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thyroid function testing in primary care

G Maltese, S V Tan, E Bruno, A Brackenridge, S Thomas
BACKGROUND: Hereditary Neuropathy with liability to Pressure Palsies (HNPP) is an autosomal dominant neuropathy, associated with deletion of the Peripheral Myelin Protein-22 (PMP-22) gene, causing recurrent painless palsies with age of onset between 10 and 30 years old. Only a few cases of Type 2 Diabetes and HNPP have been described and the coexistence of HNPP and Type 1 diabetes has never been reported. CASE REPORT: A 54-year old man with a history of Type 1 diabetes, managed with continuous subcutaneous insulin infusion (CSII), presented with deterioration of long-standing motor and sensory symptoms, previously attributed to golfer's elbow, diabetic neuropathy and spinal degenerative disease...
June 4, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Siddhesh R Rajiwade, Haritha Sagili, R Soundravally, L Subitha
Purpose: To look for endocrine abnormalities like thyroid disorders, hyperprolactinemia, hyperandrogenism and PCOS among adolescents with menstrual disorders and to compare the above endocrine status with those without menstrual disorders. Methods: This was a case-control study carried out in adolescent girls aged 10-19 years in gynecology outpatient department of a tertiary care hospital. Sample of venous blood (5 ml) was taken for hormonal studies as clinically indicated-thyroid function test, serum prolactin, total testosterone, which were analyzed by chemiluminescence system...
February 2018: Journal of Obstetrics and Gynaecology of India
C E Reusch, F Fracassi, N S Sieber-Ruckstuhl, W A Burkhardt, N Hofer-Inteeworn, C Schuppisser, M Stirn, R Hofmann-Lehmann, F S Boretti
BACKGROUND: Thyrotropin (TSH) can be increased in humans with primary hypoadrenocorticism (HA) before glucocorticoid treatment. Increase in TSH is a typical finding of primary hypothyroidism and both diseases can occur concurrently (Schmidt's syndrome); therefore, care must be taken in assessing thyroid function in untreated human patients with HA. OBJECTIVE: Evaluate whether alterations in cTSH can be observed in dogs with HA in absence of primary hypothyroidism...
November 2017: Journal of Veterinary Internal Medicine
Fatemeh Sayarifard, Fereshteh Bakhshi Imcheh, Shirinsadat Badri, Toktam Faghihi, Mostafa Qorbani, Mania Radfar
OBJECTIVE: One of the main problems facing public health providers and administrators in many countries is ensuring the rational use of high-cost drugs. In this regard, on-going process of medication use evaluation can be considered as a useful tool. In this study, we evaluated certain usage aspects of a highly-cost medication, that is, recombinant growth hormone (GH). METHODS: This cross-sectional study conducted from August 2012 to August 2014. Children receiving GH ± gonadotropin releasing hormone (GnRH) analogs were included in the study...
January 2017: Journal of Research in Pharmacy Practice
Rupendra T Shrestha, Alan Malabanan, Bryan R Haugen, Elliott G Levy, James V Hennessey
OBJECTIVE: Thyroid hormone extract is used for the treatment of thyroid disorders, but limited data exist on adverse events commonly noted by the physicians associated with this use. The purpose of this survey was to report adverse events observed by expert physicians managing patients treated for thyroid disease with thyroid hormones. METHODS: Members of the American Thyroid Association, The Endocrine Society, and the American Association of Clinical Endocrinologists developed a survey instrument modeled on the U...
May 2017: Endocrine Practice
William Grey, Rosaline Hulse, Anna Yakovleva, Dilyana Genkova, Benjamin Whitelaw, Ellen Solomon, Salvador J Diaz-Cano, Louise Izatt
The REarranged during Transfection (RET) proto-oncogene is a receptor tyrosine kinase involved in growth and differentiation during embryogenesis and maintenance of the urogenital and nervous systems in mammals. Distinct mutations across hotspot RET exons can cause Multiple Endocrine Neoplasia Type 2A (MEN2A) characterised by development of medullary thyroid cancer (MTC), phaeochromocytoma (PCC) and primary hyperparathyroidism (PHPT), with a strong correlation between genotype and phenotype. Here, we report a 42-year-old man presented in the clinic with a unilateral PCC, with subsequent investigations revealing a nodular and cystic thyroid gland...
