scholarly journals A mask that masked the diagnosis!

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Mohammad-Reza Mohajeri-Tehrani ◽  
◽  
Neda Hatami ◽  
Keyword(s):  
Weight Gain ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Face Mask ◽  
Medical Data ◽  
Chief Complaint ◽  
The Other ◽  
Thyroid Function Tests ◽  
The Face ◽  
One Year

A 31-year-old woman presented with chief complaint of muscle weakness. As this complaint was the most bothersome of all, the patient forgot to mention many other problems that she had. Asking her to remove the face-mask, made us to look for other problems because the typical moon face was masked under the mask!. The other problems were recent weight gain, purple striae on the abdomen, easy bruising and skin acne. She didn’t have hypertension. By reviewing her medical data we found out she had diabetes and was taking metformin. She used to have mild exophthalmos one year ago and thought to be due to thyroid disease but thyroid function tests were normal.

scholarly journals Management of thyroid disease in pregnancy – Room for improvement in the first trimester

2016 ◽  
Vol 9 (3) ◽  
pp. 126-129 ◽  
Author(s):  
Helen Robinson ◽  
Philip Robinson ◽  
Michael D’Emden ◽  
Kassam Mahomed
Keyword(s):  
General Practitioner ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
In Pregnancy ◽  
Stimulating Hormone

Background First-trimester care of maternal thyroid dysfunction has previously been shown to be poor. This study evaluates early management of thyroid dysfunction in pregnancy in Australia. Methods Patients reviewed by the Obstetric Medicine team for thyroid dysfunction from 1 January 2012 to 30 June 2013 were included. Data were collected on gestation at referral from the patient’s general practitioner to the antenatal clinic, information provided in the referral letter, thyroid function tests and thyroid medications. Results Eighty-five women were included in the study. At the time of general practitioner referral to antenatal services, 19% of women with preexisting thyroid disease had no thyroid function tested. Forty-three percent had an abnormal thyroid-stimulating hormone defined as being outside the laboratory-specific pregnancy reference range if available, or outside the level of 0.1–2.5 mIu/L in the first trimester, 0.2–3.0 mIu/L in the second trimester and 0.3–3.0 mIu/L in the third trimester. Only 21% of women increased their thyroxine dose prior to their first antenatal clinic review. Conclusion This study highlights that a significant proportion of women with known thyroid disease either have untested thyroid function in the first trimester or a thyroid-stimulating hormone outside of levels recommended by guidelines.

scholarly journals The Characteristics of Children with Abnormalities Detected in Thyroid Function Tests, and Distribution of Diagnoses

2020 ◽  
Author(s):  
Elif Çelik ◽  
Ayşe Anık
Keyword(s):  
Thyroid Function ◽  
Thyroid Disease ◽  
Correct Diagnosis ◽  
Thyroid Function Test ◽  
Hashimoto Thyroiditis ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Test Results ◽  
Function Tests ◽  
Function Test

INTRODUCTION: Thyroid function tests are among the most frequently implemented laboratory tests in primary, and secondary healthcare institutions. The aim of the present study was to investigate the demographic and clinical characteristics and final diagnosis of children referred by primary and secondary healthcare institutions with the suspicion of an abnormality in thyroid function test and/or with the initial diagnosis of specific thyroid disease. METHODS: A total of two hundred eighty-nine pediatric patients, aged between 4 and 18 years admitted to the outpatient clinics of Behçet Uz Children’s Health and Diseases Hospital between January 2018 and January 2020, were included in the study. The patient data were obtained retrospectively from the hospital records. RESULTS: A total of 66% of the patients who were included in the study were female with a median age of 12 years (8.7-14.4), while 64% of them were pubertal; and 78% of the cases were referred by secondary healthcare institutions. The most common reason for referral was isolated elevation of thyroid stimulating hormone (TSH). A total of 56% of the patients were asymptomatic at the time of admission, and thyroid function test results of 75% of them were within normal limits. When evaluated according to their final diagnoses, the children were normal/healthy (64%), diagnosed with Hashimoto thyroiditis (30%), nodular thyroid disease (3%), Graves disease (2%) and isolated increase of TSH was related to obesity in 5 patients (1%). DISCUSSION AND CONCLUSION: It is essential to evaluate children with abnormal thyroid function test results with detailed history and physical examination. Besides, the thyroid function tests should be performed with reliable and sensitive methods in standardized laboratories to reach the correct diagnosis in these children.

