Showing papers in "international journal of endocrinology and metabolism in 2012"

Normality Tests for Statistical Analysis: A Guide for Non-Statisticians

Abstract: Statistical errors are common in scientific literature and about 50% of the published articles have at least one error. The assumption of normality needs to be checked for many statistical procedures, namely parametric tests, because their validity depends on it. The aim of this commentary is to overview checking for normality in statistical analysis using SPSS.

Non-Contraceptive Benefits of Oral Hormonal Contraceptives

Abstract: It is becoming evident that oral hormonal contraceptives-besides being well established contraceptives-seem to become important medications for many functional or organic disturbances. So far, clinical effectiveness has been shown for treatment as well as prevention of menstrual bleeding disorders and menstrual-related pain symptoms. Also this is true for premenstrual syndrome (PMS) and premenstrual disphoric disorder (PMDD). Particular oral contraceptives (OCs) containing anti-androgenic progestogens were shown to be effective medications for treatment of androgenisation symptoms (seborrhea, acne, hirsutism, alopecia). Through perfect suppression of the hypothalamic-pituitary-ovarian axis OCs have proven to be effective in elimination of persistent follicular cysts. Endometriosis/adenomyosis related pain symptoms are well handled similar to other drugs like Gonadotropine Releasing Hormone agonists but are less expensive, with less side effects, and possibility to be used for longer periods of time. This is also true for myoma. Pelvic inflammatory disease, rheumatoid arthritis, menstrual migraine, and onset of multiple sclerosis are prevented or delayed. Bone density is preserved and asthma symptoms improved. Endometrial hyperplasia and benign breast disease can be controlled. There is definitely a significant impact on risk reduction regarding endometrial, ovarian, and colon cancers. In conclusion, it needs to be recognized that oral combined hormonal contraceptives (estrogen/ progestogen combination) are - besides being reliable forms of contraception - are cost-effective medications for many medical disorders in women. Therefore, these contraceptives drugs are important for female and global health and should be used in clinical practice.

Testosterone and Aggressive Behavior in Man

Abstract: Atavistic residues of aggressive behavior prevailing in animal life, determined by testosterone, remain attenuated in man and suppressed through familial and social inhibitions. However, it still manifests itself in various intensities and forms from; thoughts, anger, verbal aggressiveness, competition, dominance behavior, to physical violence. Testosterone plays a significant role in the arousal of these behavioral manifestations in the brain centers involved in aggression and on the development of the muscular system that enables their realization. There is evidence that testosterone levels are higher in individuals with aggressive behavior, such as prisoners who have committed violent crimes. Several field studies have also shown that testosterone levels increase during the aggressive phases of sports games. In more sensitive laboratory paradigms, it has been observed that participant’s testosterone rises in the winners of; competitions, dominance trials or in confrontations with factitious opponents. Aggressive behavior arises in the brain through interplay between subcortical structures in the amygdala and the hypothalamus in which emotions are born and the prefrontal cognitive centers where emotions are perceived and controlled. The action of testosterone on the brain begins in the embryonic stage. Earlier in development at the DNA level, the number of CAG repeats in the androgen receptor gene seems to play a role in the expression of aggressive behavior. Neuroimaging techniques in adult males have shown that testosterone activates the amygdala enhancing its emotional activity and its resistance to prefrontal restraining control. This effect is opposed by the action of cortisol which facilitates prefrontal area cognitive control on impulsive tendencies aroused in the subcortical structures. The degree of impulsivity is regulated by serotonin inhibiting receptors, and with the intervention of this neurotransmitter the major agents of the neuroendocrine influence on the brain process of aggression forms a triad. Testosterone activates the subcortical areas of the brain to produce aggression, while cortisol and serotonin act antagonistically with testosterone to reduce its effects.

