International Journal of Endocrinology and Metabolism International Journal of Endocrinology and Metabolism Int J Endocrinol Metab http://www.endometabol.com 1726-913X 1726-9148 10.5812/ijem en jalali 2017 5 30 gregorian 2017 5 30 12 2
en 10.5812/ijem.14102 Serial Explantation After Parathyroid Autotransplant for Recurrent Hypercalcemia in Chronic Renal Failure Serial Explantation After Parathyroid Autotransplant for Recurrent Hypercalcemia in Chronic Renal Failure case-report case-report Case Presentation:

This case illustrated the development of secondary and subsequently tertiary hyperparathyroidism in a 66-year-old man with a history of chronic renal failure. The patient was managed surgically by parathyroid autotransplantation and serial explantation.

Discussion:

Refractory hypercalcemia due to autonomous parathyroid tissue following parathyroidectomy can be managed with greater ease and efficacy by serial explantation of autotransplanted tissue versus a more difficult re-exploration of the neck.

Introduction:

Development of autonomous parathyroid gland function can occur in cases of long standing renal disease, leading to hyperparathyroidism and hypercalcemia. Debate exists over the optimum surgical treatment strategy and the choice lies with the individual surgeon. We illustrated the method of total parathyroidectomy and autotransplantation to the forearm and proposed it to be superior to both total and subtotal parathyroidectomy.

Case Presentation:

This case illustrated the development of secondary and subsequently tertiary hyperparathyroidism in a 66-year-old man with a history of chronic renal failure. The patient was managed surgically by parathyroid autotransplantation and serial explantation.

Discussion:

Refractory hypercalcemia due to autonomous parathyroid tissue following parathyroidectomy can be managed with greater ease and efficacy by serial explantation of autotransplanted tissue versus a more difficult re-exploration of the neck.

Introduction:

Development of autonomous parathyroid gland function can occur in cases of long standing renal disease, leading to hyperparathyroidism and hypercalcemia. Debate exists over the optimum surgical treatment strategy and the choice lies with the individual surgeon. We illustrated the method of total parathyroidectomy and autotransplantation to the forearm and proposed it to be superior to both total and subtotal parathyroidectomy.

Parathyroid hormone;Hyperparathyroidism;Hypercalcemia Parathyroid hormone;Hyperparathyroidism;Hypercalcemia http://www.endometabol.com/index.php?page=article&article_id=14102 William Robert Foley William Robert Foley School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland; 13 Woodside, Balkill Road, Howth, Co. Dublin, Ireland, Tel: +35-3860818491 School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland; 13 Woodside, Balkill Road, Howth, Co. Dublin, Ireland, Tel: +35-3860818491 Dara Lundon Dara Lundon School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland Yvonnne O’Meara Yvonnne O’Meara School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland; Department of Nephrology, Mater Misericordiae University Hospital, Dublin, Ireland School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland; Department of Nephrology, Mater Misericordiae University Hospital, Dublin, Ireland Tom Gorey Tom Gorey School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland; General, Breast and Endocrine Surgery, Mater Misericordiae University Hospital, Dublin, Ireland School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland; General, Breast and Endocrine Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
en 10.5812/ijem.10960 First Report of 3-Oxothiolase Deficiency in Iran First Report of 3-Oxothiolase Deficiency in Iran case-report case-report Discussion

This is the first Iranian 3-oxothiolase deficiency case report as searched in the literature. Because of the high rate of consanguineous marriages in Iran, physicians should consider the 3-oxothiolase deficiency in the differential diagnosis of any patient with intractable vomiting and severe metabolic acidosis.

Case Presentation

This is a case report of 3-oxothiolase deficiency in a young Iranian boy with presentation of intractable vomiting and severe metabolic acidosis following a common cold in six months of age with abundant urinary 2-methyl-3- hydroxybutyric acid.

Introduction

Mitochondrial acetoacetyl-CoA thiolase (3-oxothiolase) deficiency is a rare metabolic disorder involving ketone body metabolism characterized by acute attacks of vomiting, acidosis, ketosis, and lethargy along with some laboratory criteria including excessive excretion of 2-methyl-3-hydroxybutyric acid in urine.

Discussion

This is the first Iranian 3-oxothiolase deficiency case report as searched in the literature. Because of the high rate of consanguineous marriages in Iran, physicians should consider the 3-oxothiolase deficiency in the differential diagnosis of any patient with intractable vomiting and severe metabolic acidosis.

Case Presentation

This is a case report of 3-oxothiolase deficiency in a young Iranian boy with presentation of intractable vomiting and severe metabolic acidosis following a common cold in six months of age with abundant urinary 2-methyl-3- hydroxybutyric acid.

Introduction

Mitochondrial acetoacetyl-CoA thiolase (3-oxothiolase) deficiency is a rare metabolic disorder involving ketone body metabolism characterized by acute attacks of vomiting, acidosis, ketosis, and lethargy along with some laboratory criteria including excessive excretion of 2-methyl-3-hydroxybutyric acid in urine.

