http://hdl.handle.net/11422/25223 2026-04-29T05:24:50Z http://hdl.handle.net/11422/27810 Title: Desfechos perinatais em mulheres gestantes com diagnóstico prévio de diabetes mellitus tipo 2 tratadas em maternidade pública durante a pandemia covid-19 Author(s)/Inventor(s): Theodoro, Luciana Cristina Advisor: Zajdenverg, Lenita Abstract: The prevalence of preexisting diabetes in pregnancy has grown in the last decades, primarily due to a marked rise in the worldwide prevalence of type 2 diabetes (T2DM). In Brazil, there are 6.9% of adults living with T2DM. These numbers are largely related to rising rates of obesity and unhealthy diets. Pregnancy in women with T2DM is associated with a high risk of unfavorable maternal and fetal outcomes. The COVID-19 pandemic has made it difficult to access prenatal care. Due to the high risk of complications, this population needs accessible and specialized care. Objective: To describe the profile of pregnant women with T2DM followed in a specialized service, during the COVID-19 pandemic. Methodology: Descriptive and retrospective study, with data collection from the medical records of pregnant women with T2DM attended at the diabetology outpatient clinic in a universitary maternity hospital, between march 2020 and march 2023. Results: 192 medical records of all pregnant women assisted due to DM using insulin since the beginning of pregnancy were reviewed. We excluded 43 with diagnosis of GDM, 47 with overt diabetes, 29 with type 1 diabetes and 2 with atypical DM. We included 71 pregnant women (67,3%) with a diagnosis of T2DM. Average age was 33.9 (19-49) years old, 81.4% self-reported non-white skin color and 61.4% were married. Schooling years were less than 9 in 25,6%; 50,7% between 9 and 12 and 11,26 % over 12. Mean pregestational BMI were 31.5 (19-44.9) kg/m2. Average gestational age (GA) in the first medical appointment was 15 (6+1 to 31+4 weeks) weeks. We found that 54,9% gained weight above recommended, 33,8% complicated with preeclampsia and 87% had cesarean deliveries. We found neonatal complications in 29% of pregnancies: 1,4 % fetal malformation, 18 % LGA babies and 8,4% SGA, 16,9% preterms, 9% neonatal hypoglycemia, 14% admitted in neonatal intensive care and 5,4% stillbirth. Conclusion: Pregnant women with T2DM have late access to specialized prenatal care, gain excessive weight and are at high risk of hypertensive complications. The prevalence of complications is also high in the offspring. The role of the COVID-19 pandemic in worsening perinatal outcomes in this high-risk population should be evaluated in future studies. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização 2024-01-01T00:00:00Z http://hdl.handle.net/11422/27233 Title: As calculadoras de risco cardiovascular disponíveis são capazes de predizer adequadamente desfechos em 10 anos em pacientes com DM1 de longa duração? Author(s)/Inventor(s): Garcia, Paula de Marsillac Advisor: Rodacki, Melanie Abstract: Patients with long-standing type 1 diabetes have an increased risk of cardiovascular events or death. It is unclear if the currently available CV risk calculators are suitable for these individuals. This study aimed to evaluate the performance of the SBD, SBC and T1RE calculators in a sample with long-standing T1D. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização 2024-01-01T00:00:00Z http://hdl.handle.net/11422/27231 Title: Osteoporose secundária com fraturas espontâneas de fêmur em paciente jovem associada à acidose tubular renal tipo 1: relato de caso Author(s)/Inventor(s): Alvarenga, Laís Pedroni Cutini de Advisor: Madeira, Miguel Abstract: This paper presents a case report of a young female patient who developed spontaneous bilateral femoral fractures secondary to Type 1 Renal Tubular Acidosis (RTA-1), a rare condition that affects renal function and disrupts the body’s acid-base balance. The patient, with no relevant traumatic history, experienced spontaneous fractures in both femurs, raising suspicion of an underlying condition. Investigation revealed that Type 1 Renal Tubular Acidosis was the cause of the fractures, due to the osteomalacia associated with the disease. The diagnosis was confirmed through laboratory and clinical tests, and the treatment included correction of the acid-base imbalance and orthopedic interventions for fracture management. The purpose of this paper is to report this rare case to the scientific community, emphasizing the importance of early diagnosis and appropriate management of uncommon clinical conditions such as RTA-1 to prevent serious complications and improve patient quality of life. The reported experience contributes to the understanding of the clinical manifestation of RTA-1 and may serve as a basis for managing similar cases. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização 2024-01-01T00:00:00Z http://hdl.handle.net/11422/25806 Title: Preditores de risco para hipoparatireoidismo transitório e permanente após tireoidectomia em uma coorte retrospectiva de hospital universitário Author(s)/Inventor(s): Tischer, Veridiana Advisor: Teixeira, Patrícia de Fátima dos Santos Abstract: Hypocalcemia (hypoCa) is the most common complication of thyroidectomy, affecting up to 30–50% of patients in various series. The main cause is hypoparathyroidism (HypoPT), due to iatrogenic injury to the parathyroid glands. Fortunately, this condition is mostly transient. Objectives: to describe the frequency and clinical predictors associated with transient and permanent HypoPT following thyroidectomy in a university hospital setting. Methods: a retrospective cohort study will be conducted, including all patients who underwent thyroidectomy from 2001 to 2017 at a university hospital. Data will be collected from both electronic and physical medical records. For statistical analysis, three groups will be classified for comparison: patients with benign disease, those with malignancies, and those with Graves’ disease (GD). Patients presenting with hypoCa (corrected serum calcium < 8.5 mg/dL) and/or hyperphosphatemia (hyperP) (serum phosphorus > 4.5 mg/dL) in the postoperative period will be considered to have postsurgical HypoPT. Permanent HypoPT will be defined as: the need for calcitriol or high doses of cholecalciferol to maintain normal calcium levels; persistent hyperphosphatemia; or serum PTH levels below the reference range after 12 months of follow-up. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização 2024-01-01T00:00:00Z