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Clinical profile of hypertension patients in primary health Care in Cirebon Regency, Indonesia 印度尼西亚锡雷本县初级卫生保健中高血压患者的临床概况
Q3 Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-20 DOI: 10.1016/j.endmts.2025.100232
Tiar Masykuroh Pratamawati , Ahmad Fariz Malvi Zamzam Zein , Uswatun Khasanah , Donny Nauphar , Vincentius S.W. Budhyanto , Idrus Alwi , Asmarinah

Introduction

Hypertension is a catastrophic non-communicable disease increasing in prevalence globally. This study aimed to assess the clinical profile of hypertensive patients in primary health care services in Cirebon Regency, Indonesia.

Method

This descriptive study employed a purposive sampling method, recruiting 97 adult patients diagnosed with essential hypertension at the Talun Community Health Center, Cirebon Regency, West Java, from November 2023 to February 2024. Patients with secondary hypertension or hypertension in pregnancy were excluded. Data were collected through questionnaires, blood pressure measurements, and analysis of blood and urine samples. The clinical profile included family history, control status of hypertension, lifestyle factors, cardiometabolic parameters, and mental health status. Lifestyle factors encompassed both dietary habits and physical activity levels. Cardiometabolic parameters included body mass index (BMI), HbA1c, lipid profile, kidney function, and electrocardiogram. Mental health status was measured using the Depression Anxiety Stress Scales (DAAS). Univariate analysis was stated in frequencies, mean, or median.

Results

The mean age of the participants was 51.33 (±1.07) years, predominantly female (84.54 %). Subjects with a family history of hypertension were 52.58 %, and 75.3 % had uncontrolled blood pressure. Most subjects (79.17 %) engaged in light daily physical activity, while only 4.2 % reported excessive sodium intake. The average BMI was 26.04 kg/m2, with 35.5 % classified as class 1 obese. Additionally, 12.4 % of subjects had diabetes mellitus, 41.2 % were prediabetic, and 80.41 % had dyslipidemia. Albuminuria was detected in 54.6 % of participants, and 7.2 % showed evidence of left ventricular hypertrophy. Regarding mental health, 37.50 % experienced anxiety, 8.33 % reported stress, and 4.17 % suffered from depression.

Conclusion

The findings indicate a significant proportion of hypertensive patients in primary health care in Cirebon Regency have uncontrolled blood pressure. Sedentary lifestyle, obesity, dyslipidemia, albuminuria, and prediabetes were prevalent among these patients. Moreover, anxiety affected more than a third of the studied subjects, highlighting the need for comprehensive management strategies for managing hypertensive patients.
高血压是一种灾难性的非传染性疾病,全球患病率不断上升。本研究旨在评估印度尼西亚锡雷本县初级卫生保健服务中高血压患者的临床概况。方法采用有目的抽样方法,于2023年11月至2024年2月在西爪哇省锡雷本县塔伦社区卫生中心招募确诊为原发性高血压的成人患者97例。排除继发性高血压或妊娠期高血压患者。数据是通过问卷调查、血压测量、血液和尿液样本分析收集的。临床资料包括家族史、高血压控制状况、生活方式因素、心脏代谢参数和心理健康状况。生活方式因素包括饮食习惯和身体活动水平。心脏代谢参数包括体重指数(BMI)、糖化血红蛋白(HbA1c)、血脂、肾功能和心电图。采用抑郁焦虑压力量表(DAAS)测量心理健康状况。单变量分析用频率、平均值或中位数表示。结果参与者平均年龄为51.33(±1.07)岁,女性占84.54%。有高血压家族史的占52.58%,血压未控制的占75.3%。大多数受试者(79.17%)从事轻度日常体力活动,而只有4.2%报告钠摄入量过高。平均BMI为26.04 kg/m2,其中35.5%为1级肥胖。此外,12.4%的受试者患有糖尿病,41.2%为糖尿病前期,80.41%的受试者患有血脂异常。54.6%的参与者检测到蛋白尿,7.2%显示左心室肥厚的证据。在心理健康方面,37.50%的人感到焦虑,8.33%的人感到压力,4.17%的人患有抑郁症。结论希波本县初级卫生保健中有相当比例的高血压患者血压未得到控制。久坐不动的生活方式、肥胖、血脂异常、蛋白尿和前驱糖尿病在这些患者中普遍存在。此外,焦虑影响了超过三分之一的研究对象,这突出了管理高血压患者的综合管理策略的必要性。
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引用次数: 0
Screening of MKRN3, DLK1, KISS1, KISS1R, and PROKR2 genes sequences in related girls with central precocious puberty for a personalized management 筛选中枢性性早熟相关女孩的MKRN3、DLK1、KISS1、KISS1R和PROKR2基因序列以进行个性化管理
Q3 Medicine Pub Date : 2025-06-01 Epub Date: 2025-04-22 DOI: 10.1016/j.endmts.2025.100242
Ayah Alhusseni , Mariam Moalla , Mona Mahfood , Faten Hadj Kacem , Wafa Belabed , Wajdi Safi , Mohamed Abid , Mouna Mnif-Feki , Hassen Hadj Kacem

