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Background It is believed that genetic factors play a role in the development and severity of neural injury among people with distal symmetrical polyneuropathy (DSP), because some genes are involved in specific biological pathways, acting in different ways in the pathogenic process.

OBJETIVO: Verificar a utilização de monofilamento de 10 g no diagnóstico de neuropatia diabética (NPD) em idosos comparando-o a escores de rastreio de dois instrumentos validados. MÉTODOS: Estudo transversal descritivo, com amostra de conveniência, no qual foram avaliados 50 pacientes com NPD diagnosticada por meio dos instrumentos escore de sintomas neuropáticos (ESN) e escore de comprometimentos neuropáticos (ECN) e sensação protetora plantar através do monofilamento de Semmes-Weinstein de 10 g (laranja). RESULTADOS: 50 idosos foram diagnosticados com NPD pelos instrumentos ESN e ECN e, quando comparados quanto à presença ou ausência do monofilamento de 10 g, não se observou correlação estatística significativa através do teste de Kruskal-Wallis, inclusive, em muitos pacientes o monofilamento estava preservado. CONCLUSÃO: O monofilamento de 10 g isolado não foi capaz de indicar o diagnóstico de neuropatia diabética. Idosos com neuropatia diabética podem apresentar sensação plantar preservada.

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El incremento de casos de Diabetes Tipo 2 es notorio, un gran porcentaje de estas personas no realiza medidas preventivas para evitar o retrasar las complicaciones de esta enfermedad. El déficit del nivel de automanejo eleva los porcentajes de descontrol de este padecimiento. El objetivo de esta investigación fue determinar el nivel de automanejo en personas que viven con esta enfermedad, con riesgo de pie diabético, de Oxkutzcab, Yucatán. Para ello se realizó un estudio cuantitativo, descriptivo, transversal con una muestra de 30 personas con Diabetes Tipo 2, se recabaron los datos a través del cuestionario Partner in Health Scale y el Test de Michigan, se complementó con la valoración física a través del diapasón, monofilamento e índice de brazo tobillo en el cual se utilizó como herramienta un Doppler vascular, de esta forma se determinó el grado de riesgo de estas personas. Resultados: Los participantes fueron el 86.7% (n=26) mujeres y el 13.3% (n=4) hombres. El 100% presentó algún grado de riesgo de neuropatía diabética y el 69.9% (n=21) ha experimentado alguna sintomatología de neuropatía diabética, que es la causa principal del pie diabético. Los resultados de la prueba “Partner in Health Scale” indican que el 26.7% (n=8) obtuvo un automanejo deficiente. Conclusión: El automanejo ofrece la oportunidad para abordar este problema de salud de manera diferente, especialmente considerar no solo la necesidad de empoderar al paciente y aumentar el conocimiento sobre la enfermedad, sino también lograr una adopción de sus roles en la vida como consecuencia de su enfermedad.

Copyright of Acta Médica Peruana is the property of Colegio Medico del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Resumo Objetivo Mapear a produção científica sobre cuidados de enfermagem a pessoas com pé diabético na atenção primária à saúde. Métodos Esta revisão de escopo foi realizada no período de outubro-dezembro de 2022. Nela, foram usadas a metodologia do Joanna Briggs Institute e as seguintes fontes de informação: PubMed, CINAHL, Web of Science, Scopus, BDENF, LILACS e SciELO, artigos nos idiomas Inglês, Português e Espanhol. Os textos foram exportados para o aplicativo Rayyan, sendo suprimidos os duplicados. Resultados Foram identificados 334 estudos; após remoção de duplicatas, 318 deles permaneceram para seleção por títulos e resumos. Nesta etapa, 235 estudos foram excluídos pois não atendiam aos critérios pré-estabelecidos, resultando em 81 estudos para avaliação em texto completo. Nesta revisão, 14 deles foram selecionados, identificando pessoas com pé diabético como os principais cuidados de enfermagem na atenção primária à saúde: exame dos pés, educação em saúde sobre cuidados com os pés, cuidados com a ferida, controle glicêmico, visita domiciliar e encaminhamento ao serviço especializado de pessoas com pé diabético. Conclusão Evidências sobre cuidados de enfermagem a pessoas com pé diabético na atenção primária à saúde foram mapeadas e a análise mostrou que esta condição é complexa e multidimensional.

