ABSTRACT Introduction: a pressure ulcer is an injury that is located at the level of the skin and deeper tissues. The beginning of the appearance of pressure ulcers can constitute a major problem in the health of patients, causing physical discomfort, increasing hospitalization time and treatment costs. Objectives: describe the prevalence of hospitalized patients with pressure ulcers in the medical clinic service of the modular block of the National Hospital, 2022 - 2023. Methodology: observational, descriptive, prospective design study, which included 223 adult patients admitted to the medical clinic service of the Hospital Nacional (Itauguá, Paraguay) during the period from 2022 to 2023. Results: the prevalence found was 9.4 %. The average age was 64 years, with a predominance of males (58 %). The most frequent location of the ulcers was at the sacral level (64 %), 14 % were multiple. Cerebrovascular accident was found as a determining pathology for the development of pressure ulcers (41 %). Pressure ulcers grade 1 and 2 were the most frequent (41 % both). Conclusion: pressure ulcers are a common pathology in hospitalized patients. There are associated comorbidities, stroke being one of the most frequent.

RESUMEN Introducción: la úlcera por presión es aquella lesión que se localiza a nivel de la piel y tejidos más profundos. El comienzo de la aparición de ulceras por presión puede constituir un problema importante en la salud de los pacientes, causar molestias físicas, aumentar el tiempo de hospitalización y los costos de tratamiento. Objetivos: describir la prevalencia de pacientes internados que presentan úlceras por presión en el servicio de clínica médica del bloque modular del Hospital Nacional, 2022 a 2023. Metodología: estudio de diseño observacional, descriptivo, de corte transversal, que incluyó a 223 pacientes adultos internados en el Servicio de Clínica Médica del Hospital Nacional (Itauguá, Paraguay) durante el periodo de 2022 a 2023. Resultados: la prevalencia encontrada fue de 9,4 %. La edad media fue de 64 años, con predominio del sexo masculino (58 %). La localización más frecuente de las ulceras fue a nivel sacro (64 %), fueron múltiples el 14 %. Se encontró como patología determinante para el desarrollo de ulceras por presión el accidente cerebrovascular (41 %). Las ulceras por presión grado 1 y 2 fueron las más frecuentes (41 %, ambos). Conclusión: las ulceras por presión son una patología frecuente en pacientes internados. Existen comorbilidades asociadas, siendo el accidente cerebrovascular una de las más frecuentes.

ABSTRACT Aging is associated with physiological, economic, and psychological changes that can compromise nutritional and functional status. Aim: To determine the nutritional status of institutionalized older people living in a long-term nursing home "Fundación las Rosas" (FLR), the largest long-stay establishment in Chile, in 2019, and its relationship with functionality. Methods: Descriptive study of analysis of secondary data in 1646 older adults institutionalized in FLR (60% women). The information collected was weight, height, Body mass index (BMI), Barthel Index, Mini-Mental State Examination, area, macrozone, sex, age, and date of admission to FLR. Logistic regression models of functionality and nutritional status, unadjusted and adjusted, were performed. Results: The percentage of normal-weight people was 40.3%; 38.1% presented some degree of malnutrition due to deficit, and 9.5% presented severe malnutrition (BMI≤18.5 kg/m2). 70% of people present total dependency. The low educational level reached 73%. Logistic regressions determined that people who were overweight, 70 years of age or older, had a low level of education, and cognitive impairment were positively associated with dependency, excluding bedridden people, with the strongest associations being not having any level of schooling and having cognitive impairment. The persons of low weight, with cognitive impairment, and with a low educational level were positively associated with institutionalized bedridden elderly, the strongest associations being not having any level of schooling and having cognitive impairment. Conclusions: In this study, malnutrition due to deficit and excess are positively associated with decreased functionality, and a low educational level is associated with dependency and being bedridden.

RESUMEN El envejecimiento se asocia con cambios fisiológicos, económicos y psicológicos que pueden comprometer el estado nutricional y funcional. Objetivo: Determinar el estado nutricional de las personas mayores institucionalizadas pertenecientes a Fundación las Rosas (FLR), establecimiento de larga estadía más grande de Chile, durante el año 2019 y su relación con funcionalidad. Métodos: Estudio descriptivo de análisis de datos secundarios en 1.646 personas mayores institucionalizadas en FLR (60% mujeres). La información recolectada fue peso, talla, Índice de masa corporal (IMC), Índice de Barthel, Mini-Mental State Examination, área, macrozona, sexo, edad y fecha de ingreso a FLR. Se realizaron modelos de regresión logística de funcionalidad y estado nutricional, sin ajustar y ajustados. Resultados: El porcentaje de personas normopeso fue de 40.3% y un 38.1% presenta algún grado de malnutrición por déficit, de los cuáles 9.5% entran en la clasificación nutricional de desnutrición severa (IMC≤18.5 kg/m2). El 70% de las personas presenta dependencia total. El nivel educacional bajo alcanzó un 73%. El sobrepeso, tener 70 años o más, el nivel de educación y el deterioro cognitivo se asociaron positivamente con dependencia, excluyendo a las personas postradas, siendo las asociaciones más fuertes no tener ningún nivel de escolaridad y tener deterioro cognitivo. Las personas enflaquecidas, con deterioro cognitivo y con nivel educacional bajo se asociaron positivamente con estar postrado, siendo las asociaciones más fuertes no tener ningún nivel de escolaridad y tener deterioro cognitivo. Conclusiones: En este estudio encontró que la malnutrición por déficit y por exceso están asociadas positivamente con una funcionalidad disminuida y que un bajo nivel educacional se asocia fuertemente con dependencia y con estar postrado.

