Pub Date : 2016-01-01Epub Date: 2016-04-24DOI: 10.1155/2016/8470252
Suna Erkilic, Fatih Celenk, Zehra Bozdag
Background. Tumor multifocality and bilaterality of papillary thyroid carcinoma (PTC) are important factors when selecting the most appropriate surgical procedure. The aim of this study was to assess the bilaterality rate in PTC and the relationship between the tumor size and bilaterality. Materials and Methods. Thyroidectomy specimens with a diagnosis of PTC were retrospectively reviewed in the Pathology Department of a tertiary care medical center. Specimens were divided into three groups according to the size of the primary and contralateral tumor foci. Tumors less than or equal to 1 cm in each lobe were included in group 1. Group 2 consisted of tumors greater than 1 cm in one lobe and less than 1 cm in the other lobe. Tumors greater than 1 cm in each lobe were included in group 3. Results. We identified 868 total thyroidectomy specimens with a diagnosis of PTC between 2001 and 2011. Of these cases, both thyroid lobes were involved in 262 cases (32%). There were 109 (42%), 121 (46%), and 32 cases (12%) in group 1, group 2, and group 3, respectively. Conclusion. Bilaterality is frequent in PTC and is not related to tumor size. Accordingly, the high frequency of bilateral disease in PTC should be kept in mind when determining the extent of the surgical procedure.
{"title":"Association between Tumor Size and Bilateral Involvement in Papillary Thyroid Carcinoma.","authors":"Suna Erkilic, Fatih Celenk, Zehra Bozdag","doi":"10.1155/2016/8470252","DOIUrl":"https://doi.org/10.1155/2016/8470252","url":null,"abstract":"<p><p>Background. Tumor multifocality and bilaterality of papillary thyroid carcinoma (PTC) are important factors when selecting the most appropriate surgical procedure. The aim of this study was to assess the bilaterality rate in PTC and the relationship between the tumor size and bilaterality. Materials and Methods. Thyroidectomy specimens with a diagnosis of PTC were retrospectively reviewed in the Pathology Department of a tertiary care medical center. Specimens were divided into three groups according to the size of the primary and contralateral tumor foci. Tumors less than or equal to 1 cm in each lobe were included in group 1. Group 2 consisted of tumors greater than 1 cm in one lobe and less than 1 cm in the other lobe. Tumors greater than 1 cm in each lobe were included in group 3. Results. We identified 868 total thyroidectomy specimens with a diagnosis of PTC between 2001 and 2011. Of these cases, both thyroid lobes were involved in 262 cases (32%). There were 109 (42%), 121 (46%), and 32 cases (12%) in group 1, group 2, and group 3, respectively. Conclusion. Bilaterality is frequent in PTC and is not related to tumor size. Accordingly, the high frequency of bilateral disease in PTC should be kept in mind when determining the extent of the surgical procedure. </p>","PeriodicalId":17394,"journal":{"name":"Journal of Thyroid Research","volume":"2016 ","pages":"8470252"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/8470252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34572373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Sharma, Lokesh Sharma, D. Dutta, A. K. Gadpayle, A. Anand, K. Gaurav, S. Mukherjee, R. Bansal
Background. Predictors of thyroid dysfunction in HIV are not well determined. This study aimed to determine the prevalence and predictors of thyroid dysfunction in HIV infected Indians. Methods. Consecutive HIV patients, 18–70 years of age, without any severe comorbid state, having at least 1-year follow-up at the antiretroviral therapy clinic, underwent clinical assessment and hormone assays. Results. From initially screened 527 patients, 359 patients (61.44 ± 39.42 months' disease duration), having good immune function [CD4 count >200 cell/mm3: 90.25%; highly active antiretroviral therapy (HAART): 88.58%], were analyzed. Subclinical hypothyroidism (ScH) was the commonest thyroid dysfunction (14.76%) followed by sick euthyroid syndrome (SES) (5.29%) and isolated low TSH (3.1%). Anti-TPO antibody (TPOAb) was positive in 3.90%. Baseline CD4 count had inverse correlation with TPOAb after adjusting for age and body mass index. Stepwise linear regression revealed baseline CD4 count, TPOAb, and tuberculosis to be best predictors of ScH after adjusting for age, weight, duration of HIV, and history of opportunistic fungal and viral infections. Conclusion. Burden of thyroid dysfunction in chronic HIV infection with stable immune function is lower compared to pre-HAART era. Thyroid dysfunction is primarily of nonautoimmune origin, predominantly ScH. Severe immunodeficiency at disease onset, TPOAb positivity, and tuberculosis were best predictors of ScH.
