Cuidado ás pessoas com agravos endocrinos e metabólicos / Care for people with endocrine and metabolic problems

O objetivo desse trabalho é descrever a sistematização da Assistência de Enfermagem a pessoas com agravos endócrinos e metabólicos pautado na teoria de Calista Roy. Metodologia: Trata-se de um relato de experiência através da aplicação da Sistematização da Assistência de Enfermagem (SAE), voltado para pessoas com agravos endócrinos e metabólicos no contexto hospitalar. Resultados e discussão: Foi aplicado a teoria da adaptação nas seis fases da Teoria de Calista Roy e foi elaborado diagnósticos de enfermagem para os quatro modos de adaptação: fisiológico, interdependência, autoconceito e função de papel. Considerações finais: Ao aplicar a SAE no indivíduo com agravos endócrinos e metabólicos a enfermeira deve realizá-lo em todas as suas etapas, e utilizar os protocolos para oferecer um cuidado holístico e integral, visando a promoção da saúde, prevenção de risco potencial e adaptação diante das necessidades em saúde.(AU)

The aim of this study is to describe the systematization of nursing care for people with endocrine and metabolic disorders, based on Calista Roy's theory. Methodology: This is an experience report on the application of the Systematization of Nursing Care (SNC) to people with endocrine and metabolic disorders in a hospital setting. Results and discussion: The theory of adaptation was applied in the six phases of Calista Roy's theory and nursing diagnoses were drawn up for the four modes of adaptation: physiological, interdependence, self-concept and role function. Final considerations: When applying the SNC to individuals with endocrine and metabolic disorders, the nurse must carry it out in all its stages, and use the protocols to offer holistic and comprehensive care, aimed at promoting health, preventing potential risks and adapting to health needs.(AU)

El objetivo de este estudio es describir la sistematización de los cuidados de enfermería a personas con trastornos endocrinos y metabólicos, basándose en la teoría de Calista Roy. Metodología: Se trata de un informe de experiencia sobre la aplicación de la Sistematización de los Cuidados de Enfermería (SNC) a personas con trastornos endocrinos y metabólicos en un entorno hospitalario. Resultados y discusión: Se aplicó la teoría de la adaptación en las seis fases de la teoría de Calista Roy y se elaboraron diagnósticos de enfermería para los cuatro modos de adaptación: fisiológica, interdependencia, autoconcepto y función de rol. Consideraciones finales: Al aplicar el SNC a individuos con trastornos endocrinos y metabólicos, la enfermera debe llevarlo a cabo en todas sus fases, y utilizar los protocolos para ofrecer cuidados holísticos e integrales, dirigidos a promover la salud, prevenir riesgos potenciales y adaptarse a las necesidades de salud.(AU)

Protective Effects and Mechanisms of Huangqi Decoction Against Radiation-Induced Bystander Effects / Efectos Protectores y Mecanismos de la Decocción de Huangqi Contra los Efectos Secundarios Inducidos por la Radiación

SUMMARY: The 12C6+ heavy ion beam irradiation can cause bystander effects. The inflammatory cytokines, endocrine hormones and apoptotic proteins may be involved in 12C6+ irradiation-induced bystander effects. This study characterized the protective effects and mechanisms of Huangqi decoction (HQD) against 12C6+ radiation induced bystander effects. Wistar rats were randomly divided into control, 12C6+ heavy ion irradiation model, and high-dose/medium-dose/low-dose HQD groups. HE staining assessed the pathological changes of brain and kidney. Peripheral blood chemical indicators as well as inflammatory factors and endocrine hormones were detected. Apoptosis was measured with TUNEL. Proliferating cell nuclear antigen (PCNA) expression was determined with real-time PCR and Western blot.Irradiation induced pathological damage to the brain and kidney tissues. After irradiation, the numbers of white blood cells (WBC) and monocyte, and the expression of interleukin (IL)-2, corticotropin-releasing hormone (CRH) and PCNA decreased. The damage was accompanied by increased expression of IL-1β, IL-6, corticosterone (CORT) and adrenocorticotropic hormone (ACTH) as well as increased neuronal apoptosis. These effects were indicative of radiation-induced bystander effects. Administration of HQD attenuated the pathological damage to brain and kidney tissues, and increased the numbers of WBC, neutrophils, lymphocyte and monocytes, as well as the expression of IL-2, CRH and PCNA. It also decreased the expression of IL-1β, IL-6, CORT and ACTH as well as neuronal apoptosis. HQD exhibits protective effects against 12C6+ radiation-induced bystander effects. The underlying mechanism may involve the promotion of the production of peripheral blood cells, inhibition of inflammatory factors and apoptosis, and regulation of endocrine hormones.

