L’inibizione tireotropinica da metformina non si associa a segni cardiologici di ipertiroidismo subclinico

Recenti dati di letteratura hanno evidenziato come metformina determini una riduzione/soppressione dei livelli sierici di tireotro- pina (TSH), simulando un ipertiroidismo subclinico il cui signifi- cato clinico rimane a oggi ancora assai controverso. Sebbene l’ipertiroidismo subclinico sia nella maggioranza dei casi una condizione clinica asintomatica, è altrettanto noto come esso si associ a un aumentato rischio di aritmie (più frequentemente la fibrillazione atriale) e ad alterazioni morfo-funzionali cardiache determinando un aumento di morbilità e mortalità cardiovasco- lare. Scopo del presente studio è stato quello di valutare retrospetti- vamente le alterazioni di differenti indici elettrocardiografici in pazienti diabetici eutiroidei che, dopo aver intrapreso terapia con metformina, hanno sviluppato riduzione/soppressione dei valori di TSH comparando i dati con quelli ottenuti in pazienti con iper- tiroidismo subclinico secondario a patologie tiroidee o a terapia soppressiva con L-tiroxina. I parametri elettrocardiografici (frequenza cardiaca, durata del- l’onda P, indice di dispersione dell’onda P, QT max, QT min, indice di dispersione dell’intervallo QT) sono stati valutati in 23 pazienti diabetici in terapia con metformina prima e dopo 6 mesi dall’instaurarsi della soppressione del TSH e in 31 con- trolli con ipertiroidismo subclinico. Nessuna modifica significa- tiva è stata osservata tra i parametri elettrocardiografici rilevati prima e dopo la riduzione del TSH. Al contrario, significative dif- ferenze nella durata dell’onda P (102,9 ± 7,4 vs 92,1 ± 5,8 ms, p < 0,001), dell’indice di dispersione dell’onda P (13,1 ± 3,4 vs 7,1 ± 3,5 ms, p < 0,001), del QT max (399 ± 18 vs 388 ± 16 ms, p = 0,024), del QT min (341 ± 14 vs 350 ± 17 ms, p = 0,038) e di quello dell’intervallo QT (49,9 ± 9,6 vs 30,9 ± 9,2 ms, p < 0,001) sono state rilevate tra i controlli con iperti- roidismo subclinico e il gruppo di pazienti diabetici con valori ridotti/soppressi di TSH. I risultati del nostro studio evidenzierebbero come l’effetto di riduzione/soppressione del TSH osservato in alcuni pazienti dia- betici in terapia con metformina non si associ a marker periferi- ci cardiaci da eccesso di ormoni tiroidei. L’alterazione del profilo tiroideo metformina-indotto sembrerebbe non indicativo di iper- tiroidismo subclinico, suggerendo quindi che non sussiste la necessità di sottoporre a stretti controlli della funzione tiroidea i pazienti diabetici in terapia con metformin

Effect of Hypnotic Group Treatment on Distress Psychopathology in Mixed-group Outpatients with Depression and Anxiety

