Thyroid Function Disorders Research Articles

Anxiety and Depression among Patients with Thyroid Function Disorders.

Psychiatric comorbidities are common in thyroid disorder patients and complicate patients' life quality as well as disease management. We aimed to explore prevalence of anxiety and depression and identify associated characteristics among patients with thyroid function disorder. A descriptive, cross-sectional study was conducted on 129 thyroid disorder patients aged ?20 years. A semi-structured questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory were used for sociodemographic characteristics, anxiety, and depression respectively. Group differences were compared (Chi square) or correlations were determined (Pearson's correlation coefficient). Patients' mean age was 38.09±12.68 years; most were females (102, 79.1%) and hypothyroid (90, 69.8%). Overall prevalence of anxiety and depression were 50.4% and 42.6% respectively. Anxiety was more prevalent in females (54.9% vs 33.3% in males, p=0.046), low economic status (73.9% vs 35.5% in higher status, p=0.019), and hyperthyroid (64.1% vs 44.4% in hypothyroid, p=0.040). Depression was more prevalent in females (47.1% vs 25.9% in males, p=0.048), Janajati ethnic group (54.8% vs 31.1% in Brahmin-Chhetri, p=0.002), lower economic status (69.6% vs 35.5% in higher status, p=0.016), and hyperthyroid (56.4% vs 36.7% in hypothyroid, p=0.037). Associations with occupation, marital status, family type, religion, and duration of illness were not significant. Anxiety and depression are highly prevalent among thyroid disorder patients, especially in females, lower economic status, and hyperfunction type thyroid disorder. Management of thyroid disorders should incorporate treatment of anxiety and depression; routine psychiatric screening of the groups with higher prevalence is advisable.

Quantification of the Thyroid Scan (TS) and correlation to Multiparametric Ultrasounds (MPUS): A textbook case of nuclear molecular imaging

For decades, thyroid scintigraphy (TS) has been considered an interesting tool, especially in the field of hyperthyroidism. In recent years, TS has rapidly gained importance since it provides unique molecular information that cannot be obtained by any other modality. In fact, despite a limited 6mm spatial resolution, it can highlight molecular and histo-functional changes that characterize most thyroid function disorders. However, to become such a powerful molecular image, the TS must be quantified. How much iodine is taken-up characterizes the Uptake (Up), while where iodine distributes characterizes the Spatial Targeting (ST). Methodology, results and limits of the thyroid Uptake are presented, including suppressed tests. Methods to determine the anatomical thyroid volume are revisited with special focus on planar scintigraphy. Recent developments in quantification make the 123I-TS a new molecular imaging procedure. Since 123I targets the sodium iodide symporter (NIS) and tracks the whole organification process, we derived a fundamental linear relationship between the TSH and the precocious (120–240min) Uptake (p123IUp). This relationship indicates whether the 123I input follows the physiological TSH stimulation or is predictive of a non TSH-suppressible function, whatever the imaging pattern. This allows identification of toxic or compensated (TSH>0.1mU/L) Thyroid Functional Autonomy (TFA), even at baseline. Spatial Targeting, measured with the aid of computational algorithms, provides a reproducible Spatial Targeting Index (STI). This allows estimating a functional thyroid volume, that is likely more informative than the anatomical one. Most aspects of TS quantification and the interest to compare the structure (mostly MultiParametric US) and the function (molecular 123I-TS) are presented.

Benefits and Harms of a Prevention Program for Iodine Deficiency Disorders: Predictions of the Decision-Analytic EUthyroid Model.

