Treatment of acromegaly patients at the Federal University of Triângulo Mineiro (UFTM): Experience Report

OBJECTIVE: To evaluate the effectiveness of the treatment of acromegaly patients at the Federal University of Triangulo Mineiro. METHODS: Cross-sectional and retrospective study of thirty cases treated over a period of two decades. RESULTS: 17 men (56.7%) aged 14-67 years and 13 women aged 14-86 years were analyzed. Twenty-one patients underwent transphenoidal surgery, whichwas associated with somatostatin receptor ligands in 11 patients (39.3%), somatostatin receptor ligands + radiotherapyin 5 patients (17.8%), radiotherapy in 3 patients (10.7%), and radiotherapy + somatostatin receptorligands + cabergoline in 1 patient (3.6%). Additionally, 2 patients underwent radiotherapy and surgeryalone. Six patients received somatostatin receptor ligands before surgery, and 2 were not treated due to refusal and death. Nine patients have died, and 20 are being followed; 13 (65%) have growth hormonelevels o1 ng/mL, and 11 have normal insulin-like growth factor 1 levels. CONCLUSION: The current treatment options enable patients seen in regional reference centers to achieve strict control parameters, which allows them to be treated close to their homes

Cuidados com os pés: o conhecimento de indivíduos com diabetes mellitus

The aim of this research was to identify the knowledge of people with Diabetes Mellitus in relation to foot care, correlating the study time with the number of concordants responses, as well as, the time of diagnosis with the presence of chronic complications.It is analytical, exploratory and cross-sectional study, carried out with about 41 individuals with diabetes who attended an outpatient clinic of a city in Triangulo Mineiro. The results showed a deficit in knowledge about the feet care of this population, since the average score was 10.0 in the total of 15 questions. Education was not correlated with the level of knowledge of the practice. There was an association between the time of diagnosis and the presence of complications, where 70.0% of the sample had diabetes with complications for a period = 10 years. Therefore, educational efforts to provide access to knowledge about foot care are essential to preventing this sickness.El objetivo de esta investigación fue identificar el conocimiento de las personas con diabetes mellitus en relación con el cuidado de los pies, la correlación de tiempo de estudio con el número de respuestas concordantes, así como el momento del diagnóstico de la presencia de complicaciones crónicas. Es un estudio analítico, exploratorio y transversal realizado con 41 individuos con diabetes de una clínica de la ciudad de Triangulo Mineiro. Los resultados mostraron un déficit en el conocimiento de esta población sobre el cuidado de los pies, ya que la puntuación media fue de 10,0 del total de 15 preguntas. La educación no presentó correlación con el nivel de conocimiento de la práctica. Se observó una asociación entre el tiempo del diagnóstico y la presencia de complicaciones, donde el 70,0% de la muestra tenía diabetes con complicaciones para un período = 10 años. Por lo tanto, los esfuerzos educativos para facilitar el acceso a los conocimientos sobre el cuidado de los pies son esenciales para la prevención del pie diabético.O objetivo desta pesquisa foi identificar o conhecimento de pessoas com Diabetes Mellitus em relação aos cuidados com os pés, correlacionando o tempo de estudo com o número de respostas concordantes, bem como o tempo de diagnóstico com a presença de complicações crônicas. Trata-se de estudo analítico, exploratório e transversal, realizado com 41 indivíduos, portadores de diabetes, atendidos em um ambulatório especializado de uma cidade do Triângulo Mineiro. Os resultados mostraram déficit no conhecimento desta população sobre os cuidados podais, já que a média de acertos foi de 10,0 perante o total de 15 questões. A escolaridade não apresentou correlação com o nível de conhecimento acerca desta prática. Houve associação entre o tempo de diagnóstico e a presença de complicações, onde 70,0% da amostra com complicações tinham diabetes por período = 10 anos. Portanto, ações educativas que viabilizem o acesso ao conhecimento sobre os cuidados com os pés são essenciais para a prevenção do pé diabético

