Research

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13 pages, 3311 KiB

Open AccessArticle

Suspected Malignant Thyroid Nodules in Children and Adolescents According to Ultrasound Elastography and Ultrasound-Based Risk Stratification Systems—Experience from One Center

by Hanna Borysewicz-Sańczyk, Beata Sawicka, Agata Karny, Filip Bossowski, Katarzyna Marcinkiewicz, Aleksandra Rusak, Janusz Dzięcioł and Artur Bossowski

J. Clin. Med. 2022, 11(7), 1768; https://doi.org/10.3390/jcm11071768 - 23 Mar 2022

Cited by 4 | Viewed by 2207

Abstract

The risk of malignancy in thyroid nodules correlates with the presence of ultrasonographic features. In adults, ultrasound risk-classification systems have been proposed to indicate the need for further invasive diagnosis. Furthermore, elastography has been shown to support differential diagnosis of thyroid nodules. The [...] Read more.

The risk of malignancy in thyroid nodules correlates with the presence of ultrasonographic features. In adults, ultrasound risk-classification systems have been proposed to indicate the need for further invasive diagnosis. Furthermore, elastography has been shown to support differential diagnosis of thyroid nodules. The purpose of our study was to assess the application of the American Thyroid Association (ATA), British Thyroid Association (BTA) ultrasound risk-classification systems and strain elastography in the management of thyroid nodules in children and adolescents from one center. Seventeen nodules with Bethesda III, IV, V and VI were selected from 165 focal lesions in children. All patients underwent ultrasonography and elastography followed by fine needle aspiration biopsy. Ultrasonographic features according to the ATA and BTA stratification systems were assessed retrospectively. The strain ratio in the group of thyroid nodules diagnosed as malignant was significantly higher than in benign nodules (6.07 vs. 3.09, p = 0.036). According to the ATA guidelines, 100% of malignant nodules were classified as high suspicion and 73% of benign nodules were assessed as low suspicion. Using the BTA U-score classification, 80% of malignant nodules were classified as cancerous (U5) and 20% as suspicious for malignancy (U4). Among benign nodules, 82% were classified as indeterminate or equivocal (U3) and 9% as benign (U2). Our results suggest that application of the ATA or BTA stratification system and elastography may be a suitable method for assessing the level of suspected malignancy in thyroid nodules in children and help make a clinical decision about the need for further invasive diagnosis of thyroid nodules in children. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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14 pages, 290 KiB

Open AccessArticle

Potential Risk Factors for Isolated Hypothyroxinemia in Women of Childbearing Age—Results from Retrospective Analysis

by Małgorzata Karbownik-Lewińska, Jan Stępniak and Andrzej Lewiński

J. Clin. Med. 2021, 10(22), 5384; https://doi.org/10.3390/jcm10225384 - 18 Nov 2021

Cited by 3 | Viewed by 2895

Abstract

Isolated hypothyroxinemia (IH) unfavorably affects reproduction. This study aimed to evaluate retrospectively if any routinely measured clinical/laboratory parameters are associated with IH among women of childbearing age hospitalized in the endocrine department. A group of 466 female non-pregnant inpatients (age range 13–57 years) [...] Read more.

Isolated hypothyroxinemia (IH) unfavorably affects reproduction. This study aimed to evaluate retrospectively if any routinely measured clinical/laboratory parameters are associated with IH among women of childbearing age hospitalized in the endocrine department. A group of 466 female non-pregnant inpatients (age range 13–57 years) was considered. IH (decreased free thyroxine (FT4) with normal TSH) was found in 8/466 patients (1.72%). Vitamin D deficiency (<30 ng/mL) was found in all patients with IH, whereas severe Vitamin D deficiency (<20 ng/mL) was found in 5/6. Vitamin D concentration was lower in IH females. FT4 concentration was lower in patients with severe vitamin D deficiency and correlated positively with vitamin D concentration. Insulin resistance index (IRI) was increased (>1.25) in 5/6 patients with IH. IRI was higher in IH patients and it was the only independent linear factor for IH in the univariate regression. FT4 concentration was lower in patients with increased IRI and correlated negatively with IRI. FT4 concentration correlated negatively with body mass index (BMI) and LDL cholesterol or triglycerides, and positively with HDL cholesterol or HDLC/cholesterol ratio. Vitamin D deficiency, insulin resistance and increased BMI (as potential causative factors), and abnormal lipid profile (as a possible consequence), are associated with IH in women of childbearing age. Eliminating risk factors for hypothyroxinemia may improve reproductive health. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

