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Thyroid and amiodarone

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https://www.readbyqxmd.com/read/29762678/using-statistical-anomaly-detection-models-to-find-clinical-decision-support-malfunctions
#1
Soumi Ray, Dustin S McEvoy, Skye Aaron, Thu-Trang Hickman, Adam Wright
Objective: Malfunctions in Clinical Decision Support (CDS) systems occur due to a multitude of reasons, and often go unnoticed, leading to potentially poor outcomes. Our goal was to identify malfunctions within CDS systems. Methods: We evaluated 6 anomaly detection models: (1) Poisson Changepoint Model, (2) Autoregressive Integrated Moving Average (ARIMA) Model, (3) Hierarchical Divisive Changepoint (HDC) Model, (4) Bayesian Changepoint Model, (5) Seasonal Hybrid Extreme Studentized Deviate (SHESD) Model, and (6) E-Divisive with Median (EDM) Model and characterized their ability to find known anomalies...
May 11, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29748197/minimally-invasive-delivery-of-hydrogel-encapsulated-amiodarone-to-the-epicardium-reduces-atrial-fibrillation
#2
Jose R Garcia, Peter F Campbell, Gautam Kumar, Jonathan J Langberg, Liliana Cesar, Juline N Deppen, Eric Y Shin, Neal K Bhatia, Lanfang Wang, Kai Xu, Frank Schneider, Brian Robinson, Andrés J García, Rebecca D Levit
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia. Although treatment options for AF exist, many patients cannot be maintained in normal sinus rhythm. Amiodarone is an effective medication for AF but has limited clinical utility because of off-target tissue toxicity. METHODS: Here, we use a pig model of AF to test the efficacy of an amiodarone-containing polyethylene glycol-based hydrogel. The gel is placed directly on the atrial epicardium through the pericardial space in a minimally invasive procedure using a specially designed catheter...
May 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29594056/2018-european-thyroid-association-eta-guidelines-for-the-management-of-amiodarone-associated-thyroid-dysfunction
#3
Luigi Bartalena, Fausto Bogazzi, Luca Chiovato, Alicja Hubalewska-Dydejczyk, Thera P Links, Mark Vanderpump
Treatment with amiodarone is associated with changes in thyroid function tests, but also with thyroid dysfunction (amiodarone-induced hypothyroidism, AIH, and amiodarone-induced thyrotoxicosis, AIT). Both AIH and AIT may develop in apparently normal thyroid glands or in the presence of underlying thyroid abnormalities. AIH does not require amiodarone withdrawal, and is treated with levothyroxine replacement if overt, whereas subclinical forms may be followed without treatment. Two main types of AIT are recognized: type 1 AIT (AIT 1), a form of iodine-induced hyperthyroidism occurring in nodular goitres or latent Graves disease, and type 2 AIT (AIT 2), resulting from destructive thyroiditis in a normal thyroid gland...
March 2018: European Thyroid Journal
https://www.readbyqxmd.com/read/29558786/amiodarone-induced-thyroid-dysfunction-a-clinical-update
#4
Mohamed Nabil Elnaggar, Kahtan Jbeili, Nik Nik-Hussin, Mohandas Kozhippally, Joseph M Pappachan
Amiodarone is one of the most commonly prescribed antiarrhythmic agents in clinical practice owing to its efficacy, even with high toxicity profile. The high iodine content and the prolonged biological half-life of the drug can result in thyroid dysfunction in a high proportion of patients treated with amiodarone even after cessation of amiodarone. Both hypothyroidism and hyperthyroidism are common side effects that mandate regular monitoring of patients with thyroid function tests. Amiodarone-induced hypothyroidism (AIH) is diagnosed and managed in the same way as a usual case of hypothyroidism...
March 20, 2018: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/29523919/efficacy-and-safety-of-low-dose-amiodarone-therapy-for-tachyarrhythmia-in-congenital-heart-disease
#5
Shinya Iwasawa, Tomomi Uyeda, Mika Saito, Taku Ishii, Akio Inage, Yuji Hamamichi, Satoshi Yazaki, Tadahiro Yoshikawa
Amiodarone (AMD) is a class III anti-arrhythmic drug that is highly effective for tachyarrhythmia treatment. AMD is widely used in adults with congenital heart disease (CHD); however, higher doses of AMD (> 200 mg/day) can cause various non-cardiac side effects. The purpose of this study was to assess the efficacy, safety, and adverse events of low-dose AMD (≤ 200 mg/day) for tachyarrhythmia in patients with CHD. We retrospectively studied 80 patients with CHD and tachyarrhythmia who received oral low-dose AMD (≤ 200 mg/day) from January 2004 to March 2016...
June 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29503241/increased-admissions-due-to-cardiac-complications-of-thyrotoxicosis-in-m%C3%A4-ori
#6
Jade A U Tamatea, Marianne S Elston, John V Conaglen
BACKGROUND: As thyrotoxicosis is a risk factor for atrial fibrillation, current guidelines recommend measuring a thyroid-stimulating hormone level in patients with this disorder. Hyperthyroidism may also be associated with other heart diseases including cardiac ischaemia and cardiac failure. Currently, the prevalence of thyrotoxicosis in cardiac admissions in the absence of a rhythm disorder is unknown. AIMS: The aims of this study were: 1) to calculate the prevalence of admissions for thyrotoxicosis-associated cardiac disease, 2) determine the type of cardiac disease i...
