Endocrine Practice最新文献

{"title":"Thyroid Dysfunction Following Thermal Ablation of Large Solid and Solid-Predominant Thyroid Nodules.","authors":"Lanyan Qiu, Yuqing Huang, Yueyue Ge, Xinyu Zhao, Chen Su, Yu Yang, Yunyun Dong, Jing Liu, Xia Ma, Ran Li, Linxue Qian, Xianquan Shi","doi":"10.1016/j.eprac.2025.01.004","DOIUrl":"10.1016/j.eprac.2025.01.004","url":null,"abstract":"<p><strong>Objectives: </strong>Thermal ablation (TA) is an alternative to lobectomy for thyroid nodules (TNs). While it is believed that thyroid function remains stable after TA for cystic TNs, the impact of TA on solid TNs, especially the large ones, is less explored. This study investigates changes in thyroid hormones after TA in patients with solid-predominant TNs and identifies potential risk factors for thyroid dysfunction after TA.</p><p><strong>Methods: </strong>Euthyroid patients with solid-predominant TNs (≥ 80% solid) were enrolled. The volume, diameter, and cytopathology of TNs were assessed before TA. TA was performed using either microwave or radiofrequency ablation. Thyroid hormone levels were measured at 1 week and 1, 3, 6, and 12 months after TA.</p><p><strong>Results: </strong>Seventy-seven euthyroid patients with TNs were included. The euthyroid rate dropped to 70.1% at 1 week after TA but improved to over 90% by 1 month and returned to 100% by 12 months. At 1 week after TA, subclinical hyperthyroidism and hyperthyroidism were observed, with elevated thyroxine, free triiodothyronine, free thyroxine, and thyroglobulin antibody levels, along with decreased thyroid-stimulating hormone (TSH) levels. The diameter and total volume of TNs were positively correlated with thyroid dysfunction, while TSH-baseline was negatively correlated with thyroid dysfunction 1 week after TA. A larger diameter and lower baseline TSH were identified as independent risk factors for thyroid dysfunction.</p><p><strong>Conclusions: </strong>TA may cause short-term thyroid dysfunction, especially in patients with large TNs. Monitoring of thyroid hormone levels is recommended from 1 week to 3 months after TA to manage potential thyroid dysfunction effectively.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parathyroidectomy Reduces Inflammatory Cytokines and Increases Vitamin D Metabolites in Patients With Primary Hyperparathyroidism","authors":"Lingqiong Meng MD, PhD ,&nbsp;Sue A. Shapses PhD ,&nbsp;Xiangbing Wang MD, PhD","doi":"10.1016/j.eprac.2024.10.005","DOIUrl":"10.1016/j.eprac.2024.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>Primary hyperparathyroidism (PHPT) is accompanied by a decreased 25-hydroxyvitamin D (25OHD) and vitamin D binding protein (DBP). High parathyroid hormone (PTH) is associated with elevated interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1), yet the effect of parathyroidectomy (PTX) on DBP and cytokines is not clear. This study aims to prospectively evaluate the effect of PTX on inflammatory profiles, total and free 25OHD, and DBP in patients with PHPT.</div></div><div><h3>Methods</h3><div>Newly diagnosed patients with PHPT were recruited for the study (<em>n</em> = 70). Twenty-eight patients returned after PTX, 3 months later. Biochemical markers were measured before and after PTX. A group of age and body mass index-matched healthy subjects were included as controls (<em>n</em> = 70).</div></div><div><h3>Results</h3><div>Before PTX, patients had lower serum DBP (37.5 ± 6.0 vs 41.5 ± 6.1 mg/dL, <em>P</em> &lt; .001) and total 25OHD (30.1 ± 9.5 vs 33.3 ± 7.9 ng/mL, <em>P</em> &lt; .05) but similar free 25OHD when compared to controls. Serum IL-6, C-reactive protein, and MCP-1 were higher in patients with PHPT (<em>P</em> &lt; .05), whereas interleukin-10 was similar to that in controls. PTX increased total and free 25OHD and DBP (<em>P</em> &lt; .001) and decreased serum IL-6 and MCP-1 (<em>P</em> &lt; .05), but not C-reactive protein and interleukin-10. Multiple regression analysis indicated that the preoperative PTH explained a significant portion of the variance of IL-6 and MCP-1 (<em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>These findings suggest that PTH may upregulate the production of MCP-1 and IL-6 and downregulate circulating DBP in patients with PHPT that are normalized by PTX. The exact mechanism of IL-6 and MCP-1 on DBP, vitamin D metabolites, and clinical outcomes in patients with PHPT is an area requiring further study.