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Sample records for psycho-neuro-vegetative subclinical syndrome

  1. Subclinical Cushing syndrome: a review.

    Science.gov (United States)

    Starker, Lee F; Kunstman, John W; Carling, Tobias

    2014-06-01

    Owing to its diagnostic challenges, subclinical Cushing syndrome (SCS) is likely to be highly underdiagnosed and undertreated, and the overall incidence may be as high as 5% to 20% in patients with adrenal incidentalomas. The diagnosis can be established by a systematic and thorough biochemical evaluation. SCS has been associated with significant morbidity, which at least partly may be reversed by surgery. Given the low rates of complications and the possibility to reverse the detrimental effects of elevated cortisol secretion, minimally invasive adrenalectomy is recommended for patients with biochemically proven or suspected SCS who are appropriate surgical candidates. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Outcome of adrenalectomy for subclinical hypercortisolism and Cushing syndrome.

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    Raffaelli, Marco; De Crea, Carmela; D'Amato, Gerardo; Gallucci, Pierpaolo; Lombardi, Celestino P; Bellantone, Rocco

    2017-01-01

    We compared operative and metabolic outcomes in patients with subclinical Cushing syndrome and Cushing syndrome caused by unilateral adrenal lesion, aiming to clarify the role of glucocorticoid replacement treatment in patients with subclinical Cushing syndrome after adrenalectomy. The medical records of all the patients who underwent unilateral adrenalectomy for subclinical Cushing syndrome or Cushing syndrome were reviewed. Diagnostic criteria for subclinical Cushing syndrome were a pathologic dexamethasone suppression test plus 2 additional criteria. Twenty-nine patients with subclinical Cushing syndrome and 50 with Cushing syndrome were identified. No significant difference was found between patients with subclinical Cushing syndrome and Cushing syndrome regarding lesion size, operative time, and hospital stay. Two patients out of 29 with subclinical Cushing syndrome and 3 out of 50 patients with Cushing syndrome experienced Clavien-Dindo grade II complications (P = .87). All the patients required postoperative glucocorticoid replacement that was discontinued within 6 months in 28 of the 29 patients with subclinical Cushing syndrome and in 3 out of 50 Cushing syndrome patients (P Cushing syndrome and Cushing syndrome. Hypercortisolism was resolved in all the cases. Operative and metabolic outcomes of adrenalectomy are similar in subclinical Cushing syndrome and Cushing syndrome. Postoperative glucocorticoid replacement treatment is advisable in all patients with subclinical Cushing syndrome. Prolonged adrenal insufficiency is more frequent in Cushing syndrome patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Subclinical Cushing's syndrome: current concepts and trends.

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    Zografos, George N; Perysinakis, Iraklis; Vassilatou, Evangeline

    2014-01-01

    Clinically inapparent adrenal masses which are incidentally detected have become a common problem in everyday practice. Approximately 5-20% of adrenal incidentalomas present subclinical cortisol hypersecretion which is characterized by subtle alterations of the hypothalamic-pituitary-adrenal axis due to adrenal autonomy. This disorder has been described as subclinical Cushing's syndrome, since there is no typical clinical phenotype. The diagnosis of subclinical Cushing's syndrome is based on biochemical evaluation; however, there is still no consensus for the biochemical diagnostic criteria. An abnormal 1mg dexamethasone suppression test (DST) as initial screening test in combination with at least one other abnormal test of the hypothalamic-pituitary-adrenal axis has been advocated by most experts for the diagnosis of subclinical Cushing's syndrome. DST is the main method of establishing the diagnosis, while there is inhomogeneity of the information that other tests provide. Arterial hypertension, diabetes mellitus type 2 or impaired glucose tolerance, central obesity, osteoporosis/vertebral fractures and dyslipidemia are considered as detrimental effects of chronic subtle cortisol excess, although there is no proven causal relationship between subclinical cortisol hypersecretion and these morbidities. Therapeutic strategies include careful observation along with medical treatment of morbidities potentially related to subtle cortisol hypersecretion versus laparoscopic adrenalectomy. The optimal management of patients with subclinical Cushing's syndrome is not yet defined. The conservative approach is appropriate for the majority of these patients; however, the duration of follow-up and the frequency of periodical evaluation still remain open issues. Surgical resection may be beneficial for patients with hypertension, diabetes mellitus type 2 or abnormal glucose tolerance and obesity.

  4. Subclinical carpal tunnel syndrome in acromegaly.

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    Kameyama, S; Tanaka, R; Hasegawa, A; Tamura, T; Kuroki, M

    1993-08-01

    Median nerve conduction was studied in 16 acromegalic patients with asymptomatic carpal tunnel syndrome (CTS) to examine the incidence of subclinical CTS. Thirteen patients (81%) and 23 hands (72%) demonstrated subclinical CTS, 10 bilaterally and three unilaterally in the dominant hand. The incidence reflects the greater sensitivity of the inching method for detecting focal conduction abnormalities. Two of three patients without subclinical CTS showed normal plasma somatomedin-C concentration despite growth hormone hypersecretion. Following adenomectomy, nerve conduction normalized in only six hands (26%). The postoperative persistence of the conduction delay implies that irreversible narrowing of the carpal tunnel rather than reversible soft tissue edema is the principal cause of CTS associated with acromegaly.

  5. Subclinical hypothyroidism in children with Down syndrome: To treat ...

    African Journals Online (AJOL)

    Mohamed El Kholy

    2014-12-01

    Dec 1, 2014 ... In children with subclinical hypothyroidism, The American. Thyroid Association in 2014 ... As regards Down syndrome (DS), the therapeutic manage- ment of subclinical ... [8] Samuel Refetoff: personal communication, 2014.

  6. Subclinical Inflammatory Status in Rett Syndrome

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    Cortelazzo, Alessio; De Felice, Claudio; Guerranti, Roberto; Landi, Claudia; Valacchi, Giuseppe; Ciccoli, Lucia; Hayek, Joussef

    2014-01-01

    Inflammation has been advocated as a possible common central mechanism for developmental cognitive impairment. Rett syndrome (RTT) is a devastating neurodevelopmental disorder, mainly caused by de novo loss-of-function mutations in the gene encoding MeCP2. Here, we investigated plasma acute phase response (APR) in stage II (i.e., “pseudo-autistic”) RTT patients by routine haematology/clinical chemistry and proteomic 2-DE/MALDI-TOF analyses as a function of four major MECP2 gene mutation types (R306C, T158M, R168X, and large deletions). Elevated erythrocyte sedimentation rate values (median 33.0 mm/h versus 8.0 mm/h, P < 0.0001) were detectable in RTT, whereas C-reactive protein levels were unchanged (P = 0.63). The 2-DE analysis identified significant changes for a total of 17 proteins, the majority of which were categorized as APR proteins, either positive (n = 6 spots) or negative (n = 9 spots), and to a lesser extent as proteins involved in the immune system (n = 2 spots), with some proteins having overlapping functions on metabolism (n = 7 spots). The number of protein changes was proportional to the severity of the mutation. Our findings reveal for the first time the presence of a subclinical chronic inflammatory status related to the “pseudo-autistic” phase of RTT, which is related to the severity carried by the MECP2 gene mutation. PMID:24511209

  7. Subclinical Inflammatory Status in Rett Syndrome

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    Alessio Cortelazzo

    2014-01-01

    Full Text Available Inflammation has been advocated as a possible common central mechanism for developmental cognitive impairment. Rett syndrome (RTT is a devastating neurodevelopmental disorder, mainly caused by de novo loss-of-function mutations in the gene encoding MeCP2. Here, we investigated plasma acute phase response (APR in stage II (i.e., “pseudo-autistic” RTT patients by routine haematology/clinical chemistry and proteomic 2-DE/MALDI-TOF analyses as a function of four major MECP2 gene mutation types (R306C, T158M, R168X, and large deletions. Elevated erythrocyte sedimentation rate values (median 33.0 mm/h versus 8.0 mm/h, P<0.0001 were detectable in RTT, whereas C-reactive protein levels were unchanged (P=0.63. The 2-DE analysis identified significant changes for a total of 17 proteins, the majority of which were categorized as APR proteins, either positive (n=6 spots or negative (n=9 spots, and to a lesser extent as proteins involved in the immune system (n=2 spots, with some proteins having overlapping functions on metabolism (n=7 spots. The number of protein changes was proportional to the severity of the mutation. Our findings reveal for the first time the presence of a subclinical chronic inflammatory status related to the “pseudo-autistic” phase of RTT, which is related to the severity carried by the MECP2 gene mutation.

  8. Subclinical Carpal Tunnel Syndrome in Patients with Acute Stroke

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    Soroosh Dabiri

    2012-07-01

    Full Text Available Background: Stroke is the first cause of morbidity all around the world. Entrapment neuropathies are a known complication of stroke. The objective of this study is to assess the frequency of subclinical carpal tunnel syndrome in the healthy and paretic hands of stroke patients.Methods: The authors performed nerve conduction study in the first three days after admission in 39 stroke patients without subclinical carpal tunnel syndrome and 30 days after admission. Electrophysiological studies were done in both paretic and non-paretic hands. Both ulnar and median nerves were studied.Results: After one month we found subclinical carpal tunnel syndrome in 16 paretic hands and 13 healthy hands. We did not find any difference in the frequency of carpal tunnel syndrome in two sides.Conclusion: The authors suggest that simultaneous different mechanisms may act in inducing carpal tunnel syndrome in both hands of hemiparetic patients.

  9. Laparoscopic adrenalectomy in patients with subclinical Cushing syndrome.

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    Perysinakis, Iraklis; Marakaki, Chrisanthi; Avlonitis, Spyridon; Katseli, Anastasia; Vassilatou, Evangeline; Papanastasiou, Lambrini; Piaditis, George; Zografos, George N

    2013-06-01

    Subclinical Cushing syndrome in patients with adrenal incidentalomas has been associated with an increased prevalence of the metabolic syndrome and cardiovascular risk. The management of these patients, be it conservative or surgical, is still debated, but there is accumulating evidence that surgery is best and that laparoscopic adrenalectomy, when possible, is the most preferred procedure. Here we present the short- and long-term results of laparoscopic adrenalectomy for subclinical Cushing syndrome and determine the effect of this procedure on components of the metabolic syndrome. Twenty-nine patients, 8 men and 21 women with adrenal incidentalomas and subclinical Cushing syndrome who underwent laparoscopic adrenalectomy, were studied retrospectively. They had undergone postoperative follow-up for improvement or worsening of their arterial blood pressure, body weight, and fasting glucose level for a mean period of 77 months. Preoperatively, 17 patients (58.6 %) had arterial hypertension, 14 (48.3 %) had a body mass index exceeding 27 kg/m(2), and 12 (41.4 %) had diabetes mellitus. Postoperatively, a decrease in mean arterial pressure was found in 12 patients (70.6 %), a decrease in body mass index in 6 patients (42.9 %), and an improvement in glycemic control in 5 patients (41.7 %). Laparoscopic adrenalectomy is beneficial in many patients with subclinical Cushing syndrome because it reduces arterial blood pressure, body weight, and fasting glucose levels. Prospective randomized studies are needed to compare laparoscopic adrenalectomy with a conservative approach and to confirm these results.

  10. Subclinical nephritic syndrome in children cohabiting with pediatric patients, Presenting acute nephritic syndrome

    OpenAIRE

    Guerrero-Tinoco Gustavo Adolfo; Julio-Barrios Emil

    2012-01-01

    Introduction: subclinical nephritic syndrome is the presence of hematuria, hypocomplementemiaand/or proteinuria without the presence of signs and/or symptoms.Objective: to determine the incidence of subclinical nephritic syndrome in childrenliving with pediatric patients diagnosed with acute nephritic syndrome.Methods: family visit to identify children living together in the two previous months, with pediatric patients hospitalized with acute nephritic syndrome, at Hospital InfantilNapoleon F...

  11. Subclinical nephritic syndrome in children cohabiting with pediatric patients, Presenting acute nephritic syndrome

    OpenAIRE

    Guerrero-Tinoco Gustavo Adolfo; Julio-Barrios Emil

    2012-01-01

    Introduction: subclinical nephritic syndrome is the presence of hematuria, hypocomplementemiaand/or proteinuria without the presence of signs and/or symptoms.Objective: to determine the incidence of subclinical nephritic syndrome in childrenliving with pediatric patients diagnosed with acute nephritic syndrome.Methods: family visit to identify children living together in the two previous months, with pediatric patients hospitalized with acute nephritic syndrome, at Hospital InfantilNapoleon F...

  12. Is inflammaging an auto[innate]immunity subclinical syndrome?

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    Giunta Sergio

    2006-12-01

    Full Text Available Abstract The low-grade, chronic, systemic inflammatory state that characterizes the aging process (inflammaging results from late evolutive-based expression of the innate immune system. Inflammaging is characterized by the complex set of five conditions which can be described as 1. low-grade, 2. controlled, 3. asymptomatic, 4. chronic, 5. systemic, inflammatory state, and fits with the antagonistic pleiotropy theory on the evolution of aging postulating that senescence is the late deleterious effect of genes (pro-inflammatory versus anti-inflammatorythat are beneficial in early life. Evolutionary programming of the innate immune system may act via selection on these genetic traits. Here I propose that the already acquired knowledge in this field may pave the way to a new chapter in the pathophysiology of autoimmunity: the auto-innate-immunity syndromes. Indeed, differently from the well known chapter of conventional autoimmune diseases and syndromes where the main actor is the adaptive immunity, inflammaging may constitute the subclinical paradigm of a new chapter of autoimmunity, namely that arising from an autoimmune inflammatory response of the innate-immune-system, an old actor of immunity and yet a new actor of autoimmunity, also acting as a major determinant of elderly frailty and age-associated diseases.

  13. [Therapy of subclinical (subdiagnostic) syndromes of schizophrenia spectrum].

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    Gross, G

    2001-09-01

    Since 1911, when E. Bleuler thought of the so-called latent schizophrenia as the most frequent type of schizophrenia, but most seldom diagnosed as such, the question, whether there exist abortive forms of schizophrenia, was discussed again and again; so in 1932 by Mayer-Gross, who devoted to the uncharacteristic onset of schizophrenia a special chapter, in 1938 by Stern (so-called borderline neuroses) und in 1949 by Hoch and Polatin (pseudoneurotic schizophrenias). Since the 50s Huber had described by means of follow-up studies the uncharacteristic basic stages occurring long before the onset and after remission of the florid symptomatology, in 1957 the cenesthetic schizophrenia and in 1961 and 1966 the asthenic or pure defect of schizophrenia, which he also counts to the subclinical syndromes or formes frustes of endogenous psychoses just as the endogenous juvenile-asthenic failure syndromes, the larvate schizophrenia, the endogenous obsessive-compulsive disorder and the circumscribed cenesthopathy. The recognition of these subthreshold stages and types of the schizophrenia spectrum, which cannot be diagnosed by valid diagnostic criteria for schizophrenia, is the presupposition for an adequate therapy. The patients complain about subjectively experienced mainly dynamic, affective, cognitive (thought, perception and action disturbances), cenesthetic and vegetative basic symptoms, can be registered and documented by the Bonn Scale BSABS. We will deal with symptomatology, course and therapy of the mentioned sublinical syndromes. The psychopharmacological treatment is chosen according to the psychopathological cross-section picture and will be continued until improvement or remission of the symptomatology and after stepwise reduction stopped. If dynamic and affective basic symptoms predominate, we prefer antidepressants (e. g. amitriptyline-type or the newer SSRIs), in case of prevailing cognitive and cenethetic basic symptoms neuroleptics, today mainly atypical ones

  14. Association between metabolic syndrome and subclinical coronary atherosclerosis in asymptomatic adults.

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    Kullo, Iftikhar J; Cassidy, Andrea E; Peyser, Patricia A; Turner, Stephen T; Sheedy, Patrick F; Bielak, Lawrence F

    2004-12-15

    Metabolic syndrome was associated with the presence and quantity of coronary artery calcium, a marker of subclinical coronary atherosclerosis, in 1,129 asymptomatic adults, ages 20 to 79 years, from a community-based study. The association was independent of 10-year risk of coronary heart disease based on the Framingham risk score.

