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1.
Wiad Lek ; 74(10 cz 2): 2634-2639, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34923472

RESUMO

OBJECTIVE: The aim: Calculate CVR in patients with T2DM, obesity and SH and analyze it. PATIENTS AND METHODS: Materials and methods: The selection of patients was carried out based on the Uzhhorod District Clinical Hospital, in the period from November 2016 to July 2021. All examined patients were divided into 3 groups: 1 (n=108) with T2DM and concomitant obesity and SH, 2 (n=91) with T2DM and SH, 3 (n=46) with obesity and SH. The observation and treatment period lasted 1 year. Using American College of Cardiology (ACC) / American Heart Association Guideline on the Assessment of Cardiovascular Risk (AHAGACR) (2013) (ASCVD Risk) and Framingham Risk Score (FRS), CVR was determined in all patients before and at the end of the study. RESULTS: Results: According to the data obtained, patients in each group had a 10-year risk of CVE, however, worse CVR was observed in patients in group 1. In a more detailed analysis and comparison of the obtained data of patients with 10-year risk of CVE, worse CVR values were observed in patients with concomitant SH than without it (p<0.05). CONCLUSION: Conclusions: The presence of SH in consumers may be an additional risk factor for unwanted CVE over a 10-year period.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Hipotireoidismo , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/complicações , Fatores de Risco de Doenças Cardíacas , Humanos , Hipotireoidismo/complicações , Hipotireoidismo/epidemiologia , Obesidade/complicações , Fatores de Risco , Estados Unidos
2.
Pan Afr Med J ; 40: 9, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34650659

RESUMO

Introduction: the outbreak and rapid spread of the novel SARS-CoV-2, the causative agent of the coronavirus disease 2019 (COVID-19), has evolved into an unprecedented global pandemic. The infection impairs several human organs and systems, however, it is not clear how it affects thyroid function. The study therefore aimed at measuring plasma levels of thyroid hormones and Hs-CRP in COVID-19 patients and apparently healthy uninfected controls to assess the possible effect of SAR-CoV-2 infection on thyroid function. Methods: in this cross-sectional study carried out between May-August 2020, 90 consenting participants comprising 45 COVID-19 patients and 45 apparently healthy uninfected controls were recruited. Plasma FT3, FT4, TSH and Hs-CRP were measured using Enzyme Linked Immunosorbent Assay (ELISA) method. Data was analysed using SPSS version 20 and statistical significance set at p < 0.05. Results: the mean plasma FT3 and TSH concentrations were significantly higher in COVID-19 patients compared to controls (p < 0.001, p < 0.001 respectively). Euthyroidism was observed in all uninfected controls, whereas 35 (77.8%) COVID-19 patients were euthyroid. Sick euthyroid and subclinical hypothyroidism was observed in 7 (15.6%) and 3 (6.7%) COVID-19 patients, respectively. Conclusion: though there was a preponderance of euthyroidism among COVID-19 patients, significantly higher mean plasma levels of TSH and FT3, sick euthyroid syndrome and subclinical hypothyroidism observed among some COVID-19 patients may be indicative of disease-related thyroid function changes. Hence, there is need to pay attention to thyroid function during and after treatment of COVID-19.


Assuntos
COVID-19/complicações , Síndromes do Eutireóideo Doente/epidemiologia , Hipotireoidismo/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Adulto , Estudos de Casos e Controles , Estudos Transversais , Síndromes do Eutireóideo Doente/virologia , Feminino , Humanos , Hipotireoidismo/virologia , Masculino , Pessoa de Meia-Idade , Nigéria , Doenças da Glândula Tireoide/virologia , Hormônios Tireóideos/sangue , Adulto Jovem
3.
Psychiatr Danub ; 33(Suppl 4): 622-624, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34718290

RESUMO

The impairment of adaptive mechanisms of functional systems of the body plays an important role in the occurrence of gastrointestinal diseases. This impairment is caused by unfavorable ecological and radiation conditions, external stress factors, food containing carcinogens, macro - and microelements deficiency. Technogenic environmental pollution contributes to decrease in the level of iodine in the body and more severe course of thyroid pathology. Diseases of the digestive and endocrine systems and their combination will occupy one of the leading places among the existing pathologies according to the forecasts of WHO experts in the XXI century. Adaptation of the body to various environmental influences is the most important factor in the quality of life. The relevance of the study was determined by the high incidence of psychological disadaptation, borderline personality disorders and, as a consequence, decrease in the quality of life in patients with gastrointestinal pathology and hypothyroidism. The article presents the results of comparative analysis of the quality of life indications of patients with gastric ulcer and / or gastroesophageal reflux disease in combination with hypothyroidism. The Russian-language analogue of the international questionnaire SF36 was used to analyze the indicatoions of patients' quality of life. The results of the study will allow to formulate the diagnosis exactly and organize adequate, comprehensive multidisciplinary treatment.