{"title":"Prevalence and Predictors of Thyroid Dysfunction in Patients with HIV Infection and Acquired Immunodeficiency Syndrome: An Indian Perspective","authors":"N. Sharma, Lokesh Sharma, D. Dutta, A. K. Gadpayle, A. Anand, K. Gaurav, S. Mukherjee, R. Bansal","doi":"10.1155/2015/517173","DOIUrl":"https://doi.org/10.1155/2015/517173","url":null,"abstract":"Background. Predictors of thyroid dysfunction in HIV are not well determined. This study aimed to determine the prevalence and predictors of thyroid dysfunction in HIV infected Indians. Methods. Consecutive HIV patients, 18–70 years of age, without any severe comorbid state, having at least 1-year follow-up at the antiretroviral therapy clinic, underwent clinical assessment and hormone assays. Results. From initially screened 527 patients, 359 patients (61.44 ± 39.42 months' disease duration), having good immune function [CD4 count >200 cell/mm3: 90.25%; highly active antiretroviral therapy (HAART): 88.58%], were analyzed. Subclinical hypothyroidism (ScH) was the commonest thyroid dysfunction (14.76%) followed by sick euthyroid syndrome (SES) (5.29%) and isolated low TSH (3.1%). Anti-TPO antibody (TPOAb) was positive in 3.90%. Baseline CD4 count had inverse correlation with TPOAb after adjusting for age and body mass index. Stepwise linear regression revealed baseline CD4 count, TPOAb, and tuberculosis to be best predictors of ScH after adjusting for age, weight, duration of HIV, and history of opportunistic fungal and viral infections. Conclusion. Burden of thyroid dysfunction in chronic HIV infection with stable immune function is lower compared to pre-HAART era. Thyroid dysfunction is primarily of nonautoimmune origin, predominantly ScH. Severe immunodeficiency at disease onset, TPOAb positivity, and tuberculosis were best predictors of ScH.","PeriodicalId":17394,"journal":{"name":"Journal of Thyroid Research","volume":"27 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2015-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79100781","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}
I. Ilias, V. Karagiorga, G. Paraskevas, A. Bougea, Maria Bourbouli, A. Pappa, S. Nikopoulou, E. Kapaki
Introduction. Plasma antithyroid peroxidase (anti-TPO) and anti-thyroglobulin antibodies (anti-Tg) are widely used in the diagnosis of autoimmune thyroiditis. No research has compared anti-TPO and anti-Tg both in plasma and cerebrospinal fluid (CSF) of healthy individuals vis-à-vis patients with thyroid disease. Methods. We measured anti-TPO and anti-Tg antibodies in plasma and CSF in nine subjects (mean age ± SD: 73 ± 6 years) with hypothyroidism and nine subjects (mean age ± SD: 73 ± 8 years) without thyroid disease. Results. The concentration of anti-TPO autoantibodies in CSF was very low compared to plasma in both subjects with thyroid and without thyroid disease (P = 0.007). CSF anti-Tg autoantibodies titers were very low compared to the plasma in subjects with thyroid disease (P = 0.004), whereas, in subjects without thyroid disease, this difference did not reach statistical significance (P = 0.063). Conclusions. Thyroid autoantibodies levels were low in plasma and CSF; we did not observe any transfer of thyroid autoantibodies from the peripheral blood to the CSF. Therefore, regarding Hashimoto's encephalopathy, where elevated antithyroid autoantibodies are often measured in blood, it is more likely that thyroiditis and encephalopathy represent nonspecific, but distinct, events of an aggressive immune system.
