Quality of life associated with nursing professionals' individual resources and work.

OBJECTIVES: to assess the physical and mental components of nursing professionals' quality of life and associate them with individual, health and work characteristics. METHODS: cross-sectional research, with nursing professionals from a university hospital in São Paulo. Own questionnaire and validated instruments were applied. RESULTS: the overall quality of life was compromised. The physical component was lower in relation to low family income and among those who perceived greater control/pressure at work, and better for those who practiced physical activity and had support of leader and organization. The mental component was lower in professionals who reported dissatisfaction with work, worse self-rated physical health and were older. Scores for both components reduced due to work-related illnesses, worse work ability and increased daytime sleepiness. CONCLUSIONS: quality of life was statistically associated with controllable institutional factors and individual resources that, except age, can be promoted.

Sociodemographic factors associated with suicidal behavior at a federal public university in the Western Brazilian Amazon.

OBJECTIVE: to determine risk factors for suicidal behavior among students and employees of a federal public university in the Brazilian Western Amazon. METHODS: an analytical cross-sectional study of survey and association between variables with a sample of 475 participants. Statistical analyzes were performed using the Mann-Whitney test, Pearson's chi-square test, likelihood ratio test or Fisher's exact test and a logistic regression model. A significance level of 5% was used (p-value< 0.05). RESULTS: a higher proportion of suicidal behavior was found in younger participants, females, who had no religion or had one, but were non-practicing, who did not have children and/or had a monthly family income of less than two minimum wages. Lower proportions of suicidal behavior were identified in heterosexuals and/or married or in a stable relationship. CONCLUSION: the study suggests a relationship between sociodemographic factors and suicidal behavior in the studied academic community.

Religious/spiritual experiences, quality of life and satisfaction with life of hospitalized octogenarians.

OBJECTIVES: to assess quality of life (QoL) and satisfaction with life (SWL) indices and verify whether the frequency of religious and spiritual experiences is associated with QoL and SWL in hospitalized octogenarians. METHOD: this is a cross-sectional study, with 128 octogenarians. World Health Organization QoL instruments and Scales applied: Daily Spiritual Experience (DSES) and Satisfaction With Life (SWLS). RESULTS: more committed domains related to QoL and SWL: autonomy and physical capacity. The higher the score in DSES, the higher the scores in the psychological domains and past, present, and future QoL activities. The higher the score in DSES, the higher the score in the social involvement aspect. CONCLUSION: the results of this study showed that the higher frequency of religious and spiritual experiences of hospitalized elderly people was associated with better QoL and SWL. It is emphasized that religious and spiritual experiences should be explored in the hospital therapeutic context.

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.

Anxiety level of public university employees with suspected or confirmed COVID-19 infection.

Introduction: Workers on leave awaiting confirmation of coronavirus infection may experience worry and anticipatory stress. Objectives: The objective of this study was to assess the anxiety levels of employees at a public university in the state of São Paulo who were put on leave due to suspected or confirmed SARS-CoV-2 infection and to correlate their anxiety levels with personal and work-related variables. Methods: This cross-sectional study used an online survey to collect data from employees who took a diagnostic test for COVID-19. The participants' anxiety level was measured using Greenberger and Padesky's Anxiety Inventory, while data on personal and work-related variables were collected through a socio-demographic questionnaire. Results: Most of the 153 participants (76.5%) reported anxiety symptoms. COVID-19 infection was confirmed in 51%. The highest prevalence of severe anxiety (27%) was among employees who had indirect contact with COVID-19 patients. Three variables - being a woman, being a regular employee, and previous physical health problems - were responsible for a higher risk of anxiety. Conclusions: This study's findings indicate the need to protect the mental health of the university's employees.

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.

Evaluation of quality of life and depression in nursing technicians and nursing assistants.

