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1.
J Assoc Physicians India ; 69(2): 49-53, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33527811

RESUMO

Introduction: The thyroid hormones perpetuate a fine equilibrium of glucose metabolism. Abnormalities of thyroid function can disrupt this balance leading to glucose metabolism abnormalities and insulin resistance. Objectives: We studied the correlation between insulin resistance and thyroid status in hyperthyroid, euthyroid, and hypothyroid individuals. Methods: In this observational comparative analysis conducted at a tertiary care center, the 3 study groups comprised of 35 patients each with newly detected hyperthyroidism, hypothyroidism and euthyroid individuals. Assays were conducted for serum insulin, thyroid profile, blood sugar and routine biochemistry in the fasting state. The homeostasis model assessment for insulin resistance (HOMA-IR) was used to evaluate insulin resistance. Results: The mean HOMA-IR was highest in patients with hypothyroidism (3.22 ± 2.69) followed by the hyperthyroid group (2.25 ± 1.59). It was lowest in the euthyroid group (0.79 ± 0.58) with the intergroup difference being statistically significant (P<0.001). Hypothyroid patients showed a significant a positive correlation between TSH and HOMA-IR (r=0.945, P=<0.001) whereas hyperthyroid patients showed positive correlation between FT3 and insulin resistance (r=0.706, P<0.001). Conclusion: Thyroid dysfunction is associated with an increase in insulin resistance and glucose abnormalities validating the resultant higher risk of related cardiovascular and metabolic abnormalities observed in these patients.


Assuntos
Resistência à Insulina , Doenças da Glândula Tireoide , Humanos , Índia/epidemiologia , Centros de Atenção Terciária , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/epidemiologia
3.
BMJ Case Rep ; 13(12)2020 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-33310822

RESUMO

Horner's syndrome is a rare neurological condition seen in association with the disruption in the sympathetic nerve supply. Thyroid swelling is a common condition but rarely causes cervical sympathetic chain compression. We describe a case of a 54-year-old man who presented with Horner's syndrome secondary to a benign thyroid nodule with pressure effect on the sympathetic chain. An association between thyroid pathologies and Horner's syndrome has been mentioned previously, however, to our knowledge, this is the first case of Horner's syndrome being the initial presentation for an underlying benign thyroid swelling.


Assuntos
Síndrome de Horner/etiologia , Doenças da Glândula Tireoide/complicações , Edema/etiologia , Síndrome de Horner/patologia , Síndrome de Horner/cirurgia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças da Glândula Tireoide/patologia , Doenças da Glândula Tireoide/cirurgia , Tireoidectomia , Resultado do Tratamento
4.
PLoS One ; 15(9): e0239040, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915911

RESUMO

BACKGROUND: Individuals with Down syndrome are predisposed to a number of chronic health conditions, but the relationship between these conditions and cognitive ability is not clear. The primary objective of this systematic review is to assess this relationship by evaluating studies that measure cognitive performance in the context of Down syndrome-associated chronic health conditions. METHODS: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Studies included in this review (1) included children, adolescent, and young adult participants with Down syndrome and one or more co-occurring health conditions; (2) were quantitative; and (3) reported outcomes related to both chronic health conditions and cognitive performance. A set of predetermined chronic health conditions that are common in Down syndrome (e.g. sleep disorders, congenital heart disease, thyroid disease, seizure disorders, and pulmonary hypertension) were selected based on prevalence rates in Down syndrome. RESULTS: Fifteen studies met inclusion criteria. The majority these of studies assessed cognitive performance in association with sleep disorders (47%) and congenital heart disease (47%). Fewer studies reported on the effect of thyroid disease (7%) and seizure disorders (7%) on cognitive ability. None of the studies reported cognitive outcomes related to pulmonary hypertension. Of the chronic health conditions evaluated, associations between sleep disorders and cognitive dysfunction were most common among individuals with Down syndrome. CONCLUSIONS: Individuals with Down syndrome exhibit deficits in cognitive ability, particularly related to attention, executive function and verbal processing. These deficits may be further exacerbated by the presence of chronic health conditions, particularly sleep disorders. Individuals with Down syndrome and co-occurring sleep disorders may benefit from early interventions to mitigate their risk for adverse cognitive outcomes.


