Abstract
Chronic non-communicable diseases represent the greatest burden of health in industrialized countries and a rapidly growing problem in underdeveloped countries. The poorest countries are the most affected, since 80% of deaths from chronic diseases occur in low and middle income countries where most of the world's population lives. Approximately 1,200 million people in the world live in extreme poverty. This group is less healthy and has greater exposure to risks than economically favored groups. Even in high-income countries, those who suffer from poverty are more vulnerable to chronic diseases. Poor people often fall into a vicious circle of poverty and poor health. The relationship between chronic disease and poverty is bi-directional: there is a path from poverty to chronic health problems, and another in the opposite direction. The loss of income, the costs of treatment and marginalization due to chronic health problems adversely affect the economic status of those with chronic diseases
Highlights
11 SW Congenital adrenal hyperplasia (CAH) had adrenomedullary disfunction characterized by undetectable urine epinephrine, and interestingly, had >8 adrenal crises during infanthood
There were no significant differences in hydrocortisone (16.08 ± 3.4 mg/m2/day vs 16.98 ± 5.01 mg/m2/day) and 9fluorohydroxortisone (0.072 ± 0.06 mg/m2/day vs 0,101 ± 0.12 mg/m2 /day) doses, the mean value of 17-OHP (0.04 ng/ml (0.1-1.3) vs 26.7 ng/ml (0.1-79)); ATCH (45pg/ml (30.9-122)vs 71 pg/ml (34-271)), aldosterone (50 pg/ml (50-50) vs 50 pg/ml (50-244)), and androstenedione (0 ng/ml (0-0,4) vs 2,6 ng/ml (0-5.3)) was lower in patients with undetectable urine epinephrine
Congenital adrenal hyperplasia (CAH) defines a group of congenital diseases in which an error occurs in suprarenal steroidogenesis
Summary
Congenital adrenal hyperplasia (CAH) defines a group of congenital diseases in which an error occurs in suprarenal steroidogenesis. Patients with the more severe forms of this disease present adrenal cortex dysfunction and medullary dysfunction, with reduced catecholamine production [4]. This condition is due to the fact that the cortex and medulla are intimately related, ontogenically, anatomically and functionally, interacting and regulating their respective functions. This intimate relationship begins at the foetal stage. Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is characterized by impairment in normal steroid production. Analytical and genotypic characteristics and the therapeutic needs of patients with and without adrenomedullary disfunction
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