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28 Hacks That Can Make Going to College With a Chronic Illness Easier

The Mighty

Heading off to college can be a stressful and chaotic time on its own – but throw a chronic illness (or a few) into the mix and it becomes even trickier to manage all the demands of your day-to-day life. High stress levels or a lack of sleep can easily exacerbate your condition and lead to flare-ups, so it’s important to balance your schedule, plan ahead and make sure you have any accommodations you need to be successful. To help y...

A Mild Risk of Neonatal Hyperthyroidism Follows Radioactive Iodine Therapy for Graves’ Disease Prior to Pregnancy

Clinical Thyroidology

Graves’ disease is an autoimmune condition and the most common cause of hyperthyroidism in women of childbearing age. It is caused by the patient making an antibody called TRAB (TSH Receptor Antibody) that attacks and turns on the thyroid, making it overactive. TRAB is detectable in the blood of most patients with Graves’ disease. TRAB can pass through to the baby and cause hyperthyroidism after delivery in mothers with Graves’ disease....

A Pain in the Neck: News Reporting on Graves’ Disease

Academia

Many different illnesses exist, and it is easy for journalists to latch onto the most dramatic and widespread illnesses. Graves’ disease is an incurable condition affecting the thyroid, and related news stories have been found as far back as the late nineteenth century. The aim of this paper is to track newspaper coverage to discern how coverage changed or stayed the same over a period of more than 100 years. Early newspaper coverage...

A Validated Tool can Predict Risk of Developing Thyroid Eye Disease During Antithyroid Drug Treatment of Graves’ Disease

Clinical Thyroidology

Over-activity of the thyroid gland, called hyperthyroidism, can sometimes be caused by a flaw in a person’s immune system (the body’s natural defense system against infection). This problem is a type of autoimmune disorder called Graves’ disease. In addition to thyroid gland over-activity, Graves’ disease causes eye problems in some people, including eye bulging, loss of color vision, double vision, eye pain and dry eyes. Not e...

Accommodating Employees with Graves’ Disease

Job Accommodation Network

People with Grave’s disease may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with Grave’s disease will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist....

Accommodation Solutions Online

University of Nebraska-Lincoln

Accommodation Solutions Online (ASO), a web-based tool providing faculty and students the opportunity to work in collaboration to find tailored solutions to specific accommodation issues. Often, accommodation plans are general and based on categories of disability rather than a student’s specific needs. ASO provides a personalized menu of accommodations based on the student’s cognitive and physical characteristics in conjunction with the essen...

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131I-Induced Graves’ Disease in Patients Treated for Toxic Multinodular Goitre: Systematic Review and Descriptive Analysis

Journal of Endocrinological Investigation

Background: Graves’ disease (GD) arising after the treatment of toxic multinodular goitre (TMNG) with radioiodine has long been described but it remained unclear whether GD was in fact iodine induced, its incidence, risk factors, natural history and treatment outcomes. Methods: A systematic search using The Cochrane Library, Medline and PubMed Central allowed the pooling of data from 3633 patients with thyroid autonom...

A 6-Year Follow-Up of a Randomized Prospective Trial Comparing Methimazole Treatment With or Without Exogenous L-Thyroxine in Chinese Patients With Graves’ Disease

Experimental and Clinical Endocrinology & Diabetes

Objective: Antithyroid drug therapy is one of the main medical treatments for Graves’ disease. There have been conflicting reports as to whether the addition of exogenous L-thyroxine improves remission rates more than antithyroid drugs alone. This randomized, controlled and prospective clinical trial was undertaken to investigate the long-term outcome of methimazole treatment with or without exogenous L-thyroxine in Chi...

A New Era in the Treatment of Thyroid Eye Disease

American Journal of Ophthalmology

Purpose: Improved understanding of thyroid eye disease (TED) pathogenesis has facilitated identification of a targeted molecular approach for TED treatment offering the potential to halt or slow disease progression in a nonsurgical manner. Herein, we provide a summary of the current knowledge of TED management, followed by discussion of a novel insulin-like growth factor-1 receptor (IGF-1R) antagonist antibody and its p...

A Prospective Study of the Effects of Radioiodine Therapy for Hyperthyroidism in Patients With Minimally Active Graves’ Ophthalmopathy

The Journal of Clinical Endocrinology and Metabolism

Context: Radioiodine is an effective and safe treatment for hyperthyroidism but has been implicated as a risk factor for deterioration or new presentation of Graves’ ophthalmopathy (GO). Prophylactic glucocorticoids appear to prevent this effect. Objective: The objective of this study was to document the course of GO after radioiodine therapy. Design: This...

