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Valencia J, Jiménez J, Sanabria A. Early stimulated thyroglobulin after thyroidectomy for thyroid cancer predicts preradioiodine therapy thyroglobulin values. Minerva Endocrinol (Torino) 2023; 48:387-394. [PMID: 35822431 DOI: 10.23736/s2724-6507.22.03813-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
BACKGROUND Follow-up of patients who undergo a total thyroidectomy is performed with thyroglobulin (Tg), and antithyroglobulin antibodies (AbTg). The objective of RAI adjuvant therapy is to negativize Tg to undetectable levels to ease the follow-up. The objective of this study was to evaluate the correlation of serum Tg values measured 2 weeks after surgery with the Tg value prior to RAI adjuvant therapy in order to define its utility as a reliable predictor of pretherapy Tg and as a potential predictor to avoid RAI adjuvant therapy. METHODS Retrospective analysis of a cohort recruited prospectively. Adult patients with thyroid carcinoma who underwent total thyroidectomy and classified as intermediate or high risk by ATA guidelines. All patients were left without levothyroxine support after surgery and for at least two weeks. We measured biochemical markers two-four weeks after thyroidectomy and before and after RAI. RESULTS We included 75 patients. Thirty-three (44.0%) patients were classified as ATA high risk. In the post-RAI scan, only 1 (1.3%) showed distant metastases. The comparison between early postoperative and pretherapy Tg values showed that Tg decreased or remained stable at postoperative levels in 75 patients (100%). CONCLUSIONS Postoperative Tg measurements are a reliable marker of pretherapy Tg levels in patients with intermediate- and high-risk thyroid carcinoma who are candidates for RAI adjuvant therapy. These results need correlation with outcomes and response to therapy in high-risk patients.
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Affiliation(s)
- Julio Valencia
- School of Medicine, Department of Surgery, University of Antioquia, Medellin, Colombia
- Head and Neck Service, Pablo Tobón Uribe Hospital, Medellín, Colombia
| | - Jorge Jiménez
- Centro de Excelencia en Enfermedades de Cabeza y Cuello (CEXCA), Medellín, Colombia
| | - Alvaro Sanabria
- School of Medicine, Department of Surgery, University of Antioquia, Medellin, Colombia -
- Centro de Excelencia en Enfermedades de Cabeza y Cuello (CEXCA), Medellín, Colombia
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Shurbaji S, Al Tamimi F, Al Ghwairi MM, El Chaar D, Younes S, Majdalawieh AF, Pintus G, Al-Dewik N, Nasrallah GK. High-sensitive detection and quantitation of thyroid-stimulating hormone (TSH) from capillary/fingerstick and venepuncture whole-blood using fluorescence-based rapid lateral flow immunoassay (LFIA). Heliyon 2023; 9:e20589. [PMID: 37842620 PMCID: PMC10569953 DOI: 10.1016/j.heliyon.2023.e20589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 09/02/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023] Open
Abstract
Background In the last decade, point of care testing (POCT) such as lateral flow immunoassays (LFIA) were developed for rapid TSH measurement. Most of these TSH-LFIAs are designed for qualitative measurements (i.e., if TSH values > 5, or >15 IU/L) and as screening tests for primary hypothyroidism in children and adults. Serum or plasma, but not venepuncture whole-blood or fingerstick/capillary, are usually used to quantify TSH accurately. Studies on performance evaluation of TSH-LFIAs POCT using venepuncture or fingerstick whole-blood are limited. Additionally, limited studies evaluated the performance and validity of TSH-LFIAs POCT compared to valid and reliable reference methods. To our knowledge, this is the first study to evaluate three different blood withdrawal techniques for evaluating POCT of TSH. Aim We aim to evaluate the performance of a new fluorescence-based LFIA and its Finecare™ fluorescent reader for quantitative measurement of TSH from a fingerstick, venepuncture whole-blood, and serum. Methods 102 fingerstick, venepuncture whole-blood, and serum samples (with normal and abnormal TSH values) were analyzed by Finecare™ Rapid Quantitative LFIA test and Roche CobasPro-c503 as a reference test. Results Using serum, when compared to CobasPro-c503 reference method, Finecare™ showed high sensitivity [90.5 % (69.6-98.8)] and specificity [96.3 % (89.6-99.2)] for diagnosis of thyroid abnormalities (<0.35 or >4.5 mIU/L). The actual test values (mIU/L) of Finecare™ showed excellent agreement (Cohen's Kappa = 0.85) and strong correlation (r = 0.93, p < 0.0001) with CobasPro-c503. Using venepuncture whole-blood samples, Finecare™ showed similar results to serum with high sensitivity [95.2 % (76.2-99.9)], specificity [97.5 % (91.4-99.7)], excellent agreement (Cohen's Kappa = 0.91), and very strong correlation (r = 0.95, p < 0.0001) with CobasPro-c503. These results suggest that Finecare™ can be used for quantitative measurement of TSH using serum or venepuncture whole-blood. These key performance indicators were slightly decreased when fingerstick whole-blood samples were