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Nerve conduction and its correlations with duration of diabetes mellitus and glycosylated haemoglobin in type 2 diabetes mellitus (T2DM) 2型糖尿病(T2DM)患者神经传导与病程及糖化血红蛋白的关系
IF 0.5 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2021-02-15 DOI: 10.1080/16089677.2021.1877444
Wissam S Hamid, H. Ahmed, Mona A Osman, Rasha Babiker
Background: Diabetic neuropathy is one of the most common microvascular complications associated with diabetes mellitus. Diabetic peripheral neuropathy (DPN) has been linked to hyperglycaemia and long duration of uncontrolled type 2 diabetes mellitus (T2DM) as measured by glycosylated haemoglobin (HbA1c). To our knowledge the estimated duration between diagnosis and developing DPN and the level of HbA1c have not yet been investigated in Sudanese patients with type 2 DM. Therefore, this study aims to investigate the relationship between the duration of diabetes and HbA1c with nerve conduction velocity (NCV) in patients with type 2 DM. Methods: This cross-sectional study recruited 63 male and female patients with T2DM who attended the diabetic outpatient clinic of Academy Charity Teaching Hospital (ACTH) and Alzaytouna Private Hospital for Nerve Conduction Velocity (NCV) and electromyography (EMG) tests. Nerve conduction was done by using ADInstruments PowerLab series 26. SPSS was used to analyse the data and p-value < 0.05 was considered significant. Results: The mean duration of DM was 14.7 (± SD 9.24) years and the mean age of participants was 57.71 (± SD 12.2) years. The most common symptom was numbness (50%). Pearson's correlation test revealed a significant negative correlation between HbA1c and nerve conduction velocity (r = 0.4, p < 0.05) and negative significant correlation between the duration and the amplitude (r = 0.35, p < 0.05). Conclusion: There is a slowing of nerve conduction velocity in type 2 diabetic patients, which is accelerated by the poor glycaemic control (HbA1c). These findings support the need for tight glycaemic control to avoid drastic neuropathic complications of diabetes.
背景:糖尿病神经病变是糖尿病最常见的微血管并发症之一。通过糖化血红蛋白(HbA1c)测量,糖尿病周围神经病变(DPN)与高血糖和长时间不受控制的2型糖尿病(T2DM)有关。据我们所知,尚未对苏丹2型糖尿病患者诊断至发生DPN的估计时间与HbA1c水平进行研究。因此,本研究旨在探讨2型糖尿病患者糖尿病病程与HbA1c与神经传导速度(NCV)之间的关系。本横断面研究招募了63名在Academy Charity Teaching Hospital (ACTH)和Alzaytouna Private Hospital糖尿病门诊就诊的2型糖尿病患者,进行神经传导速度(NCV)和肌电图(EMG)测试。神经传导采用ADInstruments PowerLab系列26。采用SPSS软件对数据进行分析,p值< 0.05为差异有统计学意义。结果:DM的平均病程为14.7(±SD 9.24)年,平均年龄为57.71(±SD 12.2)岁。最常见的症状是麻木(50%)。Pearson相关检验显示HbA1c与神经传导速度呈显著负相关(r = 0.4, p < 0.05),持续时间与振幅呈显著负相关(r = 0.35, p < 0.05)。结论:2型糖尿病患者存在神经传导速度减慢,血糖控制不良(HbA1c)加速了神经传导速度减慢。这些发现支持严格控制血糖以避免糖尿病严重的神经性并发症的必要性。
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引用次数: 4
The impact of a face-to-face peer-support intervention on adults with type 2 diabetes: a cluster-randomised trial 面对面同伴支持干预对成人2型糖尿病患者的影响:一项集群随机试验
IF 0.5 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2021-01-02 DOI: 10.1080/16089677.2021.1877443
M. Pienaar, Marianne Reid, M. Nel
Objective: To establish the impact of a face-to-face peer-support intervention on adults with type 2 diabetes in South Africa. Methods: A cluster randomised controlled trial was conducted involving 288 adults with type 2 diabetes from six communities in the Free State province. Individuals (n = 141) in three communities were randomly allocated to the intervention group, and individuals (n = 147) in another three communities were randomly allocated to the control group. Trained community health workers led monthly group sessions and home visits. The control group received the usual care. The primary outcome of the study was glycated haemoglobin (HbA1c), measured at baseline and endpoint after four months. Secondary outcomes included blood pressure, body mass index and waist circumference, measured at baseline and endpoint. Descriptive statistics were calculated per group. Results: No significant changes from baseline were found between groups regarding HbA1c (p = 0.87), body mass index (p = 0.21), waist circumference (p = 0.24) and systolic blood pressure (p = 0.13). Compared with the control group, the intervention group had a significant improvement in diastolic blood pressure (p = 0.02). Conclusions: The face-to-face peer-support intervention delivered by trained community health workers in a semi-urban rural area resulted in a significant improvement in diastolic blood pressure of adults with type 2 diabetes.