Assuntos
Bócio Endêmico , Hipotireoidismo , Iodo , Humanos , Hipotireoidismo/epidemiologia , Incidência , Qualidade de Vida
4.
Med Clin North Am ; 105(6): 1033-1045, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34688413

RESUMO

Subclinical thyroid disease is frequently encountered in clinic practice. Although overt thyroid dysfunction has been associated with adverse clinical outcomes, uncertainty remains about the implications of subclinical thyroid disease. Available data suggest that subclinical hypothyroidism may be associated with increased risk of cardiovascular disease and death. Despite this finding, treatment with thyroid hormone has not been consistently demonstrated to reduce cardiovascular risk. Subclinical hyperthyroidism has been associated with increased risk of atrial fibrillation and osteoporosis, but the association with cardiovascular disease and death is uncertain. The decision to treat depends on the degree of thyroid-stimulating hormone suppression and underlying comorbidities.


Assuntos
Tomada de Decisão Clínica , Doenças da Glândula Tireoide/epidemiologia , Fatores Etários , Fibrilação Atrial/epidemiologia , Doenças Cardiovasculares/epidemiologia , Transtornos Cognitivos/epidemiologia , Comorbidade , Humanos , Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Osteoporose/epidemiologia , Fatores de Risco , Doenças da Glândula Tireoide/sangue , Tireotropina/sangue , Tiroxina/sangue
5.
JNMA J Nepal Med Assoc ; 59(240): 783-786, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34508474

RESUMO

INTRODUCTION: Thyroid hormones have a major influence on synthesis, mobilization and metabolism of lipids. Hypothyroidism accounts for a notable cause of secondary dyslipidemia. This can increase the risk for cardiovascular morbidity and mortality. This study was performed to find out the prevalence of lipid profile abnormalities in newly diagnosed primary hypothyroid states. METHODS: This descriptive cross-sectional study was conducted among 71 patients in the context of newly diagnosed primary hypothyroidism patients visiting outpatient department of internal medicine from 9th December 2018 to 30th June 2020 after taking ethical clearance from Institutional Review Committee. Case screening for lipid profile changes was performed at the time of diagnosis of primary hypothyroidism. A convenience sampling method was used. Data entry and descriptive analysis were done in Statistical Package for the Social Sciences version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: In this study including 71 cases of newly diagnosed primary hypothyroidism, 49 (69.0%) (95% Confidence Interval= 58.24-79.76) had abnormal lipid profiles. Among them, 5 (38.5%) out of 13 (18.3%) cases of subclinical hypothyroidism and 44 (75.9%) out of 58 (81.7%) cases of overt hypothyroidism had abnormal lipid profiles. CONCLUSIONS: The prevalence of abnormal lipid profile parameters was similar to the study done in various studies in similar settings except for high-density lipid which showed both similarity and dissimilarity with other studies. Our study suggested that all newly diagnosed cases of primary hypothyroidism are to be investigated for dyslipidemia thus ensuring early treatment and prevention of complications.


Assuntos
Hipotireoidismo , Estudos Transversais , Humanos , Hipotireoidismo/diagnóstico , Hipotireoidismo/epidemiologia , Lipídeos , Nepal/epidemiologia , Centros de Atenção Terciária
6.
Eur J Endocrinol ; 185(5): 673-679, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34478406

RESUMO

Objective: A decrease over time in thyroid stimulating hormone (TSH) levels when initiating levothyroxine (L-T4) therapy for hypothyroidism has been reported, where treatment most often is initiated with TSH levels below 10 mIU/L. The primary objective of this study was to investigate whether this lower TSH threshold resulted in an increased number of overtreated patients. Design and method: Retrospective cohort study comprising inhabitants in Copenhagen had TSH measurements requested by general practitioners which led to a new prescription of L-T4 between 2001 and 2012. Over- and under- treatment were defined as TSH <0.1 mIU/L or above 10 mIU/mL, respectively, in three consecutive measurements. Data were analyzed by Aalen-Johansen estimators and Cox proportional hazards models. Results: In total, 14 533 initiations of L-T4 were included in the study. The cumulative risk of being over- or undertreated was 4.7 and 7.4% after 10 years. The hazard of overtreatment was higher among women, younger adults, and with lower initial TSH levels. The hazard of overtreatment decreased over the time period from 2001 to 2012. Among overtreated individuals, the chance of returning to a normal TSH was about 55% after 10 years. In 18% of the cases, L-T4 therapy was initiated on TSH levels less than 5 mIU/L. Conclusion: Although a still decreasing threshold for initiating L-T4 therapy is known, the risk of overtreatment (and undertreatment) was low and lessened in the period 2001-2012 among Danish primary care patients. Nevertheless, as many as 18% were started on L-T4 with normal TSH levels.