Methylacetoacetyl-CoA Thiolase Deficiency;Beta-ketothiolase Deficiency;3-Oxothiolase Deficiency;Acidosis Methylacetoacetyl-CoA Thiolase Deficiency;Beta-ketothiolase Deficiency;3-Oxothiolase Deficiency;Acidosis http://www.endometabol.com/index.php?page=article&article_id=10960 Kobra Shiasi Arani Kobra Shiasi Arani Research Center for Biochemistry and Nutrition in Metabolic Disorders, Kashan University of Medical Sciences, Kashan, IR Iran; Research Center for Biochemistry and Nutrition in Metabolic Disorders, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615550026 Research Center for Biochemistry and Nutrition in Metabolic Disorders, Kashan University of Medical Sciences, Kashan, IR Iran; Research Center for Biochemistry and Nutrition in Metabolic Disorders, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615550026 Babak Soltani Babak Soltani Research Center for Biochemistry and Nutrition in Metabolic Disorders, Kashan University of Medical Sciences, Kashan, IR Iran Research Center for Biochemistry and Nutrition in Metabolic Disorders, Kashan University of Medical Sciences, Kashan, IR Iran
en 10.5812/ijem.14098 Hormones and Hemodynamics in Pregnancy Hormones and Hemodynamics in Pregnancy review-article review-article Context:

Normal pregnancy is associated with sodium and water retention, which results in plasma volume expansion prior to placental implantation. The explanation offered for these events is that pregnancy ‘resets’ both volume and osmoreceptors.

Evidence Acquisition:

The mechanisms for such an enigmatic ‘resetting’ in pregnancy have not previously been explained. However, recent human pregnancy studies have demonstrated that the earliest hemodynamic change in pregnancy is primary systemic arterial vasodilation. This arterial underfilling is associated with a secondary increase in cardiac output and activation of the neurohumoral axis, including stimulation of the renin-angiotensin-aldosterone, sympathetic, and non-osmotic vasopressin systems. Resistance to the pressor effects of angiotensin and sympathetic stimulation in pregnancy is compatible with an increase in endothelial nitric oxide synthase activity.

Results:

In contrast to the sodium and water retention which occur secondary to the primary arterial vasodilation in cirrhosis, glomerular filtration and renal blood flow are significantly increased in normal pregnancy. A possible explanation for this difference in arterial vasodilation states is that relaxin, an arterial vasodilator which increases during pregnancy, has a potent effect on both systemic and renal circulation. Endothelial damage in pregnancy is pivotal in the pathogenesis of preeclampsia in pregnancy.

Conclusions:

Against a background of the primary arterial vasodilation hypothesis, it is obvious that reversal of the systemic vasodilatation in pregnancy, without subsequent activation of the renin-angiotensin-aldosterone system (78), will evoke a reversal of all the links in the chain of events in normal pregnancy adaptation, thus, it may cause preeclampsia. Namely, a decrease of renal vasodilation will decrease glomerular filtration rate.

Context:

Normal pregnancy is associated with sodium and water retention, which results in plasma volume expansion prior to placental implantation. The explanation offered for these events is that pregnancy ‘resets’ both volume and osmoreceptors.

Evidence Acquisition:

The mechanisms for such an enigmatic ‘resetting’ in pregnancy have not previously been explained. However, recent human pregnancy studies have demonstrated that the earliest hemodynamic change in pregnancy is primary systemic arterial vasodilation. This arterial underfilling is associated with a secondary increase in cardiac output and activation of the neurohumoral axis, including stimulation of the renin-angiotensin-aldosterone, sympathetic, and non-osmotic vasopressin systems. Resistance to the pressor effects of angiotensin and sympathetic stimulation in pregnancy is compatible with an increase in endothelial nitric oxide synthase activity.

Results:

In contrast to the sodium and water retention which occur secondary to the primary arterial vasodilation in cirrhosis, glomerular filtration and renal blood flow are significantly increased in normal pregnancy. A possible explanation for this difference in arterial vasodilation states is that relaxin, an arterial vasodilator which increases during pregnancy, has a potent effect on both systemic and renal circulation. Endothelial damage in pregnancy is pivotal in the pathogenesis of preeclampsia in pregnancy.

Conclusions:

Against a background of the primary arterial vasodilation hypothesis, it is obvious that reversal of the systemic vasodilatation in pregnancy, without subsequent activation of the renin-angiotensin-aldosterone system (78), will evoke a reversal of all the links in the chain of events in normal pregnancy adaptation, thus, it may cause preeclampsia. Namely, a decrease of renal vasodilation will decrease glomerular filtration rate.

