Biomedical subjects

M Makri

Publications and source records attributed to M Makri.

13 recordsLinked to original sources

PubMed2003

Improvement of iodine deficiency after iodine supplementation in schoolchildren of Azerbaijan was accompanied by hypo and hyperthyrotropinemia and increased title of thyroid autoantibodies.

OBJECTIVE: In the mountainous areas of Azerbaijan the schoolchildren suffer from severe Iodine Deficiency (ID) with median Urinary iodine excretion (UIE) 36 mcg/l and prevalence of goiter 99% (estimated by US). In a population of 293,000 schoolchildren aged 8-14 y.o. we administered capsules containing 190 mg of iodized oil (Lipiodol-Guerbet, Cedex, France) twice yearly in 6 months apart (total 380 mg). The aim of the present study was to evaluate the efficacy, the benefits, as well as the possible side-effects in a follow-up period of 6 and 12 months after the initial administration of iodized oil. METHODS: Six and 12 months after the initial administration of iodide, two representative samples of 391 and 326 children respectively were examined. The evaluation included: estimation of goiter by US, determination of UIE and serum measurements of T3, T4, TSH, Tg, autoantibodies against thyroid peroxidase (anti-TPO) and thyroglobulin (anti-Tg). RESULTS: There was an improvement in median UIE which increased from 36 mcg/l to 68 and 81 mcg/l after 6 and 12 months of treatment respectively. The prevalence of goiter decreased from 99% to 54% and 26% respectively. Tg was decreased at 6 and 12 months from the first administration, whereas TSH remained unchanged at 6 months and decreased at 12 months when compared to the latter value. Hypothyroidism was detected in 7% of children after iodide administration both at 6 and 12 months, but overt hypothyroidism was observed only in 0.5% at 12 months. Subclinical hyperthyroidism was detected in 2% and 6% after iodide administration both at 6 and 12 months. There was a significant increase in the title of thyroid auto antibodies in 6 months which was retained and increased in 12 months. There was no relation between the appearance of thyroid dysfunction and the positive thyroid auto antibodies. CONCLUSION: The dose of 190 mg iodide administered twice yearly, improved iodine deficiency and endemic goiter in schoolchildren. The increase of UIE resulted from iodide administration, was accompanied by an increased title of thyroid auto-antibodies and an increased prevalence of hyper- and hypothyrotropinemia apparently of no autoimmune etiology.

Adolescent↗

PubMed2001

Iodine deficiency in Azerbaijan after the discontinuation of an iodine prophylaxis program: reassessment of iodine intake and goiter prevalence in schoolchildren.

The goal of this study was to assess the prevalence of iodine deficiency (ID) in Azerbaijan after the discontinuation of an iodine prophylaxis program by assessing the prevalence of goiter, iodine intake, and thyroid function. The study included 942 schoolchildren (475 boys and 467 girls) ages 8-14 years, from 13 distinct regions. The survey included the following: (1) clinical evaluation; (2) assessment of thyroid volume both by ultrasound and by palpation; (3) determination of iodide in a morning urine specimen using the classic Sandel-Kolthoff reaction in 347 schoolchildren; (4) determinations of thyrotropin (TSH), triiodothyronine (T3), thyroxine (T4), thyroglobulin (Tg), and anti-thyroid peroxidase (TPO) in serum (n = 165) and TSH in whole blood spotted on filter paper (n = 942). The prevalence of goiter for the whole country was determined by ultrasound (US) to be 86% and by palpation 66%, reaching 100% in the mountainous regions of Caucasus. The median urinary iodine excretion (UIE) was 54 microg/L, reaching level of 26 and 39 microg/L in the Caucasus region. In conclusion, according to the World Health Organization (WHO) classification, Azerbaijan now has mild to moderate ID (median UIE, 54 microg/L) and in the mountainous regions with severe ID. The high prevalence of goiter and the low UIE emphasizes the need for urgent medical reintervention. An iodination program is now implemented by our team in the mountainous regions under the auspice of the government of Azerbaijan.

