Abstract:
:Subclinical thyroid disease is defined by an abnormally high (subclinical hypothyroidism) or low (subclinical hyperthyroidism) serum thyrotropin (TSH) with peripheral thyroid hormone concentrations within the laboratory reference ranges. Such abnormalities in thyroid function tests are very common in the population and have been extensively dealt with in textbooks and reviews. Subclinical hypothyroidism is common especially in elderly women. There is no clear evidence to date that subclinical hypothyroidism causes clinical hearth disease. However, mild thyroid gland failure, evidenced solely by elevation of the serum TSH concentration, may be associated with increased morbidity, particularly for cardiovascular disease and subtly decreased myocardial contractility. In subclinical hypothyroidism both cardiac structures and function remain normal at rest, but impaired ventricular function as well as cardiovascular and respiratory adaptation to effort may became unmasked during exercise. These changes are reversible when euthyroidism is restored. Subclinical hypothyroidism does result in small increase in low density lipoprotein cholesterol and a decrease in high density lipoprotein, changes that enhance the risk for development of atherossclerosis and coronary artery disease. Because undetected subclinical hypothyroidism during pregnancy may adversely affect the neuropsychological development and survival of the fetus and be associated with hypertension and toxemia, screening pregnant women has been advocated. In addition, data suggesting that subclinical hypothyroidism is associated with ovulatory dysfunction and infertility may make screening worthwhile in this population as well. The combination of an undetectable serum thyrotropin concentration, as measured by an assay with a threshold of detection that is 0.1 mU per liter or less, and normal serum triiodothyronine and thyroxine concentrations (usually at the upper end of the normal range) is known as subclinical hyperthyroidism. This condition reflects the facts that before clinical features of thyrotoxicosis are apparent, the thyrotrophs usually respond to minor increments in thyroid hormone concentrations, which remain within the normal range, by switching off the production and secretion of thyrotropin. In the absence of clinical signs of thyroid disease, and even after additional investigations such as isotope uptake and imaging and measurement of the thyrotropin receptor antibody concentration, it may be difficult to decide whether the pattern seen on thyroid function tests is a consequence of nonthyroidal illness and concomitant medication, underlyling thyroid autonomous function or the initial phase of thyroiditis. Routine screening for thyroid disease with thyroid function tests is not recommended for asymptomatic children or adults. This recommendation does not mean that clinicians should not monitor thyroid function in patients with a previous history of thyroid disease. There is insufficient evidence to recommend for or against screening for thyroid disease with thyroid function tests in high-risk patients, including elderly persons, postpartum women, and persons with Down syndrome, but recommendations may be made on other grounds, such as the higher prevalence of disease and the increased likelihood that symptoms of thyroid disease will be overlooked in these patients. If screening is performed, the preferred test is measurement of thyroid-stimulating hormone (TSH) using a sensitive immunometric or similar assay, because of its superior sensitivity and specificity.
journal_name
Srp Arh Celok Lekjournal_title
Srpski arhiv za celokupno lekarstvoauthors
Trbojević Bkeywords:
subject
Has Abstractpub_date
2003-11-01 00:00:00pages
467-73issue
11-12eissn
0370-8179issn
2406-0895journal_volume
131pub_type
杂志文章,评审abstract::Between 1980 and 1985 we treated 21 patients with primary spinal cord tumors. There were two diffuse and ten localized ependymoma, six low grade astrocytoma and three malignant glioma. Surgery consisted of total resection in six patients, subtotal resection in three and biopsy in twelve patients. Radiation doses range...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1992-05-01 00:00:00
abstract:INTRODUCTION:Enlarged axillary lymph nodes are often found during routine examinations. They are usually circular, oval, lobular, smaller than 1 cm, with typically changed fat centers. The condition of axillary lymph nodes in breast cancer is of great importance for timely diagnosis, because its metastatic spread is a ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1997-03-01 00:00:00
abstract:INTRODUCTION:Compliance with hypertension guidelines in clinical practice is generally poor, but there was no data about compliance with any guidelines in general practice in Slovenia. OBJECTIVE:Our aim was to find out whether general practitioners in Slovenia managed their hypertensive patients according to the natio...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0704191p
更新日期:2007-03-01 00:00:00
abstract::The management of idiopathic nephrotic syndrome (INS) in children includes immunosuppressive and symptomatic treatment. The response to corticosteroid therapy is the best prognostic marker of the disease. The majority of children with INS (about 85%) are steroid-sensitive as they normalize proteinuria within 4 weeks o...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:10.2298/sarh0410352p
