Diabetes Mellitus: a risk factor for drug toxicity. / Diabetes Mellitus: fator de risco para toxicidade de medicamentos.

OBJECTIVE: To assess the effect of the antibiotic Gentamicin in an experimental model in the presence of Diabetes Mellitus through renal function and oxidative profile. METHOD: Adult male Wistar rats were distributed into groups: Citrate; Gentamicin (Genta), (intraperitoneal, i.p. gentamicin, 100 mg/kg of body weight, once a day,5 days); DM (60 mg/kg of STZ (Streptozotocin), single dose, intravenously, i.v., diluted in citrate buffer); and DM+Genta. Physiological parameters, renal function (creatinine clearance), oxidative damage (peroxides and thiobarbituric acid reactive substances - urinary TBARS) and renal hemodynamics were evaluated. RESULTS: The Diabetes Mellitus group presented chronic hyperglycemia associated with loss of body weight, polyphagia, polydipsia and polyuria, in addition to reduced renal function and with an increase in oxidative metabolite excretion. Administration of gentamicin induced a reduction in renal blood flow and increased renal vascular resistance in healthy rats. The association of Diabetes Mellitus with gentamicin resulted in an additional reduction in renal function and elevation of oxidative metabolites, with increased renal vascular resistance. CONCLUSION: The existence of Diabetes Mellitus resulted in an elevation of gentamicin nephrotoxicity, thus confirming the risk factor for drug nephrotoxicity.

Prevention of amphotericin B nephrotoxicity through use of phytotherapeutic medication. / Prevenção da nefrotoxicidade da anfotericina B por meio do uso de fitomedicamentos.

Objective To evaluate the effect of diosmin and hesperidin flavonoids in the prevention of amphotericin B nephrotoxicity, through an experimental model on rats. Method Adult, male Wistar rats were distributed into the following groups: saline; diosmin hesperidin (animals that received 50 mg/kg of diosmin hesperidin, drinking water, for ten days); amphotericin B (animals that received 15 mg/kg/day of amphotericin B through intraperitoneal treatment for five days); amphotericin B+diosmin hesperidin. Renal function, fractional excretion of sodium; potassium and magnesium and oxidative metabolites were evaluated. Results Treatment with amphotericin B reduced renal function, as shown by the clearance of creatinine, increased tubular function markers and fractional excretion of sodium, potassium, magnesium and oxidative metabolites. Pre-treatment with diosmin hesperidin ameliorated clearance of creatinine and reduced tubular and oxidative injury. Conclusion Administration of amphotericin B resulted in reduction of renal function with tubular injury, and diosmin hesperidin showing an antioxidant protective effect on the kidneys.

[Antioxidant protection of statins in acute kidney injury induced by sepsis]. / Proteção antioxidante da estatina na lesão renal aguda induzida pela sepse.

OBJECTIVE: Evaluating the effect of preconditioning with simvastatin in acute kidney injury induced by sepsis. METHOD: Male adult Wistar rats were divided into the following groups: SHAM (control); SHAM+Statin (0.5 mg/kg simvastatin, orally); Sepsis (cecal puncture ligation - CPL); Sepsis+Statin. Physiological parameters, peritoneal fluid culture, renal function, oxidative metabolites, severity of acute kidney injury and animal survival were evaluated. RESULTS: The treatment with simvastatin in induced sepsis showed elevation of creatinine clearance with attenuation of generation of oxidative metabolites, lower severity of acute kidney injury and reduced mortality. CONCLUSION: This investigation confirmed the renoprotection with antioxidant principle of the simvastatin in acute kidney injury induced by sepsis in an experimental model.

Sepsis and COVID-19: outcomes in young adults in intensive care.

OBJECTIVE: to verify sepsis incidence among young adults admitted to intensive care due to COVID-19 and to analyze its association with demographic, clinical and outcome variables. METHODS: a quantitative, longitudinal, retrospective and analytical study, consisting of 58 adults aged 20 to 40 years in intensive care for SARS-CoV-2. It was carried out in a university hospital, from March 2020 to December 2021, with data collected from electronic medical records. RESULTS: sepsis incidence was 65%. Sepsis was associated with acute kidney injury, use of vasoactive drugs and mechanical ventilation, being admitted to the emergency room, severity according to the Simplified Acute Physiology Score III and bacterial pulmonary co-infection, the latter being the most frequent etiology for sepsis. CONCLUSIONS: there was a high sepsis incidence, with 42% of deaths, which points to the importance of investing in preventive measures, especially in relation to bacterial pulmonary coinfections.

