Influence of short-time application of a low sodium diet on blood pressure in patients with hyperthyroidism or hypothyroidism during therapy.

Hyperthyroidism or hypothyroidism are commonly associated with altered blood pressure (BP). Restriction of sodium in the diet produces a decrease in BP in some individuals. It is also well known that hormones other than thyroid affect BP. The present study was designed to evaluate the influence of a low sodium diet on BP in patients with hyperthyroidism or hypothyroidism during therapy. The occurrence of salt-sensitive or salt-nonsensitive BP was compared with hormonal levels (plasma renin activity, aldosterone, atrial natriuretic peptide, and arginine vasopressin). Patients with hyperthyroidism (75 subjects) were investigated before the initiation of treatment, 2 weeks after the treatment, and after the attainment of euthyroid state. Patients with hypothyroidism (31 subjects) were studied before the treatment and in the euthyroid state. Control values were obtained from 37 healthy individuals. Blood pressure, changes of plasma volume, serum aldosterone, atrial natriuretic peptide, vasopressin levels, and plasma renin activity were measured in all investigated subjects after application of a normal sodium diet and after 3 days on a low sodium diet. Elevated systolic BP was found in patients with hyperthyroidism and hypothyroidism. Mean arterial BP was higher only in the untreated hypothyroid patients. The high incidence of salt-sensitive BP was found only in untreated hypothyroid patients. Also in hypothyroid patients the application of a low sodium diet led to a lower increase in plasma renin activity in subjects with salt-sensitive BP than in individuals with salt-resistant BP. Therefore, different mechanisms are responsible for BP elevation in patients with hyperthyroidism or hypothyroidism.

The systolic function of the left ventricle of the heart in patients with hyperthyroidism during therapy.

Hyperthyroidism is associated with enhanced systolic function. The present study was designed to evaluate systolic cardiac function in patients with hyperthyroidism during a short-term and a long-term pharmacotherapy. The diagnostic value of various indices of the left ventricle function was analysed. Fifty-one hyperthyroid patients were investigated before initiation of the treatment, after 14 days of therapy with thiamazol (mean dose 54 mg/24 hr), a short-term treatment and after attainment of normal thyroid function, a long-term treatment (mean period 9 months). Control values were obtained from 30 healthy individuals. All investigated subjects were aged 18-50 yr. The following indices were determined with ultrasonocardiographic method: preejection period (PEP), left ventricle ejection time (LVET), preejection period index (PEPI) and left ventricle ejection time index (LVETI), index PEP/LVET, left ventricle shortening fraction (LVSF), left ventricle ejection fraction (LVEF), mean velocity of the circumferential fiber shortening (mVcf), contractility index (CIx), stroke volume (SV), cardiac index (CI), output-pressure index (OPI) and end-systolic wall stress (ESWS). Additionally, total peripheral resistance index (TPRI) and double product (DP) were calculated. In patients with untreated hyperthyroidism, a significant shortening of PEP, PEPI, LVET and low PEP/LVET index and TPRI as well as increased LVSF, LVEF, mVcf, CIx, CI, OPI and DP were shown. There was no changes in LVETI, SV and ESWS. A short-term treatment resulted in changes in PEP, PEPI, LVET, mVcf, CI and OPI in direction of normal values. After a long-term treatment all altered indices were normal with an exception of OPI, CI and DP. It is concluded that enhanced systolic function of the heart in patients with hyperthyroidism becomes normal after pharmacological control of the thyroid gland. Some changes are seen after a short-term treatment with thiamazol. The indices which reverse early are PEP, PEPI, LVET, mVcf and CI. Changes in ejection function of the left ventricle in patients with hyperthyroidism are resulted from increased heart rate and were found to be related to total peripheral vascular resistance.

Changes of plasma arginine-vasopressin level in patients with hyperthyroidism during treatment.

