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Chen TT, Su WC, Liu MI. Patient-centered care in diabetes care-concepts, relationships and practice. World J Diabetes 2024; 15:1417-1429. [DOI: 10.4239/wjd.v15.i7.1417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/11/2024] [Accepted: 05/13/2024] [Indexed: 07/08/2024] Open
Abstract
We still do not have comprehensive knowledge of which framework of patient-centered care (PCC) is appropriate for diabetes care, which elements of PCC are evidence-based, and the mechanism by which PCC elements are associated with outcomes through mediators. In this review, we elaborate on these issues. We found that for diabetes care, PCC elements such as autonomy support (patient individuality), cooperation and collaboration (system-level approach), com-munication and education (behavior change techniques), emotional support (biopsychosocial approach), and family/other involvement and support are critically important. All of these factors are directly associated with different patient outcomes and indirectly associated with outcomes through patient activation. We present the practical implications of these PCC elements.
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Affiliation(s)
- Tsung-Tai Chen
- Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei 24205, Taiwan
| | - Wei-Chih Su
- Department of Gastroenterology, Taipei Tzu-Chi Hospital, New Taipei 23142, Taiwan
| | - Mei-I Liu
- Department of Pediatric Endocrinology, Mackay Children's Hospital, Taipei 10449, Taiwan
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Núñez-Baila MÁ, Gómez-Aragón A, González-López JR. Sociodemographic and Clinical Determinants on Health-Related Quality of Life in Emerging Andalusian Adults with Type 1 Diabetes: A Cross-Sectional Study. J Clin Med 2023; 13:240. [PMID: 38202247 PMCID: PMC10779847 DOI: 10.3390/jcm13010240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/16/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: Having type 1 diabetes during emerging adulthood can impact quality of life due to the challenge of balancing optimal glycemic blood levels with a period of transition and exploration. The purpose of this study was to characterize the quality of life of emerging adults aged 18 to 29 years with type 1 diabetes and to determine the associations between dimensions of Health-Related Quality of Life in type 1 diabetes and sociodemographic and diabetes-related variables. (2) Methods: This cross-sectional descriptive study was conducted in Andalusia, Spain, from October 2021 to July 2022. A total of 362 emerging adults with type 1 diabetes (67.4% women, mean age 22.8 ± 3.4 years) participated. Data were gathered via sociodemographic information form and the ViDa1 scale. Statistical evaluations, encompassing descriptive analyses, t-tests, ANOVA, Pearson correlations, and logistic regression, were conducted using SPSSv26, adhering to STROBE guidelines. (3) Results: Among the participants, 52.1% have a glycosylated hemoglobin level over 7%. Interference with Life is correlated with sex, age, and age at diagnosis, with age being the only predictor. Self-Care is correlated with and predicted by glycosylated hemoglobin levels. Well-being is correlated with and predicted by sex, Body Mass Index, and glycosylated hemoglobin levels. Concern about the Condition is correlated with and predicted by sex and glycosylated hemoglobin levels. (4) Conclusions: Despite concerns about their disease, participants generally maintain optimal levels of Health-Related Quality of Life in type 1 diabetes. Predictive factors for Health-Related Quality of Life in type 1 diabetes in this group include sex, age, Body Mass Index, and glycosylated hemoglobin.
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Affiliation(s)
| | - Anjhara Gómez-Aragón
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Seville, Spain; (M.-Á.N.-B.); (J.R.G.-L.)
