Gastrointestinal Manifestations of Chagas Disease: A Systematic Review with Meta-Analysis.

The aims of this study were to estimate the prevalence of gastrointestinal manifestations among individuals with positive serology for Chagas disease (ChD) and to describe the clinical gastrointestinal manifestations of the disease. A systematic review with meta-analysis was conducted based on the criteria and recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The PubMed, Scopus, Virtual Health Library, Web of Science, and Embase databases were used to search for evidence. Two reviewers independently selected eligible articles and extracted data. RStudio® software was used for the meta-analysis. For subgroup analysis, the studies were divided according to the origin of the individuals included: 1) individuals from health units were included in the health care service prevalence analysis, and 2) individuals from the general population were included in the population prevalence analysis. A total of 2,570 articles were identified, but after removal of duplicates and application of inclusion criteria, 24 articles were included and 21 were part of the meta-analysis. Most of the studies were conducted in Brazil. Radiological diagnosis was the most frequent method used to identify the gastrointestinal clinical form. The combined effect of meta-analysis studies showed a prevalence of gastrointestinal manifestations in individuals with ChD of 12% (95% CI, 8.0-17.0%). In subgroup analysis, the prevalence for studies involving health care services was 16% (95% CI, 11.0-23.0%), while the prevalence for population-based studies was 9% (95% CI, 5.0-15.0%). Megaesophagus and megacolon were the main forms of ChD presentation in the gastrointestinal form. The prevalence of gastrointestinal manifestations of ChD was 12%. Knowing the prevalence of ChD in its gastrointestinal form is an important step in planning health actions for these patients.

Chagas disease and perceived quality of life: a cross-sectional study.

BACKGROUND: Chagas disease (ChD) is a neglected tropical disease that is caused by the protozoan parasite Trypanosoma cruzi and can negatively impact quality of life (QoL). This study aimed to assess and compare QoL between individuals with and without ChD. METHODS: This cross-sectional study was performed within a concurrent cohort study (REDS). The participants were derived from two blood donation centers: São Paulo capital and Montes Claros, Minas Gerais, Brazil. Participants with ChD were identified in blood donations by serological diagnosis between 2008 and 2010, and those without ChD were donors with negative serology identified during the same period. QoL was assessed using the World Health Organization Quality of Life-BREF questionnaire. Logistic regression was used to compare sociodemographic and clinical characteristics between the groups, and mean, standard deviation, and beta regression were used to compare QoL. RESULTS: In total, 611 individuals participated in the study (328 with ChD and 283 without ChD). Participants with ChD had lower QoL in the physical (p=0.02) and psychological (p<0.01) domains than did individuals without CD. CONCLUSIONS: Individuals with ChD had worse QoL perceptions. These results provide a comprehensive understanding of the impact of ChD on individuals' QoL, while also highlighting potential opportunities for improving the care and treatment of those affected.

Evaluation of the properties of WHODAS-12 measurements in individuals with Chagas disease in Brazil.

Numerous tests employed to predict cardiac and functional status are expensive and not widely accessible for a considerable number of patients, particularly those diagnosed with Chagas disease (CD) residing in remote and endemic regions. To date, there is no knowledge of studies that have validated instruments that address functionality in an expanded way, including the biopsychosocial factors in patients with CD. This study aims to evaluate the psychometric properties of the World Health Organization Disability Assessment Schedule (WHODAS 2.0), in its 12-item shortened version (WHODAS-12) when applied to patients with CD. This is a cross-sectional study of a prospective cohort that follows individuals with CD (SaMi-Trop). Data collection took place between October 2019 and March 2020. In the interviews, sociodemographic information, life habits, clinical information, and indicators of disability measured by WHODAS-12 were collected. Descriptive analysis, internal consistency and construct validity of the instrument were performed. A total of 628 patients with CD were interviewed, most were women (69.5%), their mean age was of 57 years, and most declared an average self-perception of health (43.4%). The 12 items of WHODAS-12 were distributed into three factors, which together account for 61% of the variance. The Kaiser-Meyer-Olkin (KMO) index was 0.90, indicating adequacy of the sample for factor analysis. The internal consistency of the global scale showed alpha = 0.87. The percentage of incapacity was 16.05%, indicating mild incapacity for the evaluated patients. WHODAS-12 is a valid and reliable measure to assess the disability of the Brazilian population with CD.

