Portadores de diabetes parecem ter mais queixas de olho seco do que o resto da população. Acredita-se que isto possa estar associado a uma forma de neuropatia diabética expressa por uma redução na sensibilidade corneana desses pacientes. Nossos principais objetivos neste estudo foram avaliar a influência da diabetes melito tipo 2 na sensibilidade corneana central e verificar se há uma associação entre a sensibilidade corneana central e a síndrome do olho seco em indivíduos com a doença. Assim, 62 portadores de diabetes tipo 2 foram submetidos a um exame oftalmológico de rotina, a uma ceratoestesiometria e a testes específicos para avaliar olho seco e polineuropatia distal simétrica. Num outro grupo, 20 voluntários saudáveis tiveram seus olhos avaliados da mesma forma, exceto pela não realização dos testes específicos para disfunção lacrimal. Entre os indivíduos diabéticos avaliados, foram observados 53.2% com hipoestesia corneana, 54.2% com retinopatia diabética, 45.9% com polineuropatia distal simétrica e 51.6% com a síndrome do olho seco. Entre os principais achados, observamos associações significativas envolvendo: diabetes tipo 2 e hipoestesia corneana central, síndrome do olho seco e hipoestesia corneana central, produção lacrimal reflexa (avaliada pelo teste de Schirmer II) e sensibilidade corneana central e retinopatia diabética proliferativa e sensibilidade corneana central. Uma possível associação foi encontrada envolvendo síndrome do olho seco retinopatia diabética proliferativa. Os autores discutem os resultados obtidos e os mecanismos envolvidos. / Diabetes bearers seem to have more complaints of dry eye than the rest of the population. It`s believed that this fact might be associated to a kind of diabetes neuropathy wich is represented by a reduction in corneal sensibility of these patients. Our main target in this study was to evaluate the influence of type 2 diabetes mellitus in central corneal sensibility and to determine if there is an association among central corneal sensibility and the dry eye syndrome in individuals suffering of this disease. Therefore, 62 type 2 diabetic patients were submitted to an ophthalmological routine examination, to corneal esthesiometry and to specific tests to evaluate dry eye and peripheral polineurophaty. In other group, 20 healthy volunteers had their eyes evaluated in the same way, except for the non accomplishment of the specific tests for dry eye. Among the examined diabetic individuals, 53.2% had corneal hypoesthesia, 54.2% presented diabetic retinopathy, 45.9% presented periferal polineuropathy and 51.6% presented the dry eye syndrome. Among the main findings, we observed associations between: type 2 diabetes and central corneal hypoesthesia, dry eye syndrome and central corneal hypoesthesia, reflex tear production (evaluated by Schirmer 2 test) and central corneal esthesiometry and also between proliferative diabetic retinopathy and central corneal sensibility. A possible association was found involving dry eye syndrome and proliferative diabetic retinophaty. The authors discuss the results obtained and the involved mechanisms.

