Journal of thyroid disorders & therapy最新文献

{"title":"Transvaginal Probe Application in the Visualization and Evaluation of a Retrosternal Thyroid Mass","authors":"A. Kecler-Pietrzyk, P. Govender, W. Torreggiani","doi":"10.4172/2167-7948.1000215","DOIUrl":"https://doi.org/10.4172/2167-7948.1000215","url":null,"abstract":"Ultrasound evaluation of the thyroid gland is relatively easy in most cases with excellent visualization of the gland with linear transducer allowing clear characterization of lesions as well as guidance for biopsy. However when retrosternal thyroid tissue extension is present, evaluation may be difficult. We report the simple use of widely available transvaginal probe in helping to visualize and evaluate the retrosternal thyroid tissue.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45623265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loupe Assisted Thyroidectomy: Prevention of Complications is better than Treating Them","authors":"Mohamed Ali, M. Khairy, Fady H. Fayek","doi":"10.4172/2167-7948.1000214","DOIUrl":"https://doi.org/10.4172/2167-7948.1000214","url":null,"abstract":"Aim: Studying the value of the surgical loupe in the enhancement of performing safe thyroidectomy via dissection \u0000 of the major structures which are vulnerable to injury during the operation. \u0000Subjects and methods: 150 patients with benign and malignant thyroid masses underwent near total or total \u0000 thyroidectomy at Zagazig university hospitals. History taking and all necessary investigations were done. \u0000 Thyroidectomy was done under the magnification of the surgical loupe and we dissected the recurrent laryngeal \u0000 nerve, the external branch of superior laryngeal nerve, branches of superior thyroid artery and selectively ligating \u0000 them and trace the parathyroid glands by following their minute blood vessels originating from the inferior thyroid \u0000 artery. \u0000Results: Mean age of the patients was 42.5 years (range: 23-69). Female: male ratio was 19:11 (95/55). 65 \u0000 patients (43.3%) had a discrete thyroid nodule and 85 patients (56.7%) had multinodular goiter. Patients were sent \u0000 home in a mean of 1.6 days (1–4 days). No operative related mortality was encountered. Only three cases of \u0000 transient hypocalcaemia which were resolved within three days by oral calcium supplementation and symptoms did \u0000 not recur during the follow-up of these three patients. All patients were extubated without any complications. There \u0000 was no any case recorded for hoarseness of voice or low pitched voice. There was only one case of secondary \u0000 hemorrhage and was re-explored for control of the source (injured anterior jugular vein on the right side). Three \u0000 cases developed hypertrophic scars during the follow up. \u0000Conclusion: total or near total thyroidectomy can be done with a minimal number of complications by using the \u0000 surgical loupe during the dissection of the recurrent laryngeal nerve, the external branch of the superior laryngeal \u0000 nerve and the parathyroid glands and their minute blood vessels.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48511380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Conventional Ultrasound, Doppler, Elastography and Contrast Enhanced Ultrasonography Parameters with Histopathology Findings in the Differential Diagnosis of Benign and Malignant Thyroid Nodules","authors":"S. Ballal, M. Yadav, Arun Gupta, M. Jana, S. Deo, C. Bal","doi":"10.4172/2167-7948.1000213","DOIUrl":"https://doi.org/10.4172/2167-7948.1000213","url":null,"abstract":"Background: Though neck ultrasound is the first line of choice for the screening of thyroid nodules, very few studies have compared the diagnostic performances of both conventional and advanced ultrasound parameters. In this study, we aim to compare various conventional and advanced ultrasound imaging parameters and confirm it with histopathology findings to differentiate between benign and malignant thyroid nodules. \u0000Methods: One hundred and thirty nine patients with 173 thyroid nodules underwent conventional ultrasonography (cUSG) which included gray-scale parameters, colour Doppler (CD) and power Doppler (PD) followed by elastography and contrast enhanced ultrasonography (CEUSG). Post-USG imaging all patients underwent fine