March 2017: Endocrine Pathology
Mette Nygaard Andersen, Anne-Marie Schjerning Olsen, Jesper Clausager Madsen, Søren Lund Kristensen, Jens Faber, Christian Torp-Pedersen, Gunnar H Gislason, Christian Selmer
CONTEXT: Subclinical hypothyroidism is a common condition that may lead to impaired cardiac function. OBJECTIVE: This study sought to examine the effects of levothyroxine treatment in patients with subclinical hypothyroidism and heart disease. DESIGN: This was a register-based historical cohort study. SETTING AND PARTICIPANTS: The study was composed of Danish primary care patients and hospital outpatients age 18 years and older with established heart disease who were diagnosed with subclinical hypothyroidism in 1997-2011...
November 2016: Journal of Clinical Endocrinology and Metabolism
M Nazou, E Parlapani, E-I Nazlidou, P Athanasis, V P Bozikas
Thyroid hormones are crucial in adult brain metabolic activity. As a result, abnormal thyroid gland function and in particular hypofunction, might cause principally depression and neurocognitive dysfunction. Psychosis, presented mainly with thought disorders and perceptual disturbances, is a much rarer manifestation of hypothyreoidism. A correlation between hypothyreoidism and psychosis has been described since 1888, especially in cases of advanced hypothyreoidism. A few years later (1949), Asher first added the terminology "myxedema madness" to the literature...
April 2016: Psychiatrikē, Psychiatriki
Michael T Sheehan
Disorders of thyroid function are common, and screening, diagnosis, and management are often performed by primary care providers. While management of significant biochemical abnormalities is reasonably straight forward, laboratory tests only slightly outside, or even within, the normal range are becoming more difficult to appropriately manage. A large part of this increasing difficulty in appropriate management is caused by patients requesting, and even demanding, certain tests or treatments that may not be indicated...
June 2016: Clinical Medicine & Research
Jun-He Li, Hong-Hong He, Yuan Cheng, Wen-Jing He
Most thyroid lymphomas are B-lineage, and T-cell lymphomas are rare. None of primary thyroid extranasal NK/T-cell lymphoma (NKTCL) has been reported in the literature. Here, we report a case of extranasal NKTCL exclusively arising in the thyroid in an 18-year-old Chinese.The patient presented with rapid anterior swelling at the neck and aggravated dyspnea for 2 months. Neck computer tomography scan revealed diffuse thyroid enlargement in the left lobe compressing the trachea. The thyroid function test was indicative of hypothyroidism...
May 2016: Medicine (Baltimore)
Julian H Barth, Jennifer D Spencer, Stephen R Goodall, Ahai Luvai
INTRODUCTION: Laboratories are recommended to determine their own local reference intervals (RIs) to embrace the variations in local populations. We have assessed local RIs for thyroid function tests using two different approaches to selection of reference populations and also searched the literature for studies using the Advia Centaur methods. METHODS: Two independent populations were made of redundant serum samples from primary care in which exclusion criteria were used to reduce the inclusion of patients with thyroid disease...
May 2016: Annals of Clinical Biochemistry
Jaya Prakash Sahoo, Jayakumar Selviambigapathy, Sadishkumar Kamalanathan, K Nagarajan, Muthupillai Vivekanandan
BACKGROUND: Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT) in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab) titer in Addison's disease with primary hypothyroidism...
March 2016: Indian Journal of Endocrinology and Metabolism
Maria Salinas, Maite López-Garrigós, Francisco J Pomares, Emilio Flores, Joaquín Uris, Carlos Leiva-Salinas
BACKGROUND AND OBJECTIVES: Laboratory tests are crucial for diagnosis and monitoring of thyroid disorders. It is therefore necessary to study the pattern and variability in requests of thyroid function tests. The study objectives were to compare the inter-regional variability in the request of laboratory thyroid tests by general practitioners (GPs) in Spain, and to investigate the potential economic savings if the goals set for some suitability indicators were reached. METHODS: Test requests per 1,000 inhabitants and test ratios (free thyroxine (FT4)/thyrotropin (TSH), free triiodothyronine (FT3)/TSH, thyroglobulin antibody (TgAb)/peroxidase antibody (TPOAb)) were compared between the different areas, according to their setting, location, and management...
