BackgroundIn Qatar, as with other countries, non-communicable diseases (NCDs) have been the leading cause of death. This study aims to describe the prevalence of four NCDs clusters (cardiovascular diseases (coronary heart disease, stroke and peripheral vascular disease), cancers, chronic obstructive pulmonary diseases (COPD) and type 2 diabetes (T2DM)) by age, gender and nationality (Qataris and non-Qataris) accessing publicly funded primary care services to inform healthcare planning and strategies.MethodsCross-sectional study design was used. Data for individuals aged ≥18 and who visited a publicly funded primary health centre in Qatar during 2017 were extracted from electronic medical records and analysed.ResultsThe findings showed that approximately 16.2 % of the study population (N = 68 421) had one or more of the four NCDs. The prevalence of NCDs showed an increasing trend with increasing age. Highest increases in the prevalence of NCDs were seen in a relatively young age group (30–49 years). The prevalence of all NCDs except cancers was higher in men. Prevalence rates of CHD and cancers in the study were found to be similar in both Qataris and non-Qataris; however, COPD and T2DM rates were higher in Qataris compared with non-Qataris. T2DM accounted for the highest prevalence of any NCD among both Qataris (230/1000) and non-Qataris (183/1000).ConclusionsAlthough not comprehensive and nationally representative, this study is suggestive of a higher prevalence of NCDs among a younger population, men and in Qatari, Western Asian, Southern Asian, Sub-Saharan Africans, South-Eastern Asians Northern African and Western European nationalities. Prevention, treatment and control of NCDs and their risk factors are a public health problem in Qatar, and resources need to be invested towards targeted interventions with a multisectoral approach.
Adrenal masses discovered incidentally during imaging studies - adrenal incidentalomas (AIs) - are common and prompt investigations to exclude secretory lesions and malignancy. Their best management strategy is unknown. Our objectives were to identify all outcomes of AI investigation in a UK centre and to assess the performance of the 2 mg low dose (LDDST) and 1 mg overnight dexamethasone (ODST) suppression tests in this setting. Out of 125 patients referred to our centre between 2005 and 2009 with AIs, 16 (12.8%) were diagnosed with secretory adrenal adenomas. 24 patients (23%) failed to suppress on LDDST or ODST using a serum cortisol cut-off of 50 nmol/l for both tests; in 12 this was due to false positive results. 5 patients were diagnosed with adrenal Cushing's syndrome and 7 with subclinical hypercortisolism. The use of a higher post LDDST (83 nmol/l) or ODST (138 nmol/l) cortisol cut-off would have resulted in missing 1 patient with Cushing's syndrome and 4 with subclinical hypercortisolism or 2 patients with Cushing's syndrome and 1 with subclinical hypercortisolism, respectively. In patients who had both tests, the ODST systematically resulted in higher post-test cortisol values compared with the LDDST. The adenoma diameter correlated with and was predictive of the post LDDST cortisol. Our results indicate that altering the post dexamethasone cut-off in accordance to published guidelines changes the performance of the suppression tests. The ODST may result in higher post-test cortisol levels compared to LDDST when used in patients with AIs.
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