Prague, Czech Republic
Prague, Czech Republic

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Agency: European Commission | Branch: H2020 | Program: RIA | Phase: PHC-06-2014 | Award Amount: 3.38M | Year: 2015

Despite the fact that iodine deficiency (ID) can easily be prevented by iodine fortification of table salt, industrial salt and cattle food, Europe belongs to the worst regions in terms of access to iodized salt and is seriously ID, resulting in the perpetuation of the single most important, preventable cause of brain damage. European ID is due to significant heterogeneity in prevention and monitoring programs, leading to inappropriate interventions, increased disease burden, health inequities and increased health care costs. Up to 360 Million European citizens are exposed to ID disorders. An effective European monitoring program is a crucial step towards eradication of ID disorders with significant benefits for European citizens and the sustainability of health care systems. The effects of ID in total cause tremendous, preventable costs in health care systems of affected regions. The overall aim of EUthyroid is to evaluate ID prevention and monitoring programs in 24 European countries, to initiate capacity building for harmonized European ID prevention and monitoring programs, and to disseminate project outcomes for supporting measures on national and EU level in order to eradicate ID disorders in Europe. The project will position itself as international hub of current national initiatives in the attempt to coordinate and support existing national activities. EUthyroid will generate the first harmonized data set of ID resulting in the first valid map of iodine status in Europe. With a dedicated dissemination program about the unfavorable health outcomes of ID, EUthyroid will pave the way for a harmonized EU-wide regulation of iodination, a common approach to iodine and outcome monitoring and establish recommendations for scientists on how to monitor IDD prevention programs. The project aims to make Europe a benchmark for ID disorder prevention worldwide.

Vejrazkova D.,Endokrinologicky ustav
Diabetologie Metabolismus Endokrinologie Vyziva | Year: 2016

Irisine was introduced in scientific literature in 2012 as an exercise-induced myokine. In humans, its structure is identical to the murine homologue. In mice, irisin induces the formation of brown adipocytes which affect energy metabolism by increasing thermogenesis. That is why irisin became perspective as a substance that, by increasing heat production, could help in obesity treatment. This article summarizes current knowledge about irisin and critically evaluates the possibility of its use in human medicine.

Hypercalcemia associated with breast cancer arises either from metastatic bone disease or from paraneoplastic secretion of parathyroid hormone-related peptide. We report a female 69-year-old patient with invasive intraductal breast cancer and hypercalcemia (3,4 mmol/l) referred to endocrinologist. Standard care in oncology was refused and with respect to the presence of estrogenic receptors the patient accepted only antiestrogenic treatment. Bone scan revealed no skeletal metastasis. Entry laboratory exam confirmed hypercalcemia, hypophosphatemia and significantly elevated parathyroid hormone (793 ng/l). The patient complained of bone pain and dyspepsia. Neck ultrasound showed a multinodular goiter with particularly enlarged left lobe. Parathyroid gland scintigraphy revealed a possible parathyroid adenoma behind the lower pole of the left thyroid lobe. The patient underwent thyroidectomy with an excision of the parathyroid mass. Microscopic examination identified a benign adenomatous goitre and benign parathyroid adenoma. Postoperatively, both serum calcium and parathyroid hormone normalized. Replacement of calcium and vitamin D were initiated both with bisphosphonate with regard to newly diagnosed osteoporosis. This case demonstrates a patient with breast cancer and hypercalcemia unrelated to the malignant disease. Primary hyperparathyroidism should be considered as a possible cause of hypercalcemia in breast cancer patients in the setting of negative bone scan, elevated parathyroid hormone and mildly deteriorated bone mineral density.

Starka L.,Endokrinologicky ustav
Interni Medicina pro Praxi | Year: 2012

Age related decrease of testosterone levels has been established many times. Late-onset hypogonadism is accompanied by rather unspecific symptoms including vasomotor and nervous signs, disturbances of mood and cognitive function and decease and weakening of sexual functions. Guidelines from expert committees are at disposal for the examination of the hypogonadal patients, diagnosis, treatment and monitoring of the hormonal substitution. Recent guidelines underline that the adepts for testosterone reatment are only those men, in which clinical signs are accompanied by repeated subnormal levels of testosterone. The treatment should be strictly individual. Hypotestosteronemia is also present in a high deal of patient with civilisation diseases as obesity, metabolic syndrome, diabetes mellitus type 2 and cardiovascular diseases. However, until now we don't know whether hypotestosteronemia is one of the causal factors of these diseases or only their consequence.

Kalvachova B.,Endokrinologicky ustav
Pediatrie pro Praxi | Year: 2012

Although thyroid axis disorders are increasingly frequent in the population, hyperthyroidism in childhood is a rare condition. The incidence increases with age, with more than 60% of immunogenetic forms of hyperthyroidism occurring between 10 and 15 years of age, more frequently in girls. A positive family history of autoimmune thyroiditis, clinical symptoms and laboratory tests make the detection of hyperthyroidism in the first line relatively simple. Differential diagnosis, treatment and surveillance of these patients fall within the competence of a paediatric endocrinologist.