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 1","pages":"Pages 52-58"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Complex Web of Interferences With Thyroid Function Tests","authors":"Huda Al-Bahadili MD ,&nbsp;Jennifer Powers Carson PhD ,&nbsp;Alexander Markov MD ,&nbsp;Sina Jasim MD, MPH","doi":"10.1016/j.eprac.2024.10.007","DOIUrl":"10.1016/j.eprac.2024.10.007","url":null,"abstract":"<div><h3>Objective</h3><div>Thyroid disorders are common. Serum thyroid stimulating hormone is frequently measured and is the single best initial biomarker to diagnose thyroid disease. Automated immunoassays used to evaluate thyroid function are susceptible to interferences that can affect test results and therefore clinical decisions. In this comprehensive review, our aim is to discuss common assay and drug interferences leading to abnormal thyroid function tests.</div></div><div><h3>Methods</h3><div>Authors conducted a literature review of PubMed to include studies on drug related and laboratory assay interferences leading to primary and secondary thyroid dysfunction in addition to interferences with thyroid hormone replacement and thyroid function tests.</div></div><div><h3>Results</h3><div>Overall, there are several assay interferences as well as drug interferences leading to primary thyroid dysfunction including iodine-containing drugs such as amiodarone, lithium, immune checkpoint inhibitors and tyrosine kinase inhibitors, drug interferences leading to secondary thyroid dysfunction such as glucocorticoids, and drug interferences affecting thyroid hormone absorption, metabolism, and thyroid binding globulin levels. In addition, assay interferences from biotin, heterophile antibodies, macro-thyrotropin or anti-streptavidin antibodies may occur without underlying thyroid dysfunction, leading to abnormal thyroid function tests.</div></div><div><h3>Conclusion</h3><div>For appropriate patient management, it is imperative to identify assay interferences when discrepancies between clinical presentation and thyroid function test results are noted.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 1","pages":"Pages 92-101"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endocrine Practice Turns 30!","authors":"","doi":"10.1016/j.eprac.2024.12.003","DOIUrl":"10.1016/j.eprac.2024.12.003","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 1","pages":"Page 124"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Charting New Territories in Obesity Management- Traditional Techniques to Tirzepatide","authors":"Areeba Fareed MBBS ,&nbsp;Laura Ghanem MBBS ,&nbsp;Rayyan Vaid MBBS ,&nbsp;Zoha Iftikhar MBBS ,&nbsp;Adeel Ur Rehman MBBS ,&nbsp;Ayesha Sarwar MBBS ,&nbsp;Muhammad Iqbal Asif MBBS","doi":"10.1016/j.eprac.2024.09.004","DOIUrl":"10.1016/j.eprac.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Obesity, a pervasive global health challenge affecting more than 2 billion people, requires comprehensive interventions. Traditional approaches, including lifestyle modification, and diverse drugs targeting a gastrointestinal hormone, including glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (Liraglutide, Semaglutide, Exenatide, Albiglutide, Dulaglutide, Lixisenatide, Orlistat, Phentermine/Topiramate, Lorcaserin, Sibutramine, and Rimonabant) offer tailored strategies; yet their effectiveness is limited and some drugs were taken off the market. Moreover, various surgical modalities, such as Roux-en-Y Bypass surgery, sleeve gastrectomy, intragastric balloons, biliopancreatic diversion with duodenal switch, laparoscopic adjustable gastric band, and vagal nerve blockade can be considered but are associated with numerous side effects and require careful monitoring. Consequently, there is a pressing need for novel anti-obesity treatments.</div></div><div><h3>Methods</h3><div>This comprehensive review was based on the available data to discuss the traditional pharmaceutical and surgical therapeutical strategies for obesity, going further to discuss tirzepatide's mode of action, its outcomes for obesity, and the associated side effects.</div></div><div><h3>Results</h3><div>In this landscape, tirzepatide, initially designed for type 2 diabetes management, emerges as a potential game-changer. Functioning as a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, it not only addresses control but also introduces a fresh perspective on weight reduction. This review intricately explores tirzepatide's mechanism, dissecting insights from clinical studies and positioning it as a major force in obesity treatment.