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E Ruiz

Publications and source records attributed to E Ruiz.

At least 55 records · Page 3Linked to original sources
PubMed2000

Effect of estrogen-progestin replacement therapy on plasma lipids and lipoproteins in postmenopausal women.

Serum levels of cholesterol (Chol), triglycerides (TG), low-density lipoprotein cholesterol (LDL) high-density lipoprotein cholesterol (HDL), both apolipoproteins A1 and B (Apo A1, Apo B), follicle-stimulating hormone (FSH) luteinizing hormone (LH), estradiol (E2), progesterone (P), testosterone (T) and steroid hormone binding globulin (SHBG) were measured in postmenopausal women, before and after four different estrogen-progestin replacement therapies. Each woman was her own control to avoid genetic or socioeconomic differences. Our results showed that serum E2 and TG significantly increased and serum FSH, LH, LDH, Apo B, and Chol significantly decreased after all treatments. Serum P and T did not significantly change after any of the treatments. HDL, Apo A1 and SHBG significantly increased in the groups treated with medroxiprogesterone acetate (MPA) but not in the group treated with Norgestrel. We conclude that estrogen-progestin replacement therapy in postmenopausal women leads to profound and beneficial changes in plasma lipids and lipoproteins and that treatments with cyclic or continuous MPA could provide greater protection against coronary heart disease (CHD).

Apolipoprotein A-I↗
PubMed1999

Study of Calcium Dobesilate in Diabetic Rats.

According to the World Health Organization (WHO) 74% of diabetic patients die of vascular complications. Previous reports have shown that endothelium-dependent relaxation of diabetic vasculature is more sensitive to free radical-induced injury. Calcium dobesilate (DOBE) has been successfully used in the treatment of diabetic retinopathy. The aims of this study were to investigate the in vivo and ex vitro effects of DOBE on both contractile and relaxing responses in isolated diabetic rat aorta. Four groups of rats were used: Wistar rats (Group 0); spontaneously diabetic rats (BB/wor rats) (Group 1); BB/wor rats treated with DOBE 50 mg/kg/day (Group 2); and BB/wor rats treated with 500 mg/kg/day (Group 3). At 180 days after the development of diabetes, the animals were killed and the thoracic aorta were isolated, cleaned off, and mounted in an organ chamber. Two groups of experiments were carried out. In the first group (in vitro), incubation with DOBE 10(-4) in aortic rings isolated from BB/wor rats decreased the contraction induced by noradrenaline (NA) 10(-6) M (1.21 +/- 0.11 g vs 0.67 +/- 0.01 g P < 0.01, n = 8 in diabetic rings with or without the presence of DOBE 10(-4) M, respectively), and this decrease was prevented by propranolol 10(-6) M (1.20 +/- 0.6 g). DOBE 10(-5) and 10(-4) M increased the endothelium-dependent relaxation induced by ACh in BB/wor rats [the maximal relaxation with ACh 10(-5) M was 50.0 +/- 5.1 vs 72.0 +/- 11.0 (p < 0.05, n = 8) and 69.0 +/- 7.8 (p < 0.05, n = 8) in BB/wor rats and after the incubation with DOBE 10(-5) and 10(-4) M, respectively], however, incubation with DOBE did not modify the endothelium-independent relaxation in these rats. In the second part of the study (ex vitro), we found an increase in the endothelium-dependent relaxation in arteries from diabetic rats treated with DOBE (Groups 2) compared with Group 1 (BB/wor rats) although we did not find any improvement in the endothelium-independent relaxation. Thus, in spontaneously diabetic rats, DOBE restored endothelium-dependent, but not independent, relaxation to normal and also decreased the contractile responses induced by NA through a mechanism that involves beta-adrenergic receptors.

Journal Article↗
PubMed1999

The value of chest roentgenography in the diagnosis of pneumothorax after thoracentesis.

