Calcium, phosphorus and bone metabolism in hyperthyroid patients, before and after treatment

Seventy four hyperthyroid patients were selected to study calcium and phosphorus hemostasis before and after medical therapy. Fifty one patients fulfilled the post-treatment criteria. The laboratory values were compared with 30 normal individuals. Total serum calcium and ionized serum calcium were elevated in 15.7% and 39.5% of the patients, respectively. Ionized serum calcium decreased from a mean of 1.313 mmol/L to 1.242 mmol/L with treatment [p < 0.001]. Mean ionized serum calcium in the post-treatment group was significantly lower than control [p< 0.001]. Serum phosphorus decreased from a mean of 3.9 mg% to 3.41 mg% [p < 0.001]. Mean serum albumin rose from 4.0 g% to 4.44 g% [p < 0.001] but was still significantly lower than the control group [mean 4.8 g%]. Mean serum alkaline phosphatase [ALP] was 187 W/L which rose to 230 IU/L [p< 0.0001]. Mean serum ALP was 102 IU/L in the control group which was significantly lower than both pre- and post-treatment values of patients. Serum PTH rose from 48 to 65 pmol/L [p< 0.001]. Twenty-four hour urinary calcium decreased from 270 to 135 mg [p< 0.0001]. These findings indicate that in hyperthyroid patients, serum calcium rises with depression of PTH release, leading to hypercalciuria which may subsequently cause osteoporosis. The elevation of alkaline phosphatase and the drop of serum calcium to below normal values after treatment indicates increased osteoblastic activity and probably the reversibility of bone loss

FNA study of 377 thyroid nodules: a cyto- and histopathologic correlative study

377 patients with single thyroid nodule who clinically were candidates for surgery, were selected from the patients that referred to the clinics of endocrinology at Namazee Hospital, Shiraz Medical School. Fine needle aspiration [FNA] was carried out without performing thyroid scan and the results were compared with histology obtained by surgery to establish its accuracy in our center, which is an area of endemic goiter. 72% were benign confirmed by surgery, 17% malignant [of which two cases were colloid goiter] and 11% [42 cases] were suspicious: of these 42 suspicious cases, 28.5% were follicular carcinoma and the rest were benign. In this study sensitivity and specificity of FNA were 91% and 97%, respectively. In conclusion, although our area is an endemic goiter area, the accuracy of FNA is comparable to iodine sufficient areas

effect of opium on glucoregulatory factors

Effects of opium, morphine and demorphinized opium were studied on the blood sugar, liver glycogen and serum insulin level in rats. Demorphinized opium as well as morphine increased blood sugar levels and the results were similar to those of rats receiving opium. Rats receiving opium or morphinehydrochloride showed a severe terminal hypoglycemia, which was not seen in those receiving demorphinized opium. The liver glycogen contents and serum insulin levels were higher in opium or demorphinized opium treated rats compared to the controls. The above results suggest that the other opium alkaloids might differ from morphine in their effects on the glucoregulatory factors