CONTEXT AND OBJECTIVE: The stress of living with a terminal disease has a negative impact on the mental health of hemodialysis (HD) patients. Spirituality is a potential coping mechanism for stressful experiences. Studies on the relationship between spirituality and mental health among HD patients are scarce. The purpose of this study was to evaluate the relationship between mental health and spiritual well-being among HD patients. DESIGN AND SETTING: Cross-sectional observational study on hemodialysis patients at a single center in Brazil, between January and December 2011. METHODS : Mental health was assessed using the General Health Questionnaire and spiritual wellbeing was assessed using the Spiritual Wellbeing Scale; 150 HD patients participated in the study. RESULTS : A significant correlation was found between mental health and spiritual wellbeing (P = 0.001). Spiritual wellbeing was the strongest predictor of mental health, psychological distress, sleep disturbance and psychosomatic complaints. CONCLUSION: Poor mental health was associated with lower spiritual wellbeing. This has important implications for delivery of palliative care to HD patients.

PURPOSE:To evaluate metabolic effects in experimental model of glucocorticoid-induced insulin resistance. METHODS:Twenty Wistar male rats were randomly divided into two groups, which were treated with intraperitoneally injected dexamethasone 1mg/Kg/day for ten days consecutively (Group D; n=10) and placebo (Group C; n=10). The variables analyzed were:from the first to the 10th day -body weight (before and after treatment); food and water daily consumption; on the 10th day -glycemia, insulinemia, HOMA-beta and HOMA-IR. The blood samples for laboratory analysis were obtained by intracardiac puncture. Also on the 10 th day liver fragments were taken for analyzing glycogen and fattty.

Whole-body vibration contributed little to improve the functional levels of stroke patients.

PURPOSE:To extract the Melaleuca sp. oil and to assess its in vitro inhibitory effect against Staphylococcus aureus isolates obtained from lower limb wounds and resistant to several antibiotics. METHODS:A total of 14 test-tubes containing Mueller-Hinton broth were used to determine the Minimum Inhibitory Concentration (MIC). The following concentrations of the Melaleuca sp. oil were added to the first 11 tubes: 8; 4; 2; 1; 0.5; 0.2; 0.1; 0.05; 0.025; 0,0125 and 0.00625%. The 12 th and 13 th tubes, with and without oil, were used as the positive and negative controls, respectively. The experimental study was carried out in triplicate at 37ºC for 18 hours. The Minimum Bactericidal Concentration (MBC), able of killing all the microorganisms, was also determined. Two S. aureus isolates were obtained from lower limb wounds of female patients and the identification of the microorganisms (Staphylococcus aureus) and the test for susceptibility to the antimicrobial agents were carried out by automation using the apparatus MicroScan ® . After identification, the isolates were preserved in liquid Trypticase Soy medium, and inoculated for determination of the MIC and MBC. RESULTS:The MIC was 0.2% and the MBC was 0.4%. CONCLUSION:The Melaleuca sp. oil showed antimicrobial properties in vitro against strains isolated from lower limb wounds which were resistant to multiple antibiotics.

INTRODUÇÃO: Vários estudos têm demonstrado a relação entre a prática de exercício físico (EF) e a melhora da qualidade de vida (QV) da população geral. Muitos fatores contribuem para a piora da QV dos pacientes em hemodiálise (HD) e com freqüência encontramos nestes indivíduos uma baixa aptidão para a prática de EF. Nosso objetivo neste trabalho foi estudar a associação do EF com a QV do paciente em HD. MÉTODOS: Estudo transversal com 115 pacientes em hemodiálise no Hospital das Clínicas Samuel Libânio – Pouso Alegre, MG, divididos em 2 grupos: GS: pacientes sedentários; GA: pacientes que realizavam exercício físico regular. Para medida da QV foi utilizado o instrumento SF-36. Foram coletados dados clínicos, socioeconômicos e laboratoriais. Para a análise dos resultados foi utilizada estatística analítica e descritiva. Adotamos 0,05 como nível de rejeição da hipótese de nulidade. RESULTADOS: Não encontramos diferenças entre idade (GS: 53,3 ± 13,0; GA:53,8 ± 13,8); etnia (56% de caucasianos em GS e 60% em GA); hemoglobinemia (GS: 10,3 ± 1,7; GA:10,7 ± 1,9); índice de massa corpórea (GS: 23,6 ± 4,3; GA:24,1 ± 3,8). Quando comparamos os escores dos domínios do SF-36 observamos diferença entre capacidade funcional (GS:53,0 ± 27,5 e GA: 72,4 ± 20,9; p = 0,0001); aspectos físicos (GS:43,1±41,9 e GA: 56,4 ± 33,9; p = 0,05); dor (GS:60,1 ± 27,9 e GA: 70,4 ± 22,8; p = 0,03); vitalidade (GS:53,3 ± 25,1 e GA: 66,1 ± 21,2; p = 0,05) e saúde mental (GS:65,0 ± 26,7 e GA: 76,2 ± 19,2; p = 0,006). CONCLUSÃO: observamos uma relação direta do exercício físico com a qualidade de vida, mas não pudemos estabelecer uma relação de causa e efeito com este estudo

