Arquivos brasileiros de endocrinologia e metabologia最新文献_第7页

Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions. 鞍内三叉动脉持续存在并并发垂体腺瘤:两例描述及其对鞍区病变鉴别诊断的重要性。

Arquivos brasileiros de endocrinologia e metabologia Pub Date : 2014-08-01

Marcio Carlos Machado, Sergio Kodaira, Nina Rosa Castro Musolino

{"title":"Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions.","authors":"Marcio Carlos Machado, Sergio Kodaira, Nina Rosa Castro Musolino","doi":"","DOIUrl":"","url":null,"abstract":"Persistent trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebrobasilar systems. However, hormonal changes or the association of PTA with other sellar lesions, such as pituitary adenomas, are extremely rare. The aim of the present study was to report two patients with intrasellar PTA and simultaneous pituitary adenoma in order to emphasize the importance of differential diagnoses for sellar lesions. Case 1. A female patient, 41 years old, was admitted with a history of chronic headache (> 20 years). Pituitary magnetic resonance imaging (MRI) showed a rounded lesion in the left portion of the pituitary gland suggestive of adenoma (most likely clinically non-functioning adenoma). In addition to this lesion, the MRI demonstrated ecstasy of the right internal carotid artery and imaging suggestive of an intrasellar artery that was subsequently confirmed by an angio-MRI of the cerebral vessels as PTA. Case 2. A female patient, 42 years old, was admitted with a history of amenorrhea and galactorrhea in 1994. Laboratorial investigation revealed hyperprolactinemia. Pituitary MRI showed a small hyposignal area in the anterior portion of pituitary gland suggestive of a microadenoma initiated by a dopaminergic agonist. Upon follow-up, aside from the first lesion, the MRI showed a well delineated rounded lesion inside the pituitary gland, similar to a vessel. Angio-MRI confirmed a left primitive PTA. Failure to recognize these anomalous vessels within the sella might lead to serious complications during transsphenoidal surgery. Therefore, although their occurrence is uncommon, a working knowledge of vascular lesions in the sella turcica or pituitary gland is important for the differential diagnosis of pituitary lesions, especially pituitary adenomas.","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":"58 6","pages":"661-5"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32660545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnosis and management of Paget's disease of bone. 骨佩吉特病的诊断和治疗。

Arquivos brasileiros de endocrinologia e metabologia Pub Date : 2014-08-01 DOI: 10.1590/0004-2730000002941

Luiz Griz, Daniele Fontan, Patricia Mesquita, Marise Lazaretti-Castro, Victoria Zeghbi Cochenski Borba, João Lindolfo Cunha Borges, Thyciara Fontenele, Juliana Maia, Francisco Bandeira

{"title":"Diagnosis and management of Paget's disease of bone.","authors":"Luiz Griz, Daniele Fontan, Patricia Mesquita, Marise Lazaretti-Castro, Victoria Zeghbi Cochenski Borba, João Lindolfo Cunha Borges, Thyciara Fontenele, Juliana Maia, Francisco Bandeira","doi":"10.1590/0004-2730000002941","DOIUrl":"https://doi.org/10.1590/0004-2730000002941","url":null,"abstract":"Objective: To conduct a literature review on the diagnosis and management of Paget's disease of bone.Materials and methods: This scientific statement was generated by a request from the Brazilian Medical Association (AMB) to the Brazilian Society of Endocrinology and Metabolism (SBEM) as part of its Clinical Practice Guidelines program. Articles were identified by searching in PubMed and Cochrane databases as well as abstracts presented at the Endocrine Society, Brazilian Society for Endocrinology Annual Meetings and the American Society for Bone and Mineral Research Annual Meeting during the last 5 years. Grading quality of evidence and strength of recommendation were adapted from the first report of the Oxford Centre for Evidence-based Medicine. All grades of recommendation, including \"D\", are based on scientific evidence. The differences between A, B, C and D, are due exclusively to the methods employed in generating evidence.Conclusion: We present a scientific statement on Paget's disease of bone providing the level of evidence and the degree of recommendation regarding causes, clinical presentation as well as surgical and medical treatment.","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":"58 6","pages":"587-99"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000002941","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32660632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21

Screening of celiac disease in patients with autoimmune thyroid disease from Southern Brazil. 巴西南部自身免疫性甲状腺疾病患者乳糜泻筛查

