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1.
Aquichan ; 21(3): e2137, sept. 30, 2021.
Article in English | LILACS, BDENF, COLNAL | ID: biblio-1292410

ABSTRACT

Objective: To evaluate neuropathic pain (NP), its intensity, and complications in people with type 2 diabetes mellitus (T2DM) in a city of eastern São Paulo. Method: Cross-sectional study conducted with 96 individuals with T2DM served by primary health units in São João da Boa Vista-SP. The following instruments were used to screen NP: Michigan Neuropathy Screening Instrument, Leeds Assessment of Neuropathic Symptoms and Signs, Douleur Neuropathique 4, and Brief Pain Inventory. The data were analyzed using descriptive and inferential statistics, with a 5 % significance level. Results: Of the 96 people with T2DM for longer than five years, 22.9 % had pain. NP was related to high levels of fasting blood glucose (mean = 214 ± 65.58 mg/dl; p = 0.0002), glycated hemoglobin (mean = 8.8 ± 0.11 %; p < 0.001), absence of a balanced diet (p = 0.0066), obesity (p = 0.023), and high blood pressure (p < 0.001). Conclusion: Higher values ​​of glycated hemoglobin rates increased three times the chance of NP. The screening and management of painful diabetic neuropathy is a challenge but adopting a screening protocol supports the secondary prevention of this manifestation.


Objetivo: evaluar el dolor neuropático (DN), su intensidad y sus complicaciones en personas con diabetes mellitus tipo 2 (DM2) en una ciudad del este de São Paulo. Método: estudio transversal realizado con 96 individuos con DM2 atendidos en unidades básicas de salud en São João da Boa Vista-SP. Se utilizaron los siguientes instrumentos para rastrear el DN: el instrumento para la detección de la neuropatía de Michigan, la evaluación de signos y síntomas neuropáticos de Leeds, el cuestionario Douleur Neuropathique 4 y el inventario breve del dolor. Los datos se analizaron mediante estadística descriptiva e inferencial, con un nivel de significancia del 5 %. Resultados: de las 96 personas con DM2 durante más de cinco años, el 22,9 % tenía dolor. El DN se relacionó con niveles altos de glucosa en sangre en ayunas (media = 214 ± 65,58 mg/dl; p = 0,0002), la hemoglobina glucosilada (media = 8,8 ± 0,11 %; p < 0,001), la ausencia de una dieta (p = 0,0066), la obesidad (p = 0,023) y la hipertensión arterial (p < 0,001). Conclusión: los altos valores en las tasas de hemoglobina glucosilada aumentaron tres veces la probabilidad de DN. La detección y el tratamiento de la neuropatía diabética dolorosa es un desafío, pero la adopción de un protocolo de detección contribuye a la prevención secundaria de esta manifestación.


Objetivo: avaliar a dor neuropática (DN), sua intensidade e suas complicações em pessoas com diabetes mellitus tipo 2 (DM2) numa cidade do leste de São Paulo, Brasil. Método: estudo transversal realizado com 96 indivíduos com DM2 atendidos em unidades básicas de saúde em São João da Boa Vista, São Paulo. Foram utilizados os seguintes instrumentos para rastrear a DN: o instrumento para detectar a neuropatia de Michigan, a avaliação de sinais e sintomas neuropáticos de Leeds, o questionário de Douleur Neuropathique 4 e a escala breve da dor. Os dados foram analisados por meio de estatística descritiva e inferencial, com um nível de significância de 5 %. Resultados: das 96 pessoas com DM2 durante mais de cinco anos, 22,9 % sentiam dor. A DN esteve relacionada com níveis altos de glicose em sangue em jejum (média = 214 ± 65,58 mg/dl; p = 0,0002), hemoglobina glicosilada (média = 8,8 ± 0,11 %; p < 0,001), ausência de dieta (p = 0,0066), obesidade (p = 0,023) e hipertensão arterial (p < 0,001). Conclusões: os altos valores nas taxas de hemoglobina glicosilada aumentaram três vezes a probabilidade de DN. A detecção e o tratamento da neuropatia diabética dolorosa são um desafio, mas a adoção de um protocolo de detecção contribui para a prevenção secundária dessa manifestação.


Subject(s)
Physical Therapy Modalities , Diabetes Complications , Diabetes Mellitus , Diabetic Neuropathies , Chronic Pain , Nursing
2.
Nursing (Säo Paulo) ; 24(278): 5922-5931, jul.-2021.
Article in Portuguese | LILACS, BDENF | ID: biblio-1343202

ABSTRACT

Objetivo: Avaliar o pé dos indivíduos portadores de Diabetes Melitus atendidos na atenção básica de um município do interior paulista. Método: Trata-se de um estudo quantitativo. Foram examinados 100 pés dos portadores de diabetes, no período de 1 a 31 de julho de 2019, aos usuários dos serviços de saúde do município (Estratégia Saúde da Família (ESF) e Unidade Básicas de Saúde (UBS)). Resultados: Houve predominância do sexo feminino, 56% declararam que continham ensino fundamental incompleto. A hipertensão arterial foi a comorbidade mais citada. Na avaliação da história clinica associada aos cuidados com os pés, 87% dos entrevistados, declararam que nunca tiveram nenhum tipo de ulceração nos pés. Na inspeção e avaliação dos pés dos entrevistados, constatou-se que 94% não tinham nenhum tipo de lesões nos pés. Conclusão: O estudo reforçou a importância da participação dos profissionais de saúde atuando na prevenção do pé diabético.(AU)


Objective: To evaluate the foot of individuals with Diabetes Melitus assisted in primary care in a city in the interior of São Paulo. Method: This is a quantitative study. One hundred feet of people with diabetes were examined, between the 1st and 31st of July, 2019, users of health services in the municipality (Family Health Strategy (ESF) and Basic Health Units (UBS). Results: There was a predominance of females, 56% declared that they had incomplete primary education. Hypertension was the most cited comorbidity. In the evaluation of the clinical history associated with foot care, 87% of the interviewees stated that they had never had any type of foot ulceration. Upon inspection and assessment of the respondents' feet, it was found that 94% did not have any type of foot injury. Conclusion: The study reinforced the importance of the participation of health professionals working in the prevention of diabetic foot.(AU)


