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1.
Eur Thyroid J ; 12(5)2023 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-37432713

RESUMO

Objective: Ultrasound-guided percutaneous ethanol injection therapy (US-PEIT) is used in patients with recurrent symptomatic thyroid cysts as a credible alternative to surgery. Young patients commonly do not wish to undergo surgery and prefer ethanol ablation, if available. The effect of this approach on quality of life is an essential factor in deciding on the treatment options, especially in the young with a long life expectancy and no comorbidity. Methods: We performed US-PEIT in a cohort of young patients, 15-30 years, from 2015 to 2020. The patients' general quality of life (QoL), self-reported compression symptoms and neck appearance were evaluated. Results: The cohort comprised 59 patients with 63 cysts, more women than men, with a mean age of 23.8 years. About 1.5 mL of injected alcohol were needed to reach a 90.7% mean cyst volume reduction ratio in 12 months. The method did not fail in any of the patients; a single US-PEIT session was undertaken in 46% of them. The procedure significantly improved each of the patients' symptoms with a significant total score difference (P < 0.001). The total symptom score correlated with the initial cyst volume (P = 0.002; r = 0.395). The mean QoL score by SF-36 6 months after the last US-PEIT was significantly different for physical component summary 56.5 (P < 0.001) but not different for mental component summary 47.7 (P = 0.125), compared to age-corresponding norms. Conclusions: US-PEIT is a safe and effective method for the young, leading to improvements in cosmetic and subjective complaints, and should also be considered as first-line treatment in the young.


Assuntos
Adenoma Oxífilo , Cistos , Neoplasias da Glândula Tireoide , Masculino , Humanos , Feminino , Adulto Jovem , Adulto , Qualidade de Vida , Etanol/uso terapêutico , Cistos/diagnóstico
2.
Vnitr Lek ; 68(E-8): 4-7, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36575059

RESUMO

Ethanol ablation of recurrent symptomatic thyroid cystic nodules is a minimally invasive procedure that can be used as an alternative to surgery. The method is suitable for polymorbid patients with increased surgical risk. Or it can be offered to patients who do not want to undergo surgery.


Assuntos
Ablação por Cateter , Nódulo da Glândula Tireoide , Humanos , Etanol/uso terapêutico , República Tcheca , Nódulo da Glândula Tireoide/cirurgia , Ablação por Cateter/métodos , Resultado do Tratamento
3.
Artigo em Inglês | MEDLINE | ID: mdl-30945701

RESUMO

INTRODUCTION: Ultrasound-guided percutaneous ethanol injection therapy (US-PEIT) is a minimally invasive procedure that may be performed as an alternative to surgery for the treatment of recurrent symptomatic thyroid cysts for which simple aspiration failed. The present study aimed at assessing US-PEIT in a large cohort of patients, identifying factors influencing treatment outcome. METHODS: Retrospective analysis of 193 patients with 200 thyroid cysts who underwent US-PEIT in 2004-2018. RESULTS: The initial median cyst volume was 8.5 mL [5.5-16.0]; median final volume at 12 months after the completion of therapy was 0.5 mL [0.2-1.3]. A Volume Reduction Rate (VRR) of 95.0% [86.7-98.0] was achieved. For successful US-PEIT, relatively small total amount of ethanol was needed, on average corresponding to 20.0% [16.7-28.6] of the initial cyst volume. VRR positively correlated with the initial cyst volume and negatively with the presence of complex cyst. Multiple regression analysis showed the presence of complex cyst as an independent predictor of treatment efficacy. CONCLUSION: US-PEIT of thyroid cysts of all sizes was very successful with using total amounts of ethanol, corresponding to ≈20% of the initial cyst volume.


