Introduction: In hyperthyroidism, selective irradiation of the thyroid gland with radioactive iodine is a radical treatment and an alternative to surgery. The aim of this review is to assess the medium-term efficacy o...Introduction: In hyperthyroidism, selective irradiation of the thyroid gland with radioactive iodine is a radical treatment and an alternative to surgery. The aim of this review is to assess the medium-term efficacy of outpatient treatment of hyperthyroidism with iodine-131 in Africa. Methods: We identified the studies carried out in Africa on outpatient radiation therapy between 2016 and 2020. For each article included, we noted the country concerned and the year of publication, the numbers studied, the socio-demographic characteristics of the patients, the indications for radio iodine therapy, the dose administered, the results of the hormonal dosage 6 months after radiation. Results: 13 retrospective studies were included to constitute a total population of 925 patients. The average age was 40.77 years, the sex ratio of 1/5.4 with a clear female predominance. The 3 main etiologies of hyperthyroidism justifying outpatient radio iodine therapy were Graves’ disease (55.89%), toxic multinodular goiter (22.70%) and toxic adenoma (21.40%). The average dose of iodine 131 administered per course is 13.7 mCi. No short-and medium-term complications were reported. The radio iodine therapy was effective in 86.08% (n = 796) of the patients with extremes of 72% and 100%. Conclusion: Radio iodine therapy is effective in Africa. It is simple, inexpensive on an outpatient basis and well tolerated. The introduction of outpatient radio iodine therapy could improve the management of patients with hyperthyroidism in Burkina Faso.展开更多
建筑信息模型(Building Information Modeling,BIM)技术能够优化工程流程,减少返工和浪费,降低错误率和成本,提升项目的整体性能。同时,BIM技术还促进各方协同合作,提高沟通协调效率,减少信息丢失和误解。介绍BIM技术在厂房机电安装中...建筑信息模型(Building Information Modeling,BIM)技术能够优化工程流程,减少返工和浪费,降低错误率和成本,提升项目的整体性能。同时,BIM技术还促进各方协同合作,提高沟通协调效率,减少信息丢失和误解。介绍BIM技术在厂房机电安装中的应用现状,分析了BIM技术在产业园建设项目厂房机电安装方面的优势和问题,给出了扬州新能源产业园东区建设项目中应用BIM的具体案例和实施建议。展开更多
Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurrin...Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurring during treatment with lithium salts. This was a 16-year-old patient with ongoing lithium treatment for two and a half years who presented with a thyrotoxicosis syndrome without a context of iodine overload or an episode of anterior cervical pain that could suggest subacute thyroiditis or orthopathic sign. The assessment of the exploration of this patient reveals biological hyperthyroidism without anti-TSH receptor antibodies, a normal ultrasound, and white scintigraphy which makes it possible to evoke the diagnosis of subacute thyroiditis (absence of the context of iodine overload). Note the interest in a thyroid assessment before and during treatment with lithium salts. Moreover, scintigraphy occupies a place of choice in the exploration of hyperthyroidism, particularly in the context of normal thyroid ultrasound imaging.展开更多
Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hy...Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hyperthyroidism. We report the case of a 45-year-old woman admitted for management of pleuro-pericarditis associated with atrial fibrillation in the context of cardiothyreosis. The treatment consisted of a pericardial puncture associated with synthetic anti-thyroid drugs and anti-tuberculosis drugs with positive clinical and echocardiographic outcomes.展开更多
BACKGROUND Hyperthyroidism often leads to tachycardia,but there are also sporadic reports of hyperthyroidism with severe bradycardia,such as sick sinus syndrome(SSS)and atrioventricular block.These disorders are a cha...BACKGROUND Hyperthyroidism often leads to tachycardia,but there are also sporadic reports of hyperthyroidism with severe bradycardia,such as sick sinus syndrome(SSS)and atrioventricular block.These disorders are a challenge for clinicians.CASE SUMMARY We describe three cases of hyperthyroidism with SSS and found 31 similar cases in a PubMed literature search.Through the analysis of these 34 cases,we found 21 cases of atrioventricular block and 13 cases of SSS,with 67.6%of the patients experiencing bradycardia symptoms.After drug treatment,temporary pacemaker implantation,or anti-hyperthyroidism treatment,the bradycardia of 27 patients(79.4%)was relieved,and the median recovery time was 5.5(2-8)d.Only 7 cases(20.6%)needed permanent pacemaker implantation.CONCLUSION Patients with hyperthyroidism should be aware of the risk of severe bradycardia.In most cases,drug treatment or temporary pacemaker placement is recommended for initial treatment.If the bradycardia does not improve after 1 wk,a permanent pacemaker should be implanted.展开更多
