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[PMID]: 29522912
[Au] Autor:Wu SR; Kuo HC; Huang WC; Huang YF; Chiou YH; Chang YH; Nong BR
[Ad] Address:Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
[Ti] Title:Incidence, clinical characteristics, and associated diseases in patients with immune thrombocytopenia: A nationwide population-based study in Taiwan.
[So] Source:Thromb Res;164:90-95, 2018 Mar 02.
[Is] ISSN:1879-2472
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Immune thrombocytopenia (ITP) is an immune-mediated disease; it has been reported to be associated with several diseases. The data on ITP in patients with hepatitis B, tuberculosis, or thyroid diseases are relatively scarce. In addition, these diseases are not rare in Taiwan, together with hepatitis C and Helicobacter pylori which are also related to ITP. METHODS AND MATERIALS: We identified 1223 ITP patients and characterized these patients between 2000 and 2013 from the National Health Insurance Research Database. The adult ITP patients were matched with non-ITP patients. RESULTS: The overall incidence of ITP was 2.59/100,000 person-years. The frequencies of hepatitis B and C in adult ITP patients were much higher than those indicated in previous studies. The frequencies of non-traumatic intracerebral hemorrhage and gastrointestinal bleeding during hospitalization among ITP patients were low. The diseases associated with increased risks of ITP included hepatitis B (OR = 18.70, 95% CI = 9.71-36.03), hepatitis C (OR = 54.43, 95% CI = 15.94-185.88), hepatitis B and hepatitis C (OR = 7.02, 95% CI = 1.47-33.56), tuberculosis (OR = 5.37, 95% CI = 2.72-10.61), Helicobacter pylori infection (OR = 5.93, 95% CI = 3.16-11.10), hyperthyroidism (OR = 3.43, 95% CI = 2.09-5.64), hypothyroidism (OR = 6.70, 95% CI = 2.35-19.13), and simple and unspecified goiter (OR = 2.68, 95% CI = 1.43-5.03). CONCLUSIONS: Surveying for the diseases which are frequent and related to increased risks of ITP among patients with newly diagnosed ITP should be considered.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  2 / 36728 MEDLINE  
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[PMID]: 29369379
[Au] Autor:Preller G; Salloch S
[Ti] Title:Melanoma in the shopping mall: A utilitarian argument for offering unsolicited medical opinions in informal settings.
[So] Source:Bioethics;32(3):193-198, 2018 03.
[Is] ISSN:1467-8519
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Doctors occasionally make diagnoses in strangers outside of formal medical settings by using the medical skill of visual inspection, such as noticing signs of melanoma or the symptoms of hyperthyroidism. This may cause considerable moral unease and doubts on the side of the diagnosing physician. Such encounters force physicians to consider whether or not to intervene by introducing themselves to the stranger and offering an unsolicited medical opinion despite the absence of a formal doctor-patient relationship. A small body of literature has addressed the topic of the unsolicited medical opinion, often with a primary focus on practical advice. This article seeks to establish an ethical-theoretical basis for physicians' ethical obligation to offer an unsolicited medical opinion when they make a diagnosis by visual inspection in a stranger outside of the formal medical context. Using a utilitarian approach, it is argued that, if it is in the physicians' power to prevent a possible loss of well-being, without thereby sacrificing anything of equal value, physicians have an ethical obligation to intervene.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1111/bioe.12426

  3 / 36728 MEDLINE  
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[PMID]: 29521654
[Au] Autor:Subahi A; Ibrahim W; Abugroun A
[Ad] Address:Department of Internal Medicine, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI.
[Ti] Title:Diltiazem-Associated Cardiogenic Shock in Thyrotoxic Crisis.
[So] Source:Am J Ther;, 2018 Feb 28.
[Is] ISSN:1536-3686
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:CLINICAL FEATURES: The patient we present is a 39-year-old woman with a history of hyperthyroidism who developed fast atrial fibrillation secondary to thyrotoxic storm. After the initiation of intravenous diltiazem drip, she developed hypotension, bradycardia, then asystole cardiac arrest. THERAPEUTIC CHALLENGE: It is well known that calcium channel blockers and beta blockers should be used with extreme caution if the patient with thyroid storm has decompensated heart failure with reduced ejection fraction. Despite this, it is recognized that guidelines for the management of thyroid storm do not include an algorithm of action in this situation. Thus, dealing with low-output failure during thyroid storm may pose a critical challenge. SOLUTION: A significant portion of patients with thyrotoxic storm have an underlying low-output cardiac failure. Early identification, proper hemodynamic monitoring, and administration of the agents with appropriate pharmacodynamic profile and therapeutic potentials are essential to avoid treatment-induced cardiogenic shock.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1097/MJT.0000000000000739

