Cuidados com os pés: o conhecimento de indivíduos com diabetes mellitus

The aim of this research was to identify the knowledge of people with Diabetes Mellitus in relation to foot care, correlating the study time with the number of concordants responses, as well as, the time of diagnosis with the presence of chronic complications.It is analytical, exploratory and cross-sectional study, carried out with about 41 individuals with diabetes who attended an outpatient clinic of a city in Triangulo Mineiro. The results showed a deficit in knowledge about the feet care of this population, since the average score was 10.0 in the total of 15 questions. Education was not correlated with the level of knowledge of the practice. There was an association between the time of diagnosis and the presence of complications, where 70.0% of the sample had diabetes with complications for a period = 10 years. Therefore, educational efforts to provide access to knowledge about foot care are essential to preventing this sickness.El objetivo de esta investigación fue identificar el conocimiento de las personas con diabetes mellitus en relación con el cuidado de los pies, la correlación de tiempo de estudio con el número de respuestas concordantes, así como el momento del diagnóstico de la presencia de complicaciones crónicas. Es un estudio analítico, exploratorio y transversal realizado con 41 individuos con diabetes de una clínica de la ciudad de Triangulo Mineiro. Los resultados mostraron un déficit en el conocimiento de esta población sobre el cuidado de los pies, ya que la puntuación media fue de 10,0 del total de 15 preguntas. La educación no presentó correlación con el nivel de conocimiento de la práctica. Se observó una asociación entre el tiempo del diagnóstico y la presencia de complicaciones, donde el 70,0% de la muestra tenía diabetes con complicaciones para un período = 10 años. Por lo tanto, los esfuerzos educativos para facilitar el acceso a los conocimientos sobre el cuidado de los pies son esenciales para la prevención del pie diabético.O objetivo desta pesquisa foi identificar o conhecimento de pessoas com Diabetes Mellitus em relação aos cuidados com os pés, correlacionando o tempo de estudo com o número de respostas concordantes, bem como o tempo de diagnóstico com a presença de complicações crônicas. Trata-se de estudo analítico, exploratório e transversal, realizado com 41 indivíduos, portadores de diabetes, atendidos em um ambulatório especializado de uma cidade do Triângulo Mineiro. Os resultados mostraram déficit no conhecimento desta população sobre os cuidados podais, já que a média de acertos foi de 10,0 perante o total de 15 questões. A escolaridade não apresentou correlação com o nível de conhecimento acerca desta prática. Houve associação entre o tempo de diagnóstico e a presença de complicações, onde 70,0% da amostra com complicações tinham diabetes por período = 10 anos. Portanto, ações educativas que viabilizem o acesso ao conhecimento sobre os cuidados com os pés são essenciais para a prevenção do pé diabético

Cuidados com os pés: o conhecimento de indivíduos com diabetes mellitus cadastrados no programa saúde da familia

