Conhecimento e atitude sobre diabetes mellitus em pacientes hospitalizados / Knowledge and attitude about diabetes mellitus in hospitalized patients

Introdução: a educação em diabetes mellitus tem como objetivo orientar as pessoas e ajudar a enfrentar e atuar ativamente na prevenção de complicações que podem surgir com a doença. Objetivo: caracterizar os pacientes com diagnóstico de diabetes mellitus (DM) internados em um hospital terciário do Sul do Brasil por meio da análise dos seus escores de conhecimento e atitudes em relação à doença. Métodos: realizou-se um estudo transversal com 69 pacientes entre os meses de setembro de 2019 e janeiro de 2020. Para coleta de dados, foram utilizados três questionários: um sobre conhecimento do DM (DKN-A), outro acerca das atitudes psicológicas sobre a doença (ATT-19) e um último constituído por perguntas objetivas aplicadas por meio de entrevista, o qual avalia as características clínicas e sociodemográficas de cada paciente. Para a análise estatística, foram utilizados os testes qui-quadrado ou Exato de Fisher. Resultados: em relação ao questionário DKN-A, 49 pacientes avaliados (71%) obtiveram boa pontuação (escore superior a 8 pontos), a qual está associada a um bom conhecimento do DM. Verificou-se que esses pacientes realizavam acompanhamento médico do DM de forma mais regular, consultando, no mínimo, três vezes ao ano (p=0,036). 66 participantes (95,7%) apresentaram baixa pontuação no questionário ATT-19. Discussão: grande parte dos pacientes avaliados têm bom conhecimento sobre o DM, entretanto, a baixa pontuação no questionário ATT-19 apresentada pela maioria dos pacientes indica dificuldade de enfrentamento da doença. O acompanhamento médico mais regular do diabetes mellitus pode estar associado a maior envolvimento do paciente no tratamento da doença, assim como maior e mais frequente fluxo de informações entre médico e paciente.

Introduction: diabetes education aims to guide people and help to face and act actively in preventing complications that may arise with the disease. Aims: to characterize patients diagnosed with Diabetes Mellitus (DM) admitted to a tertiary hospital in southern Brazil through the analysis of their knowledge and attitudes towards the disease. Methods: a cross-sectional study with 69 patients was carried out between September 2019 and January 2020. For data collection, three questionnaires were used: one on knowledge of DM (DKN-A), another on psychological attitudes about the disease (ATT-19) and a last one consisting of objective questions applied through an interview, which assesses the clinical and sociodemographic characteristics of each patient. For statistical analysis, Chi-square or Fisher's exact tests were used. Results: regarding the DKN-A questionnaire, 49 patients evaluated (71%) obtained a good score (score greater than 8 points), which is associated with a good knowledge of DM. It was found that these patients underwent medical monitoring of Diabetes on a more regular basis, consulting at least three times a year (p = 0.036). Sixty-six participants (95.7%) had low scores on the ATT-19 questionnaire. Discussion: most of the patients evaluated have good knowledge about DM, however, the low score on the ATT-19 questionnaire presented by most patients indicates difficulty in coping with the disease. More regular medical monitoring of Diabetes may be associated with greater patient involvement in the treatment of the disease, as well as a greater and more frequent flow of information between doctor and patient.

Muscle depletion in cirrhotic patients assessed using computed tomography: a cross-sectional study.

BACKGROUND: Sarcopenia is a common complication in patients with cirrhosis and may lead to increased morbidity and mortality. OBJECTIVE: To investigate the prevalence of sarcopenia and its association with disease severity scores, among patients with cirrhosis. DESIGN AND SETTING: Observational and retrospective cohort study carried out in a tertiary-care hospital in southern Brazil. METHODS: This study was conducted among patients with chronic liver disease who were followed up at the gastroenterology and hepatology outpatient clinic of a tertiary-care hospital in southern Brazil and who underwent computed tomography scans of the abdomen through any indication. RESULTS: We included 83 patients in the study. In the population evaluated, there was a predominance of males (57.80%) and the mean age was 56 years. Hepatitis B or C virus was present in the genesis of the disease in 34.9% of the cases, followed by an etiology of alcohol abuse (30.1%). Sarcopenia was diagnosed in 41 (49.4%) of the patients when the cutoff point for cirrhotic patients was used. There was no significant correlation between the Child-Pugh and MELD severity scores and the occurrence of sarcopenia. CONCLUSION: Sarcopenia presents high prevalence among patients with chronic liver disease, without any association with predictors of severity.

