The effect of subclinical hypothyroidism on platelet parameters
Department of Hematology and Oncology, GATA Haydarpasa Training Hospital, Istanbul, Turkey. Hematology (Amsterdam, Netherlands)
(Impact Factor: 1.25).
04/2009; 14(2):115-7. DOI: 10.1179/102453309X385124
Hypothyroidism has a broad clinical spectrum. Today, physicians frequently encounter patients with very mild thyroid dysfunction instead of overt hypothyroidism. These patients have normal serum levels of thyroxine and triiodothyronine and only mildly elevated serum thyrotropin levels. Such patients are often identified through routine screening or in the course of an evaluation of common nonspecific symptoms. On the other hand, coronary heart disease is the leading cause of death in developed countries. There are studies, which suggest platelets play a role in the pathogenesis of atherosclerosis and coronary heart disease.
The aim of this study is to compare the platelet count and other platelet parameters in subclinical hypothyroidic and euthyroidic healthy control group and to investigate whether these parameters have a predictive significance in patients with subclinical hypothyroidism.
Forty-seven patients with subclinical hypothyroidism and 30 euthyroidic healthy control group were enrolled into the study.
Patients with subclinical hypothyroidism had higher mean platelet volume (MPV) and platelet distribution width (PDW) values than control group, which were statistically significant (p<0.001 and p<0.001), respectively.
Our results indicate that MPV and PDW play an important predictive role in subclinical hypothyroidism.
Available from: Libing Jiang
- "In addition, a decreased MPV has been reported in patients with ulcerative colitis, rheumatoid arthritis and ankylosing spondylitis , and acute appendicitis. Moreover, it also has been reported that hypothyroidism increases MPV values     . Thus, MPV should be used with care in diagnosing PE, and the aforementioned affection factors should be addressed in this article. "
- "A decreased MPV has been reported in patients with ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, and acute appendicitis    . Furthermore, it also has been reported that hypothyroidism increases MPV values . Thus, it would have been better if the authors had mentioned these MPV-affecting factors in greater detail. "
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ABSTRACT: Background: Little is known about the knowledge, attitudes, and infection prevention practices related to multidrug-resistant organisms (MDRO) among Emergency Medical Service (EMS) providers.
Methods: An electronic survey was sent to a stratified random sample of nationally certified EMS providers between November 2013 and February 2014. The survey included 22 items about hand hygiene, glove use, and environmental disinfection, as well as general knowledge and attitudes pertaining to MDROs. Descriptive statistics were performed.
Results: 5,293 EMS providers received the survey and 516 (9.7%) were returned. Of those, 50.1% were Emergency Medical Technician–Basics (EMT-B) and 34.6% were paramedics. 84.9% reported glove use during patient care. While 95.3% agreed that hand hygiene was necessary regardless of glove use, only 16.1% regularly disinfected their hands prior to glove use and 68.9% did so after glove use. Lack of time, interference with patient care, and low perceived risk of exposure to blood or other body fluids were the most common reasons for non-adherence with hand hygiene. While 85.9% routinely disinfected their medical equipment and stretcher after each patient encounter, less than 60% disinfected the ambulance compartment during a shift, even after visible contamination of the environment. While most had heard of methicillin-resistant Staphylococcus aureus, fewer EMT-Bs compared to paramedics were familiar with vancomycin-resistant Enterococcus, Clostridium difficile, or multidrug-resistant Gram-negative bacteria and how these organisms are transmitted. Providers reported they would be more likely to use gloves (94.6%), perform hand hygiene (91.2%), and thoroughly disinfect their environment (87.3%) if they knew that a patient had a MDRO. Perceived barriers to such awareness included lack of communication among healthcare personnel and lack of clear documentation in the medical record.
Conclusion: Opportunities exist to improve awareness, knowledge, and practices among EMS providers regarding infection prevention and MDROs through further education and standardization of policies. While non-responder bias may have influenced our survey findings, knowledge and practices are likely to be even poorer in non-responders.
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ABSTRACT: This review summarizes current knowledge of the effects of polycystic ovary syndrome, Cushing's syndrome, thyrotoxicosis, hypothyroidism, primary hyperparathyroidism, acromegaly, hypopituitarism, and growth hormone deficiency on coagulation and fibrinolysis. Several abnormalities of the coagulation-fibrinolytic system have been described among patients affected by these endocrine disorders. Although further larger studies are needed to provide more definitive information, clinically overt hypothyroidism appears to be associated with a bleeding tendency, whereas all other endocrine diseases appear to be associated with a thrombotic tendency. The disorders of coagulation and fibrinolysis observed in these endocrine pathologies usually range from mild to moderate and, rarely, to potentially severe laboratory abnormalities (e.g., bleeding diathesis in overt hypothyroidism mainly due to an acquired von Willebrand's syndrome type 1), are reversible after pharmacologic treatment of the hormonal dysfunction, and are usually of limited consequence in clinical practice. Nevertheless, the prompt recognition of potentially severe disorders of blood coagulation is mandatory for the correct management of these patients.
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