Thyroiditis

After thyroid surgery, a small percentage of patients (0.6 to 4%) experience postoperative bleeding, with most bleeding events occurring within the first 48 hours. These complications often progress rapidly and require immediate medical attention, as they can lead to serious outcomes including death in up to 0.6% of cases. Research has shown that continuous pressure increases in the neck area, related to bleeding, can be detected early through invasive pressure measurements. Current routine care relies on patient symptoms and intermittent monitoring, which may delay detection of serious bleeding. This study is evaluating the use of the ISAR-M THYRO device, a diagnostic tool designed to detect haemorrhage early by continuously measuring pressure in the thyroid area after surgery. The device aims to identify increasing cervical pressure caused by hematoma growth before symptoms appear, allowing earlier intervention within 36 to 48 hours post-surgery. Early detection could help guide treatment decisions, such as timing of wound opening, to reduce complications and improve patient safety. Participants will be monitored using the device after thyroid surgery to assess its accuracy in detecting bleeding within 48 hours. The study measures sensitivity and specificity of the device in identifying haemorrhage during this critical postoperative period. By providing objective pressure readings, the study seeks to minimize risks of severe complications like brain damage and death. The trial involves routine clinical follow-up and aims to improve management and outcomes for patients undergoing thyroid surgery.

Hypothyroidism, marked by high thyrotropin (TSH) levels, is a common issue in patients with chronic kidney disease (CKD) who are on dialysis. Previous research has linked elevated TSH, even within the normal range, to poorer quality of life and increased cardiovascular problems in this group. This trial aims to determine if thyroid hormone replacement with levothyroxine improves quality of life, physical ability, strength, heart health, and metabolic function in dialysis patients with higher TSH levels. The study will randomly assign 336 hemodialysis patients with TSH levels between >3.0 and 10.0 mIU/L and normal free thyroxine (FT4) to receive either levothyroxine or a placebo for 24 weeks. Researchers will evaluate effects on quality of life using the Short Form 36 Physical Component Score and coronary artery calcification progression as the main measures. Secondary assessments include additional quality of life surveys, physical performance, endothelial function, vascular calcification markers, body fat percentage, muscle strength, heart systolic function, and resting energy use. Participants will undergo screening and monitoring throughout the six-month treatment period. Evaluations include laboratory tests for thyroid function and cardiovascular markers, physical assessments, and questionnaires. Safety and efficacy will be closely tracked, with primary outcomes measured at baseline, 12 weeks, and 24 weeks. The study will help clarify the benefits and risks of levothyroxine therapy in hemodialysis patients with mild thyroid dysfunction.

Researchers are evaluating a special type of ultrasound imaging called multiparametric ultrasound (mpUS) to see how well it can examine and provide detailed information about cancerous and non-cancerous tissues. This study focuses on conditions like pancreatic cancer and thyroid nodules. The goal is to compare mpUS imaging with standard ultrasound methods and other common tests to determine if mpUS offers a more detailed and accurate assessment. Participants will undergo mpUS imaging during their standard ultrasound scans, which adds about 15 minutes of additional scanning time. This imaging combines different ultrasound techniques to show detailed tissue structure, blood vessels, and blood flow, potentially offering better insights than standard ultrasound alone. The study includes different groups: patients at high risk for pancreatic cancer, patients with pancreatic ductal adenocarcinoma receiving biopsies, patients with thyroid nodules undergoing biopsy, and healthy volunteers. During the study, participants will receive mpUS imaging alongside their usual care. Researchers will collect and analyze the ultrasound data to investigate the feasibility of mpUS imaging within one day. Participants will be monitored for the quality and detail of the images obtained, and information will be gathered to compare mpUS with standard imaging approaches. The study involves screening, imaging, and follow-up assessments as part of standard care and research procedures.