La irradiación con haz de iones pesados 12C6+ puede provocar efectos secundarios. Las citoquinas inflamatorias, las hormonas endocrinas y las proteínas apoptóticas pueden estar involucradas en los efectos secundarios inducidos por la irradiación 12C6+. Este estudio caracterizó los efectos y mecanismos protectores de la decocción de Huangqi (HQD) contra los efectos externos inducidos por la radiación 12C6+. Las ratas Wistar se dividieron aleatoriamente en grupos control, modelo de irradiación de iones pesados 12C6+ y grupos de dosis alta/media/baja de HQD. La tinción con HE evaluó los cambios patológicos del cerebro y el riñón. Se detectaron indicadores químicos de sangre periférica, así como factores inflamatorios y hormonas endocrinas. La apoptosis se midió con TUNEL. La expresión del antígeno nuclear de células en proliferación (PCNA) se determinó mediante PCR en tiempo real y transferencia Western blot. La irradiación indujo daños patológicos en los tejidos cerebrales y renales. Después de la irradiación, disminuyó el número de glóbulos blancos (WBC) y monocitos, y la expresión de interleucina (IL)-2, hormona liberadora de corticotropina (CRH) y PCNA. El daño estuvo acompañado por una mayor expresión de IL-1β, IL-6, corticosterona (CORT) y hormona adrenocorticotrópica (ACTH), así como un aumento de la apoptosis neuronal. Estas alteraciones fueron indicativas de efectos inducidos por la radiación. La administración de HQD atenuó el daño patológico a los tejidos cerebrales y renales, y aumentó el número de leucocitos y monocitos, así como la expresión de IL-2, CRH y PCNA. También disminuyó la expresión de IL-1β, IL-6, CORT y ACTH, así como la apoptosis neuronal. HQD exhibe mecanismos protectores contra los efectos externos inducidos por la radiación 12C6+. El mecanismo subyacente puede implicar la promoción de la producción de células sanguíneas periféricas, la inhibición de factores inflamatorios y la apoptosis y la regulación de hormonas endocrinas.

Factores asociados al autocuidado de la salud en los pacientes diabéticos / Factors associated with self-care in diabetic patients

La diabetes es una enfermedad que afecta a la población mundial, y los adultos mayores son los más propenso a padecerla, como consecuencia a los niveles de estrés y malos hábitos alimenticios que llevaron a lo largo de su vida productiva. Es por ello, que el: Objetivo de esta investigación es, describir los factores asociados al autocuidado de la salud en los pacientes diabéticos. Materiales y métodos: Investigación documental. Se incluyeron estudios de cohortes que analizaron diagnóstico y tratamiento oportuno en el autocuidado de pacientes diabéticos en bases de datos electrónicas, como lo son Porta Scielo, PubMed, Medline PLUS, Embase, Scopus y Web of Science, del 2015 al 2020. Las medidas de autocuidado son habilidades que los individuos practican para el mantenimiento de su salud, sobre todo cuando hay una patología de base que ponga en riesgo el estado de salud y el bienestar en general. Resultado: La diabetes es una enfermedad complicada, requiere vigilancia constante, conocimiento de la enfermedad y del apoyo de varios especialistas en salud, la mayor parte del cuidado y control debe prevenir del paciente mismo. Es importante que los pacientes no solo perciban los daños o la severidad de la ausencia de autocuidado, lo que puede influir en el adecuado control de la diabetes mellitus, sino que se le proporcione mediante la educación para la salud, estrategias que faciliten en ellos el aprendizaje de habilidades que le permitan percibir los beneficios de la adopción de estilos de vida saludables. Conclusiones: el equipo básico de salud desempeña un rol importante en la realización de acciones que faciliten el autocuidado en los pacientes diabéticos, lo que puede constituir una vía para que las personas tomen decisiones serias respecto al mantenimiento de un adecuado estado de su salud. Por ende, es necesario que se realicen programas que desarrollen el ajuste adecuado de expectativas, objetivos definidos, el manejo adecuado del refuerzo, el incremento del sentimiento de autoeficacia, el autocontrol, y que brinden alternativas que favorezcan un autocuidado óptimo(AU)

Diabetes is a disease that affects the world population, and older adults are the most prone to suffer from it, as a consequence of the levels of stress and poor eating habits that they led throughout their productive lives. That is why the: Objective of this research is to describe the factors associated with self-care of health in diabetic patients. Materials and methods: Documentary research. Cohort studies that analyzed diagnosis and timely treatment in the self-care of diabetic patients were included in electronic databases, such as Porta Scielo, PubMed, Medline PLUS, Embase, Scopus and Web of Science, from 2015 to 2020. The measures of Self-care are skills that individuals practice to maintain their health, especially when there is an underlying pathology that puts the state of health and well-being in general at risk. Result: Diabetes is a complicated disease, it requires constant vigilance, knowledge of the disease and the support of various health specialists, most of the care and control must be prevented by the patient himself. It is important that patients not only perceive the damage or the severity of the absence of self-care, which can influence the adequate control of diabetes mellitus, but that it is provided through health education, strategies that facilitate in them the learning skills that allow you to perceive the benefits of adopting healthy lifestyles. Conclusions: the basic health team plays an important role in carrying out actions that facilitate self-care in diabetic patients, which can constitute a way for people to make serious decisions regarding the maintenance of an adequate state of their health. Therefore, it is necessary to carry out programs that develop the adequate adjustment of expectations, defined objectives, the adequate management of reinforcement, the increase of the feeling of self-efficacy, self-control, and that provide alternatives that favor a more optimal self-care(AU)