PURPOSE: We sought to assess the yield of chest roentgenography for the detection of pneumothorax among hospitalized patients with pleural effusion who have undergone diagnostic or therapeutic thoracentesis. SUBJECTS AND METHODS: We performed a prospective study of 506 thoracentesis procedures in 370 patients. After the procedure, each operator filled out a note recording patient data and the characteristics of the thoracentesis. A chest radiograph was performed within 12 hours after the procedure in all patients. RESULTS: Eighteen (4%) pneumothoraces occurred in 17 patients, 9 (2%) of which required chest tube drainage. Of the 488 patients without symptoms, only 5 (1%) developed a pneumothorax, only 1 of which required chest tube drainage. By contrast, of the 18 patients with symptoms, 13 developed a pneumothorax, 8 of which required chest tubes. There were two independent predictors of pneumothorax: presence of symptoms (odds ratio [OR] = 250; 95% confidence interval [CI]: 65 to 980) and male gender (OR = 5.4; 95% CI: 1.9 to 69). CONCLUSIONS: Among the symptom-free patients in our sample, the risk of developing pneumothorax with clinical consequences was so low that the practice of routine chest roentgenography may not be justified.

Chest Tubes↗
PubMed1999

Clinical and urodynamic evaluation after ureterocystoplasty with different amounts of tissue.

PURPOSE: Ureter is one of the best tissues for bladder augmentation. The amount of ureteral segment available is extremely variable among patients. We compared results in patients who underwent ureterocystoplasty with 2 ureters, 1 complete ureter or a distal segment only after transureteroureterostomy. MATERIALS AND METHODS: During a 6-year period we performed 32 ureterocystoplasties at 2 pediatric centers in Argentina (16) and Chile (16). Median patient age at surgery was 9 years (range 4 months to 20 years). Clinical presentation included urinary infection, hydronephrosis, incontinence and undiversion. The diagnosis was neurogenic bladder in 20 cases, infravesical obstruction in 7, massive reflux in 3 and ureterocele in 2. All patients had poor bladder compliance and vesicoureteral reflux. We used different options to augment the bladder, including 2 ureters in 5 patients, bilateral nephrectomy in 3, a complete duplex system in 1 and a bilateral partial ureter in 1 (group 1); a complete ureter in 14 (group 2), and a distal segment of ureter with transureteroureterostomy in 13 (group 3). When transureteroureterostomy was performed, a suprapubic tube remained indwelling for 2 weeks and a Double-J stent was placed for 1 month. Median followup was 16 months (range 4 months to 6 years). Clinical and radiological evaluations, including ultrasound, cystography, urodynamics, renal scan and renal function measurement, were done 4 months postoperatively and twice yearly thereafter as needed. RESULTS: We noted no significant difference in bladder capacity when 1 or 2 ureters were used. Median increase in bladder capacity in groups 1 and 2 was 375% (range 80 to 800). All patients who received a complete segment of ureter had clinical improvement, decreased hydronephrosis and resolution of reflux with improved bladder compliance. When a partial segment of ureter was used median capacity increased 230% (range 40 to 400) with clinical improvement in 12 patients (92.3%). Compliance improved, which led to longer intervals between clean intermittent catheterizations. No patient has needed repeat augmentation to date. CONCLUSIONS: There is a difference in median increased bladder capacity when a segment of distal ureter is used to augment the bladder versus 1 or 2 whole ureters. However, the use of distal ureter still represents a safe alternative for augmenting the bladder and simultaneously resolving massive reflux. Ureterocystoplasty is an excellent choice for increasing bladder capacity and improving bladder compliance despite the different amounts of tissue available.

Adolescent↗
PubMed1999

Effect of corticotropin releasing factor injected into the median eminence on growth hormone secretion in male rats.

We determined the dose-response relationship and examined the time-related effect of CRF (corticotropin releasing factor) injected directly into the Median Eminence (ME) on GH (growth hormone) secretion in conscious intact and castrated male rats. Doses of 0.25, 0.75, 1, and 1.5 nmol CRF dissolved in 1 microl of saline, or saline alone in the controls, were injected into the ME, and blood samples collected through indwelling catheters implanted in the jugular vein, 30, 60, 90, and 120 min post-injection to determine plasma GH levels by RIA. After 120 min the animals were decapitated. Trunk blood of decapitated animals was used to determine plasma testosterone and glucose levels. CRF at all the doses studied significantly decreased plasma GH in castrated and intact animals. The results suggest that in male as in female rats, CRF inhibits by itself GH secretion, at least in part, by a central action in the ME; all the doses of CRF studied suppressed GH secretion in castrated and intact males; finally, CRF at ME levels may participate in a variety of stress-related responses, including growth inhibition, through GH suppression.

Animals↗
PubMed1999

Hyperkalemia in patients infected with the human immunodeficiency virus: involvement of a systemic mechanism.

