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hypothyroidism guideline

Gisah Amaral Carvalho, Gilberto Paz-Filho, Cleo Otaviano Mesa Junior, Hans Graf
Hypothyroidism is one of the most common hormone deficiencies in adults. Most of the cases, particularly those of overt hypothyroidism, are easily diagnosed and managed, with excellent outcomes if treated adequately. However, minor alterations of thyroid function determine nonspecific manifestations. Primary hypothyroidism due to chronic autoimmune thyroiditis is largely the most common cause of thyroid hormone deficiency. Central hypothyroidism is a rare and heterogeneous disorder characterized by decreased thyroid hormone secretion by an otherwise normal thyroid gland, due to lack of TSH...
February 28, 2018: European Journal of Endocrinology
Rosie Dew, Kathryn King, Onyebuchi E Okosieme, Simon H Pearce, Gemma Donovan, Peter N Taylor, Janis Hickey, Colin M Dayan, Graham Leese, Salman Razvi, Scott Wilkes
OBJECTIVE: To explore the attitudes and perceptions of health professionals towards management of hypothyroidism that contributes to the suboptimal treatment of hypothyroidism in general practice. DESIGN: A qualitative interview study using semistructured interviews. PARTICIPANTS: Sixteen participants were interviewed between March and August 2016 comprising nine general practitioners (GPs), four pharmacists, two practice nurses and one nurse practitioner...
February 21, 2018: BMJ Open
S Sudhanshu, I Riaz, R Sharma, M P Desai, R Parikh, V Bhatia
The Indian Society for Pediatric and Adolescent Endocrinology has formulated Clinical Practice Guidelines for newborn screening, diagnosis and management of congenital hypothyroidism (CH). This manuscript, part II addresses management and follow-up. RECOMMENDATIONS: Screening should be done for every newborn using cord blood, or postnatal blood ideally at 48 to 72 h of age. Neonates with screen TSH > 20 mIU/L serum units (or >34 mIU/L for samples taken between 24 and 48 h of age) should be recalled for confirmation...
February 17, 2018: Indian Journal of Pediatrics
R Gallizzi, C Crisafulli, T Aversa, G Salzano, F De Luca, M Valenzise, G Zirilli
Aim of this commentary is to report current knowledges on the main clinical and metabolic abnormalities which might be observed in children with longstanding and untreated subclinical hypothyroidism (SH) and to comment the most recent views about natural evolution of thyroid function in the cases with either idiopathic or Hashimoto's thyroiditis-related SH. On the basis of these preliminary remarks, the essential guidelines for an appropriate and tailored management of SH children are also proposed.
February 17, 2018: Italian Journal of Pediatrics
Yuan Fang, Liang Yao, Jing Sun, Jian Zhang, Yanxia Li, Ruifei Yang, Kehu Yang, Limin Tian
PURPOSE: This study aimed to systematically evaluate the quality of guidelines for the management of hypothyroidism in pregnancy. METHOD: Systematic searches were conducted to identify hypothyroidism in pregnancy guidelines published in electronic databases and developers' websites. Four reviewers independently evaluated eligible guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Agreement among reviewers was measured using the intraclass correlation coefficient (ICC)...
February 14, 2018: Endocrine
Hou-Yang Hu, Jun Liang, Teng Zhang, Teng Zhao, Yan-Song Lin
PURPOSE: According to the American Thyroid Association guidelines in 2015, both an unstimulated thyroglobulin (u-Tg) below 0.2 ng/ml and a stimulated thyroglobulin (s-Tg) below 1.0 ng/ml were required along with negative imaging findings to define an excellent response. This study aimed to investigate whether a u-Tg below 0.2 ng/ml coincides with a s-Tg below 1 ng/ml. PATIENTS AND METHODS: A total of 290 patients with nonmetastatic differentiated thyroid cancer were retrospectively evaluated with a median follow-up of 36 months...
March 2018: Nuclear Medicine Communications
Saumya Sara Sunny, Julie Hephzibah, David Mathew, Joseph Dian Bondu, Nylla Shanthly, Regi Oommen
Serum thyroglobulin (Tg) and thyroid whole-body radioiodine scintigraphy (TWBS) are used in the follow-up of patients with papillary thyroid carcinoma (PTC) after total thyroidectomy. Symptoms of hypothyroidism are frequent as patients discontinue levothyroxine 1 month before visit, favoring the use of unstimulated serum Tg (uSTg) only. This study was done to determine the reliability of stimulated serum Tg levels (sSTg) over uSTg. A total of 650 patients with PTC came for follow-up between June 2011 and 2016...
