POPULARITY
Raphael e Marcela convidam novamente Nathalie Santana para falar sobre tratamento do hipertiroidismo em 4 clinicagens: como escolher o melhor tratamento? como controlar os sintomas? como prescrever drogas antitireoidianas? como monitorar o paciente? Use o cupom TDC2024 para assinar o HITT do Medcof e ganhe um cupom de 6 meses gratuitos do Guia TdC! https://hiit.grupomedcof.com.br Referências: 1. Azizi, F et al. “Effect of long-term continuous methimazole treatment of hyperthyroidism: comparison with radioiodine.” European journal of endocrinology vol. 152,5 (2005): 695-701. doi:10.1530/eje.1.01904 2. Villagelin, Danilo et al. “Outcomes in Relapsed Graves' Disease Patients Following Radioiodine or Prolonged Low Dose of Methimazole Treatment.” Thyroid : official journal of the American Thyroid Association vol. 25,12 (2015): 1282-90. doi:10.1089/thy.2015.0195 3. Kahaly, George J et al. “2018 European Thyroid Association Guideline for the Management of Graves' Hyperthyroidism.” European thyroid journal vol. 7,4 (2018): 167-186. doi:10.1159/000490384 4. Villagelin, Danilo et al. “A 2023 International Survey of Clinical Practice Patterns in the Management of Graves' Disease: A Decade of Change.” The Journal of clinical endocrinology and metabolism, dgae222. 5 Apr. 2024, doi:10.1210/clinem/dgae222 5. Ross, Douglas S et al. “2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis.” Thyroid : official journal of the American Thyroid Association vol. 26,10 (2016): 1343-1421. doi:10.1089/thy.2016.0229 6. Shalaby M, Hadedeya D, Toraih EA, et al. Predictive factors of radioiodine therapy failure in Graves' Disease: A meta-analysis. Am J Surg. 2022;223(2):287-296. doi:10.1016/j.amjsurg.2021.03.068 7. Carella, C et al. “Serum thyrotropin receptor antibodies concentrations in patients with Graves' disease before, at the end of methimazole treatment, and after drug withdrawal: evidence that the activity of thyrotropin receptor antibody and/or thyroid response modify during the observation period.” Thyroid : official journal of the American Thyroid Association vol. 16,3 (2006): 295-302. doi:10.1089/thy.2006.16.295 8. Struja T, Kaeslin M, Boesiger F, et al. External validation of the GREAT score to predict relapse risk in Graves' disease: results from a multicenter, retrospective study with 741 patients. Eur J Endocrinol. 2017;176(4):413-419. doi:10.1530/EJE-16-0986 9. Park SY, Kim BH, Kim M, et al. The longer the antithyroid drug is used, the lower the relapse rate in Graves' disease: a retrospective multicenter cohort study in Korea. Endocrine. 2021;74(1):120-127. doi:10.1007/s12020-021-02725-x 10. Azizi F, Amouzegar A, Tohidi M, et al. Increased Remission Rates After Long-Term Methimazole Therapy in Patients with Graves' Disease: Results of a Randomized Clinical Trial. Thyroid. 2019;29(9):1192-1200. doi:10.1089/thy.2019.0180 11. Chaker L, Cooper DS, Walsh JP, Peeters RP. Hyperthyroidism. Lancet. 2024;403(10428):768-780. doi:10.1016/S0140-6736(23)02016-0 12. Lee SY, Pearce EN. Hyperthyroidism: A Review. JAMA. 2023;330(15):1472-1483. doi:10.1001/jama.2023.19052 13. https://www.tadeclinicagem.com.br/guia/146/tempestade-tireotoxica/
In this episode of our podcast, we delve into the fascinating and clinically significant topic of Thyrotoxicosis. Brig (Dr) J Muthukrishnan engages in a comprehensive discussion with Wg Cdr (Dr) Sandeep, a renowned endocrinologist. Together, they unpack the fundamentals of Thyrotoxicosis, shedding light on its causes, symptoms, diagnosis, and treatment options. This episode aims to enhance understanding of this condition among medical professionals and students, providing practical insights and up-to-date knowledge. Whether you're a seasoned practitioner or a curious learner, this conversation offers valuable perspectives on managing Thyrotoxicosis effectively. Tune in for an enlightening and educational experience.