Objetivo: Evaluar el pie de personas con Diabetes Melitus atendidas en atención primaria en una ciudad del interior de São Paulo. Método: Este es un estudio cuantitativo. Se examinaron cien pies de personas con diabetes, del 1 al 31 de julio de 2019, usuarios de los servicios de salud del municipio (Estrategia Salud de la Familia (ESF) y Unidades Básicas de Salud (UBS). Resultados: Predominó el sexo femenino, el 56% declaró tener educación primaria incompleta. La hipertensión fue la comorbilidad más citada. En la evaluación de la historia clínica asociada al cuidado de los pies, el 87% de los entrevistados afirmó no haber tenido nunca ningún tipo de ulceración del pie. Tras la inspección y evaluación de los pies de los encuestados, se encontró que el 94% no tenía ningún tipo de lesión en el pie. Conclusión: El estudio reforzó la importancia de la participación de los profesionales sanitarios que trabajan en la prevención del pie diabético.(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Risk Factors , Diabetic Foot/prevention & control , Diabetes Complications , Socioeconomic Factors , Diabetes Mellitus/epidemiology
3.
J. nurs. health ; 11(3): 2111320491, jun. 2021.
Article in English | LILACS, BDENF | ID: biblio-1342761

ABSTRACT

Objective: to assess the adherence of people with type 1 diabetes to self-care activities. Method: quantitative study with 60 diabetics, from Porto, Portugal. The Self-Care Scale for Diabetes in its version translated and adapted to Portuguese was applied in January to February 2019. Results: respondents are mostly young (36.7%), employed (63.4%), female (73.3%), married (36.7%), high educated (60.0%) and diagnosed with recent diabetes (50.0%). Most have good mean adherence to self-care behaviors related to food (5.0), blood glucose monitoring (6.8), foot care (5.6) and medication (6.4). Regarding physical activity (2.6) and smoking, 73.3% of respondents say they smoked a cigarette in the last seven days lower adherence was identified. Conclusions: there is a need to develop educational programs to ensure a higher adherence to healthy lifestyles.(AU)


Objetivo: avaliar a adesão de pessoas com diabetes tipo 1 às atividades de autocuidado. Método: estudo com 60 diabéticos, do Porto, Portugal. Foi aplicada a Escala de Autocuidado para Diabetes traduzida e adaptada para o português em janeiro a fevereiro de 2019. Resultados: os inquiridos são maioritariamente jovens (36,7%), empregados (63,4%), mulheres (36,7%), casados (36,7%), com ensino superior (60,0%) e com diagnóstico recente de diabetes (50,0%). A maioria tem boa adesão aos comportamentos de autocuidado relacionados à alimentação (5,0), monitoramento da glicemia (6,8), cuidados com os pés (5,6) e medicamentos (6,4). Em relação à atividade física (2,6) e ao tabagismo, 73,3% dos entrevistados afirmam que fumaram um cigarro nos últimos sete dias foi identificada menor adesão. Conclusões: há necessidade de desenvolvimento de programas educativos que garantam uma maior adesão aos estilos de vida saudáveis.(AU)


Objetivo: evaluar la adherencia de las personas con diabetes tipo 1 a las actividades de autocuidado. Método: estudio cuantitativo con 60 diabéticos, de Porto, Portugal. Se aplicó la Escala de Autocuidado de la Diabetes y se tradujo al portugués en enero a febrero de 2019. Resultados: los encuestados son principalmente jóvenes (36,7%), empleados (63,4%), mujeres (36,7%), casados (36,7%), con estudios superiores (60,0%) y con diagnóstico reciente de diabetes (50,0%). La mayoría tiene una buena adherencia al autocuidado relacionado con la alimentación (5,0), control de la glucosa en sangre (6,8), cuidado de los pies (5,6) y medicación (6,4). En cuanto a actividad física (2,6) y tabaquismo, 73,3% de los encuestados dice haber fumado un cigarrillo en los últimos siete días, se identificó menor adherencia. Conclusiones: hay necesidad de desarrollar programas educativos que aseguren una mayor adherencia a los estilos de vida saludables.(AU)


Subject(s)
Pharmacology , Healthy Lifestyle , Treatment Adherence and Compliance , Nursing Care , Diabetes Complications
4.
Rev. urug. cardiol ; 36(1): e36104, abr. 2021. tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1252413

ABSTRACT

La diabetes mellitus es una de las principales causas de morbilidad y mortalidad a nivel mundial. Este grupo de pacientes generalmente representa una población con alto o muy alto riesgo cardiovascular, razón por la cual se realiza una estratificación precoz del riesgo, buscando enfocarse objetivamente en el abordaje farmacológico y no farmacológico con una estrategia intensiva. La enfermedad cardiovascular representa la principal causa de mortalidad, pero en los últimos años se han producido avances en la terapéutica que han demostrado reducir los eventos cardiovasculares mayores. Este artículo revisa la interacción entre diabetes, enfermedades cardiovasculares y su tratamiento.


Diabetes mellitus is one of the main causes of morbidity and mortality worldwide. This group of patients generally represents a population with high or very high cardiovascular risk, that is the reason for an early stratification of risk, seeking to objectively focus on pharmacological and non-pharmacological approach with an intensive strategy. Cardiovascular disease represents the main cause of mortality, but in recent years there have been advances in therapeutics that have been shown to reduce major cardiovascular events. This article reviews the interaction between diabetes, cardiovascular diseases and their treatment.


A diabetes mellitus é uma das principais causas de morbimortalidade em todo o mundo. Esse grupo de pacientes geralmente representa uma população com alto ou muito alto risco cardiovascular, razão pela qual se estratifica precocemente o risco, buscando enfocar objetivamente a abordagem farmacológica e não farmacológica com estratégia intensiva. A doença cardiovascular representa a principal causa de mortalidade, mas nos últimos anos houve avanços na terapêutica que mostraram reduzir os eventos cardiovasculares maiores. Este artigo analisa a interação entre diabetes, doenças cardiovasculares e seu tratamento.


Subject(s)
Humans , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/drug therapy , Diabetes Complications , Diabetes Mellitus/diagnosis , Diabetes Mellitus/drug therapy , Hypoglycemic Agents/adverse effects , Biomarkers , Cardiovascular Diseases/etiology , Risk Assessment , Diabetes Mellitus/epidemiology
5.
Rev. Asoc. Odontol. Argent ; 109(1): 64-72, ene.-abr. 2021. tab
Article in Spanish | LILACS | ID: biblio-1281783

ABSTRACT

La diabetes mellitus es una enfermedad metabólica caracterizada por altos niveles de glucosa en sangre y defectos en la producción y/o la acción de la insulina. La hiperglucemia crónica puede derivar en complicaciones metabólicas y vasculares como micro- y macroangiopatías y alteraciones en el metabolismo de lípidos y proteínas. Los pacientes diabéticos mal controlados o no controlados presentan signos y síntomas evidenciables a nivel bucal. En el mundo, alrededor del 8,8% de los adultos de entre 20 y 79 años padecen este trastorno endócrino, y se estima que para el año 2045 unos 629 millones de personas de este rango etario tendrán diabetes. Por ello, es fundamental que el odontólogo se encuentre familiarizado con el manejo médico de estos pacientes, a fin de estar preparado para brindarles un tratamiento adecuado y responder a las emergencias médicas que se presenten durante su atención. En esta revisión se emplearon resultados extraídos manualmente de artículos indexados en las bases de datos MEDLINE y EBSCO que responden a la búsqueda de los términos diabetes mellitus, dental management, oral surgery y HbA1c, con el objetivo de describir el manejo médico-odontológico del paciente diabético hasta la fecha (AU)


