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ABSTRACT Objectives: to analyze the diagnostic criteria for ventilator-associated pneumonia recommended by the Brazilian Health Regulatory Agency and the National Healthcare Safety Network/Centers for Disease Control and Prevention, as well as its risk factors. Methods: retrospective cohort study carried out in an intensive care unit throughout 12 months, in 2017. Analyses included chi-square, simple linear regression, and Kappa statistical tests and were conducted using Stata 12 software. Results: the sample was 543 patients who were in the intensive care unit and under mechanical ventilation, of whom 330 (60.9%) were men and 213 (39.1%) were women. Variables such as gender, age, time under mechanical ventilation, and oral hygiene proved to be significant risk factors for the development of ventilator-associated pneumonia. Conclusions: patients submitted to mechanical ventilation need to be constantly evaluated so the used diagnostic methods can be accurate and applied in an objective and standardized way in Brazilian hospitals.

Estudo transversal desenvolvido com 374 idosos de um hospital de ensino da região dos Campos Gerais que buscou identificar a prevaleência e fatores associados ã fragilidade em idosos de um ambulatório de especialidades médicas. A coleta de dados compreendeu entrevista, Mini Exame do Estado Mental e Escala Fragilidade de Edmonton. Realizou-se análise bivariada e múltipla por meio de regessão de Poisson com respectivos intervalos de confiança de 95% e nível de significância de p?0,05. A prevalência de fragilidade foi de 40,1%, com associação significativa às variáveis sexo feminino (p=0,002), baixa escolaridade (p=0,020), presença de doença(s) autorreferida(s) (p=0,006), medicamentos (p=0,001), perda de urina (p=0,001), quedas (p=0,001) e à hospitalização (p=0,001). A prevalência de fragilidade identificada foi discretamente inferior à constatada em estudo de um centro de referência e superior a idosos da comunidade, com fatores sociodemográficos e clínicos associados. Requerendo olhar atento dos profissionais da saúde acerca deste perfil.

RESUMO Objetivo: investigar a associação entre a síndrome da fragilidade e desempenho cognitivo de idosos em atendimento ambulatorial. Método: pesquisa transversal, realizada com amostra por conveniência de 374 idosos que aguardavam consulta de especialidade em um hospital de ensino, no período de novembro de 2015 a novembro de 2016. A coleta de dados contemplou a aplicação de instrumento estruturado, Miniexame do Estado Mental e Escala de Fragilidade de Edmonton. Os dados coletados foram organizados e analisados no software Stata 12®, descritos por medidas de frequência, média e desvio-padrão (DP). Verificou-se a associação entre as variáveis por meio dos testes F de Fisher e t de Student, utilizando-se para avaliação dos resultados o nível de significância de p

The aim was to identify factors associated with smoking among users of the Family Health Strategy. A cross-sectional, descriptive and analytic epidemiological study. The sample by convenience encompassed 100 individuals who were users of a Family Health Unit from a city in the center-south region of the Brazilian State of Paraná. There was a predominance of women (n=63; 63%), with a mean age of 49.5 years, Caucasian (n=82; 82%), who had completed junior high school (n=21; 21%) and who were married (n=49; 49%). Mean daily cigarette consumption was 17.7 cigarettes/day and 56 (56%) participants had a very high or high degree of dependence on nicotine. An association was observed between mean smoking duration and age (p=0.001), marital status – widowed (p=0.035), high cholesterol (p=0.035), use of antihypertensives (p=0.031) and very high degree of dependence on nicotine (p=0.008). The identification of the factors associated with smoking makes it possible for the health team to seek and plan prevention strategies, treatment and monitoring of smokers.

Objective To investigate the prevalence of reduced grip strength and associated factors in long-lived elderly, who are users of primary health care. Method Cross-sectional quantitative study, data were collected during the period of January to December of 2013, by applying tests and questionnaires. The convenience sampling was comprised of 157 seniors. Results The findings indicate that the reduction in grip strength presents a moderate prevalence (25.5%), predominantly among females (19.1%), in the age group of 80-89 years (18.5%) and in those with lower educational levels (15.9%). The association between reduced grip strength and the variables of age and body mass index showed a statistical significance. Conclusion Investigations about the handgrip strength are essential for identifying clinical conditions of Brazilian long-lived elderly, and contribute to the development of plans towards the management of frailty.

Abstract Cross-sectional research to investigate the association between sociodemographic and clinical factors and the components hand grip strength and gait speed in long-living elderly. The sample included 243 long-living elderly from three primary health care services in Curitiba, Paraná, between January 2013 and September 2015. A significant association was identified between hand grip strength and sex (p=0.001), age (p=0.001), marital status (p=0.001), housing (p=0.001), falls in previous year (p=0.03), urine loss (p=0.001), use of cane (p=0.001) and walker (p=0.001). The gait speed was associated with sex (p=0.001), age (p=0.001), marital status (p=0.001), housing (p=0.001), falls in previous year (p=0.03), urine loss (p=0.001), use of cane (p=0.001) and walker (p=0.001). It is highlighted that the assessment of hand grip strength and gait speed helps to identify functional changes in long-living elderly and plays a fundamental role in the management of the physical frailty syndrome.

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.