Hypothyroidism in the elderly: diagnosis and management

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Bensenor, Isabela M; Olmos, Rodrigo D; Lotufo, Paulo A

2012-01-01

Thyroid disorders are highly prevalent, occurring most frequently in aging women. Thyroid-associated symptoms are very similar to symptoms of the aging process; thus, improved methods for diagnosing overt and subclinical hypothyroidism in elderly people are crucial. Thyrotropin measurement is considered to be the main test for detecting hypothyroidism. Combined evaluations of thyroid stimulating hormone (TSH) and free-thyroxine can detect overt hypothyroidism (high TSH with low free-thyroxine levels) and subclinical hypothyroidism (high TSH with normal free-thyroxine levels). It is difficult to confirm the diagnosis of thyroid diseases based only on symptoms, but presence of symptoms could be an indicator of who should be evaluated for thyroid function. The most important reasons to treat overt hypothyroidism are to relieve symptoms and avoid progression to myxedema. Overt hypothyroidism is classically treated using L-thyroxine; elderly patients require a low initial dose that is increased every 4 to 6 weeks until normalization of TSH levels. After stabilization, TSH levels are monitored yearly. There is no doubt about the indication for treatment of overt hypothyroidism, but indications for treatment of subclinical disease are controversial. Although treatment of subclinical hypothyroidism may result in lipid profile improvement, there is no evidence that this improvement is associated with decreased cardiovascular or all-cause mortality in elderly patients. In patients with a high risk of progression from subclinical to overt disease, close monitoring of thyroid function could be the best option. PMID:22573936

Subclinical Hypothyroidism: A Prospective Observational Study from Southern India.

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Sridhar, Mathrubootham; Mahadevan, Shriraam; Vishwanathan, Latha; Subbarayan, Anbezhil

2018-03-15

To assess the natural history and progression of subclinical hypothyroidism and to study factors which help predict evolution of subclinical hypothyroidism into overt hypothyroidism. Longitudinal study in 40 children (2-16 yrs) presenting with subclinical hypothyroidism in a tertiary care unit in Chennai, India. Patients showing evidence of overt hypothyroidism or thyroid stimulating hormone ≥15 mIU/mL during follow-up were started on thyroxine. Others were followed up with 3-monthly thyroid function tests up to one year. At the end of our study period 3 (7.5%) were overtly hypothyroid, 16 (40%) remained as subclinical hypothyroid, and 21 (52.5%) became euthyroid. Evidence of auto- immunity at baseline was a significant (Phypothyroidism. Subclinical hypothyroidism in children, with thyroid stimulating hormone upto 15 mIU/L and irrespective of thyroid autoimmunity, needs only periodic clinical and biochemical follow up. Thyroid autoimmunity may point to an increased probability of progression to overt hypothyroidism.

Association of metabolic risks with subclinical hypothyroidism: A cross-sectional analysis.

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Khan, Sikandar Hayat; Manzoor, Syed Mohsin; Niazi, Najumusaquib Khan; Asif, Naveed; Ijaz, Aamir; Fazal, Nadeem

2018-01-01

To compare lipid parameters, HbA1c, uric acid and albumin creatinine ratio (UACR) among subjects having euthyroidism, Sub-Clinical Hypothyroidism (SCH) and overt hypothyroidism. This comparative cross-sectional analysis was carried out from Dec-2015 to Oct-2016 in collaboration between PNS HAFEEZ hospital and department of chemical pathology and endocrinology, Armed Forces Institute of Pathology, Rawalpindi. Biochemical parameters including lipid indices, HbA1c and UACR were compared between euthyroidism (TSH: 0.5 to 4.0 mIU/L, n=163), subclinical hypothyroidism (TSH: 4.0 to 10 mIU/L, n=16) and overt hypothyroidism (TSH:≥ 10.0 mIU/L, n=9). LDL-cholesterol, non-HDL-cholesterol and UACR results were as: [(Euthyroid: 2.66 ± 0.73), (SCH: 2.68 ± 0.51) and (Overt hypothyroidism: 3.23 ± 0.59), p-value=0.063], [(Euthyroid: 3.49 ± 0.64), (SCH: 3.35 ± 0.59) and (Overt hypothyroidism: 4.01 ± 0.30), p-value=0.033] and [{Euthyroid: 2.48 (95% CI: 1.63-3.33)}, {SCH: 2.27 (95% CI: 0.37-4.90)} and {Overt hypothyroidism: 14.95 (95% CI: 10.71-19.14){, (p-value< 0.001)] Results for total cholesterol, triglycerides and HDL-cholesterol though increased in overt hypothyroid group were not found to be statistically significant. LDL-cholesterol, non-HDL-cholesterol and UACR increased from euthyroid subjects to overt hypothyroidism group. However, these changes were found to be more subtle in the subclinical hypothyroid subjects than cases with overt hypothyroidism.

Psychiatric and cognitive manifestations of hypothyroidism

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Samuels, Mary H

2014-01-01

Purpose of review Overt hypothyroidism has major effects on neuropsychiatric function, but patients with mild hypothyroidism may attribute unrelated neuropsychiatric symptoms to their thyroid condition. This review will summarize data on neuropsychiatric effects of hypothyroidism, and provide guidelines regarding the relationship between hypothyroidism and neuropsychiatric issues, and treatment indications. Recent findings Clinical investigations and functional imaging studies confirm that overt hypothyroidism is associated with affective and cognitive decrements, largely reversible with treatment. In contrast, subclinical hypothyroidism is not associated with major neuropsychiatric deficits, although studies utilizing sensitive measures show small deficits in memory and executive function. Neuropsychiatric complaints are more common when patients are aware of their thyroid disease, regardless of their thyroid function at the time of testing. Summary Neuropsychiatric dysfunction is common in overt hypothyroidism, and will improve (although perhaps not completely resolve) with therapy. On the other hand, deficits related to thyroid dysfunction are usually mild in subclinical hypothyroidism, and realistic expectations need to be set regarding symptom reversibility with treatment. Patients with mild hypothyroidism and significant distress related to neuropsychiatric symptoms most likely have independent diagnoses that should be evaluated separately. PMID:25122491

Prepregnancy hypothyroidism versus gestational hypothyroidism: A comparative study

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Prashant Ulhas Kaduskar

2017-01-01

Full Text Available Introduction: Hypothyroidism managed inadequately in pregnancy may have grave outcomes for both mother and baby. Understanding pregnancy outcomes in our country with low awareness about thyroid diseases is important. Objectives: The objectives of the study were to evaluate demographic features and biochemical parameters in patients with prepregnancy hypothyroidism versus patients diagnosed to have primary hypothyroidism during pregnancy and to assess pregnancy outcomes. Study Design: Prospective design Materials and Methods: The study was conducted in a tertiary care center in Bengaluru for 2 years. The patients were divided into two groups - Group I: Prepregnancy hypothyroidism and Group II: Hypothyroid during pregnancy. They were further staged according to ESI guidelines as subclinical or overt hypothyroidism. Statistical Analysis: Chi-square and Mann–Whitney test. Results: A total of 452 pregnant women with hypothyroidism were analyzed. The data of 371 delivered pregnancies were available. Group I and II had 196 (43.36% and 256 (56.64% patients, respectively. Age at presentation (years was 27.09 ± 4.19 in Group I versus 25.74 ± 4.29 in Group II (P = 0.003; gestational age (weeks was 9.04 ± 5.41 in Group I versus 13.81 ± 9.12 in Group II (P = 0.000. There was one case of congenital hypothyroidism in baby in each group. Mean birth weight was 2.90 ± 0.39 kg in Group I versus 2.88 ± 0.36 kg in Group II; P = 0.608. There were four abortions in Group I versus ten in Group II (P = 0.231, 104 cesarean sections in Group I compared to 133 in Group II; (P = 0.382. There was no difference in number of cesarean sections, abortions and low birth weight babies between overt and subclinical hypothyroidism subgroups. Conclusions: Group I patients presented earlier for testing suggesting awareness was good in this group. There was no difference in pregnancy outcome between the two groups. Overt versus subclinical status did not have any different

Subclinical hypothyroidism

DEFF Research Database (Denmark)

Bak, Peter; Hjortshøj, Cristel S; Gaede, Peter

2018-01-01

OBJECTIVE: Cyanotic congenital heart disease is a systemic disease, with effects on multiple organ systems. A high prevalence of subclinical hypothyroidism (SCH) has been reported in a small cohort of cyanotic congenital heart disease patients. Subclinical hypothyroidism has been associated...... with various adverse cardiovascular effects, as well as an increased risk of progression to overt hypothyroidism. The aim of this study was to examine the prevalence of SCH in cyanotic congenital heart disease patients, consider possible etiologies, and evaluate thyroid function over time. METHODS: First, 90...... follow-up (6.5 ± 1.0 years), SCH (defined as ≥2 consecutive elevated thyroid-stimulating hormone values) was present in 26%. Three patients progressed to overt hypothyroidism. Patients with SCH were younger (34 ± 12 vs 42 ± 16 years; P = .01) and had a lower oxygen saturation (80 ± 5 vs 84 ± 6%; P = .03...

Dyslipidemia in subclinical hypothyroidism

OpenAIRE

Čaparević Zorica; Bojković Gradimir; Stojanović Dragoš Lj.; Ilić Vesna

2003-01-01

Introduction Subclinical hypothyroidism is defined as an increased serum TSH and normal serum FT4 concentration. In subclinical hypothyroidism, thyroid peroxidase and thyroglobulin antibodies are frequently present. Subclinical hypothyroidism may have endogenous or exogenous causes. The prevalence of subclinical hypothyroidism is rather high. The number of patients progressing to overt hypothyroidism may be higher. These patients may be asymptomatic, or have only mild symptoms or a single sym...

Hypothyroidism in clinical practice

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Faiza Qari

2014-01-01

Full Text Available Background: Hypothyroidism is the most common endocrine disease that was seen in the clinical practice especially for family physicians. Methods: This review article covered the important practical clinical issues for managing overt hypothyroidism, subclinical hypothyroidism and hypothyroidism during pregnancy. Conclusions: The clinical issues were addressed by clinical scenario followed by questions and stressed on the important clinical points.

Hypothyroidism and obesity: An intriguing link

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Debmalya Sanyal

2016-01-01

Full Text Available According to common perception, hypothyroidism is held responsible for obesity. However, linking them causally is controversial. Overt hypothyroidism is associated with modest weight gain, but there is a lack of clarity regarding subclinical hypothyroidism. Novel view indicates that changes in thyroid-stimulating hormone (TSH could well be secondary to obesity. The increasing prevalence of obesity further confounds definition of normal TSH range in population studies. Thyroid autoantibody status may help in establishing the diagnosis of subclinical hypothyroidism in obesity. High leptin levels may play a role in the hyperthyrotropinemia of obesity and also increase susceptibility to thyroid autoimmunity and subsequent hypothyroidism. There is at most a modest effect of L-T4 treatment in overt hypothyroidism in inducing weight loss; benefit in subclinical hypothyroidism is not established with no data supporting thyroid hormone use in euthyroid obese patients.

A review of the evidence for and against increased mortality in hypothyroidism

DEFF Research Database (Denmark)

Thvilum, Marianne; Brandt, Frans; Brix, Thomas H

2012-01-01

The lifetime risk of overt hypothyroidism is around 5%, and this disease is usually preceded by subclinical hypothyroidism, which has an even higher prevalence (estimated to be up to 9%). Hypothyroidism has been linked with cardiac dysfunction, atherosclerosis, hypertension and coagulopathy....... Intuitively, this increased morbidity is expected to shorten patients' lifespan, but definitive data are lacking on whether either of these hypothyroid states (particularly overt hypothyroidism) increase mortality. Study findings are inconsistent and, overall, the pooled data do not demonstrate increased...... mortality in patients with either subclinical or overt hypothyroidism. However, none of the available studies was adequately designed to answer this question. This Review discusses major shortcomings in those studies, such as population dissimilarities, hypothyroid state classification and misclassification...

Levothyroxine treatment restored the decreased circulating fibroblast growth factor 21 levels in patients with hypothyroidism.

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Wang, Guang; Liu, Jia; Yang, Ning; Hu, Yanjin; Zhang, Heng; Miao, Li; Yao, Zhi; Xu, Yuan

2016-06-01

Fibroblast growth factor 21 (FGF21) is an important endogenous regulator of energy metabolism. Thyroid hormone has been shown to regulate hepatic FGF21 expression in rodents. The goal of this study was to evaluate the plasma FGF21 levels in participants with normal thyroid function, subclinical hypothyroidism, or overt hypothyroidism and to investigate the change of plasma FGF21 levels in patients with overt hypothyroidism after levothyroxine treatment. A total of 473 drug-naive participants were recruited, including 250 healthy control subjects, 116 patients with subclinical hypothyroidism, and 107 patients with overt hypothyroidism. Thirty-eight patients with overt hypothyroidism were assigned to receive levothyroxine treatment. The overt hypothyroidism group had decreased FGF21 levels compared with the control and subclinical hypothyroidism groups (Ptreatment markedly attenuated the increased circulating levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), high-sensitivity C-reactive protein (hsCRP), and homeostasis model assessment index of insulin resistance (HOMA-IR) in patients with overt hypothyroidism. A significant increase in plasma FGF21 levels was observed after levothyroxine treatment (Ptreatment (FT3: r=0.44; FT4: r=0.53; all Ptreatment ameliorated metabolic disorders and restored the decreased circulating FGF21 levels in patients with overt hypothyroidism. The increase in FGF21 levels after levothyroxine treatment might be partly associated with the amelioration of metabolic disorders in patients with hypothyroidism. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Prediction of progression to overt hypothyroidism or hyperthyroidism in female relatives of patients with autoimmune thyroid disease using the Thyroid Events Amsterdam (THEA) score

NARCIS (Netherlands)

Strieder, Thea G. A.; Tijssen, Jan G. P.; Wenzel, Björn E.; Endert, Erik; Wiersinga, Wilmar M.

2008-01-01

BACKGROUND: Genetic and environmental factors are involved in the pathogenesis of autoimmune thyroid disease (AITD). Family members of patients with AITD are at increased risk for AITD, but not all will develop overt hypothyroidism or hyperthyroidism. Our goal was to develop a simple predictive

Hemostasis in Hypothyroidism and Autoimmune Thyroid Disorders.

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Ordookhani, Arash; Burman, Kenneth D

2017-04-01

There are contradictory results on the effect of hypothyroidism on the changes in hemostasis. Inadequate population-based studies limited their clinical implications, mainly on the risk of venous thromboembolism (VTE). This paper reviews the studies on laboratory and population-based findings regarding hemostatic changes and risk of VTE in hypothyroidism and autoimmune thyroid disorders. A comprehensive literature search was conducted employing MEDLINE database. The following words were used for the search: Hypothyroidism; thyroiditis, autoimmune; blood coagulation factors; blood coagulation tests; hemostasis, blood coagulation disorders; thyroid hormones; myxedema; venous thromboembolism; fibrinolysis, receptors thyroid hormone. The papers that were related to hypothyroidism and autoimmune thyroid disorder and hemostasis are used in this review. Overt hypothyroidism is more associated with a hypocoagulable state. Decreased platelet count, aggregation and agglutination, von Willebrand factor antigen and activity, several coagulation factors such as factor VIII, IX, XI, VII, and plasminogen activator-1 are detected in overt hypothyrodism. Increased fibrinogen has been detected in subclinical hypothyroidism and autoimmune thyroid disease rendering a tendency towards a hypercoagulability state. Increased factor VII and its activity, and plasminogen activator inhibitor-1 are among several findings contributing to a prothrombotic state in subclinical hypothyroidism. Overt hypothyroidism is associated with a hypocoagulable state and subclinical hypothyroidism and autoimmune thyroid disorders may induce a prothrombotic state. However, there are contradictory findings for the abovementioned thyroid disorders. Prospective studies on the risk of VTE in various levels of hypofunctioning of the thyroid and autoimmune thyroid disorders are warranted.

Hypothyroidism (primary)

DEFF Research Database (Denmark)

Nygaard, Birte

2014-01-01

INTRODUCTION: Hypothyroidism is six times more common in women, affecting up to 40 in 10,000 each year (compared with 6/10,000 men). METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for clinical (overt......) hypothyroidism? What are the effects of treatments for subclinical hypothyroidism? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We...

Hypothyroidism following allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia.

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Medinger, Michael; Zeiter, Deborah; Heim, Dominik; Halter, Jörg; Gerull, Sabine; Tichelli, André; Passweg, Jakob; Nigro, Nicole

2017-07-01

Hypothyroidism may complicate allogeneic hematopoietic stem cell transplantation (allo-HSCT); we therefore analyzed risk factors in this study. We studied 229 patients with acute myeloid leukemia (AML) who underwent an allo-HSCT between 2003 and 2013 with different conditioning regimens (myeloablative, reduced-intensity, chemotherapy-based, or total body irradiation-based). Thyroid-stimulating hormone (TSH) and free thyroxine levels (fT4) were available in 104 patients before and after allo-HSCT. The median age at transplantation (n=104) was 47 (IQR 40-59)], 37 (35.6%) patients were female, and the overall mortality was 34.6% (n=36). After a median follow-up period of 47 (IQR 25-84) months, overt hypothyroidism (basal TSH>4.49mIU/l, FT4hypothyroidism (basal TSH>4.49mIU/l, normal fT4) was observed in 20 patients (19.2%). Positive thyroperoxidase (TPO) antibodies were found in 5 (4.8%) patients. A total of 13 patients (12.5%) were treated with thyroid hormone replacement. Acute graft-versus-host disease (aGvHD) ≥grade 2 occurred in 55 (52.9%) and chronic GvHD (cGvHD) in 74 (71.2%) of the patients. The risk of developing hypothyroidism was higher in the patients with repeated allo-HSCTs (P=0.024) and with positive TPO antibodies (P=0.045). Furthermore, the development of overt hypothyroidism was inversely proportional to age (P=0.043). No correlation was found with GvHD, HLA-mismatch, total body irradiation, and gender. After allo-HSCT, a significant number of patients experience thyroid dysfunction, including subclinical and overt hypothyroidism. Long-term and continuous follow-up for thyroid function after HSCT is important to provide timely and appropriate treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Association between different degrees of hypothyroidism and serum ...

African Journals Online (AJOL)

The association between overt hypothyroidism (OH) and altered lipid profile is well known, however the significance of dyslipidemia in subclinical hypothyroidism (SCH) remain controversial. Therefore, this study was conducted to determine any association between lipid profile and different degrees of thyroid dysfunction.

Prevalence of hypothyroidism in term pregnancies in North India

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Bharti Kalra

2018-01-01

Full Text Available Background: Hypothyroidism is common in pregnancy. No study has determined the prevalence of hypothyroidism in term pregnancies in India. Aim: This study aims to determine the prevalence and correlates of hypothyroidism in women who delivered at a center in Karnal, Haryana, North India. Results: Indoor records of all women who had delivered at this centre from April 2016 to March 2017 were reviewed. The prevalence of hypothyroidism was 12.3%, of which 15.5% were diagnosed during pregnancy. The dose requirement of L-thyroxine ranged from 25 to 200 μg (mean 76.38 +- 43.02. With this, 80% were able to achieve trimester-specific thyroid-stimulating hormone targets. Hypothyroidism did not correlate with any medical or obstetric complications. Conclusion: Hypothyroidism is common in term pregnancies. If treated adequately, healthy fetomaternal outcomes can be achieved.

Congenital hypothyroidism presenting with postpartum bradycardia

International Nuclear Information System (INIS)

Kara, S.; Tayman, C.; Tonbul, A.; Tatli, M.; Andiran, N.; Turkay, S.

2013-01-01

Congenital hypothyroidism is a clinical condition characterized by lack of thyroid hormone because of thyroid gland developmental and thyroid hormone biosynthesis disorders. The most common cause of permanent hypothyroidism is congenital factors. Prompt diagnosis is critical. However, overt signs of hypothyroidism are rarely present at birth, and 95% of affected babies are asymptomatic. Hypoxemia, apnea, acidosis, increased intracranial pressure, vagal stimulus and central nerve system abnormalities represent the most common causes of bradycardia in the neonate. Bradycardia associated with congenital hypothyroidism is very rare. In this paper, a case of severe congenital hypothyroidism, induced by maternal blocker antibodies, who presented with bradycardia, is reported. (author)

High radio-isotope uptakes in patients with hypothyroidism

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Wing, J.; Kalk, W.J.; Ganda, C. (University of the Witwatersrand, Johannesburg (South Africa). Dept. of Medicine)

1982-12-04

Hypothyroidism is usually associated with a low radio-isotope uptake by the thyriod gland. We report 8 cases of Hashimoto's thyroiditis with clinical and biochemical hypothyroidism and with borderline high or overtly increased technetium-99m pertechnetate and/or iodine-131 uptakes.

Headache in recent onset hypothyroidism: Prevalence, characteristics and outcome after treatment with levothyroxine.

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Lima Carvalho, Marise de Farias; de Medeiros, Josian Silva; Valença, Marcelo Moraes

2017-09-01

Objective The objective of this article is to analyze the features of headache attributed to hypothyroidism (HAH), evaluate the differences between groups with and without HAH, between "overt" and "subclinical" hypothyroidism groups, and evaluate outcomes after levothyroxine treatment. Methods Patients with hypothyroidism were selected in a cross-sectional study, followed prospectively for 12 months, and classified as subclinical or overt hypothyroidism. The patients were divided into two groups: with and without HAH. Results HAH was reported by 73/213 (34%) patients, involving the following areas: fronto-orbital (49%), temporal (37%), and posterior part of the head (15%). The HAH features were as follows: pulsatile (63%), four to 72 hours' duration (78%), unilateral (47%), nausea/vomiting (60%), and moderate-severe intensity (72%). Hypothyroidism symptomatology was similar in both groups, except for a greater frequency of hoarseness in the group with HAH. Migraine history was more frequent in the patients with HAH (53% vs 38%, p hypothyroidism. After levothyroxine treatment 78% reported a decrease in HAH frequency. Subclinical and overt hypothyroid patients reported a similar alleviation of their headaches. Conclusion Patients with HAH may present with unilateral, pulsatile, episodic pattern, and nausea/vomiting, which is at odds with the criteria for HAH established by ICHD 3 beta. Not all individuals responded to levothyroxine, and patients with the subclinical form of hypothyroidism benefit from this treatment.

Effect of levothyroxine therapy on dyslipidemia in hypothyroid patients

African Journals Online (AJOL)

Arun Kumar Agnihotri

hypothyroidism (both subclinical and overt hypothyroidism), its association with ... with dyslipidemia, replacement therapy with levothyroxine resulted in reversal to .... aseptically after 12 hours overnight fasting for lipid ..... Workers in the field also observed that restoration ... between SCH and metabolic syndrome (MetS) and.

Gender differences in symptoms of hypothyroidism

DEFF Research Database (Denmark)

Carlé, Allan; Pedersen, Inge Bülow; Knudsen, Nils

2015-01-01

of questionnaires. The gender-specific distribution of 13 hypothyroidism-associated symptoms and a simple combined score (0-13) was explored in conditional uni- and multivariate models taking into account a broad spectrum of possible confounders. Diagnostic odds ratios (DORs) were calculated as measures......OBJECTIVES: We examined the gender-specific symptom prevalences in hypothyroidism and in healthy controls and explored the extent to which symptoms indicative of thyroid status may be different in women and men. DESIGN AND METHODS: Patients newly diagnosed with overt autoimmune hypothyroidism (n...

Subclinical hypothyroidism and hyperthyroidism. I. Prevalence and clinical relevance

NARCIS (Netherlands)

Wiersinga, W. M.

1995-01-01

Subclinical hypothyroidism has a prevalence of approx. 6% in the general population; it is more common in females and in the elderly. The incidence of progression to overt hypothyroidism is 5-15% per year; women with positive thyroid antibodies are especially at risk. The biological significance

Reevaluation of the thyroidal radioactive iodine uptake test, with special reference to reversible primary hypothyroidism with elevated thyroid radioiodine uptake

International Nuclear Information System (INIS)

Okamura, K.; Sato, K.; Ikenoue, H.; Yoshinari, M.; Nakagawa, M.; Kuroda, T.; Fujishima, M.

1988-01-01

The clinical significance of the thyroidal radioactive iodine uptake (RAIU) test was reevaluated in patients with various thyroid disorders. Compared with 262 normal subjects or 194 patients with euthyroid diffuse goiter with normal serum TSH levels, RAIU values were significantly higher in 100 patients with latent primary hypothyroidism (serum TSH, 5-40 mU/L). In 126 patients with overt primary hypothyroidism (serum TSH, greater than 40 mU/L), RAIU values were either extremely high (49 patients with reversible hypothyroidism and 10 patients with postpartum hypothyroidism) or low (67 patients with irreversible hypothyroidism). The increase in RAIU values in latent, or reversible overt hypothyroidism was TSH dependent, and there was a good correlation between RAIU values and serum TSH levels (r = 0.6203; P less than 0.001). In overt primary hypothyroidism, spontaneous recovery of thyroid function during iodide restriction alone occurred in 52 of 53 patients with RAIU values above 35%, in only 7 of 23 patients with RAIU values between 10-35%, and in none of 50 patients with RAIU below 10%. Thus, recovery was predicted by high RAIU values (P less than 0.001; prediction rate, 91.4%). Goiter was found in about 80% of the patients with reversible hypothyroidism, compared with only 34% of the patients with irreversible hypothyroidism. Recovery of thyroid function during iodide restriction also occurred in 71% of the patients with latent hypothyroidism. However, RAIU measurements did not predict the prognosis of patients with latent hypothyroidism. We conclude that iodine-induced reversible hypothyroidism is common in our patient population, and RAIU measurements may be helpful in determining the prognosis of patients with overt primary hypothyroidism

Hemodynamic changes after levothyroxine treatment in subclinical hypothyroidism

DEFF Research Database (Denmark)

Faber, J; Petersen, L; Wiinberg, N

2002-01-01

by LT(4) (p treatment in SH results in changes in hemodynamic parameters of potentially beneficial character. SH and overt hypothyroidism should......In hypothyroidism, lack of thyroid hormones results in reduced cardiac function (cardiac output [CO]), and an increase of systemic vascular resistance (SVR). We speculated whether hemodynamic regulation in subjects with subclinical hypothyroidism (SH) (defined as mildly elevated thyrotropin [TSH......) and T(3) estimates) LT(4) treatment resulted in 6% reduction in supine MAP (p treatment (p

Correlation of Hypothyroidism and Obesity

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Т.Y. Yuzvenko

2016-11-01

Full Text Available Obesity and hypothyroidism are common diseases, and consequently clinicians should be particularly alert for the possible thyroid dysfunction in obese patients. The relationship between thyroid function and obesity is likely to be bidirectional, with hypothyroidism affecting weight, but obesity also influencing thyroid function. Both serum thyroid-stimulating hormone and fT3 are typically increased in obese individuals, likely mediated by leptin. Following LT4 treatment for overt hypothyroidism, weight loss appears due to water weight rather than fat. Selected thyroid analogs might be a means to improve weight loss by increasing energy expenditure in obese patients during lasting hypocaloric diet.

Subclinical hypothyroidism: Should we treat?

Science.gov (United States)

Redford, Christopher; Vaidya, Bijay

2017-06-01

Subclinical hypothyroidism (also known as compensated hypothyroidism or mild hypothyroidism) is a condition associated with a raised serum concentration of thyroid stimulating hormone (TSH) but a normal serum free thyroxine (FT4). It is common, affecting about 10% of women above the age of 55 years. Autoimmunity is the commonest cause of subclinical hypothyroidism. About 2.5% of patients with subclinical hypothyroidism progress to clinically overt hypothyroidism each year; the rate of progression is higher in patients with thyroid autoantibodies and higher thyroid stimulating hormone levels. However, thyroid function normalises spontaneously in up to 40% cases. Only a small minority of patients with subclinical hypothyroidism have symptoms, and the evidence to support that levothyroxine ameliorate the symptoms in these patients is weak. Subclinical hypothyroidism in younger patients (treatment can prevent these risks, although a large observational study of the UK general practice research database has shown that levothyroxine may reduce the risk of coronary heart disease in younger patients (hypothyroidism should be made after careful consideration of the patient's age, the presence of symptoms, the presence of thyroid antibodies and other risk factors such as cardiovascular disease.

Asymmetric Dimethyl Arginine in Hypothyroid Patients

International Nuclear Information System (INIS)

Abdel-Messeih, P.L.

2012-01-01

Thyroid diseases may lead to endothelial dysfunction, however, the mechanism underlying the endothelial dysfunction in thyroid disease is still not clear. Asymmetric dimethyl arginine (ADMA), a novel inhibitor of endothelial nitric oxide synthetase (eNOS), was reported to inhibit nitric oxide (NO) synthesis from L-arginine. The present study was carried out to investigate ADMA levels together with effects of dislipidemia in sub-clinical and overt hypothyroid females. There were significant increase in the levels of total cholesterol, low density lipoprotein-cholesterol (LDL-c), high density lipoprotein-cholesterol (HDL-c), thyroid stimulating hormone (TSH) and ADMA in hypothyroid females as compared to controls while the levels of NO and free T 4 were significantly decreased than controls. Sub-clinical hypothyroid females had significant high TSH, LDL-c and non-significantly high ADMA levels and total cholesterol as compared to controls while they had significant decrease in NO, HDL-c and non-significant decrease in free T 4 as compared to controls. There were significant negative correlations between NO and both ADMA (r 2 = 0.84) and free T 4 (r 2 = 0.95) in overt hypothyroid group while significant positive correlation (r 2 = 0.85) was detected between TSH and HDL-c in the same group. These results are highly suggestive that the decrease of nitric oxide secondary to accumulation of ADMA represent an important pathogenic factor together with dyslipidemia in endothelial dysfunction and increased cardiovascular risk especially in hypothyroid females

Asymmetric Dimethyl Arginine in Hypothyroid Patients

Energy Technology Data Exchange (ETDEWEB)

Abdel-Messeih, P. L. [Health Radiation Research Department, National Centre for Radiation Research and Technology, Cairo (Egypt)

2012-07-01

Thyroid diseases may lead to endothelial dysfunction, however, the mechanism underlying the endothelial dysfunction in thyroid disease is still not clear. Asymmetric dimethyl arginine (ADMA), a novel inhibitor of endothelial nitric oxide synthetase (eNOS), was reported to inhibit nitric oxide (NO) synthesis from L-arginine. The present study was carried out to investigate ADMA levels together with effects of dislipidemia in sub-clinical and overt hypothyroid females. There were significant increase in the levels of total cholesterol, low density lipoprotein-cholesterol (LDL-c), high density lipoprotein-cholesterol (HDL-c), thyroid stimulating hormone (TSH) and ADMA in hypothyroid females as compared to controls while the levels of NO and free T{sub 4} were significantly decreased than controls. Sub-clinical hypothyroid females had significant high TSH, LDL-c and non-significantly high ADMA levels and total cholesterol as compared to controls while they had significant decrease in NO, HDL-c and non-significant decrease in free T{sub 4} as compared to controls. There were significant negative correlations between NO and both ADMA (r{sup 2} = 0.84) and free T{sub 4} (r{sup 2} = 0.95) in overt hypothyroid group while significant positive correlation (r{sup 2} = 0.85) was detected between TSH and HDL-c in the same group. These results are highly suggestive that the decrease of nitric oxide secondary to accumulation of ADMA represent an important pathogenic factor together with dyslipidemia in endothelial dysfunction and increased cardiovascular risk especially in hypothyroid females.

Investigation of the choroidal thickness in patients with hypothyroidism

Directory of Open Access Journals (Sweden)

Fatih Ulas

2015-01-01

Full Text Available Purpose: The effect of hypothyroidism on the choroidal thickness (CT was investigated in patients with subclinical hypothyroidism and overt hypothyroidism, and biochemically and clinically euthyroid patients receiving levothyroxine treatment. The patients were compared with healthy subjects. Materials and Methods: One eye of 71 hypothyroid and 22 healthy subjects between 20 and 40 years of age were included in this study. CT measurements were taken at the fovea and at 2 points that were 1500 μm nasal and temporal to the fovea using spectral-domain optical coherence tomography. Independent sample t-test′s and was used for statistical analysis of the data. Results: The CT was significantly thicker in hypothyroid patients compared to healthy subjects (P values were 0.013 for subfoveal, 0.015 for temporal and 0.020 for nasal segments. The intraocular pressure (IOP and body mass index (BMI were also significantly higher in hypothyroid patients (P values were 0.021 and 0.003, respectively. There was not a statistically significant difference in the BMI and IOP measurements between healthy subjects and euthyroid patients (P > 0.05. However, there was a statistically significant difference in the subfoveal, temporal and nasal CT measurements between healthy subjects and euthyroid patients (P values were 0.006, 0.031 and 0.013, respectively. Conclusions: All subgroups of hypothyroid patients had thicker CT compared to healthy subjects. Euthyroid patients receiving levothyroxine treatment had lower IOP, BMI levels, and serum lipid levels than patients with subclinical hypothyroidism and overt hypothyroidism.

Subclinical and overt thyroid dysfunction and risk of all-cause mortality and cardiovascular events

DEFF Research Database (Denmark)

Selmer, Christian; Olesen, Jonas Bjerring; Hansen, Morten Lock

2014-01-01

hypothyroidism with TSH of 5-10 mIU/L [IRR 0.92 (95% CI 0.86-0.98)]. CONCLUSIONS: Heart failure is the leading cause of an increased cardiovascular mortality in both overt and subclinical hyperthyroidism. Subclinical hypothyroidism with TSH 5-10 mIU/L might be associated with a lower risk of all-cause mortality....

Overview of Hypothyroidism in Pregnancy.

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Kroopnick, Jeffrey M; Kim, Caroline S

2016-11-01

Overt hypothyroidism in pregnancy, defined as an elevated serum thyroid-stimulating hormone (TSH) and reduced serum free thyroxine or a TSH >10 mIU/L, is known to have adverse effects on pregnancy. Subclinical hypothyroidism is typically defined as an elevated TSH and normal FT4 levels. There remains much controversy on the benefit of starting levothyroxine for mothers diagnosed with subclinical hypothyroidism. Recent studies are redefining the normal range for TSH in pregnancy, and the data on whether treatment of subclinical hypothyroidism improves outcomes for the mother and fetus are unclear. One confounding variable is the presence of thyroid peroxidase antibodies, as it may be a surrogate marker for other autoimmune disorders detrimental to pregnancy. If levothyroxine treatment is initiated, the dosing and monitoring strategy is different from nonpregnant individuals. Randomized clinical trials are underway that may better elucidate whether treatment of subclinical hypothyroidism is warranted. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Impact of Overt and Subclinical Hypothyroidism on Exercise Tolerance: A Systematic Review

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Lankhaar, Jeannette A. C.; de Vries, Wouter R.; Jansen, Jaap A. C. G.; Zelissen, Pierre M. J.; Backx, Frank J. G.

2014-01-01

Purpose: This systematic review describes the state of the art of the impact of hypothyroidism on exercise tolerance and physical performance capacity in untreated and treated patients with hypothyroidism. Method: A systematic computer-aided search was conducted using biomedical databases. Relevant studies in English, German, and Dutch, published…

A Short-Term Longitudinal Study of Memorial Development during Early Grade School.

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Kunzinger, Edward L., III

1985-01-01

Overt rehearsal and free recall performance was analyzed longitudinally in two experimental testing sessions at 7 and later at 9 years of age. Measures of short- and long-term memory recall, and two measures of input processing were obtained. Significant increases between age levels were exhibited by all variables except short-term memory.…

The debate on treating subclinical hypothyroidism

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Tng, Eng Loon

2016-01-01

Subclinical hypothyroidism (SCH) represents a mild or compensated form of primary hypothyroidism. The diagnosis of SCH is controversial, as its symptoms are non-specific and its biochemical diagnosis is arbitrary. The treatment of SCH was examined among non-pregnant adults, pregnant adults and children. In non-pregnant adults, treatment of SCH may prevent its progression to overt hypothyroidism, reduce the occurrence of coronary heart disease, and improve neuropsychiatric and musculoskeletal symptoms associated with hypothyroidism. These benefits are counteracted by cardiovascular, neuropsychiatric and musculoskeletal side effects. SCH is associated with adverse maternal and fetal outcomes that may improve with treatment. Treating SCH in children is safe and may improve growth. Importantly, the evidence in this field is largely from retrospective and prospective studies with design limitations, which precludes a conclusive recommendation for the treatment of SCH. PMID:27779276

The debate on treating subclinical hypothyroidism.

Science.gov (United States)

Tng, Eng Loon

2016-10-01

Subclinical hypothyroidism (SCH) represents a mild or compensated form of primary hypothyroidism. The diagnosis of SCH is controversial, as its symptoms are non-specific and its biochemical diagnosis is arbitrary. The treatment of SCH was examined among non-pregnant adults, pregnant adults and children. In non-pregnant adults, treatment of SCH may prevent its progression to overt hypothyroidism, reduce the occurrence of coronary heart disease, and improve neuropsychiatric and musculoskeletal symptoms associated with hypothyroidism. These benefits are counteracted by cardiovascular, neuropsychiatric and musculoskeletal side effects. SCH is associated with adverse maternal and fetal outcomes that may improve with treatment. Treating SCH in children is safe and may improve growth. Importantly, the evidence in this field is largely from retrospective and prospective studies with design limitations, which precludes a conclusive recommendation for the treatment of SCH. Copyright: © Singapore Medical Association.

Improvement in subclinical cognitive dysfunction with thyroxine therapy in hypothyroidism: A study from tertiary care center

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Sridevi Paladugu

2015-01-01

Full Text Available Aim: To evaluate the effect of hypothyroidism (both overt and subclinical on cognitive function using latencies of P300 auditory evoked potentials (AEPs. P300 latency suggests that shorter latency times are related to better cognitive performance. P300 latencies were also done after thyroxine replacement to see the effect of treatment on cognitive function. Materials and Methods: Biochemically proven new onset cases with hypothyroidism (overt and subclinical were enrolled into the study, AEPs of these two groups when compared with matched controls. After detailed history and physical examination, P300 potentials were recorded at two points Cz and Pz (Cz: On the midline of the head at the vertex, Pz: On the midline of the head between the vertex and occipital protuberance using a Nicolet Viking Select neuro diagnostic system version 10.0. The study was done in electrophysiology lab in Osmania Medical College. Results: A patient characteristics of both cases and controls were comparable. The cases consisted of two groups, overt hypothyroid cases 24, mean thyroid stimulating hormone (TSH values in them was 94, subclinical cases 21 in whom mean TSH value was 12.3. Mean P300 latencies of all cases at Cz was 342.42 ± 29.5 ms, and at Pz was 345.4 ± 30 ms. Mean P300 latencies of controls at Cz was 296.4 ± 34 ms and at Pz was 297.9 ± 33 ms (difference in P < 0.001. Mean P300 values in overt cases were 362.6 ± 32.9 ms at Cz, and at Pz it was 362.5 ± 33.9 ms. Mean P300 values in subclinical cases were 319.3 ± 30.9 ms at Cz, and at Pz it was 316.4 ± 27.9 ms. P300 values in overt cases were highly significant as compared to controls, and P300 values in the subclinical cases versus controls were also significant (P < 0.001. Conclusion: P300 latency prolongation in both clinical and subclinical hypothyroid cases shows that cognitive function is affected adversely in hypothyroidism including the subclinical hypothyroid cases. Larger studies evaluating

Paradoxical Effects of Short Term Triiodothyronine administration to hypothyroid broiler chickens.

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The purpose of these experiments were to determine possible relationships among certain indices of lipid metabolism and specific gene expression in chickens fed methimazole to induce a kind of artificial hypothyroidism. In both experiments, male, broiler chickens growing from 14 to 28 days of age we...

Hypothyroidism in women above 35 years in an endemic area recently under iodine supplementation: preliminary report

International Nuclear Information System (INIS)

Mahmood, Saiyeeda; Islam, S.M. Moinul; Hossain, Gazi Abul; Chakraborty, Ratan Kumar; Akhter, Nasima; Meah, Tito

2004-01-01

The region of greater Mymensingh is known of iodine endemicity. Association of IDD with hypothyroidism is well established phenomenon. Both iodine deficiency and iodine excess can lead to thyroid dysfunction. 150 consecutive female patients of 35 plus years, who attended the Resident Physician of Mymensingh Medical College were invited to assay free T3, free T4 and TSH in CNMU, Mymensingh. Residencies of these patients were in the various districts of greater Mymensingh. 150 volunteers were offered to give their blood for the study. 134 attended CNMU, Mymensingh. Mean age was 45.03 + 6.65 y (mean + STD). Age ranged from 35 to 60 years. 24 (17.91%) had overt or sub-clinical hypothyroidism. Full blown hypothyroidism with low FT3, FT4 and high TSH were seen in 6 (4.48%) cases. 18 (13.43%) showed elevated TSH level with normal FT4 and T3, suggesting sub-clinical hypothyroidism. Overt hypothyroidism is high in this area. (author) 1 fig., 23 refs

Hypothyroidism Potentially Linked to Cutaneous Squamous Cell Carcinoma: Retrospective Study at a Single Tertiary Academic Medical Center.

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Ahadiat, Omeed; Higgins, Shauna; Trodello, Cameron; Talmor, Guy; Kokot, Niels; Wysong, Ashley

2018-01-01

There are multiple known risk factors for the development of cutaneous squamous cell carcinoma (SCC). To determine whether patients with cutaneous SCC have a higher prevalence of hypothyroidism than the general US population. A retrospective review was performed for patients seen at the University of Southern California with cutaneous SCC. Chart review was performed for the presence of hypothyroidism and thyroid replacement therapy before the diagnosis of SCC for each patient. Multiple prevalence studies were gathered from the literature for comparison, reporting the prevalence of overt and subclinical hypothyroidism in the general US population and/or elderly US population. Of the 265 patients diagnosed with SCC of the skin, 61 (23%) of patients were found to have a preceding diagnosis of hypothyroidism. The prevalence of hypothyroidism among the population of SCC patients was significantly greater than the prevalence of hypothyroidism (overt and subclinical) in any general and/or elderly US population reported. Patients with SCC of skin are more likely to have a history of hypothyroidism than the general population. The authors conclude that hypothyroidism may be linked to the development of cutaneous SCC.

Central hypothyroidism and its role for cardiovascular risk factors in hypopituitary patients

DEFF Research Database (Denmark)

Feldt-Rasmussen, Ulla; Klose, Marianne

2016-01-01

limitations given vast difficulties in diagnosing the condition correctly biochemically, and difficulties monitoring the treatment because normal thyroid-pituitary feedback interrelationships are disrupted. The present review summarizes available studies of central adult hypothyroidism and its possible......Hypothyroidism is characterized by hypometabolism, and may be seen as a part of secondary failure due to pituitary insufficiency or tertiary due to hypothalamic disease. Secondary and tertiary failures are also referred to as central hypothyroidism. Whereas overt primary hypothyroidism has a well......-known affection on the heart and cardiovascular system, and may result in cardiac failure, cardiovascular affection is less well recognized in central hypothyroidism. Studies on central hypothyroidism and cardiovascular outcome are few and given the rarity of the diseases often small. Further, there are several...

Respiratory manifestations of hypothyroidism

DEFF Research Database (Denmark)

Sorensen, Jesper Roed; Winther, Kristian Hillert; Bonnema, Steen Joop

2016-01-01

BACKGROUND: Hypothyroidism has been associated with increased pulmonary morbidity and overall mortality. We conducted a systematic review to identify the prevalence and underlying mechanisms of respiratory problems among patients with thyroid insufficiency. METHODS: PubMed and EMBASE databases were...... searched for relevant literature from January 1950 through January 2015 with study eligibility criteria: English-language publications; Adult subclinical or overt hypothyroid patients; Intervention, observational or retrospective studies; and respiratory manifestations. We followed the PRISMA statement...... and used the Cochrane's risk of bias tool. RESULTS: A total of 1699 papers were screened by two independent authors for relevant titles. Of 109 relevant abstracts, 28 papers underwent full text analyses, of which 22 were included in the review. We identified possible mechanisms explaining respiratory...

Correction of Hypothyroidism Leads to Change in Lean Body Mass without Altering Insulin Resistance.

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Sirigiri, Sangeetha; Vaikkakara, Suresh; Sachan, Alok; Srinivasarao, P V L N; Epuri, Sunil; Anantarapu, Sailaja; Mukka, Arun; Chokkapu, Srinivasa Rao; Venkatanarasu, Ashok; Poojari, Ravi

2016-12-01

Hypothyroidism is associated with insulin resistance, dyslipidemia, and abnormal body composition. This study assessed changes in body composition and insulin resistance after thyroxine (T 4 ) replacement in overt hypothyroidism. In this prospective longitudinal study carried out in a tertiary care center, adult nondiabetic patients with overt hypothyroidism were rendered euthyroid on T 4 . Anthropometry including skinfold thickness (SFT) at the triceps and subscapularis was recorded. Patients underwent testing for fasting plasma glucose, creatinine, serum insulin, T 4 , thyrotropin (TSH) and body composition analysis by dual-energy X-ray absorptiometry (DEXA) both before and at 2 months after restoration to the euthyroid state. Twenty-seven patients (20 female and 7 male) aged 35.3 ± 11.0 years (min-max: 17-59 years) with overt hypothyroidism were recruited. Serum T 4 at the time of recruitment was 48.9 ± 24.6 nmol/l (normal range = 64.4-142 nmol/l). All patients had TSH ≥50 µIU/l. Following treatment, there was a mean body weight reduction of 1.7 kg (p = 0.01). Waist circumference as well as triceps and subscapularis SFT decreased significantly (p change in fat mass (FM), percentage of fat (%FM) or bone mineral content in any of the specified regions or in the body as a whole. In contrast, mean lean body mass (LBM) decreased significantly by 0.8 kg (p resistance and level of glycemia were not affected by treatment with T 4 . LBM decreases significantly without affecting FM after correction of hypothyroidism. Insulin resistance was not influenced by T 4 treatment.

A Rare Manifestation of Hypothyroid Myopathy: Hoffmann's Syndrome

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Kang Won Lee

2015-12-01

Full Text Available Hypothyroid myopathy is observed frequently and the resolution of the clinical manifestations of myopathy following thyroid hormone replacement is well known. However, a specific subtype of hypothyroid myopathy, Hoffmann's syndrome, characterized by increased muscular mass (pseudohypertrophy, proximal muscle weakness, muscle stiffness and cramps, is rarely reported. Herein, we describe a 34-year-old male who presented with proximal muscle weakness and non-pitting edema of the lower extremities. He initially visited the neurology department where he was suspected of having polymyositis. Additional laboratory evaluation revealed profound autoimmune hypothyroidism and elevated muscle enzymes including creatine kinase. The patient was started on levothyroxine treatment and, subsequently, clinical symptoms and biochemical parameters resolved with the treatment. The present case highlights that hypothyroidism should be considered in the differential diagnosis of musculoskeletal symptoms even in the absence of overt manifestations of hypothyroidism. To our knowledge, this is the first case reported in Korea.

The Natural History of Subclinical Hypothyroidism in the Elderly: The Cardiovascular Health Study

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Somwaru, Lily L.; Rariy, Chevon M.; Arnold, Alice M.

2012-01-01

Context: Studies of long-term outcomes of subclinical hypothyroidism have assessed only baseline thyroid function, despite natural transitions to euthyroidism and overt hypothyroidism over time. Objective: We provide estimates of persistence, resolution, and progression of subclinical hypothyroidism over 4 yr, stratified by baseline TSH, anti-thyroid peroxidase antibody (TPOAb) status, age, and sex. Design, Setting, and Participants: Participants were 3996 U.S. individuals at least 65 yr old enrolled in the Cardiovascular Health Study. Subclinical hypothyroidism was detected at baseline in 459 individuals not taking thyroid medication. Main Outcome Measure: Thyroid function was evaluated at 2 and 4 yr and initiation of thyroid medication annually. Results were stratified by baseline TSH, TPOAb status, age, and sex. Results: Persistence of subclinical hypothyroidism was 56% at 2 and 4 yr. At 2 yr, resolution was more common with a TSH of 4.5–6.9 mU/liter (46 vs. 10% with TSH 7–9.9 mU/liter and 7% with TSH ≥10 mU/liter; P hypothyroidism (P hypothyroidism were common between 2 and 4 yr. Age and sex did not affect transitions. Conclusions: Subclinical hypothyroidism persists for 4 yr in just over half of older individuals, with high rates of reversion to euthyroidism in individuals with lower TSH concentrations and TPOAb negativity. Future studies should examine the impact of transitions in thyroid status on clinical outcomes. PMID:22438233

Relationship between hypothyroidism and the incidence of gestational diabetes: A meta-analysis.

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Gong, Li-Li; Liu, He; Liu, Li-Hong

2016-04-01

Hypothyroidism disorders and gestational diabetes are among the most common endocrinopathies during pregnancy. We conducted a meta-analysis to investigate whether hypothyroidism in pregnancy is associated with gestational diabetes risk. Published literature from PubMed and EMBASE were searched for eligible publications. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a fixed- or random-effects model. Seven articles described the relationship between hypothyroidism and risk of gestational diabetes. This meta-analysis revealed that overt hypothyroidism was associated with an increased risk of gestational diabetes (OR 1.892, 95% CI 1.679-2.132, p hypothyroidism, with the OR of 1.558 (95% CI 1.292-1.877, p hypothyroidism was 1.749 (95% CI 1.586-1.928, p hypothyroidism may be a risk factor for gestational diabetes. Copyright © 2016. Published by Elsevier B.V.

MANAGEMENT OF ENDOCRINE DISEASE: Pitfalls on the replacement therapy for primary and central hypothyroidism in adults.

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de Carvalho, Gisah Amaral; Paz-Filho, Gilberto; Mesa Junior, Cleo; Graf, Hans

2018-06-01

Hypothyroidism is one of the most common hormone deficiencies in adults. Most of the cases, particularly those of overt hypothyroidism, are easily diagnosed and managed, with excellent outcomes if treated adequately. However, minor alterations of thyroid function determine nonspecific manifestations. Primary hypothyroidism due to chronic autoimmune thyroiditis is largely the most common cause of thyroid hormone deficiency. Central hypothyroidism is a rare and heterogeneous disorder characterized by decreased thyroid hormone secretion by an otherwise normal thyroid gland, due to lack of TSH. The standard treatment of primary and central hypothyroidism is hormone replacement therapy with levothyroxine sodium (LT4). Treatment guidelines of hypothyroidism recommend monotherapy with LT4 due to its efficacy, long-term experience, favorable side effect profile, ease of administration, good intestinal absorption, long serum half-life and low cost. Despite being easily treatable with a daily dose of LT4, many patients remain hypothyroid due to malabsorption syndromes, autoimmune gastritis, pancreatic and liver disorders, drug interactions, polymorphisms in DIO2 (iodothyronine deiodinase 2), high fiber diet, and more frequently, non-compliance to LT4 therapy. Compliance to levothyroxine treatment in hypothyroidism is compromised by daily and fasting schedule. Many adult patients remain hypothyroid due to all the above mentioned and many attempts to improve levothyroxine therapy compliance and absorption have been made. © 2018 European Society of Endocrinology.

Potential Influence of Selenium, Copper, Zinc and Cadmium on L-Thyroxine Substitution in Patients with Hashimoto Thyroiditis and Hypothyroidism.

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Rasic-Milutinovic, Z; Jovanovic, D; Bogdanovic, G; Trifunovic, J; Mutic, J

2017-02-01

Background: Besides genetic factors, it is known that some trace elements, as Selenium, Copper, and Zinc are essential for thyroid gland fuction and thyroid hormone metabolism. Moreover, there were some metals effect that suggested patterns associated with overt thyroid disease. Aim of study: Hashimoto thyroiditis (HT), chronic autoimune inflamation of thyroid gland with cosequtive hipothyroidism, is common disease in Serbia, and we thought it is worthwile to explore potential effects of essential and toxic metals and metalloides on thyroid function and ability to restore euthyroid status of them. Results: This cross-sectional, case-control, study investigated the status of essential elements (Selenium,Copper,and Zinc) and toxic metals and metalloides (Al, Cr, Mn, Co, As, Cd, Sb, Ba, Be, Pb and Ni) from the blood of 22 female, patients with Hashimoto thyroiditis and overt hypothyroidism, and compared it with those of 55 female healthy persons. We tried to establish the presence of any correlation between previous mentioned elements and thyroid function in hypothyroid patients and healthy participants. Conclusions: The results of our study suggested that the blood concentration of essential trace elements, especially the ratio of Copper, and Selenium may influence directly thyroid function in patients with HT and overt hypothyroidism.Thus, our findings may have implication to life-long substitution therapy in terms of l-thyroxine dose reduction. Furthermore, for the first time, our study shown potential toxic effect of Cadmium on thyroid function in HT patients, which may implicate the dose of l-thyroxine substitution. © Georg Thieme Verlag KG Stuttgart · New York.

Subclinical hypothyroidism: A common finding in adult patients with cyanotic congenital heart disease.

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Bak, Peter; Hjortshøj, Cristel S; Gaede, Peter; Idorn, Lars; Søndergaard, Lars; Jensen, Annette S

2018-03-01

Cyanotic congenital heart disease is a systemic disease, with effects on multiple organ systems. A high prevalence of subclinical hypothyroidism (SCH) has been reported in a small cohort of cyanotic congenital heart disease patients. Subclinical hypothyroidism has been associated with various adverse cardiovascular effects, as well as an increased risk of progression to overt hypothyroidism. The aim of this study was to examine the prevalence of SCH in cyanotic congenital heart disease patients, consider possible etiologies, and evaluate thyroid function over time. First, 90 clinically stable cyanotic congenital heart disease patients were examined with blood samples (thyroid-stimulating hormone, C-reactive protein, hemoglobin, hematocrit, and N-terminal pro-brain-natriuretic peptide) in a cross-sectional descriptive study. Second, a longitudinal follow-up study of 43 patients originating from the first study part, was carried out. These patients had thyroid function parameters (thyroid-stimulating hormone, thyroid hormones, and thyroid peroxidase antibodies) evaluated biannually. Elevated thyroid-stimulating hormone was present in 24% of the 90 screened patients. During follow-up (6.5 ± 1.0 years), SCH (defined as ≥2 consecutive elevated thyroid-stimulating hormone values) was present in 26%. Three patients progressed to overt hypothyroidism. Patients with SCH were younger (34 ± 12 vs 42 ± 16 years; P = .01) and had a lower oxygen saturation (80 ± 5 vs 84 ± 6%; P = .03). Subclinical hypothyroidism is a very common finding in cyanotic congenital heart disease. This is not associated with increased levels of C-reactive protein, heart failure, or autoimmunity but appears to be associated with cyanosis and age. Since the clinical impact of SCH is uncertain, further studies are needed to determine this. Regular thyroid evaluation is recommended in cyanotic congenital heart disease patients since SCH can develop to overt hypothyroidism. © 2017

THYROID FUNCTION Quitting smoking-transient risk of autoimmune hypothyroidism

NARCIS (Netherlands)

Wiersinga, Wilmar M.

2012-01-01

Smoking is a risk factor for Graves disease. However, Carle et al. have demonstrated that individuals have a transient increased risk of developing overt autoimmune hypothyroidism in the first 2 years after quitting smoking. The mechanisms involved in these two opposing effects of smoking on the

Hypothyroidism and Mortality among Dialysis Patients

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Rhee, Connie M.; Alexander, Erik K.; Bhan, Ishir

2013-01-01

Summary Background and objectives Hypothyroidism is highly prevalent among ESRD patients, but its clinical significance and the benefits of thyroid hormone replacement in this context remain unclear. Design, setting, participants, & measurements This study examined the association between hypothyroidism and all-cause mortality among 2715 adult dialysis patients with baseline thyrotropin levels measured between April of 2005 and April of 2011. Mortality was ascertained from Social Security Death Master Index and local registration systems. The association between hypothyroidism (thyrotropin greater than assay upper limit normal) and mortality was estimated using Cox proportional hazards models. To reduce the risk of observing reverse-causal associations, models included a 30-day lag between thyrotropin measurement and at-risk time. Results Among 350 (12.9%) hypothyroid and 2365 (87.1%) euthyroid (assay within referent range) patients, 917 deaths were observed during 5352 patient-years of at-risk time. Hypothyroidism was associated with higher mortality. Compared with thyrotropin in the low-normal range (0.4–2.9 mIU/L), subclinical hypothyroidism (thyrotropin >upper limit normal and ≤10.0 mIU/L) was associated with higher mortality; high-normal thyrotropin (≥3.0 mIU/L and ≤upper limit normal) and overt hypothyroidism (thyrotropin >10.0 mIU/L) were associated with numerically greater risk, but estimates were not statistically significant. Compared with spontaneously euthyroid controls, patients who were euthyroid while on exogenous thyroid replacement were not at higher mortality risk, whereas patients who were hypothyroid were at higher mortality risk. Sensitivity analyses indicated that effects on cardiovascular risk factors may mediate the observed association between hypothyroidism and death. Conclusions These data suggest that hypothyroidism is associated with higher mortality in dialysis patients, which may be ameliorated by thyroid hormone replacement

Regression of the increased common carotid artery-intima media thickness in subclinical hypothyroidism after thyroid hormone replacement.

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Kim, Soo-Kyung; Kim, Se-Hwa; Park, Kyung-Sun; Park, Seok-Won; Cho, Yong-Wook

2009-01-01

The association between subclinical hypothyroidism and cardiovascular disease and the beneficial effect of levothyroxine replacement in subclinical hypothyroidism are still under debate. The present study was designed to determine whether subclinical hypothyroidism is associated with an increase in the intima-media thickness of the common carotid artery (C-IMT) and whether thyroid hormone replacement can reverse this change in the C-IMT. Patients with newly-diagnosed subclinical (n=36) and overt (n=40) hypothyroidism and healthy euthyroid individuals (n=32) participated in this study. All the patients were examined for clinical characteristics, and the serum lipid levels and the C-IMT were measured. Patients with subclinical hypothyroidism had a C-IMT measurement after 18 months of levothyroxine replacement. There were meaningful differences in total cholesterol and LDL-cholesterol levels between patients with subclinical hypothyroidism and euthyroidism. The subjects with subclinical and overt hypothyroidism had a greater C-IMT compared with euthyroid controls (0.66+/- 0.10 and 0.70+/- 0.11 vs. 0.57+/- 0.08 mm, respectively; P replacement significantly decreased the C-IMT (0.67+/- 0.11 to 0.60+/- 0.10 mm; P = 0.021) and improved the lipid profile. Based on multiple regression analysis, the decrement in LDL-cholesterol was independently associated with the regression of the C-IMT. Subclinical hypothyroidism was closely related to an increased C-IMT. Thyroid hormone replacement resulted in regression of the increased C-IMT, which was attributed to the improvement in the lipid profile.