Diabetes Mellitus is a metabolic disease characterized by high blood glucose levels and defects in the production and/or the use of insulin. Chronic hyperglycemia can lead to metabolic and vascular complications. Vascular complications include micro and macroangiopathies. The metabolic disorders are: alterations of lipid and protein metabolism. Patients with poorly controlled or uncontrolled diabetes present symptoms that are evident in the oral cavity. Around 8.8% of adults between 20-79 years old, worldwide, have this endocrine disorder and it is estimated that by 2045, 629 million people in this age group, will have diabetes. Therefore, it is essential for dentists to be familiar with the medical management of these patients, in order to provide adequate treatment and eventual management of medical emergencies that may occur during dental treatment. The present review used data extracted manually from articles indexed in the MEDLINE and EBSCO databases, using the terms: Diabetes mellitus, Dental Management, Oral Surgery and HbA1c. The following article aims to describe the medical/dental management of the diabetic patient updated to date (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Dental Care for Chronically Ill/methods , Diabetes Complications , Diabetes Mellitus/pathology , Surgery, Oral/methods , Glycated Hemoglobin A , Databases, Bibliographic , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Hyperglycemia/complications
6.
Rev. cuba. endocrinol ; 32(1): e220, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1289388

ABSTRACT

La creciente epidemia de diabetes impone la necesidad de implementar estrategias para la detección de complicaciones diabéticas en etapas tempranas cuando aún están en estadio preclínico. La enfermedad arterial periférica es una de ellas, con consecuencias devastadoras para el paciente, la familia y la sociedad. Su frecuencia aumenta con la edad y el tiempo de evolución de la diabetes. La mayoría de los pacientes son asintomáticos lo que dificulta el diagnóstico, además, las limitaciones del examen físico exigen complementarlo con estudios no invasivos. El índice de presiones tobillo-brazo es el principal método para su detección pero es necesario conocer sus limitaciones en las personas con diabetes para interpretar correctamente los resultados. Los pacientes con enfermedad arterial periférica asintomática tienen más rápida declinación funcional con probabilidad de progresar a formas mas graves de la enfermedad como la isquemia crítica y la amputación, así como, mayor riesgo de eventos cardiovasculares isquémicos en otros territorios arteriales y de mortalidad. La detección sistemática de enfermedad arterial periférica asintomática en las personas con diabetes identificaría los pacientes que se beneficiarían con intervenciones más intensivas por lo que constituye una fuerte recomendación en la actualidad. Con este trabajo nos proponemos debatir sobre la importancia de la búsqueda de esta complicación en las personas con diabetes, así como, los retos actuales para su detección y diagnóstico(AU)


The growing diabetes epidemic demands the need to implement strategies for the identification of diabetic complications in early stages, when they are still in the preclinical stage. Peripheral arterial disease is one of them, with devastating consequences for the patient, the family, and society. Its frequency of occurrence increases with age and with the time of evolution of diabetes. Most of the patients are asymptomatic, which makes diagnosis difficult. In addition, due to the limitations of physical examination, complementary tests are required, always with noninvasive studies. The ankle-brachial pressure index is the main method for detecting it, but it is necessary to know its limitations in people with diabetes, in order to interpret the results correctly. Patients with asymptomatic peripheral arterial disease have a faster functional decline with the probability of progressing to more serious forms of the disease, such as critical ischemia and amputation, as well as a higher risk of ischemic cardiovascular events in other arterial territories and of mortality. Screening for asymptomatic peripheral arterial disease in people with diabetes would permit identifying patients who would benefit from more intensive interventions; therefore, it is strongly recommended nowadays. With this work, we intend to discuss the importance of screening for this complication in people with diabetes, as well as the current challenges for its detection and diagnosis(AU)


Subject(s)
Humans , Diabetes Complications/etiology , Peripheral Arterial Disease/diagnosis , Amputation/methods , Health Strategies
7.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1178748

ABSTRACT

Objetivo: Investigar na literatura científica a eficácia dos protocolos de enfermagem direcionados ao paciente com complicações diabéticas. Método: Revisão integrativa, realizada de agosto a setembro de 2019, seguindo as recomendações do PRISMA. As bases de dados utilizadas foram: Web of Science e Scopus, através dos cruzamentos: "Diabetes Mellitus AND Nursing AND Protocols" e "Amputation AND Nursing AND Protocols". Identificaram-se 672 artigos, sendo selecionados 17. Resultados: A maior parte dos estudos foram publicados em inglês e realizados nos Estados Unidos. Verificaram-se protocolos de controle glicêmico, da cetoacidose e do autocuidado, os quais apresentaram bons resultados para o que se propõem. Um artigo abordou superficialmente os cuidados de enfermagem direcionados a pessoas com amputação. Conclusão: Os protocolos de enfermagem direcionados ao paciente com complicações diabéticas apresentaram-se eficazes.


Objective: To investigate in the scientific literature the effectiveness of nursing protocols directed to patients with diabetic complications. Method: Integrative review, conducted from August to September 2019, following the recommendations of the PRISMA.The databases used were: Web of Science and Scopus, through the crossovers: "Diabetes Mellitus AND Nursing AND Protocols" and "Amputation AND Nursing AND Protocols". A total of 672 articles were identified and 17were selected. Results: Most studies were published in English and conducted in the United States. Glycemic control, ketoacidosis and self-care protocols were verified, which presented good results for their purpose. One article superficially addressed nursing care directed to people with amputation. Conclusion: Nursing protocols directed to patients with diabetic complications were effective


Objetivo: Investigar en la literatura científica la efectividad de los protocolos de enfermería dirigidos a pacientes con complicaciones diabéticas. Método: Revisión integradora, realizada de agosto a septiembre de 2019, siguiendo las recomendaciones de PRISMA. Las bases de datos utilizadas fueron: Web of Science y Scopus, a través de los crossovers: "Diabetes Mellitus AND Enfermería AND Protocolos" y "Amputación AND Enfermería AND Protocolos". Se identificaron un total de 672 artículos y se seleccionaron 17. Resultados: La mayoría de los estudios se publicaron en inglés y se realizaron en los Estados Unidos. Se verificaron los protocolos de control glucémico, cetoacidosis y autocuidado, que presentaron buenos resultados para su propósito. Un artículo abordó superficialmente la atención de enfermería dirigida a personas con amputación. Conclusión: Los protocolos de enfermería dirigidos a pacientes con complicaciones diabéticas fueron efectivos


