Publications by authors named "Jan Jiskra"

Article Synopsis
  • An online survey of European thyroid specialists revealed that 28% believe thyroid hormone (TH) treatment may be appropriate for euthyroid patients with growing simple goiters, despite guidelines against this practice.
  • There were significant regional differences in support for TH treatment, with only 7% in The Netherlands compared to 78% in the Czech Republic.
  • Factors influencing the likelihood of recommending TH included the specialist's age and the historical iodine insufficiency of their region, while gender, country, and economic factors showed weak associations.
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Article Synopsis
  • The study analyzes urinary iodine levels and thyroid hormone concentrations in pregnant women with gestational diabetes mellitus (GDM) compared to healthy pregnant women, focusing on iodine status and its impact on thyroid function.
  • Results show that women with GDM have significantly lower urinary iodine concentrations and a higher prevalence of iodine deficiency compared to controls, with only a small percentage meeting optimal iodine intake.
  • Additionally, while there were no differences in serum TSH levels, hypothyroxinaemia was more common in GDM patients, and taking dietary iodine supplements was linked to fewer perinatal complications.
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Article Synopsis
  • - The study aimed to assess how European thyroid specialists view levothyroxine (LT4) treatment for euthyroid women with positive thyroid peroxidase antibodies (TPOAb) to improve fertility, as current evidence does not support this practice.
  • - An international survey (THESIS) revealed that 42.8% of over 2,316 respondents believe LT4 might be indicated for these patients, with significant variation across countries, highlighting a range from 22.9% to 83.7% of positive responses.
  • - Factors such as gender, age, and clinical experience influenced opinions; younger specialists and those who treat more thyroid patients were more likely to consider LT4, raising concerns about potential overtreatment risks in
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Hypothyroidism is common, however, aspects of its treatment remain controversial. Our survey aimed at documenting treatment choices of European thyroid specialists and exploring how patients' persistent symptoms, clinician demographics, and geo-economic factors relate to treatment choices. Seventeen thousand two hundred forty-seven thyroid specialists from 28 countries were invited to participate in an online questionnaire survey.

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Introduction: Thyroid specialists influence how hypothyroid patients are treated, including patients managed in primary care. Given that physician characteristics influence patient care, this study aimed to explore thyroid specialist profiles and associations with geo-economic factors.

Methods: Thyroid specialists from 28 countries were invited to respond to a questionnaire, Treatment of Hypothyroidism in Europe by Specialists: an International Survey (THESIS).

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Objectives: To describe how subclinical hypothyroidism (SubHypo) influences the quality of life (QoL) during pregnancy.

Methods: In primary data collection (NCT04167423), thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibodies, generic quality of life (QoL; 5-level version of EQ-5D [EQ-5D-5L]), and disease-specific QoL (ThyPRO-39) were measured among pregnant women. SubHypo during each trimester was defined according to the 2014 European Thyroid Association guidelines (TSH > 2.

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Graves ophthalmopathy (GO) occurs in 25-50% cases of Graves disease. Most cases are just mild, only 5% represents eye threatening diseases. About 5-10% of cases could be euthyroid and 10% hypothyroid, respectively.

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[Thyroid incidentalomas].

Vnitr Lek

November 2022

Thyroid nodules are very common. Most of them are benign non-secerning incidentally found nodules - thyroid incidentalomas. Ultrasound (US) is an essential initial diagnostic tool in thyroid nodules management.

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Background: Inconsistencies in the management of hypothyroidism have been reported among endocrinologists in different European countries. Aim of this study was to explore Czech endocrinologists' use of thyroid hormones in hypothyroid and euthyroid patients.

Methods: We used a web-based survey containing 32 questions regarding the use of thyroid hormones.

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Objective: Thyroid nodules are a common finding in the general population. The primary aim of the study was to determine the prevalence of thyroid nodules and cancer found by ultrasound (US) in women who underwent screening for thyroid dysfunction during pregnancy.

Design: A double-centric, retrospective, cohort study.

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Iodine is an essential constituent of thyroid hormones. Thyroid hormones regulate brain development, growth and metabolism of the human body. Inadequately low iodine intake and decreased thyroid hormone synthesis can lead to iodine deficiency disorders.

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The relationship between Hashimoto's thyroiditis (HT) and thyroid cancer (TC) is a controversial topic; it remains unclear if HT acts as a risk factor of TC. The aim of our study was to compare the presence of HT and thyroid function in patients with TC and benign nodules. We analyzed 2571 patients after fine needle aspiration biopsy of thyroid nodule.

