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Hypothyroid rct

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https://www.readbyqxmd.com/read/28473851/benefits-of-levothyroxine-replacement-therapy-on-nonalcoholic-fatty-liver-disease-in-subclinical-hypothyroidism-patients
#1
Lu Liu, Yong Yu, Meng Zhao, Dongmei Zheng, Xu Zhang, Qingbo Guan, Chao Xu, Ling Gao, Jiajun Zhao, Haiqing Zhang
Objectives. To evaluate the effect of levothyroxine (LT4) replacement therapy on nonalcoholic fatty liver disease (NAFLD) in subclinical hypothyroidism (SCH) patients. Methods. This study was a post hoc analysis of a randomized controlled trial and involved 33 significant and 330 mild SCH patients. All of the significant SCH patients received LT4 supplement. The mild SCH patients were grouped as LT4 treated or not. After 15 months of follow-up, prevalence of NAFLD in each group was reevaluated. Subgroup analysis was conducted in mild SCH patients with dyslipidemia...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28342184/the-lipid-lowering-effect-of-levothyroxine-in-patients-with-subclinical-hypothyroidism-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
REVIEW
Xiang Li, Yupeng Wang, Qingbo Guan, Jiajun Zhao, Ling Gao
OBJECTIVES: Dyslipidaemia is common in patients with subclinical hypothyroidism (SCH). To date, there is no universal agreement regarding the lipid-lowering effect of substitution treatment with L-T4 in patients with SCH. We aimed to clarify the effect by conducting this systematic review and meta-analysis of randomized controlled trials (RCTs). DESIGN: We systematically searched PubMed, the Cochrane Library, ClinicalTrials.gov and EMBASE for RCTs comparing substitution treatment to placebo treatment or observation...
March 25, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28329380/subclinical-thyroid-dysfunction-and-cardiovascular-diseases-2016-update
#3
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
https://www.readbyqxmd.com/read/28327089/uniform-fdg-pet-guided-gradient-dose-prescription-to-reduce-late-radiation-toxicity-upgrade-rt-study-protocol-for-a-randomized-clinical-trial-with-dose-reduction-to-the-elective-neck-in-head-and-neck-squamous-cell-carcinoma
#4
Sven van den Bosch, Tim Dijkema, Martina C Kunze-Busch, Chris H J Terhaard, Cornelis P J Raaijmakers, Patricia A H Doornaert, Frank J P Hoebers, Marije R Vergeer, Bas Kreike, Oda B Wijers, Wim J G Oyen, Johannes H A M Kaanders
BACKGROUND: In definitive radiation therapy for head and neck cancer, clinically uninvolved cervical lymph nodes are irradiated with a so-called 'elective dose' in order to achieve control of clinically occult metastases. As a consequence of high-resolution diagnostic imaging, occult tumor volume has significantly decreased in the last decades. Since the elective dose is dependent on occult tumor volume, the currently used elective dose may be higher than necessary. Because bilateral irradiation of the neck contributes to dysphagia, xerostomia and hypothyroidism in a dose dependent way, dose de-escalation to these regions can open a window of opportunity to reduce toxicity and improve quality of life after treatment...
March 21, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28323629/effects-of-levothyroxine-on-pregnancy-outcomes-in-women-with-thyroid-dysfunction-a-meta-analysis-of-randomized-controlled-trials
#5
Jia Li, Jie Shen, Lan Qin
Context • Subclinical hypothyroidism (SCH) in pregnancy can be associated with increased complications in pregnant women and neurocognitive deficits in fetuses. Two recently published meta-analyses investigated the effects of levothyroxine (LT4) supplementation on pregnancy outcomes but did not report adverse complications and neonatal outcomes. Objectives • The study intended to assess the effects of LT4 supplementation in the treatment of pregnant women with thyroid dysfunction. Design • The research team performed a meta-analysis of randomized controlled trials (RCTs) published in PubMed, Embase, Web of Science, Chinese BioMedical Literature Service System, and China National Knowledge Infrastructure databases...