Subject(s)
Humans , Male , Female , Diabetes Complications/nursing , Diabetes Mellitus/nursing , Nursing Assessment/methods , Self Care/instrumentation , Efficacy , Diabetic Ketoacidosis/nursing , Nursing Care
8.
Rev Rene (Online) ; 22: e70902, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1340609

ABSTRACT

RESUMO Objetivo detectar os fatores relacionados com a adesão negativa ao autocuidado em indivíduos com diabetes mellitus. Métodos estudo observacional, transversal, analítico e exploratório, realizado com indivíduos diagnosticados com diabetes mellitus tipo 2 e acompanhados pela Estratégia Saúde da Família. A amostra foi composta de 250 participantes. Foi utilizado o Summary of Diabetes Self-Care Activities Questionnaire para avaliação do autocuidado. Na análise realizaram-se testes de associação, razão de prevalência e regressão de Poisson com variância robusta. Resultados as atitudes negativas relacionadas com o autocuidado aumentaram em 21% para solteiros/divorciados/viúvos, 20% para aposentados, 54% para quem não fazia dieta, 28% para quem não praticava atividade física, 24% para hipertensos, 30% para quem tinha dislipidemia e 44% para quem tinha retinopatia. Conclusão fatores socioeconômicos, comportamentais, presença de comorbidades e complicações relacionadas com o diabetes mellitus estiveram relacionados com a adesão negativa ao autocuidado.


ABSTRACT Objective to detect factors related to negative adherence to self-care in individuals with diabetes mellitus. Methods observational, cross-sectional, analytical, and exploratory study, conducted with individuals diagnosed with type 2 diabetes mellitus and followed-up by the Family Health Strategy. The sample consisted of 250 participants. The Summary of Diabetes Self-Care Activities Questionnaire was used for self-care assessment. Association tests, prevalence ratio and Poisson regression with robust variance were performed in the analysis. Results negative attitudes related to self-care increased by 21% for single/divorced/widowed, 20% for retired, 54% for those who did not diet, 28% for those who did not practice physical activity, 24% for hypertensive, 30% for those with dyslipidemia, and 44% for those with retinopathy. Conclusion socioeconomic factors, behavioral factors, presence of comorbidities and complications related to diabetes mellitus were related to negative adherence to self-care.


Subject(s)
Self Care , Nursing , Patient Compliance , Diabetes Complications , Diabetes Mellitus , Medication Adherence
9.
Rev. baiana enferm ; 35: e42071, 2021.
Article in Portuguese | LILACS, BDENF | ID: biblio-1279762

ABSTRACT

Objetivo avaliar o estado de saúde e suas dimensões em pacientes com Diabetes Mellitus, atendidos em um hospital de ensino, à luz do Modelo do Senso Comum. Método estudo descritivo, com análise qualitativa dos dados. Participaram 20 pacientes hospitalizados e em atendimento ambulatorial. Os dados foram submetidos à análise de conteúdo e interpretados segundo os conceitos do Modelo do Senso Comum. Resultados os discursos foram categorizados de acordo com a identidade da doença e suas concepções; duração e tempo para o diagnóstico e os sintomas; causas da doença e suas explicações; consequências e tratamento; controle e percepções sobre o prognóstico. Considerações finais as concepções do estado de saúde e suas dimensões relacionadas ao Diabetes Mellitus, interpretadas à luz do Modelo do Senso Comum, descreveram-no como uma doença com sinais físicos e com potencial de complicação, inclusive associada à morte; contudo, também revelaram o desconhecimento das reais causas e consequências da doença.


Objetivo evaluar el estado de salud y sus dimensiones en pacientes con Diabetes Mellitus tratados en un hospital docente a la luz del Modelo de Sentido Común. Método es un estudio descriptivo con análisis cualitativo de los datos. Participaron veinte pacientes hospitalizados y en atención ambulatoria. Los datos fueron sometidos al análisis de contenido e interpretados de acuerdo con los conceptos del Modelo de Sentido Común. Resultados los discursos fueron categorizados de acuerdo con la identidad de la enfermedad y sus conceptos; duración y tiempo para el diagnóstico y los síntomas; causas de la enfermedad y sus explicaciones; consecuencias y tratamiento; control y percepciones acerca del pronóstico. Consideraciones finales los conceptos del estado de salud y sus dimensiones relacionadas con la Diabetes Mellitus, interpretadas a la luz del Modelo de Sentido Común, la describieron como una enfermedad con signos físicos y potencial de complicación, incluso asociada con la muerte; sin embargo, también revelaron ignorancia de las causas y consecuencias reales de la enfermedad.


Objective evaluating the health status and its dimensions in patients with Diabetes Mellitus treated in a teaching hospital in the light of the Commonsense Model. Method a descriptive study with qualitative analysis of the data. Participated twenty patients hospitalized and in outpatient care. The data were submitted to content analysis and interpreted according to the concepts of the Commonsense Model. Results the discourses were categorized according to the identity of the disease and its concepts; duration and time for diagnosis and symptoms; causes of the disease and its explanations; consequences and treatment; control and perceptions about prognosis. Final considerations the concepts of health status and its dimensions related to Diabetes Mellitus interpreted in the light of the Commonsense Model described it as a disease with physical signs and potential for complication, even associated with death; however, they also revealed ignorance of the real causes and consequences of the disease.


Subject(s)
Humans , Middle Aged , Aged , Perception , Health Knowledge, Attitudes, Practice , Health-Disease Process , Diabetes Mellitus , Diabetes Complications
10.
Rev. cuba. endocrinol ; 31(3): e253, sept.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156389

ABSTRACT

Introducción: La prevalencia de inactividad física en Cuba es de 40,4 por ciento pero se desconoce la frecuencia en personas con diabetes mellitus. Entre los factores asociados con la actividad física están la edad y la existencia de antecedentes familiares de diabetes mellitus, entre otros. Objetivos: Determinar el nivel de actividad física y su relación con factores clínicos y complicaciones crónicas en personas con diabetes mellitus. Métodos: Se realizó un estudio observacional, descriptivo y transversal, en una muestra de 131 personas con diabetes mellitus, mayores de 18 años, en el Policlínico "Héroes del Moncada"; donde se evaluó el nivel de actividad física a través de la versión corta del cuestionario IPAQ. Se utilizó la prueba de Chi cuadrado entre variables cualitativas y la correlación de Pearson para las variables cuantitativas. Resultados: De los pacientes estudiados, 54,9 por ciento tenían un nivel de actividad física bajo. Existió correlación negativa entre el grado de actividad física y la edad (p<0,0001), así como positiva con el peso corporal (p<0,0001). El nivel de actividad física bajo fue más frecuente en las personas con edades comprendidas entre 60 y 79 (59,7 por ciento), mientras que el alto prevaleció en los de 40-59 años (61,3 por ciento) (p<0,05). Los individuos con un solo familiar de primer grado diabético fueron más representados en el nivel de actividad física bajo (75 por ciento). No se encontró relación entre el nivel de actividad física y el número de complicaciones de la diabetes mellitus. Conclusiones: El nivel de actividad física en las personas con diabetes mellitus fue bajo, de forma similar al de la población general en Cuba y se asoció con la edad, los antecedentes familiares de diabetes y el exceso de peso corporal(AU)


