scholarly journals Prediction of Thyroid Hormone Replacement Following Thyroid Lobectomy: A Long-term Retrospective Study

OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2199200
Author(s):  
Charles Meyer ◽  
Danielle Anderson ◽  
Zhiqiao Dong ◽  
Jeanelle Braxton Riddick ◽  
Marilisa Elrod ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Thyroid Hormone ◽  
Body Mass ◽  
Demographic Data ◽  
Hormone Replacement ◽  
Thyroid Hormone Replacement ◽  
Final Pathology ◽  
Thyroid Lobectomy

Objective Following thyroid lobectomy, patients are at risk for hypothyroidism. This study sought to determine the incidence of postlobectomy thyroid hormone replacement as well as predictive risk factors to better counsel patients. Study Design Retrospective cohort study. Setting Patients aged 18 to 75 years treated in a single academic institution who underwent thyroid lobectomy from October 2006 to September 2017. Methods Patients were followed for an average of 73 months. Demographic data, body mass index, size of removed and remnant lobe, preoperative thyroid-stimulating hormone (TSH) level, final thyroid pathology, and presence of thyroiditis were collected and analyzed. Risk factors were evaluated with chi-square analyses, t tests, logistic regression, and Kaplan-Meier analysis. Results Of the 478 patients reviewed, 369 were included in the analysis, 30% of whom eventually required thyroid hormone replacement. More than 39% started therapy >12 months postoperatively, with 90% treated within 36 months. Patient age ≥50 years and preoperative TSH ≥2.5 mIU/L were associated with odds ratios of 2.034 and 3.827, respectively, for thyroid hormone replacement. Malignancy on final pathology demonstrated an odds ratio of 7.76 for hormone replacement. Sex, body mass index, volume of resected and remaining lobes, and weight of resected lobe were not significant predictors. Conclusion Nearly a third of patients may ultimately require thyroid hormone replacement. Age at the time of surgery, preoperative TSH, and final pathology are strong, clinically relevant predictors of the need for future thyroid hormone replacement. After lobectomy, patients should have long-term thyroid function follow-up to monitor for delayed hypothyroidism.

Abstract 16546: Pre-Pregnancy Body Mass Index and Risk of Peripartum Cardiomyopathy and Heart Failure in the Years Following Delivery

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yuliya Mints ◽  
Asya Lyass ◽  
Michelle D Schmiegelow ◽  
morten schou ◽  
Gunnar H Gislason ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Body Mass Index ◽  
Body Mass ◽  
Class Ii ◽  
Elevated Risk ◽  
Peripartum Cardiomyopathy ◽  
Class I ◽  
Increased Risk

Introduction: Peripartum cardiomyopathy (PPCM) is a form of systolic heart failure that occurs during pregnancy or in the early post-partum period. Obesity is known to be associated with other forms of heart failure in young adults, however it is unclear if it is also a risk factor for the development of PPCM. Objectives: To investigate the association of body mass index (BMI) with PPCM and heart failure in the years following childbirth. Methods: We conducted a retrospective review of pregnant women in the Danish National Patient Registry between 2004 - 2017. Baseline characteristics and other risk factors were obtained at the first prenatal visit (occurring at 8-11 weeks post-conception). Women were followed until the end of the study period, emigration, or death. Logistic regression was performed, adjusting for age as well as other known risk factors for PPCM. Cox proportional hazards analysis was used to assess the long-term risk of development of heart failure. Results: There were 403,820 pregnancies evaluated in 300,892 women, with an average age of 29 years. The average BMI was 24.4 kg/m2, with 21.6% classified as overweight (BMI 25 - 30 kg/m2) and 12.8% as obese (BMI > 30 kg/m2). The rate of PPCM was 0.1 per 1,000 in normal weight and overweight groups, and 0.3 per 1,000 in the obese women. After adjustment for age, ethnicity, smoking status, gestational diabetes, and presence of preeclampsia, there was a statistically significant increased risk of the development of PPCM up to 6 months after childbirth in patients who had class I (odds ratio [OR] 2.25, 95% CI 1.08-4.68) but not class II/III obesity (OR 1.63, 95% CI 0.60-4.43). This elevated risk persisted during long term follow up, with hazard ratios of 2.43 (95% CI 1.55 - 3.80) in women with class I obesity and 3.20 (95% CI 1.93 - 5.30) in women with class II/III obesity. Conclusions: High early pregnancy BMI is associated with elevated risk of development of peripartum cardiomyopathy even after adjustment for traditional risk factors. This risk of heart failure persists for several years after childbirth.