Assuntos
Transtornos Cognitivos/complicações , Síndrome de Down/complicações , Síndrome de Down/psicologia , Adolescente , Doenças Cardiovasculares/complicações , Criança , Doença Crônica , Transtornos Cognitivos/psicologia , Epilepsia/complicações , Feminino , Humanos , Pneumopatias/complicações , Masculino , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/psicologia , Doenças da Glândula Tireoide/complicações , Adulto Jovem
6.
Endocrinology ; 161(9)2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32652001

RESUMO

The current COVID-19 pandemic is the most disruptive event in the past 50 years, with a global impact on health care and world economies. It is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a coronavirus that uses angiotensin-converting enzyme 2 (ACE2) as an entry point to the cells. ACE2 is a transmembrane carboxypeptidase and member of the renin-angiotensin system. This mini-review summarizes the main findings regarding ACE2 expression and function in endocrine tissues. We discuss rapidly evolving knowledge on the potential role of ACE2 and SARS coronaviruses in endocrinology and the development of diabetes mellitus, hypogonadism, and pituitary and thyroid diseases.


Assuntos
Angiotensina II/metabolismo , Betacoronavirus/fisiologia , Complicações do Diabetes/virologia , Doenças do Sistema Endócrino/virologia , Peptidil Dipeptidase A/fisiologia , Animais , Betacoronavirus/patogenicidade , Encéfalo , Infecções por Coronavirus/complicações , Doenças do Sistema Endócrino/complicações , Expressão Gênica , Humanos , Hipogonadismo/complicações , Hipogonadismo/virologia , Camundongos , Pandemias , Peptidil Dipeptidase A/genética , Doenças da Hipófise/complicações , Doenças da Hipófise/virologia , Pneumonia Viral/complicações , Ratos , Sistema Renina-Angiotensina , Serina Endopeptidases/genética , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/virologia
7.
Endocrine ; 68(3): 471-474, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32507963

RESUMO

The novel coronavirus disease COVID-19 is produced by SARS-CoV-2. WHO has declared COVID-19 as a public health emergency, with the most susceptible populations (requiring ventilation) being the elderly, pregnant women and people with associated co-morbidities including heart failure, uncontrolled diabetes, chronic obstructive pulmonary disease, asthma and cancer. However, such general guidance does not provide information regarding COVID-19 risks in patients with suffering from pre-existing thyroid problems, and furthermore, we do not know whether patients with COVID-19 (symptomatic or without symptoms), who have not previously had thyroid issues develop endocrine thyroid dysfunction after infection. The European Society for Endocrinology recently published a statement on COVID-19 and endocrine diseases (Endocrine, 2020); however, thyroid diseases were not mentioned specifically. We have therefore reviewed the current literature on thyroid diseases (excluding cancer) and COVID-19, including data from the previous coronavirus pandemic caused by the SARS-associated coronavirus (SARS-CoV), a member of the same family Coronaviridae leading to severe acute respiratory syndrome (SARS). At the moment there are no data suggesting that thyroid patients are at higher risk of COVID-19, but this requites further research and data analysis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Doenças da Glândula Tireoide/complicações , Infecções por Coronavirus/imunologia , Humanos , Pandemias , Pneumonia Viral/imunologia , Fatores de Risco , Vírus da SARS , Síndrome Respiratória Aguda Grave , Doenças da Glândula Tireoide/imunologia , Doenças da Glândula Tireoide/virologia , Tireoidite Autoimune/virologia
8.
Ann Afr Med ; 19(2): 89-94, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32499464

