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Langenbeck's Archives of Surgery Jun 2024Weight loss failure after bariatric surgery imposes great stress on patients and surgeons and great costs on healthcare systems. The literature review shows that weight...
BACKGROUND
Weight loss failure after bariatric surgery imposes great stress on patients and surgeons and great costs on healthcare systems. The literature review shows that weight loss failure is the most common cause of redo bariatric surgery. Therefore, identifying the predictors of weight loss failure in patients in the early stages can help bariatric surgeons. The present study aims to determine the association between primary weight loss and long-term weight loss outcomes.
METHODS
This retrospective cohort study was conducted on 329 patients undergoing OAGB who were followed for 60 months. For the prediction of short-term (24 months) and long-term (60 months) successful weight loss and weight regain, we used %TWL and BMI at any regular follow-ups.
RESULTS
In preoperative indices, age, sex, DLP, hypothyroidism, and HTN were not significant to predict successful short-term and long-term weight loss but %TWL at 12 months is a significant predictor of successful weight loss in short-term and long-term follow up. In the prediction of weight regain, preoperative indices (except BMI) were not significant but 12-month %TWL was a significant predictor.
CONCLUSIONS
This index can help surgeons find these patients early and provide helpful instructions to manage their issues more promptly to reach better weight loss outcomes.
Topics: Humans; Female; Male; Weight Loss; Retrospective Studies; Gastric Bypass; Adult; Middle Aged; Obesity, Morbid; Treatment Outcome; Body Mass Index; Time Factors; Cohort Studies; Anastomosis, Surgical
PubMed: 38937299
DOI: 10.1007/s00423-024-03371-3 -
JAMA Oncology Jun 2024
PubMed: 38935383
DOI: 10.1001/jamaoncol.2024.1816 -
Cureus May 2024Hypothyroidism is a condition characterized by low thyroid hormone levels that can affect multiple organ systems with varying symptomatology. Common cardiac...
Hypothyroidism is a condition characterized by low thyroid hormone levels that can affect multiple organ systems with varying symptomatology. Common cardiac manifestations of hypothyroidism include bradycardia and decreased cardiac output. Pericardial effusion can also occur as a result of the condition and rarely can progress to cardiac tamponade. Patients with cardiac tamponade occurring as a result of underlying hypothyroidism can present atypically compared to those experiencing cardiac tamponade due to other causes. Patients with cardiac tamponade as a result of underlying hypothyroidism may present as minimally symptomatic with stable vital signs. Close monitoring of patients with pericardial effusions with underlying hypothyroidism is essential to permit early diagnosis and treatment of the condition. We outline the case of a 73-year-old male presenting with cardiac tamponade due to underlying hypothyroidism necessitating an urgent pericardial window.
PubMed: 38933628
DOI: 10.7759/cureus.61169 -
Acta Endocrinologica (Bucharest,... 2023Hashimoto thyroiditis (HT) is an autoimmune disorder associated with hypothyroidism. Lymphocyte infiltration leading to thyroid follicular cell destruction is...
BACKGROUND
Hashimoto thyroiditis (HT) is an autoimmune disorder associated with hypothyroidism. Lymphocyte infiltration leading to thyroid follicular cell destruction is counteracted by increased collagen production, deposition and scarring. However, only recently a specific subpopulation of modified fibroblasts with contractile properties, namely "myofibroblasts" (MFBs) have been linked to HT.
AIM
Our ultrastructural study aims to delineate the presence and contribution of MFBs to the fibrotic milieu of HT.
MATERIAL AND METHODS
Tissue biopsies were obtained from 5 HT-diagnosed patients and specimens were examined using a Transmission Electron Microscope (TEM).
RESULTS
Histopathological examination indicated extensive microvilli atrophy and atypical vacuolations of the thyroid follicular cells in the HT samples. In addition to interstitial extravasated lymphocytes, capillaries were encircled by MFBs (mean distance from lumen 1.248± 0.43µm) with the characteristic electron-dense α-smooth muscle actin (α-SMA), confirmable in higher magnifications. Myofibroblastic projections were found to have significantly higher representation near the capillary lumen compared to the impaired endothelial lining (P < 0.01).