</div></div><div><h3>Conclusions</h3><div>In the middle of significant shifts in obesity management, tirzepatide presents itself as a promising and cost-effective intervention. Its Food and Drug Administration approval marks a milestone in the realm of obesity therapeutics. Going beyond a recapitulation of findings, the conclusion emphasizes the imperative for ongoing exploration and vigilant safety monitoring in tirzepatide's application.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 1","pages":"Pages 102-113"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nondiagnostic Fine Needle Aspiration of Thyroid Nodules: Review of Predisposing Factors","authors":"Thaer Idrees MD ,&nbsp;Ammar A. Rashied MS ,&nbsp;Brian Kim MD","doi":"10.1016/j.eprac.2024.09.015","DOIUrl":"10.1016/j.eprac.2024.09.015","url":null,"abstract":"<div><h3>Objective</h3><div>Fine needle aspiration (FNA) of thyroid nodules is the gold standard screening test for thyroid malignancy. Unfortunately, FNA may produce insufficient material for diagnosis. If nodules requiring FNA with a higher risk for nondiagnostic (ND) cytology could be identified pre-procedure, this might allow better patient guidance and potentially facilitate an altered approach to FNA.</div></div><div><h3>Methods</h3><div>The literature investigating risk factors for ND cytology was reviewed, including studies of patient factors, sonographic or nodule factors, and procedural factors. Twenty-five studies that included assessment of at least two potential factors in ND outcomes for initial FNA were identified. Individual factors were evaluated in terms of the general consensus of studies reporting either a positive significant association with ND cytology or no association.</div></div><div><h3>Results</h3><div>Most patient and nodule factors lack consensus as far as their association with ND cytology across these studies. Factors where there are some consensuses include practitioner experience, depth of nodule, and cystic content; however, hypervascularity of the nodule does not appear to have a consensus.</div></div><div><h3>Conclusion</h3><div>A number of study design improvements suggested by this review could realistically be incorporated into higher powered future studies. Novel factors such as tissue composition anterior to the nodule or the age of the patient could also be investigated in future work. Operator experience is the most convincing procedural factor, and approaches to future studies of the FNA technique itself are proposed. That said, the factors with consensus among studies can be seen leading candidates for this future research, and the published studies illuminate a number of as yet unexplored factors that could in many cases be studied retrospectively.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 1","pages":"Pages 85-91"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of European and American College of Radiology Thyroid Imaging Reporting and Data System Classification Systems in Thyroid Nodules Over 20 mm in Diameter","authors":"Nikolaos Angelopoulos MD, PhD ,&nbsp;Dimitrios G. Goulis MD, PhD ,&nbsp;Ioannis Chrisogonidis MD, PhD ,&nbsp;Sarantis Livadas MD, PhD ,&nbsp;Rodis Paparodis MD ,&nbsp;Ioannis Androulakis MD, PhD ,&nbsp;Ioannis Iakovou MD, PhD","doi":"10.1016/j.eprac.2024.10.004","DOIUrl":"10.1016/j.eprac.2024.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>The challenge of selecting thyroid nodules for fine needle aspiration (FNA) cytology has led to the development of the Thyroid Imaging Reporting and Data System, primarily in 2 formats: European Thyroid Imaging Reporting and Data System (EU-TIRADS) and American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS). Clinical observations suggest imperfect risk assessment for TIRADS 3 nodules ≥20 mm. This study aimed to evaluate the efficacy of TIRADS systems in distinguishing benign from malignant nodules in this subgroup.</div></div><div><h3>Methods</h3><div>From May 2023 to March 2024, 1094 patients with thyroid nodules were referred for ultrasound at a University Hospital. Data on clinical, ultrasound, cytological, and histopathological parameters were collected. Nodules ≥20 mm were categorized by EU-TIRADS and ACR-TIRADS, and their predictive performance for malignancy was assessed through postthyroidectomy histopathology or FNA cytology (Bethesda classification).</div></div><div><h3>Results</h3><div>Two hundred sixty-seven patients (mean age 60.3 ± 14.3 years; 46 men, 221 women) with 308 nodules were analyzed. Twenty-two malignancies and 286 benign nodules were recorded. Recalculating European Thyroid Imaging Reporting and Data System 3 performance using 25-mm and 30-mm thresholds (ACR-modified EU-TIRADS) avoided 24% and 41% of FNAs, respectively, while ACR-TIRADS would prevent 26.6% (<em>P</em> &gt; .05). Two malignancies were missed.