Efectos de los opioides en endocrinología / Opioids effects in endocrinology

El uso de opioides ha aumentado en forma significativa en las últimas décadas, lo que nos ha permitido conocer sus diversos efectos en el sistema endocrino. Estos efectos están sub diagnosticados, en parte porque los síntomas se confunden con los de la misma enfermedad que lleva al uso de opioides y porque no los buscamos de forma dirigida. El hipogonadismo y la insuficiencia suprarrenal son sus efectos más establecidos, sin embargo, otros efectos como los provocados en el tejido óseo requieren de especial atención. La evaluación de los ejes gonadotropo, adrenal y de la salud ósea debe tenerse en consideración en los usuarios crónicos de opioides, particularmente frente a la presencia de síntomas. La suspensión o reducción del uso de opioides es el primer tratamiento del compromiso endocrinológico.

The use of opioids has increased significantly in recent decades, which has allowed us to understand its effects on the endocrine system. These effects are underdiagnosed, the symptoms are confused with those of the same disease that leads to the use of opioids and we do not look for them in a targeted way. Hypogonadism and adrenal insufficiency are its most established effects, however, other effects such as the ones caused on bone tissue require special attention. Evaluation of gonadotropic and adrenal axes as well as bone health should be taken into consideration in chronic opioid users, particularly in the presence of symptoms. Stopping or reducing opioid use is the first treatment for endocrine compromise.

Comparative assessment of effect of malt with different bud length on prolactin in hyperprolactinemia rat

Malt is the mature fruit of Hordeum vulgare L. after germination and drying and has been applied for treatment female abnormal galactorrhea. Previous studies have showed total alkaloids in malt have anti-HPRL effect. However, total alkaloids of malt change with the growth cycle, and the specified levels of total alkaloids in different bud length of malt have not been decided. To determine the definitive level of total alkaloids in different buds of malt and the most suitable bud length for clinical application by comparing effects on hyperprolactinemia rat. During the budding of malt, the content of total alkaloids first increased and then decreased, and it peaked at a bud length of 0.75 cm. Treated the HPRL model rats with different buds of malt, the PRL level was decreased, the number of PRLpositive cells and the mRNA expression level in the pituitary were significantly declined, and the number of dopamine D1 and D2 receptors in the hypothalamus was increased. The above changes were most significant in 0.75 cm bud. These results suggest that in terms of the content of effective substance and the effects on HPRL model rats, a malt bud length of 0.75 cm is optimal for clinical application.

Anatomical investigation of the measurements, shape and arterial irrigation of the adrenal gland in New Zealand rabbits / Investigação anatômica das medidas, forma e irrigação arterial da glândula adrenal em coelhos da raça Nova Zelândia

Rabbits have been used as an experimental model in many studies. These studies are important not only for veterinary clinicians, but also for researchers in different fields. The aim of this research was to describe gross morphological measurement, shape and arterial supply of the adrenal glands in healthy New Zealand rabbits. Dissections were performed in 30 adult rabbits, 15 males and 15 females, without macroscopic adrenal pathology. Adrenal measurements were made with a digital caliper: length, width, and thickness. The origin of the adrenal arteries was also determined. Both adrenal glands were localized cranially to the respective kidneys. The mean of the right adrenal gland was 0.88 cm length, 0.42 cm width and 0.16 cm thickness; the left gland measured 0.72 cm, 0.46 cm, and 0.17 cm, respectively. The right gland was significantly more elongated than the left (p = 0.0003) and the means of the measurements did not differ between sexes. Most of the right adrenal glands had a piriform shape (73.3%), whereas most of the left gland exhibited a "bean-shaped" aspect (60.0%). The arterial supply was found to arise from different arteries: lumbar, aorta, renal, caudal mesenteric, and testicular or ovarian. Comparatively, the descriptions of shape, position and arterial irrigation of the adrenal gland in rabbits are similar to those available in rodents. The data from the present investigation will assist in the interpretation of pathological and / or experimental findings in New Zealand rabbits.

