Clinical Thyroidology for the Public summarizes selected research studies discussed in the previous month’s issue of Clinical Thyroidology, an official publication of the American Thyroid Association. Editor-in-chief, Alan Farwell, MD, FACE
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Clinical Thyroidology for the Public Volume 13 Issue 6 (PDF file, 7.33 MB)
TABLE OF CONTENTS – Web Format
THYROID CANCER
Global long-term thyroid cancer death rate trends over the past 30 years
While the number of patients diagnosed with thyroid cancer has increased significantly in the last several decades in many countries, especially papillary thyroid cancer, the overall mortality rate has been largely unchanged. This comprehensive study analyzed long-term thyroid cancer mortality data from five continents using a model know as age-period-cohort models to understand the impact of risk factors on thyroid cancer mortality.
Li M et al 2020 Long term declines of thyroid cancer mortality: An international age‐period‐cohort analysis. Thyroid. Epub 2020 Jan 22. PMID: 31964280.
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THYROID CANCER
Not all enlarging papillary microcarcinomas require thyroid surgery
Multiple studies have shown that papillary microcarcinomas are very low risk and are unlikely to grow and/or spread. As such, there is significant interest in confirming whether or not thyroid surgery can be avoided for at least some people diagnosed with papillary microcarcinoma. The purpose of the study is to provide better understanding of the risk of cancer growth and spread for patients diagnosed with papillary thyroid microcarcinoma to determine whether or not thyroid surgery is needed for such patients.
Ito Y et al. 2019 Kinetic analysis of growth activity in enlarging papillary thyroid microcarcinomas. Thyroid. Epub 2019 Nov 21. PMID: 31650907.
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PEDIATRIC THYROID CANCER
Postoperative TSH-stimulated thyroglobulin may predict outcome of thyroid cancer in children
Most children who develop thyroid cancer have an excellent outcome, even if the cancer has spread outside the thyroid and into the lungs. In adults, the level of thyroglobulin prior to TSH stimulation for radioactive iodine therapy helps predict how the patient will do long term. This study was performed to look at how a stimulated thyroglobulin level prior to radioactive iodine therapy predicts outcomes for pediatric thyroid cancer patients.
Liu L et al 2020 Prognostic value of pre-ablation stimulated thyroglobulin in children and adolescents with differentiated thyroid cancer. Thyroid. Epub 2020 Jan 22. PMID: 31964278.
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THYROID AND PREGNANCY
Overtreatment of mild hypothyroidism in the mother during pregnancy may lead to behavior problems in the children
Many studies have shown the importance of maintaining normal thyroid hormone levels during pregnancy for the best pregnancy outcomes. In this study, the investigators examined the effect of thyroid function in the mother during pregnancy on the behavior of the children as assessed by questionnaires designed to evaluate mental health, ADHD symptoms and autism spectrum symptoms.
Hales C et al. Controlled antenatal thyroid screening II: Effect of treating maternal suboptimal thyroid function on child behavior. J. Clin. Endocrinol. Metab. 2020. 105:e417-e427. PMID: 3166532
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THYROID AND PREGNANCY
Subclinical hypothyroidism and thyroid autoimmunity are associated with pre-term delivery
The Consortium on Thyroid and Pregnancy was developed as a means to study the association of thyroid problems and thyroid autoimmunity in the mother with pre-term birth. The purpose of this study was to investigate whether mild/subclinical hypothyroidism, isolated hypothyroxinemia, and thyroid autoimmunity in the mother are risk factors for pre-term birth.
Korevaar TIM et al for the Consortium on Thyroid and Pregnancy—Study Group on Preterm Birth, 2019 Association of thyroid function test abnormalities and thyroid autoimmunity with preterm birth: a systematic review and meta-analysis. JAMA 2019;322:632–641. PMID: 31429897.
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THYROID SURGERY
Looking beyond readmissions as an outcome for outpatient thyroidectomy
Over the past decade, there has been an increase in thyroid surgery done as an outpatient procedure, meaning no overnight stay. Multiple studies demonstrating that these same-day discharges after thyroid surgery is a safe practice in appropriately selected patients. The aim of this study was to use a large database to compare outcomes (complications) of thyroid surgery patients that were discharged on the same day vs those that stayed in the hospital 1-2 nights.
Hu QL et al. 2020 Same-day discharge is not associated with increased readmissions or complications after thyroid operations. Surgery 167:117–123. PMID: 31582306.
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