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European Thyroid Journal

Patrick W Owens, Terri P McVeigh, Eoin J Fahey, Marcia Bell, Denis S Quill, Michael J Kerin, Aoife J Lowery
Background: International best-practice guidelines recommend completion thyroidectomy and radioiodine remnant ablation (RRA) for patients with differentiated thyroid cancer (DTC) > 4 cm or with specific risk factors. Patients with DTC < 1 cm without risk factors are recommended for lobectomy alone. Indications for aggressive surgery and RRA are less clearly defined for tumours measuring 1-4 cm. A personalised approach to decision-making is recommended. Objectives: This study assesses therapeutic approaches to DTC as compared to the current British Thyroid Association (BTA) clinical practice guidelines...
November 2018: European Thyroid Journal
Tiago Nunes da Silva, Edward Limbert, Valeriano Leite
Purpose: The role of thyroglobulin (Tg) in predicting death and recurrence risk in patients with poorly differentiated thyroid carcinoma (PDTC) is not well established. We aimed to analyze Tg levels following total thyroidectomy and adjuvant radioiodine treatment (RAI) in PDTC patients and correlate Tg levels with survival and recurrence. Methods: A retrospective analysis was conducted on 101 patients with PDTC who were treated between 1986 and 2010. Among them, 38 had no distant metastases at presentation, were managed by total thyroidectomy and adjuvant RAI, and had negative anti-Tg antibodies...
November 2018: European Thyroid Journal
Luisa Paschke, Thomas Lincke, Katja Sibylle Mühlberg, Wolfram J Jabs, Tom H Lindner, Ralf Paschke
Cabozantinib and lenvatinib have been approved for the treatment of progressive medullary thyroid cancer and radioiodine-resistant thyroid cancer, respectively. Both phase III trials of cabozantinib and lenvatinib reported that renal adverse events (AEs) rarely occurred. The cabozantinib phase III study reported no AEs related to renal toxicity. In the lenvatinib phase III trial grade 3 (CTCAE), proteinuria (urinary protein ≥3.5 g/24 h) was found in 10.0% of the lenvatinib and 0.0% of the placebo patients...
November 2018: European Thyroid Journal
Carolina Castro Porto Silva Janovsky, Fernando H Cesena, Viviane Arevalo Tabone Valente, Raquel Dilguerian de Oliveira Conceição, Raul D Santos, Márcio Sommer Bittencourt
Introduction: Thyroid hormones are involved in the regulation of body composition, lipid metabolism, and insulin resistance. Thus, it is possible that they might play a role in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). However, the role of thyroid function on NAFLD is not well defined. In this study, we evaluated the relationship between thyroid-stimulating hormone (TSH) levels, within the reference range, and presence of NAFLD in asymptomatic individuals. Study Design: We included all individuals evaluated at a preventive clinic of the Hospital Israelita Albert Einstein, between 2014 and 2015...
November 2018: European Thyroid Journal
Roberto Negro, Roberto Attanasio, Enrico Papini, Rinaldo Guglielmi, Franco Grimaldi, Vincenzo Toscano, Dan Alexandru Niculescu, Diana Loreta Paun, Catalina Poiana
Objectives: Pregnancy induces changes in thyroid function, and thyroid dysfunction during gestation is associated with adverse outcomes. We examined the management of subclinical hypothyroidism and chronic autoimmune thyroiditis in pregnancy among Italian and Romanian endocrinologists. Methods: Members of the Associazione Medici Endocrinologi (AME) and Romanian Society of Endocrinology (RSE) were invited to participate in a web-based survey investigating the topic...
November 2018: European Thyroid Journal
Bushra Shahida, Tereza Planck, Peter Åsman, Mikael Lantz
Background: Deiodinase type 2 (DIO2) is an enzyme that catalyzes the production of the active form of thyroid -hormone triiodothyronine (T3) from thyroxine (T4) and is important for maintaining intracellular T3 levels. Single nucleotide polymorphisms (SNPs) in DIO2 were associated with several diseases. The association of SNPs in DIO2 with Graves' disease (GD) was suggested in 2 Russian studies. Objectives: The aim of the study was to examine whether SNPs in DIO2 are associated with GD or Graves' ophthalmopathy (GO)...
November 2018: European Thyroid Journal
Zhi Zhang, Anita Boelen, Andries Kalsbeek, Eric Fliers
Thyroid hormone (TH) plays a key role in regulating body temperature in mammals. Cold exposure stimulates the hypothalamus-pituitary-thyroid (HPT) axis at the hypothalamic level by activating hypophysiotropic thyrotropin-releasing hormone (TRH)-producing neurons, ultimately resulting in increased plasma TH concentrations. Importantly, the local TH metabolism within various cold-responsive organs enables tissue-specific action of TH on heat production and adaption to cold independently of the circulating TH levels...
