Pub Date : 2023-11-13DOI: 10.1080/16089677.2023.2275898
E Klug, B Rayner, M Wasserfall, A Kok, M Mpe, S Ruder, NA Mohamed, D Webb
Sodium glucose co-transporter-2 inhibitors have been shown to have multiple cardiovascular and renal benefits in patients with type 2 diabetes. In large randomised controlled trials they reduced major cardiovascular outcomes, hospitalisation for heart failure and adverse kidney outcomes, independently of their glucose-lowering effects. They are simple to prescribe and do not require dose titration. Compelling indications for this class of medications in patients with type 2 diabetes include those at high or very high risk of cardiovascular events and those with established atherosclerotic cardiovascular disease. They are also indicated for patients with heart failure and chronic kidney disease, regardless of diabetic status.
{"title":"Cardiorenal effects of SGLT2 inhibitors: who might benefit?","authors":"E Klug, B Rayner, M Wasserfall, A Kok, M Mpe, S Ruder, NA Mohamed, D Webb","doi":"10.1080/16089677.2023.2275898","DOIUrl":"https://doi.org/10.1080/16089677.2023.2275898","url":null,"abstract":"Sodium glucose co-transporter-2 inhibitors have been shown to have multiple cardiovascular and renal benefits in patients with type 2 diabetes. In large randomised controlled trials they reduced major cardiovascular outcomes, hospitalisation for heart failure and adverse kidney outcomes, independently of their glucose-lowering effects. They are simple to prescribe and do not require dose titration. Compelling indications for this class of medications in patients with type 2 diabetes include those at high or very high risk of cardiovascular events and those with established atherosclerotic cardiovascular disease. They are also indicated for patients with heart failure and chronic kidney disease, regardless of diabetic status.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"56 21","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136348171","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}
Pub Date : 2023-10-02DOI: 10.1080/16089677.2023.2244801
R. R. Chetty, K. D. Konar, S. Pillay
Background: The incidence of depression is increased by 200–300% in patients living with diabetes mellitus (DM), with both conditions overlapping in about 10–15% of patients.
背景:糖尿病(DM)患者抑郁发生率增加200-300%，约10-15%的患者两种情况重叠。
{"title":"MRI brain findings in patients with depression and type 2 diabetes – a scoping review","authors":"R. R. Chetty, K. D. Konar, S. Pillay","doi":"10.1080/16089677.2023.2244801","DOIUrl":"https://doi.org/10.1080/16089677.2023.2244801","url":null,"abstract":"Background: The incidence of depression is increased by 200–300% in patients living with diabetes mellitus (DM), with both conditions overlapping in about 10–15% of patients.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"151 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135900280","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}
Pub Date : 2023-09-18DOI: 10.1080/16089677.2023.2246767
Raihaan M Ally, Danie van Zyl
Background Diabetes mellitus (DM) affects millions of people worldwide, with associated morbidity and premature mortality exacerbated by all forms of smoking. The effects of smokeless tobacco, such as snuff and chewing tobacco, have not been well researched. The use of these products is on the increase and is an important public health issue.