Assuntos
Hipotireoidismo/tratamento farmacológico , Sobremedicalização/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Tiroxina/uso terapêutico , Adulto , Idoso , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Terapia de Reposição Hormonal , Humanos , Hipotireoidismo/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Sensibilidade e Especificidade , Tireotropina/sangue , Tiroxina/administração & dosagem
7.
Bol Med Hosp Infant Mex ; 78(5): 424-431, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34571516

RESUMO

Background: An association between overweight and thyroid dysfunction, including chronic autoimmune thyroiditis (CAT), has been previously described. Patients with overweight and obesity have a higher risk of increased thyroid-stimulating hormone (TSH) and anti-thyroid antibodies. Weight gain may also be a clinical sign of hypothyroidism. This study aimed to describe the frequency of overweight and obesity in children with CAT and to compare thyroid function and antibody titles according to body weight. Methods: Clinical records from 78 patients with CAT who were followed up at a children's hospital in Mexico City were assessed. We collected demographic, anthropometric, and biochemical data, including thyroid function tests and antibodies. According to body mass index (BMI) percentiles, patients were classified as normal weight, overweight or obese according to BMI percentiles. Also, BMI changes at 6 and 12 months of follow-up were analyzed. Results: We observed 19.2% of the patients with overweight and 15.4% with obesity. Patients with obesity showed high TSH and low thyroid hormone levels. Also, the frequency of hypothyroidism at presentation was higher in this group. No significant difference was found in antibody titles between groups. A significant BMI percentile reduction was observed during follow-up of patients independently of thyroid function at diagnosis and treatment. Conclusions: Obesity is related to hypothyroidism in patients with chronic autoimmune thyroiditis, although causality cannot be established through this observational study.


Assuntos
Hipotireoidismo , Obesidade Pediátrica , Tireoidite Autoimune , Adolescente , Humanos , Hipotireoidismo/epidemiologia , Sobrepeso/epidemiologia , Obesidade Pediátrica/epidemiologia , Testes de Função Tireóidea , Tireoidite Autoimune/epidemiologia
8.
Wiad Lek ; 74(7): 1612-1616, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34459760

RESUMO

OBJECTIVE: The aim: Is to establish a relationship between serum vitamin D level with carbohydrate and lipid indexes in women with autoimmune hypothyroid disease. PATIENTS AND METHODS: Materials and methods: 146 women with autoimmune hypothyroid disease were examined in the period 2017-2019, who signed the informed consent. The mean age of women was 43.8 ± 0.7 years. Anthropometric, general clinical and biochemical examinations were performed including determination of lipid metabolism, hydrocarbon metabolism and establishment of vitamin-D status. RESULTS: Results: Vitamin D deficiency was found in 78.8%, insufficiency in 17.1% of women with autoimmune hypothyroidism. Statistical processing of results was carried out and established strong negative correlation between 25 (OH) D and Thyroid Peroxidase Antibody (r = -0,77) and thyrotropic hormone level (r = -0.72), р<0,05. Strong inverse correlations were found between vitamin D levels and body mass index (r=-0,74) and total cholesterol levels (r=-0,72), negative correlation of medium strength was with highdensity lipoprotein cholesterol (r=-0,58), triglycerides (r=-0,46), atherogenic coefficient (r=-0,65) and the HOMA-IR (r=-0,57), The values of p < 0.05 were considered reliable. CONCLUSION: Conclusions: The incidence of vitamin D hypovitaminosis in women with autoimmune thyroid disease is significantly higher than in the healthy population. Low vitamin D status is significantly associated with autoimmune thyroid dysfunction and determines the degree of metabolic disorders and cardiovascular risk in premenopausal women with autoimmune hypothyroid disease.


Assuntos
Hipotireoidismo , Doenças Metabólicas , Deficiência de Vitamina D , Adulto , Feminino , Humanos , Hipotireoidismo/epidemiologia , Vitamina D , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia , Vitaminas
9.
J Pak Med Assoc ; 71(7): 1804-1807, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34410251

RESUMO

OBJECTIVE: To evaluate the prevalence of autoimmune thyroid disease in children with diabetes. METHODS: The descriptive cross-sectional study was conducted from January to December 2019 at the Children Hospital and the Institute of Child Health, Multan, Pakistan, and comprised paediatric type 1 diabetes mellitus patients of both genders. Blood samples were obtained for detailed testing of thyroid functions tests. Data was analysed using SPSS 20. RESULTS: Of the 161 paediatric subjects, 83(51.6%) were boys. The overall mean age was 9.7±4.3 years. Thyroid peroxidase antibody was positive in 34(21.1%) patients and thyroglobulin antibody in 27(16.7%). Both antibodies were positive in 17(10.5%) patients. Six (3.7%) patients had evidence of subclinical hypothyroidism, 8(4.9%) had overt hypothyroidism and 1(0.62%) had hyperthyroidism. CONCLUSIONS: The prevalence of autoimmune thyroid disease among children and adolescents with type 1 diabetes mellitus was 21%, with hypothyroidism being more prevalent compared to hyperthyroidism.