Coelhos têm sido utilizados como modelo experimental em muitos estudos. Esses estudos são importantes não apenas para médicos veterinários, mas também para pesquisadores de diferentes campos. O objetivo desta pesquisa foi descrever as medidas morfológicas macroscópicas, forma e suprimento arterial das glândulas adrenais em coelhos saudáveis da raça Nova Zelândia. As dissecções foram realizadas em 30 coelhos adultos, 15 machos e 15 fêmeas, sem sinais macroscópicos de patologia adrenal. As medidas adrenais foram realizadas com paquímetro digital: comprimento, largura e espessura. A origem das artérias adrenais também foi determinada. Ambas as glândulas adrenais foram localizadas cranialmente nos respectivos rins. A média da glândula adrenal direita foi de 0,88 cm de comprimento, 0,42 cm de largura e 0,16 cm de espessura; a glândula esquerda mediu 0,72 cm, 0,46 cm e 0,17 cm, respectivamente. A glândula direita foi significativamente mais alongada que a esquerda (p = 0,0003) e as médias das medidas não diferiram entre os sexos. A maioria das glândulas adrenais direitas tinha uma forma piriforme (73,3%), enquanto a maioria da glândula esquerda exibia um aspecto em "forma de feijão" (60,0%). Verificou-se que o suprimento arterial provém de diferentes artérias: lombar, aorta, renal, mesentérica caudal e testicular ou ovariana. Comparativamente, as descrições de forma, posição e irrigação arterial da glândula adrenal em coelhos são semelhantes às disponíveis em roedores. Os dados da presente investigação ajudarão na interpretação de achados patológicos e / ou experimentais em coelhos da raça Nova Zelândia.

Metástasis cutánea de carcinoma diferenciado de tiroides. A propósito de un caso / Cutaneous metastasis of differentiated thyroid carcinoma. About a case

El cáncer de tiroides (CT) así como otros tipos de tumores malignos tienen la capacidad de invadir e infiltrar otros tejidos tanto contiguos como tejidos y órganos distantes produciendo lo que se conoce como metástasis (MT). Esta es una característica propia de la mayoría de los tumores cancerígenos, y el mecanismo por el cual lo realizan se produce de distintas maneras dependiendo del tipo histológico del tumor, así como de sus particularidades de diseminación propias sea vía linfática, hematógena, nerviosa o por invasión local. Hablando particularmente del cáncer de tiroides (CT) y siendo más específicos el cáncer papilar (CPT), es la variante histológica maligna que con más prevalencia e incidencia se presenta en esta glándula, además que es el cáncer tiroideo que presenta el mejor pronostico y más alternativas de tratamiento por su patrón de crecimiento lento, y por su baja capacidad de producir metástasis (MT) a distancia, presentado se en menos del 10% de pacientes con este diagnóstico. Pese a esta baja tasa de enfermedad metastásica, esta patología ha presentado un crecimiento notable en su prevalencia llegando a triplicarse en los últimos 30 años, lo que ha originado de la misma manera un aumento en la prevalencia de casos de metástasis (MT) por esta neoplasia. Cuando se presenta enfermedad metastásica del carcinoma papilar de tiroides (CPT) se localiza con mayor frecuencia en tejido ganglionar seguido por tejido pulmonar y óseo. La diseminación de este tipo de cáncer a otros sitios es infrecuente, y a piel es aún más inusual. Por este motivo se presenta el caso de una paciente femenina de 74 años, con antecedentes de diagnóstico de carcinoma diferenciado de tiroides sometida a varias intervenciones quirúrgicas previas, la cual presenta una lesión dérmica a nivel pre esternal, cuyo estudio histopatológico post resección fue compatible con diseminación metastásica cutánea de este tipo de cáncer.

Thyroid cancer (CT) as well as other types of malignant tumors have the ability to invade and infiltrate other tissues both contiguous and distant tissues and organs producing what is known as metastasis (MT). This is a characteristic of the majority of cancerous tumors, and the mechanism by which they are carried out occurs in different ways depending on the histological type of the tumor, as well as its own dissemination characteristics, whether lymphatic, hematogenous, nervous or local invasion. Speaking particularly of thyroid cancer (CT) and being more specific papillary cancer (CPT), it is the malignant histological variant that has the most prevalence and incidence in this gland, in addition it is the thyroid cancer that has the best prognosis and more treatment alternatives due to their slow growth pattern, and due to their low capacity to produce distance metastases (MT) presented in less than 10% of patients with this diagnosis. Despite this low rate of metastatic disease, this pathology has presented a remarkable growth in its prevalence, tripling in the last 30 years, which has also caused an increase in the prevalence of metastatic cases (MT) due to this neoplasia. When there is metastatic disease of papillary thyroid carcinoma (CPT), it is most often located in lymph tissue followed by lung and bone tissue. The spread of this type of cancer to other sites is uncommon, and the skin is even more unusual. For this reason, the case of a 74-year-old female patient is presented, with a history of diagnosis of differentiated thyroid carcinoma undergoing several previous surgical interventions, which presents a dermal lesion at the pre-sternal level, whose post-resection histopathological study was compatible with metastatic skin spread of this type of cancer

