COVID-19 tents: specialized triage service, a temporal analysis of the patients' profile.

OBJECTIVE: To analyze the change in the clinical-epidemiological profile of patients attended at the specialized triage service for COVID-19 (COVID-19 tent) in the first three months of operation. METHODS: Cross-sectional study, with users attended from March 2020 to May 2020 (n=379) at the COVID-19 tent in the city of Ponta Grossa, Paraná. Data collection was retrieved from an electronic form fed by tent professionals, which included sociodemographic characteristics, symptoms, risk factors of exposure, means of search and clinical conduct. Trend tests and chi-square tests were performed. RESULTS: March showed a greater demand (n=197), motivated by mild symptoms and direct search (p<0.05). In the following months, there was a decrease in demand (n=93; n=89), however the search for referrals, ambulances and conditions that required medical attention, observation and hospitalization increased (p<0.05). The search resulting from exposure to risk factors has not changed (p>0.05). CONCLUSION: the profile has changed over time, reflecting, in the end, severe and critical symptoms, requiring intervention.

COVID-19 tents: specialized triage service, a temporal analysis of the patients' profile / Tienda COVID-19: servicio de triaje especializado, un análisis temporal del perfil de pacientes atendidos / Tenda COVID-19: serviço de triagem especializado, uma análise temporal do perfil de pacientes atendidos

ABSTRACT Objective: To analyze the change in the clinical-epidemiological profile of patients attended at the specialized triage service for COVID-19 (COVID-19 tent) in the first three months of operation. Methods: Cross-sectional study, with users attended from March 2020 to May 2020 (n=379) at the COVID-19 tent in the city of Ponta Grossa, Paraná. Data collection was retrieved from an electronic form fed by tent professionals, which included sociodemographic characteristics, symptoms, risk factors of exposure, means of search and clinical conduct. Trend tests and chi-square tests were performed. Results: March showed a greater demand (n=197), motivated by mild symptoms and direct search (p<0.05). In the following months, there was a decrease in demand (n=93; n=89), however the search for referrals, ambulances and conditions that required medical attention, observation and hospitalization increased (p<0.05). The search resulting from exposure to risk factors has not changed (p>0.05). Conclusion: the profile has changed over time, reflecting, in the end, severe and critical symptoms, requiring intervention.

RESUMEN Objetivo: Analizar el cambio del perfil clínico-epidemiológico de pacientes atendidos en el servicio de triaje especializado para COVID-19 (Tienda COVID-19) en sus primeros tres meses de funcionamiento. Métodos: Estudio transversal, con usuarios atendidos de marzo a mayo de 2020 (n=379) en la Tienda COVID-19 de Ponta Grossa, Paraná. Datos recolectados de formulario electrónico completado por profesionales de la Tienda, contemplando características sociodemográficas, sintomatología, factores de riesgo de exposición, medio de búsqueda y conducta clínica. Se aplicaron tests de tendencia y Chi-cuadrado. Resultados: Hubo mayor concurrencia en marzo (n=197), con sintomatología leve y búsqueda directa (p<0,05). En los meses siguientes se redujo la concurrencia (n=93; n=89) aumentando igualmente la búsqueda referenciada, ambulancia y cuadros requiriendo atención médica, observación e internación (p<0,05). La búsqueda derivada de exposición a factores de riesgo no cambió (p>0,05). Conclusión: El perfil cambió con el tiempo, reflejando finalmente cuadros sintomatológicos graves y críticos, demandando intervención.

RESUMO Objetivo: Analisar a mudança no perfil clínico-epidemiológico de pacientes atendidos no serviço de triagem especializado para COVID-19 (Tenda COVID-19) nos três primeiros meses de funcionamento. Métodos: Estudo transversal, com usuários atendidos de março a maio de 2020 (n=379) na Tenda COVID-19 de Ponta Grossa, Paraná. Foram coletados dados de formulário eletrônico alimentado por profissionais da Tenda, contemplando características sociodemográficas, sintomatologia, fatores de risco de exposição, meio de busca e conduta clínica, e realizados teste de tendência e qui-quadrado. Resultados: Houve maior procura em março (n=197), motivada por sintomatologia leve e busca direta (p<0,05). Nos meses subsequentes, a procura diminuiu (n=93; n=89), mas aumentou a busca de forma referenciada, ambulância e quadros que requereram atendimento médico, observação e internação (p<0,05). A busca decorrente de exposição a fatores de riscos não sofreu mudanças (p>0,05). Conclusão: o perfil mudou ao longo do tempo, refletindo, ao final, quadros sintomatológicos graves e críticos, demandando intervenção.

