- Changes in the gut microbiota composition during pregnancy in patients with gestational diabetes mellitus (GDM). [Journal Article]
- SRSci Rep 2018 Aug 15; 8(1):12216
- Gestational diabetes mellitus (GDM), a common pregnancy complication, is associated with an increased risk of maternal/perinatal outcomes. We performed a prospective observational explorative study i...
Gestational diabetes mellitus (GDM), a common pregnancy complication, is associated with an increased risk of maternal/perinatal outcomes. We performed a prospective observational explorative study in 41 GDM patients to evaluate their microbiota changes during pregnancy and the associations between the gut microbiota and variations in nutrient intakes, anthropometric and laboratory variables. GDM patients routinely received nutritional recommendations according to guidelines. The fecal microbiota (by 16S amplicon-based sequencing), was assessed at enrolment (24-28 weeks) and at 38 weeks of gestational age. At the study end, the microbiota α-diversity significantly increased (P < 0.001), with increase of Firmicutes and reduction of Bacteroidetes and Actinobacteria. Patients who were adherent to the dietary recommendations showed a better metabolic and inflammatory pattern at the study-end and a significant decrease in Bacteroides. In multiple regression models, Faecalibacterium was significantly associated with fasting glucose; Collinsella (directly) and Blautia (inversely) with insulin, and with Homeostasis-Model Assessment Insulin-Resistance, while Sutterella with C-reactive protein levels. Consistent with this latter association, the predicted metagenomes showed a correlation between those taxa and inferred KEGG genes associated with lipopolysaccharide biosynthesis. A higher bacterial richness and strong correlations between pro-inflammatory taxa and metabolic/inflammatory variables were detected in GDM patients across pregnancy. Collectively these findings suggest that the development of strategies to modulate the gut microbiota might be a potentially useful tool to impact on maternal metabolic health.
- Fetal Goitrous Hypothyroidism and Polyhydramnios in a Patient with Compound Heterozygous DUOXA2 Mutations. [Journal Article]
- HRHorm Res Paediatr 2018 Aug 15; :1-6
- CONCLUSIONS: The present case not only illustrates the phenotypic diversity of DUOXA2 mutation carriers but also implies that DUOXA2 is important in prenatal thyroid hormone production.
- Goiter Prevalence and Interrelated Components from Coastal Karnataka. [Journal Article]
- IJIndian J Pediatr 2018 Aug 13
- CONCLUSIONS: Goiter prevalence at 9.3% in the coastal district contributes to the endemicity of the public health problem. The district had adequate iodine nutrition based on median urinary iodine levels. Hence, other contributing factors for the persistence of endemic goiter need to be explored.
- Thyroseq V3 Molecular Profiling for Tailoring the Surgical Management of Hürthle Cell Neoplasms. [Journal Article]
- CRCase Rep Endocrinol 2018; 2018:9329035
- Hürthle cell predominant thyroid nodules often confound the diagnostic utility of fine needle aspiration biopsy (FNAB) with cytology often interpreted as a Hürthle cell lesion with an indeterminate r...
Hürthle cell predominant thyroid nodules often confound the diagnostic utility of fine needle aspiration biopsy (FNAB) with cytology often interpreted as a Hürthle cell lesion with an indeterminate risk of malignancy, Bethesda category (BC) III or IV. Molecular diagnostics for Hürthle cell predominant nodules has also been disappointing in further defining the risk of malignancy. We present a case of a slowly enlarging nodule within a goiter initially reported as benign on FNAB, BC II but on subsequent FNAB suspicious for a Hürthle cell neoplasm, BC IV. The patient had initially requested a diagnostic lobectomy for a definitive diagnosis despite a higher risk of malignancy based on the size of the nodule > 4 cm alone. To better tailor this patient's treatment plan, a newer expanded gene mutation panel, ThyroSeq® v3 that includes copy number alterations (CNAs) and was recently found to have greater positive predictive value (PPV) for identifying Hürthle cell carcinoma (HCC), was performed on the FNAB material. Molecular profiling with ThyroSeq® v3 was able to predict a greater risk of carcinoma, making a more convincing argument in favor of total thyroidectomy. Surgical pathology confirmed a Hürthle cell carcinoma with 5 foci of angioinvasion and foci of capsular invasion.
