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Guidelines for the Treatment of Hypothyroidism

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https://www.readbyqxmd.com/read/29120650/-thyroid-screening-in-pregnancy-guideline-in-practice
#1
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
https://www.readbyqxmd.com/read/29095189/venous-thromboembolism-after-surgical-treatment-of-breast-cancer
#2
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
https://www.readbyqxmd.com/read/29070512/debate-identifying-and-treating-subclinical-thyroid-dysfunction-in-pregnancy-emerging-controversies
#3
Ines I Velasco, Peter Nicholas Taylor
Thyroid hormones are essential for an adequate growth and development of the foetus. 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...
October 25, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29067240/benign-thyroid-disease-in-pregnancy-a-state-of-the-art-review
#4
REVIEW
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
https://www.readbyqxmd.com/read/29059085/multicentric-reticulohistiocytosis-a-multicenter-case-series-and-review-of-literature
#5
Bharat Kumar, S Rahnama-Moghadam, Karolyn A Wanat, Jacob W Ijdo, Victoria P Werth, Namrata Singh
OBJECTIVE: Multicentric reticulohistiocytosis is a rare systemic disease characterized by the presence of non-Langerhans cell histiocytic infiltrate in several organ systems. Because its clinical presentation so closely resembles autoimmune conditions such as rheumatoid arthritis, it is often overlooked as a diagnosis and, even when recognized, presents a challenge for treatment because of a lack of consensus regarding guidelines for management. We here review 6 cases of multicentric reticulohistiocytosis (MRH) from 2 institutions to identify clinical features, treatment, and outcomes of MRH...
October 20, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28974300/the-treatment-of-illnesses-arising-in-pregnancy
#6
Michael Bolz, Sabine Körber, Toralf Reimer, Johannes Buchmann, Hans-Christof Schober, Volker Briese
BACKGROUND: The treatment of pregnant women who have illnesses unrelated to pregnancy can cause uncertainty among physicians. METHODS: We searched the PubMed database and specialty guidelines from Germany and abroad (the guidelines of the German Society for Gynecology and Obstetrics, the American Congress of Obstetri cians and Gynecologists, and the Royal College of Obstetricians and Gynaecologists) over the period 2007-2016 for information on standards for the diagnosis and treatment of five illnesses that can arise in pregnancy: bronchial asthma, migraine, hypothyroidism, hyperthyroidism, and varicose veins...
September 15, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28973656/incidence-of-endocrine-dysfunction-following-the-use-of-different-immune-checkpoint-inhibitor-regimens-a-systematic-review-and-meta-analysis
#7
Romualdo Barroso-Sousa, William T Barry, Ana C Garrido-Castro, F Stephen Hodi, Le Min, Ian E Krop, Sara M Tolaney
Importance: If not promptly recognized, endocrine dysfunction can be life threatening. The incidence and risk of developing such adverse events (AEs) following the use of immune checkpoint inhibitor (ICI) regimens are unknown. Objective: To compare the incidence and risk of endocrine AEs following treatment with US Food and Drug Administration-approved ICI regimens. Data Sources: A PubMed search through July 18, 2016, using the following keywords was performed: "ipilimumab," "MDX-010," "nivolumab," "BMS-963558," "pembrolizumab," "MK-3475," "atezolizumab," "MPDL3280A," and "phase...
September 28, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28959072/challenges-in-the-management-of-a-patient-with-myxoedema-coma-in-ghana-a-case-report
#8
Josephine Akpalu, Yacoba Atiase, Ernest Yorke, Henrietta Fiscian, Cecilia Kootin-Sanwu, Albert Akpalu
Myxoedema coma is a rare life-threatening disease, and it is essential that it is managed appropriately to reduce the associated high mortality. However, in the setting where efficient healthcare delivery is hampered by inadequacies, the management of such cases may pose a significant challenge. We present the case of a middle-aged woman diagnosed with myxoedema coma and severe hyponatremia. The case report highlights some of the challenges that may be encountered during the management of myxoedema coma in similar settings and outlines the management strategies undertaken to overcome them in the absence of national guidelines...
March 2017: Ghana Medical Journal
https://www.readbyqxmd.com/read/28931318/thyroid-function-testing-in-neonates-with-maternal-history-of-disease
#9
Lisa Underland, Lisa Kenigsberg, Kristina M Derrick, Rebecca Crespi, Tara Kaushal, Leslie Lam
Maternal history of thyroid disease can cause congenital hypothyroidism due to thyroid-stimulatng hormone (TSH) blocking antibodies. No guidelines exist regarding testing beyond the newborn screen. TSH and T4 levels exhibit significant fluctuations after birth which complicates testing. A total of 561 newborns with thyroid function testing done for maternal history of thyroid disease in the newborn nursery were identified retrospectively via chart review, and thyroid disease status was assessed in 352. Newborn screening data were also obtained...
