Medical Review Board

Thyrotoxicosis Linked To Risk For Incident Cognitive Disorder

For older adults, exposure to a low thyrotropin (TSH) level from either endogenous or exogenous thyrotoxicosis is associated with an increased risk for incident cognitive disorder, according to a study recently published in JAMA Internal Medicine.

Roy Adams, Ph.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a cohort study to examine whether thyrotoxicosis is associated with an increased risk for cognitive disorders. Patients aged 65 years and older with at least two visits to their primary care physicians 30 days apart were eligible; the analysis included 65,931 patients. The exposure variable was low TSH level, characterized based on the clinical context as due to endogenous thyrotoxicosis, exogenous thyrotoxicosis, or unknown cause.

The researchers found that the incidence of cognitive disorder was 11.0 and 6.4 percent by age 75 years for patients exposed and not exposed, respectively, to thyrotoxicosis. Across age groups, all-cause thyrotoxicosis was associated with the risk for cognitive disorder diagnosis after adjustment (adjusted hazard ratio, 1.39). Exogenous thyrotoxicosis remained a significant risk factor when stratified by cause and severity (adjusted hazard ratio, 1.34), with point estimates indicating a dose response.

"An increased risk of cognitive disorders is among the potential negative consequences of thyroid hormone excess, a common consequence of thyroid hormone treatment," the authors write.

One author disclosed ties to the biopharmaceutical industry.

More information: Roy Adams et al, Endogenous and Exogenous Thyrotoxicosis and Risk of Incident Cognitive Disorders in Older Adults, JAMA Internal Medicine (2023). DOI: 10.1001/jamainternmed.2023.5619

Maria Papaleontiou et al, Disentangling the Association Between Excess Thyroid Hormone and Cognition in Older Adults, JAMA Internal Medicine (2023). DOI: 10.1001/jamainternmed.2023.5618

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Johns Hopkins University Names New CEO Of Hopkins Medicine And Dean Of School Of Medicine

Johns Hopkins University Friday announced that Dr. Theodore L. DeWeese, who has been interim dean for the School of Medicine and interim CEO of Johns Hopkins Medicine since 2022, will take over the positions on a permanent basis.

DeWeese, who joined Johns Hopkins hospital as a radiation oncology resident in 1991, was appointed to the leadership roles on a temporary basis following the retirement of Paul B. Rothman. In a news release from the university, DeWeese expressed gratitude for his official appointment and a dedication to the health system's goals of advancing health care and changing lives, both around the world and locally in Baltimore.

Theodore L. DeWeese has been named the dean of the Johns Hopkins University School of Medicine and chief executive officer of Johns Hopkins Medicine. (Courtesy of Johns Hopkins)

"We are intent on cultivating diverse perspectives and engaging those who have been underrepresented in medicine and science, so that we can achieve health equity for the most vulnerable populations," DeWeese said in the release. "Johns Hopkins Medicine is a beacon globally, nationally, and locally for medical and biomedical discovery, outstanding patient care, and innovative medical education, and it is thrilling to be given the opportunity and responsibility of leading such a revered and impactful institution."

Johns Hopkins University Provost Ray Jayawardhana, who co-led the search for the new dean and CEO, described DeWeese as "by far the strongest candidate all around."

After joining the hospital as a resident, the doctor went on to become founding director of the School of Medicine's Department of Radiation Oncology. In 2018, he became the vice dean of clinical affairs, before becoming interim dean of the medical school and CEO of the health system in July 2022.

"In addition to his tremendous institutional knowledge and a deep commitment to seeing the essential transformation through to success, Ted combines savvy implementation with a willingness to pursue bold moves to sustain Johns Hopkins Medicine's preeminence," Jayawardhana said in the news release.

As CEO of Johns Hopkine Medicine, DeWeese leads a network that employs more than 40,000 people and operates six hospitals, 39 outpatient primary health care sites, and multiple suburban health care and surgery centers across three states and Washington, D.C. He also is responsible for steering a globally renowned center for research and academic medicine in his role as medical school dean, according to Friday's news release.

DeWeese grew up in public housing in Denver, according to the news release, and said he never expected to go to college, let alone lead Johns Hopkins Medicine. In the coming months, he will embark on a listening tour to develop priorities for the health network's future while working together with faculty, staff, students, patients and members of communities served by Johns Hopkins Medicine.

"What sets Johns Hopkins Medicine apart is our people: We are a global community of researchers, clinicians, staff, and students dedicated to providing exceptional care and pushing the boundaries of science and medicine," DeWeese said in the news release. "It is my honor to help sustain and grow Johns Hopkins as a leading voice for human health. And I am thoroughly confident we will achieve that goal."

In the coming years, DeWeese will preside over the renewal and modernization of Johns Hopkins Medicine's facilities, including the development of a new Life Sciences Corridor. A 12-story research tower is currently under construction at the site of the former Johns Hopkins Hospital Children's Medical and Surgical Center, which will house the Health Sciences, including basic science, translation and computational biology labs. The first wing of the building is slated to open next year, the news release said.

