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A utilização do monofilamento de 10 gramas como preditor de ulceração em indivíduos com diabetes mellitus: uma revisão sistemática

Mon, 01 Jan 2024 00:00:00 GMT

Título: A utilização do monofilamento de 10 gramas como preditor de ulceração em indivíduos com diabetes mellitus: uma revisão sistemática Autor(es): Macedo, Ariane Nascimento Primeiro Orientador: Lopes, Cícero Fidelis Abstract: Introduction: The Diabetic Foot Ulcer (DFU), a rupture of the skin of the foot involving at least the epidermis and part of the dermis, resulting from the nervous impairment caused by Diabetic Neuropathy (DN), stands out as an amalgam of pathophysiological, socioeconomic and educational factors. In this context, the identification of feet with sensitivity abnormalities that could develop ulceration, through the 10-gram Monofilament Test (10gMT), is a clinically relevant and cost-effective tool that has a significant impact on reducing the onset of UPD. Objectives: To identify observational studies that examined the relationship between the use of the 10-gram Monofilament Test, as a predictor of the incidence of ulceration in people with Diabetes Mellitus (DM), with an emphasis on population characteristics, socioeconomics and the methodological aspects of the 10gMT. Objectives: To identify observational studies that have examined the relationship between the use of the 10-gram Monofilament Test (10gMT) as a predictor of the incidence of ulceration in people with Diabetes Mellitus (DM), with emphasis on population characteristics, socioeconomic and methodological aspects of the 10gMT. Methods: This is a systematic review of the literature, following the PRISMA guidelines. The search was carried out in three electronic databases: Medline/Pubmed, Scopus and Embase, until October 31, 2023. The methodological quality of cohort studies was analyzed using the Newcastle-Ottawa Scale (NOS) tool recommended by Cochrane. Results: Of the 1179 articles extracted, 10 studies were included in the systematic review, after applying the eligibility criteria. The studies came from North America and Europe, countries with a high Human Development Index (HDI), were single-center, had a variable population sample and study duration. The average total duration of the studies was 2.8 years. The average total number of points investigated in the 10gMT methodology was 5.2 points. The percentages of abnormalities in the 10gMT, ranged from 4.8 to 75.6%, with a total average percentage of 25.06%. Only two studies used only the 10gMT to identify plantar sensitivity abnormalities. The average total percentage incidence of UPD was approximately 13%. Conclusions: The study analyzed and systematized data that may or may not corroborate the relationship between the use of the 10gMT and the incidence of UPD, a topic that has been little addressed in the national literature but which has been published extensively internationally. The 10gMT proved to be a good strategy for detecting loss of plantar protective sensitivity, being a low-cost, easily reproducible option that detects abnormalities when used alone or together. It also predicts that the foot is severely compromised and at imminent risk of ulceration. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Trabalho de Conclusão de Curso

Avaliação da perda de sensibilidade nos pés e fatores associados em pacientes com diabetes acompanhados ambulatorialmente – um estudo transversal

Mon, 01 Jan 2024 00:00:00 GMT

Título: Avaliação da perda de sensibilidade nos pés e fatores associados em pacientes com diabetes acompanhados ambulatorialmente – um estudo transversal Autor(es): Gusmão Santos Barreto, Rafael; Ramalho Lacerda, Ana Claudia; Silva Filho, Tonnison de Oliveira; Sampaio de Jesus, Breno Gabriel Araújo; Lopes, Cicero Fidelis Primeiro Orientador: Ramalho Lacerda, Ana Claudia Abstract: Background: Diabetes mellitus (DM) is a chronic metabolic disease characterized by vascular and nerve involvement, including diabetic foot complications. Protective sensory loss in the feet of diabetic patients is a critical predictor of severe complications, such as ulcers and amputations. Regular assessment of this condition is essential to prevent unfavorable outcomes. Objective: To determine the prevalence of protective sensory loss in DM patients at a university hospital and identify clinical and sociodemographic factors associated with this condition. Methods: This cross-sectional study was conducted with diabetic patients attending specialized outpatient clinics. Data were collected through patient interviews and chart reviews, along with the monofilament test to assess protective sensory loss in the feet. Statistical analysis included descriptive and exploratory tests, as well as bivariate and multivariate analyses to identify factors associated with sensory loss (p < 0.05). Results: A total of 184 patients were interviewed, with a median age of 61 years; the majority were female (72%), self-identified as mixed-race (54%), and diagnosed with type 2 diabetes mellitus (87%). The prevalence of protective sensory loss was 20%. Factors such as longer DM duration (95% CI: 1.01–1.09, p = 0.022), presence of target organ damage (95% CI: 1.25–6.84, p = 0.015), and increased body weight (OR = 1.04; 95% CI: 1.01–1.07, p = 0.007) were significantly associated with sensory loss. However, systemic arterial hypertension (SAH), although initially associated in the bivariate analysis, was not significantly associated after adjusting for other variables. Conclusions: The significant prevalence of protective sensory loss and lack of awareness about the monofilament test among many patients reinforce the need to expand neuropathy screening and health education in diabetes management. Editora / Evento / Instituição: Faculdade de Medicina da Bahia Tipo: Trabalho de Conclusão de Curso

Políticas de provimento e internações por condições sensíveis à Atenção Primária em um distrito sanitário de Salvador

Wed, 23 Aug 2017 00:00:00 GMT

Título: Políticas de provimento e internações por condições sensíveis à Atenção Primária em um distrito sanitário de Salvador Autor(es): Paixão, Caíque Beijes da Primeiro Orientador: Moreno Neto, José Luiz Abstract: Introduction: In a reality of low coverage of Primary Care Health and large areas of no assistence, the Provision Programs (Primary Care Professional Appreciation Program and More Doctors Program) arise with the objective of distributing doctors to priority regions and improving access to Primary Health Care (PHC) to contribute to improving the health levels of the population in these regions and, perhaps, to reduce the rates of hospitalizations due to sensitive conditions to ambulatory care. Objective: To analyze if there was a change in the proportions of hospitalizations in the Railway Suburb due to conditions sensitive to ambulatory care after the implementation of the PHC Provision Programs. Methods: Ecological study of time series with secondary data referring to the provision of physicians, by the city hall and the Provision Programs, and hospitalizations for conditions sensitive to Primary Care in the Unified Health System. Data were obtained from the National Registry of Health Establishments (CNES) , on the website of the Municipal Health Department (SMS/Salvador) and the Hospital Information System (SIH/SUS). Conclusion: Between 2010 and 2016, there was a 71.3% increase in the number of physicians PHC in the city of Salvador, with two-thirds of Family Health Unit present in the Subúrbio Ferroviário Sanitary District. This increase was due to the insertion of the Provision Programs, from 2013, being the More Doctors Program the most important longitudinally. The hospitalization due to Ambulatory Care Sensitive Conditions, in the period of the study, reduced overall from 21.8% in 2010 to 8.2% in 2016, concomitant with the increase in coverage, suggesting a possible association between them. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Trabalho de Conclusão de Curso

Perfil epidemiológico das vítimas de traumatismo crânio-encefálico em uma unidade de referência do SUS-Bahia

Sun, 01 Jan 2017 00:00:00 GMT

Título: Perfil epidemiológico das vítimas de traumatismo crânio-encefálico em uma unidade de referência do SUS-Bahia Autor(es): Guimarães, Bruna Siqueira de Abreu Brito Primeiro Orientador: Maldonado, Igor Lima Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Trabalho de Conclusão de Curso