Cardiovascular Risk in Women With PCOS

Abstract: Polycystic ovary syndrome (PCOS), or Stein-Leventhal syndrome, is a common endocrine disorder defined by two of the three following features: i) oligoovulation or anovulation, ii) clinical and/or biochemical signs of hyperandrogenism, or iii) polycystic ovaries, once the related endocrinological and gynaecological disorders have been excluded. PCOS does not exclusively involve the reproductive apparatus , it has a complex number of systemic relevancy symptoms. It leads to Metabolic Syndrome, with severe consequences on the cardiovascular apparatus. Many clinical studies have underlined the connection between PCOS and the cardiovascular risk profile of such female patients, due to a lipid/glucose altered metabolism, hypertension, systemic inflammatory condition (assessable by markers such as VES, TNF-alfa, citokines and C-reactive protein (hsPCR) levels), and vascular injuries. Considering the early onset of the disease, PCOS could be considered as a real cardiovascular risk factor which affects the quality of life seriously. The current review aimed to point out the main connections between PCOS and cardiovascular risk factors according to the latest findings coming from literature data analysis, and try to depict the great influences that such a common disease can have on the patients' health integrity.

An Update on Plant Derived Anti-Androgens

Abstract: Anti-androgens are an assorted group of drugs and compounds that reduce the levels or activity of androgen hormones within the human body. Disease states in which this is relevant include polycystic ovarian syndrome, hirsutism, acne, benign prostatic hyperplasia, and endocrine related cancers such as carcinoma of the prostate. We provide an overview and discussion of the use of anti-androgen medications in clinical practice and explore the increasing recognition of the benefits of plant-derived anti-androgens, for example, spearmint tea in the management of PCOS, for which some evidence about efficacy is beginning to emerge. Other agents covered include red reishi, which has been shown to reduce levels 5-alpha reductase, the enzyme that facilitates conversion of testosterone to dihydrotestosterone (DHT); licorice, which has phytoestrogen effects and reduces testosterone levels; Chinese peony, which promotes the aromatization of testosterone into estrogen; green tea, which contains epigallocatechins and also inhibits 5-alpha reductase, thereby reducing the conversion of normal testosterone into the more potent DHT; black cohosh, which has been shown to kill both androgenresponsive and non-responsive human prostate cancer cells; chaste tree, which has a reduces prolactin from the anterior pituitary; and saw palmetto extract, which is used as an anti-androgen although it shown no difference in comparison to placebo in clinical trials.

Hashimoto Encephalopathy: A Rare Intricate Syndrome

Abstract: Recently, several patients have been reported with various signs of encephalopathy and high thyroid antibody levels together with good responsiveness to glucocorticoid therapy. Despite the various clinical presentations, these cases have been termed "Hashimoto encephalopathy" (HE). Although all of the pathogenic components have not yet been clearly elucidated, it is believed that brain vasculitis and autoimmunity directed against common brain-thyroid antigens represent the most likely etiologic pathway. The most common clinical signs include unexplained or epilepsy-like seizures resistant to anti-convulsive treatment, confusion, headaches, hallucinations, stroke-like episodes, coma, impairment of cognitive function, behavioral and mood disturbance, focal neurological deficits, disturbance of consciousness, ataxia, and presenile dementia, together with the presence of high thyroid antibody levels, especially against thyroperoxidase (TPOab). In most cases, the thyroid function is normal or decreased; the thyroid function is rarely increased. The examination of the cerebrospinal fluid, EEG, MRI, SPECT, and neuropsychological examinations are primarily used as diagnostic tools. Most cases showed neural symptoms for months before the acute onset; in some cases, a dramatic acute onset was described. Once the diagnosis is made, corticosteroid treatment usually provides a dramatic recovery. The authors also present a short review of literary cases reported in last decade.

Serum leptin level is reduced in non-obese subjects with type 2 diabetes.

