Evaluation of a new strategy for detection of thyroid dysfunction in the routine laboratory.

1988 ◽  
Vol 34 (6) ◽  
pp. 1110-1114
Author(s):  
R John ◽  
R Henley ◽  
G Lloyd ◽  
G H Elder
Keyword(s):  
Thyroid Dysfunction ◽  
Thyroid Disorders ◽  
Routine Laboratory ◽  
Sensitive Assay ◽  
First Line ◽  
Replacement Treatment ◽  
Free Thyroid Hormone ◽  
New Strategy ◽  
Line Test

Abstract We assessed the use of a new strategy for detecting thyroid disorders, utilizing a sensitive assay for concentrations of thyrotropin (TSH) and free thyroid hormone in serum as follow-up tests. Of 1279 patients who were not on thyroxin (T4) replacement treatment, 82% could be classified as euthyroid and would require no further tests. In patients who were on T4 replacement, 41% fell into the euthyroid category and would require no further tests. Using this strategy to replace our existing strategy of free thyroxin as a "first-line" test would reduce the proportion of patients who would require one or more follow-up tests from 49% to 24%.

THYROID FUNCTION TESTS: A REVIEW

2021 ◽  
pp. 73-76
Author(s):  
Vasudev Sankhla ◽  
Aman Deep
Keyword(s):  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Radioactive Iodine ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Function Tests ◽  
Tsh Secretion ◽  
Line Test ◽  
Radioactive Iodine Uptake

Thyroid function tests are one of the most common endocrine panels in general practice because a good understanding of when to order them, indications for treatment are important for the optimal treatment of thyroid dysfunction. Thyroid-stimulating hormone (TSH) should be the rst test to be performed on any patient with suspected thyroid dysfunction and in follow-up of individuals on treatment. It is useful as a rst-line test because even small changes in thyroid function are sufcient to cause a signicant increase in TSH secretion. Thyroxine levels may be assessed in a patient with hyperthyroidism, to determine the severity of hyperthyroxinemia. Antithyroid peroxidase measurements should be considered while evaluating patients with subclinical hypothyroidism and can facilitate the identication of autoimmune thyroiditis during the evaluation of nodular thyroid disease. The measurement of TSH receptor antibody must be considered when conrmation of Graves’ disease is needed and radioactive iodine uptake cannot be done.

scholarly journals Lung Ultrasound as a First-Line Test in the Evaluation of Post-COVID-19 Pulmonary Sequelae

2022 ◽  
Vol 8 ◽  
Author(s):  
David Clofent ◽  
Eva Polverino ◽  
Almudena Felipe ◽  
Galo Granados ◽  
Marta Arjona-Peris ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Pulmonary Function Tests ◽  
Inverse Correlation ◽  
Strongly Correlated ◽  
First Line ◽  
Roc Curve Analysis ◽  
High Resolution Computed Tomography ◽  
Line Test ◽  
Moderate Inverse Correlation

Background: Interstitial lung sequelae are increasingly being reported in survivors of COVID-19 pneumonia. An early detection of these lesions may help prevent the development of irreversible lung fibrosis. Lung ultrasound (LUS) has shown high diagnostic accuracy in interstitial lung disease (ILD) and could likely be used as a first-line test for post-COVID-19 lung sequelae.Methods: Single-center observational prospective study. Follow-up assessments of consecutive patients hospitalized for COVID-19 pneumonia were conducted 2–5 months after the hospitalization. All patients underwent pulmonary function tests (PFTs), high-resolution computed tomography (HRCT), and LUS. Radiological alterations in HRCT were quantified using the Warrick score. The LUS score was obtained by evaluating the presence of pathological B-lines in 12 thoracic areas (range, 0–12). The correlation between the LUS and Warrick scores was analyzed.Results: Three hundred and fifty-two patients who recovered from COVID-19 pneumonia were recruited between July and September 2020. At follow-up, dyspnea was the most frequent symptom (69.3%). FVC and DLCO alterations were present in 79 (22.4%) and 234 (66.5%) patients, respectively. HRCT showed relevant interstitial lung sequelae (RILS) in 154 (43.8%) patients (Warrick score ≥ 7). The LUS score was strongly correlated with the HRCT Warrick score (r = 0.77) and showed a moderate inverse correlation with DLCO (r = −0.55). The ROC curve analysis revealed that a LUS score ≥ 3 indicated an excellent ability to discriminate patients with RILS (sensitivity, 94.2%; specificity, 81.8%; negative predictive value, 94.7%).Conclusions: LUS could be implemented as a first-line procedure in the evaluation of Post-COVID-19 interstitial lung sequelae. A normal LUS examination rules out the presence of these sequelae in COVID-19 survivors, avoiding the need for additional diagnostic tests such as HRCT.

