Medicare Coverage of Routine Screening for Thyroid Dysfunction


Book Description

When the Medicare program was established in 1965, it was viewed as a form of financial protection for the elderly against catastrophic medical expenses, primarily those related to hospitalization for unexpected illnesses. The first expansions to the program increased the eligible population from the retired to the disabled and to persons receiving chronic renal dialysis. It was not until 1980 that an expansion of services beyond those required "for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member" was included in Medicare. These services, known as preventive services, are intended either to prevent disease (by vaccination) or to detect disease (by diagnostic test) before the symptoms of illness appear. A Committee was formed "to conduct a study on the addition of coverage of routine thyroid screening using a thyroid stimulating hormone test as a preventive benefit provided to Medicare beneficiaries under Title XVIII of the Social Security Act for some or all Medicare beneficiaries."




Clinical Management of Thyroid Disease E-Book


Book Description

Clinical Management of Thyroid Disease is an exciting new book edited by Fredric Wondisford, MD—developer of the revolutionary new drug, Thyrotropin—and Sally Radovick, MD, with contributions from experts in the field. It fulfills the niche of a succinct, clinical resource to help you translate research into practice. This full-color volume offers valuable information on thyroid cancer and non-cancerous lesions, the effect of drugs on thyroid function, genetic disorders, and more in an accessible, easy-to-read consistent format. Presents the expertise of authors and editorial staff comprised of leaders in the field of thyroid research and clinical management for the best-qualified guidance on diagnosis and treatment. Provides a full-color, comprehensive approach that makes valuable information easy to locate and quick to read. Covers relevant topics applicable to all levels of training and expertise to serve as a detailed clinical reference on everything from the basic to the sophisticated. Captures research advances on hot topics such as thyroid cancer and non-cancerous lesions, the effect of drugs on thyroid function, and genetic disorders so that you can incorporate them into the way you treat patients.




The Bethesda System for Reporting Thyroid Cytopathology


Book Description

This atlas is the offspring of the “The National Cancer Institute (NCI) Thyroid Fine Needle Aspiration (FNA) State of the Science Conference,” hosted by the NCI and organized by Dr. Andrea Abati. Preparations for the conference began 18 months earlier with the designation of a steering committee and the establishment of a dedicated, p- manent web site. The meeting took place on October 22 and 23, 2007 in Bethesda, Maryland and was co-moderated by Susan J. Mandel and Edmund S. Cibas. The discussions and conclusions regarding terminology and morphologic criteria 1, 2 from the meeting were summarized in publications by Baloch et al. and form the framework for this atlas. The atlas is organized by the general categories of “Nondiagnostic,” “Benign,” “Follicular Neoplasm/Suspicious for a Follicular Neoplasm”, “Suspicious for Malignancy,” and “Malignant,” and it includes the defi- tions and morphologic criteria of these categories as set forth by Baloch et al. The majority of the conference participants also agreed on a category of “undetermined significance,” which is incorporated in this atlas (Chap. 4). It is critical that the cytopathologist communicate thyroid FNA interpretations to the referring physician in terms that are succinct, unambiguous, and helpful clinically. We recognize that the terminology used here is a flexible framework that can be modified by individual laboratories to meet the needs of their providers and the patients they serve.




Species Differences in Thyroid, Kidney and Urinary Bladder Carcinogenesis


Book Description

In November 1997, an expert group was convened to discuss available knowledge on the epidemiology, pathology and mechanisms related to certain tumors that are commonly seen in essays for carcinogenicity in rodents in order that their importance in human hazard evaluation might be assessed. The tumors of interest were urinary bladder carcinomas associated with urolithiasis, microcrystalluria and certain urinary precipitates; renal corticol tumors in male rats associated with alpha-2 urinary globulin nephropathy; and thyroid follicular cell tumors associated with imbalances in thyroid stimulating hormone. Included in the book are a series of individually authored papers on these various topics, as well as a Concensus Report including consideration of how such data may be used within the evalation process in the IARC Monographs on the Evaluation of Carcinogenic risks to Humans.




Thyroid Autoimmunity


Book Description

In 1956, three groups independently reported evidence that some thyroid disease appearing spontaneously in humans or experimentally induced in animals are related to autoimmune processes. The interval between these landmark discoveries and the present has witnessed a remarkable and continuing growth of both knowledge and concepts concerning the mechanisms of immune regulation, the pathogenesis of autoimmune thyroid diseases, and their clinical and laboratory manifestations. More importantly knowledge of thyroid autoimmunity has, in many respects, comprised the vanguard of an ever increasing appreciation and understanding of autoimmune diseases in general. On November 24-26 1986, an International Symposium on Thyroid Autoimmunity was held in Pisa. Its purpose was to commemorate the birth of thyroid autoimmunity as a scientific discipline, to summarize current knowledge and concepts in this area, and where possible, to anticipate areas of opportunity for the future - hence the theme of the Symposium, Memories and Perspectives. To open the meeting, the Magnifico Rettore (Chancellor) of the University of Pisa granted special Awards to Dr. Deborah Doniach, Dr. Ivan Roitt, and Dr. Noel R. Rose, who published the first fundamental studies in the field of thyroid autoimmunity, and to Dr. Duncan G. Adams, whose discovery of the long-acting thyroid stimulator (LATS) opened the door to our current understanding of the pathogenesis of Graves' disease. During the meeting thirty plenary lectures were presented.




