Efeitos da simpaticotomia endoscópica sobre as artérias carótidas e vertebrais na terapêutica cirúrgica da hiperidrose primária

Analisar, em pacientes submetidos a simpaticotomia videotoracoscópica para tratamento da Hiperidrose Primária (HP), as conseqüências hemodinâmicas da desnervação vascular das artérias carótidas e vertebrais após a trans-secção cirúrgica da cadeia simpática torácica (simpaticotomia), através da mensuração de parâmetros ultra-sonográficos. Método: Vinte e quatro pacientes portadores de HP submetidos a quarenta e oito simpaticotomias torácicas endoscópicas foram avaliados através da mensuração da velocidade de pico sistólico (VPS), velocidade de pico diastólico (VPD), índice de pulsatibilidade (IP) e índice de resistência (IR) nas artérias carótidas comuns, internas e externas, além da artéria vertebral bilateralmente usando o eco-doppler duplex scan. As avaliações foram realizadas antes da intervenção cirúrgica e trinta dias após o procedimento. O teste de Wilcoxon foi usado na análise das diferenças entre as variáveis antes e depois da simpaticotomia. Resultados: A simpaticotomia no nível de T3 foi a trans-secção mais realizada (95,83%), seja isoladamente (25%) ou associada a T4 (62,50%) ou a T2 (8,33%). Houve aumento significativo no IR e no IP da artéria carótida comum bilateralmente (p<0,05). A VPD da artéria carótida interna diminuiu em ambos os lados (p<0,05). A VPS e a VPD da artéria vertebral direita também aumentaram (p<0,05). Achados assimétricos foram observados, de modo que artérias do lado direito foram as mais freqüentemente afetadas. Conclusões: Alterações hemodinâmicas foram observadas nas artérias vertebral e carótida após simpaticotomia para tratamento de HP. VPS foi o parâmetro mais freqüentemente alterado, principalmente nas artérias do lado direito, representando alterações assimétricas significantes nas artérias carótida e vertebral. Entretanto, são necessárias pesquisas subseqüentes para verificar se essas alterações são definitivas ou temporárias, uma vez que as inferências clínicas somente terão validação se as alterações forem permanentes

Análise imunoistoquímica após terapia fotodinâmica com cloro-alumínio ftalocianina em tecidos gengivais de humanos

Although photodynamic therapy have been used as a useful tool over the past 30 years in oncology, few clinical trials have been conducted in dentistry. Photodynamic therapy (PDT) uses non - toxic photosensitizers and selective which are administered in target cells followed by local application of visible light, producing reactive oxygen species capable of causing cell death by apoptosis or necrosis, injured the local vasculature, and exert important effects on the im mune system. New generations of photosensitizing agents, such as nanoparticulate phthalocyanines, has shown excellent results in antitumor and antibacterial activity . In this context, the present work constitutes the first clinical protocol of local appli cation of nanoemulsion chloro - aluminum phthalocyanine (AlClFc) followed by irradiation in human gingiva, and analyzed descriptively and comparatively , by means of immunohistochemistry , the expression of RANK , RANKL , OPG and VEGF in a split - mouth model . Eight healthy volunteers with clinical indication for extraction were included in the study . Seven days before the extraction, was injected in the gingiva of participants, 5 μ M of nanoemulsion AlClFc followed by irra diation with diode laser (660nm , 7 J/cm2 ), the contralateral side was used as control. Tissue specimens were removed seven days after the TFD is performed. Tissues sample were divided into two groups (test and con trol groups) for histological and immunohistochemical analysis. Patients were monitored at days, 0, 7, 14 and 30 to assess adverse effects of the therapy. Vascular alterations were seen in gingival samples that received PDT. Areas of edema and vascular con gestion, and intense vascularization were viewed . Additionally, dystrophic calcification in subepithelial region were observed in the test group. The results showed a similar pattern of immunostaining scores of RANK, RANKL and VEGF between the test and co ntrol groups, with no statistically significant difference (p = 0.317, p = 0.777, p = 0 .814, respectively). RANK and RANKL exhibited weak or absent immunostaining in most specimens analyzed. There was n o immunostaining for OPG. VEGF showed moderate to stro ng immunostaining in specimens from the test group. In addition, the clinical study showed that therapy was well tolerated by all patients. Adverse effects were short - time and completely reversible. Taken together, the results presented in this study showe d that PDT mediated by nanoemulsion containing AlClPc is safe for clinical application in gingival tissue and suggests that a strong immunostaining for VEGF after therapy .