Contrast-induced acute kidney injury in patients submitted to coronary angioplasty: prospective cohort.

OBJECTIVE: To analyze the incidence, risk factors, and associations of clinical outcomes for contrast-induced acute kidney injury (CI-AKI) in patients with acute coronary syndrome (ACS) after coronary angioplasty. METHOD: Prospective cohort of 182 patients followed for three months after undergoing angioplasty, from July 2020 to June 2021. The analyzed variables were sociodemographic, clinical, and those related to the procedure. RESULTS: The incidence of CI-AKI was 35.7% (n = 65) and was associated with old age, diabetes mellitus, and chronic kidney disease (p = 0.004, p < 0.001, and p = 0.009, respectively). Out of the 17 patients who died within 90 days, 76.5% had CI-AKI (n = 13), the odds ratio between death and CI-AKI was approximately 7.2 times (95% confidence interval (CI), [2.41;26.36]; p = 0.001). The decrease of one unit in the patient's baseline hemoglobin showed a 6.5% increase for CI-AKI (95% CI, [-0.089; -0.040]; p < 0.0001). CONCLUSION: CI-AKI is prevalent in patients with ACS after angioplasty and is related to diabetes mellitus and chronic kidney disease, showing high mortality rates.

The renoprotective effects of Heme Oxygenase-1 during contrast-induced acute kidney injury in preclinical diabetic models.

OBJECTIVES: Contrast-induced acute kidney injury (CI-AKI) is an important clinical problem that can be aggravated by diabetes mellitus, a major risk factor. However, heme oxygenase-1 (HO-1), a promising therapeutic target, can exert antioxidant effects against CI-AKI. Thus, we investigated the role of HO-1 in CI-AKI in the presence of diabetes mellitus. METHODS: Twenty-eight male Wistar rats weighing 250-300g were subjected to left uninephrectomy, and concomitantly, diabetes induced by streptozotocin (65 mg/kg). After 12 weeks, iodinated contrast (meglumine ioxithalamate, 6 mL/kg) and hemin (HO-1 inducer-10 mg/k) were administered 60 min before iodinated contrast treatment. The rats were randomly divided into four groups: control, diabetes mellitus (DM), DM iodinated contrast (DMIC), and DMIC hemin (DMICH). Kidney function, albuminuria, oxidative profile, and histology were assessed. All experimental data were subjected to statistical analyses. RESULTS: CI-AKI in preclinical diabetic models decreased creatinine clearance and increased urinary neutrophil gelatinase-associated lipocalin (NGAL) levels and the degree of albuminuria. Additionally, the levels of oxidative and nitrosative stress metabolites (urinary peroxides, thiobarbituric acid-reactive substances, and NO) were elevated, while thiol levels in kidney tissue were reduced. Kidney histology showed tubular cell vacuolization and edema. HO-1 inducer treatment improved kidney function and reduced urinary the NGAL levels. The oxidative profile showed an increase in the endogenous thiol-based antioxidant levels. Additionally, the tubular injury score was reduced following HO-1 treatment. CONCLUSIONS: Our findings highlight the renoprotective effects of HO-1 in CI-AKI and preclinical diabetic models. Therefore, HO-1 ameliorates kidney dysfunction, reduces oxidative stress, and prevents cell necrosis.

Factors associated with urinary tract infection in a Nursing Home.

OBJECTIVE: to analyze the factors associated with urinary tract infection occurrence in institutionalized elderly. METHODS: this is a cross-sectional, analytical, quantitative study with 116 elderly people from a Nursing Home. Urinary tract infection diagnosis was carried out through urine culture and clinical assessment. Demographic data and associated factors were obtained from medical records. Statistical analysis included bivariate analysis and logistic regression models. RESULTS: the factors associated with urinary tract infection (p<0.05) were being female; wheelchair user; diaper use; diuretic use; urinary and bowel incontinence; type 1 diabetes; benign prostatic hyperplasia; dehydration. CONCLUSION: this study revealed that it is important to consider non-modifiable factors such as sex and clinical comorbidities; however, dehydration, a modifiable factor, increased the chances of developing urinary tract infections by 40 times among institutionalized elderly and demands greater attention from the health team.

