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https://www.readbyqxmd.com/read/29674207/impact-of-excessive-pre-pregnancy-body-mass-index-and-abnormal-gestational-weight-gain-on-pregnancy-outcomes-in-women-with-chronic-hypertension
#1
Sara Ornaghi, Paola Algeri, Lyudmyla Todyrenchuk, Emanuela Vertemati, Patrizia Vergani
OBJECTIVES: To investigate the effects of excessive pre-pregnancy body mass index (BMI) and abnormal gestational weight gain on adverse outcomes in women with chronic hypertension (CH). STUDY DESIGN: A retrospective cohort study of CH women with singleton pregnancy delivered at our Institution in 2002-2013. Women were categorized as normal, overweight, and obese, according to their pre-pregnancy BMI. Further stratification was based on gestational weight gain (insufficient, adequate, and excessive) as defined by 2009 IOM guidelines...
April 10, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29673554/subclinical-hypothyroidism-and-metabolic-risk-factors-association-a-health-examination-based-study-in-northern-taiwan
#2
Feng-Hsuan Liu, Jawl-Shan Hwang, Chang-Fu Kuo, Yu-Shien Ko, Szu-Tah Chen, Jen-Der Lin
BACKGROUND: Subclinical hypothyroidism (SCH) is defined as elevation in serum thyroid-stimulating hormone (TSH) levels despite normal serum levels of free thyroxine. It remains controversial whether people with SCH have higher total cholesterol and low-density lipoprotein cholesterol levels compared to normal-thyroid subjects. The aim of this study was to assess the metabolic risk factors for SCH. METHODS: Subjects were recruited from the health examination center of Chang Gung Memorial Hospital, Linkou, from January 1, 2010 to December 31, 2011...
February 2018: Biomedical Journal
https://www.readbyqxmd.com/read/29644934/management-of-subclinical-hypothyroidism-in-pregnancy-a-comment-from-the-italian-society-of-endocrinology-sie-and-the-italian-thyroid-association-ait-to-the-2017-ata-guidelines-the-italian-way
#3
Mario Rotondi, Luca Chiovato, Furio Pacini, Luigi Bartalena, Paolo Vitti
The 2017 ATA Guidelines for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum were published six years after the previous ones. They provide comprehensive clinical recommendations for the whole spectrum of thyroid diseases as well as for optimal iodine intake during pregnancy, post-partum and lactation. The present position statement mainly regards the recommended flow-chart for therapeutic decision making in pregnant women being diagnosed with subclinical hypothyroidism. The major biochemical and clinical situations and the corresponding therapeutic indications will be commented...
April 12, 2018: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29594056/2018-european-thyroid-association-eta-guidelines-for-the-management-of-amiodarone-associated-thyroid-dysfunction
#4
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/29580932/postradiation-hypothyroidism-in-head-and-neck-cancers-a-department-of-veterans-affairs-single-institution-case-control-dosimetry-study
#5
Alexander J Lin, Juying Zhang, Jennie Cho-Lim, Warren Inouye, Steve P Lee
We performed a case-control study to characterize the dose-volume relationship and other variables leading to hypothyroidism after head and neck (H&N) cancer radiation therapy (RT) in a homogenous Veterans Affairs (VA) population. All records of patients receiving RT for various H&N cancers at a single VA medical center between 2007 and 2013 (n = 143) were screened for post-RT thyroid stimulating hormone (TSH) levels (n = 77). The thyroid gland was contoured on each slice of the planning computed tomography scan when available (hypothyroid: n = 18; euthyroid > 2 years: n = 16), and dose-volume histograms based on physical dose and biologically equivalent dose (BED) were compared systematically to find the significant dose-volume thresholds that distinguish the patients who developed clinical hypothyroidism...
March 23, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/29490937/management-of-endocrine-disease-pitfalls-on-the-replacement-therapy-for-primary-and-central-hypothyroidism-in-adults
#6
Gisah Amaral Carvalho, Gilberto Paz-Filho, Cleo Otaviano Mesa Junior, Hans Graf
Hypothyroidism is one of the most common hormone deficiencies in adults. Most of the cases, particularly those of overt hypothyroidism, are easily diagnosed and managed, with excellent outcomes if treated adequately. However, minor alterations of thyroid function determine nonspecific manifestations. Primary hypothyroidism due to chronic autoimmune thyroiditis is largely the most common cause of thyroid hormone deficiency. Central hypothyroidism is a rare and heterogeneous disorder characterized by decreased thyroid hormone secretion by an otherwise normal thyroid gland, due to lack of TSH...
