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Related Concept Videos

Functions of Thyroid Hormones01:18

Functions of Thyroid Hormones

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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
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Synthesis and Regulation of Thyroid Hormones01:20

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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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The Thyroid Gland01:23

The Thyroid Gland

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
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Teratogenicity01:07

Teratogenicity

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The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
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Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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Related Experiment Video

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A Rat Model of Mild Intrauterine Hypoperfusion with Microcoil Stenosis
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Thyroid dysfunction in very low birth weight preterm infants.

Ji Hoon Lee1, Sung Woo Kim1, Ga Won Jeon1

  • 1Department of Pediatrics, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Korean Journal of Pediatrics
|July 28, 2015
PubMed
Summary

Thyroid dysfunction is common in preterm infants. Retesting thyroid function is recommended for high-risk infants, even with normal newborn screening, to prevent neurodevelopmental issues.

Keywords:
Congenital hypothyroidismNeonatal screeningPremature infantThyroid function testsVery low birth weight infant

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Area of Science:

  • Neonatalogy
  • Endocrinology
  • Pediatrics

Background:

  • Thyroid dysfunction is prevalent in preterm infants, potentially causing irreversible neurodevelopmental impairment.
  • Early detection and treatment of congenital hypothyroidism are crucial for preventing developmental deficits.

Purpose of the Study:

  • To characterize thyroid dysfunction in very low birth weight infants (VLBWIs).
  • To identify risk factors associated with hypothyroidism in VLBWIs.
  • To advocate for reassessment of thyroid function in high-risk preterm infants with initially normal newborn screening tests.

Main Methods:

  • A cohort of very low birth weight infants (VLBWIs) born between January 2010 and December 2012 was studied.
  • Infants were categorized based on the need for thyroid hormone replacement therapy.
  • Associated factors influencing thyroid dysfunction were evaluated.

Main Results:

  • Of 246 VLBWIs, 12.2% required thyroid hormone replacement.
  • Only one infant requiring treatment had an abnormal initial newborn screening thyroid-stimulating hormone (TSH) test.
  • Delayed TSH elevation was observed in most infants needing treatment (22/30), with smaller birth weight and higher incidence of small for gestational age in the treatment group.

Conclusions:

  • Normal newborn screening TSH levels do not exclude hypothyroidism in preterm infants.
  • Physicians should consider retesting thyroid function, including TSH and free thyroxine, in high-risk preterm infants.
  • This proactive approach can aid in the timely diagnosis and management of hypothyroidism, preventing adverse neurodevelopmental outcomes.