Authors have previously reported the effect of the treatment with an- tithyroid drugs (methimazol... more Authors have previously reported the effect of the treatment with an- tithyroid drugs (methimazole) on increased TSH-receptor antibodies (TRAb) serum level in patients with Graves' disease. Findings have disclosed that after 18-12 months of medica- ment treatment with "titration doses" of methimazole, about 60% of the patients become TRAb negative while 40% of the patients remained TRAb positive. In this investigation an attempt is made to treat some of the patients with persistently high TRAb findings, after the termination of 18 months titration doses therapeutic regimen, with high (immunosuppressi- ve?) doses of methimazole, including substitution with L-thyroxin. Twelve patients (2 males and 10 females, age average 33 years) have been treated. After the completion of "conven- tional" treatment of methimazole (average duration of 19,3 months) all 12 patients had elevated findings of TRAb in serum (average 136 U/l) and normal findings of "free" th...
Radio receptor assays for the detection of TSH receptor antibodies in serum are typically based o... more Radio receptor assays for the detection of TSH receptor antibodies in serum are typically based on binding the competition of TSH-R antibodies and (125)I "labeled" TSH for membrane preparation of thyrocytes (TBII tests). The sensitivity of the available tests utilizing porcine cell membranes was found to be around 80%. A new test (TRAK Dyno human, BRAHMS) utilizes human recombinant TSH receptor and human standard material that is supposed to improve the performance of the test. We have compared the results of these two assays. The sensitivity of the TRAK Assay tested in 356 patients with untreated Graves' disease was found to be 85%, and 97.5% for TRAK Dyno human in 111 newly diagnosed patients. Both tests were performed from the same serum specimen for 60 of the investigated patients. The TRAK Assay was positive in 50 patients (83.2%) and TRAK Dyno human in 59 patients (98.3%). The specificity of the new radio receptor assay was also improved.
From the clinical point of view, hyperthyroidism is generally presented as diffuse hyperactivity ... more From the clinical point of view, hyperthyroidism is generally presented as diffuse hyperactivity of thyroid tissue induced by autoimmune stimulation (Graves’ disease), or as the consequence of one, or more hyperactive autonomous nodules (Plummer’s disease). These two entities are relatively perceivable in clinical routine. Thyroid scintigraphy of the patient with Graves’ disease, presents a pattern of a diffusely enlarged gland with homogenous distribution of radioactive tracer. In Plummer’s disease, one nodule (“toxic adenoma”) or rarely few nodules (toxic nodular goiter), are presented as scintigraphicaly “hot” nodules with complete suppression of paranodular tissue. Occasionally, some scintigraphic findings that could not be so simplified are registrated. Thyroid glands of some patients with Graves' disease present nodules that can accumulate radioactive tracer of the comparable intensity to paranodular tissue (warm nodules). This occurence of the functioning adenoma in Grave...
It is generally accepted that the thyrotropin receptor antibody (TRAb) has a stimulating activity... more It is generally accepted that the thyrotropin receptor antibody (TRAb) has a stimulating activity and is the major pathogenic factor in Graves' disease (GD). In spite of that, TRAb is not routinely examined in clinical practice. The aim of this article is to briefly review the subject and suggest protocols for the diagnosis, treatment and follow-up of patients with GD based on our own studies and referring especially to TRAb. Clinical symptoms and signs and thyroid hormones may have poor sensitivity or specificity, especially in cases of endocrine ophthalmopathy and subclinical hyperthyroidism. In these cases the TRAb test is 98% sensitive and specific with a diagnostic accuracy of almost 99%. By this test it is possible to differentiate between autoimmune and other forms of thyrotoxicosis such as autonomous hyperthyroidism, destructive thyroiditis, iodine induced hyperthyroidism etc. Antithyroid drugs decrease serum TRAb levels and also induce immune remission. If after treatme...
Amiodarone (AMD) is a potent antiarrhythmic drug, liposolubile bensophuran derivative, containing... more Amiodarone (AMD) is a potent antiarrhythmic drug, liposolubile bensophuran derivative, containing 75 mg of iodide per 200 mg of active substance (2 atoms of iodine per molecule or 37,2% of molecular weight) and with elimination halflife of several months. Metabolism of 200 mg of AMD yields approximatively 6 mg/day of inorganic iodide in circulation. In susceptible patients chronical iodine overload and/or direct citotoxicity of the drug can induce thyroid disfunction (TD) - hypothyreosis (AIH), thyrotoxicosis (AIT) or subclinical TD. Cellular uptake of 99mTc-MIBI, cationic complex, is related to its charge and lipophilicity and highly negative membrane potential in the endomitochondrial element which traps the tracer within the organelle's matrix not organ specificly. MIBI is not retained in irreversibly ischemic cells and coukl be a highly sensitive marker of cell viability. It provides good quality thyroid scans. It seems that TSH and iodine overload do not influence MIBI upta...
