The year 2020 marks the centenary of the publication of a classic study by American physicians D. Marine and O. Kimball on the effectiveness of endemic goiter prevention in children in Akron, Ohio. Although goiter has been known from immemorial times, there is still a problem with determining the normal size of the thyroid gland, without which the diagnosis of goiter remains extremely subjective. For example, in Sweden over the past 20 years, not a single case of endemic goiter has been registered, which is not surprising: the country eliminated this pathology decades ago, and the median urinary iodine concentration indicates the optimal iodine intake. Cases of sporadic goiter in children in Sweden are also rare — no more than 6–8 per year. But in Belarus, with the same population (about 10 million), about 2900 cases of goiter in children, both endemic and sporadic, are recorded annually despite the fact that, due to the extensive use of iodized salt since the beginning of the 2000s, there is no iodine deficiency. The incidence of goiter in children, however, having decreased many times over the past 20 years, remains 3 times higher than in Russia, where iodine prophylaxis, if carried out on a limited scale. From the experience of Belarus, Sweden and Russia, we see that the main thing when assessing data on the incidence of goiter and other thyroid diseases associated with iodine deficiency should be not absolute numbers, but the trend of these indicators over the past years. This information should be more actively used by endocrinologists in Russia to assess the effectiveness of preventive measures both at the regional and federal levels.
{"title":"Не самый простой зоб","authors":"Григорий Анатольевич Герасимов","doi":"10.14341/KET12696","DOIUrl":"https://doi.org/10.14341/KET12696","url":null,"abstract":"The year 2020 marks the centenary of the publication of a classic study by American physicians D. Marine and O. Kimball on the effectiveness of endemic goiter prevention in children in Akron, Ohio. Although goiter has been known from immemorial times, there is still a problem with determining the normal size of the thyroid gland, without which the diagnosis of goiter remains extremely subjective. For example, in Sweden over the past 20 years, not a single case of endemic goiter has been registered, which is not surprising: the country eliminated this pathology decades ago, and the median urinary iodine concentration indicates the optimal iodine intake. Cases of sporadic goiter in children in Sweden are also rare — no more than 6–8 per year. But in Belarus, with the same population (about 10 million), about 2900 cases of goiter in children, both endemic and sporadic, are recorded annually despite the fact that, due to the extensive use of iodized salt since the beginning of the 2000s, there is no iodine deficiency. The incidence of goiter in children, however, having decreased many times over the past 20 years, remains 3 times higher than in Russia, where iodine prophylaxis, if carried out on a limited scale. From the experience of Belarus, Sweden and Russia, we see that the main thing when assessing data on the incidence of goiter and other thyroid diseases associated with iodine deficiency should be not absolute numbers, but the trend of these indicators over the past years. This information should be more actively used by endocrinologists in Russia to assess the effectiveness of preventive measures both at the regional and federal levels.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"112 1","pages":"4-11"},"PeriodicalIF":0.0,"publicationDate":"2021-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79658467","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}
G. Gerasimov, Nicholas Hutchings, Hrayr Aslanyan, Irina Tovmasyan
