scholarly journals Prevalence of Thyroid Nodules in China: A Health Examination Cohort-Based Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Yunhai Li ◽  
Cheng Jin ◽  
Jie Li ◽  
Mingkun Tong ◽  
Mengxue Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medical Records ◽  
Thyroid Nodules ◽  
Fasting Blood Glucose ◽  
Clinical Problem ◽  
High Density Lipoproteins ◽  
Multivariable Logistic Regression Analysis ◽  
Health Examination ◽  
Geographical Regions ◽  
Common Clinical Problem

BackgroundThyroid nodules are a common clinical problem and some are potentially cancerous; however, little is known about the prevalence of thyroid nodules in China. The objective of this study was to investigate the prevalence of thyroid nodules in a healthy Chinese population.MethodsWe reviewed electronic medical records of 13,178,313 participants from 30 provinces and regions who received health examinations and underwent thyroid ultrasound at Meinian Onehealth Healthcare in 2017. Among them, 6,192,357 were excluded based on predefined criteria. All thyroid nodules were diagnosed by ultrasonography, and standardized protocols were adopted for data collection, quality control, and data management.ResultsA total of 6,985,956 participants (mean age: 42.1 ± 13.1 years) were included in this study. The overall prevalence of thyroid nodules was 36.9% (95% CI, 35.7%–38.1%; age- and sex-standardized prevalence 38.0% [95% CI, 37.0%–39.1%]). The prevalence of thyroid nodules in females (44.7% [95% CI, 43.4%–45.9%], age-standardized prevalence: 45.2% [95% CI, 44.1%–46.4%]) was significantly higher than that in males (29.9% [95% CI, 28.8%–31.0%], age-standardized prevalence 31.2% [95% CI, 30.1%–32.2%]; P < 0.001). The prevalence of thyroid nodules decreased from <18 to 25 years, while increased with age over 25 years old. The top three provinces with the highest prevalence of thyroid nodules were Jilin (47.6%), Liaoning (44.8%), and Shandong (43.9%), whereas Guizhou (23.9%), Chongqing (26.2%), and Shaanxi (26.4%) had the lowest prevalence. Females had more than 10% higher rates of thyroid nodules than males in all included provinces and regions, except for Tianjin (8.0%). Based on the geographical regions of China, the northeast had the highest prevalence (46.8% [95% CI, 44.1%–49.2%]), whereas northwest had the lowest prevalence (28.9% [95% CI, 26.9%–31.6%]. Based on multivariable logistic regression analysis, factors including age, gender, body mass index, systolic blood pressure, diastolic blood pressure, uric acid, fasting blood glucose, triglycerides, high-density lipoproteins, and low-density lipoproteins were significantly associated with the presence of thyroid nodules.ConclusionThis study provides the first nationwide analysis of the prevalence of thyroid nodules in China. Our results showed that the prevalence of thyroid nodules was high in health screening Chinese people with regional-specific patterns.

scholarly journals Long-term blood pressure outcomes of laparoscopic adrenalectomy in trHTN patients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Yue Deng ◽  
Hanbo Wang ◽  
Xudong Guo ◽  
Shaobo Jiang ◽  
Jun Cai
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Adrenalectomy ◽  
Medical Information ◽  
Clinical Problem ◽  
Clinical Predictors ◽  
Unilateral Adrenalectomy ◽  
The Impact ◽  
Common Clinical Problem

