Hormones最新文献

Introduction

Computerized thoracic tomography (CT) imaging was extensively employed, especially in the early months of the COVID-19 pandemic. An incidental thyroid nodule (ITN) is defined as a nodule not previously detected or suspected clinically but identified via an imaging study. The present study aimed to determine the incidence of thyroid nodules incidentally detected in thoracic CTs for the suspicion of COVID-19 pneumonia.

Materials and methods

Adult patients who underwent thoracic CT in our hospital for COVID-19 management were retrospectively identified between March 2020 and September 2020. Medical information registered in the hospital and national health system was reviewed. The prevalence of incidental thyroid nodules at CT, thyroid function test results of patients with incidental lesions, correlation of CT findings with ultrasonography (US) findings, and fine-needle aspiration biopsy (FNAB) results were evaluated.

Results

We analyzed 35,113 patients who had COVID-19-indicated CT scans. There was information about the thyroid gland in CT reports of 3049 patients. The prevalence of ITN was 3.82% (1343/35,113 patients) and thyroid heterogeneity was 1.11% (388/35,113 patients). While it was explicitly stated that no pathology was found in the patient’s thyroid gland in 3.75% of patients (1318/35,113), no information was given about the thyroid gland in 91.32% of the patients (32064/35,113). Thus, the number of patients informed about their thyroid was 3049 (8.68%) and the number of patients with thyroid pathology was 1731 (4.93%). It was observed that 308 of 1731 patients (17.80%) had follow-up thyroid US. An FNAB was indicated in 238 patients (87.50%). Of the 238 patients with indication for biopsy, only 115 (48.31%) underwent a thyroid FNAB. The cytological diagnosis was benign in 59 (51.30%), non-diagnostic in 30 (26.08%), atypia of uncertain significance in 22 (19.13%), and suspected follicular neoplasia/follicular neoplasia in four patients (3.46%). Thyroidectomy was performed in six more patients due to large nodules and the final diagnosis was benign in two and papillary thyroid cancer in three patients.

Conclusion

Increased use of thoracic CT during the COVID-19 pandemic probably enabled improved detection of ITNs. In this large-scale study, the prevalence of thyroid nodules reported with thoracic CT was 3.82%, while thyroid cancer was detected in 1.30% of patients evaluated with US. We recommend against using thoracic CT scans as a direct means of assessing thyroid disease owing to the low number of detected cancer cases in our cohort of 35,113 patients. However, thoracic CT scans obtained for various reasons might provide the opportunity for early diagnosis and treatment of thyroid disease, including cancers.

Beta thalassemia is the most common genetic blood disorder, characterized by reduced production or complete absence of beta-globin chains. The combination of systematic red blood cell transfusion and iron chelation therapy is the most readily available supportive treatment and one that has considerably prolonged the survival of thalassemia patients. Despite this, the development of endocrine abnormalities correlated with beta thalassemia still exists and is mostly associated with iron overload, chronic anemia, and hypoxia. A multifactorial approach has been employed to investigate other factors involved in the pathogenesis of endocrinopathies, including genotype, liver disease, HCV, splenectomy, socioeconomic factors, chelation therapy, and deficiency of elements. The development of specific biomarkers for predicting endocrinopathy risk has been the subject of extensive discussion. The objective of the present narrative review is to present recent data on endocrinopathies in beta thalassemia patients, including the prevalence, the proposed pathogenetic mechanisms, the risk factors, the diagnostic methods applied, and finally the recommended treatment options.

Background

The association between total testosterone (T) and chronic obstructive pulmonary disease (COPD), remains poorly understood. We aim to investigate this association and how it varies by smoking status, body fatness, and race/ethnicity in a nationally representative sample of American men.

Methods

Data included a full sample (NHANES 1988–1991, 1999–2004, 2011–2012) and subset sample (excluding 2011–2012, no estradiol and SHBG levels available) of 2748 and 906 men (≥20 years), respectively. COPD was measured by self-report or spirometry test. Total T (ng/mL) was measured among men who participated in a morning examination session. Weighted multivariable-adjusted logistic regression models were conducted.

Results

Low T was positively associated with self-reported COPD in the full sample (OR = 2.10, 95% CI = 1.18–3.74, P_trend = 0.010), and when stratified by current smokers and body fatness. When examined across race and ethnicity strata, this association persisted among White men (OR = 2.50, 95% CI = 1.30–4.79, P_trend = 0.002) but not among Hispanic or Black men. In the subset sample, low T was positively associated with self-reported COPD (OR = 1.42, 95% CI, 0.57,3.55, P_trend = 0.04), including among smokers and White men, but not body fatness. No significant associations were observed with COPD defined with spirometry plus self-report.

Conclusion

Low levels of T were associated with an increased prevalence of self-reported COPD in the full and subset samples. Similar associations were observed after stratifying by smoking status, body fatness, and race/ethnicity in the full sample and subset sample. Prospective studies are warranted to confirm these significant associations among understudied and underserved populations.