Prevalence of latent tuberculosis and associated factors in patients with chronic kidney disease on hemodialysis.

OBJECTIVE: to identify the prevalence of latent tuberculosis in patients with chronic kidney disease on hemodialysis and associated factors. METHOD: a cross-sectional study conducted with 176 patients with chronic kidney disease on hemodialysis. The tuberculin test was performed with the standardized antigen, distributed by the Brazilian Ministry of Health, and the reading occurred after 72 to 96 hours of the application. An association test (Chi-square, Fisher's exact), prevalence ratio, and multivariate regression tests were performed. RESULTS: the prevalence of latent tuberculosis diagnosed through Tuberculosis Skin Test was 8.5% (15/176). The "has/has had diabetes" (aOR: 0.117; 95%CI: 0.015-0.92) and "having regular garbage collection (aOR: 0.076; 95%CI: 0.008-0.702) factors were associated with a lower probability of having a Positive skin test. CONCLUSION: the low prevalence of latent tuberculosis identified and the factors associated with it reinforce the need for screening for latent tuberculosis infection for diabetics combined with an analysis of previous risk factors and comorbidities.

Urinary tract infection in patients with chronic kidney disease under conservative treatment.

OBJECTIVES: to assess the prevalence and associated risk factors for urinary tract infection in patients with chronic kidney disease under conservative treatment and identify the microorganisms isolated in the urine of these patients and the staging of chronic kidney disease. METHODS: a cross-sectional, analytical study carried out at the Conservative Treatment Outpatient Clinic of a university hospital in the city of São Paulo. RESULTS: the prevalence of urinary tract infection is 22%. The risk factors Diabetes Mellitus, hypertension, heart disease, neoplasms and thyroid and autoimmune diseases stand out in the infected group (p < 0.001). Most of the microorganisms found in urine cultures (87.9%) were Gram-negative, being Escherichia coli (50.70%), followed by Klebsiella pneumoniae (23.1%) and Enterococcus spp. (9.7%). CONCLUSIONS: the findings of this investigation reveal the intrinsic association between risk factors and microorganisms for the development of urinary tract infection.

Infectious events in kidney transplant recipients from deceased expanded criteria donors: a prospective cohort.

OBJECTIVE: Analyze risk factors for infection in kidney transplant recipients from deceased expanded criteria donors (DECD) in the first two years of follow-up. METHOD: This is a prospective cohort study with 466 patients from DECD who underwent kidney transplantation in 2015 and 2016 in Brazil. A total of 551 events were recorded. The largest incidence of infectious events occurred in the first month after kidney transplantation. Cytomegalovirus infection was the most common infectious episode. RESULTS: The incidence rate of infections was 57.1%. Among bacterial infections, only 4% were due to multidrug-resistant microorganisms. The death rate was 3.3% (15) patients. The main cause of death was infectious (73.3%). Hospitalization until the first infection (aOR:1.61), Number of infections in 1 year (aOR:40.16), and Cytomegalovirus infection (aOR:13.84) was risk factors for infection by multidrug resistant microorganisms (MDR). CONCLUSION: Infection incidence with MDR bacteria was high among kidney transplant recipients from DECD, and the main cause of death was infection. Survival was high among patients with infection.

Acute Kidney Injury by SARS-CoV-2 virus in patients with COVID-19: an integrative review.

OBJECTIVE: to assess scientific evidence on SARS-CoV-2 Acute Kidney Injury in patients with COVID-19. METHODS: an integrative review, with adoption of PICO strategy and classification of the level of evidence, carried out on April 10, 2020 in the PubMed database, of articles available between December 2019 and April 2020. RESULTS: the sample consisted of six original, five observational and one experimental articles. Observational studies addressed the clinical findings of patients with COVID-19 and association between kidney damage, infection, and morbidity-mortality. CONCLUSION: the studies addressed the mechanism of intracellular infection of SARS-CoV-2, its cytopathic effects on kidney cells and incidence of acute kidney injury in patients infected with SARS-CoV-2. Acute kidney injury is associated with increased mortality and morbidity in these patients. This review realizes the need for new research that can mention kidney care to patients with COVID-19.

Contrast-Induced Nephropathy in patients submitted to percutaneous coronary intervention: an integrative review.