Adolescent↗

PubMed2001

Dissociation of the early decline in serum T(3) concentration and serum IL-6 rise and TNFalpha in nonthyroidal illness syndrome induced by abdominal surgery.

The etiology of the prompt decline in serum T(3) in patients with nonthyroidal illness syndrome has not been adequately explained. It has been attributed to various parameters, including test artifacts, inhibitors of T(4) and T(3) binding to proteins, decreased 5'-deiodinase activity, and circulating cytokines. Currently, much attention is centered on the role of IL-6 and TNFalpha in developing the nonthyroidal illness syndrome through an effect on the hypothalamus, pituitary, and possibly 5'-deiodinase activity. We therefore studied the relation of the endogenous serum IL-6 and TNFalpha rise early in the course of nonthyroidal illness syndrome to the early decline in serum T(3) in 19 apparently healthy individuals, aged 43 +/- 16 yr, who underwent elective abdominal surgery for cholelithiasis or gastroplasty. Serum T(3), free T(3), T(4), free T(4), rT(3), TSH, IL-6, and TNFalpha were measured before and at various time intervals up to 42 h after skin incision. We observed a prompt decline in serum T(3) 30 min before skin incision, which continued to decline throughout the observational period. The magnitude of the decline reached 20% from the baseline value at 2 h. The early decline of T(3) was attenuated and lasted from the 2-8 h, probably due to the sharp increase in serum TSH that started immediately after the entrance to the operating room and lasted for 2 h. In contrast, serum T(4) and free T(4) concentrations were increased soon after skin incision and remained elevated during the first postoperative day. Serum rT(3) increased approximately 6 h after the initiation of surgery and remained elevated thereafter. Serum IL-6 remained essentially undetectable for 2 h after skin incision, whereas serum T(3) was low. Two hours after skin incision, serum IL-6 increased sharply and remained elevated throughout the observational period. Serum TNFalpha remained essentially undetectable throughout the postoperative period. Serum cortisol increased rapidly upon entrance to the operating room and remained elevated throughout the postoperative period. We conclude that the decline in serum T(3) early in the course of nonthyroidal illness syndrome is not due to increased serum IL-6 or TNFalpha levels. The brisk TSH secretion soon after the onset of the syndrome attenuates the decline in serum T(3) due to T(3) secretion from the thyroid. The early and brisk cortisol response to surgery may at least in part explain the early decrease in serum T(3) in nonthyroidal illness syndrome.

Abdomen↗

PubMed1996

Thyroid function and immune profile in rheumatoid arthritis. A controlled study.

The aim of our study was to determine the prevalence of thyroid dysfunction and autoimmune abnormalities in rheumatoid arthritis (RA) and to further investigate the possible association between D-penicillamine and autoimmune thyroiditis. For this purpose, one hundred and one unselected consecutive patients with RA and 70 age and sex matched controls were studied prospectively. Evaluation included a complete history and physical examination with special attention to symptoms suggestive of thyroid pathology, routine laboratory and serologic immune profile, plus determination of serum levels of thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone (TSH), antibodies to thyroid peroxidase (AbTPO) and TSH receptor antibodies (TRAB). Serum thyroxine binding globulin (TBG) was measured in all subjects with high thyroid hormone levels, whereas free T3 and T4 concentrations were determined in all individuals with abnormal T3, T4, TSH or TBG. Six patients with hyperhyroidism, 3 with hypothyroidism and 1 with the euthyroid hyperthyroxinemia (EH) syndrome were found, whereas four of the controls had hyperthyroidism. Thirteen patients and 6 controls had high AbTPO levels whereas no one had high TRAB. No association was detected between thyroid abnormalities and any serologic RA finding. Furthermore, no correlation between thyroid dysfunction and elevated AbTPO's was found. A relatively high prevalence of thyroid dysfunction (9,9%) and subclinical autoimmune thyroiditis (12,9%), the latter indicated by elevated AbTPO's, was found in our RA patients. These figures were higher than those in the control group (5,7% and 8,6% respectively), but the difference did not reach statistical significance. Of further interest may be our finding that, despite anecdotal reports blaming D-penicillamine for cases of autoimmune thyroiditis, the incidence of the latter was similar among recipients and nonrecipients of the drug. Similarly, TRAB were not detected in any patient treated with D-penicillamine.

