Sabe-se que um dos principais problemas odontológicos na clínica de felinos é a gengivite crônica e intratável. Tal afecção pode ser iniciada e/ou exacerbada por agentes virais, como o vírus da imunodeficiência dos felinos (FIV), o Herpesvírus tipo 1 e o Calicivírus. Os gatos da raça Maine Coon apresentam grande predisposição ao desenvolvimento de gengivite-estomatite juvenil e intratável. A depleção de linfócitos T CD4+ e T CD8+ pode exercer papel determinante na iniciação e manutenção das doenças inflamatórias da gengiva. O escopo do presente estudo foi verificar se os animais da raça Maine Coon são mais predispostos à calicivirose, bem como avaliar quantitativamente a resposta imunológica celular, mediada por linfócitos TCD4+ e TCD8+, visando a correlacionar à influência do número de linfócitos na presença e curso da gengivite nesta determinada raça, utilizando-se como controle gatos de outras raças com e sem gengivite. Os valores absolutos médios de linfócitos totais em Maine Coons com gengivite crônica mostraram-se inferiores aos de gatos da raça Maine Coon sem doença oral e de gatos de outras raças com gengivite crônica (p<0,05); os valores médios de linfócitos TCD4+ em Maine Coons com gengivite crônica mostraram-se inferiores quando comparados aos valores de animais da mesma raça, sem doença oral instalada (p<0,05); animais da raça Maine Coon possuem menor relação CD4+:CD8+ quando comparados a animais de outras raças com gengivite crônica e também quando comparados a Maine Coons sem doença oral (p<0,05). O calicivírus está altamente relacionado à ocorrência da gengivite, independentemente da raça estudada, não havendo maior prevalência na raça Maine Coon. O efeito do calicivírus não foi significativo nas alterações de nenhuma das variáveis celulares estudadas. Tais fatos apontam para uma possível predisposição racial ao quadroinflamatório gengival, com alteração de alguns componentes celulares relacionados à imunidade celular. Isto tem como fator importante alertar o clínico frente ao uso de glicocorticóides no tratamento da gengivite crônica nesta raça, visando a evitar maior comprometimento da imunidade celular destes animais. / Chronic untreatable feline gingivitis is widely recognized as one of the major oral diseases seen in feline patients. It can be either triggered or exacerbated by virus such as feline immunodeficiency virus, feline herpesvirus type 1 and calicivirus. One may therefore propose that lymphocytes T CD4+ and T CD8+ depletion can play an important role in initiating and maintaining the inflammatory gingival disease. Maine Coon cats are highly predisposed to juvenile untreatable gingivitis. The purpose of this study was to evaluate whether Maine Coon cats are more predisposed to calicivirus infection and to verify, quantitatively, their immunological cellular response mediated by lymphocytes T CD4+ and TCD8+. The main idea was to investigate the influence imposed by lymphocyte counts in gingivitis development and progression within this breed; for this, we selected non-Maine Coon cats (with and without gingivitis) to serve as controls. Mean absolute values of total lymphocytes in Maine Coon cats presented with gingivitis were inferior than the same values taken for both Maine Coon cats free of oral disease and non-Maine Coon cats with chronic gingivitis (p<0,05); lymphocytes TCD4+ average values in Maine Coon cats with chronic gingivitis were also lower than the ones taken from cats of the same breed but without oral disease (p<0,05). Maine Coon cats have lower CD4+:CD8+ ratio when compared to non-Maine Coon cats with chronic gingivitis as well as with Maine Coon cats without oral disease (p<0,05). The calicivirus is highly involved with the occurrence of gingivitis, no matter the breed being evaluated. The action virus imposes in changing cellular immunology was not significant, at least considering the cellular variables studied. All these lead us to point out a possible breed predisposition to the gingival inflammation, with modification of some cellular components related with cellular immunity. Furthermore, concerning practical terms, these results serve as a relevant alert to the clinicians regarding the use of glucocorticoids for treating chronic gingivitis in this breed, in order to prevent further impairment of cellular immunity of these animals.