used: sensitivity [85.7 %(63.7-97)], specificity [90.0 %,(81.5-96)], good agreement (Cohen's Kappa = 0.7) and very strong correlation (r = 0.9, p < 0.0001) with CobasPro-c503. A subgroup analysis of abnormal TSH samples revealed a strong and significant correlation between the reference, Finecare™ whole-blood (r = 0.692; p = 0.0015), and fingerstick test Finecare™ (r = 0.66; p = 0.0025). A very strong correlation was also observed between Cobaspro-c508 serum and Finecare™ serum (r = 0.88; p < 0.0001). Conclusion: In comparison to the reference assay, our study demonstrates that Finecare™ exhibits high sensitivity, specificity, agreement, and a strong correlation. These findings provide evidence that Finecare™ is a reliable, valid, and accurate point-of-care test for TSH screening and quantitative measurement, especially in non- or small laboratory settings.
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Affiliation(s)
- Samar Shurbaji
- College of Dental Medicine, Qatar University, 2713, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, 2713, Doha, Qatar
| | - Faleh Al Tamimi
- College of Dental Medicine, Qatar University, 2713, Doha, Qatar
| | - Mahmoud M. Al Ghwairi
- Sciences of Medical Laboratory, Laboratory Analysis Technologists, Al-Ahliyya Amman University, Amman, 2213, Jordan
| | - Dayana El Chaar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, 2713, Doha, Qatar
- Biomedical Research Center, Qatar University, 2713, Doha, Qatar
| | - Salma Younes
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, 2713, Doha, Qatar
- Biomedical Research Center, Qatar University, 2713, Doha, Qatar
| | - Amin F. Majdalawieh
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, 26666, Sharjah, United Arab Emirates
| | - GianFranco Pintus
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Nader Al-Dewik
- Department of Research, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, 3050, Qatar
- Clinical and Metabolic Genetics, Department of Pediatrics, Hamad General Hospital, Hamad Medical Corporation, Doha, 3050, Qatar
- College of Health and Life Science (CHLS), Hamad Bin Khalifa University (HBKU), Doha, 34110, Qatar
| | - Gheyath K. Nasrallah
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, 2713, Doha, Qatar
- Biomedical Research Center, Qatar University, 2713, Doha, Qatar
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Zhao F, Zhang H, Cheng D, Wang W, Li Y, Wang Y, Lu D, Dong C, Ren D, Yang L. Predicting the risk of nodular thyroid disease in coal miners based on different machine learning models. Front Med (Lausanne) 2022; 9:1037944. [PMID: 36507527 PMCID: PMC9732087 DOI: 10.3389/fmed.2022.1037944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/11/2022] [Indexed: 11/27/2022] Open
Abstract
Background Nodular thyroid disease is by far the most common thyroid disease and is closely associated with the development of thyroid cancer. Coal miners with chronic coal dust exposure are at higher risk of developing nodular thyroid disease. There are few studies that use machine learning models to predict the occurrence of nodular thyroid disease in coal miners. The aim of this study was to predict the high risk of nodular thyroid disease in coal miners based on five different Machine learning (ML) models. Methods This is a retrospective clinical study in which 1,708 coal miners who were examined at the Huaihe Energy Occupational Disease Control Hospital in Anhui Province in April 2021 were selected and their clinical physical examination data, including general information, laboratory tests and imaging findings, were collected. A synthetic minority oversampling technique (SMOTE) was used for sample balancing, and the data set was randomly split into a training and Test dataset in a ratio of 8:2. Lasso regression and correlation heat map were used to screen the predictors of the models, and five ML models, including Extreme Gradient Augmentation (XGBoost), Logistic Classification (LR), Gaussian Parsimonious Bayesian Classification (GNB), Neural Network Classification (MLP), and Complementary Parsimonious Bayesian Classification (CNB) for their predictive efficacy, and the model with the highest AUC was selected as the optimal model for predicting the occurrence of nodular thyroid disease in coal miners. Result Lasso regression analysis showed Age, H-DLC, HCT, MCH, PLT, and GGT as predictor variables for the ML models; in addition, heat maps showed no significant correlation between the six variables. In the prediction of nodular thyroid disease, the AUC results of the five ML models, XGBoost (0.892), LR (0.577), GNB (0.603), MLP (0.601), and CNB (0.543), with the XGBoost model having the largest AUC, the model can be applied in clinical practice. Conclusion In this research, all five ML models were found to predict the risk of nodular thyroid disease in coal miners, with the XGBoost model having the best overall predictive performance. The model can assist clinicians in quickly and accurately predicting the occurrence of nodular thyroid disease in coal miners, and in adopting individualized clinical prevention and treatment strategies.
