Subclinical hypothyroidism in childhood, treatment or only follow-up?

BACKGROUND: Subclinical hypothyroidism (SH) is defined as serum levels of thyroid-stimulating hormone (TSH) above the upper limit with normal concentrations of free T4 (fT4). Its management remains challenging. The aim of the study was to evaluate clinical and laboratory findings as well as the clinical course of children with SH followed in a third level hospital. Sixty-five patients aged between 2 and 18 years old were retrospectively studied. METHODS: The patients were followed for a median period of 9 months (range 6 months to 24 months). Those who normalized TSH levels were discharged (Group 1). If TSH persisted mildly elevated (5-10µUI/mL) with normal fT4 and negative TPOAb/TgAb, they were classified as Group 2 and followed semi-annually without treatment. Those patients whose TSH raised ≥10µUI/mL or who maintained TSH 5-10µUI/mL and positive TPOAb/TgAb were considered suitable for thyroxin therapy (Group 3, G3). RESULTS: In 89% of our patients, TSH concentrations spontaneously reverted to normality or remained stable without treatment (Groups 1 and 2), whereas less than 11% progressed to clinical hypothyroidism (Group 3). Baseline TSH was significantly lower in group 1 than in group 3. In group 3 the prevalence of female sex (71%) was higher and TPO antibodies were present in 85% of patients. The risk of developing overt hypothyroidism in patients with positive anti-thyroid antibodies respect to those who normalized TSH was 45 (95%CI 6.5-312.5). CONCLUSION: Baseline TSH, female sex and the presence of thyroid autoimmunity were the best predictors of the evolution to SH over time.

Influence of time of residence on the sense of community and satisfaction with life in immigrants in Spain: The moderating effects of sociodemographic characteristics.

Migration is an example of adaptation with enduring effects over time and in different cultures. Few studies have analyzed the effect of the sense of community (SOC) on satisfaction with life (SWL) over time while taking into account the moderating effects of sociodemographic characteristics. We propose a model that explains the influence of time of residence on the SOC and SWL. It was hypothesized that the SOC has a positive influence on SWL and that SWL is moderated by sociodemographic characteristics and cultural differences. Participants were 2,211 immigrants residing in Malaga (Spain). Results show a positive association between years of residence and the SOC and the SWL. A positive association was found between the SOC and SWL. This study shows the relevance of analyzing the moderating effects of sociodemographic characteristics in different immigrant groups rather than according to the migration process as a whole to develop specific intervention strategies.

Personality, activities, and well-being: a study based on women in late adulthood.

The purpose of this study was to explore comparatively personality variables, subjective well-being variables, and participation in daily life activities in 150 women aged 50 to 82 years with different employment status. Moreover, we also analyzed the extent to which personality and participation in daily life activities accounted for life satisfaction, positive affect, and negative affect. Results from analyses of variance showed that there were significant differences between women with different working status. Multiple regression analyses revealed that self-esteem, optimism, and social activities accounted for a significant amount of variance in predicting life satisfaction and positive affect.

Sing4Health: Randomised controlled trial of the effects of a singing group program on the subjective and social well-being of older adults.

Group singing may be an optimal intervention strategy to promote active ageing and well-being; however, evidence with experimental validity is scarce. This study aims to fill this gap by analysing the effects of a 34-session singing group programme (SGP) on participants' subjective and social well-being and the mediating roles of social identification with the singing group and of self-esteem. An RCT with intervention (n = 89) and active waiting-list control (n = 60) conditions was conducted, and a mixed method quantitative and qualitative data collection and analysis were performed. Participants were mostly elderly day-care centre users (M = 76.66 years old; SD = 8.79) with low average levels of education and income. Structured measures of life satisfaction, positive and negative affect, self-esteem, loneliness, social identification and social well-being were collected, as well as interviews on the perceived benefits of participating in the SGP. Results showed significant effects of the SGP on the positive affect, social well-being and marginally on the self-esteem of the participants. The observed effects were sustained at the follow-up. Qualitative analysis corroborated the quantitative results. Mediation analysis showed indirect effects of social identification with the singing group on loneliness and social identification with the social care institution group; and of self-esteem on positive and negative affect.

Analizan la calidad de vida de los padres de enfermos con síndrome de Wolfram / The quality of life of parents of Wolfram syndrome patients analyzed

Objetivo: Conocer factores relevantes que inciden en la calidad de vida de los padres de personas afectadas por esta enfermedad. Diseño: Estudio analítico de casos y controles. Emplazamiento: Domicilio familiar de los afectados. Población y muestra: Familiares de aquejados por el síndrome de Wolfram en España. Se tomó contacto con pacientes diagnosticados en hospitales y sus familiares a través de esos mismos centros. Con la creación de la Asociación Española del Síndrome de Wolfram, en 1999, se conocieron nuevos pacientes y sus familias. La muestra procede de estas fuentes y está integrada por 17 familias (23 personas afectadas). Intervenciones: Se aplicó el Cuestionario de Calidad de Vida a los pacientes y sus familiares; una entrevista estructurada a los padres para conocer las reacciones manifestadas al saber que su hijo padecía una enfermedad crónica degenerativa. Se analizó el impacto económico, social y de pareja en la vida diaria; igualmente se atendieron las conductas de afrontamiento y los logros alcanzados en esta línea. Resultados: Las variables generales tomadas en conjunto no muestran diferencias significativas entre el grupo de pacientes y el de control. Tras un análisis más detallado de los ítem que componen el cuestionario CCV se desprende que las actividades sociales de los familiares se ven mermadas, los padres requieren mayor apoyo psicológico y necesitan un mínimo de dos años de adaptación a estas nuevas circunstancias. Conclusiones: La calidad de vida de los familiares cuidadores de enfermos DIDMOAD se ve afectada en algunos aspectos, se encontraron diferencias con relación al grupo control. Estas diferencias no alcanzan significación estadística pero resultan relevantes de cara a la intervención clínica con estos pacientes y sus familiares.