The Impact of Thyroid Diseases on the Working Life of Patients: A Systematic Review

Leso, Veruscka; Vetrani, Ilaria; Cicco, Luigi De; Cardelia, Alessandro; Fontana, Luca; Buonocore, Giuseppe; Iavicoli, Ivo

doi:10.3390/ijerph17124295

Cited by 31 publications

(18 citation statements)

References 47 publications

(165 reference statements)

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“…As a result, the goal of this research is to look at how thyroid diseases can affect patients’ occupational outcomes, such as their employment rate, sick leave, working ability, and income. Recently, a systematic review of Pubmed, Scopus, and Web of Knowledge databases was conducted on this topic [ 52 ].…”

Section: Risk Factors Involved In the Pathogenesis Of Thyroid Cancermentioning

confidence: 99%

“…In nearly a third of affected individuals, hyperthyroidism impairs working abilities—particularly in cases complicated by orbitopathy with diplopia. Thyroid illnesses may have an impact on many occupational outcomes, according to a recent study [ 52 ], but further research is needed to understand the association between specific pathological characteristics throughout time and workplace risk factors. This could entail complete, interdisciplinary thyroid care management, with advantages for patients’ work, social, and personal lives.…”

Section: Risk Factors Involved In the Pathogenesis Of Thyroid Cancermentioning

confidence: 99%

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Thyroid Cancer Diagnostics Related to Occupational and Environmental Risk Factors: An Integrated Risk Assessment Approach

Berinde

Socaciu

et al. 2022

Diagnostics

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There are still many questions remaining about the etiopathogenesis of thyroid cancer, the most common type of endocrine neoplasia. Numerous occupational and environmental exposures have been shown to represent important risk factors that increase its incidence. Updated information about thyroid cancer diagnostics related to occupational and environmental risk factors is reviewed here, considering an integrated risk assessment approach; new data concerning thyroid cancer etiology and pathogenesis mechanisms, diagnostic biomarkers and methodologies, and risk factors involved in its pathogenesis are presented. A special emphasis is dedicated to specific occupational risk factors and to the association between environmental risk agents and thyroid cancer development. The occupational environment is taken into consideration, i.e., the current workplace and previous jobs, as well as data regarding risk factors, e.g., age, gender, family history, lifestyle, use of chemicals, or radiation exposure outside the workplace. Finally, an integrative approach is presented, underlying the need for an accurate Risk Assessment Matrix based on a systematic questionnaire. We propose a complex experimental design that contains different inclusion and exclusion criteria for patient groups, detailed working protocols for achieving coherent and sustainable, well-defined research stages from sample collection to the identification of biomarkers, with correlations between specific oncometabolites integrated into the Risk Assessment Matrix.

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Section: Risk Factors Involved In the Pathogenesis Of Thyroid Cancermentioning

confidence: 99%

Section: Risk Factors Involved In the Pathogenesis Of Thyroid Cancermentioning

confidence: 99%

Thyroid Cancer Diagnostics Related to Occupational and Environmental Risk Factors: An Integrated Risk Assessment Approach

Berinde

Socaciu

et al. 2022

Diagnostics

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“…Long-term hypothyroidism and iatrogenic thyrotoxicosis have implications for cardiovascular disease, osteoporosis, quality of life, neurological disease, dementia, cancer treatment, and even mortality ( 7–16 ). Shorter periods with suboptimal dosage are more likely to affect quality of life, work capacity and have social consequences ( 17 , 18 ).…”

Section: Introductionmentioning

confidence: 99%

Patient-Tailored Levothyroxine Dosage with Pharmacokinetic/Pharmacodynamic Modeling: A Novel Approach After Total Thyroidectomy

