scholarly journals Controversial Screening for Thyroid Dysfunction in Preconception and Pregnancy: An Evidence-Based Review

2021 ◽  
Author(s):  
Joana Lima Ferreira ◽  
Mafalda Gomes ◽  
Rosa Maria Príncipe
Keyword(s):  
Early Pregnancy ◽  
Universal Screening ◽  
Thyroid Dysfunction ◽  
Low Cost ◽  
Screening Method ◽  
Point Of View ◽  
Evidence Based ◽  
American Thyroid Association ◽  
Selective Screening ◽  
A Prospective Study

Objective: To evaluate the recommendations on the most adequate screening method (universal or selective) for thyroid dysfunction. Although thyroid dysfunction is a common disorder in fertile women and untreated cases may have negative maternal, fetal and neonatal outcomes, its screening in preconception and early pregnancy is controversial. Materials and methods: An evidence-based review was conducted to identify publications since 2017 of American Thyroid Association (ATA) guidelines, according to the following Population, Intervention, Comparison, Outcomes and Study (PICOS): women in preconception or pregnancy without thyroid disease who underwent universal or selective screening for thyroid dysfunction. Study selection obeyed the PRISMA criteria. Results: We included 15 of 325 publications. The 2017 ATA guidelines recommend selective screening in both preconception and pregnancy. The only two reviews on preconception recommended universal screening. For pregnancy, nine articles suggested universal screening, while a prospective study advocated selective screening. The main benefits advocated for universal screening were easy and low-cost tests; absence of missed diagnosis; safe and inexpensive treatment and its potential in preventing negative outcomes. Iodine deficiency is a decisive indication, but it was not evaluated in all clinical studies. Screening harms and knowledge gaps were the main arguments against universal screening. There are very few cost-effectiveness studies. Conclusion: We recommend universal screening for thyroid dysfunction in early pregnancy, which is a distinct point of view from 2017 ATA guidelines (weak recommendation, low-quality evidence). It is not possible to make a formal recommendation for preconception (insufficient evidence). We strongly suggest an individualized analysis by each country.

scholarly journals Pregnancy and Thyroid Dysfunction: Need for Universal Screening - A Pilot Study

2013 ◽  
Vol 13 (1) ◽  
pp. 49-52
Author(s):  
M Vijayasree
Keyword(s):  
Pilot Study ◽  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Universal Screening ◽  
Thyroid Dysfunction ◽  
Medical Science ◽  
Early Screening ◽  
Fetal Complications ◽  
A Prospective Study ◽  
Rule Out

Aim: 1. To determine Thyroid dysfunction and antiTPO antibody status in pregnant women. 2. To know the benefit of LT4 therapy in maternal pregnancy outcome (antiTPO ab+ve vs antiTPO ab-ve groups) and 3. To determine the maternal and fetal outcomes in hypothyroid pregnant women and to decide whether universal screening of pregnant women for hypothyroidism is required or not. Materials and methods: A prospective study was done in mamata general hospital in the dept. of obg, over a period of 1 ½ years.105 antenatal women were included in the study. Outcome in these pregnancies were observed and analysed using appropriate statistical method. Results: There were only 3 patients with spontaneous abortions, 3 patients with pregnancy induced hypertention and only 1 patient had preterm delivery. There was more of thyroid dysfunction in anti TPO Ab +ve cases. But there was no significant adverse effect on pregnancy outcome in patients who were treated. Conclusion: Though our study included only a small number of antenatal women who were screened for thyroid abnormality since it was only a pilot study done in our hospital since our area is endemic for thyroid disorders due to iodine deficiency we recommend Universal screening to rule out thyroid dysfunction in pregnancy because the maternal and fetal complications can be reduced by early screening, diagnosing and correcting thyroid abnormality. DOI: http://dx.doi.org/10.3329/bjms.v13i1.14173 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 49-52

scholarly journals Detection of Thyroid Dysfunction in Early Pregnancy: Universal Screening or Targeted High-Risk Case Finding?

2007 ◽  
Vol 92 (1) ◽  
pp. 203-207 ◽  
Author(s):  
Bijay Vaidya ◽  
Sony Anthony ◽  
Mary Bilous ◽  
Beverley Shields ◽  
John Drury ◽  
...  
Keyword(s):  
High Risk ◽  
Early Pregnancy ◽  
Universal Screening ◽  
Thyroid Dysfunction ◽  
Case Finding ◽  
High Risk Case

“Aspirin - resistance”? A few critical considerations on definition, terminology, diagnosis, clinical value, natural course of atherosclerotic disease, and therapeutic consequences

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 429-438 ◽  
Author(s):  
Berent ◽  
Sinzinger
Keyword(s):  
Platelet Function ◽  
Point Of Care ◽  
Aspirin Resistance ◽  
Point Of View ◽  
Evidence Based ◽  
Platelet Function Tests ◽  
Clinical Value ◽  
Vascular Events ◽  
Therapeutic Consequences ◽  
Function Tests

