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NPs play a pivotal role in caring for pregnant people. This article provides an overview of gestational and postpartum thyroid disorders, including their assessment, management, and indications for referral. The goal of this article is to help providers better assess and manage thyroid disorders during pregnancy and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Pregnant women are more susceptible to iron deficiency (ID), and it can lead to several maternal and perinatal adverse effects. There are some published data on the effect of ID on thyroid function, but none of the studies were conducted in sub-Saharan African countries including Sudan. This study was conducted to investigate association between ID (ferritin < 15 µg/L) and thyroid functions [thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4)] among Sudanese women in the first trimester of pregnancy. Method: A cross-sectional study was conducted in Saad Abuelela Maternity Hospital, Sudan. Obstetric/sociodemographic characteristics were gathered through questionnaires. Hemoglobin, serum ferritin, TSH, FT3, and FT4 were measured in all pregnant women. Continuous variables were compared with either independent sample t-test if they were normally distributed, or with Mann–Whitney U- test if they were not-normally distributed. Spearman correlations were performed between the continuous variables. Results: In total, 127 pregnant women with mean [standard deviation (SD)] age of 27.0 (5.5) years and gestational age of 10.5 (3.0) weeks, respectively, were enrolled in this study. Forty-seven (37.0%) of these 127 women had ID. While the median [interquartile range (IQR)] of the parity, TSH, and FT3 were not different between women with ID and women without ID, the median (IQR) of FT4 was significantly lower in women with ID compared with women without ID [1.020 (0.910‒1.120) vs. 1.095 (0.990‒1.217) pmol, P = 0.014]. Serum ferritin was inversely correlated with FT3, (r = -0.225, P = 0.011). There was no significant correlation between serum ferritin, TSH, and FT4. Conclusions: Iron deficiency was common during the first trimester of pregnancy and was associated with thyroid dysfunctions. Therefore, ID should be evaluated to avoid thyroid dysfunction. [ABSTRACT FROM AUTHOR]

Thyroid disorders are common in older people and cause significant morbidity. There may be fewer symptoms at presentation and increased susceptibility to adverse events, making diagnosis and management more challenging. The approach to management of thyroid disorders in older people differs from that for younger individuals. Factors that need to be considered include frailty, concurrent illness, polypharmacy, drug–drug interactions, and target organ sensitivity to treatment. This review discusses the clinical presentation, pathophysiology, and management of thyroid disorders and the effects of medications on thyroid function in older people. [ABSTRACT FROM AUTHOR]

Differential diagnosis is important for clinical management of cases with thyroid diseases. We aimed to find the most useful diagnostic panel including immunohistochemistry markers and BRAF 600E mutation for papillary thyroid carcinoma. The study included 99 papillary thyroid carcinoma, 95 benign thyroid disease and 6 well differentiated tumour of uncertain malignant potential cases. Three groups were compared for immunohistochemistry marker expressions (CK19, Gal-3, HBME-1, p63, CD56). Diagnostic contribution of BRAF V600E mutation and its relationship with the immunohistochemistry and prognostic parameters were evaluated. CK19, Gal-3, HBME-1 and p63 positivity and loss of CD56 expression were significantly higher in papillary thyroid carcinoma than in benign thyroid disease. Gal-3 was the most useful marker to differentiate both papillary thyroid carcinoma and well-differentiated tumour of uncertain malignant potential cases from benign thyroid disease. CK19&HBME-1 and CK19&-Gal-3 dual panels had the highest sensitivities and high specificities for distinguishing papillary thyroid carcinoma from benign thyroid disease. Moreover, CK19&Gal-3 dual panel had the highest sensitivity and specificity to distinguish well-differentiated tumour of uncertain malignant potential from benign thyroid disease. In addition, CK19&Gal-3&HBME-1 was the most sensitive triple panel in differentiating both papillary thyroid carcinoma and well-differentiated tumour of uncertain malignant potential cases from benign thyroid disease. When combined with immunohistochemistry markers, the BRAF V600E reduced sensitivities and increased specificities towards malignancy, and it was not associated with prognostic parameters except for histological subtypes. [ABSTRACT FROM AUTHOR]

Introduction: Fine needle aspiration (FNA) is recognized worldwide as the primary diagnostic method for evaluating thyroid nodules. Samples collected by FNA can be spread directly onto slides, prepared for cell blocks, or processed as liquid-based cytology. Advocates of the traditional smear technique emphasize that background material such as colloid, cell sequencing characteristics in cell clusters, and cellularity is important in cytological diagnosis. They state that these properties are not observed in liquid-based liquids. Liquid-based cytology techniques aim to provide standardized slides of homogeneous cellular smears with well-preserved cell morphology, producing more precise visualization, shorter interpretation time, and more reproducible results. This study aimed to investigate and compare the diagnostic performance of liquid-based thyroid FNA samples prepared with SurePath and Cytospin over the last 6 years. Methods: Patients who underwent ultrasound-guided FNA between January 2015 and December 2021 were included in the study. Cytology reports, pathology reports, and demographic information of the patients were collected from the Hospital Information Management System. The programs "SPSS for Windows 21" and "MedCalc Diagnostic Test Evaluation Calculator" were used for data analysis. Chi-square tests were used in crosstab analysis. The Kolmogorov-Smirnov two-sample test, two proportions test, and the confidence interval tests were used to analyze the variables of the methods. P <.05 was considered statistically significant. Results: The study population comprised 4,855 patients, 83.8% female and 16.2% male. There were no statistical differences in age and gender distribution in the population of both methods. Nondiagnostic outcome rates were 11.2% for SurePath and 12.8% for Cytospin. Sensitivity, specificity, and accuracy values for SurePath and Cytospin methods were determined as 58.57%, 98.28%, and 91.12% and 79.07%, 96.88%, and 94.03%, respectively. Conclusion: In our study, although the qualitative analytical results were slightly in favor of the cytospin method, we think both ways can be used safely, especially in hospitals where the clinics performing sampling activities are variable and many, as well as in pathology laboratories where the workload is intense. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the differences in hemogram parameters, especially in inflammatory markers and perinatal and neonatal outcomes of pregnant women with thyroid disease, and to examine the effects of these differences on pregnancy outcomes. Material and Methods: The data of 80 pregnant women diagnosed with thyroid disease according to the American Thyroid Association (ATA) criteria at the first admission between 2016 and 2019 and 100 pregnant women whose thyroid hormone levels were within the normal reference range were retrospectively analyzed. Obstetric outcomes such as type and time of delivery, and the presence of additional disease during pregnancy, and neonatal outcomes such as weight, gender, and Apgar score at birth were compared. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC) count, and hemoglobin (Hb) and mean platelet volume (MPV) values, which are accepted as inflammation markers, were also compared between groups. Results: There was no significant difference between hypothyroid and hyperthyroid pregnant women in terms of Hb (p=0.319) and PLR (p=0.341) values. Third-trimester WBC (p=0.015) values were higher and MPV (p=0.007) values were lower in the hypothyroid pregnant women compared to the control group. The highest NLR (p=0.005) value was observed in the hypothyroid group. Comorbidities were found to be 27.4% (n=20) in the hypothyroid group, 14.3% (n=1) in the hyperthyroid group, and 1.0% (n=1) in the control group (p<0.001). Conclusion: Pregnant women with thyroid disease may have differences in hemogram parameters, especially in inflammatory markers, and these differences may affect pregnancy outcomes. [ABSTRACT FROM AUTHOR]

The article presents answers to a clinical quiz about faltering growth and sleepiness on peritoneal dialysis.

