RESUMO Objetivo Identificar o perfil clínico-epidemiológico de adolescentes e jovens vítimas de perfuração por arma de fogo internados em hospital referência em trauma na região Nordeste do Brasil. Métodos Abordagem quantitativa, descritiva, no período de junho a dezembro de 2014, em Fortaleza, no Ceará. A amostra contou com 231 participantes de 12 a 24 anos. A coleta se deu por entrevista com os participantes. Adotou-se nível de significância 5% (p<0,05). Resultados A média de idade foi de 19,96 anos, com maioria procedente de bairros de periferia (50,4%), cinco a oito moradores na família (54,1%), homens (93,5%), pardos (57,6%), com 1º grau incompleto (52,8%), usuários de drogas ilícitas (65,31%), com renda familiar ínfima (39,4%), sem ocupação (41,1%), envolvidos diretamente com a violência (69%) e desavenças como causa da lesão (25,9%). O tempo de internação foi de 16 a 30 dias (42,9%), tendo os membros como as estruturas do corpo mais atingidas (58,7%). Conclusão Este estudo possibilitou a análise dos fatores desencadeantes da violência armada e do seu impacto na sociedade, favorecendo a elaboração de medidas preventivas.

BackgroundTo assess the impact of heart transplantation (HT) on the recovery of peripheral and respiratory muscle mass and strength in patients with congestive heart failure.MethodsThe study included 23 patients with an indication for HT (patients in the waiting list [WL] group). These patients were monitored for 1.5 to 3 years after HT; 8 died before 6 months of follow-up, 15 patients completed the early follow-up period of 6 months after HT (FU6m group), 4 died between 6 months and 3 years after HT, and 11 patients completed the late follow-up period 1.5 to 3 years after HT (FU1.5-3y group). Twenty-three healthy subjects were included in the control group. The study variables included inspiratory muscle strength, expressed as the maximum inspiratory pressure (MIP); expiratory muscle strength, expressed as the maximum expiratory pressure (MEP); peripheral muscle strength, expressed as bilateral handgrip strength (bHGS); and the cross-sectional area of the bilateral psoas major muscle (CSAbPm).ResultsThe results showed a reduction in the CSAbPm (1238.9 ± 312.3 mm2), a reduction in the bHGS (27.0 ± 5.7 kg/f), a reduction in the MIP (60.2 ± 29.8 cmH2O), and a reduction in the MEP (75.2 ± 33.4 cmH2O) in patients in the WL group compared with the healthy controls. In the time series comparison, for patients in the WL, FU6m, and FU1.5-3y groups, increases were found in the CSAbPm (1305.4 vs 1458.1 vs 1431.3 mm2, respectively), bHGS (27.3 vs 30.2 vs 34.7 kg/f, respectively), MIP (59.5 vs 85.5 vs 90.9 cmH2O, respectively), and MEP (79.5 vs 93.2 vs 101.8 cmH2O, respectively) (P < 0.00).ConclusionsSarcopenia was observed in patients in the WL group. Patients recovered peripheral and respiratory muscle mass and strength at 3 years after HT.