Resumen Objetivo Elaborar y validar el contenido de un prototipo de aplicación móvil sobre la prevención de úlcera por presión (UP) para cuidadores de personas mayores. Métodos Estudio metodológico de producción tecnológica de prototipo en aplicación móvil. El desarrollo de la aplicación fue guiado por el modelo de diseño educativo contextualizado (DEC). La etapa de validación de contenido fue realizada por siete enfermeros docentes de un curso técnico para cuidadores de personas mayores de una institución educativa nacional, mediante la aplicación del instrumento Suitability Assessement of Materials (SAM). Los datos se analizaron con estadística descriptiva. Resultados El prototipo, que fue llamado LPPrev, contiene información sobre el concepto, estadificación, causas de la UP, principales lugares de acometimiento, además de recordatorios para reposicionar a la persona mayor en la cama. También tiene la posibilidad de registrar información nutricional, hidratación oral, higiene corporal e íntima y dispone de instrucciones sobre cuidados preventivos. La evaluación de contenido obtuvo un 96,6 % de concordancia entre los docentes, por lo que es considerado un material de calidad superior. Conclusión El LPPrev es un prototipo de aplicación bien estructurado según las categorías evaluadas por el SAM, con información relevante para los cuidadores de personas mayores encamadas y dependientes. Contribuye para el conocimiento teórico y los cuidados fundamentales para la prevención de úlcera por presión y está preparado para avanzar hacia las siguientes etapas del modelo de DEC. UP (UP DEC . (DEC) nacional SAM. SAM (SAM) descriptiva concepto estadificación acometimiento cama nutricional oral preventivos 966 96 6 96, superior dependientes (DEC (SAM 9

Abstract Objective To develop and validate the content of a mobile application prototype on Pressure Injury (PI) Prevention for elderly caregivers. Methods Methodological study of prototype-type technological production in mobile application. The application development was guided by the Contextualized Instructional Design (CID) model. The content validation stage was carried out by seven teaching nurses of a technical course for elderly caregivers in a federal educational institution with the application of the Suitability Assessment of Materials (SAM) instrument. Data were analyzed using descriptive statistics. Results The prototype, which was named LPPrev, contains information about the concept, staging, causes of LP, and main affecting sites, in addition to reminders to reposition the elderly in bed; registration of nutritional information, oral hydration, body and intimate hygiene, and guidance on preventive care is also possible. The content evaluation obtained 96.6% of agreement between professors, being considered a material of superior quality. Conclusion LPPrev is an application prototype properly structured according to the categories evaluated by the SAM, with relevant information for caregivers of bedridden and dependent elderly, contributing to theoretical knowledge and fundamental care in the prevention of injury by pressure, being prepared to move on to the other stages of the DIC model. PI (PI prototypetype type CID (CID model SAM (SAM instrument statistics concept staging LP sites bed hydration hygiene possible 966 96 6 96.6 professors quality pressure 9 96.

Resumo Objetivo Desenvolver e validar o conteúdo de um protótipo de aplicativo móvel sobre Prevenção de Lesão por Pressão (LP) para cuidadores de idosos. Métodos Estudo metodológico de produção tecnológica do tipo protótipo em aplicativo móvel. O desenvolvimento do aplicativo foi guiado pelo modelo de Design Instrucional Contextualizado (DIC). A etapa de validação de conteúdo foi realizada com sete enfermeiros docentes de um curso técnico para cuidador de idosos em uma instituição federal de ensino com a aplicação do instrumento Suitability Assessement of Materials (SAM). Os dados foram analisados usando a estatística descritiva. Resultados O protótipo, que foi nomeado LPPrev, contém informações sobre conceito, estadiamento, causas das LP, principais locais de acometimento, além de lembretes para reposicionar o idoso no leito; há também possibilidade de registro de informações nutricionais, hidratação oral, higiene corporal e íntima e disponibilização de orientações sobre cuidados preventivos. A avaliação de conteúdo obteve 96,6% de concordância entre os docentes, sendo considerado um material de qualidade superior. Conclusão O LPPrev é um protótipo de aplicativo adequadamente estruturado segundo as categorias avaliadas pelo SAM, com informações relevantes aos cuidadores de idosos acamados e dependentes, contribuindo para o conhecimento teórico e cuidados fundamentais na prevenção de lesão por pressão, estando preparado para avançar para as demais etapas do modelo de DIC. LP (LP DIC . (DIC) SAM. SAM (SAM) descritiva conceito estadiamento acometimento leito nutricionais oral preventivos 966 96 6 96,6 superior dependentes pressão (DIC (SAM 9 96,

Abstract Objective To identify caregivers' understanding of healthcare assistance received from primary health care regarding their own health. Method A qualitative study based on Alfred Schütz's phenomenology was conducted. The approach to caregivers of bedridden older adults was carried out by community health agents within their coverage area in a primary health care unit located in the northern region of Espírito Santo, Brazil. The choice of location was convenience-based. Data collection took place between September and December 2022 in households. A questionnaire containing questions about the participants' sociodemographic profile, along with six phenomenological questions to understand the typical experiences of each caregiver of older adults and their intentionality, was administered. Data were analyzed using phenomenological methods. Results Sixteen caregivers of bedridden older adults participated, with fifteen being female, fifteen having a family relationship with the care recipient, and fifteen lacking training qualifying them for the caregiver role. 37.5% of caregivers were aged 61 years or older. Regarding the typical experiences, the following categories emerged from the participants' narratives: 1- Physical, emotional, and social impacts on the caregiver's health; 2- Need for qualification; 3- Support from the healthcare team, with a subcategory: 3.1- Absence of medical and/or nursing professionals. Conclusion It was understood that caregivers are invisible and do not receive healthcare assistance from the healthcare team for their own health. When home visits occur, professionals focus on attending to the older adult, fragmenting the assistance that should be extended to the needs of the family community, including the caregiver. Schützs Schütz s conducted Santo Brazil conveniencebased. conveniencebased convenience based. convenience-based 202 households participants profile intentionality administered methods participated female recipient role 375 37 5 37.5 6 narratives 1 Physical emotional 2 qualification 3 subcategory 3.1 31 andor occur adult 20 37. 3.

Resumo Objetivo Identificar a compreensão de cuidadores de pessoas idosas acamadas acerca da assistência recebida pela atenção primária em relação à sua própria saúde. Método Estudo qualitativo baseado na fenomenologia de Alfred Schütz. A abordagem dos cuidadores de pessoas idosas acamadas ocorreu pelo agente comunitário em sua área de abrangência em uma unidade básica de saúde localizada no norte do Espírito Santo, Brasil. A escolha do local se deu por conveniência. A coleta de dados ocorreu entre os meses de setembro a dezembro de 2022 nos domicílios. Aplicou-se um questionário contendo questões sobre o perfil sociodemográfico dos participantes, somados a seis perguntas fenomenológicas para entender o típico vivido de cada cuidador de pessoas idosas e sua intencionalidade. Os dados foram analisados à luz da fenomenologia. Resultados Participaram 16 cuidadores de pessoas idosas acamadas, sendo 15 do sexo feminino, 15 tinham laço familiar; 15 não receberam treinamento que o qualificasse na função. 37,5% dos cuidadores apresentaram idade acima de 61 anos. Em relação ao típico vivido, emergiram das falas as seguintes categorias: 1- Impactos físicos, emocionais e sociais na saúde do cuidador; 2- Necessidade de qualificação; 3- Suporte da equipe de saúde e a subcategoria: 3.1- Ausência do profissional médico e/ou enfermeiro. Conclusão Compreendeu-se que os cuidadores são invisíveis e não recebem assistência da equipe de saúde para a sua saúde, e quando ocorre a visita domiciliar, os profissionais visam o atendimento a pessoa idosa fragmentando a assistência que deveria ser ampliada para as necessidades da comunidade familiar, incluindo o cuidador. Schütz Santo Brasil conveniência 202 domicílios Aplicouse Aplicou participantes intencionalidade 1 feminino familiar função 375 37 5 37,5 6 anos categorias físicos 2 qualificação 3 subcategoria 3.1 31 eou ou enfermeiro Compreendeuse Compreendeu domiciliar 20 37, 3.

