Search PubMed⌕ Search

Biomedical subjects

C Jaffiol

Publications and source records attributed to C Jaffiol.

At least 19 recordsLinked to original sources
PubMed1992

Thyroid hormone generalized resistance.

The syndromes of thyroid hormone resistance may affect overall or only some tissues. The generalized resistance is an inherited disease which involves a familial eumetabolic or hypometabolic goiter, increased free thyroid hormones with normal or elevated plasma TSH levels; children may present mental retardation, deafness, short stature and delayed bone age. The disease is frequently misdiagnosed. In vivo and in vitro tests may be used to assess the diagnosis. The defect of increment of sex hormone-binding globulin after administration of T3 may be useful in the demonstration of the disease. Therapy uses high T4 or T3 doses in hypometabolic patients. The generalized thyroid hormone resistance could be linked to abnormalities at the T3 receptor and c-erb A gene level, as a consequence of different point mutations or deletions involving the hormone-binding domain.

Drug Resistance↗
PubMed1992

[Endemic goiter in the La Kara region (Togo). Analysis of etiologic factors].

Among 6,035 people living in 3 villages from the area of La Kara (Togo), 984 randomized subjects were investigated to evaluate goiter prevalence and related etiologic factors. Creatinine and thiocyanates (SCN-) were measured in urine, thyroid hormones and TSH in plasma. Iodine was evaluated in urine, water, salt, soil, millet and sorgho. The amount of cassava was evaluated in food. Mean goiter prevalence was 32%, reaching to 45.9% in one village; urinary iodine remained in a low range (27.2 +/- 2.18 micrograms/g creatinine in adults, 34.3 +/- 6.7 in children--m +/- SEM) independently of the presence of endemic goiter. Urinary SCN- was increased. Low iodine values were found in food, salt, soil and water which contained few mineral elements except flour which was increased in the samples collected in one of the 3 villages. Cretinism was absent, T4, T3, TSH remained in a normal range. This study confirms a high prevalence of endemic goiter in the area of La Kara with iodine deficiency, leading to an urgent iodine supplementation.

Goiter, Endemic↗
PubMed1991

[Incidence of endemic goiter on Reunion Island. A search for etiological factors].

In an epidemiological study carried out in Reunion Island, 1,686 randomized school children aged from 11 to 15 years were examined for goitre by cervical palpation. A detailed questionnaire was fully completed by each child and his parents. The iodine level was measured in 168 urinary samples and in the salt and water consumed in the various places investigated. The overall incidence of goitre was 8.2 percent, rising up to 19.7 percent in the mountainous part of the island. The mean urinary iodine level was 40.2 +/- 2.7 micrograms I/g creatinine (m +/- SEM) and fell to 20.0 +/- 3.7 in the highlands. Water and salt contained little iodine. A significant relationship was noted between the presence of goitre on the one hand and sex, familial incidence of goitre, cassava consumption and distance from the coast on the other hand. This study demonstrates that endemic goitre and iodine deficiency are present in a limited area of Reunion Island.

Adolescent↗
PubMed1991

[Thyroid nodules and non-functional goiters. Diagnostic contribution of nuclear resonance imaging].

The finding of a "cold" thyroid nodular or goiter raises the problem of its potential malignancy, usually resulting in systematic surgery. Ultrasonography and computerized tomography provide accurate information concerning the size, structure and connections of these abnormalities, but they have very little to say about their histological nature. We evaluated the contribution of magnetic resonance imaging (MRI) to the histological diagnosis by attempting tissue characterization before surgery in 97 patients with nonfunctional thyroid nodule or goiter. Comparisons with the pathological study of operative specimens showed a very small percentage (1.05 percent) of false negative results in terms of malignancy, and this was due to reliable arguments for benignity which we were able to collect from MRI signal intensity and structural analysis. Without these criteria, a decisive answer would have been very difficult, as shown by the significant rate of false positive results (14.73 percent) and a specificity of only 81.8 percent if every lesion interpreted as doubtful is considered malignant. Attention is drawn to the difficulties encountered in characterizing lesion with intracystic vegetations and in distinguishing between thyroiditis and lymphoma. The possibility of obtaining frontal and sagittal sections increases the usefulness of MRI. The operator's experience is essential in interpreting the signals and deciding on the therapeutic approach.

Adult↗
PubMed1991

[Pathology of thyroid hormone receptors].

The syndrome of resistance to thyroid hormones may affect overall or only some tissues. The generalized resistance associates a familial eu or hypometabolic goiter, increased free thyroid hormones with normal or elevated plasma TSH levels. The inheritance of the disease is autosomal dominant in most of the patients. In vivo or in vitro tests may be used to assess the diagnosis. Therapy refers to high doses of T3 or T4. Pituitary resistance to thyroid hormones leads to hyperthyroidism with normal or high TSH levels. The treatment uses different TSH suppressive drugs. Peripheral resistance associates hypometabolism with normal T4-T3 secretion and needs high T3 doses for therapy. An inherited abnormality of T3 nuclear receptor seems to be the consequence of a mutant gene. Hypersensitivity to thyroid hormones associates hypermetabolism with low or normal free thyroid hormone levels and increased T3 nuclear receptors.

