Absence of cross-reactivity to myeloperoxidase of anti-thyroid microsomal antibodies in patients with autoimmune thyroid diseases

Background: Thyroperoxidase is the major antigen of the thyroid microsomal antibodies (TMA) detected in autoimmune thyroid diseases. Its amino acid sequence has 44% homology with myeloperoxidase (MPO), an enzyme present in the primary granules of neutrophils and one of the major antineutrophil cytoplasmic antibodies (ANCA) antigens. The objective of the present study was to investigate the presence of cross-reactivity to MPO of TMA. Methods: We studied sera from 51 patients with autoimmune thyroid diseases, all of them TMA-positive. The presence of ANCA was investigated by indirect immunofluorescence and by capture enzyme-linked immunosorbent assay. Results: ANCA were positive in 3.9% of the TMA-positive sera and none of them reacted with MPO. In contrast, the ANCA-positive sera revealed antielastase activity. None of the ANCA-positive cases presented clinical signs of vasculitis. However, these 2 patients had been on prolonged treatment with propylthiouracil. Conclusions: We conclude that there is no cross-reactivity to MPO of TMA in patients with autoimmune thyroid diseases, possibly because of difference in the spatial configuration of the immunodominant region. The presence of ANCA in patients with autoimmune thyroid diseases without evidence of vasculitis might result from propylthiouracil-induced polyclonal activation.

Thyroid cell proliferation in Graves' disease - Use of MIB-1 monoclonal antibody

OBJECTIVE: To measure thyroid cell proliferation in patients with Graves' disease (GD) before and during treatment with antithyroid drugs.STUDY DESIGN: Patients were assessed by fine needle aspiration biopsy before (n=20) and after 4 (n=19) and 12 months of treatment (n=15) with propylthiouracil or methimazole. Cell proliferation index (CPI) was estimated by immunocytochemistry using MIB-1. CPI was studied in relation to the cytologic parameters of the smears; clinical parameters, such as Wayne's Clinical Index (WCI) and time without treatment; laboratory parameters, such as (131)Iuptake and dosage of serum free thyroxin and thyroid-stimulating hormone; and thyroid ultrasound.RESULTS: CPI varied from 0.00% to 25.00% before treatment, 0.00% to 23.00% at 4 months and 0.00% to 14.84% at 12 months. CPI median values were 6.50%, 4.30% and 3.30%, respectively (before and after 4 months and 12 months of treatment). CPI had a positive correlation with WCI and FT4 at 12 months of treatment.CONCLUSION: Thyroid CPI in GD varies from case to case. However, due to its decreasing pattern during follow-up and its positive correlation with thyrotoxicosis severity, CPI may indicate the functional status of the gland and contribute to a better understanding of GD.

Profile of thyroid hormones in breast cancer patients

Estrogen involvement in breast cancer has been established; however, the association between breast cancer and thyroid diseases is controversial. Estrogen-like effects of thyroid hormone on breast cancer cell growth in culture have been reported. The objective of the present study was to determine the profile of thyroid hormones in breast cancer patients. Serum aliquots from 26 patients with breast cancer ranging in age from 30 to 85 years and age-matched normal controls (N = 22) were analyzed for free triiodothyronine (T3F), free thyroxine (T4F), thyroid-stimulating hormone (TSH), antiperoxidase antibody (TPO), and estradiol (E2). Estrogen receptor ß (ERß) was determined in tumor tissues by immunohistochemistry. Thyroid disease incidence was higher in patients than in controls (58 vs 18%, P < 0.05). Subclinical hyperthyroidism was the most frequent disorder in patients (31%); hypothyroidism (8%) and positive anti-TPO antibodies (19%) were also found. Subclinical hypothyroidism was the only dysfunction (18%) found in controls. Hyperthyroidism was associated with postmenopausal patients, as shown by significantly higher mean T3 and T4 values and lower TSH levels in this group of breast cancer patients than in controls. The majority of positive ERß tumors were clustered in the postmenopausal patients and all cases presenting subclinical hyperthyroidism in this subgroup concomitantly exhibited Erß-positive tumors. Subclinical hyperthyroidism was present in only one of 6 premenopausal patients. We show here that postmenopausal breast cancer patients have a significantly increased thyroid hormone/E2 ratio (P < 0.05), suggesting a possible tumor growth-promoting effect caused by this misbalance.