{"title":"Tobacco use in diabetes mellitus: a retrospective cohort study to determine the effect of snuff tobacco use on diabetes mellitus complications over a period of nine years","authors":"Raihaan M Ally, Danie van Zyl","doi":"10.1080/16089677.2023.2246767","DOIUrl":"https://doi.org/10.1080/16089677.2023.2246767","url":null,"abstract":"Background Diabetes mellitus (DM) affects millions of people worldwide, with associated morbidity and premature mortality exacerbated by all forms of smoking. The effects of smokeless tobacco, such as snuff and chewing tobacco, have not been well researched. The use of these products is on the increase and is an important public health issue.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135203399","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}
Pub Date : 2023-08-07DOI: 10.1080/16089677.2023.2241767
B. Pezeshki, S. Orangi, Sm Kashfi, P. Afzali Harsini, F. Mohammadkhah, A. Khani Jeihooni
Background: Eye and foot problems are two of the most common consequences of diabetes. The goal of this study was to investigate the impact of an educational programme based on the Theory of Planned Behaviour (TPB) on foot and eye care among patients with type 2 diabetes mellitus in Fasa City, Fars Province, Iran. Methods: A total of 100 individuals with non-insulin-dependent diabetes mellitus (Type II) who met the study’s inclusion criteria were included. The participants were randomly assigned to one of two groups (intervention = 50, control = 50). The questionnaires were completed by all groups and included demographic information, TPB constructs, foot and eye care, and patients’ HbA1c levels. Questionnaires were completed prior to, immediately following, and three months after the intervention by members of the experimental and control groups. During the intervention period, the experimental group attended 10 instructive sessions. SPSS 22 software was used to analyse the data. Paired t-tests, independent t-tests, chi-square, and RMA (Repeated Measurement ANOVA) were all used (p < 0.05). Results: Knowledge and all TPB components were significantly increased in the experimental group compared with the control group after intervention. In addition, foot and eye care practice and HbA1c level improved significantly among the experimental group compared with the control group (p < 0.001). Conclusion: Applying the TPB is quite helpful in designing an educational programme for diabetic people to control their blood sugar and improve behavioural foot and eye care. Aside from such programmes, follow-up education on regulating and monitoring is strongly advised.
{"title":"Effect of an educational intervention based on the Theory of Planned Behaviour in type 2 diabetic patients at a foot and eye care practice","authors":"B. Pezeshki, S. Orangi, Sm Kashfi, P. Afzali Harsini, F. Mohammadkhah, A. Khani Jeihooni","doi":"10.1080/16089677.2023.2241767","DOIUrl":"https://doi.org/10.1080/16089677.2023.2241767","url":null,"abstract":"Background: Eye and foot problems are two of the most common consequences of diabetes. The goal of this study was to investigate the impact of an educational programme based on the Theory of Planned Behaviour (TPB) on foot and eye care among patients with type 2 diabetes mellitus in Fasa City, Fars Province, Iran. Methods: A total of 100 individuals with non-insulin-dependent diabetes mellitus (Type II) who met the study’s inclusion criteria were included. The participants were randomly assigned to one of two groups (intervention = 50, control = 50). The questionnaires were completed by all groups and included demographic information, TPB constructs, foot and eye care, and patients’ HbA1c levels. Questionnaires were completed prior to, immediately following, and three months after the intervention by members of the experimental and control groups. During the intervention period, the experimental group attended 10 instructive sessions. SPSS 22 software was used to analyse the data. Paired t-tests, independent