OBJETIVO: Analisar as causas referidas na etiologia das úlceras em pés de pessoas com Diabetes mellitus (DM). MÉTODOS: Estudo seccional, quantitativo, realizado no Ambulatório de Diabetes de um Hospital Universitário em Ribeirão Preto - SP. Os dados foram coletados com instrumento estruturado e exame físico dos pés de amostra de 30 pacientes diabéticos. RESULTADOS: Amostra com idade média de 57,5 anos, predominância do sexo masculino e baixa escolaridade; 90% possuíam DM tipo 2, de longa duração e mal controlado; obesidade/sobrepeso em 77% e insensibilidade plantar em 93,3%. A região metatarsiana foi o local de úlcera referido com maior frequência, e a causa foi a calosidade. CONCLUSÃO: as causas referidas envolvidas na etiologia das úlceras correspondem, de forma direta ou indireta, a fatores extrínsecos que podem ser prevenidos com cuidados básicos e de baixo custo. A insensibilidade plantar, fator fundamental desencadeador das úlceras, no entanto não foi reconhecida pelas pessoas.

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Background Family members are the main caregivers of people with schizophrenia in community-based mental health services. The literature emphasizes the family dynamic and Expressed Emotion (EE) of the family members as fundamental determinants in the course of this mental disorder

Objective: Assess the relationship between psychiatric relapses of patients with a diagnosis of schizophrenia, the levels of expressed emotion among their relatives and related factors. Method: Prospective study carried out at a mental health outpatient clinic and two Psychosocial Care Centers, with patients and relatives responding to the Family Questionnaire -Brazilian Portuguese Version, a form containing socio-demographic and clinical variables and a structured script to assess relapses. A logistic regression model was used for the analysis. Results: A total of 89 dyads participated in the study. Of the patients investigated, 31% presented relapses and, among the relatives, 68% presented elevated levels of expressed emotion. The relationship between expressed emotion and the relapses was not significant. The logistic regression analysis demonstrated that when there were a higher number of hospital admissions in the two years preceding the study, the chance of the patient relapsing in the 24-month period is 1.34. Conclusion: Expressed emotion was insufficient to predict relapses. Thus, a relapse should be understood as a multifactorial phenomenon. These results provide support for interventions and investigations on the multiple factors involved in the evolution of schizophrenia patients in follow-up at community-based health services. DESCRIPTORS INTRODUCTIONThe concept of Expressed Emotion (EE) has long been used to investigate the family environment of patients with mental disorders. EE reflects the extent to which family members close to a patient express critical, hostile and emotionally over-involved attitudes or warmth when talking about the patient (1) . The main components of EE are critical comments (CC), which are related to negative judgment of patient conduct; hostility (H), related to the negative concept of the patient as a person; and emotional overinvolvement (EOI), which refers to feelings or attitudes, to despair, to self-sacrifice and to overprotection of the patient on the part of the family members. It is worth highlighting that hostility overlaps with critical comments. The family may be classified as having high EE if the family member that spends most of the time with the patient presents one or more of these components (2)(3) . Studies show that EE is a strong predictor of psychiatric relapses in schizophrenic patients, in different social and cultural contexts (4)(5) . A meta-analysis identified 27 articles reporting EE and psychiatric relapses in schizophrenia patients. These studies confirmed that EE is a good predictor of schizophrenia relapses, especially in patients in the most chronic phase of the disease (6) . Recent prospective studies have shown that patients with schizophrenia living with families with high levels of EE have higher chances of suffering relapses when compared to those that live in family settings with low EE (7)(8) .Relapses are defined by the exacerbation of symptoms related to the diagnosis of schizophrenia in patients with a stable condition (7)...