Abstract: BACKGROUND: Leptin, a protein released from adipose tissue, could have significant role in pathogenesis of obesity and type 2 diabetes mellitus. OBJECTIVES: This study aimed to evaluate variations in serum leptin levels in non-obese subjects with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS: We studied forty-one patients with type 2 diabetes. Fasting lipid profile, Hemoglobin A1c (HbA1c), serum leptin, insulin, and glucose levels were measured by standard methods. RESULTS: The serum leptin level in type 2 diabetic patients (19.32 +/- 11.43 ng/mL) was significantly lower than that in non-diabetic subjects (32.16 +/- 11.02 ng/mL). Serum leptin level was strongly and positively correlated with body mass index (BMI) (r = 0.658, P < 0.0001) and calculated body fat percentage (r = 0.431, P < 0.0001) in all the study subjects with a better corrlation in the control subjcts compared to control cases (r = 0.661 for BMI and r = 0.466 for body fat). On the other hand, leptin showed a positive and significant correlation with insulin and HOMA- beta (homeostasis model assessment for beta-cell function) in both groups. Furthermore, leptin related to homeostasis model assessment for insulin resistance (HOMA-IR) (r = 0.422, P = 0.006) was observed only in T2DM subjects. Leptin showed negative correlation with waist to hip ratio in diabetic (r = -0.407, P =0.008) and non-diabetic subjects (r = -0.318, P =0.049). In the regression model, BMI, HOMA-beta, and gender were independent predictors of leptin in all subjects. However, in non-diabetic and diabetic subjects, beta-cell function and insulin were independent predictors, respectively (P =0.01). CONCLUSIONS: It is speculated that lower serum leptin levels in diabetic patients may be a consequence of male gender. Moreover, results suggest that serum leptin level in women is influenced differently than that in men.

Changes in serum leptin during phases of menstrual cycle of fertile women: relationship to age groups and fertility

Abstract: Background: It is established that serum level of leptin is affected by transitional phases of reproduction. It is also reported that the puberty is triggered when body fat and circulating levels of leptin exceed the critical thresholds, butthere is less focus on the serum level of leptin and its relationship with different phases of menstrual cycle and the fertility. Objectives: The present study try to determines the serum concentration of leptin and fertility hormonesin the various phases of normal menstrual cycle of fertile women and compare any difference in serum concentration between age groups of 18-30 years and 31-41 years It is a well known fact that fertility start to decrease from age 31 years. Patients and Methods: A total of 118 healthy fertile women with normal menstrual cycle aged between 18-40, were divided into two age groups (n = 65) 18-30 years and (n = 53) 31-40 years. Serum concentrations of leptin, estradiol, progesterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) were measured on day1 (menstrual phase), day7 (proliferative/follicular phase), day14 (ovulatory phase), day21 (luteal phase) and day 28(secretory phase) of the menstrual cycle. Results: There was a significant increase (P < 0.05) in leptin levels on day 14 (12.75 + 5.8 ng/mL) and day 21 (12.91 + 3.2 ng/mL) for age group 18-30 years compared to day 14 (11.60 + 3.2 ng/mL) and day 21 (11.60 + 3.2 ng/mL) for age group 31-40 years. Leptin was positively correlated with FSH on day 14, with LH on day 7 and day 21; likewise, with progesterone on day 21 and day 28 and with estradiol on day 7 and day 14 for both age groups. Conclusions: The serum leptin level was at the lowest level during the menstrual and secretory phase and the highest level was around the luteal phase. The significant increase ofleptin in the younger age group raise this question whether circulating leptin has any role to play in the age of pregnancy and fertility. Data in this study shows that leptin level was affected with increase in age; therefore changes in leptin level will affect fertility in this study suggest that there may be a relation between leptin levels and fertility.

Effects of raloxifene on bone metabolism in hemodialysis patients with type 2 diabetes.

Abstract: Background Osteoporosis and chronic kidney disease are common conditions in older adults, and often occur concurrently. Bone disease is caused by increased bone turnover accompanying secondary hyperparathyroidism, and by factors such as bone metabolic disorder accompanying kidney disease and postmenopausal or age-related osteoporosis, even in hemodialysis patients. Raloxifene is commonly used for the treatment of postmenopausal osteoporosis in the general population, and may be a treatment option for osteoporosis in hemodialysis patients. However, the effects of raloxifene in hemodialysis patients with type 2 diabetes have not been examined in detail.

Effect of Progressive Aerobic and Resistance Exercises on the Pulmonary Functions of Individuals With Type 2 Diabetes in Nigeria