13 pages, 1851 KiB

Open AccessArticle

The Effect of Recombinant Human TSH on Sclerostin and Other Selected Bone Markers in Patients after Total Thyroidectomy for Differentiated Thyroid Cancer

by Arkadiusz Zygmunt, Kinga Krawczyk-Rusiecka, Elżbieta Skowrońska-Jóźwiak, Katarzyna Wojciechowska-Durczyńska, Ewa Głowacka, Zbigniew Adamczewski and Andrzej Lewiński

J. Clin. Med. 2021, 10(21), 4905; https://doi.org/10.3390/jcm10214905 - 24 Oct 2021

Cited by 2 | Viewed by 1426

Abstract

The direct effect of TSH on bone metabolism in vivo is difficult to capture as the changes of its concentrations are followed by respective alterations of thyroid hormone levels. We evaluated the effect of recombinant human TSH (rhTSH) on sclerostin and other bone [...] Read more.

The direct effect of TSH on bone metabolism in vivo is difficult to capture as the changes of its concentrations are followed by respective alterations of thyroid hormone levels. We evaluated the effect of recombinant human TSH (rhTSH) on sclerostin and other bone markers in 29 patients after total thyroidectomy for differentiated thyroid cancer (DTC), without any signs of disease recurrence, who received L-thyroxine, most at non-suppressive doses. For two consecutive days, the patients were administered a standard dose of 0.9 mg rhTSH, i.m. Concentrations of sclerostin, osteocalcin, β-CrossLaps, PTH, and some other parameters, were measured before and five days after the first rhTSH administration. The greater the increase in TSH concentration (∆TSH), the greater the decrease in: ∆sclerostin (r = −0.672; p < 0.001), ∆β-CrossLaps (r = −0.580; p < 0.001) and ∆osteocalcin (r = −0.405; p = 0.029) levels, were recorded. The degree of TSH increase depended on the baseline PTH (r = 0.651; p < 0.001), age, and creatinine concentrations. rhTSH strongly inhibited bone turnover, thus, TSH—independently of thyroid hormones—exerted a direct protective effect on bone metabolism. Baseline PTH affected the magnitude of TSH increase and the degree of lowering in sclerostin and β-CrossLaps that suggest factors affecting PTH may play a role in the effect of TSH on the bone. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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17 pages, 2842 KiB

Open AccessArticle

Thyroid Cancer Risk Factors in Children with Thyroid Nodules: A One-Center Study

by Iwona Ben-Skowronek, Joanna Sieniawska, Emilia Pach, Wiktoria Wrobel, Anna Skowronek, Zaklina Tomczyk, Anna Mlodawska, Magdalena Makuch, Magdalena Malka, Czeslaw Cielecki and Pawel Nachulewicz

J. Clin. Med. 2021, 10(19), 4455; https://doi.org/10.3390/jcm10194455 - 28 Sep 2021

Cited by 5 | Viewed by 2628

Abstract

Thyroid nodules are common in the adult population (13%), but in childhood, they are relatively rarely diagnosed (0.2–5%). The risk factors and diagnostic and therapeutic algorithms are well-known and effectively used in adults, but no clear procedures supported by scientific research are available [...] Read more.

Thyroid nodules are common in the adult population (13%), but in childhood, they are relatively rarely diagnosed (0.2–5%). The risk factors and diagnostic and therapeutic algorithms are well-known and effectively used in adults, but no clear procedures supported by scientific research are available in the pediatric population. Our aim in this study was to identify predictive factors for thyroid cancer in a pediatric population. We retrospectively analyzed 112 children (80 girls and 32 boys, aged 0.6–18 years, with an average group age of 13.4 ± 4.5 years) with thyroid nodules who presented or were referred between 2010 and 2021. A total of 37 children qualified for partial or total thyroidectomy. After histopathological nodule examination, the most common cases were benign lesions in 23 patients (57.5%) and malignant lesions in 14 children (32.5%). Solitary benign thyroid nodules were found in 16 children (40%). Malignancy risk was higher in children with increased nodule diameter (greater than 7 mm; p = 0.018) or hypoechogenic lesions in ultrasound (p = 0.010), with no correlation between increased blood flow in the vessels and tumor diagnosis. The relative risk of developing thyroid cancer for class III was found to be higher in comparison to adults and 11.1 times higher than for classes I and II combined. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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17 pages, 936 KiB

