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Category archives for Doctors

EXPOSURE TO POLYBROMINATED DIPHENYL ETHERS ASSOCIATES WITH HYPOTHYROIDISM

EXPOSURE TO  POLYBROMINATED DIPHENYL ETHERS  ASSOCIATES WITH HYPOTHYROIDISM Oulhote Y1, Chevrier J1, Bouchard MF Exposure to Polybrominated Diphenyl Ethers (PBDEs) and Hypothyroidism in Canadian Women. J Clin Endocrinol Metab. 2016 Feb;101(2):590-8. doi: 10.1210/jc.2015-2659. Epub 2015 Nov 25. Polybrominated diphenyl ethers (PBDEs) are used as flame retardants in a wide range of products, resulting in widespread […]

Induction of painless thyroiditis in patients receiving programmed death 1 receptor immunotherapy for metastatic malignancies

Induction of painless thyroiditis in patients receiving programmed death 1 receptor immunotherapy for metastatic malignancies Orlov S1, Salari F, Kashat L, Walfish PG. . J Clin Endocrinol Metab. 2015 May;100(5):1738-41 Immunotherapies against immune checkpoints that inhibit T cell activation [cytotoxic T lymphocyte antigen 4 (CTLA-4) and programmed cell death 1 (PD-1)] are emerging and promising […]

RAI IMPROVES OUTCOME IN INTERMEDIATE RISK THYROID CANCER

Adjuvant radioactive iodine therapy is associated with improved survival for patients with intermediate-risk papillary thyroid cancer.Ruel E1, Thomas S, Dinan M, Perkins JM, Roman SA, Sosa JA. J Clin Endocrinol Metab. 2015 Apr;100(4):1529-36 Papillary thyroid cancer (PTC) is the most common endocrine malignancy. The long-term prognosis is generally excellent. Due to a paucity of data, […]

MORE ON PROPHYLACTIC CENTRAL NODE DISSECTION

Prophylactic central compartment lymph node dissection in papillary thyroid carcinoma: clinical implications derived from the first prospective randomized controlled single institution study.Viola D1, Materazzi G, Valerio L, Molinaro E, Agate L, Faviana P, Seccia V, Sensi E, Romei C, Piaggi P, Torregrossa L, Sellari-Franceschini S, Basolo F, Vitti P, Elisei R, Miccoli P. J Clin […]

TSH Levels and Risk of Miscarriage in Women on Long-Term Levothyroxine

TSH Levels and Risk of Miscarriage in Women on Long-Term Levothyroxine: A Community-Based Study. Taylor PN 1, Minassian C, Rehman A, Iqbal A, Draman MS, Hamilton W, Dunlop D, Robinson A, Vaidya B, Lazarus JH, Thomas S, Dayan CM, Okosieme OE. J Clin Endocrinol Metab. 2014 Oct;99(10):3895-902. Thyroid dysfunction is associated with adverse obstetric outcomes, […]

Current Treatment Modalities for Spinal Metastases Secondary to Thyroid Carcinoma.

Kushchayeva YS1, Kushchayev SV, Wexler JA, Carroll NM, Preul MC, Teytelboym OM, Sonntag VK, Van Nostrand D, Burman KD, Boyle LM. Thyroid. 2014 Oct;24(10):1443-1455 The spine is the most common site of bone metastases due to thyroid cancer, which develop in more than 3% of patients with well-differentiated thyroid cancer. Nearly half of patients with […]

The Attitude Toward Hypothyroidism During Early Gestation: Time for a Change of Mind?

Pop V1, Broeren M, Wiersinga W. Thyroid. 2014 Oct;24(10):1541-1546. The approach not to screen thyroid function of all pregnant women is mainly based on conflicting evidence of whether treatment of women with mild hypothyroidism is beneficial. However, there is consensus that all women with overt hypothyroidism (OH) and those with a thyrotropin (TSH) >10 mIU/L […]

Hypothyroidism is a predictor of disability pension and loss of labor market income:

