Objetivo: Caracterizar os perfis social, clínico e hemodinâmico de pacientes admitidos em Unidade de Terapia Intensiva (UTI) que evoluíram a óbito e verificar a influência na sobrevida. Métodos: Coleta de prontuários de pacientes admitidos na UTI de um Hospital de referência terciária na região amazônica, que evoluíram a óbito (n=200), com análise das variáveis clínicas, sociais e hemodinâmicas e descrição das frequências absoluta e relativa, média, desvio padrão e intervalo de confiança de 95%. Resultados: Características sociais predominantes: idade 20-59 anos (48,5%), sexo masculino (52%), raça/cor pardo (72,5%), profissão empregada doméstica (10,5%), religião católica (6,5%), escolaridade 9 anos (21%) e estado civil solteiro (30%). Características clínicas principais: doenças respiratórias (20,5%), estado grave na admissão (70,5%), coma induzido (42%), acamados (87%), uso de ventilação mecânica invasiva (91%) e média de aspiração brônquica 1,27 ± 0,55 por dia. Complicações clínicas prevalentes: sepse (79,5%), choque (69%) e edema (61%). Uso de sonda vesical (82,5%) e tempo médio de internação 11,81 ± 9,50 dias. As características hemodinâmicas acentuadas foram: creatinina, uréia, lactato e leucócitos. Além disso, observou-se menor sobrevida de indivíduos da raça Branca e com leucocitose admissional. Conclusão: Este estudo auxilia na compreensão do perfil epidemiológico da população local, contribuindo no melhor manejo do paciente crítico. Descritores: Unidade de Terapia Intensiva, Perfil de saúde, Monitorização hemodinâmica, Sobrevida e Morte.
Pelvic floor musculature assessment methods are generally invasive, subjective, and technologically expensive. Therefore, there is a need to identify other methods that can predict changes in the function of these muscles. This study aimed to verify whether the levels of strength and myoelectric activity of pelvic floor muscles (PFM) can be related to handgrip strength (HGS), to ensure faster and earlier identification of possible dysfunctions of this musculature. Furthermore, we verified whether these variables vary across different age groups. This was a cross-sectional observational study involving 44 healthy women. The women were divided into two groups: the young (18–35 years) and middle-aged (36–55 years) adult groups. Social, anthropometric, and clinical data were collected from the participants, and a functional assessment of their PFM was performed by bidigital palpation, electromyographic biofeedback (sEMG), and HGS (using a dynamometer). The levels of physical and sexual activity were measured using the International Physical Activity Questionnaire (IPAQ) and Sexual Quotient–Female version (SQ-F) questionnaire. There were no differences in HGS, power/pressure, sEMG, SQ-F score, or IPAQ score between the two groups (p > 0.05). Moderate correlation (r = 0.601; p = 0.019) was observed during multivariate analysis. HGS is related to mean amplitudes (p = 0.123), MVC (p = 0.043), sexual function (p = 0.049), and physical activity (p = 0.004). We therefore conclude that there were no differences between HGS and PFM strength in young adult and middle-aged women. Furthermore, HGS is related to the PFM functionality, sexual function, and physical activity.