Assuntos
Cistos/tratamento farmacológico , Etanol/uso terapêutico , Doenças da Glândula Tireoide/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cistos/diagnóstico por imagem , Feminino , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doenças da Glândula Tireoide/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-30209438

RESUMO

BACKGROUND: Diseases caused by atherosclerosis play the most important role in mortality and morbidity worldwide. Serum adipocyte fatty acid binding protein (A-FABP) seems to be a new promising marker to determine the risk of atherosclerosis. OBJECTIVE: The aim of this study was to evaluate relationships between serum A-FABP levels in studied individuals and to assess the possibility of modeling the intima media thickness of the common carotid artery (C-IMT) using A-FABP levels and other observed characteristics. METHODS: Seventy two Caucasian individuals were enrolled and divided into 3 groups: dyslipidemic patients with or without metabolic syndrome (MetS+, n=17; MetS-, n= 34) and controls (n=21). RESULTS: There was confirmed the well-established risk profile of individuals with MetS (unfavorable lipid and lipoprotein profile, as well as increased parameters of insulin resistence and C-IMT). A-FABP concentrations in this group were significantly higher in comparison with both MetS- and controls. CONCLUSION: Using multiple linear regression models of C-IMT values for all individual data, healthy controls and dyslipidemic patients without metabolic syndrome (MetS-) A-FABP levels were not revealed as an important predictor of C-IMT in our model. In contrast, age, gender, waist circumference, nonHDL cholesterol levels and ApoB/ApoA1 ratio were important repressors of C- IMT in study individuals. This finding may be attributed to the overwhelming effect of other more robust risk factors for atherosclerosis in these individuals.


Assuntos
Apolipoproteína A-I/sangue , Apolipoproteína B-100/sangue , Aterosclerose/sangue , Doenças das Artérias Carótidas/sangue , Artéria Carótida Primitiva/diagnóstico por imagem , Dislipidemias/sangue , Proteínas de Ligação a Ácido Graxo/sangue , Síndrome Metabólica/sangue , Adulto , Aterosclerose/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Espessura Intima-Media Carotídea , Dislipidemias/diagnóstico por imagem , Feminino , Humanos , Resistência à Insulina , Masculino , Síndrome Metabólica/diagnóstico por imagem , Pessoa de Meia-Idade
5.
Vnitr Lek ; 62(9 Suppl 3): 56-62, 2016.
Artigo em Tcheco | MEDLINE | ID: mdl-27734693

RESUMO

Endocrine orbitopathy (EO) must be understood mainly as a result of oxidative stress. The pathological process finally affects both the appearance and vision of the patient. In the case of inappropriate or late treatment or lack of patient cooperation, it significantly influences the quality of life of those affected. In spite of the sophisticated dia-gnostic algorithms, in some cases it is difficult to confirm the diagnosis of EO. The range of laboratory methods, the essential part of the diagnostic process, has only recently been extended by the possibility of quantification of specific, stimulating immunoglobulins (TSI). A major shortcoming may be seen in an undervalued importance of orbital ultrasonography, in particular of the eye muscles (US).Key words: biological treatment - endocrine orbitopathy (EO) - Graves-Basedow disease (GB) - "hashitoxicosis" (HTX) - hyaluronan synthase 2 (HAS2) - thyroid-blocking immunoglobulins (TBI) - thyroid-stimulating immunoglobulins (TSI) - hyaluronic acid (HA) - lymphocytary, Hashimotos thyroiditis (HT) - pulse therapy - TSH-receptor - transcription factors FOXOs - orbital ultrasonography, mainly of the eye muscles (US).


Assuntos
Oftalmopatia de Graves/diagnóstico , Imunoglobulinas Estimuladoras da Glândula Tireoide/imunologia , Músculos Oculomotores/diagnóstico por imagem , Doença de Graves , Oftalmopatia de Graves/imunologia , Humanos , Estresse Oxidativo , Qualidade de Vida , Ultrassonografia
6.
Artigo em Inglês | MEDLINE | ID: mdl-24572487