BACKGROUND: The appearance of hyperkalemia has been described in human immunodeficiency virus (HIV)-positive patients treated with drugs with amiloride-like properties. Recent in vitro data suggest that individuals infected with HIV have alterations in transcellular K+ transport. METHODS: With the objective of examining the presence of alterations in transmembrane K+ equilibrium in HIV-positive patients, we designed a prospective, interventional study involving 10 HIV-positive individuals and 10 healthy controls, all with normal renal function. An infusion of L-arginine (6%, intravenously, in four 30-min periods at 50, 100, 200, and 300 ml/hr) was administered, and plasma and urine electrolytes, creatinine, pH and osmolality, total and fractional sodium and potassium excretion, transtubular potassium gradient, plasma insulin, renin, aldosterone, and cortisol were measured. RESULTS: A primary disturbance consisting of a significant rise in plasma [K+] induced by L-arginine was detected in only the HIV patients but not in the controls (P < 0.001 between groups). A K+ redistribution origin of the hyperkalemia was supported by its rapid development (within 60 min) and the lack of significant differences between HIV-positive individuals and controls in the amount of K+ excreted in the urine. The fact that the HIV-positive individuals had an inhibited aldosterone response to the increase in plasma K+ suggested a putative mechanism for the deranged K+ response. CONCLUSIONS: These results reveal that HIV-infected individuals have a significant abnormality in systemic K+ equilibrium. This abnormality, which leads to the development of hyperkalemia after the L-arginine challenge, may be related, in part, to a failure in the aldosterone response to hyperkalemia. These results provide a new basis for understanding the pathogenesis of hyperkalemia in HIV individuals, and demonstrate that the risk of HIV-associated hyperkalemia exists even in the absence of amiloride-mimicking drugs or overt hyporeninemic hypoaldosteronism.

Adult↗
PubMed1999

L-Citrulline, the by-product of nitric oxide synthesis, decreases vascular smooth muscle cell proliferation.

Endothelium injury plays an important role in atherosclerosis. Damage to the endothelium results in vascular smooth muscle cell proliferation. Natriuretic peptides present a potent antimitogenic action, mediating their biological effects via the binding of guanylate cyclase-linked atrial natriuretic peptide (ANP) receptor and the production of cyclic GMP. In a previous study, we demonstrated that L-citrulline, the by-product of nitric oxide synthesis, could relax rabbit aortic rings by stimulating the guanylate cyclase-linked ANP receptor. In this work, we investigated the effect of L-citrulline on vascular smooth muscle cell proliferation. L-Citrulline (10(-8) M) significantly decreased rat aortic (A10 cell line) vascular smooth muscle proliferation. The percentage of inhibition exerted by L-citrulline on days 3, 5, and 7 of the proliferation curve was 20.0 +/- 0.5%, 37.5 +/- 8.3%, and 28. 5 +/- 7.2%, respectively. In addition, L-citrulline also inhibited serum-induced DNA synthesis, measured as 5-bromo-2'-deoxyuridine incorporation. 5-Bromo-2'-deoxyuridine incorporation into nuclei of vehicle-treated cells was 40.5 +/- 2.4%, whereas in L-citrulline-treated cells the percentage decreased to 36.0 +/- 4.1%, 29.1 +/- 2.0% (P <.01, n = 4), 30.5 +/- 2.4% (P <.05, n = 4), and 23.1 +/- 0.5% (P <.001, n = 4) for 10(-10), 10(-9), 10(-8), and 10(-7) M, respectively. Zaprinast, a phosphodiesterase type V inhibitor, enhanced 5-bromo-2'-deoxyuridine incorporation in serum-stimulated cells. Moreover, L-citrulline inhibition of serum-stimulated DNA synthesis was abolished by HS-142-1 (10(-5) M), an ANP receptor antagonist. In another group of experiments, L-citrulline was shown to increase intracellular cyclic GMP levels from 2.1 +/- 0.2 pmol of cGMP/mg protein to 4.1 +/- 0.1 for L-citrulline (10(-8) M) (P <.001, n = 3). These findings suggest that L-citrulline decreases vascular smooth muscle cell proliferation in the A10 cell line by acting on DNA synthesis by mechanisms that involve the ANP receptor.

Animals↗
PubMed1998

Impact of oxygen therapy on antioxidant status in newborns. Relationship with infection risk.