Purpose

Central precocious puberty (CPP) occurs when the hypothalamus prematurely releases gonadotropin-releasing hormone (GnRH), triggering early sexual maturation and the onset of puberty. Mutations in five genes, including KISS1, KISS1R, DLK1, MKRN3, and PROKR2, have been reported in both sporadic and familial CPP cases. Routine screening of these genes is essential for distinguishing between CPP and early physiological puberty. This study aims to evaluate the role of genetic diagnosis in offering personalized management for familial cases of CPP.

Methods

Clinical, biochemical, and imaging assessments were conducted on two related girls. The coding regions and flanking intronic sequences of the five genes were sequenced using Sanger sequencing and screened for potential mutations.

Results

We identified a heterozygous MKRN3 c.482insC (rs763195944) loss-of-function mutation in a girl diagnosed with CPP at 6.1 years (Tanner stage: P2A2B3). She was treated with a GnRH analogue for five years, and her pubertal development has been well managed (Tanner stage: P3A3B3, at 11 years). No pathogenic variants were found in the KISS1, KISS1R, DLK1, or PROKR2 genes. Consequently, we recommended clinical follow-up only for her unmutated maternal cousin, who was diagnosed with premature thelarche (Tanner stage: P3A3B3, at 8.8 years).

Conclusions

Routine genetic screening of CPP-related genes can assist clinicians in making accurate treatment decisions for patients exhibiting a growth spurt, rapid onset of puberty, and a family history of CPP. This approach enables more targeted and personalized management of the condition.
目的中枢性性早熟(CPP)是下丘脑过早释放促性腺激素释放激素(GnRH),引发性成熟提前和青春期的发生。在散发性和家族性CPP病例中报道了5种基因的突变,包括KISS1、KISS1R、DLK1、MKRN3和PROKR2。常规筛查这些基因对于区分CPP和早期生理性青春期至关重要。本研究旨在评估基因诊断在提供家族性CPP个体化治疗中的作用。方法对2例相关患者进行临床、生化及影像学检查。采用Sanger测序法对5个基因的编码区和侧翼内含子序列进行测序,并进行潜在突变筛选。结果我们在一名6.1岁确诊为CPP的女孩(Tanner期:P2A2B3)中发现了一个杂合mkrn3c .482 insc (rs763195944)功能缺失突变。她用GnRH类似物治疗了5年,她的青春期发育得到了很好的控制(Tanner期:P3A3B3, 11岁)。未发现KISS1、KISS1R、DLK1或PROKR2基因的致病变异。因此,我们建议仅对她未突变的表兄妹进行临床随访,她被诊断为早产儿(Tanner期:P3A3B3, 8.8岁)。结论常规的CPP相关基因筛查有助于临床医生对具有生长突增、青春期早发、有CPP家族史的患者做出准确的治疗决策。这种方法可以对病情进行更有针对性和个性化的管理。
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引用次数: 0
Alpha-lipoic acid regulates pro-inflammatory cytokines and hormones in letrozole-induced polycystic ovary syndrome in rats 硫辛酸调节来曲唑诱导的多囊卵巢综合征大鼠的促炎细胞因子和激素
Q3 Medicine Pub Date : 2025-06-01 Epub Date: 2025-05-03 DOI: 10.1016/j.endmts.2025.100245
Fehintoluwa Joy Femi-Olabisi , Olawunmi Rashidat Oyerinde , Opeyemi Olubunmi Faokunla , Sikemi Adejoke Omar , Precious Evy Igene , Olamide Esther Asaluwala , Bisi Olajumoke Adeoye , Odunayo Olowolehin Oladoye
