Destaques dos novos consensos sobre doenças da tireoide da Sociedade Brasileira de Endocrinologia e Metabologia

Abstract

A consensus is a group process in which the entry of each member is carefully considered. It is a long process that synthetizes the wisdom of all participants in the best possible decision. The basis of the consensus is consent, which means giving permission. When one suggestion is agreed upon based on the evidence presented, the group is allowed to proceed with the recommendation. It is possible that not everybody agrees with the suggestion, but as the consensus was reached, the decision to move on should be followed because the best decision for the present moment was made. These new consensuses of the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM) were results of a long cooperation between our members, leading to an excellent job.The Brazilian consensus for The diagnosis and TreaTmenT of hyperThyroidism: recommendaTions By The Thyroid deparTmenT of The Brazilian socieTy of endocrinology and meTaBolism Hyperthyroidism is a disease with different etiologies and a variable clinical picture depending on the age of the patient, concentration of thyroid hormones and time from the onset of the symptoms and beginning of the treatment. It is associated with increased mortality both in the acute (thyrotoxic storm) and subclinical forms.The authors determined 53 recommendations on diagnosis, treatment, and monitoring of different forms of hyperthyroidism.Some recommendations should be emphasized: Decrease in the use of propylthiouracil (PTU): there is increased evidence on the hepatotoxic potential of PTU, mainly in kids. Nowadays, it is almost exclusively used in the first quarter of pregnancy.Increased use methimazole: with the reduced use of PTU due to its potential side effects, and the increase in the use of antithyroid drugs shown in recent studies, methimazole has become increasingly important. Another important fact was the publishing of studies demonstrating its small possibility of teratogenicity and safe use during pregnancy, particularly after the first quarter.Radioiodine and Graves ophthalmopathy: recognition that radioiodine may worsen Graves ophthalmopathy, especially in patients with risk factors (smoking, pre--existent ophthalmopathy, and high titers of TRAb).Use of glucocorticoids to prevent Graves ophthalmopathy: indication of the use of glucorticoids in patients with Graves ophthalmopathy with risk factors, who will be submitted to radioiodine.

Disfunção Da Glândula Tireoide E O Tratamento Ortodôntico: Revisão Integrativa Da Literatura

“…Pode ser de origem primária (quando há falência da glândula tireoide) ou secundária (doenças que atuam na redução indireta deste hormônio, com alterações na hipófise ou hipotálamo); congênito (malformação da glândula tireoide ou alterações de biossíntese hormonal) ou adquirido (autoimunedoença de Hashimoto, quando o sistema imunológico produz anticorpos que atacam a glândula tireoide), ou ainda de acordo com a gravidade da doença; clínico (nível baixo de T4) ou subclínico (elevação do hormônio tireoestimulante e níveis normais de T3 e T4). Apresentam sinais e sintomas característicos como ganho de peso, pele fria e grossa, hipotensão, fraqueza muscular com reflexos lentos, disminorréia, frequência cardíaca lenta (ROMALDINI; VILLAGELIN, 2013).…”