needle aspiration cytology followed by surgery if indicated and histopathological results were obtained. Stata 11.2 statistical software was used for the statistical analysis. \u0000Results: Of 173 nodules, 65 were benign and 108 were malignant. cUSG had a sensitivity, specificity, PPV, NPV and accuracy of 94.4%, 90.4%, 94.4%, 90.4%, and 91.9%, respectively with AUC:0.97. On ROC analysis, the cut-off value for differentiating malignant from benign thyroid nodules on Ueno elasticity scoring was >3; AUC: 0.86 versus >2.2 using elasticity ratio method, AUC: 0.90. CEUSG and elastography had sensitivity, specificity, PPV, NPV and accuracy of 93.8%, 95.3%, 97.2%, 89.8%, and 94.2%, respectively with AUC:0.98. On combining and ranking, both conventional and advanced cUSG parameters, the significant indicators for malignancy were heterogeneous contrast enhancement, followed by Type-IV/V PD flow patterns, absence of ring enhancement and elasticity ratio >2.2 patterns with the largest AUC:0.994. \u0000Conclusions: Conjoint analysis of specific features of thyroid nodules on cUSG, elastography and CEUSG will enhance the diagnostic value in the screening of thyroid nodules.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"2017 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2017-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43667423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Performance in Elderly Outpatients with Subclinical Hypothyroidism Compared with Euthyroid Counterparts","authors":"Abraham Vázquez-Garcia, L. C. Ibarra, J. Villarreal-Pérez, R. Meza, D. Gámez, J. Platt, Guillermo Guajardo-Álvarez, David E. Saucedo, Francisco Torres-Pérez","doi":"10.4172/2167-7948.1000212","DOIUrl":"https://doi.org/10.4172/2167-7948.1000212","url":null,"abstract":"Background: There continues to be controversy on the clinical relevance of elderly mild subclinical hypothyroidism (SH), defined as a TSH elevation (4.0-9.99 μIU/L) with normal free thyroxin levels. \u0000Objective: To compare physical performance (PP) in elderly individuals with a TSH level above normal range versus normal counterparts. Design: Case-control study of ambulatory patients enrolled between January 2009 and December 2010. Setting: Outpatient geriatric service. \u0000Participants: Elderly individuals 65-84 years old (y/o) with SH and without conditions known to affect physical mobility. \u0000Measurements: The Short Physical Performance Battery (SPPB) was performed. The statistical analysis used the Mantel-Haenszel odds ratio (M-H-OR) method and Student’s t test with an alpha of 0.05. Results: Of the183 individuals screened, 28 (15.3%) had SH. The study response was 89.3%, thus 25 individuals with SH were compared to 27 euthyroid controls matched by age and sex. Gender and age influence SPPB, increased age was associated with <4 points balance: 13.8% in 65-74 y/o vs. 44.0% in 75-84 y/o, χ2=6.1, p<0.05; strength of dominant leg and SPPB score were higher in men than women (both, p<0.05). Body mass index was higher in SH than controls in men (29.3 ± 2 vs. 23.4 ± 3, t=3.2, <0.02). Women with SH had a worse SPPB score than the control group, M-H-OR=8.4, p<0.05. Confidence intervals of mean gait speed were 0.73-0.95 vs. 0.98-1.14 m/s, respectively with results in men lacking significance. Chair stands were longer in SH than controls: 13.5 ± 2.4 vs. 10.0 ± 1.7 seconds for men and 20.6 ± 12.6 vs. 14.8 ± 2.9 seconds for women, both p<0.05. \u0000Conclusions: These data suggests an association between SH and lower physcial performance. This warrants further study to define if T4 supplementation improves physcial performance, thus preventing frailty.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7948.1000212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49404005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyrotoxicosis Associated with Cholestatic Jaundice Treated with Therapeutic Plasma Exchange-Case Report","authors":"I. Ahmeti, Viktorija Chalovska, N. Manevska, P. Dzekova-Vidimliski, V. Avramoski, D. Gjorceva","doi":"10.4172/2167-7948.1000211","DOIUrl":"https://doi.org/10.4172/2167-7948.1000211","url":null,"abstract":"Thyroid disorders, especially thyrotoxicosis, are commonly associated with hepatic dysfunction, but cholestasis is rarely reported. Heart failure, infection, weight loss may play role in