{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T10:53:57Z","timestamp":1700564037055},"reference-count":31,"publisher":"FapUNIFESP (SciELO)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Bras Endocrinol Metab"],"published-print":{"date-parts":[[2007,10]]},"abstract":"<jats:p>A neuropatia perif\u00e9rica \u00e9 o principal fator de risco para ulcera\u00e7\u00e3o em p\u00e9 de indiv\u00edduos diab\u00e9ticos. Este estudo testou a associa\u00e7\u00e3o de doen\u00e7a arterial perif\u00e9rica (DAP) \u00e0 ulcera\u00e7\u00e3o do p\u00e9 em amostra de pacientes com neuropatia sens\u00f3rio-motora sim\u00e9trica distal e se marcadores inflamat\u00f3rios subcl\u00ednicos tamb\u00e9m se associariam a esse evento. Foram avaliados 32 indiv\u00edduos diab\u00e9ticos tipo 2 com exame do monofilamento de 10 g alterado, estratificados em 2 grupos segundo a hist\u00f3ria ou presen\u00e7a de \u00falcera nas extremidades inferiores. O grupo \"com \u00falcera\" (n = 18) incluiu aqueles que apresentavam \u00falcera ativa ou cicatrizada, ou que tiveram alguma amputa\u00e7\u00e3o em membro inferior decorrente de complica\u00e7\u00f5es da \u00falcera. Al\u00e9m do exame neurol\u00f3gico e monofilamento, foram submetidos a bioestesiometria, avalia\u00e7\u00e3o vascular com Doppler e exames laboratoriais. Os grupos foram semelhantes quanto \u00e0 distribui\u00e7\u00e3o dos sexos, m\u00e9dia de idade e tempo de diabetes. O grupo com \u00falcera apresentou valores m\u00e9dios de altura (1,70 \u00b1 0,06 vs. 1,63 \u00b1 0,11 m; p = 0,044) e limiar de percep\u00e7\u00e3o vibrat\u00f3ria no mal\u00e9olo medial (40,9 \u00b1 13,0 vs. 30,6 \u00b1 12,3 V; p = 0,040) mais elevados que o sem a \u00falcera. Os grupos n\u00e3o diferiram entre si quanto \u00e0 m\u00e9dia dos marcadores inflamat\u00f3rios. A resposta do reflexo patelar foi tamb\u00e9m pior no grupo com \u00falcera (p = 0,047), no qual se observou maior propor\u00e7\u00e3o de indiv\u00edduos com o \u00edndice h\u00e1lux-braquial alterado (p = 0,030) quando comparado ao sem \u00falcera. Conclui-se que a DAP est\u00e1 associada \u00e0 presen\u00e7a de \u00falcera (atual ou pregressa) em membros inferiores de indiv\u00edduos diab\u00e9ticos neuropatas. A pesquisa de altera\u00e7\u00e3o de fluxo de art\u00e9rias digitais de membro inferior (no h\u00e1lux) contribuiu para detectar tal associa\u00e7\u00e3o. Associa\u00e7\u00e3o de neuropatia ulcerada a marcadores inflamat\u00f3rios n\u00e3o foi observada, n\u00e3o sendo poss\u00edvel exclu\u00ed-la devido \u00e0s limita\u00e7\u00f5es do tamanho da amostra. Estudos prospectivos dever\u00e3o examinar a sensibilidade do \u00edndice h\u00e1lux-braquial para identificar DAP em indiv\u00edduos diab\u00e9ticos sob risco de ulcera\u00e7\u00e3o.<\/jats:p>","DOI":"10.1590\/s0004-27302007000700017","type":"journal-article","created":{"date-parts":[[2007,12,18]],"date-time":"2007-12-18T20:38:43Z","timestamp":1198010323000},"page":"1134-1142","source":"Crossref","is-referenced-by-count":10,"title":["An\u00e1lise de fatores associados \u00e0 ulcera\u00e7\u00e3o de extremidades em indiv\u00edduos diab\u00e9ticos com neuropatia perif\u00e9rica"],"prefix":"10.1590","volume":"51","author":[{"given":"Mariana V.P.","family":"Porci\u00fancula","sequence":"first","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz Clemente P.","family":"Rolim","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciana","family":"Garofolo","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra Roberta G.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.2337\/diacare.22.9.1479","article-title":"Risk factors for severity of diabetic polineuropathy: intensive longitudinal assessment of the Rochester Diabetic Neuropathy Study cohort","volume":"22","author":"Dyck PJ","year":"1999","journal-title":"Diabetes Care","ISSN":"http:\/\/id.crossref.org\/issn\/0149-5992","issn-type":"print"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.2337\/diacare.27.6.1458","article-title":"Diabetic somatic 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