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Iclea Rocha Gama Euclides Marinho Trindade-Filho Suzana Lima Oliveira Nassib Bezerra Bueno Isabelle Tenório Melo Cyro Rego Cabral-Junior Elenita M. Barros Jaqueline A. Galvão Wanessa S. Pereira Raphaela C. Ferreira Bruna R. Domingos Terezinha da Rocha Ataide 《Metabolic brain disease》2015,30(1):93-98
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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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Coronavirus disease 2019 (COVID-19) has resulted in many challenges in patient care, especially among high-risk populations such as heart transplant recipients. Patients with heart transplant experience a significantly higher mortality rate with COVID-19 infection, and management is based on extrapolation from clinical trials done on nontransplant patients and from clinical experience. Here we report 4 cases of patients with heart transplant who presented with COVID-19 infection in late 2020. Patients presented with symptoms similar to those seen in the general population. All 4 patients were admitted to the hospital, and they were all treated with dexamethasone. In addition, 2 patients received remdesivir. Immunosuppressive medications were adjusted to maintain adequate levels of immunosuppression but at the same time allow for an adequate immune response against the infection. All patients were discharged alive from the hospital. We then performed a literature review on studies that included heart transplant patients who developed the infection and developed suggestions for a standardized management approach, which we share in this article. 相似文献