Abstract: Background: The lungs are end organs that are adversely affected in Nigerian adults with type 2 diabetes. Assessment and monitoring of the progress of pulmonary functions postexercise prescription is paramount for optimal feedback on a patient’s progress. Objective: This study was designed to investigate the pulmonary responses of individuals with T2DM to progressive aerobic exercises and resistance exercises (PAREs) and assess changes at specified points in the intervention period. Patients and Methods: A total of 60 subjects (36 females and 24 males) aged 40-75 years were consecutively recruited into this randomized control study, which comprised a PARE and a control group. Outcome measures, which included pulmonary parameters (oxygen uptake (VO2max), forced vital capacity (FVC), forced expiratory volume in one second (FEV1)) and anthropometric parameters (body mass index (BMI), waist circumference (WC), and waist hip ratio (WHR)), were assessed at baseline and at the end of Weeks 4, 8, and 12 of the intervention period. Glycosylated hemoglobin level (HbA1c) was assessed at baseline and at the end of Week 12. Data were analyzed using descriptive statistics and inferential statistics. Level of significant was set at P Results: Mean VO2max, FEV1, and FVC increased as early as 4 weeks postintervention. Significant improvements in these variables were noted in subjects (P Conclusions: PARE is beneficial in the management of pulmonary complications in adult Nigerian T2DM patients. PARE for at least 4 weeks may improve the pulmonary function of individuals with T2DM. However, postexercise prescription assessment may be commenced 8 weeks post intervention. Implication for health policy/practice/research/medical education: Pulmonary complications in type 2 diabetes are a major health issue of concern. Management and progress monitoring post exercise intervention is paramount for optimal feedback. Results of this article are useful for physiotherapist, endocrinologist, diabetes educators and clinicians in cardiopulmonary field of study. Please cite this paper as: Osho OA, Akinbo SRA, Osinubi AAA, Olawale OA. Effect of Progressive Aerobic and Resistance Exercises on the Pulmonary Functions of Individuals With Type 2 Diabetes in Nigeria. Int J endocrinol Metab. 2012;10(1): 411-7. DOI: 10.5812/ijem.3333

Health Locus of Control in Patients With Graves-Basedow Disease and Hashimoto Disease and Their Acceptance of Illness

Abstract: Background Adaptation to a chronic somatic disease depends on a variety of factors, including belief in health locus of control. Objectives Correlation between health locus of control and illness acceptance in patients with Graves-Basedow and Hashimoto diseases as well as correlation between health locus of control, illness acceptance, sex, and age. Patients and methods THREE METHODS WERE APPLIED: Multidimensional Health Locus of Control Scale by K.A. Wallston, B.S. Wallston and R. DeVellis; the Acceptance of Illness Scale by B.J. Felton, T.A. Revenson, and G.A. Hinrichsena; and a personal questionnaire. Two groups were subject to the research: 68 patients with Graves-Basedow disease and 54 patients with Hashimoto disease. Results Patients with Graves-Basedow disease, women above all, have their health locus of control in other persons (P = 0,001) and are less inclined to accept their illness (P = 0,005) when compared to patients with Hashimoto disease. A statistically significant correlation occurred between the age of patients and external (i.e., in other persons) health locus of control. Conclusions Beliefs in health locus of control and type of illness in female patient group are predictors of illness acceptance (P = 0,0009).

Management of Subclinical Hyperthyroidism

Abstract: In conclusion, management of subclinical hyperthyroidism merits careful monitoring through regular assessment of thyroid function. Treatment is mandatory in older patients (> 65 years) or in presence of comorbidities (such as osteoporosis and atrial fibrillation).

The Use of Honey in Diabetes Mellitus: Is It Beneficial or Detrimental?

