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Alwan H, Ribero VA, Efthimiou O, Del Giovane C, Rodondi N, Duntas L. A systematic review and meta-analysis investigating the relationship between metabolic syndrome and the incidence of thyroid diseases. Endocrine 2024; 84:320-327. [PMID: 37688711 PMCID: PMC11076217 DOI: 10.1007/s12020-023-03503-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/19/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE To assess the prospective association between metabolic syndrome (MetS), its components, and incidence of thyroid disorders by conducting a systematic review and meta-analysis. METHODS A systematic search was performed in Ovid Medline, Embase.com, and Cochrane CENTRAL from inception to February 22, 2023. Publications from prospective studies were included if they provided data on baseline MetS status or one of its components and assessed the incidence of thyroid disorders over time. A random effects meta-analysis was conducted to calculate the odds ratio (OR) for developing thyroid disorders. RESULTS After full-text screening of 2927 articles, seven studies met our inclusion criteria. Two of these studies assessed MetS as an exposure (N = 71,727) and were included in our meta-analysis. The association between MetS at baseline and incidence of overt hypothyroidism at follow-up yielded an OR of 0.78 (95% confidence interval [CI]: 0.52-1.16 for two studies, I2 = 0%). Pooled analysis was not possible for subclinical hypothyroidism, due to large heterogeneity (I2 = 92.3%), nor for hyperthyroidism, as only one study assessed this association. We found evidence of an increased risk of overt (RR: 3.10 (1.56-4.64, I2 = 0%) and subclinical hypothyroidism (RR 1.50 (1.05-1.94), I2 = 0%) in individuals with obesity at baseline. There was a lower odds of developing overt hyperthyroidism in individuals with prediabetes at baseline (OR: 0.68 (0.47-0.98), I2 = 0%). CONCLUSIONS We were unable to draw firm conclusions regarding the association between MetS and the incidence of thyroid disorders due to the limited number of available studies and the presence of important heterogeneity in reporting results. However, we did find an association between obesity at baseline and incidence of overt and subclinical hypothyroidism.
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Affiliation(s)
- Heba Alwan
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
- Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.
| | - Valerie Aponte Ribero
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Orestis Efthimiou
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Cinzia Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Leonidas Duntas
- Thyroid Section, Unit of Endocrinology, Diabetes and Metabolism, Evgenideion Hospital, National and Kapodistrian University of Athens, PC 11528, Athens, Greece
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Di Stefano V, Iacono S, Militello M, Leone O, Rispoli MG, Ferri L, Ajdinaj P, Lanza P, Lupica A, Crescimanno G, Monastero R, Di Muzio A, Brighina F. Comorbidity in myasthenia gravis: multicentric, hospital-based, and controlled study of 178 Italian patients. Neurol Sci 2024:10.1007/s10072-024-07368-0. [PMID: 38383750 DOI: 10.1007/s10072-024-07368-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/27/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Myasthenia gravis (MG) is an autoimmune disorder with fluctuating weakness that causes significant disability and morbidity. Comorbidities may influence the course of MG, particularly in specific subgroups. The aim of this study is to investigate the frequency of comorbidities in MG patients compared to healthy controls (HC) and to evaluate their distribution according to age at disease onset, sex, and disease severity. METHODS MG patients attending the University Hospital "Paolo Giaccone" in Palermo and "SS Annunziata" Hospital in Chieti were enrolled; HC were enrolled from the general population. Non-parametric statistics and logistic regression were used to assess the association of specific comorbidities according to age at disease onset, sex, disease subtypes, and severity of the disease. RESULTS A total of 356 subjects were included in the study: 178 MG patients (46% F; median age 60 years [51-71]) and 178 sex- and age-matched HC (46% F, median age 59 years [50-66]). Overall, 86% of MG patients and 76% of HC suffered from comorbidities, and MG patients had a higher number of comorbidities compared to HC. Patients with late-onset suffered from more comorbidities than those with early-onset MG. Hypertension was more common in male patients with MG, while thymic hyperplasia, osteoporosis, and autoimmune diseases were more common in females. Respiratory disorders and thymoma were more common in patients with more severe disease (p < 0.05 for all comparisons). CONCLUSION MG patients, particularly those with late onset, showed a higher prevalence of comorbidities than HC. Assessment of comorbidities in MG is an essential issue to identify the appropriate treatment and achieve the best management.
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Affiliation(s)
- Vincenzo Di Stefano
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy
| | - Salvatore Iacono
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy
| | - Massimiliano Militello
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy
| | - Olga Leone
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy
| | | | - Laura Ferri
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Paola Ajdinaj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Placido Lanza
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy
| | - Antonino Lupica
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy
| | - Grazia Crescimanno
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Palermo, Italy
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy.
| | - Antonio Di Muzio
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy
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Alfaro JM, Manrique R, Santamaría A, Álvarez E, Manes C, Jiménez M. Effects of endocrine disorders on maxillary and mandibular growth in Colombian children and adolescents: a cross-sectional study. Eur Arch Paediatr Dent 2024; 25:17-25. [PMID: 37999852 PMCID: PMC10942899 DOI: 10.1007/s40368-023-00850-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 09/15/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To establish the influence of overweight/obesity, medicated hypothyroidism, and medicated non-syndromic hypogrowth on maxillary and mandibular growth. MATERIALS AND METHODS The relation between 10 craniofacial anthropometric measurements and hypothyroidism (n = 216), overweight/obesity (n = 108), and non-syndromic hypogrowth (n = 250) were evaluated in patients aged 1-19 years and a control group of healthy patients (n = 587). A subgroup analysis was performed at the peak growth in all groups. RESULTS Patients with overweight/obesity and hypothyroidism showed increased craniofacial growth, while hypogrowth patients showed differences in zygomatic width and nasal base growth. Females with hypothyroidism and non-syndromic hypogrowth showed decreased head circumference at peak growth. Several anthropometric measurements were increased in patients with overweight/obesity, including head circumference. When all age groups were analyzed, overweight/obese and hypothyroidism patients showed increased zygomatic width while decreased hypogrowth. Overall, most craniofacial anthropometric measurements in overweight/obese patients were increased. Finally, the peak growth in males with hypothyroidism and subjects with non-syndromic hypogrowth was delayed compared to the control group (p < 0.05). CONCLUSIONS Children and adolescents with overweight/obesity and endocrine disorders showed alterations in craniofacial growth. Clinicians must be aware that the growth peak in these patients may be delayed when planning maxillary and mandibular orthopedic treatment.
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Affiliation(s)
- J M Alfaro
- Pediatric Endocrinologist, Pediatric Research Group, Medical School, CES Clinic, Medellín, Colombia
| | - R Manrique
- Epidemiology and Biostatistics Research Group, CES University, Medellín, Colombia
| | - A Santamaría
- LPH Research Group, Dental School, CES University, Medellín, Colombia
| | - E Álvarez
- Head and Neck Bioengineering Research Group, Dental School, CES University, Medellín, Colombia
| | - C Manes
- Master's Degree in Dental Sciences, CES University, Medellín, Colombia
| | - M Jiménez
- Master's Degree in Dental Sciences, CES University, Medellín, Colombia.
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Gong B, Wang Y, Zhang JA, Zhang Q, Zhao J, Li J, Wang X, Han Y, Yu Z, Zhang C, Peng B, Xing Y, Li Q, Wang P, Li Y, Teng W, Shan Z. Effects of altitude on thyroid disorders according to Chinese three-rung, ladder-like topography: national cross-sectional study. BMC Public Health 2024; 24:26. [PMID: 38167020 PMCID: PMC10762831 DOI: 10.1186/s12889-023-17569-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Chinese topography appears a three-rung ladder-like distribution of decreasing elevation from northwest to southeast, which is divided by two sloping edges. Previous studies have reported that prevalence of thyroid diseases differed by altitude, and geographical factors were associated with thyroid disorders. To explore the association between three-rung ladder-like regions and thyroid disorders according to unique Chinese topographic features, we conducted an epidemiological cross-sectional study from 2015-2017 that covered all 31 mainland Chinese provinces. METHODS A total of 78,470 participants aged ≥ 18 years from a nationally representative cross-sectional study were included. Serum thyroid peroxidase antibody, thyroglobulin antibody, and thyroid-stimulating hormone levels; urine iodine concentration; and thyroid volume were measured. The three-rung ladder-like distribution of decreasing elevation from northwest to southeast in China was categorized into three topographic groups according to elevation: first ladder, > 3000 m above sea level; second ladder, descending from 3000-500 m; and third ladder, descending from 500 m to sea level. The third ladder was further divided into groups A (500-100 m) and B (< 100 m). Associations between geographic factors and thyroid disorders were assessed using linear and binary logistic regression analyses. RESULTS Participants in the first ladder group were associated with lower thyroid peroxidase (β = -4.69; P = 0.00), thyroglobulin antibody levels (β = -11.08; P = 0.01), and the largest thyroid volume (β = 1.74; P = 0.00), compared with the other groups. The second ladder group was associated with autoimmune thyroiditis (odds ratio = 1.30, 95% confidence interval [1.18-1.43]) and subclinical hypothyroidism (odds ratio = 0.61, 95%confidence interval [0.57-0.66]) (P < 0.05) compared with the first ladder group. Group A (third ladder) (500-100 m) was associated with thyroid nodules and subclinical hypothyroidism (P < 0.05). Furthermore, group B (< 100 m) was positively associated with autoimmune thyroiditis, thyroid peroxidase and thyroglobulin antibody positivity, and negatively associated with overt hypothyroidism, subclinical hypothyroidism, and goiter compared with the first ladder group(P < 0.05). CONCLUSION We are the first to investigate the association between different ladder regions and thyroid disorders according to unique Chinese topographic features. The prevalence of thyroid disorders varied among the three-rung ladder-like topography groups in China, with the exception of overt hyperthyroidism.
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Affiliation(s)
- Boshen Gong
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Youmin Wang
- Department of Endocrinology, The First People's Hospital of An-Hui Medical University, Hefei, Anhui, 230000, P. R. China
| | - Jin-An Zhang
- Department of Endocrinology, Shanghai University of Medicine & Health Science Affiliated Zhoupu Hospital, Shanghai, 201318, P. R. China
| | - Qiao Zhang
- Department of Endocrinology and Metabolism, Guiqian International General Hospital, Guiyang, Guizhou, 550004, P. R. China
| | - Jiajun Zhao
- Department of Endocrinology, Hospital Affiliated With Shandong University, Jinan, Shandong, 250012, P. R. China
| | - Jiashu Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Xichang Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yutong Han
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Ziwei Yu
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Chenyu Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Bingcong Peng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yumin Xing
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Qiuxian Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Ping Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yongze Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China.
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China.
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Ashrafi S, Hatami H, Bidhendi-Yarandi R, Panahi MH. The prevalence of thyroid disorders in COVID-19 patients: a systematic review and meta-analysis. BMC Endocr Disord 2024; 24:5. [PMID: 38166835 PMCID: PMC10759498 DOI: 10.1186/s12902-023-01534-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES To conduct a systematic review and meta-analysis to evaluate the prevalence of thyroid disorders in COVID-19 patients. DATA SOURCES Scopus, PubMed, ISI Web of Science, and Google Scholar databases were used in this review. We also consider the results of grey literature. STUDY SELECTIONS Cohort, cross-sectional, and case-control studies were included. DATA EXTRACTION AND SYNTHESIS The required data were extracted by the first author of the article and reviewed by the second author. The Pooled prevalence of outcomes of interest was applied using the meta-prop method with a pooled estimate after Freeman-Tukey Double Arcsine Transformation to stabilize the variances. OUTCOMES AND MEASURED The different thyroid disorders were the main outcomes of this study. The diseases include non-thyroidal illness syndrome, thyrotoxicosis, hypothyroidism, isolated elevated free T4, and isolated low free T4. RESULTS Eight articles were included in our meta-analysis(Total participants: 1654). The pooled prevalence of events hypothyroidism, isolated elevated FT4, isolated low FT4, NTIS, and thyrotoxicosis were estimated (Pooled P = 3%, 95% CI:2-5%, I2: 78%), (Pooled P = 2%, 95% CI: 0-4%, I2: 66%), (Pooled P = 1%, 95% CI: 0-1%, I2: 0%), (Pooled P = 26%, 95% CI: 10-42%, I2: 98%), and (Pooled P = 10%, 95% CI: 4-16%, I2: 89%), respectively. CONCLUSION Thyroid dysfunction is common in COVID-19 patients, with a high prevalence of non-thyroidal illness syndrome (NTIS) and thyrotoxicosis. Our meta-analysis found a 26% prevalence of NTIS and a 10% prevalence of thyrotoxicosis. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022312601.
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Affiliation(s)
- Sadra Ashrafi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Hatami
- Department of Public Health, School of Public Health & Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Razieh Bidhendi-Yarandi
- Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Hossein Panahi
- Safety Promotion and Injury Prevention Research Center, Research Institute for Health Sciences and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Kollerits E, Zsila Á, Matuszka B. Quality of life, social support, and adherence in female patients with thyroid disorders. BMC Womens Health 2023; 23:567. [PMID: 37919706 PMCID: PMC10623692 DOI: 10.1186/s12905-023-02718-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 10/17/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND According to the 2010 European Health Interview Survey, 51% of women in Hungary have a chronic disease, and is among the poorest quartile in the EU countries. Thyroid diseases affected more than 650,000 women in 2021 based on a recent report by the Hungarian Central Statistical Office. Despite the high prevalence rates, quality of life in these patients is scarcely researched in Hungary. To fill this gap, this study aims to explore the associations of the quality of life of thyroid patients in Hungary with social support and adherence. METHODS A cross-sectional study was conducted via an online questionnaire. Data from 885 female Hungarian thyroid patients with pharmacological treatment (M = 35.6 years, SD = 10.7, age range: 18-73 years) were analyzed. Participants were divided into two patient groups based on the type of thyroid disorder: hypothyroidism (n = 824; 93.1%) and hyperthyroidism (n = 61; 6.9%). Group comparisons, correlations, and a mediation model were performed to explore differences between thyroid patients. RESULTS No differences were found between patients with different types of thyroid disorders in quality of life, adherence, and social support. Consistent, weak associations were found between quality of life and social support in both patient groups. Higher perceived social support partially explained the relationship between adherence and life quality in thyroid patients. CONCLUSIONS: No substantial differences were found between patients with different types of thyroid disease in mental well-being indicators. These patients are psychologically more vulnerable and need a socially supportive environment to recover, because higher adherence is associated with a better quality of life, and social support can facilitate this process.
