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Caracterização e fatores associados à sarcopenia em pessoas vivendo com o vírus da imunodeficiência humana

Wed, 28 Feb 2024 00:00:00 GMT

Título: Caracterização e fatores associados à sarcopenia em pessoas vivendo com o vírus da imunodeficiência humana Autor(es): Alcântara, Maria Eduarda Leal de Primeiro Orientador: Spexoto, Maria Claudia Bernardes Abstract: Sarcopenia is a disease characterized by low muscle strength and low muscle mass, its severity being determined by impaired physical performance. Studies that assessed the prevalence of sarcopenia among people living with the human immunodeficiency virus (PVHIV) used consensus and very heterogeneous criteria, which resulted in discrepant prevalence rates, between 1% and 35%. Mechanisms responsible for the reduction in muscle strength and mass may include low-grade inflammation, mitochondrial dysfunction secondary to antiretroviral therapy (ART), chronic immune activation and HIV-related metabolic disorders that can result in proteolysis, in addition harmful lifestyle habits and malnutrition that occurs especially due to inadequate dietary intake of energy and/or proteins. There are few studies in the literature after the publication of the European Working Group on Sarcopenia in Older People revised consensus (EWGSOP2). Thus, there is a need to explore and contribute to the literature with factors associated with redesigned sarcopenia. Furthermore, it may assist in clinical-nutritional management and early interventions that may have an impact on improving the prognosis of these individuals. Objectives: To characterize sarcopenia and its associated factors in individuals with the human immunodeficiency virus. Methods: This is a cross-sectional study. The study period was from April 2023 to January 2024. PLHIV attending the medical clinic and infectious disease outpatient clinic of the UFGD University Hospital, in the outpatient clinic of the Specialized Assistance Service/Testing and Counseling Center (SAE) of the municipality of Dourados-MS, using ART, aged ≥20 years, of both sexes, literate or not, who had the cognitive and physical capacity to understand and perform the tests. Sociodemographic, clinical factors related to the disease, lifestyle and anthropometric factors were collected through interviews and electronic and/or physical records. To characterize sarcopenia, the algorithm proposed by EWGSOP2 was used. Statistical analyzes conducted at the 5% significance level. Results: The sample consisted of 44 patients (42.1±12.4 years), predominantly men (62.1%), adults (95.5%) and outpatient treatment (68.2%). The prevalence of sarcopenia (confirmed and severe) was 20.5%. Associations were found between sarcopenia and the variables economic level (p=0.007), disease status (p=0.036), service level (p=0.040), body mass index (BMI) (p=0.002), muscle strength (p<0.001), skeletal muscle mass (calf circumference, CC) (p<0.001) and gait speed (GS) (p=0.004). Conclusion: In this study, the prevalence of sarcopenia (confirmed and severe) was significant. PLWH individuals with sarcopenia had lower BMI, CC and GS compared to individuals without sarcopenia and with sarcopenia probable. PLHIV individuals with a lower economic level, with the disease (AIDS) and hospitalization are factors related to sarcopenia, and it is recommended that they be investigated in clinical-nutritional care. The assessment of muscular health, linked to routine anthropometry, deserves more attention in PLHIV, especially in public hospitals. Editor: Universidade Federal da Grande Dourados Tipo: Trabalho de Conclusão de Residência

Doença renal do diabetes e os inibidores do co-transportador de SGLT2: uma revisão da literatura

Thu, 27 Oct 2022 00:00:00 GMT

Título: Doença renal do diabetes e os inibidores do co-transportador de SGLT2: uma revisão da literatura Autor(es): Giolo, Esther Ferreira Santos Primeiro Orientador: Menon, Alline Cristhine Nunes Cerchiari Abstract: Sodium-Glucose Cotransporter-2 Inhibitors (ISGLT-2) are a drug class that has shown promise, since they act doubly, reducing plasma glycemia and decelerating the process of chronic kidney injury resulting from hyperglycemia. In addition to these advantages, it is a class of drugs that has been shown to be useful in the control of Chronic Heart Failure (HF), possibly due to its natriuretic function, but also due to other physiological mechanisms in the myocardium, which are still not fully understood. The aim of this study was to carry out a literature review, systematized narrative, seeking to identify the benefits presented by the class of ISGLT2, regarding prevention of diabetes kidney disease, treatment of Diabetes Mellitus and indications of drug use in cardiovascular disease. Seven articles have been analyzed and extracted from the Medical Literature Analysis and Retrieval System online platform (Medline/PubMed), using the Health Sciences Descriptors: “SGLT2”; “diabetic nephropathy”, “chronic kidney disease”; “diabetes mellitus” and meeting inclusion criteria: free access articles, clinical studies in adult humans and that compared drug vs placebo in randomized, double-blind, multicenter, outcome groups, and included in the NIH Clinical Trials platform (www.clinicaltrials.gov). The guiding question asked whether the use of ISGLT2 in diabetic patients is an appropriate approach to prevent the onset of diabetic nephropathy. As a result of the analysis of the articles, it was possible to conclude that these drugs have the potential for nephroprotection in patients with any classification of risk severity, according to KDIGO: stages 1 to 5. Additionally, They have also been shown to be effective in preventing cardiovascular outcomes, being indicated for this purpose in patients with heart failure with or without diabetes mellitus. Editor: Universidade Federal da Grande Dourados Tipo: Trabalho de Conclusão de Curso