Ron Daniels, president of Johns Hopkins University, said in the release that Johns Hopkins Medicine could not ask for a better leader.

"Ted embodies the ideal of a servant leader," Daniels said. "For nearly 30 years, from his residency onward, Ted has served Johns Hopkins with high standards, bold vision, deep understanding of medicine, a joy in discovery, and a palpable love of this place and the exceptional people who make this institution.  He is as capable of navigating difficult business challenges as he is pursuing pathbreaking research and caring for patients, their families, and his colleagues."

This article has been updated to correct that Ron Daniels is president of Johns Hopkins University. The Sun regrets the error.

CAIR Calls For Firing Of Hopkins Doctor After Social Media Comments

The Council on American Islamic Relations held a news conference Tuesday calling for the firing of a doctor at Johns Hopkins Hospital.CAIR took issue with comments Dr. Darren Klugman made on social media regarding the Israel-Hamas war. The council also wants the Maryland Board of Physicians to revoke his license."Dr. Klugman's role requires him to care for all children. His views tell us he views Palestinian children as subhuman. These words reflect hate," CAIR Maryland director Zainab Chaudry.Chaudry is has come under fire for her own social media posts. She was temporarily suspended from the Commission on Hate Crime Response and Prevention."I categorically and unequivocally reject any allegations of antisemitism," she said.Some are standing by Klugman. An online petition has thousands of signatures. The petition says, "Dr. Klugman posted several strongly worded tweets on Oct. 7 and 8," when Hamas attacks in Israel were still ongoing.Klugman is currently on administrative leave from his duties as director of the Pediatric Cardiac Critical Care Unit at Hopkins."I am appalled that Johns Hopkins would employ such an individual," one woman said.The woman, who did not share her name, is the mother of a 14-month-old boy with a congenital heart condition. She said she isn't sure if Klugman has had any contact with her son, but she knows it is a possibility. She said she will no longer seek care at the hospital as long as he is employed there."As a parent, I want the very best medical care for my baby which is why we chose Hopkins in the first place. On top of those fears of what could go wrong during his surgery, to know that Hopkins is knowingly employing a doctor who has such hateful and radical views about an entire group of people brings doubts to my mind about their ability to give my child the very best care possible," she said.Johns Hopkins Medicine released a statement Tuesday afternoon, saying in part, "The faculty member who made these statements has been placed on leave (and thus will have no interaction with students or patients) while we conduct a thorough investigation under our policies and procedures. "Johns Hopkins Medicine and Johns Hopkins University are committed to providing a safe and inclusive environment for working, learning and patient care for every member of our community and all those we serve. Statements that explicitly threaten or extol violence against groups or individuals on the basis of national origin, race or religion violate our policies and do not represent our values."

BALTIMORE —

The Council on American Islamic Relations held a news conference Tuesday calling for the firing of a doctor at Johns Hopkins Hospital.

CAIR took issue with comments Dr. Darren Klugman made on social media regarding the Israel-Hamas war. The council also wants the Maryland Board of Physicians to revoke his license.

"Dr. Klugman's role requires him to care for all children. His views tell us he views Palestinian children as subhuman. These words reflect hate," CAIR Maryland director Zainab Chaudry.

Chaudry is has come under fire for her own social media posts. She was temporarily suspended from the Commission on Hate Crime Response and Prevention.

"I categorically and unequivocally reject any allegations of antisemitism," she said.

Some are standing by Klugman. An online petition has thousands of signatures. The petition says, "Dr. Klugman posted several strongly worded tweets on Oct. 7 and 8," when Hamas attacks in Israel were still ongoing.

Klugman is currently on administrative leave from his duties as director of the Pediatric Cardiac Critical Care Unit at Hopkins.

"I am appalled that Johns Hopkins would employ such an individual," one woman said.

The woman, who did not share her name, is the mother of a 14-month-old boy with a congenital heart condition. She said she isn't sure if Klugman has had any contact with her son, but she knows it is a possibility. She said she will no longer seek care at the hospital as long as he is employed there.

"As a parent, I want the very best medical care for my baby which is why we chose Hopkins in the first place. On top of those fears of what could go wrong during his surgery, to know that Hopkins is knowingly employing a doctor who has such hateful and radical views about an entire group of people brings doubts to my mind about their ability to give my child the very best care possible," she said.

Johns Hopkins Medicine released a statement Tuesday afternoon, saying in part, "The faculty member who made these statements has been placed on leave (and thus will have no interaction with students or patients) while we conduct a thorough investigation under our policies and procedures.

"Johns Hopkins Medicine and Johns Hopkins University are committed to providing a safe and inclusive environment for working, learning and patient care for every member of our community and all those we serve. Statements that explicitly threaten or extol violence against groups or individuals on the basis of national origin, race or religion violate our policies and do not represent our values."

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