A Prospective, Randomized Trial of Intravenous Glucocorticoids Therapy With Different Protocols for Patients With Graves’ Ophthalmopathy

The Journal of Clinical Endocrinology and Metabolism

Background: For patients with active moderate-to-severe Graves’ ophthalmopathy (GO), a course of 4.5 g iv glucocorticoids (GCs) is the recommended therapy. The weekly protocol is preferred because of the potential safety concerns with the daily protocol. However, evidence for the superiority of different administration protocols is lacking. Methods: We conducted a prospective, randomized...

A Second Course of Antithyroid Drug Therapy for Recurrent Graves’ Disease: An Experience in Endocrine Practice

European Journal of Endocrinology / European Federation of Endocrine Societies

Objective: There are scarce reports regarding the prognosis of a second course of antithyroid drug (ATD) therapy on recurrent Graves’ disease (GD). The aim of this study was to assess the long-term remission rate after a second ATD therapy and verify significant clinical predictors of a remission. Design: A prospective randomized clinical trial with long-term follow-up was conducted to ev...

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2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis

Thyroid : Official Journal of the American Thyroid Association

Background:  Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This document describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspecialty physicians and others providing care for patients wi...

2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum

Thyroid: Official Journal of the American Thyroid Association

Background: 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...

2018 European Thyroid Association Guideline for the Management of Graves’ Hyperthyroidism

European Thyroid Journal

Graves’ disease (GD) is a systemic autoimmune disorder characterized by the infiltration of thyroid antigen-specific T cells into thyroid-stimulating hormone receptor (TSH-R)-expressing tissues. Stimulatory autoantibodies (Ab) in GD activate the TSH-R leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Diagnosis of GD is straightforward in a patient with biochemically confirmed thyrotoxicosis, positive TSH-...

Consensus Statement of the European Group on Graves’ Orbitopathy (EUGOGO) on Management of Graves’ Orbitopathy

Thyroid : Official Journal of the American Thyroid Association

Graves’ orbitopathy (GO) constitutes a major clinical and therapeutic challenge. GO is an autoimmune disorder representing the commonest and most important extrathyroidal manifestation of Graves’ disease, but it may occur in patients without current or prior hyperthyroidism (euthyroid or ophthalmic Graves’ disease) or in patients who are hypothyroid due to chronic autoimmune (Hashimoto’s) thyroiditis. Although the pathogenesis of GO (5...

Effects of Treatment Modalities for Graves’ Hyperthyroidism on Graves’ Orbitopathy: A 2015 Italian Society of Endocrinology Consensus Statement

Journal of Endocrinological Investigation

Graves’ disease is the most frequent form of hyperthyroidism in iodine sufficient countries, and Graves’ orbitopathy (GO) is its most important and common extrathyroidal manifestation, affecting about 25 % of patients. Although GO is generally mild and rarely progressive, thyroid dysfunction, both hyperthyroidism, and hypothyroidism, can influence its course. GO has been reported to improve after correction of hyperthyroidism with antithyr...

Management of Patients With Graves’ Orbitopathy: Initial Assessment, Management Outside Specialised Centres and Referral Pathways

Clinical Medicine: Journal of the Royal College of Physicians of London

Graves’ orbitopathy (GO) is uncommon, but responsible for considerable morbidity. A coordinated approach between healthcare professionals is required in order to meet the needs of patients. Early diagnosis can be achieved by a simple clinical assessment. Low-cost effective interventions can be initiated by generalists, which may improve outcomes. Moderate-to-severe GO should be referred to specialised centres. Recommendations for clinical diag...

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792: Role of TSIG in Maternal Graves’ Disease for Prediction of Neonatal Thyroid Dysfunction

American Journal of Obstetrics & Gynecology

Objective: To determine the impact of maternal and fetal thyroid-stimulating immunoglobulin (TSIG) as predictors of neonatal thyroid dysfunction in pregnancies complicated by Graves’ disease. Study Design: This prospective cohort study was conducted at The University of Iowa Hospital and Clinics. We analyzed all women with a history of Graves’ disease with confirmed elevated TSIG at the...

Avoiding Grave Cardiac Outcomes in an Athlete with Grave’s Disease

American College of Sports Medicine

History: A 20-yr male college football player presented to the athletic training room with 15 pounds of unexplained weight loss over a two-week period. He reported decreased appetite, increased general fatigue and muscle fatigue over the past two weeks. His review of systems was otherwise negative. He had no chronic medical problems or current medications. His family history was significant for asthma, hypertension, and...