Background and aims: CXC chemokine ligand 10 (CXCL10) also known as chemokine interferon γ induci... more Background and aims: CXC chemokine ligand 10 (CXCL10) also known as chemokine interferon γ inducible protein (IP-10) is a CXCR3 chemokine belongs to a group of structurally related molecules, that induce the chemotaxis of diverse leukocyte subtypes including activated ...
Mobbing is a specific kind of pathological behaviour in the workplace which includes psychologica... more Mobbing is a specific kind of pathological behaviour in the workplace which includes psychological abuse by one or more persons, a longer period of time, with intent to endanger human dignity and integrity of the victim of mobbing. Numerous research revealed that there are massive social and economic losses due to frequent absences from work, changes of jobs, premature retirements etc. Our investigation included 412 respondents working in health care organizations. The results indicate that 39% of respondents were exposed to a certain form of mobbing in investigating period. They were exposed to a great extent to mobbing activities which represent an attack on professional status, quality of professional work such as: excessive control by superiors, blaming for failures that hadn’t really happened as well as ignoring suggestions; but also activities which represent an assault on capacity for social relations and activities which represent an assault on personal reputation. Authors f...
OBJECTIVESMost thyroid textbooks describe hypo-thyroidism resulting in changes in the length of t... more OBJECTIVESMost thyroid textbooks describe hypo-thyroidism resulting in changes in the length of the menstrual cycle and in the amount of bleeding. Our experience at a busy thyroid clinic had given a picture which differs from that presented in the literature. The aim of this study was to determine the frequency and type of menstrual irregularities in premenopausal hypothyroid patients.Most thyroid textbooks describe hypo-thyroidism resulting in changes in the length of the menstrual cycle and in the amount of bleeding. Our experience at a busy thyroid clinic had given a picture which differs from that presented in the literature. The aim of this study was to determine the frequency and type of menstrual irregularities in premenopausal hypothyroid patients.DESIGN AND PATIENTSWe investigated the menstrual history, starting 6 months before the discovery of the disease, in 171 female premenopausal hypothy-roid patients and 214 normal controls, with similar age and body mass index (BMI)....
Thyrotropin receptor autoantibodies (TRAb) are the most frequent thyroid stimulatory immunoglobul... more Thyrotropin receptor autoantibodies (TRAb) are the most frequent thyroid stimulatory immunoglobulins (TSI, TSAb) although they (TSAb) sometimes coexist with thyroid-blocking antibodies (TSBAb) or change into them during hyperthyroidism (1-4). Treatment of Graves' disease (antithyroid drugs, thyroidectomy, radioactive iodine) sholud influence TRAb circulatory levels (5,6). Follow-up of TRAb in 114 treated patients and comparison of findings with thyroid hormone levels in clinical states are presented.
Radio receptor assays for the detection of TSH receptor antibodies in serum are typically based o... more Radio receptor assays for the detection of TSH receptor antibodies in serum are typically based on binding the competition of TSH-R antibodies and (125)I "labeled" TSH for membrane preparation of thyrocytes (TBII tests). The sensitivity of the available tests utilizing porcine cell membranes was found to be around 80%. A new test (TRAK Dyno human, BRAHMS) utilizes human recombinant TSH receptor and human standard material that is supposed to improve the performance of the test. We have compared the results of these two assays. The sensitivity of the TRAK Assay tested in 356 patients with untreated Graves' disease was found to be 85%, and 97.5% for TRAK Dyno human in 111 newly diagnosed patients. Both tests were performed from the same serum specimen for 60 of the investigated patients. The TRAK Assay was positive in 50 patients (83.2%) and TRAK Dyno human in 59 patients (98.3%). The specificity of the new radio receptor assay was also improved.
