Mainly the younger hypothyroid patients are referred to hospital — Evidence for referral bias

Objectives: This present study was to compare the serum electrolytes (Na, K and Cl) imbalances in hypothyroidism, hyperthyroidism with euthyroidism female cases. Methods: A detail history, clinical examinations and relevant investigations were performed to all female thyroid cases. Thyroid hormones were estimated by chemiluminiscence method using Siemens Advia Centaur XP instrument. Electrolyte levels (Na+, k+ & Cl-) were measured by ion selective electrode method using Eschweiler combi. Results: Data was analyzed with the help of SPSS (version 26) software. Paired samples statistics was used. Mean ± standard deviation and t value were calculated. P value was taken less than or equal to 0.05 (p ≤ 0.05) for significant differences. Conclusions: This present study concluded that electrolytes sodium, potassium and chloride levels were significantly reduced in hypothyroidism female cases compared to euthyroids female (controls). This suggests that hypothyroid patients should be regularly checked for serum electrolytes. Early detection and treatment can prevent the further complications related to the disorder and will be helpful during the management of thyroid patients. Key words: Hypothyroidism, hyperthyroidism, euthyroidism, electrolytes.

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EVALUATION OF A SIMPLIFIED METHOD FOR DETERMINING SERUM THYROXINE BY COMPETITIVE PROTEIN BINDING ANALYSIS

Acta Endocrinologica ◽

10.1530/acta.0.0640630 ◽

1970 ◽

Vol 64 (4) ◽

pp. 630-636 ◽

Cited By ~ 8

Author(s):

Stephen C. Thorson ◽

Ronald Tsujikawa ◽

James L. Brown ◽

Robert T. Morrison ◽

Hamish W. McIntosh

Keyword(s):

Protein Binding ◽

Clinical Application ◽

Thyroid Status ◽

Serum Thyroxine ◽

Binding Analysis ◽

Simplified Method ◽

Competitive Protein Binding ◽

Hypothyroid Patients

ABSTRACT Serum thyroxine concentrations were determined in 66 euthyroid, 30 hyperthyroid and 13 hypothyroid patients using both the established Murphy method and a simplified method of competitive protein binding analysis. A diagnosis compatibility of 96% was found with both methods indicating that the simplified method has comparable clinical application as an initial screen of thyroid status.

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Level of awareness in hypothyroid patients

Endocrine Abstracts ◽

10.1530/endoabs.56.p1042 ◽

2018 ◽

Author(s):

Nilgun Sesen Oncul ◽

Mine Adas

Keyword(s):

Hypothyroid Patients

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Effect of TSH suppression therapy on serum minerals in newly diagnosed hypothyroid patients.

International Journal of Pharmaceutical Research ◽

10.31838/ijpr/2019.11.04.202 ◽

2019 ◽

Vol 11 (04) ◽

Keyword(s):

Newly Diagnosed ◽

Tsh Suppression ◽

Serum Minerals ◽

Tsh Suppression Therapy ◽

Hypothyroid Patients

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Linear modulation of serum thyrotrophin by thyroid hormone treatment in hypothyroidism

Acta Endocrinologica ◽

10.1530/acta.0.0950472 ◽

1980 ◽

Vol 95 (4) ◽

pp. 472-478 ◽

Cited By ~ 6

Author(s):

A. Eugene Pekary ◽

Jerome M. Hershman ◽

Clark T. Sawin

Keyword(s):

Thyroid Hormone ◽

Hormone Replacement ◽

Hormone Treatment ◽

Significant Negative Correlation ◽

Thyroid Hormone Replacement ◽

Basal Serum ◽

Thyroid Hormone Levels ◽

Peak Versus ◽

Hypothyroid Patients ◽

Serum Tsh

Abstract. Basal serum TSH and the peak TSH response to a 500 μg TRH bolus were measured in 57 euthyroid and in 29 hypothyroid subjects either receiving graded thyroid hormone replacement or acutely removed from full replacement therapy. Serum TSH, total T4 and T3 were determined by sensitive radioimmunoassay methods. The peak versus basal TSH data for hypothyroid patients were linear within individuals. The regression slope of the peak versus basal TSH data for all hypothyroid subjects did not differ significantly from the corresponding slope for all euthyroid subjects. Basal and peak TSH versus T3 and T4 data for hypothyroid patients were also linear within each individual. Moreover, the regression of the basal TSH values averaged over the non-replacement to full replacement state against the TSH versus T3 slope had a significant negative correlation. This trend leads to an array of regression lines which average to the familiar hyperbolic relationship between thyrotrophin and thyroid hormone levels in man.

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Health system wide “big data” analysis of rheumatologic conditions and scleritis

BMC Ophthalmology ◽

10.1186/s12886-020-01769-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Meghan K. Berkenstock ◽

Andrew R. Carey

Keyword(s):

