High plasma high-density lipoprotein levels, very low cardiovascular risk profile, and subclinical carotid atherosclerosis in postmenopausal women
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Subclinical infection
High-density lipoprotein
Intima-media thickness
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It is generally easy to diagnose and treat patients with thyroid diseases, though there has been considerable uncertainty over whether or not to treat patients with subclinical disease.An overview of clinical symptoms and complications related to subclinical thyroid disease is presented on the basis of relevant literature.Patients with subclinical hypothyreosis (elevated TSH level and normal free T4) may benefit from treatment with thyroxine in relation to well-being, serum lipid levels, and possibly also blood pressure. Patients with subclinical hyperthyreosis (suppressed TSH level and normal free T4) have an increased risk of developing atrial fibrillation and possibly also dementia.Subclinical thyroid disease is usually progressive. If a transient condition is ruled out, proper treatment should not be delayed.
Subclinical infection
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Subclinical infection
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Background Symptoms of subclinical hypothyroidism include depression, memory loss, myocardial contractility disorder, lipid metabolic disorder, and atherosclerosis. However, the relationship between subclinical hypothyroidism and depression has not been consistent. Therefore, the purpose of this study was to provide the scientific evidence for the relationship between subclinical hypothyroidism and depression. Methods This study was a meta-analysis of depression in subjects with subclinical hypothyroidism. The search engine of PubMed, EBSCO, ScienceDirect, and RISS was used to search the studies published since the 1990s. A total of 176 documents were retrieved from the literature search, and finally 10 studies were included in the analysis. Statistical analysis of effect sizes was performed using Comprehensive Meta-Analysis software version 2.2.064. Results Of the 10 studies, five studies reported that depression was associated with subclinical hypothyroidism. Two of these studies were on women and two were on the elderly. The effect size of depression in patients with subclinical hypothyroidism was 3.46 (95% confidence interval 0.20–0.74, P=0.001), and the subclinical hypothyroidism was significantly associated with depression. Conclusions This study showed that subclinical hypothyroidism is associated with depression. The results also suggest the need for regular screening of depressive symptoms of patients with subclinical hypothyroidism. Especially, elderly and women with subclinical hypothyroidism may be the main targets of depressive symptom.
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Objective To study the relationship between subclinical epileptiformdischarge and transitory cognitive impairment, Methods BM800 AEEG Was used to analyse subclinical epileptiformdischarge of 8 patients from August, 1998 to March, 2002. Results The results indicate that 8 patients suffered from subclinical epilep- tiformdischange are all accompanied with TCI. Conclusion The result is show that subclinical epileptifor- mdischarge is connected with TCI. It is necessary to inspecte by AEEG the patients who have difficulties to study but have not obvious symptoms, subclinical.
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Hypertension is a major risk factor for cardiovascular disease, particularly coronary heart disease. Risk increases with the severity of hypertension, irrespective of age or sex. However, the absolute risk is greatest in the elderly, for whom isolated systolic hypertension is particularly important. Hypertension is often accompanied by other risk factors. For example, the levels of cholesterol and high- and low-density lipoproteins are important. Diabetes increases the risk of cardiovascular disease at any level of blood pressure. Smoking increases the risk from hypertension and stopping smoking can dramatically reduce risk. A raised heart rate increases the risk of coronary events in both hypertensive and normotensive patients. However, heart rates tend to be higher in hypertensive patients. Left ventricular hypertrophy combined with hypertension increases the risk of coronary heart disease. An elevated level of fibrinogen increases the risk of cardiovascular disease in both hypertensive and normotensive patients, though the risk is greater at higher blood pressures. Cardiovascular risk profiles have been constructed to identify patients at high risk.
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Objective To analyze the variety and clinic signification of lipids in patients with subclinical hypothyr oidism. Methods The levels of TSH,FT3,FT4,TC,TG,LDL-C,HDL-C in 52 subclinical hypothyroidism patients,60 controls and 55clinical hypothyroidism patients were determined and compared. Results Compared with the control the levels of LDL-C,TSH in clinical hypothyroidism and subclinical hypothyroidism patiens were higher (P0.01); the levels of FT4,TC, TG in clinical hypothyroidism patients were higher (P0.01). The level of TC in subclinical hypothyroidism patiens and FT3 in clinical hypothyroidism patients was higher (P0.05). Compared with subclinical hypothyroidism,the levels of FT4,TC, TG,TSH、FT3 in clinical hypothyroidism patiens was higher (P 0.01 or P 0.05). Conclusion The level of lipids in subclinical hypothyroidism patients is abnormal and it amy be close to clinical hypothyroidism.
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Subclinical hypothyroidism and hyperthyroidism are diagnoses based on laboratory evaluation with few if any clinical signs or symptoms. Subclinical hypothyroidism is defined as an elevation in serum thyroid-stimulating hormone (TSH) above the upper limit of the reference range (0.45-4.5 mIU/L) with normal serum FT4 concentration; subclinical hyperthyroidism is defined as a decrease in serum TSH below the reference range with normal serum FT4 and T3 concentrations. Though these conditions represent the earliest stages of thyroid dysfunction, the benefits of detecting and treating subclinical thyroid disease are not well established. Most persons found to have subclinical thyroid disease will have TSH values between 0.1 and 0.45 mIU/L or between 4.5 and 10 mIU/L, for which the benefits of treatment are not clearly established; treatment may be beneficial in individuals with serum TSH lower than 0.1 mIU/L or higher than 10 mIU/L. This article illustrates approaches to managing patients with subclinical hypothyroidism and hyperthyroidism through 5 case scenarios that apply the principles of evidence-based medicine. Because of the substantial uncertainty concerning the consequences of untreated subclinical hypothyroidism and hyperthyroidism, as well as the benefit of initiating treatment, patient preferences are important in deciding on management of subclinical disease.
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Carotid intima media thickness (cIMT) is an intermediate phenotype of early atherosclerosis that independently predicts vascular events. It is often suggested that cIMT be used as a screening tool to select subjects with an elevated event risk. Whether cIMT adds information to traditional risk models has so far received little investigation.The 10-year follow-up of 4904 subjects from the Carotid Atherosclerosis Progression Study (CAPS) without pre-existing vascular disease included cardiovascular events and total mortality. Using Cox models and reclassification statistics, we investigated the usefulness of cIMT in individual risk prediction beyond the Framingham and the SCORE models, using risk strata of 0-5, 5-10, 10-20, and >or=20% over 10 years. Carotid intima media thickness was significantly and independently predictive for cardiovascular events. Compared with a model using the Framingham risk factors, a second model that included the common carotid-IMT led to the reclassification of 357 subjects (8.1%). In 107 subjects (30.0%), this reclassification was correct as confirmed with the actual outcome over 10 years. Net reclassification improvement was -1.41% (P = NS); integrated discrimination improvement was 0.04% (P = NS). More subjects were shifted to lower than to higher risk categories by the inclusion of cIMT. Analyses including other endpoint definitions, other carotid segments, and the SCORE risk model for baseline prediction did not result in consistently better risk prediction with cIMT.Despite cIMT being predictive for cardiovascular endpoints, it did not consistently improve the risk classification of individuals. Carotid intima media thickness may not be useful for the risk stratification of individuals in the general population.
Intima-media thickness
Surrogate endpoint
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