scholarly journals ENDOCRINE DISORDERS IN CHILDHOOD AND ADOLESCENCE: Natural history of subclinical hypothyroidism in children and adolescents and potential effects of replacement therapy: a review

2013 ◽  
Vol 168 (1) ◽  
pp. R1-R11 ◽  
Author(s):  
Alice Monzani ◽  
Flavia Prodam ◽  
Anna Rapa ◽  
Stefania Moia ◽  
Valentina Agarla ◽  
...  
Keyword(s):  
Natural History ◽  
Children And Adolescents ◽  
Replacement Therapy ◽  
Subclinical Hypothyroidism ◽  
Thyroid Volume ◽  
Overt Hypothyroidism ◽  
Endocrine Disorders ◽  
Childhood And Adolescence ◽  
History Of ◽  
Neuropsychological Functions

ObjectiveSubclinical hypothyroidism (SH) is quite common in children and adolescents. The natural history of this condition and the potential effects of replacement therapy need to be known to properly manage SH. The aim of this review is to analyze: i) the spontaneous evolution of SH, in terms of the rate of reversion to euthyroidism, the persistence of SH, or the progression to over hypothyroidism; and ii) the effects of replacement therapy, with respect to auxological data, thyroid volume, and neuropsychological functions.MethodsWe systematically searched PubMed, Cochrane, and EMBASE (1990–2012) and identified 39 potentially relevant articles of which only 15 articles were suitable to be included.Results and conclusionsSH in children is a remitting process with a low risk of evolution toward overt hypothyroidism. Most of the subjects reverted to euthyroidism or remained SH, with a rate of evolution toward overt hypothyroidism ranging between 0 and 28.8%, being 50% in only one study (nine articles). The initial presence of goiter and elevated thyroglobulin antibodies, the presence of celiac disease, and a progressive increase in thyroperoxidase antibodies and TSH value predict a progression toward overt hypothyroidism. Replacement therapy is not justified in children with SH but with TSH 5–10 mIU/l, no goiter, and negative antithyroid antibodies. An increased growth velocity was observed in children treated with levothyroxine (l-T4; two articles). l-T4 reduced thyroid volume in 25–100% of children with SH and autoimmune thyroiditis (two studies). No effects on neuropsychological functions (one study) and posttreatment evolution of SH (one study) were reported.

P2-68 NATURAL HISTORY OF ARRHYTHMIA IN CHILDREN AND ADOLESCENTS WITH WOLF-PARKINSON-WHITE SYNDROME THAT UNDERWENT RF ABLATION

2007 ◽  
Vol 122 ◽  
pp. S99
Author(s):  
Michal Orczykowski ◽  
Lukasz Szumowski ◽  
Ewa Szufladowicz ◽  
Paweł Derejko ◽  
Piotr Urbanek ◽  
...  
Keyword(s):  
Natural History ◽  
Children And Adolescents ◽  
Rf Ablation ◽  
White Syndrome ◽  
History Of

scholarly journals Most of Staphylococcus aureus and Pseudomonas aeruginosa co-infecting isolates coexist, a condition that may impact clinical outcomes in Cystic Fibrosis patients

2020 ◽  
Author(s):  
Paul Briaud ◽  
Sylvère Bastien ◽  
Laura Camus ◽  
Marie Boyadjian ◽  
Philippe Reix ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Multivariate Analysis ◽  
Natural History ◽  
Clinical Outcomes ◽  
Bacterial Colonization ◽  
Childhood And Adolescence ◽  
History Of

AbstractStaphylococcus aureus (SA) is the major colonizer of the lung of cystic fibrosis (CF) patient during childhood and adolescence. As patient aged, the prevalence of SA decreases and Pseudomonas aeruginosa (PA) becomes the major pathogen infecting adult lungs. Nonetheless, SA remains significant and patients harbouring both SA and PA are frequently found in worldwide cohort. Impact of coinfection remains controversial. Furthermore, co-infecting isolates may compete or coexist. The aim of this study was to analyse if co-infection and coexistence of SA and PA could lead to worse clinical outcomes. The clinical and bacteriological data of 212 Lyon CF patients were collected retrospectively, and patients were ranked into three groups, SA only (n=112), PA only (n=48) or SA plus PA (n=52). In addition, SA and PA isolates from co-infecting patients were tested in vitro to define their interaction profile. Sixty five percent (n=34) of SA/PA pairs coexist. Using univariate and multivariate analysis, we confirm that SA patients have a clinical condition less severe than others, and PA induce a poor outcome independently of the presence of SA. FEV1 is lower in patients infected by competition strain pairs than in those infected by coexisting strain pairs compared to SA mono-infection. Coexistence between SA and PA may be an important step in the natural history of lung bacterial colonization within CF patients.

scholarly journals Prospective evaluation of autoimmune and non-autoimmune subclinical hypothyroidism in Down syndrome children

2020 ◽  
Vol 182 (4) ◽  
pp. 385-392 ◽  
Author(s):  
Giorgia Pepe ◽  
Domenico Corica ◽  
Luisa De Sanctis ◽  
Mariacarolina Salerno ◽  
Maria Felicia Faienza ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Subclinical Hypothyroidism ◽  
Heart Defects ◽  
Thyroid Autoimmunity ◽  
Overt Hypothyroidism ◽  
Sh Group ◽  
History Of ◽  
Group A ◽  
Group B