Relative Risk ◽

Health System ◽

Systemic Disease ◽

Autoimmune Disorder ◽

Future Research ◽

Inflammatory Conditions ◽

Autoimmune Conditions ◽

Icd 10 ◽

Autoimmune Condition ◽

Referral Bias

Abstract Background The development of scleritis in the setting of autoimmune conditions has been well documented. Prior series have assessed the relationship between systemic autoimmune disorders and scleritis only in patients referred for rheumatologic or ocular inflammation. This can lead to a referral bias. We reviewed all charts within the electronic medical record (EMR) of a health system for patients with systemic autoimmune and scleritis diagnoses to determine the prevalence of both and which disorders had the highest relative risk of developing scleritis. Methods The EMR was searched for scleritis and systemic inflammatory diagnoses in the past medical history and diagnosis tabs, and for associated disease specific laboratory values. The intersection of scleritis and systemic inflammatory conditions was assessed through searching both SNOMED Clinical Terminology and ICD-10 codes for diagnoses. The prevalence of each autoimmune disorder, scleritis prevalence, the percentage of patients with an autoimmune condition having scleritis, the percentage of patients with scleritis having an autoimmune condition; the relative risk (RR) of scleritis patients having a specific autoimmune disorder were calculated. Results A total of 5.9 million charts were searched with autoimmune conditions identified in 148,993 patients. The most common autoimmune conditions overall were HLA-B27-associated diseases (n = 26,680; prevalence 0.45%); rheumatoid arthritis (RA)(N = 19,923; prevalence 0.34%). Conversely, 2702 patients were identified with scleritis (prevalence 0.05%), of which 31.4% had an associated autoimmune condition. Patients with RA represented the highest percentage of patients with an autoimmune condition having scleritis. Granulomatosis with polyangiitis (GPA) represented the highest the percentage of patients with scleritis having an autoimmune condition. Sjogrens was the third most common condition associated with scleritis- making up 4.5% of cases. An association with juvenile idiopathic arthritis (JIA) was seen in 0.3% of patients. Conclusions While this is the largest retrospective review examining the association between autoimmune disease and scleritis, the findings are similar to prior studies with nearly a third of scleritis patients having an underlying autoimmune diagnosis. Limitations of the study included accurate chart coding; having laboratory results within the searchable EMR. Future research is needed to delineate associations of systemic disease with the anatomic location of scleritis using EMR.

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Evaluation of autonomic functions in subclinical hypothyroid and hypothyroid patients

Indian Journal of Endocrinology and Metabolism ◽

10.4103/2230-8210.111642 ◽

2013 ◽

Vol 17 (3) ◽

pp. 460 ◽

Cited By ~ 6

Author(s):

AartiS Mahajan ◽

Veena Chowdhury ◽

DineshK Dhanwal ◽

AjayK Jain ◽

Ram Lal

Keyword(s):

Autonomic Functions ◽

Hypothyroid Patients

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Evaluation of free and total L-thyroxine in serum by a commercial procedure.

Clinical Chemistry ◽

10.1093/clinchem/27.1.149 ◽

1981 ◽

Vol 27 (1) ◽

pp. 149-152 ◽

Cited By ~ 3

Author(s):

M J Obregon ◽

A Kurtz ◽

R Ekins ◽

G Morreale de Escobar

Keyword(s):

Pregnant Women ◽

Plasma Proteins ◽

Diagnostic Value ◽

Free Thyroxine ◽

Total Thyroxine ◽

Dialysis Method ◽

Hypothyroid Patients ◽

Hyperthyroid Patients ◽

Normal Controls

Abstract We assessed a commercial kit (Corning Medical) for "free" and total thyroxine determination, results being compared to those obtained by the Ekins and Ellis dialysis method (free thyroxine) and the method of Weeke and Orskov (total thyroxine). The kit procedure permits determination of both free and total thyroxine within 4 to 5 h, and the combined results may disclose changes in binding to plasma proteins that would be missed if only free thyroxine were determined. With both free-thyroxine methods, the values distinguished hyperthyroid patients from normal controls and pregnant women with 100% accuracy, but there was some overlap between hypothyroid patients and controls. Absolute values with the kit procedure often exceed those obtained by dialysis, especially for hypothyroid patients and pregnant women. We conclude that the kit may be of as much diagnostic value as the dialysis method if the limitations regarding absolute values are kept in mind and the test is not used as a substitute for thyrotropin determinations in cases of suspected hypothyroidism.

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Comparing Glioblastoma Surgery Decisions Between Teams Using Brain Maps of Tumor Locations, Biopsies, and Resections

JCO Clinical Cancer Informatics ◽

10.1200/cci.18.00089 ◽

2019 ◽

pp. 1-12 ◽

Cited By ~ 8

Author(s):

Domenique M.J. Müller ◽

Pierre A.J.T. Robe ◽

Roelant S. Eijgelaar ◽

Marnix G. Witte ◽

Martin Visser ◽

...

Keyword(s):

Tumor Location ◽

Three Dimensions ◽

Multidisciplinary Teams ◽

Surgical Removal ◽

Treatment Variation ◽

Probability Maps ◽

Resected Patient ◽

The Right ◽

Referral Bias ◽

The Brain

Purpose The aim of glioblastoma surgery is to maximize the extent of resection while preserving functional integrity, which depends on the location within the brain. A standard to compare these decisions is lacking. We present a volumetric voxel-wise method for direct comparison between two multidisciplinary teams of glioblastoma surgery decisions throughout the brain. Methods Adults undergoing first-time glioblastoma surgery from 2012 to 2013 performed by two neuro-oncologic teams were included. Patients had had a diagnostic biopsy or resection. Preoperative tumors and postoperative residues were segmented on magnetic resonance imaging in three dimensions and registered to standard brain space. Voxel-wise probability maps of tumor location, biopsy, and resection were constructed for each team to compare patient referral bias, indication variation, and treatment variation. To evaluate the quality of care, subgroups of differentially resected brain regions were analyzed for survival and functional outcome. Results One team included 101 patients, and the other included 174; 91 tumors were biopsied, and 181 were resected. Patient characteristics were largely comparable between teams. Distributions of tumor locations were dissimilar, suggesting referral bias. Distributions of biopsies were similar, suggesting absence of indication variation. Differentially resected regions were identified in the anterior limb of the right internal capsule and the right caudate nucleus, indicating treatment variation. Patients with (n = 12) and without (n = 6) surgical removal in these regions had similar overall survival and similar permanent neurologic deficits. Conclusion Probability maps of tumor location, biopsy, and resection provide additional information that can inform surgical decision making across multidisciplinary teams for patients with glioblastoma.

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