Thyroid Hormone Suppression Therapy

Thyroid hormone suppression therapy is designed to lower serum thyrotropin (TSH) levels using doses of thyroid hormone in excess of what would normally be required to maintain a euthyroid state. The basis of this therapy is the knowledge that TSH is a growth factor for thyroid cancer, so that lower serum TSH levels might be associated with decreased disease activity. However, clinical studies have not documented improved outcomes with TSH suppression, except in patients with the most advanced disease. Furthermore, there are a number of negative outcomes related to aggressive thyroid hormone therapy, including osteoporosis, fracture, and cardiovascular disease. Therefore, a graded approach to TSH suppression is recommended by the American Thyroid Association, based on initial risk and ongoing risk assessmen

The Management of Thyroid Abnormalities in Chronic Heart Failure.

KEY POINTS Normal triiodothyronine (T3) levels are essential to preserve cardiac morphology and function. Overt and subclinical hypothyroidism are associated with an increased risk of heart failure, and levothyroxine is able to improve cardiovascular function in hypothyroid patients. Low T3 syndrome can develop in patients with advanced heart failure and is associated with a negative prognosis. Low T3 syndrome is associated with alterations in thyroid hormone receptors expression, contributing to the development of a cardiac fetal phenotype, leading to cardiac dysfunction. The positive effects of treatment with thyroid hormones in patients with low T3 and heart failure support their potential therapeutic approach in heart failur

Thyroid hormone therapy for hypothyroidism.

The purpose of this article will be to review the basics of thyroid hormone therapy, including various thyroid hormone formulations, the institution and monitoring of thyroid hormone therapy, adverse effects of overtreatment, the management of patients with persistent symptoms despite normal thyroid function tests, and potential new innovations in thyroid hormone therapy. The conclusions support the necessity to personalize thyroid hormone replacement therapy in hypothyroid patients

Analisis Struktur, Perilaku dan Kinerja Industri Minuman di Indonesia Periode 2006 – 2009

This study purpose is to analyze the structure, behavior and performance of the Beverage Industry in Indonesia, concentration ratio and Nerfindahl index are used to see market structure of Beverage Industri condust their activity. Descriptive analysis is used to analyze the market behavior of firms in the beverage industry.The data used in this research is secondary data, and period of research is from2006 until 2009. These studies show that market structure of Softdrink Industry in Indonesia is tight oligopoly the average concentration ratio of the four largest firms (CR4) is 97.83 percent and thebehavior of firms in determining prices is influenced by the rival pricing. Themarket beverage industry in Indonesia tends to become less competitive orconcentrated, so need oversight by the government to supervise the business activities which indicated a dominant position is and too difficult for new entrants beverage industry market in Indonesia

Subclinical Hypothyroidism

IMPORTANCE Subclinical hypothyroidism, defined as an elevated serum thyrotropin (often referred to as thyroid-stimulating hormone, or TSH) level with normal levels of free thyroxine (FT4) affects up to 10% of the adult population. OBSERVATIONS Subclinical hypothyroidism is most often caused by autoimmune (Hashimoto) thyroiditis.However, serum thyrotropin levels rise as people without thyroid disease age; serum thyrotropin concentrations may surpass the upper limit of the traditional reference range of 4 to 5mU/L among elderly patients. This phenomenon has likely led to an overestimation of the true prevalence of subclinical hypothyroidism in persons older than 70 years. In patients who have circulating thyroid peroxidase antibodies, there is a greater risk of progression from subclinical to overt hypothyroidism. Subclinical hypothyroidism may be associated with an increased risk of heart failure, coronary artery disease events, and mortality from coronary heart disease. In addition, middle-aged patients with subclinical hypothyroidism may have cognitive impairment, nonspecific symptoms such as fatigue, and altered mood. In the absence of large randomized trials showing benefit from levothyroxine therapy, the rationale for treatment is based on the potential for decreasing the risk of adverse cardiovascular events and the possibility of preventing progression to overt hypothyroidism.However, levothyroxine therapymay be associated with iatrogenic thyrotoxicosis, especially in elderly patients, and there is no evidence that it is beneficial in persons aged 65 years or older. CONCLUSIONS AND RELEVANCE Subclinical hypothyroidism iscommonand most individuals can be observed without treatment. Treatment might be indicated for patients with subclinical hypothyroidism and serum thyrotropin levels of 10mU/L or higher or for young and middle-aged individuals with subclinical hypothyroidism and symptoms consistent with mild hypothyroidis