{"title":"Thyroid Autoantibodies in the Cerebrospinal Fluid of Subjects with and without Thyroid Disease: Implications for Hashimoto's Encephalopathy","authors":"I. Ilias, V. Karagiorga, G. Paraskevas, A. Bougea, Maria Bourbouli, A. Pappa, S. Nikopoulou, E. Kapaki","doi":"10.1155/2015/819072","DOIUrl":"https://doi.org/10.1155/2015/819072","url":null,"abstract":"Introduction. Plasma antithyroid peroxidase (anti-TPO) and anti-thyroglobulin antibodies (anti-Tg) are widely used in the diagnosis of autoimmune thyroiditis. No research has compared anti-TPO and anti-Tg both in plasma and cerebrospinal fluid (CSF) of healthy individuals vis-à-vis patients with thyroid disease. Methods. We measured anti-TPO and anti-Tg antibodies in plasma and CSF in nine subjects (mean age ± SD: 73 ± 6 years) with hypothyroidism and nine subjects (mean age ± SD: 73 ± 8 years) without thyroid disease. Results. The concentration of anti-TPO autoantibodies in CSF was very low compared to plasma in both subjects with thyroid and without thyroid disease (P = 0.007). CSF anti-Tg autoantibodies titers were very low compared to the plasma in subjects with thyroid disease (P = 0.004), whereas, in subjects without thyroid disease, this difference did not reach statistical significance (P = 0.063). Conclusions. Thyroid autoantibodies levels were low in plasma and CSF; we did not observe any transfer of thyroid autoantibodies from the peripheral blood to the CSF. Therefore, regarding Hashimoto's encephalopathy, where elevated antithyroid autoantibodies are often measured in blood, it is more likely that thyroiditis and encephalopathy represent nonspecific, but distinct, events of an aggressive immune system.","PeriodicalId":17394,"journal":{"name":"Journal of Thyroid Research","volume":"134 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2015-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88893319","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}
Background. The aims of this study were to assess patients' preferences to wait or start systemic treatment and understand how patients would make tradeoffs between certain severe adverse events (AEs) and additional months of progression-free survival (PFS). Materials and Methods. Adults in France, Germany, and Spain with a diagnosis of DTC and who have had at least one RAI treatment completed a direct-elicitation question and a discrete-choice experiment (DCE) online. The direct-elicitation question asked respondents whether they would opt out of treatment when their tumor is RAI-R. In the DCE, respondents chose between 12 pairs of hypothetical RAI-R DTC treatment profiles. Profiles were defined by magnitudes of efficacy (PFS) and safety (severe hand-foot skin reaction [HFSR], severe proteinuria, and severe hypertension). A main-effects random-parameters logit model was estimated. Results. 134 patients completed the survey. Most patients (86.6%) opted for treatment rather than “wait and see” decision. Patients placed a greater weight on the risk of severe hypertension than the risk of proteinuria and HFSR. Conclusions. DTC patients showed preference toward treatment for RAI-R DTC over watchful waiting. Patients' concerns about the risk of severe hypertension appeared to have had a greater effect on patients' choice than severe proteinuria or HFSR.
背景。本研究的目的是评估患者对等待或开始全身治疗的偏好,并了解患者如何在某些严重不良事件(ae)和额外数月的无进展生存期(PFS)之间做出权衡。材料与方法。在法国、德国和西班牙,诊断为DTC并至少接受过一次RAI治疗的成年人在线完成了一个直接启发问题和一个离散选择实验(DCE)。直接启发式问题询问受访者,当他们的肿瘤是rar - r时,他们是否会选择退出治疗。在DCE中,受访者在12对假设的rar - r DTC治疗概况之间进行选择。根据疗效(PFS)和安全性(严重手足皮肤反应[HFSR]、严重蛋白尿和严重高血压)来定义概况。估计了主效应随机参数logit模型。结果:134例患者完成调查。大多数患者(86.6%)选择治疗而不是“观望”决定。患者更重视严重高血压的风险,而不是蛋白尿和HFSR的风险。结论。与观察等待相比,DTC患者更倾向于rar - r DTC治疗。患者对严重高血压风险的担忧似乎比严重蛋白尿或HFSR对患者选择的影响更大。
{"title":"Patient Benefit-Risk Tradeoffs for Radioactive Iodine-Refractory Differentiated Thyroid Cancer Treatments","authors":"A. Mohamed, J. González, Angelyn O. Fairchild","doi":"10.1155/2015/438235","DOIUrl":"https://doi.org/10.1155/2015/438235","url":null,"abstract":"Background. The aims of this study were to assess patients' preferences to wait or start systemic treatment and understand how patients would make tradeoffs between certain severe adverse events (AEs) and additional months of progression-free survival (PFS). Materials and Methods. Adults in France, Germany, and Spain with a diagnosis of DTC and who have had at least one RAI treatment completed a direct-elicitation question and a discrete-choice experiment (DCE) online. The direct-elicitation question asked respondents whether they would opt out of treatment when their tumor is RAI-R. In the DCE, respondents chose between 12 pairs of hypothetical RAI-R DTC treatment profiles. Profiles were defined by magnitudes of efficacy (PFS) and safety (severe hand-foot skin reaction [HFSR], severe proteinuria, and severe hypertension). A main-effects random-parameters logit model was estimated. Results. 