48 research outputs found
UÄinak terapije metimazolom na patohistoloÅ”ki izgled tkiva Å”titnjaÄe koji može oponaÅ”ati maligne promjene
Diffuse toxic goiter, as the most common cause of hyperthyroidism, is usually
initially treated with thyrostatic drugs such as methimazole, followed by radioiodine therapy or surgery
which may be indicated as definitive treatment. Radioactive iodine therapy has a known association
with various histopathologic features including cytologic atypia, but herein we present a rare example
of morphological thyrocyte changes induced by long-term pharmacological treatment with
methimazole that mimicked thyroid malignancy in a pathohistological sample.Difuzna toksiÄna struma, kao najuÄestaliji uzrok hipertireoze, se uglavnom lijeÄi tireostaticima kao Å”to je metimazol a
nakon poÄetne farmakoloÅ”ke terapije, ukoliko ne doÄe do spontane remisije bolesti, lijeÄenje se nastavlja primjenom radioaktivnog
joda (I-131) ili kirurŔkim zahvatom.
Primjena radioaktivnog joda dovodi do brojnih histopatoloÅ”kih izmjena u parenhimu Å”titnjaÄe, ukljuÄujuÄi i staniÄnu
atipiju, no u naÅ”em radu prikazujemo rijedak sluÄaj utjecaja dugotrajne farmakoloÅ”ke terapije metimazolom na izmjenu
morfologije tireocita koja može oponaÅ”ati izgled malignih stanica na histoloÅ”kom uzorku tkiva Å”titnjaÄe
Pristup lijeÄenju tumorskog tromba folikularnog karcinoma Å”titnjaÄe u unutarnjoj jugularnoj i brahiocefaliÄnoj veni
Thyroid gland carcinoma causing tumor thrombus in the great veins of the neck
and mediastinum is a rare condition with poor prognosis. Invasion of the internal jugular vein by
thyroid gland carcinoma has been occasionally reported, but tumor thrombi extending to the great
veins of the mediastinum are reported extremely rarely. We present a treatment approach in a case of
follicular thyroid carcinoma intravascular tumor thrombus in the left internal jugular and left brachiocephalic
vein.Karcinom Å”titnjaÄe koji uzrokuje tumorske trombe u velikim venama vrata i medijastinuma je rijedak i ima loÅ”u prognozu.
Invazija unutarnje jugularne vene karcinomom Å”titnjaÄe se povremeno opisuje u Älancima, ali tumorski trombi koji zahvaÄaju
velike vene medijastinuma su iznimno rijetko opisani.
Prikazujemo pristup lijeÄenjuintravaskularnog tumorskog tromba folikularnog karcinoma Å”titnjaÄe u lijevoj unutranjoj
jugularnoj i lijevoj brahiocefaliÄnoj veni
Symptomatology of Detrimental Effects of Pesticides - Literature Review
Poljoprivrednici koji su kroniÄno izloženi niskim razinama pesticida rijetko pokazuju kliniÄki znaÄajne znakove i simptome. Trovanje pesticidima može biti akutno i kroniÄno. Primarna ciljna tkiva toksiÄnosti su krvotvorni sustav, kardiovaskularni sustav, reprodukcijski sustav i živÄani sustav. Kod izloženih osoba pesticidi mogu uzrokovati mutacije gena i poremeÄaje kromosoma. Blaži, prolazni simptomi trovanja su Äesto glavobolja, muÄnina, povraÄanje, omaglica, proljev, bolovi u trbuhu, bolovi u miÅ”iÄima, salivacija, zbunjenost, umor itd. Od bitne je važnosti pravodobno prepoznati Å”tetno djelovanje pesticida, Äime se omoguÄava primjena odgovarajuÄe terapije Å”to je ranije moguÄe.Farm workers chronically exposed to low levels of pesticides seldom show signs and symptoms of clinical significance. Pesticide poisoning can be acute and chronic. The primary targets of toxicity are the hematopoietic system, the cardiovascular system, the reproductive system and the nervous system. Pesticides can cause gene mutations and chromosomal aberrations in exposed individuals. Mild temporary symptoms of poisoning including headache, nausea, vomiting, dizziness, diarrhea, abdominal pain, myalgia, salivation, mental confusion, fatigue, etc., may quite frequently occur. It is essential to recognize detrimental effects of pesticides timely, thus enabling the earliest possible administration of appropriate treatment
ZnaÄenje kvantitativnog scintigrama kosti u prognostici zaraÅ”tanja prijeloma