Chagas disease and perceived quality of life: a cross-sectional study

ABSTRACT Background: Chagas disease (ChD) is a neglected tropical disease that is caused by the protozoan parasite Trypanosoma cruzi and can negatively impact quality of life (QoL). This study aimed to assess and compare QoL between individuals with and without ChD. Methods: This cross-sectional study was performed within a concurrent cohort study (REDS). The participants were derived from two blood donation centers: São Paulo capital and Montes Claros, Minas Gerais, Brazil. Participants with ChD were identified in blood donations by serological diagnosis between 2008 and 2010, and those without ChD were donors with negative serology identified during the same period. QoL was assessed using the World Health Organization Quality of Life-BREF questionnaire. Logistic regression was used to compare sociodemographic and clinical characteristics between the groups, and mean, standard deviation, and beta regression were used to compare QoL. Results: In total, 611 individuals participated in the study (328 with ChD and 283 without ChD). Participants with ChD had lower QoL in the physical (p=0.02) and psychological (p<0.01) domains than did individuals without CD. Conclusions: Individuals with ChD had worse QoL perceptions. These results provide a comprehensive understanding of the impact of ChD on individuals' QoL, while also highlighting potential opportunities for improving the care and treatment of those affected.

Evaluation of the properties of WHODAS-12 measurements in individuals with Chagas disease in Brazil

ABSTRACT Numerous tests employed to predict cardiac and functional status are expensive and not widely accessible for a considerable number of patients, particularly those diagnosed with Chagas disease (CD) residing in remote and endemic regions. To date, there is no knowledge of studies that have validated instruments that address functionality in an expanded way, including the biopsychosocial factors in patients with CD. This study aims to evaluate the psychometric properties of the World Health Organization Disability Assessment Schedule (WHODAS 2.0), in its 12-item shortened version (WHODAS-12) when applied to patients with CD. This is a cross-sectional study of a prospective cohort that follows individuals with CD (SaMi-Trop). Data collection took place between October 2019 and March 2020. In the interviews, sociodemographic information, life habits, clinical information, and indicators of disability measured by WHODAS-12 were collected. Descriptive analysis, internal consistency and construct validity of the instrument were performed. A total of 628 patients with CD were interviewed, most were women (69.5%), their mean age was of 57 years, and most declared an average self-perception of health (43.4%). The 12 items of WHODAS-12 were distributed into three factors, which together account for 61% of the variance. The Kaiser-Meyer-Olkin (KMO) index was 0.90, indicating adequacy of the sample for factor analysis. The internal consistency of the global scale showed alpha = 0.87. The percentage of incapacity was 16.05%, indicating mild incapacity for the evaluated patients. WHODAS-12 is a valid and reliable measure to assess the disability of the Brazilian population with CD.

Intoxicações por alimentos e bebidas e ocorrência das doenças de transmissão hídrica e alimentar no Brasil / Food and drink poisoning and occurrence of waterborne and foodborne diseases in Brazil

O presente estudo teve como objetivo fazer um levantamento do perfil epidemiológico das notificações por intoxicação e das doenças de transmissão hídrica e alimentar (DTHA) no Brasil, entre 2016 a 2021. Trata-se de um estudo documental com análises quantitativas e descritivas dos dados coletados no Sistema de Informação de Agravos de Notificação - SINAN e Ministério da Saúde. Os resultados mostraram uma diminuição no número de notificações ao longo dos anos, apesar do grande número encontrado em 2017 e 2018. O perfil dos intoxicados entre 2016-2021, foi de indivíduos do sexo masculino (58,3%), com faixa etária 20-59 anos (60,5%) e cor parda (46,6%). Já quanto aos principais agentes etiológicos relacionados aos surtos de DTHA no período analisado, destacou-se a bactéria Escherichia coli (7,9%). A investigação dos dados disponibilizados acerca das intoxicações e DTHA se faz necessária para verificação e monitorização sobre os casos que ocorrem anualmente no Brasil e no mundo.

