Determination of free thyroid hormones and their binding proteins in a patient with severe hyperthyroidism (thyroid storm?) and thyroid encephalopathy.

A patient with severe hyperthyroidism (thyroid storm?) and thyroid encephalopathy is described. During her illness only a slightly raised level of total thyroxine and a normal level of total triiodothyronine was found in contrast with very high levels of free thyroid hormones. Very low levels of thyroxine binding globulin, albumin and low levels of thyroxine binding prealbumin in contrast with nearly normal values of T3 resin uptake were observed. All parameters of thyroid function returned to normal after therapy.Case ReportsJournal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Avaliação do cuidado prestado a pacientes diabéticos em nível primário Assessment of diabetic patient management at primary health care level

OBJETIVO: Descrever características de pacientes diabéticos acompanhados em um posto de atenção primária à saúde. MÉTODOS: Estudo transversal. Rastrearam-se 3.024 prontuários de família, em busca de pacientes com 30-75 anos, com diagnóstico de diabetes, atendidos nos últimos cinco anos. Os pacientes detectados foram entrevistados em seus domicílios, e compareceram ao posto para o exame físico e requisição para dosagem da hemoglobina glicosilada. RESULTADOS: A prevalência de diabetes foi de 4,2%. A maioria eram mulheres brancas, ±50 anos de idade, com renda familiar mensal <= 3 salários-mínimos. Menos de um terço seguia dieta; e, apenas um quinto fazia exercícios regulares. Cerca de 70% estavam em uso de hipoglicemiantes orais ou insulina. Dos que fizeram o exame (adesão de 70%), a maioria apresentou níveis normais ou aceitáveis de glicemia. CONCLUSÕES: Maior esforço deve ser dispendido pelas equipes de saúde de forma a promover a adesão dos pacientes diabéticos à dieta e ao exercício.<br>OBJECTIVE: The characterization of diabetic patients seen at a primary health care clinic. METHODS: The case notes of 3,024 families were searched by means of a cross-sectional study for patients 30 to 75 years of age with a diagnosis of diabetes mellitus who had had a medical consultation during the previsous five years. These patients were interviewed at their homes and were asked to come to the health center for physical examination and a plasma glucose test using glucosylated hemoglobin (GH). RESULTS: The prevalence of diabetes was 4%. The typical diabetic patient was a white women, ±50 years of age, from a family with a monthly income <= 3 minimum wages. Compliance with GH was observed in 70% of the patients. Diet therapy was followed by less than one third of the patients and only one fifth were engaged in regular exercise. Nearly 70% were undergoing drug therapy (oral hypoglicemic agents or insulin); of these, only 15% used insulin. Most of the patients (66%) who agreed to have the GH test showed normal or fair glucose blood levels. CONCLUSIONS: Great efforts should be made by health teams to enhance diabetic patient education in order to promote compliance with recommendations regarding diet and exercise