RESUMO Objetivo: Onde o objetivo é descrever as ações e atividades desenvolvidas pelo cirurgião-dentista nas visitas domiciliares. Métodos: A experiência ocorreu em visitas aos usuários da Unidade Básica de Saúde UBS Vila São Pedro no Município de São Bernardo do Campo, região periférica e de muita vulnerabilidade socioeconômica, sendo registrado os períodos de janeiro a dezembro de 2022. As ações e atividades descritas foram catalogadas como níveis básicos na atenção à saúde: promoção, prevenção e diagnóstico de lesões de tecidos moles e limitação de dano. Os dentistas realizaram 84 visitas domiciliares no propósito de oferecer os cuidados em saúde bucal aos usuários restritos ao leito, as ações e atividade de promoção em saúde basearam-se no estímulo à prática de hábitos saudáveis, conscientizando os cuidadores dos pacientes acamados, a importância da higiene oral, e como deveria ser realizado os cuidados na cavidade bucal desses pacientes onde os mesmos não possuem mais a capacidade o autocuidado. Resultados: As ações de prevenção foram instrução de higiene oral principalmente orientado os cuidados do paciente restrito de movimentos e que depende de um cuidador para realizar a higiene bucal, escovação ou higienização com gaze embebida com clorexidina a 0,12%, e aplicação tópica de flúor aos pacientes que ainda apresentam elementos dentários. As demais ações de limitação de danos bucais já pré-existentes foram extrações de dentárias com envolvimento periodontal. Conclusão: Sendo assim, os dentistas nas visitas domiciliares assumem um fundamental papel de promoverem qualidade de vida, e social aos pacientes que não podem ir até a uma Unidade Básica de Saúde por estarem restritos de forma transitória os permanentemente restritos ao domicílio. Objetivo cirurgiãodentista cirurgião dentista Métodos Campo socioeconômica 2022 dano 8 leito basearamse basearam se saudáveis acamados autocuidado Resultados 012 0 12 0,12% dentários préexistentes pré existentes periodontal Conclusão assim vida domicílio 202 01 1 0,12 20 0,1 2 0,

ABSTRACT Objective: The objective is to describe the actions and activities carried out by the dentist during home visits. Methods: The experience took place during visits to users of the Basic Health Unit UBS Vila São Pedro in the Municipality of São Bernardo do Campo, a peripheral region with a lot of socioeconomic vulnerability, recording the periods from January to December 2022. The actions and activities described were cataloged as basic levels in health care: promotion, prevention, and diagnosis of soft tissue injuries and damage limitation. Dentists carried out 84 home visits with the purpose of offering oral health care to users restricted to bed, health promotion actions and activities were based on encouraging the practice of healthy habits, making caregivers of bedridden patients aware of the importance of oral hygiene, and how care should be carried out in the oral cavity of these patients where they no longer have the capacity for self-care. Results: The prevention actions were oral hygiene instruction mainly aimed at caring for patients who have restricted movements and who depend on a caregiver to perform oral hygiene, brushing or cleaning with gauze soaked with 0.12% chlorhexidine, and topical application of fluoride to the patients who still have dental elements. The other actions to limit pre-existing oral damage were tooth extractions with periodontal involvement. Conclusion: Therefore, dentist-in-home visits play a fundamental role in promoting quality of life and social life for patients who cannot go to a Basic Health Unit due to being temporarily restricted or permanently restricted to their home. Objective Methods Campo vulnerability 2022 limitation 8 bed habits selfcare. selfcare self care. self-care Results 012 0 12 0.12 chlorhexidine elements preexisting pre existing involvement Conclusion Therefore dentistinhome 202 01 1 0.1 20 0. 2

Abstract Primary vaginal malignant melanomas (PVMM) are rare tumors with an incidence of 0,46/1000000 women and less than 500 cases reported in literature. The genetic patterns seem to be different from cutaneous melanomas. These tumors usually appear in women aged 60 to 70 with vaginal bleeding, discharge or a mass. It is an aggressive tumor and diagnosis is often made in advanced stages which results in low survival-rates. We present a case of a 74-year old bedridden women, with a 4 cm primary vaginal malignant melanoma. The most challenging aspect of these tumors is that no standard treatment protocol is available.

Resumo Os melanomas malignos primários da vagina são tumores raros, com uma incidência de 0,46/1000000 de mulheres e menos de 500 casos descritos na literatura. O padrão genético parece diferente do observado nos melanomas cutâneos. Estes tumores surgem, habitualmente, em mulheres entre 60-70 anos com hemorragia, corrimento ou massa vaginal. São tumores agressivos e o diagnóstico é geralmente realizado em estadios avançados, resultando em baixas taxas de sobrevivência. Apresentamos um caso de uma mulher de 74 anos, acamada, com um melanoma maligno primário da vagina com 4 cm. O maior desafio nestes tumores é o facto de não existirem protocolos de tratamento estabelecidos.