Polycystic ovary syndrome (PCOS) a common endocrine disorder affecting 5–10 % of women in their reproductive age with reproductive and metabolic disorders such as anovulation/oligo-ovulation, hyperinsulinemia, glucose intolerance, obesity and dyslipidemia. Among other heterogeneous symptoms, studies have linked PCOS to low-grade chronic inflammation. Alpha-lipoic acid (ALA), an essential mitochondrial co-factor and safe natural molecule acts as an antioxidant. In this study, letrozole-induced PCOS rat model was used to investigate the effect of ALA on inflammatory cytokines such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and hormones such as testosterone (T), luteinizing hormone (LH) and insulin. Twenty-eight rats were randomly divided into four groups of seven rats each- Group 1,2,3 and 4 (Control, PCOS, PCOS+metformin (MET) + clomiphene citrate (CC), and PCOS+ALA respectively). PCOS was induced by orally administering 1 mg/kg/day of letrozole for 21 days. ALA (1 mg/day) was administered orally to PCOS rats, and the reference drugs (7.14 mg/kg/day of MET co-administered with 2 mg/kg/day CC) were given orally for 14 days. Results revealed acyclicity in the oestrous cycle of PCOS rats characterized by persistent estrus and diestrus phases was completely reversed by ALA compared to the reference drug-treated PCOS group. ALA decreased serum fasting blood sugar, IL-6, TNF-α, total cholesterol (TC), Triglycerides (trigs), low-density lipoprotein-cholesterol (LDL-C), insulin, and LH. Serum high-density lipoprotein-cholesterol (HDLC) was significantly increased (p < 0.05) in the ALA-treated group compared to the control rats. Therefore, the efficacy of ALA as a regulator of pro-inflammatory cytokines and reproductive factors can be exploited in developing treatments for PCOS.
多囊卵巢综合征(PCOS)是一种常见的内分泌紊乱,影响5 - 10%的育龄妇女,伴有生殖和代谢紊乱,如无排卵/少排卵、高胰岛素血症、葡萄糖耐受不良、肥胖和血脂异常。在其他异质性症状中,研究已将多囊卵巢综合征与低度慢性炎症联系起来。α -硫辛酸(ALA)是线粒体必需的辅助因子,也是一种安全的天然分子,具有抗氧化剂的作用。本研究采用来曲唑诱导的PCOS大鼠模型,研究ALA对炎性细胞因子如白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)以及激素如睾酮(T)、黄体生成素(LH)和胰岛素的影响。将28只大鼠随机分为1、2、3、4组(对照组、PCOS、PCOS+二甲双胍(MET) +柠檬酸克罗米芬(CC)、PCOS+ALA),每组7只。口服来曲唑1 mg/kg/d诱导PCOS 21 d。PCOS大鼠口服ALA (1 mg/d),对照药(7.14 mg/kg/d MET与2 mg/kg/d CC共给药),连续14 d。结果显示,与对照药物治疗PCOS组相比,ALA完全逆转了PCOS大鼠持续发情和发情期的不周期性。ALA降低血清空腹血糖、IL-6、TNF-α、总胆固醇(TC)、甘油三酯(trigs)、低密度脂蛋白-胆固醇(LDL-C)、胰岛素和LH。血清高密度脂蛋白-胆固醇(HDLC)显著升高(p <;0.05),与对照组比较差异有统计学意义(p < 0.05)。因此,ALA作为促炎细胞因子和生殖因子的调节因子的功效可用于开发多囊卵巢综合征的治疗方法。
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引用次数: 0
Impact of remdesivir on liver function: A comparative study of diabetic and non-diabetic COVID-19 patients 瑞德西韦对糖尿病与非糖尿病COVID-19患者肝功能影响的比较研究
Q3 Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-31 DOI: 10.1016/j.endmts.2025.100237
Zahra Zarei , Elham Nejadsadeghi , Seyedeh Leila Dehghani , Fateme Dadgar
This study aimed to evaluate the effect of remdesivir on liver tests in diabetic and non-diabetic COVID-19 patients through a multicenter study conducted in Southeast Iran. Therefore, 200 participants, comprising 98 patients with diabetes and 102 non-diabetic subjects, were assessed based on the Declaration of Helsinki, with proper inclusion, and exclusion criteria. Demographic data were collected using a detailed questionnaire and a clinical checklist documenting underlying health conditions, particularly diabetes and hypertension. Liver function tests measured key enzymes and substances, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin, and data analysis was performed using SPSS (Confidence Interval = 0.95, p ≤ 0.05). Key findings indicate a significant correlation