Brun

Eriksen

Selseth

et al. 2021

Thyroid

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Background: After seven decades of levothyroxine (LT4) replacement therapy, dosage adjustment still takes several months. We have developed a decision aid tool (DAT) that models LT4 pharmacometrics and enables patient-tailored dosage. The aim of this was to speed up dosage adjustments for patients after total thyroidectomy. Methods: The DAT computer program was developed with a group of 46 patients post-thyroidectomy, and it was then applied in a prospective randomized multicenter validation trial in 145 unselected patients admitted for total thyroidectomy for goiter, differentiated thyroid cancer, or thyrotoxicosis. The LT4 dosage was adjusted after only two weeks, with or without application of the DAT, which calculated individual free thyroxine (fT4) targets based on four repeated measurements of fT4 and thyrotropin (TSH) levels. The individual TSH target was either <0.1, 0.1–0.5, or 0.5–2.0 mIU/L, depending on the diagnosis. Initial postoperative LT4 dosage was determined according to clinical routine without using algorithms. A simplified DAT with a population-based fT4 target was used for thyrotoxic patients who often went into surgery after prolonged TSH suppression. Subsequent LT4 adjustments were carried out every six weeks until target TSH was achieved. Results: When clinicians were guided by the DAT, 40% of patients with goiter and 59% of patients with cancer satisfied the narrow TSH targets eight weeks after surgery, as compared with only 0% and 19% of the controls, respectively. The TSH was within the normal range in 80% of DAT/goiter patients eight weeks after surgery as compared with 19% of controls. The DAT shortened the average dosage adjustment period by 58 days in the goiter group and 40 days in the cancer group. For thyrotoxic patients, application of the simplified DAT did not improve the dosage adjustment. Conclusions: Application of the DAT in combination with early postoperative TSH and fT4 monitoring offers a fast approach to LT4 dosage after total thyroidectomy for patients with goiter or differentiated thyroid cancer. Estimation of individual TSH-fT4 dynamics was crucial for the model to work, as removal of this feature in the applied model for thyrotoxic patients also removed the benefit of the DAT.

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“…High circulating levels of free thyroid hormones, free thyroxine (fT4), and free triiodothyronine (fT3) have multisystemic effects causing severe patient debilitation and may impair working ability in up to a third of affected patients. [8] The exact pathophysiology of GD seen in IRIS is still not completely known. Immune reconstitution inflammatory syndrome‐associated GD (IRIS‐GD) occurs in the context of immunoregulatory imbalance characterized by thymic enlargement, persistence of T‐cell receptor excision circle (TREC) levels in CD4 and CD8 cells, and high circulating levels of naïve CD8 cells.…”

Section: Introductionmentioning

confidence: 99%

Immune reconstitution inflammatory syndrome‐associated Graves disease in HIV‐infected patients: clinical characteristics and response to radioactive iodine therapy

Lawal

Orunmuyi²,

Popoola

et al. 2021

HIV Medicine

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Objectives We aimed to describe the clinical characteristics and the response to radioactive iodine (RAI) treatment of immune reconstitution inflammatory syndrome‐associated Graves disease (IRIS‐GD) in comparison to Graves disease (GD) seen in HIV‐uninfected patients. Methods We retrospectively reviewed the medical records of patients treated with RAI for GD. We obtained clinical, biochemical and HIV‐related information of patients from their medical records. We compared patient characteristics and response to RAI treatment between patients with IRIS‐GD and GD seen in HIV‐uninfected patients. Results A total of 253 GD patients, including 51 patients with IRIS‐GD, were included. Among IRIS‐GD patients, CD4 cell nadir was 66 cells/µL (range: 37–103) with a peak HIV viral load of 60 900 copies/mL (range: 36 542–64 500). At the time of diagnosis of IRIS‐GD, all patients had a completely suppressed HIV viraemia with a CD4 cell count of 729 cells/µL (range: 350–1279). The median interval between the commencement of HIV treatment and the onset of GD was 63 months. At 3 months follow‐up, the proportion of patients with IRIS‐GD achieving a successful RAI treatment outcome (euthyroid/hypothyroid state) was lower than that of HIV‐uninfected patients (35.3% vs. 63.4%, respectively; p < 0.001). The response rate remained lower (60.8%) among patients with IRIS GD than among HIV‐uninfected GD patients (80.2%, p = 0.004) at 6 months follow‐up. After correcting for differences in age, gender and pre‐treatment thyroid‐stimulating hormone level, there was no significant difference in RAI treatment response between the two groups. Conclusions After correcting for possible confounders, the response to RAI treatment was not different between patients with IRIS‐GD and GD in HIV‐uninfected patients.

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The Impact of Thyroid Diseases on the Working Life of Patients: A Systematic Review

Cited by 31 publications

References 47 publications

Thyroid Cancer Diagnostics Related to Occupational and Environmental Risk Factors: An Integrated Risk Assessment Approach

Thyroid Cancer Diagnostics Related to Occupational and Environmental Risk Factors: An Integrated Risk Assessment Approach

Patient-Tailored Levothyroxine Dosage with Pharmacokinetic/Pharmacodynamic Modeling: A Novel Approach After Total Thyroidectomy

Immune reconstitution inflammatory syndrome‐associated Graves disease in HIV‐infected patients: clinical characteristics and response to radioactive iodine therapy

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