RESUMO

BACKGROUND: Ultrasound-guided percutaneous ethanol injection (US-guided PEI) is used in patients with recurring symptomatic thyroid cysts in whom simple drainage was not successful. It is an alternative non-surgical approach in patients refusing or at risk during surgery. METHODS AND RESULTS: US-guided PEI was performed in 33 patients, with a success rate of 100% and significantly decreased cyst volume after 1, 3 and 6 months after the last PEI compared with the initial volume. The mean number of PEI procedures was 1.5±0.7 with a mean 96% ethanol volume of 2.4±1.2 mL. In the entire group, the initial cyst volume was significantly reduced to the final volume at 6 months after PEI (10.82±5.03 mL vs. 0.78±0.84 mL; P<0.001). Also in all patients, mean volume reduction rates were significantly increased (P<0.001) at check-ups at 1 month (83.1±8.1%), 3 months (89.9±6.3%) and 6 months (92.6±6.4%). In case of medium-sized cysts, more PEI procedures were needed than in small cysts (1.1±0.4 vs. 2.0±0.5). The total amount of 96% ethanol was equal to 22.7±7.9% of the initial cyst volume. CONCLUSION: Our experiences confirm that small and medium-sized cysts may be successfully treated with relatively small amounts of ethanol. In case of medium-sized cysts, more PEI procedures were needed. Final reduction of complex cysts was achieved later. Apart from temporary localized pain, no serious complications were observed in most cases.


Assuntos
Cistos/tratamento farmacológico , Diagnóstico por Imagem/métodos , Etanol/administração & dosagem , Neoplasias da Glândula Tireoide/tratamento farmacológico , Adulto , Idoso , Cistos/diagnóstico , Feminino , Seguimentos , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/diagnóstico , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia/métodos , Adulto Jovem
7.
Clin Biochem ; 46(9): 766-71, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23499586

RESUMO

OBJECTIVES: Both decreased and increased risk of cardiovascular events/mortality have been reported with high adiponectin levels. Only a few studies have reported an association of adiponectin with markers of hemostasis/endothelial dysfunction which might explain the reported discrepancies. DESIGN AND METHODS: We evaluated the association of total adiponectin with von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (t-PA), soluble thrombomodulin (sTM), adhesion molecules sICAM-1 and sVCAM-1, lipids and markers of insulin resistance (IR) in 308 asymptomatic dyslipidemic subjects and healthy controls. Subjects were divided into 4 dyslipidemic phenotypes (DLP): DLP1 (TG < 1.5 mmol/L + ApoB < 1.2 g/L), DLP2 (TG ≥ 1.5 + ApoB < 1.2), DLP3 (TG < 1.5 + ApoB ≥ 1.2) and DLP4 (TG ≥ 1.5 + ApoB ≥ 1.2). The results were evaluated also according to the presence (+) and absence (-) of metabolic syndrome (MS). RESULTS: In hyperlipidemic subjects (DLP2-4), PAI-1, t-PA and sICAM-1 correlated with markers of IR but only t-PA correlated inversely with adiponectin. In contrast positive association of adiponectin with vWF, sTM and sVCAM-1 was found but none of these parameters correlated with markers of insulin resistance. In multiple regression analysis, adiponectin remained independently associated with vWF [in DLP3, DLP4, DLP2-4, MS(-)], with sTM [in DLP2, DLP4, DLP2-4, MS(+)] and with sVCAM-1 [in DLP2, DLP3, DLP4, DLP2-4, MS(+)]. In healthy controls (DLP1), no association between adiponectin and markers of hemostasis/endothelial dysfunction was found. CONCLUSION: The independent positive association of adiponectin with vWF, sTM and sVCAM-1 deserves further evaluation in connection with the risk of atherothrombotic cardiovascular events.


Assuntos
Adiponectina/sangue , Quimiocinas/sangue , Dislipidemias/sangue , Trombomodulina/sangue , Fator de von Willebrand/metabolismo , Adulto , Apolipoproteínas B/sangue , Doenças Assintomáticas , Biomarcadores/sangue , Estudos de Casos e Controles , Quimiocinas CXC , Feminino , Humanos , Molécula 1 de Adesão Intercelular/sangue , Masculino , Pessoa de Meia-Idade
8.
Artigo em Inglês | MEDLINE | ID: mdl-23073522

