Managing a conflict-related, open fracture with drug-resistant infections: The case of a wounded Syrian refugee in the Hashemite Kingdom of Jordan

A critical appraisal and clinical application of Uruc V, Ozden R, Duman IG, Dogramaci Y, Yengil E, Karapinar S, Karakus A, Kalaci A. Major musculoskeletal injuries and applied treatments in the current conflicts in Syria. Acta Medica Mediterranea. 2014;30(3):637-644

Postpartum Management of Women Begun on Levothyroxine during Pregnancy

During pregnancy, the thyroid gland must produce 50% more thyroid hormone to maintain the euthyroid state. Women with decreased thyroid reserve pre-conception, most typically due to Hashimoto’s thyroiditis, may develop hypothyroidism during pregnancy. Data over the last twenty years have reported a strong association between subclinical hypothyroidism and adverse maternal/fetal events. As a result of this association, an increasing number of women are being screened for thyroid disease either pre-conception or at the first prenatal visit. Consequently, an ever increasing number of women are being initiated on levothyroxine for the first time during pregnancy. At present, there are very limited guidelines related to the management of the thyroid disease in these women postpartum. Based on an understanding of the physiology of thyroid gland during pregnancy and postpartum, and the personal clinical experience of the author, recommendations for the postpartum management of women who were started on levothyroxine during pregnancy are presented

Thyroid Antibodies and Miscarriage: Where Are We at a Generation Later?

In 1990, an association between thyroid antibody positivity and spontaneous miscarriage was first reported. A generation has passed since the initial observation. Over that time a robust literature has developed which has confirmed the initial finding and expanded upon it. The present paper reviews the literature that has been generated over the last twenty years on the following topics: (1) thyroid antibodies and spontaneous miscarriage, (2) thyroid antibodies and recurrent abortion, (3) etiology of pregnancy loss in thyroid antibody positive women, and (4) discussion of future research directions