Researchers are evaluating online outpatient follow-up care for patients who have undergone surgery for papillary thyroid cancer. This randomized, actively controlled, non-inferiority trial will run from August 2024 to August 2026 and aims to compare online follow-up visits using a mobile app with traditional offline visits. The study focuses on patients treated at the Department of Thyroid Surgery of West China Hospital of Sichuan University who are between 18 and 90 years old and can communicate in Chinese. Participants will be randomly assigned to receive follow-up care through the Huayitong app for online visits or through traditional offline visits. The online follow-up includes three scheduled check-ins at 1, 3, and 6 months after surgery. Participants may switch from online to offline visits or withdraw from the study if they encounter technical problems, need additional care, or request painkillers. Data collected includes demographics, medical history, symptoms, prescriptions, patient satisfaction, and costs. During the 12-month follow-up, researchers will assess how well participants adhere to outpatient procedures. Assessments include questionnaires on patient experience and satisfaction, reviews of electronic medical records for adverse events, and surveys conducted 30 days after the final follow-up. The study team will monitor for complications, readmissions, and overall safety throughout the observation period.

Researchers are collecting information to better understand how redifferentiating medications are used as a standard treatment for thyroid cancer that does not respond well to radioactive iodine (RAI). This registry study focuses on patients with RAI-refractory thyroid cancer or those unlikely to respond to RAI treatment. The goal is to observe the outcomes of these treatments during routine clinical care. Participants will receive redifferentiation agents as part of their usual medical care before planned diagnostic or therapeutic radioactive iodine treatments. Follow-up visits will be scheduled according to standard clinical practice, during which doctors will record how well patients tolerate the medication and note any side effects or adverse events. Patients who have been treated with these agents before or are starting treatment will be included to provide both retrospective and prospective data. Throughout the study, participants will attend regular visits where their health and treatment responses will be monitored. Adverse events will be collected at every visit for up to two years. Data collected will help researchers understand the safety and use of redifferentiation agents in everyday clinical settings for thyroid cancer patients. Participation duration depends on individual treatment schedules and follow-up care.

Researchers are evaluating active surveillance as a management option for patients with small thyroid nodules under 2 cm classified as Bethesda IV, which indicates follicular neoplasm or suspicion of it. The study addresses concerns about traditional surgery's costs, risks like hypothyroidism, nerve damage, infection, and impacts on quality of life, aiming to assess whether monitoring can safely reduce unnecessary operations while maintaining patient safety over time. This prospective cohort study focuses on the safety, feasibility, patient experience, and identifying predictors of disease progression during follow-up. The study involves active surveillance of thyroid nodules instead of immediate surgical removal. Patients will undergo regular monitoring including ultrasound assessments, clinical exams, and education at intervals of 6, 12, 18, 24, 36, 48, and 60 months. This approach aims to observe if the nodules progress or require surgery, potentially preserving thyroid function and optimizing healthcare resources over a five-year period. Participants will be evaluated periodically using ultrasound and clinical examinations to track any changes in their thyroid nodules. Researchers will measure the number of patients who undergo surgery or experience disease progression from enrollment through five years of active surveillance. This long-term follow-up will help determine the safety and outcomes of monitoring Bethesda IV thyroid nodules, with attention to patient well-being and avoidance of overtreatment.

Researchers are evaluating the pain relief effects of an Intermediate Cervical Plexus Block combined with general anesthesia using two different concentrations of bupivacaine in patients undergoing neck surgeries, specifically total thyroidectomy or total laryngectomy. This randomized comparative study follows ethical guidelines and aims to compare the effectiveness of 0.25% versus 0.125% bupivacaine concentrations for this type of anesthesia. Participants are randomly assigned to receive either 20 ml of 0.25% or 20 ml of 0.125% bupivacaine injected bilaterally using ultrasound-guided Intermediate Cervical Plexus Block. The procedure involves careful placement of a needle under the fascia of the sternocleidomastoid muscle with ultrasound guidance. General anesthesia is induced and maintained with standard medications and monitoring throughout surgery. During the study, patients are closely monitored with various devices including ECG, blood pressure, and ultrasound assessment of diaphragmatic movement before and after the block. Pain severity is measured at multiple time points up to 24 hours after surgery using a visual analog scale. Researchers also record the duration of pain relief and the amount of additional pain medication used after surgery to evaluate the analgesic effectiveness and safety of the block.

