The results of the surgical treatment of thyroid diseases in children]

The results of surgical treatment of various forms of diseases of the thyroid gland in 254 children are analysed in follow-up periods of 12 months to 20 years. Functional compensation of the thyroid occurred in all patients with nodular forms of goiter who were subjected to operation which did not exceed hemithyroidectomy in volume. The analysis showed that operative treatment of children with the diffuse toxic form of goiter attended by the autoimmune component lead to hypothyroidism in 76.6% of patients, whatever the activity of the thyroid tissue, and a recurrence developed in 11.7% of those who were operated on. In children without the autoimmune component postoperative hypothyroidism was found in 48.6% of those examined, a recurrence was found in 3.2% of cases. The indications for operative treatment are specified, measures for the prevention of postoperative complications are listed.     

Effect of heat and cold factors on amylolytic and invertase activity of the small intestine in growing rats

Acute experiments on young rats showed that exposure to heat (40–41°C) and cold (5–6°C) and injections of ACTH (4 units/100 g body weight per injection) during the first week of life led to a sharp decrease in total amylolytic and invertase activity of homogenates and everted segments of the small intestine of the animals. The inhibition of intestinal function continued throughout the next 2 weeks of life.Laboratory of the Physiology of Digestion, Institute of Physiology, Academy of Sciences of the Uzbek SSR, Tashkent. (Presented by Academician V. N. Chernigovskii.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 82, No. 10, pp. 1213–1215, October, 1976.     

17β-Estradiol and estrogen receptor α protect right ventricular function in pulmonary hypertension via BMPR2 and apelin

Women with pulmonary arterial hypertension (PAH) exhibit better right ventricular (RV) function and survival than men; however, the underlying mechanisms are unknown. We hypothesized that 17β-estradiol (E2), through estrogen receptor α (ER-α), attenuates PAH-induced RV failure (RVF) by upregulating the procontractile and prosurvival peptide apelin via a BMPR2-dependent mechanism. We found that ER-α and apelin expression were decreased in RV homogenates from patients with RVF and from rats with maladaptive (but not adaptive) RV remodeling. RV cardiomyocyte apelin abundance increased in vivo or in vitro after treatment with E2 or ER-α agonist. Studies employing ER-α–null or ER-β–null mice, ER-α loss-of-function mutant rats, or siRNA demonstrated that ER-α is necessary for E2 to upregulate RV apelin. E2 and ER-α increased BMPR2 in pulmonary hypertension RVs and in isolated RV cardiomyocytes, associated with ER-α binding to the Bmpr2 promoter. BMPR2 is required for E2-mediated increases in apelin abundance, and both BMPR2 and apelin are necessary for E2 to exert RV-protective effects. E2 or ER-α agonist rescued monocrotaline pulmonary hypertension and restored RV apelin and BMPR2. We identified what we believe to be a novel cardioprotective E2/ER-α/BMPR2/apelin axis in the RV. Harnessing this axis may lead to novel RV-targeted therapies for PAH patients of either sex.     

Use of propranolol for the treatment infantile hemangiomas in the maxillofacial region

Propranolol has been used successfully in a limited number of children with infantile hemangiomas (IHs). This study describes the efficacy and adverse effects of propranolol in IH. Seventy-one infants with IHs were treated with oral propranolol, administered at a dose of 2 mg/kg/day, for at least 12 weeks. A photograph-based severity scoring assessment was performed by five observers to evaluate efficacy, utilizing a score of 10 as the original IHs before treatment and 0 as completely normal skin. The mean of the five independent measurements was used in the analysis. Propranolol was a rapid and effective treatment for IHs at 4 weeks (P < 0.001), at 8 weeks (P < 0.001 compared with the value at 4 weeks), at 12 weeks (P < 0.05 compared with the value at 8 weeks), and thereafter up to 32 weeks (P < 0.01 compared with the value at 16 weeks). The response of IHs to propranolol was similar regardless of gender, age at the onset of treatment, type of involvement (local and extended), facial segments affected, special locations (eyelid, nasal tip, and parotid regions), ulceration, and depth of IHs. In the series of patients in this study, oral propranolol at a dosage of 2 mg/kg/day was a well-tolerated and effective treatment for IHs.     

Effect of indapamide preparations on myocardial contractility and hemodynamics in patients with hypertension

The hemodynamics and myocardial contractility were studied in 64 patients with Stages I-II hypertensive disease during 12-week monotherapy with indapamide agents (Fludex, Arifon, Lorvas). Their antihypertensive effect occurred 7-8 days later, with its peak at week 4, and was recorded in 64% patients, by normalizing the above parameters in 48% who had mainly lower or normal ejection and higher peripheral resistance. Improvement of hemodynamic and myocardial contractile parameters was parallel to a reduction in blood pressure.