November 21, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29466241/in-iodine-induced-thyrotoxicosis-steroid-therapy-today-could-keep-the-surgical-knife-at-bay
#7
Rohan K Henry, Monika Chaudhari
BACKGROUND: Amiodarone-induced thyrotoxicosis (AIT) type 2, characterized as a destructive thyroiditis, is well described in the medical literature; however, iodine-induced thyrotoxicosis (IIT) is not, though the latter has similar features and can be managed similarly. CASE PRESENTATION: We present a 17-year-old female who presented with a history of an intermittent goiter with thyroid function tests (TFTs): thyroid-stimulating hormone (TSH)<0.015 (0.4-4 μU/mL), free thyroxine (T4)≥6 (0...
April 25, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29407433/thyroid-hormone-receptor-antagonists-from-environmental-pollution-to-novel-small-molecules
#8
Louise S Mackenzie
Thyroid hormone receptors (TRs) are nuclear receptors which control transcription, and thereby have effects in all cells within the body. TRs are an important regulator in many basic physiological processes including development, growth, metabolism, and cardiac function. The hyperthyroid condition results from an over production of thyroid hormones resulting in a continual stimulation of thyroid receptors which is detrimental for the patient. Therapies for hyperthyroidism are available, but there is a need for new small molecules that act as TR antagonists to treat hyperthyroidism...
2018: Vitamins and Hormones
https://www.readbyqxmd.com/read/29235066/dysthyroidism-and-chronic-heart-failure-pathophysiological-mechanisms-and-therapeutic-approaches
#9
Caterina Rizzo, Margherita Ilaria Gioia, Giuseppe Parisi, Vincenzo Triggiani, Massimo Iacoviello
Among comorbidity in chronic heart failure (CHF), dysthyroidism represents a relevant problem especially in the ageing CHF patients worldwide. Thyroid greatly affects many cardiovascular activities and its dysfunction may worsen a CHF condition. In particular, hypothyroidism has a relative high prevalence in patients with heart failure and it plays a key role in influencing CHF onset, progression and prognosis. Hyperthyroidism, is less frequent in this clinical context but it necessitates of immediate treatment because of its negative effects on cardiovascular balance...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29080209/association-between-serum-amiodarone-and-n-desethylamiodarone-concentrations-and-development-of-thyroid-dysfunction
#10
Mikie Yamato, Kyoichi Wada, Tomohiro Hayashi, Mai Fujimoto, Kouichi Hosomi, Akira Oita, Mitsutaka Takada
OBJECTIVE: This retrospective cohort study was performed to examine the association between serum amiodarone (AMD) and N-desethylamiodarone (DEA) concentrations and the development of thyroid dysfunction. METHODS: Patients treated with AMD from January 2012 to April 2016 were identified from the computerized hospital information system database at the National Cerebral and Cardiovascular Center. Only patients whose serum AMD and DEA concentrations had been determined at least once were included in the study...
January 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29079274/glomerular-filtration-rate-is-associated-with-free-triiodothyronine-in-euthyroid-subjects-comparison-between-various-equations-to-estimate-renal-function-and-creatinine-clearance
#11
Josephine L C Anderson, Eke G Gruppen, Lynnda van Tienhoven-Wind, Michele F Eisenga, Hanne de Vries, Ron T Gansevoort, Stephan J L Bakker, Robin P F Dullaart
BACKGROUND: Effects of variations in thyroid function within the euthyroid range on renal function are unclear. Cystatin C-based equations to estimate glomerular filtration rate (GFR) are currently advocated for mortality and renal risk prediction. However, the applicability of cystatin C-based equations is discouraged in patients with overt thyroid dysfunction, since serum cystatin C and creatinine levels are oppositely affected by thyroid dysfunction. Here, we compared relationships of thyroid stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) with various measures of kidney function in euthyroid subjects...
February 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29044016/drug-induced-hypothyroidism
#12
Leonardo F L Rizzo, Daniela L Mana, Héctor A Serra
The thyroid axis is particularly prone to interactions with a wide variety of drugs, whose list increases year by year. Hypothyroidism is the most frequent consequence of drug-induced thyroid dysfunction. The main mechanisms involved in the development of primary hypothyroidism are: inhibition of the synthesis and/or release of thyroid hormones, immune mechanisms related to the use of interferon and other cytokines, and the induction of thyroiditis associated with the use of tyrosine kinase inhibitors and drugs blocking the receptors for vascular endothelial growth factor...