O diabetes melitus tipo 1 é caracterizado por hiperglicemia em decorrência da ausência de secreção de insulina, causada pela destruição de células beta do pâncreas, geralmente por alteração auto-imune. O objetivo deste estudo foi o de conhecer o perfil do paciente diabético tipo 1 em atendimento no CAPE FOUSP, relacionando as complicações as alterações sistêmicas e bucais do diabetes nestes pacientes. Foram coletados dados demográficos, dados da história médica [idade ao diagnóstico, histórico de crise de cetoacidose, hipoglicêmica e hiperglicêmica, maior e menor glicemia já registradas, presença de microangiopatias (retinopatia, doença renal, neuropatia) e macroangiopatias (doença cardiovascular, hipertensão arterial sistêmica), outras doenças sistêmicas, medicação em uso], realizado exame físico extra oral, com aferição da pressão arterial, exame físico intra-oral [para pesquisa de xerostomia, candidíase (pseudomembranosa, eritematosa, leucoplásica, queilite angular), GUNA úlcera aftosa recorrente, herpes simples, síndrome da boca ardente], índice CPOD, índice periodontal comunitário (ICP), índice gengival (IG), presença de cálculo, índice de placa, índice de maloclusão], exames complementares (avaliação do fluxo salivar, aferição da glicemia capilar e teste rápido de hemoglobina glicada) e o preenchimento do questionário Oral health impact profile (OHIP-14). Foram avaliados 26 pacientes, 11 do sexo masculino e 15 do sexo feminino, sendo que a média de idade do diagnóstico variou de 06 meses a 26 anos de idade, o tempo decorrente desde o diagnóstico variou de 1 a 37 anos, 61,53% dos pacientes apresentavam alguma microangiopatia e 27% dos pacientes alguma macroangiopatia. A manifestação bucal mais encontrada foi a xerostomia (61,53%), seguida da queilite angular (23,07%), a média do CPOD foi de 13,26, 50% dos pacientes apresentavam ICP escore 2 e os outros 50% apresentavam escore 3 e 4, 84,61% apresentavam gengivite moderada e a média do IP foi de 2,19. A maloclusão leve foi encontrada em 69% dos pacientes e 92,30% dos pacientes apresentavam fluxo salivar normal, 16 pacientes estavam com hiperglicemia, 23 pacientes apresentavam hemoglobina glicada descompensada e 58% dos pacientes apresentaram um impacto fraco de saúde bucal na qualidade de vida Concluímos que nossos pacientes com DM1 são jovens, com da glicemia e DM descompensados, apresentam a doença há mais de 10 anos, e desenvolveram microangiopatias e macroangiopatias como a doença renal e a hipertensão arterial. Apresentam poucas manifestações bucais, sendo a mais comum a xerostomia; e uma condição bucal satisfatória, em decorrência do acesso ao tratamento odontológico, independentemente da compensação da glicemia. / Diabetes mellitus type 1 is characterized by hyperglycemia due to the absence of insulin secretion caused by destruction of pancreatic beta cells, usually by autoimmune disease. The aim of this study was to establish the profile of the type 1 diabetic patients treated at CAPE FOUSP recognizing the systemic and oral complications of diabetes in these patients. We collected demographic data, medical history [age at diagnosis, history of ketoacidosis, hypoglycemic and hyperglycemic crisis, highest and lowest glycemia recorded, presence of microangiopathy (retinopathy, kidney disease, neuropathy) and macroangiopathy (cardiovascular disease, arterial hypertension), other systemic diseases, drugs in use], and performed blood pressure measurement, and extra and intra oral physical examination [searching for xerostomia, candidiasis (pseudomembranous, erythematous, leucoplakia, angular cheilitis), GUNA, aphthous ulcer, herpes simplex, burning mouth syndrome], DMFT index, community periodontal index (ICP), gingival index (GI), presence of calculus, plaque index, index of malocclusion], complementary tests (measurement of salivary flow and glycemia and a rapid test for glycated hemoglobin) and completing the questionnaire \" Oral health impact profile\" (OHIP - 14). We evaluated 26 patients, 11 males and 15 females, with age of diagnosis from 06 months to 26 years, time elapsed since diagnosis ranged from 1 to 37 years, 61.53 % presented with some microangiopathy and 27 % with macroangiopathy. The most frequent oral manifestation was xerostomia (61.53 %), followed by angular cheilitis (23.07%), the mean DMFT was 13.26, 50 % of patients had ICP score 2 and 50 % had score 3 and 4, 84.61% had moderate gingivitis and mean PI was 2.19. The slight malocclusion was found in 69 % of patients and 92.30 % of patients had normal salivary flow, 16 patients had hyperglycemia, 23 patients had glycated hemoglobin decompensated and 58 % of patients had a weak impact of oral health on quality of life. We conclude that our DM1 patients are young, with blood glucose and DM decompensated with diabetes for over 10 years, and developed microangiopathy and macroangiopathy like kidney disease and hypertension. Few patients have oral manifestations, and the most common is xerostomia, and a satisfactory oral health as a result of access to dental treatment, regardless of the rates of blood glucose.