AbstractBackground and ObjectivesTreatment resistant hypertension (trHTN) is a common clinical problem faced by many clinicians. Laparoscopic adrenalectomy effectively trims blood pressure (BP) elevation secondary to various functional adrenal disorders. However, the impact of adrenalectomy on BP within trHTN patients has never been reported. Our present study aims to investigate the effect of adrenalectomy on BP management within trHTN patients, and to explore clinical predictors for postoperative BP normalization.Patients and MethodsIn our current study, 117 patients diagnosed with trHTN and performed with unilateral adrenalectomy were consecutively enrolled, demographic and medical information were documented for baseline data collection. BP was measured with a standard electronic sphygmomanometer twice a day. Long-term periodical interview was conducted and 109 (93.2%) enrolled patients were successfully followed-up at an averaged 36.2 months.ResultsAt follow-up, 27/109 (25%) trHTN patients acquired BP normalization and 68/109 (62%) patients acquired BP improvement. Mean taking anti-hypertensive agents reduced from presurgical 4.24 to present 1.21 (P = 0.000), along with 7.2 mmHg reduction in SBP (P = 0.000). Image macro-adenoma and hypokalemia history were found to be the two strongest predictors for postoperative BP normalization. (χ2 = 28.032, P = 0.000). The incidence of adverse postoperative events was quite small.ConclusionsIn summary, this current study implicates that adrenalectomy is an efficacious and safe surgical strategy for BP management in trHTN patients. Patients with both unilateral macro-adenoma and hypokalemia are more prone to acquire postoperative BP normalization.

scholarly journals Epistaksis dan Hipertensi : Adakah Hubungannya?

2012 ◽  
Vol 1 (2) ◽  
Author(s):  
Bestari J. Budiman ◽  
Al Hafiz
Keyword(s):  
Blood Pressure ◽  
Age Groups ◽  
Clinical Problem ◽  
Emergency Rooms ◽  
Key Words Hypertension ◽  
Emergency Case ◽  
Long Duration ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy ◽  
Common Clinical Problem

Abstrak Latar Belakang: Epistaksis merupakan suatu kondisi klinis yang sering ditemui dan dapat terjadi pada semua umur dengan banyak variasi penyebabnya. Salah satu faktor risiko yang diduga ikut berperan dalam terjadinya epistaksis adalah hipertensi. Tujuan: Menjelaskan hubungan antara epistaksis dengan hipertensi. Tinjauan Pustaka: Hipertensi diduga tidak menyebabkan epistaksis secara langsung, tapi memperberat episode epistaksis. Mengendalikan tekanan darah sebagai salah satu faktor risiko, akan menurunkan insiden terjadinya epistaksis. Di ruang gawat darurat, pemberian obat anti hipertensi diberikan sebelum atau bersamaan dengan manajemen epistaksis itu sendiri. Kesimpulan: Terdapat hubungan antara epistaksis dengan hipertensi yang berlangsung lama dan adanya hipertrofi ventrikel kiri. Kata kunci : Hipertensi, kegawatdaruratan, penatalaksanaan epistaksis. Abstract Background: Epistaxis is a common clinical problem in all age groups with varied etiological factors. Hypertension has been suggested as a risk factor in epistaxis case. Purpose: To explain relationship between epistaxis and hypertension. Review: It has been suggested that hypertension does not cause epistaxis directly, but hypertension prolongs the episode of epistaxis when it does occur. The controlling for blood pressure as a risk factor will be decreased the incidencies of epistaxis. In emergency rooms, high blood pressure is usually treated before or in parallel with the management of epistaxis. Conclusion: There was an association between epistaxis and long duration of hypertension in adult and left ventricle hypertrophy. Key words : Hypertension, emergency case, management of epistaxis.

scholarly journals Caracterización del dolor perineal postparto en puérperas

2016 ◽  
Vol 18 (3) ◽  
pp. 556
Author(s):  
Paula Andrea Medina Piedrahita ◽  
Crystian Borrero Cortés ◽  
Pedro José Herrera Gómez ◽  
Juan Manuel Ospina Díaz
Keyword(s):  
Birth Weight ◽  
Observational Study ◽  
Epidural Analgesia ◽  
Medical Records ◽  
Prospective Observational Study ◽  
Clinical Problem ◽  
Analog Scale ◽  
Factors Associated ◽  
Las Mujeres ◽  
Common Clinical Problem