scholarly journals Making cotton face masks extra-protective by use of impervious cloth as the front layer to restrict flow of aerosols and droplets

2020 ◽  
Author(s):  
Priyanka L Shahane-Kapse ◽  
Moreshwar R Shende ◽  
Sumit Kar ◽  
Pradeep Deshmukh ◽  
Dhiraj Bhandari ◽  
...  
Keyword(s):  
Single Layer ◽  
Middle Layer ◽  
Face Mask ◽  
The Other ◽  
Outer Side ◽  
Carbol Fuchsin ◽  
Triple Layer ◽  
Impervious Layer ◽  
Surgical Masks ◽  
The Face

Introduction: One of the important measures to prevent spread of COVID-19 in community is use of face mask. Though the debate is going on regarding the airborne transmission of SARS-CoV-2 it makes reasonable point for universal use of face masks. A large variety of face masks are available in the market or people can make their own using household items. The efficacy of masks depends upon the type of cloth and number of layers of the cloth. Material and methods: We have created an innovative mask with two layers of cotton and an impervious layer. The impervious layer made from polypropylene coated with polyurethane was applied on the outer side in the middle half of the mask in front of mouth and nose. The efficacy of this test mask was measured against N95FFR (reference standard), triple layer surgical masks and single layer cotton mask. A manikin was used wearing these masks/respirator and aerosols/droplets of diluted red colored carbol fuchsin and fluorescent Auramine O were sprayed from distance of 1m and 2m. We also tested use of face shield. Both macroscopic and microscopic examination of the dissected masks and respirator was performed. Results: The N95FFR was able to block the aerosols/droplets by its front layer. One triple layer surgical mask showed microscopic presence of stain in its innermost layer while the other blocked it with middle layer. The single layer cotton mask was not able to protect as we observed stain on the face itself. The test mask blocked most of the stain on impervious layer and also on the front cotton layer on lateral sides, where impervious layer was absent. When fluorescent stain was used, ultraviolet examination demonstrated that the whole area covered by test mask was clean while the other non covered area was fluorescent. Conclusion: We believe that our innovation can be used in the community as well as in general areas of the hospital like, offices, labs, etc. and can be a better alternative to single use triple layer surgical masks. Further testing may be done by other organizations to rule out bias in our study.

scholarly journals Thyroid Function Screening of Psychiatric Inpatient Admissions: A Worthwhile Procedure?

1987 ◽  
Vol 80 (2) ◽  
pp. 77-78 ◽  
Author(s):  
P Bannister ◽  
A Mortimer ◽  
L Shapiro ◽  
A C P Simms
Keyword(s):  
Thyroid Function ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Screening Programme ◽  
Psychiatric Service ◽  
Psychiatric Inpatient ◽  
Thyroid Function Tests ◽  
Screening Rate ◽  
Initial Investigation ◽  
Total Thyroxine

A thyroid function screening programme of admissions to a general psychiatric service was established. Over a 22-week period 588 patients were admitted and thyroid function tests were performed on 336, a screening rate of 57.1%. Initial investigation showed that 21.3% had a total thyroxine outside the range 75–130 nmol/l. On further investigation only 9 patients (1 thyrotoxic, 8 hypothyroid) had confirmed thyroid disease. In 7 of the 9 patients the disease had been clinically suspected. Thus the screening programme identified only 2 unsuspected cases of thyroid dysfunction and we conclude that this level of detection does not warrant a formal screening programme.

scholarly journals Face masks as layers of meaning in times of COVID-19

2020 ◽  
pp. 1354067X2095754
Author(s):  
Luca Tateo
Keyword(s):  
University Students ◽  
Everyday Life ◽  
Cultural Psychology ◽  
Meaning Making ◽  
Face Mask ◽  
The Other ◽  
Different Types ◽  
The Face ◽  
The Way