The aim of this study was to evaluate the quality of life (QoL) and depression, and relate them to the sociodemographic characteristics of nursing technicians and nursing assistants in a private hospital. This was an epidemiological and cross-sectional study. The number of technicians and assistants who participated in this study was 266. The instruments used were the WHOQOL-BREF and the Beck Depression Inventory. The evaluation of quality of life of nursing technicians and assistants showed similar values to those found in individuals with chronic diseases. The presence of health problems led to higher indices of depression and lower QoL scores in the general and psychological domains and correlated to labor activity. Night-shift workers had higher scores of depression. Understanding factors, related to professional activities, which trigger health problems and alter quality of life, can provide tools in the search for alternatives to remedy or mitigate their effects.

Quality of life and cognitive and functional performance of octogenarians and nonagenarians undergoing hemodialysis.

OBJECTIVE: To evaluate the quality of life, cognitive and functional capacity of older adult patients undergoing hemodialysis who are 80 years of age or older and compare them to older adults without chronic kidney disease (CKD) treated at a geriatrics outpatient clinic. METHOD: First, 103 older adult patients undergoing hemodialysis and 103 older adults without CKD matched by gender and age were evaluated. Cognitive aspects as evaluated by the mini mental state examination, the Boston Naming Test and verbal fluency were analyzed; comorbidities according to the Charlson's comorbidity index; social support through the Medical Outcomes Study scale; functional ability through the chair sit-to-stand and gait speed tests, as well as the basic activities of daily living (BADL) and instrumental activities of daily living (IADL) and quality of life according to the Kidney Disease Quality of Life Short Form (KDQOL SF-36) questionnaires. RESULTS: The hemodialysis group had a higher rate of comorbidities (7.8 ± 2.4 vs. 5.8 ± 2.3, p < 0.001). In the multiple logistic regression analysis, the group undergoing hemodialysis presented a ninefold greater chance of dependence for IADL than controls, a 4.3 and 3.2 times greater chances for inadequacy on the gait speed and chair sit-to-stand tests, respectively, as well as a 4.4-fold higher risk of cognitive decline on the verbal fluency test. CONCLUSION: Long-lived patients undergoing hemodialysis presented worse quality of life and functional and cognitive performance compared to long-term patients attended at the outpatient clinic, indicating that preventive and protective measures should be considered and implemented.

Functional capacity and quality of life of elderly people admitted to emergency service. / Capacidade funcional e qualidade de vida de pessoas idosas internadas no serviço de emergência.

OBJECTIVE: To correlate the functional capacity and quality of life of elderly people admitted to emergency service. METHOD: This is a cross-sectional and analytical study carried out with elderly patients admitted to a university hospital's emergency service in the city of São Paulo, between December 2015 and January 2017. Data were collected through interviews using a structured questionnaire, the Medical Outcome Study 36, the Katz of Independence in Activities of Daily Living, and the Functional Independence Measure. RESULTS: Two hundred fifty elderly people with a mean age of 71.9 years, male (56.8%), white in color (67.2%), married (54.0%), with low education (32.0%), low income (58.0%), with comorbidities (81.2%) and home providers (53.6%) have participated. The most compromised Quality of Life dimensions were physical aspect (11.4%), emotional aspect (21.6%) and functional capacity (25.2%). Concerning functional capacity, independence was characterized for Basic Activities of Daily Living and moderate dependence for Instrumental Activities of Daily Living. The higher the scores of the Functional Independence Measure, the higher the quality of life scores. CONCLUSION: The more independent the elderly the better their quality of life.

Quality of life and body image of patients with urinary disorders.

OBJECTIVE: to assess the quality of life and body image of men with difficulty urinating and indwelling urinary catheter users, integrating the socio-demographic, economic and morbidity variables. METHOD: a cross-sectional analytical study with 64 male patients with urinary problems. Three questionnaires were used for data collection: one containing sociodemographic, economic and morbid data, the Medical Outcome Study 36-item short-form health survey to analyze quality of life, and the Body Dysmorphic Examination, which assesses body image. T-test, Mann-Whitney, Pearson, Spearman, Linear Regression and Stepwise were used. RESULTS: quality of life and body image were compromised in both groups, affecting emotional aspects, with a high degree of body dissatisfaction and altered physical and social adversity. CONCLUSION: changes in patients' quality of life and body image were observed, confirming the need for improvement in 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.