Armenia was one of the first post-Soviet countries, that after a relatively short break has restored the production of iodized salt at the beginning of the 2000s, and in 2004 adopted a decree that made the production and import of iodized salt mandatory, as well as its use in the food industry. A 2016 national survey showed high sustainability of the iodine prophylaxis program in Armenia – median urinary iodine concentration (UIC) in schoolchildren and pregnant women (PW) was in the optimal range (242 and 226 μg/l, respectively), and coverage of households with quality iodized salt was 95%. In addition to iodized salt used in households, more than 50% of iodine was consumed with processed foods, primarily bakery products. An essential advantage of the iodine prophylaxis program in Armenia is that it provides adequate iodine status not only for the general population, but also for PW. At the same time about 37% of PW used iodine supplements, which were not necessary. The experience of Armenia shows that the analysis of screening datasets for neonatal hypothyroidism screening makes it possible to efficiently and at minimal cost annually evaluate the iodine status of the population. And if the frequency of TSH levels > 5 mIU/L exceeds 3%, the health authorities should consider this as an alarm and conduct a more detailed assessment to find out the cause of the iodine status insufficiency and take appropriate measures
{"title":"Armenia's experience in achieving an adequate iodine status of the population","authors":"G. Gerasimov, Nicholas Hutchings, Hrayr Aslanyan, Irina Tovmasyan","doi":"10.14341/ket12525","DOIUrl":"https://doi.org/10.14341/ket12525","url":null,"abstract":"Armenia was one of the first post-Soviet countries, that after a relatively short break has restored the production of iodized salt at the beginning of the 2000s, and in 2004 adopted a decree that made the production and import of iodized salt mandatory, as well as its use in the food industry. A 2016 national survey showed high sustainability of the iodine prophylaxis program in Armenia – median urinary iodine concentration (UIC) in schoolchildren and pregnant women (PW) was in the optimal range (242 and 226 μg/l, respectively), and coverage of households with quality iodized salt was 95%. In addition to iodized salt used in households, more than 50% of iodine was consumed with processed foods, primarily bakery products. An essential advantage of the iodine prophylaxis program in Armenia is that it provides adequate iodine status not only for the general population, but also for PW. At the same time about 37% of PW used iodine supplements, which were not necessary. The experience of Armenia shows that the analysis of screening datasets for neonatal hypothyroidism screening makes it possible to efficiently and at minimal cost annually evaluate the iodine status of the population. And if the frequency of TSH levels > 5 mIU/L exceeds 3%, the health authorities should consider this as an alarm and conduct a more detailed assessment to find out the cause of the iodine status insufficiency and take appropriate measures","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76898864","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}
O. Rymar, S. Mustafina, V. I. Alferova, D. Denisova
as questionnaires, determination of UIC, comparison of the obtained data with the results of clinical and population studies conducted in Novosibirsk in 1994-1995, 2004-2005, 2009-2010. RESULTS: In 2005 32.7% of adult population consumed iodized salt. In 2010, 47% of adolescence surveyed consumed iodized salt. According to a survey conducted in 2019 it was found that among adults 19-25 years old 19.8% know that they consume iodized salt. Among schoolchildren from 13 to 18 years old, 8.1% know for sure that use iodized salt. In 1994-1995 mUIC in persons of reproductive age in Novosibirsk was 47 μg / L. In 2005 mUIC in the adult population (45-69 years old) was 107 μg / L. In 2010 mUIC was 93 μg / L, UIC less than 50 μg / L was determined in 7% of samples, among school children. In 2019 MUIC amounted to 111 μg / l in adult population, the proportion of urine samples with UIC less than 50 μg / l - 10.7%. MUIC was 123 μg / l in 2019 among adolescence, the proportion of urine samples with UIC less than 50 μg / l - 14.5%. CONCLUSIONS: Over the 24-year period of observation, there is a significant improving the iodine supply of the population in Novosibirsk. The low awareness of the young generation of the inhabitants of Novosibirsk about iodine deficiency and measures for its prevention was recorded.
