Characteristics of specialists treating hypothyroid patients:the “THESIS” collaborative

Introduction: Thyroid specialists influence how hypothyroid patients are treated, including patients managed in primary care. Given that physician characteristics influence patient care, this study aimed to explore thyroid specialist profiles and associations with geo-economic factors. Methods: Thyroid specialists from 28 countries were invited to respond to a questionnaire, Treatment of Hypothyroidism in Europe by Specialists: an International Survey (THESIS). Geographic regions were defined according to the United Nations Statistics Division. The national economic status was estimated using World Bank data on the gross national income per capita (GNI per capita). Results: 5,695 valid responses were received (response rate 33·0%). The mean age was 49 years, and 65·0% were female. The proportion of female respondents was lowest in Northern (45·6%) and highest in Eastern Europe (77·2%) (p &lt;0·001). Respondent work volume, university affiliation and private practice differed significantly between countries (p&lt;0·001). Age and GNI per capita were correlated inversely with the proportion of female respondents (p&lt;0·01). GNI per capita was inversely related to the proportion of respondents working exclusively in private practice (p&lt;0·011) and the proportion of respondents who treated &gt;100 patients annually (p&lt;0·01). Discussion: THESIS has demonstrated differences in characteristics of thyroid specialists at national and regional levels, strongly associated with GNI per capita. Hypothyroid patients in middle-income countries are more likely to encounter female thyroid specialists working in private practice, with a high workload, compared to high-income countries. Whether these differences influence the quality of care and patient satisfaction is unknown, but merits further study.</p

Innovations during COVID-19 pandemic: trends, technologies, prospects

The paper presents the mechanisms for adapting innovation processes in corporations in the context of COVID-19 and demonstrates technologies and solutions that can be applied to meet current challenges. Innovation can become the link in the company that will help to survive the crisis and open up opportunities for identification, analysis and testing new products and processes. The use of new technologies and openness to innovations can be a decisive factor for staying ahead of the competition in the future. The paper performs examples of successful startups/companies that were able to competently and timely rebuild their business, and provides examples of government initiatives that share their approaches and valuable tips on how to continue innovating even in the current unprecedented times. The research was based on the coronavirus’ impact analysis on various industries using leading industry data sources, analytical reports, international indexes and indicators

Лечение первичного гипотиреоза: нерешенные вопросы

Primary hypothyroidism is one of the most common endocrine disorders. According to modern concepts, replacement monotherapy with levothyroxine (L-T4) is the treatment of choice in primary hypothyroidism. In most cases, compensation of hypothyroidism leads to relief of symptoms and, as a consequence, improvement the quality of life. However, according to different authors, 5—10% of patients with hypothyroidism receiving adequate replacement therapy with L-T4 have persistent symptoms of hypothyroidism, increased levels of anxiety and depression. The review discusses approaches to managing of such patients, and as one of the options — transfer to combination therapy with levothyroxine and triiodothyronine (L-T4+T3)

Quality of compensation and well-being of patients with primary hypothyroidism and obesity

Aim. The aim of the study was to compare quality of hypothyroidism compensation and well-being of patients with hypothyroidism with normal weight, overweight and obesity. Methods. 306 patients with hypothyroidism on replacement therapy with L-T4 were included; of those 218 patients with compensated hypothyroidism. All patients were divided into groups depending on their body mass index: with normal body weight, overweight, obesity I and obesity II - III degree. We calculated the ideal body weight (IdBW) by Devine formula. Evaluation at baseline included: height, weight, BMI, quality of life (SF-36), TSQ, TSH, freeT3 (fT3), freeT4 (fT4) levels. Results There were no difference in the quality of compensation between groups of normal-weight, overweight and obese patients (p 0,05). L-T4 dose in patients with obesity and overweight was significantly higher compared to normal-weight patients (p 0,05). The L-T4 dose per 1 kg of actual body weight was significantly higher (p 0,001) in the normal-weight and overweight euthyroid patients compared to patients with obesity. In contrast, L-T4 dose per 1 kg of ideal body weight was significantly higher (p 0,001) in overweight (1.78 [1.52, 2.06]) and obese patients (1 9 [1.71, 2.4] 1.99 [1.72, 2.4]), as compared with normal-weight patients (1.49 [1.27, 1.78]). There were no correlation between the fT3, fT4 levels and weight, and also between the L-T4 dose and weight. QOL and TSQ levels were the same in the groups of normal-weight, overweight and obese patients (p0,05). Conclusions The compensation of hypothyroidism in patients with overweight/obesity is not worse than that of normal-weight patients. The achievement of euthyroidism requires less L-T4 dose per 1 kg of the actual weight and significantly higher dose for 1 kg of ideal weight in obesity/overweight patients

Characteristics of specialists treating hypothyroid patients: the &quot;THESIS&quot; collaborative.

INTRODUCTION: Thyroid specialists influence how hypothyroid patients are treated, including patients managed in primary care. Given that physician characteristics influence patient care, this study aimed to explore thyroid specialist profiles and associations with geo-economic factors. METHODS: Thyroid specialists from 28 countries were invited to respond to a questionnaire, Treatment of Hypothyroidism in Europe by Specialists: an International Survey (THESIS). Geographic regions were defined according to the United Nations Statistics Division. The national economic status was estimated using World Bank data on the gross national income per capita (GNI per capita). RESULTS: 5,695 valid responses were received (response rate 33·0%). The mean age was 49 years, and 65·0% were female. The proportion of female respondents was lowest in Northern (45·6%) and highest in Eastern Europe (77·2%) (p 100 patients annually (p<0·01). DISCUSSION: THESIS has demonstrated differences in characteristics of thyroid specialists at national and regional levels, strongly associated with GNI per capita. Hypothyroid patients in middle-income countries are more likely to encounter female thyroid specialists working in private practice, with a high workload, compared to high-income countries. Whether these differences influence the quality of care and patient satisfaction is unknown, but merits further study