While both pituitary and peripheral tissues show resistance to [T.sub.3] in GRTH, pituitary shows resistance to [T.sub.3] in PRTH. In PRTH, hyperthyroidism features including heart (tachycardia) and brain (nervousness, insomnia, attention deficit, hyperactivity) symptoms may be present, nevertheless, the other organ systems may not be involved (8).
A case-series study was conducted with patients, admitted to PRTH from 2009 through 2013, who had sustained vascular injuries and who, it was felt at the time, might benefit from the insertion of a TIVS prior to the commencement of definitive repair.
Before TR gene defects were recognized, patients with RTH were clinically classified as having generalized resistance to TH (GRTH) and selective pituitary resistance to TH (PRTH), based principally on symptoms and signs.
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Methods: A historical cohort study was undertaken using charts of patients admitted to Puerto Rico Trauma Hospital (PRTH) who required mechanical ventilation (MV) and underwent tracheostomies, 2000-2013.