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Retroperitoneal Castleman Disease Mimicking Paraganglioma in a Patient with Klinefelter Syndrome: A Case Report Klinefelter综合征患者的腹膜后Castleman病模拟副神经节瘤1例报告
Pub Date : 1900-01-01 DOI: 10.25179/tjem.2019-64815
S. Hepşen, M. Ozbek, E. Sencar, P. Akhanlı, A. Arıkök, D. Şeker, I. Unsal, E. Çakal
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引用次数: 0
Risk Factors for the Relapse of Graves’ Disease Following Withdrawal of Antithyroid Drugs 停用抗甲状腺药物后Graves病复发的危险因素
Pub Date : 1900-01-01 DOI: 10.25179/tjem.2021-82251
M. Yazidi, Rym Ben Othmane, N. Mansour, I. Oueslati, F. Chaker, M. Chihaoui
Objective: The treatment of Graves’ disease (GD) with antithyroid drugs (ATD) is associated with a risk of relapse. The rate and predictive factors of GD are controversial. This study aimed to assess the relapse rate after the withdrawal of ATD in patients with GD, as well as to identify its predictive factors. Material and Methods: This was a retrospective cohort study covering 35 patients with GD that were treated with ATD. Relapse was defined as the state when hyperthyroidism was detected after the withdrawal of medical therapy. Relapse was studied by establishing the survival curve according to Kaplan-Meier’s method. The Log-Rank test was used to compare the survival curves according to the clinical, biological, and therapeutic parameters of the patients. Results: The mean follow-up time after the withdrawal of ATD was 32.8±28.8 months. Relapse was observed in 13 patients (37%) after an average time of 7.8±8.8 months of ATD discontinuation. Factors associated with the risk of relapse were smoking (p=0.08), family history of thyroid disease (p=0.03), the presence of a triggering factor (p=0.004), FT4 level at the time of diagnosis at >2.3 times the normal range (p=0.002), thyroid-stimulating hormone level less than 0.76 mIU/L at three months after ATD withdrawal (p=0.05), and a benzylthiouracil dose of >125 mg/day at the time of ATD discontinuation (p=0.02). Conclusion: Relapse in patients with GD after the withdrawal of ATD is observed in almost a third of the patients. Identification of patients at a high risk of relapse is necessary to indicate radical treatment.
目的:抗甲状腺药物(ATD)治疗Graves病(GD)与复发风险相关。GD的比率和预测因素存在争议。本研究旨在评估GD患者ATD停药后的复发率,并确定其预测因素。材料和方法:这是一项回顾性队列研究,涵盖了35例接受ATD治疗的GD患者。复发定义为停药后发现甲状腺功能亢进的状态。根据Kaplan-Meier法建立生存曲线研究复发情况。根据患者的临床、生物学和治疗参数,采用Log-Rank检验比较生存曲线。结果:ATD停药后平均随访时间为32.8±28.8个月。13例患者(37%)在ATD停药平均7.8±8.8个月后复发。与复发风险相关的因素有吸烟(p=0.08)、甲状腺疾病家族史(p=0.03)、存在触发因素(p=0.004)、诊断时FT4水平>正常范围的2.3倍(p=0.002)、ATD停药后3个月促甲状腺激素水平< 0.76 mIU/L (p=0.05)、ATD停药时苄硫脲嘧啶剂量>125 mg/天(p=0.02)。结论:ATD停药后GD复发的患者几乎占1 / 3。识别复发风险高的患者是必要的,以指示根治性治疗。
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引用次数: 0
Plasma Levels of Soluble P-Selectin, Beta-Thromboglobulin and Platelet Indices in Patients With Prediabetes: Effects of Acute Hyperglycemic Stress 糖尿病前期患者血浆可溶性p -选择素、β -血栓球蛋白和血小板指数水平:急性高血糖应激的影响
Pub Date : 1900-01-01 DOI: 10.25179/tjem.2020-79546
N. Yasar, D. Konukoğlu
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引用次数: 0
Thyroid Dysfunction in Alopecia Areata 斑秃的甲状腺功能障碍
Pub Date : 1900-01-01 DOI: 10.25179/TJEM.2018-63547
Sara Saniee, A. Zare, Afsaneh Radmehr
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引用次数: 1
Low-Carbohydrate Diets and Type 1 Diabetes 低碳水化合物饮食与1型糖尿病
Pub Date : 1900-01-01 DOI: 10.25179/tjem.2019-65625
R. Bozbulut, Esra Döğer, A. Bideci, O. Çamurdan, P. Cinaz
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引用次数: 0
A Case of Plurihormonal Pituitary Giant Macroadenoma 垂体多激素巨大腺瘤1例
Pub Date : 1900-01-01 DOI: 10.25179/tjem.2020-78997
