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Graves disease may rarely subside spontaneously and may even result in spontaneous hypothyroidism However, it usually persists The ocular, cardiac, and psychological complications can become very serious and persistent even after treatment Permanent hypoparathyroidism and vocal cord palsy are risks of surgical thyroidectomy Recurrences are common following thiourea therapy but also occur after lowdose 131I therapy or subtotal thyroidectomy With adequate treatment and long-term follow-up, the results are usually good However, despite treatment for their hyperthyroidism, women experience an increased long-term risk of death from thyroid disease, cardiovascular disease, stroke, and fracture of the femur Posttreatment hypothyroidism is common It may occur within a few months or up to several years after RAI therapy or subtotal thyroidectomy Malignant exophthalmos has a poor prognosis unless treated aggressively

In Main! Calling SomeMethod( )... Greetings from SomeMethod! Back in Main( ).

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of age in the United States, elevated levels of antithyroid antibodies are found in 143% of whites, 109% of MexicanAmericans, and 53% of blacks Subclinical thyroiditis is extremely common, as evidenced in autopsy series that have found focal thyroiditis in about 40% of women and 20% of men However, only 1% of the population has serum antithyroid antibody titers greater than 1:6400 Hashimoto s thyroiditis tends to be familial and is six times more common in women than in men Its frequency is increased by dietary iodine supplementation Certain drugs (amiodarone, interferon- , interferon- , interleukin-2, GCSF) frequently induce thyroid autoantibodies Childhood or occupational exposure to head neck external beam radiation increases the lifetime risk of Hashimoto s thyroiditis Hashimoto s thyroiditis often progresses to hypothyroidism, which is usually permanent, remitting in less than 5% of cases The development of hypothyroidism may be linked to thyrotropin receptor blocking antibodies, which are detected in 10% of patients with Hashimoto s thyroiditis Among patients with Hashimoto s thyroiditis, hypothyroidism is more likely to develop in smokers than in nonsmokers, possibly due to the thiocyanates found in cigarette smoke High serum levels of thyroid peroxidase antibody also predict progression from subclinical hypothyroidism to symptomatic hypothyroidism Uncommonly, Hashimoto s thyroiditis causes acute destruction of thyroid tissue and release of stored thyroid hormone, causing transient thyrotoxicosis Rarely, a hypofunctioning gland may become hyperfunctioning with the onset of coexistent Graves disease; in patients with Graves disease, Hashimoto s thyroiditis is usually present concurrently

Subclinical hyperthyroidism refers to asymptomatic individuals with a low serum TSH and normal FT4 and T3 Such patients generally do not progress to overt thyrotoxicosis However, they may be at some increased risk for bone loss, so bone densitometry is performed periodically In persons over age 60 years, serum TSH is very low (< 01 mU/L) in 3% and mildly low (01 04 mU/L) in 9% The chance of developing atrial fibrillation is 28% yearly in elderly patients with very low TSH and 11% yearly in those with mildly low TSH Asymptomatic persons with very low TSH are monitored closely but are not treated unless atrial fibrillation or other manifestations of hyperthyroidism develop

unified access to memory and to files. At the start, moreover, he and the rest of us deferred another pioneering (though not original) element of Multics, namely writing almost exclusively in a higher-level language. PL/I, the implementation language of Multics, was not much to our tastes, but we were also using other languages, including BCPL, and we regretted losing the advantages of writing programs in a language above the level of assembler, such as ease of writing and clarity of understanding. At the time we did not put much weight on portability; interest in this arose later. (Ritchie 1993, 2)

Azizi F et al Effect of long-term continuous methimazole treatment of hyperthyroidism: comparison with radioiodine Eur J Endocrinol 2005 May;152(5):695 701 [PMID: 15879354] Chi SY et al A prospective, randomized comparison of bilateral subtotal thyroidectomy versus unilateral total and contralateral subtotal thyroidectomy for Graves disease World J Surg 2005 Feb;29(2):160 3 [PMID: 15650802] Cooper DS Antithyroid drugs N Engl J Med 2005 Mar 3;352 (9):905 17 [PMID: 15745981] Kahaly GJ et al Randomized, single blind trial of intravenous versus oral steroid monotherapy in Graves orbitopathy J Clin Endocrinol Metab 2005 Sep;90(9):5234 40 [PMID: 15998777] McKeown NJ et al Hyperthyroidism Emerg Med Clin North Am 2005 Aug;23(3):669 85 [PMID: 15982540] Migneco A et al Management of thyrotoxic crisis Eur Rev Med Pharmacol Sci 2005 Jan Feb;9(1):69 74 [PMID: 15850146] Woeber KA Observations concerning the natural history of subclinical hyperthyroidism Thyroid 2005 Jul;15(7):687 91 [PMID: 16053385]

Each method in this example outputs a handy message to indicate where the execution is. The program flow begins in Main( ) and proceeds until SomeMethod( ) is invoked. (Invoking a method is often referred to as calling the method.) At that point, program flow branches to the method. When the method completes, program flow resumes at the next line after the call to that method.

Swelling of thyroid gland, sometimes causing pressure symptoms in acute and subacute forms; painless enlargement and rubbery firmness in chronic form Thyroid function tests variable Serum antithyroperoxidase and antithyroglobulin antibody levels usually elevated in Hashimoto s thyroiditis

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