Thyroid function tests are commonly requested on children and young people in primary and secondary care settings. These tests include markers of thyroid function including thyroid stimulating hormone (TSH) and free thyroxine (FT4) concentrations. This short article aims to equip the reader to interpret them correctly. Not all biochemical parameters outside the reference range will require therapeutic intervention and there are a number of potential associated pitfalls. For example, a set of thyroid function test results may not be a cause for concern in one setting but require immediate action in another clinical context. Understanding whether abnormal thyroid function is cause or consequence and gaining insight into the likely underlying natural history are components of good clinical care. Knowing when not to treat abnormal thyroid function can be as important as knowing when treatment is required. [ABSTRACT FROM AUTHOR]

Congenital hypothyroidism is one of the most common causes of preventable intellectual disability in the UK and worldwide. Early diagnosis is critical to allow for early intervention. At present, 1 in 2000 to 1 in 3000 babies born in the UK have congenital hypothyroidism. Of these, most will not display any clinical manifestations or symptoms in the first few weeks of life. In short, babies will develop intellectual disability if they go undiagnosed. It is therefore no surprise that the day 5 blood spot is essential for good outcomes and harm reduction. Diagnosis of thyroid disorder is based on measuring the thyroid hormones and thyroid stimulating hormone levels. The most common cause of congenital hypothyroidism is an abnormality in thyroid gland development (dysgenesis) but it may also be the result of a defect in thyroid hormonogenesis or may be temporary as a result of maternal medications passing through the placenta, maternal blocking antibodies or iodine excess or deficiency. Rarely, it is the result of pituitary or hypothalamic abnormality when it is called central or secondary/tertiary hypothyroidism. This short article offers practical advice on how to diagnose and treat congenital hypothyroidism and how to interpret the results of available biochemical tests. [ABSTRACT FROM AUTHOR]

Objective We evaluated the intraday changes of thyroid function biomarkers in healthy subjects to help clinicians diagnose thyroid diseases in appropriate timing. Methods Blood samples were collected from 31 subjects at 0:00, 4:00, 8:00, 12:00, 16:00 and 20:00 on the sampling day and analyzed for thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free T3 (FT3), and free T4 (FT4). The intraday concentration changes were analyzed using Friedman's 2-way analysis of variance by ranks. Results The concentrations of TSH, T3, T4, FT3, and FT4 in males were significantly higher than those in females (P  < .01). The obvious peak circadian rhythm of TSH was observed at 0:00 AM with gradual decline thereafter, whereas other biomarkers showed no rhythmic changes. Conclusion Sex differences should be considered in interpreting thyroid function tests. It is important to select the sampling time according to the clinician's diagnostic needs, especially at night when TSH secretion peaks. [ABSTRACT FROM AUTHOR]

Background: Ethanol ablation for the treatment of thyroid cysts has been well documented in the literature as a safe, effective treatment option in the elective setting. This study demonstrates the use of ethanol ablation in the emergency setting. Methods: Three patients presenting with airway-threatening compressive symptoms secondary to a thyroid cyst were treated with ethanol ablation within 24 hours of presentation to hospital. Results: All patients had symptom resolution at a median of nine months follow up post procedure. Sixty-six per cent of patients required only one treatment. There was a median of 100 per cent radiological resolution of the cystic component. The median Glasgow Benefit Inventory score was +27.7, similar to that for tonsillectomy. Conclusion: Ethanol ablation is a safe, cost-effective and efficient treatment option for thyroid cysts in the acute setting. [ABSTRACT FROM AUTHOR]

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. Patients with nonfunctioning pituitary adenoma (NFPA) can present with different types of thyroid disorders, which are easily misdiagnosed or missed and can even result in serious clinical consequences. This study was to summarize the different types of thyroid disorders in patients with NFPA with the aim of providing references for the diagnosis and treatment of such patients. Materials and Methods. The data of pituitary adenoma (PA) patients who underwent surgical treatment at Xuanwu Hospital, Capital Medical University, from 2017 to 2021 were retrospectively analyzed, and NFPA patients with preoperative thyroid disorders were screened out to analyze their imaging, endocrine, treatment, and prognosis data. Also, thyroid disorders were classified to summarize diagnostic methods and treatment principles for different types of thyroid disorders. Results. A total of 399 NFPA patients were included in this study, of which 67 (16.8%) had thyroid disorders before surgery. Fifty-four patients had (13.5%) central hypothyroidism (CH) caused by NFPA and were treated with levothyroxine (L-T4) supplementation before and after operation. Eleven patients (2.8%) had primary hypothyroidism and were treated with L-T4 during the perioperative period, and long-term treatment of primary hypothyroidism was provided after surgery. Two NFPA patients (0.5%) were combined with primary hyperthyroidism and treated with medication for primary hyperthyroidism after tumor resection. Conclusion. Thyroid disorders are relatively common in patients with NFPA, but are difficult to be diagnosed due to their different types. CH is the most common type of thyroid disorder, which requires aggressive L-T4 supplementation during the preoperative period. The primary disease of the thyroid gland is easily missed when NFPA is combined with primary hypothyroidism or primary hyperthyroidism, and the thyroid function test results require to be analyzed carefully for continued treatment for thyroid disease after resection of the NFPA. [ABSTRACT FROM AUTHOR]

Background: It is difficult to detect optic nerve changes in patients with thyroid-associated ophthalmopathy (TAO) before the development of optic neuropathy. Purpose: To detect changes in the intraorbital segment of the optic nerve in patients with TAO using diffusion tensor imaging (DTI) and determine any correlations with disease severity. Material and Methods: A total of 74 participants (17 normal, 22 mild, and 35 moderate-severe TAO) were organized to be given 3-T DTI to measure fractional anisotropy (FA) and mean diffusivity (MD) for the orbital segments of their optic nerves. All underwent ophthalmological examinations for visual acuity, intraocular pressure, exophthalmos, and fundoscopy, and were assessed based on the Clinical Activity Score (CAS). Univariate analysis of variance and Pearson's correlation coefficients were carried out. Results: Patients with moderate-to-severe TAO had significantly lower FA values and higher MD values (P < 0.05). FA values were negatively correlated with CAS but had no obvious correlations with the degree of exophthalmos. MD values had no obvious correlations with CAS or the degree of exophthalmos. Conclusion: DTI parameters of the intraorbital optic nerves were significantly altered in moderate-to-severe patients before onset of clinical optic nerve dysfunction and may, therefore, be used as an imaging biomarker for assessing the disease. [ABSTRACT FROM AUTHOR]

The article presents the discussion on revised recommendations for celiac disease (CD) screening and biopsy including consideration of a serology-based diagnostic approach. Topics include expanded section on skin disorders showing continuous glucose monitoring (CGM)-related and insulin pump-related skin issues; and screening for thyroid disease by measurement of TSH, anti-thyroid peroxidase antibodies and anti-thyroglobulin antibodies.