Objective To evaluate the prevalence and natural course of autoimmune and non-autoimmune subclinical hypothyroidism (SH) in Down syndrome (DS) children and adolescents. Design Prospective multicenter study. Methods For the study, 101 DS patients with SH (TSH 5–10 mIU/L; FT4 12–22 pmol/L), aged 2–17 years at SH diagnosis were enrolled. Annual monitoring of TSH, FT4, BMI, height, and L-thyroxine dose was recorded for 5 years. Thyroid autoimmunity was tested at diagnosis and at the end of follow-up. Results Thirty-seven out of 101 patients displayed autoantibody positivity (group A); the remaining 64 were classified as non-autoimmune SH (group B). Group A was characterized by higher median age at SH diagnosis and by more frequent family history of thyroid disease (6.6 vs 4.7 years, P = 0.001; 32.4% vs 7.8%, P = 0.001 respectively), whereas congenital heart defects were more common in group B (65.6% vs 43.2%, P = 0.028). Gender, median BMI (SDS), height (SDS), FT4, and TSH were similar in both groups. At the end of follow-up: 35.1% of group A patients developed overt hypothyroidism (OH) vs 17.2% of group B (P = 0.041); 31.25% of group B vs 10.8% of group A became biochemically euthyroid (P = 0.02); and 37.8% of group A vs 51.5% of group B still had SH condition (P = 0.183). Logistic regression suggested autoimmunity (OR = 3.2) and baseline TSH values (OR = 1.13) as predictive factors of the evolution from SH to OH. Conclusions In DS children, non-autoimmune SH showed higher prevalence and earlier onset. The risk of thyroid function deterioration over time seems to be influenced by thyroid autoimmunity and higher baseline TSH values.

scholarly journals DETECTION OF HYPOTHYROIDISM IN EARLY PREGNANCY: UNIVERSAL SCREENING

2020 ◽  
pp. 1-4
Author(s):  
Manpreet Kour ◽  
Taranjeet Kour
Keyword(s):  
Pregnant Women ◽  
Previous History ◽  
First Trimester ◽  
Normal Serum ◽  
Systemic Review ◽  
Overt Hypothyroidism ◽  
Endocrine Disorders ◽  
History Of ◽  
Adverse Pregnancy ◽  
Hypothyroid Patients

Background: Thyroid dysfunction is one of the most common endocrine disorders in women of childbearing (1), second only to diabetes mellitus.The aim of this systemic review was to determine whether an increased maternal TSH level and normal serum T4 levels, as seen in SCH, could also be associated with pregnancy complications. Methods: This study was conducted in Nobel hospital,Pune January 2015 to July 2016 in all the pregnant women attending antenatal clinic in their first trimester of pregnancy. Data was collected on a pre-designed, pre-tested study proforma which includes socio-demographic information of patients, detailed clinical history and examinations of pregnant women and babies. Blood samples were taken under all aseptic precautions and were sent to laboratory of the institute for routine investigations and thyroid profile. Patients were followed up till delivery and babies were followed up till discharge from the hospital. Results:This study was conducted in 220 patients in obstetrics and gynaecology department in Noble Hospital, Pune. Out of 220 cases,198 cases were euthyroid, 13 cases were subclinical hypothyroid and 9 cases were overt hypothyroid. Hypothyroidism was found in 22(10%) of pregnant women in their first trimester. Out of which, 13(5.91%) had subclinical hypothyroidism and 9(4.09%) had overt hypothyroidism. Majority of the patients 45.45% were in age group of 26-30years. 90.91% of hypothyroid patients had regular cycles and 9.09% had irregular cycles. Hypothyroidism was equally distributed between primi and multigravida patients. 31.82% of hypothyroid patients had previous history of abortions and 68.18% had no such history.18.18% of hypothyroid patients had history of infertility and 31.82% had no history of infertility. Anti-TPO was present in 9.09% and none of euthyroid patients. Maternal and Fetal complications were found more in hypothyroid patients than euthyroid patients. Conclusion: Most of the patients in our study who have subclinical thyroid disease are asymptomatic, so screening is the most convenient method to identify such patients. Follow-up of abnormal TSH values with FT3 and FT4 may yield valuable results which could enable us for therapeutic intervention and may go a long way in preventing adverse pregnancy outcomes.

scholarly journals Depression and its characteristics in childhood and adolescence

2020 ◽  
Vol 9 (10) ◽  
pp. e4319108697
Author(s):  
Ana Paula Alves Guilherme ◽  
Mônica Micheli Alexandre ◽  
Mariana Moraes Pinc ◽  
Joice Karina Otênio ◽  
Guilherme Donadel ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Children And Adolescents ◽  
Psychotropic Drugs ◽  
Clinical Investigation ◽  
Behavioral Therapy ◽  
Childhood And Adolescence ◽  
Supportive Psychotherapy ◽  
Interpersonal Therapy ◽  
Treatment Of Depression ◽  
History Of

Currently the accelerated and troubled routine ends up also affecting children and adolescents, who are still unable to develop, express and assimilate what happens to them, internally and externally, understand their pains and suffering; thus, they end up developing mental disorders, such as depression. Given the importance of seeking more information about depression, this study aimed to produce a bibliographic review article on depression in childhood and adolescence and its characteristics. The databases Pubmed (US National Library of Medicine), Scielo (Scientific Electronic Library Online), and Google ScholarⓇ were used in the present study, using the descriptors: depression, psychotropic drugs, mental disorders and psychotherapy. The articles analyzed were written in Portuguese, English and Spanish, for the past 22 years. For the diagnosis of children or adolescents, the clinical investigation has its particularities, the anamnesis must be more in-depth and it must go beyond the parents' complaint and the history of the child or adolescent. During treatments, psychopharmaceuticals can be used, as well as alternative therapies, such as supportive psychotherapy, interpersonal therapy, brief dynamic psychotherapy, behavioral therapy, among others. However, according to studies carried out recently, the use of psychotropic drugs in children and adolescents brings worrying revelations. It is concluded, through the study, that care must be taken both in the diagnosis and in the treatment of depression in children and adolescents.

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