Based upon various platelet function tests and the fact that patients experience vascular events despite taking acetylsalicylic acid (ASA or aspirin), it has been suggested that patients may become resistant to the action of this pharmacological compound. However, the term “aspirin resistance” was created almost two decades ago but is still not defined. Platelet function tests are not standardized, providing conflicting information and cut-off values are arbitrarily set. Intertest comparison reveals low agreement. Even point of care tests have been introduced before appropriate validation. Inflammation may activate platelets, co-medication(s) may interfere significantly with aspirin action on platelets. Platelet function and Cox-inhibition are only some of the effects of aspirin on haemostatic regulation. One single test is not reliable to identify an altered response. Therefore, it may be more appropriate to speak about “treatment failure” to aspirin therapy than using the term “aspirin resistance”. There is no evidence based justification from either the laboratory or the clinical point of view for platelet function testing in patients taking aspirin as well as from an economic standpoint. Until evidence based data from controlled studies will be available the term “aspirin resistance” should not be further used. A more robust monitoring of factors resulting in cardiovascular events such as inflammation is recommended.

Therapeutic Aspects of Squill; An Evidence-Based Review

2020 ◽  
Vol 17 (3) ◽  
pp. 318-324 ◽  
Author(s):  
Khadije Saket ◽  
Jalil T. Afshari ◽  
Ehsan Saburi ◽  
Mahdi Yousefi ◽  
Roshanak Salari
Keyword(s):  
Side Effects ◽  
Traditional Medicine ◽  
Respiratory Diseases ◽  
Low Cost ◽  
Current Evidence ◽  
Evidence Based ◽  
Helminthic Infections ◽  
Traditional Persian Medicine ◽  
Healing Of Wounds ◽  
Bioactive Agents

From ancient times, medicinal plants have been usually utilized to treat many disorders, but today, interest in these herbs is again aroused, because of their fewer side effects and low-cost. In traditional medicine, for many diseases, various medicinal herbs have been suggested so far. Drimia maritime, also named squill, is an important medicinal plant for the treatment of many diseases, especially respiratory diseases. In the current evidence-based study, we conducted a review of the general characteristics, ingredients, administration form, and side effects of squill in traditional medicine. For this purpose, traditional Persian medicine literatures and electronic databases were examined including PubMed, Scopus, and Google Scholar. Many compounds are isolated from D.maritima, including scillaren, scillirubroside, scillarenin, and bufadienolide glycosides. Oxymel is the most commonly used form of squill for various diseases, especially respiratory diseases. Besides, squill has been used in the treatment of cardiovascular, digestive, and dermatological disorders, it is also used against various cancer cells for its antioxidant and cytotoxic properties. Moreover, there is relatively reliable evidence of its benefits for bacterial and helminthic infections, rheumatism, edema, gout, abortion induction, healing of wounds and urine induction. It seems that supplementary studies are required to explore the bioactive agents and their effective mechanisms.

scholarly journals Early pregnancy exposure to metal mixture and birth outcomes – A prospective study in Project Viva

2021 ◽  
Vol 156 ◽  
pp. 106714
Author(s):  
Mohammad L. Rahman ◽  
Emily Oken ◽  
Marie-France Hivert ◽  
Sheryl Rifas-Shiman ◽  
Pi-I D. Lin ◽  
...  
Keyword(s):  
Prospective Study ◽  
Birth Outcomes ◽  
Early Pregnancy ◽  
Metal Mixture ◽  
A Prospective Study

scholarly journals Computed Tomography Colonography as a Sensible Option for Colorectal Cancer Screening: Evidence Based on Metanalysis

2021 ◽  
Vol 41 (01) ◽  
pp. 087-095
Author(s):  
Ingrid Chaves de Souza Borges ◽  
Natália Costa Resende Cunha ◽  
Amanda Marsiaj Rassi ◽  
Marcela Garcia de Oliveira ◽  
Jacqueline Andréia Bernardes Leão-Cordeiro ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Cancer Screening ◽  
Literature Search ◽  
Web Of Science ◽  
Screening Method ◽  
Colorectal Polyp ◽  
Evidence Based ◽  
Polyp Detection ◽  
Computed Tomography Colonography

Abstract Objective This metanalysis aimed to evaluate the sensitivity and specificity of computed tomography colonography in colorectal polyp detection. Methods A literature search was performed in the PubMed and Web of Science databases. Results A total of 1,872 patients (males 57.2%, females 42.8%) aged 49 to 82 years old (mean age 59.7 ± 5.3 years) were included in this metanalysis. The estimated sensitivity of computed tomography colonography was 88.4% (46.3–95.7%, coefficient of variation [CV] = 28.5%) and the estimated specificity was 73.6% (47.4–100.0%, CV = 37.5%). For lesions up to 9 mm, the sensitivity was 82.5% (62.0–99.9%, CV = 25.1%) and the specificity was 79.2% (32.0–98.0%, CV = 22.9%). For lesions > 9 mm, the sensitivity was 90.2% (64.0–100.0%, CV = 7.4%) and the specificity was 94.7% (80.0–100.0%, CV = 6.2%). No statistically significant differences in sensitivity according to the size of the lesion were found (p = 0.0958); however, the specificity was higher for lesions > 9 mm (p < 0.0001). Conclusions Most of the studies analyzed in the present work were conducted before 2010, which is about a decade after computed tomography colonography started being indicated as a screening method by European and American guidelines. Therefore, more studies aimed at analyzing the technique after further technological advancements are necessary, which could lead to the development of more modern devices.

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