Researchers are conducting a follow-up study on the STONE cohort, which was initially established between 2016 and 2017 among Shanghai community residents aged 18 to 65 years. The study aims to update information on cardiovascular and kidney outcomes, compare metabolic risk factors and disturbances between the follow-up and baseline periods, and explore how changes in these risk factors relate to clinical outcomes. This research focuses on adults living in Shanghai and tracks conditions such as metabolic syndrome, diabetes, obesity, hypertension, dyslipidemia, thyroid diseases, bone metabolism disorders, chronic kidney disease, and cardiovascular diseases. The study will begin in May 2025 and complete data collection for all participants by June 2026, with follow-up continuing until 2035. Participants are categorized based on chronic kidney disease staging during the follow-up. The original STONE cohort included over 4,000 residents selected through random stratified sampling, who underwent questionnaires, interviews, physical exams, and clinical tests including blood and imaging studies. During the study, participants will be assessed through updated questionnaires and health examinations similar to the baseline, covering demographics, lifestyle, psychological status, physical measures, metabolic indicators, and ultrasound imaging. Researchers will monitor the number of participants who develop cardiovascular diseases over an average of 10 years. Contact will be maintained to ensure ongoing participation, and data will be collected to evaluate long-term health outcomes related to cardiovascular-kidney-metabolic conditions.

Researchers are studying thyroid nodules and thyroid carcinoma to evaluate two diagnostic methods that combine gray-scale ultrasound with contrast-enhanced ultrasound (CEUS). This study aims to compare the diagnostic performance of an integrated scoring method with an up-and-down scoring method for assessing the malignant risk of thyroid nodules and determining the need for biopsy. The trial is a multicenter retrospective clinical study conducted according to the Standards for Reporting of Diagnostic Accuracy Studies (version 2015). Participants included those with at least one thyroid nodule larger than 5 mm confirmed by ultrasound, who underwent gray-scale ultrasound, CEUS, and fine-needle aspiration biopsy. The study involved a training set of 600 participants from January 2018 to December 2022 and an external validation set of 200 participants from January to December 2022. The diagnostic methods being compared were the integrated scoring method and the up-and-down scoring method, used to evaluate the malignant risk and biopsy necessity of the thyroid nodules. During the study, each participant had one nodule assessed using both scoring methods. Researchers collected diagnostic performance data and unnecessary biopsy rates to compare the two approaches. The main outcomes measured were diagnostic accuracy and the rate of unnecessary biopsies, assessed one week after the primary study completion date. This study helps understand how CEUS can improve the diagnosis of thyroid nodules when combined with gray-scale ultrasound.

Researchers are studying cognitive function and quality of life in patients who undergo thyroid surgery for benign or malignant thyroid nodules. The study aims to better understand the extent of objective cognitive dysfunction in survivors of differentiated thyroid cancer (DTC) and how it relates to subjective cognitive complaints, thyroid hormone levels, physical activity, and overall health-related quality of life (HR-QoL). Patients with different thyroid conditions, including benign nodules and various risk levels of DTC, are included for comparison. Participants are grouped into three categories: those with follicular adenomas, those with very low-risk DTC, and those with low to high-risk DTC. The main comparison is between the benign adenoma group and the higher risk DTC group. The study involves serial online neuropsychological testing using the Amsterdam Cognition Scale (ACS) to assess cognitive function over time. During the study, patients complete online cognitive tests and questionnaires about quality of life, physical activity, and psychological and physical symptoms. Blood samples are also analyzed for thyroid hormone levels and markers of systemic inflammation. Cognitive function is evaluated from before surgery up to 12 months after surgery to track changes and outcomes related to thyroid disease and treatment.