RESUMO
Transient neonatal diabetes mellitus (TNDM) is a rare disorder, with a reported incidence of approximately 1 in 450,000 live births. It is characterized by insulin-requiring hyperglycemia in the neonatal period. The disease improves by early childhood, but the patient may relapse in later life. Diagnosis is made after genetic testing following presentation with hyperglycemia not conforming to Type 1 or Type 2 diabetes. Management is based on insulin and possible sulfonylurea administration. Three genetically distinct subtypes of TNDM are recognized. Type 1 TNDM is due to overexpression of genes at the 6q24 locus, whereas the 11p15 locus is involved in Type 2 and 3 TNDM. In this article the clinical presentation, management, and genetics of TNDM are discussed, particularly emphasizing the role of the neonatal nurse.
Assuntos
Diabetes Mellitus/diagnóstico , Diabetes Mellitus/tratamento farmacológico , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/tratamento farmacológico , Insulina/uso terapêutico , Cuidados de Enfermagem/métodos , Especialidades de Enfermagem/métodos , Diabetes Mellitus/genética , Educação Continuada em Enfermagem , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/genética , MasculinoRESUMO
INTRODUCTION: Dialysis patients are at increased risk of severe COVID-19 infection making vaccination a priority. We explored COVID-19 vaccine uptake and perceptions in our dialysis population, associated COVID-19 infection, and hospitalization rates. METHODS: This is a single-center retrospective study using telephone questionnaires and hospital records to investigate COVID-19 vaccine uptake and attitudes behind vaccination status. RESULTS: A total of 230 patients were interviewed. Vaccine uptake was 97.8% (two doses) and 86.6% (booster dose), with 79.5% vaccinated at Renal Unit. Most (58.5%) cited healthcare worker advice as a contributing factor and 54% sought protection through vaccination. COVID-19 hospitalization was higher in unvaccinated and patients vaccinated with one dose, compared to two doses (63.2% vs. 20%, p = 0.05) and booster dose (63.2% vs. 22.2%, p = 0.02). CONCLUSION: Our dialysis population recognized the importance of COVID-19 vaccination. Intensive patient education and easy access to the COVID-19 vaccine may have facilitated vaccine uptake in these patients.