No nono episódio dessa segunda temporada, vamos acelerar o metabolismo e discutir sobre definições, classificações, etiologias e manejo do paciente com hipertireoidismo e tempestade tireoitóxica. Lojinha da Amazon (Livros e Materiais recomendados) Sigam e acompanhem a gente, nas redes: Insta: @medicinarretada Tiktok: @medicinarretada Youtube: @medarretada Site: https://medicinarretada.com.br/ E-mail: suporte@medicinarretada.com.br Um "xêro" e até a próxima!
Contributor: Travis Barlock MD Educational Pearls: Clinical picture: A patient comes in with altered mental status, tachycardia, fever, elevated T4, and low TSH. What's the diagnosis?... Thyrotoxicosis secondary to Graves' Disease. How do you treat thyrotoxicosis? First, give a beta-blocker such as propranolol. This suppresses the elevated adrenergic activity. Second, give a thionamide such as propylthiouracil (PTU) or methimazole. This decreases the synthesis of new thyroid hormone. PTU is preferred because it also blocks the conversion of T4 to T3. Third, give an iodine solution such as potassium iodide. This blocks the release of thyroid hormone through a mechanism called the Wolff-Chaikoff effect. Note, this should be given about an hour after the PTU/methimazole to ensure iodine cannot be taken up and used to synthesize more thyroid hormone in individuals with toxic adenoma or toxic multinodular goiter. Fourth, give a glucocorticoid such as hydrocortisone. This will reduce thyroid hormone conversion from T4 to T3 and treat any concurrent adrenal insufficiency. References Abuid J, Larsen PR. Triiodothyronine and thyroxine in hyperthyroidism. Comparison of the acute changes during therapy with antithyroid agents. J Clin Invest. 1974 Jul;54(1):201-8. doi: 10.1172/JCI107744. PMID: 4134836; PMCID: PMC301541. Cooper DS, Saxe VC, Meskell M, Maloof F, Ridgway EC. Acute effects of propylthiouracil (PTU) on thyroidal iodide organification and peripheral iodothyronine deiodination: correlation with serum PTU levels measured by radioimmunoassay. J Clin Endocrinol Metab. 1982 Jan;54(1):101-7. doi: 10.1210/jcem-54-1-101. PMID: 6274892. Das G, Krieger M. Treatment of thyrotoxic storm with intravenous administration of propranolol. Ann Intern Med. 1969 May;70(5):985-8. doi: 10.7326/0003-4819-70-5-985. PMID: 5769631. Nayak B, Burman K. Thyrotoxicosis and thyroid storm. Endocrinol Metab Clin North Am. 2006 Dec;35(4):663-86, vii. doi: 10.1016/j.ecl.2006.09.008. PMID: 17127140. Tsatsoulis A, Johnson EO, Kalogera CH, Seferiadis K, Tsolas O. The effect of thyrotoxicosis on adrenocortical reserve. Eur J Endocrinol. 2000 Mar;142(3):231-5. doi: 10.1530/eje.0.1420231. PMID: 10700716. Summarized by Jeffrey Olson, MS2 | Edited by Jorge Chalit, OMSII
As I was preparing for a lecture on ashwagandha (Withania somnifera), I came across a case report sharing information about a women who went to the ER with tachycardia, palpitations and other symptoms of hyperthyroidism. Her TSH was almost absent, while T4 and T3 were within normal limits. The doctors there ruled out other causes and eventually determined that she had been taking ashwagandha root extract daily instead of her regular thyroid medication for approximately 2 years after a diagnosis of hypothyroidism. They suspected this might be causing her hyperthyroid symptoms. She was asked to discontinue the ashwagandha root, and at two follow-ups her TSH began to rise, while her T3 and T4 started dropping, suggesting a return to her hypothyroid state. The physicians suspected that she was in the early stages of hyperthyroidism when she presented in the ER, due to her T3 and T4 being WNL. Here is a copy of the case (open access!) if you'd like to check it out: Kamal HI, Patel K, Brdak A, Heffernan J, Ahmad N. Ashwagandha as a Unique Cause of Thyrotoxicosis Presenting With Supraventricular Tachycardia. Cureus. 2022 Mar 25;14(3):e23494. doi: 10.7759/cureus.23494. PMID: 35475098; PMCID: PMC9035336. In this episode, I discuss what we can learn from this case report, and what I wish the authors had included in their case presentation. I hope you find this discussion helpful. If you have thoughts or clinical observations regarding ashwagandha and thyroid disease, I'd love to hear them! Helpful Links for Practitioners Monday Mentoring
