scholarly journals Subclinical hypothyroidism or isolated high TSH in hospitalized patients with chronic heart-failure and chronic renal-failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amir Bashkin ◽  
Wagde Abu Saleh ◽  
Mona Shehadeh ◽  
Lea Even ◽  
Ohad Ronen
Keyword(s):  
Heart Failure ◽  
Renal Failure ◽  
Retrospective Study ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Low Dose ◽  
Hospitalized Patients ◽  
Inclusion Criteria ◽  
And Gender ◽  
Levothyroxine Treatment

AbstractSub-clinical hypothyroidism (SCH) is common in heart failure (HF) and advanced renal failure (RF), but it is unclear whether there is a thyroid disease or a transient increase in TSH level. This is a retrospective study of hospitalized patients in medical departments. All patients with SCH and a TSH level up to less than 12 mIU/L were identified. Those who had at least one recurring admission within at least 6 months were included. A change in thyroid function during the last re-admission was determined and classified as an improvement, no change, or worsening of thyroid function. Overall, 126 cases of SCH met the inclusion criteria for re-admission. Analysis of the most recent hospitalization showed that in 100 (79.4%) patients thyroid function improved, in 15 (11.9%) patients thyroid function remained unchanged and only in 11 (8.7%) patients did thyroid function worsen. In most cases, worsening of hypothyroidism was determined by initiation of a low dose levothyroxine treatment. Of the 126 participants, 43 (34.1%) and 22 (17.5%) had a diagnosis of HF and RF (CKD stages 4 and 5), respectively. There was no association between HF or advanced RF and worsening of SCH. No association was found between worsening of hypothyroidism and gender, age, TSH, or creatinine levels in the first hospitalization. A borderline association between elevated CRP levels at first hospitalization and hypothyroidism worsening was found (p = 0.066). Mildly elevated TSH in hospitalized patients with HF and advanced RF is transient and most probably not related to thyroid disease and not associated with age or gender.

scholarly journals SUN-409 Subclinical Hypothyroidism in Hospitalized Patients with Chronic Heart-Failure or Chronic Renal-Failure Is Most Probably Not Due to Thyroid Disease

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Amir Bashkin ◽  
Wagde Abu Saleh ◽  
Ohad Ronen
Keyword(s):  
Heart Failure ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Chronic Heart Failure ◽  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Thyroid Disease ◽  
Final Analysis ◽  
Hospitalized Patients ◽  
Normal Range

Abstract Introduction: Subclinical hypothyroidism is common in chronic diseases such as heart failure and advanced chronic renal failure. It is unclear whether this is a thyroid disease or an isolated TSH elevation. The goal of this study was to investigate the prevalence of worsening thyroid function in these patients with recurrent admissions. Methods: We performed a retrospective review of medical records of hospitalized patients in non-surgical wards from 2013–2016. First, all patients with TSH levels above the normal range (4.95 mIU/L) and up to 12 mIU/L with FT4 levels in the normal range were identified. We then investigated which of these patients were re-hospitalized at least once within at least six months. According to data from the re-hospitalization, an increase in TSH level above 12 mIU/L or initiation of levothyroxine treatment was defined as worsening of thyroid function. Patients treated with a drug affecting thyroid function or with a known thyroid disease prior to first hospitalization were excluded from the study. Chronic heart failure and chronic renal failure were determined according to reported diagnosis and drug treatment. Chronic renal failure patients were included if the glomerular filtration rate (GFR) in the first hospitalization was below 30 ml/min/1.72 square meter. Results: Overall, 90,199 TSH tests were sent from the non-surgical wards, most of them as part of the admissions profile. Of these, 2,116 hospitalizations met the inclusion criteria of the first hospitalization. In the final analysis, 126 inpatients with at least one re-hospitalization were included, of whom 43 (34.1%) had chronic heart failure and 22 (17.5%) had chronic renal failure. According to the most recent re-hospitalization, thyroid function was worse in 11(8.7%), 4 (9.3%) and 2 (9.1%) patients of the total, heart failure and renal failure groups respectively. The TSH level was found to be normal in re-hospitalization in 81.4% of those with heart failure and 86.4% of those with renal-failure. No association between heart failure or renal-failure and thyroid function worsening was found (p = 1.00 for both). Of 34 patients with chronic heart failure re-hospitalized after 1/2-1 year, in 29 (85.3%) the repeated TSH was normal, in 3 (8.8%) it was unchanged and in 2 (5.9%) it was worse. In most re-hospitalization the worsening was due to initiation of Levothyroxin treatment and because of the retrospective nature of the study we cannot be sure whether the initiation was justified; therefore, it is likely that the worsening percentage is even lower. Conclusions: An isolated TSH elevation in hospitalized patients with past medical history of chronic heart-failure or chronic renal failure does not indicate thyroid disease, in most cases.

