Hashimoto's thyroiditis is the commonest form of autoimmune thyroiditis in the world. It occurs most frequently in women (female/male ratio, 6:1) in the age group between 30 and 60 years. Here we report the case of a 38-year-old Caucasian man who presented with a few days' history of upper limb paresthesias, widespread joint and muscle pain, and headaches. Laboratory findings showed increased CPK, myoglobin and plasma creatinine levels with acute renal failure. Low free T3 and T4 values associated with a high TSH value, the presence of antithyroid globulin and peroxidase autoantibodies pointed to a diagnosis of hypothyroidism with Hashimoto's thyroiditis. Treatment with levothyroxine was initiated and within 2 months normalization of renal function, myoglobin, CPK and thyroid hormone levels was observed.
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Importance: Cardiovascular health outcomes associated with noncigarette tobacco products (cigar, pipe, and smokeless tobacco) remain unclear, yet such data are required for evidence-based regulation.
Objective: To investigate the association of noncigarette tobacco products with cardiovascular health outcomes.
Design, Setting, And Participants: This cohort study was conducted within the Cross Cohort Collaboration Tobacco Working Group by harmonizing tobacco-related data and conducting a pooled analysis from 15 US-based prospective cohorts with data on the use of at least 1 noncigarette tobacco product ranging between 1948 and 2015.
Cancer
January 2025
Division of Oncology, Children's National Hospital and George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Background: In the fifth National Wilms Tumor Study, patients received vincristine and dactinomycin (VA) without radiation for stage I focal anaplastic Wilms tumor (FAWT) and VA plus doxorubicin (DD4A) and radiation for stage II-IV FAWT. Four-year event-free survival (EFS) and overall survival (OS) for stage I FAWT were 67.5% and 88.
View Article and Find Full Text PDFSleep
January 2025
Santa Barbara Actuaries Inc., Santa Barbara, CA, USA.
Study Objectives: To determine the association between adherence to positive airway pressure and healthcare costs among a national sample of older adults with comorbid OSA and common chronic conditions.
Methods: Our data source was a random sample of Medicare administrative claims for years 2016-2019. Inclusion criteria included age >65 years and new diagnosis of OSA.
Kidney Med
January 2025
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Expansion of home hemodialysis (HHD) provides an opportunity to improve clinical outcomes, reduce cost of care, and address the staffing challenges currently faced in caring for patients with kidney failure on replacement therapy. To increase HHD expansion, current practices and barriers to home dialysis must be examined and addressed. One such barrier is vascular access for HHD; although tunneled hemodialysis central venous catheters (CVCs) have been used for decades, physicians still hesitate to send patients home without a mature, functional arteriovenous access.
View Article and Find Full Text PDFTypical renal involvement of antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is pauci-immune glomerulonephritis that presents clinically as rapidly progressive renal failure (RPRF). Here, we report an unusual presentation of myeloperoxidase (MPO)-specific ANCA with isolated involvement of the tubulointerstitium in the form of peritubular capillaritis as the sole lesion without any involvement of the glomerulus. A 52-year-old woman with no previous comorbidities presented with nonspecific symptoms such as fatigue, dysuria, and nausea for two months.
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