t-tests, chi-square, and RMA (Repeated Measurement ANOVA) were all used (p < 0.05). Results: Knowledge and all TPB components were significantly increased in the experimental group compared with the control group after intervention. In addition, foot and eye care practice and HbA1c level improved significantly among the experimental group compared with the control group (p < 0.001). Conclusion: Applying the TPB is quite helpful in designing an educational programme for diabetic people to control their blood sugar and improve behavioural foot and eye care. Aside from such programmes, follow-up education on regulating and monitoring is strongly advised.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"330 1","pages":"105 - 110"},"PeriodicalIF":0.5,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86782555","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}
Pub Date : 2023-05-31DOI: 10.1080/16089677.2023.2215046
A. Boli, Martine Claude Etoa Etoga, F. Mendane, Charly Feutseu, Eloumba Mbono Samba, Amazia Falmata, Arnaud Manga Ndi, J. Katte, M. Dehayem, V. Moor, J. Mbanya, E. Sobngwi
Introduction: Macroprolactin may interfere with hormonal assay and falsely increase serum prolactin levels. Therefore, failure to identify macroprolactinemia can lead to inappropriate investigations and treatment in women already susceptible to anxiety and stress. The aim of this study was to identify macroprolactinemia among women of childbearing age with hyperprolactinemia. Materials and methods: A cross-sectional study was conducted in a tertiary care setting at the endocrine unit. Study participants were recruited from both endocrine and gynaecological outpatient consultation services. They were women of childbearing age (18 to 49 years) consulting for signs and symptoms of gonadal dysfunction or hyperprolactinemia (PRL > 25 ng/ml). Total prolactin was measured using a Human direct ELISA method. Polyethylene glycol 6000 (PEG 6000) precipitation was used to detect macroprolactin. Results: A total of 33 women with a mean age of 31 ± 7 years (range 21–48) were enrolled. Twenty-seven (81.8%) participants were symptomatic, the majority (23/27) (69.7%) reported having galactorrhoea, and 21 (63.4%) women reported having an irregular menstrual cycle. The median pre-precipitation prolactinemia reduced significantly after PEG precipitation from 61.2 (IQR 33.2–115.9) ng/ml to 33.8 (IQR 17.9–70.5) ng/ml, p < 0.001. After PEG precipitation, five participants had a serum prolactin recovery rate below 60% and, therefore, a prevalence of macroprolactinemia at 15.2%. Four out of five (80%) women with macroprolactinemia presented with the symptoms amenorrhea, oligomenorrhea, and galactorrhoea. Conclusion: PEG 6000 permitted the detection of macroprolactinemia in women of childbearing age with hyperprolactinemia who otherwise would have been subjected to unnecessary medical investigations and treatment.
{"title":"Relevance and therapeutic implication of macroprolactinemia detection using PEG 6000 in women of childbearing age with hyperprolactinemia: experience at a tertiary hospital","authors":"A. Boli, Martine Claude Etoa Etoga, F. Mendane, Charly Feutseu, Eloumba Mbono Samba, Amazia Falmata, Arnaud Manga Ndi, J. Katte, M. Dehayem, V. Moor, J. Mbanya, E. Sobngwi","doi":"10.1080/16089677.2023.2215046","DOIUrl":"https://doi.org/10.1080/16089677.2023.2215046","url":null,"abstract":"Introduction: Macroprolactin may interfere with hormonal assay and falsely increase serum prolactin levels. Therefore, failure to identify macroprolactinemia can lead to inappropriate investigations and treatment in women already susceptible to anxiety and stress. The aim of this study was to identify macroprolactinemia among women of childbearing age with hyperprolactinemia. Materials and methods: A cross-sectional study was conducted in a tertiary care setting at the endocrine unit. Study participants were recruited from both endocrine and gynaecological outpatient consultation services. They were