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PubMed1999

Comprehensive assessment of the components of energy expenditure in infants using a new infant respiratory chamber.

BACKGROUND: Current methods for energy expenditure (EE) measurements in term infants do not include simultaneous measurements of basal and sleeping metabolic rates (BMR and SMR) or a measure of physical activity (PA). Furthermore, prediction equations for calculating EE are not appropriate for use in infants with metabolic disorders. OBJECTIVE: To develop and utilize a new infant respiratory chamber for simultaneous measurements of EE (kJ/d), preprandial BMR (kJ/d), SMR (kJ/d) and an index of PA (oscillations/min/kg body weight) in infants with a variety of metabolic disorders, for up to four hours in a hospital setting, while allowing parental interaction in a comfortable environment. METHODS: We obtained simultaneous measurements of EE, BMR, SMR and PA in 21 infants (66+/-73 days of age, 4.5+/-1.7 kg body weight, 55+/-8 cm in length and 16+/-7% body fat) using our new infant respiratory chamber. Six of these infants were healthy, seven had thyroid dysfunction, five were HIV-exposed, one had AIDS, one had intrauterine and postnatal growth retardation and one was a hypothermic preterm infant. Energy expenditure, BMR and SMR were extrapolated for 24 hours. Body composition was estimated by skin-fold thickness, using age-appropriate formulae. Basal metabolic rate obtained with the infant respiratory chamber was compared to BMR that was calculated using the appropriate World Health Organization (WHO) equations. RESULTS: In all infants both extrapolated 24-hour EE and BMR correlated with fat-free mass (r = 0.89, p<0.01 and r = 0.88, p<0.01 respectively). Twenty-four hour EE also correlated with PA (r = 0.52, p<0.05). The HIV-exposed infants had higher BMR (p<0.05) than that calculated by the appropriate WHO equation. We found that the caloric requirements for the infant with growth retardation were underestimated based on the infant's weight and age. CONCLUSIONS: The infant respiratory chamber can measure all of the main components of EE. Some of the results obtained differed significantly from those obtained by the WHO equations; therefore, the new infant respiratory chamber is necessary for estimating EE in infants with metabolic and growth disorders.

Acquired Immunodeficiency Syndrome↗
PubMed2000

The effect of long-term, non-suppressive levothyroxine treatment on quantitative ultrasonometry of bone in women.

OBJECTIVE: To evaluate the impact of long-term, non-suppressive levothyroxine (L-T(4)) treatment on quantitative ultrasonometry in women. DESIGN: This was a case-control study. SUBJECTS AND METHODS: Altogether 667 women (mean age+/-s.d., 49.5+/-13.1 years) were studied. Of these, 156 (23%) had non-toxic goitre or hypothyroidism and had been taking L-T(4) (75-100 microg/day) for at least 5 years (mean+/-s.d., 12.5+/-7.5 years); the remaining 511 (77%) women were not receiving L-T(4). All women had completed a questionnaire on risk factors for thyroid dysfunction and osteoporosis, and those with diseases or treatments known to effect bone metabolism - other than thyroxine or hormone replacement therapy (HRT) - were excluded. Women underwent quantitative ultrasonometry (QUS) at the heel. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and the stiffness index (SI) were compared, first, in all women taking L-T(4) and controls and, secondly, in women taking L-T(4) and controls pair-matched for age, weight, body mass index (BMI), menopausal status and HRT use. RESULTS: Even after matching for age, weight, BMI, menopausal and HRT status, women taking L-T(4) had significantly lower values for SOS and SI (P<0.05), but not for BUA. However, absolute T- and Z-scores for SI were not low in either the study or control groups. Lower values were associated, but not significantly so, with years since the menopause and duration of L-T(4) treatment. CONCLUSIONS: Long-term, non-suppressive L-T(4) treatment in women with goitre or hypothyroidism was associated with a slight reduction in QUS values, which was more pronounced in postmenopausal women. This group could be at higher risk for osteoporotic fracture.