Feet care: the knowledge of individuals with diabetes mellitus

El objetivo de esta investigación fue identificar el conocimiento de las personas con diabetes mellitus en relación con el cuidado de los pies, la correlación de tiempo de estudio con el número de respuestas concordantes, así como el momento del diagnóstico de la presencia de complicaciones crónicas. Es un estudio analítico, exploratorio y transversal realizado con 41 individuos con diabetes de una clínica de la ciudad de Triangulo Mineiro. Los resultados mostraron un déficit en el conocimiento de esta población sobre el cuidado de los pies, ya que la puntuación media fue de 10,0 del total de 15 preguntas. La educación no presentó correlación con el nivel de conocimiento de la práctica. Se observó una asociación entre el tiempo del diagnóstico y la presencia de complicaciones, donde el 70,0% de la muestra tenía diabetes con complicaciones para un período ≥ 10 años. Por lo tanto, los esfuerzos educativos para facilitar el acceso a los conocimientos sobre el cuidado de los pies son esenciales para la prevención del pie diabético.RESUMO O objetivo desta pesquisa foi identificar o conhecimento de pessoas com Diabetes Mellitus em relação aos cuidados com os pés, correlacionando o tempo de estudo com o número de respostas concordantes, bem como o tempo de diagnóstico com a presença de complicações crônicas. Trata-se de estudo analítico, exploratório e transversal, realizado com 41 indivíduos, portadores de diabetes, atendidos em um ambulatório especializado de uma cidade do Triângulo Mineiro. Os resultados mostraram déficit no conhecimento desta população sobre os cuidados podais, já que a média de acertos foi de 10,0 perante o total de 15 questões. A escolaridade não apresentou correlação com o nível de conhecimento acerca desta prática. Houve associação entre o tempo de diagnóstico e a presença de complicações, onde 70,0% da amostra com complicações tinham diabetes por período ≥ 10 anos. Portanto, ações educativas que viabilizem o acesso ao conhecimento sobre os cuidados com os pés são essenciais para a prevenção do pé diabético.ABSTRACT The aim of this research was to identify the knowledge of people with Diabetes Mellitus in relation to foot care, correlating the study time with the number of concordants responses, as well as, the time of diagnosis with the presence of chronic complications. It is analytical, exploratory and cross-sectional study, carried out with about 41 individuals with diabetes who attended an outpatient clinic of a city in Triangulo Mineiro. The results showed a deficit in knowledge about the feet care of this population, since the average score was 10.0 in the total of 15 questions. Education was not correlated with the level of knowledge of the practice. There was an association between the time of diagnosis and the presence of complications, where 70.0% of the sample had diabetes with complications for a period ≥ 10 years. Therefore, educational efforts to provide access to knowledge about foot care are essential to preventing this sickness

Impactos nutricionais da ingestão alimentar dos ácidos graxos ômega 3 e óleo de palma: uma revisão

Nutritional impacts of the food intake omega 3 fatty acids and palm oil: a literature reviewObjective: To determine whether the polyunsaturated omega 3 fatty acids and palm oil introduced in a balanced diet produce benefits in physiology and metabolism human. Material and Methods: Nutritional and functional aspects of dietary intake of omega 3 fatty acids and palm oil and its role as adjunct therapy of metabolic diseases were analyzed. The literature searches were recovered in the databases Pubmed and Capes Journal Portal. English and Portuguese language articles reporting involvement of fatty acids on cardiovascular function, blood lipid, weight redution, satiety and diabetes control. Literature additional research included examinate list of references of all relevant studies, review articles, systematic reviews and randomized controlled trials. Results and discussion: Thirteen articles involving clinical trials were selected, eight studies related to omega 3 and five on palm oil. The methodological aspects vary between studies analyzed, but all suggest a favorable association between fatty acid intake accompanied feed control, increasing the positive results in controlling obesity and diabetes. Conclusion: Fatty acids are a powerful source of energy and there is promising evidences related to its effect on satiety hormones, thus acting in the line of defense for the control of metabolic events. In this context, this review provides an update on the effect of omega 3 fatty acids and palm oil in the diet based on clinical evidence.Objetivo: Determinar se os ácidos graxos poliinsaturados ômega 3 e óleo de palma introduzidos em uma dieta equilibrada produzem benefícios na fisiologia e metabolismo humano. Materiais e Métodos: Foram analisados os aspectos nutricionais e funcionais da ingestão alimentar dos ácidos graxos ômega 3 e óleo de palma e sua atuação como coadjuvantes na terapia de doenças metabólicas. As pesquisas bibliográficas foram recuperadas nas bases de dados Pubmed e Portal de Periódicos Capes. Foram analisados artigos de língua inglesa e portuguesa relatando envolvimento de ácidos graxos sobre as funções cardiovasculares, lipidemia, redução de peso, saciedade e controle do diabetes. Pesquisas complementares de literatura incluíam examinar lista de referências de todos os estudos relevantes, artigos de revisão, revisões sistemáticas e ensaios clínicos randomizados. Resultado e discussão: Treze artigos envolvendo ensaios clínicos foram selecionados, sendo que oito estudos relacionados ao ácido graxo ômega 3 e cinco sobre óleo de palma. Os aspectos metodológicos variam entre os trabalhos analisados, mas todos sugerem associação favorável entre ingestão de ácido graxos acompanhado de um plano de alimentação bem elaborado favorecem resultados positivos no controle da obesidade e diabetes. Conclusão: Os ácidos graxos são uma poderosa fonte de energia e há evidências promissoras relacionadas a sua atuação sobre hormônios sacietógenos, atuando assim na linha de defesa para o controle dos eventos metabólicos. Neste contexto, a presente revisão fornece uma atualização sobre o efeito dos ácidos graxos ômega 3 e óleo de palma na dieta baseada em evidências clínicas.

