ABSTRACT
RESUMEN Introducción: las úlceras por presión (UPP) influyen drásticamente en la estancia hospitalaria produciendo malestar y dolor a los pacientes. Objetivo: determinar el riesgo de desarrollar UPP y evaluar conjuntamente nutrición / alimentación y grado de independencia en pacientes mayores de 65 años. Método: diseño descriptivo y transversal. Se evaluó a 444 pacientes con y sin UPP mediante la Escala de Braden, el Mini Nutritional Assessment Short y Prisma 7, internados en el Hospital Adventista Silvestre, Rio de Janeiro, Brasil, entre 2018 y 2019. Resultados: respecto de la Escala de Braden el grupo con mayor representación es el Riesgo Moderado de sufrir UPP (37,6%). La estratificación en grupo del Prima 7 muestra 2 grupos principales, el mayor (51,8%) que corresponde a Prisma positivo (>3), seguido por el grupo de Prisma negativo (35,1%). Según la escala Mini Nutritional Assessment Short 41,9% de los pacientes internados tiene riesgo de desnutrición y 34% se halla con desnutrición. Conclusión: el estudio relaciona las UPP con una serie factores como la malnutrición, la inmovilidad y pérdida de la independencia. La escala de Braden demostró ser un buen predictor de UPP. Se evidenció que las UPP son un problema con gran prevalencia en el hospital, que el acompañamiento multidisciplinar para el cuidado y tratamiento de estas lesiones es fundamental.
ABSTRACT Introduction: Pressure ulcers (PUs) drastically influence the hospital stay, causing discomfort and pain to patients. Objective: To determine the risk of developing PUs and jointly evaluate nutrition / diet and degree of independence in patients over 65 years of age. Method: Descriptive and cross-sectional design. Four hundred and forty-four patients with and without PUs, admitted to the Silvestre Adventist Hospital, Rio de Janeiro, Brazil between 2018 and 2019, were evaluated using the Braden Scale, the Mini Nutritional Assessment Short Form and the Prisma 7. Results: Regarding the Braden Scale, the group with the highest representation was the Moderate Risk of suffering Pus (37.6%). The group stratification of Prima 7 showed two main groups, the largest (51.8%) corresponding to positive Prism (> 3), followed by the negative Prism group (35.1%). According to the Mini Nutritional Assessment Short scale, 41.9% of hospitalized patients were at risk of malnutrition and 34% were malnourished. Conclusion: The study related PUs to a series of factors such as malnutrition, immobility and loss of independence. The Braden scale proved to be a good predictor of UPP. It was evidenced that PUs are a highly prevalent problem in the hospital, and that multidisciplinary support for the care and treatment of these injuries is essential.
ABSTRACT
We aim to investigate the role of A2A receptor in peritonitis-related sepsis by injection of a fecal solution (FS) as a model of polymicrobial infection. C57/black J6 wild-type (WT) and A2A-deficient mice (A2AKO) were exposed to sepsis induced by intraperitoneal injection of a FS (FS-induced peritonitis) or instead was injected with saline buffer (Sham). Survival rate and sepsis score were measured up to 48 h. The presence of bacteria in tissue homogenates was analyzed. Telemetry and speckle laser Doppler were used for systemic blood pressure and peripheral blood perfusion analysis, respectively. Histological analysis and identification of active caspase 3 were performed in selected organs, including the liver. The survival rate of A2AKO mice exposed to FS-induced peritonitis was significantly higher, and the sepsis score was lower than their respective WT counterpart. Injection of FS increases (50 to 150 folds) the number of colonies forming units in the liver, kidney, blood, and lung in WT mice, while these effects were significantly attenuated in A2AKO mice exposed to FS-induced peritonitis. A significant reduction in both systolic and diastolic blood pressure, as well as in the peripheral perfusion was observed in WT and A2AKO mice exposed to FS-induced peritonitis. Although, these last effects were significantly attenuated in A2AKO mice. Histological analysis showed a large perivascular infiltration of polymorphonuclear in the liver of WT and A2AKO mice exposed to FS-induced peritonitis, but again, this effect was attenuated in A2AKO mice. Finally, high expression of active caspase 3 was found only in the liver of WT mice exposed to FS-induced peritonitis. The absence of the A2A receptor increases the survival rate in mice exposed to polymicrobial sepsis. This outcome was associated with both hemodynamic compensation and enhanced anti-bacterial response.
Subject(s)
Peritonitis/metabolism , Receptor, Adenosine A2A/metabolism , Sepsis/metabolism , Animals , Blood Pressure/physiology , Disease Models, Animal , Mice , Mice, Knockout , Peritonitis/genetics , Peritonitis/microbiology , Peritonitis/mortality , Receptor, Adenosine A2A/genetics , Sepsis/genetics , Sepsis/mortality , Survival RateABSTRACT
Lipoinflamation is the inflammation generated in the adipose tissue. It can contribute to the development of insulin resistance. The lipoinflammation-associated mechanisms are related to the function of adipocytes and macrophages present in the adipose tissue. In this regard, the level of nucleoside adenosine is increased in individuals with obesity. Causes or consequences of this increase are unknown. Although, adenosine activating its receptors (A1, A2A, A2B and A3) is able to differentially modulate the function of adipocytes and macrophages, in order to avoid the reduction of insulin sensitivity and generate an anti-inflammatory state in subject with obesity. In this review we propose that adenosine could be a key element in the development of new strategies for limit lipoinflammation and regulate metabolic homeostasis through modulation of adipocyte-macrophage dialogue.
Subject(s)
Adenosine/physiology , Adipocytes/physiology , Macrophages/physiology , Obesity/physiopathology , Receptors, Purinergic P1/physiology , Adipose Tissue/metabolism , Adipose Tissue/physiopathology , Animals , Cell Communication , Homeostasis , Humans , Inflammation/etiology , Inflammation/physiopathology , Insulin Resistance , Interleukins/metabolism , Mice , Models, Biological , RatsABSTRACT
Con el objeto de comprobar si los valores de referencia en la citometría hemática que utiliza el Hospital Central Militar, eran aplicables a la población, se realizó un estudio transversal, observacional y analítico. El estudio abarcó población militar, derechohabiente y civil (pediátricos y adultos) a los cuales se les determinó hemoglobina, hematócrito, número de eritrocitos, índices eritrocitarios, número de leucosito, plaquetas y volumen plaquetario; el aparato que se utilizó para realizar estas determinaciones fue el analizador de hamatología Coulter Mod. STKS. Mediante el análisis estadístico se llegó a la conclusión de que sí existía diferencia estadísticamente significativa de los parámetros estudiados con los reportados en las referencias nacionales e internacionales encontradas. Estas diferencias muy probablemente se hayan debido a la diferencia de altitudes y metodologías utilizadas para cada uno de los estudios en cuestión