Use of a Continuous Glucose Monitoring System in High-Risk Hospitalized Noncritically Ill Patients With Diabetes After Cardiac Surgery and During Their Transition of Care From the Intensive Care Unit During COVID-19: A Pilot Study.

OBJECTIVE: Continuous glucose monitoring (CGM) has demonstrated benefits in managing inpatient diabetes. We initiated this single-arm pilot feasibility study during the COVID-19 pandemic in 11 patients with diabetes to determine the feasibility and accuracy of real-time CGM in patients who underwent cardiac surgery and whose care was being transitioned from the intensive care unit. METHODS: A Clarke error grid analysis was used to compare CGM and point-of-care measurements. The mean absolute relative difference (MARD) of the paired measurements was calculated to assess the accuracy of CGM for glucose measurements during the first 24 hours on CGM, the remaining time on CGM, and for different chronic kidney disease (CKD) strata. RESULTS: Overall MARD between point-of-care and CGM measurements was 14.80%. MARD for patients without CKD IV and V with an estimated glomerular filtration rate (eGFR) of ≥20 mL/min/1.73 m2 was 12.13%. Overall, 97% of the CGM values were within the no-risk zone of the Clarke error grid analysis. For the first 24 hours, a sensitivity analysis of the overall MARD for all patients and those with an eGFR of ≥20 mL/min/1.73 m2 was 15.42% ± 14.44% and 12.80% ± 7.85%, respectively. Beyond the first 24 hours, overall MARD for all patients and those with an eGFR of ≥20 mL/min/1.73 m2 was 14.54% ± 13.21% and 11.86% ± 7.64%, respectively. CONCLUSION: CGM has shown great promise in optimizing inpatient diabetes management in the noncritical care setting and after the transition of care from the intensive care unit with high clinical reliability and accuracy. More studies are needed to further assess CGM in patients with advanced CKD.

123I thyroid uptake and thyroid size at 24, 48, and 72 hours after the administration of recombinant human thyroid-stimulating hormone to normal volunteers.

CONTEXT: Recombinant human TSH (rhTSH) is used to evaluate thyroid carcinoma patients and off-label for (131)I thyroid ablation and nontoxic goiter therapy. OBJECTIVE: Our objective was to determine the optimal time for (131)I administration after rhTSH. PARTICIPANTS: Twenty-five euthyroid nongoitrous volunteers participated in the study. DESIGN: Baseline 24-h thyroid (123)I uptake (RAIU) was measured, and then 0.1 mg rhTSH was administered. (123)I was administered 24, 48, or 72 h after rhTSH, and a repeat 24-h RAIU was obtained. SETTING: The study was conducted at an academic research center. MAIN OUTCOME MEASURES: Thyroid function tests, thyroid ultrasounds, and electrocardiograms were measured before rhTSH, then daily for 4 d, and finally 7 d after rhTSH. RESULTS: Serum TSH concentrations 24 h after rhTSH increased from 1.7 +/- 0.5 muU/ml (mean +/- sd) to 13.3 +/- 4. The 24-h RAIUs rose from 25 +/- 5 to 47 +/- 8% (88% increase) when the (123)I was given at 24 h after rhTSH and from 29.8 +/- 7 to 40.5 +/- 13% (36% increase) when the (123)I was given at 48 h and were unchanged when the (123)I was given at 72 h. The post-rhTSH RAIU increase was greater at 24 than at 72 h (P < 0.005) and marginally greater than at 48 h (P = 0.057). Thyroid volumes significantly increased 48 h after rhTSH (10 +/- 3.8 vs. 11.1 +/- 3.7 ml; P < 0.009). Electrocardiograms were normal. CONCLUSIONS: Marked increases in RAIU occurred when (123)I was given 24 h after rhTSH administration to euthyroid volunteers. Smaller increases were observed at 48 h and none at 72 h.

Saúde bucal no programa de saúde da família na cidade de Feira de Santana (BA): o perfil do cirurgião-dentista / Dental health in feira de santana (ba) family health program: thesurgeon dentist profile

O cirurgião-dentista, cuja formação tem valorizado mais práticas curativas, foi incluído na estratégia saúde da família devido à necessidade de melhorar os indicadores epidemiológicos de saúde bucal e ampliar o acesso da população brasileira na Estratégia Saúde da Família (ESF). O objetivo deste estudo é conhecer o perfil dos profissionais de odontologia inseridos no ESF em Feira de Santana (BA), a fim de investigar se esse perfil é adequado às diretrizes e objetivos desse programa, no que tange às questões de promover, proteger e recuperar a saúde. Trata-se de uma pesquisa quantitativa, que utilizou como instrumento de coleta de dados o questionário. Os resultados evidenciaram que 68 porcento dos Cirurgiões-Dentistas são do sexo feminino, com faixa etária compreendida entre 23 e 45 anos de idade, cerca de 20 porcento tem 3 anos de formados e fizeram sua graduação na Universidade Estadual de Feira de Santana. No processo de inserção no programa não foi realizado concurso público, sendo 100 porcento dos entrevistados admitidos por meio de contrato. No que se refere à capacitação 68 porcento a possui com foco na Estratégia Saúde da Família e, destes, 100 porcento realizam atividades relacionadas à educação em saúde, executadas na própria unidade ou em escolas, asilos, igrejas e creches. Concluiu-se que a grande maioria dos participantes tem uma visão coletiva, voltada para a prevenção, o que representa um avanço na prática em Saúde Bucal, e aponta para um novo modelo de atenção em Odontologia.

The surgeon dentist, whose education has given more emphasis to healing practices, was included in the family health strategy due to the necessity of improving buccal health epidemiological indicators and increasing access to Brazilian population. The objective of this study is to find out the profile of odontology professionals who take part in Feira de Santana (BA) Family Health Strategy (FHS), in order to ascertain whether this profile meets the Program?s guidelines and objectives in terms of health promotion, preservation and recovery. This is a quantitative research conducted through a questionnaire with 44 questions. Results pointed out that 68 porcent of the surgeon-dentists population are female, aged 23 to 45 years; approximately 20 porcent have had 3 years of practice and graduated in Feira de Santana State University. There was no public entrance exam and 100 porcent of the interviewed were hired through contract. 68 porcent have qualification focusing on family health strategy and, out of these, 100 % carry out activities related to health education in the units or in schools, shelter homes, churches and daycare centers. It is assumed that most participants have a collective view, directed towards prevention which represents an advance in terms of Buccal Health practice and points to a new model of Odontological care.