Impactos nutricionais da ingestão alimentar dos ácidos graxos ômega 3 e óleo de palma: uma revisão

Objetivo: Determinar se os ácidos graxos poliinsaturados ômega 3 e óleo de palma introduzidos em uma dieta equilibrada produzem benefícios na fisiologia e metabolismo humano. Materiais e Métodos: Foram analisados os aspectos nutricionais e funcionais da ingestão alimentar dos ácidos graxos ômega 3 e óleo de palma e sua atuação como coadjuvantes na terapia de doenças metabólicas. As pesquisas bibliográficas foram recuperadas nas bases de dados Pubmed e Portal de Periódicos Capes. Foram analisados artigos de língua inglesa e portuguesa relatando envolvimento de ácidos graxos sobre as funções cardiovasculares, lipidemia, redução de peso, saciedade e controle do diabetes. Pesquisas complementares de literatura incluíam examinar lista de referências de todos os estudos relevantes, artigos de revisão, revisões sistemáticas e ensaios clínicos randomizados. Resultado e discussão: Treze artigos envolvendo ensaios clínicos foram selecionados, sendo que oito estudos relacionados ao ácido graxo ômega 3 e cinco sobre óleo de palma. Os aspectos metodológicos variam entre os trabalhos analisados, mas todos sugerem associação favorável entre ingestão de ácido graxos acompanhado de um plano de alimentação bem elaborado favorecem resultados positivos no controle da obesidade e diabetes. Conclusão: Os ácidos graxos são uma poderosa fonte de energia e há evidências promissoras relacionadas a sua atuação sobre hormônios sacietógenos, atuando assim na linha de defesa para o controle dos eventos metabólicos. Neste contexto, a presente revisão fornece uma atualização sobre o efeito dos ácidos graxos ômega 3 e óleo de palma na dieta baseada em evidências clínicas. ABSTRACT Nutritional impacts of the food intake omega 3 fatty acids and palm oil: a literature reviewObjective: To determine whether the polyunsaturated omega 3 fatty acids and palm oil introduced in a balanced diet produce benefits in physiology and metabolism human. Material and Methods: Nutritional and functional aspects of dietary intake of omega 3 fatty acids and palm oil and its role as adjunct therapy of metabolic diseases were analyzed. The literature searches were recovered in the databases Pubmed and Capes Journal Portal. English and Portuguese language articles reporting involvement of fatty acids on cardiovascular function, blood lipid, weight redution, satiety and diabetes control. Literature additional research included examinate list of references of all relevant studies, review articles, systematic reviews and randomized controlled trials. Results and discussion: Thirteen articles involving clinical trials were selected, eight studies related to omega 3 and five on palm oil. The methodological aspects vary between studies analyzed, but all suggest a favorable association between fatty acid intake accompanied feed control, increasing the positive results in controlling obesity and diabetes. Conclusion: Fatty acids are a powerful source of energy and there is promising evidences related to its effect on satiety hormones, thus acting in the line of defense for the control of metabolic events. In this context, this review provides an update on the effect of omega 3 fatty acids and palm oil in the diet based on clinical evidence

