No abstract

Milk may represent an important source of infectious agents to hospitalized pediatric patients. To describe the bacterial microflora isolated from the hands, stools, pharynx of all workers at milk kitchens in pediatric hospitals in the city of Salvador, Brazil, as well as in the formulas prepared by them, we carried out this cross-sectional study with all 91 workers from the 20 milk kitchens of all the public and private hospitals in Salvador, Brazil. Hand and pharynx swabs and stool samples were collected from all workers, as well as samples of the milk and formulas delivered by the kitchens. All samples were cultured for the detection of pathogenic and non-pathogenic bacteria. Pathogenic bacteria were isolated from 20 (22.0%) and 8 (8.8%) cultures of the hands and pharynx of the workers, respectively. No pathogenic bacteria were isolated from stool samples. Pathogenic bacteria were isolated from 17 (18.7%) milk samples. The prevalence of pathogenic bacteria in hand swabs was significantly higher in workers from public (37.8%) than from private (6.5%) hospitals (prevalence ratio [PR]=5.8; p<0.01). Pathogenic bacteria were isolated from two (4.4%) workers from public hospitals and six (13.0%) workers from private hospitals (PR=0.38; p=0.27). Pathogenic bacteria were isolated from 11 (24.4%) milk samples from public hospitals and 6 (13.0%) from private hospitals (PR=1.9; p=0.16). A high prevalence of contamination was found, mainly on the hands of workers on units for manipulation of milk. Preventive efforts should be intensified and focus primarily on effective hand washing and continuous work supervision.

The socioeconomic conditions and psychological characteristics of the study participants were negatively associated with glycated hemoglobin results. These data reinforce the importance of the studied variables as predictors of glycemic control.

ResumoIntrodução: O controle glicêmico na criança e no adolescente com diabetes melito tipo 1 (DM1) é influenciado por fatores como hábitos alimentares, prática de exercícios físicos, monitoração da glicemia capilar, insulinoterapia, interação familiar, condições socioeconômicas e aspectos emocionais vivenciados por esses indivíduos em seu processo saúdedoença. Objetivo: Revisão crítica da literatura sobre os fatores associados ao controle glicêmico em crianças e adolescentes com DM1. Metodologia: Foram pesquisados através dos bancos de dados MEDLINE/PubMed e LILACS-BIREME artigos científicos publicados nos últimos 10 anos que abordassem fatores modificadores do controle glicêmico em crianças e adolescentes com DM1. Resultados: Estudos mostram que indivíduos que aderiram ao plano alimentar, apresentaram redução média de 0,9% da HbA1c (hemoglobina glicada). Observou-se ainda diminuição significante nos níveis de HbA1c após adesão a um programa de atividade física regular, monitoração domiciliar da glicemia e uso de regimes intensivos de insulina. O envolvimento da família é um fator fundamental para adesão ao tratamento e controle glicêmico. Portadores do DM1 com menor nível socioeconômico e que vivenciam abalos emocionais apresentam um pior controle glicêmico. Conclusão: As evidências na literatura sugerem que os fatores mencionados na pesquisa estão intimamente ligados ao manejo do DM1. As informações mostram ainda que alterações desses aspectos conduz a criança e o adolescente a níveis de HbA1c acima do normal, levando-os assim a um controle glicêmico ruim/inadequado. Palavras chave: Glicemia. Criança. Adolescente. Diabetes Mellitus. AbstractIntroduction: The glycemic control in children and adolescents with type 1 diabetes mellitus (T1DM) is influenced by factors such as diet, physical exercise, blood glucose monitoring, insulin therapy, family interaction, socioeconomic and emotional aspects experienced by these individuals in their disease process. Objective: Critical review of the literature investigating factors associated with glycemic control in children and adolescents with T1DM. Methods: We searched through MEDLINE / PubMed and LILACS-BIREME databases, articles published in the last 10 years that addressed modifying factors of glycemic control in children and adolescents with DM1. Results: Studies demonstrate that individuals who adhered to the diet plan, showed an average reduction of 0.9% in HbA1c (glycated hemoglobin). There was also a significant reduction in HbA1c levels after adherence to a program of regular physical activity, home blood glucose monitoring and the use of intensive insulin regimens. Family involvement is a key factor in treatment adherence and glycemic control. T1DM patients with lower socioeconomic status and who experience emotional aftershocks have a poorer glycemic control. Conclusion: The evidence in the literature suggests that the factors mentioned in the research are closely linked to the management of T1DM. The information also show that changes in these aspects leads to...

RESUMOObjetivo: esta pesquisa tem como objetivo conhecer a percepção dos usuários com diabetes acerca da assistência recebida na Atenção Primária à Saúde. Métodos: estudo descritivo, de natureza qualitativa, realizado junto a 20 pessoas com diabetes tipo 2 cadastradas e assistidas em seis equipes da Estratégia de Saúde da Família. A coleta de dados ocorreu por meio de entrevista domiciliar, utilizando questões norteadoras direcionadas para o objetivo do estudo. As mesmas foram gravadas, transcritas e submetidas à análise de conteúdo na modalidade temática. Resultados: participaram do estudo 15 mulheres e cinco homens, com idade média de 56 anos. Mediante as entrevistas emergiram três categorias temáticas: Receptividade, acessibilidade, acolhimento e rapidez na realização da consulta: potencialidades da assistência na perspectiva de pessoas com DM2; e Limites e fragilidades na assistência às pessoas com DM2 no âmbito da APS. Conclusão: percebe-se que um atendimento realizado de forma organizada, humanizado e individualizado, baseado no vínculo comunidade-equipe, que disponibilize os medicamentos e que preze pelo acesso e acessibilidade às consultas e atendimentos em geral é fundamental para a satisfação dos usuários. ABSTRACTObjective: the objective was to learn about the perception of diabetes patients regarding the assistance received in primary health care. Methods: this was a descriptive study, qualitative in nature, carried out with 20 people with type 2 diabetes, enrolled and assisted in Family Health Strategy teams. Data was collected through home interviews using guided questions directed to the purpose of the study. These were recorded, transcribed, and run through content analysis in the thematic mode. Results: the study included 15 women and five men, with a mean age of 56 years. Through the interviews, three themes emerged: openness, accessibility, comprehensive and rapid care in carrying out the consultation; potential assistance, from the perspective of people with type 2 diabetes; and limits and weaknesses in care for people with type 2 diabetes within the primary health care context. Conclusion: it is noted that patient care conducted in an organized, humanized, and individualized manner, based on the community-team link, that ensures availability of medications and that respects access and accessibility to consultations and care in general is key to user satisfaction.