You searched for:"Amaury Cezar Jorge"
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Original Article
Functional independence and spirometry in adult post-intensive care unit patients
Rev Bras Ter Intensiva. 2021;33(2):243-250
Abstract
Original ArticleFunctional independence and spirometry in adult post-intensive care unit patients
Rev Bras Ter Intensiva. 2021;33(2):243-250
DOI 10.5935/0103-507X.20210031
Views0ABSTRACT
Objective:
To relate functional independence to the degree of pulmonary impairment in adult patients 3 months after discharge from the intensive care unit.
Methods:
This was a retrospective cohort study conducted in one adult intensive care unit and a multi-professional post-intensive care unit outpatient clinic of a single center. Patients admitted to the intensive care unit from January 2012 to December 2013 who underwent (3 months later) spirometry and answered the Functional Independence Measure Questionnaire were included.
Results:
Patients were divided into groups according to the classification of functional independence and spirometry. The study included 197 patients who were divided into greater dependence (n = 4), lower dependence (n = 12) and independent (n = 181) groups. Comparing the three groups, regarding the classification of the Functional Independence Measure, patients with greater dependence had higher Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment values at intensive care unit admission with more advanced age, more days on mechanical ventilation, and longer stay in the intensive care unit and hospital. The majority of patients presented with pulmonary impairment, which was the obstructive pattern observed most frequently. When comparing functional independence with pulmonary function, it was observed that the lower the functional status, the worse the pulmonary function, with a significant difference being observed in peak expiratory flow (p = 0.030).
Conclusion:
The majority of patients who returned to the outpatient clinic 3 months after discharge had good functional status but did present with pulmonary impairment, which is related to the degree of functional dependence.
Keywords:Ambulatory care facilities, hospitalCritical careIntensive care unitsMobility limitationPeak expiratory flow rateRespiration, artificialSpirometrySee more -
Case Reports
Marchiafava-Bignami disease: a rare entity with a poor outcome
Rev Bras Ter Intensiva. 2013;25(1):68-72
Abstract
Case ReportsMarchiafava-Bignami disease: a rare entity with a poor outcome
Rev Bras Ter Intensiva. 2013;25(1):68-72
DOI 10.1590/S0103-507X2013000100013
Views0Marchiafava-Bignami disease is a rare affliction characterized by primary degeneration of the corpus callosum associated with chronic consumption of ethanol. The disease may occasionally occur in patients who are not alcoholics but are chronically malnourished. A complex deficiency of group B vitamins is the main etiopathogenic hypothesis, and many patients improve after the administration of these compounds. However, a good response is not always observed. The definitive diagnosis of Marchiafava-Bignami disease can be problematic and is based on features of neuroimaging studies, especially magnetic resonance imaging. Its treatment is still controversial and shows variable results. Because nutritional factors are implicated, as in Wernicke’s encephalopathy, some authors claim that replacement of B vitamins is beneficial. The present article is a case report of a severe acute form of Marchiafava-Bignami disease in an alcohol-dependent male patient who improved after the administration of parenteral B vitamins. As a consequence of his neurological and immunologic conditions, he developed multiple pulmonary infections and had a protracted course in the intensive care unit. He eventually died of sepsis associated with an uncommon fungus, Rhodotorula mucilaginosa. The present article reports the clinical and neuroimaging data from this patient and contains a review of Marchiafava-Bignami disease and Rhodotorula infections in the intensive care unit.
Keywords:AlchoolismBrain diseasesCase reportsinfectionMagnetic resonance imagingMarchiafava-Bignami diseaseSee more
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Case reports Child Coronavirus infections COVID-19 Critical care Critical illness Extracorporeal membrane oxygenation Infant, newborn Intensive care Intensive care units Intensive care units, pediatric mechanical ventilation Mortality Physical therapy modalities Prognosis Respiration, artificial Respiratory insufficiency risk factors SARS-CoV-2 Sepsis