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Biomedical subjects

L S Ward

Publications and source records attributed to L S Ward.

14 recordsLinked to original sources
PubMed2000

Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases.

CONTEXT: Screening programs not only offer the opportunity to trace and treat almost all cases of congenital hypothyroidism but also mean large savings to the health system. However, carefully planned strategies are necessary to extend their benefits and reduce costs. OBJECTIVE: To determine the possible influence of maternal diseases that affect maternal-fetal placenta dynamics on primary thyroid stimulating hormone (TSH) screening for congenital hypothyroidism. DESIGN: Prospective non-randomized clinical trial with at least 3 months of follow-up. SETTING: A public university referral center [CAISM/Hospital das Clínicas, Faculty of Medicine, University of Campinas, Campinas, SP]. PARTICIPANTS: 415 neonates divided into 5 groups: eighty-three infants born from cardiac mothers; 98 from mothers that had toxemia; 54 of the mothers had diabetes mellitus; 40 were HIV positive and 140 had no diseases. INTERVENTION: All newborns had cord blood samples collected on filter paper at birth. MAIN MEASUREMENTS: TSH was measured from dried blood spots using a homemade immunofluorescence assay (sensitivity in dried blood spots = 0.1 mU/L). RESULTS: There was no significant difference in the mean TSH levels among the 5 groups. Moreover, TSH levels were around 5 mU/L in 48% of the newborns, indicating that our region is severely deficient in iodine. CONCLUSIONS: Our results indicate that primary TSH screening programs using cord blood are not affected by maternal diseases. We suggest that, besides its technical advantages over heel punctures with T4 primary approaches, neonatal screening using primary cord blood TSH may also be used as a monitoring tool for evaluation and control of iodine deficiency disorders (IDD).

Acquired Immunodeficiency Syndrome↗
PubMed2000

Serum cytokine levels in autoimmune and non-autoimmune hyperthyroid states.

Although the role of interleukin-2 (IL-2) and interferon gamma (gammaIFN) is still poorly understood in hyperthyroid diseases, it is reasonable to assume that these cytokines may be present at higher levels in Graves' disease (GD) than in other primarily non-autoimmune thyroid diseases. In order to look for an easy method to distinguish GD from primarily non-autoimmune causes of hyperthyroidism, we compared 13 healthy individuals with 21 treated and untreated hyperthyroid GD patients and with 19 patients with hyperthyroidism due to other etiologies: 7 cases of multinodular goiter, 5 cases of excessive hormone replacement and 7 cases of amiodarone-associated hyperthyroidism. All patients presented low TSH levels and a dubious clinical thyroid state. We found a good correlation between TSH and serum IL-2 levels (r = 0.56; P<0.01). Serum IL-2 (P<0.01) and gammaIFN (P<0.01) levels were lower in the hyperthyroid group of patients than in control subjects, suggesting a depressed TH1 pattern in the T-cell subset of hyperthyroid patients. GD had normal IL-2 levels, while patients with other forms of thyrotoxicosis presented decreased IL-2 levels (P<0.05). There was no difference between treated and untreated GD patients. We suggest that the direct measurement of serum IL-2 level may help to confirm hyperthyroidism caused by GD.

Adolescent↗
PubMed1998

Studies of allelic loss in thyroid tumors reveal major differences in chromosomal instability between papillary and follicular carcinomas.

Loss of heterozygosity (LOH) studies have been used to identify sites harboring tumor suppressor genes involved in tumor initiation or progression. Previous reports have suggested that regions within chromosomes 3p, 11q, 2p, 2q, 10q, and 1p may be frequently deleted in human follicular thyroid cell tumors. We have extended the analysis of these and other selected regions to 65 paired thyroid tumor tissues. Twenty-four were follicular adenomas, 30 were papillary carcinomas, 10 were follicular carcinomas, and 1 was an anaplastic carcinoma. Sixty percent of the follicular carcinomas, 33% of the follicular adenomas, and 23% of the papillary carcinomas presented LOH at least at 1 site. Fifty percent of the follicular carcinomas showed 2 or more chromosome arms affected by deletions, whereas just 1 of the 24 follicular adenomas and none of the papillary carcinomas presented this feature. However, none of the specific loci examined had a rate of LOH greater than 33%, even in follicular carcinomas. This prompted us to place our findings into a broader context, and we, therefore, performed a meta analysis of all published studies of LOH in follicular thyroid neoplasms. There was a phenotype dependency in the overall rate of LOH, with no specific region displaying a particularly high prevalence. Most notably, by contrast to follicular carcinomas, papillary carcinomas had exceedingly low rates of LOH. Thus, there is a sharp distinction between the two major forms of differentiated thyroid cancer in their tendency to lose genetic material. This probably results from a fundamental difference in mechanisms controlling chromosomal stability in these two forms of cancers that in all likelihood has implications for tumor behavior and prognosis.

Adenocarcinoma, Follicular↗
PubMed1996

A method for isolating beta-casein.