The present study aimed to investigate the epidemiological profile of notifications for intoxication and water and foodborne diseases (WFD) in Brazil, between 2016 and 2021. This was a documentary, quantitative, descriptive study with data collected from the Notifiable Diseases Information System - SINAN and Ministry of Health. The results showed a decrease in the number of notifications over the years, despite the high number found in 2017 and 2018. The profile of people intoxicated between 2016 and 2021 was male (58.3%), aged 20-59 years (60.5%) and brown (46.6%). As for the main etiological agents related to WFD outbreaks in the analyzed period, the bacterium Escherichia coli (7.9%) stood out. The investigation of available data on intoxications and WFD is necessary for verification and monitoring of cases that occur annually in Brazil and in the world.

Hospitalizations due to gastrointestinal Chagas disease: National registry.

OBJECTIVES: Analyze the hospitalizations of patients admitted for Chagas disease with gastro-intestinal involvement (CD-GI) in the Brazilian Unified Health System, describe the epidemiological profile, mortality and costs. METHODS: This is an observational study that uses secondary data from the National Hospital Information System (SIH-SUS) for the years 2017-2019. CD-GI admissions were defined by specific ICD-10 codes that identify the main diagnosis. RESULTS: From 2017 to 2019, there were 4,407 hospitalizations for CD-GI in Brazil, considering only public hospitals and those associated with the SUS. This corresponds to an average of 1,470 hospitalizations per year, or 0.6 per 100,000 inhabitants, with significant regional variation. Hospitalizations increased with age and were slightly higher in men. More than 60% were emergencies and in 50% the procedure performed was surgical. The most used code was the one for megaesophagus followed by megacolon. In-hospital mortality was 5.8% and 17.2% went to intensive care units. The median cost was USD$ 553.15 per hospitalization, and an overall cost of USD$ 812,579.98 per year to the SUS budget. CONCLUSION: The numbers, rates and costs presented here are possibly underestimated but they give us an idea of the overall profile of hospitalizations due to CD-GI, which are not rare and are related to significant in-hospital mortality. CD-GI is a neglected manifestation of a neglected disease.

Quality of clinical studies present in the package inserts of coagulation factors used in the treatment of hemophilia.

OBJECTIVE: To identify and analyze the quality of scientific evidence from clinical efficacy studies present in the package inserts of coagulation factors, used in the treatment of hemophilia A and B. METHODS: Documentary study developed in two stages. The first stage consisted of identifying the medicine packages inserts electronically registered in the Brazilian Health Regulatory Agency, and analyzing the availability of the bibliographic references cited therein. This analysis was conducted in the PubMed, SciELO, Google Scholar, and Web of Science databases. The second step was the analysis of the methodological quality of the efficacy studies. Two trained researchers used the Cochrane Collaboration Risk of Bias version 5.1.0 tools for methodological quality analysis, and Review Manager 5.4 software to generate the risk of bias graph. RESULTS: Of the 17 medicines listed, 7 had referenced package inserts. Of these, 10 studies were eligible for analysis of methodological quality. More than half of the analyzed studies did not control for selection, performance, and detection bias. A total of 100% controlled attrition and reporting biases, and 50% had a high risk of conflict of interest. CONCLUSION: The biases present are significant and may have influenced the overestimation of the effects of the outcomes of each of the studies.

Quality of clinical studies present in the package inserts of coagulation factors used in the treatment of hemophilia

ABSTRACT Objective To identify and analyze the quality of scientific evidence from clinical efficacy studies present in the package inserts of coagulation factors, used in the treatment of hemophilia A and B. Methods Documentary study developed in two stages. The first stage consisted of identifying the medicine packages inserts electronically registered in the Brazilian Health Regulatory Agency, and analyzing the availability of the bibliographic references cited therein. This analysis was conducted in the PubMed, SciELO, Google Scholar, and Web of Science databases. The second step was the analysis of the methodological quality of the efficacy studies. Two trained researchers used the Cochrane Collaboration Risk of Bias version 5.1.0 tools for methodological quality analysis, and Review Manager 5.4 software to generate the risk of bias graph. Results Of the 17 medicines listed, 7 had referenced package inserts. Of these, 10 studies were eligible for analysis of methodological quality. More than half of the analyzed studies did not control for selection, performance, and detection bias. A total of 100% controlled attrition and reporting biases, and 50% had a high risk of conflict of interest. Conclusion The biases present are significant and may have influenced the overestimation of the effects of the outcomes of each of the studies.