RESUMO

Background: Thyroid disorders are one of the most common endocrine disorders seen globally. Diagnostic challenge may arise both clinically and biochemically because of the multiple function of thyroid hormones (THs). Request for thyroid function test (TFT s) may be based on clinical impression that may suggest thyroid dysfunction or obvious symptoms and signs that are diagnostic of hyperthyroidism or hypothyroidism. Materials and Methods: This retrospective study looks at the biochemical patterns of TFTs and the clinical impression of thyroid disorders in a rural tertiary institution. Information extracted from the laboratory register includes indication for the test, the hospital number, the gender, the age, and the THs assayed. The corresponding biochemical pattern of the TFT result was established. Results: A total of 297 requests were submitted for TH assay; 34 were excluded from the present study because there were no clinical information. There were 239 females and 24 males giving a female-to-male ratio of 9.9:1. Majority of the requests (36.5%) were for goiters, followed by gynecological disorders (20.9%) and clinical thyroid disorders (17.9%). About 46% (45.8%) of the goiter cases were biochemically euthyroid, whereas 13.5% were biochemically primary hyperthyroid. Among the 47 cases of thyroid disorders by the physician's clinical impression, 27.7% were euthyroid, 17% were biochemically hyperthyroid, and 10.6% were hypothyroid. Of the 55 gynecological disorders assessed, only 7.3% show biochemical evidence of TH alteration with 56.4% being euthyroid. About 47% (46.6%) of those that did routine medical examination had altered TH level that includes hyperthyroidism and hypothyroidism. Conclusion: Goiter is the most prevalent thyroid disorder in this environment. Biochemical pattern of thyroid function test in our environment was mostly euthyroid despites clinical features suggestive of thyroid disorders.


Assuntos
Bócio/epidemiologia , Saúde da População Rural , Doenças da Glândula Tireoide/epidemiologia , Testes de Função Tireóidea/métodos , Adulto , Feminino , Humanos , Hipertireoidismo/diagnóstico , Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Estudos Retrospectivos , Doenças da Glândula Tireoide/complicações , Glândula Tireoide
9.
Artigo em Inglês | MEDLINE | ID: mdl-32560169

RESUMO

Thyroid diseases are characterized by a wide range of physical and mental symptoms that can affect biological function, emotional and social life of patients. However, their impact on work functioning is not yet fully understood. Therefore, this review aims to address the way in which thyroid diseases can affect occupational outcomes, i.e., the employment rate, sick leave, working capacity and work income of patients. A systematic review of Pubmed, Scopus and ISI Web of Knowledge databases has been performed. Although it is not possible to extrapolate precise data for benign pathologies, about a third of the survivors of thyroid cancer could be unemployed. Hyperthyroid and hypothyroid patients presented a greater risk of long-term sick leave than controls, depending on the severity of the disease. Hyperthyroidism impaired working ability in about a third of affected patients, particularly in cases complicated by orbitopathy with diplopia. A possible influence of thyroid diseases on various occupational outcomes emerged from our review, however further research seems necessary to understand the relationship between work problems, specific pathological characteristics over time and risk factors in the workplace. This may support a comprehensive, interdisciplinary management of thyroid disorders, with benefits for patients' personal, social and professional life.


Assuntos
Hipertireoidismo , Hipotireoidismo , Ocupações , Doenças da Glândula Tireoide , Adulto , Feminino , Humanos , Hipertireoidismo/complicações , Hipotireoidismo/complicações , Masculino , Pessoa de Meia-Idade , Licença Médica , Doenças da Glândula Tireoide/complicações , Carga de Trabalho , Adulto Jovem
10.
J Craniofac Surg ; 31(5): e477-e479, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32516216

RESUMO

A 34-year-old man with Basedow disease consulted us to treat disfiguring proptosis. On examination, the patient showed right lower eyelid retraction and right inferior rectus muscle enlargement, which were consistent with thyroid eye disease. Hertel's exophthalmometric examination demonstrated proptosis of 25.5 and 24.0 mm on the right and left sides, respectively. Computed tomography (CT) images revealed absence of the sphenoid door jamb. To correct both exorbitism and exophthalmos, the patient underwent bilateral "shallow" decompression of the lateral and medial orbital walls with orbital fat removal under general anesthesia. The authors removed 2.5 and 1.0 mL of orbital fat from the inferolateral quadrant of the right and left orbits, respectively. At 3 months postoperatively, based on the measurements of the axial globe position on sagittal CT images, postoperative proptosis reductions of 7.5 and 6.5 mm were observed on the right and left sides, respectively.