{"title":"Epidemiological studies of iodine deficiency in Novosibirsk: data of 25-years observation","authors":"O. Rymar, S. Mustafina, V. I. Alferova, D. Denisova","doi":"10.14341/KET12539","DOIUrl":"https://doi.org/10.14341/KET12539","url":null,"abstract":"as questionnaires, determination of UIC, comparison of the obtained data with the results of clinical and population studies conducted in Novosibirsk in 1994-1995, 2004-2005, 2009-2010. RESULTS: In 2005 32.7% of adult population consumed iodized salt. In 2010, 47% of adolescence surveyed consumed iodized salt. According to a survey conducted in 2019 it was found that among adults 19-25 years old 19.8% know that they consume iodized salt. Among schoolchildren from 13 to 18 years old, 8.1% know for sure that use iodized salt. In 1994-1995 mUIC in persons of reproductive age in Novosibirsk was 47 μg / L. In 2005 mUIC in the adult population (45-69 years old) was 107 μg / L. In 2010 mUIC was 93 μg / L, UIC less than 50 μg / L was determined in 7% of samples, among school children. In 2019 MUIC amounted to 111 μg / l in adult population, the proportion of urine samples with UIC less than 50 μg / l - 10.7%. MUIC was 123 μg / l in 2019 among adolescence, the proportion of urine samples with UIC less than 50 μg / l - 14.5%. CONCLUSIONS: Over the 24-year period of observation, there is a significant improving the iodine supply of the population in Novosibirsk. The low awareness of the young generation of the inhabitants of Novosibirsk about iodine deficiency and measures for its prevention was recorded.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86423194","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}
D. Rebrova, I. Sleptsov, R. Chernikov, A. Uspenskaya, V. Rusakov, L. Krasnov, E. Fedorov, I. Sablin, M. Isheyskaya, Irina V. Olovyanishnikova, Yury N. Fedotov, A. Bubnov
Thyrotropinoma is a rare pituitary tumor that causes the development of thyrotoxicosis syndrome as a result of hyperproduction of thyroid stimulating hormone (TSH). In the Russian literature over the past 10 years, one case of thyrotropinoma in a child, four cases of TSH-producing pituitary adenoma in women and only one in a man have been described. The article presents a unique clinical case of a 20-years history of observation of a patient with TSH-oma. The rarity of this disease led to the fact that it took more than 10 years to make a correct diagnosis. The first operation of thyroid gland was performed before the diagnosis of pituitary adenoma and inappropriate TSH secretion syndrome. That right hemithyroidectomy was supposed to cure a toxic adenoma of thyroid gland. The diagnosis of thyrotropin-secreting piruitary tumor was established only after 6 years even after finding a combination of pituitary adenoma and thyrotoxicosis. After that, the patient steadfastly refuses neurosurgical treatment, despite the presence of macroadenoma with intrasellar growth. The therapy with somatostatin analogs led to patient’s intolerance with gastrointestinal side effects and hospitalization for acute pancreatitis. The absence of the therapy due to low compliance led to long-term persistence of thyrotoxicosis. The absence of signs and symptoms of expanding tumor mass (visual field defects, loss of vision, headache, partial or total hypopituitarism) demonstrates the slow growth of this kind of pituitary tumor. The long-term effect of elevated TSH levels led to diffuse goiter with compression of the neck organs, and the need of the surgical treatment of the thyroid. Stable euthyroidism after the operation led to stable normoglycemia in the patient with previously diagnosed diabetes mellitus type 2. This fact should keep an attention of physicians and endocrinologists to screen for the secondary reasons of hyperglycemia in a patient with diabetes mellitus manifestation. Long-term history of thyrotoxicosis led to the deleterious effects of thyroid hormone excess on the heart (atrial fibrillation, cardiomyopathy, cardiac failure). Those effects are still observed even after thyroidectomy and medical euthyroidism achievement. This fact demonstrates the importance of early diagnosis and treatment of TSH-omas.
