Análise do perfil epidemiológico de pacientes portadores de diabetes mellitus que apresentam sinal da prece
Tipo
TCC
Data de publicação
2024-06-20
Periódico
Citações (Scopus)
Autores
Costa, Bruno Pugsley da
Conti, Diogo de
Conti, Diogo de
Orientador
Zella, Maria Augusta Karas
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Resumo
A síndrome da mobilidade articular limitada, ou quiroartropatia diabética, caracteriza-se por limitação do movimento das articulações metacarpofalangeanas e interfalangeanas, a qual, por dificuldade e/ou incapacidade de flexo-extensão dos quirodáctilos, resulta na existência de espaço remanescente entre as mãos quando se busca mantê-las juntas e espalmadas, identificando o chamado "Sinal da Prece". Nota-se que essa condição, assim como outras alterações musculoesqueléticas, repercute em pacientes portadores de diabetes mellitus (DM) e acarreta cada vez mais comprometimento ao indivíduo, à medida que a doença perdura por prolongados períodos de tempo sem adequado controle da glicemia. Objetivos: Analisar o perfil epidemiológico dos pacientes com diabetes mellitus em atendimento terciário que apresentam o Sinal da Prece, bem como a prevalência desse achado semiológico nos portadores da doença. Métodos: Trata-se de um estudo transversal, observacional, avaliando 60 pacientes acima de 18 anos com diabetes, internados no Hospital Universitário Evangélico Mackenzie do Paraná e/ou em atendimento ambulatorial. Os entrevistados foram submetidos a responder formulário impresso acerca do perfil do indivíduo portador de diabetes, seguido pela avaliação clínica - através de breve exame físico e inspeção por parte dos examinadores - para aferir a presença do Sinal da Prece e Tabletop Sign em suas mãos, além da contratura de Dupuytren, síndrome do túnel do carpo, capsulite adesiva de ombro, tenossinovite de DeQuervain e presença da tenossinovite estenosante dos flexores dos dedos (dedos em gatilho). Resultados: O grupo avaliado foi formado por 8,3% (n = 5) pacientes com DM1 e por 91,7% (n = 55) com DM2, havendo predomínio do sexo masculino (60%). O achado semiológico do Sinal da Prece foi prevalente (43,3%) nos pacientes que faziam mais consultas/ano com endocrinologistas e diretamente relacionado com a presença de pelo menos uma das seguintes comorbidades: dislipidemia (p = 0,001), doença arterial obstrutiva periférica (p = 0,01), neuropatia (p = 0,002), tenossinovite de DeQuervain (p = 0,04), insuficiência renal (p = 0,007), históricos de hemodiálise (p = 0,0002) e amputação (p = 0,02). Conclusão: A prevalência do Sinal da Prece foi de 43,3% nos indivíduos avaliados, associado a sete comorbidades e ao maior número de consultas realizadas no ambulatório de endocrinologia por quadro crônico de descontrole do diabetes.
The limited joint mobility syndrome, or diabetic cheiroarthropathy, is characterized by limited movement of the metacarpophalangeal and interphalangeal joints, which, due to difficulty and/or inability of flexion-extension of the fingers, results in the presence of remaining space between the hands when attempting to keep them together and flat, identifying the so-called "Prayer Sign". It is noted that this condition, as well as other musculoskeletal disorders, affects patients with diabetes mellitus (DM) and increasingly compromises the patient as the disease persists for long periods of time without adequate glycemia control. Objectives: To analyze the epidemiological profile of patients with diabetes mellitus in tertiary care who present the Prayer Sign, as well as the prevalence of this semiological finding in patients with the disease. Methods: This is a cross-sectional, observational study, evaluating 60 patients over 18 years of age with diabetes, hospitalized at the Mackenzie Evangelical University Hospital of Paraná (Hospital Universitário Evangélico Mackenzie) and/or receiving outpatient care. The interviewees were asked to answer a printed form about the profile of the individual with diabetes, followed by clinical evaluation - through a brief physical examination and inspection by the examiners - to assess the presence of the Prayer Sign and Tabletop Sign in their hands, as well as Dupuytren's contracture, carpal tunnel syndrome, adhesive capsulitis, DeQuervain's tenosynovitis, and the presence of stenosing flexor tenosynovitis (trigger fingers). Results: The assessed group consisted of 8.3% (n = 5) patients with type 1 diabetes (DM1) and 91.7% (n = 55) with type 2 diabetes (DM2), with a predominance of males (60%). The semiological finding of the Prayer Sign was prevalent (43.3%) in patients who had more consultations/year with endocrinologists and directly related to the presence of at least one of the following comorbidities: dyslipidemia (p = 0.001), occlusive peripheral arterial disease (p = 0.01), neuropathy (p = 0.002), DeQuervain's tenosynovitis (p = 0.04), renal insufficiency (p = 0.007), and histories of hemodialysis (p = 0.0002) and amputation (p = 0.02). Conclusion: The prevalence of the Prayer Sign was 43.3% in the evaluated individuals, associated with seven comorbidities and higher number of consultations conducted at the endocrinology outpatient clinic due to chronic diabetes control issues.
The limited joint mobility syndrome, or diabetic cheiroarthropathy, is characterized by limited movement of the metacarpophalangeal and interphalangeal joints, which, due to difficulty and/or inability of flexion-extension of the fingers, results in the presence of remaining space between the hands when attempting to keep them together and flat, identifying the so-called "Prayer Sign". It is noted that this condition, as well as other musculoskeletal disorders, affects patients with diabetes mellitus (DM) and increasingly compromises the patient as the disease persists for long periods of time without adequate glycemia control. Objectives: To analyze the epidemiological profile of patients with diabetes mellitus in tertiary care who present the Prayer Sign, as well as the prevalence of this semiological finding in patients with the disease. Methods: This is a cross-sectional, observational study, evaluating 60 patients over 18 years of age with diabetes, hospitalized at the Mackenzie Evangelical University Hospital of Paraná (Hospital Universitário Evangélico Mackenzie) and/or receiving outpatient care. The interviewees were asked to answer a printed form about the profile of the individual with diabetes, followed by clinical evaluation - through a brief physical examination and inspection by the examiners - to assess the presence of the Prayer Sign and Tabletop Sign in their hands, as well as Dupuytren's contracture, carpal tunnel syndrome, adhesive capsulitis, DeQuervain's tenosynovitis, and the presence of stenosing flexor tenosynovitis (trigger fingers). Results: The assessed group consisted of 8.3% (n = 5) patients with type 1 diabetes (DM1) and 91.7% (n = 55) with type 2 diabetes (DM2), with a predominance of males (60%). The semiological finding of the Prayer Sign was prevalent (43.3%) in patients who had more consultations/year with endocrinologists and directly related to the presence of at least one of the following comorbidities: dyslipidemia (p = 0.001), occlusive peripheral arterial disease (p = 0.01), neuropathy (p = 0.002), DeQuervain's tenosynovitis (p = 0.04), renal insufficiency (p = 0.007), and histories of hemodialysis (p = 0.0002) and amputation (p = 0.02). Conclusion: The prevalence of the Prayer Sign was 43.3% in the evaluated individuals, associated with seven comorbidities and higher number of consultations conducted at the endocrinology outpatient clinic due to chronic diabetes control issues.
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Palavras-chave
artropatia do diabetes , sinal da prece , complicações crônicas , diabetes arthropathy , prayer sign , chronic complications