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Affiliation(s)
- Eliza Kollerits
- ELTE Doctoral School of Psychology, Kazinczy u. 23-27, Budapest, 1075, Hungary.
- ELTE Institute of Psychology, Kazinczy u. 23-27, Budapest, 1075, Hungary.
- Institute of Psychology, Pázmány Péter Catholic University, Mikszáth Kálmán tér 1., Budapest, 1088, Hungary.
| | - Ágnes Zsila
- ELTE Institute of Psychology, Kazinczy u. 23-27, Budapest, 1075, Hungary
- Institute of Psychology, Pázmány Péter Catholic University, Mikszáth Kálmán tér 1., Budapest, 1088, Hungary
| | - Balázs Matuszka
- Institute of Psychology, Pázmány Péter Catholic University, Mikszáth Kálmán tér 1., Budapest, 1088, Hungary
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Singh P, Seth A. Transition of Care of Pediatric Patients with Special Needs to Adult Care Settings: Children with Diabetes Mellitus and Other Endocrine Disorders. Indian J Pediatr 2023; 90:1134-1141. [PMID: 37542570 DOI: 10.1007/s12098-023-04780-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 07/12/2023] [Indexed: 08/07/2023]
Abstract
Childhood onset endocrine disorders need long-term medical, psychological and social management. Over time, many illnesses evolve, while others may witness onset of new complications. Thus, the components of the care change as the child grows into adolescence and then adulthood. The transition of children and adolescents with chronic endocrine disorders to adult care continues to be a major challenge. Pediatric and adult healthcare teams should together design a transitional care plan that is developmentally appropriate and responsive to the needs of young adults. The preparation for transition to adult care should begin early in adolescence and involve both the adolescent and his parents. A structured and planned transitional care bridges the gap between pediatric and adult care teams, promote ongoing engagement and build trust with the new healthcare teams. Combined pediatric-adult care transition model for endocrine conditions has yielded high adherence rates and patient satisfaction.
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Affiliation(s)
- Preeti Singh
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Anju Seth
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India.
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Abstract
Systemic diseases can cause heart block owing to the involvement of the myocardium and thereby the conduction system. Younger patients (<60) with heart block should be evaluated for an underlying systemic disease. These disorders are classified into infiltrative, rheumatologic, endocrine, and hereditary neuromuscular degenerative diseases. Cardiac amyloidosis owing to amyloid fibrils and cardiac sarcoidosis owing to noncaseating granulomas can infiltrate the conduction system leading to heart block. Accelerated atherosclerosis, vasculitis, myocarditis, and interstitial inflammation contribute to heart block in rheumatologic disorders. Myotonic, Becker, and Duchenne muscular dystrophies are neuromuscular diseases involving the myocardium skeletal muscles and can cause heart block.
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Affiliation(s)
- Syed Rafay A Sabzwari
- University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Mail Stop B130, Aurora, CO 80045, USA
| | - Wendy S Tzou
- Cardiac Electrophysiology, University of Colorado Anschutz Medical Campus, 12401 E 17th Avenue, MS B-136, Aurora, CO 80045, USA.
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Kruger EM, Shehata SA, Toraih EA, Abdelghany AA, Fawzy MS. Type 2 diabetes and thyroid cancer: Synergized risk with rising air pollution. World J Diabetes 2023; 14:1037-1048. [PMID: 37547591 PMCID: PMC10401455 DOI: 10.4239/wjd.v14.i7.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/28/2023] [Accepted: 05/30/2023] [Indexed: 07/12/2023] Open
Abstract
Diabetes is a complex condition, and the causes are still not fully understood. However, a growing body of evidence suggests that exposure to air pollution could be linked to an increased risk of diabetes. Specifically, exposure to certain pollutants, such as particulate Matter and Ozone, has been associated with higher rates of diabetes. At the same time, air pollution has also been linked to an increased risk of thyroid cancer. While there is less evidence linking air pollution to thyroid cancer than to diabetes, it is clear that air pollution could have severe implications for thyroid health. Air pollution could increase the risk of diabetes and thyroid cancer through several mechanisms. For example, air pollution could increase inflammation in the body, which is linked to an increased risk of diabetes and thyroid cancer. Air pollution could also increase oxidative stress, which is linked to an increased risk of diabetes and thyroid cancer. Additionally, air pollution could increase the risk of diabetes and thyroid cancer by affecting the endocrine system. This review explores the link between diabetes and air pollution on thyroid cancer. We will discuss the evidence for an association between air pollution exposure and diabetes and thyroid cancer, as well as the potential implications of air pollution for thyroid health. Given the connections between diabetes, air pollution, and thyroid cancer, it is essential to take preventive measures to reduce the risk of developing the condition.
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Affiliation(s)
- Eva M Kruger
- School of Medicine, Tulane University, New Orleans, LA 70112, United States
| | - Shaimaa A Shehata
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Eman A Toraih
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, United States
- Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ahmed A Abdelghany
- Department of Ophthalmology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Manal S Fawzy
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
- Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar 1321, Saudi Arabia
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Mandrioli J, Zucchi E, Martinelli I, Van der Most L, Gianferrari G, Moglia C, Manera U, Solero L, Vasta R, Canosa A, Grassano M, Brunetti M, Mazzini L, De Marchi F, Simonini C, Fini N, Tupler R, Vinceti M, Chiò A, Calvo A. Factors predicting disease progression in C9ORF72 ALS patients. J Neurol 2023; 270:877-90. [PMID: 36280624 DOI: 10.1007/s00415-022-11426-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To unveil clinical features, comorbidities, disease progression and prognostic factors in a population-based cohort of ALS patients carrying C9ORF72 expansion (C9 + ALS). METHODS This is a retrospective observational study on ALS patients residing in Emilia Romagna and Piedmont-Valle D'Aosta regions whose data are available through population based registers. We analysed patients who underwent genetic testing, focusing on C9 + ALS subgroup. RESULTS Among 2204 genotyped patients of the two registers, 150 were C9 + ALS. In comparison with patients without mutation, a higher proportion of family history (12.85 vs 68%, p < 0.001) and frontotemporal dementia (3.93% vs 10.67%, p < 0.001) was detected in C9 + ALS. C9 + ALS presented a faster disease progression as measured by monthly decline in ALS Functional Rating Scale-Revised (1.86 ± 3.30 vs 1.45 ± 2.35, p < 0.01) and in forced vital capacity (5.90 ± 5.24 vs 2.97 ± 3.47, p < 0.01), a shorter diagnostic delay (8.93 ± 6.74 vs 12.68 ± 12.86 months, p < 0.01) and earlier onset (58.91 ± 9.02 vs 65.04 ± 11.55 years, p < 0.01). Consistently, they reached death or tracheostomy earlier than other patients (31 vs 37 months, HR = 1.52, 95% C.I. 1.27-1.82, p < 0.001). With respect to other genotyped patients, C9 + ALS patients did not present a significantly higher prevalence of concomitant diseases. Independent prognostic factors of survival of C9 + ALS included sex, age, progression rate, presence of frontotemporal dementia and thyroid disorders, with the latter being associated with prolonged ALS survival (43 vs 29 months, HR = 0.42, 95% C.I. 0.24-0.74, p = 0.003). CONCLUSION Even in the context of a more aggressive disease, C9 + ALS had a longer survival in presence of thyroid disorders. This finding may suggest protective pathogenic pathways in C9 + ALS to be explored, looking for therapeutic strategies to slow disease course.
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Tayier R, Wang C, Ma P, Yuan Y, Zhang Y, Wu S, Zhang L. Iodine Nutritional Status of Pregnant Women After 14 Years of Lipiodol Supplementation: a Cross-Sectional Study in Historically Iodine-Deficient Areas of China. Biol Trace Elem Res 2023; 201:14-22. [PMID: 35322354 DOI: 10.1007/s12011-022-03123-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/17/2022] [Indexed: 01/11/2023]
Abstract
Southern Xinjiang has a history of serious iodine deficiency. Since 2007, pregnant women in this area have taken iodized salt and oral lipiodol preparations to prevent iodine deficiency disorders. However, the current status of iodine nutrition and thyroid function in this population is unknown. A cross-sectional study was conducted on 555 pregnant women from 5 counties (cities) in southern Xinjiang and 429 pregnant women from 3 counties in northern Xinjiang. The participants were given a questionnaire and serum concentrations of free triiodothyronine (FT3), free thyroxine (FT4), thyrotropic stimulating hormone (TSH), thyroglobulin antibody (Tg-Ab), and thyroid peroxidase antibody (TPO-Ab), and the urine iodine concentration (UIC) was measured. The median UIC and interquartile range [M (IQR)] of the 984 pregnant women in the study was 189.38 (143.15, 288.77) μg/L. Positive Tg-Ab and TPO-Ab titers were detected in 6.74% and 9.55%, 8.30% and 9.84%, and 7.39% and 10.55% in T1, T2, and T3, respectively. The incidence of subclinical hypothyroidism, clinical hypothyroidism, and isolated hypothyroxinemia in pregnant women in areas where lipiodol pills were taken was 4.32%, 0%, and 1.44%, respectively, which was significantly lower than those in areas where lipiodol pills were not taken. The median UIC (IQR) of pregnant women in the two regions was 213.80 (130.44, 331.77) μg/L and 168.30 (155.0, 254.8) μg/L, the UIC of pregnant women who took lipiodol pills was higher than in those who did not take lipiodol pills, and the difference was statistically significant (p < 0.05). According to WHO standards, all pregnant women in southern Xinjiang are in a state of adequate iodine nutrition. Taking lipiodol pills has improved the iodine nutrition level of pregnant women in this area. The results of this study did not find that oral lipiodol pills had adverse effects on pregnant women's thyroid function, but it is necessary to further study the effect of oral lipiodol pills on the offspring.
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Affiliation(s)
- Rishalaiti Tayier
- College of Public Health, Xinjiang Medical University, Urumqi, 830011, Xinjiang, People's Republic of China
| | - Chenchen Wang
- Xinjiang Uighur Autonomous Region Centre for Disease Control and Prevention, Urumqi, 830011, People's Republic of China
| | - Pinjiang Ma
- Xinjiang Uighur Autonomous Region Centre for Disease Control and Prevention, Urumqi, 830011, People's Republic of China
| | - Yimu Yuan
- Xinjiang Production and Construction Corps Hospital, Urumqi, 830011, Xinjiang, People's Republic of China
| | - Yuxia Zhang
- Urumqi Maternal and Child Health Hospital, Urumqi, 830011, Xinjiang, People's Republic of China
| | - Shunhua Wu
- Department of Occupational and Environmental Health, School of Public Health, Xinjiang Medical University, Urumqi, 830001, People's Republic of China.
| | - Ling Zhang
- Xinjiang Uighur Autonomous Region Centre for Disease Control and Prevention, Urumqi, 830011, People's Republic of China.
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Yadav P, Sarode LP, Gaddam RR, Kumar P, Bhatti JS, Khurana A, Navik U. Zebrafish as an emerging tool for drug discovery and development for thyroid diseases. Fish Shellfish Immunol 2022; 130:53-60. [PMID: 36084888 DOI: 10.1016/j.fsi.2022.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 12/06/2022]
Abstract
Zebrafish is a useful model for understanding human genetics and diseases and has evolved into a prominent scientific research model. The genetic structure of zebrafish is 70% identical to that of humans. Its small size, low cost, and transparent embryo make it a valuable tool in experimentation. Zebrafish and mammals possess the same molecular mechanism of thyroid organogenesis and development. Thus, thyroid hormone signaling, embryonic development, thyroid-related disorders, and novel genes involved in early thyroid development can all be studied using zebrafish as a model. Here in this review, we emphasize the evolving role of zebrafish as a possible tool for studying the thyroid gland in the context of physiology and pathology. The transcription factors nkx2.1a, pax2a, and hhex which contribute a pivotal role in the differentiation of thyroid primordium are discussed. Further, we have described the role of zebrafish as a model for thyroid cancer, evaluation of defects in thyroid hormone transport, thyroid hormone (TH) metabolism, and as a screening tool to study thyrotoxins. Hence, the present review highlights the role of zebrafish as a novel approach to understand thyroid development and organogenesis.
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Affiliation(s)
- Poonam Yadav
- Department of Pharmacology, Central University of Punjab, Ghudda, Bathinda, Punjab, India
| | - Lopmudra P Sarode
- Department of Pharmaceutical Sciences, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur, 440033, Maharashtra, India
| | - Ravinder Reddy Gaddam
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, IA, USA
| | - Puneet Kumar
- Department of Pharmacology, Central University of Punjab, Ghudda, Bathinda, Punjab, India
| | - Jasvinder Singh Bhatti
- Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Ghudda, Bathinda, Punjab, India
| | - Amit Khurana
- Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry (IFMPEGKC), RWTH Aachen University Hospital, Pauwelsstr. 30, D-52074, Aachen, Germany.
| | - Umashanker Navik
- Department of Pharmacology, Central University of Punjab, Ghudda, Bathinda, Punjab, India.
