Tipos de partos y niveles de oxitocina, cortisol y hormonas tiroideas en plasma del cordón umbilical / Types of deliveries and levels of oxytocin, cortisol and thyroid hormones in umbilical cord plasma

Introducción: La placenta sintetiza y secreta varias hormonas que permiten la regulación del embarazo, el trabajo de parto y la adaptación metabólica materno-fetal. Su comportamiento asociado al tipo de parto puede dar información relevante sobre efectos epigenéticos. Objetivo: Describir el tipo de parto con los niveles de oxitocina, cortisol y hormonas tiroideas en plasma de cordón umbilical al nacer. Método: A 50 mujeres con embarazos principalmente normales se les cuantificaron los niveles neurohormonales en plasma de cordón umbilical, obtenido inmediatamente tras el periodo expulsivo. Los resultados se incorporaron a la base de datos clínicos de cada participante y se analizaron con Stata v.14.0. El protocolo fue aprobado por el comité de ética. Resultados: Hubo 33 partos vaginales (12 espontáneos, 13 acelerados y 8 inducidos) y 17 cesáreas (7 electivas y 10 de urgencia). Se observaron mayores niveles de cortisol en los partos vaginales acelerados; las cesáreas tuvieron menores niveles de cortisol y hormona estimulante de la tiroides. Las intervenciones clínicas, con altos o bajos niveles hormonales, están en directa relación con el tipo de parto. Conclusiones: El cortisol y la hormona estimulante de la tiroides medidos en plasma de cordón umbilical variaron según el tipo de parto. Esto es una primera cuantificación de hormonas en plasma de cordón umbilical y su posible regulación placentaria a propósito del tipo de parto.

Introduction: The placenta synthesizes and secretes several hormones allowing the regulation of pregnancy, labor and maternal-fetal metabolic adaptation. Their behavior associated with the type of delivery, may provide relevant information on epigenetic effects. Objective: To describe the type of delivery with the levels of oxytocin, cortisol and thyroid hormones in umbilical cord plasma at birth. Method: Neurohormonal levels from umbilical cord plasma obtained immediately post expulsion, were quantified in 50 women with mainly normal pregnancies. Results incorporated into the clinical database of each participant, statistically analyzed in Stata v.14.0. Protocol approved by ethics committee. Results: 33 were vaginal deliveries (12 spontaneous, 13 accelerated, 8 induced) and 17 cesarean sections (7 elective and 10 emergency). Higher cortisol levels were observed in accelerated vaginal deliveries, cesarean sections had lower cortisol and thyroid stimulating hormone levels. While clinical interventions, with high or low hormone levels, were related to the type of delivery. Conclusions: Cortisol and thyroid stimulating hormone measured in umbilical cord plasma varied according to the type of delivery. This is a first quantification of hormones in umbilical cord plasma and their possible placental regulation in relation to the type of delivery.

Copper sulfate and arginine supplements on performance, thyroid hormones and blood biochemistry of broilers fed with canola meal-based diets / Avaliação da suplementação com sulfato de cobre e arginina sobre o desempenho, hormônios tireoidianos e bioquímica sanguínea de frangos alimentados com dietas à base de canola

The present evaluated the effects of copper sulfate solution (CSS) and arginine powder (Arg) supplements on performance, thyroid hormones and blood biochemistry of broiler chickens fed with canola meal (CM)-based diets. The experimental design was completely randomized with a 3 × 3 factorial and 9 treatments, corresponding to 3 levels of CSS (0, 125 and 250 mg/kg) and 3 levels of Arg (0, 0.1 and 0.2%) (n = 45 per treatment). Feeds were offered ad libitum for 21 days, from 22 to 42 days of age. Feed efficiency was significantly affected by the dietary addition of 250 mg/kg CSS and 0.2% Arg, and by the CSS × Arg interaction. CM supplemented with CSS improved the thyroid gland status and increased the plasma levels of triiodothyronine and thyroxine. Birds fed diets supplemented with 0.2% Arg had lower blood glucose level than the other treatments. The addition of 250 mg/kg CSS and 0.2% Arg reduced the stress caused by the rapid growth of broilers, also increasing the overall bird welfare.

O objetivo do presente trabalho foi avaliar os efeitos da suplementação com solução de sulfato de cobre (SSC) e arginina em pó (Arg) sobre o desempenho, hormônios tireoidianos e bioquímica sanguínea de frangos de corte alimentados com dietas à base de canola DC. O desenho experimental foi completamente casualizado com fatorial 3 × 3 e nove tratamentos correspondentes a três níveis de inclusão de SSC (0, 125 e 250 mg/kg) e três níveis de Arg (0, 0,1 e 0,2%) (n = 45 para cada tratamento). As rações foram oferecidas ad libitum por 21 dias, de 22 até 42 dias de idade. A eficiência alimentar foi significativamente afetada pela adição de 250 mg/kg de SSC e 0,2% de Arg, assim como pela interação SSC × Arg. A suplementação da DC com SSC melhorou os parâmetros da glândula tireoide e aumentou os níveis plasmáticos de triiodotironina e tiroxina. As aves alimentadas com dietas suplementadas com 0,2% de Arg apresentaram menor nível de glicose sanguínea do que as dos demais tratamentos. A adição de 250 mg/kg de SSC e 0,2% de Arg reduz o estresse causado pelo rápido crescimento dos frangos, além de melhorar as condições gerais de bem estar das aves.