Pan, Wenliang. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 138-163). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Tsang Po Ting. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 135-152). / Abstracts in English and Chinese. / Acknowledgements --- p.i / Abstract --- p.ii / Abstract 摘要 --- p.iv / List of Figures --- p.vi / List of Tables --- p.viii / List of Abbreviations --- p.ix / Table of Contents --- p.xii / Chapter Chapter 1: --- General Introduction --- p.1 / Chapter 1.1 --- The Role of Glucose in Biological System --- p.1 / Chapter 1.2 --- Glucose Transporter Families --- p.1 / Chapter 1.2.1 --- Na+-Dependent Glucose Transporters --- p.2 / Chapter 1.2.2 --- Facilitative Glucose Transporters --- p.3 / Chapter 1.3 --- Glucose Transporter Type1 --- p.7 / Chapter 1.3.1 --- Primary Structure of the Glutl Protein --- p.7 / Chapter 1.3.2 --- Secondary Structure --- p.8 / Chapter 1.3.3 --- Tertiary Structure --- p.8 / Chapter 1.3.4 --- Kinetics Properties --- p.11 / Chapter 1.3.5 --- Tissue Distribution --- p.12 / Chapter 1.3.6 --- Multifunctional Property --- p.13 / Chapter 1.3.7 --- Characterization of GLUT1 Gene --- p.13 / Chapter 1.3.8 --- Regulation of GLUT1 Expression --- p.14 / Chapter 1.4 --- Glucose Transporter Type 1 and the Brain --- p.16 / Chapter 1.5 --- Glucose Transporter Type 1 Deficiency Syndrome (GIutlDS) --- p.19 / Chapter 1.5.1 --- Backgronnd of GIutlDS --- p.19 / Chapter 1.5.2 --- Clinical Features of GIutlDS --- p.23 / Chapter 1.5.3 --- Genotype-Phenotype Correlations --- p.24 / Chapter 1.5.4 --- Diagnosis --- p.26 / Chapter 1.5.5 --- Manage nent --- p.27 / Chapter 1.5.5.1 --- Ketogenic Diet --- p.27 / Chapter 1.6 --- Hypothesis and Objectives --- p.29 / Chapter Chapter 2: --- Biochemical and Molecular Analysis of GLUT1 in a Suspected GlutlDS Case --- p.31 / Chapter 2.1 --- Materials --- p.32 / Chapter 2.1.1 --- Clinical History of Suspected GlutlDS Patient --- p.32 / Chapter 2.1.2 --- Blood Samples --- p.32 / Chapter 2.1.3 --- Reagents and Buffers for Reverse Transcription --- p.32 / Chapter 2.1.4 --- Reagents and Buffers for TA Cloning --- p.34 / Chapter 2.1.5 --- Reagents for Genomic DNA Extraction --- p.34 / Chapter 2.1.6 --- Reagents and Buffers for Polymerase Chain Reaction (PCR) --- p.34 / Chapter 2.1.7 --- Reagents and Buffers for Agarose Gel Electrophoresis --- p.35 / Chapter 2.1.8 --- Reagents for Zero-trans 3-OMG Influx in Erythrocytes --- p.37 / Chapter 2.1.9 --- Reagents for Zero-trans 3-OMG Efflux from Erythrocytes --- p.38 / Chapter 2.1.10 --- Reagents for Erythrocytes Membrane Extraction and Detection --- p.39 / Chapter 2.2 --- Methods --- p.44 / Chapter 2.2.1 --- GLUT1 Gene Analysis --- p.44 / Chapter 2.2.2 --- Zero-trans 3-OMG Influx into Erythrocytes --- p.51 / Chapter 2.2.3 --- Zero-trans 3-OMG Efflux from Erythrocytes --- p.52 / Chapter 2.2.4 --- Glutl Protein Expression --- p.54 / Chapter 2.2.5 --- Statistics --- p.57 / Chapter 2.3 --- Results --- p.58 / Chapter 2.3.1 --- Molecular Analysis of the GLUT1 Gene of a Suspected GlutlDS Patient --- p.58 / Chapter 2.3.2 --- Functional Analysis of the GlutlDS Patient's Glutl Protein --- p.61 / Chapter 2.3.3 --- Glutl Protein Expression in the GlutlDS Patient --- p.64 / Chapter 2.4 --- Discussion --- p.66 / Chapter Chapter 3: --- Pathogenicity Studies of GLUT1 Mutations --- p.71 / Chapter 3.1 --- Materials --- p.72 / Chapter 3.1.1 --- Construction of Glutl-Encoding Vectors --- p.72 / Chapter 3.1.2 --- Cell Lire --- p.73 / Chapter 3.1.3 --- "Cell Culture Media, Buffers and Other Reagents" --- p.73 / Chapter 3.1.4 --- Cell