Background Of Hypothyroidism Research Articles

CAPACITY OF THE MAGNETIC RESONANT TOMOGRAPHY IN DIAGNOSTIC OF THE ARMS ENTRAPMENT NEUROPATHIES IN PATIENTS WITH HYPOTHYROSIS

Symptoms of neuromuscular dysfunction are quite common in patients with hypothyroidism. Structural changes of myelin and dysfunction of oligodendroglial processes in axons have pathogenetic significance in patients with neuropathies against the background of hypothyroidism. However, the etiopathogenesis of the development of neuropathies in hypothyroidism is not fully understood. Magnetic resonance imaging (MRI) is a modern imaging method that now provides an image of nerve trunks with a quality sufficient to assess their condition. The main task of MRI is to assess the difficult and atypical cases of nerve compression. We examined 26 patients diagnosed with hypothyroidism, including 8 patients with degenerative-dystrophic diseases of the spine, 1 patient — an anomaly of nerves and muscles, 2 patients were found to have the consequences of injuries, 1 patient was diagnosed with De-Kervin disease, and 14 patients with comorbidity, leading to nerve compression, was not found. The aim of the study was to assess the diagnostic capabilities of magnetic resonance imaging for compression-ischemic neuropathies of the hands in patients with hypothyroidism. Neurological examination and data from stimulation electroneuromyography allows you to accurately determine the area of investigation for MRI. The article shows the diagnostic capabilities of MRI, as well as its place in the diagnostic algorithm of compression-ischemic neuropathies of the hands in patients with hypothyroidism.

СТАН СИСТЕМИ ПРОТЕЇНАЗИ/ІНГІБІТОРИ ПРОТЕЇНАЗ У ЩУРІВ У ДИНАМІЦІ ІММОБІЛІЗАЦІЙНОГО СТРЕСУ НА ТЛІ ГІПОТИРЕОЗУ

Вступ. У патогенезі багатьох патологічних станів важливе місце посідають порушення протеїназо-інгібіторної системи. При відсутності належного контролю за протеолізом розвиваються патологічні стани, що супроводжуються виникненням деструктивних, запальних та імунних реакцій. Ряд дослідників встановив захисну дію йодовмісних тиреоїдних гормонів при стресі, які реалізуються в результаті їх взаємодії з клітинним геномом, що призводить до стимуляції локальних стрес-лімітуючих систем.
 Мета дослідження – встановити особливості функціонування системи протеїнази/інгібітори протеїназ за умов іммобілізаційного стресу на тлі зниження рівня йодовмісних гормонів щитоподібної залози.
 Методи дослідження. Гіпотиреоз моделювали, щоденно вводячи тваринам per os тиреостатик мерказоліл (“Здоров’я”, Україна) у дозі 25 мг/кг протягом 21-ї доби. Гострий іммобілізаційний стрес моделювали шляхом прив’язування піддослідних щурів у положенні на спині за 4 кінцівки без обмеження рухо­мості голови тривалістю 3 год.Для дослідження концентрації йодовмісних гормонів щитоподібної залози, активності протеїназної системи і вмісту інгібіторів протеолізу використано спектрофотометричні та імуноферментні методи.
 Результати й обговорення. Досліджено вплив іммобілізаційного стресу в щурів з попередньо змодельованим гіпотиреозом на показники протеїназо-інгібіторної системи крові. На стадії тривоги розвитку стрес-реакції в евтиреоїдних тварин встановлено підвищення протеолітичної активності крові на тлі збільшення вмісту α1-інгібітора протеаз та α2-макроглобуліну, що вказує на посилення антипротеолітичного потенціалу для стримування розвитку деструкції.На стадії резистентності відбувалася стабілізація протеолітичної активності крові. Однак при тривалому стресі (стадія виснаження) вона знову достовірно зростала на тлі зниження активності інгібіторів протеаз, що свідчить про виснаження захисного інгібіторного резерву. У тварин з гіпотиреозом на всіх стадіях розвитку стрес-реакції мало місце достовірне підвищення протеолітичної активності крові, причому показники інгібіторів протеаз достовірно зменшувалися. Це призводило до різкого зростання індексу протеолізу, що відбувалося на тлі збільшення проникності лізосомальних мембран.
 Висновок. На тлі гіпотиреозу спостерігають інтенсивніше, ніж у евтиреоїдних тварин, зростання протеолітичної активності крові на фоні пригнічення антипротеазної активності та збільшення проникності лізосомальних мембран.