Clinical research and long-term follow-up of early hypothyroidism after 131I treatment for hyperthyroidism

International Nuclear Information System (INIS)

Liu Jianfeng; Zhang Youren; Xing Jialiu; Ye Genyao

2004-01-01

Objective: To evaluate the clinical research and long-term follow-up results of early hypothyroidism after 131 I treatment for hyperthyroidism. Methods: One hundred and forty-five patients with hyperthyroidism who developed hypothyroidism within 12 months after 131 I therapy were evaluated by clinical symptoms and plasma T 3 , T 4 , thyroid-stimulating hormone (TSH). One year after treatment, 121 of 145 patients were divided into two groups according to the occurrence of hypothyroidism. Results: 1) Group 1: transient hypothyroidism (n=33), 64%(21/33) of the patients developed euthyroidism and 36%(12/33) patients had recurrent hyperthyroidism within 1 year after being diagnosed with hypothyroidism after 131 I treatment. The long-term follow-up showed 2 patients were with euthyroidism and 2 patients who were previously with hyperthyroidism developed permanent hypothyroidism after 3 months ∼6 years. Three patients who were previously with hyperthyroidism developed euthyroidism after 3 months ∼5 years. Group 2: permanent hypothyroidism (n=88), 82.95% (73/88) patients of group 2 were treated with low-dose 131 I, 86.36% (76/88) cases of this group were found with clinical hypothyroidism. Conclusions: 72.73% (88/121) patients of early hypothyroidism after 131 I therapy developed permanent hypothyroidism. The incidence of permanent hypothyroidism in the patients treated with low-dose 131 I was higher. Recovery of transient hypothyroidism after 131 I therapy did not predict future thyroid function. (authors)

Visual evoked potentials in overt hypothyroid patients before and after achievement of euthyroidism

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Aprajita

2017-01-01

Full Text Available Background: Visual evoked potential (VEP measures the time taken for visual stimulus to travel from the eye to the occipital cortex. Hypothyroidism affects the central nervous system (CNS through its role in gene expression, myelin production, axonal transportation, and neurotransmitters. Delay in the conduction of impulses results in abnormal VEP. Objective: Correlate the electrophysiological findings of VEP in newly diagnosed treatment-naive hypothyroid patients before and after 3 months of treatment and to find the correlation with serum thyroid-stimulating hormone (TSH levels. Materials and Methods: VEP was measured using Recorders and Medicare Systems Electromyograph Evoked Potential Mark II machine in 30 patients (serum TSH ≥10 mIU/L between 18 and 50 years of age who were followed up after 3 months of treatment. Results: The mean age (±standard deviation of the patients was 31.8 (±8.3 years. There was prolongation of VEP latencies which tends to decrease following hormone replacement therapy. It was found to be most significant for P100 (ms waveform (P < 0.001. The amplitude (P100-N75 mV which was decreased in hypothyroid patients showed improvement following achievement of euthyroidism. Significant positive correlation was found between P100, N75 latency and pretreatment serum TSH levels. Conclusion: Hypothyroid patients may have changes in the latencies and the amplitude of VEP which are reversible to a great extent with thyroxine replacement therapy. VEP thus acts as a dependable marker for CNS affection in thyroid diseases to detect subtle early changes and to assess the response to treatment in correlation with the clinical improvement.

Respiratory Manifestations of Hypothyroidism: A Systematic Review.

Science.gov (United States)

Sorensen, Jesper Roed; Winther, Kristian Hillert; Bonnema, Steen Joop; Godballe, Christian; Hegedüs, Laszlo

2016-11-01

Hypothyroidism has been associated with increased pulmonary morbidity and overall mortality. A systematic review was conducted to identify the prevalence and underlying mechanisms of respiratory problems among patients with thyroid insufficiency. PubMed and EMBASE databases were searched for relevant literature from January 1950 through January 2015 with the following study eligibility criteria: English-language publications; adult subclinical or overt hypothyroid patients; intervention, observational, or retrospective studies; and respiratory manifestations. The Preferred Reporting Items for Systematic reviews and Meta-Analyses statement was followed, and Cochrane's risk of bias tool was used. A total of 1699 papers were screened by two independent authors for relevant titles. Of 109 relevant abstracts, 28 papers underwent full-text analyses, of which 22 were included in the review. Possible mechanisms explaining respiratory problems at multiple physiological levels were identified, such as the ventilator control system, diaphragmatic muscle function, pulmonary gas exchange, goiter caused upper airway obstruction, decreased capacity for energy transduction, and reduced glycolytic activity. Obstructive sleep apnea syndrome was found among 30% of newly diagnosed patients with overt hypothyroidism, and demonstrated reversibility following treatment. The evidence for or against a direct effect on pulmonary function was ambiguous. However, each of the above-mentioned areas was only dealt with in a limited number of studies. Therefore, it is not possible to draw any strong conclusions on any of these themes. Moreover, most studies were hampered by considerable risk of bias due for example to small numbers of patients, lack of control groups, randomization and blinding, and differences in body mass index, sex, and age between subjects and controls. Mechanistic data linking hypothyroidism and respiratory function are at best limited. This area of research is therefore

Central hypothyroidism and its role for cardiovascular risk factors in hypopituitary patients.

Science.gov (United States)

Feldt-Rasmussen, Ulla; Klose, Marianne

2016-10-01

Hypothyroidism is characterized by hypometabolism, and may be seen as a part of secondary failure due to pituitary insufficiency or tertiary due to hypothalamic disease. Secondary and tertiary failures are also referred to as central hypothyroidism. Whereas overt primary hypothyroidism has a well-known affection on the heart and cardiovascular system, and may result in cardiac failure, cardiovascular affection is less well recognized in central hypothyroidism. Studies on central hypothyroidism and cardiovascular outcome are few and given the rarity of the diseases often small. Further, there are several limitations given vast difficulties in diagnosing the condition correctly biochemically, and difficulties monitoring the treatment because normal thyroid-pituitary feedback interrelationships are disrupted. The present review summarizes available studies of central adult hypothyroidism and its possible influence on the cardiovascular system, describe differences from primary thyroid failure and seek evidence for performing guidelines for clinical management of this particular thyroid and hypothalamo-pituitary disorder.

Altered fructosamine and lipid fractions in subclinical hypothyroidism.

Science.gov (United States)

Udupa, Sridevi V; Manjrekar, Poornima A; Udupa, Vinit A; Vivian, D'Souza

2013-01-01

Thyroid function disorders lead to changes in the lipoprotein metabolism. To study the lipid and the glycaemic abnormalities in the subclinical hypothyroidism cases and to compare the same with the euthyroid, overt hypothyroid and the hyperthyroid subjects. Four groups, euthyroid (Group-I), hypothyroid (Group-II), subclinical hypothyroid (Group-III) and hyperthyroid (Group-IV), which consisted of 30 subjects each, of either sex, who were aged 25-55 years, underwent Fasting Plasma Glucose (FPG), fructosamine, lipid profile and total T3, T4 and TSH estimations. The subjects who were on lipid lowering or thyroid disorder drugs and known diabetics were excluded from the study. In Group-III, all the lipid fractions were comparable to those of Group-II and they were significantly deranged, as compared to those of Group-I. The fructosamine levels were significantly higher in Group-II and Group-III (phypothyrodism, the subclinical hypothyroid cases also need to be treated similarly. The fructosamine values which are largely in excess of the FPG values, indicate a higher propensity to glycation and a decreased turnover of the proteins in the hypothyroid and the subclinical hypothyroid pools. Vice versa is true of the hyperthyroid pool. Fructosamine can be included in the thyroid work up of the patients to assess the metabolic function and the subsequent response after the initiation of the therapy.

Short- and long-term influence of diet and simvastatin on brachial artery endothelial function

DEFF Research Database (Denmark)

Jensen, Lisette Okkels; Thayssen, Per; Petersen, Knud Erik

2006-01-01

BACKGROUND: Endothelium-dependent dilation (EDD) has often been studied in patients with hypercholesterolemia without overt coronary atherosclerosis where an improvement after statin treatment has been documented within few weeks. The aim of the study was to assess the short-term effect of diet...

Subclinical Hypothyroid

Directory of Open Access Journals (Sweden)

Mohammad Reza Kalantar Hormozi

2011-04-01

Full Text Available Background: subclnical hypothyroid (SCH, defined by a normal total or free T4 level and a midly Elevated TSH, is common in adults. Subclinical hypothyroid is a risk factor for developing hypothyroidism complication . the goal of screening is to identify and treatment patients with sublinical hypothyroid before they develop these complication. Methods: The sample size of this study was the articles indexed in pubmed,ovid, tripdatabase, new spring link black coehrane, Elsevirer, Embase and contained the terms subclinical hypothyroid, Anti-tpo, Thyrotropin, levothyroxine trapy. Results: 831 articles were found that 75 articles were investigated for this issue. The results are discussed under. The subtile such as subclinical hypothyroid, screening for subclinical hypothyroid, Indication of treatment of Subclinical hypothyroid. Conclusion: In this summary, we tried to review the current literature about definition, Indection of screening and treatment of subclinical hypothyroid and reach a comprehensive guidline for practical significance of this subject in routines practice.

SUBCLINICAL HYPOTHYROIDISM IN METABOLIC SYNDROME AND ROLE OF CRP IN 50 ADULT PATIENTS

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Pratik Shah

2017-04-01

Full Text Available BACKGROUND Metabolic Syndrome (MetS is generally characterised as a clustering of the abnormal levels of blood lipids (low HDL and high triglycerides, impaired fasting glucose, elevated blood pressure, and excess abdominal obesity. The objectives of the study areTo evaluate presence of Subclinical Hypothyroidism in the study population of the patients with metabolic syndrome. To find out relation between Subclinical Hypothyroidism and different parameters of metabolic syndrome. To evaluate whether patients of metabolic syndrome with raised hs-CRP have an increased risk of having hypothyroidism. MATERIALS AND METHODS A total of 50 adult patients who met with inclusion criteria were selected. Patients with metabolic syndrome (MetS who fulfilled the NCEP-ATP III criteria: 3 out of 5 criteria positive. Patients with liver disorders, renal disorders, congestive cardiac failure, pregnant women, patients on oral contraceptive pills, statins and other medications that alter thyroid functions (e.g. lithium, amiodarone or γ-interferon were excluded from the study. RESULTS A total of 50 patients of metabolic syndrome were enrolled. Out of which 36 were euthyroid, 3 were overt hypothyroid and 11 were subclinical hypothyroid. Out of 11 patients of subclinical hypothyroidism, 9 were female and 2 were male patients. Out of 28 females, 9 (32% were SCH while out of 22 males, 2 (9% were SCH. Out of 50 patients, 3 were overt hypothyroid. All 3 patients had BP >130/85, waist circumference was >88 cm and HDL of 130/85, HDL 150 mg/dL and fasting blood glucose of >100 mg/dL were more associated with male patients. CONCLUSION Subclinical Hypothyroidism was present in 22% of study population and more so in females having metabolic syndrome (32%. Hence, it will be worthwhile to screen female metabolic syndrome patients for thyroid function abnormality. Abnormal blood pressure, triglycerides and HDL cholesterol levels were more associated with subclinical hypothyroidism

Iatrogenic, sulfonamide-induced hypothyroid crisis in a Labrador Retriever.

Science.gov (United States)

Brenner, K; Harkin, K; Schermerhorn, T

2009-12-01

This case report describes a sulfonamide-induced hypothyroid crisis in a 4-year-old Labrador Retriever bitch. Empirical therapy with high-dose trimethoprim-sulfamethoxazole for 10 days produced signs of weakness, ataxia and mental depression and the clinicopathological results supported hypothyroid-induced central nervous system depression. Short-term levothyroxine sodium therapy led to complete resolution of all clinical signs and follow-up thyroid hormone assays ruled out underlying thyroid pathology. This case report is the first to highlight this potentially life-threatening manifestation of sulfonamide-induced hypothyroidism. Sulfonamide combinations are widely used antimicrobials in veterinary medicine and early recognition of this syndrome is critical.

Cardiac function in acute hypothyroidism

International Nuclear Information System (INIS)

Donaghue, K.; Hales, I.; Allwright, S.; Cooper, R.; Edwards, A.; Grant, S.; Morrow, A.; Wilmshurst, E.; Royal North Shore Hospital, Sydney

1985-01-01

It has been established that chronic hypothyroidism may affect cardiac function by several mechanisms. It is not known how long the patient has to be hypothyroid for cardiac involvement to develop. This study was undertaken to assess the effect of a short period of hypothyroidism (10 days) on cardiac function. Nine patients who had had total tyroidectomy, had received ablative radioiodine for thyroid cancer and were euthyroid on replacement therapy were studied while both euthyroid and hypothyroid. Cardiac assessment was performed by X-ray, ECG, echocardiography and gated blood-pool scans. After 10 days of hypothyroidisms, the left-ventricular ejection fraction failed to rise after exercise in 4 of the 9 patients studied, which was significant (P<0.002). No significant changes in cardiac size or function at rest were detected. This functional abnormality in the absence of any demonstrable change in cardiac size and the absence of pericardial effussion with normal basal function suggest that short periods of hypothyroidism may reduce cardiac reserve, mostly because of alterations in metabolic function. (orig.)

Myopathy in acute hypothyroidism

OpenAIRE

Ma, JTC; Yu, YL; Kung, AWC

1987-01-01

Hypothyroid myopathy has so far been reported in long standing cases of hypothyroidism. We describe two adult patients with myopathy associated with acute transient hypothyroidism. Both presented with severe muscle aches and cramps, stiffness and spasms. Muscle enzymes were markedly elevated and electromyography in one patient showed myopathic features. Histological changes were absent in muscle biopsy, probably because of the short duration of metabolic disturbance. The myopathy subsided pro...

Myopathy in acute hypothyroidism.

OpenAIRE

Kung, A. W.; Ma, J. T.; Yu, Y. L.; Wang, C. C.; Woo, E. K.; Lam, K. S.; Huang, C. Y.; Yeung, R. T.

1987-01-01

Hypothyroid myopathy has so far been reported in long standing cases of hypothyroidism. We describe two adult patients with myopathy associated with acute transient hypothyroidism. Both presented with severe muscle aches and cramps, stiffness and spasms. Muscle enzymes were markedly elevated and electromyography in one patient showed myopathic features. Histological changes were absent in muscle biopsy, probably because of the short duration of metabolic disturbance. The myopathy subsided pro...

Subclinical hypothyroidism: Controversies to consensus

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Syed Abbas Raza

2013-01-01

Full Text Available Diagnoses of subclinicaal hypothyroidism (SCH is biochemically made, when serum thyroid stimulating hormone (TSH levels is elevated while free thyroid hormone levels are within normal reference range. SCH is diagnosed after excluding all other causes of elevated TSH levels. Symptoms of SCH may vary from being asymptomatic to having mild nonspecific symptoms. The risk of progression to overt hypothyroidism is related to number of factors including initial serum TSH concentration, presence of auto antibodies, family history and presence goiter. Various screening recommendations for thyroid function assessment are in practice. There are still controversies surrounding SCH and associated risk of various cardiovascular diseases (CVDs, pregnancy outcomes, neuropsychiatric issues, metabolic syndrome, and dyslipidemia. Consensus will require more large randomized clinical studies involving various age groups and medical condition, especially in developing countries. All these efforts will definitely improve our understanding of disease and ultimately patient outcomes.

The nocturnal thyroid-stimulating hormone surge is absent in overt, present in mild primary and equivocal in central hypothyroidism

NARCIS (Netherlands)

Adriaanse, R.; Romijn, J. A.; Endert, E.; Wiersinga, W. M.

1992-01-01

The nocturnal TSH surge was studied in controls, in 34 patients with hypothalamic/pituitary disease and in 21 patients with primary hypothyroidism. It was absent in 5/12 hypothyroid patients and in 5/22 euthyroid patients with hypothalamic/pituitary disease (42% vs 23%, NS). Central hypothyroidism

Beneficial Effects on Pregnancy Outcomes of Thyroid Hormone Replacement for Subclinical Hypothyroidism

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Norman J. Blumenthal

2017-01-01

Full Text Available Background. Hypothyroidism and raised thyroid antibody levels have been associated with adverse obstetrical outcomes. Several studies have investigated causal associations, but results have been inconsistent and few studies have reported the effects of thyroxine replacement therapy on pregnancy outcomes in hypothyroid patients. Objective. The primary study objective was to determine the outcome of pregnancies in women diagnosed with overt and subclinical hypothyroidism (SCH (serum TSH > 2.5 mIU/L and those with elevated circulating thyroid autoantibody levels in the first trimester of pregnancy and after the institution of appropriate thyroxine replacement therapy to maintain the serum TSH ≤ 2.5 mIU/L. Study Design. This prospective observational study was undertaken between 2013 and 2016. Blood samples were taken from 1025 women at presentation for thyroid stimulating hormone (TSH, anti-thyroglobulin antibodies (TGAb, and thyroid peroxidase antibodies (TPOAb. Those with a TSH > 2.5 mIU/L were treated with thyroxine and managed appropriately to ensure that the TSH was maintained ≤2.5 mIU/L. Outcomes in these patients were compared to those in euthyroid patients. Maternal antenatal complications and perinatal outcomes were recorded. Results. There were a total of 1025 patients of whom 382 (37.5% were nulliparous. 10.1% had a TSH level > 2.5 mIU/L and 18.2% had at least one raised thyroid antibody level. No differences in adverse outcomes of pregnancy were evident in women treated for SCH or overt hypothyroidism compared to the euthyroid group. There was also no association between raised thyroid antibodies and adverse pregnancy outcomes in either group. Conclusion. There were no adverse outcomes of pregnancy found in pregnant women who had been diagnosed and treated with thyroxine for SCH at the time of presentation when compared to euthyroid patients. There was also no relationship with thyroid antibodies and adverse pregnancy

Obstructive sleep apnea syndrome and hypothyroidism - merely concurrence or causal association?

Science.gov (United States)

Kuczyński, Wojciech; Gabryelska, Agata; Mokros, Łukasz; Białasiewicz, Piotr

2016-01-01

The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) ranges from 4 to 7% in men and from 2 to 5% in women. Its deleterious consequences such as traffic accidents, cardiovascular complications increasing morbidity and mortality, make it a major health problem. Apart from obesity (a major risk factor for OSAHS), hypothyroid patients are prone to reveal this phenotype. Although hypothyroidism seems an acknowledged risk factor for OSAHS, some authors report the lack of clinically relevant association. The argument partly depends on the increased prevalence of hypothyroidism in OSAHS patients, but the epidemiological data is limited and somehow inconsistent; even less is known about sub-clinical hypothyroidism in OSAHS patients. Even if frequency of overt and sub-clinical hypothyroidism in OSAHS patients is comparable to the general population, screening for it seems beneficial, as hormone replacement therapy may improve sleep disordered breathing. Unfortunately, this favorable outcome was found only in a few studies with limited number of patients with hypothyroidism. Yet, despite the lack of international guidelines and no large multicentre studies on the topic available, we think that TSH screening might prove beneficial in vast majority of OSAHS patients.

Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison's disease with primary hypothyroidism.

Science.gov (United States)

Sahoo, Jaya Prakash; Selviambigapathy, Jayakumar; Kamalanathan, Sadishkumar; Nagarajan, K; Vivekanandan, Muthupillai

2016-01-01

Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT) in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab) titer in Addison's disease with primary hypothyroidism. This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L) and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical) was defined as high thyroid stimulating hormone (TSH) with/without low free thyroxine (fT4). TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations.

Hypothyroidism in adults. Levothyroxine if warranted by clinical and laboratory findings, not for simple TSH elevation.

Science.gov (United States)

2015-10-01

Hypothyroidism is a common disorder due to inadequate thyroid hormone secretion. When a patient has signs and symptoms suggestive of hypothyroidism, how is it determined whether thyroid hormone replacement therapy will have a favourable harm-benefit balance? How should treatment be managed? To answer these questions, we conducted a review of the literature using the standard Prescrire methodology. The symptoms of hypothyroidism are due to slow metabolism (constipation, fatigue, sensitivity to cold, weight gain, etc.) and to polysaccharide accumulation in certain tissues, leading to hoarseness, eyelid swelling, etc. A blood TSH concentration of less than 4 or 5 mlU/L rules out peripheral hypothyroidism. TSH levels increase with age. Between 30% and 60% of high TSH levels are not confirmed on a second blood test. In overt hypothyroidism, the TSH level is high and the free T4 (thyroxine) level is low. Most of these patients are symptomatic. So-called subclinical hypothyroidism, which is rarely symptomatic, is characterised by high blood TSH levels and normal free T4 levels. The natural history of hypothyroidism depends on its cause. In chronic autoimmune thyroiditis, the most common form seen in rich countries, hypothyroidism generally worsens over time. However, other situations can lead to transient hypothyroidism that may last several weeks or months. Subclinical hypothyroidism, as the name implies, is usually asymptomatic. The risk of progression to overt hypothyroidism is about 3% to 4% per year overall but increases with the initial TSH level. Treatment guidelines are mainly based on physiological and pharmacological considerations and generally recommend levothyroxine therapy. The adverse effects of levothyroxine are signs of thyrotoxicosis in case of overdose (tachycardia, tremor, sweating, etc.). Even a slight overdose carries a risk of osteoporotic fractures and atrial fibrillation, especially in the elderly. In young adults, levothyroxine is usually started

Hypothyroid Symptoms Fail to Predict Thyroid Insufficiency in Old People

DEFF Research Database (Denmark)

Carlé, Allan; Pedersen, Inge Bülow; Knudsen, Nils

2016-01-01

patients newly diagnosed with overt autoimmune hypothyroidism in a population (n = 140, median thyroid-stimulating hormone, 54.5; 95% confidence interval [CI], 28.3-94.8; median total T4, 37; 95% CI, 18-52) and individually matched each patient with 4 controls free of thyroid disease (n = 560...... at disease onset were 6.2, 5.0, and 3.6 at the ages of 0 to 49 years, 50 to 59 years, and 60+ years, respectively. In young versus old people with 0 to 1 symptoms, the odds ratio for being hypothyroid was 0.04 (95% CI, 0.007-0.18) versus 0.34 (95% CI, 0.15-0.78) (reference all other groups). In young versus...... but fails to identify hypothyroidism in the elderly. Thus, thyroid function should be tested on wide indications in old age....

Hippocampal volume is decreased in adults with hypothyroidism.

Science.gov (United States)

Cooke, Gillian E; Mullally, Sinead; Correia, Neuman; O'Mara, Shane M; Gibney, James

2014-03-01

Thyroid hormones are important for the adult brain, particularly regions of the hippocampus including the dentate gyrus and CA1 and CA3 regions. The hippocampus is a thyroid hormone receptor-rich region of the brain involved in learning and memory. Consequently, alterations in thyroid hormone levels have been reported to impair hippocampal-associated learning and memory, synaptic plasticity, and neurogenesis. While these effects have been shown primarily in developing rats, as well as in adult rats, little is known about the effects in adult humans. There are currently no data regarding structural changes in the hippocampus as a result of adult-onset hypothyroidism. We aimed to establish whether hippocampal volume was reduced in patients with untreated adult-onset hypothyroidism compared to age-matched healthy controls. High-resolution magnetization-prepared rapid acquisition with gradient echo (MPRAGE) scans were performed on 11 untreated hypothyroid adults and 9 age-matched control subjects. Hypothyroidism was diagnosed based on increased levels of thyrotropin (TSH) and reduced levels of free thyroxine (fT4). Volumetric analysis of the right and left hippocampal regions, using functional magnetic resonance imaging of the brain (FMRIB) integrated registration and segmentation tool (FIRST), demonstrated significant volume reduction in the right hippocampus in the hypothyroid patients relative to the control group. These findings provide preliminary evidence that hypothyroidism results in structural deficits in the adult human brain. Decreases in volume in the right hippocampus were evident in patients with adult-onset overt hypothyroidism, supporting some of the findings in animal models.

Optimal Levothyroxine Replacement Adequately Improves Symptoms of Hypothyroidism; Residual Symptoms Need Further Evaluation for Other than Hypothyroidism Causation.

Science.gov (United States)

Singh, Rekha; Tandon, Ashwani; Gupta, Sushil Kumar; Saroja, K

2017-01-01

Many patients with hypothyroidism complain of persistent residual symptoms, despite optimal treatment, although the similar prevalence is seen in patients with documented absence of thyroid disorder in primary health-care setup. We aimed to investigate symptomatic relief in new cases of primary hypothyroidism and compare with controls with other chronic conditions. This prospective case-control follow-up study enrolled patients from July 2014 to May 2015 in an endocrine outpatient clinic of a tertiary hospital. Controls were age- and gender-matched ambulatory individuals with well-controlled other chronic diseases and no major comorbidity. Thyroid symptom questionnaire (TSQ) was administered at pretreatment to all the cases and then they were started on levothyroxine (LT). At euthyroidism, TSQ was readministered. For controls, TSQ was administered only once. TSQ was measured on Likert scale 1-4 for lack of energy, dry skin, constipation, aches and pains, cold intolerance, poor memory, depression, weight gain, tiredness after walking, and difficulty in getting up (DGU). P < 0.05 was considered statistically significant. A total of 194 cases (147 females and 47 males) and 259 controls (187 females and 72 males) were analyzed. A significant difference in the symptoms prevalence was seen between controls and pretreatment cases, except for DGU, and between subclinical and overt hypothyroidism. Pretreatment serum thyroid-stimulating hormone in cases correlated significantly with all their pretreatment symptoms score. All symptoms prevalence decreased significantly posttreatment. At euthyroidism, the mean symptoms score in posttreatment cases was similar or lower than the controls. LT effectively improves the symptoms of hypothyroidism in newly diagnosed cases of primary hypothyroidism. The residual symptoms need an alternation explanation other than hypothyroidism.

Optimal levothyroxine replacement adequately improves symptoms of hypothyroidism; Residual symptoms need further evaluation for other than hypothyroidism causation

Directory of Open Access Journals (Sweden)

Rekha Singh

2017-01-01

Full Text Available Objectives: Many patients with hypothyroidism complain of persistent residual symptoms, despite optimal treatment, although the similar prevalence is seen in patients with documented absence of thyroid disorder in primary health-care setup. We aimed to investigate symptomatic relief in new cases of primary hypothyroidism and compare with controls with other chronic conditions. Methods: This prospective case–control follow-up study enrolled patients from July 2014 to May 2015 in an endocrine outpatient clinic of a tertiary hospital. Controls were age- and gender-matched ambulatory individuals with well-controlled other chronic diseases and no major comorbidity. Thyroid symptom questionnaire (TSQ was administered at pretreatment to all the cases and then they were started on levothyroxine (LT. At euthyroidism, TSQ was readministered. For controls, TSQ was administered only once. TSQ was measured on Likert scale 1-4 for lack of energy, dry skin, constipation, aches and pains, cold intolerance, poor memory, depression, weight gain, tiredness after walking, and difficulty in getting up (DGU. P < 0.05 was considered statistically significant. Results: A total of 194 cases (147 females and 47 males and 259 controls (187 females and 72 males were analyzed. A significant difference in the symptoms prevalence was seen between controls and pretreatment cases, except for DGU, and between subclinical and overt hypothyroidism. Pretreatment serum thyroid-stimulating hormone in cases correlated significantly with all their pretreatment symptoms score. All symptoms prevalence decreased significantly posttreatment. At euthyroidism, the mean symptoms score in posttreatment cases was similar or lower than the controls. Conclusion: LT effectively improves the symptoms of hypothyroidism in newly diagnosed cases of primary hypothyroidism. The residual symptoms need an alternation explanation other than hypothyroidism.

Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison's disease with primary hypothyroidism

Science.gov (United States)

Sahoo, Jaya Prakash; Selviambigapathy, Jayakumar; Kamalanathan, Sadishkumar; Nagarajan, K.; Vivekanandan, Muthupillai

2016-01-01

Background: Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT) in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab) titer in Addison's disease with primary hypothyroidism. Materials and Methods: This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L) and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical) was defined as high thyroid stimulating hormone (TSH) with/without low free thyroxine (fT4). TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Results: Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. Conclusions: The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations. PMID:27042409

Hypothyroidism during second-line treatment of multidrug-resistant tuberculosis: a prospective study.

Science.gov (United States)

Bares, R; Khalid, N; Daniel, H; Dittmann, H; Reimold, M; Gallwitz, B; Schmotzer, C

2016-07-01

Hypothyroidism is an adverse effect of certain anti-tuberculosis drugs. This is a prospective study of the frequency and possible pathomechanisms associated with hypothyroidism due to second-line treatment of multidrug-resistant tuberculosis. Fifty human immunodeficiency virus negative patients and 20 controls were included. All participants underwent ultrasonography of the thyroid and measurement of thyroid stimulating hormone (TSH). TSH levels were checked every 3 months. If hypothyroidism was present, T3, T4 and thyroid peroxidase autoantibodies were measured, and imaging extended to scintigraphy and repeated ultrasonography. Before treatment, 7 patients (14%) and 1 control (5%) were hypothyreotic. During the first 6 months of treatment, TSH levels increased in 41 patients (82%), 39 (78%) had values above the normal range and 19 (38%) had overt hypothyroidism. As none of the patients had signs of autoimmune thyroiditis, interaction with anti-tuberculosis drugs was assumed to be the cause of hypothyroidism. Nine patients died during treatment, all of whom had developed hypothyroidism. In seven, the metabolic situation at their death was known, and they had become euthyreotic following levothyroxine substitution. TSH levels should be checked before initiating anti-tuberculosis treatment and after 3 and 6 months to start timely replacement of levothyroxine. Further studies are needed to elucidate the exact pathomechanism involved in hypothyroidism and whether hypothyroidism can be used as predictor of treatment failure.

Speech, "Inner Speech," and the Development of Short-Term Memory: Effects of Picture-Labeling on Recall.

Science.gov (United States)

Hitch, Graham J.; And Others

1991-01-01

Reports on experiments to determine effects of overt speech on children's use of inner speech in short-term memory. Word length and phonemic similarity had greater effects on older children and when pictures were labeled at presentation. Suggests that speaking or listening to speech activates an internal articulatory loop. (Author/GH)

Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison′ s disease with primary hypothyroidism

Directory of Open Access Journals (Sweden)

Jaya Prakash Sahoo

2016-01-01

Full Text Available Background: Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab titer in Addison's disease with primary hypothyroidism. Materials and Methods: This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical was defined as high thyroid stimulating hormone (TSH with/without low free thyroxine (fT4. TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Results: Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. Conclusions: The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations.

Short-Term and Working Memory Impairments in Early-Implanted, Long-Term Cochlear Implant Users Are Independent of Audibility and Speech Production.

Science.gov (United States)

AuBuchon, Angela M; Pisoni, David B; Kronenberger, William G

2015-01-01

To determine whether early-implanted, long-term cochlear implant (CI) users display delays in verbal short-term and working memory capacity when processes related to audibility and speech production are eliminated. Twenty-three long-term CI users and 23 normal-hearing controls each completed forward and backward digit span tasks under testing conditions that differed in presentation modality (auditory or visual) and response output (spoken recall or manual pointing). Normal-hearing controls reproduced more lists of digits than the CI users, even when the test items were presented visually and the responses were made manually via touchscreen response. Short-term and working memory delays observed in CI users are not due to greater demands from peripheral sensory processes such as audibility or from overt speech-motor planning and response output organization. Instead, CI users are less efficient at encoding and maintaining phonological representations in verbal short-term memory using phonological and linguistic strategies during memory tasks.

Prevalence and predictors of hyperprolactinemia in subclinical hypothyroidism.

Science.gov (United States)

Sharma, Lokesh Kumar; Sharma, Neera; Gadpayle, Adesh Kisanji; Dutta, Deep

2016-11-01

Hyperprolactinemia has been reported in 0-57% of primary hypothyroidism. Data on hyperprolactinemia in subclinical hypothyroidism (ScH) is scant and inconsistent. This study aimed to determine the prevalence and predictors of hyperprolactinemia in ScH. Consecutive patients diagnosed to have normal thyroid function, ScH or overt primary hypothyroidism underwent serum prolactin, gonadotropins, testosterone and estradiol estimation. Patients with pregnancy, pituitary adenomas, secondary hypothyroidism, hyperthyroidism, comorbid states and drug-induced hyperprolactinemia were excluded. From initially screened 4950 patients, hormonal data from 2848 individuals who fulfilled all criteria were analyzed. The occurrence of hyperprolactinemia (females:males) was highest in primary hypothyroidism (42.95%:39.53%) (n=192), followed by ScH (35.65%:31.61%) (n=770) and euthyroid individuals (2.32%:2.02%) (n=1886) (P10mIU/L (females: males) was 25.56%:20.73%, 49.07%:50% and 61.43%:35.71% respectively (Phypothyroidism. In females, testosterone was lowest in patients with primary hypothyroidism. In males, serum estradiol was significantly higher, and testosterone significantly lower in men with ScH and primary hypothyroidism. Regression analysis revealed serum TSH followed by free T 4 , to be best predictors of serum prolactin in both sexes. Hyperprolactinemia is common in ScH, especially in those with TSH>7.5mIU/L. ROC analysis confirmed that TSH≥7.51mIU/L in females and ≥8.33mIU/L in males had a sensitivity of ≈50% with a very high specificity of >90% in detecting hyperprolactinemia. Prolactin screening may be warranted in ScH with TSH>7.5mIU/L, and may form an indication for treating ScH. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Subclinical hypothyroidism

DEFF Research Database (Denmark)

Bak, Peter; Hjortshøj, Cristel S; Gaede, Peter

2018-01-01

follow-up (6.5 ± 1.0 years), SCH (defined as ≥2 consecutive elevated thyroid-stimulating hormone values) was present in 26%. Three patients progressed to overt hypothyroidism. Patients with SCH were younger (34 ± 12 vs 42 ± 16 years; P = .01) and had a lower oxygen saturation (80 ± 5 vs 84 ± 6%; P = .03...... clinically stable cyanotic congenital heart disease patients were examined with blood samples (thyroid-stimulating hormone, C-reactive protein, hemoglobin, hematocrit, and N-terminal pro-brain-natriuretic peptide) in a cross-sectional descriptive study. Second, a longitudinal follow-up study of 43 patients...... originating from the first study part, was carried out. These patients had thyroid function parameters (thyroid-stimulating hormone, thyroid hormones, and thyroid peroxidase antibodies) evaluated biannually. RESULTS: Elevated thyroid-stimulating hormone was present in 24% of the 90 screened patients. During...

Short stature and hypothyroidism in a child with Nail-Patella Syndrome. A case report.

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Goecke, C; Mellado, C; García, C; García, H

2018-02-01

Nail-Patella syndrome (NPS) (OMIM: 161200) or hereditary onycho-osteodysplasia is an autosomal dominant disorder characterized by skeletal anomalies, nail dysplasia, renal and ocular abnor malities. The diagnosis is based on clinical and radiological findings and confirmed by the identification of a heterozygous pathogenic variant in the LMX1B gene. Management of these patients involves conti nuous follow-up and treatment ofthe orthopedical, ocular and renal problems that mayoccur. To describe a case of NPS with short stature and hypothyroidism, an association that has not been described in the literature. An eleven-year-old boy with a height of 130 cm (-2.01 Stan dard Deviations [SD]) was referred to the Endocrine Unit at the age of 2 years due to altered thyroid tests. At that time, dysplastic nails and disproportionate short stature were detected. Radiological abnormalities initially suggested a skeletal dysplasia. A primary hypothyroidism was confirmed, without anti-thyroid antibodies and with a normal thyroid ultrasound. Levothyroxine treatment was initiated. The diagnosis of NPS was confirmed by a genetic study with a single pathogenic variant in the LMX1B gene. His father presented a similar phenotype with normal stature. His bone age was equivalent to his chronological age. Laboratory screening for short stature and a GH stimulation test were normal. We present a child with proven NPS with short stature and hypothyroi dism. We did not find publications that described this triple association. It can't be ruled out that there could be a relationship between NPS and the thyroid alterations found in this patient.

Hypothyroidism leads to increased collagen-based stiffness and re-expression of large cardiac titin isoforms with high compliance.

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Wu, Yiming; Peng, Jun; Campbell, Kenneth B; Labeit, Siegfried; Granzier, Henk

2007-01-01

Because long-term hypothyroidism results in diastolic dysfunction, we investigated myocardial passive stiffness in hypothyroidism and focused on the possible role of titin, an important determinant of diastolic stiffness. A rat model of hypothyroidism was used, obtained by administering propylthiouracil (PTU) for times that varied from 1 month (short-term) to 4 months (long-term). Titin expression was determined by transcript analysis, gel electrophoresis and immunoelectron microscopy. Diastolic function was measured at the isolated heart, skinned muscle, and cardiac myocyte levels. We found that hypothyroidism resulted in expression of a large titin isoform, the abundance of which gradually increased with time to become the most dominant isoform in long-term hypothyroid rats. This isoform co-migrates on high-resolution gels with fetal cardiac titin. Transcript analysis on myocardium of long-term PTU rats, provided evidence for expression of additional PEVK and Ig domain exons, similar to what has been described in fetal myocardium. Consistent with the expression of a large titin isoform, titin-based restoring and passive forces were significantly reduced in single cardiac myocytes and muscle strips of long-term hypothyroid rats. Overall muscle stiffness and LV diastolic wall stiffness were increased, however, due to increased collagen-based stiffness. We conclude that long term hypothyroidism triggers expression of a large cardiac titin isoform and that the ensuing reduction in titin-based passive stiffness functions as a compensatory mechanism to reduce LV wall stiffness.

Soy isoflavones inducing overt hypothyroidism in a patient with chronic lymphocytic thyroiditis: a case report.

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Nakamura, Yuya; Ohsawa, Isao; Goto, Yoshikazu; Tsuji, Mayumi; Oguchi, Tatsunori; Sato, Naoki; Kiuchi, Yuji; Fukumura, Motonori; Inagaki, Masahiro; Gotoh, Hiromichi

2017-09-05

Many people have thyroid conditions that make them susceptible to hypothyroidism. If the foods they eat may interfere with the production of thyroid hormone, which can lead to development of serious hypothyroidism. The danger of health drinks should always be noted. A 72-year-old Japanese woman was previously diagnosed with chronic lymphocytic thyroiditis caused by a goiter and had an elevated thyroid-stimulating hormone level (6.56 μIU/ml), a high anti-thyroid peroxidase antibody level (>600 IU/ml), and a high antithyroglobulin level (> 4000 IU/ml) but normal levels of free triiodothyronine (3.08 pg/ml) and thyroxine (1.18 ng/ml). She presented to our hospital with sudden-onset general malaise, edema, and hoarseness with an elevated thyroid-stimulating hormone (373.3 μIU/ml) level and very low triiodothyronine (Hypothyroidism might be affected by ingredients of health drinks. She discontinued consumption of the health drink immediately and began taking 12.5 μg of levothyroxine. The amount of levothyroxine was gradually increased every 3 days up to 100 μg. At day 61, her thyroid-stimulating hormone level had decreased (6.12 μIU/ml), her free triiodothyronine (2.69 pg/ml) and thyroxine (1.56 ng/ml) levels had increased, and her general condition was improved. Among risky foods lowering thyroid function, some experimental studies have revealed that isoflavones reduce thyroid function. Therefore, we measured the presence of isoflavones in the patient's frozen serum with thin-layer chromatography. After she discontinued consumption of the health drink, two components quickly disappeared, and the other three components gradually decreased. On the basis of developing solvent composition and a positive ferric chloride reaction in thin-layer chromatography experiment, the five ingredients that disappeared or decreased were highly suspected to be soy isoflavones. This case emphasizes that consuming health drinks that include soy isoflavone powder extracts

The effect of hypothyroidism, hyperthyroidism, and their treatment on parameters of oxidative stress and antioxidant status.

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Erdamar, Hüsamettin; Demirci, Hüseyin; Yaman, Halil; Erbil, M Kemal; Yakar, Tolga; Sancak, Banu; Elbeg, Sehri; Biberoğlu, Gürsel; Yetkin, Ilhan

2008-01-01

Free radical-mediated oxidative stress has been implicated in the etiopathogenesis of several autoimmune disorders. Also, there is growing evidence supporting the role of reactive oxygen species in the pathogenesis of thyroid disorders. The aim of this study was to investigate the influence of hypothyroidism, hyperthyroidism, and their treatments on the metabolic state of oxidative stress, and antioxidant status markers. A total of 20 newly diagnosed patients with overt hypothyroidism due to Hashimoto's thyroiditis, 20 patients with overt hyperthyroidism due to Graves' disease, and 20 healthy subjects as the control group were enrolled in the study. Fasting blood samples (12 h), taken at the initiation, after the 30th and 60th day of therapy were analyzed for malondialdehyde, nitrite, vitamin E, vitamin A, beta-carotene, ascorbate, and myeloperoxidase and superoxide dismutase activity. No patient presented additional risk factors for increased reactive oxygen species levels. Malondialdehyde, nitrite, vitamin E, and myeloperoxidase activity increased in patients with hypothyroidism. After 2 months, the levels of nitrite and vitamin E were reduced to control levels by treatment. The patients with hyperthyroidism had increased levels of malondialdehyde and myeloperoxidase activity in comparison with the controls. Treatment with propylthiouracil attenuated these increments after 1 month. Our results reveal an increased generation of reactive oxygen species and impairment of the antioxidant system in patients with hyperthyroidism, and particularly in patients with hypothyroidism. These findings indicate that thyroid hormones have a strong impact on oxidative stress and the antioxidant system.

Word-length effect in verbal short-term memory in individuals with Down's syndrome.

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Kanno, K; Ikeda, Y

2002-11-01

Many studies have indicated that individuals with Down's syndrome (DS) show a specific deficit in short-term memory for verbal information. The aim of the present study was to investigate the influence of the length of words on verbal short-term memory in individuals with DS. Twenty-eight children with DS and 10 control participants matched for memory span were tested on verbal serial recall and speech rate, which are thought to involve rehearsal and output speed. Although a significant word-length effect was observed in both groups for the recall of a larger number of items with a shorter spoken duration than for those with a longer spoken duration, the number of correct recalls in the group with DS was reduced compared to the control subjects. The results demonstrating poor short-term memory in children with DS were irrelevant to speech rate. In addition, the proportion of repetition-gained errors in serial recall was higher in children with DS than in control subjects. The present findings suggest that poor access to long-term lexical knowledge, rather than overt articulation speed, constrains verbal short-term memory functions in individuals with DS.

Hypothyroidism and depression: Are cytokines the link?

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Parimal S Tayde

2017-01-01

Full Text Available Context: Primary hypothyroidism has been thought of as an inflammatory condition characterized by raised levels of cytokines such as C-reactive protein (CRP, interleukin-6 (IL-6, and tumor necrosis factor-alpha (TNF-α. Depression is also well known to occur in hypothyroidism. Depression is also characterized by elevated inflammatory cytokines. We planned to study whether cytokines play an important part in linking these two conditions. Objectives: (1 To know the prevalence of depression in overt hypothyroidism due to autoimmune thyroid disease. (2 To correlate the levels of inflammatory markers with the occurrence of depression. (3 To study the effect of levothyroxine on inflammatory markers and depression. Materials and Methods: In this longitudinal, case–controlled study, 33 patients with autoimmune hypothyroidism (thyroid-stimulating hormone >10 uIU/ml were included with 33 age-, sex-, and body max index-matched healthy controls. Individuals were tested for Serum TNF-α, IL-6, high-sensitivity-CRP (hs-CRP. They were assessed for depression using Montgomery Asberg Depression Rating Scale (MADRS and World Health Organization Quality of Life (QOL Scale. Patients received L Thyroxine titrated to achieve euthyroidism and were reassessed for inflammatory markers and cognitive dysfunction. Results: Nineteen patients (57% had mild to moderate depression (MADRS >11. After 6 months of treatment, eight patients (42% had remission of depression with significant improvement in QOL scores (P < 0.05. TNF-α, IL-6, and hs-CRP were significantly elevated in patients compared with controls and reduced with therapy but did not reach baseline as controls. The change in inflammatory markers correlated with improvement in QOL scores in social and environmental domains (P < 0.01. Conclusions: Primary autoimmune hypothyroidism is an inflammatory state characterized by elevated cytokines which decline with LT4 therapy. It is associated with depression and poor

The TSH levels and risk of hypothyroidism: Results from a population based prospective cohort study in an Iranian adult's population.

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Aminorroaya, Ashraf; Meamar, Rokhsareh; Amini, Massoud; Feizi, Awat; Nasri, Maryam; Tabatabaei, Azamosadat; Faghihimani, Elham

2017-06-01

The aim of current study was to assess the relationship between serum TSH levels and hypothyroidism risk in the euthyroid population. In a population-based cohort study, a total of 615 individuals with a normal baseline TSH, from of total population (n=2254) in 2006, were followed up for 6years. TSH, total T4, thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured. The relative risk (RR) and 95% confidence interval (95%CI) were calculated based on logistic regression. The Receiver Operating Characteristic (ROC) analysis along with area under the curve (AUC) was used to prediction of future hypothyroidism. TSH level in 2006 was a significant predictor for overt hypothyroidism, in the total population (RR=3.5) and female (RR=1.37) (all, P valuehypothyroidism from euthyroid. However, this cut off was not observed when we included only negative TPO and TgAbs people in 2006. The RR of hypothyroidism increased gradually when TSH level increased from 2.06-3.6mIU/L to >3.6mIU/L in the total population and both sexes. In women, the risk of overt hypothyroidism was significantly higher in subjects with TSH above 3.6 than those subject with THS levels≤2.05 [RR: (CI95 %), 20.57(2.-207.04), P valuehypothyroidism in future. However, it was not applicable for people with negative TPOAb and negative TgAb. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Subclinical hypothyroidism has little influences on muscle mass or strength in elderly people.

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Moon, Min Kyong; Lee, You Jin; Choi, Sung Hee; Lim, Soo; Yang, Eun Joo; Lim, Jae-Young; Paik, Nam-Jong; Kim, Ki Woong; Park, Kyong Soo; Jang, Hak C; Cho, Bo Youn; Park, Young Joo

2010-08-01

Sarcopenia, the age-related decline in muscle mass, affects the muscle strength and muscle quality, and these changes decrease functional capacity. The prevalence of thyroid dysfunction increases with age, and changes in thyroid hormone level lead to neuromuscular deficits. We investigated the effects of subclinical hypothyroidism on the muscle mass, strength or quality in elderly people. One thousand one hundred eighteen subjects aged > or = 65 yr were randomly selected from a local population and classified into a euthyroid (280 men and 358 women), subclinically hypothyroid (61 men and 75 women), or overtly hypothyroid (7 men and 16 women) group. Although women with subclinical hypothyroidism had a higher prevalence of sarcopenia, defined according to the ratio of appendicular skeletal muscle mass to the square of height, muscle mass, strength or quality did not differ in relation to thyroid status in men or in women. Multivariate analysis including age, diabetes, hypertension, acute coronary event, alcohol, smoking, presence of pain, physical activity score, and lipid profile, showed that thyroid-stimulating hormone level was not associated with muscle mass, strength or quality. In conclusion, subclinical hypothyroidism has little influences on muscle mass, strength or quality, and may not be associated with sarcopenia.

Evaluation of Selected Atherosclerosis Risk Factors in Women with Subclinical Hypothyroidism Treated with L-Thyroxine.

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Adamarczuk-Janczyszyn, Maria; Zdrojowy-Wełna, Aleksandra; Rogala, Natalia; Zatońska, Katarzyna; Bednarek-Tupikowska, Grażyna

2016-01-01

Subclinical hypothyroidism (SCH) is a common endocrine disorder, probably increasing cardiovascular (CV) risk. However, the relation between SCH and atherosclerosis risk factors remains unclear. The aim of the study was to evaluate selected atherosclerosis risk factors in women with SCH in comparison to a group of healthy women and women with overt hypothyroidism, as well as to investigate the influence of L-thyroxine replacement on those risk factors. The study group consisted of 187 obese women aged between 50 and 70 years: 100 women with SCH, 45 women with overt hypothyroidism and 42 women with TSH level in reference ranges. Anthropometric parameters were evaluated. Laboratory tests included thyroid hormones concentrations, lipid profile with apolipoproteins, CRP, homocysteine. Atherosclerotic indexes were calculated: LDL C/HDL C ratio, apoA1/apoB ratio and Castelli risk index. Women with hypothyroidism were given L-thyroxine treatment and after 6 months in euthyroidism the evaluation was repeated. Total cholesterol, LDL-cholesterol and triglycerides concentrations as well as LDL-C/HDL-C ratio and Castelli index were higher in SCH than in controls and decreased after L-thyroxin substitution. All of the calculated atherosclerosis indexes showed significant positive correlations with TSH concentration in SCH group. Also in this group the systolic and diastolic blood pressure decreased significantly after treatment. Dyslipidemia in obese SCH women is not severe, but if untreated for many years, it may lead to atherosclerosis. Substitution therapy improves the lipid profile, changing the relations between protective and proatherogenic fractions of serum lipids, and optimises blood pressure.

Congenital hypothyroidism screening in term neonates using umbilical cord blood TSH values

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Ravi Bhatia

2018-01-01

Full Text Available Congenital hypothyroidism remains one of the most common preventable causes of mental retardation among children. Screening for congenital hypothyroidism remains one of the most cost-effective tools to prevent mental retardation in the population. Umbilical cord blood thyroid-stimulating hormone (TSH levels remain an attractive and a practical step for screening for congenital hypothyroidism. The aims of this study were as follows: (1 to find normative values of cord blood TSH for the study group and (2 to use cord blood TSH levels as a marker for screening of congenital hypothyroidism. Cord blood of 1824 neonates who were of term gestation, weighed >2.5 kg at birth, whose mothers were off thyroid medication were a part of the study group. Umbilical cord blood was collected at the time of delivery and TSH was estimated. All babies who had a cord blood TSH value of >20 mIU/L were called bay on day 7 of life for a full thyroid profile. Cord blood samples of 1824 neonates were tested for TSH. Male–female ratio was 979:845 = 1.15:1. The birth weights ranged between 2.5 and 4.5 kg with an average birth weight of 2.811 kg. Mean (standard deviation TSH value was 7.725 (8.99. TSH values ranged between 1.2 and 100 mIU/ml. TSH values corresponding to the 3rd, 10th, 25th, 50th, 90th, 95th, and 97th percentile were 2.32, 4.05, 5.67, 7.5, 12, 20.63, and 30.88, respectively. Out of the 88 babies recalled for repeat testing, 80 babies only turned up; eventually one turned out to be hypothyroid on repeat testing. The incidence of congenital hypothyroidism in our study was 1 in 1824. To conclude, we can safely use a cutoff of cord blood TSH value of >20 mIU/L for the purpose of screening for congenital hypothyroidism. For logistic angles, a higher cutoff of >30 mIU/L can be used. Large population-based studies are required to establish normative values for cord blood TSH in our country.

Symptomatic Overt Hypothyroidism Post Induction

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2017-10-21

American Society of Anesthesiologists Annual Meeting 2017 (ASA), Boston MA 21-24 Oct 2017 14. ABSTRACT 1 S. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF...morbid obesity , CKD undergoing L4 -LS posterior lumbar interbodyfusion. Surgical history: LS-51 PUF 󈧆, Right TKA 󈧑, Left TKA 󈧑 w/o anesthesia

Prevalence of Hypothyroidism and Its Association with Diabetes Mellitus in Patients of an Ambulatory Clinic.

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Bernal, Mariela; Escobar, Eddy; Rodríguez González, Carmen E

2016-01-01

Hypothyroidism is the most common thyroid disorder in the adult population. Studies have found a higher prevalence of overt hypothyroidism in type 2 diabetic population than in the general population, but the relationship between subclinical hypothyroidism and diabetes mellitus 2 is still controversial. The aim of this study is to estimate the prevalence rate of hypothyroidism in the adult population receiving services in an ambulatory clinic and to determine if there is an association between hypothyroidism and diabetes mellitus. From the database of all adult patients who attended the outpatient clinic at Family Medicine Center Policlínica Bella Vista in Mayagüez, P.R. during 2014, a random sample of 200 subjects was obtained and the medical records were reviewed. The prevalence rate of diabetes mellitus in this group was 22% and the prevalence rate of hypothyroidism was 17%. The prevalence rate of hypothyroidism in diabetic patients was 10/44 (22.7%). The prevalence rate of hypothyroidism in non-diabetic patients was 24/156 (15.4%). The prevalence ratio was 1.48 (95% CI: 0.77, 2.85; X2 = 1.31, p = 0.25). The results of this cross-sectional study showed a non-statistically significant tendency for a higher prevalence of hypothyroidism in diabetic patients, which suggest that screening for hypothyroidism among patients with diabetes should be considered. More studies with more patients are necessary to investigate the association between thyroid dysfunction and diabetic patients.

Functional capacity and muscular abnormalities in subclinical hypothyroidism.

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Reuters, Vaneska S; Teixeira, Patrícia de Fátima S; Vigário, Patrícia S; Almeida, Cloyra P; Buescu, Alexandre; Ferreira, Márcia M; de Castro, Carmen L N; Gold, Jaime; Vaisman, Mario

2009-10-01

Neuromuscular abnormalities and low exercise tolerance are frequently observed in overt hypothyroidism, but it remains controversial if they can also occur in subclinical hypothyroidism (sHT). The aim of this study is to evaluate neuromuscular symptoms, muscle strength, and exercise capacity in sHT, compared with healthy euthyroid individuals. A cross-sectional study was performed with 44 sHT and 24 euthyroid outpatients from a university hospital. Neuromuscular symptoms were questioned. Muscle strength was tested for neck, shoulder, arm, and hip muscle groups, using manual muscle testing (MMT). Quadriceps muscle strength was tested with a chair dynamometer and inspiratory muscle strength (IS) by a manuvacuometer. Functional capacity was estimated based on the peak of oxygen uptake (mL/kg/min), using the Bruce treadmill protocol. Cramps (54.8% versus 25.0%; P muscle strength by MMT and the coexistence of neuromuscular complaints in patients with sHT may indicate neuromuscular dysfunction.

Subclinical hypothyroidism and cognitive function in people over 60 years

DEFF Research Database (Denmark)

Akintola, Abimbola A; Jansen, Steffy W; van Bodegom, David

2015-01-01

from the 15 studies was pooled, and meta-analyzed cross-sectionally for global cognition [assessed by Mini-Mental State Examination (MMSE)], executive function, and memory, using random effects models. Pooled effect size (ES) for MMSE was -0.01 (95% CI -0.09, 0.08), with heterogeneity (I (2)) of 55......Subclinical hypothyroidism (SCH), defined as elevated thyroid stimulating hormone (TSH) and normal thyroid hormone levels, and cognitive impairment are both common in older people. While the relation between overt hypothyroidism and cognitive impairment is well established, data on the association...... between SCH and cognitive impairment are conflicting. This systematic review and meta-analysis was performed to assess available evidence on the association of SCH with cognition in community dwelling, relatively healthy older adults. PubMed, EMBASE, Web of Science, COCHRANE, CINAHL, Psyc...

Hypothyroidism during pregnancy and its association to perinatal and obstetric morbidity: a review.

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Martínez, María; Soldevila, Berta; Lucas, Anna; Velasco, Inés; Vila, Lluis; Puig-Domingo, Manel

2018-02-01

There is currently no consensus among the different scientific societies on screening for thyroid dysfunction in the first trimester of pregnancy. Indeed, diagnosis and treatment of subclinical hypothyroidism during pregnancy are controversial, as no cut-off value for thyrotropin (TSH) is universally accepted. TSH measurement may be influenced by different factors throughout pregnancy, but especially during the first trimester. The association between overt hypothyroidism during pregnancy and obstetric and perinatal complications is well established. It is also accepted that thyroid hormones are important for neurodevelopment of the offspring. However, there is no scientific evidence available about the impact of subclinical hypothyroidism and its treatment during the first trimester of pregnancy on children's neurodevelopment. In recent years, studies conducted in the offspring of mothers with subclinical hypothyroidism have reported new biochemical parameters which may eventually serve as biomarkers of offspring neurodevelopment and which are more reproducible and are measured at an earlier time than the conventional clinical tests. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

Short- and long-term reliability of language fMRI.

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Nettekoven, Charlotte; Reck, Nicola; Goldbrunner, Roland; Grefkes, Christian; Weiß Lucas, Carolin

2018-08-01

When using functional magnetic resonance imaging (fMRI) for mapping important language functions, a high test-retest reliability is mandatory, both in basic scientific research and for clinical applications. We, therefore, systematically tested the short- and long-term reliability of fMRI in a group of healthy subjects using a picture naming task and a sparse-sampling fMRI protocol. We hypothesized that test-retest reliability might be higher for (i) speech-related motor areas than for other language areas and for (ii) the short as compared to the long intersession interval. 16 right-handed subjects (mean age: 29 years) participated in three sessions separated by 2-6 (session 1 and 2, short-term) and 21-34 days (session 1 and 3, long-term). Subjects were asked to perform the same overt picture naming task in each fMRI session (50 black-white images per session). Reliability was tested using the following measures: (i) Euclidean distances (ED) between local activation maxima and Centers of Gravity (CoGs), (ii) overlap volumes and (iii) voxel-wise intraclass correlation coefficients (ICCs). Analyses were performed for three regions of interest which were chosen based on whole-brain group data: primary motor cortex (M1), superior temporal gyrus (STG) and inferior frontal gyrus (IFG). Our results revealed that the activation centers were highly reliable, independent of the time interval, ROI or hemisphere with significantly smaller ED for the local activation maxima (6.45 ± 1.36 mm) as compared to the CoGs (8.03 ± 2.01 mm). In contrast, the extent of activation revealed rather low reliability values with overlaps ranging from 24% (IFG) to 56% (STG). Here, the left hemisphere showed significantly higher overlap volumes than the right hemisphere. Although mean ICCs ranged between poor (ICC0.75) were found for all ROIs. Voxel-wise reliability of the different ROIs was influenced by the intersession interval. Taken together, we could show that, despite of

Risk Factors for New Hypothyroidism During Tyrosine Kinase Inhibitor Therapy in Advanced Nonthyroidal Cancer Patients.

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Lechner, Melissa G; Vyas, Chirag M; Hamnvik, Ole-Petter R; Alexander, Erik K; Larsen, P Reed; Choueiri, Toni K; Angell, Trevor E

2018-04-01

Thyroid dysfunction during tyrosine kinase inhibitor (TKI) cancer treatment is common, but predisposing risk factors have not been determined. Recommendations for monitoring patients treated with one or multiple TKI and in conjunction with other relevant cancer therapies could be improved. The study objective was to assess the risk factors for new thyroid dysfunction in TKI-treated previously euthyroid cancer patients. A retrospective cohort study of patients with advanced nonthyroidal cancer treated with TKI from 2000 to 2017, having available thyroid function tests showing initial euthyroid status, excluding patients with preexisting thyroid disease or lack of follow-up thyroid function tests. During TKI treatment, patients were classified as euthyroid (thyrotropin [TSH] normal), subclinical hypothyroidism (TSH 5-10 mIU/L, or higher TSH if free thyroxine normal), or overt hypothyroidism (TSH >10 mIU/L, low free thyroxine, or requiring thyroid hormone replacement). The timing of thyroid dysfunction and TKI used were assessed. Risk factors for incident hypothyroidism were evaluated using multivariate models. In 538 adult patients included, subclinical hypothyroidism occurred in 71 (13.2%) and overt hypothyroidism occurred in 144 (26.8%) patients with TKI therapy, following a median cumulative TKI exposure of 196 days (interquartile range [IQR] 63.5-518.5 days). The odds of hypothyroidism were greatest during the first six months on a TKI. Median exposure time on the TKI concurrent with thyroid dysfunction in patients treated with only one TKI was 85 days (IQR 38-293.5 days) and was similar to the 74 days (IQR 38-133.3 days) in patients treated previously with other TKI (p = 0.41). Patients who developed hypothyroidism compared to those who remained euthyroid had greater odds of being female (odds ratio = 1.99 [confidence interval 1.35-2.93], p < 0.01), but greater cumulative TKI exposure and greater number of TKI received were not associated with

Association of Van Wyk Grumbach and Debre Semelaigne Syndromes with Severe Hypothyroidism.