Assuntos
Diabetes Mellitus Tipo 1 , Hipertireoidismo , Hipotireoidismo , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/epidemiologia , Feminino , Humanos , Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Masculino , Prevalência
10.
Expert Rev Endocrinol Metab ; 16(5): 251-257, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34424110

RESUMO

OBJECTIVE: There is an increasing body of literature on the impact of COVID-19 on the pituitary-thyroid axis. Therefore, we conducted a systematic review to assess the prevalence of hypothyroidism in patients with COVID-19. METHODS: A literature review was conducted using LitCOVID for study selection in PubMed and MEDLINE till May 2021. All relevant original articles evaluating thyroid dysfunction were included and information regarding the prevalence of hypothyroid disease in COVID-19 was retrieved from the eligible articles. RESULTS: Out of 32 articles, six articles qualified for the final analysis which included 1160 patients. There was significant heterogeneity among the included articles. Most of the patients had lower mean triiodothyronine (T3) and normal or low thyroid-stimulating hormone (TSH). Increased TSH ranged from 5.1% to 8% while low T3 was present in up to 28% of the patients. In these studies, the prevalence of altered thyroid hormones was significantly more in COVID-19 patients as compared to control groups. A positive correlation between low mean T3 and clinical severity of COVID-19 was reported. CONCLUSION: This systematic review reveals a significant proportion of hypothyroidism associated with COVID-19. Therefore, routine assessment of thyroid function is warranted in hospitalized COVID-19 patients.


Assuntos
COVID-19/sangue , COVID-19/epidemiologia , Hipotireoidismo/sangue , Hipotireoidismo/epidemiologia , Hormônios Tireóideos/sangue , COVID-19/diagnóstico , Humanos , Hipotireoidismo/diagnóstico , Glândula Tireoide/metabolismo , Glândula Tireoide/virologia
11.
Phys Med ; 89: 219-225, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34425512

RESUMO

PURPOSE: To predict the incidence of radiation-induced hypothyroidism (RHT) in nasopharyngeal carcinoma (NPC) patients, dosiomics features based prediction models were established. MATERIALS AND METHODS: A total of 145 NPC patients treated with radiotherapy from January 2012 to January 2015 were included. Dosiomics features of the dose distribution within thyroid gland were extracted. The minimal-redundancy-maximal-relevance (mRMR) criterion was used to rank the extracted features and selected the most relevant features. Machine learning (ML) algorithms including logistic regression (LR), support vector machine (SVM), random forest (RF), and k-nearest neighbor (KNN) were utilized to establish prediction models, respectively. Nested sampling and hyper-tuning methods were adopted to train and validate the prediction models. The dosiomics-based (DO) prediction models were evaluated through comparing with the dose-volume factor-based (DV) models in terms of the area under the receiver operating characteristic (ROC) curve (AUC). The demographics factors (age and gender) were included in both DO model and DV model. RESULTS: Age, V45 and 37 dosiomics features exhibited significant correlations with RHT in univariate analysis. For prediction performance, DO prediction models exhibited better results with the best AUC value 0.7 while DV prediction models 0.61. In DO prediction models, the AUC values displayed a trend from ascending to descending with the increasing of selected features. The highest AUC value was achieved when the number of selected features was 3. In DV prediction model, similar trend was not observed. CONCLUSION: This study established a prediction model based on the dosiomics features with better performance than conventional dose-volume factors, leading to early predict the possible RHT among NPC patients who had received radiotherapy and take precaution measures for NPC patients.