between increasing age and diabetes prevalence, with older age groups exhibiting higher rates of diabetes. Gender analysis revealed a slight predominance of females among diabetic patients, while educational attainment appeared lower in this group, suggesting a potential link between education and diabetes incidence. In patients with diabetes, AST levels rose from 19.2 ± 2.1 U/L before treatment to 25.3 ± 3.1 U/L after treatment, while ALT levels increased from 18.1 ± 1.4 U/L to 23.5 ± 2.2 U/L. Non-diabetic patients showed less pronounced increases in liver enzymes, with AST rising from 28.7 ± 3.1 U/L to 13.2 ± 2.1 U/L after treatment and ALT changing from 18.6 ± 3.2 U/L to 19.6 ± 3.1 U/L. Health-related factors, particularly the prevalence of hypertension and obesity, were notably higher among patients with diabetes. Lifestyle behaviors, including smoking and physical activity levels, further distinguished the two groups, with patients with diabetes showing a higher smoking prevalence and a lower engagement in regular exercise. The impact of remdesivir treatment on liver function revealed significant increases in liver enzyme levels among patients with diabetes post-treatment, contrasting with stable liver function in non-diabetic patients. The study underscores the intricate relationship between diabetes, liver health, and COVID-19, emphasizing the importance of considering comorbidities in treatment and management strategies for diabetic patients.
本研究旨在通过在伊朗东南部开展的一项多中心研究,评估瑞德西韦对糖尿病和非糖尿病COVID-19患者肝脏检查的影响。因此,200名参与者,包括98名糖尿病患者和102名非糖尿病受试者,根据赫尔辛基宣言进行评估,并采用适当的纳入和排除标准。人口统计数据是通过详细的问卷调查和记录潜在健康状况的临床检查表收集的,特别是糖尿病和高血压。肝功能试验检测关键酶和物质,包括天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、碱性磷酸酶(ALP)和总胆红素,数据采用SPSS统计软件进行分析(置信区间= 0.95,p≤0.05)。主要研究结果表明,年龄增长与糖尿病患病率之间存在显著相关性,年龄越大的人群糖尿病发病率越高。性别分析显示,糖尿病患者中女性略占优势,而这一群体的受教育程度较低,这表明教育程度与糖尿病发病率之间存在潜在联系。糖尿病患者AST水平由治疗前的19.2±2.1 U/L上升至治疗后的25.3±3.1 U/L, ALT水平由治疗前的18.1±1.4 U/L上升至23.5±2.2 U/L。非糖尿病患者肝酶升高不明显,治疗后AST由28.7±3.1 U/L上升至13.2±2.1 U/L, ALT由18.6±3.2 U/L上升至19.6±3.1 U/L。与健康相关的因素,特别是高血压和肥胖的患病率,在糖尿病患者中明显更高。生活方式行为,包括吸烟和体育活动水平,进一步区分了两组,糖尿病患者显示出更高的吸烟率和更低的定期锻炼。瑞德西韦治疗对肝功能的影响显示,治疗后糖尿病患者的肝酶水平显著升高,而非糖尿病患者的肝功能稳定。该研究强调了糖尿病、肝脏健康和COVID-19之间的复杂关系,强调了在糖尿病患者的治疗和管理策略中考虑合并症的重要性。
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引用次数: 0
Risk factors of central compartment lymph node metastasis posterior to the right recurrent laryngeal nerve in differentiated thyroid carcinoma: A single-center prospective study in Vietnam 分化型甲状腺癌中央间室淋巴结转移至右喉返神经后方的危险因素:越南的一项单中心前瞻性研究
Q3 Medicine Pub Date : 2025-06-01 Epub Date: 2025-04-15 DOI: 10.1016/j.endmts.2025.100240
Phan Hoang Hiep , Tran Ngoc Luong , Doan Quoc Hung , Tran Doan Ket , Pham Quyet Thang , Do Van Ky , Nguyen Giang Son , Truong Quang Huy , Ngo Van Thanh , Do Trung Anh , Doan Vu Tu Quyen
