Quality of life Body imageSelf-concept Self-esteem a b s t r a c tThe aim of this study was to investigate the quality of life and self-esteem in patients with intestinal stoma. This is a clinical, primary, descriptive, analytical study, conducted at the Ostomized People's Pole of Pouso Alegre, after approval by the Ethics Committee of the Faculdade de Ciências da Saúde Dr. Jose Antonio Garcia Coutinho under opinion No. 23,227.Three instruments -a questionnaire on demographics and stoma, Rosenberg Self-Esteem Scale/UNIFESP-EPM and Flanagan Quality of Life Scale -were used in the data collection.The following tests were used for statistical analysis: chi-squared and Kruskal-Wallis tests and Spearman correlation. For all statistical tests, the level of significance of 5% (p < 0.05) was considered. Most participants were older than 60 years, of male gender and attended support groups. Twenty-one (30%) of respondents were illiterate. Neoplasia was the most frequent of the causes that led patients to receive an ostomy; permanent colostomy was the type of ostomy used. Individuals were not submitted to stoma demarcation and did not make irrigation. Regarding the type of complication, 34 (48.60%) had dermatitis; 14 (20%) showed retraction.The mean of Rosenberg Self-Esteem Scale/UNIFESP-EPM was 10.81 and the mean of Flanagan Quality of Life Scale was 26.16. It was concluded that individuals with intestinal stoma participating in the survey showed impaired self-esteem/quality of life.

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for the BaSICS investigators and the BRICNet members IMPORTANCE Slower intravenous fluid infusion rates could reduce the formation of tissue edema and organ dysfunction in critically ill patients; however, there are no data to support different infusion rates during fluid challenges for important outcomes such as mortality.OBJECTIVE To determine the effect of a slower infusion rate vs control infusion rate on 90-day survival in patients in the intensive care unit (ICU). DESIGN, SETTING, AND PARTICIPANTS Unblinded randomized factorial clinical trial in 75 ICUs in Brazil, involving 11 052 patients requiring at least 1 fluid challenge and with 1 risk factor for worse outcomes were randomized from May 29, 2017, to March 2, 2020. Follow-up was concluded on October 29, 2020. Patients were randomized to 2 different infusion rates (reported in this article) and 2 different fluid types (balanced fluids or saline, reported separately).INTERVENTIONS Patients were randomized to receive fluid challenges at 2 different infusion rates; 5538 to the slower rate (333 mL/h) and 5514 to the control group (999 mL/h). Patients were also randomized to receive balanced solution or 0.9% saline using a factorial design. MAIN OUTCOMES AND MEASURESThe primary end point was 90-day survival.RESULTS Of all randomized patients, 10 520 (95.2%) were analyzed (mean age, 61.1 years [SD, 17.0 years]; 44.2% were women) after excluding duplicates and consent withdrawals. Patients assigned to the slower rate received a mean of 1162 mL on the first day vs 1252 mL for the control group. By day 90, 1406 of 5276 patients (26.6%) in the slower rate group had died vs 1414 of 5244 (27.0%) in the control group (adjusted hazard ratio, 1.03; 95% CI, 0.96-1.11; P = .46). There was no significant interaction between fluid type and infusion rate (P = .98).CONCLUSIONS AND RELEVANCE Among patients in the intensive care unit requiring fluid challenges, infusing at a slower rate compared with a faster rate did not reduce 90-day mortality. These findings do not support the use of a slower infusion rate.

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Introduction: In the present study, we aimed to describe the evolution of the healing of chronic leg ulcers using the Pressure Ulcer Scale for Healing (PUSH) tool. Methods: The data were collected from July 2010 to May 2011. The inclusion of patients in the study followed the order of arrival. The lesion was evaluated weekly according to the PUSH tool. Results: The study included 15 (30%) patients with diabetes and foot ulcers and 35 (70%) patients with venous ulcers. At the beginning of the data collection process, the average ulcer length and width were 9.26 cm 2 (range, 12.1-24.0 cm 2). At 9 months of treatment, the average ulcer length and width was 2.04 cm 2 (range, 0.3-0.6 cm 2). At the beginning of the study, the average amount of exudate was 1.71 (moderate amount), whereas at 9 months after the beginning of treatment, the average amount of exudate was 0.14 (absence of exudate). At 9 months of treatment, 19 (38%) patients had closed ulcers, 17 (34%) had ulcers with granulation tissue, and 14 (28%) had ulcers with epithelialized tissue. Conclusions: Use of the PUSH tool enabled monitoring of the ulcer healing process through the evaluation of length vs. width, exudate amount, and type of tissue present in the wound, thus favoring the selection of the correct dressing for each stage of wound healing.

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