Pre-Operative Ultrasound Identification of Thyroiditis Helps Predict the Need for Thyroid Hormone Replacement after Thyroid Lobectomy

2013 ◽  
Vol 19 (6) ◽  
pp. 1015-1020 ◽  
Author(s):  
Lilah Morris ◽  
Isabella Iupe ◽  
Beth Edeiken-Monroe ◽  
Carla Warneke ◽  
Mandy Hansen ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Hormone Replacement ◽  
Thyroid Hormone Replacement ◽  
Thyroid Lobectomy ◽  
Operative Ultrasound

scholarly journals Thyroid hormone replacement after thyroid lobectomy

Surgery ◽  
2009 ◽  
Vol 146 (4) ◽  
pp. 554-560 ◽  
Author(s):  
Samantha J. Stoll ◽  
Susan C. Pitt ◽  
Jing Liu ◽  
Sarah Schaefer ◽  
Rebecca S. Sippel ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Hormone Replacement ◽  
Thyroid Hormone Replacement ◽  
Thyroid Lobectomy

Risk factors for adult acquired subglottic stenosis

2016 ◽  
Vol 131 (3) ◽  
pp. 264-267 ◽  
Author(s):  
E A Nicolli ◽  
R M Carey ◽  
D Farquhar ◽  
S Haft ◽  
K P Alfonso ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Body Mass ◽  
Economic Status ◽  
Significant Risk ◽  
Patient Characteristics ◽  
Subglottic Stenosis ◽  
Patient Demographics ◽  
Obesity And Diabetes

AbstractObjective:The aetiology and outcomes for patients with acquired subglottic stenosis are highly variable. This study aimed to identify risk factors for subglottic stenosis and patient characteristics that predict long-term clinical outcomes.Methods:A retrospective review was performed on 63 patients with subglottic stenosis and 63 age-matched controls. Patient demographics and clinical characteristics were compared. Subglottic stenosis patients were further grouped according to tracheostomy status (i.e. tracheostomy never required, tracheostomy initially required but patient eventually decannulated, and tracheostomy-dependent). Patient factors from these three groups were then compared to evaluate risk factors for long-term tracheostomy dependence.Results:Compared to controls, patients with subglottic stenosis had a significantly higher body mass index (30.8vs26.0 kg/m2;p< 0.001) and were more likely to have diabetes (23.8 per centvs7.94 per cent;p= 0.01). Comparing tracheostomy outcomes within the subglottic stenosis group, body mass index trended towards significance (p= 0.08). Age, gender, socio-economic status, subglottic stenosis aetiology and other co-morbidities did not correlate with outcome.Conclusion:Obesity and diabetes are significant risk factors for acquiring subglottic stenosis. Further investigations are required to determine if obesity is also a predictor for failed tracheostomy decannulation in subglottic stenosis.

Uncertainty in the management of thyroid cancer.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 238-238
Author(s):  
Megan Haymart ◽  
Mousumi Banerjee ◽  
Di Yang ◽  
Andrew Stewart ◽  
James Sisson ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Radioactive Iodine ◽  
Hormone Replacement ◽  
Thyroid Hormone Replacement ◽  
Cancer Management ◽  
Post Surgery ◽  
Iodine Treatment

238 Background: Little is known about treatment practices in thyroid cancer, a cancer that is increasing in incidence. We sought to identify aspects of thyroid cancer management that have the greatest variation and thereby uncertainty in management. Methods: We surveyed 944 physicians involved in thyroid cancer care from 251 hospitals affiliated with the U.S. National Cancer Database. Using vignettes and additional survey items, physicians were asked questions in the following four domains: thyroid surgery, radioactive iodine use, thyroid hormone replacement post-surgery, and long-term thyroid cancer management. To identify aspects of thyroid cancer management with the greatest uncertainty, we calculated the ratio of observed variation to hypothetical maximum variation under the assumed distribution of the response. Ratios closer to 1 indicate greater uncertainty. Results: There is large uncertainty in multiple aspects of thyroid cancer management, including the role of central lymph node dissections, the role of pretreatment scans before radioactive iodine treatment, and all aspects of long-term thyroid cancer management, including applications of ultrasound and radioactive iodine scans. For the management of small thyroid cancers, uncertainty exist in all domains, including optimal extent of surgery and the role of both radioactive iodine treatment and suppressive doses of thyroid hormone replacement. Conclusions: We identified areas of uncertainty in thyroid cancer management. Since both a lack of data and a lack of acceptance of the existing data may be contributing to the variation demonstrated, to improve the management of thyroid cancer there is a need for more research and more research dissemination.

scholarly journals Associations between legal performance-enhancing substance use and future cardiovascular disease risk factors in young adults: A prospective cohort study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244018
Author(s):  
Jason M. Nagata ◽  
Kyle T. Ganson ◽  
Mitchell L. Cunningham ◽  
Deborah Mitchison ◽  
Jason M. Lavender ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Young Adults ◽  
Body Mass ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Us ◽  
Prospective Association

