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Sun Young Jang, Ka Hyun Lee, Jong Rok Oh, Bo Yeon Kim, Jin Sook Yoon
PURPOSE: To report clinical characteristics of thyroid-associated ophthalmopathy (TAO) in patients who previously underwent total thyroidectomy for thyroid cancer or a benign mass of the thyroid. MATERIALS AND METHODS: Of the patients who were diagnosed with TAO from March 2008 to March 2012, we performed a retrospective chart review on those who had undergone total thyroidectomy for thyroid cancer or a benign mass of the thyroid before the occurrence of ophthalmopathy...
September 2015: Yonsei Medical Journal
Young Sun Cho, Kyung Min Nam, Jang Ho Park, Sang Hwan Byun, Jin Suck Ryu, Hyun Ju Kim
Sodium picosulfate/magnesium citrate (Picolight Powder), which is used as a bowel preparation for the colon and the rectum, can cause a severe electrolyte imbalance like hyponatremia. When hyponatremia gets severe or occurs rapidly, it can lead to death due to associated complications. We have experienced a case of hyponatremia associated with seizure and loss of consciousness in a 76-year-old woman, who took sodium picosulfate/magnesium citrate as a bowel preparation for colonoscopy. She was taking thiazide and synthroid for the treatment of hypertension and hypothyroidism, respectively, and she had other underlying medical conditions such as a history of seizure and dementia...
December 2014: Annals of Coloproctology
C A Capone, J Gebb, P Dar, R U Shenoy
Fetal supraventricular tachycardia (SVT), characterized by a fetal ventricular heart rate faster than 200 beats per minute (bpm), is often diagnosed during routine fetal heart monitoring or prenatal ultrasound examinations. Clinical guidelines for management of fetal SVT have not been determined in standardized trials, nor do we have a clear sense regarding the long-term developmental outcomes and side effects of in utero antiarrhythmic therapy. We describe our approach to the treatment of refractory SVT in a fetus with hydrops using direct umbilical vein treatment with amiodarone coupled with effusion evacuation...
2014: Journal of Neonatal-perinatal Medicine
Grace E Ching Sun, Kevin M Pantalone, Charles Faiman, Manjula Gupta, Leann Olansky, Betul Hatipoglu
OBJECTIVE: Original absorption studies for levothyroxine (LT4) were validated using total thyroxine (TT4) measurements. Free thyroxine (FT4) has largely supplanted TT4 in clinical practice. The objective of our study was to assess the clinical utility of FT4 in oral LT4 absorption testing. METHODS: In this retrospective electronic health record analysis, we recorded data of patients who underwent LT4 oral absorption testing between November 2010 and January 2012 because of persistent hypothyroidism despite a greater than anticipated weight-based dose of LT4...
September 2014: Endocrine Practice
Sarah B Dubbs, Ryan Spangler
Hypothyroidism is a very common, yet often overlooked disease. It can have a myriad of signs and symptoms, and is often nonspecific. Identification requires analysis of thyroid hormones circulating in the bloodstream, and treatment is simply replacement with exogenous hormone, usually levothyroxine (Synthroid). The deadly manifestation of hypothyroidism is myxedema coma. Similarly nonspecific and underrecognized, treatment with exogenous hormone is necessary to decrease the high mortality rate.
May 2014: Emergency Medicine Clinics of North America
Jefferson P Lomenick, Lulu Wang, Steve B Ampah, Benjamin R Saville, Fayrisa I Greenwald
CONTEXT: Clinicians who prescribe levothyroxine (LT4) for hypothyroidism often feel strongly about using a brand-name drug instead of a generic. OBJECTIVE: The objective of the study was to determine whether Synthroid resulted in better control of congenital hypothyroidism than generic LT4. DESIGN: This was a 5-year retrospective study. SETTING: The study was conducted at 1 tertiary care center. PATIENTS: Children who were 0-36 months old with congenital hypothyroidism followed up at our center from 2006 to 2011 were treated with either Synthroid exclusively (35 subjects) or generic LT4 exclusively (27 subjects)...
