Causes for syncope are multifaceted. Hormonal etiology, specifically hypothyroidism, is associated with cardiac arrhythmias [1]. Sinus bradycardia, low voltage, nonspecific T-wave changes and dissociative atrioventricular (AV) abnormalities are some of descriptive electrocardiographic features [2]. In the majority of well know clinical presentations complete AV block requires the insertion of a permanent pacemaker. However hypothyroidism related bradycardia and consequential symptomatic AV blocks could be reversible with timely and proper management.
We report a case of severe hypothyroidism resulting in insertion of transient pacemaker with favorable clinical course and fully reversible complete AV block after accordant pharmacological hormonal substitution.
PPI-INDUCED BICYTOPENIA: MATTER OF CONCERN by RxVichuZ! ;)RxVichuZ
This presentation deals with bicytopenia induced by proton pump inhibitors, that were reported and published as a Case Report by researchers from China.
References have been provided as a separate textbox under each slide, for extensive referencing into the same.
Despite major advances in the cardiovascular medicine in the 20th century, heart failure (HF) is an exceptional with estimated prevalence of >37.7 million globally caused by secondary aetiologies ultimately affecting their quality of life, including dyspnoea, poor exercise tolerance, fatigue, and fluid retention. Currently, angiotensin receptor blockers (ARBs), angiotensin converting enzyme (ACE) inhibitors, mineralocorticoid receptor antagonists, β blockers, angiotensin receptor blocker neprilysin inhibitors (ARNIs) and advanced device therapies have been administered to patients with reduced ejection fraction (EF).
Causes for syncope are multifaceted. Hormonal etiology, specifically hypothyroidism, is associated with cardiac arrhythmias [1]. Sinus bradycardia, low voltage, nonspecific T-wave changes and dissociative atrioventricular (AV) abnormalities are some of descriptive electrocardiographic features [2]. In the majority of well know clinical presentations complete AV block requires the insertion of a permanent pacemaker. However hypothyroidism related bradycardia and consequential symptomatic AV blocks could be reversible with timely and proper management.
We report a case of severe hypothyroidism resulting in insertion of transient pacemaker with favorable clinical course and fully reversible complete AV block after accordant pharmacological hormonal substitution.
PPI-INDUCED BICYTOPENIA: MATTER OF CONCERN by RxVichuZ! ;)RxVichuZ
This presentation deals with bicytopenia induced by proton pump inhibitors, that were reported and published as a Case Report by researchers from China.
References have been provided as a separate textbox under each slide, for extensive referencing into the same.
Despite major advances in the cardiovascular medicine in the 20th century, heart failure (HF) is an exceptional with estimated prevalence of >37.7 million globally caused by secondary aetiologies ultimately affecting their quality of life, including dyspnoea, poor exercise tolerance, fatigue, and fluid retention. Currently, angiotensin receptor blockers (ARBs), angiotensin converting enzyme (ACE) inhibitors, mineralocorticoid receptor antagonists, β blockers, angiotensin receptor blocker neprilysin inhibitors (ARNIs) and advanced device therapies have been administered to patients with reduced ejection fraction (EF).
Hyperthyroidism, Reference: Hyperthyroid, Harrison's Principles of Internal Medicine, Soheil Elahi, Islamic Azad University of Medicine- International Branch (IAUM-int)
A case report on Rheumatoid Arthritis with sickle cell traitPARUL UNIVERSITY
A female patient aged 6 years, a suspected case of sickle cell trait (SCT) having symptoms of Rheumatoid arthritis (RA),
while evaluating joint complaints in adult sickle cell disease (SCD) patients, a number of sickle cell-based entities come
to mind such as avascular necrosis, osteomyelitis, bone infarcts, and septic arthritis. RA is a chronic systemic
inflammatory disease, many reports highlighted the occurrence of RA in SCD presenting as diagnostic challenges for
cases with chronic inflammatory arthritis, SCT also have appeared to persist in some populations at a perplexingly high
rate given the degree of early mortality of homozygosity of SCD, our case report showed that not only SCD but if a patient
has SCT they can develop RA as complication. Our case report concludes that during the evaluation of a SCT patient who
presents with chronic synovitis, one should strongly consider the possibility of coexistence of RA and SCT.
SGLT2 inhibitors in Heart failure: A prized addition to HF treatment optionsahvc0858
Early Diabetes and Dyslipidaemia Treatment Optimisation.