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Affiliation(s)
- Feng Zhao
- The First Hospital of Anhui University of Science & Technology (Huainan First People’s Hospital), Huainan, China
| | - Hongzhen Zhang
- Anhui University of Science and Technology College of Medicine, Huainan, China
| | - Danqing Cheng
- Graduate School of Bengbu Medical College, Bengbu, China
| | - Wenping Wang
- Graduate School of Bengbu Medical College, Bengbu, China
| | - Yongtian Li
- Anhui University of Science and Technology College of Medicine, Huainan, China
| | - Yisong Wang
- Anhui University of Science and Technology College of Medicine, Huainan, China
| | - Dekun Lu
- The First Hospital of Anhui University of Science & Technology (Huainan First People’s Hospital), Huainan, China
| | - Chunhui Dong
- Anhui University of Science and Technology College of Medicine, Huainan, China
| | - Dingfei Ren
- Occupational Control Hospital of Huai He Energy Group, Huainan, Anhui, China
| | - Lixin Yang
- The First Hospital of Anhui University of Science & Technology (Huainan First People’s Hospital), Huainan, China,*Correspondence: Lixin Yang,
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Zhao F, Zhang H, Ren D, Li CM, Gu Y, Wang Y, Lu D, Zhang Z, Lu Q, Shi X, Yang L. Association of coal mine dust lung disease with Nodular thyroid disease in coal miners: A retrospective observational study in China. Front Public Health 2022; 10:1005721. [PMID: 36388340 PMCID: PMC9650273 DOI: 10.3389/fpubh.2022.1005721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/13/2022] [Indexed: 01/27/2023] Open
Abstract
Background Coal dust is a major risk factor for the occupational health of coal miners, and underground workers with coal mine dust lung disease (Coal miners with coal mine dust lung disease (CMDLD) may have a higher risk of developing Nodular thyroid disease (NTD). The aim of this study was to investigate the relationship between coal mine dust lung disease and the development of Nodular thyroid disease in coal miners. Methods This was a clinical retrospective observational study that included 955 male coal miners from 31 different coal mining companies in Huainan, Anhui Province, China, who were examined in April 2021 at the Huainan Occupational Disease Prevention and Control Hospital to collect all their clinical physical examination data, including general conditions, laboratory test indices and imaging indices. Based on the presence or absence of Nodular thyroid disease, 429 cases with Nodular thyroid disease were classified as the diseased group and 526 cases without Nodular thyroid disease were classified as the control group. Logistic regression was used to analyse the correlation between the occurrence of Nodular thyroid disease in coal miners, and further single- and multi-factor logistic regression was used to screen the risk exposure factors for Nodular thyroid disease in coal miners. Results Age, coal mine dust lung disease (CMDLD), red blood cells (RBC), mean red blood cell volume (MCV), albumin (ALB), albumin/globulin (A/G), indirect bilirubin (IBIL), globulin (GLOB), total bilirubin (TBil) and myeloperoxidase (MPO) were associated with the development of Nodular thyroid disease in coal miners (p < 0.05) The results of univariate and multifactorial logistic regression analysis showed that CMDLD (OR:4.5,95%CI:2.79-7.51) had the highest OR and CMDLD was the strongest independent risk exposure factor for the development of Nodular thyroid disease in coal miners. Conclusions There is a strong correlation between coal mine dust lung disease and Nodular thyroid disease in underground coal miners, and clinicians need to be highly aware of the high risk of NTD in coal miners with CMDLD and adopt individualized clinical prevention strategies.
