Christian Elias Nasr

Interests

No activities entered.

Courses

No activities entered.

Scholarly Contributions

Journals/Publications

• Petersen, E. A., Stauss, T. G., Scowcroft, J. A., Jaasma, M. J., Edgar, D. R., White, J. L., Sills, S. M., Amirdelfan, K., Guirguis, M. N., Xu, J., Yu, C., Nairizi, A., Patterson, D. G., Creamer, M. J., Galan, V., Bundschu, R. H., Mehta, N. D., Sayed, D., Lad, S. P., , DiBenedetto, D. J., et al. (2026). High-Frequency 10-kHz Spinal Cord Stimulation Provides Long-term (24-Month) Improvements in Diabetes-Related Pain and Quality of Life for Patients with Painful Diabetic Neuropathy. Journal of diabetes science and technology, 20(1), 124-133.
  More info

  The SENZA-PDN study evaluated high-frequency 10-kHz spinal cord stimulation (SCS) for the treatment of painful diabetic neuropathy (PDN). Over 24 months, 10-kHz SCS provided sustained pain relief and improved health-related quality of life. This report presents additional outcomes from the SENZA-PDN study, focusing on diabetes-related pain and quality of life outcomes.
• Bauzon, J., Ponce de Leon-Ballesteros, G., Lincango, E., Medina-Franco, H., Perez-Soto, R., Lashin, O., Geiger, J. L., Nasr, C., Shin, J., Siperstein, A., & Romero-Velez, G. (2025). Neoadjuvant Therapy with Multikinase Inhibitors for Locally Advanced Differentiated Thyroid Cancer: A Systematic Review. Thyroid : official journal of the American Thyroid Association, 35(10), 1108-1119.
  More info

  The use of multikinase inhibitors (MKIs) in thyroid cancer has been established to downsize and facilitate resection of poorly differentiated, differentiated high-grade, anaplastic, and medullary thyroid cancer. Case reports and case series have suggested the potential use of MKIs as neoadjuvant therapies for locally advanced differentiated thyroid cancer (DTC). Our objective was to review available studies and assess if neoadjuvant therapy with MKI can improve surgical and oncological outcomes in patients with locally advanced DTC. A systematic search of four different databases (PubMed, Cochrane Library, Scopus, and EMBASE) with no time restrictions was performed to identify relevant observational studies evaluating patients with locally advanced DTC who received neoadjuvant therapy before surgery with MKI (PROSPERO ID: CRD420251012812). A total of 119 participants from 23 observational studies (12 case reports, 9 case series, and 2 prospective phase II studies) were included. Lenvatinib was the most frequently used MKI, followed by sorafenib. Tumor volume reduction ranged from 25% to 87%, and partial response rates ranged between 33.3% and 76.9%, whereas progressive disease was described only in seven cases. Of 114 patients with inoperable or potentially resectable tumors with associated high perioperative morbidity, 95 (83.3%) were able to undergo surgery. Neoadjuvant MKIs in locally advanced DTC may improve resection rates. The overall low quality of evidence prompts further prospective studies to confirm these findings.
• Dickerson, K., Milas, M., Metzger, R., Tomeh, C., Shellenberger, T., Ahmad, I., Hebert, M., Nasr, C., Nelson, J. A., Westfall, E., Eisen, R., & Niu, J. (2025). Neoadjuvant systemic therapy for inoperable differentiated thyroid cancers: Impact on tumor resectability. Surgery, 177, 108836.
  More info

  Limited treatment options exist for inoperable thyroid cancers. We evaluated whether neoadjuvant use of systemic tyrosine kinase inhibitors facilitates surgery of differentiated thyroid cancers in this challenging context.
• Vincent, A. B., Engelmann, A. R., Hwang, C. J., & Nasr, C. (2025). Thyroid eye disease: What's the latest?. Cleveland Clinic journal of medicine, 92(11), 693-701.
  More info

