The association of TSH-receptor antibody with the clinical and laboratory parameters in patients with newly diagnosed Graves’ Hyperthyroidism: Experience from a tertiary referral center including a large number of patients with TSH-receptor antibody-negative Graves’ hyperthyroidism

Abstract Background Although hyperthyroidism may be associated with atherosclerosis, its pathogenesis is not well known. TSH receptor antibody (TRAb) has been shown to be responsible for increased orbital fat tissue in Graves ophthalmopathy. Epicardial fat tissue thickness (EFT) has been found to be increased in case of overt hyperthyroidism. In our study, we aimed to investigate if TRAb is associated with the increased EFT in newly diagnosed hyperthyroidism. Methods Twenty six TRAb positive (group 1) and 26 TRAb negative (group 2) newly diagnosed patients with hyperthyroidism, and 26 healthy control subjects (group 3) were enrolled. EFT was measured by the same cardiologist using an echocardiography device. Serum TRAb levels were measured by the radio-receptor assay and levels above 1.75 IU/L were considered as positive. Results There was no difference among groups in terms of age, gender and body mass index. Although there was no significant difference between group 1 and 2, both group 1 (0.38±0.15 cm) and group 2 (0.4±0.17 cm) had significantly higher EFT levels when compared to group 3 (0.25±0.06 cm) (p=0.004 and p=0.001, respectively). However we did not find any correlation between TRAb and EFT levels. Conclusion The results of our study suggested that EFT was increased in hyperthyroidism and this increasing was not dependent of TRAb level. EFT elevation might be depending directly to the cardiovascular effects of hyperthyroidism.

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Incidence and surgical care of retinal detachment during the first SARS-CoV-2 lockdown period at a tertiary referral center in Austria

PLoS ONE ◽

10.1371/journal.pone.0248010 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248010

Author(s):

Markus Schranz ◽

Michael Georgopoulos ◽

Stefan Sacu ◽

Adrian Reumueller ◽

Gregor S. Reiter ◽

...

Keyword(s):

Reference Group ◽

Case Series ◽

Surgical Care ◽

Control Group ◽

Tertiary Referral ◽

Total Delay ◽

Tertiary Referral Center ◽

Referral Center ◽

Time Period ◽

Number Of Patients

Purpose To assess the influence of the SARS-CoV-2 lockdown in spring on frequency, severity and quality of care of rhegmatogeneous retinal detachments (RRD) in a tertiary referral center in Vienna, Austria. Methods Single center, consecutive case series with historical controls. Patients presenting with primary RRD during the first Austrian SARS-CoV-2 lockdown (March 16th–May 3rd 2020) and a corresponding control group consisting of the same time period of the preceding 3 years. Results The mean number of patients with RD in the reference group (RG) was 22 (± 1) and in the lockdown group (LG) 15. Median total delay, defined as onset of symptoms until surgery, in the RG was 5 (lower quartile: 3.0; upper quartile: 8.0) compared to 7 (3.0; 12.0) days in the LG, (p = 0.740). During the lockdown 67% of patients were referred from an external ophthalmologist compared to 52% in the RG, (p = 0.395). 34% of patients in the RG presented with an attached macula compared to 33% in the LG (p = 0.597). PVR was present in 49% of cases in the RG compared to 73% in the LG. Single surgery success (SSS) rates were lower in the LG (73.3%) compared to the RG (85.3%), (p = 0.275). Conclusion Patients with RRD during the SARS-CoV-2 lockdown presented and were treated within acceptable time limits, showed the same macula-on ratios but a higher PVR rate and a tendency towards worse SSS rates compared to the time period of the preceding 3 years.

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Prevalence of Macroprolactinemia in Patients with Hyperprolactinemia Using Roche Elecsys Platform in a Large Tertiary Referral Center in UAE

Dubai Diabetes and Endocrinology Journal ◽

10.1159/000519094 ◽

2021 ◽

pp. 1-5

Author(s):

Abdulla Al Nuaimi ◽

Raya Almazrouei ◽

Yusra Othman ◽

Salem Beshyah ◽

Khaled M. Aldahmani

Keyword(s):

