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Scientific Reports Sep 2023Thyroid cancer (TC) is caused by genetic factors and or their cross talk with lifestyle and environment. An important role of miRNA involvement has been identified in...
Thyroid cancer (TC) is caused by genetic factors and or their cross talk with lifestyle and environment. An important role of miRNA involvement has been identified in different human diseases alongside the cancer. The growing cloud of miRNA discoveries narrates miRNA-221 and miRNA-222 as key elements of ready arsenal in the cancer micro-niches. The aim of present study was to identify the variations of miRNA-221 and miRNA-222 expression in TC tissues and their likely association with TC. miRNA-221 and miRNA-222 were investigated for their expressional alterations in TC tissue samples and healthy thyroid tissue. Expression of miRNA-221 and -222 was analyzed through real time PCR. The relative gene expression of both the miRNA was quantified and statistically evaluated. miRNA-221 and miRNA-222 were found to be highly over expressed when compared with samples of multinodular goiter (MNG) and normal controls. Interestingly, it was also noted that miRNA-221 and miRNA-222 expression is working in a cluster in thyroid cancer patients. So, it can be concluded that the expressional alterations of miRNA-221 and -222 are playing their potential role in the development of thyroid cancer.
Topics: Humans; Tumor Microenvironment; Thyroid Neoplasms; MicroRNAs; Cross Reactions
PubMed: 37737255
DOI: 10.1038/s41598-023-42941-1 -
Journal of Clinical & Translational... Sep 2023The incidence of thyroid cancer has increased over the last three decades with studies showing incidence of thyroid cancer is higher among patients with Graves' Disease...
BACKGROUND
The incidence of thyroid cancer has increased over the last three decades with studies showing incidence of thyroid cancer is higher among patients with Graves' Disease (GD) when compared to Toxic multinodular goiter. We conducted a retrospective study to further investigate characteristics and outcomes in patients with thyroid cancer and GD.
METHODS
We retrospectively reviewed 62 patients with a diagnosis of Differentiated Thyroid Cancer (DTC). We compared age at diagnosis, type, size of tumor, radioactive iodine (RAI) use, and DTC recurrence amongst patients with GD, non-GD patients. We used Chi-square to test for independence among categorical variables at a nominal level of 0.05; comparison was based on -test.
RESULTS
Out of 62 patients, 29 patients had GD and DTC (47%). 94% had papillary thyroid cancer. Patients with GD were diagnosed with DTC at a younger age (mean 46 years) in comparison to patients without GD (mean 53 years). There was no difference in the type of DTC. Patients with GD had significantly smaller tumor size (mean size 1.035 cm; p value = 0.002), more Stage 1 and 2 compared to patients without GD (p-value = 0.009). Both groups of patients had similar rates of recurrence on follow up and RAI use.
CONCLUSION
We found patients with GD had smaller tumor size, early-stage DTC when compared to patients without GD and potentially favorable prognosis. More data is needed to understand whether this is due to pathogenesis like Graves antibodies promoting tumor formation or merely earlier detection of DTC in GD.
PubMed: 37547825
DOI: 10.1016/j.jcte.2023.100321 -
Clinical Nuclear Medicine Jun 2024This article aims to describe the presentation of Plummer disease and its evolution after radioiodine treatment and determine factors that may influence treatment...
PURPOSE
This article aims to describe the presentation of Plummer disease and its evolution after radioiodine treatment and determine factors that may influence treatment efficacy.
PATIENTS AND METHODS
The sample included retrospective medical records of 165 adult patients with toxic nodular goiter treated with radioiodine between 1997 and 2017, followed up at a single thyroid center.
