The Role of Ivabradine in Cardiac Rehabilitation in Patients With Recent Coronary Artery Bypass Graft.

Background: Little is known about ivabradine in cardiac rehabilitation in patients with coronary artery bypass graft (CABG).

Methods: In this prospective, randomized study, suitable patients admitted for cardiac rehabilitation after recent CABG were randomized to ivabradine 5 mg twice a day + standard medical therapy including bisoprolol 1.25 mg once daily (group I-BB, n = 38) or standard medical therapy including bisoprolol 2.

Enterovesical fistula and acute pyelonephritis in renal transplantation. Role of ultrasound.

The enterovesical fistula is a communication between the urinary tract and the colon and is a rare complication of various inflammatory and cancer diseases. The most frequent cause is represented by diverticulitis of the sigmoid colon and less frequently from Crohn's disease, tumors of the colon and bladder, trauma, radiation therapy and appendicitis. In this report we describe the occurrence of an enterovesical fistula in a patient with renal allograft from a cadaveric donor, which onsetted with signs of acute pyelonephritis and pneumaturia due to diverticulitis of the sigmoid colon, clinically silent.

What happens in a 5-year follow-up of benign thyroid nodules.

To determine an optimal time for follow-up of benign thyroid nodules, we retrospectively evaluated 249 euthyroid patients with uni-multinodular goiter, who underwent annual visit, and significant events that occurred in 5 years' time were registered. A significant event (appearance of new nodule, increase of nodule diameter >50%, appearance of compressive symptoms, thyroidectomy, repetition of FNA on the same nodule, and execution of FNA on new nodule) occurred in 26.1% of patients, with more than one event occurring in the same patient in 27.

Diagnosis and management of subclinical hypothyroidism in pregnancy.

In prospective studies, the prevalence of undiagnosed subclinical hypothyroidism in pregnant women ranges from 3% to 15%. Subclinical hypothyroidism is associated with multiple adverse outcomes in the mother and fetus, including spontaneous abortion, pre-eclampsia, gestational hypertension, gestational diabetes, preterm delivery, and decreased IQ in the offspring. Only two prospective studies have evaluated the impact of levothyroxine therapy in pregnant women with subclinical hypothyroidism, and the results were mixed.

2014 European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children.

This guideline has been produced as the official statement of the European Thyroid Association guideline committee. Subclinical hypothyroidism (SCH) in pregnancy is defined as a thyroid-stimulating hormone (TSH) level above the pregnancy-related reference range with a normal serum thyroxine concentration. Isolated hypothyroxinaemia (defined as a thyroxine level below the 2.

Levothyroxine liquid solution versus tablet for replacement treatment in hypothyroid patients.

Background: Although replacement treatment with L-thyroxine (LT4) seems easy to manage, about one-third of hypothyroid patients show thyroid-stimulating hormone (TSH) values outside the normal range.

Objectives: To explore whether LT4 liquid formulation (monodose vials or drops) affects TSH stability values and to assess its ability to maintain TSH within the normal range compared to tablets.

Methods: A total of 100 hypothyroid patients on replacement treatment with LT4 liquid solution were enrolled (Liquid Group) at a follow-up visit (revisit).

Maternal subclinical hypothyroidsm and gestational diabetes mellitus: a meta-analysis.

Objective: The association between subclinical hypothyroidism (SCH) and gestational diabetes mellitus (GDM) is controversial. This review evaluates whether the risk of GDM is different in pregnant women with SCH compared to euthyroid pregnant women.

Methods: A computerized search of the MEDLINE and EMBASE databases was conducted from their inceptions to July 2013 and was complemented with the perusal of the reference sections of the retrieved articles.

Clinical aspects of hyperthyroidism, hypothyroidism, and thyroid screening in pregnancy.

Objective: To evaluate the peer-reviewed literature on hypothyroidism, hyperthyroidism, and thyroid autoimmunity in pregnancy.

Methods: We review published studies on thyroid autoimmunity and dysfunction in pregnancy, the impact of thyroid disease on pregnancy, and discuss implications for screening.

Results: Overt hyperthyroidism and hypothyroidism are responsible for adverse obstetric and neonatal events.

Thyrotropin values in patients with micropapillary thyroid cancer versus benign nodular disease.

Objective: Studies published in the last few years suggest that increased thyroid-stimulating hormone (TSH) values are associated with increased risk of thyroid cancer and/or a more advanced stage of malignancy. The aim of this study was to explore the hypothesis that TSH may be a risk factor for thyroid cancer initiation, which was tested by comparing TSH concentrations in patients with incidental micro papillary cancer (mPTC) and controls with a negative histologic exam.

Methods: Patients were retrospectively selected from medical records from 3 district hospitals.

A longitudinal study of thyroidectomized patients in a region of northern Italy: benign versus malignant disease.

Objective: Thyroid disease is very common, particularly nodular goiter. Total thyroidectomy is a therapeutic option for both malignant and benign disease. The aim of the study was to evaluate the number of total thyroidectomy surgeries and the rate of benign and malignant histologic exams over the last decade.

