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  1. Article ; Online: Can We Predict Long-term Growth of Cytologically Benign Thyroid Nodules?

    Nasr, Christian E

    The Journal of clinical endocrinology and metabolism

    2023  Volume 108, Issue 10, Page(s) e1155–e1156

    MeSH term(s) Humans ; Thyroid Nodule/diagnosis ; Thyroid Neoplasms/diagnosis ; Thyroid Neoplasms/surgery
    Language English
    Publishing date 2023-03-28
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 3029-6
    ISSN 1945-7197 ; 0021-972X
    ISSN (online) 1945-7197
    ISSN 0021-972X
    DOI 10.1210/clinem/dgad160
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  2. Article ; Online: Is a serum TSH measurement sufficient to monitor the treatment of primary hypothyroidism?

    Nasr, Christian

    Cleveland Clinic journal of medicine

    2016  Volume 83, Issue 8, Page(s) 571–573

    Language English
    Publishing date 2016-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639116-3
    ISSN 1939-2869 ; 0891-1150
    ISSN (online) 1939-2869
    ISSN 0891-1150
    DOI 10.3949/ccjm.83a.15165
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  3. Article ; Online: Insulin pumps: Great devices, but you still have to press the button.

    Nasr, Christian

    Cleveland Clinic journal of medicine

    2015  Volume 82, Issue 12, Page(s) 843–845

    MeSH term(s) Humans ; Insulins
    Chemical Substances Insulins
    Language English
    Publishing date 2015-12
    Publishing country United States
    Document type Comment ; Journal Article
    ZDB-ID 639116-3
    ISSN 1939-2869 ; 0891-1150
    ISSN (online) 1939-2869
    ISSN 0891-1150
    DOI 10.3949/ccjm.82a.15047
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  4. Article ; Online: Subclinical hypothyroidism: When to treat.

    Azim, Sidra / Nasr, Christian

    Cleveland Clinic journal of medicine

    2019  Volume 86, Issue 2, Page(s) 101–110

    Abstract: Subclinical hypothyroidism is defined by an elevated serum thyroid-stimulating hormone (TSH) level along with a normal free thyroxine ( ... ...

    Abstract Subclinical hypothyroidism is defined by an elevated serum thyroid-stimulating hormone (TSH) level along with a normal free thyroxine (T
    MeSH term(s) Adult ; Aged ; Clinical Decision-Making ; Female ; Humans ; Hypothyroidism/drug therapy ; Male ; Middle Aged ; Practice Guidelines as Topic ; Thyroxine/therapeutic use
    Chemical Substances Thyroxine (Q51BO43MG4)
    Language English
    Publishing date 2019-02-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 639116-3
    ISSN 1939-2869 ; 0891-1150
    ISSN (online) 1939-2869
    ISSN 0891-1150
    DOI 10.3949/ccjm.86a.17053
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  5. Article ; Online: Correction: Subclinical hypothyroidism.

    Azim, Sidra / Nasr, Christian

    Cleveland Clinic journal of medicine

    2019  Volume 86, Page(s) 392

    Abstract: In Azim S, Nasr C, "Subclinical hypothyroidism: When to treat," Cleve Clin J Med 2019; 86(2):101-110, on page 103, in the section "Subclinical hypothyroidism can resolve or progress," the sentence "The rate of progression to overt hypothyroidism is ... ...

    Abstract In Azim S, Nasr C, "Subclinical hypothyroidism: When to treat," Cleve Clin J Med 2019; 86(2):101-110, on page 103, in the section "Subclinical hypothyroidism can resolve or progress," the sentence "The rate of progression to overt hypothyroidism is estimated to be 33% to 35% over 10 to 20 years of follow-up" contained an error. The correct rate of progression is 33% to 55%. This error has been corrected online.
    Language English
    Publishing date 2019-06-13
    Publishing country United States
    Document type Journal Article ; Published Erratum
    ZDB-ID 639116-3
    ISSN 1939-2869 ; 0891-1150
    ISSN (online) 1939-2869
    ISSN 0891-1150
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  6. Article ; Online: Hürthle cell-predominant thyroid fine needle aspiration cytology: A four risk-factor model highly accurate in excluding malignancy and predicting neoplasm.

    Yuan, Lisi / Nasr, Christian / Bena, James F / Elsheikh, Tarik M

    Diagnostic cytopathology

    2022  Volume 50, Issue 9, Page(s) 424–435

    Abstract: Background: Interpretation of Hürthle cell-predominant cytologies (HCP) is very challenging as a majority is diagnosed as indeterminate. Prior studies have reported various cytologic features to help distinguish non-neoplastic (NN) from neoplastic and ... ...