Objetivo: determinar la prevalencia de la neuropatía periférica (NP) dolorosa y asintomática en personas con diabetes mellitus tipo 2 (DM2) y sus características asociadas. Materiales y métodos: estudio transversal-descriptivo de pacientes del programa de pie en riesgo del Servicio de Endocrinología del Hospital Nacional María Auxiliadora (HMA). Se incluye a pacientes con DM2 atendidos entre el 2015 y el 2020. La definición de NP fue según el Consenso de Toronto, que considera la evaluación de tres componentes: síntomas, signos y reflejo aquíleo, calificando la certeza como posible y probable, según su combinación. Para la evaluación de síntomas se aplicó el puntaje total de síntomas (TTS, del inglés Total Symptom Score); para los signos se usó la prueba de monofilamento y se evaluó la sensibilidad vibratoria con diapasón de 128 Hz. La prevalencia de NP se calculó según sintomatología y la certeza del diagnóstico. Además, se describieron las características clínicas entre los grupos. Resultados: se incluyó a 1006 personas con una edad media de 60,5 años, de las cuales el 69,3% correspondió a mujeres. En aquellos que tenían al menos un criterio de Toronto (neuropatía posible y probable), un 60,5% presentó NP dolorosa y un 21,8% NP asintomática. Utilizando una mayor certeza diagnóstica, es decir, dos de tres criterios positivos (solo neuropatía probable), la prevalencia de NP dolorosa fue del 42,2% y la NP asintomática, 6,5%. Se establecieron cuatro grupos que presentaron distribuciones diferentes respecto a sexo, tiempo de diabetes, antecedente de úlcera, enfermedad arterial periférica y control glicémico. Conclusión: en pacientes del Servicio de Endocrinología del HMA, el 42,2 y el 6,5% presentaron una mayor certeza de presentar NP probable dolorosa y asintomática respectivamente. Se requiere estudios que confirmen la utilidad de estos criterios para estimar correctamente la carga de enfermedad.

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Objetivo: relatar a experiência na elaboração de um panfleto informativo contendo orientações sobre cuidados com o pé diabético. Materiais e Métodos: trata-se de um relato de experiência vivenciado pelas acadêmicas do 6º período do curso de Enfermagem de uma instituição de ensino superior. A atividade foi realizada em uma Estratégia de Saúde da Família de Montes Claros-MG durante os meses de agosto e setembro de 2022. Foram realizadas consultas de enfermagem voltadas para o rastreamento do pé diabético, acompanhadas da distribuição de panfletos informativos acerca da temática como meio de conscientizar a população adscrita. Resultado: notou-se a existência de dúvidas quanto à prevenção do pé diabético pelos pacientes, mostrando a necessidade de um instrutivo com as devidas informações de maneira explicativa, clara e objetiva, que foi solucionado através da distribuição dos panfletos. Conclusão: os pacientes envolvidos na atividade mostraram-se atentos às informações fornecidas de forma clara e objetiva, quanto aos cuidados que devem ter com o pé diabético. A intervenção da equipe proporcionou que os participantes assumissem o compromisso de cuidar-se adequadamente para que não ocorram ferimentos ou lesões graves.

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Propósito: la neuropatía periférica tiene un espectro clínico inespecífico y multifactorial, con frecuente subdiagnóstico y terapéutica de eficacia variable. Existe una heterogénea prescripción de vitaminas B, las cuales pueden desempeñar un rol importante en el manejo de diferentes neuropatías; sin embargo, en Colombia no existen guías clínicas al respecto. El propósito de este trabajo es orientar en el reconocimiento temprano de las neuropatías periféricas y genera recomendaciones sobre el uso adecuado de vitaminas B neurotrópicas. Descripción de la metodología: acuerdo de expertos sobre la neuropatía periférica y el rol terapéutico de las vitaminas B con énfasis en la epidemiología en Colombia, diagnóstico y tratamiento. Contenidos: en Colombia, la prevalencia de neuropatía periférica se estima en alrededor del 10?%, sin embargo, no hay datos recientes. Dentro de las etiologías más frecuentes se encuentran la neuropatía diabética, infecciosas, inflamatorias, carenciales, toxicas y farmacológicas. Se recomiendan las siguientes herramientas de tamizaje en población de riesgo: DN4, MNSI, test de monofilamento, test de vibración y valoración de reflejos. Las vitaminas B1, B6 y B12 son seguras, accesibles y pueden ser eficaces en neuropatía periférica, incluso cuando el déficit no ha sido demostrado, pero con requerimientos particulares en su administración conjunta. Conclusiones: las neuropatías periféricas son un reto diagnóstico y terapéutico que requiere la identificación oportuna para el tratamiento de la etiología subyacente y el control de síntomas. El uso de vitaminas B neurotrópicas es efectivo y seguro en neuropatía periférica carencial, y también parece ser eficaz en el manejo de neuropatías periféricas de diferentes etiologías.