OBJECTIVE: to demonstrate scientific evidence on incidence and factors associated with contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. METHODS: an integrative review carried out in the VHL, PubMed, VHL Regional Portal and SciELO databases, of articles published between 2014 and 2019. RESULTS: the sample consisted of five original articles, two cohorts, two control cases and a clinical trial. The incidence of contrast-induced nephropathy ranged from 6% to 24%. It stands out among patients with advanced age, male gender, diabetes mellitus, systemic arterial hypertension, volume of contrast infused and osmolarity. Intravenous hydration, sodium bicarbonate, ascorbic acid and statin were important prophylactic agents. CONCLUSION: this study envisioned the main risk factors for contrast-induced nephropathy in patients undergoing percutaneous coronary intervention and elucidated preventive measures that guide multidisciplinary health care aiming at a quality and safe care.

Quality of life and spirituality of patients with chronic kidney disease: pre- and post-transplant analysis.

OBJECTIVE: to compare the quality of life (QoL) of patients under dialysis and after kidney transplant; correlate the QoL of transplant patients to sociodemographic, morbid and spirituality/religiosity variables. METHOD: prospective study with a quantitative approach, with a sample of 27 patients who underwent peritoneal dialysis or dialysis undergoing kidney transplant. QoL and spirituality were assessed by the KDQOL-SF and WHOQOL-SRPB tools, being correlated with sociodemographic and economic variables. RESULTS: the dimensions of total mental component, kidney disease effects and kidney disease burden showed significant improvement in the post-transplant period, with p <0.0004. There was a significant correlation between four dimensions of spirituality and seven dimensions of QoL; p ranged from 0.04 to 0.006. CONCLUSION: there was a significant improvement in QoL in the post-transplant period. The dimensions of spirituality: wholeness and integration, spiritual connection, wonder and inner peace were positively correlated with seven dimensions of QoL.

Effects of Justicia acuminatissima, or Amazonian Sara Tudo, on ischemic acute kidney injury: an experimental study. / Efeito da Justicia acuminatissima, Sara Tudo do Amazonas, na injúria renal aguda isquêmica: estudo experimental.

OBJECTIVE: To evaluate the effects of Justicia acuminatissima , or Amazonian Sara Tudo , on renal hemodynamics, oxidative profile, and renal histology in rats with ischemic acute kidney injury. METHOD: Preclinical assay with adult male Wistar rats, weighing from 250 g to 350 g, distributed into Sham, ischemia, and ischemia + Sara Tudo groups. Hemodynamic parameters, renal function, oxidative stress, and renal histology were evaluated. RESULTS: Pretreatment with Sara Tudo reduced the functional injury, which was shown by the increase in creatinine clearance and thiols; reduction of oxidative markers, renal vascular resistance, and tubulointerstitial injury in the renal tissue; and the significant improvement in renal blood flow. CONCLUSION: The renoprotection provided by Justicia acuminatissima , or Sara Tudo , in cases of ischemic acute kidney injury was characterized by a marked improvement in renal function, reducing the oxidative injury, and impacting on renal histology positively.

Training in recovery, perfusion and packaging of organs for transplants: profile of professionals and analysis of post-course learning.

OBJECTIVE: To understand the profile of professionals working in organ harvesting, and analyze the learning results of those trained before and after the course on recovery, perfusion and packaging of organs for transplants. METHODS: A retroprospective, quantitative, analytical-descriptive study about the Course on Recovery, Perfusion and Packaging of Liver and Kidney, in the period from 2012 to 2014. Pre- and post-tests, with ten questions were used to assess knowledge about organ harvesting. The association of knowledge with applied content was verified by the McNemar test. RESULTS: Of the total of 334 participants, 187 (56.0%) were physicians, 104 (31.1%) nurses, and 43 (12.9%) scrub nurses. The majority of participants was male (58.4%), mean age of 39.1 years, 50% had graduated 5 to 10 years before, and 50.4% had less than one-year experience in organ harvesting. In knowledge assessment, there was an increase in the weighted mean, from 6.1 in the pre-test to 7.9 in the post-test. A significant increase in learning was observed in the post-test in 50% of scrub nurses, 33.3% in nurses 20% in physicians. CONCLUSION: The professionals were starting work in organ harvesting, and most were from Southeastern, Northeastern and Northern regions. In terms of learning, the course contributed to enhancing knowledge of the multiprofessional health team, and represented better learning standard.