目的:探讨面对面同伴支持干预对南非成人2型糖尿病患者的影响。方法:对来自自由邦省6个社区的288名成人2型糖尿病患者进行了一项随机对照试验。将3个社区的141人随机分配到干预组,另外3个社区的147人随机分配到对照组。训练有素的社区卫生工作者每月领导小组会议和家访。对照组接受常规护理。该研究的主要结局是糖化血红蛋白(HbA1c),在基线和4个月后的终点测量。次要结局包括基线和终点测量的血压、体重指数和腰围。每组计算描述性统计。结果:两组患者的HbA1c (p = 0.87)、体重指数(p = 0.21)、腰围(p = 0.24)和收缩压(p = 0.13)与基线相比无显著变化。与对照组比较,干预组舒张压明显改善(p = 0.02)。结论:在半城市农村地区,由训练有素的社区卫生工作者进行面对面的同伴支持干预,可显著改善成人2型糖尿病患者的舒张压。
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引用次数: 3
Prevalence and clinical risk factors for morphometric vertebral fractures in older subjects in KwaZulu-Natal 夸祖鲁-纳塔尔省老年人椎体形态骨折的患病率和临床危险因素
IF 0.5 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2021-01-02 DOI: 10.1080/16089677.2021.1877445
M. Esaadi, F. Paruk, B. Cassim
Objectives: There are limited data on vertebral fractures (VFs) in South Africa (SA). Therefore a study was undertaken to compare the demographic profile, clinical risk factors and bone mineral density (BMD) in subjects aged 60 years and over with and without morphometric VFs. Patients and methods: In a descriptive case-controlled study, demographic data, clinical risk factors (CRF) and BMD were collected. Morphometric VFs were identified using the semi-quantitative Genant method. Descriptive analysis was undertaken using Student’s t-test, the Mann–Whitney U-test and the chi-square test. Results: In the 197 subjects enrolled, the median age was 72.0 years (IQR 67.0–78.5 years) and morphometric VFs were identified in 41 subjects (20.8%). The prevalence of VFs increased with age, and while more common in women compared with men (23.8% vs. 13.0%), this was not significant (p 0.095). There was no difference in the prevalence of VFs between African and Indian subjects (23.4% vs. 17.4%; p 0.240), nor CRFs between subjects with and without VFs. Subjects with a VF had a significantly lower BMD at the spine (p = 0.020), but not at the neck of femur and total hip. Conclusion: This study highlights the need for adequate screening and management protocols for osteoporosis in all ethnic groups in SA.
目的:关于南非椎体骨折(VFs)的数据有限。因此,进行了一项研究,比较60岁及以上受试者的人口统计学特征、临床危险因素和骨密度(BMD),这些受试者患有和不患有形态测量性VFs。患者和方法:在一项描述性病例对照研究中,收集了人口统计学资料、临床危险因素(CRF)和骨密度。采用半定量Genant方法鉴定形态计量学VFs。描述性分析采用Student 's t检验、Mann-Whitney u检验和卡方检验。结果:197例受试者中位年龄为72.0岁(IQR 67.0 ~ 78.5岁),形态测量性VFs 41例(20.8%)。VFs的患病率随着年龄的增长而增加,虽然女性比男性更常见(23.8%比13.0%),但这并不显著(p 0.095)。非洲和印度受试者的VFs患病率无差异(23.4% vs. 17.4%;p 0.240),有和没有VFs的受试者之间的CRFs也没有。VF患者脊柱的骨密度显著降低(p = 0.020),但股骨颈和全髋关节的骨密度不明显降低。结论:本研究强调了在SA所有种族中对骨质疏松症进行充分筛查和管理的必要性。
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引用次数: 1
Acute effects of single-bout exercise in adults with type 2 diabetes: a systematic review of randomised controlled trials and controlled crossover trials 成人2型糖尿病患者单次运动的急性效应:随机对照试验和对照交叉试验的系统综述
IF 0.5 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2020-11-30 DOI: 10.1080/16089677.2020.1850033
Dominic Hicks, R. Hickner, Usha Govinden, T. Sookan
Background: Exercise interventions improve type 2 diabetes (T2D). Published randomised control trials and crossover control trials were systematically examined to establish the differences in the effect of single-bout exercise on glucose control and insulin sensitivity in individuals with type 2 diabetes. Methods: Using PRISMA guidelines on three electronic databases, studies that tested the effects of a single bout of exercise on glucose control and insulin sensitivity in T2D were identified. To be included, studies had to meet the PRISMA criteria and contain data on the effects of a single bout of exercise on blood glucose and/or insulin resistance in individuals with T2D. Results: Three of the 205 articles met the inclusion criteria. All of the studies prescribed a single bout of continuous aerobic exercise at 40–60% heart rate reserve (HRR), 60% HRR, or 73% VO2 peak. Aerobic exercise was associated with improved glucose control when compared with resistance exercise. Continuous aerobic exercise significantly lowered average glucose during the first 24 hours post-exercise. Interval walking decreased mean and maximal blood glucose when compared with that in control. Conclusions: In conclusion, the findings of this review suggest high-intensity interval training to be the most effective form of exercise.