Infection related to Klebsiella pneumoniae producing carbapenemase in renal transplant patients.

OBJECTIVE: To evaluate the risk factors related to Klebsiella pneumoniae carbapenemase infection after renal transplantation. METHODS: This was a retrospective epidemiological (case-control) study, conducted from October 2011 to march 2016. Transplanted patients with infection by this bacteria during hospitalization were selected as cases. The controls were paired by age, sex, type of donor and transplant time. The proportion of cases and controls was 1:2. RESULTS: Thirty hundred and five patients were included in the study (45 cases and 90 controls). The risk factors found for infection by KPC were: time of hospitalization after the transplant (OR: 4.82; CI95% 2.46-9.44), delayed kidney function (OR: 5.60; CI95% 1.91-11.01) and previous infectious for another microorganism ( OR: 34.13 CI95% 3.52-132.00). CONCLUSION: The risk of acquisition of this bacterium was directly related to invasive procedures and exposure to the hospital environment. The findings reinforce the importance of prevention measures and control of infection by this microorganism.

Functional capacity and quality of life of hospitalized octogenarians.

OBJECTIVE: To evaluate the ability to perform activities of daily living (ADL) and to correlate functional capacity with quality of life (QoL) of hospitalized octogenarians. METHOD: A cross-sectional study with 128 patients using the quality of life instruments WHOQOL-OLD and WHOQOL-BREF and the Katz Scale. RESULTS: The majority of patients was fully dependent; patients with higher schooling had less independence; older adults with partial dependence and independence had higher scores in perceived QoL; in the domains of autonomy, past, present and future activities; and better overall QoL than those with full dependence. Partially dependent patients had higher scores in the death and dying domain than independent patients. CONCLUSION: Older adults' QoL is associated with the maintenance of autonomy and functional capacity. Older adults experience a health decline during the hospitalization process, due to the limitation in performing their ADL and lack of encouragement by the health team.

Quality of life of institutionalized aged with and without symptoms of depression.

OBJECTIVE: compare the quality of life (QOL) of aged residents in homes for aged people with or without symptoms of depression, and identify social, physical activity; leisure; health and basic activities of daily living (ADL) variables that correlate with QOL scores. METHOD: cross-sectional study conducted with 101 institutionalized aged. Multiple linear regression was used for data analysis. RESULTS: symptoms of depression changed negatively the QOL in the domains: autonomy; present, past and future activities; social participation; intimacy and total score. Dependent aged presented lower QOL for the performance of ADL in the domains: autonomy; social participation and total score; dancing without limitation of movement; liking the residential and not presenting symptoms of depression were the variables that positively influenced the QOL of the aged. CONCLUSION: social and psychological support, good living conditions and stimulating assistance can improve the QOL of institutionalized elderlies.

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.

Quality of life associated with nursing professionals' individual resources and work / Calidad de vida asociada a los recursos individuales y al trabajo de los profesionales de enfermería / Qualidade de vida associada a recursos individuais e do trabalho de profissionais de enfermagem

ABSTRACT Objectives: to assess the physical and mental components of nursing professionals' quality of life and associate them with individual, health and work characteristics. Methods: cross-sectional research, with nursing professionals from a university hospital in São Paulo. Own questionnaire and validated instruments were applied. Results: the overall quality of life was compromised. The physical component was lower in relation to low family income and among those who perceived greater control/pressure at work, and better for those who practiced physical activity and had support of leader and organization. The mental component was lower in professionals who reported dissatisfaction with work, worse self-rated physical health and were older. Scores for both components reduced due to work-related illnesses, worse work ability and increased daytime sleepiness. Conclusions: quality of life was statistically associated with controllable institutional factors and individual resources that, except age, can be promoted.

