Is thyroid hormone suppression therapy prothrombotic?

The purpose of this study was to determine whether chronic thyroid hormone suppression therapy (THST) is prothrombotic.We obtained blood samples from 14 thyroid cancer patients while on THST and after they had become hypothyroid for radioiodine whole-body scanning and therapy. Prothrombin fragment 1 + 2, fibrinogen, factor VIII, antithrombin, tissue plasminogen activator antigen (tPA), plasminogen activator inhibitor 1 (PAI-1), PAI-1/tPA, and C-reactive protein were significantly (P < 0.05) higher in the hyper- than in the hypothyroid state, whereas protein C and plasmin-antiplasmin complexes were significantly lower during the hyperthyroid period. When the 10 female patients were hyperthyroid, their levels of prothrombin fragment 1 + 2, fibrinogen, protein S, antithrombin, tPA, PAI-1, and PAI-1/tPA were significantly higher (P 相似文献   

Is hyperamylasemia after cardiac surgery due to cardiopulmonary bypass?

Although hyperamylasemia has been reported in a large proportion of patients undergoing cardiac surgery with cardiopulmonary bypass, its clinical significance and pathogenetic mechanisms remain poorly understood. The study was designed to investigate whether avoidance of cardiopulmonary bypass would limit amylase elevation. Serum levels of amylase and lipase were measured preoperatively as well as 24 and 48 hours postoperatively in 58 patients undergoing elective coronary artery bypass grafting. Three surgical approaches were used: cardiopulmonary bypass (n = 32) and off-pump through a median sternotomy (n = 14) or a left minithoracotomy (n = 12). There was no hospital mortality or postoperative abdominal complications. Transient hyperamylasemia occurred in 14 patients: 7 (22%), 5 (36%), and 2 (17%) in the respective groups. The increase in amylase levels was similar among the groups. However, no lipase elevation was detected in any patient. There was no clear correlation between hyperamylasemia and increased creatinine levels. Perioperative plasma calcium levels were normal in patients who had hyperamylasemia. Our results indicate that hyperamylasemia after bypass surgery is not related to the use of cardiopulmonary bypass or the mode of surgical access.     

Could a virus contribute to weight gain?

OBJECTIVE: Obesity is a serious public health problem associated with increased morbidity and mortality. Although the causes for obesity are unclear, it seems that environmental, genetic, neural and endocrine factors contribute to its development. However, the rapid global spread of obesity resembles epidemiologically the spread of an infectious disease. Thus far, little consideration has been given to the possibility that the epidemic of obesity could be due to an infectious agent. Seven viruses and a scrapie agent have been implicated in obesity. DESIGN: This review evaluates the infectious pathogens and the evidence that these viruses are associated with obesity and concludes that a strong evidence base is emerging that associates certain viruses with obesity. CONCLUSION: More work is however required to elucidate the mechanisms of weight gain after viral infection. In the mean time, discounting viruses as a contributing factor to obesity would deprive us of a potential new avenue of investigating and treating the ever increasing epidemic of obesity.     

Is hyperthyroidism often present in patients with thyroid differentiated carcinoma?

The coexistence of thyroid cancer and hyperthyroidism is confirmed by many authors. It appears that the frequency of both disease can be greater as a result of lack of proper and penetrating biopsy diagnosis and of qualification to surgery treatment patients with hyperfunctional goiter and Graves disease, especially coexisting with nodes. The aim of our study was estimation of occurrence of hyperthyroidism in the patients with thyroid differentiated cancer. We examined group of 217 patients with diagnosed thyroid differentiated cancer, 20 patients (9.1%) of them were earlier hyperthyroidism diagnosed. 17 of them were hyperfunctional nodular goiter diagnosed and three as Graves disease, confirmed by presence of anti-TSH receptor antibodies (TRAK). Before thyroidectomy ultrasonography showed nodular goiter in 17 patients and hypoechogenic goiter with nodules in 3 patients. After thyroidectomy at the hyperthyroid patients in 16 papillary thyroid cancer and in 4 follicular thyroid cancers were diagnosed. The frequency of coexistence of cancer and hyperthyroidism in our material amounted for 9.1%. The results of our observation do not diverge from facts given in world literature and is point out the need for precise analysis of patients with hyperthyroidism and of proper qualification to surgery treatments changes suspected to be malignant process.     