BACKGROUND: Hyperthyroidism is associated with several kinds of changes in the circulatory system, including alterations in blood volume. Arginine-vasopressin (AVP) is known to be one of the major factors regulating plasma volume. The present study was designed to evaluate the plasma AVP level in patients with hyperthyroidism during treatment. MATERIAL AND METHODS: AVP was measured under basal conditions and after stimulation with a low-sodium diet and upright position. Seventy-four patients with hyperthyroidism and 37 controls were investigated. Measurements were taken before treatment, two weeks after pharmacological treatment, and after attaining euthyroid status. The following indices were determined: AVP, total and free thyroxin and triiodothyronine, thyrotropin, sodium, potassium, hematocrit, arterial blood pressure, cardiac index, and total peripheral resistance index. Plasma osmolality and changes in plasma volume were calculated indirectly. RESULTS: Plasma AVP was higher in patients with hyperthyroidism before treatment. After normalization of thyroid status, the AVP level was similar to that of the controls. The application of a low-sodium diet and upright position resulted in a greater decrease in plasma volume than the controls. AVP correlated with thyroxin level and plasma osmolality in patients with hyperthyroidism. CONCLUSION: Enhanced AVP level in patients with hyperthyroidism is suggested to be the result of alterations in plasma volume and is relatively independent of changes in plasma osmolality.

Immunological parameters and respiratory functions in patients suffering from atopic bronchial asthma after intravenous treatment with salmon calcitonin.

This study reports the effect of salmon calcitonin on airway function and peripheral blood parameters in asthmatic subjects. The premise for the study is that calcitonin is given to asthmatics that require systemic corticosteroids as a way to counter problems with calcium balance and osteoporosis, and that it has an immunosuppressive effect. Salmon calcitonin (100 IU) was administered to 18 patients with atopic bronchial asthma, and the following spirometric parameters were evaluated: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak respiratory flow rate (PEFR) and forced expiratory flow rates at 25%, 50% and 75% of the forced vital capacity (FEF25%, FEF50% and FEF75%). Calcitonin significantly decreased the levels of FVC and FEV1 by 20 min after starting the infusion. The effect of 500 mg aminophylline, used as a reference drug in this study, was much more profound, with a significant increase in all investigated parameters. Also, the effect of salmon calcitonin on some immune parameters (white blood cell count, number of eosinophils, serum levels of immunoglobulins IgG, IgM and IgA, and serum levels of lymphocytes subpopulations CD3, CD4, CD8 and CD19) was determined in another group of 30 patients suffering from atopic bronchial asthma. Calcitonin at a dose of 100 IU/day subcutaneously for 3 days did not alter the immune parameters studied, thus rendering it safe for such and similar treatment schedules in a variety of medical conditions.

[The respiratory system of workers employed in the casting and processing of copper]. / Uklad oddechowy u pracowników zatrudnionych przy odlewaniu i przetwarzaniu miedzi.

The aim of the study was to examine the influence of work in exposure to copper on the respiratory system. The study was carried out in 267 men aged (x +/- SD) 40.6 +/- 7.2 yrs, workers of a colour metal mill. 134 of them dealt with casting and processing of copper (the mean weighed concentration of copper on work posts was below 0.05 mg x m-3) and 133, not employed in a contaminated environment, comprised the control group. The subjects were divided into five groups according to the degree of energy expenditure at work and, additionally cigarette smoking was taken into account. All subjects underwent medical examination and spirometry. However the mean values of the ventilatory parameters in the compared groups did not significantly differ (p > 0.05), the multivarious regression analysis has shown a decreasing trend of FEV1 and FVC with relation to the exposition to copper and tobacco smoking. The frequency of chronic bronchitis as well as of radiological changes was not increased. The authors conclude: 1. At copper concentration not exceeding the MAC, and an advantageous microclimate, this exposition only slightly diminishes the pulmonary ventilation and does not cause other comprehensible pulmonary pathological sequelae, especially chronic bronchitis. 2. Tobacco smoking is a favourable factor for the occurrence of chronic bronchitis.

Lack of effect of salmon calcitonin on serum level of soluble form of E-selectin (CD 62E) in patients with atopic bronchial asthma.

The effect of salmon calcitonin on serum level of soluble form of E-selectin was investigated in patients with atopic bronchial asthma. A slight decrease in serum soluble E-selectin level was shown in patients with mild asthma. There was no effect of calcitonin (100 units, s.c., daily for three days) on serum E-selectin.

Gastric emptying in hyperthyroidism.