Lesão renal aguda e COVID-19 em adultos jovens na terapia intensiva / Lesión renal aguda y COVID-19 en adultos jóvenes en cuidados intensivos / Acute kidney injury and COVID-19 in young adults in intensive care

Resumo Objetivo Descrever a prevalência de lesão renal aguda em adultos jovens com diagnóstico da COVID-19 admitidos em unidade terapia intensiva. Métodos Estudo retrospectivo, quantitativo e analítico. A amostra foi de adultos jovens (20 a 40 anos) admitidos em unidades de terapia intensiva, com diagnóstico de infecção por SARS-CoV-2 entre março e dezembro de 2020. Os dados foram obtidos por meio do prontuário eletrônico, e a lesão renal aguda foi definida pelo valor da creatinina, segundo critérios das diretrizes da Kidney Disease Improving Global Outcomes. A significância estatística foi de p≤0,05. Resultados Foram internados 58 adultos jovens, sendo 63,8% do sexo masculino. A hipertensão arterial sistêmica esteve presente em 39,6%, a obesidade em 18,9% e o diabetes mellitus em 8,6%. A lesão renal aguda foi identificada em 55,1%, sendo o estágio 3 predominante em 43,1% deles. Nesses pacientes, o uso de ventilação mecânica e de drogas vasoativas foi significativo em 92%, assim como a disfunção orgânica respiratória (80%), seguida da renal (76%). Fatores de risco, como transplante renal ou doença renal crônica e obesidade, aumentaram em 12,3 e 9,0 vezes, respectivamente, a chance de desenvolver lesão renal aguda. Conclusão Este estudo demonstrou alta prevalência de lesão renal em adultos jovens e sua associação com comorbidades prévias. Obesidade, transplante renal e doença renal crônica elevaram a chance de o adulto jovem desenvolver lesão renal aguda, resultando em desfechos a favor da morbimortalidade.

Resumen Objetivo Describir la prevalencia de lesión renal aguda en adultos jóvenes con diagnóstico de COVID-19 admitidos en unidad de cuidados intensivos. Métodos Estudio retrospectivo, cuantitativo y analítico. La muestra fue de adultos jóvenes (20 a 40 años) admitidos en unidades de cuidados intensivos, con diagnóstico de infección por SARS-CoV-2 entre marzo y diciembre de 2020. Los datos se obtuvieron por medio de historias clínicas electrónicas, y la lesión renal aguda fue definida por el valor de la creatinina, de acuerdo con criterios de las directrices de la Kidney Disease Improving Global Outcomes. La significación estadística fue de p≤0,05. Resultados Hubo 58 adultos jóvenes internados, el 63,8 % de sexo masculino. La hipertensión arterial sistémica estuvo presente en el 39,6 %, la obesidad en el 18,9 % y la diabetes mellitus en el 8,6 %. Se identificó lesión renal aguda en el 55,1 %, de nivel 3 como predominante en el 43,1 % de los casos. En esos pacientes, el uso de ventilación mecánica y de drogas vasoactivas fue significativo en el 92 %, así como también la disfunción orgánica respiratoria (80 %), seguida de la renal (76 %). Los factores de riesgo, como trasplante renal o enfermedad renal crónica y obesidad, aumentaron 12,3 y 9,0 veces respectivamente la probabilidad de presentar lesión renal aguda. Conclusión Este estudio demostró alta prevalencia de lesión renal en adultos jóvenes y su asociación con comorbilidades previas. La obesidad, el trasplante renal y la enfermedad renal crónica aumentaron la probabilidad de que los adultos jóvenes presenten lesión renal aguda, lo que da como resultado desenlaces a favor de la morbimortalidad.