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Graves orbitopathy (GO) occurs in 25-50 % cases of Graves disease. Only in 5 % of patients the eye threatening GO is present. About 5-10 % and 10 % cases are present in euthyroid and hypothyroid patients respectively.

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Hypothyroidism is frequently found in patients with heart disease. It is a risk factor for atherosclerosis and ischemic heart disease and has a direct negative effect on both the left and right ventricular functions (hypothyroidism-induced cardiomyopathy). The confirmed manifest hypothyroidism is always a reason for replacement therapy with levothyroxine; regarding patients with heart disease, we always begin treatment with a small dose and increase it gradually.

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Thyroid nodules are common finding. Most of them are of benign origin without thyroid dysfunction. Diagnosis is based on evaluation of thyroid function by assessment of serum thyroid stimulating hormone, and ultrasound for the purpose to identify the nodules which should be referred to fine needle aspiration biopsy (FNAB).

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Thyroid hormones are crucial for the growth and maturation of many target tissues, especially the brain and skeleton. During critical periods in the first trimester of pregnancy, maternal thyroxine is essential for fetal development as it supplies thyroid hormone-dependent tissues. The ontogeny of mature thyroid function involves organogenesis, and maturation of the hypothalamus, pituitary and the thyroid gland; and it is almost complete by the 12th-14th gestational week.

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To determine the expression of chemokine receptors in lymphocytes from thyroid nodules and peripheral blood in patients with and without Hashimoto's thyroiditis (HT). The study included 46 women with thyroid nodules and HT and 60 women with thyroid nodules without HT (controls) who underwent a fine needle aspiration biopsy (FNAB). Expression of chemokine receptors CXCR3, CCR5, and CRTH2 was assessed by flow cytometry in lymphocytes from FNAB samples and from peripheral blood.

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Cardiovascular system is essentially affected by thyroid hormones by way of their genomic and non-genomic effects. Untreated overt thyroid dysfunction is associated with higher cardiovascular risk. Although it has been studied more than 3 decades, in subclinical thyroid dysfunction the negative effect on cardiovascular system is much more controversial.

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Introduction: Iodine deficiency is a global public health problem which is particularly noticeable in pregnant or breastfeeding women and their children. Even mild iodine deficiency during pregnancy can lead to damage to the developing brain and thus affecting the fetus intelligence, his cognitive and neurological function, embryogenesis and growth.

Patients: In the period 2010-2015 was determined by spectrophotometry at the Institute of Endocrinology the basal urinary iodine in 532 pregnant women at the age of 32 ± 5 (18-44) years, which came from Prague, Hradec Kralove and Mlada Boleslav.

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Association between autoimmune thyroiditis (CLT) and thyroid cancer remains not clear. Although both diseases often occur simultaneously in histological samples, it is not yet clear whether CLT can be regarded as a risk factor for thyroid malignancy. This review focus on the known epidemiological and molecular genetics links between both diseases.

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Functional thyropathies present significant health risks for patients. Advanced functional thyropathies are always treated while indications for therapy of subclinical thyropathies are individual and often controversial. It is widely agreed that these disorders should be diagnosed and individuals should be followed.

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In the process of reducing health budget the question of the effectiveness of investment in population-based screening programs is very actual. Because of the scope, screening is becoming very expensive and burdens healthy people. An essential part of any screening program is careful consideration, registration and monitoring of the results.

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Resistance to thyroid hormones (RTH) is a rare disease with prevalence 1 : 40 000-50 000. About 85% of cases are caused by mutation of thyroid hormone receptor gene β (TRβ) and in 15% of cases the mutation cannot be detected (nonTR-RTH). Elevated thyroid hormone and non-suppressed TSH in the blood, goitre and variable other clinical symptoms are typical for the disease.

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Functional deficiency of mannan-binding lectin (MBL) has been associated with adverse pregnancy outcome. Adverse events during pregnancy have also been described in women with autoimmune thyroid diseases (AITD), and thyroid hormones have been shown to influence serum levels of MBL. Therefore, the aim of this study was to analyse the impact of MBL-deficiency on the outcome of pregnancy in relation to the presence of AITD.

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Background: Hypothyroidism and/or autoimmune thyroid disorders (AITD) may contribute to spontaneous abortions (SpA). Cost-effectiveness analyses of thyroid screening in women after SpA are lacking. Our aim was to evaluate the cost-effectiveness of screening for AITD and/or hypothyroidism and their treatment in women after SpA with regard to their reproductive health.

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