La polineuropatía diabética dolorosa (PDD) es una complicación frecuente de la diabetes mellitus, con una pre- valencia estimada entre 40 a 50% en las personas con neuropatía diabética. Es la causa líder de las neuropatías periféricas con importante compromiso en la calidad de vida. Son varias las hipótesis que intentan explicar la génesis de la neuropatía diabética. Los mecanismos fisiopatológicos del componente doloroso aun se desconocen. En este capitulo se exponen los tratamientos sintomáticos más utilizados, clasificados de acuerdos a ensayos clínicos aleatorios existentes y con su eficacia expresada según el numero necesario a tratar (NNT).

La neuropatía diabética se presenta hasta en el 60% de los pacientes diabéticos. La neuropatía diabética periférica es la causa más común de neuropatía en el mundo. La fisiopatología de la neuropatía diabética involucra daño periférico nervioso por acumulación de productos tóxicos derivados de la hiperglicemia. El sistema nervioso central se ve posteriormente involucrado a través de sensibilización, disminución de la función del sistema inhibitorio y aumento en la excitabilidad del sistema de facilitación. La clínica más común se manifiesta de manera simétrica afectando fibras sensitivas pequeñas y grandes, aunque se han encontrado formas atípicas de presentación. Las pruebas diagnósticas confirmatorias se reservan para la duda diagnóstica, casos de síntomas atípicos o investigación. El consenso en cuanto a tratamiento es el uso de gabapentinoides, antidepresivos tricíclicos e inhibidores de recaptura de serotonina y noradrenalina. Estas tres familias se consideran como primera línea de tratamiento.

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Background Cutaneous silent period (CSP) is the interruption in muscle activity after painful stimulation of a sensory nerve.

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to describe the evolution of risk factors for the development of foot ulcers in patients with DM, in three subsequent exams over a period of 3 years, in a medical specialty center. Method: a descriptive, retrospective and longitudinal study, with 102 patients, between the years 2016 and 2019, who performed three sequential foot exams, based on the standard established by the international consensus of the diabetic foot, being use of footwear, collected from the Diabetic Foot System. Results: 86.27% of patients reported neuropathic symptoms, mainly burning, numbness and tingling. Most were hypertensive (74.71%) and elderly (67.65%), of these, 13.73% had previous infarction and 72.55% were female. From the first to the third examination, the "very low risk" increased 7.84% and the "low risk" 8.83%, while the "high risk" reduced 17.65%. Conclusion: the systematic clinical feet exam, associated with effective educational strategies, results in a more effective control of the risk of ulceration. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physiotherapy Research / Revista Pesquisa em Fisioterapia is the property of Journal of Physiotherapy Research / Revista Pesquisa em Fisioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To develop a tool to assess the diabetic foot in Primary Health Care in a health unit in the east of Maranhão. This is a methodological study, carried out in the Family Health Strategy (ESF), developed in three stages: 1) Construction based on the literature review; 2) Application of the instrument for the pre-test with the target audience; 3) Application of the content by post-test professionals. In the pre-test phase, 53 patients were identified, the first version of the instrument consisted of 8 items, at the end of the pre-test, the identification items, assessment of risk factors, risk stratification and self-care capacity, the last stage of construction and validation of this instrument was the application by the higher education professionals of the ESF Pirajá. The use of a technology in health services contributes to the adequacy and improvement of the assistance provided. [ABSTRACT FROM AUTHOR]

Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Objetivo: Diante da alta prevalência do Diabetes Mellitus, o estudo se propõe a identificar os fatores associados ao maior risco de desenvolver úlceras nos membros inferiores. Métodos: O trabalho foi exploratório-descritivo, transversal e com abordagem quantitativa. A amostra foi composta por pacientes com Diabetes acima de 18 anos de um serviço de saúde particular e um público. A coleta de dados ocorreu através de anamnese, exame físico e procura em prontuário. A análise estatística foi realizada pelo Programa SPSS 20.0. Resultados: Obteve-se 102 participantes no estudo, destes, 67,6% apresentaram critérios diagnósticos para Polineuropatia Simétrica Distal. Os fatores associados ao risco de ulceração foram: o envelhecimento, a maior duração da Diabetes, hipertensão, doença arterial periférica e a presença de sintomas típicos da Polineuropatia. Conclusão: É necessário investir na prevenção de úlceras em indivíduos com Diabetes através de educação em saúde e acompanhamento por profissionais da saúde.

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Objective: to compare pain and quality of life in individuals with and without diabetic neuropathy. Method: a cross-sectional study with 251 participants with type 2 diabetes mellitus. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale was used to assess diabetic neuropathy, pain characteristics, loss of protective sensitivity (LPS) and to assess the quality of life by Short-Form 6 Dimensions-Brasil/SF-6D. Descriptive statistical analysis was performed. Results: among the participants, 16.3% had neuropathy, 97.6% complained of pain, most of them chronic and in the feet or calves. Also, 51.2% of neuropathic patients had LPS in the monofilament test (p=0.001). The pain descriptors most frequently reported by neuropathic patients were: burning (p=0.004), tingling (p=0.002), and pinprick and/or needling (p=0.003). The affected quality of life domains were: pain, mental health, and vitality. Conclusion: those with neuropathy have greater pain intensity, wake up at night, and have altered foot sensitivity, which can be tracked in primary care.

Enquadramento: A neuropatia diabética (ND) é uma complicação que afeta o paciente com diabetes mellitus (DM), doença crónica com elevada prevalência em idosos. Objetivo: Avaliar os fatores preditivos da neuropatia diabética em idosos atendidos na atenção primária em saúde. Metodologia: Estudo transversal realizado com 111 idosos com DM tipo 2. Foi realizada análise bioquímica e utilizado Inventário de Depressão de Beck (BDI), Escala Numérica Visual (ENV) e Escala de Dor - Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). Análise de regressão foi realizada no IBM SPSS Statistics, versão 20.0. Resultados: A prevalência de ND foi 29,7%. A intensidade de dor nos pés e gémeos foi significativamente associada à ND (p = 0,001). Foram significativamente associados à ND: hemoglobina glicada (p < 0,001), glicemia em jejum (p = 0,001), triglicerídeos (p = 0,038), depressão (p < 0,001) e sedentarismo (p < 0,001). Após a regressão permaneceram associadas à ND: hemoglobina glicada elevada, sedentarismo e depressão. Conclusão: Os fatores preditivos para ND em idosos foram depressão, hemoglobina glicada elevada e sedentarismo.