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Alobaid AM, Zulyniak MA, Ajjan RA, Brož J, Hopkins M, Campbell MD. Barriers to Exercise in Adults With Type 1 Diabetes and Insulin Resistance. Can J Diabetes 2023; 47:503-508. [PMID: 37121543 DOI: 10.1016/j.jcjd.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/05/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVE Our aim in this study was to assess attitudes toward exercise and quality of life (QoL) in adults with type 1 diabetes (T1D) with and without insulin resistance (IR). METHODS We pooled baseline pretreatment data from a subset of individuals with T1D from 2 randomized controlled trials. Estimated glucose disposal rate (eGDR), a validated surrogate marker of IR, was calculated using an established formula to classify individuals according to IR status with a cutpoint of <6 mg/kg/min for the determination of IR. Self-reported barriers to exercise were obtained using a validated questionnaire, the Barriers to Physical Activity in T1D (BAPAD-1). In addition, QoL was determined using the 36-item Short Form (SF-36) questionnaire. Differences between dichotomized variables were assessed using the independent t test, Mann-Whitney U test, or Fisher exact test. Linear regression was employed to explore the association of eGDR with BAPAD-1 and QoL scores, with sequential adjustment for potential confounders. RESULTS Of the 85 individuals included in our study, 39 were classified as having IR. The mean BAPAD-1 total score was higher for individuals with IR (IR: 3.87±0.61; non-IR: 2.83±0.55; p<0.001). The highest exercise barrier scores for individuals with IR were risk of hypoglycemia (5.67±1.26) and risk of hyperglycemia (5.23±1.20), whereas the highest scoring exercise barrier scores for non-IR individuals were not diabetes-related, with low level of fitness (3.91±1.26) and physical health status, excluding diabetes (3.67±1.48), ranked highest. QoL scores were comparable between groups (p>0.05). CONCLUSIONS Risk of hypoglycemia was the greatest barrier to exercise in individuals with T1D with IR, whereas non-diabetes-related barriers to exercise were more salient in individuals with T1D without IR.
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Affiliation(s)
- Anwar M Alobaid
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom; Ministry of Health, Farwaniya Hospital, Kuwait City, Kuwait
| | - Michael A Zulyniak
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Ramzi A Ajjan
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Jan Brož
- Department of Internal Medicine, Second Medical Faculty, Charles University, Prague, Czech Republic
| | - Mark Hopkins
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Matthew D Campbell
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom; School of Nursing and Health Sciences, University of Sunderland, Sunderland, United Kingdom; Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom.
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Alhaddad JA, Alshakes NA, Aljasim MN. Quality of Life Among Children With Type 1 Diabetes Mellitus in Alahsa: A Cross-Sectional Study. Cureus 2023; 15:e40766. [PMID: 37485197 PMCID: PMC10362093 DOI: 10.7759/cureus.40766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is the most common endocrine disease in children, and its annual prevalence is increasing worldwide. Health-related quality of life (HRQoL) is a crucial indicator of chronic illnesses such as DM. This study aimed to assess the HRQoL and determine the associated factors among children and adolescents with type 1 DM in Alahsa region in 2022. METHODS An analytical cross-sectional study was conducted in the DiabeterSA center using the Arabic version of the Pediatric Quality of Life Inventory (PedsQl 3.2). All patients aged 5-16 years and diagnosed with type 1 DM were included in the study. Face-to-face interviews were conducted during the patients' routine visits to the outpatient clinic from September 2022 to January 2023. RESULT A total of 254 children aged 5-16 years (mean age: 10.87 ± 2.89 years) were recruited. The mean HRQoL total score reported by the children and adolescents was 72.61 ± 15.36. Older age, higher family socioeconomic status, excellent school performance, and higher parental education level, particularly in mothers, were significantly associated with higher total HRQoL scores. In the regression analysis, male sex (β = -0.157,P = 0.018), older age (β = 0.246, P <0.001), and excellent school performance (β = -0.290, P < 0.001) were identified as independent predictors of the HRQoL total score. Nearly 19% of the participants achieved glycemic control. CONCLUSION The quality of life of children and adolescents with type 1 DM in Alahsa region was relatively good. Increased age, good family economic status, and higher parent education levels positively influenced the participants' quality of life. Therefore, regular evaluation of HRQoL is recommended for children and adolescents with type 1 DM to identify problems and initiate an appropriate intervention for improving child health and the health care system.