</div></div><div><h3>Conclusion</h3><div>EU-TIRADS and ACR-TIRADS show similar efficacy when using a 25 mm FNA threshold. Raising the cutoff for FNA in European Thyroid Imaging Reporting and Data System 3 nodules could reduce unnecessary procedures but may increase the risk of missed malignancies, impacting patient outcomes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 1","pages":"Pages 72-79"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The University of Iowa Neuroendocrine Tumor Clinic","authors":"James R. Howe MD ,&nbsp;Yusuf Menda MD ,&nbsp;Chandrikha Chandrasekharan MBBS ,&nbsp;Andrew M. Bellizzi MD ,&nbsp;Dawn E. Quelle PhD ,&nbsp;M. Sue O’Dorisio MD, PhD ,&nbsp;Joseph S. Dillon MB, BCh","doi":"10.1016/j.eprac.2024.09.018","DOIUrl":"10.1016/j.eprac.2024.09.018","url":null,"abstract":"<div><div>The Iowa Neuroendocrine Tumor (NET) Clinic was founded and developed by two remarkable physicians, Thomas and Sue O’Dorisio. Tom was an Endocrinologist and close friend and colleague of Aaron Vinik. Both men were pioneers in studies of gastrointestinal hormones and the management of patients with NETs. Sue was a Pediatric Oncologist and research scientist with great expertise in new drug development and clinical trials. She and Tom were leaders in bringing somatostatin analogs and somatostatin-conjugated radioligands to the clinic for the therapy and diagnosis of NETs. All three physicians received lifetime achievement awards for their contributions to the field of NETs. This is the story of how the Iowa NET Clinic developed over the years to become a model for the multidisciplinary mantagement of patients with NETs, culminating in its designation as a European Neuroendocrine Tumor Society NET Center of Excellence, and the receipt of a Specialized Project of Research Excellence (SPORE) grant for the study of NETs from the National Institutes of Health.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 1","pages":"Pages 4-18"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With 30-Day Readmissions After Transsphenoidal Pituitary Surgery","authors":"Aditi Kumar MBBS ,&nbsp;Mona Vahidi Rad MD ,&nbsp;Alyssa K. McGary MS ,&nbsp;Janna C. Castro BS ,&nbsp;Curtiss B. Cook MD","doi":"10.1016/j.eprac.2024.10.003","DOIUrl":"10.1016/j.eprac.2024.10.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Determine the association between clinical and demographic factors and 30-day readmission risk after pituitary surgery.</div></div><div><h3>Methods</h3><div>Patients undergoing pituitary surgery between January 2018 and December 2022 were retrospectively reviewed. Cases were extracted from a converged electronic health record that included surgeries performed at the Midwest, Southeast, and Southwest campuses of the same healthcare Enterprise. Variables were compared between patients with 30-day readmission following discharge after pituitary surgery (<em>N</em> = 83) and a randomly sampled patient cohort with pituitary surgery but no readmission within 30 days (<em>N</em> = 174).</div></div><div><h3>Results</h3><div>In a multivariable regression model looking at the relationship between patient characteristics and readmission risk, every increase in the Medicare Severity Diagnosis Related Group score resulted in a nearly 2.3-fold increase in the risk of readmission (OR = 2.335, 95% CI 1.050, 5.562, <em>P</em> = .045). The presence of arginine vasopressin deficiency increased the odds of readmission by more than 2-fold (OR = 2.784, 95% CI 1.118, 7.124, <em>P</em> = .029). The Midwest site was observed to have a nearly 67% decrease in readmission risk compared to the Southwest site (OR = 0.334, 95% CI 0.134, 0.813, <em>P</em> = .016), with the Southeast site being comparable to the Southwest.</div></div><div><h3>Conclusion</h3><div>Our study identifies postoperative arginine vasopressin deficiency, greater co-morbidities, and geographic location as risk factors for 30-day readmission after pituitary surgery. Further investigation is required to determine how site-specific care processes can be adopted to lower readmission risk at other locations in the same healthcare enterprise.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 1","pages":"Pages 28-33"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Info for Readers/Subscription page","authors":"","doi":"10.1016/S1530-891X(24)00849-8","DOIUrl":"10.1016/S1530-891X(24)00849-8","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 1","pages":"Pages A1-A2"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}