Bakgrund: Diabetes Mellitus är en samling av kroniska sjukdomar, som påverkar kroppensförmåga att hantera blodsockernivån. I Sverige uppskattas att cirka 470 000 människor liderav sjukdomen. Det mest effektiva sättet att förebygga diabetes sena komplikationer är attpatienten själv bedriver en god egenvård. Sjuksköterskans roll i diabetesbehandling är av storbetydelse, då de stödjer och handleder patienter att bedriva god egenvård. Syfte: Syftet meddenna litteraturstudie var att undersöka sjuksköterskors erfarenhet av patienters följsamhet tillegenvårdsråd vid diabetes typ 2. Metod: Studien har genomförts som en kvalitativlitteraturstudie baserat på tio artiklar som har hämtats från databaserna CINAHL ochPubMed. SBU:s granskningsmall har använts för kvalitetsgranskning. Analysen gjordesutifrån metoden som är för kvalitativ innehållsanalys. Resultat: Resultatet presenteras utifråntre kategorier: Sociokulturella aspekters betydelse, Förutsättningar inom vården ochSjuksköterskans kunskap. Ur dessa skapades även tio underkategorier: Religiöst tankesätt,Kulturellt tankesätt, Stöd från anhöriga, Egenvård och delaktighet, Samverkan i team medandra vårdprofessioner, Resurser och stöd, Personcentrerad vård, Erfarenhet, Utbildning,Sjuksköterskornas metod att förmedla kunskap Slutsats: Sjuksköterskor upplevde att etteffektivt samspel mellan sjuksköterskor och övriga professioner, ökade deras motivation ochsjälvförtroende i diabetesbehandlingen för både patienter och sjuksköterskor. Vidare framgårdet att hänsyn till patienters sociokulturella aspekter och bruk av ett personcentrerattillvägagångssätt är avgörande faktorer i patientens följsamhet till sjuksköterskors rådgivning / Background: Diabetes Mellitus is a collection of chronic diseases which affect the body’sability to regulate the blood sugar level. In Sweden alone, there are approximately 470 000diagnosed patients. The most effective method to counteract and treat the disease is for thepatient in question to establish proper self-care practices. The nurse plays a central role in thediabetes treatment since the nurse supports and guides the patient to conduct a good self-careroutine. Aim: This literature review aims to investigate nurses’ experience of patientcompliance to self-care advice regarding diabetes type 2. Method: The study has beenconducted as a literature review of ten articles, where a qualitative approach has been used tocompile a result. The articles have been collected from the databases CINAHL and PubMed.Further, the quality of the studies has been examined with the help of SBU’s review templatefor qualitative studies. The analysis was conducted by the method presented in qualitativecontent analysis. Result: The result was presented from three categories: The importance ofsociocultural aspects, Conditions in the care and the nurses’ knowledge. From thesecategories a total of ten subcategories were used: Religious mindset, Cultural mindset,Support from relatives, Self-care and participation, Cooperation in teams with othercare-professions, Resources and support, Personcentred care, Experience, Education and thenurses’ method to convey information. Conclusion: Nurses experienced that an effectiveteamwork with the other involved professions increased their motivation and self-confidenceand made the diabetes treatment easier for both patients and nurses. Further, it was clear thatconsideration to the patients’ sociocultural aspects and using a patient-centered approach arecrucial factors that affect patients’ adherence to the nurses’ advice.

Novos agentes terapêuticos que preservem as células <font face=\"Symbol\">&#946 do pâncreas e o controle do peso são importantes para o diabetes melittus tipo 2 (DM-2), constituindo uma importante área de investimento farmacêutico. Com o objetivo de contribuir com a toxinologia comparada de venenos de répteis e com a eventual descoberta de novos agentes insulinotrópicos, o presente estudo realizou a prospecção de compostos hipoglicemiantes análogos à exendina-4 (isolada de lagartos Heloderma) ou inibidores da dipeptidil-peptidase IV (DPP-IV) no veneno da serpente Bothrops jararaca. A espectrometria de massas identificou uma K49 Fosfolipase A2 inédita neste veneno. Inibidores da DPP-IV não foram encontrados. Porém, a existência de frações polipeptídicas deste veneno sem similares estruturais descritos, sem efeito na pressão arterial média, imunologicamente similares à exendina-4 e com efeito hipoglicemiante e provável capacidade de ligação ao receptor do peptídeo glucagon-símile tipo 1, caracterizaram, pela primeira vez, a ação de veneno de serpente sobre o metaboloma. / New therapeutic agents that protect pancreatic <font face=\"Symbol\">&#946 cells and regulate body mass are important to diabetes mellitus type 2 (DM-2). The search for these agents is one of the main objectives of investments made by pharmaceutical industries. To contribute to the comparative toxinology studies of reptile venoms and to reveal new insulinotropic agents, the present investigation searched for hypoglycemiant compounds such as exendin-4 analogues (isolated from Heloderma lizards) or dipeptidyl-peptidase IV (DPP-IV) inhibitors in the venom of the snake Bothrops jararaca. The mass spectrometry analysis identified a novel K-49 Phospholipase A2 in this venom. DPP-IV inhibitors were not found. However, the existence of polypeptide fractions from this venom without structural similarity with reported compounds, without effect on mean arterial blood pressure and with immunological similarity with exendin-4 and probable ability to bind to glucagon-like peptide type 1 receptor, led to the first characterization of snake venom activity on metaboloma.