Educational practices in diabetic patient and perspective of health professional: a systematic review / Práticas educativas no paciente diabético e perspectiva do profissional de saúde: uma revisão sistemática

Abstract This systematic review has sought to identify the multidisciplinary scientific production, addressing factors for proper diabetes mellitus management focusing on health education, from the perspective of the patient and the professional. The goal was to synthesize the knowledge produced and point out its implications for the practice of patient care. A search was conducted in PubMed, Medline, SCOPUS, LILACS and BIREME. The intervention programs present methodologies and different structures, although the theoretical basis is education for self-management. The evaluation methodologies for effectiveness of educational programs focused on the number of subscriptions and stay in groups. Some studies also evaluated psychological, social and pathophysiological parameters. The results show qualitative improvements in self-care, humanization in care, and quality of life of patients. The evidence shows that there seems to be a positive response to the intervention programs whenever comparing the physiological, psychological, educational and social parameters, initial and final of the studies.

Resumo Esta revisão sistemática procurou identificar a produção científica multiprofissional, que aborde fatores para o adequado manejo do diabetes mellitus com enfoque na educação em saúde, na perspectiva do paciente e do profissional. O objetivo foi sintetizar o conhecimento produzido e apontar suas implicações na prática do atendimento ao doente. Foi realizada uma busca nas bases de PubMed, Medline, SCOPUS, LILACS e BIREME. Os programas de intervenção apresentam metodologias e estruturas distintas, embora a base teórica seja a educação para autogestão. As metodologias de avaliação da eficácia dos programas educativos incidiram no número de adesões e permanência nos grupos. Alguns estudos também avaliaram parâmetros psicológicos, fisiopatológicos e sociais. Os resultados mostram ganhos qualitativos no autocuidado, na humanização do atendimento, e na qualidade de vida dos pacientes. As evidências apontam que parece haver uma resposta positiva aos programas de intervenção quando comparados os parâmetros fisiológicos, psicológicos, educativos e sociais, iniciais e finais dos estudos.

Accuracy of mucocutaneous leishmaniasis diagnosis using polymerase chain reaction: systematic literature review and meta-analysis

The diagnosis of mucocutaneous leishmaniasis (MCL) is hampered by the absence of a gold standard. An accurate diagnosis is essential because of the high toxicity of the medications for the disease. This study aimed to assess the ability of polymerase chain reaction (PCR) to identify MCL and to compare these results with clinical research recently published by the authors. A systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement was performed using comprehensive search criteria and communication with the authors. A meta-analysis considering the estimates of the univariate and bivariate models was performed. Specificity near 100% was common among the papers. The primary reason for accuracy differences was sensitivity. The meta-analysis, which was only possible for PCR samples of lesion fragments, revealed a sensitivity of 71% [95% confidence interval (CI) = 0.59; 0.81] and a specificity of 93% (95% CI = 0.83; 0.98) in the bivariate model. The search for measures that could increase the sensitivity of PCR should be encouraged. The quality of the collected material and the optimisation of the amplification of genetic material should be prioritised.