The pandemic of COVID-19 has brought to the front a particular object: the face mask. I have explored the way people make-meaning of an object generally associated with the medical context that, under exceptional circumstances, can become a presence in everyday life. Understanding how people make meaning of their use is important. Using cultural psychology, I analyse preferences toward different types of face masks people would wear in public. The study involved 2 groups, 44 Norwegian university students and 60 international academics. In particular, I have focused on the role of the mask in regulating people affective experience. The mask evokes safety and fear, it mediates in the auto-dialogue between “I” and “Me” through the “Other”, and in the hetero-dialogue between “I” and the “Other” through “Me” The dialogue is characterized by a certain ambivalence, as expected. Meaning-making is indeed the way to deal with the ambivalence of human existence.

Hair Loss in the Course of Lithium Treatment: A Report of Two Cases*

1983 ◽  
Vol 28 (2) ◽  
pp. 132-133 ◽  
Author(s):  
Ramzy Yassa ◽  
Jambur Ananth
Keyword(s):  
Thyroid Function ◽  
Hair Loss ◽  
Side Effect ◽  
Lithium Treatment ◽  
Lithium Therapy ◽  
The Other ◽  
Thyroid Function Tests ◽  
Underlying Factor ◽  
Function Tests ◽  
Benign Thyroid

Two cases of hair loss attributed to lithium therapy are presented. In one case, lithium did not have to be discontinued, and in the other, hair loss led to noncompliance. This side effect is usually benign. Thyroid function tests should always be performed to exclude hypothyroidism as the underlying factor for this symptom.

Neonatal mannequin comparison of the Upright self-inflating bag and snap-fit mask versus standard resuscitators and masks: leak, applied load and tidal volumes

2017 ◽  
Vol 103 (6) ◽  
pp. F562-F566 ◽  
Author(s):  
Anthony Richard Rafferty ◽  
Lucy Johnson ◽  
Peter G Davis ◽  
Jennifer Anne Dawson ◽  
Marta Thio ◽  
...  
Keyword(s):  
Tidal Volume ◽  
Airway Pressure ◽  
Applied Load ◽  
Face Mask ◽  
The Other ◽  
Mask Ventilation ◽  
Additional Load ◽  
The Face

ObjectiveNeonatal mask ventilation is a difficult skill to acquire and maintain. Mask leak is common and can lead to ineffective ventilation. The aim of this study was to determine whether newly available neonatal self-inflating bags and masks could reduce mask leak without additional load being applied to the face.DesignForty operators delivered 1 min episodes of mask ventilation to a mannequin using the Laerdal Upright Resuscitator, a standard Laerdal infant resuscitator (Laerdal Medical) and a T-Piece Resuscitator (Neopuff), using both the Laerdal snap-fit face mask and the standard Laerdal size 0/1 face mask (equivalent sizes). Participants were asked to use pressure sufficient to achieve ‘appropriate’ chest rise. Leak, applied load, airway pressure and tidal volume were measured continuously. Participants were unaware that load was being recorded.ResultsThere was no difference in mask leak between resuscitation devices. Leak was significantly lower when the snap-fit mask was used with all resuscitation devices, compared with the standard mask (14% vs 37% leak, P<0.01). The snap-fit mask was preferred by 83% of participants. The device-mask combinations had no significant effect on applied load.ConclusionsThe Laerdal Upright Resuscitator resulted in similar leak to the other resuscitation devices studied, and did not exert additional load to the face and head. The snap-fit mask significantly reduced overall leak with all resuscitation devices and was the mask preferred by participants.

scholarly journals Evaluation of maternal thyroid function during pregnancy: the importance of using gestational age-specific reference intervals

2007 ◽  
Vol 157 (4) ◽  
pp. 509-514 ◽  
Author(s):  
Rt Stricker ◽  
M Echenard ◽  
R Eberhart ◽  
M-C Chevailler ◽  
V Perez ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Gestational Age ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Reference Intervals ◽  
Specific Reference ◽  
Thyroid Function Tests ◽  
Laboratory Evidence ◽  
Maternal Thyroid

