Prolonged mechanical ventilation patient outcome after discharge from an intensive care unit

Background: Mechanical ventilation (MV) is one of the pillars of therapy in the Intensive Care Unit (ICU) as many patients require ventilatory support. This study aimed to analyze the outcome of Prolonged Mechanical Ventilation (PMV) patients after discharge from an Intensive Care Unit (ICU). Methods: This is a retrospective cross-sectional study of 142 medical charts of patients admitted to an ICU and a Special Care Unit (SCU) in Brazil from 2012 to 2014. Results: Participants’ mean age was 66.5 and the majority were men (58.5%). Outcome in the ICU was correlated with laparotomies before (p=0.043) and after (p=0.049) admission, sepsis (p=0.013), dialysis-requiring acute kidney injury (AKI) (p<0.001), and hemodynamic instability (p=0.003). Dialysis requiring AKI (p=0.012), non-dialysis-requiring AKI (p=0.023) and atelectasis (p=0.045) during ICU stay were correlated with death in SCU patients. Only hemodynamic instability (p=0.002) and diarrhea (p=0.045) were correlated with outcome in the SCU. Additionally, 91 (64.1%) PMV patients in the ICU were discharged to the SCU, 50 (35.2%) died, and one (0.7%) was transferred to another hospital. Furthermore, 15 (16.5%) SCU patients were discharged to the Home Care Program and one (1.1%) was transferred to another hospital. Conclusions: PMV patients exhibited longer hospital stay and higher mortality. Dialysis-requiring AKI and hemodynamic instability were associated with increased risk of death. Only a few PMV patients were successfully discharged or referred to Home Care.info:eu-repo/semantics/publishedVersio

Prevalence and health promotion actions related to hyposalivation and mouth discomfort in a nursing homesfor elders

Objectiveto verify the prevalence of hyposalivation inan institutionalized elder population and its relationship with oral discomfort. A cross-sectional study was conducted with older people living in a Nursing Homein Fortaleza-Brazil. Data collection occurred through the application of sociodemographic questionnaire; sialometry examination, test for evaluating the salivary flow speed; and by a subjective quantification of dry mouth intensity (Visual Analog Scale). Results: sixty-five older people aged between 61 and 91 years (mean74.5±8.0) were evaluated, 30(46.2%) were women and 35(53.8%) men. The majority had low monthly income (55;84.6%) and low schooling (44;67.7%). The mean salivary flow was 0.4 ±0.2, withvery low flow (0.1-0.3 ml/min) being more prevalent; females presented lower salivary flow (p=0.033) than males; there was an association between salivary flow and dry mouth sensation (p<0.001) and halitosis (p<0.001). The correlation between sialometry and VAS showed that the lower the salivary flow, the greater the perception of dry mouth sensation. Health promotion actions and treatment (proper hydration; tooth brushing; saliva stimulants) can be performed in order to minimize dry mouth/ hyposalivation impact on elders’ quality of life. Conclusion: Low salivary flow was prevalent in the study subjects. It interferes in oral discomfort and causes dry mouth sensation.info:eu-repo/semantics/publishedVersio

SUPLEMENTAÇÃO COM Bacillus toyonensis MODULA A PRODUÇÃO DE ANTICORPOS EM CAMUNDONGOS SENSIBILIZADOS COM ANTÍGENOS DE Leishmania (Leishmania) infatum chagasi