RESUMEN Objetivos: evaluar los componentes físicos y mentales de la calidad de vida de los profesionales de enfermería y asociarlos con características individuales, de salud y laborales. Métodos: investigación transversal, con profesionales de enfermería de un hospital universitario de São Paulo. Se aplicó cuestionario propio e instrumentos validados. Resultados: la calidad de vida general se vio comprometida. El componente físico fue menor en relación con bajos ingresos familiares y entre quienes percibieron mayor control/presión en el trabajo, y mejor para quienes practicaban actividad física y contaban con apoyo de la dirección y organización. El componente mental fue menor en los profesionales que refirieron insatisfacción con el trabajo, peor salud física autovalorada y mayor edad. Las puntuaciones de ambos componentes se redujeron debido a enfermedades relacionadas con el trabajo, peor capacidad laboral y aumento de la somnolencia diurna. Conclusiones: la calidad de vida se asoció estadísticamente con factores institucionales controlables y recursos individuales que, excepto la edad, pueden ser promovidos.

RESUMO Objetivos: avaliar os componentes físico e mental da qualidade de vida de profissionais de enfermagem e associá-los às características individuais, de saúde e do trabalho. Métodos: pesquisa transversal, com profissionais de enfermagem de um hospital universitário de São Paulo. Aplicados questionário próprio e instrumentos validados. Resultados: a qualidade de vida geral mostrou-se comprometida. O componente físico foi menor em relação à baixa renda familiar e entre os que percebiam maior controle/pressão no trabalho, e melhor para quem praticava atividade física e tinha apoio da chefia e organização. O componente mental foi menor nos profissionais que referiram insatisfação com o trabalho, pior autoavaliação de saúde física e com idade elevada. Escores de ambos componentes reduziram mediante doenças relacionadas ao trabalho, pior capacidade para o trabalho e aumento da sonolência diurna. Conclusões: a qualidade de vida foi estatisticamente associada a fatores institucionais controláveis e recursos individuais que, exceto idade, podem ser promovidos.

Alcohol consumption, Quality of Life and Brief Intervention among Nursing university students.

OBJECTIVE: To evaluate nursing university students' alcohol consumption patterns, Brief Intervention and Quality of Life (QoL). METHOD: This is a prospective and longitudinal study containing sociodemographic, economic information concerning alcoholic beverages, BI and QoL evaluation among 281 nursing university students. Since surveys have been applied, seminars have been given and consumption patterns have been discussed, an educational material was delivered after university students' revaluation and BI reinforcement. Descriptive and analytical statistics have been conducted. RESULTS: 90% of the students have already consumed alcohol and 20.6% that consumed for the first time and abused alcohol were minors. After the implementation of BI, the alcohol consumption has decreased among university students. Besides the vitality, generate state of health, and emotional aspects have decreased, mental health was substantially low among the students that used to drink. CONCLUSION: BI contributes to decrease alcoholic beverages consumption and promotes health.

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.

Alterações bioquímicas de pacientes com COVID-19 / Alteraciones bioquímicas de pacientes con COVID-19 / Biochemical changes in patients with COVID-19

Resumo Objetivo identificar as alterações bioquímicas dos pacientes com apresentação moderada e grave da doença Covid-19 e as preditivas de gravidade nos que evoluíram do estagio moderado para o grave. Métodos Estudo de coorte prospectivo com 709 pacientes internados com diagnóstico confirmado de COVID-19 e apresentação moderada e grave da doença. Foi realizado em um hospital universitário de média e alta complexidade do estado de São Paulo, no período de abril de 2020 a dezembro de 2021. Os dados coletados dos prontuários foram exames laboratoriais e evolução clínica dos pacientes. Na análise descritiva, foi utilizado frequência absoluta, percentual, média e desvio padrão. Os Testes do Qui-Quadrado de Pearson, Exato de Fisher, Mann-Whitney ou t de Student foram utilizados para comparar as diferenças entre os grupos dos moderados e graves. O nível de significância adotado foi de 0,05. Resultados A média de idade foi significantemente maior nos pacientes graves em relação aos moderados (p<0,001). Os valores da hemoglobina e plaquetas foram estatisticamente menores na internação no grupo dos pacientes graves, proteína C-reativa e D-Dímero, maiores (p<0,001). O número de óbitos foi significantemente maior nos pacientes que foram internados em estado grave (p<0,001) e verificamos também que a hemoglobina e plaquetas estavam abaixo dos valores de referência na internação deste grupo. Dos 533 pacientes que internaram em estado moderado, 38 evoluiram para quadro grave. Conclusão Os resultados mostram a importância da avaliação clínica das variáveis bioquímicas no momento da internação como preditivas de gravidade. Os achados reportados nesta investigação corroboram com dados da literatura e podem elucidar intervenções precoces para melhor manejo dos pacientes desde o momento da internação.