Iodine prophylaxis implemented at the territory of former Yugoslavia in 1953, has successfully co... more Iodine prophylaxis implemented at the territory of former Yugoslavia in 1953, has successfully corrected previously existent mild iodine deficiency in East Serbia. Clinical findings (incidence of goiter in school children, ratio of diffuse to focal toxic goiters, uptake of 131I in healthy persons) in subsequent decades were adequate for the areas with corrected iodine deficiency. Iodine content in consume salt was increased from 10mg KI/ kg to 20 mg KI/kg, for the entire territory of Serbia, by federal legislation, in 1993. This report is presenting an occasional investigation of variation in thyroid morbidity and neonatal TSH, in the area of corrected iodine deficiency, in conditions of increasing iodine consumption. Investigated parameters included: neonatal TSH, incidence of autoimmune thyroid diseases (Graves'-Basedow disease, Hashimoto's thyroiditis, primary hypothyroidism), and autonomous thyrotoxicosis (Plummer's disease), incidence of goiter in school children, u...
... Paunković Jane a , Doktor Robert b , Paunković Neboja a , Whitton Robert c , Garshnek Victor... more ... Paunković Jane a , Doktor Robert b , Paunković Neboja a , Whitton Robert c , Garshnek Victoria d , Crnčević Nenad e. a Univerzitet Megatrend ... Hollowell, JG, Staehling, NW, Flanders, W., Hannon, W., Gunter, EW, Spencer, CA, Braverman, LE (2002) Serum TSH, T(4), and ...
... are required to elucidate the potential role of CXCL10 polymorphisms to predict the severity ... more ... are required to elucidate the potential role of CXCL10 polymorphisms to predict the severity ofGD. ... 8. Nicoletti F, Conget I, Di Mauro M, Di Marco R, Mazzarino MC, Bendtzen K, Messina A ... 16. Venturelli E, Galimberti D, Fenoglio C, Lovati C, Finazzi D, Guidi I, Corrà B, Scalabrini D ...
Background and aims: CXC chemokine ligand 10 (CXCL10) also known as chemokine interferon γ induci... more Background and aims: CXC chemokine ligand 10 (CXCL10) also known as chemokine interferon γ inducible protein (IP-10) is a CXCR3 chemokine belongs to a group of structurally related molecules, that induce the chemotaxis of diverse leukocyte subtypes including activated ...
Authors have previously reported the effect of the treatment with an- tithyroid drugs (methimazol... more Authors have previously reported the effect of the treatment with an- tithyroid drugs (methimazole) on increased TSH-receptor antibodies (TRAb) serum level in patients with Graves' disease. Findings have disclosed that after 18-12 months of medica- ment treatment with "titration doses" of methimazole, about 60% of the patients become TRAb negative while 40% of the patients remained TRAb positive. In this investigation an attempt is made to treat some of the patients with persistently high TRAb findings, after the termination of 18 months titration doses therapeutic regimen, with high (immunosuppressi- ve?) doses of methimazole, including substitution with L-thyroxin. Twelve patients (2 males and 10 females, age average 33 years) have been treated. After the completion of "conven- tional" treatment of methimazole (average duration of 19,3 months) all 12 patients had elevated findings of TRAb in serum (average 136 U/l) and normal findings of "free" th...
Radio receptor assays for the detection of TSH receptor antibodies in serum are typically based o... more Radio receptor assays for the detection of TSH receptor antibodies in serum are typically based on binding the competition of TSH-R antibodies and (125)I "labeled" TSH for membrane preparation of thyrocytes (TBII tests). The sensitivity of the available tests utilizing porcine cell membranes was found to be around 80%. A new test (TRAK Dyno human, BRAHMS) utilizes human recombinant TSH receptor and human standard material that is supposed to improve the performance of the test. We have compared the results of these two assays. The sensitivity of the TRAK Assay tested in 356 patients with untreated Graves' disease was found to be 85%, and 97.5% for TRAK Dyno human in 111 newly diagnosed patients. Both tests were performed from the same serum specimen for 60 of the investigated patients. The TRAK Assay was positive in 50 patients (83.2%) and TRAK Dyno human in 59 patients (98.3%). The specificity of the new radio receptor assay was also improved.
