Thyroxine treatment of patients with thyroid diseases, foreign experience and its use in Russia (lecture)

Thyroxine is one of the 13 most commonly prescribed drugs in the United States. Thyroxine is even more frequently prescribed to patients in several countries of Western Europe, where, due to iodine deficiency, there is a high prevalence of thyroid diseases. Indication for the use of thyroxine is either conventional replacement therapy in patients with hypothyroidism, or blocking the secretion of thyroid stimulating hormone (TSH) in patients with nodular goiter or after surgery for thyroid cancer. Hypothyroidism is a common disease: according to foreign authors, from 1.5 to 2% of women and about 0.2% of men suffer from it. Among people over 60, the prevalence of hypothyroidism is even higher: up to 6% of women and 2.5% of men have a TSH level that is 2 times higher than the upper limit of normal. According to foreign studies conducted in areas without iodine deficiency (UK), thyroid nodules are found in 0.8% of men and 5% of women, and the frequency of nodes increases after 45 years. In areas with iodine deficiency in the biosphere, which includes the vast majority of the territory of Russia, the frequency of nodular goiter in women of reproductive age reaches 10% or more. Thyroid cancer is the most common endocrine localization of malignant tumors. In 1984, 10,000 new cases of thyroid cancer were reported in the United States. For a long time, the selection of thyroxine doses for substitution and suppressive therapy was purely empirical and was based mainly on clinical signs: dynamics of mass, pulse, disappearance of myxedema, etc. At present, there are objective methods for controlling the thyroxine dose.

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Some Subgroups of Reproductive Age Women in the United States May Be at Risk for Iodine Deficiency

Journal of Nutrition ◽

10.3945/jn.109.120147 ◽

2010 ◽

Vol 140 (8) ◽

pp. 1489-1494 ◽

Cited By ~ 60

Author(s):

Cria G. Perrine ◽

Kirsten Herrick ◽

Mary K. Serdula ◽

Kevin M. Sullivan

Keyword(s):

United States ◽

At Risk ◽

Iodine Deficiency ◽

The United States ◽

Reproductive Age ◽

Reproductive Age Women

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The prevalence of iodine deficiency in women of reproductive age in the United States of America

Public Health Nutrition ◽

10.1017/s1368980007360862 ◽

2007 ◽

Vol 10 (12A) ◽

pp. 1532-1539 ◽

Cited By ~ 43

Author(s):

Joseph G Hollowell ◽

James E Haddow

Keyword(s):

United States ◽

Pregnant Women ◽

Iodine Deficiency ◽

National Health ◽

United States Of America ◽

The United States ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Iodine Status ◽

Health And Nutrition

AbstractObjective: To review the iodine status of women as assessed through National Health and Nutrition Examination Surveys from 1971 to 2002.Design and Setting: National normative estimates of iodine status of the civilian, non-institutionalized population in the United States of America.Subjects: Women of reproductive age and pregnant women.Results: In the United States of America, iodine began to be added to the diet in the 1920s. An excessive iodine intake was documented by the first National Health and Nutrition Examination Survey (NHANES I) in the 1970s which reported a median urinary iodine (UI) concentration of 320 μg l-1. In the NHANES III survey, conducted between 1988 and 1994, the median UI concentration had decreased to 145 μg l-1, while 14.9% of women aged 15-44 years and 6.9% of pregnant women had a UI concentration 50 μg l-1. The concentrations of serum T4 and thyroid-stimulating hormone of women with a low UI concentration did not, however, indicate an iodine deficiency.Conclusions: Further studies of the association between iodine excretion and biochemical and physiological changes should be undertaken to better understand women's needs for iodine and to develop criteria to monitor them in pregnancy. Because of the potential harm caused by iodine deficiency during pregnancy, we support the use of iodine supplements for all pregnancies while these data are being collected.