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陈 永, 吕 庆, 吴 宇, 徐 师, 万 恒, 钟 莉, 曹 洪, 张 雨, 童 南. [Iodine Nutritional Status and Prevalence of Thyroid Disorders among Adults in Chengdu]. Sichuan Da Xue Xue Bao Yi Xue Ban 2022; 53:649-655. [PMID: 35871736 PMCID: PMC10409461 DOI: 10.12182/20220760505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Indexed: 06/15/2023]
Abstract
Objective To investigate the prevalence of thyroid disorders, iodine nutritional status and relevant risk factors among adults in Chengdu city on the basis of two population-based surveys, one conducted between 2016 and 2017 and the other, between 2019 and 2020, and to provide references for making health-related administrative decisions. Methods Two population-based sampling surveys were conducted. The first one was done between October 2016 and December 2017, using stratified cluster random sampling to select subjects from 2 urban and 2 rural communities in Chengdu. Then, between December 2019 and February 2020, sequential cluster sampling was used to select subjects from communities in the peripheral regions of Longquanyi District, Chengdu. Both surveys covered natural populations of people who were 18 or older and who met the inclusion criteria. In the first survey, questionnaires, physical examination, thyroid ultrasound, and examinations of serum thyroid biochemical markers and urine iodine were performed, while in the second survey, only questionnaire concerning thyroid disorders and physical examination were performed. Statistical analysis of the nutritional status of iodine, the prevalence of thyroid disorders, and potential risk factor was conducted. Results A total of 1859 subjects were enrolled for the first survey and 16152 for the second. According to the results of the first survey, the median urine iodine concentration was 172.10 μg/L, and the group with adequate or more than adequate iodine accounted for more than 60% of the surveyed population. The prevalence of thyroid disorders was found to be 0.48% for overt hyperthyroidism, 0.43% for subclinical hyperthyroidism, 0.43% for Grave's disease, 1.34% for overt hypothyroidism, 16.62% for subclinical hypothyroidism, 16.73% for positive thyroid antibody, 12.96% for TPOAb positive, 10.06% for TGAb positive, 0.81% for goiter, 14.85% for single nodule, 14.42% for multi-nodules, and 29.26% for thyroid nodules. Excess iodine is a risk factor for subclinical hypothyroidism ( OR=1.50, 95% confidence interval [ CI]: 1.07-2.10, P<0.05), and iodine deficiency is a risk factor for multiple thyroid nodules ( OR=1.45, 95% CI: 1.02-2.05, P<0.05). The total prevalence of hyperthyroidism, hypothyroidism and Hashimoto's thyroiditis in the two surveys was 6.58% and 5.95%, respectively, showing no significant difference. The second survey lacked accurate data on thyroid nodules. Conclusion The iodine nutritional status of adults in Chengdu in recent years was appropriate. The total prevalence of hyperthyroidism, hypothyroidism and Hashimoto's thyroiditis remained stable, while that of thyroid nodule increased in recent years. We should continue with the implementation of the universal salt iodization policy and reinforce efforts in monitoring. Furthermore, we should make an active effort to look into the etiology of thyroid nodules.
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Affiliation(s)
- 永连 陈
- 四川大学华西医院 内分泌代谢科 (成都 610041)Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西医院 糖尿病与代谢研究中心 糖尿病与胰岛移植研究室 (成都 610041)Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 庆国 吕
- 四川大学华西医院 内分泌代谢科 (成都 610041)Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西医院 糖尿病与代谢研究中心 糖尿病与胰岛移植研究室 (成都 610041)Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 宇超 吴
- 四川大学华西医院 内分泌代谢科 (成都 610041)Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西医院 糖尿病与代谢研究中心 糖尿病与胰岛移植研究室 (成都 610041)Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 师师 徐
- 四川大学华西医院 内分泌代谢科 (成都 610041)Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西医院 糖尿病与代谢研究中心 糖尿病与胰岛移植研究室 (成都 610041)Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 恒 万
- 四川大学华西医院 内分泌代谢科 (成都 610041)Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 莉 钟
- 四川大学华西医院 内分泌代谢科 (成都 610041)Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 洪义 曹
- 四川大学华西医院 内分泌代谢科 (成都 610041)Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 雨薇 张
- 四川大学华西医院 内分泌代谢科 (成都 610041)Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西医院 糖尿病与代谢研究中心 糖尿病与胰岛移植研究室 (成都 610041)Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 南伟 童
- 四川大学华西医院 内分泌代谢科 (成都 610041)Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西医院 糖尿病与代谢研究中心 糖尿病与胰岛移植研究室 (成都 610041)Laboratory of Diabetes and Islet Transplantation Research, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu 610041, China
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Khaleghzadeh-Ahangar H, Talebi A, Mohseni-Moghaddam P. Thyroid Disorders and Development of Cognitive Impairment: A Review Study. Neuroendocrinology 2022; 112:835-844. [PMID: 34963121 DOI: 10.1159/000521650] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/22/2021] [Indexed: 11/19/2022]
Abstract
Dementia is a neurological disorder that is spreading with increasing human lifespan. In this neurological disorder, memory and cognition are declined and eventually impaired. Various factors can be considered as the background of this disorder, one of which is endocrine disorders. Thyroid hormones are involved in various physiological processes in the body; one of the most important of them is neuromodulation. Thyroid disorders, including hyperthyroidism or hypothyroidism, can affect the nervous system and play a role in the development of dementia. Despite decades of investigation, the nature of the association between thyroid disorders and cognition remains a mystery. Given the enhancing global burden of dementia, the principal purpose of this study was to elucidate the association between thyroid disturbances as a potentially modifiable risk factor of cognitive dysfunction. In this review study, we have tried to collect almost all of the reported mechanisms demonstrating the role of hypothyroidism and hyperthyroidism in the pathogenesis of dementia.
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Affiliation(s)
- Hossein Khaleghzadeh-Ahangar
- Department of Physiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
- Immunoregulation Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Anis Talebi
- Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Parvaneh Mohseni-Moghaddam
- Department of Physiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Abstract
Systemic diseases can cause heart block owing to the involvement of the myocardium and thereby the conduction system. Younger patients (<60) with heart block should be evaluated for an underlying systemic disease. These disorders are classified into infiltrative, rheumatologic, endocrine, and hereditary neuromuscular degenerative diseases. Cardiac amyloidosis owing to amyloid fibrils and cardiac sarcoidosis owing to noncaseating granulomas can infiltrate the conduction system leading to heart block. Accelerated atherosclerosis, vasculitis, myocarditis, and interstitial inflammation contribute to heart block in rheumatologic disorders. Myotonic, Becker, and Duchenne muscular dystrophies are neuromuscular diseases involving the myocardium skeletal muscles and can cause heart block.
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Doustmohammadian S, Doustmohammadian A, Momeni M. Association between thyroid disorders and COVID-19: a protocol for a systematic review and meta-analysis. Thyroid Res 2021; 14:21. [PMID: 34587983 PMCID: PMC8479499 DOI: 10.1186/s13044-021-00113-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/20/2021] [Indexed: 11/29/2022] Open
Abstract
Background The novel coronavirus (COVID-19) epidemic initially appeared in Wuhan, Hubei Province, China, on 31 December 2019 and was spread rapidly worldwide. Most underlying diseases reported with COVID-19 patients are diabetes, hypertension, coronary heart diseases, and cerebrovascular disease. We do not know whether individuals with thyroid disease are at increased risk of COVID-19 infection. Methods Two experienced researchers will conduct an electronic search of the databases including PubMed/MEDLINE, the Cochrane Reviews, and the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, and ProQuest, for articles published since October 2019. Clinical trials and observational studies will be included. Studies will be screened after de-duplication. A standardized data extraction form will be developed through discussions with the review team and will be revised after piloting. An appropriate risk of bias assessment tool will be used to assess the quality of studies. Two independent reviewers will assess the eligibility, extraction of detailed information, and quality assessment of studies. The results will be pooled for meta-analysis, subgroup analysis and/or descriptive analysis based on the included data conditions. Conclusion Results of this study will provide current evidence on the association of COVID-19 diseases with any thyroid disorders such as hypothyroidism, thyrotoxicosis, and thyroid cancer with or without radioiodine therapy. Findings will be disseminated in peer-reviewed publications and conference presentations. Trial registration
PROSPERO registration number: CRD42020184289. https://www.crd.york.ac.uk/PROSPERO/#recordDetails Supplementary Information The online version contains supplementary material available at 10.1186/s13044-021-00113-1.
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Affiliation(s)
| | - Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Behafarin St., Karimkhan Ave., Vali-asr Sq, Tehran, Iran.
| | - Marjan Momeni
- Department of Health Information Technology, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran
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Taheriniya S, Arab A, Hadi A, Fadel A, Askari G. Vitamin D and thyroid disorders: a systematic review and Meta-analysis of observational studies. BMC Endocr Disord 2021; 21:171. [PMID: 34425794 PMCID: PMC8381493 DOI: 10.1186/s12902-021-00831-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 07/30/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The contribution of vitamin D to thyroid disorders has received paramount attention; however, results are mixed. Hence, we designed a systematic review and meta-analysis to obtain a definitive conclusion. METHODS The search included PubMed, ISI Web of Science, Scopus, and Google Scholar databases up to March 2021 to collect available papers reporting the relationship between serum levels of vitamin D and thyroid disorders. The pooled effect was reported as weighted mean difference (WMD) and 95% confidence interval (CI). RESULTS Out of 6123 datasets, 42 were eligible to get into this systematic review and meta-analysis. Serum vitamin D was markedly lower in autoimmune thyroid diseases (AITD) (WMD - 3.1 ng/dl; 95% CI, - 5.57 to - 0.66; P = 0.013; I2 = 99.9%), Hashimoto's thyroiditis (HT) (WMD - 6.05 ng/dl; 95% CI, - 8.35 to - 3.75; P < 0.001; I2 = 91.0%) and hypothyroidism patients (WMD - 13.43 ng/dl; 95% CI, - 26.04 to - 0.81; P = 0.03; I2 = 99.5%), but not in subjects with Graves' disease (GD) (WMD - 4.14 ng/dl; 95% CI, - 8.46 to 0.17; P = 0.06; I2 = 97.5%). CONCLUSIONS Our findings suggested lower vitamin D levels in patients with hypothyroidism, AITD, and HT compared to healthy subjects. However, the link between serum vitamin D and GD was only significant among subjects ≥40 years old.
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Affiliation(s)
- Sorour Taheriniya
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Hadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdulmannan Fadel
- School of Sport and Exercise Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Yadav A, Yadav GAM, Narsingrao KK, Nanda Kumar LG, Yadav GSN. Prevalence of thyroid disorders among patients with diabetes in rural South India. Diabetes Metab Syndr 2021; 15:885-889. [PMID: 33894503 DOI: 10.1016/j.dsx.2021.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND & AIMS Diabetes mellitus (DM) and thyroid disorders are the most common endocrine disorders in clinical practice. Unrecognized thyroid disorders have an adverse effect on metabolic functions. The aim of the study is to demonstrate the prevalence of thyroid disorders in individuals with diabetes mellitus. METHODS A prospective observational study, conducted at Sree Sidhi Vinayaka Diabetic Center, between September 2013 to December 2019. A total of 5037 patients attended the outpatient clinic, among which 2470 met the inclusion criteria. All patients underwent a clinical and laboratory evaluation. RESULTS A total of 2321 individuals with diabetes had consented to be the part of the study, 102 had Type 1 diabetes mellitus (T1DM) and 2219 Type 2 diabetes mellitus (T2DM). The mean age was 48.4 ± 10.7, among which 1128 females and 1193 are males. 79.9% (1853) individuals with diabetes were euthyroid; 13.8% (321) subclinical hypothyroidism; 3.4% (79) clinical hypothyroidism, and 2.9% (68) were having hyperthyroidism. 14.1% of T2DM had subclinical hypothyroidism, in contrast, clinical hypothyroidism was common in T1DM (6.9%). CONCLUSION A high index of suspicion for thyroid dysfunction in diabetics should be considered to screen for thyroid function in them for early detection and effective management of both the conditions.
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Affiliation(s)
- Anurag Yadav
- Department of Biochemistry, MNR Medical College, Sangareddy, MNR Nagar, Sangareddy, Telangana State, 502295, India
| | | | - Karewad Kaveri Narsingrao
- Dept. of Physiology, MNR Medical College, Sangareddy, MNR Nagar, Sangareddy, Telangana State, 502295, India.
| | - L G Nanda Kumar
- Dept. of Physiology, MNR Medical College, Sangareddy, MNR Nagar, Sangareddy, Telangana State, 502295, India.
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Martins JRM, Villagelin DGP, Carvalho GA, Vaisman F, Teixeira PFS, Scheffel RS, Sgarbi JA. Management of thyroid disorders during the COVID-19 outbreak: a position statement from the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM). Arch Endocrinol Metab 2021; 65:368-375. [PMID: 33844898 PMCID: PMC10065338 DOI: 10.20945/2359-3997000000352] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This position statement was prepared to guide endocrinologists on the best approach to managing thyroid disorders during the coronavirus disease (COVID-19) pandemic. The most frequent thyroid hormonal findings in patients with COVID-19, particularly in individuals with severe disease, are similar to those present in the non-thyroidal illness syndrome and require no intervention. Subacute thyroiditis has also been reported during COVID-19 infection. Diagnosis and treatment of hypothyroidism during the COVID-19 pandemic may follow usual practice; however, should avoid frequent laboratory tests in patients with previous controlled disease. Well-controlled hypo and hyperthyroidism are not associated with an increased risk of COVID-19 infection or severity. Newly diagnosed hyperthyroidism during the pandemic should be preferably treated with antithyroid drugs (ATDs), bearing in mind the possibility of rare side effects with these medications, particularly agranulocytosis, which requires immediate intervention. Definitive treatment of hyperthyroidism (radioiodine therapy or surgery) may be considered in those cases that protective protocols can be followed to avoid COVID-19 contamination or once the pandemic is over. In patients with moderate Graves' ophthalmopathy (GO) not at risk of visual loss, glucocorticoids at immunosuppressive doses should be avoided, while in those with severe GO without COVID-19 and at risk of vision loss, intravenous glucocorticoid is the therapeutic choice. Considering that most of the thyroid cancer cases are low risk and associated with an excellent prognosis, surgical procedures could and should be postponed safely during the pandemic period. Additionally, when indicated, radioiodine therapy could also be safely postponed as long as it is possible.