Pregnancy;Arterial;Osmolar Concentration;Relaxin;Nitric Oxide;Pre-Eclampsia, Endothelium Pregnancy;Arterial;Osmolar Concentration;Relaxin;Nitric Oxide;Pre-Eclampsia, Endothelium http://www.endometabol.com/index.php?page=article&article_id=14098 Oleksandra Tkachenko Oleksandra Tkachenko Division of Renal Diseases and Hypertension, University of Colorado Denver, Denver, Colorado, USA Division of Renal Diseases and Hypertension, University of Colorado Denver, Denver, Colorado, USA Dmitry Shchekochikhin Dmitry Shchekochikhin Division of Renal Diseases and Hypertension, University of Colorado Denver, Denver, Colorado, USA Division of Renal Diseases and Hypertension, University of Colorado Denver, Denver, Colorado, USA Robert W. Schrier Robert W. Schrier Division of Renal Diseases and Hypertension, University of Colorado Denver, Denver, Colorado, USA; Department of Medicine, University of Colorado, 12700 East 19th Avenue C281, Aurora, CO 80045, USA. Tel: +1-3037244837, Fax: +1-3037244868 Division of Renal Diseases and Hypertension, University of Colorado Denver, Denver, Colorado, USA; Department of Medicine, University of Colorado, 12700 East 19th Avenue C281, Aurora, CO 80045, USA. Tel: +1-3037244837, Fax: +1-3037244868
en 10.5812/ijem.13539 Surgical Management of an Atypical Presentation of a Thyroid Storm Surgical Management of an Atypical Presentation of a Thyroid Storm case-report case-report Introduction

Thyroid storm is a rare complication of Graves' disease that can carry a poor prognosis. In order to prevent major complications, thyroid storm must be quickly identified in patients and treatment must be promptly implemented. Medical treatment is usually initiated with antithyroid medications, such as propylthiouracil (PTU), methimazole, and beta-blockers. However, some patients may experience adverse reactions to these medications and alternate treatment options must be explored.

Case Presentation

We report a case of a 30-year-old female initiated on PTU after diagnosis with Graves' disease that later presented an acute thyroid storm.

Discussion

Therapy was changed to methimazole, yet the patient subsequently developed angioedema and dyspnea. Medical management was discontinued and emergent thyroidectomy was performed without complication.

Introduction

Thyroid storm is a rare complication of Graves' disease that can carry a poor prognosis. In order to prevent major complications, thyroid storm must be quickly identified in patients and treatment must be promptly implemented. Medical treatment is usually initiated with antithyroid medications, such as propylthiouracil (PTU), methimazole, and beta-blockers. However, some patients may experience adverse reactions to these medications and alternate treatment options must be explored.

Case Presentation

We report a case of a 30-year-old female initiated on PTU after diagnosis with Graves' disease that later presented an acute thyroid storm.

Discussion

Therapy was changed to methimazole, yet the patient subsequently developed angioedema and dyspnea. Medical management was discontinued and emergent thyroidectomy was performed without complication.

Thyroid Crisis;Thyroidectomy;Graves; Disease;Antithyroid Agents Thyroid Crisis;Thyroidectomy;Graves; Disease;Antithyroid Agents http://www.endometabol.com/index.php?page=article&article_id=13539 Ricardo Mario Aulet Ricardo Mario Aulet Tufts University School of Medicine, Boston, USA Tufts University School of Medicine, Boston, USA Richard O. Wein Richard O. Wein Department of Otolaryngology-HNS, Tufts Medical Center, Boston, USA; Otolaryngology Department, Tufts Medical Center, Boston, USA. Tel: +61-76368711, Fax:+ 61-7636-1479 Department of Otolaryngology-HNS, Tufts Medical Center, Boston, USA; Otolaryngology Department, Tufts Medical Center, Boston, USA. Tel: +61-76368711, Fax:+ 61-7636-1479 Richard D. Siegel Richard D. Siegel Department of Endocrinology and Diabetes, Tufts Medical Center, Boston, USA Department of Endocrinology and Diabetes, Tufts Medical Center, Boston, USA
en 10.5812/ijem.13633 Prevalence of Obesity in Patients With Type 2 Diabetes Mellitus in Yemen Prevalence of Obesity in Patients With Type 2 Diabetes Mellitus in Yemen research-article research-article Conclusions:

The prevalence of obesity in patients with type 2 diabetes mellitus in Yemen is high with respect to the Yemeni population, especially in females.

Objectives:

We conducted this study to assess the prevalence of obesity in Yemeni patients with type 2 diabetes mellitus.

Patients and Methods:

Body mass index (BMI) of patients with type 2 diabetes mellitus who were 25-years-old or older was measured during their first visit to an endocrinology and diabetes clinic in Sana’a, Yemen over a 4-year period from May 2007 to May 2011.

Results:

The BMI was measured in 1640 patients (721 males and 919 females) who attended the clinic. According to the measured BMI, 328 (45.5%), 314 (43.5%), 79 (11%) of the male patients were non-obese (BMI < 25 kg/m2), overweight (BMI 25-29.9 kg/m2), and obese (BMI ≥ 30 kg/m2), respectively. On the other hand, 256 (28%), 369 (40.0%), and 294 (32%) of the female patients were non-obese (BMI < 25 kg/m2), overweight (BMI 25-29.9 kg/m2), and obese (BMI ≥ 30 kg/m2), respectively.

Background:

Obesity is common in type 2 diabetic patients in some of the Middle Eastern countries, which are amongst the countries with highest rates of diabetes mellitus and obesity.

Conclusions:

The prevalence of obesity in patients with type 2 diabetes mellitus in Yemen is high with respect to the Yemeni population, especially in females.