the pathogenesis of cholestasis. Cholestasis could be worsened by treatment of hyperthyroidism using Thiamazole, but cholestasis in undiagnosed thyrotoxicosis is uncommon. We present 23 year old female with jaundice, goiter, palpitation and confirmed thyrotoxicosis associated with hepatomegaly, hepatocelluar damage and cholestasis. Liver biopsy excluded the suspicion of autoimmune hepatitis. Therapeutic plasma exchange was performed 5 days after starting the treatment with thyroid supressive therapy, and hepatoprotective therapy due to progressive increase of serum levels of bilirubin (conjugated/direct) and liver enzymes. The patient treatment continued with low doses of thyroid suppressive therapy. Patient achieved euthyroid state after 2 months with normalization of the serum levels of liver enzymes and bilirubin. The final treatment option for our patient was surgical total thyroidectomy.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47011322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Should the Correct Extent of Thyroidectomy be in a Developing Area Where Goiter is an Endemic Problem","authors":"B. Hung-Hin","doi":"10.4172/2167-7948.1000e128","DOIUrl":"https://doi.org/10.4172/2167-7948.1000e128","url":null,"abstract":"","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"6 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7948.1000e128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47013533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proper Management of Rapidly Growing Large B-Cell Primary Thyroid Lymphoma, Case Report and Review of Literature","authors":"M. Hafez, R. Nason","doi":"10.4172/2167-7948.1000210","DOIUrl":"https://doi.org/10.4172/2167-7948.1000210","url":null,"abstract":"Background: Primary thyroid lymphoma is a rare type of thyroid cancer. It accounts for 1 to 5% of all thyroid cancers and 1 to 2% of all lymphomas outside the lymph nodes. Frequently, based on histology and fine-needle aspiration biopsy (FNA), it is difficult to distinguish between anaplastic carcinoma and thyroid lymphoma. Open biopsy is usually needed to confirm diagnosis. \u0000Case Presentation: We present the clinical history, physical findings, imaging studies and treatment plan of a 60-year-old male patient with malignant B cell lymphoma of the thyroid gland. The patient was presented to cancer care Manitoba with rapidly growing neck mass and Hoarseness for three weeks. CT scan of the neck showed large right-sided paratracheal mass consistent with thyroid malignancy, with destruction of the right side of the thyroid cartilage and abnormal small Level II right-sided nodes. The mass was measured to be 7.1 × 4.5 × 5.7 cm. There was displacement of the trachea to the left, but with no compromise of the airway noted. FNA was not diagnostic. Open biopsy under general anesthesia was done and sent for frozen section, which came suggestive of lymphoma. The patient kept intubated in surgical ICU and started on high dose steroid until the diagnosis was confirmed as B-Cell lymphoma then medical oncology staff managed him. \u0000Conclusion: Lymphoma of the thyroid gland should be considered in patients with a rapidly enlarging goiter. If there is any doubt of the diagnosis, open surgical biopsy should be performed to confirm the diagnosis.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46999560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern, Clinical Presentation and Pregnancy Outcome of Thyroid Diseases in Pregnant Women at National Endocrine Referral Clinic of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia from June 2010 to June 2015","authors":"Kurabachew Debebe, Gashayeneh Genetu, Y. Feleke, T. Kebede","doi":"10.4172/2167-7948.1000209","DOIUrl":"https://doi.org/10.4172/2167-7948.1000209","url":null,"abstract":"Background: The major disorders of thyroid gland are hypothyroidism and hyperthyroidism and thyroid disorders are predominantly of autoimmune etiology in pregnant women. To date there is no study done in Ethiopia to show pattern and pregnancy outcomes of pregnant women with thyroid disorders. \u0000Objectives: To assess pattern of thyroid diseases, thyroid function test profiles, clinical presentations and pregnancy outcomes in pregnant women at National Endocrine Referral Clinics of Tikur Anbessa Specialized Hospital. \u0000Methods: A