Background: Iodine deficiency is one of the most prevalent causes of intellectual disability and can lead to impaired thyroid function and other iodine deficiency disorders (IDDs). Despite progress made on eradicating iodine deficiency in the last decades in Europe, IDDs are still prevalent. Currently, evidence-based information on the benefit/harm balance of IDD prevention in Europe is lacking. We developed a decision-analytic model and conducted a public health decision analysis for the long-term net benefit of a mandatory IDD prevention program for the German population with moderate iodine deficiency, as a case example for a European country. Methods: We developed a decision-analytic Markov model simulating the incidence and consequences of IDDs in the absence or presence of a mandatory IDD prevention program (iodine fortification of salt) in an open population with current demographic characteristics in Germany and with moderate ID. We collected data on the prevalence, incidence, mortality, and quality of life from European studies for all health states of the model. Our primary net-benefit outcome was quality-adjusted life years (QALYs) predicted over a period of 120 years. In addition, we calculated incremental life years and disease events over time. We performed a systematic and comprehensive uncertainty assessment using multiple deterministic one-way sensitivity analyses. Results: In the base-case analysis, the IDD prevention program is more beneficial than no prevention, both in terms of QALYs and life years. Health gains predicted for the open cohort over a time horizon of 120 years for the German population (82.2 million inhabitants) were 33 million QALYs and 5 million life years. Nevertheless, prevention is not beneficial for all individuals since it causes additional hyperthyroidism (2.7 million additional cases). Results for QALY gains were stable in sensitivity analyses. Conclusions: IDD prevention via mandatory iodine fortification of salt increases quality-adjusted life expectancy in a European population with moderate ID, and is therefore beneficial on a population level. However, further ethical aspects should be considered before implementing a mandatory IDD prevention program. Costs for IDD prevention and treatment should be determined to evaluate the cost effectiveness of IDD prevention.

Comparison of Biochemical and Oxidative Stress Parameters in Hypo and Hyperthyroid Rat Models

Background: Thyroid functional disorders are relatively common in the general population. Different factors play a role in the development of thyroid disorders. These factors can be associated with the deterioration of the oxidation state of the body and the induction of oxidative stress. Thyroid hormones play an important role in the oxidation state. Objectives: Regarding the role of oxidative stress in different pathologies and the development of various complications, including thyroid disorders, we aimed to compare the biochemical and oxidative stress parameters in hypo and hyperthyroid rat models. Methods: Twenty-one male Wistar rats were assigned into three groups of control, hypothyroid, and hyperthyroid. Hypothyroidism and hyperthyroidism were inducted with PTU (propylthiouracil) and LTX (levothyroxine), respectively. After five weeks of induction, serum biochemical factors and oxidative stress parameters, such as TAC (total antioxidant capacity), MDA (Malondialdehyde), and the thiol group, were measured in these groups. Results: The means of TAC, MDA and UA (uric acid) in the hyperthyroid group were significantly higher than those in the hypothyroid group (P < 0.01, P < 0.01, P < 0.05) but the mean of thiol in the hypothyroid group was significantly higher than that of the hyperthyroid group (P < 0.01). Also, the mean of TAC level in the hypothyroid group was significantly lower than the control group (P < 0.05) and the mean of thiol group in the hypothyroid group was significantly higher than the control group (P < 0.05), but there was no other significant difference between the groups compared to the control group. Among the biochemical parameters, the mean LDH (lactate dehydrogenase) in the hyperthyroid group also showed a significant difference in comparison to the hypothyroid group (P < 0.05), but there was no significant difference between the groups in the mean of the other biochemical parameters. Conclusions: According to the results of this study, hypothyroidism and hyperthyroidism are associated with a disturbance in the oxidation state of the body, and the use of antioxidants can help improve these diseases, especially in hyperthyroidism, due to enhanced metabolism and production of more free radicals.

Thyroid function disorders in low birth weight/preterm neonates admitted in NICU, Children Hospital Complex Multan.