Fatores que influenciam nas complicações das tireoidectomias

O resultado pós-operatório das tireoidectomias é imputado a fatores relativos ao paciente, à tireopatia e ao cirurgião. OBJETIVO: Analisar a experiência de um serviço quanto a complicações com a tireoidectomia. Desenho do estudo: coorte histórica com corte transversal. MATERIAL E MÉTODO: Foram avaliados os prontuários de 228 pacientes submetidos à tireoidectomia, entre 1991 e 2004. Foram estudadas as complicações transitórias, definitivas e totais, persistência e recidiva da tireopatia de base, em relação a fatores clínico-laboratoriais. RESULTADOS: Ocorreram 34,65% de complicações totais, 18,86% de complicações transitórias (9,21% hipocalcemia, 0,44% paralisia de cordas vocais, 4,82% outras), associadas aos primeiros anos de cirurgia no serviço e queixas compressivas, e 17,98% de complicações definitivas (8,77% hipoparatireoidismo, 1,75% paralisia de cordas vocais, 0,44% rouquidão), associadas à malignidade e cirurgias mais radicais. Houve persistência da doença de base em 17,98% dos casos, associada à idade, e recidiva em 10,96%, associada aos primeiros anos de cirurgia, benignidade e cirurgias menos radicais. CONCLUSÃO: Complicações pós-operatórias se associaram a queixas compressivas, história curta, malignidade e cirurgias mais radicais. A recidiva se associou aos primeiros anos de cirurgia no serviço, tireopatias benignas e cirurgias menos radicais. A persistência da doença se associou à maior idade.

Associação de tireopatias em uma população de pacientes com diabetes

OBJETIVO: Avaliar morfológica e funcionalmente a tireóide de pacientes com diabetes mellitus (DM) acompanhados ambulatorialmente no Hospital das Clínicas de Botucatu. MÉTODOS: No período de 1996 a 1998, a todo paciente com DM, exceto os com tireopatia prévia, era solicitada dosagem sérica de T4L, TSH, anti-TPO e TRAb e ultra-sonografia (US) da tireóide. Diagnosticou-se tireopatia quando havia dois ou mais parâmetros séricos ou a US alterados. Procedeu-se igualmente com pacientes ambulatoriais da mesma Instituição, sem DM e não-tireopatas prévios (controle). RESULTADOS: Os 256 pacientes com DM apresentaram maior freqüência de tireopatias que os 75 controles (51,6% vs. 38,7%; P<0,05). Entre os com tireopatias, ambos os grupos não diferiram quanto ao estado funcional da tireóide. Entre os pacientes com DM com e sem tireopatias, os primeiros apresentaram maior freqüência de mulheres, de DM tipo 2 e de história familiar de tireopatia. CONCLUSÕES: A elevada prevalência de tireopatias na população com DM conduz à recomendação de avaliação tireoidiana em todo paciente com DM.

Consenso brasileiro para a abordagem clínica e tratamento do hipotireoidismo subclínico em adultos: recomendações do Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia

INTRODUÇÃO: O hipotireoidismo subclínico (HSC), definido por concentrações elevadas do TSH em face de níveis normais dos hormônios tireoidianos, tem elevada prevalência no Brasil, particularmente entre mulheres e idosos. Embora um número crescente de estudos venha associando o HSC com maior risco de doença arterial coronariana e de mortalidade, não há ensaio clínico randomizado sobre o benefício do tratamento com levotiroxina na redução dos riscos e o tratamento permanece controverso. OBJETIVO: Este consenso, patrocinado pelo Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia e desenvolvido por especialistas brasileiros com vasta experiência clínica em tireoide, apresenta recomendações baseadas em evidências para uma abordagem clínica do paciente com HSC no Brasil. MATERIAIS E MÉTODOS: Após estruturação das questões clínicas, a busca das evidências disponíveis na literatura foi realizada inicialmente na base de dados do MedLine-PubMed e posteriormente nas bases Embase e SciELO - Lilacs. A força da evidência, avaliada pelo sistema de classificação de Oxford, foi estabelecida a partir do desenho de estudo utilizado, considerando-se a melhor evidência disponível para cada questão e a experiência brasileira. RESULTADOS: Os temas abordados foram definição e diagnóstico, história natural, significado clínico, tratamento e gestação, que resultaram em 29 recomendações para a abordagem clínica do paciente adulto com HSC. CONCLUSÃO: O tratamento com levotiroxina foi recomendado para todos os pacientes com HSC persistente com níveis séricos do TSH > 10 mU/L e para alguns subgrupos especiais de pacientes.