RESULTS
The efficacy of treatment with a single dose of radioiodine was higher than 90%. The mean radioiodine activity was 28.9 ± 3.4 mCi. The mean time between radioiodine performance and hyperthyroidism resolution was 3.6 ± 3.0 months, ranging from 1-12 months. After the first year, 33.9% of the patients were under hypothyroidism, 59.4% under euthyroidism, and 6.7% under hyperthyroidism. Among the nonresponders, the variables that showed statistical difference were the presence of multinodular goiter and the radioiodine activity (mean, 25.5 ± 6.5 mCi; median, 30 [15-30 mCi]). The cumulative rate of hypothyroidism was 48.9% over 20 years of follow-up.
CONCLUSIONS
Radioiodine therapy is an effective and safe treatment. In Plummer disease, high rates of euthyroidism are expected after the radioiodine treatment. Therapeutic failure was observed mainly in patients with larger multinodular goiters treated with lower doses of radioiodine. The evolution to hypothyroidism was mostly observed in younger patients with larger and uninodular goiters.
Topics: Humans; Iodine Radioisotopes; Female; Male; Middle Aged; Thyroid Nodule; Follow-Up Studies; Adult; Aged; Retrospective Studies; Treatment Outcome; Time Factors; Aged, 80 and over
PubMed: 38619976
DOI: 10.1097/RLU.0000000000005189 -
Endocrine Practice : Official Journal... May 2024To assess the bedside utility of Spectral Doppler Ultrasound (SDUS) in the initial evaluation of patients presenting with thyrotoxicosis.
OBJECTIVE
To assess the bedside utility of Spectral Doppler Ultrasound (SDUS) in the initial evaluation of patients presenting with thyrotoxicosis.
METHODS
This is a retrospective cross-sectional study of patients diagnosed with thyrotoxicosis at an academic outpatient endocrinology clinic from August 2019 to November 2022. The thyroid arteries' peak systolic velocities (PSV) were measured bilaterally using SDUS. PSV ≥40 cm/s in at least a single thyroid artery was considered a reasonable cut-off for Graves' disease and PSV of perinodular artery ≥ 25 cm/s for toxic adenoma.
RESULTS
We identified 73 patients. Mean age ± standard deviation 45.2 ± 16.4 years, 54 (74.0%) were female, 49 (67.1%) were Caucasian, 23 (31.5%) were African American, and 1 (1.4%) was Asian. The confirmed diagnoses were 48 (65.8%) Graves' disease, 13 (17.8%) thyroiditis, four (5.5%) toxic adenoma, four (5.5%) amiodarone-induced thyroiditis type 2, 1 (1.4%) toxic multinodular goiter, 1 (1.4%) had an unremarkable repeat thyroid function testing, and two (2.7%) were unconfirmed. Diagnosis based on the SDUS initial assessment was accurate in 65 (89.0%) of the patients, and it was conclusive and confirmatory during the initial encounter in 55 (75.3%) of the patients before additional testing. A thyroid scan was obtained in nine (12.3%) patients. Incorrectly diagnosed patients were observed in two patients of each of the following categories: Graves' disease, thyroiditis, toxic adenoma, and unconfirmed diagnoses.
CONCLUSIONS
SDUS can be a valuable, efficient, and cost-effective bedside tool in the initial assessment of patients presenting with thyrotoxicosis.
Topics: Humans; Female; Thyrotoxicosis; Cross-Sectional Studies; Male; Retrospective Studies; Middle Aged; Adult; Thyroid Gland; Graves Disease; Ultrasonography, Doppler; Point-of-Care Testing
PubMed: 38331386
DOI: 10.1016/j.eprac.2024.02.001 -
Journal of Clinical Medicine Sep 2023Uncontrolled acromegaly causes increased morbidity and mortality. The analysis of acromegaly comorbidities and complications is important when establishing a standard of...