Zofkova I.,Endokrinologicky ustav
Interni Medicina pro Praxi | Year: 2012

In this review foundamental physiological and pathophysiological aspects of clacaemia regulation are mentioned. Syptomatology, consequences and treatment of hypercalcaemia, incl. hypercalcaemic cisis, are discussed. Attention is focused on primary hyperparathyroidism, which is, together with malignant diseases, the most frequent cause of hypercalcaemia (90 %). In diferential diagnosis malignant and granulomatous diseases, renal failure, endocrinopathies, effect of drugs or immobilization and benign familiar hypocalciuric hypercalcaemia (caused by inactivation mutation in calcium - sensing receptor gene) are necessary to exclude. At the end of the article the step diagnostic procedure in hypercalcaemia is outlined.

Starka L.,Endokrinologicky Ustav
Interni Medicina pro Praxi | Year: 2012

In the course of aging the hormonal regulation originating in the axis hypothalamus-pituitary-adrenals is changed. The levels of dehydroepiandrosterone (DHEA) decrease markedly, whereas cortisol secretion has tendency to increase. In such way the ratio cortisol/DHEA increases followed by a shift from anabolism to catabolism, from support of immunity processes to their partial inhibition and to the change of neurosteroid activity in the brain. Damped secretion activity is recorded also in adrenal z. glomerulosa and in the course of aging the sensitivity of aldosterone secretion to various challenges is changed. Deficit of DHEA in some limited cases can be ameliorated by supplementation with DHEA; the consequences of higher aldosterone secretion can be corrected by antimineralo-corticoid drugs as spirolactone, ACE-inhibitors or sartanes. Selectively acting anti-mineralocorticoid is not for disposition until now.

Starka L.,Endokrinologicky ustav
Casopis Lekaru Ceskych | Year: 2012

Age dependant decrease of testosterone levels leads in many men to hypogonadism called as late-onset hypogonadism. Morbidity and mortality of men with subnormal testosterone levels is higher than that of men sufficiently supplied with androgens. Cardiovascular diseases, obesity or diabetes take often part in these events. Low testosterone level is risk factor for these diseases. However, it is until now not clear whether testosterone deficiency is a cause or consequence of atherosclerosis or metabolic syndrome. A handful of symptoms and metabolic parameters present in hypogonadal men can be ameliorated by testosterone supplementation. Testosterone has a beneficial effect on cardiovascular risk factors, but it is not clear whether it can reduce mortality.

Iodine is an essential element and a component of thyroid hormones triiodothyronine (T3) and tetraiodothyronine (thyroxine – T4). Thyroid hormones are potent regulators of energetic metabolism and differentiation. Its reservoir is seawater; lack of iodine (iodopenia) is frequent in continental regions. Consequences of iodopenia affect the entire organism. Sufficient intake of iodine for adult persons is over 150µg/ daily (for pregnant women 250µg/ daily). Criteria for evaluation of iodine saturation are as follows: concentration of iodine in urine (ioduria), prevalence of goitre, thyroglobulin level and parameters of thyroid function. The Czech Republic is a region of iodine deficiency. A complete programme of iodine supplementation can compensate this defect and therefore, according to WHO criteria, the CR is considered as a country with compensated iodine deficiency. The effects of increased iodine intake on thyroid autoimmunity are still questionable. The current trend in reduced consumption of salt, as part of the prevention of cardiovascular disease, may be a risk factor for iodine saturation that should be systematically monitored in order to prevent its decrease and its possible negative effects on intelligence and general quality of population. © 2015, Ambit Media a.s. All rights reserved.

Dvorakova M.,Endokrinologicky ustav
Pediatrie pro Praxi | Year: 2015

Thyroid associated orbitopathy is a chronic eyes disease associated with autoimmune reaction against the thyroid gland. Chronic inflammation affectes all orbital structures- orbital fat and connective tissue, extraocular muscles, tear glands and orbital septum. Increasing orbital volume cases eye replacement, disorder of the venous outflow and causes changes of the muscle elastic properties which in turn start pulling the eyeball backwards. The patients with Graves-Basedow tyreotoxikosis are most often occured, less in the chronic autoimmune thyroiditis. Incidence of the thyroid associated orbitopathy isn't so frequent in children as in adults, the forms aren't so serious. Prompt and correct diagnosis, quick arrangement of the thyroid gland function, assessment of the activity and seriousness of Graves orbitopathy and correct therapy is essential for other prognosis in children. A complex approach is for treating EO necessary. The European Group of Graves' Orbitopathy (EUGOGO) recommends that patiens should be treated in specialized centres.

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