Introducción: El dolor perineal posparto es un problema clínico frecuente, no abordado en profundidad en Colombia. Objetivo: Determinar la prevalencia, severidad y posibles factores asociados con el dolor perineal postparto en una muestra de mujeres en el Hospital La Victoria-Instituto Materno Infantil de Bogotá.  Materiales y métodos: Estudio observacional prospectivo. Se evaluó el grado de dolor perineal percibido en 133 pacientes en posparto, mediante la escala análoga numérica de dolor, estando acostada, sentada, caminando y yendo al baño (micción y/o defecación), a las 12 y 48 horas postparto. Datos demográficos, del parto y recién nacido fueron tomados directamente de las historias clínicas. Resultados: Prevalencia global del dolor perineal moderado a severo 36-39,5% dependiendo de la actividad a las 12 horas del parto y entre 28-31,6% a las 48 horas. El dolor perineal se encontró asociado, en cualquiera de las actividades valoradas, con el uso de analgesia epidural durante el trabajo de parto, desgarro grado II o mayor, peso y perímetro cefálico del recién nacido. Se registra mejor efecto analgésico con dosis de acetaminofén de 3 g diarios o más.  Conclusiones: El dolor perineal moderado a severo afecta a menos del 50% de las mujeres postparto vaginal; se asocia con la frecuencia y magnitud del trauma perineal. Los resultados sugieren la necesidad de profundizar en el estudio del manejo analgésico más adecuado para estas pacientes.Abstract Introduction: Postpartum perineum pain is a common clinical problem, which is not addressed in detail in Colombia. Objective: To assess prevalence, magnitude and possible factors associated with postpartum perineum pain in a sample of women in the Hospital “La Victoria-Instituto Materno Infantil”, in Bogotá. Materials and methods: A prospective observational study was performed where the degree of perineum pain perceived by 133 postpartum patients was evaluated by using numerical analog scale of pain when they were sitting down, lying, walking and going to the bathroom (urination and/or defecation), at 12 and 48 hours of postpartum . Demographic, birth and newborn data were taken directly from the medical records. Results: Overall prevalence of moderate to severe perineum pain 36 to 39.5% depending on the activity at 12 hours of delivery, and since 28 to 31.6% at 48 hours after it. Perineum pain was associated, during any of the activities assessed, with the use of epidural analgesia during labor, laceration of degree II or greater, birth weight and head circumference of the newborn. Better analgesic effect of acetaminophen doses as 3 g per day or more was registered. Conclusions: Moderate to severe perineum pain affects less than 50 % of women with vaginal postpartum. It is associated with the frequency and degree of perineum trauma. The results suggest the need for further study of the most appropriate analgesic doses for these patients.

scholarly journals Metabolic Syndrome Among Physicians: A Pilot Study from Chattogram, Bangladesh

2021 ◽  
Vol 20 (2) ◽  
pp. 65-68
Author(s):  
Anisul Awal ◽  
Farid Uddin Ahmed
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Fasting Blood Glucose ◽  
Preventive Health Care ◽  
Medical College Hospital ◽  
High Density Lipoproteins ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Background : Although the information on Metabolic Syndrome (MetS) in the general population from different parts of Bangladesh is available, the information regarding the same is scarcely available from physicians of Bangladesh. This study was aimed to assess the prevalence of MetS among physicians working at Chattogram Medical College Hospital, Bangladesh. Materials and methods : Data was collected for this cross-sectional study from 255 working physicians of Chittagong Medical College Hospital in 2018. The participants filled a structured questionnaire followed by physical and biochemical measurements including waist circumference, blood pressure, lipid profile, and fasting blood glucose. National Cholesterol Education Program’s Adult Treatment Panel III report (ATP III) defines criteria were used to identify physicians with the MetS. Results : Among 255 participants (males - 192 and females - 63), 100 (39.2%) were with MetS. Prevalence of same was higher in females (41.3%) than males (38.5%). The elderly physicians (>40 years) had a higher prevalence compared to the younger (£40 years) physicians [72 (50.3%) vs. 28 (25.0%)]. In the males, low High-Density Lipoproteins-Cholesterol (HDL-C) was the major contributor to the prevalence of MetS followed by high blood pressure. However, in females, low HDL-C and greater waist circumference contributed the maximum to MetS. Conclusion : This study showed a high prevalence of MetS among physicians of Bangladesh, and thereby warrants the urgent implementation of preventive health care strategies to reduce both morbidity and mortality related to this medical problem. Further studies ought to focus on the working conditions and lifestyles of individuals in these high-risk groups. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 65-68