更新日期:2004-09-01 00:00:00
abstract:INTRODUCTION:Nurse/patient relationship as a complex interrelation or as an interaction of the factor patient and factor nurse has been a subject of a number of studies during the past ten years. Nurse/patient communication is a special entity, usually observed within a framework of the wider nurse/patient relationship...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1002079v
更新日期:2010-01-01 00:00:00
abstract::Cardiovascular disorders are the most frequent cause of death (46-60%) among patients with advanced chronic renal failure (CRF), and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD) and anemia are the most important contributing factors. Associa...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:10.2298/sarh1412747p
更新日期:2014-11-01 00:00:00
abstract::A sudden onset of the syndrome Guillain-Barré in 48-year-old woman presenting as an acute motor neuropathy was associated with antibodies against ganglioside GM1 detected by ELISA. The neurological examination revealed flaccid quadriplegia without affection of the sensory system, and the additional investigation showe...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1996-07-01 00:00:00
abstract:INTRODUCTION:Trichomoniasis is frequent, parasitic and sexually transmitted infection of genitourinary tract. It is treated by metronidazole (5-nitroimidazole), according to protocol recommended by Center for Disease Control (CDC, formerly called: Communicable Disease Center) [19]. The resistance of Trichomonas vaginal...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0304156v
更新日期:2003-03-01 00:00:00
abstract::Our results of surgery of developmental disorder of the hip (DDH) in older children and adolescents by using the combination of Selter's innominate osteotomy and osteotomy of the superior pubis ramus were presented in this paper, enclosing the period from 1993 to 1995. The study included 11 hips, i.e. 9 patients, aged...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh04s1023b
更新日期:2004-10-01 00:00:00
abstract::The recent data about the treatment of advanced breast cancer patients with synthetic LH-RH analogues are presented. Although synthetized 20 years ago, the agonistic analogues of LH-RH were introduced in clinical oncology recently. The inhibition of pituitary and gonadal function that occurs after chronic administrati...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:INTRODUCTION:At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE) has been a standard of care for patients with resectable esophageal cancer since 2009. As a next and final step in the change management, from Ja...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1508410b
更新日期:2015-07-01 00:00:00
abstract:INTRODUCTION:Adenocarcinoma of the small bowel is a rare gastrointestinal neoplasm usually affecting the distal duodenum and proximal jejunum. Because of their rarity and poorly defined abdominal symptoms, a correct diagnosis is often delayed. CASE OUTLINE:We present a 43-year-old woman admitted at the Clinic for Endo...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1304232i
更新日期:2013-03-01 00:00:00
abstract:INTRODUCTION:Perthes disease is idiopathic avascular osteonecrosis of the hip in children, with unknown etiology. Inflammation is present during development of Perthes disease and it is known that this process influences bone remodeling. OBJECTIVE:Since genetic studies related to inflammation have not been performed i...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:Numerous authors have indicated the beneficial effect of glycoregulation on micro- and macro-angiopathic complications. OBJECTIVE:The aim of the study was to examine whether intensive treatment with maintaining blood glucose concentrations close to normal range could improve electrophysiological parameter...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,随机对照试验
doi:10.2298/sarh1206285m
更新日期:2012-05-01 00:00:00
abstract::The authors studied the effect of working conditions and harmful organic solvents on the frequency of gynaecological diseases and menstrual disorders in 138 women. The experimental group consisted of 88 women exposed to evaporation and increased concentrations of organic solvents, and the control group was composed of...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:INTRODUCTION:Penetrating injury is characterized by the existence of entry wound only, and it can be with or without an intraocular foreign body (IOFB). IOFB can lead to a mechanical injury of the eye and to cause infection or to manifest other toxic effects on intraocular structures. Iron and copper can dissolve and c...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1306371k
更新日期:2013-05-01 00:00:00
