Эндокринология

[Наталья П.]

Эндокринология

[Наталья П.]

Обновленная формулировка критериев "Метаболического синдрома" от Международной федерации диабета (апрель 2005):

The metabolic syndrome, which includes diabetes or prediabetes, abdominal obesity, unfavorable lipid profile and hypertension, triples the risk of myocardial infarction or stroke and doubles mortality from these conditions. It also increases the risk of developing type 2 diabetes, if not already present, fivefold. Recent data from Australia and the U.S. suggest that up to one quarter of the adult population may have the metabolic syndrome.

The new diagnostic criteria are
central obesity, defined as waist equal to or more than 94 cm for males and 80 cm for females in Europids, and ethnic-specific levels in Chinese, Japanese and South Asians;
together with two of the following:
raised triglycerides of at least 1.7 mmol/L or 150 mg/dL;
low HDL-cholesterol, defined as less than 1.04 mmol/L (40 mg/dL) in males and less than 1.29 mmol/L (50 mg/dL) in females;
raised blood pressure of at least 130/85 mm Hg;
fasting hyperglycemia, defined as glucose equal to or greater than 5.6 mmol/L (100mg/dL) or previous diagnosis of diabetes or impaired glucose tolerance.

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Рациональный базис для создания новых критериев:

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__________________
Искренне,
Вадим Валерьевич.

обновить

[Наталья П.]

От Яны Студенцовой

The ‘Edmonton’ Protocol
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[Наталья П.]

Ресурсы для специалистов и пациентов по диабету

Диабет в Великобритании
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University of Massachusetts
Diabetes Division
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It's a New Day In Diabetes
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[Melnichenko]

Ассоциация пациентов с заболеваниями гипофиза ( Великобритания)
The Pituitary Foundation
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[yananshs]

THYROID DISEASE MANAGER © offers an up-to-date analysis of thyrotoxicosis, hypothyroidism, thyroid nodules and cancer, thyroiditis, and all aspects of human thyroid disease and thyroid physiology. [Ссылки доступны только зарегистрированным пользователям ]

[Наталья П.]

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Endocrinology Update
Журнал
полнотекстовый свободный доступ в пдф.


Endocrinology Update is a quarterly publication for physicians that highlights trends in endocrinology-related procedures and disease management strategies at Mayo Clinic.

To contact the Department of Endocrinology at Mayo Clinic for a referral or physician consultation, please call 800-313-5077. For an endocrine surgery consultation, please call 507-284-2166.

To subscribe to Endocrinology Update, please send an e-mail with your request to [Ссылки доступны только зарегистрированным пользователям ].

[Наталья П.]

KIM C, Kim H, Nam J, Cho M, et al.
Internet diabetic patient management using a short messaging service automatically produced by a knowledge matrix system.
Diabetes Care. 2007;.
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[Наталья П.]

dding "value" to clinical practice guidelines
Can Fam Physician
Vol. 53, No. 8, August 2007, pp.1326 - 1327
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"Evidence-based medicine is not just a synopsis of research evidence.
Evidence-based medicine has been defined as "the integration of best research evidence with clinical expertise and patients' values." The third component of this definition, patients' values, has been further defined as "the unique preferences, concerns and expectations each patient brings to a clinical encounter and which must be integrated into clinical decisions if they are to serve the patient." Guidelines created to aid in the development of CPGs suggest CPGs "should discuss the role of patient preferences for different courses of health care for those conditions or technologies in which patients' values and preferences may be important decision-making factors" and they should "...describe the role of patient preferences when a recommendation involves a substantial element of personal choice or values."

The authors "analyzed the current Canadian CPG documents for diabetes, dyslipidemias, hypertension, and osteoporosis to determine the degree to which they mentioned the importance of patients' values and preferences in therapeutic decisions. In addition, they assessed whether the CPGs acknowledged the importance of discussing risks and benefits with patients, and the degree to which they presented clinicians with the tools and data
that would enable them to engage patients in informed discussions about the benefits and harms of available therapeutic options. "

[Наталья П.]

Clinical Practice

Gynecomastia
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G.D. Braunstein

Free full-text audio on beta.nejm.org

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[Наталья П.]

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по ссылке - полный текст

BMJ 2007;335:497 (8 September)

Benefits and harms of antidiabetic agents in patients with diabetes and heart failure: systematic review.

Eurich DT, McAlister FA, Blackburn DF, Majumdar SR, Tsuyuki RT, Varney J, Johnson JA.
Institute of Health Economics, Edmonton, AB, Canada, T5J 3N4.