scholarly journals SUN-478 Poorly Differentiated Thyroid Cancer Arising from a Hyperfunctioning Nodule Treated with I-131

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Eli Miller ◽  
Jonathan Robert Anolik
Keyword(s):  
Nuclear Medicine ◽  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Thyroid Nodules ◽  
Clinical Problem ◽  
Whole Body ◽  
American Thyroid Association ◽  
Hot Nodule ◽  
Poorly Differentiated ◽  
Common Clinical Problem

Abstract Thyroid nodules are a common clinical problem with an incidence of up to 1% in men and 7–15% of cases representing thyroid cancer. Current American Thyroid Association guidelines do not recommend cytologic evaluation of hyperfunctioning nodules as they rarely harbor malignancy. We present a case of a hyperfunctioning nodule which years after ablation was diagnosed as a poorly differentiated thyroid cancer. A 38 year old male had a 4cm thyroid nodule discovered in 1994. Nuclear Medicine (NM) imaging revealed a warm nodule though patient was euthyroid. Biopsy was benign with good sample. Nodule was followed with serial ultrasound (US) and TSH. In 2008 he became hyperthyroid. Scan showed hot nodule and he was given 27.3 mCi I-131 with normalization of the TSH. In 2013 patient again developed hyperthyroidism. NM imaging showed a hot nodule. After 29.5 mCi I-131 he became hypothyroid requiring levothyroxine. Intermittent US showed stability. In early 2019 nodule was 3.7cm, solid and hypoechoic but more heterogeneous. Despite TIRADS recommendation that nodule no longer be followed by US, FNA was performed and revealed Bathesda IV cytology. Gene classification with Thyroseq revealed a TERT mutation. On total thyroidectomy pathology demonstrated a 4.5cm poorly differentiated carcinoma thought to be of follicular origin. Tumor was partially encapsulated with multiple areas of vascular invasion and extensive tumor necrosis. Tumor was present at inked margin but no extrathyroidal extension was noted. There was a <1mm metastasis noted in 1 peri-isthmus lymph node. One month post operatively thyroglobulin was 123.5 ng/mL. I-123 whole body scan demonstrated bilateral uptake in the region of the thyroid suggesting adenopathy; there were similar findings on FDG-PET scan but no adenopathy was identified on US or the CT portion of the PET. Patient was treated with 129mCI of I-131 with focally intense activity in the lower neck on post treatment scan but nothing elsewhere. Follow up lab testing is pending. Though thyroid nodules are a common clinical problem, there are only isolated case reports of hyperfunctioning nodules being later found to have thyroid cancer. One retrospective series of over 6000 patients found a thyroid cancer prevalence of 0.15% in hyperthyroid patients treated with I-131.i Poorly differentiated thyroid cancer is thought to occur as a mutation from a differentiated cancer. Here, we present a novel case of the 25 year course of a benign, hyperfunctioning nodule later mutating into an aggressive poorly differentiated cancer. We hypothesize that this nodule mutated late in the course as it was clearly benign on initial biopsy and had a benign course until recent events. This case supports periodic screening of hyperfunctioning nodules after ablation, especially if the nodule does not shrink significantly after I-131. Endnotes i Angusti T et al. The Journal of Nuclear Medicine 41(6):1006–1009.

