Aims We aimed to determine the incidence, prevalence and mortality of type 1 diabetes (T1D) in Uzbekistan in children <15 years old. Methods In a prospective study from 1998 to 2014 the primary ascertainment of incidence, prevalence and mortality, and cause of death was via data collected by endocrinology dispensaries in Uzbekistan's 14 administrative divisions. A second data collection for 2008‐2010 from a national audit in 2011 was used to determine age structure. Results Over 1998‐2014 T1D prevalence roughly doubled (7.8 to 15.3/100,000 population aged <15 years, P = .10), following a doubling of incidence (1.5 to 3.1/100 000 < 15 years), a 5.6% annualized increase, P = .001), with a fall in mortality per 1000 patient years (24.5 to 2.0, P = .001). There was a female preponderance, with a male:female ratio of 0.89 in 2008‐2010. In every year, T1D incidence was highest in the 10‐14.99 year age‐group, although the proportion of diagnoses under 5 years of age increased from 6.0% of total diagnoses in 1998‐2002, to 13.4% in 2008‐2010. Peak age of onset in 2008‐2010 was 13 years. Notable regional variation was evident, with incidence being highest in Tashkent‐City (P = .005). The most common cause of death was chronic renal failure—responsible for 31 deaths in children <15 years during the study period. Conclusions Our results provide the first long‐term epidemiological data for T1D in Uzbekistan and the region. Uzbekistan is country of low but rising T1D incidence and prevalence, and falling mortality. Attention to improving clinical care is warranted, to reduce long‐term complications.
A prospective population-based survey in a region of the Republic of Uzbekistan determined the incidence of fractures at the hip. The hip fracture rates were used to create a FRAX® model to facilitate fracture risk assessment in Uzbekistan. Objective This paper describes the epidemiology of hip fracture in the Republic of Uzbekistan that was used to develop a country-specific FRAX® tool for fracture prediction. Methods During a 1-year (2016/17) prospective population-based survey in the Pap district of the Republic of Uzbekistan, hip fractures were prospectively identified from hospital registers, trauma centres and primary care and community sources. Age-and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Uzbekistan. Fracture probabilities were compared with those from neighbouring Kazakhstan and Kyrgystan. Results Approximately 41% of hip fracture cases did not come to medical attention, and two thirds of patients overall were not admitted to hospital. The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 16,764 and is predicted to increase more than threefold to 60,272 in 2050. FRAX-based probabilities were higher in Uzbekistan than Kazakhstan or Kyrgystan. Conclusion The FRAX model should enhance accuracy of determining fracture probability among the Uzbek population and help guide decisions about treatment.
Несмотря на проводимые мероприятия, направленные на ликвидацию йододефицитные состояния в стране РУз остается зоной высокой распространенности ЙДЗ. Динамика к снижению йоддефицита была связана с активной работой по ликвидации йоддефицитных заболевания (ЙДЗ) – это обеспечение йодирующими установками и йодатом калия соледобывающих и солеперерабатывающих предприятий, проведение широкомасштабных санитарно-просветительских мероприятий среди различных слоев населения, государственных предприятий и частного сектора, проведение регулярного мониторинга содержания йода в соли и моче. В мае 2007 г. был принят закон РУз «О профилактике йододефицитных заболеваний». В настоящей работе приводится анализ йододефицитных состояний в РУз согласно рекомендациям ВОЗ, сентинельным методом. Согласно данным йодурии нормальные значения йодурии (100-300 мкг/л) наблюдались в 1998 году у 5,6%, в 2016 году у 77% населения. Оптимальный уровень потребления йодированной соли (15,0-55 мкг/г йодата калия) в 1998 году составлял 7,6 % и в 2016 году увеличился до 81 % среди населения. Распространённость эндемического зоба снизился от 70% в 1998 году до 31% в 2016 году среди населения РУз. Таким образом, отмечается заметное улучшение показателей ЙДЗ по сравнению с предыдущими годами. Однако целевые значения пока не достигнуты.
The article is devoted to prevalence, contemporary diagnostic methods and treatment of Grave’s disease. Advantages and disadvantages of different treatment options are discussed. The cause of the disease can be environmental conditions, infectious diseases, severe operational intervention, drugs, trauma, especially brain traumas, iodine deficiency and radiation damage of thyroid in iodine deficiency conditions, familial predisposition. The ideal treatment of Graves’ disease should ensure a fairly rapid elimination of clinical symptoms of thyrotoxicosis, return to an euthyroid state, with minimal risk of complications. The relapse rate of the disease can reach up to 80 %, using conservative treatment. The radioiodine ablation is relatively simple, non-invasive, effective and cheap. There are special indications for surgical treatment. Indications for surgical treatment: 1) large goiter (the volume of the thyroid gland is more than 45 ml); 2) frequent recurrences of thyrotoxicosis and failure of the drug and RIT; 3)malignancy of goiter; 4) allergic and toxic (leukopenic) reactions to thyreostatics. Patients with Graves’ disease should referred to a specialized center with multidisciplinary team.
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