Stress urinary incontinence (SUI) results from an increase in intravesical pressure, which exceeds the pressure at which the urethra remains closed. Symptoms cause social and sexual intercourse discomfort directly or indirectly, which affect health-related quality of life and are associated with pelvic floor muscle (PFM) dysfunction. We aimed to verify the variation in strength and PFM bioelectrical activity and sexual function in women with SUI. Additionally, we analyzed the impact of this dysfunction on quality of life. This was an observational cross-sectional study. Women aged 25–55 years with frequent sexual intercourse were included. Women with SUI were included in a study group (G2, n = 17), and those without any type of incontinence were included in a control group (G1, n = 16). Primary outcomes were level of strength and PFM bioelectrical activity and sexual function as determinants of worse SUI in the control group. Secondary outcomes were associated between the primary outcomes and severity of urinary loss, impact on daily life, and quality of life in women with SUI. In the domains evaluated in the Female Sexual Function Index (FSFI), only sexual desire was lower in women with SUI (G2) than in the controls (p = 0.033). During analysis of G1 variables, a positive and moderate correlation was observed between power/myoeletric activation and maximum voluntary contraction (MVC) (p < 0.01), peak (p < 0.01), and mean amplitudes (p = 0.017). There was a high positive correlation between sexual arousal and other variables, including vaginal lubrication, sexual orgasm, and total FSFI value (p < 0.001 for all analyses). During evaluation of G2 variables, the MVC was positively correlated with the peak and mean amplitudes (p < 0.0001). Additionally, there was a high and positive correlation between the mean amplitudes (%MVC) and personal relationships (KHQ) (p = 0.001); the same was observed between the total (ICIQ) and activities of daily living (ICIQ) (p < 0.0001). Therefore, women with SUI presented with lower sexual desire and bioelectric activity but were not related to PFM strength. Additionally, the domains of sexual function and certain variables of quality of life are aggravated by SUI.
Objetivo: Analisar as variáveis sociais, clínicas e hemodinâmicas dos pacientes internados em Unidade de Terapia Intensiva (UTI) que evoluíram com sepse. Metodologia: Estudo retrospectivo, observacional e transversal. Foram elegíveis 224 prontuários, divididos em dois grupos: sepse presente (SP) n=165 e sepse ausente (SA) n=59. Foram descritas e analisadas as variáveis sociais, clínicas e hemodinâmicas. Resultados: As variáveis que tiveram associação com a sepse foram a baixa escolaridade e o estado civil casado. Nas variáveis clínicas observou-se que pacientes que precisam de intervenções invasivas foram associadas à sepse. As variáveis hemodinâmicas PaCO2, Be, Bicarbonato, leucócitos, hemácias, uréia, sódio e potássio alterados foram associados ao quadro de sepse. Estes pacientes permaneceram maior tempo na UTI e tiveram o óbito como desfecho. Conclusão: Existem variáveis sociais, clínicas e hemodinâmicas específicas que estão relacionadas à sepse. O conhecimento destas variáveis pode direcionar para que investimentos e recursos sejam direcionados visando prevenir esta complicação clínica.
Background Postoperative nausea and vomiting (PONV) is a distressing complication of anesthesia and can lead to aspiration, dehydration, and electrolyte imbalance. Antiemetic agents are conventionally prescribed to manage PONV; however, they have associated side effects. Therefore, unconventional methods, such as auricular acupuncture (AA), are also utilized to prevent and control emesis after surgery. AA originated in traditional Chinese medicine and is based on a diagnostic and treatment system that aims to normalize dysfunction through stimulation of reflex points on the ear. The aim of this study is to evaluate the effects of AA in controlling PONV. Methods We will perform a systematic review according to the Cochrane methodology. An overall search strategy will be developed and adapted for PubMed, PEDro, the Virtual Health Library, SciELO, EMBASE, the Web of Science, SciVerse Scopus, and the Cochrane Library to search for the following descriptors: “Acupressure”; “Antiemetics”; “Postoperative nausea and vomiting”; “Surgery”; “Auriculotherapy”; “Nausea”; “Vomiting”; and “Postoperative period.” Articles with a mean score of 6 ± 1.5 on the PEDro scale will be evaluated. The size of the intervention effect (Z) will be calculated for each outcome included in this review. The primary outcome will be the incidence of PONV. The secondary outcome will be the severity of PONV. Quality assessment will be performed with the Cochrane instrument. If possible, a meta-analysis will be performed using Review Manager 5.3 software. Discussion Several studies have reported positive outcomes of AA for patients with PONV. This study could provide robust and conclusive evidence of the usefulness of AA as an effective treatment alternative for emesis without the side effects of conventional medication. Trial registration Systematic review registration number: CRD42020149772 (S1 File)
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