November 2018: European Thyroid Journal
Remo Accorona, Inge Huskens, Jeroen Meulemans, Carlo Cappelli, Piero Nicolai, Davide Lombardi
Representations of thyroid swelling, intended as an enlarged anterior neck region, in the artworks of various periods are sporadically reported in the scientific literature, and different intents may be hypothesized. A comprehensive review of the international literature was performed on PubMed, Embase, and ResearchGate with the aim to analyze the modalities of representation of thyroid swelling through the ages by different artistic movements. Thyroid swelling is frequently represented in the artworks of many stylistic periods and seems to be a known condition even by the earliest cultures...
October 2018: European Thyroid Journal
Abbas Al-Kurd, David J Gross, David Zangen, Karine Atlan, Haggi Mazeh, Simona Grozinsky-Glasberg
Background: Multiple endocrine neoplasia (MEN) 2A is an autosomal dominant disorder that results from a mutation in the RET proto-oncogene on chromosome 10. Almost all of the affected patients develop medullary thyroid carcinoma (MTC). The American Thyroid Association recommends prophylactic thyroidectomy in MEN 2A pediatric patients, with the age of the recommended thyroidectomy varying according to the codon mutation present. Objectives: This report questions the reliability of the currently placed guidelines and whether the age threshold for prophylactic thyroidectomy in patients with known codon 634 mutations should be lowered, in parallel with an earlier evaluation of calcitonin levels in the serum...
October 2018: European Thyroid Journal
Amruth R Palla, Craig Allen Bollig, Jeffrey Brian Jorgensen
Liposarcoma of the thyroid gland is a pathology that is rarely encountered in clinical practice, given the paucity of these cases. For the same reason, a definite treatment protocol has not been established for these cases. We present a case of a 49-year-old man who presented with a thyroid mass that was found to be a well-differentiated liposarcoma and was treated surgically with no adjuvant therapy other than close surveillance with clinical examination and MRI scans. On his most recent clinical visit, 9 months after surgery, there was no clinical or radiologic evidence of recurrence and the patient is doing well with good speech and swallow functions and no new symptoms...
October 2018: European Thyroid Journal
Pedro Weslley Souza Rosario, Gabriela Franco Mourão, Pedro Henrique Lopes Oliveira, Tulio Henrique Silva
Background: Patients with small papillary thyroid carcinomas (PTC) can currently be maintained under active surveillance (AS). The recommended criteria are the following: adult individual, tumor ≤1 cm and not adjacent to the trachea or recurrent laryngeal nerve, cytology non-suggestive of the aggressive subtype, absence of lymph node (LN) involvement and extrathyroidal extension (ETE) on ultrasonography (US), and absence of clinical distant metastases. This study aimed to evaluate the frequency of the following peri- and postoperative findings in patients who met the criteria for PTC being candidate for AS: tumor > 1 cm, aggressive subtype or vascular invasion, ETE, clinical LN metastases (cN1), and distant metastases...
October 2018: European Thyroid Journal
Luca Damiani, Sabrina Lupo, Roberta Rossi, Stefania Bruni, Mirco Bartolomei, Stefano Panareo, Paola Franceschetti, Paolo Carcoforo, Giovanni Lanza, Stefano Pelucchi, Ettore Degli Uberti, Maria Chiara Zatelli
Background: BRAF V600E (c.1799T>A) somatic mutation evaluation in fine needle aspiration biopsies (FNAB) is a powerful diagnostic tool in the settings of papillary thyroid cancer (PTC). However, its prognostic value is still a matter of great debate and has been addressed mostly in retrospective studies. Objectives: To evaluate whether the somatic BRAF V600E mutation, assessed by direct sequencing in FNAB material of thyroid nodules, may correlate with disease persistence in PTC patients...
October 2018: European Thyroid Journal
Luba Freja Michaelsson, Jeppe Lerche la Cour, Bjarke Borregaard Medici, Torquil Watt, Jens Faber, Birte Nygaard
Objectives: According to one hypothesis, the popularity of levothyroxine (L-T4 )/liothyronine (L-T3 ) combination therapy relates to weight loss. The purpose of this study was to detect a possible correlation between thyroid-related quality of life (QoL) and weight loss in hypothyroid patients switched from L-T4 monotherapy to L-T4 /L-T3 combination therapy. Methods: In an open-label cohort study, all hypothyroid patients referred to the University Hospital endocrine clinic due to persistent symptoms despite adequate L-T4 monotherapy (without other explanations for the symptoms) were switched from L-T4 monotherapy to L-T4 / L-T3 combination therapy at a ratio of approximately 17/1...