Presentation by Dr Chan Wan Xian
Cardiologist, Echocardiologist
Heart Failure Intensivist
Asian Heart & Vascular Centre
www.ahvc.com.sg
Chronic lymphocytic thyroiditis (hashimoto thyroiditis, autoimmuneDr. Saad Saleh Al Ani
Chronic lymphocytic thyroiditis (Hashimoto Thyroiditis ) The most common cause of thyroid disease in children and adolescents and the most common cause of acquired hypothyroidism, with or without goiter. Approximately 60% of infiltrating lymphoid cells are T cells, and approximately 30% express B-cell markers.A variety of different thyroid antigen autoantibodies are involved
Thyrotoxicosis is any syndrome caused by excess thyroid hormone and
can be related to excess hormone production (hyperthyroidism).It is Also called as overactive thyroid.Symptoms include unexpected weight loss, rapid or irregular heartbeat, sweating and irritability, although the elderly often experience no symptoms.
Treatments include radioactive iodine, medication and sometimes surgery.
Hyperthyroidism, Reference: Hyperthyroid, Harrison's Principles of Internal Medicine, Soheil Elahi, Islamic Azad University of Medicine- International Branch (IAUM-int)
A case report on Rheumatoid Arthritis with sickle cell traitPARUL UNIVERSITY
A female patient aged 6 years, a suspected case of sickle cell trait (SCT) having symptoms of Rheumatoid arthritis (RA),
while evaluating joint complaints in adult sickle cell disease (SCD) patients, a number of sickle cell-based entities come
to mind such as avascular necrosis, osteomyelitis, bone infarcts, and septic arthritis. RA is a chronic systemic
inflammatory disease, many reports highlighted the occurrence of RA in SCD presenting as diagnostic challenges for
cases with chronic inflammatory arthritis, SCT also have appeared to persist in some populations at a perplexingly high
rate given the degree of early mortality of homozygosity of SCD, our case report showed that not only SCD but if a patient
has SCT they can develop RA as complication. Our case report concludes that during the evaluation of a SCT patient who
presents with chronic synovitis, one should strongly consider the possibility of coexistence of RA and SCT.
SGLT2 inhibitors in Heart failure: A prized addition to HF treatment optionsahvc0858
Early Diabetes and Dyslipidaemia Treatment Optimisation.
Presentation by Dr Chan Wan Xian
Cardiologist, Echocardiologist
Heart Failure Intensivist
Asian Heart & Vascular Centre
www.ahvc.com.sg
Chronic lymphocytic thyroiditis (hashimoto thyroiditis, autoimmuneDr. Saad Saleh Al Ani
Chronic lymphocytic thyroiditis (Hashimoto Thyroiditis ) The most common cause of thyroid disease in children and adolescents and the most common cause of acquired hypothyroidism, with or without goiter. Approximately 60% of infiltrating lymphoid cells are T cells, and approximately 30% express B-cell markers.A variety of different thyroid antigen autoantibodies are involved
Thyrotoxicosis is any syndrome caused by excess thyroid hormone and
can be related to excess hormone production (hyperthyroidism).It is Also called as overactive thyroid.Symptoms include unexpected weight loss, rapid or irregular heartbeat, sweating and irritability, although the elderly often experience no symptoms.
Treatments include radioactive iodine, medication and sometimes surgery.
Esther De Boer Es& Zn portretten voor Frascati magazineestherdeboer
01 >> ko van den bosch, 02 >> rosa / de tijd, 03 >> adelheid roosen en sabri saad el hamus, 04 >> eric de vroedt / mighty society, 05 >> anouk van dijk, 06 >> dood paard / kuno bakker, 07 >> laura van dolron
concept / fotografie >> esther de boer
voor >> frascati magazine
SVILUPPO DI UNA APPLICAZIONE PER L’ACQUISIZIONE DI DATI DA SUPPORTO CARTACEO:...guest12aaa586
Presentazione PowerPoint tesi di laurea Faelli Roberto dal titolo "SVILUPPO DI UNA APPLICAZIONE PER L’ACQUISIZIONE DI DATI DA SUPPORTO CARTACEO: CASO DEI CURRICULUM VITAE"
Thyroid and critical illness
Non Thyroidal Illness Syndrome (NTIS)
Sick Euthyroid Syndrome
Euthyroid Sick Syndrome (ESS)
Low T3 Syndrome
NTIS, formerly known as euthyroid sick syndrome, often occurs in patients who have severe, prolonged critical illness and is essentially a laboratory abnormality to be monitored.
By Usama Ragab Youssif
Thyroid and its pathology (Hypothyroidism).Vikas Reddy
GREEK :- THYREOS – SHIELD ; EIDOS – FORM
1.LOCATION:- Anterior to trachea in between the cricoid cartilage and the suprasternal notch.
2.SHAPE:- It has 2 lobes connected with an isthmus, each lobe in turn has two poles.
3.Weighs around 10-20 gm, highly vascular and soft in consistency.
4. 4 Parathyroid glands which secrete PTH are located posterior to each pole of thyroid
The RLN traverse the lateral border of thyroid gland and must be identified during thyroid surgery to avoid injury and vocal cord paralysis.
Develops from the floor of primitive pharynx during the 3rd week of gestation.