scholarly journals Expected ages in the patients of chronic diseases

2016 ◽  
Vol 10 (4) ◽  
Author(s):  
Intesaruk Rashid Khan ◽  
Ahmed Imran Siddiqui ◽  
Wafa Aftab
Keyword(s):  
Heart Failure ◽  
Renal Failure ◽  
Retrospective Study ◽  
Chronic Disease ◽  
Chronic Renal Failure ◽  
Hepatic Cirrhosis ◽  
Disease Process ◽  
Chronic Illnesses ◽  
The Body ◽  
Medical Wards

This retrospective study was conducted to find out the expected ages in the patients of hepatic cirrhosis, chronic renal failure and heart failure. This study thus covers most of the patients of out medical wards presenting with chronic illnesses. On comparison of these expected ages it is also found that the expected age in all these three groups is not much different. So, the disease process or the mechanism of the chronic disease in the body may be different, but somehow the final out come is not much different in terms of life span.

scholarly journals Association of Thyroid Function with Suicidal Behavior: A Systematic Review and Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 714
Author(s):  
Freddy J. K. Toloza ◽  
Yuanjie Mao ◽  
Lakshmi Menon ◽  
Gemy George ◽  
Madhura Borikar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Thyroid Function ◽  
Suicidal Behavior ◽  
Thyroid Disease ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Thyroid Function Tests ◽  
Inclusion Criteria ◽  
Free Triiodothyronine ◽  
Suicide Behavior

Thyroid disease is a very common condition that influences the entire human body, including cognitive function and mental health. As a result, thyroid disease has been associated with multiple neuropsychiatric conditions. However, the relationship between thyroid dysfunction and suicide is still controversial. We conducted a systematic review and meta-analysis to describe the association of thyroid function with suicidal behavior in adults. We searched four data bases (MEDLINE, EMBASE, PsycINFO, and Scopus) from their inception to 20 July 2018. Studies that reported mean values and standard deviation (SD) of thyroid hormone levels [Thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3)] in patients with suicidal behavior compared with controls were included in this meta-analysis. The abstracts and papers retrieved with our search strategies were reviewed independently and in duplicate by four reviewers for assessment of inclusion criteria and data extraction, as well as for evaluation of risk of bias. Random-effects models were used in this meta-analysis to establish the mean difference on thyroid function tests between groups. Overall, 2278 articles were identified, and 13 studies met the inclusion criteria. These studies involved 2807 participants, including 826 participants identified with suicidal behavior. We found that patients with suicide behavior had lower levels of FT3 (−0.20 pg/mL; p = 0.02) and TT4 (−0.23 µg/dL; p = 0.045) compared to controls. We found no differences in either TSH, FT4, or TT3 levels among groups. With our search strategy, we did not identify studies with a comparison of overt/subclinical thyroid disease prevalence between patients with and without suicide behavior. The studies included in this meta-analysis had a low-to-moderate risk of bias. In the available literature, the evidence regarding the association of thyroid disorders and suicidal behavior is limited. We found that patients with suicidal behavior have significantly lower mean FT3 and TT4 levels when compared to patients without suicidal behavior. The clinical implications and pathophysiologic mechanisms of these differences remain unknown and further research is needed.

scholarly journals Do urine heteroplasmy rates predict the outcome of the m.3243A>G mutation?

2018 ◽  
Vol 1 (09) ◽  
pp. 40-41
Author(s):  
Josef Finsterer, MD, PhD ◽  
Fulvio A. Scorza, MD
Keyword(s):  
Heart Failure ◽  
Renal Failure ◽  
Retrospective Study ◽  
Status Epilepticus ◽  
Adverse Events ◽  
Clinical Manifestations ◽  
Major Adverse Events

In a recent study, Fayssoil et al. investigated the relation between serum/urine heteroplasmy rates and clinical manifestations at onset and major adverse events (MAE) during follow-up in a retrospective study of 43 patients carrying the m.3243A>G mutation1 MAE included strokelike episodes (SLEs), status epilepticus, heart failure, renal failure, and intestinal pseudo-obstruction1 We want to add some comments and concerns.

scholarly journals Low-dose nitroglycerin improves microcirculation in hospitalized patients with acute heart failure

2009 ◽  
Vol 11 (4) ◽  
pp. 386-390 ◽  
Author(s):  
Corstiaan A. den Uil ◽  
Wim K. Lagrand ◽  
Peter E. Spronk ◽  
Martin van der Ent ◽  
Lucia S.D. Jewbali ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Low Dose ◽  
Hospitalized Patients

scholarly journals Low-dose nitroglycerin improves microcirculation in hospitalized patients with acute heart failure

Critical Care ◽  
2009 ◽  
Vol 13 (Suppl 1) ◽  
pp. P178
Author(s):  
CA Den Uil ◽  
WK Lagrand ◽  
PE Spronk ◽  
M Ent ◽  
L Jewbali ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Low Dose ◽  
Hospitalized Patients
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