  Thyroid eye disease (TED) is an inflammatory autoimmune condition now recognized as being associated not only with Graves hyperthyroidism but also with euthyroidism and hypothyroidism. A high index of suspicion is required to diagnose TED and to recognize sight-threatening disease. Care is best provided in a multidisciplinary setting among primary care clinicians, endocrinologists, and ophthalmologists. This review summarizes the pathophysiology, risk factors, clinical presentation, and activity and severity evaluation of TED as well as the most recent advances in its treatment.
• Klonoff, D. C., Levy, B. L., Jaasma, M. J., Bharara, M., Edgar, D. R., Nasr, C., Caraway, D. L., Petersen, E. A., & Armstrong, D. G. (2024). Treatment of Painful Diabetic Neuropathy with 10 kHz Spinal Cord Stimulation: Long-Term Improvements in Hemoglobin A1c, Weight, and Sleep Accompany Pain Relief for People with Type 2 Diabetes. Journal of pain research, 17, 3063-3074.
  More info

  The recent SENZA-PDN study showed that high-frequency (10kHz) spinal cord stimulation (SCS) provided significant, durable pain relief for individuals with painful diabetic neuropathy (PDN), along with secondary benefits, including improved sleep quality and HRQoL. Given that metabolic factors and chronic neuropathic pain are related, we evaluated potential secondary effects of 10kHz SCS on hemoglobin A1c (HbA1c) and weight in SENZA-PDN participants with type 2 diabetes (T2D).
• Nasr, C. E. (2023).

  Can one predict long-term growth of cytologically-benign thyroid nodules?

  . The Journal of Clinical Endocrinology & Metabolism, 108(10), e1155-e1156. doi:10.1210/clinem/dgad160
• Nasr, C. E. (2023). Can We Predict Long-term Growth of Cytologically Benign Thyroid Nodules?. The Journal of clinical endocrinology and metabolism, 108(10), e1155-e1156.
• Petersen, E. A., Stauss, T. G., Scowcroft, J. A., Jaasma, M. J., Brooks, E. S., Edgar, D. R., White, J. L., Sills, S. M., Amirdelfan, K., Guirguis, M. N., Xu, J., Yu, C., Nairizi, A., Patterson, D. G., Tsoulfas, K. C., Creamer, M. J., Galan, V., Bundschu, R. H., Mehta, N. D., , Sayed, D., et al. (2023). Long-term efficacy of high-frequency (10 kHz) spinal cord stimulation for the treatment of painful diabetic neuropathy: 24-Month results of a randomized controlled trial. Diabetes research and clinical practice, 203, 110865.
  More info

  To evaluate the long-term efficacy of high-frequency (10 kHz) spinal cord stimulation (SCS) for treating refractory painful diabetic neuropathy (PDN).
• Wu, S. S., Joshi, N., Sharrett, J., Rao, S., Shah, A., Scharpf, J., Burkey, B., Lamarre, E. D., Prendes, B., Siperstein, A., Shin, J., Berber, E., Jin, J., Krishnamurthi, V., Nasr, C., Hong, L., Buchberger, D. S., Woody, N., Koyfman, S. A., & Geiger, J. L. (2023). Risk Factors Associated With Recurrence and Death in Patients With Tall Cell Papillary Thyroid Cancer: A Single-Institution Cohort Study With Predictive Nomogram. JAMA otolaryngology-- head & neck surgery, 149(1), 79-86.
  More info

  Tall cell morphology (TCM) is a rare and aggressive variant of papillary thyroid carcinoma (PTC) that has been associated with poor outcomes; however, the risk factors for worse survival are not well characterized.
• Wu, S. S., Lamarre, E. D., Yalamanchali, A., Brauer, P. R., Hong, H., Reddy, C. A., Yilmaz, E., Woody, N., Ku, J. A., Prendes, B., Burkey, B., Nasr, C., Skugor, M., Heiden, K., Chute, D. J., Knauf, J. A., Campbell, S. R., Koyfman, S. A., Geiger, J. L., & Scharpf, J. (2023). Association of Treatment Strategies and Tumor Characteristics With Overall Survival Among Patients With Anaplastic Thyroid Cancer: A Single-Institution 21-Year Experience. JAMA otolaryngology-- head & neck surgery, 149(4), 300-309.
  More info

  Survival outcomes for anaplastic thyroid cancer (ATC), the most aggressive subtype of thyroid cancers, have remained poor. However, targeted therapies and immunotherapies present new opportunities for treatment of this disease. Evaluations of survival outcomes over time with new multimodal therapies are needed for optimizing treatment plans.
• Zimmer, D., Plitt, G., Prendes, B., Ku, J., Silver, N., Lamarre, E., Yilmaz, E., Geiger, J., Nasr, C., El Hage, L., Skugor, M., Cambpell, S., Koyfman, S., Miller, J., Woody, N., Heiden, K., Joshi, N., Elsheikh, T., Li, H., & Scharpf, J. (2023). Utilizing Dynamic Risk Stratification in Patients With Tall Cell Variant Papillary Thyroid Cancer. The Laryngoscope, 133(9), 2430-2438.
  More info

