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Clinical and experimental thyroidology

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Vol 8, No 4 (2012)

Articles

18-24 405
Abstract
The article is devoted to the relevance of Betesda System for Reporting Thyroid Cytopathology. This article summarizes recent data on the main differences and advantages of new classification system. Application of the Betesda System for Reporting Thyroid Cytopathology leads to the increased sensitivity and specificity of FNA.
42-46 459
Abstract
The aim of the present study was to evaluate myocardial diastolic function in patients with autoimmune thyroiditis (AT) against the TSH level within the reference range and subclinical interval as well as to determine whether it is related to the thyroid function or other metabolic and functional indices. METHODS. We studied diastolic function of left and right ventricles by the ratio of mitral and tricuspid annular early and late diastolic velocities (em/am and et/at respectively) using tissue Doppler imaging; structural heart characteristics by echocardiography; lipid profile and peroxidation parameters; serum ferritin and iron concentrations in 132 middle-aged women. 36 of them were euthyroid controls, 96 had AT and were ranged according to their TSH value into 4 groups: women with “low- normal” (0.4–2.5 mU/L) and “upper-normal” (2.5–4.0 mU/L) TSH range; patients with subclinical hypothyroidism and TSH below and above 6 mU/L. RESULTS. The increase of TSH value within reference range and subclinical interval was associated with the parallel tendency to the em/am and et/at ratio decrease suggesting detrimental effect of the mildest thyroid failure on the left and right ventricles diastolic function. Thus, patients with TSH values >6 mU/L had significantly lower em/am and et/at ratio compared to the “low-normal” TSH group ( p < 0.05) and controls ( p < 0.01). Among them, the highest LDL cholesterol, myocardial mass index and oxidative stress rate were detected as well as lower iron and ferritin serum concentrations ( p < 0.05 compared to controls with regard to all the parameters listed above). Abnormalities in heart structure, lipid and iron metabolism correlated with alterations in ventricular relaxation suggesting that they can contribute, at least partly, to the diastolic dysfunction devel- opment CONCLUSION. The increase of TSH value within reference range and subclinical interval can affect diastolic function of the heart. Its detrimental effect may be mediated, at least partly, by ventricular mass changes, lipid profile and iron metabolism alterations.
47-52 5461
Abstract
There are different intravenous (iv) glucocorticoid (GC) schedules to treat active Graves’ Orbitopathy (GO). There is one study compared the efficacy of two different pulse-therapy regimens (Sanchez-Ortiga R. et al, 2009): first regimen - traditional therapy, second – GC dose dependents on body weight. Both regimens were effective, but percentage clinical improvement with second regimen was 92% vs 100% with second regimen.Design. The present study compares the efficacy of two different intravenous methylprednisolone (ivGC) dosing regimens: 1000 mg of ivGC daily for 5 days (group I, n = 20) or weekly for 5 weeks (group II, n = 16). Comparisons were made for efficacy according to СAS, exophthalmos, diplopia in 1, 4, 12, 24, 52 weeks after treatment withdrawal. Results. Both regimens had a beneficial effect on soft tissue, exophthalmos. In the first regimen peak of effectiveness occurred between 4 and 24 weeks, in the second regimen- between 4 and 12 weeks. The daily regimen led quickly to reduce the degree of diplopia than weekly dosing regimen. However, in the first group more patients were reported diplopia progression compared with the second group.Conclusion. Both schedules were equally effective and can be used in clinical practice.


ISSN 1995-5472 (Print)
ISSN 2310-3787 (Online)