The Objective is to identify the knowledge of individuals with diabetes mellitus type 1 or 2 registered in the HIPERDIA program, correlate study time with the number of concordant answers about foot care and describe the complications on second time of diagnosis. Analytical study, exploratory, cross-sectional quantitative analysis, conducted with 116 individuals with diabetes type 1 or 2 followed at HIPERDIA Program in a Health Unit Matrix became evident that most of the individuals were female, mean age 49, 9 years, elementary school, has type 2 diabetes. 69% had hypertension and 45.7% dyslipidemia. The majority reported appropriate behaviors in their day-to-day for foot care, 98.3% thought important to take care of your feet to prevent diabetic foot, however, 19% performed the examination of the feet to a health professional at least once a year. Statistical tests showed that there was low correlation between study time and the number of concordant answers about foot care, but was not significant (rs = 0.026, p = 0.781). Among those up to 10 years of diagnosis, 79.7% had no complications and 62.2% said they were for those aged 10 or more (χ2= 19.83, p <0.001). We conclude that having knowledge of the individual's level of knowledge about diabetic foot care allows the health professional to direct the actions of health education aimed at promoting and encouraging this practice.El objetivo es identificar el conocimiento de los individuos con Diabetes mellitus tipo 1 o 2 catastrados en el Programa HIPERDIA, correlacionar el tiempo de estudio con el número de respuestas concordantes acerca de los cuidados con los pies y describir las complicaciones según tiempo de diagnóstico. Estudio analítico, exploratorio y transversal, con análisis cuantitativo, realizado con 116 individuos diabéticos tipo 1 o 2 acompañados en el Programa HIPERDIA en una Unidad Matricial de Salud. Se evidenció que la mayor parte de los individuos era del sexo femenino, edad promedia de 49,9 años, enseñanza básica incompleta, posee diabetes tipo 2. 69% presentaban hipertensión arterial y 45,7% dislipidemia. La mayoría refirió conductas adecuadas para el cuidado con los pies, 98,3% hallaban importante cuidar de los pies para prevenir el pie diabético, pero, 19% realizaba el examen de los pies con profesional de salud por lo menos una vez al año. Los tests estadísticos muestrearon que hubo una baja correlación entre el tiempo de estudio y el número de respuestas concordantes acerca de los cuidados con los pies, pero no fue significativa (rs=0,026; p=0,781). De entre aquellos con hasta 10 años de diagnóstico, 79,7% no presentaron complicaciones y 62,2% mencionaron tener, para aquellos con 10 años o más (χ2= 19,83; p<0,001). Se concluyó que tener ciencia del nivel de conocimiento del individuo diabético sobre los cuidados con los pies permite al profesional de salud direccionar las acciones de educación en salud que promuevan e incentiven esta práctica.O objetivo é identificar o conhecimento dos indivíduos com Diabetes Mellitus tipo 1 ou 2 cadastrados no Programa HIPERDIA, correlacionar o tempo de estudo com o número de respostas concordantes acerca dos cuidados com os pés e descrever as complicações segundo tempo de diagnóstico. Estudo analítico, exploratório e transversal, com análise quantitativa, realizado com 116 indivíduos diabéticos tipo 1 ou 2 acompanhados no Programa HIPERDIA em uma Unidade Matricial de Saúde. Evidenciou-se que a maior parte dos indivíduos era do sexo feminino, idade média de 49,9 anos, ensino fundamental incompleto, possui diabetes tipo 2. 69% apresentavam hipertensão arterial e 45,7% dislipidemia. A maioria referiu condutas adequadas para o cuidado com os pés, 98,3% achavam importante cuidar dos pés para prevenir o pé diabético, e 19% realizavam o exame dos pés com profissional de saúde pelo menos uma vez ao ano. Houve uma correlação baixa entre o tempo de estudo e o número de respostas concordantes acerca dos cuidados com os pés, mas não foi significativa (rs=0,026; p=0,781). Dentre aqueles com até 10 anos de diagnóstico, 79,7% não apresentaram complicações e 62,2% mencionaram ter, para aqueles com 10 anos ou mais (χ2=19,83; p<0,001). Conclui-se que ter ciência do nível de conhecimento do indivíduo diabético sobre os cuidados com os pés permite ao profissional de saúde direcionar as ações de educação em saúde que visem promover e incentivar esta prática

The Importance of C4d in Biopsies of Kidney Transplant Recipients

Antibody-mediated rejection (AMR) is highly detrimental to the prolonged survival of transplanted kidneys. C4d has been regarded as a footprint of AMR tissue damage, and the introduction of C4d staining in daily clinical practice aroused an ever-increasing interest in the role of antibody-mediated mechanisms in allograft rejection. Despite the general acceptance of the usefulness of C4d in the identification of acute AMR, the data for C4d staining in chronic AMR is variable. The presence of C4d in the majority of the biopsies with features of chronic antibody-mediated rejection is reported, but this rejection without C4d staining is observed as well, suggesting that C4d is specific but not sensitive. Further studies on AMR with positive C4d staining in biopsy specimens are really important, as well as the study of novel routine markers that may participate in the pathogenesis of this process

Influence of the expression of inflammatory markers on kidney after fetal programming in an experimental model of renal failure

