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R.D. Olmos R.C. de Figueiredo E.M. Aquino P.A. Lotufo I.M. Bensenor 《Brazilian journal of medical and biological research》2015,48(8):751-758
Thyroid diseases are common, and use of levothyroxine is increasing worldwide. We
investigated the influence of gender, race and socioeconomic status on the diagnosis
and treatment of thyroid disorders using data from the Brazilian Longitudinal Study
of Adult Health (ELSA-Brasil), a multicenter cohort study of civil servants (35-74
years of age) from six Brazilian cities. Diagnosis of thyroid dysfunction was by
thyrotropin (TSH), and free thyroxine (FT4) if TSH was altered, and the use of
specific medications. Multivariate logistic regression models were constructed using
overt hyperthyroidism/hypothyroidism and levothyroxine use as dependent variables and
sociodemographic characteristics as independent variables. The frequencies of overt
hyper- and hypothyroidism were 0.7 and 7.4%, respectively. Using whites as the
reference ethnicity, brown, and black race were protective for overt hypothyroidism
(OR=0.76, 95%CI=0.64-0.89, and OR=0.53, 95%CI=0.43-0.67, respectively, and black race
was associated with overt hyperthyroidism (OR=1.82, 95%CI=1.06-3.11). Frequency of
hypothyroidism treatment was higher in women, browns, highly educated participants
and those with high net family incomes. After multivariate adjustment, levothyroxine
use was associated with female gender (OR=6.06, 95%CI=3.19-11.49) and high net family
income (OR=3.23, 95%CI=1.02-10.23). Frequency of hyperthyroidism treatment was higher
in older than in younger individuals. Sociodemographic factors strongly influenced
the diagnosis and treatment of thyroid disorders, including the use of
levothyroxine. 相似文献
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目的 通过对公开发表在网络和数据库的有关中医药治疗2019新型冠状病毒肺炎(corona virus disease 2019,COVID-19)的文献进行方、药、证的可视化分析,客观全面的对COVID-19的中医药治疗进行探讨,为现代中医临床诊疗提供参考。方法 本文选用运用文献计量学方法和VOSviewer可视化软件对纳入文献中的用药情况进行数据拆分、整理和分析。结果 本研究高质量数据的主要期刊来源是核心期刊《中医杂志》;新冠临床用方以解表清热剂、开窍补益剂、辟秽祛湿剂为主;临床用药以解表药、清热解毒药、化湿祛痰药以及补益药为主;临床治病思路以六经辨证、三焦辨证和卫气营血辨证理论为指导;临床常见证型为湿、热、寒、毒相关证型;重视新冠前期预防以及后期恢复调养;治疗过程用药考究,注重养阴与祛邪并进。结论 新冠的中医临床诊治考病全面,并注重养阴与祛邪并进,可为官方制定治疗方案提供参考。 相似文献
129.
Characteristics of hyperparathyroid states in the Canadian multicentre osteoporosis study (CaMos) and relationship to skeletal markers
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Psoriasis is a chronic, inflammatory, immune‐mediated disease. Approximately 30% of patients have disease onset before age 18 years. Psoriasis in children and adolescents may be difficult to control, with subsequent poor quality of life and psychosocial consequences. We describe the case of a 12‐year‐old boy with severe, refractory, chronic plaque psoriasis for 6 years. Various therapeutic regimens including different topical corticosteroids, topical vitamin D analogs, phototherapy, photochemotherapy, systemic therapy with methotrexate, cyclosporin, and combination therapies showed only partial or transient responses with frequent relapses. Because anti‐interleukin‐12/23 agents have been successfully used in adults with psoriasis, ustekinumab was initiated and our patient showed a rapid, excellent, sustained response. No recurrence or flares have been observed after 33 months of follow‐up. This case illustrates that ustekinumab may be an effective and safe therapeutic option in adolescents with psoriasis. 相似文献