Efeito de dois sistemas de resfriamento sobre os hormônios tireoidianos e as variáveis termofisiológicas de matrizes suínas em lactação / Effect of two cooling systems on thyroid hormones and thermophysiological variables of lactating sows

Avaliaram-se os efeitos do sistema de resfriamento evaporativo com pressão negativa (SRE) e aspersão de água sobre o telhado (AAT), as variáveis termofisiológicas, os hormônios tireoidianos e a relação neutrófilo:linfócito (N:L) em porcas. Utilizaram-se 61 fêmeas em lactação, que foram divididas nos dois ambientes térmicos, sendo 30 em SRE e 31 em AAT, no verão. A temperatura e a umidade do ar, a frequência respiratória (FR), as temperaturas de superfície (TS) e retal (TR), a concentração de tiroxina e de tri-iodotironina, o número de neutrófilos e linfócitos e a relação N:L foram determinados. A temperatura ambiente pela manhã foi menor em SRE que em AAT (22,1ºC vs. 23,5ºC) e pela tarde (24,8ºC vs. 28,0ºC). Em ambos os períodos, a FR, a TS e a TR foram menores em SRE (de manhã 49 resp.min-1, 31,1ºC e 38,5ºC, respectivamente, e à tarde 55 resp.min-1, 30,3ºC e 38,8ºC, respectivamente) que em AAT (de manhã 54 resp.min-1, 32,8ºC e 38,6ºC, respectivamente; e à tarde 65 resp.min-1, 31,4ºC e 39,1ºC, respectivamente). Animais sob galpão AAT apresentaram menores concentrações de T4 que animais sob SRE (37,84 vs. 42,22nmol.L-1). Em ambiente tropical, no verão, porcas lactantes de ambos os sistemas mantêm a homeotermia.(AU)

The effects of the evaporative cooling system with negative pressure (ECS) and water spray on the roof (WSR) on physiological variables, thyroid hormones and neutrophil/lymphocyte ratio (N:L) in lactating sows were evaluated. Sixty-one lactating females were divided in the two thermal environments, being 30 in SRE and 31 in the AAT shed in the summer. The air temperature and humidity, respiratory frequency (RF), surface temperatures (ST) and rectal (RT), serum thyroxine and triiodothyronine concentration, number of neutrophils and lymphocytes and the N/L ratio were determined. In the afternoon, the matrices in ECS (Tar: 25.0°C and THI: 74.7) and WSR (Tar: 27.6°C and THI: 77.3) were exposed to heat stress. In the morning, RF, ST and RT were lower in ECS (49 breaths.min -1 , 31.1°C and 38.5°C, respectively) than WSR (54 breaths.min -1 , 32.8°C and 38.6°C) and also in the afternoon ECS (55 breaths.min -1 , 30.3°C and 38.8°C, respectively) and WSR (65 breaths.min -1 , 31.4°C and 39.1°C, respectively). Animals under WSR shed presented lower concentrations of T4 than animals under ECS (37.84 vs 42.22nmol.L -1 ). In a tropical environment, in the summer, lactating sows of both systems maintain homeothermia.(AU)

Avaliação dos níveis séricos de hormônios tireoidianos em araras (Ara spp) pelo método de quimioluminescência / Evaluation of serum levels of thyroid hormones in macaws (Ara spp) by chemiluminescence

Este trabalho investigou a eficiência do método de quimioluminescência para obtenção das concentrações séricas de hormônios tireoidianos em 23 exemplares de araras [Ara ararauna (n=12) e Ara chloropterus (n=11)], de ambos os sexos [machos (n=11) e fêmeas (n=12)], mantidas em cativeiro. Os valores de T4 total, T4 livre, T3 livre e TSH variaram, respectivamente, de 0,3 a 2,5µg/dL (média=0,94µg/dL), 0,11 a 0,46ɳg/dL (média=0,28ɳg/dL), 1,46 a 3,59pg/mL (média= 2,42pg/mL) e 0,01 a 0,12µUI/mL (média=0,04µUI/mL). Houve interação entre espécie e sexo (P<0,05) sobre as concentrações de T4 total: os machos possuem maiores valores do que as fêmeas de Ara ararauna, enquanto as fêmeas de Ara chloropterus dispõem de níveis mais altos do que os machos desta espécie. Efeito de sexo não foi observado (P>0,05) para os valores de T4 livre, T3 livre e TSH, mas o efeito de espécie foi constatado (P<0,05) para as concentrações de T3 livre. Neste caso, as concentrações de T3 livre são menores em Ara ararauna do que em Ara chloropterus. Os intervalos de referência obtidos sugerem que é possível mensurar as concentrações séricas de hormônios tireoidianos em araras pelo método de quimioluminescência, devendo-se considerar variações relevantes entre diferentes espécies e sexos.(AU)

This paper investigated the efficiency of chemiluminescence in obtaining serum concentrations of thyroid hormones in twenty-three macaws kept in captivity, from two sexes [male (n=10) and female (n=12)] and two species [Ara ararauna (n=12) and Ara chloropterus (n=11)]. Reference intervals for the hormones sampled were indicated and the effects of species and sex on these values were analyzed. Concentration values of total T4, free T4, free T3 and TSH varied respectively from 0,3 to 2,5µg/dL (average =0,94µg/dL), 0,11 - 0,46ɳg/dL (average = 0,28ɳg/dL), 3,59 - 1,46pg/mL (average =2,42pg/mL), and 0,01 - 0,12µUI/mL (average= 0,04µUI/mL). There was interaction between species and sex (P<0.05) on total T4 concentrations. Males had higher values than females in Ara ararauna, while females had higher values than males in Ara chloropterus. Sex effect was not observed (P>0.05) for concentrations of free T4, free T3 and TSH, but species effect was observed (P<0.05) for free T3 concentrations. In this case, concentrations of free T3 were lower in Ara ararauna than in Ara chloropterus. The results of this study suggest that it is possible to measure serum concentration of thyroid hormones in macaws by means of chemiluminescence method, as long as relevant variations between different species and sexes are taken into account.(AU)

Thyroid hormones affect decidualization and angiogenesis in the decidua and metrial gland of rats / Hormônios tireoidianos afetam a decidualização e a angiogênese na decídua e glândula metrial de ratas