Uncontrolled acromegaly causes increased morbidity and mortality. The analysis of acromegaly comorbidities and complications is important when establishing a standard of care for the entire population of acromegaly patients. The aim of this study was to determine the frequency of comorbidities and complications of acromegaly and their dependence on the activity of the disease. A retrospective analysis of medical records from 124 patients with acromegaly was carried out, including 39 who were cured, 73 treated with somatostatin analogs and 12 newly diagnosed patients. The incidence of comorbidities and complications was very high, and those most frequently observed were arterial hypertension, multinodular goiter, lipid disorders, hypopituitarism and degenerative changes. At least one complication of acromegaly was observed in 92% of patients undergoing successful neurosurgery and in all pharmacologically treated patients. By contrast, two or more complications were observed in 77% of cured patients and in pharmacologically controlled and uncontrolled patients, 82% and 91%, respectively. Conclusions: Acromegaly is associated with a high prevalence of complications. Active acromegaly is associated with a higher incidence of complications than in treated groups. Untreated patients have more complications than treated patients. Successfully cured patients have significantly fewer complications than pharmacologically controlled patients and patients with active acromegaly.
PubMed: 37834952
DOI: 10.3390/jcm12196309 -
Endocrinologia, Diabetes Y Nutricion Apr 2024Thyrotoxicosis is the clinical condition resulting from an excess of thyroid hormones for any reason. The main causes are Graves-Basedow disease, toxic multinodular... (Review)
Review
Thyrotoxicosis is the clinical condition resulting from an excess of thyroid hormones for any reason. The main causes are Graves-Basedow disease, toxic multinodular goitre and toxic adenoma. The medical treatment to control thyroid function includes antithyroid drugs, beta blockers, iodine solutions, corticosteroids and cholestyramine. Although therapeutic plasma exchange is not generally part of the therapy, it is an alternative as a preliminary stage before the definitive treatment. This procedure makes it possible to eliminate T4, T3, TSI, cytokines and amiodarone. In most cases, more than one cycle is necessary, either daily or every three days, until clinical improvement is observed. The effect on thyrotoxicosis is temporary, with an approximate duration of 24-48h. This approach has been proposed as a safe and effective alternative when the medical treatment is contraindicated or not effective, and when there is multiple organ failure or emergency surgery is required.
Topics: Humans; Thyrotoxicosis; Plasma Exchange; Female; Middle Aged; Male
PubMed: 38735679
DOI: 10.1016/j.endien.2024.01.009 -
Annales de Pathologie Mar 2024
Topics: Humans; Goiter; Goiter, Nodular
PubMed: 37730460
DOI: 10.1016/j.annpat.2023.08.004 -
Indian Journal of Otolaryngology and... Dec 2023The focal point of thyroidectomy surgery has always been to reduce the incidence of inadvertent damage to the recurrent laryngeal nerve(RLN). The intracapsular...
The focal point of thyroidectomy surgery has always been to reduce the incidence of inadvertent damage to the recurrent laryngeal nerve(RLN). The intracapsular thyroidectomy is one such technique with minimum chance of injuring the nerve. To compare retrospectively the surgical outcomes between the two methods of thyroidectomy-coventional thyroidectomy Vs intracapsular thyroidectomy. Materials and methods-55 cases of benign thyroid disease for whom thyroidectomy was performed in our hospital between the period of 2019-2022 were compared retrospectively. Out of these 34 cases had undergone intracapsular thyroidectomy and 21 cases underwent routine extracapsular thyroidectomy. The surgical outcomes including operation time, pain, postoperative infection, postoperative hypocalcemia, postoperative recurrent laryngeal nerve paralysis and mean hospital stay were analyzed. The mean operating time were very low in the intracapsular limb as compared to the other group. The pain and the mean hospital stay was also far lesser for the intracapsular limb. Both cohorts had no incidence of hypocalcemia. The incidence of recurrent laryngeal nerve palsy was very low in the intracapsular cohort (only 1 case of temporary unilateral RLN palsy), whereas it was higher in the routine extracapsular cohort (5 cases of permanent palsy). The risk of having vocal cord palsy (left/right) is 1.172 times more with conventional/standard thyroidectomy as compared to intracapsular thyroidectomy. Intracapsular technique is a much more rewarding method to perform thyroidectomy, without the risk of the recurrent laryngeal nerve palsy as compared to routine thyroidectomy.