Cohort profile update: the main and new findings from the SaMi-Trop Chagas cohort.

The SaMi-Trop project is a cohort study conducted in 21 municipalities of endemic areas of Chagas disease, including 1,959 patients with chronic Chagas cardiomyopathy. In this article we updated the results of the project, adding information from the second cohort visit. Trypanosoma cruzi-seropositive patients were enrolled from the primary care Telehealth service in Minas Gerais State, Brazil. The eligibility criterium for the second visit was the participation in the baseline evaluation. Of 1,959 participants at the baseline assessment, 1,585 (79.9%) returned after two years for the second evaluation. The mortality rate was 6.7%, but varied from 0.9% to 18.2% when it was stratified by certain clinical characteristics. A lower age-adjusted NT-Pro-BNP level (less than 300) and a prior benznidazole treatment were associated with lower mortality. There was an improvement in most quality of life domain scores. Participants have also reported fewer signs and symptoms and greater use of medication. The second follow-up visit will be complete in Oct 2021.

Quality of life in patients with Chagas disease and the instrument used: an integrative review.

Chagas disease (CD) is a neglected tropical highly morbid disease that can have a negative impact on the quality of life (QoL). The purpose of this study was to conduct an integrative review to analyze the QoL of patients with CD in the chronic phase of the disease, as well as the instruments used and the effect of different interventions. The review was carried out based on the criteria and recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guideline (PRISMA) using the PubMed, Scopus, Web of Science and Science Direct databases. An analysis of the reference list of the included articles was also carried out. Publications in all languages have been included. Two independent reviewers selected the eligible articles and extracted the data. A total of 1,479 articles were identified, and after applying the inclusion criteria 18 articles were included. Four different instruments were used to assess QoL and the most used was the Minnesota Living with Heart Failure Questionnaire (MLWHFQ) [33.3% (n = 6)]. Investigations involving intervention showed a positive impact on the patients' QoL, and the Environment domain had the lowest score. Heterogeneity of instruments and lack of methodology standardization for assessing QoL was observed. QoL proved to be an important indicator for the planning and monitoring of patients with CD, however it is suggested that the instruments for its assessment should be the ones recommended by the validation studies. This process will allow the comparison of data between investigations.

Biomarkers of severity and chronification in chikungunya fever: a systematic review and meta-analysis.

Currently, there are no biomarkers for Chikungunya fever (CHIK) in clinical practice that can accurately predict the severity or chronification of the disease. The aim of this study is to evaluate the existing literature on biomarkers related to the severity and chronification of CHIK. In this sense, a systematic review was conducted based on the PRISMA Statement guideline. Articles that described the association of biomarkers with the evolution of the disease (severity or chronification), published until August 20th 2019 were considered eligible. The search was carried out in the PubMed, Scopus, Virtual Health Library (VHL) and Science Direct databases. After searching the databases, 17 articles were added to the review, and after analyzing the articles, several biomarkers were associated with severity, such as increased levels of IL-6, IP-10, IL-1b, MIG, MCP-1, and reduced levels of RANTES and IL-8 or chronification, such as increased levels of IL-6, TNF-α, MCP-1, IL-12, INF-α, IL-13, INF-γ, GM-CSF, CRP, IL-1a, IL-15, Factor VII, IP-10, IL-10, IL-4, IL-1RA, IL-8, MIP-1α, MIP-1ß, ferritin, MIG, ESR, NO, malondialdehyde, and reduced levels of RANTES, ferritin, eotaxin, HGF, IL-27, IL-17A, IL-29, TGF-ß, IL-10, and thiols. IL-6, CRP and TNF-α were included in the meta-analysis to assess the relationship with chronification, although they did not reach statistical significance. It was concluded that several biomarkers showed a relationship with severity and chronification of CHIK; the search for these biomarkers can reveal prognostic factors and important therapeutic targets for the treatment of the disease.