Open AccessArticle

Hyperthyroidism in Pregnancy: The Delicate Balance between Too Much or Too Little Antithyroid Drug

by Monica Livia Gheorghiu, Roxana Georgiana Bors, Ancuta-Augustina Gheorghisan-Galateanu, Anca Lucia Pop, Dragos Cretoiu and Valentin Nicolae Varlas

J. Clin. Med. 2021, 10(16), 3742; https://doi.org/10.3390/jcm10163742 - 23 Aug 2021

Cited by 8 | Viewed by 3952

Abstract

Overt hyperthyroidism (HT) during pregnancy is associated with a risk of maternal–fetal complications. Antithyroid drugs (ATD) have a potential risk for teratogenic effects and fetal–neonatal hypothyroidism. This study evaluated ATD treatment and thyroid function control during pregnancy, and pregnancy outcome in women with [...] Read more.

Overt hyperthyroidism (HT) during pregnancy is associated with a risk of maternal–fetal complications. Antithyroid drugs (ATD) have a potential risk for teratogenic effects and fetal–neonatal hypothyroidism. This study evaluated ATD treatment and thyroid function control during pregnancy, and pregnancy outcome in women with HT. Patients and methods: A retrospective analysis of 36 single fetus pregnancies in 29 consecutive women (median age 30.3 ± 4.7 years) with HT diagnosed before or during pregnancy; a control group of 39 healthy euthyroid pregnant women was used. Results: Twenty-six women had Graves’ disease (GD, 33 pregnancies), 1 had a hyperfunctioning autonomous nodule, and 2 had gestational transient thyrotoxicosis (GTT). Methimazole (MMI) was administered in 22 pregnancies (78.5%), Propylthiouracil (PTU) in 2 (7.1%), switch from MMI to PTU in 4 (14.2%), no treatment in 8 pregnancies (3 with subclinical HT, 5 euthyroid with previous GD remission before conception). In the 8 pregnancies of GD patients diagnosed during gestation or shortly before (<6 weeks), i.e., with fetal exposure to uncontrolled HT, there was 1 spontaneous abortion at 5 weeks (3.4% of all ATD-treated pregnancies), and 1 premature delivery at 32 weeks with neonatal death in 24 h (3.4%); 1 child had neonatal hyperthyroidism (3.3% of live children in GD women) and a small atrial sept defect (4% of live children in ATD treated women). In women treated more than 6 months until conception (20 pregnancies): (a) median ATD doses were lower than those in women diagnosed shortly before or during pregnancy; (b) ATD was withdrawn in 40% of pregnancies in trimester (T)1, all on MMI < 10 mg/day (relapse in 14.2%), and in up to 55% in T3; (c) TSH level was below normal in 37%, 35% and 22% of pregnancies in T1, T2 and T3 respectively; FT4 was increased in 5.8% (T1) and subnormal in 11.75% in T2 and T3; (d) no fetal birth defects were recorded; one fetal death due to a true umbilical cord knot was registered. Mean birth weight was similar in both ATD-treated and control groups. Hyperthyroidism relapsed postpartum in 83% of GD patients (at median 3 ± 2.6 months). Conclusion: In hyperthyroid women with long-term ATD treatment before conception, drugs could be withdrawn in T1 in 40% of them, the thyroid function control was better, and pregnancy and fetal complications were rarer, compared to women diagnosed during pregnancy. Frequent serum TSH and FT4 monitoring is needed to maintain optimal thyroid function during pregnancy. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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12 pages, 6831 KiB

Open AccessArticle

Higher EU-TIRADS-Score Correlated with BRAF V600E Positivity in the Early Stage of Papillary Thyroid Carcinoma

by Karolina Skubisz, Joanna Januszkiewicz-Caulier, Patrycja Cybula, Elwira Bakuła-Zalewska, Krzysztof Goryca, Agnieszka Paziewska, Filip Ambrożkiewicz, Kosma Woliński, Michał Mikula, Jerzy Ostrowski and Marek Dedecjus

J. Clin. Med. 2021, 10(11), 2304; https://doi.org/10.3390/jcm10112304 - 25 May 2021

Cited by 4 | Viewed by 2133

Abstract

The data demonstrating a correlation between sonographic markers of malignancy of thyroid cancer (TC) and its genetic status are scarce. This study aimed to assess whether the addition of genetic analysis at the preoperative step of TC patients’ stratification could aid their clinical [...] Read more.