Objective. To evaluate the expression of inflammatory markers in experimental renal failure after fetal programming. Methods. The offspring aged two and fivemonths were divided into four groups: CC (control dams, control offspring)DC (diabetic dams, control offspring)CFA (control dams, folic acid offspring, 250 mg/Kg)and DFA (diabetic dams, folic acid offspring). Gene expression of inflammatory markersMCP-1, IL-1, NOS3, TGF-beta, TNF-alpha, and VEGF was evaluated by RT-PCR. Results. MCP-1 was increased in the CFA and DFA groups at two and fivemonths of age, as well as in DC5 when compared to CC5. There was a higher expression of IL-1 in the CFA2, DFA2, and DC2 groups. There was a decrease in NOS3 and an increase in TNF-alpha in DFA5 in relation to CFA5. The gene expression of TGF-beta increased in cases that had received folic acid at two and five months, and VEGF decreased in the CFA5 and DFA5 groups. DC5 showed increased VEGF expression in comparison with CC5. Conclusions. Gestational diabetes mellitus and folic acid both change the expression of inflammatory markers, thus demonstrating that the exposure to harmful agents in adulthood has a more severe impact in cases which underwent fetal reprogramming.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Fundacao de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG)Fundacao de Ensino e Pesquisa de Uberaba (FUNEPU)Discipline of General Pathology, Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, BrazilDepartment of Health Sciences, Lavras Federal University, Lavras, MG, BrazilDiscipline of Physiology, Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, BrazilNephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, SP, BrazilDepartment of Immunology, Institute of Biomedical Sciences IV, University of São Paulo (USP), São Paulo, SP, BrazilDepartment of General Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, BrazilNephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, SP, BrazilWeb of Scienc

Feet care: the knowledge of individuals with diabetes mellitus

El objetivo de esta investigación fue identificar el conocimiento de las personas con diabetes mellitus en relación con el cuidado de los pies, la correlación de tiempo de estudio con el número de respuestas concordantes, así como el momento del diagnóstico de la presencia de complicaciones crónicas. Es un estudio analítico, exploratorio y transversal realizado con 41 individuos con diabetes de una clínica de la ciudad de Triangulo Mineiro. Los resultados mostraron un déficit en el conocimiento de esta población sobre el cuidado de los pies, ya que la puntuación media fue de 10,0 del total de 15 preguntas. La educación no presentó correlación con el nivel de conocimiento de la práctica. Se observó una asociación entre el tiempo del diagnóstico y la presencia de complicaciones, donde el 70,0% de la muestra tenía diabetes con complicaciones para un período ≥ 10 años. Por lo tanto, los esfuerzos educativos para facilitar el acceso a los conocimientos sobre el cuidado de los pies son esenciales para la prevención del pie diabético.RESUMO O objetivo desta pesquisa foi identificar o conhecimento de pessoas com Diabetes Mellitus em relação aos cuidados com os pés, correlacionando o tempo de estudo com o número de respostas concordantes, bem como o tempo de diagnóstico com a presença de complicações crônicas. Trata-se de estudo analítico, exploratório e transversal, realizado com 41 indivíduos, portadores de diabetes, atendidos em um ambulatório especializado de uma cidade do Triângulo Mineiro. Os resultados mostraram déficit no conhecimento desta população sobre os cuidados podais, já que a média de acertos foi de 10,0 perante o total de 15 questões. A escolaridade não apresentou correlação com o nível de conhecimento acerca desta prática. Houve associação entre o tempo de diagnóstico e a presença de complicações, onde 70,0% da amostra com complicações tinham diabetes por período ≥ 10 anos. Portanto, ações educativas que viabilizem o acesso ao conhecimento sobre os cuidados com os pés são essenciais para a prevenção do pé diabético.ABSTRACT The aim of this research was to identify the knowledge of people with Diabetes Mellitus in relation to foot care, correlating the study time with the number of concordants responses, as well as, the time of diagnosis with the presence of chronic complications. It is analytical, exploratory and cross-sectional study, carried out with about 41 individuals with diabetes who attended an outpatient clinic of a city in Triangulo Mineiro. The results showed a deficit in knowledge about the feet care of this population, since the average score was 10.0 in the total of 15 questions. Education was not correlated with the level of knowledge of the practice. There was an association between the time of diagnosis and the presence of complications, where 70.0% of the sample had diabetes with complications for a period ≥ 10 years. Therefore, educational efforts to provide access to knowledge about foot care are essential to preventing this sickness