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Affiliation(s)
- Feng Zhao
- The First Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan, China
| | - Hongzhen Zhang
- Anhui University of Science and Technology College of Medicine, Huainan, China
| | - Dingfei Ren
- Occupational Control Hospital of Huaihe Energy Group, Huainan, China
| | - Chang-ming Li
- Occupational Control Hospital of Huaihe Energy Group, Huainan, China
| | - Yaqi Gu
- Xinhua Hospital, Huainan Xinhua Medical Group, Huainan, China
| | - Yisong Wang
- Anhui University of Science and Technology College of Medicine, Huainan, China
| | - Dekun Lu
- The First Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan, China
| | - Zongyao Zhang
- The First Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan, China
| | - Qi Lu
- The First Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan, China
| | - Xinxin Shi
- The First Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan, China
| | - Lixin Yang
- The First Hospital of Anhui University of Science and Technology (Huainan First People's Hospital), Huainan, China,*Correspondence: Lixin Yang
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El-Sebai Ali M, Atef Ebada H, El-Shaheed MA, Musaad AbdElFattah A, Kamal ELS. Routine thyroidectomy with total laryngectomy: Is it really indicated? A randomized controlled trial. Ann Med Surg (Lond) 2022; 74:103309. [PMID: 35145675 PMCID: PMC8818527 DOI: 10.1016/j.amsu.2022.103309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/08/2022] [Accepted: 01/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background We investigated the incidence of thyroid gland invasion in patients with advanced laryngeal carcinoma who were treated with total laryngectomy, also the impact of different preoperative and intraoperative predictors on thyroid gland invasion. Moreover, the impact of thyroid gland preservation on the locoregional tumor control and the recurrence rates after surgery were investigated. Materials and methods This study was conducted over 5 years on 100 patients with advanced laryngeal carcinoma who underwent total laryngectomy. The adopted protocol in our hospital is to perform an ipsilateral thyroid lobectomy if there is subglottic extension, thyroid or cricoid cartilage invasion or true invasion of the thyroid gland. The patients of the study were divided into thyroid sparing and thyroid sacrificing groups. The two groups were compared in terms of demographic data, tumor characteristics, incidence of postoperative hypothyroidism and tumor recurrence. Results There was no significant difference between groups regarding the tumor profile. Regarding local tumor spread, the only two subsites that showed significant difference is anterior commissure and thyroid cartilage invasion. In the thyroid sacrificing group, invasion of the thyroid gland was proved histopathologically in only one patient. Postoperatively, the incidence of hypothyroidism was significantly higher in the thyroid sacrificing group. However, there was no statistically significant difference between the two groups regarding the incidence of tumor recurrence. Conclusion The incidence of thyroid gland invasion by an advanced laryngeal carcinoma is low. Preservation of the thyroid gland during laryngectomy to reduce the risk of thyroid dysfunction does not affect the oncological control. Thyroid gland invasion incidence in advanced laryngeal carcinoma is low. Thyroid gland Preservation during laryngectomy does not affect the oncological control. There was no statistically significant difference between the thyroid sparing and thyroid sacrificing group regarding the incidence of recurrence. Due toding author”. Due toding author".
