Amateur ballet practicing, body image and eating behaviors: a comparative study of classical ballet dancers, gym users and sedentary women.

BACKGROUND: Ballet dancers are a risk group for body image (BI) distortion, dissatisfaction and eating disorders (ED), but few studies have investigated these aspects in amateur adult practitioners. This study aimed to evaluate if amateur female adult classical ballet dancers presented different BI and behaviors for ED than gym users and sedentary women. METHODS: This is a cross-sectional study where classical ballet dancers (n = 19) were compared to gym users (n = 19) and sedentary women (n = 19). Body mass index (BMI) was assessed, and a figure rating scale was applied to assess BI distortion/dissatisfaction. The body shape questionnaire (BSQ) was used to measure BI concern. The eating attitudes test (EAT-26) and the bulimic investigatory test, Edinburgh (BITE) were used for behaviors toward anorexia and bulimia. RESULTS: BMI was significantly lower in ballet dancers than gym users and sedentary women (F, p = .04). BI distortion did not differ among the studied groups. BI dissatisfaction was lower (X2, p = .041) in ballet dancers (75.0%) and gym users (70.6%) compared to sedentary women (100%). Correspondence analysis showed ballet dancers were mostly not concerned with BI, which was not observed among the other groups. The EAT-26 did not differ between the studied groups. The BITE score was lower (Tukey's post hoc test, p = .005) in the ballet dancers [mean 5.3 (5.6)] compared to the sedentary women [mean 10.9 (4.8)]. CONCLUSIONS: Data suggest that amateur classical ballet practicing is associated to better BI and fewer behaviors for ED in the studied population. The lower BMI in ballet dancers might explain these findings, and further studies should explore these associations.

Hyporeninemic hypoaldosteronism and diabetes mellitus: Pathophysiology assumptions, clinical aspects and implications for management.

Patients with diabetes mellitus (DM) frequently develop electrolyte disorders, including hyperkalemia. The most important causal factor of chronic hyperkalemia in patients with diabetes is the syndrome of hyporeninemic hypoaldosteronism (HH), but other conditions may also contribute. Moreover, as hyperkalemia is related to the blockage of the renin-angiotensin-aldosterone system (RAAS) and HH is most common among patients with mild to moderate renal insufficiency due to diabetic nephropathy (DN), the proper evaluation and management of these patients is quite complex. Despite its obvious relationship with diabetic nephropathy, HH is also related to other microvascular complications, such as DN, particularly the autonomic type. To confirm the diagnosis, plasma aldosterone concentration and the levels of renin and cortisol are measured when the RAAS is activated. In addition, synthetic mineralocorticoid and/or diuretics are used for the treatment of this syndrome. However, few studies on the implications of HH in the treatment of patients with DM have been conducted in recent years, and therefore little, if any, progress has been made. This comprehensive review highlights the findings regarding the epidemiology, diagnosis, and management recommendations for HH in patients with DM to clarify the diagnosis of this clinical condition, which is often neglected, and to assist in the improvement of patient care.

Caracterização clínico-terapêutica de idosos diabéticos tipo 2 atendidos em hospital universitário / Clinical and therapeutic characters of elderly diabetic in university hospital

Justificativa e objetivos: O Hospital Universitário Lauro Wanderley, é um serviço de referência no atendimento de pacientes com endocrinopatias na Paraíba. Uma parcela importante dos diabéticos paraibanos é encaminhada a esse serviço a partir das unidades básicas de saúde (UBS). A maioria se apresenta sob uso de alguma terapêutica na primeira consulta; indicada por um médico generalista. Neste estudo caracterizou-se um grupo de pacientes idosos com diabetes mellitus tipo 2 (DM2) atendido no ambulatório de endocrinologia do HULW, a respeito das opções terapêuticas, do uso de insulina e frequência de comorbidades. Método: Foram incluídos no estudo pacientes acima de 60 anos atendidos no ambulatório de diabetes de julho a dezembro de 2006. Observaram-se características sóciodemográficas, clinicas, níveis glicêmicos e opções iniciais de tratamento (dieta, hipoglicemiantes orais, exercício, insulina). Posteriormente, um subgrupo de pacientes foi definido a partir do nível de compensação metabólica. Resultados: Foram atendidos, neste período, 1271 pacientes com diabetes. Destes, foram estudados 510 idosos (40,1%), dos quais 96 apresentavam-se para sua primeira consulta no ambulatório de diabetes. Por ocasião do primeiro atendimento ambulatorial de diabéticos adultos em geral, 49,4% apresentavam-se descompensados metabolicamente. A proporção de idosos descompensados no primeiro atendimento foi de 54,5%. A maior parte dos pacientes fazia uso de terapêutica com hipoglicemiante (62,7%) e dieta (97,8%). A efetividade do tratamento ficou prejudicada devido ao baixo índice de retornos (11,9%) no período de estudo. Conclusão: Os dados mostraram que um elevado percentual de diabéticos que procurou o HULW pertence à faixa etária de idosos. Grande parte destes pacientes apresenta-se com compensação metabólica insatisfatória.(...)