  15. Dietary determinants of subclinical inflammation, dyslipidemia and components of the metabolic syndrome in overweight children: a review

    NARCIS (Netherlands)

    Zimmermann, M.B.; Aeberli, I.

    2008-01-01

    Objective: To review and summarize the dietary determinants of the metabolic syndrome, subclinical inflammation and dyslipidemia in overweight children. Design: Review of the current literature, focusing on pediatric studies. Participants: Normal weight, overweight, or obese children and

  16. Dietary determinants of subclinical inflammation, dyslipidemia and components of the metabolic syndrome in overweight children: a review

    NARCIS (Netherlands)

    Zimmermann, M.B.; Aeberli, I.

    2008-01-01

    Objective: To review and summarize the dietary determinants of the metabolic syndrome, subclinical inflammation and dyslipidemia in overweight children. Design: Review of the current literature, focusing on pediatric studies. Participants: Normal weight, overweight, or obese children and adolescents

  17. Subclinical Cushing’s syndrome with bilateral adrenal tumours in a patient with gallbladder multiple stone: therapeutical options

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    Carsote Mara

    2015-08-01

    Full Text Available Introduction The field of Cushing syndrome is a various area; there are still subjects incompletely clarified as the subclinical pattern as well as cortisol producing bilateral adrenal tumours.

  18. Dietary determinants of subclinical inflammation, dyslipidemia and components of the metabolic syndrome in overweight children: a review

    NARCIS (Netherlands)

    Zimmermann, M.B.; Aeberli, I.

    2008-01-01

    Objective: To review and summarize the dietary determinants of the metabolic syndrome, subclinical inflammation and dyslipidemia in overweight children. Design: Review of the current literature, focusing on pediatric studies. Participants: Normal weight, overweight, or obese children and adolescents

  19. Subclinical hypothyroidism in children with Down syndrome: To treat ...

    African Journals Online (AJOL)

    Solaf M. Elsayed

    2014-09-16

    Sep 16, 2014 ... The cause of neonatal hypothyroidism in this particular syndrome remains unclear ... delay in the maturation of the hypothalamic-pituitary-thyroid axis [8]. Others postulated that ... in the thyroid gland [11]. The issue whether ...

  20. Subclinical Sjögren's syndrome and anti-Ro/SSA-positive autoimmune fatigue syndrome in children.

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    Itoh, Y; Imai, T; Fujino, O; Igarashi, T; Fukunaga, Y

    2002-09-01

    Abstract Although Sjögren's syndrome (SS) is quite rare among children, subclinical conditions without any sicca symptoms have been reported. This condition is characterized by nonspecific rheumatic symptoms and histopathological findings in salivary glands which are equivalent to SS. Many children with subclinical SS are positive for anti-Ro/SSA. On the other hand, autoimmune fatigue syndrome (AIFS) is characterized by chronic nonspecific complaints and positive antinuclear antibodies, with or without fulfilling the criteria for chronic fatigue syndrome. Although a novel autoantibody against a 62 kD nuclear protein (anti-Sa) is detected in about 40% of AIFS patients, few marker antibodies for autoimmune diseases, such as anti-DNA, anti-Sm, anti-U1-ribonucleoprotein (RNP), or anticardiolipin, are found in AIFS patients. In this study, however, anti-Ro/SSA was detected in sera from 8 out of 122 AIFS patients. Seven of the 8 anti-Ro/SSA-positive patients were female. All 8 patients had fatigue and low-grade fever, but none complained of xerosis. Western immunoblot analysis revealed that 7 sera reacted with Ro52, and that none was positive for anti-La/SSB or anti-Sa. Two of the 8 patients had histories of recurrent parotitis. Lip biopsies showed mild chronic inflammation compatible with subclinical SS in these 2 patients, although the other 6 patients had no abnormal histopathology. Thus, at least some anti-Ro/SSA-positive patients could be diagnosed as having SS.

  1. Adrenal incidentaloma: A case of pheochromocytoma with sub-clinical Cushing′s syndrome

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    Ashutosh Goyal

    2013-01-01

    Full Text Available Adrenal incidentalomas (AIs are a cluster of different pathologies, but AIs with dual functional aspects are very rare. We report a case of AI with the evidence of both pheochromocytoma and sub-clinical Cushing′s syndrome. A 42-year-old female patient presented with the history of abdominal pain. Abdominal computed tomography revealed right adrenal mass suggestive of pheochromocytoma. On endocrine evaluation, she admitted history of intermittent headache and palpitations for 4 years and was on treatment for hypertension and diabetes. There were no signs and symptoms suggestive of Cushing′s syndrome. The laboratory data demonstrated 10 times raised 24-h urinary fractionated metanephrines with non-suppressible serum cortisol after 2-day low-dose dexamethasone suppression test. She underwent right-sided adrenalectomy with subsequent resolution of both pheochromocytoma and hypercortisolism. Patient was discharged in good clinical condition.

  2. Atrial fibrillation associated with exogenous subclinical hyperthyroidism, changing axis deviation, troponin-I positive and without acute coronary syndrome.

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    Patanè, Salvatore; Marte, Filippo

    2011-08-04

    Changing axis deviation has been rarely reported also during atrial fibrillation or atrial flutter. Changing axis deviation has been also rarely reported during acute myocardial infarction associated with atrial fibrillation or at the end of atrial fibrillation during acute myocardial infarction. Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Serum troponin-I is a sensitive indicator of myocardial damage but abnormal troponin-I levels have been also reported without acute coronary syndrome and without cardiac damage. Abnormal troponin-I levels after supraventricular tachycardia have been also reported. We present a case of changing axis deviation in a 49-year-old Italian man with atrial fibrillation, exogenous subclinical hyperthyroidism and troponin-I positive without acute coronary syndrome. Also this case focuses attention on changing axis deviation, on subclinical hyperthyroidism and on the importance of a correct evaluation of abnormal troponin-I levels.

  3. Clinical Characteristics and Metabolic Features of Patients with Adrenal Incidentalomas with or without Subclinical Cushing's Syndrome

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    Bo-Yeon Kim

    2014-12-01

    Full Text Available BackgroundThe aim of this study was to examine the clinical characteristics of adrenal incidentalomas discovered by computed tomography (CT and to investigate metabolic features of subclinical Cushing's syndrome (SCS in patients with adrenal incidentalomas in a tertiary hospital in Korea.MethodsThis retrospective study examined the clinical aspects of 268 patients with adrenal incidentalomas discovered by CT at Soonchunhyang University Bucheon Hospital. Clinical data and endocrine function of the patients as well as histological findings were obtained from medical records, while anatomic characteristics were analyzed by reviewing imaging studies. Hormonal tests for pheochromocytoma, Cushing's syndrome, and aldosterone-secreting adenoma were performed.ResultsMost (n=218, 81.3% cases were nonfunctioning tumors. Of the 50 patients with functioning tumors (18.7%, 19 (7.1% were diagnosed with SCS, nine (3.4% with overt Cushing's syndrome, 12 (4.5% with primary aldosteronism, and 10 (3.7% with pheochromocytoma. Malignant tumors (both primary and metastatic were rare (n=2, 0.7%. Body mass index, fasting glucose, hemoglobin A1c, and total cholesterol were significantly higher in patients with SCS in comparison with those with nonfunctioning tumors. The prevalence of type 2 diabetes mellitus and hypertension were significantly higher in patients with SCS compared with those with nonfunctioning tumors.ConclusionFunctioning tumors, especially those with subclinical cortisol excess, are commonly found in patients with adrenal incidentalomas, although malignancy is rare. In addition, patients with SCS in adrenal incidentalomas have adverse metabolic and cardiovascular profiles.

  4. Novel SCN5A mutation associated with idiopathic ventricular fibrillation due to subclinical Brugada syndrome

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    Juan Jiménez-Jáimez

    2011-12-01

    Full Text Available Idiopathic ventricular fibrillation can be caused by subclinical channelopathies such as Brugada syndrome. Our objective is to study the clinical behaviour of a new SCN5A mutation found in a woman with idiopathic ventricular fibrillation. A 53-year-old woman presented with multiple episodes of ventricular fibrillation, a structurally normal heart and normal baseline electrocardiogram. Genetic testing included KCNQ1, KCNH2, SCN5A, KCNE1, KCNE2 and KCNJ2 and identified a mutation in SCN5A (D1816fs/g98747-98748insT. We studied 15 immediate family members by means of electrocardiogram, echocardiogram, flecainide challenge test and genetic study. Eight subjects had the mutation. The flecainide challenge test was positive for Brugada syndrome in two subjects in the case group and none in the control group. The PR and QRS intervals on the baseline electrocardiogram were longer in the case group. The left atrial volume indexed to body surface was higher in the case group, likely due to the fact that two patients with the mutation had atrial fibrillation and none had it in the control group. The D1816fs/g98747-98748insT mutation in SCN5A may be associated with idiopathic ventricular fibrillation and Brugada syndrome with a broad phenotypic spectrum and incomplete penetrance. Genetic testing may be useful to identify the etiology of idiopathic ventricular fibrillation in patients with a negative thorough clinical evaluation.

  5. Subclinical mucosal inflammation in diarrhea-predominant irritable bowel syndrome (IBS) in a tropical setting.

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    De Silva, Arjuna Priyadarsin; Nandasiri, Shanika Dulanjalee; Hewavisenthi, Janaki; Manamperi, Aresha; Ariyasinghe, Madurangi Prasadi; Dassanayake, Anuradha Supun; Jewell, Derek P; de Silva, Hithanadura Janaka

    2012-06-01

    There is evidence for low-grade inflammation in the pathophysiology of post-infectious irritable bowel syndrome (IBS). We assessed the degree of subclinical intestinal mucosal inflammation in diarrhea-predominant IBS (IBS-D) in a tropical setting. In a prospective study over 1 year, we investigated 49 patients with IBS-D (cases; median age 34 years (range 18-59); M:F 36:13), diagnosed on Rome III criteria. 14 individuals with a family history of colon cancer (median age 46.5 years (range 23-56); M:F 6:8) were selected as controls. Stools of cases and controls were tested for calprotectin. During colonoileoscopy, serial biopsies were obtained. Mucosal mast cells, neutrophils, eosinophils and lymphocytes/plasma cell infiltrate were quantified. Tissue expression of IL-8 and IL-10 was assessed in biopsies by semi-quantitative RT-PCR. A history suggestive of an episode of infectious diarrhea (ID) was present in 16/49 cases and 0/14 controls (p = 0.013). In cases, there were significantly more mucosal mast cells in the ileum and all segments of colon and significantly more eosinophils in the cecum. Tissue expression of IL-8 was significantly higher and IL-10 significantly lower in cases compared with controls (target/standard cDNA ratio, median (range) IL-8: 1.25 (0.75-2) vs. 0.85 (0.63-1.3), p < 0.0001, Mann-Whitney U test; IL-10: 0.33 (0-0.63) vs. 0.55 (0.5-0.7), p < 0.0001). There was a significant inverse correlation between IL-8 and IL-10 expression (Pearson correlation, (-) 0.509; p < 0.01). There was evidence of subclinical intestinal mucosal inflammation in patients with IBS-D. The finding of increased eosinophils is novel, and may be of special relevance to IBS-D in the tropics.

  6. The Recovery of Hypothalamic-Pituitary-Adrenal Axis Is Rapid in Subclinical Cushing Syndrome.

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    Kim, Hee Kyung; Yoon, Jee Hee; Jeong, Yun Ah; Kang, Ho Cheol

    2016-12-01

    In subclinical Cushing syndrome (SC), it is assumed that glucocorticoid production is insufficient to cause a clinically recognizable syndrome. Differences in hormonal levels or recovery time of the hypothalamic-pituitary-adrenocortical (HPA) axis after adrenalectomy between patients with overt Cushing syndrome (OC) and SC remain unknown. Thirty-six patients (10 with OC and 26 with SC) with adrenal Cushing syndrome who underwent adrenalectomy from 2004 to 2014 were reviewed retrospectively. Patients were treated with glucocorticoid after adrenalectomy and were reevaluated every 1 to 6 months using a rapid adrenocorticotropic hormone (ACTH) stimulation test. Levels of basal 24-hour urine free cortisol (UFC), serum cortisol after an overnight dexamethasone suppression test (DST), and serum cortisol and 24-hour UFC after low-dose DST and high-dose DST were all significantly lower in patients with SC compared with OC. Basal ACTH levels showed significantly higher in patients with SC compared with OC. The probability of recovering adrenal function during follow-up differed significantly between patients with OC and SC (P=0.001), with significant correlations with the degree of preoperative cortisol excess. Patients with OC required a longer duration of glucocorticoid replacement to recover a normal ACTH stimulation test compared with patients with SC (median 17.0 months vs. 4.0 months, P<0.001). The HPA axis recovery time after adrenalectomy in patients with SC is rapid and is dependent on the degree of cortisol excess. More precise definition of SC is necessary to achieve a better management of patients and to avoid the risk of under- or over-treatment of SC patients.

  7. The Recovery of Hypothalamic-Pituitary-Adrenal Axis Is Rapid in Subclinical Cushing Syndrome

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    Hee Kyung Kim

    2016-12-01

    Full Text Available BackgroundIn subclinical Cushing syndrome (SC, it is assumed that glucocorticoid production is insufficient to cause a clinically recognizable syndrome. Differences in hormonal levels or recovery time of the hypothalamic-pituitary-adrenocortical (HPA axis after adrenalectomy between patients with overt Cushing syndrome (OC and SC remain unknown.MethodsThirty-six patients (10 with OC and 26 with SC with adrenal Cushing syndrome who underwent adrenalectomy from 2004 to 2014 were reviewed retrospectively. Patients were treated with glucocorticoid after adrenalectomy and were reevaluated every 1 to 6 months using a rapid adrenocorticotropic hormone (ACTH stimulation test.ResultsLevels of basal 24-hour urine free cortisol (UFC, serum cortisol after an overnight dexamethasone suppression test (DST, and serum cortisol and 24-hour UFC after low-dose DST and high-dose DST were all significantly lower in patients with SC compared with OC. Basal ACTH levels showed significantly higher in patients with SC compared with OC. The probability of recovering adrenal function during follow-up differed significantly between patients with OC and SC (P=0.001, with significant correlations with the degree of preoperative cortisol excess. Patients with OC required a longer duration of glucocorticoid replacement to recover a normal ACTH stimulation test compared with patients with SC (median 17.0 months vs. 4.0 months, P<0.001.ConclusionThe HPA axis recovery time after adrenalectomy in patients with SC is rapid and is dependent on the degree of cortisol excess. More precise definition of SC is necessary to achieve a better management of patients and to avoid the risk of under- or over-treatment of SC patients.