OBJECTIVES: We undertook a prospective study to survey gastric emptying of a solid meal in patients with hyperthyroidism until euthyroidism was reached after pharmacological treatment with thiamazole. METHODS: Eleven women (aged 33.2 +/- 3.2 SE yr) with recently diagnosed hyperthyroidism participated in the study. Thyroid function parameters and gastric emptying were examined on three occasions, before treatment, during the third week of treatment, and after euthyroidism was restored. The control group was composed of 12 age-matched healthy women (aged 34.5 +/- 2.3 yr). Gastric emptying of a 390-kcal 99mTc-labeled solid meal was continuously recorded under a gamma camera over 90 min. A power-exponential model was used for analysis of the gastric emptying course. Three gastric emptying parameters were computed: t1/2, the gastric half-emptying time, S, the curve shape parameter, and K, the slope of the curve. RESULTS: Pretreatment solid phase gastric emptying of the patients was not statistically significantly different from that of the healthy control subjects: t1/2, 82.8 +/- 4.9 vs 93.5 +/- 6.0 min; S, 0.996 +/- 0.103 vs 1.032 +/- 0.064; and K, 8.42 +/- 0.47 vs 7.64 +/- 0.39 min(-1) x 10(-3). Gastric emptying during the third week of treatment did not change in comparison with pretreatment gastric emptying: t1/2, 84.3 +/- 8.2 min; S, 1.014 +/- 0.123; and K, 8.92 +/- 1.12 min(-1) x 10(-3). On the other hand, a slight increase in rate of gastric emptying was observed after the restoration of euthyroidism (t1/2, 74.6 +/- 5.8 min, and K, 9.65 +/- 0.76 min(-1) x 10(-3), p < 0.05 vs healthy control subjects for both parameters), but no significant change was observed in the shape parameter (S, 0.980 +/- 0.066). CONCLUSIONS: In women with hyperthyroidism, gastric emptying of solids does not differ significantly from that observed in age-matched healthy control subjects and remains unaffected during pharmacological treatment. After restoration of euthyroidism, a slight but statistically significant increase in the rate of gastric emptying occurs in patients as compared with healthy control subjects.

Gastric emptying in hypothyreosis.

The purpose of this study was to compare the solid phase gastric emptying (GE) in hypothyreotic patients before treatment and after euthyreosis has been reached. Ten female patients (aged 44.8 +/- 9.5[SD] y) with recently diagnosed hypothyroidism were included in the study. Their thyrometabolic state and GE were examined before treatment and after a median of 5 1/2 months (range 2 1/2-12 1/2), i.e., when euthyreosis was achieved. The control group consisted of 12 healthy women (aged 34.5 +/- 8.1y). GE of a 390-kcal 99mTc-labelled solid meal was continuously recorded under a gamma camera during 90 min. A power-exponential model was used for the analysis of the GE course. Compared to the controls, the solid phase GE of the hypothyreotics was characterized by a significantly lower curve shape parameter S (0.745 +/- 0.217 vs. 1.032 +/- 0.223, p < 0.01) and slope of the curve K (4.8 +/- 2.2 min-1.10(-3) vs. 7.6 +/- 1.3 min-1.10(-3), p < 0.01). Restoration of euthyreosis resulted in an increase of both parameters, making the GE pattern no longer statistically significantly different from that encountered in healthy subjects. The treatment did not affect the gastric half emptying time T1/2 (median: 125 min and 130 min before and after the treatment, respectively; healthy controls: 94 min). A wide variation of individual GE data was found either before or after the treatment, and in a few cases delayed GE persisted despite an effective substitutive treatment. The GE kinetics was, however, in no way related to the severity of the disease. Further research on the pathogenesis of this phenomenon is warranted.

Markers of tissue response to thyroid hormones in patients with hyperthyroidism or hypothyroidism.

Changes in serum cholesterol and aminoterminal type III procollagen propeptide (PIIIPN) were compared in 33 patients with hyperthyroidism, 16 patients with hypothyroidism, and 23 healthy individuals. An increase in PIIIPN was found in patients with hyperthyroidism and an increase in serum cholesterol level was associated with hypothyroidism. There was no correlation between investigated indices. It is suggested that PIIIPN changes were a result of altered connective tissue metabolism, while serum cholesterol was related to the intensity of body metabolism.

[The influence of salmon calcitonin on the soluble form of VCAM-1 (CD 106) and E-selectin (CD 62E) in serum of patients with atopic bronchial asthma]. / Wplyw kalcytoniny lososiowej na stezenie rozpuszczalnych form VCAM-1 (CD 106) i e-selektyny (CD 62E) w surowicy u chorych na astme oskrzelowa atopowa.

The aim of the study was to evaluate the effect of salmon calcitonin (CT) on serum level of soluble form of VCAM-1 (sVCAM-1 = soluble vascular cell adhesion molecule-1) and E-selectin (sE-selectin = soluble E-selectin) in patients with atopic bronchial asthma. Twenty-four individuals divided into 4 groups (6 persons each) were investigated. The first group consisted of patients with chronic moderate bronchial asthma, the second and third groups consisted of patients with mild bronchial asthma and the fourth group K consisted of healthy individuals. The patients of the first and second group were treated with CT at a dose of 100 i.v./days s.c. for three days. The patients of the third group were given placebo (phychological saline) in similar way as CT. The indices were measured before the treatment with CT or placebo and on the 4th day of the treatment. It was found that CT treatment decreased sVCAM-1 in serum only in the patients of the first group (p < 0.05) but had no effect upon sE-selectin level. The obtained results suggest that CT interfered into mechanisms of inflammation involving adhesion molecules in patients with bronchial asthma.

[Cognitive function in patients with systemic sclerosis]. / Procesy poznawcze u chorych na twardzine ukladowa.

Central nervous system involvement is seldom reported in patients with systemic sclerosis (SSc). Cognitive functions were determined in 21 patients with definite SSc and 42 healthy controls. Thyroid function was also measured in order to eliminate the effect of hypothyroidism on cognitive functioning. It was found that the SSc patients with normal thyroid function showed defective long-term and recent memory, learning ability, criticism, perception and visuo-perceptual skills, their simple reaction time was prolonged. Similar but less advanced cognitive defects were shown in the SSc patients with overt or latent hypothyroidism. The obtained results indicate that the central nervous system involvement is more common in patients with SSc than it has been reported earlier.

[The influence of heart infarction on the concentration of aminoterminal type III procollagen peptide in blood serum]. / Wplyw zawalu miesnia sercowego na stezenie aminoterminalnego peptydu prokolagenu typu III w surowicy krwi.

UNLABELLED: The reconstructive processes in a heart infarction pertain also the fibrous tissue sceleton, of which the main element are collagen fibres. The aim of the study was determination of variability of a specific collagen synthesis marker, i.e. the serum aminoterminal type III procollagen peptide (PIIINP) and its correlation with hydroxyproline (HP), hydroxylysin (HL) concentration as well as activity of creatine kinase (CK) and aspartate aminotransferase (AspAT) in serum after heart infarction. The investigations were carried out in 30 patients with a heart infarction with Q wave (group I), in 20 subjects with a heart infarction without Q wave (group II) and in 30 healthy subjects, comprising the C group. All these parameters were determined on the 1st, 2nd, 3rd, 5th and 10th day after onset of infarction. In comparison to the C group, in group I on the 1st day the PIIINP concentration was 3-fold higher and in group II it 2 1/2-fold higher (C = 4.3 +/- 1.8; I = 14.2 +/- 3.9; II = 10.4 +/- 2.0 micrograms/l; p < 0.001). In group I even on the 10th day the concentration did not return to normal values, instead in group II it reached the values x + SD in C group after 5 days. There was no significant correlation between concentration of PIIINP and all other examined parameters stated. Heart infarction with a Q wave caused a relatively highest (% of mean values in C group) increase in CK and AspAT activity, PIIINP held a medial position, while HP and HL the lowest. After infarction without a Q wave the relative elevation of PIIINP concentration was near to the AspAT and HP increase. CONCLUSIONS: 1. the differences of serum PIIINP concentration are probably resulted by the magnitude of heart infarction. 2. During 10 days after the onset of heart infarction the serum concentration of PIIINP does not show any correlation with HP, HL and enzymatic heart infarct markers. 3. The results indirectly show, that the scar formation after heart infarction begins already on the first day.

[Effect of heart infarction on levels of type I procollagen carboxyterminal peptide in blood serum]. / Wplyw zawalu miesnia sercowego na stezenie karboksyterminalnego peptydu prokolagenu typu I w surowicy krwi.

The aim of the study was determination of the influence of heart infarction on the blood serum level of type I procollagen carboxyterminal peptide (PICP) and its covariability with concentration of hydroxyproline (HP) and hydroxylysine (HL) as well as activity of creatine kinase (CK) and aspartate transferase (AspAT). The investigations were carried out in 30 patients with a heart infarction with Q wave (group I) and in 20 subjects with a heart infarction without Q wave. The control group comprised 30 healthy subjects. The determination of all parameters was performed on the 1st, 2nd, 3rd, 5th and 10th day after the infarct onset. On the 1st day of heart infarction, the concentration of PICP in serum was (x +/- SD): gr. I-235 +/- 33, gr. II-209 +/- 8, gr. C-65 +/- 17 micrograms/l. There was no co-variability of PICP concentration and the values of all other determined parametres. The authors conclude: 1. the increase of serum PICP concentration is connected probably with the magnitude of heart infarction, 2. the reconstruction process of the heart fibrous tissue and scar formation begins already on the first day of infarction onset, 3. during 10 days after infarction onset the serum PICP concentration does not correlate with HP, HL as well as the enzymatic heart infarct indices, namely CK and AspAT.

[Evaluation of stomach emptying in patients with hyperthyroidism]. / Ocena kinetyki oprózniania zoladka u chorych z nadczynnoscia tarczycy.

The study aimed at the evaluation of the kinetics of gastric emptying (GE) of a solid meal in hyperthyroid patients during a pharmacological treatment with thiamazole until the moment of euthyroid restoration. Fourteen female patients ((33.4 +/- 2.6 y, mean +/- SE) with recently diagnosed hyperthyreosis took part in the study. Twelve age matched healthy women (34.5 +/- 2.3 y) constituted a control group (C). Every patient underwent the GE examination before treatment (I). In 12 patients the GE was reexamined on the 3rd treatment week (II). After the achievement of euthyroid, which happened after 4.5 mo (median; interquartile range 2.0 to 7.3 mo), a third GE measurement was taken in 13 patients (III). The GE of a 99mTc-labelled solid meal was measured with the use of a gamma camera. Time-activity curves from the gastric region of interest were used, after subjection to appropriate corrective procedures, to calculate the mean gastric transit time (MTT 90) and the fraction of the test meal retained in the stomach after 90 min (F90). Before the treatment and on the third week of management the GE of hyperthyroidism was not statistically significantly different from that of healthy controls (MTT90:39.44 +/- 0.30 min [I] 39.31 +/- 0.64 min [II] and 40.06 +/- 0.29 [C]; F90:46.6 +/- 1.9% [I], 47.9 +/- 3.7% [II] and 50.8 +/- 2.4% [C]). The restoration of euthyreosis was accompanied by a slight but statistically significant increase in the GE -p < 0.05 in the case of F90 vs the pre-treatment situation. Also the patients' GE was found then to be slightly but statistically faster than in healthy controls (MTT90:38.72 +/- 0.39 min [III], and F90: 42.2 +/- 2.3% [III] -p < 0.05 vs [C] for both parameters). We conclude that in hyperthyreotic women the GE of solids does not differ significantly from age-matched healthy female controls and remains unchanged during a pharmacological treatment. After achievement of euthyreosis a slightly but statistically significantly faster GE is observed in the patients when compared to healthy controls.

[Evaluation of gastric emptying in patients with hypothyroidism]. / Ocena kinetyki oprózniania zoladka u chorych z niedoczynnoscia tarczycy.