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Oden Akman, Alkim; Tayfun, Meltem; Demirel, Fatma; Ucakturk, Seyit Ahmed; Gungor, Ali

2015-12-01

Van Wyk Grumbach syndrome (VWGS) and Kocher-Debre Semelaigne syndrome (KDSS) are rare forms of pseudo-precocious puberty and myopathy in patients with longstanding untreated hypothyroidism. We present the case of an adolescent girl who developed pseudo-precocious puberty and myopathy caused by long-term untreated hypothyroidism. A 17-year-old female patient was referred to our outpatient clinic due to menstrual irregularities. She had muscle pain and multiple cystic ovaries in addition to clinical signs of severe congenital hypothyroidism. High levels of creatinine and creatinine kinase and accompanying muscle hypertrophy were present. After the initiation of L-thyroxine therapy, the symptoms were alleviated in a short time. Congenital and acquired hypothyroidism should be considered in the differential diagnosis of pseudo-precocious puberty and myopathy that presents with muscle pain, muscle hypertrophy, and elevated creatinine kinase levels. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Longitudinal study on thyroid function in patients with thalassemia major: High incidence of central hypothyroidism by 18 years

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Ashraf T Soliman

2013-01-01

Full Text Available Introduction: Primary hypothyroidism is one of the most frequent complications observed in-patients suffering from thalassemia. We investigated and reviewed the thyroid function in all thalassemic patients attending the Pediatric Endocrine Clinic of Hamad Medical Center, Doha, Qatar during the last 10 years of follow-up. Patients and Methods: A total of 48 patients with ί-thalassemia major between 5 years and 18 years of age. Thyroid dysfunction was defined as follows: Overt hypothyroidism (low Free thyroxine [FT4] and increased thyroid-stimulating hormone [TSH] levels >5 μIU/ml; subclinical hypothyroidism (normal FT4, TSH between 5 μIU/ml and 10 μIU/ml and central (secondary hypothyroidism (low FT4 and normal or decreased TSH. Results: A total of 48 patients (22 males and 26 females completed a 12 year-period of follow-up. During this period, hypothyroidism was diagnosed in 17/48 (35% of patients. There was no significant difference in the prevalence in males 7/22 (32% versus females 10/26 (38%. Sixteen of the patients had hypothyroidism after the age of 10 years (94%. The prevalence of overt hypothyroidism had risen from 0% at the age of 7 years to 35% at the age of 18 years. None of the patients had high anti-thyroperoxidase antibody titers. Out of 17 patients, 13 patients with hypothyroidism had normal or low TSH level (not appropriately elevated indicative of defective hypothalamic pituitary response to low FT4 (central hypothyroidism. Three patients (6.3% had subclinical hypothyroidism (TSH between 5 uIU/ml and 10 uIU/ml and normal FT4. The general trend of FT4 level showed progressive decrease over the 12 years, whereas, TSH levels did not show a corresponding increase. These data suggested defective hypothalamic pituitary thyroid axis involving both TSH and FT4 sretion in patients with thalassemia major over time. There was a significant negative correlation between serum ferritin and FT4 (r = −0.39, P = 0.007, but no correlation

Evaluation and Management of the Child with Hypothyroidism.

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Leung, Alexander K C; Leung, Alexander A C

2018-05-08

Thyroid hormones are critical for early neurocognitive development as well as growth and development throughout childhood. Prompt recognition and treatment of hypothyroidism is therefore of utmost importance to optimize physical and neurodevelopmental outcomes. To review in depth the evaluation, diagnosis, and treatment of hypothyroidism in children. A PubMed search was completed in Clinical Queries using the key term "hypothyroidism". Patents were searched using the key term "hypothyroidism" from www.freepatentsonline.com. Hypothyroidism may be present at birth (congenital hypothyroidism) or develop later in life (acquired hypothyroidism). Thyroid dysgenesis and dyshormonogenesis account for approximately 85% and 15% of permanent cases of congenital primary hypothyroidism, respectively. More than 95% of infants with congenital hypothyroidism have few, if any, clinical manifestations of hypothyroidism. Newborn screening programs allow early detection of congenital hypothyroidism. In developed countries, Hashimoto thyroiditis is the most common cause of goiter and acquired hypothyroidism in children and adolescents. Globally, iodine deficiency associated with goiter is the most common cause of hypothyroidism. Central hypothyroidism is uncommon and may be associated with other congenital syndromes and deficiencies of other pituitary hormones. Familiarity of the clinical features would allow prompt diagnosis and institution of treatment. Recent patents related to the management of childhood hypothyroidism are discussed. To optimize neurocognitive outcome in infants with congenital hypothyroidism, treatment with levothyroxine should be started as soon as possible, preferably within the first two weeks of life. Children with acquired hypothyroidism should also be treated early to ensure normal growth and development as well as cognitive outcome. The target is to keep serum TSH hypothyroidism. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Acute psychosis as an initial manifestation of hypothyroidism: a case report.

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Ueno, Shinichi; Tsuboi, Satoko; Fujimaki, Motoki; Eguchi, Hiroto; Machida, Yutaka; Hattori, Nobutaka; Miwa, Hideto

2015-11-17

Hypothyroidism is one of the most important causes of treatable dementia, and psychosis occasionally associated with it is known as myxedema madness. We report a case of a 90-year-old patient who developed myxedema madness acutely without overt clinical symptoms and signs suggestive of hypothyroidism. A 90-year-old Japanese man, a general practitioner, was admitted to our emergency room because of acute-onset lethargy, delusions, and hallucinations. He had been actively working until 3 days before the admission. Upon admission, his general physical examination was unremarkable. However, a blood investigation showed the presence of hypothyroidism, and computed tomography revealed pleural effusion and ascites. Electroencephalography revealed diffuse slow waves with a decrease of α-wave activity. A single-photon emission computed tomography scan revealed a decrease of cerebral blood flow in both frontal lobes. The patient was soon treated with thyroid hormone replacement therapy. Following normalization of his thyroid function, both pleural effusion and ascites diminished and his electroencephalographic activity improved simultaneously; however, he did not recover from his psychosis. Myxedema madness should be kept in mind in the differential diagnosis of acute psychosis in elderly patients, particularly the oldest patients as in our case, because manifestations of hypothyroidism often may be indistinguishable from the aging process.

IMPAIRMENT IN SHORT-TERM BUT ENHANCED LONG-TERM SYNAPTIC POTENTIATION AND ERK ACTIVATION IN ADULT HIPPOCAMPAL AREA CA1 FOLLOWING DEVELOPMENTAL HYPOTHYROIDISM.

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The EPA must evaluate the risk of exposure of the developing brain to chemicals with the potential to disrupt thyroid hormone homeostasis. The existing literature identifies morphological and neurochemical indices of severe neonatal hypothyroidism in the early postnatal period i...

Short-term clinical experience with hip resurfacing arthroplasty.

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Cieliński, Łukasz; Kusz, Damian; Wojciechowski, Piotr; Dziuba, Anna

2007-01-01

This paper discusses the authors' experience with hip resurfacing arthroplasty. Although introduced many years ago, the method did not gain wide popularity because of poor long-term outcomes. At present, owing to the introduction of metal-on-metal bearings and hybrid fixation techniques, short- and mid-term results are very good and encourage wider use of this technique, especially in the younger and more active patients whose results with standard total hip replacements would be unsatisfactory. We performed 13 hip resurfacing arthroplasties at our institution between August 1, 2005, and May 1, 2006. Twelve patients reported for the scheduled follow-up and were included in the study. Treatment outcomes were assessed according to the Harris Hip Score. The short-term outcomes of hip resurfacing arthroplasties are encouraging. In the study group there were no intraoperative complications, infections, peripheral nerve palsy, hip dislocations or clinically overt vein thrombosis. All of the patients reported complete or major pain relief. Clinical assessment according to the Harris Hip Score revealed improvement from an average of 57.7 (20.1) points preoperatively to an average of 87.7 (12) points after the surgery. Crutches were used for a maximum of 6 weeks postoperatively. All of the patients are currently able to walk without crutches with full weight-bearing. 1) Hip resurfacing arthroplasty seems to be an advisable method of operative management of younger, active patients, in whom standard THR would be associated with a high risk of failure; it allows THR to be postponed and carried out as a revision surgery with the acetabular component already in place. 2) Despite the good short- and mid-term results, the utility of this method should be evaluated with caution due to the lack of adequate long-term follow-up data.

Eye Movements and Overt Rehearsal in Word Recall

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Geiselman, Ralph E.; Bellezza, Francis S.

1977-01-01

Rates of overt rehearsal and eye movement were compared to each other, and were also compared as predictors of immediate and delayed recall. Concludes that total looking time was the best predictor of long-term retention and that recall performance following overt rehearsal was different from recall performance following silent study. (Editor/RK)

A Japanese Family with Central Hypothyroidism Caused by a Novel IGSF1 Mutation.

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Nishigaki, Satsuki; Hamazaki, Takashi; Fujita, Keinosuke; Morikawa, Shuntaro; Tajima, Toshihiro; Shintaku, Haruo

2016-12-01

Hemizygous mutations in the immunoglobulin superfamily member 1 (IGSF1) gene have been demonstrated to cause congenital central hypothyroidism in males. This study reports a family with a novel mutation in the IGSF1 gene located on the long arm of the X chromosome. A two-month-old boy was diagnosed with central hypothyroidism because of prolonged jaundice. A thyrotropin-releasing hormone (TRH) stimulation test indicated dysfunction in both the hypothalamus and the pituitary gland, and prompted the IGSF1 gene to be analyzed. The patient had a novel nonsense variant, c.2713C>T (p.Q905X), in exon 14 of the IGSF1 gene. Studies of the family revealed that the patient's sister and mother were heterozygous carriers of the IGSF1 mutation. The patient's maternal uncle carried the same mutation as the proband but had no overt symptoms. The mother and uncle started levothyroxine supplementation because of subclinical hypothyroidism. A novel mutation (c.2713C>T, p.Q905X) of the IGSF1 gene was identified that causes congenital central hypothyroidism in a Japanese family. The findings further expand the clinical heterogeneity of this entity.

Central hypothyroidism - a neglected thyroid disorder.

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Beck-Peccoz, Paolo; Rodari, Giulia; Giavoli, Claudia; Lania, Andrea

2017-10-01

Central hypothyroidism is a rare and heterogeneous disorder that is characterized by a defect in thyroid hormone secretion in an otherwise normal thyroid gland due to insufficient stimulation by TSH. The disease results from the abnormal function of the pituitary gland, the hypothalamus, or both. Moreover, central hypothyroidism can be isolated or combined with other pituitary hormone deficiencies, which are mostly acquired and are rarely congenital. The clinical manifestations of central hypothyroidism are usually milder than those observed in primary hypothyroidism. Obtaining a positive diagnosis for central hypothyroidism can be difficult from both a clinical and a biochemical perspective. The diagnosis of central hypothyroidism is based on low circulating levels of free T 4 in the presence of low to normal TSH concentrations. The correct diagnosis of both acquired (also termed sporadic) and congenital (also termed genetic) central hypothyroidism can be hindered by methodological interference in free T 4 or TSH measurements; routine utilization of total T 4 or T 3 measurements; concurrent systemic illness that is characterized by low levels of free T 4 and normal TSH concentrations; the use of the sole TSH-reflex strategy, which is the measurement of the sole level of TSH, without free T 4 , if levels of TSH are in the normal range; and the diagnosis of congenital hypothyroidism based on TSH analysis without the concomitant measurement of serum levels of T 4 . In this Review, we discuss current knowledge of the causes of central hypothyroidism, emphasizing possible pitfalls in the diagnosis and treatment of this disorder.

Transient hypothyroidism following radioiodine therapy for thyrotoxicosis

International Nuclear Information System (INIS)

Connell, J.M.C.; McCruden, D.C.; Alexander, W.D.; Hilditch, T.E.

1983-01-01

A prospective study of thyroid function including serial tracer radioisotope uptake measurements in 55 patients treated with 131 I therapy is described. Five patients had an episode of transient hypothyroidism within eight months of treatment: in three of these patients this was due to impaired organification of iodide, with normal iodide trapping by the thyroid (as measured by a twenty minute 123 I uptake) being preserved. In contrast, in all patients who developed permanent hypothyroidism, iodide trapping was markedly diminished and did not recover. It is suggested that hypothyroidism due to organification failure following 131 I therapy is potentially short-lived; where hypothyroidism is associated with gross impairment of iodide trapping, recovery is unlikely. Early iodine uptake measurements may be of value in selecting those patients whose hypothyroidism is transient and who do not require permanent thyroid hormone replacement. (author)

Death rates for acquired hypothyroidism and thyrotoxicosis in English populations (1979-2010): comparison of underlying cause and all certified causes.

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Goldacre, M J; Duncan, M E

2013-03-01

Overt hypothyroidism and thyrotoxicosis have widespread systemic effects and are associated with increased mortality. Most death certificates that include them do not have the thyroid disease coded as the underlying cause of death. To describe regional (1979-2010) and national (1995-2010) trends in mortality rates for acquired hypothyroidism and thyrotoxicosis, analysing all certified causes of death (termed 'mentions') and not just the underlying cause. Analysis of death registration data. Analysis of data for the Oxford region (mentions available from 1979) and English national data (mentions available from 1995). The data were grouped in periods defined by different national rules for selecting the underlying cause of death (1979-83, 1984-92, 1993-2000 and 2001-10) and were also analysed as single calendar years. Mentions mortality for acquired hypothyroidism in the Oxford region declined significantly from 1979 to 2010: the average annual percentage change (AAPC) was -2.6% (95% confidence intervals -3.5, -1.8). Most of the decrease occurred during the 1980s. The AAPC in rates for later years in England (1995-2010) was non-significant at 0.2% (-0.7, 1.0). Mortality rates for thyrotoxicosis decreased significantly: the AAPC was -2.8% (-4.1, -1.5) in the Oxford region and -3.8% (-4.7, -3.0) in England. In England, between 2001 and 2010, hypothyroidism or thyrotoxicosis was coded as the underlying cause of death on, respectively, 17 and 24% of death certificates that included them. Mortality rates for hypothyroidism and thyrotoxicosis have fallen substantially. The fall is probably wholly or mainly a result of improved care.

Very early onset of autoimmune thyroiditis in a toddler with severe hypothyroidism presentation: a case report.

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Marzuillo, Pierluigi; Grandone, Anna; Perrotta, Silverio; Ruggiero, Laura; Capristo, Carlo; Luongo, Caterina; Miraglia Del Giudice, Emanuele; Perrone, Laura

2016-06-18

In infants under 3 years of age acquired primary hypothyroidism caused by autoimmune thyroiditis is very rare. Hypothyroidism can manifest with different signs and symptoms and has a wide range of presentations from subclinical hypothyroidism to overt form. We describe a child with acquired autoimmune thyroiditis during a very early period of life and with a severe hypothyroidism presentation. A 22-month-old white male patient with normal neonatal screening presented with a six-month history of asthenia and cutaneous pallor. At general clinical and biochemical exams he showed weight gain, statural growth deceleration, poor movements, sleepy expression, instability while walking, myxoedema, bradycardia, open anterior fontanelle, changes in the face habitus, macrocytic anaemia, ascites, and high CPK, creatinine and cholesterol levels. Acquired autoimmune thyroiditis was the final diagnosis. The thyroxine replacement therapy normalized all the clinical and biochemical abnormalities but at the age of 30 months his mental age showed a delay of 6 months. Our case could give useful learning points: i) although the screening for congenital hypothyroidism is routinely performed, a severe hypothyroidism (for example due to autoimmune thyroiditis) can anyway occur early in life and the clinicians should consider this possibility; ii) hypothyroidism can have a misleading and multi-face clinical presentation; iii) anemia, rhabdomyolysis and high creatinine levels should always include the hypothyroidism in the differential diagnosis; iv) thyroxine replacement therapy is able to revert all the clinical manifestations related to the hypothyroidism; v) evaluating the patient's previous pictures could play an important role in resolving a diagnostic conundrum.

Inherited hypothyroidism.

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Jackson, I M

1976-03-01

Familial hypothyroidism results from both thyroidal and extrathyroidal dysfunction. Specific intrathyroidal abnormalities in thyroid hormone synthesis causing goitrous hypothyroidism are iodide trap defect, organification defect, "coupling" defect, iodoprotein defect, and dehalogenase defect. The diagnostic studies for each are outlined utilizing radioiodine(131I) studies. Other causes of cretinism include failure of the thyroid gland to respond to TSH and lack of pituitary TSH (or hypothalamic TRH). The syndrome of peripheral resistance to thyroid hormone is discussed. The diagnosis of inherited hypothyrodism rests on an adequate family history and measurement of both T4 and TSH levels which can be determined in cord blood or peripheral blood from the infant. The importance of early treatment of hypothyroidism in the neonatal period to prevent brain damage is emphasized. The rec:nt discovery of the importance of reverse T3 (RT3) in fetal thyroid metabolism is described, and the possibility of amniocentesis as an aid in prenatal diagnosis is considered. The place of intrauterine administration of thyroid hormone to the fetus at risk from hypothyroidism is uncertain at this time and requires carefully controlled studies and long-term follow-up.

Subclinical hypothyroidism in pregnant rats impaired learning and memory of their offspring by promoting the p75NTR signal pathway

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Fan Zhang

2018-05-01

Full Text Available Objective: Maternal hypothyroidism during pregnancy can affect the neurodevelopment of their offspring. This study aimed to investigate the effects of maternal subclinical hypothyroidism (SCH on spatial learning and memory, and its relationship with the apoptotic factors in cerebral cortex of the offspring. Methods: Female adult Wistar rats were randomly divided into three groups (n = 15 per group: control (CON group, SCH group and overt hypothyroidism (OH group. Spatial learning and memory in the offspring were evaluated by long-term potentiation (LTP and Morris water-maze (MWM test. The protein expression of the p75 neurotrophin receptor (p75NTR, phospho-c-Jun N-terminal kinase (p-JNK, the pro-apoptotic protein p53 and Bax were detected by Western blotting. Results: The Pups in the SCH and OH groups showed longer escape latencies in the MWM and decreased field-excitatory post synaptic potentials in LTP tests compared with those in the CON group. p75NTR, p-JNK, p53 and Bax expression levels in the cerebral cortex increased in pups in the SCH and OH groups compared with those in the CON group. Conclusions: Maternal SCH during pregnancy may impair spatial learning and memory in the offspring and may be associated with the increased apoptosis in the cerebral cortex.

The early development of transient and permanent hypothyroidism following radioiodine therapy for hyperthyroid Graves' disease

International Nuclear Information System (INIS)

Peden, N.R.; Hart, J.R.

1984-01-01

The outcome in 110 patients first treated with radioiodine (mean dose 6.56 mCi) for hyperthyroid Graves' disease in 1980 was reviewed. In 23 percent of the patients the disease had not been controlled by the initial dose after 3 months, and 17 percent were given one or two more doses. Within 2 years 65 percent of the patients required replacement thyroxine therapy. Although about half of the patients were biochemically hypothyroid 3 months after the last dose of iodine 131, this condition was transient in a third of them; five of these patients even became hyperthyroid again. Patients with transient, as opposed to permanent, hypothyroidism at 3 months tended to be clinically euthyroid but to have residual palpable thyroid tissue and only a modest reduction in the serum thyroxine level. It is therefore recommended that patients not overtly hypothyroid 3 months after treatment with 131 I be observed still longer before thyroxine replacement therapy is instituted

The frequency of hypothyroidism and its relationship with HCV positivity in patients with thalassemia major in southern Iran.

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Haghpanah, Sezaneh; Jelodari, Shohreh; Karamifar, Hammdollah; Saki, Forough; Rahimi, Rahil; De Sanctis, Vincenzo; Dehbozorgian, Javad; Karimi, Mehran

2018-03-27

Hypothyroidism is one the most complication due to iron overload in patients with β-thalassemia major (TM). On the other hand these patients are prone to Hepatitis C virus (HCV) infection that can cause  thyroid dysfunction by itself or as the side effect of treatment with interferon (INF) or IFN plus ribavirin. The aim of this study is to evaluate the association of hypothyroidism with HCV positivity and serum ferritin levels in patients with TM. In this cross-sectional study, 201 randomly selected patients with TM who were registered at the Thalassemia Clinic of a tertiary hospital in Shiraz, southern Iran were investigated. Thyroid function tests and serologic screening assays for HCV seropositivity (HCV Ab and HCV-RNA) were conducted for all patients. Frequency of hypothyroidism was 22.9% including 19.9% subclinical hypothyroidism, 2% primary overt hypothyroidism and 1% central hypothyroidism. Eighty six patients (42.8%) were HCV Ab positive and 60 patients (29.9%) were HCV RNA positive. No significant relationship was found between hypothyroidism and HCV positivity or receiving IFN-α (P>0.05). Hypothyroidism showed a borderline significant association with high serum ferritin levels in TM patients (P=0.055). Our results showed no significant association between hypothyroidism and HCV infection in TM patients. It seems that the main mechanism of hypothyroidism in our patients is iron overload; however, for better evaluation a larger multicenter study is recommended.  Also due to the importance of consequences of HCV infection, more careful pre-transfusional screening of blood should be considered in TM patients.

Verbal episodic memory in young hypothyroid patients

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Vatsal Priyadarshi Pandey

2017-01-01

Full Text Available Context: Hypothyroidism affects cognitive functions especially memory. However, most of the previous studies have generally evaluated older hypothyroid patients and sample size of these studies varied in terms of age range. Aims: To see whether hypothyroidism affects memory in young patients. Settings and Design: The sample consisted of 11 hypothyroid patients with an age of 18–49 and 8 healthy controls matched on age and education. Subjects and Methods: Verbal episodic memory was assessed using Hindi adaptation of Rey-Auditory Verbal Learning Test. Statistical Analysis Used: An independent t-test was used to see the difference between mean performance of the patient group and healthy control on memory measures. Results: Results indicated nonsignificant difference between verbal episodic memory of patient group and healthy controls. Conclusions: On the basis of these findings, it was concluded that hypothyroidism may not affect younger patients in terms of episodic verbal memory the same way as it does in the older patients.

Efficacy of Low-dose (2 millicurie) versus Standard-dose (4 millicurie) Radioiodine Treatment for Cats with Mild-to-Moderate Hyperthyroidism.

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Lucy, J M; Peterson, M E; Randolph, J F; Scrivani, P V; Rishniw, M; Davignon, D L; Thompson, M S; Scarlett, J M

2017-03-01

Radioiodine ( 131 I) is effective treatment for hyperthyroidism in cats, but optimal dose to restore euthyroidism without inducing hypothyroidism is unclear. Treatment-induced hypothyroidism can lead to azotemia and reduced duration of survival. To compare efficacy and short-term outcomes of low-dose 131 I versus higher, standard-dose 131 I as treatment for hyperthyroidism. A total of 189 client-owned cats undergoing 131 I treatment for mild-to-moderate hyperthyroidism (serum T 4 ≥ 4.0 μg/dL and hyperthyroidism, overt hypothyroidism (low T 4 , high TSH), subclinical hypothyroidism (normal T 4 , high TSH), and azotemia. There was no significant difference in prevalence of cats with persistent hyperthyroidism between standard- and low-dose treatment groups at 3 (0% versus 5.3%; P = .34) and 6 (0% versus 3.3%; P = .51) months. Overt (18% versus 1%; P = .0005) or subclinical (46% versus 21%; P = .004) hypothyroidism was more common in cats at 6 months after standard-dose 131 I. No difference in incidence of azotemia existed between groups, but cats treated with standard-dose 131 I had higher creatinine concentrations (P effective for cats with mild-to-moderate hyperthyroidism, as evidenced by a cure rate of >95% with reduced frequency of iatrogenic hypothyroidism and azotemia. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

A 2013 survey of clinical practice patterns in the management of primary hypothyroidism.

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Burch, Henry B; Burman, Kenneth D; Cooper, David S; Hennessey, James V

2014-06-01

In 2012, comprehensive clinical practice guidelines (CPGs) were published regarding the management of hypothyroidism. We sought to document current practices in the management of primary hypothyroidism and compare these results with recommendations made in the 2012 American Thyroid Association (ATA)/American Association of Clinical Endocrinologists (AACE) hypothyroidism CPGs. In addition, we sought to examine differences in management among international members of U.S.-based endocrine societies and to compare survey results with those obtained from a survey of ATA members performed 12 years earlier. Clinical members of The Endocrine Society (TES), the ATA, and the AACE were asked to take a web-based survey consisting of 30 questions dealing with testing, treatment, and modulating factors in the management of primary hypothyroidism. In total, 880 respondents completed the survey, including 618 members of TES, 582 AACE members, and 208 ATA members. North American respondents accounted for 67.6%, Latin American 9.7%, European 9.2%, Asia and Oceania 8.1%, and Africa and Middle East 5.5%. Overt hypothyroidism would be treated using l-T4 alone by 99.2% of respondents; 0.8% would use combination l-T4 and liothyronine (l-T3) therapy. Generic l-T4 would be used by 49.3% and a brand name by 49.9%. The rate of replacement would be gradual (38.5%); an empiric dose, adjusted to achieve target (33.6%); or a calculated full replacement dose (27.8%). A target TSH of 1.0 to 1.9 mU/L was favored in the index case, but 3.0 to 3.9 mU/L was the most commonly selected TSH target for an octogenarian. Persistent hypothyroid symptoms despite achieving a target TSH would prompt testing for other causes by 84.3% of respondents, a referral to primary care by 11.3%, and a change to l-T4 plus l-T3 therapy by 3.6%. Evaluation of persistent symptoms would include measurement of T3 levels by 21.9% of respondents. Subclinical disease with a TSH 5.0 to 10.0 mU/L would be treated without further

Hypothyroidism During Tyrosine Kinase Inhibitor Therapy Is Associated with Longer Survival in Patients with Advanced Nonthyroidal Cancers.

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Lechner, Melissa G; Vyas, Chirag M; Hamnvik, Ole-Petter R; Alexander, Erik K; Larsen, P Reed; Choueiri, Toni K; Angell, Trevor E

2018-04-01

Tyrosine kinase inhibitor (TKI)-induced thyroid dysfunction is recognized as a common adverse effect of treatment, but the importance of incident hypothyroidism during TKI therapy remains unclear. This study analyzed the prognostic significance of hypothyroidism during TKI therapy in cancer patients. This was a retrospective cohort study of adult patients with advanced nonthyroidal cancer treated with TKI and available thyroid function testing at three affiliated academic hospitals from 2000 to 2017. Patients with preexisting thyroid disease were excluded. Demographic, clinical, and cancer treatment data were collected. Thyroid status with TKI treatment was determined from thyroid function testing and initiation of thyroid medication, and classified as euthyroid (thyrotropin [TSH] normal), subclinical hypothyroidism (SCH; TSH 5-10 mIU/L, or higher TSH if free thyroxine normal), or overt hypothyroidism (OH; TSH >10 mIU/L, low free thyroxine, or requiring replacement). Multivariate models were used to evaluate the effect of TKI-related hypothyroidism on overall survival (OS). Of 1120 initial patients, 538 remained after exclusion criteria. SCH occurred in 72 (13%) and OH in 144 (27%) patients with TKI therapy. Patients with hypothyroidism had significantly longer OS, with median OS in euthyroid patients of 685 days [confidence interval (CI) 523-851] compared to 1005 days [CI 634-1528] in SCH and 1643 days [CI 1215-1991] in OH patients (p hypothyroid patients (SCH and OH) with TSH >5 and hypothyroidism in cancer patients treated with TKI is associated with significantly improved OS, should not necessitate TKI dose reduction or discontinuation, and may provide independent prognostic information.

Hypothyroidism

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... to meet your body's needs. This condition is hypothyroidism. Hypothyroidism is more common in women, people with other ... cause. Other causes include thyroid nodules, thyroiditis, congenital hypothyroidism, surgical removal of part or all of the ...

Postpartum follow-up in women diagnosed with subclinical hypothyroidism during pregnancy

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K Neelaveni

2017-01-01

Full Text Available Background: Management guidelines about the thyroid disease in pregnancy are silent about the postpartum course of new onset subclinical hypothyroidism (SCH. Hence, we analyzed the 2 years outcome of SCH diagnosed during pregnancy. Materials and Methods: We conducted this retrospective study using the medical records of patients with new onset SCH during pregnancy between 2010 and 2013 (n = 718. Patients who stopped their levothyroxine after delivery with a 2-year follow-up record were included. We excluded patients with known thyroid disorders and continuous use of drugs that affect the thyroid results. The patients were divided into two groups (Group 1 – euthyroid and Group 2 – hypothyroid based on the final outcome after 2 years. The data were analyzed using appropriate statistical methods and a P < 0.05 was considered statically significant. Results: A total of 559 (77.8% women stopped levothyroxine after delivery, and the final follow-up data were available for 467 patients only. At the end of 2 years, 384 (82.2% remained euthyroid, and the remaining 83 (17.8% developed hypothyroidism. SCH and overt hypothyroidism were seen in 22 and 61 patients, respectively. Group 2 patients had higher mean age (25.5 vs. 23.6 years, goiter (51 vs. 2%, initial thyroid stimulating hormone (7.9 vs. 5.1 μIU/mL, and thyroid antibody positivity (76 vs. 13% (P < 0.001. Conclusion: The majority of patients with SCH during pregnancy remain euthyroid after delivery. Advanced age, goiter, positive family history, and thyroid autoimmunity increase the future risk of hypothyroidism in patients with SCH diagnosed during pregnancy.

Incidence of hypothyroidism occurring long after iodine-131 therapy for hyperthyroidism

International Nuclear Information System (INIS)

Holm, L.E.; Lundell, G.; Israelsson, A.; Dahlgvist, I.

1982-01-01

We have studied the long-term incidence of hypothyroidism in 4,473 formerly hyperthyroid patients given I-131 therapy between 1951 and 1975. The mean age at the first I-131 treatment was 56 yr. Six percent developed hypothyroidism within one year of therapy, and 72% within 26 yr. Prior antithyroid medication did not affect the incidence of hypothyroidism. Patients cured with one dose of I-131 had a lower cumulative long-term incidence of hypothyroidism than those requiring more than one dose

No impact of dietary iodine restriction in short term development of hypothyroidism following fixed dose radioactive iodine therapy for Graves' disease.

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Jacob, Jubbin Jagan; Stephen, Charles; Paul, Thomas V; Thomas, Nihal; Oommen, Regi; Seshadri, Mandalam S

2015-01-01

The increased incidence of autoimmune thyroid disease with increasing dietary iodine intake has been demonstrated both epidemiologically and experimentally. The hypothyroidism that occurs in the first year following radioactive iodine therapy is probably related to the destructive effects of the radiation and underlying ongoing autoimmunity. To study the outcomes at the end of six months after fixed dose I, (131)therapy for Graves' disease followed by an iodine restricted diet for a period of six months. Consecutive adult patients with Graves' disease planned for I(131) therapy were randomized either to receive instructions regarding dietary iodine restriction or no advice prior to fixed dose (5mCi) I(131) administration. Thyroid functions and urinary iodine indices were evaluated at 3(rd) and 6(th) month subsequently. Forty seven patients (13M and 34F) were assessed, 2 were excluded, 45 were randomized (Cases 24 and Controls 21) and 39 patients completed the study. Baseline data was comparable. Median urinary iodine concentration was 115 and 273 μg/gm creat (p = 0.00) among cases and controls respectively. Outcomes at the 3(rd) month were as follows (cases and controls); Euthyroid (10 and 6: P = 0.24), Hypothyroid (3 and 5: P = 0.38) and Hyperthyroid (7 and 8: P = 0.64). Outcomes at the end of six months were as follows (cases and controls); Euthyroid (10 and 5: P = 0.12), Hypothyroid (3 and 5: P = 0.38) and Hyperthyroid (7 and 9: P = 0.43). Of the hypothyroid patients 5 (cases 1 and controls 4: P = 0.13) required thyroxine replacement. There was no statistical significant difference in the outcome of patients with dietary iodine restriction following I(131) therapy for Graves' disease.

Language familiarity effects in short-term memory: the role of output delay and long-term knowledge.

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Thorn, Annabel S C; Gathercole, Susan E; Frankish, Clive R

2002-10-01

Four experiments examined the origins of language familiarity effects in bilingual short-term recall. In Experiments 1A and 1B, bilingual adults were tested on serial recall and probed serial recall of words and nonwords in their first and second languages. A first-language advantage was obtained on both measures, indicating that the beneficial effects of language familiarity are not exclusively attributable to lesser output delay during overt recall. In Experiments 2A and 2B, the same group of bilinguals was tested on serial recall and serial recognition of word lists in both languages. Although a sizeable first-language advantage was obtained on the serial recall measure, recognition performance was comparable in the two languages. On the basis of these results it is suggested that language differences in bilingual immediate memory arise in large part as a consequence of the differential availability of language-specific long-term knowledge with which to support retrieval processes in serial recall.

Prevalence of subclinical hypothyroidism in adults visiting primary health-care setting in Riyadh.

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Al Eidan, Eidan; Ur Rahman, Saeed; Al Qahtani, Saeed; Al Farhan, Ali I; Abdulmajeed, Imad

2018-01-01

Background and objectives : Subclinical hypothyroidism is an asymptomatic condition with normal thyroxin and raised thyroid stimulating hormone (TSH) level. The objective of the study was to determine the prevalence of subclinical hypothyroidism in primary health care (PHC) settings in Riyadh and explore the relationship of TSH level with age, gender, family history, body mass index, and co-morbid conditions. Subjects and methods : A cross-sectional study of adult visitors to nine satellites PHC clinics in military housing in Riyadh was carried out. TSH concentration and free T4 levels were measured. Data were collected by nurses and physicians during routine clinical practice in primary care. Descriptive analysis was performed on all variables in study, and relationships were explored using chi-square, t -test, analysis of variance, and linear regression. Results : A total of 340 out of 394 participants in the study gave blood samples. Subclinical hyperthyroidism was identified in 2.1% ( p  = .001) and subclinical hypothyroidism in 10.3% ( p  = .001) of the PHC visitors. TSH levels were found to be significantly higher ( p  = .047) in elderly population of ≥60 years and those with family history of thyroid disease. Non-significant upward trends were noted in TSH levels with hyperlipidemia and increasing blood pressure. No overt hyperthyroidism or hypothyroidism was found in our study sample. Conclusion : Subclinical hypothyroidism has a prevalence of 10% of adults visiting PHC's. TSH levels are higher in the elderly, which warrants screening of those aged 60 years and above.

Thyroid volume in hypothyroidism due to autoimmune disease follows a unimodal distribution: evidence against primary thyroid atrophy and autoimmune thyroiditis being distinct diseases

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Carlé, Allan; Pedersen, Inge Bülow; Knudsen, Nils

2009-01-01

CONTEXT: Primary overt autoimmune hypothyroidism is often divided into primary idiopathic hypothyroidism with thyroid atrophy (Ord's disease) and hypothyroidism with goitre (Hashimoto's disease). OBJECTIVE: The aim of the present study was to characterize the two subtypes of disease. DESIGN...... program including thyroid ultrasonography and measurements of thyroid autoantibodies. Of the 144 patients investigated (58% of all invited), 139 were compared with 556 sex-, age-, and region-matched controls from the cohort. RESULTS: Patients had lower median (11.6 ml vs. 13.5 ml, P = 0.001) and a more...... dispersed distribution of thyroid volumes compared with controls (P thyroid volume showed a Gaussian distribution in both males and females with no bimodal pattern. Nearly all patients had measurable thyroid autoantibodies, but with increasing thyroid volume (quartile I, II, III, and IV...

Ocular changes in primary hypothyroidism.

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Ozturk, Banu T; Kerimoglu, Hurkan; Dikbas, Oguz; Pekel, Hamiyet; Gonen, Mustafa S

2009-12-29

To determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy. Thirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT), anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus) and cup to disc ratio (C/D), mean retinal thickness and mean retinal nerve fiber layer (RNFL) thickness measurements with optical coherence tomography (OCT) in addition to ophthalmological examination preceeding the replacement therapy and at the 1(st), 3(rd )and 6(th )months of treatment. The mean age of the patients included in the study were 40.58 +/- 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP) revealed no significant change. The mean CCT was 538.05 +/- 3.85 mu initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 +/- 0.03 and the mean retinal thickness was 255.83 +/- 19.49 mu initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered. Neither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.

Hyperprolactinemia in Children with Subclinical Hypothyroidism.

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Sharma, Neera; Dutta, Deep; Sharma, Lokesh Kumar

2017-12-15

Prevalence of hyperprolactinemia in children with subclinical hypothyroidism (ScH) is not known. This study aimed to determine the occurrence and predictors of hyperprolactinemia in euthyroid children and in children with ScH and overt primary hypothyroidism (OPH). Serum prolactin levels were estimated in consecutive children hypothyroidism, multiple pituitary hormone deficiency, comorbid states, and drug-induced hyperprolactinemia were excluded. From the initially screened 791 children, hormonal data from 602 children who fulfilled all criteria were analyzed. Seventy-one (11.79%) of these had ScH, and 33 (5.48%) had OPH. Occurrence of hyperprolactinemia was highest in the OPH group (51.51%), followed by ScH (30.98%) and euthyroid children (4.41%) (p<0.001). Median (25 th -75 th percentiles) levels for prolactin in euthyroid, ScH, and OPH children were 13.3 (9.4-17.95), 19.15 (15.97-30.12), and 28.86 (17.05-51.9) ng/mL, respectively (p<0.001). In children, prolactin levels were comparable in males and females. An age-related increase in serum prolactin was noted in euthyroid children, which was statistically significant in post-pubertal (16-18 years) children. Area under the curve for thyroid stimulating hormone (TSH) in predicting hyperprolactinemia in children was 0.758 (95% confidence interval: 0.673-0.829; p<0.001). TSH ≥4.00 mIU/L had a sensitivity of 69.4% and specificity of 77.6% in detecting hyperprolactinemia. Hyperprolactinemia is common in children with ScH and OPH. TSH ≥4.00 mIU/L has a good sensitivity and specificity in predicting hyperprolactinemia in children. More studies are needed to establish if hyperprolactinemia should be an indication for treating ScH in children.

[Economic evaluation od the value of early diagnosis and management of hypothyroidism in hypercholesterolemia].

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Lenne, X; Allenet, B; Laurent, P; Lebrun, T; Wemeau, J L

1999-11-01

The aim of the study was to assess the economic consequences of the early screening and management for overt hypothyrodism in elderly women suffering from hypercholesterolaemia. A cost analysis was performed using screening decision tree followed by a Markov model, targeted on an hypothetical cohort of elderly women (i.e. > or = 55 years of age) suffering from hypercholesterolaemia. Two arms were compared, "no diagnosis", patients being treated by lipid lowering drugs in the long run, "diagnosis", patients being screened for thyroid disturbance and proposed adequate correction by hormone treatment. Relevant clinical data introduced into the model were obtained from published data and from experts. At the end of the initial diagnostic, patients could enter three different health states: euthyroidism, subclinical hypothyroidism or overt hypothyroidism. During 30 years, patients were assumed to be seen each year by a general practitioner for clinical examination and cholesterol dosage, plus, according to the health state evolution, TSH and T4 screening. In the baseline analysis, euthyroidian patients who had a inexplicable degradation of hypercholesterolaemia control were tested for TSH and, if abnormal, T4 serum; for subclinical hypothyroidian patients, TSH and T4 were measured every year. The direct costs taken into account were concerning medical supervision, drug treatment and biologic exams. Costs were analysed from the societal perspective and were expressed in 1998 French Francs (FF) with an accounting rate of 5% by year. A sensitivity analysis was also performed. The total cost at 30-year was equal to 25,006 F for "diagnosis" strategy, to 24,390 F for "no diagnosis" strategy. The incremental cost of the first strategy decreased according to the time horizon. It was 6.8% at 5-year and 2.5% at 30-year. Results were sensitive to variation in response rate of hypercholesterolaemic patients to hormone treatment of hypothyroidism (0.25 in base-case). The investment

The Effects of Altered Membrane Cholesterol Levels on Sodium Pump Activity in Subclinical Hypothyroidism

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Suparna Roy

2017-02-01

Full Text Available BackgroundMetabolic dysfunctions characteristic of overt hypothyroidism (OH start at the early stage of subclinical hypothyroidism (SCH. Na+/K+-ATPase (the sodium pump is a transmembrane enzyme that plays a vital role in cellular activities in combination with membrane lipids. We evaluated the effects of early changes in thyroid hormone and membrane cholesterol on sodium pump activity in SCH and OH patients.MethodsIn 32 SCH patients, 35 OH patients, and 34 euthyroid patients, sodium pump activity and cholesterol levels in red blood cell membranes were measured. Serum thyroxine (T4 and thyroid stimulating hormone (TSH levels were measured using enzyme-linked immunosorbent assays. Differences in their mean values were analysed using post hoc analysis of variance. We assessed the dependence of the sodium pump on other metabolites by multiple regression analysis.ResultsSodium pump activity and membrane cholesterol were lower in both hypothyroid groups than in control group, OH group exhibiting lower values than SCH group. In SCH group, sodium pump activity showed a significant direct dependence on membrane cholesterol with an inverse relationship with serum TSH levels. In OH group, sodium pump activity depended directly on membrane cholesterol and serum T4 levels. No dependence on serum cholesterol was observed in either case.ConclusionDespite the presence of elevated serum cholesterol in hypothyroidism, membrane cholesterol contributed significantly to maintain sodium pump activity in the cells. A critical reduction in membrane cholesterol levels heralds compromised enzyme activity, even in the early stage of hypothyroidism, and this can be predicted by elevated TSH levels alone, without any evident clinical manifestations.

Development of Autoimmune Overt Hypothyroidism Is Highly Associated With Live Births and Induced Abortions but Only in Premenopausal Women

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Carle, Allan; Pedersen, Inge Buelow; Knudsen, Nils

2014-01-01

: In conditional multivariate logistic regression models, we analyzed the associations between the development of autoimmune hypothyroidism and age at menarche/menopause, years of menstruations, pregnancies, spontaneous and induced abortions, live births, and years on oral contraceptives and postmenopausal hormone...

Free recall in Williams syndrome: is there a dissociation between short- and long-term memory?

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Brock, Jon; Brown, Gordon D A; Boucher, Jill

2006-04-01

Two experiments used the free recall paradigm to investigate verbal memory abilities in Williams syndrome (WS)--a rare genetic disorder. In an earlier free recall study, Vicari et al. (1996a) reported that, unlike TD controls, children with WS showed a recency effect but failed to show a primacy effect. These authors interpreted their findings as evidence for a dissociation between relatively strong verbal short-term memory and relatively impaired verbal long-term memory. In Experiment 1 of the current study, children with WS and TD controls showed comparable improvements in performance with repeated testing of the same material, indicating similar long-term learning of the test items. Neither group showed evidence of primacy effects. However, the extent of primacy effects in free recall is known to depend on the rehearsal strategy that participants adopt. In Experiment 2, therefore, participants were encouraged to engage in overt cumulative rehearsal. This manipulation resulted in significant and comparable primacy effects in both groups, although neither group demonstrated a significant change in overall performance. There was therefore no evidence from either experiment for a dissociation between short- and long-term verbal memory in WS.

A Prospective Study of Routine Screening of Hypothyroidism in Antenatal Patients and their Outcome with Levothyroxine Treatment

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Manisha Sahu

2017-10-01

Full Text Available Introduction: Pregnancy with hypothyroidism is associated with significant maternal, fetal and neonatal complications. Early diagnosis and treatment can effectively reduce such complications. Aim: To find out the complications that can be prevented or reduced in severity in adequately treated hypothyroid pregnant women. Materials and Methods: Pregnant women attending obstetrics’ OPD upto 20 weeks were screened with serum Thyroid Stimulating Hormone (TSH and free Thyroxine FT4. Those having Subclinical Hypothyroidism (SCH, Overt Hypothyroidism (OH and pre pregnant women with hypothyroid were treated with levothyroxine as per consulting with endocrine unit. They were followed up till delivery and any adverse outcomes were documented such as Pregnancy Induced Hypertension (PIH, Pre Eclamptic Toxemia (PET, Abruption, Preterm Premature Rupture Of Membranes (PPROM, Low Birth Weight (LBW, oligohydramnios, Gestational Diabetes Mellitus (GDM, abortion, Intra Uterine Death (IUD, mode of delivery and Neonatal Intensive Care Unit (NICU admission were compared with similar complications documented among normal pregnant women excluding the treated hypothyroid during a period of one year study. Untreated or late trimester diagnosed hypothyroidism were excluded from study group. Results: Incidence of PIH, GDM, Oligohydramnios, PPROM, NICU admissions and caesarean section were higher among hypothyroid pregnant women though adequately treated than the control pregnant women. But incidence of LBW baby is less and no one had developed PET, Eclampsia or abruption among treated group. Comparing between SCH and OH incidence of PIH is almost equal in both while association of GDM is more in OH. A p-value for PIH, GDM, Oligohydramnios, PPROM developed in hypothyroid pregnant ladies which were calculated by Yates corrected Chi-Square and Fisher’s-exact test from open epic version 3.03a. A p-value is significant (<0.001 for PIH, GDM, PPROM and oligohydramnios but

Hypothyroidism

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... weight gain, cold intolerance, constipation, impaired fertility, and depression. • Women are much more likely than men to develop hypothyroidism. • Women with hypothyroidism should discuss ...

Association between the clinical classification of hypothyroidism and reduced TSH in LT4 supplemental replacement treatment for pregnancy in China.

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Zhang, Lyu; Zhang, Zhaoyun; Ye, Hongying; Zhu, Xiaoming; Li, Yiming

2016-01-01

The study was aimed to evaluate the effects of levothyroxine (LT4) supplemental replacement treatment for pregnancy and analyze the associations between the clinical classification of hypothyroidism and reduced thyroid-stimulating hormone (TSH) in LT4 therapy. Totally, 195 pregnant women with hypothyroidism receiving routine prenatal care were enrolled. They were categorized into three groups: overt hypothyroidism (OH), subclinical hypothyroidism (SCH) with negative thyroperoxidase antibody (TPOAb), and SCH with positive TPOAb. The association between the clinical classification and reduced TSH in LT4 supplemental replacement treatment was assessed. The results indicated that reduced TSH was significantly different among the groups according to the clinical classifications (p = 0.043). The result was also significantly different between patients with OH and patients with SCH and negative TPOAb (p = 0.036). Similar result was reported for the comparison between patients with OH and patients with SCH and positive TPOAb (p = 0.016). Multiple variable analyses showed that LT4 supplementation, gestational age and the variable of clinical classifications were associated with reduced TSH independently. Our data suggested that the therapeutic effect of substitutive treatment with LT4 was significantly associated with different clinical classifications of hypothyroidism in pregnancy and the treatment should begin as soon as possible after diagnosis.

Audit of long-term and short-term liabilities

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Korinko M.D.

2017-03-01

Full Text Available The article determines the importance of long-term and short-term liabilities for the management of financial and material resources of an enterprise. It reviews the aim, objects and information generators for realization of audit of short-term and long-term obligations. The organizing and methodical providing of audit of long-term and short-term liabilities of an enterprise are generalized. The authors distinguish the stages of realization of audit of long-term and short-term liabilities, the aim of audit on each of the presented stages, and recommend methodical techniques. It is fixed that it is necessary to conduct the estimation of the systems of internal control and record-keeping of an enterprise by implementation of public accountant procedures for determination of volume and maintenance of selection realization. After estimating the indicated systems, a public accountant determines the methodology for realization of public accountant verification of long-term and short-term liabilities. The analytical procedures that public accountants are expedient to use for realization of audit of short-term and long-term obligations are determined. The authors suggest the classification of the educed defects on the results of the conducted public accountant verification of short-term and long-term obligations.

Depression and anxiety in hypothyroidism.

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Demet, M M; Ozmen, B; Deveci, A; Boyvada, S; Adiguzel, H; Aydemir, O

2003-09-01

The aim of the study was to determine the prevalence and severity of depression and anxiety in patients with hypothyroidism and to compare this with euthyroid patients. Thirty patients with hypothyroidism and 30 euthyroid controls attending the Endocrinology outpatient department of Celal Bayar University, Medical Faculty were included in the study. The hormonal screening was done by immunoassay and haemagglutination methods. Then, for psychiatric assessment, Hospital Anxiety and Depression Scale (HAD), Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A) were used. There was no difference between the two groups in terms of demographic features. Total scores obtained from the scales used in the study did not differ significantly (p > 0.05). The frequency of items of both HAM-D and HAM-A did not show any differences in the two groups. By Wilks' Lambda discriminant analysis, depressive mood (HAM-D#1) was found to be the discriminating feature between the hypothyroid group and the euthyroid group. Therefore, depression and anxiety were not outstanding features in hypothyrodism. However, depression was more significant in the hypothyroid than euthyroid group.

Ocular changes in primary hypothyroidism

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Pekel Hamiyet

2009-12-01

Full Text Available Abstract Background To determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy. Findings Thirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT, anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus and cup to disc ratio (C/D, mean retinal thickness and mean retinal nerve fiber layer (RNFL thickness measurements with optical coherence tomography (OCT in addition to ophthalmological examination preceeding the replacement therapy and at the 1st, 3rd and 6th months of treatment. The mean age of the patients included in the study were 40.58 ± 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP revealed no significant change. The mean CCT was 538.05 ± 3.85 μ initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 ± 0.03 and the mean retinal thickness was 255.83 ± 19.49 μ initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered. Conclusions Neither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.

Risks and safety of combination therapy for hypothyroidism.

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Jonklaas, Jacqueline

2016-08-01

Hypothyroidism is currently a condition that can be treated, but not cured. Although levothyroxine reverses stigmata of hypothyroidism in most individuals, some patients feel dissatisfied with 'monotherapy', and this has stimulated interest in 'combination therapy' with both levothyroxine and liothyronine. A search of PubMed was conducted using terms including hypothyroidism, treatment, benefits, risks, and safety. Based on the articles identified, the body of evidence regarding the efficacy of traditional levothyroxine is reviewed. Concerns with levothyroxine therapy including impaired quality of life in treated patients, thyroxine-predominant hormone ratios, and inadvertent iatrogenic thyroid disease are discussed. The trials of combination therapy performed since 1999 were reviewed. The heterogeneity of these trials, both in terms of design and results, is discussed. The potential for new trials to determine whether combination therapy can reverse the dissatisfaction associated with monotherapy, while avoiding non-physiologic hormone ratios, inadvertent thyrotoxicosis, and unacceptable side effects is discussed. Expert commentary: Research regarding which therapy fully reverses hypothyroidism at a tissue and cellular level is ongoing. The field would be advanced by the development of an extended release preparation of liothyronine. In the future regeneration of functional thyroid follicles from stem cells may offer hope for curing hypothyroidism.

Hypothyroidism

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Myxedema coma, the most severe form of hypothyroidism, is rare. It occurs when thyroid hormone levels get very ... or certain medicines in people with untreated hypothyroidism. Myxedema coma is a medical emergency that must be treated ...

Amiodarone-induced hypothyroidism. A common complication of prolonged therapy: a report of eight cases

International Nuclear Information System (INIS)

Hawthorne, G.C.; Campbell, N.P.; Geddes, J.S.; Ferguson, W.R.; Postlethwaite, W.; Sheridan, B.; Atkinson, A.B.

1985-01-01

Amiodarone is a widely used antiarrhythmic drug, which contains 75 mg of iodide per 200 mg of active substance. Eight patients receiving long-term amiodarone therapy became hypothyroid. Seven of these patients had no previous history of thyroid dysfunction or goiter. Antithyroid antibodies were absent, and standard perchlorate discharge tests were positive in seven patients when hypothyroidism was diagnosed. In one patient, amiodarone therapy was withdrawn; over the next nine months, the hypothyroidism resolved, and results of the perchlorate discharge test reverted to normal. The authors conclude that amiodarone-induced hypothyroidism is similar to previously described iodide-induced hypothyroidism. It may develop in the absence of a previous history of thyroid disease, and all patients receiving long-term amiodarone therapy should therefore be regularly monitored for hypothyroidism

Linear Analysis of Autonomic Activity and Its Correlation with Creatine Kinase-MB in Overt Thyroid Dysfunctions.

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Mavai, Manisha; Singh, Yogendra Raj; Gupta, R C; Mathur, Sandeep K; Bhandari, Bharti

2018-04-01

Autonomic activity may be deranged in thyroid dysfunctions and may lead to cardiovascular morbidity and mortality. Myopathy is a common manifestation in thyroid disorders and may be associated with raised serum creatine kinase (CK). We hypothesized that cardiovascular abnormality in thyroid dysfunction may manifest as raised CK-MB. This study was designed to investigate the correlation of CK and its isoform CK-MB with thyroid profile and linear parameters of heart rate variability (HRV). The study was conducted on 35 hypothyroid and hyperthyroid patients each, and 25 age-matched healthy controls. Autonomic activity was assessed by simple short term 5-min HRV. Biochemical evaluation of serum thyroid profile, CK-NAC and CK-MB were estimated in all the subjects. Our results demonstrated low HRV in hypo- as well as hyperthyroid patients. We observed significantly higher serum CK levels in hypothyroid patients when compared to hyperthyroids and controls. However, no significant differences were observed in CK-MB levels in the three groups. Significant positive correlation of CK with TSH and negative correlation with some HRV parameters (LF power, HF power, total power, SDNN, RMSSD) was observed in hypothyroid patients. Whereas correlation of CK-MB with thyroid profile as well as HRV parameters was non-significant in all the groups. Based on the CK and CK-MB findings and their correlation, we conclude that the cardiovascular changes seen in thyroid dysfunctions may primarily be due to autonomic imbalance without apparent cardiac muscle involvement. Whereas, raised CK levels indicate predominantly skeletal muscle involvement in hypothyroid patients.

Neurotoxicity of developmental hypothyroxinemia and hypothyroidism in rats: Impairments of long-term potentiation are mediated by phosphatidylinositol 3-kinase signaling pathway

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Wang, Yi; Wei, Wei; Wang, Yuan; Dong, Jing; Song, Binbin; Min, Hui [Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang (China); Teng, Weiping, E-mail: twpendocrine@yahoo.com.cn [Liaoning Provincial Key Laboratory of Endocrine Diseases, the First Hospital of China Medical University, Shenyang (China); Chen, Jie, E-mail: chenjie@mail.cmu.edu.cn [Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang (China)

2013-09-01

Neurotoxicity of iodine deficiency-induced hypothyroidism during developmental period results in serious impairments of brain function, such as learning and memory. These impairments are largely irreversible, and the underlying mechanisms remain unclear. In addition to hypothyroidism, iodine deficiency may cause hypothyroxinemia, a relatively subtle form of thyroid hormone deficiency. Neurotoxicity of developmental hypothyroxinemia also potentially impairs learning and memory. However, more direct evidence of the associations between developmental hypothyroxinemia and impairments of learning and memory should be provided, and the underlying mechanisms remain to be elucidated. Thus, in the present study, we investigated the effects of developmental hypothyroxinemia and hypothyroidism on long-term potentiation (LTP), a widely accepted cellular model of learning and memory, in the hippocampal CA1 region. The activation of the phosphatidylinositol 3-kinase (PI3K) signaling pathway – a pathway closely associated with synaptic plasticity and learning and memory – was also investigated. Wistar rats were treated with iodine deficient diet or methimazole (MMZ) to induce developmental hypothyroxinemia or hypothyroidism. The results showed that developmental hypothyroxinemia caused by mild iodine deficiency and developmental hypothyroidism caused by severe iodine deficiency or MMZ significantly reduced the field-excitatory postsynaptic potential (f-EPSP) slope and the population spike (PS) amplitude. Decreased activation of the PI3K signaling pathway was also observed in rats subjected to developmental hypothyroxinemia or hypothyroidism. Our results may support the hypothesis that neurotoxicity of both developmental hypothyroxinemia and hypothyroidism causes damages to learning and memory. Our results also suggest that decreased activation of the PI3K signaling pathway may contribute to impairments of LTP caused by neurotoxicity of both developmental hypothyroxinemia and

Neurotoxicity of developmental hypothyroxinemia and hypothyroidism in rats: Impairments of long-term potentiation are mediated by phosphatidylinositol 3-kinase signaling pathway

International Nuclear Information System (INIS)

Wang, Yi; Wei, Wei; Wang, Yuan; Dong, Jing; Song, Binbin; Min, Hui; Teng, Weiping; Chen, Jie

2013-01-01

Neurotoxicity of iodine deficiency-induced hypothyroidism during developmental period results in serious impairments of brain function, such as learning and memory. These impairments are largely irreversible, and the underlying mechanisms remain unclear. In addition to hypothyroidism, iodine deficiency may cause hypothyroxinemia, a relatively subtle form of thyroid hormone deficiency. Neurotoxicity of developmental hypothyroxinemia also potentially impairs learning and memory. However, more direct evidence of the associations between developmental hypothyroxinemia and impairments of learning and memory should be provided, and the underlying mechanisms remain to be elucidated. Thus, in the present study, we investigated the effects of developmental hypothyroxinemia and hypothyroidism on long-term potentiation (LTP), a widely accepted cellular model of learning and memory, in the hippocampal CA1 region. The activation of the phosphatidylinositol 3-kinase (PI3K) signaling pathway – a pathway closely associated with synaptic plasticity and learning and memory – was also investigated. Wistar rats were treated with iodine deficient diet or methimazole (MMZ) to induce developmental hypothyroxinemia or hypothyroidism. The results showed that developmental hypothyroxinemia caused by mild iodine deficiency and developmental hypothyroidism caused by severe iodine deficiency or MMZ significantly reduced the field-excitatory postsynaptic potential (f-EPSP) slope and the population spike (PS) amplitude. Decreased activation of the PI3K signaling pathway was also observed in rats subjected to developmental hypothyroxinemia or hypothyroidism. Our results may support the hypothesis that neurotoxicity of both developmental hypothyroxinemia and hypothyroidism causes damages to learning and memory. Our results also suggest that decreased activation of the PI3K signaling pathway may contribute to impairments of LTP caused by neurotoxicity of both developmental hypothyroxinemia and

Long-term outcome in levothyroxine treated patients with subclinical hypothyroidism and concomitant heart disease

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Andersen, Mette Nygaard; Olsen, Anne-Marie Schjerning; Madsen, Jesper Clausager

2016-01-01

Context: Subclinical hypothyroidism is a common condition that may lead to impaired cardiac function. Objective: This study sought to examine the effects of levothyroxine treatment in patients with subclinical hypothyroidism and heart disease. Design: This was a register-based historical cohort s...