  8. PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH PSORIATIC ARTHRITIS: ITS ASSOCIATION WITH INFLAMMATION AND SUBCLINICAL ATHEROSCLEROSIS

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    E. I. Markelova

    2016-01-01

    Full Text Available Metabolic syndrome (MS is a cluster of metabolic disorders giving rise to atherosclerotic  cardiovascular diseases (CVD. The combination  of inflammatory activity and a high spread of traditional  risk factors (RF for CVD in patients with psoriatic arthritis (PsA permits them to be referred to as a higher cardiovascular risk group as compared to the general population.Objective: to estimate the spread of MS and its association with inflammation and subclinical atherosclerosis in patients with PsA.Subjects and methods. This investigation enrolled 128 patients with PsA (61.7% women and 38.3% men; their median age was 43 [34; 49.5] years; the duration of PsA and psoriasis – 7 [3; 13] and 15 [6; 26] years, respectively. There was a preponderance of patients with moderate (3.7 ≥ DAS > 2.4 and high (DAS > 3.7 disease activity: 33 (25.8% and 74 (57.8%, respectively. MS was diagnosed on the basis of the 2011 National  Guidelines of the Russian Cardiology Society for Cardiovascular Prevention.  All the patients underwent carotid Doppler ultrasound (CDU for the diagnosis of subclinical atherosclerosis. Results and discussion. MS was diagnosed in 49 (38.3% patients with PsA. The most common  MS criteria were abdominal  obesity in 72 (56.3% and dyslipidemia [an elevation of low-density lipoproteins (LDL  level in 101 (78.9%, and a decrease in high-density lipoproteins (HDL  level in 65 (50.8]. Hypertension was diagnosed in 32 (25%. 65 (50.8% patients were found to have subclinical atherosclerosis,  as evidenced by CDU.The patients with MS were older than those without this condition  (46 [43; 52] and 39 [31; 46] years, respectively; p < 0.0001. These groups did not differ in PsA duration (15 [7; 29] and 15 [5.5; 25] years respectively; p = 0.47. The patients with MS had higher DAS values (4.4 [3.2; 5.6] and 3.6 [2.5; 4.7], respectively; p = 0.02; mean intima media thickness (IMT  (0.78 [0.72; 0.86] and 0.73 [0.66; 0.77] mm; p < 0.0001 and

  9. The Relationship between Subclinical Asperger’s Syndrome and Frontotemporal Lobar Degeneration

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    Akira Midorikawa

    2012-04-01

    Full Text Available Background/Aims: The existence of the behavioral variant of frontotemporal dementia (bv-FTD, including senile Asperger’s syndrome (AS, has been proposed. However, there are no empirical case reports to support the proposal. In this report, we present 3 patients who showed symptoms of bv-FTD and demonstrated signs of autistic spectrum disorder, especially AS. Methods: We evaluated 3 subjects using the diagnostic criteria for bv-FTD, and their caregivers retrospectively provided data to calculate the Autism-Spectrum Quotient, Japanese version [Wakabayashi et al.: Shinrigaku Kenkyu 2004;75:78–84]. We also compared these data with those obtained from 3 individuals with Alzheimer’s disease. Results: All 3 patients met the criteria for bv-FTD and had a higher Autism-Spectrum Quotient score than did comparable Alzheimer’s disease subjects. Conclusion: It is possible that some senile persons with frontotemporal lobar degeneration-like maladaptive behavior may suffer from subclinical AS.

  10. Conn’s Syndrome, Subclinical Cushing’s Syndrome and Thyrotoxicosis Presenting as Hypokalemic Periodic Paralysis: A Case Report

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    İnan Anaforoğlu

    2009-12-01

    Full Text Available Thyrotoxicosis and primary hyperaldosteronism both cause hypokalemic periodic paralysis. Here we report a 51-year-old woman presenting with severe hypokalemia due to both thyrotoxicosis and primary hyperaldosteronism. At first presentation, she had a potassium level of 1.5 mEq/L and thyrotoxicosis due to a hot nodule, and was diagnosed as having thyrotoxic hypokalemic periodic paralysis. After treatment with propylthiouracil and potassium, she completely regained muscle strength. Nevertheless, a decrease in potassium level was observed again when the replacement of potassium was discontinued. The further diagnostic work-up of the patient, who had also history of hypertention, revealed primary hyperaldosteronism and subclinical Cushing’s syndrome due to adrenal adenoma on the left side. Whether thyrotoxicosis contributed to the hypokalemic periodic paralysis in this patient is a matter of debate. Adrenal hyperfunction should be considered in all patients with hypertension and hypokalemia regardless of the presentation of the case. Turk Jem 2009; 13: 87-90

  11. Subclinical inflammation during third trimester of pregnancy was not associated with markers of the metabolic syndrome in young adult offspring

    DEFF Research Database (Denmark)

    Danielsen, Inge; Granström, Charlotta; Rytter, Dorte

    2013-01-01

    for maternal smoking during pregnancy, height, prepregnancy body mass index (BMI), education, and offspring's sex. Offspring MS markers included waist circumference, BMI, blood pressure, HOMA insulin resistance, and plasma levels of fasting glucose, triglycerides, cholesterol fractions, insulin, and leptin......OBJECTIVE: Growing evidence indicates that the metabolic syndrome (MS) is rooted in adverse exposures during fetal life. The aim of this study was to assess the possible associations between biomarkers of inflammation during third trimester of pregnancy and markers of MS in adult offspring. METHODS...... for potential confounding. CONCLUSION: Markers for subclinical inflammation in third trimester in healthy women were not associated with components of MS in their adult offspring....

  12. Subclinical Cushing's syndrome due to unilateral or bilateral adrenal incidentalomas. Problems of diagnostic and indication to surgical treatment. Review of literature

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    Nikolay Sergeevich Kuznetsov

    2015-05-01

    Full Text Available Today subclinical Cushing's syndrome is the most widespread variant of hormonal activity of incidentaloma's hormonal activity. This pathology is defined as a mild intensity autonomous cortisol hypersecretion, not causing specific clinical signs of hypercorticism, but detectable biochemically as derangements of the hypothalamic-pituitary-adrenal axis function. Some clinical symptomatology of metabolic syndrome, such as obesity, impaired carbohydrate metabolism and hypertension, are peculiar to subclinical hypercorticism more than to population. As a result all these symptomatology could lead to increasing cardiovascular risk. Till now there isn't a definite opinion about the need of surgical treatment of present pathology. But there is evidence, that after removing of incidentalomas clinical symptomatology of metabolic syndrome are improving. For understanding all possible risks, connected with subclinical hypercorticism, it's necessary to study the origins of their arising and present about the most adequate screening tests. 

  13. Analysis of subclinical Cushing syndrome%亚临床库欣综合征临床分析

    Institute of Scientific and Technical Information of China (English)

    张锐强; 张玉石; 王海; 李汉忠

    2010-01-01

    目的 提高亚临床库欣综合征的诊治水平.方法 回顾分析24例亚临床库欣综合征的临床表现、内分泌检查、影像学检查、治疗方法以及光镜、电镜检查资料.结果 24例患者均无典型库欣综合征体征,内分泌检查24 h尿游离皮质醇升高18例(75%),皮质醇节律消失12例(50%),小剂量地塞米松抑制试验不被抑制24例(100%),大剂量地塞米松抑制试验不被抑制11例(46%).CT检查提示肾上腺肿瘤直径1.8~4.5 cm,平均3.1 cm.24例均行腹腔镜下肾上腺瘤切除术.标本病理报告均为肾上腺皮质腺瘤,电镜下见细胞质内存在较多分泌颗粒.随访3个月,患者血压正常,皮质醇节律恢复.结论 内分泌检查尤其是小剂量地塞米松抑制试验对亚临床库欣综合征诊断具有重要意义,诊断明确者手术治疗疗效满意.%Objective To evaluate subclinical Cushing syndrome cases and to improve the diagnosis.Methods A retrospective analysis was done on the data of 24 subclinical Cushing syndrome cases.Clinical data included clinical manifestations,endocrinal tests,imaging,treatments,light microscopic and electron microscopic results.Results No typical sign of Cushing syndrome was found in these 24 cases.Endocrine tests showed that 24-hour urine free cortisol increased in 18 cases (75%),cortisol rhythm disappeared in 12 cases(50%),high-dose dexamethasone suppression test was not inhibited in 11 cases (46%),and low-dose dexamethasone suppression test (LDDST) was not suppressed in all 24 cases (100%).CT scan showed the average tumor diameter was 3.1(1.8-4.5)cm.Laparoscopic resections of adrenal tumors were performed for all 24 patients.The light microscopic examination of the tumor specimens showed adrenocortical adenoma,and the electron microscopic examination found a greater number of cytoplasmic secretory granules.After 3 months' followup,patient's blood pressure was normal and the normal cortisol rhythm was detected

  14. Subclinical Hypothyroid

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Kalantar Hormozi

    2011-04-01

    Full Text Available Background: subclnical hypothyroid (SCH, defined by a normal total or free T4 level and a midly Elevated TSH, is common in adults. Subclinical hypothyroid is a risk factor for developing hypothyroidism complication . the goal of screening is to identify and treatment patients with sublinical hypothyroid before they develop these complication. Methods: The sample size of this study was the articles indexed in pubmed,ovid, tripdatabase, new spring link black coehrane, Elsevirer, Embase and contained the terms subclinical hypothyroid, Anti-tpo, Thyrotropin, levothyroxine trapy. Results: 831 articles were found that 75 articles were investigated for this issue. The results are discussed under. The subtile such as subclinical hypothyroid, screening for subclinical hypothyroid, Indication of treatment of Subclinical hypothyroid. Conclusion: In this summary, we tried to review the current literature about definition, Indection of screening and treatment of subclinical hypothyroid and reach a comprehensive guidline for practical significance of this subject in routines practice.

  15. Subclinical hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Kalantar Hormozi

    2013-09-01

    Full Text Available Background: Subclinical hyperthyroidism occurs when peripheral thyroid hormone levels are within the normal labaratory reference range and serum thyroid stimulating hormone level is less than normal. For patients with sustained subclinical hyperthyroidism (serum TSH level< 0/1mlu/L, therapy is recommended especially in older patients. Observation or selective therapy should be considered for patients with: Serum TSH level between 0/1 and 0/4 mlu/L and postmonoposel osteoprosis, recent atrial fibrillation congestive heart failure, angina pectoris and infertility or menstrual disorder. This review article aimed to assess the indication of treatment of the patients with subclinical hypothyroidism. Material and Methods: The sample size of this study was the article index in block cochrance, embase, pubmed databases and enutained the terms subclinical hyperthyroid, thyroxin, and thyrotropin. Results: 209 articles were found that 53 articles were investigated for this issue. The results are discussed under the subtitles such as subclinical hypothyroidism and indication of treatment of subclinical hyperthyroidism. Conclusion: In this summary, we tried to review the current literature about subclinical hyperthyroidism and indication of treatment of subclinical hyperthyroidism.

  16. Patients with post-polio syndrome are more likely to have subclinical involvement as compared to polio survivors without new symptoms

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    Arzu Yagiz On

    2016-01-01

    Full Text Available Background: Post-polio syndrome (PPS is a condition that affects polio survivors decades after recovery from an initial acute attack. It is a well-known entity that limbs thought to be nonaffected by polio survivors commonly demonstrate electromyography (EMG evidence of prior polio. Although the diagnosis of PPS requires a remote history of acute paralytic polio, clinically unapparent damage caused by poliovirus can be associated with PPS later in life. Objective: To evaluate EMG abnormalities and late progressive symptoms in limbs thought to be nonaffected by polio survivors, in order to determine the prevalence of subclinical motor neuron involvement in those fulfilling criteria for PPS comparing to those without such symptoms. Materials and Methods: Clinical and EMG findings of 464 limbs in 116 polio survivors who had been admitted to our clinic were analyzed. Affection of the limbs by polio was classified based on the patient′s self-report on remote weakness during the acute phase of poliomyelitis, muscle strength measured by manual muscle testing, and four-limb needle EMG. Results: Seventy-six of the patients (65.5% met the criteria of PPS. Needle EMG studies revealed subclinical involvement in 122 out of 293 (42% limbs with no history of remote weakness during the acute phase of poliomyelitis. Prevalence of subclinical involvement was found 47% in polio survivors who met the criteria of PPS compared to 33% in those without PPS (P = 0.013. Among the limbs that had developed new weakness in PPS patients, 33.5% had subclinical involvement. Discussion and Conclusion: Subclinical involvement is common in limbs thought to be nonaffected by polio survivors, and this is especially present in those fulfilling criteria for PPS. New muscle weakness may develop in apparently nonaffected, subclinically involved muscles. Thus we believe that four-limb EMG studies should be performed in all polio survivors, especially in those with the symptoms of PPS.

  17. Subclinical hyperthyroidism

    OpenAIRE

    2013-01-01

    Background: Subclinical hyperthyroidism occurs when peripheral thyroid hormone levels are within the normal labaratory reference range and serum thyroid stimulating hormone level is less than normal. For patients with sustained subclinical hyperthyroidism (serum TSH level< 0/1mlu/L), therapy is recommended especially in older patients. Observation or selective therapy should be considered for patients with: Serum TSH level between 0/1 and 0/4 mlu/L and postmonoposel osteoprosis, recent atrial...

  18. The relationship between subclinic atherosclerosis and red cell distribution width in patients with metabolic syndrome

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    Ali Rıza Gülcan

    2013-12-01

    Full Text Available Objectıve: We have investigated the possible associationbetween red cell distribution width (RDW and subclinicatherosclerosis which can assessed by carotidintima-media thickness (CIMT measurement in patientswith metabolic syndrome (MetS.Methods: 74 patients with MetS were enrolled to thestudy. Patients were divided into 2 groups according tocarotid intima-media thickness (CIMT measurement: 35patients with CIMT≥1.0 mm were at group 1 and 39 patientswith CIMT<1.0 mm were at group 2. RDW weremeasured using an automated blood cell counter.Results: The RDW level was not statistically significantin patients with CIMT≥1,0 mm than in patients withCIMT<1,0 mm (13.73±0.79% vs. 13.77±1.04 %; p=0.85.Conclusion: In our study, we found that RDW was notdifferent in the MetS patients with CIMT≥1.0 mm comparedwith the MetS patients with CIMT<1.0 mm.Key words: red cell distribution width, metabolic syndrome,complete blood count

  19. Predictors of Subclinical Cardiovascular Disease in Women with Polycystic Ovary Syndrome: Interrelationship of Dyslipidemia and Arterial Blood Pressure

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    Djuro Macut

    2015-01-01

    Full Text Available Background. Women with polycystic ovary syndrome (PCOS could develop subclinical atherosclerosis during life. Purpose. To analyze cardiovascular risk (CVR factors and their relation to clinical markers of cardiovascular disease (CVD in respect to their age. Material and Methods. One hundred women with PCOS (26.32±5.26 years, BMI: 24.98±6.38 kg/m2 were compared to 50 respective controls. In all subjects, total cholesterol (TC, HDL-C, LDL-C, triglycerides, TC/HDL-C and TG/HDL-C ratios, glucose, insulin and HOMA index, waist-to-hip ratio (WHR, systolic and diastolic blood pressure (SBP and DBP, resp., and carotid intima-media thickness (CIMT were analyzed in respect to their age and level of androgens. Results. PCOS over 30 years had higher WHR (P=0.008, SBP (P<0.001, DBP (P<0.001, TC (P=0.028, HDL-C (P=0.028, LDL-C (P=0.045, triglycerides (P<0.001, TC/HDL-C (P<0.001, and triglycerides/HDL-C (P<0.001 and had more prevalent hypertension and pronounced CIMT on common carotid arteries even after adjustment for BMI (P=0.005 and 0.036, resp.. TC/HDL-C and TG/HDL-C were higher in PCOS with the highest quintile of FAI in comparison to those with lower FAI (P=0.045 and 0.034, resp.. Conclusions. PCOS women older than 30 years irrespective of BMI have the potential for early atherosclerosis mirrored through the elevated lipids/lipid ratios and through changes in blood pressure.

