Objective: The avoidance of pressure ulcers development in critically ill patients is a major nursing challenge. Prevention is thus relevant for assurance of high quality care. This study aimed to evaluate the applicability of the Braden scale in intensive care unit patients. Methods: This was a prospective study based which evaluated all adult patients staying in the intensive care unit from July 14 to August 10, 2009. The data were collected using the Braden's scale by three examiners who identified the pressure ulcer development risk. The data were analyzed using the SAS Statistical Software. For determination of the examiners' rates degree of coincidence, the Kappa value was used (95%CI). Results: Regarding the related risk factors: 36.4% had mild sensory perception impairment; 50.9% had occasionally moist skin; 97.3% bedfast; 39.1% had very limited mobility; 45% probably had inappropriate nutrition; 61.8% had friction and shear problems. An agreement between the examiners was identified for nutrition and physical activity (38.1% to 100.0%); the Kappa population zero hypothesis was rejected; a paired examiners agreement (41.7% to 100.0%) was identified for the items humidity and physical activity, and the Kappa values ranged from 0.13 to 1. Conclusions: These intensive care patients were identified to have increased risk of developing pressure ulcers. This tool was considered appropriate to support the implementation of preventive measures.
Intercellular junctions play a role in regulating islet cytoarchitecture, insulin biosynthesis and secretion. In this study, we investigated the animal metabolic state as well as islet histology and cellular distribution/expression of CAMs and F-actin in the endocrine pancreas of C57BL/6/JUnib mice fed a high-fat diet (HFd) for a prolonged time period (8 months). Mice fed a HFd became obese and type 2 diabetic, displaying significant peripheral insulin resistance, hyperglycemia and moderate hyperinsulinemia. Isolated islets of HFd-fed mice displayed a significant impairment of glucose-induced insulin secretion associated with a diminished frequency of intracellular calcium oscillations compared with control islets. No marked change in islet morphology and cytoarchitecture was observed; however, HFd-fed mice showed higher beta cell relative area in comparison with controls. As shown by immunohistochemistry, ZO-1, E-, N-cadherins, α- and β-catenins were expressed at the intercellular contact site of endocrine cells, while VE-cadherin, as well as ZO-1, was found at islet vascular compartment. Redistribution of N-, E-cadherins and α-catenin (from the contact region to the cytoplasm in endocrine cells) associated with increased submembranous F-actin cell level as well as increased VE-cadherin islet immunolabeling was observed in diabetic mice. Increased gene expression of VE-cadherin and ZO-1, but no change for the other proteins, was observed in islets of diabetic mice. Only in the case of VE-cadherin, a significant increase in islet content of this CAM was detected by immunoblotting in diabetic mice. In conclusion, CAMs are expressed by endocrine and endothelial cells of pancreatic islets. The distribution/expression of N-, E- and VE-cadherins as well as α-catenin and F-actin is significantly altered in islet cells of obese and diabetic mice.
universitários respectivamente, a história familiar apresenta alta prevalência para os fatores determinantes das doenças crônicas, os lanches calóricos tem preferência do grupo, o sedentarismo está presente em boa parte dos pesquisados.
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