Newborns requiring intensive clinical care are susceptible to a wide range of excessive oxygen free radical production-related problems. In utero, fetal organs, particularly lungs, are exposed to relatively hypoxic tensions which rise abruptly after birth and this transition may cause oxidative injury in the neonate. The aims of this study were to determine oxygen free radical activity in neonates at the first 24 h, examine the role of immaturity and infection risk and compare the degree of oxidant stress in newborns treated with different oxygen concentrations. Plasma selenium levels in neonates with high infection risk (IR) were significantly lower than in healthy neonates. Comparative study of selenium in preterm, term and young infants showed age-related increases and differences were significant. Plasma selenium values were lower when oxygen therapy was administered. Vitamin E levels were significantly decreased in IR compared with healthy newborns. The results suggest that selenium and vitamin E deficiencies predispose to neonatal infection and that supplementary oxygen contributes significantly to decreasing the antioxidant defence system.

Antioxidants↗
PubMed1998

Oxidant-antioxidant imbalance in blood of children with juvenile rheumatoid arthritis.

Juvenile rheumatoid arthritis (JRA) is the most commonly diagnosed rheumatic disease in children and may represent not a single disease, but rather a syndrome of diverse aetiologies in which inflammation is an exceedingly complex process. Oxidative free radical production at inflammation sites contributes to tissue damage and could also play a significant role in the pathogenesis of JRA. The aim of this study was to evaluate the antioxidant status and lipid peroxidation parameters related to the clinical form of JRA. Plasma malondialdehyde and hydroperoxide concentrations in children with polyarticular and systemic JRA subtypes were significantly higher than in controls. Plasma vitamin E and beta-carotene levels of the JRA children were lower in the three forms compared with healthy children. Patients with JRA present an imbalance in the oxidant-antioxidant system that manifests clearly in the polyarticular and systemic forms through an increase in lipoperoxidation products and significant decrease in the lipid-soluble antioxidants vitamin E and beta-carotene.

Antioxidants↗
PubMed1998

Calcium dobesilate increases endothelium-dependent relaxation in endothelium-injured rabbit aorta.

Calcium dobesilate (DOBE) is an orally administered angioprotective agent which is used in some vascular diseases such as diabetic retinopathy, although its mechanism of action is not yet fully understood. The aim of this work was to correlate previous rising single quote, left (low)in vitro' findings carried out in our laboratory with an rising single quote, left (low)ex vivo' model of endothelium-injury by overdose of vitamin D2. Male New Zealand White rabbits were used. The study was divided into two protocols. Protocol 1: 10 days of treatment; and Protocol 2: 30 days of treatment. Rabbits in each group were treated with vitamin D2 (200"000 IU day-1) for the first 2 days and two groups were subsequently treated with DOBE at different doses (50 mg kg-1 per day or 500 mg kg-1 per day). The concentration-response curve induced by NA (10(-8)-10(-4) M) in aorta arteries was shifted downwards in the groups treated with DOBE (in both Protocol 1 and 2), whereas only in Protocol 2 (30 days of treatment) was this curve affected in the hypervitaminic group. The endothelium-dependent relaxation induced by ACh (10(-8)-10(-5) M) decreased in the hypervitaminic groups (in both Protocol 1 and 2) but only in Protocol 2 (30 days of treatment) was the endothelium-dependent relaxation restored to normal (control, untreated group) in both DOBE-treated groups. The endothelium-independent relaxation induced by sodium nitroprusside (SNP) (10(-8)-10(-4) M) decreased in the hypervitaminic groups only in Protocol 1. We did not find differences in the DOBE-treated groups in any protocol compared with the control (untreated) group. These findings show evidence that DOBE restored endothelial functionality in endothelium-injured rabbit aorta only after 30 days of treatment. (c) 1998 The Italian Pharmacological Society.

Acetylcholine↗
PubMed1998

Calcium dobesilate increased endothelium-dependent relaxation in isolated rabbit aorta.