RESUMO

INTRODUCTION: Like hypertension, prehypertension is associated with cardiovascular disease. AIMS: The aim of this study was to evaluate: a) the prevalence of prehypertension/hypertension in individuals with various dyslipidemic phenotypes; b) the relation between blood pressure (BP) and other risk factors for atherosclerosis; c) atherogenic potential of prehypertension by the assessment of intima-media thickness of the arteria carotis communis (IMT). METHODS: 667 clinically asymptomatic subjects were divided into four dyslipidemic phenotypes (DLP) according to apolipoprotein B (apoB) and triglycerides (TG): DLP1 (n=198, normo-apoB/normo-TG), DLP2 (n=179, normo-apoB/hyper-TG), DLP3 (n=87, hyper-apoB/normo-TG), DLP4 (n=203, hyper-apoB/hyper-TG). DLP1 served as a control group. RESULTS: There was significantly higher prevalence of prehypertension and hypertension in subjects with dyslipidemia (DLP2 43.0%, 41.3%; DLP3 42.5%, 29.9%; DLP4 42.4%, 47.8%) than in normolipidemic individuals (DLP1 32.8%, 20.2%). Systolic and diastolic blood pressure (SBP + DBP) correlated with age, total cholesterol, TG, non-HDL-cholesterol, body mass index and waist circumference; SBP additionally with C-peptide, fasting glycemia; DBP additionally with apoB, homeostasis model assessment (HOMA) and plasminogen activator inhibitor-1. The IMT of hypertensive and of prehypertensive subjects was higher than that of subjects with normal BP in all DLPs. CONCLUSIONS: The prevalence of prehypertension was higher in all dyslipidemic patients. The common prevalence of prehypertension/hypertension was highest in the hypertriglyceridemic subjects. Prehypertensive and hypertensive patients had higher IMT than normotensive individuals in all DLPs.


Assuntos
Biomarcadores/sangue , Espessura Intima-Media Carotídea , Dislipidemias/sangue , Dislipidemias/patologia , Hipertensão/sangue , Hipertensão/patologia , Pré-Hipertensão/sangue , Pré-Hipertensão/patologia , Adulto , Apolipoproteínas B/sangue , Pressão Sanguínea , Índice de Massa Corporal , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , República Tcheca/epidemiologia , Dislipidemias/complicações , Dislipidemias/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Pré-Hipertensão/epidemiologia , Pré-Hipertensão/etiologia , Prevalência , Triglicerídeos/sangue , Circunferência da Cintura
9.
Case Rep Endocrinol ; 2012: 363690, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23213580

RESUMO

Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. It may be suspected based on severe clinical signs, significant laboratory findings, and the tumor size. High-resolution ultrasonography with Doppler imaging has become the principal imaging method in the preoperative diagnosis of primary hyperparathyroidism. The ultrasound finding is not specific, but three of the described pictures are different from the typical appearance of benign adenoma of the thyroid gland and were suspicious in the context of clinical findings. According to the ultrasound criteria, one finding was benign and only the histological examination revealed carcinoma.

10.
Neuro Endocrinol Lett ; 33 Suppl 2: 26-31, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23183506

RESUMO

OBJECTIVES: Some findings support the role of serum adipocyte fatty acid-binding protein (A-FABP) as a key pro-inflammatory mediator that links obesity with cardiovascular diseases. The aim of the study was to evaluate the association of A-FABP with endothelial/hemostatic markers [von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1), tissue-plasminogen activator (t-PA), soluble intercellular cell adhesion molecule-1 (s-ICAM-1) and soluble vascular cell adhesion molecule-1 (s-VCAM-1)] in asymptomatic dyslipidemic subjects. DESIGN: We examined 105 dyslipidemic patients (with apolipoprotein B concentration ≥1.2 g/l and/or triglyceride (TG) concentration ≥1.5 mmol/l) without clinical manifestation of atherosclerosis and 50 normolipidemic healthy subjects, who served as a control group. Except of endothelial/hemostatic markers, anthropometric and lipid parameters, markers of insulin resistance and inflammation were assessed. RESULTS: In dyslipidemic patients, A-FABP positively correlated with age (p<0.05), TG (p<0.05), insulin (p<0.05), homeostatic model assessment (HOMA) index (p<0.05), body mass index (p<0.001), waist circumference (p<0.05), high sensitivity C reactive protein (p<0.01), and vWF (p<0.05) and negatively with male gender (p<0.05). There were no correlations between A-FABP and PAI-1, t-PA, s-VCAM-1 or s-ICAM-1. By using linear multivariate regression analysis the positive association between A-FABP and vWF was independent of age, gender, insulin resistance, and visceral obesity. CONCLUSION: Study displayed an independent positive association of A-FABP with vWF in clinically asymptomatic dyslipidemic subjects. Contribution of A-FABP in the process of endothelial dysfunction could help to explain the role of obesity in cardiovascular damage.