This study presents to evaluate patients with malignant or operated for benign reasons in terms of the Eastern Black Sea region of Turkey which is an endemic region of Goiter. Within the scope of the study, 460 patients over the age of 18 who applied to the RecepTayip Erdoğan University Training and Research Hospital General Surgery Outpatient Clinic between January 2013 and July 2016 and underwent total thyroidectomy or hemithyroidectomy for benign or malign reasons were retrospectively analyzed. Age, gender, TSH values of the patients, preoperative (preop.) Thyroid or neck ultrasonography (USG) reports, thyroid fine-needle aspiration biopsy (FNAB) results, and pathological/morphological examination results were evaluated. 352 of 460 patients were women (76.5%) and the mean age of all patients was calculated as 52.2 (± 11.39). 70 cases (18%) non-diagnostic cytology, 104 cases (26.8%) benign cytology, 59 cases (15.2%) atypia of uncertain significance, 61 cases (15.7%) suspicion of follicular neoplasia/neoplasia, 78 cases (20.1%) were suspected of malignancy and 16 cases (4.1%) were detected as malignant cytology. While malignancy was diagnosed histopathologically in 248 of 352 female patients who were operated on (70.5%), malignancy was detected in 81 of 108 male patients (75%). The most common thyroid papillary microcarcinoma (51.5%) was observed in histopathological examination. While tumor diameter was <1cm in 53% of patients, the multifocality was detected in 57.3%. When comparing the results of patients who underwent thyroidectomy in our city, and its surroundings where is an endemic goiter region, with the results in the literature, it showed heterogeneity, and our study was found to be above the rate of malignancy in the histopathological examination of Turkey and the world average. [ABSTRACT FROM AUTHOR]

Copyright of Namık Kemal Tıp Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tuberculosis (TB) of the thyroid gland is extremely rare, even in areas where the prevalence of TB is very high. Only a few such cases have been reported in the literature. The clinical course may resemble toxic goiter or acute thyroiditis. We report the case of a 23-year-old male who presented with painless swelling of the thyroid gland associated with mild fever and weight loss. On ultrasound neck, a large echogenic solid lesion was seen. Fine-needle aspiration cytology was suggestive of colloid goiter, but histopathology study suggested TB of the thyroid gland along with colloid goiter. We report this case to emphasize that TB of the thyroid gland, although rare, should be kept in the differential diagnosis of thyroid nodules, especially in countries such as India which are endemic for TB. [ABSTRACT FROM AUTHOR]

Objective: Data about the impact of Cushing's syndrome (CS) on thyroid is scarce. We aimed to identify the prevalence of thyroid diseases in patients with CS. Patients and Methods: Nineteen patients with CS and 40 healthy participants were included in the study. All patients were tested for free tri-iodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), anti-thyroglobulin (anti-Tg), and antithyroid peroxidase (anti-TPO) levels, and thyroid ultrasonography (US). Results: Overt hypothyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism was evident in 5.3%, 5.3%, and 21.1% of patients with CS; and 2.5%, 7.5%, and 15% of healthy subjects, respectively. fT3 and fT4 levels were lower in patients with CS. None of the patients with CS and 27.5% of the control group had autoimmune thyroid disease (AITD), which was demonstrated by both US findings and anti-TPO positivity (P=0.01). Frequency of thyroid nodule was 52.6% and 52.5% in patients with CS and controls, respectively (P=0.99). Conclusion: The prevalence of thyroid dysfunction, nodular thyroid disease, and goiter is comparable to healthy population. However, AITD is less prevalent among patients with CS. Although, hypercortisolism has an impact on hypothalamic-hypophyseal-thyroid axis, its clinical implication does not seem to be significant. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the characteristics of incidental findings (IFs) on computed tomography (CT) scans of trauma admissions, examine associations between IFs and gender and age-groups, and discuss the management strategies. Methods: The CT reports were retrospectively reviewed to evaluate IFs. Cases were divided into five age-groups (0--19, 20--39, 40--59, 60--79, ≥ 80). IFs were classified as "Group 1": congenital anomalies that do not require further investigation, nondegenerative/minor degenerative findings; "Group 2": findings that do not require immediate intervention, require outpatient follow-up/in case of symptoms; and "Group 3": findings that require immediate intervention/further investigation. Results: There were 2385 CT scans and 1802 incidental findings (IFs) in 783 trauma cases. CT scans with IFs constituted 50.2%. The percentage of IFs was 75.6% in males and 24.4% in females, and they occurred in 4.8%, 27.6%, 44.3%, 20.9%, and 2.4% of age groups 1 to 5, respectively. Group 1 had 34.6%, group 2 had 54.6%, and group 3 had 10.8% IFs. There was not any significant association between the classification and gender or age-groups. In terms of organs, IFs of the thyroid and gall bladder & bile ducts were significantly higher among females (P = 0.044 and P < 0.001, respectively), while IFs in the head & neck region were significantly higher in males (P < 0.001). Incidental findings in the kidney, liver, adrenal gland, and vascular structures differed significantly across age-groups (P < 0.05). Conclusion: There were no significant relationships between the classification of IFs and gender or age-groups. However, the distribution of IFs was significantly associated with gender and age-groups in terms of organs. Healthcare professionals should consider this relationship when following up and treating patients. [ABSTRACT FROM AUTHOR]

Objective: To study whether maternal thyroid disease in pregnancy is associated with pubertal timing in sons and daughters.Design: Cohort study.Setting: National birth cohort and health registers.Patient(s): A total of 15,763 mothers and children from the Danish National Birth Cohort and its Puberty Cohort.Intervention(s): Register-based and self-reported information on maternal thyroid diseases during pregnancy (hyperthyroidism, hypothyroidism, benign goiter, or no thyroid disease [reference group]).Main Outcome Measure(s): The adjusted mean age difference (months) at attaining several self-reported pubertal milestones collected every 6 months using an interval-censored regression and the average difference in age at attaining all pubertal milestones using the Huber-White robust variance estimation (primary outcome).Result(s): Sons of mothers with hyperthyroidism had earlier pubertal development (average difference, -2.9 [95% confidence interval (CI), -5.0 to -0.7] months) than unexposed sons. Maternal hypothyroidism was not associated with pubertal development in sons (average difference, -1.2 [95% CI, -5.1 to 2.7] months). We observed nonstatistically significant indications of earlier pubertal development in sons of mothers with benign goiter (average difference, -1.9 [95% CI, -4.6 to 0.9] months). Maternal thyroid disease was not associated with pubertal development in daughters (average difference (months), hyperthyroidism, -0.8 [95% CI, -2.8 to 1.2]; hypothyroidism, 0.3 [95% CI, -3.1 to 3.8]; and benign goiter, 0.7 [95% CI, -2.0 to 3.4]).Conclusion(s): We found indications of earlier pubertal development in sons of mothers with hyperthyroidism. More research is needed to further investigate the observed sex-specific association. [ABSTRACT FROM AUTHOR]