O suporte ventilatório mecânico é decorrente da incapacidade pulmonar realizar suas funções, quando este suporte é utilizado por mais de 6h por dia, a partir de 21 dias consecutivos recebe a classificação de ventilação mecânica prolongada. O estudo teve como objetivo analisar os pacientes em ventilação mecânica prolongada em Unidade de Terapia Intensiva. Foi realizada uma pesquisa de natureza descritiva, longitudinal, com abordagem quantitativa dos resultados no período de outubro a dezembro de 2016. O estudo foi obtido por análise de prontuários dos pacientes, que ficaram em ventilação mecânica prolongada, internados em Unidades de Terapia Intensiva. Foram incluídos no estudo nove prontuários de pacientes em ventilação mecânica prolongada, com idade média 38,33±16,49 anos. Com relação ao diagnóstico clínico, o Traumatismo Cranioencefálico obteve maior predominância, sendo o acidente de moto a principal causa. A maioria dos pacientes se encontrava com sinais vitais e índice de oxigenação normais, eutróficos, com balanço hídrico positivo e alcalose metabólica. Em relação à função respiratória, algumas complicações foram aprensentadas nas variáveis Raio X, Ausculta Pulmonar e Secreção Traqueobrônquica. Já o modo ventilatório mais utilizado foi a Ventilação com Pressão de Suporte 67% (n=6). Conclui-se que houve incidência de 14, 7% pacientes em ventilação mecânica prolongada no hospital de trauma, e que as causas ou fatores associados a este prolongamento da ventilação pulmonar mecânica são diversos. Palavras-chave: Ventilação Mecânica. Terapia Intensiva. Trauma AbstractMechanical ventilatory support results from pulmonary inability to perform its functions, when it is used for more than 6 hours per day, from 21 consecutive days, and it  is classified as prolonged mechanical ventilation. The objective of the study was to analyze patients on prolonged mechanical ventilation in an intensive care unit. A descriptive, longitudinal study was carried out with a quantitative approach of the results from October to December 2016. The study was obtained from the patients’ medical records who underwent prolonged mechanical ventilation in intensive care units. Patients’ nine charts on prolonged mechanical ventilation, with a mean age of 38.33 ± 16.49 years, were included in the study. Regarding the clinical diagnosis, Cranioencephalic trauma was more prevalent, motorcycle accident being the main cause. Most patients had normal, eutrophic vital signs and oxygenation index, with positive water balance and metabolic alkalosis. Regarding the respiratory function, some complications were presented in the variables X-ray, Pulmonary Auscultation and Tracheobronchial Secretion. On the other hand, the most used ventilatory mode was Ventilation with Support Pressure 67% (n = 6). It was concluded that there was an incidence of 14.7% of patients on prolonged mechanical ventilation in  trauma hospital, and that the causes or factors associated with this prolongation of mechanical pulmonary ventilation are diverse.                                                                                                                               Keywords: Mechanical ventilation; Intensive therapy; Trauma

Objective: To determine the incidence of preterm newborn infants in mechanical ventilation who developed bronchopulmonary dysplasia in a public hospital at Fortaleza/CE. Method: Descriptive, retrospective and longitudinal quantitative analysis with 1250 preterm infants admitted to the Intensive Care Unit, Dr. César Cals General Hospital, at Fortaleza, from July 2006 to June 2007. Data collection occurred during two months, with visits to units twice a week, where the medical records were done. Were included in these sample newborns that were in mechanical ventilation and developed bronchopulmonary dysplasia. Then the gestational average was 28.6 weeks; the mean weight of infants was 1125.33 grams, born vaginally or cesarean section, of both sexes and with various primary diseases such as respiratory distress syndrome, jaundice and neonatal infection. Results: In the sample from the total admissions, 34.48% were for mechanical ventilation and 3.48% developed bronchopulmonary dysplasia. Conclusion: Despite the low prevalence, bronchopulmonary dysplasia is a important complication of prematurity, directly related to the duration of mechanical ventilation, thus the team must be committed on weaning and extubation of those as soon as possible, preferably within the first week of life.

The International Classification of Functioning, Disability and Health (ICF) generates health information and allows identification of the impact on the functionality in different clinical situations, for example in drilling by firearms (PAF). Objective: The aim of the study was describe the impact of violence by firearms on adolescent and young hospitalized in a referral hospital in trauma based in the international classification of functioning, disability and health. Method: Descriptive, cross-sectional, quantitative, conducted from June to December 2014, in Fortaleza-CE, Brazil. The sample consisted of 231 participants of both genders and aged 12 to 24 years. Applied a summary list of ICF in two moments, the admission and discharge. Results: The most altered categories of Activity and Participation component at admission were mobility (72.27%), interactions relationships (65.4%) and self-care (37.8%); Body component and respiratory functions were (26.71%), and sensory pain (25.35%), voice and speech (20.1%), mental (13.26%) and neuromusculoskeletal (11,04%). At discharge, the most altered categories of Activity and Participation component were interactions relationships (64.5%), mobility (36.79%) and self-care (29.29%); and the Body Functions component were sensory and pain (23.38), voice and speech (16.8%), mental (13.26%), neuromusculoskeletal (10.45%), and respiratory system (5.05%). The categories related to mobility and breathing, were those with the highest percentages of improvement in high, while the sensory functions and activities related to interpersonal interaction showed the lowest percentage of improvement. Conclusion: This classification made it possible to trace a feature profile of these individuals and encode information by CIF, detecting the risk of functional impairment at admission and discharge, decisive for the resolution of the clinical realities.