Objectives: Congenital hypothyroidism (CHT) is one of the major endocrine and metabolic disorders in neonates. Delayed diagnosis and treatment of CHT may lead to certain neuro-developmental disorders. Study Design: Prospective study. Setting: NICU of Children Hospital, Institute of Child Health Multan, Pakistan. Period: September 2018 to November 2019. Material & Methods: A total of 142 neonates of both gender having birth weight of less than 1500 grams were enrolled in this study. Thyroid function tests, like TSH, free T4 and T4 levels were performed in all these neonates between 1- 5th day, 2nd week and 4th week of life by radioimmunoassay. Results: Out of 142 neonates, 76 (53.5%) were male and 66 (46.5%) female. Mean gestational age was 31.41+1.93 weeks while mean birth weight was found to be 1261.53 + 170.36 grams. Gestational age of < 28 weeks was noted in 9 (6.3%) neonates, 28 to <30 weeks in 59 (40.4%), 30 to 32 weeks in 33 (23.2%) and 41 (28.9%) were above 32 weeks. Thyroid function disorders were noted in 89 (62.7%) neonates while transient hypothyroxinemia was the most common one, found in 65 (45.7%) neonates, transient hyperthyroxinemia in 12 (8.4%) and Congenital hypothyroidism (CHT) in 12 (8.4%). Nasal continuous positive airway pressure (NCPAP) was used for treating respiratory distress syndrome (RDS) in 107 (75.4%) neonates. Surfactant administration was done in 69 (48.6%). Patent ductus arteriosis (PDA) was noted in 27 (19.0%), intraventricular hemorrhage (IVH) in 8 (5.6%) and culture proven sepsis was seen in 18 (12.7%). Conclusion: In low birth weight / preterm neonates, thyroid function disorders are quite common. Transient Hypothyroxinemia was noted to be the most common disorder and congenital hypothyroidism was present in 8.4% of neonates.

Evaluation of anxiety and depression in patients with thyroid function disorder.

OBJECTIVES We aim to determine the anxiety and depression levels of patients treated for hypothyroidism who assumed euthyroid status. These patients also frequently attend family medicine outpatient clinics. METHODS This study was conducted on 76 euthyroid volunteer participants (patient groups) who were treated for hypothyroidism and followed-up and 22 healthy volunteers (control group). Questionnaires were administered to all participants to assess anxiety and depression levels. The Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were applied to all the groups. In addition, BAI sub-parameters were evaluated in detail. RESULTS At least mild depression was detected in 54.5% of the first group, 41.7% of the second group, and 33.3% of the third group. When the BDI and BAI total scores of the participants in different groups were compared, statistically significant differences were determined. Statistically significant results were detected related to different BAI sub-parameters between the patient groups and in comparison to the fourth group. CONCLUSIONS We found that patients were predisposed to anxiety and depression even if they were euthyroid. When the sub-parameters of BAI were evaluated in detail, we observed that the duration of the disease significantly affected some anxiety-related symptoms.

Protocolo diagnóstico y tratamiento de la patología tiroidea en la mujer embarazada y en el posparto

A common cause of medical consultancy in pregnancy is thyroid pathology, specifically thyroid function disorders. Physiological changes during pregnancy: a) cause an increase in levothyroxine requirements; b) narrow TSH reference values, mainly in the first trimester, increasing scenarios compatible with hyperthyroidism and primary hypothyroidism and c) facilitate clinical changes in autoimmune hyperthyroidism. Mismanagement or ignorance of these features over fetus well-being can result in negative effects on the health of the mother and the fetus/child. In postpartum, typical pregnant immune tolerance is lost, treatment has to be adjusted, appearing characteristic disorders like silent thyroiditis.

The spectrum of Thyroid function Abnormalities and associated Biochemical factors in Patients with Chronic Kidney Disease in Cameroon

Chronic Kidney Disease (CKD) can lead to thyroid function disorders. The extent to which this relationship exists among Cameroonian CKD patients is not known. The aim of this study, was to determine the spectrum of thyroid dysfunction (TD) and their associated factors among CKD patients in Cameroon.

Thyroid Pathology in End-Stage Renal Disease Patients on Hemodialysis.

