Vol 7, No 2 (2011)

Cover Page
Articles
De Gustibus “About radioiodine without panic ”
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Abstract
Подготавливая колонку, посвященную 25-летию аварии на Чернобыльской АЭС в предыдущий номер журнала, я даже не мог предположить, что спустя буквально несколько недель произойдет новая крупная авария, теперь уже на АЭС “Фукусима” в Японии. Эта авария вызвала паническую реакцию во многих странах мира. В Китае, например, в течение нескольких часов были раскуплены многомесячные запасы йодированной соли в магазинах. Впрочем, иной соли в Китае и не продается. Покупали ее потому, что считали, что йод спасает “от радиации”. На российском Дальнем Востоке жители с энтузиастом скупали и поглощали любые препараты йода, имеющиеся в аптечной сети. В прессе даже сообщалось о случаях отравления йодом. Печально и то, что в СМИ появлялись невежественные рекомендации медиков по йодной профилактике: кто-то рекомендовал использовать доступные в аптеках йодные добавки, кто-то даже считал, что достаточно просто скушать ложку салата из морской капусты. В этой связи я решил в своей колонке написать о том, что же надо делать врачу-клиницисту в ситуации аварии на ядерном объекте.
Clinical and experimental thyroidology. 2011;7(2):4-6
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Selenium and thyroid gland
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Abstract
Известно, что дисбаланс микроэлементов в окружающей среде оказывает непосредственное влияние на функционирование практически всех органов и систем организма человека, и при избыточном или недостаточном поступлении этих веществ начинают действовать механизмы адаптации. Микроэлементы принимают участие в синтезе и метаболизме гормонов, образовании ферментов, влияют на их активность, оказывают действие на деятельность сердечно-сосудистой, нервной, эндокринной и других систем. В настоящее время наблюдается быстрое увеличение объема научных работ о метаболизме соединений селена, селенопротеинах и их функциях, что определяется важностью их эффектов на здоровье человека.
Clinical and experimental thyroidology. 2011;7(2):7-18
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Population of antithyroid autoantibodies as a source of antibodies of various levels of specificity and functionality: the clinical importance of a phenomenon of combination theory at monitoring of patients with autoimmune diseases of a thyroid gland
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Abstract
The review of literature is dedicated to comparative analysis of pathogenetic and clinicodiagnostic significance of antithyroid autoantibodies (autoAB) differing in their specificity (АB to thyroglobulin (anti-TG) and АB to thyroid peroxidase (anti-TPO), anti-TGPO), and functionality TG- and TPO-antibodies, namely antibodies-proteases in pathogenesis autoimmune diseases thyroid gland and possibility of their use in modern diagnostics of autoimmune thyroid diseases.
Clinical and experimental thyroidology. 2011;7(2):19-27
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News of thyroidology
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Abstract
Clinical and experimental thyroidology. 2011;7(2):28-32
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Use of iodized salt in the households improves the iodine status of pregnant women and school-age children in Donetsk, Ukraine: A double-blind randomized controlled trial
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Abstract
This study analyzed the effect of iodized salt consumption on the iodine status of pregnant women and school children living in the households of Donetsk, Ukraine. 160 households with a healthy pregnant woman and a child aged 6–12 years were assigned in concealed sequence 1 : 1 to the use of either common or iodized salt. Casual urine samples were collected and the consumption of specific foods was obtained verbally from the women and the children during a baseline and a follow-up visit in each household. All the women (age 30 years; pregnancy duration 20 weeks) and the children (age 8.5 years) completed the trial without any adverse event. At the baseline visit, the mean household salt iodine content was 10.2 mg/kg (SD 3.1) and the median urinary iodine (UI) concentration in the women (89 μg/L) and the children (101 μg/L) was not significantly different. The salt iodine content during the trial in the experimental households was 43.3 mg/kg (SD 4.6) and starkly higher (p<0.001) than in comparison house- holds (11.4 mg/kg; SD 5.1). The final UI of the pregnant women (141μg/L; 95% CI: 123–163) in experimental households was lower (p < 0.05) than of the children (169μg/L; 95% CI: 147–194), but the net effect of iodized salt consumption on the UI levels of the women (73μg/L; 95% CI: 66–81) was significantly higher (p<0.01) than that of the children (59μg/L; 95% CI: 53–67). The baseline UI (in both groups), and the consumption of marine fish (both groups) and of dairy products other than cheese (in children) were significant effect modifiers. Introduction of iodized salt in the households of Donetsk was associated with adequate iodine intake in school-age children but it did not realize sufficient iodine intake in pregnant women, despite the greater net effect on the UI concentration in the latter group.