Efeitos da simpaticotomia endoscópica sobre as artérias carótidas e vertebrais na terapêutica cirúrgica da hiperidrose primária

Analisar, em pacientes submetidos a simpaticotomia videotoracoscópica para tratamento da Hiperidrose Primária (HP), as conseqüências hemodinâmicas da desnervação vascular das artérias carótidas e vertebrais após a trans-secção cirúrgica da cadeia simpática torácica (simpaticotomia), através da mensuração de parâmetros ultra-sonográficos. Método: Vinte e quatro pacientes portadores de HP submetidos a quarenta e oito simpaticotomias torácicas endoscópicas foram avaliados através da mensuração da velocidade de pico sistólico (VPS), velocidade de pico diastólico (VPD), índice de pulsatibilidade (IP) e índice de resistência (IR) nas artérias carótidas comuns, internas e externas, além da artéria vertebral bilateralmente usando o eco-doppler duplex scan. As avaliações foram realizadas antes da intervenção cirúrgica e trinta dias após o procedimento. O teste de Wilcoxon foi usado na análise das diferenças entre as variáveis antes e depois da simpaticotomia. Resultados: A simpaticotomia no nível de T3 foi a trans-secção mais realizada (95,83%), seja isoladamente (25%) ou associada a T4 (62,50%) ou a T2 (8,33%). Houve aumento significativo no IR e no IP da artéria carótida comum bilateralmente (p<0,05). A VPD da artéria carótida interna diminuiu em ambos os lados (p<0,05). A VPS e a VPD da artéria vertebral direita também aumentaram (p<0,05). Achados assimétricos foram observados, de modo que artérias do lado direito foram as mais freqüentemente afetadas. Conclusões: Alterações hemodinâmicas foram observadas nas artérias vertebral e carótida após simpaticotomia para tratamento de HP. VPS foi o parâmetro mais freqüentemente alterado, principalmente nas artérias do lado direito, representando alterações assimétricas significantes nas artérias carótida e vertebral. Entretanto, são necessárias pesquisas subseqüentes para verificar se essas alterações são definitivas ou temporárias, uma vez que as inferências clínicas somente terão validação se as alterações forem permanentes

Prevalência de alterações fundoscópicas em estudantes na cidade de Natal/Brasil

Objetivo: Determinar a prevalência de alterações fundoscópicas em estudantes de escolas das redes pública e privada de Natal-RN. Métodos: Avaliação oftalmológica foi realizada em 990 alunos, de 5 a 21 anos, matriculados nas escolas das redes públicas e privada do município de Natal- RN, que estiveram cursando alguma série do ensino fundamental ou médio, no período de 03 a 06 de 2001. Resultados: Alterações fundoscópicas foram observadas em 5,3% dos estudantes. As anormalidades encontradas, por ordem de freqüência, foram: branco sem pressão, 1,0%; cicatriz de retinocoroidite sugestiva de toxoplasmose, 1,0%; atrofia do epitélio pigmentado da retina, 0,8%; nevos da coróide, 0,4%; escavação da cabeça do nervo óptico aumentada, 0,4%; degeneração em treliça, 0,3%; buraco operculado, 0,2%; fundus miópico, 0,2%; tortuosidade vascular aumentada, 0,2%; granuloma sugestivo de toxocaríase, 0,2%; hipoplasia da cabeça do nervo óptico, 0,1%; persistência da artéria hialoidea, 0,1%; persistência de fibras de mielina, 0,1%; retina sal e pimenta, 0,1%; retinosquise, 0,1%. Conclusão: Houve uma baixa prevalência de alterações fundoscópicas na população estudada

