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1.
Rev Med Liege ; 75(1): 37-42, 2020 Jan.
Artigo em Francês | MEDLINE | ID: mdl-31920042

RESUMO

OBJECTIVE: Perfluoroalkyl substances (PFAS) are chemicals widely employed in the industry. Long term consequences of the newborns' contamination by PFAS on thyroid function are of concern. The aim of this study is to assess the potential associations between PFAS contamination measured at birth and thyroid function assessed few months later. PFAS levels were previously determined in cord blood from a cohort of newborns recruited in Liege. METHOD: Parents of the children belonging to the first and the fifth quintiles of exposure to PFAS were contacted in order to measure the thyroid stimulating hormone (TSH) levels in their child few months after birth. Twenty-eight children participated in the study. Moreover, we performed a literature review about associations between pre- or perinatal exposure to persistent organic pollutants and thyroid function during early childhood. RESULT: No significant difference was highlighted between both groups of contamination (Mann-Whitney, p-value = 0.91). Literature review highlighted the critical need of new longitudinal data about this problematic. CONCLUSION: Our results suggest that the PFAS levels at birth are not associated with TSH levels later in life. Large scale studies are required to confirm our results.


Assuntos
Poluentes Ambientais , Fluorcarbonetos , Doenças da Glândula Tireoide , Glândula Tireoide , Criança , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Gravidez , Doenças da Glândula Tireoide/epidemiologia , Glândula Tireoide/fisiopatologia
2.
Tuberk Toraks ; 67(2): 131-135, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31414644

RESUMO

Chronic obstructive pulmonary disease (COPD) has many systemic effects influencing morbidity and mortality of the disease. Thyroid diseases which are more common in COPD patients than who do not have COPD are underestimated despite important clinical consequences. Similar to general population, thyroid dysfunctions are more common in females than males among COPD patients. Both hypothyroidism and hyperthyroidism may be associated to COPD. As well as systemic inflammation hypoxia, age, glucocorticoid use and smoking are some of the effective factors on developing thyroid dysfunction in COPD patients. In this article thyroid dysfunctions that are underrecognized comorbidities of COPD patients, their mechanisms of action and clinical outcomes were reviewed.


Assuntos
Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Comorbidade , Feminino , Humanos , Hipertireoidismo/epidemiologia , Hipertireoidismo/fisiopatologia , Hipotireoidismo/epidemiologia , Hipotireoidismo/fisiopatologia , Inflamação , Masculino , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Fumar , Doenças da Glândula Tireoide/fisiopatologia
3.
Diabetes Metab Syndr ; 13(4): 2513-2517, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405670

RESUMO

OBJECTIVE: It is usually difficult to clinically identify thyroid abnormalities in diabetics as features of thyroid dysfunction may simulate diabetes symptoms or complications. So, assessing thyroid dysfunction prevalence in patients with type 2 diabetes mellitus (DM) would help better control of DM and its complications. Several studies reported this prevalence, however, some included small sample size or lacked a control group. We aimed to determine thyroid dysfunction prevalence in diabetic patients as well as its relation to glycemic control. METHODS: A cross-sectional study included 200 patients having type 2 DM and 200 apparently healthy controls. Each participant was tested for fasting and 2-h post-prandial blood glucose, glycated haemoglobin (HbA1C), thyroid function tests: thyroid-stimulating hormone (TSH), free tri-iodothyronine (FT3), free thyroxine (FT4), serum total cholesterol and triglycerides and thyroid antibodies; anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) for hypothyroidism only. RESULTS: There was a significant increase in serum TSH and T3 levels in diabetics when compared with the controls, (P < 0.001, P = 0.001), respectively. Thyroid dysfunction was significantly more prevalent in patients with HbA1c ≥ 8%, (P = 0.0001), and in those having longer diabetes duration, (P < 0.001). CONCLUSION: There was a higher prevalence of thyroid dysfunction among patients with type 2 DM. This dysfunction increased with the rise of HbA1c. This could suggest that poor glycemic control may have a role in the development of thyroid dysfunction in type 2 DM patients. Subclinical hypothyroidism was the most prevalent type of thyroid dysfunction in diabetic patients.