    Abstract Background: Interpretation of Hürthle cell-predominant cytologies (HCP) is very challenging as a majority is diagnosed as indeterminate. Prior studies have reported various cytologic features to help distinguish non-neoplastic (NN) from neoplastic and malignant lesions but had contradicting results. Our aim was to identify risk factors predictive of neoplasm and/or malignancy by correlating cytologic features with clinical and ultrasound findings.
    Methods: Sixty-nine HCP cases with surgical follow-up were identified, including 35 NN, 20 adenomas, and 14 carcinomas. Ultrasound data were recorded utilizing Thyroid Imaging Reporting and Data System (TI-RADS) and American Thyroid Association (ATA) scoring systems. Sixteen cytologic criteria were evaluated and semi-quantitatively scored. Data were assessed by univariable, multivariable and stepwise logistic regression analysis; and statistical significance achieved at P-value <0.05.
    Results: On univariable analysis, significant predictors of neoplasm were high cellularity, isolated single cells, absent colloid, non-uniform HC population (anisonucleosis), larger nodule size, and higher ATA score. Large-cell dysplasia and transgressing blood vessels were not found to be significant factors. Multivariable analysis identified a combination of four risk factors (high cellularity, anisonucleosis, absent colloid, and size ≥2.9 cm) that was associated with neoplasm in 10/11 patients. None of 15 patients with zero or 1 out of 4 risk factors had malignancy or neoplasm on follow-up. This model also significantly outperformed ATA and TI-RADS scoring systems.
    Conclusion: In the absence of four or three risk factors, the model excluded malignancy and neoplasm in all patients. The presence of all four factors predicted neoplasm and malignancy in 91% and 46% of cases, respectively.
    MeSH term(s) Biopsy, Fine-Needle/methods ; Colloids ; Humans ; Oxyphil Cells/pathology ; Retrospective Studies ; Thyroid Neoplasms/pathology ; Thyroid Nodule/pathology
    Chemical Substances Colloids
    Language English
    Publishing date 2022-06-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632710-2
    ISSN 1097-0339 ; 8755-1039
    ISSN (online) 1097-0339
    ISSN 8755-1039
    DOI 10.1002/dc.25000
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  7. Article ; Online: Advances in Interventional Therapies for Painful Diabetic Neuropathy: A Systematic Review.

    Xu, Li / Sun, Zhuo / Casserly, Elizabeth / Nasr, Christian / Cheng, Jianguo / Xu, Jijun

    Anesthesia and analgesia

    2022  Volume 134, Issue 6, Page(s) 1215–1228

    Abstract: Background: Painful diabetic neuropathy (PDN) is one of the major complications of diabetes mellitus. It is often debilitating and refractory to pharmaceutical therapies. Our goal was to systematically review and evaluate the strength of evidence of ... ...

    Abstract Background: Painful diabetic neuropathy (PDN) is one of the major complications of diabetes mellitus. It is often debilitating and refractory to pharmaceutical therapies. Our goal was to systematically review and evaluate the strength of evidence of interventional management options for PDN and make evidence-based recommendations for clinical practice.
    Methods: We searched PubMed, Scopus, Google Scholar, and Cochrane Llibrary and systematically reviewed all types of clinical studies on interventional management modalities for PDN.
    Results: We identified and analyzed 10 relevant randomized clinical trials (RCTs), 8 systematic reviews/meta-analyses, and 5 observational studies of interventional modalities for PDN using pain as primary outcome. We assessed the risk of bias in grading of evidence and found that there is moderate to strong evidence to support the use of dorsal column spinal cord stimulation (SCS) in treating PDN in the lower extremities (evidence level: 1B+), while studies investigating its efficacy in the upper extremities are lacking. Evidence exists that acupuncture and injection of botulinum toxin-A provide relief in pain or muscle cramps due to PDN with minimal side effects (2B+/1B+). Similar level of evidence supports surgical decompression of lower limb peripheral nerves in patients with intractable PDN and superimposed nerve compression (2B±/1B+). Evidence for sympathetic blocks or neurolysis and dorsal root ganglion (DRG) stimulation is limited to case series (2C+).
    Conclusions: Moderate to strong evidence exists to support the use of SCS in managing lower extremity pain in patients who have failed conventional medical management for PDN. Acupuncture or injection of botulinum toxin-A can be considered as an adjunctive therapy for PDN. Surgical decompression of peripheral nerves may be considered in patients with PDN superimposed with nerve compression. High-quality studies are warranted to further evaluate the safety, efficacy, and cost-effectiveness of interventional therapies for PDN.
    MeSH term(s) Botulinum Toxins ; Diabetes Mellitus ; Diabetic Neuropathies/therapy ; Humans ; Pain ; Pain Management ; Pain Measurement
    Chemical Substances Botulinum Toxins (EC 3.4.24.69)
    Language English
    Publishing date 2022-01-20
    Publishing country United States
    Document type Journal Article ; Systematic Review ; Research Support, N.I.H., Extramural
    ZDB-ID 80032-6
    ISSN 1526-7598 ; 0003-2999
    ISSN (online) 1526-7598
    ISSN 0003-2999
    DOI 10.1213/ANE.0000000000005860
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  8. Article ; Online: PSEUDOHYPONATREMIA IN THE SETTING OF HYPERCHOLESTEROLEMIA.

