scholarly journals Precision Medicine in Autoimmune Thyroiditis and Hypothyroidism

2021 ◽  
Vol 12 ◽  
Author(s):  
Silvia Martina Ferrari ◽  
Francesca Ragusa ◽  
Giusy Elia ◽  
Sabrina Rosaria Paparo ◽  
Valeria Mazzi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Autoimmune Thyroiditis ◽  
Thyroid Autoimmunity ◽  
Liquid Solution ◽  
Autoimmune Thyroid Diseases ◽  
Autoimmune Thyroid ◽  
Organ Specific ◽  
New Treatments ◽  
And Function

Autoimmune thyroid diseases (AITD) are T-cell-mediated organ specific autoimmune disorders, deriving from an altered response of the immune system that leads to the immune attack to the thyroid. Hashimoto’s thyroiditis (HT) and Graves’ disease (GD) are the two principal AITD clinical presentations. Hypothyroidism and thyrotoxicosis are, respectively, the clinical hallmarks of HT and GD. Patients with autoimmune thyroiditis are treated daily with synthetic L-thyroxine (L-T4) at the dose of 1.5–1.7 μg/kg. Various L-T4 formulations are commercially available (tablet, liquid solution, or soft gel capsule). L-T4 in tablets is generally prescribed to treat hypothyroidism, whereas the liquid formulation, or soft gel capsules, can be administered in hypothyroid patients in case of malabsorption or in patients in therapy with drugs interfering with L-T4 absorption. Furthermore, myoinositol has a crucial role in thyroid autoimmunity and function. Clinical studies reported a significant decline in TSH and antithyroid autoantibodies levels after treatment with myoinositol + selenium in patients with subclinical hypothyroidism and autoimmune thyroiditis. Moreover, thyroidectomy can be rarely recommended in patients with autoimmune thyroiditis, with cosmetic reasons for a goiter, or with important signs or symptoms of local compression, or nodular disease with a “suspicious” cytology for malignancy. Furthermore, a recent randomized trial suggested that total thyroidectomy can improve quality of life and fatigue, while medical therapy did not. In this review, we overview currently available evidence in personalized medicine in patients with autoimmune thyroiditis and hypothyroidism. Further research is needed in larger population to investigate the effect of these new treatments on quality of life.

Autoimmune thyroid disease

2011 ◽  
pp. 416-431 ◽  
Author(s):  
Anthony P. Weetman
Keyword(s):  
Thyroid Autoimmunity ◽  
Basic Knowledge ◽  
Autoimmune Thyroid Diseases ◽  
Autoimmune Thyroid ◽  
Slow Progression ◽  
Organ Specific ◽  
Autoimmune Conditions ◽  
Progression Of Disease ◽  
Main Factors ◽  
Ease Of Access

Along with neoplasia, autoimmunity is the most common cause of endocrine disease and, of this group of disorders, thyroid autoimmunity is the most frequent. Conversely, the autoimmune thyroid diseases are the most common organ-specific or nonorgan-specific autoimmune conditions affecting any site. This prevalence, the ease of access to the target organ, the often slow progression of disease, and the historical legacy of being the first distinctive autoimmune process to be defined, have ensured that there is now a reasonable understanding of the main factors involved in pathogenesis. This chapter assumes a basic knowledge of immunology; readers unfamiliar with this topic can obtain further details about the fundamental processes involved in self/non-self discrimination by the immune system elsewhere (1).

scholarly journals Achalasia and thyroid disease: possible autoimmune connection?

2012 ◽  
Vol 56 (9) ◽  
pp. 677-682 ◽  
Author(s):  
Ana Rosa P. Quidute ◽  
Eduardo Vasconcelos de Freitas ◽  
Tadeu Gonçalves de Lima ◽  
Ana Márcia Lima Feitosa ◽  
Joyce Paiva dos Santos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Disease ◽  
Case Reports ◽  
Thyroid Peroxidase ◽  
Esophageal Dilatation ◽  
Autoimmune Thyroid Diseases ◽  
Autoimmune Thyroid ◽  
Histocompatibility Complex ◽  
Radioiodine Ablation

Many cases have been published showing a co-existence of autoimmune thyroid diseases (AITDs) and other autoimmune diseases. About a quarter of patients with achalasia have a concurrent thyroid disease, most commonly associated with hypothyroidism. Although relatively rare, the association of achalasia and hyperthyroidism requires attention. The physiopathology of Grave's Disease (GD) involves B- and T-mediator lymphocytes, which have an affinity for known thyroid antigens: thyroglobulin, thyroid-peroxidase, and thyrotrophin receptor. Currently, however, the real physiopathogenesis of achalasia continues to be unknown. Some important findings are suggestive of an autoimmune mechanism: significant infiltration of the myoenteric plexus by monocytes, presence of the class II-Human Histocompatibility Complex DQwl antigen and antibodies to myoenteric neurons. The present case reports a patient who, despite testing negative for Chagas' disease, had achalasia, progressed to developing significant wasting and worsening of his quality of life, was later diagnosed with hyperthyroidism. After endoscopic esophageal dilatation and radioiodine ablation of the thyroid gland, there was great improvement in the patient clinical condition. Arq Bras Endocrinol Metab. 2012;56(9):677-82

