Vol 10, No 1 (2014)

Articles
De Gustibus A long time ago
Gerasimov G.A.

Abstract

Моя колонка, несмотря на противоречивое название (“О вкусах…”), изначально вовсе не задумывалась как кулинарный форум. Но вопрос о полезности того, что мы употребляем в пищу, всегда остается актуальным в нашей жизни. В одной из прошлых колонок мы уже обсуждали сомнительную пользу биологически активных добавок (БАД). Можно ли сказать подобное в отношении многочисленных диет, тоже якобы имеющих научное обоснование? Слыхали ли вы, например, о палеолитической диете? Я вот долго пребывал в невежестве, пока не прочитал о ней в одном популярном научном журнале. Адепты этой диеты считают, что, являясь существами биологически идентичными нашим далеким предкам, жившим в каменном веке, питаемся мы сегодня совершенно иной пищей, которой не было и быть не могло в седой древности. А так как наш организм был генетически и эволюционно приспособлен к питанию, доступному первобытным охотникам и собирателям корешков, ягод и орехов, то современная диета является губительной для организма. Ведь львов в зоопарке кормят сырым мясом, а не лапшой быстрого приготовления, не так ли?

Clinical and experimental thyroidology. 2014;10(1):4-8
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Iodine Deficiency and Human Development
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Abstract

Iodine is а vital microelements that are essential for the normal human development and functions. Iodine deficiency is a global problem: about 2 billion individuals worldwide suffer from a lack of iodine. Despite goiter is the most visually noticeable manifestation of iodine deficiency, the most significant consequence of the iodine deficiency is impaired neurodevelopment, particularly early in life. Moreover, moderate to severe iodine deficiency increases the risk of spontaneous abortion, low birth weight and infant mortality. Babies in utero affected by iodine deficiency are at increased risk of mental developmental disorders, cretinism is their extreme degree. In addition, moderate to severe iodine deficiency in childhood negatively affects somatic growth. Iodine deficiency compensation improves cognitive and motor function in children. Iodine prophylaxis of deficient populations is an extremely effective approach to reduce the substantial adverse effects of iodine deficiency throughout the life cycle.
Clinical and experimental thyroidology. 2014;10(1):9-20
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News of thyroidology
., ., .

Abstract

Clinical and experimental thyroidology. 2014;10(1):21-30
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Long-term Results of Papillary Thyroid Cancer Treatment and Comparative Analisis of Various Treatment Strategies
., ., ., ., ., ., ., ., ., ., ., ., ., ., ., .

Abstract

There are discriminating approaches towards differentiated thyroid carcinomas due to their different prognoses according to the European, American and Japanese thyroid recommendations. Materials and Methods. We have analyzed data on 331 patients with papillary thyroid cancer, operated on during the period of 1966-2000 years. Mean observation period was 18.8 years, the maximum period of observation was 57 years.Results. Survival rate analysis after surgical treatment showed favourable prognosis for thyroid cancer patients, adjusted for that there was no ultrasonography and FNAB during those years, and patients had generally more progressive tumours. One of the most important factors for the prognosis of a patient is the size of a tumour at the moment of operation and presence of distant metastases. Long-term results of surgical treatment are practically independent of its extent (thyroidectomy or thyroid resection, prophylactic lymphodissection). Mortality and recurrence rates in patients who were not submitted to radioactive iodine treatment do not differ considerably from literature data.
Clinical and experimental thyroidology. 2014;10(1):31-37
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Ways of Sonoelastography Diagnostic Value Improvement in the Differentiation of Thyroid Nodules
., ., ., ., .