    El Hage, Lea / Reineks, Edmunds / Nasr, Christian

    AACE clinical case reports

    2018  Volume 5, Issue 2, Page(s) e172–e174

    Abstract: Objective: To describe a case of pseudohyponatremia in the setting of hypercholesterolemia.: Methods: A 69-year-old man was admitted to the hospital after asymptomatic hyponatremia was detected on follow-up blood work for acute, drug-induced ... ...

    Abstract Objective: To describe a case of pseudohyponatremia in the setting of hypercholesterolemia.
    Methods: A 69-year-old man was admitted to the hospital after asymptomatic hyponatremia was detected on follow-up blood work for acute, drug-induced cholestatic hepatitis.
    Results: Plasma sodium (P
    Conclusion: Around two thirds of laboratories in the United States use indirect ISE. Awareness of pseudohyponatremia is important to prevent inappropriate management.
    Language English
    Publishing date 2018-11-01
    Publishing country United States
    Document type Case Reports
    ISSN 2376-0605
    ISSN (online) 2376-0605
    DOI 10.4158/ACCR-2018-0309
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  9. Article ; Online: Should we be concerned about thyroid cancer in patients taking glucagon-like peptide 1 receptor agonists?

    Kannan, Subramanian / Nasr, Christian

    Cleveland Clinic journal of medicine

    2015  Volume 82, Issue 3, Page(s) 142–144

    MeSH term(s) Animals ; Blood Glucose/metabolism ; Contraindications ; Diabetes Mellitus, Experimental ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Glucagon-Like Peptide 1/agonists ; Glucagon-Like Peptide 1/metabolism ; Humans ; Hypoglycemic Agents/therapeutic use ; Metformin/therapeutic use ; Thyroid Neoplasms/complications ; Thyroid Neoplasms/diagnosis ; Thyroid Neoplasms/metabolism
    Chemical Substances Blood Glucose ; Hypoglycemic Agents ; Glucagon-Like Peptide 1 (89750-14-1) ; Metformin (9100L32L2N)
    Language English
    Publishing date 2015-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 639116-3
    ISSN 1939-2869 ; 0891-1150
    ISSN (online) 1939-2869
    ISSN 0891-1150
    DOI 10.3949/ccjm.81a.13066
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  10. Article: Pleural effusion as a novel prognostic factor in metastatic thyroid carcinoma.

    Broome, David T / Gadre, Gauri B / Fayazzadeh, Ehsan / Bena, James F / Nasr, Christian

    Endocrine connections

    2020  Volume 9, Issue 8, Page(s) 812–823

    Abstract: Objective: To identify novel prognostic risk factors and compare them with other known prognostic risk factors in follicular-cell-derived thyroid carcinoma (FDTC) with distant metastases.: Methods: A retrospective review was conducted of adult ... ...

    Abstract Objective: To identify novel prognostic risk factors and compare them with other known prognostic risk factors in follicular-cell-derived thyroid carcinoma (FDTC) with distant metastases.
    Methods: A retrospective review was conducted of adult patients with metastatic FDTC seen at a tertiary care center between January 1990 and December 2010. A 15-year Kaplan-Meier survival estimate was created for overall survival (OS) and cancer-specific survival (CSS). Hazard ratios (HR) and P values from Cox proportional hazard models were used with a 95% CI.
    Results: There were 143 patients (60.1% male, 39.9% female), of whom 104 (72.7%) patients had papillary, 30 (21.0%) had follicular, 5 (3.5%) had poorly differentiated, and 4 (2.8%) had Hürthle cell cancers. Median length of follow-up was 80.0 months (range 1.0-564.0). The 15-year mortality rate was 32.2% and cancer-specific mortality was 25.2%, with OS and CSS having the same risk factors. Lung was the most common site of metastases in 53 patients (37.1%), and patients with pleural effusions had significantly lower CSS (HR = 5.21, CI = 1.79-15.12). Additional risk factors for a decreased CSS included: older age upon diagnosis (>45 years, HR = 4.15, CI = 1.43-12.02), multiple metastatic locations (HR = 3.75, CI = 1.32-10.67), and incomplete/unknown tumor resection (HR = 2.35, CI = 1.18-4.67).
    Conclusion: This study is the first to demonstrate that pleural effusion is a poor prognostic sign in patients with FDTC with distant metastases and compare this risk with other accepted prognostic variables.
    Language English
    Publishing date 2020-07-31
    Publishing country England
    Document type Journal Article
    ZDB-ID 2668428-7
    ISSN 2049-3614
    ISSN 2049-3614
    DOI 10.1530/EC-20-0193
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