The study aims to examine the incidence of central compartment lymph node metastasis on the right side posterior to the recurrent laryngeal nerve in cases of papillary thyroid cancer, as well as the risk factors that may increase this incidence. A total thyroidectomy was conducted on 230 patients diagnosed with differentiated thyroid cancer, accompanied by right central compartment lymph node dissection at Viet Nam National hospital of endocrinology in 2024. The central lymph nodes were categorized into two groups: pre-nerve lymph nodes and post-nerve lymph nodes. The clinical and paraclinical characteristics of the primary tumor and metastatic cervical lymph nodes were documented. The result showed that 52 cases (22.6 %) presenting metastatic lymph nodes. Age >55 years, female gender, tumor size exceeding 1 cm, concurrent thyroiditis, and metastasis to pre-nerve central lymph nodes and ipsilateral lateral neck lymph nodes were significantly correlated with elevated rates of metastasis to lymph nodes located posterior to the recurrent laryngeal nerve (p < 0.05). Tumor location, multifocality, and extrathyroidal invasion did not significantly influence the metastasis rate to post-nerve lymph nodes (p > 0.05). Multivariate regression analysis revealed four independent prognostic factors for post-nerve lymph node metastasis: tumor size exceeding 1 cm, concurrent chronic thyroiditis, metastasis to pre-nerve lymph nodes, and metastasis to ipsilateral lateral neck lymph nodes. In conclusion, patient with above characteristics, precise dissection is recommended to prevent the oversight of metastatic lymph nodes.
本研究旨在探讨甲状腺乳头状癌右侧喉返神经后侧中央室淋巴结转移的发生率,以及可能增加该发生率的危险因素。本文于2024年在越南国立内分泌医院对230例诊断为分化型甲状腺癌并伴有右侧中央室淋巴结清扫的患者行甲状腺全切除术。中枢淋巴结分为两组:神经前淋巴结和神经后淋巴结。记录了原发肿瘤和转移性颈部淋巴结的临床和临床旁特征。结果显示52例(22.6%)出现转移性淋巴结。年龄55岁、女性、肿瘤大小超过1cm、并发甲状腺炎、神经前中枢淋巴结和同侧颈部外侧淋巴结转移与喉返神经后淋巴结转移率升高显著相关(p <;0.05)。肿瘤的位置、多灶性和甲状腺外浸润对神经后淋巴结转移率无显著影响(p >;0.05)。多因素回归分析显示神经后淋巴结转移的4个独立预后因素:肿瘤大小超过1cm、并发慢性甲状腺炎、神经前淋巴结转移、同侧颈外淋巴结转移。综上所述,对于具有上述特征的患者,建议进行精确的淋巴结清扫,以防止转移淋巴结被忽视。
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引用次数: 0
The correlation between COVID-19 severity and elevated level of serum glucose COVID-19严重程度与血糖升高的相关性
Q3 Medicine Pub Date : 2025-06-01 Epub Date: 2025-05-19 DOI: 10.1016/j.endmts.2025.100248
Zahraa Q. Ali , Nawar S. Mohammed , Hussam H. Muhammed
The collision of COVID-19 and type 2 diabetes (T2D) highlights T2D as the second most prevalent comorbidity in COVID-19. This infection exacerbates complications in diabetics. It elevates blood glucose through excessive glucocorticoid and catecholamine release. This hyperglycemia triggers pro-inflammatory monocytes, heightens platelet reactivity, and amplifies cardiovascular deaths in diabetics. This cross-sectional study, conducted at Private Nursing Home Hospital in Baghdad, focused on 143 COVID-19 patients diagnosed via RNA detection in nasopharyngeal secretions using PCR from May to August 2021. The patients, aged 18 to 76, had no prior history of diabetes upon admission. An 86-member control group, free from COVID-19 and diabetes history, aged 20 to 73, was also included. BMI, platelet count, WBC, ESR, RBG, and serum levels of the alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) levels were measured. The results revealed statistically highly differences in RBG between the two groups (p-value = 0.001), and significant variations in the Mean ± SD values of ALT and AST enzyme levels, as well as in WBC and ESR, when comparing COVID patients to non-COVID patients. In summary, our findings show a positive correlation between admission hyperglycemia and the risk of severe COVID-19, emphasizing the significance of monitoring and managing blood glucose levels. Effective glycemic control could aid in mitigating COVID-19 progression and is integral to comprehensive treatment. These glucose-related changes and COVID-19 impact on the pancreas may contribute to the development of T2D.