  20. Amelioration by mecobalamin of subclinical carpal tunnel syndrome involving unaffected limbs in stroke patients.

    Science.gov (United States)

    Sato, Yoshihiro; Honda, Yoshiaki; Iwamoto, Jun; Kanoko, Tomohiro; Satoh, Kei

    2005-04-15

    Our previous study showed that overuse of the nonparetic hand and wrist of the nonparetic side following stroke result in significantly more abnormal on the nonparetic side than on the hemiparetic side in terms of electrophysiologic indices of median nerve function. The purpose of this study was to evaluate the effects of the orally administered mecobalamin, an analogue of vitamin B12, for carpal tunnel syndrome (CTS) in the nonparetic side in patients following stroke. In a randomized open label and prospective study of stroke patients, 67 received of 1500 mug mecobalamin daily for 2 years, and the remaining 68 (untreated group) did not. At baseline, sensory nerve conduction velocity, motor nerve conduction velocity, sensory nerve action potentials (SNAP) at the wrist, palm-to-wrist distal sensory latency, palm-to-wrist SNAP, motor nerve conduction velocity compound motor action potentials, and distal motor latency of median nerve were significantly more abnormal on the nonparetic side than on the hemiparetic side or in controls. Before the treatment 21 patients (31%) of untreated and 20 patients (30%) of treated group met electrophysiologic criteria for CTS. Sensory impairment of the nonparetic side had lessened in the treated group. After 2 years, all electrophysiologic indices of nonparetic side were significantly improved in the treated group compared with those in the untreated group. The improvement from baseline of electrophysiologic parameters in sensory nerve in the treated group was greater than the improvement measured in motor nerve. There were no side effects. Oral mecobalamin treatment is a safe and potentially beneficial therapy for CTS in stroke patients.

  1. Subclinical hypopituitarism.

    Science.gov (United States)

    Fernandez-Rodriguez, Eva; Bernabeu, Ignacio; Andujar-Plata, Paula; Casanueva, Felipe F

    2012-08-01

    The presence of subclinical or minor pituitary hormone deficiencies could be recognised in clinical practice and might represent intermediate situations among normal pituitary hormone secretion and clinical hypopituitarism. However, this entity has not been correctly identified and associated clinical impairment and even more, long-term consequences regarding to morbidity and mortality, strongly related to clinical hypopituitarism, has not been correctly settled. Furthermore, best test or methods for diagnosis and the cut off to define these intermediate situates are also unknown. With this purpose, long-term controlled studies are needed to define correctly this entity, the appropriate methods for diagnosis and the potential benefits of substitutive hormone therapy in detected cases. The present review will focus on the available evidence concerning the prevalence, clinical features and diagnosis of subclinical hypopituitarism.

  2. Management of subclinical hyperthyroidism.

    Science.gov (United States)

    Santos Palacios, Silvia; Pascual-Corrales, Eider; Galofre, Juan Carlos

    2012-01-01

    The ideal approach for adequate management of subclinical hyperthyroidism (low levels of thyroid-stimulating hormone [TSH] and normal thyroid hormone level) is a matter of intense debate among endocrinologists. The prevalence of low serum TSH levels ranges between 0.5% in children and 15% in the elderly population. Mild subclinical hyperthyroidism is more common than severe subclinical hyperthyroidism. Transient suppression of TSH secretion may occur because of several reasons; thus, corroboration of results from different assessments is essential in such cases. During differential diagnosis of hyperthyroidism, pituitary or hypothalamic disease, euthyroid sick syndrome, and drug-mediated suppression of TSH must be ruled out. A low plasma TSH value is also typically seen in the first trimester of gestation. Factitial or iatrogenic TSH inhibition caused by excessive intake of levothyroxine should be excluded by checking the patient's medication history. If these nonthyroidal causes are ruled out during differential diagnosis, either transient or long-term endogenous thyroid hormone excess, usually caused by Graves' disease or nodular goiter, should be considered as the cause of low circulating TSH levels. We recommend the following 6-step process for the assessment and treatment of this common hormonal disorder: 1) confirmation, 2) evaluation of severity, 3) investigation of the cause, 4) assessment of potential complications, 5) evaluation of the necessity of treatment, and 6) if necessary, selection of the most appropriate treatment. 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).

  3. Management of Subclinical Hyperthyroidism

    Science.gov (United States)

    Santos Palacios, Silvia; Pascual-Corrales, Eider; Galofre, Juan Carlos

    2012-01-01

    The ideal approach for adequate management of subclinical hyperthyroidism (low levels of thyroid-stimulating hormone [TSH] and normal thyroid hormone level) is a matter of intense debate among endocrinologists. The prevalence of low serum TSH levels ranges between 0.5% in children and 15% in the elderly population. Mild subclinical hyperthyroidism is more common than severe subclinical hyperthyroidism. Transient suppression of TSH secretion may occur because of several reasons; thus, corroboration of results from different assessments is essential in such cases. During differential diagnosis of hyperthyroidism, pituitary or hypothalamic disease, euthyroid sick syndrome, and drug-mediated suppression of TSH must be ruled out. A low plasma TSH value is also typically seen in the first trimester of gestation. Factitial or iatrogenic TSH inhibition caused by excessive intake of levothyroxine should be excluded by checking the patient’s medication history. If these nonthyroidal causes are ruled out during differential diagnosis, either transient or long-term endogenous thyroid hormone excess, usually caused by Graves’ disease or nodular goiter, should be considered as the cause of low circulating TSH levels. We recommend the following 6-step process for the assessment and treatment of this common hormonal disorder: 1) confirmation, 2) evaluation of severity, 3) investigation of the cause, 4) assessment of potential complications, 5) evaluation of the necessity of treatment, and 6) if necessary, selection of the most appropriate treatment. 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). PMID:23843809

  4. Subclinical Diabetes

    Directory of Open Access Journals (Sweden)

    LUÍS M.T.R. LIMA

    Full Text Available ABSTRACT Type 2 diabetes mellitus (T2DM is increasing in prevalence worldwide, and those non-diagnosed or misdiagnosed comprise a significant group compared to those diagnosed. Accumulated scientific evidence indicate that the current diagnostic markers (fasting glycemia, 2h glycemia after an oral glucose load and HbA1c are indeed late diagnostic criteria when considering the incidence of diabetes-related complications and comorbidities, which are also at high risk in some groups among normoglycemic individuals. Additionally, the earlier identification of future risk of diabetes is desirable since it would allow better adherence to preventive actions such as lifestyle intervention, ultimately avoiding complications and minimizing the economic impact/burden on health care expenses. Insulin resistance and hyperhormonemia (insulin, amylin, glucagon are non-disputable hallmarks of T2DM, which already takes place among these normoglycemic, otherwise health subjects, characterizing a state of subclinical diabetes. Insulin resistance and hyperinsulinemia can be computed from fasting plasma insulin as an independent variable in normoglycemia. An overview of the current diagnostic criteria, disease onset, complications, comorbidities and perspectives on lifestyle interventions are presented. A proposal for early detection of subclinical diabetes from routine evaluation of fasting plasma insulin, which is affordable and robust and thus applicable for the general population, is further suggested.

  5. [Subclinical hyperthyroidism].

    Science.gov (United States)

    Feldkamp, J

    2013-10-01

    Subclinical hyperthyroidism is defined as abnormal low TSH level with thyroid hormones within their reference range. This laboratory condition may be symptomatic in a relevant number of patients leading to tachycardia, sweating, nervousness, anxiety and insomnia. The risk for cardiovascular disease is increased with more frequent atrial fibrillation and increased left ventricular mass including diastolic dysfunction. Cardiovascular mortality and overall mortality surmounts the average of the normal population. Longterm TSH suppression leads to decreased bone mineral density and an increased fracture rate in the hip and in the spine. After evaluation of underlying causes, therapy should be considered, especially if TSH levels are below 0.1 mIU/l. © Georg Thieme Verlag KG Stuttgart · New York.

  6. The association of nonalcoholic fatty liver disease, obesity, and metabolic syndrome, with systemic inflammation and subclinical atherosclerosis: the Multi-Ethnic Study of Atherosclerosis (MESA).

    Science.gov (United States)

    Al Rifai, Mahmoud; Silverman, Michael G; Nasir, Khurram; Budoff, Matthew J; Blankstein, Ron; Szklo, Moyses; Katz, Ronit; Blumenthal, Roger S; Blaha, Michael J

    2015-04-01

    We characterized the association of 3 metabolic conditions - obesity, metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD) - with increased inflammation and subclinical atherosclerosis. We conducted cross-sectional analysis of 3976 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with adequate CT imaging to diagnose NAFLD. Obesity was defined as BMI ≥ 30 kg/m(2), metabolic syndrome by AHA/NHLBI criteria, and NAFLD using non-contrast cardiac CT and a liver/spleen attenuation ratio (L/S)  0. We studied the association of a stepwise increase in number of these metabolic conditions (0-3) with increased inflammation and CAC, stratifying results by gender and ethnicity. Mean age of participants was 63 (±10) years, 45% were male, 37% white, 10% Chinese, 30% African American, and 23% were Hispanic. Adjusting for obesity, metabolic syndrome and traditional risk factors, NAFLD was associated with a prevalence odds ratio for hsCRP ≥2 mg/L and CAC >0 of 1.47 (1.20-1.79) and 1.37 (1.11-1.68) respectively. There was a positive interaction between female gender and NAFLD in the association with hsCRP ≥2 mg/L (p = 0.006), with no interaction by race. With increasing number of metabolic conditions, there was a graded increase in prevalence odds ratios of hsCRP ≥2 mg/L and CAC >0. NAFLD is associated with increased inflammation and CAC independent of traditional risk factors, obesity and metabolic syndrome. There is a graded association between obesity, metabolic syndrome, and NAFLD with inflammation and CAC. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Probable association of tachyarrhythmia with nebulized albuterol in a child with previously subclinical wolff Parkinson white syndrome

    NARCIS (Netherlands)

    Kroesen, M.; Maseland, M.; Smal, J.; Reimer, A.; Setten, P. van

    2012-01-01

    We present the case of a 2-year-old asthmatic boy with atrioventricular (AV)-reentry tachycardia following albuterol inhalation, who was later diagnosed with Wolff-Parkinson-White (WPW) syndrome. The Naranjo adverse drug reaction probability scale score for this adverse event was 7, indicating that

  8. Regulation of steroidogenesis in a primary pigmented nodular adrenocortical disease-associated adenoma leading to virilization and subclinical Cushing’s syndrome

    Science.gov (United States)

    Hofland, Johannes; de Herder, Wouter W; Derks, Lieke; Hofland, Leo J; van Koetsveld, Peter M; de Krijger, Ronald R; van Nederveen, Francien H; Horvath, Anelia; Stratakis, Constantine A; de Jong, Frank H; Feelders, Richard A

    2014-01-01

    Context Primary pigmented nodular adrenocortical disease (PPNAD) can lead to steroid hormone overproduction. Mutations in the cAMP protein kinase A regulatory subunit type 1A (PRKAR1A) are causative of PPNAD. Steroidogenesis in PPNAD can be modified through a local glucocorticoid feed-forward loop. Objective Investigation of regulation of steroidogenesis in a case of PPNAD with virilization. Materials and methods A 33-year-old woman presented with primary infertility due to hyperandrogenism. Elevated levels of testosterone and subclinical ACTH-independent Cushing’s syndrome led to the discovery of an adrenal tumor, which was diagnosed as PPNAD. In vivo evaluation of aberrantly expressed hormone receptors showed no steroid response to known stimuli. Genetic analysis revealed a PRKAR1A protein-truncating Q28X mutation. After adrenalectomy, steroid levels normalized. Tumor cells were cultured and steroidogenic responses to ACTH and dexamethasone were measured and compared with those in normal adrenal and adrenocortical carcinoma cells. Expression levels of 17β-hydroxysteroid dehydrogenase (17β-HSD) types 3 and 5 and steroid receptors were quantified in PPNAD, normal adrenal, and adrenal adenoma tissues. Results Isolated PPNAD cells, analogous to normal adrenal cells, showed both increased steroidogenic enzyme expression and steroid secretion in response to ACTH. Dexamethasone did not affect steroid production in the investigated types of adrenal cells. 17β-HSD type 5 was expressed at a higher level in the PPNAD-associated adenoma compared with control adrenal tissue. Conclusion PPNAD-associated adenomas can cause virilization and infertility by adrenal androgen overproduction. This may be due to steroidogenic control mechanisms that differ from those described for PPNAD without large adenomas. PMID:23065993

  9. Estimating the Severity and Subclinical Burden of Middle East Respiratory Syndrome Coronavirus Infection in the Kingdom of Saudi Arabia.

    Science.gov (United States)

    Lessler, Justin; Salje, Henrik; Van Kerkhove, Maria D; Ferguson, Neil M; Cauchemez, Simon; Rodriquez-Barraquer, Isabel; Hakeem, Rafat; Jombart, Thibaut; Aguas, Ricardo; Al-Barrak, Ali; Cummings, Derek A T

    2016-04-01

    Not all persons infected with Middle East respiratory syndrome coronavirus (MERS-CoV) develop severe symptoms, which likely leads to an underestimation of the number of people infected and an overestimation of the severity. To estimate the number of MERS-CoV infections that have occurred in the Kingdom of Saudi Arabia, we applied a statistical model to a line list describing 721 MERS-CoV infections detected between June 7, 2012, and July 25, 2014. We estimated that 1,528 (95% confidence interval (CI): 1,327, 1,883) MERS-CoV infections occurred in this interval, which is 2.1 (95% CI: 1.8, 2.6) times the number reported. The probability of developing symptoms ranged from 11% (95% CI: 4, 25) in persons under 10 years of age to 88% (95% CI: 72, 97) in those 70 years of age or older. An estimated 22% (95% CI: 18, 25) of those infected with MERS-CoV died. MERS-CoV is deadly, but this work shows that its clinical severity differs markedly between groups and that many cases likely go undiagnosed.

  10. Subclinical Hypothyroidism and Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Sunghwan Suh

    2015-09-01

    Full Text Available Subclinical hypothyroidism (SCH is a common disorder that is characterized by elevated thyroid-stimulating hormone levels in conjunction with free thyroxine concentrations within the normal reference range. Thyroid hormones are known to affect the heart and vasculature and, as a result, the impact of SCH on the cardiovascular (CV system has recently become an important topic of research. Strong evidence points to a link between SCH and CV risk factors such as alterations in blood pressure, lipid levels, and atherosclerosis. Additionally, accumulating evidence indicates that SCH is associated with metabolic syndrome and heart failure. The present review proposes that SCH may be a potentially modifiable risk factor of CV disease and mortality. However, large-scale clinical trials with appropriate power investigating the risks and benefits of SCH treatment are required to determine whether these benefits can be achieved with levothyroxine therapy.