Assuntos
Biomarcadores/sangue , Diabetes Mellitus Tipo 2/complicações , Hemoglobina A Glicada/análise , Doenças da Glândula Tireoide/epidemiologia , Hormônios Tireóideos/sangue , Glicemia/análise , Estudos de Casos e Controles , Estudos Transversais , Feminino , Seguimentos , Índice Glicêmico , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/etiologia , Testes de Função Tireóidea
4.
Postgrad Med ; 131(8): 607-611, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31452426

RESUMO

Objectives: Thyroid disease is managed by primary and a range of secondary care specialties. Interventions for common thyroid conditions are effective, but delays in diagnosis, ineffective or inappropriate treatment may affect outcomes and be subject to litigation. This study aimed to analyze trends in thyroid malpractice litigation in the UK over a 14-year period.Methods: This retrospective cohort study analyzed negligence claims recorded by the NHS Litigation Authority from 2002 to 2016. Data on incident details, outcomes, time to settlement, costs, and specialties involved were collected and analyzed.Results: Out of 189 cases reviewed, an outcome was decided in 134 cases; of which, 67.9% were successful for the claimant, resulting in compensation being paid. The most common reasons for successful claims were treatment complications (47 cases) and delay or failure of diagnosis (22 cases). Nerve and/or vocal cord damage and hypoparathyroidism were cited in 12 and 3 cases, respectively. Common specialties involved in successful claims were general surgery, ENT and endocrinology. The median (range) costs paid for compensation were £50,701.35 (£189.00 to £4.5 million). The median (interquartile range) time from incident to settlement was 1254 (992-1756) days. The number of claims (overall and successful) has reduced over the 14-year period, but there has been no change in the total cost per successful claim from 2002 to 2014 (p = 0.151).Conclusion: This overview demonstrates common causes and identifies trends in thyroid malpractice litigation in the UK, highlighting the significant costs incurred. The outcomes of the study will provide a basis to enable clinicians to avoid potential pitfalls and formulate guidelines to minimize risk.


Assuntos
Imperícia/estatística & dados numéricos , Medicina Estatal/legislação & jurisprudência , Doenças da Glândula Tireoide/epidemiologia , Compensação e Reparação/legislação & jurisprudência , Erros de Diagnóstico/legislação & jurisprudência , Erros de Diagnóstico/estatística & dados numéricos , Humanos , Imperícia/economia , Estudos Retrospectivos , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/terapia , Tempo para o Tratamento , Reino Unido/epidemiologia
5.
BMC Endocr Disord ; 19(1): 83, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31362731

RESUMO

BACKGROUND: Thyroid dysfunction is one of the prevalent endocrine disorders. The relationship between lifestyle factors and thyroid dysfunction was not clear and some of the factors seemed paradoxical. METHODS: We conducted this population-based study using data from 5154 She ethnic minority people who had entered into the epidemic survey of diabetes between July 2007 to September 2009. Life style information was collected using a standard questionnaire. Body mass index (BMI), Blood pressure and serum TSH, TPOAb, triglycerides (TG), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL) were collected. RESULTS: The study showed that people who drank, had higher education or suffered from insomnia have lower incidence of hyperthyroidism. On the other hand, smoking, alcohol consumption, exercise, undergoing weight watch and chronic headache were associated with decreased incidence of hypothyroidism. Using multivariable logistic regression analysis, we found that alcohol consumption was associated with decreased probability of hyperthyroidism, hypothyroidism, as well as positive TPOAb. The amounts of cigarettes smoked daily displayed a positive correlation with hyperthyroidism among smokers. Accordingly, smoking seemed to be associated with decreased risk for hypothyroidism and positive TPOAb. Exercise and maintaining a healthy weight might have a beneficial effect on thyroid health. Interestingly, daily staple amount showed an inverse correlation with incidence of positive TPOAb. CONCLUSIONS: Within the Chinese She ethnic minority, we found associations between different lifestyle factors and the incidence of different thyroid diseases. Understanding the nature of these associations requires further investigations.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Estilo de Vida , Grupos Minoritários/estatística & dados numéricos , Doenças da Glândula Tireoide/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoanticorpos/sangue , China/epidemiologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Doenças da Glândula Tireoide/sangue , Adulto Jovem
6.
Toxicol Lett ; 315: 55-63, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31445060