abstract::Galea flap (GF) consists of two parts: Galea aponeurotica and superficial layer of temporal muscle. This flap is useful in plastic and reconstructive surgery of the defects of oral mucosa, lips, but also in reconstruction of orbital floor defects. Many authors have stressed that most of troubles in GF as reconstructio...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::The ileal pouch-anal operation is the best procedure because it liberates the patient from ulcerative colitis i.e. from diseased mucosa of the large intestine. The ileal pouch forms a new reservoir for the storage of feces. Symptomatic pouch inflammation (pouchitis) appeared in 7-40% of the patients. The authors descr...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::In order to standardize language of medicine, it is essential to have a good command of ancient Greek and Latin. We cannot deny a huge impact of ancient Greek medicine on medical terminology. Compounds of Greek origin related to terms for organs, illnesses, inflammations, surgical procedures etc. have been listed as e...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0710606m
更新日期:2007-09-01 00:00:00
abstract:INTRODUCTION:Psychiatric treatment in developed countries has significantly changed in the last few decades, with a significant shortening of the duration of hospitalization. Numerous West European countries are undertaking health system reforms to improve treatment efficiency. OBJECTIVE:The aim of the study was to pr...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2011-12-01 00:00:00
abstract::The authors report on the method, course and results of treatment of patients with meningococcal septicaemia. The two most common forms of meningococcal disease are meningococcal septicaemia (MS) and meningitis. Severe MS is a fulminant form of sepsis characterized by a rapidly spreading purpuric rash, haemodynamic in...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2001-05-01 00:00:00
abstract::Parkinson's disease (PD), that has usually been associated with movement disorders, is also associated with depression in about 40% of patients [9]. Transcranial magnetic stimulation (TMS) is a new non-invasive technique for direct stimulation of the cerebral cortical neurons [1]. Several open studies have shown that ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract::During the space flight the cosmonaut is exposed to many stressogenic factors. The science is especially interested in microgravitation as an environmental element affecting the life of the crew in a cosmic vehicle, which is in contrast with human physiology in terrestrial conditions. The space medicine is interested ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:
更新日期:1995-07-01 00:00:00
abstract::Clinical presentation of excessive aldosterone secretion is often not specific. The presence of resistant severe hypertension (HT) and signs of hypokalemia is useful but inconsistent characteristic. Plasma aldosterone level in primary aldosteronism (PA) could be normal, although inappropriately high for a low plasma r...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:10.2298/sarh1212800c
更新日期:2012-11-01 00:00:00
abstract:INTRODUCTION:The seroprevalence study was performed in Vojvodina during May and June 2010 in order to asses the effects of the 2009 pandemic influenza A(H1N1)v epidemic on herd immunity. It was a part of the Serbian Ministry of Health funded nationwide study. OBJECTIVE:Prevalence of antibodies against 2009 pandemic in...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2012-11-01 00:00:00
abstract:INTRODUCTION:The cardiovascular changes (vascular structure changes, hypertrophy of the left ventricle) contribute to both the increased cardiovascular morbidity and the mortality of essential hypertension. Therefore, modern treatment strategies should not only target blood pressure (BP) reduction but also normalize ca...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,随机对照试验
doi:10.2298/sarh0604106t
更新日期:2006-03-01 00:00:00
abstract::The aim of this work is to evaluate cytologic examination of secretions of nose and maxillary sinuses in patients with naso-sinusal disorders. The material for cytologic examination is taken from 128 nasal cavities of 101 patients with inflammation or tumour diseases of nose and maxillary sinuses, and from 114 maxilla...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2002-05-01 00:00:00
abstract::Acalculia is an acquired disturbance of calculation that has several clinical expressions. Disturbances cna be aphasic and nonaphasic. Further division is into alexia and agraphia for numbers, anarithmetria and spatial acalculia. In addition to these manifestations due to focal cerebral lesions also diffuse lesions ca...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1997-11-01 00:00:00
abstract:INTRODUCTION:In most countries, cardiovascular diseases are the leading disorders, with ischemic heart diseases being the leading cause of death. According to WHO data, every year about 17 million people die of cardiovascular diseases, which is 30% of all deaths. Ischemic heart diseases contribute from one-third to one...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0812598r
更新日期:2008-11-01 00:00:00
abstract::During the last five years at our Department renal biopsy was carried out in 41 patients with systemic lupus erythematosus. On the basis of the pathologic findings glomerular changes were classified as follows: minimal in 5 patients; mesangial proliferative glomerulonephritis in 11; focal and segmental proliferative g...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00