The STATFLUX code: a statistical method for calculation of flow and set of parameters, based on the Multiple-Compartment Biokinetical Model

The code STATFLUX, implementing a new and simple statistical procedure for the calculation of transfer coefficients in radionuclide transport to animals and plants, is proposed. The method is based on the general multiple-compartment model, which uses a system of linear equations involving geometrical volume considerations. Flow parameters were estimated by employing two different least-squares procedures: Derivative and Gauss-Marquardt methods, with the available experimental data of radionuclide concentrations as the input functions of time. The solution of the inverse problem, which relates a given set of flow parameter with the time evolution of concentration functions, is achieved via a Monte Carlo Simulation procedure.Program summaryTitle of program: STATFLUXCatalogue identifier: ADYS_v1_0Program summary URL: http://cpc.cs.qub.ac.uk/summaries/ADYS_v1_0Program obtainable from: CPC Program Library, Queen's University of Belfast, N. IrelandLicensing provisions: noneComputer for which the program is designed and others on which it has been tested: Micro-computer with Intel Pentium III, 3.0 GHzInstallation: Laboratory of Linear Accelerator, Department of Experimental Physics, University of São Paulo, BrazilOperating system: Windows 2000 and Windows XPProgramming language used: Fortran-77 as implemented in Microsoft Fortran 4.0. NOTE: Microsoft Fortran includes non-standard features which are used in this program. Standard Fortran compilers such as, g77, f77, ifort and NAG95, are not able to compile the code and therefore it has not been possible for the CPC Program Library to test the program.Memory, required to execute with typical data: 8 Mbytes of RAM memory and 100 MB of Hard disk memoryNo. of bits in a word: 16No. of lines in distributed program, including test data, etc.: 6912No. of bytes in distributed Program, including test data, etc.: 229 541Distribution format: tar.gzNature of the physical problem: the investigation of transport mechanisms for radioactive substances, through environmental pathways, is very important for radiological protection of populations. One such pathway, associated with the food chain, is the grass-animal-man sequence. The distribution of trace elements in humans and laboratory animals has been intensively studied over the past 60 years [R.C. Pendlenton, C.W. Mays, R.D. Lloyd, A.L. Brooks, Differential accumulation of iodine-131 from local fallout in people and milk, Health Phys. 9 (1963) 1253-1262]. In addition, investigations on the incidence of cancer in humans, and a possible causal relationship to radioactive fallout, have been undertaken [E.S. Weiss, M.L. Rallison, W.T. London, W.T. Carlyle Thompson, Thyroid nodularity in southwestern Utah school children exposed to fallout radiation, Amer. J. Public Health 61 (1971) 241-249; M.L. Rallison, B.M. Dobyns, F.R. Keating, J.E. Rall, F.H. Tyler, Thyroid diseases in children, Amer. J. Med. 56 (1974) 457-463; J.L. Lyon, M.R. Klauber, J.W. Gardner, K.S. Udall, Childhood leukemia associated with fallout from nuclear testing, N. Engl. J. Med. 300 (1979) 397-402]. From the pathways of entry of radionuclides in the human (or animal) body, ingestion is the most important because it is closely related to life-long alimentary (or dietary) habits. Those radionuclides which are able to enter the living cells by either metabolic or other processes give rise to localized doses which can be very high. The evaluation of these internally localized doses is of paramount importance for the assessment of radiobiological risks and radiological protection. The time behavior of trace concentration in organs is the principal input for prediction of internal doses after acute or chronic exposure. The General Multiple-Compartment Model (GMCM) is the powerful and more accepted method for biokinetical studies, which allows the calculation of concentration of trace elements in organs as a function of time, when the flow parameters of the model are known. However, few biokinetics data exist in the literature, and the determination of flow and transfer parameters by statistical fitting for each system is an open problem.Restriction on the complexity of the problem: This version of the code works with the constant volume approximation, which is valid for many situations where the biological half-live of a trace is lower than the volume rise time. Another restriction is related to the central flux model. The model considered in the code assumes that exist one central compartment (e.g., blood), that connect the flow with all compartments, and the flow between other compartments is not included.Typical running time: Depends on the choice for calculations. Using the Derivative Method the time is very short (a few minutes) for any number of compartments considered. When the Gauss-Marquardt iterative method is used the calculation time can be approximately 5-6 hours when similar to 15 compartments are considered. (C) 2006 Elsevier B.V. All rights reserved.

Paralisia de corda vocal e cisto de tiroide

The authors present a rare case of vocal cord paralysis following thyroid cyst. The clinical diagnostic and evolution aspects are presented. The importance of precise evaluation of the thyroid gland in all cases of vocal cord paralysis is emphasized.

Tumores da glandula tireoide. Estudo retrospectivo de 130 casos com enfase especial em biopsia aspirativa, biopsia de congelacao e exame histopatologico

The authors studied retrospectively 130 patients with thyroid tumors comparing the histopathologic diagnoses with fine needle aspirate (FNA) and frozen section results. FNA was performed in 118 patients with the following results: 75 (63.6%) benign, 21 (17.8%) malignant and 22 (18.6%) not conclusives. In seven cases false-negative result was obtained and there were six false-positive. These data reveals some drawbacks of this procedure. These results indicated that frozen as well as FNA are useful diagnostic procedure in helping to choose the most appropriate therapy in patients with thyroid tumors. On the other hand, traditional methods seems to be also important methods, such as scintilography, in the evaluation of thyroid diseases.