134 patients completed the survey. Most patients (86.6%) opted for treatment rather than “wait and see” decision. Patients placed a greater weight on the risk of severe hypertension than the risk of proteinuria and HFSR. Conclusions. DTC patients showed preference toward treatment for RAI-R DTC over watchful waiting. Patients' concerns about the risk of severe hypertension appeared to have had a greater effect on patients' choice than severe proteinuria or HFSR.","PeriodicalId":17394,"journal":{"name":"Journal of Thyroid Research","volume":"18 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2015-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73097797","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}
Rajendra Kc, S. Khatiwada, Kishun Deo Mehta, P. Pandey, M. Lamsal, S. Majhi
Objectives. To assess cardiovascular risk factors in Nepalese population with subclinical hypothyroidism as compared to age and sex matched controls. Materials and Methods. A case control study was conducted among 200 subjects (100 subclinical hypothyroid and 100 euthyroid) at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. Demographic and anthropometric variables including systolic and diastolic blood pressure (BP) were taken. Blood samples were assayed for serum free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and high sensitivity C reactive protein (hs-CRP). Results. Subclinical hypothyroid patients had significantly higher diastolic BP, total cholesterol, LDL cholesterol, and hs-CRP than controls. The odds ratio of having hypercholesterolemia (>200 mg/dL), low HDL cholesterol (<40 mg/dL), undesirable LDL-cholesterol (>100 mg/dL), high hs-CRP (>1 mg/L), and high diastolic BP (>80 mmHg) and being overweight (BMI ≥ 23 Kg/m2) in subclinical hypothyroidism was 2.29 (95% CI; 1.2–4.38, p = 0.011), 1.73 (95% CI; 0.82–3.62, p = 0.141), 3.04 (95% CI; 1.66–5.56, p < 0.001), 2.02 (95% CI; 1.12–3.64, p = 0.018), 3.35 (95% CI; 1.72–6.55, p < 0.001), and 0.9 (95% CI; 0.48–1.67, p = 0.753), respectively, as compared to controls. Conclusion. Subclinical hypothyroid patients are associated with higher risk for cardiovascular disease than euthyroid subjects.
目标。评估尼泊尔亚临床甲状腺功能减退患者的心血管危险因素,并与年龄和性别匹配的对照组进行比较。材料与方法。在尼泊尔达兰B.P.柯伊拉腊健康科学研究所对200名受试者(100名亚临床甲状腺功能减退和100名甲状腺功能正常)进行了病例对照研究。测量人口统计学和人体测量变量,包括收缩压和舒张压(BP)。检测血清游离三碘甲状腺原氨酸(fT3)、游离甲状腺素(fT4)、促甲状腺激素(TSH)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、高敏C反应蛋白(hs-CRP)。结果。亚临床甲状腺功能减退患者的舒张压、总胆固醇、低密度脂蛋白胆固醇和hs-CRP明显高于对照组。亚临床甲状腺功能减退患者高胆固醇血症(>200 mg/dL)、低高密度脂蛋白胆固醇(100 mg/dL)、高hs-CRP (>1 mg/L)、高舒张压(>80 mmHg)和超重(BMI≥23 Kg/m2)的比值比为2.29 (95% CI;1.2-4.38, p = 0.011), 1.73 (95% CI;0.82-3.62, p = 0.141), 3.04 (95% CI;1.66-5.56, p < 0.001), 2.02 (95% CI;1.12-3.64, p = 0.018), 3.35 (95% CI;1.72-6.55, p < 0.001)和0.9 (95% CI;0.48-1.67, p = 0.753)。结论。亚临床甲状腺功能减退患者发生心血管疾病的风险高于甲状腺功能正常者。
{"title":"Cardiovascular Risk Factors in Subclinical Hypothyroidism: A Case Control Study in Nepalese Population","authors":"Rajendra Kc, S. Khatiwada, Kishun Deo Mehta, P. Pandey, M. Lamsal, S. Majhi","doi":"10.1155/2015/305241","DOIUrl":"https://doi.org/10.1155/2015/305241","url":null,"abstract":"Objectives. To assess cardiovascular risk factors in Nepalese population with subclinical hypothyroidism as compared to age and sex matched controls. Materials and Methods. A case control study was conducted among 200 subjects (100 subclinical hypothyroid and 100 euthyroid) at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. Demographic and anthropometric variables including systolic and diastolic blood pressure (BP) were taken. Blood samples were assayed for serum free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and high sensitivity C reactive protein (hs-CRP). Results. Subclinical hypothyroid patients had significantly higher diastolic BP, total cholesterol, LDL cholesterol, and hs-CRP than controls. The odds ratio of having hypercholesterolemia (>200 mg/dL), low HDL cholesterol (<40 mg/dL), undesirable LDL-cholesterol (>100 mg/dL), high hs-CRP (>1 mg/L), and high diastolic BP (>80 mmHg) and being overweight (BMI ≥ 23 Kg/m2) in subclinical hypothyroidism was 2.29 (95% CI; 1.2–4.38, p = 0.011), 1.73 (95% CI; 0.82–3.62, p = 0.141), 3.04 (95% CI; 1.66–5.56, p < 0.001), 2.02 (95% CI; 1.12–3.64, p = 0.018), 3.35 (95% CI; 1.72–6.55, p < 0.001), and 0.9 (95% CI; 0.48–1.67, p = 0.753), respectively, as compared to controls. Conclusion. Subclinical hypothyroid patients are associated with higher risk for cardiovascular disease than euthyroid subjects.","PeriodicalId":17394,"journal":{"name":"Journal of Thyroid Research","volume":"23 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2015-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91077188","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}
