Personal Considerations on the 2011 American Thyroid Association and the 2007 Endocrine Society Pregnancy and Thyroid Disease Guidelines

Thyroid ◽  
2011 ◽  
Vol 21 (10) ◽  
pp. 1049-1051 ◽  
Author(s):  
Daniel Glinoer
Keyword(s):  
Thyroid Disease ◽  
American Thyroid Association ◽  
Endocrine Society

scholarly journals Long-term cardiovascular and cerebrovascular morbidity in Israeli thyroid cancer survivors

2019 ◽  
Vol 8 (4) ◽  
pp. 398-406 ◽  
Author(s):  
Elena Izkhakov ◽  
Joseph Meyerovitch ◽  
Micha Barchana ◽  
Yacov Shacham ◽  
Naftali Stern ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Disease ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
Study Group ◽  
American Thyroid Association ◽  
Cox Proportional Hazards Models ◽  
Increased Risk

Objective Thyroid cancer (TC) survivors may be at risk of subsequent cardiovascular and cerebrovascular (CaV&CeV) morbidity. The 2009 American Thyroid Association (ATA) guidelines recommended less aggressive treatment for low-risk TC patients. The aim of this study was to assess the atherosclerotic CaV&CeV outcome of Israeli TC survivors compared to individuals with no thyroid disease, and the atherosclerotic CaV&CeV outcome before (2000–2008) and after (2009–2011) implementation of the 2009 ATA guidelines. Methods All members of the largest Israeli healthcare organization who were diagnosed with TC from 1/2000 to 12/2014 (study group) and age- and sex-matched members with no thyroid disease (controls) were included. Adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using Cox proportional hazards models. Results The mean follow-up was 7.6 ± 4.2 and 7.8 ± 4.1 years for the study (n = 5,677, 79% women) and control (n = 23,962) groups, respectively. The former had an increased risk of new atherosclerotic CaV&CeV events (adjusted HR 1.26, 95% CI 1.15–1.39). The 5-year incidence of CaV&CeV was lower (adjusted HR 0.49, 95% CI 0.38–0.62) from 2009 to 2011 compared to 2000 to 2008, but remained higher in the study group than in the control group (adjusted HR 1.5, 95% CI 1.14–1.69). Conclusions This large Israeli population-based cohort study showed greater atherosclerotic CaV&CeV morbidity in TC survivors compared to individuals with no thyroid diseases. There was a trend toward a decreased 5-year incidence of atherosclerotic CaV&CeV events among TC survivors following the implementation of the 2009 ATA guidelines, but it remained higher compared to the general population.

scholarly journals Eventos Internacionales en Endocrinología

2017 ◽  
Vol 1 (1) ◽  
pp. 49
Author(s):  
Revista ACE
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Thyroid Cancer ◽  
Los Angeles ◽  
Annual Meeting ◽  
European Association ◽  
American Diabetes Association ◽  
American Association ◽  
American Thyroid Association ◽  
Endocrine Society

12th Annual Word Congress on Insulin Resistance, Diabetes & Cardiovascular Disease (WCIRDC). 30 de Octubre a 01 de Noviembre de 2014. Los Ángeles, California, Estados Unidos. ENDO 2015 - The Endocrine Society´s 97th Annual Meeting & Expo. 05 al 08 de Marzo de 2015. San Diego, California, Estados Unidos. AACE 2015 - 24th Annual Scientific & Clinical Congress. 13 al 17 de Mayo de 2015. Nashville, Tennessee, Estados Unidos. 17th European Congress of Endocrinology. 16 al 20 de Mayo de 2015. Dublín, Irlanda. ADA 2015 - 75th Scientific Sessions American Diabetes Association. 05 al 09 de Junio de 2015. Boston, Massachusetts, Estados Unidos. American Association of Clinical Endocrinologists Advances in the Medical and surgical Management of Thyroid Cancer. 23 y 24 de Junio de 2015. Tampa, Florida, Estados Unidos. 51st EASD Annual Meeting, European Association for the Study of Diabetes. 14 al 18 de Septiembre de 2015. Estocolmo, Suecia. 15th International Thyroid Congress (ITC hosted by the American Thyroid Association). 18 al 23 de Octubre de 2015. Orlando, Florida, Estado Unidos.