Abstract: Diabetes mellitus is a metabolic disorder that is characterized by chronic hyperglycemia, due to defects in insulin secretion and/or action activity (1). In the past decades, there has been a renewed interest in the use of natural products, including herbs and honey, in the treatment of diabetes. This commentary is written to allay fears that the use of honey is detrimental in diabetes. Recent findings indicate that honey improves glycemic control and exerts hypoglycemic effect in non-diabetic, alloxanand streptozotocin-induced diabetic rats (2-5). The combination of antidiabetic drugs with honey further improves glycemic control in diabetic rats (6). In humans, honey supplementation reduces hyperglycemia (3, 7). Only one study suggests that the use of honey in diabetes is detrimental, observing that honey-supplemented diabetic patients had significantly increased glycosylated hemoglobin (8). In contrast, no such effect was observed in diabetic controls (8). The findings from this study seem to suggest that the use of honey worsens glycemic control in diabetes. However, a closer examination of the study design and the honey that was used in the study indicates that such a conclusion is invalid. First, the honey-treated diabetic group received graded doses of honey orally for 8 weeks, starting from 1 g/kg/day for the first and second weeks, 1.5 g/kg/day for the third and fourth weeks, 2 g/kg/ day for the fifth and sixth weeks, and 2.5 g/kg/day for the seventh and eight weeks (8). Increasing the dose of any pharmacological agent, including honey, without proper therapeutic monitoring is inappropriate. Second, the majority of honey samples contain more fructose than glucose (or the same proportion) or fructose: glucose ratio ≥ 1.0 (6, 9). The honey used in the study had more glucose than fructose (fructose:glucose ratio, 0.46) (9), meaning that the amount of glucose in this honey was twice the amount of fructose. The reason for the unusually high glucose content in this honey remains unclear. Whether this honey was adulterated, in whatever form, without the authors’ knowledge is another subject entirely (10). This issue is significant due to its clinical implications in diabetic patients. Compelling evidence implicates the role of fructose in the hypoglycemic effect of honey (3). Therefore, administering honey that contains fructose levels that are twice as low compared with other honeys might not produce a similar effect as other honey varieties with high fructose contents. Further, administering Copyright c 2012 Kowsar M. P. Co. All rights reserved.

ABCG8 Gene Responses to 8 Weeks Treadmill Running With or Without Pistachia atlantica (Baneh) Extraction in Female Rats.

Abstract: Background: It is well established that the excess cellular cholesterol concentration, as well as high density lipoprotein (HDL) and total cholesterol levels are strongly correlated with the incidence of coronary artery disease (CAD). Reverse cholesterol transport (RCT) is a term used to describe the efflux of excess cellular cholesterol. ABCG8 is a member of ABCG family that play a critical role in this process. Objectives: The current study was conducted to investigate the effect of endurance exercise with or without Pistachia atlantica (Baneh) extraction on small intestine and kidney ABCG8 gene, also plasma high density lipoprotein (HDL-c), triglyceride (TG), total cholesterol (TC), glucose, and estrogen levels in female rats. Materials and Methods: In this study twenty Wistar female rats (six to eight weeks old, 125-135 g weight) were used. Animals were randomly assigned into training (n = 10) and control (n = 10) groups and further divided into saline-control (SC), saline-training (ST), Baneh-control (BC), and Baneh-training (BT) groups. Training groups was given exercise on a motor-driven treadmill at 25 m/min (0% grade) for 60 min/day, 5 days/week for eight weeks. Animals were fed orally with Baneh extraction and saline for four week. After the last training session, rats were sacrificed, small intestine and kidney were excised, and ABCG8 expression was detected by Real-time PCR method. Plasma also was collected for plasma variable measurements. Statistical analysis was performed using a one way analysis of variance, and significance was accepted at P < 0.05. Correlation was calculated using the Pearson Product Moment correlation. Results: Exercise increased (P < 0.01) and Baneh reduced intestinal ABCG8 mRNA (P < 0.05). In kidney tissue, there wasnt significant change between the groups (P < 0.40). Plasma HDL-C level was increased by exercise (P < 0.05) and decreased by Baneh (P < 0.02) that was correlated by intestine ABCG8 (r = 0.81, P < 0.001). Plasma TG and TC were unchanged, but glucose and estradiol were increased and decreased in Baneh groups (P < 0.02), respectively. Conclusions: Our study shows that exercise increases intestinal ABCG8 mRNA, and Baneh can increase plasma glucose concentration and reduce ABCG8 expression, HDL-C, and estrogen levels probably due to high fatty acid components.

Postprandial Peaking and Plateauing of Triglycerides and VLDL in Patients with Underlying Cardiovascular Diseases Despite Treatment

Abstract: Background Dyslipidemia is associated with cardiovascular morbidities and mortality. Currently, fasting lipid profile determination is used to monitor treatment response. Recently, postprandial lipemia is of increasing interest because of its atherogenic and thrombogenic potential and also was found to be more predictive for cardiovascular diseases.

Effects of circuit resistance training intensity on the plasma ghrelin to obestatin ratios in healthy young women.

Abstract: Background Ghrelin and obestatin are orexigenic and anorexigenic peptides, respectively. It appears that an accurate balance between theses peptides is important for regulating energy homeostasis and body weight.

