Crossed renal ectopia with fusion: Report of two patients

Crossed renal ectopia is one of the rarest urinary system anomalies. It is more often seen at autopsy than in clinical practice. Most cases of renal ectopia remain asymptomatic during life and are diagnosed incidentally. Renal ultrasonography, intravenous pyelography, computerized tomography, and renal scintigraphy (technetium-based tests) are the imaging methods used for diagnosis. Demonstration of crossed renal ectopia is important because it is a predisposing factor for obstruction, infection, and neoplasia of the urinary system. We report two male patients who had Unremarkable clinical findings. Both had left-to-right inferior crossed renal ectopia with fusion. Additionally, the first patient had a history of surgery for a recurrent inguinal hernia, whereas the second had crossed fused renal ectopia associated with nephroptosis. Surgeons should be aware of ectopic and fused kidneys to minimize perioperative complications because of the uncertain anatomy

Overt and Mild Subclinical Hypothyroidism Do Not Influence Mean Platelet Volume in Premenopausal Women Having Low Cardiac Risk

Mean platelet volume (MPV) was studied in subclinical hypothyroidism (SH) and the results are conflicting. The aim of this study is to assess how MPV is affected in overt hypothyroidism (OH) and mild SH, the 2 end points of hypothyroidism, in patients having low cardiac risk. Premenopausal women without any cardiac risk, 18 with OH, 30 with mild SH, and 37 euthyroid controls were enrolled. Overt hypothyroidism group had higher low-density lipoprotein cholesterol (LDL-C) and total cholesterol levels than the control group (P < .001 and P < .05, respectively). Increase in MPV was insignificant in OH group when compared with SH and control groups. No correlation was observed between MPV and metabolic and hormonal parameters. Both OH and SH did not influence MPV and high-sensitivity C-reactive protein (hs-CRP) in patients with low cardiovascular risk, but these findings need to be further evaluated in this patient group

Calcitriol treatment in patients with low vitamin D levels

The aim of the the study is to compare the effects of cholecalciferol and calcitriol on bone mineral metabolism in women with vitamin D deficiency. Calcitriol was associated with a significant increase in bone mineral density at the lumbar spine in patients with low vitamin D levels.Purpose/introductionActive vitamin D analogs may have larger impact in decreasing bone loss and fracture rate compared to cholecalciferol in osteoporosis. However, their effects in the treatment of vitamin D deficiency compared to cholecalciferol are not clear. The aim of the present study is to compare the effects of cholecalciferol and calcitriol on bone mineral metabolism and bone mineral density in pre- and postmenopausal women with vitamin D deficiency.MethodsThis was a 6-month prospective, open-label, controlled clinical trial. Eligible 120 participants were pre- and postmenopausal women diagnosed with vitamin D deficiency. Forty-three subjects (group 1) received 1000IU of cholecalciferol and 1g of calcium daily. The other 77 subjects (group 2) received 0.5g calcitriol in addition to 400IU of cholecalciferol and 1g of calcium daily.ResultsOral vitamin D supplementation did not increase bone mineral density after 6months of intervention in group 1. On the other hand, bone mineral density at the lumbar spine increased from 0.8090.172 to 0.848 +/- 0.161g/cm(2) in group 2 patients (p<0.017 vs baseline).ConclusionsOral daily calcitriol was associated with a significant increase in bone mineral density at the lumbar spine in patients with low vitamin D, elevated PTH, and osteoporosis

Anorexia nervosa and Raynaud's phenomenon: A case report

Objective: To describe and discuss potential relationships between anorexia nervosa (AN) and Raynaud's phenomenon, the course and concurrent treatment of these two disorders as they appeared simultaneously, and a potential treatment modification entailed in such concurrent therapies

Serum adipokines and low density lipoprotein subfraction profile in hypopituitary patients with growth hormone deficiency

