ABSTRACT Objective: To evaluate the precipitating factors of diabetic ketoacidosis (DKA) in patients with type 1 diabetes hospitalized through the emergency department of a tertiary hospital. Materials and methods: Individuals with type 1 diabetes hospitalized for DKA from January 2005 to March 2010 (first period [P1], n = 75) and from April 2010 to January 2017 (second period [P2], n = 97) were identified through a query of electronic medical records. Data were collected by reviewing medical records. Only the first hospitalization of each participant in each period was included. Results: In P2, 44 patients (45.4%) were women, mean age was 26.2 ± 14.5 years, and 74 patients (76.3%) had a previous diagnosis of type 1 diabetes. Only 1 patient had glycated haemoglobin (HbA1c) below 64 mmol/mol (8.0%). Most patients (62.2%) had had a previous episode of DKA. In P1, non-adherence was the main cause of DKA (38.7%), followed by infection (24.0%). In P2, these rates were 34.0% and 24.7%, respectively; no statistical difference was observed between the two study periods (p = 0.790). Conclusion: Over time, non-adherence remained the main precipitating factor of DKA, followed by infection, and no significant difference was observed between the two study periods. Elevated HbA1c, outside the therapeutic range, indicates suboptimal diabetes care and may explain, at least in part, poor adherence as a precipitating factor of decompensation. Health strategies, such as improved self-management of type 1 diabetes, may contribute to a future reduction in DKA episodes.

ABSTRACT Two researchers conducted independent searches on five different electronic databases: PubMed/MEDLINE, Embase, SciELO, LiLACS and Web of Science. Studies were selected that covered cross-cultural adaptation methodology and validation in Brazil with type 1 and type 2 diabetes patients of any age. After reading the full-text articles, data related to psychometric characteristics were extracted from each study selected. Reliability was assessed with Cronbach’s α (Cα). The initial searches identified 2,211 studies. After exclusions, 26 were included, covering a total of 31 questionnaires. Questionnaires were grouped into 11 domains based on their main focus of interest: adherence (n = 8), quality of life (n = 7), diabetes knowledge (n = 3), hypoglycemia (n = 3), self-efficacy (n = 3), satisfaction with pharmaceutical services (n = 1), emotional stress (n = 2), hope (n = 1), attitude towards diabetes (n = 1), perception of disease severity (n=1), and risk of developing diabetes (n = 1). This study identified and reviewed all of the diabetes-specific questionnaires that have been validated for Brazilian Portuguese, which should facilitate selection of the most appropriate instrument for each domain of interest in future research and clinical settings.

Compararam-se as técnicas de impregnação para glóbulos segundo o Manual de Normas Técnicas para Farmácias Homeopáticas (MNTFH) da Associação Brasileira de Farmacêuticos Homeopatas (ABFH), Farmacopeia Homeopática Brasileira (FHB) e variações destas técnicas. As variáveis avaliadas neste processo foram: três tamanhos diferentes de glóbulos (n.º 3, 5 e 7); a solução hidroalcóolica a 70% (v/v) de minoxidil a 2% (p/v) foi utilizada para impregnar os glóbulos nas concentrações de 2, 3, 4, 5% (v/p) e na impregnação a 10% (v/p) utilizaram-se as soluções hidroalcóolicas a 70, 80 e 90% (v/v); e quatro técnicas de impregnação diferentes ( A -vidro, B -papel, C -copo e D -FHB). A impregnação foi validada através da uniformidade de dose por conteúdo, sendo o minoxidil a substância quantificada. Como os resultados da uniformidade de dose por conteúdo não demonstraram distribuição normal, utilizaram-se o One way ANOVA e um modelo estatístico não paramétrico para sua avaliação. Considerando-se a média, o desvio padrão (DP), a variância individual de cada grupo e os gráficos de análise de componentes principais (ACP), observou-se que a impregnação que utilizou o glóbulo nº5, a concentração para impregnação de 5% (v/p), graduação alcoólica de 70% (v/v) e técnica “A” apresentou a melhor uniformidade de dose. Quanto à secagem, verificou-se a necessidade do uso de uma fonte de calor.

We compared the impregnation techniques for globules according to the Manual of Technical Norms for Homeopathic Pharmacies (MNTFH) of the Association of Homeopathic Pharmacists (ABFH), Brazilian Homeopathic Pharmacopoeia (FHB) and variations of these techniques. The variables were evaluated in this procedure, three different sizes of globules (N o . 3, 5 and 7), the hydroalcoholic solution of 70% (v/v) Minoxidil 2% (w/v) was used to impregnate the globules in concentrations of 2, 3, 4, 5% (v/w) and the impregnation at 10 %(v/w) was used hydroalcoholic solutions at 70, 80 and 90% (v/v), and four impregnation techniques various ( A -glass, B -paper, C -cup and D -FHB). As the results of content uniformity did not demonstrate a normal distribution, the one way ANOVA and a nonparametric statistical model were used for evaluation. Considering the average, the standard deviation (SD), the individual variance of each group and the principal components analysis graphs (PCA), it was observed that the “A” impregnation of globules technique, with 5% (v/w) of the impregnation concentrations and the No.5 globule presented the best uniformity of dose. As to the drying, there was a need to use a heat source.