Ann Marie presents a case to Dan, Jack, and Sharmin of a young patient with tachycardia, lower extremity edema, who later develops pharyngitis. Thyrotoxicosis Schema Pharyngitis Schema Peripheral Edema Schema Download CPSolvers App here RLRCPSOLVERS
This week's episode kicks off the endocrine content with the thyroid. In this episode we cover:- Physiology of thyroid hormone and iodine metabolism- Hyper and hypothyroidism- Interpreting thyroid function tests - Thyroiditis, covering: hashimoto's subacute, reidel's, postpartum, radiation and amiodarone thyroiditis- Thyrotoxicosis, covering: grave's disease including thyroid eye disease, the toxic multinodular goitre, toxic adenoma/toxic solitary nodule, and amiodarone thyroiditisDisclaimerThe information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this podcast.The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam. No responsibility or liability is accepted by the author in relation to the performance of any person in the exam. This podcast is not a substitute for candidates undertaking their own preparations for the exam.To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.The information contained in this podcast has not been independently verified.© Amanda Nikolic 2021
Thyroid Storm and Thyrotoxicosis are often misdiagnosed due to presenting similarly to many other disease processes. How do we identify this condition? What are the standard treatment options? And how do we treat a patient who is refractory to conventional therapy? Joined by EM pharmacist, Chase Turner, we discuss all things hyperthyroidism in this podcast episode. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment. -------------------------------------------- Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com Creative Commons Attribution 3.0 Unported License https://creativecommons.org/licenses/by/3.0/deed.en_US
Rabih, Reza, PrezSharmin, and Arsalan break down thyrotoxicosis, by revisiting a case initially presented at our December 18th VMR. Schema Patreon website Download CPSolvers App here Episode Quiz
Blazing hot tips to diagnose and treat hyperthyroidism with Dr Eve Bloomgarden, @evebmd (Northwestern). We cover a ton of ground including how to: interpret thyroid function tests, use your thumbs (or an ultrasound) to examine the thyroid, become an expert on Graves’ orbitopathy, prescribe methimazole and decide who needs surgery or radioactive iodine therapy. Plus, a bit on subclinical hyperthyroidism. This episode is on fire! Listeners can claim Free CE credit through VCU Health at curbsiders.vcuhealth.org (CME goes live at 0900 ET on the episode’s release date). Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Tima Karginov and Matthew Watto MD, FACP Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Eve Bloomgarden MD Sponsors Pediatrics On Call podcast by the American Academy of Pediatrics If you provide medical care to children, Pediatrics On Call — the new podcast from the American Academy of Pediatrics — will help you do it better. Each week, hear the latest news and research on children's health, on topics from obesity and mental health to keeping the kiddos safe when they’re stuck at home. Subscribe from your favorite podcast provider or find the latest episodes here. VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit. Time