Objectives: Chronic kidney disease is a rising cause of morbidity and mortality in developed countries, including end-stage renal disease (ESRD). The prevalence of thyroid comorbidities in persons with chronic kidney disease is documented higher than in normal population. The study aims to investigate the prevalence of morphological and functional thyroid disorders in patients with chronic kidney disease, with renal replacement therapy (hemodialysis). Methods: A cross-sectional study was performed on 123 consecutive patients with chronic kidney disease stage 5, on hemodialysis during a period of one month (May 2019–June 2020). All patients were enrolled for maintenance hemodialysis in B Braun Hemodialysis Center Timisoara and were examined on conventional 2B ultrasound. Thyroid blood tests were done, including serum free thyroxin (FT4), free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH) at the time of starting hemodialysis. Results: We evaluated 123 patients (male to female ratio 70/53) mean age 62.2 ± 11.01, mostly above 65 years old, enrolled in the end-stage renal disease program, on renal replacement therapy. From the cohort, 76/123 presented thyroid disease, including autoimmune hypothyroidism, nodular goiter or thyroid cancer. Among them, 63 patients presented nodular goiter, including 3 thyroid cancers, confirmed by surgery and histopathological result, 22 patients had thyroid autoimmune disease. The serum thyroid-stimulating hormone levels found in the cohort was 3.36 ± 2.313 mUI/mL, which was in the normal laboratory reference range. The thyroid volume was 13 ± 7.18 mL. A single patient in the cohort presented Graves Basedow disease, under treatment and three patients present subclinical hyperthyroidism. We have found that thyroid disease risk is increased by 3.4-fold for the female gender and also the increase of body mass index (BMI) with one unit raises the risk of developing thyroid disease with 1.083 times (p = 0.018). Conclusion: To conclude, this study aimed to quantify the prevalence of thyroid disease in end-stage kidney disease population, especially nodular goiter, important for differential diagnosis in cases with secondary hyperparathyroidism. Thyroid autoimmune disease can be prevalent among these patients, as symptoms can overlap those of chronic disease and decrease the quality of life. We have found that thyroid disease has a high prevalence among patients with end-stage renal disease on hemodialysis. Thyroid goiter and nodules in ESRD patients were more prevalent than in the general population. Clinical surveillance and routine screening for thyroid disorders can improve the quality of life in these patients.

The influence of thyroid function disorders on pregnant women on the Apgar scale and psychomotor development of the child in the first 18 months of life

Introduction. In the prenatal period, there are many exogenous and endogenous factors, which adversely affect the normal development of the fetus and may affect the further development of the child. The impaired reference level of thyroid hormones pregnant woman may entail a number of complications, especially in the first trimester of pregnancy, wherein the process takes place organogenesis and the formation of the nervous system.Goal. The overall objective of the work is to verify the correlation between hypothyroidism and child developmental problems in the first eighteen months of life and the Apgar scale.Materials and methods. The study included 200 pregnant women aged 17 to 40 years of age. The research tool was an online, proprietary questionnaire, which has been placed in social groups, which included pregnant women struggling with hypothyroidism.Conclusions. Developmental disorders up to 18 months of children age occurred in 45% of women with thyroid dysfunction, of which 43% related to symptoms of neurological problems including 56% of impaired muscle tone. The present study demonstrates that the final outcome Apgar does not forecast problems in the course of further development of the child up to 18 months of age. Significant further research, which will help establish the presence of mechanisms adverse impact on offspring and pregnancy outcomes.

Thyroid Function and Depressive Symptoms in Older Adults: A Five-Year Follow-Up

Background: Thyroid function and depressive disorders have a reciprocal correlation. Objectives: This study was performed to assess the association between thyroid function and depressive symptoms in older adults. Methods: In this cohort study, all older adults (aged 60 or over) recruited in the Amirkola Health and Ageing Cohort Project (AHAP) were followed from 2011 to 2016. At a baseline examination, depressive symptoms were assessed using the geriatric depression scale (GDS). Thyroid function was evaluated with the serum levels of T3, T4, and thyroid stimulating hormone (TSH). Older adults whose GDS scores showed no depressive symptoms at the baseline were followed for five years. The t-test, ANOVA, logistic regression model, and Pearson’s correlation coefficient were used for data analysis. Results: Totally, 1,463 individuals completed the first phase of the study. We showed that 623 (45.3%) persons with a mean age of 69.6 ± 7.3 years had mild-to-severe depression and 840 (54.7%) individuals had no depressive symptoms. The baseline thyroid function of the participants showed that the mean levels of T3 (0.330), T4 (0.312), and TSH (0.064) had no significant difference between patients with depressive symptoms and individuals without these symptoms. After the baseline assessment, 571 individuals who did not have depressive symptoms were followed for five years. The results showed that 69 (12.1%) persons were hypothyroid and six (1.1%) were hyperthyroid. Overt or subclinical hypo (P = 0.103) or hyper (P = 0.128) thyroid function had no significant difference between older adults who were depressed and non-depressed. Conclusions: A five-year follow-up of elderly people revealed no significant correlation between depressive symptoms and thyroid function in this population.