A síndrome de Chanarin-Dorfman é uma doença rara autossômica recessiva, que pode estar associada à ictiose, caracteriza-se pela presença de gotículas lipídicas intracelulares em células dos mais variados tecidos, especialmente nos queratinócitos e granulócitos. Mutações no gene ABHD5, que codifica uma proteína da esterase/lipase/subfamília tioesterase, têm sido identificadas como o principal motivo da desordem. As manifestações extracutâneas são heterogêneas, tanto em intensidade quanto em características. O envolvimento sistêmico pode incluir hepatoesplenomegalia, cataratas de dupla face, retardo de crescimento, miopatia, ataxia e perda auditiva neurossensorial bilateral.(1) Desde os primeiros relatos da síndrome,(1) apenas 30 pacientes foram descritos na literatura, a maioria proveniente de países do Oriente Médio.(2) O diagnóstico é confirmado pela presença de gotículas lipídicas em granulócitos de sangue periférico.(3)

Chanarin-Dorfman syndrome is a rare autosomal recessive disease that may be associated with ichthyosis and is characterized by the presence of intracellular lipid droplets in the cells of many different tissues, in particular in keratinocytes and granulocytes. Mutations in the gene that encodes the ABHD5 protein of the esterase/lipase/thioesterase subfamily have been identified as the main cause of the disorder. The extracutaneous manifestations are heterogeneous, both in intensity and characteristics. Systemic involvement may include hepatosplenomegaly, double-sided cataracts, growth retardation, myopathy, ataxia and bilateral sensorineural hearing loss.(1) Since the first reports of the syndrome (1) only 30 patients have been described in the literature, mostly from Middle Eastern countries.(2) The diagnosis is confirmed by the presence of lipid droplets in granulocytes of peripheral blood.(3)

O eritrovírus infecta células precursoras eritroides, determinando a interrupção temporária da eritropoese. Neste contexto, é importante o conhecimento das principais doenças hematológicas que podem estar associadas à presença do vírus, principalmente quando estão presentes em condições mórbidas, tais como nas anemias hemolíticas hereditárias. Este trabalho tem como objetivo relatar as principais doenças hematológicas que cursam com a infecção pelo eritrovírus B19.

Erythroviruses infect precursor erythroid cells, determining a temporary disruption of erythropoiesis. Thus, knowledge of the main hematological diseases that may be associated with the virus is important, especially when they are present in morbid conditions, such as in hereditary hemolytic anemia. This paper aims at reporting the main hematological diseases that are associated with erythrovirus infections.

O ácido glicólico é amplamente utilizado na terapêutica para se obter um peeling suave, levando ao afinamento do estrato córneo útil na renovação da epiderme e na redução das linhas faciais. Porém, em concentrações elevadas pode estar associado a um alto potencial de irritação da pele. O peeling químico tem diversas aplicações clínicas dentre elas o tratamento da pele facial lesada por problemas como acne, ictiose, melasma, verrugas e outros problemas. O presente trabalho objetivou estabelecer e validar a metodologia analítica para a determinação do teor de ácido glicólico na matéria-prima e em formulações dermocosméticas, tendo empregado o método titulométrico de neutralização ácido-base, determinando-se o ponto de equivalência com indicador e/ou indicação potenciométrica. A análise do teor de ácido glicólico na matéria-prima e, particularmente, no produto acabado, é importante para o controle de qualidade, principalmente, para a segurança dos consumidores. Portanto, a matéria-prima e os produtos, contendo ácido glicólico, foram analisados em dois dias, quanto ao teor de ácido glicólico livre e total utilizando soluções de hidróxido de sódio 0,1 N e o ácido clorídrico 0,1 N. A metodologia desenvolvida baseou-se na reação com a substância ativa e com as características próprias destas formulações, demonstrando ser prática e eficaz na quantificação do ácido glicólico.

Glycolic acid is widely used in therapeutical care as a soft peeling, leading to the thickness of the horny layer, which is useful in the renewal of the epidermis and the reduction of the face lines. However, in high concentrations it can be associated to a potential of irritation of the skin. A chemical peeling has diverse clinical applications, among them the treatment of injured skin face like: acne, ichthyose, melasma, warts and other else. The present work had the goal to establish and to validate an analytical methodology for the determination of the glycolic acid purity in the raw material and in the dermocosmetic formulations, the acid-base neutralization titration method was used, and the end point was determined with visual indicator as well as potenciometric. The analysis of glycolic acid in the raw material, and particularly, in the finished product is important to maintain the quality control and to guarantee the consumers security. Therefore, the raw material and the products, with glycolic acid, were analyzed in two days, as its purity in free and total glycolic acid was determined using sodium hydroxide 0,1 N and the hydrochloric acid 0,1 N solutions. The developed methodology was based on the reaction with the active substance and with the property characteristics of these formulations. It was demonstrated to be practical and efficient in quantify the glycolic acid.