Hatice Özişik, Banu SARER YÜREKLİ, Y. Ertan, C. Eraslan, E. Özgiray, F. Saygili
Introduction Pituitary adenomas producing more than one pituitary hormone are defined as plurihormonal pituitary adenomas (PPA) according to the 2017 World Health Organization (WHO) classification of pituitary tumors (1). While the majority of functioning pituitary adenomas produce a single hormone, an imWe would like to draw the attention of the readers to Pit-1 positive giant macroadenomas in this work. A 62-year-old male patient was admitted to the hospital due to his vision loss and blurred vision in the left eye. His pituitary magnetic resonance imaging revealed the presence of a diffuse and homogeneous mass lesion originating from the pituitary gland having grade 4 invasion into the bilateral cavernous sinus and eroding the base of the sella. He consulted our department before his operation in 2016. Laboratory examination revealed that pituitary hormone levels were within normal ranges while the testosterone level [total testosterone 0.27 ng/mL (2.8-8)] was low. Pathological findings revealed a pituitary adenoma that displayed focal immunoreactivity to thyrotrophin, growth hormone, and prolactin. While the main prevalence and the basic mechanism of plurihormonal pituitary adenomas are not clear, one of the hypotheses is based on the role of divergent transcription factors such as Pit-1. According to this condition, we should perform a complete biochemical and histologic evaluation in patients with pituitary adenomas.
根据2017年世界卫生组织(WHO)垂体肿瘤分类(1),产生一种以上垂体激素的垂体腺瘤被定义为多激素垂体腺瘤(PPA)。虽然大多数功能性垂体腺瘤只产生一种激素,但我们希望在本工作中引起读者对Pit-1阳性巨大腺瘤的注意。一名62岁男性患者因视力下降和左眼视力模糊而入院。他的垂体磁共振成像显示存在一个起源于垂体的弥漫性均匀肿块病变,侵犯双侧海绵窦并侵蚀鞍底,程度为4级。他在2016年手术前咨询了我们的科室。实验室检查垂体激素水平正常,睾酮水平低[总睾酮0.27 ng/mL(2.8 ~ 8)]。病理结果显示垂体腺瘤对促甲状腺素、生长激素和催乳素表现局灶性免疫反应。虽然多激素垂体腺瘤的主要患病率和基本机制尚不清楚,但其中一种假设是基于诸如Pit-1之类的分化转录因子的作用。根据这种情况,我们应该对垂体腺瘤患者进行完整的生化和组织学评估。
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引用次数: 0
Turkish Adaptation of Michigan Diabetes Research and Training Center’s Revised Diabetes Knowledge Test and Determination of Factors Affecting the Knowledge Level of Diabetic Individuals 土耳其对密歇根糖尿病研究培训中心修订后的糖尿病知识测试的适应和糖尿病个体知识水平影响因素的确定
Pub Date : 1900-01-01 DOI: 10.25179/tjem.2019-71974
C. Idiz, S. Celik, Elif Bagdemir, M. Dişsiz, I. Satman
Objective: Education is the cornerstone of diabetes management, and numerous educational studies used Diabetes Knowledge Level Tests to determine the effectiveness of education. Our study was planned to adopt the revised Diabetes Knowledge Test (DKT2) of the Michigan Diabetes Research and Training Center for the Turkish population. Material and Methods: A total of 296 diabetic subjects using insulin were included in the study. After the determination of the validity of the language and content of the test, it was applied to the patients. The reliability of the study was assessed using Cronbach’s alpha coefficient. The results of the DKT2 demographic values, and laboratory tests of the patients were noted. Results: Cronbach’s alpha values were 0.60, 0.59, and 0.70 for the first part, second part, and complete test, respectively. The test-retest reliability values were 0.76 and 0.87 (p<0.001), respectively. The correct response rate to the first part was 32.68±2.47% in patients with Type 1 diabetes and 32.16±2.66% in patients with Type 2 diabetes using insulin. The correct response rate to the second part was 19.68±2.05% and 19.55±2.96%, respectively. Discussion: The Turkish adapted version of DKT2 is a reliable tool to measure patients’ level of diabetes knowledge. However, in order to increase the level of knowledge of the patients, education of diabetes should be improved.