Studies of fracture healing are aimed at differentiating normal from delayed bone union. Delayed union, nonunion with the development of pseudarthrosis, and infection are complications of fracture healing. In the present study, quantitative analysis by three-phase bone scintigraphy was evaluated in the early prognosis of the course of fracture healing, to assess its potential in the early detection and therapy of healing complications. In 105 patients with long bone fractures, three-phase bone scintigraphy was performed early (day 4-7), and 3 weeks, 3 months and 6 months of injury. Based on clinical, laboratory and radiological findings, patients were retrospectively divided into four groups of normal healing, pseudarthrosis, delayed union, and healing with infection. The region of interest method was used to analyze all three scintigraphy phases, i.e. perfusion, vascular space image, and static scintigram at 3 h of injection. Comparison of impulse count in the fracture area with the contralateral, intact side produced a relative index for each step of three-phase scintigraphy. Infection at the fracture site can be suspected on the basis of perfusion index in the earliest stages following injury. Delayed bone union can also be predicted very early, within three weeks of injury, by use of perfusion index. Quantitative analysis of the vascular space phase and late static scintigrams can contribute to the diagnosis of complications, however, only in later stages of disease, which in part limits their clinical relevance. Three-phase bone scintigraphy is a valuable study when expecting problems in the process of bone union.Ispitivanje zarastanja prijeloma ima za cilj razlikovanje normalnog od usporenog zarastanja kosti. Odloženo zarastanje, nezarastanje s razvojem pseudoartroze te infekcija komplikacije su zarastanja prijeloma. S ciljem Å”to ranijeg otkrivanja, a time i ranije terapije komplikacija, željeli smo ispitati moguÄnosti kvantitativne analize troetapne scintigrafije kosti u ranoj prognozi tijeka zarastanja prijeloma. U 105 ispitanika s prijelomima dugih kostiju uÄinjena je troetapna scintigrafija kosti neposredno nakon traume (4.-7. dan nakon traume), te 3 tjedna, 3 i 6 mjeseci nakon traume. Ispitanici su na osnovi kliniÄkih, laboratorijskih i radioloÅ”kih nalaza retrospektivno podijeljeni u Äetiri skupine: normalno zarastanje, pseudoartroza, odloženo zarastanje i zarastanje uz infekciju. Metodom regije interesa (ROI) analizirali smo sve tri faze scintigrama: perfuziju, snimku vaskularnih prostora, te statiÄki scintigram 3 sata nakon injiciranja. UsporeÄujuÄi broj impulsa podruÄja frakture s kontralateralnom, zdravom stranom dobili smo relativne indekse (RI) za svaku fazu troetapne scintigrafije. U najranijim stadijima nakon povrede moguÄe je, na temelju indeksa perfuzije, posumnjati na infekciju na mjestu frakture. Odloženo zarastanje takoÄer se može predskazati indeksom perfuzije vrlo rano, unutar tri tjedna od prijeloma. Kvantitativna analiza faze vaskularih prostora i kasnih statiÄkih scintigrama može doprinijeti dijagnostici komplikacija, ali u kasnim fazama bolesti, Å”to donekle umanjuje njihovo kliniÄko znaÄenje. Troetapna scintigrafija kosti vrijedna je pretraga u sluÄajevima kada se oÄekuju problemi zarastanja kosti
Thyroid Hormones Are Not Associated with Plasma Osteocalcin Levels in Adult Population with Normal Thyroid Function