RESUMO

Occupational and environmental exposure to pesticides has been associated with thyroid dysfunction, particularly changes in circulating thyroid hormone levels (T3, T4) and thyroid stimulating hormone (TSH). This study assessed the association between environmental exposure to pesticides and the risk of developing thyroid diseases. A population-based case-control study was carried out among Spanish populations living in areas categorized as of high or low pesticide use according to agronomic criteria, which were used as surrogates for environmental exposure to pesticides. The study population consisted of 79.431 individuals diagnosed with goiter, thyrotoxicosis, hypothyroidism, and thyroiditis (according to the International Classification of Diseases, Ninth Revision) and 1.484.257 controls matched for age, sex and area of residence. Data were collected from computerized hospital records for the period 1998 to 2015. Prevalence rates and risk of having thyroid diseases were significantly higher in areas with higher pesticide use, with a 49% greater risk for hypothyroidism, 45% for thyrotoxicosis, 20% for thyroiditis and 5% for goiter. Overall, this study indicates an association between increased environmental exposure to pesticides as a result of a greater agricultural use and diseases of the thyroid gland, thus supporting and extending previous evidence. This study also provides support to the methodology proposed for real-life risk simulation, thus contributing to a better understanding of the real life threat posed by exposure to multiple pesticides from different sources.


Assuntos
Exposição Ambiental/efeitos adversos , Praguicidas/efeitos adversos , Doenças da Glândula Tireoide/induzido quimicamente , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco , Espanha/epidemiologia , Doenças da Glândula Tireoide/epidemiologia
7.
BMC Oral Health ; 19(1): 169, 2019 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366342

RESUMO

BACKGROUND: Lichen planus (LP) is a chronic inflammatory mucocutaneous disease that commonly affects the oral cavity. Previous reports have suggested a possible association between LP and thyroid gland diseases (TGDs). The purpose of this study was to investigate possible associations between oral lichen planus (OLP) and TGDs. METHODS: Patients diagnosed with OLP, both clinically and histopathologically (N = 102), were classified according to clinical course (symptomatic/asymptomatic), type (reticular/plaque, atrophic and erosive) and location of lesions. Data on TGDs was compared to age- and gender-matched controls (N = 102) without OLP. Diagnosis of any type of TGD and related medication for study and control groups was recorded from the medical files provided by patients' physicians. Statistical analysis used Student's t-test and Fisher's exact test; significance was set at p < 0.05. RESULTS: TGDs (all), hypothyroidism and related medications were found in 16.6, 12.7 and 12.7% of patients with OLP, respectively. These findings were similar to the control group: TGDs (all) -15.7%, hypothyroidism - 9.8% and thyroid gland disease-related medication - 9.8% (p > 0.05). No significant associations were found between different characteristics of OLP and hypothyroidism or other TGD (p > 0.05). CONCLUSIONS: We found no significant associations between the co-existence of OLP and TGD or related-medications. Our findings are in agreement with some of the previously published similar studies but in controversy with others. Further well-designed, multicenter studies with large groups of patients and controls may help to establish the nature of the associations between OLP and TGDs.


Assuntos
Líquen Plano Bucal/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Doença de Hashimoto/epidemiologia , Humanos , Israel/epidemiologia , Líquen Plano Bucal/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Nódulo da Glândula Tireoide/epidemiologia
8.
G Ital Cardiol (Rome) ; 20(6): 342-350, 2019 Jun.
Artigo em Italiano | MEDLINE | ID: mdl-31184320

RESUMO

Thyroid dysfunction is a quite common clinical condition in the general population and often completely misunderstood. Thyroid hormones play a crucial role in the cardiovascular (CV) system contributing to the control of cardiac function and peripheral hemodynamics. In addition, they are involved in the regulation of glucose, lipid and coagulation homeostasis, further affecting CV risk stratification. The aim of the present article is to systematically review and summarize the available evidence on the possible association between thyroid dysfunction and CV morbidity and mortality. Overt hypothyroidism and hyperthyroidism significantly increase CV risk through either direct (on myocardial cell and coronary flow) and indirect (influencing the peripheral vascular system, lipid and glucose metabolism and coagulation homeostasis) mechanisms. Less clear is the contribution of subclinical conditions of hyperthyroidism and hypothyroidism to the stratification of CV risk. Treatment of subclinical hypothyroidism seems to guarantee greater benefits, especially in younger subjects at low CV risk. On the other hand, the treatment of subclinical hyperthyroidism allows greater advantages in older patients with a greater burden of associated comorbidities.