Prevalence of overweight and obesity in the adult indigenous population in Brazil: A systematic review with meta-analysis.

To carry out a systematic review to identify the prevalence of overweight and obesity in the adult indigenous population in Brazil. The databases used were PubMed, Scopus, Virtual Health Library (VHL), and Science Direct, with the following search strategy: "overweight" OR "obesity" AND "indigenous" OR "tribe" AND "Brazil". For the meta-analysis, RStudio® software was used. Were 22 articles included. The combined effect of the meta-analysis studies showed a global prevalence of overweight and obesity of 45%. Approximately half (45%) of indigenous Brazilian adults have excess weight. These findings highlight the need to implement public policies for the prevention and treatment of these morbidities.

Análise dos efeitos adversos associados ao uso do anorexígeno sibutramina: revisão sistemática / Analysis of the adverse effects associated with the use of the anorexiant sibutramine: Systematic Review

Introdução: nos dias atuais, a obesidade tornou-se um problema de saúde pública em escala global. Entre os tratamentos disponíveis, destaca-se o uso da sibutramina. Entretanto, este fármaco apresentou diversos efeitos adversos (EA), sendo os de maior relevância os cardiovasculares. Objetivo: o objetivo deste estudo foi avaliar se a terapia com a sibutramina traz malefícios à saúde humana. Métodos: a revisão sistemática foi realizada seguindo o protocolo PRISMA para revisões sistemáticas e utilizando as bases de dados PubMed, LILACS e SciElo. Nestas, buscaram-se estudos publicados entre 2006 e 2016, utilizando-se dos descritores "sibutramine" e "adverse effects" junto com o operador booleano "AND". Resultados: dezoito artigos, das 479 publicações encontradas, atenderam aos critérios de inclusão, sendo, então, utilizados para compor a presente revisão. Os EA mais encontrados foram complicações cardiocirculatórias (66,6%), sendo as mais frequentes a taquicardia e a hipertensão arterial sistêmica (HAS). Adicionalmente a esses, a constipação intestinal e a boca seca/xerostomia (55,5%), cefaleia e insônia (38,8%) e alterações de humor (26,6%) também foram relatados. Além disso, o tratamento com sibutramina mostrou-se eficaz na perda de peso em 88,88% dos estudos analisados. Conclusão: apesar da terapêutica com sibutramina ter apresentado efetividade na redução de peso, não se pode concluir acerca da segurança desse fármaco.(AU)

Introcuction: in the modern times, obesity has become a global health problem. Sibutramine stands out among the available treatments. However, this drug is associated to several adverse events (AE), being the cardiovascular the most relevant ones. Objetive: the aim of this study was to evaluate whether therapy with sibutramine is harmful to human health. Methods: the systematic review was performed following the PRISMA protocol for systematic reviews and using the databases PubMed, LILACS and SciElo, aiming for studies published between 2006 and 2016. For the search of the papers, the descriptors "sibutramine" and "adverse effects" were used, together with the boolean operator "AND". Results: eighteen studies of 479 publications met the inclusion criteria, and were used in the present review. The main AE founded after the analysis of the articles were cardiocirculatory complications (66.6%), with more frequent tachycardia and systemic arterial hypertension. In addition, intestinal constipation and dry mouth/xerostomia (55.5%), headache and insomnia (38.8%) and mood alteration (26.6%) were also reported. Furthermore, treatment with sibutramine was effective in reducing weight in 88.88% of the studies analyzed. Conclusion: although sibutramine therapy has an effective effect on weight reduction, the safety of the drug is not proved.(AU)

What is the association between social capital and diabetes mellitus? A systematic review.

