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
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Clinical Thyroidology for the Public Volume 16 Issue 6 (PDF file, 2.76 MB)
TABLE OF CONTENTS – Web Format
The effect of delayed surgery on survival in older patients with papillary thyroid cancer
Once a cancer is diagnosed and surgery is an option, patients usually proceed with surgery quickly after diagnosis. An exception to this is papillary thyroid cancer. The aim of this study was to evaluate whether a delay in surgery affects survival in patients older than age 65 diagnosed with papillary thyroid cancer.
Chaves N et al 2023 Delay in surgery and papillary thyroid cancer survival in the United States: A SEER-Medicare analysis. J Clin Endocrinol Metab. Epub 2023 Mar 29. PMID: 36987566.
Quality of life considerations in patients treated for thyroid cancer
In 2020, more than 200,000 patients in China were diagnosed with thyroid cancer. Little is known about the quality of life of thyroid cancer survivors from Mainland China. In this study, the authors examined quality of life measures and identified associated factors in thyroid cancer survivors from Mainland China.
Chen C et al 2023 Health-related quality of life and thyroid cancer-specific symptoms in patients treated for differentiated thyroid cancer: A single center, cross-sectional survey from Mainland China. Thyroid. Epub 2023 Feb 15. PMID: 36792949.
Timing of discharge after thyroid surgery differs between hospitals
Traditionally, people who undergo total thyroidectomy were admitted to the hospital, at least overnight, to monitor for rare complications that might develop after this surgery. Since dangerous complications after total thyroidectomy are very rare, many surgeons have started to discharge people who undergo total thyroidectomy from the hospital the same day the surgery is performed. This study examined how common same day discharge following total thyroidectomy is and also how surgeons decide which patients qualify for early discharge.
Hsu S et al 2023 Outpatient endocrine surgery practice patterns are highly variable among US endocrine surgery fellowship programs. Surgery 173:76–83. PMID: 36192212.
THYROID DISEASE AND PREGNANCY
TSH levels may need to be kept lower prepregnancy in women with Hashimoto’s thyroiditis to ensure normal thyroid hormone levels in early pregnancy.
Thyroid hormone is critical for normal development of the baby. Women who are already taking levothyroxine for hypothyroidism usually require higher dose of levothyroxine during pregnancy and some not on thyroid hormone will require levothyroxine during pregnancy. This study aimed to determine how many patients with Hashimoto’s thyroiditis develop hypothyroidism in early pregnancy, and what pre-pregnancy TSH level would indicate that patients need to increase or start levothyroxine once pregnant.
Moleti M et al Preconception thyrotropin levels and thyroid function at early gestation in women with Hashimoto’s thyroiditis. J Clin Endocrinol Metab. Epub 2023 Jan 9. PMID: 36620924
Age- and sex-specific reference ranges for thyroid function tests reduce misdiagnosis of subclinical thyroid dysfunction.
Subclinical thyroid disease is described as the presence of abnormal TSH levels with normal blood levels of the thyroid hormones T4 and T3. In order for the diagnosis of subclinical thyroid disease to be accurate, it is important to describe and establish a normal range for blood TSH. This study evaluated the influence of age and sex on thyroid function tests and rates of subclinical thyroid disease.
Yamada S et al. 2023 The impact of age- and sex-specific reference ranges for serum TSH and FT4 on the diagnosis of subclinical thyroid dysfunction: A multi-center study from Japan. Thyroid. Epub 2023 Feb 10. PMID: 36772798.
The effect of subclinical hyperthyroidism on prognosis after a cardiac stent procedure
Subclinical hyperthyroidism can affect the heart muscle and increase the risk of heart problems such as irregular heart rhythms, heart failure, and death. Despite this, limited studies have investigated the heart effects of subclinical hyperthyroidism in patients with preexisting heart disease. In the present study, the authors specifically examined the association between subclinical hyperthyroidism and outcomes in patients with preexisting heart disease who underwent a cardiac stent procedure.
Yang J et al 2022. The impact of subclinical hyperthyroidism on cardiovascular prognosis in patients undergoing percutaneous coronary intervention. J Clin Endocrinol Metab 107:986–997. PMID: 34850030.