2017: Medicina
https://www.readbyqxmd.com/read/28960089/efficacy-and-safety-of-dronedarone-in-the-treatment-of-patients-with-atrial-fibrillation
#13
REVIEW
Mohammed Hasan Khan, Yogita Rochlani, Wilbert S Aronow
Dronedarone, a derivative of amiodarone with structural modifications, was designed to have similar electrophysiological properties with a less toxic profile. Areas covered: Brief overview of the pharmacology of dronedarone followed by a summary of randomized clinical trials testing the efficacy of dronedarone in maintaining normal sinus rhythm and clinical outcomes associated with these trials. In depth discussion and commentary on trial findings which may seem contradictory at first approach and brief discussion of post-marketing surveillance studies...
December 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28942732/is-graves-disease-a-primary-immunodeficiency-new-immunological-perspectives-on-an-endocrine-disease
#14
REVIEW
Tristan Struja, Alexander Kutz, Stefan Fischli, Christian Meier, Beat Mueller, Mike Recher, Philipp Schuetz
BACKGROUND: Uncertainty about factors influencing the susceptibility and triggers for Graves' disease persists, along with a wide variation in the response to anti-thyroid drugs, currently at approximately 50% of non-responders. The aim of this narrative review is to summarize immunological concepts, with a combined endocrine and immunological perspective, to highlight potential new areas of research. MAIN TEXT: Relevant studies were identified through a systematic literature search using the PubMed and EMBASE databases in March 2016...
September 25, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28912982/severe-thyrotoxicosis-secondary-to-povidone-iodine-from-peritoneal-dialysis
#15
Kirstie Lithgow, Christopher Symonds
A 73-year-old male on home peritoneal dialysis (PD) with recent diagnosis of atrial fibrillation presented with fatigue and dyspnea. Hyperthyroidism was diagnosed with TSH < 0.01 mIU/L and FT4 > 100 pmol/L. He had no personal or family history of thyroid disease. There had been no exposures to CT contrast, amiodarone, or iodine. Technetium thyroid scan showed diffusely decreased uptake. He was discharged with a presumptive diagnosis of thyroiditis. Three weeks later, he had deteriorated clinically...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28884613/frequency-of-adverse-event-monitoring-in-ambulatory-patients-on-amiodarone-or-dofetilide
#16
Joshua P Rickard, Jenna Negrelli, Jeffery L Olson, Travis Dick
BACKGROUND: Published studies state that adherence to regular laboratory assessments for anti-arrhythmic drugs is as low as 20%. Monitoring adherence is important as other studies have shown that up to 93% of patients on amiodarone experience an adverse drug event leading to a potentially lethal event. OBJECTIVE: To determine whether patients prescribed amiodarone or dofetilide are being monitored according to package labeling and guideline recommendations for adverse events...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28883920/exogenous-t3-toxicosis-following-consumption-of-a-contaminated-weight-loss-supplement
#17
R D'Arcy, M McDonnell, K Spence, C H Courtney
A 42-year-old male presented with a one-week history of palpitations and sweating episodes. The only significant history was of longstanding idiopathic dilated cardiomyopathy. Initial ECG demonstrated a sinus tachycardia. Thyroid function testing, undertaken as part of the diagnostic workup, revealed an un-measureable thyroid-stimulating hormone (TSH) and free thyroxine (T4). Upon questioning the patient reported classical thyrotoxic symptoms over the preceding weeks. Given the persistence of symptoms free tri-iodothyronine (T3) was measured and found to be markedly elevated at 48...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28822614/heterogeneity-in-a-large-pedigree-with-danon-disease-implications-for-pathogenesis-and-management
#18
Jonathan C P Roos, Matthew J Daniels, Elizabeth Morris, Hanna I Hyry, Timothy M Cox
BACKGROUND: Danon disease is an X-linked disturbance of autophagy manifesting with cognitive impairment and disordered heart and skeletal muscle. After a period of relative stability, patients deteriorate rapidly and may quickly become ineligible for elective heart transplantation - the only life-saving therapy. METHODS: We report a large pedigree with diverse manifestations of Danon disease in hemizygotes and female heterozygotes. RESULTS: Malignant cardiac arrhythmias requiring amiodarone treatment induced thyroid disease in two patients; intractable thyrotoxicosis, which enhances autophagy, caused the death of a 21year-old man...
February 2018: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28814251/the-role-of-radiopharmaceuticals-in-amiodarone-induced-thyroid-pathology
#19
Alexandru Irimie, Doina Piciu
BACKGROUND AND OBJECTIVE: The use of amiodarone for the treatment of ventricular and supraventricular dysrhythmias brings in organism an increased amount of iodine, interfering with thyroid function. If the treatment needs to be interrupted, iodine remains at abnormal levels for months or even years. The aim of the study was to review the literature regarding the optimal tests for early diagnostic and to analyze the role of nuclear medicine tests in the differential and correct assessment of the amiodarone-induced thyroid pathology...
November 10, 2017: Current Radiopharmaceuticals
https://www.readbyqxmd.com/read/28705229/brugada-syndrome-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report
#20
Anusha Battineni, Rohit Gummi, Naresh Mullaguri, Raghav Govindarajan
BACKGROUND: Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis...
July 14, 2017: Journal of Medical Case Reports
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