Objectives: To relate the knowledge and attitudes of users with type 2 diabetes mellitus (DM2), according to educational level and duration of disease. Methods: This was a quantitative, descriptive transversal study conducted in a Basic Health District Unit in the municipality of Ribeirão Preto, SP, in 2010. We interviewed 123 users with DM2, who met the inclusion criteria. For data collection we used: Knowledge Questionnaire (DKN-A) and Questionnaire of Psychological Attitudes about Diabetes (TA-19). Data were collected through direct interviews. For the analysis, we used the Fisher exact test. Results: The mean age was 63.87 ± 9.09 years, 4.54 ± 3.66 years of study, mean disease duration 11.18 ± 8.64 years. The education and disease duration were statistically signifi cant (p <0.01 and 0.02, respectively) for the acquisition of knowledge and readiness for self-care in diabetes. Conclusions: education and disease duration are variables that infl uence the knowledge and attitude of patients with DM2. RESUMENObjetivos: Relacionar el conocimiento y la actitud de usuarios con Diabetes mellitus tipo 2 (DM2), conforme la escolaridad y el tiempo de la enfermedad. Métodos: Estudio de abordaje cuantitativo, descriptivo transversal realizado en una Unidad Básica Distrital de Salud del municipio de Ribeirão Preto, SP, en el 2010. Fueron entrevistados 123 usuarios con DM2, que reunían los criterios de inclusión. Para la recolección de los datos, fueron utilizados: Cuestionario de Conocimiento (DKN-A) y Cuestionario de Actitudes Psicológicas de la Diabetes (ATT-19). Los datos fueron obtenidos por medio de entrevista dirigida. Para el análisis, se utilizo el test Exacto de Fisher. Resultados: El promedio de edad fue de 63,87±9,09 años, 4,54±3,66 años de estudio, tiempo promedio de enfermedad 11,18±8,64 años. La escolaridad y el tiempo de enfermedad se mostraron estadísticamente signifi cativos (p<0,01 e 0,02, respectivamente) para la adquisición del conocimiento y prontitud para el autocuidado en Diabetes. Conclusiones: La escolaridad y el tiempo de enfermedad son variables que infl uyen en el conocimiento y actitud del paciente con DM2. Descriptores: Diabetes mellitus tipo 2; Conocimiento; Actitud; Escolaridad

Objective: Investigating the association between adherence to treatment of type 2 diabetes mellitus and sociodemographic, clinical and metabolic control variables. Methods: Cross-sectional study with 423 patients with diabetes mellitus. The Fisher's exact test and logistic regression models were used to investigate the association between adherence to treatment and the studied variables.Results: There was no association between adherence to treatment of T2DM and socio-demographic and clinical variables. It was found that total cholesterol and HbA1c were significantly associated with adherence to diet (p = 0.036) and exercise (p = 0.006). Conclusion: The chance of a patient with cholesterol within the recommended level adhering to diet is almost five times the chance of the patient in poor lipid control. The chance of patients with poor glycemic control adhering to exercise is almost twice the chance of those who keep adequate glycemic control. ResumoObjetivo: Investigar associação entre adesão ao tratamento do diabetes mellitus tipo 2 e variáveis sociodemográficas, clínicas e controle metabólico. Métodos: Desenho cross seccional com 423 portadores de diabetes mellitus. Para verificar a associação entre adesão ao tratamento e as variáveis estudadas, utilizou-se teste exato de Fisher e modelos de regressão logística. Resultados: Não houve associação entre adesão ao tratamento do DM2 e variáveis sociodemográficas e clínicas. Verificou-se que o colesterol total e a HbA1c apresentaram associação estatisticamente significativa com a adesão ao plano alimentar (p = 0.036) e de exercício físico (p = 0.006). Conclusão: A chance do paciente com colesterol dentro do valor recomendado apresentar adesão ao plano alimentar é quase cinco vezes a chance do paciente em mau controle lipídico. A chance dos pacientes com mau controle glicêmico apresentarem adesão ao exercício físico é quase duas vezes a chance daquele sem controle adequado da glicemia.