Pub Date : 2015-01-01Epub Date: 2015-07-13DOI: 10.1155/2015/796871
Emil Moser, Tanja Sikjaer, Leif Mosekilde, Lars Rejnmark
Background. Studies on bone effects of long-term substitution therapy with levothyroxine (LT4) have shown discrepant results. Previous studies have, however, not evaluated volumetric bone mineral densities (vBMD), bone structure, and strength using high resolution peripheral quantitative computed tomography (HR-pQCT) and finite element analysis (FEA). Using a cross-sectional design, we aimed to determine whether BMD, structure, and strength are affected in hypothyroid patients on LT4 substitution therapy. Methods. We compared 49 patients with well-substituted hypothyroidism with 49 age- and gender-matched population based controls. Areal BMD was assessed by DXA, vBMD and bone geometry by HR-pQCT, and bone strength by FEA. Results. Patients had been thyroidectomized due to thyroid cancer (10%) and nontoxic (33%) or toxic goiter (57%). 82% were women. TSH levels did not differ between groups, but patients had significantly higher levels of T4 (p < 0.001) and lower levels of T3 (p < 0.01). Compared to controls, patients had higher levels of magnesium (p < 0.05), whereas ionized calcium and PTH were lower (p < 0.05). Bone scans did not reveal any differences in BMD, bone geometry, or strength. Conclusion. If patients with hypothyroidism are well-substituted with LT4, the disease does not affect bone indices to any major degree.
{"title":"Bone Indices in Thyroidectomized Patients on Long-Term Substitution Therapy with Levothyroxine Assessed by DXA and HR-pQCT.","authors":"Emil Moser, Tanja Sikjaer, Leif Mosekilde, Lars Rejnmark","doi":"10.1155/2015/796871","DOIUrl":"https://doi.org/10.1155/2015/796871","url":null,"abstract":"<p><p>Background. Studies on bone effects of long-term substitution therapy with levothyroxine (LT4) have shown discrepant results. Previous studies have, however, not evaluated volumetric bone mineral densities (vBMD), bone structure, and strength using high resolution peripheral quantitative computed tomography (HR-pQCT) and finite element analysis (FEA). Using a cross-sectional design, we aimed to determine whether BMD, structure, and strength are affected in hypothyroid patients on LT4 substitution therapy. Methods. We compared 49 patients with well-substituted hypothyroidism with 49 age- and gender-matched population based controls. Areal BMD was assessed by DXA, vBMD and bone geometry by HR-pQCT, and bone strength by FEA. Results. Patients had been thyroidectomized due to thyroid cancer (10%) and nontoxic (33%) or toxic goiter (57%). 82% were women. TSH levels did not differ between groups, but patients had significantly higher levels of T4 (p < 0.001) and lower levels of T3 (p < 0.01). Compared to controls, patients had higher levels of magnesium (p < 0.05), whereas ionized calcium and PTH were lower (p < 0.05). Bone scans did not reveal any differences in BMD, bone geometry, or strength. Conclusion. If patients with hypothyroidism are well-substituted with LT4, the disease does not affect bone indices to any major degree. </p>","PeriodicalId":17394,"journal":{"name":"Journal of Thyroid Research","volume":"2015 ","pages":"796871"},"PeriodicalIF":2.1,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/796871","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33967126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aims of this study were to evaluate the utility of shear wave elastography (SWE) using acoustic radiation force impulse (ARFI) for diagnosing chronic autoimmune thyroiditis (CAT) and to verify the effect of fibrotic thyroid tissue on shear wave velocity (SWV). The subjects were 229 patients with 253 normal thyroid lobes (controls) and 150 CAT lobes. The SWV for CAT (2.47 ± 0.57 m/s) was significantly higher than that for controls (1.59 ± 0.41 m/s) (P < 0.001). The area under the receiver operating characteristics (ROC) curve for CAT was 0.899, and the SWV cut-off value was 1.96 m/s. The sensitivity, specificity, and diagnostic accuracy were 87.4%, 78.7%, and 85.1%, respectively. Levels of anti-thyroperoxidase antibodies and thyroid isthmus thickness were correlated with tissue stiffness in CAT. However, there was no correlation between levels of anti-thyroglobulin antibodies and tissue stiffness. Quantitative SWE is useful for diagnosing CAT, and it is possible that SWE can be used to evaluate the degree of fibrosis in patients with CAT.