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Affiliation(s)
- Jumanah A Alhaddad
- Joint Residency Program Preventive Medicine, Al-Ahsa Health Cluster, Ministry of Health, Alahsa, SAU
| | - Nariman A Alshakes
- Model of Care, Rural Health Network, First Eastern Cluster, Ministry of Health, Alahsa, SAU
| | - Majdi N Aljasim
- Research and Public Health Unit, Department of Preventive Medicine, Al-Ahsa Health Cluster, Ministry of Health, Alahsa, SAU
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Hatzir L, Tuval-Mashiach R, Pinhas-Hamiel O, Silberg T. Good Health Practices and Well-Being among Adolescents with Type-1 Diabetes: A Cross-Sectional Study Examining the Role of Satisfaction and Frustration of Basic Psychological Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1688. [PMID: 36767047 PMCID: PMC9914057 DOI: 10.3390/ijerph20031688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/08/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Abstract
Type 1 diabetes (T1D) is a chronic disease requiring medical adherence. However, among adolescents, non-adherence rates may reach up to 75%. Satisfaction or frustration with psychological needs is a crucial factor in the motivation and management of health-related behaviors. This study aimed to examine the differences in good health practices and psychological and physical well-being among adolescents with and without T1D and the mediating role of satisfaction and frustration of psychological needs on the association between good health practices and well-being in this population. A total of 94 adolescents (42 with T1D, 52 healthy controls, mean age 14.83 ± 1.82 years) completed questionnaires assessing good health practices, satisfaction or frustration of psychological needs, and well-being. Adolescents with T1D reported lower levels of physical well-being compared to healthy controls. Satisfaction or frustration of psychological needs had an effect on good health practices and psychological and physical well-being among healthy controls. Among adolescents with T1D, satisfaction or frustration of psychological needs was related to psychological well-being and partially related to physical well-being, but not to good health practices. The results demonstrate that the satisfaction or frustration of psychological needs has a unique effect on health behaviors and well-being among adolescents with T1D. This calls for further examination of the underlying mechanisms involved in health-related behaviors and well-being among adolescents with T1D.
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Affiliation(s)
- Lika Hatzir
- Department of Psychology, Bar-Ilan University, Ramat-Gan 52900, Israel
| | | | - Orit Pinhas-Hamiel
- Pediatric Endocrinology and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv 69978, Israel
| | - Tamar Silberg
- Department of Psychology, Bar-Ilan University, Ramat-Gan 52900, Israel
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Ramat-Gan 52621, Israel
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Ludvigsson J, Edna M, Ramaiya K. Type 1 diabetes in low and middle-income countries - Tanzania a streak of hope. Front Endocrinol (Lausanne) 2023; 14:1043370. [PMID: 37033222 PMCID: PMC10080134 DOI: 10.3389/fendo.2023.1043370] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
INTRODUCTION In several of the Low and Middle Income countries , many patients with Type 1 diabetes (T1D) are most probably not diagnosed at all which may contribute to their low incidence. As an example of a country with low income and poor resources, we have chosen to study T1D in children/young people in Tanzania. METHODS Analyses of casebooks and statistics at several Tanzanian hospitals treating young patients with insulin dependent diabetes, usually Type 1 diabetes, and collection of information from different organisations such a Tanzanian Diabetes Association, Life for a Child, Changing Diabetes in Children and World Diabetes Foundation. RESULTS The incidence in several areas is low. However, a lot of data are often missing at studied clinics and therefore the incidence might be higher, and with increased awareness in recent years the number of patients has increased many-folds. Most patients present with typical symptoms and signs of T1D, and a high proportion with plausible ketoacidosis , although this proportion has decreased from about 90% to about 40% in recent decades. Many patients have poor blood glucose control, and complications often develop already after short diabetes duration. In recent years resources have increased, awareness has increased and diabetes clinics started where staff has got training. CONCLUSIONS There are problems with diabetes care in Tanzania but several facts give hope for the future.