This study aimed to evaluate the effects of thyroid hormone on the decidua and metrial gland of rats and to examine the expression of angiogenic factors. 72 adult, female rats were divided into hypothyroid, T4-treated2, and control groups. At 10, 14 and 19 days of gestation (DG), the decidua and metrial gland were collected for histomorphometric and immunohistochemical evaluation of the expression of VEGF, Flk-1 and Tie-2. Hypothyroidism reduced the area of the decidua at 10 and 19 DG. Furthermore, VEGF was increased at 10 and 14 DG, and Flk-1 only at 14 DG, but both was reduced at 19 DG in the metrial gland without significantly changing the area occupied by blood vessels. Rats treated with T4 showed an increase in the decidua blood vessels at 10 and 19 DG. However, at 10 DG, excess T4 resulted in increased of Flk-1 in the decidua and metrial gland. Hypothyroidism increased the Tie-2 at 10 and 19 DG in the decidua and metrial gland. In conclusion, hypothyroidism reduces the area of the decidua and increases the expression of VEGF, Tie-2 and Flk-1. The excess of T4 promotes tissue angiogenesis by increasing the number of vessels in the decidua because of the increased expression of Flk-1.(AU)

Este estudo teve como objetivo avaliar os efeitos dos hormônios tireoidianos sobre a decídua e a glândula metrial pela análise da expressão de fatores angiogênicos em ratas. 72 ratas adultas, fêmeas foram distribuídas nos grupos hipotiroideo, tratado com T4 e controle. Aos 10, 14 e 19 dias de gestação (DG), a decídua e a glândula metrial foram coletadas para avaliação histomorfométrica e imunoistoquímica da expressão de VEGF, Flk-1 e Tie-2. O hipotireoidismo reduziu a área da decídua aos 10 e 19 DG. Além disso, o VEGF aumentou aos 10 e 14 DG e o Flk-1 apenas aos 14 DG, mas ambos foram reduzidos aos 19 DG na glândula metrial sem alterar significativamente a área ocupada pelos vasos sanguíneos. As ratas tratadas com T4 apresentaram aumento do número de vasos sanguíneos na decídua aos 10 e 19 DG. Além disso, aos 10 DG, o excesso de T4 resultou no aumento de Flk-1 na decídua e na glândula metrial. O hipotireoidismo aumentou o Tie-2 em 10 e 19 DG na decídua e na glândula metrial. Desta forma, pode-se concluir que o hipotireoidismo reduz a área da decídua e aumenta a expressão de VEGF, Tie-2 e Flk-1. O excesso de T4 promove a angiogênese tecidual ao aumentar o número de vasos na decídua devido ao aumento da expressão de Flk-1.(AU)

Hematology, biochemical profile and thyroid hormones of four species of freshwater stingrays of the genus Potamotrygon / Hematologia, perfil bioquímico e hormônios da tireoide em quatro espécies de arraias de água doce do gênero Potamotrygon

Potamotrygonidae is a family of freshwater stingray endemic in South America. We determined the hematological and serum biochemistry parameters of Potamotrygon motoro and Potamotrygon falkneri from Parana Basin and Potamotrygon orbignyi and Potamotrygon scobina from the Amazon Basin. Blood was collected from 55 specimens of Potamotrygon sp., and these parameters were evaluated: red blood cell count, hematocrit percent, hemoglobin concentration, leucocytes count, trombocytes count, total protein concentration, albumin, uric acid, urea, creatinine, triglycerides, cholesterol, high-density lipoprotein HDL, calcium, phosphorus, calcium/phosphorus relationship, creatine kinase CK, gamma-glutamyl transpeptidase GGT, Aspartate transaminase AST, alanine transaminase ALT, globulin, albumin/globulin relationship, alkaline phosphatase AP, sodium, chloride, potassium, triiodothyronine T3, and thyroxine T4 hormones. The hematological indices were similar for all species, except for levels of heterophils in P. orbignyi and P. scobina that were higher. Calcium, phosphorus, calcium/phosphorus relationship, sodium, potassium, chloride, AST, ALT, GGT, CK, albumin/globulin relationship, uric acid, creatinine, urea, triglycerides, HDL, T3, T4 levels had no significant difference between the species. These results suggest that there is low influence of habitat and feeding habits. AP, total protein, albumin, globulin, glucose, and total cholesterol had significant differences between the studied species. These results support the theory that stingrays migrated from the Atlantic Ocean, adapting to different conditions over time and placed themselves geographically distant from each other.

Potamotrygonidae e um grupo de raias endêmicas da América do Sul distribuídas nas principais bacias hidrográficas brasileiras, mas informações sobre suas variáveis hematológicas e bioquímicas são escassas. Este estudo teve como objetivo determinar estas variáveis em Potamotrygon motoro e P. falkneri na Bacia do Rio Paraná, Estado do Paraná e de P. orbignyi e P. scobina do Rio Piririm, na Bacia Amazônica, Estado do Amapá. Foi capturado um total de 53 espécimes de Potamotrygon spp. para colheita de sangue e avaliações do hemograma e variáveis bioquímicas séricas. Os valores do hemograma foram próximos para as quatro espécies e os resultados com diferenças significativas entre Potamotrygon falkneri, P. motoro, P. orbigni e P. scobina ocorreram quanto ao número de eritrócitos e heterófilos. Apesar da diversidade geográfica os resultados apresentaram pouca interferência dos diferentes habitats nas variáveis avaliadas. Os níveis de proteínas, globulinas, relação albumina:globulina, acido úrico, creatinina, ureia, HDL-C, relação cálcio:fósforo, sódio, cloreto, AST, ALT, creatinoquinase (CK), fosfatase alcalina, hormônios triiodotironina (T3) e tiroxina (T4) não diferiram entre as espécies de Potamotrygon. Porem, os níveis de albumina, glicose, colesterol total, triglicerídeos e gama glutamil transferase (GGT) apresentaram diferenças. Este fato sugere pouca interferência do habitat nas variáveis avaliadas apesar da diversidade geográfica de origem das raias de vida livre.

