Background. Traumatic spinal cord injury (SCI) is a lesion that can affect several spinal structures, including the vertebrae, spinal cord, ligaments, and other adjacent parts of the spine. Traumatic spinal cord injury (SCI) can cause functional changes in patients of different ages. Material and methods. The study aims to determine whether there are social, clinical, and radiological differences between young, middle-aged, and elderly adults with SCI caused by a ground-level fall. This retrospective study analyzed the records of patients with a clinical diagnosis of SCI. It enrolled patients with traumatic spinal cord injury after a ground-level fall divided as follows: young aged adults 18–35 years of age (G1); middle-aged adults aged 36–60 years (G2); and elderly adults aged over 60 years (G3). Their clinical, social, and radiological variables were analyzed. Results. It is observed that low schooling level, being widowed, and being a homemaker were more frequently encountered among elderly adults, whereas being single was more common in middle-aged adults. The morphologic diagnosis of compression fracture and the associated injury of facial trauma occurred more frequently in elderly adults, with an increasing tendency with age. Conservative therapeutic management was most commonly encountered in elderly adults, compared to surgery from a posterior approach in middle-aged adults. Listhesis was better identified in middle-aged adults by computed tomography (CT). Spinal cord contusion and injury to the C1 vertebra were demonstrated in young adults by magnetic resonance imaging (MRI). Conclusions. 1. Elderly adults with low education level, widowed, and homemakers were more susceptible to SCI caused by a fall. 2. Single marital status was more frequently noted in young adults. 3. The most frequent clinical aspects were the morphological aspect of compression fracture and fa­cial trauma as an associated injury in elderly adults, with the occurrence of facial trauma increasing with age. 4. Conservative therapeutic management was more common in elderly adults than surgery from a po­sterior approach in middle-aged adults. 5. Re­garding the radiological aspects of CT, listhesis was better identified in middle-aged adults. Spi­nal cord contusions and C1 vertebra lesions were better identified in young adults by MRI.

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.

Objetivo: Avaliar os efeitos da fisioterapia nas experiências positivas com o parto em um hospital na região Amazônica oriental. Método: Estudo piloto, intervencional, não-randomizado, com abordagem quantitativa e análises descritivas e inferenciais. Foram coletadas variáveis sociodemográficas, econômicas, histórico obstétrico e variáveis do parto; A experiência positiva no parto foi avaliada pela subescala do questionário de experiência e satisfação com o parto. Resultados: Participaram 43 parturientes, alocadas em grupo intervenção (GI) e grupo controle (GC); ambos os grupos apresentaram experiência positiva moderada; as mulheres que realizaram fisioterapia consideraram-se um membro útil e cooperativo com a equipe médica que a acompanhou; as primíparas no GI foram 80,9% e no GC 54,5%; observa-se que mulheres primíparas apresentaram associação com a presença de laceração (RR: 2,05 [IC 95%: 1,08; 3,91]; p = 0,007) e houve associação entre infecção do trato urinário inferior (ITU) e laceração (RR: 2,02; IC: 1,20; 3,39; p: = 0,003); mulheres que sofreram laceração tiveram um tempo de trabalho de parto maior (laceração(+): 18,50 horas [IC 95%: 11,33; 39,79]; laceração(-): 6,00 [IC 95%: -5,052;  33,95]; U: 78,00; p = 0,013). Conclusão: As mulheres que realizaram fisioterapia apresentaram como experiência positiva o fato de se considerarem um membro útil e cooperativo com a equipe médica que a acompanhou durante o parto. Além disso, observa-se que a primiparidade foi associada a laceração, sendo esta aumentada junto com o tempo de trabalho de parto e presença de ITU.

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)

Background: The aim of this study was to analyze the influence of sociodemographic and clinical variables as determinants of mortality and survival in patients with ST-segment elevation acute myocardial infarction in the Eastern Amazon. Design and methods: This observational, longitudinal, and retrospective study was conducted at the Gaspar Vianna Clinical Hospital Foundation in patients hospitalized from January 2017 to June 2020. Patients were divided into two groups: those who survived (G1) ( n = 646) and those who died (G2) ( n = 37). Sociodemographic and clinical variables associated with mortality and survival in these two groups were analyzed. Results: Patients with STEMI who had the highest risk of death were often the oldest (G1: 61.58 ± 10.74 years; G2: 69.57 ± 9.02 years; t = −4.492; p = 0.001), with Killip III-IV classifications (OR = 0.13; 95% CI = 0.02–0.71; p = 0.03), and with diseases such as heart failure (OR = 0.07; 95% CI = 0.004–1.50; p = 0.168) or renal failure (OR = 0.03; 95% CI = 0.006–0.16; p = 0.0001). In addition, female sex (hazard ratio = 2.073; 95% CI = 1.413–5.170), Killip III-IV classifications (hazard ratio = 4.041; 95% CI = 1.703–18.883) and the presence of heart failure (hazard ratio = 34.102; 95% CI = 4.410–263.684) or renal failure (hazard ratio = 14.278; 95% CI = 3.275–62.248) shortened in-hospital survival. Conclusions: Specific sociodemographic and clinical aspects influenced mortality and survival in patients with acute ST -elevation myocardial infarction.