Arquivos brasileiros de endocrinologia e metabologia Pub Date : 2014-08-01 DOI: 10.1590/0004-2730000003003

Laila M Teixeira, Renato Nisihara, Shirley Ramos da Rosa Utiyama, Ricardo S de Bem, Cristina Marcatto, Michelli Bertolazo, Gisah A de Carvalho

{"title":"Screening of celiac disease in patients with autoimmune thyroid disease from Southern Brazil.","authors":"Laila M Teixeira, Renato Nisihara, Shirley Ramos da Rosa Utiyama, Ricardo S de Bem, Cristina Marcatto, Michelli Bertolazo, Gisah A de Carvalho","doi":"10.1590/0004-2730000003003","DOIUrl":"https://doi.org/10.1590/0004-2730000003003","url":null,"abstract":"Objective: The objective of this study was to determine the prevalence of celiac disease (CD) in adults with autoimmune thyroid disease (ATD) from the endocrinology outpatient setting in a university hospital in Southern Brazil.Subjects and methods: From the years 2007 to 2011, 254 patients with ATD were enrolled consecutively, Grave's disease was diagnosed in 143 (56.3%) and Hashimoto's thyroiditis in 111 (43.7%) of them. All patients answered a questionnaire related to symptoms that could be associated with CD and serum samples to screen for IgA anti-endomysial (EmA-IgA) were collected. EmA-IgA-positive patients were offered upper gastrointestinal endoscopy and biopsy of duodenum.Results: A total of 254 patients were included; 222 (87.4%) female, mean age 45.4 ± 13.43 years (18 to 79 years). EmA-IgA was positive in seven patients (2.7%) and five done endoscopy with biopsy. Of these, three diagnosis of CD was confirmed (1.2%). All the three patients with CD had higher EmA-IgA titration, were female and had Hashimoto's thyroiditis. Like other patients with ATD, CD patients had nonspecific gastrointestinal symptoms, such as heartburn and gastric distention. In our study, one in each 85 patients confirmed the diagnosis of CD.Conclusion: We found a prevalence of 1.2% (1:85) of confirmed CD among Brazilian patients with ATD. Although some IgA-EmA positive patients had Graves' disease and one was male, all three patients with confirmed CD were female and had Hashimoto's thyroiditis.","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":"58 6","pages":"625-9"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000003003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32660636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

Hydrochloride pioglitazone protects diabetic rats against podocyte injury through preserving glomerular podocalyxin expression. 盐酸吡格列酮通过维持肾小球足alyxin表达来保护糖尿病大鼠足细胞损伤。

Arquivos brasileiros de endocrinologia e metabologia Pub Date : 2014-08-01 DOI: 10.1590/0004-2730000003141

Yan Xing, Shandong Ye, Yumi Chen, Wen Hu, Yan Chen

{"title":"Hydrochloride pioglitazone protects diabetic rats against podocyte injury through preserving glomerular podocalyxin expression.","authors":"Yan Xing, Shandong Ye, Yumi Chen, Wen Hu, Yan Chen","doi":"10.1590/0004-2730000003141","DOIUrl":"https://doi.org/10.1590/0004-2730000003141","url":null,"abstract":"Objective: We sought to test the effect of different dosages of pioglitazone (PIO) on the glomerular expression of podocalyxin and urinary sediment podocalyxin excretion and to explore the potential renoprotective mechanism.Materials and methods: Type 1 diabetes induced with streptozotocin (65 mg/kg) in 36 male Sprague-Dawley rats were randomly allocated to be treated with vehicle or 10, 20, 30 mg/kg/d PIO respectively for 8 weeks. Eight rats were enrolled in the normal control group.Results: At 8th week, rats were sacrificed for the observation of kidney injury through electron microscope. Glomerular podocalyxin production including mRNA and protein were determined by RT-PCR and immunohistochemistry respectively. Levels of urinary albumin excretion and urinary sediment podocalyxin, kidney injury index were all significantly increased, whereas expression of glomerular podocalyxin protein and mRNA were decreased significantly in diabetic rats compared to normal control. Dosages-dependent analysis revealed that protective effect of PIO ameliorated the physiopathological changes and reached a peak at dosage of 20 mg/kg/d.Conclusion: PIO could alleviate diabetic kidney injury in a dose-dependent pattern and the role may be associated with restraining urinary sediment podocalyxin excretion and preserving the glomerular podocalyxin expression.","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":"58 6","pages":"630-9"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000003141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32660637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Long-term risks of bisphosphonate therapy. 双膦酸盐治疗的长期风险。

