Immunogenic and Non-Immunogenic Hyperthyroidism

1995 ◽  
Vol 34 (03) ◽  
pp. 92-99 ◽  
Author(s):  
Maria Listewnik ◽  
H. Rosier ◽  
Elisabeth Bartkowiak ◽  
Claudine Als

SummaryAnnual occurrences of immunogenic (IH) and non-immunogenic hyperthyroidism (NIH) between Berne (1976, 1982, 1991) and Szczecin (1973, 1980, 1991) were compared. Out of 21,025 patients referred for thyroid examinations, 10.1% (average) were hyperthyroid. In Berne (former endemic goiter region) and Szczecin (without goiter endemicity) IH occurred in 41% and 68%, NIH in 59% and 32% of hyperthyroid patients, respectively. Within a stable incidence of NIH in Berne, toxic adenomas (TA) decreased from 41% (1976) to 17% (1991) (p <0.005). In Szczecin, where iodine deficiency is in an early stage, the TA frequency did not change significantly: from 24% (1973) to 28% (1991). Increases of TA or of multifocal functional autonomy apparently “mark” incipient or, respectively, decreasing deficiencies in nutritious iodine. Hyperthyroid patients in Berne compared to Szczecin were older, both with IH (54 versus 45 y) and NIH (65 versus 52 y). Age at diagnosis was stable in Berne but increasing (p <0.05) in Szczecin (from 43 to 52 y).

1993 ◽  
Vol 129 (6) ◽  
pp. 497-500 ◽  
Author(s):  
F Aghini-Lombardi ◽  
A Pinchera ◽  
L Antonangeli ◽  
T Rago ◽  
GF Fenzi ◽  
...  

It is well established that iodine supplementation is effective in correcting iodine deficiency and reducing goiter prevalence. In Italy, legislation has allowed the production of iodized salt since 1972, but its consumption is on a voluntary basis. In the present study, the efficacy of legislative measures that made compulsory the availability of iodized salt in foodstores has been evaluated. Urinary iodine excretion and thyroid size, scored according to Pan American Health Organization recommendations, were determined prior to (1981) and 10 years after (1991) the introduction of legislative measures in the whole schoolchildren population residing in a restricted area of the Tuscan Appennines. Moreover, in 1991, thyroid volume was determined by ultrasonography. In 1981, mean urinary iodine excretion was 47.1±22.4 mg/kg creatinine (0.412 μmol/l) and goiter prevalence was 60%, indicating a moderate iodine deficiency. Eighty of the families subsequently used iodized salt on a regular basis; as a result of this excellent compliance, in 1991 the mean urinary iodine excretion increased to 129.7±73 mg/kg creatinine (1.24 μmol/l) and goiter prevalence dropped to 8.1%. The results of this study underline the effectiveness of iodine prophylaxis in correcting iodine deficiency and abating endemic goiter in schoolchildren, and suggest that implementation of measures that make compulsory the availability of iodized salt in foodstores overcomes the fact that there is no law governing the exclusive production and trading of iodized salt.


2012 ◽  
Vol 99 (6) ◽  
pp. 813-820 ◽  
Author(s):  
W. van de Water ◽  
E. Bastiaannet ◽  
O. M. Dekkers ◽  
A. J. M. de Craen ◽  
R. G. J. Westendorp ◽  
...  

1997 ◽  
Vol 43 (4) ◽  
pp. 3-6
Author(s):  
E. P. Kasatkina ◽  
D. E. Shilin ◽  
G. V. Ibragimova ◽  
M. I. Pykov ◽  
G. A. Ryumin ◽  
...  

The incidence of endemic goiter in the Orel district of Russia has been studied in order to assess the informative value of the new WHO classification for identification of iodine deficiencies (1994). A total of 2103 children living in three rural regions, two of which were polluted with low-dose radiation after the Chernobyl accident, have been examined in 1992-1996. The incidence of goiter and thyroid dysfunction in the newborns corresponded to grave endemia, and the median of blood thyroglobulin was moderately increased in the region with the highest pollution (5 to 15 Ci/km2 for 127Cs), characterized by a slight iodine deficiency. In a less contaminated region (1 to 5 Ci/km2) with a similar level of iodine deficiency, incidence of goiter, and median of blood thyroglobulin the incidence of thyroid dysfunction in the newborns was moderate. In a pure region, despite a more evident iodine deficit and a compatible increase of the median of blood thyroglobulin, the incidence of endemic goiter and thyroid dysfunction of the newborns was the minimal. Hence, the values of the analyzed iodine deficit indicators did not correlate with the actual iodine deficiency in all the regions examined. These differences suggest a possible contribution of strumogenic factors other than iodine deficit to the formation of goiter endemia in the examined district. The detection of these factors in the environment is needed for objective evaluation of the causes and severity of the endemic process and for the development of differentiated approaches to the prevention and treatment of thyroid abnormalities in the population exposed to radiation.


2001 ◽  
Vol 82 (5) ◽  
pp. 377-377
Author(s):  
Z. M. Zakirov ◽  
R. M. Kharisova

Iodine is a micronutrient: the daily requirement is 100-200 mcg. The most obvious manifestation of iodine deficiency is endemic goiter. Iodine deficiency increases the frequency of congenital hypothyroidism and leads to irreversible brain damage in the fetus and newborn. In addition to pronounced forms of mental retardation, iodine deficiency causes a decrease in the intellectual potential of the entire population living in an area of iodine deficiency.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17554-e17554
Author(s):  
Ioana Danciu ◽  
Samantha Erwin ◽  
Greeshma Agasthya ◽  
Tate Janet ◽  
Benjamin McMahon ◽  
...  

e17554 Background: The ability to understand and predict at the time of diagnosis the trajectories of prostate cancer patients is critical for deciding the appropriate treatment plan. Evidence-based approaches for outcome prediction include predictive machine learning algorithms that harness health record data. Methods: All our analyses used the Veterans Affairs Clinical Data Warehouse (CDW). We included all individuals with a non-metastatic (early stage) prostate cancer diagnosis between 2002 and 2017 as documented in the CDW cancer registry (N = 111351). Our predictors were demographics (age at diagnosis, race), disease staging parameters abstracted at diagnosis ( Stage grouping AJCC, Gleason score, SEER summary stage) and prostate specific antigen (PSA) laboratory values in the last 5 years prior to diagnosis (last value, the value before last, average, minimum, maximum, rate of the change of the last 2 PSAs and density). The predicted outcome was disease progression at 2 years (N = 3469) and 5 years (N = 6325) defined as metastasis - taking either Abiraterone, Sipuleucel-T, Enzalutamide or Radium 223, registry cancer related death or PSA > 50. We used 4 different machine learning classifiers to train prediction models: random forest, k-nearest neighbor, decision trees, and xgboost all with hyper parameter optimization. For testing, we used two approaches: (1) 20% sample held out at the beginning of the study, and (2) stratified test/train split on the remaining data. Results: The table below shows the performance of the best classifier, xgboost. The top five predictors of disease progression were the last PSA, Gleason Score, maximum PSA, age at diagnosis, and SEER summary stage. The last PSA had a significantly higher contribution than the other predictors. More than one PSA value is important for prediction, emphasizing the need for investigating the PSA trajectory in the period before diagnosis. The models are overall very robust going from outcome at 2 years compared to 5 years. Conclusions: A machine learning based xgboost classifier can be integrated in clinical decision support at diagnosis, to robustly predict disease progression at 2 and 5 years. [Table: see text]


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