Resumen Objetivo Identificar las alteraciones bioquímicas de los pacientes con cuadro moderado y grave de la enfermedad de COVID-19 y las predictivas de gravedad en los que evolucionaron de nivel moderado a grave. Métodos Estudio de cohorte prospectivo con 709 pacientes internados con diagnóstico confirmado de COVID-19 y cuadro moderado y grave de la enfermedad. Fue realizado en un hospital universitario de complejidad mediana y alta en el estado de São Paulo, durante el período de abril de 2020 a diciembre de 2021. Los datos obtenidos a partir de las historias clínicas fueron pruebas de laboratorio y evolución clínica de los pacientes. En el análisis descriptivo se utilizó frecuencia absoluta, porcentaje, promedio y desviación típica. Para comparar las diferencias entre los grupos de los moderados y graves se utilizaron las pruebas χ2 de Pearson, exacta de Fisher, Mann-Whitney o t de Student. El nivel de significación adoptado fue de 0,05. Resultados El promedio de edad fue considerablemente más alto en los pacientes graves en relación con los moderados (p<0,001). Los valores de la hemoglobina y de las plaquetas fueron estadísticamente inferiores en la internación en el grupo de los pacientes graves, proteína C reactiva y dímero D, superiores (p<0,001). El número de defunciones fue considerablemente más alto en los pacientes que ingresaron en estado grave (p<0,001) y verificamos también que la hemoglobina y las plaquetas estaban por debajo de los valores de referencia en la internación de este grupo. De los 533 pacientes que ingresaron en estado moderado, 38 evolucionaron hacia cuadros graves. Conclusión Los resultados muestran la importancia de la evaluación clínica de las variables bioquímicas en el momento de la internación como predictivas de gravedad. Los resultados informados en esta investigación confirman los datos de la literatura y pueden esclarecer intervenciones tempranas para un mejor manejo de los pacientes desde el momento de la internación.

Abstract Objective To identify the biochemical alterations of patients with moderate and severe COVID-19 and the predictors of severity in those who progressed from the moderate to the severe stage. Methods This is a prospective cohort study with 709 patients hospitalized with a confirmed diagnosis of COVID-19 and moderate and severe illness. It was carried out in a university hospital of medium and high complexity, in the state of São Paulo, from April 2020 to December 2021. Data collected from medical records were laboratory tests and clinical progression of patients. In the descriptive analysis, absolute frequency, percentage, mean and standard deviation were used. Pearson's chi-square, Fisher's exact, Mann-Whitney or Student's t tests were used to compare the differences between the moderate and severe groups. The significance level adopted was 0.05. Results The mean age was significantly higher in severe patients than in moderate ones (p<0.001). Hemoglobin and platelet values were statistically lower upon admission in the group of critically ill patients, C-reactive protein and D-dimer higher (p<0.001). The number of deaths was significantly higher in patients who were hospitalized in a serious condition (p<0.001) and we also found that hemoglobin and platelets were below the reference values at hospitalization in this group. Of the 533 patients who were hospitalized in a moderate condition, 38 progressed to a severe condition. Conclusion The results show the importance of clinical assessment of biochemical variables at the time of admission as predictors of severity. The findings reported in this investigation corroborate data from the literature and can elucidate early interventions for better management of patients from the moment of hospitalization.

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.