From the clinical point of view, hyperthyroidism is generally presented as diffuse hyperactivity ... more From the clinical point of view, hyperthyroidism is generally presented as diffuse hyperactivity of thyroid tissue induced by autoimmune stimulation (Graves’ disease), or as the consequence of one, or more hyperactive autonomous nodules (Plummer’s disease). These two entities are relatively perceivable in clinical routine. Thyroid scintigraphy of the patient with Graves’ disease, presents a pattern of a diffusely enlarged gland with homogenous distribution of radioactive tracer. In Plummer’s disease, one nodule (“toxic adenoma”) or rarely few nodules (toxic nodular goiter), are presented as scintigraphicaly “hot” nodules with complete suppression of paranodular tissue. Occasionally, some scintigraphic findings that could not be so simplified are registrated. Thyroid glands of some patients with Graves' disease present nodules that can accumulate radioactive tracer of the comparable intensity to paranodular tissue (warm nodules). This occurence of the functioning adenoma in Grave...
It is generally accepted that the thyrotropin receptor antibody (TRAb) has a stimulating activity... more It is generally accepted that the thyrotropin receptor antibody (TRAb) has a stimulating activity and is the major pathogenic factor in Graves' disease (GD). In spite of that, TRAb is not routinely examined in clinical practice. The aim of this article is to briefly review the subject and suggest protocols for the diagnosis, treatment and follow-up of patients with GD based on our own studies and referring especially to TRAb. Clinical symptoms and signs and thyroid hormones may have poor sensitivity or specificity, especially in cases of endocrine ophthalmopathy and subclinical hyperthyroidism. In these cases the TRAb test is 98% sensitive and specific with a diagnostic accuracy of almost 99%. By this test it is possible to differentiate between autoimmune and other forms of thyrotoxicosis such as autonomous hyperthyroidism, destructive thyroiditis, iodine induced hyperthyroidism etc. Antithyroid drugs decrease serum TRAb levels and also induce immune remission. If after treatme...
Amiodarone (AMD) is a potent antiarrhythmic drug, liposolubile bensophuran derivative, containing... more Amiodarone (AMD) is a potent antiarrhythmic drug, liposolubile bensophuran derivative, containing 75 mg of iodide per 200 mg of active substance (2 atoms of iodine per molecule or 37,2% of molecular weight) and with elimination halflife of several months. Metabolism of 200 mg of AMD yields approximatively 6 mg/day of inorganic iodide in circulation. In susceptible patients chronical iodine overload and/or direct citotoxicity of the drug can induce thyroid disfunction (TD) - hypothyreosis (AIH), thyrotoxicosis (AIT) or subclinical TD. Cellular uptake of 99mTc-MIBI, cationic complex, is related to its charge and lipophilicity and highly negative membrane potential in the endomitochondrial element which traps the tracer within the organelle's matrix not organ specificly. MIBI is not retained in irreversibly ischemic cells and coukl be a highly sensitive marker of cell viability. It provides good quality thyroid scans. It seems that TSH and iodine overload do not influence MIBI upta...
Background and aims: CXC chemokine ligand 10 (CXCL10) also known as chemokine interferon γ induci... more Background and aims: CXC chemokine ligand 10 (CXCL10) also known as chemokine interferon γ inducible protein (IP-10) is a CXCR3 chemokine belongs to a group of structurally related molecules, that induce the chemotaxis of diverse leukocyte subtypes including activated ...
Mobbing is a specific kind of pathological behaviour in the workplace which includes psychologica... more Mobbing is a specific kind of pathological behaviour in the workplace which includes psychological abuse by one or more persons, a longer period of time, with intent to endanger human dignity and integrity of the victim of mobbing. Numerous research revealed that there are massive social and economic losses due to frequent absences from work, changes of jobs, premature retirements etc. Our investigation included 412 respondents working in health care organizations. The results indicate that 39% of respondents were exposed to a certain form of mobbing in investigating period. They were exposed to a great extent to mobbing activities which represent an attack on professional status, quality of professional work such as: excessive control by superiors, blaming for failures that hadn’t really happened as well as ignoring suggestions; but also activities which represent an assault on capacity for social relations and activities which represent an assault on personal reputation. Authors f...
OBJECTIVESMost thyroid textbooks describe hypo-thyroidism resulting in changes in the length of t... more OBJECTIVESMost thyroid textbooks describe hypo-thyroidism resulting in changes in the length of the menstrual cycle and in the amount of bleeding. Our experience at a busy thyroid clinic had given a picture which differs from that presented in the literature. The aim of this study was to determine the frequency and type of menstrual irregularities in premenopausal hypothyroid patients.Most thyroid textbooks describe hypo-thyroidism resulting in changes in the length of the menstrual cycle and in the amount of bleeding. Our experience at a busy thyroid clinic had given a picture which differs from that presented in the literature. The aim of this study was to determine the frequency and type of menstrual irregularities in premenopausal hypothyroid patients.DESIGN AND PATIENTSWe investigated the menstrual history, starting 6 months before the discovery of the disease, in 171 female premenopausal hypothy-roid patients and 214 normal controls, with similar age and body mass index (BMI)....