Assuntos
Hipotireoidismo , Neoplasias Nasofaríngeas , Humanos , Hipotireoidismo/epidemiologia , Hipotireoidismo/etiologia , Aprendizado de Máquina , Carcinoma Nasofaríngeo/radioterapia , Neoplasias Nasofaríngeas/radioterapia , Curva ROC
12.
Eur J Obstet Gynecol Reprod Biol ; 264: 232-240, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34333366

RESUMO

INTRODUCTION: We aimed to estimate the prevalence of urinary incontinence (UI) in women with hypothyroidism and subclinical hypothyroidism and to examine the association of hypothyroidism and UI. METHODS: This cross-sectional study was based on the population-based Lolland-Falster Health Study (LOFUS), Denmark. Data comprising a questionnaire, physical examination, and blood samples were collected between 2016 and 2020. Multiple logistic regression was used to estimate odds ratios (OR) and control for possible confounders: age, body mass index, diabetes, smoking, and education. RESULTS: Of 7,699 women included in the study, 7.9% had hypothyroidism, and 2.4% had subclinical hypothyroidism. The prevalence of any UI in women with hypothyroidism, subclinical hypothyroidism, and a control group (normal level of thyroid hormones) was 43.6%, 38.1%, and 39.3%, respectively. After controlling for confounders, no association between hypothyroidism and any UI (OR 1.01, 95% CI 0.85-1.20) or frequent UI (OR 1.05, 95% CI 0.84-1.32) were demonstrated. Additional, no association between subclinical hypothyroidism and any UI (OR 0.87, 95% CI 0.64-1.18) or frequent UI (OR 1.15, 95 CI 0.79-1.69) were demonstrated. CONCLUSIONS: In our female sample, the prevalence of UI was high regardless of the thyroid status. No association between hypothyroidism and any or frequent UI was demonstrated. The prevalence of hypothyroidism was 7.9%.


Assuntos
Hipotireoidismo , Incontinência Urinária , Estudos Transversais , Dinamarca/epidemiologia , Feminino , Humanos , Hipotireoidismo/epidemiologia , Prevalência , Fatores de Risco , Inquéritos e Questionários , Incontinência Urinária/epidemiologia
13.
Schizophr Res ; 235: 12-16, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34298238

RESUMO

AIM: To assess the association between acute phase treatment by valproate as an adjunctive drug and risk of new onset hypothyroidism in a large cohort of patients affected by schizophrenia. METHODS: We conducted a retrospective cohort study in a psychiatric hospital in China between January 2016 and December 2018. We obtained approval from the Ethics Committee of the study hospital prior to the commencement of the study. Patients who were diagnosed with schizophrenia and admitted to the study hospital during the study period with thyroid function tests at admission and during hospitalization were included. Patients with abnormal thyroid function at admission were excluded. Hypothyroidism, defined as TSH>4.2 mU/L or on L-thyroxine treatment, was the primary outcome. The primary exposure was adjunctive valproate plus atypical antipsychotics (AAPD), the secondary exposure was lithium plus AAPD and the comparison group was AAPD only. Adjusted relative risk (RR) and 95% confidence interval (CI) were estimated by log-binomial model to assess the independent association between valproate treatment and risk of hypothyroidism. RESULTS: A total of 1622 eligible patients were included the final analysis. Rate of new onset hypothyroidism was 10.7% and 20.9% in AAPD only and valproate plus AAPD groups, respectively. Adjusted RR (95% CI) for valproate plus AAPD was 1.85 (1.44-2.38), with AAPD only group as reference. Similarly, adjusted RR (95% CI) for lithium plus AAPD was 1.93 (1.32-2.69). CONCLUSION: Similar with lithium, valproate as adjunctive drug is associated with increased risk of new onset hypothyroidism during acute phase treatment for schizophrenia.


Assuntos
Hipotireoidismo , Esquizofrenia , Antimaníacos/efeitos adversos , Humanos , Hipotireoidismo/induzido quimicamente , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/epidemiologia , Estudos Retrospectivos , Esquizofrenia/tratamento farmacológico , Ácido Valproico/efeitos adversos
14.
J Autoimmun ; 123: 102687, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34311142

RESUMO

The impact of SARS-CoV-2 infection in patients with autoimmune/auto-inflammatory rheumatic diseases (AARD) under immunomodulatory treatment has been a focus of interest during the COVID-19 pandemic. In this observational study, demographic data, disease related features and comorbidities, COVID-19 manifestations and outcome as well as antibody responses to SARS-CoV-2 were recorded among 77 consecutive patients with underlying AARD infected by SARS-CoV-2. Analysis of data was performed using univariate and multivariate models. Most patients (68.8%) had a mild COVID-19 course. The predominant clinical manifestations were fatigue (58.4%), low grade fever (45.4%) and upper respiratory tract symptoms (68.8%). About a quarter of patients required hospitalization (23.3%) and the mortality rate was 1.3%. Regarding COVID-19 severity, prior treatment with corticosteroids, mycophenolate mofetil or rituximab was more common in patients who developed a more serious disease course (60.0 vs 29.9%, p = 0.003, 40.0 vs 7.5%, p = 0.003, 10.0 vs 0.0%, p = 0.009, respectively). When disease related features and comorbidities were considered in multivariate models, older age and lung disease in the context of the AARD were found to be independent predictive factors for hospitalization (OR [95%]: 1.09 [1.03-1.15] and 6.43 [1.11-37.19]). Among COVID-19 related features, patients with shortness of breath and high-grade fever were more likely to get hospitalized (OR [95%]: 7.06 [1.36-36.57], 12.04 [2.96-48.86]), while anosmia was independently associated with lower hospitalization risk (OR [95%]: 0.09 [0.01-0.99]). Though the majority of AARD patients displayed a mild COVID-19 course, certain underlying disease features and COVID-19 related manifestations should prompt alertness for the physician to identify patients with AARD at high risk for severe COVID-19 and need for hospitalization.