Assuntos
Doenças Cardiovasculares/complicações , Doenças da Glândula Tireoide/complicações , Doenças Cardiovasculares/epidemiologia , Humanos , Hipotireoidismo/complicações , Morbidade , Doenças da Glândula Tireoide/epidemiologia
9.
Artigo em Alemão | MEDLINE | ID: mdl-31250039

RESUMO

BACKGROUND: Billing diagnoses are used for quality assurance, estimates of prevalence and resource allocation. Validity studies showed relevant limitations. In Germany, there are no population-based data on the agreement of outpatient billing diagnoses with clinical data of thyroid disorders. OBJECTIVES: The study investigated the agreement of ICD-diagnosed thyroid nodules, goitre, hyperthyroidism, hypothyroidism and thyroiditis with clinical and self-reported data from the population-based cohort study called the Study of Health in Pomerania (SHIP). MATERIALS AND METHODS: Billing data from the Association of Statutory Health Insurance Physicians Mecklenburg-Vorpommern were linked on an individual level for the period from 2002-2016 with data from SHIP. The agreement was evaluated using sensitivity, specificity and positive and negative predictive value (PPW, NPW). Data were weighted to ensure population representativeness. RESULTS: The data of 5746 participants were analysed (46% male, average age 55 years, SD [standard deviation] ± 15, min: 20 years, max: 93 years). Based on clinical data, 63% (3451/5511, missing values n = 235) and based on billing data 25% (1421/5746) of the participants had thyroid disorders. The sensitivity was 12-36%, the specificity was 84-98%, the PPW was highest for thyroid nodules (75%) and hypothyroidism (70%) and the NPW was between 63 and 94%, depending on the investigated thyroid disorder. CONCLUSIONS: Thyroid disorders are common and often undiagnosed. Billing data have a low sensitivity to identify clinically relevant thyroid disorders.


Assuntos
Codificação Clínica , Formulário de Reclamação de Seguro/estatística & dados numéricos , Doenças da Glândula Tireoide/epidemiologia , Glândula Tireoide/anormalidades , Adulto , Idoso , Estudos de Coortes , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde , Reprodutibilidade dos Testes , Doenças da Glândula Tireoide/diagnóstico
10.
BMC Endocr Disord ; 19(1): 47, 2019 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-31064360

RESUMO

BACKGROUND: Ovarian reserve, vital for reproductive function, can be adversely affected by thyroid diseases. Despite alternations of thyroid hormones with ageing, data on interactions between the overtime trend of thyroid functions and ovarian reserve status has rarely been reported. We aimed to examine the overtime trend of thyroid hormones, thyroid peroxidase antibody (TPO Ab) and their associations with ovarian reserve status, identified by levels of age specific anti-mullerian hormone (AMH) in reproductive aged women, who participated in 12-year cohort of Tehran Thyroid Study (TTS). METHODS: Reproductive age women(n = 775) without any thyroid disease or ovarian dysfunction were selected from the Tehran Thyroid Study cohort. Participants were divided into four age specific AMH quartiles (Q1-Q4), Q1, the lowest and Q4, the highest. AMH was measured at the initiation of study and thyroid stimulating hormone (TSH), free T4 (FT4), and TPO Ab were measured at baseline and at three follow up visits. RESULTS: At baseline, there was no statistically significant difference in thyroid hormones between women of the four quartiles, although TPO Ab levels were higher in women of Q1. During the follow ups, FT4 was decreased in all quartiles (p < 0.05), whereas TPO Ab increased in Q1 (p = 0.02). Odds ratio of overall TPO Ab positivity in women of Q1 was 2.08 fold higher than those in Q4. (OR: 2.08, 95%CI: 1.16, 3.72; p = 0.01). CONCLUSION: Women with the lowest ovarian reserves had higher levels of TPO Ab, with a positive trend of this antibody overtime in comparison to other quartiles, indicating that this group may be at a higher risk of hypothyroidism over time.


Assuntos
Autoimunidade/fisiologia , Infertilidade Feminina/prevenção & controle , Reserva Ovariana/fisiologia , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/imunologia , Hormônios Tireóideos/sangue , Adulto , Biomarcadores/análise , Feminino , Seguimentos , Humanos , Incidência , Infertilidade Feminina/sangue , Irã (Geográfico)/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Gravidez , Prognóstico , Doenças da Glândula Tireoide/epidemiologia , Adulto Jovem
11.
Arch Endocrinol Metab ; 63(4): 351-357, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31038589

