Clinical Thyroidology for the Public summarizes selected research studies discussed in the previous month’s issue of Clinical Thyroidology, an official publication of the American Thyroid Association. Editor-in-chief, Alan Farwell, MD, FACE
Volume 11 Issue 6
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Clinical Thyroidology for the Public Volume 11 Issue 6 (PDF file, 5.99 MB)
TABLE OF CONTENTS – Web Format
THYROID CANCER Surveillance for thyroid cancer in survivors of childhood and young adult cancer needs to be discussed between survivors and their healthcare providers
Children and young adults who are survivors of cancer have a higher risk to develop thyroid nodules and thyroid cancer since most treatments included radiation therapy. However, there is no consensus on surveillance for these survivors. Thus, the objective of this study was to develop guidelines for thyroid cancer surveillance in survivors of childhood, adolescent and young adult cancer.
Clement SC et al. 2018 Balancing the benefits and harms of thyroid cancer surveillance in survivors of childhood, adolescent and young adult cancer: recommendations from the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration with the PanCareSurFup Consortium. Cancer Treat Rev 63:28–39. PMID: 29202445.
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HYPOTHYROIDISM Body weight appears to be the main levothyroxine dose adjustment variable
The dose of the Levothyroxine for any individual patient with hypothyroidism is different. However, many patients with hypothyroidism do not take the right dose and are either over-treated or undertreated. In this study, the authors evaluated the effect of sex, age and body weight on the blood level of thyroid hormone in patients taking Levothyroxine.
Younis IR et al 2018 Stable isotope pharmacokinetic studies provide insight into effects of age, sex, and weight on levothyroxine metabolism. Thyroid 28:41–49. Epub 2018 Jan 2. PMID: 29212434
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HYPOTHYROIDISM Levothyroxine dosing in hypothyroidism
This study examined whether small changes in TSH blood test results affect quality of life, mood, and brain function in adults with hypothyroidism who were taking levothyroxine. Without knowing the type of change made, patients had their dose of levothyroxine either slightly increased, slightly decreased, or unchanged for six months. The patients completed questionnaires designed to assess quality of life, mood, and cognition before and at the end of the study period.
Samuels MH ey al Effects of altering levothyroxine (L-T4) doses on quality of life, mood, and cognition in L-T4 treated subjects. J Clin Endocrinol Metab (ePub ahead of print)
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GRAVES’ DISEASE Does having Graves’ disease increase a patient’s risk of suicide?
It has been noted that anxiety and other mood disorders are common in patients with hyperthyroidism and can be severe. One aspect of Graves’ disease that may make underlying anxiety and mood disorders worse is the present of Graves’ eye disease. This study was done to understand whether patients with Graves’ disease, especially those with eye disease are at a higher risk of death from suicide.
Ferlov-Schwensen C et al Death by suicide in Graves’ disease and Graves’ orbitopathy: a nationwide Danish register study. Thyroid. October 30, 2017 [Epub ahead of print]. (http:// online.liebertpub.com/doi/pdf/10.1089/thy.2017.0365)
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THYROID CANCER Patients with advanced papillary thyroid cancer have fewer cancer recurrences after undergoing surgery by high-volume surgeons
It is known that patients under the care of high-volume thyroid surgeons have fewer surgical complications, such as recurrent laryngeal nerve injury and hypoparathyroidism, shorter hospital stay and lower costs related to the thyroid surgery. However, the impact of the surgeon’s experience and number of patients on long-term outcomes after thyroid cancer surgery is not known. The aim of this study was to evaluate the impact of the surgeon volume on the recurrence rates in patients with advanced thyroid cancer and metastasis of the cancer to the lymph nodes of the neck.
Kim HI et al 2018 Surgeon volume and prognosis of patients with advanced papillary thyroid cancer and lateral nodal metastasis. Br J Surg 105:270–278. PMID: 29405275
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ATA ALLIANCE FOR THYROID PATIENT EDUCATION