The purpose of this study is to analyze 70 patients with diabetic foot ulcers admitted as in-patients for treatment in the Triângulo Mineiro School of Medicine, Uberaba, MG. The lesions were evaluated considering the patient's type of diabetes mellitus (DM), the period of time between the diagnosis of DM and the admission, bacterial pathogens commonly found in the culture materials, the type of treatment required and the clinical outcome of the patients. Eightyseven per cent of the patients had type 2 DM. There was no relation to gender and the patients were mainly in the 6 th and 7 th decades of life. The lesions were more frequent in patients with more than 5 years' duration of DM. The most common bacterial pathogens detected in the culture materials were Proteus mirabilis and Staphylococcus sp. The patients were treated with specific antibiotics, daily dressings and debridements whenever needed. Amputation and mortality rates were 61.4% and 15.7%, respectively. The average length of in-hospital stay was 38 days and the causes of death were mainly sepsis. The diabetic foot is a public health problem of significant magnitude. It requires a long-term therapy and may result in drastic changes in the patients' lifestyle. Prevention is still the best

Introduction:Over the past 20 to 30 years, alternative dementia care models have been developed. Dementia villages challenge popular perceptions about life with dementia and contrast to the traditional model of long-term care facilities that are often seen as institutional, impersonal, and risk-averse. The first dementia village, De Hogeweyk, was developed in 2009 and is located in Weesp, Netherlands. Hogeweyk aims to create a safe environment, enabling the person with dementia to live an “ordinary life” with as much autonomy as possible and also maintaining integration with the local community. Other dementia villages have been established in several countries, following De Hogeweyk model.Objectives:The aim of this presentation is to describe the functioning of dementia villages and evaluate its benefits on dementia patients.Methods:A non-systematic review of the literature was performed on PubMed, PsycINFO and Web of science using selected keywords. We also consult the official websites of the institutions.Results:Dementia villages seem to improve functioning and reduce the need for medication. Anxiety, restlessness and homesickness can still persist, but are reduced by the homelike and hospitable setting in which residents live. In fact, antipsychotic medication use at the residence has decreased from approximately 50% of residents, before the dementia village was introduced, to approximately 12% in 2019. The staff also reported greater job satisfaction. Although dementia villages are growing throughout the Western world, this concept has also been criticized, arguing that this type of living is dishonest, misleading the residents to believe that they are still living in the ‘real community’.Conclusions:Dementia villages are guided by the principles “deinstitutionalize, transform and normalize” care for people with advanced dementia. Although its intuitive advantages, there is no research evidence to demonstrate that this environment has any beneficial effect in behaviour, functional ability or cognition. In future studies, clinical outcomes could be used as a measure of quality of care. Hogeweyk concept has made societies rethinking dementia care and has been inspiring the development of other innovative models of dementia care.

A comparison was made between the years 1980 and 1990 for the frequency and causes of sudden death occurring in the urban and rural areas of the city of Uberaba in individuals older than 15 years. It aims mainly to analyse the current frequency of sudden death in that region and to evaluate the impact, it any, of prophylaxis and therapy on sudden death due to Chagas' disease. For the 1226 deaths cases studied from our 1980, 54 (4.4%) were sudden ones; out of these, 13 (24.1%) were supposedly due to Chagas' disease. For the 1740 death cases studied form our 1990 series, 44 (2.5%) were sudden ones; out of these, only 3 (6.8%) were considered to be due to Chagas' disease. The results indicate a significant decrease in the frequency both for sudden death in general and for sudden death due to Chagas' disease when the year 1990 is compared with 1980. Probable explanations for the findings are discussed.

Familial acromegaly may occur as an isolated pituitary disorder or as a feature of hereditary syndromes, such as multiple endocrine neoplasia type 1 (MEN1) or the Carney complex. Herein, we characterized a newly identified kindred with isolated acromegaly and searched for germline mutation in genes that have been associated with endocrine tumors [i.e. MEN1, Gs alpha (GNAS1), and Gi2 alpha (GNAI2)], as well as the GHRH receptor (GHRH-R) gene. Genomic DNA was used to amplify exons 2-10 of MEN1, followed by dideoxy fingerprinting mutation analysis and direct sequencing. The GHRH-R gene was analyzed via direct sequencing of PCR-amplified fragments representing the coding exons and intron-exon junctions. To exclude mutation at hot spot areas of GNAS1 and GNAI2, exons 8 and 9 of GNAS1 and exons 5 and 6 of GNAI2 were amplified and screened for mutation via denaturing gradient gel electrophoresis. No mutations were detected in any of the four genes. The present data extend prior reports of the absence of mutation in MEN1, GHRH-R, and GNAS1 and describe the first family with isolated acromegaly in which germline mutation in GNAI2 has been searched.

Lithium is the oldest and still one of the most frequently prescribed mood stabilizers in the treatment of bipolar disorder. Though, the implications of lithium use in the older population remain less understood. This work aims to provide an understanding of the impact of lithium in older age bipolar disorder, including tolerability and efficacy.A non-systematic review was performed on PubMed database, using the key words “lithium older adult bipolar disorder” and references from recent international bipolar disorder guidelines.There is an evidence base that lithium is effective in older age bipolar disorder. Aging-associated pharmacokinetic and pharmacodynamic changes as well as increased rates of medical comorbidities and polypharmacy predispose older patients to a higher risk of lithium toxicity. Careful monitoring and adjustment of lithium dosage is especially important in older adults to minimize the risk of toxicity.