Fetal cells in which developmental transcription factors TTF-1,TTF-2 & PAX-8 are expressed selectively form the thyroid gland ,secondly they result in induction of thyroid specific genes
Tg,TPO,NIS,TSH-R.
Mutations-THYROID AGENESIS & DYSHORMONOGENESIS(CONG. HYPOTHYROIDISM).
The developing gland migrates along the thyroglossal duct to reach its final location in the neck.
LINGUAL THYROID AND THYROGLOSSAL DUCT CYST.
Thyroid hormone synthesis begins at about 11 weeks of gestation.
Until 11 week of gestation and even later, it is the maternal thyroid hormones which cross the placenta to reach the fetus and aid its development.
Therefore a child born to a hypothyroid mother would suffer from features of congenital hypothyroidism.
Secondly if the mother has TSH-R blocking antibodies or has received anti thyroid therapy during pregnancy, might lead to transient congenital hypothyroidism.
Hormones and Mental Health - Thyroid and Testosterone.pptxLouis Cady, MD
In this presentation for the Psychiatry Redefined program, Dr.
Cady breaks down and deconstructs the accepted, unthinking, "practice guideline based" notions of thyroid and tesotsterone, with there seemingly "normal" levels and dosing, versus what the actual peer reviewed medical literature says. In this presentation, do use of all forms of thyroid, and all forms of testosterone are reviewed. The idiocy of "T4 only treatment" is covered. The use of T4, T3, a combination of T4 and T3, and all of the porcine and compounded products is review.
In terms of testosterone, dr. Katie reviews the concept of "do you want to be optimal or do you want to be normal." He notes that it is "normal" for oil in cars to deteriorate and break down with age. It's also "normal" for men's and women's testosterone (as well as thyroid) to go down with age. The question is, "do we want to do anything about it?"
Logical ways of intervening in both the thyroid and female and male gonadal axes are covered. There is scrupulous attention paid to the thyroid hormone pathways, and the relevance of reverse T3 versus free T3. Similarly, in terms of women, the downstream effect of estradiol coming from testosterone is also reviewed.
Thyroid hormones parameters of patients with thyroid disorders attending spe...Premier Publishers
Thyroid hormones, triiodothyronine (T3) and Thyroxin (T4), affect almost all metabolic activities of tissues and are produced under influence of the interior pituitary hormone, the thyroid stimulating hormone (TSH), which stimulates secretion of thyroid releasing hormone (TRH). The present study was conducted to observe the effect of non-detectable levels of TSH on thyroid hormones, on the basis of gender and age. A total of 88 patients (50 patients with hyperthyroidism and hypothyroidism and 33 healthy people as control) attending special out-patient clinic were involved in the study. Serums T3, T4 and TSH were measured using the commercially available kits (Abbot Laboratories) through Enzyme Immune Assay (EIA) technique (Roche Diagnostics GmbH). Analysis of data using SPSS software version 15.0 revealed that prevalence of thyroid disorders in the studied group was more among female population. However, the disorders were not age dependent. Most common conditions associated with sub-clinical hyperthyroidism. As males are equally exposed to these environmental factors, hence further investigations are required to know why these factors affect females more than the males. In our opinion, TSH and FT4 are the most valuable indicators in assessing thyroid function in a healthy population and TSH and TT4 are the most meaningful in hyperthyroidism and hypothyroidism.
Similar to Immunomodulators in patients with hasimoto thyroiditis and cancer (20)
Thyroid hormones parameters of patients with thyroid disorders attending spe...
Immunomodulators in patients with hasimoto thyroiditis and cancer
1. Improved thyroid function in oncological
patients with Hashimoto Thyroiditis treated
with Immunomodulators
Francesco Matozza MD*, Guillermo H. Artero Ph **, Guillermo E. Artero
MD***, Monica Rodriguez Laborda MD****
Introduction
Hashimoto's thyroiditis is chronic autoimmune inflammation of the thyroid with
lymphocytic infiltration
The destruction of the thyroid gland occurs through the action of CD8 positive killer
T cells. CD4 positive helper T cells and B cells are also identified in the thyroid
glands of patients with Hashimoto thyroiditis
Hashimoto's thyroiditis is the most common cause of primary of hypothyroidism
The disease is 7 times more frequent in women.
The incidence of Hashimoto thyroiditis worldwide is estimated to be 0.3-1.5 cases
per 1000 of population per year
Incidence increases with age and in patients with chromosomal disorders,
including Turner's, Down, and Klinefelter's syndromes. A family history of thyroid
disorders is common.
An increased incidence of cancer is seen in people with an autoimmune disease.
The treatment of Hashimoto thyroiditis consists of replacing thyroid hormone with
levothyroxine, when the patients have become hypothyroid.