{"title":"Utility of Shear Wave Elastography for Diagnosing Chronic Autoimmune Thyroiditis.","authors":"Takahiro Fukuhara, Eriko Matsuda, Shoichiro Izawa, Kazunori Fujiwara, Hiroya Kitano","doi":"10.1155/2015/164548","DOIUrl":"https://doi.org/10.1155/2015/164548","url":null,"abstract":"<p><p>The aims of this study were to evaluate the utility of shear wave elastography (SWE) using acoustic radiation force impulse (ARFI) for diagnosing chronic autoimmune thyroiditis (CAT) and to verify the effect of fibrotic thyroid tissue on shear wave velocity (SWV). The subjects were 229 patients with 253 normal thyroid lobes (controls) and 150 CAT lobes. The SWV for CAT (2.47 ± 0.57 m/s) was significantly higher than that for controls (1.59 ± 0.41 m/s) (P < 0.001). The area under the receiver operating characteristics (ROC) curve for CAT was 0.899, and the SWV cut-off value was 1.96 m/s. The sensitivity, specificity, and diagnostic accuracy were 87.4%, 78.7%, and 85.1%, respectively. Levels of anti-thyroperoxidase antibodies and thyroid isthmus thickness were correlated with tissue stiffness in CAT. However, there was no correlation between levels of anti-thyroglobulin antibodies and tissue stiffness. Quantitative SWE is useful for diagnosing CAT, and it is possible that SWE can be used to evaluate the degree of fibrosis in patients with CAT. </p>","PeriodicalId":17394,"journal":{"name":"Journal of Thyroid Research","volume":"2015 ","pages":"164548"},"PeriodicalIF":2.1,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/164548","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33908721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01Epub Date: 2015-07-28DOI: 10.1155/2015/540183
Shailendra Kapoor
Recent data suggests that valproic acid (VPCA) also attenuates and limits tumor growth in a number of systemic malignancies [1]. For instance, VPCA has a suppressive effect on tumor growth in renal malignancies. Oertl et al. have recently shown that VPCA mediates this role in part by altering the expression of beta1 integrins in tumor cells [2]. VPCA also mediates this role in part by upregulating BAX expression. These changes have recently been confirmed in Caki-1 and KTC-26 cell lines. In addition, VPCA accentuates the expression of ULBP1 and ULBP2. Jones et al. have recently demonstrated that, at the same time, VPCA accentuates p21 expression [3]. Recent data also suggests that IFN-alpha accentuates the cytotoxic effects of VPCA. Cyclin B and cyclin D3 levels are also modulated by VPCA [4]. Yang et al. have recently demonstrated that VPCA also accentuates the cytotoxicity of NK cells against renal cancer cells [5]. In addition, VPCA also affects tumor cell adhesiveness thereby further attenuating tumor expansion in renal carcinomas [6]. Similarly, VPCA has an inhibitory effect on tumor growth in gastric malignancies. VPCA has a positive impact on acetyl-α-tubulin levels. It also mediates this role in part by attenuating c-Myc expression. Bcl-2 expression is downregulated concurrently. As a result, tumor cell apoptosis is markedly augmented. Zhao et al. have recently demonstrated that this is accompanied by accentuation of p21 (Waf/cip1) expression [7]. These changes have recently been confirmed in BGC-823, OCUM-2MD3, HGC-27, and SGC-7901 cell lines. In addition, VPCA has a negative impact on cyclin A as well as cyclin D1 expression. At the same time, tumor cell proliferation is markedly attenuated [8]. This is accompanied by accentuation of acetyl-histone H3 levels. G1 phase arrest is typically seen. In addition, Yagi et al. have recently demonstrated that survivin expression is significantly downregulated [9]. Mad1 expression is upregulated concurrently. p27 expression is also accentuated simultaneously. Besides the above-mentioned changes, VPCA also augments and enhances caspase 9 and caspase 3 activation thereby further abrogating tumor growth in gastric carcinomas. As is obvious from the above discussion, VPCA exhibits potent tumor growth mitigating effects. Hopefully, the coming few years will see an increase in the utilization of VPCA as an antineoplastic agent.
