Objetivo: determinar os principais fatores de risco para a morte em pacientes com sepse em uma unidade de terapia intensiva. Métodos: trata-se de uma coorte retrospectiva, onde foram incluídos 124 prontuários de pacientes que tiveram diagnóstico clínico e laboratorial de sepse. A probabilidade condicional de morte foi calculada através do método de Kaplan-Meier; o risco de morte foi estimado pela razão de risco, utilizando modelo de regressão de Cox com p<0,050. Resultados: o foco principal da infecção foi o sistema respiratório. Em relação ao desfecho, morreram 40,3% pacientes com sepse, 73,9% com sepse grave e 69,2% com choque séptico. Os pacientes com sepse abdominal e que utilizaram vasopressores apresentaram maior risco de morte. Conclusão: pacientes sépticos com fonte abdominal de infecção e fazendo uso de agentes vasopressores apresentaram maior risco de morte, enquanto que pacientes traqueostomizados tiveram melhores chances de sobreviver.

Aims: The present work evaluated the synergistic effect of therapeutic ultrasound associated with fluconazole on Candida albicans in vitro. Place and Duration of Study: The experiments were carried out at the Phytopathology Laboratory at the Federal University of Acre (UFAC) and the Microbiology Laboratory at the Estácio Meta University Center in Rio Branco City, State of Acre, Brazil. Methodology: The experiments used a standard strain of Candida albicans (ATCC 10231). Planktonic suspensions of C. albicans were prepared and exposed to ultrasonic waves at frequencies of 1 MHz and 3 MHz, and intensity of 1.0 W/cm², with application times of 5, 10, and 15 minutes. The treatment groups were ultrasound (UST) alone, Fluconazole alone (FLU), ultrasound combined with Fluconazole (UST + FLU), and a control group (no UST, no FLU). After 24 hours, a count of the Colony Forming Units (CFUs) was performed. Results: According to the results, a greater growth inhibition was observed in treatments (UST + FLU) at both frequencies for all three application times. It indicates that, at least in the conditions we used, therapeutic ultrasound combined with fluconazole inhibited the growth of C. albicans in vitro. The antimicrobial effect of this treatment was greater than the one with UST alone and with fluconazole alone. Conclusion: The association of antifungals with ultrasound can be considered a promising strategy to treat infections caused by fungi, allowing a reduced therapeutic period.

Objetivo: identificar o perfil epidemiológico, os fatores associados ao óbito e nortear as intervenções de enfermagem frente aos pacientes com sepse de foco abdominal. Método: trata-se de um estudo quantitativo, descritivo, transversal, realizado com 40 pacientes internados em uma em uma Unidade de Terapia Intensiva. Realizou-se a associação com o óbito por meio dos testes de qui-quadrado de Pearson e exato de Fisher. Apresentaram-se os resultados em forma de tabelas. Resultados: registra-se que, dos 40 (100%) pacientes, 57,5% eram do sexo masculino, 67,5% tinham um diagnóstico inicial pertencente ao sistema gastrointestinal. Elencam-se as variáveis que apresentaram a associação com o óbito nesta UTI: idade maior a 60 anos, que, embora representasse apenas 22,5% da amostra, respondeu por, aproximadamente, 90% das mortes (p-valor 0,005) e pacientes que foram classificados com choque séptico, já que 56,7% dos 75% foram a óbito (p-valor 0,04). Conclusão: entende-se que os fatores de risco associados ao óbito nos pacientes com sepse de foco abdominal na UTI estão relacionados com idade maior a 60 anos e com choque séptico. Descritores: Sepse; Fatores de Risco; Mortalidade; Unidade de Terapia Intensiva; Enfermagem; Perfil Epidemiológico.Abstract Objective: to identify the epidemiological profile, the factors associated with death, and to guide nursing interventions in patients with sepsis of abdominal focus. Method: this is a quantitative, descriptive, cross-sectional study of 40 patients hospitalized in one in an Intensive Care Unit. The association with death was performed using Pearson's chi-square test and Fisher's exact test. Results were presented in the form of tables. Results: it was recorded that of the 40 (100%) patients, 57.5% were male, 67.5% had an initial diagnosis belonging to the gastrointestinal system. The variables that showed association with death in this ICU were: age greater than 60 years, which, although representing only 22.5% of the sample, accounted for approximately 90% of the deaths (p-value 0.005) and patients which were classified as septic shock, since 56.7% of the 75% died (p-value 0.04). Conclusion: it is understood that the risk factors associated with death in patients with sepsis of abdominal focus in the ICU are related to age greater than 60 years and with septic shock. Descriptors: Sepsis; Risk Factors; Mortality; Intensive Care Unit; Nursing; Profile Epidemiological.Resumen Objetivo: identificar el perfil epidemiológico, los factores asociados al óbito y orientar las intervenciones de enfermería frente a los pacientes con sepsis de foco abdominal. Método: se trata de un estudio cuantitativo, descriptivo, transversal, realizado con 40 pacientes internados en una Unidad de Terapia Intensiva. Se realizó la asociación con el óbito por medio de las pruebas de chi-cuadrado de Pearson y exacto de Fisher. Se presentaron los resultados en forma de tablas. Resultados: se registra que, de los 40 (100%) pacientes, el 57,5% eran del sexo masculino, el 67,5% tenían un diagnóstico inicial perteneciente al sistema gastrointestinal. Se identifican las variables que presentaron la asociación con el óbito en esta UTI: edad mayor a 60 años, que, aunque representaba apenas el 22,5% de la muestra, respondió por aproximadamente el 90% de las muertes (p-valor 0,005) y pacientes que fueron clasificados con shock séptico, ya que el 56,7% del 75% fue la muerte (p-valor 0,04). Conclusión: se entiende que los factores de riesgo asociados al óbito en los pacientes con sepsis de foco abdominal en la UTI están relacionados con edad mayor a 60 años y con shock séptico. Descriptors: Sepsis; Factores de riesgo; Mortalidad; Intensive Care Unit; Enfermería; Perfil Epidemiológico.

Introduction: Breast engorgement (BE) is a problem that affects many women, especially in the first days of breastfeeding, producing inflammatory symptoms. Nonpharmacological therapies are inexpensive, safe, and can produce symptom relief. Objective: This study aims to analyze the safety of therapeutic ultrasound regarding possible risks of overheating and the effects of its use alone and associated with lymphatic drainage (LD) in women. Material and Methods: Effectiveness is measured through thermography, visual analog scale, and six-point scale of BE. This is a nonrandomized clinical trial with a sample of 34 in the ultrasound group (G1), 28 in the ultrasound and LD group (G2), and 37 in the control group (G3). Results: The mean reduction for engorgement was 1.3 ± 0.8 to G1, 1.4 ± 1.0 to G2, and 1.2 ± 0.9 to G3 according to the six-point scale. The mean reduction for pain level was 3.6 ± 2.1 to G1, 4.0 ± 3.1 to G2, and 4.0 ± 2.2 to G3 according to the visual analogue scale. Conclusion: It was observed that all therapies were effective in reducing the level of engorgement, according to the six-point scale. However, combined ultrasound and LD therapy has been shown to be more effective in reducing the level of pain. Brazilian Registry of Clinical Trials (RBR-6btb6zz).