Social capital has been included as an element that could influence the self-perception of health, mortality and mental diseases. We systematically reviewed papers that studied the influence of social capital in the control of diabetes mellitus (DM). We included studies published up to Feb. 16, 2017, without restriction of time or year of publication. Quantitative studies were included since they presented one well-defined parameter to evaluate DM and specifically measured social capital. We used the PRISMA and STROBE guidelines to perform this review and to evaluate the quality of papers. Only three papers met the inclusion criteria. All studies adopted cross-sectional design. The population, the instruments used to measure social capital, and the statistical analysis were different among the papers. In conclusion, although social capital seems to be related to DM, more studies are necessary to understand which dimensions are more important in this association, if the association is the same at the individual or neighborhood level, and what kind of population in terms of education, poverty and culture would be more influenced by social capital in DM control.

Effectiveness of individual strategies for the empowerment of patients with diabetes mellitus: A systematic review with meta-analysis.

AIMS: To identify and evaluate the effectiveness of individual empowerment strategies in patients with diabetes mellitus (DM). METHODS: A systematic review was performed in the PubMed, Scopus, Science Direct and BVS. For meta-analysis and evaluation of Cochrane Risk and Bias, Revman V 5.2 software was used. RESULTS: Eleven studies of 1073 publications met the inclusion criteria. The strategies used were individual consultations, phone calls, sessions via a website and use of a booklet. Glycemic Hemoglobin (HbA1c) was used to evaluate the effectiveness of the strategies, and 45.4% of the studies also used the Diabetes Empowerment Scale. Five studies (45.5%) showed significant improvements in HbA1c reduction, improvements in self-efficacy (18.2%), knowledge levels of DM (18.2%), quality of life (18.2%). However, after meta-analysis, no statistically significant improvement was found for HbA1c. CONCLUSION: This systematic review showed that individual strategies for DM empowerment were not effective in reducing HbA1c, despite contributing to improvements in psychosocial parameters. Therefore, individual strategies need to be reviewed so that they become effective in DM control.

Consumo alimentar de pacientes com diabetes mellitus tipo 2 de Ribeirão Preto / Food in take by patients of Ribeirão Preto with diabetes mellitus type 2

O consumo alimentar adequado é de grande importância para pacientes com Diabetes Mellitus tipo 2 (DM2) por controlaros níveis glicêmicos e evitar complicações. Diante disso, o objetivo desse trabalho foi avaliar as variáveis associadasao consumo alimentar de pacientes com DM2 cadastrados em Unidades de Saúde da Família (USF), da cidade deRibeirão Preto-SP. Este é um estudo descritivo do tipo inquérito, com amostra constituída por 100 indivíduos cadastradosem Unidades de Saúde da Família, da cidade de Ribeirão Preto-SP. Para avaliação do consumo alimentar utilizou-se oQuestionário de Frequência de Consumo Alimentar. Aplicou-se o Odds Ratio para verificar associações entre as variáveissociodemográficas, de acesso ao serviço de saúde e o consumo alimentar. Foram analisados os dados por meio detestes estatísticos, com erro tipo I igual a 5% (IC 95%). Dos 100 participantes, 64% eram do sexo feminino, a média deidade dos participantes foi de 66,7 anos, com predomínio de brancos (78%), casados (58%), com ensino fundamentalincompleto (56%). Foi encontrada associação entre o consumo adequado de macronutrientes e escolaridade (OR: 0,29;IC: 0,11; 0,73), e ter convenio de saúde privado (OR:0,13; IC:0,03; 0,51). No que se refere à quantidade de carboidratos,proteínas e lipídeos, 64%, 60% e 81% dos entrevistados, respectivamente, consomem quantidades adequadas; comrelação às fibras 79% consomem mais que 20 gramas/dia. A média de Valor Calórico Total observada foi de 1500 kcale da Taxa Metabólica Basal foi de 1.619,5 kcal. Assim conclui-se que, grande parte dos pacientes consome a quantidaderecomendada de macronutrientes, e o consumo adequado está associado ao maior nível de escolaridade e ter convêniode saúde privado(AU)