Memories of the future

With bated breath we follow the fate of the long-suffering law On the prevention of diseases caused by iodine deficiency. What can be expected in terms of improving public health after the adoption and successful implementation of this bill, which provides for the enrichment with iodine of edible salt of extra, higher and first varieties, grinding No. 0 and No. 1? In addition, in the production of bakery products, the recipe of which contains edible salt, the use of iodized salt will become mandatory. According to the experience of many near and far countries, within 23 years from the start of the program of mandatory salt iodization, one can expect a significant (at times) reduction in the incidence of endemic goiter. This trend will not exhaust itself in subsequent years. In the medium term (after about 10 years), a decrease (by half or more) in the incidence of thyrotoxicosis can also be expected in Russia. However, in the short term (57 years), a transient increase in the incidence of thyrotoxicosis in people over 60 years of age is possible, which can be considered a kind of payment for the previous iodine deficiency. The trend towards an increase in the incidence of subclinical and, possibly, manifest hypothyroidism may continue, but this will not be a consequence of an increase in iodine supply. Optimization of iodine intake against the background of mandatory salt iodization should reduce the frequency of transient disorders of thyroid function in newborns and, possibly, congenital hypothyroidism.

Psychiatric Disorders in the Adolescent Offspring of Mothers with Thyroid Problems During Pregnancy.

Maternal thyroid problems during pregnancy have been linked to neurocognitive impairments in children. While studies suggest that disorders of maternal thyroid function during pregnancy are associated with symptoms of mental health problems in children, little is known about the risk of clinically significant psychiatric disorders in adolescence. A sample of 2451 Canadian adolescents enrolled in the Ontario Child Health Study completed the Mini International Neuropsychiatric Interview for Children and Adolescents at 12-17years of age. Their mothers self-reported thyroid problems during pregnancy. Gestational thyroid problems were associated with offspring oppositional defiant disorder (ODD; OR 3.73; 95% CI 1.69-8.24), conduct disorder (CD; OR 12.95; 95% CI 5.12-32.75), and social anxiety disorder (SAD; OR 6.25; 95% CI 2.53-15.47). Neither sex nor gestational age moderated associations between prenatal thyroid dysfunction and the majority of outcomes. School performance mediated 8% of the association between thyroid problems and SAD, 21% for CD and 53% for ODD.

HEMATOLOGICAL PROFILE IN PRIMARY HYPOTHYROIDISM

Introduction: Thyroid function disorders are among the most common endocrine diseases. Females are affected more than males, especially during the reproductive age. Hypothyroidism is the most prevalent type with a reported frequency of 2–5% worldwide. Thyroid hormones are essential for virtually all body tissues. So deficiency may affect hematopoiesis in bone marrow and eventually hematopoietic cells. Hematological abnormalities have frequently been reported in thyroid disorders. Anemia is frequently observed in patients with primary hypothyroidism.
 Objectives: To study the hematological changes and pattern of anemia in primary hypothyroid patients.
 Materials & Methods: This is a cross sectional study conducted on newly diagnosed 100 patients with primary hypothyroidism, between 18 –60 years. They were categorized as 35 patients of subclinical and 65 patients of overt hypothyroidism based on TSH level. Patients’ who fulfills the inclusion exclusion criteria were evaluated for thyroid function tests (T3, T4 and TSH) and hematological parameters (CBC and PBF).
 Results: Our analysis revealed an overall prevalence rate of anemia was 56% in patients with hypothyroidism which is higher than the WHO reported data of prevalence of anemia throughout the world. Our results showed that prevalence of normocytic normochromic anemia was significantly higher, microcytic anemia had the second rank, while macrocytic anemia had the lowest prevalence rate. On subgroup analysis, there was no statistical difference between subclinical hypothyroid and overt hypothyroid, in term of hematological parameters and type of anemia.
 Conclusion: Without proper diagnosis and effective treatment of the underlying thyroid disease, it is often difficult to achieve a complete correction of the anemia. The high prevalence of anemia in patients with hypothyroidism suggests screening for hypothyroidism during the differential diagnosis of cases presenting with anemia.
 Keywords: Hypothyroidism, subclinical, overt, anemia, hematological, thyroid, blood.

