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https://www.readbyqxmd.com/read/29162475/-thyrotropin-reference-ranges-during-pregnancy-in-the-province-of-huelva-spain
#1
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
https://www.readbyqxmd.com/read/29120650/-thyroid-screening-in-pregnancy-guideline-in-practice
#2
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/29113553/individualizing-surgery-in-papillary-thyroid-carcinoma-based-on-a-detailed-sonographic-assessment-of-extrathyroidal-extension
#3
Eric James Kuo, William J Thi, Feibi Zheng, Kyle 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: We retrospectively reviewed patients with Bethesda V or VI cytology who underwent surgery for PTC (January 2016 to May 2017). Eligibility for lobectomy was based both tumor (unilateral, intrathyroidal tumors ≤ 3 cm in size) and non-tumor (history of hypothyroidism, radiation exposure, etc...
November 7, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29105255/analysis-of-current-thyroid-function-test-ordering-practices
#4
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
https://www.readbyqxmd.com/read/29095189/venous-thromboembolism-after-surgical-treatment-of-breast-cancer
#5
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/identifying-and-treating-subclinical-thyroid-dysfunction-in-pregnancy-emerging-controversies
#6
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
https://www.readbyqxmd.com/read/29067240/benign-thyroid-disease-in-pregnancy-a-state-of-the-art-review
#7
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
#8
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/28989877/postpartum-follow-up-in-women-diagnosed-with-subclinical-hypothyroidism-during-pregnancy
#9
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
https://www.readbyqxmd.com/read/28989870/prepregnancy-hypothyroidism-versus-gestational-hypothyroidism-a-comparative-study
#10
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
https://www.readbyqxmd.com/read/28982961/mechanisms-in-endocrinology-maternal-thyroid-dysfunction-during-pregnancy-and-behavioural-and-psychiatric-disorders-of-children-a-systematic-review
#11
REVIEW
Dagnachew Muluye Fetene, Kim S Betts, Rosa Alati
BACKGROUND: Maternal thyroid dysfunction during pregnancy may lead to persistent neurodevelopmental disorders in the offspring appearing in later life. This study aimed to review the available evidence concerning the relationship between maternal thyroid status during pregnancy and offspring behavioural and psychiatric disorders. METHODS: Systematic electronic database searches were conducted using PubMed, Embase, PsycNET, Scopus, Google Scholar and Cochrane library...
November 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28974300/the-treatment-of-illnesses-arising-in-pregnancy
#12
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
#13
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/28973128/screening-guidelines-for-thyroid-function-in-children-with-alopecia-areata
#14
Deepa Patel, Ping Li, Andrew J Bauer, Leslie Castelo-Soccio
Importance: The incidence of thyroid disease in children with alopecia areata (AA) has been widely studied with no consensus on whether a true association with AA exists. In addition, screening practices for thyroid dysfunction in children with AA vary widely among clinicians. Objective: To reduce health care costs, eliminate unnecessary testing, and standardize clinical practices, we sought to to characterize thyroid function in children with AA to establish guidelines for screening...
September 27, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28959072/challenges-in-the-management-of-a-patient-with-myxoedema-coma-in-ghana-a-case-report
#15
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
#16
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
#17
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/28911144/randomized-trial-comparing-two-algorithms-for-levothyroxine-dose-adjustment-in-pregnant-women-with-primary-hypothyroidism
#18
RANDOMIZED CONTROLLED TRIAL
Shannon D Sullivan, Erin Downs, Geanina Popoveniuc, Alexander Zeymo, Jacqueline Jonklaas, Kenneth D Burman
Context: Regulation of maternal thyroid hormones during pregnancy is crucial for optimal maternal and fetal outcomes. There are no specific guidelines addressing maternal levothyroxine (LT4) dose adjustments throughout pregnancy. Objective: To compare two LT4 dose-adjustment algorithms in hypothyroid pregnant women. Design: Thirty-three women on stable LT4 doses were recruited at <10 weeks gestation during 38 pregnancies and randomized to one of two dose-adjustment groups...
September 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28904049/use-of-thyroid-stimulating-hormone-tests-for-identifying-primary-hypothyroidism-in-family-medicine-patients
#19
Elizabeth Birk-Urovitz, M Elisabeth Del Giudice, Christopher Meaney, Karan Grewal
OBJECTIVE: To assess the use of thyroid-stimulating hormone (TSH) tests for identifying primary hypothyroidism in 2 academic family medicine settings. DESIGN: Descriptive study involving a retrospective electronic chart review of family medicine patients who underwent TSH testing. SETTING: Two academic family practice sites: one site is within a tertiary hospital in Toronto, Ont, and the other is within a community hospital in Newmarket, Ont...
September 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28868522/primary-care-provider-management-of-congenital-hypothyroidism-identified-through-newborn-screening
#20
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: Annals of Thyroid Research
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