CONCLUSION
Our TEM findings suggest that the intrusion of endothelia by myofibroblastic projections can be a significant factor towards the malfunction of follicular cells in HT patients and offer a paradigmal understanding of the ultrastructural interactions that may underlie the HT pathology.
PubMed: 38933253
DOI: 10.4183/aeb.2023.415 -
Acta Endocrinologica (Bucharest,... 2023The objective of this study was to evaluate the Systemic Inflammation Index (SII), Platelet to Lymphocyte Ratio (PLR), and Neutrophil to Lymphocyte Ratio (NLR) in HT and...
OBJECTIVES
The objective of this study was to evaluate the Systemic Inflammation Index (SII), Platelet to Lymphocyte Ratio (PLR), and Neutrophil to Lymphocyte Ratio (NLR) in HT and NIH, as well as their diagnostic value to predict the presence of inflammation.
SUBJECTS AND METHODS
The study included 505 patients, including 190 healthy controls, 166 euthyroid Hashimoto's thyroiditis (HT), 91 hypothyroid HT, and 58 non- immunogenic hypothyroidism (NIH) patients. The records of the patients in each group were reviewed retrospectively.
RESULTS
In terms of SII, there was a significant difference between the control and patient groups (p<0.001). PLR and NLR values were also found to be significantly higher in the patient group (p<0.001 and p=0.007, respectively). When euthyroid HT, hypothyroid HT, and NIH subgroups were compared to the control group, there was a significant difference in SII, PLR (for all p<0.001), but not in NLR (p=0.059). SII, PLR, and NLR were not different between the subgroups (p=0.595, p=0.861, and p=0.777, respectively).
CONCLUSIONS
It was found that the PLR, NLR, and SII indices were higher in Hashimoto's thyroiditis and non-immunogenic hypothyroidism. Of these indices, SII was the most powerful marker to predict the presence of inflammation.
PubMed: 38933249
DOI: 10.4183/aeb.2023.435 -
Acta Endocrinologica (Bucharest,... 2023This study aims to investigate the factors affecting development of acute kidney injury (AKI) in patients with severe hypothyroidism.
OBJECTIVE
This study aims to investigate the factors affecting development of acute kidney injury (AKI) in patients with severe hypothyroidism.
METHODS
This retrospective observational study involved patients with primary hypothyroidism and thyroid stimulating hormone (TSH) levels of more than 50 mIU/L at their review in the endocrinology outpatient clinic, between January 2015 and April 2021. Factors affecting the development of AKI were examined by logistic regression analysis.
RESULTS
A total of 100 patients, 20 (11 male (M), 9 female (F)) in the AKI (case) group and 80 (23 M, 57 F) patients in control group, were included in our study. The median age of the case group (56 years, interquartile range (IQR) 44.3-68.5) was significantly higher than the control group (49 years, IQR 32.3-60; p = 0.027), and the ratio of males to females was significantly higher in the case group (p = 0.001). Multivariate logistic regression analyses showed that hypothyroidism diagnosed after the age of 60 years (odds ratio (OR) 59.674, 95% confidence intervals (CI) 5.955-598.031; p = 0.001), free triiodothyronine (FT3) < 1.3 pg/mL (OR 17.151, 95% CI 2.491-118.089; p = 0.004) and creatine kinase (CK) > 1000 U/L (OR 1.522, 95% CI 1.602-82.848; p = 0.015) were predictors for the development of AKI in patients with severe hypothyroidism.
CONCLUSION
We recommend close follow-up and monitoring of patients with AKI caused by severe hypothyroidism if patients who are diagnosed at age > 60 years, CK > 1000 U/L or FT3 < 1.3 pg/mL.
PubMed: 38933242
DOI: 10.4183/aeb.2023.456 -
Acta Endocrinologica (Bucharest,... 2023Hyponatremia is a common electrolyte abnormality.