目的:教育是糖尿病管理的基石,许多教育研究使用糖尿病知识水平测试来确定教育的有效性。我们的研究计划采用密歇根糖尿病研究和培训中心针对土耳其人群修订的糖尿病知识测试(DKT2)。材料与方法:共纳入296例使用胰岛素的糖尿病患者。在确定语言和测试内容的效度后,将其应用于患者。本研究的信度采用Cronbach’s alpha系数进行评估。记录患者的DKT2人口学值和实验室检查结果。结果:第一部分、第二部分和完整检验的Cronbach’s alpha值分别为0.60、0.59和0.70。重测信度值分别为0.76、0.87 (p<0.001)。1型糖尿病患者对第一部分的正确反应率为32.68±2.47%,2型糖尿病患者对第一部分的正确反应率为32.16±2.66%。第二部分的正确率分别为19.68±2.05%和19.55±2.96%。讨论:土耳其版的DKT2是衡量患者糖尿病知识水平的可靠工具。然而,为了提高患者的知识水平,应加强对糖尿病的教育。
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引用次数: 2
Relationship Between Sarcopenia and Type 2 Diabetes Mellitus in Elderly Patients 老年患者肌肉减少症与2型糖尿病的关系
Pub Date : 1900-01-01 DOI: 10.25179/tjem.2018-62624
Z. Sayiner, Z. Öztürk
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引用次数: 0
Medication Adherence and Associated Factors Among Type II Diabetic Patients in East Azerbaijan, Iran 伊朗东阿塞拜疆2型糖尿病患者的药物依从性及其相关因素
Pub Date : 1900-01-01 DOI: 10.25179/tjem.2019-65597
Fereshteh Rezaie, Delara Laghousi, M. Alizadeh
D O I: 10 .2 51 79 /t je m .2 01 965 59 7 Objective: The aim of this study was to determine the factors contributing to non-adherence to medication and nonmedication treatments among diabetic patients. Material and Methods: This cross-sectional study was conducted in family medicine clinics in Tabriz, Northwest of Iran, from May-September of 2018. The Persian version of the eight-item Morisky Medication Adherence Scale was used to assess the adherence to treatment, and a validated questionnaire was used to determine the factors influencing non-adherence to treatment. We analyzed the data using descriptive statistics, t-test, chi-square test, and logistic regression modeling. Results: A total of 320 diabetic patients were included in this study with a mean age of 58.1±13.7 years, with 36.2% males and 63.8% females. Of the patients, 0.9%, 14%, and 85% of patients had high, moderate, and low adherence to medication, respectively. In univariate logistic regression, the factors that associated with high adherence to treatment were female gender, living alone, living in urban, lacking insurance, and having diabetic complications. In contrast, in multivariate logistic regression, only two factors associated with high adherence to treatment, namely, living alone (odds ratio, 3.29; 95% confidence interval: 1.44– 7.94) and unemployment odds ratio, 0.085; 95% confidence interval: 0.008–0.9). Conclusion: Adherence to treatment in our study population was suboptimal. Our study population specified the lack of places for physical activity and difficulty in maintaining diet as major barriers for adherence to treatment. We also identified occupation and living arrangement to be predictive factors for adherence to treatment.