January 2018: World Journal of Nuclear Medicine
M P Desai, R Sharma, I Riaz, S Sudhanshu, R Parikh, V Bhatia
The Indian Society for Pediatric and Adolescent Endocrinology has formulated locally relevant Clinical Practice Guidelines for newborn screening, diagnosis and management of primary congenital hypothyroidism (CH). RECOMMENDATIONS: Screening should be done for every newborn using cord blood, or postnatal blood, ideally at 48 to 72 h of age. On this screen sample, neonates with TSH > 20 mIU/L serum units (or >34 mIU/L for samples taken between 24 to 48 h of age) should be recalled for confirmation...
January 30, 2018: Indian Journal of Pediatrics
Colin Dayan, Vijay Panicker
Background: Whilst trials of combination levothyroxine/liothyronine therapy versus levothyroxine monotherapy for thyroid hormone replacement have not shown any superiority, there remains a small subset of patients who do not feel well on monotherapy. Whilst current guidelines do not suggest routine use of combination therapy they do acknowledge a trial in such patients may be appropriate. It appears that use of combination therapy and dessicated thyroid extract is not uncommon but often being used by non-specialists and not adequately monitored...
2018: Thyroid Research
Simone De Leo, Elizabeth N Pearce
Understanding of changes in thyroid function and the consequences of thyroid disease during pregnancy has rapidly grown in the past two decades, and revised American Thyroid Association guidelines on this topic were published in 2017. This Review explores the association between thyroid autoimmunity and complications during and after pregnancy. Thyroid autoimmunity refers to the presence of antibodies to thyroperoxidase or thyroglobulin, or thyroid-stimulating hormone receptor antibodies (TRAbs), or a combination of these, and is present in up to 18% of pregnant women...
December 12, 2017: Lancet Diabetes & Endocrinology
A Ortega Carpio, I Vázquez Rico, M A Castaño López, L Duarte González, M Montilla Álvaro, A Ruiz Reina
OBJECTIVE: The correct diagnosis of hypothyroidism during pregnancy requires knowledge of the local trimester-specific thyrotropin (TSH) reference ranges. When these are not available, the guidelines recommend upper limits of 2.5, 3.0, and 3.0μU/ml for the 1(st), 2(nd), and 3(rd) trimesters, respectively. The aim is to establish the reference range for our local population. MATERIAL AND METHODS: A population-based observational study was performed on healthy pregnant women from 11 healthcare centres in the province of Huelva...
November 18, 2017: Semergen
Patrícia Páleníková, Iveta Kalafutová, Zdenka Horníková, Juraj Payer
Thyroid diseases may adversely affect the conception, maintain pregnancy. They increase the risk of complications in pregnancy and may have a negative effect on the fetus. Therefore it is necessary to capture thyroid diseases in the population of pregnant women, in the early stage of pregnancy. In Slovakia, since 2009, the Expert Guideline of the Ministry of Health of the Slovak Republic for the diagnosis and treatment of autoimmune thyroid diseases in women during pregnancy has been in force. In our patient cohort, we monitored 666 pregnant patients, the timeliness of screening, thyroid parameters, the number of pregnancies and their complications, the need for levothyroxine treatment...
2017: Vnitr̆ní Lékar̆ství
Eric J Kuo, William J Thi, Feibi Zheng, Kyle A Zanocco, Masha J Livhits, Michael W Yeh
BACKGROUND: Lobectomy may be sufficient for patients with intrathyroidal papillary thyroid carcinomas (PTC) <4 cm without nodal metastasis. Based on the 2015 American Thyroid Association guidelines, a strategy using ultrasound to identify appropriate candidates for lobectomy was implemented. METHODS: Patients with Bethesda V or VI cytology who underwent surgery for PTC (January 2016 to May 2017) were retrospectively reviewed. Eligibility for lobectomy was based on both tumor (unilateral, intrathyroidal tumors ≤3 cm in size) and non-tumor (history of hypothyroidism, radiation exposure, etc...
