Pé diabético: o cuidado de enfermeiras / Diabetic foot: nurses' care / Pie diabético: cuidados de enfermeira

Objetivo: Descrever o cuidado para prevenção do pé diabético realizado por enfermeiras. Método:revisão integrativa da literatura a partir do levantamento realizado em janeiro de 2024 através da biblioteca virtual da PubMed. Foram incluídos artigos nos idiomas inglês e português, artigos originais relacionados ao tema e disponíveis na íntegra com acesso gratuito, publicados entre os anos de 2012 até o ano de 2024. Como critérios de exclusão: artigos que não atendam o objeto de estudo, duplicados, teses, livros, revisões e artigos não originais.Resultados:O levantamento resultou na seleção de 15 artigos que evidenciaram que o cuidado para prevenção do pé diabético se desenvolvem a partir da atuação do enfermeiro, e por meio da aplicação de cuidados, como avaliação do paciente, educação em saúde para os pacientes e a educação permanente para os profissionais de saúde, controle glicêmico, verificação do Índice tibial braquial-ITB para diagnóstico de doença arterial obstrutiva periférica (DAOP), uso de termometria cutânea ou imagem infravermelha, criação de software e exames laboratoriais. Conclusão:O estudo poderá contribuir para melhoria da qualidade de vida dos pacientes diabéticos através do conhecimento dos profissionais de enfermagem acerca dos cuidados elencados para melhor atender aos pacientes bem como contribuir com a diminuição de casos de úlceras em pé diabético.

Objective: To describe the care to prevent diabetic foot provided by nurses. Method:integrative literature review based on the survey carried out in January 2024 through the PubMed virtual library. Articles in English and Portuguese were included, original articles related to the topic and available in full with free access, published between 2012 and 2024. Exclusion criteria were: articles that do not meet the object of study, duplicates, theses, books, reviews and non-original articles. Results:The survey resultedin the selection of 15 articles that showed that care to prevent diabetic foot develops from the role of nurses, and through the application of care, such as patient assessment, health education for patients and continuing education for health professionals, glycemic control, verification of the brachial tibial index-ABI for diagnosing peripheral arterial obstructive disease (PAOD), use of skin thermometry or infrared imaging, creation of software and laboratory tests. Conclusion:The study may contribute to improving the quality of life of diabetic patients through the knowledge of nursing professionals about the care provided to better serve patients as well as contributing to the reduction of cases of diabetic foot ulcers.

Objetivo: Describir los cuidados para la prevención del pie diabético brindados por enfermeras. Método:revisión integrativa de la literatura a partir de la encuesta realizada en enero de 2024 a través de la biblioteca virtual PubMed. Se incluyeron artículos en inglés y portugués, artículos originales relacionados con el tema y disponibles íntegramente con acceso gratuito, publicados entre 2012 y 2024. Los criterios de exclusión fueron: artículos que no cumplan con el objeto de estudio, duplicados, tesis, libros, reseñas y artículos no originales. Resultados:La encuesta resultó en la selección de 15 artículos que mostraron que los cuidados para prevenir el pie diabético se desarrollan desde el rol del enfermero, y a través de la aplicación de cuidados, como la evaluación del paciente, la educación en salud de los pacientes y la educación continua de los profesionales de la salud, la glucemia. control, verificación del índice braquial tibial-ITB para el diagnóstico de enfermedad arterial obstructiva periférica (EAP), uso de termometría cutánea o imágenes infrarrojas, creación de software y pruebas de laboratorio. Conclusión:El estudio puede contribuir a mejorar la calidad de vida de los pacientes diabéticos a través del conocimiento de los profesionales de enfermería sobre los cuidados brindados para atender mejor a los pacientes, así como contribuir a la reducción de casos de úlceras del pie diabético.

Autonomic Modulation in Duchenne Muscular Dystrophy During a Computer Task: A Prospective Transversal Controlled Trial Assessment by Non-linear Techniques.

Introduction: Due to functional and autonomic difficulties faced by individuals with Duchenne Muscular Dystrophy (DMD), the use of assistive technology is critical to provide or facilitate functional abilities. The key objective was to investigate acute cardiac autonomic responses, by application of Heart Rate Variability (HRV), during computer tasks in subjects with DMD via techniques based on non-linear dynamics. Method: HRV was attained via a Polar RS800CX. Then, was evaluated by Chaotic Global Techniques (CGT). Forty-five male subjects were included in the DMD group and age-matched with 45 in the healthy Typical Development (TD) control group. They were assessed for 20 min at rest sitting, and then 5 min whilst performing the maze task on a computer. Results: Both TD and DMD subjects exhibited a significantly reduced HRV measured by chaotic global combinations when undertaking the computer maze paradigm tests. DMD subjects presented decreased HRV during rest and computer task than TD subjects. Conclusion: While there is an impaired HRV in subjects with DMD, there remains an adaptation of the ANS during the computer tasks. The identification of autonomic impairment is critical, considering that the computer tasks in the DMD community may elevate their level of social inclusion, participation and independence.

Colombian Health System on its Way to Improve Allocation Efficiency-Transition from a Health Sector Reform to the Settlement of an HTA Agency.

Over the past 20 years, Colombia has invested major efforts in ensuring universal health care access to its citizens while facing epidemiological transition and demographic changes. The country, as any other region in the world, is challenged by financial constraints and market pressures for entry of new and frequently costly technologies. After the 1993 health sector reform, Colombian citizens are entitled to health care access via mandatory health insurance through a benefits plan. Inclusions to this plan were the first attempt to establish a formal methodology of health technology assessment. Later on, the dynamics of insurers, market pressure, reimbursement decisions, and judicial actions drove the government toward the formulation of an infrastructure to improve efficiency in the use of resources. This article accounts for the steps undertaken by the Colombian health system until the establishment of a health technology assessment body and outlines the most important issues that can be learned from this process.