scholarly journals Update on Lung Cancer

2015 ◽  
Vol 10 (2) ◽  
Author(s):  
Nicole Bouchard MD, FRCPC ◽  
Jason Scott Agulnik MD, CM, BSc
Keyword(s):  
Lung Cancer ◽  
Tnm Classification ◽  
Cancer Staging ◽  
Small Cell Lung ◽  
First Line ◽  
Node Metastasis ◽  
Molecular Tests ◽  
Line Test ◽  
Tumour Node

Investigation and treatment of lung cancer has changed dramatically since the last articles in this journal in 2008. These changes include a new study on lung cancer staging, a new tumour, node, metastasis (TNM) classification, linear endoscopic ultrasound as a first-line test formediastinal staging, investigation and follow-up of ground glass and mixed-lung nodules, radiosurgery for inoperable patients with localized lung tumours, and molecular tests and targeted therapies for advanced non-small cell lung cancer.

scholarly journals Prescription of the thyroid test results at the biochemistry laboratory in Antananarivo in 2018

2021 ◽  
Vol 5 (2) ◽  
pp. 019-024
Author(s):  
Rakotoniaina TL ◽  
Ranaivosoa MK ◽  
Rakotonindrina FI ◽  
Rakoto Alson OA ◽  
Rasamindrakotroka A
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Thyroid Dysfunction ◽  
Test Results ◽  
First Line ◽  
National Authority ◽  
Biochemical Tests ◽  
Blood Tests ◽  
The Mean

According to National Authority for Health, the isolated dosage of TSH, in first-line, is a sufficient supply for the diagnosis and monitoring of thyroid dysfunction. The purpose of this study are to determine the prevalence of prescriptions of thyroid test, evaluate the practices on the prescription of thyroid tests compared to international recommendations. It is a descriptive retropective study within a period of 12 months. All the files with a request for TSH and / or thyroid hormone were included in this study. All files with a previous thyroid check-up or as part of a dysthyroidism follow-up assessment were excluded. Among the 72600 prescriptions for biochemical tests, 184 corresponded to the prescription of thyroid tests, it means 0.25% compared to other biochemical blood tests recorded. Among the 184 prescriptions requesting thyroid tests,117 files were retained. The mean age of the patients was 42.3 years, with a sex ratio of 0.18. One hundred sixteen files included a request of TSH dosage; 28,21% included only a TSH dosage and 70.94% included a request of simultaneous TSH dosage with one of two thyroid hormones. One prescription (0.85%) asked for a thyroid hormones dosage only without preliminary TSH dosage. TSH ranged from <0.05 to 93.97µUI/mL. It was normal in 68.96%, reduced in 16.39% and increased in 14.65% of the dosages. The number of thyroid hormone dosage in first-line in this study is important. Their prescription should be adapted to current recommendations in order to avoid the additional cost of unnecessary dosages for patients.

A simplified strategy for testing thyroid function.

1989 ◽  
Vol 35 (5) ◽  
pp. 828-830 ◽  
Author(s):  
J M Beaman ◽  
J S Woodhead
Keyword(s):  
Thyroid Function ◽  
Simultaneous Measurement ◽  
Diagnostic Efficiency ◽  
Test Results ◽  
First Line ◽  
Current Strategy ◽  
New Strategy ◽  
Thyroid Function Testing ◽  
Line Test ◽  
Function Testing

Abstract We assessed a new strategy for thyroid-function testing that involves simultaneous measurement of free thyroxin and thyrotropin, both in singletons, with chemiluminescent assays. Using our current strategy of measuring free thyroxin as a first-line test with selected back-up testing, the results show that, of 810 patients without previous thyroid disease, 445 received back-up tests. Of these, 345 were euthyroid, whereas 63 classified as euthyroid and not selected for further testing in fact had abnormal back-up test results. Evidently the simultaneous measurement of free thyroxin and thyrotropin with the "Magic Lite" technology greatly improves diagnostic efficiency compared with this current strategy.