Introduction: The prevalence of physical inactivity in Cuba is 40.4% but the frequency in people with diabetes mellitus is unknown. Factors associated with physical activity include age and a family history of diabetes mellitus, among others. Objectives: Determine the level of physical activity and its relation to clinical factors and chronic complications in people with diabetes mellitus. Methods: An observational, descriptive and cross-sectional study was conducted in a sample of 131 people over the age of 18 with diabetes mellitus, in "Heroes of the Moncada" Polyclinic where the level of physical activity was assessed through the short version of IPAQ questionnaire. The Chi square test between qualitative variables and Pearson's correlation was used for quantitative variables. Results: Of the patients studied, 54.9 percent had a low level of physical activity. There was negative correlation between the degree of physical activity and the age (p<0.0001), as well as positive with body weight (p<0.0001). Low level of physical activity was more common in people aged 60 to 79 (59.7 percent), while high level prevailed in those aged 40-59 (61.3 percent) (p<0.05).Individuals with just one diabetic first-degree family member were more represented at the low physical activity level (75 percent).No relationship was found between the level of physical activity and the number of complications of diabetes mellitus. Conclusions: The level of physical activity in people with diabetes mellitus was low, similar to that of the general population in Cuba and was associated with age, family history of diabetes and excess body weight(AU)


Subject(s)
Humans , Adult , Middle Aged , Exercise , Diabetes Complications , Diabetes Mellitus/epidemiology , Sedentary Behavior , Motor Activity/physiology , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Studies as Topic
11.
Rev. cuba. med. mil ; 49(4): e918, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156512

ABSTRACT

Introducción: La COVID-19 se ha caracterizado por un amplio espectro de manifestaciones y formas clínicas que comprenden desde enfermedad ligera hasta la muerte. Es de suma importancia identificar a aquellos con mayores probabilidades de desarrollar las complicaciones. Objetivo: Identificar factores de riesgo para desarrollar complicaciones en los pacientes atendidos con la COVID-19. Métodos: Fueron revisadas las 250 historias clínicas de pacientes ingresados por la COVID-19. Se recopilaron edad, sexo, antecedentes patológicos personales, exámenes de laboratorio y la presencia o no de complicaciones. Se utilizó ji cuadrado para identificar relación entre las complicaciones y el sexo. Fue calculado el Odds Ratio (OR) para complicaciones por grupos de edad, antecedentes patológicos personales y parámetros humorales. Resultados: El distrés respiratorio fue más frecuente en hombres (p = 0,023). Los grupos de edad más afectados fueron de 60 a 79 años y de 80 años y más (OR = 4,85 y 30,53 respectivamente). Fueron factores de riesgo los antecedentes de hipertensión arterial, cardiopatía isquémica, diabetes mellitus, insuficiencia renal crónica y demencia (OR = 4,48; 4,22; 8,75; 17,98 y 10,39 respectivamente). Predispusieron a complicaciones, hematocrito y linfocitos bajo, así como neutrófilos, glucemia, creatinina, ASAT, GGT y LDH altos. Conclusiones: El mayor riesgo de complicaciones lo tuvieron pacientes mayores de 60 años, con enfermedades cardiovasculares, diabetes mellitus, insuficiencia renal y demencia. La presencia de hematocrito y linfocitos bajo, o neutrófilos, glucemia, creatinina, ASAT, GGT y LDH altos, alerta sobre posibles complicaciones(AU)


Introduction: COVID-19 has been characterized by a wide spectrum of manifestations and clinical forms that range from mild illness to death. Identifying those most likely to develop complications is critical. Objective: To identify risk factors for developing complications in patients treated with COVID-19. Methods: 250 medical records of patients admitted for COVID-19 were reviewed. Age, sex, personal pathological history, laboratory tests and the presence or absence of complications were collected. Chi-square was used to identify the relationship between complications and sex. The Odds Ratio (OR) was calculated for complications by age groups, personal pathological history, and humoral parameters. Results: Respiratory distress was more frequent in men (p=0.023). The most affected age groups were 60 to 79 years and 80 years and over (OR=4.85 and 30.53 respectively). Risk factors were the history of arterial hypertension, ischemic heart disease, diabetes mellitus, chronic kidney insufficiency and dementia (OR=4.48, 4.22, 8.75, 17.98 and 10.39 respectively). Low hematocrit and lymphocytes were predisposed to complications, as well as high neutrophils, glycaemia, creatinine, ASAT, GGT and LDH. Conclusions: The highest risk of complications was in patients older than 60 years, with cardiovascular diseases, diabetes mellitus, kidney insufficiency and dementia. The presence of low hematocrit and lymphocytes, or high neutrophils, glycaemia, creatinine, ASAT, GGT and LDH, alerts you to possible complications(AU)


Subject(s)
Humans , Male , Female , Risk Factors , Myocardial Ischemia/complications , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Diabetes Complications/diagnosis , Renal Insufficiency, Chronic/complications , Hypertension
12.
ABCS health sci ; 45(Supl. 3): e020108, 10 June 2020.
Article in English | LILACS | ID: biblio-1252391

ABSTRACT

Diabetic Macular Edema is a major cause of visual impairment in economically active population, being responsible for a significant impact in quality of life in the affected population, as well as high costs to the health care system. Over decades, some studies have compared treatments using Laser, Anti-VEGF and intravitreous corticosteroids, establishing protocols to reach effectives therapies. Thus, it is essential an entire understanding of available therapies to reach the goal of disease control, in an individual basis and in a collective health care system, as efficient as possible.


Subject(s)
Humans , Macular Edema/therapy , Diabetes Complications , Laser Coagulation , Vascular Endothelial Growth Factors , Tomography, Optical Coherence , Intravitreal Injections
13.
Autops. Case Rep ; 10(2): e2020164, Apr.-June 2020. graf
Article in English | LILACS | ID: biblio-1131820

ABSTRACT

Emphysematous gastritis (EG) is a rare and potentially lethal process caused by invasive, gas-producing bacteria leading to inflammation and gas dissection of the stomach. The most common etiologic agents are Clostridium infections, but other organisms, including enterobacteria, staphylococcus, and fungi have also been identified. We report the first case of EG due to Sarcina ventriculi in a solid organ transplant recipient, who presented with epigastric pain and vomiting. The patient had a history of type 1 diabetes mellitus (DM) with recurrent episodes of ketoacidosis and systemic diabetic complications, including severe gastroparesis. CT scan studies demonstrated EG with venous air, and endoscopy showed severe gastritis and ulcerations. In the gastric biopsies, abundant Sarcina ventriculi were noted in areas of mucosal/submucosal necrosis. Antibiotic treatment was instituted at admission, and subsequent endoscopy demonstrated the disappearance of Sarcina, with some improvement of the gastric inflammation; however, the patient developed septic shock with multiorgan failure and expired. This case highlights the need to consider other infectious etiologies in transplant patients, in addition to the well-known opportunistic infections.