Background Legal performance-enhancing substances (PES), such as creatine, are commonly used by adolescents and young adults. As PES are mostly unregulated by the US Food and Drug Administration, there has been limited empirical attention devoted to examining their long-term safety and health outcomes. Preliminary studies have demonstrated associations between PES use and severe medical events, including hospitalizations and death. PES could be linked to cardiovascular disease (CVD), the most common cause of mortality in the US, by altering the myocardium, vasculature, or metabolism. The objective of this study was to examine prospective associations between the use of legal PES in young adulthood and CVD risk factors at seven-year follow-up. Materials and methods Nationally representative longitudinal cohort data from the National Longitudinal Study of Adolescent to Adult Health, Waves III (2001–2002) and IV (2008), were analyzed. Regression models determined the prospective association between the use of legal PES (e.g. creatine monohydrate) and CVD risk factors (e.g. body mass index, diabetes, hypertension, hyperlipidemia), adjusting for relevant covariates. Results Among the diverse sample of 11,996 male and female participants, no significant differences by PES use in body mass index, diabetes, hypertension, or hyperlipidemia were noted at Wave III. In unadjusted comparisons, legal PES users (versus non-users) were more likely to be White, be male, be college educated, drink alcohol, and engage in weightlifting, exercise, individual sports, team sports, and other strength training. There were no significant prospective associations between legal PES use at Wave III and body mass index, hemoglobin A1c, systolic and diastolic blood pressure, and cholesterol (total, HDL, LDL, triglycerides) deciles at seven-year follow-up (Wave IV), adjusting for demographics, health behaviors, and Wave III CVD risk factors. Similarly, there were no significant prospective associations between legal PES use and diabetes, hypertension, or hyperlipidemia based on objective measures or self-reported medications and diagnoses, adjusting for demographics, health behaviors, and Wave III CVD risk. Conclusions We do not find evidence for a prospective association between legal PES use and CVD risk factors in young adults over seven years of follow-up, including BMI, diabetes, hypertension, or hyperlipidemia. It should be noted that legal PES use was operationalized dichotomously and as one broad category, which did not account for frequency, amount, or duration of use. Given the lack of regulation and clinical trials data, observational studies can provide much needed data to inform the safety and long-term health associations of legal PES use and, in turn, inform clinical guidance and policy.

scholarly journals Risk factors for thyroid hormone replacement therapy after hemithyroidectomy and development of a predictive nomogram

2021 ◽  
Author(s):  
Zhen Cao ◽  
Rui Liu ◽  
Mengwei Wu ◽  
Xiequn Xu ◽  
Ziwen Liu
Keyword(s):  
Risk Factors ◽  
Thyroid Hormone ◽  
Regression Model ◽  
Thyroid Nodule ◽  
Goodness Of Fit ◽  
Hormone Replacement ◽  
Goodness Of Fit Test ◽  
Thyroid Hormone Replacement ◽  
Preoperative Serum ◽  
Serum Tsh

Abstract Purpose Hemithyroidectomy is a valid operation to retain functional contralateral thyroid lobe that is indicated for a variety of thyroid diseases. This study aimed at determination of the risk factors for thyroid hormone replacement following hemithyroidectomy and to develop a predictive nomogram. Methods Data of patients treated by hemithyroidectomy for benign thyroid disease between January 2015 and January 2020 were retrospectively analyzed. Baseline characteristics, surgery-related variables, and preoperative and postoperative thyroid function of patients were collected from the case records and compared between patients with postoperative euthyroidism and patients with postoperative hypothyroidism. Postoperative euthyroidism patients without thyroid hormone replacement were compared to those who developed postoperative hypothyroidism with thyroid hormone replacement. The factors associated with thyroid hormone replacement were used to construct a binomial logistic-regression model and visualized as a predictive nomogram to evaluate the risk of thyroid hormone replacement following hemithyroidectomy. Results Of the 378 patients (74% female) included in the study, 110 (29.1%) developed postoperative hypothyroidism. Preoperative serum thyroid-stimulating hormone (TSH) > 2.172 µIU/mL was identified as an independent risk factor for postoperative hypothyroidism (odds ratio [OR] = 8.02; 95% confidence interval [CI]: 4.87-13.20; P < 0.001). Of 110 patients with postoperative hypothyroidism, 56 (50.9%) received thyroid hormone replacement. Unilateral thyroid nodule and preoperative serum TSH > 2.172 µIU/mL were independent predictors of postoperative thyroid hormone replacement (P = 0.01, and P < 0.001, respectively). Temporary subclinical hypothyroidism occurred in 12 patients; all 12 reverted to euthyroid state without thyroid hormone replacement. The discriminative effect of the binomial regression model was proved reliable by the Hosmer–Lemeshow goodness-of-fit test (P = 0.856), and predictive ability of the nomogram was satisfactory with a C-index of 0.85. Conclusion Hypothyroidism is common after hemithyroidectomy, and almost half of the patients will need thyroid hormone replacement. Elevated preoperative serum TSH level and unilateral thyroid nodule were independent predictors of thyroid hormone replacement following hemithyroidectomy. The predictive nomogram could be a useful tool for clinical practice.

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