Arterial blood pressure measurement in a population of healthy geriatric dogs

2000 ◽  
Vol 36 (6) ◽  
pp. 497-500 ◽  
Author(s):  
KM Meurs ◽  
MW Miller ◽  
MR Slater ◽  
K Glaze
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Clinical Problem ◽  
Systemic Hypertension ◽  
Control Group ◽  
Pressure Measurements ◽  
Arterial Blood ◽  
Arterial Blood Pressure Measurement ◽  
Age Range ◽  
Common Clinical Problem

The purpose of this study was to evaluate healthy geriatric dogs for the presence of systemic hypertension. Thirty-three geriatric dogs (i.e., dogs exceeding the geriatric age range for their weight group) and 22 control dogs (i.e., dogs less than six years of age) were evaluated by measuring blood pressure with an oscillometric monitor. Five consecutive blood pressure measurements were taken in each dog, averaged, and compared. Diastolic and mean blood pressure measurements were significantly lower in the geriatric group as compared to the control group. Systolic blood pressure measurements were not significantly different between the two groups. Systemic hypertension does not appear to be a common clinical problem in the healthy geriatric dog.

scholarly journals Predominant Causes of Metabolic Syndrome in Adolescents vs Adults of Northwest India

2015 ◽  
Vol 49 (3) ◽  
pp. 121-125
Author(s):  
Anil Bhansali ◽  
Abhimanyu Saini ◽  
Daisy Sahni
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
High Density ◽  
High Density Lipoproteins ◽  
The Metabolic Syndrome ◽  
Common Risk Factors ◽  
Northwest India

ABSTRACT Prevalence and distribution of metabolic syndrome was studied among 167 adolescents (aged 12—17 years) and 361 adults (aged 18—80 years) of Chandigarh zone of northwest India. Measurements of anthropometric variables, blood pressure, triglycerides (TGs), high-density lipoproteins and fasting blood glucose were taken. The metabolic syndrome was examined using criteria reported by national cholesterol education program adult treatment panel III. The overall prevalence of metabolic syndrome was 9% in adolescents and 40.7% in adults. No gender differences in its incidence were noted in adolescents or adults. In adolescents, the contribution of TGs was highest, high blood pressure and low high-density lipoprotein were of about equal significance as risk factors. The least common risk factors were fasting blood sugar and waist circumference. In adults, abdominal obesity was the most common inconsistent factor among the subjects having metabolic syndrome. Efforts should be made to screen out the metabolic syndrome positive subjects, as it is one of leading risk factors of cardiovascular disease and diabetes mellitus. How to cite this article Saini A, Sahni D, Bhansali A. Predominant Causes of Metabolic Syndrome in Adolescents vs Adults of Northwest India. J Postgrad Med Edu Res 2015;49(3):121-125.

scholarly journals Differentiation of thyroid nodules on US using features learned and extracted from various convolutional neural networks

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Eunjung Lee ◽  
Heonkyu Ha ◽  
Hye Jung Kim ◽  
Hee Jung Moon ◽  
Jung Hee Byon ◽  
...  
Keyword(s):  
Machine Learning ◽  
Neural Networks ◽  
Convolutional Neural Networks ◽  
Thyroid Nodules ◽  
Main Tool ◽  
Clinical Problem ◽  
Machine Learning Technique ◽  
Non Invasive ◽  
Learning Technique ◽  
Common Clinical Problem

AbstractThyroid nodules are a common clinical problem. Ultrasonography (US) is the main tool used to sensitively diagnose thyroid cancer. Although US is non-invasive and can accurately differentiate benign and malignant thyroid nodules, it is subjective and its results inevitably lack reproducibility. Therefore, to provide objective and reliable information for US assessment, we developed a CADx system that utilizes convolutional neural networks and the machine learning technique. The diagnostic performances of 6 radiologists and 3 representative results obtained from the proposed CADx system were compared and analyzed.

scholarly journals Blood pressure screening in midlife aids in prediction of dementia later in life