Prophylactic effect of Spirulina platensis on radiation-induced thyroid disorders and alteration of reproductive hormones in female albino rats

BackgroundIonizing-radiation induces oxidative stress and thyroid toxicity. Thyroid function disorders have a great impact on fertility in both sexes.Materials and MethodsForty female rats were divided into four groups. Control, Spirulina-treated (300 mg/kg); given orally for 15 days, γ-irradiated; given (5 Gy whole body γ-rays) and Spirulina+irradiated; given Spirulina for 15 days before irradiation. Animals were sacrificed the 3rd day post-irradiation. The level of the oxidant/antioxidant markers: Malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) was evaluated. In addition, caspase-3 activity was measured as apoptotic marker and comet assay to detect DNA-damage. Serum thyroid stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4) were determined to evaluate the thyroid function alterations. Also, analysis of reproductive hormones; follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and progesterone (P4) was detected. ResultsWhole body γ-irradiation-induced oxidative stress, denoted by significant decreases of antioxidant markers and an increase in MDA content. The activity of caspase-3 was significantly increased and comet assay revealed DNA damage. Also, serum level of TSH was significantly increased, while T3, and T4, significantly decreased in irradiated rats. Moreover, the reproductive hormones showed significant decreases. Spirulina treatment has significantly attenuated oxidative stress in thyroid tissues, decreased caspase-3 activity and ameliorated DNA damage, concomitant with significant amelioration in the levels of thyroid and reproductive hormones.ConclusionSpirulina may alleviate γ-rays-induced thyroid damage and play a significant role in the regulation of thyroid and reproductive hormones in female rats.

Thyroid disorders in subfertility and early pregnancy.

Disorders of thyroid function are common in pregnancy and have implications for foetal and maternal health. Thyroid autoimmunity, as evidenced by the presence of elevated levels of anti-thyroid antibodies (anti-TPO and anti-Tg antibodies) is associated with an increased risk of miscarriage, though the mechanism remains poorly understood. There has been considerable focus on the implications and optimal management of pregnant women with thyroid disease, especially those undergoing assisted reproduction. Pregnancy results in significant changes in thyroid physiology and these need to be understood by clinicians involved in the care of pregnant women. Guidelines for the use of thyroxine and target thyroid function tests have been produced by international bodies but it is recognised that these predominantly reflect expert opinion rather than established evidence-based practice. Importantly a number of key clinical trials have been performed to aid understanding, particularly of the consequences of hypothyroidism for mother and baby, and the effectiveness of thyroid hormone use in autoimmune and subclinical hypothyroidism. This review summarises the current knowledge base and guidance for practice relating to thyroid disorders in pregnancy and subfertility.

Comparison of TIRADS [Thyroid imaging reporting and data system] with histopathology in assessment of thyroid nodules

Introduction: The thyroid gland is an endocrine organ, which acts perfectly in maintaining the normal growth and activity of human beings. Factors causing a disturbance in its auto-regulatory mechanism leads to various thyroid function disorders that may or may not result in thyroid nodules. Malignancy comprises of less than 10% of all thyroid nodules on the basis of already established Breast Imaging Reporting and Data System (BIRADS) for breast nodules a categorization system of ultrasound features in thyroid nodules-the Thyroid Imaging Reporting and Data System (TIRADS) is suggested. Aims and Objectives: To assess validity of TIRADS in Indian population in differentiating thyroid nodules as benign and malignant taking histopathology as gold standard. Methodology: A descriptive study was done at JSS Hospital over a period of 18 months for 82 patients presenting with clinically palpable thyroid nodules and results were drawn assuming 50 percent sensitivity of TIRADS grading in differentiating the lesion as benign and malignant with an alpha error of 5 percent and a precision of 15 percent. All demographic data was summarized as proportion, mean, standard deviation and sensitivity, specificity, positive predictive value, negative predictive value were measured with 95% confidence interval. The inferential statistics were obtained using Chi-square and Cramer’s V tests. Results: 42.7 per cent cases were present in TIRADS II, 34.1 per cent in TIRADS III, 9.8 per cent in TIRADS IV A, 4.9percent each in TIRADS 1V B and C, 3.7 per cent in TIRADS V. TIRADS grading when compared with histopathology was found to have a sensitivity of 82.35 percent, a specificity of 92.30 percent, positive predictive value of 73.68 percent and a negative predictive value of 95.24 percent. Conclusion: TIRADS grading is a useful tool in pre operative evaluation and management, aids in deciding the timing of FNAC and when used along with it improves the diagnostic ability of a clinician in overall assessment of thyroid nodules.

