New thyroid screening statement

ENDO 2015 SAW THE DEBUT OF THE ENDOSCAPES COMPETITION that featured a variety of images taken right from researchers’ microscopes and displayed throughout the conference. The winner is Sandra Grimm from the Baylor College of Medicine for her image, “Pretty Flowers.” The image is DCIS breast cancer cells stained for progesterone receptor (red) and keratin 14 (green). Nuclei are stained blue. The cells that express high levels of PR cluster together and lose K14 expression. The image was captured using a Nikon Eclipse 80i microscope with a Photometrics Coolsnap cf CCD camera at 20x magnification (Nikon Plan Apo 20X/0.75). A rotating selection of images was presented on a flatscreen television monitor at the Life Sciences Pavilion, and attendees cast their ballots for their favorites.

Wysham Named Society CPT Advisor

Carol Wysham, MD, has been named the Society’s advisor to the American Medical Association’s Current Procedural Terminology (CPT) Advisory Committee, which oversees the development and refinement of CPT codes. Wysham has been a key thought leader in the Endocrine Society for more than 20 years and has extensive experience in coding and reimbursement through her decades of work in clinical practice. The Society looks forward to continuing to work with Wysham in her new position.

Endocrinology EIC Featured on Australian Television

In March, Andrea Gore, PhD, a researcher and professor at the University of Texas and editor-in-chief of Endocrinology, was featured on the Australian science news show Catalyst. Gore, along with a panel of American, Australian, Canadian, and New Zealander experts, discussed chemicals’ effects on the body in a segment called “Our Chemical Lives.”

The program pointed out that more than 80,000 chemicals are used in everyday products, saying that it’s “impossible to escape them” and that there is a “growing concern that these chemicals are not safe.” Gore focused on endocrine-disrupting chemicals (EDCs) — her area of expertise — explaining that EDCs mimic or interfere with hormones, which can have “very devastating consequences.”

The panel then discussed bisphenol A (BPA) and the fact that some countries are reducing or even banning its use in packaged products. France, for example, introduced legislation to ban BPA in products that come in direct contact with food, while industry groups call for the ban to be overturned. And the European Food Safety Authority has temporarily lowered the safe limit of BPA from 50 micrograms to four micrograms, pending studies.

However, Gore said that four micrograms is arbitrary and she believes that if a chemical is an endocrine disruptor it cannot be considered safe at any level. Gore also took issue with the fact that the people who are involved in the BPA decisionmaking process are being influenced by “groups that have a vested interest in those products.” “I consider it a conflict of interest,” she said.

Finally, Gore gave viewers tips on how they can minimize their exposure, such as buying fresh fruits and vegetables, minimizing trash output, and keeping a clean house to minimize exposure to chemicals from bug sprays.

Watch the video of the program and read the transcript at au/catalyst/stories/4207313.htm.

Society Issues Statement on Screening for Thyroid Dysfunction

On March 24, 2015, the U.S. Preventive Services Task Force (USPSTF) issued its final statement on Screening for Thyroid Dysfunction. While the USPSTF changed the scope of its recommendation statement to screening for thyroid dysfunction to emphasize that screening can detect biochemical abnormalities as well as potentially clinically important disease, the USPSTF’s ultimate assessment remained the same as in the previous recommendation. The Task Force concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening for thyroid dysfunction in nonpregnant, asymptomatic adults. This final report was published in the Annals of Internal Medicine.

While the Society agrees with the USPSTF statement that universal screening for thyroid disorders is not recommended, it does strongly support screening for thyroid dysfunction in specific situations, especially in relation to pregnancy.

In accordance with the Society’s Clinical Practice Guideline, Management of Thyroid Dysfunction during Pregnancy and Postpartum, the Society supports the following recommendations to our clinician members and the public:

1. Thyroid function testing is normal practice in caring for patients who have symptoms or signs suggestive of hypothyroidism or hyperthyroidism, goiter, or a history of thyroid irradiation.
2. Universal screening of healthy women for thyroid dysfunction before pregnancy is not recommended. However, women who intend to become pregnant and are considered “high risk” for thyroid illness should be tested. This includes women over age 30 years, with a family history of autoimmune thyroid disease or hypothyroidism, goiter, known thyroid autoantibodies, symptoms or clinical signs suggestive of thyroid hypofunction, type 1 diabetes, infertility, prior history of preterm delivery, prior therapeutic head or neck irradiation, prior thyroid surgery, or currently receiving levothyroxine replacement therapy.
3. Because of the significant incidence of thyroid disorders among pregnant women and the known adverse effects on pregnancy, the Endocrine Society strongly supports testing all pregnant women for elevated TSH concentrations by the ninth week of pregnancy or at the time of their first visit during pregnancy, or at a minimum, aggressive case finding to identify and test high-risk women as defined above.
4. Women with thyroid autoimmunity who are euthyroid in the early stages of pregnancy are at risk of developing hypothyroidism and should be monitored for elevation of TSH above the normal range for pregnancy and treated with levothyroxine when appropriate.
5. Women known to have thyroid autoantibodies, a history of postpartum thyroiditis or type 1 diabetes should have TSH measured at 6 – 12 weeks postpartum and at six months postpartum, or as clinically indicated. Patients with elevated TSH levels should be considered for levothyroxine treatment when appropriate.

While the Society supports the USPSTF’s call for more research into thyroid disease screening studies, it also encourages physicians and their patients to discuss the specific situations when thyroid function testing and treatment may be appropriate.

Wartofsky Named Editor-in-Chief of Endocrine Reviews

Leonard Wartofsky, MD, chairman emeritus of the Department of Medicine at Washington Hospital Center in Washington, D.C., has been named editor-in-chief of Endocrine Reviews.

Endocrine Reviews publishes bimonthly comprehensive, authoritative, and timely review articles balancing both experimental and clinical endocrinology themes. The journal has repeatedly ranked fi rst in Impact Factor among more than 100 journals in the “Endocrinology & Metabolism” category of Thomson Reuters’ annual “Journal Citation Report”, including in the most recent 2012 and 2013 editions.

“It is truly an honor to take the helm of such a prestigious scholarly journal,” Wartofsky says. “Endocrine Reviews publishes comprehensive and authoritative review articles that address current trends in experimental and clinical endocrinology as well as related areas. As editor-in-chief, I will strive to maintain and build on the journal’s reputation for excellence.”

In addition to his position at the Washington Hospital Center, Wartofsky is a professor of medicine, anatomy, physiology, and genetics at the Uniformed Services University of the Health Sciences in Bethesda, Md., professor of medicine at Georgetown University and clinical professor of medicine at the University of Maryland, Howard University, and George Washington University Schools of Medicine. He is a past president of both the Endocrine Society and the American Thyroid Association. The Endocrine Society has honored him with the Robert H. Williams Distinguished Leadership Award and Distinguished Educator Award.

Journal of Clinical Endocrinology & Metabolism. An internationally renowned expert in clinical thyroid disease with emphasis on patients with thyroid cancer, Wartofsky has published more than 300 articles and book chapters and has lectured across the globe.

Wartofsky’s term as editor-in-chief began May 1.

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