822 resultados para Diabetes Mellitus Tipo 2


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A retinopatia e a nefropatia estão entre as mais prevalentes e incapacitantes complicações secundárias a dano microvascular no diabete melito. A gravidade da hiperglicemia e a presença de hipertensão arterial sistêmica estão entre os principais fatores de risco para essas complicações. A monitorização ambulatorial da pressão arterial (MAPA) permitiu uma melhor compreensão dos padrões de variação da pressão arterial em pacientes diabéticos. Vem se acumulando evidências de que pacientes com diabetes podem apresentar padrões alterados da homeostase pressórica durante as 24h. Mesmo pequenas alterações da homeostase pressórica podem estar implicadas no aumento de risco de complicações microvasculares, incluindo pacientes considerados normotensos na avaliação da pressão arterial por aferição em consultório. Essas alterações pressóricas associadas à hiperglicemia, podem produzir perda da auto-regulação dos vasos retinianos, acelerando ou agravando a retinopatia diabética. Provavelmente a MAPA poderá se tornar um instrumento de avaliação clínica útil em pacientes diabéticos normotensos, auxiliando no processo de identificação precoce de pacientes em risco de desenvolvimento de complicações microangiopáticas. O objetivo desse artigo é fornecer uma revisão atualizada e orientada para a clínica sobre homeostase pressórica e diabetes.

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This study assessed the level of knowledge, attitude and practice of Pap smear and human papillomavirus (HPV), in addition to analyzing the prevalence of genital HPV infection, Herpes Simplex Type 2 (HSV-2) and Chlamydia trachomatis in teenagers. The study consisted of two approaches, one based only on interviews conducted with adolescents enrolled in public schools or in public health facilities in the city of Natal. The other approach involved only a group of 132 adolescents enrolled among those admitted to two health units in Natal-RN. This second group of participants two specimens were collected for laboratory analysis: one was directed to prepare the blade for the Pap test, and other processed for DNA extraction for molecular analysis, focusing on the detection of HPV, HSV-2 and C . trachomatis. The presence of DNA of the three pathogens was investigated by the technique of polymerase chain reaction (PCR). The presence of each of the three pathogens was analyzed in terms of socio-demographic characteristics, as well as sexual and reproductive activity to identify risk factors for infection and development of lesions of the uterine cervix. The results show that the adolescents in this study had levels of knowledge and attitude very low, both in relation to cytology to HPV as though they have made a reasonable percentage of adequate practice exam and prevention of HPV infection. The overall prevalence of HPV infection was 54.5% and 48.2% in adolescents with normal cytology and 86.4% in those with abnormal cytology. We observed a higher proportion of cases of infection in the age group of 18 to 21. The prevalence of HPV infection was slightly higher among pregnant teenagers. The overall prevalence of HSV-2 infection was 13.6% and 11.8% in women with normal cytology and 22.7% in those with abnormal cytology. A higher proportion of cases of infection was found in the age group from 14 to 17, with a slightly higher prevalence among pregnant women. The C. trachomatis was found with an overall prevalence of 19.7% and 21.8% in adolescents with normal cytology and 9.1% in those with abnormal cytology. The prevailing rate was highest in the age group 18 to 21 years and in nonpregnant

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TNF microsatellite and HLA class II polymorphisms were studied in 28 recently diagnosed Brazilian patients presenting type 1 diabetes mellitus (T1DM) and in 120 healthy controls. TNFa-e and HLA-DRB1/DQB1 alleles were identified using sets of sequence-specific primers. Compared to controls, the DRB1* 03 and DQBI*02 allele groups, TNFa1 allele, and the TNFa4-b5-c1-d4-e3 and TNFa10-b5-c1-d4-e3 haplotypes were overrepresented in patients. TNF microsatellite together with HLA polymorphisms is associated with type 1 diabetes in Brazilian patients, corroborating the participation of the MHC genes in disease susceptibility.

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Popular Health Education in its emancipatory dimension refers to individuals and groups to exchange knowledge and experiences, allowing them to associate health to the outcomes of their living conditions. Under this view, health workers and health users are subjects of the educative process. Thus, this study aims to identify the key clinical and socio sanitary attributes and promote educational activities with patients with Diabetes Mellitus (DM) in a Family Health Care Unit of the Western Sanitary District, in the city of Natal / RN. It is an action research which uses the references of the Theory of Liberating Education, which is based on a problem-solving pedagogy and that values dialogue in the process of understanding oneself and the world. Thirty-six diabetics, who are residents of the area covered by the health care unit, and thirty health workers participated in the survey. Each group had an average of twelve participants, and the meetings took place at the Unit´s hall, using conversation wheels, group dynamics, life narratives, experiences telling, movie exhibition and discussions, music, knowledge telling, desires, limitations, beliefs and values socially constructed. Data collection took place during the second half of two thousand and thirteen through Free Word Association Technique (FWAT), recordings of conversation wheels, participative observation, group dynamics, testimonies, questionnaires, life narratives and photographs. The empirical material was organized and subjected to three analyzes: thematic content (Bardin), textual statistics analysis by software IRAMUTEQ (Ratinaud), and photographic analysis (Edmund Feldman). The data analyses originated words, expressions, categories, themes and creative situations showing that popular health education is in process of construction, but still very incipient in primary care. The National Policy on Popular Health Education shows us the necessary ways for the transformation of health practices and the build of a more shared and solidary society. The meetings could be place to reverse that normative logic that has been happening over the years in primary care, but that by itself is not enough. It is possible to conclude that the use of active practices, increasing of listening and training on Popular Health Education will enable changes in the scenario where users and health workers deal with diabetes mellitus. Thus we see the popular health education is being timidly incorporated to the educational process of the subjects involved in this study, and far away from the principles of participation, organization of political work, increase opportunities for dialogue, respect, solidarity and tolerance among different actors involved in addressing the health problems that are fundamental to the improvement in building healthy practices of primary care

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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OBJETIVO: Avaliar a freqüência de hipertensão arterial (HA) em mulheres, após 3 a 12 anos da gestação-alvo e na época, classificadas em um dos 4 grupos: TGN: tolerância à glicose normal; HDG: hiperglicemia diária gestacional; DMG: diabetes melito gestacional; DMG e HDG. MÉTODOS: de 3.113 gestantes, participaram 535 mulheres selecionadas por processo aleatório e proporcional ao número em cada grupo. As mulheres TGN diferiam das demais na maioria das características clínicas consideradas. Mediu-se a pressão arterial de todas as participantes. Utilizaram-se os testes de Goodman e do qui-quadrado. RESULTADOS: A freqüência de HA foi maior nas mulheres DMG e HDG que nas TGN (40,9 vs. 23,6%; P<0,05) e intermediária, semelhante entre si e às anteriores, nas HDG e nas DMG (28,3 e 31,2%, respectivamente). Ter sido do grupo DMG e HDG dobra o risco para HA. CONCLUSÃO: Mulheres com passado de DMG e HDG têm risco aumentado para HA, além daquele para o diabetes.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)