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Biomedical subjects

H Ursu

Publications and source records attributed to H Ursu.

11 recordsLinked to original sources
PubMed1992

A retrospective study on the treatment and evolution of Graves' ophthalmopathy.

Although Graves' ophthalmopathy (GO) seems to be unanimously considered as an autoimmune disease, its pathogenesis is still unknown. That is why the different therapeutical formulas led to ambiguous results. We think that a critical retrospective analysis on our therapeutical possibilities in GO will help us to become aware of our limits in treating this pathology. Our study performed on 123 patients with GO-stage III-IV who were admitted several times in the Thyroid Department of our Institute between 1975-1991; mean age 42 yrs (42 in men and 43 in women. One hundred and twelve patients presented GO associated with thyroid hyperfunction and 11 patients--with hypo- and euthyroidism. Thyroid status was evaluated through clinical examination and laboratory investigations (radioiodine uptake--RIU, 2h, 24 hrs, Achillean reflexogram--AR, T4, T3--radioimmunoassay-RIA). Three therapeutical formulas which were available to us were used in our subjects with GO: 1) general corticotherapy (C) was given in 77.6% of the cases; initial doses: 60-40 mg prednisone for 3 weeks followed by decreasing doses for 2 months (number of cures according to GO severity); 2) orbital radiotherapy (RT) alone was administered from the very beginning to the subjects in whom general C was not possible (7.4% of the cases); 3) general C associated with orbital RT were applied in the very severe cases of GO stage IV-VI (15% of the cases). The two available formulas acted particularly on oedematous symptoms (53% with C and 55.55% with RT alone). Muscular changes were improved by C in 30.83% and by RT only in 11.11% of the cases. It was noticed a mild positive effect on protrusion under C in only 11.66%, and under RT in 33% of the cases. The less favourable results in the cases under both C and RT can be explained by the fact that these groups included cases with stages IV-VI of GO with severe evolution. In 24% of the patients we noted an aggravation of the GO evolution regardless the therapy administered. The possible pathological relationship between the exophthalmic syndrome (ES) and hyperthyroidism (HT) is also supported by our data. The onset of ES together with HT occurred in 63% of the cases. On the other hand, we can notice that it was a more severe disease evolution when both ES and HT were associated. The treatment of hyperthyroidism led to GO aggravation (following 131I, thyroidectomy and antithyroid agents (ATD) in 43%, 52% and 29% of the cases, respectively).

Adult↗
PubMedDate not supplied

Radioiodine treatment in recurrences of subacute thyroiditis.

The three cases of subacute thyroiditis treated by radioiodine were refractory to systemic corticoid therapy (2-3 recurrences in a mean duration of 7.6 mos) and to external antiinflammatory radiotherapy (relapses after 2 and 4 mos, respectively). No relapse after radioiodine administration has appeared (mean follow-up period: 3 yrs) and post-iodine hypothyroidism was mild.

Adult↗
PubMedDate not supplied

Thyroglobulin autoantibodies in endocrine diseases.

A simple, rapid haemagglutination laboratory kit was developed for the measurement of the thyroglobulin autoantibodies (Tgl-AAb). The Tgl-AAb kit was applied to the measurement of the AAbs titres in the sera collected from 2861 endocrine patients either hospitalized in the Institute of Endocrinology (about 75%) or endocrine outpatients--the great part of patients (over 90%) being however diagnosed as thyroid disorders. The sex classification showed the F/M ratio 6.61/1 for the whole group and 7.4/1 for the positive cases. The prevalence of the Tgl-AAbs positive sera at low titre (under 1:200) is 11.6% about twofold higher than in a population of 700 blood donors (6.4%), previously reported. Among the significant Tgl-AAbs titres, chosen more or less arbitrarily over 1:200, 30.47% of the patients have titres in the range 1:200-1:5000. The Tgl-AAbs positive and negative sera are classified and analysed according to the endocrine pathology but especially thyroid disorders and the positive thyroid disease are grouped by low, high and very high Tgl-AAbs titres and by Tgl-precipitin positive. Our results are rather similar to those reported for endocrine collectivities in other countries. The technical and methodological sources of some discrepancies between the laboratory Tgl-AAbs results and the clinical symptoms and/or anatomo-pathologic results are commented as well as some of the future perspectives of the laboratory investigation of the thyroid autoimmune diseases. Concluding, a strategy schema for a possible immunogram is presented.

Autoantibodies↗
PubMedDate not supplied

Hyperthyroidism in the elderly. II. Laboratory tests.

The paraclinical findings in 100 elderly hyperthyroid patients were analysed. T3-thyrotoxicosis was found in 26% of the patients and T4-thyrotoxicosis in 7.6%. T3-thyrotoxicosis was found in 50% of the cases of toxic adenoma investigated. Hypomagnesiemia and hypocholesterolemia were found in 40.4% and 20.41%, respectively, and low values of Achilles' reflex test were found in 38.4%.

Achilles Tendon↗
PubMedDate not supplied

The serum osteocalcin levels in patients with thyroid diseases.

