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thyrotoxicosis guidelines

Tetsurou Satoh, Osamu Isozaki, Atsushi Suzuki, Shu Wakino, Tadao Iburi, Kumiko Tsuboi, Naotetsu Kanamoto, Hajime Otani, Yasushi Furukawa, Satoshi Teramukai, Takashi Akamizu
Thyroid storm is an endocrine emergency which is characterized by multiple organ failure due to severe thyrotoxicosis, often associated with triggering illnesses. Early suspicion, prompt diagnosis and intensive treatment will improve survival in thyroid storm patients. Because of its rarity and high mortality, prospective intervention studies for the treatment of thyroid storm are difficult to carry out. We, the Japan Thyroid Association and Japan Endocrine Society taskforce committee, previously developed new diagnostic criteria and conducted nationwide surveys for thyroid storm in Japan...
October 15, 2016: Endocrine Journal
Alfredo Campennì, Salvatore Giovinazzo, Salvatore Antonio Pignata, Francesca Di Mauro, Domenico Santoro, Lorenzo Curtò, Francesco Trimarchi, Rosaria Maddalena Ruggeri, Sergio Baldari
Parathyroid carcinoma is a rare malignancy, which usually occurs as a sporadic disease, and less frequently in the setting of genetic syndromes. Despite the association of parathyroid and thyroid disorders being quite common, the coexistence of parathyroid carcinoma and thyroid disease is rare. We reviewed the pertinent literature. The terms "parathyroid carcinoma" and "thyroid disease, hyperthyroidism, thyrotoxicosis, hypothyroidism, thyroid nodule(s), Graves' disease, autonomously functioning thyroid nodules" were used both separately and in reciprocal conjunction to search MEDLINE for articles published from January 2007 to March 2016...
October 15, 2016: Endocrine
Douglas S Ross, Henry B Burch, David S Cooper, M Carol Greenlee, Peter Laurberg, Ana Luiza Maia, Scott A Rivkees, Mary Samuels, Julie Ann Sosa, Marius N Stan, Martin A Walter
BACKGROUND: Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This document describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspecialty physicians and others providing care for patients with this condition. METHODS: The American Thyroid Association (ATA) previously cosponsored guidelines for the management of thyrotoxicosis that were published in 2011...
October 2016: Thyroid: Official Journal of the American Thyroid Association
Marwa Al Aamri, Ramamoorthy Ravichandran, John Pichy Binukumar, Naima Al Balushi
BACKGROUND: Treatments for thyrotoxicosis and carcinoma thyroid are carried out by oral administration of radioactive iodine ((131)I) in the form of liquid or capsules. The liquid form of (131)I has higher risk factors such as vapourization, spillage and need for management of higher activity wastes. Use of (131)I in capsule form simplify procedures of handling compared to liquid form of (131)I. The guidelines of safe handling and quality assurance aspects for therapeutic use (131)I are well outlined by International Atomic Energy Agency (IAEA) reports...
July 2016: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
David S Cooper, Blair Anton
BACKGROUND: The purpose of this study was to assess the current status of the clinical thyroidology literature using bibliographic analysis. METHODS: The subject "clinical thyroidology" was divided into six broad topics: iodine deficiency/iodine nutrition, hypothyroidism, hyperthyroidism/thyrotoxicosis, thyroiditis/autoimmune thyroid disease, thyroid nodules/multinodular goiter, and thyroid cancer. Using Scopus, an online bibliographic searching tool, this study sought to examine the trends in the publication of clinical thyroid disease-related research articles over the decade from 2006 through the end of 2015...
August 2016: Thyroid: Official Journal of the American Thyroid Association
Vandana Kumar Dhingra, Sunil Saini, Sandip Basu
OBJECTIVE: We describe and discuss the various medical, social and financial aspects of setting up, and optimizing, working conditions of a tertiary Nuclear Medicine Department. This department was established in a North Indian state which comprises 93% of hilly area. During the first three years after establishment we have developed infrastructure, cooperation with other departments, improved radiation safety and cost effectiveness of our work and designed future perspectives. The facility was established in a cancer center of a tertiary care hospital where a medical college infrastructure was developed...
September 2015: Hellenic Journal of Nuclear Medicine
(no author information available yet)
Hypothyroidism is a common disorder due to inadequate thyroid hormone secretion. When a patient has signs and symptoms suggestive of hypothyroidism, how is it determined whether thyroid hormone replacement therapy will have a favourable harm-benefit balance? How should treatment be managed? To answer these questions, we conducted a review of the literature using the standard Prescrire methodology. The symptoms of hypothyroidism are due to slow metabolism (constipation, fatigue, sensitivity to cold, weight gain, etc...