January 2016: Endocrinología y Nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición
Faiza Abdulaziz Qari
BACKGROUND: Thyroid hormone has the a major role in the cardiovascular system function and cardiac a As well as to maintain the cardiovascular homeostasis A slightly change ind thyroid status actually affects cardiovascular mortality hemodynamic. The background of this study was to define the prevalence of thyroid dysfunction in acute coronary syndrome (ACS). OBJECTIVES: The primary objective was to define the prevalence of thyroid dysfunction in acute coronary syndrome, including Non-ST Segment Elevation Myocardial Infarction (NSTEMI), ST-segment Elevation Myocardial Infarction (STEMI), and unstable angina groups...
July 2015: Iranian Red Crescent Medical Journal
Zehra Yasar, Cenk Kirakli, Pınar Cimen, Zeynep Zeren Ucar, Fahrettin Talay, Gultekin Tibet
INTRODUCTION: Non-thyroidal illness syndrome (NTIS) is considered to be associated with adverse outcomes in intensive care unit (ICU) patients. In this study, we evaluated the association between NTIS and prolonged weaning in chronic obstructive pulmonary disease (COPD) patients admitted to the ICU. MATERIALS AND METHODS: In total, 125 patients with COPD admitted to our ICU who underwent invasive mechanical ventilation (MV) were enrolled. We collected each patient's baseline characteristics including Acute Physiology and Chronic Health Evaluation (APACHE) II score, body mass index (BMI), and thyroid hormones 24 h after ICU admission...
2015: International Journal of Clinical and Experimental Medicine
Linda M Thienpont, James D Faix, Graham Beastall
Given the prevalence of thyroid disorders and the subtle signs and symptoms that may accompany subclinical disease, reliable laboratory testing for serum TSH and free thyroid hormones is important for both primary care physicians and endocrinologists. The laboratory community has recognized the need for standardization of thyroid function tests to achieve comparability of measurement results between methods. This applies in particular to tests for free T4 (FT4), which may be considered controversial in terms of clinical and analytical validity...
2015: Endocrine Journal
Linda M Thienpont, James D Faix, Graham Beastall
No abstract text is available yet for this article.
July 23, 2015: Clinical Endocrinology
Kim S Griswold, Paula A Del Regno, Roseanne C Berger
Psychosis is a symptom complex that may include hallucinations, delusions, disorders of thought, and disorganized speech or behavior. Acute psychosis is primary if it is symptomatic of a psychiatric disorder, or secondary if caused by a specific medical condition. Patients with primary psychiatric disorders are likely to have auditory hallucinations, prominent cognitive disorders, and complicated delusions. If psychosis is caused by a medical condition, the patient may exhibit cognitive changes and abnormal vital signs, and may have visual hallucinations...
June 15, 2015: American Family Physician
Mette Nygaard Andersen, Anne-Marie Schjerning Olsen, Jesper Clausager Madsen, Jens Faber, Christian Torp-Pedersen, Gunnar Hilmar Gislason, Christian Selmer
BACKGROUND: Subclinical hypothyroidism is associated with a number of cardiovascular risk factors, yet only limited data exist on long-term outcome of levothyroxine treatment of this condition with respect to hard end-points. The aim of this retrospective cohort study was to determine effects of levothyroxine treatment on myocardial infarction (MI), cardiovascular death and all-cause mortality, in patients with subclinical hypothyroidism. METHODS AND RESULTS: Primary care patients aged 18 years and older that underwent thyroid function tests between 2000 and 2009 were enrolled...
2015: PloS One
Rebecca Hardwick, Janet Heaton, Glyn Griffiths, Bijay Vaidya, Sue Child, Simon Fleming, William Trevor Hamilton, Julie Tomlinson, Zhivko Zhelev, Anthea Patterson, Chris Hyde
BACKGROUND: The ordering of thyroid function tests (TFTs) is increasing but there is not a similar increase in thyroid disorders in the general population, leading some to query whether inappropriate testing is taking place. Inconsistent clinical practice is thought to be a cause of this, but there is little evidence of the views of general practitioners, practice nurses or practice managers on the reasons for variation in the ordering of TFTs. AIM: To find out the reasons for variation in ordering of TFTs from the perspective of primary healthcare professionals Methods: Fifteen semi-structured interviews were carried out with primary healthcare professionals (general practitioners, practice nurses, practice managers) that used one laboratory of a general hospital in South West England for TFTs...
2014: Quality in Primary Care
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