Objectives:

We conducted this study to assess the prevalence of obesity in Yemeni patients with type 2 diabetes mellitus.

Patients and Methods:

Body mass index (BMI) of patients with type 2 diabetes mellitus who were 25-years-old or older was measured during their first visit to an endocrinology and diabetes clinic in Sana’a, Yemen over a 4-year period from May 2007 to May 2011.

Results:

The BMI was measured in 1640 patients (721 males and 919 females) who attended the clinic. According to the measured BMI, 328 (45.5%), 314 (43.5%), 79 (11%) of the male patients were non-obese (BMI < 25 kg/m2), overweight (BMI 25-29.9 kg/m2), and obese (BMI ≥ 30 kg/m2), respectively. On the other hand, 256 (28%), 369 (40.0%), and 294 (32%) of the female patients were non-obese (BMI < 25 kg/m2), overweight (BMI 25-29.9 kg/m2), and obese (BMI ≥ 30 kg/m2), respectively.

Background:

Obesity is common in type 2 diabetic patients in some of the Middle Eastern countries, which are amongst the countries with highest rates of diabetes mellitus and obesity.

Obesity;Overweight;Type 2 Diabetes Mellitus;Body Mass Index;HbA1c Obesity;Overweight;Type 2 Diabetes Mellitus;Body Mass Index;HbA1c http://www.endometabol.com/index.php?page=article&article_id=13633 Butheinah A. Al-Sharafi Butheinah A. Al-Sharafi Department of Medicine, Sana’a University Medical School, Sana’a, Yemen; Department of Medicine, Sana’a University Medical School, Sana’a, Yemen. Tel: +96-7733733573, Fax: +96-7771213337 Department of Medicine, Sana’a University Medical School, Sana’a, Yemen; Department of Medicine, Sana’a University Medical School, Sana’a, Yemen. Tel: +96-7733733573, Fax: +96-7771213337 Abdallah A. Gunaid Abdallah A. Gunaid Department of Medicine, Sana’a University Medical School, Sana’a, Yemen Department of Medicine, Sana’a University Medical School, Sana’a, Yemen
en 10.5812/ijem.13946 Gender Differences in Risk Factors of Congenital Hypothyroidism: An Interaction Hypothesis Examination Gender Differences in Risk Factors of Congenital Hypothyroidism: An Interaction Hypothesis Examination research-article research-article Background:

Several studies have demonstrated an increased risk of congenital hypothyroidism (CH) in girls in comparison to boys.

Objectives:

The aim of this study was to determine the potential interactions that are able to change the effect of gender on congenital hypothyroidism.

Patients and Methods:

We conducted a matched 1:4 case-control study in Hamadan Province, western of Iran, from 2005 to 2011. Based on screening program data, neonates with TSH ≥ 10 mU/L and T4 ≤ 6.4 μg/dL were considered as congenital hypothyroidism (Cases). Cases and controls were matched regarding the year and place of birth. Data was analyzed using two different approaches including propensity score and multiple conditional logistic regression model.

Results:

A total of 277 cases and 1036 controls were included in the study. Girls accounted for 57.4% of the cases and 51.2% of controls (P = 0.065). Based on the multiple conditional logistic regressions, only the interaction of gender (girl) and birth season (summer) increased the likelihood of CH significantly (OR = 3.09; 95% CI: 1.09-8.74; P = 0.034). On the other hand, the ORs of the interaction of gender and all other factors (except for birth season) were not statistically significant in CH.

Conclusions:

Birth season might act as an interaction that is able to increase the risk of CH in girls. Accordingly, awareness of the birth season could help policymakers who plan preventive programs to reduce the false negative results among neonates, especially girls.

Background:

Several studies have demonstrated an increased risk of congenital hypothyroidism (CH) in girls in comparison to boys.

Objectives:

The aim of this study was to determine the potential interactions that are able to change the effect of gender on congenital hypothyroidism.

Patients and Methods:

We conducted a matched 1:4 case-control study in Hamadan Province, western of Iran, from 2005 to 2011. Based on screening program data, neonates with TSH ≥ 10 mU/L and T4 ≤ 6.4 μg/dL were considered as congenital hypothyroidism (Cases). Cases and controls were matched regarding the year and place of birth. Data was analyzed using two different approaches including propensity score and multiple conditional logistic regression model.

Results:

A total of 277 cases and 1036 controls were included in the study. Girls accounted for 57.4% of the cases and 51.2% of controls (P = 0.065). Based on the multiple conditional logistic regressions, only the interaction of gender (girl) and birth season (summer) increased the likelihood of CH significantly (OR = 3.09; 95% CI: 1.09-8.74; P = 0.034). On the other hand, the ORs of the interaction of gender and all other factors (except for birth season) were not statistically significant in CH.

Conclusions:

Birth season might act as an interaction that is able to increase the risk of CH in girls. Accordingly, awareness of the birth season could help policymakers who plan preventive programs to reduce the false negative results among neonates, especially girls.