Complement System and C4d expression in cases of Membranous nephropathy

Abstract Introduction: Membranous nephropathy (MN) is one of the major causes of nephrotic syndrome. The complement system plays a key role in the pathophysiology of MN. Objectives: To identify the complement pathway possibly activated in MN cases and correlate the presence of C4d with more severe clinical and histological markers. Methods: Sixty nine cases from renal biopsy with membranous nephropathy were investigated. The presence of C1q was analyzed by direct immunofluorescence; and expression of C4d by immunohistochemistry. Clinical and epidemiological data were obtained upon biopsy request. Results: The presence of focal segmental glomerulosclerosis, global glomerulosclerosis, vascular lesions and tubulointerstitial fibrosis were collected by anatomopathological report. C4d(+) was found in 58 (84%), and C1q(+) was found in 12 (17%) of the cases. Twelve patients had C4d(+)/C1q(+), 46 had C4d(+)/C1q(-), and 11 patients had C4d(-)/C1q(-), probably indicating the activation of the classical, lectin and alternative pathways, respectively. Conclusion: C4d was associated with increased interstitial fibrosis, but not with clinical markers of poor prognosis. Through the deposition of C4d and C1q we demonstrated that all complement pathways may be involved in MN, highlighting the lectin pathway. The presence of C4d has been associated with severe tubulointerstitial lesions, but not with clinical markers, or can be taken as a universal marker of all cases of MN

Care of the feet: the knowledge of individuals with diabetes mellitus registered family health program

El objetivo es identificar el conocimiento de los individuos con Diabetes mellitus tipo 1 o 2 catastrados en el Programa HIPERDIA, correlacionar el tiempo de estudio con el número de respuestas concordantes acerca de los cuidados con los pies y describir las complicaciones según tiempo de diagnóstico. Estudio analítico, exploratorio y transversal, con análisis cuantitativo, realizado con 116 individuos diabéticos tipo 1 o 2 acompañados en el Programa HIPERDIA en una Unidad Matricial de Salud. Se evidenció que la mayor parte de los individuos era del sexo femenino, edad promedia de 49,9 años, enseñanza básica incompleta, posee diabetes tipo 2. 69% presentaban hipertensión arterial y 45,7% dislipidemia. La mayoría refirió conductas adecuadas para el cuidado con los pies, 98,3% hallaban importante cuidar de los pies para prevenir el pie diabético, pero, 19% realizaba el examen de los pies con profesional de salud por lo menos una vez al año. Los tests estadísticos muestrearon que hubo una baja correlación entre el tiempo de estudio y el número de respuestas concordantes acerca de los cuidados con los pies, pero no fue significativa (rs=0,026; p=0,781). De entre aquellos con hasta 10 años de diagnóstico, 79,7% no presentaron complicaciones y 62,2% mencionaron tener, para aquellos con 10 años o más (χ 2 = 19,83; p<0,001). Se concluyó que tener ciencia del nivel de conocimiento del individuo diabético sobre los cuidados con los pies permite al profesional de salud direccionar las acciones de educación en salud que promuevan e incentiven esta práctica.RESUMO O objetivo é identificar o conhecimento dos indivíduos com Diabetes Mellitus tipo 1 ou 2 cadastrados no Programa HIPERDIA, correlacionar o tempo de estudo com o número de respostas concordantes acerca dos cuidados com os pés e descrever as complicações segundo tempo de diagnóstico. Estudo analítico, exploratório e transversal, com análise quantitativa, realizado com 116 indivíduos diabéticos tipo 1 ou 2 acompanhados no Programa HIPERDIA em uma Unidade Matricial de Saúde. Evidenciou-se que a maior parte dos indivíduos era do sexo feminino, idade média de 49,9 anos, ensino fundamental incompleto, possui diabetes tipo 2. 69% apresentavam hipertensão arterial e 45,7% dislipidemia. A maioria referiu condutas adequadas para o cuidado com os pés, 98,3% achavam importante cuidar dos pés para prevenir o pé diabético, e 19% realizavam o exame dos pés com profissional de saúde pelo menos uma vez ao ano. Houve uma correlação baixa entre o tempo de estudo e o número de respostas concordantes acerca dos cuidados com os pés, mas não foi significativa (rs=0,026; p=0,781). Dentre aqueles com até 10 anos de diagnóstico, 79,7% não apresentaram complicações e 62,2% mencionaram ter, para aqueles com 10 anos ou mais (χ 2 =19,83; p<0,001). Conclui-se que ter ciência do nível de conhecimento do indivíduo diabético sobre os cuidados com os pés permite ao profissional de saúde direcionar as ações de educação em saúde que visem promover e incentivar esta práticaABSTRACT The Objective is to identify the knowledge of individuals with diabetes mellitus type 1 or 2 registered in the HIPERDIA program, correlate study time with the number of concordant answers about foot care and describe the complications on second time of diagnosis. Analytical study, exploratory, cross-sectional quantitative analysis, conducted with 116 individuals with diabetes type 1 or 2 followed at HIPERDIA Program in a Health Unit Matrix became evident that most of the individuals were female, mean age 49, 9 years, elementary school, has type 2 diabetes. 69% had hypertension and 45.7% dyslipidemia. The majority reported appropriate behaviors in their day-to-day for foot care, 98.3% thought important to take care of your feet to prevent diabetic foot, however, 19% performed the examination of the feet to a health professional at least once a year. Statistical tests showed that there was low correlation between study time and the number of concordant answers about foot care, but was not significant (rs = 0.026, p = 0.781). Among those up to 10 years of diagnosis, 79.7% had no complications and 62.2% said they were for those aged 10 or more (χ 2 = 19.83, p <0.001). We conclude that having knowledge of the individual's level of knowledge about diabetic foot care allows the health professional to direct the actions of health education aimed at promoting and encouraging this practice