Thyroid hormones (THs) play an indispensable role in skeletal development and bone remodeling. Some studies have reported associations of THs with serum osteocalcin (OC) levels, but the results are quite inconsistent and the molecular mechanism of their simultaneous or interdependent activity on bone is almost unknown. Therefore, the aim of this study was to determine the possible associations of plasma THs with plasma OC levels and the possible mediating effect of OC on the relationship between THs and bone mineral density (BMD). For this purpose, out of the initial 1981 participants, we selected healthy euthyroid participants controlled for available confounding factors that can affect thyroid function and bone metabolism (N = 694). Given our results, we could not confirm any associations of THs with plasma OC levels nor the mediating effect of OC on the relationship between THs and BMD in euthyroid population. In the group of women controlled for menopause status (N = 396), we found a significant negative association of body mass index (BMI) with OC levels (Ī² = ā0.14, p = 0.03). We also found a negative association of free triiodothyronine (fT3) (Ī² = ā0.01, p = 0.02) and age (Ī² = ā0.003, p < 0.001) with BMD, and a positive association of BMI (Ī² = 0.004, p < 0.001) and male gender (Ī² = 0.1, p < 0.001) with BMD. In addition, we found significantly higher plasma OC levels and lower values of BMD in postmenopausal euthyroid women compared with premenopausal euthyroid women. In our opinion, the results of previous studies suggesting an association between circulating THs and serum OC levels may be influenced by an inconsistent selection of participants and the influence of confounding factors
Guillain-Barre Syndrome in Patients with Seroconversion of IgG Antibodies to Borrelia Burgdorferi sensu lato
A case of polyneuroradiculitis (Guillain-Barre Syndrome) is presented, which was diagnosed in a 62 year-old man after
progressive weakness in the legs and arms and double vision, preceded by severe pain in the back. Diagnosis was
made on the basis of electromioneurography, a specific finding of cerebrospinal fluid (albumino-citological dissociation),
and the clinical course of the disease. Serological analysis of serum included Borellia Burgdorferi sensu lato (BBSL).
Positive findings (slowing of conduction velocity of sensor and motor neurones, and marked albumino-citological dissociation),
together with the dynamics of these findings on the 33rd, 67th and 101st days and one year and a half after the
first clinical signs of disease, indicated the possibility of BBSL infection. Because of the absence of clear clinical and
serological signs of other infections it was assumed that BBSL might be the possible trigger for Guillain-Barre Syndrome.
The fact that there were no obvious clinical signs of infection with BBSL, only serological, suggests that in the
case of unclear aetiology of Guillain-Barre Syndrome BBSL should not be excluded
Determinants of thyroid volume in healthy young adults of Dalmatia
Background and purpose: The aim of this study was to investigate thyroid volume (TV) and its determinants in healthy young adults without present or previous thyroid disease.
Materials and methods: The study was performed in a sample of 145 healthy young participants aged 19-29 years, living in an iodine-sufficient area of Dalmatia. Dimensions of the thyroid gland were obtained by ultrasound and used to determine TV. Anthropometric data was collected, and measurements of serum TSH, fT4, Tg, TgAb, and TPOAb levels were determined. Correlations between TV and other continuous variables were determined using the Pearson correlation test, while multivariate linear regression analysis was used to determine the associations of the potential predictors for the TV.
Results: TV in men was larger than in women (p=3.53x10-8) and was positively correlated with anthropometric measurements, with the highest correlation coefficient for height (r=0.53, p=6.36x10-12), then body surface area, BSA (r=0.48, p=1.68x10-9), weight (r=0.43, p=8.28x10-8) and body mass index, BMI (r=0.17, p=0.04). Age and cigarette smoking did not appear to be significantly associated with TV (p=0.13 and p=0.95, respectively). Univariate analysis showed TV correlated with fT4 plasma levels (r=0.35, 1.73x10-5), while multivariate analysis showed height and fT4 levels to be important parameters with a significant role in TV.
