The aim of this study was to assess the level of agreement between an institutional protocol and the Manchester protocol for the risk assessment of patients attended in an emergency room of a public hospital in Belo Horizonte -MG -Brazil. This is a descriptive and comparative study, in which 382 patients' reports were evaluated and the risk was classified, using the institutional protocol and the Manchester protocol. Rates were calculated through weighted and unweighted kappa, in order to determine the level of agreement between the protocols.The results showed that the correlation between the protocols is average when considering that classification errors occurred between neighboring colors (kappa=0.48), and good when considering that classification errors occurred between extreme colors (kappa=0.61).The Manchester protocol increased the patients' level of priority of patients and has been considered more inclusive. Clasificación de riesgo en primeros auxilios: concordancia entre un protocolo institucional brasileño y el de ManchesterEste estudio tuvo por objetivo verificar el grado de concordancia entre un protocolo institucional y el protocolo de Manchester para la clasificación de riesgo de pacientes atendidos en primeros auxilios de un hospital público de Belo Horizonte -MG -Brasil.Se trata de estudio descriptivo comparativo en el cual 382 fichas fueron evaluadas y, realizada la clasificación de riesgo utilizando los protocolos mencionados encima, a partir del registro realizado por los enfermeros. Índices kappa ponderado y no ponderado fueron calculados para determinar el grado de concordancia entre los protocolos.Los resultados mostraron que la concordancia entre los protocolos es media, cuando considerados los errores de clasificación ocurridos entre colores vecinos (kappa=0,48) y buena, cuando considerados los errores de clasificación ocurridos entre colores extremos (kappa=0,61). Se concluye que el protocolo de Manchester aumentó el nivel de prioridad de los pacientes, demostrando ser un protocolo que incluye más.

Fall is used as an indicator of quality in healthcare institutions specialized in elderly care and is also considered an important indicator of quality of life of seniors in all environments. This is a cross-sectional study with a convenience sample of 108 elderlies enrolled at a Health Center, in Belo Horizonte, Minas Gerais, in order to determine the occurrence of falls in elderly people and also look for its association with some variables. Data were collected from clinical records and interviews during home healthcare visits using a structured and specific instrument. It was found that 64 (59.3%) of the elderly patients have already suffered falls, and a significant statistical relationship (p=0.01) between the elderly cognitive ability and the occurrence of the falls. It is recommended that nursing care focuses in the early identification of the elderlies that are more likely to suffer falls, especially those who, in addition to the risk of falling are at increased risk of suffering serious injury originated from the falls.

BACKGROUNDPyoderma gangrenosum (PG) is a rare, chronic, and cutaneous ulcerative disease with a distinctive morphologic presentation typified by painful ulcers with violaceous, undermined borders, typically on the lower extremities. This is a relatively infrequent, noninfectious, idiopathic, chronic, relapsing inflammatory dermatosis, with a local destructive character, usually associated with other local or systemic diseases. Clinically, the presence of hemorrhagic pustules, painful nodules or multiple vesicles and pustules are observed. These lesions evolve into destructive ulcers that grow centrifugally with slightly elevated, violaceous, sharply delineated, excavated edges presenting a necrotic center with presence of blood, pus and granulation tissue. Despite the existence of diagnostic criteria, there is no gold standard for diagnosis or treatment. Recognizing and treating PG is even more challenging since skin and soft tissue bacterial and non-bacterial infections are common mimickers. The most common treatment modalities include systemic corticosteroids and cyclosporine. Other reported treatments are methotrexate, dapsone, and cyclophosphamide.

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