Regeneration of market squares in historic town centres: ideas, discussions, controversies

2018 ◽  
Vol 60 (1) ◽  
pp. 67-79
Author(s):  
Natalia Bursiewicz
Keyword(s):  
Quality Of Life ◽  
Form And Function ◽  
Points Of View ◽  
And Function ◽  
Historic Cities ◽  
Lower Silesia

Abstract In Poland, the last 15 years have been marked by various, numerous regeneration projects of historic cities that were supposed to improve the citizens quality of life and their security, as well as to create an attractive tourist offer. Those programs were often focused on the renewal, reshape and modernization of public squares. Such changes never go unnoticed. On contrary, these are frequently associated with criticism, debate and disagreements. The research has been focused on the analysis of regeneration projects from selected Market Squares in historic cities and town centres in Lower Silesia. The main aim was to exhibit the medieval origin of those squares and recently introduced contemporary layout. Moreover it was to present diverse opinions regarding square’s form and function, that can be crucial in understanding the architects, planners and citizens’ points of view and their ‘feelings’ towards the space.

Treatment Given Near the End of Life in Castration-Resistant Prostate Cancer

2012 ◽  
Vol 29 (7) ◽  
pp. 536-540 ◽  
Author(s):  
Hanna A. Zaghloul ◽  
Jose R. Murillo
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
End Of Life ◽  
Treatment Options ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Related Quality ◽  
Impact On Survival ◽  
New Treatments

Chemotherapy treatment options are limited for patients with castration-resistant prostate cancer (CRPC). The purpose of this study is to report treatment use and adverse effects (AEs) within the last three months of life in patients with CRPC. Of the 88 patients identified, 32% received treatment within 3 months of death, and documented AEs occurred in 25% of patients. Of those, neutropenia (18.3%), nausea/vomiting (18.3%), and febrile neutropenia (13.6%) were the most frequent. Results of this study show high treatment utility towards the end-of-life in patients with CRPC, with one fourth of patients experiencing AEs. Attention to health-related quality of life becomes increasingly important as new treatments appear to have small impact on survival, and AEs of those treatments may significantly impact patient quality of life.

scholarly journals Importance of Diagnostic Waxing in Oral Rehabilitation: Case Report

2020 ◽  
Vol 22 (2) ◽  
pp. 146-150
Author(s):  
Mariana Lima da Costa Valente ◽  
Marcela Silva Costa ◽  
Paulo Marcos Bérgamo ◽  
Denise Tornavoi de Castro
Keyword(s):  
Quality Of Life ◽  
Treatment Plan ◽  
Dental Restoration ◽  
Oral Rehabilitation ◽  
Correct Treatment ◽  
Life Planning ◽  
End Of Treatment ◽  
Patient Reported ◽  
And Function

Currently, aesthetics, and especially the smile, adds considerable social value. In this way, patients suffering from dental loss wish that their rehabilitation be performed quickly and safely. The aim of oral rehabilitation is to restore masticatory, phonetic, aesthetic and quality of life to the patient. The diagnostic step is one of the most important and relevant steps in establishing a correct treatment plan and, in this way, it is possible to obtain excellent results. The present study aimed to demonstrate the importance of diagnostic waxing in oral rehabilitation. Patient sought treatment at the Dental Prosthesis Specialization Course at Odonto School, due to complaints associated with aesthetics and function. To improve their quality of life, planning of case was carried out through diagnostic waxing and a prosthetic solution was proposed. At the end of treatment and during the follow-up of the case, the patient reported satisfaction and significant improvement in quality of life. It can be concluded that the diagnostic waxing presents customized solutions offering, through a previous study, an effective clinical resolution to the patient. Keywords: Mouth Rehabilitation. Dental Restoration, Temporary. Dental Restoration, Temporary. Resumo Atualmente, a estética, e em especial o sorriso, agregam um valor social considerável. Dessa forma, ao sofrerem a perda dental, os pacientes desejam que sua reabilitação seja realizada de forma rápida e segura. A reabilitação oral tem como objetivo devolver ao paciente a eficiência mastigatória, fonética, estética e a qualidade de vida. A etapa diagnóstica constitui um dos passos mais importantes e relevantes no estabelecimento de um correto planejamento do tratamento e, desta forma, torna-se possível obter resultados de excelência. O presente estudo teve como objetivo demonstrar a importância do enceramento diagnóstico na reabilitação oral. Paciente procurou tratamento no Curso de Especialização em Prótese Dentária da Odonto School, devido a queixas associadas a estética e função. Para melhorar sua qualidade de vida, foi realizado o planejamento do caso por meio do enceramento diagnóstico e uma solução protética foi proposta. Ao final do tratamento e durante o acompanhamento do caso, a paciente relatou satisfação e melhora significativa na qualidade de vida. Pode-se concluir que o enceramento diagnóstico apresenta soluções personalizadas oferecendo, por meio de estudo prévio, uma resolução clínica efetiva ao paciente. Palavras-chave: Reabilitação Bucal. Restauração Dentária Temporária. Prótese Dentária Temporária.