Muscle depletion in cirrhotic patients assessed using computed tomography: a cross-sectional study

ABSTRACT BACKGROUND: Sarcopenia is a common complication in patients with cirrhosis and may lead to increased morbidity and mortality. OBJECTIVE: To investigate the prevalence of sarcopenia and its association with disease severity scores, among patients with cirrhosis. DESIGN AND SETTING: Observational and retrospective cohort study carried out in a tertiary-care hospital in southern Brazil. METHODS: This study was conducted among patients with chronic liver disease who were followed up at the gastroenterology and hepatology outpatient clinic of a tertiary-care hospital in southern Brazil and who underwent computed tomography scans of the abdomen through any indication. RESULTS: We included 83 patients in the study. In the population evaluated, there was a predominance of males (57.80%) and the mean age was 56 years. Hepatitis B or C virus was present in the genesis of the disease in 34.9% of the cases, followed by an etiology of alcohol abuse (30.1%). Sarcopenia was diagnosed in 41 (49.4%) of the patients when the cutoff point for cirrhotic patients was used. There was no significant correlation between the Child-Pugh and MELD severity scores and the occurrence of sarcopenia. CONCLUSION: Sarcopenia presents high prevalence among patients with chronic liver disease, without any association with predictors of severity.

Prevalência de sobrepeso e obesidade em crianças e adolescentes de uma unidade básica de saúde em Canoas, Rio Grande do Sul, e comparação do diagnóstico nutricional entre os gráficos do CDC 2000 e da OMS 2006 / Prevalence of overweight and obesity in children and adolescents in a healthcare unit from Canoas, Rio Grande do Sul, Brazil, and comparison of the nutritional diagnosis between the CDC 2000 and WHO 2006 growth charts

Objetivos: verificar a prevalência de sobrepeso e obesidade em crianças e adolescentes em uma unidade básica de saúde de Canoas, Rio Grande do Sul, e comparar o diagnóstico nutricional entre os gráficos do Centers for Disease Control and Prevention (CDC) 2000 e da Organização Mundial da Saúde (OMS) 2006. Métodos: um estudo transversal descritivo incluiu pacientes com idade entre 5 e 18 anos, selecionados através de revisão de prontuários, com última consulta médica no período entre junho de 2007 e junho de 2008. Foi avaliado o índice de massa corporal por idade e gênero e classificado o estado nutricional segundo curvas padrões.Resultados: dos 272 pacientes analisados, 53,8% eram adolescentes e 56,9% eram do sexo feminino. A prevalência de sobrepeso foi de 14,4% pelo CDC e de 18,4% pela OMS; a de obesidade, 15,6% pelos dois critérios, totalizando uma prevalência de excesso de peso de 30% ou 33,8%, conforme o gráfico utilizado. Comparando-se o excesso de peso entre os gêneros, não houve diferença estatisticamente significativa.Conclusões: a prevalência de excesso de peso neste estudo foi superior à encontrada em outros estudos semelhantes. Não foi encontrada maior frequência de obesidade em meninos do que em meninas, ao contrário de dados da literatura. Quando comparada à curva da OMS 2006, a do CDC 2000 subestimou o diagnóstico de sobrepeso e superestimou o de baixo peso.

Aims: To determine the prevalence of overweight and obesity in children and adolescents in a healthcare unit in Canoas, Rio Grande do Sul, and to compare the nutritional diagnosis between the Centers for Disease Control and Prevention (CDC) 2000 and World Health Organization (WHO) 2006 growth charts.Methods: A descriptive cross-sectional study included patients from 5 to 18 years old, selected through review of the medical records, in which the last appointment with the consulting physician in the healthcare unit was between June 2007 and July 2008. Body mass index was assessed and analyzed by age and sex, and nutritional status was classified according to standard curves.Results: Of the 272 patients included, 53.8% were teenagers and 56.9% were female. Prevalence of overweight was 14.4% by CDC charts and 18.4% by WHO charts. Prevalence of obesity was 15.6% according to both criteria, accounting for a total prevalence of excess weight of 30% or 33.8%. When genders were compared, prevalence of weight excess had no statistically significant difference. Conclusions: Prevalence of weight excess in this study was superior to those found in other similar studies. Unlike data from previous studies, boys did not have higher incidence of obesity when compared to girls in this study. When compared to the WHO 2006 chart, the CDC 2000 chart underestimated overweight and overestimated low weight.