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Affiliation(s)
- Johnny Ludvigsson
- Crown Princess Victoria Children's Hospital and Division of Pediatrics, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- *Correspondence: Johnny Ludvigsson,
| | - Majaliwa Edna
- Department of Pediatrics and Child Health, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Kaushik Ramaiya
- Hindu Mandal Hospital, Dar es Salaam, Tanzania
- Tanzanian Diabetes Association, Dar es Salaam, Tanzania
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Raicevic M, Obradovic A, Samardzic M, Raicevic M, Curovic Popovic N, Panic Zaric S. Quality of Life of Elementary School Students with Type 1 Diabetes in a Developing Country during the COVID Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14873. [PMID: 36429590 PMCID: PMC9690466 DOI: 10.3390/ijerph192214873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
Type 1 diabetes (T1D) is a condition that affects all aspects of life, and thus is closely related to the quality of life itself. Dealing with it during the COVID-19 pandemic is a big challenge. A case-control study conducted in Montenegro at the end of 2021 included 87 elementary school students with T1D and 248 of their peers as controls matched by gender. Standardized questionnaires were distributed to participants (Peds-QL Generic core 4.0 questionnaire for all participants and Peds-QL Diabetes Module 3.2 only for cases). Based on them, the results of obtained scores were measured and compared using non-parametric statistical methods in relation to gender, region and type of household. Children with T1D reported lower quality of life comparing to matching controls with lower scores in almost all domains. Differences in the same domains among patients and their classmates were also observed in the different gender subgroups, environment type subgroups and in the central region. Results of the study provide insights to prioritizing actions for children with diabetes care as well as for public healthcare planning.
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Affiliation(s)
- Maja Raicevic
- Institute for Children’s Diseases, Clinical Centre of Montenegro, 81000 Podgorica, Montenegro
| | | | - Mira Samardzic
- Institute for Children’s Diseases, Clinical Centre of Montenegro, 81000 Podgorica, Montenegro
- Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
| | - Marija Raicevic
- Institute of Public Health of Montenegro, 81000 Podgorica, Montenegro
| | - Natasa Curovic Popovic
- Institute for Children’s Diseases, Clinical Centre of Montenegro, 81000 Podgorica, Montenegro
| | - Sanja Panic Zaric
- Mother and Child Health Care Institute of Serbia “Dr Vukan Cupic”, 11000 Belgrade, Serbia
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Ferraz RS, Santos LCB, da-Silva-Cruz RL, Braga-da-Silva CH, Magalhães L, Ribeiro-dos-Santos A, Vidal A, Vinasco-Sandoval T, Reis-das-Mercês L, Sena-dos-Santos C, Pereira AL, Silva LSD, de Melo FTC, de Souza ACCB, Leal VSG, de Figueiredo PBB, Neto JFA, de Moraes LV, de Lemos GN, de Queiroz NNM, Felício KM, Cavalcante GC, Ribeiro-dos-Santos Â, Felício JS. Global miRNA expression reveals novel nuclear and mitochondrial interactions in Type 1 diabetes mellitus. Front Endocrinol (Lausanne) 2022; 13:1033809. [PMID: 36506063 PMCID: PMC9731375 DOI: 10.3389/fendo.2022.1033809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/03/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Considering the potential role of miRNAs as biomarkers and their interaction with both nuclear and mitochondrial genes, we investigated the miRNA expression profile in type 1 diabetes (T1DM) patients, including the pathways in which they are involved considering both nuclear and mitochondrial functions. METHODS We analyzed samples of T1DM patients and control individuals (normal glucose tolerance) by high throughput miRNA sequencing (miRNome). Next, five miRNAs - hsa-miR-26b-5p, hsa-let-7i-5p, hsa-miR-143-3p, hsa-miR-501-3p and hsa-miR-100-5p - were validated by RT-qPCR. The identification of target genes was extracted from miRTarBase and mitoXplorer database. We also performed receiver operating characteristic (ROC) curves and miRNAs that had an AUC > 0.85 were considered potential biomarkers. RESULTS Overall, 41 miRNAs were differentially expressed in T1DM patients compared to control. Hsa-miR-21-5p had the highest number of predicted target genes and was associated with several pathways, including insulin signaling and apoptosis. 34.1% (14/41) of the differentially expressed miRNAs also targeted mitochondrial genes, and 80.5% (33/41) of them targeted nuclear genes involved in the mitochondrial metabolism. All five validated miRNAs were upregulated in T1DM. Among them, hsa-miR-26b-5p showed AUC>0.85, being suggested as potential biomarker to T1DM. CONCLUSION Our results demonstrated 41 DE miRNAs that had a great accuracy in discriminating T1DM and control group. Furthermore, we demonstrate the influence of these miRNAs on numerous metabolic pathways, including mitochondrial metabolism. Hsa-miR-26b-5p and hsa-miR-21-5p were highlighted in our results, possibly acting on nuclear and mitochondrial dysfunction and, subsequently, T1DM dysregulation.