  Tall cell variant (TCV) papillary thyroid cancer (PTC) is a subtype of PTC associated with aggressive tumor behavior, advanced stage, and higher rates of recurrence and mortality. The present study aimed to test an established dynamic risk stratification tool in the TCV population, with the goal of better predicting the postoperative course of these patients.
• Kunte, S., Sharett, J., Wei, W., Nasr, C., Prendes, B., Lamarre, E., Ku, J., Lorenz, R. R., Scharpf, J., Burkey, B. B., Shah, A., Joshi, N., & Geiger, J. L. (2022). Poorly Differentiated Thyroid Carcinoma: Single Institution Series of Outcomes. Anticancer research, 42(5), 2531-2539.
  More info

  Poorly differentiated thyroid cancer (PDTC) is a rare but aggressive subtype of thyroid cancer that portends a poor prognosis. There remains a paucity of literature on PDTC outcomes. The aim of our study was to evaluate outcomes of PDTC in our tertiary care facility.
• Nasr, C. E., Andrioli, M., Endo, M., Harrell, R. M., Livhits, M. J., Osakwe, I., Polavarapu, P., Siperstein, A., Wei, S., Zheng, X., Jiang, R., Hao, Y., Huang, J., Klopper, J. P., Kloos, R. T., Kennedy, G., & Angell, T. E. (2022). Real World Performance of The Afirma Genomic Sequencing Classifier (GSC) - A Meta-analysis. The Journal of clinical endocrinology and metabolism.
  More info

  The Afirma® GSC aids in risk stratifying indeterminate thyroid nodule cytology (ITN). The 2018 GSC validation study (VS) reported a sensitivity (SN) of 91%, specificity (SP) of 68%, positive predictive value (PPV) of 47%, and negative predictive value (NPV) of 96%. Since then, 13 independent real world (RW) post-validation studies have been published.
• Petersen, E. A., Stauss, T. G., Scowcroft, J. A., Brooks, E. S., White, J. L., Sills, S. M., Amirdelfan, K., Guirguis, M. N., Xu, J., Yu, C., Nairizi, A., Patterson, D. G., Tsoulfas, K. C., Creamer, M. J., Galan, V., Bundschu, R. H., Mehta, N. D., Sayed, D., Lad, S. P., , DiBenedetto, D. J., et al. (2022). Durability of High-Frequency 10-kHz Spinal Cord Stimulation for Patients With Painful Diabetic Neuropathy Refractory to Conventional Treatments: 12-Month Results From a Randomized Controlled Trial. Diabetes care, 45(1), e3-e6.
• Petersen, E. A., Stauss, T. G., Scowcroft, J. A., Brooks, E. S., White, J. L., Sills, S. M., Amirdelfan, K., Guirguis, M. N., Xu, J., Yu, C., Nairizi, A., Patterson, D. G., Tsoulfas, K. C., Creamer, M. J., Galan, V., Bundschu, R. H., Mehta, N. D., Sayed, D., Lad, S. P., , DiBenedetto, D. J., et al. (2022). High-Frequency 10-kHz Spinal Cord Stimulation Improves Health-Related Quality of Life in Patients With Refractory Painful Diabetic Neuropathy: 12-Month Results From a Randomized Controlled Trial. Mayo Clinic proceedings. Innovations, quality & outcomes, 6(4), 347-360.
  More info

  To evaluate high-frequency (10-kHz) spinal cord stimulation (SCS) treatment in refractory painful diabetic neuropathy.
• Xu, L., Sun, Z., Casserly, E., Nasr, C., Cheng, J., & Xu, J. (2022). Advances in Interventional Therapies for Painful Diabetic Neuropathy: A Systematic Review. Anesthesia and analgesia, 134(6), 1215-1228.
  More info

  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.
• Yuan, L., Nasr, C., Bena, J. F., & Elsheikh, T. M. (2022). Hürthle cell-predominant thyroid fine needle aspiration cytology: A four risk-factor model highly accurate in excluding malignancy and predicting neoplasm. Diagnostic cytopathology, 50(9), 424-435.
  More info

