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Free Thyroxine Index

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41. Subacute granulomatous thyroiditis

recent viral infection myalgia malaise tremor heat intolerance viral infection HLA-Bw35 and B35 Diagnostic investigations thyroid-stimulating hormone (TSH) total T4, total T3, T3 resin uptake, free thyroxine index T3:T4 ratio radioactive iodine uptake ESR CRP antithyroid antibodies (thyroid peroxidase antibodies) fine needle aspiration biopsy ultrasonography of thyroid salivary CRP Treatment algorithm ACUTE Contributors Authors Associate Chief Director of the Thyroid Health Center Section

2018 BMJ Best Practice

42. Free thyroxine is an independent predictor of subcutaneous fat in euthyroid individuals. (PubMed)

Free thyroxine is an independent predictor of subcutaneous fat in euthyroid individuals. Thyroid function parameters have been associated with obesity, but associations with the type of adiposity have not been examined. We used ultrasound (US) to assess regional adiposity and investigated associations of thyroid function with parameters of central obesity.Cross-sectional study.A total of 303 apparently healthy individuals (age 42.9+/-8.8, body mass index (BMI) 19.0-43.3, median 26.2 kg/m(2 (...) ), 181 women) were examined for indices of the metabolic syndrome. BMI, waist and hip circumference, abdominal subcutaneous fat (SF), and preperitoneal fat (PF) layer was estimated. TSH, free thyroxine (fT(4)), triiodothyronine (T(3)), thyroid autoantibodies, insulin, glucose, and lipid levels were measured. Subjects receiving T(4) (9.2%) were excluded.SF and SF/PF ratio were inversely correlated with fT(4) levels (r=-0.169, P=0.023, r=-0.193, P=0.009 respectively). In multivariate analysis, fT(4

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2009 European Journal of Endocrinology

43. Levothyroxine

Levothyroxine sodium is widely prescribed to treat primary hypothyroidism. There is consensus that levothyroxine should be taken in the morning (...) on an empty stomach. A pilot study showed that levothyroxine intake at bedtime significantly decreased thyrotropin levels and increased free thyroxine and total triiodothyronine levels. To date, no large randomized trial investigating the best time of levothyroxine intake, including quality-of-life evaluation, has been performed. To ascertain if levothyroxine (...) with subclinical hypothyroidism and TSH values <10mIU/L. METHODS: A case-control study in which patients 65years or older with TSH (...) levels of 4.2-10mIU/L who died in the years 2012-2016 ('cases') were compared with matched individuals who did not die during this period ('controls'). Matching was based on gender, age, Charlson comorbidity index, date of TSH testing, duration of follow-up and TSH quartile. All cases of known thyroid disease or cases in which anti-thyroid medications or glucocorticoids were

2018 Trip Latest and Greatest

44. Propranolol

of remission with the 20-minute (132)I uptake falling to normal, although the free-thyroxine index remains slightly raised. It is likely that these remissions reflect the natural tendency of the disease to remit since propranolol is not considered to have any direct in-vivo effect on thyroid function.However, because of failure to gain 1973 11. Endoscopic Band Ligation (EBL) Versus Propranolol for Primary Prophylaxis of Variceal Bleeding Endoscopic Band Ligation (EBL) Versus Propranolol for Primary (...) Br Med J 0372673 0007-1447 9Y8NXQ24VQ Propranolol AIM IM Arch Dis Child. 1974 Oct;49(10):813-5 4429365 Humans Hyperthyroidism drug therapy Infant, Newborn Infant, Premature, Diseases drug therapy (...) Male Propranolol therapeutic use PMC1632113 1977 9 17 1977 9 17 0 1 1977 9 17 0 0 ppublish 912277 PMC1632113 1977 9. Preliminary report on the use of propranolol in thyrotoxicosis: I. Effect on serum thyroxine, triiodothyronine and reverse triiodothyronine concentrations. 688126 1978 11 22 1978 11

2018 Trip Latest and Greatest

45. The Collaborative Assessment, OTCA12, on “C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs)


2019 EUnetHTA

46. Management of Infertility

the analytic framework that guided our work. • KQ 1. What are the comparative safety and effectiveness of available treatment strategies for women with polycystic ovary syndrome who are infertile and who wish to become pregnant? o KQ 1a. Does the optimal treatment strategy vary by patient characteristics such as age, ovarian reserve, race, body mass index (BMI), presence of other potential causes of female infertility, or presence of male factor infertility? • KQ 2. What are the comparative safety (...) , or other adverse outcomes associated with donation? ES-5 Figure A. Analytic framework Abbreviations: ART=assisted reproductive technology; BMI=body mass index; GnRH=gonadotropin-releasing hormone; KQ=Key Question; OHSS=ovarian hyperstimulation syndrome; PCOS=polycystic ovary syndrome Potential Modifiers • Age • Ovarian reserve • Race/ethnicity • Obesity/BMI • Prior treatments • Primary vs. secondary infertility • Maternal parity • Concomitant diagnoses o Male factor + female factor o Multiple female