空间调制(Spatial Modulation, SM)技术和OFDM多模子载波索引调制(OFDMMulti-Mode Index Modulation, MM-OFDM-IM)技术分别在能量效率(Energy Efficiency,EE)和频谱效率(Spectral Efficiency,SE)上有着很大的优势。多维度索引调制技术...空间调制(Spatial Modulation, SM)技术和OFDM多模子载波索引调制(OFDMMulti-Mode Index Modulation, MM-OFDM-IM)技术分别在能量效率(Energy Efficiency,EE)和频谱效率(Spectral Efficiency,SE)上有着很大的优势。多维度索引调制技术相结合能够应用多种物理资源,应对无线通信系统对数据传输和系统容量的高需求,由此将SM与MMOFDM-IM系统灵活结合,构建基于空频结合的多模复合索引调制(OFDM-Multiple-Mode Space Frequency Composite Index Modulation,MM-OFDM-SFCIM)系统,保留传统子载波索引调制技术中的静默子载波,拓展新的复合系数维度,提高系统的SE和EE。针对系统的复杂特性,提出了基于符号能量及对数似然的联合检测算法(REML based on symbolic Energy and LLR,EL-REML)。仿真结果表明,MM-OFDM-SFCIM系统比传统的空频结合系统在SE上提高了约30%,并且MM-DFDM-SPCIM系统中提出的EL-REML算法比LLR算法在误码率上提高了3~4 dB,相比传统的ML算法,其计算复杂度更低。展开更多
Sub clinical hyperthyroidism (SCH) is characterized by normal free thyroid hormone concentrations along with a low or undetectable serum TSH (thyrotropin) level. The increased use of TSH as a screening measure and imp...Sub clinical hyperthyroidism (SCH) is characterized by normal free thyroid hormone concentrations along with a low or undetectable serum TSH (thyrotropin) level. The increased use of TSH as a screening measure and improved assay sensitivity is contributing to the diagnosis of sub clinical hyperthyroidism more frequently than ever in our clinical practise leading to the increased prevalence of the disease. The significance of SCH remains uncertain for most patients as some will revert to normal thyroid status over time whereas others will either remain static or progress to overt thyroid disease in the future. The detrimental effects of a persistently suppressed TSH has now been extensively studied and its effect on the cardiovascular system, the skeleton, mood disturbance, quality of life is quite significant leading to considerable morbidity and mortality. Majority of the patients are asymptomatic and lack overt features but the relevance of treatment is more focussed in elderly patients where the risk of developing cardiac arrhythmia and loss of bone mineral density is much more than young people in whom a conservative approach is usually preferred. The issue is contentious, the situation is challenging and the benefits of treatment are debatable. The consensus for who, when and how to treat is growing but still hasn’t been universally accepted. We attempt to review the recent literature available for sub clinical hyperthyroidism and suggest an analytical approach to its investigations and management.展开更多
文摘Introduction: In hyperthyroidism, selective irradiation of the thyroid gland with radioactive iodine is a radical treatment and an alternative to surgery. The aim of this review is to assess the medium-term efficacy of outpatient treatment of hyperthyroidism with iodine-131 in Africa. Methods: We identified the studies carried out in Africa on outpatient radiation therapy between 2016 and 2020. For each article included, we noted the country concerned and the year of publication, the numbers studied, the socio-demographic characteristics of the patients, the indications for radio iodine therapy, the dose administered, the results of the hormonal dosage 6 months after radiation. Results: 13 retrospective studies were included to constitute a total population of 925 patients. The average age was 40.77 years, the sex ratio of 1/5.4 with a clear female predominance. The 3 main etiologies of hyperthyroidism justifying outpatient radio iodine therapy were Graves’ disease (55.89%), toxic multinodular goiter (22.70%) and toxic adenoma (21.40%). The average dose of iodine 131 administered per course is 13.7 mCi. No short-and medium-term complications were reported. The radio iodine therapy was effective in 86.08% (n = 796) of the patients with extremes of 72% and 100%. Conclusion: Radio iodine therapy is effective in Africa. It is simple, inexpensive on an outpatient basis and well tolerated. The introduction of outpatient radio iodine therapy could improve the management of patients with hyperthyroidism in Burkina Faso.