Physical activity as a strategy to reduce the risk of osteoporosis and fragility fractures.

Abstract: Childhood and adolescence are critical periods for the skeleton. Mechanical load has then been shown to be one of the best stimuli to enhance not only bone mass, but also structural skeletal adaptations, as both contributing to bone strength. Exercise prescription also includes a window of opportunity to improve bone strength in the late pre- and early peri-pubertal period. There is some evidence supporting the notion that skeletal gains obtained by mechanical load during growth are maintained at advanced age despite a reduction of physical activity in adulthood. The fact that former male athletes have a lower fracture risk than expected in their later years does not oppose the view that physical activity during growth and adolescence is important and it should be supported as one feasible strategy to reduce the future incidence of fragility fractures.

Advantage of Applying OSC to 1 H NMR-Based Metabonomic Data of Celiac Disease

Abstract: Background Celiac disease (CD) is a disorder associated with body reaction to gluten. After the gluten intake, an immune reaction against the protein occurs and damages villi of small intestine in celiac patients gradually.

Tuberculous Cervical Lymphadenitis Masquerding as Metastatis From Papillary Thyroid Carcinoma

Abstract: Clinically apparent cervical lymphadenopathy has been found at the initial presentation in 23 to 56 % of cases of papillary thyroid carcinoma. Here we report tuberculous lymphadenitis mimicking metastatic lymph nodes from papillary thyroid carcinoma and suggest that tuberculosis apart from metastasis in papillary thyroid carcinoma should also be considered in the etiology of enlarged lymph nodes in such patients, especially in those with risk factors for tuberculosis. Therefore, the importance of careful pre-operative evaluation of cervical lymph node metastasis cannot be overestimated, so that patients do not undergo unnecessary neck dissection for other benign conditions.

Von hippel-lindau disease: a new approach to an old problem.

Abstract: Background: Von Hippel-Lindau (VHL) disease is a hereditary, autosomal dominant syndrome which is manifested by a range of different benign and malignant tumors. This disease can present with different clinical presentations such as; retinal angioma (RA), hemangioblastoma (HB) of the central nervous system (CNS), pheochromocytoma (Pheo), and epididymal cystadenoma. Tumors are usually accompanied with cysts. Objectives: As the disease can display different clinical presentations, which are mainly unspecific, and considering the importance of an early diagnosis and the proper and early management of it, this study was carried out to present a general overview of VHL. Moreover, the present article reviews screening methods and emphasizes the need for increasing the awareness of different health care professionals to diagnose and refer the patients in the early stages. Materials and Methods: A thorough search of internet medical databases, such as PubMed, was carried out on known or suggested; clinical presentations, pathogenesis, screening, causes and criteria for diagnosis of patients and their referrals. Results: Our research demonstrated that VHL is caused by a mutation in the von Hippel-Lindau (VHL) gene. It also showed that different screening methods can be utilized for the early diagnosis and referral of patients. Different clinical presentations of the disease are also elaborated in some detail and their treatment options are discussed. Conclusions: Considering the need for a multidisciplinary approach to VHL, especially, given the number of cases which have been reported and diagnosed in Iran, it is of great importance that clinicians remain vigilant in order to identify cases that present with clinical characteristics of the disease, and that they are prompt in referring them to a multidisciplinary VHL clinic. It is also important to establish links with existing VHL Family Alliances and other related organizations around the world.

Bone density in patients with late onset Pompe disease

Abstract: Background Pompe disease is an inherited metabolic disorder characterized by α-glycosidase deficiency, which leads to lysosomal glycogen accumulation in many different tissues. The infantile form is the most severe with a rapidly fatal outcome, while the late onset form has a greater phenotypic variability, characterized by skeletal muscle dysfunction and early respiratory involvement. Bone mineral density (BMD) has been recently reported to be reduced in many patients with both forms of the disease. Enzyme replacement therapy (ERT) is now available with an undefined, impact on BMD in patients with late onset disease.