women of childbearing age (18 to 49 years) consulting for signs and symptoms of gonadal dysfunction or hyperprolactinemia (PRL > 25 ng/ml). Total prolactin was measured using a Human direct ELISA method. Polyethylene glycol 6000 (PEG 6000) precipitation was used to detect macroprolactin. Results: A total of 33 women with a mean age of 31 ± 7 years (range 21–48) were enrolled. Twenty-seven (81.8%) participants were symptomatic, the majority (23/27) (69.7%) reported having galactorrhoea, and 21 (63.4%) women reported having an irregular menstrual cycle. The median pre-precipitation prolactinemia reduced significantly after PEG precipitation from 61.2 (IQR 33.2–115.9) ng/ml to 33.8 (IQR 17.9–70.5) ng/ml, p < 0.001. After PEG precipitation, five participants had a serum prolactin recovery rate below 60% and, therefore, a prevalence of macroprolactinemia at 15.2%. Four out of five (80%) women with macroprolactinemia presented with the symptoms amenorrhea, oligomenorrhea, and galactorrhoea. Conclusion: PEG 6000 permitted the detection of macroprolactinemia in women of childbearing age with hyperprolactinemia who otherwise would have been subjected to unnecessary medical investigations and treatment.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"104 1","pages":"100 - 104"},"PeriodicalIF":0.5,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81762800","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}
Pub Date : 2023-05-19DOI: 10.1080/16089677.2023.2198348
A. Kok, H. Makan, G. Podgorski, S. Joshi, V. Chetty, L. Nojoko, H. Bacus, Naeem Moosa, D. Khutsoane
Background: The ARISE study was a 26-week, multicentre, prospective, open-label, non-interventional observational study to investigate clinical outcomes in people with T2D treated with IDegAsp in everyday clinical practice. Objectives: To report results from the South African cohort of the ARISE study and compare them with those from the overall population. Design: Non-interventional observational study. Setting: General and specialist private practices. Subjects: Adults ≥ 18 years of age with a diagnosis of T2D could be included in the study if they had been switched to, or had initiated, IDegAsp at the discretion of the treating physician. The primary endpoint was change in HbA1c from baseline to end of study. Outcome measures: The primary endpoint was change in HbA1c from baseline to end of study. Results: Data were available from 179 patients. Prior to starting IDegAsp, the majority of the patients (76%) were already being treated with insulin therapy and the mean duration of follow-up was 210 days. The most commonly reported reasons for switching to IDegAsp were to improve glycaemic control (88.8%) and reduce the risk of hypoglycaemia (39.1%). In comparison with baseline values, mean HbA1c and fasting plasma glucose were significantly lower at end of study (8.4% vs. 9.6%; estimated mean difference −1.3% [95% confidence interval −1.6 to −1.1, p < 0.0001]; and 7.3 vs. 10.9 mmol/L; −3.5 mmol/L [−4.5 to −2.5, p < 0.0001], respectively). Improvement in glycaemic control after the switch to IDegAsp was achieved with lower daily insulin doses and less hypoglycaemia when compared with the time period prior to switch. Two patients discontinued IDegAsp due to adverse events. Conclusion: In this South African cohort, initiating or switching to IDegAsp was associated with improved glycaemic control, lower insulin dose requirements among patients already on insulin therapy, and significantly lower rates of non-severe (overall and nocturnal) and severe hypoglycaemia in comparison with previous therapy.
背景:ARISE研究是一项为期26周、多中心、前瞻性、开放标签、非干预性观察性研究，旨在调查在日常临床实践中使用IDegAsp治疗T2D患者的临床结果。目的:报告ARISE研究的南非队列的结果，并将其与总体人群的结果进行比较。设计:非干预性观察研究。环境:普通和专业私人执业。受试者:年龄≥18岁且诊断为T2D的成年人，如果他们在治疗医生的决定下已经切换到或已经开始使用IDegAsp，则可以纳入研究。主要终点是HbA1c从基线到研究结束的变化。结果测量:主要终点是HbA1c从基线到研究结束的变化。结果:179例患者的数据。在开始使用IDegAsp之前，大多数患者(76%)已经接受胰岛素治疗，平均随访时间为210天。切换到IDegAsp最常见的报告原因是改善血糖控制(88.8%)和降低低血糖风险(39.1%)。与基线值相比，研究结束时平均HbA1c和空腹血糖显著降低(8.4% vs. 9.6%;估计平均差- 1.3%[95%置信区间- 1.6至- 1.1,p < 0.0001];7.3 vs. 10.9 mmol/L;4.5−3.5更易/ L(−−2.5,p < 0.0001),分别)。切换到IDegAsp后，与切换前相比，每日胰岛素剂量更低，低血糖发生率更低，血糖控制得到改善。2例患者因不良事件停用IDegAsp。结论:在这个南非队列中，启动或切换到IDegAsp与改善血糖控制有关，在已经接受胰岛素治疗的患者中，胰岛素剂量需求降低，与先前治疗相比，非严重(总体和夜间)和严重低血糖的发生率显著降低。