{"title":"TSH secreting pituitary tumor — an experience of 20 years follow-up","authors":"D. Rebrova, I. Sleptsov, R. Chernikov, A. Uspenskaya, V. Rusakov, L. Krasnov, E. Fedorov, I. Sablin, M. Isheyskaya, Irina V. Olovyanishnikova, Yury N. Fedotov, A. Bubnov","doi":"10.14341/ket12430","DOIUrl":"https://doi.org/10.14341/ket12430","url":null,"abstract":"Thyrotropinoma is a rare pituitary tumor that causes the development of thyrotoxicosis syndrome as a result of hyperproduction of thyroid stimulating hormone (TSH). In the Russian literature over the past 10 years, one case of thyrotropinoma in a child, four cases of TSH-producing pituitary adenoma in women and only one in a man have been described. The article presents a unique clinical case of a 20-years history of observation of a patient with TSH-oma. The rarity of this disease led to the fact that it took more than 10 years to make a correct diagnosis. The first operation of thyroid gland was performed before the diagnosis of pituitary adenoma and inappropriate TSH secretion syndrome. That right hemithyroidectomy was supposed to cure a toxic adenoma of thyroid gland. The diagnosis of thyrotropin-secreting piruitary tumor was established only after 6 years even after finding a combination of pituitary adenoma and thyrotoxicosis. After that, the patient steadfastly refuses neurosurgical treatment, despite the presence of macroadenoma with intrasellar growth. The therapy with somatostatin analogs led to patient’s intolerance with gastrointestinal side effects and hospitalization for acute pancreatitis. The absence of the therapy due to low compliance led to long-term persistence of thyrotoxicosis. The absence of signs and symptoms of expanding tumor mass (visual field defects, loss of vision, headache, partial or total hypopituitarism) demonstrates the slow growth of this kind of pituitary tumor. The long-term effect of elevated TSH levels led to diffuse goiter with compression of the neck organs, and the need of the surgical treatment of the thyroid. Stable euthyroidism after the operation led to stable normoglycemia in the patient with previously diagnosed diabetes mellitus type 2. This fact should keep an attention of physicians and endocrinologists to screen for the secondary reasons of hyperglycemia in a patient with diabetes mellitus manifestation. Long-term history of thyrotoxicosis led to the deleterious effects of thyroid hormone excess on the heart (atrial fibrillation, cardiomyopathy, cardiac failure). Those effects are still observed even after thyroidectomy and medical euthyroidism achievement. This fact demonstrates the importance of early diagnosis and treatment of TSH-omas.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"395 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78987874","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}
E. Grineva, U. Tsoy, T. L. Karonova, T. V. Andreychenko, G. A. Bogdanova, V. Vanushko, A. Dalmatova, I. Danilov, E. V. Ivanikha, D. S. Lebedev, T. V. Malakhova, E. N. Mikhaylov, D. Ryzhkova, B. A. Tatarskiy, E. Troshina, V. Fadeev
Amiodarone is an antiarrhythmic drug that is commonly used for treatment of various supraventricular and ventricu-lar arrhythmias. Amiodarone and its main active metabolite desethylamiodarone have a direct dose-dependent cytotoxic effect on thyroid follicular cells. Consequently, some patients receiving amiodarone may develop thyroid dysfunction: amiodarone-induced hypothyroidism (AIH) or amiodarone-induced thyrotoxicosis (AIT). The diagnosis, classification, and treatment of amiodarone-induced thyroid dysfunction remain to be a challenge to all clinicians deal with this problem. diagnosis of diffuse toxic goiter and, consequently, AIT1. Colour-flow Doppler sonography (CFDS) is proposed as the basic method of differential diagnosis of AIT 1 and AIT 2. CFDS «pattern 0», usually indicates AIT 2, the presence of «patterns I-III» mostly typical for AIT 1. The thyreostatics are recommended for AIT 1, oral glucocorticoids for AIT 2 and their combination for a mixed AIT. Emergency thyroidectomy should be applied to patients with deteriorating cardiovascular pathology and ineffective drug therapy. In the absence of clinical suspicion on thyroid dysfunction, thyroid hormones assessment should be done 3 months after the start of amiodarone treatment, thereafter every 6 months.