Culture Wares --- p.75 / Chapter 3.1.5 --- Reagents for Transfection --- p.75 / Chapter 3.1.6 --- Reagents for Protein Determination and Western Blot Analysis --- p.76 / Chapter 3.1.7 --- Consumables for Confocal Microscopy --- p.77 / Chapter 3.1.8 --- Reagents and Buffers for Flow Cytometry --- p.77 / Chapter 3.1.9 --- Reagents for 2-DOG Uptake in CHO-K1 Cells --- p.77 / Chapter 3.2 --- Methods --- p.79 / Chapter 3.2.1 --- Cell Culture Methodology --- p.79 / Chapter 3.2.2 --- Construction of GLUT1 Mutants --- p.80 / Chapter 3.2.3 --- Establishment of Wild Type and Mutant Glutl Expressing Cell Lines --- p.84 / Chapter 3.2.4 --- Protein Expression Study --- p.85 / Chapter 3.2.5 --- 2-DOG Influx Assay in CHO-K1 Cells --- p.87 / Chapter 3.2.6 --- Confocal Microscopy Studies on Glutl Cellular Localization --- p.89 / Chapter 3.2.7 --- Statistics --- p.90 / Chapter 3.3 --- Results --- p.91 / Chapter 3.3.1 --- Molecular Analysis of 1034-1035Insl2 Mutation --- p.91 / Chapter 3.3.2 --- Expression of the Wild Type and Mutant GFP-Glutl Fusion Proteins --- p.92 / Chapter 3.3.3 --- Functional Analysis of the 1034-1035Insl2 Mutant --- p.95 / Chapter 3.4 --- Discussion --- p.97 / Chapter Chapter 4: --- GLUT1 Promoter Study --- p.100 / Chapter 4.1 --- Materials --- p.101 / Chapter 4.1.1 --- Construction of GLUT1 Promoter Vectors --- p.101 / Chapter 4.1.2 --- Cell Lines --- p.102 / Chapter 4.1.3 --- Cell Culture Media and Other Reagents --- p.103 / Chapter 4.1.4 --- Dual Luciferase Reporter Assay System --- p.103 / Chapter 4.2 --- Methods --- p.105 / Chapter 4.2.1 --- Bioinformatics --- p.105 / Chapter 4.2.2 --- Cell Culture --- p.105 / Chapter 4.2.3 --- Construetion of GLUT1 Promoter Vectors --- p.105 / Chapter 4.2.4 --- 5'-Deletion Analysis of GLUT1 Promoter --- p.108 / Chapter 4.2.5 --- Determination of the Activities of GLUT1 Promoter Fragments --- p.110 / Chapter 4.2.6 --- Statistics --- p.113 / Chapter 4.3 --- Results --- p.114 / Chapter 4.3.1 --- Determination of the Promoter Activity of the 5'-deletion Fragments --- p.114 / Chapter 4.3.2 --- Prediction of Transcription Factors in the 5'-deletion Fragments --- p.119 / Chapter 4.4 --- Discussion --- p.121 / Chapter Chapter 5: --- General Conclusion and Future Perspectives --- p.133 / References --- p.135

The chronically ill participants in this study are vulnerable experts in life’s uncertainties, and have become aware over time of multiple medical and social needs and practices. But, unlike the hypo-aware respondents documented in some studies of diabetes mellitus Type 1, these research participants are also conscious of their inability to recognise when their own fluctuating blood glucose levels are rising or falling to extremes, a loss of hyper- or hypo-awareness that puts their lives constantly at risk. Particular sources of better life management, increased self-esteem and means of social (re-)integration are trained medical alert assistance dogs who share the human home, and through keen olfactory sensitivity, are able to give advance warning when their partners’ blood sugar levels enter ‘danger’ zones. Research studies in anthrozoology and anthropology provide extensive literature on historic and contemporary human bonds with domestic and/or wild nonhuman animals. Equally, the sociology of health and illness continues to extend research into care practices performed to assist people with chronic illness. This study draws from these disciplines in order to add to multispecies ethnographic literature by exploring human-canine engagement, contribution and narrative, detailing