Arquivos brasileiros de endocrinologia e metabologia Pub Date : 2014-07-01 DOI: 10.1590/0004-2730000003308

Nelson B Watts

引用次数: 26

Physical exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women. 体育锻炼与骨质疏松症:不同类型的运动对绝经后妇女骨骼和身体功能的影响。

Arquivos brasileiros de endocrinologia e metabologia Pub Date : 2014-07-01 DOI: 10.1590/0004-2730000003374

Linda Denise Fernandes Moreira, Mônica Longo de Oliveira, Ana Paula Lirani-Galvão, Rosângela Villa Marin-Mio, Rodrigo Nolasco dos Santos, Marise Lazaretti-Castro

{"title":"Physical exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women.","authors":"Linda Denise Fernandes Moreira, Mônica Longo de Oliveira, Ana Paula Lirani-Galvão, Rosângela Villa Marin-Mio, Rodrigo Nolasco dos Santos, Marise Lazaretti-Castro","doi":"10.1590/0004-2730000003374","DOIUrl":"https://doi.org/10.1590/0004-2730000003374","url":null,"abstract":"Physical exercise is an important stimulus for osteoporosis prevention and treatment. However, it is not clear yet which modality would be better to stimulate bone metabolism and enhance physical function of postmenopausal women. This review paper aims to summarize and update present knowledge on the effects of different kinds of aquatic and ground physical exercises on bone metabolism and physical function of postmenopausal women. Moderate to intense exercises, performed in a high speed during short intervals of time, in water or on the ground, can be part of a program to prevent and treat postmenopausal osteoporosis. Mechanical vibration has proven to be beneficial for bone microarchitecture, improving bone density and bone strength, as well as increasing physical function. Although impact exercises are recognized as beneficial for the stimulation of bone tissue, other variables such as muscle strength, type of muscle contraction, duration and intensity of exercises are also determinants to induce changes in bone metabolism of postmenopausal women. Not only osteoanabolic exercises should be recommended; activities aimed to develop muscle strength and body balance and improve the proprioception should be encouraged to prevent falls and fractures. ","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":"58 5","pages":"514-22"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000003374","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32621239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 167

Osteoporosis management in patient with renal function impairment. 肾功能损害患者骨质疏松症的处理。

Arquivos brasileiros de endocrinologia e metabologia Pub Date : 2014-07-01 DOI: 10.1590/0004-2730000003360

Guilherme Alcantara Cunha Lima, Francisco de Paula Paranhos Neto, Giselly Rosa Modesto Pereira, Carlos Perez Gomes, Maria Lucia Fleiuss Farias

引用次数: 10

The multiple effects of thyroid disorders on bone and mineral metabolism. 甲状腺疾病对骨和矿物质代谢的多重影响。

Arquivos brasileiros de endocrinologia e metabologia Pub Date : 2014-07-01 DOI: 10.1590/0004-2730000003311

Ludmilla F Cardoso, Léa M Z Maciel, Francisco J A de Paula

{"title":"The multiple effects of thyroid disorders on bone and mineral metabolism.","authors":"Ludmilla F Cardoso, Léa M Z Maciel, Francisco J A de Paula","doi":"10.1590/0004-2730000003311","DOIUrl":"https://doi.org/10.1590/0004-2730000003311","url":null,"abstract":"Differently from most hormones, which commonly are specialized molecules able to influence other cells, tissues and systems, thyroid hormones (TH) are pleiotropic peptides, whose primordial function is difficult to identify. The complex action of TH on human economy can be easily witnessed by examining the diverse consequences of TH excess and deficiency during development and after maturity. In particular, different manifestations in bone modeling and remodeling reflect the circumstantial consequences of thyroid disturbances, which are age dependent. While hyperthyroidism during childhood enhances bone mineralization and accelerates epiphyseal maturation, in adults it induces bone loss by predominant activation of osteoclast activity. Furthermore, the syndrome of TH resistance is a multifaceted condition in which different sites exhibit signs of hormone excess or deficiency depending on the configuration of the TH receptor isoform. The investigation of the impact of TH resistance on the skeleton still remains to be elucidated. We present here a thorough review of the action of TH on bone and of the impact of thyroid disorders, including hyper- and hypothyroidism and the syndrome of TH resistance, on the skeleton. ","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":"58 5","pages":"452-63"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000003311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32621289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 51