  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.
• Buehler, L. A., Madhun, N. Z., Bena, J., Nasr, C., Scharpf, J., & Zhou, K. (2021). Hormonal Outcomes Following Hemithyroidectomy. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 164(5), 1011-1018.
  More info

  To assess hormonal outcomes and thyroid hormone (TH) replacement after hemithyroidectomy (HT).
• Petersen, E. A., Stauss, T. G., Scowcroft, J. A., Brooks, E. S., White, J. L., Sills, S. M., Amirdelfan, K., Guirguis, M. N., Xu, J., Yu, C., Nairizi, A., Patterson, D. G., Tsoulfas, K. C., Creamer, M. J., Galan, V., Bundschu, R. H., Paul, C. A., Mehta, N. D., Choi, H., , Sayed, D., et al. (2021). Effect of High-frequency (10-kHz) Spinal Cord Stimulation in Patients With Painful Diabetic Neuropathy: A Randomized Clinical Trial. JAMA neurology, 78(6), 687-698.
  More info

  Many patients with diabetic peripheral neuropathy experience chronic pain and inadequate relief despite best available medical treatments.
• Broome, D. T., Gadre, G. B., Fayazzadeh, E., Bena, J. F., & Nasr, C. (2020). Pleural effusion as a novel prognostic factor in metastatic thyroid carcinoma. Endocrine connections, 9(8), 812-823.
  More info

  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.
• Endo, M., Nabhan, F., Angell, T. E., Harrell, R. M., Nasr, C., Wei, S., & Sipos, J. A. (2020). Use of Molecular Diagnostic Tests in Thyroid Nodules with Hürthle Cell-Dominant Cytology. Thyroid : official journal of the American Thyroid Association, 30(9), 1390-1392.
• Krane, J. F., Cibas, E. S., Endo, M., Marqusee, E., Hu, M. I., Nasr, C. E., Waguespack, S. G., Wirth, L. J., & Kloos, R. T. (2020). The Afirma Xpression Atlas for thyroid nodules and thyroid cancer metastases: Insights to inform clinical decision-making from a fine-needle aspiration sample. Cancer cytopathology, 128(7), 452-459.
  More info

  Recent analytical and clinical validation of the Afirma Xpression Atlas (XA) demonstrates test reliability and the identification of genomic alterations that may inform patient management. The updated Afirma Genomic Sequencing Classifier and XA reports aim to optimize the understanding of these contributions, including decisions about observation versus surgery, the need for disease‐specific preoperative testing, associated neoplasm types, prognostics, the identification of molecular targets for systemic therapy, and the recognition of potential hereditary syndromes.
• Mekhail, N. A., Argoff, C. E., Taylor, R. S., Nasr, C., Caraway, D. L., Gliner, B. E., Subbaroyan, J., & Brooks, E. S. (2020). High-frequency spinal cord stimulation at 10 kHz for the treatment of painful diabetic neuropathy: design of a multicenter, randomized controlled trial (SENZA-PDN). Trials, 21(1), 87.
  More info

  Painful diabetic neuropathy (PDN), a debilitating and progressive chronic pain condition that significantly impacts quality of life, is one of the common complications seen with long-standing diabetes mellitus. Neither pharmacological treatments nor low-frequency spinal cord stimulation (SCS) has provided significant and long-term pain relief for patients with PDN. This study aims to document the value of 10-kHz SCS in addition to conventional medical management (CMM) compared with CMM alone in patients with refractory PDN.
• San Martin, V. T., Lawrence, L., Bena, J., Madhun, N. Z., Berber, E., Elsheikh, T. M., & Nasr, C. E. (2020). Real-world Comparison of Afirma GEC and GSC for the Assessment of Cytologically Indeterminate Thyroid Nodules. The Journal of clinical endocrinology and metabolism, 105(3).
  More info

  Molecular tests have improved the accuracy of preoperative diagnosis of indeterminate thyroid nodules. The Afirma Gene Sequencing Classifier (GSC) was developed to improve the specificity of the Gene Expression Classifier (GEC). Independent studies are needed to assess the performance of GSC.
• Azim, S., & Nasr, C. (2019). Correction: Subclinical hypothyroidism. Cleveland Clinic journal of medicine, 86, 392.
  More info

