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Introduction: The Pressure Ulcer Scale for Healing (PUSH) represent a serious problem around the world since they have important consequences, personal and economic, this making it a public problem health. The PUSH are a challenge for professionals nursing at all levels of care., Objectve: Identify the frequency of Pressure Ulcer Scale for Healing in patients hospitalized in coronary and intensive unit care of a high specialty hospital., Material and Methods: A descriptive, observational, prospective, and cross-sectional study. The population was composed of 139 patients who were admitted in June and July period of 2015 in the Coronary and Intensive Unit Care., Results: The total of patients valued (139) show a mean age of 50 years old, the 51.8% male, of these the 61.4% developed a skin lesion related to prostration. The 84.17% are not mobilized as recommended, of these the (45.3%) belonged to Neurosurgery, with a range hospital stay from 1 to 36-day. The 79.8% (111 patients) were under sedation drug. Directly related to the emergence of PUSH, obtaining 41% of patients ulcerated lesions the 8.2 average days., Conclusions: The PUSH as problem are present in a Coronary and General Intensive Care Unit frequently (41%) in June and July of 2015. The care and treatment of people with PUSH must be dynamic and interdisciplinary.

Background: Esophageal trauma is considered one of the most severe lesions of the digestive tract. There is still much controversy in choosing the best treatment for cases of esophageal perforation since that decision involves many variables. The readiness of medical care, the patient's clinical status, the local conditions of the perforated segment, and the severity of the associated injuries must be considered for the most adequate therapeutic choice., Aim: To demonstrate and to analyze the results of urgent esophagectomy in a series of patients with esophageal perforation., Methods: A retrospective study of 31 patients with confirmed esophageal perforation. Most injuries were due to endoscopic dilatation of benign esophageal disorders, which had evolved with stenosis. The diagnosis of perforation was based on clinical parameters, laboratory tests, and endoscopic images. ‪The main surgical technique used was transmediastinal esophagectomy followed by reconstruction of the digestive tract in a second surgical procedure. Patients were evaluated for the development of systemic and local complications, especially for the dehiscence or stricture of the anastomosis of the cervical esophagus with either the stomach or the transposed colon., Results: Early postoperative evaluation showed a survival rate of 77.1% in relation to the proposed surgery, and 45% of these patients presented no further complications. The other patients had one or more complications, being pulmonary infection and anastomotic fistula the most frequent. The seven patients (22.9%) who underwent esophageal resection 48 hours after the diagnosis died of sepsis. At medium and long-term assessments, most patients reported a good quality of life and full satisfaction regarding the surgery outcomes., Conclusions: Despite the morbidity, emergency esophagectomy has its validity, especially in well indicated cases of esophageal perforation subsequent to endoscopic dilation for benign strictures.

Context: Malnutrition is frequently observed in inpatients with malignant diseases and may contribute to longer hospital stays., Objective: To compare the nutritional status, lymphocyte count, hemoglobin values and length of hospital stay of patients with and without malignant diseases., Methods: This comparative study assessed indicators of nutritional status, namely body mass index, recent weight loss, lymphocyte count, hemoglobin and length of hospital stay, of 928 surgical patients with and without malignant diseases (50.2% females and 49.8% males). The chi-square test was used to compare proportions and the Mann-Whitney test was used to compare continuous measurements between two groups. The significance level was set at 5%., Results: Patients with malignant diseases had longer hospital stays (P<0.0001), furthermore, a higher percentage of patients with malignant diseases had body mass index <18.5 (P<0.0001) and experienced recent weight changes (P<0.0002). Lymphocyte count also differed statistically between the groups (P = 0.0131), which lower levels were identified among patients with malignant diseases., Conclusion: The lymphocyte count, hemoglobin values and weight loss are important findings of nutritional depletion in patients with malignant diseases.

Objective: The objective of this study was to identify the associations between the nutritional status of elderly patients and length of hospital stay and presence of dental and gastrointestinal changes., Casuistic and Method: This cross-sectional study analyzed anthropometric and food intake indicators, dental and gastrointestinal changes and length of hospital stay of 441 elderly patients of both genders. The Pearson's correlation coefficient was used to verify the correlation between the nutritional status of the elderly patients and length of hospital stay and presence of dental and gastrointestinal changes. The significance level was set at P < 0.05., Results: Dietary and anthropometric variables as well as length of hospital stay were similar for patients with and without dental changes. Patients with gastrointestinal changes consumed less energy (P < 0.05) than patients without gastrointestinal changes. Length of hospital stay was inversely correlated with body mass index (r = -0.15; P < 0.05); arm circumference was inversely correlated with presence of dental changes (r = -0.12; P < 0.05) and mid-arm muscle circumference was inversely correlated with gastrointestinal changes (r = -0.12; P < 0.05)., Conclusion: Dental and gastrointestinal changes are important indicators of nutritional depletion and dietary intake of inpatients., (© 2010 Blackwell Publishing Ltd.)

Objectives: The aim of the study is to evaluate cervical esophagogastric anastomosis complications between mechanical device versus manual suture., Method: Thirty patients with megaesophagus with grade III/IV submitted to the esophagectomy transmediastinal approach were reviewed with average age from 31 to 68 years. The reconstruction was performed by gastric transposition and with anastomosis in the cervical region. The patients were divided in two groups: A) 15 patients had mechanical suture with the DHC 29 mm device, and B) 15 patients had manual suture in two layers., Results: Five patients (16.6%) presented pneumonia, and they were managed clinically. Three patients were in group B and two were in group A, and no statistical significance was found. Six patients (20%) presented leakage at the cervical esophagogastric anastomosis; one in group A (6.6%) and five in group B (33.3%), with no statistical significance. Anastomosis leakage with development of stricture occurred in five patients in group B, and in three in group A, as well in other two without leakage complications. All of them were managed successfully with endoscopic dilatation. Statistical evaluation was not significant for this complication between group B (33.3%) and group A (20%). There were no deaths in this study., Conclusion: This study showed that mechanical suture is as adequate as manual suture by presenting anastomosis leakage incidence smaller, however, with no statistical significance, and with similar stricture incidence.

A case of Hand-Schüller-Christian disease which presented a pyramidal syndrome besides elements of the classical triad and concentric retraction of the visual field is reported. The rare involvement of non-hypothalamic encephalic structures in that disease is emphasized together with the favourable effect of corticotherapy and radiotherapy.