Abstract Introduction Cancer-associated thrombosis is a leading cause of morbidity and mortality in malignancy patients. Prophylactic anticoagulation is under-utilized and the cost of low-molecular-weight heparin (LMWH) and direct oral anticoagulants is a major barrier in developing countries. Material and methods A retrospective analysis was performed of all cancer-associated thrombosis patients attending the thrombosis clinic at a tertiary-level referral hospital based in North India between 2011 and 2015. Patient demographics and disease-related parameters were collected and analyzed. Results A total of 771 patients attended the thrombosis clinic during study period, of which 64 cases were malignancy-associated. Of these, 56% of the patients were female and 20% were bedridden. The median age was 48.5 years, adenocarcinoma (48%) being the most common histological subtype. Gynecological malignancies (30%) were the most common malignancies, followed by genitourinary (11%) malignancies. Most of the cases occurred during first year of diagnosis (51%), and only 14% occurred after 3 years. Most of the patients were on combined treatment. Almost 40% of the patients developed thrombosis within 30 days of surgical treatment. Lower limb thrombosis was the most commonly seen type (56%), while abdominal and pulmonary thrombosis were both seen in 5%. Patients were managed with LMWH and vitamin K antagonists (84.3%) and only 6.25% with LMWH alone. Direct oral anticoagulants were not commonly used during the study period. Discussion At the hospital studied, most of the cases occurred early in the disease course. Postoperative prophylaxis could have contributed towards reducing thrombosis in the peri-operative period. Early suspicion and prompt treatment can improve quality of life in such patients. Cancerassociated Cancer associated underutilized under utilized lowmolecularweight low molecular weight (LMWH countries cancerassociated cancer tertiarylevel tertiary level 201 2015 diseaserelated related analyzed 77 period 6 malignancyassociated. malignancyassociated associated. malignancy-associated these 56 20 bedridden 485 48 5 48. years 48% (48% subtype 30% (30% 11% 11 (11% 51%, 51 51% , (51%) 14 40 56%, (56%) 5% 84.3% 843 84 (84.3% 625 25 6.25 alone studied course perioperative peri operative 7 2 4 (48 (30 1 (11 (51% (56% 84.3 8 (84.3 62 6.2 (4 (3 (1 (51 (56 84. (84. 6. ( (5 (84 (8

SUMMARY OBJECTIVE: The aim of this study was to evaluate serum 25(OH)D concentrations in the homebound elderly people and relate them to level of dementia, nutritional risk, and route of dietary administration. METHODS: This is a cross-sectional study involving 207 bedridden elderly people assisted by the Home Care Service in the city of Santo André – SP, from June to December 2016. The following factors were evaluated: dietary intake of vitamin D, arm circumference, triceps skin fold thickness, calf circumference, nutritional risk by Mini-Nutritional Assessment, level of dementia by the adapted Clinical Dementia Rating questionnaire, and laboratory tests such as serum concentrations of 25(OH)D, ultrasensitive C-reactive protein, alkaline phosphatase, serum calcium, and parathormone. RESULTS: The mean age of the elderly people was 81.6 (9.2) years. Deficiency of 25(OH)D was observed in 76.3% of the elderly people. There was an inverse correlation between serum concentrations of 25(OH)D: parathormone (r=-0.418, p<0.001) and alkaline phosphatase (r=-0.188, p=0.006) and a direct correlation with serum calcium (r=-0.158, p=0.022). Logistic regression showed that vitamin D deficiency was directly and independently associated with oral feeding (odds ratio 7.71; 95%CI 2.91–20.40). CONCLUSION: Bedridden households showed high prevalence of vitamin D deficiency without association with nutritional risk and level of dementia. Oral diet was associated with vitamin D deficiency, possibly due to low consumption of source foods. OBJECTIVE 25OHD OHD 25 OH administration METHODS crosssectional cross sectional 20 SP 2016 evaluated circumference thickness MiniNutritional Mini Nutritional Assessment questionnaire 25OHD, Creactive C reactive protein RESULTS 816 81 6 81. 9.2 92 9 2 (9.2 years 763 76 3 76.3 r=0.418, r0418 r r= 0.418, 0 418 (r=-0.418 p<0.001 p0001 p 001 r=0.188, r0188 0.188, 188 (r=-0.188 p=0.006 p0006 006 r=0.158, r0158 0.158, 158 (r=-0.158 p=0.022. p0022 p=0.022 . 022 p=0.022) odds 7.71 771 7 71 95CI CI 95 2.91–20.40. 2912040 2.91–20.40 91 40 2.91–20.40) CONCLUSION foods 201 8 9. (9. 76. r=0.418 r041 0418 0.418 41 (r=-0.41 p<0.00 p000 00 r=0.188 r018 0188 0.188 18 (r=-0.18 p=0.00 r=0.158 r015 0158 0.158 15 (r=-0.15 p002 p=0.02 02 7.7 77 291204 2.91–20.4 4 (9 r=0.41 r04 041 0.41 (r=-0.4 p<0.0 p00 r=0.18 r01 018 0.18 1 (r=-0.1 p=0.0 r=0.15 015 0.15 7. 29120 2.91–20. ( r=0.4 r0 04 0.4 (r=-0. p<0. p0 r=0.1 01 0.1 p=0. 2912 2.91–20 r=0. 0. (r=-0 p<0 p=0 291 2.91–2 r=0 (r=- p< p= 29 2.91– (r= 2.91 (r 2.9 2.