The aim was to evaluate the concentrations of lipid subfractions in relation to adipokines and metabolic parameters in adult growth hormone (GH)-deficient hypopituitary patients on conventional replacement therapy. The study included 21 GH deficient-hypopituitary patients (age: 36.0 +/- A 15.1 years, male/female: 7/14) on conventional replacement therapy other than GH and 20 comparable controls (age: 37.3 +/- A 14.0 years, male/female: 6/14). Lipid subfractions (Lipoprint system), serum adipokine (leptin, adiponectin, resistin) concentrations, body composition, a surrogate marker for insulin resistance (HOMA) and conventional lipid profile were evaluated. No statistically significant difference was found with respect to HOMA, adipokine concentrations and anthropometric parameters between patients and controls except for significantly increased waist-to-hip ratio in hypopituitary group. Total and LDL cholesterol concentrations were significantly higher in the patients. LDL particle size (268.88 +/- A 3.16 vs. 271.31 +/- A 3.11 a"<<, P = 0.151) and small-dense LDL subfraction did not differ significantly. According to logistic regression analysis, triglyceride concentrations a parts per thousand yen1.69 mmol/L was the sole parameter significantly and independently predicted small (< 268 a"<<) LDL particle size (P = 0.019) in the whole group. Increased triglyceride concentrations affect LDL particle size in GH-deficient hypopituitary patients. Small dense LDL seems not directly contribute to atherogenic potential in hypopituitarism

Leptin concentration indexed to fat mass is increased in untreated anorexia nervosa (AN) patients

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Evaluation of the effect of L-thyroxin therapy on cardiac functions by using novel tissue Doppler-derived indices in patients with subclinical hypothyroidism

Objectives Subclinical hypothyroidism (SH) is characterized by normal serum free T4 (fT4), free T3 (fT3) levels and increased serum thyroid stimulating hormone (TSH) levels. The aim of this study was to assess the validity of tissue Doppler imaging (TDI) in evaluating cardiac effects of SH and to demonstrate the improving effects of L-thyroxin(L-T4) on TDI parameters

Evaluation of the effect of L-thyroxin therapy on endothelial functions in patients with subclinical hypothyroidism

Subclinical hypothyroidism (SH) is characterized by normal serum free T4 (FT4), free T3 (FT3) levels and increased serum thyroid-stimulating hormone (TSH) levels. Endothelial dysfunction, which is an early step of atherosclerosis, has been reported in patients with subclinical hypothyroidism. The aim of this study is to evaluate endothelial functions and the effect of L-thyroxin (L-T4) therapy on endothelial functions in SH. Twenty-seven patients with SH and 22 healthy controls were evaluated in terms of endothelial functions, using brachial artery Doppler ultrasonography. After restorating euthyroidism, measurements were repeated. Baseline and nitroglycerin induced diameter (NID) of brachial artery were similar in patients with SH and the control group. Compared to the control group, the patients with SH showed significantly reduced flow-mediated diameter (FMD). Baseline and NID values were significantly higher after LT4 therapy in SH group. FMD also significantly increased after LT4 therapy. Hypothyroidism accelerates atherogenesis through modification of athero-sclerotic risk factors and direct effects on the blood vessels. In this study, we observed marked improvement in endothelial functions after L-T4 therapy in SH patients. We suggest that thyroid hormone replacement therapy may help to prevent atherosclerosis in this group of patients

Pituitary Metastasis of Breast Carcinoma

Rarely, primary carcinomas can metastasize to the pituitary. Mostly the posterior lobe is affected and diabetes insipidus can develop. We report a 47-year-old woman who was on follow-up for metastatic breast carcinoma and admitted to the endocrinology unit for polyuria and polydypsia, which had worsened gradually. Her laboratory findings were compatible with diabetes insipidus. Magnetic resonance imaging revealed a huge mass involving the suprasellar cistern, surrounding the cavernous sinus and compressing the optic chiasm and infundibulum. Radiotherapy for the sellar region and chemotherapy were performed and desmopressin was started. The symptoms were controlled with desmopressin. Increased amounts of urine output and oral fluid intake in a patient with a diagnosis of carcinoma should alert the physicians of a possibility of pituitary metastasis, and the hormonal insufficiency should be corrected to increase the patient's quality of life

Utility of baseline serum phosphorus levels for predicting remission in acromegaly patients

Purpose High GH and IGF I levels increase tubular phosphate reabsorption in patients with acromegaly. We aimed to investigate the utility of serum phosphorus levels as an indicator for predicting chance of remission in acromegaly patients