October 2018: European Thyroid Journal
Eric Fliers, Barbara Demeneix, Ashok Bhaseen, Thomas H Brix
Several European countries have seen major health issues after a switch from one levothyroxine brand to another, as well as following the introduction of several levothyroxine formulation changes. While the relationship between these health issues and brand or formulation changes merits further investigation, the current position statement on behalf of both health-care providers and patients summarizes recent events in several European countries and provides a number of recommendations to limit the burden for patients, so as to prevent increased health-care consumption and health-care expenses in this context...
October 2018: European Thyroid Journal
Luca Persani, Georg Brabant, Mehul Dattani, Marco Bonomi, Ulla Feldt-Rasmussen, Eric Fliers, Annette Gruters, Dominique Maiter, Nadia Schoenmakers, A S Paul van Trotsenburg
Objectives: Central hypothyroidism (CeH) is a rare form of hypothyroidism characterized by insufficient thyroid stimulation due to disturbed pituitary and/or hypothalamic functioning. Due to its origin and the whole clinical context, CeH represents a challenging condition in clinical practice as it is characterized by suboptimal accuracy of clinical and biochemical parameters for diagnosis and management. Since no expert consensus or guidance for this condition is currently available, a task force of experts received the commitment from the European Thyroid Association (ETA) to prepare this document based on the principles of clinical evidence...
October 2018: European Thyroid Journal
Germán A Jimenez Londoño, Ana Maria Garcia Vicente, Julia Sastre Marcos, Francisco Jose Pena Pardo, Mariano Amo-Salas, Manuel Moreno Caballero, Maria Prado Talavera Rubio, Beatriz Gonzalez Garcia, Niletys Dafne Disotuar Ruiz, Angel Maria Soriano Castrejón
Aim: Based on the response criteria of the 2015 American Thyroid Associations guidelines, our objectives were to -determine the response rate when using a low dose of -131-I GBq in patients with low-risk differentiated thyroid cancer (LRDTC) and the influence of clinical and analytical variables on the prediction of complete response. Methods: We performed a multicentre and longitudinal study, including patients who were operated for LRDTC and who underwent radioiodine remnant ablation with a low-dose of 131-I...
August 2018: European Thyroid Journal
Mathieu Spaas, Brigitte Decallonne, Annouschka Laenen, Jaak Billen, Sandra Nuyts
Objective: The prognostic value of stimulated thyroglobulin (sTg) and Tg-related parameters prior to and immediately after radioactive iodine (RAI) administration was assessed in a cohort of patients presenting with differentiated thyroid cancer (DTC) as a predictor of recurrent or progressive structural disease. Methods: Clinical records of 180 DTC patients were retrospectively reviewed, and serum TSH, Tg, and Tg antibodies were recorded just before RAI administration (pre-) and at the time of whole body scanning (post-)...
August 2018: European Thyroid Journal
Helmi Khadra, Ahmed Deniwar, Khuzema Mohsin, Dominique Monlezun, Emad Kandil
Background: Papillary thyroid carcinoma (PTC) can be predicted from certain suspicious ultrasound (US) features of thyroid nodules. The aim of this study was to examine if these suspicious features can predict the more aggressive PTC associated with B-type Raf kinase (BRAFV600E) mutation. Methods: This was a retrospective review of prospectively collected data on patients with PTC and known BRAFV600E status. All patients underwent preoperative US by the same surgeon who performed all the operations...
August 2018: European Thyroid Journal
(no author information available yet)
On April 18, 2018 the EUthyroid consortium released the Krakow Declaration on Iodine in response to the increasing concern about the deteriorating commitment of policymakers to address public health strategies against iodine deficiency disorders (IDD) in the European populations. Regulators and policymakers should harmonize obligatory Universal Salt Iodization to ensure free trade of fortified foodstuffs in Europe. Similarly, iodized animal feed requires regulatory approval to ensure free trade within the EU...
August 2018: European Thyroid Journal
Henry Völzke, Iris Erlund, Alicja Hubalewska-Dydejczyk, Till Ittermann, Robin P Peeters, Margaret Rayman, Monika Buchberger, Uwe Siebert, Betina H Thuesen, Michael B Zimmermann, Stefan Grünert, John H Lazarus
Background: Iodine deficiency disorders (IDD) represent a global health threat to individuals and societies. IDD prevention programmes have been introduced in many parts of the world. However, challenges remain, particularly in Europe due to fragmentation and diversity of approaches that are not harmonized. Objectives: This review is dedicated to the public-health impact of IDD prevention programmes. It sums up experiences collected by the EUthyroid consortium so far and provides information on stakeholders that should be involved in actions directed to improve the impact of IDD prevention...
August 2018: European Thyroid Journal
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