Adult↗

PubMed1996

Prolactin and growth hormone in perinatal asphyxia.

To assess the pituitary response to perinatal asphyxia, the prolactin (PRL) and growth hormone (hGH) serum concentrations were measured in 55 asphyctic (15 preterm and 40 full-term) and 35 control (15 preterm and 20 full-term) newborns at 2-4, 24, 48 and 98 h of life. At 2-4 h the median PRL in the preterm asphyctic neonates was 5.2 U/l, whereas in the preterm control newborns it was 3.2. In the full-term newborns with and without hypoxic-ischaemic encephalopathy (HIE) it was 5.8 and 3.4, respectively. In the full-term neonates with HIE the PRL remained significantly higher than in the controls up to the fourth day. At 2-4 h the median hGH in the preterm asphyctic and control newborns was 106.2 and 54.8 mU/l, respectively. In full-term newborns it was 85.0 and 40.8, respectively. The lowest hGH concentrations were found in the severe HIE. The increased PRL and hGH in asphyxia may result from a stress-related hormone release, whereas the very low hGH concentrations in severe HIE may result from a damage at the hypothalamic-hypophyseal axis.

Asphyxia Neonatorum↗

PubMed1994

Increased levels and positive correlation between erythropoietin and hemoglobin concentrations in newborn children of mothers who are smokers.

The mean erythropoietin concentration in the cord blood of neonates whose mothers were smokers was greater than in neonates whose mothers were not smokers. There was a significant positive correlation between erythropoietin and hemoglobin concentrations. The findings suggest that approximately one of five fetuses who are exposed to tobacco smoke are in a state of chronic hypoxia.

Arginine Vasopressin↗

PubMed1994

Medium- and long-chain triglycerides have different effects on the synthesis of tumor necrosis factor by human mononuclear cells in patients under total parenteral nutrition.

OBJECTIVE: Lipid emulsions containing both long- and medium-chain triglycerides (LCT/MCT) have been used in total parenteral nutrition (TPN) regimens and seem to have certain advantages for seriously ill patients. The aim of the present study was to investigate the effect of lipid emulsions containing 100% LCT or 50% LCT/50% MCT on tumor necrosis factor (TNF) production by human mononuclear cells. STUDY DESIGN: This was a prospective study, in which 20 malnourished patients were randomly allocated to receive either 100% LCT or 50% LCT/50% MCT for > 30 days. We measured TNF synthesis before initiation of TPN, as well as at 15 and 30 days during TPN. SETTING: Departments of Medicine and Surgery, Patras University Medical School, Patras, Greece. PARTICIPANTS: Members of the staff of the Departments of Medicine and Surgery, Patras University Medical School. RESULTS: We found that TNF production was significantly (p < 0.01) elevated at 30 days in the LCT group, while no significant differences were detected in the LCT/MCT group. CONCLUSIONS: It is concluded that long-term TPN formulas, where LCT have been partially replaced by MCT, do not change TNF synthesis by peripheral blood mononuclear cells, and this may be beneficial in seriously ill, cachectic patients.

Adult↗

PubMed1994

Prolactin, growth hormone and insulin-like growth factor-I in newborn children of smoking mothers.