Establishment of Trimester-Specific Reference Intervals for Thyroid Hormones in Korean Pregnant Women

BACKGROUND: Establishment of trimester- and assay-specific reference intervals for every population is recommended. The aim of this study was to establish a trimester- and assay-specific reference interval for thyroid-stimulating hormone (TSH) and free thyroxine (FT4) in Korean pregnant women. METHODS: From April 2012 to December 2012, 531 pregnant women receiving prenatal care and 238 age-matched, non-pregnant women were enrolled in this study. After excluding patients with pregnancy-associated complications or thyroid-specific autoantibody, 465 pregnant and 206 non-pregnant women were included. Non-parametric analysis (2.5-97.5th percentile) was performed to determine the reference interval. Levels of TSH and FT4 were determined by electrochemiluminescence immunoassay (Elecsys thyroid tests, Roche Diagnostics, Germany). RESULTS: The TSH reference intervals were 0.01-4.10, 0.01-4.26, and 0.15-4.57 mIU/L for the first, second, and third trimester, respectively. From the first trimester to the third trimester, the median TSH levels showed a significantly increasing trend (P<0.0001). The FT4 reference intervals were 0.83-1.65, 0.71-1.22, and 0.65-1.13 ng/dL for the first, second, and third trimester, respectively, showing a significantly decreasing trend (P<0.0001). CONCLUSIONS: Establishing trimester-specific reference intervals in pregnant women is essential for accurate assessment of thyroid function. Our population-specific and method-specific reference intervals will be useful for screening Korean pregnant women for thyroid disease.

Tratamento da hipercolesterolemia: quais os mais importantes produtos de pesquisa? / Hypercholesteromia the most important products being researched?

As estatinas são produtos farmacêuticos de grande sucesso em todo mundo. Entretanto, muitos pacientes, ou por não as tolerarem adequadamente, ou por necessitarem de taxas mais baixas de LDL-colesterol estabelecidas como metas, poderão ter benefícios clínicos com o emprego de novos medicamentos. Numerosas linhas de pesquisa encontram-se em evolução, avaliando produtos com atuação em diferentes vias moleculares: inibidores de síntese da apolipoproteína B, inibidores da DGAT2, da ACAT2, da MTP, da esqualeno sintase, tireoidemiméticos e inibidores da PCSK9. Espera-se, para futuro próximo, a introdução no mercado desses medicamentos, que poderão auxiliar ainda mais na prevenção primária e secundária da doença aterosclerótica coronária, flagelo deste novo século.

Statins are pharmaceutical products that obtained worldwide success. However, some patients with inadequate tolerability to these medications and the need of achieving lower LDL-cholesterol levels as recommended targets, may receive clinical benefits with the use of new drugs. Many research lines have been in evolution evaluating products that act in different molecular pathways: inhibitors of apoliprotein B synthesis, inhibitors of DGAT2, ACAT2, MTP, squalene synthase, thyromimetics, and inhibitors of PCSK9. It is a hope that the future introduction of many of these products on the market will help furthermore primary and secondary prevention of coronary heart disease, a scourge of this new century.

Actualización de la conducta diagnóstica en el nódulo de tiroides / Updating on diagnostic behavior in thyroid nodule

En los últimos años la frecuencia diagnóstica del nódulo de tiroides se ha incrementado, y constituye una de las entidades de mayor asistencia en las consultas de endocrinología en nuestro país. A pesar de no existir cambios en el diagnóstico diferencial de acuerdo con el estado funcional del nódulo, sí se han incorporado algunos elementos diagnósticos útiles para identificar mejor el riesgo de malignidad de la lesión. El ultrasonido aporta nuevos datos y aparecen estudios novedosos como la elastografía. El objetivo de esta actualización es rememorar algunos criterios sobre el diagnóstico del nódulo tiroideo, así como plantear los aspectos que tienen un nivel de evidencia científica reconocida en la actualidad. Puede servir como guía de trabajo para contribuir a una racional y óptima toma de decisiones en el paciente con un nódulo de tiroides(AU)

In past years the diagnostic frequency of thyroid nodule increased and it is one of entities of more attendance to Endocrinology consultations in our country. Despite there are not changes in differential diagnosis according to the nodule functional status, certainly some useful diagnostic elements have been incorporated to identify better the malignancy risk of lesion. The ultrasound (US) provides new data and to appear novel studies e g the elastography. The objective of present updating is to remember some criteria on the diagnosis of thyroid nodule, as well as to propose the features with a recognized scientific evidence at present time. May to be a working guide to contribute to a rational and optimal decision-making in the patient presenting with a thyroid nodule(AU)

Effect of early cold exposure on the endocrine responses of broiler chickens and the incidence of ascites syndrome

Two hundred and fifty day-old broiler chickens were housed in a high altitude farm and divided in two experimental groups [cold-exposed and control]. At the age of 3 and 4 d, the cold-exposed chickens were exposed to 15°C for 3 h, while the control birds were reared under normal condition. During the period between 14 and 28 days, both groups of chickens were exposed to a low environmental temperature. For hormonal analyses, blood samples were taken at days three and four [before and after cold exposure], and followed by samples taken at seven, 14, 28 and 42 days. The mean plasma corticosterone level was significantly higher in cold chickens, who were first exposed to cold temperature at days three and four of age. However, this result was reversed at day 28 during the second cold challenge. Cold-exposed birds showed significantly higher T3 levels compared to control chickens at day three after exposure to cold temperatures. During the second cold exposure [day 28], the T3 level was significantly lower in cold chickens compared to control chickens. At days three [after cold exposure] and four [before cold exposure], the concentrations of T4 were significantly lower in cold-exposed chickens compared to the control chickens. Such hormonal responses coincided with a marked reduction of ascites mortality in the early cold-exposed chickens compared with control chickens. In the present study, repeated cold exposure resulted in a moderate response; lower corticosterone and T3 levels resulted from the second cold exposure than from the first one alone. It can be concluded that early cold exposure improves the thermotolerance of broiler chickens at a later age, which consequently leads to an adaptation that reduces the incidence of the ascites syndrome

Avaliação da fosfatase alcalina óssea e hepática em gatos com tirotoxicose induzida / Evaluation of bone and liver alkaline phosphatase in cats with induced

A tirotoxicose é caracterizada pelas excessivas concentrações séricas dos hormônios tiroidianos, podendo desencadear graves alterações no metabolismo ósseo, sendo a elevação da fosfatase alcalina total uma alteração laboratorial freqüentemente observada no hipertiroidismo felino. O aumento global dos níveis séricos de fosfatase alcalina pode ser decorrente de diferentes isoenzimas e, no caso do hipertiroidismo em humanos, as isoenzimas de origem óssea e hepática apresentam-se comumente elevadas. A partir da avaliação da bioquímica sérica de oito gatos com tirotoxicose induzida e elevação da fosfatase alcalina associada, o presente trabalho demonstra um aumento significativamente maior dos níveis séricos da fosfatase alcalina de origem óssea quando comparado com a isoenzima de origem hepática. Conclui-se que as alterações no metabolismo ósseo foram as principais responsáveis pelo aumento da fosfatase alcalina nos gatos com tirotoxicose induzida

