Avaliação dos resultados da atenção multiprofissional sobre o controle glicêmico, perfil lipídico e estado nutricional de diabéticos atendidos em nível primário Evaluating the results of multiprofessional health care on the glucemic control, lipid profile, and nutritional status of diabetic patients assisted at primary level

OBJETIVO: Avaliar o resultado da intervenção multiprofissional sobre o controle glicêmico, o perfil lipídico e o estado nutricional de diabéticos atendidos em nível primário em Belo Horizonte, MG. MÉTODOS: Analisaram-se a glicemia, o índice de massa corporal e o perfil lipídico de 190 diabéticos tipo 2 (31 a 83 anos), atendidos no período de 1993 a 2000. Os dados foram coletados no momento inicial (primeira consulta de nutrição) e após três meses, tendo alguns sido coletados também uma terceira vez (6 meses após a primeira consulta). RESULTADOS: Inicialmente foram observados valores médios e medianos elevados, para índice de massa corporal, glicemia de jejum, colesterol total, LDL-c e triglicerídeos. Nos primeiros três meses após a intervenção, houve redução do índice de massa corporal (de 28,3 para 27,8kg/m²), glicemia de jejum (de 178,5 para 135,0mg/dL), colesterol total (de 251,0 para 230,0mg/dL), LDL-c (de 185,5 para 159mg/dL) e triglicerídeos (de 243,0 para 190,0mg/dL), não ocorrendo alteração dos níveis de HDL-c. Os pacientes com índice de massa corporal <30kg/m² e os com diabetes de manifestação mais recente, obtiveram melhores resultados. CONCLUSÃO: Os resultados deste estudo indicam que o atendimento multiprofissional é importante para o controle do diabetes, devendo ser iniciado precocemente.<br>OBJECTIVE: This work evaluates the multiprofessional intervention results on glucemic control, lipid profile, and nutritional status of diabetic patients, who received primary level health care in Belo Horizonte, state of Minas Gerais, Brazil. METHODS: An examination was carried out, to evaluate the levels of glucemia, body mass index, and lipid profile of 190 type-2 diabetic patients (31 to 83 years old), assisted during the period of 1993 to the year 2000. The data were collected at the 1st. consultation on nutrition, and after three months, whereas some data were also collected at a 3rd. moment (6 months after the initial consultation). RESULTS: Initially, the registered data were the high average and medium values for body mass index, fasting glucemia, total cholesterol, LDL-c and triglycerides. Over the first three months after intervention, a significant reduction occurred in the body mass index (from 28.3 to 27.8kg/m²), fasting glucemia levels (from 178.5 to 135.0mg/dL), total cholesterol (from 251.0 to 230.0mg/dL), LDL-c (from 185.5 to 159mg/dL) and triglycerides (from 243.0 to 190.0mg/dL); however, no alteration occurred in the HDL-c levels. The patients with body mass index <30kg/m², as well as those with a more recent history of diabetes obtained better outcomes. CONCLUSION: This study's results allow us to conclude that multiprofessional health care is fundamental in controlling diabetes, and such care should begin as soon as possible

Inversions and adaptation to the plant toxin ouabain shape DNA sequence variation within and between chromosomal inversions of Drosophila subobscura

Adaptation is defined as an evolutionary process allowing organisms to succeed in certain habitats or conditions. Chromosomal inversions have the potential to be key in the adaptation processes, since they can contribute to the maintenance of favoured combinations of adaptive alleles through reduced recombination between individuals carrying different inversions. We have analysed six genes (Pif1A, Abi, Sqd, Yrt, Atpa and Fmr1), located inside and outside three inversions of the O chromosome in European populations of Drosophila subobscura. Genetic differentiation was significant between inversions despite extensive recombination inside inverted regions, irrespective of gene distance to the inversion breakpoints. Surprisingly, the highest level of genetic differentiation between arrangements was found for the Atpa gene, which is located outside the O1 and O7 inversions. Two derived unrelated arrangements (O3+4+1 and O3+4+7) are nearly fixed for several amino acid substitutions at the Atpa gene that have been described to confer resistance in other species to the cardenolide ouabain, a plant toxin capable of blocking ATPases. Similarities in the Atpa variants, conferring ouabain resistance in both arrangements, may be the result of convergent substitution and be favoured in response to selective pressures presumably related to the presence of plants containing ouabain in the geographic locations where both inversions are present.This work was supported by a pre-doctoral fellowship to CP (2009FIC-00096) from the Generalitat de Catalunya (Spain). Research was funded by projects CGL2006-13423-C02-02 from the Ministerio de Ciencia y Tecnología (MCYT, Spain) and CTM2013-48163-C2-2-R from the Ministerio de Economía y Competitividad (MINECO, Spain). MP and FM are members of the research group 2014-SGR336 from the Generalitat de Catalunya (Spain)