Congenital Hypothyroidism;Propensity Score;Sex Characteristics;Interaction;Iran Congenital Hypothyroidism;Propensity Score;Sex Characteristics;Interaction;Iran http://www.endometabol.com/index.php?page=article&article_id=13946 Shahab Rezaeian Shahab Rezaeian Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, IR Iran Abbas Moghimbeigi Abbas Moghimbeigi Research Center for Health Sciences, Department of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran Research Center for Health Sciences, Department of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran Nader Esmailnasab Nader Esmailnasab Kurdistan Research Center for Social Determinants of Health (KRCSDH), School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, IR Iran; Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, P.O.Box:66177-13446, Sanandaj, IR Iran. Tel: +98-8716131384, Fax: +98-8716664674 Kurdistan Research Center for Social Determinants of Health (KRCSDH), School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, IR Iran; Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, P.O.Box:66177-13446, Sanandaj, IR Iran. Tel: +98-8716131384, Fax: +98-8716664674
en 10.5812/ijem.14424 Efficacy of Different Protocols of Radioiodine Therapy for Treatment of Toxic Nodular Goiter: Systematic Review and Meta-Analysis of the Literature Efficacy of Different Protocols of Radioiodine Therapy for Treatment of Toxic Nodular Goiter: Systematic Review and Meta-Analysis of the Literature review-article review-article Context:

To evaluate treatment success and hypothyroidism following main methods of radioiodine therapy of toxic nodular goiter (TNG); calculated versus fixed dose and high versus low dose of radioiodine.

Evidence Acquisitions:

We searched MEDLINE and SCOPUS databases from inception till July 2013, for clinical trials that compared two different methods of radioiodine administration in TNG. The trials were classified into two groups, those that compared fixed versus calculated dosimetry method and those that assessed high fixed dose versus low fixed dose method. Treatment response was defined as euthyroidism or hypothyroidism, one year after radioiodine administration. We calculated the risk ratio and risk difference of treatment response as well as permanent hypothyroidism as outcome variables. Random effects model was used for data pooling.

Results:

The literature search yielded 2538 articles. Two randomized and five non-randomized clinical trials with 669 patients met the eligibility criteria for the meta-analysis. Patients with TNG who were treated according to the calculated method had 9.6% higher cure rate (risk ratio=1.17) and only 0.3% more permanent hypothyroidism compared to patients treated with the fixed dose method. There was no significant difference in the amount of administered radio-iodine in the two groups. Patients treated with fixed high dose had 18.1% more cure rate (risk ratio = 1.2) and 23.9% more permanent hypothyroidism (risk ratio = 2.40) compared to patients treated by fixed low dose protocols.

Conclusions:

Calculated radioiodine therapy may be preferred to fixed dose method in patients with TNG. High dose methods are associated with more response and more hypothyroidism.

Context:

To evaluate treatment success and hypothyroidism following main methods of radioiodine therapy of toxic nodular goiter (TNG); calculated versus fixed dose and high versus low dose of radioiodine.

Evidence Acquisitions:

We searched MEDLINE and SCOPUS databases from inception till July 2013, for clinical trials that compared two different methods of radioiodine administration in TNG. The trials were classified into two groups, those that compared fixed versus calculated dosimetry method and those that assessed high fixed dose versus low fixed dose method. Treatment response was defined as euthyroidism or hypothyroidism, one year after radioiodine administration. We calculated the risk ratio and risk difference of treatment response as well as permanent hypothyroidism as outcome variables. Random effects model was used for data pooling.

Results:

The literature search yielded 2538 articles. Two randomized and five non-randomized clinical trials with 669 patients met the eligibility criteria for the meta-analysis. Patients with TNG who were treated according to the calculated method had 9.6% higher cure rate (risk ratio=1.17) and only 0.3% more permanent hypothyroidism compared to patients treated with the fixed dose method. There was no significant difference in the amount of administered radio-iodine in the two groups. Patients treated with fixed high dose had 18.1% more cure rate (risk ratio = 1.2) and 23.9% more permanent hypothyroidism (risk ratio = 2.40) compared to patients treated by fixed low dose protocols.

Conclusions:

Calculated radioiodine therapy may be preferred to fixed dose method in patients with TNG. High dose methods are associated with more response and more hypothyroidism.

Thyrotoxicosis;Goiter;Nodular;Iodine;Hyperthyroidism Thyrotoxicosis;Goiter;Nodular;Iodine;Hyperthyroidism http://www.endometabol.com/index.php?page=article&article_id=14424 Haleh Rokni Haleh Rokni Endocrinology Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Endocrinology Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Ramin Sadeghi Ramin Sadeghi Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Zohreh Moossavi Zohreh Moossavi Endocrinology Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Endocrinology Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Giorgio Treglia Giorgio Treglia Department of Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland Department of Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland Seyed Rasoul Zakavi Seyed Rasoul Zakavi Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran; Nuclear Medicine Research Center, Ghaem Hospital, Ahmadabad St, Mashhad, IR Iran. Tel: +98-5118012799, Fax: +98-5118419521 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran; Nuclear Medicine Research Center, Ghaem Hospital, Ahmadabad St, Mashhad, IR Iran. Tel: +98-5118012799, Fax: +98-5118419521
en 10.5812/ijem.13612 The Experience of Women Affected by Polycystic Ovary Syndrome: A Qualitative Study From Iran The Experience of Women Affected by Polycystic Ovary Syndrome: A Qualitative Study From Iran research-article research-article Background:

Polycystic ovary syndrome (PCOS) is the most common chronic endocrine disorder. It has significant and diverse clinical consequences including reproductive, metabolic, and psychological morbidities as well as predisposition to malignancies. It is unclear how women with PCOS experience symptoms of this syndrome.

