Navegando por Assunto "Diabetes"
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Item Acesso aberto (Open Access) Adesão ao tratamento em adolescentes com diabetes tipo 1: dois estudos de caso(Universidade Federal do Pará, 2011-04-01) SILVA, Ingrid Ferreira Soares da; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723Diabetes mellitus type 1 (DM1) is a chronic degenerative disease of major impact on the quality of life of children and adolescents. The DM1 affects predominantly children and young adults under 30 years of age with peak incidence from 10 to 14 years of age. As a chronic disease it involves changes in daily habits, and rule following becomes a key behavior to achieve such changes. This study aimed to examine factors that influenced the behavior of following the rules prescribed for the treatment of adolescents diagnosed with DM1. These rules relate specifically to the measurement of the blood glucose, the usage of the diet plan in choosing the menu and the application of insulin. The study included two adolescents aged 14 and 17 years, diagnosed with DM1, which had difficulties in controlling the disease according to medical evaluation. Also included as participants of this study were those responsible for each adolescent. The following survey instruments were used: 1) Set of interviews with the parents; 2) Inventory of parenting styles; 3) Questionnaire to evaluate the quality of life of adolescents with DM1; 4) Set of interviews with the adolescents; 5) Diabetes social support questionnaire – family version; and 6) Self monitoring forms for Treatment Compliance Behavior. The data collection was performed in the households of the adolescents. The procedure involved the following steps: 1) Selection of participants; 2) Individual interviews with the parents/guardians; 3) Individual interviews with the adolescents, including applications for inventory on their support network, characterization of the baseline behavior of measuring blood glucose, tracking diet plan, and insulin administration, interviews with positive feedback, and final interview. The results from the analysis of compliance behaviors and from the environmental factors reported by each participant throughout the research identified that the participant which emitted compliance behaviors appropriately had a good quality of life, a good level of knowledge about DM1, his parents owned a positive parenting style, perceived support provided by family, besides having a social condition satisfactory to meet the needs of the family. But the participant with a low compliance, although demonstrating a good quality of life, his parents were using a lot of negative practices, despite their parenting style being also positive, the family support perceived by the participant was inconsistent and his social status was insufficient to provide all the tools necessary for his treatment compliance. Thus, it was possible to analyze the factors that influence compliance to treatment, however further research should be conducted using a larger number of participants and also have a longitudinal character, with long-term monitoring to verify the effect of the variables described in the research along the lives of the participants.Item Acesso aberto (Open Access) Avaliação da presença de metais pesados na água potável fornecida à população urbana de Altamira e o seu possível impacto epidemiológico sobre doenças crônicas renais(Universidade Federal do Pará, 2024-04-30) STORCH, Wesley; FAIAL, Kleber R. Freitas; http://lattes.cnpq.br/0166366420811929; HTTPS://ORCID.ORG/0000-0002-8575-1262; PEREIRA, Adenilson Leão; http://lattes.cnpq.br/3184636120604556The Xingu River is crucial for potable water supply in Altamira, but it faces risks of heavy metal pollution, especially mercury, due to illegal mining and UHBM activities. Mercury can bioaccumulate in humans and be associated with an increased risk of hypertension and kidney diseases. This study evaluated the presence of heavy metals in Altamira's drinking water and outlined the epidemiological profile of chronic kidney disease (CKD) in Altamira and the Xingu region. Concentrations of Al, As, Cr, Cd, Pb, Fe, and Hg were measured in 24 water samples collected in July 2022, using ICP/MS by the Evandro Chagas Institute, compared to Brazilian legislation and WHO limits. Mortality data from CKD, diabetes mellitus (DM), and systemic arterial hypertension (SAH) from 2000 to 2020 were analyzed using public data from DATASUS. Additionally, medical records of CKD patients treated at HRPT from 2007 to 2023 were analyzed. The concentrations of metals in the analyzed water samples were within established limits, except for aluminum (Al), which was elevated in two water samples. Mortality data obtained from DATASUS between 2000 and 2020 showed a significant increase in mortality due to SAH in Altamira (R²=0.80), while mortality from CKD (R²=0.30) and DM (R²=0.31) had a smaller impact on the mortality rate during the studied period. Considering the medical records of CKD patients treated at HRPT, it was identified that between 2007 and 2023, 174 CKD patients treated at HRPT were from Altamira, with 64.4% men and 35.6% women. Regarding age, 48.85% were over 60 years old, and 36.78% were between 41 and 60 years old. The main comorbidity associated with CKD was SAH (56.90%), followed by the association of SAH and DM (36.94%). Altamira presented an average prevalence of 8.99 cases per 100,000 inhabitants and an average incidence of 10.24 new cases per year of CKD during the analyzed period. In the Xingu region, 403 CKD cases were identified, predominantly in men (61.5%) with an average age of 60 years. The main comorbidity associated with CKD was SAH (49.88%), followed by the association of SAH and DM (37.47%). The average prevalence of CKD in the region was 6.97 cases per 100,000 inhabitants, with an average incidence of 23.70 new cases per year of CKD during the analyzed period. The levels of metals in the analyzed water samples are within the limits recommended by Brazilian legislation and WHO. The high prevalence of CKD in Altamira and the Xingu region raises concerns about public health impacts. Historical mercury contamination may be related to the high mortality from SAH and the prevalence of CKD associated with SAH. These results emphasize the need for continuous monitoring of water quality and public policies to mitigate the impacts of CKD in the region.Item Acesso aberto (Open Access) Cuidados com os pés diabéticos: investigação de variáveis que determinam o seguimento de regras de tratamento(Universidade Federal do Pará, 2013-06-20) NOVAES, Vera Ribeiro; ALBUQUERQUE, Luiz Carlos de; http://lattes.cnpq.br/5261537967195189One of the most serious complications of diabetes mellitus (DM) is neuropathy that affects the skin sensitivity, causing decreased or even absent, facilitating the development of diabetic foot. Such complications can be reduced with adherence to treatment rules of foot care for diabetic patients. Therefore, this study aimed to evaluate the effects of rules, justifications for tracking and social reinforcement, and also compare the effects of a questionnaire (Questionnaire 2 - Q2) specifying the behavior of foot care with effect from another questionnaire ( Questionnaire 1 - Q1) without specifying such behaviors in six diabetic adults through the following instruments: Interview Script Initial Script Initial Questions, Observation Protocol feet, Questionnaire 2 - List of Behaviors Care Feet, Quiz 1 - Protocol Questions about Behavior Care Feet, Rules and Foot Care Rules with Additional Justifications for Foot Care. Seven meetings were held weekly, in which participants were exposed to procedure A (Baseline [Q2] - Q1 - Q2) and procedure B (Baseline [Q1] - Q2 - Q1) in Conditions 1 (social reinforcement), 2 (justification) and 3 (without social reinforcement / without justification). The results showed that half of the participants reported receiving no guidance foot care, four of the six had anatomical deformities in the feet, all had some aspect circulatory and dermatological, and only one participant wearing proper footwear. Terms of reported behaviors of foot care, it was found that participants exposed to Q2 (P11a, P21a and P31a) had a larger number of reports than participants exposed to Q1 (P12b, P22b and P32b). However, there is clear evidence in this study, treatment adherence. One fact that supports this assertion is the fact that the number of reported behaviors of foot care, participants presented P11a, P21a and P31a have decreased when these participants were exposed to Q1.Item Acesso aberto (Open Access) Determination of myricetin derivatives in Chrysobalanus icaco L. (Chrysobalanaceae)(2006-09) BARBOSA, Wagner Luiz Ramos; PERES, Amiraldo; GALLORI, Sandra; VINCIERI, Franco FrancescoThe flavonoidic fraction composition of the hydroalcoholic extract of Chrysobalanus icaco L. (Chrysobalanaceae) leaves, which are largely used in the traditional medicine in Northern Brazil to control the glycaemia of diabetic patients, was characterised. Myricetin 3-O-glucuronide (miricitrin) and quercitrin, among other minor myricetin derivatives, were evidenced by HPLC/DAD and HPLC/MS analysisItem Acesso aberto (Open Access) Efeitos de regras sobre relatos de comportamentos de cuidados com os pés em pessoas com diabetes(2014) NAJJAR, Enise Cássia Abdo; ALBUQUERQUE, Luiz Carlos de; FERREIRA, Eleonora Arnaud Pereira; PARACAMPO, Carla Cristina PaivaAiming to establish reports on foot care, baseline reports of diabetic adults were registered before experimental manipulations. In Experiment 1, Condition 1, questions were made to 6 participants and their feet were examined. In Condition 2, no questions were made and an exam was performed. In Condition 3, no questions were made and no exam was