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Affiliation(s)
- João Roberto M Martins
- Departamento de Tireoide, Sociedade Brasileira de Endocrinologia e Metabologia, Rio de Janeiro, RJ, Brasil.,Laboratório de Endocrinologia Molecular e Translacional, Disciplina de Endocrinologia e Metabologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp/EPM), São Paulo, SP, Brasil
| | - Danilo G P Villagelin
- Departamento de Tireoide, Sociedade Brasileira de Endocrinologia e Metabologia, Rio de Janeiro, RJ, Brasil.,Endocrinologia e Metabolismo, Hospital da PUC-Campinas, Campinas, SP, Brasil.,Pós-graduação em Clínica Médica, Unicamp, Campinas, SP, Brasil
| | - Gisah A Carvalho
- Departamento de Tireoide, Sociedade Brasileira de Endocrinologia e Metabologia, Rio de Janeiro, RJ, Brasil.,Departamento de Endocrinologia e Metabologia (SEMPR), Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR),Curitiba, PR, Brasil
| | - Fernanda Vaisman
- Departamento de Tireoide, Sociedade Brasileira de Endocrinologia e Metabologia, Rio de Janeiro, RJ, Brasil.,Unidade de Endocrinologia Oncológica, Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA), Rio de Janeiro, RJ, Brasil
| | - Patrícia F S Teixeira
- Departamento de Tireoide, Sociedade Brasileira de Endocrinologia e Metabologia, Rio de Janeiro, RJ, Brasil.,Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Rafael S Scheffel
- Departamento de Tireoide, Sociedade Brasileira de Endocrinologia e Metabologia, Rio de Janeiro, RJ, Brasil.,Unidade de Tireoide, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - José A Sgarbi
- Departamento de Tireoide, Sociedade Brasileira de Endocrinologia e Metabologia, Rio de Janeiro, RJ, Brasil.,Unidade de Tireoide, Disciplina de Endocrinologia e Metabolismo, Departamento de Medicina, Faculdade de Medicina de Marília, Marília, SP, Brasil,
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20
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Kiran Z, Sheikh A, Islam N. Association of thyroid antibodies status on the outcomes of pregnant women with hypothyroidism (maternal hypothyroidism on pregnancy outcomes, MHPO-4). BMC Pregnancy Childbirth 2021; 21:136. [PMID: 33588796 PMCID: PMC7885223 DOI: 10.1186/s12884-021-03594-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 01/27/2021] [Indexed: 01/19/2023] Open
Abstract
Background Autoimmunity increases with age and is often commonly evaluated in women of the reproductive age group. Prevalence of thyroid antibodies is common even in euthyroid pregnant women. We aim to compare the association of thyroid antibody status on the maternal and neonatal outcomes in pregnant women with hypothyroidism. Methods We conducted a cross-sectional retrospective study on 718 cases in the Aga Khan University Hospital. Information was collected on pregnant women who have been diagnosed with hypothyroidism before conception or during their antenatal period. Laboratory data were recorded for thyroid peroxidase antibodies, anti-thyroglobulin antibodies, and thyroid-stimulating hormone levels. Maternal and neonatal outcomes were also noted from medical file records. Data analysis was performed on Statistical Package for the Social Sciences version 20.0. Results Overall, 146 out 718 cases were included for final analysis. Thyroid peroxidase antibodies were positive in 66.4% and anti-thyroglobulin was positive in 52.1% cases, whereas 43.8% of cases had both antibodies positive. Pre-gestational diabetes was significantly associated with thyroid autoimmunity. There was a 73% less chance of gestational hypertension for thyroid autoimmune groups. Gestational diabetes and maternal (chronic) hypertension were found to have an independent effect on postpartum hemorrhage. Hypertensive disorders in pregnancy were found to have an independent risk for premature birth. Conclusion Our study reports a 74.7% prevalence of positive thyroid antibodies in hypothyroid pregnant women, with higher association with pre-gestational diabetes. Gestational hypertension was least likely to occur in thyroid autoimmune groups. None of the outcomes were independently associated with worse outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03594-y.
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Affiliation(s)
- Zareen Kiran
- Section of Endocrinology, Department of Medicine, The Aga Khan University, P.O. Box 3500, Stadium Road, Karachi, Pakistan.
| | - Aisha Sheikh
- Section of Endocrinology, Department of Medicine, The Aga Khan University, P.O. Box 3500, Stadium Road, Karachi, Pakistan
| | - Najmul Islam
- Section of Endocrinology, Department of Medicine, The Aga Khan University, P.O. Box 3500, Stadium Road, Karachi, Pakistan
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21
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Lisovskaya TV, Dubrovina OS, Treshchilov IM, Senturina LB, Sevostyanova OY, Mayasina EN, Buev YE, Salimov DF. Thyroid disorders and pathospermia in the ART clinic patients. Gynecol Endocrinol 2021; 37:4-7. [PMID: 34937506 DOI: 10.1080/09513590.2021.2006439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE Over the past decade, a decrease in the semen quality in men of reproductive age, along with an increase in the incidence of thyroid diseases among young patients have been clearly noticed. The study was designed to determine various forms of pathospermia in the ART clinic patients with thyroid disorders. MATERIALS AND METHODS 168 men of reproductive age in infertile marriage were examined. Men with male infertility factor associated with erectile dysfunction and normospermia (9 patients, 5.3%) were excluded. The study included 159 men and the patients were divided into three groups: the 1st study group consisted of men with non-obstructive azoospermia - 11 men (6.9%); the 2nd study group included men with other forms of pathospermia - 38 men (23.9%) and the control group consisted of men in infertile marriage with normospermia - 110 men (69.2%). All patients had anthropometric measurements, laboratory tests, thyroid and testicular ultrasonography. Spermogram was analyzed in accordance with the WHO classification, 5th revision, 2010. RESULTS Among all examined men with pathospermia (n = 49 patients), 51.02% had various thyroid disorders, while it was firstly verified in 34.7% men. In 45.5% patients with non-obstructive azoospermia, previously undiagnosed nodular goiter with normal values of thyroid-stimulating hormone and free thyroxine were found, and a significant correlation between nodular goiter and the presence of azoospermia was revealed: r = 0.610, p = .01. CONCLUSION. Men with various forms of pathospermia and patients of the ART clinic had higher risks of thyroid disorders than in general population that could possibly affect fertility. Patients of the ART clinic with non-obstructive azoospermia are at risk for nodular thyroid disorders, even with normal values of thyroid function tests, and require thyroid ultrasonography.
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Affiliation(s)
- T V Lisovskaya
- Clinical Institute for Reproductive Medicine, LLC, Yekaterinburg, Russia
| | - O S Dubrovina
- Clinical Institute for Reproductive Medicine, LLC, Yekaterinburg, Russia
| | - I M Treshchilov
- Clinical Institute for Reproductive Medicine, LLC, Yekaterinburg, Russia
| | - L B Senturina
- Clinical Institute for Reproductive Medicine, LLC, Yekaterinburg, Russia
| | - O Y Sevostyanova
- Ural State Medical University of the Ministry of Health of Russian Federation, Yekaterinburg, Russia
| | - E N Mayasina
- Clinical Institute for Reproductive Medicine, LLC, Yekaterinburg, Russia
| | - Yu E Buev
- Clinical Institute for Reproductive Medicine, LLC, Yekaterinburg, Russia
| | - D F Salimov
- Clinical Institute for Reproductive Medicine, LLC, Yekaterinburg, Russia
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22
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Vasile CM, Ghenea AE, Udriştoiu AL, Udriştoiu Ş, Popescu M, Padureanu V, Alexandru DO. A Cross-Sectional Study to Assess Thyroid Function in Infants and Children in a City from South-Western Romania. Curr Health Sci J 2021; 47:420-7. [PMID: 35003775 DOI: 10.12865/CHSJ.47.03.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 09/28/2021] [Indexed: 11/18/2022]
Abstract
Thyroid hormones are critical regulators of growth, myelination of the nervous system, metabolism, and organ function. The most prevalent endocrinopathies in childhood are related to thyroid disorders. Thyroid problems in children and adolescents have a significantly different etiology and clinical presentation than in adults. Thus, pediatric medical care involves an understanding of the unique features of thyroid function and dysfunction during childhood and adolescence. The etiology and clinical manifestations of thyroid disorders in children and adolescents are vastly different from those in adults. The particular aspects of thyroid function and malfunction in childhood and adolescence are hence part of pediatric medical therapy. To prevent persistent nervous system damage and developmental problems, it is vital to recognize and treat thyroid dysfunction in neonates as early as possible. The purpose of the research was to understand more how children's thyroid problems function, structure, and prevalence. The research examined 30 children under the age of 16 years who had symptoms that were linked to thyroid problems. In addition to demographic and family information, thyroid ultrasounds and blood samples for the detection of T3, T4, and TSH were obtained. Females surpassed males by a small majority (2.33:1 ratio).Out of the total children included in the study, 14(46.7%) cases for autoimmune thyroiditis, 2(6.67%) cases for congenital hypothyroidism, 1(3.33%) case for hyperthyroidism, 1(3.33%) case for hyperthyroidism-Graves disease, 8(26.7%) cases for hypothyroidism and 4(13.3%) cases for subclinical hypothyroidism.
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23
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Taïbi K, Ait Abderrahim L, Helal F, Hadji K. Ethnopharmacological study of herbal remedies used for the management of thyroid disorders in Algeria. Saudi Pharm J 2021; 29:43-52. [PMID: 33603538 DOI: 10.1016/j.jsps.2020.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/08/2020] [Indexed: 12/13/2022] Open
Abstract
Traditional medicine is gaining an increasing importance in diseases management. Besides, thyroid disease is one of the common endocrine disorders spreading at high frequency worldwide. The present work is an ethnopharmacological study aiming to identify, document and analyze aromatic and medicinal plants used in Algerian traditional medicines for thyroid disorders management. Semi-structured interviews with 120 herbalists and traditional practitioners and rural dwellers were realized in eleven locations in Algeria throughout field studies achieved from June 2017 to July 2019. Results reveal the use of 63 medicinal plants belonging to 59 genera and 34 families. The most represented botanical families were Lamiaceae, Fabaceae, Apiaceae, Amaranthaceae and Asteraceae. However, the most cited plant species were Atriplex halimus L., Bunium incrassatum (Boiss.) Amo, Nigella sativa L., Aquilaria malaccensis Lam. and Saussurea costus (Falc.) Lipsch. These species are taken alone or in mixtures of two or more ingredients from different origins such as honey, olive oil, and goat milk. Our findings revealed new therapeutic uses of 60 medicinal plants that have not been previously reported for the treatment of thyroid in Algeria. This is the first study documenting the traditional uses based on herbal medicine for thyroid management in Algeria. Our findings are relevant in the search for novel drug discovery. Obviously, it is the time to increase effective scientific studies on mechanisms of action of these medicinal plants in order to validate their popular usages.
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24
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El-Eshmawy MM, Shahin M. Thyroid and Eye: Where They Meet in Clinical Practice. Endocr Metab Immune Disord Drug Targets 2020; 20:39-49. [PMID: 31237221 DOI: 10.2174/1871530319666190618120107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/25/2019] [Accepted: 05/03/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Thyroid Hormones (TH) are essential for normal growth, development and continued optimal function of most of the body organs including the eye. TH signaling plays a central role in the regulation of retinal development and maturation. Deficiency in TH during fetal and early postnatal development impairs growth of the eye and proliferation of all retinal cell types. The present article reviews the most important topics of the different derangements in thyroid function and structure and its relation with eye diseases. METHODS A literature search strategy was conducted for all English-language literature. RESULTS From a clinical practice viewpoint, it should be mentioned that both hypothyroidism and hyperthyroidism are accompanied by ocular diseases i.e. thyroid-associated ophthalmopathy, diabetic retinopathy and age-related macular degeneration. Although the orbit and globe are not common sites for metastatic thyroid cancers, orbital metastasis may be the primary clinical manifestation of thyroid carcinoma. Finally, some medications as amiodarone may be accompanied by both thyroid dysfunction and adverse ocular events. CONCLUSION Thyroid disorders and eye diseases are interrelated through several mechanisms thus, awareness of this relation has a great impact on early diagnosis and treatment.
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Affiliation(s)
- Mervat M El-Eshmawy
- Internal Medicine Department, Mansoura Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Maha Shahin
- Ophthalmology Department, Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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25
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Parthymos I, Liamis G, Dounousi E, Pentheroudakis G, Mauri D, Zarkavelis G, Florentin M. Metabolic consequences of immune checkpoint inhibitors: A new challenge in clinical practice. Crit Rev Oncol Hematol 2020; 151:102979. [PMID: 32480349 DOI: 10.1016/j.critrevonc.2020.102979] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 02/29/2020] [Accepted: 05/03/2020] [Indexed: 12/13/2022] Open
Abstract
Treatment of oncologic patients has progressed greatly the last few years with the development of immune checkpoint inhibitors (ICPIs). These drugs are associated with the immune system and, thus, may cause side effects of immune origin, the so called immune related adverse events (irAEs). Immune related AEs may actually affect all organs and systems and frequently resemble clinical entities commonly encountered in clinical practice. As ICPIs have improved both quality of life and life expectancy, clinicians of various specialties may need to deal with irAEs in their everyday practice. Therefore, they should be able to recognize them timely and treat them accordingly. Herein, we review the pathophysiology, clinical manifestations and treatment of irAEs.
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Affiliation(s)
- Ioannis Parthymos
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - George Liamis
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Evangelia Dounousi
- Department of Internal Medicine, Division of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - George Pentheroudakis
- Department of Medical Oncology, University Hospital of Ioannina, Ioannina, Greece Society for Study of Clonal Heterogeneity of Neoplasia (EMEKEN), Ioannina, Greece
| | - Davide Mauri
- Department of Medical Oncology, University Hospital of Ioannina, Ioannina, Greece Society for Study of Clonal Heterogeneity of Neoplasia (EMEKEN), Ioannina, Greece
| | - George Zarkavelis
- Department of Medical Oncology, University Hospital of Ioannina, Ioannina, Greece Society for Study of Clonal Heterogeneity of Neoplasia (EMEKEN), Ioannina, Greece
| | - Matilda Florentin
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece.
