Multidisciplinary thyroid disease management in The Gambia: Results of a 6-year multinational collaboration
Notice bibliographique
Résumé
Background Thyroid disease remains prevalent in West Africa, with pathogenetic contributions from dietary and genetic factors. Specialist services for the management of thyroid disease were previously unavailable at Serrekunda General Hospital, leaving a considerable unmet need at this large urban referral hospital in The Gambia. This study sought to document clinical characteristics and outcomes among patients attending a multidisciplinary, collaborative, 1-stop clinic offering surgical and medical management of thyroid disease in The Gambia. Methods We retrospectively evaluated demographic, clinical, and outcome data from patients with thyroid disease who were medically or surgically treated from March 2012 through January 2018 by visiting teams representing Medicos en Accion (MEA), a Canadian nonprofit organization. Variables evaluated included history of presenting concern, comorbidities, current medications, thyroid function status, surgical procedure, histopathology, and postoperative outcomes, including surgical complications. Patients were followed up at least biannually; long-term follow-up was defined as ≥1 year after thyroidectomy. A subset of surgical specimens underwent histopathologic analysis. Results A total of 352 patients were assessed (331 female; median age, 36 years). Primary diagnoses included toxic multinodular goitre (MNG, 30.6%), nontoxic MNG (37.5%), solitary nodule (8.6%), and Graves’ disease (13.8%). Hyperthyroidism was present in 49.2% of patients at initial assessments, yet only 28.5% of these patients were on appropriate medical therapy. Hypertension was found in 33.8% of all patients, but less than half (42.9%) of these were on treatment at presentation. Thyroidectomy was performed for 83 patients (23.6%): 35 total thyroidectomies and 48 partial thyroidectomies. At the end of a median follow-up duration of 12 months, all patients were disease-free with reference to their initial surgical indications. Serious postoperative complications occurred in 2 patients, both of whom recovered fully with no long-term sequelae. Conclusions This study demonstrated the feasibility of establishing a multidisciplinary thyroid clinic in a low-resource setting, leading to improved access to care and public awareness of thyroid disease, as evidenced by the annual increase in patients managed through the study period at Serrekunda General Hospital. These results provide previously unavailable evidence on the profile of thyroid disease in The Gambia.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».