Fine-needle aspiration cytology is considered the gold standard screening test in the evaluation of a thyroid nodule. We studied whether cell block cytology can be used in addition to conventional smears for the evaluation of tissue from fine-needle aspirations or fluid aspirations and also compared it with histopathological diagnosis. Aims: The primary aim of this study was to know the utility of cell blocks in the diagnosis of thyroid lesions. Settings and Design: This was a prospective observational study conducted from June 2018 to September 2020 at a tertiary Care Hospital in Eastern India. Ethical approval was obtained from the Ethics Committee of the institution. Patients above 18 years who presented with goiter were included in the study. Thirty patients were enrolled in the study after informed consent. Methods and Material: Smears prepared from the aspirates were stained with Leishman-Giemsa (LG) and Pap stain. The remnant from the needle hub was transferred to a sterile container. Cell blocks were prepared from the remnants. Smears were scored based on cell obscuration by blood, cellularity, cell degeneration, and cell architecture. The results were compared with histopathology. Statistical Analysis Used: Data were recorded using Microsoft Excel. Descriptive statistics, frequency, and proportion were used to describe demographic variables. Results: The majority of the patients (23.3%) were in their third decade of life, followed by 16.7% of the patients in their fourth and fifth decades. The patient age ranged from 25 to 80 years, with a mean age of 50.83 years and a standard deviation of 16.72. The largest number of patients were females accounting for 80% (24/30) of the total participants. The majority of the patients (36.7%) (11/30) had thyroid gland enlargement for a period of 15 days to three months. 14% of the participants were not able to recall its duration. The majority (60%) (18/30) had left lobe lesions, followed by 33.3% (10/30) who had right lobe lesions, and 6.7% (2/30) who had bilateral lobe swelling. The mean size of the lesion was 2.84 cm. 50% were found to be Bethesda II lesions, while 13.3% were Bethesda IV, and 36.7% were found to be Bethesda VI lesions. The cell block score (7) was found to be better compared to Fine Needle Aspiration Cytology (FNAC) (4.7). Tissue Coagulum Clot and Clot Scrape methods were found to yield better results compared to the Cytocentrifuge method. The P value was found to be significant (<0.001). Conclusions: Cell blocks were found to improve the cell morphology compared to FNAC alone and can be used as an adjunct to FNAC in the diagnosis of various thyroid lesions. [ABSTRACT FROM AUTHOR]

The aim of the study: the present study is to evaluate the accuracy of fine needle aspiration cytology (FNAC) of thyroid swellings and to correlate with histopathological findings to avoid unnecessary surgeries for benign lesions. Methods: this is a prospective study. A total of 55 cases were studied in the Department of Pathology at A.C.S Medical College and Hospital. Fine needle aspiration cytology was done and correlated with histopathological examination. Sensitivity, specificity, and accuracy were calculated. Results: majority were noted among 41-50 years (60 %). Females i.e., 78.1 % (43/55) outnumbered males 21.8 % (12/55). Solitary nodule thyroid in Right lobe is 54.5 % (30/55) and left lobe is 45.4 % (25/55). In the present study 65.4 % (36/55) presented with symptoms for 1month -- 1 year. Non neoplastic lesions constituted 76.3 % (42/55) in our study on FNAC. Among non-neoplastic lesions, nodular goiter was most reported and constituted 36.6 % (20/55). Neoplastic lesions constituted 23.6 % (13/55) and among neoplastic lesions follicular neoplasm occupied 9.09 % (05/55). Nodular goiter was most reported and constituted 29.0 % (17/55). Follicular adenoma occupied 20 % (11/55), 9.09 % (05/55) as PTC and 5.4 % (02/55) reported as follicular carcinoma. 1.8 % (01/55) each reported as medullary carcinoma and anaplastic carcinoma. Non-neoplastic lesions constituted 76.3 % (42/55) in our study on FNAC and neoplastic lesions constituted 23.6 % (13/55). Conclusion: FNAC is a minimally invasive, highly accurate and cost-effective procedure. FNAC helps the clinician to diagnose malignant lesions with confidence. It has high rates of specificity and accuracy but comparatively has less sensitivity to diagnose the solitary thyroid nodule. However, it is an important diagnostic tool for further management of patients with thyroid swelling [ABSTRACT FROM AUTHOR]

Background: This research aims to find out which radiopharmaceutical is more efficient to evaluate thyroid lesions, such as hyperthyroidism, Graves' disease (GD), or even cold or hot thyroid nodule identification (is 99mtechnetium [99mTc] or 123iodine [123I] suitable in this case?). Materials and Methods: An extensive computerized search was done by the authors, revealing 61 studies in total. 49 studies were excluded for various reasons, so only 12 were eligible for inclusion in this review. Results: Majority of the studies suggested that the use of 99mTc over 123I. 99mTc is a suitable choice to evaluate thyroid disorders. However, 123I can be broadly used in assessing thyroid functions, detecting malignancy and causes of thyrotoxicosis, calculating therapeutic dosages of 131I, and identifying cold or hot lesions effectively due to its superior accumulation in thyroid. Conclusion: 99mTc is a nonphysiologic compound widely used to evaluate thyroid abnormalities, and it has a noticeably low biodistribution in the thyroid. On the other hand, 123I is an organic compound with excellent biodistribution that is used to gather further information on thyroid functions and susceptibility and prevalence of toxic adenoma, GD, and cold or hot thyroid nodule evaluation. [ABSTRACT FROM AUTHOR]

There are many thyroid diseases affecting people all over the world. Many diseases affect the thyroid gland, like hypothyroidism, hyperthyroidism, and thyroid cancer. Thyroid inefficiency can cause severe symptoms in patients. Effective classification and machine learning play a significant role in the timely detection of thyroid diseases. This timely classification will indeed affect the timely treatment of the patients. Automatic and precise thyroid nodule detection in ultrasound pictures is critical for reducing effort and radiologists' mistake rate. Medical images have evolved into one of the most valuable and consistent data sources for machine learning generation. In this paper, various machine learning algorithms like decision tree, random forest algorithm, KNN, and artificial neural networks on the dataset create a comparative analysis to better predict the disease based on parameters established from the dataset. Also, the dataset has been manipulated for accurate prediction for the classification. The classification was performed on both the sampled and unsampled datasets for better comparison of the dataset. After dataset manipulation, we obtained the highest accuracy for the random forest algorithm, equal to 94.8% accuracy and 91% specificity. [ABSTRACT FROM AUTHOR]