Cardiovascular risk factors in patients with subclinical hypothyroidism

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Pešić Milica

2007-01-01

Full Text Available Background/Aims. Overt hypothyroidism is disease associated with accelerated arteriosclerosis and coronary heart disease. Whether subclinical hypothyroidism (SH is associated with increased cardiovascular risk is contraversial. As SH is a high prevalence thyroid dysfunction, specially in older women, it is important to evaluate cardiovascular risk factors in these patients and that was the aim of this study. Methods. We examined 30 patients with SH and 20 healthy controls. Subclinical hypothireoidism was defined as an elevated thyrotropin (TSH (> 4.5 mU/L and normal free thyroxine (FT4 level. In all the participants we determined body mass index (BMI, blood pressure, TSH, FT4, antibodies to thyroid peroxidase, antibodies to thyroglobulin, total cholesterol, high density lipoprotein (HDL cholesterol, low density lipoprotein (LDL cholesterol, triglicerides, total cholesterol/HDL cholesterol ratio and LDL/HDL cholesterol ratio. Results. Mean BMI in patients with SH was significantly higher (p < 0.05, as well as diastolic blood pressure (p < 0.01 compared with the controls. Average levels of total cholesterol (5.40±0.62 vs 5.06±0.19 mmol/l, p < 0.01 and triglycerides (2.16±0.56 vs 1.89±0.24 mmol/l, p < 0.05 were also significantly higher in the group with SH. Individual analysis revealed that the percentage of patients with SH having borderline elevated total cholesterol (63.33%, hypertrigliceridemia (43.33% and elevated total cholesterol/HDL cholesterol ratio (26.67% were significantly higher than the percentage in the controls. No significant correlation between TSH and lipid parameters was detected. Conclusion. Subclinical hypothyroidism was associated with higher BMI, diastolic hypertension, higher total cholesterol and triglicerides levels and higher total cholesterol/HDL cholesterols ratio. This might increase the risk of accelerated arteriosclerosis in patients with SH.

Subclinical Hypothyroidism in Children: Normal Variation or Sign of a Failing Thyroid Gland?

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Kaplowitz PaulB

2010-05-01

Full Text Available Subclinical hypothyroidism (SCH, defined by a normal total or free T4 level and a mildly elevated TSH (typically 5–10 mU/L, is common in children, but there is currently no consensus on management. Several recent pediatric studies indicate that progression of SCH to overt hypothyroidism (OH is uncommon and that over a period of several years, elevated TSH usually either normalizes or persists but does not increase. The etiology appears to be multifactorial, with some cases representing minor developmental abnormalities, some related to obesity, some to mild autoimmune thyroiditis, and some associated with mutations in the gene for the TSH-receptor. There are no pediatric studies showing clinical benefit of treating these children with thyroid hormone, but additional studies in this area are needed. Since few cases of pediatric SCH progress to OH, treatment can be deferred, and periodic follow-up testing may be the preferred strategy, with elevated thyroid antibodies or a goiter being considered risk factors for eventual OH.

Long-term results of radioiodine (131I) therapy in 331 patients with Graves' disease

International Nuclear Information System (INIS)

Saito, Shintaro; Sakurada, Toshiro; Yamamoto, Makiko; Yoshida, Katsumi; Kaise, Kazuo

1980-01-01

To evaluate the long-term results of 131 I treatment for Graves' disease, the thyroid function was studied in 331 patients 5 - 17 years after this therapy. Twenty-five patients were hypothyroid and had already been on thyroid medication. Among the remaining 306 patients without any treatment for thyroid disorder, 188 patients (61.4%) had a normal thyroid-stimulating hormone (TSH) level (less than 10 μU/ml) of whom 151 were euthyroid with normal thyroxine (T 4 ) and triiodothyronine (T 3 ) level. 118 patients (38.6%) had a high TSH level, of whom 22 were hypothyroid with low T 4 and T 3 levels and 38 were with normal T 3 and low T 4 levels, and 14 patients out of this 38 were clinically hypothyroid. Although all of the patients with high TSH levels do not require the replacement therapy for hypothyroidism, the overt hypothyroidism seems to occur sooner or later in patients with a lower T 4 level. Among 331 patients studied, 61 (18.4%) were clinically hypothyroid. The incidence of hypothyroidism was 20.7% after 10 years of 131 I treatment and 33% after 15 - 17 years. The incidence of patients with high TSH levels was 50% after 10 years of 131 I treatment and 60% after 15 - 17 years. Both of cumulative incidence of hypothyroidism and patients with high TSH levels increased linearly with years after the treatment, which coincided with the linear decrease of mean T 4 and T 3 levels and linear increase of mean TSH level with years after the treatment. The difference of positive incidence of antithyroid antibodies between cases of normal TSH level and high TSH level was not significant. (author)

The interrelation between hypothyroidism and glaucoma

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Thvilum, Marianne; Hjelm Brandt Kristensen, Frans; Brix, Thomas Heiberg

2017-01-01

Data on the association between hypothyroidism and glaucoma are conflicting. We sought to shed light on this by conducting a critical review and meta-analyses. The meta-analyses were conducted in adherence with the widely accepted MOOSE guidelines. Using the Medical Subject Heading (MeSH) terms......: hypothyroidism, myxoedema and glaucoma or intraocular pressure, case-control studies, cohort studies and cross-sectional studies were identified (PubMed) and reviewed. Using meta-analysis, the relative risk (RR) of coexistence of glaucoma and hypothyroidism was calculated. Based on the literature search......, thirteen studies fulfilled the inclusion criteria and could be categorized into two groups based on the exposure. The designs of the studies varied considerably, and there was heterogeneity related to lack of power, weak phenotype classifications and length of follow-up. Eight studies had glaucoma (5757...

Celiac-Associated Autoimmune Thyroid Disease: A Study of 16 Patients with Overt Hypothyroidism

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Hugh J Freeman

1995-01-01

Full Text Available Previous reports have suggested that autoimmune thyroid disorders (including Hashimoto’s or lymphocytic thyroiditis may occur in patients with celiac disease. In this study, the prevalence of thyroid disease was explored in a series of 96 consecutive patients seen with biopsy-defined adult celiac disease (average age 47.3 years. Sixteen celiac patients (average age 58.1 years were detected with hypothyroidism, including four treated with radio-iodine ablation or thyroidectomy for Grave’s disease. In addition to celiac disease, almost half had dermatitis herpetiformis, a small intestinal neoplasm (particularly lymphoma or both. Diagnosis of thyroid disease preceded diagnosis of celiac disease in 13 patients or was made concurrently in two patients. In only one patient was thyroid disease detected after celiac disease was diagnosed. This indicates that thyroid diseases occur more commonly in celiac disease than is currently appreciated, possibly due to shared embryological origins or common immunopathological features, and may be the presenting clinical manifestation in adults especially if there is coexistent dermatitis herpetiformis. Careful monitoring of this subgroup may be warranted because of the frequency of neoplastic intestinal diseases, particularly lymphoma.

Medicines for Hypothyroidism

Science.gov (United States)

... T4 made by your body. What is the treatment for hypothyroidism? People who have hypothyroidism must take a pill ... Questions to ask your doctor • Do I have hypothyroidism? • What treatment do I need for it? • What are the ...

Thyroid antibody status, subclinical hypothyroidism, and the risk of coronary heart disease: an individual participant data analysis.

Science.gov (United States)

Collet, Tinh-Hai; Bauer, Douglas C; Cappola, Anne R; Asvold, Bjørn O; Weiler, Stefan; Vittinghoff, Eric; Gussekloo, Jacobijn; Bremner, Alexandra; den Elzen, Wendy P J; Maciel, Rui M B; Vanderpump, Mark P J; Cornuz, Jacques; Dörr, Marcus; Wallaschofski, Henri; Newman, Anne B; Sgarbi, José A; Razvi, Salman; Völzke, Henry; Walsh, John P; Aujesky, Drahomir; Rodondi, Nicolas

2014-09-01

Subclinical hypothyroidism has been associated with increased risk of coronary heart disease (CHD), particularly with thyrotropin levels of 10.0 mIU/L or greater. The measurement of thyroid antibodies helps predict the progression to overt hypothyroidism, but it is unclear whether thyroid autoimmunity independently affects CHD risk. The objective of the study was to compare the CHD risk of subclinical hypothyroidism with and without thyroid peroxidase antibodies (TPOAbs). A MEDLINE and EMBASE search from 1950 to 2011 was conducted for prospective cohorts, reporting baseline thyroid function, antibodies, and CHD outcomes. Individual data of 38 274 participants from six cohorts for CHD mortality followed up for 460 333 person-years and 33 394 participants from four cohorts for CHD events. Among 38 274 adults (median age 55 y, 63% women), 1691 (4.4%) had subclinical hypothyroidism, of whom 775 (45.8%) had positive TPOAbs. During follow-up, 1436 participants died of CHD and 3285 had CHD events. Compared with euthyroid individuals, age- and gender-adjusted risks of CHD mortality in subclinical hypothyroidism were similar among individuals with and without TPOAbs [hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.87-1.53 vs HR 1.26, CI 1.01-1.58, P for interaction = .62], as were risks of CHD events (HR 1.16, CI 0.87-1.56 vs HR 1.26, CI 1.02-1.56, P for interaction = .65). Risks of CHD mortality and events increased with higher thyrotropin, but within each stratum, risks did not differ by TPOAb status. CHD risk associated with subclinical hypothyroidism did not differ by TPOAb status, suggesting that biomarkers of thyroid autoimmunity do not add independent prognostic information for CHD outcomes.

Effects of 18 months of L-T4 replacement in women with subclinical hypothyroidism.

LENUS (Irish Health Repository)

Adrees, M

2012-02-01

CONTEXT: Some of the cardiovascular and renal abnormalities seen in overt hypothyroidism have also been reported in subclinical hypothyroidism (SCH). Short-term L-T4 replacement in SCH improves cardiovascular risk markers and reduces carotid intima-media thickness (CIMT), a surrogate marker of atherosclerosis. The haemodynamic and renal effects of L-T4 replacement in SCH are poorly understood. OBJECTIVES: To compare cardiovascular risk factors and renal variables in women with SCH and normal women. To study the effects of L-T4 replacement in SCH subjects on these variables and on structural and functional changes in common carotid and brachial arteries. DESIGN: Fifty-six women with SCH before and after L-T4 replacement for 18 months and 56 normal women of similar age distribution were studied. Blood Pressure (BP), plasma lipids and homocysteine were measured and renal function evaluated [estimation of glomerular filtration rate (eGFR) using standard equations and measurement of serum Cystatin-C] in women with SCH before and after 18 months of l-T4, and in healthy women. CIMT and endothelial function (using brachial artery ultrasound) were studied before and after L-T4 in a subgroup of women with SCH. RESULTS: Systolic and diastolic BP, total cholesterol, triglyceride, LDL-cholesterol, lipoprotein(a) and homocysteine were greater in SCH (P < 0.05), and following L-T4 replacement decreased (P < 0.05) to levels that no longer differed from normal subjects. Estimated GFR was reduced and serum Cystatin-C increased (P < 0.05) in SCH. These variables also normalized following L-T4. Following L-T4 replacement the carotid artery baseline diameter increased by 7.1% and CIMT decreased by a mean value of 13%, while brachial artery diameter increased basally by 12.5% and following endothelium-dependent vasodilatation by 17.5% (P < 0.05). However, the increment following reactive hyperaemia did not differ before or following L-T4 replacement. CONCLUSION: Normalization of

Pediatric polytrauma : Short-term and long-term outcomes

NARCIS (Netherlands)

vanderSluis, CK; Kingma, J; Eisma, WH; tenDuis, HJ

Objective: To assess the short-term and long-term outcomes of pediatric polytrauma patients and to analyze the extent to which short-term outcomes can predict long-term outcomes. Materials and Methods: Ail pediatric polytrauma patients (Injury Severity Score of greater than or equal to 16, less than

Hypothyroidism in Women.

Science.gov (United States)

Dunn, Donna; Turner, Carla

2016-01-01

Hypothyroidism, a disease in which the thyroid gland does not make enough thyroid hormone, is the second most common endocrine disorder among women. Symptoms of hypothyroidism include fatigue, weight gain, alteration in cognition, infertility, and menstrual abnormalities. The most common cause of hypothyroidism in the United States is Hashimoto's thyroiditis. The American Thyroid Association recommends an initial screening for thyroid disease at age 35years and every 5years thereafter. Thyroid-stimulating hormone is highly sensitive to thyroid dysfunction and is used to evaluate thyroid disorders. Monotherapy with levothyroxine is the standard for treating hypothyroidism. Diagnosing hypothyroidism requires appropriate diagnostic tests to facilitate prompt diagnosis and treatment. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

Hypothyroidism (image)

Science.gov (United States)

Hypothyroidism is a decreased activity of the thyroid gland which may affect all body functions. The rate ... and physical sluggishness. The most severe form of hypothyroidism is myxedema, which is a medical emergency.

Central Diabetes Insipidus, Central Hypothyroidism, Renal Tubular ...

African Journals Online (AJOL)

readmitted to the hospital because of jaundice and failure to thrive, for which he was investigated and diagnosed to have central congenital hypothyroidism. Shortly thereafter, he was admitted to our institute with a history of vomiting, decreased oral intake, polyuria, and dehydration having lasted 5 days. He was investigated ...

Hypothyroidism and the Heart.

Science.gov (United States)

Udovcic, Maja; Pena, Raul Herrera; Patham, Bhargavi; Tabatabai, Laila; Kansara, Abhishek

2017-01-01

Hypothyroidism is a commonly encountered clinical condition with variable prevalence. It has profound effects on cardiac function that can impact cardiac contractility, vascular resistance, blood pressure, and heart rhythm. With this review, we aim to describe the effects of hypothyroidism and subclinical hypothyroidism on the heart. Additionally, we attempt to briefly describe how hypothyroid treatment affects cardiovascular parameters.

Congenital Hypothyroidism

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... Disease Featured Resource Find an Endocrinologist Search Congenital Hypothyroidism March 2012 Download PDFs English Espanol Editors Rosalind S. ... Resources MedlinePlus (NIH) Mayo Clinic What is congenital hypothyroidism? Newborn babies who are unable to make enough ...

Hypothyroidism in children

Directory of Open Access Journals (Sweden)

Renata Karwowska

2017-12-01

Full Text Available Thyroid hormones are crucial for normal development of a child from early foetal life. They have an impact on the development of the central nervous system, both prenatally and up to the age of 3 years, and regulate growth and most metabolic processes. Their importance has led to the introduction of screening for congenital hypothyroidism, which has been conducted in Poland for over 40 years. The diagnosis of congenital hypothyroidism necessitates immediate levothyroxine implementation and strict treatment monitoring. Thanks to iodine prophylaxis, children in Poland do not require additional iodine administration. An isolated increase in thyroid-stimulating hormone concentration without clinical signs of hypothyroidism and with negative antithyroid antibodies does not require treatment, but only monitoring of thyroidstimulating hormone levels. Children with positive antithyroid antibodies, genetic syndromes that predispose to hypothyroidism and history of thyroid irradiation require more frequent controls. The recommendations for suspected hypothyroidism presented in this article are based on the European Thyroid Association guidelines from 2014 on the management of subclinical hypothyroidism in children and pregnant women.

Long-term associative learning predicts verbal short-term memory performance

OpenAIRE

Jones, Gary; Macken, Bill

2017-01-01

Studies using tests such as digit span and nonword repetition have implicated short-term memory across a range of developmental domains. Such tests ostensibly assess specialized processes for the short-term manipulation and maintenance of information that are often argued to enable long-term learning. However, there is considerable evidence for an influence of long-term linguistic learning on performance in short-term memory tasks that brings into question the role of a specialized short-term...

Long-term associative learning predicts verbal short-term memory performance.

Science.gov (United States)

Jones, Gary; Macken, Bill

2018-02-01

Studies using tests such as digit span and nonword repetition have implicated short-term memory across a range of developmental domains. Such tests ostensibly assess specialized processes for the short-term manipulation and maintenance of information that are often argued to enable long-term learning. However, there is considerable evidence for an influence of long-term linguistic learning on performance in short-term memory tasks that brings into question the role of a specialized short-term memory system separate from long-term knowledge. Using natural language corpora, we show experimentally and computationally that performance on three widely used measures of short-term memory (digit span, nonword repetition, and sentence recall) can be predicted from simple associative learning operating on the linguistic environment to which a typical child may have been exposed. The findings support the broad view that short-term verbal memory performance reflects the application of long-term language knowledge to the experimental setting.

Hypothyroidism and the Heart

Science.gov (United States)

Udovcic, Maja; Pena, Raul Herrera; Patham, Bhargavi; Tabatabai, Laila; Kansara, Abhishek

2017-01-01

Hypothyroidism is a commonly encountered clinical condition with variable prevalence. It has profound effects on cardiac function that can impact cardiac contractility, vascular resistance, blood pressure, and heart rhythm. With this review, we aim to describe the effects of hypothyroidism and subclinical hypothyroidism on the heart. Additionally, we attempt to briefly describe how hypothyroid treatment affects cardiovascular parameters. PMID:28740582

Hypothyroidism following treatment for head and neck cancer

International Nuclear Information System (INIS)

Vrabec, D.P.; Heffron, T.J.

1981-01-01

One hundred ninety-six head and neck patients were studied to determine the effects of radiation therapy and surgery on thyroid function. Serum thyroid-stimulating hormone (TSH) levels were obtained as a screening test for primary hypothyroidism. Elevated TSH levels were found in 57 of the 196 patients (29.1%). The highest incidence of abnormal TSH values (66%) occurred in the group treated with combination radiation therapy and surgery, including partial thyroidectomy. TSH levels rose early in the posttreatment period with 60% of the abnormal values occurring within the first three posttreatment years. Posttreatment thyroid dysfunction was twice as common in women (48.6%) as in men (25.4%). When serum thyroxine levels by radioimmunoassay (T4RIA) were correlated with the elevated serum TSH levels, a similar pattern was seen with 65% of the patients in Group 3 having a decreased T4RIA level indicating overt hypothyroidism. Pretreatment levels of thyroid function including thyroid antibody studies should be established for all patients. Serial TSH levels should be done every three months during the first three posttreatment years and semiannually thereafter as long as the patient will return for follow-up care. All patients treated with combination radiation therapy and surgery who develop elevated TSH levels should be treated with thyroid replacement therapy. Patients receiving radiation therapy alone should receive replacement thyroid therapy if they develop a depressed T4RIA value or a pattern of gradually increasing TSH levels

Hypothyroidism: etiology, diagnosis, and management.

Science.gov (United States)

Almandoz, Jaime P; Gharib, Hossein

2012-03-01

Hypothyroidism is the result of inadequate production of thyroid hormone or inadequate action of thyroid hormone in target tissues. Primary hypothyroidism is the principal manifestation of hypothyroidism, but other causes include central deficiency of thyrotropin-releasing hormone or thyroid-stimulating hormone (TSH), or consumptive hypothyroidism from excessive inactivation of thyroid hormone. Subclinical hypothyroidism is present when there is elevated TSH but a normal free thyroxine level. Treatment involves oral administration of exogenous synthetic thyroid hormone. This review presents an update on the etiology and types of hypothyroidism, including subclinical disease; drugs and thyroid function; and diagnosis and treatment of hypothyroidism. Copyright © 2012 Elsevier Inc. All rights reserved.

Central hypothyroidism

Directory of Open Access Journals (Sweden)

Vishal Gupta

2011-01-01

Full Text Available Central hypothyroidism is defined as hypothyroidism due to insufficient stimulation by thyroid stimulating hormone (TSH of an otherwise normal thyroid gland. It has an estimated prevalence of approximately 1 in 80,000 to 1 in 120,000. It can be secondary hypothyroidism (pituitary or tertiary hypothyroidism (hypothalamus in origin. In children, it is usually caused by craniopharyngiomas or previous cranial irradiation for brain tumors or hematological malignancies. In adults, it is usually due to pituitary macroadenomas, pituitary surgeries or post-irradiation. Fatigue and peripheral edema are the most specific clinical features. Diagnosis is established by the presence of normal to low-normal TSH on the background of low-normal thyroid hormones, confirmed by the thyrotropin releasing hormone stimulation test. Therapy includes use of levothyroxine titrated to improvement in symptomology and keeping free T4 in the upper limit of normal reference range.

Hypothyroidism caused by 131I treatment for Graves disease

International Nuclear Information System (INIS)

Deng Shouzhen; Lin Xiangtong; He Wanting; Zhang Kaili; Zhang Jinming; Kuai Dayu

1991-01-01

The refollow-up has been carried out in hypothyroidism caused by 131 I treatment for Graves disease. The serum HS-TSH(IRMA), FT3, TSH(RIA), TT3, TT4, FT4I, MCA, TGA, Cholesterol and Triglyceride has been measured in 26 patient after 131 I treatment for 9.5 years in average. At the same time TRH stimulation test was also performed, and the clinical symptoms and signs assessed. The results showed that TSH is the most sensitive criterion for hypothyroidism, followed by Cholesterol and FT 4 I. The occurence of hypothyroidism may be related to the presence of thyroid antibody as demonstrated by the elevation of serum MCA, TGA. Therefore measurement of serum TSH, FT 4 I and Cholesterol during long term follow-up is beneficial for early diagnosis of hypothyroidism and evaluating the effect of substitution treatment

Comparative Effectiveness of Replacement Therapy with L-thyroxine in Women with Postoperative and Autoimmune Hypothyroidism

Directory of Open Access Journals (Sweden)

M Sch Madiyarova

2014-03-01

Full Text Available Objective. To compare the lipid profile, psychoemotional features, cognitive function, quality of life in women receiving adequate replacement therapy with levothyroxine for postoperative hypothyroidism and autoimmune (Hashimoto's hypothyroidism.Methods. 121 women (18-45 y.o. with primary hypothyroidism receiving levothyroxine for more than one year participated in the study. 66 women with autoimmune hypothyroidism, 55 - with hypothyroidism after subtotal thyroidectomy for Graves' disease. The scores for the Short-Form 36, Hospital Anxiety and Depression Scale, symptoms of hypothyroidism, Inventory of memory and attention, TSH, free T3, free T4 and lipid profiles were analyzed. Results. There were no significant differences between groups in the age, BMI, TSH, fT3, fT4 levels. The total cholesterol was higher in patients with postoperative hypothyroidism in comparison to autoimmune hypothyroidism ( р = 0,041. The levels of social functioning and mental health that reflect mental component of health were lower in patients with autoimmune hypothyroidism than with postoperative hypothyroidism ( p = 0,038, p = 0,019, respectively. The anxiety was higher in the same group ( p = 0,004. There was no difference in memory and attention levels. The anxiety level was higher in autoimmune hypothyroidism and “low-normal” TSH (0,4 - 2 µU/L than in postoperative hypothyroidism and the same TSH ( p = 0,016. Also in the group with postoperative hypothyroidism and “low-normal” TSH the cholesterol and prevalence of hypercholesterolemia were higher than in autoimmune hypothyroidism ( p = 0,017; р = 0,013. Conclusion. In young women with compensated autoimmune hypothyroidism the mental component of health is lower and the anxiety - higher than in postoperative hypothyroidism. Even in stable compensation of postoperative hypothyroidism the cholesterol level is higher comparing to the patients with autoimmune thyroiditis. And even in “low-normal” TSH

Opposing effects of oxytocin on overt compliance and lasting changes to memory.

Science.gov (United States)

Edelson, Micah G; Shemesh, Maya; Weizman, Abraham; Yariv, Shahak; Sharot, Tali; Dudai, Yadin

2015-03-01

From infancy we learn to comply with societal norms. However, overt compliance is not necessarily accompanied by a change in internal beliefs. The neuromodulatory processes underlying these different phenomena are not yet understood. Here, we test the role of oxytocin in controlling overt compliance versus internalization of information delivered by a social source. After intranasal oxytocin administration, participants showed enhanced compliance to the erroneous opinion of others. However, this expression was coupled with a decrease in the influence of others on long-term memories. Our data suggest that this dissociation may result from reduced conflict in the face of social pressure, which increases immediate conforming behavior, but reduces processing required for deep encoding. These findings reveal a neurobiological control system that oppositely affects internalization and overt compliance.

Rhabdomyolysis case based on hypothyroidism

OpenAIRE

Bilal Katipoglu; Ihsan Ates; Fatih Acehan; Ayşenur Meteris; Nisbet Yılmaz

2016-01-01

Summary Hypothyroidism is a wide clinical spectrum disorder and only a few cases in literature show this. Rhabdomyolysis and acute renal impairment can be seen concurrently in a hypothyroid state. We report a case of severe hypothyroidism with poor drug compliance leading to rhabdomyolysis and acute kidney injury. Learning points: Hypothyroidism is a rare cause of acute kidney injury. In this case report, we studied a rare occurrence of acute renal impairment due to hypothyroidism with poor d...

Short-term Assessment of HSCT Effects on the Hypothalamus-Pituitary Axis in Pediatric Thalassemic Patients.

Science.gov (United States)

Hamidieh, Amir Ali; Mohseni, Fariba; Behfar, Maryam; Hamidi, Zohreh; Alimoghaddam, Kamran; Pajouhi, Mohamad; Larijani, Bagher; Mohajeri-Tehrani, Mohammad-Reza; Ghavamzadeh, Ardeshir

2018-02-01

Beta thalassemia major (BTM) and its treatment by hematopoietic stem cell transplantation (HSCT) may have deleterious effects on the endocrine systems. We assessed endocrine complications of HSCT in pediatric patients for 3 months. In 20 (6 female) pediatric major thalassemic patients (mean age of 10.8 ± 3.9 years old), prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), T4, T3, thyroid-stimulating hormone (TSH), IGF-1, testosterone (in males) or estradiol (in females) were measured as a batch at the Endocrinology and Metabolism Research Center (EMRC) of Tehran University of Medical Sciences (TUMS) laboratories before HSCT and 1 and 3 months afterwards. The cosyntropin test for all and the clonidine test for short stature patients was conducted before HSCT. Before HSCT, delayed puberty and hypogonadotropic hypogonadism was found in 10% and 20% of patients, respectively. GH deficiency, low IGF1 and short stature was found in 25%, 55% and 40% of patients, respectively. Hypocortisolism, hypothyroidism and panhypopituitarism was found in 15%, 10% and 15% of patients, respectively. Prevalence of hypogonadotropic hypogonadism, low IGF1, hypothyroidism and panhypopituitarism was found in 20%, 40%, 10% and 10% of patients after 3 months, respectively (delayed puberty and short stature prevalence do not change after 3 months). HSCT caused lower T3 and estradiol and higher TSH. Corticosteroid users (15) had higher GH and lower T3 and testosterone or estradiol. Ferritin had a significant (negative) correlation with (before) prolactin and a significant correlation with T3 and T4 after HSCT. Age and acute graft-versus-host disease (GVHD) had no significant effect. Considering the small sample size and short duration of the study, it is difficult to reach any conclusion however it seems HSCT does not appear to have an overall positive or negative effect on prevalence of pituitary- hypothalamus axis disorders in pediatric thalassemic patients in 3 months. �

Oxidative stress in hypothyroid patients and the role of antioxidant supplementation

Directory of Open Access Journals (Sweden)

Sumit Kumar Chakrabarti

2016-01-01

Full Text Available Context: The available data concerning oxidant stress and antioxidant capacity in hypothyroidism are scanty and inconclusive. While some authors suggest that tissues may be protected from oxidant damage because of a hypometabolic state in hypothyroidism, others report increased oxidative stress in hypothyroidism. Selenium acts as a cofactor for the thyroid hormone (TH deiodinases that activate and then deactivate various THs and their metabolites. Selenium may inhibit thyroid autoimmunity. Aims: The study was designed, first, to study the impact of oxidative stress in patients of primary hypothyroidism due to autoimmune thyroiditis, by estimation of serum malondialdehyde (MDA as a biomarker of oxidative stress. Second, to study the change in MDA level pre- and post-L-thyroxine treatment. Finally, to look into the possible role of selenium supplementation on oxidative stress in autoimmune hypothyroidism. Subjects and Methods: Patients attending endocrine outpatient department (OPD services of IPGMER and SSKM hospital were considered for the study. Sixty treatment-naive adult patients (age > 18 years with hypothyroidism were included in the study. The patients were divided into two groups, each comprised thirty patients. One group was treated with L-thyroxine and placebo (Group A. The other group received L-thyroxine replacement along with selenium (100 mcg twice a day as antioxidant supplementation (Group B. The patients were blinded about selenium and placebo. The study duration for both groups was 6 months. The starting dose of L-thyroxine was 1.6 mcg/kg body weight free thyroxine (FT4, and thyroid-stimulating hormone (TSH was repeated after 12 weeks. L-thyroxine dose adjustments were done if needed. MDA was assessed at the beginning and at the end of the study, i.e., after 6 months of treatment. The control cohort was composed of thirty healthy adults. Only overt hypothyroidism (OH cases were included in the study. Statistical Analysis Used

Thyroiditis de Quervain. Are there predictive factors for long-term hormone-replacement?

Science.gov (United States)

Schenke, S; Klett, R; Braun, S; Zimny, M

2013-01-01

Subacute thyroiditis is a usually self-limiting disease of the thyroid. However, approximately 0.5-15% of the patients require permanent thyroxine substitution. Aim was to determine predictive factors for the necessity of long-term hormone-replacement (LTH). We retrospectively reviewed the records of 72 patients with subacute thyroiditis. Morphological and serological parameters as well as type of therapy were tested as predictive factors of consecutive hypothyroidism. Mean age was 49 ± 11 years, f/m-ratio was 4.5 : 1. Thyroid pain and signs of hyperthyroidism were leading symptoms. Initial subclinical or overt hyperthyroidism was found in 20% and 37%, respectively. Within six months after onset 15% and 1.3% of the patients developed subclinical or overt hypothyroidism, respectively. At latest follow-up 26% were classified as liable to LTH. At onset the thyroid was enlarged in 64%, and at latest follow-up in 8.3%, with a significant reduction of the thyroid volume after three months. At the endpoint the thyroid volume was less in patients in the LTH group compared with the non-LTH group (41.7% vs. 57.2% of sex-adjusted upper norm, p = 0.041). Characteristic ultrasonographic features occurred in 74% of the patients in both lobes. Serological and morphological parameters as well as type of therapy were not related with the need of LTH. In this study the proportion of patients who received LTH was 26%. At the endpoint these patients had a lower thyroid volume compared with euthyroid patients. No predictive factors for LTH were found.

Overt theft and the peculiarities of the qualification

OpenAIRE

Abramavičius, Armanas; Vosyliūtė, Andželika

2017-01-01

The article focuses on understanding the Overt theft as one of the aggravating elements of the theft stipulated in Part 2 of Article 178 of the Criminal Code of Lithuania. The content of Overt theft is presented. Moreover, the authors show the difficulties of the Criminal law concerning the aggravated theft enforcement in judicial practice; evaluate the expediency of the Overt theft defined by the Criminal law as aggravating one, discusses the issue of judicial problems relating to the Overt ...

Pregnancy Complications Associated With Maternal Hypothyroidism: A Systematic Review.

Science.gov (United States)

Shinohara, Danielle Rosani; Santos, Thais da Silva; de Carvalho, Hayalla Corrêa; Lopes, Laíza Cristina Bahls; Günther, Luciene Setsuko Akimoto; Aristides, Sandra Mara Alessi; Teixeira, Jorge Juarez Vieira; Demarchi, Izabel Galhardo

2018-04-01

Hypothyroidism is one of the most prevalent diseases in pregnancy, but there is no consensus about its management in pregnant women. In this systematic review, we evaluated the association between pregnancy complications and treated or untreated maternal hypothyroidism. PubMed and reference lists were searched for the Medical Subject Headings terms "pregnancy complications" and "hypothyroidism." The eligibility criteria for inclusion in the study were an original study published between 2002 and 2013. Six reviewers independently selected the studies, and 3 extracted the data. Two reviewers assessed the risk of bias and quality of the studies. Eighteen studies were included in the systematic review. The most prevalent complications associated with maternal hypothyroidism were abortion, intrauterine fetal death, preterm delivery, and preeclampsia. The pregnancy outcome depended on the treatment that was received by the patient. Strong evidence indicates that maternal hypothyroidism is associated with maternal-fetal complications, but no consensus was found among the studies reviewed herein. The dose of levothyroxine that is required to maintain euthyroidism is still questioned, but studies have suggested that levothyroxine should be adjusted according to the gestational period and laboratory profile.

Long-Term Outcome in Levothyroxine Treated Patients With Subclinical Hypothyroidism and Concomitant Heart Disease.

Science.gov (United States)

Andersen, Mette Nygaard; Olsen, Anne-Marie Schjerning; Madsen, Jesper Clausager; Kristensen, Søren Lund; Faber, Jens; Torp-Pedersen, Christian; Gislason, Gunnar H; Selmer, Christian

2016-11-01

Subclinical hypothyroidism is a common condition that may lead to impaired cardiac function. This study sought to examine the effects of levothyroxine treatment in patients with subclinical hypothyroidism and heart disease. This was a register-based historical cohort study. The study was composed of Danish primary care patients and hospital outpatients age 18 years and older with established heart disease who were diagnosed with subclinical hypothyroidism in 1997-2011. Patients were stratified according to whether they claimed a subsequent prescription of levothyroxine. Event rates and incidence rate ratios (IRR) were calculated by use of time-dependent multivariable Poisson regression models. Measures included all-cause mortality and major adverse cardiac events (MACEs), defined as cardiovascular death, fatal or nonfatal myocardial infaction and stroke, and all-cause hospital admissions. Of 61 611 patients with a diagnosis of cardiac disease having their first time thyroid function testing, 1192 patients with subclinical hypothyroidism (mean age 73.6 [SD ± 13.3] y, 63.8% female) were included, of whom 136 (11.4%) were treated with levothyroxine. During a median follow-up time of 5.6 y (interquartile range, 6.5 y), 694 (58.2%) patients died. Patients treated with levothyroxine displayed no significantly increased risk of all-cause mortality (adjusted IRR, 1.17; 95% confidence interval [CI], 0.90-1.52), MACE (adjusted IRR, 1.08; 95% CI, 0.80-1.45), or hospital admission (adjusted IRR, 0.94; 95% CI, 0.71-1.24), when compared with patients not treated with levothyroxine. Levothyroxine treatment in patients with subclinical hypothyroidism and heart disease was not associated with a significant benefit nor risk of all-cause mortality, MACE, or hospital admission in this large real-world cohort study.

Pediatric Hypothyroidism: Diagnosis and Treatment.

Science.gov (United States)

Wassner, Ari J

2017-08-01

Thyroid hormone has important physiologic functions in nearly every organ system. The critical role of thyroid hormone in growth and in physical and neurologic development lends particular importance to the prompt diagnosis and appropriate treatment of hypothyroidism in infants and children. Congenital hypothyroidism is common and has potentially devastating neurologic consequences. While the approach to diagnosis and treatment of severe congenital hypothyroidism is well established, data continue to emerge about the genetic causes, clinical significance, and prognosis of the milder forms of congenital hypothyroidism that are increasingly being diagnosed by newborn screening. Similarly, the diagnosis and treatment of severe acquired hypothyroidism is straightforward and clearly of clinical benefit, but uncertainty remains about the optimal management of mild subclinical hypothyroidism. This review summarizes current knowledge of the causes, clinical manifestations, diagnosis, treatment, and prognosis of hypothyroidism in infants and children, with a focus on recent developments and areas of uncertainty in this field.

Hypothyroidism after x irradiation to the neck: three case reports and a brief review of the literature

International Nuclear Information System (INIS)

Adler, R.A.; Corrigan, D.F.; Wartofsky, L.

1976-01-01

Three patients who developed hypothyroidism after x irradiation to the neck are presented. The first two cases demonstrate that patients can develop clinical and chemical hypothyroidism after a very short interval following radiotherapy. Hypothyroidism developed in the first patient in the absence of surgical manipulation of the neck, or a large iodine load 4 months after receiving 6800 rad of x-ray therapy to his neck for carcinoma of the larynx. The second patient developed hypothyroidism approximately 6 months after his radiotherapy for carcinoma of the esophagus. Both of these patients demonstrated high titers of serum antithyroid antibodies. A third patient with Hodgkin's disease did not manifest clinical symptoms and signs of hypothyroidism until 6 years after radiation therapy. These cases demonstrate the variability of onset of hypothyroidism after radiotherapy and emphasize the need for careful evaluation of thyroid function before and after neck irradiation

Orofacial manifestations of congenital hypothyroidism: Clinicoradiological case report

Directory of Open Access Journals (Sweden)

Gundareddy N Suma

2014-01-01

Full Text Available Thyroid disorders have a widespread effect on the ossification of cartilage, growth of teeth, facial contour, and overall body proportions. Both growth hormones and thyroid hormones show permissive action on growth stimulation. Deregulation in thyroid homeostasis can result in various orofacial and skeletal abnormalities. This report describes a case of congenital hypothyroidism in a 20-year-old female patient, presenting with a short stature, hypotonia, alopecia, euryprosopic face with puffiness, multiple retained deciduous teeth, delayed fusion of the intracranial sutures, and epiphysis and diaphysis of the long bones. Based on various biochemical and radiographic investigations, diagnosis of congenital hypothyroidism was established. Craniometry and hand-wrist radiographic evaluation of the growth pattern further aided in strengthening the diagnosis.

Effect of subclinical hypothyroidism on the skeletal system and improvement with short-term thyroxine therapy.

Science.gov (United States)

Gao, Cuixia; Wang, Yu; Li, Tingting; Huang, Jing; Tian, Limin

2017-10-27

The purpose of the study was to observe changes in the skeletal system of rats with subclinical hypothyroidism (SCH) and to determine whether L-thyroxine (L-T4) administration suppresses those changes. Sixty male Wistar rats were randomly divided into control, SCH, and SCH+T4 groups. SCH was induced in rats by administration of methimazole (MMI), and rats in the SCH+T4 group were treated with L-T4 after 45 days of MMI administration. The SCH group had higher thyroid-stimulating hormone (TSH) level than the control and SCH+T4 groups. There were no differences in serum thyroid hormone (FT4 and FT3) levels among the three groups. Bone mineral density; serum levels of BALP and TRACP-5b, two bone metabolic markers; and the biomechanical properties of the femurs were lower in the SCH group than in the control group. After L-T4 treatment, serum BALP and TRACP-5b levels and the femur biomechanical properties were higher in the SCH+T4 than the SCH group. Histopathological examination revealed damage to the structure of the femur trabecular bone network in rats with SCH, and L-T4 treatment improved this condition to some extent. These findings demonstrate that L-T4 treatment ameliorates the destructive effects of SCH on the skeletal system in rats.

The effect of oxidative stress on the progression of Hashimoto's thyroiditis.

Science.gov (United States)

Ates, Ihsan; Arikan, Mehmet Fettah; Altay, Mustafa; Yilmaz, Fatma Meric; Yilmaz, Nisbet; Berker, Dilek; Guler, Serdar

2017-11-29

We aimed to investigate the effects of oxidative stress in the pathogenesis and progression of Hashimoto's thyroiditis (HT). Forty euthyroid and 40 subclinical hypothyroid patients older than 18 years and not yet had received treatment were enrolled in the study. In the 9 months follow-up, 14 of the HT patients developed overt hypothyroidism. The mean total oxidant status (TOS) and oxidative stress index (OSI) were higher in patients who developed overt hypothyroidism than those who did not (p  .05). Multivariable Cox regression model showed thyroid stimulating hormone level (HR = 1.348, p OSI ratio (HR = 2.349, p OSI level, being over 2.96 with 92.9% sensitivity and 62.5% specificity, predicts the risk of hypothyroidism. Oxidative stress may be an effective risk factor in the development of overt hypothyroidism in HT.

Primary and secondary hypothyroidism (image)

Science.gov (United States)

Hypothyroidism is a decreased activity of the thyroid gland which may affect all body functions. The rate ... and physical sluggishness. The most severe form of hypothyroidism is myxedema, a medical emergency. Hypothyroidism can be ...

Genetics Home Reference: congenital hypothyroidism

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... Facebook Twitter Home Health Conditions Congenital hypothyroidism Congenital hypothyroidism Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Congenital hypothyroidism is a partial or complete loss of function ...

A review on cardiovascular diseases originated from subclinical hypothyroidism.

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Mansourian, Azad Reza

2012-01-15

Thyroid hormones play an important role on the cardiovascular systems and thyroid disorder ultimately have a profound adverse effects on myocardium and vascular functions. There are extensive reports on the role of overt thyroid dysfunction which adversely can modify the cardiovascular metabolism but even at the present of some controversial reports, the subclinical thyroid disorders are able also to manipulate cardiovascular system to some extent. The aim of this study is to review the cardiovascular disorders accompanied with subclinical hypothyroidism. It is concluded that adverse effect of thyroid malfunction on myocardium and vascular organs are through the direct role of thyroid hormone and dyslipidemia on heart muscle cells at nuclear level and vascular system, respectively. It seems many cardiovascular disorders initially would not have been occurred in the first place if the thyroid of affected person had functioned properly, therefore thyroid function tests should be one of a prior laboratory examinations in cardiovascular disorders.

What are the differences between long-term, short-term, and working memory?

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Cowan, Nelson

2008-01-01

In the recent literature there has been considerable confusion about the three types of memory: long-term, short-term, and working memory. This chapter strives to reduce that confusion and makes up-to-date assessments of these types of memory. Long- and short-term memory could differ in two fundamental ways, with only short-term memory demonstrating (1) temporal decay and (2) chunk capacity limits. Both properties of short-term memory are still controversial but the current literature is rather encouraging regarding the existence of both decay and capacity limits. Working memory has been conceived and defined in three different, slightly discrepant ways: as short-term memory applied to cognitive tasks, as a multi-component system that holds and manipulates information in short-term memory, and as the use of attention to manage short-term memory. Regardless of the definition, there are some measures of memory in the short term that seem routine and do not correlate well with cognitive aptitudes and other measures (those usually identified with the term "working memory") that seem more attention demanding and do correlate well with these aptitudes. The evidence is evaluated and placed within a theoretical framework depicted in Fig. 1.

Central Hypothyroidism in Miniature Schnauzers

NARCIS (Netherlands)

Voorbij, Annemarie M W Y; Leegwater, Peter A J; Buijtels, Jenny J C W M; Daminet, Sylvie; Kooistra, Hans S

2016-01-01

BACKGROUND: Primary hypothyroidism is a common endocrinopathy in dogs. In contrast, central hypothyroidism is rare in this species. OBJECTIVES: The objective of this article is to describe the occurrence and clinical presentation of central hypothyroidism in Miniature Schnauzers. Additionally, the

Thyroid autoimmunity, hypothyroidism and ovarian reserve: a cross-sectional study of 5000 women based on age-specific AMH values.

Science.gov (United States)

Polyzos, Nikolaos P; Sakkas, Evangelos; Vaiarelli, Alberto; Poppe, Kris; Camus, Michel; Tournaye, Herman

2015-07-01

Is there any association between thyroid autoimmunity (TAI) and diminished ovarian reserve (DOR)? TAI and hypothyroidism are not associated with low ovarian reserve. TAI is a common co-existent endocrinopathy in women with primary ovarian insufficiency. Several studies support a potential link between TAI and the reduction in ovarian reserve. However, robust evidence regarding its prevalence in women with DOR is lacking. This study is a large cross-sectional analysis of retrospective data from the Centre for Reproductive Medicine/University Hospital of Brussels. Serum measurements were taken for anti-Mullerian hormone (AMH), free thyroxine (FT4), thyroid-stimulating hormone (TSH) and anti-thyroperoxidase (anti-TPO). Among 5076 consecutive women, 4894 women had their AMH, FT4, TSH and anti-TPO levels measured on the same day. AMH levels were plotted in relation to age for the whole patients' cohort and age-specific AMH values (per year) were considered in order to categorize women according to the AMH levels of ovarian reserve. There were 3929 women who demonstrated normal reserve, 487 women who had low ovarian reserve and 478 women who demonstrated high ovarian reserve. Serum FT4 and TSH levels were comparable between different ovarian reserve categories (P = 0.611 and 0.811, respectively). No significant differences were observed in the prevalence of positive anti-TPO antibodies among women with low (12.1%), normal (10.3%) and high (9.8%) ovarian reserve (P = 0.423). Finally, the prevalence of overt or subclinical hypothyroidism was comparable between the groups (4.1% in low, 4.6% in normal and 3.8% in high ovarian reserve women, P = 0.645).Analysis according to the exact cause of low ovarian reserve demonstrated that women with a genetic cause of low ovarian reserve had a significantly higher prevalence of overt hypothyroidism and subclinical hypothyroidism compared with women with unexplained low ovarian reserve for their age (25 versus 3.2%, P = 0.002 and 18

Thyroid dysfunction and pregnancy outcomes

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Sima Nazarpour

2015-07-01

Full Text Available Background: Pregnancy has a huge impact on the thyroid function in both healthy women and those that have thyroid dysfunction. The prevalence of thyroid dysfunction in pregnant women is relatively high. Objective: The objective of this review was to increase awareness and to provide a review on adverse effect of thyroid dysfunction including hyperthyroidism, hypothyroidism and thyroid autoimmune positivity on pregnancy outcomes. Materials and Methods: In this review, Medline, Embase and the Cochrane Library were searched with appropriate keywords for relevant English manuscript. We used a variety of studies, including randomized clinical trials, cohort (prospective and retrospective, case-control and case reports. Those studies on thyroid disorders among non-pregnant women and articles without adequate quality were excluded. Results: Overt hyperthyroidism and hypothyroidism has several adverse effects on pregnancy outcomes. Overt hyperthyroidism was associated with miscarriage, stillbirth, preterm delivery, intrauterine growth retardation, low birth weight, preeclampsia and fetal thyroid dysfunction. Overt hypothyroidism was associated with abortion, anemia, pregnancy-induced hypertension, preeclampsia, placental abruption, postpartum hemorrhage, premature birth, low birth weight, intrauterine fetal death, increased neonatal respiratory distress and infant neuro developmental dysfunction. However the adverse effect of subclinical hypothyroidism, and thyroid antibody positivity on pregnancy outcomes was not clear. While some studies demonstrated higher chance of placental abruption, preterm birth, miscarriage, gestational hypertension, fetal distress, severe preeclampsia and neonatal distress and diabetes in pregnant women with subclinical hypothyroidism or thyroid autoimmunity; the other ones have not reported these adverse effects. Conclusion: While the impacts of overt thyroid dysfunction on feto-maternal morbidities have been clearly

Inner Speech's Relationship With Overt Speech in Poststroke Aphasia.

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Stark, Brielle C; Geva, Sharon; Warburton, Elizabeth A

2017-09-18

Relatively preserved inner speech alongside poor overt speech has been documented in some persons with aphasia (PWA), but the relationship of overt speech with inner speech is still largely unclear, as few studies have directly investigated these factors. The present study investigates the relationship of relatively preserved inner speech in aphasia with selected measures of language and cognition. Thirty-eight persons with chronic aphasia (27 men, 11 women; average age 64.53 ± 13.29 years, time since stroke 8-111 months) were classified as having relatively preserved inner and overt speech (n = 21), relatively preserved inner speech with poor overt speech (n = 8), or not classified due to insufficient measurements of inner and/or overt speech (n = 9). Inner speech scores (by group) were correlated with selected measures of language and cognition from the Comprehensive Aphasia Test (Swinburn, Porter, & Al, 2004). The group with poor overt speech showed a significant relationship of inner speech with overt naming (r = .95, p speech and language and cognition factors were not significant for the group with relatively good overt speech. As in previous research, we show that relatively preserved inner speech is found alongside otherwise severe production deficits in PWA. PWA with poor overt speech may rely more on preserved inner speech for overt picture naming (perhaps due to shared resources with verbal working memory) and for written picture description (perhaps due to reliance on inner speech due to perceived task difficulty). Assessments of inner speech may be useful as a standard component of aphasia screening, and therapy focused on improving and using inner speech may prove clinically worthwhile. https://doi.org/10.23641/asha.5303542.

Hypothyroidism in patients treated with radiotherapy for head and neck carcinoma: standardised long-term follow-up study.

Science.gov (United States)

Alba, J R; Basterra, J; Ferrer, J C; Santonja, F; Zapater, E

2016-05-01

Hypothyroidism is a common complication when radiotherapy is part of the treatment for head and neck tumours. This study aimed to show the incidence of hypothyroidism and possible risk factors in these patients. Factors related to the population, tumour, treatment and occurrence of hypothyroidism were analysed in 241 patients diagnosed with head and neck carcinoma. Approximately 53 per cent of patients were diagnosed with radiation-induced hypothyroidism. Its occurrence was related to: tumour location, laryngeal surgery type, neck dissection type, post-operative complications, cervical radiotherapy and radiotherapy unit type (linear particle accelerator or telecobalt therapy technology). Control of thyroid function should be standardised for several years after treatment, particularly in patients with risk factors, such as those treated with telecobalt therapy, those with post-operative complications and for whom the thyroid parenchyma is included in the irradiated area (laryngeal or pharyngeal location and bilateral cervical radiation).

Pericardiocentesis in massive pericardial effusions due to hypothyroidism

Science.gov (United States)

Nainggolan, F. H.; Dalimunthe, N. N.; Harahap, S.; Isnanta, R.; Realsyah, T.; Safri, Z.; Hasan, R.

2018-03-01

Pericardial effusion is the accumulation of abnormal fluid in the pericardial cavity. The symptoms are not specific and associated with the underlying disease. It was reported that a 53-year-old male patient entered the Emergency Room with a shortness of breath, and getting worse during activity and position. There was weight loss and smoking history. The history of diabetic, hypertension and malignancy were denied. On physical examination showed the enlarged right and left heart border and weakened heartbeat sheer off is found and edema pretibial and normal the other. The laboratory results;blood routine, renal and liver function within normal; lipid profile: hypercholesterolemia; viral marker is non-reactive.Rontgen thorax suggests cardiomegaly, but there was no infiltrate or nodules. Electrocardiogram (ECG) showed a low voltage. Echocardiography examination showed massive pericardial effusion. Pericardiosynthetis performed produces 750 cc of clear yellow liquid and showed transudate. Other laboratory tests such as ANA test, anti ds-DNA, cyfra were a normal impression. Thyroid function: hypothyroid, Mantoux test is negative. Finally, the patient is a massive pericardial effusion caused by hypothyroidism. The pericardiocentesis took, and the hypothyroid drug of euthirax is administered. The patient was well done and continued for recontrol.

[Subclinical and manifested hypothyroidism as a consequence of thyroid autoimmune disease].

Science.gov (United States)

Milosević, Dragoslav P; Djurica, Snezana; Davidović, Mladen; Stević, Radmila; Rajić, Miodrag; Marković, Natasa

2005-10-01

Chronic thyroiditis (Hashimoto's disease) is a slowly developing persistent inflamation of the thyroid gland, which frequently leads to hypothyroidism. Some of the up-to-date knowledge about hypothyroidism, both subclinical and manifested, caused by autoimmune disease, was presented. Autoimmune thyroid gland disease can occur at any age, but predominantly affects women after periods of high emotional and physical stress or accidents, as well as during periods of hormonal changes. It can also develop in families, and having an autoimmune disease slightly increases the risk of developing another. This paper showed an increasing incidence of subclinical hypothyroidism (4.17%) in elderly, and, at the same time, the incidence of primary hypothyroidism accounting for 1%. It is very usefull to estimate the stimulated thyrotropin (TSH) response, as well as the value of fast, short time thyroid gland reserves, analyzed by T3 and T4 serum level at 60th minute after TRH stimulation. Treatment of choice for HT (hypothyroidism of any cause) is thyroid hormone replacement. Drug of choice is orally administered levothyroxine sodium, usually for life-time. The standard dose is 1.6-1.8 mcg/kg body weight per day, but is in most cases patient dependent. Elderly patients usually require smaller replacement dose of levothyroxine, sometimes less than 1 mcg/kg body weight per day with coronary dilatator at the same time.

The Demonstration of Short-Term Consolidation.

Science.gov (United States)

Jolicoeur, Pierre; Dell'Acqua, Roberto

1998-01-01

Results of seven experiments involving 112 college students or staff using a dual-task approach provide evidence that encoding information into short-term memory involves a distinct process termed short-term consolidation (STC). Results suggest that STC has limited capacity and that it requires central processing mechanisms. (SLD)

Features of Type 2 Diabetes Mellitus in Combination with Hypothyroidism

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T.Yu. Yuzvenko

2015-11-01

Full Text Available Background. The last decades are characterized by the considerable increase in the prevalence of endocrine disorders with the change of the structure, and first of all cases of polyendocrinopathy, the special place among which is occupied by combination of diabetes mellitus (DM and thyroid diseases. Increase in the incidence of DM type 2 associated with hypothyroidism affects the clinical course of this pathology, remains topical problem of modern medical science. The objective: to study the prevalence of hypothyroidism in patients with type 2 DM and to establish clinical features of DM type 2 in combination with hypothyroidism. Materials and methods. We have examined 179 patients with DM associated with primary hypothyroidism, including 64 patients with DM type 1 and 115 patients with type 2 DM. Comparison group consisted of 62 patients with DM without hypothyroidism (27 of them — with DM type 1, 35 — with DM type 2. Thyroid function was assessed by determining the basal concentrations of thyroid stimulating hormone and free thyroxine fraction. Results. It was found that patients with DM type 2 and hypothyroidism belonged to an older age group than patients with DM type 1 and hypothyroidism. Thus, the age of patients with DM type 1 and hypothyroidism was 35.3 ± 9.5 years, and in patients with type 2 DM and hypothyroidism — 47.6 ± 11.0 years. In all groups of patients, the percentage of women was much higher than men. The significant differences were detected in terms of the amplitude of glycemic index, namely its increase in patients with DM type 1 and hypothyroidism. When DM type 2 was combined with hypothyroidism, lipid metabolism indices were higher than in DM type 2 without thyroid disease. This confirms the effect of hypothyroidism on lipid metabolism and causes increased risk of progression of cardiovascular events at the presence of two diseases. Conclusions. Among examined patients, hypothyroidism occurred 2.4 times more often

What are the differences between long-term, short-term, and working memory?

OpenAIRE

Cowan, Nelson

2008-01-01

In the recent literature there has been considerable confusion about the three types of memory: long-term, short-term, and working memory. This chapter strives to reduce that confusion and makes up-to-date assessments of these types of memory. Long- and short-term memory could differ in two fundamental ways, with only short-term memory demonstrating (1) temporal decay and (2) chunk capacity limits. Both properties of short-term memory are still controversial but the current literature is rath...

MENSTRUAL IRREGULARITIES IN HYPOTHYROIDISM

OpenAIRE

Kalyani

2015-01-01

AIM OF THE STUDY: To study the effect of hypothyroidism, on the menstrual cycle of women in the reproductive age group. MATERIAL & METHODS: A total number of 50 cases of hypothyroidism patients recruited over a period of one year from the department of Nuclear Medicine K.G.H Visakhapatnam. All these subjects were evaluated clinically and the data recorded as per the proforma. RESULTS: In my study out of 50 hypothyroid women, 22% had normal menstrual cycle &...

Short-term memory across eye blinks.

Science.gov (United States)

Irwin, David E

2014-01-01

The effect of eye blinks on short-term memory was examined in two experiments. On each trial, participants viewed an initial display of coloured, oriented lines, then after a retention interval they viewed a test display that was either identical or different by one feature. Participants kept their eyes open throughout the retention interval on some blocks of trials, whereas on others they made a single eye blink. Accuracy was measured as a function of the number of items in the display to determine the capacity of short-term memory on blink and no-blink trials. In separate blocks of trials participants were instructed to remember colour only, orientation only, or both colour and orientation. Eye blinks reduced short-term memory capacity by approximately 0.6-0.8 items for both feature and conjunction stimuli. A third, control, experiment showed that a button press during the retention interval had no effect on short-term memory capacity, indicating that the effect of an eye blink was not due to general motoric dual-task interference. Eye blinks might instead reduce short-term memory capacity by interfering with attention-based rehearsal processes.

Renal Function in Hypothyroidism

International Nuclear Information System (INIS)

Khalid, S.; Khalid, M; Elfaki, M.; Hassan, N.; Suliman, S.M.

2007-01-01

Background Hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatremia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective Renal function is profoundly influenced by thyroid status; the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and Patients In 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate (GFR) using modified in diet renal disease (MDRD) formula. Result In hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR Increased. The hypothyroid patients showed elevated serum creatinine levels (> 1.1mg/dl) compared to control group (p value .000). In patients mean estimated GFR decreased, compared to mean estimated GFR increased in the control group (p value= .002).

Short-term memory and dual task performance

Science.gov (United States)

Regan, J. E.

1982-01-01

Two hypotheses concerning the way in which short-term memory interacts with another task in a dual task situation are considered. It is noted that when two tasks are combined, the activity of controlling and organizing performance on both tasks simultaneously may compete with either task for a resource; this resource may be space in a central mechanism or general processing capacity or it may be some task-specific resource. If a special relationship exists between short-term memory and control, especially if there is an identity relationship between short-term and a central controlling mechanism, then short-term memory performance should show a decrement in a dual task situation. Even if short-term memory does not have any particular identity with a controlling mechanism, but both tasks draw on some common resource or resources, then a tradeoff between the two tasks in allocating resources is possible and could be reflected in performance. The persistent concurrence cost in memory performance in these experiments suggests that short-term memory may have a unique status in the information processing system.

Hypothyroidism: Can It Cause Peripheral Neuropathy?

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Hypothyroidism: Can it cause peripheral neuropathy? Can hypothyroidism cause peripheral neuropathy and, if so, how is it treated? Answers from Todd B. Nippoldt, M.D. Hypothyroidism — a condition in which your ...

Post-external radiotherapy hypothyroidism: 15 cases

International Nuclear Information System (INIS)

Kaffel, N.; Mnif, M.; Abid, M.; Daoud, J.

2001-01-01

Post-external radiotherapy hypothyroidism: 15 cases. Hypothyroidism frequency is estimated to be between 10 and 45% after radiotherapy alone, and 40 to 67% after radiotherapy associated with thyroidectomy. This hypothyroidism is infra-clinical in 60% of the cases. Our study concerned 15 cases of hypothyroidism after external radiotherapy delivered between and 1991 and 1999. An irradiation of the cervical, cerebral and thorax regions was indicated for different types of cancers. Larynx carcinoma epidermoid was the most frequent cancer (seven cases); the radiation treatment used cobalt 60 with conventional fractionation, i.e., 2 Gy per treatment, five treatments a week. In nine cases, the hypothyroidism was discovered during a systematic examination; it was clinically evident in the six remaining cases. Hypothyroidism appeared after an irradiation dose average of 50 Gy (extremes 30-65 Gy). The average duration of the irradiation was about 7 weeks and the hypothyroidism appeared in a mean 22 months. In all cases, the substituting treatment was initiated with a favorable progression. Faced with the risk of hypothyroidism, it is necessary to check patients who have undergone external irradiation of the neck. (authors)

A 2016 clinical practice pattern in the management of primary hypothyroidism among doctors from different clinical specialties in New Delhi

Directory of Open Access Journals (Sweden)

Vineet Surana

2017-01-01

restoring euthyroidism for overt primary hypothyroidism. There is a need for spreading awareness regarding TSH targets in pregnancy.