1. The aim of this study was to investigate the effects of calcium dobesilate on relaxant and contractile responses in the isolated rabbit aorta. 2. Calcium dobesilate (10(-6) and 10(-4) M) shifted the concentration-response curve induced by noradrenaline (10(-8)-10(-4) M) downward and to the right, the IC50 being 5.1 +/- 1.1 x 10(-7) M in the control and 7.5 +/- 1.2 x 10(-6) M and 3.1 +/- 1.9 x 10(-6) M in the presence of calcium dobesilate, 10(-6) M and 10(-4) M respectively. 3. Calcium dobesilate, 10(-5) M, increased the endothelium-dependent relaxation induced by acetylcholine (10(-8)-10(-5) M) but had no actions in the absence of endothelium.

Animals↗
PubMed1998

Calcium dobesilate: pharmacology and future approaches.

1. Calcium dobesilate (2,5-dihydroxybenzene sulfonate) is a drug commonly used in the treatment of diabetic retinopathy and chronic venous insufficiency. 2. The pharmacology of calcium dobesilate reveals its ability to decrease capillary permeability, as well as platelet aggregation and blood viscosity. 3. Furthermore, recent data show that calcium dobesilate increases endothelium-dependent relaxation owing to an increase in nitric oxide synthesis.

Animals↗
PubMed1998

Possible role of GH/IGF-1 in the ovarian function of adult hypothyroid rats.

We have monitored estrous cycle and measured serum estradiol, GH, IGF-1, T4 and T3 levels in adult hypothyroid female rats which were divided into four groups: H group, hypothyroid rats without treatment; H-T4 group, hypothyroid rats injected daily with T4; HT4-PTU group, hypothyroid rats injected daily with T4 plus PTU (propylthiouracil), and H-T4-IOP group, hypothyroid rats injected daily with T4 plus IOP (iopanoic acid); Euthyroid rats (E group) were used as control. Our results indicate that the lack of sexual cycle in H animals was associated with lower values of estradiol, GH and IGF-1 in comparison to E group; the restoration of sexual cycle in H-T4 group was associated with values of estradiol, GH and IGF-1 higher than those of H group, whereas in H-T4-PTU and H-T-IOP groups the restoration was associated with higher values of GH and IGF-1 and values of estradiol similar to those of H group. These data could suggest a potential role of GH/IGF-1 axis, at least in part, in the lack of sexual cycle in H group and in the ovulation induction in H-T4, H-T4-PTU and H-T4-IOP groups.

Animals↗
PubMed1998

Relaxant effects of L-citrulline in rabbit vascular smooth muscle.

1. Vascular endothelium plays a pivotal role in the control of vascular tone through the release of vasoactive factors such as EDRF (NO). 2. The aim of this study was to investigate whether the addition of exogenous L-citrulline, the byproduct of the NO-synthesis, could relax vascular smooth muscle. 3. L-citrulline relaxed both endothelium-denuded and endothelium-intact rabbit aortic rings precontracted with noradrenaline 10(-6) M (maximum relaxations induced by L-citrulline 10(-8) M were 74.1+/-5.2% vs 51.3+/-2.8% in endothelium-denuded and endothelium-intact arteries, respectively). 4. This relaxant effect was enhanced by zaprinast (a phosphodiesterase type 5 inhibitor) and inhibited by HS-142-1 (a particulate guanylate cyclase inhibitor) and by apamin (a K(Ca)-channel blocker). 5. L-citrulline (10(-13)-10(-8) M) increased cGMP levels in aortic rings (maximum value with L-citrulline 10(-8) M was 0.165+/-0.010 pmol cGMP mg(-1) of tissue vs 0.038+/-0.009 pmol mg(-1) of tissue in basal). 6. L-citrulline as well as NO were released from endothelial cells in culture stimulated with ACh. The values were 6.50+/-0.50 microM vs 2.30+/-0.20 microM (stimulated with ACh and basal respectively) for L-citrulline and 4.22+/-0.10 microM vs 0.87+/-0.26 microM (stimulated with ACh and basal respectively) for NO. 7. These results suggest that L-citrulline could be released together with NO from endothelium and may have actions complementary to those of NO in the control of vascular smooth muscle relaxation.

Animals↗
PubMed1998

In vitro effects of calcium dobesilate on the responsiveness of spontaneously diabetic rat aorta.