2019 Effective Health Care Program (AHRQ)

47. ASCIA Guidelines: Chronic Spontaneous Urticaria (CSU)

in this document ASST autologous serum skin test CIndU chronic inducible urticaria CSU chronic spontaneous urticaria CU-Q2oL chronic urticaria quality of life questionnaire DLQI dermatology life quality index EAACI European Academy of Allergology and Clinical Immunology EDF European Dermatology Forum GA 2 LEN Global Allergy and Asthma European Network IgE Immunoglobulin E IVIg Intravenous immunoglobulin LTRA leukotriene receptor antagonists QoL quality of life TNF tumour necrosis factor UAS urticaria activity (...) - Leukotriene receptor antagonists (LTRAs) 10 - Omalizumab 10 - Ciclosporin 13 - Dapsone 14 - Hydroxychloroquine 14 - Corticosteroids 14 - Anticoagulants 14 - Thyroxine 14 - Other treatments 14 • Drug treatment in paediatric populations 15 • Drug availability in New Zealand • PBS requirements in Australia • Non-drug management • Management of CSU in pregnancy and lactation 16 16 17 18 3. Treatment algorithms 19 • Australia • New Zealand 4. References 21 ASCIA INFORMATION FOR HEALTH PROFESSIONALS 3 1

2019 Australasian Society of Clinical Immunology and Allergy

49. Inotersen sodium (Tegsedi) - Amyloidosis

EMA/411876/2018 Page 4/142 List of abbreviations A/C Urine albumin/creatinine ratio ADA Antidrug antibodies AE Adverse event AESI Adverse event of special interest ALT Alanine aminotransferase ANCOVA Analysis of covariance aPTT Activated partial thromboplastin time ASO Antisense oligonucleotide AST Aspartate aminotransferase ATTR Transthyretin amyloidosis AUC/ AUC 0-168h Area under the curve / Area under the curve baseline to 168 hours BMI Body mass index BCRP Human breast cancer resistance (...) Interventricular septum Assessment report EMA/411876/2018 Page 5/142 IXRS Interactive voice/web-response system LBM Lean body mass LCRIS Local cutaneous reaction at the injection site LLN Lower limit of normal LSM Least squares mean LV Left ventricular 2’-MOE 2’-O-(2-methoxyethyl) mBMI Modified body mass index MMRM Mixed Effects Model with Repeated Measures mNIS+7 Modified Neuropathy Impairment Score+7 mRNA Messenger ribonucleic acid NIS Neuropathy Impairment Score NIS-C NIS-cranial nerve muscle strength NIS

2018 European Medicines Agency - EPARs

50. Treatment of Drug-Resistant Tuberculosis

of diagnostic tools and algorithms ( ). Treatment and Monitoring of DR-TB Regimens should only include drugs to which the patient’s isolate has documented or high likelihood of susceptibility. Drugs known to be ineffective, on the basis of in vitro resistance or clinical and epidemiological information (i.e., resistance in the index case or high population prevalence of resistance), should not be used, even when resistance is present in only a small percentage of the mycobacteria in the population

2019 Infectious Diseases Society of America

51. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures

circumstances. DOI:10.4158/GL-2019-0406 © 2019 AACE. 7 ABBREVIATIONS A1C = hemoglobin A1C; AACE = American Association of Clinical Endocrinologists; ABCD = adiposity-based chronic disease; ABOM = American Board of Obesity Medicine; ACE = American College of Endocrinology; ADA = American Diabetes Association; AGA = American Gastroenterological Association; AHI = Apnea-Hypopnea Index; ASA = American Society of Anesthesiologists; ASMBS = American Society of Metabolic and Bariatric Surgery; BMI = body mass (...) index; BPD = biliopancreatic diversion; BPD/DS = biliopancreatic diversion with duodenal switch; CI = confidence interval; CPAP = continuous positive airway pressure; CPG = clinical practice guideline; CRP = C-reactive protein; CVD = cardiovascular disease; DBCD = dysglycemia-based chronic disease; DS = duodenal switch; DVT = deep venous thrombosis; DXA = dual- energy X-ray absorptiometry; EL = evidence level; EN = enteral nutrition; ERABS = enhanced recovery after bariatric surgery; ESG