RESUMO

OBJECTIVE: In this study, we aimed to describe the prevalence and distribution of positive antithyroperoxidase antibodies (TPOAb) according to sex, age strata, and presence of thyroid dysfunction using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). MATERIALS AND METHODS: Thyroid hormone tests were obtained from each study participant at baseline. Levels of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were measured using a third-generation immunoenzymatic assay. Antithyroperoxidase antibodies were measured by electrochemiluminescence and were considered to be positive when ≥ 34 IU/mL. RESULTS: The prevalence of TPOAb among 13,503 study participants was 12%. Of participants with positive TPOAb, 69% were women. Almost 60% of the individuals with positive TPOAb were white. The presence of positive TPOAb was associated with the entire spectrum of thyroid diseases among women, but only with overt hyperthyroidism and overt hypothyroidism in men. CONCLUSION: The distribution of positive TPOAb across sex, race, age, and thyroid function in the ELSA-Brasil study is aligned with the worldwide prevalence of positive TPOAb reported in iodine-sufficient areas. In women, the presence of TPOAb was related to the entire spectrum of thyroid dysfunction, while in men, it was only related to the occurrence of overt thyroid disease.


Assuntos
Anticorpos/sangue , Iodeto Peroxidase/sangue , Doenças da Glândula Tireoide/epidemiologia , Adulto , Distribuição por Idade , Idoso , Índice de Massa Corporal , Brasil/epidemiologia , Brasil/etnologia , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Doenças da Glândula Tireoide/sangue , Tireotropina/sangue , Tiroxina/sangue
13.
BMC Surg ; 18(Suppl 1): 80, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31074392

RESUMO

BACKGROUND: Thyroid diseases are frequent in patients with end-stage renal disease, but data on renal transplant recipients are conflicting. This study evaluated the incidence of thyroid disease and cancer in a population of kidney transplant recipients performed in a single center. METHODS: Seven hundred sixty patients receiving a kidney transplantation between January 2000 and October 2017 were followed with thyroid ultrasonography to determine nodules together with thyroid hormone levels. Ultrasound-guided fine-needle aspiration citology (FNAc) was performed to the nodules > 10 mm . RESULTS: Two hundred four patients (26.8%) patients demonstrated functional or morphologic changes in the thyroid gland compared with pre-transplant period. Among the 204 patients with newly diagnosed thyroid disease, 165 patients had single or multiple nodular lesions less than 1 cm in diameter, and were followed yearly. Nodule size progression was observed in 23 patients (13.9%), and they underwent a FNAc. A total of sixty-two patients (30.3%) underwent FNAc. The biopsy samples were cytologically interpreted as benign in 20 patients (32.2%), suspicious in 40 patients (64.5%), or at high risk of cancer in 2 patients (3.2%). Forty-two patients underwent total thyroidectomy. At histological examination, 18 patients had a thyroid cancer (papillary cancer in 17 patients, follicular cancer in one). Thyroid cancer was more frequent in male patients with a mean time from transplant to diagnosis of 5.6 years. At a mean follow-up was 8 ± 1.2 years, all patients are alive with a normal functioning graft. CONCLUSIONS: Thyroid diseases are common in transplant recipients. Thyroid disease may evolve after transplantation, probably as a consequence of immunosuppression. A complete evaluation of thyroid disease is mandatory in kidney transplant recipients because early diagnosis and appropriate treatment of thyroid disease and cancer may significantly decrease the morbidity and mortality in these patients.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim , Doenças da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Adenocarcinoma Folicular/epidemiologia , Adulto , Biópsia por Agulha Fina , Carcinoma Papilar/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/epidemiologia , Tireoidectomia/métodos , Ultrassonografia
14.
J Pediatr Endocrinol Metab ; 32(6): 597-606, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31112508

RESUMO

Background For several decades, transient hypothyroxinemia of prematurity (THOP) has been a topic of debate. The pathophysiology is incompletely understood and consensus on the therapeutic approach is lacking. This study aimed at gaining a better insight into the pathogenesis by studying the trends in thyroid hormone (TH) levels during the first week of life. Methods This single-center prospective observational study analyzed the plasma levels of total thyroxine (T4) and free thyroxine (fT4), total triiodothyronine (T3), thyroid-stimulating hormone (TSH) and T4-binding globulin (TBG) in cord blood and at the end of the first week of life in 120 preterm infants (gestational age [GA] <37 weeks). The change over time was calculated (delta, ∆). The impact of perinatal and subsequently postnatal variables on ∆ was studied by hierarchical multiple regression. The impact of ∆ on the neurodevelopmental outcome at the corrected ages of 9 and 24 months, measured by the Bayley Scales of Infant Development (BSID)-II, was assessed by logistic regression. Results ∆fT4 levels were negatively affected by GA and use of dopamine, whereas only GA was associated with low ∆T3 levels. Negative ∆fT4 levels were present in 75% of the extremely low-for-gestational-age infants, whereas 23.5% had a negative ∆T3 level. There was an increased risk for an abnormal mental developmental score (<85) with decreasing ∆T3 at 9 months, corrected age, but not at 24 months. Conclusions A negative evolution in circulating TH levels is principally an immaturity phenomenon, whereas dopamine can further suppress the hypothalamic-pituitary-thyroid axis. There is at least a temporary negative effect of this evolution on the infants' neurodevelopment.