Drug Resistance↗
PubMed1990

[Influence of abnormal weight and imbalanced diet on female fertility].

The cult of a slim body without the slightest bit of adipose tissue and the food restriction or selection habits it creates are extremely common in our society. Their influence on menstrual cycle and female infertility is not negligible. A vegetarian low calorie diet may induce cycle disorders and a short luteal phase. Disturbances in the pulsatility of gonadotropic hormones are responsible for anovulation, and they occur when slimness with excessive reduction of the body fat mass is associated with psycho-socio-professional stress factors or with intensive sporting activities. The greater frequency of dysovulation in obese women, notably those who put on weight rapidly, is accompanied by numerous hormonal changes, including reduced sex hormone-binding globulin, increased ovarian and adrenal androgen production, increased peripheral aromatization of androgens to oestrogens, and altered gonadotropin pulsatile secretion. The hyperinsulinism consecutive to insulin resistance in obese subjects might act as co-factor of the luteinizing hormone and as such participate in abnormalities of follicular maturation by stimulating the insulin-like growth factor and the ovarian androgens. However, the relative importance of these various factors in the physiopathology of abnormal ovulation remains to be determined. Overweight reduces the effectiveness of clomiphene citrate, menopausal gonadotropins and gonadotropin-releasing hormone in stimulating the follicles. Weight loss reduces hormonal disturbances and facilitates follicular maturation and ovulation in spontaneous or induced cycles.

Androgens↗
PubMed1990

A case of hypersensitivity to thyroid hormones with normally functioning thyroid gland and increased nuclear triiodothyronine receptors.

A 52-year-old male presented himself with tachycardia crises which appeared first during childhood, increased in frequency without goiter or exophthalmos. Cardiac and adrenergic diseases were excluded. The thyroid function was normal regarding T4, free T4 and T3, TBG, radioiodine uptake, TSH and T3 suppressibility; however the TSH response to TRH was decreased. The lymphocyte nuclear T3 receptor was found with an affinity close to that of normal volunteers (Ka: 1.42 x 10(10) M-1 vs 1.95 +/- 0.35 x 10(10) M-1) and a binding capacity markedly increased (9.9 vs 3.7 +/- 0.4 fmol T3/100 micrograms DNA). Pindolol was inefficient on the dysrhythmia which disappeared with carbimazole and relapsed after withdrawal of the antithyroid drug. Under carbimazole, the plasma T4 markedly decreased (27.7 +/- 3.6 nmol/l) but the patient remained euthyroid. The clinical course and the laboratory data suggest that the tachycardia crises are the consequence of a hypersensitivity of the heart to thyroid hormones, associated with an increased number of T3 nuclear receptor sites in lymphocytes.

Carbimazole↗
PubMed1990

[Methods of analysis of hormonal pulsatility].

Methods for detection and characterization of episodic fluctuations in circulating hormone levels are frequently used for endocrine investigations, related to the physiological importance of the pulsatile nature of hormone secretion in modulating target-cells response. Several sophisticated methods of pulse analysis have been recently developed and validated, aiming to minimize the false-positive and false-negative error rates. The present report mainly devoted to the clinician aims to analyze and discuss the main features of the most widely used methods for pulse detection.

Blood Chemical Analysis↗
PubMed1990

Effects of ACE-inhibition on glucose metabolism.

ACE inhibition is widely used for treatment of arterial hypertension or congestive heart failure. No change occurs in glucose metabolism either in diabetic or non diabetic subjects. No change occurs in glucose metabolism in patients with chronic renal failure. Glucose intolerance induced by diuretics is attenuated when ACE inhibitor is associated with thiazides. In some very rare circumstances (with high plasmatic levels of norepinephrine), insulin sensitivity seems to be enhanced by captopril. Then, in clinical use, no adverse effect occurs with ACE inhibition in non diabetic or diabetic subjects. Under thiazide treatment, ACE inhibitors protect against glucose intolerance.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1990

[New techniques of thyroid medical imaging. Value and limitations in the exploration of isolated thyroid nodules].

The exploration of thyroid nodules deals mainly with the problem of detection of malignancy. Except in the cases of characteristic clinical situations which suggest at once malignancy, classical investigations offer mostly an insufficient approach including erroneous conclusions. Scintigraphy, whose morphological definition remains limited, can miss non- or hypofixing lesions. Pharmacological tests of nodule reduction by suppression of thyreostimulin do not provide specific informations. Fine needle- biopsy cannot absolutely exclude malignancy, depending too much of the sites of punction and of the difficulties of cytological analysis. Echography brings an important progress in the precision of thyroid volume, nodules counting and gross connections. The liquid or solid characterization is an important echographic information as well. Tomodensitometry provides useful data in the retrosternal and retrotracheal areas. The connections with aerodigestive tract are more clearly pointed out and the presence of metastatic nodes as well. Magnetic resonance imaging gives further information because of the ability of multiple longitudinal slices, and of the trial of a tissular characterization from signal analysis and ultrastructural macroanatomic study. Additive precisions will be likely in the future by a more accurate determination of criteria of malignancy. The complementarity of magnetic resonance imagery and fine needle-biopsy should lead to a more frequent use of these investigations before the decision of surgical removal.