{"title":"Initiating or switching to IDegAsp in a real-world South African population with type 2 diabetes – a cohort analysis from the ARISE study","authors":"A. Kok, H. Makan, G. Podgorski, S. Joshi, V. Chetty, L. Nojoko, H. Bacus, Naeem Moosa, D. Khutsoane","doi":"10.1080/16089677.2023.2198348","DOIUrl":"https://doi.org/10.1080/16089677.2023.2198348","url":null,"abstract":"Background: The ARISE study was a 26-week, multicentre, prospective, open-label, non-interventional observational study to investigate clinical outcomes in people with T2D treated with IDegAsp in everyday clinical practice. Objectives: To report results from the South African cohort of the ARISE study and compare them with those from the overall population. Design: Non-interventional observational study. Setting: General and specialist private practices. Subjects: Adults ≥ 18 years of age with a diagnosis of T2D could be included in the study if they had been switched to, or had initiated, IDegAsp at the discretion of the treating physician. The primary endpoint was change in HbA1c from baseline to end of study. Outcome measures: The primary endpoint was change in HbA1c from baseline to end of study. Results: Data were available from 179 patients. Prior to starting IDegAsp, the majority of the patients (76%) were already being treated with insulin therapy and the mean duration of follow-up was 210 days. The most commonly reported reasons for switching to IDegAsp were to improve glycaemic control (88.8%) and reduce the risk of hypoglycaemia (39.1%). In comparison with baseline values, mean HbA1c and fasting plasma glucose were significantly lower at end of study (8.4% vs. 9.6%; estimated mean difference −1.3% [95% confidence interval −1.6 to −1.1, p < 0.0001]; and 7.3 vs. 10.9 mmol/L; −3.5 mmol/L [−4.5 to −2.5, p < 0.0001], respectively). Improvement in glycaemic control after the switch to IDegAsp was achieved with lower daily insulin doses and less hypoglycaemia when compared with the time period prior to switch. Two patients discontinued IDegAsp due to adverse events. Conclusion: In this South African cohort, initiating or switching to IDegAsp was associated with improved glycaemic control, lower insulin dose requirements among patients already on insulin therapy, and significantly lower rates of non-severe (overall and nocturnal) and severe hypoglycaemia in comparison with previous therapy.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"63 1","pages":"92 - 99"},"PeriodicalIF":0.5,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84000173","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}
Pub Date : 2023-05-03DOI: 10.1080/16089677.2023.2198349
M. Noeth, T. Kemp, T. Botha
Background: Turner syndrome is a multisystem disease with varied clinical features influenced by genetic composition and possibly ethnicity. Objective: To review local data and identify the clinical features more common in our population. Methods: A retrospective review of the clinical, biochemical features and karyotype of all patients with a confirmed diagnosis of Turner syndrome receiving treatment at the adult endocrinology clinic, Steve Biko Academic Hospital, was performed. Seventeen patients with complete data sets were identified. Conclusion: Our population group had a higher percentage of mosaic Turner syndrome than that described in the literature. The clinical features also differed significantly from the classic features described, with the exception of the universal presence of short stature and hypogonadism. This may explain the delayed age of diagnosis. Screening programmes are necessary, and the consistent finding of short stature can be used as a screening tool in early childhood to identify more patients who will benefit from referral.