Is parity a risk factor for excessive weight gain during pregnancy and postpartum weight retention? A systematic review and meta‐analysis

The aim of this study was to systematically review and meta‐analyse the associations between parity, pre‐pregnancy body mass index (BMI), gestational weight gain (GWG) and, when included, postpartum weight retention (PPWR). Papers reporting associations between parity and BMI and/or GWG in adult women were eligible: 2,195 papers were identified, and 41 longitudinal studies were included in the narrative synthesis; 17 studies were included in a meta‐analysis. Findings indicated that parity was associated positively with pre‐pregnancy BMI. In contrast, the role of parity in GWG was less clear; both positive and negative relationships were reported across studies. Parity was not associated directly with PPWR. This pattern of results was supported by our meta‐analysis with the only significant association between parity and pre‐pregnancy BMI. Overall, parity was associated with higher pre‐pregnancy BMI; however, the role of parity in GWG and PPWR remains unclear, and it is likely that its influence is indirect and complex. Further research to better understand the contribution of parity to maternal obesity is warranted.     

Effects of thyroid status on bone metabolism: a primary role for thyroid stimulating hormone or thyroid hormone?

Thyroid hormones are essential for normal skeletal growth and the maintenance of bone mass in adulthood, although their mechanism of action in bone is poorly understood. Hypothyroidism causes impaired bone formation and growth retardation whereas thyrotoxicosis results in accelerated growth, advanced bone age and decreased bone mass. Adults with thyrotoxicosis or a suppressed thyroid stimulating hormone (TSH) from any cause have an increased risk of osteoporotic fracture. Conventionally, bone loss in thyrotoxicosis has been regarded as a direct consequence of thyroid hormone excess acting locally on bone. Recently, however, it has been proposed that TSH may be a direct negative regulator of bone turnover acting via the TSH receptor on both osteoblasts and osteoclasts. Thus, TSH deficiency could be partly responsible for the skeletal loss seen in thyrotoxicosis. Here we provide an overview of the molecular actions of thyroid hormone in bone and discuss in detail the current evidence relating to a possible role for TSH in bone metabolism.     

Adiposity signaling and biological defense against weight gain: absence of protection or central hormone resistance?

An abundant and compelling literature supports the existence of a homeostatic system that dynamically adjusts energy intake and energy expenditure to promote stability of body fat mass. In the context of this system, the ease with which many individuals gain weight is difficult to explain. Some have argued that energy homeostasis operates primarily to defend against weight loss and that, over the course of evolution, biological defense against weight gain was not selected for. According to this Absence of Protection model, obesity is seen as the natural result of living in an obesigenic environment. An alternative hypothesis, termed the Central Resistance model, proposes that under normal circumstances, the energy homeostasis system provides an effective defense against weight gain as well as weight loss and that common forms of obesity involve genetic or acquired defects (or interactions between them) that impair the function of this system. Here, we discuss these dichotomous possibilities within the context of current literature regarding energy homeostasis and suggest a strategy for distinguishing between them.     

Is hypertension after cyclosporin treatment related to sodium proton exchanger activity ?

A sodium-proton exchanger (NHE) is a membrane transport system taking part in intracellular sodium homeostasis. An increased NHE activity was observed in erythrocytes of primary hypertension (NTP) patients. The clinical use of cyclosporine A has provided new perspectives in organ transplantation and in the treatment of autoimmune diseases but is accompanied by side effects like hypertension. Study group consisted of 40 patients with end stage renal failure (ESRF) before and after renal transplantation and 48 controls. The activity of NHE was significantly higher after transplantation than before renal transplantation (p = 0.05) and than control group (p = 0.05). There was positive correlation between NHE activity and cyclosporins blood level. We excluded (in vitro and in vivo study) the influence of uremic toxins on NHE activity in patients with ESRF before renal transplantation. It gave opportunity to compare the activity of NHE before and after renal transplantation according only to aspect of immunosuppressive treatment.