OBJECTIVE: Since maternal smoking causes fetal circulatory abnormalities, as well as disturbances of the maternal endocrine equilibrium, we measured the PRL, hGH and insulin-like growth factor-I (IGF-I) concentrations in the cord and venous blood of neonates of smoking mothers to determine whether or not the tobacco smoke affects the endocrine status of the neonate. DESIGN: The above hormones were measured in the cord blood of the newborns of both smoking and non-smoking mothers. Also, PRL and hGH were determined at 24 and 72 hours after birth in newborns of both groups. PATIENTS: Fifty-three newborns of smoking and 47 newborns of non-smoking mothers were investigated. Seventeen of the newborns of the smoking and 21 of the non-smoking mothers were preterm. The remainder were full-term. MEASUREMENTS: PRL was measured with a solid-phase immunoradiometric assay, hGH with a solid-phase two-site immunoradiometric assay and IGF-I with a solid-phase radioimmunoassay after extraction with acid-ethanol. RESULTS: The median value of PRL in the 17 preterm newborns of smoking mothers was 4941 mU/I (range 1322-7230), whereas in the 21 preterm newborns of non-smoking mothers it was 2013 mU/I (range 243-4740) (P = 0.0002). The median hGH value in the above subjects was 102.0 mU/I (range 35.2-208.4) and 59.8 mU/I (range 11.6-134.2), respectively (P = 0.0039). The median IGF-I was 580.7 U/I (range 253.2-4851.1) and 530.6 U/I (range 239.6-3591.5), respectively (P = 0.429). In the 36 full-term newborns of smoking mothers the median PRL value was 5171 mU/I (range 2074-7530), whereas in the 26 full-term newborns of non-smoking mothers it was 5081 (range 244-6540) (P = 0.048). The median hGH was 69.6 mU/I (range 42.3-280.0) and 32.2 mU/I (range 6.2-200.0), respectively (P = 0.0031). Also, the median IGF-I value was 926.3 U/I (range 348.5-5344.7) and 462.1 U/I (range 250.2-1578.7), respectively (P = 0.0024). On the 3rd day the PRL in the preterm neonates of both smoking and non-smoking mothers showed the same 16.5% drop, and thus the difference between the groups was maintained. A similar reduction in the hormone levels was observed in the full term neonates. CONCLUSIONS: The findings indicate that the maternal tobacco-smoking causes disturbances of the endocrine status of the fetus, as shown by the increased levels of PRL, hGH and IGF-I, which are more pronounced between 30 and 37 weeks of gestation than at term.

Female↗

PubMed1994

Peripheral blood mononuclear cells from patients with rheumatoid arthritis suppress erythropoiesis in vitro via the production of tumor necrosis factor alpha.

Anemia is a frequent manifestation of rheumatoid arthritis, with a probably multifactorial etiology. We investigated the effect of peripheral blood mononuclear cell supernatants (PBMCS) from rheumatoid arthritis (RA) patients on hematopoietic colony formation in vitro, by using a methylcellulose assay. PBMCS from patients suppress in vitro erythroid (BFU-E), mixed-lineage (CFU-GEMM) and to a lesser degree granulocyte-macrophage (CFU-GM) progenitors. PBMCS from anemic RA patients were more suppressive for BFU-E than those from non-anemic patients. Addition of antibodies to tumor-necrosis factor alpha (TNF alpha) almost completely reversed the inhibition of BFU-E and CFU-GEMM, but had little effect on the CFU-GM colony formation. Antibodies to interferon-gamma (IFN gamma) and interleukin-1 (IL-1) were not effective. The above data suggest that PBMCS from RA patients suppress in vitro erythropoiesis via the production of TNF alpha; a pathogenetic role for TNF alpha in the anemia of RA can be implied.

Adult↗

PubMed1994

Growth hormone, insulin-like growth factor-I and prolactin in small for gestational age neonates.

Growth hormone (hGH), insulin-like growth factor-I (IGF-I) and prolactin (PRL) were measured in the cord and venous blood of small for gestational age (SGA) neonates in order to evaluate their endocrine status during the first 3 days of life. Although there were SGA newborns with both high and normal levels of hGH, the mean (+/- SD) concentration of hGH in the cord blood of the SGA neonates was 72.1 +/- 50.6 ng/ml, whereas in the appropriate for gestational age (AGA) newborns it was 37.0 +/- 23.5 (p = 0.001). The IGF-I in the cord blood of the SGA and the AGA newborns was 194.2 +/- 174.8 ng/ml and 77.3 +/- 50.2, respectively (p = 0.013). The PRL in the SGA and AGA newborns was 184.8 +/- 62.4 ng/ml and 126.8 +/- 60.5, respectively (p = 0.0005). On the 3rd day the hGH in the SGA babies was 50.7 +/- 41.2, whereas in the AGA it was 24.3 +/- 12.3 (p = 0.034). On the same day the IGF-I was 133.9 +/- 120.9 and 44.8 +/- 31.6, respectively (p > 0.05). Similarly, the PRL was 157.1 +/- 52.3 and 90.9 +/- 52.5, respectively (p = 0.0008). All neonates with high hGH concentrations had low IGF-I levels, whereas of those with normal hGH half had high and half normal IGF-I levels. There was no difference in the hormone levels between symmetric and asymmetric intrauterine growth-retarded infants. The findings suggest that the SGA neonates are heterogeneous comprising three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