Síndrome de Walker-Warburg / Walker-Warburg syndrome

A síndrome de Walker-Warburg (SWW) é uma doença autossômica recessiva rara, caracterizada por distrofia muscular congênita e associada a malformações cerebrais e oculares. Pode ser suspeitada ainda no pré-natal e o diagnóstico é firmado ao nascimento através de alterações clínicas e patológicas. O objetivo deste trabalho é relatar o caso de uma paciente com 3 meses de vida portadora de SWW. A SWW é uma síndrome severa e letal, diagnosticada através de quatro critérios: distrofia muscular congênita, anormalidades oculares, lissencefalia tipo II e malformação cerebelar. Seu tratamento visa apenas ao suporte e à prevenção de complicações. Pacientes com esta doença geralmente vão a óbito ainda no primeiro ano de vida

The Walker-Warburg syndrome (WWS) is a rare autosomal recessive disorder characterized by congenital muscular dystrophy and associated with cerebral and ocular malformations. It may be suspected even in the prenatal period and the diagnosis is made at birth through clinical and pathological characteristics. The aim of this study is to report the case of a 3-month-old with WWS. The WWS is a severe and lethal syndrome that is diagnosed by four criteria: congenital muscular dystrophy, ocular abnormalities, type II lissencephaly, and cerebellar malformation. Its treatment is only supportive and intended to prevent complications. Patients with this disease usually will die within the first year of life

Schmid-Fraccaro syndrome: severe neurologic features.

Schmid-Fraccaro syndrome is a rare genetic disease, characterized by modifications of chromosome 22 (partial trisomy or tetrasomy), accompanied by eye abnormality (coloboma) and anal atresia. Clinical and phenotypic features are variable, and neurologic disturbance with delays of mental, psychologic, and motor development may be present. Its definitive diagnosis is based on karyotype. We report on a 17-year-old girl with Schmid-Fraccaro syndrome and severe cognitive deficits and motor deficits, who presented at our healthcare unit for a medical consultation. Her physical examination was remarkable for bilateral coloboma of the iris, hypertelorism, bilateral preauricular tags, scoliosis, and cardiac systolic murmur. After her birth, she was evaluated for anal atresia and congenital cardiac disease, which led to a genetic investigation and a diagnosis of Schmid-Fraccaro syndrome. Life expectancy in Schmid-Fraccaro syndrome depends on the number and variety of malformations, but in most cases the prognosis is favorable.

Perfil dos pacientes adultos atendidos em ambulatório de reumatologia em um hospital geral em Porto Alegre – RS / Characteristics of adult persons consulting in an outpatient rheumatology office in a general hospital in Porto Alegre – RS

Introdução: O conhecimento do perfil dos pacientes atendidos em um serviço médico é de fundamental importância para o planejamento de ações preventivas e curativas. As doenças reumáticas são reconhecidas pela cronicidade das queixas e grande morbidade que as acompanham, acarretando grande prejuízo em qualidade de vida e custo elevado para os sistemas de saúde. Objetivo: Verificar o perfil dos pacientes adultos atendidos no ambulatório de reumatologia do Complexo Hospitalar Santa Casa de Porto Alegre, RS. Métodos: Estudo ransversal descritivo, realizado através da aplicação de questionário na primeira consulta de pacientes atendidos no ambulatório de Reumatologia da Santa Casa, em período de seis meses. Resultados: Foram entrevistados 276 pacientes com média de idade de 52,5 anos, sendo 77,5% do sexo feminino e 56% procedentes de Porto Alegre. O tempo de ocorrência das queixas era de mais de um ano em 34,8% dos questionados, sendo que 12,7% tinham doença por tempo maior do que cinco anos. Trinta e quatro por cento dos pacientes já haviam buscado reumatologista previamente, sendo que 37,5% destes já haviam consultado cinco ou mais vezes pela mesma queixa. Médicos de outras especialidades foram procurados por 66%, sendo os traumatologistas os mais prevalentes (52%). Conclusão: Doenças articulares representam a segunda principal causa de incapacidade para o trabalho e o custo anual no atendimento desses pacientes repercute fortemente sobre os serviços de saúde. O investimento em políticas de saúde pública, com ações preventivas e curativas parte do conhecimento do perfil dos pacientes atendidos em determinado serviço de saúde.

Introduction: Knowledge of the profile of patients cared for at a medical service is critical for planning preventive and therapeutic strategies. Rheumatic diseases are known for the chronicity of complaints and associated high morbidity, leading to decreased quality of life for the patients and elevated costs for the health systems. Aim: To determine the profile of adults patients cared for at a rheumatology service of the Hospital Complex Santa Casa of Porto Alegre, RS. Methods: This is a descriptive cross-sectional study carried out through the application of a questionnaire responded by outpatients at their first visit to the above-mentioned rheumatology service during 6 months. Results: 276 patients (mean age = 52.5 years) were interviewed, of whom 77.5% were females and 56% lived in Porto Alegre. The reported beginning of complaints were older than one year among 34.8% of the sample, and 12.7% had the disease for longer than 5 years. 34% of the respondents had consulted with a rheumatologist in the past, and among these, 37.5% had already consulted five or more times because of the same complaint. Physicians of specialties other than rheumatology were consulted by 66% of the patients, traumatologists being the most prevalent ones (52%). Conclusion: Joint disorders are the second leading cause of disability for work, and the annual cost for caring for these patients exacts a heavy toll from health systems. The investment in public health policies, with preventive and therapeutic strategies, should start from knowledge of the profile of patients cared for at a particular health service.

