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Perfis de qualidade de vida, atividade física e fadiga em pessoas vivendo com HIV: uma análise de clusters

2025-02-17T00:00:00Z

Título: Perfis de qualidade de vida, atividade física e fadiga em pessoas vivendo com HIV: uma análise de clusters Autor(es): Sales, Thiago Silva Abstract: The Acquired Immune Deficiency Syndrome (AIDS) epidemic remains a major public health issue, with fatigue being a common chronic symptom that impacts quality of life and treatment adherence. Despite the control of the disease in Brazil through antiretroviral therapy, it is crucial to mitigate this symptom and investigate its relationship with quality of life and physical activity. Objective: To identify and characterize subgroups of people living with Human Immunodeficiency Virus (HIV) based on their quality of life profiles and physical activity levels, and to investigate the association of these profiles with the experience of fatigue. Methodology: The variables were categorized into sociodemographic factors (age, skin color, marital status, biological sex, education level); disease- and treatment-related factors (time since diagnosis, mode of transmission, infection stage, medication use, treatment adherence); and psychosocial and personal factors (fatigue, habitual physical activity, quality of life, disease perception, financial satisfaction, feelings of exclusion, and suffering due to stigma and/or prejudice). Data were collected at the Centro de Especialidade Médica de Aracaju (CEMAR) from 115 adults living with HIV and users of Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PeP). Four questionnaires were applied: a sociodemographic questionnaire, the Fatigue Assessment Scale, the WHOQOL-HIV-Bref, and the Habitual Physical Activity questionnaire. Cluster analysis was conducted using hierarchical analysis with Ward's method and squared Euclidean distance, followed by K-means analysis, using Zscores for quality of life and total physical activity level, with convergence in four iterations. ANOVA and non-parametric tests were used for characterization and comparison between clusters. For comparisons of continuous variables among the three clusters, the Kruskal-Wallis test was performed, followed by pairwise comparisons with Bonferroni correction. For categorical variables, the chi-square test or Fisher's exact test was used. The relationship between the identified clusters and fatigue was analyzed using robust Poisson regression. Results: Cluster analysis identified three groups: Cluster 1 (high quality of life and physical activity), Cluster 2 (moderate quality of life and physical activity), and Cluster 3 (low quality of life and physical activity). Poisson regression showed that, compared to Cluster 3, participants in Cluster 1 had a 70.8% lower prevalence of fatigue (PR=0.29; 95% CI: 0.14-0.57; p<0.001), and those in Cluster 2 had a 30.7% lower prevalence (PR=0.69; 95% CI: 0.49-0.96; p=0.031). Conclusion: There is an association between negative perceptions of quality of life, lower physical activity levels, and greater experiences of fatigue among people living with HIV receiving care at CEMAR, Sergipe.

Análise biomecânica de miniparafusos ortodônticos submetidos a múltiplas inserções e esterilização física

2025-07-29T00:00:00Z

Título: Análise biomecânica de miniparafusos ortodônticos submetidos a múltiplas inserções e esterilização física Autor(es): Santos, Victor Luiz Meneses Machado Abstract: Introduction: Anchorage control is crucial in orthodontics, so the use of auxiliary devices is necessary for treatment. Orthodontic tooth movement occurs through forces that cause action and reaction. Various devices are available to reinforce anchorage, but they do not eliminate the reaction caused by movement. Temporary anchorage devices, supported by a fixed point, eliminate the reaction effect caused by orthodontic movement. An excellent option is the orthodontic miniscrew, as it is easy to install and can be placed in various locations. Due to its low osseointegration, stability occurs through mechanical retention, so the main concern is the possibility of fracture. Objective: To evaluate the maximum insertion and removal torque of orthodontic miniscrews subjected to physical sterilization. Methodology: This study used 40 miniscrews, distributed into four groups (n=10), divided by the number of reuses and sterilizations. The miniscrews were inserted into a test specimen, then removed, sterilized, and reinserted to assess their resistance to insertion and removal torque. Torque was measured using a digital torque meter. Results: A statistically significant decrease in maximum insertion torque was observed, while maximum removal torque varied between the torque averages at the various times they were removed. However, a statistically significant decrease was observed between removals. The groups showed no statistical difference when evaluated at the same insertion and removal times, revealing homogeneity of the data.

Caracterização fenotípica e molecular de bactérias multirresistentes isoladas em um hospital universitário