Análise da qualidade de vida de pacientes oncológicos em cuidados paliativos no Brasil – uma revisão bibliográfica

Wed, 27 Oct 2010 00:00:00 GMT

Título: Análise da qualidade de vida de pacientes oncológicos em cuidados paliativos no Brasil – uma revisão bibliográfica Autor(es): Vilela, Vera Maria Rocha de Luca Primeiro Orientador: Menon, Alline Cristhine Nune Cerchiari Abstract: Palliative care is an approach provided by a multidisciplinary team, aiming to improve the quality of life of patient and their families facing the problems associated with a life-threatening disease, such as cancer in advanced stages. The recommended actions should focus on the prevention and relief of suffering, treating pain and other physical, social, psychological and spiritual symptoms. In addition, palliative care can also contribute to the reduction of unnecessary hospitalizations and the use of health services, contributing to the efficient use of resources. Considering the fact that the implementation of palliative care in health services in Brazil is recent and that we have not yet reached levels of excellence, the objective of the present study was to review the literature aiming to evaluate the quality of life in cancer patients undergoing palliative care in Brazil. In this way, it is expected that this research could contribute to the debate on palliative care in Brazil and to the implementation and increase of palliative care in Brazilian health services. Editor: Universidade Federal da Grande Dourados Tipo: Trabalho de Conclusão de Curso

Abordagem clínica e terapêutica da cetoacidose diabética euglicêmica causada pelos inibidores de SGLT2: revisão da literatura

Thu, 27 Oct 2022 00:00:00 GMT

Título: Abordagem clínica e terapêutica da cetoacidose diabética euglicêmica causada pelos inibidores de SGLT2: revisão da literatura Autor(es): Manzur, Annie Letiscia Paniagua Primeiro Orientador: Longhi, Renata Praça Abstract: Diabetic ketoacidosis (DKA) is one of the most serious complications of diabetes. It is characterized by the triad of hyperglycemia (glycemia >250 mg/dl), metabolic acidosis (arterial pH <7.3 and serum bicarbonate <18 mEq/L) and ketosis. Rarely, these patients may have blood glucose levels below 200 mg/dl, which is defined as euglycemic CAD (E-CAD). Possible etiology of E-CAD includes current insulin use, decreased caloric intake, excessive alcohol consumption, chronic liver disease, and glycogen storage disorders. DKA in pregnancy has also been reported with euglycemia. Recent use of sodium glucose cotransporter 2 (SGLT2) inhibitors has shed light on another possible mechanism of euglycemic DKA. SGLT-2 inhibitors reduce blood glucose levels by increasing urinary glucose excretion, which reduces the stimulus for insulin secretion by pancreatic β cells. Insulin normally acts to inhibit hormone-sensitive lipase, thereby decreasing the generation of free fatty acids that serve as a substrate for β-oxidation and ketogenesis. With SGLT-2 inhibitors, marked glycosuria and consequent decrease in insulin secretion result in uninhibited lipolysis, increased β-oxidation, and ketogenesis. As a result of decreased blood glucose levels, pancreatic α cells are stimulated to increase glucagon secretion, further promoting lipolysis and ketogenesis. It was concluded that clinicians should maintain a high index of suspicion of euglycemic diabetic ketoacidosis in patients using SGLT2 so that appropriate therapy can be provided in a timely manner. The present work aims to present bibliographic research on the mechanism of SGLT2 in severe euglycemic metabolic ketoacidosis as well as clinical and therapeutic approaches. Editor: Universidade Federal da Grande Dourados Tipo: Trabalho de Conclusão de Curso