Educação e vulnerabilidade a doenças sexualmente transmissíveis/HIV entre militares em um quartel em Porto Alegre, RS / Education and vulnerability to sexually transmitted diseases/HIV among members of a military unit in Porto Alegre, RS

Introdução: As doenças sexualmente transmissíveis (DST) são assunto frequente nos diversos veículos de informação, acessíveis a todas as faixas etárias e classes sociais, e alvo de campanhas de divulgação, educação e prevenção, motivadas pela grande relevância deste grupo de doenças em matéria de saúde pública. Apesar disso, ainda são crescentes os casos de DST em serviços de atendimento primário de saúde, o que põe em questionamento as razões para tal incapacidade de controle destas doenças. Objetivo: O presente trabalho teve por objetivo verificar o conhecimento dos soldados recrutas de um quartel em Porto Alegre, RS, acerca da transmissão do vírus da imunodeficiência humano (HIV), bem como verificar a ocorrência de práticas comportamentais de risco para transmissão ou aquisição de DST. Métodos: Após aprovação do projeto por comitê de ética em pesquisa, autorização pelo comandante da organização militar selecionada e consentimento dos sujeitos da pesquisa, foi aplicado um questionário semi-estruturado a 195 soldados incorporados no ano de 2007 em um quartel em Porto Alegre, RS. Resultados: Os resultados deste trabalho mostram que embora exista adequado conhecimento sobre as formas de transmissão do vírus HIV pela maioria dos entrevistados, há ocorrência de comportamentos de risco, como a prática de sexo sem preservativos nas relações sexuais, e há referência à percepção de que a ocorrência de DST é pouco possível em suas vidas. Conclusões: Infere-se, com base nestes resultados, que embora haja conhecimento correto sobre as formas de transmissão de DST pela população estudada, há falta de comprometimento e responsabilidade ao não praticar sexo de forma segura.

Background: Sexually transmitted diseases (STD) are frequently discussed in the news and midia - easily accessed by people at any age and social cast – and have been the purpose of several campaigns, educational and prevention programs, once it is a huge concern in public health matters. Despite that, cases of STD are still rising in primary attention centers, what stimulates questions on the reason why it is so difficult to control it. Aim: The present paper aimed to verify the knowledge on STD/Human Immunodeficiency Virus (HIV) transmission and patterns of sex behavior among recruited soldiers of a military unit in Porto Alegre, RS. Methods: After approval of the ethics review board and the commandant of the military unit, an informed consent was obtained from the 195 subjects of the survey before application of a questionnaire containing topics on STD. Results: The results showed that despite an adequate knowledge on the transmission of STD/HIV, there are still a great number of risky attitudes in sex behavior, like the practice of sex without condoms, and a low chance self-perception for getting sick with a STD. Conclusions: The authors question the reason of the lack of commitment and responsibility among the population studied, once it was noted a correct perception on the transmission of STD/HIV.

Necrobiose lipoídica diabeticorum: relato de caso / Necrobiosis lipoidica diabeticorum: case report

O diabete melito (DM) é um distúrbio endocrinológico bastante prevalente na popula- ção e caracteriza-se pelo estado hiperglicêmico patológico e crônico, ao qual surgem diversas manifestações sistêmicas e grande prejuízo à qualidade de vida a longo prazo. A necrobiose lipoídica diabeticorum é uma dermatose rara, porém característica e marcadora do DM, podendo ser precursora da enfermidade. Clinicamente apresenta-se com máculas ou placas de forma oval ou irregular, confluentes, com uma área central atrófica e/ou depressiva, com telangectasias, sendo inicialmente eritematosa e, posteriormente, de coloração amarelada. Embora não desencadeie sintomas aos pacientes, pode causar complicações secundárias a traumas ou infecções e desconforto estético. Não há consenso quanto ao tratamento, de modo que muitas medicações são sugeridas, com resultados controversos, mas promissores (AU)

Diabetes mellitus (DM) is a highly prevalent endocrinological disease among the general population. It is featured by chronic and pathological hyperglycemia, which may result in systemic manifestations and great loss of quality of life in the long run. Although necrobiosis lipoidica diabeticorum (NLD) is a rare dermatosis, it is commonly associated with DM and can be a precursor of it. Clinically seen as confluent, irregular oval maculae or papules, with an atrophic and/or depressed central area and telangiectasis, NLD begins as erythematous lesions which eventually become yellowish. Although NLD does not cause symptoms in the patient, it may lead to secondary complications due to trauma or infection and aesthetic discomfort. As yet there is no standard treatment for NLD, and so plenty of medications have been suggested, with controversial but promising results (AU)