2019 American Association of Clinical Endocrinologists

52. AACE/ACE Guidelines for Management of Growth Hormone Deficiency in Adults and Patients Transitioning from Pediatric to Adult Care

and reduced reported side effects, dependent on age, gender, body mass index, and various other individual characteristics. With care- ful dosing of rhGH replacement, many features of adult GHD are reversible and side effects of therapy can be minimized. Scientific studies have consistently shown rhGH therapy to be beneficial for adults with GHD, includ - ing improvements in body composition and quality of life, and have demonstrated the safety of short- and long-term rhGH replacement. Abbreviations: AACE (...) = American Association of Clinical Endocrinologists; ACE = American College of Endocrinology; AHSG = alpha-2-HS-glycoprotein; AO-GHD = adult-onset growth hormone deficiency; ARG = arginine; BEL = best evidence level; BMD = bone mineral density; BMI = body mass index; CI = confidence interval; CO-GHD = childhood-onset growth hormone deficiency; CPG = clinical practice guideline; CRP = C-reactive protein; DM = diabetes mellitus; DXA = dual-energy X-ray absorptiometry; EL = evidence level; FDA = Food

2019 American Association of Clinical Endocrinologists

53. British Association of Dermatologists? guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis

. Rushbook, 8 R.R. Coelho, 9 S.J. Catten, 1 K.Y.C. Lee, 1 A.M. Skellett, 1 A.G. Af?eck, 10 L.S. Exton, 11 M.F. Mohd Mustapa 11 and N.J. Levell 1 1 Dermatology Department, 2 Haematology Department, 7 Nephrology Department and 8 Hepatology Unit, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, U.K. 3 Dermatology Department, Royal United Hospital, Combe Park, Bath BA1 3NG, U.K. 4 Dermatology Department, Royal Free Hospital, Pond Street, London NW3 2QG, U.K. 5 General Practitioner, Chet (...) and verbal rating scale. 18 The use of a patient-completed 10-cm VAS and perhaps the Dermatology Life Quality Index 19 is rec- ommended to provide a baseline measure of itch activity to help quantify management outcomes. However, as yet, there is no international consensus on how to measure the severity of itch. 20 Moreover, there may be differences in how patients and physicians assess the severity of pruritus. 21–23 The management of pruritus depends on the treatment of any underlying disease

2018 British Association of Dermatologists

54. Testosterone Therapy in Men with Hypogonadism

of some anticonvulsants. @ Potentially reversible functional causes of secondary hypogonadism are listed in . % If there is clinical indication of hypopituitarism or sella abnormality on imaging, evaluation of other pituitary hormones ( e.g. , free thyroxine, morning cortisol and ACTH stimulation test if clinical hypocortisolism is suspected) should be performed. ^ Perform pituitary imaging (magnetic resonance imaging) to exclude pituitary and/or hypothalamic tumor or infiltrative disease when severe (...) pituitary hormones ( e.g. , free thyroxine, morning cortisol and ACTH stimulation test if clinical hypocortisolism is suspected) should be performed. ^ Perform pituitary imaging (magnetic resonance imaging) to exclude pituitary and/or hypothalamic tumor or infiltrative disease when severe secondary hypogonadism [ e.g. , serum T < 150 ng/dL (5.2 nmol/L)], panhypopituitarism, persistent hyperprolactinemia, or symptoms or signs of tumor mass effect (such as new-onset headache, visual impairment, or visual

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2018 The Endocrine Society

55. Thyroid hormone treatment does not help adults with mildly abnormal thyroid tests

evidence that hormone treatment of subclinical hypothyroidism, gives no measurable benefit either. This may help inform practice, spare patients unnecessary treatment, and save NHS resources. Share your views on the research. Why was this study needed? Hypothyroidism is a condition where the thyroid gland doesn’t produce enough hormones, which can have various underlying causes. Hypothyroidism is characterised by low blood levels of free thyroxine (T4) and high levels of thyroid stimulating hormone (...) of free thyroxine (T4) and high levels of thyroid stimulating hormone (TSH), which is released from the pituitary gland to try and stimulate the thyroid. Subclinical hypothyroidism is diagnosed when there is a raised level of TSH, but normal levels of free T4. It’s thought to affect around 5-6% of adults and is more common in women and older people. To date, there has been little evidence to guide the management of subclinical hypothyroidism. Two large randomised controlled trials were recently

2019 NIHR Dissemination Centre

56. National minimum retesting intervals in pathology: A final report detailing consensus recommendations for minimum retesting intervals for use in pathology