Hypothyroidism and myxedema coma.

Science.gov (United States)

Finora, Kevin; Greco, Deborah

2007-01-01

Hypothyroidism is a common endocrinopathy in dogs but is rare in cats. Lymphocytic thyroiditis and idiopathic thyroid atrophy are common causes of this condition. Specific thyroid function tests, in conjunction with clinical signs and physical examination findings, are used to help confirm a diagnosis of hypothyroidism. This disease can be managed with synthetic hormone supplementation and has an excellent prognosis. Myxedema coma is a rare and potentially fatal manifestation of severe hypothyroidism that can be successfully treated using intravenous levothyroxine.

Short-term LNG-markets

International Nuclear Information System (INIS)

Eldegard, Tom; Lund, Arne-Christian; Miltersen, Kristian; Rud, Linda

2005-01-01

The global Liquefied Natural Gas (LNG) industry has experienced substantial growth in the past decades. In the traditional trade patterns of LNG the product has typically been handled within a dedicated chain of plants and vessels fully committed by long term contracts or common ownership, providing risk sharing of large investments in a non-liquid market. Increasing gas prices and substantial cost reductions in all parts of the LNG chain have made LNG projects viable even if only part of the capacity is secured by long-term contracts, opening for more flexible trade of the remainder. Increasing gas demand, especially in power generation, combined with cost reductions in the cost of LNG terminals, open new markets for LNG. For the LNG supplier, the flexibility of shifting volumes between regions represents an additional value. International trade in LNG has been increasing, now accounting for more than one fifth of the world's cross-border gas trade. Despite traditional vertical chain bonds, increased flexibility has contributed in fact to an increasing LNG spot trade, representing 8% of global trade in 2002. The focus of this paper is on the development of global short-term LNG markets, and their role with respect to efficiency and security of supply in European gas markets. Arbitrage opportunities arising from price differences between regional markets (such as North America versus Europe) are important impetuses for flexible short-term trade. However, the short-term LNG trade may suffer from problems related to market access, e.g. limited access to terminals and regulatory issues, as well as rigidities connected to vertical binding within the LNG chain. Important issues related to the role of short-term LNG-trade in the European gas market are: Competition, flexibility in meeting peak demand, security of supply and consequences of differences in pricing policies (oil-linked prices in Europe and spot market prices in North America). (Author)

A Clinical Study on Hypothyroidism

International Nuclear Information System (INIS)

Park, Keun Jo; Park, Sun Yang; Park, Jung Sik; Lee, Myung Chul; Koh, Chang Soon; Lee, Mun Ho

1976-01-01

A clinical study was made on 263 patients of hypothyroidism among the 5,970 patients of Various thyroid diseases diagnosed and treated at the Radioisotope Clinic and Laboratory, Seoul National University Hospital from May, 1960 to Aug, 1975. The results obtained with this study are as follows: 1) The etiological classification of hypothyroidism revealed 244 cases (93%) of primary hypothyroidism and 19 cases (7%) of secondary hypothyroidism. 2) The most frequent cause of the thyroprivic primary hypothyroidism was post radioiodine therapy with 109 cases (41.4%). 3) There were 37 cases (14%) of male and 226 cases (86%) of female, showing a ratio of 1 : 6. 4) The majority of patients were between the ages of 30 and 60 with the peak incidence (87 cases, 33%) in their fourth decades of lives. 5) The major symptoms and signs were weakness (97%), edema of face and extremities (92%); Decreased Achilles tendon reflex (87%), cold intolerance (82%), gain in weight (76%), constipation (58%) and cold skin (51%). 6) The cumulative incidence of hypothyroidism in patient treated with 131 I (3-8 mci) was 7.2% at first year, 33.3% at tenth year and the 50% at fourteenth year and the annual increment was 2.9%. 7) The incidence of hypothyroidism related to the numbers of 131 I therapy was not linear. 8) The diagnostic compatibilities of the various tests to hypothyroidism were TSH (100%), T 4 (93.8%), 24-hour-RNIU (91.5%), ATR (86.7%), T 3 RU (66.1%) and BMR (64.9%).

A Clinical Study on Hypothyroidism

Energy Technology Data Exchange (ETDEWEB)

Park, Keun Jo; Park, Sun Yang; Park, Jung Sik; Lee, Myung Chul; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1976-03-15

A clinical study was made on 263 patients of hypothyroidism among the 5,970 patients of Various thyroid diseases diagnosed and treated at the Radioisotope Clinic and Laboratory, Seoul National University Hospital from May, 1960 to Aug, 1975. The results obtained with this study are as follows: 1) The etiological classification of hypothyroidism revealed 244 cases (93%) of primary hypothyroidism and 19 cases (7%) of secondary hypothyroidism. 2) The most frequent cause of the thyroprivic primary hypothyroidism was post radioiodine therapy with 109 cases (41.4%). 3) There were 37 cases (14%) of male and 226 cases (86%) of female, showing a ratio of 1 : 6. 4) The majority of patients were between the ages of 30 and 60 with the peak incidence (87 cases, 33%) in their fourth decades of lives. 5) The major symptoms and signs were weakness (97%), edema of face and extremities (92%); Decreased Achilles tendon reflex (87%), cold intolerance (82%), gain in weight (76%), constipation (58%) and cold skin (51%). 6) The cumulative incidence of hypothyroidism in patient treated with {sup 131}I (3-8 mci) was 7.2% at first year, 33.3% at tenth year and the 50% at fourteenth year and the annual increment was 2.9%. 7) The incidence of hypothyroidism related to the numbers of {sup 131}I therapy was not linear. 8) The diagnostic compatibilities of the various tests to hypothyroidism were TSH (100%), T{sub 4} (93.8%), 24-hour-RNIU (91.5%), ATR (86.7%), T{sub 3}RU (66.1%) and BMR (64.9%).

Diural TSH variations in hypothyroidism.

Science.gov (United States)

Weeke, J; Laurberg, P

1976-07-01

There is a circadian variation in serum TSH in euthyroid subjects. A similar diurnal variation has been demonstrated in patients with hypothyroidism. In the present study the 24-hour pattern of serum TSH was investigated in eight patients with hypothyroidism of varying severity and in five hypothyroid patients treated with thyroxine (T4). There was a circadian variation in serum TSH in patients with hypothyroidism of moderate degree, and in patients treated for severe hypothyrodism with thyroxine. The pattern was similar to that found in normal subjects, i.e., low TSH levels in the daytime and higher levels at night. In severely hypothyroid patients, no diurnal variation in serum TSH was observed. A practical consequence is that blood samples for TSH measurements in patients with moderately elevated TSH levels are best taken after 1100 h, when the low day levels are reached.

Short-term incentive schemes for hospital managers

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Lucas Malambe

2013-10-01

Full Text Available Orientation: Short-term incentives, considered to be an extrinsic motivation, are commonly used to motivate performance. This study explored hospital managers’ perceptions of short term incentives in maximising performance and retention. Research purpose: The study explored the experiences, views and perceptions of private hospital managers in South Africa regarding the use of short-term incentives to maximise performance and retention, as well as the applicability of the findings to public hospitals. Motivation for the study: Whilst there is an established link between performance reward schemes and organisational performance, there is little understanding of the effects of short term incentives on the performance and retention of hospital managers within the South African context. Research design, approach, and method: The study used a qualitative research design: interviews were conducted with a purposive sample of 19 hospital managers, and a thematic content analysis was performed. Main findings: Short-term incentives may not be the primary motivator for hospital managers, but they do play a critical role in sustaining motivation. Participants indicated that these schemes could also be applicable to public hospitals. Practical/managerial implications: Hospital managers are inclined to be more motivated by intrinsic than extrinsic factors. However, hospital managers (as middle managers also seem to be motivated by short-term incentives. A combination of intrinsic and extrinsic motivators should thus be used to maximise performance and retention. Contribution/value-add: Whilst the study sought to explore hospital managers’ perceptions of short-term incentives, it also found that an adequate balance between internal and external motivators is key to implementing an effective short-term incentive scheme.

Short-Term Intercultural Psychotherapy: Ethnographic Inquiry

Science.gov (United States)

Seeley, Karen M.

2004-01-01

This article examines the challenges specific to short-term intercultural treatments and recently developed approaches to intercultural treatments based on notions of cultural knowledge and cultural competence. The article introduces alternative approaches to short-term intercultural treatments based on ethnographic inquiry adapted for clinical…

Why do short term workers have high mortality?

DEFF Research Database (Denmark)

Kolstad, Henrik; Olsen, Jørn

1999-01-01

or violence, the rate ratios for short term employment were 2.30 (95% Cl 1.74-3.06) and 1.86 (95% Cl 1.35-2.56), respectively. An unhealthy lifestyle may also be a determinant of short term employment. While it is possible in principle to adjust for lifestyle factors if proper data are collected, the health......Increased mortality is often reported among workers in short term employment. This may indicate either a health-related selection process or the presence of different lifestyle or social conditions among short term workers. The authors studied these two aspects of short term employment among 16...

The Effects of Elaboration and Rehearsal on Long-Term Retention of Shape Names by Kindergarteners

Science.gov (United States)

Gallimore, Ronald; And Others

1977-01-01

Elaboration and overt rehearsal are compared as instructional paradigms for memory retention. Superior long-term retention was produced in the elaboration condition when the initial acquisition effects were statistically removed. Short-term data suggest acquisition was complexly affected by experimental condition, I.Q., and task. Elaboration…

Short-term mechanisms influencing volumetric brain dynamics

Directory of Open Access Journals (Sweden)

Nikki Dieleman

2017-01-01

Full Text Available With the use of magnetic resonance imaging (MRI and brain analysis tools, it has become possible to measure brain volume changes up to around 0.5%. Besides long-term brain changes caused by atrophy in aging or neurodegenerative disease, short-term mechanisms that influence brain volume may exist. When we focus on short-term changes of the brain, changes may be either physiological or pathological. As such determining the cause of volumetric dynamics of the brain is essential. Additionally for an accurate interpretation of longitudinal brain volume measures by means of neurodegeneration, knowledge about the short-term changes is needed. Therefore, in this review, we discuss the possible mechanisms influencing brain volumes on a short-term basis and set-out a framework of MRI techniques to be used for volumetric changes as well as the used analysis tools. 3D T1-weighted images are the images of choice when it comes to MRI of brain volume. These images are excellent to determine brain volume and can be used together with an analysis tool to determine the degree of volume change. Mechanisms that decrease global brain volume are: fluid restriction, evening MRI measurements, corticosteroids, antipsychotics and short-term effects of pathological processes like Alzheimer's disease, hypertension and Diabetes mellitus type II. Mechanisms increasing the brain volume include fluid intake, morning MRI measurements, surgical revascularization and probably medications like anti-inflammatory drugs and anti-hypertensive medication. Exercise was found to have no effect on brain volume on a short-term basis, which may imply that dehydration caused by exercise differs from dehydration by fluid restriction. In the upcoming years, attention should be directed towards studies investigating physiological short-term changes within the light of long-term pathological changes. Ultimately this may lead to a better understanding of the physiological short-term effects of

Verbal Short-Term Memory Span in Speech-Disordered Children: Implications for Articulatory Coding in Short-Term Memory.

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Raine, Adrian; And Others

1991-01-01

Children with speech disorders had lower short-term memory capacity and smaller word length effect than control children. Children with speech disorders also had reduced speech-motor activity during rehearsal. Results suggest that speech rate may be a causal determinant of verbal short-term memory capacity. (BC)

Real-time energy resources scheduling considering short-term and very short-term wind forecast

Energy Technology Data Exchange (ETDEWEB)

Silva, Marco; Sousa, Tiago; Morais, Hugo; Vale, Zita [Polytechnic of Porto (Portugal). GECAD - Knowledge Engineering and Decision Support Research Center

2012-07-01

This paper proposes an energy resources management methodology based on three distinct time horizons: day-ahead scheduling, hour-ahead scheduling, and real-time scheduling. In each scheduling process the update of generation and consumption operation and of the storage and electric vehicles storage status are used. Besides the new operation conditions, the most accurate forecast values of wind generation and of consumption using results of short-term and very short-term methods are used. A case study considering a distribution network with intensive use of distributed generation and electric vehicles is presented. (orig.)

The Mind and Brain of Short-Term Memory

OpenAIRE

Jonides, John; Lewis, Richard L.; Nee, Derek Evan; Lustig, Cindy A.; Berman, Marc G.; Moore, Katherine Sledge

2008-01-01

The past 10 years have brought near-revolutionary changes in psychological theories about short-term memory, with similarly great advances in the neurosciences. Here, we critically examine the major psychological theories (the “mind”) of short-term memory and how they relate to evidence about underlying brain mechanisms. We focus on three features that must be addressed by any satisfactory theory of short-term memory. First, we examine the evidence for the architecture of short-term memory, w...

Very-long-term and short-term chromatic adaptation: are their influences cumulative?

Science.gov (United States)

Belmore, Suzanne C; Shevell, Steven K

2011-02-09

Very-long-term (VLT) chromatic adaptation results from exposure to an altered chromatic environment for days or weeks. Color shifts from VLT adaptation are observed hours or days after leaving the altered environment. Short-term chromatic adaptation, on the other hand, results from exposure for a few minutes or less, with color shifts measured within seconds or a few minutes after the adapting light is extinguished; recovery to the pre-adapted state is complete in less than an hour. Here, both types of adaptation were combined. All adaptation was to reddish-appearing long-wavelength light. Shifts in unique yellow were measured following adaptation. Previous studies demonstrate shifts in unique yellow due to VLT chromatic adaptation, but shifts from short-term chromatic adaptation to comparable adapting light can be far greater than from VLT adaptation. The question considered here is whether the color shifts from VLT adaptation are cumulative with large shifts from short-term adaptation or, alternatively, does simultaneous short-term adaptation eliminate color shifts caused by VLT adaptation. The results show the color shifts from VLT and short-term adaptation together are cumulative, which indicates that both short-term and very-long-term chromatic adaptation affect color perception during natural viewing. Copyright © 2010 Elsevier Ltd. All rights reserved.

[Hypothyroidism in patients with heart disease].

Science.gov (United States)

Jiskra, Jan

Hypothyroidism is frequently found in patients with heart disease. It is a risk factor for atherosclerosis and ischemic heart disease and has a direct negative effect on both the left and right ventricular functions (hypothyroidism-induced cardiomyopathy). The confirmed manifest hypothyroidism is always a reason for replacement therapy with levothyroxine; regarding patients with heart disease, we always begin treatment with a small dose and increase it gradually. The treatment of subclinical hypothyroidism in patients with heart disease is disputable and its benefits probably depend on age. At a higher age, the therapy-related risks often outweigh its benefits, so we make do with the target levels of the thyroid stimulating hormone being within the upper band of the normal range, or even slightly above it, rather than overdosing the patient. To summarize in a simplified way, the treatment of subclinical hypothyroidism in patients with heart disease is the most effective in younger individuals, mainly those aged below 65, while at a higher age > 80 years the risk usually outweighs the benefit.Key words: cardiovascular risk - hypothyroidism - ischemic heart disease - left ventricular dysfunction - right ventricular dysfunction - subclinical hypothyroidism - thyroid peroxidase antibodies.

Massive pericardial effusion associated with hypothyroidism.

Science.gov (United States)

Ionescu, Simona Daniela; Tănase, Daniela Maria; Ouatu, Anca; Ambăruş, V; Dosa, Anca; Arsenescu-Georgescu, Cătălina

2014-01-01

The diagnosis of hypothyroidism is difficult because hypothyroidism in adults and especially the elderly, classic, has an insidious onset with a range of nonspecific symptoms which may delay diagnosis for months or even years. Old age seems to represent trigger factor for autoimmune diseases, including hypothyroidism. Clinical features in hypothyroidism, such as weight gain, fatigue, cold intolerance, constipation, dry skin, edema and muscle weakness, and decreased osteo-tendinous reflexes are usually subtle and can be overlooked. Thyroid dysfunction may be associated with a negative impact on the cardiovascular system. Pericardial, pleural and peritoneal effusions are common findings in hypothyroidism. This case report represents a typical primary hypothyroidism (autoimmune) and shows the clinical features of this disease. Basically we talked about a severe myxedema with the involvement of internal organs in an elderly woman and the euthyroidism restoration, under thyroid replacement therapy, was correlated with the clinical improvement and cardiovascular and neurological status, with radiographic remission and regression to extinction of pericardial effusion at repeated echocardiographic evaluations.

Renal Function in Hypothyroidism

International Nuclear Information System (INIS)

Khalid, A. S; Ahmed, M.I; Elfaki, H.M; Hassan, N.; Suliman, S. M.

2006-12-01

Background hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatraemia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective renal function is profoundly influenced by thyroid status, the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and patients in 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate(GFR) using modified in diet renal disease (MDRD) formula. Result in hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR increased. The hypothyroid patients showed elevated serum creatinine levels(>1.1 mg/d1) compared to control group (p value= 000). In patients mean estimated GFR increased in the control group (p value=.002).Conclusion thus the kidney, in addition to the brain, heart and muscle, is an important target of the action of thyroid hormones.(Author)

Radioimmunoassay of luteinizing hormone in hypothyroidism

International Nuclear Information System (INIS)

Sobieszczyk, S.

1975-01-01

Radioimmunoassay of luteinizing hormone was performed in 18 women with primary hypothyroidism and 15 women with secondary hypothyroidism. The results of determinations were compared with LH values found in healthy women at reproductive age and after menopause. It was observed that in primary hypothyroidism the level of LH is normal, in young women it was from 6 to 25 m IU/ml, while in the postmenopausal period it increased to 70 to 200 m IU/ml. In secondary hypothyroidism due to pituitary hypofunction the LH level is undetectable or lies in the range of lowest values observed in healthy subjects, not exceeding 8 m IU/ml. Determinations of serum LH may be useful for differential diagnosis of primary and secondary hypothyroidism. (author)

Levothyroxine rescues the lead-induced hypothyroidism and impairment of long-term potentiation in hippocampal CA1 region of the developmental rats

International Nuclear Information System (INIS)

Wu Chuanyun; Liu Bing; Wang Huili; Ruan Diyun

2011-01-01

Lead (Pb) exposure during development has been associated with impaired long-term potentiation (LTP). Hypothyroidism happening upon subjects with occupational exposure to Pb is suggestive of an adverse effect of Pb on thyroid homeostasis, leading to the hypothesis that Pb exposure may alter thyroid hormone homeostasis. Hippocampus is one of the targets of Pb exposure, and is sensitive to and dependent on thyroid hormones, leading us to explore whether levothyroxine (L-T 4 ) administration could alter the thyroid disequilibrium and impairment of LTP in rat hippocampus caused by Pb exposure. Our results show that Pb exposure caused a decrease in triiodothyronine (T 3 ) and tetraiodothyronine (T 4 ) levels accompanied by a dramatic decrease of TSH and application of L-T 4 restored these changes to about control levels. Hippocampal and blood Pb concentration were significantly reduced following L-T 4 treatment. L-T 4 treatment rescued the impairment of LTP induced by the Pb exposure. These results suggest that Pb exposure may lead to thyroid dysfunction and induce hypothyroidism and provide a direct electrophysiological proof that L-T 4 relieves chronic Pb exposure-induced impairment of synaptic plasticity. - Highlights: → Lead may interfere with thyroid hormone homeostasis and induce hypothyroidism. → Levothyroxine decreases the hippocampal and blood Pb concentration. → Levothyroxine amends the T 3 , T 4 and TSH levels in blood. → Levothyroxine rescues the impaired LTP in CA1.

Do Premenopausal Hypothyroid Women on Levothyroxine Therapy Need Bone Status Monitoring?

Directory of Open Access Journals (Sweden)

Ruby P. Babu

2015-01-01

Full Text Available Background Suppressive doses of levothyroxine therapy are reported to reduce bone mineral density (BMD in women. Data on bone changes in premenopausal hypothyroid women with replacement therapy are limited. Hence, this study was undertaken to evaluate bone changes in this group using bone markers and BMD. Materials and Methods A hospital-based case–control study including 75 premenopausal women aged 30–45 years was conducted. The subjects were categorized based on their thyroid function and history into three groups of 25 euthyroid, 25 newly diagnosed hypothyroid, and 25 hypothyroid women on 100–200 μg of levothyroxine for a minimum of 5 years. The bone changes were evaluated and compared among the groups biochemically by estimating their plasma osteocalcin and serum calcium and phosphorus and radiologically by measuring their BMD by quantitative ultrasonography. Statistical analysis was conducted by using analysis of variance, Tukey's test, and Pearson's correlation using IBM SPSS Statistics 20. Results Levels of plasma osteocalcin, serum calcium, and serum phosphorus in patients on long-term levothyroxine therapy were significantly higher than those in newly diagnosed hypothyroid women and in the euthyroid group. BMD showed definite features of osteopenia ( T -score: −2.26 ± 0.5 among the women in the treatment group, while it was well within the normal range in the newly diagnosed and euthyroid women. A significant correlation was found between the osteocalcin levels and T -score. Conclusion Hypothyroid women on long-term levothyroxine therapy showed signs of increased bone turnover and increased resorptive changes, though not frank osteoporosis. Hence, it may be important to evaluate the bone status of patients on levothyroxine for >5 years.

Congenital hypothyroidism and concurrent renal insufficiency in a kitten

OpenAIRE

Chee Kin Lim; Chantal T. Rosa; Yolanda de Witt; Johan P. Schoeman

2014-01-01

A 3-month-old male domestic short-hair kitten was presented with chronic constipation and disproportionate dwarfism. Radiographs of the long bones and spine revealed delayed epiphyseal ossification and epiphyseal dysgenesis. Diagnosis of congenital primary hypothyroidism was confirmed by low serum total thyroxine and high thyroid stimulating hormone concentrations. Appropriate supplementation of levothyroxine was instituted. The kitten subsequently developed mild renal azotaemia and renal pro...

The interrelation between hypothyroidism and glaucoma: a critical review and meta-analyses.

Science.gov (United States)

Thvilum, Marianne; Brandt, Frans; Brix, Thomas Heiberg; Hegedüs, Laszlo

2017-12-01

Data on the association between hypothyroidism and glaucoma are conflicting. We sought to shed light on this by conducting a critical review and meta-analyses. The meta-analyses were conducted in adherence with the widely accepted MOOSE guidelines. Using the Medical Subject Heading (MeSH) terms: hypothyroidism, myxoedema and glaucoma or intraocular pressure, case-control studies, cohort studies and cross-sectional studies were identified (PubMed) and reviewed. Using meta-analysis, the relative risk (RR) of coexistence of glaucoma and hypothyroidism was calculated. Based on the literature search, thirteen studies fulfilled the inclusion criteria and could be categorized into two groups based on the exposure. The designs of the studies varied considerably, and there was heterogeneity related to lack of power, weak phenotype classifications and length of follow-up. Eight studies had glaucoma (5757 patients) as exposure and hypothyroidism as outcome. Among these, we found a non-significantly increased risk of hypothyroidism associated with glaucoma (RR 1.65; 95% confidence interval [CI]: 0.97-2.82). Based on five studies (168 006 patients) with hypothyroidism as exposure and glaucoma as outcome, we found the risk of glaucoma to be significantly increased (RR 1.33; 95% CI: 1.13-1.58). Based on these meta-analyses, there seems to be an association between hypothyroidism and glaucoma, which does not seem to be the case between glaucoma and hypothyroidism. However, larger scale studies with better phenotype classification, longer follow-up and taking comorbidity and other biases into consideration are needed to address a potential causal relationship. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Short term memory in echo state networks

OpenAIRE

Jaeger, H.

2001-01-01

The report investigates the short-term memory capacity of echo state recurrent neural networks. A quantitative measure MC of short-term memory capacity is introduced. The main result is that MC 5 N for networks with linear Output units and i.i.d. input, where N is network size. Conditions under which these maximal memory capacities are realized are described. Several theoretical and practical examples demonstrate how the short-term memory capacities of echo state networks can be exploited for...

Verbal short-term memory as an articulatory system: evidence from an alternative paradigm.

Science.gov (United States)

Cheung, Him; Wooltorton, Lana

2002-01-01

In a series of experiments, the role of articulatory rehearsal in verbal [corrected] short-term memory was examined via a shadowing-plus-recall paradigm. In this paradigm, subjects shadowed a word target presented closely after an auditory memory list before they recalled the list. The phonological relationship between the shadowing target and the final item on the memory list was manipulated. Experiments 1 and 2 demonstrated that targets sounding similar to the list-final memory item generally took longer to shadow than unrelated targets. This inhibitory effect of phonological relatedness was more pronounced with tense- than lax-vowel pseudoword recall lists. The interaction between vowel tenseness and phonological relatedness was replicated in Experiment 3 using shorter lists of real words. In Experiment 4, concurrent articulation was applied during list learning to block rehearsal; consequently, neither the phonological relatedness effect nor its interaction with vowel tenseness emerged. Experiments 5 and 6 manipulated the occurrence frequencies and lexicality of the recall items, respectively, instead of vowel tenseness. Unlike vowel tenseness, these non-articulatory memory factors failed to interact with the phonological relatedness effect. Experiment 7 orthogonally manipulated the vowel tenseness and frequencies of the recall items; slowing in shadowing times due to phonological relatedness was modulated by vowel tenseness but not frequency. Taken together, these results suggest that under the present paradigm, the modifying effect of vowel tenseness on the magnitude of slowing in shadowing due to phonological relatedness is indicative of a prominent articulatory component in verbal short-term retention. The shadowing-plus-recall approach avoids confounding overt recall into internal memory processing, which is an inherent problem of the traditional immediate serial recall and span tasks.

Hypothyroidism after radiotherapy to the neck

International Nuclear Information System (INIS)

Yoden, Eisaku; Soejima, Toshinori; Maruta, Tsutomu; Demizu, Yusuke; Nishimura, Hideki; Ejima, Yasuo; Sasaki, Ryohei; Yamada, Kazunari; Sugimura, Kazuro

2004-01-01

The purpose of this study was to investigate the incidence and possible predictors of hypothyroidism after radiotherapy to the neck, focusing on radiation dose-volume factors. Thyroid function was measured in 169 patients treated with radiation ports including the thyroid, between 1989 and 2000. Hypothyroidism was determined with an endpoint of elevated serum thyroid stimulating hormone (TSH) levels >10.0 μU/ml. In 60 patients, radiation dose-volume factors were calculated; e.g., total volume of the thyroid, mean radiation dose to the thyroid, and %-volume of the thyroid which received radiation doses of no less than 10-70 Gy (V 10 -V 70 ). The evaluated risk factors for hypothyroidism included these dose-volume factors, sex, age, primary disease, combined chemotherapy, and follow-up period. Hypothyroidism was detected in 33 (19.5%) of the 169 patients. None of them had clinical symptoms of hypothyroidism. V 10 , V 20 , and V 30 seemed to be possible predictors of hypothyroidism and had a significant impact on the peak level of serum TSH. Radiation dose-volume factors of the thyroid seemed to correlate with the incidence of hypothyroidism, and V 10 , V 20 , and V 30 had a significant impact on the peak level of serum TSH. (author)

Smoking cessation is followed by a sharp but transient rise in the incidence of overt autoimmune hypothyroidism – A population‐based, case–control study

DEFF Research Database (Denmark)

Carlé, Allan; Bülow Pedersen, Inge; Knudsen, Nils

2012-01-01

habits were verified by measuring urinary cotinine (a nicotine metabolite). Incident hypothyroidism was very common in people who had recently stopped smoking: OR vs never smokers (95%‐CI); quit smoking 10 years, 0·76 (0·38–1·51). Results were consistent in both sexes and irrespective of age. Within two...

Short term and medium term power distribution load forecasting by neural networks

International Nuclear Information System (INIS)

Yalcinoz, T.; Eminoglu, U.

2005-01-01

Load forecasting is an important subject for power distribution systems and has been studied from different points of view. In general, load forecasts should be performed over a broad spectrum of time intervals, which could be classified into short term, medium term and long term forecasts. Several research groups have proposed various techniques for either short term load forecasting or medium term load forecasting or long term load forecasting. This paper presents a neural network (NN) model for short term peak load forecasting, short term total load forecasting and medium term monthly load forecasting in power distribution systems. The NN is used to learn the relationships among past, current and future temperatures and loads. The neural network was trained to recognize the peak load of the day, total load of the day and monthly electricity consumption. The suitability of the proposed approach is illustrated through an application to real load shapes from the Turkish Electricity Distribution Corporation (TEDAS) in Nigde. The data represents the daily and monthly electricity consumption in Nigde, Turkey

Does Hypothyroidism Affect Gastrointestinal Motility?

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Olga Yaylali

2009-01-01

Full Text Available Background. Gastrointestinal motility and serum thyroid hormone levels are closely related. Our aim was to analyze whether there is a disorder in esophagogastric motor functions as a result of hypothyroidism. Materials and Methods. The study group included 30 females (mean age ± SE 45.17 ± 2.07 years with primary hypothyroidism and 10 healthy females (mean age ± SE 39.40 ± 3.95 years. All cases underwent esophagogastric endoscopy and scintigraphy. For esophageal scintigraphy, dynamic imaging of esophagus motility protocol, and for gastric emptying scintigraphy, anterior static gastric images were acquired. Results. The mean esophageal transit time (52.56 ± 4.07 sec for patients; 24.30 ± 5.88 sec for controls; P=.02 and gastric emptying time (49.06 ± 4.29 min for the hypothyroid group; 30.4 ± 4.74 min for the control group; P=.01 were markedly increased in cases of hypothyroidism. Conclusion. Hypothyroidism prominently reduces esophageal and gastric motor activity and can cause gastrointestinal dysfunction.

Hypothyroidism associated with parathyroid disorders.

Science.gov (United States)

Mantovani, Giovanna; Elli, Francesca Marta; Corbetta, Sabrina

2017-03-01

Hypothyroidism may occur in association with congenital parathyroid disorders determining parathyroid hormone insufficiency, which is characterized by hypocalcemia and concomitant inappropriately low secretion of parathormone (PTH). The association is often due to loss of function of genes common to thyroid and parathyroid glands embryonic development. Hypothyroidism associated with hypoparathyroidism is generally mild and not associated with goiter; moreover, it is usually part of a multisystemic involvement not restricted to endocrine function as occurs in patients with 22q11 microdeletion/DiGeorge syndrome, the most frequent disorders. Hypothyroidism and hypoparathyroidism may also follow endocrine glands' damages due to autoimmunity or chronic iron overload in thalassemic disorders, both genetically determined conditions. Finally, besides PTH deficiency, hypocalcemia can be due to PTH resistance in pseudohypoparathyroidism; when hormone resistance is generalized, patients can suffer from hypothyroidism due to TSH resistance. In evaluating patients with hypothyroidism and hypocalcemia, physical examination and clinical history are essential to drive the diagnostic process, while routine genetic screening is not recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.

The heart and hypothyroidism | Bennett | South African Medical ...

African Journals Online (AJOL)

The association of hypothyroidism with heart disease is reviewed. The. relative rarity of cardiac failure due to hypothyroidism is stressed, and structural abnormalities of the heart due to hypothyroidism are discussed. The clinical management of hypothyroid patients with heart disease is described.

Hypothyroidism simulating as polymyositis.

Science.gov (United States)

Aslam, Hina; Sayeed, Mohammad Ahsan; Qadeer, Rashid; Afsar, Salahuddin

2015-05-01

Polymyositis-like syndrome in hypothyroidism is a rare condition characterised by proximal muscle weakness and elevated muscle enzymes. Patients with this condition can initially be misdiagnosed as having polymyositis due to similar characteristics of both diseases; however a response to thyroxine is the main differentiating feature. This report highlights the case of a 30-year-old male who had severe myalgia and proximal muscle weakness. In addition to raised creatinine phosphokinase (CPK) levels, his biochemical profile showed hypothyroidism. Initially thought to be suffering from polymyositis, improvement in both clinical and biochemical profile with thyroxine led to the diagnosis of polymyositis-like syndrome associated with hypothyroidism.

Therapy of endemic goiter and hypothyroidism

Energy Technology Data Exchange (ETDEWEB)

Luft, D.

1983-09-12

Successful treatment of endemic goitre depends on the correct diagnosis and the comprehension of the pathophysiologic changes as well. Several criteria, e.g. anamnestic data, general clinical condition, local symptoms and signs, certainty of diagnosis, contraindications, rates of success, and side effects, determine the particular form of therapy (suppression with thyroid hormones, surgical resection, radio-iodine). The decision criteria are discussed. Prophylaxis of recurrent goitre with either thyroid hormones or iodine salts is necessary after successful treatment. Some endemic goitres behave like either hyper- or hypothyroidism. Treatment with thyroid hormones of patients with latent hyperthyroidism is senseless and dangerous, whereas other methods of treatment may be applied. An unequivocal indication for treatment exists in patients with latent hypothyroidism accompanied by goitre, but not in all patients without goitre. Hormonal replacement therapy of manifest hypothydroidism is simple, but long term success is not achieved in all patients.

Therapy of endemic goiter and hypothyroidism

International Nuclear Information System (INIS)

Luft, D.

1983-01-01

Successful treatment of endemic goitre depends on the correct diagnosis and the comprehension of the pathophysiologic changes as well. Several criteria, e.g. anamnestic data, general clinical condition, local symptoms and signs, certainty of diagnosis, contraindications, rates of success, and side effects, determine the particular form of therapy (suppression with thyroid hormones, surgical resection, radio-iodine). The decision criteria are discussed. Prophylaxis of recurrent goitre with either thyroid hormones or iodine salts is necessary after successful treatment. Some endemic goitres behave like either hyper- or hypothyroidism. Treatment with thyroid hormones of patients with latent hyperthyroidism is senseless and dangerous, whereas other methods of treatment may be applied. An unequivocal indication for treatment exists in patients with laent hypothyroidism accompanied by goitre, but not in all patients without goitre. Hormonal replacement therapy of manifest hypothydroidism is simple, but long term success is not achieved in all patients. (orig.) [de

Palpebral redundancy from hypothyroidism.

Science.gov (United States)

Wortsman, J; Wavak, P

1980-01-01

A patient is described with disabling palpebral edema. Primary hypothyroidism had been previously diagnosed and treated. Testing of thyroid function revealed persistence of the hypothyroidism. Treatment with L-thyroxine produced normalization of the biochemical parameters and resolution of palpebral edema. The search for hypothyrodism in patients with palpebral redundancy is emphasized.

Vegan diets and hypothyroidism.

Science.gov (United States)

Tonstad, Serena; Nathan, Edward; Oda, Keiji; Fraser, Gary

2013-11-20

Diets eliminating animal products have rarely been associated with hypothyroidism but may protect against autoimmune disease. Thus, we investigated whether risk of hypothyroidism was associated with vegetarian compared to omnivorous dietary patterns. The Adventist Health Study-2 was conducted among church members in North America who provided data in a self-administered questionnaire. Hypothyroidism was queried at baseline in 2002 and at follow-up to 2008. Diet was examined as a determinant of prevalent (n = 4237 of 65,981 [6.4%]) and incident cases (1184 of 41,212 [2.9%]) in multivariate logistic regression models, controlled for demographics and salt use. In the prevalence study, in addition to demographic characterstics, overweight and obesity increased the odds (OR 1.32, 95% CI: 1.22-1.42 and 1.78, 95% CI: 1.64-1.93, respectively). Vegan versus omnivorous diets tended to be associated with reduced risk (OR 0.89, 95% CI: 0.78-1.01, not statistically significant) while a lacto-ovo diet was associated with increased risk (OR 1.09, 95% CI: 1.01-1.18). In the incidence study, female gender, white ethnicity, higher education and BMI were predictors of hypothyroidism. Following a vegan diet tended to be protective (OR 0.78, 95% CI: 0.59-1.03, not statistically significant). In conclusion, a vegan diet tended to be associated with lower, not higher, risk of hypothyroid disease.

Thyroidectomy for Graves' disease: is hypothyroidism inevitable?

OpenAIRE

Davenport, M.; Talbot, C. H.

1989-01-01

The outcome of 234 patients with Graves' disease treated by subtotal thyroidectomy over a 12-year period is analysed with specific reference to hypothyroidism. Of definite hypothyroid cases, 98% occurred within 2 years. Failure to develop hypothyroidism was statistically related to large remnant size and a large goitre preoperatively. Histological review showed that any degree of lymphocytic infiltration was associated with the development of hypothyroidism (50% vs 22%). Late onset hypothyroi...

A baby with congenital hypothyroidism born to a hypothyroid mother who expressed undiagnosed thyroid stimulation blocking antibody

Directory of Open Access Journals (Sweden)

Mock Ryeon Kim

2016-09-01

Full Text Available In adults, hypothyroidism caused by thyroid stimulation blocking antibody (TSB Ab is rare, and confirmed cases are even fewer, as TSB Ab levels are rarely assayed. However, this may create problems in babies, as the transplacental passage of maternal TSB Ab can cause a rare type of hypothyroidism in the infant. Prompt levothyroxine replacement for the baby starting immediately after birth is important. We describe a congenital hypothyroid baby born to a hypothyroid mother who was not aware of the cause of her hypothyroid condition, which turned out to be associated with the expression of TSB Ab. This cause was confirmed in both the infant and mother using a series of thyroid function tests and measurements of autoantibody levels, including TSB Ab. During periodic follow-up, the TSB Ab and thyroid stimulating hormone receptor antibody titers became negative in the baby at 8 months of age, but remained positive in the mother. Evaluation of hypothyroidism and its cause in mothers during pregnancy is important for both maternal and child health.

Rhabdomyolysis in a Patient with Severe Hypothyroidism.

Science.gov (United States)

Salehi, Nooshin; Agoston, Endre; Munir, Iqbal; Thompson, Gary J

2017-08-22

BACKGROUND Muscular symptoms, including stiffness, myalgia, cramps, and fatigue, are present in the majority of the patients with symptomatic hypothyroidism, but rhabdomyolysis, the rapid breakdown of skeletal muscle, is a rare manifestation. In most patients with hypothyroidism who develop rhabdomyolysis, precipitating factors, such as strenuous exercise or use of lipid-lowering drugs, can be identified. CASE REPORT We report a case of a 52-year-old Hispanic woman with a history of hypothyroidism, hypertension, and type 2 diabetes mellitus who presented with fatigue, severe generalized weakness, bilateral leg pain, and recurrent falls. She reported poor medication compliance for the preceding month. Initial laboratory testing showed elevated thyroid stimulating hormone (TSH) and creatine kinase (CK) levels, indicating uncontrolled hypothyroidism with associated rhabdomyolysis. Supportive treatment with intravenous fluids and intravenous levothyroxine were initiated and resulted in dramatic clinical improvement. CONCLUSIONS We report a case of rhabdomyolysis, which is a rare but potentially serious complication of hypothyroidism. Screening for hypothyroidism in patients with elevated muscle enzymes should be considered, since an early diagnosis and prompt treatment of hypothyroidism is essential to prevent rhabdomyolysis and its consequences.

Conversion of autoimmune hypothyroidism to hyperthyroidism.

Science.gov (United States)

Furqan, Saira; Haque, Naeem-ul; Islam, Najmul

2014-08-03

Graves' disease and Hashimoto's thyroiditis are the two autoimmune spectrum of thyroid disease. Cases of conversion from hyperthyroidism to hypothyroidism have been reported but conversion from hypothyroidism to hyperthyroidism is very rare. Although such cases have been reported rarely in the past we are now seeing such conversions from hypothyroidism to hyperthyroidism more frequently in clinical practice. We are reporting three cases of middle aged Asian females who presented with classical symptoms of hypothyroidism and the investigations showed elevated thyroid stimulating hormone with positive thyroid antibodies. Diagnosis of autoimmune hypothyroidism was made and thyroxine replacement therapy was initiated. Patients became asymptomatic with normalization of thyroid stimulating hormone level. After few years they developed symptoms of hyperthyroidism with suppressed thyroid stimulating hormone level. Over replacement of thyroxine was considered and the dose of thyroxine was decreased, but they remain symptomatic. After gradual decrease in the dose of thyroxine it was stopped finally. Even after few months of stopping thyroxine, the symptoms of hyperthyroidism did not improve and the biochemical and imaging modalities confirmed that the patients have developed hyperthyroidism. Anti-thyroid treatment was then started and the patients became symptom free. High index of suspicion should be there for possible conversion of hypothyroidism to hyperthyroidism if a patient with primary hypothyroidism develops persistent symptoms of hyperthyroidism. Otherwise it can be missed easily considering it as an over replacement with thyroid hormone.

Short-Term Memory and Aphasia: From Theory to Treatment.

Science.gov (United States)

Minkina, Irene; Rosenberg, Samantha; Kalinyak-Fliszar, Michelene; Martin, Nadine

2017-02-01

This article reviews existing research on the interactions between verbal short-term memory and language processing impairments in aphasia. Theoretical models of short-term memory are reviewed, starting with a model assuming a separation between short-term memory and language, and progressing to models that view verbal short-term memory as a cognitive requirement of language processing. The review highlights a verbal short-term memory model derived from an interactive activation model of word retrieval. This model holds that verbal short-term memory encompasses the temporary activation of linguistic knowledge (e.g., semantic, lexical, and phonological features) during language production and comprehension tasks. Empirical evidence supporting this model, which views short-term memory in the context of the processes it subserves, is outlined. Studies that use a classic measure of verbal short-term memory (i.e., number of words/digits correctly recalled in immediate serial recall) as well as those that use more intricate measures (e.g., serial position effects in immediate serial recall) are discussed. Treatment research that uses verbal short-term memory tasks in an attempt to improve language processing is then summarized, with a particular focus on word retrieval. A discussion of the limitations of current research and possible future directions concludes the review. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Subclinical hypothyroidism and cognitive function in people over 60 years: A systematic review and meta- analysis.

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Abimbola A. Akintola

2015-08-01

Full Text Available Subclinical hypothyroidism (SCH, defined as elevated thyroid stimulating hormone and normal thyroid hormone levels, and cognitive impairment are both common in older people. While the relation between overt hypothyroidism and cognitive impairment is well established, data on the association between SCH and cognitive impairment are conflicting. This systematic review and meta- analysis was performed to assess available evidence on the association of SCH with cognition in community dwelling, relatively healthy older adults.PubMed, EMBASE, Web of Science, COCHRANE, CINAHL, PsycINFO and Academic Search Premier (January 1966 to April 1, 2015 were searched without language restrictions, as were references of key articles, for studies on the association between SCH and cognition in older adults (>60 years. These studies were reviewed by two independent reviewers according to predefined criteria for eligibility and methodological quality, and data extracted using standardized forms.Of the 844 reports initially identified, 270 remained after exclusion of duplicates. Of the 270, fifteen studies comprising 19, 944 subjects, of whom 1, 199 had subclinical hypothyroidism were included. Data from the 15 studies was pooled, and meta- analyzed cross-sectionally for global cognition (MMSE, executive function, and memory, using random effects models. Pooled effect size (ES for MMSE was -0.01 (95% CI -0.09, 0.08, with heterogeneity (I2 of 55.1%. Pooled ES was <0.001 (95% CI -0.10, 0.09 for executive function (I2 = 13.5%, and 0.01 (95% CI -0.12, 0.14 for memory (I2 = 46.9%. In addition, prospective analysis including four studies showed pooled ES of 0.033 (95% CI -0.001-0.067 for MMSE (I2 <0.001%, indicating that subclinical hypothyroidism was not significantly associated with accelerated cognitive decline.This systematic review and meta-analysis provides no evidence that supports an association between SCH and cognitive impairment in relatively healthy older

Frequency of hypothyroidism in patients of beta-thalassaemia

International Nuclear Information System (INIS)

Malik, S.A.; Syed, S.; Ahmed, N.

2010-01-01

To determine the frequency of hypothyroidism in patients suffering from homozygous-thalassaemia. This descriptive study included 70 diagnosed thalassaemia major patients aged 5-14 years. Demographic data as well as history of blood transfusion and chelation therapy was collected. Random blood samples were drawn and thyroid profile (serum thyroxine [T4], triiodothyronine [T3] and thyroid stimulating hormone concentrations [TSH]) was done by enzyme-linked immunosorbent assay (ELISA). Primary hypothyroidism was defined by a TSH level >4 macro IU/ml. Results were analysed by descriptive statistical methods. Primary hypothyroidism was seen in 18 (25.7%) patients. Of these, 17 had normal T4 levels with elevated TSH levels consistent with a diagnosis of compensated primary hypothyroidism whereas only one patient showed a decreased T4 level with elevated TSH (uncompensated primary hypothyroidism). Mean age of hypothyroid patients was 9.2 +- 2.6 years. Frequency of hypothyroidism was associated with increased serum ferritin levels. Primary hypothyroidism occurs in a significant proportion of thalassaemia major patients in the absence of obvious clinical signs of hypothyroidism. Regular follow-up for early detection and timely treatment of such complications could improve the quality of life of these patients (JPMA 60:17; 2010). (author)

Attentional Processes in Children's Overt and Relational Aggression

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Arsenault, Darin J.; Foster, Sharon L.

2012-01-01

This study examined attention and memory processes assumed by the social information-processing model to be biased in aggressive children. We also explored whether similar biases were associated with overt and relational aggression. A total of 96 fourth through sixth graders saw videos of overtly and relationally aggressive child actors and…

High androgen levels protect against hypothyroidism.

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Schmidt, Johanna; Dahlgren, Eva; Bryman, Inger; Berntorp, Kerstin; Trimpou, Penelope; Wilhelmsen, Lars; Landin-Wilhelmsen, Kerstin

2017-01-01

Hypothyroidism is a common disorder, appearing mainly in women although less frequently found in women with polycystic ovary syndrome (PCOS). The objective was to test the hypothesis that hyperandrogenism might protect against hypothyroidism. The data from three prospective follow-up studies (up to 21 years) and one register study were compared: women with PCOS (Rotterdam criteria), n = 25, women with Turner syndrome, n = 217, a random population sample of women, n = 315, and men, n = 95 (the WHO MONICA study). Findings were to be verified or rejected in all females, n = 553 716, from the same region. The proportion of hypothyroidism was calculated and thyroid peroxidase antibodies (TPO) in serum were measured. Hypothyroidism at >50 years of age was found in 8% of women with PCOS, 4% in men (PCOS vs. men; ns), 43% of women with Turner syndrome, irrespective of karyotype (p Hypothyroidism increased with age in all groups except PCOS women and men. In the register study, hypothyroidism was less common in women with PCOS >25 years (5.5%) than in women without PCOS (6.8%) from the same region (p Hypothyroidism was less frequently seen in women with PCOS and in men compared with women in the general population and among women with Turner syndrome. This was not explained by altered autoimmunity or the Y-chromosome. Androgens seem to protect against hypothyroidism. © 2016 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology.

Frequency of other endocrine disorders in hypothyroidism

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Bjekić-Macut Jelica

2012-01-01

Full Text Available Hypothyroidism is a condition of reduced production, distribution, or absence of action of thyroid hormones. Clinical diagnosis of hypothyroidism is not easily established due to the nonspecific clinical manifestations. Determination of serum TSH is the first-line test for the diagnosis of hypothyroidism. The aim of the study was to determine the presence of other endocrine disorders in patients with subclinical (TSH levels between 5 and 10 mIU/l, or clinical (TSH above 10 mIU/l hypothyrodism. We analyzed 50 patients (35 with clinical hypothyroidism and 15 with subclinical form. In all patients anthropometric data (age, sex, weight, height, body mass index, blood pressure and heart rate, and clinical signs of hypothyroidism (skin changes, menstrual disorders were determined. Blood was drawn in fasting state for measurement of FT4, sTSH, glucose, lipids, ionized calcium, PTH, cortisol, ACTH, prolactin, gonadotropins, estradiol in women of reproductive age, and testosterone in men. Skin lesions were rarely present. Oligomenorrhea was more frequent in subclinical hypothyroidism, and menopause in clinical hypothyroidism. Blood pressure was normal in all subjects. Patients with clinical hypothyroidism compared to those with subclinical form had higher TSH values (19.5 ± 5.7 vs. 5.9 ± 0.3 mIU/l, and higher doses of L-thyroxine (81.2 ± 4.6 vs. 21.4 ± 3.5 μg/day. Disturbance of glycemic control was present in 18% of patients. Total cholesterol and LDL were insignificantly higher in patients with hypothyroidism than in subclinical form of the disease. FT4, calcium, PTH, cortisol, ACTH, gonadotropins, estradiol and testosterone did not differ between groups. The proatherogenic relation of estradiol with triglycerides was established in women with clinical form of hypothyroidism.

Prevalence of Hypothyroidism in Nonalcoholic Fatty Liver disease

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Pagadala, Mangesh R.; Zein, Claudia O.; Dasarathy, Srinivasan; Yerian, Lisa; Lopez, Rocio; McCullough, Arthur J.

2014-01-01

Background A possible association between nonalcoholic fatty liver disease (NAFLD) and hypothyroidism has been suggested. Possible explanations for this association are the recognized links between hypothyroidism and various elements of the metabolic syndrome which is often present in NAFLD. To further explore this association, we determined the prevalence of hypothyroidism in a cohort of patients with NAFLD and analyzed the potential factors associated with hypothyroidism in this patient population. Methods Two hundred and forty six patients with biopsy proven NAFLD attending hepatology clinics at the Cleveland Clinic between October 2006 to June 2009 and 430 age, gender, race and BMI matched control subjects seen in the general internal medicine clinic were included. Patients with a clinical diagnosis of hypothyroidism who were on thyroid replacement therapy were considered to be hypothyroid. Results Hypothyroidism was more frequent among patients with NAFLD (21%vs 9.5%.; Phypothyroidism were 2.1 (95% CI: 1.1, 3.9,P=0.02)) and 3.8 (95% CI:2,6.9, Phypothyroidism. NAFLD subjects who reported mild alcohol consumption were less likely to have hypothyroidism compared to those who reported complete abstinence (OR 0.37, P=0.008). Conclusions A higher prevalence of hypothyroidism was demonstrated in patients with NAFLD compared to controls. Patients with hypothyroidism were more likely to have NASH. Among subjects with NALFD, female gender, increased BMI and history of abstinence from alcohol were associated with hypothyroidism. Further studies are needed in order to confirm and better characterized these findings as well as the described associations and their pathogenesis. PMID:22183820

Short-term memories with a stochastic perturbation

International Nuclear Information System (INIS)

Pontes, Jose C.A. de; Batista, Antonio M.; Viana, Ricardo L.; Lopes, Sergio R.

2005-01-01

We investigate short-term memories in linear and weakly nonlinear coupled map lattices with a periodic external input. We use locally coupled maps to present numerical results about short-term memory formation adding a stochastic perturbation in the maps and in the external input

Narcissism and boredom revisited: an exploration of correlates of overt and covert narcissism among Dutch university students.

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Zondag, Hessel J

2013-04-01

This article presents a study of the relationship between narcissism, overt and covert, and seven aspects of boredom, defined as listlessness, drawn out experience of time, depletion, lack of concentration, restlessness, experience seeking, and lack of interest. The survey was conducted using questionnaires administered to 32 men and 177 women. The mean age of male respondents was 30.9 yr. (SD = 11.9), that of female respondents 30.2 yr. (SD = 12.2). In general terms, covert narcissism was found to be positively, and overt narcissism negatively, associated with boredom. The results showed a more complex pattern than was found in previous research into the relationship between narcissism and boredom and suggest that overt and covert narcissism are at opposite ends of the adjustment continuum.

Vegan Diets and Hypothyroidism

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Serena Tonstad

2013-11-01

Full Text Available Diets eliminating animal products have rarely been associated with hypothyroidism but may protect against autoimmune disease. Thus, we investigated whether risk of hypothyroidism was associated with vegetarian compared to omnivorous dietary patterns. The Adventist Health Study-2 was conducted among church members in North America who provided data in a self-administered questionnaire. Hypothyroidism was queried at baseline in 2002 and at follow-up to 2008. Diet was examined as a determinant of prevalent (n = 4237 of 65,981 [6.4%] and incident cases (1184 of 41,212 [2.9%] in multivariate logistic regression models, controlled for demographics and salt use. In the prevalence study, in addition to demographic characterstics, overweight and obesity increased the odds (OR 1.32, 95% CI: 1.22–1.42 and 1.78, 95% CI: 1.64–1.93, respectively. Vegan versus omnivorous diets tended to be associated with reduced risk (OR 0.89, 95% CI: 0.78–1.01, not statistically significant while a lacto-ovo diet was associated with increased risk (OR 1.09, 95% CI: 1.01–1.18. In the incidence study, female gender, white ethnicity, higher education and BMI were predictors of hypothyroidism. Following a vegan diet tended to be protective (OR 0.78, 95% CI: 0.59–1.03, not statistically significant. In conclusion, a vegan diet tended to be associated with lower, not higher, risk of hypothyroid disease.

Rhabdomyolysis in a Patient with Severe Hypothyroidism

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Salehi, Nooshin; Agoston, Endre; Munir, Iqbal; Thompson, Gary J.

2017-01-01

Patient: Female, 52 Final Diagnosis: Hypothyroidism induced rhabdomyolysis Symptoms: Bilateral leg pain • fatigue Medication: Levothyroxine • Calcitriol • Calcium Gluconate Clinical Procedure: — Specialty: Endocrinology and Metabolic Objective: Unusual clinical course Background: Muscular symptoms, including stiffness, myalgia, cramps, and fatigue, are present in the majority of the patients with symptomatic hypothyroidism, but rhabdomyolysis, the rapid breakdown of skeletal muscle, is a rare manifestation. In most patients with hypothyroidism who develop rhabdomyolysis, precipitating factors, such as strenuous exercise or use of lipid-lowering drugs, can be identified. Case Report: We report a case of a 52-year-old Hispanic woman with a history of hypothyroidism, hypertension, and type 2 diabetes mellitus who presented with fatigue, severe generalized weakness, bilateral leg pain, and recurrent falls. She reported poor medication compliance for the preceding month. Initial laboratory testing showed elevated thyroid stimulating hormone (TSH) and creatine kinase (CK) levels, indicating uncontrolled hypothyroidism with associated rhabdomyolysis. Supportive treatment with intravenous fluids and intravenous levothyroxine were initiated and resulted in dramatic clinical improvement. Conclusions: We report a case of rhabdomyolysis, which is a rare but potentially serious complication of hypothyroidism. Screening for hypothyroidism in patients with elevated muscle enzymes should be considered, since an early diagnosis and prompt treatment of hypothyroidism is essential to prevent rhabdomyolysis and its consequences. PMID:28827517

Prognostic Role of Hypothyroidism in Heart Failure

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Ning, Ning; Gao, Dengfeng; Triggiani, Vincenzo; Iacoviello, Massimo; Mitchell, Judith E.; Ma, Rui; Zhang, Yan; Kou, Huijuan

2015-01-01

Abstract Hypothyroidism is a risk factor of heart failure (HF) in the general population. However, the relationship between hypothyroidism and clinical outcomes in patients with established HF is still inconclusive. We conducted a systematic review and meta-analysis to clarify the association of hypothyroidism and all-cause mortality as well as cardiac death and/or hospitalization in patients with HF. We searched MEDLINE via PubMed, EMBASE, and Scopus databases for studies of hypothyroidism and clinical outcomes in patients with HF published up to the end of January 2015. Random-effects models were used to estimate summary relative risk (RR) statistics. We included 13 articles that reported RR estimates and 95% confidence intervals (95% CIs) for hypothyroidism with outcomes in patients with HF. For the association of hypothyroidism with all-cause mortality and with cardiac death and/or hospitalization, the pooled RR was 1.44 (95% CI: 1.29–1.61) and 1.37 (95% CI: 1.22–1.55), respectively. However, the association disappeared on adjustment for B-type natriuretic protein level (RR 1.17, 95% CI: 0.90–1.52) and in studies of patients with mean age hypothyroidism associated with increased all-cause mortality as well as cardiac death and/or hospitalization in patients with HF. Further diagnostic and therapeutic procedures for hypothyroidism may be needed for patients with HF. PMID:26222845

Short-term memory

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Toulouse, G.

This is a rather bold attempt to bridge the gap between neuron structure and psychological data. We try to answer the question: Is there a relation between the neuronal connectivity in the human cortex (around 5,000) and the short-term memory capacity (7±2)? Our starting point is the Hopfield model (Hopfield 1982), presented in this volume by D.J. Amit.

Pleiotropic Effects of Thyroid Hormones: Learning from Hypothyroidism

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Martha Franco

2011-01-01

Full Text Available Hypothyroidism induces several metabolic changes that allow understanding some physiopathological mechanisms. Under experimental hypothyroid conditions in rats, heart and kidney are protected against oxidative damage induced by ischemia reperfusion. An increased resistance to opening of the permeability transition pore seems to be at the basis of such protection. Moreover, glomerular filtration rate of hypothyroid kidney is low as a result of adenosine receptors-induced renal vasoconstriction. The vascular tone of aorta is also regulated by adenosine in hypothyroid conditions. In other context, thyroid hormones regulate lipoprotein metabolism. High plasma level of LDL cholesterol is a common feature in hypothyroidism, due to a low expression of the hepatic LDL receptor. In contrast, HDL-cholesterol plasma levels are variable in hypothyroidism; several proteins involved in HDL metabolism and structure are expressed at lower levels in experimental hypothyroidism. Based on the positive influence of thyroid hormones on lipoprotein metabolism, thyromimetic drugs are promising for the treatment of dyslipidemias. In summary, hypothyroid status has been useful to understand molecular mechanisms involved in ischemia reperfusion, regulation of vascular function and intravascular metabolism of lipoproteins.

Hypertrichosis due to primary hypothyroidism.

OpenAIRE

Stern, S R; Kelnar, C J

1985-01-01

A 10 year old girl with hypertrichosis associated with primary hypothyroidism that resolved after 6 months' replacement treatment with thyroxine is reported. It is important to consider the diagnosis of hypothyroidism in children with abnormal hairiness or distribution of body hair.

Competitive short-term and long-term memory processes in spatial habituation.

Science.gov (United States)

Sanderson, David J; Bannerman, David M

2011-04-01

Exposure to a spatial location leads to habituation of exploration such that, in a novelty preference test, rodents subsequently prefer exploring a novel location to the familiar location. According to Wagner's (1981) theory of memory, short-term and long-term habituation are caused by separate and sometimes opponent processes. In the present study, this dual-process account of memory was tested. Mice received a series of exposure training trials to a location before receiving a novelty preference test. The novelty preference was greater when tested after a short, rather than a long, interval. In contrast, the novelty preference was weaker when exposure training trials were separated by a short, rather than a long interval. Furthermore, it was found that long-term habituation was determined by the independent effects of the amount of exposure training and the number of exposure training trials when factors such as the intertrial interval and the cumulative intertrial interval were controlled. A final experiment demonstrated that a long-term reduction of exploration could be caused by a negative priming effect due to associations formed during exploration. These results provide evidence against a single-process account of habituation and suggest that spatial habituation is determined by both short-term, recency-based memory and long-term, incrementally strengthened memory.