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[PMID]: 29521049
[Au] Autor:Kapelko-Slowik K; Slowik M; Szalinski M; Dybko J; Wolowiec D; Prajs I; Bohdanowicz-Pawlak A; Biernat M; Urbaniak-Kujda D
[Ad] Address:Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Poland.
[Ti] Title:Elevated serum concentrations of metalloproteinases (MMP-2, MMP-9) and their inhibitors (TIMP-1, TIMP-2) in patients with Graves' orbitopathy.
[So] Source:Adv Clin Exp Med;27(1):99-103, 2018 Jan.
[Is] ISSN:1899-5276
[Cp] Country of publication:Poland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Graves' orbitopathy (GO), also known as thyroid-associated ophthalmopathy, is characterized by dramatic tissue reactivity. Both inflammation and tissue remodeling characterize the clinical course of GO. Some data has been found regarding the association of MMPs and TIMPs in GO. MATERIAL AND METHODS: Serum concentrations of MMP-9, MMP-2, TIMP-1, and TIMP-2 were determined by ELISA method. OBJECTIVES: Forty-eight patients (34 females, 14 males, with median age 51.5 years) with GD and hyperthyroidism were enrolled in the study. In 28 patients, active, moderate-to-severe grade orbitopathy was diagnosed. The aim of this study was to assess the serum concentrations of MMP-2, MMP-9, TIMP-1, and TIMP-2 in patients with Graves' disease (GD), with and without GO, and their relationship with disease severity, as well as to evaluate how these concentrations change after successful treatment. RESULTS: Median serum concentrations of MMP-2 and MMP-9 were significantly higher in all patients with GD as well as in the subgroup with GO than in the control group. Median serum concentrations of TIMP-1 and TIMP-2 were significantly higher in all patients with GD than in controls. The same significant differences were observed in the subgroups with and without GO in comparison with controls. The GO subgroup showed a significant positive correlation between the MMP-9 concentration and the serum level of TSHRAb antibodies, and a clinical activity score ≥4 according to EUGOGO. CONCLUSIONS: In our study we found that only MMP-9 differentiates the patients with and without GO, and may be used as a marker of the disease severity in patients with this manifestation of GD.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.17219/acem/68991

  5 / 36728 MEDLINE  
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[PMID]: 29484422
[Au] Autor:Zheng Y; Zhao C; Zhang N; Kang W; Lu R; Wu H; Geng Y; Zhao Y; Xu X
[Ad] Address:Department of Pediatrics, Shu Yang Union Medical College Hospital, Suqian, Jiangsu 223600, P.R. China.
[Ti] Title:Serum microRNA miR-206 is decreased in hyperthyroidism and mediates thyroid hormone regulation of lipid metabolism in HepG2 human hepatoblastoma cells.
[So] Source:Mol Med Rep;17(4):5635-5641, 2018 Apr.
[Is] ISSN:1791-3004
[Cp] Country of publication:Greece
[La] Language:eng
[Ab] Abstract:The actions of thyroid hormone (TH) on lipid metabolism in the liver are associated with a number of genes involved in lipogenesis and lipid metabolism; however, the underlying mechanisms through which TH impacts on lipid metabolism remain to be elucidated. The present study aimed to investigate the effects of hyperthyroidism on the serum levels of the microRNA (miR) miR206 and the role of miR206 on THregulated lipid metabolism in liver cells. Serum was obtained from 12patients diagnosed with hyperthyroidism and 10 healthy control subjects. Human hepatoblastoma (HepG2) cells were used to study the effects of triiodothyronine (T3) and miR206 on lipid metabolism. Expression of miR206 in serum and cells was determined by reverse transcriptionquantitative polymerase chain reaction analysis. Lipid accumulation in HepG2 cells was assessed with Oil Red O staining. Suppression or overexpression of miR206 was performed via transfection with a miR206 mimic or miR206 inhibitor. Serum miR206 was significantly decreased in patients with hyperthyroidism compared with euthyroid controls. Treatment of HepG2 cells with T3 led to reduced total cholesterol (TC) and triglyceride (TG) content, accompanied by reduced miR206 expression. Inhibition of endogenous miR206 expression decreased intracellular TG and TC content in HepG2 cells. By contrast, overexpression of miR206 in HepG2 partially prevented the reduction in TG content induced by treatment with T3. In conclusion, serum miR206 expression is reduced in patients with hyperthyroidism. In addition, miR206 is involved in T3mediated regulation of lipid metabolism in HepG2 cells, indicating a role for miR206 in thyroid hormoneinduced disorders of lipid metabolism in the liver.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.3892/mmr.2018.8633