The data demonstrating a correlation between sonographic markers of malignancy of thyroid cancer (TC) and its genetic status are scarce. This study aimed to assess whether the addition of genetic analysis at the preoperative step of TC patients’ stratification could aid their clinical management. The material consisted of formalin-fixed paraffin-embedded tumor fragments of 49 patients who underwent thyroidectomy during the early stages of papillary TC (PTC). Tumor DNA and RNA were subjected to next-generation sequencing (NGS) on Ion Proton using the Oncomine™ Comprehensive Assay panel. We observed a significant correlation between BRAF V600E and a higher EU-TIRADS score (p-value = 0.02) with a correlation between hypoechogenicity and taller-than-wide tumor shape in analysed patients. There were no other significant associations between the identified genetic variants and other clinicopathological features. For TC patient’s stratification, a strong suspicion of BRAF V600E negativity in preoperative management of TC patients could limit the over-treatment of asymptomatic, very low-risk, indolent disease and leave room for active surveillance. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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11 pages, 931 KiB

Open AccessArticle

Measurements of Bone Health after Thyroid-Stimulating Suppression Therapy in Postmenopausal Women with Differentiated Thyroid Carcinoma: Bone Mineral Density versus the Trabecular Bone Score

by Chae Won Chung, Hoon Sung Choi, Sung Hye Kong, Young Joo Park, Do Joon Park, Hwa Young Ahn and Sun Wook Cho

J. Clin. Med. 2021, 10(9), 1964; https://doi.org/10.3390/jcm10091964 - 03 May 2021

Cited by 6 | Viewed by 2223

Abstract

Background: Thyroid-stimulating hormone (TSH) suppression therapy is an important treatment modality for differentiated thyroid carcinoma (DTC), but it increases fracture risk. The aim of this study was to evaluate changes in bone mineral density (BMD) and trabecular bone score (TBS) in postmenopausal DTC [...] Read more.

Background: Thyroid-stimulating hormone (TSH) suppression therapy is an important treatment modality for differentiated thyroid carcinoma (DTC), but it increases fracture risk. The aim of this study was to evaluate changes in bone mineral density (BMD) and trabecular bone score (TBS) in postmenopausal DTC patients receiving TSH suppression therapy. Methods: A total of 410 postmenopausal DTC patients who underwent thyroidectomy and had at least two dual-energy X-ray absorptiometry measurements, including a preoperative measurement, were included. Patients who had osteoporosis medication for more than 1 year were classified as ‘patients with osteoporosis’. Results: In patients without osteoporosis, the change in %BMD was similar between TSH suppression (−) and (+) groups, while the decrease in %TBS was significantly greater in the TSH suppression (+) group than that of the TSH suppression (−) group. The relative risk of vertebral fracture was decreased by TBS changes but not by BMD changes. In patients with osteoporosis, both BMD and TBS showed significant increases in the TSH suppression (−) group but not in TSH suppression (+) group. At year 4, TBS was significantly lower in the TSH suppression (+) group than that in the TSH suppression (−) group, while BMD showed no difference between groups. Conclusions: TBS may better reflect bone health than BMD in postmenopausal DTC patients with TSH suppression therapy. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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8 pages, 935 KiB

Open AccessArticle

Robotic Completion Thyroidectomy via the Bilateral Axillo-Breast Approach

by JungHak Kwak, Su-jin Kim, Zhen Xu, Keunchul Lee, Jong-hyuk Ahn, Hyeong Won Yu, Young Jun Chai, June Young Choi and Kyu Eun Lee

J. Clin. Med. 2021, 10(8), 1707; https://doi.org/10.3390/jcm10081707 - 15 Apr 2021

Cited by 11 | Viewed by 2697

Abstract

Background: Bilateral axillo-breast approach (BABA) robotic thyroidectomy has been successfully performed for thyroid cancer patients with excellent cosmetic results. Completion thyroidectomy is sometimes necessary after thyroid lobectomy, and whether it has a higher complication rate than the primary operation due to the presence [...] Read more.

