¿Qué es la Hashitoxicosis?

alexandrossfakianakis shared this article with you from Inoreader ¿Qué es la Hashitoxicosis? via Cuida tu tiroides La tiroiditis de Hashimoto es la patología tiroidea más frecuente. Se presenta mucho más frecuentemente en mujeres y puede aparecer a cualquier edad. Es una inflamación crónica autoinmune, generalmente indolora, caracterizada por una infiltración linfocitaria de la glándula tiroidea, parcial o total. La función tiroidea puede no verse alterada o puede producirse una disminución de la misma (hipofunción tiroidea), y se caracteriza por la presencia de anticuerpos antiperoxidasa (anti-TPO) y/o anti-tiroglobulina (anti-Tg). En este tipo de tiroiditis se puede desarrollar un hipotiroidismo de forma lenta y generalmente progresiva. Excepcionalmente algunos pacientes desarrollan una presentación clínica y bioquímica de hiperfunción tiroidea, desarrollando hipertiroidismo, cuadro conocido como "Hashitoxicosis". Se puede definir como una enfermedad mixta, caracterizada por tirotoxicosis, gran aumento sérico de anticuerpos antitiroideos y presencia de hiperplasia-hipertrofia (aumento de volumen) folicular e infiltración linfocítica. ¿Por qué algunas personas con tiroiditis de Hashimoto tienen Hashitoxicosis? En pacientes con diagnóstico de tiroiditis de Hashimoto, la incidencia es escasa (5-10%), si bien es cierto que la alteración bioquímica no viene acompañada claramente de una clínica de hiperfunción tiroidea y la clínica puede pasar desapercibida. La Hashitoxicosis es un cuadro de hipertiroidismo que se presenta generalmente en pacientes con o sin diagnóstico previo de tiroiditis de Hashimoto, que confunde muchas veces el diagnóstico por su similitud con un brote de Enfermedad de Graves – Basedow. De hecho, las características clínicas de hiperfunción tiroidea no varían. El tamaño del bocio suele ser evidente y con más dureza a la palpación, y a nivel bioquímico no difiere en cuanto al nivel de anticuerpos antitiroideos, pero se diferencia de la enfermedad de Graves en que las personas no tendrán niveles elevados de anticuerpos antirreceptor de TSH (TSI). ¿Cuál es la causa del hipertiroidismo derivado de la Hashitoxicosis en la tiroiditis de Hashimoto? En este caso el hipertiroidismo no es causado por el estímulo de TSH sobre la liberación de hormonas tiroideas como ocurre con la enfermedad de Graves, sino que es producido por la liberación de las hormonas tiroideas contenidas en los folículos que se han destruido. De ahí que el cuadro generalmente sea de corta duración y muchas veces autolimitado. Muchas veces el diagnóstico de la Hashitoxicosis es tardío y sobre todo debido a una hiperrespuesta al tratamiento con medicamentos antitiroideos en un paciente inicialmente diagnosticado de enfermedad de Graves, por eso es importante hacer una buena valoración clínica inicial que incluya determinación de anticuerpos antirreceptor de TSH (TSI). ¿Hay que tratar la Hashitoxicosis? El tratamiento con fármacos antitiroideos es pocas veces necesario, porque el cuadro suele ser transitorio y se indica porque la clínica lo aconseja. Debe valorarse al paciente a corto plazo por el riesgo de hipotiroidismo yatrógeno (hipotiroidismo inducido por medicación). Lo más aconsejable es mantener al paciente con un betabloqueante. Durante la fase aguda de la tirotoxicosis, los betabloqueantes pueden ser útiles. La Hashitoxicosis generalmente precede a un cuadro de hipofunción tiroidea que requerirá tratamiento sustitutivo permanente con hormonas tiroideas. Si te ha gustado este artículo, quizá te interese leer: ¿Puede la Tiroiditis de Hashimoto tener complicaciones? Dieta para la Tiroditis de Hashimoto: Qué alimentos comer o evitar Hinchazón en el cuello: causas y síntomas La entrada ¿Qué es la Hashitoxicosis? se publicó primero en Cuida tu tiroides. View on Web