February 28, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29467136/attitudes-and-perceptions-of-health-professionals-towards-management-of-hypothyroidism-in-general-practice-a-qualitative-interview-study
#7
Rosie Dew, Kathryn King, Onyebuchi E Okosieme, Simon H Pearce, Gemma Donovan, Peter N Taylor, Janis Hickey, Colin M Dayan, Graham Leese, Salman Razvi, Scott Wilkes
OBJECTIVE: To explore the attitudes and perceptions of health professionals towards management of hypothyroidism that contributes to the suboptimal treatment of hypothyroidism in general practice. DESIGN: A qualitative interview study using semistructured interviews. PARTICIPANTS: Sixteen participants were interviewed between March and August 2016 comprising nine general practitioners (GPs), four pharmacists, two practice nurses and one nurse practitioner...
February 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29455331/newborn-screening-guidelines-for-congenital-hypothyroidism-in-india-recommendations-of-the-indian-society-for-pediatric-and-adolescent-endocrinology-ispae-part-ii-imaging-treatment-and-follow-up
#8
REVIEW
S Sudhanshu, I Riaz, R Sharma, M P Desai, R Parikh, V Bhatia
The Indian Society for Pediatric and Adolescent Endocrinology has formulated Clinical Practice Guidelines for newborn screening, diagnosis and management of congenital hypothyroidism (CH). This manuscript, part II addresses management and follow-up. RECOMMENDATIONS: Screening should be done for every newborn using cord blood, or postnatal blood ideally at 48 to 72 h of age. Neonates with screen TSH > 20 mIU/L serum units (or >34 mIU/L for samples taken between 24 and 48 h of age) should be recalled for confirmation...
February 17, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29454373/subclinical-hypothyroidism-in-children-is-it-always-subclinical
#9
R Gallizzi, C Crisafulli, T Aversa, G Salzano, F De Luca, M Valenzise, G Zirilli
Aim of this commentary is to report current knowledges on the main clinical and metabolic abnormalities which might be observed in children with longstanding and untreated subclinical hypothyroidism (SH) and to comment the most recent views about natural evolution of thyroid function in the cases with either idiopathic or Hashimoto's thyroiditis-related SH. On the basis of these preliminary remarks, the essential guidelines for an appropriate and tailored management of SH children are also proposed.
February 17, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29445919/appraisal-of-clinical-practice-guidelines-on-the-management-of-hypothyroidism-in-pregnancy-using-the-appraisal-of-guidelines-for-research-and-evaluation-ii-instrument
#10
REVIEW
Yuan Fang, Liang Yao, Jing Sun, Jian Zhang, Yanxia Li, Ruifei Yang, Kehu Yang, Limin Tian
PURPOSE: This study aimed to systematically evaluate the quality of guidelines for the management of hypothyroidism in pregnancy. METHOD: Systematic searches were conducted to identify hypothyroidism in pregnancy guidelines published in electronic databases and developers' websites. Four reviewers independently evaluated eligible guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Agreement among reviewers was measured using the intraclass correlation coefficient (ICC)...
April 2018: Endocrine
https://www.readbyqxmd.com/read/29438217/suppressed-thyroglobulin-performs-better-than-stimulated-thyroglobulin-in-defining-an-excellent-response-in-patients-with-differentiated-thyroid-cancer
#11
Hou-Yang Hu, Jun Liang, Teng Zhang, Teng Zhao, Yan-Song Lin
PURPOSE: According to the American Thyroid Association guidelines in 2015, both an unstimulated thyroglobulin (u-Tg) below 0.2 ng/ml and a stimulated thyroglobulin (s-Tg) below 1.0 ng/ml were required along with negative imaging findings to define an excellent response. This study aimed to investigate whether a u-Tg below 0.2 ng/ml coincides with a s-Tg below 1 ng/ml. PATIENTS AND METHODS: A total of 290 patients with nonmetastatic differentiated thyroid cancer were retrospectively evaluated with a median follow-up of 36 months...