Background & Aims: Thyroid disorders including hypothyroidism and hyperthyroidism are common condition in the world and the right diagnosis and treatment are important. Now a days screening for thyroid dysfunction recommend only in a specific situation, thus unnecessary tests could have undesirable outcomes such as improper sampling and costs related to long-term follow-up which could affect patients and health system. (5-10. Except for cases of inappropriate doing thyroid function tests, it should be noted that TSH measurement alone has a high sensitivity for the initial investigation and diagnosis of thyroid diseases (7, 10) so, in context of abnormal TSH it is necessary to measure other thyroid hormones. It is worth mentioning that in the case of hospitalized patients, thyroid laboratory disorders are more common without the presence of thyroid gland homeostasis disorder (11), which shows the necessity of paying more attention to the target population in requested examinations. Therefore, according to the importance of the subject, the present study investigated the request patterns of thyroid function tests and the logical cases of their request in Tehran's Firouzgar Hospital affiliated to Iran University of Medical Sciences, during the second 6 months of 2017. In this cross-sectional study, 484 inpatients for whom each of the Thyroid function tests was requested selected as a sample by census and included in the study. The samples included in the study were evaluated by clinical evaluation and history taking with the aim of finding the indications for thyroid test request, and if it is possible to diagnose thyroid function disorders in the next stage of the requested tests in terms of compliance with the algorithms and instructions The existing one was checked. Finally, if the laboratory tests lead to the final diagnosis, the proportionality of the requested functional test with the final diagnosis is checked. Methods: In this study, the definition of essential thyroid tests included the patients who have a known thyroid disease based on previous history or hospital records and clinical examinations, or there is a high clinical suspicion for their thyroid disease, it is reasonable to perform TSH & T4 & T3RU or TSH & FT4 tests. SPSS version 24 software was used for statistical analysis of data. Results: The average age of the participants in the study was 54.2 years with a standard deviation of 17 years and 59.4% were female. In total requested tests the most patients 101 (20.7%) were hospitalized in the neurology department and the least patients 2 (0.4%) were from the toxicology ward. Out of a total of 488 patients for whom thyroid tests were requested, only 259 patients were found to have a specific reason for requesting these types of tests based on the clinical records, history or clinical examination, and 99 patients (38.2%) were hypothyroid. TSH was requested for 477 patients, and the mean TSH was 3.583. Out of a total of 69 patients whose treatment status changed, 27 patients (39.1%) had an increase in the treatment dose. The most patients whom TSH was requested without indication, most cases (26.3%) were admitted to the neurology department. The most common pattern of requesting thyroid tests in people participating in our study was the combination of TSH, T3, T4. In this study, 69 patients out of 488 patients for whom thyroid tests were performed treatment was changed. Out of 194 patients who had a logical reason to request thyroid tests based on their previous history of thyroid diseases or current examination and history, only 54 patients, equivalent to 27.83%, have undergone treatment change. Conclusion: The purpose of this study was to examine the patterns of requests for thyroid function tests and to determine the logical cases of their requests in Firozgar Hospital in a period of 6 months. Considering that hypothyroidism and hyperthyroidism have a significant prevalence in the world and also due to the high prevalence of iodine deficiency in our country, thyroid diseases are also common. Since the symptoms of thyroid diseases are mostly nonspecific and shared with other diseases, it is better to avoid unnecessary sampling and related problems, including high cost, the need for long follow-up and the patient's and family's concern about the results. As a result of the tests, the measurement of thyroid function tests should be used only in reasonable cases and with a suitable pattern. There is no need to check thyroid tests in all hospitalized patients who are unrelated to thyroid diseases. In general, it seems that the measurement of thyroid tests in logical cases and with the correct pattern has positive results for the patient and health system. In the current study, thyroid tests were requested for 488 patients, compared to the study of Small et al., it can be said that the sample size of our study was slightly smaller than that study. (11) About 60% of the studied patients were women, which can indicate that thyroid tests are more common in women than in men, regardless of whether the request is reasonable or unreasonable. In terms of average age, it can be stated that thyroid tests are performed at different ages of people, although the average age in this study was 54 years, but a wide standard deviation of 17 years was also observed among patients. Regarding the frequency of unnecessary requests, T3 with 99.2%, TSH with 60.6%, and T4 with 59.4%, T3RU with 59%, and Anti TPO Ab with 38% had the highest to lowest amount respectively. It should be noted that all requests for fT3 and fT4 tests were unnecessary. In our study, the most number of cases for whom thyroid tests were requested were hospitalized in the departments of neurology, endocrinology, neurosurgery, and neurology ICU, respectively. It seems that this amount can be reduced if endocrinologists are consulted about the indication of requesting thyroid tests. The most common request patterns for thyroid function tests were TSH&T4&T3 with 69.87% and TSH&T4 with 15.57% respectively. In the study of Roti et al., the most common requested pattern with 56% was the combination of TSH, T3, T4, and for this reason, the two studies are similar (10). was requested, 27.83% of them had a change in their treatment procedure, which is higher compared to the study of Mr. Small et al., where only 2% of patients had a change in treatment (11). In our study, among the patients whose test results were in favor of changing the treatment or starting of thyroid medication or increasing the dose of drugs was the most common case with 39.1%. In this study, among patients who had a history of thyroid problems, TSH and T4 tests were reported as the most frequently performed tests among these people. In general, based on the obtained results, it seems that requesting all thyroid indicators at the same time is a common finding. It can also be added that the unusual patterns of requesting thyroid function tests, multiple cases of requesting thyroid function tests, and the non-optimal contractual TSH threshold level cause unnecessary requests for thyroid function tests. One of the most important limitations of this type of study is that the algorithms and instructions are different in different field of medicine and the way of requesting thyroid function tests may be different between two medical specialties. Another limitation of this study is the lack of sufficient previous studies. One of the final suggestions can be the point that cases of inappropriate requests for thyroid hormones in free hormones are taken at the same time as taking total hormone levels, which are the most suitable places for intervention to reduce cases of inappropriate requests for thyroid function tests. It is also suggested that studies with a larger sample size and a longer follow-up period be conducted in the future. [ABSTRACT FROM AUTHOR]

Background: Considering the changes in thyroid physiology associated with pregnancy and poor outcomes related to abnormal maternal thyroid function, international guidelines recommend using population-based trimester-specific reference intervals (RIs) for thyroid testing. If these RIs are not available in the laboratory, implementing recommended fixed cut-off values globally is still controversial. To address this issue, we aimed to establish appropriate RI of thyroid-stimulating hormone (TSH) in pregnant Turkish women for our laboratory and compare the prevalence of thyroid dysfunction based on the established and recommended criteria.Methods: Of 2638 pregnant women, 1777 women followed in the obstetric outpatient were enrolled in the reference interval study after applying exclusion criteria related to medical and prenatal history. A retrospective study was conducted by collecting data from July 2016 to March 2019. Serum TSH was measured by UniCel DxI 800 Immunoassay System (Beckman Coulter Inc., Brea, CA, USA). The study design relied on two approaches in order to classify pregnant women: trimester-specific and subgroup-specific; the latter involved dividing each trimester into two subgroups: T1a, T1b, T2a, T2b, T3a, T3b. The lower and upper limits of the RIs were derived by the parametric method after normalizing the data distribution using the modified Box-Cox power transformation method.Results: The lowest TSH value was detected at 8-12 weeks in early pregnancy, and the median value of TSH in the T1b subgroup was significantly lower than the T1a subgroup (P < 0.05). TSH levels showed a gradual trend of increase along with the pregnancy and increased significantly in the T2a, T2b, and T3b subgroups compared to the preceding subgroups (P < 0.05). Compared to the diagnostic criteria recommended by American Thyroid Association (ATA), the prevalence of thyroid dysfunction was significantly different from the established trimester- and subgroup-specific RIs throughout the pregnancy (P < 0.001).Conclusions: We conclude that establishing gestation- and laboratory-specific RIs, especially for TSH, is essential for diagnosing thyroid disorders in pregnancy, and the recommended universal cut-off values, which may contribute to the risk of a misdiagnosis or a missed diagnosis, should be taken with caution in the clinical setting. However, regarding the fluctuation of thyroid function tests throughout pregnancy, trimester-specific RIs are insufficient, and implementing split phases is required. [ABSTRACT FROM AUTHOR]