Tejido adiposo y su función endocrina / Adipose tissue and its endocrine function

Recientemente se ha descubierto que el tejido adiposo (TA) tiene una crucial influencia sobre diversos procesos fisiológicos a través de la secreción de múltiples factores endocrinos, paracrinos y autocrinos, conocidos como adipoquinas. Desde su descubrimiento, a gran parte de las adipoquinas se les ha atribuido un importante papel en el metabolismo energético, regulando el almacenaje y producción de triglicéridos y colesterol. Uno de los descubrimientos más importantes sobre las funciones del tejido adiposo es como el aumento de su tamaño estimula la secreción de citocinas con carácter pro-inflamatorio, influyendo así en el control de su propia celularidad, la angiogénesis y la migración de células inmunes. Estudios recientes han mostrado como, ante cambios en la homeostasia, el tejido adiposo puede modificar los procesos de coagulación y fibrinólisis. La participación del tejido adiposo en la vascularización y la angiogénesis ha dado nuevos y reveladores resultados, centrados en nuevas adipoquinas como la quemerina y la monobutirina. El estudio de las adipoquinas y su gama de efectos sobre el organismo amplían cada vez más el panorama de las funciones del tejido adiposo y su importancia en el control del metabolismo y la homeostasia. Considerando toda la nueva información disponible, esta revisión bibliográfica busca enumerar, describir y analizar las principales funciones endocrinas del TA. La metodología utilizada para ello consistió en una revisión bibliográfica de tipo descriptivo realizada mediante la revisión sistemática de artículos científicos, consultando diversas bases de datos. Finalmente, se seleccionaron 30 artículos de los útimos cinco años, en español e inglés...(AU)

Hallazgos ecográficos de la glándula tiroides en el personal técnico ocupacionalmente expuesto y no expuesto a radiaciones ionizantes del Hospital Central Universitario Dr. Antonio María Pineda / Ultrasound findings of the thyroid gland in technical staff occupationally exposed and not exposed to ionizing radiations of the Hospital Central Universitario Dr. Antonio María Pineda

Con el objetivo de identificar hallazgos ecográficos en el parénquima tiroideo en el personal ocupacionalmente expuesto y no expuesto a radiación ionizante (RI) del Hospital Central Universitario Dr. Antonio María Pineda, se realizó un estudio descriptivo transversal con una muestra de 45 individuos expuestos a RI del Servicio de Radiología y Diagnóstico por Imágenes Dr. Theoscar Sanoja Hernández y 38 individuos de los Servicios de Traumatología y Ortopedia y Medicina Física y Rehabilitación que no están expuestos a RI obteniendo que el 63% del personal expuesto presentaron algún tipo de alteración en el ultrasonido tiroideo en comparación con el 43% del personal no ocupacionalmente expuesto; los hallazgos más frecuentes en el personal expuesto fueron bocio difuso (44%), nódulos (32%) y quistes (24%) mientras que en el personal no expuesto fueron quistes (38%), bocio difuso (19%) y nódulos (19%). Estos hallazgos permiten concluir que el porcentaje del personal con afectación de la glándula tiroides fue mayor en personal expuesto y que los hallazgos ecográficos difieren entre los grupos estudiados(AU)

In order to identify ultrasound findings in thyroid parenchyma of hospital staff exposed and not exposed to ionizing radiation (IR) of the Hospital Central Universitario Dr. Antonio Maria Pineda, we performed a cross-sectional descriptive study with a sample of 45 individuals exposed to IR who worked in the Servicio de Radiología y Diagnóstico por Imágenes Dr. Theoscar Sanoja Hernández and 38 individuals who worked at the Servicios de Traumatología y Ortopedia y Medicina Física y Rehabilitación and were not exposed. The results showed that 63% of the exposed group had ultrasound thyroid findings in contrast to 43% of the non-exposed group. The most common findings in the exposed group were diffuse goiter (44%), nodules (32%) and cysts (24%) and in the non-exposed group were cysts (38%), diffuse goiter (19%) y nodules (19%). These findings show that ultrasound thyroid findings was higher in exposed hospital staff and that the type of thyroid disease differ among both groups(AU)

Efectos fisiológicos de los péptidos bioactivos derivados de las proteínas del lactosuero en la salud: Una revisión / Physiological health effects of whey protein-derived bioactive peptides: A review

RESUMEN El lactosuero es un subproducto derivado de la elaboración de queso. La calidad de la composición química de las proteínas del lactosuero las convierte en un sustrato ideal para la generación de péptidos con actividad biológica. La presente revisión tiene por objetivo analizar y discutir los efectos fisiológicos de los péptidos bioactivos derivados de las proteínas del lactosuero (PBDL) en la salud. Asimismo, este trabajo muestra detalladamente las estructuras químicas de las secuencias de los PBDL capaces de ejercer efectos favorables in vitro e in vivo e influir positivamente en los sistemas cardiovascular, endócrino e inmunológico. Sin embargo, las metodologías para generar PBDL de manera controlada, la dosificación y las concentraciones óptimas han sido poco exploradas. Por lo que es importante llevar a cabo investigación de frontera que permita avanzar el umbral del conocimiento vislumbrando la posibilidad de utilizar los PBDL como coadyuvantes en la prevención y tratamiento de enfermedades.