scholarly journals Practice Variation in the Care of Subclinical Hypothyroidism During Pregnancy: A National Survey of Physicians in the United States

2019 ◽  
Vol 3 (10) ◽  
pp. 1892-1906 ◽  
Author(s):  
Freddy J K Toloza ◽  
Naykky M Singh Ospina ◽  
Rene Rodriguez-Gutierrez ◽  
Derek T O’Keeffe ◽  
Juan P Brito ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Online Survey ◽  
The United States ◽  
American Thyroid Association ◽  
Clinical Practices ◽  
Endocrine Society ◽  
Clinical Scenarios ◽  
In Pregnancy ◽  
Current Practices

Abstract Evidence regarding the effects of subclinical hypothyroidism (SCH) on adverse pregnancy outcomes and the ability of levothyroxine (LT4) treatment to prevent them is unclear. Available recommendations for the management of SCH during pregnancy are inconsistent. We conducted a nationwide survey among physicians assessing their knowledge of and current practices in the care of SCH in pregnancy and compared these with the most recent American Thyroid Association (ATA) recommendations. In this cross-sectional study, an online survey was sent to active US members of the Endocrine Society. This survey included questions about current practices and clinical scenarios aimed at assessing diagnostic evaluation, initiation of therapy, and follow-up in pregnant women with SCH. In total, 162 physicians completed the survey. ATA guidelines were reviewed by 76%, of whom 53% indicated that these guidelines actually changed their practice. Universal screening was the preferred screening approach (54%), followed by targeted screening (30%). For SCH diagnosis, most respondents (52%) endorsed a TSH level >2.5 mIU/L as a cutoff, whereas 5% endorsed a population-based cutoff as recommended by the ATA. The decision to initiate treatment varied depending on the specific clinical scenario; however, when LT4 was initiated, respondents expected a small/very small reduction in maternofetal complications. In conclusion, despite recently updated guidelines, there is still wide variation in clinical practices regarding the care of women with SCH in pregnancy. Highly reliable randomized trials are required to evaluate the effectiveness of the most uncertain treatment practices on the care of pregnant women with SCH.

scholarly journals Review of American Thyroid Association guidelines for the diagnosis and management of thyroid disease during pregnancy and the postpartum

2018 ◽  
Vol 14 (3) ◽  
pp. 128-139
Author(s):  
Valentin V. Fadeyev
Keyword(s):  
Thyroid Disease ◽  
Critical Appraisal ◽  
Clinical Decision Making ◽  
Task Force ◽  
Synthesis Methods ◽  
American Thyroid Association ◽  
Thyroid Function Tests ◽  
Diagnosis And Management ◽  
Published Evidence ◽  
In Pregnancy

Thyroid disease in pregnancy is a common clinical problem. Since the guidelines for the management of these disorders by the American Thyroid Association (ATA) were first published in 2011, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid disease in women during pregnancy, preconception, and the postpartum period. The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles were eligible for inclusion. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations. The guideline task force had complete editorial independence from the ATA. Competing interests of guideline task force members were regularly updated, managed, and communicated to the ATA and task force members. The revised guidelines for the management of thyroid disease in pregnancy include recommendations regarding the interpretation of thyroid function tests in pregnancy, iodine nutrition, thyroid autoantibodies and pregnancy complications, thyroid considerations in infertile women, hypothyroidism in pregnancy, thyrotoxicosis in pregnancy, thyroid nodules and cancer in pregnant women, fetal and neonatal considerations, thyroid disease and lactation, screening for thyroid dysfunction in pregnancy, and directions for future research. We have developed evidence-based recommendations to inform clinical decision-making in the management of thyroid disease in pregnant and postpartum women. While all care must be individualized, such recommendations provide, in our opinion, optimal care paradigms for patients with these disorders.

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