背景:运动干预可改善2型糖尿病(T2D)。已发表的随机对照试验和交叉对照试验被系统地检查,以确定单次运动对2型糖尿病患者血糖控制和胰岛素敏感性的影响差异。方法:在三个电子数据库中使用PRISMA指南,确定了测试单次运动对糖尿病血糖控制和胰岛素敏感性影响的研究。纳入的研究必须符合PRISMA标准,并包含单次运动对糖尿病患者血糖和/或胰岛素抵抗影响的数据。结果:205篇文章中有3篇符合纳入标准。所有的研究都规定在40-60%心率储备(HRR)、60% HRR或73% VO2峰值时进行单次连续有氧运动。与抗阻运动相比,有氧运动与改善血糖控制有关。在运动后的前24小时内,持续的有氧运动显著降低了平均血糖。与对照组相比,间歇步行可降低平均血糖和最高血糖。结论:总之,本综述的研究结果表明,高强度间歇训练是最有效的运动形式。
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引用次数: 1
Bone health in patients undergoing surgery for primary hyperparathyroidism at Tygerberg Hospital, Cape Town, South Africa 南非开普敦Tygerberg医院原发性甲状旁腺功能亢进手术患者的骨骼健康
IF 0.5 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2020-11-30 DOI: 10.1080/16089677.2020.1843841
M. Budge, W. Conradie, K. Beviss-Challinor, L. Martin, M. Conradie, A. Coetzee
Background: Increased bone resorption is a well-described consequence of primary hyperparathyroidism (PHPT). In South Africa, little is known about the impact of PHPT on skeletal health. Objective: To determine the prevalence of decreased bone mineral density (BMD), vertebral fractures and osteitis fibrosa cystica in patients with PHPT who underwent parathyroidectomy. Methods: Retrospective study of patients who underwent parathyroidectomy for PHPT at Tygerberg Hospital in Cape Town, from January 2010 to December 2019. Clinical, biochemical and BMD parameters are described. Results: Final analysis included 56 patients (median age 63.5 years; 80.4% female). Initial calcium, parathyroid hormone (PTH) and 25-hydroxyvitamin D (25[OH]D) levels were 2.93 mmol/l, 19.4 pmol/l and 34.0 nmol/l, respectively. Of the total cohort, 71.4% had decreased BMD. The prevalence of osteoporosis and osteopenia in postmenopausal women and men ≥ 50 years was 50.0% and 39.1% respectively; low bone mass for age in premenopausal women and men < 50 years was 20.0%. Vertebral fractures were seen in 21.2% of patients on radiography. Osteitis fibrosa cystica was present in five patients (9.6%). PTH levels were significantly elevated in patients with osteoporosis compared with those with normal BMD (36.4 vs. 16.1 pmol/l; p = 0.02). Conclusion: Two-thirds of patients who underwent parathyroidectomy for PHPT had decreased BMD, with osteoporosis present in 50% of postmenopausal women and older men. One in five had vertebral fractures. These findings underscore the importance of skeletal assessment in the management of PHPT.
