais de enfermagem.

Abstract Objective To analyze the risk of falls and its association with demographic and clinical variables, cognitive status, risk of sarcopenia and frailty among older adults hospitalized in a medical clinic of a university hospital. Method A quantitative, observational, cross-sectional analytical study of 60 older adults hospitalized in the medical clinic of a university hospital in São Paulo city, São Paulo state, Brazil, was carried out. Questionnaires collecting demographic profile and clinical data, the Mini-Mental State Examination, Morse Scale, SARC-F Scale and Tilburg Frailty Indicator were applied. Descriptive analyses and the Kolmogorov-Smirnov normality test were performed. Spearman's correlation test was used for quantitative variables and the Mann-Whitney U-test for categorical variables. Multiple linear regression was used to identify the associations and a significance level of 5% was adopted. Results The study sample comprised predominantly individuals that were female, aged 60-79 years and without a partner. Overall, 80% had cognitive impairment, 88.3% were diagnosed as frail, 60% were at risk for sarcopenia, and 75% had a high risk of falls during hospitalization. Cognitive impairment, frailty and sarcopenia risk were associated with risk of falls in the hospitalized older adults. Conclusion High risk of falls in the hospitalized older adults was directly associated with the presence of cognitive impairment, frailty syndrome and sarcopenia risk, confirming that these factors warrant attention from managers and nursing professionals.

Is calf circumference associated with clinical and nutritional outcome in older patients? / A circunferência da panturrilha está associada ao desfecho clínico e nutricional em pacientes idosos?

ABSTRACT BACKGROUND: Previous studies have shown a relationship between calf circumference (CC) and outcomes in hospitalized patients. AIMS: To investigate the relationship between CC and clinical and nutritional outcomes in older in-patients (OiP) in a surgery ward. METHODS: This was a cross-sectional study with 417 OiP in a surgery ward. Clinical variables, anthropometry, and nutritional screening instruments such as subjective global assessment (SGA), mini nutritional assessment (MNA), and nutritional risk screening (NRS) were used in the investigation. The tests Pearson's chi-square, Mann-Whitney, Kruskal-Wallis, and Spearman's coefficient, and multiple linear regression analyses were used to review the factors associated with CC. RESULTS: Lower CC values were found in the age group 80 years and over (p<0.0001), presence of complications (p=0.0269), NRS (p<0.0001), SGA (p<0.0001), and MNA (p<0.0001). Gender (p=0.0011; partial R2=0.01151), age (p=0.0002; partial R2=0.06032), body mass index (p≤0.0001; partial R2=0.40820), and arm circumference (p≤0.0001; partial R2=0.11890) are variables that together were associated with CC. There was also a relationship between SGA (p=0.0166; partial R2=0.00605) and absence of complications during hospitalization (p=0.0047; R2=0.01154) with CC. CONCLUSIONS: Gender, age, body mass index, and arm circumference were jointly associated with CC, in addition to SGA and absence of complications. The CC is a relevant indicator for OiP in the clinical practice.

RESUMO RACIONAL: Estudos anteriores mostraram uma relação entre a circunferência da panturrilha (CP) e desfechos em pacientes hospitalizados. OBJETIVOS: Investigar a relação entre CP e desfecho clínico e nutricional em pacientes idosos hospitalizados (PIH) em uma enfermaria cirúrgica. MÉTODOS: Este foi um estudo transversal com 417 PIH em uma enfermaria de cirurgia. Variáveis clínicas, antropometria e instrumentos de triagem nutricional como avaliação subjetiva global (ASG), mini avaliação nutricional (MAN) e triagem de risco nutricional (NRS) foram utilizados na investigação. Qui-quadrado, Mann-Whitney, Kruskal-Wallis, coeficiente de Spearman e análise de regressão linear múltipla foram usados para analisar os fatores associados a CP. RESULTADOS: Menores valores de CP foram encontrados na faixa etária de 80 anos (p<0,0001), complicações (p=0,0269), risco nutricional pelo NRS (p<0,0001), ASG (p<0,0001) e MAN (p<0,0001). Sexo (p=0,0011; R2 parcial=0,01151), idade (p=0,0002; R2 parcial=0,06032), IMC (p≤0,0001; R2 parcial=0,40820) e circunferência do braço (CB) (p≤0,0001; R2 parcial=0,11890) foram variáveis que juntas estiveram associadas com a CP. Também houve relação entre ASG (p=0,0166; R2 parcial=0,00605) e ausência de complicações durante a internação (p=0,0047; R2= 0,01154) com a CP. CONCLUSÕES: Sexo, idade, IMC e CB associaram-se conjuntamente com CP, ASG e ausência de complicações. CP é um indicador relevante em PIH na prática clínica.