文摘建筑信息模型(Building Information Modeling,BIM)技术能够优化工程流程,减少返工和浪费,降低错误率和成本,提升项目的整体性能。同时,BIM技术还促进各方协同合作,提高沟通协调效率,减少信息丢失和误解。介绍BIM技术在厂房机电安装中的应用现状,分析了BIM技术在产业园建设项目厂房机电安装方面的优势和问题,给出了扬州新能源产业园东区建设项目中应用BIM的具体案例和实施建议。
文摘Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurring during treatment with lithium salts. This was a 16-year-old patient with ongoing lithium treatment for two and a half years who presented with a thyrotoxicosis syndrome without a context of iodine overload or an episode of anterior cervical pain that could suggest subacute thyroiditis or orthopathic sign. The assessment of the exploration of this patient reveals biological hyperthyroidism without anti-TSH receptor antibodies, a normal ultrasound, and white scintigraphy which makes it possible to evoke the diagnosis of subacute thyroiditis (absence of the context of iodine overload). Note the interest in a thyroid assessment before and during treatment with lithium salts. Moreover, scintigraphy occupies a place of choice in the exploration of hyperthyroidism, particularly in the context of normal thyroid ultrasound imaging.
文摘Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hyperthyroidism. We report the case of a 45-year-old woman admitted for management of pleuro-pericarditis associated with atrial fibrillation in the context of cardiothyreosis. The treatment consisted of a pericardial puncture associated with synthetic anti-thyroid drugs and anti-tuberculosis drugs with positive clinical and echocardiographic outcomes.
基金the Clinical Medical Research Center Project of Hainan Province,China,No.LCYX202207Key R&D Plan Project of Hainan Province,China,No.ZDYF2020118.
文摘BACKGROUND Hyperthyroidism often leads to tachycardia,but there are also sporadic reports of hyperthyroidism with severe bradycardia,such as sick sinus syndrome(SSS)and atrioventricular block.These disorders are a challenge for clinicians.CASE SUMMARY We describe three cases of hyperthyroidism with SSS and found 31 similar cases in a PubMed literature search.Through the analysis of these 34 cases,we found 21 cases of atrioventricular block and 13 cases of SSS,with 67.6%of the patients experiencing bradycardia symptoms.After drug treatment,temporary pacemaker implantation,or anti-hyperthyroidism treatment,the bradycardia of 27 patients(79.4%)was relieved,and the median recovery time was 5.5(2-8)d.Only 7 cases(20.6%)needed permanent pacemaker implantation.CONCLUSION Patients with hyperthyroidism should be aware of the risk of severe bradycardia.In most cases,drug treatment or temporary pacemaker placement is recommended for initial treatment.If the bradycardia does not improve after 1 wk,a permanent pacemaker should be implanted.
文摘空间调制(Spatial Modulation, SM)技术和OFDM多模子载波索引调制(OFDMMulti-Mode Index Modulation, MM-OFDM-IM)技术分别在能量效率(Energy Efficiency,EE)和频谱效率(Spectral Efficiency,SE)上有着很大的优势。多维度索引调制技术相结合能够应用多种物理资源,应对无线通信系统对数据传输和系统容量的高需求,由此将SM与MMOFDM-IM系统灵活结合,构建基于空频结合的多模复合索引调制(OFDM-Multiple-Mode Space Frequency Composite Index Modulation,MM-OFDM-SFCIM)系统,保留传统子载波索引调制技术中的静默子载波,拓展新的复合系数维度,提高系统的SE和EE。针对系统的复杂特性,提出了基于符号能量及对数似然的联合检测算法(REML based on symbolic Energy and LLR,EL-REML)。仿真结果表明,MM-OFDM-SFCIM系统比传统的空频结合系统在SE上提高了约30%,并且MM-DFDM-SPCIM系统中提出的EL-REML算法比LLR算法在误码率上提高了3~4 dB,相比传统的ML算法,其计算复杂度更低。
文摘Sub clinical hyperthyroidism (SCH) is characterized by normal free thyroid hormone concentrations along with a low or undetectable serum TSH (thyrotropin) level. The increased use of TSH as a screening measure and improved assay sensitivity is contributing to the diagnosis of sub clinical hyperthyroidism more frequently than ever in our clinical practise leading to the increased prevalence of the disease. The significance of SCH remains uncertain for most patients as some will revert to normal thyroid status over time whereas others will either remain static or progress to overt thyroid disease in the future. The detrimental effects of a persistently suppressed TSH has now been extensively studied and its effect on the cardiovascular system, the skeleton, mood disturbance, quality of life is quite significant leading to considerable morbidity and mortality. Majority of the patients are asymptomatic and lack overt features but the relevance of treatment is more focussed in elderly patients where the risk of developing cardiac arrhythmia and loss of bone mineral density is much more than young people in whom a conservative approach is usually preferred. The issue is contentious, the situation is challenging and the benefits of treatment are debatable. The consensus for who, when and how to treat is growing but still hasn’t been universally accepted. We attempt to review the recent literature available for sub clinical hyperthyroidism and suggest an analytical approach to its investigations and management.