The Thyroid and Its Diseases


Book Description

This book is an up-to-date and comprehensive guide to all the common thyroid disorders that may be seen by internists, endocrinologists, nuclear medicine physicians, and endocrine surgeons. While the fundamentals of thyroid hormone function and regulation in health and disease are well covered, the primary focus is on the clinical approach to thyroid disease, with detailed coverage of both initial diagnosis and management and the role of imaging. Because most endocrine diseases are chronic and lifelong, special emphasis is placed on long-term management and the common pitfalls that may be encountered by the clinician. The editors are internationally acknowledged leaders in the field of thyroid disease and have gathered an outstanding team of authors, all of whom are also highly expert in their respective areas, but who, equally importantly, write in a clear and lucid style. The numerous isotope scan and ultrasonographic images ensure that the book will serve as a valuable reference atlas to which the physician will return again and again.




Thyroid Disorders


Book Description

This book provides comprehensive knowledge about thyroid gland and highlights the recent trends in the management of thyroid dysfunctions. Thyroid disorders are amongst the most prevalent of medical conditions possibly after diabetes. The prevalence of thyroid dysfunction in adults in the general population ranges from 1 to 10 percent, and is even higher in selected groups. In the United Kingdom, 1–2% of the adult population is found to have thyroid dysfunction. It is interesting to note that thyroxin is the sixth most commonly dispensed drug in Scotland. Virtually all studies report higher prevalence rates for hypothyroidism in women and with advancing age. Abnormal thyroid functions have important public health consequences. Suppressed TSH levels have been associated with decreased bone density and with an increased risk of atrial fibrillation and premature atrial beat. It has been known for decades that overt hypothyroidism contributes to elevated serum cholesterol levels and cardiovascular risk and recent studies suggest this may also be true with subclinical hypothyroidism​.




Thyroid Ultrasound and Ultrasound-Guided FNA Biopsy


Book Description

Over the past two decades ultrasound has undergone numerous advances in technology such as gray-scale imaging, real-time sonography, high resolution 7.5-10 MHz transducers, and color-flow Doppler. This makes ultrasound unsurpassed in its ability to provide very accurate images of the thyroid gland quickly, inexpensively, and safely. However, in spite of these advances, ultrasound remains drastically underutilized by endocrinologists. In part, this is due to a lack of understanding of the ways in which ultrasound can aid in the diagnosis of various thyroid conditions and to a lack of experience in the ultrasound technique by the clinician. Thyroid Ultrasound and Ultrasound-Guided FNA Biopsy presents a `hands-on' approach to using ultrasound in the clinical evaluation and management of thyroid disease. It is written specifically for the clinician and discusses the subtleties one needs to be aware of in using this technique. Particular attention is paid to using ultrasound in conjunction with FNA biopsy. New technology such as three-dimensional ultrasound, color-flow Doppler, and percutaneous injection of cysts and nodules are discussed and demonstrated. Numerous ultrasound examples are used to show the interactions between ultrasound and tissue characteristics and explain their clinical significance. Also presented is the work of several groups of investigators worldwide who have explored new applications of ultrasound, that has led to novel techniques that are proving clinically useful.




Thyroid Nodules


Book Description

Utilizing the most current evidence, this practical book is the first publication of its kind to focus exclusively on the clinical and laboratory evaluation and therapy of thyroid nodules, including advances in evaluation and controversies in management. Opening with chapters presenting the epidemiology, history, laboratory and clinical evaluation of thyroid nodules, the use of radioactive isotope ultrasound and CT scanning in diagnosis is then described. The interpretation of thyroid cytology following fine needle aspiration (FNA) biopsies and the use of molecular markers are discussed in detail, as is the controversial use of thyroxine therapy. Following a presentation of the common and minimally invasive surgical approaches to thyroid nodules, chapters on multinodal goiters, incidentalomas and thyroid nodules in children round out the presentation. Written and edited by leading US and international thyroidologists, Thyroid Nodules is a useful, state-of-the-art text for endocrinologists, surgeons, and primary care physicians.




Thyroid Hormone Metabolism


Book Description