Thyrotoxicosis, characterized by excessive serum levels of thyroidhormones, can cause serious effects in bone metabolism, elevating the total alkaline phosphatase, which is a frequent laboratorial alteration observed in feline hyperthyroidism. A rise in total serum levels of alkaline phosphatase can be caused by different isoenzymes, and in human hyperthyroidism, bone and hepatic isoenzymes are commonly increased. After serum biochemical evaluation of eight cats with induced thyrotoxicosis and associated elevation of alkaline phosphatase, the present paper shows a significant elevation of bone isoenzyme serum levels when compared with hepatic isoenzyme. It was possible to conclude that bone metabolism alterations were the main responsible for the increase of serum alkaline phosphatase in cats with induced thyrotoxicosis.

Concentrações plasmáticas de testosterona, triiodotironina (T3) e tiroxina (T4) em bodes submetidos ao estresse calórico / Plasma concentrations of testosterone, triiodothyronine (T3), and thyroxine (T4) in bucks submitted to heat stress

Para verificar o efeito do estresse calórico (EC) nas concentrações plasmáticas de testosterona, triiodotironina (T3) e tiroxina (T4), oito bodes, das raças Saanen (n=4) e Alpina (n=4), foram mantidos em câmara bioclimática, sob condições de termoneutralidade (13,0ºC a 26,7ºC) durante 30 dias e, após um período (60 dias) de descanso, submetidos ao EC (23,7ºC a 34,0ºC) por 30 dias. Para minimizar as variações sazonais nos perfis hormonais devido ao fotoperíodo, durante toda fase experimental, incluindo a de adaptação em condições de termoneutralidade (30 dias), o fotoperíodo foi controlado utilizando-se alternância de dias longos (16h de luz e 8h de escuro) e de dias curtos (8h de luz e 16h de escuro) a cada 30 dias. As amostras de sangue foram coletadas duas vezes por semana durante cinco semanas. No conjunto das raças, o EC não influenciou (P>0,05) as concentrações de testosterona (1,8±0,2 vs 1,3±0,2ng/ml) e nem a de T4 (52,7±2,8 vs 50,0±2,8ng/ml). Houve declínio (P<0,01) das concentrações de T3 nos animais submetidos ao experimento (1,3±0,1 vs 1,0±0,1ng/ml), mas a redução foi observada somente nos bodes Saanen. Em ambas as raças, as concentrações de T3 e T4 variaram (P<0,01) conforme o dia da coleta das amostras de sangue. O EC foi suficiente para produzir uma resposta fisiológica com redução das concentrações plasmáticas de T3 em bodes das raças Saanen, mas não da raça Alpina, assim como não foi capaz de alterar os níveis plasmáticos de testosterona e nem de T4.

To verify the effect of heat stress (HS) on plasma testosterone, triiodothyronine (T3), and thyroxine (T4) concentrations, eight Saanen (n=4) and Alpine Brown (n=4) bucks were kept in climate chamber under thermal neutral conditions (13.0ºC to 26.7ºC) for 30 days. After a resting period (60 days), the same bucks were submitted to heat stress (23.7ºC to 34.0ºC) for another 30 days. To neutralize the seasonal variations of hormonal profiles throughout the period, the photoperiod was controlled every 30 days altering long (16 hours of light and 8 hours of darkness) and short days (8 hours of light and 16 hours of darkness). The blood samples were collected twice a week during five weeks. In both breeds, there was no effect of HS (P>0.05) on plasma concentrations of testosterone (1.8±0.2 vs 1.3±0.2ng/ml) and T4 (52.7±2.8 vs 50.0±2.8ng/ml). There was a decline (P<0.01) of plasma T3 concentrations (1.3±0.1 vs 1.0±0.1ng/ml) after HS treatment, but this reduction was only evident in Saanen bucks. In both breeds, the plasma concentrations of T3 and T4 varied (P<0.01) according to the day of blood sample collection. The HS was sufficient to provoke a physiological response with reduction of plasma concentrations of thyroid hormones mainly of T3 in Saanen bucks, but not in Alpine ones. The HS did not affect the plasma testosterone and T4 levels.

Alteraciones neuro-funcionales y neuro-endocrinas en una cohorte de pacientes que cursan con trastorno por estrés post traumático / Neuroendocrine and neurofunctional alterations in patient with post traumatic stress disorder

El trastorno por estrés post traumático (TEPT) se perfila en la actualidad como una patología emergente debido a las condiciones de vida modernas cada vez más exigentes y al énfasis epidemiológico y en salud mental por pesquisar las consecuencias de traumas cotidianos, como de aquellos derivados de conflictos bélicos o de la acción de fuerzas de seguridad y orden ciudadanos. Se describe que aproximadamente un 8 por ciento de quienes sufren un trauma experimentarán un cuadro clínico compatible con TEPT. Sin embargo, la larga duración y frecuente cronicidad de estos casos demanda un enorme esfuerzo al equipo de salud y costos elevados a los organismos que acogen a estos pacientes. El presente trabajo tiene por objetivo realizar un estudio neuro-funcional, clínico y de laboratorio en una muestra de 7 pacientes que cursan con un cuadro compatible con TEPT. Método: Se evaluó clínicamente a 7 pacientes que cursaban con TEPT, aplicándoseles una escala de evaluación para esta patología (Escala de Davidson) y el inventario de depresión de Beck. Se obtuvieron muestras de sangre con el objeto de evaluar los niveles de cortisol plasmático y hormonas tiroideas T3, T4 y TSH. Finalmente, los sujetos fueron evaluados a partir de la técnica de neuro SPECT delineándose una serie de Regiones e Interés (ROI) involucradas en la neurobiología del TEPT. Resultados: Se reportan para todos los pacientes de la cohorte estudiada valores elevados en escala Davidson para TEPT y en la escala de Beck para depresión (91.85 y 25.28 respectivamente). Se describen valores promedios normales de cortisol plasmático y de hormonas tiroideas T3, T4 y TSH (17.35 ug/dl, 1.34 ng/ml, 6,98 ug/dl y 2,95 uUI/ml respectivamente). Destaca la presencia de hiper-cortisolemia en tres de los pacientes estudiados. Los hallazgos neuro-funcionales se caracterizan por una hiper-perfusión a nivel de córtex fronto-parietal e hipo-perfusión...

