According to the results of the present study, the prevalence of postpartum thyroiditis was higher in women with a history of gestational diabetes than in healthy women. We recommend that all women with gestational diabetes and women who have previous thyroid dysfunction should be screened for thyroid hormonal abnormalities during pregnancy and for 1 year after pregnancy.
Thyroglossal duct cysts (TGDCs) are the most common form of congenital cysts on the neck. The incidence of papillary thyroid carcinoma in TGDC is less than 1%. In most cases, the diagnosis is made postoperatively. We present a case of 22-year-old female with papillary thyroid carcinoma arising from a TGDC, identified in pathologic study after Sistrunk operation. There was no clinical evidence of malignancy in the cyst. There was neither invasion to adjacent tissue nor lymph node involvement. The patient then underwent total thyroidectomy and bilateral neck dissection. The patient was treated with radioactive iodine and thyroid suppression therapy was given as adjuvant treatment. She has been followed-up for 2 years without any metastasis. Because of the rarity of TGDC, this diagnosis may be missed, drastically affecting the appropriateness of the treatment provided. Surgeons should be aware of TGDC in surgical planning and postoperative treatment and should include this pathology in differential diagnosis of anterior midline neck masses.
Congestive heart failure (CHF) is a major cause of mortality and morbidity. Among patients with heart failure, sleep disordered breathing (SDB) is a common problem. Current evidence suggests that SDB, particularly central SDB, is more prevalent in patients with CHF than in the general population, but it is underdiagnosed as SDB symptoms that are less prevalent in CHF. The main aims of this study were to determine the relationship between nocturnal hypoxemia and left ventricular ejection fraction in patients with chronic heart failure. By means of echocardiography, 108 patients with left ventricular ejection fraction ≤45% were divided into mild, moderate, and severe CHF. Hypoxemia was recorded overnight in the hospital and was measured by portable pulse oximetry. In the 108 patients with CHF, 44 (40.7%) were severe, 17 (15.7%) moderate, and 47 (43.6%) mild CHF. 95 (88%) of patients with CHF had abnormal patterns of nocturnal hypoxemia suggestive of Cheyne-Stokes respiration. Ejection fraction correlated negatively with dip frequency. There was no correlation between nocturnal hypoxemia with BMI and snoring. This study confirms strong associations between sleep apnea and heart disease in patients with CHF. Overnight oximetry is a useful screening test for CheyneStokes respiration in patients with known heart failure.
Barakat syndrome (also known as HDR syndrome) is an autosomal dominant disorder characterized by hypoparathyroidism, sensorineural deafness, and renal disease caused by mutation of the GATA3 gene located at chromosome 10p15. The exact prevalence of this disorder is not known but is very rare, with only about a dozen cases reported in the literature. Here, we report a case of 58-year-old man from Ardabil who presented with seizure due to hypocalcemia. Further history revealed bilateral deafness. Audiogram confirmed sensorineural hearing loss of both sides. His laboratory data were consistent with hypoparathyroidism and renal failure. He was diagnosed to have Barakat syndrome based on his clinical and laboratory data. In conclusion, we need to be aware of rare inherited conditions in a patient with abnormal physical and laboratory findings even though their initial presentation was seizure and hypocalcemia.
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