Cardiovascular Risk Factors and Graves’ Disease

Endocrine Society

Introduction: The cardiovascular system function is modulated by thyroid hormone levels. The antibodies involved in Graves’ disease are central to the pathophysiological consequences of the disease but the impact of their evolution over time is still an area of interest. Aim: To evaluate the relationship between thyroid function, autoimmunity, insulin resistance and cardiovascular risk...

Changing Trend in Diagnostic Methods for Graves’ Disease: Is an Immunological Diagnosis Preferred?

Endocrine Society

The diagnosis of Graves’ disease (GD) is traditionally based on the clinical features of persisting hyperthyroidism, enlarged thyroid gland, and often the presence of ophthalmopathy. However, when the clinical presentation of thyrotoxicosis is not diagnostic of GD, the 2011 American Thyroid Association guideline recommends “a radioactive iodine uptake scan should be performed”. Although it is long recognized that Thyrotropin (TSH) recept...

Clinical Characteristics of Patients Requiring a Second Dose of Radioactive Iodine for the Treatment of Graves’ Disease

Thyroid

Graves’ disease is an autoimmune condition affecting the thyroid gland and is a common cause of hyperthyroidism. The main treatment goals are the reduction in thyroid hormone overproduction either with antithyroid drugs (ATD), surgery or radioactive iodine (RAI) therapy. The aim of RAI (I-131) therapy is to treat hyperthyroidism by destroying sufficient thyroid tissue to render the patient either euthyroid or hypothyroid. The objecti...

Decision Aid for Patients with Graves Disease

Endocrine Society

There are three effective treatments for Graves Disease (GD): thyroidectomy, radioactive iodine, and antithyroid drugs. These options differ in their efficacy, safety, convenience, and costs; none is clearly superior to the others for all patients. Practice patterns, however, suggest that patients are more likely to receive a particular mode of therapy depending on where they receive care. This inconsistency of practice suggests that GD patien...

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Early Diagnosis of Thyroid Eye Disease (TED)

Horizon Pharma

Early Symptoms TED can first present with signs or symptoms such as sensitivity to light, a feeling of grittiness in the eyes, excessive tearing, eye pain, or dry eyes. However, these symptoms are often confused with other conditions, such as allergies or dry eye symptoms. Evidence shows that even these first, seemingly mild symptoms can negatively affect patient quality of life. Overlooking them can lead to unnecessary...

Graves’ Disease

Springer

This indispensable volume is designed to facilitate the best possible physician–patient discussion on Graves’ disease by providing the most up-to-date evidence-based information in a clinically useful and patient-centric manner. Comprehensive and covering such topics as Professionalism and the Art of Patient-centric Thyroidology, the Immunopathogenesis of Graves’ Disease, and the Diagnosis and Management of Thyroid Storm, the book addres...

Graves’ Disease

Family Practice Notebook

Epidemiology: Most common cause of Thyrotoxicosis in the United States (up to 60-80% of cases). Pathophysiology: • Autoimmune disorder. • Thyroid stimulating antibodies bind TSH receptors, resulting in Thyroid hormone synthesis and release. Risk Factors: • Female gender. • Autoimmune Disorder (or Family History of autoimmune disorder)....

Graves’ Orbitopathy

Family Practice Notebook

Epidemiology: Eye complications occur in 25-50% of Grave’s disease. Pathophysiology: Grave’s disease induced eye changes:    • Sensitized orbital tissue-specific T-Lymphocytes    • Local inflammatory cellular infiltration of eye Orbital fibroblasts mediate changes:    • Adipose hypertrophy    • Glycosaminoglycan accumulates R...

Recent Developments in Graves’ Ophthalmopathy

Springer

Recent Developments in Graves’ ophthalmopathy offers an overview of the pathogenesis, assessment and management of patients with thyroid-associated eye disease. Each chapter is written by an expert and truly represents the current state of the art on the particular topic. This book can therefore almost be considered a textbook on this enigmatic disorder. Recent developments in Graves’ ophthalmopathy is designed for all those interested...

Thyroid Disorders and Diseases, an Issue of Medical Clinics, 1st Edition

Elsevier

This issue of Medical Clinics of North America provides the latest essential updates on thyroid disorders and diseases. Topics covered include the following: thyroid synthesis and physiology; hyperthyroidism; hypothyroidism; thyroid nodules; goiter; differentiated thyroid cancer; subacute, silent, and postpartum thyroiditis; thyroid and pregnancy; thyroid and the elderly; medications and thyroid hormones; thyroid and the heart; thyroid and lip...

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