Особливості клітинного і гуморального імунітету у пацієнток з зовнішнім генітальним ендометріозом на тлі гіпотиреозу

Особливості клітинного і гуморального імунітету у пацієнток з зовнішнім генітальним ендометріозом на тлі гіпотиреозу

Affective disorders on the
 background of hypothyroidism.

Introduction. Affective disorders are the most common psychopathological symptoms of hypothyroidism. Hypothyroidism greatly reduces the effectiveness of antidepressants and replacement L-thyroxine therapy is not enough to eliminate the anxiety and depressive disorders in hypothyroidism. Aim. The purpose of the research is study of psychosomatic and somatopsychical relationships in hypothyroidism and depression. Material and methods. Four hundred and six patients (78 men and 328 women) with affective disorders aged 51,3 ± 4,7 years were examined. The concentration of thyroid-stimulating hormone (TSH), thyroxine (T4), cortisol, adrenocorticotropic hormone (ACTH) in the blood, urinary excretion of norepinephrine and epinephrine was determined. Severity of depression was estimated by the Hamilton Depression Rating Scale (HDRS), alexithymia level - by the Toronto alexithymia scale (TAS-26). Results. In euthyroid patients TSH level was 2,7 ± 0,13 mU/l, in hypothyroid - 14,1 ± 1,21 mU / l (p<0.001), T4 level was 14,4 ± 1,36 and 7.1±1.16 pmol/l, respectively (p<0.001). Depressive disorders were revealed in 374 patients (92.1%), other affective disorders - in 32 patients (7.9%). Hypothyroid patients had more pronounced depression by the Hamilton Rating Scale for Depression and a higher average score by TAS-26 as compared to euthyroid patients (17,8 ± 2,1 vs 15,3 ± 1,9 points, p=0.001and 79,9 ± 4,6 vs. 71,1 ± 4,4 points; p<0.001 respectively). TSH level has a direct correlation with severity of depression (R=0,62; р<0,001). Severe depression was observed in hypothyroid patients more often than in euthyroid patients (9.5% vs. 5.0%; р=0,029). Patients with affective disorders and hypothyroidism have a higher cortisol level and lower ACTH level than euthyroid patients (503±12.1 vs. 420±10.9 nmol/l; р<0.001 and 12.9±3.07 vs. 15.3±3.4; р<0.001 respectively). Urinary excretion of epinephrine and norepinephrine in hypothyroid patients was higher than that in euthyroid patients: 37,8 ± 2,18 vs. 31,1 ± 2,06 nmol (p<0.001) and 39,2 ± 2,14 vs. 33,4 ± 2,1 nmol (p<0.001), respectively. Conclusions. Prevalence of hypothyroidism among patients with affective disorders is higher than in the general population. The severity of the depression has a direct correlation with TSH. Activity of the sympathetic division of the autonomic nervous system is higher in patients with hypothyroidism than in patients with euthyroidism.

Стан системи нітроген (ІІ) оксиду в щурів з пародонтитом на фоні гіпер- та гіпотиреозу