Background: There is evidence of hypnosis being effective in reducing both emotional distress, anxiety, and depression. Hypnosis as a technique promotes enhanced mental mastery over the body. This may result in hypnosis being particularly salient in treating distress associated with somatic and psychological symptoms. Objective: This research aims at verifying the effectiveness of a group treatment, which provides for the use of hypnosis-related techniques in mixed-group outpatients with anxiety or depression. Methods: Participants. 31 outpatients (average age= 49.005; DS =12.1) including 13 with mild-moderate depression (average age= 49.17; DS=12.20) and 18 with mild-moderate anxiety (average age=48.84; DS=13.02). Procedure. The group treatment comprised 8 sessions, during which a hypnotic state was induced, aimed at generating a sensation of profound wellbeing in the participants. They could share their experience in a penultimate group session, and were provided with individualised recommendations on nutrition and lifestyle in the last individual session. Patients were prescribed to practice self-hypnosis every day at home with the support of a CD-ROM. Psychopathological symptomatology (SCL-90R), depression (BDI), and anxiety (STAI-Y1, SAS) were assessed at pre, post, and 3-month follow-up. Statistical analysis. Friedman, Kruskal-Wallis and Mann-Whitey tests were used. The Bonferroni\u2019s correction was applied as needed. The effect size (Cohen\u2019s d) was also measured. Results: For the total sample, for all tests, significant differences were observed in the phases. The effect size was found to vary from \u201csmall\u201d at pre to \u201dmedium\u201d at post. A \u201clarge\u201d effect size was observed when comparing pre and follow-up phases. An overall reduction in the symptoms of distress measured by the SCL-90 R \u2013 with the anxiety group showing better outcomes \u2013 alongside with an improvement in the symptoms of depression and anxiety were observed in all participants. Conclusion: The clinical impact appears to be relevant, as shown by the values for d. The treatment is cost-effective for highly prevalent disorders in outpatients. The outcomes of this study support the effectiveness of hypnotic group treatment

Oral liquid L-thyroxine (L-t4) may be better absorbed compared to L-T4 tablets following bariatric surgery.

Drug malabsorption is a potential concern after bariatric surgery. We present four case reports of hypothyroid patients who were well replaced with thyroxine tablets to euthyroid thyrotropin (TSH) levels prior to Roux-en-Y gastric bypass surgery. These patients developed elevated TSH levels after the surgery, the TSH responded reversibly to switching from treatment with oral tablets to a liquid formulation

A Case of Concurrent Riedel's, Hashimoto's and Acute Suppurative Thyroiditis

Riedel's thyroiditis (RT) is a rare form of infiltrative and inflammatory disease of the thyroid, first described by Bernard Riedel in 1896. The concurrent presence of RT and other thyroid diseases has been reported, but, the association of RT with Hashimoto's thyroiditis and acute thyroiditis has not yet been reported. We present a case of concurrent Riedel's, Hashimoto's and acute thyroiditis that occurred in a 45-year-old patient

Effect of Metal Cocatalysts and Operating Conditions on the Product Distribution and the Productivity of the CO2 Photoreduction

open7The CO2 photoreduction is a promising way to convert one of the most abundant greenhouse gases to valuable chemicals. The photoreduction in the liquid phase is limited by the low solubility of CO2 in water, but this point is overcome here by using an innovative photoreactor, which allows one to work up to pressures of 20 bar, improving the overall productivity. The photoreduction was performed in the presence of Na2SO3 and using in primis commercial titanium dioxide (P25) and a set of titania catalysts functionalized by surface deposition of either monometallic or bimetallic cocatalysts. The gaseous products were hydrogen and traces of CO, while, in the liquid phase, formic acid/formate, formaldehyde and methanol were quantitatively detected. The pH was observed to shift the products distribution. A neutral environment led mainly to hydrogen and methanol, while, at pH 14, formate was the most abundant compound. The trend for monometallic cocatalysts showed enhanced productivity when using noble metals (i.e., gold and platinum). In order to limit the cost of the catalytic material, bimetallic cocatalysts were explored, adding titania with Au+Ag or Au+Pt. This may open to the possibility of performing the reaction with a smaller amount of the most expensive metals. In the end, we have expressed some conclusions on the cost of the photocatalysts here employed, to support the overall feasibility assessment of the process.openConte F.; Villa A.; Prati L.; Pirola C.; Bennici S.; Ramis G.; Rossetti I.Conte, F.; Villa, A.; Prati, L.; Pirola, C.; Bennici, S.; Ramis, G.; Rossetti, I

Anabolic steroids purchased on the Internet as a cause of prolonged hypogonadotropic hypogonadism