Background and objectives: The University Hospital Lauro Wanderley is a reference service in the care of patients with endocrinopathies in Paraiba. An important part of diabetics is routed to this service from basic health units. Many of them present a use of any therapy in the first consult, indicated by a general practitioner. This study characterized a group of elderly patients with T2DM seen at the endocrinology clinic of HULW, in respect of treatment options, use of insulin and frequency of comorbidities. Method: This study evaluated outpatients over 60 years who attended the diabetes clinic in the period of July to December 2006. It was observed socio-demographic characteristics, clinical, blood glucose levels and options for initial treatment (diet, oral hypoglycemic, physical activity, Insulin). Subsequently, a subgroup of patients was defined according to the level of metabolic compensation. Results: 1271 patients with diabetes were seen in this period. Among them, 510 elderly people were studied, included 96 who had been there to their first appointment at the clinic of diabetes. It was observed that at the first consult of diabetic adults, 49.4% were metabolically decompensated. The proportion of decompensate elderly first attendance was 54.5%. Patients treated with oral antidiabetic (62.7%) and diet (97.8%). The effectiveness of treatment was impaired due to the low returns (11.9%). Conclusion: The data showed that a high percentage of patients seeking HULW pertain to the elderly group. Most of them presented poor metabolic compensation. This high frequency of metabolic decompensation implies the need to adapt health services to the care of elderly people, especially considering their specific comorbidities. Cultural factors interfering with the control and treatment were highlighted.

[Genetic screening of multiple endocrine neoplasia type 2: experience of the USP Endocrine Genetics Unit]. / Rastreamento gênico da neoplasia endócrina múltipla tipo 2: experiência da Unidade de Endocrinologia Genética da USP.

Multiple endocrine neoplasia type 2 (MEN-2) is an inherited tumor syndrome that includes medullary thyroid carcinoma (MTC), primary hyperparathyroidism, pheochromocytoma and other non-endocrine diseases. Since the first RET missense mutations in association with MEN-2 were identified, RET mutation analysis had a great impact in the clinical management of MEN-2, such as in early diagnosis and treatment of MTC. Presently, early total thyroidectomy provides real cure of MTC for cases in which molecular diagnosis has been performed at early ages. After RET mutation identification, family members should be screened for this mutation by using methods as DGGE, SSCP, restriction enzyme, genetic sequencing or mini-sequencing. In this paper, we briefly review our experience with the direct RET gene sequencing and DGGE approaches. In 50 typical MEN-2 patients analyzed using both methods, we found no false results suggesting that DGGE is a reliable screening method for RET proto-oncogene mutation analysis.

Rastreamento gênico da neoplasia endócrina múltipla tipo 2: experiência da Unidade de Endocrinologia Genética da USP / Genetic screening of multiple endocrine neoplasia type 2: experience of the USP Endocrine Genetics Unit

A neoplasia endócrina múltipla tipo 2 (NEM-2) é uma síndrome tumoral hereditária que compreende: carcinoma medular de tireóide, hiperparatiroidismo primário, feocromocitoma e outras doenças não-endócrinas. Desde a identificação das primeiras mutações missense no RET associadas ao NEM-2, a detecção de mutações no RET adquiriu grande impacto no tratamento clínico da NEM-2, tais como o pronto diagnóstico e tratamento do CMT. Atualmente a tireoidectomia total possibilita real cura dos casos de CMT nos quais os diagnósticos moleculares foram efetuados precocemente. Depois de identificadas as mutações no RET, os demais familiares devem ser rastreados para esta mutação utilizando-se métodos como DGGE, SSCP, enzima de restrição, seqüenciamento e mini-seqüenciamento gênico. Apresentamos uma breve revisão da nossa experiência com seqüenciamento gênico direto do RET e DGGE. Em 50 pacientes com NEM-2 analisados por ambas as técnicas, não encontramos falsos resultados, sugerindo que o DGGE é uma metodologia de rastreamento adequada para mutações no proto-oncogene RET.

O paciente odontológico portador de diabetes meliltus: uma revisão de literatura / Buccal attendance of the patient with diabetes mellitus: a revision of literature

O diabetes mellitus abrange um grupo de disturbios metabólicos que podem levar a hiperglicemia. Os principais sintomas são polidpsia, poliúria, polifagia e perda de peso. Há insuficiência vascular periférica, profocando disturbios de cicatrização, e alterações fisiológicas que diminuem a capacidade imunológica, aumentando a susceptibilidade às infecções, 3 a 4 porcento dos pacientes que se submetem a tratamento odontológicos são diabéticos. Dentre as alterações bucais desses pacientes, estão a hipoplasia, a hipocalcificação do esmalte, diminuição do fluxo e aumento da acidez e da viscosidade salivar, que são fatores de risco para cárie. O maior conteúdo de glicose e cálcio na saliva favorece o aumento na quantidade de cálculos e fatores irritantes nos tecidos. Ocorre xerostomia, glossodini, ardor na língua, eritema e distúrbios de gustação. A doença periodontal é a manifestação odontológica mais comum, estando presente em 75 porcento destes pacientes. Além disso, emergências como a hipoglicemia e a cetoacidose metabólica podem ocorrer durante o atendimento, e o cirurgião-dentista deve estar atento para suspeitar previamento de um diabetes mellitus não diagnosticado. O objetivo dessa revisão e esclarecer as principais correlações entre o diabetes mellitus e essas manifestações, evidenciando as condutas indicadas a serem tomadas pelo cirurgião-dentista, e ressaltar a importância do diálogo mais efetivo entre odontologia e medicina, elevando os índices de sucesso terapêutico

Identificação de mutações do proto-oncogene RET associados à forma hereditária do carcinoma medular de tireóide / Identification of proto-oncogene RET mutations associated to hereditary form of medullary thyroid carcinoma

A forma hereditária de carcinoma medular de tireóide (CMT) apresenta um caráter autossômico dominante e pode associar-se ao feocromocitoma e/ou hiperparatiroidismo, compondo o quadro das neoplasias endócrinas múltplas do tipo 2 (NEM2)...

The hereditary form of medullary thyroid carcinoma (MTC) has an autosomal dominant pattern and may be associated to pheochromocytoma and/or hyperparathyroidism, as multiple endocrine neoplasia type 2 (MYEN2)...