Analysis of influencing factors of transient hypothyroxinemia and low T3 syndrome in premature infants / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the influencing factors of transient hypothyroxinemia (THT) and low T3 syndrome (LT3S) in premature infants.</p><p><b>METHOD</b>We have studied 418 premature infants whose gestational age was between 26 and 36 weeks.Serum thyronine (T4), triiodothyronine (T3) and thyrotropin (TSH) of them were detected on the fourteenth day approximately after birth. The patients were divided according to their serum T4, T3 and TSH into 3 groups (transient hypothyroxinemia, low T3 syndrome and normal). Then 20 Perinatal factors which may be associated with THT and LT3S were collected. The factors were analyzed by using Chi-square test and Logistic regression.</p><p><b>RESULT</b>Forty-nine infants were found suffering from THT, 35 infants suffering from LT3S, and 334 infants in normal group. The prevalence rate of THT was 11.7%, and the prevalence rate of LT3S was 8.4%. Among the 20 factors, the factors related to the incidence of THT were male gender (OR = 1.863, 95%CI 0.966-3.594), albumin (OR = 2.401, 95%CI 1.294-4.455), dopamine (OR = 3.295, 95%CI 1.110-9.783) and those related to the incidence of LT3S were male gender (OR = 2.592, 95%CI 1.171-5.736), gestational age ≤ 28 wk (OR = 3.503, 95%CI 1.275-9.627).</p><p><b>CONCLUSION</b>Male gender, albumin and dopamine are perinatal risk factors of THT, meanwhile, male gender and gestational age ≤ 28 wk are perinatal risk factors of LT3S.With the use of risk factors identified in our study, it may be possible to separate infants having the highest risk of THT and LT3S, so as to form optimizing treatment strategies.</p>

Effect of academic examination stress on hormonal level in healthy medical technology students

Stress may alter many physiological functions and may lead to psychiatric diseases, such as anxiety and depression. In this study, the effect of academic exam stress on thyroid stimulating hormone [TSH], thyroxin T4, triiodothyronine T3, Testosterone, and cortisol were studied Blood samples were taken from students before examination Another blood samples were collected from the same students during normal collage days. The results obtained showed stress caused significant increase in the hormones measured except the triiodothyronine, which shows no significant increase during stress. It has been suggested that acute increase of TSH level may result from central catecholaminergic stimulation and increased levels of catecholamines Stress was accompanied by increased hypothalamic-pituitary-adrenal axis function

Contrast induced complications in congenital heart diseases

Renal and thyroid dysfunctions were reported in children after exposure to iodine containing radiological contrast agents. With this background, the aim of this study was to evaluate the influence of iodine containing radiological contrast media on serum creatinine, free thyroxine [FT4] and thyroid stimulating hormone [TSH] in children with congenital heart diseases [CHD]. This study comprised 60 patients [45 males and 15 females] with CHD following up in the Cardiology clinic of Ain Shams University hospitals whose ages ranged from 7 months to 12 years [mean +/- SD 6.5 +/- 3.9 years]. Patients were compared to a control group comprised of 15 age and sex matched apparently healthy participants [9 males and 6 females] whose ages ranged from 6 months to 12 years [mean +/- SD = 8.2 +/- 1.6 years]. All participants were subjected to careful history taking, thorough clinical examination and Creatinine, FT4 and TSH were measured before performance of procedures utilizing iodine containing radiological contrast agent in order to ascertain normality of their basal levels. The second sample was taken in the first day [24 hours] after exposure and the third sample was taken one week after exposure. The third sample for creatinine assessment was taken on the third to fifth day [instead of one week] after exposure. Weekly assessment was done for patients with significant creatinine or TSH elevation or decreased FT4 until normalization of their levels. Decreased FT4 with elevated creatinine and TSH occurred in 20 patients [representing 33.3%] of the study group comprised of 60 patients with CHD. Peak elevation of creatinine levels occurred 3-5 days after exposure and normalized by the second week [about 10 days] after exposure while peak decreased FT4 levels occurred by the first week and normalized by the third week after exposure. On the other hand, TSH levels exhibited progressive elevation reaching peak stable levels by 3-4 weeks followed by spontaneous progressive decrease till TSH normalization 8-10 weeks after exposure to iodine containing radiological contrast agents .There was a statistically highly significant [P = <0.001] relation between the ingested dose of iodine containing radiological contrast agent / kilogram body weight versus decreased FT4 or elevated creatinine or TSH. All affected patients [20 patients] had negative history of other imaging procedures using iodine containing radiological contrast agents performed during the present study or in the last month before inclusion in the present study which rules out sources of exposure to iodine other than procedures utilizing iodine containing radiological contrast agent performed during the present study and none of the patients received drugs during the period of the study that could alter levels of creatinine or thyroid hormones. Diagnostic procedures utilizing iodine containing radiological contrast agents produce decreased FT4 with elevated creatinine and TSH which were statistically highly significantly [P = <0.001] related to the dose of contrast agent / kilogram body weight used during performance of these procedures to patients with CHD irrespective of their ages or type of CHD. Thus pediatricians and cardiologists should be alert to the possible occurrence of these complications after exposure to iodine containing radiological contrast agent in order to supply regular laboratory assessment, follow up and early management if needed

