ABSTRACT
The goals of this undertaking were to assess the outcomes of thyroid screening tests and adherence to thyroid screening guidelines across five Down syndrome (DS) specialty clinics in various states. Data related to thyroid screening were collected for 663 individuals across five clinics specializing in the comprehensive care of individuals with DS for a period of 1 year. Of the 663 participants, 47.7% of participants had a TSH and free T4 ordered at their DS specialty clinic visit. Approximately 19.0% (60/316) had a new thyroid disorder diagnosis made. We conclude that a sizable proportion of the patients with DS are not up-to-date on current guidelines when they present to a DS specialty clinic, while adherence to thyroid screening guidelines helps facilitate early diagnoses. Hypothyroidism is prevalent in the population, consistent with reported literature. DS specialty clinics can help patients stay current on screening guidelines.
Subject(s)
Down Syndrome/physiopathology , Hypothyroidism/physiopathology , Thyroid Diseases/physiopathology , Adolescent , Adult , Aged , Child , Child, Preschool , Down Syndrome/blood , Down Syndrome/complications , Female , Humans , Hypothyroidism/blood , Hypothyroidism/complications , Infant , Male , Middle Aged , Registries , Thyroid Diseases/blood , Thyroid Diseases/complications , Thyroid Function Tests , Thyroid Gland/physiopathology , Thyrotropin/blood , Thyroxine/bloodABSTRACT
The main purposes of this undertaking were to determine how often patients with Down syndrome (DS) are screened for celiac disease (CD) across five DS specialty clinics, which symptoms of CD are most often reported to DS specialty providers at these clinics, and, how many individuals were diagnosed with CD by these clinics. This was accomplished by following 663 individuals with DS for 1 year, across five clinics in different states specializing in the comprehensive care of people with DS. Of the 663 participants, 114 individuals were screened for CD at their visit to a DS specialty clinic. Protracted constipation (43.2%) and refractory behavioral problems (23.7%) were symptoms most often reported to DS specialty providers. During the 1 year study period, 13 patients screened positive for CD by serology. Of those, eight underwent duodenal biopsy, and three were diagnosed with CD. We conclude that CD is an important consideration in the comprehensive care of individuals with DS. However, while symptoms are common, diagnoses are infrequent in DS specialty clinics. © 2016 Wiley Periodicals, Inc.
Subject(s)
Celiac Disease/diagnosis , Down Syndrome/diagnosis , Genetic Counseling , Adolescent , Adult , Biopsy , Celiac Disease/complications , Celiac Disease/physiopathology , Child , Child, Preschool , Down Syndrome/complications , Down Syndrome/physiopathology , Female , Humans , Infant , Infant, Newborn , Male , Young AdultABSTRACT
BACKGROUND: It is unclear whether participation in home-delivered meal programs similar to the Older Americans Act home-delivered meals program influence weight status among older adults with hypertension and/or hyperlipidemia. OBJECTIVE: To examine the influence of a home-delivered Dietary Approaches to Stop Hypertension (DASH) meal intervention on body mass index (BMI), energy consumed, and percent of energy needs consumed. DESIGN: A 1-year randomized control trial of home-delivered DASH meals and medical nutrition therapy conducted from 2003 through 2005. Participants who received DASH meals were compared with those who did not receive meals. Data were collected in participants' homes at baseline, 6 months, and 12 months. PARTICIPANTS/SETTING: The study sample was composed of 298 adults aged >60 years with hypertension and/or hyperlipidemia residing in a county in the southeastern part of North Carolina. INTERVENTION: Participants in the meals intervention group received seven frozen meals per week for 1 year. The meals were designed to meet one third of participants' energy and nutrient needs and to comply with the DASH diet. MAIN OUTCOME MEASURES: Change in BMI, energy consumed, and percent of energy needs consumed. STATISTICAL ANALYSES PERFORMED: Difference-in-differences models were used to estimate the effects of the meal intervention on BMI, energy consumed, and percent of daily energy needs consumed. Analyses were conducted among the full sample and by subgroup (ie, race, income, and baseline obesity status). RESULTS: In the full sample, receipt of meals did not have a significant effect on BMI, energy consumed, or percent of daily energy needs consumed. Among those living at or above the 165% poverty threshold, receipt of home-delivered meals was significantly associated with a decrease in energy consumed and, therefore, percent of daily energy needs consumed. CONCLUSIONS: Participation in a home-delivered DASH meal program did not lead to weight gain or weight loss in a group of mostly overweight or obese older adults with hypertension and/or hyperlidemia.