Assuntos
Descompressão Cirúrgica , Exoftalmia/cirurgia , Órbita/cirurgia , Doenças da Glândula Tireoide/cirurgia , Tecido Adiposo/cirurgia , Adulto , Exoftalmia/diagnóstico por imagem , Exoftalmia/etiologia , Oftalmopatia de Graves , Humanos , Masculino , Músculos Oculomotores/cirurgia , Órbita/diagnóstico por imagem , Período Pós-Operatório , Osso Esfenoide/cirurgia , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/diagnóstico por imagem , Tomografia Computadorizada por Raios X
11.
Diabetes Metab Syndr ; 14(4): 615-617, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32422445

RESUMO

BACKGROUND AND AIMS: To study the prevalence of thyroid disorders and their association with microvascular complications among adult type 2 diabetes mellitus (T2DM) patients from south-coastal Andhra Pradesh, India METHODS: This cross-sectional study included 500 subjects with T2DM and was conducted in a tertiary health care center from south-coastal Andhra Pradesh. Participants previously diagnosed with thyroid disorders were excluded from the study. RESULTS: Thyroid dysfunction was observed in 98 (19.6%) subjects of which subclinical hypothyroidism (n = 66, 13.2%) was the most common. Subclinical hypothyroidism (SCH) was more frequent in obese patients (16.2% vs 7.6%, p = 0.007) and metformin users (9.6% vs 18.7%, p = 0.0044). Diabetic retinopathy (27.3% vs 8.9%, p = 0.001) was significantly more frequent in SCH patients than euthyroid T2DM patients. CONCLUSION: Among T2DM patients from south-coastal Andhra Pradesh the prevalence of thyroid dysfunction, especially that of SCH was high; SCH was more frequent among obese and nonmetformin users and was associated was associated with increased risk of diabetic retinopathy.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Angiopatias Diabéticas/complicações , Doenças da Glândula Tireoide/complicações , Adulto , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças da Glândula Tireoide/epidemiologia
12.
Rev Assoc Med Bras (1992) ; 66(1): 55-60, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130382

RESUMO

OBJECTIVE: It has been observed that celiac disease (CD) is not restricted to a single type characterized by diarrhea but also has atypical, asymptomatic (silent), and latent forms. The prevalence of this autoimmune disease, which affects approximately 1% of the world, is estimated to be around 3%, including atypical and asymptomatic cases. In our study, we aimed to evaluate adult celiac patients. METHODS: Between December 2008-2015, patients diagnosed with CD over the age of 18 years old were included in the study. Patients' symptoms at admission, frequency and type of anemia, transaminase levels, and celiac antibody positivity, and autoimmune diseases diagnosed at follow up were evaluated retrospectively. RESULTS: Of 195 patients, 151 (77.4%) were female. The mean age of the patients was 35.73 ± 12.19 years (range, 18-71 years). A hundred patients (51.3%) had gastrointestinal symptoms. At the time of admission, 118 patients (60.5%) had anemia, and 52 (26.7%) had hypertransaminasemia. During the mean follow-up period of 58 months (36-120 months), 84 (43.1%) of the patients presented at least one autoimmune disease, and this rate was 96.6% in individuals diagnosed above the age of 50 years. CONCLUSION: In adult CD, resistant anemia, dyspepsia, and hypertransaminasemia are very common findings at the time of diagnosis, and the association with other autoimmune diseases, especially Hashimoto's thyroiditis, is high.


Assuntos
Anemia/epidemiologia , Doenças Autoimunes/epidemiologia , Doença Celíaca/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Anemia/complicações , Doenças Autoimunes/complicações , Doença Celíaca/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Estatísticas não Paramétricas , Centros de Atenção Terciária/estatística & dados numéricos , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/epidemiologia , Transaminases/sangue , Turquia/epidemiologia , Adulto Jovem
13.
Adv Clin Exp Med ; 29(1): 157-163, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31990461

RESUMO

Palmoplantar pustulosis (PPP) is a chronic inflammatory disease, most often occurring in middle-aged women. In the course of the condition, painful skin lesions appear on the hands and feet, i.e., areas that are extremely important in everyday life. Therefore, the disease significantly reduces quality of life. The pathogenesis of this disease is poorly understood, although it is known that genetic, immunological and environmental factors play a role in its development. Clinical observations confirm the role of nicotine and contact allergens in the development of the lesions. The skin lesions can also occur as a side effect of certain medications. In some cases, PPP coexists with other diseases, i.e., seronegative arthropathies, as well as celiac and thyroid diseases. There is also a connection between the disease and infectious bacterial foci. Exacerbation of the skin lesions is triggered by stress. Therefore, patients require multidirectional tests, since finding the cause of the disease is essential to administering effective treatment.