RESUMENEstudio transversal, cuyo objetivo fue analizar la adherencia al tratamiento farmacoló-gico y no farmacológico en 17 unidades de Estrategia Salud de la Familia (ESF). Participaron 423 pacientes con diabetes mellitus tipo 2 seleccionados mediante muestreo aleatorio estratificado en unidades de ESF de un municipio de Minas Gerais en el año 2010. Los resultados mostraron que la tasa de prevalencia de la adherencia al tratamiento farmacológico fue superior a 60% en las 17 unidades investigadas; en relación a la actividad física, ésta fue superior a 60% en el 58,8% de las unidades; y para el plan de alimentación, no tuvo efecto en 52,9% de las unidades. Se concluye que: la adherencia al tratamiento farmacológico fue alta en la mayoría de las unidades, la prác-tica de actividad física fue heterogénea y la adherencia a la dieta fue baja en todas las unidades. Se recomienda el fortalecimiento de las normas institucionales y estrategias educativas en consonancia con las directrices del SUS para hacer frente a los desafíos impuestos por la falta de adherencia. DESCRIPTORES Diabetes mellitusComplimiento de la medicación Salud de la Familia Evaluación en salud Atención Primaria de Salud RESUMOEstudo transversal que teve como objetivo analisar a adesão ao tratamento medicamentoso e não medicamentoso em 17 unidades da Estratégia Saúde da Família (ESF). Participaram 423 pacientes com diabetes mellitus tipo 2 selecionados por meio de amostragem aleatória estratificada, nas unidades da ESF de um município do interior de Minas Gerais, em 2010. Os resultados mostraram que a adesão ao tratamento medicamentoso foi superior a 60% nas 17 unidades investigadas; em relação à atividade física foi superior a 60% em 58,8% das unidades; entretanto, para o plano alimentar, foi nula em 52,9% das unidades. Conclui-se que a adesão ao tratamento medicamentoso foi alta na maioria das unidades; a prática de atividade físi-ca foi heterogênea e, em relação ao plano alimentar foi baixa em todas as unidades. Recomenda-se o fortalecimento das diretrizes institucionais e estratégias educativas, em consonância com as diretrizes do SUS, para o enfrentamento dos desafios impostos pela falta de adesão. DESCRITORES Diabetes mellitus Adesão à medicaçãoSaúde da família Avaliação em saúde Atenção Primária à Saúde ABSTRACTThis cross-sectional study aimed to analyze the adherence to drug and non-drug treatments in 17 Family Health Strategy units. A total of 423 patients with type 2 diabetes mellitus were selected through stratified random sampling in Family Health Strategy units of a city in the state of Minas Gerais, Brazil, in 2010. The results showed that the prevalence rate of adherence to drug therapy was higher than 60% in the 17 units investigated; in relation to physical activity, adherence was higher than 60% in 58.8% units; and for the diet plan, there was no adherence in 52.9% units. Therefore, we concluded that adherence to drug therapy in most units was high and the practice of physical activity was heterogeneous, and in relation to diet adher...

This descriptive cross-sectional study was conducted from March to November 2007 at a research and community services center of a Brazilian university. It aimed to explore the knowledge and attitude of people with diabetes mellitus who were attending a diabetes self-care education program. The sample was composed of 82 adults with diabetes mellitus. Data were collected through the Portuguese versions of the Diabetes Knowledge Questionnaire (DKN-A) and the Diabetes Attitude Questionnaire (ATT-19). Results revealed that 78.05% of the participants obtained scores higher than eight on knowledge about diabetes, which indicates they have knowledge and understand the disease. Scores on attitude ranged from 25 to 71 suggesting difficulty in coping with the disease. We conclude that although participants obtained a good score on knowledge, their attitude did not change so as to more adequately cope with the disease.

In the Krishna-Godavari Delta region of the State of Andhra Pradesh, India, 866 sera obtained from trapped birds of 13 species were tested for neutralizing antibody to Japanese encephalitis (JE) virus; two species of birds belonging to the family Ardeidae, Ardeola grayii (pond heron) and Bubulcus ibis (cattle egret), contributed 514 of these sera. Neutralizing antibody to JE virus--i.e. sera giving positive reactions--was detected in 179 sera (34.8%) from these two species; in addition, two sera (0.4%) gave equivocal reactions, presumably indicating partial protection. There were only nine positive reactors (2.6%) among the remaining 352 sera from all other bird species. Of the 181 sera from ardeid birds in which neutralizing activity was detected, 174 were tested for neutralizing antibody to West Nile (WN) virus. The results indicated that 35.6% of these 179 sera had antibody specific to JE virus only and 63.8% possessed neutralizing antibodies to JE virus or to WN virus or to both; these figures represent 12.5% and 22.5% , respectively, of the total of 514 birds of these two species which were tested for neutralizing antibody to JE virus. The findings suggest that ardeid birds may be involved in the natural cycle of JE virus and, possibly, also of WN virus in India.