Summaries CMV Cytomegalovirus CPS Clinical Practice Section EASL European Association of the Study of the Liver ED Exposure day e-GFR Estimated glomerular filtration rate EGTM European Group on Tumour Markers EP Electrophoresis ESR Erythrocyte sedimentation rate ESC European of Society of Cardiology FSH Follicule stimulating hormone FBC Full blood count FMH Fetomaternal haemorrhage fT3 Free triiodothyronine fT4 Free thyroxine GAD65 Glutamic acid decarboxylase antibody GAIN Guidelines and Audit (...) ACB Association for Clinical Biochemistry and Laboratory Medicine AFB Acid-fast bacilli ALP Alkaline phosphatase AMPA 2 Amino-3 (5-Methyl 3 Oxo-1,2 Oxazole 4 Yl) Propanoic Acid ANA Antinuclear antibody ANCA Antineutrophil cytoplasmic antibodies APTT Activated Partial Thromboplastin Time (APTT) ASCO American Society of Clinical Oncology ASO Antistreptolysin O ATPOab Anti-thyroid peroxidase antibodies BCSH British Committee for Standards in Haematology BMI Body mass index BNF British National

2016 Royal College of Pathologists

57. CRACKCast E128 – Thyroid and Adrenal Disorders

! Shownotes – Key Concepts Hyperthyroidism Thyroid hormone exerts effects on nearly every organ system. A high degree of suspicion is needed to diagnose hyperthyroidism. The laboratory evaluation of choice is determination of the TSH concentration with free T4 and T3 levels. Total T4 and T3 levels are of limited value. Thyroid storm is a life-threatening thyrotoxic crisis that requires prompt recognition and therapy, as well as identification and treatment of any precipitating cause, such as infection (...) event in patients with untreated or undertreated hypothyroidism. Treatment with thyroid hormone replacement must be initiated, often solely on clinical findings. Adrenal Insufficiency Clinical manifestations of primary and secondary adrenal insufficiency may be vague and nonspecific and require a high index of suspicion for diagnosis. Predominant complaints include fatigue, weakness, dizziness, nausea, vomiting, and other nonspecific GI symptoms. Patients with primary adrenal insufficiency

2017 CandiEM

58. The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum

and raised free thyroxine levels with or without a suppressed thyroid stimulating hormone level. These patients rarely have thyroid antibodies and are euthyroid clinically. The biochemical thyrotoxicosis resolves as the HG improves 22 and treatment with antithyroid drugs is inappropriate. Liver function tests are abnormal in up to 40% of women with HG, 23 with the most likely abnormality being a rise in transaminases. Bilirubin levels can be slightly raised but without jaundice, and amylase levels can (...) is in the first trimester of pregnancy and other causes of nausea and vomiting have been excluded. How is HG diagnosed? HG can be diagnosed when there is protracted NVP with the triad of more than 5% prepregnancy weight loss, dehydration and electrolyte imbalance. How can the severity of NVP be classified? An objective and validated index of nausea and vomiting such as the Pregnancy-Unique Quantification of Emesis (PUQE) score can be used to classify the severity of NVP . What initial clinical assessment

2016 Royal College of Obstetricians and Gynaecologists

59. The Expressed Genome in Cardiovascular Diseases and Stroke: Refinement, Diagnosis, and Prediction: A Scientific Statement From the American Heart Association

. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article The Expressed Genome in Cardiovascular Diseases and Stroke: Refinement, Diagnosis, and Prediction: A Scientific Statement From the American Heart Association , MD, PhD, MPH, FAHA, Chair , MD, PhD, FAHA, Co-Chair , PhD, FAHA , MD, FAHA , MD, FAHA , MD, MHS, FAHA , MD, MPH, FAHA , MD , and MD, FAHA MD, MS, FAHAon behalf of the American Heart Association Committee on Molecular (...) . Biomarker studies can broadly be divided into targeted (or candidate-driven) and untargeted (or discovery) approaches. The targeted approaches are based on a hypothesis about a specific mechanism or pathway; therefore, they typically focus on 1 or a few biomarkers representing that biological system. In contrast, the untargeted approaches are hypothesis free, or rather hypothesis generating, and aim at surveying a whole class of biomarkers in an unbiased way. The use of untargeted approaches

2017 American Heart Association

60. NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children: Recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nu

: Complete blood count (CBC) with differential, AST, bilirubin (total, conjugated), alkaline phosphatase, GGT, international normalized ratio (INR), albumin, total protein, hemoglobin A1c Exclude infections (eg, hepatitis A IgM, hepatitis B surface antigen, hepatitis C antibody, other chronic viral infections) Exclude endocrine disorders (thyroid-stimulating hormone [TSH], free thyroxine [T4]) Exclude autoimmune causes of ALT elevation (total IgA, total IgG and tissue transglutaminase antibody (...) pediatric studies, independent of body mass index (BMI) and standard metabolic risk factors (11,12). It is not known whether OSA treatment ameliorates NASH. Among children newly diagnosed with type 2 diabetes mellitus (T2DM), elevated ALT is more frequent in Hispanic children compared to African American children (13). In addition, pediatric patients with panhypopituitarism appear to have increased risk of NAFLD, NASH, and even cirrhosis (14,15), similar to the increased preva- lence (77%) and severity

2017 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

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