Effects of acute and chronic maternal deprivation on hypothalamo-pituitary adrenal axis in rat pups with hyperthyroidal mothers

Hyperthyroidism is a common endocrine problem encountered in human pregnancy. It is well known that hyperthyroidism induces an increase in the activity of hypothalamic-pituitary-adrenal [HPA] axis. Between the age of 4 and 14 days, the HPA axis of the rat displays a relative stress hyporesponsive period [SHRP]. There are no reports about development of the HPA axis in rat pups of hyperthyroid mothers. Therefore, this study was designed to investigate the effects of acute and chronic maternal deprivation on their pups HPA axis function of hyperthyroid mothers and the influence of treatment administration to hypothyroid mothers from conception to the end of experiment. 30 adult female rats were used after induction of pregnancy and hyperthyroidism. Maternal deprivation for 24 hours was done at two different ages during postnatal development at mid and outside the SHRP. Also, repeated maternal deprivation was done in another group. Now, pups groups are: Control deprived, control non deprived, treated deprived, treated non deprived, nontreated deprived and nontreated nondeprived. The plasma thyroxin [T4] levels of treated deprived groups were significantly lower than non treated groups, while, plasma thyroid stimulating hormone [TSH] levels of treated groups were significantly higher than non treated deprived groups. There is no significant difference in plasma T4 between control and treated nondeprived group. There is no significant difference in plasma corticosterone and adrenocorticotropin hormone [ACTH] in treated deprived in comparison to treated nondeprived at postnatal day 9 and with repeated maternal deprivation. With repeated deprivation plasma corticosterone levels were not different in nontreated deprived group in comparison with the nontreated nondeprived group. Maternal deprivation in rats with hyperthyroidal mother depended on the age of pups at which procedure is applied

Functional status of the thyroid gland in complicated versus uncomplicated pregnancies

Many Adverse pregnancy outcome have been reported in pregnant women with thyroid dysfunction. The prevalence of thyroid dysfunction and its relation to pregnancy outcome had not been studied in our locality. To assess the magnitude of thyroid disorders during pregnancy and their relation to pregnancy outcome. A prospective clinical observational study. Subjects and One-hundred-fifty four, pregnant women attending the Ante-natal Care Unit, Mansoura University Hospital. Clinical examination was undertaken. Laboratory evaluation utilizing the highly sensitive chemiluminscent serum TSH assay was performed, together with estimation of serum total T3 and total T4. Cases with abnormal TSH levels were subjected to free T4 estimation to confirm the state of thyroid dysfunction. Urine examination, blood count, liver function tests, kidney function tests and plasma glucose were carried out. Thyroid and abdominal ultrasound were performed. The studied cases were classified into two groups; group 1; 12 women having different antenatal complications and group II; 42 women having no pregnancy complications. The studied cases were also grouped into rural and urban groups, according to their residence in villages or Mansoura town respectively No hyperthyroid cases were detected in either groups. The clinical manifestations of hypothyroidism were not fulfilled, but utilizing serum TSH and FT4 testing, forty five cases out of the 154 studied cases revealed subclincial hypothyroidism [29.2%] being significantly higher among the complicated pregnancy group [33.9%] than the non complicated group [16.7%] and significantly more frequent among the rural cases than the urban group [p<0.001]. Subclincial hypothyroidism has a tendency to increase with increasing gestational age. The most prevalent complications were severe preeclamptic toxemia in 73.7% and second trimester abortion in 15.8% of cases. Subclinical hypothyroidism is common, especially in rural localities. TSH screening of pregnant women in each trimester is suggested