Assuntos
Biomarcadores/sangue , Doenças do Prematuro/fisiopatologia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Transtornos do Neurodesenvolvimento/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Hormônios Tireóideos/sangue , Bélgica/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido Prematuro/sangue , Masculino , Transtornos do Neurodesenvolvimento/sangue , Transtornos do Neurodesenvolvimento/diagnóstico , Prognóstico , Estudos Prospectivos , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/diagnóstico , Testes de Função Tireóidea
15.
BMC Endocr Disord ; 19(1): 36, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30953492

RESUMO

BACKGROUND: This study aimed to investigate the occurrence and risk factors of thyroid dysfunction (TD) in patients with chronic hepatitis C (CHC) infection in Taiwan. METHODS: The data in this study were obtained from the Taiwan National Health Insurance Research (Taiwan NHIR) database between 2001 and 2013. CHC patients treated with pegylated interferon/ribavirin (PEG-IFN/RBV) were enrolled as case patients, and nontreated CHC patients were enrolled as controls and were matched at a control:case ratio of 3:1 by index date, age (± 3 years), and sex. We compared the cumulative incidence of TD between the cohorts at follow-up until 2013. RESULTS: During the study period, 3810 cases and 9393 controls were included in the study. Among the study subjects, 173 (4.5%) case patients and 244 (2.6%) controls were diagnosed with TD during the follow-up period. The types of TD were hypothyroidism (42.9%), hyperthyroidism (31.2%), and thyroiditis (25.9%). Compared to controls during the 13-year follow-up, patients treated with PEG-IFN/RBV had a higher incidence rate of TD (P < 0.0001), as determined using the Kaplan-Meier method. Cox proportional hazards regression analysis showed that female sex (adjusted hazard ratio (HR): 1.49; 95% confidence interval (CI): 1.23-1.75; P < 0.001), treatment with PEG-IFN/RBV (HR: 1.68; 95% CI: 1.38-2.06; P < 0.001), hyperlipidemia (HR: 1.38; 95% CI: 1.12-1.71; P < 0.001), and past history of goiter (HR: 6.40; 95% CI: 5.00-8.18; P < 0.001) were independent predictors for the development of TD. CONCLUSIONS: PEG-IFN/RBV treatment may be an independent risk factor for thyroid dysfunction among patients with hepatitis C virus (HCV) infection. Monitoring thyroid function keenly during PEG-IFN/RBV therapy in patients with chronic HCV infection is recommended for clinicians, especially for female patients and for patients with a history of hyperlipidemia and goiter.


Assuntos
Antivirais/efeitos adversos , Hepacivirus/efeitos dos fármacos , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/efeitos adversos , Polietilenoglicóis/efeitos adversos , Ribavirina/efeitos adversos , Doenças da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Quimioterapia Combinada , Feminino , Seguimentos , Hepatite C Crônica/virologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Proteínas Recombinantes/efeitos adversos , Fatores de Risco , Taiwan , Doenças da Glândula Tireoide/induzido quimicamente , Doenças da Glândula Tireoide/epidemiologia , Adulto Jovem
16.
Presse Med ; 48(4): e199-e207, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31005502