Assuntos
Aterosclerose/sangue , Dislipidemias/sangue , Dislipidemias/epidemiologia , Endotélio Vascular/metabolismo , Proteínas de Ligação a Ácido Graxo/sangue , Adulto , Aterosclerose/epidemiologia , Biomarcadores/sangue , Feminino , Homeostase/fisiologia , Humanos , Molécula 1 de Adesão Intercelular/sangue , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Obesidade/sangue , Obesidade/epidemiologia , Fatores de Risco , Ativador de Plasminogênio Tecidual/sangue , Molécula 1 de Adesão de Célula Vascular/sangue , Fator de von Willebrand/metabolismo
11.
Artigo em Inglês | MEDLINE | ID: mdl-21475379

RESUMO

INTRODUCTION: Adiponectin is adipocytokin with anti-inflammatory and anti-atherogenic effects. However, studies examining the relationship between adiponectin and cardiovascular diseases have shown inconsistent results. AIMS: The aim of this study was to evaluate the plasma levels of adiponectin in clinically asymptomatic subjects with various dyslipidemic phenotypes. The associations between adiponectin and risk factors for atherosclerosis, markers of insulin resistance, and the intima-media thickness of the common carotid artery (IMT) were also evaluated. METHODS: 234 asymptomatic subjects were divided into four dyslipidemic phenotypes (DLP) according to apolipoprotein B (apoB) and triglycerides (TG): DLP1 (n=58, apoB<1.2 g/l and TG<1.5 mmol/l), DLP2 (n=47, apoB<1.2 g/l and TG≥1.5 mmol/l), DLP3 (n=31, apoB≥1.2 g/l and TG<1.5 mmol/l) and DLP4 (n=98, apoB≥1.2 g/l and TG≥1.5 mmol/l). DLP1 (normo-apoB/normo-TG) served as a control group. RESULTS: Significant differences in adiponectin levels between normolipidemic phenotype - DLP1 (16.1[10.3-20.8] mg/l) and hypertriglyceridemic phenotypes - DLP2 (9.5[6.8-13.0] mg/l, p<0.01) and DLP4 (10.1[7.4-16.8] mg/l, p<0.01) after adjustment for age, sex and body mass index were found. Adiponectin correlated positively with highdensity lipoprotein cholesterol and apolipoprotein A1 (apoA1), negatively with triglycerides, apoB/apoA1, highsensitivity C-reactive protein, insulin, homeostasis model assessment and waist circumference. ApoA1 and insulin were detected as independent predictors for adiponectin levels in multivariate regression analysis. Adiponectin did not correlate with IMT. CONCLUSIONS: Individuals with hypertriglyceridemic phenotypes showed decreased adiponectin levels in comparison with normolipidemic subjects. Adiponectin was associated with lipid parameters, markers of insulin resistance, chronic inflammation and visceral obesity. But no association between adiponectin and IMT was found.


Assuntos
Adiponectina/sangue , Dislipidemias/sangue , Túnica Íntima/patologia , Apolipoproteínas B/sangue , Índice de Massa Corporal , Artéria Carótida Primitiva/patologia , Dislipidemias/patologia , Humanos , Triglicerídeos/sangue , Circunferência da Cintura
12.
J Thromb Thrombolysis ; 31(1): 27-36, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20640487