Clinical and experimental thyroidology. 2011;7(2):33-42
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Evaluation of epitopes specificity of antibodies to thyroid peroxidase in autoimmune thyroid disorders
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Abstract
The problem of the human antithyroid peroxidase autoantibodies epitopes heterogeneity diagnosed in case of Graves' disease and Hashimoto's thyroiditis has been researched using monoclonal antibodies to thyroid peroxidase. It was shown, that in the competition for the binding sites of thyroid peroxidase and autoantibodies taken from patients with Graves' disease and Hashimoto's thyroiditis sera participate 8 mAb to epitopes 1, 70, 82, 88, 2, 3, 77 and 79. The maxima of the binding inhibition has been marked for the conformation epitope mAb 3: in case of Graves' disease it amounts to 60.3 ± 12.7%, in case of Hashimoto's thyroiditis – 61.8 ± 32.2%. Moreover the level of the binding inhibition did not depend on the concentration of Ab to thyroid peroxidase in the sera of patient with Graves' as opposed to the serum of patients with Hashimoto's thyroiditis. Autoantibodies in the serum of the patientswith Hashimoto's thyroiditis inhibited the binding of mAb to epitope 77 much more effectively, than in the serum of the patients with: 36.3 ± 17.2 and 54.3 ± 9.6% (p ≤ 0.05).The obtained results represented the specific reaction of the autoantibodies to the certain thyroid peroxidase molecular patterns which corresponds to the literature data. It is possible to assume that the further research of the competitive interactions with other autoantibodies to monoclonal antibodies, not included in this trial, and widening of the different thyroid diseased patients' serum palette can expose new immunodominant thyroid peroxidase molecular patterns, forming antibodies for different diseases, and enable the development of diagnostics and control of the thyroid functions and applied therapy.
Clinical and experimental thyroidology. 2011;7(2):43-48
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Combined analysis of BRAF-gene mutation and galectin-3 expression in preoperative diagnostics of thyroid cancer
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Abstract
To assess the utility of combined detection BRAF gene mutation and Gal-3 expression from FNAB specimens in preoperative diagnostic of thyroid gland cancer. 41 patients with thyroid gland nodules were included in the study. By cytological conclusions of evaluated FNA specimens 20 patients had papillar thyroid cancer (PTC), 17 – follicular neoplasia, and 4 – nodular colloid goiter. Gal-3 expression were evaluated by flow cytometry method; BRAF gene mutation were evaluated by PCR. In our study the sensitivity of combined detection BRAF gene mutation and Gal-3 expression was 95%, specificity – 95%, diagnostic accuracy – 95%. Combined detection of BRAF gene mutation by PCR and Gal-3 expression by flow cytometry could be used in preoperative diagnostic of thyroid glad cancer.
Clinical and experimental thyroidology. 2011;7(2):49-56
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Thyroid function in the people with obesity
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Abstract
The aim of this study is to identify the association of thyroid stimulating hormone and thyroxin levels with body mass index (BMI) and waste circumference in men and women with overweight and obesity. Current study was performed within the HAPIEE. The sample of 280 subjects (125 men (44.6%) and 155 women (55.4%)) was analyzed. Thyroid stimulating hormone level was high in integrated subsample with II and III obesity degree (body mass index ≥35 kg/m2). Average levels of general thyroxin were significantly higher in abdominal obese women with body mass index ≥30 (according to NCEP-АТР III, 2001), than in subjects with normal weight and overweight. Significant decrease of general thyroxin was detected in men with gross obesity (body mass index ≥35 kg/m2). In comparison with men women have positive correlation between general thyroxin level and waist circumference.
Clinical and experimental thyroidology. 2011;7(2):57-62
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Parameters of platelet activity in patients with thyrotoxicosis in the presence of chronic hyperglycemia and atrial fibrillation
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Abstract
Object. The study of platelet hemostasis in patients with thyrotoxicosis in the presence of chronic hyperglycemia and atrial fibrillation to prevent coagulation disorders. Material and methods. A comprehensive analysis of the parameters of platelet and coagulation hemostasis in 91 patients (67 women and 24 men) with uncomplicated thyrotoxicosis, as well as with the atrial fibrillation or a combination of hyperthyroidism with diabetes has been completed. Results. The aggregation activity of platelets in uncomplicated thyrotoxicosis comparable with that of healthy people. atrial fibrillation, as well as chronic hyperglycemia, modify platelet activity by increasing the average volume of platelets, their ability to aggregate intensification of the release reaction and along with the decrease of disaggregation properties. Regardless of the presence of diabetes or atrial fibrillation, hyperthyroidism is accompanied by the activation of coagulation. Conclusion. The presence of transforming effects of chronic hyperglycemia and atrial fibrillation on the platelet activity determines the feasibility of differentiated approach to the prevent of coagulation disorders in patients with thyrotoxicosis.
Clinical and experimental thyroidology. 2011;7(2):63-67
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Thyrotropin-producing adenoma: diagnostic challenges (Сase report)
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Abstract
Pituitary thyrotropin-producing adenomas (TSH-omas) are rare tumors that cause hyperthyroidism. Failure to recognize this disease may result in dramatic consequences, such as improper thyroid ablation in patients with central hyperthyroidism. This article concerns the current issues of pathogenesis, diagnostics, differential diagnostics and treatment of TSH-omas. It also describes a case study of a young woman with thyrotropin-producing adenoma.
Clinical and experimental thyroidology. 2011;7(2):68-73
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