COVID-19和2型糖尿病(T2D)的冲突表明,T2D是COVID-19中第二大常见合并症。这种感染加剧了糖尿病患者的并发症。它通过释放过量的糖皮质激素和儿茶酚胺来升高血糖。这种高血糖会触发促炎单核细胞,提高血小板反应性,并增加糖尿病患者的心血管死亡。这项横断面研究是在巴格达私立养老院医院进行的,重点研究了2021年5月至8月期间通过PCR在鼻咽分泌物中检测RNA诊断的143名COVID-19患者。患者年龄18至76岁,入院时无糖尿病病史。对照组86人,无新冠肺炎和糖尿病病史,年龄在20至73岁之间。测定BMI、血小板计数、WBC、ESR、RBG、血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)水平。结果显示,两组患者的RBG差异具有统计学意义(p值= 0.001),ALT和AST酶水平的Mean±SD值以及WBC和ESR的差异具有统计学意义,与未患COVID的患者相比。综上所述,我们的研究结果表明入院时高血糖与重症COVID-19的风险呈正相关,强调了监测和管理血糖水平的重要性。有效的血糖控制有助于缓解COVID-19的进展,是综合治疗的组成部分。这些血糖相关的变化和COVID-19对胰腺的影响可能导致T2D的发展。
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引用次数: 0
The association between serum leptin, adiponectin and resistin levels with chronic kidney disease with and without hemodialysis patients 血清瘦素、脂联素和抵抗素水平与慢性肾病伴和不伴血液透析患者的关系
Q3 Medicine Pub Date : 2025-06-01 Epub Date: 2025-04-24 DOI: 10.1016/j.endmts.2025.100244
Maha Elttayef Jasim , Firas Faris Rija , Sura Zahim Hussein
Chronic kidney disease (CKD) is major and urgent public health problem caused by a progressive reduce in renal function during some months or years which cause functional or structural abnormalities of the kidney. In renal failure, many adipokines are important in endothelial dysfunction, like inflammation and oxidative stress. This study aims to evaluate the changes of some adipokines in chronic kidney disease (CKD) with and without hemodialysis (HD) Patients. Blood samples were collected from dialysis Unit in Tikrit Teaching Hospital in Tikrit city which started from January- July 2024 who aged (18 - 68) years old. The study subjects were 90 individuals who consist of 30 healthy individuals, 30 CKD patients with hemodialysis treatment and 30 CKD patients without hemodialysis treatment. The present study showed that leptin, adiponectin and resistin were increased in CKD patients with HD and (adiponectin and resistin) were decreased in CKD patients without HD while leptin was increased in CKD patients without HD when compared with control group. Adipokines changes in hemodialysis patients rather than pre dialysis CKD patients.
慢性肾脏疾病(CKD)是一种严重而紧迫的公共卫生问题,它是由几个月或几年的肾功能进行性下降引起的,导致肾脏的功能或结构异常。在肾衰竭中,许多脂肪因子在内皮功能障碍中起重要作用,如炎症和氧化应激。本研究旨在评估慢性肾脏疾病(CKD)伴和不伴血液透析(HD)患者中一些脂肪因子的变化。从2024年1月至7月在提克里特市提克里特教学医院透析室采集了年龄在(18 - 68)岁的血液样本。研究对象为90人,包括30名健康个体,30名接受血液透析治疗的CKD患者和30名未接受血液透析治疗的CKD患者。本研究显示,与对照组相比,合并HD的CKD患者瘦素、脂联素和抵抗素升高,不合并HD的CKD患者瘦素(脂联素和抵抗素)降低,而不合并HD的CKD患者瘦素升高。血液透析患者而非透析前CKD患者的脂肪因子变化。
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引用次数: 0
Impending thyroid storm in a case of Down syndrome with burr hole surgery: A case report 唐氏综合征伴钻孔手术的甲状腺风暴:1例报告
Q3 Medicine Pub Date : 2025-06-01 Epub Date: 2025-05-21 DOI: 10.1016/j.endmts.2025.100250
Ayyesha Yuanita , Hermina Novida