The importance of employing homologous serum free of thyronines in radioimmunoassays to assess circulating thyroid hormones in rainbow trout

A pesar de ser abundante, la información relacionada con los valores de tironinas circulantes en la trucha arcoiris, es confusa. El presente estudio demuestra la importancia de mantener especies sero-homólgoas durante la medición de tironinas con RIE para eviatar falsos resultados. La utilización de suero homólogo (trucha) libre de tironinas en la curva estándar permite la estandarización de radioinmunoensayos exactos y específcos para cuantificar los niveles circulates de T3 y T4 en 10 microl de suero de trucha arcoiris. El límite de detección fue de 50 pg para ambas tironinas. Los coeficientes de variación inter e intra ensayo fueron menores al 10 por ciento. Los valores promedio para T3 y T4 + - DEM en la población de truchas estudiadas (n=34) fueron 23.6 + - 1.2 y 12.0 + - 2.3 ng/ml respectivamente. Se obsevó una correlación positiva y significativa (p < 0.005) entre el peso corporal y T3 confirmando la participación activa de esta tironina en el proceso de crecimiento.

Single daily dose of carbimazole in the treatment of hyperthyroidism.

BACKGROUND. The antithyroid drugs, methimazole and carbimazole, are conventionally used in divided daily doses. However, these drugs have a longer intrathyroidal than a plasma half-life. We undertook this prospective, controlled study, in an area of mild iodine deficiency, to compare the efficacy of a single daily dose of carbimazole with divided doses in the treatment of hyperthyroidism. METHODS. Nineteen patients with hyperthyroidism received 30 mg of carbimazole daily at bed time (group A) while 14 received 10 mg of carbimazole every 8 hours (group B). These patients were assessed clinically and biochemically by estimation of serum total thyroxine, total triiodothyronine and thyrotropin before and 1, 2, 3, 4 and 6 weeks after treatment. RESULTS. There was no significant difference between mean baseline concentrations of thyroxine and triiodothyronine. After 1, 2, 3, 4 and 6 weeks there was a decline in their concentrations which was similar in both groups (p > 0.05). Euthyroidism was achieved in 4.6 +/- 1.4 weeks (range 2-6 weeks) in group A and in 3.8 +/- 1.2 weeks (range 3-6 weeks) in group B (p > 0.05). CONCLUSIONS. We conclude that carbimazole in a single daily dose is an effective method for treating hyperthyroidism in an area of mild iodine deficiency and its efficacy is comparable to divided dose therapy. This practical and acceptable method of treatment can be specially useful in patients who find it difficult to remember to take divided doses.

Determinaçäo dos níveis séricos de tiroxina (T4-RIA) e triiodotiromina (T3-RIA) em bovinos de duas regiöes fisiográficas do Estado de Minas Gerais / Bovine serum levels of thyroxine and triiodothyronine from the two regions of the State of Minas Gerais, Brazil

Dosagens de hormônios tireoideanos empregando-se a técnica de radioimunoensaio (RIA) foram realizadas em 106 bovinos mestiços Zebu, machos, castrados, provenientes de duas áreas fisiográficas do Estado de Minas Gerais, abatidos em matadouro comercial. Os valores médios de tiroxina e de triiodotironina foram 9,45 mais ou menos 2,58 mcg/dl e 158,41 mais ou menos 34,26 ng/dl, para os animais do Triângulo Mineiro, e 6,98 mais ou menos 1,95 mcg/dl e 121,35 mais ou menos 33,07 ng/dl, para os do Norte do Estado, respectivamente

T-toxicosis in Alexandria

The incidence of T[3] toxicosis among thyrotoxic patients in Alexandria was found to be 5.9%. Because of this relatively low occurrence, it is thought that serum T[3] estimation should not be performed as a routine test for thyroid functions