Acute pancreatitis secondary to oral contraceptive-induced hypertriglyceridemia: a case report.

Hypertriglyceridemia is the third most common cause of acute pancreatitis. Among the causes that lead to secondary hypertriglyceridemia, the use of contraceptive agents is the main reason to be assessed in young women. We report a case of a 31-year-old woman who had suffered two acute pancreatitis episodes secondary to hypertriglyceridemia. In the investigation, the previous medical team indicated a genetic screening before ruling out all secondary causes. LPL, apo CII and apo AV genes were negative for mutations. In the first appointment with us, the patient reported the use of a contraceptive agent for about 2 years. She was instructed to discontinue the drug. After one year of follow-up, her serum triglycerides are within the normal range and a copper intrauterine device was the method chosen by the patient for contraception.

Avaliação da qualidade do sono e atores associados em pacientes diabéticos tipo 2 / Evaluation of sleep quality and associated factors in type 2 diabetespatients

Analisar a qualidade do sono e possíveis fatores associados em pacientes diabéticos tipo 2. Estudo descritivo transversal e quantitativo com 74 pacientes. Foram utilizados o Índice de Qualidade de Sono de Pittsburgh (PSQI) para avaliação da qualidade do sono e um questionário com informações socioeconômicas e clínicas. As análises multivariadas foram conduzidas por meio de regressão logística. A maioria dos pacientes tinha 50 anos ou mais de idade (54,1%). Quase 80% tinham diagnóstico de hipertensão arterial, 60,3% eram obesos e 61,6% usavam insulina. Observou-se que 64,9% dos pacientes referiram má qualidade do sono. Ter diagnóstico de diabetes mellitus por 10 anos ou mais esteve associado à má qualidade do sono (OR=3,0;IC=1,045-8,394). A hemoglobina glicada apresentou correlação positiva e significativa para frequência de uso de medicamentos para dormir (r=0,27; p=0,02). Os resultados demonstraram alto percentual de pacientes diabéticos com má qualidade do sono. Ressalta-se a importância de direcionar ações de prevenção e enfrentamento ao cuidado desses pacientes, principalmente aqueles com maior tempo de diagnóstico e os que utilizam medicamentos para dormir

To analyze the sleep quality and possible associated factors in patients diagnosed with type II Diabetes, a quantitative, descriptive cross-sectional study involving 74 patients was performed. The Pittsburg Sleep Quality Index (PSQI) was used for the evaluation of Sleep Quality, and a questionnaire was applied for socioeconomic and clinical information. Multivariate analyses were conducted through logistic regression. Most patients were 50 years old or older (54.1%). Almost 80% were diagnosed with arterial hypertension, 60.3% were obese, and 61.6% used of insulin. The results showed that 64% of patients reported poor sleep quality. Having type II Diabetes diagnosed for 10 years or more was associated with poor sleep quality (OR=3.0; CI=1.045-8.394). Glycated haemoglobin showed a positive and significant correlation with the frequency of sleep medication use (r=0.27; p=0.02). The results demonstrated a high percentage of diabetic patients reporting poor sleep quality. It is necessary to emphasize the importance of directing preventive actions and facing the challenges concerning the care of these patients; especially of those who have been diagnosed for a longer period and those using sleep medication

Changes associated with percutaneous ethanol injection in the treatment of thyroid nodules.

Percutaneous ethanol injection (PEI) is an alternative therapy for thyroid nodules (TN). However, some concern is raised on its carcinogenic effects. To evaluate the cytological and clinical changes caused by PEI in patients with benign TN. Thirty-nine patients with TN (23.1% hyperfunctioning) were submitted to a median of three PEI sessions. After a median of 17 months, patients were reassessed. A new ultrasound-guided fine needle biopsy (US-FNB) was performed, and the smears were analyzed after May-Grünwald-Giemsa staining. The diagnostic findings and the cellular characteristics were compared before and after treatment. There was an increase in the proportion of nondiagnostic/unsatisfactory results (from 2.5% to 18.9%). No malignant cases were observed. The proportion of moderate/intense macrophage infiltration decreased from 60% to 15%. Before treatment, 23.1% patients had hyperthyroidism, which was completely or partially resolved in 66.7%. By ultrasound, the percentage of homogeneous nodules decreased from 64.0% to 38.4% (p=0.0235), and the mean nodule volume decreased from 13.4 ± 12.2 to 5.3 ± 5.1 cm(3). We demonstrate that PEI increases the proportion of nondiagnostic/unsatisfactory results from US-FNB. Therefore, cytological findings after PEI must be evaluated with caution. Our results also suggest that PEI is an efficacious and safe therapeutic option, with no carcinogenic effects observed on cytological evaluations. Safety and efficacy must be evaluated in larger studies with longer follow-up periods.