Introduction

An accidental injury requiring surgery in a patient with Down syndrome (DS) and hyperthyroidism is an uncommon case, in which thyroid hormone control plays a crucial role in successful surgery.

Case presentation

An Indonesian woman, 33 years old, suffered an accidental brain injury and gradually lost consciousness. She was born with DS and had no prior medical consultation. At the emergency room, she was diagnosed with hyperthyroidism and an acute subdural hematoma. According to the Burch-Wartofsky (BW) score, the examination revealed an impending thyroid storm (40 points). Management of hyperthyroidism aims to avoid the thyroid storm before, during, and after double burr hole drainage, which is treated with glucocorticoid and antithyroid drugs. She was followed up for 6 months after surgery and had considerable improvement.

Conclusion

Management of hyperthyroidism have a crucial role in DS patient with burr hole drainage to improve surgical outcomes, control of cardiac output, and minimize thyroid storm.
唐氏综合征(DS)合并甲状腺功能亢进患者发生意外伤害需要手术治疗是一种罕见的病例,其中甲状腺激素的控制对手术成功起着至关重要的作用。病例介绍:一名33岁的印度尼西亚妇女意外脑损伤并逐渐失去意识。她出生时患有退行性椎体滑移,事先没有接受过医疗咨询。在急诊室,她被诊断为甲状腺功能亢进和急性硬膜下血肿。根据Burch-Wartofsky (BW)评分,检查显示甲状腺风暴即将来临(40分)。治疗甲状腺功能亢进的目的是避免双钻孔引流前、引流中、引流后甲状腺风暴的发生,并给予糖皮质激素和抗甲状腺药物治疗。术后随访6个月,病情明显好转。结论处理甲状腺功能亢进对DS钻孔引流术患者改善手术效果、控制心排血量、减少甲状腺风暴有重要作用。
{"title":"Impending thyroid storm in a case of Down syndrome with burr hole surgery: A case report","authors":"Ayyesha Yuanita ,&nbsp;Hermina Novida","doi":"10.1016/j.endmts.2025.100250","DOIUrl":"10.1016/j.endmts.2025.100250","url":null,"abstract":"<div><h3>Introduction</h3><div>An accidental injury requiring surgery in a patient with Down syndrome (DS) and hyperthyroidism is an uncommon case, in which thyroid hormone control plays a crucial role in successful surgery.</div></div><div><h3>Case presentation</h3><div>An Indonesian woman, 33 years old, suffered an accidental brain injury and gradually lost consciousness. She was born with DS and had no prior medical consultation. At the emergency room, she was diagnosed with hyperthyroidism and an acute subdural hematoma. According to the Burch-Wartofsky (BW) score, the examination revealed an impending thyroid storm (40 points). Management of hyperthyroidism aims to avoid the thyroid storm before, during, and after double burr hole drainage, which is treated with glucocorticoid and antithyroid drugs. She was followed up for 6 months after surgery and had considerable improvement.</div></div><div><h3>Conclusion</h3><div>Management of hyperthyroidism have a crucial role in DS patient with burr hole drainage to improve surgical outcomes, control of cardiac output, and minimize thyroid storm.</div></div>","PeriodicalId":34427,"journal":{"name":"Endocrine and Metabolic Science","volume":"18 ","pages":"Article 100250"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimizing pre-genetic diagnosis of monogenic diabetes: clinical thresholds for targeted testing 优化单基因糖尿病的遗传前诊断:靶向检测的临床阈值
Q3 Medicine Pub Date : 2025-06-01 Epub Date: 2025-04-23 DOI: 10.1016/j.endmts.2025.100243
Pichakacheri Sureshkumar , Sidharth S. Kumar

Background

Monogenic Diabetes Mellitus (MDM) represents a minority of Diabetes Mellitus (DM) cases but poses diagnostic complexities owing to its clinical overlap with other forms of DM. Preliminary clinical screening is crucial for diagnosis due to the paucity of genetic testing facilities.

Aim

We aimed to identify clinical thresholds that could enhance the likelihood of obtaining positive genetic test results while excluding young-onset T2DM in suspected cases of MDM.

Methodology

We analyzed the demographic, anthropometric, and biochemical details of genetically confirmed MDM participants (n = 10) from our center and compared them with those of clinically suspected patients who tested negative for MDM (n = 67), excluding two neonatal DM (NDM) cases. Using Receiver Operating Characteristic curves, we determined the thresholds for various parameters, prioritizing a sensitivity of ≥75 %.

Results

The upper cut-off values obtained for identifying individuals with a potential for genetic positivity were age of onset of DM 25.5 years, BMI 23.5 kg/m2, visceral fat 7 %, waist circumference (irrespective of gender) 86 cm, random C-peptide 1.41 ng/mL, AST 31 units/dL, ALT 41 units/dL, triglyceride 150 mg/dL, and for HDL, the lower cut-off point was 48.5 mg/dL.

Conclusion

These defined thresholds offer a potential to enhance the efficient use of genetic testing by ensuring more targeted utilization, thus optimizing resource allocation and improving diagnostic accuracy in the assessment of MDM.
背景单基因糖尿病(MDM)占糖尿病(DM)病例的少数,但由于其与其他形式的DM的临床重叠,使诊断变得复杂。由于缺乏基因检测设施,初步的临床筛查对诊断至关重要。我们旨在确定临床阈值,以提高获得阳性基因检测结果的可能性,同时排除疑似MDM病例中年轻发病的T2DM。方法:我们分析了我们中心遗传证实的MDM参与者(n = 10)的人口学、人体测量学和生化细节,并将其与临床疑似MDM阴性患者(n = 67)进行比较,不包括2例新生儿DM (NDM)病例。使用受试者工作特征曲线,我们确定了各种参数的阈值,优先考虑灵敏度≥75%。结果识别潜在遗传阳性个体的上限临界值为DM发病年龄25.5岁,BMI 23.5 kg/m2,内脏脂肪7%,腰围(不分性别)86 cm,随机c肽1.41 ng/mL, AST 31单位/dL, ALT 41单位/dL,甘油三酯150 mg/dL, HDL的下限临界值为48.5 mg/dL。结论这些定义的阈值有可能通过确保更有针对性的利用来提高基因检测的效率,从而优化资源分配,提高MDM评估的诊断准确性。
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引用次数: 0
Association between lipid profiles and Graves orbitopathy: A systematic review and meta analysis 血脂与Graves眼病之间的关系:一项系统综述和meta分析
Q3 Medicine Pub Date : 2025-06-01 Epub Date: 2025-04-07 DOI: 10.1016/j.endmts.2025.100234
Nanny Natalia Mulyani Soetedjo , Louis Fabio Jonathan Jusni , Eric Ricardo Yonatan , Steven Alvianto , Nicolas Daniel Widjanarko , Hikmat Permana