DYSLIPIDEMIA IN THYROID DISORDERS

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Kashish Narula ◽  
Narendra Kumar Dara ◽  
Shyam Lal Meena
Keyword(s):  
Lipid Metabolism ◽  
Thyroid Dysfunction ◽  
Cross Sectional Study ◽  
Control Group ◽  
Thyroid Disorders ◽  
Cross Sectional ◽  
Carbohydrate And Lipid Metabolism ◽  
History Of ◽  
Thyroid Profile ◽  
Basal Energy Expenditure

Background: Thyroid hormones influence nearly all major metabolic pathways. Their most obvious and well-known action is the increase in basal energy expenditure obtained by acting on protein, carbohydrate and lipid metabolism. The lipid metabolism is more influenced by the thyroid hormone. Methods: A cross-sectional study was conducted on 100 patients with suspicion of thyroid disorders were taken as cases. One hundred patients with normal thyroid profile and no history of other chronic diseases were taken as control group. Results: The serum TC, TG and LDL levels in hypothyroid individuals (both overt and subclinical) were significantly higher than euthyroid subjects but the levels were comparable between hyperthyroid and euthyroid group. Conclusion: Dyslipidemias are associated with thyroid disorders, so biochemical screening for thyroid dysfunction in all dyslipidemic patients. Therefore, patients presenting with dyslipidemia are recommended for investigation to explore thyroid dysfunction. Keywords: Thyroid profile, Total cholesterol, Triglycerides and LDL

Why Do We Need New Markers for Male Hypogonadism and How Seminal Proteomics Might Solve the Problem?

2020 ◽  
Vol 27 (12) ◽  
pp. 1186-1191
Author(s):  
Giuseppe Grande ◽  
Domenico Milardi ◽  
Silvia Baroni ◽  
Andrea Urbani ◽  
Alfredo Pontecorvi
Keyword(s):  
Serum Testosterone ◽  
Clinical Syndrome ◽  
Testosterone Replacement ◽  
Total Testosterone ◽  
Male Hypogonadism ◽  
Grey Zone ◽  
Testosterone Levels ◽  
Normal Number ◽  
Replacement Treatment

Male hypogonadism is “a clinical syndrome that results from failure of the testis to produce physiological concentrations of testosterone and/or a normal number of spermatozoa due to pathology at one or more levels of the hypothalamic– pituitary–testicular axis”. The diagnostic protocol of male hypogonadism includes accurate medical history, physical exam, as well as hormone assays and instrumental evaluation. Basal hormonal evaluation of serum testosterone, LH, and FSH is important in the evaluation of diseases of the hypothalamus-pituitary-testis axis. Total testosterone levels < 8 nmol/l profoundly suggest the diagnosis of hypogonadism. An inadequate androgen status is moreover possible if the total testosterone levels are 8-12 nmol/L. In this “grey zone” the diagnosis of hypogonadism is debated and the appropriateness for treating these patients with testosterone should be fostered by symptoms, although often non-specific. Up to now, no markers of androgen tissue action can be used in clinical practice. The identification of markers of androgens action might be useful in supporting diagnosis, Testosterone Replacement Treatment (TRT) and clinical follow-up. The aim of this review is to analyze the main findings of recent studies in the field of discovering putative diagnostic markers of male hypogonadism in seminal plasma by proteomic techniques. The identified proteins might represent a “molecular androtest” useful as a seminal fingerprint of male hypogonadism, for the diagnosis of patients with moderate grades of testosterone reduction and in the follow-up of testosterone replacement treatment.