ABSTRACT Whey is a by-product of cheese production. The relevant chemical composition of whey proteins makes them an ideal substrate to release peptides with biological activity. The objective of this manuscript was to analyze and discuss the effects of whey-derived proteins bioactive peptides in health. Moreover, this review shows in detail sequences able to benefit human systems. Several in vitro and in vivo studies showed the capacity of these bioactive peptides to positively influence cardiovascular, endocrine and immune systems. However, the methodologies to obtain them in a controlled way, as well as dose and optimum concentrations have been scarcely explored. Therefore, it is necessary to conduct new research to improve knowledge that focuses on the possibility of using whey-derived bioactive peptides in the prevention and treatment of diseases.

Metabolic and endocrinal effects of epidural glucocorticoid injections

INTRODUCTION@#Epidural steroid injections are an integral part of nonsurgical management of radicular pain from lumbar spine disorders. We studied the effect of dexamethasone 8 mg epidural injections on the hypothalamic-pituitary-adrenal axis and serum glucose control of Asian patients.@*METHODS@#18 patients were recruited: six diabetics and 12 non-diabetics. Each patient received a total of dexamethasone 8 mg mixed with a local anaesthetic solution of lignocaine or bupivacaine, delivered into the epidural space. Levels of plasma cortisol, adrenocorticotropic hormone (ACTH), serum glucose after an overnight fast and two-hour postprandial glucose, as well as weight, body mass index, blood pressure and heart rate were measured within one week prior to the procedure (baseline) and at one, seven and 21 days after the procedure.@*RESULTS@#Median fasting blood glucose levels were significantly higher on post-procedure Day 1 than at baseline. However, there was no significant change in median two-hour postprandial blood glucose from baseline levels. At seven and 21 days, there was no significant difference in fasting or two-hour postprandial glucose levels. Both ACTH and serum cortisol were significantly reduced on Day 1 compared to baseline in all patients. There was no significant difference in ACTH and serum cortisol levels from baseline at Days 7 and 21.@*CONCLUSION@#Our study shows that epidural steroid injections with dexamethasone have a real, albeit limited, side effect on glucose and cortisol homeostasis in an Asian population presenting with lower back pain or sciatica.

Effects of 3,3′,4,4′,5-pentachlorobiphenyl on human Kv1.3 and Kv1.5 channels

Among the environmental chemicals that may be able to disrupt the endocrine systems of animals and humans are polychlorinated biphenyls (PCBs), a chemical class of considerable concern. PCB consists of two six-carbon rings linked by a single carbon bond, and theoretically, 209 congeners can form, depending on the number of chlorines and their location on the biphenyl rings. Furthermore, 3,3′,4,4′,5-pentachlorobiphenyl (PCB126) exposure also increases nitric oxide production and nuclear factor kappa-light-chain-enhancer of activated B cells binding activity in chondrocytes, thus contributing as an initiator of chondrocyte apoptosis and resulting in thymic atrophy and immunosuppression. This study identified whether cardiac and immune abnormalities from PCB126 were caused by the Kv1.3 and Kv1.5 channels. PCB126 did not affect either the steady-state current or peak current of the Kv1.3 and Kv1.5 channels. However, PCB126 right-shifted the steady-state activation curves of human Kv1.3 channels. These results suggest that PCBs can affect the heart in a way that does not block voltage-dependent potassium channels including Kv1.3 and Kv1.5 directly.

Human Immunodeficiency Virus Infection and the Endocrine System

In the current era of effective antiretroviral therapies (ARTs), human immunodeficiency virus (HIV) infection became a chronic disorder that requires long term follow-up. Among other medical issues, these patients may develop endocrine problems, specific to HIV infection and its treatment. The purpose of this review is to give an overview of common endocrine complications associated with HIV infection, and to propose diagnostic and therapeutic strategies. HIV can affect the endocrine system at several levels. Adrenal and gonadal dysfunction, osteoporosis with increased fracture risk, dyslipidemia with increased cardiovascular risk, are some of the endocrine disorders prevalent in HIV-infected patients that may negatively influence quality of life, and increase morbidity and mortality. While ARTs have dramatically increased life expectancy in the HIV-infected population, they are not devoid of adverse effects, including endocrine dysfunction. Physicians caring for HIV-infected patients should be knowledgeable and exercise a high index of suspicion for the diagnosis of endocrine abnormalities, and in particular be aware of those that can be life threatening. Endocrine evaluation should follow the same strategies as in the general population, including prevention, early detection, and treatment.