Achados da fundoscopia e alterações do pé diabético em pacientes do Hospital Universitário Onofre Lopes/UFRN

Trabalho com o objetivo de identificar as alterações do pé diabético causadas pelas lesões microangiopáticas e das lesões do fundo de olho secundárias aretinopatia diabética. Métodos:76 pacientes com Diabetes Melito tipos 1 e 2atendidos no ambulatório de Oftalmologia e Cirurgia Vascular do HUOL/UFRN, Natal, RN, no período de novembro de 2004 a janeiro de 2005, com queixas relativas a alterações da retinopatia diabéticae/oudo pé diabético. Em todos os pacientes foi realizado exame clínico geral, vascular e oftalmológico. Na avaliação específicado pé diabético deu-se ênfase paraa investigação do status vascular pela Classificação de Fontaine para Doença Arterial Obstrutiva Periférica, biomecânica,e teste do monofilamento de Semmes-Weinstein. O exame oftalmológico constou de refração e fundoscopiaatravés da qual identificou-se as formas clínicas da retinopatia diabética. Os dados foram submetidos à análise estatística das variáveis primárias que consistiu em caracterizar o grupo quanto a idade, tempo de doença, nível de glicose A segunda estratégia da análise dos dados constituiu na realização de testes de associação entrealgumas variáveis secundárias selecionadas. O software utilizado para os testes estatísticos foi o Statistica Versão 5, 1997.Resultado: Dos 76 pacientes diabéticos 97% tinham idade superior a 40 anos. O tempo de doença65% tinham mais de 10 anos. Com relação à glicose 72,72% apresentaram níveis de glicose em jejum acima de 100mg/dl. 55,26% apresentavam algum grau de retinopatia diabética contra 44,74% que não apresentavamesses sinais. Com as alterações do pé diabético, identificou-se 59,93% com lesões com área de predominância isquêmica, enquanto 41,07% tinham ausência de sinais. 58,82% apresentaram área de predominância neuropática, e 41,18% sem sinais de neuropatia. Dos com retinopatia diabética 78,57% tinham comprometimento isquêmico no pé e 47,62% tinham algum grau de neuropatia diabética. Observou-se que a retinopatia diabética não proliferativa, nos seus diversos graus de comprometimento apresentou-se com percentuais em torno de 80% junto às lesões do pé diabético, seja isquêmico ou neuropático. Dos pacientes que tinham retinopatia 60,46% tinham alterações biomecânicas dos pés. Conclusão: Concluiu-se que a RDNP leve foi mais freqüente nas lesões do pé diabético isquêmico, enquanto a RDNP severa mostrou-se mais presente no pé diabético neuropático

Prevalência de alterações fundoscópicas em estudantes na cidade de Natal-Brasil

Objetivo: Determinar a prevalência de alterações fundoscópicas em estudantes de escolas das redes pública e privada de Natal-RN. Métodos: Avaliação oftalmológica foi realizada em 990 alunos, de 5 a 21 anos, matriculados nas escolas das redes públicas e privada do município de Natal-RN, que estiveram cursando alguma série do ensino fundamental ou médio, no período de 03 a 06 de 2001. Resultados: Alterações fundoscópicas foram observadas em 5,3% dos estudantes. As anormalidades encontradas, por ordem de freqüência, foram: branco sem pressão, 1,0%; cicatriz de retinocoroidite sugestiva de toxoplasmose, 1,0%; atrofia do epitélio pigmentado da retina, 0,8%; nevos da coróide, 0,4%; escavação da cabeça do nervo óptico aumentada, 0,4%; degeneração em treliça, 0,3%; buraco operculado, 0,2%; fundus miópico, 0,2%; tortuosidade vascular aumentada, 0,2%; granuloma sugestivo de toxocaríase, 0,2%; hipoplasia da cabeça do nervo óptico, 0,1%; persistência da artéria hialoidea, 0,1%; persistência de fibras de mielina, 0,1%; retina sal e pimenta, 0,1%; retinosquise, 0,1%. Conclusão: Houve uma baixa prevalência de alterações fundoscópicas na população estudada