Assuntos
Psoríase , Doenças da Glândula Tireoide , Doença Crônica , Feminino , Pé/patologia , Mãos/patologia , Humanos , Pessoa de Meia-Idade , Psoríase/complicações , Psoríase/diagnóstico , Psoríase/terapia , Qualidade de Vida , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/terapia
14.
J Cutan Med Surg ; 24(1): 23-27, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31994934

RESUMO

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by painful nodules, sinus tracts, and significant scarring. Although the pathogenesis of this disease is not well established, there is increasing evidence to suggest that it is an immune-mediated disorder. Previous studies have suggested a relationship between HS and thyroid disease, which is also driven by an autoimmune process. We sought to assess whether an association exists between HS and thyroid disease. OBJECTIVES: To determine whether HS is associated with thyroid disease via meta-analysis of case-control studies. METHODS: A systematic review and meta-analysis was performed according to recommended PRISMA guidelines. Electronic searches were performed using 6 electronic databases from their inception until August 2018. Data were extracted and analyzed according to predefined clinical endpoints. Odds ratio (OR) was used as the summary effect size. RESULTS: We identified 5 case-controls studies included for meta-analysis. There were a total of 36 103 HS cases compared with 170 517 control cases. We found a significant association between HS and thyroid disease (OR 1.36, 95% CI 1.13-1.64, I 2 = 78%, P = .001). CONCLUSIONS: This pooled analysis of existing case-control studies to date supports an association between HS and any thyroid disease. Clinicians treating patients with HS should be aware of this potential association with thyroid disease.


Assuntos
Autoimunidade , Citocinas/metabolismo , Hidradenite Supurativa/etiologia , Doenças da Glândula Tireoide/complicações , Hidradenite Supurativa/imunologia , Hidradenite Supurativa/metabolismo , Humanos , Doenças da Glândula Tireoide/imunologia , Doenças da Glândula Tireoide/metabolismo
15.
Laryngoscope ; 130(5): 1343-1348, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31408213

RESUMO

OBJECTIVES/HYPOTHESIS: Obesity is an increasing health concern worldwide. It has been associated with perioperative complications that could affect patient outcomes. Our aim was to compare surgical outcomes in obese and nonobese patients after transoral robotic thyroid (TORT) surgery. STUDY DESIGN: Retrospective cohort study. METHODS: A total of 304 consecutive patients who underwent TORT between January 2012 to December 2017 were included in the study. Patients were divided into two groups according to their body mass index (BMI): BMI < 30 kg/m2 and BMI ≥30 kg/m2 . Patient demographics, operative extent, pathological data, surgical outcomes, and postoperative complications were included and analyzed. A χ2 test was used to compare categorical variables, and a Student t test was used to compare changes of continuous variables between groups. Statistical significance was conferred by a two-tailed P value of ≤.05. RESULTS: There were 290 patients in the non-obese group and 14 patients in the obese group. There was no statistically significant difference between the two groups in terms of patient demographics, operative procedure, or pathological characteristics. The only statistically significant difference was for lymph node dissection (P = .012); however, for both groups, unilateral central node dissection was the most common procedure. There was also no statistically significant difference found for operative time, length of stay, pain score, or postoperative complications including TORT-specific complications such as oral commissure tear and general complications such as recurrent nerve injury. CONCLUSIONS: This initial experience shows that TORT appears to be a safe and feasible option for obese patients pursuing scarless thyroid surgery. LEVEL OF EVIDENCE: NA Laryngoscope, 130:1343-1348, 2020.