Polyethylene Glycol ◽

Prolactin Level ◽

High Reactivity ◽

Newly Diagnosed ◽

Menstrual Irregularity ◽

Tertiary Referral ◽

Tertiary Referral Center ◽

Referral Center ◽

Tertiary Center ◽

Mri Evaluation

Objectives: Macroprolactin (macroPRL) excess is an important cause of hyperprolactinemia. Several prolactin assays have high reactivity to macroPRL. However, macroPRL screening is not routinely performed in many labs. This study aimed to evaluate the prevalence of macroprolactinemia (MP) in patients with elevated prolactin using the Roche Elecsys assay in a large tertiary center in UAE. Materials and Methods: Consecutive samples of patients with elevated prolactin presenting to Tawam Hospital from June to August 2018 were evaluated for MP. Polyethylene glycol (PEG) was used to precipitate macroPRL. Monomeric prolactin recovery cutoff ≤50% was used to determine the prevalence of MP. Results: A total of 180 patients with elevated prolactin were included in the study with a mean age of 33.1 ± 11.9 years. The majority were women (87.2%), and about 77.8% were newly diagnosed patients with hyperprolactinemia. The main indications for prolactin testing were menstrual irregularity (n = 121), infertility (n = 11), galactorrhea (n = 11), and sellar masses (n = 12). MP was present in 8.3% of the patients. The median (IQR) of total prolactin level was 740.5 (579–1,085) IU/m before PEG precipitation and was not significantly different between MP and true hyperprolactinemia cases. Three patients with MP had pituitary MRI evaluation, which was normal. Eight patients with MP were treated with cabergoline. Conclusion: One in 12 patients with hyperprolactinemia had MP on the Roche Elecsys assay defined as the cutoff recovery of ≤50% post-PEG precipitation. Physicians should be aware of the prolactin assay used in their labs, and we recommend routine macroPRL assessment in mild hyperprolactinemia samples in labs using the Roche Elecsys platform.

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2057 UTILIZATION PATTERNS OF RADIOGRAPHIC IMAGING IN MEN WITH NEWLY DIAGNOSED PROSTATE CANCER AT A TERTIARY REFERRAL CENTER

The Journal of Urology ◽

10.1016/j.juro.2013.02.2476 ◽

2013 ◽

Vol 189 (4S) ◽

Author(s):

Samuel Nickles ◽

James Rosoff ◽

Alisa Tykal ◽

Sandip Prasad ◽

Stephen Savage

Keyword(s):

Prostate Cancer ◽

Radiographic Imaging ◽

Newly Diagnosed ◽

Tertiary Referral ◽

Tertiary Referral Center ◽

Referral Center ◽

Utilization Patterns

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Eye-related emergencies incidence at a tertiary referral center in Southern Italy during COVID-19 related lockdown

F1000Research ◽

10.12688/f1000research.51526.1 ◽

2021 ◽

Vol 10 ◽

pp. 316

Author(s):

Alfredo Niro ◽

Giancarlo Sborgia ◽

Rossella Favale ◽

Alessandra Sborgia ◽

Valentina Pastore ◽

...

Keyword(s):

Southern Italy ◽

Anterior Segment ◽

Healthcare Services ◽

Tertiary Referral ◽

Tertiary Referral Center ◽

Referral Center ◽

Number Of Patients ◽

Number Of Visits ◽

The Impact ◽

Eye Clinic

Background: In order to contain the community spread of coronavirus disease (COVID-19) in Italy, a stringent lockdown was imposed, which also impacted the healthcare services. The purpose of this study is to investigate the drop in the number of outpatients in the Ophthalmic Emergency Service (OES) in the Eye Clinic of University of Bari during the COVID-19 lockdown. Methods: A retrospective analysis of electronic medical records from a tertiary referral center in Southern Italy was performed. Demographics and medical characteristics of patients examined in the OES between March 10th, 2020 and May 3rd, 2020 were assessed and compared with records from the same period in 2019. We categorized the patients by sex, age group, and by the type of eye disease that was recorded as the principal diagnosis. The change (%) in the number of patients and diseases between the study periods was analyzed. Results: We observed a reduction in the number of OES visits during the lockdown (-63.4%) compared to the number of visits in 2019. The greatest changes were observed in the youngest (≤20 years; -76.6%) and the most elderly patients (≥81 years; -70.9%). The decrease in the number of patients presenting with each pathology ranged from -82% to -28.5%, depending on the pathology, and mainly involved the orbital and palpebral pathologies, anterior segment disorders, non-specific visual symptoms, and minor injuries. The diagnosis of chronic pathologies, rhegmatogenous retinal detachment, and vitreous haemorrhage increased by 134%, 100%, and 75%, respectively. Conclusions: Our results revealed the impact of the COVID-19 lockdown on OES activities in the Eye Clinic of University of Bari. A drop in number of visits across all age groups was observed. The number of patients presenting with minor and nonurgent conditions decreased, whereas the number of patients presenting with chronic diseases and urgent but deferrable conditions increased.

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