the impact each member of the dyad has on the other, and by observing the 'doing' of the partnerships' daily routines to ward off hypo-glycaemia and hospitalisation. In addition, the project investigates the place, role and 'otherness' of a medical alert dog in a chronically ill person's understanding of 'the-body-they-do'. The perspective of symbolic interactionism assists in disentangling individual and shared meanings inherent in the interspecies collaboration by examining the mutualistic practices of care performed. The often-flexible moral boundaries that humans construct to differentiate between acceptable use and unacceptable exploitation of nonhuman animals are questioned within ethics-of-care theory, based on the concept of dogs as animate instruments and biomedical resources.

Background: Each year approximately 700 children are affected by type 1 diabetes in Sweden. This chronic disease has an impact on the whole family but especially the parents who have the responsibility as a caregiver. Parents are therefore in need of support from friends and family as well as help from the nurse to deal with the situation. The nurse can provide support with a family focused care and will therefore include the whole family and use their strengths and resources. Aim: The aim of this study was to describe parents' experience of living with a child with type 1 diabetes. Method: The method used was a literature study with the aim to contribute to evidence based care with an analysis based on qualitative research. Ten scientific articles were analyzed. Three themes and seven subthemes emerged. Results: Three main themes and seven subthemes emerged during the analysis that responded to parents' experience living with a child with type 1 diabetes. The main themes were the stress that parents are exposed to, need of help and the unique community. Conclusion: Parents experienced a change in everyday life for the whole family. Therefore, the nurse needs to be responsive and adapt the nursing care to the parents, so they can support the child in a better way. / Studien beskriver föräldrars upplevelser av att leva med ett barn med typ 1 diabetes. Typ 1 diabetes är den mest förekommande autoimmuna sjukdomen hos barn i hela världen. Sjukdomen innebär att kroppen har slutat producera hormonet insulin, vilket medför en förhöjd blodsockernivå som kan leda till komplikationer. Studiens resultat baseras på tio vetenskapliga artiklar. Dessa söktes fram via två databaser. Genom analys och sammanställning av artiklarna framkom en beskrivning av föräldrarnas upplevelser. Detta redovisas som teman och subteman i resultatet. I resultatet beskrivs föräldrarnas omställning från att leva med ett friskt barn till att leva med ett barn med kronisk sjukdom och vilka känslor som uppstår vid bearbetningen samt det förändrade föräldraansvaret. Resultatet beskriver också de förhållanden som underlättar föräldrarnas bearbetning. Resultatet lyfter även fram de krav och förväntningar som föräldrarna har på vårdpersonal och personer i omgivningen samt den saknade förståelsen från människor runt föräldrarna.  Typ 1 diabetes påverkar barnens rätt att vara som andra och relationen med andra barn. Även relationen mellan barnet och föräldrarna påverkas. Sjukdomen drabbar inte bara barnet utan hela familjen. Sjuksköterskan är ansvarig för att ge familjen en god familjefokuserad vård och för att ge individanpassat stöd till föräldrarna i den förändrade livssituationen. Denna studie kan ge sjuksköterskor mer kännedom om vilka omvårdnadsbehov som föräldrarna har.