Assuntos
Obesidade/complicações , Complicações Pós-Operatórias/epidemiologia , Procedimentos Cirúrgicos Robóticos , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
17.
Foot Ankle Surg ; 26(4): 445-448, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31186135

RESUMO

BACKGROUND: Hallux valgus and lesser toe deformities are common foot disorders with substantial functional consequences. While the exact etiologies are multi-factorial, it is unknown if certain endocrine abnormalities, such as thyroid dysfunction, may be associated with these pathologies. The current study sought to investigate the prevalence of thyroid disease in patients with hallux valgus or lesser toe deformities. METHODS: Every new patient who presented to our institution's foot and ankle clinic during a three-month time period was given a survey to determine the presence of a known thyroid disorder. The diagnosis for each visit was then recorded. Additionally, a national, publicly available database was queried for patients diagnosed with thyroid disease and concomitant hallux valgus or specific forefoot pathology. Odds ratios for the presence of thyroid dysfunction were then calculated for each patient group. RESULTS: Three-hundred and fifty initial visit patient surveys were collected, and 74 (21.1%) patients had a known diagnosis of thyroid disease. The most common diagnoses were primary hypothyroidism (n = 61, 17.4%), secondary hypothyroidism (n = 6, 1.7%), thyroiditis (n = 4, 1.1%), and hyperthyroidism (n = 3, 0.9%). Thyroid disease was present in 16 of 26 patients (61.5%) with a diagnosis of hallux valgus (OR 7.3, CI[3.16-16.99], p < 0.0001). Lesser toe deformities, including hammertoes, mallet toes, bunionettes and crossover toes, were also significantly associated with thyroid disease (OR 5.45, CI[1.83-16.26], p < 0.002). The national database revealed 905,924 patients with a diagnosis of a specific forefoot deformity, and 321,656 of these patients (35.5%) had a concomitant diagnosis of a thyroid condition (OR 2.11, CI[2.10-2.12], p < 0.0001). CONCLUSIONS: The current study suggests a significant association between forefoot pathology and thyroid dysfunction, especially hallux valgus and lesser toe deformities. Increased understanding of these correlations may offer an important opportunity in population health management, both in diagnosis and treatment. While further studies with long-term outcomes are necessary, the early diagnosis of thyroid disease may provide an opportunity to predict and potentially alter the course of forefoot pathology.


Assuntos
Deformidades do Pé/complicações , Doenças da Glândula Tireoide/epidemiologia , Adulto , Idoso , Feminino , Deformidades do Pé/diagnóstico , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/etiologia , Estados Unidos/epidemiologia
18.
Ann Pharmacother ; 54(5): 486-495, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31744311

RESUMO

Objective: To describe the various pharmacotherapeutic strategies in managing thyroid disease-induced pericarditis (TDIP). Considerations for both hypothyroid-induced and hyperthyroid-induced pericarditis will be discussed. Data Sources: A literature search of MEDLINE, including PubMed, was performed inclusive of all years, using the following search terms: thyroid disease, pericardial diseases, pericarditis, acute pericarditis, cholesterol pericarditis, hypothyroidism, hyperthyroidism, colchicine, corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, methimazole, propylthiouracil, and P-glycoprotein. Product monographs were reviewed as well. Study Selection and Data Extraction: Relevant English-language studies and data as well as the most current guidelines for diagnosis and management of thyroid and pericardial diseases were considered. Because of limited data regarding the subject matter, no date range limits were established during literature search. Data Synthesis: It is well documented that thyroid dysfunction can adversely affect cardiovascular function. Additionally, there are published guidelines on the diagnosis and management of pericarditis and, separately, thyroid disease. There are limited data, however, on managing TDIP. The sequela of untreated TDIP can be detrimental. Relevance to Patient Care and Clinical Practice: Strategies on managing TDIP are scarcely reported in the literature. This review provides clinicians with a single reference source for treatment strategies toward managing hypothyroidism-induced and hyperthyroidism-induced pericarditis as well as significant drug interactions that can potentially confound the management of hypothyroidism- and hyperthyroidism-induced pericarditis. Conclusions: Treatment of TDIP involves addressing both the thyroid disease as well as the pericarditis. Along with treatment strategies, clinicians should also consider potential drug-drug and drug-disease interactions that can potentially worsen clinical outcomes.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Aspirina/uso terapêutico , Colchicina/uso terapêutico , Pericardite/tratamento farmacológico , Doenças da Glândula Tireoide/tratamento farmacológico , Corticosteroides/administração & dosagem , Corticosteroides/uso terapêutico , Anti-Inflamatórios não Esteroides/administração & dosagem , Aspirina/administração & dosagem , Colchicina/administração & dosagem , Interações Medicamentosas , Humanos , Hipertireoidismo/complicações , Hipertireoidismo/tratamento farmacológico , Hipotireoidismo/complicações , Hipotireoidismo/tratamento farmacológico , Pericardite/diagnóstico , Pericardite/etiologia , Doenças da Glândula Tireoide/complicações
19.
Medicine (Baltimore) ; 98(52): e18537, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876751