March 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28290237/multiple-nutritional-factors-and-the-risk-of-hashimoto-s-thyroiditis
#6
Shiqian Hu, Margaret P Rayman
BACKGROUND: Hashimoto's thyroiditis (HT) is considered to be the most common autoimmune disease. It is currently accepted that genetic susceptibility, environmental factors, and immune disorders contribute to its development. With regard to nutritional factors, evidence implicates high iodine intake and deficiencies of selenium and iron with a potential relevance of vitamin D status. To elucidate the role of nutritional factors in the risk, pathogenesis, and treatment of HT, PubMed and the Cochrane Library were searched for publications on iodine, iron, selenium, and vitamin D and risk/treatment of HT...
May 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28286688/beneficial-effects-on-pregnancy-outcomes-of-thyroid-hormone-replacement-for-subclinical-hypothyroidism
#7
Norman J Blumenthal, Creswell J Eastman
Background. Hypothyroidism and raised thyroid antibody levels have been associated with adverse obstetrical outcomes. Several studies have investigated causal associations, but results have been inconsistent and few studies have reported the effects of thyroxine replacement therapy on pregnancy outcomes in hypothyroid patients. Objective. The primary study objective was to determine the outcome of pregnancies in women diagnosed with overt and subclinical hypothyroidism (SCH) (serum TSH > 2.5 mIU/L) and those with elevated circulating thyroid autoantibody levels in the first trimester of pregnancy and after the institution of appropriate thyroxine replacement therapy to maintain the serum TSH ≤ 2...
2017: Journal of Thyroid Research
https://www.readbyqxmd.com/read/28275115/safety-and-tolerability-of-pd-1-pd-l1-inhibitors-compared-with-chemotherapy-in-patients-with-advanced-cancer-a-meta-analysis
#8
REVIEW
Tomohiro F Nishijima, Shlomit S Shachar, Kirsten A Nyrop, Hyman B Muss
BACKGROUND: Compared with chemotherapy, significant improvement in survival outcomes with the programmed death receptor-1 (PD-1) inhibitors nivolumab and pembrolizumab and the programmed death-ligand 1 (PD-L1) inhibitor atezolizumab has been shown in several types of advanced solid tumors. We conducted a systematic review and meta-analysis to compare safety and tolerability between PD-1/PD-L1 inhibitors and chemotherapy. METHODS: PubMed and American Society of Clinical Oncology (ASCO) databases were searched 1966 to September 2016...
April 2017: Oncologist
https://www.readbyqxmd.com/read/28260263/iodine-supplementation-for-women-during-the-preconception-pregnancy-and-postpartum-period
#9
REVIEW
Kimberly B Harding, Juan Pablo Peña-Rosas, Angela C Webster, Constance My Yap, Brian A Payne, Erika Ota, Luz Maria De-Regil
BACKGROUND: Iodine is an essential nutrient required for the biosynthesis of thyroid hormones, which are responsible for regulating growth, development and metabolism. Iodine requirements increase substantially during pregnancy and breastfeeding. If requirements are not met during these periods, the production of thyroid hormones may decrease and be inadequate for maternal, fetal and infant needs. The provision of iodine supplements may help meet the increased iodine needs during pregnancy and the postpartum period and prevent or correct iodine deficiency and its consequences...
March 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28249936/subclinical-hypothyroidism-to-treat-or-not-to-treat-that-is-the-question-a-systematic-review-with-meta-analysis-on-lipid-profile
#10
Isabel M Abreu, Eva Lau, Bernardo de Sousa Pinto, Davide Carvalho
Previous studies suggested that subclinical hypothyroidism has a detrimental effect on cardiovascular risk factors, and that its effective treatment may have a beneficial impact on overall health. The main purpose of this review and meta-analysis was to assess whether subclinical hypothyroidism treatment is of clinical relevance, based on cardiovascular risk parameters correction. A systemic research of the literature using MEDLINE tool was performed to identify the relevant studies. Only placebo-controlled randomized control trials were included...
April 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28176152/thyroid-dysfunction-and-heart-failure-mechanisms-and-associations
#11
REVIEW
Hernando Vargas-Uricoechea, Anilza Bonelo-Perdomo
PURPOSE OF REVIEW: The purpose of this review is to provide an update on the current knowledge of the pathophysiology, the mechanisms, and the cardiovascular impact of the different stages of thyroid dysfunction (TD) in heart failure (HF) patients. RECENT FINDING: The influence of thyroid hormones (THs) on the cardiovascular system involves the regulation of key processes related to maintenance of cardiac function; however, there are no long-term studies available showing that intervening the TD changes the incidence or the prognosis in HF individuals...