Efeitos da microgravidade em plantas de cana-de-açúcar

Sugarcane (Saccharum spp.) is a plant from Poaceae family that has an impressive ability to accumulate sucrose in the stalk, making it a significant component of the economy of many countries. About 100 countries produce sugarcane in an area of 22 million hectares worldwide. For this reason, many studies have been done using sugarcane as a plant model in order to improve production. A change in gravity may be one kind of abiotic stress, since it generates rapid responses after stimulation. In this work we decided to investigate the possible morphophysiological, biochemical and molecular changes resulting from microgravity. Here, we present the contributions of an experiment where sugarcane plants were submitted to microgravity flight using a vehicle VSB-30, a sounding rocket developed by Aeronautics and Space Institute teams, in cooperation with the German Space Agency. Sugarcane plants with 10 days older were submitted to a period of six minutes of microgravity using the VSB-30 rocket. The morphophysiological analyses of roots and leaves showed that plants submitted to the flight showed changes in the conduction tissues, irregular pattern of arrangement of vascular bundles and thickening of the cell walls, among other anatomical changes that indicate that the morphology of the plants was substantially influenced by gravitational stimulation, besides the accumulation of hydrogen peroxide, an important signaling molecule in stress conditions. We carried out RNA extraction and sequencing using Illumina platform. Plants subjected to microgravity also showed changes in enzyme activity. It was observed an increased in superoxide dismutase activity in leaves and a decreased in its activity in roots as well as for ascorbate peroxidase activity. Thus, it was concluded that the changes in gravity were perceived by plants, and that microgravity environment triggered changes associated with a reactive oxygen specie signaling process. This work has helped the understanding of how the gravity affects the structural organization of the plants, by comparing the anatomy of plants subjected to microgravity and plants grown in 1g gravity

Alterações de linguagem oral e escreta em crianças pré-escolares e escolares com epilepsia

A epilepsia cursa com diversas comorbidades e, entre elas, estão as alterações de linguagem, que levam a criança a problemas educacionais e sociais desfavoráveis. A etiologia das alterações de linguagem envolve aspectos orgânicos, cognitivos e sociais, ocorrendo, na maioria das vezes, uma interrelação entre todos esses fatores. A idade da primeira crise epiléptica, o tipo de epilepsia, o uso de drogas antiepilépticas e a intervenção medicamentosa em politerapia podem implicar na ocorrência dessas alterações em crianças. O objetivo dessa pesquisa foi verificar a ocorrência de alterações de linguagem em crianças pré-escolares e escolares com diagnóstico de epilepsia atendidas no setor de Neurologia Infantil do Hospital de Pediatria Professor Heriberto Ferreira Bezerra. Caracterizou-se como um estudo prospectivo e transversal realizado com 90 crianças com epilepsia, submetidas à avaliação fonoaudiológica de linguagem oral e de leitura e escrita e como pesquisa interdisciplinar uma vez que envolveu áreas como a Fonoaudiologia, a Neurologia e a Psicologia. Os critérios de inclusão foram: 1) diagnóstico inequívoco de epilepsia, segundo a definição da ILAE (2005), 2) idade de 3 aos 12 anos, 3) padrão neurológico e desenvolvimento neuropsicomotor normais; os de exclusão: 1) diagnóstico de epilepsia duvidoso, 2) padrão neurológico e desenvolvimento neuropsicomotor alterados, 3) crianças com patologias pediátricas associadas. Foram analisadas as seguintes variáveis: sexo, idade da primeira crise epiléptica, tipo de crise epiléptica, regime de tratamento, presença de crise epiléptica, frequência à escola, tipo de escola e repetência. A análise estatística centrou-se na análise descritiva; determinou-se a razão de chances (odds ratio), adotando-se um intervalo de confiança de 95%; e na aplicação do teste exato de Fisher, levando-se em consideração p<0,05. Portanto, no que se refere à presença de alterações de linguagem oral, pôdese observar que o início das crises epilépticas durante o período de aquisição e desenvolvimento da linguagem oral bem como o tratamento medicamentoso neste período podem interferir no desenvolvimento da linguagem devido à imaturidade do sistema nervoso central além dos aspectos socioambientais, uma vez que o estigma e as crenças errôneas interferem negativamente no processo interacional tão importante para a aquisição e desenvolvimento da linguagem, o que também repercute nas habilidades de leitura e escrita. Dessa forma percebe-se a importância da atuação de uma equipe interdisciplinar (Fonoaudiologia, Psicologia e Neurologia Infantil) no processo avaliativo e no acompanhamento dos pacientes com epilepsia, o que trará benefícios psicosocioafetivos no que se refere à reorganização da sua qualidade de vida e, consequentemente, de seus familiares.