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2018-11-14T12:45:33Z No. of bitstreams: 2 Dissertação - Cleyton Rafael Gomes Silva - 2018.pdf: 3259568 bytes, checksum: 21f7d8194e8929ef29e8df95ef8f6a0a (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-11-14T13:02:15Z (GMT) No. of bitstreams: 2 Dissertação - Cleyton Rafael Gomes Silva - 2018.pdf: 3259568 bytes, checksum: 21f7d8194e8929ef29e8df95ef8f6a0a (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-11-14T13:02:15Z (GMT). No. of bitstreams: 2 Dissertação - Cleyton Rafael Gomes Silva - 2018.pdf: 3259568 bytes, checksum: 21f7d8194e8929ef29e8df95ef8f6a0a (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-09-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Examining human pupillary behavior is a non-invasive, low-cost method for assessing neurological activity. Changes in this behavior are correlated to various health conditions, such as: Parkinson’s, Alzheimer’s, autism and diabetes. In order to obtain information about the pupillary behavior, it is necessary to measure the pupil diameter in procedures that induce pupillary reflexes, known as Pupilometry. Pupillary measurement is made by filming the procedures when applying computer vision techniques for pupil recognition. The objective of this research was to develop an Automated Pupilometry System (SAP) to support the investigation of patients with type II diabetes mellitus. SAP was able to record, induce, and extract 96 pupil features. In the experiment with 15 healthy patients and 16 diabetics, a 94% accuracy in the identification of diabetics type II was obtained, demonstrating the efficiency of SAP for the performance of examinations, and evidencing the potential of pupil use in the investigation of diabetes mellitus type II. / Examinar o comportamento pupilar humano é um método não-invasivo e de baixo-custo para avaliar atividade neurológica. Alterações neste comportamento são correlacionadas a várias condições de saúde, como: Parkinson, Alzheimer, autismo e diabetes. Para se obter informações do comportamento pupilar é necessário medir o diâmetro da pupila em procedimentos que induzem os reflexos pupilares, conhecidos como Pupilometria. A medição pupilar é feita por meio da filmagem dos procedimentos ao aplicar-se técnicas de visão computacional para reconhecimento da pupila. O objetivo desta pesquisa foi desenvolver um Sistema Automatizado de Pupilometria (SAP) para apoiar a investigação de pacientes com diabetes mellitus tipo II. O SAP foi capaz de gravar, induzir, e extrair 96 característicaspupilares. No experimento com 15 pacientes saudáveis e 16 diabéticos foi obtida uma acurácia de 94% na identificação de diabéticos tipo II, demonstrando a eficiência do SAP para a performance de exames, e evidenciando o potencial do uso da pupila na investigação de diabetes mellitus tipo II.

Novos agentes terapêuticos que preservem as células <font face=\"Symbol\">&#946 do pâncreas e o controle do peso são importantes para o diabetes melittus tipo 2 (DM-2), constituindo uma importante área de investimento farmacêutico. Com o objetivo de contribuir com a toxinologia comparada de venenos de répteis e com a eventual descoberta de novos agentes insulinotrópicos, o presente estudo realizou a prospecção de compostos hipoglicemiantes análogos à exendina-4 (isolada de lagartos Heloderma) ou inibidores da dipeptidil-peptidase IV (DPP-IV) no veneno da serpente Bothrops jararaca. A espectrometria de massas identificou uma K49 Fosfolipase A2 inédita neste veneno. Inibidores da DPP-IV não foram encontrados. Porém, a existência de frações polipeptídicas deste veneno sem similares estruturais descritos, sem efeito na pressão arterial média, imunologicamente similares à exendina-4 e com efeito hipoglicemiante e provável capacidade de ligação ao receptor do peptídeo glucagon-símile tipo 1, caracterizaram, pela primeira vez, a ação de veneno de serpente sobre o metaboloma. / New therapeutic agents that protect pancreatic <font face=\"Symbol\">&#946 cells and regulate body mass are important to diabetes mellitus type 2 (DM-2). The search for these agents is one of the main objectives of investments made by pharmaceutical industries. To contribute to the comparative toxinology studies of reptile venoms and to reveal new insulinotropic agents, the present investigation searched for hypoglycemiant compounds such as exendin-4 analogues (isolated from Heloderma lizards) or dipeptidyl-peptidase IV (DPP-IV) inhibitors in the venom of the snake Bothrops jararaca. The mass spectrometry analysis identified a novel K-49 Phospholipase A2 in this venom. DPP-IV inhibitors were not found. However, the existence of polypeptide fractions from this venom without structural similarity with reported compounds, without effect on mean arterial blood pressure and with immunological similarity with exendin-4 and probable ability to bind to glucagon-like peptide type 1 receptor, led to the first characterization of snake venom activity on metaboloma.