scholarly journals Efficacy of two-week therapy with doxycycline-based quadruple regimen versus levofloxacin concomitant regimen for helicobacter pylori infection: a prospective single-center randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marouf Alhalabi ◽  
Mohammed Waleed Alassi ◽  
Kamal Alaa Eddin ◽  
Khaled Cheha
Keyword(s):  
Clinical Trial ◽  
Helicobacter Pylori ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Controlled Trial ◽  
Helicobacter Pylori Infection ◽  
First Line ◽  
Link Type ◽  
Syrian Population

Abstract Background Antibiotic-resistance reduces the efficacy of conventional triple therapy for Helicobacter Pylori infections worldwide, which necessitates using various treatment protocols. We used two protocols, doxycycline-based quadruple regimen and concomitant levofloxacin regimen. The aim was to assess the effectiveness of doxycycline-based quadruple regimen for treating Helicobacter Pylori infections compared with levofloxacin concomitant regimen as empirical first-line therapy based on intention-to-treat (ITT) and per-protocol analyses (PPA) in Syrian population. Settings and design An open-label, randomised, parallel, superiority clinical trial. Methods We randomly assigned 78 naïve patients who tested positive for Helicobacter Pylori gastric infection, with a 1:1 ratio to (D-group) which received (bismuth subsalicylate 524 mg four times daily, doxycycline 100 mg, tinidazole 500 mg, and esomeprazole 20 mg, each twice per day for 2 weeks), or (L-group) which received (levofloxacin 500 mg daily, tinidazole 500 mg, amoxicillin 1000 mg, and esomeprazole 20 mg each twice per day for two weeks). We confirmed Helicobacter Pylori eradication by stool antigen test 8 weeks after completing the treatment. Results Thirty-nine patients were allocated in each group. In the D-group, 38 patients completed the follow-up, 30 patients were cured. While in the L-group, 39 completed the follow-up, 32patients were cured. According to ITT, the eradication rates were 76.92%, and 82.05%, for the D-group and L-group respectively. Odds ratio with 95% confidence interval was 1.371 [0.454–4.146]. According to PPA, the eradication rates were 78.9%, and 82.05% for the D-group and L-group respectively. The odds ratio with 95% confidence interval was 1.219 [0.394–3.774]. We didn’t report serious adverse effects. Conclusions Levofloxacin concomitant therapy wasn’t superior to doxycycline based quadruple therapy. Further researches are required to identify the optimal first-line treatment for Helicobacter-Pylori Infection in the Syrian population. Trial registration We registered this study as a standard randomized clinical trial (Clinicaltrial.gov, identifier-NCT04348786, date:29-January-2020).

scholarly journals Duodenal adenocarcinoma with skin metastasis as initial manifestation: A case report

2021 ◽  
Vol 16 (1) ◽  
pp. 395-398
Author(s):  
Yixiao Fu ◽  
Cuiping Zheng ◽  
Jian Huang ◽  
Shenghao Wu ◽  
Yanyan Dai
Keyword(s):  
Oral Treatment ◽  
Duodenal Biopsy ◽  
Skin Metastasis ◽  
Metastatic Adenocarcinoma ◽  
Duodenal Adenocarcinoma ◽  
Initial Manifestation ◽  
Case Presentation ◽  
Replacement Treatment ◽  
Lost To Follow Up

Abstract Background Duodenal adenocarcinoma (DA) with skin metastasis as initial manifestation is clinically rare. In this study, we report a rare case of skin metastasis of DA. Case presentation An 84-year-old male patient developed multiple ecchymoses on the trunk and lower extremities. Physical examination showed that the ecchymosis was dark red and had a hard texture, but showed no bulging, rupture, or tenderness. The skin biopsy implied skin metastatic adenocarcinoma. After an endoscopic duodenal biopsy, the patient was finally diagnosed with DA with skin metastasis. The patient received two courses of oral treatment of Tegafur (40 mg, bid d1–d14). However, the patient stopped taking Tegafur because of its poor effect and received Chinese medicine as a replacement treatment. Unfortunately, he was lost to follow-up. Conclusions Early diagnosis of DA metastasis is of significant importance as prognosis of these patients is poor.

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