Background Studies highlight the inaccuracy of glycated hemoglobin (HbA1c) for the assessment of glycemic control in dialysis diabetics and suggest the use of continuous glucose monitoring (CGM) as an alternative. Of the CGMs, FreeStyle Libre® is the most used in worldwide, but there is still no consensus on its use in dialysis. Method A 3-week prospective study was performed with 12 patients comparing capillary and interstitial glucose during dialysis. Results Comparing capillary and interstitial measurements, similar values were observed in pre-dialysis in the 1st week (184.1 ± 69.5 mg/dl and 173.1 ± 78.9 mg/dl, respectively, p = 0.303), in patients with body mass index less than 24.9 kg/m2 (214.2 ± 72.2 mg/dl and 201.3 ± 77.0 mg/dl respectively, p = 0.466), in those dialysis fluid loss less than 2 l (185.5 ± 82.6 mg/dl and 183.1 ± 94.0 mg/dl respectively and p = 0.805) and in those with hemoglobin greater than 12 g/dl (152.0 ± 35, 5 mg/dl and 129.5 ± 47.4 mg/dl respectively, p = 0.016). In the correlation of the capillary measurement with the interstitial sensor, it was observed that the proportions in the Clarke Error Grid of zone A, zone B, zone C, zone D and zone E were 62.5%, 27.1%, 0.0%, 10.4% and 0.0% respectively and in the Parkes error grid in zone A, zone B, zone C, zone D and zone E were 80.6%, 9.7%, 9.7% 0.0% and 0.0%, respectively. Conclusion The mean absolute relative difference in dialysis patients is higher than the general population without end-stage renal disease. However, clinical decision-making based on the values measured by the system can be made with a good margin based on the correlation between interstitial and capillary measurements.

BackgroundDiabetes is closely linked with coronary artery disease, either by means of direct effects of hyperglycemia, or indirectly by its frequent association with dyslipidemia. Any treatment for diabetes that has beyond the capacity of reduce glycated hemoglobin, the propensity to improve lipid profile and reduce weight will bring many benefits to patients.MethodWe compare the effects of vildagliptin with the gliclazide on lipid profile before and after a standardized meal test, on glycemic control and oxidative stress in diabetic patients using metformin without adequate glycemic control. This is a prospective study of 16 weeks with diabetic patients using metformin without adequate glycemic control. Patients were randomized to receive gliclazide 30–120 mg/day or vildagliptin 100 mg/day.Results36 patients were randomized, with no loss of follow up. Regarding the lipid profile the difference observed at the end of the study was a higher HDL level in the vildagliptin group compared with gliclazide fasting (62.3 vs. 51.3 mg/dL, p = 0.021) and postprandial (62.9 vs. 51.1 mg/dL, p = 0.015). We also observed a variation of negative weight (decrease the end compared to the beginning) of the vildagliptin and a positive (increase) in the gliclazide (−0.3 vs. +1.4 Kg, p = 0.048). The decrease in A1c was lower in the vildagliptin group compared to gliclazide (−1.7 vs.−2.3 %, P = 0.031), however there was no difference in the number of patients reaching target glycated hemoglobin <7 % (50 vs. 61.1 %, p = 0.738). Only the group of vildagliptin presented at the end of the study compared to the beginning, decreased insulin values (599.6 vs.705, 59 pg/ml, p = 0.021), glucagon (46.6 vs.65, 2 pg/ml, p = 0.004) and the marker of oxidative stress TBARS (8.0 vs. 9.0 nmol MDA/ml, p = 0.035).ConclusionVildagliptin showed some advantages in addition to metformin in relation to addition of gliclazide. Patients treated with vildagliptin had a higher HDL at the end of the study, less variance in weight, reduced insulin and glucagon as well as reduction of oxidative stress.