Assuntos
Doenças Autoimunes/epidemiologia , COVID-19/epidemiologia , Doenças do Tecido Conjuntivo/epidemiologia , SARS-CoV-2 , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/biossíntese , Infecções Assintomáticas/epidemiologia , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/imunologia , Comorbidade , Doenças do Tecido Conjuntivo/tratamento farmacológico , Doenças do Tecido Conjuntivo/imunologia , Estado Terminal , Feminino , Grécia/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Hipotireoidismo/epidemiologia , Hospedeiro Imunocomprometido , Imunoglobulina G/biossíntese , Fatores Imunológicos/efeitos adversos , Fatores Imunológicos/uso terapêutico , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Inflamação , Pneumopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Observacionais como Assunto , Literatura de Revisão como Assunto , Doenças Reumáticas/tratamento farmacológico , Doenças Reumáticas/epidemiologia , SARS-CoV-2/imunologia , Índice de Gravidade de Doença , Avaliação de Sintomas
15.
Endocrine ; 74(3): 616-624, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34331679

RESUMO

PURPOSE: The protective effect of onion against thyroid hypofunction has been reported in animal studies. However, in humans, the association between onion consumption and subclinical hypothyroidism (SCH) are unclear. The study sought to explore the association between habitual onion intake and SCH among adult population from an iodine-replete area. METHODS: A cross-sectional study (6515 men and 5290 women) was performed in Tianjin, China. Frequency of onion consumption was assessed using a valid self-administered food frequency questionnaire. Serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were determined by chemiluminescence immunoassay. SCH was diagnosed with TSH > 4.78 mIU/L. Multiple logistic regression was used to evaluate the association of onion intake with SCH. RESULTS: The prevalence of SCH was 2.56% in men and 7.18% in women, respectively. In women, the fully adjusted odds ratios [95% confidence interval (CI)] of having SCH across increasing frequency of onion intake were 1.00 (reference) for <1 time/week, 0.99 (0.73, 1.34) for 1-3 times/week, 0.74 (0.53, 1.03) for 4-6 times/week, and 0.67 (0.47, 0.97) for ≥7 times/week (P for trend <0.01). However, we observed no significant association between onion intake and SCH in men. Stratified analyses suggested a potential effect modification by age: the odds ratios (95% CI) across extreme quartiles was 0.37 (0.17, 0.80) in <40 women and 1.11 (0.51, 2.47) in >60 women. CONCLUSIONS: Frequent consumption of onion is inversely associated with SCH in adult women from an iodine-replete area. Further studies are needed to explore the casual relationship. TRIAL REGISTRATION WEBSITE: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137.


Assuntos
Dieta , Hipotireoidismo , Cebolas , Adulto , Estudos Transversais , Feminino , Humanos , Hipotireoidismo/epidemiologia , Iodo , Masculino , Testes de Função Tireóidea , Tireotropina , Tiroxina
16.
J Coll Physicians Surg Pak ; 31(8): 995-997, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34320724

RESUMO

This study was conducted to determine the frequency of subclinical hypothyroidism (SCH) in the old age population (>60 years). A cross-sectional study was conducted from July 2019 to January 2020 at Jinnah Postgraduate Medical Centre, Karachi, Pakistan. Healthy subjects (having no active complaint) of either sex aged 60-80 years were included. Those already on thyroid replacement, preexisting thyroid diseases, prior radiation therapy, or having chronic kidney disease were excluded. A total of 133 participants, 79 males and 54 females, were selected with a mean age of 69.5 ± 6.4 years. There were 29 diabetics, 30 hypertensives, and 10 smokers. A total of 17 (12.8%) were found to have SCH. On stratification, gender, diabetes mellitus, and hypertension had a significant association with the presence of SCH. SCH is a modifiable risk factor, more in females, diabetics, hypertensives, and the old age population. These results highlight the need for screening for SCH in primary care settings, especially in old age. Key Words: Subclinical hypothyroidism, Old age, Gender, Diabetes, Hypertension.