  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.
• Azim, S., & Nasr, C. (2019). Subclinical hypothyroidism: When to treat. Cleveland Clinic journal of medicine, 86(2), 101-110.
  More info

  Subclinical hypothyroidism is defined by an elevated serum thyroid-stimulating hormone (TSH) level along with a normal free thyroxine (T) level. Whether it should be treated remains controversial. Currently, the best practical approach is to base treatment decisions on the degree of TSH elevation, thyroid autoimmunity, and associated comorbidities.
• El Hage, L., Reineks, E., & Nasr, C. (2019). PSEUDOHYPONATREMIA IN THE SETTING OF HYPERCHOLESTEROLEMIA. AACE clinical case reports, 5(2), e172-e174.
  More info

  To describe a case of pseudohyponatremia in the setting of hypercholesterolemia.
• Goldner, W. S., Angell, T. E., McAdoo, S. L., Babiarz, J., Sadow, P. M., Nabhan, F. A., Nasr, C., & Kloos, R. T. (2019). Molecular Variants and Their Risks for Malignancy in Cytologically Indeterminate Thyroid Nodules. Thyroid : official journal of the American Thyroid Association, 29(11), 1594-1605.
  More info

  Gene panels are routinely used to assess predisposition to hereditary cancers by simultaneously testing multiple susceptibility genes and/or variants. More recently, genetic panels have been implemented as part of solid tumor malignancy testing assessing somatic alterations. One example is targeted variant panels for thyroid nodules that are not conclusively malignant or benign upon fine-needle aspiration (FNA). We systematically reviewed published studies from 2009 to 2018 that contained genetic data from preoperative FNA specimens on cytologically indeterminate thyroid nodules (ITNs) that subsequently underwent surgical resection. Pooled prevalence estimates per gene and variant, along with their respective positive predictive values (PPVs) for malignancy, were calculated. Our systematic search identified 540 studies that were supplemented by 18 studies from bibliographies or personal files. Sixty-one studies met all inclusion criteria and included >4600 ITNs. Overall, 26% of nodules contained at least 1 variant or fusion. However, half of them did not include details on the specific gene, variant, and/or complete fusion pair reported for inclusion toward PPV calculations. The PPVs of genomic alterations reported at least 10 times were limited to (98%, 95% confidence interval [CI 96-99%]), (55% [CI 34-78%]), (45% [CI 22-72%]), (42% [CI 19-68%]), and (38% [CI 23-55%]). Excluding , the pooled PPV for all other specified variants and fusions was 47%. Multiple variants within the same nodule were identified in ∼1% of ITN and carried a cumulative PPV of 77%. The chance that a genomic alteration predicts malignancy depends on the individual variant or fusion detected. Only five alterations were reported at least 10 times; had a PPV of 98%, while the remaining four had individual PPVs ranging from 38% to 55%. The small sample size of most variants and fusion pairs found among ITNs, however, limits confidence in their individual PPV point estimates. Better specific reporting of genomic alterations with cytological category, histological subtype, and cancer staging would facilitate better understanding of cancer prediction, and the independent contribution of the genomic profile to prognosis.
• Haddad, R. I., Nasr, C., Bischoff, L., Busaidy, N. L., Byrd, D., Callender, G., Dickson, P., Duh, Q. Y., Ehya, H., Goldner, W., Haymart, M., Hoh, C., Hunt, J. P., Iagaru, A., Kandeel, F., Kopp, P., Lamonica, D. M., McIver, B., Raeburn, C. D., , Ridge, J. A., et al. (2018). NCCN Guidelines Insights: Thyroid Carcinoma, Version 2.2018. Journal of the National Comprehensive Cancer Network : JNCCN, 16(12), 1429-1440.
  More info

  The NCCN Guidelines for Thyroid Carcinoma provide recommendations for the management of different types of thyroid carcinoma, including papillary, follicular, Hürthle cell, medullary, and anaplastic carcinomas. These NCCN Guidelines Insights summarize the panel discussion behind recent updates to the guidelines, including the expanding role of molecular testing for differentiated thyroid carcinoma, implications of the new pathologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features, and the addition of a new targeted therapy option for V600E-mutated anaplastic thyroid carcinoma.
• Mikhael, A., Patell, R., Tabet, M., Bena, J., Berber, E., & Nasr, C. (2018). Chest X-ray Prior to Thyroidectomy: Is It Really Needed?. World journal of surgery, 42(5), 1403-1407.
  More info

