Annual Incidence of Thyroid Disease in Patients Who First Time Visit Department for Thyroid Diseases in Tuzla Canton

Evaluation of the ultrasound findings of thyroid gland enlargement in Cape Coast Teaching Hospital, Ghana: A retrospective cross-sectional study

Background and Aim

Goiter is a major source of morbidity in the world, especially in the developing world, where dietary iodine deficiency, a known cause of this condition, is endemic. The diagnosis is mostly by ultrasonography (USG) scan, which can give anatomical, pathological, and functional information for the management of goiter. This study aimed to determine the commonest ultrasound findings of goiter in Ghana.

Method

The records of all 213 patients with goiter diagnosed by USG scan over a 5-year period were retrieved. Data collected were sociodemographics, ultrasound features, thyroid nodules diameter, and Thyroid Imaging Reporting and Data System (TI-RADS) scores, which were analyzed using GNU PSPP, version 1.2.0-3. χ 2 and two-tailed independent samples t-test were also employed, with p ≤ 0.05.

Results

A total of 213 patients with goiter diagnosed by USG scan were obtained over the study period. The mean age of the participants was 50.01 ± 17.27 years, with an age range of 16-92 years and females constituting the majority (82.16%). The commonest ultrasound features were well-defined solid nodules. The lesion sites for most patients were the whole thyroid (28.17%), both lobes (24.41%), and the right lobe (20.19%). The mean difference in sizes of cysts and solid nodules among genders was 0.26 (CI: -0.14 to 0.67, p = 0.20) and 0.12 (CI: -0.43 to 0.66, p = 0.67), respectively. The TI-RADS score featured TI-RADS 4 (36.62%), TI-RADS 1 (28.17%), TI-RADS 3 (25.82%), TI-RADS 5 (5.16%), and TI-RADS 2 (4.23%). Solid nodules (49.32%, p = 0.001) and cysts (35.71%, p = 0.003) were more common within 41-60 years and less frequent in those <21 years. A p ≤ 0.05 was considered significant in this study.

Conclusion

The predominant ultrasound features were well-defined solid nodules, simple cysts, and solid nodules with cystic changes, mostly located in the entire thyroid gland and least located in the isthmus only. Cysts and solid nodules were mostly seen in the 41-60 years age group.

Reasons for Referring Patients for Determining the Hormonal Status of the Thyroid Gland From the Level of Primary Health Care in Sarajevo Canton

Background

Thyroid dysfunction includes hyper- and hypofunction of the thyroid gland (hyperthyroidism and hypothyroidism). The spectrum encompasses both subclinical and clinical disease presentation. The etiology is vast and varied, as are the risk factors and simptoms.

Objective

The main aim of the research is to indicate the leading symptom for initial thyroid hormone status evaluation, as well as to identify the distribution of positive and negative test results, and specific disorders according to sex and age groups.

Methods

The research is designed as a retrospective, clinical, descriptive study. There were 500 participants included, 355 female and 145 male. Patients were referred to the Department of endocrinology by their primary care physicians. The data was collected through patient documentation.

Results

The study included 500 participants, 71% of diagnostic requests made were for women. 80% of subjects had normal thyroid hormone status, p<0.001. Most requests were made for the 41-60 age group, p<0.001. Women had similar number of positive and negative test outcomes, as well as men. When it comes to the age groups, outcomes were similar in all of them, 15-23% positive and 77-85% negative. There were significant differences in the type of symptom expressed in both men and women, as well as all the age groups. Men reported high blood pressure as the most common symptom (30.3%), while women reported weight gain (22.3%). In the 18-25 and 26-40 age groups most common symptom belongs to the category of other. Age group of 41-60 reported weight gain as the most common symptom, while in participants older than 60, high blood pressure is proven to be the most common. Hypothyroidism is the most common disorder in both men and women, as well as in all age groups.

Conclusion

It is statistically proven that there were more requests made for women, and older age groups. Leading symptom for initial thyroid hormone status evaluation is high blood pressure. There is no statistically significant difference in distribution of thyroid disorders according to sex or age groups.

Assessment of thyroiditis risk associated with HPV vaccination among girls aged 9-18 years: A time-varying cohort study

BACKGROUND

Previous studies have suggested a relationship between human papillomavirus vaccine and autoimmune diseases, including thyroiditis. Thus, we aimed to evaluate the risk of thyroiditis associated with HPV vaccination among girls using the Primary Care Database For Pharmacoepidemiological Research (BIFAP) in Spain.

METHODS

In this retrospective cohort study, girls in BIFAP aged 9-18 years from 2007 to 2016, free of past thyroiditis and HPV vaccination, were included. Hazard Ratios (HRs; 95% CI) of thyroiditis were calculated within exposed periods (up to 2 years of vaccination) and post-exposed periods (from 2 years after vaccination onwards) compared with non-exposed periods, overall, by dose and by type of vaccine, adjusted for potential confounders collected at different times. In a post-hoc analysis, we moved back the thyroiditis date (30 days) as a theoretical delay in diagnosis.

RESULTS

Out of the 388,411 girls included in the cohort, 153,924 were vaccinated against HPV and 480 thyroiditis (253 autoimmune) cases were identified (334 non-exposed; 103 exposed; 43 post-exposed). Adjusted HR was 1.18 [95% CI: 0.79-1.76] for exposed (1.25 [0.77-2.04] for bi- and 1.15 [0.76-1.76] for quadri-valent vaccines) and 1.26 [0.74-2.14] for post-exposed periods. HR was 1.50 [0.87-2.59] for the 1^st dose, 1.13 [0.66-1.91] for the 2^nd and 1.11 [0.71-1.72] for the 3^rd one. When the diagnosis date was moved back, the risk was 1.14 [0.76-1.70] for exposed period, being 1.80 [0.86-3.76] and 1.40 [0.74-2.66] after 1^st dose of bi- and quadri-valent, respectively.