Retrieval-Induced Inhibition in Short-Term Memory.

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Kang, Min-Suk; Choi, Joongrul

2015-07-01

We used a visual illusion called motion repulsion as a model system for investigating competition between two mental representations. Subjects were asked to remember two random-dot-motion displays presented in sequence and then to report the motion directions for each. Remembered motion directions were shifted away from the actual motion directions, an effect similar to the motion repulsion observed during perception. More important, the item retrieved second showed greater repulsion than the item retrieved first. This suggests that earlier retrieval exerted greater inhibition on the other item being held in short-term memory. This retrieval-induced motion repulsion could be explained neither by reduced cognitive resources for maintaining short-term memory nor by continued inhibition between short-term memory representations. These results indicate that retrieval of memory representations inhibits other representations in short-term memory. We discuss mechanisms of retrieval-induced inhibition and their implications for the structure of memory. © The Author(s) 2015.

Evaluation of Short Term Memory Span Function In Children

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Barış ERGÜL

2016-12-01

Full Text Available Although details of the information encoded in the short-term memory where it is stored temporarily be recorded in the working memory in the next stage. Repeating the information mentally makes it remain in memory for a long time. Studies investigating the relationship between short-term memory and reading skills that are carried out to examine the relationship between short-term memory processes and reading comprehension. In this study information coming to short-term memory and the factors affecting operation of short term memory are investigated with regression model. The aim of the research is to examine the factors (age, IQ and reading skills that are expected the have an effect on short-term memory in children through regression analysis. One of the assumptions of regression analysis is to examine which has constant variance and normal distribution of the error term. In this study, because the error term is not normally distributed, robust regression techniques were applied. Also, for each technique; coefficient of determination is determined. According to the findings, the increase in age, IQ and reading skills caused the increase in short term memory in children. After applying robust regression techniques, the Winsorized Least Squares (WLS technique gives the highest coefficient of determination.

Evaluation of Short Term Memory Span Function In Children

OpenAIRE

Barış ERGÜL; Arzu ALTIN YAVUZ; Ebru GÜNDOĞAN AŞIK

2016-01-01

Although details of the information encoded in the short-term memory where it is stored temporarily be recorded in the working memory in the next stage. Repeating the information mentally makes it remain in memory for a long time. Studies investigating the relationship between short-term memory and reading skills that are carried out to examine the relationship between short-term memory processes and reading comprehension. In this study information coming to short-term memory and the factors ...

Conversion of autoimmune hypothyroidism to hyperthyroidism

OpenAIRE

Furqan, Saira; Haque, Naeem-ul; Islam, Najmul

2014-01-01

Background Graves’ disease and Hashimoto’s thyroiditis are the two autoimmune spectrum of thyroid disease. Cases of conversion from hyperthyroidism to hypothyroidism have been reported but conversion from hypothyroidism to hyperthyroidism is very rare. Although such cases have been reported rarely in the past we are now seeing such conversions from hypothyroidism to hyperthyroidism more frequently in clinical practice. Case presentation We are reporting three cases of middle aged Asian female...

Hypothyroidism in late-onset Pompe disease.

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Schneider, Joseph; Burmeister, Lynn A; Rudser, Kyle; Whitley, Chester B; Jarnes Utz, Jeanine

2016-09-01

In Pompe disease, a deficiency of acid α-glucosidase enzyme activity leads to pathologic accumulation of glycogen in tissues. Phenotype heterogeneity in Pompe includes an infantile form and late-onset forms (juvenile- and adult-onset forms). Symptoms common to all phenotypes include progressive muscle weakness and worsening respiratory function. Patients with late-onset forms of Pompe disease commonly complain of chronic fatigue and generalized muscle weakness prior to being diagnosed with Pompe disease, and this may lead to consideration of hypothyroidism in the differential diagnosis. This study aimed to evaluate the prevalence of hypothyroidism in the adult-onset form of Pompe disease. Electronic chart review was performed at the Advanced Therapies Clinic at the University of Minnesota Medical Center (UMMC) to identify patients with late-onset Pompe disease. The identified charts were reviewed for a co-diagnosis of hypothyroidism. A query was made to the clinical data repository at UMMC searching diagnosis ICD9 code 244.9 (hypothyroidism not otherwise specified) and/or presence of levothyroxine from 2011 to 2014 in patients 18 years of age and older. The clinical data repository found a prevalence of hypothyroidism of 3.15% (56,072 of 1,782,720 patients) in the adult patient population at UMMC. Ten adult patients with Pompe disease were identified, five with the diagnosis of hypothyroidism (50%, 95% CI: 23.7, 76.3, p Hypothyroidism was found at a higher prevalence in patients with late-onset Pompe disease compared to the general adult population at UMMC. Studies in larger populations of patients with Pompe disease would be needed to confirm an association of Pompe disease and hypothyroidism. Challenges include finding an adequate sample size, due the rarity of Pompe disease.

Short-term Memory as a Processing Shift

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Lewis-Smith, Marion Quinn

1975-01-01

The series of experiments described here examined the predictions for free recall from sequential models and the shift formulation, focusing on the roles of short- and long-term memory in the primacy/recency shift and on the effects of expectancies on short- and long-term memory. (Author/RK)

Canine hypothyroidism. A diagnostic challenge?

International Nuclear Information System (INIS)

Boretti, Felicitos; Reusch, C.E.

2010-01-01

Hypothyroidism is one of the most common endocrinopathies in dogs. Clinical symptoms and hematological and biochemical parameters lead to a first suspicion. To confirm diagnosis can be challenging, however. Determination of total serum T4 concentration is accepted as the primary screening test for the disease, and low serum T4 concentrations are intuitively suggestive of hypothyroidism. However it is well known that low T4 concentrations are frequently encountered in euthyroid dogs with various nonthyroidal diseases and in dogs receiving certain pharmacologic agents. Since assessment of endogenous TSH (canine TSH) using current canine TSH assays shows normal values in a high percentage of hypothyroid dogs (up to 40%), its diagnostic value is only limited. The TSH-stimulation test can still be recognized as the gold standard for the diagnosis of hypothyroidism in dogs. Determination of circulating T4 concentration before and 6 hours after the administration of exogenous TSH (recombinant human TSH, Thyrogen registered ) provides an assessment of the functional reserve capacity of the thyroid gland with minimal change in post-TSH T4 concentration, compared with the basal concentration, expected in dogs with hypothyroidism. Also this test can be influenced by nonthyroidal illness and by medications known to affect thyroid function. This suppressing influence seems to be less pronounced using a higher dose of TSH. Therefore, to improve the discriminatory power of the TSH stimulation test to differentiate between euthyroid-sick and primary hypothyroidism, the higher dose should be used in cases in which testing cannot be delayed. More recently, ultrasonography and scintigraphy have been used for the diagnosis of primary hypothyroidism. Using ultrasonography, a sensitivity of 98% was reported if size and echogenicity of the gland were combined. However, specificity was as low as 77%. and care must be taken when measuring the gland because of a relatively high

On the relationship between short- and long-term memory

DEFF Research Database (Denmark)

Sørensen, Thomas Alrik

James (1890) divided memory into separate stores; primary and secondary – or short-term and long-term memory. The interaction between the two stores often assumes that information initially is represented in volatile short-term store before entering and consolidating in the more durable long-term......, accepted). Counter to popular beliefs this suggest that long-term memory precedes short-term memory and not vice versa....... memory system (e.g. Atkinson & Shiffrin, 1968). Short-term memory seems to provide a surprising processing bottleneck where only a very limited amount of information can be represented at any given moment (Miller, 1956; Cowan, 2001). A number of studies have investigated the nature of this processing...

Etiological evaluation of primary congenital hypothyroidism cases.

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Bezen, Diğdem; Dilek, Emine; Torun, Neşe; Tütüncüler, Filiz

2017-06-01

Primary congenital hypothyroidism is frequently seen endocrine disorder and one of the preventable cause of mental retardation. Aim of study was to evaluate the frequency of permanent/transient hypothyrodism, and to detect underlying reason to identfy any marker which carries potential to discriminate permanent/transient form. Forty eight cases older than 3 years of age, diagnosed as primary congenital hypothyroidism and started thyroxin therapy in newborn-period, and followed up between January 2007-June 2013 were included in the study. Thyroid hormon levels were evaluated and thyroid ultrasonography was performed in cases who are at the end of their 3 years of age, after 6 weeks of thyroxine free period. Thyroid sintigraphy was performed if serum thyroid-stimulating hormone was high (≥ 5 mIU/mL) and perchlorate discharge test was performed if uptake was normal or increased on sintigraphy. Cases with thyroid-stimulating hormone levels ≥ 5 mIU/mL were defined as permanent primary congenital hypothyroidism group and as transient primary congenital hypothyroidism group with normal thyroid hormones during 6 months. The mean age was 3.8±0.7 years. Mean diagnosis age was 16.6±6.5 days and 14 cases (29.2%) were diagnosed by screening program of Ministry of Health. There were 23 cases (14F, 9M) in permanent primary congenital hypothyroidism group and 12 (52.2%) of them were dysgenesis (8 hypoplasia, 4 ectopia), and 11 (47.8%) dyshormonogenesis. In transient primary congenital hypothyroidism group, there were 25 cases (17M, 8F). The mean thyroid-stimulating hormone levels at diagnosis were similar in two groups. The mean thyroxin dose in permanent primary congenital hypothyroidism group was significantly higher than transient group at the time of thyroxin cessation (2.1±0.7, 1.5±0.5 mg/kg/d, respectively, p=0.004). Thyroxin dose ≥1.6 mcg/kg/d was 72% sensitive and 69.6% specific for predicting permenant primary congenital hypothyroidism. Transient primary

Short-term memory and long-term memory are still different.

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Norris, Dennis

2017-09-01

A commonly expressed view is that short-term memory (STM) is nothing more than activated long-term memory. If true, this would overturn a central tenet of cognitive psychology-the idea that there are functionally and neurobiologically distinct short- and long-term stores. Here I present an updated case for a separation between short- and long-term stores, focusing on the computational demands placed on any STM system. STM must support memory for previously unencountered information, the storage of multiple tokens of the same type, and variable binding. None of these can be achieved simply by activating long-term memory. For example, even a simple sequence of digits such as "1, 3, 1" where there are 2 tokens of the digit "1" cannot be stored in the correct order simply by activating the representations of the digits "1" and "3" in LTM. I also review recent neuroimaging data that has been presented as evidence that STM is activated LTM and show that these data are exactly what one would expect to see based on a conventional 2-store view. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Fast Weight Long Short-Term Memory

OpenAIRE

Keller, T. Anderson; Sridhar, Sharath Nittur; Wang, Xin

2018-01-01

Associative memory using fast weights is a short-term memory mechanism that substantially improves the memory capacity and time scale of recurrent neural networks (RNNs). As recent studies introduced fast weights only to regular RNNs, it is unknown whether fast weight memory is beneficial to gated RNNs. In this work, we report a significant synergy between long short-term memory (LSTM) networks and fast weight associative memories. We show that this combination, in learning associative retrie...

Hypothyroidism in Cancer Patients on Immune Checkpoint Inhibitors with anti-PD1 Agents: Insights on Underlying Mechanisms.

Science.gov (United States)

Alhusseini, M; Samantray, J

2017-04-01

Background: Immune therapy using monoclonal antibodies against cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and programmed cell death 1 receptor (PD-1) for various cancers have been reported to cause thyroid dysfunction. Little is known, however, about the underlying pathogenic mechanisms and the course of hypothyroidism that subsequently develops. In this report, we use the change in thyroglobulin and thyroid antibody levels in patients on immune therapy who develop hypothyroidism to better understand its pathogenesis as well as examine the status of hypothyroidism in the long term. Methods: We report a case series of 10 patients who developed hypothyroidism after initiation of immune therapy (either anti-PD-1 alone or in combination with anti-CTLA-4). Available thyroid antibodies including anti-thyroglobulin (anti-Tg), anti-thyroid peroxidase (anti-TPO), and thyroid stimulating immunoglobulin (TSI) were noted during the initial thyroiditis phase as well as the hypothyroid phase. Persistence or remission of hypothyroidism was noted at 6 months. Summary: During the thyroiditis phase, 50% of the patients had elevated Tg titers, 40% had elevated anti-Tg, and 40% had elevated TSI. All of these titers decreased during the hypothyroid phase. Permanent hypothyroidism was noted in 80% of the cases. Conclusion: Hypothyroidism following initiation of immune therapy has immunologic and non-immunologic mediated mechanisms and is likely to be persistent. © Georg Thieme Verlag KG Stuttgart · New York.

Recurrent thyrotoxicosis after I-131 induced hypothyroidism

International Nuclear Information System (INIS)

Liu, L.; Borowski, G.D.; Shtasel, P.; Rose, L.I.

1984-01-01

The first clinically and biochemically documented case of recurrent thyrotoxicosis after I-131 induced hypothyroidism in a patient with Graves' disease is reported. Two months after the administration of 9.2 mCi of I-131, the subject developed hypothyroidism. One month later, the patient became euthyroid. Then, nine months following ablation, the patient again developed thyrotoxicosis. A second dose of I-131 of 12.5 mCi was required to finally produce permanent hypothyroidism. This case illustrates the recurrence of hypothyroidism after what had seemed to have been adequate I-131 radiation

Adult onset-hypothyroidism increases response latency and long-term potentiation (LTP) in rat hippocampus

Science.gov (United States)

Thyroid hormones (TH) influence central nervous system (CNS) function during both development and in adulthood. The hippocampus is critical for some types of learning and memory and is particularly sensitive to thyroid hormone deficiency. Hypothyroidism in adulthood has been ass...

Excess mortality in patients diagnosed with hypothyroidism

DEFF Research Database (Denmark)

Thvilum, Marianne; Brandt, Frans; Pedersen, Dorthe Almind

2013-01-01

Background: Although hypothyroidism is associated with increased morbidity, an association with increased mortality is still debated. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism influences mortality. Methods: In an observational cohort study from...... January 1, 1978 until December 31, 2008 using record-linkage data from nationwide Danish health registers, 3587 singletons and 682 twins diagnosed with hypothyroidism were identified. Hypothyroid individuals were matched 1:4 with nonhypothyroid controls with respect to age and gender and followed over...... a mean period of 5.6 years (range 0-30 years). The hazard ratio (HR) for mortality was calculated using Cox regression analyses. Comorbidity was evaluated using the Charlson score (CS). Results: In singletons with hypothyroidism, the mortality risk was increased (HR 1.52; 95% confidence interval [CI]: 1...

Short-term power plant operation scheduling in thermal systems with long-term boundary conditions

International Nuclear Information System (INIS)

Wolter, H.

1990-01-01

For the first time, the modeling of long-term quantitative conditions within the short-term planning of the application of power stations is made via their shadow prices. It corresponds to a decomposition of the quantitative conditions by means of the method of the Langrange relaxation. The shadow prices determined by the planning for energy application regarding long- term quantitative conditions pass into the short-term planning for power station application and subsidize or rather punish the application of limited amounts as for as they are not claimed for sufficiently or excessively. The clear advantage of this modeling is that the short-term planning of power station application can deviate from the envisioned energy application regarding the total optimum, because the shadow prices contain all information about the cost effect of the energy shifts in the residual total period, which become necessary due to the deviations in the short-term period to be planned in the current short-term period. (orig./DG) [de

Improving creativity performance by short-term meditation

Science.gov (United States)

2014-01-01

Background One form of meditation intervention, the integrative body-mind training (IBMT) has been shown to improve attention, reduce stress and change self-reports of mood. In this paper we examine whether short-term IBMT can improve performance related to creativity and determine the role that mood may play in such improvement. Methods Forty Chinese undergraduates were randomly assigned to short-term IBMT group or a relaxation training (RT) control group. Mood and creativity performance were assessed by the Positive and Negative Affect Schedule (PANAS) and Torrance Tests of Creative Thinking (TTCT) questionnaire respectively. Results As predicted, the results indicated that short-term (30 min per day for 7 days) IBMT improved creativity performance on the divergent thinking task, and yielded better emotional regulation than RT. In addition, cross-lagged analysis indicated that both positive and negative affect may influence creativity in IBMT group (not RT group). Conclusions Our results suggested that emotion-related creativity-promoting mechanism may be attributed to short-term meditation. PMID:24645871

The Treatment of Hypothyroidism in Pregnancy

OpenAIRE

Miulescu Rucsandra Dănciulescu; Mihai Andrada Doina

2017-01-01

Hypothyroidism is a pathologic condition generated by the thyroid hormone deficiency. The American Thyroid Association advises for the screening of hypothyroidism beginning at 35 years and thereafter every 5 years in people at high risk for this condition: females older than 60 years, pregnant women, patients with other autoimmune disease or patients with a history of neck irradiation. In pregnant women, hypothyroidism can been associated with adverse effect for both mother and child. The „Gu...

Incipient and overt diabetic nephropathy in African Americans with NIDDM.

Science.gov (United States)

Dasmahapatra, A; Bale, A; Raghuwanshi, M P; Reddi, A; Byrne, W; Suarez, S; Nash, F; Varagiannis, E; Skurnick, J H

1994-04-01

OBJECTIVE--To determine the prevalence of incipient and overt nephropathy in African-American subjects with non-insulin-dependent diabetes mellitus (NIDDM) attending a hospital clinic. Contributory factors, such as blood pressure (BP), duration and age at onset of diabetes, hyperglycemia, hyperlipidemia, and body mass index (BMI) also were evaluated. RESEARCH DESIGN AND METHODS--We recruited 116 African-American subjects with NIDDM for this cross-sectional, descriptive, and analytical study. BP, BMI, 24-h urine albumin excretion, creatinine clearance, serum creatinine, lipids, and GHb levels were measured. Albumin excretion rate (AER) was calculated, and subjects were divided into three groups: no nephropathy (AER 200 micrograms/min). Frequency of hypertension and nephropathy was analyzed by chi 2 testing, group means were compared using analysis of variance, and linear correlations were performed between AER and other variables. Multiple regression analysis was used to examine the association of these variables while controlling for the effects of other variables. RESULTS--Increased AER was present in 50% of our subjects; 31% had incipient and 19% had overt nephropathy. Hypertension was present in 72.4%; nephropathy, particularly overt nephropathy, was significantly more prevalent in the hypertensive group. Mean BP and diastolic blood pressure (dBP) were higher in the groups with incipient and overt nephropathy, and systolic blood pressure (sBP) was increased in overt nephropathy. Men with either form of nephropathy had higher sBP, dBP, and mean BP, whereas only women with overt nephropathy had increased sBP and mean BP. Subjects with incipient or overt nephropathy had a longer duration of diabetes, and those with overt nephropathy had a younger age at onset of diabetes. By multiple regression analysis, AER correlated with younger age at diabetes onset, but not with diabetes duration. No correlation with age, lipid levels, or GHb was noted. BMI correlated with AER

The Structure and Content of Long-Term and Short-Term Mate Preferences

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Peter K. Jonason

2013-12-01

Full Text Available This study addresses two limitations in the mate preferences literature. First, research all-too-often relies on single-item assessments of mate preferences precluding more advanced statistical techniques like factor analysis. Second, when factor analysis could be done, it exclusively has done for long-term mate preferences, at the exclusion of short-term mate preferences. In this study (N = 401, we subjected 20 items designed to measure short- and long-term mate preferences to both principle components (n = 200 and confirmatory factor analysis (n = 201. In the long-term context, we replicated previous findings that there are three different categories of preferences: physical attractiveness, interpersonal warmth, and social status. In the short-term context, physical attractiveness occupied two parts of the structure, social status dropped out, and interpersonal warmth remained. Across short- and long-term contexts, there were slight changes in what defined the shared dimensions (i.e., physical attractiveness and interpersonal warmth, suggesting prior work that applies the same inventory to each context might be flawed. We also replicated sex differences and similarities in mate preferences and correlates with sociosexuality and mate value. We adopt an evolutionary paradigm to understand our results.

Short-term energy outlook, annual supplement 1994

International Nuclear Information System (INIS)

1994-08-01

The Short-Term Energy Outlook Annual Supplement (Supplement) is published once a year as a complement to the Short-Term Energy Outlook (Outlook), Quarterly Projections. The purpose of the Supplement is to review the accuracy of the forecasts published in the Outlook, make comparisons with other independent energy forecasts, and examine current energy topics that affect the forecasts

Short-term energy outlook annual supplement, 1993

Energy Technology Data Exchange (ETDEWEB)

NONE

1993-08-06

The Short-Term Energy Outlook Annual Supplement (supplement) is published once a year as a complement to the Short-Term Energy Outlook (Outlook), Quarterly Projections. The purpose of the Supplement is to review the accuracy of the forecasts published in the Outlook, make comparisons with other independent energy forecasts, and examine current energy topics that affect the forecasts.

Cerebral blood flow in hypothyroidism: Response to therapy and associated cognitive performance

International Nuclear Information System (INIS)

Ilgin, N.; Akdemir, U.O.; Yetkin, I.; Eroglu, A.

2002-01-01

Hypothyroidism is often associated with defective memory, psychomotor slowing and depression. However, the relationship between thyroid status, related cognitive state and associated cerebral circulatory and/or metabolic abnormalities have not been elucidated. Purpose: The aim of this study was to evaluate pre-and post-therapy brain perfusion patterns in 9 hypothyroid patients presenting with Hashimoto thyroiditis. Method: Patients were referred on the basis of abnormal levels of anti-thyroglobulin and anti-microsomal antibodies, hypothyroidism and symptoms of cognitive dysfunction. Cognitive performance was tested using Raven's Coloured Progressive Matrices and Bender Gestalt Test. Functional evaluation of the brain was also performed via the methods of electroencephalography (EEG) and single photon emission tomography (SPECT). An initial SPECT study was carried out after I.V. injection of Tc99m-HMPAO and semiquantitative rCBF analysis was performed by drawing irregular regions of interest (ROIs) in three slices. A total number of 12 sector regions of interest placed on the two hemispheres and regional cerebral blood flow (rCBF) was determined using cortical region/cerebellum ratios obtained in each hemisphere. A repeat SPECT study was undertaken in 5 subjects 3-6 months after the initiation of medical therapy. Results: Pre-therapy perfusion data in four patients showed that the cortical ratios were globally depressed at the levels of 0.65-0.85 where these ratios improved quickly to the near normal-above normal levels (range of rCBF improvement as % difference from baseline 25%-45%) within 3-4 months of therapy. Conclusion: These results indicate that brain activity was globally decreased in severe hypothyroidism of short duration which normalized steadily as the hypothyroid state is corrected

Congenital hypothyroidism due to ectopic sublingual thyroid gland in Prader-Willi Syndrome: a case report.

Science.gov (United States)

Bocchini, Sarah; Fintini, Danilo; Grugni, Graziano; Boiani, Arianna; Convertino, Alessio; Crinò, Antonino

2017-09-22

Thyroid gland disorders are variably associated with Prader-Willi syndrome (PWS). Many of the clinical features in newborns with PWS are similar to those found in congenital hypothyroidism (CH). We report a case of a girl with CH and PWS. At the age of 9 months CH caused by an ectopic sublingual thyroid was diagnosed, and hormone replacement therapy was started. In spite of this treatment a decrease in growth velocity, weight excess and delayed development were observed. At the age of 9 years PWS was suspected on the basis of phenotype and genetic tests confirmed a maternal uniparental disomy of chromosome 15. This is the second reported case of hypothyroidism due to an ectopic sublingual thyroid gland in PWS suggesting that, although rare, an association between CH and PWS may exist. In our case diagnosis of PWS was delayed because mental retardation, hypotonia, obesity and short stature were initially attributed to hypothyroidism. In this context PWS should be considered in obese children with CH who do not improve adequately with l-thyroxine therapy. Also, thyroid function in all PWS children should be assessed regularly in order to avoid delayed diagnosis of hypothyroidism.

Spontaneous Bacterial Peritonitis in Subclinical Hypothyroidism

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Dalip Gupta

2013-11-01

Full Text Available Hypothyroidism is an uncommon cause of ascites. Here we describe a case of a 75 year-old female patient with spontaneous bacterial peritonitis and subclinical hypothyroidism that resolved with thyroid replacement and antibiotic therapy respectively. Ascitic fluid analysis revealed a gram-positive bacterium on gram staining. A review of the literature revealed just one other reported case of myxoedema ascites with concomitant spontaneous bacterial peritonitis and no case has till been reported of spontaneous bacterial peritonitis in subclinical hypothyroidism.

In Search of Decay in Verbal Short-Term Memory

Science.gov (United States)

Berman, Marc G.; Jonides, John; Lewis, Richard L.

2009-01-01

Is forgetting in the short term due to decay with the mere passage of time, interference from other memoranda, or both? Past research on short-term memory has revealed some evidence for decay and a plethora of evidence showing that short-term memory is worsened by interference. However, none of these studies has directly contrasted decay and…

Attention Problems, Phonological Short-Term Memory, and Visuospatial Short-Term Memory: Differential Effects on Near- and Long-Term Scholastic Achievement

Science.gov (United States)

Sarver, Dustin E.; Rapport, Mark D.; Kofler, Michael J.; Scanlan, Sean W.; Raiker, Joseph S.; Altro, Thomas A.; Bolden, Jennifer

2012-01-01

The current study examined individual differences in children's phonological and visuospatial short-term memory as potential mediators of the relationship among attention problems and near- and long-term scholastic achievement. Nested structural equation models revealed that teacher-reported attention problems were associated negatively with…

Antithyroid drug-induced fetal goitrous hypothyroidism

DEFF Research Database (Denmark)

Bliddal, Sofie; Rasmussen, Ase Krogh; Sundberg, Karin

2011-01-01

Maternal overtreatment with antithyroid drugs can induce fetal goitrous hypothyroidism. This condition can have a critical effect on pregnancy outcome, as well as on fetal growth and neurological development. The purpose of this Review is to clarify if and how fetal goitrous hypothyroidism can...... be prevented, and how to react when prevention has failed. Understanding the importance of pregnancy-related changes in maternal thyroid status when treating a pregnant woman is crucial to preventing fetal goitrous hypothyroidism. Maternal levels of free T(4) are the most consistent indication of maternal...... and fetal thyroid status. In patients with fetal goitrous hypothyroidism, intra-amniotic levothyroxine injections improve fetal outcome. The best way to avoid maternal overtreatment with antithyroid drugs is to monitor closely the maternal thyroid status, especially estimates of free T(4) levels....

Congenital hypothyroidism: insights into pathogenesis and treatment

OpenAIRE

Cherella, Christine E.; Wassner, Ari J.

2017-01-01

Congenital hypothyroidism occurs in approximately 1 in 2000 newborns and can have devastating neurodevelopmental consequences if not detected and treated promptly. While newborn screening has virtually eradicated intellectual disability due to severe congenital hypothyroidism in the developed world, more stringent screening strategies have resulted in increased detection of mild congenital hypothyroidism. Recent studies provide conflicting evidence about the potential neurodevelopmental risks...

Lipid profile in hypothyroidism

International Nuclear Information System (INIS)

Ramalho, A.; Medeiros, F.; Campos, C.; Medeiros, N.; Kuklinsky-Sobral, J.; Araujo, E.

1995-01-01

The elevated levels of cholesterol (T-C), more specifically, the increase of carried cholesterol by low density protein (LDL-C), is the principal responsible to atheroma's plaque. This elevated levels had been associated with chronic renal disease, bile pathway obstruction and hypothyroidism; this pathology is an important and frequent cause of reversible hyperlipidaemia by hormonal treatment. In 50 hypothyroidism cases diagnosed by radioimmunoassay method, principally primary form, have been met elevated levels of TC (68%), triglyceride (14%), LDL-C (78%), HDL-C (66%) and coronary heart disease (CHD) risk, LDL-C/HDL-C (82%). These percentages showed that the low concentration of thyroid hormones conduct to high concentration of LDL-C, which represents the risk factor to CHD, despite the increase of HDL-C. Thereby, the hypothyroidism must be always searched in hyperlipemic patients without apparent cause. (author). 17 refs., 3 tabs

Short-Term Reciprocity in Late Parent-Child Relationships

Science.gov (United States)

Leopold, Thomas; Raab, Marcel

2011-01-01

Long-term concepts of parent-child reciprocity assume that the amount of support given and received is only balanced in a generalized fashion over the life course. We argue that reciprocity in parent-child relationships also operates in the short term. Our analysis of short-term reciprocity focuses on concurrent exchange in its main upward and…

Implementing a short-term loyalty program : case: Bosch Lawn & Garden and the Ventum short-term loyalty program

OpenAIRE

Logvinova, Veronika

2015-01-01

In 2015, one of the Bosch Home and Garden divisions, Bosch Lawn and Garden, has made a strategic decision to adopt a points-based short-term loyalty program called Ventum LG in the German supermarkets and petrol stations. It was decided that the base of this program will be completed Ventum PT short-term loyalty program which was managed by another division, Bosch Power Tools, and proved to be successful. This thesis aims to evaluate the worthiness of the Ventum LG loyalty program for Bosch L...

Treatment for primary hypothyroidism: current approaches and future possibilities

Science.gov (United States)

Chakera, Ali J; Pearce, Simon HS; Vaidya, Bijay

2012-01-01

Primary hypothyroidism is the most common endocrine disease. Although the diagnosis and treatment of hypothyroidism is often considered simple, there are large numbers of people with this condition who are suboptimally treated. Even in those people with hypothyroidism who are biochemically euthyroid on levothyroxine replacement there is a significant proportion who report poorer quality of life. This review explores the historical and current treatment options for hypothyroidism, reasons for and potential solutions to suboptimal treatment, and future possibilities in the treatment of hypothyroidism. PMID:22291465

Decay uncovered in nonverbal short-term memory.

Science.gov (United States)

Mercer, Tom; McKeown, Denis

2014-02-01

Decay theory posits that memory traces gradually fade away over the passage of time unless they are actively rehearsed. Much recent work exploring verbal short-term memory has challenged this theory, but there does appear to be evidence for trace decay in nonverbal auditory short-term memory. Numerous discrimination studies have reported a performance decline as the interval separating two tones is increased, consistent with a decay process. However, most of this tone comparison research can be explained in other ways, without reference to decay, and these alternative accounts were tested in the present study. In Experiment 1, signals were employed toward the end of extended retention intervals to ensure that listeners were alert to the presence and frequency content of the memoranda. In Experiment 2, a mask stimulus was employed in an attempt to distinguish between a highly detailed sensory trace and a longer-lasting short-term memory, and the distinctiveness of the stimuli was varied. Despite these precautions, slow-acting trace decay was observed. It therefore appears that the mere passage of time can lead to forgetting in some forms of short-term memory.

Short-term energy outlook annual supplement, 1993

International Nuclear Information System (INIS)

1993-01-01

The Energy Information Administration (EIA) prepares quarterly, short-term energy supply, demand, and price projections for publication in February, May, August, and November in the Short-Term Energy Outlook (Outlook). An annual supplement analyzes the performance of previous forecasts, compares recent cases with those of other forecasting services, and discusses current topics related to the short-term energy markets. (See Short-Term Energy Outlook Annual Supplement, DOE/EIA-0202.) The forecast period for this issue of the Outlook extends from the third quarter of 1993 through the fourth quarter of 1994. Values for the second quarter of 1993, however, are preliminary EIA estimates (for example, some monthly values for petroleum supply and disposition are derived in part from weekly data reported in the Weekly Petroleum Status Report) or are calculated from model simulations using the latest exogenous information available (for example, electricity sales and generation are simulated using actual weather data). The historical energy data are EIA data published in the Monthly Energy Review, Petroleum Supply Monthly, and other EIA publications. Minor discrepancies between the data in these publications and the historical data in this Outlook are due to independent rounding

PROPYLTHIOURACIL (PTU)-INDUCED HYPOTHYROIDISM: EFFECTS ON SYNAPTIC TRANSMISSION AND LONG TERM POTENTIATION IN HIPPOCAMPAL SLICES.

Science.gov (United States)

Concern has been raised over endocrine effects of some classes of environmental chemicals. Severe hypothyroidism during critical periods of brain developmental leads to alterations in hippocampal structure, learning deficits, yet neurophysiological properties of the hippocampus...

The issue of neuropsychiatric disorders in patients with hypothyroidism

Directory of Open Access Journals (Sweden)

Kutashov V.A.

2016-09-01

Full Text Available The aim of the study was assessment of thyroid function in patients with psychiatric and psychological assistance; to study the structure of AR in patients with hypothyroidism, to reveal alexithymical identifying of personality characteristics of patients with hypothyroidism and AP Materials and Methods. 406 patients with AR at the age of 51.3±4.7 years. To verify the useofTSH hypothyroidism rate and to assess depressive disorder — Hamilton Scale and the Montgomery— Asberg; with clinical and psychopathological study: 1 the scale of self-BH alarm Spielberger (Y. L. Hanin, 2 questionnaire G. Shmisheka 3 Toronto alexithymia scale. Results. Hypothyroidism is set at 116 (28.6% of 406 patients suffering from RA. Among the 374 patients with depressive disorders hypothyroidism was observed in 116: subclinical — in 76 patients (65.5%, symptomatic — in 40 (34.5%. The first group consisted of 258 patients with the presence of depressive disorders and without hypothyroidism; second — 116 patients with the presence of depression and hypothyroidism. TSH in patients suffering AR, without thyroid dysfunction was 5.2 times lower than in patients with the presence of hypothyroidism. Among AP comorbid with hypothyroidism, are predominant depressive with a predominance of mild and moderate forms. Dominating are anxious-depressive, dysphoric, adynamic, sad, depressive disorders. Conclusion. In patients with AR and hypothyroidism predominant types of personality accentuation are dysthymic, anxious, demonstrative and meticulous.

Hemostasis in Overt and Subclinical Hyperthyroidism

Science.gov (United States)

Ordookhani, Arash; Burman, Kenneth D.

2017-01-01

Context There are contradictory results on the effect of hyperthyroidism on hemostasis. Inadequate population-based studies limited their clinical implications, mainly on the risk of venous thromboembolism (VTE). The present review focuses on hemostatic changes in overt and subclinical hyperthyroidism. Methods A systematic literature search was conducted employing MEDLINE database. The following words were used for the search: Hyperthyroidism; thyrotoxicosis; Graves disease; goiter, nodular; hemostasis; blood coagulation factors; blood coagulation disorders; venous thromboembolism; bleeding; fibrinolysis. The articles that were related to hyperthyroidism and hemostasis are used in this manuscript. Results Hyperthyroidism, either overt or subclinical, renders a hypercoagulable state, although there are several studies with contradictory findings in the literature. Hypercoagulability may be caused by an increase in the level of various coagulation factors such as factor (F) VIII, FX, FIX, von Willebrand F (vWF), and fibrinogen, while hypofibrinolysis by changes in coagulation parameters such as a decrease in plasmin and plasmin activator or an increase in α2-antiplasmin, plasminogen activator inhibitor-1 and thrombin activatable fibrinolysis inhibitor Conclusions Although many reports are in favor of a hypercoagulable state in overt hyperthyroidism but this finding at the biochemical level and its clinical implication, on the occurrence of VTE, has yet to be confirmed. PMID:29201071

Electrophysiological dynamics of covert and overt visual attention

DEFF Research Database (Denmark)

Ordikhani-Seyedlar, Mehdi

Attention is a key neural function for choosing certain information to receive more processing than others. Attention is allocated either by directly looking at the target (overt) or without eye movement towards the target (covert). The current study was designed to extract relevant features...... by using steady-state visual evoked potentials (SSVEP) task. SSVEP task was presented to subjects at the same time that the electroencephalography (EEG) signals were recorded by the scalp electrodes. Subjects were instructed to respond to a certain stimulus by pressing a button. This way attention...... was measure in continuous manner. Results showed that the amplitude of SSVEP frequencies is higher in overt than covert attention. This indicates that by overt attention events are registered with larger power. However, exploring the harmonics of frequencies showed that covert attention generates larger 2nd...

Parent-Offspring Conflict over Short-Term Mating Strategies

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Spyroulla Georgiou

2011-12-01

Full Text Available Individuals engage in short-term mating strategies that enable them to obtain fitness benefits from casual relationships. These benefits, however, count for less and cost more to their parents. On this basis three hypotheses are tested. First, parents and offspring are likely to disagree over short-term mating strategies, with the former considering these as less acceptable than the latter. Second, parents are more likely to disapprove of the short-term mating strategies of their daughters than of their sons. Finally, mothers and fathers are expected to agree on how much they disagree over the short-term mating strategies of their children. Evidence from a sample of 148 Greek-Cypriot families (140 mothers, 105 fathers, 119 daughters, 77 sons provides support for the first two hypotheses and partial support for the third hypothesis. The implications of these findings for understanding family dynamics are further discussed.

Hypothyroidism-induced myocardial damage and heart failure: an overlooked entity.

Science.gov (United States)

Shuvy, Mony; Shifman, Oshrat E Tayer; Nusair, Samir; Pappo, Orit; Lotan, Chaim

2009-01-01

Hypothyroid state may induce cardiac muscle impairment such as diastolic dysfunction and abnormal relaxation time. Advanced heart failure in hypothyroid patients has been described only in severe symptomatic cases, mostly during myxedematous coma. We describe an unusual case of asymptomatic patient with hypothyroidism who presented with severely reduced cardiac function with elevated cardiac enzymes reflecting significant myocardial injury. Comprehensive evaluation for heart failure was suggestive only for long-standing untreated hypothyroidism. Endomyocadial biopsy demonstrated unique histological findings of mucopolysaccharide accumulation attributed to hypothyroid state. Asymptomatic hypothyroidism may cause severe reduction in cardiac function accompanied with elevated cardiac enzymes. To our knowledge, this is the first description of human myocardial biopsy revealing mucopolysaccharide accumulation attributed to hypothyroid state.

Extension of radiotherapy (involved field vs subtotal nodal) after short-term chemotherapy in early-stage Hodgkin's disease (ESHD)

International Nuclear Information System (INIS)

Zanini, M.; Bonfante, V.; Soncini, F.; Di Russo, A.; Santoro, A.; Viviani, S.; Devizzi, L.; Gasparini, M.; Tesoro, Tess J.D.; Valagussa, P.; Bonadonna, G.

1995-01-01

Aims of this study were to avoid staging laparotomy, to improve the results of radiotherapy (RT) alone by a combined modality approach, to evaluate the optimal extent of RT after short-term chemotherapy (CT) and to reduce the long-term toxicity in patients cured for ESHD. From (2(90)) to (1(95)), 110 consecutive patients with clinical stage I (bulky and/or B), IIA, IIA bulky and IIEA entered a randomized trial comparing subtotal nodal irradiation (STNI) vs involved field radiotherapy (IFRT), both after short-term chemotherapy (ABVD for 4 cycles). The doses of RT were 30 Gy to uninvolved and 36 Gy to involved sites, respectively. With a median follow-up of 38 mos., the main results in 96 evaluable patients (stage I: 13 pts., stage II: 83 pts., median age 28 yrs., range 17-64) are as reported below. Most patients achieved complete remission (CR) after CT (92%), while 8 partial responders attained CR with RT (IFRT 5 pts., STNI 3 pts.). Four stage II patients relapsed (IFRT 2, pts., STNI 2 pts.), mainly in extranodal or not irradiated sites. Up-to-date the most remarkable toxicities include: acute myocardial infarction (1%), aspecific EKG changes (5%), reductions in pulmonary function tests (most mild and/or transient) in 45%, subclinical or clinical hypothyroidism 26% (only in pts. irradiated to the neck), 3 cases of azoospermia in 23 evaluable patients (13%) and transient amenorreha in(1(44)) patients. No second malignancies have been so far observed. The results of this study seem to indicate that 4 courses of ABVD plus RT are an effective treatment in clinical ESHD, with moderate long-term toxicities. In almost 10% of patients RT changed partial into complete remission. Should these results be confirmed on a longer follow-up, IFRT will definitely replace STNI in a combined modality treatment

Overt Primary Hypothyroidism in an Industrial Area in São Paulo, Brazil: The Impact of Public Disclosure

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Maria Angela Zaccarelli-Marino

2016-11-01

Full Text Available Background: Primary hypothyroidism (PH is the most common thyroid pathology. Purpose: to evaluate the impact of public disclosure of an unexpected number of PH cases on the frequency of patients seeking medical evaluation for endocrinological diseases. Methods: data on 6306 subjects (3356 living in the surroundings of a petrochemical complex and 2950 in a control region were collected over a 15-year time span. Thyroid function was determined by serum levels of triiodothyronine, thyroxine, free thyroxine and thyrotrophin. Antithyroglobulin and antithyroperoxidase antibodies and sonographic scans of the thyroid were performed in all patients. The data were analyzed via log-linear models to compute odds and odds ratios. Results: An increasing trend in the odds of PH was detected along the observation period with greater slope in the study region than in the control region. The odds of PH in the post-disclosure period (2002 to 2004 are greater than the corresponding ones in the pre-disclosure period (1989 to 2001. Conclusions: This study shows that living in the surroundings of a petrochemical complex may be an important risk factor for PH for both adults and children. Furthermore, public disclosure of such risk factor contributes to the awareness of the problem and to the possibility of an early diagnosis.

Overt Primary Hypothyroidism in an Industrial Area in São Paulo, Brazil: The Impact of Public Disclosure.

Science.gov (United States)

Zaccarelli-Marino, Maria Angela; Saldiva André, Carmen Diva; Singer, Julio M

2016-11-22

Background : Primary hypothyroidism (PH) is the most common thyroid pathology. Purpose : to evaluate the impact of public disclosure of an unexpected number of PH cases on the frequency of patients seeking medical evaluation for endocrinological diseases. Methods : data on 6306 subjects (3356 living in the surroundings of a petrochemical complex and 2950 in a control region) were collected over a 15-year time span. Thyroid function was determined by serum levels of triiodothyronine, thyroxine, free thyroxine and thyrotrophin. Antithyroglobulin and antithyroperoxidase antibodies and sonographic scans of the thyroid were performed in all patients. The data were analyzed via log-linear models to compute odds and odds ratios. Results : An increasing trend in the odds of PH was detected along the observation period with greater slope in the study region than in the control region. The odds of PH in the post-disclosure period (2002 to 2004) are greater than the corresponding ones in the pre-disclosure period (1989 to 2001). Conclusions : This study shows that living in the surroundings of a petrochemical complex may be an important risk factor for PH for both adults and children. Furthermore, public disclosure of such risk factor contributes to the awareness of the problem and to the possibility of an early diagnosis.

CARDIOVASCULAR DISORDERS WITH HYPOTHYROIDISM AND ADIPOKINES

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S. Ye. Myasoyedova

2015-01-01

Full Text Available The article describes the mechanisms of development of cardiovascular disorders and dyslipidemia with hypothyroidism. Reference data are presented that are devoted to the study of adipokines content with hypothyroidism and their effect on echocardiographic indicators.

Transient hypothyroidism after 131I treatment of Graves disease

International Nuclear Information System (INIS)

Liu Jianfeng; Fang Yi; Zhang Xiuli; Ye Genyao; Xing Jialiu; Zhang Youren

2003-01-01

Objective: To evaluate the results of the transient hypothyroidism after 131 I treatment of Graves disease. Methods: A total of 32 transient hypothyroidism patients treated with 131 I for Graves disease were studied and followed up. Results: Transient hypothyroidism occurred within 2-6 months after 131 I treatment and 19 patients were symptomatic. At diagnosis of transient hypothyroidism, T 3 and T 4 levels were decreased had normal, TSH levels were increased, normal or low. Follow-up examination found that 20 patients were normal and 12 patients had relapse of hyperthyroidism. Conclusions: Therapy of Graves disease with low doses of 131 I causes a high incidence of transient hypothyroidism. After recovery of transient hypothyroidism, some patients have relapse of hyperthyroidism

Dosimetric predictors of hypothyroidism in oropharyngeal cancer patients treated with intensity-modulated radiation therapy

International Nuclear Information System (INIS)

Chyan, Arthur; Chen, Josephine; Shugard, Erin; Lambert, Louise; Quivey, Jeanne M; Yom, Sue S

2014-01-01

Radiation to the neck has long been associated with an elevated risk of hypothyroidism development. The goal of the present work is to define dosimetric predictors of hypothyroidism in oropharyngeal cancer (OPC) patients treated with intensity-modulated radiation therapy. Data for 123 patients, with a median follow up of 4.6 years, were retrospectively analyzed. Patients with elevated thyroid-stimulating hormone levels or with a clinical diagnosis were categorized as hypothyroid. Patient demographic parameters, thyroid volume, mean thyroid dose, the percent of thyroid volume receiving minimum specified dose levels (VxxGy), and the absolute thyroid volume spared from specified dose levels (VSxxGy) were analyzed. Normal-tissue complication probability (NTCP) was also calculated using several recently published models. Thyroid volume and many radiation dosimetric parameters were statistically different in the hypothyroid group. For the patients with initial thyroid volumes of 8 cc or greater, several dosimetric parameters were found to define subgroups at statistically significant lower risk of developing hypothyroidism. Patients with VS45 Gy of at least 3 cc, VS50 Gy at least 5 cc, VS50 Gy at least 6 cc, V50 Gy below 45%, V50 Gy below 55%, or mean thyroid dose below 49 Gy had a 28-38% estimated risk of hypothyroidism at 3 years compared to a 55% risk for the entire study group. Patients with a NTCP of less than 0.75 or 0.8, calculated using recently published models, were also observed to have a lower risk of developing hypothyroidism. Based on long-term follow up data for OPC patients treated with IMRT, we recommend plan optimization objectives to reduce the volume of thyroid receiving over 45 Gy to significantly decrease the risk of developing hypothyroidism. The online version of this article (doi:10.1186/s13014-014-0269-4) contains supplementary material, which is available to authorized users

MANAGEMENT OF ENDOCRINE DISEASE: Hypothyroidism-associated hyponatremia: mechanisms, implications and treatment.

Science.gov (United States)

Liamis, G; Filippatos, T D; Liontos, A; Elisaf, M S

2017-01-01

Patients with moderate to severe hypothyroidism and mainly patients with myxedema may exhibit reduced sodium levels (treatment in patients with hypothyroidism. Hypothyroidism is one of the causes of hyponatremia, thus thyroid-stimulating hormone determination is mandatory during the evaluation of patients with reduced serum sodium levels. The main mechanism for the development of hyponatremia in patients with chronic hypothyroidism is the decreased capacity of free water excretion due to elevated antidiuretic hormone levels, which are mainly attributed to the hypothyroidism-induced decrease in cardiac output. However, recent data suggest that the hypothyroidism-induced hyponatremia is rather rare and probably occurs only in severe hypothyroidism and myxedema. Other possible causes and superimposed factors of hyponatremia (e.g. drugs, infections, adrenal insufficiency) should be considered in patients with mild/moderate hypothyroidism. Treatment of hypothyroidism and fluid restriction are usually adequate for the management of mild hyponatremia in patients with hypothyroidism. Patients with possible hyponatremic encephalopathy should be urgently treated according to current guidelines. Severe hypothyroidism may be the cause of hyponatremia. All hypothyroid patients with low serum sodium levels should be evaluated for other causes and superimposed factors of hyponatremia and treated accordingly. © 2017 European Society of Endocrinology.

Comparison of Thyroid Hormones Consumption in Russia and European Countries

OpenAIRE

V V Fadeyev; T B Morgunova

2009-01-01

Hypothyroidism is one of the most common endocrine diseases. The prevalence of hypothyroidism in adults is estimated to be 1–2% for overt hypothyroidism and 7–10% for subclinical hypothyroidism, especially in elder women. Considering high prevalence of hypothyroidism and negative consequences of nontreated hypothyroidism for health, we conducted the work which aim was the assessment of consumption of thyroid hormones in Russia in comparison with the countries of Europe. The aim of this analys...

Hypothyroidism among SLE patients: Case-control study.

Science.gov (United States)

Watad, Abdulla; Mahroum, Naim; Whitby, Aaron; Gertel, Smadar; Comaneshter, Doron; Cohen, Arnon D; Amital, Howard

2016-05-01

The prevalence of hypothyroidism in SLE patients varies considerably and early reports were mainly based on small cohorts. To investigate the association between SLE and hypothyroidism. Patients with SLE were compared with age and sex-matched controls regarding the proportion of hypothyroidism in a case-control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services. The study included 5018 patients with SLE and 25,090 age and sex-matched controls. The proportion of hypothyroidism in patients with SLE was increased compared with the prevalence in controls (15.58% and 5.75%, respectively, Phypothyroidism (odds ratio 2.644, 95% confidence interval 2.405-2.908). Patients with SLE have a greater proportion of hypothyroidism than matched controls. Therefore, physicians treating patients with SLE should be aware of the possibility of thyroid dysfunction. Copyright © 2016 Elsevier B.V. All rights reserved.

Neonatal hypothyroidism

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... the first month or so usually have normal intelligence. Untreated mild hypothyroidism can lead to severe intellectual ... 2018, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM ...

Circadian modulation of short-term memory in Drosophila.

Science.gov (United States)

Lyons, Lisa C; Roman, Gregg

2009-01-01

Endogenous biological clocks are widespread regulators of behavior and physiology, allowing for a more efficient allocation of efforts and resources over the course of a day. The extent that different processes are regulated by circadian oscillators, however, is not fully understood. We investigated the role of the circadian clock on short-term associative memory formation using a negatively reinforced olfactory-learning paradigm in Drosophila melanogaster. We found that memory formation was regulated in a circadian manner. The peak performance in short-term memory (STM) occurred during the early subjective night with a twofold performance amplitude after a single pairing of conditioned and unconditioned stimuli. This rhythm in memory is eliminated in both timeless and period mutants and is absent during constant light conditions. Circadian gating of sensory perception does not appear to underlie the rhythm in short-term memory as evidenced by the nonrhythmic shock avoidance and olfactory avoidance behaviors. Moreover, central brain oscillators appear to be responsible for the modulation as cryptochrome mutants, in which the antennal circadian oscillators are nonfunctional, demonstrate robust circadian rhythms in short-term memory. Together these data suggest that central, rather than peripheral, circadian oscillators modulate the formation of short-term associative memory and not the perception of the stimuli.

The Role of Short-term Consolidation in Memory Persistence

OpenAIRE

Timothy J. Ricker

2015-01-01

Short-term memory, often described as working memory, is one of the most fundamental information processing systems of the human brain. Short-term memory function is necessary for language, spatial navigation, problem solving, and many other daily activities. Given its importance to cognitive function, understanding the architecture of short-term memory is of crucial importance to understanding human behavior. Recent work from several laboratories investigating the entry of information into s...

The interaction of short-term and long-term memory in phonetic category formation

Science.gov (United States)

Harnsberger, James D.

2002-05-01

This study examined the role that short-term memory capacity plays in the relationship between novel stimuli (e.g., non-native speech sounds, native nonsense words) and phonetic categories in long-term memory. Thirty native speakers of American English were administered five tests: categorial AXB discrimination using nasal consonants from Malayalam; categorial identification, also using Malayalam nasals, which measured the influence of phonetic categories in long-term memory; digit span; nonword span, a short-term memory measure mediated by phonetic categories in long-term memory; and paired-associate word learning (word-word and word-nonword pairs). The results showed that almost all measures were significantly correlated with one another. The strongest predictor for the discrimination and word-nonword learning results was nonword (r=+0.62) and digit span (r=+0.51), respectively. When the identification test results were partialed out, only nonword span significantly correlated with discrimination. The results show a strong influence of short-term memory capacity on the encoding of phonetic detail within phonetic categories and suggest that long-term memory representations regulate the capacity of short-term memory to preserve information for subsequent encoding. The results of this study will also be discussed with regards to resolving the tension between episodic and abstract models of phonetic category structure.

Semantic and phonological contributions to short-term repetition and long-term cued sentence recall.

Science.gov (United States)

Meltzer, Jed A; Rose, Nathan S; Deschamps, Tiffany; Leigh, Rosie C; Panamsky, Lilia; Silberberg, Alexandra; Madani, Noushin; Links, Kira A

2016-02-01

The function of verbal short-term memory is supported not only by the phonological loop, but also by semantic resources that may operate on both short and long time scales. Elucidation of the neural underpinnings of these mechanisms requires effective behavioral manipulations that can selectively engage them. We developed a novel cued sentence recall paradigm to assess the effects of two factors on sentence recall accuracy at short-term and long-term stages. Participants initially repeated auditory sentences immediately following a 14-s retention period. After this task was complete, long-term memory for each sentence was probed by a two-word recall cue. The sentences were either concrete (high imageability) or abstract (low imageability), and the initial 14-s retention period was filled with either an undemanding finger-tapping task or a more engaging articulatory suppression task (Exp. 1, counting backward by threes; Exp. 2, repeating a four-syllable nonword). Recall was always better for the concrete sentences. Articulatory suppression reduced accuracy in short-term recall, especially for abstract sentences, but the sentences initially recalled following articulatory suppression were retained better at the subsequent cued-recall test, suggesting that the engagement of semantic mechanisms for short-term retention promoted encoding of the sentence meaning into long-term memory. These results provide a basis for using sentence imageability and subsequent memory performance as probes of semantic engagement in short-term memory for sentences.

[Hypothyroidism in adults in a basic health area].

Science.gov (United States)

López-Macías, I; Hidalgo-Requena, A; Pérez-Membrive, E; González-Rodríguez, M E; Bellido-Moyano, C; Pérula-de Torres, L A

2018-04-01

The objective of the present study is to study the prevalence, as well as the clinical and epidemiological characteristics of hypothyroid disease in adults using the computerised clinical records. Observational, descriptive and cross-sectional study. The target population was the patients of the health centres of Lucena I and II (Córdoba). Patients 14 years or older, diagnosed with hypothyroidism, born and resident in Lucena. Two hundred and fourteen patients were recruited by random sampling, who then underwent a clinical interview using a questionnaire. The mean age of the patients was 49.71 years (SD 17.03; 95% CI 47.34-51.98), with 85.5% women. A diagnosis of sub-clinical hypothyroidism was found in 74.8%, compared to 18.7% of primary hypothyroidism, and 6.5% of secondary hypothyroidism. The 53.7% (95% CI 46.81-60.59) of patients diagnosed with hypothyroidism did not have thyroid antibodies results. However, 75.2% (95% CI 68.89-80.86) were being treated with levothyroxine. The prevalence of hypothyroidism was 5.7% (95% CI 5.46-5.96). Sub-clinical hypothyroidism is very common in Primary Care clinics. Many patients are not correctly diagnosed and many are over-medicated, suggesting a need to review the diagnosis. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Short-term and long-term sick-leave in Sweden

DEFF Research Database (Denmark)

Blank, N; Diderichsen, Finn

1995-01-01

The primary aim of the study was to analyse similarities and differences between repeated spells of short-term sick-leave (more than 3 spells of less than 7 days' duration in a 12-month period) and long-term absence through sickness (at least 1 spell of more than 59 days' duration in a 12-month p...

Hypothyroidism: The Thyroid and You | NIH Medlineplus the Magazine

Science.gov (United States)

... of this page please turn Javascript on. Feature: Hypothyroidism The Thyroid and You: Coping with a Common ... is made by the pituitary gland. What is hypothyroidism? Hypothyroidism is a condition in which the thyroid ...

Panhypopituitarism with empty sella a sequel of pituitary hyperplasia due to chronic primary hypothyroidism.

Science.gov (United States)

Dutta, Deep; Maisnam, Indira; Ghosh, Sujoy; Mukhopadhyay, Pradip; Mukhopadhyay, Satinath; Chowdhury, Subhankar

2012-12-01

Asymptomatic reversible pituitary hyperplasia is common in patients with untreated primary hypothyroidism. Occurrence of empty sella (ES) in this scenario is extremely rare (only three reports till the date) and panhypopituitarism has not been reported in such patients. We report a 27 year man with severe short stature (height-133 cm; standard deviation score-7.36) and delayed puberty who had symptoms suggestive of hypothyroidism along with chronic persistent headache since 6 years of age. Pituitary imaging done for headache at 11 years age showed pituitary hyperplasia. He was diagnosed of primary hypothyroidism for the 1(st) time at 21 year age, a diagnosis which was likely missed for 15 years. Levothyroxine therapy leads to resolution of all symptoms and a height gain of 28 cm over last 6 years. Evaluation for lack of progression of puberty along with chronic nausea, vomiting, fatigue and weight loss for the last 1 year revealed secondary hypocortisolism (9 am cortisol-4.8 mcg/dl; ACTH-3.2 pg/ml), growth hormone deficiency (IGF-1: 65 ng/ml; normal: 117-325 ng/ml) and hypogonadotrophic hypogonadism (9 am testosterone: 98 ng/dl; [280-1500] LH-0.01 mIU/L [1.14-5.75]) with ES on magnetic resonance imaging (MRI) brain. Uncontrolled thyrotroph hyperplasia due to chronic untreated primary hypothyroidism for 15 years may have been damaging the adjacent corticotrophs, somatotrophs and gonadotrophs resulting in panhypopituitarism and empty sella. This is perhaps the first report of panhypopituitarism with empty sella syndrome developing in a patient with pituitary hyperplasia, a sequel of chronic untreated primary hypothyroidism.

Diphenyl ditelluride impairs short-term memory and alters neurochemical parameters in young rats.

Science.gov (United States)

Stangherlin, Eluza Curte; Rocha, João Batista Teixeira; Nogueira, Cristina Wayne

2009-01-01

The aim of this study was to investigate if maternal exposure to 0.03 mg/kg of diphenyl ditelluride (PhTe)2 during the first 14 days of lactational period in Wistar rats alters recognition memory and neurochemical parameters in young rats. Object recognition memory task, evaluation of synaptosomal [3H]glutamate uptake and release as well as cerebral Na+/K+ATPase activity were evaluated in 4 week-old rats. There were no significant specific overt signs of maternal intoxication. The body weight gain of rats was similar among groups. (PhTe)2-exposed group showed a significantly lower time exploring the novel object when compared to the performance of the control group in short-term memory (STM) test. In addition, (PhTe)2 significantly inhibited synaptosomal [3H]glutamate uptake and cerebral Na+/K+ATPase activity in animals. The synaptosomal [3H]glutamate release was similar between (PhTe)2 and control groups. In conclusion, the present study establishes that young rats presented cognitive impairment after exposure to (PhTe)2 via maternal milk, demonstrated by the performance of animals in object recognition memory task. The possible mechanism involved in (PhTe)2 action in memory of recognition might involve inhibition of cerebral Na+/K+ATPase activity and synaptosomal [3H]glutamate uptake.

The effect of L-thyroxine treatment on hypothyroid symptom scores and lipid profile in children with subclinical hypothyroidism.

