Clinical endocrinology
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Clinical endocrinology · Oct 2008
Thyroglobulin measurement before rhTSH-aided 131I ablation in detecting metastases from differentiated thyroid carcinoma.
Thyroidectomy followed by administration of large activities of 131-iodine ((131)I) is the treatment of choice for differentiated thyroid carcinoma (DTC). The serum thyroglobulin (Tg) measurement during hypothyroidism (offT4-Tg), just before radioiodine thyroid ablation, has proved to be effective for predicting persistent/recurrent disease. However, the Tg measurement cannot be used as a corresponding value for pre-ablative offT4-Tg when recombinant human TSH (rhTSH) is used as stimulus before treatment. The present study was undertaken to evaluate if post-thyroidectomy Tg values, measured before rhTSH-stimulated radioiodine ablation is of prognostic value in patients affected by DTC. ⋯ Based on our data we conclude that pre-ablative onT4-Tg is a prognostic marker and should be used instead of pre-ablative TSH-stimulated Tg measurement when rhTSH-aided radioiodine ablation is done.
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Clinical endocrinology · May 2008
Comparative StudyInsulin resistance and body composition in preterm born children during prepubertal ages.
Premature born children may show insulin resistance in childhood which may be due to intrauterine or postnatal adverse environmental factors. ⋯ Premature born AGA and SGA children do not have insulin resistance when compared to term children if they have made a catch-up growth appropriate for their target height and have normal BMI. The similar insulin levels in preterm SGA and preterm AGA children together with increased insulin levels in term SGA children points to the fact that it is the intrauterine restriction in the third trimester that has an adverse effect on future adverse metabolic outcome.
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Clinical endocrinology · Apr 2008
Three years prospective investigation of anterior pituitary function after traumatic brain injury: a pilot study.
It has been recently demonstrated that traumatic brain injury (TBI)-mediated hypopituitarism could be more frequent than previously known. However, most of the previous data were obtained from retrospective studies, and the natural history of the hypopituitarism due to TBI is still unclear. So far no study has been reported in which the pituitary function of the same patients has been investigated more than 1 year after TBI. Therefore, we report the results of 3 years prospective follow-up of anterior pituitary function in patients with mild, moderate and severe TBI. ⋯ GH deficiency is the most common pituitary deficit 1 and 3 years after TBI. In patients with mild and moderate TBI, pituitary function improves over time in a considerable number of patients, but it may also worsen rarely over the 3-year period. In patients with severe TBI, ACTH and GH deficiencies at 1st year evaluation persist at 3rd year.
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Clinical endocrinology · Feb 2008
Predictors of anterior pituitary insufficiency after traumatic brain injury.
Several studies have reported a high prevalence of hypopituitarism after traumatic brain injury (TBI). Risk stratification is a prerequisite for cost-effective hormonal screening of these patients. However, it is still unclear which risk factors predispose patients to develop anterior hypopituitarism after TBI. ⋯ We have defined specific risk factors for the development of post-traumatic hypopituitarism that are consistent with pathophysiological considerations. These findings might help to identify at-risk patients.
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Clinical endocrinology · Feb 2008
Clinicopathological correlations of Bcl-xL and Bax expression in differentiated thyroid carcinoma.
The Bcl-2 family proteins are essential mediators in the apoptotic process. Our aim was to investigate whether anti-apoptotic Bcl-xL and pro-apoptotic Bax were over-expressed in a large series of differentiated thyroid carcinomas (DTC) and to study their association with tumour presentation at diagnosis and prognosis. ⋯ Immunohistochemical expression of Bcl-xL might be a valuable tool in the prediction of tumour aggressiveness in DTC.