{"title":"Features of Turner syndrome in patients managed at the adult endocrinology clinic, Steve Biko Academic Hospital","authors":"M. Noeth, T. Kemp, T. Botha","doi":"10.1080/16089677.2023.2198349","DOIUrl":"https://doi.org/10.1080/16089677.2023.2198349","url":null,"abstract":"Background: Turner syndrome is a multisystem disease with varied clinical features influenced by genetic composition and possibly ethnicity. Objective: To review local data and identify the clinical features more common in our population. Methods: A retrospective review of the clinical, biochemical features and karyotype of all patients with a confirmed diagnosis of Turner syndrome receiving treatment at the adult endocrinology clinic, Steve Biko Academic Hospital, was performed. Seventeen patients with complete data sets were identified. Conclusion: Our population group had a higher percentage of mosaic Turner syndrome than that described in the literature. The clinical features also differed significantly from the classic features described, with the exception of the universal presence of short stature and hypogonadism. This may explain the delayed age of diagnosis. Screening programmes are necessary, and the consistent finding of short stature can be used as a screening tool in early childhood to identify more patients who will benefit from referral.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"11 1","pages":"87 - 91"},"PeriodicalIF":0.5,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79903897","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}
Pub Date : 2023-04-14DOI: 10.1080/16089677.2023.2178274
K. Naidu, V. Saksenberg, N. Goolam Mahyoodeen
Background: The detection of thyroid nodules is increasingly common in clinical practice owing to the widespread use of ultrasonography. Objectives: The aims of this study were to describe the clinical and biochemical characteristics of patients undergoing fine-needle aspiration (FNA) of thyroid nodules and to assess the ultrasound, cytologic and, where relevant, histologic features of thyroid nodules in this cohort. Methods: A retrospective study was conducted of 313 patients undergoing FNA at a private hospital in Johannesburg from October 2015 to July 2019. Demographic, clinical and biochemical data were recorded. Ultrasound features were graded according to the American Thyroid Association (ATA) guidelines and cytology was reported according to the Bethesda System for Reporting Thyroid Cytopathology. Results: The mean (SD) age of patients in this study was 48.0 (12.7) years and 250 (80.1%) were female. White and Asian/Indian patients made up 79% of the cohort. Cytology results showed the following (n [%]): benign, 272 (86.9); indeterminate, 15 (4.79); suspicious/malignant, 25 (7.99). Sonographic characteristics associated with malignancy were microcalcifications and hypoechogenicity (OR [95% CI], p-value: 3.93 (1.62, 9.53), p = 0.001and 2.34 (1.01, 5.41), p = 0.04, respectively). There was an association with the composite ATA score and malignancy (3.59 [2.06, 6.25], p < 0.0005). Conclusion: Thyroid ultrasound and FNA are important diagnostic modalities in identifying clinically relevant thyroid nodules. Concordance was shown with the ATA guidelines, Bethesda System for Reporting Thyroid Cytopathology and malignant histology, which validates their accuracy in the local population.
{"title":"Clinical and ultrasound characteristics distinguishing benign and malignant thyroid nodules in Johannesburg, South Africa","authors":"K. Naidu, V. Saksenberg, N. Goolam Mahyoodeen","doi":"10.1080/16089677.2023.2178274","DOIUrl":"https://doi.org/10.1080/16089677.2023.2178274","url":null,"abstract":"Background: The detection of thyroid nodules is increasingly common in clinical practice owing to the widespread use of ultrasonography. Objectives: The aims of this study were to describe the clinical and biochemical characteristics of patients undergoing fine-needle aspiration (FNA) of thyroid nodules and to assess the ultrasound, cytologic and, where relevant, histologic features of thyroid nodules in this cohort. Methods: A retrospective study was conducted of 313 patients undergoing FNA at a private hospital in Johannesburg from October 2015 to July 2019. Demographic, clinical and biochemical data were recorded. Ultrasound features were graded according to the American Thyroid Association (ATA) guidelines and cytology was reported according to the Bethesda System for Reporting Thyroid Cytopathology. Results: The mean (SD) age of patients in this study was 48.0 (12.7) years and 250 (80.1%) were female. White and Asian/Indian patients made up 79% of the cohort. Cytology results showed the following (n [%]): benign, 272 (86.9); indeterminate, 15 (4.79); suspicious/malignant, 25 (7.99). Sonographic characteristics associated with malignancy were microcalcifications and hypoechogenicity (OR [95% CI], p-value: 3.93 (1.62, 9.53), p = 0.001and 2.34 (1.01, 5.41), p = 0.04, respectively). There was an association with the composite ATA score and malignancy (3.59 [2.06, 6.25], p < 0.0005). Conclusion: Thyroid ultrasound and FNA are important diagnostic modalities in identifying clinically relevant thyroid nodules. Concordance was shown with the ATA guidelines, Bethesda System for Reporting Thyroid Cytopathology and malignant histology, which validates their accuracy in the local population.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"35 1","pages":"62 - 68"},"PeriodicalIF":0.5,"publicationDate":"2023-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86090699","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}
Pub Date : 2023-04-14DOI: 10.1080/16089677.2023.2170955
Amm Ollivry, ZJ Joubert
Thyrotoxic periodic paralysis (TPP) is a complication of hyperthyroidism commonly seen in Asian populations. It presents as sudden-onset muscle paralysis and hypokalaemia. Diagnosis is often delayed due to the rarity of the disease, the subtlety of the hyperthyroidism and the fleeting nature of the clinical presentation. With global expansion, physicians outside Asia should be aware of this disease for early recognition and treatment as severe cardiac arrhythmias, which may prove fatal, can occur. Several breakthroughs have been made in identifying the pathophysiological mechanism resulting in the severe hypokalaemia, including mutations in the Kir2.6 channel, an inwardly rectifying potassium channel, which results in a massive intracellular potassium shift. Treating the underlying hyperthyroidism is the definitive treatment; however, beta blockers and potassium supplementation are vital in acute management of this condition. This is a report of a case seen in Cape Town, South Africa with a review of the literature regarding the clinical features, pathophysiology and treatment.