Incontinence associated dermatitis in elderly people admitted to a university hospital.

OBJECTIVE: To identify the frequency and factors associated to incontinence associated dermatitis in elderly people. METHODS: Cross-sectional study with 202 elderly patients admitted to a university hospital between September 2017 and January 2018. Data collection included: cognitive screening, sociodemographic and clinical questionnaire. It was performed exploratory and descriptive analysis, where prevalence and ratios (PR) were calculated. RESULTS: Prevalence of injury was 9.4%, age range 70-79 years (13.5%), African American (21.4%), hospitalization period ≥ 21 days (44.4%), in use of nasogastric tube (33.3%), medical device (11.3%), restricted mobility (18.5%). It was associated with hospitalization period, use of nasogastric tube, restricted mobility, medical devices, and cognition. CONCLUSION: It was confirmed an average frequency of incontinence associated dermatitis in elderly patients and association to factors such as hospitalization period, immobility, cognition, use of nasogastric tube and devices. It must be highlighted the importance of prevention measures, early detection, assessment and monitoring of this type of injury.

The Impact of Urinary Incontinence on Sexual Function: A Systematic Review.

INTRODUCTION: Many studies have been developed to investigate the relationship between urinary incontinence (UI) and female sexuality especially how it interferes on the sexual function of affected women, but many questions remain unclear. OBJECTIVES: To summarize the relevant scientific literature published in the last 10 years that focused on the study of the impact of UI on the sexual function of incontinent women. METHODS: The PubMed and Bireme databases were searched using the keyword string "urinary incontinence" and "sexual function" or "sexual satisfaction" or "sexuality" for studies focusing the impact of UI on the sexual function of affected women older than 18 years, published in the last 10 years. MAIN OUTCOME MEASURES: The main outcome measure was the review of published literature on the impact of UI on sexual function by reporting study design, group of population studied, type of UI, and findings. RESULTS: 18 studies were selected for the study. UI has a negative impact on sexual function. The type of UI affected the quality of life and sexual function of the women in different ways. There is a shortage of articles that further study the underlying mechanisms of negative UI outcomes in sexual function. CONCLUSION: UI has negative impact on sexual function. It is probable that this interference, directly or indirectly, contributes decisively to the avoidance of women in having sex. The way this influence occurs remains unclear, especially when we seek to understand the mechanisms involved in this outcome. Pinheiro Sobreira Bezerra LR, Britto DF, Ribeiro Frota IP, et al. The Impact of Urinary Incontinence on Sexual Function: A Systematic Review. Sex Med 2020;8:393-402.

Incontinence associated dermatitis in elderly people admitted to a university hospital / Dermatitis relacionada a la incontinencia en ancianos internados en un hospital universitário / Dermatite associada à incontinência em idosos internados em um hospital universitário

ABSTRACT Objective: To identify the frequency and factors associated to incontinence associated dermatitis in elderly people. Methods: Cross-sectional study with 202 elderly patients admitted to a university hospital between September 2017 and January 2018. Data collection included: cognitive screening, sociodemographic and clinical questionnaire. It was performed exploratory and descriptive analysis, where prevalence and ratios (PR) were calculated. Results: Prevalence of injury was 9.4%, age range 70-79 years (13.5%), African American (21.4%), hospitalization period ≥ 21 days (44.4%), in use of nasogastric tube (33.3%), medical device (11.3%), restricted mobility (18.5%). It was associated with hospitalization period, use of nasogastric tube, restricted mobility, medical devices, and cognition. Conclusion: It was confirmed an average frequency of incontinence associated dermatitis in elderly patients and association to factors such as hospitalization period, immobility, cognition, use of nasogastric tube and devices. It must be highlighted the importance of prevention measures, early detection, assessment and monitoring of this type of injury.