The mechanism of bone, calcium, phosphorus and proteins abnormalities observed in hyperthyroidism is rather complex and as yet not wholly understood. Increased serum osteocalcin was recently reported in hyperthyroid patients and its decrease after 4-8 months of treatment. Osteocalcin was measured by RIA in the sera of 211 women and 18 men with thyroid diseases. The patients were divided into 3 groups according to diagnosis: I. polynodular goitre and subacute thyroiditis (59 women, 5 men); II. Graves' disease (70 women, 3 men) and III. thyroid cancer, after treatment by surgery and 131I (82 women, 10 men). The osteocalcin levels in the sera of these patients were: 2.97 +/- 2.63 ng/ml (mean +/- SD) for the women and 3.56 +/- 2.10 ng/ml for the men in the 1st group; 16.31 +/- 11.34 ng/ml for the women and 12.75 +/- 6.09 ng/ml for the man in the IInd group and, 1.01 +/- 0.60 ng/ml for the women and 0.78 +/- 0.46 ng/ml for the men in the IIIrd group. No differences were found between the osteocalcin concentrations in the hyperthyroid female patients treated with antithyroid drugs (no = 58) and the non-treated hyperthyroid women (no = 12): 16.22 +/- 11.40 ng/ml vs 16.74 +/- +/- 11.53 ng/ml. These data suggest that bone resorption stimulated by endogenous thyroid-hormones is a rather resistant processus, persisting even after 6-8 mos of associated anti-thyroid therapy. Further are analyzed the possible causes of the subnormal osteocalcin levels observed in patients with thyroid cancer treated by surgery and radioisotope, whose suppression therapy was discontinued 2-3 weeks before blood sampling.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Significance of high levels of serum malonyl dialdehyde (MDA) and ceruloplasmin (CP) in hyper- and hypothyroidism.

The lipid peroxidation process is enhanced in both hyperoxygenated or underoxygenated tissues though its mechanism of production is different. Because in thyroid functional diseases there are severe disorders in tissue oxygenation we studied the lipid peroxidation process by using the serum level of malondialdehyde (MDA) as indicator. We also determined the serum ceruloplasmin (CP), an enzymatic protein belonging to the circulating system of antioxidative protection and also playing a role in the cell-mediated immunity. We also followed serum level of uric acid (UA). The determinations were performed on serum samples collected from three groups: 1, adult control subjects: 2. adult untreated hyperthyroid patients, and 3. adult hypothyroid thyroidectomized patients to whom replacement therapy was discontinued for at least 15 days. The mean MDA level was significantly higher in both hyperthyroid and hypothyroid patients by comparison to the control group. CP mean level was significantly lower than in controls. It was concluded that in post thyroidectomy hypothyroidism an enhancement of lipid peroxidation does exist and that its consequences are probably aggravated by the low serum CP level. The enhancement of the process occurs by other mechanisms than for hyperthyroid group. At hypothyroid patients there is an ADP excess which is degenerated to xanthine, the substrate of xanthine oxidase resulting in toxic anion superoxide and UA. In contrast with hyperthyroid group, in hypothyroid patients we observed significant higher values of UA in comparison to the controls. The excess of MDA found in hyperthyroid patients is statistically significant, but its consequences are probably less severe because the serum CP is higher than normal, a rather expected finding for an autoimmune disease.

Adult↗
PubMedDate not supplied

Hyperthyroidism in the elderly. I. Clinical manifestations.

The most frequent clinical manifestations in 100 elderly hyperthyroid patients entered in our study were: weight loss (83%), palpitations (85%), nodular goiter (71%) and tremor (74%). Association of weight loss with anorexia and constipation was found in 6% of the patients. The apathetic form of thyrotoxicosis was present in 2% of our patients. Thyrotoxic atrial fibrillation and thyrotoxic heart disease were found in 42% and 51% respectively.

Adult↗
PubMedDate not supplied

Determination of urinary mucopolysaccharides in Graves' disease.

Urinary mucopolysaccharides (u MPZ) were determined in 114 patients with thyroid diseases. The values were elevated in 95.8% of patients with Graves' disease with infiltrative ophthalmopathy, and in 66.6% of patients with Graves' disease without clinically manifest infiltrative ophthalmopathy; in the second group of patients we consider that there is a subclinical infiltrative ophthalmopathy. In conclusion, the determination of u MPZ can be considered as a criterion for the diagnosis of Graves' disease in patients with hyperthyroidism without clinically manifest infiltrative ophthalmopathy; in a number of these cases, infiltrative ophthalmopathy may become clinically manifest. For that reason, increased u MPZ can represent a criterion for an eventual delay of an ablative therapy in Graves' disease. It is not a significant statistic difference (p greater than 0.1) between the values of u MPZ in patients with Graves' disease with clinically manifest ophthalmopathy and in those with subclinical infiltrative ophthalmopathy. The thyroid functional status does not influence in any way the values of u MPZ (p greater than 0.1). There is no correlation between the degree of eye protrusion and the values of u MPZ (r = = -0.05)

Circadian Rhythm↗
PubMedDate not supplied

Diagnosis and treatment of hyperthyroidism in elderly patients.

The clinical signs of hyperthyroidism in the elderly are often atypical and have an insidious onset. The hyperkinetic form and the exophthalmic syndrome are rare. Apathetic thyreotoxicosis occurs, with few exceptions, in the elderly. Part of the clinical signs of hyperthyroidism may be erroneously attributed to the normal aging process. Most authors consider radioiodine as the treatment of choice in elderly hyperthyroid patient.

Age Factors↗