performed. In Experiment 2, all 16 participants were exposed to rules on how to take care of their feet. In Condition 1, reports were reinforced; in Condition 2 reasons for following the rules were presented; in Condition 3 there were reinforcement and reasons; and in Condition 4, neither reinforcement for reports nor reasons were presented. In all conditions of Experiment 2, the number of reports increased. The effects of the variables involved in rule-governed behavior are discussed.Item Acesso aberto (Open Access) Efeitos do treino de cuidadores sobre comportamentos de apoio à adesão às orientações nutricionais por portadores de diabetes(Universidade Federal do Pará, 2005-05-13) MALCHER, Michele da Silva; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723Health studies have pointed out that social support is one of the factors related to the adherence to diabetes patients treatment. Based on behavior analysis reference and especially on Goldiamonds constructional approach this study aimed to evaluate the effects of training procedure on caregivers support behavior offered to adult patients feeding behavior. Further, it was intended to analyze effects of this training on the patients adherence to dietary prescription. Taking part on this study were three women enrolled in a program for diabetes patients and one family member of each patient, amounting to three caregiver-patient dyads, two of which were allocated on a Training Condition (TC) and one, on a Non-Training Condition (NTC). As information sources, one used the verbal reports of the patients and of the caregivers, direct observation of behavioral interaction and clinical indicators. Using the subject as its own control, the intervention consisted on the training in contingency analysis and behavioral handling, accomplished in home visits by means of self monitoring records. The results showed that caregivers who took part on the Training Condition presented enlargement on the support behavior repertoire, which was not verified regarding the caregiver who took part on the Non-Training Condition. The glycemic levels reduction and the reports presented by the Training Condition patients suggest that the intervention has contributed to improvements on the adherence to nutritional orientations by theses patients.Item Acesso aberto (Open Access) Eletrofisiologia da visão em modelo experimental de ratos com diabetes e hipotireoidismo(Universidade Federal do Pará, 2014-03-28) GUIMARÃES, Glenda Figueira; GOMES, Bruno Duarte; http://lattes.cnpq.br/4932238030330851; ROCHA, Fernando Allan de Farias; http://lattes.cnpq.br/3882851981484245Diabetes mellitus is a worldwide public health problem because of its potential morbidity and mortality. This pathology is characterized as a metabolic disorder with chronic hyperglycemia, results from an absolute or relative deficiency in the secretion and/or insulin action. Associated to this case, problems with the thyroid are often found in patients with diabetes, especially with advancing age. Furthermore, there is a body of knowledge describing that both diabetes and hypothyroidism cause visual loss, however, there are not many publications on the physiology involving both pathologies in conjunction with the visual complications. Therefore, this work aimed to investigate issues relevant to a more detailed understanding of the framework for the evolution of retinal impairment in animal models simultaneously affected by two diseases: diabetes and hypothyroidism. For this, 50 male Wistar rats (Rattus norvegicus) were used, two-months-old, weighing between 80 to 120 grams, divided into four groups: a control group without procedures; a group with hypothyroidism opting for a bilateral experimental model of thyroidectomy; a group with diabetes, with application of 200 mg/kg to 2% Aloxana; and two groups with both pathologies, adopting both experimental procedures by changing the sequence of the pathologies in question. In the studied groups, it was used the electroretinogram (ERG), a non-invasive method widely used in academia to evaluate the visual changes, in different periods of 30, 45 and 60 days. We found a decrease in the average amplitude of the wave-a of the animals in the groups with diabetes and with both pathologies in all the realized registrations, the ones that showed the highest statistical differences were in relation to the registration of maximum estocópica, as well as difference in oscillatory potential of both groups with both pathologies. These results support the hypothesis that both concomitant pathologies (diabetes and hypothyroidism) significantly diminish the ERG responses.Item Acesso aberto (Open Access) Fitoterapia tradicional por meio do uso da planta “insulina” (Cissus Verticillata), no tratamento do diabetes mellitus, em uma comunidade costeira do nordeste do Pará (Amazônia, Brasil)(Universidade Federal do Pará, 2020-07-30) MORAES, Jones