December 2017: Thyroid: Official Journal of the American Thyroid Association
Joseph K Kluesner, Darrick J Beckman, Joshua M Tate, Alexis A Beauvais, Maria I Kravchenko, Jana L Wardian, Sky D Graybill, Jeffrey A Colburn, Irene Folaron, Mark W True
RATIONALE: Current guidelines recommend thyroid stimulating hormone (TSH) alone as the best test to detect and monitor thyroid dysfunction, yet free thyroxine (FT4) and free triiodothyronine (FT3) are commonly ordered when not clinically indicated. Excessive testing can lead to added economic burden in an era of rising healthcare costs, while rarely contributing to the evaluation or management of thyroid disease. OBJECTIVE: To evaluate our institution's practice in ordering thyroid function tests (TFTs) and to identify strategies to reduce inappropriate FT4 and FT3 testing...
November 3, 2017: Journal of Evaluation in Clinical Practice
Arash Momeni, Justin P Fox
BACKGROUND: Venous thromboembolism (VTE) remains a serious complication after the surgical treatment of breast cancer. Contemporary guidelines limit VTE chemoprophylaxis to the period of hospitalization. We conducted this study to evaluate the frequency of postdischarge VTE among surgically treated breast cancer patients and identify patient level factors associated with postdischarge VTE. METHODS: Using Arkansas, Florida, Nebraska, and New York state inpatient databases, we conducted a retrospective cohort study of adult women who underwent surgical treatment for breast cancer between October 1, 2008, and September 30, 2013...
October 31, 2017: Annals of Plastic Surgery
Inés Velasco, Peter Taylor
Thyroid hormones are essential for an adequate growth and development of the fetus. In addition to the classical association between maternal hypothyroidism and neurological impairment in the progeny, other adverse reproductive events have been associated with maternal thyroid dysfunction including infertility, miscarriage and preterm delivery. Although all scientific societies endorse the treatment of overt hypothyroidism; the management and/or treatment of subclinical hypothyroidism, hypothyroxinemia or antithyroid antibody-positive women should be considered with caution...
January 2018: European Journal of Endocrinology
Efterpi Tingi, Akheel A Syed, Alexis Kyriacou, George Mastorakos, Angelos Kyriacou
Thyroid dysfunction is the commonest endocrine disorder in pregnancy apart from diabetes. Thyroid hormones are essential for fetal brain development in the embryonic phase. Maternal thyroid dysfunction during pregnancy may have significant adverse maternal and fetal outcomes such as preterm delivery, preeclampsia, miscarriage and low birth weight. In this review we discuss the effect of thyroid disease on pregnancy and the current evidence on the management of different thyroid conditions in pregnancy and postpartum to improve fetal and neonatal outcomes, with special reference to existing guidelines on the topic which we dissect, critique and compare with each other...
December 2016: Journal of Clinical & Translational Endocrinology
Bharat Kumar, Namrata Singh, S Rahnama-Moghadam, Karolyn A Wanat, Jacob W Ijdo, Victoria P Werth
No abstract text is available yet for this article.
January 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
K Neelaveni, K V S Hari Kumar, Rakesh Sahay, Jayanthy Ramesh
BACKGROUND: Management guidelines about the thyroid disease in pregnancy are silent about the postpartum course of new onset subclinical hypothyroidism (SCH). Hence, we analyzed the 2 years outcome of SCH diagnosed during pregnancy. MATERIALS AND METHODS: We conducted this retrospective study using the medical records of patients with new onset SCH during pregnancy between 2010 and 2013 ( n = 718). Patients who stopped their levothyroxine after delivery with a 2-year follow-up record were included...
September 2017: Indian Journal of Endocrinology and Metabolism
Prashant Ulhas Kaduskar, Mala Dharmalingam, Pramila Kalra
INTRODUCTION: Hypothyroidism managed inadequately in pregnancy may have grave outcomes for both mother and baby. Understanding pregnancy outcomes in our country with low awareness about thyroid diseases is important. OBJECTIVES: The objectives of the study were to evaluate demographic features and biochemical parameters in patients with prepregnancy hypothyroidism versus patients diagnosed to have primary hypothyroidism during pregnancy and to assess pregnancy outcomes...
September 2017: Indian Journal of Endocrinology and Metabolism
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