Navegando por Assunto "Osteoporose"

Agora exibindo 1 - 2 de 2

Análise dos fatores de risco para o desenvolvimento de fragilidade óssea em pacientes portadores de diabetes mellitus tipo 2 atendidos no Centro de Especialidades Médicas do CESUPA
(Centro Universitário do Estado do Pará, 2022) Oliveira, Ana Clara Moura de; Medeiros, Luma de Melo; Lima, Glauce Leão; Araújo, Fernando Costa; http://lattes.cnpq.br/6048529625820449; http://lattes.cnpq.br/7526159894502830
INTRODUCTION: Diabetes mellitus (DM) is a chronic metabolic disease with high worldwide prevalence. Type 2 diabetes patients are at risk of developing several complications, with bone fragility being the most recently reported. Osteoporosis is characterized by low bone mass, which predisposes to fragility fractures, being the gold standard method for its diagnosis the bone densitometry exam. The influence of diabetes on bone has multifactorial etiology, requiring further studies to make this relationship more consistent. OBJECTIVES: To analyze the presence of risk factors associated with the development of bone fragility and osteoporosis in type 2 diabetic patients treated at the “Centro de Especialidades Médicas do CESUPA” (CEMEC), and also generate an educational product with the purpose of guidance and health promotion, for use in the specialty medical clinics. METHODOLOGY: A cross- sectional, observational and analytical-descriptive study was carried out, based on an interview with the application of a specific questionnaire to patients treated at the “Centro de Especialidades Médicas do Cesupa” (CEMEC), and also an analysis of laboratorial and image exams that were contained in the medical records. RESULTS: A sample of 80 patients was used, being 72,5% female and aged between 51-70 years (58,8%). Most (52,5%) had been diagnosed with diabetes for more than 10 years, 70% had fasting glucose <150mg/dL and 77,5% had glycated hemoglobin levels below 8,5%. Among the 80 patients surveyed, 48,8% referred to be a former smoker in the past and 16,3% reported chronic use of corticosteroids. Most (66,3%) related using antidiabetic drugs with an impact on bone metabolism, 8,8% reported previous fragility bone fractures and 26,4% of the fifty-three patients with target-organ lesions had diabetic neuropathy. Those who underwent bone densitometry corresponded to 42,5%, of whom 28,8% received the densitometric diagnosis of osteoporosis. Most (46,3%) individuals had an average fracture risk calculated by FRAX®. CONCLUSION: There was a significant association between previous fragility fracture, smoking and chronic use of corticosteroids with increased risk of fracture. Bone fragility should be considered a complication of diabetes, and the design of prevention and screening strategies is essential, in addition to spreading information to patients about their disease and ways to improve its control.
Perfil clínico-epidemiológico dos pacientes do ambulatório de metabolismo do cálcio atendidos no Centro de Especialidades Médicas do CESUPA
(Centro Universitário do Estado do Pará, 2023-05-30) Souza, Júlia Tainá Dias de; Pegado, Walkyria Abrahim; Nunes, Lucas Lobato Acatauassu; http://lattes.cnpq.br/8764136693335864; Rodrigues, Fabíola Brasil Barbosa; http://lattes.cnpq.br/2425897539868497; Lima, Glauce Leão; http://lattes.cnpq.br/7526159894502830
Introduction: Bone Metabolic Disorders (BMD) represent a heterogeneous group of conditions that compromise the homeostasis of the skeletal system, with most of these cases presenting a chronic component that reinforces the need for patients to be treated on an outpatient basis, with specialized long-term follow-up as a cornerstone in health promotion. The proper management of these diseases have several obstacles, as it is influenced by factors such as the prolonged use of medication, age, and comorbidities, highlighting the need to identify all aspects that interfere with the health care of this specific population. Objective: To determine the clinical-epidemiological profile of patients attending the Calcium Metabolism Outpatient Clinic at the Center for Medical Specialties of CESUPA (CEMEC). Methodology: This is a cross-sectional descriptive analytical study carried out through the collection of data from medical records made available by the Center for Medical Specialties of CESUPA (CEMEC). Results: The sample of 245 medical records is predominantly composed of female patients (90.2%), aged over 60 years (68.2%), self-declared brown-skinned (66.1%), with systemic arterial hypertension (48.5%), and under follow-up for osteoporosis (78.4%). A significant association was found between the patients gender and the following pathologies: Osteoporosis (p<0.001), Low Bone Mass (p=0.007), Idiopathic Hypoparathyroidism (p=0.049), Post-surgical Hypoparathyroidism (p=0.015), and Osteogenesis Imperfecta (p<0.001). There was a predominance of follow-up time from 1 to 4 years (46.1%) and a frequency of 2 to 4 annual consultations (74.3%). Regarding adequate calcium consumption and the presence of early menopause, most of the sample did not have these characteristics (73.9% and 64.3%, respectively). Regarding the pattern of bone densitometry, there was a predominance of 1 to 2 exams registered (43.3%), and a positive association of this variable with follow-up time (p<0.001). The most observed T-Score results were <-3 and between -1 and -2.4 in the lumbar spine and femoral neck, respectively, with values <-3 significantly (p=0.002) associated with the occurrence of fractures. Total calcium and vitamin D values were mostly within the normal range (n=167; 68.2% and n=138; 56.3%, respectively). The most used drugs in the treatment of BMD were vitamin D (67.8%), calcium carbonate (41.6%), and bisphosphonates (59.6%). Conclusion: In light of the above, the individualization of care and the valorization of patients clinical history over standardized disease management protocols were evidenced. Such an approach was essential for the patients adherence to the initial therapeutic scheme, with a considerable clinical improvement in the underlying condition, based on evidence of predominance of laboratory tests within the normal range. Thus, the positive impact of the researched service on the maintenance of patients health is evident, and it is necessary to establish strategies to correct the identified shortcomings and further expand this positive scenario.