September 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28923288/delaying-thyroxine-until-positive-beta-human-chorionic-gonadotropin-is-safe-for-patients-receiving-fertility-therapy-applying-new-ata-guidelines-to-subclinical-hypothyroidism
#10
Alyse S Goldberg, Shoba Sujana Kumar, Ellen Greenblatt, Iliana C Lega, Heather Shapiro
OBJECTIVE: This study sought to examine the effect of changing TSH threshold recommendations from 2.5 to 4 mIU/L before fertility therapy on the prevalence of early gestational subclinical hypothyroidism (SCH) (TSH2 >2.5 mIU/L) and to evaluate implications on progression to clinical pregnancy (defined as detection of cardiac activity on ultrasound). METHODS: A retrospective chart review was performed in an academic fertility clinic on all patients with a measured pre-treatment TSH (TSH1) and positive beta-human chorionic gonadotropin following fertility treatment...
September 8, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28868522/primary-care-provider-management-of-congenital-hypothyroidism-identified-through-newborn-screening
#11
N A Rosenthal, E Bezar, S Mann, L K Bachrach, S Banerjee, M E Geffner, M Gottschalk, S K Shapira, L Hasegawa, L Feuchtbaum
OBJECTIVE: To assess Primary Congenital Hypothyroidism (CH) management patterns and feasibility of providing long-term care for patients with CH identified through newborn screening by Primary Care Providers (PCPs) in California and Hawaii. STUDY DESIGN: A survey was mailed to all physicians (N=823) listed as the referral doctor for confirmed patients with CH identified through newborn screening programs in both states between 01/01/2009-12/31/2013. Information was collected on CH management patterns, barriers to providing care, and knowledge on CH treatment...
2017: Ann Thyroid Res
https://www.readbyqxmd.com/read/28697689/vitamin-d-treatment-in-patients-with-hashimoto-s-thyroiditis-may-decrease-the-development-of-hypothyroidism
#12
Bekir Ucan, Mustafa Sahin, Muyesser Sayki Arslan, Nujen Colak Bozkurt, Muhammed Kizilgul, Askin Güngünes, Erman Cakal, Mustafa Ozbek
The relationship between Hashimoto's thyroiditis and vitamin D has been demonstrated in several studies. The aim of the present study was to evaluate vitamin D concentrations in patients with Hashimoto's thyroiditis, the effect of vitamin D therapy on the course of disease, and to determine changes in thyroid autoantibody status and cardiovascular risk after vitamin D therapy. We included 75 patients with Hashimoto's thyroiditis and 43 healthy individuals. Vitamin D deficiency is defined as a 25-hydroxy vitamin D (25(OH)D3) concentration less than 20ng/mL...
July 12, 2017: International Journal for Vitamin and Nutrition Research. Journal International de Vitaminologie et de Nutrition
https://www.readbyqxmd.com/read/28683860/latent-hypothyroidism-in-adults
#13
Jeannine Schübel, Joachim Feldkamp, Antje Bergmann, Wolfgang Drossard, Karen Voigt
BACKGROUND: The prevalence of latent/subclinical hypothyroidism is between 3% and 10%, according to epidemiologic studies that have been carried out in the USA, the United Kingdom, and Denmark. As persons with latent hypo - thyroidism are often asymptomatic, the diagnosis is often made incidentally in routine laboratory testing. METHODS: This review is based on a selective search in PubMed for publications on the diagnosis and treatment of latent hypothyroidism...
June 23, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28683242/targeted-levothyroxine-therapy-for-treatment-of-congenital-hypothyroidism
#14
Melissa J Schoelwer, Wanzhu Tu, Junyi Zhou, Erica A Eugster
OBJECTIVE: The purpose of this study was to determine if infants with congenital hypothyroidism (CH) whose initial dose of levothyroxine (LT4) is based on thyroid gland anatomy require fewer dose adjustments in the first 6 months of life than those who were started empirically on LT4. METHODS: Newborns with CH who had a thyroid ultrasound performed at diagnosis were eligible for this prospective, historical case-controlled study. The daily LT4 dose prescribed was based on results on the thyroid ultrasound as follows: 15 mcg/kg for athyreosis, 12 mcg/kg for a dysgenetic thyroid, and 10 mcg/kg for an anatomically normal gland...