We tested the effect of calcium dobesilate (DOBE) in aorta from spontaneously diabetic (BB/wor) rats. The contraction induced by 10(-6) M noradrenaline (NA) in BB/wor rats was smaller than that induced in control rats (1.21+/-0.11 vs 0.82+/-0.02 g, P<0.01, n=8, respectively) in arteries with intact endothelium. Incubation with DOBE (10(-4) M) impaired the contractions induced by NA in BB/wor rats (1.21+/-0.11 vs 0.67+/-0.01 g, P<0.01, n=8). The effect of DOBE was reversed by 10(-6) M propranolol (0.67+/-0.01 vs 1.20+/-0.60g, P<0.001, n=8, with 10(-4) M DOBE and 10(-4)M DOBE plus 10(-6) M propranolol, respectively). DOBE increased the endothelium-dependent relaxation in arteries from diabetic rats. These findings suggest that DOBE might improve vascular reactivity in BB/wor rats.

Acetylcholine↗
PubMed1998

Oxidative stress at onset and in early stages of type 1 diabetes in children and adolescents.

OBJECTIVE: In diabetes, the persistence of hyperglycemia has been reported to cause increased production of oxygen free radicals through glucose autooxidation and nonenzymatic glycation. The aim of this study was to determine whether oxidative cellular damage occurs at the clinical onset of diabetes and in later stages of the disease in young patients. RESEARCH DESIGN AND METHODS: Indicative parameters of lipoperoxidation, protein oxidation, and changes in the status of antioxidant defense systems were evaluated in single blood samples from 54 diabetic children, adolescents, and young adults and 60 healthy age- and sex-matched control subjects. RESULTS: Malondialdehyde and protein carbonyl group levels in plasma were progressively higher in diabetic children and adolescents than in control subjects (P < 0.0001). The highest erythrocyte superoxide dismutase (SOD) activity was found in diabetic children at onset of clinical diabetes. In diabetic adolescents, SOD was also significantly higher (P < 0.0001) than in control subjects. Erythrocyte glutathione peroxidase was significantly lower in diabetic children and adolescents compared with control subjects (P < 0.002). A significant decline in blood glutathione content at the recent onset of diabetes was found (P < 0.0001). Furthermore, our results demonstrated progressive glutathione depletion during diabetes evolution. The plasma alpha-tocopherol/total lipids ratio and beta-carotene levels during diabetes development (P < 0.001) were low. CONCLUSIONS: This cross-sectional study in young diabetic patients showed that systemic oxidative stress is present upon early onset of type 1 diabetes and is increased by early adulthood. Decreased antioxidant defenses may increase the susceptibility of diabetic patients to oxidative injury. Appropriate support for enhancing antioxidant supply in these young diabetic patients may help prevent clinical complications during the course of the disease.

Adolescent↗
PubMed1998

[Cardiac manifestations of primary hypothyroidism. Determinant factors and treatment response].

INTRODUCTION AND OBJECTIVES: Previous studies have not fully established the magnitude and determinant factors of cardiac manifestations of primary hypothyroidism. This study was aimed to assess the effects of thyroid deficiency on cardiac performance and structure. PATIENTS AND METHODS: We studied by echocardiography 19 patients with overt and 23 with subclinical hypothyroidism, and 21 control subjects. Patients were restudied one year after L-thyroxine therapy. Systolic function was assessed by the observed/predicted fractional shortening ratio. The predicted fractional shortening was calculated from the inverse relation of fractional shortening to end-systolic stress (p < 0.0001) in normal subjects. RESULTS: The observed/predicted fractional shortening ratio was lower (p = 0.043) and left ventricular mass was higher (p = 0.028) in overt hypothyroidism than in subclinical hypothyroidism and control subjects. By multivariate analysis, fractional shortening ratio was related to thyroxine levels (p = 0.0002), systemic vascular resistance (p = 0.0001) and age (p = 0.0009), and left ventricular mass was related to thyroxine levels (p = 0.0004) and weight (p = 0.0001). Pericardial effusion was observed in 37% of patients with overt hypothyroidism and 9% of patients with subclinical hypothyroidism (p = 0.03), and was mainly related to TSH levels (p = 0.0098). Hormone replacement therapy increased systolic function in overt hypothyroidism. Left ventricular mass did not change after therapy. Pericardial effusion disappeared in all patients. CONCLUSIONS: Primary hypothyroidism produces a decrease in myocardial contractility and an increase in left ventricular mass, both related to the severity of hormone deficiency. Pericardial effusion is mainly related to thyrotrophin plasma levels. Most of cardiac manifestations of hypothyroidism reverse with L-thyroxine therapy.

Adolescent↗