ABSTRACT BACKGROUND: Social distancing has led to lifestyle changes among older adults during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES: This study aimed to estimate the prevalence risk of sarcopenia (RS) and investigate its associated factors during the COVID-19 pandemic in older Brazilian adults. DESIGN AND SETTING: Cross-sectional observational analysis of baseline data as part of the Remobilize Study. METHODS: Participants in the study were older adults (≥ 60 years), excluding those who were bedridden or institutionalized. The data collected consisted of answers about the RS (SARC-F), functional status, walking, sedentary behavior (SB), pain, comorbidity, and life space mobility. RESULTS: A total of 1,482 older adults (70 ± 8.14 years, 74% women) participated in the study, and an RS prevalence of 17.1% was found. (95% confidence interval [CI] 15.25–19.15%). The adjusted multivariate model showed a significant association between RS and functional limitation (odds ratio [OR]: 19.05; CI 13.00–28.32), comorbidity (OR: 5.11; CI 3.44–7.81), pain (OR: 4.56; CI 3.33–6.28), total walking (OR: 0.99; CI 0.99–1.00), SB of 8–10 hours (OR: 1.85; CI 1.15–2.93), and SB of > 10 hours (OR: 3.93; CI 2.48–6.22). RS was associated with mobility during the pandemic (OR: 0.97; CI 0.96–0.98). P < 0.05. CONCLUSIONS: During the pandemic, the prevalence of RS in older Brazilians was estimated at 17.1%. Moderate to severe functional limitation, comorbidities, presence of pain, walking, longer SB period, and reduced life space mobility significantly contributed to RS in older adults during the pandemic. BACKGROUND 201 COVID19 COVID 19 (COVID-19 OBJECTIVES (RS COVID-1 SETTING Crosssectional Cross sectional Study METHODS ≥ ( 6 years , years) institutionalized SARCF, SARCF SARC F (SARC-F) status SB, (SB) RESULTS 1482 1 482 1,48 70 (7 814 8 14 8.1 74 women 171 17 17.1 found 95% 95 (95 [CI 15.25–19.15%. 15251915 15.25–19.15% . 15 25 15.25–19.15%) odds OR [OR] 19.05 1905 05 13.00–28.32, 13002832 13.00–28.32 13 00 28 32 13.00–28.32) (OR 5.11 511 5 11 3.44–7.81, 344781 3.44–7.81 3 44 7 81 3.44–7.81) 4.56 456 4 56 3.33–6.28, 333628 3.33–6.28 33 3.33–6.28) 0.99 099 0 99 0.99–1.00, 099100 0.99–1.00 0.99–1.00) 810 8–1 1.85 185 85 1.15–2.93, 115293 1.15–2.93 2 93 1.15–2.93) 3.93 393 2.48–6.22. 248622 2.48–6.22 48 22 2.48–6.22) 0.97 097 97 0.96–0.98. 096098 0.96–0.98 96 98 0.96–0.98) 005 0.05 CONCLUSIONS comorbidities period 20 COVID1 (COVID-1 COVID- (SARC-F (SB 148 1,4 8. 17. 9 (9 1525191 15.25–19.15 [OR 19.0 190 1300283 13.00–28.3 5.1 51 34478 3.44–7.8 4.5 45 33362 3.33–6.2 0.9 09 09910 0.99–1.0 8– 1.8 18 11529 1.15–2.9 3.9 39 24862 2.48–6.2 09609 0.96–0.9 0.0 (COVID- 1, 152519 15.25–19.1 19. 130028 13.00–28. 5. 3447 3.44–7. 4. 3336 3.33–6. 0. 0991 0.99–1. 1. 1152 1.15–2. 3. 2486 2.48–6. 0960 0.96–0. (COVID 15251 15.25–19. 13002 13.00–28 344 3.44–7 333 3.33–6 0.99–1 115 1.15–2 248 2.48–6 096 0.96–0 1525 15.25–19 1300 13.00–2 34 3.44– 3.33– 0.99– 1.15– 24 2.48– 0.96– 152 15.25–1 130 13.00– 3.44 3.33 1.15 2.48 0.96 15.25– 13.00 3.4 3.3 1.1 2.4 15.25 13.0 2. 15.2 13. 15.

Resumen Objetivo Evaluar la calidad de vida de los cuidadores familiares y su relación con las condiciones socioeconómicas, de salud y de prestación de cuidado. Métodos Estudio transversal y analítico realizado en la ciudad de Palmas, estado de Tocantins, en el período 2020-2022, con una muestra de 49 cuidadores familiares de adultos mayores encamados. La calidad de vida fue evaluada mediante el instrumento “12-Item- Short- Form Health Survey” (SF-12). Se utilizó el test-T para verificar la relación entre los componentes físicos y mentales y las variables independientes. Resultados Los cuidadores presentaron un valor promedio del componente físico de 43,26 puntos (IC 95 %: 39,87 – 46,64) y del componente mental de 50,98 puntos (IC 95 %: 47,96 – 54,00). Se observaron diferencias significativas en la puntuación del componente mental en disfunción familiar, consumo de bebida alcohólica y sobrecarga; y en el componente físico, en multimorbilidad, polifarmacia, índice de masa corporal y sobrecarga. Conclusión Los resultados de este estudio demostraron que existe relación entre las condiciones sociales, de salud, cuidado y calidad de vida, lo que permite que los profesionales de la salud tengan conocimientos para la planificación de acciones que busquen mejorar la calidad de vida de del cuidador. socioeconómicas Palmas Tocantins 20202022, 20202022 2020 2022, 2022 2020-2022 4 encamados 12Item Item 12 “12-Item Short Survey SF12. SF12 SF . (SF-12) testT test T independientes 4326 43 26 43,2 IC 9 % 3987 39 87 39,8 46,64 4664 46 64 5098 50 98 50,9 4796 47 96 47,9 54,00. 5400 54,00 54 00 54,00) familiar sobrecarga multimorbilidad polifarmacia sociales cuidador 2020202 202 2020-202 1 SF1 (SF-12 432 2 43, 398 3 8 39, 46,6 466 6 509 5 50, 479 47, 540 54,0 0 202020 20 2020-20 (SF-1 46, 54, 20202 2020-2 (SF- 2020- (SF

Abstract Objective To assess the quality of life of family caregivers and their relationship with socioeconomic, health and care conditions. Methods a cross-sectional and analytical study carried out in the city of Palmas/TO, in the period of 2020-2022, with a sample of 49 family caregivers of bedridden older adults. Quality of life was assessed by the instrument “12-Item- Short- Form Health Survey” (SF-12). To verify the relationship between physical and mental components and independent variables, the t-test was used. Results Caregivers presented mean values of the physical component of 43.26 points (95% CI: 39.87 – 46.64) and the mental component of 50.98 points (95% CI: 47.96 – 54.00). Significant differences were found between the scores of the mental component for family dysfunction, alcohol consumption and overload, and between the physical component for multimorbidity, polypharmacy, body mass index and overload. Conclusion The findings of this study demonstrated a relationship between social conditions, health, care and quality of life, thus granting knowledge to health professionals to guide them in planning actions aimed at improving caregivers’ quality of life. socioeconomic conditions crosssectional cross sectional PalmasTO Palmas TO Palmas/TO 20202022, 20202022 2020 2022, 2022 2020-2022 4 adults 12Item Item 12 “12-Item Short Survey SF12. SF12 SF . (SF-12) variables ttest t test used 4326 43 26 43.2 95% 95 (95 CI 3987 39 87 39.8 46.64 4664 46 64 5098 50 98 50.9 4796 47 96 47.9 54.00. 5400 54.00 54 00 54.00) dysfunction overload multimorbidity polypharmacy 2020202 202 2020-202 1 SF1 (SF-12 432 2 43. 9 (9 398 3 8 39. 46.6 466 6 509 5 50. 479 47. 540 54.0 0 202020 20 2020-20 (SF-1 ( 46. 54. 20202 2020-2 (SF- 2020- (SF