Temporal changes in plasma concentration of leptin, igf-1, insulin and metabolites under extended fasting and re-feeding conditions in growing lambs

Abstract: Background: A fall in plasma concentration of energy status related hormones (leptin, insulin-like growth factor-1 (IGF-1) and insulin) and body energy expenditure occurs in response to short term fasting. Nevertheless, the relations of the fasting-induced changes in energy related hormones and metabolites with fasting energy expenditure (FEE) under extended fasting condition have received little attention so far. Objectives: It is not clear how energy status related hormones coordinate to cope with feed deprivation under extended fasting time conditions and how quickly these hormones re-bound to fed-state values in response to re-feeding. Thus the objectives of this study were: 1) to determine the effects of extended fasting on plasma concentration of leptin, IGF-1, insulin, glucose, NEFA, 3-?-hydroxybutyrate (BOHB) and urea; and 2) to study the relations of energy status related hormones with FEE and substrate oxidations under extended fasting conditions. Materials and Methods: Eighteen six-month-old growing lambs (9 females and 9 males) were fasted for three days. Blood samples were taken one hour before (-1H) and 48 and 72 hours after fasting (48H and 72H) and two hours after re-feeding (+2H) from jugular vein. During the last 22 hours of fasting, gas exchange (CO2 production and O2 consumption) were measured using an open-circuit indirect calorimeter. Respiratory quotient (RQ), FEE and relative proportions of oxidized protein, fat and carbohydrate were calculated. Results: Plasma levels of leptin, insulin, IGF-1 and glucose decreased but NEFA and urea levels increased within 48H of fasting. Concentration of insulin significantly increased with extended fasting while leptin and IGF-1 levels remained constant. Glucose was the only blood variable that showed a quick re-bound within two hours after re-feeding. Leptin and IGF-1 showed significant positive relations with glucose and BOHB but negative relations with NEFA and Urea. Carbohydrate, fat and proteins contributed to 17%, 61% and 22% of FEE respectively in three-day-fasted lambs. FEE was negatively correlated with insulin and NEFA concentrations in plasma. Conclusions: Even though plasma levels of leptin and IGF-1 decreased and remained constant under extended fasting, neither leptin nor IGF1 re-bounded to fed-status values within two hours after re-feeding. Under extended fasting condition, firstly an insulin resistance develops and secondly, a fall in FEE through a switch from carbohydrate- to fat-based metabolism occurs and there is an evident negative correlation between FEE and plasma concentration of NEFA.

Reduced Antioxidant Potential of LDL Is Associated With Increased Susceptibility to LDL Peroxidation in Type II Diabetic Patients.

Abstract: Background Type II diabetes mellitus is a complex heterogeneous group of metabolic conditions characterized by an increased level of blood glucose, due to impairment in insulin action and/or insulin secretion. Hyperglycemia is a major factor in the pathogenesis of atherosclerosis in diabetes. Oxidative modification of low density lipoprotein (LDL) is recognized as one of the major processes involved in the early stages of atherosclerosis in type II diabetes. LDL contains different antioxidants, which increase LDL resistance against oxidative modification, this is known as its antioxidant potential (AOP).

Diagnosis of Men-I Syndrome on 68 Ga-DOTANOC PET-CT and Role of Peptide Receptor Radionuclide Therapy With 177 Lu-DOTATATE

Abstract: MEN-I is a rare genetic disorder classically characterized by a predisposition to tumors of the parathyroid glands, anterior pituitary gland, and pancreatic islet cells. We present a case of MEN-I syndrome diagnosed using predominantly nuclear medicine imaging followed by radionuclide therapy, thus emphasizing the role of nuclear imaging in diagnosing and treating MEN-I.

Remission of type 2 diabetes mellitus by ileal interposition with sleeve gastrectomy

Abstract: Article history: Received: 05 Feb 2011 Revised: 22 Apr 2011 Accepted: 07 May 2011

Serum Intact Parathyroid Hormone Level After Total Thyroidectomy or Total Thyroidectomy Plus Lymph Node Dissection for Thyroid Nodules: Report From 296 Surgical Cases

Abstract: Background Transient hypocalcemia is one of the postoperative complications of thyroidectomy for thyroid nodules, and intraoperative and postoperative intact parathyroid hormone (iPTH) assays are used to predict postoperative hypocalcemia.

Postprandial effect of orlistat on the peaking of lipid level after sequential high fat meals.