Normocalcemic primary hyperparathyroidism: long-term follow-up associated with multiple adenomas. 正常血钙水平原发性甲状旁腺功能亢进:与多发腺瘤相关的长期随访。

Arquivos brasileiros de endocrinologia e metabologia Pub Date : 2014-07-01 DOI: 10.1590/0004-2730000003367

Larissa Pimentel, Sirley Portela, Alyne Loureiro, Francisco Bandeira

{"title":"Normocalcemic primary hyperparathyroidism: long-term follow-up associated with multiple adenomas.","authors":"Larissa Pimentel, Sirley Portela, Alyne Loureiro, Francisco Bandeira","doi":"10.1590/0004-2730000003367","DOIUrl":"https://doi.org/10.1590/0004-2730000003367","url":null,"abstract":"Normocalcemic primary hyperparathyroidism (NPHPT) is a condition characterized by elevation of the parathyroid hormone (PTH) in the presence of normal serum calcium and the absence of secondary causes. The case described illustrates the long-term follow-up of a postmenopausal woman with NPHPT patient who progressed with multiple adenomas. This case reports a 77-year-old female who has chronic generalized pain and osteoporosis. Her initial serum PTH was 105 pg/mL, with total serum calcium of 9.6 mg/dL, albumin 4.79 g/dL, phosphorus 2.8 mg/dL, and 25OHD after supplementation was 34.6 ng/mL. The bone densitometry (BMD) results were as follows: lumbar spine: T-score -3.0, femoral neck: T-score -2.6 and distal radius: -4.2. Other causes of secondary hyperparathyroidism were ruled out and cervical ultrasound and Tc-99-Sestamibi scan were negative. She used oral alendronate and three infusions of zoledronic acid for treatment of osteoporosis. In the 10th year of follow-up, after successive negative cervical imaging, ultrasound showed a nodule suggestive of an enlarged right inferior parathyroid gland. PTH levels in fluid which was obtained during fine-needle aspiration (FNA) were over 5,000 pg/mL and a Sestamibi scan was negative. The patient underwent parathyroidectomy, and a histological examination confirmed parathyroid adenoma. Post-operatively serum PTH remained elevated in the presence of normal serum calcium levels. A follow-up cervical ultrasound showed a new solid nodule suggestive of an enlarged right superior parathyroid gland. PTH levels in the aspiration fluid were remarkably high. A second parathyroidectomy was performed, with the excision of a histologically confirmed parathyroid adenoma. In conclusion, this is an unusual presentation of NPHPT and highlights the long-term complications. ","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":"58 5","pages":"583-6"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000003367","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32620625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Trabecular bone score: perspectives of an imaging technology coming of age. 骨小梁评分:一种成像技术的发展前景。

Arquivos brasileiros de endocrinologia e metabologia Pub Date : 2014-07-01 DOI: 10.1590/0004-2730000003456

Barbara C Silva, John P Bilezikian

{"title":"Trabecular bone score: perspectives of an imaging technology coming of age.","authors":"Barbara C Silva, John P Bilezikian","doi":"10.1590/0004-2730000003456","DOIUrl":"https://doi.org/10.1590/0004-2730000003456","url":null,"abstract":"The trabecular bone score (TBS) is a new method to describe skeletal microarchitecture from the dual energy X-ray absorptiometry (DXA) image of the lumbar spine. While TBS is not a direct physical measurement of trabecular microarchitecture, it correlates with micro-computed tomography (µCT) measures of bone volume fraction, connectivity density, trabecular number, and trabecular separation, and with vertebral mechanical behavior in ex vivo studies. In human subjects, TBS has been shown to be associated with trabecular microarchitecture and bone strength by high resolution peripheral quantitative computed tomography (HRpQCT). Cross-sectional and prospective studies, involving a large number of subjects, have both shown that TBS is associated with vertebral, femoral neck, and other types of osteoporotic fractures in postmenopausal women. Data in men, while much less extensive, show similar findings. TBS is also associated with fragility fractures in subjects with secondary causes of osteoporosis, and preliminary data suggest that TBS might improve fracture prediction when incorporated in the fracture risk assessment system known as FRAX. In this article, we review recent advances that have helped to establish this new imaging technology. ","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":"58 5","pages":"493-503"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000003456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32621237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 52