OBJECTIVE: To report a case of hypogonadotropic hypogonadism due to the chronic abuse of anabolic steroids purchased over the Internet. DESIGN: Case report. SETTING: Endocrinology unit of the University of Brescia. PATIENT(S): A 34-year-old man. INTERVENTION(S): A single dose (100 μg) of triptorelin (triptorelin test). MAIN OUTCOME MEASURE(S): Clinical symptoms, androgen normalization, levels of serum testosterone, follicle-stimulating hormone, and luteinizing hormone. RESULT(S): Within 1 month, the patient's serum testosterone was in the normal range, and he reported a return to normal energy and libido. CONCLUSION(S): The World Anti-Doping Code has proved to be a very powerful and effective tool in the harmonization of antidoping efforts worldwide, but it is insufficient to combat this illegal phenomenon. To tackle the serious side effects caused by doping we believe that it is necessary to increase monitoring and adopt severe sanctions, particularly with regard to Internet sites

Physiological and sensorial aspects of peach fruits cv. Chimarrita depending on the season and management of green pruning.

Made available in DSpace on 2018-01-11T23:32:07Z (GMT). No. of bitstreams: 1 LuisEduardoPODAVERDECHIMARRITA.pdf: 371835 bytes, checksum: e3f18ade57a63bec5503b96c84f41f1f (MD5) Previous issue date: 2018-01-10bitstream/item/170739/1/Luis-Eduardo-PODA-VERDE-CHIMARRITA.pd

The effect of pregnancy on subsequent relapse from Graves' disease after a successful course of antithyroid drug therapy.

OBJECTIVE: Pregnancy and the postpartum (PP) period are associated with profound changes of the immune system, which largely influence the clinical activity of autoimmune diseases. The aim of this study was to evaluate the effect of pregnancy and/or the PP period in driving a clinical relapse of hyperthyroidism in patients with Graves' disease (GD) who are in remission after antithyroid drug (ATD) treatment. Data were retrospectively collected from 150 female patients with GD, who were assigned to two groups according to the occurrence of a successful pregnancy after ATD withdrawal. RESULTS: Relapsing Graves' hyperthyroidism was observed in 70 of 125 patients in group I (no pregnancy after ATD withdrawal) (56.0%) and 21 of 25 patients in group II (pregnancy after ATD withdrawal) (84.0%) (P < 0.05). Logistic regression analysis (dependent variable: relapse/nonrelapse; covariates: age, positive family history for autoimmune thyroid disease, duration of treatment with ATD, number pregnancies at diagnosis, number of pregnancies after ATD withdrawal) showed a significant effect only for the number of pregnancies after ATD withdrawal [4.257 (1.315-13.782)]. The effect was ascribed to the PP period rather than to pregnancy itself because in 20 of 21 patients of group II (95.2%), the relapse of Graves' hyperthyroidism occurred between 4 and 8 months after delivery. CONCLUSIONS: The PP period is significantly associated with a relapse of hyperthyroidism in GD patients being in remission after ATD. We therefore recommend that patients with GD in remission after a course of ATD should have their thyroid function tested at 3 and 6 months after delivery

On the canonical map of surfaces with q>=6

We carry out an analysis of the canonical system of a minimal complex surface of general type with irregularity q>0. Using this analysis we are able to sharpen in the case q>0 the well known Castelnuovo inequality K^2>=3p_g+q-7. Then we turn to the study of surfaces with p_g=2q-3 and no fibration onto a curve of genus >1. We prove that for q>=6 the canonical map is birational. Combining this result with the analysis of the canonical system, we also prove the inequality: K^2>=7\chi+2. This improves an earlier result of the first and second author [M.Mendes Lopes and R.Pardini, On surfaces with p_g=2q-3, Adv. in Geom. 10 (3) (2010), 549-555].Comment: Dedicated to Fabrizio Catanese on the occasion of his 60th birthday. To appear in the special issue of Science of China Ser.A: Mathematics dedicated to him. V2:some typos have been correcte