Adult↗
PubMed2000

The quantitative measurement of autoantibodies to thyroglobulin and thyroid peroxidase by automated microparticle based immunoassays in Hashimoto's disease, Graves' disease and a follow-up study on postpartum thyroid disease.

The aim of this study was to investigate the association between various autoimmune thyroid diseases and the presence of anti-TPO and anti-Tg antibodies using two novel automated microparticle based immunoassays developed for the AxSYM analyzer. Serum samples from 65 individuals with Hashimoto's Disease, 38 with Graves' Disease and 80 UK blood donors were assayed. In addition, samples were taken from 50 women known to be positive for TPO antibodies, for up to 24 weeks following delivery. Precision for both assays ranges from 5.7-9.1% CV, while analytical sensitivity was determined to be 1.0 IU/ml for Anti-Tg and 0.3 IU/ml for Anti-TPO. The Anti-TPO test showed positive results in 86% of Hashimoto's Disease and 87% of Graves' Disease. The figures obtained for Anti-Tg were 58% and 73% respectively. Specificity was 94% with Anti-TPO and 99% with Anti-Tg. The postpartum women were divided into 2 groups, group A remained symptomless while group B developed thyroid dysfunction. Within the 2 groups, medians calculated at each time point were compared between and within groups using the Mann-Whitney Rank Sum Test or the Kruskal-Wallis One Way ANOVA on Ranks. Anti-TPO baseline levels (week 6) were statistically different between both groups (median 36 vs. 167 IU/ml, p = 0.002). In group A, the median values increased from 36 to 87 IU/ml within the observation period, although the difference was not statistically significant. In group B, antibody titres showed a statistically significant increase from 168 IU/ml (week 6) up to 676 IU/ml after 20 weeks (p < 0.001). Anti-Tg baseline levels were not statistically different between the two groups. In group A, the median values did not change significantly over time (range: 47-86 IU/ml) whereas antibody titres in group B showed a statistically significant increase from 79 IU/ml (week 6) to 276 IU/ml after 24 weeks (p = 0.002). Results obtained indicate that these assays provide useful tools for the quantitative determination of autoantibodies in both primary diagnosis as shown with the Hashimoto's disease and Graves' disease samples and patient follow-up as demonstrated with the postpartum samples. The automation and high precision of the assays make them perfectly suited to routine diagnostic use.

Autoanalysis↗
PubMed1994

Alopecia areata in aging C3H/HeJ mice.

A disease closely resembling human alopecia areata was found in a large production colony of C3H/HeJ mice that had no evidence of thyroid dysfunction or an infectious etiology. Alopecia developed diffusely or in circular areas on the dorsal surface. Histologically, the changes in this non-scarring alopecia were limited to anagen follicles that were surrounded by mononuclear cells. This infiltrate, composed primarily of cytotoxic (CD8+) and helper (CD4+) T cells, was associated with follicular and hair shaft dystrophy. This infiltrate was markedly reduced by intralesional injection of triamcinolone acetonide with subsequent hair regrowth in the affected site. Pedigree tracing of affected C3H/HeJ mice suggests that this non-scarring alopecia may be an inherited disease. Breeding results of normal haired mice with alopecia areata mice or between alopecia areata mice suggests that this is a complex polygenic disease with a female predominance at younger ages. Female mice developed the disease earlier than male mice (3-5 versus > 6 months), with equal numbers affected by 18 months of age. The relative incidence of alopecia areata in one production colony of C3H/HeJ mice was 0.25% for female and 0.035% for male mice, but selective breeding has raised the frequency to nearly 20%. The frequency in an aging colony selectively bred for inflammatory bowel disease reached 4.7%, with equal sex distribution, for mice over 18 months of age, suggesting that this might be a common aging change in C3H/HeJ mice. This C3H/HeJ mouse disease may prove to be a valuable animal model to study specific subtypes of human alopecia areata.

Aging↗
PubMed2006

Use of frozen sera for FT4 standardization: investigation by equilibrium dialysis combined with isotope dilution-mass spectrometry and immunoassay.

