A Efetividade do Cuidado Oferecido aos Portadores de Diabetes Mellitus / The effectiveness of the care provided to people with diabetes mellitus

Introdução: O envelhecimento e o aumento da ocorrência de excesso de peso na população brasileira têm propiciado considerável aumento na prevalência de diabetes mellitus (DM). O estudo objetivou verificar e aumentar a efetividade do cuidado oferecido aos indivíduos com DM por meio de estudo do tipo antes e depois. Métodos: Foram realizados dois inquéritos epidemiológicos rápidos nas zonas de abrangência da UBS Areal Leste com Estratégia Saúde da Família (ESF). Foram implementadas medidas de intervenção entre as duas coletas, constituindo-se em um estudo do tipo antes-depois. Foram incluídos ambos os sexos acima de 40 anos de idade com diagnóstico de diabetes mellitus. Resultados: Foram encontradas diferenças nos intervalos de confiança em relação ao exame dos pés diabéticos e instruções sobre atividade física. Conclusão: A melhora constatada no exame dos pés nos pacientes que consultavam na unidade provavelmente foi resultado da intervenção. Os resultados mostraram deficiências e fortalezas do serviço, esperando-se a manutenção dos indicadores positivos e a superação dos resultados negativos.

Introduction: The aging and the increased occurrence of overweight in the Brazilian population have led to a considerable increase in the prevalence of diabetes mellitus (DM). The study aimed to verify and increase the effectiveness of the care provided to individuals with DM through a before-and-after study. Methods: The study conducted two rapid epidemiological surveys in the area covered by UBS Areal Leste with Family Health Strategy (FHS). Intervention measures were implemented between the two surveys, constituting a before-after study. The sample included men and women, over 40 years old, diagnosed with diabetes mellitus. Results: It presented differences in confidence intervals regarding diabetic foot examination and instructions on physical activity. Conclusion: The improvement seen in foot examination in patients consulting in the unit was probably a result of the intervention. The results showed deficiencies and strengths of the service, expecting to maintain the positive indicators and overcome the negative results.

Disseminated cutaneous leishmaniasis due to Leishmania (Leishmania) amazonensis in human immunodeficiency virus (HIV)-infected patients: A report of two cases

Rationale: Co-infection of human immunodeficiency virus (HIV) and Leishmania spp. has impact on clinical and therapeutic outcomes of leishmaniases. Most studies do not present the identification of Leishmania species causing American tegumentary leishmaniasis in co-infections. In the Americas, Leishmania (L.) Viannia (V.) braziliensis and L. (V.) guyanensis have been identified. Patient concerns: In this study, two cases of American tegumentary leishmaniasis in patients infected with HIV are described. Patients presented several lesions with rapid dissemination and mucosal involvement. Diagnosis: Disseminated cutaneous leishmaniasis caused by L. amazonensis was identified by molecular test. Interventions: The patients were treated with conventional therapies for HIV infection and American tegumentary leishmaniasis. Outcomes: In co-infection, the clinical manifestations are atypical and the treatment response can be impaired. Lessons: These cases show that HIV infection impacts L. amazonensis infection and point to the relevance of identifying Leishmania species, which can lead to a better patient management.