Introduction. Inflammatory periodontal disease is one of the most urgent problems of dentistry, which has a social significance due to the high prevalence, pronounced changes in the tissues of the periodontal disease and the body of the patient as a whole, and the defeat of young people.The aim of the study – to investigate the functional state of the nitrogen (II) oxide system in rats with periodontitis without concomitant pathology and against the background of hyper- and hypothyroidism.Research Methods. The study was carried out on 48 white non-linear male rats. The total activity of NO-synthase (NOS) was determined colorimetrically by the number of formed nitrates and nitrites in the incubation medium. The total content of nitrates and nitrites (NOx) was determined by the Gris method.Results and Discussion. Experimental periodontitis is accompanied by increased general activity of NO-synthase in periodontal tissue homogenate by 2.2 times vs control. NOx content in the serum of animals with periodontitis increased by 46.2% and in the periodontal tissue homogenate – by 74.7% compared with the control. In rats with periodontitis against hyperthyroidism, NOS activity increased by 3.9 times relative to the control group of animals and by 75.9% exceeded the rate of rats with periodontitis without concomitant pathology. In rats with periodontitis, against the background of hypothyroidism, the activity of NOS was 29.6% higher than that of rats with periodontitis without concomitant pathology and 2.9-fold of control.Conclusions. Experimental periodontitis is accompanied by a marked increase in the intensity of nitroxidergic processes both in the homogenate of periodontal tissues and in the blood. The imbalance of thyroid hormones increases the synthesis of nitrogen (II) oxide in the experimental periodontitis, especially expressed in hyperthyroidism.

ПОКАЗНИКИ КІСТКОВОГО МЕТАБОЛІЗМУ У ЩУРІВ З ПАРОДОНТИТОМ НА ФОНІ ГІПЕР- ТА ГІПОТИРЕОЗУ

ВСТУП. В Україні за останні п’ять років кількість хворих з дисфункцією щитоподібної залози збільшилася у 5 разів. Зміни діяльності щитоподібної залози неминуче позначаються на різних системах організму, у тому числі і на функції і морфології органів і тканин порожнини рота.Метою дослідження було дослідити показники кісткового метаболізму у щурів з пародонтитом без супутньої патології і на фоні гіпер- та гіпотиреозу.Матеріал і методи. Досліди проведено на 48 безпородних статевозрілих білих щурах-самцях, які були розділені на чотири групи: контрольна, група з пародонтитом, група з пародонтитом на тлі гіпертиреозу, група з пародонтитом на тлі гіпотиреозу.Результати. Експериментальний пародонтит супроводжується порушеннями метаболізму кісткової тканини за рахунок підвищення як процесів резорбції, так і процесів кісткоутворення. Пародонтит на тлі гіпертиреозу характеризується більш вираженими порушення кісткового метаболізму за рахунок одночасного підвищення процесів резорбції та кісткоутворення. Пародонтит на тлі гіпотиреозу супроводжується гальмуванням процесів резорбції кісткової тканини та менш вираженим кісткоутворенням.

Особливості імунного профілю у крові щурів з гострим поширеним перитонітом на тлі гіпотиреозу

Introduction. Peritonitis remains one of the most common complications of surgical diseases of the abdominal cavity [5, 11]. According to individual authors, in severe forms of disseminated purulent peritonitis, the mortality reaches 50–80 % [3, 13, 15]. All this points to the need for further improvement of the methods of diagnosis and treatment of this pathological process.The aim of the study – establishment of features of the immune system cellular and humoral units functioning in rats with acute widespread peritonitis on the background of experimental hypothyroidism.Materials and Methods. White Wistar rats were used in the work. Hypothyroidism was modeled by the administration of Mercazolil at a dose of 25 mg / kg for 21 days. Acute common peritonitis was modeled by injecting 0.5 ml of 10 % filtered fecal suspension into the abdominal cavity of the animals under study. Cellular (CD4+, CD8+, CD22+-lymphocyte) and humoral (IgA, IgM, IgG) immunity were measured. The animals were decapitated under thiopental anesthesia after 24 hours, on the 4th, 7th and 10th days from the beginning of peritonitis modeling.Results and Discussion. It was found that in animals with acute widespread peritonitis against hypothyroidism, there is a significant decrease in CD4+ lymphocytes, a violation of the ratio of the main subpopulations of lymphocytes (CD4+ and CD8+), which is accompanied by a significant decrease in the immunoregulatory index. The dynamics of changes in B-lymphocytes CD22+, which are producers of immunoglobulins, was indicative. These changes correlated with the state of specific humoral immunity – the concentration of immunoglobulins in the serum of the corresponding groups of animals.When simulating common peritonitis, euthyroid animals showed a decrease in IgG concentration and an increase in IgM and IgA. Against the background of hypothyroidism, we noted a decrease in the level of immunoglobulins of all classes after 24 hours of the duration of the pathological process with a further decrease to the tenth day. The indices of all classes of immunoglobulins were also significantly lower than those of euthyroid animals with acute widespread peritonitis.Conclusions. In animals with acute common peritonitis, hypothyroidism is significantly reduced CD4+ lymphocytes, a violation of the ratio of the main subpopulations of lymphocytes (CD4+ and CD8+), which is accompanied by a significant decrease in the immunoregulatory index. The insufficiency of the cellular part of the immune response was found to reflect an increase in the mutual negative effect of the inflammatory process in the peritoneum and systemic disorders of immune defense in conditions of concomitant hypothyroidism. There is a direct relationship between the reduced level of CD22+ lymphocytes and the indices of immunoglobulins of classes A and G.In acute widespread peritonitis against the background of mercazolil-induced hypothyroidism, there is a violation of the functionality of the immune system, manifested by an imbalance of immunoglobulins in the bloodstream and a decrease in the resistance of the humoral link of the immune system.

The indices of metabolismin rats with periodontitis on the background of hyper- and hypothyroidism

Introduction. The multifaceted action of thyroid hormones on the rate of metabolic processes reflected on the tissues of periodontium has been known for a long time. In this case, the prevalence of periodontitis in the population, the complexity of the implementation of prevention and treatment of the disease, ambiguity in the interpretation of the main pathogenetic mechanisms makes this problem extremely relevant.The aim of the study – to learn the indices of metabolismin blood serum of rats with periodontitis without concomitant pathology and against the background of hyper- and hypothyroidism.Research Methods. The study was carried out on 48 white non-linear male rats. Determination of glucose, total protein, albumin, urea, creatinine, total cholesterol, α-cholesterol and β-cholesterol in serum was carried out on a semi-automatic biochemical analyzer Humalyzer 2000 (Human, Germany).Results and Discussion. Experimental periodontitis is accompanied by a decrease in the concentration of glucose in the blood serum, hypoalbuminemia, an increase in the concentration of urea, total cholesterol, β-cholesterol and a decrease in the concentration of α-cholesterol. The imbalance of thyroid hormones has a multifaceted effect on metabolism in experimental periodontitis. Thus, in rats with periodontitis in case of hyperthyroidism, the concentration of glucose and total protein increased, albumin concentration decreased, urea concentration increased, total cholesterol and α-cholesterol concentrations decreased, and no significant changes in β-cholesterol concentration were observed. In rats with periodontitis, combined with hypothyroidism, glucose concentration decreased, total protein concentration increased, albumin concentration decreased, urea concentration increased, total cholesterol and β-cholesterol concentrations increased, and the concentration of α-cholesterol decreased.Conclusions. Reasonable changes in all major spectra of metabolism – carbohydrate, protein and lipid in case of experimental periodontitis indicate that periodontitis is a local process that affects the general state of the organism. The imbalance of thyroid hormones has a pronounced effect on the overall metabolic processes, especially on proatherogenic changes in serum, which are more pronounced in case of an experimental periodontitis in the background of hypothyroidism.

Ozone therapy of the adenomyosis at women with sterility and hypothyroidism

Aim of research – specification of hormonal-immunologic shifts and increase of the effectiveness of sterility treatment in patients with adenomyosis and hypothyroidism.Materials and methods. There were examined 90 women with the primary sterility, who participated in the program of auxiliary reproductive technologies (ART) – extracorporal fertilization ART, among them 60 with adenomyosis and hypothyroidism (main group), the control group included 30 patients without thyroid pathologies without gynecological diseases. The main group was divided in 2 clinical groups: 30 patients, who underwent the traditional treatment and 30 whom the ozone therapy was additionally prescribed to. The methods of ultrasound examination, MRT, determination of the hormonal and immunologic status, cytokines state before and after the treatment were used.Results. At adenomyosis at the background of hypothyroidism were determined the changes of hypophysis and ovary function that may be caused by the increase of thyrotropic hormone (TTG), follicles stimulating hormone (FSH), luteinizing hormone (LH) and prolactin secretion. Adenomyosis, associated with hypothyroidism disturbs the cellular and humoral immunity, favors shifts in the cytokine link of immunity. At the further observation over patients of the main group, the ART extracorporal fertilization program demonstrated its more effectiveness in sterility treatment by the ozone therapy (26,7 %), comparing with the traditional treatment (16,6 %).Conclusions. The use of ozone therapy favors normalization of hormonal and immune parameters in women with adenomyosis and thyroid pathology, resulting in the increase of auxiliary reproductive technologies (ARD) effectiveness

Features endogenous intoxication in rats with galactosamined hepatitis on the background of merkazolil-induced hypothyroidism

In the article the changes of markers of endogenous intoxication in rats with liver toxicity on the background of merkazolil galactosamine-induced hypothyroidism, and investigated changes in the activity of lysosomal enzymes. It is concluded that under the experimental galactosamined hepatitis against the background of hypothyroidism is inhibition of lysosomal enzymes, which are characterized by changes in indicators of acid phosphatase and cathepsin D in liver homogenate and enhance markers of endogenous intoxication such as erythrocytic index of intoxication.

COMPLEX DISORDERS OF HEART RHYTHM AND CONDUCTIVITY IN A PATIENT WITH HYPOTHYROIDISM (CLINICAL OBSERVATION)

The article describes a clinical case of the occurrence of complex disorders of the heart rhythm and conductivity in a patient of 45 years with decompensated hypothyroidism. The literature data on specific cardiomyopathy appearing in patients with hypothyroidism (“hypothyroid heart”), metabolic, hemodynamic changes against the background of hypothyroidism and possible violations of heart rhythm and conductivity are given. In the described clinical case the patient’s medical history is given, who has been observed in an endocrinologist for hypothyroidism for the last 3 years. 6 months before this hospitalization patient stopped taking levothyroxine on her own initiative. She noticed deterioration in the last 3 months: the clinic of hypothyroidism appeared and began to grow, a frequent extrasystole appeared. At an objective survey — a symptomatology of the expressed hypothyroidism. A comprehensive examination of the patient was performed, which revealed atrioventricular blockade of the 1st degree, frequent ventricular extrasystole, prolongation of the QT interval on the ECG, late ventricular potentials against the background of low concentrations of sodium and potassium in the blood. During the first 24 hours of hospitalization, there was a clinical death. A clear positive dynamics was traced against the background of therapy aimed at the correction of electrolyte disorders, as well as hormone replacement therapy with levothyroxine.

PO-0801 Clinical And Pathogenetic Aspects Of The Delayed Psychoverbal Development In Children Of An Early Age

26 children at the age of 1.5 to 4 with delayed psychoverbal development (DPVD) without movement disorders were examined. All children were born full-term, had cerebral ischaemia of the 1st and 2nd degrees, were observed by a neurologist during the 1st year of life and were further observed according to their place of residence. The complex of examination included: video-EEG monitoring of the daytime sleep, brain MRI, transcranial dopplerography (TCDG) and consultation of a psychologist, logopedist, endocrinologist and geneticist. The data of psychological testing revealed mental retardation of a different level and character: immaturity of emotional regulation, skills of communicative behaviour and cooperative activity as well as partial delay of cognitive development against the background of general speech underdevelopment, delay of sensorimotor development (12), intellectual deficiency of cerebral-organic genesis with neurodynamic disorders (10) and traits of autistic behaviour (4). As a result of logopedist’s examination it was revealed that more than 1/3 of children had alalia, 2 children had dysarthria and 15 children had dyslalia. According to the data of video-EEG 13 children had decrease of functional lability of cortical processes, 6 children had paroxysmal activity, 2 children had epiactivity in the form of ‘peak-slow wave’ complexes, 5 children had delay in the basic rhythm formation that conformed to the presence of organicity as per the data of brain MRI in the form of periventricular gliosis and allowed to consider DPVD of cerebral-organic type. As a result of complex examination the following clinical entities were revealed: subclinical hypothyroidism (2), syndrome of cognitive epileptiform disintegration (2), autism (3), organic lesion of central nervous system (5), encephalasthenia (7) and syndrome of minimal brain dysfunction (9). The analysis of results revealed different variants of DPVD: dysontogenetic variant due to immaturity, encephalopathic variant against the background of minor organic lesion of CNS, secondary DPVD against the background of hypothyroidism that determined the initial approach and amount of therapy as well as further prognosis for the disease.

Effect of mexidol on the lipid peroxidation and antioxidant activity of saliva in patients with periodontitis at the background of hypothyroidism

Effect of mexidol on the lipid peroxidation and antioxidant activity of saliva in patients with periodontitis at the background of hypothyroidism

Особливості клініки, перебігу та лікування хворих на подагру на тлі гіпотиреозу

Метою роботи було дослідження поширеності субклінічного і маніфестного гіпотиреозу у хворих на подагру, його впливу на клініку і прояви подагри, шляхи корекції лікування шляхом введення в лікувальний комплекс левотироксину і фітокомплексу зобофіт.Матеріал і методи. Обстежено 127 хворих на подагру віком 37–77 років. Діагностику гіпотиреозу здійснювали згідно з рекомендаціями провідних вітчизняних та зарубіжних наукових центрів шляхом визначення в сироватці крові рівнів ТТГ, вільних Т4, Т3 імуноферментним методом, за потреби — антитіл до тиреоїдної пероксидази, а також УЗД щитоподібної залози, її пальпації та аналізу можливих скарг.Результати. Встановлено наявність субклінічного і маніфестного гіпотиреозу в 19,25 % серед обстежених, причому серед жінок він траплявся у 2,3 раза частіше. Обидві форми гіпотиреозу погіршують перебіг подагри, сприяють її прогресуванню, зниженню ефективності лікування і посиленню поліморбідного фону. Запропонована рання скринінг-діагностика гіпотиреозу у пацієнтів із подагрою віком понад 50–55 років або молодшого віку у випадках посилення клінічних симптомів подагри і погіршення її перебігу. Застосування в антиподагричній терапії левотироксину (маніфестний гіпотиреоз) і фітокомплексу зобофіт (субклінічна форма) покращили динаміку поліморбідного фону, показників тиреоїдного гомеостазу, ліпідного обміну і клубочкової фільтрації нирок.

Latent Autoimmune Diabetes in Adults Presenting as Diabetes “Recurrence” After Bariatric Surgery: A Case Report

Here, we describe a novel presentation of latent autoimmune diabetes in adults (LADA) involving a deterioration of glycemic control in a patient after bariatric surgery. A 43-year-old woman with a 7-year diagnosis of type 2 diabetes (T2D), treated initially with metformin and then also insulin glargine 2 years later, and a background of hypothyroidism and vitiligo was referred for bariatric surgery. Her weight was 106 kg (maximum lifetime weight 114 kg), and BMI was 35 kg/m2. HBA1c 97 mmol/mol (11%) improved to 57 mmol/mol (7.4%) with no change in weight with addition of the glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide preoperatively. After laparoscopic proximal gastric bypass (LPGB), insulin and liraglutide were discontinued. Weight loss was 29% after 6 months and 38% after 1 year; however, glycemic improvement was less than expected: HbA …

Morphofunctional Changes in the Kidneys in Chronic Endotoxemia against the Background of Hypothyroidism

We studied morphological structure of the kidneys in chronic endotoxemia modeled against the background of hypothyroidism. The detected changes did not differ from those under conditions of basic endotoxemia model and were characterized by the development of glomerulosclerosis and glomerulohyalinosis. The changes were less severe in rats with hypothyroidism and appeared at the late terms of the experiment. This indicated a moderate protective effect of preexisting thyroid hormone deficiency.