[Intrathyroidal parathyroid adenoma and ectopic parathyroid gland in thyroid nodule - report of two cases].

Ectopic locations of parathyroid adenomas are a rare condition and can cause difficulty in their diagnosis and surgical treatment. We report two cases of intrathyroid parathyroid lesions. In the first patient, preoperative localization studies suggested the possibility of a parathyroid adenoma outside the thyroid gland. When a pathological gland is not found during surgery for primary hyperparathyroidism, an ectopic parathyroid gland was found in the thyroid tissue. In the second patient, in an existing thyroid nodule was found an ectopic normal parathyroid gland postoperatively.

[Mean age of menopause onset in Bulgarian women]. / Sredna vuzrast na nastupvane na menopauzata sred bulgarskite zheni.

The age of menopause in women is a key point, because early menopause is associated with increased risk for many diseases. The purpose of this study was to collect data on age of menopause in Bulgarian women and to detect possible changes in it. 6017 women aged 50 years and over were included, 5363 of them were postmenopausal. Mean age of menopause in the whole study group was 49.3 years. In younger menopausal women (age 51-59 yrs.) mean age of menopause was 47.7 yrs., whereas in elderly women (71-79 yrs.) it was 49.2 yrs. This shift down of the menopausal transition is due also to the increasing part of women with early or premature menopause, including iatrogenic causes. The main consequence is the "growing younger" of many common and socially important diseases among Bulgarian women, which require active prevention.

[Andropenia and hormone-replacement therapy in men]. / Andropeniia i khormono-zamestitelno lechenie pri muzhe.

The andropause (andropaenia) or PADAM-syndrome represents a combination of clinical and laboratory symptoms, developed during aging. The most frequently reported clinical feature is erectile dysfunction. From the laboratory parameters the most typical finding is low normal or reduced serum testosterone levels. Very useful questionnaires have been developed helping in diagnosing the PADAM syndrome. Nowadays the hormonal replacement therapy with testosterone derivatives is considered to be the "gold standard". It has positive impact on the cardiovascular risk profile and its different components. This therapy is being prescribed on clear indications and according to strict rules. Available preparations in our country are the injectable and oral ones. Replacement therapy with other hormones is still not a part of clinical practice.

[Forearm density in women with early menopause]. / Kostna plutnost na predmishnitsata u zheni s rano nastupila menopauza.

The early menopause is well known to have deleterious effects on bone mass. Trabecular bone is thought to be mainly affected. Aim of this study was to produce evidence on charges in forearm total, cortical and trabecular bone density in women with early menopause. The study included 40 women menopaused before the age of 43 years and 44 age- and size-matched healthy controls, menopaused after the age of 45 years. Bone densitometry was carried out on a single X-ray DTX-100 densitometer. A special calculation procedure was used to determine bone density of cortical and trabecular bone. The early menopaused women had low bone density both at the Distal (mainly trabecular) bone. We conclude that early-onset menopause affects mainly trabecular bone and causes premature ageing of bone.

[Low-dose estrogens in the treatment of the climacteric syndrome]. / Niskodozirani estrogeni v lechenieto na klimakterichniia sindrom.

UNLABELLED: The present prospective study is aimed to estimate the effect of a low-dose combined oestrogen drug Cyclo-Menorette on climacteric syndrome in women with early menopause. MATERIAL AND METHODS: The criteria for inclusion in the study were ac follows: 9-12 months of menopause, increased FSH levels, moderately expressed climacteric syndrome confirmed by the menopausal index of Kupperman and Hamilton-Anxiety-Scale /HAMA/. According to acceptance of hormone replacement therapy /HRT/ the women were divided into 2 groups--control T /n = 31/ and Cunder treatment T /n = 35/. The degree of climacteric syndrome expression after Kupperman and HAMA was estimated in all patients at the beginning as well as on the 3-d, 6-th 12-d months. The presence and dynamics of side effects were followed in the patients treated with HRT. RESULTS: Spontaneous improvement of complaints was found out in the control group with an increase of intragroup differences during the follow-up period. Most expressed improvement in the group under treatment was established during the first 3-6 months, the beneficial effect being preserved until the end of the study. CONCLUSION: The use of 1 mg oestradiol valerat in combination with 2 mg oestriol results in a significant decrease of climacteric syndrome manifestation with slightly expressed and transient side effects.

[Immunoenzyme methods for determining thyroid hormones]. / Imunoenzimni metodi za opredeliane na tireoidni khormoni.

The analytical reliability of the immunoenzyme methods for determination of the thyroid hormones thyroxin, triiodothyronine, thyroid-binding globulin, thyrotropic hormone and the thyroid-binding capacity was examined by the peroxidase activity of the marker enzyme of "Specol-11" 28 healthy controls, 28 patients with subcompensated insulin-dependent diabetes with mean duration of 8.4 years and 11 patients with hypogonadism were examined. In the diabetic patients were found changes in their thyroid state characteristic for hypothyroidism--increased thyroxin and a decrease of the thyroid-stimulating hormone with a lowered level of the binding proteins. The patients with hypogonadism showed changes mainly in the binding proteins level, a decrease of the thyroid-binding capacity with 70%. The results reveal interrelations between the thyroid gland hormonal state and other hormonal disorders.

[Endothelial vascular desquamation in diabetics]. / Prouchvane na endotelnata sudova deskvamatsiia pri diabetno bolni.

The endothelial vascular desquamation was studied in 32 diabetic patients and 150 healthy controls. In the diabetic patients a significantly high desquamation was found. No differences in the desquamation due to the type of diabetes, I or II, and its duration were found. The authors are of the opinion that the early vascular desquamation is the result of the high glycemia.

[A unique case of pseudohypoparathyroidism]. / Za edin osoben sluchai na psevdokhipoparatireoidizum.

A case of pseudohypoparathyroidism is reported. The case presents with unusual features: primary hypogonadism (a rare feature) and several features undescribed until now with the syndrome--changes in the amino acid composition, coxae valgae, shallow fossa olecrani as well as normal values of the parathyroid hormones which is considered as a "phase state" due to the exhaustion of the secreting function of the parathyroid glands. The role of the G-unit in the etiology of the disease is discussed.