Alterações no metabolismo de zinco relacionadas ao envelhecimento

Although many studies point to alterations in the organic concentrations of zinc in elderly patients, the mechanisms by which aging might cause changes in the metabolism of this nutrient remain unclear. Thus, we assessed the changes in plasma zinc, Zinc Binding Capacity to Plasma Protein (ZnBCPP) and Saturation Index (SI), comparing elderly individuals and young adults. The zinc analyses were performed by atomic absorption spectrophotometry. A statistically significant difference (p < 0.001) was found between the two groups, in relation to plasma zinc and SI, but the ZnBCPP did not differ between the younger and older subjects. In agreement with this result, it was shown in the young group that 76% (R2 = 0.760) of the ZnBCPP variations are explained by the variations in plasma zinc and SI. In the elderly group this measure decreased to 30.5% (R2 = 0.305). We conclude, therefore, that aging may be a factor associated to changes in control mechanisms and in zinc homeostasis, and could even alter ZnBCPP response patterns and other zinc-related indicators of nutritional status.

Perfil periodontal de pacientes portadores de alterações endócrino-metabólicas

Objective- Convinced that periodontium, many times, can show alterations in human health, the aim of these studies was to investigate the periodontal situation in patients with endocrine-metabolic disorders such as, Berardinelli-Seip Syndrome, hyperthyroidism, hypothyroidism and acromegaly. Methods- Eight patients with Berardinelli-Seip Syndrome, 16 acromegalics, 30 hypothyroids, 30 hyperthyroids, and a control group with 35 patients were evaluated. Clinical attachment loss, probing depth, gingival bleeding index, gingival overgrowth and Index of Decayed, Missing and Filled Teeth were measured in each patient. All ethical aspects were rigidly observed, being the study conducted after its approval by the University of Fortaleza Research Ethics Committee. Results- The presence of periodontitis was marked in hyperthyroids and in patients with Berardinelli-Seip Syndrome. Hypothyroids showed not much presence of periodontitis, while all acromegalics presented absence of periodontitis. Conclusions- The protective effect of periodontitis in acromegalic patients is a new finding, whose mechanisms are not yet clear, but may be related to the anabolic effects of growth hormone. The presence of periodontitis in Berardinelli-Seip Syndrome may occur due the early onset of diabetes. In hyperthyroids, the high prevalence of periodontitis could be linked to thyroid hormones effects on bone, explaining also the minor prevalence in hypothyroids

Alterações nas concentrações das SRAT, conteúdo de GSH e atividade da CAT em pacientes com esquistossomose aguda