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Aziz A, Masood MQ, Sattar S, Fatima S, Islam N. Follicular Thyroid Carcinoma in a Developing Country: A 10-Year Retrospective Study. Cureus 2021; 13:e16594. [PMID: 34430179 PMCID: PMC8378411 DOI: 10.7759/cureus.16594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 11/11/2022] Open
Abstract
Background The most common endocrine tumor is thyroid cancer. Follicular thyroid carcinoma (FTC) accounts for 5-10% of all thyroid cancers. Patients with FTC frequently present with more advanced diseases and a higher occurrence of distant metastases because of the propensity of vascular invasion. FTC is mainly treated with surgery while radioactive iodine (RAI) therapy is the main adjuvant therapy according to the American Thyroid Association guidelines. Methodology This was a retrospective observational study of FTC patients aged 18 and above conducted at a tertiary care hospital in Karachi from January 01, 2010 to December 31, 2019. Results A total of 404 patients with thyroid carcinoma were sorted, of which 40 (10.1%) were FTC cases. Overall, 50% of the patients were in the age group of 41-60 years, and the female-to-male ratio was 1.5:1. The majority of patients (60%) presented with neck swelling, followed by bone and lung metastasis in 20% and compressive symptoms in another 20%. On fine needle aspiration cytology (FNAC), 50% had Bethesda category III-IV nodules while 10% had Bethesda category II. Overall, 50% had a total thyroidectomy while 50% had a lobectomy followed by a completion thyroidectomy. On histopathology, 23 (57.5%) patients had minimally invasive FTC while 17 (42.5%) had widely invasive FTC. A total of 17 (42.5%) patients had received RAI 30-100 mCi while 10 (25%) received more than 100 mCi. Conclusions FTC can present with both local or metastatic symptoms. The atypical presentation of metastatic FTC should be considered, diagnosed, and managed early to limit mortality and morbidity. Ultrasound is the best diagnostic investigation of choice followed by FNAC. Surgery is the mainstay of treatment and should be followed by RAI in select cases. Thus, understanding the trend of FTC and proper planning and utilization of the resources will help developing countries in effectively treating the FTC.
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Affiliation(s)
- Abdul Aziz
- Department of Medicine, Section of Endocrinology, Aga Khan University Hospital, Karachi, PAK
| | - Muhammad Qamar Masood
- Department of Medicine, Section of Endocrinology, Aga Khan University Hospital, Karachi, PAK
| | - Saadia Sattar
- Department of Medicine, Section of Endocrinology, Aga Khan University Hospital, Karachi, PAK
| | - Saira Fatima
- Department of Pathology & Laboratory Medicine, Section of Histopathology, Aga Khan University Hospital, Karachi, PAK
| | - Najmul Islam
- Department of Medicine, Section of Endocrinology, Aga Khan University Hospital, Karachi, PAK
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Dedhia PH, Stoeckl EM, McDow AD, Saruni S, Schneider DF, Long KL. Preoperative surgeon-performed ultrasound of massive thyroid goiter in rural Kenya. Am J Surg 2021; 221:925-926. [DOI: 10.1016/j.amjsurg.2020.09.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/26/2020] [Indexed: 02/03/2023]
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Marini TJ, Oppenheimer DC, Baran TM, Rubens DJ, Toscano M, Drennan K, Garra B, Miele FR, Garra G, Noone SJ, Tamayo L, Carlotto C, Trujillo L, Waks E, Garra K, Egoavil MS, Berrospi J, Castaneda B. New Ultrasound Telediagnostic System for Low-Resource Areas: Pilot Results From Peru. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:583-595. [PMID: 32798267 DOI: 10.1002/jum.15420] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 05/26/2023]
Abstract
Billions of people around the world lack access to diagnostic imaging. To address this issue, we piloted a comprehensive ultrasound telediagnostic system, which uses ultrasound volume sweep imaging (VSI) acquisitions capable of being performed by operators without prior traditional ultrasound training and new telemedicine software capable of sending imaging acquisitions asynchronously over low Internet bandwidth for remote interpretation. The telediagnostic system was tested with obstetric, right upper quadrant abdominal, and thyroid volume sweep imaging protocols in Peru. Scans obtained by operators without prior ultrasound experience were sent for remote interpretation by specialists using the telemedicine platform. Scans obtained allowed visualization of the target region in 96% of cases with diagnostic imaging quality. This telediagnostic system shows promise in improving health care disparities in the developing world.