BACKGROUND: Serum-free thyroxine (FT4) testing is recommended for diagnosis or monitoring of thyroid dysfunction, particularly in cases of hormone binding abnormalities. However, the poor intermethod agreement among commercial FT4 assays suggests a need for standardization with a hierarchically higher measurement procedure. To that purpose, we applied equilibrium dialysis (ED) in combination with isotope dilution-liquid chromatography/tandem mass spectrometry (ID-LC-tandem MS). METHODS: After ED, we collected dialysate into tubes containing [13C6]-T4 for ID and [13C9]-T4 as carrier, purified the samples by solid-phase extraction, and analyzed them with LC/tandem MS. We evaluated the procedure's analytical performance and tested its suitability for measurement of hypo-, eu-, and hyperthyroid serum FT4 concentrations. We conducted a pilot method comparison study with 3 commercial assays to investigate whether frozen sera could be used for the purpose of FT4 standardization. RESULTS: The within-run, between-run, and total CVs (inclusive ED) were 3.7%, 4.2%, and 5.6%, respectively (17.7 pmol/L; n = 20). The mean accuracy, estimated from recovery experiments with dialysate and dialysis buffer supplemented at 8.7, 18.7, and 33.5 pmol/L, and from analysis of certified sera gravimetrically diluted to 9.8, 19.2, and 34.8 pmol/L, was 98.0% to 102.8%. The procedure's limit of detection and limit of quantification were 0.5 and 1.3 pmol/L, respectively. The method comparison demonstrated the suitability of the selected sera for standardization of FT4 assays and confirmed the lack of assay comparability. CONCLUSIONS: We demonstrated that the described ED-ID-LC/tandem MS procedure and the selected type of sera qualify for standardization of FT4 measurements.

Blood Proteins↗
PubMed1985

[Effect of clinical hyperthyroidism and hypothyroidism on patent diabetes. 59 cases].

Fifty-nine patients with both clinical evidence of thyroid dysfunction and patent diabetes mellitus were investigated in our diabetology department. Patients with euthyroid goitre and iatrogenic or pituitary hypothyroidism were excluded from the study. Among the 45 diabetics with hyperthyroidism, 32 had Graves' disease and 13 had toxic adenoma; 71% were insulin-treated. Hyperthyroidism had passed unnoticed in 7 of these 32 patients because fatigue and loss of weight, which initially were the predominant or sole symptoms, are extremely frequent in uncontrolled diabetes. These symptoms, as well as polyuria, polyphagia and even sweating are common to both diseases. Considerable deterioration in the control of glycaemia was observed in 63% of the insulin-treated patients when hyperthyroidism developed, with a 17 to 212% (mean 82%) increase in insulin dosage in 53%. There was no correlation between the degree of hyperthyroidism and the loss of control. Following treatment of the hyperthyroidism, control was improved in 63%, with an 11-83% (mean 44%) decrease in insulin dosage in 59% of them. Insulin therapy could be withdrawn in only one of the 32 insulin-treated patients. Non-iatrogenic primary hypothyroidism was found in 0.2% of the diabetics investigated. This incidence was significantly higher than the calculated probability of the two diseases occurring by chance in the same patient. Eleven out of 14 patients were insulin-treated. When hypothyroidism developed, 73% of them had their insulin dosage reduced, with a high frequency of hypoglycaemic disorders: repeated "malaise" in 55% and coma in 27%. A higher proportion of vitiligo was also noted: 14% in the total patient population reported, and 18% in insulin-treated patients.

Adult↗
PubMed2001

Thyroid peroxidase antibodies during gestation are a marker for subsequent depression postpartum.