  11. Screening of subclinical hepatic encephalopathy

    NARCIS (Netherlands)

    Groeneweg, M; Moerland, W; Quero, J C; Hop, W C; Krabbe, P F; Schalm, S W

    2000-01-01

    BACKGROUND/AIMS: Subclinical hepatic encephalopathy adversely affects daily functioning. The aim of this study was to determine which elements of daily life have predictive value for subclinical hepatic encephalopathy. METHODS: The study was performed in 179 outpatients with liver cirrhosis. Subclin

  12. Update on subclinical hyperthyroidism.

    Science.gov (United States)

    Donangelo, Ines; Braunstein, Glenn D

    2011-04-15

    Subclinical hyperthyroidism is defined by low or undetectable serum thyroid-stimulating hormone levels, with normal free thyroxine and total or free triiodothyronine levels. It can be caused by increased endogenous production of thyroid hormone (as in Graves disease or toxic nodular goiter), administration of thyroid hormone for treatment of malignant thyroid disease, or unintentional excessive thyroid hormone therapy. The rate of progression to overt hyperthyroidism is higher in persons who have suppressed thyroid-stimulating hormone levels compared with those who have low but detectable levels. Subclinical hyperthyroidism is associated with an increased risk of atrial fibrillation in older adults, and with decreased bone mineral density in postmenopausal women; however, the effectiveness of treatment in preventing these conditions is unknown. There is lesser-quality evidence suggesting an association between subclinical hyperthyroidism and other cardiovascular effects, including increased heart rate and left ventricular mass, and increased bone turnover markers. Possible associations between subclinical hyperthyroidism and quality of life parameters, cognition, and increased mortality rates are controversial. Prospective randomized controlled trials are needed to address the effects of early treatment on potential morbidities to help determine whether screening should be recommended in the asymptomatic general population.

  13. Associations between social cognition, skills, and function and subclinical negative and positive symptoms in 22q11.2 deletion syndrome

    DEFF Research Database (Denmark)

    Vangkilde, A; Jepsen, J R M; Schmock, H

    2016-01-01

    . Association between social impairment and negative and positive symptoms levels was examined in cases only. RESULTS: Subjects with 22q11.2DS were highly impaired in social function, social skills, and social cognition (p ≤ 6.2 × 10(-9)) relative to control peers and presented with more negative (p = 5.8 × 10......-related symptoms. The aims of this study were to conduct a comprehensive investigation of social impairments at three different levels (function, skill, and cognition) and their interrelationship and to determine to what degree the social impairments correlate to subclinical levels of negative and positive...... symptoms, respectively, in a young cohort of 22q11.2DS not diagnosed with schizophrenia. METHODS: The level of social impairment was addressed using questionnaires and objective measures of social functioning (The Adaptive Behavior Assessment System), skills (Social Responsiveness Scale), and cognition...

  14. Prevalence of the Metabolic Syndrome in Latin America and its association with sub-clinical carotid atherosclerosis: the CARMELA cross sectional study

    Science.gov (United States)

    Escobedo, Jorge; Schargrodsky, Herman; Champagne, Beatriz; Silva, Honorio; Boissonnet, Carlos P; Vinueza, Raul; Torres, Marta; Hernandez, Rafael; Wilson, Elinor

    2009-01-01

    Background Metabolic syndrome increases cardiovascular risk. Limited information on its prevalence in Latin America is available. The Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study included assessment of metabolic syndrome in 7 urban Latin American populations. Methods CARMELA was a cross-sectional, population-based, observational study conducted in Barquisimeto, Venezuela; Bogota, Colombia; Buenos Aires, Argentina; Lima, Peru; Mexico City, Mexico; Quito, Ecuador; and Santiago, Chile. The prevalence of metabolic syndrome, defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), and associated carotid atherosclerosis were investigated in 11,502 participants aged 25 to 64 years. Results Across CARMELA cities, metabolic syndrome was most prevalent in Mexico City (27%) and Barquisimeto (26%), followed by Santiago (21%), Bogota (20%), Lima (18%), Buenos Aires (17%), and Quito (14%). In nondiabetic participants, prevalence was slightly lower but followed a comparable ranking. Overall, 59%, 59%, and 73% of women with high triglycerides, hypertension, or glucose abnormalities, respectively, and 64%, 48% and 71% of men with abdominal obesity, hypertension, or glucose abnormalities, respectively, had the full metabolic syndrome. Prevalence of metabolic syndrome increased with age, markedly so in women. Mean common carotid artery intima-media thickness (CCAIMT) and prevalence of carotid plaque increased steeply with increasing numbers of metabolic syndrome components; mean CCAIMT was higher and plaque more prevalent in participants with metabolic syndrome than without. Conclusion The prevalence of metabolic syndrome and its components by NCEP ATP III criteria was substantial across cities, ranging from 14% to 27%. CARMELA findings, including evidence of the association of metabolic syndrome and carotid atherosclerosis, should inform appropriate clinical and public health interventions. PMID

  15. Prevalence of the Metabolic Syndrome in Latin America and its association with sub-clinical carotid atherosclerosis: the CARMELA cross sectional study

    Directory of Open Access Journals (Sweden)

    Torres Marta

    2009-09-01

    Full Text Available Abstract Background Metabolic syndrome increases cardiovascular risk. Limited information on its prevalence in Latin America is available. The Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA study included assessment of metabolic syndrome in 7 urban Latin American populations. Methods CARMELA was a cross-sectional, population-based, observational study conducted in Barquisimeto, Venezuela; Bogota, Colombia; Buenos Aires, Argentina; Lima, Peru; Mexico City, Mexico; Quito, Ecuador; and Santiago, Chile. The prevalence of metabolic syndrome, defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III, and associated carotid atherosclerosis were investigated in 11,502 participants aged 25 to 64 years. Results Across CARMELA cities, metabolic syndrome was most prevalent in Mexico City (27% and Barquisimeto (26%, followed by Santiago (21%, Bogota (20%, Lima (18%, Buenos Aires (17%, and Quito (14%. In nondiabetic participants, prevalence was slightly lower but followed a comparable ranking. Overall, 59%, 59%, and 73% of women with high triglycerides, hypertension, or glucose abnormalities, respectively, and 64%, 48% and 71% of men with abdominal obesity, hypertension, or glucose abnormalities, respectively, had the full metabolic syndrome. Prevalence of metabolic syndrome increased with age, markedly so in women. Mean common carotid artery intima-media thickness (CCAIMT and prevalence of carotid plaque increased steeply with increasing numbers of metabolic syndrome components; mean CCAIMT was higher and plaque more prevalent in participants with metabolic syndrome than without. Conclusion The prevalence of metabolic syndrome and its components by NCEP ATP III criteria was substantial across cities, ranging from 14% to 27%. CARMELA findings, including evidence of the association of metabolic syndrome and carotid atherosclerosis, should inform appropriate clinical and public health

  16. Prevalence of the Metabolic Syndrome in Latin America and its association with sub-clinical carotid atherosclerosis: the CARMELA cross sectional study

    OpenAIRE

    Torres Marta; Vinueza Raul; Boissonnet Carlos P; Silva Honorio; Champagne Beatriz; Schargrodsky Herman; Escobedo Jorge; Hernandez Rafael; Wilson Elinor

    2009-01-01

    Abstract Background Metabolic syndrome increases cardiovascular risk. Limited information on its prevalence in Latin America is available. The Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study included assessment of metabolic syndrome in 7 urban Latin American populations. Methods CARMELA was a cross-sectional, population-based, observational study conducted in Barquisimeto, Venezuela; Bogota, Colombia; Buenos Aires, Argentina; Lima, Peru; Mexico City, Mexico; Qu...

  17. Prevalence of the Metabolic Syndrome in Latin America and its association with sub-clinical carotid atherosclerosis: the CARMELA cross sectional study

    OpenAIRE

    Torres Marta; Vinueza Raul; Boissonnet Carlos P; Silva Honorio; Champagne Beatriz; Schargrodsky Herman; Escobedo Jorge; Hernandez Rafael; Wilson Elinor

    2009-01-01

    Abstract Background Metabolic syndrome increases cardiovascular risk. Limited information on its prevalence in Latin America is available. The Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study included assessment of metabolic syndrome in 7 urban Latin American populations. Methods CARMELA was a cross-sectional, population-based, observational study conducted in Barquisimeto, Venezuela; Bogota, Colombia; Buenos Aires, Argentina; Lima, Peru; Mexico City, Mexico; Qu...

  18. Subclinical hypothyroidism in childhood.

    LENUS (Irish Health Repository)

    O'Grady, M J

    2012-02-01

    Subclinical hypothyroidism (SH) is defined as an elevated thyroid stimulating hormone (TSH) in association with a normal total or free thyroxine (T4) or triiodothyronine (T3). It is frequently encountered in both neonatology and general paediatric practice; however, its clinical significance is widely debated. Currently there is no broad consensus on the investigation and treatment of these patients; specifically who to treat and what cut-off level of TSH should be used. This paper reviews the available evidence regarding investigation, treatments and outcomes reported for childhood SH.

  19. [Hyperprolactinemia in subclinical hypothyroidism].

    Science.gov (United States)

    Pietrobelli, D J; Artese, R; Duhart, J E; Katz, D; Benencia, H

    2001-01-01

    Most patients with subclinical hypothyroidism are asymptomatic; however, when this disorder is associated with alterations of the lactotroph, clinical and biochemical manifestations are evident, along with involvement of the gonadotrophic function. In this report, we selected 11 women with hypothyroidism, 5 of them in stage I and 6 in stage II. In all of them, the thyroid function was altered while the most affected was the gonadal axis. The available literature on this subject is scarce, so that we propose a systematic investigation in order to exclude other associated disorders.

  20. Relationship of Insulin Resistance to Prevalence and Progression of Coronary Artery Calcification Beyond Metabolic Syndrome Components: Shiga Epidemiological Study of Subclinical Atherosclerosis.

    Science.gov (United States)

    Yamazoe, Masahiro; Hisamatsu, Takashi; Miura, Katsuyuki; Kadowaki, Sayaka; Zaid, Maryam; Kadota, Aya; Torii, Sayuki; Miyazawa, Itsuko; Fujiyoshi, Akira; Arima, Hisatomi; Sekikawa, Akira; Maegawa, Hiroshi; Horie, Minoru; Ueshima, Hirotsugu

    2016-08-01

    The association between insulin resistance (IR) and coronary artery calcification (CAC) has been uncertain after adjustment for metabolic syndrome components. We aimed to evaluate whether IR is associated with CAC prevalence or progression independently of metabolic syndrome components. We conducted a population-based study in a random sample of Japanese men aged 40 to 79 years and determined IR using the homeostasis model assessment of insulin resistance (HOMA-IR). The associations of HOMA-IR and other diabetic parameters per 1-SD increase with CAC prevalence and progression were evaluated using multivariable logistic regression. Of 1006 total participants at baseline (mean age, 64±10 years), CAC prevalence was observed in 646 (64.2%), and of 789 participants at follow-up (mean duration, 4.9±1.3 years), CAC progression was observed in 365 (46.3%). After adjustment for covariates including metabolic syndrome components, higher HOMA-IR was independently associated with CAC prevalence (adjusted odds ratio 1.34, 95% confidence interval 1.10-1.63; P=0.003) and progression (odds ratio 1.32, 95% confidence interval 1.09-1.60; P=0.004). In participants without diabetes mellitus, positive associations were similarly observed (prevalence: odds ratio 1.29, 95% confidence interval 1.04-1.60; P=0.022; and progression: odds ratio 1.25, 95% confidence interval 1.01-1.55; P=0.042), whereas glucose and hemoglobin A1c were not associated with CAC prevalence and progression. Higher IR was associated with CAC prevalence and progression independently of metabolic syndrome components in Japanese men and also in those without diabetes mellitus. Among diabetic measures, IR and fasting insulin, but not glucose and hemoglobin A1c, predicted CAC progression in men without diabetes mellitus. © 2016 American Heart Association, Inc.

  1. Subclinical heart failure in juvenile idiopathic arthritis: a consequence of chronic inflammation and subclinical atherosclerosis

    Directory of Open Access Journals (Sweden)

    Hamada S Ahmad

    2016-01-01

    Conclusion Our findings indicate the presence of subclinical heart failure in these patients. JIA patients with subclinical atherosclerosis, with systemic disease, and with active disease are at greatest risk of developing subclinical heart failure.

  2. Economic efficiency analysis of different strategies to control post-weaning multi-systemic wasting syndrome and porcine circovirus type 2 subclinical infection in 3-weekly batch system farms.

    Science.gov (United States)

    Alarcon, Pablo; Rushton, Jonathan; Nathues, Heiko; Wieland, Barbara

    2013-06-01

    The study assessed the economic efficiency of different strategies for the control of post-weaning multi-systemic wasting syndrome (PMWS) and porcine circovirus type 2 subclinical infection (PCV2SI), which have a major economic impact on the pig farming industry worldwide. The control strategies investigated consisted on the combination of up to 5 different control measures. The control measures considered were: (1) PCV2 vaccination of piglets (vac); (2) ensuring age adjusted diet for growers (diets); (3) reduction of stocking density (stock); (4) improvement of biosecurity measures (bios); and (5) total depopulation and repopulation of the farm for the elimination of other major pathogens (DPRP). A model was developed to simulate 5 years production of a pig farm with a 3-weekly batch system and with 100 sows. A PMWS/PCV2SI disease and economic model, based on PMWS severity scores, was linked to the production model in order to assess disease losses. This PMWS severity scores depends on the combination post-weaning mortality, PMWS morbidity in younger pigs and proportion of PCV2 infected pigs observed on farms. The economic analysis investigated eleven different farm scenarios, depending on the number of risk factors present before the intervention. For each strategy, an investment appraisal assessed the extra costs and benefits of reducing a given PMWS severity score to the average score of a slightly affected farm. The net present value obtained for each strategy was then multiplied by the corresponding probability of success to obtain an expected value. A stochastic simulation was performed to account for uncertainty and variability. For moderately affected farms PCV2 vaccination alone was the most cost-efficient strategy, but for highly affected farms it was either PCV2 vaccination alone or in combination with biosecurity measures, with the marginal profitability between 'vac' and 'vac+bios' being small. Other strategies such as 'diets', 'vac+diets' and 'bios

  3. Subclinical Thyroid Dysfunction and Fracture Risk

    DEFF Research Database (Denmark)

    Blum, Manuel R; Bauer, Douglas C; Collet, Tinh-Hai

    2015-01-01

    IMPORTANCE: Associations between subclinical thyroid dysfunction and fractures are unclear and clinical trials are lacking. OBJECTIVE: To assess the association of subclinical thyroid dysfunction with hip, nonspine, spine, or any fractures. DATA SOURCES AND STUDY SELECTION: The databases of MEDLI...

  4. Subclinical organ damage and cardiovascular risk prediction

    DEFF Research Database (Denmark)

    Sehestedt, Thomas; Olsen, Michael H

    2010-01-01

    by measuring subclinical organ damage. We have (i) reviewed recent studies linking markers of subclinical organ damage in the heart, blood vessels and kidney to cardiovascular risk; (ii) discussed the evidence for improvement in cardiovascular risk prediction using markers of subclinical organ damage; (iii...

  5. Subclinical depressive symptoms and continued cannabis use: predictors of negative outcomes in first episode psychosis.

    Directory of Open Access Journals (Sweden)

    Itxaso González-Ortega

    Full Text Available Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use.64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a patients with subclinical depressive symptoms at least once during follow-up (DPG, and (b patients without subclinical depressive symptoms during follow-up (NDPG. Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS, depressive symptoms using the Hamilton Depression Rating Scale (HDRS-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF. A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome.Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001 and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009.Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients.