October 2015: Prescrire International
D Benaiges, M Garcia-Retortillo, A Mas, N Cañete, T Broquetas, M Puigvehi, J J Chillarón, J A Flores-Le Roux, E Sagarra, B Cabrero, D Zaffalon, R Solà, J Pedro-Botet, J A Carrión
OBJECTIVE: The clinical value of thyrotropin receptor antibodies for the differential diagnosis of thyrotoxicosis induced by pegylated interferon-alpha remains unknown. We analyzed the diagnostic accuracy of thyrotropin receptor antibodies in the differential diagnosis of thyrotoxicosis in patients with chronic hepatitis C (CHC) receiving pegylated interferon-alpha plus ribavirin. METHODS: Retrospective analysis of 274 patients with CHC receiving pegylated interferon-alpha plus ribavirin...
January 2016: Experimental and Clinical Endocrinology & Diabetes
Brenda McCulloch
High-output heart failure is not seen as commonly as low-output heart failure and some of the typical guideline recommendations may not benefit patients with high-output failure. High-output failure is caused by several diseases, including thyrotoxicosis and beriberi, highlighted in this article. Thyrotoxicosis, caused by excessive thyroid hormone production, has profound hemodynamic effects. Wet beriberi, affecting predominately the cardiovascular system, is caused by severe thiamine deficiency, most commonly seen in patients with chronic alcoholism or poor nutrition from other causes...
December 2015: Critical Care Nursing Clinics of North America
Andrew W Petersen, Gisela D Puig-Carrión, Angel López-Candales
Thyroid storm is a rare but potentially catastrophic disease expression of thyrotoxicosis with well-recognized cardiovascular manifestations such as heart failure and atrial fibrillation. Even through some studies have found an increased risk of cardiac thrombus formation and subsequent thromboembolism in these patients, the use of anticoagulation to prevent thromboembolic sequelae of thyrotoxic atrial fibrillation remains unclear. We present a patient presenting with new onset dilated cardiomyopathy and resistant atrial fibrillation with thyroid storm that had a large left atrial appendage clot...
January 2015: Boletín de la Asociación Médica de Puerto Rico
Bikei Ryu, Takakazu Kawamata, Koji Yamaguchi, Akitsugu Kawashima, Masami Ono, Yoshikazu Okada
BACKGROUND: Moyamoya disease (MMD) concurrent with Graves' disease (GD) is rare. There is no guideline about optimizing thyroid hormones and the appropriate timing of surgical treatment for MMD with GD. METHODS: We encountered eight patients with MMD and GD presenting with cerebral ischemia who were treated by direct bypass. Thyroid hormones [free thyroxin (fT4) and free triiodothyronine (fT3)], thyroid-stimulating hormone (TSH), and TSH receptor antibody (TRAb) were measured sequentially...
July 2015: Acta Neurochirurgica
Steven A Lubitz, Xiaoyan Yin, Michiel Rienstra, Renate B Schnabel, Allan J Walkey, Jared W Magnani, Faisal Rahman, David D McManus, Thomas M Tadros, Daniel Levy, Ramachandran S Vasan, Martin G Larson, Patrick T Ellinor, Emelia J Benjamin
BACKGROUND: Guidelines have proposed that atrial fibrillation (AF) can occur as an isolated event, particularly when precipitated by a secondary, or reversible, condition. However, knowledge of long-term AF outcomes after diagnosis during a secondary precipitant is limited. METHODS AND RESULTS: In 1409 Framingham Heart Study participants with new-onset AF, we examined associations between first-detected AF episodes occurring with and without a secondary precipitant and both long-term AF recurrence and morbidity...
May 12, 2015: Circulation
Chiara Sabbadin, Gabriella Donà, Luciana Bordin, Maurizio Iacobone, Valentina Camozzi, Caterina Mian, Decio Armanini
BACKGROUND: Primary hyperparathyroidism (PHPT) is often found on routine blood tests, at a relatively asymptomatic stage. However many studies suggest different systemic effects related to PHPT, which could be enhanced by an abnormal cortisol release due to chronic stress of hyperparathyroidism. Being PHPT frequently found in the 6(th) to 7(th) decade of life, a careful and multifaceted approach should be taken. CASE PRESENTATION: We report the case of an elderly patient with symptomatic PHPT and incidental pulmonary embolism...