  Chest X-ray (CXR) prior to thyroid surgery continues to be routinely obtained at some institutions despite the lack of evidence for its utility. This study aimed to determine the utility of preoperative CXR in patients undergoing thyroidectomy at a single institution.
• Molenaar, R. J., Sidana, S., Radivoyevitch, T., Advani, A. S., Gerds, A. T., Carraway, H. E., Angelini, D., Kalaycio, M., Nazha, A., Adelstein, D. J., Nasr, C., Maciejewski, J. P., Majhail, N. S., Sekeres, M. A., & Mukherjee, S. (2018). Risk of Hematologic Malignancies After Radioiodine Treatment of Well-Differentiated Thyroid Cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 36(18), 1831-1839.
  More info

  Purpose To investigate the risk and outcomes of second hematologic malignancies (SHMs) in a population-based cohort of patients with well-differentiated thyroid cancer (WDTC) treated or not with radioactive iodine (RAI). Methods Patients with WDTC were identified from SEER registries. Competing risk regression analysis was performed to calculate the risks of SHMs that occurred after WDTC treatment and outcomes after SHM development were assessed. Results Of 148,215 patients with WDTC, 53% received surgery alone and 47% received RAI. In total, 783 patients developed an SHM after a median interval of 6.5 years (interquartile range, 3.3 to 11.2 years) from WDTC diagnosis. In multivariable analysis, compared with those undergoing thyroidectomy alone, RAI treatment was associated with an increased early risk of developing acute myeloid leukemia (AML; hazard ratio, 1.79; 95% CI, 1.13 to 2.82; P = .01) and chronic myeloid leukemia (CML; hazard ratio, 3.44; 95% CI, 1.87 to 6.36; P < .001). This increased risk of AML and CML after RAI treatment was seen even in low-risk and intermediate-risk WDTC tumors. Occurrence of AML but not CML in patients with WDTC was associated with shorter median overall survival compared with matched controls (8.0 years v 31.0 years; P = .001). In addition, AML developing after RAI trended toward inferior survival compared with matched controls with de novo AML (median overall survival, 1.2 years v 2.9 years; P = .06). Conclusion Patients with WDTC treated with RAI had an increased early risk of developing AML and CML but no other hematologic malignancies. AML that arises after RAI treatment has a poor prognosis. RAI use in patients with WDTC should be limited to patients with high-risk disease features, and patients with WDTC treated with adjuvant RAI should be monitored for myeloid malignancies as part of cancer surveillance.
• Molenaar, R. J., Sidana, S., Radivoyevitch, T., Gerds, A. T., Carraway, H. E., Kalaycio, M., Nazha, A., Adelstein, D. J., Nasr, C., Maciejewski, J. P., Majhail, N. S., Sekeres, M. A., & Mukherjee, S. (2018). Reply to A. Piccardo et al, E. Hindié et al, M.C. Kreissl et al, M. Doss, J. Buscombe, R. Fisher, M. Sollini et al, M. Lichtenstein, and M. Tulchinsky et al. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 36(18), 1889-1892.
• Patell, R., Mikhael, A., Tabet, M., Bena, J., Berber, E., & Nasr, C. (2018). Assessing the utility of preoperative serum thyroglobulin in differentiated thyroid cancer: a retrospective cohort study. Endocrine, 61(3), 506-510.
  More info

  Serum thyroglobulin (TG) is used to monitor for recurrence or progression of differentiated thyroid cancer (DTC). The role of preoperative TG measurement is more ambiguous, yet still being used in some centers. We aimed to determine whether preoperative TG correlates with disease stage or metastatic burden.
• Sakr, H. I., Chute, D. J., Nasr, C., & Sturgis, C. D. (2017). cMYC expression in thyroid follicular cell-derived carcinomas: a role in thyroid tumorigenesis. Diagnostic pathology, 12(1), 71.
  More info

  cMYC regulates approximately 15% of human genes and is involved in up to 20% of all human cancers. Reports discussing cMYC protein expression in thyroid carcinomas are limited, with controversies pertaining to cMYC expression patterns noted in the literature. The aims of the current study were to clarify patterns and intensities of cMYC expression in follicular cell-derived thyroid carcinomas across a spectrum of cancer morphologies and disease aggressivities, to correlate cMYC with BRAF expression, and to evaluate the potential role of cMYC in progression of well-differentiated thyroid carcinomas into less well-differentiated carcinomas.
• Aliyev, A., Patel, J., Brainard, J., Gupta, M., Nasr, C., Hatipoglu, B., Siperstein, A., & Berber, E. (2016). Diagnostic accuracy of circulating thyrotropin receptor messenger RNA combined with neck ultrasonography in patients with Bethesda III-V thyroid cytology. Surgery, 159(1), 113-7.
  More info