Post Traumatic Stress Disorder (PTSD) is one of the most important emergent pathologies in mental health and is usually associated with current post modern´s life styles and with specific traumatic event such as belic conflicts or incident involving criminal behaviors affecting civilians. It is well known that 8% of victims of a traumatic event will develop PTSD. Furthermore, the chronicity and social impairment associated to this clinical entity requires an enormous effort from mental health’s professionals and huge costs to the systems involved in the rehabilitation of these patients. The aim of this study is to evaluate a sample of 7 patients affected from PTSD in order to understand their clinical characteristics, neuro-functional features and possible neuro-endocrine abnormatilies. Method: 7 patient affected with PTSD were clinically evaluated and submitted to a specific-validated post traumatic scale (Davidson scale) and also to a depression inventory (Beck depression inventory). Then, blood samples were taken in order to assess Neuro- endocrine levels of cortisol in plasma and T3, T4 and TSH levels. Finally, the subjects were studied by means of SPECT, delineating specific Region of Interest (ROI) involved in the neurobiological basis of PTSD. Results: we report on, for the entire sample, high scores on both scales used (Davidson scale: 91.85; Beck inventory: 25.28). These results confirm the previously reported high comorbidity between this two clinical entities. We describe average normal values for plasmatic cortisol levels and thyroid hormones levels T3, T4, TSH (17.35 ug/dl, 1.34 ng/ml, 6.98 ug/dl and 2.95 uUI/ml respectively). It is important to remark the presence of hypercortisolemia in 3 of the patients studied. Neuro-functional features were characterized by a cortical fronto-parietal hyper-perfusion and hypo-perfusion on limbic areas. This results were consistently replicated in the entire sample...

Enfermedad de Basedow Graves en pacientes pediátricos / Graves-Basedow disease in pediatric patients

Objective: Determine differences in the epidemiology, clinical features and diagnosis of Graves-Basedow disease (GBD) in prepubertal and pubertal patients. Method: Retrospective study analyzing medical records of 38 patients with GBD at Pontificia Universidad Católica de Chile between 1992-2007. Statistical analysis was performed with non parametric test of Mann-Whitney U and proportions difference with Fisher Test (SPSS 10.0 for Windows and Graphpad Prism 4). Results: 21 patients were prepubertal and 17 were pubertal, with ages between 3 and 15,9 years. There were more girls than boys in both groups (5:2 and 15:2, respectively; p = 0.2). The most common clinical presentations were diffuse goiter, hyperactivity, frequent bowel movements, insomnia and heat intolerance. The prepubertal group had a taller stature (+2.4 SDS) compared with the pubertal group (+0.2 SDS; p = 0.03) and the most frequent ocular manifestation was exophthalmus in both groups. Conclusions: We did not find any differences in the clinical presentations of Graves-Basedow disease among prepubertal and pubertal patients. Neuropsychiatric symptoms such as hyperactivity and insomnia, together with tall stature are common features in children with GBD.

Objetivo: Determinar si existen diferencias en las características epidemiológicas y clínicas al momento del diagnóstico de hipertiroidismo por Basedow Graves (BG) en sujetos pre-púberes y púberes. Pacientes y Método: Estudio descriptivo y retrospectivo. Universo: Pacientes con diagnóstico de BG en control en endocrinología pediátrica en la Pontificia Universidad Católica de Chile, entre 1991 y abril 2007 (n = 38). Se registraron los hallazgos clínicos y de laboratorio. Se evaluó las diferencias entre los grupos con pruebas no paramétricas (Mann-Whitney U), las diferencias de proporciones con la Prueba de Fisher (SPSS 10.0 para Windows y graphpad Prism 4). Resultados: El rango de edad fue 3 a 15,9 años. Veintiún sujetos eran pre-púberes y 17 eran púberes; hubo más mujeres que hombres (5: 2 y 15: 2, respectivamente; p = 0,2). Los síntomas y signos más frecuentes fueron bocio difuso, hiperactividad, polidefecación, insomnio e irradiación de calor. No hubo diferencias entre los pre-púberes y púberes. El grupo pre-púber tenía talla más alta que su carga genética (+2,4 DS) comparados con los púberes (+0,2 SDS; p = 0,03). El compromiso ocular más frecuente fue el exoftalmo. Conclusión: No encontramos diferencias en la forma de presentación del BG entre los niños pre-púberes y púberes. Los síntomas neuropsiquiátricos tales como hiperactividad e insomnio, y una talla mayor a la esperada para la diana familiar, fueron hallazgos frecuentes en los niños con BG.

Effect of non detectable thyroid stimulating hormone [TSH] levels on thyroid activity

Thyroid hormones, triiodothyronine [T3] and thyroxin [T4], affect almost all metabolic activities of tissues and are produced under influence of the anterior pituitary hormone, the thyroid stimulating hormone [TSH], which stimulates secretion of thyroid hormones, and is itself under the control of the hypothalamic thyroid releasing hormone [TRH]. The present study was conducted to observe the effect of non-detectable levels of TSH on thyroid hormones, on the basis of gender and age. Analysis of data through student's 't'-test revealed that prevalence of thyroid disorders in the studied group was more among females. However, the disorders were not age dependent. Most common condition associated with non-detectable TSH levels was hyperactivity of the thyroid gland, followed by sub-clinical hyperthyroidism

Avaliação dos níveis séricos de hormônios tireóideos em revascularização miocárdica / Evaluation of serum levels of thyroid hormones in myocardial revascularization