Assuntos
Hipertensão , Hipotireoidismo , Idoso , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Hipotireoidismo/epidemiologia , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Fatores de Risco
17.
J Occup Health ; 63(1): e12252, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34286911

RESUMO

OBJECTIVES: Evidence suggests that subclinical hypothyroidism (SCH) is associated with burnout and metabolic syndrome (MetS). We examined the relationship between burnout and MetS among healthcare workers (HCWs) and investigated the potential mediation of SCH. METHODS: This cross-sectional study included HCWs from a tertiary medical center; demographic data were obtained using a questionnaire. Burnout was evaluated according to the Chinese version of the Maslach Burnout Inventory-Health Services Survey (MBI-HSS). MetS and thyroid function data were obtained from a physical check-up. Logistic regression models were used to evaluate the adjusted odds ratio (aOR), and mediation analysis was employed to examine the mediation effect. RESULTS: Among 945 non-doctor/nurse and 1868 doctor/nurse staff, MetS was 30% and 14%, respectively, and the prevalence of burnout was nearly 6.5%. The results showed that burnout induced higher aOR of MetS in the doctor/nurse group (1.27, 95% confidence interval [CI]: 1.05-3.62). Thyroid-stimulating hormone (TSH) showed a positive association factor of MetS in doctor/nurse group-adjusted burnout (aOR = 1.15, 95% CI: 1.01-4.19). A higher TSH level was associated with an increased odds of MetS in younger doctor/nurse staff with burnout syndrome (aOR = 1.74; 95% CI: 1.04-3.22). There was a borderline significant mediation effect of SCH in the association between burnout and MetS in doctor/nurse staff. CONCLUSIONS: The results showed that higher TSH levels were positively associated with burnout and MetS in doctor/nurse professionals, especially in the young cohort. Burnout may rely on the borderline mediation effect of SCH, which is likely to affect MetS.


Assuntos
Esgotamento Profissional/epidemiologia , Pessoal de Saúde/psicologia , Hipotireoidismo/epidemiologia , Síndrome Metabólica/epidemiologia , Doenças Profissionais/epidemiologia , Adulto , Esgotamento Profissional/complicações , Estudos Transversais , Feminino , Humanos , Hipotireoidismo/psicologia , Modelos Logísticos , Masculino , Síndrome Metabólica/psicologia , Pessoa de Meia-Idade , Doenças Profissionais/psicologia , Razão de Chances , Prevalência , Inquéritos e Questionários , Taiwan/epidemiologia
18.
Sci Rep ; 11(1): 14902, 2021 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-34290330

RESUMO

Thyroid disease, particularly hypothyroidism, has been reported in systemic sclerosis (SSc). Some clinical features of SSc can also present in hypothyroidism. Our aims were to determine the prevalence of, and describe clinical features associated with, hypothyroidism in SSc patients. We conducted a historical cohort study of adult SSc patients who underwent screening thyroid function tests at the Scleroderma Clinic, Khon Kaen University, Thailand, between 2009 and 2018. The patients who had any thyroid disorders before the onset of SSc and were diagnosed as an overlap syndrome were excluded. A total of 200 SSc were included according to sample size calculation, among whom the female to male ratio was 2:1. The majority of cases (137; 69.5%) were diffuse cutaneous SSc subset. The mean age was 55.8 ± 10.7 years and the median duration of disease 4.9 (IQR 1.6-9.9) years. Of the total, 9 had primary hypothyroidism (prevalence 4.5%; 95%CI 2.1-8.4) and 22 had subclinical hypothyroidism (prevalence 11%; 95%CI 7.0-16.2). Of the latter 22, 71% had dcSSc. Logistic regression analysis indicated that unexplained anemia was significantly associated with either subclinical hypothyroid or hypothyroidism (OR 2.74; 95% CI 1.17-6.47), whereas Raynaud's phenomenon had a negative association (OR 0.28; 95% CI 0.11-0.66). Neither severity of skin tightness nor internal organ involvement were associated with hypothyroidism among SSc patients. Clinical-subclinical hypothyroidism is uncommon among SSc patients, it is frequently associated with anemia, and less so Raynaud's phenomenon. Clinical-subclinical hypothyroidism should thus be considered in cases of unexplained anemia in SSc patients.