RESUMO

The aim of this study was to evaluate the plasma levels of prothrombotic markers--von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (t-PA)--in asymptomatic subjects with dyslipidemia. Asymptomatic subjects with dyslipidemia and their relatives (n = 234) were assessed for lipids and prothrombotic markers. Individuals were divided into four dyslipidemic phenotypes (DLP) according to apolipoprotein B (apoB) and triglycerides (TG): DLP1 (n = 58, apoB < 1.2 g/l and TG < 1.5 mmol/l), DLP2 (n = 47, apoB < 1.2 g/l and TG ≥ 1.5 mmol/l), DLP3 (n = 31, apoB ≥ 1.2 g/l and TG < 1.5 mmol/l) and DLP4 (n = 98, apoB ≥ 1.2 g/l and TG ≥ 1.5 mmol/l). Associations between prothrombotic markers and risk factors for atherosclerosis, markers of insulin resistance, and the intima-media thickness of the common carotid artery (IMT) were assessed too. Significant differences in PAI-1 between normolipidemic phenotype--DLP1 (62.5 (35.9-82.9) ng/ml) and hypertriglyceridemic phenotypes--DLP2 (82.2 (61.1-122.1) ng/ml, p < 0.01) and DLP4 (91.4 (63.5-111.8) ng/ml, p < 0.001) after adjustment for age, sex and body mass index, were found. Levels of t-PA were different only between DLP1 and DLP4 (1.9 (0.9-3.3) ng/ml vs. 5.3 (2.5-8.6) ng/ml, p < 0.05). There were no significant differences of vWF between DLPs. PAI-1 and t-PA correlated with lipid parameters, markers of insulin resistance, blood pressure and obesity. VWF was independently associated with IMT, which was increased in DLP4. Individuals with hypertriglyceridemic phenotypes showed increased levels of PAI-1 in comparison with normolipidemic subjects. The elevation of t-PA was presented only in patients with simultaneously elevated TG and apoB. The significant increase of IMT confirmed in the patients with DLP4 reveals individuals with the highest risk for atherosclerosis manifestation.


Assuntos
Fatores de Coagulação Sanguínea/análise , Dislipidemias/sangue , Trombose/sangue , Adulto , Fatores Etários , Idoso , Aterosclerose/sangue , Biomarcadores/sangue , Fatores de Coagulação Sanguínea/metabolismo , Feminino , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais
13.
Clin Biochem ; 42(12): 1246-51, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19450572

RESUMO

OBJECTIVE: To characterize the differences in various risk factors for atherosclerosis between individuals with apoB higher (H) and lower (L) than predicted from regression equation apoB vs LDL-C. METHODS: We evaluated 391 dyslipidemic subjects not treated with hypolipidemic drugs. The measured parameters included lipid profile, apolipoproteins A-1 and B, markers of insulin resistance and inflammation/hemostasis. RESULTS: Correlation coefficient between apoB and LDL-C was 0.9 (p<0.0001). Individuals with H apoB compared to L apoB had significantly higher sex and age adjusted BMI, waist circumference, insulin, HOMA (fasting insulinglucose/22.5), C-peptide, proinsulin, PAI-1, sICAM-1, sVCAM-1, t-PA, vWF, frequency of metabolic syndrome and lower values of TC, LDL-C and HDL-C (p<0.05 to <0.001 for all parameters). CONCLUSION: Individuals with apoB higher than predicted by their LDL-C levels are more insulin resistant and have more atherogenic risk profile. Thus, at least for dyslipidemic patients with high cardiometabolic risk, apoB is a more appropriate marker of risk than LDL-C.


Assuntos
Apolipoproteínas B/sangue , Aterosclerose/sangue , LDL-Colesterol/sangue , Adulto , Biomarcadores/sangue , Feminino , Humanos , Resistência à Insulina , Masculino , Síndrome Metabólica/sangue , Pessoa de Meia-Idade , Fatores de Risco , Estatística como Assunto
14.
Thromb Res ; 123(3): 466-75, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-18417194