JUSTIFICATIVAS E OBJETIVOS: Os hormônios tireóideos tiroxina (T4) e triiodotironina (T3) regulam o anabolismo de proteínas, lipídios e carboidratos e aumentam o consumo de oxigênio. Estresse cirúrgico e circulação extracorpórea (CEC) podem alterar os níveis hormonais ativos por meio de interferência na conversão periférica e diminuição do nível sérico de T3 sem alterações da tirotrofina (TSH), caracterizando a síndrome eutireóidea. Objetivou-se comparar os níveis séricos de T3, T4 e TSH em pacientes submetidos à revascularização miocárdica (RM) com ou sem utilização de CEC. MÉTODO: Foram estudados 18 pacientes com programação para cirurgia eletiva de RM, sendo: Grupo CEC (n = 9): pacientes submetidos à CEC e Grupo sem CEC (n = 9): pacientes não submetidos à CEC. Realizou-se dosagem de T3, T4 e TSH séricos antes da indução anestésica (início SO), ao término da cirurgia (final SO), no primeiro dia (1º PO) e no segundo dia de pós-operatório (2º PO). Na análise estatística (Análise de Variância de medidas repetidas, teste de Mann-Whitney e prova de Friedman) considerou-se significativo p < 0,05. RESULTADOS: Ocorreu diminuição do nível sérico de T3 nos dois grupos. Os níveis séricos de T4 mostraram diferença entre os momentos final SO e 1º PO, quando o grupo não-submetido à CEC mostrou níveis mais elevados de T4. Os níveis séricos de TSH permaneceram dentro dos limites da normalidade. CONCLUSÕES: Ocorre diminuição dos níveis séricos de T3 após revascularização miocárdica com e sem a utilização de CEC e com maior diminuição de T4 no grupo submetido à CEC. A ausência de resposta hipofisária às alterações dos níveis séricos de T3 e T4 caracteriza a síndrome eutireóidea nos dois grupos.

BACKGROUND AND OBJECTIVES: Thyroid hormones, thyroxine (T4) and triiodothyronine (T3), regulate anabolism of proteins, lipids, and carbohydrates, and increase oxygen consumption. Surgical stress and cardiopulmonary bypass (CPB) can change active hormone levels by interfering with the peripheral conversion and reducing serum levels of T3, without changing the levels of thyrotropin (TSH), which are the characteristics of the euthyroid syndrome. The objective of this work was to compare serum levels of T3, T4 and TSH in patients undergoing myocardial revascularization (MR) with or without ECC. METHODS: Eighteen patients scheduled for elective MR divided as follows: CPB Group (n = 9): patients undergoing CPB, and the Group without CPB (n = 9): patients that did not undergo CPB. The serum levels of T3, T4 and TSH were determined before anesthetic induction (initial OR), at the end of the surgery (final OR), in the first (1st PO) and in the second (2nd PO) postoperative days. Statistical analysis (Analysis of Variance for repeated measures, Mann-Whitney test, and Friedman test) considered significant a p < 0.05. RESULTS: There was a reduction in serum levels of T3 in both groups. Serum levels of T4 showed differences in final OR and 1st PO, which were elevated in the group that did not undergo CPB. Serum levels of TSH remained within normal limits. CONCLUSIONS: Serum levels of T3 are reduced after myocardial revascularization with and without CPB, with greater reduction in T4 in the group that underwent CPB. The absence of pituitary response to changes in serum levels of T3 and T4 characterized the euthyroid syndrome in both groups.

JUSTIFICATIVAS Y OBJETIVOS: Las hormonas tireoideas tiroxina (T4) y triiodotironina (T3) regulan el anabolismo de proteínas, lipídeos y carbohidratos y aumentan el consumo de oxígeno. Estrés quirúrgico y circulación extracorpórea (CEC) pueden alterar los niveles hormonales activos por medio de interferencia en la conversión periférica y en la disminución del nivel sérico de T3 sin alteraciones de la tirotrofina (TSH), caracterizando el síndrome eutireóideo. Se pensó comparar los niveles séricos de T3, T4 y TSH en pacientes sometidos a la revascularización miocárdica (RM) con o sin utilización de CEC. MÉTODO: Fueron estudiados 18 pacientes con programación para cirugía electiva de RM, siendo: Grupo CEC (n = 9): pacientes sometidos a la CEC y Grupo sin CEC (n = 9): pacientes no sometidos a la CEC. Se realizó la dosificación de T3, T4 y TSH séricos antes de la inducción anestésica (Inicio SO), al término de la cirugía (Final SO), al primer día (1º PO) y en el segundo día del postoperatorio (2º PO). En el análisis estadístico (Análisis de Variancia de medidas repetidas, test de Mann-Whitney y prueba de Friedman) se consideró el significativo p < 0,05. RESULTADOS: Ocurrió una disminución del nivel sérico de T3 en los dos grupos. Los niveles séricos de T4 mostraron diferencia entre los momentos Final SO y 1º PO, cuando el grupo no sometido a la CEC mostró niveles más elevados de T4. Los niveles séricos de TSH permanecieron dentro de los límites de la normalidad. CONCLUSIONES: Ocurre una disminución de los niveles séricos de T3 después de la revascularización miocárdica con y sin la utilización de CEC y con más disminución de T4 en el grupo sometido a la CEC. La falta de respuesta hipofisaria a las alteraciones de los niveles séricos de T3 y T4 caracteriza el síndrome eutireóideo en los dos grupos.

