New diagnosis of hyperthyroidism in primary care

Bathgate, Gabriella; Karra, Efthimia; Khoo, Bernard

doi:10.1136/bmj.k2880

Cited by 2 publications

(4 citation statements)

References 9 publications

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“…Patients with overt hyperthyroidism should be referred to an appropriate specialist for further management unless the GP has relevant training and experience [21]. Recently Bathgate in 2018 proposed that we should offer referral to an endocrinologist for all patients with newly diagnosed hyperthyroidism for investigation of the underlying cause and recommendation of a management plan [22]. Pending referrals, if the patient is likely to wait a long time it may be appropriate for the GP to initiate treatment with anti-thyroid drugs in consultation with the endocrinologist concerned, also β-blocker may be prescribed to control the patient symptoms if not contraindicated as (propranolol 40 mg three times daily) [21].…”

Section: Discussionmentioning

confidence: 99%

“…Before you start; Perform baseline full blood count and liver function tests, and explain the risk of agranulocytosis and hepatotoxicity (with carbimazole and propylthiouracil) associated with anti-thyroid drugs, provide written information about the need to stop treatment and attend for urgent blood tests if fever, sore throat, mouth ulcers, or jaundice develop. Before initiation, seek guidance from a local endocrinologist on dosing and monitoring if needed [22].…”

Section: Discussionmentioning

confidence: 99%

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Knowledge and Attitude of Doctors in Primary Care Settings Towards Thyroid Disorders: An Interventional Study

Hussien¹,

Eldin²

2021

SJPH

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Thyroid disorders are important and growing health problems worldwide. However, considering real life, assessment of knowledge and attitudes of physicians towards thyroid diseases in primary care is lacking. The study aimed to determine the difference in knowledge and attitudes of Family physicians (FPs), General Practitioners (GPs) and internists in primary care settings of Ministry of Health and Population (MOHP) towards Hypo and hyperthyroidism before and after medical education. This study is a pre-post interventional study done in primary health care facilities on 70 physicians from the three medical disciplines. Doctors were interviewed at their work place with a questionnaire consisting of personal data of the doctor and twenty questions about knowledge and attitudes towards thyroid disorders then they were handled the ideal answers according to the guidelines and the interview was repeated after two months. This study revealed that the mean age of physicians was 34±7.8, the mean duration of work was 6.8±5 years. The pre-interventional knowledge of internists was superior to family physicians and general practitioners. There was a highly significant change of physician knowledge (from 4.1±1.4 to 8±1.6) after intervention and there was a weakly significant change in attitude (from 3.1±0.9 to 3.2±0.9 and from 3.1±1.5 to 3.3±1.6 respectively) among general practitioners and family physicians after intervention. It was concluded that doctors from the three medical disciplines had a significant change in their responses to knowledge questions after intervention. So, it's a must to train doctors in primary care how-to pick-up cases of thyroid disorders and how to manage them according to the guidelines and when they need to refer these cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Knowledge and Attitude of Doctors in Primary Care Settings Towards Thyroid Disorders: An Interventional Study

Hussien¹,

Eldin²

2021

SJPH

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“…The liver is an important tissue for thyroid hormones metabolism, thus hyperthyroid liver injury is more common clinically. In recent years, liver dysfunction is often observed in patients with hyperthyroidism and the occurrence reported varies from 37% to77.9%. − Previous studies have shown that increased thyroid hormones increase the production of reactive oxygen species (ROS) in the liver, and oxidative stress is closely linked to hyperthyroid liver injury. − The GSH is synthesized in the cytoplasm, especially in the liver, − which can directly react with ROS to promote ROS metabolism. − Excessive thyroid hormones in the serum of hyperthyroidism can significantly reduce GSH level, , and the decrease in GSH level is a potential early activation signal for apoptosis, and subsequently, ROS promotes apoptosis. − Considering the diagnosis of hyperthyroid liver injury in the clinic requires the thyroid dysfunction to be clarified first, and then liver function tests can be performed, and the liver function damage and hepatomegaly caused by other reasons must be ruled out. , The diagnosis process is complicated and tedious. Therefore, the development of rapid and simple methods that can simultaneously monitor thyroid function and assess the degree of hyperthyroid liver injury is of great significance.…”

mentioning

confidence: 99%

“…33−36 Considering the diagnosis of hyperthyroid liver injury in the clinic requires the thyroid dysfunction to be clarified first, and then liver function tests can be performed, and the liver function damage and hepatomegaly caused by other reasons must be ruled out. 37,38 The diagnosis process is complicated and tedious. Therefore, the development of rapid and simple methods that can simultaneously monitor thyroid function and assess the degree of hyperthyroid liver injury is of great significance.…”

mentioning

confidence: 99%

Evaluating Hyperthyroidism-Induced Liver Injury Based on In Situ Fluorescence Imaging of Glutathione and Phosphate via Nano-MOFs Sensor

Zhang

Wang

et al. 2020

Anal. Chem.

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Hyperthyroidism-induced liver injury is quite common in clinical settings. Therefore, developing rapid and simple methods for the assessment of hyperthyroid liver injury is of great significance. Considering phosphorus metabolism is disordered because of hyperthyroidism, and the hyperthyroid liver injury is closely related to the abnormal level of glutathione (GSH). Thus, development of a new method that can simultaneously detect changes in blood phosphorus and GSH levels of serum, liver, kidney, and other organs to assess the degree of hyperthyroid liver injury is necessary for clinical medical research. Herein, a novel fluorescent metal–organic frameworks (MOFs) nanoprobe using the UiO-66(OH)2 as core and Cu-MOFs as shell was designed and synthesized. Through the specific action between Zr (IV) and phosphate, and the combine interaction of MOFs active center Cu (II) and GSH, high sensitivity and specific fluorescence detection of phosphate and GSH were achieved, respectively. Finally, the nanosensor was applied for evaluating different degrees of hyperthyroid liver injury in mice models and realized the monitoring of serum, liver, kidney, and other organs’ blood phosphorus and GSH levels, and found that the levels of phosphate and GSH in serum were negatively correlated with the degree of hyperthyroid liver injury, while the changes of phosphate and GSH levels in the liver and kidney organs were positively correlated with the degree of hyperthyroid liver injury. In general, the present works provide a new way to effectively evaluate liver injury induced by hyperthyroidism in the early clinical stage.

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New diagnosis of hyperthyroidism in primary care

Cited by 2 publications

References 9 publications

Knowledge and Attitude of Doctors in Primary Care Settings Towards Thyroid Disorders: An Interventional Study

Knowledge and Attitude of Doctors in Primary Care Settings Towards Thyroid Disorders: An Interventional Study

Evaluating Hyperthyroidism-Induced Liver Injury Based on In Situ Fluorescence Imaging of Glutathione and Phosphate via Nano-MOFs Sensor

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