Causal inference on the impact of nutrition policies using observational data

We discuss the state-of-the-art in the application of quasi-experimental methods to estimate the impact of nutrition policies based on observational data. This field of application is less mature compared to other settings, especially labour and health policy, as food economists have started to implement widely counterfactual methods only over the last decade. We review the underlying assumptions behind the most prominent methods, when they can be regarded as credible and if/when they can be tested. We especially focus on the problem of dealing with unobserved confounding factors, emphasizing recent evidence on the limitations of propensity score methods, and the hard task of convincing reviewers about the quality of instrumental variables. We discuss the application of Difference-in-Difference, with an emphasis on its potential in consumer panel data applications, and how results from Regression Discontinuity Design studies should be interpreted. Finally, we cover the estimation of counterfactual outcomes using structural methods and provide an overview of recent developments and current gaps

RNA-seq analysis of salt-stressed versus non salt-stressed transcriptomes of chenopodium quinoa landrace R49

Quinoa (Chenopodium quinoa Willd.), a model halophytic crop species, was used to shed light on salt tolerance mechanisms at the transcriptomic level. An RNA-sequencing analysis of genotype R49 at an early vegetative stage was performed by Illumina paired-ends method comparing high salinity and control conditions in a time-course pot experiment. Genome-wide transcriptional salt-induced changes and expression profiling of relevant salt-responsive genes in plants treated or not with 300 mM NaCl were analyzed after 1 h and 5 days. We obtained up to 49 million pairs of short reads with an average length of 101 bp, identifying a total of 2416 differentially expressed genes (DEGs) based on the treatment and time of sampling. In salt-treated vs. control plants, the total number of up-regulated and down-regulated genes was 945 and 1471, respectively. The number of DEGs was higher at 5 days than at 1 h after salt treatment, as reflected in the number of transcription factors, which increased with time. We report a strong transcriptional reprogramming of genes involved in biological processes like oxidation-reduction, response to stress and response to abscisic acid (ABA), and cell wall organization. Transcript analyses by real-time RT-qPCR supported the RNA-seq results and shed light on the contribution of roots and shoots to the overall transcriptional response. In addition, it revealed a time-dependent response in the expression of the analyzed DEGs, including a quick (within 1 h) response for some genes, suggesting a \u201cstress-anticipatory preparedness\u201d in this highly salt-tolerant genotype

Medidas comparativas de eficiências aeroportuárias.

São encontradas na literatura algumas formas de medida de eficiência aeroportuária. É aqui apresentada uma nova abordagem baseada em Análise de Envoltório de Dados, que utiliza programação linear para calcular uma medida de eficiência comparada. São utilizados os dados encontrados na literatura e o estudo é dividido em dois conjuntos de avaliação: aeroportos brasileiros e aeroportos brasileiros em conjunto com aeroportos estrangeiros. Em ambos os casos, calculam-se as eficiências operacional, comercial (que considera as receitas não aeroportuárias) e global

Radial Growth of Qilian Juniper on the Northeast Tibetan Plateau and Potential Climate Associations

There is controversy regarding the limiting climatic factor for tree radial growth at the alpine treeline on the northeastern Tibetan Plateau. In this study, we collected 594 increment cores from 331 trees, grouped within four altitude belts spanning the range 3550 to 4020 m.a.s.l. on a single hillside. We have developed four equivalent ring-width chronologies and shown that there are no significant differences in their growth-climate responses during 1956 to 2011 or in their longer-term growth patterns during the period AD 1110–2011. The main climate influence on radial growth is shown to be precipitation variability. Missing ring analysis shows that tree radial growth at the uppermost treeline location is more sensitive to climate variation than that at other elevations, and poor tree radial growth is particularly linked to the occurrence of serious drought events. Hence water limitation, rather than temperature stress, plays the pivotal role in controlling the radial growth of Sabina przewalskii Kom. at the treeline in this region. This finding contradicts any generalisation that tree-ring chronologies from high-elevation treeline environments are mostly indicators of temperature changes