Resumo Objetivo Avaliar a qualidade de vida dos cuidadores familiares e sua relação com as condições socioeconômicas, de saúde e de prestação de cuidado. Métodos Estudo transversal e analítico realizado na cidade de Palmas/TO, no período de 2020-2022, com amostra de 49 cuidadores familiares de idosos acamados. A qualidade de vida foi avaliada pelo instrumento “12-Item- Short- Form Health Survey” (SF-12). Para verificar a relação entre os componentes físico e mental e variáveis independentes, utilizou-se o Teste T. Resultados Os cuidadores apresentaram valores médios do componente físico de 43,26 pontos (IC 95%: 39,87 – 46,64) e no componente mental, de 50,98 pontos (IC 95%: 47,96 – 54,00). Encontraram-se diferenças significativas entre os escores do componente mental para disfunção familiar, consumo de bebida alcóolica e sobrecarga; e, entre o componente físico para multimorbidade, polifarmácia, índice de massa corpórea e sobrecarga. Conclusão Os achados deste estudo demonstraram relação entre condições sociais, de saúde, cuidado e qualidade de vida, concedendo assim conhecimento aos profissionais de saúde para orientá-los no planejamento de ações que visem a melhoria da qualidade de vida do cuidador. socioeconômicas PalmasTO Palmas TO Palmas/TO 20202022, 20202022 2020 2022, 2022 2020-2022 4 acamados 12Item Item 12 “12-Item Short Survey SF12. SF12 SF . (SF-12) independentes utilizouse utilizou se T 4326 43 26 43,2 IC 95% 95 3987 39 87 39,8 46,64 4664 46 64 5098 50 98 50,9 4796 47 96 47,9 54,00. 5400 54,00 54 00 54,00) Encontraramse Encontraram familiar sobrecarga multimorbidade polifarmácia sociais orientálos orientá los cuidador 2020202 202 2020-202 1 SF1 (SF-12 432 2 43, 9 398 3 8 39, 46,6 466 6 509 5 50, 479 47, 540 54,0 0 202020 20 2020-20 (SF-1 46, 54, 20202 2020-2 (SF- 2020- (SF

Introduction: Meckel’s diverticulum is a saccular defect located in the distal ileum, with a complication rate of 4%. Surgical resection is indicated when these complications occur, yet resection in asymptomatic or incidental cases remains controversial. Among these complications, the appearance of tumors such as gastrointestinal stromal (GIST), may occur. Case Report: A 57-year-old male, bedridden due to multi- ple factors, presents with a complicated grade IV sacral pressure ulcer with a torpid evolution. An end colostomy is performed, evidencing a suspicious-looking Meckel’s diverticulum intraoperatively, which was resected and resulted to be a low-risk GIST. At a 6-month follow-up, the patient showed no evidence of tumor recurrence. Discussion: While surgery seems to be imperative in complications, there is still a debate regarding the indications for resection of Meckel’s diverticulum found incidentally intraoperatively due to surgery for another cause. Although it could increase morbidity and mortality, resection could be indicated according to certain characteristics such as age, sex, size and appearance, given the risk of developing complications and neoplasm.

Resumen Introducción: El divertículo de Meckel es un defecto sacular ubicado en el íleon distal, con una tasa de complicaciones de 4%. La resección quirúrgica está indicada en estas complicaciones, siendo controversial en casos asintomáticos o incidentales. Dentro de las complicaciones existen tumores como los estromales gastrointestinales (GIST). Caso Clínico: Hombre de 57 años, postrado por múltiples factores, presenta úlcera por presión sacra grado IV sobreinfectada y con evolución tórpida. Se decide realizar colostomía terminal, evidenciando un divertículo de Meckel en el intraoperatorio con aspecto sospechoso, por lo cual se decide resecar, resultando en un GIST de bajo riesgo. Se mantiene en seguimiento por 6 meses, sin recidiva tumoral. Discusión: Mientras que la cirugía pareciera ser imperativa en complicaciones, aún existe debate respecto a las indicaciones de resección de divertículo de Meckel hallado incidentalmente en el intraoperatorio por cirugía de otra causa. Si bien puede aumentar la morbimortalidad, la resección estaría indicada según ciertas características como edad, sexo, tamaño y aspecto, dado el riesgo de desarrollo de complicaciones y neoplasias.

RESUMO Introdução: O Diabetes Gestacional é um grupo de desordens metabólicas que resultam na intolerância à glicose durante a gravidez, dentre o leque de tratamentos está a dieta, o uso continuo de medicamentos, e acompanhamento psicológico. Por ser um tratamento multidisciplinar, é importante que haja um protocolo adequado para um desfecho favorável. Há questionamentos quanto aos benefícios de atividades físicas como terapia complementar. Objetivo: Verificar o impacto da adição de exercícios ao protocolo hospitalar para pacientes com diabetes gestacional, tanto nos riscos de diabetes tipo 2 em grávidas quanto na obesidade de seus descendentes. Métodos: Sessenta mulheres grávidas que foram diagnosticadas com Diabetes Gestacional foram aleatoriamente divididas em grupos controle e intervenção. Ambos grupos receberam tratamento e intervenção específicos e o grupo experimental praticou atividade física de intensidade moderada controlada (125-146bpm). Amostras de sangue em jejum matinal foram coletados em ambos os grupos para verificar níveis de glicose e insulina em jejum, indicadores de metabolismo lipídico, colesterol lipoproteico de baixa e alta densidade, apolipoproteína B. Verificou-se também o nível de fadiga pela escala Brog, ruptura prematura de bolsa, hemorragia pós-parto, asfixia neo-natal, macrossomia entre outros. Resultados: Os níveis de colesterol total no sangue periférico foram de 5,93, 5.38, os níveis de colesterol lipoproteico de baixa densidade foram 2,95 antes contra 2,64 depois e os níveis de apolipoproteína B foram 1,84 contra 1,59 no grupo controle, o conteúdo de colesterol lipoproteico de alta densidade aumentou de 1,74 para 1,88, os níveis de colesterol, e apolipoproteína B sanguíneos depois da intervenção no grupo experimental foram menores que os do grupo controle, com elevação do colesterol lipoprotéico de alta densidade. Conclusão: O exercício aeróbico mostrou-se mais adequado para pacientes com diabetes gestacional nos estágios posteriores da gravidez, podendo ser adaptado inclusive para as pacientes acamadas refratárias aos fármacos tradicionais. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