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Hiperparatiroidismo: Todo lo que debes saber

alexandrossfakianakis shared this article with you from Inoreader Hiperparatiroidismo: Todo lo que debes saber via Cuida tu tiroides ¿Qué es el hiperparatiroidismo? Las glándulas paratiroideas, generalmente en número de 4 o 5, son pequeñas glándulas situadas en la parte posterior de la glándula tiroides. Son independientes del mismo pero muchas veces están incrustadas dentro del tejido tiroideo. Segregan la hormona paratiroidea (PTH), que junto con la vitamina D, es esencial para mantener el equilibrio fosforo-calcio de forma constante, y así tener una buena salud ósea y un buen funcionamiento del sistema nervioso y muscular. El hiperparatiroidismo (HPT) se define como un exceso de secreción de la hormona paratiroidea (PTH). Es una patología frecuente, que afecta más a mujeres y su incidencia se incrementa con la edad a partir de la menopausia. La presencia en un paciente joven o de antecedentes familiares obliga a descartar una patología genética asociada. Tipos de Hiperparatiroidismo Existen dos tipos de hiperparatiroidismo: 1.Hiperparatiroidismo primario. Es debido a la hipersecreción autónoma de PTH por una glándula paratiroidea (adenoma paratiroideo), o varias glándulas (hiperplasia paratiroidea). Las lesiones son generalmente benignas. La presencia de un carcinoma paratiroideo es excepcional. La mayoría de las veces el HPT es esporádico, pero existen casos familiares de HPT aislados o asociados a otras patologías genéticas endocrinológicas (denominadas MEN), que coexisten con otras glándulas afectadas (hipófisis, suprarrenales, islotes pancreáticos u hormonas digestivas). 2.Hiperparatiroidismo secundario. Se produce por la respuesta secretoria de las glándulas paratiroideas a una disminución de la calcemia, lo que secundariamente provoca la hipersecreción de PTH para mantener la homeostasis de calcio-fósforo. Las causas más frecuentes de HPT secundario son: Deficiencia de Vitamina D cuya acción principal es favorecer la absorción del calcio intestinal. Se precisa una deficiencia severa de vitamina D para que se produzca un estímulo secundario de la hipersecreción de PTH por las glándulas paratiroideas. El déficit poblacional de vitamina D es cada vez más frecuente por baja exposición solar o por baja ingesta oral. Hipocalcemia secundaria a baja ingesta de calcio o alteración de la absorción del mismo como consecuencia de cirugías abdominales con resecciones intestinales. Insuficiencia renal crónica (IRC): La IRC se asocia a una disminución de la hidroxilación renal de Vit D, así como hipocalcemia y secundariamente a una elevación de los niveles de PTH para mantener el equilibrio calcio-fósforo. La insuficiencia renal crónica es la causa más frecuente de HPT secundario y causa a su vez del HPT terciario que provoca una hipercalcemia causada por la secreción de PTH excesiva y autónoma en un paciente con HPT secundario. ¿Cuáles son los síntomas del Hiperparatiroidismo? La mayoría de las veces, el diagnóstico del HPT, se realiza de forma casual observando una hipercalcemia en una analítica de rutina y suele ser asintomático en los estadios iniciales. Como es una enfermedad de desarrollo lento, los síntomas dependen del daño orgánico que provoca la hipercalcemia (cólicos renales secundarios a litiasis cálcica, dolores articulares por daño óseo y síntomas derivados de la osteoporosis, incluso mayor incidencia de fracturas e hipertensión arterial). ¿Cómo se trata el Hiperparatiroidismo? El HPT primario se trata generalmente con intervención quirúrgica del adenoma si es localizado con técnicas de imagen. La indicación de cirugía además de la localización se realiza en base a criterios clínicos como nivel de calcemia, presencia de osteoporosis y presencia de otras complicaciones. Cuando existe hiperplasia o las condiciones del paciente impiden la cirugía podemos recurrir a opciones de tratamiento médico. En el HPT secundario requiere controlar la causa como la suplementación de Vitamina D cuando hay déficit, aporte de calcio cuando hay déficit o tratamiento específico en el paciente con IRC, que incluso puede llegar a cirugía de glándulas paratiroides cuando se produce un HPT terciario. Si te ha gustado este artículo, quizá te interese leer: Hipocalcemia después de operación de tiroides Pérdida de peso involuntaria: causas ¿Qué es el test de supresión tiroidea? La entrada Hiperparatiroidismo: Todo lo que debes saber se publicó primero en Cuida tu tiroides. View on Web