  6 / 36728 MEDLINE  
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[PMID]: 29264764
[Au] Autor:Quintard B; Giorgiadis M; Feirrera X; Lefaux B; Schohn C; Lemberger K
[Ad] Address:Parc Zoologique et botanique de Mulhouse, 51 rue du jardin Zoologique, 68100, Mulhouse, France. benoit.quintard@mulhouse-alsace.fr.
[Ti] Title:Evidence for the possible occurrence of Grave's disease in a blue-eyed black lemur (Eulemur flavifrons).
[So] Source:Primates;59(2):123-126, 2018 Mar.
[Is] ISSN:1610-7365
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:The blue-eyed black lemur (Eulemur flavifrons) is classified by the International Union for Conservation of Nature (IUCN) as critically endangered. A 23-year-old male housed at Mulhouse Zoo presented with lethargy, polyphagia, alopecia, and chronic weight loss. Clinical examination suggested an endocrine pathology such as hyperthyroidism. Secondary examinations included cervical ultrasound, thyroid biopsy, and scintigraphy. The latter revealed elevated thyroid activity. Blood analysis was performed to measure the level of anti-receptor thyroid-stimulating hormone antibodies, which allowed us to test the autoimmune hypothesis. The high level of antibodies together with levels of thyroid-stimulating hormone and the scintigraphy images led to the diagnosis of Grave's disease. Carbimazole treatment followed by thyroidectomy resulted in a quick weight gain and general improvement in health status. The following breeding season, the treated individual sired an offspring. To the authors' knowledge, this is the first report of likely Grave's disease in a non-human primate.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1007/s10329-017-0644-5

  7 / 36728 MEDLINE  
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[PMID]: 29517512
[Au] Autor:Rajapreyar I; Acharya D; Tallaj J; Hornbuckle L; Sharpton J; Joly J; Pamboukian S
[Ti] Title:Left Ventricular Assist Device Thrombosis-Amiodarone-Induced Hyperthyroidism: Causal Link?
[So] Source:ASAIO J;, 2018 Mar 05.
[Is] ISSN:1538-943X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Ventricular arrhythmias occurs in 20-50% of patients supported with left ventricular assist devices (LVAD). Ventricular arrhythmias are well tolerated with LVAD support but long-term consequences include worsening right ventricular function. Management of ventricular arrhythmias in LVAD patients includes use of antiarrhythmic agents or ablation. Amiodarone has been used a first-line agent to treat ventricular arrhythmias post-LVAD implantation. Chronic treatment with amiodarone for arrhythmias can result in hyperthyroidism and hypothyroidism in 5-10% of patients. Hyperthyroidism is known to cause endothelial dysfunction, alterations in coagulation, and fibrinolytic pathways favoring hypercoagulable state. We describe two cases of left ventricular assist device (LVAD) thrombosis potentiated by amiodarone-induced hyperthyroidism (AIT) and discuss pathophysiological mechanisms for hypercoagulable state induced by hyperthyroidism.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1097/MAT.0000000000000773