Objectives:

The aim of this study was to clarify the dimensions and components of quality of life in iranian women with PCOS.

Patients and Methods:

This study was a qualitative study to explore and document perceptions of women with PCOS about their disorder and quality of life. Semi-structured interviews with open ended questions were conducted with 23 women with PCOS. The interviews were continued to reach data saturation. The study was conducted in the Reproductive Endocrinology Research Center of Shahid Beheshti University of Medical Sciences. All the interviews were recorded and transcribed. Constant comparative analysis of the data was conducted manually according to the Strauss and Corbin analysis method.

Results:

The study revealed that the most important factors affecting quality of life in women with PCOS were the role functioning items as well as physical, mental, emotional, cognitive, and social dimensions.

Conclusions:

Comprehensive cares concerning various mental, emotional, cognitive, and social dimensions of quality of life should be planned for women with PCOS.

Background:

Polycystic ovary syndrome (PCOS) is the most common chronic endocrine disorder. It has significant and diverse clinical consequences including reproductive, metabolic, and psychological morbidities as well as predisposition to malignancies. It is unclear how women with PCOS experience symptoms of this syndrome.

Objectives:

The aim of this study was to clarify the dimensions and components of quality of life in iranian women with PCOS.

Patients and Methods:

This study was a qualitative study to explore and document perceptions of women with PCOS about their disorder and quality of life. Semi-structured interviews with open ended questions were conducted with 23 women with PCOS. The interviews were continued to reach data saturation. The study was conducted in the Reproductive Endocrinology Research Center of Shahid Beheshti University of Medical Sciences. All the interviews were recorded and transcribed. Constant comparative analysis of the data was conducted manually according to the Strauss and Corbin analysis method.

Results:

The study revealed that the most important factors affecting quality of life in women with PCOS were the role functioning items as well as physical, mental, emotional, cognitive, and social dimensions.

Conclusions:

Comprehensive cares concerning various mental, emotional, cognitive, and social dimensions of quality of life should be planned for women with PCOS.

Polycystic Ovary Syndrome;Quality of Life;Qualitative Study;Experience Polycystic Ovary Syndrome;Quality of Life;Qualitative Study;Experience http://www.endometabol.com/index.php?page=article&article_id=13612 Fatemeh Nasiri Amiri Fatemeh Nasiri Amiri Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Fahimeh Ramezani Tehrani Fahimeh Ramezani Tehrani Reproductive Endocrinology Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, IR Iran; Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2122432500, Fax: +98-2122416264 Reproductive Endocrinology Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, IR Iran; Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2122432500, Fax: +98-2122416264 Masoumeh Simbar Masoumeh Simbar Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Ali Montazeri Ali Montazeri Mental Health Research Center, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, Tehran, IR Iran Mental Health Research Center, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, Tehran, IR Iran Reza Ali Mohammadpour Thamtan Reza Ali Mohammadpour Thamtan Department of Biostatistics, Mazandaran University of Medical Sciences, Sari, IR Iran Department of Biostatistics, Mazandaran University of Medical Sciences, Sari, IR Iran
en 10.5812/ijem.15297 The Effect of Leptin and Adiponectin on KiSS-1 and KissR mRNA Expression in Rat Islets of Langerhans and CRI-D2 Cell Line The Effect of Leptin and Adiponectin on KiSS-1 and KissR mRNA Expression in Rat Islets of Langerhans and CRI-D2 Cell Line research-article research-article Background:

Leptin and adiponectin are the two key metabolic hormones secreted from adipocytes to control food intake and energy expenditure. The action of both hormones in regulation of Gonadotropin Releasing Hormone (GnRH) secretion from the hypothalamus is mediated through Kisspeptins. Kisspeptins are products of KiSS-1 gene. Leptin and adiponectin are modulators of KiSS-1 expression in the hypothalamus. These peptides have also important roles in pancreatic β-cells to control insulin synthesis and secretion and their receptors are detected in Langerhans islets. We hypothesized that leptin and adiponectin might alter KiSS-1 and Kiss Receptor mRNA expression in the islets.

Objectives:

The aim of this study is to investigate any modulatory effect that leptin and adiponectin may have on the expression of Kiss-1 and KiSSR gene in Langerhans islets.

Materials and Methods:

We isolated the islets from adult male rats by collagenase and cultured CRI-D2 cell lines to investigate the effect of leptin and adiponectin. Then, we incubated them with different concentrations of leptin and adiponectin for 24 hours. After that, RNA was extracted from the islets and CRI-D2 cells and transcripted to cDNA. KiSS-1 and KissR expression levels were evaluated by real time PCR.

