Ankle-brachial index and subclinical atherosclerosis in type 1 diabetes

SUMMARY OBJECTIVE: To assess the prevalence of altered ankle-brachial index (<0.9 or >1.3) in patients with type 1 diabetes and to compare it with the presence of subclinical atherosclerosis by carotid ultrasound. METHODS: Prospective, cross-sectional study in which 45 adults with type 1 diabetes were evaluated (age 34±10 years, 46.7% men). The data collected included anamnesis, clinical evaluation, calculation of the ankle-brachial index (relationship between systolic blood pressure in the ankle and brachial artery), and performance of carotid ultrasound. RESULTS: Thirty-two patients had ankle-brachial index >1.3 (66.7%) and no patient had ankle-brachial index <0.9. Carotid echocardiography was performed on 21 patients, 4 (19%) of whom had atherosclerosis. Age >35 years and ankle-brachial index >1.4 showed a good correlation with atherosclerosis (r=0.49, p=0.021; r=0.56, p=0.008, respectively). A model associating age >35 years and ankle-brachial index >1.4 showed an excellent relationship with atherosclerosis (r=0.59, p=0.004). CONCLUSIONS: Our study showed that vascular calcification (ankle-brachial index >1.4) was frequent in this population with type 1 diabetes and associated with subclinical atherosclerosis. A model combining ankle-brachial index >1.4 and age >35 years showed an excellent correlation with atherosclerosis and can assist in clinical suspicion and optimize the request for additional tests.

Granuloma piogênico: descrição de dois casos clínicos / Pyogenic granuloma: description of two clinical cases

O granuloma piogênico representa uma hiperplasia inflamatória assintomática da pele ou da mucosa e pode causar interpretações errôneas devido ao seu rápido crescimento, sendo confundido com processos malignos. São apresentados, neste trabalho, dois casos de granuloma piogênico em crianças, na fase de dentição decídua, atendidas na Clínica de Odontopediatria da Universidade do Estado do Rio de Janeiro. O tratamento consistiu na remoção total do tecido de granulação. O controle pós-operatório não revelou sinais de recidiva