{"title":"Draft of the federal clinical recommendations for diagnosisi and treatment of amiodarone-induced thyroid dysfunction","authors":"E. Grineva, U. Tsoy, T. L. Karonova, T. V. Andreychenko, G. A. Bogdanova, V. Vanushko, A. Dalmatova, I. Danilov, E. V. Ivanikha, D. S. Lebedev, T. V. Malakhova, E. N. Mikhaylov, D. Ryzhkova, B. A. Tatarskiy, E. Troshina, V. Fadeev","doi":"10.14341/KET12693","DOIUrl":"https://doi.org/10.14341/KET12693","url":null,"abstract":"Amiodarone is an antiarrhythmic drug that is commonly used for treatment of various supraventricular and ventricu-lar arrhythmias. Amiodarone and its main active metabolite desethylamiodarone have a direct dose-dependent cytotoxic effect on thyroid follicular cells. Consequently, some patients receiving amiodarone may develop thyroid dysfunction: amiodarone-induced hypothyroidism (AIH) or amiodarone-induced thyrotoxicosis (AIT). The diagnosis, classification, and treatment of amiodarone-induced thyroid dysfunction remain to be a challenge to all clinicians deal with this problem. diagnosis of diffuse toxic goiter and, consequently, AIT1. Colour-flow Doppler sonography (CFDS) is proposed as the basic method of differential diagnosis of AIT 1 and AIT 2. CFDS «pattern 0», usually indicates AIT 2, the presence of «patterns I-III» mostly typical for AIT 1. The thyreostatics are recommended for AIT 1, oral glucocorticoids for AIT 2 and their combination for a mixed AIT. Emergency thyroidectomy should be applied to patients with deteriorating cardiovascular pathology and ineffective drug therapy. In the absence of clinical suspicion on thyroid dysfunction, thyroid hormones assessment should be done 3 months after the start of amiodarone treatment, thereafter every 6 months.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83749896","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":"Was there a boy?","authors":"G. Gerasimov","doi":"10.14341/ket12492","DOIUrl":"https://doi.org/10.14341/ket12492","url":null,"abstract":"","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82299915","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}
Graves’ disease (GD) is a systemic autoimmune disorder characterized by the infiltration of thyroid antigen-specific T-cells into thyroid-stimulating hormone receptor (TSH-R)-expressing tissues. Stimulatory autoantibodies (Ab) in GD activate the TSH-R leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Diagnosis of GD is straightfor-ward in a patient with biochemically confirmed thyrotoxicosis, positive TSH-R-Ab, a hypervascular and hypoechoic thyroid gland (ultrasound), and associated orbitopathy. In GD, measurement of TSH-R-Ab is recommended for an accurate diagno-sis/differential diagnosis, prior to stopping antithyroid drug (ATD) treatment and during pregnancy. Graves’ hyperthyroidism is treated by decreasing thyroid hormone synthesis with the use of ATD, or by reducing the amount of thyroid tissue with radioactive iodine (RAI) treatment or total thyroidectomy. Patients with newly diagnosed Graves’ hyperthyroidism are usually medically treated for 12–18 months with methimazole (MMI) as the preferred drug. In children with GD, a 24- to 36-month course of MMI is recommended. Patients with persistently high TSH-R-Ab at 12–18 months can continue MMI treatment, repeating the TSH-R-Ab measurement after an additional 12 months, or opt for therapy with RAI or thyroidectomy. Women treated with MMI should be switched to propylthiouracil when planning pregnancy and during the first trimester of pregnancy. If a patient relapses after completing a course of ATD, definitive treatment is recommended; however, continued long-term low-dose MMI can be considered. Thyroidectomy should be performed by an experienced high-volume thyroid surgeon. RAI is contraindicated in Graves’ patients with active/severe orbitopathy, and steroid prophylaxis is warranted in Graves’ patients with mild/active orbitopathy receiving RAI. The literature review presented in this article does not claim to be a full-fledged systematic review, not only for the reason that to date, only 51 works have been found at the time of writing in the databases for the keywords «thyroid and COVID-19» and «adrenal and COVID-19», after excluding duplicates, but also because these messages themselves contain little information and are mainly based on analogies with previously existing viral infections and their role in the development of hypothalamus-pituitary axis pathology-adrenal glands and hypothalamus-pituitary-thyroid.