2015: BMC Endocrine Disorders
Juan J Díez, Pedro Iglesias, Sergio Donnay
Recent clinical practice guidelines on thyroid dysfunction and pregnancy have changed health care provided to pregnant women, although their recommendations are under constant revision. Trimester- and area-specific reference ranges for serum thyroid-stimulating hormone are required for proper diagnosis of hypothyroidism and hyperthyroidism. There is no doubt on the need of therapy for overt hypothyroidism, while therapy for subclinical hypothyroidism is controversial. Further research is needed to settle adverse effects of isolated hypothyroxinemia and thyroid autoimmunity...
October 21, 2015: Medicina Clínica
Edoardo Guastamacchia, Vincenzo Triggiani, Alberto Aglialoro, Antimo Aiello, Lucia Ianni, Mauro Maccario, Michele Zini, Carlo Giorda, Rinaldo Guglielmi, Corrado Betterle, Roberto Attanasio, Giorgio Borretta, Piernicola Garofalo, Enrico Papini, Roberto Castello, Antonio Ceriello
Thyroid disease and diabetes mellitus, the most common disorders in endocrine practice, are not infrequently associated in the same subject. An altered thyroid function may affect glucose tolerance and worsen metabolic control in patients with diabetes. Thyrotoxicosis increases the risk of hyperglycemic emergencies, while a clinically relevant hypothyroidism may have a detrimental effect on glycemic control in diabetic patients. The association of alterations in thyroid function with diabetes mellitus may adversely affect the risk of cardiovascular and microvascular complications resulting from diabetes...
June 2015: Endocrine
D Führer, K Mann, J Feldkamp, H Krude, C Spitzweg, J Kratzsch, M Schott
Thyroid dysfunction may impair fertility, course of pregnancy and fetal development. Physiological alterations of thyroid function parameters, that occur during pregnancy need to be distinguished from pathophysiological states of hypo- and hyperthyroidism. We performed a literature search (PubMed 1990-2013) and review relevant publications as well as consensus and practice guidelines of international thyroid/endocrine societies. Interpretation of thyroid function values in pregnancy must be based on trimester-specific TSH and T4 ranges...
October 2014: Deutsche Medizinische Wochenschrift
Edison So, Richard Arakaki
The management of symptomatic hyperthyroidism in patients with end stage renal disease (ESRD) is challenging because of altered clearance of medications and iodine with dialysis; moreover, many patients meeting these criteria are medically fragile. A 77-year-old man with type 2 diabetes and ESRD requiring hemodialysis, with dilated cardiomyopathy and paroxysmal atrial fibrillation, was found to have subclinical hyperthyroidism. Over a 2-year period he became clinically hyperthyroid with serum TSH level of <0...
July 2014: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Fereidoun Azizi, Atieh Amouzegar, Ladan Mehran, Shahram Alamdari, Imam Subekti, Bijay Vaidya, Kris Poppe, Farzaneh Sarvghadi, Teofilo San Luis, Takashi Akamizu
Maternal hyperthyroidism in pregnancy is associated with adverse impacts on both mother and fetus. Recently, the American Thyroid Association and the Endocrine Society have published guidelines for the management of thyroid diseases in pregnancy. We aimed to disclose the impact of these guidelines in current practices of Asian members of the Asia-Oceania Thyroid Association (AOTA) regarding the management of hyperthyroidism in pregnancy. Completed questionnaire survey, based on clinical case scenarios, was collected from 321 Asian physician members of AOTA from 21 Asian countries in 2013...
2014: Endocrine Journal
R Paschke, M Niedziela, B Vaidya, L Persani, B Rapoport, J Leclere
All cases of familial thyrotoxicosis with absence of evidence of autoimmunity and all children with persistent isolated neonatal hyperthyroidism should be evaluated for familial non-autoimmune autosomal dominant hyperthyroidism (FNAH) or persistent sporadic non-autoimmune hyperthyroidism (PSNAH). First, all index patients should be analysed for the presence/absence of a thyroid-stimulating hormone (TSH) receptor (TSHR) germline mutation, and if they display a TSHR germline mutation, all other family members including asymptomatic and euthyroid family members should also be analysed...
October 2012: European Thyroid Journal
Marianne S Elston, Kelson Tu'akoi, Goswin Y Meyer-Rochow, Jade A U Tamatea, John V Conaglen
BACKGROUND: Women requiring thyroid hormone replacement after definitive therapy (surgery or radioiodine) for Graves' disease who later conceive require an early increase in levothyroxine dose and monitoring of thyroid hormone levels throughout pregnancy. In addition, as TSH receptor antibodies (TRAb) can cross the placenta and affect the fetus, measurement of these antibodies during pregnancy is recommended. AIM: To review the management of pregnancies following definitive treatment for Graves' disease in order to assess the rates of maternal hypothyroidism and TRAb measurement...
August 2014: Australian & New Zealand Journal of Obstetrics & Gynaecology
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