  8 / 36728 MEDLINE  
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[PMID]: 29516685
[Au] Autor:Mon SY; Riedlinger G; Abbott CE; Seethala R; Ohori NP; Nikiforova MN; Nikiforov YE; Hodak SP
[Ad] Address:Division of Endocrinology and Metabolism, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
[Ti] Title:Cancer risk and clinicopathological characteristics of thyroid nodules harboring thyroid-stimulating hormone receptor gene mutations.
[So] Source:Diagn Cytopathol;, 2018 Mar 08.
[Is] ISSN:1097-0339
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Thyroid-stimulating hormone receptor (TSHR) gene mutations play a critical role in thyroid cell proliferation and function. They are found in 20%-82% of hyperfunctioning nodules, hyperfunctioning follicular thyroid cancers (FTC), and papillary thyroid cancers (PTC). The diagnostic importance of TSHR mutation testing in fine needle aspiration (FNA) specimens remains unstudied. METHODS: To examine the association of TSHR mutations with the functional status and surgical outcomes of thyroid nodules, we evaluated 703 consecutive thyroid FNA samples with indeterminate cytology for TSHR mutations using next-generation sequencing. Testing for EZH1 mutations was performed in selected cases. The molecular diagnostic testing was done as part of standard of care treatment, and did not require informed consent. RESULTS: TSHR mutations were detected in 31 (4.4%) nodules and were located in exons 281-640, with codon 486 being the most common. Allelic frequency ranged from 3% to 45%. Of 16 cases (12 benign, 3 FTC, 1 PTC) with surgical correlation, 15 had solitary TSHR mutations and 1 PTC had comutation with BRAF V600E. Hyperthyroidism was confirmed in all 3 FTC (2 overt, 1 subclinical). Of 5 nodules with solitary TSHR mutations detected at high allelic frequency, 3 (60%) were FTC. Those at low allelic frequency (3%-22%) were benign. EZH1 mutations were detected in 2 of 4 TSHR-mutant malignant nodules and neither of 2 benign nodules. CONCLUSION: We report that TSHR mutations occur in ∼5% thyroid nodules in a large consecutive series with indeterminate cytology. TSHR mutations may be associated with an increased cancer risk when present at high allelic frequency, even when the nodule is hyperfunctioning. Benign nodules were however most strongly correlated with TSHR mutations at low allelic frequency.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1002/dc.23915

  9 / 36728 MEDLINE  
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[PMID]: 29275552
[Au] Autor:Zhang MZ; Li BX; Zhao R; Guan DW; Zhang GH; Wu X; Zhu BL; Li RB
[Ad] Address:Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang 110122, China.
[Ti] Title:[Forensic Analysis of 6 Cases of Sudden Death due to Hyperthyroid Heart Disease].
[So] Source:Fa Yi Xue Za Zhi;33(5):482-485, 2017 Oct.
[Is] ISSN:1004-5619
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVES: To analyse the cases of sudden death due to hyperthyroid heart disease, and explore the general information of deaths and the forensic pathological characteristics to provide reference evidence for forensic identification of such cases. METHODS: Six cases of sudden death due to hyperthyroid heart disease between 2001 and 2016 were selected from School of Forensic Medicine, China Medical University. The general information (gender and age), clinical manifestations, medical history, anatomical and histopathological findings, biochemical parameters and cause of death were analysed retrospectively. RESULTS: Most of the 6 patients had definite history of hyperthyroidism, and they all showed certain degrees of symptoms of cardiovascular disease; had obvious incentive factors of death; histopathological examination of thyroid conformed to the performances of diffuse toxic goiter; with increase of cardiac weight, dilatation of cardiac chambers, myocardial hypertrophy and focal necrosis; postmortem biochemical analyses of pericardial fluid could be used as an additional method for diagnostic of sudden death due to hyperthyroid heart disease. CONCLUSIONS: The identification of death due to hyperthyroid heart disease should be based on the clinical history and the results of autopsy, histopathological examination, postmortem toxicology tests. The postmortem biochemical detection of thyroid and cardiac function should be performed if necessary.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.3969/j.issn.1004-5619.2017.05.005

  10 / 36728 MEDLINE  
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[PMID]: 29246269
[Au] Autor:Giuliano L; Fatuzzo D; Mainieri G; La Vignera S; Sofia V; Zappia M
[Ad] Address:Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy.
[Ti] Title:Adult-Onset Sleepwalking Secondary to Hyperthyroidism: Polygraphic Evidence.
[So] Source:J Clin Sleep Med;14(2):285-287, 2018 Feb 15.
[Is] ISSN:1550-9397
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:ABSTRACT: Sleepwalking is a disorder characterized by complex motor behaviors arising from slow wave sleep usually occurring in children. The adult onset of sleepwalking suggests the presence of an external precipitating factor leading to the occurrence of the disorder. Hyperthyroidism has been reported to be the possible cause of sleepwalking in a few cases. We present the case of a 36-year-old man who reported a sudden appearance of nocturnal episodes of sleepwalking. He underwent a complete video polysomnography (VPSG), which showed a polygraphic pattern arising from stage N3 sleep related to the presence of simple motor behaviors. Routine blood tests showed a mild hyperthyroidism. After 4 months of thyrostatic treatment, the patient reported no more sleepwalking events. A VPSG performed at the last follow-up showed the absence of pathological electroclinical events arising from stage N3 sleep. Therefore, we hypothesize that there is a link between sleepwalking and thyroid dysfunction in our patient.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.5664/jcsm.6954


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