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26
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Kiel S, Ittermann T, Völzke H, Chenot JF, Angelow A. Frequency of thyroid function tests and examinations in participants of a population-based study. BMC Health Serv Res 2020; 20:70. [PMID: 32000765 PMCID: PMC6993310 DOI: 10.1186/s12913-020-4910-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 01/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thyroid disorders are common in the adult German population. Little is known about guideline implementation in clinical practice and the prevalence of diagnostic procedures in ambulatory care. The study aims to investigate the use of thyroid hormone measurements, thyroid ultrasound, thyroid scintiscan and associated costs in ambulatory care at population level. METHODS Data were derived from two independent population-based cohorts of the Study of Health In Pomerania (SHIP). Ambulatory billing data from the Association of Statutory Health Insurance Physicians Mecklenburg-Vorpommern were individually linked for the period 2002-2016 with SHIP data. The main outcomes were the frequency of outpatient ultrasound, scintiscan, serum TSH level measurement, free triiodothyronine (fT3) and free thyroxine (fT4) measurement, TSH-receptor-antibodies and microsomal antibodies measurement within 1 year and 3 years prior to the study entrance of the participants. Multinomial logistic regression models were used to assess the association of age, sex, thyroid medication intake and Charlson-Comorbidity-Index with frequency of TSH measurements and ultrasound examinations. RESULTS A total of 5552 participants (47% male, median age 55) were included in the analysis. 25% (1409/5552) had a diagnosed thyroid disorder or treatment, 40% (2191/5552) had clinical findings based on ultrasound or laboratory testing in SHIP only and 35% (1952/5552) neither a coded thyroid disorder or clinical finding nor thyroid medication. In the total study population 30% (1626/5552) received at least one TSH measurement, 6.8% (378/5552) at least one thyroid ultrasound and 2.6% (146/5552) at least one scintiscan within the past year before the study examination. Tests were performed more frequently in patients with thyroid medication and coded thyroid disorders. Hence, this group caused the highest expenditures. CONCLUSIONS Given the high prevalence of thyroid disorders, diagnostic and monitoring tests should be used rationally with regard to costs. TSH levels should be monitored regularly in patients on thyroid medication. A consensus on monitoring frequency and iteration of monitoring of morphological thyroid disorders with TSH and ultrasound and specific guideline recommendations are needed. TRIAL REGISTRATION Versorgungsforschung Deutschland (VfD_17_003880).
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Affiliation(s)
- Simone Kiel
- Department of General Practice, Institute for Community Medicine, University Medicine Greifswald, Fleischmannstraße 6, 17475, Greifswald, Germany.
| | - Till Ittermann
- Department of SHIP/ Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Department of SHIP/ Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Jean-François Chenot
- Department of General Practice, Institute for Community Medicine, University Medicine Greifswald, Fleischmannstraße 6, 17475, Greifswald, Germany
| | - Aniela Angelow
- Department of General Practice, Institute for Community Medicine, University Medicine Greifswald, Fleischmannstraße 6, 17475, Greifswald, Germany
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Baharvand P, Hormozi M, Aaliehpour A. Comparison of thyroid disease prevalence in patients with celiac disease and controls. Gastroenterol Hepatol Bed Bench 2020; 13:44-49. [PMID: 32190224 PMCID: PMC7069534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM This study aimed to investigate the prevalence of thyroid disease (TD) in untreated CD patients and to evaluate the effect of gender and age on its prevalence. BACKGROUND Celiac disease (CD) is a form of intestinal malabsorption syndrome which is closely related to endocrine disorders, especially autoimmune thyroid disease and diabetes. The prevalence of TD is possibly high among patients with CD which necessitates the need for screening for TD among them. METHODS This comparative cross-sectional study was conducted on 288 consecutive untreated patients with CD (mean age, 27.9±14) and 250 controls (mean age, 29.01±13.15) referred for endoscopy in a hospital located in Iran. Thyroid function was evaluated by measuring T3, T4, and TSH levels using ELISA technique, and testing anti-thyroperoxidase (anti-TPO) antibodies through electrochemiluminescence method. Data analysis was conducted in SPSS v.22 software using descriptive statistics and chi-squared test. RESULTS Thyroid disease prevalence was 4-fold higher in patients than in controls (13.6% vs. 3.2%, p<0.05). Hypothyroidism was diagnosed in 30 patients and 7 controls, while hyperthyroidism was observed in 9 patients and in one control. Chi-squared test results reported a significant difference in TD prevalence between patients and controls based on gender and age (p<0.05). In both groups, women were significantly more affected than men, and the TD prevalence was higher in younger patients compared to adults. CONCLUSION There was a strong association between thyroid dysfunction and CD. In this regard, it is necessary to screen patients for TD.
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Affiliation(s)
- Parastoo Baharvand
- Department of Social Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Maryam Hormozi
- Department of Biochemistry, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Asghar Aaliehpour
- Department of Pathology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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28
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Kiran Z, Sheikh A, Malik S, Meraj A, Masood M, Ismail S, Rashid MO, Shaikh Q, Majeed N, Sheikh L, Islam N. Maternal characteristics and outcomes affected by hypothyroidism during pregnancy (maternal hypothyroidism on pregnancy outcomes, MHPO-1). BMC Pregnancy Childbirth 2019; 19:476. [PMID: 31805890 PMCID: PMC6896307 DOI: 10.1186/s12884-019-2596-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 11/13/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hypothyroidism in pregnancy is an arena of ongoing research, with international conflicts regarding screening, management, and outcomes. Various studies have described the outcomes depending on geographical and international diagnostic criteria. No study has been conducted in this regard from the region of Pakistan. Therefore, we aim to report the clinical features and maternal outcomes of hypothyroid pregnancies and compare the maternal outcomes between uncontrolled and controlled TSH levels in the preconception as well as the gestational period. METHODS We conducted a cross-sectional retrospective study on 718 cases in the Aga Khan University Hospital after ethical approval. We collected information on pregnant females who have diagnosed hypothyroidism before conception or during their antenatal period. We noted the maternal characteristics and maternal comorbidities. Laboratory data were recorded for thyroid stimulating hormone levels before conception and during gestation. We recorded maternal outcomes as pregnancy loss (including miscarriage, stillbirth/intrauterine death, medical termination of pregnancy and ectopic pregnancy), gestational hypertension, pre-eclampsia, postpartum hemorrhage, placental abruption, and modalities of delivery. Data analysis was performed on Statistical Package for the Social Sciences version 20.0. RESULTS Among 708 hypothyroid women 638 had live births. Postpartum hemorrhage was the most frequent maternal outcome (38.8%). The emergency cesarean section occurred in 23.4% of cases. We determined TSH levels in 53.2, 56.7, 61.7 and 66.6% of cases in preconception, 1st, 2nd, and 3rd trimester periods. A significant association existed between cesarean section and preconception thyrotropin levels > 2.5 mIU/L, whereas postpartum hemorrhage was significantly associated with thyrotropin levels > 2.5 mIU/L in the preconception and third trimester. CONCLUSION Successful live births in our patients were complicated by maternal postpartum hemorrhage and a frequent number of emergency cesarean section.
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Affiliation(s)
- Zareen Kiran
- Section of Endocrinology, Department of Medicine, Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi, Pakistan.
| | - Aisha Sheikh
- Section of Endocrinology, Department of Medicine, Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi, Pakistan
| | - Sarwar Malik
- Department of Endocrinology, Ali Medical Center, Islamabad, Pakistan
| | - Areeba Meraj
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Maha Masood
- Karachi Medical & Dental College, Karachi, Pakistan
| | - Safana Ismail
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Owais Rashid
- Section of Endocrinology, Department of Medicine, Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi, Pakistan
| | | | - Numan Majeed
- Department of Chemical Pathology, Army Medical College, Rawalpindi, Pakistan
| | - Luman Sheikh
- Department of Obstetrics & Gynecology, Aga Khan University Hospital, Karachi, Pakistan
| | - Najmul Islam
- Section of Endocrinology, Department of Medicine, Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi, Pakistan
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29
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Dobrinja C, Scomersi S, Giudici F, Vallon G, Lanzaro A, Troian M, Bonazza D, Romano A, Zanconati F, de Manzini N, Bortul M. Association between benign thyroid disease and breast cancer: a single center experience. BMC Endocr Disord 2019; 19:104. [PMID: 31623603 PMCID: PMC6798360 DOI: 10.1186/s12902-019-0426-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 09/10/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The relationship between breast cancer (BC) and thyroid disease (TD) is still controversial. The aim of the study was to investigate the possible coexistence of TD in patients with newly diagnosed BC and its correlation with BC clinical presentation with regard to menopausal status and stage of disease. METHODS This is a retrospective cohort study of all patients treated for primary BC between 2014 and 2016 at the Breast Unit of Trieste University Hospital. Clinical charts and reports were reviewed for coexisting thyroid disorders (i.e. hyperthyroidism, hypothyroidism, benign TD, thyroid cancer, thyroid autoimmunity) and menopausal status at the time of BC diagnosis. Biomolecular profile, stage, and grading of BC were also evaluated. RESULTS A total of 786 women and 7 men were included in the study. Co-presence of TD was found in 161(20.3%) cases: of these, 151(19.4%) patients presented benign TD and 10(1.3%) patients presented thyroid carcinoma. Thyroid autoimmunity was found in 51(32%) patients. Regarding thyroid function, 88(55%) patients had hypothyroidism, 19(12%) hyperthyroidism, and 54(33%) normal thyroid function. No statistically significant correlation was found between age and TD (p = 0.16), although TD was more common in women aged ≥60 years. Women with BC diagnosed at pre-menopausal age were more likely to have thyroid autoimmune diseases (45% vs. 29%, p = 0.05). No association was detected among BC molecular profiles with either thyroid autoimmunity (p = 0.26) or altered thyroid function (p = 0.63). High-grade BC was more frequent in women with hyperthyroidism (52.9%, p = 0.04), but the grading was independent from the presence of thyroid autoimmune disease (p = 0.87). BC stage was related to both thyroid autoimmunity (p = 0.04) and thyroid function (p < 0.001), with 55.2% of women affected by benign TD presenting with stage I BC and more aggressive BCs found in hypothyroid patients. CONCLUSIONS According our study results, patients with primary BC present a greater incidence of autoimmunity disorders, especially when diagnosed in the pre-menopausal setting. However, further prospective studies are required to definitively prove causality.
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Affiliation(s)
- Chiara Dobrinja
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Serena Scomersi
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
- Breast Unit Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - Fabiola Giudici
- Breast Unit Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - Giulia Vallon
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Alessio Lanzaro
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Marina Troian
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Deborah Bonazza
- UCO Anatomia e Istologia Patologica-Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - Andrea Romano
- UCO Anatomia e Istologia Patologica-Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - Fabrizio Zanconati
- UCO Anatomia e Istologia Patologica-Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - Nicolò de Manzini
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Marina Bortul
- Breast Unit Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
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Lin CL, Wu SY, Huang WT, Feng YH, Yiu CY, Chiang WF, Ho SY, Lin SH. Subsequent thyroid disorders associated with treatment strategy in head and neck cancer patients: a nationwide cohort study. BMC Cancer 2019; 19:461. [PMID: 31096939 PMCID: PMC6524259 DOI: 10.1186/s12885-019-5697-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 05/09/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND We investigated the risk of thyroid disorders, namely hypothyroidism, thyrotoxicosis and thyroiditis, in head and neck cancer patients undergoing multimodal treatment. METHODS A cohort study design using Taiwan's National Health Insurance Research Database was used to assess head and neck cancer patients over 20 years old. The cohort was divided into one group who underwent primary tumor excision only (PTE) and another with additional neck dissection (PTE + ND). The tumor sites were stratified to estimate the tumor-site-specific risk of thyroid disorders. The effect of subsequent resurgery, radiotherapy (RT), chemotherapy (CT), and concomitant (CCRT) or sequential chemoradiation therapy (sequential CT+ RT) on the risk of thyroid disorders was explored. RESULTS For 1999-2012, 7460 patients who underwent PTE + ND and 3730 who underwent PTE were enrolled and followed-up until the end of 2013. There were 122 and 50 patients in the two groups, respectively, who developed thyroid disorders, with no statistical difference between the groups. Patients with hypopharyngeal, oropharyngeal, or laryngeal cancer in the PTE + ND group had a higher risk of thyroid disorders (adjusted HR: 1.50, 95% CI: 0.67-3.38) than those in the PTE group when adjusted for covariates and mortality. Patients who underwent subsequent RT (adjusted HR: 3.64, 95% CI: 1.05-2.77) and CCRT (adjusted HR: 1.70, 95% CI: 1.05-2.77) after PTE + ND had a significantly higher risk of thyroid disorders. CONCLUSION RT results in a major risk of subsequent thyroid disorders, and ND may exacerbate this effect. Physicians should monitor thyroid function from two years after treatment initiation, especially in patients who undergo ND and subsequent RT.
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Affiliation(s)
- Chien-Liang Lin
- Division of Hematology and Oncology, Chi-Mei Medical Center, Liouying Campus, Tainan, Taiwan.,Min-Hwei Junior College of Health Care Management, Tainan, Taiwan
| | - Shang-Yin Wu
- Division of Hematology and Oncology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Wen-Tsung Huang
- Division of Hematology and Oncology, Chi-Mei Medical Center, Liouying Campus, Tainan, Taiwan
| | - Yin-Hsun Feng
- Division of Hematology and Oncology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Ching-Yi Yiu
- Division of Otolarygology, Head and Neck Surgery, Chi-Mei Medical Center, Liouying Campus, Tainan, Taiwan
| | - Wei-Fan Chiang
- Division of Oral Maxillo-facial Surgery, Chi-Mei Medical Center, Liouying Campus, Tainan, Taiwan
| | - Sheng-Yow Ho
- Division of Radiation Oncology, Chi-Mei Medical Center, Liouying Campus, Tainan, Taiwan
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, 138, Shengli Road, Tainan, Taiwan. .,Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan. .,Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng-Kung University, Tainan, Taiwan.