Nutritional assessment of patients with secondary hyperparathyroidism / Avaliação nutricional de pacientes com hiperparatireoidismo secundário / Evaluación nutricional de pacientes con hiperparatiroidismo secundario

Secondary hyperparathyroidism (SHPT) is a common complication in patients undergoing hemodialysis. Nutritional counseling is an integral part of treatment, with potential positive impact on retention of calcium and phosphorus. The aim of this study was to monitor the nutritional status during a year of nutritional intervention. Forty-one hemodialysis patients, in the Outpatient Renal Osteodystrophy, Hospital das Clinicas in São Paulo, with a mean age of 43.4 (15.7) years were evaluated. During the evaluation period, some patients underwent parathyroidectomy (PTX) and surgical or chemical analysis was based on three groups according to treatment: diet group (n = 21), PTX chemical group (n = 9) and PTX surgical group (n = 11). Could be evaluated intakes of energy, protein, calcium and phosphorus in the nutrition survey in three days. Weight, height, BMI and% body fat were measured, and biochemical markers of bone metabolism. Dietary measures, and anthropometric and biochemical changes were implemented in early clinical intervention and after one year. There were no significant changes in intakes of energy, protein and calcium during the study, even after nutritional counseling. The dietary phosphorus remained within the recommendations. There were no changes in anthropometric parameters. There was a significant decrease in total serum calcium, ionized calcium, phosphorus, CaxP product and iPTH levels in patients undergoing surgical PTX. Although this practice has shown significant improvement in biochemical parameters of SHPT, dietary control can be effective for non-aggravation of the nutritional status of the parameters of SHPT with low cost.

O hiperparatiroidismo secundário (HPTS) é uma complicação comum em pacientes que realizam hemodiálise. A orientação nutricional é parte integrante do tratamento, com potencial impacto favorável na retenção de cálcio e fósforo. O objetivo deste estudo foi monitorar o estado nutricional durante um ano de intervenção nutricional. Quarenta e um pacientes hemodializados, atendidos no Ambulatório de Osteodistrofia Renal do Hospital das Clínicas, em São Paulo, com média de idade de 43,4 (15,7) anos foram avaliados. Durante o período de avaliação, alguns pacientes foram submetidos à paratiroidectomia (PTX) química ou cirúrgica e a análise foi feita baseada em três grupos, de acordo com o tratamento: grupo dieta (n=21), grupo PTX química (n=9) e grupo PTX cirúrgica (n=11). Puderam ser avaliadas as ingestões de energia, proteína, cálcio e fósforo por inquérito alimentar de três dias. Peso, altura, IMC e % gordura corporal foram mensurados, bem como marcadores bioquímicos do metabolismo ósseo. As medidas dietéticas, antropométricas e bioquímicas foram executadas no início da intervenção clínica e após um ano. Não houve alterações significativas nas ingestões de energia, proteína e cálcio durante o estudo, mesmo após a orientação nutricional. O fósforo dietético permaneceu dentro das recomendações. Não foram observadas alterações nos parâmetros antropométricos. Houve diminuição significativa no cálcio sérico total, cálcio iônico, fósforo, produto CaxP e níveis de PTHi nos pacientes submetidos à PTX cirúrgica. Embora esta prática tenha apresentado significante melhora nos parâmetros bioquímicos do HPTS, o controle dietético pode ser efetivo para o não-agravo do estado nutricional dos parâmetros do HPTS com baixo custo.

El hiperparatiroidismo secundario (HPTS) es una complicación frecuente en pacientes sometidos a hemodiálisis. consejería nutricional es una parte integral del tratamiento, con un impacto potencial positivo en la retención de calcio y fósforo. El objetivo de este estudio fue monitorear el estado nutricional durante un año de la intervención nutricional. Cuarenta y un pacientes en hemodiálisis, en la osteodistrofia renal para pacientes ambulatorios del Hospital das Clínicas de São Paulo, con una edad media de 43,4 (15,7) años fueron evaluados. Durante el período de evaluación, algunos pacientes fueron sometidos a paratiroidectomía (PTX) y el análisis quirúrgica o química se basa en tres grupos según el tratamiento: grupo de la dieta (n = 21), grupo PTX químicos (n = 9) y PTX quirúrgica grupo (n = 11). ¿Podría ser evaluado la ingesta de energía, proteínas, calcio y fósforo en la encuesta de nutrición en tres días. Peso, talla, índice de masa corporal y el% de grasa corporal fueron medidos, y los marcadores bioquímicos del metabolismo óseo. Medidas dietéticas y cambios antropométricos y bioquímicos se llevaron a cabo en la intervención clínica temprana y después de un año. No hubo cambios significativos en la ingesta de energía, proteínas y calcio durante el estudio, incluso después del asesoramiento nutricional. El fósforo en la dieta se mantuvo dentro de las recomendaciones. No hubo cambios en los parámetros antropométricos. Hubo una disminución significativa en el calcio sérico total, calcio iónico, fósforo, producto CaxP y los niveles de PTH en pacientes sometidos a cirugía PTX. Aunque esta práctica ha demostrado una mejora significativa en los parámetros bioquímicos de SHPT, control de la dieta puede ser eficaz para que no se agrave la situación nutricional de los parámetros de SHPT con bajo costo.

Adaptive changes in thyroid function of female rats fed a high-fat and low-protein diet during gestation and lactation

The percent of lipids in the western diet has been continuously increasing in the last decades and is associated with a decrease in the proportion of protein intake. Recently, we demonstrated that protein malnutrition during lactation is associated with lower body weight and thyroid hypofunction in female rats and their offspring. Our objective in the present study was to determine if a high-fat and low-protein diet was associated with similar changes. Three-month-old female Wistar rats were randomly assigned to one of the following groups with 8 animals each: high-fat and low-protein (40% lipid, 5% protein, and 55% carbohydrate of the total energy content) from the 3rd week of gestation to the end of lactation; control group - standard diet (11% lipid, 23% protein, and 66% carbohydrate of the total energy content). Food consumption and body weight were monitored daily. Serum thyrotropin and thyroid hormone concentrations were determined by specific radioimmunoassay at the end of lactation. Animals receiving high-fat and low-protein diet had a significantly lower body weight (13.9% at weaning, P < 0.05) and serum albumin (25%, P < 0.05) and thyrotropin (26.2%, P < 0.01) concentrations, and a higher serum triiodothyronine concentration (74%, P < 0.005) and 131I-thyroid uptake (77%, P < 0.005). These data show that a high-fat and low-protein diet can promote maternal thyroid hyperfunction that differs from the thyroid hypofunction observed in dams fed a low-protein diet, a phenomenon that can be of adaptive importance for pup nurturing.

Funcao tireoidiana em recem-nascidos doentes / Thyroid function in sick newborns

Revisar as alteracoes da funcao em recem-nascidos doentes...