CONTEXT
Hyponatremia is a common electrolyte abnormality.
OBJECTIVE
We report a patient who presented with hyponatremia and diagnosed as small cell lung cancer metastatic to hypothalamus and pituitary.
CASE REPORT
A 68 year old male patient was admitted with fever and cough and pneumonia was considered. Serum sodium level was 113 mmol/L. Syndrome of inappropriate ADH (SIADH) is considered. Thyroid function tests and cortisol levels pointed out a central deficiency in both axes. Pituitary MRI was performed and a hypothalamic and pituitary mass were observed. Prednisolone therapy was started followed by L thyroxine replacement. A chest computer tomography (CT) was taken 2 weeks later revealed a mass lesion. Bronchoscopic biopsy was performed and histopathological diagnosis of the tumor was reported as small cell lung cancer.
RESULT
Many mechanisms were considered as the cause of hyponatremia in our patient. SIADH, secondary adrenal insufficiency and secondary hypothyroidism due to pituitary metastasis are possible causes.
CONCLUSION
The reason of hyponatremia is sometimes complex. When the underlying causes of hyponatremia are not evaluated in detail, many diagnoses can be missed.
PubMed: 38933238
DOI: 10.4183/aeb.2023.501 -
Journal of Diabetes and Metabolic... Jun 2024fluctuation in serum levels of thyroid hormones or thyroid-associated dysfunction can negatively affect the sexual behaviors or performance, and disruption in couples`... (Review)
Review
INTRODUCTION
fluctuation in serum levels of thyroid hormones or thyroid-associated dysfunction can negatively affect the sexual behaviors or performance, and disruption in couples` relationship or satisfaction. Thus, this systematic review and meta-analysis study was aimed to investigate the global prevalence of sexual dysfunction in men with thyroid gland disorders (TGD).
METHODS
this systematic review and meta-analysis study conducted based on PRISMA statement criteria regarding the available evidences representing the prevalence of sexual dysfunction in men with TGD. The initial searching process was applied on July, 2023. In this era, the main keywords of "Prevalence", "Sexual disorders", "Sexual disorder", "Sexual dysfunction", "Male sexual dysfunction", "Erectile dysfunction", "Males", "Men", "Thyroid disorders", "Thyroid diseases", "Hyperthyroidism", "Thyroid", and "Thyroiditis" were hired. Also, "AND" and "OR" operators were used for keywords combination. All intended studies were searched using the databases of Web of Science, Google Scholar, Scopus, ScienceDirect, PubMed, and Embase. Random effects model was used to perform the analysis and the heterogeneity of the studies was assessed through I index. Data analysis was applied with CMA software (v.2).
RESULTS
following the assessment of 17 eligible studies with a sample size of 501 individuals, the global prevalence of male sexual dysfunction with TGD was found 51.5% (95% CI:38.7-64). Also, the prevalence of male sexual dysfunction in hypothyroidism and hyperthyroidism cases was 59.1% (95% CI:37.2-77.8) and 41.5% (95% CI:25.9-59.1), respectively. The meta-regression analysis showed that following incremental trend in sample size, the global prevalence of male sexual dysfunction with TGD decreases. This assessment also revealed that the prevalence of male sexual dysfunction increases with the year of study conduction, significantly ( < 0.05).
CONCLUSION
the global prevalence of sexual dysfunction in men with TGD was found relatively high. also, the highest prevalence of sexual disorders was reported in hypothyroid cases. Thus, health policymakers are suggested to inform the individuals prone to this pathology regarding the negative effects of TGD on sexual dysfunction. Besides, TGD-affected cases can prevent sexual disorders and unpleasant consequences through timely medical treatments.
PubMed: 38932831
DOI: 10.1007/s40200-024-01408-4 -
Journal of Diabetes and Metabolic... Jun 2024This study aims to investigate comorbidities, clinical features, laboratory values, and diagnoses in non-diabetic patients experiencing hypoglycemic episodes.
PURPOSE
This study aims to investigate comorbidities, clinical features, laboratory values, and diagnoses in non-diabetic patients experiencing hypoglycemic episodes.