{"title":"Review of European Thyroid Association Guideline (2018) for the Manage-ment of Graves’ Hyperthyroidism","authors":"F. Fadeev","doi":"10.14341/ket12474","DOIUrl":"https://doi.org/10.14341/ket12474","url":null,"abstract":"Graves’ disease (GD) is a systemic autoimmune disorder characterized by the infiltration of thyroid antigen-specific T-cells into thyroid-stimulating hormone receptor (TSH-R)-expressing tissues. Stimulatory autoantibodies (Ab) in GD activate the TSH-R leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Diagnosis of GD is straightfor-ward in a patient with biochemically confirmed thyrotoxicosis, positive TSH-R-Ab, a hypervascular and hypoechoic thyroid gland (ultrasound), and associated orbitopathy. In GD, measurement of TSH-R-Ab is recommended for an accurate diagno-sis/differential diagnosis, prior to stopping antithyroid drug (ATD) treatment and during pregnancy. Graves’ hyperthyroidism is treated by decreasing thyroid hormone synthesis with the use of ATD, or by reducing the amount of thyroid tissue with radioactive iodine (RAI) treatment or total thyroidectomy. Patients with newly diagnosed Graves’ hyperthyroidism are usually medically treated for 12–18 months with methimazole (MMI) as the preferred drug. In children with GD, a 24- to 36-month course of MMI is recommended. Patients with persistently high TSH-R-Ab at 12–18 months can continue MMI treatment, repeating the TSH-R-Ab measurement after an additional 12 months, or opt for therapy with RAI or thyroidectomy. Women treated with MMI should be switched to propylthiouracil when planning pregnancy and during the first trimester of pregnancy. If a patient relapses after completing a course of ATD, definitive treatment is recommended; however, continued long-term low-dose MMI can be considered. Thyroidectomy should be performed by an experienced high-volume thyroid surgeon. RAI is contraindicated in Graves’ patients with active/severe orbitopathy, and steroid prophylaxis is warranted in Graves’ patients with mild/active orbitopathy receiving RAI. The literature review presented in this article does not claim to be a full-fledged systematic review, not only for the reason that to date, only 51 works have been found at the time of writing in the databases for the keywords «thyroid and COVID-19» and «adrenal and COVID-19», after excluding duplicates, but also because these messages themselves contain little information and are mainly based on analogies with previously existing viral infections and their role in the development of hypothalamus-pituitary axis pathology-adrenal glands and hypothalamus-pituitary-thyroid.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79329265","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}
A. Serikbayeva, Z. Tauesheva, B. Kultanov, A. Turmukhambetova, R. Dosmagambetova, L. Shcherbakova, O. Rymar
Background:The Aral crisis consider as one of the largest ecological catastrophes on the planet. TheKazakhstan part of the Aral Sea regiondeclared an environmental disaster zone. The constantly changing unfavorable environmental situation contributed to higher number of thyroid pathology and initiates the study of this problem in women of reproductive age in the AralSea area.Aims:To study thyroid function in women of reproductive age living in ecologically unfavorable territories of Kazakhstan part of the Aral Sea region.Materials and methods: The survey was conducted within scientific and technical program: “Integrated approaches in managing the health status of the population of the Aral Sea region” 2014–2016 years, performed by Ministry of Health and Social Development of the Republic of Kazakhstan. The study was cross-sectional, observational, uncontrolled and multicenter.Study included the representative sample of 2205 women of reproductive age from 18 to 49 years old living in the Aral Sea region.The levels ofTSH,FT4and AntiTPOweredetermined by the laboratory of collective use of KSMU on the Evolis Robotized System using“Tiroid-ELISA-TTG,0.23-3.4µIU/ml”, “Thyroid–ELISAfreeT4,10-23.2pmol/l”,“Tiroid ELISA – atTPO,<30EDU/ml”testsystems.Results:A huge number of women from environmental disadvantaged areas of the Kazakhstan part of the Aral Sea region have TSH values exceeding reference of 3.4 μI/ml.The frequency of SH was 0.2%;0.9%,0.2% in the different study areas at TTG values≥10.0 μIU/ml and freeT4 from 10to23.2 pmol/l. The frequency of MH was 2.4%;2.7%,2.5% in the studied areas at TSH values ≥10.0μIU/ml and FreeT4<10.0 pmol/l, Thus, the data obtained on the prevalence of reduced thyroid function in women living in the studied areas of the Aral Sea ecological disaster can be considered as comparative. About3%of women of reproductive age neededon replacement therapy for hypothyroidism. Thelargest number of women with elevated AT-TPO identified in the zone of the ecological crisis. Almost same number of women with hypothyroidism was revealed among AT-TPO hosts in all studied zones.Conclusions: Women of reproductive age living in ecologically unfavorable territories havea high, comparable frequency of manifest hypothyroidism in the three studied zones of the Kazakhstan part of the Aral Sea region of the Republic of Kazakhstan.
