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Related Concept Videos

Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
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Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

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Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
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Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
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Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

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Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
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Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

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Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Intra-Operative Neural Monitoring of Thyroid Surgery in a Porcine Model
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Amiodarone-induced thyroid dysfunction in Taiwan: a retrospective cohort study.

Chun-Jui Huang1, Po-Ju Chen, Jing-Wen Chang

  • 1Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei City, Taiwan.

International Journal of Clinical Pharmacy
|February 12, 2014
PubMed
Summary

Amiodarone-induced hypothyroidism (AIH) is more common than thyrotoxicosis (AIT) in Taiwan. Higher baseline thyroid-stimulating hormone (TSH) levels are the main risk factor for developing AIH.

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Area of Science:

  • Endocrinology
  • Cardiology
  • Pharmacology

Background:

  • Amiodarone is an effective antiarrhythmic drug.
  • Amiodarone can cause thyroid dysfunction, including thyrotoxicosis and hypothyroidism.
  • The incidence and risk factors for amiodarone-induced thyroid dysfunction vary.

Purpose of the Study:

  • To investigate the clinical and biochemical features of amiodarone-induced thyroid dysfunction.
  • To identify risk factors for amiodarone-induced thyrotoxicosis (AIT) and amiodarone-induced hypothyroidism (AIH) in Taiwan.

Main Methods:

  • Retrospective analysis of 527 patients treated with amiodarone from 2008-2009.
  • Assessment of incidence and risk factors for AIT and AIH.
  • Cox regression analysis for risk stratification in elderly populations.

Main Results:

  • AIH occurred in 13.1% of patients, while AIT occurred in 4.0%.
  • Risk factors for AIH included older age, higher baseline TSH, lower baseline free T4, lower cumulative amiodarone dose, and shorter treatment duration.
  • Increased risk of AIH was observed in older age groups (75-84 and ≥85 years).
  • Higher baseline TSH and lower cumulative amiodarone dosage were significant independent risk factors for AIH.

Conclusions:

  • AIH is significantly more prevalent than AIT in Taiwan, an iodine-sufficient area.
  • Elevated baseline TSH levels are a primary independent risk factor for developing AIH.
  • Findings highlight the importance of baseline TSH monitoring for predicting AIH risk.