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De Sanctis V, Soliman AT, Canatan D, Yassin MA, Daar S, Elsedfy H, Di Maio S, Raiola G, Corrons JV, Kattamis C. Thyroid Disorders in Homozygous β-Thalassemia: Current Knowledge, Emerging Issues and Open Problems. Mediterr J Hematol Infect Dis 2019; 11:e2019029. [PMID: 31205633 DOI: 10.4084/MJHID.2019.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 03/08/2019] [Indexed: 12/19/2022] Open
Abstract
Changes in thyroid function and thyroid function tests occur in patients with β-thalassemia major (TM). The frequency of hypothyroidism in TM patients ranges from 4% to 29 % in different reports. The wide variation has been attributed to several factors such as patients’ genotype, age, ethnic heterogeneity, treatment protocols of transfusions and chelation, and varying compliance to treatment. Hypothyroidism is the result of primary gland failure or insufficient thyroid gland stimulation by the hypothalamus or pituitary gland. The main laboratory parameters of thyroid function are the assessments of serum thyroid-stimulating hor-mone (TSH) and serum free thyroxine (FT4). It is of primary importance to interpret these measurements within the context of the laboratory-specific normative range for each test. An elevated serum TSH level with a standard range of serum FT4 level is consistent with subclinical hypothyroidism. A low serum FT4 level with a low, or inappropriately normal, serum TSH level is consistent with secondary hypothyroidism. Doctors caring for TM patients most commonly encounter subjects with subclinical primary hypothyroidism in the second decade of life. Several aspects remain to be elucidated as the frequency of thyroid cancer and the possible existence of a relationship between thyroid dysfunction, on one hand, cardiovascular diseases, components of metabolic syndrome (insulin resistance) and hypercoagulable state, on the other hand. Further studies are needed to explain these emerging issues. Following a brief description of thyroid hormone regulation, production and actions, this article is conceptually divided into two parts; the first reports the spectrum of thyroid disease occurring in patients with TM, and the second part focuses on the emerging issues and the open problems in TM patients with thyroid disorders.
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PAKDEL F, GHAZAVI R, HEIDARY R, NEZAMABADI A, PARVIZI M, HAJI SAFAR ALI MEMAR M, GHAREBAGHI R, HEIDARY F. Effect of Selenium on Thyroid Disorders: Scientometric Analysis. Iran J Public Health 2019; 48:410-420. [PMID: 31223567 PMCID: PMC6570790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Association of Selenium (Se) deficiency, an essential trace element, has been found with human diseases. Identifying literature trends on the effects of Se on the thyroid may guide in planning future studies. METHODS A literature search was conducted using the Web of Science database to identify studies on Se and the thyroid published over the 20 years duration (1995-Dec 2014). Scientometric indices were used to draw field maps. The scientific processes, structure, evidence history, and international collaborations were included in the map. The most influential authors, journals, institutions, and countries were also examined. RESULTS Our search identified 184 research and review papers. The number of scientific studies on Se and the thyroid has been irregular, but interest in this topic has increased in recent years. The highest number of studies was published in 2014 (16 papers) and overall growth factor of publication was 3.78. Overall, 744 authors from 282 institutions in 43 countries published in this field. The author J. Kohrle (828 citations, 14 publications), and German scientists (1272 citations, 30 publications) were most influential. CONCLUSION This study reveals the interrelationships between different publications on the effects of Se on the thyroid. Leading scientific issues and their extent of impact were successfully determined by examining citations. The results of systematic citations and mapping fields can be used to assist in policy and management contexts.
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Affiliation(s)
- Farzad PAKDEL
- Department of Oculofacial, Eye Research Center, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Roghayeh GHAZAVI
- Vice Chancellery of Research and Technology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Athena NEZAMABADI
- Department of Oculofacial, Eye Research Center, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam PARVIZI
- Department of Pathology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa HAJI SAFAR ALI MEMAR
- Department of Oculofacial, Eye Research Center, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza GHAREBAGHI
- International Virtual Ophthalmic Research Center, Tehran, Iran,Corresponding Authors:
| | - Fatemeh HEIDARY
- Immunoregulation Research Center, Shahed University, Tehran, Iran, Department of Ophthalmology, Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Corresponding Authors:
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Munoz JL. Fetal thyroid disorders: Pathophysiology, diagnosis and therapeutic approaches. J Gynecol Obstet Hum Reprod 2019; 48:231-233. [PMID: 30634005 DOI: 10.1016/j.jogoh.2019.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/17/2018] [Accepted: 01/08/2019] [Indexed: 11/28/2022]
Abstract
Fetal thyroid disorders while uncommon in general, have significant morbidity and profound effects in the neonate. Pregnancy provides the opportunity not only for the diagnosis of these conditions but also for therapeutic interventions. In careful balance, these disorders range from hypothyroidism to hyperthyroidism, both may manifest with fetal thyroid goiters as well. The intrauterine therapeutic approach of these must also weight the balance in this range as well as the maternal well being which may also express thyroid dysfunction. In this review we explore the different fetal manifestations of thyroid disease, describe the pathophysiology and therapeutic approaches both in practice and in development.
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Affiliation(s)
- Jessian L Munoz
- OB/GYN and Women's Health Institute A81, Cleveland Clinic, Cleveland, OH, 44105, USA.
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Fröhlich E, Wahl R. The forgotten effects of thyrotropin-releasing hormone: Metabolic functions and medical applications. Front Neuroendocrinol 2019; 52:29-43. [PMID: 29935915 DOI: 10.1016/j.yfrne.2018.06.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/07/2018] [Accepted: 06/20/2018] [Indexed: 11/18/2022]
Abstract
Thyrotropin-releasing hormone (TRH) causes a variety of thyroidal and non-thyroidal effects, the best known being the feedback regulation of thyroid hormone levels. This was employed in the TRH stimulation test, which is currently little used. The role of TRH as a cancer biomarker is minor, but exaggerated responses to TSH and prolactin levels in breast cancer led to the hypothesis of a potential role for TRH in the pathogenesis of this disease. TRH is a rapidly degraded peptide with multiple targets, limiting its suitability as a biomarker and drug candidate. Although some studies reported efficacy in neural diseases (depression, spinal cord injury, amyotrophic lateral sclerosis, etc.), therapeutic use of TRH is presently restricted to spinocerebellar degenerative disease. Regulation of TRH production in the hypothalamus, patterns of expression of TRH and its receptor in the body, its role in energy metabolism and in prolactin secretion are addressed in this review.
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Affiliation(s)
- Eleonore Fröhlich
- Internal Medicine (Dept. of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry), University of Tuebingen, Otfried-Muellerstrasse 10, 72076 Tuebingen, Germany; Center for Medical Research, Medical University Graz, Stiftingtalstr. 24, 8010 Graz, Austria
| | - Richard Wahl
- Internal Medicine (Dept. of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry), University of Tuebingen, Otfried-Muellerstrasse 10, 72076 Tuebingen, Germany.
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Abstract
Immune checkpoint inhibitors are drugs that inhibit the "checkpoint molecules". Different types of cancer immune checkpoint inhibitors have been approved recently: CTLA-4 monoclonal antibodies (as ipilimumab); anti-PD-1 monoclonal antibodies (as pembrolizumab and nivolumab); and anti-PD-L1 monoclonal antibodies (as atezolizumab, avelumab, and durmalumab). The increased immune response induced by these agents leads to immune-related adverse events (irAEs), that can vary from mild to fatal, according to the organ system and severity. Immune-related endocrine toxicities are thyroid dysfunctions, hypophysitis, adrenal insufficiency, and type 1 diabetes mellitus, and are usually irreversible in 50%. In particular, hypophysitis is the most frequent anti-CTLA-4-antibodies-related irAE, while thyroid abnormalities (as hypothyroidism, thyrotoxicosis, painless thyroiditis, or even "thyroid storm") are more frequently associated with anti-PD-1-antibodies. The combination of anti-CTLA-4-antibodies, with anti-PD-1-antibodies, is associated with about 30% of irAEs. Clinical signs and symptoms vary according to the influenced target organ. Endocrinopathies can often be managed by the treating oncologist. However in more severe cases (i.e. in the presence of insulin-dependent diabetes, adrenal insufficiency, or disorders of gonadal hormones, or severe hyperthyroidism, or hypothyroidism, or long-lasting management of hypophysitis) an endocrinological evaluation, and a prompt therapy, are needed.
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Affiliation(s)
- Silvia Martina Ferrari
- Department of Clinical and Experimental Medicine, University of Pisa, School of Medicine, Via Savi, 10, I-56126, Pisa, Italy
| | - Poupak Fallahi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Fabio Galetta
- Department of Clinical and Experimental Medicine, University of Pisa, School of Medicine, Via Savi, 10, I-56126, Pisa, Italy
| | - Emanuele Citi
- Department of Clinical and Experimental Medicine, University of Pisa, School of Medicine, Via Savi, 10, I-56126, Pisa, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Messina, Italy
- Interdepartmental Program of Molecular and Clinical Endocrinology and Women's Endocrine Health, Azienda Ospedaliera Universitaria Policlinico 'G. Martino', I-98125, Messina, Italy
| | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, School of Medicine, Via Savi, 10, I-56126, Pisa, Italy.
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Ozair M, Noor S, Raghav A, Siddiqi SS, Chugtai AM, Ahmad J. Prevalence of thyroid disorders in North Indian Type 2 diabetic subjects: A cross sectional study. Diabetes Metab Syndr 2018; 12:301-304. [PMID: 29279270 DOI: 10.1016/j.dsx.2017.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 12/19/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a major health burden worldwide with many patients encountering thyroid dysfunction later in their life. Various studies have found that diabetes and thyroid disorders mutually influence each other and both disorders tend to coexists. However, the prevalence of thyroid dysfunction and associated clinical variables in these patients has not been investigated. OBJECTIVES The study aimed at determining the incidence and prevalence of thyroid dysfunction in patients with T2DM in relation to age, sex, metabolic syndrome and other co-morbid conditions. RESEARCH DESIGNS & METHODS In this cross-sectional study, 250 Type 2 DM patients were enrolled aged between 40 and 75 years. All the patients were evaluated for thyroid dysfunction by testing thyroid profile (T3, T4 and TSH. These subjects were also investigated for fasting blood sugar (FBS), post prandial glucose (PPG) glycosylated hemoglobin (HbA1c), serum cholesterol, serum triglycerides, high density lipoprotein (HDL), low density lipoprotein(LDL), very low density lipoprotein(VLDL), blood urea, serum creatinine and presence of other co-morbid conditions. The observations and interpretations were recorded and results obtained were statistically analyzed. RESULTS A high prevalence of thyroid dysfunction (28%) was observed in type 2 diabetic patients with subclinical hypothyroidism (18.8%) as the commonest thyroid disorder. Thyroid dysfunction was more prevalent in females, with presence of dyslipidemia, retinopathy, poor glycemic state (HbA1c ≥7) and longer duration of diabetes as significant contributing factors associated. CONCLUSIONS In addition to glycemic status, screening of thyroid disorder should be routinely done in type 2 diabetic subjects along with other comorbid conditions.
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Affiliation(s)
- Maaz Ozair
- Rajiv Gandhi Centre for Diabetes and Endocrinology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh, India
| | - Saba Noor
- Rajiv Gandhi Centre for Diabetes and Endocrinology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh, India
| | - Alok Raghav
- Rajiv Gandhi Centre for Diabetes and Endocrinology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh, India
| | - Sheelu Shafiq Siddiqi
- Rajiv Gandhi Centre for Diabetes and Endocrinology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh, India
| | - Anjum Mirza Chugtai
- Department of Medicine, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
| | - Jamal Ahmad
- Rajiv Gandhi Centre for Diabetes and Endocrinology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh, India.
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Jørgensen P, Langhammer A, Krokstad S, Forsmo S. Mortality in persons with undetected and diagnosed hypertension, type 2 diabetes, and hypothyroidism, compared with persons without corresponding disease - a prospective cohort study; The HUNT Study, Norway. BMC Fam Pract 2017; 18:98. [PMID: 29212453 PMCID: PMC5719734 DOI: 10.1186/s12875-017-0672-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 11/28/2017] [Indexed: 12/24/2022]
Abstract
Background Suggested strategies in reducing the impact of non-communicable diseases (NCD) are early diagnosing and screening. We have limited proof of benefit of population screening for NCD. Increased mortality in persons with diagnosed NCD has been shown for decades. However, mortality in undetected NCD has barely been studied. This paper explores whether all-cause mortality differed between persons with diagnosed hypothyroidism, type 2 diabetes (T2DM), and hypertension, compared with persons with undetected-, and with persons without the corresponding disease. Methods A prospective cohort study of the general population in Nord-Trøndelag, Norway. Persons ≥20 years at baseline 1995–97 were followed until death or June 15, 2016. Cox proportional hazards models were used to compute age and multiple adjusted hazard ratios (HR) with 95% confidence intervals (CI) for the association between disease status and all-cause mortality. The number of participants in the hypothyroidism study was 31,960, in the T2DM study 37,957, and in the hypertension study 63,371. Results Mortality was increased in persons with diagnosed type 2 diabetes and hypertension, compared to persons without corresponding disease; HR 1.69 (95% CI 1.55–1.84) and HR 1.23 (95% CI 1.09–1.39), respectively. Among persons with undetected T2DM, the HR was 1.21 (95% CI 1.08–1.37), whilst among undetected hypothyroidism and hypertension, mortality was not increased compared with persons without the diseases. Further, the association with mortality was stronger in persons with long duration of T2DM (HR 1.96 (95% CI 1.57–2.44)) and hypertension (HR 1.32 (95% CI 1.17–1.49)), compared with persons with short duration (HR 1.29 (1.09–1.53) and HR 1.16 (1.03-1-30) respectively). Conclusions Mortality was increased in persons with diagnosed T2DM and hypertension, and in undetected T2DM, compared with persons without the diseases. The strength of the association with mortality in undetected T2DM was however lower compared with persons with diagnosed T2DM, and mortality was not increased in persons with undetected hypothyroidism and hypertension, compared with persons without the diseases. Thus, future research needs to test more thoroughly if early diagnosing of these diseases, such as general population screening, is beneficial for health.