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Tracking down the recent surge of polio virus in endemic and outbreak countries.

alexandrossfakianakis shared this article with you from Inoreader Tracking down the recent surge of polio virus in endemic and outbreak countries. via Journal of Medical Virology Abstract Continuous and progressive efforts are being made globally to eradicate the incidence of polio virus. The detrimental nature of polio calls for action of global vaccination. Owing to large scale vaccination efforts, many countries have been declared polio-free and the people are fully vaccinated against polio virus. However, concern still remains as new cases are being identified in countries declared polio free. This scenario is particularly noticed due to the comprised healthcare system in the past three years of the Corona pandemic. Conditions for lower middle income countries are more problematic, where there are meager healthcare resources and the burden on the healthcare system is higher. Studies indicate some cases of non-paralytic species of polio including cVDPV1, cVDPV2, and cVDPV3 in the group of outbreak countries. However, the major problem is associated with wild type polio virus i.e. WPV1 that leads to paralytic disease and is still present in endemic countries, such as Afghanistan and Pakistan. The incidence rate of wild polio cases has significantly decreased in comparison to the past years but the problem needs to be dealt with at the grass-roots level. In this article, the most recent data has been collected pertaining to the incidence of multi-variant species of polio virus, with a special focus on endemic and outbreak countries. A short overview of challenges to vaccination and a recommendatory overview has also been included for dealing with polio surges. This article is protected by copyright. All rights reserved. View on Web

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Exploring Patient's Preference of Patient‐Reported Outcome Measures in Laryngeal Movement Disorders

alexandrossfakianakis shared this article with you from Inoreader Exploring Patient's Preference of Patient‐Reported Outcome Measures in Laryngeal Movement Disorders via The Laryngoscope Background Despite many available patient-reported outcome measures (PROMs) for laryngeal movement disorders, there is a lack of patient input regarding which PROM most accurately and conveniently captures aspects related to their vocal disease. This study aimed to assess patients' preferences among a selection of voice-related PROMs (Voice Handicap Index-10 [VHI-10], OMNI-Vocal Effort Scale [OMNI-VES], Communicative Participation Item Bank-General Short Form [CPIB-10], and Visual Analog Scales [VAS]) within the laryngeal movement disorder population and investigate associations between selected instruments. Methods Prior to botulinum toxin A injection, patients with laryngeal dystonia and/or essential tremor of the vocal tract were administered the VHI-10, OMNI-VES, CPIB-10, and three novel VAS questions in a randomized order. Patients rank ordered the four PROMs based on the PROMs' reflection of their voice problems. Pearson's correlation coefficients evaluated pairwise associations among PROM scores. Fisher's exact test compared the preferred PROM rankings. Results Seventy patients (53 female, mean age = 60.7 years) participated. The VHI-10 and CPIB-10 were most preferred at 33.9% and 27.4% respectively. The OMNI-VES and VAS scales were less favored (19.4%, each). When analyzed by age ≥60 years, the CPIB-10 was most favored (33.3%), but for age <60 years, VHI-10 was most preferred (42.3%). There was a strong correlation between scores of all administered PROMs (strongest correlation between OMNI-VES and VAS, r = 0.8, p < 0.001; the weakest correlation between OMNI-VES and VHI-10, r = 0.6, p < 0.001). Conclusions With an increasing trend in PROMs usage and a strong correlation between all evaluated outcome instruments, insight regarding patients' PROM preferences is an area for further consideration. Level of Evidence N/A Laryngoscope, 2022 View on Web

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“Alexa, lock my front door”: An empirical study on factors affecting consumer's satisfaction with VCA‐controlled security devices

alexandrossfakianakis shared this article with you from Inoreader “Alexa, lock my front door”: An empirical study on factors affecting consumer's satisfaction with VCA‐controlled security devices via Psychology & Marketing Abstract Voice conversation agents (VCAs) have moved beyond simple tasks such as information gathering. The integration of VCAs in smart technologies for security has grown in the consumer market. This paper investigates consumers' motivation to use smart technologies controlled by voice conversational agents and how that impacts their perceived hedonic and utilitarian value, which eventually leads to their satisfaction with smart technologies usage. Two cross-sectional studies and a netnography were conducted. The findings showed that the variables measuring technology acceptance mediate the relationship between consumers' motivation and the perceived value of the VCA-controlled smart technologies. Study 1 results show that ease of use and usefulness of the VCA-controlled smart technologies have a more substantial mediating effect between motivation and hedonic value than utilitarian value. For study 2, results show that the mediators had a stronger influence on hedonic and utilitarian va lues for outdoor voice conversational agent-controlled smart technologies than indoor smart technologies. Study 3 showed that smart technologies have both risks and benefits and depend on whether they are being used for themselves or others. The results suggest that marketers need to consider consumer's emphasis on the products' features including its ease of use and usefulness, and strategically complement it with consumers' prevention and promotion focus for each product. View on Web

