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Prague, Czech Republic

The increased number of obese patients, and the increasing degree of obesity in them neccessitates better awarenes of therapeutic options by doctors of all specialities. Presented article summarises current approach to treating obesity, starting with lifestyle modificiations, ie. change in diet and improvement in exercise patterns, discusses pharmacotherapeutic modalities, either registered in the Czech republic, or imported individually, and concludes with a brief summary of surgical treatments in form of bariatric surgery.

Potlukova E.,III. Interni Klinika VFN | Jiskra J.,III. Interni Klinika VFN | Telicka Z.,III. Interni Klinika VFN | Bartakova J.,III. Interni Klinika VFN | Springer D.,Ustav Klinicke Biochemie A Laboratorni Diagnostiky VFN
Diabetologie Metabolismus Endokrinologie Vyziva | Year: 2011

Introduction: The utility of screening for antibodies against thyroperoxidase (TPOAb) in early pregnancy remains controversial. The aim of our study was to examine the thyroid function of initially euthyroid TPOAb+ women at a longer period after delivery. Methods: We invited 822 women screened positive for thyroid disorders in the first trimester of pregnancy for follow-up. This included measurement of thyroid-stimulating hormone (TSH), free thyroxine (FT4), TPOAb and filling of a detailed questionnaire. Results: 189 (23 %) of invited women joined the study. Of these, 100 were TPOAb+ and initially euthyroid in pregnancy. Only 48 % of all TPOAb+ women had a positive family history for thyroid disorders. Median time between delivery and follow-up reached 22 months. At follow-up, 13 % of the initially euthyroid TPOAb+ women had TSH below 0,37 mU/l, 15 % had TSH between 4 and 10 mU/l; and 8 % had TSH above 10 mU/l. Thirty-five percent of those women who were never treated for thyroid disorders developed thyroid dysfunction at the follow-up. Surprisingly, 29 % of women who were currently treated had TSH outside of the normal range at the time of follow-up. Conclusion: More than one third of TPOAb+ women euthyroid in early pregnancy have TSH outside of the normal range at 22 months after delivery. TPOAb+ women after delivery should be closely monitored even if they are euthyroid during pregnancy.

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