OBJECTIVE: Depression is not adequately diagnosed in many cases. Therefore, the question arises as to whether markers exist for depression. We investigated whether the presence of thyroperoxidase antibodies (TPOAbs) during pregnancy can be regarded as a marker for depression in the first year postpartum, particularly in relation to (overt or subclinical) thyroid dysfunction and other determinants of depression. DESIGN: This work was a prospective observational study. PATIENTS: A cohort of 310 unselected women (residing in the Kempen Region, southeastern Netherlands) were visited at 12 and 32 weeks gestation and at 4, 12, 20, 28 and 36 weeks postpartum. METHODS: At each visit, TSH, free thyroxine and TPOAb testing was performed, determinants associated with depression were asked for, and depression was assessed (according to the Research Diagnostic Criteria). Multiple logistic regression was performed to determine independent risk factors (odds ratios, ORs) for depression in gestation and/or postpartum depression. RESULTS: Data for 291 women were available for analysis; 41 women (14.1%) had TPOAbs at one or more time points, and 117 women (40.1%) had depression at one or more time points postpartum. The multiple logistic regression analysis showed that TPOAbs were independently associated with depression at 12 weeks gestation and at 4 and 12 weeks postpartum (OR, 95% confidence interval: 2.4 (1.1-6.0), 3.8 (1.3-7.3) and 3.6 (1.2-7.1) respectively). After the exclusion of women who were depressed at 12 weeks gestation (n=70), the presence of TPOAbs during early pregnancy was still found to be associated with the development of postpartum depression (OR, 95% confidence interval: 2.8 (1.7-4.5); after exclusion of women who had had depression in earlier life (n=51), TPOAb during early gestation was still associated with postpartum depression (OR, 95% confidence interval: 2.9 (1.8-4.3). CONCLUSIONS: The presence of TPOAbs during gestation is associated with the occurrence of subsequent depression during the postpartum period and as such can be regarded as a marker for depression.

Adult↗
PubMed2026

A per- and polyfluoroalkyl substances-based gene signature links prognosis to immune landscapes in thyroid cancer.

BACKGROUND: Thyroid cancer (THCA) is the most common endocrine malignancy with a rising global incidence and significant heterogeneity. Although per- and polyfluoroalkyl substances (PFAS) exposure is linked to thyroid dysfunction, the prognostic value of per- and polyfluoroalkyl substances-related genes (PFASRGs) and their role in the tumor immune microenvironment (TME) remain poorly understood. This study aims to systematically screen key PFASRGs and evaluate their prognostic value as biomarkers for THCA. METHODS: Utilizing The Cancer Genome Atlas (TCGA)-THCA transcriptomic data and PFASRGs, we constructed a prognostic model through differential expression analysis, univariate and multivariate Cox regression analyses, and the least absolute shrinkage and selection operator (LASSO). The model's robustness was validated using receiver operating characteristic (ROC) curves, Kaplan-Meier analysis, and clinical nomograms. Furthermore, the TME, immunotherapy response, and drug sensitivities were systematically evaluated. Distinct molecular landscapes were characterized by stratifying the cohort via unsupervised consensus clustering analysis. RESULTS: The eight-gene prognostic model demonstrated robust performance, with area under the curve (AUC) values exceeding 0.85 across all validation cohorts. High-risk patients exhibited significantly shorter overall survival and an "inflamed" TME characterized by high immune scores and checkpoint expression. In contrast, the therapeutic efficacy of anti-programmed death-ligand 1 (PD-L1) agents was more pronounced in the low-risk category, as evidenced by a superior objective response. Furthermore, distinct molecular subtypes and risk-specific sensitivities to targeted agents, such as sorafenib and sunitinib, were identified, highlighting the model's clinical utility for personalized treatment. CONCLUSIONS: We established a novel THCA prognostic framework based on eight PFASRGs. This model exhibits superior performance in risk stratification, effectively distinguishing cohorts with divergent clinical trajectories, unique immune microenvironment features, and varied therapeutic responses. Our findings provide a powerful predictive tool for refining prognostic evaluation and facilitating the implementation of personalized management strategies for THCA patients.

Per- and polyfluoroalkyl substances-related genes ↗
PubMed1977

Reversible corticospinal tract disease due to hyperthyroidism.

