Objective:To evaluate the relation between diabetes-related distress and the clinical and sociodemographic characteristics of type 2 diabetes mellitus patients.Methods:A cross-sectional study based on a secondary analysis of data collected at a specialized care outpatient center in Brazil. Participants completed a questionnaire on sociodemographic and clinical characteristics and the Brazilian version of the Diabetes Distress Scale (B-DDS).Results:About 31% of the 130 eligible patients reported diabetes distress, and the mean B-DDS score was 2.6. Multiple regression analysis showed the B-DDS score was positively correlated with marital status (p=0.0230), use of diet and physical activities for diabetes management (p=0.0180), and use of insulin therapy (p=0.0030). The “emotional burden”, “regimen-related distress”, and “interpersonal distress” domains from B-DDS were associated with the use of insulin therapy (p=0.0010), marital status (p=0.0110), and the presence of three or more comorbidities (p=0.0175).Conclusion:These findings suggest the clinical and sociodemographic variables are relatively weak predictors of diabetes-related distress. The highest scores in the B-DDS were observed in the emotional burden domain, indicating the presence of diabetes distress among the participants of the study.

No abstract

Objetiva-se refletir sobre o tema biofilme e ferida crônica para o cuidado de enfermagem. Estudo teórico-reflexivo,no qual os dados foram baseados em pesquisa na base de dados Scientific Electronic Library Online (SciELO) ePubMed, no período de 2010 à 2015, utilizando-se os descritores infecção, biofilmes e cicatrização de feridas. Osresultados apresentaram o crescimento microbiano em feridas crônicas é uma preocupação na prática clínica e apresença do biofilme prejudica o processo de cicatrização. O biofilme obtém nutrientes do plasma e do exsudatopresentes no leito da ferida, e regula o metabolismo, a virulência e motilidade pela liberação e detecção demoléculas denominadas de quorum sensing. Abordagens no tratamento de feridas crônicas com foco no biofilmeconsistem na avaliação das características da ferida e na utilização de métodos de desbridamento para remoçãoda necrose e do esfacelo. Concluí-se que a limpeza do leito da ferida e o uso de antimicrobianos contribuem para ocontrole da carga microbiana, mas a administração destes produtos requer uma avaliação criteriosa. Novos métodosde diagnóstico para o controle do biofilme são necessários com vistas à prevenção, ao tratamento e cura das lesõesem menor tempo.Palavras-chave: Infecção; Biofilmes; Cicatrização de Feridas. ABSTRACTThe aim is to reflect on biofilms in chronic wound for nursing care. A theoretical and reflective study basedon Scientific Electronic Library Online (SciELO) and PubMed database, on the period 2010 to 2015. The useddescriptors were infection, biofilms and wound healing. The results showed the microbial growth in chronicwounds is a concern in a clinical practice, and the presence of biofilm harms the healing process. The biofilmobtains plasma and exudate nutrients found in the wound bed, and regulates metabolism, virulence and motilityby releasing and detecting molecules named quorum sensing. Approaches on treatment of chronic woundsfocused on biofilm consist on the evaluation of the wound characteristics and on the usage of debridementmethods to remove necrotic tissue and slough. It concludes that cleaning the wound bed help on controllingmicrobial load, but the usage of antimicrobial agents is also an expedient currently employed to control biofilm.The search for new diagnostic methods and biofilm control is necessary in order to prevent, to treat and to healthe wound in lesser time.Keywords: Infection; Biofilms; Wound Healing.

Diabetes mellitus is associated with impaired wound healing. The topical use of insulin is a promising therapy because it may favor all phases of the wound healing process. This study aimed to investigate the therapeutic outcomes of insulin gel in wounds of hyperglycemic mice. After diabetes induction, a 1-cm 2 full-thickness wound was created on each animal's dorsum. The lesions were treated daily for 14 days with insulin gel (insulin group) or vehicle gel without insulin (vehicle group). Tissue samples were extracted on days 4, 7, 10, and 14 after the creation of the lesion. The samples were analyzed with hematoxylin/eosin and Sirius red staining, immunohistochemistry, Bio-Plex immunoassays, and western blotting. Insulin gel favored re-epithelialization at day 10 and increased the organization and deposition of collagen. Additionally, it modulated the expression of cytokines (interleukin (IL)-4 and IL-10) and increased the expression of arginase I, VEGF receptor 1, and VEGF on day 10. Activation of the insulin signaling pathway occurred via IRβ, IRS1, and IKK on day 10 and activation of Akt and IRS1 on day 14. These results suggested that insulin gel improved wound healing in hyperglycemic mice by modulating the expression of inflammatory factors, growth factors, and proteins of the insulin signaling pathway.

Polycaprolactone (PCL) is a synthetic polymer with good mechanical properties that are useful to produce biomaterials of clinical application. It can be successfully combined with chitosan, which enhances the biomaterial properties through the modulation of molecular and cellular mechanisms. The objective of this study was to evaluate the effects of the use of electrospun fibrous membranes consisting of polycaprolactone (PCL) or polycaprolactone coated with chitosan and poly(ethylene oxide) (PCL+CHI/PEO) on mouse skin lesions. Sixty four Black-57 mice were divided into PCL and PCL+CHI/PEO groups. A 1 cm2 lesion was made on the animals’ backs, and the membranes were sutured in place. The tissues were extracted on the 3rd, 7th, and 14th days after the lesion. The tissues were analyzed by histology with Hematoxylin and Eosin (H&E) and Sirius Red stains, morphometry, immunohistochemistry, and Western blot. On the 3rd, 6th, and 9th days after the lesion, the PCL+CHI/PEO group showed a higher wound-healing rate (WHR). On the 3 day, the PCL+CHI/PEO group showed a greater amount of inflammatory infiltrate, greater expression of proliferating cell nuclear antigen (PCNA), and smooth muscle actin (α-SMA) (p < 0.05) compared to the PCL group. On the 7th day after the lesion, the PCL+CHI/PEO group showed a greater amount of inflammatory infiltrate, expression of Tumor Necrosis Factor (TNF-α) and PCNA (p < 0.05). In addition, it showed a greater immunolabeling of Monocyte Chemoattractant Protein-1 (MCP-1) and deposition of collagen fibers compared to the PCL group. The PCL+CHI/PEO membrane modulated the increase in the inflammatory infiltrate, the expression of MCP-1, PCNA, and α-SMA in lesions of mice.