{"title":"Tumor Growth Mitigating Effects of Valproic Acid in Systemic Malignancies.","authors":"Shailendra Kapoor","doi":"10.1155/2015/540183","DOIUrl":"https://doi.org/10.1155/2015/540183","url":null,"abstract":"Recent data suggests that valproic acid (VPCA) also attenuates and limits tumor growth in a number of systemic malignancies [1]. \u0000 \u0000For instance, VPCA has a suppressive effect on tumor growth in renal malignancies. Oertl et al. have recently shown that VPCA mediates this role in part by altering the expression of beta1 integrins in tumor cells [2]. VPCA also mediates this role in part by upregulating BAX expression. These changes have recently been confirmed in Caki-1 and KTC-26 cell lines. In addition, VPCA accentuates the expression of ULBP1 and ULBP2. Jones et al. have recently demonstrated that, at the same time, VPCA accentuates p21 expression [3]. Recent data also suggests that IFN-alpha accentuates the cytotoxic effects of VPCA. Cyclin B and cyclin D3 levels are also modulated by VPCA [4]. Yang et al. have recently demonstrated that VPCA also accentuates the cytotoxicity of NK cells against renal cancer cells [5]. In addition, VPCA also affects tumor cell adhesiveness thereby further attenuating tumor expansion in renal carcinomas [6]. \u0000 \u0000Similarly, VPCA has an inhibitory effect on tumor growth in gastric malignancies. VPCA has a positive impact on acetyl-α-tubulin levels. It also mediates this role in part by attenuating c-Myc expression. Bcl-2 expression is downregulated concurrently. As a result, tumor cell apoptosis is markedly augmented. Zhao et al. have recently demonstrated that this is accompanied by accentuation of p21 (Waf/cip1) expression [7]. These changes have recently been confirmed in BGC-823, OCUM-2MD3, HGC-27, and SGC-7901 cell lines. In addition, VPCA has a negative impact on cyclin A as well as cyclin D1 expression. At the same time, tumor cell proliferation is markedly attenuated [8]. This is accompanied by accentuation of acetyl-histone H3 levels. G1 phase arrest is typically seen. In addition, Yagi et al. have recently demonstrated that survivin expression is significantly downregulated [9]. Mad1 expression is upregulated concurrently. p27 expression is also accentuated simultaneously. Besides the above-mentioned changes, VPCA also augments and enhances caspase 9 and caspase 3 activation thereby further abrogating tumor growth in gastric carcinomas. \u0000 \u0000As is obvious from the above discussion, VPCA exhibits potent tumor growth mitigating effects. Hopefully, the coming few years will see an increase in the utilization of VPCA as an antineoplastic agent.","PeriodicalId":17394,"journal":{"name":"Journal of Thyroid Research","volume":"2015 ","pages":"540183"},"PeriodicalIF":2.1,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/540183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34004114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01Epub Date: 2015-01-11DOI: 10.1155/2015/192736
R Dash, A Mohapatra, B S Manjunathswamy
Aim. The aim of the study was to study the relation of vitiligo with demographic data like age, sex, and duration and determine the prevalence of thyroid autoimmunity in vitiligo patients. Materials and Methods. This study was a cross sectional study consisting of 100 patients clinically diagnosed (old and new) as having vitiligo irrespective of age or sex. Patients with known thyroid disease on supplementation therapy, or who had undergone thyroid surgery, those on antithyroid medication, patients with other causes of leukoderma, and cases who do not provide informed consent were excluded from the study. Serum TSH and anti-TPO antibodies were measured in all the patients. Results. The prevalence of anti-TPO antibody positivity was found to be 28%. Conclusion. According to our study, none of our vitiligo patients had symptoms or signs of thyroid disease at the time of presentation but, on biochemical evaluation, anti-TPO antibodies were found in a considerable number of patients. Hence, we recommend screening of these patients with thyroid antibodies.