Schistosomiasis is an ancient disease caused by helminth Schistosoma mansoni and is a public health problem in Brazil. The granulomatous lesion, typical of the disease, associates itself with increase in the oxidative damage through the generation of free radicals. The aim of this work was to evaluate the occurrence of changes in parameters oxidant / antioxidant that are part of the human defense system, and observe whether they would cause oxidative stress in subjects with schistosomiasis. Moreover, correlating with some biochemical and hematological parameters. Two groups were selected for study, consisting of individuals of both sexes, aged between 16 and 30 years. A control group, formed by individuals without schistosomiasis (n = 30) and a test group, formed by individuals with schistosomiasis (n = 30). The evaluation of lipid peroxidation in plasma was performed by determination of malondialdehyde and antioxidant defense by the quantification of reduced glutathione and catalase activity. For the parameters that assess oxidative stress, the results showed a decrease in the content of reduced glutathione and no change in the activity of catalase, with an increase in the value of malondialdehyde. Therefore, the data found suggest the occurrence of oxidative stress in subjects with schistosomiasis. Of the parameters that assess hepatic function, only levels of aspartate aminotransferase have been high, while there was a decrease of bilirubine. There was a significant change in the lipid profile (p <0.5), however with regard to the renal function of patients, there was a decrease in creatinine. The assessment hematological, made through hemogram and the quantification of hemoglobin, shows increase of eosinophils individuals in the group test, which can be related to the presence of the parasite. The amendments suggest the involvement of oxidative stress in the pathophysiology of this disease

Investigação das alterações citogenéticas em pacientes pediátricos com leucemia linfóide aguda do Rio Grande do Norte

Leukemia is a heterogeneous group of hematologic malignancies that result from partial or total transformation of the blast cells. The Acute Lymphoblastic Leukemia (ALL) is the most common malignancy in childhood, especially in male, Caucasian children younger than 14 years. Several criteria are adopted to classify ALL, including the cell morphology, cytochemistry, immunophenotyping and cytogenetic analysis. Cytogenetic studies allow a more detailed analysis to detect chromosomal abnormalities of leukemic cells. These modifications will determine the diagnosis, classification, stage characterization, remission assessment and prognosis. In this study were evaluated 30 patients, aged from four months to seventeen years, of both sexes and various ethnicities. The age distribution showed that 67% of patients had between one and ten years (with mean age of XX years old), the most prevalent ethnic was Caucasian (50%) and 57% were males. According to immunophenotype, 93% of patients had B-cells progenitor ALL and 7% early lineage T. Considering the total studied population, the most frequent medical findings were lymphadenopathy (37%), hepatomegaly (77%) and splenomegaly (70%), where one patient could present more than one of these medical findings. Regarding the CBC, the majority of patients had hemoglobin below 10 g / dl (73%), leukocyte count less than 10.000/μL (60%) and platelet count below 150.000/μL (83%). Chromosomal abnormalities were observed in 64% of all patients, where hyperdiploidy was the most common numerical change (67%), followed by hypodiploid (33%). All these data are in agreement with the literature. Moreover, complexes structural and/or number changes not yet described in literature were observed, which indicated poor prognosis. Finally, we concluded that this study demonstrated the importance of cytogenetic study in the diagnosis and identification of prognostic factors in pediatric patients with ALL in Rio Grande do Norte. The results obtained in this study are extremely useful and emphasizes that surveys of this nature must be conducted more frequently in our state