Subject(s)
Humans , Adult , Diabetes Complications , Transplant Recipients , Infections/etiology , Autopsy , Opportunistic Infections/etiology , Cholestasis , Clostridium Infections , Liver Failure , Fatal Outcome , Gastroparesis/complications , Renal Insufficiency/complications , Graft Rejection
14.
Rev. argent. cir ; 112(1): 43-50, mar. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1125780

ABSTRACT

Antecedentes: la colecistitis enfisematosa (CE) es una forma de presentación infrecuente de la colecistitis aguda. Material y métodos: presentecedentes patológicos, mientras que los otros eran diabéticos. A todos se les realizó tomografía computarizada (TC). Dos pacientes fueron sometidos a colecistectomía videolaparoscópica (CL) con buena evolución, mientras que en un caso se realizó colecistostomía percutánea (CP). Discusión: la CE se refiere a la presencia de gas en la luz o en la pared de la vesícula biliar. La tasa de morbilidad es del 50%. Los pacientes suelen padecer diabetes, pero puede presentarse en pacientes más jóvenes sin factores de riesgo. La TC es el método de elección para el diagnóstico. El tratamiento definitivo es la CL, aunque la CP es otra opción válida. Conclusión: la CL se considera un enfoque eficaz y seguro para el tratamiento de la CE.


Background: Emphysematous cholecystitis (EC) is a rare presentation of acute cholecystitis. Material and methods: We report three cases of EC in two men and one woman between 55 and 79 years. One of the patients was otherwise healthy while the other two were diabetics. A computed tomography (CT) scan was performed in all the cases. Two patients underwent video-assisted laparoscopic cholecystectomy with favorable outcome and one patient underwent percutaneous cholecystostomy. Discussion: Emphysematous cholecystitis is characterized by the presence of gas in the gallbladder lumen or wall. Mortality rate is 50%. Most patients are diabetics, but EC may present in younger patients without risk factors. Computed tomography scan is the method of choice for the diagnosis. Cholecystectomy is indicated as definite treatment, but percutaneous cholecystostomy may be a valid option. Conclusions: Laparoscopic cholecystectomy and antibiotics are effective and safe to treat.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Cholecystectomy, Laparoscopic/methods , Emphysematous Cholecystitis/surgery , Cholecystostomy/methods , Tomography, X-Ray Computed/methods , Abdominal Pain/complications , Emphysematous Cholecystitis/drug therapy , Emphysematous Cholecystitis/diagnostic imaging , Diabetes Complications , Abdomen/diagnostic imaging , Hypertension/complications
15.
REME rev. min. enferm ; 24: e1327, fev.2020. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1135987

ABSTRACT

RESUMO Objetivo: avaliar o risco de ulceração nos pés de pessoas com diabetes mellitus atendidas na atenção primária. Método: estudo transversal analítico realizado em Teresina, Piauí, com 308 pacientes, sendo incluídos maiores de 18 anos diagnosticados com diabetes mellitus e excluídos aqueles com ulceração ativa e/ou neuropatia atribuída a outros agravos. Os dados foram coletados mediante formulário sociodemográfico, clínico e de classificação do risco de ulceração nos pés, no período de fevereiro a agosto de 2019. A análise ocorreu a partir de estatísticas descritiva e inferencial. Resultados: dos participantes, 56,5% tinham mais de 60 anos, 59,7% não realizavam o controle da glicemia, 56,2% não praticavam atividade física, 51,3% estavam com sobrepeso e 54,2% apresentaram grau de risco 1 para ulceração nos pés. A situação conjugal, ocupação e diabetes mellitus há mais de 10 anos, controle glicêmico inadequado, hipertensão arterial, dislipidemia e obesidade tiveram associação estatisticamente significativa com o risco de ulceração. Aqueles com pele seca, deformidades, reflexo do tornozelo e percepção de vibração no hálux alterados apresentaram mais probabilidade de ulceração nos pés. Constatou-se que o exame clínico dos pés e a sensibilidade preservada ao monofilamento foram fatores de proteção. Conclusão: observouse que os aspectos sociodemográficos e clínicos interferem na probabilidade de ulceração, sendo que a maioria apresentou risco baixo. Além disso, no exame clínico dos pés, as alterações na sensibilidade vibratória e no reflexo do tornozelo aumentaram a probabilidade de ulceração, destacando-se que a classificação do risco de ulceração é imprescindível na assistência às pessoas com diabetes mellitus.


RESUMEN Objetivo: evaluar el riesgo de ulceración del pie en personas con diabetes mellitus tratadas en atención primaria. Método: estudio analítico transversal realizado en Teresina, Piauí, con 308 pacientes, incluidos los mayores de 18 años diagnosticados de diabetes mellitus y excluidos aquéllos con ulceración activa y / o neuropatía atribuida a otras condiciones. Los datos se recogieronde febrero a agosto de 2019 por medio de un formulario sociodemográfico, clínico y de clasificación de riesgo para la ulceración en el pie. El análisis se realizó a través de estadística descriptiva e inferencial. Resultados: el 56,5% de los participantes tenía más de 60 años, el 59,7% no realizaba control glucémico, el 56,2% no practicaba actividad física, el 51,3% tenía sobrepeso y el 54,2% tenía un grado de riesgo 1 de ulceración del pie. La situación conjugal, ocupación, diabetes mellitus durante más de 10 años, el inadecuado control glucémico, la hipertensión arterial, la dislipidemia y la obesidad tuvieron una asociación estadísticamente significativa con el riesgo de ulceración. Aquéllos con piel seca, deformidades, reflejo del tendón de Aquiles alterado y percepción alterada de la vibración del hallux tenían más probabilidades de ulceración de pies. Se encontró que el examen clínico de los pies y la sensibilidad conservada al monofilamento eran factores protectores. Conclusión: se observó que los aspectos sociodemográficos y clínicos interfieren con la probabilidad de ulceración, siendo la mayoría de bajo riesgo. Además, en el examen clínico de los pies, los cambios en la sensibilidad vibratoria y en el reflejo del tendón de Aquiles aumentaron la probabilidad de ulceración, destacando que la clasificación del riesgo de ulceración es esencial en la atención de las personas con diabetes mellitus.


ABSTRACT Objective: to evaluate the risk of foot ulceration in people with diabetes mellitus treated in primary care. Method: this is a cross-sectional analytical study carried out in Teresina, Piauí, with 308 patients, including those over 18 years old diagnosed with diabetes mellitus and excluding those with active ulceration and/ or neuropathy attributed to other conditions. The data were collected using a sociodemographic, clinical, and risk classification form for the foot ulceration, from February to August 2019. The analysis was based on descriptive and inferential statistics. Results: in the study, 56.5% of the participants were over 60 years old, 59.7% did not perform glycemic control, 56.2% did not practice physical activity, 51.3% were overweight and 54.2% had a degree of risk 1 for foot ulceration. Marital status, occupation, and diabetes mellitus for more than 10 years, inadequate glycemic control, arterial hypertension, dyslipidemia, and obesity had a statistically significant association with the risk of ulceration. Those with dry skin, deformities, ankle reflexes, and altered perception of hallux vibration were more likely to have foot ulcers. We found that the clinical examination of the feet and the preserved sensitivity to the monofilament were protective factors. Conclusion: we observed that the sociodemographic and clinical aspects interfere with the probability of ulceration and most of them present a low risk. Also, in the clinical examination of the feet, changes in vibratory sensitivity and ankle reflex increased the likelihood of ulceration, noting that the classification of the risk of ulceration is essential in assisting people with diabetes mellitus.


Subject(s)
Humans , Primary Health Care , Risk Factors , Diabetic Foot , Diabetes Complications/prevention & control , Primary Care Nursing
16.
Rev. bras. epidemiol ; 23: e200009, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1092617

ABSTRACT

RESUMO: Introdução: A comorbidade tuberculose e diabetes ainda continua um desafio para a saúde pública mundial. Objetivo: Analisar o perfil sociodemográfico e as características do diagnóstico e tratamento dos casos de tuberculose com e sem diabetes no Brasil. Métodos: Estudo transversal, com dados do Sistema de Informação de Agravos de Notificação e do Sistema de Gestão Clínica de Hipertensão Arterial e Diabetes Mellitus da Atenção Básica, no período de 2007 a 2011. Modelo de regressão de Poisson com variância robusta foi utilizado para estimar a razão de prevalência (RP) e seus respectivos intervalos de confiança. Resultados: A comorbidade estudada foi encontrada em 7,2% dos casos. Modelo hierárquico mostrou maior RP entre indivíduos do sexo feminino (RP = 1,31; intervalo de confiança de 95% - IC95% 1,27 - 1,35); maior associação nas faixas etárias 40-59 anos e ≥ 60 anos (RP = 11,70; IC95% 10,21 - 13,39 e RP = 17,49; IC95% 15,26-20,05) e com resultado positivo da baciloscopia - primeira amostra (RP = 1,40; IC95% 1,35 - 1,47). Reingresso após abandono e abandono foram inversamente associados na comorbidade (RP = 0,66; IC95% 0,57 - 0,76 e RP = 0,79; IC95% 0,72 - 0,87). Conclusão: Os achados, como a relação inversa do abandono ao tratamento da tuberculose no grupo das pessoas com comorbidade, reforçam a importância de ações integradas nos serviços para mudar o cenário dessa desafiadora comorbidade.


ABSTRACT: Introduction: Tuberculosis and diabetes comorbidity remains a challenge for global public health. Objective: To analyze the sociodemographic profile and the diagnostic and treatment characteristics of tuberculosis cases with and without diabetes in Brazil. Methods: This is a cross-sectional study with data from the Notifiable Diseases Information System and the Hypertension and Diabetes Mellitus Primary Care Clinical Management System, from 2007 to 2011. We adopted a Poisson regression model with robust variance to estimate the prevalence ratios (PR) and their respective confidence intervals. Results: We found the studied comorbidity in 7.2% of cases. The hierarchical model showed a higher PR among women (PR=1.31; 95% confidence interval - 95%CI 1.27-1.35); a greater association in the age groups 40-59 years and ≥ 60 years (PR=11.70; 95%CI 10.21-13.39, and PR=17.49; 95%CI 15.26-20.05), and in those with positive sputum smear microscopy results - 1st sample (PR=1.40; 95%CI 1.35-1.47). Return after treatment discontinuation and treatment discontinuation were inversely associated with comorbidity (PR=0.66; 95%CI 0.57-0.76 and PR=0.79; 95%CI 0.72-0.87). Conclusion: The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Tuberculosis/complications , Tuberculosis/epidemiology , Diabetes Complications/epidemiology , Socioeconomic Factors , Tuberculosis/diagnosis , Tuberculosis/therapy , Brazil/epidemiology , Comorbidity , Prevalence , Cross-Sectional Studies , Sex Distribution , Age Distribution , Diabetes Complications/diagnosis , Diabetes Complications/therapy , Middle Aged
17.
Clinics ; 75: e1588, 2020. tab, graf
Article in English | LILACS | ID: biblio-1101089

ABSTRACT

OBJECTIVES: The number of bariatric procedures has significantly increased in Brazil, especially in the public Unified Health System. The present study describes health outcomes and medication use in obese patients treated in a major hospital that performs publicly funded surgery in Brazil. METHODS: A retrospective, single center study was conducted to collect real-world evidence of health outcomes and medication use in 247 obese patients (female, 82.2%) who underwent open Roux-en-Y gastric bypass. Changes in weight and body mass index (BMI), presence of apnea, hypertension, and type 2 diabetes (T2D), and medication use (hypertension, diabetes, and dyslipidemia) were assessed preoperatively and up to 24 months postoperatively. The mean cost of medications was calculated for the 12-month preoperative and 24-month postoperative periods. RESULTS: During the surgery, the mean age of patients was 43.42 years (standard deviation [SD], 10.9 years), and mean BMI was 46.7 kg/m2 (SD, 6.7 kg/m2). At 24 months, significant declines were noted in weight (mean, -37.6 kg), BMI (mean, -14.3 kg/m2); presence of T2D, hypertension, and apnea (-29.6%, -50.6%, and -20.9%, respectively); and number of patients using medications (-66.67% for diabetes, -41.86% for hypertension, and -55.26% for dyslipidemia). The mean cost of medications (total costs for all medications) decreased by >50% in 12-24 postoperative months compared to that in 12 preoperative months. CONCLUSION: Roux-en-Y gastric bypass successfully reduced weight, BMI, and comorbidities and medication use and cost at 24 months in Brazilian patients treated in the public Unified Health System.