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Affiliation(s)
- Pål Jørgensen
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway.
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway.,Levanger Hospital, Nord-Trøndelag Hospital Trust, 7600, Levanger, Norway
| | - Siri Forsmo
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway
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Plonczak AM, DiMarco AN, Dina R, Gujral DM, Palazzo FF. Breast cancer metastases to the thyroid gland - an uncommon sentinel for diffuse metastatic disease: a case report and review of the literature. J Med Case Rep 2017; 11:269. [PMID: 28934992 PMCID: PMC5609028 DOI: 10.1186/s13256-017-1441-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/29/2017] [Indexed: 12/22/2022] Open
Abstract
Background Metastases to the thyroid are rare. The most common primary cancer to metastasize to the thyroid is renal cell carcinoma, followed by malignancies of the gastrointestinal tract, lungs, and skin, with breast cancer metastases to the thyroid being rare. Overall, the outcomes in malignancies that have metastasized to the thyroid are poor. There are no prospective studies addressing the role of surgery in metastatic disease of the thyroid. Isolated thyroidectomy has been proposed as a local disease control option to palliate and prevent the potential morbidity of tumor extension related to the airway. Here, we present a case of a patient with breast cancer metastases to the thyroid gland and discuss the role of thyroidectomy in the context of the current literature. Case presentation A 62-year-old Afro-Caribbean woman was diagnosed as having bilateral breast carcinoma in 2004, for which she underwent bilateral mastectomy. The pathology revealed multifocal disease on the right, T2N0(0/20)M0 grade 1 and 2 invasive ductal carcinoma, and on the left side, T3N1(2/18)M0 grade 1 invasive ductal carcinoma. Surgery was followed by adjuvant chemotherapy and regional radiotherapy. The disease was under control on hormonal therapy until 2016, when she developed cervical lymphadenopathy. The fine-needle aspiration cytology of the thyroid was reported as papillary thyroid cancer; and the fine-needle biopsy of the left lateral nodal disease was more suggestive of breast malignancy. She underwent a total thyroidectomy and a clearance of the central compartment lymph nodes and a biopsy of the lateral nodal disease. The histopathological analysis was consistent with metastatic breast cancer in the thyroid and lymph nodes with no evidence of a primary thyroid malignancy. Conclusions A past history of a malignancy elsewhere should raise the index of suspicion of metastatic disease in patients presenting with thyroid lumps with or without cervical lymphadenopathy. Detection of metastases to the thyroid generally indicates poor prognosis, obviating the need of surgery in an already compromised patient. An empirical thyroidectomy should be considered in select patients for local disease control.
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Affiliation(s)
- Agata M Plonczak
- Department of Thyroid & Endocrine Surgery, Hammersmith Hospital, Imperial College Hospitals NHS Trust, London, W12 0HS, UK.
| | - Aimee N DiMarco
- Department of Thyroid & Endocrine Surgery, Hammersmith Hospital, Imperial College Hospitals NHS Trust, London, W12 0HS, UK
| | - Roberto Dina
- Department of Histopathology, Hammersmith Hospital, Imperial College Hospitals NHS Trust, London, W12 0HS, UK
| | - Dorothy M Gujral
- Department of Oncology, Charing Cross Hospital, Imperial College Hospitals NHS Trust, London, W6 8RF, UK
| | - Fausto F Palazzo
- Department of Thyroid & Endocrine Surgery, Hammersmith Hospital, Imperial College Hospitals NHS Trust, London, W12 0HS, UK
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Rajiwade SR, Sagili H, Soundravally R, Subitha L. Endocrine Abnormalities in Adolescents with Menstrual Disorders. J Obstet Gynaecol India 2018; 68:58-64. [PMID: 29391677 DOI: 10.1007/s13224-017-1035-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022] Open
Abstract
Purpose To look for endocrine abnormalities like thyroid disorders, hyperprolactinemia, hyperandrogenism and PCOS among adolescents with menstrual disorders and to compare the above endocrine status with those without menstrual disorders. Methods This was a case-control study carried out in adolescent girls aged 10-19 years in gynecology outpatient department of a tertiary care hospital. Sample of venous blood (5 ml) was taken for hormonal studies as clinically indicated-thyroid function test, serum prolactin, total testosterone, which were analyzed by chemiluminescence system. Results Oligomenorrhea was the most common menstrual abnormality in our study, the prevalence being 61.0% in cases followed by primary amenorrhea (16.4%). Thyroid dysfunction was found in 13.6% girls with menstrual disorders compared to 3.5% in those without menstrual disorders, and this was statistically significant (p = 0.006). Biochemical hyperandrogenism was seen in 9.04% cases compared to 0.7% controls (p = 0.001). The overall prevalence of hyperprolactinemia was 0.94%, and there was no statistically significant difference in girls with and without menstrual disorders. The prevalence of PCOS was 12.4% in the study population and 22.6% cases. Oligomenorrhea and PCOS were the most prevalent phenotypes in 52.5% of PCOS girls. No endocrine abnormality was detected in cases of polymenorrhea, hypomenorrhea and intermenstrual bleeding. Conclusions Although immaturity of hypothalamic pituitary ovarian axis is considered to be the most common cause of menstrual irregularities in adolescent girls, endocrine abnormalities, namely thyroid dysfunction and hyperandrogenism, may be responsible in some cases, thus warranting further evaluation.
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Chu CY, Cho YT, Jiang JH, Lin EIC, Tang CH. Epidemiology and comorbidities of patients with chronic urticaria in Taiwan: A nationwide population-based study. J Dermatol Sci 2017; 88:192-198. [PMID: 28743610 DOI: 10.1016/j.jdermsci.2017.07.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/21/2017] [Accepted: 07/11/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Comprehensive data regarding the epidemiology of chronic urticaria (CU) in general populations are scant. OBJECTIVES To investigate the prevalence, incidence, and comorbidities of CU in general population. METHODS The data were sourced from the National Health Insurance Research Database (NHIRD) for 2009-2012. Patients who had a primary/secondary ICD-9-CM diagnosis code of 708.1, 708.8, or 708.9 during the year with at least two outpatient visits and an antihistamine prescription, were identified as the cases of CU for each year. The incidence, persistence and comorbidities of CU were examined. RESULTS The prevalence of CU ranged from 0.69% to 0.79% for each year from 2009 to 2012, and the incidence was around 0.50% per year from 2010 to 2012. Comparing to the Standard Population, the standardized prevalence ratios (SPRs) for the rheumatic diseases, thyroid disorders, inflammatory diseases, and psychiatric disorders among CU patients were 2.74, 1.81, 1.57 and 1.87, respectively. CONCLUSION The prevalence of CU in Taiwan is about 0.69-0.79%. CU is associated with a significantly increased risk of psychiatric disorders, inflammatory diseases, thyroid disorders, and rheumatic diseases. Except for thyroid disorders, the prevalence of these comorbidities tends to increase the longer CU persists.
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Affiliation(s)
- Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung-Tsu Cho
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jhih-Hua Jiang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | | | - Chao-Hsiun Tang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
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Ramli NSF, Mat Junit S, Leong NK, Razali N, Jayapalan JJ, Abdul Aziz A. Analyses of antioxidant status and nucleotide alterations in genes encoding antioxidant enzymes in patients with benign and malignant thyroid disorders. PeerJ 2017; 5:e3365. [PMID: 28584708 PMCID: PMC5457668 DOI: 10.7717/peerj.3365] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 04/28/2017] [Indexed: 12/15/2022] Open
Abstract
Background Synthesis of thyroid hormones and regulation of their metabolism involve free radicals that may affect redox balance in the body. Thyroid disorders causing variations in the levels of thyroid hormones may alter cellular oxidative stress. The aim of this study was to measure the antioxidant activities and biomarkers of oxidative stress in serum and red blood cells (RBC) of patients with benign and malignant thyroid disorders and to investigate if changes in the antioxidant activities in these patients were linked to alterations in genes encoding the antioxidant enzymes. Methods Forty-one patients with thyroid disorders from University of Malaya Medical Centre were recruited. They were categorised into four groups: multinodular goitre (MNG) (n = 18), follicular thyroid adenoma (FTA) (n = 7), papillary thyroid cancer (PTC) (n = 10), and follicular thyroid cancer (FTC) (n = 6). Serum and RBC of patients were analysed for antioxidant activities, antioxidant enzymes, and biomarkers of oxidative stress. Alterations in genes encoding the antioxidant enzymes were analysed using whole exome sequencing and PCR–DNA sequencing. Results Patients with thyroid disorders had significantly higher serum superoxide dismutase (SOD) and catalase (CAT) activities compared to control, but had lower activities in RBC. There were no significant changes in serum glutathione peroxidase (GPx) activity. Meanwhile, GPx activity in RBC was reduced in PTC and FTC, compared to control and the respective benign groups. Antioxidant activities in serum were decreased in the thyroid disorder groups when compared to the control group. The levels of malondialdehyde (MDA) were elevated in the serum of FTA group when compared to controls, while in the RBC, only the MNG and PTC groups showed higher MDA equivalents than control. Serum reactive oxygen species (ROS) levels in PTC group of both serum and RBC were significantly higher than control group. Whole exome sequencing has resulted in identification of 49 single nucleotide polymorphisms (SNPs) in MNG and PTC patients and their genotypic and allelic frequencies were calculated. Analyses of the relationship between serum enzyme activities and the total SNPs identified in both groups revealed no correlation. Discussion Different forms of thyroid disorders influence the levels of antioxidant status in the serum and RBC of these patients, implying varying capability of preventing oxidative stress. A more comprehensive study with a larger target population should be done in order to further evaluate the relationships between antioxidant enzymes gene polymorphisms and thyroid disorders, as well as strengthening the minor evidences provided in literatures.
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Affiliation(s)
- Nur Siti Fatimah Ramli
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sarni Mat Junit
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ng Khoon Leong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nurhanani Razali
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Azlina Abdul Aziz
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Iyer SK, Menon SK, Bahuleyan B. An Analysis of Dynamic Pulmonary Functions of Hypothyroid Patients. J Clin Diagn Res 2017; 11:CC10-CC12. [PMID: 28511377 DOI: 10.7860/jcdr/2017/24653.9579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 12/28/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Hypothyroidism is a silent epidemic of our times. In India, the prevalence of hypothyroidism is 11%. The effect of hypothyroidism on respiratory system is debatable with studies suggesting both obstructive and restrictive disease patterns. The symptoms range from mild dyspnoea to life-threatening respiratory failure. This study emphasizes the effect of hypothyroidism on dynamic respiratory functions. AIM To find out the changes in dynamic respiratory functions (FVC, FEV1, FEV1% and PEFR) in both male and female hypothyroid patients within age group of 18-45 years. MATERIALS AND METHODS This cross-sectional study was conducted in Jubilee Mission Medical College, Thrissur, Kerala, India. Total number of 60 newly detected cases of both sexes in 18-45 years age group attending endocrinology outpatient department were enrolled. Patients with previous respiratory diseases and history of smoking were excluded. Proforma was filled up followed by clinical examination. Spirometry was performed using a computerised spirometer 'microQuark'. The data was analysed by paired t-test and Analysis of Variance (ANOVA) test. RESULTS The mean of the observed values in all the dynamic pulmonary parameters showed highly significant difference from the predicted mean of the parameters (p<0.001). They also decreased considerably with age, gender and BMI which were statistically significant (p<0.05). CONCLUSION The above findings suggest that respiratory abnormality in newly detected cases of hypothyroidism shows a mixed pattern. This highlights that while investigating a patient with respiratory disorder, the thyroid status should always be probed into, as the effects of hypothyroidism can be reversed with proper treatment.
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Affiliation(s)
- Seethalakshmi Krishna Iyer
- Junior Resident, Department of Physiology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | - Sunil K Menon
- Associate Professor, Department of Endocrinology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | - Biju Bahuleyan
- Professor and Head, Department of Physiology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
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Wolny-Rokicka E, Tukiendorf A, Wydmański J, Roszkowska D, Staniul B, Zembroń-Łacny A. Thyroid Function after Postoperative Radiation Therapy in
Patients with Breast Cancer. Asian Pac J Cancer Prev 2016; 17:4577-4581. [PMID: 27892665 PMCID: PMC5454600 DOI: 10.22034/apjcp.2016.17.10.4577] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective: The aim of this study was to assess thyroid function in breast cancer patients exposed to therapeutic external beam radiation. The focus was on possible progressive changes and any relationships between the incidence of primary hypothyroidism, the time required to become hypothyroid, and factors such as chemotherapy, hormonotherapy and immunotherapy. Materials and Methods: Seventy females undergoing 3D conformal and IMRT radiation therapy for breast cancers were enrolled in a non-randomized prospective study. The patients was divided into two groups: those after mastectomy or breast conserving surgery (BCS) were irradiated to a scar of the chest wall/breast and the ipsilateral supraclavicular and the axillary areas (supraclavicular radiotherapy group - SC-RT group – 32 patients) and the control group receiving adjuvant chest wall/breast RT only (BCT group - 38 patients).The total doses were 50.0 to 70 Gy in 5 to 7 weeks. The median follow-up term was 24 months (range, 1–40 months). Thyroid function was evaluated by measuring thyroid stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) levels. The minimum, maximum and mean thyroid gland doses for 20 Gy (V20) were calculated for all patients. Results: Statistically significant results were obtained for the SC-RT group. Two yearsa fter the end of RT the chance of an event was increased in 6% of the population (p=0.009) in the SC-RT group. In the BCT group no significance was noted. No statistically significant differences were found for V20, chemio-, immunotherapy and hormonotherapy or Ki67 values (p=0.12). No significant results were obtained for development of hypothyroidism and clinical factors (age, thyroid volume, treatment modalities). Conclusion: Radiotherapy is associated with a higher incidence of thyroid toxicity in breast cancer patients. Routine thyroid function monitoring should be recommended in such cases.
