RESUMO
This is a case of a 25-year-old primigravida who was referred to the hypertension specialist for elevated blood pressures. The patient had an elevated thyroid-stimulating hormone with normal free thyroxine (T4) levels and was positive for thyroid peroxidase antibodies resulting in a diagnosis of subclinical hypothyroidism. The patient was successfully treated with levothyroxine which normalized the blood pressure without the need for antihypertensive treatment. This case illustrates a cause of secondary hypertension that is not always considered in the differential diagnosis of a patient with hypertension in pregnancy.
Assuntos
Autoanticorpos/sangue , Hipertensão/etiologia , Hipotireoidismo/tratamento farmacológico , Tiroxina/uso terapêutico , Adulto , Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Hipertensão/sangue , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Hipertensão Induzida pela Gravidez/diagnóstico , Hipotireoidismo/sangue , Hipotireoidismo/complicações , Metildopa/administração & dosagem , Metildopa/uso terapêutico , Gravidez , Encaminhamento e Consulta , Tireotropina/sangue , Tiroxina/sangueAssuntos
Fenômeno do Membro Alienígena/etiologia , Coma Hiperglicêmico Hiperosmolar não Cetótico/complicações , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Leucoaraiose/patologia , Imageamento por Ressonância Magnética , Idoso , Fenômeno do Membro Alienígena/sangue , Fenômeno do Membro Alienígena/fisiopatologia , Feminino , Humanos , Coma Hiperglicêmico Hiperosmolar não Cetótico/sangue , Coma Hiperglicêmico Hiperosmolar não Cetótico/fisiopatologia , Infusões Intravenosas , Resultado do Tratamento , Gravação em VídeoRESUMO
The present study aims to determine the prevalence of self-reported sleep duration and sleep habits and their associated factors in patients with type 2 diabetes in Trinidad. This was a cross-sectional multicenter study. There were 291 patients with type 2 diabetes studied. Sleep habits were assessed using the Epworth Sleepiness Scale (ESS) and the National Health and Nutrition Examination Survey sleep disorder questionnaire. Demographic, anthropometric and biochemical data were also collected. The sample had a mean age of 58.8 years; 66.7% were female. The mean BMI was 28.9 kg/m(2). The prevalence of Excessive Daytime Sleepiness (EDS) was 11.3%. The prevalence of patients with short sleep (⩽6h) was 28.5%. The prevalence of patients with poor sleep was 63.9%. Poor sleep was associated with age, intensive anti-diabetic treatment and longer duration of diabetes. Short sleep was associated with intensive anti-diabetic treatment and BMI, while EDS was associated with increased BMI. In a sample of patients with type 2 diabetes, a high prevalence of self-reported sleep duration and unhealthy sleep habits was found. There needs to be an increased awareness of sleep conditions in adults with type 2 diabetes by doctors caring for these patients.