Background Previous studies have posited that an association exists between thyroid function and the heart and vasculature. It remains unclear, however, whether longitudinal trends in thyroid function contribute to the development of atherosclerosis. We conducted a cohort study to examine the association of longitudinal trends in thyroid function with incident carotid atherosclerosis (CA) in middle-aged and older euthyroid subjects. Methods This cohort study's participants were recruited from the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study in Tianjin, China. Free triiodothyronine (FT3), thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured using chemiluminescence immunoassay. CA was assessed using carotid ultrasonography. Thyroid function and ultrasonography were assessed yearly during follow-up. Multivariable Cox proportional hazards regression models were used to assess the association between thyroid function and incident CA. Results A total of 3,181 participants were enrolled in the cohort study. Within 7,762 person-years of follow-up, 944 participants developed CA, the incidence rate of CA was 122 per 1,000 person-years. The fully adjusted hazards ratios (95% confidence interval) of CA for per 1-unit increase in changes of FT3, FT4 and TSH were 1.34(1.22–1.47), 1.22(1.19–1.26) and 0.92 (0.77–1.09) (P  < 0.0001, <0.0001 and = 0.32, respectively), respectively. Similar significant associations between mean levels of FT3 and FT4 and incident CA were observed. However, baseline thyroid function was not associated with incident CA. Conclusions These findings suggest that higher mean levels and higher values of changes in thyroid hormones were associated with a higher risk of incident CA in middle-aged and older euthyroid subjects. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: The prevalence of thyroid disorders is high in Saudi Arabia. Among the disorders, goiter and thyroiditis are the most common and have unique ultrasound (US) features, underscoring the need for US screening for thyroid pathologies. This study aimed to determine the prevalence of thyroiditis and thyroid nodules in patients attending the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University. Methods: This registry-based crosssectional study analyzed laboratory and US data from 240 patients who attended the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University from January 2020 to December 2021. Abnormalities of the thyroid gland were categorized according to laboratory and US data. Associations between different types of thyroid pathology and clinical and laboratory findings were assessed using appropriate statistical methods. Results: The majority of participants were Saudi women. The prevalence of thyroiditis in the study population was 43%. Approximately 25% of these patients had more than 1 nodule, and fine-needle aspiration biopsy showed that most nodules were benign. Most nodules were found in clinically euthyroid patients. Thyroiditis might be associated with abnormal thyroid function. Conclusions: Thyroiditis and thyroid nodules were common in our cohort. Vitamin D deficiency, other autoimmune diseases, and a family history of thyroid disorders were associated with thyroiditis and thyroid nodules. US is useful for identifying the type of thyroid disease. [ABSTRACT FROM AUTHOR]

The thyroid gland is a major regulator of cellular metabolism and influences numerous physiological processes including growth and development, thermogenesis, lipid and carbohydrate metabolism, heart rate, reproduction, and cognitive function1. The thyroid gland secretes the thyroid hormones, T4 (thyroxine) and T3 (triiodothyronine), that impact almost every cell and organ in the body. Due to these widespread effects, thyroid dysfunction is associated with various non-specific symptoms, which often leads to a delayed or misdiagnosis of thyroid disease. [ABSTRACT FROM AUTHOR]

Thyroglossal duct cyst (TDC) is the most common congenital anomaly of the neck. The thyroglossal duct is an embryological structure which connects the base of the tongue to the thyroid gland, which when fails to obliterate results in this anomaly. The incidence of this anomaly is approximately 7%, representing about 75% of the congenital masses of the neck. This cystic lesion is usually mobile and nontender in nature and usually presents with respiratory distress in infants. A lingual TDC is the rarest form of a TDC, and differs from a classical thyroglossal cyst totally in presentation and management. We present here a rare case of 2-month infant presenting with respiratory distress due to lingual TDC extending up to the suprathyroid region. [ABSTRACT FROM AUTHOR]

Background: Published data show that thyroid function laboratory tests are often ordered inappropriately in the acute care setting, which leads to unnecessary costs and inappropriate therapy decisions. Pilot data at our institution indicated that approximately two-thirds of the thyroid-stimulating hormone (TSH) laboratories were unnecessary, correlating to a potential cost avoidance of more than $20,000 annually. The purpose of this study was to improve the appropriateness of thyroid function test ordering with a multipronged initiative. Methodology : This controlled, single-center, before and after study included inpatients or emergency department (ED) patients at Wake Forest Baptist Medical Center who were at least 18 years of age and had a TSH level ordered during the study period. Patients with a history of thyroid cancer were excluded. The initiative included an electronic ordering intervention, direct education of providers (medical residents, attendings, and clinical pharmacists), and distribution of pocket information cards with appropriate ordering criteria. The primary outcome was the number and percentage of inappropriate TSH tests ordered before and after implementing the 3 interventions. Secondary outcomes included cost savings, inappropriate changes in thyroid therapy based on improperly ordered tests, and the number of free T4 lab tests ordered on patients with a TSH within the therapeutic range. Results : All 3 interventions were implemented, except for education of ED residents and faculty, who chose to forgo the direct education component. Inappropriate ordering of TSH levels decreased from 63 to 50 (13% reduction, P =.062) after implementation. Inappropriate TSH ordering decreased across all services, except in the ED. Inappropriate Free T4 orders decreased from 191 to 133 (30% reduction, P =.01). There were no therapy changes based on inappropriate TSH orders. Extrapolated annual cost savings were approximately $6,000. Conclusion : This multipronged interprofessional collaborative quality improvement initiative was associated with a nonstatistically significant reduction in inappropriate TSH orders, statistically significant reduction in inappropriate free T4 orders, and cost savings. There was a reduction in inappropriate ordering across all services except the ED, which may have been due the ED not participating in the direct education component of the initiative. [ABSTRACT FROM AUTHOR]

Background: Although a nodular thyroid disease is higher in patients with pituitary adenoma, concurrent thyroid cancer with pituitary tumor is uncommon. Case Presentation: We report a young woman with discovered papillary thyroid carcinoma after 1-year transsphenoidal surgery for Cushing's disease. Thyroidectomy was done and patient is well after three years follow-up. Conclusion: We suggest the patient with functional pituitary adenoma be evaluated for thyroid tumor. [ABSTRACT FROM AUTHOR]