RESUMO

Thyroid disorders are associated with blood glucose abnormalities. For rendering the patients euthyroid, routine screening and care are essential. Therefore, the aim of this study was to investigate the association between continuity of care (COC) and type 2 diabetes onset among patients with thyroid disorders.We used the national claim data. Our study population was 4099 patients with hyperthyroidism or hypothyroidism. For calculating COC, the Most Frequent Provider Continuity Index (MFPCI), Modified Modified Continuity Index (MMCI), and COC Index (COCI) were used. The dependent variable was type 2 diabetes onset. The Cox proportional hazard regression model was used.Among 4099 patients with thyroid disorders, 25.3% experienced onset of type 2 diabetes. Thyroid patients who had MFPCI and COCI below the median were more likely to experience onset of type 2 diabetes than who had these indices above the median (MFPCI: hazard ratio [HR] = 1.26, 95% confidence interval [CI] = 1.09-1.46; COCI: HR = 1.22, 95% CI = 1.06-1.41). Our subgroup analysis showed that female patients and those 20 to 34 years of age showed a significant association between COC and onset of type 2 diabetes.Patients with thyroid disorders with low COC showed an increased risk of developing type 2 diabetes. Therefore, efforts to enhance COC among patients with thyroid disorders needs to be encouraged.


Assuntos
Continuidade da Assistência ao Paciente , Diabetes Mellitus Tipo 2/etiologia , Doenças da Glândula Tireoide/complicações , Adulto , Fatores Etários , Idoso , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Hipertireoidismo/complicações , Hipertireoidismo/terapia , Hipotireoidismo/complicações , Hipotireoidismo/terapia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de Risco , Fatores Sexuais , Doenças da Glândula Tireoide/terapia , Adulto Jovem
20.
Medicine (Baltimore) ; 98(50): e18293, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852107

RESUMO

RATIONALE: Ectopic thyroid is most common in the tongue. Here we reported a rare case of thyroid tissue located in the gallbladder wall, accompanied with adenoma and a cyst lined with pseudostratified ciliated columnar epithelium in the neck region of gallbladder neck. PATIENT CONCERNS: A 39-year-old female presented with recurrent upper abdominal pain and radiating back pain. DIAGNOSES: Based on ultrasonography, gallbladder polyps and calculous cholecystitis were suspected. INTERVENTIONS: The patient was treated by laparoscopic cholecystectomy, and thyroid tissue located in the gallbladder wall was found. Histopathological examination showed no features of papillary thyroid neoplasm. OUTCOMES: The patient had no thyroid nodules or suspicious enlarged lymph nodes, and no other symptoms or complications by follow-up for 2.5 years up to September 2019. LESSONS: We should pay attention to the rare location of ectopic thyroid tissue in the gallbladder and rule out primary thyroid malignancy to avoid unnecessary overtreatment.


Assuntos
Adenoma/diagnóstico , Coristoma/diagnóstico , Neoplasias da Vesícula Biliar/diagnóstico , Vesícula Biliar , Doenças da Glândula Tireoide/diagnóstico , Adenoma/complicações , Adenoma/cirurgia , Adulto , Biópsia , Colecistectomia Laparoscópica/métodos , Coristoma/cirurgia , Diagnóstico Diferencial , Feminino , Neoplasias da Vesícula Biliar/complicações , Neoplasias da Vesícula Biliar/cirurgia , Humanos , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/cirurgia
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