  6. Subclinical depressive symptoms and continued cannabis use: predictors of negative outcomes in first episode psychosis.

    Science.gov (United States)

    González-Ortega, Itxaso; Alberich, Susana; Echeburúa, Enrique; Aizpuru, Felipe; Millán, Eduardo; Vieta, Eduard; Matute, Carlos; González-Pinto, Ana

    2015-01-01

    Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use. 64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a) patients with subclinical depressive symptoms at least once during follow-up (DPG), and (b) patients without subclinical depressive symptoms during follow-up (NDPG). Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), depressive symptoms using the Hamilton Depression Rating Scale (HDRS)-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF). A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome. Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001) and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009). Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients.

  7. [Subclinical atheroesclerosis and metabolic syndrome in children].

    Science.gov (United States)

    Arnaiz, Pilar; Barja, Salesa; Villarroel, Luis; Domínguez, Angélica; Godoy, Iván; Castillo, Oscar; Farías, Marcelo; Mardones, Francisco

    2013-01-01

    Introducción: El síndrome metabólico (SM) en niños se ha vinculado al desarrollo de ateroesclerosis subclínica, estimada por el grosor intimo-medial carotideo (CIMT). Objetivos: Estudiar la asociación del CIMT con los componentes del SM, la resistencia insulínica (RI) y el estado nutricional en escolares, además de explorar puntos de corte asociados a riesgo. Métodos: Estudio transversal de 447 niños asistentes a escuelas públicas de Santiago, Chile (2009-2011), seleccionados por presentar uno o más componentes del SM y RI. Se realizó antropometría y toma estandarizada de presión de arteria braquial, además de muestras de sangre para determinar lípidos glicemia e insulinemia. Se midió el CIMT por ultrasonografía de alta resolución. Se utilizó correlación de Pearson, t de Student, chi cuadrado y regresión logística. Resultados: Edad 11,5 ± 1,0 años (rango 10-14); 59% mujeres; 93% púberes; 72% con exceso de peso; 24% con SM y 15% con RI. Los promedios de los componentes del SM en los niños con CIMT ≥?percentil 75 vs < percentil 75 tuvieron diferencias para presión arterial sistólica o diastólica ≥?percentil 90 (PA) y colesterol unido a lipoproteínas de alta densidad =?40 mg/dL (CHDL). En la regresión logística para CIMT ≥?percentil 75 fueron seleccionadas PA y CHDL. En la regresión logística para CIMT ≥?percentil 90 no hubo variables seleccionadas. Conclusiones: En este grupo de niños los niveles de PA y CHDL se asocian con CIMT ≥?percentil 75. No se encontró asociación con estado nutricional y RI posiblemente por ser una muestra seleccionada.

  8. [Subclinical hyperthyroidism: from diagnosis to treatment].

    Science.gov (United States)

    Corvilain, B

    2012-09-01

    Subclinical hyperthyroidism is a common clinical entity. Subclinical hyperthyroidism is defined as a serum TSH below the reference range but a normal T4 and T3 level in an asymptomatic patient. Whether or not subclinical hyperthyroidism should be treated remains a matter of debate. Cross-sectional studies and longitudinal population-based studies demonstrate association between subclinical hyperthyroidism and risk of atrial fibrillation, osteoporosis and cardiovascular and global mortality. However, there are no randomized clinical trials answering the question whether long term-health outcomes are improved by the treatment of subclinical hyperthyroidism. Therefore in the absence of evidence for or against treatment of subclinical hyperthyroidism, it seems appropriate to follow algorithms that consider the level of TSH and the presence of risks factors (age > 65 years, osteoporosis, post menopause and cardiac disease).

  9. Increased Cardiovascular Events and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients: 1 Year Prospective Single Centre Study

    Science.gov (United States)

    Ruscitti, Piero; Cipriani, Paola; Masedu, Francesco; Romano, Silvio; Berardicurti, Onorina; Liakouli, Vasiliki; Carubbi, Francesco; Di Benedetto, Paola; Alvaro, Saverio; Penco, Maria; Valenti, Marco; Giacomelli, Roberto

    2017-01-01

    Objectives Several studies showed the close relationship between Rheumatoid Arthritis (RA) and cerebro-cardiovascular events (CVEs) and subclinical atherosclerosis. In this study, we investigated the occurrence of CVEs and subclinical atherosclerosis during the course of RA and we evaluated the possible role of both traditional cardiovascular (CV) and disease related risk factors to predict the occurrence of new CVEs and the onset of subclinical atherosclerosis. Methods We designed a single centre, bias-adjusted, prospective, observational study to investigate, in a homogeneous subset of RA patients, the occurrence of new onset of CVEs and subclinical atherosclerosis. Statistical analyses were performed to evaluate the role of traditional CV and disease-related risk factors to predict the occurrence of new CVEs and subclinical atherosclerosis. Results We enrolled 347 RA patients prospectively followed for 12 months. An increased percentage of patients experienced CVEs, developed subclinical atherosclerosis and was affected by systemic arterial hypertension (SAH), type 2 diabetes mellitus and metabolic syndrome (MS), at the end of follow up. Our analysis showed that the insurgence of both SAH and MS, during the follow up, the older age, the CVE familiarity and the lack of clinical response, were associated with a significantly increased risk to experience CVEs and to develop subclinical atherosclerosis. Conclusions Our study quantifies the increased expected risk for CVEs in a cohort of RA patients prospectively followed for 1 year. The occurrence of both new CVEs and subclinical atherosclerosis in RA patients may be explained by inflammatory burden as well as traditional CV risk factors. PMID:28103312

  10. Reactive thrombocytosis accompanying subclinical hypothyroidism due to Hashimoto's thyroiditis.

    Science.gov (United States)

    Beyan, Cengiz; Kaptan, Kürşat

    2013-09-01

    The important thing in a patient in whom platelet values were detected to be greater than normal is whether thrombocytosis is a reactive phenomenon due to a different pathology or due to a clonal hematological pathology. In this case report, reactive thrombocytosis observed in a case with subclinical hypothyroidism due to Hashimoto's thyroiditis is reported; and according to our literature review, this is the first reported case of reactive thrombocytosis due to Hashimoto's thyroiditis and/or subclinical hypothyroidism. A 31-year-old man without any complaint was admitted to the Hematology Department for thrombocytosis which was detected in his routine follow-up. He had been using thyroid hormone replacement for 2 years because of hypothyroidism as Hashimoto's thyroiditis was earlier diagnosed. Due to miscommunication, he stopped his medication levothyroxine 0.1 mg/day 2 weeks in advance and he was still off-drug on admission. Platelet count was 715×10/l in the first admission center. Subclinical hypothyroidism diagnosis was made with the present findings and thyroid hormone replacement therapy was again commenced gradually. Platelet counts and thyroid-stimulating hormone value were normal 6 weeks later. As a result, before making diagnosis of thrombocytosis related to myeloproliferative disease or myelodysplastic syndromes, secondary causes should be investigated carefully.

  11. The impact of subclinical psychosis on the transition from subclinicial mania to bipolar disorder

    NARCIS (Netherlands)

    Kaymaz, Nil; van Os, Jim; de Graaf, Ron; ten Have, Margreet; Nolen, Willern; Krabbendam, Lydia

    Background: In the general population, symptoms of mania and psychosis are more broadly distributed than their associated clinical syndromes. Little is known, however, about how these subclinical population phenotypes co-vary with and impact on each other. Method: In a representative population

  12. The impact of subclinical psychosis on the transition from subclinicial mania to bipolar disorder

    NARCIS (Netherlands)

    Kaymaz, Nil; van Os, Jim; de Graaf, Ron; ten Have, Margreet; Nolen, Willern; Krabbendam, Lydia

    2007-01-01

    Background: In the general population, symptoms of mania and psychosis are more broadly distributed than their associated clinical syndromes. Little is known, however, about how these subclinical population phenotypes co-vary with and impact on each other. Method: In a representative population coho

  13. The impact of subclinical psychosis on the transition from subclinicial mania to bipolar disorder

    NARCIS (Netherlands)

    Kaymaz, Nil; van Os, Jim; de Graaf, Ron; ten Have, Margreet; Nolen, Willern; Krabbendam, Lydia

    2007-01-01

    Background: In the general population, symptoms of mania and psychosis are more broadly distributed than their associated clinical syndromes. Little is known, however, about how these subclinical population phenotypes co-vary with and impact on each other. Method: In a representative population coho

  14. Electromyographic Findings in Overt Hypothyroidism and Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Emel Oğuz Akarsu

    2013-12-01

    Full Text Available OBJECTIVE: Hypothyroidism may cause neurologic signs and symptoms as its effects neuromuscular system like many other systems. Subclinical hypothyroidism is the most common thyroid dysfuntion, it may cause neuromuscular signs and symptoms. In this retrospective study, it is aimed to compare neuromuscular symptoms and electromyographic (EMG manifestations between hypothyroid patients and control group with normal thyroid function and without a disease causing polyneuropathy. METHODS: 31 overt hypothyroidic, 139 subclinic hypothyroidic patients and 50 individuals with normal thyroid function, without a disease causing polyneuropathy, as control group whom made EMG for another reason were included to the study. Neuromuscular symptoms, neurological examination and electrophysiological findings was obtained from the patient records. RESULTS: In our study, we observed frequent neuromuscular complaints such as fatigue, morning stiffness, cramp, general pain and paresthesia in favor of both for overt and subclinic hypothyroidism. Carpal Tunnel Syndrom(CTS, was statistically higher in overt hypothyroidism group than control group. CTS was also observed higher in subclinic hypothyroidism group when compared with control group but it didn't reach to statistical significance. We did not detect polyneuropathy in any group. Motor nerve velocity and compound muscle action potential amplitudes were found to be statistically significant difference between hypothyroid ve control group. CONCLUSION: Since motor fibres' and neuromuscular area's being affected in hypothyroidism, which we interpret to happen due to basal metabolism's slowing down, can show a significant recovery after thyroid replacement therapy. We consider that, in further studies, comparison of electrophysiological findings after treatment with the findings of pre -treatment is necessary.

  15. Atrial fibrillation associated with subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2009-05-29

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. We present a case of atrial fibrillation associated with subclinical hyperthyroidism, in a 78-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  16. Subclinical Depressive Symptoms and Continued Cannabis Use: Predictors of Negative Outcomes in First Episode Psychosis

    Science.gov (United States)

    González-Ortega, Itxaso; Alberich, Susana; Echeburúa, Enrique; Aizpuru, Felipe; Millán, Eduardo; Vieta, Eduard; Matute, Carlos; González-Pinto, Ana

    2015-01-01

    Background Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use. Methods 64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a) patients with subclinical depressive symptoms at least once during follow-up (DPG), and (b) patients without subclinical depressive symptoms during follow-up (NDPG). Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), depressive symptoms using the Hamilton Depression Rating Scale (HDRS)-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF). A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome. Results Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001) and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009). Conclusions Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients. PMID:25875862

  17. Subclinical hypothyroidism after vascular complicated pregnancy

    NARCIS (Netherlands)

    Zanden, M. van der; Hop-de Groot, R.J.; Sweep, F.C.; Ross, H.A.; Heijer, M. den; Spaanderman, M.E.A.

    2013-01-01

    OBJECTIVE: Women with a history of vascular complicated pregnancy are at risk for developing remote cardiovascular disease. It is associated with underlying cardiovascular risk factors both jeopardizing trophoblast and vascular function. Subclinical hypothyroidism may relate to both conditions. METH

  18. [Subclinical adrenal diseases: silent pheochromocytoma and subclinical Addison's disease].

    Science.gov (United States)

    Thuillier, P; Kerlan, V

    2012-10-01

    The silent pheochromocytoma, a hidden form of pheochromocytoma, exposes the patient to an increased risk of mortality if the diagnosis is not established on time. Biological diagnosis of pheochromocytoma can be difficult. Catecholamine secretion is dependent on tumor size and a large number of physiological, pharmacological, lifestyle modifications and sampling conditions influence the measurement of urinary and plasma metanephrines. The prevalence of pheochromocytoma is 2% among adrenal incidentaloma smaller than 3 cm (2/3 of tumors). Recent studies suggest the almost zero risk of pheochromocytoma among these tumors if they are hypodense (<10 housefield units) on adrenal tomography. Addison's disease is a pathology affecting about 1 in 8000. Immunopathology is still unknown, but some elements advocated the hypothesis of a predominant cell-mediated immunity in particular Interferon-gamma production by CD4 T lymphocytes in the presence of an epitope from the 21-hydroxylase, as well as IgG1 subtype produced by activated B lymphocytes, autoantibodies do appear to be a simple marker of the disease. Subclinical Addison's disease is defined by the presence of anti-21-hydroxylase autoantibodies, without clinical symptoms. It evolves faster to the clinical phase in young subjects, male, having high levels of autoantibodies and with an initially impaired adrenal function. Dosage of ACTH, plasma renin active, and basal cortisol and after Synacthen allow to discriminate the subjects with low or high risk of evolution and establish an appropriate monitoring. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  19. Atrial fibrillation associated with exogenous subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-11-19

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Moreover acute myocardial infarction has been reported during L-thyroxine substitution therapy. Far more common and relatively less studied is exogenous subclinical hyperthyroidism caused by L-thyroxine administration to thyroidectomized or hypothyroid patients or patients with simple or nodular goiter. We present a case of atrial fibrillation associated with exogenous subclinical hyperthyroidism, in a 72-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  20. Frequency of Nonalcoholic Fatty Liver Disease and Subclinical Atherosclerosis Among Young Mexican Americans.

    Science.gov (United States)

    Gill, Clarence; Vatcheva, Kristina P; Pan, Jen-Jung; Smulevitz, Beverly; McPherson, David D; Fallon, Michael; McCormick, Joseph B; Fisher-Hoch, Susan P; Laing, Susan T

    2017-06-01

    Nonalcoholic fatty liver disease (NAFLD) is considered as the hepatic manifestation of the metabolic syndrome, whose criteria are risk factors for atherosclerotic cardiovascular disease. We aimed to evaluate the prevalence of NAFLD, its association with subclinical atherosclerosis, and factors that may account for this association in Mexican Americans. In a population-based cross-sectional sample drawn from the Cameron County Hispanic Cohort in Texas, carotid intima media thickness (cIMT), an indicator of subclinical atherosclerosis, was measured. Abnormal carotid ultrasound study was defined as mean cIMT >75th percentile for age and gender and/or plaque presence. NAFLD was defined as steatosis by ultrasound in the absence of other causes of liver disease. Multivariable weighted regression analyses were performed to evaluate associations between NAFLD and cIMT. Mean age was 50.4 ± 1.2 years with 58.3% women. Mean body mass index was 31.0 ± 0.4 kg/m(2), and 54.0% had the metabolic syndrome. NAFLD was highly prevalent (48.80%); subjects with NAFLD had greater body mass index, central obesity, fasting glucose levels, and dyslipidemia and were more likely to have the metabolic syndrome. Nearly 1/3 of subjects with NAFLD also had evidence of subclinical atherosclerosis (31.2%). After adjusting for covariates, there was an independent association between NAFLD and increased cIMT only in younger subjects diabetic and have the metabolic syndrome. In conclusion, NAFLD is highly prevalent in this Mexican American cohort, with an independent association between NAFLD and subclinical atherosclerosis among younger subjects; clustering of diabetes, obesity, and metabolic syndrome in this health disparity cohort increases the risk of both liver disease and early atherosclerosis in young adults. Published by Elsevier Inc.