Introduction

Graves orbitopathy (GO) is an autoimmune disorder affecting the tissues around the eyes, seen in 25–50 % of individuals with Graves disease (GD). Thyroid receptor antibodies (TRAb) target the TSH receptor, which can provoke an inflammatory response and promote fat cell formation by activating these receptors. Given this mechanism, statins that are commonly used for managing hyperlipidemia could be a potential treatment for GO. This review explores the connection between Graves orbitopathy and lipid profiles.

Method

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Articles were sourced from databases such as MEDLINE, ScienceDirect, EBSCO, ProQuest, Cochrane, and Google Scholar. The inclusion criteria covered both published and unpublished studies examining the relationship between GO and lipid profiles. Meta-analysis was conducted using Review Manager 5.4, and the risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS).

Result

This review included a total of four cross-sectional studies. All studies found a significant association between LDL cholesterol levels and Graves orbitopathy. However, the relationships with triglycerides (TG), HDL levels, and total cholesterol (TC) were not consistently statistically significant. The meta-analysis revealed significant differences in TC, LDL cholesterol, and TG levels across all groups (SMD = 0.48, CI = 0.17–0.80, p = 0.002, I2 = 67 %; SMD = 0.42, CI = 0.18–0.67, p = 0.0008, I2 = 47 %; SMD = 0.24, CI = 0.07–0.41, p = 0.005, I2 = 0 %, respectively), while HDL levels did not show significant differences among the groups (SMD = 0.16, CI = −0.02-0.34, p = 0.08, I2 = 10 %).

Conclusion

Significant differences in serum lipid profiles, including TC, LDL, and TG except HDL, were found between patients with GO and those without. Further research is needed to confirm these findings.
Graves眼病(GO)是一种影响眼周组织的自身免疫性疾病,见于25 - 50%的Graves病(GD)患者。甲状腺受体抗体(TRAb)以TSH受体为靶点,通过激活这些受体,可以引发炎症反应并促进脂肪细胞的形成。考虑到这一机制,通常用于治疗高脂血症的他汀类药物可能是氧化石墨烯的潜在治疗方法。这篇综述探讨了Graves眼病和血脂之间的联系。方法本研究遵循系统评价和荟萃分析首选报告项目(PRISMA)指南。文章来源于MEDLINE、ScienceDirect、EBSCO、ProQuest、Cochrane和谷歌Scholar等数据库。纳入标准包括已发表和未发表的研究,研究氧化石墨烯与脂质谱之间的关系。meta分析采用Review Manager 5.4进行,偏倚风险采用Newcastle-Ottawa量表(NOS)进行评估。结果本综述共纳入4项横断面研究。所有研究均发现低密度脂蛋白胆固醇水平与Graves眼病之间存在显著关联。然而,与甘油三酯(TG)、高密度脂蛋白水平和总胆固醇(TC)的关系在统计学上并不一致。荟萃分析显示,各组TC、LDL胆固醇和TG水平存在显著差异(SMD = 0.48, CI = 0.17-0.80, p = 0.002, I2 = 67%;SMD = 0.42, CI = 0.18 - -0.67, p = 0.0008, I2 = 47%;SMD = 0.24, CI = 0.07-0.41, p = 0.005, I2 = 0%),而HDL水平各组间无显著差异(SMD = 0.16, CI = - 0.02-0.34, p = 0.08, I2 = 10%)。结论除HDL外,氧化石墨烯患者与非氧化石墨烯患者血清脂质谱(包括TC、LDL和TG)存在显著差异。需要进一步的研究来证实这些发现。
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引用次数: 0
期刊
Endocrine and Metabolic Science
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