Complement System and C4d expression in cases of Membranous nephropathy

<div><p>Abstract Introduction: Membranous nephropathy (MN) is one of the major causes of nephrotic syndrome. The complement system plays a key role in the pathophysiology of MN. Objectives: To identify the complement pathway possibly activated in MN cases and correlate the presence of C4d with more severe clinical and histological markers. Methods: Sixty nine cases from renal biopsy with membranous nephropathy were investigated. The presence of C1q was analyzed by direct immunofluorescence; and expression of C4d by immunohistochemistry. Clinical and epidemiological data were obtained upon biopsy request. Results: The presence of focal segmental glomerulosclerosis, global glomerulosclerosis, vascular lesions and tubulointerstitial fibrosis were collected by anatomopathological report. C4d(+) was found in 58 (84%), and C1q(+) was found in 12 (17%) of the cases. Twelve patients had C4d(+)/C1q(+), 46 had C4d(+)/C1q(-), and 11 patients had C4d(-)/C1q(-), probably indicating the activation of the classical, lectin and alternative pathways, respectively. Conclusion: C4d was associated with increased interstitial fibrosis, but not with clinical markers of poor prognosis. Through the deposition of C4d and C1q we demonstrated that all complement pathways may be involved in MN, highlighting the lectin pathway. The presence of C4d has been associated with severe tubulointerstitial lesions, but not with clinical markers, or can be taken as a universal marker of all cases of MN.</p></div

Correlation between hypertension cardiopathies and atherosclerosis in the aortic artery

Systemic arterial hypertension is a multifactorial disease, behaving as a triggering factor for cardiovascular diseases and atherosclerosis. The objective was to describe the association of age, gender, skin color and, the atherosclerosis level in the aortic artery in hypertensive cardiopathy of autopsied individuals. We assessed 34 parts of abdominal aortic arteries of autopsied individuals with hypertensive cardiopathy (20) and without hypertensive cardiopathy (14). We collected age, gender, skin color and cause of death from the autopsy report; the quantification of the atherosclerosis intensity and the atherosclerosis level were determined using a standardized scale. In this study, the cause of death and atherosclerosis intensity had a significant association with hypertensive cardiopathy; there was a prevalence of large atheroma plaques among individuals with this entity. Thus, atherosclerosis should be investigated in individuals with hypertensive cardiopathy to prevent severe repercussions which could lead to death

Fetal Wound Healing Biomarkers

Fetal skin has the intrinsic capacity for wound healing, which is not correlated with the intrauterine environment. This intrinsic ability requires biochemical signals, which start at the cellular level and lead to secretion of transforming factors and expression of receptors, and specific markers that promote wound healing without scar formation. The mechanisms and molecular pathways of wound healing still need to be elucidated to achieve a complete understanding of this remodeling system. The aim of this paper is to discuss the main biomarkers involved in fetal skin wound healing as well as their respective mechanisms of action