Background: Approximately 2–4% of individuals worldwide with diabetes mellitus have foot ulcers. This study aims to assess the factors affecting the outcomes of severe foot ulcers in diabetic individuals. Methods: An analytical prospective cohort study was conducted from March 1st, 2015, to March 1st, 2017. A total of 34 individuals was selected. The study included patients with foot ulcers below the ankle who were at risk of amputation. All tests used a <5% level of significance and confidence interval of 95%. A Pearson’s chi-squared test and binary multiple regression were performed to assess the factors related to healing. Results: Only 11.7% of the individuals required amputation; ulcers classified as 2/B according to the University of Texas Diabetic Foot Ulcer Classification System healed before the 1/B ulcers. Neuropathic ulcers were the most prevalent (58.8%); 61.8% healed after 1 year. Most of the individuals were overweight, 47.1% had reduced glomerular filtration rates, and 78.8% had glycated hemoglobin >7%. Body mass index and osteomyelitis were the two significant variables in logistic regression. Conclusions: In this study, osteomyelitis was the main complication related to the risk of amputation, and elevated body mass index and osteomyelitis were the significant factors that induced a slower healing time.

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.

Introduction: Diabetes, a chronic metabolic disease with high prevalence in Brazil, is a risk factor for severe SARS COV-2 infection. The relationship between previous glycemic control and the prognosis of patients hospitalized with COVID-19 is not fully understood. Objective: analyze the clinical outcome of patients with diabetes mellitus infected by SARS-COV-2. Outlining: A retrospective analysis of medical records was carried out using the Trakcare electronic system of all diabetic patients hospitalized with a confirmatory diagnosis of pneumonia due to COVID-19 in the medical clinic ward of HRAN, from June to August 2021, who, upon admission, performed the glycated hemoglobin test and analyzed it using the SPSS software (20.0). Results: A sample of 52 patients was obtained during the study period. Most patients are female, with a mean age of approximately 58 years. The comorbidity most associated with the participants was systemic arterial hypertension, with most diabetics presenting good prior glycemic control, represented by HbA1c ≤ 7%. The lethality found was 7.7%. Implications: The study shows a high lethality of diabetic patients infected by COVID 19, but no statistical significance was found for HbA1c levels with the increase in length of stay, use of non-rebreathing mask, need for invasive mechanical ventilation or lethality

Objetivo: Descrever as características clinicas, endoscópicas e abordagem terapêutica de crianças com o diagnóstico de Aspiração de Corpo Estranho (ACE) atendidos na Emergência da Broncoesofagologia -HBDF. Métodos:Estudo descritivo e retrospectivo, baseado em prontuários de pacientes com ACE atendidos na Emergência da Broncoesofagologia-HBDF( janeiro de 2012 a janeiro de 2015). Foram consideradas crianças neste estudo pacientes com idade < 18 anos. Foram analisadas as variavéis: sexo, idade, características do corpo estranho(CE) aspirado(tipo e localização), clínica, radiologia, tratamento, complicações e mortalidade.Resultados: 51 pacientes tiveram o diagnóstico de ACE. 45(88,2%) com idade < 18 anos (crianças). Entre as crianças, a ACE predominou no sexo masculino (73,3%) e na faixa etária de 1-3 anos (53,3%). Sementes foram os CE mais aspirados (40%). Houve predomínio da ACE na arvore brônquica direita (46,4%). Tosse e dispnéia após engasgo foram as queixas principais. Dezoito (40%) possuiam CE radiopacos ao Rx-tórax. A broncoscopia rígida sob anestesia geral foi utilizada em 95,5%. Dois pacientes necessitaram de UTI devido insuficiência respiratória aguda pela ACE e dois por desconforto respiratório secundário à laringoespasmo ou edema glótico-subglótico pós-procedimento. Cinco(11,1%) menores possuiam pneumonia e um bronquiectasias como complicação pelo CE na arvore traqueobrônquica. Não houve óbito e procedimento cirúrgico aberto para remoção do CE.Conclusões: ACE foi um acidente predominante nos pacientes pediátricos ( principalmente meninos com idade entre 1-3 anos). Sementes foram os CE mais aspirados. Houve predominância da ACE na arvore brônquica direita. A broncoscopia mostrou-se segura e eficaz no tratamento.