RESUMO
OBJECTIVE: To describe the patterns of diabetic ketoacidosis (DKA) occurrence in children newly diagnosed with type 1 diabetes (T1DM) across several Latin American pediatric diabetes centers from 2018 to 2022. METHODS: A retrospective chart review included children under 18 with new-onset T1DM from 30 Latin American pediatric diabetes centers (Argentina, Chile, and Peru) between 30 December 2018 and 30 December 2022. Multiple logistic regression models examined the relationships between age, gender, medical insurance, BMI, and DKA at new-onset T1DM. As far as we know, there are no large studies in Latin American countries exploring the patterns of DKA in new-onset T1DM. RESULTS: A total of 2,026 (983 females) children, median age 9.12 (5.8 -11.7) years with new-onset-T1DM were included. Approximately 50% had no medical insurance. Mean glucose values were 467 mg/dL, pH 7.21, bicarbonate 13 mEq/L, HbA1c 11.3%, and BMI 18. The frequency of DKA was 1,229 (60.7%), out of which only 447 (36%) were severe. There was a significant decrease in the frequency of DKA as age increased: 373 (70.2%) in children under 6, 639 (61.6%) in those between 6 and 12, 217 and (47.5%) in those over 12. Children with medical insurance (58.8%) had a significantly lower frequency of DKA than those without (62.7%). The multiple logistic regression models showed that DKA was significantly and inversely associated with age [OR, 0.72 (95% CI 0.60-0.86)], BMI [OR, 0.95 (95% CI 0.92-0.99)], and medical insurance [OR, 0.75 (95% CI 0.60-0.94)] adjusted for sex. CONCLUSION: Latin American children with new-onset T1DM exhibited a substantial occurrence of DKA. Younger ages and the lack of medical insurance were significantly associated with DKA in new-onset T1DM.
RESUMO
The skin of premature infants is an ineffective barrier. The stratum corneum is thinner than that found in full-term infants. We report on a premature patient with extravasation injury from sodium bicarbonate. Daily treatment with sterile petrolatum resulted in restitutio ad integrum.
Assuntos
Emolientes/uso terapêutico , Extravasamento de Materiais Terapêuticos e Diagnósticos/tratamento farmacológico , Doenças do Prematuro/tratamento farmacológico , Vaselina/uso terapêutico , Dermatopatias/tratamento farmacológico , Humanos , Recém-Nascido , MasculinoRESUMO
El recién nacido prematuro posee una piel incapaz de comportarsecomo una barrera protectora. El estrato córneo es más fino que el de los recién nacidos a término. Se presenta un paciente prematuro con lesión por extravasación con bicarbonato desodio que recibió tratamiento diario con vaselina estéril y en el que se observó recuperación ad integrum.