Proper food intake is very important for patients with diabetes mellitus type 2 (DM2) for controlling blood sugar levels andpreventing complications. Thus, the aim of this study was to evaluate the variables associated with the food consumptionof patients with DM2, registered in Unidades de Saúde da Família (USF) of Ribeirão Preto city (São Paulo state, Brazil).This is a survey-type descriptive study, with a sample of 100 individuals who are registered in Unidades de Saúde daFamília, of Ribeirão Preto city. Food consumption was evaluated using the Food Frequency Questionnaire. The OddsRatio was applied to verify association between the sociodemographic variables of access to a health service, and foodconsumption. The data were analyzed by statistical tests, with a type-I error of 5 % (95 % confidence interval, CI). Womancomprised 64 % of the population studied. The subjects averaged 66.7 years of age, were predominantly white (78 %),married (58 %), with an incomplete basic education (56 %). We found a significant correlation between macronutrientconsumption and schooling level (OR: 0.29; CI: 0.11; 0.73), and having private health insurance (OR:0.13; IC:0.03; 0.51).Concerning the uptake of carbohydrates, proteins and lipids, 64 %, 60 % and 81 % of the population, respectively,consumed properly; furthermore, 79 % of the subjects consume more than 20 g of fiber daily. The average total caloricvalue was 1500 Kcal, and the basal metabolic rate was 1,619.5 Kcal. Thus, it follows that the majority of the patientsconsume the recommended amount of macronutrients, and their behavior is closely related to a higher level of educationand having private health insurance(AU)

Diferenças de gênero na utilização dos serviços de saúde por indivíduos com diabetes mellitus tipo 2 / Gender differences in the use of health services by type 2 diabetes mellitus individuals

Objetivo: Analisar as diferenças de gênero na utilização dos serviços de saúde dos indivíduos com diabetes tipo 2. Métodos: Trata-se de um estudo transversal realizado com 100 mulheres e 100 homens em Unidades de Saúde da Família de Ribeirão Preto, São Paulo. As variáveis de interesse foram sociodemográficas, estilo de vida e clínicas. Resultados: Predominou-se a autopercepção da saúde como muito boa/boa nos homens (61%) e mulheres (51%). O consumo do álcool foi maior nos homens (28%) que nas mulheres (4%). O tabagismo foi três vezes mais frequente entre os homens (18%). A maioria dos homens (73%) e mulheres (67%) utilizavam as Unidades de Saúde da Família para o tratamento do diabetes. A média de doenças autorreferidas associadas ao diabetes foi de 2,5 nas mulheres e 1,6 nos homens. Conclusões: Verificaram-se diferenças na relação entre gênero e cuidados em diabetes (AU).

OBJECTIVE: To analyze the gender differences in the use of health services by type 2 diabetes individuals. METHODS: This is a cross-sectional study with 100 women and 100 men in Family Health Units of the city of Ribeirão Preto, state of São Paulo. The variables of interest were the sociodemographic, lifestyle and clinical ones. RESULTS: Health self-perception as very good/good predominated in men (61%) and women (51%). Alcohol consumption was higher in men (28%) than in women (4%). Smoking was three times more frequent among men (18%). Most men (73%) and women (67%) went to the Family Health Units to treat diabetes. The mean number of self-reported diabetesassociated diseases was 2.5 in women and 1.6 in men. CONCLUSIONS: There were differences in genderdiabetes care relationship (AU).

Collective empowerment strategies for patients with Diabetes Mellitus: A systematic review and meta-analysis.

AIMS: To perform a systematic review and meta-analysis to identify and analyze collective empowerment strategies for patients with Diabetes Mellitus (DM). METHODS: The systematic review was performed using PubMed/MEDLINE, Science Direct and BVS. The term "Diabetes Mellitus" was used with each of the following describers, along with the connector "AND": "self-care", "health education", "motivation" and "empowerment". Inclusion criteria were: intervention study with control group published between 2004 and 2014. For meta-analysis, RevMan V 5.3 software was used. RESULTS: Among the nine analyzed articles, 66.7% (n=6) were developed in patients diagnosed with DM2. Concerning the indicators for intervention effectiveness evaluation, all articles (n=9) used glycated hemoglobin (HbA1c) and the most used instrument was Summary of Diabetes Self Care Activities Measure, representing 44.4% (n=4) of the studies. The types of strategies used were similar in the articles. There was evidence of a decrease in HbA1c levels in 66.7% (n=6). The meta-analysis found significant evidence indicating beneficial effects of empowerment. CONCLUSIONS: Programs based on collective empowerment in DM have shown the interventions lead to improvement in clinical parameters, behavior, increased knowledge about DM, and self-care.