RESUMEN Objetivo: Identificar la prevalencia y los factores relacionados a la dermatitis relacionada a la incontinencia en ancianos. Métodos: Estudio transversal, con 202 ancianos internados en un hospital universitario, entre septiembre de 2017 a enero de 2018. La recogida de datos contempló: rastreo cognitivo, cuestionario sociodemográfico y clínico. Se realizó análisis exploratorio y descriptivo, siendo calculadas las prevalencias y razones de prevalencia (RP). Resultados: Prevalencia de la lesión ha sido de 9,4%, franja etaria 70-79 años (13,5%), raza negra (21,4%), tiempo de internación de ≥ 21 días (44,4%), en uso de sonda nasoenteral (33,3%), dispositivo médico (11,3%), movilidad restricta (18,5%). Se presentó relacionada con el tiempo de internación, sonda nasoenteral, movilidad restricta, dispositivos médicos y cognición. Conclusión: Se verificó la media prevalencia de dermatitis relacionada a la incontinencia en ancianos internados y relación a los factores: tiempo de internación, inmovilidad, cognición, uso de sonda nasoenteral y dispositivos. Se destaca la importancia de acciones de prevención, identificación precoz, evaluación y monitoreo de ese tipo de lesión.

RESUMO Objetivo: Identificar a prevalência e os fatores associados à dermatite associada à incontinência em idosos. Métodos: Estudo transversal, com 202 idosos internados em um hospital universitário, entre setembro de 2017 a janeiro de 2018. A coleta de dados contemplou: rastreio cognitivo, questionário sociodemográfico e clínico. Realizou-se análise exploratória e descritiva, sendo calculadas as prevalências e razões de prevalência (RP). Resultados: Prevalência da lesão foi de 9,4%, faixa etária 70-79 anos (13,5%), raça negra (21,4%), tempo de internação de ≥ 21 dias (44,4%), em uso de sonda nasoenteral (33,3%), dispositivo médico (11,3%), mobilidade restrita (18,5%). Apresentou-se associada com o tempo de internação, sonda nasoenteral, mobilidade restrita, dispositivos médicos e cognição. Conclusão: Verificou-se a média prevalência de dermatite associada à incontinência em idosos internados e associação aos fatores: tempo de internação, imobilidade, cognição, uso de sonda nasoenteral e dispositivos. Destaca-se a importância de ações de prevenção, identificação precoce, avaliação e monitoramento desse tipo de lesão.

Incontinência urinária e função sexual feminina: revisão integrativa de questionários validados / Incontinencia urinaria y función sexual femenina: revisión integrativa de cuestionarios validados / Urinary incontinence and female sexual function: an integrative review of validated questionnaires

Resumo Objetivo: Analisar a produção científica nacional e internacional quanto à relação escores dos instrumentos ICIQ-UI-SF (Internacional Consultation on Incontinence Questionnaire - Urinary Incontinence/Short Form (ICIQ-UI/SF) e FSFI (Female Sexual Function Index) na população feminina. Métodos: Revisão integrativa da literatura, realizada durante os meses de Dezembro de 2017 a Maio de 2018, nas bases de dados Scielo, Lilacs, Scopus e Pubmed. As buscas foram conduzidas através da associação dos nomes dos questionários como descritores, sem delimitações quanto ao ano de publicação, idioma e disponibilidade em texto completo. Priorizados achados com nível de evidência de no mínimo 3A para estudos observacionais. Totalizaram 5 artigos científicos. Resultados: As evidências encontradas sobre a relação direta dos instrumentos apresentaram como objetivo predominante a sua aplicação para validar a efetividade de técnicas cirúrgicas para a correção da incontinência urinária. Mesmo diante da melhora da incontinência, os achados divergiram quanto a melhora da função sexual, apresentando modificações apenas em alguns domínios do FSFI ou nenhuma mudança. Apenas um estudo buscou investigar a relação direta dos instrumentos, indicando fraca ligação. Já a busca isolada dos instrumentos, associada com descritores específicos apontara que a incontinência urinária é fator determinante para a deterioração tanto da qualidade de vida quanto e da função sexual. Conclusão: O baixo quantitativo de produções e resultados encontrados demonstraram que é necessário um maior aprofundamento sobre a temática, para um embasamento e qualificação da assistência para portadoras de incontinência urinária.