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Affiliation(s)
- Rafaella Sousa Ferraz
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Para, Belem, PA, Brazil
| | - Lucas Cauê Bezerra Santos
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Para, Belem, PA, Brazil
| | - Rebecca Lais da-Silva-Cruz
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Para, Belem, PA, Brazil
| | - Cintia Helena Braga-da-Silva
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Para, Belem, PA, Brazil
| | - Leandro Magalhães
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Para, Belem, PA, Brazil
| | - Arthur Ribeiro-dos-Santos
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Para, Belem, PA, Brazil
| | - Amanda Vidal
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Para, Belem, PA, Brazil
- Instituto Tecnológico Vale Desenvolvimento Sustentável Vale, Institute of Technology, Belem, PA, Brazil
| | - Tatiana Vinasco-Sandoval
- Laboratoire de Génomique et Radiobiologie de la Kératinopoïèse, Institut de Biologie François Jacob, CEA/DRF/IRCM, Evry, France
| | - Laís Reis-das-Mercês
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Para, Belem, PA, Brazil
| | - Camille Sena-dos-Santos
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Para, Belem, PA, Brazil
| | | | | | - Franciane T. Cunha de Melo
- Endocrinology Research Center, Joao de Barros Barreto University Hospital, Federal University of Para, Belem, PA, Brazil
| | - Ana Carolina C. Braga de Souza
- Endocrinology Research Center, Joao de Barros Barreto University Hospital, Federal University of Para, Belem, PA, Brazil
| | - Valéria S. Galvão Leal
- Endocrinology Research Center, Joao de Barros Barreto University Hospital, Federal University of Para, Belem, PA, Brazil
| | | | - João F. Abrahão Neto
- Endocrinology Research Center, Joao de Barros Barreto University Hospital, Federal University of Para, Belem, PA, Brazil
| | - Lorena Vilhena de Moraes
- Endocrinology Research Center, Joao de Barros Barreto University Hospital, Federal University of Para, Belem, PA, Brazil
| | - Gabriela Nascimento de Lemos
- Endocrinology Research Center, Joao de Barros Barreto University Hospital, Federal University of Para, Belem, PA, Brazil
| | | | - Karem Miléo Felício
- Endocrinology Research Center, Joao de Barros Barreto University Hospital, Federal University of Para, Belem, PA, Brazil
| | - Giovanna C. Cavalcante
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Para, Belem, PA, Brazil
| | - Ândrea Ribeiro-dos-Santos
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Para, Belem, PA, Brazil
- Oncology Research Center, Graduate Program in Oncology and Medical Sciences, Joao de Barros Barreto University Hospital, Federal University of Para, Belem, PA, Brazil
| | - João Soares Felício
- Endocrinology Research Center, Joao de Barros Barreto University Hospital, Federal University of Para, Belem, PA, Brazil
- *Correspondence: João Soares Felício,
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