Science.gov (United States)

Çatlı, Gönül; Anık, Ahmet; Ünver Tuhan, Hale; Böber, Ece; Abacı, Ayhan

2014-12-01

To evaluate i) the frequency of typical hypothyroidism symptoms in children with subclinical hypothyroidism (SH), ii) to evaluate the association of SH with lipoproteins and iii) to investigate possible improving effects of L-thyroxine (LT4) treatment on these findings. Twenty-seven children with SH who had elevated thyroid-stimulating hormone (TSH: >4.94 µIU/L) but normal free T4 levels and healthy euthyroid children of similar age and sex were enrolled in the study. Anthropometric and laboratory (lipid profile and thyroid function tests) measurements were performed at diagnosis and six months after euthyroidism was achieved. All children were also subjected to a questionnaire on hypothyroid symptoms at diagnosis. The SH patients were subjected to the questionnaire also following treatment. Pre-treatment data were compared with those of controls and post-treatment measurements. Anthropometric and laboratory parameters of the groups were not statistically different except for higher TSH levels in the SH group. Serum lipoprotein levels and dyslipidemia frequency were similar between the groups. Compared to the controls, hypothyroidism symptom score was significantly higher in the SH group. Six months after euthyroidism was achieved, a significant reduction in the hypothyroid symptom score was obtained in the SH group. Except for significantly higher serum TSH values, no significant differences regarding demographic characteristics, symptom scores and lipid parameters were present between patients with Hashimoto's thyroiditis and the remaining SH patients. The results of this study showed that in children with SH i) the hypothyroidism symptom score was significantly higher than in euthyroid children, ii) LT4 treatment improved the hypothyroidism symptom score and iii) SH does not seem to be associated with dyslipidemia.

Hypothyroidism:Symptoms,Diagnosis and Treatment | NIH Medlineplus the Magazine

Science.gov (United States)

... of this page please turn Javascript on. Feature: Hypothyroidism Hypothyroidism: Symptoms, Diagnosis & Treatment Past Issues / Spring 2012 Table ... of its symptoms are seen in other diseases, hypothyroidism usually cannot be diagnosed based on symptoms alone. ...

Hypothyroidism - new aspects of an old disease

OpenAIRE

Kostoglou-Athanassiou, I; Ntalles, K

2010-01-01

Hypothyroidism is divided in primary, caused by failure of thyroid function and secondary (central) due to the failure of adequate thyroid-stimulating hormone (TSH) secretion from the pituitary gland or thyrotrophin-releasing hormone (TRH) from the hypothalamus. Secondary hypothyroidism can be differentiated in pituitary and hypothalamic by the use of TRH test. In some cases, failure of hormone action in peripheral tissues can be recognized. Primary hypothyroidism may be clinical, where free ...

Huge bilateral ovarian cysts in adulthood as the presenting feature of Van Wyk Grumbach syndrome due to chronic uncontrolled juvenile hypothyroidism

Directory of Open Access Journals (Sweden)

K S Shivaprasad

2013-01-01

Full Text Available Juvenile primary hypothyroidism causing cystic ovaries and pseudoprecocious puberty (Van-Wyk Grumbach syndrome (VWGS is well documented in literature. There are only a few reports of primary hypothyroidism presenting as ovarian cysts in adults. Here we present a case of huge bilateral ovarian cysts in adulthood as the presenting feature of VWGS due to chronic uncontrolled juvenile hypothyroidism. Large uniloculor right ovarian cyst (119 × 81 × 90 mm and a multicystic left ovary (55 × 45 × 49 mm were detected in a 24 year lady with secondary amenorrhea, galactorrhea, and palpable abdominal mass with history of neonatal jaundice, delayed milestones, short stature, and precocious menarche at age of 7.5 years age. She had elevated levels of cancer antigen (CA-125 which normalized post levothyroxine supplementation. Elevated CA-125 may lead to misdiagnosis of ovarian carcinoma and inadvertent treatment. Bilateral ovarian cysts in adults are a rare presentation of juvenile hypothyroidism. It is necessary to screen for primary hypothyroidism in patients presenting with bilateral ovarian cysts to prevent unnecessary evaluation and treatment.

The emergence of levothyroxine as a treatment for hypothyroidism.

Science.gov (United States)

Hennessey, James V

2017-01-01

To describe the historical refinements, understanding of physiology and clinical outcomes observed with thyroid hormone replacement strategies. A Medline search was initiated using the search terms, levothyroxine, thyroid hormone history, levothyroxine mono therapy, thyroid hormone replacement, combination LT4 therapy, levothyroxine Bioequivalence. Pertinent articles of interest were identified by title and where available abstract for further review. Additional references were identified in the course of review of the literature identified. Physicians have intervened in cases of thyroid dysfunction for more than two millennia. Ingestion of animal thyroid derived preparations has been long described but only scientifically documented for the last 130 years. Refinements in hormone preparation, pharmaceutical production and regulation continue to this day. The literature provides documentation of physiologic, pathologic and clinical outcomes which have been reported and continuously updated. Recommendations for effective and safe use of these hormones for reversal of patho-physiology associated with hypothyroidism and the relief of symptoms of hypothyroidism has documented a progressive refinement in our understanding of thyroid hormone use. Studies of thyroid hormone metabolism, action and pharmacokinetics have allowed evermore focused recommendations for use in clinical practice. Levothyroxine mono-therapy has emerged as the therapy of choice of all recent major guidelines. The evolution of thyroid hormone therapies has been significant over an extended period of time. Thyroid hormone replacement is very useful in the treatment of those with hypothyroidism. All of the most recent guidelines of major endocrine societies recommend levothyroxine mono-therapy for first line use in hypothyroidism.

Short-term Consumer Benefits of Dynamic Pricing

OpenAIRE

Dupont, Benjamin; De Jonghe, Cedric; Kessels, Kris; Belmans, Ronnie

2011-01-01

Consumer benefits of dynamic pricing depend on a variety of factors. Consumer characteristics and climatic circumstances widely differ, which forces a regional comparison. This paper presents a general overview of demand response programs and focuses on the short-term benefits of dynamic pricing for an average Flemish residential consumer. It reaches a methodology to develop a cost reflective dynamic pricing program and to estimate short-term bill savings. Participating in a dynamic pricing p...

Hypothyroidism as a risk factor for statin intolerance.

Science.gov (United States)

Robison, Craig D; Bair, Tami L; Horne, Benjamin D; McCubrey, Ray O; Lappe, Donald L; Muhlestein, Joseph B; Anderson, Jeffrey L

2014-01-01

Three-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) are one of the most commonly prescribed classes of medications because of their proven cardiovascular benefits. However, statin intolerance occurs in 5% to 20% of patients. Understanding the basis for statin intolerance remains a key issue in preventive medicine. To evaluate the association of statin intolerance with hypothyroidism in a large integrated health care system, including its sex-specific relationship and subsequent statin rechallenge and prescription history. The Intermountain Healthcare electronic medical record database identified patients (n = 2686; males = 1276, females = 1410) with a documentation of intolerance ("allergy") to at least 1 statin. Age and sex similar controls (n = 8103; males = 3892, females = 4211) were identified among patients prescribed statins without documented intolerance. Patients were evaluated for a history of hypothyroidism, development of hypothyroidism, and statin prescription history up to 5 years of follow-up. A total of 30.2% patients (210 males, 16.5%; 602 females, 42.7%) with statin intolerance had a history of hypothyroidism compared with 21.5% of statin-tolerant patients (475 males, 12.2%; 1266 females, 30.1%), for an odds ratio (OR) in the total population of 1.49 (95% confidence interval [CI] 1.34-1.65; P intolerance and hypothyroidism were less likely to be on a statin than their statin-intolerant counterparts without hypothyroidism (hazard ratio 0.84; 95% CI 0.75-0.94; P = .002). Hypothyroidism is more prevalent in those with statin intolerance, both in males and, especially, in females. People with hypothyroidism are less likely to have a prescription for a statin at follow-up than those without hypothyroidism. Copyright © 2014 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Clinical, behavioural and pharmacogenomic factors influencing the response to levothyroxine therapy in patients with primary hypothyroidism-protocol for a systematic review.

Science.gov (United States)

Dew, Rosie; Okosieme, Onyebuchi; Dayan, Colin; Eligar, Vinay; Khan, Ishrat; Razvi, Salman; Pearce, Simon; Wilkes, Scott

2017-03-21

Suboptimal thyroid hormone therapy including under-replacement and over-replacement is common amongst patients with hypothyroidism. This is a significant health concern as affected patients are at risk of adverse cardiovascular or metabolic consequences. Despite a growing body of evidence on the effects of various factors on thyroid hormone replacement, a systematic appraisal of the evidence is lacking. This review aims to appraise and quantify the extent to which clinical, behavioural and pharmacogenomic factors affect levothyroxine therapy in patients with primary hypothyroidism. The databases Web of Science, Cochrane Library, EMBASE and PubMed will be searched. Patients must be adults over the age of 18 years, suffering from primary hypothyroidism including overt and subclinical hypothyroidism and receiving levothyroxine treatment. Studies in children, pregnant women and patients with secondary or tertiary hypothyroidism will not be included. We will also exclude studies focused on forms of thyroid hormone replacement therapy other than levothyroxine. The primary outcome is to quantify the effect of clinical, behavioural and pharmacogenomic factors on thyroid stimulating hormone (TSH) levels. Secondary outcomes are the effect these factors have on thyroxine (T4) and triiodothyronine (T3) levels, mortality, morbidity, quality of life, treatment complications, adverse effects, physical and social functioning. Studies will be screened through reading the title, abstract and then full text. Two reviewers will independently extract the data and select articles, and a third reviewer will be consulted if there is any disagreement. We will undertake a meta-analysis of studies in which there is a defined intervention or exposure, patients are receiving levothyroxine for hypothyroidism, there is an appropriate control group of levothyroxine treated patients that are not exposed to the intervention, and the primary outcome is determined by serum TSH levels. Studies will

Hypothyroidism in Patients with Psoriasis or Rosacea: A Large Population Study.

Science.gov (United States)

James, Sara M; Hill, Dane E; Feldman, Steven R

2016-10-15

Hypothyroidism is a common disease, and there may be a link between hypothyroidism and inflammatory skin disease. The purpose of this study is to assess whether hypothyroidism is more prevalent in psoriasis or rosacea patients. We utilized a large claims-based database to analyze rates of hypothyroidism in patients with psoriasis and rosacea compared to other patients with skin diseases. Participants were patients between 20-64 years of age with ICD-9 diagnosis codes for psoriasis, rosacea, and hypothyroidism. We found that rates of hypothyroidism in rosacea and psoriasis patients were similar to rates of hypothyroidism in those without rosacea or psoriasis.

Evaluation of dermal symptoms in hypothyroidism and hyperthyroidism.

Science.gov (United States)

Razi, Ahad; Golforoushan, Farideh; Nejad, Amir Bahrami Shahla Babaee; Goldust, Mohamad

2013-06-01

Many symptoms arise in thyroid diseases. The aim of this study was to evaluate the dermal symptoms in hypothyroidism and hyperthyroidism. In this cross sectional study, 120 patients with hyperthyroidism and 50 patients suffering from hypothyroidism were studied. Cutaneous, hair and nail clinical symptoms were studied and registered in a special questionnaire. Mean age of patients suffering from hypothyroidism and hyperthyroidism were 38.24 +/- 14.45 and 25.86 +/- 14.69 years old. Dry and Coarse/rough skin were the most prevalent manifestations in the skin involvement in hypothyroidism since softness was the most prevalent ones in hyperthyroidism. Fragileness was the most prevalent symptom in patients with nail involvement in hypothyroidism since soft skin was the most prevalent ones in hyperthyroidism. Coarse/rough skin was observed more in patients with hair involvement in hypothyroidism since the most prevalent ones was separation of nail from its bed in hyperthyroidism. High prevalence of skin, hair and nail symptoms in thyroid patients, early diagnosis of the signs may be helpful in premature diagnosis and treatment of thyroid diseases.

Hypothyroidism Is Associated With Coronary Endothelial Dysfunction in Women

Science.gov (United States)

Sara, Jaskanwal D; Zhang, Ming; Gharib, Hossein; Lerman, Lilach O; Lerman, Amir

2015-01-01

Background Hypothyroidism is associated with an increased risk of coronary artery disease, beyond that which can be explained by its association with conventional cardiovascular risk factors. Coronary endothelial dysfunction precedes atherosclerosis, has been linked to adverse cardiovascular events, and may account for some of the increased risk in patients with hypothyroidism. The aim of this study was to determine whether there is an association between epicardial and microvascular coronary endothelial dysfunction and hypothyroidism. Methods and Results In 1388 patients (mean age 50.5 [12.3] years, 34% male) presenting with stable chest pain to Mayo Clinic, Rochester, MN for diagnostic coronary angiography, and who were found to have nonobstructive coronary artery disease (hypothyroidism, defined as a documented history of hypothyroidism or a thyroid-stimulating hormone (TSH) >10.0 mU/mL, n=188, and euthyroidism, defined as an absence of a history of hypothyroidism in the clinical record and/or 0.3hypothyroidism had a significantly lower % Δ CBF Ach (48.26 [80.66] versus 64.58 [128.30]) compared to patients with euthyroidism, while the % Δ CAD Ach did not vary significantly between groups. After adjusting for covariates, females with hypothyroidism still had a significantly lower % Δ CBF Ach (estimated difference in % Δ CBF Ach [SE]: −16.79 [8.18]). Conclusions Hypothyroidism in women is associated with microvascular endothelial dysfunction, even after adjusting for confounders, and may explain some of the increased risk of cardiovascular disease in these patients. PMID:26224049

Musical and Verbal Memory in Alzheimer's Disease: A Study of Long-Term and Short-Term Memory

Science.gov (United States)

Menard, Marie-Claude; Belleville, Sylvie

2009-01-01

Musical memory was tested in Alzheimer patients and in healthy older adults using long-term and short-term memory tasks. Long-term memory (LTM) was tested with a recognition procedure using unfamiliar melodies. Short-term memory (STM) was evaluated with same/different judgment tasks on short series of notes. Musical memory was compared to verbal…

A least squares approach for efficient and reliable short-term versus long-term optimization

DEFF Research Database (Denmark)

Christiansen, Lasse Hjuler; Capolei, Andrea; Jørgensen, John Bagterp

2017-01-01

The uncertainties related to long-term forecasts of oil prices impose significant financial risk on ventures of oil production. To minimize risk, oil companies are inclined to maximize profit over short-term horizons ranging from months to a few years. In contrast, conventional production...... optimization maximizes long-term profits over horizons that span more than a decade. To address this challenge, the oil literature has introduced short-term versus long-term optimization. Ideally, this problem is solved by a posteriori multi-objective optimization methods that generate an approximation...... the balance between the objectives, leaving an unfulfilled potential to increase profits. To promote efficient and reliable short-term versus long-term optimization, this paper introduces a natural way to characterize desirable Pareto points and proposes a novel least squares (LS) method. Unlike hierarchical...

Acute mania after thyroxin supplementation in hypothyroid state

Directory of Open Access Journals (Sweden)

Rohit Verma

2013-01-01

Full Text Available The current literature variedly ascribes depressive and manic symptoms to hypo- and hyperthyroid state, respectively, reporting mania in hypothyroidism as an unusual entity. More unusual is precipitation of manic state in hypothyroid subjects after thyroxine supplementation for which studies report otherwise treating manic symptoms in hypothyroid state with thyroxine. We report a case of a patient whose acute mania appears to have been precipitated by thyroxine supplementation in hypothyroidism state. This case underscores the importance of thyroid screening in patients with mood and psychotic disorders, as well as the potency of thyroxine in producing manic symptoms.

Do Short-Term Managerial Objectives Lead to Under- or Over-Investment in Long-Term Projects

OpenAIRE

Lucian Arye Bebchuk; Lars A. Stole

1994-01-01

This paper studies managerial decisions about investment in long-run projects in the presence of imperfect information (the market knows less about such investments than the firm's managers) and short-term managerial objectives (the managers are concerned about the short-term stock price as well as the long-term stock price). Prior work has suggested that imperfect information and short-term managerial objectives induce managers to underinvest in long-run projects. We show that either underin...

A New Look at Precipitants of Overt Hepatic Encephalopathy in Cirrhosis.

Science.gov (United States)

Pantham, Ganesh; Post, Anthony; Venkat, Deepak; Einstadter, Douglas; Mullen, Kevin D

2017-08-01

Overt hepatic encephalopathy (HE) is a major cause of significant morbidity and mortality in patients with liver cirrhosis. We examined the frequency and profile of the precipitating factors resulting in hospitalizations for overt HE. We conducted both retrospective and prospective studies to identify clinical precipitants of overt HE in patients with cirrhosis. The retrospective study patients were hospitalized at a large urban safety-net hospital, and the prospective study included the patients admitted at a liver transplant center. There were a total of 149 patients with cirrhosis and overt HE (91 males, mean age 55.3 ± 8.6 years) in the retrospective group and 45 patients (27 males, mean age 58.3 ± 8.2 years) in the prospective group of the study. The average MELD score was 16 ± 6.8 in the retrospective group and 22.7 ± 7.2 in the prospective group. Dehydration (46-76%), acute kidney injury (32-76%), lactulose nonadherence (about 50%), constipation (about 40%), and infections (20-42%) were the most frequently identified precipitants for hospitalization in retrospective and prospective groups. Multiple precipitants were identified in 60 (40.3%) patients in the retrospective group and 34 (76%) patients in the prospective group. Multiple concurrent precipitating factors were identified in the majority of patients with overt HE requiring hospitalization. Dehydration due to various causes was the most common precipitant of overt HE, followed by acute kidney injury (AKI), constipation, and infections. Prevention of dehydration, AKI, and constipation by close outpatient monitoring may be an effective measure to prevent hospitalization for overt HE in patients with cirrhosis.

Sleep Quality, Short-Term and Long-Term CPAP Adherence

Science.gov (United States)

Somiah, Manya; Taxin, Zachary; Keating, Joseph; Mooney, Anne M.; Norman, Robert G.; Rapoport, David M.; Ayappa, Indu

2012-01-01

Study Objectives: Adherence to CPAP therapy is low in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). The purpose of the present study was to evaluate the utility of measures of sleep architecture and sleep continuity on the CPAP titration study as predictors of both short- and long-term CPAP adherence. Methods: 93 patients with OSAHS (RDI 42.8 ± 34.3/h) underwent in-laboratory diagnostic polysomnography, CPAP titration, and follow-up polysomnography (NPSG) on CPAP. Adherence to CPAP was objectively monitored. Short-term (ST) CPAP adherence was averaged over 14 days immediately following the titration study. Long-term (LT) CPAP adherence was obtained in 56/93 patients after approximately 2 months of CPAP use. Patients were grouped into CPAP adherence groups for ST ( 4 h) and LT adherence ( 4 h). Sleep architecture, sleep disordered breathing (SDB) indices, and daytime outcome variables from the diagnostic and titration NPSGs were compared between CPAP adherence groups. Results: There was a significant relationship between ST and LT CPAP adherence (r = 0.81, p CPAP adherence groups had significantly lower %N2 and greater %REM on the titration NPSG. A model combining change in sleep efficiency and change in sleep continuity between the diagnostic and titration NPSGs predicted 17% of the variance in LT adherence (p = 0.006). Conclusions: These findings demonstrate that characteristics of sleep architecture, even on the titration NPSG, may predict some of the variance in CPAP adherence. Better sleep quality on the titration night was related to better CPAP adherence, suggesting that interventions to improve sleep on/prior to the CPAP titration study might be used as a therapeutic intervention to improve CPAP adherence. Citation: Somiah M; Taxin Z; Keating J; Mooney AM; Norman RG; Rapoport DM; Ayappa I. Sleep quality, short-term and long-term CPAP adherence. J Clin Sleep Med 2012;8(5):489-500. PMID:23066359

Hypothyroidism and Hyponatremia: Rather Coincidence Than Causality.

Science.gov (United States)

Wolf, Peter; Beiglböck, Hannes; Smaijs, Sabina; Wrba, Thomas; Rasoul-Rockenschaub, Susanne; Marculescu, Rodrig; Gessl, Alois; Luger, Anton; Winhofer, Yvonne; Krebs, Michael

2017-05-01

Hypothyroidism is referred to be a rare but possible cause of hyponatremia. However, there is only poor evidence supporting this association. Since hyponatremia and hypothyroidism are both common conditions themselves, co-occurrence does not have to be causal. To address a potential relationship, a retrospective analysis of data from the Division of Endocrinology of the Medical University of Vienna from April 2004 to February 2016 was performed. A total of 8053 hypothyroid patients (48 ± 18 years of age; 71% female) with thyrotropin >4.0 μIU/mL and available blood tests for free thyroxine and sodium (Na + ) within maximal ± seven days were included and screened for hyponatremia. Patients' records were searched for concomitant disease and medication when Na + concentration was causes of hyponatremia in 442/448 (98.88%) patients (i.e., side effects of medication, concomitant underlying disease, or other endocrine disorders). This distribution did not differ between patients suffering from clinical or subclinical hypothyroidism. No case of clinically relevant hyponatremia (Na + hypothyroidism. There was a very weak but statistically significant trend toward a positive association between thyroid function and serum Na + levels (Na + /thyrotropin: R = 0.022, p = 0.046; Na + /free thyroxine: R = -0.047, p hypothyroid patients with moderate to severe hyponatremia often have other potential explanations for their low serum Na + concentrations in routine care.

Assessing the associative deficit of older adults in long-term and short-term/working memory.

Science.gov (United States)

Chen, Tina; Naveh-Benjamin, Moshe

2012-09-01

Older adults exhibit a deficit in associative long-term memory relative to younger adults. However, the literature is inconclusive regarding whether this deficit is attenuated in short-term/working memory. To elucidate the issue, three experiments assessed younger and older adults' item and interitem associative memory and the effects of several variables that might potentially contribute to the inconsistent pattern of results in previous studies. In Experiment 1, participants were tested on item and associative recognition memory with both long-term and short-term retention intervals in a single, continuous recognition paradigm. There was an associative deficit for older adults in the short-term and long-term intervals. Using only short-term intervals, Experiment 2 utilized mixed and blocked test designs to examine the effect of test event salience. Blocking the test did not attenuate the age-related associative deficit seen in the mixed test blocks. Finally, an age-related associative deficit was found in Experiment 3, under both sequential and simultaneous presentation conditions. Even while accounting for some methodological issues, the associative deficit of older adults is evident in short-term/working memory.

The secondary hypothyroidism after radioiodine therapy and the replacement treatment

International Nuclear Information System (INIS)

Xu Ying; Xu Xiaohui

2004-01-01

The secondary hypothyroidism is the most important intercurrent disease after radioiodine therapy. The early hypothyroidism and the late hypothyroidism are incompletely different in pathogenesis. It needs researching further. there has not yet been an affirmable answer to choose the distillates from animal hypothyroid extract or complex preparation of levo-thyroxine in replacement treatment. (authors)

Incidence of Subclinical Hypothyroidism and Hypothyroidism in Early Pregnancy.

Science.gov (United States)

Akram, Frida Hosseini; Johansson, Bengt; Möllerström, Gunnar; Landgren, Britt-Marie; Stavreus-Evers, Anneli; Skjöldebrand-Sparre, Lottie

2017-11-01

Untreated and subclinical hypothyroidism (SCH) has been associated with adverse pregnancy complications such as increased risk of miscarriage, hypertension, preeclampsia, and preterm delivery. However, in Sweden, screening for thyroid dysfunction during pregnancy is only recommended for women with a high risk of thyroid disease. Therefore, the aim of this study was to determine the incidence of clinical and SCH in women in the first trimester of pregnancy. In this prospective study, 1298 pregnant women were divided into three groups: one unselected general screening group (n = 611), one low-risk group comprising women without risk factors for thyroid disorder (n = 511), and one high-risk group comprising women with an inheritance or suspicion of thyroid disease or undergoing treatment for thyroid disease (n = 88). Serum was obtained up to gestational week 13, and thyrotropin (TSH) was analyzed. The incidences of thyroid dysfunction in the three screening groups were 9.8% in the general screening group, 9.6% in the low-risk group, and 10.2%, p = 0.948, in the high-risk group. In the women with known hypothyroidism on levothyroxine treatment, 50.6% had serum TSH levels above 2.0 mIU/L. High-risk screening is not useful in predicting which women are at risk of thyroid disease in early pregnancy since ∼10% of women with SCH or hypothyroidism could not be diagnosed in this way.

Comparison of Thyroid Hormones Consumption in Russia and European Countries

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V V Fadeyev

2009-03-01

Full Text Available Hypothyroidism is one of the most common endocrine diseases. The prevalence of hypothyroidism in adults is estimated to be 1–2% for overt hypothyroidism and 7–10% for subclinical hypothyroidism, especially in elder women. Considering high prevalence of hypothyroidism and negative consequences of nontreated hypothyroidism for health, we conducted the work which aim was the assessment of consumption of thyroid hormones in Russia in comparison with the countries of Europe. The aim of this analysis, in turn, is the approximate estimation of hypodiagnostics of hypothyroidism in our country.

[Treatment of primary hypothyroidism in adult patients].

Science.gov (United States)

Salmela, Pasi; Metso, Saara; Moilanen, Leena; Niskanen, Leo; Nuutila, Pirjo; Schalin-Jäntti, Camilla

2016-01-01

The diagnosis of hypothyroidism is based on the findings of an increased serum TSH (above the reference range) and decreased serum free T4 (below the reference range) concentration. Treatment of subclinical hypothyroidism is indicated if serum THS is above 10 mU/l. For less severe forms of subclinical hypothyroidism, the treatment should be individually tailored. The treatment of choice is synthetic human levothyroxine. The goals for treatment are amelioration of symptoms and normalization of TSH and free T4 concentrations.

The pedagogy of Short-Term Study-Abroad Programs

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Jude Gonsalvez

2013-10-01

Full Text Available This paper focuses on establishing guidelines on the pedagogy of short term study abroad programs. This study follows 33 students who participated in a short-term study-abroad program to India with the researcher from 2006 through 2011. The study relies heavily on the student reflections and expressions as they experienced them. It is qualitative in nature. Focus groups were the main method of data collection, where participants were invited to reflect, express, and share their experiences with one another. This provided an opportunity for the participants to come together, relive their experiences, and help provide information as to how and what type of an influence this short-term study-abroad program provided.

Genetic deletion of melanin-concentrating hormone neurons impairs hippocampal short-term synaptic plasticity and hippocampal-dependent forms of short-term memory.

Science.gov (United States)

Le Barillier, Léa; Léger, Lucienne; Luppi, Pierre-Hervé; Fort, Patrice; Malleret, Gaël; Salin, Paul-Antoine

2015-11-01

The cognitive role of melanin-concentrating hormone (MCH) neurons, a neuronal population located in the mammalian postero-lateral hypothalamus sending projections to all cortical areas, remains poorly understood. Mainly activated during paradoxical sleep (PS), MCH neurons have been implicated in sleep regulation. The genetic deletion of the only known MCH receptor in rodent leads to an impairment of hippocampal dependent forms of memory and to an alteration of hippocampal long-term synaptic plasticity. By using MCH/ataxin3 mice, a genetic model characterized by a selective deletion of MCH neurons in the adult, we investigated the role of MCH neurons in hippocampal synaptic plasticity and hippocampal-dependent forms of memory. MCH/ataxin3 mice exhibited a deficit in the early part of both long-term potentiation and depression in the CA1 area of the hippocampus. Post-tetanic potentiation (PTP) was diminished while synaptic depression induced by repetitive stimulation was enhanced suggesting an alteration of pre-synaptic forms of short-term plasticity in these mice. Behaviorally, MCH/ataxin3 mice spent more time and showed a higher level of hesitation as compared to their controls in performing a short-term memory T-maze task, displayed retardation in acquiring a reference memory task in a Morris water maze, and showed a habituation deficit in an open field task. Deletion of MCH neurons could thus alter spatial short-term memory by impairing short-term plasticity in the hippocampus. Altogether, these findings could provide a cellular mechanism by which PS may facilitate memory encoding. Via MCH neuron activation, PS could prepare the day's learning by increasing and modulating short-term synaptic plasticity in the hippocampus. © 2015 Wiley Periodicals, Inc.

Relationship between short and long term radon measurements

International Nuclear Information System (INIS)

Martinez, T.; Ramirez, D.; Navarrete, M.; Cabrera, L.; Ramirez, A.; Gonzalez, P.

2000-01-01

In this work the radon group of the Faculty of Chemistry at the National University of Mexico presents the results obtained in the establishment of a relation between the short and long term radon measures made with passive electret detectors E-PERM type LLT and HST. The measures were carried out inside single family dwellings (open house condition) located in the southeast of Mexico City (in Xochimilco) during the four seasons of the year 1997. A correlation was established between the short term measures (five days) and those of a long term for every season as well as an annual average, with an equation that relates them. The objective and advantage of this correlation are that with a short term measure it is possible to predict the annual mean radon concentration, that represents a saving of human and economic resources. (author)

Hypothyroidism in diabetes mellitus patients in Eastern Nepal

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Robin Maskey

2015-01-01

Full Text Available Context: The coexistence of diabetes mellitus (DM with hypothyroidism is a known clinical observation. Aims: To estimate prevalence and co-relate that of hypothyroidism in patients with DM in relation to the age and sex, the lipid profile, body mass index visiting diabetes clinic and inpatients in B. P. Koirala Institute of Health Sciences. Settings and Design: The hospital-based descriptive study. Materials and Methods: Two hundred and seventy-one known or newly detected cases of DM aged more than 15 years were selected randomly from September 2012 to September 2013 and subjected to evaluation for thyroid function - clinically and biochemically and other relevant investigations were done. Statistical Analysis Used: For descriptive statistics mean, standard deviation, percentage, proportion were calculated. For inferential statistics following test were carried out at the level of significant 0.05 where confidence interval is 95%. The statistical operations were done through Statistical Package for the Social Sciences version 10. Results: Of 271 subjects, the prevalence of hypothyroidism (clinical and subclinical in diabetics was, 4.05% (11/271 with females preponderance, of which 7 (30.4% were clinically hypothyroid and 4 (17.4% were subclinical hypothyroid. One (4.3% patient had subclinical hyperthyroidism. The mean age at diagnosis of type 2 DM was 51-60 years. 8.69% of diabetics with primary hypothyroids were having morbid obesity. High-density lipoprotein among different thyroid status were statistically significant (P = 0.042. Conclusions: Hypothyroidism is not uncommon in diabetes, and we found body mass index, mean triglyceride and cholesterol levels were more in those diabetic patients having coexisting hypothyroidism.

Primary hypothyroidism masquerading pituitary macroadenoma

OpenAIRE

Agrawal Amit; Reddy Amareesh P.; Malleswara Rao G.; Reddy V. Umamaheswara

2014-01-01

Diffuse and reactive pituitary gland enlargement secondary to primary hypothyroidism is an uncommon occurrence and that can masquerade many pituitary disorders. In present article, we report a case of 19 year female severe hypothyroidism presenting with diffuse enlargement of pituitary gland and hyperprolactinemia and review the clinical importance of this entity. Knowledge of this entity is very important to avoid unnecessary surgery and irreversible complications in this sub-group of patients.

Impact of short-term severe accident management actions in a long-term perspective. Final Report

International Nuclear Information System (INIS)

2000-03-01

The present systems for severe accident management are focused on mitigating the consequences of special severe accident phenomena and to reach a safe plant state. However, in the development of strategies and procedures for severe accident management, it is also important to consider the long-term perspective of accident management and especially to secure the safe state of the plant. The main reason for this is that certain short-term actions have an impact on the long-term scenario. Both positive and negative effects from short-term actions on the accident management in the long-term perspective have been included in this paper. Short-term actions are accident management measures taken within about 24 hours after the initiating event. The purpose of short-term actions is to reach a stable status of the plant. The main goal in the long-term perspective is to maintain the reactor in a stable state and prevent uncontrolled releases of activity. The purpose of this short Technical Note, deliberately limited in scope, is to draw attention to potential long-term problems, important to utilities and regulatory authorities, arising from the way a severe accident would be managed during the first hours. Its objective is to encourage discussions on the safest - and maybe also most economical - way to manage a severe accident in the long term by not making the situation worse through inappropriate short-term actions, and on the identification of short-term actions likely to make long-term management easier and safer. The Note is intended as a contribution to the knowledge base put at the disposal of Member countries through international collaboration. The scope of the work has been limited to a literature search. Useful further activities have been identified. However, there is no proposal, at this stage, for more detailed work to be undertaken under the auspices of the CSNI. Plant-specific applications would need to be developed by utilities

Effect of Combination Treatment for Hypothyroidism on Renal Function in Patients with Hypothyroidism

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O.M. Didushko

2016-02-01

Full Text Available Objective. To improve known methods of diagnosing kidney damage in patients suffering from hypothyroidism with elements of metabolic syndrome, to study the effect of combined treatment on renal function. Materials and methods. The study included 240 patients with primary hypothyroidism (among them — 130 patients with primary hypothyroidism with components of the metabolic syndrome. All patients were divided into 2 groups: the I group included 42 patients with hypothyroidism without obesity (age 44.8 ± 5.7 years; body mass index (BMI 21.3 ± 2.6 kg/m2; group II — 45 patients with hypothyroidism and abdominal obesity (age 43.8 ± 6.1 years; BMI 33.4 ± 4.8 kg/m2. The control group included 20 healthy individuals (age 43.5 ± 5.9 years; BMI 22.0 ± 2.4 kg/m2. Kidney damage was detected in violation of glomerular filter permeability — occurrence of albuminuria and parameters of glomerular filtration rate (GFR were determined using CKD-EPI formulas. The concentration of monocyte chemoattractant protein-1 (MCP-1, leptin, insulin was determined by immunoenzyme assay. Results. During the correlation analysis, between GFR in patients of group I we have established: moderate inverse correlation between the level of GFR and thyroid stimulating hormone (TSH (r = 0.571, GFR and vascular endothelial growth factor (r = –0.616, GFR anf interleukin-6 (IL-6 (r = –0.418, total cholesterol (ChS (r = –0.311, GFR and insulin resistance index (IIR (r = –0.606 and weak inverse relationship between level of GFR and MCP-1 (r = –0.2917. In the II group of patients, a strong direct correlation between the level of GFR and IIR (r = 0.819, Caro index (r = 0.793 and a strong inverse correlation between GFR and TSH (r = –0.782, GFR and HOMA index (r = –0.875, moderate inverse correlation between the levels of GFR and ChS (r = –0.577, leptin (r = –0.476, GFR and IL-6 (r = –0.418, GFR and glucose (r = –0.436 and vascular endothelial growth factor (r

[Hypothyroidism incidence after multimodal treatment for laryngeal cancer].

Science.gov (United States)

Ortega-Gutiérrez, César; Luna-Ortiz, Kuauhyama; Villavicencio-Valencia, Verónica; Herrera Gómez, Angel; Téllez-Palacios, Daniela; Contreras-Buendía, Marlen

2012-01-01

Hypothyroidism following total laryngectomy or radiotherapy treatment for laryngeal cancer is not a rare event, especially in advanced stages. There are no reports on the incidence of hypothyroidism in patients who received chemotherapy and radiotherapy. The objective of this study is to determine the incidence of thyroid dysfunction in a group of patients with laryngeal cancer who underwent surgery as sole treatment, total laryngectomy or radiotherapy alone, and patients with combined treatment: surgery plus radiotherapy, concomitant chemoradiation therapy and chemoradiation therapy plus salvage surgery. A prospective study of patients diagnosed with laryngeal cancer whose serum TSH and T4 levels were evaluated in a serial fashion. 70 patients with laryngeal cancer were studied; the average age at diagnosis was 70.2 years. Male patients were more affected, with a men-women ratio of 3.6:1. Glottic localization was the most frequent (44%). 64% of tumors were locally advanced carcinomas and 51% received multimodal treatment. 45 patients (63%) were diagnosed with hypothyroidism; 49% of the patients with subclinical hypothyroidism, and 51% with clinical hypothyroidism. Hypothyroidism is a complication following treatment for laryngeal cancer. It is recommended to evaluate the thyroid function periodically for timely detection.

Ordered short-term memory differs in signers and speakers: Implications for models of short-term memory

OpenAIRE

Bavelier, Daphne; Newport, Elissa L.; Hall, Matt; Supalla, Ted; Boutla, Mrim

2008-01-01

Capacity limits in linguistic short-term memory (STM) are typically measured with forward span tasks in which participants are asked to recall lists of words in the order presented. Using such tasks, native signers of American Sign Language (ASL) exhibit smaller spans than native speakers (Boutla, Supalla, Newport, & Bavelier, 2004). Here, we test the hypothesis that this population difference reflects differences in the way speakers and signers maintain temporal order information in short-te...

Update on the treatment of hypothyroidism.

Science.gov (United States)

Jonklaas, Jacqueline

2016-01-01

Differentiated thyroid cancer is a malignancy that is rapidly increasing in frequency. As thyroidectomy plays a central role in the treatment of thyroid cancer, it is incumbent on physicians treating this patient group to be well versed in the intricacies of treating hypothyroidism. Treatment of hypothyroidism may be refined by careful attention to dose selection, monitoring of therapy and achievement of thyrotropin goals that are specific to the individual patient's overall clinical situation. These goals are common not only to patients with a sole diagnosis of hypothyroidism, as discussed in the recent American Thyroid Association Guidelines, but also to patients with hypothyroidism in the setting of thyroid cancer. Several recent studies have illuminated our understanding of the benefits and risks of thyrotropin suppression therapy in patients with differentiated thyroid cancer. Multiple studies of combination therapy with levothyroxine and liothyronine for treating hypothyroidism have not led to a clear conclusion about its benefits over levothyroxine monotherapy. Animal studies have advanced our understanding of the altered serum and tissue milieu that characterizes levothyroxine monotherapy. Crossing the bridge from this translational research into clinical research using sustained release triiodothyronine preparations may ultimately enhance the health of our patients. Continued refinement of our understanding of thyroid status and our ability to flawlessly implement thyroid hormone replacement is an active area of research.

Juvenile-onset hypothyroidism in a dog

International Nuclear Information System (INIS)

Greco, D.S.; Peterson, M.E.; Cho, D.Y.; Markovits, J.E.

1985-01-01

Juvenile-onset hypothyroidism was diagnosed in an adult mixed-breed dog examined because of quadraparesis. Unusual clinical signs attributable to juvenile-onset or congenital hypothyroidism included disproportionate dwarfism; enlarged, protruding tongue; mental dullness; and retention of a 'puppy' coat, which was soft and fluffy, without guard hairs. Radiography of the vertebral column and long bones revealed multiple areas of delayed epiphyseal closure and epiphyseal dysgenesis. Myelography demonstrated several intervertebral disk protrusions in the cervical and lumbar regions. Hypothyroidism was confirmed on the basis of a low basal serum thyroxine concentration that failed to increase after the administration of thyroid stimulating hormone. Other laboratory abnormalities included nonregenerative, normocytic, normochromic anemia; mild hypercalcemia; and an impaired growth hormone (GH) secretory response after xylazine administration. At necropsy, the thyroid gland was small and weighed only 0.2g. Microscopic examination of the thyroid gland revealed a loss of glandular tissue, which was replaced by adipose tissue along its periphery. Gross or microscopic abnormalities were not noted in the pituitary gland, and immunohistochemical staining of the pituitary gland revealed a normal number of GH-containing acidophils. This suggests that primary hypothyroidism may result in an impaired secretion of growth hormone, and that pituitary dwarfism or GH deficiency may be difficult to differentiate from hypothyroid dwarfism on the basis of provocative GH testing alone

Short-term and long-term deflection of reinforced hollow core ...

African Journals Online (AJOL)

This paper presents a study on different methods of analysis that are currently used by design codes to predict the short-term and long-term deflection of reinforced concrete slab systems and compares the predicted deflections with measured deflections. The experimental work to measure deflections involved the testing of ...

Robust short-term memory without synaptic learning.

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Samuel Johnson

Full Text Available Short-term memory in the brain cannot in general be explained the way long-term memory can--as a gradual modification of synaptic weights--since it takes place too quickly. Theories based on some form of cellular bistability, however, do not seem able to account for the fact that noisy neurons can collectively store information in a robust manner. We show how a sufficiently clustered network of simple model neurons can be instantly induced into metastable states capable of retaining information for a short time (a few seconds. The mechanism is robust to different network topologies and kinds of neural model. This could constitute a viable means available to the brain for sensory and/or short-term memory with no need of synaptic learning. Relevant phenomena described by neurobiology and psychology, such as local synchronization of synaptic inputs and power-law statistics of forgetting avalanches, emerge naturally from this mechanism, and we suggest possible experiments to test its viability in more biological settings.

Robust short-term memory without synaptic learning.

Science.gov (United States)

Johnson, Samuel; Marro, J; Torres, Joaquín J

2013-01-01

Short-term memory in the brain cannot in general be explained the way long-term memory can--as a gradual modification of synaptic weights--since it takes place too quickly. Theories based on some form of cellular bistability, however, do not seem able to account for the fact that noisy neurons can collectively store information in a robust manner. We show how a sufficiently clustered network of simple model neurons can be instantly induced into metastable states capable of retaining information for a short time (a few seconds). The mechanism is robust to different network topologies and kinds of neural model. This could constitute a viable means available to the brain for sensory and/or short-term memory with no need of synaptic learning. Relevant phenomena described by neurobiology and psychology, such as local synchronization of synaptic inputs and power-law statistics of forgetting avalanches, emerge naturally from this mechanism, and we suggest possible experiments to test its viability in more biological settings.

Robust Short-Term Memory without Synaptic Learning

Science.gov (United States)

Johnson, Samuel; Marro, J.; Torres, Joaquín J.

2013-01-01

Short-term memory in the brain cannot in general be explained the way long-term memory can – as a gradual modification of synaptic weights – since it takes place too quickly. Theories based on some form of cellular bistability, however, do not seem able to account for the fact that noisy neurons can collectively store information in a robust manner. We show how a sufficiently clustered network of simple model neurons can be instantly induced into metastable states capable of retaining information for a short time (a few seconds). The mechanism is robust to different network topologies and kinds of neural model. This could constitute a viable means available to the brain for sensory and/or short-term memory with no need of synaptic learning. Relevant phenomena described by neurobiology and psychology, such as local synchronization of synaptic inputs and power-law statistics of forgetting avalanches, emerge naturally from this mechanism, and we suggest possible experiments to test its viability in more biological settings. PMID:23349664

Irisin levels increase after treatment in patients with newly diagnosed Hashimoto thyroiditis.

Science.gov (United States)

Uc, Z A; Gorar, S; Mizrak, S; Gullu, S

2018-05-18

Irisin is a newly identified myokine secreted by skeletal muscle and has significant effects on body metabolism. Thyroidal functional state has a profound influence on the metabolism of human body. Therefore, the aim of this study was to investigate the possible changes in serum irisin concentrations before and after treatment in hypothyroid subjects. The study included 26 patients with overt hypothyroidism due to Hashimoto thyroiditis and 19 healthy subjects. Baseline serum thyroid function tests and presence of thyroid autoantibodies and levels of creatine kinase (CK) and irisin were measured in both groups. All measurements in the hypothyroid group were repeated after euthyroidism was achieved. Serum irisin levels were significantly lower in the hypothyroid groups than the control group (p treatment (p hypothyroid patients were treated to achieve euthyroidism. To the best of our knowledge, this is the first study providing insight that low serum irisin levels significantly increased following treatment to euthyroid state in overt hypothyroid patients with Hashimoto thyroiditis. Larger scale studies are needed to confirm these results and to ensure irisin as a possible biomarker of Hashimoto's thyroiditis.

Increased psychiatric morbidity before and after the diagnosis of hypothyroidism

DEFF Research Database (Denmark)

Thvilum, Marianne; Brandt, Frans; Pedersen, Dorthe Almind

2014-01-01

Background: Thyroid hormones are necessary for fetal brain development, while hypothyroidism in adults has been associated with mood symptoms and reduced quality of life. Nevertheless, our knowledge regarding the association and temporal relation between hypothyroidism and mental disorders...... is ambiguous. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism is associated with psychiatric morbidity. Methods: Observational cohort study. Based on record-linkage between different Danish health registers, 2822 hypothyroid singletons each matched with 4 non......-hypothyroid controls were identified and followed over a mean period of 6 years (range 1-13). Additionally, we included 385 same sex twin pairs discordant for hypothyroidism. Diagnoses of psychiatric disorders as well as treatment with antidepressants, antipsychotics and anxiolytics were recorded. Logistic and cox...

Panhypopituitarism with empty sella a sequel of pituitary hyperplasia due to chronic primary hypothyroidism

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Deep Dutta

2012-01-01

Full Text Available Asymptomatic reversible pituitary hyperplasia is common in patients with untreated primary hypothyroidism. Occurrence of empty sella (ES in this scenario is extremely rare (only three reports till the date and panhypopituitarism has not been reported in such patients. We report a 27 year man with severe short stature (height-133 cm; standard deviation score-7.36 and delayed puberty who had symptoms suggestive of hypothyroidism along with chronic persistent headache since 6 years of age. Pituitary imaging done for headache at 11 years age showed pituitary hyperplasia. He was diagnosed of primary hypothyroidism for the 1 st time at 21 year age, a diagnosis which was likely missed for 15 years. Levothyroxine therapy leads to resolution of all symptoms and a height gain of 28 cm over last 6 years. Evaluation for lack of progression of puberty along with chronic nausea, vomiting, fatigue and weight loss for the last 1 year revealed secondary hypocortisolism (9 am cortisol-4.8 mcg/dl; ACTH-3.2 pg/ml, growth hormone deficiency (IGF-1: 65 ng/ml; normal: 117-325 ng/ml and hypogonadotrophic hypogonadism (9 am testosterone: 98 ng/dl; [280-1500] LH-0.01 mIU/L [1.14-5.75] with ES on magnetic resonance imaging (MRI brain. Uncontrolled thyrotroph hyperplasia due to chronic untreated primary hypothyroidism for 15 years may have been damaging the adjacent corticotrophs, somatotrophs and gonadotrophs resulting in panhypopituitarism and empty sella. This is perhaps the first report of panhypopituitarism with empty sella syndrome developing in a patient with pituitary hyperplasia, a sequel of chronic untreated primary hypothyroidism.

Factors contributing to the development of overt encephalopathy in liver cirrhosis patients.

Science.gov (United States)

Iwasa, Motoh; Sugimoto, Ryosuke; Mifuji-Moroka, Rumi; Hara, Nagisa; Yoshikawa, Kyoko; Tanaka, Hideaki; Eguchi, Akiko; Yamamoto, Norihiko; Sugimoto, Kazushi; Kobayashi, Yoshinao; Hasegawa, Hiroshi; Takei, Yoshiyuki

2016-10-01

The aim of this study was to clarify the relationships among psychometric testing results, blood ammonia (NH3) levels, electrolyte abnormalities, and degree of inflammation, and their associations with the development of overt hepatic encephalopathy (HE) in liver cirrhosis (LC) patients. The relationships between covert HE and blood NH3, sodium (Na), and C-reactive protein (CRP) were examined in 40 LC patients. The effects of elevated NH3, hyponatremia, and elevated CRP on the development of overt HE were also investigated. The covert HE group had significantly lower serum Na levels and significantly higher serum CRP levels. During the median observation period of 11 months, 10 patients developed overt HE, and the results of multivariate analysis showed that covert HE and elevated blood NH3 were factors contributing to the development of overt HE. Electrolyte abnormalities and mild inflammation are involved in the pathogenesis of HE. Abnormal psychometric testing results and hyperammonemia are linked to subsequent development of overt HE.

Short-term memory binding deficits in Alzheimer's disease

OpenAIRE

Parra, Mario; Abrahams, S.; Fabi, K.; Logie, R.; Luzzi, S.; Della Sala, Sergio

2009-01-01

Alzheimer's disease impairs long term memories for related events (e.g. faces with names) more than for single events (e.g. list of faces or names). Whether or not this associative or ‘binding’ deficit is also found in short-term memory has not yet been explored. In two experiments we investigated binding deficits in verbal short-term memory in Alzheimer's disease. Experiment 1 : 23 patients with Alzheimer's disease and 23 age and education matched healthy elderly were recruited. Participants...

Relationship between short-term sexual strategies and sexual jealousy.

Science.gov (United States)

Mathes, Eugene W

2005-02-01

In a classic study, Buss, Larson, Westen, and Semmelroth reported that men were more distressed by the thought of a partner's sexual infidelity (sexual jealousy) and women were more distressed by the thought of a partner's emotional infidelity (emotional jealousy). Initially, Buss and his associates explained these results by suggesting that men are concerned about uncertainty of paternity, that is, the possibility of raising another man's child while believing the child is their own. However, later they explained the results in terms of men's preference for short-term sexual strategies. The purpose of this research was to test the explanation of short-term sexual strategies. Men and women subjects were instructed to imagine themselves in a relationship which was either short-term (primarily sexual) or long-term (involving commitment) and then respond to Buss's jealousy items. It was hypothesized that, when both men and women imagined a short-term relationship, they would be more threatened by a partner's sexual infidelity, and, when they imagined a long-term relationship, they would be more threatened by a partner's emotional infidelity. Support was found for this hypothesis.

Thyroid Dysfunction in Non-Interferon Treated Hepatitis C Patients Residing in Hepatitis Endemic Area

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Nayab Batool

2017-01-01

Full Text Available Background. Association of thyroid dysfunction (TD with interferon treatment of HCV is well known to clinicians. However, a few studies have highlighted the role of hepatitis C virus per se in the development of TD. The aim of this study was to know the prevalence of TD in non-interferon treated HCV infected patients referred for thyroid function testing. Patients and Methods. Among 557 ELISA-positive HCV patients 446 (341 females, 105 males were selected for this study. Serums FT4, FT3, and TSH were determined by radioimmunoassay method. Results. TD was detected in 15.2% of patients: 9.0% hypothyroidism and 6.3% hyperthyroidism. In increasing order subclinical hypothyroidism, overt hypothyroidism, overt hyperthyroidism, and subclinical hyperthyroidism were found in 4.7%, 4.3%, 3.6%, and 2.7% patients, respectively. Overall TD was more common in female than in male HCV patients but the difference was not significant (16.1% versus 12.4%; p=0.648. Hyperthyroidism and subclinical hypothyroidism were slightly more common in female and overall hypothyroidism and overt hypothyroidism in male patients but the difference was not statistically significant (p>0.05. The incidence of TD was relatively high in patients above 36 years (median age but the difference was not statistically significant either collectively or in gender base groups (p>0.05. Conclusion. Prior to interferon treatment, HCV infection itself causes biochemical thyroid dysfunction in 15.2% of local HCV patients.

Impact of long-term and short-term therapies on seminal parameters

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Jlenia Elia

2013-04-01

Full Text Available Aim: The aim of this work was: i to evaluate the prevalence of male partners of subfertile couples being treated with long/short term therapies for non andrological diseases; ii to study their seminal profile for the possible effects of their treatments on spermatogenesis and/or epididymal maturation. Methods: The study group was made up of 723 subjects, aged between 25 and 47 years. Semen analysis was performed according to World Health Organization (WHO guidelines (1999. The Superimposed Image Analysis System (SIAS, which is based on the computerized superimposition of spermatozoa images, was used to assess sperm motility parameters. Results: The prevalence of subjects taking pharmacological treatments was 22.7% (164/723. The prevalence was 3.7% (27/723 for the Short-Term Group and 18.9% (137/723 for the Long-Term Group. The subjects of each group were also subdivided into subgroups according to the treatments being received. Regarding the seminal profile, we did not observe a significant difference between the Long-Term, Short-Term or the Control Group. However, regarding the subgroups, we found a significant decrease in sperm number and progressive motility percentage in the subjects receiving treatment with antihypertensive drugs compared with the other subgroups and the Control Group. Conclusions: In the management of infertile couples, the potential negative impact on seminal parameters of any drugs being taken as Long-Term Therapy should be considered. The pathogenic mechanism needs to be clarified.

Model documentation report: Short-Term Hydroelectric Generation Model

International Nuclear Information System (INIS)

1993-08-01

The purpose of this report is to define the objectives of the Short- Term Hydroelectric Generation Model (STHGM), describe its basic approach, and to provide details on the model structure. This report is intended as a reference document for model analysts, users, and the general public. Documentation of the model is in accordance with the Energy Information Administration's (AYE) legal obligation to provide adequate documentation in support of its models (Public Law 94-385, Section 57.b.2). The STHGM performs a short-term (18 to 27- month) forecast of hydroelectric generation in the United States using an autoregressive integrated moving average (UREMIA) time series model with precipitation as an explanatory variable. The model results are used as input for the short-term Energy Outlook

Both hypothyroidism and hyperthyroidism increase atrial fibrillation inducibility in rats.

Science.gov (United States)

Zhang, Youhua; Dedkov, Eduard I; Teplitsky, Diana; Weltman, Nathan Y; Pol, Christine J; Rajagopalan, Viswanathan; Lee, Bianca; Gerdes, A Martin

2013-10-01

Evidence indicates that cardiac hypothyroidism may contribute to heart failure progression. It is also known that heart failure is associated with an increased risk of atrial fibrillation (AF). Although it is established that hyperthyroidism increases AF incidence, the effect of hypothyroidism on AF is unclear. This study investigated the effects of different thyroid hormone levels, ranging from hypothyroidism to hyperthyroidism on AF inducibility in thyroidectomized rats. Thyroidectomized rats with serum-confirmed hypothyroidism 1 month after surgery were randomized into hypothyroid (N=9), euthyroid (N=9), and hyperthyroid (N=9) groups. Rats received placebo, 3.3-mg l-thyroxine (T4), or 20-mg T4 pellets (60-day release form) for 2 months, respectively. At the end of treatment, hypothyroid, euthyroid, and hyperthyroid status was confirmed. Hypothyroid animals showed cardiac atrophy and reduced cardiac systolic and diastolic functions, whereas hyperthyroid rats exhibited cardiac hypertrophy and increased cardiac function. Hypothyroidism and hyperthyroidism produced opposite electrophysiological changes in heart rates and atrial effective refractory period, but both significantly increased AF susceptibility. AF incidence was 78% in hypothyroid, 67% in hyperthyroid, and the duration of induced AF was also longer, compared with 11% in the euthyroid group (all Phyperthyroidism lead to increased AF vulnerability in a rat thyroidectomy model. Our results stress that normal thyroid hormone levels are required to maintain normal cardiac electrophysiology and to prevent cardiac arrhythmias and AF.

Primary hypothyroidism masquerading pituitary macroadenoma

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Agrawal Amit

2014-03-01

Full Text Available Diffuse and reactive pituitary gland enlargement secondary to primary hypothyroidism is an uncommon occurrence and that can masquerade many pituitary disorders. In present article, we report a case of 19 year female severe hypothyroidism presenting with diffuse enlargement of pituitary gland and hyperprolactinemia and review the clinical importance of this entity. Knowledge of this entity is very important to avoid unnecessary surgery and irreversible complications in this sub-group of patients.

Synthetic prevention and treatment for hypothyroidism after radioiodine therapy hyperthyroidism

International Nuclear Information System (INIS)

Li Shiyun

2004-01-01

Hypothyroidism is main complication after 131 I therapy for hyperthyroidism in Graves' disease. The hypothyroidism restricts its popular application that 131 I treatment for Graves' disease. In clinic practice, different factors of every patient, involved case selection, sensitivity estimation, unite using medicine before 131 I therapy are analysed, and synthetic measures for posttreatment examination, transient hypothyroidism and permanent hypothyroidism after 131 I therapy are discussed

Short-term flow induced crystallization in isotactic polypropylene : how short is short?

NARCIS (Netherlands)

Ma, Z.; Balzano, L.; Portale, G.; Peters, G.W.M.

2013-01-01

The so-called "short-term flow" protocol is widely applied in experimental flow-induced crystallization studies on polymers in order to separate the nucleation and subsequent growth processes [Liedauer et al. Int. Polym. Proc. 1993, 8, 236–244]. The basis of this protocol is the assumption that

Myxedema coma in a patient with subclinical hypothyroidism.

Science.gov (United States)

Mallipedhi, Akhila; Vali, Hamza; Okosieme, Onyebuchi

2011-01-01

Myxedema coma is the extreme manifestation of hypothyroidism, typically seen in patients with severe biochemical hypothyroidism. Its occurrence in association with subclinical hypothyroidism is extremely unusual. We describe a patient with subclinical hypothyroidism who developed clinical manifestations of myxedema coma. A 47-year-old woman presented to our endocrine clinic with complaints of fatigue and biochemical findings of subclinical hypothyroidism. She was started on treatment with thyroxine (T4) but remained unwell and was later admitted to hospital with hormone profile showing persisting subclinical hypothyroidism (elevated thyrotropin and normal free T4 [FT4] and free triiodothyronine [FT3]): FT4 10.7 pmol/L (reference range 10.3-24.5), FT3 2.7 pmol/L (reference range 2.67-7.03), and thyrotropin 6.09 mU/L (reference range 0.4-4.0). She subsequently developed hypothermia (temperature 33.2°C), circulatory collapse, and coma. Biochemical profile showed hyponatremia, elevated creatinine phosphokinase, metabolic acidosis, and renal failure. An echocardiogram revealed a moderate-sized pericardial effusion. We diagnosed myxedema coma and started treatment with intravenous T3. She responded dramatically with improvement in level of consciousness and normalization of metabolic parameters. We found no explanation other than hypothyroidism to account for the presentation. Adrenocorticotrophic hormone (ACTH) stimulation tests excluded adrenal insufficiency, and serum gonadotrophins were within the normal reference range. FT4 estimation by equilibrium dialysis excluded analytical interference, and molecular analysis for the thyroid hormone receptor β gene associated with thyroid hormone resistance was negative. To the best of our knowledge this is the first report of myxedema coma in a patient with subclinical hypothyroidism. The reason for normal thyroid hormone levels is unclear but may reflect deviation from a higher pre-morbid set-point. The case

Comparison of Short Term with Long Term Catheterization after Anterior Colporrhaphy Surgery

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F. Movahed

2010-07-01

Full Text Available Introduction & Objective: This belief that overfilling the bladder after anterior colporrhaphy might have a negative influence on surgical outcome, causes routine catheterization after operation. This study was done to compare short term (24h with long term (72h catheterization after anterior colporrhaphy.Materials & Methods: This randomized clinical trial was carried out at Kosar Hospital , Qazvin (Iran in 2005-2006. One hundred cases candidating for anterior colporrhaphy , were divided in two equal groups . In the first group foley catheter was removed 24 hours and in the second group 72 hours after the operation. Before removing catheter, urine sample was obtained for culture . After removal and urination, residual volume was determinded. If the volume exceeded 200 ml or retention occured, the catheter would be fixed for more 72 hours. Need for recatheterization, urinary retention, positive urine culture,and hospital stay were surveyed. The data was analyzed using T and Fisher tests.Results: Residual volume exceeding 200 ml and the need for recatheterization occurred in one case (2% in the short term group but in the long term group none of the subjects needed recatheterization (P=1. Retention was not seen. In the both groups, one case (2% had positive urine culture with no statistically significant difference (P=1. Mean hospital stay was short in the first group (P=0.00.Conclusion: Short term catheterization after anterior colporrhaphy does not cause urinary retention and decreases hospital stay.