背景:骨吸收增加是原发性甲状旁腺功能亢进(PHPT)的一个很好的结果。在南非,人们对PHPT对骨骼健康的影响知之甚少。目的:了解行甲状旁腺切除术的PHPT患者骨密度降低、椎体骨折和囊性纤维性骨炎的发生率。方法:回顾性研究2010年1月至2019年12月在开普敦Tygerberg医院接受甲状旁腺切除术的PHPT患者。描述了临床、生化和骨密度参数。结果:最终分析纳入56例患者(中位年龄63.5岁;80.4%的女性)。初始钙、甲状旁腺激素(PTH)和25[OH]D (25[OH]D)水平分别为2.93 mmol/l、19.4 pmol/l和34.0 nmol/l。在整个队列中,71.4%的人骨密度下降。绝经后年龄≥50岁的女性和男性骨质疏松和骨质减少的患病率分别为50.0%和39.1%;绝经前女性和年龄< 50岁的男性骨量低的比例为20.0%。21.2%的患者有椎体骨折。囊性纤维性骨炎5例(9.6%)。与骨密度正常的患者相比,骨质疏松患者PTH水平显著升高(36.4 vs 16.1 pmol/l;p = 0.02)。结论:三分之二接受甲状旁腺切除术的PHPT患者骨密度降低,50%的绝经后女性和老年男性存在骨质疏松症。五分之一的人有椎体骨折。这些发现强调了骨骼评估在PHPT治疗中的重要性。
{"title":"Bone health in patients undergoing surgery for primary hyperparathyroidism at Tygerberg Hospital, Cape Town, South Africa","authors":"M. Budge, W. Conradie, K. Beviss-Challinor, L. Martin, M. Conradie, A. Coetzee","doi":"10.1080/16089677.2020.1843841","DOIUrl":"https://doi.org/10.1080/16089677.2020.1843841","url":null,"abstract":"Background: Increased bone resorption is a well-described consequence of primary hyperparathyroidism (PHPT). In South Africa, little is known about the impact of PHPT on skeletal health. Objective: To determine the prevalence of decreased bone mineral density (BMD), vertebral fractures and osteitis fibrosa cystica in patients with PHPT who underwent parathyroidectomy. Methods: Retrospective study of patients who underwent parathyroidectomy for PHPT at Tygerberg Hospital in Cape Town, from January 2010 to December 2019. Clinical, biochemical and BMD parameters are described. Results: Final analysis included 56 patients (median age 63.5 years; 80.4% female). Initial calcium, parathyroid hormone (PTH) and 25-hydroxyvitamin D (25[OH]D) levels were 2.93 mmol/l, 19.4 pmol/l and 34.0 nmol/l, respectively. Of the total cohort, 71.4% had decreased BMD. The prevalence of osteoporosis and osteopenia in postmenopausal women and men ≥ 50 years was 50.0% and 39.1% respectively; low bone mass for age in premenopausal women and men < 50 years was 20.0%. Vertebral fractures were seen in 21.2% of patients on radiography. Osteitis fibrosa cystica was present in five patients (9.6%). PTH levels were significantly elevated in patients with osteoporosis compared with those with normal BMD (36.4 vs. 16.1 pmol/l; p = 0.02). Conclusion: Two-thirds of patients who underwent parathyroidectomy for PHPT had decreased BMD, with osteoporosis present in 50% of postmenopausal women and older men. One in five had vertebral fractures. These findings underscore the importance of skeletal assessment in the management of PHPT.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"41 1","pages":"16 - 23"},"PeriodicalIF":0.5,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78828830","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
Prevalence of succinate dehydrogenase deficiency in paragangliomas and phaeochromocytomas at a tertiary hospital in Cape Town: a retrospective review 琥珀酸脱氢酶缺乏症的流行副神经节瘤和嗜铬细胞瘤在开普敦三级医院:回顾性审查
IF 0.5 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2020-11-26 DOI: 10.1080/16089677.2020.1838161
C. Bruce-Brand, A. C. van Wyk
Introduction: A substantial proportion of phaeochromocytomas and paragangliomas are associated with underlying germline mutations, of which the majority are due to mutations in one of the genes in the succinate dehydrogenase (SDH) complex. A commercially available immunohistochemical stain for SDHB has excellent correlation with SDH gene mutation status when staining is lost. This abnormal loss of staining can identify potential familial tumours and tumours with a higher risk of malignant behaviour. The prevalence of SDH deficiency in the South African setting has not been published previously. Methods: A retrospective laboratory-based study at Tygerberg Hospital in Cape Town used immunohistochemistry on archived tumour tissue to assess loss of SDHB staining in phaeochromocytomas and paragangliomas submitted to the histopathology laboratory (National Health Laboratory Service) between 2005 and 2015. Results: Tumour tissue from 52 patients was tested. In total, 36% showed loss of staining. Loss of staining was significantly correlated with a younger age at presentation (z = −3.59, p < 0.001). The median age of those who showed loss of staining was 26 years (IQR 21–41), compared with 50.5 years (IQR 36–61) for those who showed retained staining. The inter-observer agreement in the interpretation of the immunohistochemical stain was excellent (Cohen’s kappa = 0.917; 95% confidence interval, 0.81–1, p < 0.001). Conclusion: Approximately one-third of phaeochromocytomas and paragangliomas in our setting are likely to be associated with germline mutations in one of the SDH genes. Immunohistochemical testing of tumour tissue can identify this group to allow better prognostication and appropriate genetic testing and counselling.