Alteraciones de la fracción lipídica en los pacientes quemados

Introducción: Las alteraciones lipídicas constituyen un marcador de mal pronóstico y en los últimos tiempos se ha postulado como marcador biológico en la evolución de los pacientes grandes quemados. Objetivo: Determinar las alteraciones de la fracción lipídica en los pacientes quemados. Métodos: Se realizó un estudio analítico, prospectivo y de corte longitudinal con el objetivo de determinar las alteraciones de la fracción lipídica en los pacientes quemados ingresado en el Hospital Universitario Manuel Ascunce Domenech de la ciudad Camagüey, en el período comprendido desde enero de 2019 hasta el mes de febrero de 2022. Se estudiaron 30 pacientes en quienes se tuvieron en cuenta las variables: índice de gravedad, las cifras del colesterol sérico y de los triglicéridos, el por ciento de superficie corporal quemada, los patrones lipídicos, la sepsis y el estado al egreso. Resultados: Las cifras medias más bajas de colesterol sérico y las cifras medias más altas de triglicéridos ocurrieron en aquellos pacientes con más de un 30 por ciento de superficie corporal quemada. En los pacientes con índice de gravedad de muy grave, crítico y crítico extremo fue donde se registraron las cifras más bajas de colesterol. En los períodos evolutivos de siete a 14 días los estados de triglicéridos altos se encontraron en grupos de pacientes muy graves y crítico extremos con cinco pacientes en cada grupo, lo que representa el 16,67 % y cuatro pacientes críticos para el 13,33 %. Del total de los pacientes estudiados, en 13 de ellos se presentó un patrón lipídico formado por colesterol bajo con triglicéridos altos, y el 40 % de este grupo presentaron sepsis. Conclusiones: Los grandes quemados presentan alteraciones importantes en el metabolismo de los lípidos con consecuencias desfavorables en su evolución.

Introduction: The lipid alterations constitute a marker of bad forecast and in recent times it has run for candidate like biological marker in the evolution of the big burnt patients. Objective: To determine the alterations of the lipid fraction in the burned patients. Methods: An analytic, prospective and of longitudinal study was carried out for the sake of determining the alterations of the lipid fraction in the burned patient entered in the Hospital Universitario Manuel Ascunce Domenech of the city Camagüey, in the period understood since January of the 2019 to the month of February of 2022. They studied 30 patients in those who had into account variables: Severity rate, the figures of the serum cholesterol and of the triglycerides, the percent of corporal burned-out surface, the lipid patterns, the sepsis and the state to the medical release. Results: The half a lower amounts of serum cholesterol and the figures the more tall stockings of triglycerides happened in those patients with over 30 percent of corporal burned-out surface. In the patients with severity rate of very severe, critic and the extreme critic was where lower the figures of cholesterol got registered. In the evolutionary periods of seven to 14 days the states of tall triglycerides met fundamentally very seriously ill patients' groups, and critic extreme with five patients in each group, what represents the 16.67 % and four critical patients for the 13.33 %. Of the total of the patients studied, in 13 of them a lipid pattern educated by cholesterol bass with tall triglycerides showed up, and 40 % of this group presented sepsis. Conclusions: The great burned-out patients present important alterations in the metabolism of the lipids with unfavorable consequences in their evolution.

Hospital Dermatology: analysis of dermatological consultations in a tertiary teaching hospital