Results:

In islet and CRI-D2 cells, leptin increased the KiSS-1 mRNA expression significantly, but adiponectin decreased it was expected.

Conclusions:

These findings indicated the possibility that KiSS-1 mRNA expression is a mediator of leptin and adiponectin function in the islets.

Background:

Leptin and adiponectin are the two key metabolic hormones secreted from adipocytes to control food intake and energy expenditure. The action of both hormones in regulation of Gonadotropin Releasing Hormone (GnRH) secretion from the hypothalamus is mediated through Kisspeptins. Kisspeptins are products of KiSS-1 gene. Leptin and adiponectin are modulators of KiSS-1 expression in the hypothalamus. These peptides have also important roles in pancreatic β-cells to control insulin synthesis and secretion and their receptors are detected in Langerhans islets. We hypothesized that leptin and adiponectin might alter KiSS-1 and Kiss Receptor mRNA expression in the islets.

Objectives:

The aim of this study is to investigate any modulatory effect that leptin and adiponectin may have on the expression of Kiss-1 and KiSSR gene in Langerhans islets.

Materials and Methods:

We isolated the islets from adult male rats by collagenase and cultured CRI-D2 cell lines to investigate the effect of leptin and adiponectin. Then, we incubated them with different concentrations of leptin and adiponectin for 24 hours. After that, RNA was extracted from the islets and CRI-D2 cells and transcripted to cDNA. KiSS-1 and KissR expression levels were evaluated by real time PCR.

Results:

In islet and CRI-D2 cells, leptin increased the KiSS-1 mRNA expression significantly, but adiponectin decreased it was expected.

Conclusions:

These findings indicated the possibility that KiSS-1 mRNA expression is a mediator of leptin and adiponectin function in the islets.

Leptin;Adiponectin;Kisspeptins;Kiss1r Protein, Mouse;Islets of Langerhans Leptin;Adiponectin;Kisspeptins;Kiss1r Protein, Mouse;Islets of Langerhans http://www.endometabol.com/index.php?page=article&article_id=15297 Mandana Mahmoodzadeh Sagheb Mandana Mahmoodzadeh Sagheb Department of Biology, Kazeroon Branch, Islamic Azad University, Kazeroon, IR Iran; Department of Biology, Kazeroon Branch, Islamic Azad University, Kazeroon, IR Iran. Tel/ fax: +98-7116474331 Department of Biology, Kazeroon Branch, Islamic Azad University, Kazeroon, IR Iran; Department of Biology, Kazeroon Branch, Islamic Azad University, Kazeroon, IR Iran. Tel/ fax: +98-7116474331 Negar Azarpira Negar Azarpira Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Ramin Yaghobi Ramin Yaghobi Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.5812/ijem.16502 The Time of Prenatal Androgen Exposure Affects Development of Polycystic Ovary Syndrome-Like Phenotype in Adulthood in Female Rats The Time of Prenatal Androgen Exposure Affects Development of Polycystic Ovary Syndrome-Like Phenotype in Adulthood in Female Rats research-article research-article Background:

Polycystic ovary syndrome (PCOS) is one of the most common reproductive disorders in women. Previous studies have shown that prenatal exposure of female fetuses to androgen can be considered an important factor in the development of PCOS.

Objectives:

In the present study we aimed to examine the effects of prenatal exposure of female rat fetuses to previously documented doses of testosterone on different embryonic days on the development of PCOS phenotype in adulthood.

Materials and Methods:

Pregnant rats were divided into four groups, experimental and control groups. Three mg of free testosterone was administered subcutaneously to experimental group 1 on gestational days 16-19, daily and 20 mg on day 20, to experimental group 2, and the controls received solvent at the same times. Female offspring of these mothers aged between 90-100 days were examined for development and function of the reproductive system. Independent-sample student t test was used to compare the results between the experimental groups and controls.

Results:

Anogenital distance (P < 0.001) and clitoris length were significantly increased in the offspring of both experimental groups (P < 0.001 and P < 0.05 respectively). Nipples were not formed in the offspring of experimental group 1, whereas in experimental group 2 the number of nipples was unchanged. Vaginal length was significantly decreased in the offspring of experimental group 1 (P < 0.001), whereas in experimental group 2, no significant difference was observed. In the offspring of experimental group 1, hormonal profiles did not differ, but in experimental group 2, levels of testosterone (P < 0.05) and LH (P < 0.01) were significantly increased, but estrogen (P < 0.05) and anti-Mullerian hormone levels (P < 0.001) were significantly decreased. A significant increase in the number of preantral and antral follicles was observed in the ovaries of offspring of experimental group 1 (P < 0.05); whereas there was no such a difference in experimental group 2.

Conclusions:

The time of prenatal exposure to androgens may have a significant role in the development of PCOS. Increased prenatal androgen levels are associated with hormonal changes and morphological disorders of the reproductive system. Therefore, avoiding exposure to androgen excess during critical periods of fetal development may prevent or reduce adulthood PCOS manifestations caused by prenatal excess androgen.

Background:

Polycystic ovary syndrome (PCOS) is one of the most common reproductive disorders in women. Previous studies have shown that prenatal exposure of female fetuses to androgen can be considered an important factor in the development of PCOS.

Objectives:

In the present study we aimed to examine the effects of prenatal exposure of female rat fetuses to previously documented doses of testosterone on different embryonic days on the development of PCOS phenotype in adulthood.

Materials and Methods:

Pregnant rats were divided into four groups, experimental and control groups. Three mg of free testosterone was administered subcutaneously to experimental group 1 on gestational days 16-19, daily and 20 mg on day 20, to experimental group 2, and the controls received solvent at the same times. Female offspring of these mothers aged between 90-100 days were examined for development and function of the reproductive system. Independent-sample student t test was used to compare the results between the experimental groups and controls.

Results:

Anogenital distance (P < 0.001) and clitoris length were significantly increased in the offspring of both experimental groups (P < 0.001 and P < 0.05 respectively). Nipples were not formed in the offspring of experimental group 1, whereas in experimental group 2 the number of nipples was unchanged. Vaginal length was significantly decreased in the offspring of experimental group 1 (P < 0.001), whereas in experimental group 2, no significant difference was observed. In the offspring of experimental group 1, hormonal profiles did not differ, but in experimental group 2, levels of testosterone (P < 0.05) and LH (P < 0.01) were significantly increased, but estrogen (P < 0.05) and anti-Mullerian hormone levels (P < 0.001) were significantly decreased. A significant increase in the number of preantral and antral follicles was observed in the ovaries of offspring of experimental group 1 (P < 0.05); whereas there was no such a difference in experimental group 2.

Conclusions:

The time of prenatal exposure to androgens may have a significant role in the development of PCOS. Increased prenatal androgen levels are associated with hormonal changes and morphological disorders of the reproductive system. Therefore, avoiding exposure to androgen excess during critical periods of fetal development may prevent or reduce adulthood PCOS manifestations caused by prenatal excess androgen.

Androgens; Exposure Time;Fetus; Polycystic Ovary Syndrome;Rats Androgens; Exposure Time;Fetus; Polycystic Ovary Syndrome;Rats http://www.endometabol.com/index.php?page=article&article_id=16502 Fahimeh Ramezani Tehrani Fahimeh Ramezani Tehrani Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. P.O. Box: 1985717413, Tel: +98-2122432500, Fax: +98-2122416264 Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. P.O. Box: 1985717413, Tel: +98-2122432500, Fax: +98-2122416264 Mahsa Noroozzadeh Mahsa Noroozzadeh Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Saleh Zahediasl Saleh Zahediasl Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Abbas Piryaei Abbas Piryaei Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Somayeh Hashemi Somayeh Hashemi Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Fereidoun Azizi Fereidoun Azizi Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 10.5812/ijem.18719 Obituary, Dr. Saleh Zahedi-Asl Obituary, Dr. Saleh Zahedi-Asl obituary obituary Obituary Obituary http://www.endometabol.com/index.php?page=article&article_id=18719 Fereidoun Azizi Fereidoun Azizi Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-22432500, E-mail: azizi@endocrine.ac.ir Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-22432500, E-mail: azizi@endocrine.ac.ir Azita Zadeh-Vakili Azita Zadeh-Vakili Cellular and Molecular Research Center, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Cellular and Molecular Research Center, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Niloofar Shiva Niloofar Shiva Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 10.5812/ijem.19886 Cooregendium: Comparing the Effects of Ginger and Glibenclamide on Dihydroxybenzoic Metabolites Produced in Stz-Induced Diabetic Rats [published Int J Endocrinol Metab. 2013;11(4):e10266] Cooregendium: Comparing the Effects of Ginger and Glibenclamide on Dihydroxybenzoic Metabolites Produced in Stz-Induced Diabetic Rats [published Int J Endocrinol Metab. 2013;11(4):e10266] correction correction http://www.endometabol.com/index.php?page=article&article_id=19886 Ramesh Ahmadi Ramesh Ahmadi Department of Physiology, Qom Branch, Islamic Azad University, Qom, IR Iran; Department of chemistry, Qom branch, Islamic Azad university of Qom, 15 Khordad St, Qom, IR Iran. Tel:+98-2537780001, Fax:+98-2137770001 Department of Physiology, Qom Branch, Islamic Azad University, Qom, IR Iran; Department of chemistry, Qom branch, Islamic Azad university of Qom, 15 Khordad St, Qom, IR Iran. Tel:+98-2537780001, Fax:+98-2137770001 Saeede Pishghadam Saeede Pishghadam Department Of Biology, Qom branch, Islamic Azad University, Qom, IR Iran Department Of Biology, Qom branch, Islamic Azad University, Qom, IR Iran Fatemeh Mollaamine Fatemeh Mollaamine Department of chemistry, Qom branch, Islamic Azad university, Qom, IR Iran Department of chemistry, Qom branch, Islamic Azad university, Qom, IR Iran Mohammad Reza Zand Monfared Mohammad Reza Zand Monfared Department of chemistry, Qom branch, Islamic Azad university, Qom, IR Iran Department of chemistry, Qom branch, Islamic Azad university, Qom, IR Iran