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Affiliation(s)
- Thomas J Marini
- Department of Imaging Sciences, University of Rochester, and University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, New York, USA
| | - Daniel C Oppenheimer
- Department of Imaging Sciences, University of Rochester, and University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, New York, USA
| | - Timothy M Baran
- Department of Imaging Sciences, University of Rochester, and University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, New York, USA
| | - Deborah J Rubens
- Department of Imaging Sciences, University of Rochester, and University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, New York, USA
| | - Marika Toscano
- Department of Obstetrics and Gynecology, University of Rochester, and University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, New York, USA
| | - Kathryn Drennan
- Department of Obstetrics and Gynecology, University of Rochester, and University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, New York, USA
| | - Brian Garra
- Medical Imaging Ministries of the Americas, Clermont, Florida, USA
| | - Frank R Miele
- Medical Imaging Ministries of the Americas, Clermont, Florida, USA
| | - Gail Garra
- Medical Imaging Ministries of the Americas, Clermont, Florida, USA
| | | | | | | | | | - Erin Waks
- Medical Imaging Ministries of the Americas, Clermont, Florida, USA
| | - Katie Garra
- Medical Imaging Ministries of the Americas, Clermont, Florida, USA
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Hassan-Kadle MA, Adani AA, Eker HH, Keles E, Muse Osman M, Mahdi Ahmed H, Görçin Karaketir Ş. Spectrum and Prevalence of Thyroid Diseases at a Tertiary Referral Hospital in Mogadishu, Somalia: A Retrospective Study of 976 Cases. Int J Endocrinol 2021; 2021:7154250. [PMID: 34987575 PMCID: PMC8720598 DOI: 10.1155/2021/7154250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Thyroid disorder is one of the most common noncommunicable diseases worldwide and neglected public health issues in Somalia. The aim of the study thus was to investigate the thyroid disorders in patients attending to the largest tertiary referral hospital in Somalia. METHODS This retrospective study was conducted on patients admitted to the internal department of Somalia Mogadishu-Turkey Education and Research Hospital, Somali, between January 2017 and December 2019. Patients who were tested for thyroid function tests and had complete data were included. Patients with incomplete data and currently treated for any thyroid disorder were excluded from the study. Abstracted data including patients' sociodemographic characteristics, thyroid function tests, and histopathological findings were retrieved from the hospital database system. RESULTS A total of 976 patients with thyroid disorders were enrolled, of whom 66.6% (n = 650) were female and 33.4% (n = 326) were male. The mean age of the patients was 47 ± 18.5 years. The majority of the patients were reported in the 31-50 (35.9%) age range. The most reported thyroid function disorders were 58.8% euthyroid sick syndrome followed by 15.4% hypothyroidism, 12.5% subclinical hypothyroidism, 7.6% hyperthyroidism, and 5.7% subclinical hyperthyroidism. The distribution of comorbidity indicated that 13.4% had diabetes mellitus, 10.4% had HIV, 4.9% had malaria, and 4.5% had HIV and malaria coinfection. Thyroid malignancies were detached in 22 (2.2%) patients including eleven papillary thyroid cancer, nine patients had follicular thyroid cancer, and two patients had differentiated thyroid cancer. CONCLUSIONS Euthyroid sick syndrome was the most common type of thyroid disease in our setup. Hypothyroidism is the second most common, followed by subclinical hypothyroidism. Papillary thyroid cancer was the predominant histology among thyroid malignancies, followed by follicular thyroid cancer. This study revealed that thyroid diseases emerge as an important endocrine disorder encountered in Somali, necessitating a major public health response.
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Affiliation(s)
- Mohamed A. Hassan-Kadle
- SomGastro Clinic, Center for Digestive and Liver Disease, College of Medicine & Health Science, Abrar University, Mogadishu, Somalia
| | - Abdulkamil Abdullahi Adani
- Department of Internal Medicine, University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia
| | - Hasan Huseyin Eker
- Department of Public Health, University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Istanbul 34668, Turkey
| | - Esra Keles
- Department of Gynecologic Oncology, University of Health Sciences Turkey, Zeynep Kamil Training and Research Hospital, Istanbul 34668, Turkey
| | - Marian Muse Osman
- Department of Public Health, University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia
| | - Hussein Mahdi Ahmed
- Department of Internal Medicine, University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia
| | - Şeyma Görçin Karaketir
- Occupational Health Training Programme, Department of Public Health, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
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Does thyroid-sparing total laryngectomy decrease the risk of hypothyroidism? The Journal of Laryngology & Otology 2020; 134:1069-1072. [PMID: 33243316 DOI: 10.1017/s0022215120002479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Thyroid lobectomy is recommended with total laryngectomy for laryngeal cancer in the National Comprehensive Cancer Network ('NCCN') guidelines. However, it is associated with a 32-89 per cent risk of hypothyroidism, with or without adjuvant radiotherapy. OBJECTIVE The study aimed to determine whether preserving the whole thyroid, compared to a single lobe, does indeed significantly lower the incidence of hypothyroidism in the setting of total laryngectomy. METHOD A retrospective study was conducted at Groote Schuur Hospital in Cape Town, South Africa. RESULTS Eighty-four patients met the inclusion criteria. The overall incidence of hypothyroidism was 45.2 per cent. The incidence of hypothyroidism was significantly reduced in patients who underwent thyroid-sparing total laryngectomy compared to hemithyroidectomy (p = 0.037). Adjuvant radiotherapy was associated with a higher incidence of hypothyroidism (p = 0.001). CONCLUSION Thyroid-preserving laryngectomy should be advocated in carefully selected patients with advanced laryngeal carcinoma, as it reduces the incidence of hypothyroidism.
