Utility of ultra-portable ultrasound devices for the risk-stratification of thyroid dysfunctions in an emergency setting.

IF 5.4 2区医学 Q1 Medicine

Journal of Endocrinological Investigation Pub Date : 2024-10-07 DOI:10.1007/s40618-024-02437-9

Irene Campi, Laura Fugazzola

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引用次数: 0

Abstract

Purpose: We previously showed that the rapid TSH (rTSH) screening is able to detect a high prevalence of thyroid diseases in patients presenting to the Emergency department (ED), with a 7% prevalence of undiagnosed thyroid dysfunctions. The purpose of the present study is to implement our diagnostic flow-chart for thyroid dysfunctions in the ED with a rapid point-of-care thyroid ultrasound (rPOCUS).

Methods: rPOCUS was performed by an app-based mobile ultrasound device (Lumify^® by Philips Healthcare) in patients with suppressed rTSH undergoing urgent procedures requiring iodinate contrast media.

Results: Our results suggest that rPOCUS is cost- and time-effective for the management of patients with a newly diagnosed hyperthyroidism requiring urgent iodinated contrast media or amiodarone administration. Moreover, this handled US scanner avoided rTSH measurement in patients found to have a normal thyroid gland, and detected some incidental findings (nodules, heterogeneous echotexture), which would lead to further diagnostic investigations.

Conclusion: We demonstrate, for the first time, that rPOCUS greatly improves the management of patients attending the ED, including the prompt characterization and correct treatment of hyperthyroidism, and the prevention of iodine-induced thyrotoxicosis.

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超便携超声设备在急诊环境下对甲状腺功能障碍进行风险分级的实用性。

目的：我们之前的研究表明，快速促甲状腺激素（rTSH）筛查能够发现急诊科（ED）就诊患者中甲状腺疾病的高患病率，其中未确诊的甲状腺功能障碍患病率为7%。本研究的目的是通过快速甲状腺超声检查（rPOCUS）在急诊科实施我们的甲状腺功能障碍诊断流程图。方法：使用基于应用程序的移动超声设备（飞利浦医疗保健公司生产的Lumify®）对rTSH受抑制的患者进行rPOCUS检查，这些患者正在接受需要碘化造影剂的紧急手术：结果：我们的研究结果表明，对于需要紧急使用碘化造影剂或胺碘酮的新诊断甲亢患者，rPOCUS 具有成本和时间上的优势。此外，这种手持式 US 扫描仪可避免对甲状腺正常的患者进行 rTSH 测量，并能检测出一些偶然发现（结节、异质回声纹理），而这些发现会导致进一步的诊断检查：我们首次证明，rPOCUS 能极大地改善急诊室患者的管理，包括对甲状腺功能亢进症的及时鉴定和正确治疗，以及预防碘引起的甲状腺毒症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Endocrinological Investigation ENDOCRINOLOGY & METABOLISM-

CiteScore

8.10

自引率

7.40%

发文量

242

期刊介绍： The Journal of Endocrinological Investigation is a well-established, e-only endocrine journal founded 36 years ago in 1978. It is the official journal of the Italian Society of Endocrinology (SIE), established in 1964. Other Italian societies in the endocrinology and metabolism field are affiliated to the journal: Italian Society of Andrology and Sexual Medicine, Italian Society of Obesity, Italian Society of Pediatric Endocrinology and Diabetology, Clinical Endocrinologists’ Association, Thyroid Association, Endocrine Surgical Units Association, Italian Society of Pharmacology.