Background: Bilateral axillo-breast approach (BABA) robotic thyroidectomy has been successfully performed for thyroid cancer patients with excellent cosmetic results. Completion thyroidectomy is sometimes necessary after thyroid lobectomy, and whether it has a higher complication rate than the primary operation due to the presence of adhesions remains controversial. The aim of this study was to evaluate surgical outcomes, including operation time and postoperative complications, in patients who underwent BABA robotic completion thyroidectomy. Methods: From Jan 2012 to Aug 2020, 33 consecutive patients underwent BABA robotic completion thyroidectomy for a thyroid malignancy after BABA robotic thyroid lobectomy. The procedures were divided into five steps: (1) robot setting and surgical draping, (2) flap dissection, (3) robot docking, (4) thyroidectomy, and (5) closure. Clinicopathological characteristics, operation time, and postoperative complications were reviewed. Results: The total operation time was shorter for completion thyroidectomy than for the initial operation (164.8 ± 31.7 min vs. 179.8 ± 27.1 min, p = 0.043). Among the robotic thyroidectomy steps, the duration of the thyroidectomy step was shorter than that of the initial operation (69.6 ± 20.9 min vs. 83.0 ± 19.5 min, p = 0.009. One patient (1/33, 3.0%) needed hematoma evacuation under the flap area immediately after surgery. Three patients (3/33, 9.1%) showed transient hypoparathyroidism, and one patient (1/33, 3.0%) had permanent hypoparathyroidism. Two patients (2/33, 6.1%) showed transient vocal cord palsy and recovered within 3 months following the completion thyroidectomy. There were no cases of open conversion, tracheal injury, flap injury or wound infection. Conclusions: BABA robotic completion thyroidectomy could be performed safely without completion-related complication. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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9 pages, 1243 KiB

Open AccessArticle

Secular Trends in Ablation Therapy for Graves’ Disease: An Analysis of a 15-Year Experience at a Tertiary Hospital in South Korea

by Min Joo Kim, Ye An Kim, Sun Wook Cho, Su-jin Kim, Kyu Eun Lee, Young Joo Park, Do Joon Park and Bo Youn Cho

J. Clin. Med. 2021, 10(8), 1629; https://doi.org/10.3390/jcm10081629 - 12 Apr 2021

Cited by 3 | Viewed by 1782

Abstract

Ablation therapy, such as radioactive iodine (RAI) therapy or thyroidectomy, is generally used as the second-line treatment for Graves’ disease (GD) in Asia. This study investigated changes in the clinical characteristics and outcomes of ablation therapies for GD over 15 years. Patients who [...] Read more.

Ablation therapy, such as radioactive iodine (RAI) therapy or thyroidectomy, is generally used as the second-line treatment for Graves’ disease (GD) in Asia. This study investigated changes in the clinical characteristics and outcomes of ablation therapies for GD over 15 years. Patients who underwent ablation therapy between 2001 and 2015 at a single tertiary hospital were included. Among the 10,991 GD patients treated over this 15-year period, 1357 (12.3%) underwent ablation therapy, and the most common reason was intractable GD. The proportion of patients who underwent any type of ablation therapy significantly decreased from 9.0% (2001–2005) to 7.7% (2011–2015). However, the proportion of patients who underwent surgery significantly increased from 1.1% (2001–2005) to 2.4% (2011–2015), and the proportion of patients who received ablation therapy due to suspected thyroid cancer increased from 5% to 13% over time. With a median follow-up duration of 6.2 years, remission was achieved in 86% and 98% of patients in the RAI and surgery groups, respectively, and these rates remained stable over time. In conclusion, although the proportion of patients who underwent ablation therapy for GD decreased during 15 years, the proportion of those who underwent surgery increased in association with the increased rate of suspected thyroid cancers. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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11 pages, 954 KiB

Open AccessArticle

Obesity and Overweight Are Associated with Minimal Extrathyroidal Extension, Multifocality and Bilaterality of Papillary Thyroid Cancer

by Krzysztof Kaliszewski, Dorota Diakowska, Marta Rzeszutko and Jerzy Rudnicki

J. Clin. Med. 2021, 10(5), 970; https://doi.org/10.3390/jcm10050970 - 02 Mar 2021

Cited by 7 | Viewed by 1882

Abstract

Epidemiological studies have shown a strong association between high body mass index (BMI) and papillary thyroid cancer (PTC). We assessed the clinical and histopathological features of PTC in patients with a higher BMI and compared them to analogous parameters in PTC patients with [...] Read more.