O diabetes melitus tipo 1 é caracterizado por hiperglicemia em decorrência da ausência de secreção de insulina, causada pela destruição de células beta do pâncreas, geralmente por alteração auto-imune. O objetivo deste estudo foi o de conhecer o perfil do paciente diabético tipo 1 em atendimento no CAPE FOUSP, relacionando as complicações as alterações sistêmicas e bucais do diabetes nestes pacientes. Foram coletados dados demográficos, dados da história médica [idade ao diagnóstico, histórico de crise de cetoacidose, hipoglicêmica e hiperglicêmica, maior e menor glicemia já registradas, presença de microangiopatias (retinopatia, doença renal, neuropatia) e macroangiopatias (doença cardiovascular, hipertensão arterial sistêmica), outras doenças sistêmicas, medicação em uso], realizado exame físico extra oral, com aferição da pressão arterial, exame físico intra-oral [para pesquisa de xerostomia, candidíase (pseudomembranosa, eritematosa, leucoplásica, queilite angular), GUNA úlcera aftosa recorrente, herpes simples, síndrome da boca ardente], índice CPOD, índice periodontal comunitário (ICP), índice gengival (IG), presença de cálculo, índice de placa, índice de maloclusão], exames complementares (avaliação do fluxo salivar, aferição da glicemia capilar e teste rápido de hemoglobina glicada) e o preenchimento do questionário Oral health impact profile (OHIP-14). Foram avaliados 26 pacientes, 11 do sexo masculino e 15 do sexo feminino, sendo que a média de idade do diagnóstico variou de 06 meses a 26 anos de idade, o tempo decorrente desde o diagnóstico variou de 1 a 37 anos, 61,53% dos pacientes apresentavam alguma microangiopatia e 27% dos pacientes alguma macroangiopatia. A manifestação bucal mais encontrada foi a xerostomia (61,53%), seguida da queilite angular (23,07%), a média do CPOD foi de 13,26, 50% dos pacientes apresentavam ICP escore 2 e os outros 50% apresentavam escore 3 e 4, 84,61% apresentavam gengivite moderada e a média do IP foi de 2,19. A maloclusão leve foi encontrada em 69% dos pacientes e 92,30% dos pacientes apresentavam fluxo salivar normal, 16 pacientes estavam com hiperglicemia, 23 pacientes apresentavam hemoglobina glicada descompensada e 58% dos pacientes apresentaram um impacto fraco de saúde bucal na qualidade de vida Concluímos que nossos pacientes com DM1 são jovens, com da glicemia e DM descompensados, apresentam a doença há mais de 10 anos, e desenvolveram microangiopatias e macroangiopatias como a doença renal e a hipertensão arterial. Apresentam poucas manifestações bucais, sendo a mais comum a xerostomia; e uma condição bucal satisfatória, em decorrência do acesso ao tratamento odontológico, independentemente da compensação da glicemia. / Diabetes mellitus type 1 is characterized by hyperglycemia due to the absence of insulin secretion caused by destruction of pancreatic beta cells, usually by autoimmune disease. The aim of this study was to establish the profile of the type 1 diabetic patients treated at CAPE FOUSP recognizing the systemic and oral complications of diabetes in these patients. We collected demographic data, medical history [age at diagnosis, history of ketoacidosis, hypoglycemic and hyperglycemic crisis, highest and lowest glycemia recorded, presence of microangiopathy (retinopathy, kidney disease, neuropathy) and macroangiopathy (cardiovascular disease, arterial hypertension), other systemic diseases, drugs in use], and performed blood pressure measurement, and extra and intra oral physical examination [searching for xerostomia, candidiasis (pseudomembranous, erythematous, leucoplakia, angular cheilitis), GUNA, aphthous ulcer, herpes simplex, burning mouth syndrome], DMFT index, community periodontal index (ICP), gingival index (GI), presence of calculus, plaque index, index of malocclusion], complementary tests (measurement of salivary flow and glycemia and a rapid test for glycated hemoglobin) and completing the questionnaire \" Oral health impact profile\" (OHIP - 14). We evaluated 26 patients, 11 males and 15 females, with age of diagnosis from 06 months to 26 years, time elapsed since diagnosis ranged from 1 to 37 years, 61.53 % presented with some microangiopathy and 27 % with macroangiopathy. The most frequent oral manifestation was xerostomia (61.53 %), followed by angular cheilitis (23.07%), the mean DMFT was 13.26, 50 % of patients had ICP score 2 and 50 % had score 3 and 4, 84.61% had moderate gingivitis and mean PI was 2.19. The slight malocclusion was found in 69 % of patients and 92.30 % of patients had normal salivary flow, 16 patients had hyperglycemia, 23 patients had glycated hemoglobin decompensated and 58 % of patients had a weak impact of oral health on quality of life. We conclude that our DM1 patients are young, with blood glucose and DM decompensated with diabetes for over 10 years, and developed microangiopathy and macroangiopathy like kidney disease and hypertension. Few patients have oral manifestations, and the most common is xerostomia, and a satisfactory oral health as a result of access to dental treatment, regardless of the rates of blood glucose.

