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Content available remote Prognosis of thyroid function after hemithyroidectomy
Identify criteria and create a risk scoring system to predict hypothyroidism after hemithyroidectomy. We have retrospectively studied 216 cases of patients with goiter who had undergone hemithyroidectomy from January 2002 to December 2007 at Vilnius University Hospital Santariškių Klinikos. Patients were divided into two groups according to their thyroid function after hemithyroidectomy: 168 (77.8%) patients’ thyroid function was normal (group A), 48 (22.2%) patients had symptoms of hypothyroidism (group B). The relationship between groups and parameters such as patients’ sex, age, patient’s weight, preoperative serum thyroid-stimulating hormone (TSH) level, weight of the remnant gland, ratio of the remaining thyroid gland weight to patient’s weight was statistically analysed. The patients’ mean age was 41.6 ± 14.1 years in group A and 52.9 ± 13.9 years in group B (p=0.0002). The mean preoperative TSH level was 0.79 ± 0.5 mU/L in group A, compared with 1.42 ± 1.00 mU/L in group B (p= 0.005). The mean ratio of the remaining thyroid gland weight to patient’s weight was 0.102 ± 0.053 g/kg in group A and 0.063 ± 0.027 g/kg in group B (p=0.04). The groups did not establish a significant difference between patients’ sex, patient’s weight or weight of the remaining gland. Patient’s age, preoperative serum TSH level, ratio of the remaining thyroid gland weight to patient’s weight is the main factors of hypothyroidism after hemithyroidectomy. A risk scoring system was created to predict hypothyroidism after hemithyroidectomy before the operation.
Content available remote Thyroid dysfunction and cardiovascular risk factors in Bulgarian adults
The aim of this study was to determine the prevalence of thyroid dysfunction and its association with cardiovascular risk factors in an adult Bulgarian population. 2402 subjects were studied, 1347 female, 20–94y (median: 48.0y) and 1055 male, 20–91y (median: 45.5y). Body weight, height, waist circumference, arterial blood pressure, TSH, FT4 and lipids were measured. Known hypothyroidism was reported by 53 subjects (2.2%) and hyperthyroidism by 20 (0.8%). New hypothyroidism was found in 98 (4.1%), [subclinical (3.2%), overt (0.9%)]. New hyperthyroidism was found in 68 (2.9%), [subclinical (2.5%), overt (0.4%)]. New diagnosis of hypothyroidism and hyperthyroidism was entered in 84% and 87% in male subjects and 60% and 65% in the females respectively. Arterial hypertension was present in 40% of the women and in 47% of the men (p<0.001) and was more prevalent in hypothyroidism. Abdominal obesity and dyslipidemia were more prevalent in males and hypothyroid subjects. Arterial hypertension depended on age, gender and lipid status but not on thyroid function. CHD history depended on thyroid function and age. Conclusion: Most cases of thyroid dysfunction were undiagnosed, especially in the males. CV risk factors were more prevalent in the males with thyroid dysfunction a major determinant of CHD, but not hypertension.
Content available remote Gross pericardial effusion with tamponade in 2nd trimester of pregnancy
Hypothyroidism in pregnancy is associated with serious maternal and fetal risk. Rarely, it is manifested by life-threatening cardiac complications, such as gross pericardial effusion and tamponade. We present a case of successfully treated gross pericardial effusion and tamponade in a 22-week pregnant woman with hypothyroidism. The patient was treated by pericardial drainage with further treatment of hypothyroidism with levothyroxine. During the follow-up pregnancy was uncomplicated without recurrence of pericardial effusion and successful delivery of full-term baby. We conclude that careful monitoring of thyroid functional tests and proper management should be performed in pregnant women with hypothyroidism to prevent cardiac complications of the disease, like pericardial effusion and tamponade.
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