HU - Hospital Universitário

URI Permanente desta comunidadehttps://repositorio.univasf.edu.br/handle/123456789/1307

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    Perfil clínico-epidemiológico e microbiológico das pneumonias associadas à ventilação mecânica na unidade de terapia intensiva de hospital universitário do sertão do Pernambuco
    (2026-05-21) Pinto, João Pedro de Carvalho; Naue, Carine Rosa; Aquino, Samuel Ricarte de
    Background: Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in intensive care units, associated with increased morbidity and mortality, prolonged hospital stay, and higher healthcare costs. Understanding the clinical, epidemiological, and microbiological profile of affected patients is essential to guide prevention and treatment strategies.Objective: To describe the clinical, epidemiological, and microbiological profile of patients diagnosed with VAP in the intensive care unit of a university hospital in the São Francisco Valley. Methods: This is a cross-sectional, analytical, and retrospective study including 107 patients diagnosed with VAP between January 2023 and July 2025 at the University Hospital of the Federal University of Vale do São Francisco (HU-UNIVASF). Sociodemographic, clinical, microbiological, and outcome data were collected from electronic medical records. Continuous variables were expressed as mean and standard deviation, while categorical variables were presented as absolute and relative frequencies. Statistical analysis was performed using Student’s t-test and the chi-square test. Results: A predominance of male patients (75.7%) was observed, with a mean age of 47.8 ± 19.6 years. The main causes of admission were trauma-related conditions, particularly traumatic brain injury (53.7%) and polytrauma from traffic accidents (28.0%). Microbiological analysis showed a predominance of Gram-negative bacteria (76.4%), with Acinetobacter baumannii being the most frequent pathogen (40.2%), followed by Staphylococcus aureus (21.5%), Pseudomonas aeruginosa (17.8%), and Klebsiella pneumoniae (13.1%). The mean hospital length of stay was 49.1 days, and the mean duration of mechanical ventilation was 21.3 days. The mortality rate was 28%, with higher mean age among non-survivors compared to survivors (56.9 ± 21.3 vs. 43.5 ± 18.4 years; p = 0.012). Conclusion: VAP predominantly affected male patients with trauma-related conditions, especially traumatic brain injury and polytrauma, and was associated with a predominance of Gram-negative pathogens, high mortality, and prolonged hospitalization and mechanical ventilation. Higher CPIS scores were not associated with worse outcomes.
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    Associação entre padrões pressóricos de 24 h e remodelamento cardíaco ao ecocardiograma em pacientes com insuficiência cardíaca de ejeção reduzida: subanálise do estudo IMPACT-HF
    (2026-05-27) Diniz Junior, Edvaldo Alves; Armstrong, Anderson da Costa
    This research is a cross-sectional, descriptive, and exploratory analytical study of patients with heart failure with reduced ejection fraction (LVEF < 40%) included in the IMPACT-HF study, who underwent ambulatory blood pressure monitoring (ABPM) and echocardiography before the start of the intervention. The recruitment period was from September 2024 to February 2026, totaling a sample size of 21 patients with a mean age of 52.4 ± 9.0 years, predominantly male (66.7%; 95% CI: 46.4% – 86.9%). Its objective is to correlate ABPM blood pressure patterns with echocardiographic phenotypes in this group of patients, in order to evaluate the association between ABPM patterns and echocardiographic markers of remodeling. To assess the associations between the qualitative variables of ABPM and the echocardiographic domains, the Chi-square test of independence or, preferably, Fisher's exact test was applied, with the level of statistical significance set at 5% (p < 0.05) for all tests performed. The data obtained revealed a negative correlation between the percentage of nocturnal decrease in systolic blood pressure and the E/A ratio (r = -0.527; p = 0.017), highlighting that the "Non-Dipper" and "Riser" patterns are associated with worsening diastolic dysfunction indices and increased filling pressures of the cardiac chambers. The "Non- Dipper" pattern was also associated with ventricular remodeling, accounting for 40% of all cases of hypertrophy and chamber dilation. Altered systolic pressure load (≥ 20%) showed a strong positive association with relative left ventricular wall thickness (r = 0.557; p = 0.009) and an inverse association with indexed end-diastolic volume (r = -0.502; p = 0.020), relating increased pressure load to myocardial thickening and consequent restriction of the ventricular cavity's dilation and accommodation capacity. Finally, this study did not correlate a more stringent blood pressure target (SBP < 120 mmHg) with echocardiographic worsening in this patient profile.