Natural Killer Cells and Thyroid Diseases

Abnormal production of thyroid hormone is one of the common endocrine disorders, and thyroid hormone production declines with age. The aging process also negatively affects the immune system. An interaction between endocrine system and the immune system has been proposed to be bidirectional. Emerging evidence suggests an interaction between a lymphocyte population, called natural killer (NK) cells and thyroid gland function. Here, we review the relationship between NK cells and thyroid function and disease.

Understanding the molecular mechanisms of bisphenol A action in spermatozoa / 대한생식의학회지

Bisphenol A (BPA) is an endocrine-disrupting chemical that is capable of interfering with the normal function of the endocrine system in the body. Exposure to this chemical from BPA-containing materials and the environment is associated with deleterious health effects, including male reproductive abnormalities. A search of the literature demonstrated that BPA, as a toxicant, directly affects the cellular oxidative stress response machinery. Because of its hormone-like properties, it can also bind with specific receptors in target cells. Therefore, the tissue-specific effects of BPA mostly depend on its endocrine-disrupting capabilities and the expression of those particular receptors in target cells. Although studies have shown the possible mechanisms of BPA action in various cell types, a clear consensus has yet to be established. In this review, we summarize the mechanisms of BPA action in spermatozoa by compiling existing information in the literature.

Lesões de adrenais em 300 cães / Adrenal lesions in 300 dogs

Foram estudadas as adrenais de 300 cães submetidos à necropsia no Laboratório de Patologia Veterinária da Universidade Federal de Santa Maria, no período de março de 2012 a junho de 2013. Os tecidos coletados foram fixados em formol 10% e encaminhados ao processamento his­tológico de rotina para confecção e análise de lâminas histológicas. Posteriormente, foram revisados os protocolos de necropsia e dados epidemiológicos referentes aos cães que tiveram as adrenais coletadas foram anotados. Dos 300 cães analisados, 82% tinham uma ou mais alterações nas adrenais, que foram classificadas de acordo com a patogênese e a prevalência. Lesões hiperplásicas foram as mais prevalentes, com 91,5% das ocorrências, seguido de lesões degenerativas (26,%), circulatórias (20,3%), neoplásicas (15%), inflamatórias (4,1%) e outras lesões (14,2%). Macroscopicamente, as hiperplasias caracterizavam-se por variável quantidade de nódulos brancacentos, de até 1,5cm de diâmetro. Em 72,9% dos casos de hiperplasia, os nódulos eram constituídos de células da camada glomerulosa. A maioria dos animais que apresentou lesões hiperplásicas era constituída de fêmeas (60,4%), idosos (46,9%) e cães com raça definida (55,6%). A degeneração gordurosa foi a lesão degenerativa mais prevalente (54,7%) e era caracterizada por células da zona fasciculada e da zona reticular com grandes vacúolos citoplasmáticos. Entre as alterações neoplásicas, tumores primários foram mais prevalentes (75,7%), com predomínio de adenomas (57,1%), seguido de feocromocitomas (25%) e carcinomas corticais (17,9%). Os tumores metastáticos perfizeram 24,3% dos casos de alterações neoplásicas. As adrenais foram sítio de metástase de carcinoma mamário, osteossarcoma, melanoma, linfoma, colangiocarcinoma, sarcoma histiocítico e adenocarcinoma pulmonar. No item "outras lesões", adrenal de estresse foi a alteração mais prevalente (37,1%). Essa alteração era caracterizada histologicamente por córtex de aspecto variegado, com áreas de fina vacuolização citoplasmática das células da camada fasciculada, intercaladas por grupos de células hipereosinofílicas. Este estudo possibilitou concluir que lesões nas adrenais de cães são extremamente frequentes, de modo que a avaliação cuidadosa desse órgão se faz necessária na rotina de diagnóstico em patologia.(AU)

