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Simone Aparecida Domingos,1 Carolina Nunes França,1 Izabela Tuleta,2 Marianne Penachini da Costa Rezende Barbosa,3 Andre Luis Lacerda Bachi,1 Lucas Melo Neves1,4 1Program in Health Sciences, Santo Amaro University, São Paulo, Brazil; 2Department of Cardiology I, University Hospital Muenster, Muenster, Germany; 3Educational Foundation of the Municipality of Assis (FEMA) and Universidade, Estadual Paulista (UNIP), Assis, Brazil; 4Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, BrazilCorrespondence: Lucas Melo NevesProgram in Health Sciences, Santo Amaro University, Rua Prof. Enéas de Siqueira Neto, 340. Building F1 - Health Sciences Room - Jardim Das Imbuias, São Paulo, SP, 04829-300, BrazilTel +55 11 2141-8584Email lucasmeloneves@uol.com.brAim: Lower limb amputation (LLA) is a severe consequence of type 2 diabetes mellitus (T2DM), and can affect up to 1% of T2DM patients, leading to an increased risk of premature mortality. Among the factors to predict LLA, it has been highlighted sex, marital status, and previous amputation. However, there is a lack of information about the association between these predictive factors, self-care, and urgency LLA in T2DM patients.Purpose: To verify the behavior of self-care and to relate it with the predictive factors (sex, marital status, and previous amputation) in urgency LLA T2DM patients.Patients and Methods: Non-interventional study, with 106 T2DM patients who were in the postoperative period of urgency LLA caused by complications resulting from T2DM. A structured questionnaire was used for sociodemographic and clinical characterization of the sample as well as the Summary of Diabetes Self-Care Activities (SDSCA) tool. It was used the Wilcoxon, Friedman, and Mann–Whitney tests (median, nonparametric populations) to assess the significance of the differences between groups (sex, marital status, and previous amputation), also Spearman correlation coefficient to assess the association between the data (comparison between diagnostic time, sex, previous amputation, ethnicity and systolic arterial hypertension) and a logistic regression analysis considering the item SDSCA related to sex, age and marital status (with partner).Results: Significant differences (p< 0.05) in the questions “Specific Food” and “Foot care” were found when the participants were grouped by sex. In the relation to marital status, significant differences (p< 0.05) were observed for the question “Specific Food”. No differences were found between groups with or without previous amputation.Conclusion: By SDSCA tool, we were able to report that T2DM patients submitted to urgency LLA presented differences in self-care, particularly for sex and marital status.Keywords: self-care activities, surgery, diabetes mellitus, food, foot care

In the healthcare industry, there is strong pressure to reduce costs that, together with several factors, have contributed significantly to the scarcity of resources in the health system. Besides, health systems will continue to be under pressure to serve their users. Therefore, it is necessary to develop an innovative model that combines quality, sustainability, and increased access. For the success of any decision-making process regarding the purchase, rental, or lending of automation equipment, not only costing assessments are required, but above all, alignment with the institutional strategy, ideally conceptualized in an organization model by optimized workflows and work processes, in order to, ultimately, be able to remain profitable and competitive in the current global business environment, which requires continuous improvement in levels of productivity, quality, agility, and service provision.

Background: The use of point-of-care testing (POCT) in different clinical applications is justified by the fact that the time to release the result is shortened, allowing the physician to define the diagnosis and most appropriate therapy in a shorter time. However, the negative aspects must also be highlighted and studied so that we can move forward with the use of these devices. These negative aspects include greater analytical imprecision compared to laboratory automation, the variability between different equipment from different manufacturers, the risk of inappropriate use, a low level of global regulation, higher costs compared with laboratory testing and cost ineffectiveness in terms of health care. Methods and., Results: This review presents some clinical applications of POCT in different scenarios, such as for diabetes mellitus, infectious diseases, pediatrics, and chronic kidney disease, among others., Conclusions: We hope to see a global consensus on an acceptable quality standard for performing POCT that is adaptable, practical, and cost effective in primary care settings, ensuring patient safety, and minimizing the risk of harm.

Point-of-Care Testing (POCT) has been highlighted in the health care sector in recent decades. On the other hand, due to its low demand, POCT is at a disadvantage compared to conventional equipment, since its cost is inversely proportional to the volume of use. In addition, for the implementation of POCT to succeed, it is essential to rely on the work of a multidisciplinary team. The awareness of health professionals of the importance of each step is perhaps the critical success factor. The trend towards the continuous advancement of the use of POCT and the great potential of its contributions reinforce the need to implement quality management tools, including performance indicators, to ensure their results. This review presents some advantages and disadvantages concerning POCT and the real need to use it. A worldwide call for the availability of easy-to-use health technologies that are increasingly closer to the final user is one of the main reasons for this focus.

The paper summarizes the difficulties to study the rare population of endothelial progenitor cells in clinical trials, based on the experience of our group in many publications in this area.

An alternative device for the immobilization of the hind limb of the rat was developed to study the effects of chronic disuse on the soleus and tibialis anterior muscles, maintained for 3 weeks in the shortening and the stretching positions, respectively. The proposed device is made of steel mesh and cotton materials, and has some advantages when compared to cast or plaster cast: it is cheaper, lighter (12 g or 4% of the body weight of the rat) and the same unit can be easily adjusted and used several times in the same animal or in animals of similar size. Immobilization is also useful to restrain the movements of the hip, knee, and ankle joints. Male rats (291 +/- 35 g and aged 14 +/- 2 weeks) were used to develop and test the model. The soleus muscle of 18 rats was maintained in a shortened position for 21 consecutive days and lost 19 +/- 7% of its length (P = 0.008) and 44 +/- 6% of its weight (P = 0.002) compared to the contralateral intact muscle. No difference (P = 0.67) was found in the stretched tibialis anterior of the same hind limb when compared to the contralateral muscle. No ulcer, sore or foot swelling was observed in the animals. Immobilization was effective in producing chronic muscle disuse in the hind limbs of rats and is an acceptable alternative to the traditional methods of immobilization such as cast or plaster cast.