RESUMO

INTRODUCTION: The aim of this study was to evaluate the plasma levels of endothelial haemostatic markers - von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (t-PA) and soluble thrombomodulin (sTM) - in asymptomatic, nonsmoking members of families with familial combined hyperlipidemia (FCH). We investigated the association between these factors and the intima-media thickness (IMT) of the common carotid artery, selected risk factors of atherosclerosis and markers of insulin resistance. METHODS: 82 members of 29 FCH families were divided into two groups: HL (probands and hyperlipidemic first-degree relatives, n=47) and NL (normolipidemic first-degree relatives, n=35). The control groups C-HL (n=20) and C-NL (n=20) consisted of sex- and age-matched healthy individuals. IMT was measured by ultrasound at a far wall of both common carotid arteries. RESULTS: Compared with healthy controls, hyperlipidemic subjects had significantly higher levels of vWF (146.4+/-73.2% versus 112.2+/-29.4%, p<0.05), of PAI-1 (102.4[83.0-117.0] ng/ml versus 63.5[31.8-87.3] ng/ml, p<0.01) and of t-PA (5.1[2.5-7.9] ng/ml versus 3.4[1.4-5.8] ng/ml, p<0.05). They had increased IMT, which correlated with vWF (r=0.29, p<0.05). Their normolipidemic relatives had significantly higher levels of vWF (137.2+/-42.8% versus 106.6+/-24.0%, p<0.01) and of PAI-1 (75.3[53.2-92.0] ng/ml versus 48.6[37.4-85.9] ng/ml, p<0.05). Levels of vWF, PAI-l and t-PA were independently associated with several markers of insulin resistance. CONCLUSIONS: Asymptomatic members of FCH families have increased endothelial haemostatic factors- vWF, PAI-1, t-PA, which are associated with insulin resistance. VWF correlates with morphological vascular changes, detected by the increase of IMT, presented in only hyperlipidemic subjects.


Assuntos
Hiperlipidemia Familiar Combinada/sangue , Adulto , Aterosclerose/sangue , Aterosclerose/etiologia , Aterosclerose/fisiopatologia , Biomarcadores/sangue , Endotélio Vascular/fisiopatologia , Feminino , Hemostasia , Humanos , Hiperlipidemia Familiar Combinada/complicações , Hiperlipidemia Familiar Combinada/patologia , Hiperlipidemia Familiar Combinada/fisiopatologia , Masculino , Pessoa de Meia-Idade , Inibidor 1 de Ativador de Plasminogênio/sangue , Fatores de Risco , Trombomodulina/sangue , Ativador de Plasminogênio Tecidual/sangue , Túnica Íntima/patologia , Adulto Jovem , Fator de von Willebrand/metabolismo
16.
J Clin Ultrasound ; 36(4): 243-6, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18092317

RESUMO

Parathyroid cysts are uncommon lesions that do not have a specific sonographic appearance. We report a rare case of a functionally active cystic parathyroid adenoma as a cause of primary hyperparathyroidism and discuss the difficulties associated with the diagnosis. In this case, the association with a multinodular goiter made preoperative differentiation from thyroid cysts difficult. Demonstration of a high intact parathyroid hormone level in the aspirated cyst fluid was critical for the correct diagnosis.


Assuntos
Adenoma/complicações , Bócio/complicações , Hiperparatireoidismo Primário/etiologia , Neoplasias das Paratireoides/complicações , Adenoma/diagnóstico por imagem , Adenoma/cirurgia , Idoso , Biópsia por Agulha Fina , Diagnóstico Diferencial , Feminino , Bócio/diagnóstico por imagem , Bócio/cirurgia , Humanos , Hiperparatireoidismo Primário/diagnóstico por imagem , Hiperparatireoidismo Primário/cirurgia , Neoplasias das Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/cirurgia , Tireoidectomia , Ultrassonografia
17.
Atherosclerosis ; 197(2): 725-31, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17714716