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-06-12T17:33:35Z No. of bitstreams: 1 KellySilva.pdf: 1053190 bytes, checksum: 14ae6885897006b813bbfa8df8168e7c (MD5) / Made available in DSpace on 2017-06-12T17:33:35Z (GMT). No. of bitstreams: 1 KellySilva.pdf: 1053190 bytes, checksum: 14ae6885897006b813bbfa8df8168e7c (MD5) Previous issue date: 2016-07-25 / Diabetes Mellitus (DM) is a heterogeneous group of metabolic disorders that have in common hyperglycemia. Diabetics under treatment with insulin therapy must embrace responsibility of the control and management of their condition on a daily basis; in this context the congnitive theory of self efficacy (SE) proposed by Bandura can be considered a decisive factor in achieving behavioral goals of diabtes, resulting in improvements to self-care and glycemic control. The research here presented aimed to analyse the self efficacy to the treatment of patients with diabetes mellitus type 1 and 2 in insulin therapy and its correlaton with sociodemographic and clinical variables. To that end, we conducted and analytical study of cross-sectional, with quantitative approach and sample consisting on 134 patients with DM type 1 and 2 in insulin therapy at University Hospital's Endocrinology Clinic - Unit President Dutra (HUUPD) of São Luís-MA. For data collection, we used two instruments: identification data with open and closed questions related to sociodemographic and clinical variables and the Insulin Management Diabetes Self Efficacy (IMDSES), Brazilian version. The search resulted 3.07 global media, on the scale of self efficacy, the areas that stood out with the highest and lowest average respectively were the general management domain (3.38) and the diet field (2.90). We have found the following significant correlations: marital status (widowed had more SE in the diet), education (the higher the education, the better the SE in the management, control and correction of glycemia), treatment with diet and insulin (higher SE in the diet), absence of dyslipidemia (increased SE to the overall management of diabtes) and age (higher SE for older in the diet). It was concluded that there are factors relates to socioeconomic and clinical features that interfare in self efficacy of patients with Diabetes mellitus type 1 e 2 in insulin therapy, against the desease. / O Diabetes Mellitus (DM) é um grupo heterogêneo de distúrbios metabólicos que apresentam em comum a hiperglicemia, resultado de defeitos na ação da insulina, na secreção de insulina ou em ambas. Os diabéticos que fazem tratamento com insulinoterapia devem assumir a responsabilidade do controle e gestão de sua condição no dia a dia. Nesse contexto, a teoria cognitiva da autoeficácia (AE) proposta por Bandura pode ser considerada um fator decisivo para atingir as metas comportamentais do diabetes, resultando em melhorias para o autocuidado e controle glicêmico. A pesquisa que se apresenta, teve como objetivo analisar a autoeficácia do tratamento dos portadores de diabetes mellitus tipo 1 e 2 em insulinoterapia e a sua correlação com as variáveis sociodemográficas e clínicas. Para tanto, foi realizado um estudo analítico de corte transversal, com abordagem quantitativa e amostra de 134 portadores de DM tipo 1 e 2 em insulinoterapia, atendidos no Ambulatório de Endocrinologia do Hospital Universitário - Unidade Presidente Dutra (HUUPD) de São Luís-MA. Para a coleta de dados, utilizaram-se dois instrumentos: dados de identificação com questões abertas e fechadas referente às variáveis sociodemográficas e clínicas e o Insulin Management Diabetes Self Efficacy (IMDSES), versão brasileira. A pesquisa resultou média global de 3,07 na escala de autoeficácia, os domínios que se destacaram com maior e menor média respectivamente foram o domínio administração geral (3,38) e o domínio dieta (2,90). Encontraram-se as seguintes correlações significativas: estado civil (viúvos tinham maior AE na dieta), escolaridade (quanto maior a escolaridade, melhor a AE na administração, controle e correção da glicemia), tratamento com dieta e insulina (maior AE na dieta), ausência de dislipidemia (maior AE para o manejo geral do diabetes) e idade (maior AE para os mais velhos na dieta). Concluiu-se que existem fatores relacionados às características socioeconômicas e clínicas que interferem na autoeficácia do portador de Diabetes mellitus tipo 1 e 2 em Insulinoterapia, frente à doença.