February 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28158982/study-protocol-thyroid-hormone-replacement-for-untreated-older-adults-with-subclinical-hypothyroidism-a-randomised-placebo-controlled-trial-trust
#12
RANDOMIZED CONTROLLED TRIAL
David J Stott, Jacobijn Gussekloo, Patricia M Kearney, Nicolas Rodondi, Rudi G J Westendorp, Simon Mooijaart, Sharon Kean, Terence J Quinn, Naveed Sattar, Kirsty Hendry, Robert Du Puy, Wendy P J Den Elzen, Rosalinde K E Poortvliet, Jan W A Smit, J Wouter Jukema, Olaf M Dekkers, Manuel Blum, Tinh-Hai Collet, Vera McCarthy, Caroline Hurley, Stephen Byrne, John Browne, Torquil Watt, Douglas Bauer, Ian Ford
BACKGROUND: Subclinical hypothyroidism (SCH) is a common condition in elderly people, defined as elevated serum thyroid-stimulating hormone (TSH) with normal circulating free thyroxine (fT4). Evidence is lacking about the effect of thyroid hormone treatment. We describe the protocol of a large randomised controlled trial (RCT) of Levothyroxine treatment for SCH. METHODS: Participants are community-dwelling subjects aged ≥65 years with SCH, diagnosed by elevated TSH levels (≥4...
February 3, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28104521/endoscopic-versus-microscopic-transsphenoidal-surgery-in-the-treatment-of-pituitary-adenoma-a-systematic-review-and-meta-analysis
#13
Aijun Li, Weisheng Liu, Peicheng Cao, Yuehua Zheng, Zhenfu Bu, Tao Zhou
BACKGROUND: Inconsistent findings have been reported regarding the efficacy and safety of endoscopic and microscopic transsphenoidal surgery for pituitary adenoma. This study aimed to assess the benefits and shortcomings of these surgical methods in patients with pituitary adenoma. METHODS: The electronic databases PubMed, Embase, and the Cochrane Library were systematically searched, as well as proceedings of major meetings. Eligible studies with a retrospective or prospective design that evaluated endoscopic versus microscopic methods in patients with pituitary adenoma were included...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28045962/association-of-tsh-elevation-with-all-cause-mortality-in-elderly-patients-with-chronic-kidney-disease
#14
Mei-Hsing Chuang, Kuo-Meng Liao, Yao-Min Hung, Yi-Chang Chou, Pesus Chou
Chronic kidney disease (CKD) is a widespread condition in the global population and is more common in the elderly. Thyroid-stimulating hormone (TSH) level increases with aging, and hypothyroidism is highly prevalent in CKD patients. However, the relationship between low thyroid function and mortality in CKD patients is unclear. Therefore, we conducted a retrospective cohort study to examine the relationship between TSH elevation and all-cause mortality in elderly patients with CKD. This retrospective cohort study included individuals ≥65 years old with CKD (n = 23,786) in Taipei City...
2017: PloS One
https://www.readbyqxmd.com/read/27852303/the-effects-of-nigella-sativa-on-thyroid-function-serum-vascular-endothelial-growth-factor-vegf-1-nesfatin-1-and-anthropometric-features-in-patients-with-hashimoto-s-thyroiditis-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Mahdieh Abbasalizad Farhangi, Parvin Dehghan, Siroos Tajmiri, Mehran Mesgari Abbasi
BACKGROUND: Hashimoto's thyroiditis is an autoimmune disorder and the most common cause of hypothyroidism. The use of Nigella sativa, a potent herbal medicine, continues to increase worldwide as an alternative treatment of several chronic diseases including hyperlipidemia, hypertension and type 2 diabetes mellitus (T2DM). The aim of the current study was to evaluate the effects of Nigella sativa on thyroid function, serum Vascular Endothelial Growth Factor (VEGF) - 1, Nesfatin-1 and anthropometric features in patients with Hashimoto's thyroiditis...