Treatment of acromegaly patients at the Federal University of Triângulo Mineiro (UFTM): Experience Report

OBJECTIVE: To evaluate the effectiveness of the treatment of acromegaly patients at the Federal University of Triangulo Mineiro. METHODS: Cross-sectional and retrospective study of thirty cases treated over a period of two decades. RESULTS: 17 men (56.7%) aged 14-67 years and 13 women aged 14-86 years were analyzed. Twenty-one patients underwent transphenoidal surgery, whichwas associated with somatostatin receptor ligands in 11 patients (39.3%), somatostatin receptor ligands + radiotherapyin 5 patients (17.8%), radiotherapy in 3 patients (10.7%), and radiotherapy + somatostatin receptorligands + cabergoline in 1 patient (3.6%). Additionally, 2 patients underwent radiotherapy and surgeryalone. Six patients received somatostatin receptor ligands before surgery, and 2 were not treated due to refusal and death. Nine patients have died, and 20 are being followed; 13 (65%) have growth hormonelevels o1 ng/mL, and 11 have normal insulin-like growth factor 1 levels. CONCLUSION: The current treatment options enable patients seen in regional reference centers to achieve strict control parameters, which allows them to be treated close to their homes

Timing of thyroid ultrasonography in the etiological investigation of congenital hypothyroidism

<div><p>ABSTRACT Objectives To describe the findings of thyroid ultrasonography (T-US), its contribution to diagnose congenital hypothyroidism (CH) and the best time to perform it. Subjects and methods Forty-four patients with CH were invited to undergo T-US and 41 accepted. Age ranged from 2 months to 45 years; 23 patients were females. All were treated with L-thyroxine; 16 had previously undergone scintigraphy and 30 had previous T-US, which were compared to current ones. Results At the current T-US, the thyroid gland was not visualized in its normal topography in 10 patients (24.5%); 31 T-US showed topic thyroid, 17 with normal or increased volume due to probable dyshormonogenesis, 13 cases of hypoplasia and one case of left-lobe hemiagenesis. One patient had decreased volume due to central hypothyroidism. Scintigraphy scans performed 3-4 years earlier showed 100% agreement with current results. Comparisons with previous T-US showed concordant results regarding thyroid location, but a decrease in current volume was observed in eight due to the use of L-thyroxine, calling the diagnosis of hypoplasia into question. Conclusions The role of T-US goes beyond complementing scintigraphy results. It allows inferring the etiology of CH, but it must be performed in the first months of life. An accurate diagnosis of CH will be attained with molecular study and the T-US can guide this early assessment, without therapy withdrawal.</p></div

A RECURRENT MUTATION IN TSHB GENE UNDERLYING CENTRAL CONGENITAL HYPOTHYROIDISM UNDETECTABLE IN NEONATAL SCREENING

ABSTRACT Objective: To describe the case of a patient with central congenital hypothyroidism (CCH) due to a recurrent mutation in the TSHB gene, as well as to conduct a genetic study of his family. Case description: It is presented a case report of a 5-month-old boy with a delayed diagnosis of isolated CCH in whom the molecular analysis was performed 12 years later and detected a recurrent mutation (c.373delT) in TSHB gene. The parents and sister were carriers of the mutant allele. Comments: The c.373delT mutation has previously been reported in patients from Brazil, Germany, Belgium, United States, Switzerland, Argentina, France, Portugal, United Kingdom and Ireland. In summary, our case and other ones reported in the literature support the theory that this mutation may be a common cause of isolated TSH deficiency. Isolated TSH deficiency is not detected by routine TSH-based neonatal screening, representing a clinical challenge. Therefore, when possible, molecular genetic study is indicated. Identification of affected and carriers allows the diagnosis, treatment and adequate genetic counseling