2. Purpose.
The aim of the study was to evaluate the improvement in thyroid function as well as
quality of life in oncological patients with Hashimoto Thyroiditis treated with
Immunomodulators
.
Material
We retrospectively review in a multicentric study, 161 patients with Hashimoto
thyroiditis, and different types of tumors (breast, kidney, ovarian, uterus, colorectal,
thyroid, lung, pancreas, larynx, stomach, bladder, prostate, etc).
Age range 40 to 70 years old.
98 patients were treated with (chemotherapy or radiotherapy) + levothyroxine and
Immunomodulators during 6 month.
3. This Immunomodulators compound contains: Astragalus Ext., Zinc, Mg and
Selenium.”
63 patients treated only with oncological treatment (chemotherapy or radiotherapy)
+ levothyroxine as a control group.
Method
Thyroid function: T3.T4. TSH, TPO and TG antibodies were measured before,
during and after six month treatment with Immunomodulators treatment.
Immunomodulators was administered orally sublingual at a dose of 4ml / day
In the control group the thyroid function was evaluated every four month
Result
87 patients (78.5 %) treated with Immunomodulators showed increase T3, T4, and
diminution of TSH, TPO and TG after 2 month of treatment.
These patients required less levothyroxine than there were taken before.
8 patients (8.16%) did not show changes in their thyroid function.
3 patients (3.06%) withdrew the treatment
We also observed a better quality of life in these patients. (Increase WBC, RBC).
Less fatigue, dry skin, depression, Cold Intolerance,
In the control group the thyroid function as well as the antibodies did not show any
changes.
5. Hashimoto treated with
immunomodulators
Hashimoto AFTER
IMMUNOMODULATOR
Subclinic Clinic Subclinic Clinic
↑ ↓
TSH N N
↓↓ ↑↑
FT4 N N
↓↓ ↑↑
FT3 N N
↑↑ ↑↑ ↓↓ ↓↓
TPO
↑↑ ↑↑
TG
↓↓ ↓↓
Clinical implication
Evolution of hashimoto thyroiditis
1-Hahimoto disease --------------------Hashimoto thyroiditis ( HT)
2-Hashimoto disease-------------------- other autoimmune disease LES, AR, Psoriasis,
3-Hashimoto disease ------------------- ovarian cyst, breast dysplasia, uterus fibroma
4-Hashimoto disease ---------------- malignant tumors (breast, ovarian, lung, prostate,
Colorectal,)
Immunomodulators improves thyroid function in patients with Hashimoto thyroiditis
No side effect were seen in this patients
IM treatment is safe and well tolerated
6. In cancer patients with Hahimoto thyroiditis IM also improve, RBC, WBC, platelets and the
disease free survival period.
Keywords: hashimoto thyroiditis-Immunomodulators-cancer-thyroid function
Francesco Matozza Is Oncologist at Rawson Hospital in Buenos Aires,
Guillermo E. Artero is Physician at Tornu Hospital in Buenos Aires
Guillermo H Artero is Pharmacist in Pharmaceutical Industry in Buenos Aires, Argentina
Monica Rodriguez Laborda is psychoimmunoendocrinologist in Buenos Aires
Contact
F.Matozza M:D. frankmatozza@libero.it
G.H.Artero Ph arteroguillermo@fibertel.com.ar
References
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Immune system effects of echinacea, ginseng, and astragalus: a review.
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Selenium Supplementation in Autoimmune Thyroiditis Female Patient-Effects on Thyroid
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Biol Trace Elem Res. 2008 Aug 6. [Epub ahead of print]
PMID: 18679588 [PubMed - as supplied by publisher]
3-Duntas LH.
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Trace element levels in hashimoto thyroiditis patients with subclinical hypothyroidism.
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Selenoproteins in human thyroid tissues.
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PMID: 11583018 [PubMed - indexed for MEDLINE]
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Trace element levels in hashimoto thyroiditis patients with subclinical hypothyroidism.
Biol Trace Elem Res. 2008 Summer;123(1-3):1-7. Epub 2008 Mar 6.
PMID: 18322655 [PubMed - indexed for MEDLINE]
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G Stassi, R De Maria - Nat Rev Immunol, 2002 - ncbi.nlm.nih.gov
Autoimmunity to thyroid antigens leads to two distinct pathogenic processes with
opposing clinical outcomes: hypothyroidism in Hashimoto's thyroiditis and
hyperthyroidism in Graves' disease. The high frequency of these diseases ...
8. 12-Control of target cell survival in thyroid autoimmunity by T helper cytokines via
regulation of …
G Stassi, D Di Liberto, M Todaro, A Zeuner, L … - Nature Immunology, 2000 -
nature.com
Article. Nature Immunology 1, 483 - 488 (2000) doi:10.1038/82725 Control
of target cell survival in thyroid autoimmunity by T helper cytokines
via regulation of apoptotic proteins. Giorgio Stassi ...