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    Análise do perfil epidemiológico, clínico e genético da amiloidose por transtirretina no interior de Pernambuco
    (Universidade Federal do Vale do São Francisco, 2026-07-19) Queiroz, Ana Júlia dos Santos; Armstrong, Anderson da Costa
    Transthyretin amyloidosis (ATTR) is a systemic disease caused by extracellular deposition of amyloid fibrils derived from the transthyretin protein, occurring in hereditary (ATTRv) and wild-type (ATTRwt) forms. Despite recent therapeutic advances, ATTR remains underdiagnosed, especially in regions with limited epidemiological data, such as the inland areas of Northeastern Brazil. This study aimed to characterize the epidemiological, clinical, and genetic profile of patients with ATTR treated at the rare diseases outpatient clinic of UNIVASF, located in Petrolina, Pernambuco, Brazil. This was a retrospective, observational, cross-sectional analytical study including 207 patients evaluated between January 2022 and August 2025. Patients were stratified into TTR-positive (n = 85) and non-TTR (n = 122) groups. Pearson’s chi-square and Mann–Whitney tests were applied, considering statistical significance at p < 0.05. The mean age was 54.4 ± 23.2 years, with a slight female predominance (51.2%). The Val142Ile mutation was identified in 97.7% of TTRpositive cases. The predominant phenotypes were mixed (50%), cardiac (25%), and neurological (25%). Significant associations were observed between TTR positivity and age (p = 0.04), sex, mutation type, and clinical phenotype (p < 0.05). Only 14.11% of patients were receiving tafamidis therapy. A possible regional cluster was identified in the municipalities of Cabrobó, Salgueiro, and Petrolina. The predominance of the Val142Ile mutation and the identification of possible geographic aggregation reinforce the need for active screening strategies and strengthening of specialized regional centers for the diagnosis and management of ATTR in inland Northeastern Brazil.
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    Fatores determinantes da mobilização precoce em pacientes neurocríticos adultos em unidade de terapia intensiva: estudo retrospectivo observacional
    (Universidade Federal do Vale do São Francisco, 2026-08-03) Luna, Emelle de Espíndola; Maia, Thais Lopes Ferreira Diniz
    Early mobilization reduces complications related to immobility in intensive care units (ICUs); however, its implementation in neurocritical patients remains inconsistent and poorly characterized in real-world settings. This study identifies barriers to early mobilization in adult neurocritical patients admitted to the ICU and evaluates the compliance of documented justifications for non-mobilization with the institutional protocol. This is a retrospective, single-center observational study including adult neurocritical patients admitted to an ICU. The analyzed outcomes include daily mobilization status, reasons for non-mobilization categorized as clinical, organizational, and structural barriers, and the compliance of clinical justifications with the institutional Standard Operating Procedure (SOP). Among 163 patients, corresponding to 1,798 patient-days, 64.7% of ICU days occurred without mobilization. Clinical barriers predominated (82.6%), particularly general clinical and hemodynamic criteria, whereas organizational and structural barriers accounted for 16.6% and 0.6%, respectively. Of the 1,164 justifications for non-mobilization, 66.4% were compliant with the SOP, a proportion significantly higher than expected by chance (exact binomial test, p < 0.001; 95% CI, 63.6%–69.1%). A relevant proportion of justifications was not included in the protocol, indicating possible gaps between formal guidelines and bedside practice. Early mobilization in neurocritical ICU patients is predominantly limited by clinical restrictions, reflecting the complexity of this population; however, organizational factors and protocol gaps also contribute to this scenario. Periodic protocol review and continuous interprofessional education may improve alignment between guidelines and practice, promoting safer and more consistent implementation of early mobilization.