September 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28670583/quality-of-life-among-family-caregivers-of-patients-on-hemodialysis-and-its-relevant-factors-a-systematic-review
#15
REVIEW
Seyedeh Azam Sajadi, Abbas Ebadi, Seyed Tayeb Moradian
BACKGROUND: Family caregivers are considered as hidden patients experiencing physical and mental disorders. This affects the quality of not only their lives but also the health care provided to patients.This study aimed to investigate the quality of life (QOL) and its related factors among the caregivers of patients undergoing hemodialysis. METHODS: This systematic review was conducted based on the eight-step guidelines presented by the York University. The databases relevant to the medical field including Nursing and Allied Health, Web of Science, Scopus, Pubmed, Embase, PsycINFO and Psychology Library were used...
July 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/28661901/long-term-and-late-treatment-consequences-endocrine-and-metabolic-effects
#16
Thang S Han, Helena K Gleeson
PURPOSE OF REVIEW: Cancer therapies often result in the 'late effect of cancer treatment' whereby secondary health complications emerge years after radiotherapy and chemotherapy. This review focuses on endocrine and metabolic consequences in adult cancer survivors as late treatment effects. RECENT FINDINGS: Endocrine and metabolic disorders are among the most common late effects. Endocrine disorders include hypopituitarism, which leads to growth hormone deficiency, hypogonadism, adrenal insufficiency and hypothyroidism and related clinical manifestations...
September 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28572820/tsh-variability-of-patients-affected-by-differentiated-thyroid-cancer-treated-with-levothyroxine-liquid-solution-or-tablet-form
#17
Carlo Cappelli, Ilenia Pirola, Elena Gandossi, Claudio Casella, Davide Lombardi, Barbara Agosti, Fiorella Marini, Andrea Delbarba, Maurizio Castellano
BACKGROUND: Recent guidelines from the American Thyroid Association (ATA) indicate that, in many patients affected by differentiated thyroid cancer (DTC), the serum TSH should be maintained between 0.1 and 0.5 mU/L. The purpose of this study was to evaluate the TSH variability of patients affected by DTC treated with liquid L-T4 formulation or in tablet form. PATIENTS AND METHODS: Patients were eligible if (a) they were submitted to a total thyroidectomy and (131)I remnant ablation for DTC in our institution and (b) they were classified low-risk patients according to ATA guidelines 2009...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28538388/myxedema-coma-a-case-report-of-pediatric-emergency-care
#18
Yueniu Zhu, Wenjuan Qiu, Mengyan Deng, Xiaodong Zhu
RAIONALE: Myxedema coma (MC) is extremely rare but lethal in pediatric patients with hypothyroidism leading to altered mental status and hypothermia. But there is no clinical guideline for such cases. PATIENT CONCERNS: A 6-year-old Chinese girl presented with coma and hypothermia preceded by pneumonia. Her lab results were: free thyroxin (T4) 4.18 pmol/L and thyroid-stimulating hormone (TSH) > 150 μIU/mL with extremely elevated anti-thyroid peroxidase (TPO-Ab) and anti-thyroglobulin...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28459030/the-thyroid-registry-clinical-and-hormonal-characteristics-of-adult-indian-patients-with-hypothyroidism
#19
Bipin Sethi, Sumitav Barua, M S Raghavendra, Jagdish Gotur, Deepak Khandelwal, Upal Vyas
OBJECTIVES: Appropriate treatment of hypothyroidism requires accurate diagnosis. This registry aimed to study the disease profile and treatment paradigm in hypothyroid patients in India. MATERIALS AND METHODS: We registered 1500 newly diagnosed, treatment-naïve, adult hypothyroid males and nonpregnant females across 33 centers and collected relevant data from medical records. The first analysis report on baseline data is presented here. RESULTS: The mean age of the study population was 41...
March 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28329380/subclinical-thyroid-dysfunction-and-cardiovascular-diseases-2016-update
#20
Carmen Floriani, Baris Gencer, Tinh-Hai Collet, Nicolas Rodondi
Subclinical thyroid dysfunction comprises subclinical hypothyroidism (SHypo), defined as elevated thyroid-stimulating hormone (TSH) by normal free thyroxine (FT4), and subclinical hyperthyroidism (SHyper) with decreased or undetectable TSH and normal FT4. Up to 10% of the elderly have SHypo, which is usually asymptomatic. Individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration show that SHypo is associated with increased coronary heart disease (CHD) mortality [hazard ratio (HR) 1,58 for TSH ≥ 10 mIU/L, 95% CI 1...
February 27, 2017: European Heart Journal
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