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Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To evaluate neuropathic pain (NP), its intensity, and complications in people with type 2 diabetes mellitus (T2DM) in a city of eastern São Paulo. Method: Cross-sectional study conducted with 96 individuals with T2DM served by primary health units in São João da Boa Vista-SP. The following instruments were used to screen NP: Michigan Neuropathy Screening Instrument, Leeds Assessment of Neuropathic Symptoms and Signs, Douleur Neuropathique 4, and Brief Pain Inventory. The data were analyzed using descriptive and inferential statistics, with a 5 % significance level. Results: Of the 96 people with T2DM for longer than five years, 22.9 % had pain. NP was related to high levels of fasting blood glucose (mean = 214 ± 65.58 mg/dl; p = 0.0002), glycated hemoglobin (mean = 8.8 ± 0.11 %; p < 0.001), absence of a balanced diet (p = 0.0066), obesity (p = 0.023), and high blood pressure (p < 0.001). Conclusion: Higher values of glycated hemoglobin rates increased three times the chance of NP. The screening and management of painful diabetic neuropathy is a challenge but adopting a screening protocol supports the secondary prevention of this manifestation. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes Mellitus (DM) is a chronic disease characterized by elevated blood glucose above the normal rate. Patients with DM may manifest low sensitivity, irregularity in proprioception, low flexibility and muscle atrophy. Objective: To answer the following question: What strategies can be used in the physical therapy rehabilitation of patients with diabetic neuropathy (ND)? Methodology: Study conducted through systematic review. Twenty-seven studies published between 2007 and 2019 were used for the composition of this article. For the development of the results, a thorough synthesis was performed in the Google Scholar, PubMed, Scielo, Medline and University Repositories databases on the forms of physiotherapeutic treatments of diabetic neuropathy. Results: Previously, 24 studies were selected and from these 5 were used to compose a chart with the measures that can be used in physical therapy rehabilitation in individuals with diabetic neuropathy. All 5 studies achieved positive results with their respective treatments. Discussion: There are still few ways to treat neuropathy in the literature. This needs to be changed, because as seen the treatment brings benefits to those affected by this condition. Conclusion: The physiotherapist, through their care, contributes to a significant reduction of the damage caused by diabetic neuropathy. This professional needs to be able to identify the type of neuropathy that affects the individual and decide on the treatment that best suits the patient. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Enfermagem Referência is the property of Escola Superior de Enfermagem de Coimbra and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Diabetic neuropathy represents a polyneuropathy with electrophiosiological alterations. Electroneuromyography (NMD) plays an important role in the evaluation of patient with diabetes mellitus type 2 (DM2) and doubtful neuropathy. Objective: To determine clinical manifestations in patients with distal symmetrical sensory polyneuropathy (DSSP) and to correlate them with electromyographic alterations. Material and methods: Transversal, analytical study. 138 patients over 18 years old, with DM2 and PSSD were selected. They underwent physical examination, laboratory studies and electromyography (EM) with 4-channel Nicolet electromyograph. Measures of central tendency and their dispersion were analyzed; data normality with Kolmogorov-Smirnov; Student's t test and Spearman's correlation. Results: Thalar hyperkeratosis was the most frequent clinical finding in 103 (74%) patients. The most frequent symptoms were paresthesia in 132 (95.7%) patients and tingling in 93 (67.4%) patients. Exploration of superficial sensitivity determined neuropathy in 42 (30.4%) patients finding greater insensitivity in the medial plantar nerve territory. In the EM, the nerve with the greatest absent response was the left lateral plantar nerve in 51 (59%) patients. A significant correlation (p < 0.05) was found between the variables of EM with age, years of evolution and levels of glycated hemoglobin A1c. Conclusions: The higher the lack of glycemic control, the chronobiology of the patient and the time of illness, the greater the electromyographic affection. [ABSTRACT FROM AUTHOR]

Introducción: el Pie Diabético es una alteración clínica de base etiopatogénica neuropática e inducida por la hiperglucemia mantenida, en la que con o sin coexistencia de isquemia, y previo desencadenante traumático, produce lesión y/o ulceración del pie. Presentación del caso: se presenta el caso de un paciente blanco, de 44 años de edad, que acudió al cuerpo de guardia porque hace varios días se perforo la región plantar del pie derecho con un clavo, nos plantea que no tiene sensibilidad en los pies, se dio cuenta por la pérdida de sangre, aumento de volumen del pie con cambio de coloración decir enrojecimiento que fue aumentando hasta tomar la pierna, así como fiebre elevada de 39 grados centígrados. Se ingresa al paciente con el diagnóstico de un Síndrome de Respuesta Inflamatoria Sistémica por un Pie Diabético Séptico grado 3 en la Sala de hospitalización y se comienza tratamiento. Conclusiones: se puede concluir que la aplicación del Heberprot-P mostró resultados satisfactorios re-incorporando al paciente a su vida social y laboral, sin limitaciones físicas, en un corto período de tiempo.

