Influência do Diabetes Mellitus tipo 2 sobre desfechos clínicos de pacientes internados por COVID-19 em uma unidade de terapia intensiva em Manaus, Amazonas

Introdução: Estudos evidenciaram o impacto do Diabetes Mellitus tipo 2 (DM2) sobre a gravidade da COVID-19. Manaus foi epicentro da pandemia no Brasil e este estudo avaliou a influência do DM2 sobre desfechos clínicos de pacientes internados por COVID-19 em uma unidade de terapia intensiva (UTI) de um hospital da cidade, respectivamente: tempo de internação na UTI, tempo em Ventilação Mecânica Invasiva (VMI), necessidade de hemodiálise e mortalidade na UTI. Métodos: Estudo observacional, retrospectivo, descritivo e analítico através da revisão de 89 prontuários eletrônicos de pacientes internados na UTI do Hospital Universitário Getúlio Vargas (HUGV) entre abril-maio de 2020 e janeiro-fevereiro de 2021, após aplicação dos critérios de seleção. Foram feitas análises entre os dois momentos da pandemia citados e entre pacientes com e sem DM2. Resultados: Pacientes diabéticos apresentaram mais comorbidades (p=0,048), sobretudo hipertensão (p=0,02) e doença cardiovascular (p=0,001). Em média, entre os diabéticos, o tempo de internação na UTI foi 13 dias (p=0,510), o tempo em VMI foi 12 dias (p=0,610), 38,5% realizaram hemodiálise e 96,2% evoluíram para óbito na UTI.  Conclusão: A mortalidade na UTI foi superior no segundo momento da pandemia (89,9%, p=0,026), porém o DM2 não influenciou de forma significativa os desfechos clínicos de interesse

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

Produção e Validação do Programa Telediabetes: tecnologia educacional para profissionais da atenção primária

Objective: Produce and validate the Telediabetes Program´s script for classes as an educational technology for primary care health professionals. Methods: Methodological research, carried out in three stages: production of a script with content to qualify the assistance provided in primary care to people living with diabetes; content validation by expert judges; restructuring of the script to prepare the final version. The study was carried out nationwide, by digital means, reaching the five regions of the country. Results: &nbsp;In the production stage, the initial version with six classes emerged. In the validation stage, 18 judges from health area participated. From the content validation, a content validity index of 0.89 was obtained. Validation took place in a single round. During the restructuring stage, the suggestions for the final version were accepted. Conclusion: The script for classes in the Telediabetes Program was consedered valid and adequate for the continuing education of primary care professionals.Objetivo: produzir e validar o roteiro de aulas do Programa Telediabetes como uma tecnologia educacional para profissionais de saúde da atenção primária do interior do Amazonas.  Métodos: pesquisa metodológica, realizada em três etapas: produção do roteiro, com conteúdo para qualificar a assistência prestada na atenção primária às pessoas que convivem com diabetes, baseada em uma revisão da literatura e nas dificuldades dos profissionais de saúde compartilhadas no Telessaúde; validação dos conteúdos por juízes-especialistas; reestruturação do roteiro para elaboração da versão final. Resultados: na etapa de produção, emergiu a versão inicial com seis aulas. Na etapa de validação, participaram 18 juízes da área da saúde das cinco regiões do país. Na validação de conteúdo, obteve-se índice de validade de conteúdo de 0,89. A validação ocorreu por meio digital em uma única rodada. Na etapa de reestruturação, foram acatadas as sugestões para a versão final. Conclusão: o roteiro de aulas do Programa Telediabetes foi considerado válido e adequado para a educação permanente de profissionais da atenção primária

Differential gene expression profile of multinodular goiter.

IntroductionThe goiter, a neglected heterogeneous molecular disease, remains a major indication for thyroidectomies in its endemic regions.ObjectivesThis study analyzed differential gene expression in surgical specimens diagnosed with multi nodular and compared the data to that of thyroid tissue without multinodular goiter from patients undergoing thyroidectomy in Manaus-AM, Brazil using RNA-seq technology.MethodologyThe transcriptome information of the surgical specimen fragments with and without multinodular goiter was accessed by Illumina HiSeq 2000 New Generation Sequencing (NGS) using the RNA-seq NEBNext® Ultra™ RNA Library Prep Kit for Illumina®-#E7530L protocol and differential gene expression analysis.ResultsDifferences were found between the gene expression profiles of the diseased tissues and those of the healthy control tissues; at least 70 genes were differentially expressed. The HOTS gene was expressed only in multinodular goiter tissues (p ConclusionThese results demonstrate that the gene expression profile of multinodular goiter is pro-tumoral and that HOTS can play a central role in multinodular goiter development

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities