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Objective:Endogenous subclinical hyperthyroidism (eSCH) is defined by subnormal serum thyroid-stimulating hormone (TSH) level. There is limited evidence of metabolic changes induced by eSCH. The aim of our work was to evaluate changes in BMI and lipid parameters after radioiodine treatment in patients with grade 1 (TSH: 0.1–0.39 mlU/L) and 2 (TSH <0.1 mlU/L) eSCH. Design:A retrospective study was performed on 74 patients with eSCH caused by benign autonomous nodular goiter which was treated with radioiodine. Methods:We assessed BMI, lipids parameters, and TSH after radioiodine therapy. The 12-month follow-up time point was used to compare the primary outcome variables. TSH was measured by the electrochemiluminescence method. Results:After radioiodine therapy, the absolute and relative increases in BMI at 12 months were significantly higher in the grade 2 group than in the grade 1 group (1.07 ± 0.27 kg/m2 vs. 0.26 ± 0.15 kg/m2, respectively; p= 0.023 and 4.01 ± 0.98% vs. 1.01 ± 0.56%, respectively; p= 0.026). Compared to baseline, significant increases in the levels of total cholesterol and LDL were observed after treatment in the grade 2 eSCH group (16.7 ± 4.5 mg/dL p< 0.01 and 14.3 ± 4.1 mg/dL p< 0.01, respectively) but not in the grade 1 group. In a multivariate model, a negative correlation was observed between pretreatment TSH levels and absolute BMI gain (p< 0.01). Conclusions:After correction of eSCH, increases in BMI and LDL levels were observed only in patients with grade 2 eSCH. Pretreatment serum TSH was the main independent factor associated with BMI changes after radioiodine treatment.

Las tesis son el primer acercamiento riguroso a la investigación realizado por los estudiantes bajo la dirección de un tutor experimentado; a pesar de los hallazgos valiosos encontrados en estas, pocas llegan a ser publicadas. El presente estudio tiene como objetivo determinar la prevalencia y los factores asociados a la publicación de tesis sustentadas en un pregrado.

El transcurso del envejecimiento altera las etapas del sueño, y las personas mayores que consultan por este problema tienden a recibir tratamiento farmacológico, lo cual a largo plazo causa efectos secundarios y elevados costos en salud. En cambio, la práctica de ejercicio físico pudiese ser una alternativa, la cual tiene efectos multifactoriales, bajo costo y es accesible. Además estos beneficios podrían extrapolarse a la calidad del sueño. Por esto, el objetivo de esta revisión es determinar la dosificación de ejercicio físico a través del principio frecuencia, intensidad, tiempo y tipo de ejercicio y su efecto en la calidad de sueño, insomnio y somnolencia diurna en personas mayores. Esto generaría un cambio de paradigma en el tratamiento de los trastornos del sueño y ser una alternativa en el tratamiento de las personas mayores.

La tasa de error anti-sacádico (AS) se utiliza como un medio diagnóstico para alteraciones neurológicas. El proceso natural del envejecimiento podría generar dificultad para realizar procesos paralelos neurales de inhibición motora y movimiento ocular consciente. Por lo tanto, si se le impone a una persona mayor el control del balance en posiciones bípedas durante un movimiento AS es esperable un aumento de la tasa de errores AS.

Context:Relatively low radioiodine uptake (RAIU) represents a common obstacle for radioiodine (131I) therapy in patients with multinodular goiter complicated by hyperthyroidism.Objective:To evaluate whether thiamazole (MTZ) pretreatment can increase 131I therapeutic efficacy.Design and Setting:Twenty-two patients with multinodular goiter, subclinical hyperthyroidism, and RAIU < 50% were randomized to receive either a low-iodine diet (LID; n = 10) or MTZ 30 mg/d (n = 12) for 42 days. Thyroid function and 24-hour RAIU were measured before and after treatment. Thyroid volume was evaluated by either magnetic resonance imaging or single photon emission computed tomography.Results:Mean 24-hour RAIU increased significantly from 32 ± 10% to 63 ± 18% in the MTZ group (P< .001). Consequently, there was a 31% decrease in the calculated median therapeutic 131I activity after MTZ (P< .05). No significant changes in 24-hour RAIU were observed after diet. In the MTZ group, median serum TSH levels increased significantly by 9% and mean serum free T4and free T3concentrations decreased by 22% and 15%, respectively, whereas no changes in thyroid function were observed in the LID group. Thyroid volume did not significantly change in either of the two groups. At 12 months after radioiodine treatment, median serum TSH was within the normal range in both groups.Conclusions:MTZ treatment before 131I therapy resulted in an average 2-fold increase in thyroid RAIU and enhanced the efficiency of radioiodine therapy assessed at 12 months. MTZ pretreatment is therefore a safe, easily accessible alternative to recombinant human TSH stimulation and a more effective option than LID.

Vitamin D deficiency (VDD) is associated with an increased cardiovascular risk. We investigated the effect of VDD on the cardiovascular system of growing male rats fed with a vitamin D-deficient diet. Using isolated rat aorta, we assessed both superoxide anion and endothelial-dependent relaxations. Microarray technology was used to identify changes induced by VDD in cardiac gene expression. Compared with control, VDD increased systolic blood pressure (P< 0.05) and superoxide anion production in the aortic wall (P< 0.05) and tended to increase serum levels of angiotensin II and atrial natriuretic peptide (P< 0.15). However, VDD slightly improved maximal relaxation to acetylcholine from 75 % ± 3% to 83% ± 2% (P< 0.05). Incubation of aortic rings either with nitro-l-arginine methyl ester (l-NAME) or catalase did not eliminate the enhancement of endothelial-mediated relaxation observed in vitamin D-deficient rats. Only incubation with indometacin or calcium-activated potassium channels blockers suppressed this difference. Compared with control, the expression of 51 genes showed different expression, including several genes involved in the regulation of oxidative stress and myocardial hypertrophy. In conclusion, VDD in early life increases arterial blood pressure, promotes vascular oxidative stress, and induces changes in cardiac gene expression. However, the endothelial-mediated regulation of vasomotor tone is maintained throughout the enhancement of an NO-independent compensatory pathway.

Registers of diagnoses and treatments exist in different forms in the European countries and are potential sources to answer important research questions. Prevalence and incidence of thyroid diseases are highly dependent on iodine intake and, thus, iodine deficiency disease prevention programs. We aimed to collect European register data on thyroid outcomes to compare the rates between countries/regions with different iodine status and prevention programs.Register-based cross-sectional study.National register data on thyroid diagnoses and treatments were requested from 23 European countries/regions. The provided data were critically assessed for suitability for comparison between countries/regions. Sex- and age-standardized rates were calculated.Register data on ≥1 thyroid diagnoses or treatments were available from 22 countries/regions. After critical assessment, data on medication, surgery, and cancer were found suitable for comparison between 9, 10, and 13 countries/regions, respectively. Higher rates of antithyroid medication and thyroid surgery for benign disease and lower rates of thyroid hormone therapy were found for countries with iodine insufficiency before approx. 2001, and no relationship was observed with recent iodine intake or prevention programs.The collation of register data on thyroid outcomes from European countries is impeded by a high degree of heterogeneity in the availability and quality of data between countries. Nevertheless, a relationship between historic iodine intake and rates of treatments for hyper- and hypothyroid disorders is indicated. This study illustrates both the challenges and the potential for the application of register data of thyroid outcomes across Europe.

New and potent immunosuppressive regimens allow for reduced doses of corticosteroids after renal transplantation. The aims of our study were to investigate whether the use of low-dose corticosteroids is associated with a reduction in posttransplant bone loss and to assess the ability of cholecalciferol supplementation to further decrease bone loss in this setting.

Although the importance of selenium for bone metabolism is unknown, some clinical conditions such as Kashin‐Beck osteoarthropathy have been associated with selenium deficiency. Although selenium deficiency induces growth retardation in rats, it has not been established whether this growth inhibition is associated with changes in bone metabolism. We investigated the effect of selenium deficiency on bone metabolism in growing male rats fed a selenium‐deficient diet for two generations (Se−). In Se− rats, erythrocyte glutathione peroxidase activity and plasma selenium concentration were strongly reduced compared with pair‐fed selenium‐adequate rats (Se+). Weight and tail length were reduced by 31% and 13% in the Se− rats, respectively (p< 0.001). The Se− diet was associated with a 68% reduction of pituitary growth hormone (GH; p= 0.01) and a 50% reduction of plasma insulin‐like growth factor I (IGF‐I; p< 0.001). Plasma calcium was lower and urinary calcium concentration was greater in Se− rats. This group had a 2‐fold increase in parathyroid hormone (PTH) and 1,25‐dihydroxyvitamin D3[1,25(OH)2D3] in plasma. Plasma osteocalcin and urinary deoxypyridoline were reduced by 25% and 57% in the Se− rats (p< 0.001). Selenium deficiency resulted in a 23% and 21% reduction in bone mineral density (BMD) of the femur and tibia (p< 0.001) and this effect persisted after adjustment for weight in a linear regression model. A 43% reduction in trabecular bone volume of the femoral metaphysis (p< 0.001) was found in Se− rats. This experimental study shows that growth retardation induced by selenium deficiency is associated with impaired bone metabolism and osteopenia in second‐generation selenium‐deficient rats.

A 60-year-old men was admitted mid-January for acute left abdominal pain. He had no medical history and didn’t smoke or take any medication. Abdominal CT-scan showed a voluminous (61×57×47mm), heterogeneous, hemorrhagic mass in left adrenal gland with a high spontaneous density (45UH). Pheochromocytoma diagnosis was first suspected although 24-hours urine fractionated metanephrines and catecholamines measurements were only slightly increased (NA:1.1xULN and NMN:1.2xULN). Hormonal evaluation did not demonstrate excessive cortisol or sexual steroids secretion. 18F-FDG PET-CT imaging revealed intense FDG-uptake in the left adrenal gland as well as in the right adrenal gland and in the heart. With this new information, the differential diagnosis includes carcinoid cardiac tumor, malignant cardiac myxoma, sarcoma and metastases. All others tumor markers were negative (5HIAA, NSE, CA 19-9, CA 125, CEA, PSA, β-hCG). For Valentine's Day, cardiac MRI confirmed a pathological thickening of right inter-atrioventricular groove with marked late enhancement at this level, corresponding to pathological areas in isotopic imaging. Next day, patient presented acute right flank pain similar to the one he had on left side one month earlier. New abdominal CT-scan showed a large hemorrhage in right adrenal gland that was not present on 18F-FDG PET-CT performed 3 days before. Latest Ga-DOTATATE-PET imaging didn’t show anywhere STT-receptors presence. Morning cortisol level (411 nmol/L) remained non-suggestive of adrenal insufficiency. This case was discussed by web-conference with the French experts of the national COMETE multidisciplinary committee: it was decided to obtain histology from left adrenal tumor by percutaneous biopsy rather than by unilateral adrenalectomy because the radicality of surgery might change depending on histological diagnosis. So far, diagnosis has not yet been established. This case underlines importance of discussing complex situations with experts as allowed by COMETE or ENDO-ERN networks.

•Gonadal maturation and spawning in winter months finally achieved.•An increase in temperature would be the cue for triggering ovarian development.•Thermic control could be the key to the production of juveniles year-round.•Non-invasive reproduction control methods are promising for native species conservation.•This study contributes to reproduction control on subtropical and temperate palaemonids.

Fertrin: Agios Pharmaceuticals, Inc.: Research Funding.

La dysplasie micronodulaire pigmentée des surrénales (PPNAD) est une cause rare (<1 %) de syndrome de Cushing ACTH indépendant.