Background: Given the ubiquity of statin use and prevalence of thyroid diseases, such as thyroid cancer, hyperthyroidism, and thyroiditis, understanding their association deserves further attention. Objective: To examine the association between statin use and thyroid cancer, thyrotoxicosis, goiter, and thyroiditis. Methods: Using Tricare data, 2 propensity score (PS)-matched cohorts of statin users and nonusers were formed: (1) a PS-matched general cohort (all patients aged 30-85 years) and (2) a PS-matched healthy cohort (excluded patients with cardiovascular diseases or severe comorbidities). Outcomes were thyroid cancer, thyrotoxicosis, goiter, and thyroiditis. Odds ratios (ORs) and 95% CIs of outcomes were estimated using conditional regression analysis. Results: Of 43 438 patients, the PS-matched general cohort matched 6342 statin users to 6342 nonusers. The OR of thyroid cancer was 0.62 (95% CI = 0.39-0.996). There was no significant difference between statin users and nonusers in risk of thyrotoxicosis (OR = 0.88; 95% CI = 0.71-1.09), goiter (OR = 0.9; 95% CI = 0.77-1.03), or thyroiditis (OR = 0.78; 95% CI = 0.53-1.15). In the PS-matched healthy cohort (3351 statin users to 3351 nonusers), there was no difference between statin users and nonusers in any outcome. Limitations of the study include its retrospective observational design and use of administrative codes in outcomes ascertainment. Conclusion and Relevance: This study did not demonstrate any association of statins with harmful effects on thyroid diseases, which offers assurance to clinicians and patients. Furthermore, statin use appears to be associated with a decreased risk of thyroid cancer, but more studies are needed. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to evaluate the prevalence of thyroid abnormalities in patients with stable chronic obstructive pulmonary disease (COPD) and the relationship between thyroid disorder and ventilatory function tests and arterial blood gas analyses. Material and methods: This cross-sectional study was conducted with 60 patients with stable COPD without diagnosed thyroid disorder before the study (37 males and 23 females aged 40-75) as the Investigated Group (IG) and 30 subjects from the general population without COPD as the Control Group (CG). They were matched by age, gender and body mass index with the IG. All patients underwent laboratory tests, thyroid hormones -free thyroxin (fT4), thyroid-stimulating hormone (TSH), and free triiodothyronine (fT3), pulmonary function tests (FEV1, FVC%, FEV1/FVC, FEF25-75%), and ABG parameters (PH, PaCO2,PaO2, HCO3, O2 saturation). The severity level in patients with COPD was determined according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria and classified into four stages GOLD I, II, III, and IV. Results: Our results presented a statistically significant difference between prevalence of thyroid hormones abnormalities in stable COPD compared to controls 18 (30.0%) vs 3 (10.0%), p = 0.0355; p < 0.05). Thyroid dysfunction among COPD patients was more common in females than males. Serum level of TSH was lower than the normal range in 18 patients (30.0%) from the IG and in 3 (10.0%) from the CG, with a statistically significant difference, p = 0.0355; p < 0.05. Thyrotoxicosis with low serum TSH and a higher serum level of fT3, according to the referent range, was present in 8 patients (13.3%), and in no patients from the CG 0 (0.0%), p = 0.0375; p < 0.05. The prevalence of subclinical hyperthyroidism with low serum TSH and normal serum level of fT3 was higher in the IG -10 patients (16.7%) compared with 3 (10.0%) of the CG, but the difference was not statistically significant p = 0.3970. Acute exacerbation frequency of IG was significantly higher than in the CG (1.6 ± 0.42 and 0.82 ± 0.79 respectively; p < 0.0001). A positive significant relationship between acute exacerbation frequency and TSH values was found (p < 0.0001; r = 0.82). The mean values of fT3 in the IG were significantly increasing with the increased severity of COPD. The degree of airflow limitation in COPD (FEV1 as a percentage of the predicted value, FEV1%pred) was significantly negatively correlated to fT3, Pearson correlation, (R = -0.525; p = 0.000; p < 0.01). FEV1%pred was positively correlated with TSH (R = 0.358; p = 0.005; p < 0.01). Significant negative correlations were present between fT3 levels and both PaO2 and SO2 in the IG, and elevation of fT3 was associated with higher PaCO2. Conclusion: The present study confirms that both clinical and subclinical hyperthyroidism was higher in patients with COPD compared to the non-COPD group. TSH and fT3 are related to lung function. A better understanding of the correlation between thyroid gland disorders and COPD may contribute to better care of patients. [ABSTRACT FROM AUTHOR]

Objective: Thyroid disorders are the most common endocrine disorders worldwide (4-7% of population). Excision of all thyroid lesions is impractical. For rapid diagnosis, Fine needle aspiration cytology (FNAC) is simple, safe, rapid diagnostic procedure. However, indeterminate cases were reported occasionally where the patient cannot be confidently assigned to a manageable category. Aim: We conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of FNAC in thyroid lesions and the correlation between cytological and histopathological diagnosis. Method: A literature search of published studies was conducted using Medline/PubMed, reasearchgate, Scielo (scientific electronic library online), and Google Scholar as international databases, and IVSL (Iraqi Virtual Science Library) and IASJ (Iraqi Academic Scientific Journals) as national databases. Results: A total of 24 studies are analyzed. The median sample size of the studies included was 100 (range, (20?23)5). The sensitivity and specificity ranged from 0.38 to 0.98 (pooled sensitivity: 0.81; 95% confidence interval (CI), 0.78?0.83) and from 0.47 to 1.00 (pooled specificity: 0.93; 95% CI, 0.92?0.94), respectively. By SROC curve, the Q-value was 0.883 and the area under the curve (AUC) was 0.945, indicating a high level of overall accuracy. Conclusion: The recognized accuracy of FNAC in detecting thyroid cancers is applicable only to papillary carcinoma and not to other malignancies. Moreover, FNAC should be considered as a screening rather than diagnostic tool for follicular lesions. Thus, FNAC helps to orientate patient management rather than to provide final definitive diagnosis. [ABSTRACT FROM AUTHOR]

Thyroid acropachy is a rare manifestation of autoimmune thyroid disease with characteristic imaging findings. Clinically, it is almost always associated with thyroid ophthalmopathy and dermopathy. It presents as nail clubbing and swelling of the digits and toes. Especially, symmetrical swelling of the hands and feet as well as clubbing of the nails may require differential diagnosis with many hepatic, pulmonary, renal and even rheumatologic diseases. Radiologically, soft-tissue swelling and periosteal new bone formations are particularly significant. We present a 22-year-old female with Graves' disease who presented with bilateral swelling of the hands and feet and was diagnosed with thyroid acropachy following clinical and radiological evaluations. [ABSTRACT FROM AUTHOR]

Background: Thyroid fine needle aspiration (FNA) is the procedure of choice in the management of thyroid nodules. Acute thyroid swelling after FNA is a rare complication and is reported in a finite number of literatures. To the best of our knowledge, only seven reported cases exist in literatures. This study describes an addition case with an acute thyroid swelling after FNA, as well as puts forward a new hypothesis of this phenomenon.Case Presentation: The case is presented of a 30-year-old female with an acute thyroid swelling after FNA, with funicular hypoechoic lesions in thyroid gland. The size of thyroid was 1.5-fold enlarged in the unilateral thyroid gland. No complains of pain or other discomforts with her and no signs of hemorrhage were found along the passage of the fine needle. The episode was recovered spontaneously.Conclusions: An acute thyroid swelling is a rare complication of FNA. A hypothesis of anaphylactic reaction was suggested in our study. Physicians should pay more attention of this phenomenon and more information is needed to support our hypothesis. [ABSTRACT FROM AUTHOR]