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Selenium ameliorates inflammation by decreasing autophagic flux and mitogen‐activated protein kinase signalling on experimentally induced rat periapical lesions

alexandrossfakianakis shared this article with you from Inoreader Selenium ameliorates inflammation by decreasing autophagic flux and mitogen‐activated protein kinase signalling on experimentally induced rat periapical lesions via International Endodontic Journal Abstract AIM To reveal the molecular mechanisms that targets mitogen-activated protein kinase (MAPK) signalling and the autophagic flux and to investigate the possible effects of the systemic administration of selenium (Se) on experimentally induced rat periapical lesions. METHODOLOGY Thirty adult Sprague Dawley rats were divided equally into negative control, positive control and Se groups. In the positive control and Se groups, the pulp chambers of their mandibular first molars were exposed to the oral environment to induce periapical lesions The Se group received daily intraperitoneal injections of Se at a dose of 0.1 mg kg−1. After 28 days, the amount of bone destruction; severity of inflammation; penetration of microorganisms along the root canal; collagen degradation in periodontal ligament; interleukin (IL)-6, hypoxia-inducible factor-1 (HIF-1), cyclooxygenase-2 (COX-2) and caspase-3 expression; autophagic flux; and p38 MAPK signalling were evaluated using radiographic, histopathological, Gram staining, picrosirius red stain, immunohistochemical, quantitative real-time polymerase chain (qRT–PCR) and western blot methods, respectively. The data was analysed through the Kruskal–Wallis and Dunnett's tests (p<0.05). RESULTS The area of radiographic periapical bone loss, histopathological scores, the area of periapical bone loss and the scores for the bacteria localisation, the intensity of immunohistochemical staining for IL-6, HIF-1, COX-2 and caspase-3 in the Se group was significantly less than those of the positive control group (p<0.01). The mRNA expression levels of Beclin-1, Atg3, Atg5, Atg7, and Atg16L1 were lower in the Se group than in the positive control group (p<0.01). The protein expressions of Beclin-1, Atg5 and LC3-II, the phosphorylation ratio of the p38 MAPK and the ratios of LC3II/LC3I were significantly higher (p<0.05) in the positive control and Se groups. On the other hand, the expression of the p62/SQSTM1 protein was significantly lower (p < 0.05) in the positive control and Se groups than in the negative control group. CONCLUSION The induction of periapical lesions in rats increased autophagic flux and activated p38 MAPK signal transduction processes. Se suppressed the inflammatory process, reduced bone destruction and both the autophagic flux and p38 MAPK activation. View on Web

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A congenital CSF3R mutation in chronic neutropenia reveals a vital role for a cytokine receptor extracellular hinge motif in the response to granulocyte colony‐stimulating factor

alexandrossfakianakis shared this article with you from Inoreader A congenital CSF3R mutation in chronic neutropenia reveals a vital role for a cytokine receptor extracellular hinge motif in the response to granulocyte colony‐stimulating factor via Pediatric Blood & Cancer Abstract We describe a patient with congenital neutropenia (CN) with a homozygous germline mutation in the colony-stimulating factor 3 receptor gene (CSF3R). The patient's bone marrow shows lagging neutrophil development with subtle left shift and unresponsiveness to CSF3 in in vitro colony assays. This patient illustrates that the di-proline hinge motif in the extracellular cytokine receptor homology domain of CSF3R is critical for adequate neutrophil production, but dispensable for in vivo terminal neutrophil maturation. This report underscores that CN patients with inherited CSF3R mutations should be marked as a separate clinical entity, characterized by a failure to respond to CSF3. View on Web