Resumen Objetivo: Analizar la producción científica nacional e internacional en cuanto a la relación entre los indicadores de los ICIQ-UI-SF (ICIQ-UI / SF) y FSFI (Female Sexual Function Index) en la población femenina. Métodos: Durante los meses de diciembre de 2017 a mayo de 2018, se realizó una revisión integrativa de la literatura en las bases de datos Scielo, Lilacs, Scopus y Pubmed. Las búsquedas se hicieron a través de la asociación de los nombres de los cuestionarios como descriptores, sin delimitaciones en cuanto al año de publicación, idioma y disponibilidad en texto completo. Se priorizaron hallazgos con nivel de evidencia de por lo menos 3A para estudios observacionales. Hubo un total de 5 artículos científicos. Resultados: Las evidencias encontradas sobre la relación directa de los instrumentos presentaron como objetivo predominante su aplicación para validar la efectividad de técnicas quirúrgicas para la corrección de la incontinencia urinaria. Incluso ante la mejora de la incontinencia, los hallazgos divergían en cuanto a la mejora de la función sexual, presentando modificaciones sólo en algunos dominios del FSFI o ningún cambio. Solo un estudio buscó investigar la relación directa de los instrumentos e indicó débil conexión. La búsqueda aislada de los instrumentos, asociada con descriptores específicos, apunta que la incontinencia urinaria es un factor determinante para el deterioro tanto de la calidad de vida como de la función sexual. Conclusión: La poca cantidad de producciones y resultados encontrados demostró que es necesario una mayor profundización sobre la temática para una base y calificación de la asistencia para portadoras de incontinencia urinaria.

Abstract Objective: To analyze the national and international scientific production regarding the relationship between the ICIQ-UI-SF (International Consultation on Incontinence Questionnaire - Urinary Incontinence/Short Form (ICIQ-UI/SF) and FSFI (Female Sexual Function Index) in the female population. Methods: Integrative literature review, carried out from December 2017 to May 2018, in the Scielo, Lilacs, Scopus and Pubmed databases. Searches were conducted through the association of the names of the questionnaires as descriptors, without delimitations regarding the year of publication, language, and availability of full text. Findings with a level of evidence of at least 3A for observational studies were prioritized. There was a total of five scientific papers. Results: The evidence found about the direct relationship of the instruments had as predominant objective their application to validate the effectiveness of surgical techniques to correct urinary incontinence. Even with the improvement of incontinence, the findings were different regarding the improvement of sexual function, showing changes only in some FSFI domains, or no change. Only one study sought to investigate the direct relationship of the instruments, indicating a poor connection. On the other hand, the isolated search of the instruments, associated with specific descriptors, indicated that urinary incontinence is a determining factor for the deterioration of both quality of life and sexual function. Conclusion: The low number of productions and results found have shown that a deeper understanding of the subject is necessary for a justification and qualification of care for patients with urinary incontinence.

Mechanical ventilation weaning in inclusion body myositis: feasibility of isokinetic inspiratory muscle training as an adjunct therapy.

Inclusion body myositis is a rare myopathy associated with a high rate of respiratory complications. This condition usually requires prolonged mechanical ventilation and prolonged intensive care stay. The unsuccessful weaning is mainly related to respiratory muscle weakness that does not promptly respond to immunosuppressive therapy. We are reporting a case of a patient in whom the use of an inspiratory muscle-training program which started after a two-week period of mechanical ventilation was associated with a successful weaning in one week and hospital discharge after 2 subsequent weeks.