RESUMO

INTRODUCTION: Immunotherapy is a standard not only in second line but also in first line treatment in patients with non-small cell lung cancer (NSCLC) and other tumors. Thyroid dysfunctions are the most common endocrine toxicities. OBJECTIVE: To determine the incidence of thyroid dysfunctions during treatment with a PD-1 monoclonal antibody (nivolumab) in patients with NSCLC. METHODS: Retrospective study of patients treated with nivolumab for NSCLC between May 2015 and December 2016; euthyroidism within the 3 months preceding immunotherapy; monitoring of thyroid function tests until stopping nivolumab, death or February 2017. Patients treated with levothyroxine, amiodarone or another immunotherapy were excluded. RESULTS: Among 183 patients treated, 105 fullfilled the inclusion criteria (72 males, median age: 61 years [range: 41-80]). Fifteen patients (14.3%) experienced a thyroid dysfunction; among them, compared to the "control" group (n=90), we found more females (53.3% vs. 27.8%; P=0.07), and younger patients (median age: 56 years vs. 62 years; P=0.02). Thirteen patients had thyrotoxicosis (median onset: 8 weeks), and then hypothyroidism was observed in 5 patients. Isolated hypothyroidism was rare (n=2) and late (median: 30 weeks). Three patients had anti-TPO antibodies. Three patients discontinued immunotherapy transiently due to thyroid dysfunctions. After a median follow-up of 9 months [95% CI, 7.5-10.3], one patient (6.7%) in the "thyroid dysfunctions" group and 30 patients (33.3%) in the "control" group died, with a trend toward a higher overall survival in the "thyroid dysfunctions" group (HR: 0.16 [95% CI, 0.02-1.15]; P=0.07). CONCLUSION: Thyroid dysfunctions (isolated thyrotoxicosis, biphasic thyroiditis and hypothyroidism) were common, and required patients with NSCLC to be screened during nivolumab therapy.


Assuntos
Antineoplásicos Imunológicos/efeitos adversos , Nivolumabe/efeitos adversos , Doenças da Glândula Tireoide/induzido quimicamente , Doenças da Glândula Tireoide/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Imunológicos/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Feminino , Humanos , Incidência , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Nivolumabe/uso terapêutico , Estudos Retrospectivos
17.
Asia Pac J Clin Nutr ; 28(1): 15-22, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30896409

RESUMO

BACKGROUND AND OBJECTIVES: In Australia, two public health measures were introduced between 2009 and 2010 to reduce iodine deficiency. However there has been a shortage of information regarding their effectiveness and the ongoing prevalence of iodine deficiency in Australia. The primary aim of this study was to assess the extent to which these public health measures have reduced rates of iodine deficiency among pregnant and lactating women. METHODS AND STUDY DESIGN: A review was conducted to identify all studies published since January 2010 that quantitatively measured the iodine status of pregnant and/or lactating women in Australia. RESULTS: We found 25 publications, of which seven were included in this review after our exclusion criteria were applied. Of the seven included publications, three demonstrated the pregnant and lactating women in their studies to be iodine replete (median urinary iodine concentrations (MUIC) greater than 150 µg/L, or a breast milk iodine concentration (BMIC) of greater than 100 µg/L). The remaining four publications found MUIC of pregnant and lactating women to be below the 150 µg/L threshold, in the mild-to-moderate iodine deficiency category. Only two studies, documented iodine sufficiency among pregnant and lactating women in the absence of iodine supplementation. CONCLUSIONS: Many pregnant and lactating women in Australia remain at least mildly iodine deficient. Antenatal iodine supplementation was the factor most consistently associated with an adequate iodine status. Larger, more representative studies or sentinel studies with a National coordination are needed to understand the differences in iodine status that exist across the country.


Assuntos
Iodo/deficiência , Cloreto de Sódio na Dieta/administração & dosagem , Doenças da Glândula Tireoide/prevenção & controle , Adulto , Austrália/epidemiologia , Aleitamento Materno , Suplementos Nutricionais , Feminino , Humanos , Iodo/administração & dosagem , Gravidez , Doenças da Glândula Tireoide/epidemiologia
18.
J Pediatr Surg ; 54(6): 1226-1232, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30879752