retrospective study was conducted at National Referral Endocrine Clinics of TASH from June 2010 to June 2015. All pregnant women with thyroid disorders were included in the study and patients’ charts were retrieved from follow up clinics and hospital archive by two trained residents of Internal medicine using pre-structured data collection tools. \u0000Results: Among a total of 1124 patients with endocrine disorders, 670 (59.6%) were patients with thyroid disorders and 9.25% (62) were pregnant women. Among pregnant women with thyroid disorders, majority, 51 (82.2%) were pregnant women with hyperthyroidism with mean (SD) age of 30 ± (6.45) years. Majority of patients with hyperthyroidism, 43(84.3%) were diagnosed to have TMNG followed by Graves’ disease. Among pregnant women with hypothyroidism, six were cases of iodine deficiency. The commonly seen symptoms of hyperthyroidism were, anterior neck swelling (94.1%), palpitation (47.1%) and heat intolerance (31.4%). Patients with hypothyroidism, accounted for 17.74% of thyroid diseases in pregnancy and the common symptoms were fatigue and cold intolerance each accounting for 9 (81.8%) of the cases. Most of pregnant women with hyperthyroidism, 37 (72.5%) gave birth to an alive neonate, 11 (21.6%) had abortion and the remaining 3 (5.9%) had IUFD. \u0000Conclusion: From our study, most of pregnant women with thyroid disorders were patients with hyperthyroidism. The pregnancy outcome of these patients was generally good. \u0000Recommendation: We recommend proper documentation and electronic medical recording to be practiced in the hospital and to have pre-pregnancy counseling for all reproductive age women who have follow up at endocrine referral clinics. We also recommend doing more comprehensive research on pregnancy outcomes of pregnant women with thyroid disorders and neonatal screening for congenital hypothyroidism.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47771914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trimester Specific Nutritional Status of Iodine among Euthyroid Pregnant Women","authors":"R. Rajput, L. Yadav, N. Smiti, R. Yadav","doi":"10.4172/2167-7948.1000208","DOIUrl":"https://doi.org/10.4172/2167-7948.1000208","url":null,"abstract":"Objective: To evaluate the present nutritional status of iodine among euthyroid pregnant women by \u0000 measurement of urinary iodine levels. \u0000Material and Methods: 381 pregnant women attending antenatal clinic in the obstetrics and gynaecology department were included in study. Out of 381, 285 euthyroid women were selected as study population. Median \u0000 urinary iodine levels (MUI) were compared among euthyroid pregnancy women according to trimester of gestation \u0000 and thyroid peroxidase antibody (TPO Ab) level. \u0000Results: MUI level of euthyroid pregnant women was 119.2 μg/L (IQR=35.8-310.95) with 2.5th and percentile \u0000 97.5th being 5.55 μg/L and 1058.68 μg/L respectively. Out of 285 euthyroid women, 153(53.68%) were having MUI \u0000 level below 150 μg/L. Trimester specific MUI levels decreased from 193.2 μg/L to 111.8 μg/L to 97.65 μg/L as \u0000 gestational age increased from 1st to 2nd to 3rd trimesters respectively but this decrease with gestational age was not \u0000 statistically significant. MUI levels of Anti-TPO antibody positive and negative euthyroid women were 153.8 μg/L and \u0000 118.4 μg/L respectively without being statistically significant (p=0.98). 138(54.12%) of Anti-TPO antibody negative \u0000 and 15(50%) of Anti-TPO antibody positive were having MUI level below 150 μg/L. \u0000Conclusions: In the present study, we found that 53.68% of pregnant women were having MUI levels in iodine \u0000 deficient range as per WHO guidelines.","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7948.1000208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46363196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is There A Safe, Therapeutic Window for Thyroid Hormone Therapy in Heart Failure?","authors":"Martin Gerdes A","doi":"10.4172/2167-7948.1000E127","DOIUrl":"https://doi.org/10.4172/2167-7948.1000E127","url":null,"abstract":"","PeriodicalId":91565,"journal":{"name":"Journal of thyroid disorders & therapy","volume":"6 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70842943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}