Objective: To assess the quantitative serum levels of tropomyosin receptor kinase receptor B, and to estimate its association with serum concentration of brain-derived neurotrophic factor and obesity in patients with painful and painless forms of diabetic polyneuropathy. Methods: We examined 70 patients with diabetic polyneuropathy with confirming peripheral nerve dysfunction by electroneuromyography and measuring of serum levels tropomyosin receptor kinase receptor B and brain-derived neurotrophic factor by enzyme immunoassay. Diabetic polyneuropathy was diagnosed using the modified Toronto Consensus (2011) criteria, while neuropathic pain was assessed using an 11-point Numerical Pain Rating Scale. The patients were divided into two groups according to presence or absence of neuropathic pain. Control Group consisted of 14 healthy persons. Results: The serum levels of tropomyosin receptor kinase receptor B and brain-derived neurotrophic factor in patients with diabetic polyneuropathy are significantly higher than healthy controls (p=0.000). Hyperexpression of brain-derived neurotrophic factor in serum was associated with painful form of diabetic polyneuropathy (R=0.392, p=0.012) and obesity (R=0.412, p=0.001). On the contrary high concentration of tropomyosin receptor kinase receptor B in serum associated with painless diabetic polyneuropathy by Pain DETECT (R=-0.354, p=0.015), low body weight (R=-0.354, p=0.015) and severe demyelization of nerve fibers (R=-0.574, p=0.001), indicated “non-working” receptor detected in serum. Conclusion: Tropomyosin receptor kinase receptor B signaling is involved in the modulation of neuropathic pain and obesity in diabetic polyneuropathy. [ABSTRACT FROM AUTHOR]

Introduction: Neuropathic pain is complex and despite the pharmacological and non-pharmacological advances of recent years, it is the main cause of suffering in insulin-dependent diabetic patients. Objective: To update a non-systematic review of the literature on neuropathic pain in the insulin-dependent diabetic patient. Material and methods: A literature search was conducted on August 3 of 2019 in the PubMed databases of the National Medical Library of the United States (NLM), with the following English-language descriptors: insulin-dependent diabetes mellitus AND neuropathic pain, which offered a total of 133 publications. When the filter was activated in humans, 11 articles were maintained. With the filter in the last five years, full text remained one whose title is not related to the proposed project. Conclusions: The general insulin-dependent diabetic patient presents with neuropathic pain of varying intensity, which affects their quality of life and requires specialized treatment. [ABSTRACT FROM AUTHOR]

Introducción: la diabetes mellitus es causa importante de discapacidad y muerte. Se estima que para el año 2030 supere la cifra de 435 millones de personas. Aproximadamente del 60 al 70% de estos pacientes tienen algún grado de neuropatía; en su tratamiento se utilizan analgésicos, antidepresivos, anticonvulsivantes y terapias tradicionales como la acupuntura y las plantas medicinales. Objetivo: evaluar los resultados terapéuticos del uso de la farmacopuntura en el tratamiento de la polineuropatía periférica en pacientes con diabetes mellitus tipo 2. Método: se realizó un estudio de desarrollo, descriptivo, prospectivo, longitudinal, cuasi experimental en el Hospital “Comandante Manuel Fajardo Rivero” de Santa Clara de octubre de 2010 hasta septiembre de 2014. La muestra quedó conformada por 66 pacientes, a través de un método no probabilístico, por criterios. La inclusión a cada grupo se realizó de manera aleatoria. El tratamiento se realizó con vitaminas B1, B6 y B12. A los pacientes del grupo estudio se les administró 0,3cc en puntos acupunturales, en dependencia del diagnóstico por Zang Fu, y al grupo control 1cc de cada una por vía intramuscular; a todos por 10 sesiones de tratamiento. Resultados: los pacientes del grupo estudio presentaron una evolución clínica más favorable en un tiempo corto de remisión. Los principales eventos adversos se presentaron en el grupo control. Los resultados terapéuticos del grupo estudio fueron satisfactorios en mayor número de pacientes que en el grupo control. Conclusiones: se lograron resultados terapéuticos satisfactorios con el uso de la farmacopuntura en el tratamiento de la polineuropatía periférica diabética.