Both hyperthyroidism and hypothyroidism can have adverse effects in pregnancy. The most common causes of thyrotoxicosis in pregnancy are gestational transient thyrotoxicosis and Graves' disease. It is important to distinguish between these entities as treatment options differ. Women of reproductive age who are diagnosed with Graves' disease should be counseled regarding the impact of treatment options on a potential pregnancy. Although the absolute risk is small, antithyroid medications can have teratogenic effects. Propylthiouracil appears to have less severe teratogenicity compared to methimazole and is therefore favored during the first trimester if a medication is needed. Women should be advised to delay pregnancy for at least 6 months following radioactive iodine to minimize potential adverse effects from radiation and ensure normal thyroid hormone levels prior to conception. As thyroid hormone is critical for normal fetal development, hypothyroidism is associated with adverse obstetric and child neurodevelopmental outcomes. Women with overt hypothyroidism should be treated with levothyroxine (LT4) to a thyrotropin (thyroid-stimulating hormone; TSH) goal of <2.5 mIU/L. There is mounting evidence for associations of maternal hypothyroxinemia and subclinical hypothyroidism with pregnancy loss, preterm labor, and lower scores on child cognitive assessment. Although there is minimal risk of LT4 treatment to keep TSH within the pregnancy-specific reference range, treatment of mild maternal thyroid hypofunction remains controversial, given the lack of clinical trials showing improved outcomes with LT4 treatment. [ABSTRACT FROM AUTHOR]

Context: Thyroid ultrasound screening is recommended in children with PTEN hamartoma tumor syndrome (PHTS) due to increased risk of thyroid neoplasia, but the natural history of thyroid disease in children with PHTS is unclear.Objective: Determine the prevalence and natural history of thyroid disease in children with PHTS.Methods: Retrospective cohort study (1998-2019) in an academic pediatric hospital of individuals with genetically confirmed PHTS diagnosed before age 19 years. Clinical, thyroid ultrasound, and laboratory characteristics are described. Primary outcomes were the prevalence of thyroid nodules ≥10 mm diameter and time course and risk factors for nodule development assessed by Cox regression analysis. Secondary outcomes included thyroid nodule requiring biopsy, other ultrasound findings, and prevalence of autoimmune thyroid disease.Results: Among 64 subjects with PHTS, 50 underwent thyroid ultrasound. A thyroid nodule ≥10 mm was diagnosed in 22/50 (44%) subjects at median (range) age 13.3 (7.0-22.9) years. Nodules were diagnosed earlier in females than in males (10.8 [7.0-17.9] vs 14.2 [9.9-22.9] years, P = .009). In multivariate analysis, risk of thyroid nodules was significantly associated with female sex (hazard ratio 2.90, 95% CI 1.16-7.27, P = .02) and inversely associated with the presence of neurologic findings of PHTS (HR 0.27, 95% CI 0.10-0.69, P = .007). Abnormal-appearing lymph nodes with echogenic foci were observed by ultrasound in 20% of subjects, but these were not associated with malignancy. Autoimmune thyroid disease was present in 10/33 (30.3%) of subjects in whom it was assessed.Conclusion: Thyroid disease is common in children with PHTS. This study supports current consensus recommendations for ultrasound screening. [ABSTRACT FROM AUTHOR]

The article describes the case of a 70-year-old male diagnosed with primary tuberculosis (TB) of the thyroid gland. The patient presented with a large fluctuating right neck mass present for the previous 4 months. Topics covered include the findings of the contrast enhanced compute tomography of the neck, the treatment given to the patient and the variability of the presentation of the primary thyroid TB.

Amiodarone is a class III antiarrhythmic drug containing 37% iodine by weight, with a structure similar to that of thyroid hormones. Deiodination of amiodarone releases large amounts of iodine that can impair thyroid function, causing either hypothyroidism or thyrotoxicosis in susceptible individuals reflecting ~20% of patients administered the drug. Not only the excess iodine, but also the amiodarone (or its metabolite, desethylamiodarone) itself may cause thyroid dysfunction by direct cytotoxicity on thyroid cells. We present an overview of the epidemiology and pathophysiology of amiodarone-induced thyroid disorders, with a focus on the various forms of clinical presentation and recommendations for personalized management of each form. [ABSTRACT FROM AUTHOR]

Many of the people now a days are suffering with thyroid disorder. Hence, the earlier detection of thyroid becomes very important in medical field to cure the patient.The detection methods are based on pattern recognition, machine learning and data mining. Thyroid disorder was caused by the imbalanced state of thyroid hormones, and is of two types, they are over production (hyperthyroidism) and less production (hypothyroidism). In this paper we applied machine learning models on the hypothyroid dataset taken from the UCI data repository to partially fulfill the detection of thyroid disorder. The experimental results have shown that, the proposed model willgive the good results [ABSTRACT FROM AUTHOR]

Objective: Thyroglossal duct cysts (TGDCs) are relatively common congenital midline neck masses that are treated with surgical excision. Traditionally these are removed along with any associated tract and the central portion of the hyoid bone through an anterior neck incision. Some patients with TGDCs want to avoid an external neck scar. Methods: We describe the details of a transoral endoscopic vestibular excision of a TGDC and the associated hyoid bone in an adolescent patient. Results: This novel approach was successful and there were no complications. Conclusion: We propose that cervical TGDCs can be safely and completely removed with this approach in appropriately selected patients while avoiding a neck scar. [ABSTRACT FROM AUTHOR]

Context: Physiological alterations challenge the assessment of maternal thyroid function in pregnancy. It remains uncertain how the reference ranges vary by week of pregnancy, and how the classification of disease varies by analytical method and type of thyroid function test.Design: Serum samples from Danish pregnant women (n = 6282) were used for the measurement of thyrotropin (TSH), total and free thyroxine (T4), total and free 3,5,3'-triiodothyronine (T3), and T-uptake using "Method A" (Cobas 8000, Roche Diagnostics). TSH and free T4 were also measured using "Method B" (ADVIA Centaur XP, Siemens Healthineers).Main Outcome Measures: Pregnancy week- and method-specific reference ranges were established among thyroid antibody-negative women (n = 4612). The reference ranges were used to classify maternal thyroid function, and results were compared by analytical method and type of thyroid function test.Results: The reference ranges for TSH showed a gradual decrease during pregnancy weeks 4 to 14, a gradual increase was observed for total T4, total T3, and T-uptake, whereas free T4 and free T3 showed less variation. When TSH and free T4 were used, Method A classified 935 (14.9%) with abnormal thyroid function, Method B a total of 903 (14.4%), and the methods agreed on 554 individuals. When TSH and total T4 were used, 947 (15.1%) were classified with abnormal thyroid function, and classifications by either total T4 or free T4 agreed on 584 individuals.Conclusions: Even when pregnancy week- and method-specific reference ranges were established, the classification of maternal thyroid dysfunction varied considerably by analytical method and type of thyroid function test. [ABSTRACT FROM AUTHOR]