{"title":"Anti-thyroid peroxidase antibody in vitiligo: a prevalence study.","authors":"R Dash, A Mohapatra, B S Manjunathswamy","doi":"10.1155/2015/192736","DOIUrl":"https://doi.org/10.1155/2015/192736","url":null,"abstract":"<p><p>Aim. The aim of the study was to study the relation of vitiligo with demographic data like age, sex, and duration and determine the prevalence of thyroid autoimmunity in vitiligo patients. Materials and Methods. This study was a cross sectional study consisting of 100 patients clinically diagnosed (old and new) as having vitiligo irrespective of age or sex. Patients with known thyroid disease on supplementation therapy, or who had undergone thyroid surgery, those on antithyroid medication, patients with other causes of leukoderma, and cases who do not provide informed consent were excluded from the study. Serum TSH and anti-TPO antibodies were measured in all the patients. Results. The prevalence of anti-TPO antibody positivity was found to be 28%. Conclusion. According to our study, none of our vitiligo patients had symptoms or signs of thyroid disease at the time of presentation but, on biochemical evaluation, anti-TPO antibodies were found in a considerable number of patients. Hence, we recommend screening of these patients with thyroid antibodies. </p>","PeriodicalId":17394,"journal":{"name":"Journal of Thyroid Research","volume":"2015 ","pages":"192736"},"PeriodicalIF":2.1,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/192736","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33030116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01Epub Date: 2014-04-06DOI: 10.1155/2014/430510
Neelam Sood, Jitendra Singh Nigam
Background. Chronic lymphocytic thyroiditis is the second most common thyroid lesion diagnosed on FNAC after goiter. FNAC is reliable tool in the diagnosis of thyroid lesion. Objective. To correlate FNAC cytologic findings with TFT in the lymphocytic thyroiditis. Methods. 175 patients with thyroid swellings were referred for FNAC as well as TFT during 2011-2013. Fine needle aspiration cytology was performed using non-aspiration or aspiration techniques and TFT performed on Beckman culter access 2. Results. Lymphoid infiltrate was seen in 55 cases. The commonest age group of lymphocytic thyroiditis was 21-30 years with male : female ratio being 1 : 10. Anti-TPO and TSH were elevated in 96.16% (25/26) of cases with grade 3 lymphoid infiltrate, 94.12% (16/17) of cases with grade 2, and 91.67% (11/12) of cases with 1 grade. Increased anti-TPO with raised TSH without any lymphoid infiltrate was seen in 5 cases and 5 cases showed only raised TSH without raised anti-TPO and without any lymphoid infiltrate. We observed that grade 3 lymphocytic infiltration has correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. We also observed that anti-TPO and TSH together are significant even if no lymphocytic infiltration is present. Conclusion. Grade 3 lymphocytic infiltration has statistical correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. Anti TPO was adjunct to TSH in grade 3. The presence of Hurthle cell change, giant cells, and granulomas has no statistical correlation with lymphocytic thyroiditis.
{"title":"Correlation of fine needle aspiration cytology findings with thyroid function test in cases of lymphocytic thyroiditis.","authors":"Neelam Sood, Jitendra Singh Nigam","doi":"10.1155/2014/430510","DOIUrl":"https://doi.org/10.1155/2014/430510","url":null,"abstract":"<p><p>Background. Chronic lymphocytic thyroiditis is the second most common thyroid lesion diagnosed on FNAC after goiter. FNAC is reliable tool in the diagnosis of thyroid lesion. Objective. To correlate FNAC cytologic findings with TFT in the lymphocytic thyroiditis. Methods. 175 patients with thyroid swellings were referred for FNAC as well as TFT during 2011-2013. Fine needle aspiration cytology was performed using non-aspiration or aspiration techniques and TFT performed on Beckman culter access 2. Results. Lymphoid infiltrate was seen in 55 cases. The commonest age group of lymphocytic thyroiditis was 21-30 years with male : female ratio being 1 : 10. Anti-TPO and TSH were elevated in 96.16% (25/26) of cases with grade 3 lymphoid infiltrate, 94.12% (16/17) of cases with grade 2, and 91.67% (11/12) of cases with 1 grade. Increased anti-TPO with raised TSH without any lymphoid infiltrate was seen in 5 cases and 5 cases showed only raised TSH without raised anti-TPO and without any lymphoid infiltrate. We observed that grade 3 lymphocytic infiltration has correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. We also observed that anti-TPO and TSH together are significant even if no lymphocytic infiltration is present. Conclusion. Grade 3 lymphocytic infiltration has statistical correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. Anti TPO was adjunct to TSH in grade 3. The presence of Hurthle cell change, giant cells, and granulomas has no statistical correlation with lymphocytic thyroiditis. </p>","PeriodicalId":17394,"journal":{"name":"Journal of Thyroid Research","volume":"2014 ","pages":"430510"},"PeriodicalIF":2.1,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/430510","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32325511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}