{"title":"INDICATORS OFTHYROID FUNCTIONOF WOMEN OF REPRODUCTIVE AGE, LIVING ON THE ECOLOGICALLY UNFAVORABLE TERRITORIES OF ARAL SEA REGION OF KAZAKHSTAN.","authors":"A. Serikbayeva, Z. Tauesheva, B. Kultanov, A. Turmukhambetova, R. Dosmagambetova, L. Shcherbakova, O. Rymar","doi":"10.14341/ket11222","DOIUrl":"https://doi.org/10.14341/ket11222","url":null,"abstract":"Background:The Aral crisis consider as one of the largest ecological catastrophes on the planet. TheKazakhstan part of the Aral Sea regiondeclared an environmental disaster zone. The constantly changing unfavorable environmental situation contributed to higher number of thyroid pathology and initiates the study of this problem in women of reproductive age in the AralSea area.Aims:To study thyroid function in women of reproductive age living in ecologically unfavorable territories of Kazakhstan part of the Aral Sea region.Materials and methods: The survey was conducted within scientific and technical program: “Integrated approaches in managing the health status of the population of the Aral Sea region” 2014–2016 years, performed by Ministry of Health and Social Development of the Republic of Kazakhstan. The study was cross-sectional, observational, uncontrolled and multicenter.Study included the representative sample of 2205 women of reproductive age from 18 to 49 years old living in the Aral Sea region.The levels ofTSH,FT4and AntiTPOweredetermined by the laboratory of collective use of KSMU on the Evolis Robotized System using“Tiroid-ELISA-TTG,0.23-3.4µIU/ml”, “Thyroid–ELISAfreeT4,10-23.2pmol/l”,“Tiroid ELISA – atTPO,<30EDU/ml”testsystems.Results:A huge number of women from environmental disadvantaged areas of the Kazakhstan part of the Aral Sea region have TSH values exceeding reference of 3.4 μI/ml.The frequency of SH was 0.2%;0.9%,0.2% in the different study areas at TTG values≥10.0 μIU/ml and freeT4 from 10to23.2 pmol/l. The frequency of MH was 2.4%;2.7%,2.5% in the studied areas at TSH values ≥10.0μIU/ml and FreeT4<10.0 pmol/l, Thus, the data obtained on the prevalence of reduced thyroid function in women living in the studied areas of the Aral Sea ecological disaster can be considered as comparative. About3%of women of reproductive age neededon replacement therapy for hypothyroidism. Thelargest number of women with elevated AT-TPO identified in the zone of the ecological crisis. Almost same number of women with hypothyroidism was revealed among AT-TPO hosts in all studied zones.Conclusions: Women of reproductive age living in ecologically unfavorable territories havea high, comparable frequency of manifest hypothyroidism in the three studied zones of the Kazakhstan part of the Aral Sea region of the Republic of Kazakhstan.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"113 1","pages":"28-37"},"PeriodicalIF":0.0,"publicationDate":"2020-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86232287","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}
E. Troshina, G. Melnichenko, E. S. Senyushkina, N. Mokrysheva
The “new disease” COVID-19, which causes acute respiratory distress syndrome, by the time of writing this article had already affected 5 million 400 thousand people on Earth and claimed the lives of at least 400 thousand people in more than 200 countries. The disease can be either asymptomatic or occur with the development of severe viral pneumonia, complicated by acute respiratory syndrome and sepsis, myocarditis and renal failure. Although the likelihood of a more severe course is noted in individuals with diabetes, and these patients are mainly drawn to the attention of endocrinologists in the pandemic, the actual endocrine manifestations of COVID-19 are not yet considered in detail. There are few data on coronavirus damage to the pituitary, hypothalamus, thyroid gland and adrenal glands, their structural and functional disorders in case of COVID-19 infection, due to the lack of convincing results of preclinical and clinical studies. The literature review presented in this article does not claim to be a full-fledged systematic review, not only for the rea-son that to date, only 51 works have been found at the time of writing in the databases for the keywords «thyroid and COVID-19» and «adrenal and COVID-19», after excluding duplicates, but also because these messages themselves contain little information and are mainly based on analogies with previously existing viral infections and their role in the development of hypothalamus-pituitary axis pathology-adrenal glands and hypothalamus-pituitary-thyroid.