Fundamento: la polineuropatía diabética es la complicación más frecuente de la diabetes mellitus. Sin embargo, en la actualidad no se ha definido su verdadera incidencia y prevalencia. Objetivo: determinar los hallazgos neurofisiológicos y las características clínicas de la polineuropatía diabética. Métodos: se realizó un estudio descriptivo, prospectivo, y transversal, realizado en el laboratorio de neurofisiología del Hospital Pediátrico Paquito González Cueto de Cienfuegos, durante los meses de marzo a junio de 2016. El universo lo constituyeron los 57 pacientes diabéticos que acudieron al laboratorio en ese periodo de tiempo con el objetivo de realizarse estudios de conducción nerviosa. Se incluyeron pacientes mayores de 18 años de ambos sexos. Las variables demográficas analizadas fueron: edad, sexo, así como los relacionados a la diabetes mellitus (tiempo de evolución). Asimismo, se determinó la presencia de sintomatología sensitiva, como dolor, parestesias, disestesias, entre otras. Se calculó el porcentaje de pacientes con polineuropatía diabética y se determinó su relación con la edad, sexo, tiempo de evolución de la diabetes y sintomatología sensitiva. Todas las operaciones estadísticas fueron realizadas con el programa informático para análisis de datos SPSS 15,0 para Windows. Resultados: el 94,7 % de pacientes presentó compromiso motor, con criterios de polineuropatía diabética, la edad osciló entre 36 y 55 años, 43 fueron mujeres (75,4 %), el tiempo de enfermedad promedio fue de 10 años y el 80,7 % refirió síntomas sensitivos. Conclusiones: la exhaustiva anamnesis a pacientes diabéticos encontró sintomatología sugestiva de polineuropatía diabética, además presentaron hallazgos neurofisiológicos compatibles con dicha patología.

La neuropatía autonómica cardíaca es una complicación frecuente y subdiagnosticada de la diabetes, se asocia con una mayor mortalidad por causas cardiovasculares e incapacidad física. El tratamiento actual está basado en recomendaciones de expertos y experiencias locales, debido a la falta de estudios de alto peso epidemiológico que orienten el manejo de estos pacientes. Con esta revisión se busca generar conciencia a la comunidad médica acerca de la importancia de esta entidad, de su reconocimiento temprano, formas de diagnóstico y tratamiento disponibles con la evidencia actual.

RESUMO Introdução: a percepção sensorial tátil alterada é uma complicação do diabetes mellitus que antecede a neuropatia e que pode ser identificada pelo enfermeiro. Deve envolver exame neurológico dos pés, avaliação da sensibilidade (tátil, dolorosa-térmica e vibratória) e de reflexos tendíneos. Os avaliadores devem estar aptos a implementar as avaliações. Para isso, treinamento é necessário. Objetivo: estabelecer o grau de concordância interavaliadores na avaliação da percepção sensorial tátil alterada em pacientes com diabetes mellitus. Métodos: estudo transversal realizado com três avaliadores para obter a concordância na avaliação dos pés de pacientes com diabetes atendidos em um ambulatório de referência de Campina Grande, Paraíba, Brasil. Foram avaliados 60 membros inferiores (pés) de 30 pacientes, a partir dos testes de sensibilidade protetora, térmica, vibratória, dolorosa e o reflexo aquileu. Para a avaliação da concordância interavaliadores, foi utilizado o coeficiente de Kappa e adotado o nível de significância com o valor p < 0,05. Resultados: a maioria dos pacientes era do sexo feminino, com idade média de 59,3 anos, tempo de diagnóstico de 12,6 anos. Observou-se concordância geral, havendo variação no coeficiente de Kappa entre 0,814 e 0,902 entre os avaliadores com o padrão-ouro. Os índices obtidos indicam concordâncias quase perfeitas. Conclusão: os avaliadores foram julgados aptos a realizar a avaliação neurológica dos pés de pacientes com diabetes mellitus após período de capacitação. A concordância interavaliadores é fundamental para pesquisas clínicas, uma vez que favorece o ajuste entre as avaliações em diferentes técnicas para a coleta de informações clínicas.

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Introduction: Type 2 diabetes mellitus often presents complications including peripheral neuropathy of the lower limbs. This is a micro-vascular complication, altering the quality of life and increasing the morbidity and mortality of those who suffer from it. Materials and methods: A cross-sectional study was conducted on a sample of 323 patients. This was calculated with 95% confidence, 30% prevalence of obesity, 5% inference error, infinite population, and they entered the study sequentially. The diagnosis of neuropathy was made with the DN4 questionnaire. Data were collected directly. Results: The prevalence of neuropathy was 44,0% (95% CI 35,8-52,2); in women 49,3%, in men 34,0%; in children under 40 years 0%; between 40-64 years 42,6% and those over 64 years 48,3%, Conclusions: The prevalence of neuropathy was higher than the 30% stated in the hypothesis, and was associated with the time of evolution of diabetes. [ABSTRACT FROM AUTHOR]

