The aim: The study was aimed to compare the efficiency of intrathyroid steroid injection to oral steroid intake in patients with subacute thyroiditis. Materials and methods: 32 patients with subacute thyroiditis with insufficient result from NSAIDs treatment were randomly divided into two groups. The 1st group received two intrathyroid steroid injections, the 2nd group received oral prednisone. The results of the treatment were evaluated via ultrasound and evaluation of ESR and CRP at 0, 2, 4, 8 and 16 weeks of treatment. Results: Patients of the 1st group showed much faster result at the ultrasound compared to the 2nd group: mean decrease in hypoechogenity area 44,42% vs 16,35% at week 2, p < 0,001; 93,29% vs 75,98% at week 4, p < 0,001; 97,8% vs 95,24% at week 8, p = 0,4; mean decrease in ESR 66,34% vs 51,92% at week 2, p = 0,023; 84,43% vs 74,94% at week 4, p = 0,023; mean decrease in CRP 26,53% vs 20,77% at week 2, p = 0,024, 33,77% vs 29,98%, at week 4, p = 0,026. No side effects were noted during the treatment of patients of the 1st group. Conclusions: Compared to oral steroid intake intrathyroid steroid injection is faster, safer and generally better tolerated by patients.
The actual problem of internal medicine is the managemen of patients with comorbid pathology. Arterial hypertension (AH) is determined in about quarter of the population in the world. Moreover, the coexistence of AH and type 2 diabetes mellitus (DM) connected with the increased risk of cardiovascular complications (CVC) compared with patients with AH. In principle dyslipidemia is the common link between AH and type 2 DM, which need the correction. No doubt that reduction of atherogenic and increase of anti atherogenic lipoproteins is necessary for persons with comorbid pathology. The objective of our study was the assessment of atorvastatin treatment in patients with AH, diabetic nephropathy and type 2 DM. We obtained 96 patients with AH, diabetic nephropathy and type 2 DM (І group), 25 persons with AH (ІІ group), 15 conditionally healthy individuals. Persons had CVC in the past. For patients from the І and ІІ group CVC were defined accordingly (4,97 ± 0,20) years and (4,10 ± 0,05) years ago (P = 0,0291). The duration of AH is (8,1 ± 0,2) years for the І group and (8,90 ± 0,13) years for the ІІ group. The levels of lipid profile spectrum were determined according to the methods of W. T. Friedewald. The results of investigation were analyzed with the help of Microsoft Excel 2016. Correction of lipid profile spectrum is the important part of multipurpose treatment for persons with coexistent pathology. All patients were treated by atorvastatin (10−40 mg/day) during 6 months in a complex therapy. The target levels of general cholesterol during 6 months were presented in 30 persons (31.91 %), low density lipoproteids – in 10 persons (10.64 %), high density lipoproteids – in 26 persons (27.66 %), triglycerides – in 34 persons (36.17 %) among patients with AH, diabetic nephropathy and type 2 DM. In conclusion, it is advisable to prescribe atorvastatin (10–40 mg/day) for correction of dyslipidemia, reduction of proatherogenic orientation, prevention of atherosclerotic process manifestation and cardiovascular complications in patients with AH with diabetic nephropathy and type 2 diabetes mellitus.
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