Background Studies highlight the inaccuracy of glycated hemoglobin (HbA1c) for the assessment of glycemic control in dialysis diabetics and suggest the use of continuous glucose monitoring (CGM) as an alternative. Of the CGMs, FreeStyle Libre ® is the most used in worldwide, but there is still no consensus on its use in dialysis. Method: A 3-week prospective study was performed with 12 patients comparing capillary and interstitial glucose during dialysis. Results Comparing capillary and interstitial measurements, similar values were observed in pre-dialysis in the first week (184.1 ± 69.5 mg/dl and 173.1 ± 78.9 mg/dl, respectively, p = 0.303), in patients with body mass index less than 24.9 kg/m2 (214.2 ± 72.2 mg/dl and 201.3 ± 77.0 mg/dl respectively, p = 0.466), in those dialysis fluid loss less than 2 liters (185.5 ± 82.6 mg/dl and 183.1 ± 94.0 mg/dl respectively and p = 0.805) and in those with hemoglobin greater than 12g/dl (152.0 ± 35, 5 mg/dl and 129.5 ± 47.4 mg/dl respectively, p = 0.016). In the correlation of the capillary measurement with the interstitial sensor, it was observed that the proportions in the Clarke Error Grid of zone A, zone B, zone C, zone D and zone E were 62.5%, 27.1%, 0.0 %, 10.4% and 0.0% respectively and in the Parkes Error Grid in zone A, zone B, zone C, zone D and zone E were 80.6%, 9.7%, 9.7% 0.0% and 0.0%, respectively. Conclusion The mean absolute relative difference in dialysis patients is higher than the general population without end-stage renal disease. However, clinical decision-making based on the values measured by the system can be made with a good margin based on the correlation between interstitial and capillary measurements.

RESUMODistúrbios dos hormônios tireoideanos há muitos anos são associados à depressão, no entanto, a natureza dessa relação tem levotiroxina, comparados com controles com função tireoidena normal. Para avaliação da presença de depressão foi usado o Inventário de Depressão de Beck (IDB). Participaram do estudo 40 pacientes. A pontuação no IDB teve média de 16,1 ± 13,2 no grupo hipotireoidismo; e de 9,5 ± 7,2, no grupo controle (p = 0,054). Não houve relação entre níveis séricos maiores de TSH e Palavras-chave: Hipotireoidismo. Depressão. Hormônios tireoideanos. ABSTRACTDisorders of the thyroid hormones have long been associated with depression, however, the nature of this relationship has been sectional study, the presence of depression in patients with primary hypothyroidism properly treated with levothyroxine compared with controls with normal thyroid function. To evaluate the presence of depression was used Beck Depression Inventory (BDI). The study included 40 patients. The score on the BDI averaged 16.1 ± 13.2 in the hypothyroidism group; and 9.5 ± 7.2 in the control group (p = 0.054). There was no relationship between higher serum levels of TSH and higher scores on the BDI. There was although it was observed a tendency to an increased risk of depression in hypothyroidism group. Considering the limited sample

Purpose Competitions in high-performance sports are based on the premise of fairness and the absence of advantages for participants. Therefore, several metrics were created to divide participants into categories and neutralize the advantages of some athletes. The division by sex is justified in the face of differences in body development between men and women due to testosterone levels. Faced with the difficulties of determining a single unequivocal criterion for determining sex, major sports entities periodically change the rules that guide the inclusion criteria to compete in the female category. The purpose of this study is to assess whether changes in gender metric rules bring female sports performance closer to male performance, reducing the equality of conditions for female competitors. Design/methodology/approach This is a retrospective study that compared female and male results from the past 5 Olympic games in the 100-metre dash, high jump and javelin throw. Findings The performance in the men's category in the 100-metre dash was superior to the women's in the Olympic Games in Sydney by 8.78% (± 0.16), in Athens by 9.88% (± 0.21), in Beijing by 10.11% (± 0.29), in London by 9.25% (± 0.59) and in Rio de Janeiro by 8.6% (± 0.23). The male high jump was higher than the female by 17.24% (± 1.18) in Sydney, 16.61% (± 1.83) in Athens, 17.01% (± 1.79) in Beijing, 15.47% (± 1.96 higher) in London and 19.67% (± 1.09) in Rio de Janeiro. In the javelin throw, the male superiority was 34.87% (± 2.35) in Sydney, 29.88% (± 4.15) in Athens, 31.87% (± 4.15) in Beijing, 29.44% (± 3.24) in London and 32.31% (± 2.69) in Rio de Janeiro. Research limitations/implications As limitations of the study, this study mentions the lack of hormonal dosage of the athletes involved, the non-evaluation of other modalities with different dynamics of execution and muscular requirements and the non-evaluation of the rules in sexual metrics during the qualifying stages for the games. Practical implications In this manuscript, the authors show that interference of the International Olympic Committee in the sex metric influences the athletic performance of women in some sports. Rules that facilitate participation of transgender athletes, or with sexual differentiation disorder and other forms of hyperandrogenism, improve female athletic performance overall. Originality/value The authors believe that this manuscript is appropriate for publication by International Journal of Human Rights in Healthcare because it is an original paper that fits the goals of the publication. This manuscript creates a paradigm for future policies that rule the sex determination metrics in competitive sports.