The purpose of this study is to investigate the specific quality of life of patients with diabetes mellitus. It is a crosssectional study, which was conducted from August 2-28, 2012 in two basic health units, in the interior of São Paulo. A convenience sample, made up of 75 patients, 18 years old or older, both sexes, in a group of self-monitoring of blood glucose, was used. The Diabetes 39 (D-39) Instrument Evaluation, containing five dimensions: energy and mobility (15 items), diabetes control (12), anxiety and worry (4) social overload (5) and sexual behavior (3), was used. Quality of life proved to be highly affected in the items related to the social overload dimension: embarrassment for having diabetes, being called diabetic and diabetes interfering with family life. The elucidation of the assessed factors contributes to the planning of educational programs, insofar as they may hinder the achievement of metabolic control in patients with diabetes.Descriptors: Quality of life. Diabetes Mellitus. Nursing. RESUMO Este estudo teve como objetivo investigar a qualidade de vida específica de pacientes com Diabetes Mellitus. Trata-se de estudo transversal, realizado de 02 a 28 de agosto de 2012, em duas unidades básicas de saúde do interior paulista. A amostra foi constituída por conveniência de 75 pacientes, com idade igual ou maior a 18 anos, de ambos os sexos, em um grupo de automonitorização da glicemia capilar. Utilizou-se o Instrumento de Avaliação de Diabetes 39 (D-39), contendo cinco dimensões:"energia e mobilidade" (15 itens), "controle do diabetes" (12), "ansiedade e preocupação" (4), "sobrecarga social" (5)

BackgroundThe repair of large bone defects is a major orthopedic challenge because autologous bone grafts are not available in large amounts and because harvesting is often associated with donor-site morbidity. Considering that bone marrow stromal cells (BMSC) are responsible for the maintenance of bone turnover throughout life, we investigated bone repair at a site of a critically sized segmental defect in sheep tibia treated with BMSCs loaded onto allografts. The defect was created in the mid-portion of the tibial diaphysis of eight adult sheep, and the sheep were treated with ex-vivo expanded autologous BMSCs isolated from marrow aspirates and loaded onto cortical allografts (n = 4). The treated sheep were compared with control sheep that had been treated with cell-free allografts (n = 4) obtained from donors of the same breed as the receptor sheep.ResultsThe healing response was monitored by radiographs monthly and by computed tomography and histology at six, ten, fourteen, and eighteen weeks after surgery. For the cell-loaded allografts, union was established more rapidly at the interface between the host bone and the allograft, and the healing process was more conspicuous. Remodeling of the allograft was complete at 18 weeks in the cell-treated animals. Histologically, the marrow cavity was reestablished, with intertrabecular spaces being filled with adipose marrow and with evidence of focal hematopoiesis.ConclusionsAllografts cellularized with AOCs (allografts of osteoprogenitor cells) can generate great clinical outcomes to noncellularized allografts to consolidate, reshape, structurally and morphologically reconstruct bone and bone marrow in a relatively short period of time. These features make this strategy very attractive for clinical use in orthopedic bioengineering.

Regulatory T cells (Tregs) are a unique population of CD25+CD4+ T cells that regulate innate and adaptive immune responses and have the ability to control the excessive or misdirected effects of the immune system. This modulation involves different mechanisms, such as the suppression of T cell proliferation and cytokine production, the secretion of suppressive cytokines (IL-10 and TGF-β) and the induction of effector T cell apoptosis in humans with infectious diseases such as Leishmania infections. The aim of this study was to evaluate the expression of Foxp3, IL-10 and TGF-β through immunohistochemistry in 22 skin biopsies of patients with localized cutaneous leishmaniasis (LCL) caused by Leishmania (Viannia) spp. from an endemic area in pre-Amazonian area of Maranhão State, Brazil. The density of these markers was also analyzed according to the species of parasite and the progression of the disease. The cellular density was 234 cells/mm(2) for Foxp3+ cells, 357 cells/mm(2) for TGF-β+ cells and 648 cells/mm(2) for IL-10+ cells in the studied skin lesions. The analysis of the cellular density of these immunological markers in relation to the species of Leishmania demonstrated that lesions caused by L. (V.) braziliensis had a lower density of Foxp3+ cells than lesions caused by L. (Viannia) spp. The expression of IL-10 was also lower in lesions caused by L. (V.) braziliensis. There were no significant differences in TGF-β expression between the two groups. The evaluation of these markers according to the progression of the disease did not reveal any significant differences. These findings suggest that Treg Foxp3+ cells, IL-10, and TGF-β play important roles in the immunopathogenesis of LCL and that these roles differ depending on the causal Leishmania species.