PubMed1992

Development of thyrotropin circadian rhythm in infancy.

Normal children and adults show a similar pattern of diurnal variation of TSH secretion with lower values at 1100 h and higher around 2300 h. The purpose of this study was to investigate the age of appearance of TSH circadian rhythm. In 57 fullterm infants 0-6 months old and in 37 premature infants 1-4 weeks old TSH was measured at 1030, 1100, 1130 h and 2230, 2300, and 2330 h. No diurnal rhythm was detected in both premature and fullterm infants less than 4 weeks of life. After the first month of life a significant difference between AM and PM values was observed in fullterm infants. In infants 1-2 months old mean +/- SEM AM and PM values were 2.8 +/- 0.2 and 3.5 +/- 0.4 mU/L, respectively (P less than 0.025), in infants 3-4 months old 3.0 +/- 0.6 and 4.1 +/- 0.8 (P less than 0.01) and in infants 5-6 months old 1.8 +/- 0.2 and 2.6 +/- 0.3 (P less than 0.0005). These data clearly indicate that the development of TSH circadian rhythm starts after the first month of life.

Circadian Rhythm↗

PubMedDate not supplied

The effect of light on plasma melatonin levels in premature infants.

Recent studies have shown that full term neonates actively secrete melatonin and that light deprivation during the first 72 h of life significantly increases plasma melatonin levels. In order to evaluate pineal gland activity and responsiveness to light in premature infants, we measured plasma melatonin levels in 23 healthy infants, 33-36 weeks of gestation, during their first week of life. Nine infants (Group A) remained under constant illumination conditions for 48 hour prior to melatonin measurements. Fourteen infants (Group B) were exposed for the same time period to an artificial alternation of day and night cycles by covering the eyes of the infants with eye pads during the night (20.00-08.00 h). Mean +/- SEM plasma melatonin at 20.00 h, 04.00 h, 12.00 h and 20.00 h was 14.8 +/- 1.6, 16.2 +/- 2.8, 18.7 +/- 3.1, 20.9 +/- 3.1 pg/ml in Group A and 20.5 +/- 3.2, 22.3 +/- 2.9, 20.2 +/- 2.2, 18.5 +/- 2.2 pg/ml in Group B respectively. The differences observed between the two groups were not statistically significant. Our results indicate that at this gestational age the pineal gland is actively secreting melatonin but does not respond to the light alternations attempted. Further studies are needed in order to evaluate the developmental maturation of the pineal gland in humans.

Birth Weight↗

PubMedDate not supplied

Tumor necrosis factor production by human mononuclear cells during total parenteral nutrition containing long-chain triglycerides.

The effect of fat contained in total parenteral nutrition (TPN) regimens on the immune system is controversial. The purpose of our study was to examine whether the synthesis of tumor necrosis factor (TNF), a macrophage-derived protein with several immunomodulating effects, is influenced by the duration of TPN. We studied 20 patients on glucose- and fat-based TPN with lipid emulsions containing long-chain triglycerides (LCTs). Ten of our patients received TPN for 15 days (group A) and the other 10 for 30-40 days (group B). We measured TNF production by phytohemagglutinin- and endotoxin-stimulated peripheral blood mononuclear cells before and after TPN via enzyme-linked immunosorbent assay. The production of TNF before and after TPN was similar in group A but significantly (p less than 0.01) elevated in group B after long-term TPN. Therefore, long-term TPN containing LCTs may increase TNF production, and this may be the result of an immunomodulating effect of fat.

Adult↗