Úlceras de pressão: um estudo com pacientes de unidade de terapia intensiva

To characterize patients according to gender, age category, internment time, diagnostical hypothesis and location of the pressure ulcer; to identify the susceptibility conditions, intrinsical and extrinsical factors present on ICU patients and to verify on the existence of association between the susceptibility conditions and the intrinsecal and extrinsecal factors on the occurrence of PU. Methods: It is a descriptive study, of longitudinal design of the panel type, with quantitative approach, performed on two ICU s of a private hospital located in Natal/RN, with 40 patients interned at these units. The data collection was performed on all three shifts through a structured observation and physical exam of the patients' skin form seeking to identify the presence of PU. Results: The greatest occurence of PU was on individuals of the male gender (70%) when compared to the female gender (30%), that difference being statistically significant (p=0,0267), with the male gender presenting 4,3 times greater chance of developing PU than the female; the predominant age category was from 60 years of age on (85%), 60,0% presented 1 to 2 PU s after 7 (seven) days of permanence in the ICU s, the predominant diagnostical hypothesis on the patients with PU were the respiratory diseases (42,3%) and the most frequent locations of PU were the sacral region (40,0%) and heels (36,0%). 25 PU s of stage I were diagnosed on 50,0% of the followed patients, with general incidence of 50,0% on both ICUs. from the 88 variables researched, 75 were identified on the patients from the study, being the predominant conditions (anemia, hypotension, leukocytosis, other diseases hypertension blood pressure, cardiac insuffience, pneumonia - and ansiolythic), the intrinsecal factors (diminished muscular strenght and/or mass, discrete edema, totally compromised mobile coordination and total inability for movement on the bed) and the extrinsecal factors (inadequate mattress type, permanence on a single position for >2 hours, shearing/friction force, bed clothes with folds that leave marks on the body, pressure force) predominated on patients with PU. The male gender variables (p=0,0267,OR=4,3), sedation (p=0,0006,OR=4,1), psychomotive agitation (p=0,0375,OR=5,8) and leukocytosis (p=0,0285,OR=5,0) presented a significant statistical diference when analyzed independently. We verified an association of 17,3%, statistically significant (p=0,0384), between the susceptibility conditions (anemia, leukocytosis and hypotension), the intrinsecal factors (age equal or above 60 years, diminished/absent pain sensibility and smooth, fine or delicate skin) and the extrinsecal factors (inadequate mattress, pressure forces, shearing/friction force, permanence on a single position for more than 2 hours, elevation between 30 to 45 degrees and inadequate bed clothes' conditions), with a chance ratio of 4,6 times the risk of occurrence of PU on the patients that presented the referred association. Conclusion: The incidence of PU detected on the ICU-interned patients was high and we made evident the existence of association between the susceptibility conditions, the intrinsecal and extrinsecal factors on the occurrence of PU s on the ICUinterned patients, and thus we accept the alternative hypothesis proposed on the study

Escritura nômade e tédio em "Harmada", de João Gilberto Noll

In the context of poetic productions of modernity and postmodernity (Hutcheon, 1999), this paper, from the concept of nomadism (Deleuze, 2012), together with the philosopher Derrida's notion of writing (2009), has the objective to study Harmada the novel (1993), written by artist Joao Gilberto Noll, the aspect of Nolliana nomadic scripture and boredom towards deconstruction of the Romanesque style. The narrative focus on introducing a transit fiction, promoted by nomadisms scripture of the wandering narrator who, in the work constitution, will the conduct of language, a plot that invades the body of the characters full of boredom and foreigners themselves, moving in fragmented and fluid spatiality of narrating. In this perspective, the research is limited with theoretical and methodological foundation in poststructuralist discussions in relation to considerations of literary aesthetics and concerning the thinkers-teóricos- critics: Derrida (2009), Deleuze (1995), Foucault (1996, 2001), Barthes (1977), Svendsen (2006). Against the background of critical understanding, the nomadic writing Harmada interlace in three stages: first, in the author's language; Second, the characters, the narrator-protagonist leading, unnamed, living overwhelming crises and painful existential ambiguity, placed through the artist's metaphor failed under the sign of "missing" while searching for other possible artistic ways of being in the world; and, finally, the nomadic reading instance as presentification effect (GUMBRECHT, 2010) for a reader experimentation. Finally, our work addresses the relationship between the nomadic scripture and the experience of boredom as a strategic power in the literature do Noll gear.