Assessing the risk of false-negative fine-needle aspiration cytology and of incidental cancer in nodular goiter.

Objective: In cases of multinodular goiter with negative cytologic result, reasonable management options include surgical treatment, simple follow-up, or more recently introduced conservative therapies such as laser or radiofrequency ablation, and recombinant human thyroid-stimulating hormone-augmented radioiodine. For patients who are eligible for follow-up or nonsurgical treatments, the possibility that they may have an undiagnosed malignancy (false-negative [FN]-fine-needle aspiration cytology [FNAC] result or incidental thyroid cancer [ITC]) should be considered. The aim of our study was to assess the risk of malignancy in patients known to have presumably benign thyroid disease.

Incidental thyroid cancer in toxic and nontoxic goiter: Is TSH associated with malignanCy rate? Results of a meta-analysis.

Objective: In the last 6 years, several studies reported a positive association between thyrotropin (TSH) and papillary cancer risk. The rationale is based on stimulatory action exerted by TSH on thyroid cell proliferation and/or progression of a pre-existing papillary carcinoma. To validate this hypothesis, we performed a meta-analysis comparing the incidence of thyroid cancer in 2 groups of patients who underwent surgery for toxic or nontoxic nodular goiter.

Management of Hyperthyroidism in Pregnancy: Results of a Survey among Members of the European Thyroid Association.

Background: An optimal management of maternal hyperthyroidism is important for positive pregnancy outcome, and to this end, the Endocrine Society published their guidelines in 2007. This survey aimed to investigate to what extent the clinical practice relating to the management of hyperthyroidism during pregnancy in Europe is uniform and consistent with the guidelines.

Materials And Methods: We e-mailed an online questionnaire survey based on clinical case scenarios to 605 members of the European Thyroid Association.

Acute interstitial nephritis, a rare complication of Giardiasis.

Acute interstitial nephritis is a relevant cause of acute renal failure. Drugs are the predominant cause, followed by infections and idiopathic lesions. Acute interstitial nephritis as a form of hypersensitivity reaction is an uncommon manifestation in the setting of human parasitic infections.

Thyroid disease in pregnancy.

Thyroid diseases are common in women of childbearing age and it is well known that untreated thyroid disturbances result in an increased rate of adverse events, particularly miscarriage, preterm birth and gestational hypertension. Furthermore, thyroid autoimmunity per se seems to be associated with complications such as miscarriage and preterm delivery. While strong evidence clearly demonstrates that overt dysfunctions (hyper- or hypothyroidism) have deleterious effects on pregnancy, subclinical disease, namely subclinical hypothyroidism, has still to be conclusively defined as a risk factor for adverse outcomes.

Tracheal laceration after laser ablation of nodular goitre.

A tracheal perforation was discovered after Nd-YAG laser thermal ablation (LTA) of a thyroid nodule. The LTA is a relatively new method of treatment of thyroid nodules, which consists of delivering laser energy into the thyroid by means of two optical fibres. The patient presented with a multinodular goitre and initially refused surgery, then underwent an LTA of a thyroid nodule.

Thyroid autoimmunity and pre-term delivery: brief review and meta-analysis.

Background: About 10% of women in childbearing age are positive for thyroid antibodies. The presence of such antibodies has been associated with adverse obstetrical outcomes, in particular miscarriage and pre-term delivery, even though the strength of these associations varies widely from one study to another.

Aim: To evaluate from the available data of the literature, the association between thyroid autoimmunity and pre-term delivery.

Thyroid antibody positivity in the first trimester of pregnancy is associated with negative pregnancy outcomes.

Context: Thyroid antibody positivity during pregnancy has been associated with adverse outcomes including spontaneous miscarriage, recurrent miscarriage, and preterm delivery.

Objective: The objective of the study was to determine whether thyroid antibody positivity in the first trimester of pregnancy in euthyroid women was associated with maternal and neonatal adverse outcomes.

Design: The present trial is a component of a prospective trial published in 2010 that evaluated screening for thyroid disease during pregnancy and the impact of levothyroxine therapy in women who were thyroid peroxidase positive with a TSH above 2.

Hypothyroxinemia and pregnancy.

Objective: To evaluate the peer-reviewed literature on iodine deficiency and hypothyroxinemia in pregnancy.

Methods: We review published studies on isolated hypothyroxinemia in pregnancy, methodology of free thyroxine (T4) assays, impact of iodine deficiency on free T4 levels, and status of ongoing prospective randomized trials of isolated hypothyroxinemia during pregnancy.

Results: Hypothyroxinemia during pregnancy is common.

Juxta-anastomotic stenosis of native arteriovenous fistulas: surgical treatment versus percutaneous transluminal angioplasty.

Purpose: Juxta-anastomotic stenosis (JAS) is a complication of arteriovenous fistulas (AVFs). Both surgical revision (SR) and percutaneous transluminal angioplasty (PTA) may correct JAS. In this study we compare the results for SR treatment versus PTA.