Metabolism and Internal Medicine

Anderson, United States

Metabolism and Internal Medicine

Anderson, United States
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Rajewska J.,Poznan University of Medical Sciences | Lacka K.,Metabolism and Internal Medicine | Stawny B.,Gastroenterological and Endocrinological Surgery
Polski Merkuriusz Lekarski | Year: 2010

Patient with primary hyperparathyroidism and papillary thyroid cancer was presented. The female patient, 45 years old, because of papillary thyroid cancer was treated in the typical way by total stru-mectomy with lymphadenectomy following by 1131 therapy and L-thyroxine suppressive therapy. After 9 years, during one of control routine examinations, the serum levels of calcium and parathormone were increased (Ca2+: 1.449 mmol/l; Ca: 2.91 mmol/l; PTH: 256 pg/ml). Primary hyperparathyroidism was diagnosed and the patient underwent the surgery in the anterior cervical region with removal of parathyroid adenoma, histopathologically confirmed. Serum PTH level together with calcium levels decreased into the normal range. The coexistence of primary hyperparathyroidism and thyroid non-medullary cancer was already reported, but in this case the time of the onset was delayed. Due to the fact that patients after the treatment of thyroid non-medullary cancer, especially after of the neck radiation or radioactive iodine therapy, are more exposed to develop hyperparathyroidism, complete and wide examinations, even many years after treatment of thyroid cancer, are needed.

PubMed | Metabolism and Internal Medicine, Medical University of Warsaw and Poznan University of Medical Sciences
Type: | Journal: Therapeutics and clinical risk management | Year: 2016

This study aims to explore and compare the efficacy of radioiodine treatment (RIT) in hyperthyroid and euthyroid patients who have been treated with amiodarone (AM) in the past or are currently undergoing AM treatment. Clinical observation of a group of patients with amiodarone-induced hypothyroidism during a 12-month follow-up period was used for comparison.This was a observational, two-centered study. Patients were assessed at baseline and at 2 months, 6 months, 8 months, and 12 months after RIT.Group A: At baseline (61 males [M] and 17 females [F], mean age 5019 years), there were 78 euthyroid patients with cardiac arrhythmias, who were treated with AM and developed amiodarone-induced thyrotoxicosis, and currently require retreatment with AM. Group B: Hyperthyroid patients (92 M and 26 F, mean age 7211.8 years) after AM therapy in the past. Group C: Hyperthyroid patients (66 M and 13 F, mean age 63.913.2 years) currently treated by AM. Group D: Hypothyroid patients (6 M and 16 F, mean age 61.410.4 years) after AM therapy. The patients from Groups A, B, and C were retreated with AM after ~3-6 weeks of RIT.In Group A, after 12 months of RIT therapy, recurrent thyrotoxicosis was observed in six (7.7%) cases, and persistent hypothyroidism was diagnosed in 42 (53.8%) cases. In Group B, hyperthyroidism occurring during treatment with AM was found in 40 (33.9%) patients, and permanent hypothyroidism was observed in eleven (12.5%) cases. After annual follow-up in Group C, nine (11.4%) patients were diagnosed with hypothyroidism, while 27 (34.1%) patients were diagnosed with hyperthyroidism. In Group D, all patients had permanent hypothyroidism and when the concentration of serum thyroid-stimulating hormone was >10 IU/mL, l-thyroxine was applied.Our study showed that radioiodine administration is advisable in certain circumstances, even in euthyroid patients. It allows for continuation of further long-term AM treatment. Additionally, RIT allows for the reintroduction of AM therapy that was previously terminated. Hence, it can help control life-threatening tachyarrhythmias and decrease episodes of thyrotoxicosis.

Herman W.A.,Outpatients Unit of Endocrine Diseases | Krzoska A.,Poznan University of Medical Sciences | Lacka K.,Metabolism and Internal Medicine | Bugaj R.,Laboratory of Neurobiology | Dorszewska J.,Laboratory of Neurobiology
Polski Merkuriusz Lekarski | Year: 2013

Metabolic syndrome (MS) is associated with low-grade systemic inflammation. Hyperhomocysteinemia is considered recently as a consequence of immune activation. Acute phase proteins, proinflammatory cytokines and probably homocysteine (hHcy) are involved in the pathogenesis of MS, atherosclerosis and ageing. The aim of our study was to investigate the reciprocal links between hHcy and selected negative and positive acute phase reactants as well as interleukin-18 in men over 40 years of age suffering from MS compared to healthy subjects. Material and methods. In 160 randomly selected men aged 40 to 70 years hHcy, C-reactive protein, transferrin, α1- antichymotrypsin and IL-18 were evaluated and features of MS using IDF (International Diabetes Federation-2005) criteria were estimated. Results. Hcy plasma levels are not correlated with age. Men suffering from MS revealed significantly higher serum hHcy levels than healthy subjects (11.52 ±6.87 μM/L vs 10.08 ±5.44 μM/L, p=0.0074). A weak but positive (r=0.099; p=0.014) correlation between hHcy and the numbers of MS traits is shown. However, the plasma hHcy level is correlated only with HDL-cholesterol serum levels (r= -0.132; p=0.035) and fasting blood glucose (r=0.164; p=0.009). hHcy concentration is strongly positively correlated with IL-18 (r=0.276; p=0.005), although not with CRP, α1-ACT and transferrin. Conclusions. In men over 40 years of age suffering from MS significant higher serum Hcy levels than healthy subjects are presented, but hHcy (as opposed to acute phase reactants) correlates only with IL-18 plasma concentrations.

Kolanska K.,Metabolism and Internal Medicine | Owecki M.,Metabolism and Internal Medicine | Nikisch E.,Poznan University of Medical Sciences | Sowinski J.,Metabolism and Internal Medicine
Neuroendocrinology Letters | Year: 2010

OBJECTIVE: The influence of obesity on cancer development has been proven for numerous tumours. In contrast, the association between obesity and non-secreting adrenal incidentaloma has never been proven. Therefore, the aim of this study was to investigate this relationship in a large sample of patients. METHODS: 143 patients with benign non-secreting adrenal incidentalomas treated in the Department of Endocrinology at the Poznan University of Medical Sciences between the years 2000-2007 were examined. To rule out subclinical hyperfunctioning lesions, serum dehydroepiandrosterone sulphate, Cortisol (8 am, 6 pm, and after 1 mg dexamethasone suppression), sodium and potassium, along with concentrations of sodium, potassium, vanillylmandelic acid, metanephrine and normetanephrine in 24-hour urine collection were determined. Radiological evaluation included computed tomography and/or magnetic resonance imaging. Only non-secreting lesions and those of benign radiologic appearance were considered. The patients body mass index was compared to that of the general population of Poland and the Western Poland Region of Wielkopolska. RESULTS: The average body mass index of our patients was 28.77 kg/m2 (SD=4.71), with a 40% prevalence of obesity in the study group. One-proportion z-test showed a statistically significantly higher prevalence of obesity as compared to the general population of Poland and Wielkopolska (40% vs 12.5%, p<0.005); the results were similar for the whole cohort, and for each gender separately. CONCLUSIONS: This clinical research study demonstrates a strong association between obesity and incidentally discovered non-functioning adrenal tumours. © 2010 Neuroendocrinology Letters.

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