Assuntos
Hipotireoidismo/etiologia , Escleroderma Sistêmico/complicações , Idoso , Anemia/etiologia , Feminino , Humanos , Hipotireoidismo/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Escleroderma Sistêmico/epidemiologia , Tailândia/epidemiologia
19.
Eur J Endocrinol ; 185(3): 375-385, 2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34228632

RESUMO

Objective: To evaluate if subclinical thyroid dysfunction is associated with cardiovascular (CV) risk in patients with atrial fibrillation (AF). Methods: Swiss-AF is a prospective cohort of community-dwelling participants aged ≥ 65 years with AF. Primary outcome was a composite endpoint of CV events (myocardial infarctions, stroke/transitory ischemic events, systemic embolism, heart failure (HF) hospitalizations, CV deaths). Secondary outcomes were component endpoints, total mortality, and AF-progression. Exposures were thyroid dysfunction categories, TSH and fT4. Sensitivity analyses were performed for amiodarone use, thyroid hormones use, and competing events. Results: 2415 patients were included (mean age: 73.2 years; 27% women). 196 (8.4%) had subclinical hypothyroidism and 53 (2.3%) subclinical hyperthyroidism. Subclinical thyroid dysfunction was not associated with CV events, during a median follow-up of 2.1 years (max 5 years): age- and sex-adjusted hazard ratio (adjHR) of 0.99 (95% CI: 0.69-1.41) for subclinical hypothyroidism and 0.55 (95% CI: 0.23-1.32) for subclinical hyperthyroidism. Results remained robust following multivariable adjustment and sensitivity analyses. In euthyroid patients, fT4 levels were associated with an increased risk for the composite endpoint and HF (adjHR: 1.46, 95% CI: 1.04-2.05; adjHR: 1.70, 95% CI: 1.08-2.66, respectively, for the highest quintile vs the middle quintile). Results remained similar following multivariable adjustment and remained significant for HF in sensitivity analyses. No association between subclinical thyroid dysfunction and total mortality or AF-progression was found. Conclusions: Subclinical hypothyroidism was not associated with increased CV risk in AF patients. Higher levels of fT4 with normal TSH were associated with a higher risk for HF.


Assuntos
Fibrilação Atrial/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Idoso , Fibrilação Atrial/complicações , Doenças Cardiovasculares/complicações , Feminino , Humanos , Hipotireoidismo/complicações , Hipotireoidismo/epidemiologia , Masculino , Estudos Prospectivos , Fatores de Risco , Doenças da Glândula Tireoide/complicações
20.
Clin Pharmacol Ther ; 110(4): 1075-1086, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34118065

RESUMO

Patients treated with oral anticancer agents (e.g., kinase inhibitors) are a high-risk population for medication errors due to, for example, polymedication, age, and limited adherence. Systematic evaluations regarding frequencies and causes of medication errors and resulting harm are lacking. Our previously published multicenter randomized AMBORA trial revealed that an intensified support by clinical pharmacologists/pharmacists for patients and the treatment team considerably reduced drug-related problems and improved patient-reported outcomes. Using this database, we performed a comprehensive, additional analysis focusing on medication errors related to the patients' complete medication with consideration of the antitumor agents, concomitantly administered drugs, and herb/food intake. Two hundred two patients starting a new oral anticancer drug regardless of the tumor entity were included. Clinical pharmacologists/pharmacists performed advanced medication reviews for 12 weeks. Medication errors were characterized regarding type, cause, patient harm, and the involved medicines. We detected 1.7 medication errors per patient (335/202). Of the medication errors (216/335), 64.5% occurred within the concomitant medication. Patients caused 28.4% of the medication errors. There were 67.8% detected immediately after the start of the new oral regimen, and 14.9% resulted in temporary harm. Drug-drug or drug-food interactions accounted for 24.8% of the medication errors. Patients and physicians need to be addressed in strategies for systematic reduction of medication errors during treatment with new oral antitumor drugs. Clinical decision support systems focusing on drug-drug interactions capture only a minority of the medication errors. Specialists with expertise in clinical pharmacology/pharmacy should support both the treating physicians as well as the patients for improved patient safety.


Assuntos
Antineoplásicos/uso terapêutico , Interações Medicamentosas , Interações Alimento-Droga , Erros de Medicação/estatística & dados numéricos , Neoplasias/tratamento farmacológico , Polimedicação , Administração Oral , Adulto , Idoso , Idoso de 80 Anos ou mais , Analgésicos/uso terapêutico , Antiulcerosos/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Comorbidade , Doença das Coronárias/tratamento farmacológico , Doença das Coronárias/epidemiologia , Sistemas de Apoio a Decisões Clínicas , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/epidemiologia , Dislipidemias/tratamento farmacológico , Dislipidemias/epidemiologia , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Hipolipemiantes/uso terapêutico , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/epidemiologia , Masculino , Pessoa de Meia-Idade , Inibidores de Proteínas Quinases/uso terapêutico , Hormônios Tireóideos/uso terapêutico , Vitaminas/uso terapêutico
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