2022 ◽  
Vol 127 ◽  
Author(s):  
Linn Moberg ◽  
Jerzy Leppert ◽  
Simon Liljeström ◽  
Mattias Rehn ◽  
Lena Kilander ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Cox Regression ◽  
Fasting Blood Glucose ◽  
Activity Level ◽  
Health Examination ◽  
Community Based ◽  
Increased Risk ◽  
Study Population

Background: There is substantial evidence that midlife hypertension is a risk factor for late life dementia. Our aim was to investigate if even high blood pressure at a single timepoint in midlife can predict an increased risk for all-cause dementia, Alzheimer’s disease (AD), or vascular dementia (VaD) later in life. Methods: The community-based study population comprised 30,102 dementia-free individuals from the Westmannia Cardiovascular Risk Factors Study. The participants were aged 40 or 50 years when the health examination took place in 1990–2000. Diagnose registers from both hospitals and primary healthcare centers were used to identify individuals who after inclusion to the study developed dementia. The association between midlife high blood pressure (defined as systolic blood pressure >140 and/or diastolic blood pressure >90 mmHg) at a single timepoint and dementia was adjusted for age, gender, body mass index (BMI), fasting blood glucose, education, smoking, and physical activity level. Multivariate binary cox regression analyses were used. Results: After a mean follow-up time of 24 years resulting in 662,244 person/years, 761 (2.5%) individuals had been diagnosed with dementia. Midlife high blood pressure at a single timepoint predicted all-cause dementia (hazard ratio [HR]: 1.22, 95% confidence interval [CI]: 1.02–1.45) and VaD (HR: 2.10, 95% CI: 1.47–3.00) but not AD (HR: 1.06, 95% CI: 0.81–1.38). Conclusion: This study suggests that even midlife high blood pressure at a single timepoint predicts all-cause dementia and more than doubles the risk for VaD later in life independently of established confounders. Even though there was no such association with AD, this strengthens the importance of midlife health examinations in order to identify individuals with hypertension and initiate treatment.

scholarly journals Study on the independent effect of thyroid hormone based on uric acid level on NAFLD

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Guanqun Chao ◽  
Liying Chen
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Uric Acid ◽  
Waist Circumference ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Independent Effect ◽  
Health Examination ◽  
Alcoholic Fatty Liver ◽  
Independent Risk Factors

Abstract Objective This study aims to explain the correlation among non-alcoholic fatty liver disease (NAFLD), hyperuricemia, and thyroid function and to find independent risk factors for each other. Methods Data were obtained from subjects who underwent health examination in the Health Promotion Centre of Sir Run Run Shaw Hospital of Zhejiang University from January 2017 to February 2019. The diagnosis of NAFLD was according to the clinical diagnosis of the guidelines. Serum uric acid (SUA) > 360 μmol/L (female) and SUA > 420 μmol/L (male) were enrolled in the hyperuricemia group. R software was used for statistical analysis. Results 55,449 subjects were included in the analysis. 34.27% of patients were classified as NAFLD group (N=19004), and 65.73% of patients were classified as non-NAFLD group (N=36445). The levels of gender ratio, age, BMI, waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), HbA1c, triglyceride (TG), high-density lipoprotein (HDLC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen (BUN), creatinine (CR), FT3, FT4, and TSH were significantly different between the non-NAFLD group and NAFLD group. Age, BMI, waist circumference, DBP, fFBG, HbA1c, total cholesterol (TC), low-density lipoprotein (LDLC), AST, and UA were all independent risk factors for NAFLD. In the normal uric acid group, variables other than SBP and TSH were independent factors of NAFLD. In the hyperuricemia group, all variables except SBP, FT4, and TSH were independent factors of NAFLD. Conclusion The level of uric acid is related to the occurrence of NAFLD. Hyperuricemia is one of the independent risk factors of NAFLD. TSH level is not related to the occurrence of NAFLD, while FT3 and FT4 may be related to NAFLD.

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