Avaliação de efeitos toxicológicos e comportamentais de ginseng panax em ratos

Panax ginseng CA Meyer (Araliaceae) is a herbaceous plant widely used in China, South Korea, Japan and other Asian countries for the treatment of various diseases micro circulatory, cerebrovascular, among others, representing one of the drugs used by older man. It has over 30 biologically active ginsenosides with different pharmacological and behavioral effects and inhibitory effect on the NMDA receptor. The amino acid glycine is a co-agonist of the NMDA receptor, activating this receptor. At the cellular level, ketamine is widely known to be NMDA receptor antagonist. The aim of this study was to evaluate the general activity in the open field, and anxiety in elevated plus maze, mice treated with P. ginseng compared with the action of ketamine and glycine, to better understand the action of this herbal medicine at the NMDA receptor. We used 66 adult male rats were divided into six groups: a positive control, treated for 30 days with water by gavage, who received glycine (500mg/kg; po) on days 7, 14, 21 and 28 of treatment, one hour before of behavioral assessment, a negative control was treated for 30 days with water by gavage received ketamine (5mg/kg, ip) on days 7, 14, 21 and 28 of treatment, one hour prior to behavioral evaluation, three experimental groups, receiving 100, 200 or 300 mg / kg P. ginseng by gavage for 30 days and one group treated solely with white water, and is also administered 1 ml of water by gavage one hour prior to behavioral evaluation. Animal behavior in these three groups was also examined on days 7, 14, 21 and 28 of treatment. On day 30 of treatment, the animals were anesthetized with thiopental (70mg/kg) for blood collection and after euthanasia, withdrawal of various organs. There were no changes in weight and body weight gain and weight reasons in organ / body weight. However the consumption of water and food values showed a significant increase. Serum levels of AST was increased in a dose-dependently in the animals treated with doses of P. ginseng, glycine and ketamine as compared to the blank group. Unlike creatinine levels proved to be decreased in all treated groups when compared with white. However, the level of urea in these groups was reduced and no changes were observed in the ALT parameter. Histopathological examination revealed no changes in cell morphology in different tissues. There were no behavioral changes in the elevated plus maze and few changes were observed in the open field, animals treated with P. ginseng, glycine and ketamine when compared to white. These data suggest that the doses of P. ginseng employed were unable to induce general toxicity in rats treated for 30 days and also shows that the general behavior of mice treated with P. ginseng was slightly different from that observed in animals treated with ketamine and glycine. Finally, the study on the elevated plus maze showed that the extract of P. ginseng showed no anxiolytic or anxiogenic action

Prevalência de doença arterial obstrutiva periférica (DAOP) e alterações sensoriais em pacientes diabéticos tipo 2: impacto da DAOP sobre a qualidade de vida, nível de atividade física e composição corporal

Diabetes Mellitus (DM) affected approximately 171 million people in the world in the year 2000 as described by the World Health Organization (WHO). Because DM is a multisystem disease it can cause several complications especially those related to the cardiovascular system. The Peripheral Arterial Disease (PAD) of the lower limbs and the Diabetic Distal Symmetric Polyneuropathy (DDSP) can affect the DM patient causing consequences as the diabetic foot and eventually amputations. The main objective of this study was to determine the prevalence of PAD and sensorial impairment in 73 type 2 DM (DM2) patients and also assess the impact of PAD on quality of life, level of physical activity and body composition. For clinical assessment it was used: the ankle-brachial index (ABI); quantitative sensorial test for tactile sensibility (ST), pain (SD), vibration (SV); Achilles tendon reflex (RA); quality of life questionnaire (SF-36); modified Baecke physical activity questionnaire and bioelectric impedance. Prevalence of PAD in the studied population was 13.7%. ABI was inversely correlated to age (p=0,03; rhô= -0,26), diabetes duration (p=0,02; rhô= -0,28) and blood pressure (p= 0,0007; rhô= -0,33). There were lower scores for physical health summary on the SF-36 in DM2 patients; however, the presence of PAD predominantly mild did not significantly impact quality of life, body composition or physical activity level assessed by questionnaire. Fourteen patients (19.2%) present bilateral and symmetrical alterations in two or more sensorial tests compatible to DPN diagnosis. Abnormalities in ST, SD and SV were present in 27.3%, 24.6% and 8.2%; respectively. There was association of results from ST abnormalities with RA and mainly with SD, suggesting the importance of 10g monofilament use in DM2 routine assessment. In conclusion, the prevalence of PAD in subclinical DM2 was slightly higher compared to the general population and in agreement to previously published data in DM patients. The PAD severity was predominantly mild and still without repercussion on quality of life and body composition. Our study demonstrated a significant prevalence of both PAD and DPN in DM2 without previous diagnosis of these complications and indicates the necessity of early preventive and therapeutic interventions for this population

Análise da relação entre alterações do padrão do sono e dor lombo-pélvica em mulheres no segundo trimestre gestacional

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior