[Thyroid function in women: problems created by oral contraceptives, pregnancy and menopause (author's transl)]. / Fonction thyroidienne de la femme. Problemes poses par les contraceptifs oraux, la grossesse, la menopause.

PIP: Thyroid anomalies are more frequent in women than men. Variations in estrogen levels as observed during pregnancy and oral contraception using combined pills may vitiate the results of certain types of thyroid hormone analysis. Consequently, as a result of an increase in thyroxine carrier proteine levels, the total thyroxine levels will be falsely higher whereas the results of the Hamolsky test will be falsely lower. However, the free thyroxine index obtained by combining the results of the 2 tests is not altered by the fluctuations of carrier proteins induced by estrogen overcharge. Although estrogen fluctuations modify thyroxine carrier proteine levels, they hardly influence thyroid function, particularly if hyperthyroidea occurs in menopause. It is simply coincidental. In the same way, thyroidal pathology actually interferes very little with ovarian function. As for the treatment of thyroid problems in pregnant women, difficulties may occur in the case of hyperthyroidea, since theoretically the usual treatments (lugol, beta-blockers, synthetic antithyroidals, radioactive iodine, or surgery on evolutive hyperthyroidea) cannot be applied. In practice, the best solution is to prescribe mild doses of synthetic antithroidals in order to decrease the basic problem without inducing hypothryoidea. (author's)^ieng

[Thyroid hemiagenesis (single thyroid lobe). 8 cases (author's transl)]. / Hémiagénésie thyroïdienne (lobe thyroïdien unique). 8 observations.

Thyroid agenesis would appear to be a rare abnormality (50 cases, including 8 personal). In fact, it is a simple anatomical curiosity which may be found in the presence of any type of thyroid condition (simple goitre: 4 cases, thyrotoxicosis: 2 cases, cold nodule: 2 cases, as far as our own patients were concerned). Our 8 patients were all women, hemiagenesis being more commonly discovered in the female sex. In 2 patients the right lobe was absent, and the left in the other 6. In general, the abnormality affects the left lobe three times more commonly than the right. The differential diagnosis essentially lies with autonomic thyroid nodules, which are much more common, and isotope scanning provides the answer.

[Why are some cases of Hashimoto's thyroiditis operated on? Apropos of a series of cases]. / Perchè si operano alcune tiroiditi di Hashimoto? A proposito di una serie di osservazioni

Hashimoto's thyroiditis is a polymorphous condition. Its clinical diagnosis depends on the presence of a moderately large goitre of recent onset (2-3 yr) that is usually symmetrical and node-free, and particularly hard and rubbery. In addition, a high level of antithyroid antibodies is observed. A search for these antibodies should certainly be made more often. Histological confirmation is required as soon as the level of antibodies is low, or when the goitre is nodular with cold scintiscan areas. Furthermore, development of the intrathyroid lymphoid system is of uncertain import, especially since there is no relation between the number of cells that could theoretically be secreting antibodies (i.e. intrathyroid plasma cells) and the incidence or level of the various antithyroid antibodies.

[Biological diagnosis of Zollinger-Ellison syndrome in the context of a polyendocrine adenomatosis]. / Diagnostic biologique du syndrome de Zollinger-Ellison dans le cadre d'une adénomatose poly-endocrinienne

The diagnostic features of Zollinger-Ellison syndrome (ZES) in patients with type I poly-endocrine adenomatosis with a gastrinoma are analysed on the basis of 11 cases. Both from a clinical (frequency of ulcer disease and of diarrhoea) and biological standpoint (hypersecretion of gastric acid, hypergastrinaemia, or results of secretin stimulation test), the characteristics of ZES are not different whether a gastrinoma is present alone or in association with involvement of other endocrine glands. However the signs may be either masked by changes related to another endocrine disorder or appear late. They should therefore be sought routinely in all patients with an endocrine disorder which might fall into the context of a type I poly-endocrine adenomatosis. The sole difficulty is the interpretation of gastric acid hypersecretion and/or hypergastrinaemia in a patient with hyperparathyroidism. In this latter case, such abnormalities are not necessarily due to ZES and may disappear after removal of the parathyroid adenoma.

[Current problems of vaccination, especially in France (author's transl)]. / Aktuelle Impfprobleme -- speziell in Frankreich

Although being a routine procedure, the vaccination almost daily confronts the physician with problems. The contraindications for vaccinations are either misjudged or overestimated. The approach to be assumed in case of a pregnant woman or a patient of old age is often poorly defined. The order of vaccinations to be observed prior to intercontinental travels is generally ignored. However, in view of the regression of most of the infectious diseases, prophylaxis by vaccination must not slacken. For the rest, intensive research is carried on at present to further improve the existing vaccines and to produce vaccines against new diseases.