A new method was developed for obtaining pure beta-CN. Calcium caseinate (3%) was reconstituted, renneted to form a gel, cooled (4 degrees C) to allow beta-CN dissociation from the caseinate gel, and centrifuged. The supernatant was warmed to 30 degrees C, precipitating pure beta-CN from solution. Large quantities of beta-CN were recovered by scaling-up this procedure, but these beta-CN preparations were less pure than the beta-CN that was prepared on a smaller scale. Chromatography (FPLC) and urea-PAGE showed beta-CN to be the main component in the precipitate. Chymosin, used to form the caseinate gel, did not extensively hydrolyze beta-CN under the conditions of these experiments. Calcium concentration, cooling time, and caseinate concentration influenced the recovery of beta-CN. Maximum recovery of beta-CN, under the experimental conditions used, occurred at 10 mM calcium, 48 h of cooling, and 3% caseinate concentration.

Calcium↗
PubMedDate not supplied

Serum cytokines in chronic Chagas' disease.

We studied the serum levels of IL-2, IFN-gamma and TNF in different clinical forms of Chagas' disease and in patients clinically compensated and decompensated. Cytokines measured in 91 patients with the chronic form of the disease did not differ from those of 13 normal individuals, suggesting the absence of activation of the TH1 pattern of lymphocyte response. There were no statistical differences among the 17 patients in the indeterminate form of the disease, the patients presenting either early (n = 4) or well-developed signs of cardiomyopathy (n = 62), the digestive (n = 4) or the mixed (n = 4) forms of the disease. Serum TNF was undetectable and IFN-gamma levels did not differ between clinical forms and severities of Chagas' disease. However, we found IL-2 higher levels in the 25 non-controlled patients than in the 66 controlled individuals (p < 0.001). We suggest that IL-2 dosage may be useful as an indicator of the need for more aggressive procedures.

Adult↗
PubMedDate not supplied

Nested-PCR using MPB64 fragment improves the diagnosis of pleural and meningeal tuberculosis.

Fluids in which Mycobacterium tuberculosis are seldom found, such as pleural and cerebrospinal liquids, are good candidates to be studied using PCR techniques. We detail our experience with a PCR assay applied to pleural and cerebrospinal fluids using the primer MPB64. Seventy three specimens were analyzed: 30 pleural fluids (PF), 26 pleural biopsies (PB) and 17 cerebrospinal fluids (CSF). The gold standard for the diagnosis of tuberculous meningitis was the positive culture for M. tuberculosis in CSF. Tuberculous pleural effusion was diagnosed when cultures of PF and/or PB were positive for M. tuberculosis, or the PB histology showed granulomas. Our results, compared to the gold standards employed, showed a sensitivity of 70%, specificity of 88%, positive predictive value of 82% and negative predictive value of 80%. The high specificity of the MPB64 fragment while still retaining a good sensitivity makes it very well suited for pleural and cerebrospinal tuberculosis diagnosis.

Antigens, Bacterial↗
PubMedDate not supplied

[Predictive value of the measurement of iodothyronines in the prognosis of patients with severe nonthyroidal illness].

PURPOSE: In order to find prognostic parameters in patients with severe diseases, we analyzed sequentially the levels of thyroid hormones. METHODS: We measured iodothyronines (T3, T4 and rT3) in 42 patients before the admission and after the discharge in an intensive care unit. In addition, we also measured the iodothyronines in other 17 patients after the discharge. RESULTS: Comparing the group of good outcome with the patients who died, we observed in the former group initial normal T4 levels in 76% of the patients, which were maintained in 65% of them during hospitalization and in 70% of them at the time of delivery from the intensive care unit. Patients who died, however, presented initial low T4 levels in 56% of them, decreasing values in 95% of them during hospitalization and low levels in 81% of patients at the last dosage. The combined profile of T3 and T4 also differentiated good and bad outcome. CONCLUSION: We suggest that serial analysis of serum levels of thyroid hormones may help the evaluation of critical care patients.

Critical Illness↗
PubMedDate not supplied

[Comparison of two strategies for the early detection of congenital hypothyroidism].

OBJECTIVE: Compare two different strategies in newborn screening for congenital hypothyroidism, primary TSH in the umbilical cord blood (method 1) and primary T4 in blood collected from the heel in the 2nd day of life (method 2). METHODS: We compared both strategies in 10,000 newborns, measuring TSH by a sensitive immunofluorimetric assay and T4 by a radioimmunoassay. RESULTS: Both strategies detected all cases of hypothyroidism (4 cases, 1/2,500 newborns). The recalling index owing to insufficient amount of blood to perform the assays was zero in method 1 and 8.5% (850 newborns) in method 2. The recalling index for confirmation of the results was 0.06% (6 newborns) in method 1 and 2.25% (225 newborns) in method 2; when method 2 included supplementary TSH, the recalling index was reduced to 1.63% (163 newborns). CONCLUSION: Our data indicate the technical superiority of the umbilical cord blood compared to heel and primary TSH compared to primary T4 in the neonatal thyroid screening for congenital hypothyroidism.

Congenital Hypothyroidism↗
PubMedDate not supplied

Determination of glucose levels using dried filter paper blood spots: new perspective in home monitoring.

We present a method for the determination of blood glucose using dried filter paper blood spots. To validate this method, we compared our results using filter paper and simultaneously collected venous blood. We demonstrated that there is a linear relationship between the filter paper glucose levels and those determined in whole blood (r = 0.98). There was no significant difference between the results of the two methods (p > 0.05). This method is a cheap alternative which may improve the control of diabetes mellitus, and may also be very useful in the diagnosis of postprandial hypoglycemia and other special situations.

Blood Glucose↗