INFLUÊNCIA DA FISIOTERAPIA NA SÍNDROME DO IMOBILISMO

A síndrome da imobilidade é um conjunto de alterações que ocorrem no indivíduo acamado por um período de tempo prolongado podendo levar alterações no sistema osteomusculares, dificultando as atividades de vida diária. O tratamento fisioterápico é uma ferramenta importante para diminuir os danos causados pelo imobilismo. Foi realizado 20 sessões de fisioterapia, em duas pacientes do sexo feminino, com idade de 87 anos (paciente 1) e 74 anos (paciente 2) acamadas a mais de um mês, ambas com diagnóstico de Doença de Alzheimer, apresentavam quadro de incapacidade funcional, diminuição da amplitude de movimento e da força muscular. Foi realizada mobilizações articulares de membros superiores e inferiores, alongamentos e relaxamento. A paciente 2 além de receber o tratamento acima descrito, recebeu o tratamento com Estimulação Elétrica Funcional (FES) por 10 minutos. O FES é uma corrente de baixa frequência, indicada para fortalecimento muscular, manutenção de ADM, entre outros. A paciente 1 não apresentou melhora em seu quadro motor, a paciente 2 melhorou sua capacidade funcional, sua ADM, retração muscular e ganho de força muscular. Portanto é importante entender o grande número de comorbidades que envolvem o paciente submetido à imobilidade, pois o tornam mais suscetível as complicações, perda funcional e incapacidades

Review Article Renal Biopsy: Use of Biomarkers as a Tool for the Diagnosis of Focal Segmental Glomerulosclerosis

Focal segmental glomerulosclerosis (FSGS) is a glomerulopathy associated with nephrotic syndrome and podocyte injury. FSGS occurs both in children and adults and it is considered the main idiopathic nephrotic syndrome nowadays. It is extremely difficult to establish a morphological diagnosis, since some biopsies lack a considerable quantifiable number of sclerotic glomeruli, given their focal aspect and the fact that FSGS occurs in less than half of the glomeruli. Therefore, many biological molecules have been evaluated as potential markers that would enhance the diagnosis of FSGS. Some of these molecules and receptors are associated with the pathogenesis of FSGS and have potential use in diagnosis

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Effect of capacitive radiofrequency on the dermis of the abdominal region

The purpose of this study is to evaluate the effects of radiofrequency (RF) on sagging skin. This is a case series study with five volunteers who received a single application of capacitive RF (BTL-6000 TR-Therapy Pro®) in the right infraumbilical abdominal region, with epidermal temperature above 40°C, for 10 min (2 min per applicator area), and the skin of the contralateral region was used as control. After 30 days, on average, the skin of the abdominal region was collected for histological analysis and stained with hematoxylin and eosin, Picro-sirus, and Verhoff. The percentage of collagen and elastic fibers found was marked by the Image J®. The statistical analysis was performed in the SPSS program (version 20), with a significance level of 95%. This was registered with the ethics and research comitee of UFTM n 3.461.688 on Jul 12, 2019 and clinical trial registration n. NCT04182542, retrospectively registered. Morphometric analysis demonstrated a remodeling of collagen and elastic fibers on the side treated with RF; however, the morphometry for collagen showed no significant difference, with an average percentage of 60.94 ± 0.32 for the control side and 61.97 ± 2.80 for the treated with p=0.32. Similarly, elastic fibers also showed no significant difference between groups, with a mean percentage of 5.67 ± 2.70 for control and 6.21 ± 2.01 for treated with p=0.19. The RF with the parameters used in this study was able to cause morphological changes in collagen and elastic fibers of the abdominal region skin; however, it showed no change in the percentage of these fibers.info:eu-repo/semantics/publishedVersio

Computing with Words -- When Results Do Not Depend on the Selection of the Membership Function

Often, we need to transform natural-language expert knowledge into computer-understandable numerical form. One of the most successful ways to do it is to use fuzzy logic and membership functions. The problem is that membership functions are subjective. It is therefore desirable to look for cases when the results do not depend on this subjective choice. In this paper, after describing a known example of such a situation, we list several other examples where the results do not depend on the subjective choice of a membership function

Renal Biopsy: Use of Biomarkers as a Tool for the Diagnosis of Focal Segmental Glomerulosclerosis

Focal segmental glomerulosclerosis (FSGS) is a glomerulopathy associated with nephrotic syndrome and podocyte injury. FSGS occurs both in children and adults and it is considered the main idiopathic nephrotic syndrome nowadays. It is extremely difficult to establish a morphological diagnosis, since some biopsies lack a considerable quantifiable number of sclerotic glomeruli, given their focal aspect and the fact that FSGS occurs in less than half of the glomeruli. Therefore, many biological molecules have been evaluated as potential markers that would enhance the diagnosis of FSGS. Some of these molecules and receptors are associated with the pathogenesis of FSGS and have potential use in diagnosis

Nodular glomerulosclerosis in a non-diabetic hypertensive, dyslipidemic, smoker patient: a case report

Abstract Introduction: This is a case report of a patient with idiopathic nodular glomerulosclerosis whose pathogenesis and morphology are similar to diabetic nephropathy. Case presentation: A 64-year-old Brazilian man, leukoderma, dyslipidemic, obese with chronic obstructive pulmonary disease secondary to tobacco smoking, known to be hypertensive for five years and he had no history of diabetes. He was admitted with sudden anasarca, rapid loss of renal function and needed to start hemodialysis immediately. Renal biopsy was performed, and the sections were examined by light microscopy, immunofluorescence and electron microscopy. Morphological and ultrastructural findings showed that the profile of the disease studied herein strongly resembles diabetic nephropathy. However, the absence of diabetes mellitus, the presence of arteriolar hyalinosis in renal arterioles, tobacco smoking, and other clinical factors observed can play a significant role in nodular formation. Conclusion: The clinical features of the patient, and most importantly, the fact that he is a smoker, favor the diagnosis of "nodular glomerulosclerosis associated with smoking", a nomenclature proposed by some authors as an alternative to the term idiopathic nodular glomerulosclerosis. This clinical case report highlights idiopathic nodular glomerulosclerosis as a rare disease of little known etiopathogenesis; thus, further studies are necessary in order to elucidate the causes of this disease