OBJECTIVE: To review the literature on the association between antidiabetic agents and morbidity and mortality in people with heart failure and diabetes.
DESIGN: Systematic review and meta-analysis of controlled studies (randomised trials or cohort studies) evaluating antidiabetic agents and outcomes (death and admission to hospital) in patients with heart failure and diabetes.
DATA SOURCES: Electronic databases, manual reference search, and contact with investigators.
REVIEW METHODS: Two reviewers independently extracted data. Risk estimates for specific treatments were abstracted and pooled estimates derived by meta-analysis where appropriate.
RESULTS: Eight studies were included. Three of four studies found that insulin use was associated with increased risk for all cause mortality (odds ratio 1.25, 95% confidence interval 1.03 to 1.51; 3.42, 1.40 to 8.37 in studies that did not adjust for diet and antidiabetic drugs; hazard ratio 1.66, 1.20 to 2.31; 0.96, 0.88 to 1.05 in the studies that did). Metformin was associated with significantly reduced all cause mortality in two studies (hazard ratio 0.86, 0.78 to 0.97) compared with other antidiabetic drugs and insulin; 0.70, 0.54 to 0.91 compared with sulfonylureas); a similar trend was seen in a third. Metformin was not associated with increased hospital admission for any cause or for heart failure specifically. In four studies, use of thiazolidinediones was associated with reduced all cause mortality (pooled odds ratio 0.83, 0.71 to 0.97, I2=52%, P=0.02). Thiazolidinediones were associated with increased risk of hospital admission for heart failure (pooled odds ratio 1.13 (1.04 to 1.22), I2=0%, P=0.004). The two studies of sulfonylureas had conflicting results, probably because of differences in comparator treatments. Important limitations were noted in all studies.
CONCLUSION: Metformin was the only antidiabetic agent not associated with harm in patients with heart failure and diabetes. It was associated with reduced all cause mortality in two of the three studies.

[Наталья П.]

Association of Overweight With Increased Risk of Coronary Heart Disease Partly Independent of Blood Pressure and Cholesterol Levels: A Meta-analysis of 21 Cohort Studies Including More Than 300 000 Persons.

Bogers RP, Bemelmans WJ, Hoogenveen RT, Boshuizen HC, Woodward M, Knekt P, van Dam RM, Hu FB, Visscher TL, Menotti A, Thorpe RJ Jr, Jamrozik K, Calling S, Strand BH, Shipley MJ; for the BMI-CHD Collaboration Investigators.

Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, the Netherlands. [Ссылки доступны только зарегистрированным пользователям ].

BACKGROUND: The extent to which moderate overweight (body mass index [BMI], 25.0-29.9 [calculated as weight in kilograms divided by height in meters squared]) and obesity (BMI, >/= 30.0) are associated with increased risk of coronary heart disease (CHD) through adverse effects on blood pressure and cholesterol levels is unclear, as is the risk of CHD that remains after these mediating effects are considered.
METHODS: Relative risks (RRs) of CHD associated with moderate overweight and obesity with and without adjustment for blood pressure and cholesterol concentrations were calculated by the members of a collaboration of prospective cohort studies of healthy, mainly white persons and pooled by means of random-effects models (RRs for categories of BMI in 14 cohorts and for continuous BMI in 21 cohorts; total N = 302 296).
RESULTS: A total of 18 000 CHD events occurred during follow-up. The age-, sex-, physical activity-, and smoking-adjusted RRs (95% confidence intervals) for moderate overweight and obesity compared with normal weight were 1.32 (1.24-1.40) and 1.81 (1.56-2.10), respectively. Additional adjustment for blood pressure and cholesterol levels reduced the RR to 1.17 (1.11-1.23) for moderate overweight and to 1.49 (1.32-1.67) for obesity. The RR associated with a 5-unit BMI increment was 1.29 (1.22-1.35) before and 1.16 (1.11-1.21) after adjustment for blood pressure and cholesterol levels.
CONCLUSIONS: Adverse effects of overweight on blood pressure and cholesterol levels could account for about 45% of the increased risk of CHD. Even for moderate overweight, there is a significant increased risk of CHD independent of these traditional risk factors, although confounding (eg, by dietary factors) cannot be completely ruled out.
PMID: 17846390 [PubMed - in process]

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[Наталья П.]

Подборка видео для информирования пациентов от JoslinDiabetesCenter
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А вероятно такие плакатики можно сделать в детской поликлинике
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Diabetes symptoms

[Наталья П.]

Endocrine Abstracts provides searchable abstracts of presentations at key conferences in endocrinology. It is also a permanent, citable record, freely available to all without access restrictions.
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[Наталья П.]

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A peer-reviewed transdisciplinary Journal covering Neuroendocrinology, Neuroscience, Neurophysiology, Neuropsychopharmacology, Psychoneuroimmunology, Reproductive Medicine, Chronobiology and Human Ethology for RAPID publication of Original Papers, Review Articles and State-of-the-art from basic research and clinical research.