Background: Maternal thyroid dysfunction has been associated with a variety of adverse pregnancy outcomes. Laboratory measurement of thyroid function plays an important role in the assessment of maternal thyroid health. However, occult thyroid disease and physiologic changes associated with pregnancy can complicate interpretation of maternal thyroid function tests (TFTs). Objective and methods: To 1) establish the prevalence of laboratory evidence for autoimmune thyroid disease (AITD) in pregnant women; 2) establish gestational age-specific reference intervals for TFTs in women without AITD; and 3) examine the influence of reference intervals on the interpretation of TFT in pregnant women. Serum samples were collected from 2272 pregnant women, and TFT performed. Gestational age-specific reference intervals were determined in women without AITD, and then compared with the non-pregnant assay-specific reference intervals for interpretation of testing results. Results: Thyroid peroxidase antibodies (TPO-Ab) and thyroglobulin antibodies (Tg-Ab) were positive in 10.4 and 15.7% of women respectively. TPO-Ab level was related to maternal age, but TPO-Ab status, Tg-Ab status, and Tg-Ab level were not. Women with TSH > 3.0 mIU/l were significantly more likely to be TPO-Ab positive. Gestational age-specific reference intervals for TFT were significantly different from non-pregnant normal reference intervals. Interpretation of TFT in pregnant women using non-pregnant reference intervals could potentially result in misclassification of a significant percentage of results (range: 5.6–18.3%). Conclusion: Laboratory evidence for thyroid dysfunction was common in this population of pregnant women. Accurate classification of TFT in pregnant women requires the use of gestational age-specific reference intervals.

scholarly journals Association of Thyroid Function with Suicidal Behavior: A Systematic Review and Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 714
Author(s):  
Freddy J. K. Toloza ◽  
Yuanjie Mao ◽  
Lakshmi Menon ◽  
Gemy George ◽  
Madhura Borikar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Thyroid Function ◽  
Suicidal Behavior ◽  
Thyroid Disease ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Thyroid Function Tests ◽  
Inclusion Criteria ◽  
Free Triiodothyronine ◽  
Suicide Behavior

Thyroid disease is a very common condition that influences the entire human body, including cognitive function and mental health. As a result, thyroid disease has been associated with multiple neuropsychiatric conditions. However, the relationship between thyroid dysfunction and suicide is still controversial. We conducted a systematic review and meta-analysis to describe the association of thyroid function with suicidal behavior in adults. We searched four data bases (MEDLINE, EMBASE, PsycINFO, and Scopus) from their inception to 20 July 2018. Studies that reported mean values and standard deviation (SD) of thyroid hormone levels [Thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3)] in patients with suicidal behavior compared with controls were included in this meta-analysis. The abstracts and papers retrieved with our search strategies were reviewed independently and in duplicate by four reviewers for assessment of inclusion criteria and data extraction, as well as for evaluation of risk of bias. Random-effects models were used in this meta-analysis to establish the mean difference on thyroid function tests between groups. Overall, 2278 articles were identified, and 13 studies met the inclusion criteria. These studies involved 2807 participants, including 826 participants identified with suicidal behavior. We found that patients with suicide behavior had lower levels of FT3 (−0.20 pg/mL; p = 0.02) and TT4 (−0.23 µg/dL; p = 0.045) compared to controls. We found no differences in either TSH, FT4, or TT3 levels among groups. With our search strategy, we did not identify studies with a comparison of overt/subclinical thyroid disease prevalence between patients with and without suicide behavior. The studies included in this meta-analysis had a low-to-moderate risk of bias. In the available literature, the evidence regarding the association of thyroid disorders and suicidal behavior is limited. We found that patients with suicidal behavior have significantly lower mean FT3 and TT4 levels when compared to patients without suicidal behavior. The clinical implications and pathophysiologic mechanisms of these differences remain unknown and further research is needed.

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