Abstract Objective To describe acute kidney injury prevalence in young adults diagnosed with COVID-19 admitted to the Intensive Care Unit. Methods This is a retrospective, quantitative and analytical study. The sample consisted of young adults (20 to 40 years old) admitted to Intensive Care Units, diagnosed with SARS-CoV-2 infection between March and December 2020. Data were obtained through electronic medical records, and kidney injury acute was defined by the creatinine value, according to the Kidney Disease Improving Global Outcomes guidelines criteria. Statistical significance was p≤0.05. Results A total of 58 young adults were hospitalized, 63.8% of whom were male. Hypertension was present in 39.6%, obesity in 18.9%, and diabetes mellitus in 8.6%. Acute kidney injury was identified in 55.1%, with stage 3 predominating in 43.1% of them. In these patients, the use of mechanical ventilation and vasoactive drugs was significant in 92% as well as respiratory organ dysfunction (80%), followed by renal organ dysfunction (76%). Risk factors such as kidney transplantation or chronic kidney disease and obesity increased by 12.3 and 9.0 times, respectively, the chances of developing acute kidney injury. Conclusion This study demonstrated a high kidney injury prevalence in young adults and its association with previous comorbidities. Obesity, kidney transplantation and chronic kidney disease increased the chance of young adults to develop acute kidney injury, resulting in outcomes in favor of morbidity and mortality.

Sepsis-induced acute kidney injury: kidney protection effects by antioxidants.

OBJECTIVE: To evaluate the antioxidant action of N-acetylcysteine and diosmin-hesperidin in an experimental model of sepsis-induced acute kidney injury in rats. METHODS: The study used 20 Wistar adult male rats divided into the following groups: control (laparotomy with no induction of abdominal sepsis), sepsis (experimental model of sepsis with cecal ligation and puncture), N-acetylcysteine + sepsis and diosmin-hesperidin + sepsis. The evaluation contemplated physiological parameters (temperature, glycemia, and average blood pressure), kidney function (creatinine clearance), oxidative stress (urinary peroxides) and kidney histology. RESULTS: The animals submitted to cecal ligation and puncture (sepsis) presented lower body temperature, lower average blood pressure, reduced creatinine clearance and increased urinary hydrogen peroxide levels. Treatment with diosmin-hesperidin improved kidney function and led to a reduction in the excretion of oxidative metabolites. CONCLUSION: The present study highlighted the protective antioxidant action of diosmin-hesperidin in the experimental model of sepsis-induced acute kidney injury.

Use of vitamin D and infection in patients with chronic kidney disease.

OBJECTIVE: To evaluate the effectiveness of vitamin D supplementation as protection factor against infection of patients with chronic kidney disease on conservative treatment. METHOD: Retrospective cohort study carried out between 2013 and 2016 in the Conservative Treatment Outpatient Clinics (Ambulatório de Tratamento Conservador) of the Hypertension and Kidney Hospital (Hospital do Rim e Hipertensão) of the Universidade Federal de São Paulo. Data on sociodemographic factors, comorbidity, infection episodes and use or nonuse of vitamin D supplementation for at least 6 months were collected from medical records. The primary outcomes considered in both groups were: presence or absence of infection anywhere on the body (bloodstream, urinary, respiratory and surgical sites). RESULTS: A total of 263 patients were included and those who received (n=43) vitamin D had 59% less chance of developing infections (OR=0.41; 95%CI; 0.15-0.99), when compared to those who did not receive. CONCLUSION: Vitamin D supplementation was a protective factor against infections of all causes.

Qualidade do sono e burnout em docentes do ensino superior / Sleep quality and burnout in higher education teachers

RESUMO Objetivo avaliar a associação da qualidade do sono e presença da síndrome de burnout com o perfil epidemiológico de docentes do ensino superior. Métodos estudo observacional, analítico, do tipo transversal, realizado com 140 docentes, por meio do Índice de Qualidade do Sono de Pittsburgh e Maslach Burnout Inventory. Resultados na amostra, a maioria era do sexo feminino (54,3%), com idades entre 26 e 40 anos (58,6%). Houve predomínio de docentes com título de especialista (48,6%), com faixa salarial de até R$ 5.000,00 (85,7%), com dois ou mais vínculos empregatícios (52,1%). Constatou-se que docentes que recebiam mais de R$ 5.000,00 (p=0,003), com dois ou mais empregos, classificaram a eficiência habitual do sono como ruim/muito ruim (p=0,027). Todavia, aqueles com qualidade subjetiva do sono boa apresentaram menores escores nos domínios Exaustão emocional (p=0,005) e Despersonalização em relação à referida síndrome (p=0,023). Conclusão diversos fatores colaboram para o desenvolvimento de distúrbios relacionados ao sono na classe docente, tornando-a mais suscetível à manifestação do burnout. Contribuições para a prática os resultados podem subsidiar medidas preventivas para a saúde dos docentes e manutenção da qualidade de suas atividades laborais, visando diminuir o efeito-mediação das variáveis que favorecem o esgotamento psicológico.