RESUMO

The aim of our study was to evaluate the relationship of adiponectin to soluble forms of vascular cell adhesion molecule-1 (sVCAM-1) and intercellular cell adhesion molecule-1 (sICAM-1) in patients with cardiovascular disease or dyslipidemia. Two hundred and sixty-four patients (134 men/130 women, mean age 43.8+/-14.8/46.0+/-14.9 years) of Lipid Center, University Hospital Olomouc, off hypolipidemic therapy for at least 6 weeks, participated in the study. In multiple regression analysis, adiponectin was independently positively associated with serum HDL-cholesterol (p<0.0001) and sVCAM-1 (p<0.0001), female gender (p<0.0001) and negatively with hs-CRP (p=0.014). Serum concentration of adiponectin and sICAM-1 did not correlate but sICAM-1 was independently, positively associated with sVCAM-1 (p<0.0001) and negatively with markers of insulin resistance and inflammation, namely atherogenic index log[triglycerides/HDL-cholesterol] (p<0.0001), hs-CRP (p<0.001) and HOMA (p<0.05). Positive association of adiponectin with HDL-C and negative association with hs-CRP indicate anti-atherogenic properties of adiponectin. The finding of the positive association of adiponectin with sVCAM-1 in patients at risk is unexpected. We hypothesize that adiponectin may be involved (directly or indirectly) in shedding of ectodomains of VCAM-1 from endothelial surface and in this way down-regulates their effects. This process may be protective in the initial stages of atherosclerosis.


Assuntos
Doença da Artéria Coronariana/sangue , Hipercolesterolemia/sangue , Hipertrigliceridemia/sangue , Molécula 1 de Adesão Intercelular/sangue , Molécula 1 de Adesão de Célula Vascular/sangue , Adiponectina/sangue , Adulto , Idoso , Proteína C-Reativa , HDL-Colesterol/sangue , Estudos de Coortes , Compostos de Epóxi , Feminino , Humanos , Inflamação/sangue , Resistência à Insulina/fisiologia , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/sangue , Acidente Vascular Cerebral/sangue
18.
Artigo em Inglês | MEDLINE | ID: mdl-16170396

RESUMO

Familial combined hyperlipidemia (FCH) is the most common familial hyperlipidemia with a high risk for early atherosclerosis. The aim of this study was to compare levels of soluble intercellular cell adhesion molecule 1 (s-ICAM-1) and soluble vascular cell adhesion molecule 1 (s-VCAM-1) in asymptomatic members of FCH families with healthy controls and to determine the relation between s-ICAM-1, s-VCAM-1 and risk factors accompanying FCH. We also investigated the association between adhesion molecules and the intima-media thickness (IMT) of the common carotid artery, a recognized morphological marker of early atherosclerosis. 82 members of 29 FCH families were divided into the 2 groups: HL (probands and hyperlipidemic first-degree relatives, n = 47) and NL (normolipidemic first-degree relatives, n = 35). The control groups--HL-C (n = 20) and NL-C (n = 20)--consisted of sex- and age-matched healthy individuals. Hyperlipidemic members had significantly higher concentration of s-ICAM-1 (633.7 +/- 169.6 ng/ml versus 546.2 +/- 155.9 ng/ml, p < 0.05). The elevation of s-VCAM-1 was not significant (880.8 +/- 202.9 ng/ml versus 826.5 +/- 174.6 ng/ml, N.S.). Levels of s-ICAM-1 and of s-VCAM-1 in normolipidemic relatives were not significantly different from the control group (530.8 +/- 113.9 ng/ml versus 530.0 +/- 101.0 ng/ml and 860.2 +/- 265.7 ng/ml versus 822.1 +/- 197.0 ng/ml respectively). There was a significant correlation between s-ICAM-1 and apoB (r = 0.42; p < 0.01) in hyperlipidemic subjects and between s-ICAM-1 and proinsulin (r = 0.54; p < 0.01) in normolipidemic subjects. S-ICAM-1 correlated with IMT (r = 0.32; p < 0.05) in all members of FCH families. The increase of s-ICAM-1 in asymptomatic hyperlipidemic members of FCH families reflects their high cardiovascular risk. The positive association between s-ICAM-1 and IMT could indicate s-ICAM-1 as a potential predictor of atherosclerosis manifestation.


Assuntos
Hiperlipidemia Familiar Combinada/sangue , Molécula 1 de Adesão Intercelular/sangue , Molécula 1 de Adesão de Célula Vascular/sangue , Adulto , Aterosclerose/etiologia , Índice de Massa Corporal , Artéria Carótida Primitiva/patologia , Colesterol/sangue , Feminino , Humanos , Hiperlipidemia Familiar Combinada/complicações , Hiperlipidemia Familiar Combinada/patologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Triglicerídeos/sangue
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