Clinical practice guidelines for the management of hypothyroidism
Author
dc.contributor.author
Brenta, Gabriela
Author
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Vaisman, Mario
es_CL
Author
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Sgarbi, José Augusto
es_CL
Author
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Bergoglio, Liliana María
es_CL
Author
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Carvalho de Andrada, Nathalia
es_CL
Author
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Pineda Bravo, Pedro
es_CL
Author
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Orlandi, Ana María
es_CL
Author
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Graf, Hans
es_CL
Admission date
dc.date.accessioned
2014-01-24T13:24:05Z
Available date
dc.date.available
2014-01-24T13:24:05Z
Publication date
dc.date.issued
2013
Cita de ítem
dc.identifier.citation
Arq Bras Endocrinol Metab. 2013;57(4):265-99
en_US
Identifier
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https://repositorio.uchile.cl/handle/2250/129161
General note
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Artículo de publicación ISI
en_US
Abstract
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Introduction: Hypothyroidism has long been known for its effects on different organ systems,
leading to hypometabolism. However, subclinical hypothyroidism, its most prevalent form, has
been recently related to cardiovascular risk and also to maternal-fetal complications in pregnant
women. Objectives: In these clinical practice guidelines, several aspects of this field have been
discussed with the clear objectives of helping physicians treat patients with hypothyroidism,
and of sharing some of our Latin American-based clinical experience. Materials and methods:
The Latin American Thyroid Society commissioned a Task Force on Hypothyroidism to develop
evidence-based clinical guidelines on hypothyroidism. A systematic review of the available literature,
focused on the primary databases of MedLine/PubMed and Lilacs/SciELO was performed.
Filters to assess methodological quality were applied to select the best quality studies. The
strength of recommendation on a scale from A-D was based on the Oxford Centre for Evidence-
-based Medicine, Levels of Evidence 2009, allowing an unbiased opinion devoid of subjective
viewpoints. The areas of interest for the studies comprised diagnosis, screening, treatment and
a special section for hypothyroidism in pregnancy. Results: Several questions based on diagnosis,
screening, treatment of hypothyroidism in adult population and specifically in pregnant
women were posed. Twenty six recommendations were created based on the answers to these
questions. Despite the fact that evidence in some areas of hypothyroidism, such as therapy, is
lacking, out of 279 references, 73% were Grade A and B, 8% Grade C and 19% Grade D. Conclusions:
These evidence-based clinical guidelines on hypothyroidism will provide unified criteria
for management of hypothyroidism throughout Latin America. Although most of the studies
referred to are from all over the world, the point of view of thyroidologists from Latin America
is also given.