Diagnostic Imaging↗
PubMed1990

[Role of imaging in the exploration of the adrenal glands].

Currently, the major method of adrenal gland imaging is computed tomography. This method allows demonstration of normal adrenals and the diagnosis of adrenal masses (if these are greater than 1 cm in diameter). The examination should be directed by clinical signs and known laboratory investigations. Computed tomography is therefore the first line investigation to perform. Certain lesions may be better demonstrated by other methods: MRI and MIBG scintigraphy offer a greater specificity in the investigation of pheochromocytomas. In addition, scintigraphy can identify possible ectopic tumours or recurrences. Selective catheterisation of the adrenal veins allows aldosterone and cortisone secretions to be assayed. There remains the problem of the incidental finding of adrenal masses in either an asymptomatic patient or in the context of investigation of spread of a know cancer. These lesions may benefit from diagnostic percutaneous guided biopsy.

Adrenal Gland Neoplasms↗
PubMed1989

[Variations in the metabolism of lipoproteins as a function of thyroid hormones].

Like the demonstrated action of thyroid hormones on low density lipoproteins receptors and lipoproteins metabolism enzymes, plasma lipoprotein assays provide an insight into the classical variations of cholesterol blood levels observed in thyroid gland pathology. Thyroid hormones seem to play an important part in the regulation of lipid metabolism by accelerating the endogenous production of cholesterol as well as its penetration into cells. However, their most original effect consists of stimulation of tissue cholesterol removal, which may confer these hormones an anti-atherogenic property. The exact underlying mechanisms, notably their effect on the quantitative and qualitative distribution of apoproteins among lipoproteins, remain to be explored. Measurements of the cholesterol flows entering and leaving peripheral cells seem to provide a more accurate index than lipoprotein concentration to evaluate the actions of thyroid hormones, particularly those on atherogenesis.

Cholesterol↗
PubMed1989

[Pulsatile administration of LH-RH: diagnostic and therapeutic applications].

Hypothalamic hypogonadotropic hypogonadism (HHH), a disorder occurring in both sexes, is characterized by a partial or complete inability to synthesize and/or release LH-RH from the hypothalamus which result in absence or defects of amplitude and frequency of gonadotropin secretion. Long term substitution by pulsatile exogenous LH-RH usually result in complete normalization of both pituitary and gonadic hormones. Such a treatment allows differentiation between hypothalamic and pituitary causes of hypogonadotrophic hypogonadism. Ovulation and fertility can be achieved in most of women with hypothalamic amenorrhea treated with pulsatile LH-RH using i.v. bolus doses of 25-100 ng/kg at 1-2 h intervals. In opposite LH-RH therapy yields inferior results to human menopausal gonadotropin (hMG) in chronic anovulatory patients with persistent LH secretion or polycystic ovary syndrome (PCOS) as shown by one randomized and several non-controlled studies. Successful pulsatile LH-RH treatment following a 2 months LH-RH analog suppression in PCOS previously refractory to LH-RH alone represents a new promising approach. The majority of men with complete HHH begin to produce sperm only after 1 year of therapy. Both the testicular volume and the mean sperm concentrations were below the normal values after 2 years of treatment in spite of normalization of testosterone, LH and FSH levels. Pulsatile LH-RH does not seem significantly improve the treatment of infertile HHH men compared to hMH/hCG.

Amenorrhea↗
PubMed1987

Are pituitary and thyroid function tests useful for the monitoring of antithyroid drug treatment and the post therapeutic control of Graves' disease?

The control of Graves' disease patients treated with antithyroid drugs (ATD) involves monitoring the dose of ATD, the duration of therapy and the prediction of the long-term outcome of the disease. The sequential follow-up of free thyroid hormones and ultrasensitive TSH (USTSH) helps in monitoring of ATD therapy, except in patients complemented with thyroid hormones. The normalization of early thyroid uptake of radioiodine or pertechnetate, which seems to be closely related to circulating thyroid-stimulating immunoglobulins, confirms the remission that leads to stopping ATD therapy. The raise of plasma USTSH in a normal range within the six months following ATD withdrawal is another indicator of remission. However, the post therapeutic course of Graves' patients remains unpredictable: late relapses and hypothyroidism may occur despite the normalization of the pituitary-thyroid axis, leading to a yearly clinical control with USTSH evaluation.

Antithyroid Agents↗