The adrenal glands of 300 dogs, underwent to necropsy in the Laboratório de Patologia Veterinária at the Universidade Federal de Santa Maria (LPV/UFSM), were studied from March 2012 to June 2013. The collected tissues were fixed in 10% buffered formalin and sent to the routine histological processing in order to preparation and analysis of histological slides. Subsequently, it was reviewed the necropsy reports and the epidemiological data of the dogs which had the adrenal glands collected. Out of the 300 dogs examined, 82% had one or more adrenal lesions that were classified according to the pathogenesis and prevalence. The hyperplastic lesions were the most prevalent, comprising 91.5% of the cases, followed by degenerative (26%), circulatory (20.3%), neoplastic (15%), inflammatory (4.1%) and other lesions (14.2%). Grossly, hyperplasia was characterized by a variable amount of whitish nodules, ranging from 0.2-1.5 cm of diameter. In 72.9% of the hyperplasia cases, the nodules were composed by cells of the glomerulosa zone. Most of the animals that showed hyperplastic lesions consisted of females (60.4%), elderly (46.9%) and purebred dogs (55.6%). Fatty degeneration was the most prevalent degenerative lesions (54.7%), characterized by cells of the fasciculata and reticularis zones with large cytoplasmic vacuoles. Among the neoplastic changes, primary tumors were the most prevalent (75.7%), with predominance of adenomas (57.1%), followed by pheochromocytomas (25%) and cortical carcinomas (17.9%). Metastatic tumors corresponded to 24.3% of all cases of neoplastic changes. The adrenal glands were the site of metastasis of mammary gland carcinoma, osteosarcoma, melanoma, lymphoma, cholangiocarcinoma, histiocytic sarcoma and lung adenocarcinoma. Under "other lesions", adrenal of stress was the most prevalent change (37.1%). It was characterized histologically by a cortex with irregular appearance, with areas of mild cell vacuolation in the fasciculata zone, interspersed with hypereosinophilic cell groups. This study allowed the conclusion that the lesions in adrenal glands of dogs are extremely common, highlighting the importance of a careful evaluation of this organ in the routine of pathological diagnostic.(AU)

Predictive Value of Endometrial Thickness for Anemia in Adolescent Girls with Abnormal Uterine Bleeding / 임상소아혈액종양

BACKGROUND: Immaturity of the endocrine system that controls the normal menstrual cycle frequently results in abnormal uterine bleeding (AUB) and elicits anemia in adolescent girls. This study was conducted to assess the predictive value of endometrial thickness (ET) for anemia in adolescent girls with AUB. METHODS: A retrospective chart review was performed for a cohort of adolescents (12–18 years old) with AUB who presented over a 10-year period. Complete blood count and ultrasonographic data of 115 adolescent girls with AUB were analyzed. Subjects were classified according to ET as group I (ET < 11 mm) and group II (≥11 mm), and the incidence of anemia was compared. Subjects were also classified according to age as group Y (12–15 years old of age) and group O (16–18 yr), and ET, hemoglobin (Hb), and incidence of anemia were compared. RESULTS: The incidence of anemia in all subjects was 67.8% and was significantly higher in group II than in group I (P < 0.001). The incidence of severe anemia was 56.9% in group II, which was higher than in group I (P=0.039). The incidence of anemia was not significantly different between groups Y and O. However, the incidence of severe anemia was significantly higher in group Y than in group O (P=0.001). CONCLUSION: AUB can result in severe anemia in adolescent girls particularly those who are close to menarche or have a thick endometrium. Early supervision of AUB is required in order to avoid anemia in adolescent girls with AUB.

Treatment with Phytoestrogens Reversed Triclosan and Bisphenol A-Induced Anti-Apoptosis in Breast Cancer Cells

Triclosan (TCS) and bisphenol A (BPA) are endocrine-disrupting chemicals that interfere with the hormone or endocrine system and may cause cancer. Kaempferol (Kaem) and 3,3′-diindolylmethane (DIM) are phytoestrogens that play chemopreventive roles in the inhibition of carcinogenesis and cancer progression. In this study, the influence of TCS, BPA, Kaem, and DIM on proliferation and apoptotic abilities of VM7Luc4E2 breast cancer cells were examined. MTT assay revealed that TCS (0.1–10 μM), BPA (0.1–10 μM) and E2 (0.01–0.0001 μM) induced significant cell proliferation of VM7Luc4E2 cells, which was restored to the control (0.1% DMSO) by co-treatment with Kaem (30 μM) or DIM (15 μM). Reactive oxygen species (ROS) production assays showed that TCS and BPA inhibited ROS production of VM7Luc4E2 cells similar to E2, but that co-treatment with Kaem or DIM on VM7Luc4E2 cells induced increased ROS production. Based on these results, the effects of TCS, BPA, Kaem, and DIM on protein expression of apoptosis and ROS production-related markers such as Bax and Bcl-xl, as well as endoplasmic reticulum (ER) stress-related markers such as eIF2α and CHOP were investigated by Western blot assay. The results revealed that TCS, and BPA induced anti-apoptosis by reducing ROS production and ER stress. However, Kaem and DIM effectively inhibited TCS and BPA-induced anti-apoptotic processes in VM7Luc4E2 cells. Overall, TCS and BPA were revealed to be distinct xenoestrogens that enhanced proliferation and anti-apoptosis, while Kaem and DIM were identified as natural chemopreventive compounds that effectively inhibited breast cancer cell proliferation and increased anti-apoptosis induced by TCS and BPA.