Prevalence and risk factors of thyroid dysfunction in young age

We examined people aged from 17 to 22 on the state of the thyroid gland. Analyzed results of the ultrasonography, laboratory test data, health assessment questionnaires and food records of the 300 study participants. Risk factors of thyroid dysfunction development for young people were analyzed. Signs of structural changes of the thyroid gland were detected amongst 57 % of study participants. The laboratory test results confirmed 44 % of the primary outcome received after palpation and ultrasonography. As a result 67 % of the examined volunteers from the in need of treatment group and 35 % intact volunteers were transferred into the group of dynamic follow-up thyroid gland monitoring. Discovered a less number of cases of the structural and/or functional thyroid disorders amongst people who have lived for 5 years in ecologically clean regions. All study participants had chronic alimentary iodine insufficiency which didn’t allow us to confirm the fundamental role of the iodine deficiency in the thyroid gland dysfunction development amongst young people. Laboratory confirmed diagnoses autoimmune thyroid disorders were found only amongst volunteers that consumed less than ¼ of the daily dose of iodine and lived in ecologically unsafe districts.

Nocturnal haemodialysis is associated with a reduced occurrence of low triiodothyronine serum levels in haemodialysed patients.

BackgroundEnd-stage renal disease (ESRD) is associated with a broad spectrum of morphological and functional thyroid disorders. Recent studies have shown that low free triiodothyronine (fT3) levels are related to inflammatory status and endothelial activation in ESRD patients on haemodialysis (HD). Limited data exist about a possible relationship between dialysis regimen, namely long nocturnal haemodialysis (LNHD), and thyroid function parameters. The aim of this study was to evaluate the relationship between dialysis regimen and thyroid function, and consequently with the main patient outcomes.MethodsTo this purpose, we performed a retrospective, single-centre cohort study including 220 incident chronic HD patients treated during an 8-year period (from January 2010 to December 2017). The main clinical and haematochemical parameters, including thyroid function, were evaluated and related to the main patient outcomes.ResultsPatients with low fT3 levels (<3.05 ng/mL) showed significantly lower survival rates than patients with normal fT3 levels (>3.05 ng/mL) (P < 0.001), although there were no substantial differences in the demographic and clinical characteristics between the two groups. After propensity score 1:3 matching of 25 patients treated with nocturnal HD to 75 patients treated with diurnal HD, LNHD patients showed significantly higher survival rates (88.0% versus 61.3%, P = 0.001) and lower incidence of cardiovascular events than patients on diurnal dialysis (8.0% versus 40.0%, P = 0.001). Moreover, an 8-year time-dependent analysis showed that at any time, except for baseline, the rate of patients with fT3 levels >3.05 ng/mL was significantly higher in LNHD patients than in patients treated with diurnal dialysis.ConclusionsOur data suggest that the application of alternative dialysis regimens, also reducing the frequency of low T3, could ameliorate outcomes and therefore reduce the incidence of cardiovascular events in HD patients.

Оценка функции щитовидной железы и метаболических нарушений при лечении рака предстательной железы агонистами лютеинизирующего гормона рилизинг-гормона

Оценка функции щитовидной железы и метаболических нарушений при лечении рака предстательной железы агонистами лютеинизирующего гормона рилизинг-гормона