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A calcitonina é um hormônio polipeptídico que regula o metabolismo do cálcio no organismo. Por muitos anos a calcitonina tem sido usada para manter e melhorar a densidade mineral óssea e reduzir a incidência de fraturas. Muitos estudos mostraram que a calcitonina teve efeito analgésico em várias condições físicas de dor. Esse efeito de melhoria da dor é irrelevante diante de seu efeito inibidor osteoclástico e de mecanismos, tais como a alteração do canal de Na+ e da expressão do receptor de serotonina, inclusive a hipótese do mecanismo mediado pela endorfina, que foram usados para explicar esse efeito. Neste estudo, fizemos uma revisão completa sobre o papel da calcitonina como agente analgésico em diferentes cenários e investigamos o fato de que a calcitonina pode ser uma medicação viável para aliviar a dor. Muitos estudos centraram no efeito analgésico da calcitonina em várias condições de dor, inclusive dores agudas relacionadas a fraturas vertebrais, metástases, enxaqueca e distrofia simpática reflexa, bem como dores neuropáticas relacionadas a lesões medulares ou ao diabetes e dor fantasma. Além disso, a calcitonina mostrou ser um aditivo útil à anestesia local para o controle mais efecaz da dor pós‐operatória ou neuralgia do trigêmeo. Porém, nos deparamos com alguns dados contraditórios em condições como estenose do canal lombar, síndrome complexa da dor regional, dor fantasma e malignidades. Este estudo mostrou que a calcitonina pode ser um analgésico útil em diferentes condições de dor. A calcitonina pode ser considerada um tratamento elegível para as dores agudas relacionadas a fraturas vertebrais e uma opção viável para o tratamento das dores neuropáticas agudas e crônicas em que outros medicamentos podem falhar. Calcitonin is a polypeptide hormone regulating the metabolism calcium in the body. For many years calcitonin has been used to maintain and improve bone mineral density and to reduce the fracture rate. Many studies showed that calcitonin had analgesic role in several painful circumstances. This pain‐ameliorating effect is irrelevant to its osteoclastic inhibitory effect and mechanisms like altering Na+ channel and serotonin receptor expression or hypothesis including the endorphin‐mediated mechanism were used to explain this effect. In this study we performed a thorough review on the role of calcitonin as an analgesic agent in different scenarios and investigated the fact that calcitonin can be a feasible medication to relieve pain. Many studies focused on the analgesic effect of calcitonin in several painful circumstances, including acute pains related to vertebral fractures, metastasis, migraine and reflex sympathetic dystrophy as well as neuropathic pains related to spinal injuries or diabetes, and phantom pain. Also, calcitonin was showed to be a useful additive to local anesthesia in the case of controlling postoperative pain or trigeminal neuralgia more effectively. However we faced some contradictory data for conditions like lumbar canal stenosis, complex regional pain syndrome, phantom pain and malignancies. This study showed that calcitonin could be helpful analgesic agent in different painful situations. Calcitonin can be considered an eligible treatment for acute pains related to vertebral fractures and a feasible alternative for the treatment of the acute and chronic neuropathic pains where other medications might fail. [ABSTRACT FROM AUTHOR]

ABSTRACT Since 1994, the University of Michigan Diabetes Research and Training Center proposed an instrument to measure neuropathies not yet adapted to use in Brazil. Then, this study aimed to adapt cross-culturally the Michigan Neuropathy Screening Instrument (MNSI) into Brazilian Portuguese, verifying its reliability. Thirty diabetic patients were initially evaluated with the adapted version after completed the essential steps to accomplish the cross-cultural adaptation. Twenty-two of them completed the procedures to repeat the measured scores after day 1 (trial 0). The repeated measurements were tested at days 2 or 3 (trial 1) by another rater (inter-rater reliability) and retested at day 20 (trial 2) by one of the attended raters (inter-test reliability). There were not great semantics, linguistics or cultural differences between two versions and excellent reliability was confirmed by intra-class correlation coefficient above 0.840. It was concluded that MNSI in the Brazilian version is reliable and it is ready to use.