ABSTRACT Introduction: Gestational Diabetes is a group of metabolic disorders that result in glucose intolerance during pregnancy. Among the range of treatments are diet, continuous use of medication, and psychological monitoring. Since it is a multidisciplinary treatment, a proper protocol is vital for a favorable outcome. In addition, there are questions about the benefits of physical activity as a complementary therapy. Objective: To verify the impact of adding exercise to the hospital protocol for patients with gestational diabetes, both on the risks of type 2 diabetes in pregnant women and on the obesity of their offspring. Methods: Sixty pregnant women diagnosed with Gestational Diabetes were randomly divided into control and intervention groups. Both groups received specific treatment and intervention, and the experimental group practiced controlled moderate-intensity physical activity (125-146bpm). Morning blood samples were collected from both groups to check fasting glucose and insulin levels, indicators of lipid metabolism, low and high-density lipoprotein cholesterol, apolipoprotein B. The Brog scale measured the fatigue level. In addition, the premature rupture of membranes, postpartum hemorrhage, neonatal asphyxia, macrosomia, and others was checked. Results: The peripheral blood total cholesterol levels were 5.93, 5. 38, low-density lipoprotein cholesterol levels were 2.95 before versus 2.64 after, and apolipoprotein B levels were 1.84 versus 1.59 in the control group, high-density lipoprotein cholesterol content increased from 1.74 to 1.88, blood cholesterol, and apolipoprotein B levels after the intervention in the experimental group were lower than those in the control group, with an elevation of high-density lipoprotein cholesterol. Conclusion: Aerobic exercise proved to be more appropriate for patients with gestational diabetes in the later stages of pregnancy and may also be adapted for bedridden patients refractory to traditional drugs. Evidence Level II; Therapeutic Studies - Investigating the result.

Resumen Introducción: La diabetes gestacional es un grupo de trastornos metabólicos que dan lugar a una intolerancia a la glucosa durante el embarazo. Entre la gama de tratamientos se encuentra la dieta, el uso continuado de medicamentos y el seguimiento psicológico. Al tratarse de un tratamiento multidisciplinar, es importante contar con un protocolo adecuado para obtener un resultado favorable. Existen dudas sobre los beneficios de la actividad física como terapia complementaria. Objetivo: Comprobar el impacto de añadir el ejercicio al protocolo hospitalario para pacientes con diabetes gestacional, tanto en los riesgos de diabetes tipo 2 en las mujeres embarazadas como en la obesidad de su descendencia. Métodos: Sesenta mujeres embarazadas a las que se les diagnosticó diabetes gestacional fueron divididas aleatoriamente en grupos de control y de intervención. Ambos grupos recibieron un tratamiento y una intervención específicos y el grupo experimental practicó una actividad física controlada de intensidad moderada (125-146bpm). Se tomaron muestras de sangre en ayunas por la mañana de ambos grupos para comprobar los niveles de glucosa e insulina en ayunas, los indicadores del metabolismo de los lípidos, el colesterol de lipoproteínas de baja y alta densidad, la apolipoproteína B. También se comprobó el nivel de fatiga según la escala de Brog, la rotura prematura de bolsa, la hemorragia posparto, la asfixia neonatal y la macrosomía, entre otros. Resultados: Los niveles de colesterol total en sangre periférica fueron de 5,93, 5. 38, los niveles de colesterol de lipoproteínas de baja densidad eran de 2,95 antes frente a 2,64 después y los niveles de apolipoproteína B eran de 1,84 frente a 1,59 en el grupo de control, el contenido de colesterol de lipoproteínas de alta densidad aumentó de 1,74 a 1,88, el colesterol en sangre y los niveles de apolipoproteína B después de la intervención en el grupo experimental fueron inferiores a los del grupo de control, con una elevación del colesterol de lipoproteínas de alta densidad. Conclusión: El ejercicio aeróbico resultó ser más apropiado para las pacientes con diabetes gestacional en las últimas fases del embarazo, y puede adaptarse incluso a las pacientes encamadas y refractarias a los fármacos tradicionales. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Resumo: Introdução: A mobilidade é uma ação básica praticada durante a execução dos cuidados gerais de enfermagem durante a hospitalização. Contudo, quando se trata de pessoas idosas, essa ação geralmente é polemizada por se constituir um risco para quedas. Objetivo: Apreender a estrutura da representação social da equipe de enfermagem acerca da mobilidade para pessoa idosa hospitalizada. Método: Pesquisa descritiva-exploratória de abordagem qualitativa, fundamentada na Teoria das Representações Sociais, com foco na abordagem estrutural. O grupo social estudado foi composto por 100 profissionais da equipe de enfermagem atuantes em unidades destinadas ao cuidado de pessoas idosas, em um hospital universitário, na cidade de Salvador, Bahia, Brasil. A coleta dos dados ocorreu em dois momentos, através da associação livre de palavras e entrevista não- estruturada. Os dados da associação livre de palavras foram processados pelo software EVOC que determinou a estrutura da representação social através do quadro de quatro casas. Para as entrevistas utilizou-se a análise de conteúdo. A discussão envolveu todo o corpus da pesquisa. Resultados: No quadro, considerando a frequência e a ordem média das evocações, os termos “Queda, Acamado e Cuidado” compuseram o núcleo central. Da análise das entrevistas, surgiram três categorias temáticas: cuidados de mobilidade envolvendo os riscos, cuidados de mobilidade, voltados para manter a independência/autonomia e cuidado para lidar com as barreiras à mobilidade. Para a equipe de enfermagem investigada a representação social da mobilidade está associada a deambulação, com movimentos limitados diante dos riscos de queda que interfere na autonomia e independência. Conclusão: A estrutura das Representações Sociais sobre a mobilidade da pessoa idosa hospitalizada está ancorada em situações do cotidiano da prática profissional do grupo investigado, evidenciando conflitos entre promover prevenção/recuperação da incapacidade pela hospitalização e evitar outros danos à saúde pelo risco de quedas.

Abstract: Introduction: Mobility is a basic action practiced during the execution of general nursing care during hospitalization, however, when it comes to elderly people, this action is usually controversial because it constitutes a risk for falls. Objective: To apprehend the structure of the social representations of the nursing team regarding the mobility of the hospitalized elderly person. Methods: This is exploratory descriptive research with a qualitative approach, based on the principles of the Theory of Social Representations, with a focus on the structural approach. The social group studied was composed of 100 professionals from the nursing team who work in units dedicated to the care of the elderly at a university hospital in the city of Salvador, Bahia, Brazil. Data collection took place in two moments, through the free word association and unstructured interview techniques. The free word association data were processed by the EVOC software, which determined the structure of the social representation through the four-place table. Content analysis was used for the interviews. The discussion involved the entire research corpus. Results: In the table, considering the frequency and the average order of evocations, the terms “fall, bedridden and care” composed the central nucleus. From the analyses of interviews, three thematic categories emerged: Mobility care involving risks, mobility care, aimed at maintaining independence/autonomy and care to deal with barriers to mobility. For the nursing team investigated, the social representation of mobility is associated with ambulation, with limited movements in the face of the risk of falling, which stimulates autonomy and independence. Conclusion: The structure of the Social Representations on the mobility of the hospitalized elderly person is anchored in everyday situations of the professional practice of the investigated group, evidencing conflicts between promoting prevention/recovery of incapacity through hospitalization and avoiding other health damages due to the risk of falls.