  1. The correlation between subclinical thyroid function and risk factors of the metabolic syndrome%亚临床甲状腺功能异常与代谢综合征发病因素的关系

    Institute of Scientific and Technical Information of China (English)

    杨曙晖; 谢培文; 唐小玲; 肖梓栋; 翁晓旭; 沈闲茹; 翁焕; 吴丽楠

    2014-01-01

    目的:探讨亚临床甲状腺功能异常患者发生代谢综合征的因素,以及这些因素与甲状腺功能异常的关系,为亚临床甲状腺功能异常患者预防治疗代谢综合征提供依据。方法选取门诊及住院患者中亚临床甲状腺功能亢进合并代谢综合征的23例患者(观察Ⅰ组)及亚临床甲状腺功能减退合并代谢综合征的21例患者(观察Ⅱ组)进行研究,以同时期健康体检者52例为对照组,分别检测3组的促甲状腺素( TSH)、游离三碘甲状腺原氨酸( FT3)和游离甲状腺素( FT4)水平,以及三酰甘油( TG)、总胆固醇( TC)、高密度脂蛋白胆固醇( HDL-C)、低密度脂蛋白胆固醇( LDL-C)、血糖( Glu)、血压和体质指数水平。结果与对照组比较,观察Ⅱ组患者的TSH、TC以及LDL-C差异有统计学意义( P<0.05),血压、体质指数、TG和HDL-C也略有变化,但差异无统计学意义(P>0.05);观察Ⅱ组患者的Glu水平略低于对照组,但差异无统计学意义(P>0.05),而观察Ⅰ组患者的Glu水平明显高于对照组,差异有统计学意义( P<0.05)。结论亚临床甲状腺功能减退患者罹患代谢综合征可能由血脂异常引起,但其血糖代谢与甲状腺功能无关,临床糖尿病乃至代谢综合征的风险相对低;但亚临床甲状腺功能亢进患者的血糖代谢明显升高,血糖升高可能是亚临床甲状腺功能亢进患者罹患代谢综合征的重要因素。%Objective To study the risk factors of subclinical thyroid dysfunction in patients with metabolic syn -drome ( MS) and thus to investigate the correlation among them .Methods A total of 44 patients with subclinical thyroid dysfunction and MS were studied , with 52 healthy subjects as control group .TSH, FT3 , FT4 , TG, TC, LDL-C, HDL-C, Glu, BP and BMI were assessed .Results Compared to the control group , the levels of THS, TC and LDL

  2. 多囊卵巢综合征伴或不伴亚临床甲状腺功能减退症患者内分泌代谢指标差异研究%Differences in endocrine and metabolic parameters in polycystic ovary syndrome patients with and without subclinical hypothyroidism

    Institute of Scientific and Technical Information of China (English)

    谢艳妮; 王娈; 马瑞欣

    2014-01-01

    Objective To compare the endocrine and metabolic parameters between patients suffering from polycystic ovary syndrome (PCOS) with or without subclinical hypothyroidism.Methods One hundred and fifty-six PCOS patients and 47 healthy controls were enrolled.Height,weight,waist circumference,and hip circumference were measured and recorded.Fasting blood samples were collected for measuring luteinizing hormone (LH),follicular stimulating hormone (FSH),total testosterone,prolactin,estrogen,sex hormone binding globulin (SHBG),thyroidstimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4),blood glucose,serum insulin,triglycerides,total cholesterol,low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol (HDL-C).Body mass index,waist-to-hip ratio,LH-to-FSH ratio,and free androgen index (FAI) were calculated.Homeostasis model assessment of insulin resistance (HOMA-IR) and β cell function (HOMA-β) were assessed.All patients underwent ultrasound for diagnosing polycystic ovary.All the patients were subdivided into two groups in terms of TSH value:subclinical hypothyroidism group with TSH level ≥4.2 μIU/ml and non-subclinical hypothyroidism group with TSH level<4.2 μIU/ml.The differences in endocrine and metabolic parameters were compared between two subgroups.Results Compared with healthy controls,the PCOS patients had significantly higher body mass index,waist-to-hip ratio,LH,LH-to-FSH ratio,total testosterone,FAI,TSH,and lower SHBG (all P<0.05).The other indexes were not different between two groups (P>0.05).24.4% PCOS patients were diagnosed as cases of subclinical hypothyroidism.TSH,prolactin,and triglycerides levels were higher in PCOS patients with subclinical hypothyroidism than those without (P<0.01).Whereas estrogen,FT3,FT4 were significantly lower(P<0.01).The differences of other parameters were not significant between two groups(P>0.05).The results of correlation analysis and TSH quartiles showed no

  3. Multiethnic Exome-Wide Association Study of Subclinical Atherosclerosis

    NARCIS (Netherlands)

    Natarajan, Pradeep; Bis, Joshua C; Bielak, Lawrence F; Cox, Amanda J; Dörr, Marcus; Feitosa, Mary F; Franceschini, Nora; Guo, Xiuqing; Hwang, Shih-Jen; Isaacs, Aaron; Jhun, Min A; Kavousi, Maryam; Li-Gao, Ruifang; Lyytikäinen, Leo-Pekka; Marioni, Riccardo E; Schminke, Ulf; Stitziel, Nathan O; Tada, Hayato; van Setten, Jessica; Smith, Albert V; Vojinovic, Dina; Yanek, Lisa R; Yao, Jie; Yerges-Armstrong, Laura M; Amin, Najaf; Baber, Usman; Borecki, Ingrid B; Carr, J Jeffrey; Chen, Yii-Der Ida; Cupples, L Adrienne; de Jong, Pim A; de Koning, Harry; de Vos, Bob D; Demirkan, Ayse; Fuster, Valentin; Franco, Oscar H; Goodarzi, Mark O; Harris, Tamara B; Heckbert, Susan R; Heiss, Gerardo; Hoffmann, Udo; Hofman, Albert; Išgum, Ivana; Jukema, J Wouter; Kähönen, Mika; Kardia, Sharon L R; Kral, Brian G; Launer, Lenore J; Massaro, Joseph; Mehran, Roxana; Mitchell, Braxton D; Mosley, Thomas H; de Mutsert, Renée; Newman, Anne B; Nguyen, Khanh-Dung; North, Kari E; O'Connell, Jeffrey R; Oudkerk, Matthijs; Pankow, James S; Peloso, Gina M; Post, Wendy; Province, Michael A; Raffield, Laura M; Raitakari, Olli T; Reilly, Dermot F; Rivadeneira, Fernando; Rosendaal, Frits; Sartori, Samantha; Taylor, Kent D; Teumer, Alexander; Trompet, Stella; Turner, Stephen T; Uitterlinden, André G; Vaidya, Dhananjay; van der Lugt, Aad; Völker, Uwe; Wardlaw, Joanna M; Wassel, Christina L; Weiss, Stefan; Wojczynski, Mary K; Becker, Diane M; Becker, Lewis C; Boerwinkle, Eric; Bowden, Donald W; Deary, Ian J; Dehghan, Abbas; Felix, Stephan B; Gudnason, Vilmundur; Lehtimäki, Terho; Mathias, Rasika; Mook-Kanamori, Dennis O; Psaty, Bruce M; Rader, Daniel J; Rotter, Jerome I; Wilson, James G; van Duijn, Cornelia M; Völzke, Henry; Kathiresan, Sekar; Peyser, Patricia A; O'Donnell, Christopher J

    2016-01-01

    BACKGROUND: -The burden of subclinical atherosclerosis in asymptomatic individuals is heritable and associated with elevated risk of developing clinical coronary heart disease (CHD). We sought to identify genetic variants in protein-coding regions associated with subclinical atherosclerosis and the

  4. Multiethnic Exome-Wide Association Study of Subclinical Atherosclerosis

    NARCIS (Netherlands)

    Natarajan, Pradeep; Bis, Joshua C; Bielak, Lawrence F; Cox, Amanda J; Dörr, Marcus; Feitosa, Mary F; Franceschini, Nora; Guo, Xiuqing; Hwang, Shih-Jen; Isaacs, Aaron; Jhun, Min A; Kavousi, Maryam; Li-Gao, Ruifang; Lyytikäinen, Leo-Pekka; Marioni, Riccardo E; Schminke, Ulf; Stitziel, Nathan O; Tada, Hayato; van Setten, Jessica|info:eu-repo/dai/nl/345493990; Smith, Albert V; Vojinovic, Dina; Yanek, Lisa R; Yao, Jie; Yerges-Armstrong, Laura M; Amin, Najaf; Baber, Usman; Borecki, Ingrid B; Carr, J Jeffrey; Chen, Yii-Der Ida; Cupples, L Adrienne; de Jong, Pim A|info:eu-repo/dai/nl/287955672; de Koning, Harry; de Vos, Bob D; Demirkan, Ayse; Fuster, Valentin; Franco, Oscar H; Goodarzi, Mark O; Harris, Tamara B; Heckbert, Susan R; Heiss, Gerardo; Hoffmann, Udo; Hofman, Albert; Išgum, Ivana|info:eu-repo/dai/nl/31484984X; Jukema, J Wouter; Kähönen, Mika; Kardia, Sharon L R; Kral, Brian G; Launer, Lenore J; Massaro, Joseph; Mehran, Roxana; Mitchell, Braxton D; Mosley, Thomas H; de Mutsert, Renée; Newman, Anne B; Nguyen, Khanh-Dung; North, Kari E; O'Connell, Jeffrey R; Oudkerk, Matthijs; Pankow, James S; Peloso, Gina M; Post, Wendy; Province, Michael A; Raffield, Laura M; Raitakari, Olli T; Reilly, Dermot F; Rivadeneira, Fernando; Rosendaal, Frits; Sartori, Samantha; Taylor, Kent D; Teumer, Alexander; Trompet, Stella; Turner, Stephen T; Uitterlinden, André G; Vaidya, Dhananjay; van der Lugt, Aad; Völker, Uwe; Wardlaw, Joanna M; Wassel, Christina L; Weiss, Stefan; Wojczynski, Mary K; Becker, Diane M; Becker, Lewis C; Boerwinkle, Eric; Bowden, Donald W; Deary, Ian J; Dehghan, Abbas; Felix, Stephan B; Gudnason, Vilmundur; Lehtimäki, Terho; Mathias, Rasika; Mook-Kanamori, Dennis O; Psaty, Bruce M; Rader, Daniel J; Rotter, Jerome I; Wilson, James G; van Duijn, Cornelia M; Völzke, Henry; Kathiresan, Sekar; Peyser, Patricia A; O'Donnell, Christopher J

    2016-01-01

    BACKGROUND: -The burden of subclinical atherosclerosis in asymptomatic individuals is heritable and associated with elevated risk of developing clinical coronary heart disease (CHD). We sought to identify genetic variants in protein-coding regions associated with subclinical atherosclerosis and the

  5. Subclinical hyperthyroidism: current concepts and scintigraphic imaging.

    Science.gov (United States)

    Intenzo, Charles; Jabbour, Serge; Miller, Jeffrey L; Ahmed, Intekhab; Furlong, Kevin; Kushen, Medina; Kim, Sung M; Capuzzi, David M

    2011-09-01

    Subclinical hyperthyroidism is defined as normal serum free thyroxine and a free triiodothyronine level, with a thyroid-stimulating hormone level suppressed below the normal range and is usually undetectable. Although patients with this diagnosis have no or few signs and symptoms of overt thyrotoxicosis, there is sufficient evidence that it is associated with a relatively higher risk of supraventricular arrhythmias as well as the acceleration or the development of osteoporosis. Consequently, the approach to the patient with subclinical hyperthyroidism is controversial, that is, therapeutic intervention versus watchful waiting. Regardless, it is imperative for the referring physician to identify the causative thyroid disorder. This is optimally accomplished by a functional study, namely scintigraphy. Recognition of the scan findings of the various causes of subclinical hyperthyroidism enables the imaging specialist to help in diagnosing the underlying condition causing thyroid-stimulating hormone suppression thereby facilitating the workup and management of this thyroid disorder.

  6. Approach to the patient with subclinical hyperthyroidism.

    Science.gov (United States)

    Cooper, David S

    2007-01-01

    Endogenous subclinical hyperthyroidism, defined by normal circulating levels of free T4 and T3 and low levels of TSH, is a common clinical entity and is typically caused by the same conditions that account for the majority of cases of overt hyperthyroidism: Graves' disease, toxic multinodular goiter, and solitary autonomously functioning thyroid nodules. Subclinical hyperthyroidism has been associated with an increased risk of atrial fibrillation and mortality, decreased bone mineral density in postmenopausal women, and mild hyperthyroid symptoms. Treatment of subclinical hyperthyroidism remains controversial, given the lack of prospective randomized controlled trials showing clinical benefit with restoration of the euthyroid state. Nevertheless, it seems reasonable to treat older individuals whose serum TSH levels are less than 0.1 mU/liter and certain high-risk patients, even when the serum TSH is between 0.1 and the lower limit of the normal range.

  7. Subclinical hypothyroidism in HIV-infected subjects.

    Science.gov (United States)

    Bongiovanni, Marco; Adorni, Fulvio; Casana, Maddalena; Tordato, Federica; Tincati, Camilla; Cicconi, Paola; Bini, Teresa; d'Arminio Monforte, Antonella

    2006-11-01

    The correlation between subclinical hypothyroidism [thyroid stimulating hormone (TSH)>4 mIU/L with normal free triiodothyroxine and free thyroxine levels], HIV infection and HAART is still unclear. To evaluate the predictive factors of subclinical hypothyroidism in an HIV-infected population, we identified three groups of subjects: G1, subjects on stable highly active antiretroviral therapy (HAART) (for at least 1 year) at baseline and at month 24 (n=97); G2, subjects naive at both baseline and month 24 (n=47); G3, subjects starting HAART at baseline (n=46). The three groups were comparable with respect to age, gender, body weight and prevalence of HCV infection. At baseline, subclinical hypothyroidism was detected in 14 subjects in G1 (14.4%), 5 in G2 (10.6%) and 4 in G3 (8.7%) (P=0.18) and these were excluded from the analysis. At month 24, 15 subjects had developed subclinical hypothyroidism: 4 in G1 (4.8%), 3 in G2 (7.1%) and 8 in G3 (19.0%). In the multivariable analysis, the higher increase in total cholesterol was predictive of subclinical hypothyroidism (RR: 1.53 for each additional 10 mg/dL, 95% CI 1.23-1.90; P<0.01); other variables, which were statistically significant in the univariate analysis, such as G3 group, body weight and higher increase in CD4+ cell count and in triglyceride serum levels were not confirmed to be associated with TSH alterations. The occurrence of subclinical hypothyroidism in HIV-positive patients seems to be related to the increase in total cholesterol serum levels occurring after HAART initiation. Thyroid function should be monitored in all HIV-infected subjects, especially in those starting HAART.

  8. Influence of subclinical hyperthyroidism on the cardiovascular system

    Directory of Open Access Journals (Sweden)

    T Y Demidova

    2015-06-01

    Full Text Available Subclinical hyperthyroidism occurs when the serum TSH is below the lower limit of the reference range and the free T4 and T3 concentrations are normal. Тhe clinical significance of subclinical hyperthyroidism is much debated. Subclinical hyperthyroidism has been associated with several biological effects on cardiovascular system, such as increased heart rate, left ventricular mass. Observational studies have reported an association between subclinical hyperthyroidism and coronary heart disease, incident atrial fibrillation, and cardiac dysfunction.