Corticospinal tract malfunction was seen in a patient with Graves' disease. The absence of intracranial and intraspinal lesions likely to cause the neurologic manifestations and their regression after control of thyroid dysfunction favors a cause-effect relationship. We review and compare similar cases previously reported and discuss the mechanisms.

Adult↗
PubMed1998

Lithium in the over-65s: who is taking it and who is monitoring it? A survey of older adults on lithium in the Cambridge Mental Health Services catchment area.

OBJECTIVES: To determine the prevalence of lithium therapy in the over-65s in the Cambridge Mental Health Services catchment area, to obtain a profile of this group and to find out how well and by whom lithium treatment is being monitored. METHODS: A census was carried out of patients over the age of 65 in the Cambridge Mental Health Services catchment area who were on lithium therapy on 1 February 1995. The records of these patients were examined retrospectively for demographic details, details of lithium therapy, information about lithium monitoring and risk factors associated with lithium treatment. RESULTS: One hundred and forty-eight patients were identified representing a point prevalence of 0.27%. GPs carried out lithium monitoring for the majority of this group and 47% had not been seen by a psychiatrist in the 12 months leading up to the census date. Thirty-two per cent of the group were on thyroxine treatment or had raised TSH levels. CONCLUSIONS: The prevalence of lithium therapy in this study was greater than the prevalences reported in studies of patients of all ages. Standards of monitoring varied widely and were not always better where psychiatrists monitored the treatment, although psychiatrists were more likely than GPs to monitor renal function. There was a high rate of thyroid dysfunction in the study group.

Aged↗
PubMed1976

Mantle irradiation in Hodgkin's disease. An analysis of technique, tumor eradication, and complications.

Analysis of the treatment and follow-up records of 377 Hodgkin's disease patients who received mantle irradiation but no planned chemotherapy reveals an overall supradiaphragmatic relapse rate of 21%. Complications of treatment included symptomatic pulmonary radiation reaction (20%), pericarditis (13%), Lhermitte's sign (15%), and thyroid dysfunction (13%). The addition of a subcarinal block after 2500 to 3500 rads and the use of the thin lung block technique in selected patients have reduced the incidence of pulmonary and pericardial complications to less than 5% without sacrificing local control. Further modifications in technique and treatment policy are discussed in terms of improving the therapeutic ratio.

Hodgkin Disease↗
PubMed2001

Interferon-mediated fatigue.

Fatigue is a common side effect of interferon (IFN) therapy, reported in 70-100% of patients treated with IFN. The etiology of IFN-mediated fatigue (IMF) is multifactorial, with endocrine failure, neuropsychiatric disturbance, autoimmunity, and cytokine dysregulation potentially being contributors. Thyroid dysfunction, associated with the development of autoantibodies, is seen in 8-20% of patients receiving IFN-alpha. IFN-alpha also suppresses the hypothalamic-pituitary-adrenal axis. In addition, IFN-alpha therapy leads to depression and cognitive slowing, and depressed patients are predisposed to develop fatigue. Clinical management of IMF is challenging because the syndrome is variable in onset and severity and the pathophysiology is poorly understood. Current management typically centers on dose reduction, but ancillary nonpharmacologic measures may help improve symptoms. Other strategies include antidepressant or anxiolytic therapy and treatment of coexisting hypothyroidism. Future studies utilizing IFN should include quantitative guidelines for grading and managing IMF.

Antineoplastic Agents↗
PubMed1981

Fatigue in human metabolic myopathy.