METHODS
A retrospective observational study was conducted at Shariati Hospital in Iran from 2016 to 2023. Seventy-four non-diabetic patients admitted with a diagnosis of hypoglycemia were included, while patients with diabetes were excluded. Demographic data, symptoms, and biochemical assessments were obtained from the hospital information system. Hypoglycemic episodes were identified based on low measured blood glucose, recorded medications for hypoglycemia treatment, or recorded codes indicating hypoglycemia. Hypoglycemia was defined as blood glucose below 70 mg/dL (3.9 mmol/L) along with two other criteria of the Whipple triad. Statistical analysis was performed using SPSS software (version 26).
RESULTS
Among the enrolled patients, 63.5% were female, and 13.5% were elderly (≥ 65 years). The most common comorbidities observed were cardiovascular disease (20.3%), psychological disorders (20.3%), hypothyroidism (14.9%), and hypertension (8.1%). The prevalent symptoms included weakness, loss of consciousness, sweating, palpitations, dizziness, and tremors. Non-diabetic hypoglycemia was caused by factitious disorders, insulinoma, organ failure, and infection, respectively.
CONCLUSION
Due to the diverse range of clinical symptoms, hypoglycemia in non-diabetic patients may be diagnosed late, leading to misdiagnoses such as psychological disorders or seizures. It is crucial to consider the possibility of hypoglycemia in non-diabetic patients and determine its underlying cause. Given the poor prognosis associated with hypoglycemia, timely interventions are essential.
PubMed: 38932802
DOI: 10.1007/s40200-023-01346-7 -
Endocrinology, Diabetes & Metabolism Jul 2024To determine the incidence, presentation, frequency and management of immune checkpoint inhibitors (ICI)-related endocrinopathies in a comprehensive cancer centre in...
OBJECTIVES
To determine the incidence, presentation, frequency and management of immune checkpoint inhibitors (ICI)-related endocrinopathies in a comprehensive cancer centre in Oman, particularly with programme death 1/programme death-ligand 1 (PD-1/PD-L1) inhibitors.
BACKGROUND
A high number of patients treated with PD-1/PD-L1 inhibitors for the management of solid tumours developed endocrinopathies.
METHODS
This is a retrospective study of patients admitted to Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC) from August 2021 to December 2022. All adults diagnosed with solid cancers and have received at least one dose of ICIs were included. Patients with incomplete data were excluded from the analysis. Data regarding the ICI-induced endocrinopathy were collected.
RESULTS
A total of 139 patients were included in the study of which 58% were females. The median age of the cohort was 56 years. The incidence of endocrine-related adverse events was 28%. The mean time for the development of endocrine adverse events after treatment initiation was 4.1 ± 2.8 months. Of the patients who developed toxicity, 90% had hypothyroidism. Ten patients developed hyperthyroidism, two patients were diagnosed with secondary adrenal insufficiency/hypophysitis and one patient developed Type 1 diabetes mellitus (DM). Using univariable logistic regression weight and body mass index (BMI) significantly impacted the development of endocrine immune-related adverse events (irAEs).
CONCLUSIONS
This is the first study from the Sultanate of Oman to assess PD-1/PDL-1 ICI-induced endocrinopathies. The most common endocrine adverse event is thyroid dysfunction, mainly hypothyroidism followed by hyperthyroidism. Hypophysitis, primary adrenal insufficiency and CIADM occur less frequently, but have a more significant effect on the patient's health. The treating physician should be aware of ICI-induced endocrinopathies, screening and treatment. Furthermore, our study showed that patients with a higher BMI have a greater risk of developing irAES. Further studies are needed to establish the predictors of endocrine irAEs.
Topics: Humans; Female; Male; Immune Checkpoint Inhibitors; Retrospective Studies; Middle Aged; Endocrine System Diseases; Neoplasms; Oman; Adult; Aged; Incidence; Cancer Care Facilities; Hypothyroidism
PubMed: 38932429
DOI: 10.1002/edm2.505