Stamps 00:00 Sponsors - VCU Health Continuing Education and the AAP’s Pediatrics On Call podcast 00:30 Intro, disclaimer, guest bio 03:15 Guest one-liner, favorite failure, Picks of the Week*: After the Fall (How Humpty Dumpty Got Back Up Again) (children’s book), Circe (book), IMPACT https://www.impact4hc.com/ (Non-profit) 08:50 Sponsor - the AAP’s Pediatrics On Call podcast 10:37 Background, Definition of Hyperthyroidism, thyrotoxicosis; Basic labs 14:20 Case from Kashlak, Symptoms of Hyperthyroidism 25:00 Grave’s eye disease: exam, therapy and counseling 32:35 Thyroid exam and ultrasound 38:55 Thyroid Stimulating Immunoglobulin 41:00 Biotin 44:30 Thyroid Scintigraphy 49:00 Causes of Thyrotoxicosis 52:00 Treatment & Adherence to antithyroid medication (methimazole) 56:20 Beta Blockers in thyrotoxicosis 64:50 Subclinical Hyperthyroidism 67:00 Take Home Points, Outro Sponsor - VCU Health Continuing Education Links* After the Fall (How Humpty Dumpty Got Back Up Again (Children’s book) Circe (book) Impact4hc.com Dr Bloomgarden and friends started this non-profit to address the infodemic during COVID19 *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra. Goal Listeners will develop an approach to the diagnosis and management of hyperthyroidism and thyrotoxicosis. Learning objectives After listening to this episode listeners will… Recognize the signs and symptoms of thyrotoxicosis Perform the appropriate diagnostic evaluation to differentiate between the various causes of thyrotoxicosis Counsel and treat patients with thyrotoxicosis Develop an approach to subclinical hyperthyroidism Disclosures Dr Bloomgarden reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. Citation Bloomgarden E, Karginov T, Williams PN, Watto MF. “#228 Thyroid on Fire: Hyperthyroidism with Dr Eve Bloomgarden”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date August 3, 2020.
Join the EMGuideWire team from Carolinas Medical Center Emergency Medicine Residency Program as they discuss the challenging condition of thyrotoxicosis and thyroid storm! From evaluation to management, this critical state requires our respect and attention!
This episode of CRACKCast covers Rosen's Chapter 120, Thyroid and Adrenal disorders. This episode is going to have a nice breakdown of how each of these major endocrine glands can go haywire and what to do when the storm approaches. The shownotes also have some additional material worth checking out!
This episode of CRACKCast covers Rosen's Chapter 120, Thyroid and Adrenal disorders. This episode is going to have a nice breakdown of how each of these major endocrine glands can go haywire and what to do when the storm approaches. The shownotes also have some additional material worth checking out!
Today's episode is a quick review of Thyroid emergencies by Dr. Patrick Ng, a 3rd year EM resident in San Antonio, recorded by Jacob Schriner MS-3. Thyroid emergencies can be difficult to recognize in the ED because they present in so many different ways. Today's episode will review how to recognize these emergencies, order the right tests, and provide the correct critical treatments.
Dr Emma Lei MBBS 19 Jun 2012
Thu, 1 Jan 1976 12:00:00 +0100 https://epub.ub.uni-muenchen.de/8167/1/8167.pdf Scriba, Peter Christian; Blumenstein, J.; Nolte, J. ddc:610, Medizin
Mon, 1 Jan 1973 12:00:00 +0100 https://epub.ub.uni-muenchen.de/9239/1/9239.pdf Scriba, Peter Christian; Horn, K.; Nolte, J. ddc:610, Medizin
Sat, 1 Jan 1972 12:00:00 +0100 https://epub.ub.uni-muenchen.de/8000/1/8000.pdf Scriba, Peter Christian; Schneider, H.; Kiefhaber, P.; Bachmaier, B.; Pette, D.; Nolte, J. ddc:61
Thu, 1 Jan 1970 12:00:00 +0100 https://epub.ub.uni-muenchen.de/7986/1/7986.pdf Scriba, Peter Christian; Pette, D.; Kiefhaber, P.; Bachmaier, B.; Nolte, J. ddc:610, Medizin