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Affiliation(s)
- Edyta Wolny-Rokicka
- Department of Radiotherapy, Regional Clinical Hospital in Zielona Gora Zyty 26, 65-001 Zielona Gora, Poland |University of Zielona Gora, Faculty of Medicine and Health Sciences, Poland,
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Xu H, Brusselaers N, Lindholm B, Zoccali C, Carrero JJ. Thyroid Function Test Derangements and Mortality in Dialysis Patients: A Systematic Review and Meta-analysis. Am J Kidney Dis 2016; 68:923-932. [PMID: 27596516 DOI: 10.1053/j.ajkd.2016.06.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/29/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND We evaluated current evidence associating thyroid function test result derangements with risk for mortality in patients with chronic kidney failure treated by long-term dialysis. STUDY DESIGN Systematic review and meta-analysis of cohort studies. SETTING & POPULATION Dialysis patients. SELECTION CRITERIA FOR STUDIES We searched PubMed, Web of Science, Science Citation Index, Cochrane Library, and Embase databases from inception through December 2015. PREDICTORS Hypothyroidism (thyrotropin level greater than reference range) and low triiodothyronine (T3) and thyroxine (T4) levels. OUTCOMES All-cause and cardiovascular mortality. RESULTS 12 studies involving 14,766 participants (4,450 deaths) were identified. Of those, 6 studies provided data for cardiovascular mortality (2,772 participants with 327 cardiovascular deaths). Overall, confidence in the available evidence was moderate. Pooled adjusted HRs for all-cause mortality associated with hypothyroidism, low T3 level, and low T4 level were 1.24 (95% CI, 1.14-1.34), 1.67 (95% CI, 1.23-2.27), and 2.40 (95% CI, 1.47-3.93), respectively. Pooled adjusted HRs for cardiovascular mortality associated with low T3 and T4 levels were 1.84 (95% CI, 1.24-2.74) and 3.06 (95% CI, 1.29-7.24), respectively. LIMITATIONS Fewer studies reporting on T4 and thyrotropin outcomes. CONCLUSIONS In patients treated with long-term dialysis, (cardiovascular) mortality is consistently higher in the presence of thyroid function test result derangements.
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Affiliation(s)
- Hong Xu
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Division of Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Nele Brusselaers
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Lindholm
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Division of Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Carmine Zoccali
- Division of Nephrology, Dialysis and Kidney Transplantation, CNR Hospital, Reggio Calabria, Italy
| | - Juan Jesús Carrero
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Division of Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
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Guhanandam H, Rajamani R, Noorunnisa N, Durairaj M. Expression of Cytokeratin-19 and Thyroperoxidase in Relation to Morphological Features in Non-Neoplastic and Neoplastic Lesions of Thyroid. J Clin Diagn Res 2016; 10:EC01-3. [PMID: 27504290 DOI: 10.7860/jcdr/2016/18522.7919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/24/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Thyroperoxidase (TPO) is a protein involved in thyroid hormone synthesis. TPO gene suppression and mutation were involved in thyroid tumours. CK-19 plays important role in the structural integrity of epithelial cells. Reduced TPO expression with increased CK-19 immunoreactivity has been implicated as a marker for differentiating non neoplastic and neoplastic thyroid lesions. AIM To study the histopathological features of thyroid lesions and to evaluate the diagnostic role of thyroperoxidase and CK-19 in non-neoplastic and neoplastic thyroid lesions. MATERIALS AND METHODS Prospective observational study of 65 thyroid specimens was studied for detailed histopathological examination and Expression of Immunohistochemical Markers Cytokeratin-19 (CK-19) and Thyroperoxidase. RESULTS TPO IHC marker was expressed by non-neoplastic and benign lesions of thyroid but not in malignancy. CK-19 was expressed 100% in papillary carcinoma of thyroid and its variants, focal and weak staining noted in goitre and hyperplastic areas. CONCLUSION Most of the non-neoplastic and neoplastic lesions were diagnosed based on histopathological features. When the histopathological diagnosis are equivocal, immunohistochemical markers aids in diagnosing malignancy. Diffuse and strong TPO expression indicates non-neoplastic thyroid lesions whereas diffused and strong CK-19 expression indicates thyroid malignancy.
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Affiliation(s)
- Hemanathan Guhanandam
- Post Graduate Student, Department of Pathology, Shri Sathya Sai Medical College and Research Institute , Ammapettai, Kancheepuram, Tamil Nadu, India
| | - Revathishree Rajamani
- Assistant Professor, Department of Pathology, Shri Sathya Sai Medical College and Research Institute , Ammapettai, Kancheepuram, Tamil Nadu, India
| | - Naseen Noorunnisa
- Professor, Department of Pathology, Shri Sathya Sai Medical College and Research Institute , Ammapettai, Kancheepuram, Tamil Nadu, India
| | - Manimaran Durairaj
- Professor, Department of Pathology, Shri Sathya Sai Medical College and Research Institute , Ammapettai, Kancheepuram, Tamil Nadu, India
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Andrès E, Weitten T, Mourot-Cottet R, Keller O, Zulfiqar AA, Serraj K, Vogel T, Tebacher M. [Antithyroid agents related agranulocytosis: Literature review]. Rev Med Interne 2016; 37:544-50. [PMID: 27241077 DOI: 10.1016/j.revmed.2016.02.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 12/08/2015] [Accepted: 02/25/2016] [Indexed: 12/31/2022]
Abstract
The antithyroid agents (carbimazole, methimazole, thiamazole, propylthiouracil and benzylthiouracile) are the drug class that is associated with a high risk of agranulocytosis. Acute and profound (<0.5×10(9)/L) isolated neutropenia occurring in a subject treated with antithyroid agents should be considered as a drug-induced agranulocytosis, until proven otherwise. The clinical spectrum ranges from discovery of acute severe but asymptomatic neutropenia, to isolated fever, localized infections (especially ear, nose and throat, or pulmonary) or septicemia. With an optimal management (discontinuation of antithyroid agents, antibiotics in the presence of fever or a documented infection, or use of hematopoietic growth factor) the current mortality is close to 2%.
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Afsar B, Yilmaz MI, Siriopol D, Unal HU, Saglam M, Karaman M, Gezer M, Sonmez A, Eyileten T, Aydin I, Hamcan S, Oguz Y, Covic A, Kanbay M. Thyroid function and cardiovascular events in chronic kidney disease patients. J Nephrol 2016; 30:235-242. [PMID: 27039198 DOI: 10.1007/s40620-016-0300-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 03/22/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS Abnormalities of thyroid function are commonly seen in chronic kidney disease (CKD) patients. They are associated with adverse clinical conditions such as atherosclerosis, endothelial dysfunction, inflammation and abnormal blood pressure variability. We investigated the association between thyroid disorders and endothelial function, assessed by flow-mediated dilatation (FMD) and carotid intima-media thickness (CIMT), and cardiovascular events (CVE) in CKD patients. MATERIALS AND METHODS This observational cohort study included 305 CKD (stages 1-5) patients. Routine biochemistry, including free T3, free T4 and thyroid stimulating hormone, fibroblast growth factor-23 (FGF-23) and FMD, CIMT were measured. We divided patients into four groups according to thyroid hormone status: euthyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, and euthyroid sick syndrome. Fatal and composite CVE were recorded for a median 29 months. RESULTS Patients with subclinical hypothyroidism had a higher prevalence of hypertension and diabetes and also were more likely to have higher values of systolic CIMT, phosphorus, intact parathormone (iPTH), FGF-23, homeostasis model assessment-insulin resistance and lower levels of FMD than euthyroid patients. In the unadjusted survival analysis, subclinical hypothyroidism and euthyroid sick syndrome were associated with an increased risk for the outcome as compared with euthyroidism [hazard ratio 30.63 (95 % confidence interval 12.27-76.48) and 12.17 (3.70-39.98), respectively]. The effects of subclinical hypothyroidism and euthyroid sick syndrome were maintained even in fully adjusted models. CONCLUSION We demonstrated that subclinical hypothyroidism and euthyroid sick syndrome are associated with increased CVE in CKD patients. Further studies are needed to explore these issues.
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Affiliation(s)
- Baris Afsar
- Department of Nephrology, Konya Numune State Hospital, Konya, Turkey
| | | | - Dimitrie Siriopol
- Nephrology Clinic, Dialysis and Renal Transplant Center, 'C.I. PARHON' University Hospital, 'Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Hilmi Umut Unal
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Mutlu Saglam
- Department of Radiology, Gulhane School of Medicine, Ankara, Turkey
| | - Murat Karaman
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Mustafa Gezer
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Alper Sonmez
- Department of Endocrinology, Gulhane School of Medicine, Ankara, Turkey
| | - Tayfun Eyileten
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Ibrahim Aydin
- Department of Endocrinology, Gulhane School of Medicine, Ankara, Turkey
| | - Salih Hamcan
- Department of Biochemistry, Gulhane School of Medicine, Ankara, Turkey
| | - Yusuf Oguz
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Adrian Covic
- Nephrology Clinic, Dialysis and Renal Transplant Center, 'C.I. PARHON' University Hospital, 'Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Mehmet Kanbay
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey. .,Department of Medicine, Division of Nephrology, Koc University School of Medicine, Topkapı, 03490, Istanbul, Turkey.
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Gul N, Farid J, Idris M, Sarwar J. Screening For Hypothyroidism-Results Of A Study Conducted At District Headquarter Hospital, Abbottabad. J Ayub Med Coll Abbottabad 2016; 28:312-314. [PMID: 28718539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Sub-clinically hypo-functioning thyroid is a condition in which there is biochemical evidence of hypothyroidism but patient is clinically asymptomatic. This concept is not new. The typical picture of this condition is increased thyroid stimulating hormone and normal thyroxine levels. Subclinical hypothyroidism has been found to have variable prevalence ranging from 4-10% to 10- 26%. METHODS This cross sectional study was conducted on 378 adult patients coming to outpatient department of District Headquarter Hospital Abbottabad over a period of two years from February 2013 to February 2015. RESULTS Out of the 378 individuals studied, 37 (9.78%) had subclinical hypothyroidism. Mean age of the patients was 43.5±10.5 years. Females outnumbered males, i.e., 24 out of 37 (65%). It was noted that there was no correlation between mean TSH level and gender or age of the patients. CONCLUSIONS Subclinical hypothyroidism is not an uncommon condition and its diagnosis is established easily by doing thyroid hormone levels in fasting condition. Early diagnosis and therapeutic intervention may not only prevent the progression to clinical hypothyroidism but also help in preventing the wastage of resources on doing unnecessary investigations.
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Affiliation(s)
- Nasreen Gul
- Department of Pathology, Ayub Medical College, Abbottabad, Pakistan
| | - Jamila Farid
- Department of Pathology, Ayub Medical College, Abbottabad, Pakistan
| | - Muhammad Idris
- Department of Pathology, Ayub Medical College, Abbottabad, Pakistan
| | - Javed Sarwar
- Department of Medicine, Women Medical College, Abbottabad, Pakistan
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Abstract
About 300 million people across the world suffer from thyroid gland dysfunction. Environmental factors play an important role in causation of autoimmune thyroid diseases in susceptible individuals. Genetics contributes to 70% of the risk. In order to reduce the risk, we need to understand the association of environmental agents with thyroid dysfunction. These factors are especially relevant for those at increased risk due to positive family history. The ideal study to see the impact of a thyroid toxicant consists of directly measuring the degree of exposure to toxicant in an individual with his thyroid status. Knowledge of various factors influencing thyroid dysfunction can help in interpreting the results of such studies in a better way. This article is an attempt to highlight the various possible toxicants affecting thyroid function so that adequate measures can be undertaken to control excessive exposure in future to reduce the prevalence of thyroid disorders.
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Affiliation(s)
| | - Poonam Salwan
- Assistant Professor, Department of Pharmacology, SGT Medical College and Hospital, Gurgaon, India
| | - Shalini Salwan
- Associate Professor, Department of Pharmacology, PIMS, Jalandhar, India
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Perić I, Paladin I, Lozo Vukovac E, Vela Ljubić J, Gudelj I, Lozo M. Tracheomalatia, to stent or not to stent. Respir Med Case Rep 2015; 16:137-9. [PMID: 26744681 PMCID: PMC4682007 DOI: 10.1016/j.rmcr.2015.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 09/26/2015] [Accepted: 09/28/2015] [Indexed: 11/25/2022] Open
Abstract
Benign thyroid disorders such as goiter, especially retrosternal, can cause tracheostenosis by extrinsic tracheal compression, which is due to the lack of specific symptoms often misdiagnosed. Tracheomalatia develops as a result to long term tracheal compression and refers to weakness of the trachea characterized by softness of the tracheal cartilage arches and by loss of regular tracheal structure. Tracheomalatia is characterized by reduction of the endotracheal lumen and may affect the entire trachea or may be localized to one portion of it. We present the case of a 72-year old patient with distinct tracheostenosis and tracheomalatia, caused by long term pressure by the retrosternal goiter. We have been monitoring the patient for last 20 years after the second endotracheal stent had been placed. The first one was placed 34 years ago, in 1981. On both occasions granulation tissue and colonization of bacteria occurred. In the end the placed stents were rejected and migrated to the main carina. Despite the tracheal diameter narrower than 5 mm the patient has been living normally without the stent for 17 years, with the exception of no hard physical labor. He had a few short term antibiotic therapies and bronchial toilets during symptomatic deteriorations. Diagnosing retrosternal goiter and surgical treatment on time is of crucial importance in cases such as this one. Considering the complications caused by the stent, our opinion is that the majority of patients may require conservative treatment with closely monitoring during respiratory infections.
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Affiliation(s)
- Irena Perić
- Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia
| | - Ivan Paladin
- The Croatian Institute of Emergency Medicine, Split, Croatia
| | - Emilija Lozo Vukovac
- Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia
| | - Jadranka Vela Ljubić
- Department of Ear, Nose, Throat, Head and Neck Surgery, University Hospital Center Split, Split, Croatia
| | - Ivan Gudelj
- Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia
| | - Mislav Lozo
- Department of Cardiology, University Hospital Center Split, Split, Croatia
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