  The aim of this study was to analyze the usefulness of thyrotropin receptor messenger RNA (TSHR-mRNA) combined with neck ultrasonography (US) in the management of thyroid nodules with Bethesda III-V cytology.
• Nasr, C. (2016). Is a serum TSH measurement sufficient to monitor the treatment of primary hypothyroidism?. Cleveland Clinic journal of medicine, 83(8), 571-3.
• Aliyev, A., Gupta, M., Nasr, C., Hatipoglu, B., Milas, M., Siperstein, A., & Berber, E. (2015). CIRCULATING THYROID-STIMULATING HORMONE RECEPTOR MESSENGER RNA AS A MARKER OF TUMOR AGGRESSIVENESS IN PATIENTS WITH PAPILLARY THYROID MICROCARCINOMA. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 21(7), 777-81.
  More info

  We have previously shown that thyroid-stimulating hormone receptor messenger RNA (TSHR mRNA) is detectable in the peripheral blood of patients with papillary thyroid microcarcinoma (PTmC). The aim of this study was to analyze the utility of TSHR mRNA status as a marker of tumor aggressiveness in patients with PTmC.
• Aliyev, A., Soundararajan, S., Bucak, E., Gupta, M., Hatipoglu, B., Nasr, C., Siperstein, A., & Berber, E. (2015). The utility of peripheral thyrotropin receptor mRNA in the management of differentiated thyroid cancer. Surgery, 158(4), 1089-93; discussion 1093-4.
  More info

  Our aim was to analyze the utility of peripheral thyrotropin receptor (TSHR) messenger RNA (mRNA) in predicting and detecting the recurrence of differentiated thyroid cancer.
• Ching Sun, G. E., Kashyap, S. R., & Nasr, C. (2015). In reply. Cleveland Clinic journal of medicine, 82(1), 11-2.
• Kannan, S., & Nasr, C. (2015). Should we be concerned about thyroid cancer in patients taking glucagon-like peptide 1 receptor agonists?. Cleveland Clinic journal of medicine, 82(3), 142-4.
• Nasr, C. (2015). Insulin pumps: Great devices, but you still have to press the button. Cleveland Clinic journal of medicine, 82(12), 843-5.
• Ching Sun, G. E., Kashyap, S. R., & Nasr, C. (2014). Diabetes therapy and cancer risk: where do we stand when treating patients?. Cleveland Clinic journal of medicine, 81(10), 620-8.
  More info

  The pathophysiology of type 2 diabetes mellitus conveys increased cancer risk, and any antidiabetic drug may alter that risk in a favorable or unfavorable way. This article discusses the links between diabetes and cancer, the different agents available for treating diabetes, and the cancer risk associated with these therapies.
• Ching Sun, G. E., Kashyap, S. R., & Nasr, C. (2014). In reply. Cleveland Clinic journal of medicine, 81(12), 714-5.
• Ergin, A. B., & Nasr, C. E. (2014). Thyroid cancer & sarcoidosis. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG, 31(3), 239-43.
  More info

  The association of thyroid cancer and SA has been previously described in individual case reports. We are describing 4 patients with co-existence of papillary thyroid cancer (PTC) and SA who presented a diagnostic and management challenge.
• Karagkounis, G., Chute, D. J., Nasr, C. E., & Berber, E. (2014). Tall-cell variant papillary thyroid carcinoma arising from struma ovarll. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 20(2), e24-7.
  More info

  To present a case of tall-cell variant (TCV) papillary thyroid carcinoma (PTC) arising from Struma ovarii (SO) and to discuss special considerations in the management of this patient.
• Ergin, A. B., Nasr, G., Yared, J. P., Bena, J., & Nasr, C. (2013). Glycemic control with use of insulin glargine after cardiothoracic surgery: a retrospective study. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 19(3), 485-93.
  More info