RESUMO Úlceras por pressão são lesões ocasionadas na pele e tecidos subjacentes devido à força de pressão local, geralmente em pontos de proeminências ósseas. Cita-se aqui o caso de uma paciente acamada devido à lesão medular por mielomeningocele que evoluiu com úlcera em região isquiática à direita, tratada com técnica de retalhos muscular e fasciocutâneo de face posterior da coxa. Por ser lesão rotineiramente encontrada nesses pacientes portadores de limitações funcionais, é fundamental a realização de tratamentos adequados que visem a melhora clínica do paciente e minimizar índice de recidivas. Além disso, é de suma importância a implementação de novas técnicas cirúrgicas, haja vista a enorme variedade de lesões por pressão

ABSTRACT Pressure ulcers are lesions caused on the skin and underlying tissues due to local pressure force, usually at points of bony prominences. Here, we mention the case of a bedridden patient due to a spinal cord injury caused by myelomeningocele who developed an ulcer in the right ischial region, treated with the technique of muscular fasciocutaneous flaps on the posterior aspect of the thigh. As it is a lesion routinely found in these patients with functional limitations, it is essential to carry out adequate treatments aimed at the patient’s clinical improvement and minimizing the rate of relapses. In addition, the implementation of new surgical techniques is extremely important, given the enormous variety of pressure injuries.

ABSTRACT Introduction: Caring for patients with high dependency and limited mobility represents in practice that these patients spend long periods of time in bed, arising important challenges for themselves and for their caregivers in different dimensions related to their rest, either in bed or sitting. Bed confinement can cause problems in three broad dimensions: patient dynamics in bed, impact on caregivers caring for the affected person, and clinical complications related to prolonged stay in bed. Today there are beds on the market with special features (smart care beds) which facilitate the care of bedridden patients and help to reduce both clinical problems related to the situation of immobility, as well as its repercussions on caregivers when mobilizing them, but we will see throughout the article that the introduction of robotics applied to the movements of smart beds leads to an evolution of the same: the smart therapeutical surfaces. These provide unique, automatized, programmable and personalized robotic movements, which can lead to a new dimension in the care of bedridden people. Methods: Two clinical cases are presented corresponding to the use of the V-Chair® system, a Smart Therapeutic Surface (S.T. Surface®) with the dual functionality of indoor electric wheelchair and a clinical hospital bed, with unique and patented movements non existing in any other option on the market. Due to nowadays results apparently increasing the quality of life and autonomy of the highly dependent bedridden patient. The multiple movements options provided by V-Chair® facilitates the prevention and reduction of clinical problems resulting from prolonged bed rest, the reduction of the number of nursing staff required during care and handling tasks, while reducing strain and poor posture on the side of the nursing staff. V-Chair® was used in the care of two highly dependent patients with limited mobility, with intellectual disabilities, admitted to a social-health care center. The impact of its use is evaluated, both clinically and in the management of the patients by their caregivers. Results: The use of the V-Chair® system has contributed to solve clinical problems related to bed rest (pressure ulcers, dysphagia control, constipation, and weight reduction), and even more it has added the possibility of making more postural changes with fewer human resources; has reduced the caregiver's time for performing hygiene and has reduced the number of patient transfers. Being highly considered by the nursing and caregivers' staff, due to the highly safety and easy mechanisms for making postural changes and whatever mobilization.

RESUMEN Introducción: El cuidado de pacientes de alta dependencia y movilidad limitada, en la práctica representa que estos pasen largos períodos en la cama y surjan importantes retos para ellos mismos y para sus cuidadores en diferentes dimensiones relacionadas con su descanso, ya sea en cama ya sea en sedestación. El encamamiento puede producir problemas en tres grandes dimensiones: dinámica del paciente en la cama, impacto en los cuidadores que atienden a la persona afectada y complicaciones clínicas relacionadas con la estancia prolongada en la cama. Hoy en día existen en el mercado camas con prestaciones especiales (las smart care beds), que facilitan el cuidado de los pacientes encamados y ayudan a disminuir tanto problemas clínicos relacionados con la situación de inmovilidad como sus repercusiones en los cuidadores a la hora de movilizarlos. A lo largo del artículo veremos que la introducción de la robótica aplicada a los movimientos de las camas inteligentes conlleva a una evolución de estas: las smart therapeutical surfaces. Estas proveen de movimientos robóticos únicos, automatizados, programables y personalizables, lo que puede abrir una nueva dimensión en los cuidados a personas encamadas. Metodología: Se presentan 2 casos clínicos correspondientes a la utilización del sistema V-Chair®, una smart therapeutical surface (S.T. Surface®), con la doble funcionalidad de silla de ruedas eléctrica indoor y cama clínica articulada hospitalaria, con movimientos únicos y patentados no existentes en ninguna otra opción de mercado, que permiten incrementar la calidad de vida y la autonomía del paciente encamado de alta dependencia. Las múltiples opciones de movimientos que permite V-Chair® aparentemente facilitan la prevención y la reducción de problemas clínicos derivados del encamamiento prolongado, la reducción de la cantidad de personal asistencial necesario durante las tareas de cuidado y manipulación, a la vez que reducen los esfuerzos y malas posturas por parte del personal de enfermería. V-Chair® se utilizó en el cuidado de dos pacientes de alta dependencia y movilidad limitada, con discapacidad intelectual, ingresados en un centro sociosanitario. Se evalúa el impacto de su utilización, tanto a nivel clínico como en el manejo de los pacientes por parte de sus cuidadores. Resultados: La utilización del sistema V-Chair® ha contribuido a solucionar problemas clínicos relacionados con el encamamiento (lesiones por presión, control de disfagias, reducción de estreñimiento y reducción de peso), ha representado la posibilidad de realizar más cambios posturales con menos recursos humanos, ha permitido disminuir el tiempo de los profesionales para realizar los cuidados de higiene y ha disminuido la realización de transferencias de los pacientes, y se ha valorado muy bien por el equipo asistencial en cuanto a la facilitación segura de los cambios posturales y a la movilización de los pacientes.