- Graves' Disease Presenting as Painful Goiter: A Case Report and Review of the Literature. [Journal Article]
- CCureus 2018 Jun 08; 10(6):e2765
- A painful and tender thyroid gland is a rare phenomenon in Graves' disease. We present a case of 31-years-old Guyanese female who was admitted to the hospital with complaints of neck pain for the pas...
A painful and tender thyroid gland is a rare phenomenon in Graves' disease. We present a case of 31-years-old Guyanese female who was admitted to the hospital with complaints of neck pain for the past few days. She also reported increase appetite for a few weeks; she did not have palpitations, heat intolerance, or muscle weakness. The presence of hyperthyroidism with elevated TSI suggested that the patient had Graves' disease. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were within normal limit, thus the diagnosis of thyroiditis was effectively ruled out. This is a rare case of a painful and tender thyroid gland in Graves' disease without the evidence of sub-acute thyroiditis.
- International Surgery Electives During General Surgery Residency: A 9-Year Experience at an Independent Academic Center. [Journal Article]
- JSJ Surg Educ 2018 Aug 09
- CONCLUSIONS: Incorporation of IEs into our general surgery residency has demonstrated numerous benefits. IE participation provides valuable operative experience in both volume and variety, and can be especially impactful for those who may not have elected to pursue such opportunities independently. These experiences have the potential to empower general surgery residents to invest in similar practices and acts of generosity in their future careers.
- STIMULATORY TSH-RECEPTOR ANTIBODIES AND OXIDATIVE STRESS IN GRAVES' DISEASE. [Journal Article]
- JCJ Clin Endocrinol Metab 2018 Aug 06
- CONCLUSIONS: Monoclonal M22 and polyclonal serum TSAb augment ROS generation and/or induce lipid peroxidation.
- The Impact of Uniform Capsular Dissection Technique of Total Thyroidectomy on Postoperative Complications: An Experience of More Than 1000 Total Thyroidectomies from an Endocrine Surgery Training Centre in North India. [Journal Article]
- IJIndian J Endocrinol Metab 2018 May-Jun; 22(3):362-367
- CONCLUSIONS: TT with uniform technique of CD is a safe procedure. Certain risk factors may predispose to complications, which can be avoided and managed adequately if anticipated beforehand.
- Genetics and management of congenital hypothyroidism. [Review]
- BPBest Pract Res Clin Endocrinol Metab 2018; 32(4):387-396
- Several evidences support a relevant genetic origin for Congenital Hypothyroidism (CH), however familial forms are uncommon. CH can be due to morphogenetic or functional defects and several genes hav...
Several evidences support a relevant genetic origin for Congenital Hypothyroidism (CH), however familial forms are uncommon. CH can be due to morphogenetic or functional defects and several genes have been originally associated either with thyroid dysgenesis or dyshormonogenesis, with a highly variable expressivity and a frequently incomplete penetrance of the genetic defects. The phenotype-driven genetic analyses rarely yielded positive results in more than 10% of cases, thus raising doubts on the genetic origin of CH. However, more recent unsupervised approaches with systematic Next Generation Sequencing (NGS) analysis revealed the existence of hypomorphic alleles of these candidate genes whose combination can explain a significant portion of CH cases. The co-segregation studies of the hypothyroid phenotype with multiple gene variants in pedigrees confirmed the potential oligogenic origin of CH, which finally represents a suitable explanation for the frequent sporadic occurrence of this disease.
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- An assessment of the relationship between thyroid nodule characteristics, insulin resistance and arterial stiffness in euthyroid nodular goiter. [Journal Article]
- EEndocrine 2018 Aug 06
- CONCLUSIONS: We found that PWV was significantly higher in patients with euthyroid nodular goiter. This result suggests that these patients may be at risk for cardiovascular disease.