Epidemiological studies have shown a strong association between high body mass index (BMI) and papillary thyroid cancer (PTC). We assessed the clinical and histopathological features of PTC in patients with a higher BMI and compared them to analogous parameters in PTC patients with a normal BMI. We retrospectively analyzed 5021 medical records of patients admitted and surgically treated for thyroid tumors in one center between 2008 and 2018. Finally, we extracted data from 523 adult patients with PTC and stratified patients into two groups according to BMI: Group 1 with BMI < 25 kg/m² and Group 2 with BMI ≥ 25 kg/m². Data stratification was performed to estimate the association of overweight and obesity with clinical and histopathological features of PTC in both univariable and multivariable binary logistic regression analyses. Overall, compared to patients with a normal BMI, overweight and obese patients had a greater risk of minimal extrathyroidal extension (minimal ETE), multifocality and bilaterality of PTC (p < 0.001 for all). Analysis did not show that BMI was significantly associated with the more advanced tumor-node-metastasis (TNM) stage (p = 0.894). Obesity and overweight were significantly associated with higher aggressiveness of PTC. When considering various management options for PTC patients, these findings regarding overweight and obesity should be taken into consideration during the decision-making process. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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12 pages, 299 KiB

Open AccessArticle

by Benjamín Romero-Gómez, Paula Guerrero-Alonso, Juan Manuel Carmona-Torres, Diana P. Pozuelo-Carrascosa, José Alberto Laredo-Aguilera and Ana Isabel Cobo-Cuenca

J. Clin. Med. 2020, 9(12), 3864; https://doi.org/10.3390/jcm9123864 - 27 Nov 2020

Cited by 6 | Viewed by 4109

Abstract

The use of levothyroxine is not always related to the elimination of the symptoms of hypothyroidism. The aim of this study is to compare the health-related quality of life (HRQOL) of a group of hypothyroid women under levothyroxine treatment with that of a [...] Read more.

The use of levothyroxine is not always related to the elimination of the symptoms of hypothyroidism. The aim of this study is to compare the health-related quality of life (HRQOL) of a group of hypothyroid women under levothyroxine treatment with that of a group of non-hypothyroid women. Methodology: A case–control study was performed. We used convenience sampling. The case group consisted of 152 levothyroxine-treated hypothyroid women; the control group consisted of 238 women without hypothyroidism disorders. All of the participants were euthyroid according to the clinical practice guidelines. We used as instruments the Short Form-12 questionnaire (SF-12v1) and a sociodemographic questionnaire. Results: Hypothyroid women scored significantly lower in HRQOL in SF-12v1 mental and physical components than the control group (mental component summary: 41.23 ± 12.12 vs. 46.45 ± 10.22, p < 0.001; physical component summary: 49.64 ± 10.16 vs. 54.75 ± 5.76, p < 0.001). body mass index (BMI) and age showed an influence on the physical component (p < 0.001 in both variables). Adjusted for age and BMI, hypothyroidism was still related to worse scores (p < 0.001). Conclusion: Despite being euthyroid, women with hypothyroidism showed a poorer quality of life than women without hypothyroidism. Health professionals need to assess the HRQOL of women with hypothyroidism. Further research on HRQOL and hypothyroidism is needed. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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11 pages, 272 KiB

Open AccessReview

The Importance of miRNA in the Diagnosis and Prognosis of Papillary Thyroid Cancer

by Mariusz Rogucki, Angelika Buczyńska, Adam Jacek Krętowski and Anna Popławska-Kita

J. Clin. Med. 2021, 10(20), 4738; https://doi.org/10.3390/jcm10204738 - 15 Oct 2021

Cited by 20 | Viewed by 1941

Abstract

In recent years, the global incidence of thyroid cancer has been increasing. Despite the significant progress in the diagnostic tools applied for papillary thyroid cancer (PTC) diagnosis, commonly used methods require undergoing invasive diagnostic procedures, such as liquid biopsy, which still, in some [...] Read more.