Hypothyroidism is a predictor of disability pension and loss of labor market income: a danish register-based study. Thvilum M1, Brandt F, Brix TH, Hegedüs L. J Clin Endocrinol Metab. 2014 Sep;99(9):3129-35 Hypothyroidism is associated with an increased somatic and psychiatric disease burden..We compared with a matched control group, the risk of receiving disability pension (before […]

Hypothyroxinemia and TPO-Antibody Positivity Are Risk Factors for Premature Delivery

Hypothyroxinemia and TPO-Antibody Positivity Are Risk Factors for Premature Delivery: The Generation R Study. Korevaar TI, Schalekamp-Timmermans S, de Rijke YB, Visser WE, Visser W, de Muinck Keizer-Schrama SM, Hofman A, Ross HA, Hooijkaas H, Tiemeier H, Bongers-Schokking JJ, Jaddoe VW, Visser TJ, Steegers EA, Medici M, Peeters RP. J Clin Endocrinol Metab. 2013 Nov;98(11):4382-90. […]

Birth defects after early pregnancy use of antithyroid drugs:

Birth defects after early pregnancy use of antithyroid drugs: a danish nationwide study. Andersen SL, Olsen J, Wu CS, Laurberg P. J Clin Endocrinol Metab. 2013 Nov;98(11):4373-81. doi: 10.1210/jc.2013-283 Hyperthyroidism in pregnant women should be adequately treated to prevent maternal and fetal complications, but teratogenic effects of antithyroid drug (ATD) treatment have been described. Evidence […]

MORE DATA FROM THE CHERNOBYL EXPERIENCE

  Twenty-five years after chernobyl: outcome of radioiodine treatment in children and adolescents with very high-risk radiation-induced differentiated thyroid carcinoma. Reiners C, Biko J, Haenscheid H, Hebestreit H, Kirinjuk S, Baranowski O, Marlowe RJ, Demidchik E, Drozd V, Demidchik Y. J Clin Endocrinol Metab. 2013 Jul;98(7):3039-48. PMID:23616148 After severe reactor emergencies with release of radioactive […]

TREATMENT OF A LINGUAL THYROID

QUESTION–A young 23 years old girl diagnosed to have Functional ectopic lingual thyroid with Overt Hypothyroidism with absence of tracer uptake in the thyroid region on Tc99 scintigraphy in the year 2004. Since she has been on 125mcg Thyroxine replacement. Her TSH was 19uIU/ml in Feb 2013 and on proper dose titration as now TSH reached to […]

CHILDHOOD OBESITY FOSTERS ANTITHYROID IMMUNITY??

Childhood weight gain and thyroid autoimmunity at age 60-64 years: the 1946 british birth cohort study.Ong KK, Kuh D, Pierce M, Franklyn JA. J Clin Endocrinol Metab. 2013 Apr;98(4):1435-42. doi: 10.1210/jc.2012-3761 Complex bidirectional relationships have been described between body weight, thyroid function, and risk of thyroid disorders, including thyroid autoimmunity. We used a life-course approach […]

MORE ON LOW VS HIGH DOSE 131-I ABLATION

Low- or high-dose radioiodine remnant ablation for differentiated thyroid carcinoma: a meta-analysis. Cheng W, Ma C, Fu H, Li J, Chen S, Wu S, Wang H. J Clin Endocrinol Metab. 2013 Apr;98(4):1353-60. doi: 10.1210/jc.2012-3682. There is uncertainty over the dose of (131)I required for thyroid remnant ablation.: The aim of this study was to assess […]

SYNTHROID VS GENERICS, AGAIN- EQUIVALENT, OR NOT?? 24 Feb 2013

NO-Generic and brand-name L-thyroxine are not bioequivalent for children with severe congenital hypothyroidism.Carswell JM, Gordon JH, Popovsky E, Hale A, Brown RS. J Clin Endocrinol Metab. 2013 Feb;98(2):610-7. doi: 10.1210/jc.2012-3125. In the United States, generic substitution of levothyroxine (l-T(4)) by pharmacists is permitted if the formulations are deemed to be bioequivalent by the Federal Drug […]

The noninvestigational use of tyrosine kinase inhibitors in thyroid cancer: establishing a standard for patient safety and monitoring

The noninvestigational use of tyrosine kinase inhibitors in thyroid cancer: establishing a standard for patient safety and monitoring.Carhill AA, Cabanillas ME, Jimenez C, Waguespack SG, Habra MA, Hu M, Ying A, Vassilopoulou-Sellin R, Gagel RF, Sherman SI, Busaidy NL. J Clin Endocrinol Metab. 2013 Jan;98(1):31-42 The increasing use of tyrosine kinase inhibitor therapy outside of […]

RAI ABLATION WITH BRAF+ 1.2CM NODE-NEGATIVE PAPILLARY CANCER?