Bakgrund: Diabetes mellitus typ II är en av de snabbast växande sjukdomarna i världen. Det är en kronisk endokrin sjukdom som kräver många livsförändringar och determination. Det kännetecknas främst av att bukspottkörteln producerar otillräckligt med insulin. Den främsta orsaken till diabetes typ II inkluderar riskfaktorer som ärftlighet, ohälsosam livsstil avseende dålig kost, fysisk inaktivitet, fetma och ålder. Tidiga symtom på diabetes typ II är ökad törst, frekvent urinering, trötthet och muntorrhet. Syfte: Syftet var att belysa sjuksköterskors upplevelser av att vårda patienter med diabetes mellitus typ II. Metod: En litteraturstudie baserad på 10 kvalitativa artiklar som kritiskt analyserades och sammanfattades. Sökningar som härrörde från relevanta sökord gjordes i databaserna PubMed och Cinahl. Detta bidrog till att finna relevanta studier som genomförts i olika världsdelar samt kvalitetsgranskades. Resultat: Resultatet visade att majoriteten av sjuksköterskorna upplevde  bristande strategi och oförmåga att informera patienterna gällande livsstilsförändringar. Sjuksköterskorna upplevde även att patienterna var beroende av dem och såg egenvården som en utmaning. Resultatet visade även att personcentrerad vård var avgörande för att ge effektiv vård och förbättra patienternas deltagande.  Slutsats: Sjuksköterskor behöver mer kunskap, kompetens samt organisatoriska förutsättningar, för att ge en effektiv personcentrerad vård med behandling som stödjer en person som lever med diabetes typ II. Sjuksköterskor önskade mer kunskap inom kulturella och socioekonomiska faktorer för att ge optimal vård och stärka patientens förmåga. Brist på effektivt samarbete mellan vårdpersonal inom diabetesvården identifierades också som ett hinder för god vård. / Background: Diabetes mellitus type II is one of the fastest growing disease worldwide. It is a chronic endocrine disease that requires a lot of life changes and determination. It is characterized primarily by the pancreas producing insufficient insulin. The main cause of diabetes type II includes risk factors such as heredity and unhealthy lifestyle regarding poor diet, physical inactivity, obesity and age. Early symptoms of diabetes type II are increased thirst, frequent urinary, fatigue and dry mouth. Aim: The purpose was to explore nurses´ perception in caring of patients with diabetes mellitus type II. Method: A literature review of which 10 qualitative articles were critically analyzed and summarized. Searches derived from relevant keywords were made in PUBMED and CINAHL databases. This contributed to the finding of relevant articles that were conducted worldwide and were quality-reviewed.  Result: The articles acknowledged  that the majority of the nurses perceived a lack of strategy and inability to inform patients about lifestyle changes. The result also showed that person-centered care was crucial in order to provide effective care and improve patient participation. Conclusion: Nurses need more knowledge, competence and organizational conditions in order to provide effective person-centered care with treatment that supports a person living with type II diabetes. Nurses  also required more knowledge within cultural and social economic factors in order to provide optimal care and strengthen the patient’s abilities. Lack of effective collaboration between healthcare professionals in diabetes care was also identified as an obstacle to provide good care.