Morphometric study by image analysis of Ag-stained nucleoli in thyroids bearing proliferating lesions

The Ag-NOR staining technique and image analysis were used to evaluate morphological parameters (area, perimeter and axis ratio) in nucleoli from normal thyroids and from thyroids bearing proliferating lesions (carcinomas, adenomas and hyperplasias). Regions with normal appearance located close to adenomatous and carcinomatous regions, in the thyroid of every patient, were also analyzed for comparison with the respective pathological regions and with normal thyroids. Statistical analysis of data for the nucleolar area and perimeter allowed the separation of adenomas and carcinomas from hyperplasias and normal tissue but not the two components in each of these two groups. However, if we look at the numbers, a sequence of increasing nucleolar mean areas in the order: normal, hyperplasia, adenoma and carcinoma may be observed, indicating the sequence of increasing rRNA requirements in these different kinds of cells. The axis ratio that denotes the nucleolar shape (round or oblong) did not show significant differences among tissues, suggesting that shape is not important in the characterization of these pathologies. Differences in nucleolar areas and perimeter between normal and affected regions from each patient were statistically significant for adenomas and carcinomas. When these normal regions were compared with the normal thyroids, significant differences were not obtained in the three evaluated parameters. The observations and their importance for histopathological diagnosis are discussed.

Qualidade de vida em mulheres na pós-menopausa usuárias e não usuárias da terapia hormonal em unidade básica de saúde de Franca-SP

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Avaliação da espessura íntima-média de carótidas em pacientes com hipotireoidismo subclínico, com e sem síndrome metabólica

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Diagnóstico por imagem nas enfermidades tireoidianas em cães: revisão

The diagnosis of various diseases has become more accessible and accurate with the rapid development of imaging modalities aiming to assist in medical diagnosis, and thereby in veterinary medicine. Different diagnostic imaging modalities such as ultrasonography, computed tomography, magnetic resonance imaging and scintigraphy can be performed to obtain information about thyroid diseases, each one with advantages and disadvantages, depending on the thyroid disease in question. Diagnostic imaging is a tool that not only assists in the diagnosis, but also helps treatment and assessment of prognosis of thyroid diseases. The aim of this article is to discuss the limitations and benefits of each diagnostic imaging modality available in the veterinary medical field, and also to present the newest diagnostic imaging modalities in order to maximize and make more accurate diagnosis of thyroid diseases.

Metabolic disturbances in male broilers of different strains. 2. Relationship between the thyroid and somatotropic axes with growth rate and mortality

Seven male broiler strains (Arbor Acres, Avian Farms, Cobb-500, Hubbard-Peterson, ISA, Naked Neck, and Ross) were compared for their growth rate, feed efficiency, and mortality due to sudden death and ascites. In addition, weekly plasma levels of thyroid hormones [3,3′,5-triiodothyronine (T3) thyroxine (T4), T3: T4 ratio, growth hormone (GH), and insulin-like growth factor-I (IGF-I)] were determined. The highly productive, commercial strains were very similar in their endocrine profiles but differed markedly from the Naked Neck chickens. Naked Neck chickens were characterized by higher plasma T3 and lower T4 levels at similar ages as well as when compared on the same body weight basis. The present findings support the hypothesis that the slightly hypothyroid state of high productive broilers renders them more sensitive to metabolic disorders. Naked Neck chickens also had higher plasma GH levels than those of their age-matched commercial broilers. The coefficient of variation for GH was highest for Naked Neck chickens, which is indicative for an amplified GH burst amplitude. It may be stated that changes in plasma thyroid hormone concentration in indirect response to selection for low feed conversion and fast growth may be causatively linked to susceptibility for metabolic disturbances such as sudden death syndrome and ascites.

Chronic Diseases: Chronic Diseases and Development 2 Health, agricultural, and economic effects of adoption of healthy diet recommendations

Transition to diets that are high in saturated fat and sugar has caused a global public health concern as the pattern of food consumption is a mayor modifiable risk factor for chronic non-communicable diseases Although agri food systems are intimately associated with this transition, agriculture and health sectors are largely disconnected in their priorities policy, and analysis with neither side considering the complex inter relation between agri trade patterns of food consumption health, and development We show the importance of connection of these perspectives through estimation of the effect of adopting a healthy diet on population health, agricultural production trade the economy and livelihoods, with a computable general equilibrium approach on the basis of case studies from the UK and Brazil we suggest that benefits of a healthy diet policy will vary substantially between different populations, not only because of population dietary intake but also because of agricultural production trade and other economic factors