February 2013: Journal of Clinical Endocrinology and Metabolism
Jeremi M Carswell, Joshua H Gordon, Erica Popovsky, Andrea Hale, Rosalind S Brown
CONTEXT: In the United States, generic substitution of levothyroxine (L-T(4)) by pharmacists is permitted if the formulations are deemed to be bioequivalent by the Federal Drug Administration, but there is widespread concern that the pharmacokinetic standard used is too insensitive. OBJECTIVE: We aimed to evaluate the bioequivalence of a brand-name L-T(4) (Synthroid) and an AB-rated generic formulation (Sandoz, Princeton, NJ) in children with severe hypothyroidism...
February 2013: Journal of Clinical Endocrinology and Metabolism
Tamera Pearson
Hypothyroidism frequently affects older adults' general sense of health, their cognitive abilities, and quality of life. Management decisions regarding when to start treatment and at what dosage to begin medication are influenced by both laboratory values and patient symptoms. Although specific guidelines regarding management of hypothyroidism in older adults do not exist, general recommendations include initiating hormone replacement with levothyroxine (Levoxyl(®), Synthroid(®), and others) at 12.5 mcg to 25 mcg and titrating the dose slowly based on response at 6-week intervals...
January 2013: Journal of Gerontological Nursing
Philippe Colucci, Pina D'Angelo, Giuseppe Mautone, Claudia Scarsi, Murray P Ducharme
OBJECTIVE: To assess the pharmacokinetic equivalence of a new soft capsule formulation of levothyroxine versus a marketed reference product and to assess the soft capsule formulated with stricter potency guidelines versus the capsule before the implementation of the new potency rule. METHOD: Two single-dose randomized two-way crossover pharmacokinetic equivalence studies and one dosage form proportionality single-dose study comparing low, medium, and high strengths of the new formulation...
June 2011: Therapeutic Drug Monitoring
Khadija H Chaudrey, Tarik B Naser, Ashley Steinberg, Kuntal D Avashia, Mehdi Nouri-Kolouri, Sara Asadi, Shumaila I Irshad Khan, Muhammad Ihsan
Depakote-induced hepatotoxicity has been well established as an adverse effect, and periodic monitoring of drug level is often required. Depakote-induced hepatotoxicity mostly occurs at supratherapeutic drug level. Rarely, an idiosyncratic response is triggered, and hepatotoxicity can occur at the therapeutic drug level mostly in chronic users. Here, we describe a rare case of idiosyncratic depakote-induced hepatotoxicity. A 25-year-old female with non-insulin-dependent diabetes mellitus, hypothyroidism, seizure disorder, and Dandy Walker Syndrome presented with an unwitnessed seizure and altered mental status...
November 2012: American Journal of Therapeutics
Crystal Strickler, Andrew F Pilon
Papilledema is considered a neuro-ophthalmic emergency because of its capacity to induce irreversible end-organ damage and the often grave nature of its precipitating factor. Even more concern is warranted when papilledema presents in a pediatric setting. After excluded the contributions of intracranial masses, congenital malformations, ischemic insults and acute infections, the investigation must focus on determining the contributions of other uncharacteristic causes of pediatric pseudotumor cerebri. Pediatric pseudotumor cerebri is a rare clinical entity which shares few commonalities to the adult condition in regards to its predicating factors or symptoms...
December 2007: Clinical Ophthalmology
Guillermo Di Girolamo, Guillermo A Keller, Antonio R de Los Santos, Daniel Schere, Claudio D Gonzalez
BACKGROUND: Levothyroxine has a narrow therapeutic index; therefore, precise and accurate assessment of the bioequivalence of different levothyroxine products is critical. Bioavailability estimates of levothyroxine formulations might be affected by baseline concentrations of the hormone. OBJECTIVES: The aim of this study was to assess the bioequivalence of 100 microg of a test (T4 Montpellier 100, Química Montpellier S.A., Buenos Aires, Argentina) and reference (Synthroid, Abbott Laboratories, Abbott Park, Illinois) formulation of levothyroxine...