ABSTRACT Objective to evaluate the association of sleep quality and the presence of burnout syndrome with the epidemiological profile of higher education teachers. Methods an observational, analytical, cross-sectional study of 140 teachers, using the Pittsburgh Sleep Quality Index and the Maslach Burnout Inventory. Results in the sample, the majority was female (54.3%), aged between 26 and 40 years (58.6%). There was a predominance of teachers with a specialist title (48.6%), with a salary range of up to R$ 5,000.00 (85.7%), with two or more employment relationships (52.1%). It was found that teachers who received more than R$ 5,000.00 (p=0.003), with two or more jobs, classified the usual sleep efficiency as poor/feeble (p=0.027). However, those with good subjective sleep quality had lower scores in the Emotional exhaustion (p=0.005) and Depersonalization domains in relation to the syndrome (p=0.023). Conclusion several factors contribute to the development of sleep-related disorders in teachers, making them more susceptible to the manifestation of burnout. Contributions to practice the results can support preventive measures for the health of teachers and maintain the quality of their work activities, aiming to reduce the mediation effect of the variables that favor psychological exhaustion.

Sepsis and COVID-19: outcomes in young adults in intensive care / Sepsis y COVID-19: resultados en adultos jóvenes en cuidados intensivos / Sepse e COVID-19: desfechos em adultos jovens em terapia intensiva

ABSTRACT Objective: to verify sepsis incidence among young adults admitted to intensive care due to COVID-19 and to analyze its association with demographic, clinical and outcome variables. Methods: a quantitative, longitudinal, retrospective and analytical study, consisting of 58 adults aged 20 to 40 years in intensive care for SARS-CoV-2. It was carried out in a university hospital, from March 2020 to December 2021, with data collected from electronic medical records. Results: sepsis incidence was 65%. Sepsis was associated with acute kidney injury, use of vasoactive drugs and mechanical ventilation, being admitted to the emergency room, severity according to the Simplified Acute Physiology Score III and bacterial pulmonary co-infection, the latter being the most frequent etiology for sepsis. Conclusions: there was a high sepsis incidence, with 42% of deaths, which points to the importance of investing in preventive measures, especially in relation to bacterial pulmonary coinfections.

RESUMEN Objetivo: verificar la incidencia de sepsis entre adultos jóvenes ingresados en cuidados intensivos por COVID-19 y analizar su asociación con variables demográficas, clínicas y de resultado. Métodos: estudio cuantitativo, longitudinal, retrospectivo y analítico, formado por 58 adultos de 20 a 40 años en cuidados intensivos por SARS-CoV-2. Se llevó a cabo en un hospital universitario, de marzo de 2020 a diciembre de 2021, con datos recolectados de historias clínicas electrónicas. Resultados: la incidencia de sepsis fue del 65%. La lesión renal aguda, el uso de fármacos vasoactivos y ventilación mecánica, el ingreso a urgencias, la gravedad según el Simplified Acute Physiology Score III y la coinfección pulmonar bacteriana se asociaron a sepsis, siendo esta última la etiología más frecuente de sepsis. Conclusiones: hubo una alta incidencia de sepsis, con 42% de las muertes, lo que apunta a la importancia de invertir en medidas preventivas, especialmente en relación con las coinfecciones pulmonares bacterianas.

RESUMO Objetivo: verificar a incidência de sepse entre adultos jovens admitidos na terapia intensiva por COVID-19 e analisar sua associação com variáveis demográficas, clínicas e desfechos. Métodos: estudo quantitativo, longitudinal, retrospectivo e analítico, composto por 58 adultos de 20 a 40 anos em terapia intensiva por SARS-CoV-2. Foi realizado em hospital universitário, no período de março de 2020 a dezembro de 2021, sendo os dados coletados dos prontuários eletrônicos. Resultados: a incidência de sepse foi de 65%. Estiveram associados à sepse lesão renal aguda, uso de droga vasoativa e de ventilação mecânica, ser admitido do pronto atendimento, a gravidade segundo o Simplified Acute Physiology Score III e a coinfecção pulmonar bacteriana, sendo essa última a etiologia mais frequente para sepse. Conclusões: observou-se alta incidência de sepse, com 42% de óbito, o que aponta para a importância de investimento em medidas preventivas, especialmente em relação às coinfecções pulmonares bacterianas.