RAI ABLATION WITH BRAF+ 1.2CM NODE-NEGATIVE PAPILLARY CANCER? 22Jan2013 QUESTION- your opinion on this patient please. 34 yo anesthesiologist noted a midline thyroid nodule 1 month ago, no hx of irradiation to head and neck. us revealed a 1.2 cm hypoechoic nodule at jx of isthmus and right lobe, fna highly suspicious for mjalignancy, 2nd […]

Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes

Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes. J Clin Endocrinol Metab. 2012 Dec;97(12):4464-72, Karakosta P, Alegakis D, Georgiou V, Roumeliotaki T, Fthenou E, Vassilaki M, Boumpas D, Castanas E, Kogevinas M, Chatzi L. Maternal thyroid dysfunction, especially in early pregnancy, may lead to […]

Association and Predictive Accuracy of High TSH Serum Levels in First Trimester and Adverse Pregnancy Outcomes

Association and Predictive Accuracy of High TSH Serum Levels in First Trimester and Adverse Pregnancy Outcomes. Schneuer FJ, preterm birth; 0.70 (95% CI, 0.61-0.79) for miscarriage; and 0.63 (95% CI, 0.60-0.65) for any adverse pregnancy outcome. High TSH serum levels during the first trimester of pregnancy were associated with adverse pregnancy outcomes; however, the predictive […]

Central hypothyroidism: pathogenic, diagnostic, and therapeutic challenges 17 Oct 2012

Central hypothyroidism: pathogenic, diagnostic, and therapeutic challenges.17 Oct 2012 Persani L. luca.persani@unimi.it. J Clin Endocrinol Metab. 2012 Sep;97(9):3068-78. Central hypothyroidism (CH) is a particular hypothyroid condition due to an insufficient stimulation by TSH of an otherwise normal thyroid gland. This condition raises several challenges for clinicians; therefore, a review of the most relevant findings on […]

Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. 17 Oct 2012

Alexander, EK,) of undetermined clinical significance,” “follicular neoplasm or lesion suspicious for follicular neoplasm,” or “suspicious cytologic findings” were 95%, 94%, and 85%, respectively. Analysis of 7 aspirates with false negative results revealed that 6 had a paucity of thyroid follicular cells, suggesting insufficient sampling of the nodule. These data suggest consideration of a more […]

Management of Thyroid Dysfunction during Pregnancy and Postpartum

Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline.De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, Eastman CJ, Lazarus JH, Luton D, Mandel SJ, Mestman J, Rovet J, Sullivan S J Clin Endocrinol Metab. 2012 Aug;97(8):2543-65. Endocrine Society Guidelines on management of thyroid problems before, […]

NEW CLINICAL OBSERVATIONS REGARDING THYROID CANCER

. NEW CLINICAL OBSERVATIONS REGARDING THYROID CANCER The most recent issue of JCEM is filled with interesting studies on thyroid cancer. Balasubramaniam S, Ron E, Gridley G, Schneider AB, Brenner AV.( Association between Benign Thyroid and Endocrine Disorders and Subsequent Risk of Thyroid Cancer among 4.5 Million U.S. Male Veterans. J Clin Endocrinol Metab. 2012 […]

T4 PLUS T3, AGAIN

Biondi B, Wartofsky L. Combination treatment with t4 and t3: toward personalized replacement therapy in hypothyroidism? J Clin Endocrinol Metab. 2012 Jul;97(7):2256-71. Levothyroxine therapy is the traditional lifelong replacement therapy for hypothyroid patients. Over the last several years, new evidence has led clinicians to evaluate the option of combined T(3) and T(4) treatment to improve […]