The ability of muscle fibres to sustain force can be related to their economy of energy utilization and to their capacity to regenerate energy under the prevailing conditions (aerobic or anaerobic) of contraction. The pathophysiology of muscle fatigue is analysed in patients with thyroid dysfunction and with impaired glycogenolysis, and in a patient with abnormal mitochondrial function. Muscle from hypothyroid patients, like cooled muscle, is slow in relaxing and shows a reduced energy requirement (energy economy) and reduced fatiguability, whereas muscle of hyperthyroid patients may show the opposite features. In myophosphorylase deficiency the energy economy is normal in the fresh state and increases as contraction proceeds; however, fatigue is premature and associated with impaired excitation rather than an overall depletion of energy stores. With abnormal mitochondrial function the muscle tends to be effectively anaerobic and fatigue is associated with impaired excitation-contraction coupling. This appears to result from either muscle ischaemia or the dominant use of anaerobic metabolism for energy regeneration. Fatigue in these disorders of energy metabolism may ultimately be due to a reduced supply of ATP but direct evidence of this is lacking and, if it occurs, its physiological expression is probably variable.

Adenosine Triphosphate↗
PubMedDate not supplied

Hypothyroidism presenting as a polymyositis-like syndrome. Report of two cases.

Two patients with proximal muscle weakness and marked elevations of serum muscle enzymes were initially believed to have polymyositis; however electromyography and muscle biopsies were normal. Both patients were subsequently found to have hypothyroidism. Each regained her muscle strength, and serum enzymes normalized with thyroid hormone replacement. Because muscle weakness and an elevated creatine phosphokinase occur in most patients with hypothyroidism, thyroid dysfunction must be considered in the differential diagnosis of polymyositis.

Adult↗
PubMed1997

Long-term low-dose amiodarone therapy in the management of ventricular and supraventricular tachyarrhythmias: efficacy and safety.

BACKGROUND: Amiodarone hydrochloride has been in use for two decades for the control of ventricular and supraventricular arrhythmias. Established and emerging evidence indicates that amiodarone has an antiarrhythmic efficacy superior to that of most other drugs. HYPOTHESIS: The study was undertaken to evaluate the efficacy and acceptability of low-dose amiodarone therapy in the long-term management of supraventricular and ventricular tachyarrhythmias. METHODS: A total of 124 patients with symptomatic drug-refractory or life-threatening arrhythmias managed with low-dose oral amiodarone therapy over a 10-year period was analyzed retrospectively. Of these, 45 patients (36%) had ventricular arrhythmias, 52 (42%) had atrial arrhythmias, and 27 (22%) had atrioventricular reentry tachycardia. Loading doses of amiodarone 600 mg daily for 1 week were administered for supraventricular arrhythmias and 600-1200 mg daily for 2 weeks for ventricular arrhythmias. Maintenance daily doses were 194 +/- 48 and 206 +/- 55 mg, respectively. Mean treatment duration was 32 +/- 28 months, with 326.3 patient years of therapy. RESULTS: Of 39 patients with sustained ventricular tachyarrhythmias, the actuarial incidence of satisfactory arrhythmia control (absence of sudden cardiac death or nonfatal arrhythmia recurrence) was 78% at 1 year and 71% at 2 years. Satisfactory control of supraventricular arrhythmias (mean ventricular rate < 100/min with significant symptomatic improvement for sustained atrial arrhythmias and < 1 attack per year for paroxysmal atrial or atrioventricular arrhythmias) was achieved in 73, 65, and 62% of patients at 1, 2, and 3 years, respectively. The cumulative incidence of amiodarone-related adverse effects was 5.8 per 100 patient years, with drug withdrawal required in 12 patients (9.7%). Fifteen patients had thyroid dysfunction, 2 had hepatic toxicity, and 1 developed nonfatal pulmonary fibrosis. Overall, the incidence of successful use of amiodarone (satisfactory arrhythmia control and freedom from side effects) was 67, 59, and 53% at 1, 2, and 3 years, respectively. CONCLUSIONS: The results of this study suggest that the efficacy of low-dose amiodarone therapy in the management of serious ventricular and supraventricular arrhythmias would be similar to those achieved with higher doses, but with a much more acceptable side effect profile.

Amiodarone↗
PubMed1994

Rapeseed meal-glucosinolates and their antinutritional effects. Part 5. Animal reproduction.