2025-08-29T00:00:00Z

Título: Caracterização fenotípica e molecular de bactérias multirresistentes isoladas em um hospital universitário Autor(es): Matos, Rita de Cássia Santa Rosa Abstract: Healthcare-associated infections are a global concern, as they often involve multidrug resistant and virulent microorganisms, increasing mortality, hospital costs, and patient insecurity. These bacteria, both Gram-negative and Gram-positive, spread easily and can become superbugs by acquiring virulence factors and developing resistance mechanisms such as extended-spectrum β-lactamase (ESBL) production, carbapenemases, and vancomycin resistance. Thus, the present study investigated the antimicrobial resistance profile and virulence factors in multidrug-resistant bacteria isolated by the University Hospital of Lagarto (HUL), through phenotypic and genetic characterization. The project was approved by the Teaching and Research Management of HUL and by the Ethics Committee of the Federal University of Sergipe. The research was conducted between September 2023 and January 2025. Fifty strains were analyzed, and tests were performed for the detection of antimicrobial resistance, phenotypic detection of ESBL through the double-disk synergy test, and phenotypic detection of carbapenemases through the modified carbapenem inactivation method. Molecular tests were carried out to verify the presence of genes encoding ESBLs and carbapenemases. Tests were also conducted to detect virulence factors (polysaccharide capsule, type 1 fimbriae, hypermucoviscosity, and biofilm). Paeruginosa species were subjected to genetic testing for virulence genes (aprA, plcN, plcH, algD, and lasB). The most frequently found microorganism was Klebsiella pneumoniae (52 %), followed by Pseudomonas aeruginosa (14 %), Escherichia coli (10 %), Enterococcus faecalis (6 %), and other bacteria (18 %). The main source of isolates was urine (52 %). Regarding antimicrobial resistance, K. pneumoniae showed 92% resistance to fourth-generation cephalosporins and 73 % to carbapenems. Paeruginosa showed 100 % resistance to carbapenems, and E. coli showed 100% resistance to fluoroquinolones. Enterococcus faecalis and faecium showed 100% resistance to both vancomycin and teicoplanin. The most prevalent ESBL gene was TEM, with 51.1 %. 22.2 % of Gram-negative samples simultaneously harbored TEM + SHV + CTX-M-1 genes. The blaKPC gene was the most prevalent carbapenemase, detected in 40% of isolates, especially in P. aeruginosa (85.7 %). 35.1 % of Gram negative samples presented both carbapenemase and ESBL genes simultaneously. The vanA gene was found in 60 % of Enterococcus isolates. Among the virulence factors, 78 % had a polysaccharide capsule, 66 % had type 1 fimbriae, 94 % were biofilm producers, and all P. aeruginosa strains presented the tested virulence genes. The results confirmed the national trend of increasing detection of multidrug-resistant Gram-negative bacteria, especially K. pneumoniae and P. aeruginosa. The significant detection of biofilm and other virulence factors indicates a high infectious potential of the strains. The findings will serve as a basis for future studies and may contribute to improving the institution's protocols in combating healthcare-associated infections.

Disfunções do assoalho pélvico e sintomas urinários em mulheres hospitalizadas com doenças respiratórias

2024-08-30T00:00:00Z

Título: Disfunções do assoalho pélvico e sintomas urinários em mulheres hospitalizadas com doenças respiratórias Autor(es): Rebouças, Danielle Alves de Andrade Abstract: Introduction: Individuals affected by respiratory conditions may develop biomechanical and neuromuscular impairments associated with symptoms and dysfunctions of the pelvic floor. However, few studies have examined this set of conditions and analyzed their impacts on quality of life and survival, hospitalization, occurrence of infections, length of stay, and clinical outcomes. Objective: To analyze factors associated with pelvic floor dysfunction and urinary symptoms in hospitalized women affected by respiratory conditions. Method: This is a primary, observational, cross-sectional, descriptive, and analytical study conducted at the University Hospital of Lagarto (HUL). Participant selection and data collection were carried out in three stages. The first stage involved using electronic medical records to collect sociodemographic, anthropometric, functional, and clinical data. In the second stage, cognitive screening was performed using the 10-CS-Edu, and direct data on obstetric and urogynecological history were collected through interviews. In the third stage, the questionnaires used were: Pelvic Floor Disability Index (PFDI-20) (pelvic floor discomfort) and Chalder Fatigue Questionnaire (CFQ-11) (physical and mental fatigue symptoms). Results: A total of 92 women were evaluated, with a mean age of 70.93 years; most had low body weight, low education, and restrictive and infectious respiratory conditions. For the second stage, 64 (69.56%) participants were excluded due to clinical instability, motor, cognitive, or consciousness deficits. Twenty-one women were recruited for the administration of the PFDI-2 and CFQ-11 questionnaires. Quantitative analyses were performed on data from 73 of the 92 participants using Stata 17.0® software, with statistical significance set at a 5% level (p < 0.05). Differences in sample characteristics based on urinary tract infection and indwelling urinary catheter (IUC) were analyzed using chi-square tests, analysis of variance (ANOVA), and Tukey's post hoc test. A total of 66.7% of participants self-reported mild pelvic floor dysfunction symptoms, with a mean score of 5.28 (± 6.47) on the urinary symptom subscale (UDI-6). Additionally, 66.7% exhibited signs of fatigue, with a mean score of 7.71 (± 6.09) in the physical domain. The prevalence of urinary tract infection and use of an indwelling urinary catheter (IUC) in the population was 48.39%, with 21.43% having isolated urinary tract infections and 51.61% having IUCs. After adjusting for confounding variables (age, marital status, BMI, and current IMS), the association between IUC use and urinary tract infection remained significant (adjusted OR = 3.98; 95% CI: 1.13 - 14.00; p = 0.031). Conclusion: Therefore, women with reduced functionality who use IUCs are at an increased risk of developing urinary tract infections in the hospital setting.