Precipitating factors of diabetic ketoacidosis at a public hospital in a middle-income country.

AIMS: To study precipitating factors of diabetic ketoacidosis (DKA) at a public hospital in a middle-income country. METHODS: Eighty patients with type 1 diabetes who had an emergency hospitalization for DKA between January 2005 and March 2010 at a tertiary care teaching hospital in Southern Brazil were studied. Data were collected by reviewing medical records and telephone calls. Treatment non-adherence was defined as the precipitating factor if there was diet abuse or insulin therapy noncompliance without identifiable infection. RESULTS: The mean age of patients was 26±13 years. The majority (91.5%) of the patients had unsatisfactory metabolic control before the hospitalization. The most common DKA precipitating factor was treatment non-adherence: 39% of cases when all patients were evaluated and 49% when only patients with previous type 1 diabetes diagnosis were analyzed. Comparison between patients with DKA precipitated by treatment non-adherence and by other causes showed that the former group had more episodes of previous DKA and more frequently reported insulin omission previous to DKA. CONCLUSIONS: Treatment noncompliance is the leading precipitating factor of DKA in Southern Brazil. Further efforts to reduce the occurrence of DKA should focus on patients with prior reports and evidence of treatment non-adherence.

[Prevalence of the use of anabolic agents among strength training apprentices in Porto Alegre, RS]. / Prevalência do uso de agentes anabólicos em praticantes de musculação de Porto Alegre.

This study aimed to determine through a questionnaire applied to interviewers, the current or past use of anabolic androgenic steroids (AAS), as well as other hormones (OH), and other medicines (OM), food supplement and illicit drugs among strength training apprentices in the city of Porto Alegre, RS. We interviewed 288 subjects draw from a sample of 13 gyms. The prevalence of current and past use of AAS was about 11.1% (32/288), OH 5.2% (16/288) and OM 4.2% (12/288). The most used AAS were nandrolone and stanozolol; the OH were gonadotropin, triiodothyronine (T3) and OM, like lipostabil, diuretics and veterinary medicines (Monovin E). The most frequent side-effects were behavioral such as humor oscillation, irritability and hostility, and endocrine disturbances such as acne and increased or decreased libido. When analyzed together with other hormones in a variable named "hormonal agents" (AH), AAS presented a statistical difference (p< 0.05) among genders considering that the most frequent use of AH occurred among men and those who consume food supplements. The comparison of these findings to other national and international results is difficult due to the epidemiological design. Even if it is considered, the observed prevalence suggests that preventive attitudes as well as special care in the orientation and education of this population must be taken.

Prevalência do uso de agentes anabólicos em praticantes de musculação de Porto Alegre / Prevalence of the use of anabolic agents among strength training apprentices in Porto Alegre, RS

Este estudo procura determinar, através de questionário realizado por entrevistadores, a prevalência do uso atual ou passado de esteróides anabólicos androgênicos (EAA), outros hormônios (OH), outros medicamentos (OM) e outras substâncias (suplementos alimentares e drogas ilícitas) em praticantes de musculação da cidade de Porto Alegre, entrevistando 288 indivíduos sorteados de uma amostra de 13 academias. A prevalência observada foi de 11,1 por cento (32/288) para EAA, 5,2 por cento (16/288) para OH e 4,2 por cento (12/288) para OM. Os EAA mais usados foram decanoato de nandrolona e estanozolol. Os OH foram gonadotrofina coriônica humana, triiodotironina e OM como lipostabil, diuréticos e medicamentos veterinários (ex.: Monovin E). Os efeitos colaterais mais freqüentes foram comportamentais (variação de humor, irritabilidade e agressividade) e endócrinos (acne e aumento/ diminuição da libido). Quando analisados os EAA juntamente aos OH na variável denominada "agentes hormonais" (AH), observamos diferença estatística (p< 0,05) entre os sexos, sendo o uso de AH mais prevalente em homens e entre os consumidores de suplementos alimentares. Comparar este estudo a outros é difícil, pois existe diferença no desenho epidemiológico. Entretanto, a alta prevalência observada sugere a necessidade de medidas preventivas, educativas e de cuidados na assistência desta população.

This study aimed to determine through a questionnaire applied to interviewers, the current or past use of anabolic androgenic steroids (AAS), as well as other hormones (OH), and other medicines (OM), food supplement and illicit drugs among strength training apprentices in the city of Porto Alegre, RS. We interviewed 288 subjects draw from a sample of 13 gyms. The prevalence of current and past use of AAS was about 11.1 percent (32/288), OH 5.2 percent (16/288) and OM 4.2 percent (12/288). The most used AAS were nandrolone and stanozolol; the OH were gonadotropin, triiodothyronine (T3) and OM, like lipostabil, diuretics and veterinary medicines (Monovin E). The most frequent side-effects were behavioral such as humor oscillation, irritability and hostility, and endocrine disturbances such as acne and increased or decreased libido. When analyzed together with other hormones in a variable named "hormonal agents" (AH), AAS presented a statistical difference (p< 0.05) among genders considering that the most frequent use of AH occurred among men and those who consume food supplements. The comparison of these findings to other national and international results is difficult due to the epidemiological design. Even if it is considered, the observed prevalence suggests that preventive attitudes as well as special care in the orientation and education of this population must be taken.