  Perioperative glycemic control in critically ill cardiothoracic surgery patients may improve postsurgical outcomes. The objective of the study was to compare outcomes before and after the implementation of a protocol using subcutaneous (SC) glargine at transition from intravenous insulin infusion (IVII).
• Li, M., Milas, M., Nasr, C., Brainard, J. A., Khan, M. J., Burkey, B. B., & Scharpf, J. (2013). Anaplastic thyroid cancer in young patients: a contemporary review. American journal of otolaryngology, 34(6), 636-40.
  More info

  Little is known about prognostic factors and treatment outcomes in young patients with anaplastic thyroid cancer (ATC). The goal of this study is to define the clinical features of this subgroup.
• Sun, G. E., Pantalone, K. M., Gupta, M., Kennedy, L., Nasr, C., Constantiner, M., Hamrahian, A. H., & Hatipoglu, B. (2013). Is chronic nipple piercing associated with hyperprolactinemia?. Pituitary, 16(3), 351-3.
  More info

  Literature on hyperprolactinemia in the setting of a nipple piercing is limited to individuals with concomitant breast/chest wall infection. It is unclear if chronic nipple stimulation from a piercing alone can cause sustained elevations of serum prolactin. Nipple piercing is emerging as a more mainstream societal form of body art, and the answer to this clinical question would potentially alter patient management. Our aim was to assess serum prolactin levels in subjects with nipple piercing. Inclusion criteria were as follows: men and women ≥ 18 years old with nipple piercing(s) present > 6 months. Exclusion criteria included: women who are pregnant, lactating or < 6 months postpartum; subjects on medications known to increase prolactin levels; chest wall/breast infection at the time of phlebotomy or conditions known to be associated with hyperprolactinemia. Three men and eight women were enrolled. Median (range) ages for men and women were 33 (24-42) and 27 years (23-42), respectively. All except one subject had bilateral piercings. The median interval from nipple piercing to blood draw was 4.0 (2.0-12.0) years. None of the subjects had hyperprolactinemia. Median (range) prolactin levels for men and women were 5.6 ng/mL (3.8-7.4) and 8.0 ng/mL (2.8-10.9), respectively. Our results suggest that in the absence of any concomitant infection, chronic nipple piercing is not associated with hyperprolactinemia.
• Abdelmalak, B., Ibrahim, M., Yared, J. P., Modic, M. B., & Nasr, C. (2012). Perioperative glycemic management in insulin pump patients undergoing noncardiac surgery. Current pharmaceutical design, 18(38), 6204-14.
  More info

  Increasingly more Americans are being diagnosed with diabetes mellitus, and the number of those using the continuous subcutaneous insulin infusion pump (CSII), commonly known as the insulin pump, is on the rise. Although evidence is lacking on how best to manage insulin pump patients perioperatively, several individual or institutional approaches have been developed. Here we propose a comprehensive algorithm for perioperative glycemic management in insulin pump patients undergoing noncardiac surgery. Where applicable, we discuss the rationale behind the algorithm.
• Cheng, V., Brainard, J., & Nasr, C. (2012). Co-occurrence of papillary thyroid carcinoma and primary lymphoma of the thyroid in a patient with long-standing Hashimoto's thyroiditis. Thyroid : official journal of the American Thyroid Association, 22(6), 647-50.
  More info

  Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, whereas mucosa-associated lymphoid tissue (MALT) lymphoma of the thyroid gland is uncommon. Simultaneous occurrence of both disease entities is very rare.
• Pantalone, K. M., & Nasr, C. (2010). Approach to a low TSH level: patience is a virtue. Cleveland Clinic journal of medicine, 77(11), 803-11.
  More info

  Confronted with a low serum level of thyrotropin (thyroid-stimulating hormone, TSH), physicians should not jump to the conclusion that it is due to a hyperthyroid state, as other conditions and some drugs can be associated with a TSH level that is slightly low (0.1-0.4 microIU/mL) or frankly suppressed (< 0.1 microIU/mL). This review discusses how to approach a low TSH, stressing the frequent need to reassess thyroid function before making a diagnosis, the underlying processes and the drugs that can be responsible, and the degree of TSH suppression and its role in the evaluation.