CONCLUSIONS

We did not observe an increased risk of thyroiditis following HPV vaccination (whether bi- or quadri-valent). Even though the point estimate was higher after 1^st HPV vaccination dose than after subsequent doses, a dose-effect was not confirmed. Results remained similar after applying a lag time.

Comparison between an Emerging Point-of-Care Tool for TSH Evaluation and a Centralized Laboratory-Based Method in a Cohort of Patients from Southern Italy

Endocrine and metabolic disorders are a common condition in Europe and worldwide, and, among these, thyroid dysfunction still remains a problem. The measurement of thyroid stimulating hormone (TSH) levels represents the first-line assay for the assessment of thyroid function. In the present study, we compared serum concentrations of TSH, measured using a commercially available point-of-care test (POCT) method (FastPack^® IP) and an established "conventional" laboratory-based method (Beckmann Access 2) in a cohort of patients from Foggia in Southern Italy. A strong correlation (r = 0.994) was found between both methods and was also confirmed by receiver operating characteristic (ROC) curve analysis (0.82). The within-run coefficient of variation (CV) using FastPack^® ranged from 4.03% and 8.57% at the TSH concentrations of 39.49 and 0.70 mIU/L, respectively. The between-run CV was 10.34% and 6.33% at the TSH concentrations of 0.87 and 26.55 mIU/L, respectively. The ratios of within- to between-assay CV were 0.83 and 1.06 at the TSH levels of 0.70 and 52.59 mIU/mL, respectively. In this study, we showed that serum TSH levels can be measured in a few minutes and at low-cost in terms of materials and equipment required. We observed that this approach is user-friendly, accurate, reproducible, and suitable for use in the clinic, while also meeting the criteria for effectiveness, impact, efficiency, and sustainability.

An Estimation of the Incidence of Thyroiditis Among Girls in Primary Care in Spain

OBJECTIVE

As for other auto-immune processes, thyroiditis is monitored after vaccinations. The aim was to estimate the baseline incidence of thyroiditis among girls, before investigating papillomavirus vaccination as a potential risk factor.

METHODS

Observational cohort study including girls aged 9-18 years and registered between 2002-2016 in the Spanish Primary Care Database for Pharmacoepidemiological Research. Girls were followed until a thyroiditis occurred, 19 years of age, left the cohort, died, or the study ended. Anonymized records were reviewed for diagnosis confirmation (endocrine discharge letter and/or free-text comments) in a random sample. Incidence rate (IR) per 10⁵ person years (/10⁵ py) was estimated.

RESULTS

The cohort numbered 480,169 girls, of whom 641 had a record of thyroiditis: 346 autoimmune thyroiditis; 17 thyroiditis of other types; and 278 unspecified. Incidence of recorded thyroiditis increased with age, from 23.96 at age 9 years to 47.91 at age 14 years, and stabilized around 31.06-34.43 among girls aged 15-18 years. Of the 98 records reviewed, 60.2% were ‘confirmed’ cases, 32.7% ‘possible’ and 7.1% were discarded. After correction for discarded cases, IR=20.83 ‘confirmed’ cases, increasing to 32.12/10⁵ py when ‘confirmed’ plus ‘possible’ cases were included. Between 2002-2005, incidences were lower (16.28 and 20.93 cases/10⁵ py) than in the period 2007-2016 (21.17 and 33.78 cases/10⁵ py) for ‘confirmed’ and ‘confirmed’ plus ‘possible’, respectively.

CONCLUSION

Two-thirds of the recorded thyroiditis included confirmatory evidence. The incidence of thyroiditis among girls increased with age and in the later period, and remained stable among girls aged 15-18 years.

Evaluation of antithyroid potential of Luffa acutangula peel extract and its chemical constituents as identified by HR-LC/MS

Although some reports are there indicating the medicinal values of fruit peels, on vegetable peels investigations are meager. The present study is an attempt to explore the hitherto unknown potential of Luffa acutangula peel extract in T4-induced hyperthyroid female mice. Animals were made hyperthyroid by administering pre-standardized dose of l-thyroxin (l-T4 at 0.5 mg/kg/day) for 12 consecutive days and then the effects of the test peel extract at 25 and 50 mg/kg for 15 days were studied on the changes in serum thyroid hormones, glucose, different lipids; hepatic lipid peroxidation (LPO); enzymatic antioxidants such as superoxide dismutase, catalase, glutathione peroxidase, and in reduced glutathione. The main chemical constituents of the extract were identified by high resolution liquid chromatography mass spectrometry. Administration of the test peel extract to the hyperthyroid mice at both the test doses decreased the levels of serum thyroid hormones, glucose and tissue LPO suggesting its antithyroid, antihyperglycemic and antiperoxidative potential. These positive effects were also supported by an improved lipid profile as well as liver histology. LC-MS analyses revealed the presence of kaempferol-3-O-rutinoside, kameferol-O-neohesporoside, quercetin, cinnamic acid ethyl ester, caffeic acid derivatives such as 4-O-caffeyol quinic acid, 3-sinapoylquinic acid and 4,5-dihydroxyprenyl caffeate, orientin and sinapic acid. It is presumed that the antithyroid and anti-hyperglycemic actions of the test plant extract could be the result of antioxidative properties of these phytochemicals.