Thyrotropin receptor autoantibodies (TRAb) are the most frequent thyroid stimulatory immunoglobul... more Thyrotropin receptor autoantibodies (TRAb) are the most frequent thyroid stimulatory immunoglobulins (TSI, TSAb) although they (TSAb) sometimes coexist with thyroid-blocking antibodies (TSBAb) or change into them during hyperthyroidism (1-4). Treatment of Graves' disease (antithyroid drugs, thyroidectomy, radioactive iodine) sholud influence TRAb circulatory levels (5,6). Follow-up of TRAb in 114 treated patients and comparison of findings with thyroid hormone levels in clinical states are presented.
Radio receptor assays for the detection of TSH receptor antibodies in serum are typically based o... more Radio receptor assays for the detection of TSH receptor antibodies in serum are typically based on binding the competition of TSH-R antibodies and (125)I "labeled" TSH for membrane preparation of thyrocytes (TBII tests). The sensitivity of the available tests utilizing porcine cell membranes was found to be around 80%. A new test (TRAK Dyno human, BRAHMS) utilizes human recombinant TSH receptor and human standard material that is supposed to improve the performance of the test. We have compared the results of these two assays. The sensitivity of the TRAK Assay tested in 356 patients with untreated Graves' disease was found to be 85%, and 97.5% for TRAK Dyno human in 111 newly diagnosed patients. Both tests were performed from the same serum specimen for 60 of the investigated patients. The TRAK Assay was positive in 50 patients (83.2%) and TRAK Dyno human in 59 patients (98.3%). The specificity of the new radio receptor assay was also improved.
Iodine prophylaxis implemented at the territory of former Yugoslavia in 1953, has successfully co... more Iodine prophylaxis implemented at the territory of former Yugoslavia in 1953, has successfully corrected previously existent mild iodine deficiency in East Serbia. Clinical findings (incidence of goiter in school children, ratio of diffuse to focal toxic goiters, uptake of 131I in healthy persons) in subsequent decades were adequate for the areas with corrected iodine deficiency. Iodine content in consume salt was increased from 10mg KI/ kg to 20 mg KI/kg, for the entire territory of Serbia, by federal legislation, in 1993. This report is presenting an occasional investigation of variation in thyroid morbidity and neonatal TSH, in the area of corrected iodine deficiency, in conditions of increasing iodine consumption. Investigated parameters included: neonatal TSH, incidence of autoimmune thyroid diseases (Graves'-Basedow disease, Hashimoto's thyroiditis, primary hypothyroidism), and autonomous thyrotoxicosis (Plummer's disease), incidence of goiter in school children, u...
... Paunković Jane a , Doktor Robert b , Paunković Neboja a , Whitton Robert c , Garshnek Victor... more ... Paunković Jane a , Doktor Robert b , Paunković Neboja a , Whitton Robert c , Garshnek Victoria d , Crnčević Nenad e. a Univerzitet Megatrend ... Hollowell, JG, Staehling, NW, Flanders, W., Hannon, W., Gunter, EW, Spencer, CA, Braverman, LE (2002) Serum TSH, T(4), and ...
... are required to elucidate the potential role of CXCL10 polymorphisms to predict the severity ... more ... are required to elucidate the potential role of CXCL10 polymorphisms to predict the severity ofGD. ... 8. Nicoletti F, Conget I, Di Mauro M, Di Marco R, Mazzarino MC, Bendtzen K, Messina A ... 16. Venturelli E, Galimberti D, Fenoglio C, Lovati C, Finazzi D, Guidi I, Corrà B, Scalabrini D ...
Background and aims: CXC chemokine ligand 10 (CXCL10) also known as chemokine interferon γ induci... more Background and aims: CXC chemokine ligand 10 (CXCL10) also known as chemokine interferon γ inducible protein (IP-10) is a CXCR3 chemokine belongs to a group of structurally related molecules, that induce the chemotaxis of diverse leukocyte subtypes including activated ...
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