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Pub Date : 2023-03-06DOI: 10.1080/16089677.2023.2178156
T. Mothiba, M. Mphasha, TT Molepo, H. Bastiaens, J. Wens
Background: The Finnish Diabetes Risk Score (FINDRISC) tool is used to identify undetected cases of diabetes and risk scores. The FINDRISC tool outlines questions to ask, including anthropometric parameters to measure, during screening and detection of diabetes cases. This study assessed the feasibility for the introduction of FINDRISC tool for use in South Africa. The aim is to determine the overall competence of home-based carers (HBCs) in utilising this tool. Method: A quantitative approach and cross-sectional feasibility study was conducted involving 52 HBCs who were sampled using homogeneous purposive sampling. The study was conducted in clinics of Ga-Dikgale Village in Polokwane. A FINDRISC questionnaire was used to assess competence of HBCs. Data were analysed using SPSS, with both descriptive and inferential statistical analysis. Results: None (0%) of the participants were fully competent, 6% were incompetent and 94% were moderately competent on use of the FINDRISC tool. Conclusion: Most HBCs were moderately competent in the use of this tool, while none were competent. It is feasible that the FINDRISC tool can be adapted and utilised by HBCs in South Africa. However, a proper training should be offered to HBCs on the use of the FINDRISC tool. It is also recommended to assess components of requiring professionals considering the scope of work and qualification.
{"title":"Feasibility study on the use of the modified Finnish Diabetes Risk Score in South African context: a case of home-based carers","authors":"T. Mothiba, M. Mphasha, TT Molepo, H. Bastiaens, J. Wens","doi":"10.1080/16089677.2023.2178156","DOIUrl":"https://doi.org/10.1080/16089677.2023.2178156","url":null,"abstract":"Background: The Finnish Diabetes Risk Score (FINDRISC) tool is used to identify undetected cases of diabetes and risk scores. The FINDRISC tool outlines questions to ask, including anthropometric parameters to measure, during screening and detection of diabetes cases. This study assessed the feasibility for the introduction of FINDRISC tool for use in South Africa. The aim is to determine the overall competence of home-based carers (HBCs) in utilising this tool. Method: A quantitative approach and cross-sectional feasibility study was conducted involving 52 HBCs who were sampled using homogeneous purposive sampling. The study was conducted in clinics of Ga-Dikgale Village in Polokwane. A FINDRISC questionnaire was used to assess competence of HBCs. Data were analysed using SPSS, with both descriptive and inferential statistical analysis. Results: None (0%) of the participants were fully competent, 6% were incompetent and 94% were moderately competent on use of the FINDRISC tool. Conclusion: Most HBCs were moderately competent in the use of this tool, while none were competent. It is feasible that the FINDRISC tool can be adapted and utilised by HBCs in South Africa. However, a proper training should be offered to HBCs on the use of the FINDRISC tool. It is also recommended to assess components of requiring professionals considering the scope of work and qualification.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"10 1","pages":"76 - 82"},"PeriodicalIF":0.5,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87626629","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}
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