Abstract Background In hospital settings, dermatology can offer substantial clinical support for the diagnosis and management of skin conditions, reducing morbidity and mortality. Thus, the study aimed to analyze the profile of referrals and consultations performed by the Dermatology Service of the Santa Casa de Misericordia de Porto Alegre, from August 2018 to January 2020. Methods This study is descriptive, quantitative, and retrospective, conducted through data collection and review of medical records and referrals. The variables included were clinical data of referrals, in-patients profiles, dermatological diagnoses, complementary exams, therapeutic conduct, and recommended follow-ups. Results A total of 1020 referrals were analyzed, which resulted in 641 consultations (328 men, 313 women). The most prevalent skin disease groups were 'Dermatitis and Eczema' (33.1%) and 'Other infectious skin diseases (21.8%), while the most frequent ICD-10 were 'Drug eruptions - L27' (9.9%) and 'Other and unspecified dermatitis - L30' (6.6%). Corticoids were the most recommended treatments (27.7%), followed by antifungals (13.1%). 'Consultation Discharge' (44%) and 'Outpatient' Dermatology follow-up (27%) were the most frequent causes for ending consultation. Study limitations Among the study limitations, the authors highlight its retrospective nature, with data analysis based on referrals and medical records, which may present inaccurate or incomplete information. In addition to this, the study may demonstrate a certain degree of subjectivity due to the review and interpretation process conducted by the researchers. However, the definition of objective criteria based on previous studies attenuates such possible bias. Furthermore, considering that the Dermatology teams are composed of a preceptor dermatologist and residents, the established diagnoses were not submitted to third-party verification, except in the cases of skin biopsies and cultures. Thus, the professional's experience and skills may have influenced the dermatological diagnoses. Conclusions These findings underlie the importance of Dermatology in hospital assistance, contributing to the management of a wide range of skin conditions.

The use of toys by nursing as a therapeutic resource in the care of hospitalized children / El uso del juguete por la enfermería como recurso terapéutico en la atención al niño hospitalizado / O uso do brinquedo pela enfermagem como recurso terapêutico na assistência à criança hospitalizada

ABSTRACT Objectives: to describe the use of toys by nursing during the care of children in the inpatient unit; to analyze the factors that influence the use of therapeutic toys by nursing in the care of hospitalized children. Methods: qualitative research, conducted in a pediatric hospital in Rio de Janeiro between July and August 2019. Semi-structured interview and thematic analysis were used as methodological procedure. Results: the 12 nurses and 7 nursing technicians revealed minimizing fear, relieving tension, and creating a bond between the child and the professional as the main benefits; they use as resources: children's toys, hospital materials, cartoons, and children's videos. The high demand for work, deficit of human resources, and appropriate ludic materials are factors that interfere with the use of toys as a therapeutic resource. Final Considerations: although the participants recognize the importance of the toy as a therapeutic resource, there is no systematization of its use in pediatric practice.

RESUMEN Objetivos: describir uso del juguete por la enfermería durante la atención al niño en unidad de internación; analizar los factores que influencian la utilización del juguete terapéutico por la enfermería en la atención al niño hospitalizado. Métodos: investigación cualitativa, realizada en un hospital pediátrico de Rio de Janeiro entre julio y agosto de 2019. Procedimiento metodológico fue la entrevista semiestructurada y análisis temático. Resultados: los 12 enfermeros y 7 técnicos de enfermería revelan como principales beneficios minimizar miedo, aliviar tensión y construir vínculo entre niño y profesional; utilizan como recursos: juguetes del niño, materiales hospitalarios, dibujos animados y videos infantiles. La alta demanda de trabajo y el déficit de recursos humanos y materiales lúdicos apropiados son factores que interferen en el uso del juguete como recurso terapéutico. Consideraciones Finales: aunque los participantes reconozcan la importancia del juguete mientras recurso terapéutico, no hay sistematización de su utilización en la práctica pediátrica.

RESUMO Objetivos: descrever o uso do brinquedo pela enfermagem durante a assistência à criança na unidade de internação; analisar os fatores que influenciam a utilização do brinquedo terapêutico pela enfermagem no cuidado da criança hospitalizada. Métodos: pesquisa qualitativa, realizada em um hospital pediátrico do Rio de Janeiro entre julho e agosto de 2019. O procedimento metodológico foi a entrevista semiestruturada e análise temática. Resultados: os 12 enfermeiros e 7 técnicos de enfermagem revelam como principais benefícios minimizar o medo, aliviar a tensão e criar vínculo entre criança e profissional e; utilizam como recursos: brinquedos da criança, materiais hospitalares, desenhos animados e vídeos infantis. A alta demanda de trabalho e o déficit de recursos humanos e materiais lúdicos apropriados são fatores que interferem no uso do brinquedo como recurso terapêutico. Considerações Finais: embora os participantes reconheçam a importância do brinquedo enquanto recurso terapêutico, não há sistematização de sua utilização na prática pediátrica.