{"title":"Adaptation of the hypothalamo-pituitary-thyroid and hypothalamo-pituitary-adrenal systems to a new infectious disease - COVID-19 in the development of COVID-19 pneumonia and/or cytokine storm","authors":"E. Troshina, G. Melnichenko, E. S. Senyushkina, N. Mokrysheva","doi":"10.14341/ket12461","DOIUrl":"https://doi.org/10.14341/ket12461","url":null,"abstract":"The “new disease” COVID-19, which causes acute respiratory distress syndrome, by the time of writing this article had already affected 5 million 400 thousand people on Earth and claimed the lives of at least 400 thousand people in more than 200 countries. The disease can be either asymptomatic or occur with the development of severe viral pneumonia, complicated by acute respiratory syndrome and sepsis, myocarditis and renal failure. Although the likelihood of a more severe course is noted in individuals with diabetes, and these patients are mainly drawn to the attention of endocrinologists in the pandemic, the actual endocrine manifestations of COVID-19 are not yet considered in detail. There are few data on coronavirus damage to the pituitary, hypothalamus, thyroid gland and adrenal glands, their structural and functional disorders in case of COVID-19 infection, due to the lack of convincing results of preclinical and clinical studies. The literature review presented in this article does not claim to be a full-fledged systematic review, not only for the rea-son that to date, only 51 works have been found at the time of writing in the databases for the keywords «thyroid and COVID-19» and «adrenal and COVID-19», after excluding duplicates, but also because these messages themselves contain little information and are mainly based on analogies with previously existing viral infections and their role in the development of hypothalamus-pituitary axis pathology-adrenal glands and hypothalamus-pituitary-thyroid.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76299790","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}
This time, the traditional column “De Gustibus” was prepared by three authors who began writing fragments of this article in late January – early February this year, once again discussing position of various departments and individuals about the development and adoption of the federal law “Prevention of iodine deficiency disorders in Russian Federation”. The fate of this unfortunate and necessary law reveals the shortcomings of education, culture, the level of scientific research, the state of prevention of non-communicable diseases, the social responsibility of business and many other problems that exist in our society. Self-interest and absurdity can become a downfall in which once again this necessary law will disappear.
{"title":"What prevents passing the law about prevention of iodine deficiency disorders in the country with iodine deficiency?","authors":"G. Melnichenko, G. Gerasimov, E. Troshina","doi":"10.14341/ket12424","DOIUrl":"https://doi.org/10.14341/ket12424","url":null,"abstract":"This time, the traditional column “De Gustibus” was prepared by three authors who began writing fragments of this article in late January – early February this year, once again discussing position of various departments and individuals about the development and adoption of the federal law “Prevention of iodine deficiency disorders in Russian Federation”. The fate of this unfortunate and necessary law reveals the shortcomings of education, culture, the level of scientific research, the state of prevention of non-communicable diseases, the social responsibility of business and many other problems that exist in our society. Self-interest and absurdity can become a downfall in which once again this necessary law will disappear.","PeriodicalId":10284,"journal":{"name":"Clinical and experimental thyroidology","volume":"286 1","pages":"162-168"},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80280686","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}
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