PubMed: 37974880
DOI: 10.1007/s12070-023-04074-9 -
Cureus Jan 2024Subclinical thyrotoxicosis (SCH) is characterized by normal serum thyroid hormone levels and low thyrotropin levels. The impact of this condition on the skeletal system...
BACKGROUND
Subclinical thyrotoxicosis (SCH) is characterized by normal serum thyroid hormone levels and low thyrotropin levels. The impact of this condition on the skeletal system may vary depending on its cause, yet the relationship is not fully comprehended in premenopausal women. Studies are scarce about its effects on bone health in our population.
OBJECTIVES
This study aims to evaluate the bone mineral density (BMD) and bone turnover markers in premenopausal women with SCH and determine if any differences exist based on the condition's etiology.
METHODS
A cross-sectional study was conducted at Ramaiah Medical College involving 36 participants for one year and six months after approval from the Ethics Committee. The carboxy-terminal telopeptide of type I collagen in blood and BMD were measured at the lumbar vertebrae (L1-L4) and femoral neck by dual-energy x-ray absorptiometry (Hologic v 2.0, Hologic, Massachusetts, U.S.). Statistical analysis was done using IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York, United States). Results: The mean age of the study population was 35.2 ± 7.2 years. The etiology was Graves' disease [n=11 (33.3%)], iatrogenic [n=14(38.8%)], toxic adenoma [n=6 (15.1%)], and multi-nodular goiter [n=5 (15.1%)]. The mean BMI was 23.5 ± 3.8 kg/m, and the mean levels of corrected calcium, phosphorus, and 25 hydroxy-vitamin D were 9.12 ± 0.25 mg/dl, 2.95 ± 0.34 mg/dl, and 29.4 ± 6.4 ng/ml, respectively. The mean BMD at hip and spine was 0.81 ±0.16 g/cm and 0.92±0.08 g/cm respectively. The mean Z-score was (-0.02 ± 0.8) and (-0.92± 0.08) at the hip and spine. No significant difference was observed in the BMD at the hip (p = 0.14) or spine (p = 0.44) between the endogenous and exogenous subclinical thyrotoxic subgroups. At the same time, the carboxy-terminal telopeptide of type I collagen was significantly different between the two groups (p<0.05).
CONCLUSION
In our cross-sectional study of premenopausal women with SCH, BMD at the hip or spine as measured by dual-energy X-ray absorptiometry did not reveal any significant reduction. The subclinical thyrotoxic state may not have an adverse effect on bone health in premenopausal females with sufficient levels of serum 25-hydroxy-vitamin D in the short term.
PubMed: 38374858
DOI: 10.7759/cureus.52610 -
Journal of Pediatric Endocrinology &... Aug 2023To present a case of a new pathogenic variant of DICER1.
OBJECTIVES
To present a case of a new pathogenic variant of DICER1.
CASE PRESENTATION
13-year-old female with non-toxic multinodular goiter and ovarian Sertoli-Leydig cell tumor, in whom a pineal parenchymal tumor of intermediate differentiation was diagnosed. Next-generation sequencing revealed a new germline mutation in the gene (exon 16, c2488del [pGlu830Serfs*2] in heterozygosis), establishing the diagnosis of DICER1 syndrome.
CONCLUSIONS
Mutations in the gene cause genetic predisposition to a wide spectrum of benign or malignant tumors from childhood to adulthood.
Topics: Female; Humans; Adolescent; Child; Young Adult; Sertoli-Leydig Cell Tumor; Ovarian Neoplasms; Pinealoma; Goiter; Brain Neoplasms; Pineal Gland; Cell Differentiation; Ribonuclease III; DEAD-box RNA Helicases
PubMed: 37307239
DOI: 10.1515/jpem-2023-0149