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Does Thyroid Gland Preserving Total Laryngectomy Affect Oncological Control in Laryngeal Carcinoma? Laryngoscope 2019; 130:1465-1469. [DOI: 10.1002/lary.28235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/27/2019] [Accepted: 07/23/2019] [Indexed: 11/07/2022]
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Jayarajah U, Fernando A, Prabashani S, Fernando EA, Seneviratne SA. Incidence and histological patterns of thyroid cancer in Sri Lanka 2001-2010: an analysis of national cancer registry data. BMC Cancer 2018; 18:163. [PMID: 29415672 PMCID: PMC5804040 DOI: 10.1186/s12885-018-4083-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 01/31/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND An increasing incidence of thyroid cancer is observed in many developed countries. Increasing incidence may also reflect better reporting or increased diagnostic scrutiny. We conducted this study to examine trends in thyroid cancer incidence and histological patterns in Sri Lanka. METHODS A retrospective cohort evaluation of patients with thyroid cancer during 2001-2010 was performed using population based data published from the Sri Lanka National Cancer Registry. Trends in incidence and histological patterns were analysed by age and gender. RESULTS The age-standardized incidence of thyroid cancer increased from 2.44 per 100,000 in 2001 (95% confidence interval [95% CI]: 2.21-2.67) to 5.16 per 100,000 in 2010 (95% CI: 4.85-5.47); a 2.1-fold increase (p < 0.05 for trend). A greater part of this increase is attributable to increase in incidence of papillary thyroid cancer, which increased from 1.64 to 3.61 per 100,000; a 2.2-fold increase (p < 0.05 for trend). Follicular cancer showed lesser, yet a significant increase from 0.56 to 0.95 per 100,000 (p < 0.05). Other varieties of thyroid cancer showed no significant increases in incidence. Trends in the increases in incidence of papillary cancer in females showed a much greater increase compared with males (from 2.45 to 5.60 per 100,000, a 2.28-fold increase in females compared with from 0.82 to 1.55; a 1.89-fold increase in males, p < 0.001). Highest incidence of papillary cancer was observed in 30-39-year age group, which has increased from 5.56 to 12.9 per 100,000; a 2.32-fold increase (p < 0.001). CONCLUSIONS The increasing incidence of thyroid cancer in Sri Lanka is predominantly due to the increasing incidence of papillary cancers. These trends may reflect increased detection and better reporting, although an inherent increase in the incidence is the likely main contributor. Further studies including tumour stage and mortality may help answer these questions.
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Affiliation(s)
- Umesh Jayarajah
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Ashan Fernando
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Saumyakala Prabashani
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Eshani A Fernando
- National Cancer Control Programme, Ministry of Health, Colombo, Sri Lanka
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Abstract
Endocrinology relies on hormone and metabolite measurement for public health screening, diagnostics, and disease management. Advances in microfluidics, immunoassay technology, electronics, and software are moving in vitro endocrine diagnostics from the laboratory to the point of care. Point-of-care endocrine diagnostics provide results clinically equivalent to those produced by expensive laboratory instrumentation for a fraction of the cost and with a substantially more rapid turnaround time. Similar to the transformation of mainframe computers into laptops, tablets, and smartphones, clinical laboratories are evolving into point-of-care technologies.
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Affiliation(s)
- Joel Ehrenkranz
- i-calQ LLC, 466 North Wall Street, Salt Lake City, UT 84103, USA; Division of Endocrinology, Department of Medicine, University of Colorado School of Medicine, 13001 East 17th Place, Aurora, CO 80045, USA.
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Affiliation(s)
- Salvatore Benvenga
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, School of Medicine, 98125, Messina, Italy.
- Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, School of Medicine, 98125, Messina, Italy.
- Interdepartmental Program on Molecular & Clinical Endocrinology, and Women's Endocrine Health, University Hospital, A.O.U. Policlinico G. Martino, 98125, Messina, Italy.
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