Differently from classical criteria based on pulsed Doppler, Tissue Doppler imaging identifies a group of asymptomatic normotensive diabetics with diastolic dysfunction and reduced exercise tolerance. Confirmation of the prognostic importance of our findings could justify the use of Tissue Doppler imaging for diastolic function assessment in diabetics with otherwise healthy hearts.

Background: Advanced echocardiography using two- and three-dimensional myocardial strain proposes to identify subclinical systolic dysfunction in different clinical conditions. Strain assessment plays an important role in the early diagnosis of diabetic cardiomyopathy in diabetes mellitus (DM). However, the findings of published articles are heterogeneous. Here we conducted a systematic review to analyze the current role of strain assessment in patients with DM. Methods: This systematic review of five databases identified 19 studies that used twodimensional strain and 8 studies that used three-dimensional strain. Results: The studies of two-dimensional strain included 1,774 DM patients (mean age, 57.1 years; median age, 55 years; 47.5% women), while those of three-dimensional strain included 488 DM patients (mean age, 55.7 years; median age, 63 years; 51% women). Global longitudinal strain was the myocardial deformation marker that differed most frequently between the DM and control groups. Conclusion: Myocardial strain imaging by two- and three-dimensional speckle tracking echocardiography allows the identification of subclinical systolic dysfunction in DM patients, and differences become more marked when associated with risk factors and ventricular remodeling.

A autoimagem corporal consiste na representação mental sobre seu próprio corpo e que, quando de difere da idealizada, gera insatisfação. Considerando os padrões de beleza ideal estabelecidos pela mídia, frequentemente indivíduos sofrem de uma insatisfação excessiva, o que pode levar a distorção da autoimagem e transtornos alimentares. Diante disso, o presente estudo buscou realizar um panorama sobre a influência das mídias sociais na autoimagem corporal e na ocorrência de transtornos alimentares, destacando o papel do nutricionista nesses casos. Pode-se observar que as mídias sociais possuem impacto direto na insatisfação corporal, repassando o corpo magro como sinônimo de status, sucesso e sensualidade, com maior destaque para as redes sociais. Nesse cenário, as mais atingidas são as mulheres, principalmente as adolescentes, que passam por mudanças corporais nesse período, ficam mais expostas as mídias e são mais influenciáveis. Casos de transtornos alimentares, como anorexia e bulimia nervosa, podem ser desenvolvidos e constantemente são acompanhados por uma autoimagem distorcida. Por fim, foi possível identificar que o nutricionista, dentro de uma equipe multidisciplinar de tratamento, possui papel fundamental, pois pode atuar tanto no diagnóstico, ao verificar alterações, quanto no tratamento em si, através da reeducação alimentar e outras metodologias, sendo essencial o conhecimento específico do tema.

Introduction. Diabetic neuropathy (DN) is one of the most devastating complications of diabetes mellitus; however, in contrast to other countries, there are no scientific studies in Portugal evaluating the impact of demographic and clinical characteristics of this pathological entity. The aim of this study was to evaluate the impact of gender, metabolic control, age of diabetic patients, as well as time of disease progression, the appearance of complaints related to neuropathic pain.Material and methods. A multicentre study with a non-probabilistic, convenience sample of 359 patients was performed employing the quantitative method, using the Statistical Package for Social Science 24 software. The p-value of p < 0.05 was defined to consider a result statistically significant. The Spearman correlation coefficient (r) was determined to determine the relationship between categorical variables.Results. There was no statistically significant difference in the prevalence of DN between genders (p = 0.633 and r = 0.025). There was a statistically significant relationship between the value of HbA1c and DN, with p = 0.010 and r = 0.136. There is a relationship between age and complaints of neuropathic pain, with p = 0.034 and r = 0.112. The variable, time of disease progression, is also correlated with the appearance of complaints of neuropathic pain with p = 0.020 and r = 0.112.Conclusion. The prevalence of neuropathic pain in subjects with diabetes is not negligible and is associated with modifiable risk factors that can be identified, possibly modified and prevented. The correct approach for these patients, which involves screening and early treatment, is decisive improving functionality and quality of life.

Abstract:The lack of land ownership databases in developing countries has influenced inhabitants of these countries to occupy public lands. This situation has resulted in areas of informal housing, commerce, and agriculture, ultimately creating new informal settlements, which are becoming a serious problem in developing countries. These informal settlements contain inhabitants settled on public land without any infrastructure and against the landowner's wishes. This process results in uncontrolled land occupation that promotes new informal areas without any proper urban utilities, positioned in risky areas, where the minimum requirements for healthy living are not being met. In some cases, this incentivizes an informal economy. Building a cadastral map in informal settlement areas is fundamental to supporting the future transformation of illegal areas, and in regulating the occupation of new subdivisions and new expansion areas. In this paper, we present a methodology developed to support the management of informal settlement areas. The method we used has the potential for replication so that it can be adapted to multiple types of informal settlements, as can the model used to register the land tenure. The model was developed using a series of qualitative and quantitative data that determine the identification and classification of buildings, along with a physical and functional description. A Geographic Information System, an initial survey of existing land titles of possession, and public proposals to develop new expansion areas were used to develop the model. A case study is presented where the land management model was implemented in Chã da Caldeiras in Ilha do Fogo, which is an informal settlement in Cape Verde. The proposal created using the results was accepted by the population and local authorities.