November 2008: Clinical Therapeutics
Dimple Pabla, Fatemeh Akhlaghi, Hossein Zia
Levothyroxine (T4) is a narrow therapeutic index drug with classic bioequivalence problem between various available products. Dissolution of a drug is a crucial step in its oral absorption and bioavailability. The dissolution of T4 from three commercial solid oral dosage forms: Synthroid (SYN), generic levothyroxine sodium by Sandoz Inc. (GEN) and Tirosint (TIR) was studied using a sensitive ICP-MS assay. All the three products showed variable and pH-dependent dissolution behaviors. The absence of surfactant from the dissolution media decreased the percent T4 dissolved for all the three products by 26-95% (at 30 min)...
May 2009: European Journal of Pharmaceutics and Biopharmaceutics
D L Horwitz
No abstract text is available yet for this article.
October 1984: Western Journal of Medicine
Sonia Ananthakrishnan, Lewis E Braverman, Robert M Levin, Barbarajean Magnani, Elizabeth N Pearce
BACKGROUND: Recent literature describing the effect of gastric acid suppression on levothyroxine absorption has been inconsistent. Also, ezetimibe, a lipid-lowering compound that inhibits intestinal absorption of cholesterol, may interfere with levothyroxine absorption. The objective of this study was to measure changes in levothyroxine absorption before and after famotidine, esomeprazole or single-dose ezetimibe." METHODS: We conducted levothyroxine absorption testing on 30 healthy volunteers, excluding those with thyroid disease...
May 2008: Thyroid: Official Journal of the American Thyroid Association
Adam C Urato, Inga Peter, Jacob Canick, Geralyn Lambert-Messerlian, Andrea Pulkkinen, George Knight, Young-Ju Jeong, Kirby L Johnson, Diana W Bianchi
OBJECTIVE: Cell-free DNA is a marker of cellular apoptosis and necrosis. We wished to determine if maternal smoking affects maternal and fetal serum cell-free DNA levels. METHODS: Case-control sets of stored second-trimester serum-screening samples from 27 smoking and 90 nonsmoking pregnant women were developed. Smoking status was confirmed by measuring serum cotinine levels. Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) and DYS1 levels were determined using real-time polymerase chain reaction (PCR) to measure total and fetal cell-free DNA, respectively...
March 2008: Prenatal Diagnosis
R Thiel, Steven Wm Fowkes
Individuals with Down syndrome (DS) not only have increased risk of hypothyroidism, they also tend to develop a relatively novel mild form of neonatal hypothyroidism. One problem that may predispose those with trisomy 21 to hypothyroidism is the overexpression of the gene DYRK1A, which may have an affect on the thyroid. While thyroxine supplementation (such as Synthroid) is increasingly being advised for those with DS, this treatment may have both positive and negative effects. Nutritional support for hypothyroidism offers some of the same benefits as drug therapy but without the likely negative long-term effects...
2007: Medical Hypotheses
(no author information available yet)
No abstract text is available yet for this article.
February 2006: Mayo Clinic Women's Healthsource
Joseph A Puma, Salman A Haq, Terrence J Sacchi
Acute peripheral arterial occlusion may be caused by thrombosis or embolism. The objectives of therapy are to preserve limb and life by restoration of blood flow. Thrombolytic therapy has been the mainstay, but is limited by a high risk of bleeding. Surgical treatment, often required, is invasive with higher rates of morbidity and mortality. Rheolytic thrombectomy offers a percutaneous means of thrombus removal. A 62-year-old man with chronic atrial fibrillation, idiopathic dilated cardiomyopathy, and hypothyroidism presented with sudden onset of left arm pain...
October 2005: Catheterization and Cardiovascular Interventions
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