相当大比例的嗜铬细胞瘤和副神经节瘤与潜在的种系突变有关,其中大多数是由于琥珀酸脱氢酶(SDH)复合体中一个基因的突变。市售的SDHB免疫组织化学染色在染色丢失时与SDH基因突变状态有很好的相关性。这种染色的异常丧失可以识别潜在的家族性肿瘤和具有较高恶性行为风险的肿瘤。SDH缺乏症在南非的流行率以前没有发表过。方法:在开普敦Tygerberg医院进行回顾性实验室研究,利用免疫组织化学对存档的肿瘤组织进行免疫组化,评估2005年至2015年间提交给组织病理学实验室(国家卫生实验室服务)的嗜色细胞瘤和副神经节瘤中SDHB染色的损失。结果:对52例患者的肿瘤组织进行检测。总共有36%的人出现了染色丧失。染色丧失与出现时年龄较小显著相关(z = - 3.59, p < 0.001)。显示染色丧失的中位年龄为26岁(IQR 21-41),而显示染色保留的中位年龄为50.5岁(IQR 36-61)。免疫组织化学染色解释的观察者间一致性极好(Cohen’s kappa = 0.917;95%置信区间为0.81-1,p < 0.001)。结论:在我们的研究中,大约三分之一的嗜铬细胞瘤和副神经节瘤可能与SDH基因之一的种系突变有关。肿瘤组织的免疫组化测试可以确定这一组,以便更好地预测和适当的基因检测和咨询。
{"title":"Prevalence of succinate dehydrogenase deficiency in paragangliomas and phaeochromocytomas at a tertiary hospital in Cape Town: a retrospective review","authors":"C. Bruce-Brand, A. C. van Wyk","doi":"10.1080/16089677.2020.1838161","DOIUrl":"https://doi.org/10.1080/16089677.2020.1838161","url":null,"abstract":"Introduction: A substantial proportion of phaeochromocytomas and paragangliomas are associated with underlying germline mutations, of which the majority are due to mutations in one of the genes in the succinate dehydrogenase (SDH) complex. A commercially available immunohistochemical stain for SDHB has excellent correlation with SDH gene mutation status when staining is lost. This abnormal loss of staining can identify potential familial tumours and tumours with a higher risk of malignant behaviour. The prevalence of SDH deficiency in the South African setting has not been published previously. Methods: A retrospective laboratory-based study at Tygerberg Hospital in Cape Town used immunohistochemistry on archived tumour tissue to assess loss of SDHB staining in phaeochromocytomas and paragangliomas submitted to the histopathology laboratory (National Health Laboratory Service) between 2005 and 2015. Results: Tumour tissue from 52 patients was tested. In total, 36% showed loss of staining. Loss of staining was significantly correlated with a younger age at presentation (z = −3.59, p < 0.001). The median age of those who showed loss of staining was 26 years (IQR 21–41), compared with 50.5 years (IQR 36–61) for those who showed retained staining. The inter-observer agreement in the interpretation of the immunohistochemical stain was excellent (Cohen’s kappa = 0.917; 95% confidence interval, 0.81–1, p < 0.001). Conclusion: Approximately one-third of phaeochromocytomas and paragangliomas in our setting are likely to be associated with germline mutations in one of the SDH genes. Immunohistochemical testing of tumour tissue can identify this group to allow better prognostication and appropriate genetic testing and counselling.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"4 1","pages":"9 - 15"},"PeriodicalIF":0.5,"publicationDate":"2020-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84849595","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
Prevalence and aetiology of thyrotoxicosis in patients with hyperemesis gravidarum presenting to a tertiary hospital in Cape Town, South Africa 南非开普敦一家三级医院妊娠剧吐患者甲状腺毒症的患病率和病因学
IF 0.5 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2020-11-18 DOI: 10.1080/16089677.2020.1831740
T. van der Made, M. van de Vyver, M. Conradie-Smit, M. Conradie
Background: The association between hyperemesis gravidarum (HG) and abnormal thyroid function is well known. Aims: The prevalence, aetiology and course of thyrotoxicosis in women with hyperemesis gravidarum (HG) were studied. Methods: Women admitted for HG, who underwent thyroid function evaluation between 1 August 2016 and 30 April 2019, were studied. Laboratory data included baseline human chorionic gonadotropin (hCG) and baseline (t1), discharge (t2) and follow-up (t3) thyroid function tests (thyroid stimulating hormone [TSH] and free thyroxin [fT4]). Available TSH receptor antibody status was assessed. Results: Eighty-two patients were included. The incidence of thyrotoxicosis was 49% based on local laboratory TSH range and 48% if trimester-specific ranges used. In the majority of normal pregnancies, thyrotoxicosis was hCG-mediated (72.5%), 15% were confirmed to have Graves’ disease and 12% had a molar pregnancy. Very high fT4 levels (> 40 pmol/l) at baseline [t1] were documented in 24% of women with hCG-mediated thyrotoxicosis. Clinical features were absent in a third of women with Graves’ disease and the diagnosis was reliant on positive antibody status. Free T4 values declined from (t1) to later in gestation (t3) (p < 0.001). Conclusion: The incidence of thyrotoxicosis in women with HG is high. Free-T4 values decrease with clinical stabilisation of HG, suggesting a contribution of dehydration to the large variation in baseline fT4 measurements. Testing for TSH-receptor antibodies should be considered in women with TSH < 0.01 pmol/l and persistent fT4 elevation on follow-up. Final review of thyroid function should be performed after 15 weeks’ gestation.