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Biocompatibility and bioactive potential of an experimental tricalcium silicate‐based cement in comparison with Bio‐C Repair and MTA HP Repair materials

alexandrossfakianakis shared this article with you from Inoreader Biocompatibility and bioactive potential of an experimental tricalcium silicate‐based cement in comparison with Bio‐C Repair and MTA HP Repair materials via International Endodontic Journal Abstract Aim To evaluate the tissue reaction of a tricalcium silicate-based repair material associated with 30% calcium tungstate (TCS + CaWO4) in comparison to Bio-C Repair (Bio-C; Angelus, Brazil) and to MTA Repair HP (MTA HP; Angelus, Brazil). Methodology Polyethylene tubes filled with one of the materials or left empty (control group, CG) were implanted into the subcutaneous tissues of rats for 7, 15, 30 and 60 days (n = 32/group). The capsule thickness, number of inflammatory cells, collagen content, interleukin-6 (IL-6), osteocalcin (OCN), von Kossa reaction and analysis under polarised light were evaluated. The data which were subjected to generalised linear models for repeated measures, except the OCN. OCN data were submitted to Kruskal-Wallis and Dunn's post hoc test, and Friedman followed by Nemenyi's test at significance level of 5%. Results At all time points, significant differences in the number of inflammatory cells were not observed between TCS + CaWO4 and Bio-C whereas, at 15, 30 and 60 days, no significant difference was detected between TCS + CaWO4 and MTA HP. At all periods, significant differences were not detected in the number of fibroblasts in TCS + CaWO4 versus MTA HP and, at 60 days, no significant difference was demonstrated between these groups and CG. Significant differences in the immunoexpression of IL-6 were not detected among bioceramic materials at all periods. From 7 to 60 days, significant reduction in the number of inflammatory cells, number of IL-6-immunopositive cells and in the capsule thickness was accompanied by significant increase in the collagen in all groups. OCN-immunolabelled cells, von Kossa-positive structures and amorphous calcite deposits were observed around all materials whereas, in the CG, these structures were not seen. Conclusions These findings indicate that the experimental material (TCS + CaWO4) is biocompatible and has a bioactive potential, similarly to the MTA HP and Bio-C Repair, and suggest its use as a root repair material. View on Web

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Survey the effect of drug treatment on modulation of cytokines gene expression in Allergic Rhinitis

alexandrossfakianakis shared this article with you from Inoreader Survey the effect of drug treatment on modulation of cytokines gene expression in Allergic Rhinitis via Fundamental & Clinical Pharmacology Abstract Allergic rhinitis as common airway disease has high prevalence in all peoples worldwide. In allergic diseases, Th2 cells release type 2 cytokines which support the inflammation in airways. All the drugs used for allergic rhinitis, do not cure completely, and the choice of drugs according to cost and efficacy is very important in all groups of atopic patients. Therefore, in this study, the effect of commercial drugs on cytokine gene expression has been studied. Male Balb/c mice were divided into six groups. Allergic rhinitis was induced in five of the six groups with ovalbumin, and four of these five groups were treated with salbutamol, budesonide, theophylline and montelukast. The 5th group was used as positive control group and the 6th group as negative control group. For the survey, RNA was extracted, cDNA was synthesized, and quantitative real time PCR was done for 21 genes. The four drugs had different effect on mRNA expression of cytokines (IL-1b, 2, 4, 5, 7, 8, 9, 11, 12, 13 , 17, 18, 22, 25, 31, 33, 37, IFN-γ, TNF-α, TGF-β1 and Eotaxin) in the allergic rhinitis groups. Salbutamol can be used during pregnancy and breastfeeding, but it has some side effects. Budesonide in the inhaled form is generally safe in pregnancy. Theophylline cannot control allergic attack in the long run. Montelukast is not useful in the treatment of acute. Immunomodulatory and anti-inflammatory effects of drugs in control of allergic rhinitis via Th2 cytokines can be new approaches in molecular medicine. View on Web

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Deep-learning-based automatic facial bone segmentation using a two-dimensional U-Net

alexandrossfakianakis shared this article with you from Inoreader Deep-learning-based automatic facial bone segmentation using a two-dimensional U-Net via International Journal of Oral and Maxillofacial Surgery via MedWorm.com In this study, a U-Net was used to investigate the automatic segmentation of facial bones into eight areas, with the aim of facilitating virtual surgical planning (VSP) and computer-aided design and manufacturing (CAD/CAM) in maxillofacial surgery. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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