Conclusions: We confirmed previously observed association of TV with sex and anthropometric parameters and reported a significant correlation between TV and fT4 levels. Furthermore, fT4 levels and height were found to be the important parameters for predicting TV.</p
UÄestalost RET mutacije u papilarnom karcinomu Å”titnjaÄe i korelacija s kliniÄko-patoloÅ”kim karakteristikama
The purpose of this study was to analyze the possible prognostic value of RET mutation in papillary thyroid carcinoma and its incidence in the past few decades in our population, due to the increasing incidence of papillary thyroid carcinoma. The present study included 180 patients operated for papillary thyroid carcinoma. The clinical and histopathologic characteristics were analyzed. Paraffin sections of the selected histologic slides were cut again and immunohistochemically stained by the Clone 3F8 P (HIER) from Novocastra (Vision Bio Systems Europe, Newcastle upon Tyne, UK) monoclonal antibody to RET oncoprotein. Univariate analysis indicated sex (p=0.01), histologic subtype (p=0.075) and capsular invasion (p=0.010) to be statistically significant predictors of lymph node metastases, whereas age (p=0.796), tumor size (p=0.556) and intraglandular dissemination (p=0.131) showed no such correlation. The presence of RET mutation (p=0.704) was not a statistically significant predictor of the tumor metastasizing potential. RET mutation (p=0.500) showed no statistically significant correlation with papillary thyroid carcinoma classifed into prognostic groups according to clinicopathologic features either. RET mutation was detected in 30% of 180 papillary thyroid carcinomas. This is the first large study demonstrating that RET mutation incidence in papillary thyroid carcinoma in Croatian population is consistent with the classic distribution of sporadic cases, despite the increased prevalence of papillary thyroid carcinoma in the past few decades.Cilj ovoga rada bio je ispitati moguÄe prognostiÄko znaÄenje RET mutacije u papilarnom karcinomu Å”titnjaÄe i uÄestalost mutacije u odnosu na porast uÄestalosti papilarnog karcinoma Å”titnjaÄe u posljednjih nekoliko desetljeÄa. U istraživanje je bilo ukljuÄeno 180 bolesnika operiranih zbog papilarnog karcinoma Å”titnjaÄe. Analizirane su kliniÄke i patohistoloÅ”ke osobitosti. HistoloÅ”ki rezovi iz parafinskih blokova odabranih uzoraka imunohistokemijski su obojani monoklonskim protutijelom na RET onkoprotein Clone 3F8 P (HIER) proizvoÄaÄa Novocastra (Vision Bio Systems Europe, Newcastle upon Tyne, UK). Univarijatnom analizom utvrÄena je statistiÄki znaÄajna povezanost spola (p=0,01), histoloÅ”kog podtipa (p=0,075) i kapsularne invazije (p=0,010) kao prediktora pojave metastaza u limfne Ävorove vrata, dok takva povezanost nije zabilježena za dob (p=0,796), veliÄinu tumora (p=0,556) i intraglandularnu diseminaciju tumora (p=0,131). Prisutnost RET mutacije nije bila statistiÄki znaÄajan prediktor metastatskog potencijala tumora (p=0,704). TakoÄer, RET mutacija nije bila statistiÄki znaÄajno povezana s prognostiÄkim skupinama papilarnog karcinoma koje su sastavljene na temelju kliniÄko-patoloÅ”kh osobitosti (p=0,500). RET mutacija bila je prisutna u 30% od 180 papilarnih karcinoma Å”titnjaÄe. Ovo je prvo veÄe istraživanje kojim je dokazano da je RET mutacija u papilarnom karcinomu Å”titnjaÄe u Hrvatskoj u skladu s uÄestaloÅ”Äu pojave spontane mutacije, iako se bilježi porast uÄestalosti papilarnog karcinoma Å”titnjaÄe tijekom posljednjih desetljeÄa