November 16, 2016: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/27766119/study-of-optimal-replacement-of-thyroxine-in-the-elderly-sorted-results-from-the-feasibility-randomised-controlled-trial
#16
Salman Razvi, Lorna Ingoe, Vicky Ryan, Simon H S Pearce, Scott Wilkes
BACKGROUND: Hypothyroidism is a common condition, particularly in the older population. Thyroid hormone requirements change with age and serum TSH levels also alter, especially in older patients. However, in practice laboratory reference ranges for thyroid function are not age-specific and treatment in older patients aims to achieve a similar target thyroid function level as younger age groups. METHODS: A dual centre, single blind, randomised controlled trial was conducted to determine the feasibility of a future definitive RCT in hypothyroid individuals aged 80 years or older who were treated with levothyroxine...
2016: Thyroid Research
https://www.readbyqxmd.com/read/27699011/effect-of-l-thyroxine-treatment-versus-a-placebo-on-serum-lipid-levels-in-patients-with-sub-clinical-hypothyroidism
#17
Xue Li, Zhaowei Meng, Qiang Jia, Xiaojun Ren
Sub-clinical hypothyroidism is a common disease and whether L-thyroxine replacement treatment improves serum lipid levels in affected patients remains controversial. Thus, the aim of the present meta-analysis was to assess the effect of L-thyroxine therapy on serum lipid levels in sub-clinical hyperthyroidism. Relevant randomized controlled trials (RCTs) containing continuous data, published until July 2015 were retrieved from the Cochrane Library, PubMed, Medline, Google Scholar and Embase databases and subjected to meta-analysis using Review Manager software version 5...
October 2016: Biomedical Reports
https://www.readbyqxmd.com/read/27354814/comparative-efficacy-and-safety-of-axitinib-versus-sorafenib-in-metastatic-renal-cell-carcinoma-a-systematic-review-and-meta-analysis
#18
REVIEW
Hai Wang, Libo Man, Guizhong Li, Guanglin Huang, Jianwei Wang
OBJECTIVE: This study was performed to evaluate the comparative efficacy and safety of axitinib and sorafenib in the therapy of metastatic renal cell carcinoma. MATERIALS AND METHODS: Eligible studies were searched from PubMed, Embase, and Future Medicine databases. The pooled hazard ratios and relative risk ratios (RRs) were calculated by using Stata 12.0 software. RESULTS: A total of 1,011 patients qualified to participate in this Phase III study that included randomized controlled trials...
2016: OncoTargets and Therapy
https://www.readbyqxmd.com/read/27270263/a-worthy-finding-decrease-in-total-cholesterol-and-low-density-lipoprotein-cholesterol-in-treated-mild-subclinical-hypothyroidism
#19
Meng Zhao, Lu Liu, Fei Wang, Zhongshang Yuan, Xu Zhang, Chao Xu, Yongfeng Song, Qingbo Guan, Ling Gao, Zhongyan Shan, Haiqing Zhang, Jiajun Zhao
BACKGROUND: Mild subclinical hypothyroidism (SCH) affects a large number of people and is known to be a risk factor for dyslipidemia. However, whether mild SCH patients should be treated with L-thyroxine to improve lipid profiles remains controversial. In addition, it is also unclear whether all mild SCH patients can benefit from L-thyroxine treatment, regardless of basal thyrotropin or lipid levels. This study aimed to assess the effects of L-thyroxine replacement therapy on the lipid profiles of mild SCH patients...
August 2016: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27266544/radioiodine-therapy-versus-antithyroid-drugs-in-graves-disease-a-meta-analysis-of-randomized-controlled-trials
#20
Junqi Wang, Lan Qin
OBJECTIVE: This meta-analysis was performed to compare radioiodine therapy with antithyroid drugs in terms of clinical outcomes, including development or worsening of ophthalmopathy, hyperthyroid cure rate, hypothyroidism, relapse rate and adverse events. METHODS: Randomized controlled trials (RCTs) published in PubMed, Embase, Web of Science, SinoMed and National Knowledge Infrastructure, China, were systematically reviewed to compare the effects of radioiodine therapy with antithyroid drugs in patients with Graves' disease...
June 27, 2016: British Journal of Radiology
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