Objective: To verify self-care activities of patients with type 2 diabetes mellitus and to analyze the relationship with sociodemographic and clinical variables. Method: A cross-sectional study was performed of 149 people using the Diabetes Self-Care Activities Questionnaire. Results: Of the 15 self-care activities analyzed, appropriate behavior was observed for aspects related to medication use and inadequate for fruit/vegetable consumption, blood sugar testing and physical exercise. The correct use of medications was correlated to marital status. Regarding inadequate behaviors, there were associations of fruit/vegetable consumption with skin color and place of residence and blood sugar testing with marital status and inverse correlations of physical exercise with systolic blood pressure, pulse pressure, waist circumference and postprandial glycemia. Conclusion: The results of this research contribute by strengthening the line of care in chronic diseases and assist in divulging the importance of supported self-care. Implications for practice: The findings of this research provided information relevant to the planning of care.

Introduction:In venous ulcers, the presence of Staphylococcus aureus and coagulase-negative staphylococcus resistance phenotypes can aggravate and limit the choices for treatment. Methods: Staphylococcus isolated from 69 patients (98 ulcers) between October of 2009 and October of 2010 were tested. The macrolide, lincosamide, streptogramin B (MLS B ) group resistance phenotype detection was performed using the D-test. Isolates resistant to cefoxitin and/or oxacillin (disk-diffusion) were subjected to the confirmatory test to detect minimum inhibitory concentration (MIC), using oxacillin strips (E-test®). Results: The prevalence of S. aureus was 83%, and 15% of coagulase-negative staphylococcus (CoNS). In addition were detected 28% of methicillin-resistant Staphylococcus aureus (MRSA) and 47% of methicillin-resistant coagulase-negative staphylococcus (MRCoNS). Among the S. aureus, 69.6% were resistant to erythromycin, 69.6% to clindamycin, 69.6% to gentamicin, and 100% to ciprofloxacin. Considering the MRSA, 74% were highly resistant to oxacillin, MIC ≥ 256µg/mL, and the MLS B c constitutive resistance predominated in 65.2%. Among the 20 isolates sensitive to clindamycin, 12 presented an inducible MLS B phenotype. Of the MRCoNS, 71.4%were resistant to erythromycin, ciprofloxacin and gentamicin. Considering the isolates positive for β-lactamases, the MIC breakpoint was between 0.5 and 2µg/mL. Conclusions: The results point to a high occurrence of multi-drug resistant bacteria in venous ulcers in primary healthcare patients, thus evidencing the need for preventive measures to avoid outbreaks caused by multi-drug resistant pathogens, and the importance of healthcare professionals being able to identifying colonized versus infected venous ulcers as an essential criteria to implementing systemic antibacterial therapy.

Bastonetes Gram-negativos em úlceras venosas e implicações para o atendimento de enfermagem na atenção primária*Gram-negative rods in venous ulcers and implications for primary care nursing care Bacilos Gram-negativos en úlceras venosas, implicancias para la atención de enfermería en la atención primaria

ABstrAct:The aim in this study was to assess the pain resulting from leg ulcers during dressing change and to identify the most painful procedures in the opinion of SUS patients. Cross-sectional study with the participation of 76 patients with leg ulcers, 69.8% being male with an average age of 57.8 (sd=13.2) who were admitted at Primary Health Care Units and at the Outpatient Care Centre of Goiania Hospital das Clínicas, in the state of Goias, Brazil. For the assessment of pain, a Numerical Rating Scale (1-10) and the McGill Pain Questionnaire were used. The occurrence of pain during dressing change was 76.3%, with a moderate intensity (Mean=5, Q1=3, Q3+8, Min=1, Max=10). The degree of pain was described as tiring (63.2%) and throbbing (55.3%). The most painful procedures in the opinion of the participants included cleaning the wound and removing the previous dressing. The pain during dressing change for leg ulcers was frequent and increased during wound cleaning and removal of previous dressing.

Resumo: objetivo: Identificar o conhecimento dos enfermeiros responsáveis pela instalação e acompanhamento do ato transfusional. Metodologia: estudo transversal descritivo A coleta de dados se realizou por entrevista semi-estruturada com 31 enfermeiros. A análise dos dados foi conduzida no programa STATA, versão 12.0. Resultados: Dos investigados, 16 (51,6%) enfermeiros com pós-graduação latu sensu;  23 (74,2%) com tempo de experiência superior há 2 anos. Relacionado ao conhecimento, 21 (67,7%) enfermeiros conhecem a RDC 34; 20 (64,5%) referem tempo máximo de infusão de 4 horas, 16 (51,6%) consideram-se informados sobre o tema. Sobre atitudes, 23 (74,2%) enfermeiros realizam verificação de sinais vitais no começo e final da transfusão; 20 (64,5%) investigam, registram e realizam ações corretivas frente a eventos adversos. Conclusão: embora apenas 8% das questões tenham sido respondidas erroneamente, a necessidade de capacitação sobre hemotransfusão se fez presente no relato dos profissionais.

No abstract

This transversal study aimed to analyze factors related to, and defining characteristics of, Impaired Tissue Integrity in persons with vascular ulcers, and compare the mean of these factors between the groups presenting different degrees in the severity of tissue compromise. The study was undertaken in February-August 2009, in the municipal health network of Goiânia in the state of Goiás, using interviews, clinical examinations and photographic records of the wounds. For analysis, simple and percentage frequencies and the Student t-test (p<0.05) were used. Five related factors were identified in more than half of the 42 participants: impaired circulation, knowledge deficit, chemical irritants, fluid excess and nutritional factors. Three defining characteristics were identified in all of the participants. There was no difference in the mean of related factors between groups. Impaired Tissue Integrity in persons with vascular ulcers was a phenomenon which demands professional attention extending beyond circulatory impairment. The mean of factors did not indicate greater or lesser severity of the compromising of the tissue integrity.

O conhecimento da equipe de saúde sobre os atributos da atenção primária é um dos fatores essenciais para uma assistência efetiva. Objetivou-se avaliar a presença e extensão dos atributos da Atenção Primaria à Saúde apresentado por profissionais da saúde. Trata-se de um estudo quantitativo, transversal realizado com 13 médicos e 17 enfermeiros trabalhadores de Unidades Básicas de Saúde, de um município do Sudoeste Goiano, representando 88,2% da população de estudo. Utilizou-se o Instrumento de Avaliação da Atenção Primária - PCATool-Brasil. Os dados foram analisados utilizando o SPSS 17.0. O estudo obteve parecer favorável CEP 345.619. Dos participantes, 70% são do sexo feminino, idade entre 30 e 39 anos (65,1%), com tempo de formação e atuação predominante entre 1 e 5 anos (36,7%) e (56,7%) respectivamente. Quanto à formação, 30% possuem especialização na área de saúde pública. Na associação do tempo de formação com os atributos, verificou-se significância para o atributo sistema de informações (p<0,05). Os profissionais sem especialização obtiveram maior pontuação, em todos os atributos. O Escore Médio Geral estimado resultou em 7,2. Portanto, os profissionais estão orientados quanto aos atributos da atenção primaria devido ao alto escore geral, necessitando de atenção especial no atributo acessibilidade.