背景:妊娠剧吐与甲状腺功能异常之间的关系是众所周知的。目的:探讨妊娠剧吐(HG)妇女甲状腺毒症的发病情况、病因及病程。方法:对2016年8月1日至2019年4月30日期间接受甲状腺功能评估的HG入院女性进行研究。实验室数据包括基线人绒毛膜促性腺激素(hCG)和基线(t1)、出院(t2)和随访(t3)甲状腺功能测试(促甲状腺激素[TSH]和游离甲状腺素[fT4])。评估可用TSH受体抗体状态。结果:纳入82例患者。根据当地实验室TSH范围,甲状腺毒症的发生率为49%,如果使用妊娠期特异性范围,则为48%。在大多数正常妊娠中,甲状腺毒症是由hcg介导的(72.5%),15%确诊为Graves病,12%为磨牙妊娠。24%的hcg介导的甲状腺毒症患者在基线时fT4水平非常高(> 40 pmol/l) [t1]。三分之一的格雷夫斯病妇女没有临床特征,诊断依赖于抗体阳性状态。游离T4值从(t1)到妊娠后期(t3)下降(p < 0.001)。结论:女性HG患者甲状腺毒症发生率高。游离t4值随着HG的临床稳定而下降,提示脱水对基线fT4测量值的巨大变化有贡献。对于TSH < 0.01 pmol/l且随访中fT4持续升高的女性,应考虑检测TSH受体抗体。妊娠15周后复查甲状腺功能。
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引用次数: 2
Defaulters. Are they worse off? Analysing reasons for this phenomenon amongst patients with diabetes with and without HIV infection 违约者。他们的情况更糟了吗?分析合并和不合并HIV感染的糖尿病患者出现这一现象的原因
IF 0.5 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2020-09-01 DOI: 10.1080/16089677.2020.1823678
S. Pillay
Background: Ideal control of diabetes mellitus (DM) remains elusive globally. Identifying defaulting reasons in diabetes clinics can provide potential interventional areas. Methods: Data of patients booked for the Edendale Hospital diabetes clinic (attendees and defaulters) between August 2019 and February 2020 were used to determine whether control in defaulters differed from attendees and to analyse defaulting reasons. Results: A total of 581 patients living with diabetes (PLWD) attended; 213 defaulted (defaulting rate 26.79%). Defaulters (1) had poorer glycaemic and lipid control; (2) with HIV infection and type 2 DM (T2DM) had inferior glycaemic control; (3) performed more self-monitoring of blood glucose (SMBG). Substantially more females defaulted across all categories. They had poorer glycaemia and lipid control with higher body mass index. The commonest defaulting reasons were forgetting appointments, too many clinics (TMC), patient sick and work commitments (44.3% vs. 24.5% vs. 13.1% vs. 10.8%). Within HIV-infected defaulters, reasons ranged from TMC, work commitments and other reasons to forgot appointment (57.7% vs. 26.1% vs. 23.8% vs. 13.8%). A significant number of HIV-infected and patients on antiretroviral therapy, of both sexes, with T2DM, defaulted secondary to TMC. Patients with hypertension and chronic kidney disease (CKD) defaulted due to TMC. Bivariate analysis revealed that being a pensioner, increased age, employment and presence of T2DM were significantly associated with being sick. Older patients defaulted in poor weather while younger patients specified school/work commitments. Patients who complained of TMC had higher creatinine levels. Conclusions: The defaulting rate in PLWD remains high. Defaulters had sub-optimal glycaemic and lipid control. TMC proved to be significant for patients with chronic diseases (HIV infection, hypertension and CKD) highlighting the need for combined communicable and non-communicable diseases clinics. Defaulting females and HIV-infected PLWD had high prevalence of cardiovascular risk factors. Afternoon clinics might assist with work/school commitments. Wireless uploading of SMBG results and teleconsultation is an option.
背景:糖尿病(DM)的理想控制在全球范围内仍然难以捉摸。在糖尿病诊所中识别不合格的原因可以提供潜在的干预领域。方法:使用2019年8月至2020年2月期间在Edendale医院糖尿病诊所预约的患者(出席者和违约者)的数据,确定违约者的控制是否与出席者不同,并分析违约原因。结果:共纳入581例糖尿病患者(PLWD);213个违约(违约率26.79%)。违约者(1)血糖和血脂控制较差;(2) HIV感染合并2型糖尿病(T2DM)患者血糖控制较差;(3)更多的自我监测血糖(SMBG)。更多的女性在所有类别中都默认。他们的血糖和血脂控制较差,体重指数较高。最常见的违约原因是忘记预约、诊所太多、病人生病和工作承诺(44.3% vs. 24.5% vs. 13.1% vs. 10.8%)。在感染艾滋病毒的违约者中,原因从TMC、工作承诺和其他原因到忘记预约(57.7% vs. 26.1% vs. 23.8% vs. 13.8%)不等。相当数量的艾滋病毒感染者和接受抗逆转录病毒治疗的患者,无论男女,患有2型糖尿病,默认继发于TMC。高血压和慢性肾脏疾病(CKD)患者因TMC而违约。双变量分析显示,领取养老金、年龄增加、就业和患有2型糖尿病与患病显著相关。年龄较大的患者在恶劣天气中违约,而年龄较小的患者则指定学校/工作义务。主诉TMC的患者肌酐水平较高。结论:PLWD的违约率仍然很高。违约者血糖和血脂控制欠佳。事实证明,TMC对慢性病患者(艾滋病毒感染、高血压和慢性肾病)非常重要,这突出表明需要建立传染病和非传染性疾病联合诊所。女性和hiv感染的PLWD有较高的心血管危险因素。下午的诊所可能有助于工作/学校的安排。无线上传SMBG结果和远程咨询是一种选择。
{"title":"Defaulters. Are they worse off? Analysing reasons for this phenomenon amongst patients with diabetes with and without HIV infection","authors":"S. Pillay","doi":"10.1080/16089677.2020.1823678","DOIUrl":"https://doi.org/10.1080/16089677.2020.1823678","url":null,"abstract":"Background: Ideal control of diabetes mellitus (DM) remains elusive globally. Identifying defaulting reasons in diabetes clinics can provide potential interventional areas. Methods: Data of patients booked for the Edendale Hospital diabetes clinic (attendees and defaulters) between August 2019 and February 2020 were used to determine whether control in defaulters differed from attendees and to analyse defaulting reasons. Results: A total of 581 patients living with diabetes (PLWD) attended; 213 defaulted (defaulting rate 26.79%). Defaulters (1) had poorer glycaemic and lipid control; (2) with HIV infection and type 2 DM (T2DM) had inferior glycaemic control; (3) performed more self-monitoring of blood glucose (SMBG). Substantially more females defaulted across all categories. They had poorer glycaemia and lipid control with higher body mass index. The commonest defaulting reasons were forgetting appointments, too many clinics (TMC), patient sick and work commitments (44.3% vs. 24.5% vs. 13.1% vs. 10.8%). Within HIV-infected defaulters, reasons ranged from TMC, work commitments and other reasons to forgot appointment (57.7% vs. 26.1% vs. 23.8% vs. 13.8%). A significant number of HIV-infected and patients on antiretroviral therapy, of both sexes, with T2DM, defaulted secondary to TMC. Patients with hypertension and chronic kidney disease (CKD) defaulted due to TMC. Bivariate analysis revealed that being a pensioner, increased age, employment and presence of T2DM were significantly associated with being sick. Older patients defaulted in poor weather while younger patients specified school/work commitments. Patients who complained of TMC had higher creatinine levels. Conclusions: The defaulting rate in PLWD remains high. Defaulters had sub-optimal glycaemic and lipid control. TMC proved to be significant for patients with chronic diseases (HIV infection, hypertension and CKD) highlighting the need for combined communicable and non-communicable diseases clinics. Defaulting females and HIV-infected PLWD had high prevalence of cardiovascular risk factors. Afternoon clinics might assist with work/school commitments. Wireless uploading of SMBG results and teleconsultation is an option.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"68 6 1","pages":"70 - 79"},"PeriodicalIF":0.5,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88015602","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: 1
Perceptual systems of the self-management of students living with diabetes mellitus: an IQA approach 糖尿病学生自我管理的感知系统:一个IQA方法
IF 0.5 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2020-09-01 DOI: 10.1080/16089677.2020.1817281