In recent years, the global incidence of thyroid cancer has been increasing. Despite the significant progress in the diagnostic tools applied for papillary thyroid cancer (PTC) diagnosis, commonly used methods require undergoing invasive diagnostic procedures, such as liquid biopsy, which still, in some cases, remains imprecise. In this case, novel screening and diagnostic biomarkers are still being evaluated using highly specialized techniques, which could increase PTC detection. Currently, a number of genes and proteins associated with PTC development are currently under investigation to assess their clinical utility. Accordingly, a literature search was undertaken to collect novel information about the diagnosis of and prognosis for PTC with a particular emphasis on the role of microRNA (miRNA) evaluation. The early identification of novel biomarkers is essential for facilitating appropriate therapeutic decisions. Moreover, the evaluation of plasma- and serum-derived miRNA measurements could be considered as equivalent thyroid cancer screening tools in the future. On the other hand, the PTC pathogenesis could be evaluated further with the use of miRNA evaluation, which may bring novel insights for potential medical target determination. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

17 pages, 1599 KiB

Open AccessReview

The Role of Snail-1 in Thyroid Cancer—What We Know So Far

by Katarzyna Wieczorek-Szukala and Andrzej Lewinski

J. Clin. Med. 2021, 10(11), 2324; https://doi.org/10.3390/jcm10112324 - 26 May 2021

Cited by 4 | Viewed by 3873

Abstract

Thyroid carcinomas, despite the usually indolent behaviour and relatively good overall prognosis, show a high tendency to gain invasive phenotype and metastasise in some cases. However, due to a relatively slow progression, the exact mechanisms governing the metastatic process of thyroid carcinomas, including [...] Read more.

Thyroid carcinomas, despite the usually indolent behaviour and relatively good overall prognosis, show a high tendency to gain invasive phenotype and metastasise in some cases. However, due to a relatively slow progression, the exact mechanisms governing the metastatic process of thyroid carcinomas, including the epithelial-to-mesenchymal transition (EMT), are poorly described. One of the best-known regulators of cancer invasiveness is Snail-1—a zinc-finger transcription factor that plays a key role as an EMT inducer. More and more attention is being paid to the role of Snail with regard to thyroid cancer development. Apart from the obvious implications in the EMT process, Snail-1 plays an important role in the regulation of chemoresistance of the thyroid cells and cancer stem cell (CSC) formation, and it also interacts with miRNA specific to the thyroid gland. The aim of this review was to summarise the knowledge on Snail-1, especially in the context of thyroid oncogenesis. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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8 pages, 592 KiB

Open AccessReview

Thyroid Storm in Head and Neck Emergency Patients

by Mohamed A. Radhi, Basaviah Natesh, Paul Stimpson, Jonathan Hughes, Francis Vaz and Raghav C. Dwivedi

J. Clin. Med. 2020, 9(11), 3548; https://doi.org/10.3390/jcm9113548 - 04 Nov 2020

Cited by 3 | Viewed by 4834

Abstract

Background: Thyroid storm is a rare but life-threatening emergency that prompts urgent intervention to halt its potentially disastrous outcomes. There is not much literature available on thyroid storm in head neck trauma and non-thyroid/parathyroid head neck surgery. Due to rarity of thyroid storm [...] Read more.

Background: Thyroid storm is a rare but life-threatening emergency that prompts urgent intervention to halt its potentially disastrous outcomes. There is not much literature available on thyroid storm in head neck trauma and non-thyroid/parathyroid head neck surgery. Due to rarity of thyroid storm in head and neck trauma/surgery patients, its diagnosis becomes challenging, is often misdiagnosed and causes delay in the diagnosis and management. Therefore, the aim of this work was to compile, analyze and present details to develop a consensus and augment available literature on thyroid storm in this group of patients. Materials and methods: A comprehensive literature search of the last 30 years was performed on PUBMED/MEDLINE, EMBASE, CINAHL and Science Citation Index for thyroid storm using MeSH words and statistical analyses were performed. Results: Seven articles describing seven cases of thyroid storm were reviewed. All patients required medical management and one patient (14.3%) required adjunctive surgical management. Burch and Wartofsky Diagnostic criteria for thyroid storm were used in diagnosis of 42% patients. Time of diagnosis varied from immediately upon presentation to formulating a retrospective diagnosis of having a full-blown thyroid storm at 4 days post presentation. It was misdiagnosed and unthought of initially in majority of these cases, (71.4%) were not diagnosed in the first day of hospital stay. Conclusion: Early recognition of thyroid storm in head and neck patients markedly reduce morbidity/mortality. Albeit unexpected, it should be ruled out in any symptomatic head and neck trauma or post-surgery patient. Full article

(This article belongs to the Special Issue New Insights and Clinical Management of Thyroid Diseases)

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