Background/aim Motor function impairment is a frequent problem in stroke patients and many questions remain about the application of vibration therapy for neurological patients. This study aims to verify the effects of vibration training on lower limb function in patients affected by stroke. Methods This was a clinical, prospective study. The study's subjects were selected via a convenience sample from Samuel Libanio Hospital's Physical Therapy and Neurology Out-patient clinics in Pouso Alegre, Brazil. The sample comprised of 27 individuals presenting with spastic hemiparesis due to stroke. Participants received whole body vibration training at a frequency of 50 Hz and 2 mm amplitude, for 8 weeks. In the first 4 weeks, participants underwent a series of four 60-second periods of vibration in the following positions: in orthostatic posture, first with the knees semi-flexed at 30°, then with the knees semi-flexed at 90°, and then with the affected knee semi-flexed at 30°, and finally in orthostatic posture again with the knees semi-flexed at 30°. In the last 4 weeks, we doubled the number of series of vibration, but used the same positions. The six minute walking test (6MWT), the stair climbing test (SCT) and the timed get up and go test (TUG) were applied to evaluate the lower members' motor function. The tests were applied before and after the intervention, as well as after a follow-up, which was performed 1 month later. Results This study found statistical differences in the 6MWT (P=0.00), SCT (P=0.00), and TUG (P=0.00), indicating improvement in the participants' lower limbs motor function. Conclusion Vibration therapy can contribute to the improvement of the lower limbs' motor function in patients affected by stroke.

PURPOSE:To extract the Melaleuca sp. oil and to assess its in vitro inhibitory effect against Staphylococcus aureus isolates obtained from lower limb wounds and resistant to several antibiotics. METHODS:A total of 14 test-tubes containing Mueller-Hinton broth were used to determine the Minimum Inhibitory Concentration (MIC). The following concentrations of the Melaleuca sp. oil were added to the first 11 tubes: 8; 4; 2; 1; 0.5; 0.2; 0.1; 0.05; 0.025; 0.0125 and 0.00625%. The 12 th and 13 th tubes, with and without oil, were used as the positive and negative controls, respectively. The experimental study was carried out in triplicate at 37ºC for 18 hours. The Minimum Bactericidal Concentration (MBC), able of killing all the microorganisms, was also determined. Two S. aureus isolates were obtained from lower limb wounds of female patients and the identification of the microorganisms (Staphylococcus aureus) and the test for susceptibility to the antimicrobial agents were carried out by automation using the apparatus MicroScan ® . After identification, the isolates were preserved in liquid Trypticase Soy medium, and inoculated for determination of the MIC and MBC. RESULTS:The MIC was 0.2% and the MBC was 0.4%. CONCLUSION:The Melaleuca sp. oil showed antimicrobial properties in vitro against strains isolated from lower limb wounds which were resistant to multiple antibiotics.

Introdução: O “How to do a 3-minute diabetic foot exam”, elaborado por Armstrong et al foi projetado para fornecer aos profissionais de saúde uma forma aprofundada, resumida e facilmente aplicável para avaliar os pés do paciente diabético na Atenção Primária à Saúde. Objetivo: Traduzir para a língua portuguesa, adaptar ao contexto cultural brasileiro e testar as propriedades de medidas deste instrumento. Métodos: Seguindo orientação padrão da literatura, o instrumento foi traduzido para o português, adaptado culturalmente e testado em relação à reprodutibilidade, validade de face, conteúdo e construto. Nas etapas de adaptação cultural e validação foram entrevistados 30 profissionais de saúde e 60 pacientes, respectivamente. Resultados: O instrumento foi adaptado ao contexto linguístico e cultural da população mantendo todas as características essenciais do instrumento original em Inglês e sendo preservadas as equivalências idiomática, semântica, conceitual e cultural. Todos os itens do instrumento apresentaram concordância calculado pelo Índice de Validade de Conteúdo (IVC) > 0,9. O α de Cronbach foi de 0,67. O Coeficiente de Correlação Intraclasse interobservador foi de 0,73 (IC95%:0,58-0,85) e intraobservador foi de 0,65 (IC95%: 0,45-0,81), demostrando uma reprodutibilidade satisfatória. O instrumento e o teste do monofilamento apresentaram correlação positiva com significância estatística (ρ = 0,41; p <0,01). Conclusão: Este trabalho traduziu para a língua portuguesa, adaptou ao contexto cultural brasileiro e testou as propriedades de medidas do instrumento americano: “How to do a 3-minute diabetic foot exam”.