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J Jácome de Castro

Publications and source records attributed to J Jácome de Castro.

10 recordsLinked to original sources
PubMed2006

The relationship between body mass index and educational level in young Portuguese males: 1995 and 1999 cohorts.

INTRODUCTION: Over the last decades, a progressive increase in height and weight has been observed throughout Europe. Increase in weight has been more marked however, with a resulting increase in overweight and obesity prevalence. RESULTS published have analyzed the relationship between body mass index (BMI) and educational level. Most studies indicate an inverse relationship between BMI and educational level in developed countries. OBJECTIVE: This study's main objective was to evaluate the relationship between BMI and educational level (years of schooling) in young Portuguese males in 1995 and 1999. METHODS: Transverse study of data (BMI and years of schooling) from the military inspection records of virtually the entire Portuguese male population with an average age of 20 years, examined in 1995 and 1999, totaling 81 363 and 71 254, respectively. Four classes of BMI (<20, 20-24.9, 25-29.9 and > or =30 kg/m2) and four schooling levels (<5, 5-9, 10-12, and >12 years) were considered. We applied the chi2 test for associations between BMI and educational level and the odds ratio to quantify categorical variables. The significance level was 5%. RESULTS: In 1995, 15.2% were overweight (BMI> or =25 years), increasing to 20.8% in 1999. The percentage of obesity (BMI> or =30 years) was 1.4% in 1995 and 2.2% in 1999. The percentage of overweight and obesity increased directly in line with the increase in educational level, both in 1995 and 1999. In 1995, the percentage of subjects with obesity according to years of schooling was as follows: <5 years--1.4%; 5-9 years--1.4%; 10-12 years--1.5% and >12 years--1.7%. In 1999, the results were as follows: <5 years--1.4%; 5-9 years--2.2%; 10-12 years--2.8% and >12 years--3.2%. CONCLUSIONS: We can conclude that the prevalence of overweight and obesity in young male Portuguese increased in the last decade and that, unlike most developed countries, the higher the level of education, the greater the percentage of overweight and obesity, both in 1995 and 1999.

Adolescent↗
PubMed2005

[Pituitary macroadenoma associated with pulmonary and cutaneous sarcoidosis--a clinical case].

Sarcoidosis is a granulomatous disease of unknown etiology that can affect all organs and systems, including the central nervous system in approximately 5% of patients. Although the hypothalamo-hypophyseal system may be one of the areas affected by neurosarcoidosis, pseudotumoral lesions are very rare. This paper reports the case of a 42-year-old male Caucasian patient followed by the Pneumology and Dermatology services for pulmonary and cutaneous sarcoidosis. Corticotherapy was initiated five months from diagnosis and the patient showed clear clinical and imagiological signs of improvement. In the following two months, the patient experienced visual disturbances and a slight decrease in libido, but denied having other symptoms associated with hypothalamo-hypophyseal hypofunction. Laboratorial evaluation (basal determinations and stimulation tests) revealed panhypopituitarism. The EC-NMR showed a bulky intrasellar lesion extending into the suprasellar and right parasellar regions, with evidence of optic chiasm compression, erosion of the floor of the sella and cavernous sinus invasion. Campimetry showed a bitemporal hemianopsia. For the purposes of chiasmatic decompression and histological study of the lesion the patient underwent a right frontal craniotomy, with a subtotal resection of the hypophyseal lesion. The histological diagnosis revealed a pituitary adenoma with no immunohistochemical expression. The patient began radiotherapy six months after surgery. Although today's diagnostic tools allow for a high degree of accuracy, hypophyseal lesions still present problems to the endocrinologist as their identification is essential for determining the appropriate treatment. At times the final diagnosis is only achieved after a histological identification of the lesion (biopsy/surgery). It should be noted that the described cases of association between sarcoidosis and hypophyseal adenoma are very rare, making the differential diagnosis with neurosarcoidosis difficult--a condition which has a preferential medical approach and a different prognosis.

Adenoma↗
PubMed2005

[Autoimmune thyroid disease: a case report].

Autoimmune thyroid disease is the most common cause of subclinical thyroid dysfunction (hypo and hyperthyroidism) in the western countries. Autoimmune thyroid diseases with clinical relevance (Graves' disease and autoimmune hypothyroidism) are common and can present with a large clinical and laboratorial spectrum. Hypo and hyperthyroidism can exist in the same patient, on different times. Progression from Graves hyperthyroidism to chronic autoimmune thyroiditis and hypothyroidism is now well-recognized and the inverse might also occur, although being rare. We describe a case report of Graves' disease in a patient with a chronic autoimmune hypothyroidism of long course (diagnosed 21 years ago).

Aged↗
PubMed2005

[A rare case of malabsorption of thyroid hormones].

We describe the case of a 22-year old male undergoing a total thyroidectomy for euthyroid multi-nodular goitre (TSH: 1.6 microUI/ml). He was discharged treated with LT4 100 mg id. After discharge, he went into full clinical and laboratorial hypothyroidism (TSH = 396 microUI/mL). We were able to rule out failure to take the medication and concomitant use of drugs. In the evaluation of intestinal absorption, only the D-Xylose test proved to be abnormal. After unsuccessful administration of oral T4 and T3, under close nursing supervision, intramuscular (IM) and subcutaneous (SC) forms of administration of T4 were experimented. While both forms achieved normal levels of thyroid hormones, we opted for IM injection as the patient complained of local pain during SC administration. This seems to be the second case described in which it was necessary to resort to parenteral administration of T4 to achieve clinical and laboratorial euthyroidism.