Short-term versus long-term market opportunities and financial constraints

International Nuclear Information System (INIS)

Ferrari, Angelo

1999-01-01

This presentation discusses gas developments in Europe, the European Gas Directive, short term vs. long term, and Snam's new challenges. The European gas market is characterized by (1) The role of gas in meeting the demand for energy, which varies greatly from one country to another, (2) A growing market, (3) Decreasing role of domestic production, and (4) Increasing imports. Within the European Union, the Gas Directive aims to transform single national markets into one integrated European market by introducing third party access to the network for eligible clients as a means of increasing the competition between operators. The Gas Directive would appear to modify the form of the market rather than its size, and in particular the sharing of responsibility and risk among operators. The market in the future will offer operators the possibility to exploit opportunities deriving mainly from demands for increased flexibility. Opportunities linked to entrepreneurial initiatives require long-term investments characteristic of the gas business. Risks and opportunities must be balanced evenly between different operators. If everyone takes on their own risks and responsibilities, this means a wider distribution of the risks of long-term vs. short-term, currently borne by the gas companies that are integrated, into a market that tends to favour the short-term. A gradual liberalization process should allow incumbent operators to gradually diversify their activities in new gas market areas or enter new business activities. They could move beyond their local and European boundaries in pursuit of an international dimension. The market will have to make the transition from the national to the European dimension: as an example, Snam covers 90% of the Italian market, but its share of an integrated European market will be about 15%

Comparison of short-term effects between interventional embolization treatment and iodine-131 therapy for graves'hyperthyroidism

International Nuclear Information System (INIS)

Zhu Gaohong; Zhao Wei; Yuan Weihong; Wang Bailing; Yi Gengfa; Yang Shumin

2010-01-01

Objective: To compare the short-term effects between interventional arterial embolization and iodine-131 therapy in treating Graves' disease. Methods: A total of 84 patients with Graves' disease (GD), confirmed by clinical data and laboratory tests, were divided into two groups: interventional group (n = 42) receiving arterial embolization and iodine-131 group (n = 42)receiving iodine-131 therapy. Before and after the treatment thyroid angiography and SPECT / CT imaging were performed to determine the shape and size of the thyroid, and radioimmunoassay method was used to measure serum levels of FT3, FT4, TSH and TRAb at 3, 6 and 12 months after the therapy. The results were compared and statistically analyzed. The occurrence of complications was observed. Results: No statistically significant difference in short-term therapeutic effects was found between interventional group and iodine-131 group. The occurrence of early severe complication was much higher in interventional group than that in iodine-131 group, while the occurrence of hypothyroidism was obviously higher in iodine-131 group than that in interventional group. Conclusion: Both interventional embolization and iodine-131 therapy have reliable effect for the treatment of Graves' disease. Iodine-131 therapy may be used in patients who plan to receive initial treatment or in patients who failed to effectively respond to other kinds of therapies, while interventional embolization may be employed in patients who are not able to receive surgery or in patients who have failed to respond to anti-thyroid drug treatment, or in patients whose iodine-131 intake rate is too low to undergo iodine-131 therapy, especially in patients with refractory and intractable hyperthyroidism. Interventional embolization can be regarded as an alternative treatment for Graves' disease. (authors)

Features of the nervous system lesion in primary hypothyroidism (literature review

Directory of Open Access Journals (Sweden)

I.I. Bilous

2018-03-01

Full Text Available The review presents the pathogenetic mechanisms of central and peripheral nervous system pathology in primary hypothyroidism. Lack of thyroid hormones leads to changes in the organization of the central nervous system, decrease in the energy supply of neurons, changes in the synthesis of some specific proteins of the nervous system that cause the development of cretinism in children. The role of hypothyroidism in the development of cognitive impairment in adults, such as decreased cognitive function, memory and attention, has been proved. The impairment of logical thinking is found already in patients with subclinical hypothyroidism. Disorders in mediation exchange lead to the development of depression. Neuromuscular disorders (hypothyroid myopathy and myotonic phenomenon and affection to the peripheral nerves are best studied in hypothyroidism. Primary hypothyroidism may be masked by tunnel neuropathy, polyneuropathy and atactic syndrome. Despite the existing papers on the problem of hypothyroidism and its neurological complications, some issues of pathogenesis, diagnosis, course and treatment of neurological pathology in primary hypothyroidism require further research.

Short-Term Group Treatment for Adult Children of Alcoholics.

Science.gov (United States)

Cooper, Alvin; McCormack, WIlliam A.

1992-01-01

Adult children of alcoholics (n=24) were tested on measures of loneliness, anxiety, hostility, depression, and interpersonal dependency before and after participation in short-term group therapy. Highly significant test score changes supported effectiveness of individual therapy in short-term groups. (Author/NB)

Hypothyroidism in late-onset Pompe disease

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Joseph Schneider

2016-09-01

Conclusions: Hypothyroidism was found at a higher prevalence in patients with late-onset Pompe disease compared to the general adult population at UMMC. Studies in larger populations of patients with Pompe disease would be needed to confirm an association of Pompe disease and hypothyroidism. Challenges include finding an adequate sample size, due the rarity of Pompe disease.

College Adjustment Difficulties and the Overt and Covert Forms of Narcissism

Science.gov (United States)

Weikel, Kim A.; Avara, Renee Mowery; Hanson, Chad A.; Kater, Hope

2010-01-01

Overt narcissism correlated negatively with emotional distress and interpersonal difficulties among female, but not male, students. After controlling for self-esteem, overt narcissism correlated positively with depression among female students and with emotional distress and interpersonal difficulties among male students. Covert narcissism…

Frequency-specific insight into short-term memory capacity

OpenAIRE

Feurra, Matteo; Galli, Giulia; Pavone, Enea Francesco; Rossi, Alessandro; Rossi, Simone

2016-01-01

We provided novel evidence of a frequency-specific effect by transcranial alternating current stimulation (tACS) of the left posterior parietal cortex on short-term memory, during a digit span task. the effect was prominent with stimulation at beta frequency for young and not for middle-aged adults and correlated with age. Our findings highlighted a short-term memory capacity improvement by tACS application.

Reconciling long-term cultural diversity and short-term collective social behavior.

Science.gov (United States)

Valori, Luca; Picciolo, Francesco; Allansdottir, Agnes; Garlaschelli, Diego

2012-01-24

An outstanding open problem is whether collective social phenomena occurring over short timescales can systematically reduce cultural heterogeneity in the long run, and whether offline and online human interactions contribute differently to the process. Theoretical models suggest that short-term collective behavior and long-term cultural diversity are mutually excluding, since they require very different levels of social influence. The latter jointly depends on two factors: the topology of the underlying social network and the overlap between individuals in multidimensional cultural space. However, while the empirical properties of social networks are intensively studied, little is known about the large-scale organization of real societies in cultural space, so that random input specifications are necessarily used in models. Here we use a large dataset to perform a high-dimensional analysis of the scientific beliefs of thousands of Europeans. We find that interopinion correlations determine a nontrivial ultrametric hierarchy of individuals in cultural space. When empirical data are used as inputs in models, ultrametricity has strong and counterintuitive effects. On short timescales, it facilitates a symmetry-breaking phase transition triggering coordinated social behavior. On long timescales, it suppresses cultural convergence by restricting it within disjoint groups. Moreover, ultrametricity implies that these results are surprisingly robust to modifications of the dynamical rules considered. Thus the empirical distribution of individuals in cultural space appears to systematically optimize the coexistence of short-term collective behavior and long-term cultural diversity, which can be realized simultaneously for the same moderate level of mutual influence in a diverse range of online and offline settings.

Short-Term Robustness of Production Management Systems : New Methodology

NARCIS (Netherlands)

Kleijnen, J.P.C.; Gaury, E.G.A.

2000-01-01

This paper investigates the short-term robustness of production planning and control systems. This robustness is defined here as the systems ability to maintain short-term service probabilities (i.e., the probability that the fill rate remains within a prespecified range), in a variety of

Evaluation of olfactory function in adults with primary hypothyroidism.

Science.gov (United States)

Günbey, Emre; Karlı, Rıfat; Gökosmanoğlu, Feyzi; Düzgün, Berkan; Ayhan, Emre; Atmaca, Hulusi; Ünal, Recep

2015-10-01

Sufficient clinical data are not available on the effect of hypothyroidism on olfactory function in adults. In this study, we aimed to evaluate the olfactory function of adult patients diagnosed with primary hypothyroidism. Forty-five patients aged between 18 and 60 years who were diagnosed with clinical primary hypothyroidism and 45 healthy controls who had normal thyroid function tests were included in the study. Sniffin' Sticks olfactory test results of the 2 groups were compared. The relationships between thyroid function tests and olfactory parameters were evaluated. Odor threshold, identification, and discrimination scores of the hypothyroid group were significantly lower than those of the control group (p adults with hypothyroidism. FT3 levels were found to have a more significant relationship with olfactory parameters than TSH or FT4 levels. © 2015 ARS-AAOA, LLC.

Differences in health status between long-term and short-term benzodiazepine users.

NARCIS (Netherlands)

Zandstra, S.M.; Furer, J.W.; Lisdonk, E.H. van de; Bor, J.H.J.; Zitman, F.G.; Weel, C. van

2002-01-01

BACKGROUND: Despite generally accepted advice to keep treatment short, benzodiazepines are often prescibed for more than six months. Prevention of long-term benzodiazepine use could be facilitated by the utilisation of risk indicators for long-term use. However, the characteristics of long-term

The roles of long-term phonotactic and lexical prosodic knowledge in phonological short-term memory.

Science.gov (United States)

Tanida, Yuki; Ueno, Taiji; Lambon Ralph, Matthew A; Saito, Satoru

2015-04-01

Many previous studies have explored and confirmed the influence of long-term phonological representations on phonological short-term memory. In most investigations, phonological effects have been explored with respect to phonotactic constraints or frequency. If interaction between long-term memory and phonological short-term memory is a generalized principle, then other phonological characteristics-that is, suprasegmental aspects of phonology-should also exert similar effects on phonological short-term memory. We explored this hypothesis through three immediate serial-recall experiments that manipulated Japanese nonwords with respect to lexical prosody (pitch-accent type, reflecting suprasegmental characteristics) as well as phonotactic frequency (reflecting segmental characteristics). The results showed that phonotactic frequency affected the retention not only of the phonemic sequences, but also of pitch-accent patterns, when participants were instructed to recall both the phoneme sequence and accent pattern of nonwords. In addition, accent pattern typicality influenced the retention of the accent pattern: Typical accent patterns were recalled more accurately than atypical ones. These results indicate that both long-term phonotactic and lexical prosodic knowledge contribute to phonological short-term memory performance.

Visual Short-Term Memory Complexity

DEFF Research Database (Denmark)

Sørensen, Thomas Alrik

Several recent studies have explored the nature and limits of visual short-term memory (VSTM) (e.g. Luck & Vogel, 1997). A general VSTM capacity limit of about 3 to 4 letters has been found, thus confirming results from earlier studies (e.g. Cattell, 1885; Sperling, 1960). However, Alvarez...

Brain oscillatory substrates of visual short-term memory capacity.

Science.gov (United States)

Sauseng, Paul; Klimesch, Wolfgang; Heise, Kirstin F; Gruber, Walter R; Holz, Elisa; Karim, Ahmed A; Glennon, Mark; Gerloff, Christian; Birbaumer, Niels; Hummel, Friedhelm C

2009-11-17

The amount of information that can be stored in visual short-term memory is strictly limited to about four items. Therefore, memory capacity relies not only on the successful retention of relevant information but also on efficient suppression of distracting information, visual attention, and executive functions. However, completely separable neural signatures for these memory capacity-limiting factors remain to be identified. Because of its functional diversity, oscillatory brain activity may offer a utile solution. In the present study, we show that capacity-determining mechanisms, namely retention of relevant information and suppression of distracting information, are based on neural substrates independent of each other: the successful maintenance of relevant material in short-term memory is associated with cross-frequency phase synchronization between theta (rhythmical neural activity around 5 Hz) and gamma (> 50 Hz) oscillations at posterior parietal recording sites. On the other hand, electroencephalographic alpha activity (around 10 Hz) predicts memory capacity based on efficient suppression of irrelevant information in short-term memory. Moreover, repetitive transcranial magnetic stimulation at alpha frequency can modulate short-term memory capacity by influencing the ability to suppress distracting information. Taken together, the current study provides evidence for a double dissociation of brain oscillatory correlates of visual short-term memory capacity.

SHORT-TERM MEMORY IS INDEPENDENT OF BRAIN PROTEIN SYNTHESIS

Energy Technology Data Exchange (ETDEWEB)

Davis, Hasker P.; Rosenzweig, Mark R.; Jones, Oliver W.

1980-09-01

Male Swiss albino CD-1 mice given a single injection of a cerebral protein synthesis inhibitor, anisomycin (ANI) (1 mg/animal), 20 min prior to single trial passive avoidance training demonstrated impaired retention at tests given 3 hr, 6 hr, 1 day, and 7 days after training. Retention was not significantly different from saline controls when tests were given 0.5 or 1.5 hr after training. Prolonging inhibition of brain protein synthesis by giving either 1 or 2 additional injections of ANI 2 or 2 and 4 hr after training did not prolong short-term retention performance. The temporal development of impaired retention in ANI treated mice could not be accounted for by drug dosage, duration of protein synthesis inhibition, or nonspecific sickness at test. In contrast to the suggestion that protein synthesis inhibition prolongs short-term memory (Quinton, 1978), the results of this experiment indicate that short-term memory is not prolonged by antibiotic drugs that inhibit cerebral protein synthesis. All evidence seems consistent with the hypothesis that short-term memory is protein synthesis independent and that the establishment of long-term memory depends upon protein synthesis during or shortly after training. Evidence for a role of protein synthesis in memory maintenance is discussed.

Impaired short-term memory for pitch in congenital amusia.

Science.gov (United States)

Tillmann, Barbara; Lévêque, Yohana; Fornoni, Lesly; Albouy, Philippe; Caclin, Anne

2016-06-01

Congenital amusia is a neuro-developmental disorder of music perception and production. The hypothesis is that the musical deficits arise from altered pitch processing, with impairments in pitch discrimination (i.e., pitch change detection, pitch direction discrimination and identification) and short-term memory. The present review article focuses on the deficit of short-term memory for pitch. Overall, the data discussed here suggest impairments at each level of processing in short-term memory tasks; starting with the encoding of the pitch information and the creation of the adequate memory trace, the retention of the pitch traces over time as well as the recollection and comparison of the stored information with newly incoming information. These impairments have been related to altered brain responses in a distributed fronto-temporal network, associated with decreased connectivity between these structures, as well as in abnormalities in the connectivity between the two auditory cortices. In contrast, amusic participants׳ short-term memory abilities for verbal material are preserved. These findings show that short-term memory deficits in congenital amusia are specific to pitch, suggesting a pitch-memory system that is, at least partly, separated from verbal memory. This article is part of a Special Issue entitled SI: Auditory working memory. Copyright © 2015 Elsevier B.V. All rights reserved.

Both Hypothyroidism and Hyperthyroidism Increase Atrial Fibrillation Inducibility in Rats

Science.gov (United States)

Zhang, Youhua; Dedkov, Eduard I.; Teplitsky, Diana; Weltman, Nathan Y.; Pol, Christine J.; Rajagopalan, Viswanathan; Lee, Bianca; Gerdes, A. Martin

2014-01-01

Background Evidence indicates that cardiac hypothyroidism may contribute to heart failure (HF) progression. It is also known that HF is associated with an increased risk of atrial fibrillation (AF). While it is established that hyperthyroidism increases AF incidence, the effect of hypothyroidism on AF is unclear. This study investigated the effects of different thyroid hormone levels, ranging from hypothyroidism to hyperthyroidism on AF inducibility in thyroidectomized rats. Methods and Results Thyroidectomized rats with serum confirmed hypothyroidism 1 month after surgery were randomized into hypothyroid (n=9), euthyroid (n=9) and hyperthyroid (n=9) groups. Rats received placebo, 3.3mg L-thyroxine (T4), or 20 mg T4 pellets (60 day release form) for 2 months, respectively. At the end of treatment, hypothyroid, euthyroid and hyperthyroid status was confirmed. Hypothyroid animals showed cardiac atrophy and reduced cardiac systolic and diastolic function, while hyperthyroid rats exhibited cardiac hypertrophy and increased cardiac function. Hypothyroidism and hyperthyroidism produced opposite electrophysiological changes in heart rates and atrial effective refractory period, but both significantly increased AF susceptibility. AF incidence was 78% in hypothyroid, 67% in hyperthyroid, and the duration of induced AF was also longer, compared with 11% in the euthyroid group (all phyperthyroidism lead to increased AF vulnerability in a rat thyroidectomy model. Our results stress that normal thyroid hormone levels are required to maintain normal cardiac electrophysiology and prevent cardiac arrhythmias and AF. PMID:24036190

The uranium industry: long-term planning for short-term competition

International Nuclear Information System (INIS)

Vottero, X.; Georges Capus, G.

2001-01-01

Long term planning for short term competition Today, uranium producers face new challenges in terms of both production (new regulatory, environmental and social constraints) and market conditions (new sources of uranium supply, very low prices and tough competition). In such a context, long-term planning is not just a prerequisite to survive in the nuclear fuel cycle industry. In fact, it also contributes to sustaining nuclear electricity generation facing fierce competition from other energy sources in increasingly deregulated markets. Firstly, the risk of investing in new mining projects in western countries is growing because, on the one hand, of very erratic market conditions and, on the other hand, of increasingly lengthy, complex and unpredictable regulatory conditions. Secondly, the supply of other sources of uranium (uranium derived from nuclear weapons, uranium produced in CIS countries, ...) involve other risks, mainly related to politics and commercial restrictions. Consequently, competitive uranium supply requires not only technical competence but also financial strength and good marketing capabilities in order to anticipate long-term market trends, in terms of both demand and supply. It also requires taking into account new parameters such as politics, environment, regulations, etc. Today, a supplier dedicated to the sustainable production of nuclear electricity must manage a broad range of long-term risks inherent to the procurement of uranium. Taking into account all these parameters in a context of short-term, fast-changing market is a great challenge for the future generation. World Uranium Civilian Supply and Demand. (authors)

Subclinical hypothyroidism in childhood - current knowledge and open issues.

Science.gov (United States)

Salerno, Mariacarolina; Capalbo, Donatella; Cerbone, Manuela; De Luca, Filippo

2016-12-01

Subclinical hypothyroidism is defined as serum levels of TSH above the upper limit of the reference range, in the presence of normal concentrations of total T 4 or free T 4 . This biochemical profile might be an indication of mild hypothyroidism, with a potential increased risk of metabolic abnormalities and cardiovascular disease recorded among adults. Whether subclinical hypothyroidism results in adverse health outcomes among children is a matter of debate and so management of this condition remains challenging. Mild forms of untreated subclinical hypothyroidism do not seem to be associated with impairments in growth, bone health or neurocognitive outcome. However, ongoing scientific investigations have highlighted the presence of subtle proatherogenic abnormalities among children with modest elevations in their TSH levels. Although current findings are insufficient to recommend levothyroxine treatment for all children with mild asymptomatic forms of subclinical hypothyroidism, they highlight the potential need for assessment of cardiovascular risk among children with this condition. Increased understanding of the early metabolic risk factors associated with subclinical hypothyroidism in childhood will help to improve the management of affected individuals.

Focal intestinal lymphangiectasia: An unusual cause of acute overt obscure gastrointestinal bleeding

Directory of Open Access Journals (Sweden)

Ashish Kumar Jha

2014-01-01

Full Text Available Detection of bleeding lesion in a patient of acute overt obscure gastrointestinal bleeding is a real challenge. Recently, authors have showed superiority of urgent capsule endoscopy (CE over angiography in patients with acute overt obscure gastrointestinal bleeding. Focal type of intestinal lymphangiectasia is a rare cause of acute gastrointestinal bleeding. Here, we describe a case of focal lymphangiectasia who presented to us with acute overt obscure gastrointestinal bleeding and diagnosed by urgent CE.

Overt and covert attention to location-based reward.

Science.gov (United States)

McCoy, Brónagh; Theeuwes, Jan

2018-01-01

Recent research on the impact of location-based reward on attentional orienting has indicated that reward factors play an influential role in spatial priority maps. The current study investigated whether and how reward associations based on spatial location translate from overt eye movements to covert attention. If reward associations can be tied to locations in space, and if overt and covert attention rely on similar overlapping neuronal populations, then both overt and covert attentional measures should display similar spatial-based reward learning. Our results suggest that location- and reward-based changes in one attentional domain do not lead to similar changes in the other. Specifically, although we found similar improvements at differentially rewarded locations during overt attentional learning, this translated to the least improvement at a highly rewarded location during covert attention. We interpret this as the result of an increased motivational link between the high reward location and the trained eye movement response acquired during learning, leading to a relative slowing during covert attention when the eyes remained fixated and the saccade response was suppressed. In a second experiment participants were not required to keep fixated during the covert attention task and we no longer observed relative slowing at the high reward location. Furthermore, the second experiment revealed no covert spatial priority of rewarded locations. We conclude that the transfer of location-based reward associations is intimately linked with the reward-modulated motor response employed during learning, and alternative attentional and task contexts may interfere with learned spatial priorities. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Insensitivity of visual short-term memory to irrelevant visual information.

Science.gov (United States)

Andrade, Jackie; Kemps, Eva; Werniers, Yves; May, Jon; Szmalec, Arnaud

2002-07-01

Several authors have hypothesized that visuo-spatial working memory is functionally analogous to verbal working memory. Irrelevant background speech impairs verbal short-term memory. We investigated whether irrelevant visual information has an analogous effect on visual short-term memory, using a dynamic visual noise (DVN) technique known to disrupt visual imagery (Quinn & McConnell, 1996b). Experiment I replicated the effect of DVN on pegword imagery. Experiments 2 and 3 showed no effect of DVN on recall of static matrix patterns, despite a significant effect of a concurrent spatial tapping task. Experiment 4 showed no effect of DVN on encoding or maintenance of arrays of matrix patterns, despite testing memory by a recognition procedure to encourage visual rather than spatial processing. Serial position curves showed a one-item recency effect typical of visual short-term memory. Experiment 5 showed no effect of DVN on short-term recognition of Chinese characters, despite effects of visual similarity and a concurrent colour memory task that confirmed visual processing of the characters. We conclude that irrelevant visual noise does not impair visual short-term memory. Visual working memory may not be functionally analogous to verbal working memory, and different cognitive processes may underlie visual short-term memory and visual imagery.

Occurrence of hypothyroidism after treatment of Basedow's diseases with 131I

International Nuclear Information System (INIS)

Torizuka, Kanji; Mori, Toru; Konishi, Junji; Ikekubo, Katsuji; Morita, Rikushi

1975-01-01

Description was made as to the present condition of occurrence of hypothyroidism after treatment of Basedow's disease with 131 I. It was showed that hypothyroidism was not necessarily based on numerical over-dose of 131 I, there were early stage hypothyroidism due to 131 I sensitivity of an individual and delayed hypothyroidism due to irreversible and progressive disorder of the thyroid gland, and examination of inflammatory findings before treatment and reduction of first administered dose of 131 I were effective in prevention of early stage hypothyroidism. At present, the origin of delayed hypothyroidism is not clarified and thus there is not adequate prevention method. It was suggested that it was duty of the person in charge of treatment to observe and guide treated case by careful remote-investigation and to continue efforts in prevention of hypothyroidism hereafter. (M. Tsunoda)

Remembering over the short-term: the case against the standard model.

Science.gov (United States)

Nairne, James S

2002-01-01

Psychologists often assume that short-term storage is synonymous with activation, a mnemonic property that keeps information in an immediately accessible form. Permanent knowledge is activated, as a result of on-line cognitive processing, and an activity trace is established "in" short-term (or working) memory. Activation is assumed to decay spontaneously with the passage of time, so a refreshing process-rehearsal-is needed to maintain availability. Most of the phenomena of immediate retention, such as capacity limitations and word length effects, are assumed to arise from trade-offs between rehearsal and decay. This "standard model" of how we remember over the short-term still enjoys considerable popularity, although recent research questions most of its main assumptions. In this chapter I review the recent research and identify the empirical and conceptual problems that plague traditional conceptions of short-term memory. Increasingly, researchers are recognizing that short-term retention is cue driven, much like long-term memory, and that neither rehearsal nor decay is likely to explain the particulars of short-term forgetting.

Unresolved Subclinical Hypothyroidism is Independently Associated with Progression of Chronic Kidney Disease

Science.gov (United States)

Kim, Eun Oh; Lee, Ihn Suk; Choi, Yoo A; Lee, Sang Ju; Chang, Yoon Kyung; Yoon, Hye Eun; Jang, Yi Sun; Lee, Jong Min; Kim, Hye Soo; Yang, Chul Woo; Kim, Suk Young; Hwang, Hyeon Seok

2014-01-01

Background and Aim: Patients with chronic kidney disease (CKD) often have subclinical hypothyroidism. However, few reports have investigated changes in the status of subclinical hypothyroidism in CKD patients and its clinical significance in CKD progression. Methods: We included 168 patients with nondialysis-dependent CKD stages 2-4. The normalization of subclinical hypothyroidism during follow-up was assessed, and the association between transitions in subclinical hypothyroid status and the rate of decline of the estimated glomerular filtration rate (eGFR) was investigated. Results: At baseline, 127 patients were euthyroid and 41 (24.4%) patients were diagnosed with subclinical hypothyroidism. Of these 41 patients, 21 (51.2%) spontaneously resolved to euthyroid during follow-up. The rate of eGFR decline of patients with resolved subclinical hypothyroidism was similar to that of euthyroid patients. The patients with unresolved subclinical hypothyroidism showed a steeper renal function decline than patients with euthyroidism or resolved subclinical hypothyroidism (all p hypothyroidism than in those who were euthyroid (p = 0.006). In multivariate linear regression for rate of eGFR decrease, unresolved subclinical hypothyroidism (β = -5.77, p = 0.001), baseline renal function (β = -0.12, p hypothyroidism did not resolve to euthyroidism, and this lack of resolution was independently associated with rapid renal function decline. PMID:24396286

Gummed-up memory: chewing gum impairs short-term recall.

Science.gov (United States)

Kozlov, Michail D; Hughes, Robert W; Jones, Dylan M

2012-01-01

Several studies have suggested that short-term memory is generally improved by chewing gum. However, we report the first studies to show that chewing gum impairs short-term memory for both item order and item identity. Experiment 1 showed that chewing gum reduces serial recall of letter lists. Experiment 2 indicated that chewing does not simply disrupt vocal-articulatory planning required for order retention: Chewing equally impairs a matched task that required retention of list item identity. Experiment 3 demonstrated that manual tapping produces a similar pattern of impairment to that of chewing gum. These results clearly qualify the assertion that chewing gum improves short-term memory. They also pose a problem for short-term memory theories asserting that forgetting is based on domain-specific interference given that chewing does not interfere with verbal memory any more than tapping. It is suggested that tapping and chewing reduce the general capacity to process sequences.

Thyroid Stimulating Hormone Reference Range and Prevalence of Thyroid Dysfunction in the Korean Population: Korea National Health and Nutrition Examination Survey 2013 to 2015

Science.gov (United States)

2017-01-01

Background No nationwide epidemiological study evaluating the prevalence of subclinical and overt forms of hypothyroidism and hyperthyroidism has yet been conducted in Korea. This study aimed to evaluate the reference range of serum thyroid stimulating hormone (TSH) and the national prevalence of thyroid dysfunctions in Korea. Methods Nation-wide cross-sectional data were analyzed from a representative sample of the civilian, non-institutionalized Korean population (n=6,564) who underwent blood testing for thyroid function and anti-thyroid peroxidase antibody (TPOAb) as part of the Korea National Health and Nutrition Examination Survey VI (2013 to 2015). Results The reference interval of serum TSH in the Korean reference population was 0.62 to 6.68 mIU/L. Based on this reference interval, the prevalence of overt and subclinical hypothyroidism was 0.73% (males 0.40%, females 1.10%) and 3.10% (males 2.26%, females 4.04%), respectively. The prevalence of hypothyroidism increased with age until the age group between 50 to 59 years. Positive TPOAb were found in 7.30% of subjects (males 4.33%, females 10.62%). The prevalence of overt and subclinical hypothyroidism TPOAb-positive subjects was 5.16% and 10.88%, respectively. The prevalence of overt and subclinical hyperthyroidism was 0.54% (males 0.30%, females 0.81%) and 2.98% (males 2.43%, females, 3.59%), respectively. Conclusion The Serum TSH reference levels in the Korean population were higher than the corresponding levels in Western countries. Differences were found in the prevalence of hypothyroidism and hyperthyroidism according to age, sex, and TPOAb positivity. This study provides important baseline information for understanding patterns of thyroid dysfunction and diseases in Korea. PMID:28116874

Thyroid Stimulating Hormone Reference Range and Prevalence of Thyroid Dysfunction in the Korean Population: Korea National Health and Nutrition Examination Survey 2013 to 2015

Directory of Open Access Journals (Sweden)

Won Gu Kim

2017-01-01

Full Text Available BackgroundNo nationwide epidemiological study evaluating the prevalence of subclinical and overt forms of hypothyroidism and hyperthyroidism has yet been conducted in Korea. This study aimed to evaluate the reference range of serum thyroid stimulating hormone (TSH and the national prevalence of thyroid dysfunctions in Korea.MethodsNation-wide cross-sectional data were analyzed from a representative sample of the civilian, non-institutionalized Korean population (n=6,564 who underwent blood testing for thyroid function and anti-thyroid peroxidase antibody (TPOAb as part of the Korea National Health and Nutrition Examination Survey VI (2013 to 2015.ResultsThe reference interval of serum TSH in the Korean reference population was 0.62 to 6.68 mIU/L. Based on this reference interval, the prevalence of overt and subclinical hypothyroidism was 0.73% (males 0.40%, females 1.10% and 3.10% (males 2.26%, females 4.04%, respectively. The prevalence of hypothyroidism increased with age until the age group between 50 to 59 years. Positive TPOAb were found in 7.30% of subjects (males 4.33%, females 10.62%. The prevalence of overt and subclinical hypothyroidism TPOAb-positive subjects was 5.16% and 10.88%, respectively. The prevalence of overt and subclinical hyperthyroidism was 0.54% (males 0.30%, females 0.81% and 2.98% (males 2.43%, females, 3.59%, respectively.ConclusionThe Serum TSH reference levels in the Korean population were higher than the corresponding levels in Western countries. Differences were found in the prevalence of hypothyroidism and hyperthyroidism according to age, sex, and TPOAb positivity. This study provides important baseline information for understanding patterns of thyroid dysfunction and diseases in Korea.

A Short Term Analogue Memory

DEFF Research Database (Denmark)

Shah, Peter Jivan

1992-01-01

A short term analogue memory is described. It is based on a well-known sample-hold topology in which leakage currents have been minimized partly by circuit design and partly by layout techniques. Measurements on a test chip implemented in a standard 2.4 micron analogue CMOS process show a droop...

Hypothyroidism after radiotherapy for early glottic cancer

International Nuclear Information System (INIS)

Katayama, Motoyuki; Nishimura, Tetsuo; Nozue, Masashi; Kawai, Hiroaki; Takai, Michikatsu; Kaneko, Masao; Nishi, Shigeo

1993-01-01

Reported is the case of a 46-year-old male with hypothyroidism after radiotherapy for early glottic cancer, T1N0M0, Stage I. Six months after 60 Co irradiation 66 Gy with the radiation field size of 5 x 5 cm was given, the clinical signs of acute hypothyroidism was presented. Retrospective CT examinations proved that over 80% of the total dose was irradiated to about 10% of whole thyroid volume. Since laboratory examinations revealed high serum level of thyrogobrin antibody, we postulated immunological mechanism was associated with the onset of hypothyroidism. (author)

Epidemiology of subtypes of hypothyroidism in Denmark

DEFF Research Database (Denmark)

Carlé, Allan; Laurberg, Peter; Pedersen, Inge B.

2006-01-01

in the cohort; the incidence rate was 32.8 per 100 000 person-years (standardised to the Danish population). Nosological types of hypothyroidism were: spontaneous (presumably autoimmune) 84.4%, post-partum 4.71%, amiodarone-associated 4.0%. subacute thyroiditis 1.8%. previous radiation or surgery 1.......8%. congenital 1.6% and lithium-associated 1.6%. Crude incidence rates were 29.0 around Aalborg and 40.6 in an area of Copenhagen. The higher incidence rate of hypothyroidism in the area with higher iodine intake was caused solely by more cases of spontaneous (presumably autoimmune) hypothyroidism, whereas...

Hypothyroidism and acute kidney injury: an unusual association.

Science.gov (United States)

Neves, Precil Diego Miranda de Menezes; Bridi, Ramaiane Aparecida; Balbi, André Luis; Ponce, Daniela

2013-08-09

Association between severe hypothyroidism and acute kidney injury (AKI) is rare. A 40-year-old woman presented with 15 days history of generalised muscle pain, weakness, weight gain and oedema. hypertension and hypothyroidism. dry skin, peripheral/periorbital oedema, slow thought and speaking, thyroid increased. Laboratory examinations: high levels of creatine kinase , creatinine, uric acid and lactate dehydrogenase. Free T4 was very low (hypothyroidism-induced rhabdomyolysis. Intravenous fluids were started, urinary alkalisation and increased l-thyroxine dose replacement. On the day after admission, forced diuresis with furosemide was introduced leading to a progressive improvement of symptoms. Although hypothyroidism and AKI is unusual, it should be suspected in patients presenting decrease of renal function and high creatine kinase in the absence of other causes of rhabdomyolysis.

Subclinical Hypothyroidism and Survival: The Effects of Heart Failure and Race

Science.gov (United States)

Curhan, Gary C.; Alexander, Erik K.; Bhan, Ishir; Brunelli, Steven M.

2013-01-01

Context: Studies examining the association between subclinical hypothyroidism and mortality have yielded conflicting results. Emerging data suggest these associations may depend upon underlying congestive heart failure (CHF) and/or race, but this has not been empirically determined. Objective: Our objective was to examine the association between subclinical hypothyroidism and hypothyroidism overall with mortality according to pre-existing CHF and race. Design and Participants: We examined the associations of subclinical hypothyroidism (TSH higher than assay upper limit of normal; total T4 within reference) and hypothyroidism overall (TSH higher than assay upper limit of normal; total T4 below lower limit of normal or within reference) with all-cause mortality among Third National Health and Nutrition Examination Survey participants stratified by CHF and race using multivariable Cox models. To confirm whether differences between strata were statistically significant, we tested for interaction on the basis of CHF (separately) and race by likelihood ratio testing. Results: There were 14 130 (95.0%) euthyroid controls and 749 (5.0%) participants with hypothyroidism, 691 (4.6%) of whom had subclinical disease. Subclinical hypothyroidism vs euthyroidism was associated with greater mortality in those with CHF but not in those without: adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) = 1.44 (1.01–2.06) and 0.97 (0.85–1.11), respectively (P interaction = .03). Similar findings were observed for hypothyroidism overall. Hypothyroidism overall vs euthyroidism was associated with greater mortality in Black participants (HR = 1.44 [95% CI = 1.03–2.03]) but not in non-Blacks (HR = 0.95 [95% CI = 0.83–1.08]) (P interaction = .03). Conclusion: Among participants with CHF, subclinical hypothyroidism and hypothyroidism overall are associated with greater death risk. Additional studies are needed to confirm findings and explore possible mechanisms for the

Selected markers of endothelial dysfunction in patients with subclinical and overt hyperthyroidism

International Nuclear Information System (INIS)

Modzelewska, A.; Szelachowska, M.; Zonenberg, A.; Abdelrazek, S.; Nikolajuk, A.; Gorska, M.

2006-01-01

Introduction: There are many factors causing endothelial dysfunction. The aim was to observe chosen markers of endothelial function in patients with subclinical and overt hyperthyroidism. Material and methods: We studied 97 patients with hyperthyroidism: 51 with subclinical (44 F/7 M; mean age 49.3 ± 15.9 y) and 46 patients with overt (39 F/7 M, mean age 50.4 ± 13.2 y). The control comprised of 39 healthy volunteers (26 F/13 M, mean age 47.5 ± 11.8 y). Concentration of TSH, FT3, FT4 were measured by MEIA, TPO Ab, TG Ab, E-selectin, interleukin 6, VCAM-1, ICAM-1 by ELISA. Results: The goiter was found in 71 persons 63F/8M, mean age 49.9 ± 15.3 y, (42-subclinical, 29-overt). Morbus Graves--Basedow was diagnosed in 26 persons, 20 F/6 M, mean age 49.5 ± 12.8 y (9-subclinical, 17-overt). There were no significant differences serum concentration of E-selectin, IL-6, ICAM-1 in patients with subclinical and overt hyperthyroidism compared to the control. Statistically significant differences were shown between concentration of IL-6 in patients with Graves-Basedow compared with the control (p < 0.05). Significance of VCAM-1 values were found in the patients with subclinical and overt hyperthyroidism compared to the control (p < 0.001; p < 0.001, respectively). Conclusions: Among persons with overt and subclinical hyperthyroidism occurs endothelial dysfunction which doesn't depends on exciting cause of thyrotoxicosis but on degree of hyperthyroidism. Elevated concentrations of endothelial markers may confirm that persons with thyroid disorders are extremely exposed to the occurrence of the cardiovascular diseases. (author)

Veganism as a cause of iodine deficient hypothyroidism.

Science.gov (United States)

Yeliosof, Olga; Silverman, Lawrence A

2018-01-26

Iodine deficiency is the most common cause of acquired hypothyroidism worldwide. Although uncommon in the Western world, the incidence of iodine deficiency may be rising due to the increased use of restrictive diets. We present a 23-month-old boy diagnosed with iodine deficiency hypothyroidism, induced by a vegan diet. This case highlights the risk for iodine deficiency in children on a vegan diet after discontinuation of breast/formula feeding that could lead to acquired hypothyroidism.

Retention interval affects visual short-term memory encoding.

Science.gov (United States)

Bankó, Eva M; Vidnyánszky, Zoltán

2010-03-01

Humans can efficiently store fine-detailed facial emotional information in visual short-term memory for several seconds. However, an unresolved question is whether the same neural mechanisms underlie high-fidelity short-term memory for emotional expressions at different retention intervals. Here we show that retention interval affects the neural processes of short-term memory encoding using a delayed facial emotion discrimination task. The early sensory P100 component of the event-related potentials (ERP) was larger in the 1-s interstimulus interval (ISI) condition than in the 6-s ISI condition, whereas the face-specific N170 component was larger in the longer ISI condition. Furthermore, the memory-related late P3b component of the ERP responses was also modulated by retention interval: it was reduced in the 1-s ISI as compared with the 6-s condition. The present findings cannot be explained based on differences in sensory processing demands or overall task difficulty because there was no difference in the stimulus information and subjects' performance between the two different ISI conditions. These results reveal that encoding processes underlying high-precision short-term memory for facial emotional expressions are modulated depending on whether information has to be stored for one or for several seconds.

Coexistence of hypothyroidism with inflammatory arthritis is associated with cardiovascular disease in women.

NARCIS (Netherlands)

Raterman, H.G.; Nielen, M.M.J.; Peters, M.J.L.; Verheij, R.A.; Nurmohamed, M.T.; Schellevis, F.G.

2012-01-01

OBJECTIVES: Hypothyroidism and inflammatory arthritis tend to coexist, but data on this association are sparse. In terms of cardiovascular risk, this association may have clinical relevance as this coexistence may carry an additional cardiovascular risk. This study calculates, first, the prevalence

Hypothyroidism after radiotherapy for head and neck cancer patients

International Nuclear Information System (INIS)

Ozawa, Hiroyuki; Saito, Hideyuki; Inagaki, Kouji; Mizutari, Kunio

2004-01-01

We report two cases of hypothyroidism with clinical symptoms that occurred after radiotherapy for cancer of the head and neck. The first patient underwent total laryngectomy without thyroidectomy for laryngeal cancer and partial gastrectomy for gastric cancer. Radiation of the neck was carried out postoperatively. Two years later, he developed chest pain and pericardial effusion was detected, leading to a diagnosis of myxedema due to hypothyroidism. The second patient received radiotherapy alone for laryngeal carcinoma. Two months later, a low serum sodium concentration and anemia were detected, both of which proved difficult to correct. The cause of these changes was found subsequently to be hypothyroidism. From the experience of these 2 cases, we measured thyroid function in 37 patients who had received neck radiation for head and neck cancers at our hospital over the past 10 years. In 13 of the 37 patients (35%), hypothyroidism was observed. The prevalence of hypothyroidism was higher in the 13 patients treated with both radiation and surgery, with 6 (46%) showing this condition, compared with 7 of the 24 patients (29%) who received radiation alone. The risk factor responsible for hypothyroidism was not evident from statistical analysis of these cases. We consider that thyroid function should be evaluated periodically in patients who have received neck radiotherapy, as it is often difficult to diagnose hypothyroidism from clinical symptoms. (author)

Both experimental hypothyroidism and hyperthyroidism increase cardiac irisin levels in rats.

Science.gov (United States)

Atici, E; Menevse, E; Baltaci, A K; Mogulkoc, R

2018-01-01

Irisin is a newly discovered myokine and adipokine that increases total body energy expenditure. The aim of this study was to determine the effect of experimental hypothyroidism and hyperthyroidism on the levels of irisin in heart tissue in rats. The study was performed on the 40 male Sprague-Dawley rats. Experimental groups were designed as; Control, Hypothyroidism, Hypothyroidism+L-Thyroxine, Hyperthyroidism and Hyperthyroidism + PTU. Following 3 weeks experimental period, irisin levels were determined in heart tissues. Hypothyroidism group values of irisin were higher than in the control group, but lower than in the hyperthyroidism group. The hyperthyroidism group had the highest levels of cardiac irisin. The results of the study showed that the experimental hypothyroidism and hyperthyroidism increased the heart irisin levels, but the increase in the hyperthyroidism group was much higher than in the hypothyroidism group. However, treatment of hypothyroidism and hyperthyroidism corrected cardiac irisin levels (Fig. 1, Ref. 28).

Radioiodine-131 treatment of thyrotoxicosis: Dose required for and some factors affecting the early induction of hypothyroidism

International Nuclear Information System (INIS)

Alevizaki, C.C.; Alevizaki-Harhalaki, M.C.; Ikkos, D.G.

1985-01-01

The results of 131 I treatment of thyrotoxicosis in 1,168 patients (302 males, 866 females; 58.5% diffuse and 41.5% multinodular toxic goitre) are presented. At the end of the 1st year post-treatment, 54.4% were hypothyroid, and the incidence of hypothyroidism after the 2nd year increased by 3% per year. When the results were analysed according to the calculated radiation dose the thyroid, it was found that the cumulative incidence of hypothyroidism from 6 months to 2 years post-treatment rose almost proportionally to the dose in cases of doses of 1,500-15,0000 rad, but increased very little for higher doses; however, the long-term incidence of hypothyroidism was almost independent of the thyroid dose. Multivariate analysis showed that the results of 131 I therapy at 6 months depended also on sex (treatment being more effective in women), the consistency of the thyroid gland and the year of treatment, with the same radiation dose giving a higher incidence of hypothyroidism in patients treated recently, in comparison to those treated in early in the period studied. Of the patients treated in the period 1978-1982 (mean dose, 300 μCi/g), 93.5% were cured with a single dose of 131 I, and 78% were hypothyroid at 6 months post-treatment. (orig.)

Radioiodine-131 treatment of thyrotoxicosis: Dose required for and some factors affecting the early induction of hypothyroidism

Energy Technology Data Exchange (ETDEWEB)

Alevizaki, C C; Alevizaki-Harhalaki, M C; Ikkos, D G

1985-05-01

The results of /sup 131/I treatment of thyrotoxicosis in 1,168 patients (302 males, 866 females; 58.5% diffuse and 41.5% multinodular toxic goitre) are presented. At the end of the 1st year post-treatment, 54.4% were hypothyroid, and the incidence of hypothyroidism after the 2nd year increased by 3% per year. When the results were analysed according to the calculated radiation dose the thyroid, it was found that the cumulative incidence of hypothyroidism from 6 months to 2 years post-treatment rose almost proportionally to the dose in cases of doses of 1,500-15,0000 rad, but increased very little for higher doses; however, the long-term incidence of hypothyroidism was almost independent of the thyroid dose. Multivariate analysis showed that the results of /sup 131/I therapy at 6 months depended also on sex (treatment being more effective in women), the consistency of the thyroid gland and the year of treatment, with the same radiation dose giving a higher incidence of hypothyroidism in patients treated recently, in comparison to those treated in early in the period studied. Of the patients treated in the period 1978-1982 (mean dose, 300 ..mu..Ci/g), 93.5% were cured with a single dose of /sup 131/I, and 78% were hypothyroid at 6 months post-treatment.

Asymptomatic myotonia congenita unmasked by severe hypothyroidism.

Science.gov (United States)

Passeri, Elena; Sansone, Valeria A; Verdelli, Chiara; Mendola, Marco; Corbetta, Sabrina

2014-04-01

Myotonia congenita is an inherited muscle disorder sustained by mutations in the skeletal muscle chloride channel gene CLCN1. Symptoms vary from mild to severe and generalized myotonia and worsen with cold, stressful events and hormonal fluctuations. Here we report the case of a young woman who sought medical attention because of subacute onset of diffuse and severe limb myotonia. CLCN1 gene sequencing showed a heterozygous transversion (T550M), two polymorphisms and one silent mutation. Thyroid function screening revealed severe hypothyroidism. She was placed on l-thyroxine replacement therapy which dramatically improved myotonia. We conclude that hypothyroidism unmasked a genetically determined, clinically asymptomatic chloride channelopathy. Diagnostic work-up in patients with clinically isolated myotonia should not be limited to genetic screening of non-dystrophic or dystrophic myotonias. Considering the high prevalence of hypothyroidism in females, systematic thyroid function screening by looking for additional hypothyroid symptoms and serum TSH levels measurement is mandatory in these patients. Copyright © 2014 Elsevier B.V. All rights reserved.

Acute compartment syndrome caused by uncontrolled hypothyroidism.

Science.gov (United States)

Modi, Anar; Amin, Hari; Salzman, Matthew; Morgan, Farah

2017-06-01

Acute compartment syndrome is increased tissue pressure exceeding perfusion pressure in a closed compartment resulting in nerve and muscle ischemia. Common precipitating causes are crush injuries, burns, substance abuse, osseous or vascular limb trauma. This is a case of 42year old female with history of hypothyroidism who presented to emergency room with acute onset of severe pain and swelling in right lower extremity. Physical examination was concerning for acute compartment syndrome of right leg which was confirmed by demonstration of elevated compartmental pressures. No precipitating causes were readily identified. Further laboratory testing revealed uncontrolled hypothyroidism. Management included emergent fasciotomy and initiating thyroid hormone replacement. This case represents a rare association between acute compartment syndrome and uncontrolled hypothyroidism. We also discuss the pathogenesis of compartment syndrome in hypothyroid patients and emphasize the importance of evaluating for less common causes, particularly in setting of non-traumatic compartment syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison of Sugammadex and Neostigmine in Short Term Surgery

Directory of Open Access Journals (Sweden)

Fatih Koc

2014-03-01

Full Text Available Aim: This study compared the efficacy and cost effectivines of sugammadex and neostigmine for reversal of neuromuscular blockade induced by rocuronium for short term elective surgery. Material and Method: After written informed consent, 33 patients aged 18%u201365, ASA I-III, who were undergoing short term surgery (

Short-term memory for scenes with affective content

OpenAIRE

Maljkovic, Vera; Martini, Paolo

2005-01-01

The emotional content of visual images can be parameterized along two dimensions: valence (pleasantness) and arousal (intensity of emotion). In this study we ask how these distinct emotional dimensions affect the short-term memory of human observers viewing a rapid stream of images and trying to remember their content. We show that valence and arousal modulate short-term memory as independent factors. Arousal influences dramatically the average speed of data accumulation in memory: Higher aro...

When canary primes yellow: effects of semantic memory on overt attention.

Science.gov (United States)

Léger, Laure; Chauvet, Elodie

2015-02-01

This study explored how overt attention is influenced by the colour that is primed when a target word is read during a lexical visual search task. Prior studies have shown that attention can be influenced by conceptual or perceptual overlap between a target word and distractor pictures: attention is attracted to pictures that have the same form (rope--snake) or colour (green--frog) as the spoken target word or is drawn to an object from the same category as the spoken target word (trumpet--piano). The hypothesis for this study was that attention should be attracted to words displayed in the colour that is primed by reading a target word (for example, yellow for canary). An experiment was conducted in which participants' eye movements were recorded whilst they completed a lexical visual search task. The primary finding was that participants' eye movements were mainly directed towards words displayed in the colour primed by reading the target word, even though this colour was not relevant to completing the visual search task. This result is discussed in terms of top-down guidance of overt attention in visual search for words.

Prognostic Role of Hypothyroidism in Heart Failure: A Meta-Analysis.

Science.gov (United States)

Ning, Ning; Gao, Dengfeng; Triggiani, Vincenzo; Iacoviello, Massimo; Mitchell, Judith E; Ma, Rui; Zhang, Yan; Kou, Huijuan

2015-07-01

Hypothyroidism is a risk factor of heart failure (HF) in the general population. However, the relationship between hypothyroidism and clinical outcomes in patients with established HF is still inconclusive.We conducted a systematic review and meta-analysis to clarify the association of hypothyroidism and all-cause mortality as well as cardiac death and/or hospitalization in patients with HF. We searched MEDLINE via PubMed, EMBASE, and Scopus databases for studies of hypothyroidism and clinical outcomes in patients with HF published up to the end of January 2015. Random-effects models were used to estimate summary relative risk (RR) statistics. We included 13 articles that reported RR estimates and 95% confidence intervals (95% CIs) for hypothyroidism with outcomes in patients with HF. For the association of hypothyroidism with all-cause mortality and with cardiac death and/or hospitalization, the pooled RR was 1.44 (95% CI: 1.29-1.61) and 1.37 (95% CI: 1.22-1.55), respectively. However, the association disappeared on adjustment for B-type natriuretic protein level (RR 1.17, 95% CI: 0.90-1.52) and in studies of patients with mean age hypothyroidism associated with increased all-cause mortality as well as cardiac death and/or hospitalization in patients with HF. Further diagnostic and therapeutic procedures for hypothyroidism may be needed for patients with HF.

Photobiomodulation laser improves the early repair process of hypothyroid rats

Science.gov (United States)

Uzêda e Silva, V. D.; Rodriguez, T. T.; Xavier, F. C. A.; dos Santos, J. N.; Vasconcelos, R. M.; Ramalho, L. M. P.

2018-04-01

Delay in wound healing has been observed in the hypothyroidism disfunction. Laser light can modulate various biological phenomena acting on different cell types. However, there are few reports in the literature regarding the effects of laser on wound healing of hypothyroid models. This study aimed to evaluate the differences in reepithelialization process of cutaneous wounds on hypothyroid and euthyroid rats treated with laser phototherapy. Forty-eight rats were divided into two main groups: euthyroid (EU) and hypothyroid (HYPO). Hypothyroidism was induced by Thyroidectomy. Each group was divided into subgroups: control (without laser) and laser groups. Standard surgical wound was created on the dorsum of each rat. The irradiation protocols (λ660 nm, 40 mW, CW; 10 J/cm2) was carried out immediately after wounding and repeated every 24h during 3 and 7 days. After animal death, specimens were taken, routinely processed, cut, stained with hematoxylin-eosin, and underwent histological analysis. Three days after the surgery, it was possible to observe initial reepithelialization in more advanced stages in the wound area of the irradiated hypothyroid group when compared to control hypothyroid group (p<0.05). No significant difference was found in the experimental period of 7 days among the groups. It was concluded that the laser light did influence reepithelialization process on hypothyroid rats in early stages of healing process.

LANGUAGE REPETITION AND SHORT-TERM MEMORY: AN INTEGRATIVE FRAMEWORK

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Steve eMajerus

2013-07-01

Full Text Available Short-term maintenance of verbal information is a core factor of language repetition, especially when reproducing multiple or unfamiliar stimuli. Many models of language processing locate the verbal short-term maintenance function in the left posterior superior temporo-parietal area and its connections with the inferior frontal gyrus. However, research in the field of short-term memory has implicated bilateral fronto-parietal networks, involved in attention and serial order processing, as being critical for the maintenance and reproduction of verbal sequences. We present here an integrative framework aimed at bridging research in the language processing and short-term memory fields. This framework considers verbal short-term maintenance as an emergent function resulting from synchronized and integrated activation in dorsal and ventral language processing networks as well as fronto-parietal attention and serial order processing networks. To-be-maintained item representations are temporarily activated in the dorsal and ventral language processing networks, novel phoneme and word serial order information is proposed to be maintained via a right fronto-parietal serial order processing network, and activation in these different networks is proposed to be coordinated and maintained via a left fronto-parietal attention processing network. This framework provides new perspectives for our understanding of information maintenance at the nonword-, word- and sentence-level as well as of verbal maintenance deficits in case of brain injury.

Language repetition and short-term memory: an integrative framework.

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Majerus, Steve

2013-01-01

Short-term maintenance of verbal information is a core factor of language repetition, especially when reproducing multiple or unfamiliar stimuli. Many models of language processing locate the verbal short-term maintenance function in the left posterior superior temporo-parietal area and its connections with the inferior frontal gyrus. However, research in the field of short-term memory has implicated bilateral fronto-parietal networks, involved in attention and serial order processing, as being critical for the maintenance and reproduction of verbal sequences. We present here an integrative framework aimed at bridging research in the language processing and short-term memory fields. This framework considers verbal short-term maintenance as an emergent function resulting from synchronized and integrated activation in dorsal and ventral language processing networks as well as fronto-parietal attention and serial order processing networks. To-be-maintained item representations are temporarily activated in the dorsal and ventral language processing networks, novel phoneme and word serial order information is proposed to be maintained via a right fronto-parietal serial order processing network, and activation in these different networks is proposed to be coordinated and maintained via a left fronto-parietal attention processing network. This framework provides new perspectives for our understanding of information maintenance at the non-word-, word- and sentence-level as well as of verbal maintenance deficits in case of brain injury.

Short-horizon regulation for long-term investors

NARCIS (Netherlands)

Shi, Z.; Werker, B.J.M.

2012-01-01

We study the effects of imposing repeated short-horizon regulatory constraints on long-term investors. We show that Value-at-Risk and Expected Shortfall constraints, when imposed dynamically, lead to similar optimal portfolios and wealth distributions. We also show that, in utility terms, the costs

Motor Neuropathy in Hypothyroidism: Clinical and Electrophysiological Findings

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Sabina Yeasmin

2009-11-01

Full Text Available Background: Hypothyroidism is a clinical condition associated with low levels of thyroid hormones with raised TSH. Peripheral neuropathy may be associated with hypothyroidism which usually develops insidiously over a long period of time due to irregular taking of drugs or lack of thyroid hormone replacement. Objectives: The present study was done to evaluate the clinical and electro-physiological findings in hypothyroid patients in order to evaluate the neuromuscular dysfunction as well as motor neuropathy. Method: In this study, 70 subjects with the age range from 20 to 50 years of both sexes were included of whom 40 hypothyroids were taken in study group (B with the duration of 6 months to 5 years and 30 healthy euthyroid subjects were taken as control (Group A. On the basis of their TSH level, group B was further divided into group B1 with TSH level <60 MIU /L (less severe and group B2 with TSH >60 MIU /L (severe group. The d latency and NCV for motor nerve function were measured by NCV machine in median and ulnar nerve for upper limb and in common peroneal nerve for lower limb. TT3, TT4 were measured by RIA and TSH by IRMA method. All these parameters were measured on the day 1 (one of their first visit. Data were analysed statistically by ANOVA and Z test. Result: Both TT3, TT4 levels were significantly (P<0.01 lower in hypothyroids in comparison to those of control. Diminished or absence of most of the deep tendon reflexes were found in all the hypothyroids. Most of the patients (67.5% showed significantly higher (P <0.01 motor distal latencies (MDL with lower (P> 0.001 conduction velocities (MNCV and all these changes were more marked in group B2. Conclusion: So, the study revealed that motor neuropathy may be a consequence of hypothyroidism.DOI: 10.3329/bsmmuj.v1i1.3692 Key Words: Hypothyroidism; neuropathy; electrophysiology BSMMU J 2008; 1(1: 15-18

Diagnosis and Management of Subclinical Hypothyroidism in Elderly Adults: A Review of the Literature.

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Hennessey, James V; Espaillat, Ramon

2015-08-01

The estimated prevalence of subclinical hypothyroidism (SCH) in the general population is 3% to 8%. As the average age of the population in the United States and other countries continues to increase, the overall prevalence of SCH may also be expected to increase. Although age-related changes in thyroid function are well described, normal thyroid-stimulating hormone (TSH) reference limits, derived for age-specific populations, are not routinely used to identify thyroid dysfunction in elderly adults. Therefore, currently accepted values for the upper limit of normal of TSH may be inappropriate for diagnosing SCH in individuals aged 65 and older, resulting in potential overestimation of the prevalence of SCH in this population. This review discusses the current evidence of the effects of SCH on cardiovascular health and neuropsychiatric function in older adults. Although the results of some studies are conflicting, the overall evidence suggests that the consequences of SCH may be different for elderly adults than for younger populations. Treatment of SCH in older individuals requires special consideration with regard to thyroid hormone replacement therapy and expected clinical outcomes. Although careful identification of individuals with persistent SCH who could benefit from levothyroxine treatment is necessary, current evidence suggests that individuals with TSH levels greater than 10 mIU/L who test positive for antithyroid antibodies or are symptomatic may benefit from levothyroxine treatment to reduce the risk of progression to overt hypothyroidism, decrease the risk of adverse cardiovascular events, and improve their quality of life. After treatment is initiated, careful monitoring is essential. © 2015, The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Effects of perinatal hypothyroidism in the carbohydrate composition of cochlear tectorial membrane.

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Gil-Loyzaga, P; Bueno, A M; Broto, J P; Pérez, A M

1990-04-01

The presence of carbohydrates in the cochlear tectorial membrane (TM) of normal and hypothyroid rats was analyzed using fluorescent lectin probes. SBA and WGA lectins exhibited a similar reactivity in both normal and hypothyroid TMs. DBA, RCA1, UEA1 and Con A lectins were also reactive, although they showed a different distribution pattern between normal and hypothyroid TMs. Lastly, one of the lectins, PNA, was only labeled in hypothyroid TMs. These findings suggest that carbohydrate chains containing residues of N-acetyl-D-galactosamine (GalNAc) and N-acetyl-D-glucosamine, are similarly distributed in normal and hypothyroid TMs. Other carbohydrate residues as GalNAc alpha 1,3 GalNAc, D-galactose (Gal), L-fucose and D-mannose, are present, but are abnormally distributed in hypothyroid TMs. The Gal beta 1,3GalNAc residues, recognized by PNA, could be present only in the hypothyroid TMs. Alterations in glycosylation of the glycoproteins in the hypothyroid TM could be responsible for the abnormal distribution pattern of carbohydrate residues here described, and for the distorted shape of the hypothyroid TM.