March 2018: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/29398964/stimulated-serum-thyroglobulin-levels-versus-unstimulated-serum-thyroglobulin-in-the-follow-up-of-patients-with-papillary-thyroid-carcinoma
#12
Saumya Sara Sunny, Julie Hephzibah, David Mathew, Joseph Dian Bondu, Nylla Shanthly, Regi Oommen
Serum thyroglobulin (Tg) and thyroid whole-body radioiodine scintigraphy (TWBS) are used in the follow-up of patients with papillary thyroid carcinoma (PTC) after total thyroidectomy. Symptoms of hypothyroidism are frequent as patients discontinue levothyroxine 1 month before visit, favoring the use of unstimulated serum Tg (uSTg) only. This study was done to determine the reliability of stimulated serum Tg levels (sSTg) over uSTg. A total of 650 patients with PTC came for follow-up between June 2011 and 2016...
January 2018: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29380252/newborn-screening-guidelines-for-congenital-hypothyroidism-in-india-recommendations-of-the-indian-society-for-pediatric-and-adolescent-endocrinology-ispae-part-i-screening-and-confirmation-of-diagnosis
#13
M P Desai, R Sharma, I Riaz, S Sudhanshu, R Parikh, V Bhatia
The Indian Society for Pediatric and Adolescent Endocrinology has formulated locally relevant Clinical Practice Guidelines for newborn screening, diagnosis and management of primary congenital hypothyroidism (CH). RECOMMENDATIONS: Screening should be done for every newborn using cord blood, or postnatal blood, ideally at 48 to 72 h of age. On this screen sample, neonates with TSH > 20 mIU/L serum units (or >34 mIU/L for samples taken between 24 to 48 h of age) should be recalled for confirmation...
January 30, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29375671/management-of-hypothyroidism-with-combination-thyroxine-t4-and-triiodothyronine-t3-hormone-replacement-in-clinical-practice-a-review-of-suggested-guidance
#14
REVIEW
Colin Dayan, Vijay Panicker
Background: Whilst trials of combination levothyroxine/liothyronine therapy versus levothyroxine monotherapy for thyroid hormone replacement have not shown any superiority, there remains a small subset of patients who do not feel well on monotherapy. Whilst current guidelines do not suggest routine use of combination therapy they do acknowledge a trial in such patients may be appropriate. It appears that use of combination therapy and dessicated thyroid extract is not uncommon but often being used by non-specialists and not adequately monitored...
2018: Thyroid Research
https://www.readbyqxmd.com/read/29246752/autoimmune-thyroid-disease-during-pregnancy
#15
REVIEW
Simone De Leo, Elizabeth N Pearce
Understanding of changes in thyroid function and the consequences of thyroid disease during pregnancy has rapidly grown in the past two decades, and revised American Thyroid Association guidelines on this topic were published in 2017. This Review explores the association between thyroid autoimmunity and complications during and after pregnancy. Thyroid autoimmunity refers to the presence of antibodies to thyroperoxidase or thyroglobulin, or thyroid-stimulating hormone receptor antibodies (TRAbs), or a combination of these, and is present in up to 18% of pregnant women...
December 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29162475/-thyrotropin-reference-ranges-during-pregnancy-in-the-province-of-huelva-spain
#16
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
#17
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...
December 0: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29113553/individualizing-surgery-in-papillary-thyroid-carcinoma-based-on-a-detailed-sonographic-assessment-of-extrathyroidal-extension
#18
Eric J Kuo, William J Thi, Feibi Zheng, Kyle A 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: Patients with Bethesda V or VI cytology who underwent surgery for PTC (January 2016 to May 2017) were retrospectively reviewed. Eligibility for lobectomy was based on both tumor (unilateral, intrathyroidal tumors ≤3 cm in size) and non-tumor (history of hypothyroidism, radiation exposure, etc...
December 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29105255/analysis-of-current-thyroid-function-test-ordering-practices
#19
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
#20
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...
February 2018: Annals of Plastic Surgery
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