Abstract: Background: Postprandial lipemia has been found to be strongly associated with atherosclerosis due to its atherogenic and thrombogenic lipoprotein changes. This phenomenon occurs even in normal subjects especially after high fat meals. Orlistat, an anti- obesity drug, has been shown to address postprandial lipemia after a single high fat meal. Objectives: To compare the effects of orlistat and placebo on the postprandial lipid levels after sequential high-fat meals in healthy individuals with normal fasting lipid levels. Patients and Methods: Thirty-one healthy adult volunteers with normal fasting lipid levels were fed 50% fat meals (3 meals and 2 snacks of pre-weighted butter and bread). The subjects were blindly randomized to receive either placebo or orlistat 120 mg before each main meal. The outcome parameters were total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and very-lowdensity lipoprotein (VLDL) cholesterol levels measured at fasting (0 h) and every 2 h thereafter, until the sixteenth hour. Additionally, we estimated the lipid levels at the fifth and ninth hour. Results: The non-orlistat group showed a significant postprandial rise in the levels of TG and VLDL, which began 4 h after breakfast (P < 0.05); this rise in levels was sustained until 9 h after breakfast for TG and up to 10 h after breakfast for VLDL. In contrast, only one significant rise in both TG and VLDL levels (at 4 h after breakfast) was noted in the orlistat group. The maximum mean difference from the baseline TG level for the orlistat group was lower than that for the non-orlistat group (0.22 mmol/L vs. 0.756 mmol/L, respectively). Similarly, the maximum mean difference from the baseline VLDL level from baseline in the orlistat group was only 0.099 mmol/L, which was lower than that in the non-orlistat group (0.588 mmol/L). LDL levels rose to a lesser extent in the orlistat group than in the non-orlistat group (0.268 vs. 0.362 mmol/L). The TC levels did not show a postprandial rise; instead, the levels reduced in both groups, with the orlistat group showing a higher reduction than the non-orlistat group (-0.288 vs. -0.188 mmol/L). The orlistat group did not show any significant differences in the HDL measurements. Conclusions: Administration of orlistat abolished the significantly sustained postprandial rise of TG and VLDL levels in healthy individuals who were fed sequential 50% fat meals.

The Effects of a Hydroalcoholic Extract of Matricaria chamomilla Flower on the Pituitary-Gonadal Axis and Ovaries of Rats

Abstract: Article history: Received: 01 Apr 2011 Revised: 20 May 2011 Accepted: 03 Jun 2011

Urinary Total Protein as the Predictor of Albuminuria in Diabetic Patients

Abstract: Background: In order to detect nephropathy, measurement of total (24 hrs) urinary albumin or albumin/creatinin ratio in random urine samples is being recommended. But methods of albumin measurement are not available in all laboratories and also cost about 6 times more than that of urinary total protein measurement. Objectives: This Study was performed to determine appropriate cut off point in 24 hours urine total protein to diagnose micro- and macroalbuminuria in patients with diabetes mellitus. Patients and Methods: In this study, 204 patients with diabetes mellitus type I and II were selected. In collected 24 hours urine from patients, protein and albumin were measured by using Pyrogallol and Immunoturbidimetry methods, respectively. Results: Normoalbuminuri (albumin 300 mg/24 hrs urine) were detected in 130, 51, and 23 patients, respectively. In 24 hrs urine collections, amounts of protein and albumin were compared to calculate cut off point of exerted protein for nephropathy diagnosis. cut off point of 73 mg/day for urinary total protein had appropriate sensitivity (94.5 %, CI = 91.4 % -97.6 %) and specificity (77.9 %, CI = 72.8 % -82.9 %) for microalbuminuria, while cut off point of 514 mg/day (sensitivity 95.7 %; specificity 98.9 %) was detected for diagnosis macroalbuminuria. Urine protein exertion of 150 mg/day that is currently considered as a normal value in most laboratory kits had a sensitivity of 73.1 % by which 30 % of microalbuminuric cases remained undiagnosed. Conclusions: Urinary total protein cut-off points of 73 mg/day and 514 mg/day were diagnostic for micro- and macroalbuminuria, respectively.

Effect of Clomiphene Citrate on Follicular Recruitment, Development, and Superovulation During the First Follicular Wave in Rahmani Ewes

Abstract: Article history: Received: 05 Feb 2011 Revised: 26 Apr 2011 Accepted: 07 May 2011