Consumo alimentar de pacientes com diabetes mellitustipo 2 de Ribeirão Preto / Food intake by patients of Ribeirão Preto with diabetes mellitustype 2

O consumo alimentar adequado é de grande importância para pacientes com Diabetes Mellitus tipo 2 (DM2) por controlaros níveis glicêmicos e evitar complicações. Diante disso, o objetivo desse trabalho foi avaliar as variáveis associadas ao consumo alimentar de pacientes com DM2 cadastrados em Unidades de Saúde da Família (USF), da cidade de Ribeirão Preto-SP. Este é um estudo descritivo do tipo inquérito, com amostra constituída por 100 indivíduos cadastrados em Unidades de Saúde da Família, da cidade de Ribeirão Preto-SP. Para avaliação do consumo alimentar utilizou-se o Questionário de Frequência de Consumo Alimentar. Aplicou-se o Odds Ratio para verificar associações entre as variáveis sociodemográficas, de acesso ao serviço de saúde e o consumo alimentar. Foram analisados os dados por meio detestes estatísticos, com erro tipo I igual a 5% (IC 95%). Dos 100 participantes, 64% eram do sexo feminino, a média de idade dos participantes foi de 66,7 anos, com predomínio de brancos (78%), casados (58%), com ensino fundamental incompleto (56%). Foi encontrada associação entre o consumo adequado de macronutrientes e escolaridade (OR: 0,29;IC: 0,11; 0,73), e ter convenio de saúde privado (OR:0,13; IC:0,03; 0,51). No que se refere à quantidade de carboidratos,proteínas e lipídeos, 64%, 60% e 81% dos entrevistados, respectivamente, consomem quantidades adequadas; com r lação às fibras 79% consomem mais que 20 gramas/dia. A média de Valor Calórico Total observada foi de 1500 kcale da Taxa Metabólica Basal foi de 1.619,5 kcal. Assim conclui-se que, grande parte dos pacientes consome a quantidade recomendada de macronutrientes, e o consumo adequado está associado ao maior nível de escolaridade e ter convênio de saúde privado

Proper food intake is very important for patients with diabetes mellitus type 2 (DM2) for controlling blood sugar levels andpreventing complications. Thus, the aim of this study was to evaluate the variables associated with the food consumptionof patients with DM2, registered in Unidades de Saúde da Família (USF) of Ribeirão Preto city (São Paulo state, Brazil).This is a survey-type descriptive study, with a sample of 100 individuals who are registered in Unidades de Saúde da Família, of Ribeirão Preto city. Food consumption was evaluated using the Food Frequency Questionnaire. The OddsRatio was applied to verify association between the sociodemographic variables of access to a health service, and foodconsumption. The data were analyzed by statistical tests, with a type-I error of 5 % (95 % confidence interval, CI). Womancomprised 64 % of the population studied. The subjects averaged 66.7 years of age, were predominantly white (78 %),married (58 %), with an incomplete basic education (56 %). We found a significant correlation between macronutrientconsumption and schooling level (OR: 0.29; CI: 0.11; 0.73), and having private health insurance (OR:0.13; IC:0.03; 0.51).Concerning the uptake of carbohydrates, proteins and lipids, 64 %, 60 % and 81 % of the population, respectively,consumed properly; furthermore, 79 % of the subjects consume more than 20 g of fiber daily. The average total caloricvalue was 1500 Kcal, and the basal metabolic rate was 1,619.5 Kcal. Thus, it follows that the majority of the patientsconsume the recommended amount of macronutrients, and their behavior is closely related to a higher level of educationand having private health insurance