The study aimed at the evaluation of the gastric emptying (GE) kinetics in hypothyroid patients before and after a substitutive treatment with L-thyroxin. Twelve female hypothyroid (aged 45.3 +/- 8.7 years, mean +/- SD) and a control group of 12 healthy women (aged 34.5 +/- 8.1 years) were examined. The GE of a 99mTc-labelled solid meal was measured with the use of a gamma camera in every patient before the treatment, and in 10 of them a repeat GE examination was performed after the restoration of euthyroid; the median duration of the treatment was 5.5 mo (range 2.5 to 12 mo). The mean gastric transit time (MTT90) and the fraction of the test meal retained in the stomach after 90 min (F90) were statistically significantly greater in untreated hypothyroid than in healthy controls (MTT90: 42.01 +/- 1.86 min patients vs 40.06 +/- 1.00 min controls, p = 0.0043; F90: 64.3 +/- 15.4% patients vs 50.8 +/- 8.2% controls, p = 0.0173). In ten patients in whom a second GE measurement was taken after the achievement of euthyroid, a slight increase of the GE was observed (MTT90:41.46 +/- 1.49 min before vs 41.04 +/- 1.81 min after the treatment, NS) which was then no longer statistically significantly different from that of the healthy controls. No relationship was found between the GE and the severity of clinical symptoms of hypothyroidism. GE remained, however, slowed in some patients despite the restoration of euthyreosis. We conclude that: (I) long-lasting hypothyreosis is accompanied by a slightly slowed GE of solids, and (II) restoration of euthyreosis does not imply a parallel improvement of the hypothyroidism-associated delay in GE.

[Investigations concerning the effect of nabumetone on gastric mucosa]. / Badanie wplywu nabumetonu na sluzówke zoladka.

The investigations were carried out in 9 patients (6 women and 3 men) with rheumatoid arthritis or degenerative joint disease. All subjects were given 1000 mg nabumetone (NA) in a single daily dose at the evening, during 21 days. Before and after the therapeutic course, endoscopic examination of the upper digestive tract was carried out. On day at the begin and on the 22nd day of the NA treatment, the gastric transmucosal electric potential difference (PD) was determined, in (a) standard condition, (b) after intragastric application of 1000 mg NA, and (c) after a similar application of 1000 mg of acetylsalicylic acid (AAS). On the contrary to the effect caused by AAS (p < 0.001), NA did not result any significant change of the PD (p > 0.05), neither after a single nor after 21 day-long application (the lowest PD value before the NA therapeutic course was after a single NA dose -45.8 +/- 2.7 mV and after a single dose of AAS -40.4 +/- 2.45 mV; after the end of the NA therapy course the values were: after additional NA dose -46.7 +/- 3.5 mV and after AAS -40.5 +/- 2.7 mV) Endoscopically, any changes of the upper digestive tract mucosa which could be related to the NA therapeutic course were not detected.

Premictional volume and contractility of the urinary bladder in patients with systemic sclerosis.

Ultrasonographic measurements of the urinary bladder in 21 women with systemic sclerosis (SSc) revealed abnormal volume of the bladder in about 65% of patients; 6/21 had a smaller bladder and 7/21 had a larger bladder than the controls. The volume of the remaining urine after miction was higher in 7 patients. Fibrosis of the bladder wall leading to a small rigid bladder and ureteral obstruction resulting in a large bladder with low contractility are suggested as phenomena involved in disturbed function of the urinary bladder in SSc patients. Patients with symptoms lasting more than 14 yrs. were found to have larger premictional volume of the bladder than those with short-lasting disease. No correlation between age, number of deliveries and bladder volume was found.

[Influence of energy expenditure and other factors on the incidence of arterial hypertension in employees with some types of employment in Tychy]. / Wplyw wydatku energetycznego i innych czynników na czestosc wystepowania nadcisnienia tetniczego u pracowników niektórych tyskich zakladów pracy.

The aim of the work was to evaluate the incidence of arterial hypertension in the inhabitants of Tychy, a city polluted by ecotoxins, in relation to the energy expenditure of professional work, in consideration of overweight, cholesterolaemia, uricemia, alcohol consumption, age and sex. Investigations were carried out on 1964 individuals (1392 men, 572 women) divided in 5 groups with different intensity of professional work. Serum uric acid and cholesterol levels were determined in all examined persons. Incidence of the obesity was also considered. The authors conclude that the risk of arterial hypertension in the examined individuals of Tychy is average 17.4% for both men and women, and it decreases with enhanced energy expenditure at professional work for men. Arterial hypertension appears in subjects from obesity, hyperuricaemia and drinking more than 4.0 dl of pure ethanol per week.