scholarly journals Safety of Aesthetic Medicine Procedures in Patients with Autoimmune Thyroid Disease: A Literature Review

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 30
Author(s):  
Kamil Adamczyk ◽  
Ewa Rusyan ◽  
Edward Franek
Keyword(s):  
Platelet Rich Plasma ◽  
Fat Grafting ◽  
Thyroid Diseases ◽  
Autoimmune Thyroid Diseases ◽  
Aesthetic Medicine ◽  
Autoimmune Thyroid ◽  
Wide Range ◽  
Organ Specific ◽  
Safety Studies ◽  
Potential Possibility

Autoimmune thyroid diseases are the most common organ-specific autoimmune diseases, affecting 2–5% of the world’s population. Due to the autoimmune background of thyroid diseases, we analyzed a wide range of cosmetic procedures, from minimally invasive cosmetic injections (mesotherapy) to highly invasive procedures, such as lifting threads. Out of the seven categories of treatments in aesthetic medicine analyzed by us—hyaluronic acid, botulinum toxin, autologous platelet-rich plasma, autologous fat grafting, lifting threads, IPL and laser treatment and mesotherapy—only two, mesotherapy and lifting threads, are not recommended. This is due to the lack of safety studies and the potential possibility of a higher frequency of side effects in patients with autoimmune thyroid diseases.

scholarly journals Practical aspects of extended half-life products for the treatment of haemophilia

2018 ◽  
Vol 9 (9) ◽  
pp. 295-308 ◽  
Author(s):  
Thierry Lambert ◽  
Gary Benson ◽  
Gerry Dolan ◽  
Cedric Hermans ◽  
Victor Jiménez-Yuste ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Half Life ◽  
Severe Disease ◽  
Coagulation Factor ◽  
Intravenous Injections ◽  
Active Lifestyles ◽  
Recombinant Fviii ◽  
Safety Considerations ◽  
New Treatments

Haemophilia A and haemophilia B are congenital X-linked bleeding disorders caused by deficiency of coagulation factor VIII (FVIII) and IX (FIX), respectively. The preferred treatment option for patients with haemophilia is replacement therapy. For patients with severe disease, prophylactic replacement of coagulation factor is the treatment of choice; this has been shown to reduce arthropathy significantly, reduce the frequency of bleeds and improve patients’ quality of life. Prophylaxis with standard recombinant factor requires regular intravenous infusion at least two (FIX) to three (FVIII) times a week. Recombinant FVIII and FIX products with an extended half-life are in development, or have been recently licensed. With reported mean half-life extensions of 1.5–1.8 times that of standard products for FVIII and 3–5 times that of standard products for FIX, these products have the potential to address many of the unmet needs of patients currently treated with standard factor concentrates. For example, they may encourage patients to switch from on-demand treatment to prophylaxis and improve the quality of life of patients receiving prophylaxis. Indeed, extended half-life products have the potential to reduce the burden of frequent intravenous injections, reducing the need for central venous lines in children, promote adherence, improve outcomes, potentially allow for more active lifestyles and, depending on the dosing regimen, increase factor trough levels. Members of the Zürich Haemophilia Forum convened for their 19th meeting to discuss the practicalities of incorporating new treatments into the management of people with haemophilia. This review of extended half-life products considers their introduction in haemophilia treatment, including the appropriate dose and schedule of infusions, laboratory monitoring, patient selection, safety considerations, and the economic aspects of care.

Impediments in Healthcare Digital Transformation

2021 ◽  
pp. 1704-1719
Author(s):  
Robert Furda ◽  
Michal Gregus
Keyword(s):  
Quality Of Life ◽  
Information Technologies ◽  
Enterprise Architecture ◽  
Digital Transformation ◽  
Healthcare Sector ◽  
Successful Implementation ◽  
Managerial Decisions ◽  
And Function ◽  
Structural Aspects

This article is addressing the specific impediments that appear in the process of healthcare digital transformation. Enterprise architecture provides the framework for investigating the behavioral and active structural aspects that apply to business and application layers. This includes an analysis of, including inherent relationship between, selected scopes such as strategy, business, and education to standard elements such as process, service, and function of an application. The presented classification and assignment of individual impediments indicate to healthcare managers where they may potentially struggle during different stages of digital transformation. Among others, they facilitate strategic planning and managerial decisions during implementation of the emerging information technologies and techniques. In addition, the idea is to contribute to the successful implementation of healthcare digital transformation, thereby delivering business value within healthcare sector, and consequently to a better quality of life.

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