Souza; SILVA, Iracely Rodrigues da; http://lattes.cnpq.br/5393264898435715; OLIVEIRA, Euzébio de; http://lattes.cnpq.br/1807260041420782; https://orcid.org/0000-0001-8059-5902The Caeté river basin, situated in northern Brazil, that belongs to the Brazilian Amazonia region, Northeast of the Pará State, presents a large number of plant species with varied medicinal properties, widely used by residents of the region's traditional populations, highlighted in this case, for the traditional riverside/coastal populations that live there. Nevertheless, a lot of these plants have not yet been identified or had their medical uses registered in traditional ways. This study aimed to analyze the therapeutic/medicinal uses of the plant's ethno species Cissus verticillata, popularly known as “Insulin”, in treatment of the Mellitus Diabetes, on the riverside/coastal community of Ponta de Urumajó NE of Pará. The research presents a qualitative methodological approach, realized through the field research, using as the instruments of collection of data, the application of free listing, interviews with key-informers, application of forms, collection of vegetable samples, observation, recording of audio/video and pictures. Results point out that the community of Ponta do Urumajó demonstrates a great knowledge about medicinal plants, using it in the most diverse ways, in addition, of course, to know, with great propriety, the practices used for the use of medicinal plants, that are used for health care, which in this case is the Cissus verticillata, that is used for the treatment of Mellitus Diabetes. The community has been using “Insulin” widely, however, not knowing if this plant has any toxic effect and/or danger of adverse reactions. To that end, the conclusion of this work tends to contribute to the recognition and appreciation of the knowledge and local practices of traditional riverside/coastal populations in the Brazilian Amazonia, in relation to the use of medicinal plants, as well as seeking a greater integration between scientific and traditional knowledge to the consolidation of species conservation practices, such as its safe medicinal use, giving quality of life to diabetic patients.Item Acesso aberto (Open Access) Influência da suplementação de vitamina D na variabilidade glicêmica em pacientes com diabetes Mellitus tipo 1(Universidade Federal do Pará, 2016-01-27) FELÍCIO, Karem Mileo; YAMADA, Elizabeth Sumi; http://lattes.cnpq.br/7240314827308306; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863Recent studies suggest that glycemic variability (GV) could influence the risk of complications in diabetes, independently from glycemic control (GC). GV is the evaluation of the daily fluctuations of glycemia through specific calculations. The few studies that have assessed the effects of supplementation with vitamin D (VD) in patients with diabetes type 1(DM1) on GC are controversial and there is no data about a possible action of VD on GV in these patients. Our study aims to evaluate the effects of VD supplementation on GV in patients with DM1. We executed a prospective, controlled study with 22 patients with DM1. Doses of either 4.000 or 10.000 IU/day of cholecalciferol were administered for 12 weeks according to the patient’s previous vitamin D serum levels. All patients were submitted to continuous glucose monitoring system (CGMS) with the analysis of 41.000 glycemias, dosage of vitamin D and HbA1c before and after the treatment. When the pre and post treatment variables were compared, no differences were observed, except for the expected improvement of the levels and status of VD (26,1 ± 9,0 vs 44,4 ± 24,7 ng/mL ; p<0,01 e 1,00 ± 0,76 vs 0,36 ± 0,66 ; p<0,01), respectively. Correlations were found between the percentage variation (Δ) of the glycemia standard deviation (ΔGSD), calculated using the CGMS, with Δ of the basal (r= 0,6; p<0,01) and total insulin (r= 0,6; p<0,01). Our study also found a correlation between the VD status after supplementation and Δ of the prandial (r= 0,5; p<0,05) and total insulin (r= 0,4; p<0,05), indicating that the better the vitamin D status, lower the doses of insulin needed by the patients. To efficiently study the GV, patients were divided in two groups: Patients in which the ΔGSD improved (group 1; N= 12 (55%)) and those in which the ΔGSD worsened (group 2; N= 10 (45%)). Group 1 when compared to group 2 showed lower needs of insulin (Δbasal insulin = -8,0 vs 6,3%; (p<0,05)) and lower frequency of hypoglycemia (12/44 (27%) vs 21/33 (64%), hypoglycemias / days evaluated ; p<0,01). Our data suggests that supplementation of VD on patients with DM1 could improve the GV associated to a lower need of insulin in more than 50% of these patients. The improvement of GV was strongly associated with reduction in frequency of hypoglycaemia. However, it was not possible to demonstrate benefits of vitamin D on glycaemic control measured