{"title":"Medication Adherence and Associated Factors Among Type II Diabetic Patients in East Azerbaijan, Iran","authors":"Fereshteh Rezaie, Delara Laghousi, M. Alizadeh","doi":"10.25179/tjem.2019-65597","DOIUrl":"https://doi.org/10.25179/tjem.2019-65597","url":null,"abstract":"D O I: 10 .2 51 79 /t je m .2 01 965 59 7 Objective: The aim of this study was to determine the factors contributing to non-adherence to medication and nonmedication treatments among diabetic patients. Material and Methods: This cross-sectional study was conducted in family medicine clinics in Tabriz, Northwest of Iran, from May-September of 2018. The Persian version of the eight-item Morisky Medication Adherence Scale was used to assess the adherence to treatment, and a validated questionnaire was used to determine the factors influencing non-adherence to treatment. We analyzed the data using descriptive statistics, t-test, chi-square test, and logistic regression modeling. Results: A total of 320 diabetic patients were included in this study with a mean age of 58.1±13.7 years, with 36.2% males and 63.8% females. Of the patients, 0.9%, 14%, and 85% of patients had high, moderate, and low adherence to medication, respectively. In univariate logistic regression, the factors that associated with high adherence to treatment were female gender, living alone, living in urban, lacking insurance, and having diabetic complications. In contrast, in multivariate logistic regression, only two factors associated with high adherence to treatment, namely, living alone (odds ratio, 3.29; 95% confidence interval: 1.44– 7.94) and unemployment odds ratio, 0.085; 95% confidence interval: 0.008–0.9). Conclusion: Adherence to treatment in our study population was suboptimal. Our study population specified the lack of places for physical activity and difficulty in maintaining diet as major barriers for adherence to treatment. We also identified occupation and living arrangement to be predictive factors for adherence to treatment.","PeriodicalId":425605,"journal":{"name":"The Turkish Journal of Endocrinology and Metabolism","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121372627","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: 2
The Effect of Treatment of Iron Deficiency Anemia on Thyroid Volume 治疗缺铁性贫血对甲状腺体积的影响
Pub Date : 1900-01-01 DOI: 10.25179/tjem.2018-62120
D. Etik, M. Erdoğan
D O I: 10 .2 51 79 /t je m .2 01 862 12 0 Objective: Iron and iodine, which are the two important micronutrients, are still deficient in a large number of women worldwide. This study aimed to examine the thyroid volumes of iron deficient, anemic women before and after correction of the anemia in a mildly iodine deficient environment. Material and Methods: Sixty six women aged 18-45 years were prospectively enrolled in this study. Inclusion criteria included serum hemoglobin (Hb) level <11.0 g/dL, ferritin level <13 ng/mL, thyroid hormones within normal reference ranges and negative thyroid antibodies. Oral iron supplement (567 mg ferrous sulfate, twice a day) for six months was prescribed and strongly recommended. All patients were re-evaluated at the end of the iron treatment. Results: Initially, the median (minimum/maximum) Hb and ferritin levels of patients were 10.2 g/dL (5.6/11.1) and 3.95 ng/mL (0.44/10.7), respectively. Six months later, median Hb and ferritin values increased significantly to 13.15 g/dL (9.3/15.6) (p<0.001) and 19.575 ng/mL (3.74/79) (p<0.001) respectively. Median thyroid volume decreased significantly from 15.705 mL (7.15/54.2) to 13.212 mL (6.11/52.8) (p<0.001). The patients were grouped according to the improvements in Hb and ferritin levels, initial thyroid gland volume, and response to the treatment. The reduction in thyroid gland size, at the end of the treatment, was more significant in patients with improvement in both Hb and ferritin levels as compared to those with improvement only in Hb levels (p<0.05). Conclusion: Iron may be responsible for efficient organification of iodine, active iodine utilization from thyroglobulin, and control of hyperkinetic blood-flow to the thyroid gland. The findings of this study support that other than iodine, iron supplementation has a significant effect on the regression of thyroid volume in women with iron deficiency anemia.
目的:世界范围内仍有大量妇女缺乏铁和碘这两种重要的微量营养素。本研究旨在研究轻度缺碘环境下缺铁贫血妇女在纠正贫血前后甲状腺体积的变化。材料和方法:66名年龄在18-45岁之间的女性前瞻性入选本研究。纳入标准:血清血红蛋白(Hb)水平<11.0 g/dL,铁蛋白水平<13 ng/mL,甲状腺激素在正常参考范围内,甲状腺抗体阴性。口服铁补充剂(567毫克硫酸亚铁,每天两次)六个月,并强烈建议。所有患者在铁治疗结束时重新评估。结果:最初,患者Hb和铁蛋白水平的中位数(最小/最大)分别为10.2 g/dL(5.6/11.1)和3.95 ng/mL(0.44/10.7)。6个月后,Hb和铁蛋白的中位值分别显著升高至13.15 g/dL (9.3/15.6) (p<0.001)和19.575 ng/mL (3.74/79) (p<0.001)。甲状腺中位容积由15.705 mL(7.15/54.2)降至13.212 mL(6.11/52.8),差异有统计学意义(p<0.001)。患者根据血红蛋白和铁蛋白水平的改善、初始甲状腺体积和对治疗的反应进行分组。治疗结束时,与仅Hb水平改善的患者相比,Hb和铁蛋白水平均改善的患者甲状腺大小的减少更为显著(p<0.05)。结论:铁可能对碘的有效组织、甲状腺球蛋白对碘的有效利用和控制甲状腺的高运动血流量起作用。本研究结果支持,除碘外,补充铁对缺铁性贫血妇女甲状腺体积的消退有显著影响。
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The Turkish Journal of Endocrinology and Metabolism
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