The aim of this study was to evaluate the effect of supplementation with the probiotic Bacillus toyonensis on the production of IgG, IgG1 and IgG2a antibodies against Leishmania (Leishmania) infantum chagasi antigens. Twenty-four female albino BALB/c mice, 21 days old, were immunized experimentally against L. (L.) infantum chagasi, divided into three experimental groups. Group A received no supplementation, group B was continuously supplemented until day 56 and in group C the probiotic was administered seven days before and seven days after each immunization for the same period. The experiment was conducted until day 84. Seroconversion was used to evaluate the humoral immune response. During the supplementation, all the animals presented total IgG seroconversion against the antigen used, without statistical difference (p&gt;0.05) between the groups. In the isotype analysis, the group supplemented with probiotic in the continuous period presented seroconversion results of the upper IgG2a / IgG1 ray when compared to the control group (1.8 times) and to that supplemented seven days before and seven days after supplementation (1.2 times) on day 70, keeping their titre superior to the groups in question until the end of the experiment (1.2 times on day 84). Based on these results, it can observed a greater ability of the supplemented group to continuously modulate favorably the humoral immune response and to maintain the production of IgG2a isotype antibodies against the antigen in question.Keywords: Canine leishmaniasis; probiotic; immune response.O estudo teve como objetivo avaliar o efeito da suplementação com o probiótico Bacillus toyonensis na cinética da produção de anticorpos IgG, IgG1 e IgG2a contra antígenos de Leishmania (Leishmania) infatum chagasi. Foram utilizados 24 camundongos BALB/c, fêmeas, tendo em média 21 dias de idade, sensibilizados experimentalmente contra L. (L.) infantum chagasi, divididos em três grupos experimentais. O grupo A não recebeu suplementação, o grupo B foi suplementado de forma contínua até o dia 56 e no grupo C o probiótico foi administrado sete dias antes e sete dias após cada sensibilização, pelo mesmo período. O experimento foi conduzido até o dia 84. Foi utilizada a soroconversão para avaliação da resposta imune humoral. Durante a suplementação todos os animais apresentaram soroconversão de IgG total contra o antígeno utilizado, sem ser identificada diferença estatística (p&lt;0,05) entre os grupos. Na análise de isotipagem, o grupo suplementado com probiótico no período contínuo apresentou resultados de soroconversão da razão IgG2a/IgG1 superior quando comparado ao grupo controle (1,8 vezes) e ao suplementado sete dias antes e sete dias após a suplementação (1,2 vezes) no dia 70, mantendo o seu título superior aos grupos em questão até o final do experimento (1,2 vezes no dia 84). Com base nesses resultados, pode-se observar maior habilidade do grupo suplementado continuamente modular favoravelmente a resposta imune humoral e manter a produção de anticorpos do isotipo IgG2a contra o antígeno em questão.Palavras-chave: Leishmaniose canina, probiótico, resposta imunológica

Barros Filho, Clóvis de y Karnal, Leandro (2016): Felicidade ou morte. Campinas, SP: Papirus 7 Mares, Coleção Papirus Debate

O livro proporciona ao leitor um diálogo entre seus dois autores, Clóvis de Barros Filho e Leandro Karnal, acerca da essência da felicidade dentro da civilização humana

Impacto psicossocial do isolamento durante pandemia de covid-19 na população brasileira: análise transversal preliminar

Este artigo trata de uma pesquisa quantitativa, descritiva e analítica da população brasileira em isolamento social (IS) durante pandemia do novo coronavírus, com o objetivo de identificar preditores de estresse psicossocial com dados recolhidos por questionário on-line nas redes sociais em abril de 2020. Do total de 3.836 pessoas participantes, prevaleceram: mulheres (2.821; 73,5%); faixa etária de 30 a 39 anos (1.101; 28,7%); com pós-graduação (2075;54,1%); estando em IS (3.447; 89,9%). Houve diferença significativa pelo fato de as pessoas estarem em IS: sentir medo de serem infectadas pelo coronavírus (p&lt;0,001); preocupação se alguém precisava sair de casa (p&lt;0,001); rotina modificada após o IS, destacando “entretanto conseguiram se adaptar à nova realidade”, comparado aos que “tiveram a rotina alterada sem conseguir se adaptar” (p&lt;0,001); tristeza ou preocupação, fazendo outras atividades como exercício físico, práticas religiosas, atividades lúdicas (p&lt;0,001); e não pensaram numa solução para esse problema (p&lt;0,001); além de mudança no padrão de sono (p=0,006). Os achados revelam a necessidade de discussão ampliada dos determinantes sociais da saúde, que devem envolver não só a doença, mas levar em consideração as relações sociais, as manifestações culturais e a economia, que podem impactar a saúde mental das pessoas.This is a quantitative, descriptive, and analytical study of the Brazilian population in social isolation (SI) during the novel coronavirus pandemic whose aim was to identify predictive factors for psychosocial stress using data collected by a social media-based online questionnaire administered in April 2020. Among the 3,836 participants, most were women (2,821; 73.5%), aged from 30 to 39 years (1,101; 28.7%), with postgraduate education (2,075;54.1%), and in SI (3,447; 89.9%). We found significant differences between individuals who were in SI and those who were not regarding: feeling afraid of being infected by the coronavirus (p&lt;0.001) and worried if someone had to leave the house (p&lt;0.001); changes in routine after self-isolating in those who managed to adapt to the new reality compared to those who could not adapt (p&lt;0.001); feeling sad and worried while doing other activities, such as physical exercise, religious practices, or recreational activities (p&lt;0.001); inability to imagine a solution to this problem (p&lt;0.001), and changes in sleep pattern (p=0.006). Our findings indicate the need for further discussions about the social determinants of health, addressing not only the disease per se, but also social relations, cultural manifestations, and the economy, which may impact people’s mental health