by the HbA1c.Item Acesso aberto (Open Access) Prevenção em diabetes: efeitos do treino de automonitoração na redução de fatores de risco(Universidade Federal do Pará, 2005-04-14) CASSEB, Mariene da Silva; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723Data from the Brasilian Society for Diabetes show the rapid growth of diabetes mellitus over the population and the great majority of bearers are not aware of the diagnosis. Analysis of behavior applied to health matches the proposal of the World Health Organization which places priority on environment and behavior variables to prevent and manage chronical conditions and has carried out many studies with focus on adherence of patients to the treatment and on the reduction of harm caused by chronic deseases. However, cut-off or reduction of future costs has become indispensable as to people under risk factors such as overweight, family history, sedentariness and inadequate nutrition. On the other hand, studies indicate that the training on automonitoring can prove to be effective on the acquisition and maintaining of behaviors that promote health and reduce the incidence of illnesses. Bases on the constructional model, the objective of this study was to verify by means of case study, the effects of a training on automonitoring on the construction and amplification of preventive behaviors of four individuals with diabetes family history, inadequate nutrition and sedentariness, sons of patients being attended by the Attention to Diabetes Bearer Program at Bettina Ferro de Souza Campus Hospital. Participants were distributed over two conditions: two on Training Condition (TC) and two on Non-Training Condition (NTC). Home visits were carried out for investigation of socio-demographic data, Base Lines 1 and 2 of nutritional behavior and of physical activity, intervention with the CT participants, fortnightly interview with the CNT participants and final interview. The results show significant changes concerning the acquisition and amplification of healthier nutritional habits and physical activities by CT participants and point out few changes on the acquisition and amplification of these habits by CNT participants. The discussion about the results covers aspects that indicate the acquisition of preventive habits, relating them to the literature used and at the end a general conclusion is draw over the accomplishment of this study.Item Acesso aberto (Open Access) Vitamina D e nefropatia em pacientes com diabetes Mellitus tipo 1(Universidade Federal do Pará, 2015-10-06) LUZ, Rafael Mendonça; YAMADA, Elizabeth Sumi; http://lattes.cnpq.br/7240314827308306; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863Diabetes Mellitus type 1 (DM1) results from destruction of the pancreatic beta cells by an immunological process, which may progress to kidney complications. Both genetic and environmental factors are involved in the pathogenesis of type 1 diabetes, and vitamin D deficiency appears as a candidate among the risk factors for developing both diabetes and diabetic nephropathy. The objective of this study was to evaluate the existence of an association between low levels of vitamin D with the presence and degree of diabetic nephropathy in patients with type 1 diabetes. Additionally, our study aimed to establish the prevalence of vitamin D deficiency in normal individuals of our region and determine if it differs from DM1 patients. A cross-sectional study, between November 2013 and December 2014, in which levels of 25 (OH) D and albuminuria were analyzed in 37 patients with DM1, normal creatinine levels and 36 control subjects. The patients with DM1 and hypovitaminosis D had higher levels of albuminuria compared with those with normal vitamin D levels (albuminuria = log10 1.92 vs. 1.44; p <0.05). When the group of patients was separeted according to the stage of diabetic nephropathy in those with normoalbuminuria, microalbuminuria, and macroalbuminuria, we found lower levels of 25(OH)D in the latter when compared to the first two groups (26.7 ± 6.2, 24.8 and 15.9 ± 7 ± 7.6 ng / mL; p <0.05, respectively). In DM1 group, we found correlations between vitamin D levels with the levels of albuminuria and diabetic nephropathy stages (r= -0.5, p<0.01 r= -0.4; p <0.05, respectively). Additionally, the prevalence of vitamin D deficiency among control subjects was quite high (78%), and there was no difference compared to patients with DM1, whose prevalence was 73%. Patients with type 1 diabetes when compared to control group also showed no difference regarding the average levels of 25(OH)D (24.2 ± 7.4 versus 25.8 ± 11.2 ng / mL, NS). Our data suggest an association between reduced levels of vitamin D and the presence and severity of diabetic nephropathy. In addition, patients with type 1 diabetes mellitus, when compared to normal control subjects in our region did not differ in average and status of 25(OH)D levels.