Jkd Jacobs, Wd Basson, MJ Basson
Introduction: Diabetes mellitus (DM) is a chronic metabolic disease defined by elevated blood glucose levels over a long period of time. One in 10 people are living with DM. Objective: The main purpose of this investigative study was to gain knowledge regarding the perceptions of students’ self-management living with diabetes mellitus at a tertiary institute. Methods: The Interactive Qualitative Analysis (IQA) was used to construct and describe a cognitive mind map of students’ perceptions of their self-management living with DM. Results: An analysis of the participants’ mind map representing students living with DM revealed eight main components (affinities), namely: Social awareness and acceptance, Food available on campus, Keeping insulin cool, Independent lifestyle, Adjusting by cooking, Hurdles in the academic environment, Causes of changing blood sugar and Adapting to effects of changing blood sugar. Conclusion: The final perceptual system was an informative representation of the self-management of students living with DM. The system reflects barriers to compliance with self-management facing students living with DM. The system produced four recognisable loops or cycles, namely the Ignorance loop, the Revision loop, the Developing loop and the Self-management loop. These loops created pathways through the system for the students living with DM to find a way to better self-management.
简介:糖尿病(DM)是一种慢性代谢性疾病,其特征是长期血糖水平升高。十分之一的人患有糖尿病。目的:本调查研究的主要目的是了解高等院校学生对糖尿病患者自我管理的看法。方法:采用互动定性分析(Interactive Qualitative Analysis, IQA)构建并描述糖尿病学生自我管理认知思维导图。结果:对糖尿病学生思维导图的分析揭示了八个主要成分(亲和力),即:社会意识和接受度,校园食物,保持胰岛素凉爽,独立的生活方式,通过烹饪调整,学术环境中的障碍,血糖变化的原因和适应血糖变化的影响。结论:最后的感知系统是糖尿病学生自我管理的信息表征。该系统反映了糖尿病学生遵守自我管理的障碍。该系统产生了四个可识别的循环,即无知循环、修正循环、发展循环和自我管理循环。这些循环为患有糖尿病的学生在系统中找到更好的自我管理方式创造了途径。
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引用次数: 0
Pseudohypoparathyroidism presenting in children at a tertiary hospital in Johannesburg, South Africa 南非约翰内斯堡一家三级医院的儿童出现假性甲状旁腺功能低下
IF 0.5 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2020-09-01 DOI: 10.1080/16089677.2020.1817282
N. Madi, F. Moosa, K. Parbhoo, J. Pettifor, K. Thandrayen
Pseudohypoparathyroidism (PHP) represents a group of disorders due to end organ resistance to the actions of parathyroid hormone (PTH) and abnormalities in the PTH signalling pathway. PHP is characterised by hypocalcaemia and hyperphosphataemia, with or without a variable expression of physical features. The constellation of these physical features together are termed Albright hereditary osteodystrophy (AHO). PHP and related disorders are primarily clinical diagnoses in our setting as confirmatory laboratory testing is not widely available. Molecular genetics is the gold standard for confirmation and categorisation of PHP into the different subtypes, but with recent advances in molecular diagnostics a pathophysiological approach appears to be more practical in the clinical setting. The aim of our report is to describe the diverse clinical features, clinical course and genetic testing of nine patients who have been followed up at our paediatric Metabolic Bone Clinic at Chris Hani Baragwanath Academic Hospital in Soweto, South Africa.
假性甲状旁腺功能减退症(PHP)是由终末器官对甲状旁腺激素(PTH)的抵抗和PTH信号通路异常引起的一组疾病。PHP的特点是低钙血症和高磷血症,有或没有可变的物理特征表达。这些身体特征的组合被称为奥尔布赖特遗传性骨营养不良(who)。PHP和相关疾病主要是临床诊断在我们的设置,确认实验室测试是不广泛可用。分子遗传学是确认和将PHP分类为不同亚型的黄金标准,但随着分子诊断的最新进展,病理生理学方法似乎在临床环境中更实用。我们报告的目的是描述我们在南非索韦托Chris Hani Baragwanath学术医院的儿科代谢骨诊所随访的9名患者的不同临床特征、临床过程和基因检测。
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引用次数: 2
期刊
Journal of Endocrinology Metabolism and Diabetes of South Africa
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