RESUMO
Erythrocyte abnormalities are frequently associated with thyroid dysfunction. However, they are rarely investigated and related to the thyroid. This study was aimed to determine the nature and frequency of erythrocyte abnormalities in thyroid disease and look for their evolution after thyroid function restoration. This retrospective study included 412 patients with peripheral thyroid disease; hyperthyroidism [n=235] or hypothyroidism [n=177]. Hyperthyroidism was considered for TSH <0.10 IUI/ml and hypothyroidism for TSH> 5.01 IUI/ml. Anemia was defined by hemoglobin level <13 g/dl in men and <12 g/dl in women, microcytosis by mean corpuscular volume [MCV] <80 fl, macrocytosis by MCV> 98 fl, and hypchromia by mean corpuscular hemoglobin [MCH] <25 pg. Restoration of euthyroid state was considered in patients with normal TSH levels for at least 3 months. Anaemia was observed in 40.9% of patients with hyperthyroidism and 57.1% of patients with hypothyroidism. Among these, normocytic or macrocytic anaemia was present in 46.3% of cases. Whereas, microcytosis, with or without anaemia, was noted in 87.7% of patients with hyperthyroidism. FT4 was positively correlated with the number of red blood cells and haemoglobin, and inversely correlated with MCV and MCH. After restoration of euthyroid state, most erythrocyte abnormalities were corrected. Thyroid diseases are frequently associated with erythrocyte abnormalities, including normocytic anaemia in hypothyroidism and microcytosis in hyperthyroidism. These abnormalities should be investigated and corrected. Their presence could steer towards subclinical thyroid dysfunction, allowing its early management
RESUMO
Good blood pressure control is one of the recommended targets in diabetic patient's management.To evaluate blood pressure [BP] control in hypertensive treated diabetic patients using ambulatory blood pressure measurement [ABPM]. Two hundred and six hypertensive treated diabetic patients were enrolled in this study [83 men and 123 women]. Mean age were 60.3 +/- 9.6 years-old with mean diabetic duration of 9.1 +/- 8.2 years. All of them underwent 24 hours ABPM. Intervals between measurements were 20 minutes at diurnal period and 30 minutes at nocturnal period. 28 patients [13.6%] only were at recommended target levels of blood pressure control [mean diurnal BP < 130/80 mmHg and nocturnal BP < 115/65 mmHg] and 137 patients were at the most bed control levels [mean diurnal BP ? 140/90 mmHg or nocturnal BP ? 125/75 mmHg]. Bed controlled patients had mildly higher waist circumference [p=0.08]. Poor BP control was associated with non dipper character [p<0.001], diabetic nephropathy [p<0.01] and diabetic retinopathy [p<0.01]. Our hypertensive treated diabetic patients were far from good blood pressure control. ABPM showed that the loss of nocturnal blood pressure fall was the most associated abnormality with poor BP control. Diabetic microangiopathy were more frequent in poor controlled patients
RESUMO
Long term blood glucose control is still difficult to obtain in type 2 diabetic patients. To evaluate quality of control, we analyzed data from 300 patients who attended our outpatient department in 2002 and performed at least one glycated hemoglobin measure. Mean age was 59.9 +/- 10.2 years; 58.7% were women and known duration of diabetes was 11.0 +/- 74; years. The glycated hemoglobin level was less than 7% in 21.3% of patients; those having lower duration of the disease, being more frequently treated with oral drugs, having a better control of other cardio vascular risk factors and having more frequent screening for complications. These results confirm the difficulty in obtaining optimal glucose control in patients with type 2 diabetes and the need for intensive anti-diabetic treatment