Subject(s)
Humans , Female , Adult , Drug Prescriptions/statistics & numerical data , Obesity, Morbid/surgery , Gastric Bypass/methods , Laparoscopy , Bariatric Surgery , Obesity, Morbid/complications , Brazil , Weight Loss , Gastroesophageal Reflux/complications , Gastroesophageal Reflux/drug therapy , Body Mass Index , Retrospective Studies , Treatment Outcome , Outcome Assessment, Health Care , Diabetes Complications/drug therapy , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Dyslipidemias/complications , Dyslipidemias/drug therapy , Hypertension/complications , Hypertension/drug therapy
18.
Einstein (Säo Paulo) ; 18: eAO4483, 2020. tab
Article in English | LILACS | ID: biblio-1056068

ABSTRACT

ABSTRACT Objective To analyze the characteristics of patients with hypertension and/or diabetes mellitus from Primary Healthcare units. Methods This is a retrospective study, with data collected from December 2014 of patients with hypertension and/or diabetes from 13 Primary Healthcare units located in the Southern region of Sao Paulo (SP, Brazil). Patients were compared by sex, diagnosis and cardiovascular risk using student t test, one way analysis of variance (ANOVA), and Mann-Whitney, Kruskal-Wallis and χ2 tests. Results We evaluated 28,496 patients aged 20 years to 79 years (mean of 57.8 years). Most of patients were women (63.2%) and aged 50 years old or older (74.2%). The participation in the Programa Remédio em Casa (Medicine at Home Program) was higher among women (12.7%), and the proportions of hypertension, diabetes and both diseases were 68.0%, 7.9% and 24.1%, respectively. Patients with hypertension and diabetes had higher participation in Medicine at Home Program (13.3%), and those with diabetes only had higher participation in Programa de Automonitoramento Glicêmico (Self-Monitoring Glucose Program) (20.0%). The proportions of low, moderate, and high cardiovascular risk were 33.0%, 15.5%, and 51.5%, respectively. Conclusion The sample of this study consisted of patients who were mostly women, aged 50 years or older and diagnosed with hypertension. Almost a quarter of patients also had diabetes and approximately one third and half of them were classified as low and high cardiovascular risk.


RESUMO Objetivo Analisar as características de pacientes com hipertensão arterial e/ou diabetes mellitus de unidades de Atenção Primária à Saúde. Métodos Estudo retrospectivo, com dados de dezembro de 2014 de pacientes com hipertensão e/ou diabetes, de 13 unidades de Atenção Primária à Saúde localizadas na região sul da cidade de São Paulo (SP). Os pacientes foram comparados por sexo, diagnósticos e risco cardiovascular, por meio dos testes t de Student, análise de variância de um fator, Mann-Whitney, Kruskal-Wallis e χ2. Resultados Foram avaliados 28.496 pacientes, de 20 anos a 79 anos de idade (média de 57,8 anos), sendo a maioria do sexo feminino (63,2%) e com 50 anos ou mais de idade (74,2%). A participação no Programa Remédio em Casa foi maior no sexo feminino (12,7%) e as proporções de hipertensão, diabetes e de ambas as doenças foram de 68,0%, 7,9% e 24,1%, respectivamente. Os pacientes com hipertensão e diabetes apresentaram maior proporção de participação no Programa Remédio em Casa (13,3%) e aqueles com apenas diabetes apresentaram maior proporção de participação no Programa de Automonitoramento Glicêmico (20,0%). As proporções de risco cardiovascular baixo, moderado e alto foram de 33,0%, 15,5% e 51,5%, respectivamente. Conclusão A amostra deste estudo foi constituída por pacientes em sua maioria do sexo feminino, com 50 anos ou mais de idade e diagnóstico de hipertensão. Cerca de um quarto dos pacientes apresentava também diabetes e aproximadamente um terço e metade deles foram categorizados como risco cardiovascular baixo e alto, respectivamente.


Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , Primary Health Care/statistics & numerical data , Diabetes Mellitus/epidemiology , Hypertension/epidemiology , Brazil/epidemiology , Blood Glucose Self-Monitoring/statistics & numerical data , Cardiovascular Diseases/complications , Retrospective Studies , Risk Factors , Sex Distribution , Age Distribution , Diabetes Complications/diagnosis , Diabetes Complications/blood , Diabetes Complications/epidemiology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/blood , Home Care Services/statistics & numerical data , Hypertension/complications , Hypertension/diagnosis , Middle Aged
19.
Article in English | LILACS, BBO | ID: biblio-1101877

ABSTRACT

ABSTRACT The World Health Organization has emphasized that one of the most important questions to address regarding the covid-19 pandemic is to understand risk factors for disease severity. We conducted a brief review that synthesizes the available evidence and provides a judgment on the consistency of the association between risk factors and a composite end-point of severe-fatal covid-19. Additionally, we also conducted a comparability analysis of risk factors across 17 studies. We found evidence supporting a total of 60 predictors for disease severity, of which seven were deemed of high consistency, 40 of medium and 13 of low. Among the factors with high consistency of association, we found age, C-reactive protein, D-dimer, albumin, body temperature, SOFA score and diabetes. The results suggest that diabetes might be the most consistent comorbidity predicting disease severity and that future research should carefully consider the comparability of reporting cases, factors, and outcomes along the different stages of the natural history of covid-19.


Subject(s)
Humans , Male , Female , Pneumonia, Viral/epidemiology , Severity of Illness Index , Coronavirus Infections/epidemiology , Betacoronavirus , Risk Factors , Risk Assessment , Diabetes Complications , Pandemics , SARS-CoV-2 , COVID-19
20.
Article in English | LILACS, BBO | ID: biblio-1101870

ABSTRACT

ABSTRACT The coronavirus disease 2019 (covid-19) pandemic has caused a public health emergency worldwide. Risk, severity and mortality of the disease have been associated with non-communicable chronic diseases, such as diabetes mellitus. Accumulated evidence has caused great concern in countries with high prevalence of this morbidity, such as Brazil. This text shows the picture of diabetes in Brazil, followed by epidemiological data and explanatory hypothesis for the association between diabetes and covid-19. We emphasized how the burden of these two morbidities in a middle-income country has aggravated this pandemic scenario. The comprehension of this association and biological plausibility may help face this pandemic and future challenges.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Diabetes Complications/epidemiology , Diabetes Mellitus/epidemiology , Betacoronavirus , Pneumonia, Viral/physiopathology , Severity of Illness Index , Brazil/epidemiology , Cardiovascular Diseases/complications , Cardiovascular Diseases/physiopathology , Cardiovascular Diseases/epidemiology , Comorbidity , Prevalence , Risk Factors , Age Factors , Coronavirus Infections/physiopathology , Diabetes Complications/physiopathology , Diabetes Mellitus/physiopathology , Pandemics , SARS-CoV-2 , COVID-19 , Hypertension/complications , Hypertension/physiopathology , Hypertension/epidemiology , Middle Aged , Obesity/complications , Obesity/physiopathology , Obesity/epidemiology
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