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Increasing Incidence of Thyroid Cancer in the United States, 1973–2002

Yearbook of Endocrinology ◽

10.1016/s0084-3741(08)70123-9 ◽

2007 ◽

Vol 2007 ◽

pp. 252-255

Author(s):

E.L. Mazzaferri

Keyword(s):

United States ◽

Thyroid Cancer ◽

The United States

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Faculty Opinions recommendation of Trends in Testosterone Replacement Therapy Use from 2003 to 2013 among Reproductive-Age Men in the United States.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726901135.793556667 ◽

2019 ◽

Author(s):

Suks Minhas ◽

Saiful Miah ◽

Tharu Tharakan

Keyword(s):

United States ◽

Replacement Therapy ◽

The United States ◽

Reproductive Age ◽

Testosterone Replacement ◽

Testosterone Replacement Therapy

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The Most Commonly Occurring Papillary Thyroid Cancer in the United States Is Now a Microcarcinoma in a Patient Older than 45 Years

Thyroid ◽

10.1089/thy.2010.0137 ◽

2011 ◽

Vol 21 (3) ◽

pp. 231-236 ◽

Cited By ~ 143

Author(s):

David T. Hughes ◽

Megan R. Haymart ◽

Barbra S. Miller ◽

Paul G. Gauger ◽

Gerard M. Doherty

Keyword(s):

United States ◽

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

The United States ◽

Papillary Thyroid

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Utilization of total thyroidectomy for papillary thyroid cancer in the United States

Surgery ◽

10.1016/j.surg.2007.09.002 ◽

2007 ◽

Vol 142 (6) ◽

pp. 906-913.e2 ◽

Cited By ~ 37

Author(s):

Karl Y. Bilimoria ◽

David J. Bentrem ◽

John G. Linn ◽

Andrew Freel ◽

Jen Jen Yeh ◽

...

Keyword(s):

United States ◽

Thyroid Cancer ◽

Total Thyroidectomy ◽

Papillary Thyroid Cancer ◽

The United States ◽

Papillary Thyroid

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Use of imaging tests after primary treatment of thyroid cancer in the United States: population based retrospective cohort study evaluating death and recurrence

BMJ ◽

10.1136/bmj.i3839 ◽

2016 ◽

pp. i3839 ◽

Cited By ~ 16

Author(s):

Mousumi Banerjee ◽

Jaime L Wiebel ◽

Cui Guo ◽

Brittany Gay ◽

Megan R Haymart

Keyword(s):

United States ◽

Cohort Study ◽

Thyroid Cancer ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

The United States ◽

Primary Treatment ◽

Population Based ◽

United States Population

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Health Care-Related Economic Burden of Polycystic Ovary Syndrome in the United States: Pregnancy-Related and Long-Term Health Consequences

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab613 ◽

2021 ◽

Author(s):

Carrie Riestenberg ◽

Anika Jagasia ◽

Daniela Markovic ◽

Richard P Buyalos ◽

Ricardo Azziz

Keyword(s):

United States ◽

Polycystic Ovary Syndrome ◽

Economic Burden ◽

Polycystic Ovary ◽

The United States ◽

Reproductive Age ◽

Cochrane Library ◽

Control Group ◽

Ovary Syndrome

Abstract Context Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive-aged women, affecting approximately 5-20% of women of reproductive age. A previous estimate noted that the economic burden of PCOS approximates $3.7 billion annually in 2020 USD when considering only the costs of the initial diagnosis and of reproductive endocrine morbidities, not considering the costs of pregnancy-related and long-term morbidities. Objective To estimate the excess prevalence and economic burden of pregnancy-related and long-term health morbidities attributable to PCOS. Data Sources PubMed, EmBase and Cochrane Library. Study Selection Studies in which the diagnosis of PCOS was consistent with the Rotterdam, National Institutes of Health (NIH), or Androgen Excess & PCOS (AE-PCOS) Society criteria, or that used electronic medical record diagnosis codes, or diagnosis based on histopathologic sampling were eligible for inclusion. Studies that included an outcome of interest and a control group of non-PCOS patients who were matched or controlled for body mass index (BMI) were included. Data Extraction Two investigators working independently extracted data on study characteristics and outcomes. Data Synthesis Data was pooled using random-effects meta-analysis. The I 2statistic was used to assess inter-study heterogeneity. The quality of selected studies was assessed using the Newcastle-Ottawa Scale. Results The additional total healthcare-related economic burden due to pregnancy-related and long-term morbidities associated with PCOS in the United States is estimated to be $4.3 billion annually in 2020 USD. Conclusions Together with our prior analysis, the economic burden of PCOS is estimated at $8 billion annually in 2020 USD.

