Clinical Thyroidology for Patients

Clinical Thyroidology for Patients is a collection of summaries of recently published articles from the medical literature that covers the broad spectrum of thyroid disorders.

Starting with the May 2009 issue, Clinical Thyroidology for Patients will be published on a monthly basis and include summaries of research studies that were discussed in the previous month’s issue of Clinical Thyroidology, a publication of the American Thyroid Association for physicians. Dr. Mazzaferri is the Editor-in-Chief of Clinical

June 2009 Volume 2 Issue 2

Now available in pdf format for saving and printing and Web page format for viewing online

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Clinical Thyroidology for Patients June 2009 Volume 2 Issue 2 (PDF file, 315 KB)


Editor’s Comments

TSH Recent studies indicate that TSH levels increase with age. It is unclear if this is a normal part of getting older or means that these older people are becoming hypothyroid. The aim of this study is to look at TSH and thyroxine (T4) levels in very old people (>90 yeas old) and compare them with TSH and T4 levels in younger people.
Atzmon G, Barzilai N, Hollowell JG, Surks MI, Gabriely I. Extreme longevity is associated with increased serum thyrotropin. J Clin Endocrinol Metab 2009;94:1251-4.
(PDF File for saving and printing, 76 KB)

THYROID AND THE HEART Heart function may be decreased in very sick patients in the hospital who have infections, liver disease or other major illnesses, even though they do not have heart disease. In these patients, the heart function returns to normal after they get better. Thyroid hormone levels are also decreased in these very sick patients due to their illnesses for reasons that are unclear. This study looked at whether the decreased heart function was related to the low thyroid levels in these sick patients.
Lee SJ, Kang JG, Ryu OH, Kim CS, Ihm SH, Choi MG, Yoo HJ, Hong KS. The relationship of thyroid hormone status with myocardial function in stress cardiomyopathy. Eur J Endocrinol/ EJE-08-0808 [Pii] 10.1530/EJEJ 2009[doi]
(PDF File for saving and printing, 85 KB)

THYROID CANCER Papillary microcarcinoma is a form of thyroid cancer where the cancer is very small. Very few patients with Papillary microcarcinoma will die of their cancer, so it is not clear how aggressive treatment should be for these patients. This study looks at what features in these patients may cause the cancer to come back or spread after the initial treatment.
Mercante G, Frasoldati A, Pedroni C, Formisano D, Renna L, Piana S, Gardini G, Valcavi R, Barbieri V. Prognostic factors affecting neck lymph node recurrence and distant metastasis in papillary microcarcinoma of the thyroid: results of a study in 445 patients. Thyroid 19(7) 2009:1-10.
(PDF File for saving and printing, 82 KB)

THYROID CANCER The number of new cases of thyroid cancer has been rising over the last 30 years. Most thyroid cancers occur in women and currently thyroid cancer is the 6th most common cancer in women. Part of the reason is likely due to the increased use of imaging and biopsy studies, so smaller thyroid cancers can now be found. However, there is growing awareness that there may be other as yet unidentified causes for the increased number of new cases of thyroid cancer. This study was done to determine the rate of new cases of thyroid cancer and the trends in cancer size in Vigo, Spain, from 1979 through 2001.
Rego-Iraeta A, Perez-Mendez LF, Mantinan B, Garcia-Mayor RV. Time trends for thyroid cancer in northwestern Spain: true rise in the incidence of micro and larger forms of papillary thyroid carcinoma. Thyroid 2009;19:333-40.
(PDF File for saving and printing, 84 KB)

THYROID CANCER A total thyroidectomy is the usual first treatment for papillary cancer, the most common type of thyroid cancer. There is a current debate as to how aggressive the initial surgery should be in removing lymph nodes. A common complication of thyroid surgery is low calcium levels (hypocalcemia) after surgery, which may be more common after more extensive surgery. This study looks at the effects of more aggressive as opposed to less aggressive surgery on cancer spread and on levels of calcium after surgery.
Roh JL, Park JY, Park CI. Total thyroidectomy plus neck dissection in differentiated papillary thyroid carcinoma patients: pattern of nodal metastasis, morbidity, recurrence, and postoperative levels of serum parathyroid hormone. Ann Surg 2007;245 (4):604-10.
(PDF File for saving and printing, 95 KB)