Animal and human studies have consistently demonstrated that recurrent hypoglycaemia (RH) blunts both hormonal and behavioral counter regulatory responses (CRR) to further episodes of hypoglycaemia. It is now well established that the brain is involved in regulating whole-body glucose homeostasis, including the CRR to hypoglycaemia. The aim of the current study was to investigate if adaptations occur, following RH, which are intrinsic to glucose-sensing neurons in the absence of synaptic/glial inputs or signals from the periphery. Utilising the GT1-7 hypothalamic mouse cell line as an in vitro model of homogenous glucose-excited neurons, the current study has demonstrated that recurrent low glucose exposure reprograms intracellular metabolism towards a “hypometabolic state”. This result occurs in conjunction with an attenuated ability of the cells to hyperpolarise in response to low glucose and a reduction in the sensitivity of the KATP channel to activation by MgADP. In an attempt to reverse the changes observed in KATP channel activity, the SUR1-selective KATP channel opener, NN414, was applied chronically to GT1-7 cells. However, chronic KATP channel activation severely reduced channel conductance and sensitivity to activation by MgADP and further NN414 application. These results suggest that chronic activation of the KATP channel leads to the induction of a negative feedback mechanism to reduce channel activity. This may be in an attempt to maintain neuronal membrane potential within a physiological range. These results also suggest activation of central KATP channels during RH may be driving the resulting defective CRR. However, adaptations in metabolism following RH may also be altering the function of central KATP channels.

Forskning visar att ungdomar med typ 1 diabetes (T1D) har dubbelt så stor risk att drabbas av en ätstörning jämfört med ungdomar utan T1D. Dessutom ökar även mortalitet och morbiditet avsevärt hos ungdomarna med denna kombination. Syftet med litteraturstudien var att beskriva vad ungdomars upplevelser är i samband med ätstörningar och T1D. Dataanalysen genomfördes med inspiration från metoden innehållsanalys. Litteraturstudiens resultat visar kunskap från sju vetenskapliga artiklar. Efter tolkningen av resultaten i de vetenskapliga artiklarna formulerades fem teman: Social dimension, Fysisk dimension, Emotionell dimension, Triggerfaktorer och Coping. Resultatet gestaltade att stöd från familj och vänner upplevdes underlättande för ungdomarna, men även som ett ofullständigt stöd. Stödet från sjukvårdspersonalen upplevdes betydelsefullt. En del av ungdomarna upplevde negativa kroppsbilder, vilket föranledde till underdosering av insulin. Ätstörningarna kunde förorsaka depressiva känslor och samtidigt upplevd kroppskontroll. Stressade livssituationer kunde trigga igång ätstörningen. Upplevda copingstrategier som gav stöd i återhämtningen från ätstörningen var att dela sina erfarenheter med ungdomar i samma situation. Litteraturstudien visar att sjuksköterskan kan vara stödjande för ungdomar med T1D och ätstörningar genom att visa ett förhållningssätt i former av att vara lyssnande, icke dömande och visa tilltro. Litteraturstudien visar behov av ytterligare forskning för ett mer evidensbaserat kliniskt vårdande. / Research shows that adolescents with T1D runs a double risk of eating disorders compared to adolescents without T1D. Additionally, morbidity and mortality increases considerably at the combination. The aim of this literature study was to describe adolescents' experiences of living with T1D and eating disorders. The results in this literature study shows knowledge from seven scientific articles. Data analysis was inspired by content analysis. The results in this literature study shows knowledge from seven scientific articles. The interpretation resulted in five formulated themes: Social dimension, Physical dimension, Emotional dimension, Triggers and Coping. Results indicate that support originating from family, friends and healthcare professionals was experienced as facilitating, but also as an uncomplete support. Some adolescents experienced negative body images, which conduced to insulin omission. The eating disorders provided depressive feelings and simultaneously experienced body control. Stressed life situations could trigger eating disorders. Coping strategies which aided the recovery of eating disorders was sharing experiences with peers. This literature study indicate that nurses can be supportive for adolescents with T1D and eating disorders through approaching in forms of being listening, non-judging and trustful. This literature study display requirements of supplementary research for a more evidence based clinical caring.