Absorption↗
PubMed2004

[Assessment of an obesity clinic in a center hospital].

INTRODUCTION: Slight weight losses (5%) are consensually accepted as important in the treatment of obesity today. Some authors also consider that maintaining weight is an indicator of success in the treatment of this condition. OBJECTIVE: Characterisation and assessment of changes in weight in obese patients monitored at an obesity clinic in a hospital endocrinology department. METHODOLOGY: Retrospective analysis of the clinical files of the Endocrinology Clinic. The patients included were overweight adults (BMI = 25 kg/m2) who had been monitored since 1999 and were not suffering from thyroid dysfunction or hypercortisolism. Data were gathered on bio-demographic and anthropometric characteristics, reason for consultation, type of treatment, results achieved and dropouts. The statistical analysis included calculating central tendency measures and dispersion for the continuous variables and building frequency tables to describe the categorical variables. We used the t-test to compare average values between samples. Frequencies were compared by means of the chi-squared test or Fisher's exact test. The significance level was 5%. RESULTS: We studied 457 patients (60.6% female) with an average age of 53 years (DP +/- 15) and an average BMI of 32.4 +/- 5.1 Kg/m2. 51.9% of the patients came to the clinic because of overweight (n = 237) (Obesity Group-OBG), while the rest did so because of diabetes mellitus (35.4%) or some other disease (12.7%) (Other Cause Group-OCG). A dietary plan was prescribed for 86.1% (OBG) and 81.8% (OCG), drugs for 16.9% (OBG) and 6.4% (OCG) and physical activity for 77.6% (OBG) and 77.7% (OCG). The average weight loss was 2.1% in the OBG. The individuals who dropped out of the clinic had lost less weight (1.3% vs. 2.9%), although the difference was not significant. More than half (57.7%) of the individuals studied lost weight, 14.4% remained the same and 27.8% gained weight. CONCLUSIONS: 1) Only 50% of overweight patients come to our department to lose weight. 2) More than 75% of overweight patients have a prescribed, structured diet plan, regardless of the reason for their first visit. 3) About 75% of patients achieve acceptable objectives (maintaining or losing weight), and 25% of these have lost more than 5% of their initial weight.

Adolescent↗
PubMed2004

[Secular trends of weight in Portugal at the end of the 20th century].

Obesity and the associated mortality and morbidity constitute one of the major problems and challenges for Public Health systems in Western countries. The majority of published studies show a progressive increase of obesity prevalence, that assumes even an higher importance in younger groups. This study aims to assess the trends in height, weight and body mass index (BMI) in young men in Portugal, in the last ten years. We extracted data from military census records of medical inspections 1994-95 (81,363 subjects) and 1998-99 (71,254 subjects). The data included recruitment center, age, weight, height and BMI. The results showed an increase of weight, height and body mass index between 1995 and 1999 (p<0.001). In 1995 the percentage of subjects with a BMI equal or higher than 25 was 15% and in 1999 was 22%. The percentage of subjects with a BMI higher than 30 was 1.4% and 2.3%, respectively. According to these results obesity and overweight prevention programs and therapeutic strategies must continue to be a major issue in health politics.

Adolescent↗
PubMedDate not supplied

[Mature onset diabetes of the young (MODY)].

Maturity-onset diabetes of the young (MODY) is a rare form of juvenile diabetes mellitus, defined by early onset, absence of ketosis, non-insulin-dependent diabetes and autosomal dominant inheritance. Advances in molecular genetic analysis have identified mutations accounting for different MODY subtypes, all of them associated with defects of insulin secretion. We present a case of a nine year-old boy, admitted to our outpatient clinic because of mild and intermittent osmotic symptoms (polyuria, polyphagia and polydipsia) and persistently high values of fasting blood glucose in the last year. He had a family history of diabetes in three consecutive generations compatible with autossomal dominant inheritance. His height was 138.5 cm (90th centile) and his weight was 33.5 Kg (90th centile). General examination was unremarkable, in a prepubertal boy. A standard oral glucose tolerance test was performed. The fasting blood glucose was 118 mg/dl with a two hour value of 160 mg/dl. ICA, IAA and GAD autoantibodies were undetectable. He started on diet therapy, keeping his fasting blood glucose measurements on the upper limits of normal and HbA1c in the normal range. He was diagnosed as having MODY 2 on a clinical basis, as it is not possible to perform molecular analysis of this pathology in Portugal. As MODY is recently thought to account for 2-5% of all cases of type 2 Diabetes Mellitus it is important to consider it as a possible diagnosis in children who present with incidental hyperglycaemia. Molecular genetic testing is very important as it enables us to make a firm diagnosis of MODY, to define a follow up plan and to reassure patients families, once the prognosis is significantly different among the different sub-types of MODY. We emphathize the need of creating national and international reference centres where such testing can be done.

Blood Glucose↗