Although there is no clear evidence to fully describe the mechanism involved in glucosinolate-related effects on animal reproduction, lowered fertility in animals fed diets with rapeseed meal (RSM) inclusion is related to glucosinolate content in the diet. Negative effects can result both from multidirectional action of glucosinolates, malnutrition of mother due to the thyroid dysfunction, transfer of goitrogenic compounds to foetus and reduced transfer of nutritive compounds (e.g. iodine) through the placenta. The degree of reproduction impairment depends both on glucosinolate content and on the type of animal. Pregnant female rats are sensitive to the presence of glucosinolates, and the first symptoms of fertility impairment and lowering of offspring survival rate may occur at low glucosinolate levels, e.g. with diets containing low glucosinolate rapeseed meal (LG-RSM). In the case of swine, the limiting value above which sows fertility may be impaired is 4 mumol of total glucosinolates per g diet and 8 mmol of daily intake of these compounds. Opinions on the permitted RSM inclusion in diet for hens are very divergent. Some authors recommend limiting of the RSM inclusion to 10%, while others did not find any lowering of egg production in hens fed with two- or three-fold greater RSM inclusion rates. Most long-term experiments with heifers, cows and ewes indicate that ruminants tolerate the level of glucosinolate in LG-RSM although feeding this fodder as the only high-protein concentrate component may lead to impaired fertility.

Animal Nutritional Physiological Phenomena↗
PubMed2005

Peginterferon alfa-2b plus ribavirin treatment in children and adolescents with chronic hepatitis C.

Peginterferon plus ribavirin is standard therapy for adults with chronic hepatitis C. As no data are available for children, the aim of the study was to evaluate the efficacy and tolerability of peginterferon alfa-2b in combination with ribavirin in chronically infected children. Genotypes, alanine aminotransferase levels, and different routes of viral transmission were considered. In an open-labeled, uncontrolled pilot study, 62 children and adolescents (range, 2-17 years) were treated with subcutaneous peginterferon alfa-2b at a dose of 1.5 microg/kg body weight once per week plus oral ribavirin (15 mg/kg x day) for 48 weeks. Sixty-one patients completed the study. Twenty-three children discontinued therapy after 6 months according to study protocol. Sustained viral response was documented in 22 (47.8%)of 46 patients with genotype 1, in 13 (100%) of 13 with genotype 2 or 3, in 1 of 2 with genotype 4, in 19 (70.4%) of 27 children with parenteral, in 12 (48%) of 25 with vertical, and in 5 of 9 with unknown route of infection. Overall, treatment was well tolerated. Nevertheless, some side effects were present in all treated patients. Eighty-three percent had leucopenia, but only 3 individuals required dose reduction and 10.3% developed thyroid autoantibodies and thyroid dysfunction. In conclusion, combination treatment of peginterferon alfa-2b with ribavirin showed encouraging results and was well tolerated in children and adolescents with chronic hepatitis C. Weekly dosing of peginterferon alfa-2b is a considerable advance for this age group. The treatment is not approved for children. Further controlled trials are needed.

Adolescent↗
PubMed1986

Radiation-associated thyrotoxicosis.

We studied 154 consecutive patients with a diagnosis of thyrotoxicosis seen at Roswell Park Memorial Institute from 1963 to 1982. The retrospective review of the clinical materials revealed that 23 (15%) had a previous history of therapeutic radiation for various diseases. The radiation dose ranged from several to 3600 rads to the thyroid with a mean latency of 14.2 +/- 3.0 years. In 11 out of 16 patients who were tested for antithyroglobulin and antimicrosomal showed positive titers of either or both antibodies (69%). In a small number of patients, thyroid stimulating immunoglobulins were studied; long-acting thyroid stimulators (LATS) were positive in one of six tested and thyrotrophin binding inhibitory immunoglobulins (TBII) in five of eight. The radiation-associated thyroidal dysfunction appears to be associated with the organ-specific autoimmune processes and could manifest as either hypo- or hyperfunction of the gland.

Acne Vulgaris↗

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