Graves’ hyperthyroidism in pregnancy: a clinical review

Abstract Background Graves’ hyperthyroidism affects 0.2% of pregnant women. Establishing the correct diagnosis and effectively managing Graves’ hyperthyroidism in pregnancy remains a challenge for physicians. Main The goal of this paper is to review the diagnosis and management of Graves’ hyperthyroidism in pregnancy. The paper will discuss preconception counseling, etiologies of hyperthyroidism, thyroid function testing, pregnancy-related complications, maternal management, including thyroid storm, anti-thyroid drugs and the complications for mother and fetus, fetal and neonatal thyroid function, neonatal management, and maternal post-partum management. Conclusion Establishing the diagnosis of Graves’ hyperthyroidism early, maintaining euthyroidism, and achieving a serum total T4 in the upper limit of normal throughout pregnancy is key to reducing the risk of maternal, fetal, and newborn complications. The key to a successful pregnancy begins with preconception counseling

Challenging Magic Squares for Magicians

We present several effective ways for a magician to create a 4-by-4 magic square where the total and some of the entries are prescribed by the audience

Bilateral Simultaneous Assessment of Cerebral Flow Velocity during Mental Activity

The purpose of this study was to assess the potential of transcranial Doppler (TCD) ultrasonography for detecting selective changes in cerebral blood flow velocity during mental activity. Mean flow velocity was continuously and simultaneously measured in the right and left middle cerebral arteries in 26 healthy right-handed young subjects at rest and during performance of verbal and visual-imaging mental tasks. These two mental tasks produced significantly different effects on the right and left sides: the verbal task produced a higher increase of flow velocity (mean absolute difference above baseline +/- SD) with respect to the basal values in the left than in the right middle cerebral artery (5.56 +/- 3.8 cm/s vs 1.25 +/- 3.1 cm/s); the visual-imaging task was accompanied by a higher increase in the right than in the left middle cerebral artery (3.92 +/- 3.3 cm/s vs 1.52 +/- 3.1 cm/s)--analysis of variance (ANOVA) three-fold interaction side of recording x task x condition, F = 25.67, p < .0001). Heart rate, blood pressure, and skin conductance showed comparable increases during performance of both mental tasks. Respiratory activity showed no modification during the mental activity with respect to the rest phase. These results demonstrate the possibility of delivering specific functional information via bilateral TCD and suggest wider utilization of this noninvasive technique in neuropsychological studies