RESUMO

BACKGROUND: Previous studies of pediatric thyroidectomies suggest a volume-outcome relationship, but none have focused exclusively on pediatric surgical specialists. Our objective was to examine the effects of pediatric surgeon volume and specialty on post-thyroidectomy outcomes. METHODS: The Pediatric Health Information System was queried for patients ≤21 years who underwent partial or total thyroidectomy between 2005 and 2016. Multivariable logistic regression with propensity score weighting was used to assess the relationships between surgeon volume or specialty and 90-day thyroidectomy-specific complications. High-volume surgeons/hospitals were defined as those in the top tertile of annual thyroidectomies. RESULTS: The inclusion criteria were met by 3149 patients. Patients treated by higher-volume surgeons had significantly fewer complications than those treated by lower-volume surgeons (15.0% vs. 19.2%, p = 0.01). Patients with thyroid cancer also had less morbidity when treated by higher-volume surgeons compared to lower-volume surgeons (25.0% vs. 35.1%, p = 0.03), as did children with Graves' disease (19.8% vs. 29.3%, p = 0.007). Patients managed by pediatric surgeons had fewer complications than those managed by pediatric otolaryngologists across all patients (14.0% vs. 22.5%, p < 0.001) and among cancer (25.3% vs. 42.1%, p < 0.001) and Graves' patients (20.1% vs. 37.3%, p < 0.001) specifically. CONCLUSIONS: Morbidity following pediatric thyroidectomy is associated with surgeon volume. TYPE OF STUDY: Prognostic Study. LEVEL OF EVIDENCE: Level II.


Assuntos
Cirurgiões/estatística & dados numéricos , Tireoidectomia , Criança , Humanos , Complicações Pós-Operatórias/epidemiologia , Pontuação de Propensão , Doenças da Glândula Tireoide/epidemiologia , Doenças da Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Tireoidectomia/estatística & dados numéricos
19.
Otolaryngol Head Neck Surg ; 160(3): 457-464, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30829140

RESUMO

OBJECTIVES: As the country ages, thyroidectomies can be expected to be performed more frequently among the elderly. In this study, we stratified patients by age to explore demographics and complications of patients undergoing thyroidectomy. STUDY DESIGN: Retrospective study with a national database. SETTING: Nationwide Inpatient Sample. SUBJECTS AND METHODS: A total of 414,079 thyroidectomy cases from 2005 to 2013 were identified. Complications, outcomes, demographics, length of stay, and hospital charges were evaluated among patients and stratified by age into 4 cohorts: younger (<65 years), advanced age (65-74 years), elderly (75-84 years), and superelderly (≥85 years). RESULTS: Of 414,079 thyroidectomy cases identified, patients aged <65 years accounted for 75.6% of cases, while those aged 65-74, 75-84, and ≥85 years accounted for 16.3%, 7.2%, and 0.9%, respectively ( P < .001). There was a significant difference in length of stay, total hospital charges, and mortality throughout the different age groups ( P < .001), all trending upward with advancing age. In the aging population, incidence of recurrent laryngeal nerve injury, transfusion of erythrocytes, and acute cardiac complications increased with increasing age ( P < .001), while hypoparathyroidism decreased with age ≥65 but ≤85 years ( P < .001). Patients aged ≥75 years had increased odds of mortality as compared with their younger counterparts ( P < .001). CONCLUSION: This study utilized a national database to describe and elucidate trends in older populations undergoing thyroidectomy. Thyroid-related complications, including blood transfusion and recurrent laryngeal nerve injury, increased with increasing patient age. This information will help to guide pre- and postoperative care for aging patients undergoing thyroidectomy.


Assuntos
Complicações Pós-Operatórias/epidemiologia , Doenças da Glândula Tireoide/cirurgia , Tireoidectomia/estatística & dados numéricos , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doenças da Glândula Tireoide/epidemiologia , Doenças da Glândula Tireoide/patologia , Tireoidectomia/efeitos adversos , Estados Unidos/epidemiologia
20.
Braz J Med Biol Res ; 52(2): e8417, 2019 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-30785482

RESUMO

Thyroid disorders are common diseases, both in Brazil and worldwide. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a prospective cohort study that investigates cardiovascular diseases, diabetes, and associated factors, including non-classical cardiovascular risk factors such as thyroid function. Thyroid function was classified according to thyrotropin stimulating hormone (TSH), free thyroxine (FT4), and use of medication to treat thyroid disorders, after excluding participants who reported use of any medication that could alter the results of the TSH and FT4 tests. All analyses included in this review are cross-sectional using baseline data (2008 to 2010). The results showed an association of subclinical thyroid disorders with biomarkers of subclinical atherosclerosis, measured by carotid intima-media thickness and coronary artery calcium, insulin resistance, metabolic syndrome, and some psychiatric disorders. No association was found with the biomarker of inflammation high-sensitivity C-reactive protein, or changes in pulse wave velocity or heart rate variability.


Assuntos
Doenças da Glândula Tireoide/epidemiologia , Adulto , Idoso , Brasil/epidemiologia , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Glândula Tireoide/diagnóstico
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