Abstract

Over last ten years, the clinical significance of real-time elastography or sonoelastography (SEG) has been widely discussed for the discovery of thyroid cancer. However, there is no works which revealed the relation between parameters of SEG and endocrine status of the patients for improving of diagnostic value of this method; this issue was the aim of our study. 81 patients (20 - benign adenomas and 61 - thyroid cancer (TC): 13 - follicular and 48 - papillary) were evaluated prospectively. Mean age was 48.0 ± 16.4 years. It was shown that the blue colour or 4-5 elastotype of SEG was mainly discovered in TC vs adenoma (65.6% vs 20.0% χ2 = 12.61, р = 0.0004). At the same time, the Strain Ratio more than 3.0 was frequently revealed in TC patients vs adenoma (57.4% vs 40.0%) but it did not reach level of significance (χ2 = 1,83, р = 0,18). Parameters of the sensitivity, specificity and accuracy were equal 90.2%, 60.0% and 82.7% for SEG, and 96.7%, 40.0% and 82.7% for fine-needle aspiration biopsy (FNAB), respectively. The combination of 38 SEG with FNAB or with body mass index increased specificity of SEG by 65% and 70%, respectively. The combination of SEG with another measures of hormone-metabolic status (glucose level, TSH, thyroglobulin, etc) did not improve diagnostic accuracy of SEG. In result, SEG was slightly more specific than FNAB in predicting malignancy of the thyroid nodules. The specificity of SEG could be increased by combination with both FNAB and anthropometry. Further improvement of presurgical diagnosis of TC, especially follicular TC, could be possibly reached via the combination of cytological, hormonal, genetic and instrumental methods, including shear wave elastography.
Clinical and experimental thyroidology. 2014;10(1):38-43
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Comparative Effectiveness of Replacement Therapy with L-thyroxine in Women with Postoperative and Autoimmune Hypothyroidism
., ., ., ., .

Abstract

Objective. To compare the lipid profile, psychoemotional features, cognitive function, quality of life in women receiving adequate replacement therapy with levothyroxine for postoperative hypothyroidism and autoimmune (Hashimoto's) hypothyroidism.Methods. 121 women (18-45 y.o.) with primary hypothyroidism receiving levothyroxine for more than one year participated in the study. 66 women with autoimmune hypothyroidism, 55 - with hypothyroidism after subtotal thyroidectomy for Graves' disease. The scores for the Short-Form 36, Hospital Anxiety and Depression Scale, symptoms of hypothyroidism, Inventory of memory and attention, TSH, free T3, free T4 and lipid profiles were analyzed. Results. There were no significant differences between groups in the age, BMI, TSH, fT3, fT4 levels. The total cholesterol was higher in patients with postoperative hypothyroidism in comparison to autoimmune hypothyroidism ( р = 0,041). The levels of social functioning and mental health that reflect mental component of health were lower in patients with autoimmune hypothyroidism than with postoperative hypothyroidism ( p = 0,038, p = 0,019, respectively). The anxiety was higher in the same group ( p = 0,004). There was no difference in memory and attention levels. The anxiety level was higher in autoimmune hypothyroidism and “low-normal” TSH (0,4 - 2 µU/L) than in postoperative hypothyroidism and the same TSH ( p = 0,016). Also in the group with postoperative hypothyroidism and “low-normal” TSH the cholesterol and prevalence of hypercholesterolemia were higher than in autoimmune hypothyroidism ( p = 0,017; р = 0,013). Conclusion. In young women with compensated autoimmune hypothyroidism the mental component of health is lower and the anxiety - higher than in postoperative hypothyroidism. Even in stable compensation of postoperative hypothyroidism the cholesterol level is higher comparing to the patients with autoimmune thyroiditis. And even in “low-normal” TSH level in this group the prevalence of hypercholesterolemia is 47%.
Clinical and experimental thyroidology. 2014;10(1):44-54
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Immune and Histological Changes in the Endocrines Glands in Experimental Thyrotoxicosis and Hypothyroidism
., .

Abstract

Experimental thyrotoxicosis rats showed significant elevation in serum rates of pro-and-anti-inflammatory cytokines: IL-1β, IFNγ and IL-10 against in control. The rats with tentative experimentally-induced hypothy- roidism showed significant elevation in serum TNF-α. IFN-γ / IL-10 correlation both in system and organs was determined observed close to Th1 with minor dominance of Th2 marker cytokines in situ of healthy rats and tenfold ratio change towards Th1 marker cytokines at organ level in thyrotoxicosis. Morphological changes in thyroid were shown in mastocytar focal infiltration of follicles stroma indicating activation of T-cell population of lymphocytes. Augmentation of cells with proliferative phase of cell cycle with amitotic activity was detected in glomerular and fas- ciculate zone of adrenal glands and in adenohypophysis. Hereby findings prove interdependence of hormone, mor- phological and immune changes in endocrine system under thyrotoxicosis and enlarge our view about the concep- tion of Grave’s Disease development.
Clinical and experimental thyroidology. 2014;10(1):55-60
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