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Differences of US-FNA BSRTC class, postoperative pathology, and mutation landscape of thyroid nodules between China and other countries.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.3055 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 3055-3055

Author(s):

Yuntao Song ◽

Jie Liu ◽

Weiran Wang ◽

Tonghui Ma

Keyword(s):

United States ◽

Thyroid Cancer ◽

Thyroid Nodules ◽

Malignant Tumors ◽

The United States ◽

Braf V600e ◽

Class V ◽

Ras Mutation ◽

First Choice ◽

Significant Difference

3055 Background: Ultrasound and ultrasound-guided fine needle aspiration (US-FNA) are the first choice for judging benign and malignant thyroid nodules. This study will report on the differences of US-FNA BSRTC class, postoperative pathology and mutation landscape of thyroid nodules between China and other countries. Methods: We conducted a prospective study containing 383 FNA samples of thyroid nodules. For most of these FNA samples, genomic DNA and RNA were extracted and sequenced with FSZ-Thyroid NGS Panel V1, and postoperative pathology were followed up. Moreover, we also compared results of this study with those of West China Hospital in China, Yamashita Thyroid Hospital in Japan, and Cleveland Clinic in the United States. Results: Among the 383 FNA samples, the proportions of BSRTC class I to VI were 10.7%, 6.3%, 18.8%, 3.7%, 12.3%, and 48.3% respectively. Compared with study in other countries, the proportion of class II was significantly lower than that in Japan and the United States. Meanwhile, the proportion of class V and VI were significantly higher than the above two countries. Subsequently, 232 thyroid nodules were surgically removed. Postoperative pathology showed that the proportion of malignant tumors (85.3%) was also significantly higher than reported in Japan and the United States. But compared with other studies in China, there was no significant difference. Most of the malignant tumors were papillary thyroid cancer (PTC, 96%), accompanied with 2 follicular thyroid cancer (FTC), 3 medullary cancer (MTC) and 3 anaplastic thyroid cancer (ATC). Compared with study in the United States, the proportion of PTC and FTC were elevated (96% vs. 85.3%) and reduced (1% vs. 9.3%) respectively. At last, we also analysis the mutation landscape of 180 malignant tumors. Compared with TCGA study, the frequency of BRAF V600E in PTC in our study was significantly higher than that of TCGA (73.3% vs. 58%), and the frequency of RAS mutation was significantly lower (1.2% vs. 12.6%). And compared with an institutional experience of ThyroSeq v3 for Bethesda III and IV at the University of Pittsburgh Medical Center, the frequency of BRAF V600E and RAS mutation in Bethesda III-IV malignant tumors was also significantly higher (45.8% vs. 1.4%) and lower (8.3% vs. 47.1%). Conclusions: There were significant differences in BSRTC class and postoperative pathology between China and other countries, such as Japan and the United States. The possible reasons included that the indications for FNA in China were different. For example, most of patients who underwent FNA in this study had suspicious clinical/ultrasound features. So the proportion of BSRTC class V and VI as well as the malignant rate were elevated. On the other hand, more BRAF V600E and less RAS mutations were detected in malignant tumors in this study which might result from racial differentiation and discrepancy in proportion of PTC and FTC.

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