  9. Influence of subclinical hyperthyroidism on the cardiovascular system

    OpenAIRE

    2015-01-01

    Subclinical hyperthyroidism occurs when the serum TSH is below the lower limit of the reference range and the free T4 and T3 concentrations are normal. Тhe clinical significance of subclinical hyperthyroidism is much debated. Subclinical hyperthyroidism has been associated with several biological effects on cardiovascular system, such as increased heart rate, left ventricular mass. Observational studies have reported an association between subclinical hyperthyroidism and coronary heart diseas...

  10. Treatment of Subclinical Hypothyroidism in Obese Patients

    Directory of Open Access Journals (Sweden)

    T Demidova

    2008-03-01

    Full Text Available We observed 20 women suffering from adiposity and subclinical hypothyroidism. Lipid spectrum, carbohydrate metabolism, BP and insulinresistance, the extent and variants of fat tissue distribution, a test with physical exercise, all research in dynamics (in the beginning and 6 months after normalization of TSH level against the background of substitution therapy with L-T4 were evaluated. The positive shifts revealed during the afore mentioned research allow us to express our opinion in favour of carrying out substitution therapy with L-T4 at subclinical hypothyroidism .

  11. Spontaneous Bacterial Peritonitis in Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Dalip Gupta

    2013-11-01

    Full Text Available Hypothyroidism is an uncommon cause of ascites. Here we describe a case of a 75 year-old female patient with spontaneous bacterial peritonitis and subclinical hypothyroidism that resolved with thyroid replacement and antibiotic therapy respectively. Ascitic fluid analysis revealed a gram-positive bacterium on gram staining. A review of the literature revealed just one other reported case of myxoedema ascites with concomitant spontaneous bacterial peritonitis and no case has till been reported of spontaneous bacterial peritonitis in subclinical hypothyroidism.

  12. Reversible dilated cardiomyopathy due to subclinical hyperthyroidism.

    Science.gov (United States)

    Tsarouhas, Kostantinos; Kafantaris, Ioannis; Antonakopoulos, Athanasios; Vavetsi, Spiridoula; Pavlidis, Pavlos; Constantinou, Loizos L

    2010-01-01

    We present a patient without primary heart disease in whom subclinical hyperthyroidism was accompanied by manifestations of dilated cardiomyopathy, as evaluated by echocardiography, coronary angiography, and radionuclide ventriculography. His condition was reversed 6 months after conventional treatment (furosemide, carvedilol, angiotensin-converting-enzyme inhibitor and thiamazole administration). This patient represents an exceptional case, as overt congestive heart failure with left ventricular dilatation and depressed ventricular ejection fraction is not a common finding in patients with hyperthyroidism, let alone patients with subclinical hyperthyroidism and no underlying heart disease.

  13. Impact of bovine subclinical mastitis and effect of lactational treatment

    NARCIS (Netherlands)

    van den Borne, B.H.P.|info:eu-repo/dai/nl/304836826

    2010-01-01

    This thesis aimed to quantify the impact of subclinical mastitis in dairy cattle in the Netherlands and to explore the epidemiologic and economic effects of antimicrobial treatment of recently acquired subclinical mastitis during lactation. First, the occurrence of (sub)clinical mastitis was

  14. Study of subclinical hypothyroidism among patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Shabnam S

    2015-07-01

    Full Text Available Background: The clinical association between type 2 diabetes mellitus (T2DM and subclinical hypothyroidism is important as both of these conditions are common in patients with metabolic syndrome who are prone to develop cerebrovascular and cardiovascular complications. Methods: In this cross-sectional study, the burden of subclinical hypothyroidism defined as elevated thyroid stimulating hormone (TSH (>4.2IU/mL with normal concentrations of serum total thyroxin (T4 and free T4 (FT4 in 50 patients with T2DM and 50 age-and gender-matched healthy control subjects. Results: We observed a significantly higher proportion of patients with T2DM had subclinical hypothyroidism compared to healthy control subjects [9/50 (18% Vs 3/60 (6%; p=0.009]. We also observed a statistically significant positive correlation between the fasting plasma glucose and serum TSH levels (p<0.001. Conclusion: Our observations suggest that screening for subclinical hypothyroidism may be beneficial in patients with T2DM and may help in detecting the condition early.

  15. Fat embolism syndrome

    OpenAIRE

    Jacob George; Reeba George; Dixit, R; Gupta, R C; Gupta, N.

    1997-01-01

    Fat embolism syndrome, an important contributor to the development of acute respiratory distress syndrome, has been associated with both traumatic and nontraumatic disorders. Fat embolization after long bone trauma is probably common as a subclinical event. Fat emboli can deform and pass through the lungs, resulting in systemic embolization, most commonly to the brain and kidneys. The diagnosis of fat embolism syndrome is based on the patient’s history, supported by clinical signs of pulmonar...

  16. Hyperprolactinemia in association with subclinical hypothyroidism

    OpenAIRE

    Bahar, Adele; Akha, Ozra; Kashi, Zahra; Vesgari, Zakiie

    2011-01-01

    Background: Hyperprolactinemia is the most common endocrine disorder in hypothalamic-pituitary axis and has been reported in variable levels in patients with overt primary hypothyroidism. We decided to determine the prevalence of hyperprolactinemia and clinical related symptoms in subclinical hypothyroidism patients.

  17. Prevalence and clinical outcome of subclinical bacteriuria in female dogs.

    Science.gov (United States)

    Wan, Stephanie Y; Hartmann, Faye A; Jooss, Michelle K; Viviano, Katrina R

    2014-07-01

    To determine the prevalence of subclinical bacteriuria and its natural clinical course over a 3-month period in healthy female dogs. Observational, prospective, cross-sectional study. 101 healthy client-owned female dogs. In all dogs, screening clinicopathologic tests and bacteriologic culture of urine were performed. In culture-positive dogs, subclinical bacteriuria was confirmed by 2 positive culture results within 2 weeks and dogs were reevaluated at 3 months. The prevalence of subclinical bacteriuria in healthy female dogs was 9 of 101 (8.9%). Three-month follow-up data were available for 8 of 9 dogs with subclinical bacteriuria. Four dogs had persistent bacteriuria, and 4 had transient bacteriuria. No dogs with subclinical bacteriuria developed clinical signs during the 3-month observation period. Subclinical bacteriuria was diagnosed in 6 of 51 (12%) young and middle-aged dogs and 3 of 50 (6.0%) senior and geriatric dogs. No significant difference was found in the prevalence of subclinical bacteriuria with age. Results suggested that subclinical bacteriuria is a nonprogressive condition in healthy female dogs and can be persistent or transient. No significant difference in the prevalence of subclinical bacteriuria in young and middle-aged dogs versus senior and geriatric dogs was detected. No dogs with subclinical bacteriuria developed clinical signs requiring antimicrobial treatment during the 3-month observation period. Healthy female dogs with subclinical bacteriuria may be a population of dogs in which antimicrobial treatment is unnecessary.

  18. Subclinical hypothyroidism: Controversies to consensus

    Directory of Open Access Journals (Sweden)

    Syed Abbas Raza

    2013-01-01

    Full Text Available Diagnoses of subclinicaal hypothyroidism (SCH is biochemically made, when serum thyroid stimulating hormone (TSH levels is elevated while free thyroid hormone levels are within normal reference range. SCH is diagnosed after excluding all other causes of elevated TSH levels. Symptoms of SCH may vary from being asymptomatic to having mild nonspecific symptoms. The risk of progression to overt hypothyroidism is related to number of factors including initial serum TSH concentration, presence of auto antibodies, family history and presence goiter. Various screening recommendations for thyroid function assessment are in practice. There are still controversies surrounding SCH and associated risk of various cardiovascular diseases (CVDs, pregnancy outcomes, neuropsychiatric issues, metabolic syndrome, and dyslipidemia. Consensus will require more large randomized clinical studies involving various age groups and medical condition, especially in developing countries. All these efforts will definitely improve our understanding of disease and ultimately patient outcomes.

  19. Subclinical Hypothyroidism in PCOS: Impact on Presentation, Insulin Resistance, and Cardiovascular Risk.

    Science.gov (United States)

    Yu, Qun; Wang, Jin-Bei

    2016-01-01

    Aim of Study. To assess status of thyroid function and thyroid disorders particularly subclinical hypothyroidism (SCH) in subjects with polycystic ovarian syndrome (PCOS) and impact of SCH on various clinical and biochemical parameters and cardiovascular risk in PCOS. Methods. Hundred females diagnosed with PCOS as per Rotterdam criteria and 100 normal controls were recruited and were subjected to elaborate anthropometric, clinical, and biochemical assessment. Results. Notable findings included significantly higher frequency of subjects with subclinical hypothyroidism (p = 0.0002), autoimmune thyroiditis (p PCOS subjects were found to harbor significantly higher HOMA-IR (p PCOS and euthyroid control subjects. Though frequency of subjects with cardiovascular risk factors was higher in SCH PCOS group than euthyroid PCOS group, it failed to reach statistical significance. Conclusion. We concluded that PCOS is associated with high incidence of SCH and AIT compared to normal population and SCH poses increased risk of cardiovascular disorder in PCOS.

  20. [Subclinical mastitis in sheep milked mechanically].

    Science.gov (United States)

    Vitkov, M

    1979-01-01

    Studied were the occurrence and the etiologic structure of subclinical mastitis of ewes with which mechanical milking was practiced. It was found that as many as 21,9 per cent of the animals responded positively after the Bernburg test. Eight per cent out of the 875 ewes studied were affected with subclinical mastitis. Etiologically, Staphylococcus aureus and Staph. epidermidis were found to take part in the incidence of the disease. Predisposing factors contributing to the outbreak of this type of mastitis were the traumatic injuries of the udder due to the so-called blind milking and the individual deviations in the morphology of the mammary gland. Secretory troubles were found in 11.7 per cent of the sheep.

  1. Subclinical sensory involvement in monomelic amyotrophy.

    Science.gov (United States)

    Liao, Jenny P; Waclawik, Andrew J; Lotz, Barend P

    2005-12-01

    An 18-year-old woman presented with weakness and atrophy in her hand without associated sensory symptoms, preceding events, or structural abnormalities on neuroimaging. No sensory deficits were detected on neurologic examination. Electrophysiological studies showed not only the expected motor findings for monomelic amyotrophy (MA) in the affected limb, but also markedly reduced sensory nerve action potentials when compared with the unaffected side. These findings suggest that subclinical sensory involvement can exist in patients with otherwise classic presentations of MA.

  2. The clinical significance of subclinical thyroid dysfunction.

    Science.gov (United States)

    Biondi, Bernadette; Cooper, David S

    2008-02-01

    Subclinical thyroid disease (SCTD) is defined as serum free T(4) and free T(3) levels within their respective reference ranges in the presence of abnormal serum TSH levels. SCTD is being diagnosed more frequently in clinical practice in young and middle-aged people as well as in the elderly. However, the clinical significance of subclinical thyroid dysfunction is much debated. Subclinical hyper- and hypothyroidism can have repercussions on the cardiovascular system and bone, as well as on other organs and systems. However, the treatment and management of SCTD and population screening are controversial despite the potential risk of progression to overt disease, and there is no consensus on the thyroid hormone and thyrotropin cutoff values at which treatment should be contemplated. Opinions differ regarding tissue effects, symptoms, signs, and cardiovascular risk. Here, we critically review the data on the prevalence and progression of SCTD, its tissue effects, and its prognostic implications. We also examine the mechanisms underlying tissue alterations in SCTD and the effects of replacement therapy on progression and tissue parameters. Lastly, we address the issue of the need to treat slight thyroid hormone deficiency or excess in relation to the patient's age.

  3. [Subclinical thyroid disease--should we treat, should we screen for it?].

    Science.gov (United States)

    Trbojević, Bozo

    2003-01-01

    Subclinical thyroid disease is defined by an abnormally high (subclinical hypothyroidism) or low (subclinical hyperthyroidism) serum thyrotropin (TSH) with peripheral thyroid hormone concentrations within the laboratory reference ranges. Such abnormalities in thyroid function tests are very common in the population and have been extensively dealt with in textbooks and reviews. Subclinical hypothyroidism is common especially in elderly women. There is no clear evidence to date that subclinical hypothyroidism causes clinical hearth disease. However, mild thyroid gland failure, evidenced solely by elevation of the serum TSH concentration, may be associated with increased morbidity, particularly for cardiovascular disease and subtly decreased myocardial contractility. In subclinical hypothyroidism both cardiac structures and function remain normal at rest, but impaired ventricular function as well as cardiovascular and respiratory adaptation to effort may became unmasked during exercise. These changes are reversible when euthyroidism is restored. Subclinical hypothyroidism does result in small increase in low density lipoprotein cholesterol and a decrease in high density lipoprotein, changes that enhance the risk for development of atherossclerosis and coronary artery disease. Because undetected subclinical hypothyroidism during pregnancy may adversely affect the neuropsychological development and survival of the fetus and be associated with hypertension and toxemia, screening pregnant women has been advocated. In addition, data suggesting that subclinical hypothyroidism is associated with ovulatory dysfunction and infertility may make screening worthwhile in this population as well. The combination of an undetectable serum thyrotropin concentration, as measured by an assay with a threshold of detection that is 0.1 mU per liter or less, and normal serum triiodothyronine and thyroxine concentrations (usually at the upper end of the normal range) is known as subclinical

  4. Acute myocardial infarction and subclinical hyperthyroidism without significant coronary stenoses.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; Di Bella, Gianluca; Turiano, Giuseppe

    2009-05-29

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes but increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. It has been also reported an acute myocardial infarction with normal coronary arteries associated with iatrogenic hyperthyroidism and with a myocardial bridge too. Moreover, it has been reported that simply measuring maximum P wave duration and P wave dispersion values, may help to determine the patients with subclinical hyperthyroidism and high risk for the development of atrial fibrillation. We present a case of an acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  5. Occurrence of subclinical mastitis in dairy does in Duhok, Iraq

    OpenAIRE

    Balqees A. Ali

    2012-01-01

    California mastitis tests (CMT) and white side test (WST) were used to determine the occurrence rate of subclinical mastitis in dairy does in Duhok province of Iraq. The rate of subclinical mastitis was 40.5% and 37.5% by CMT and WST respectively. The Staphylococcus aureus was the most prevalent isolate with 72.38% followed by Klebsiella spp. (29.79%) and Escherichia coli (27.65%). This is the first report on subclinical mastitis repor...

  6. Prevalence of subclinical thyroid disorders in type 2 diabetes mellitus

    OpenAIRE

    Satvic C Manjunath; Vishwanath Krishnamurthy; Balaraj K Puttaswamy; Srinivasa Prabhu; Poornachandra M Vishwanathaiah

    2013-01-01

    Background: Subclinical thyroid disorders usually do not produce symptoms of thyroid disease until they turn into over thyroid disease. Thyroid disease is more common in people with diabetes mellitus than in the general population and it is important to detect thyroid disorder before its clinical manifestation. Subclinical hypothyroidism (SCH) can produce dyslipidemia, obesity thus resulting increased predisposition to coronary artery disease. Subclinical hyperthyroidism can aggravate hypergl...

  7. SUBCLINICAL INTERSTITIAL PULMONARY INJURY IN RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    D. V. Bestaev

    2015-01-01

    Full Text Available Subjects and methods. The study enrolled 61 inpatients diagnosed with RA (according to the 1987 American College of Rheumatology criteria who were treated at the V.A. Nasonova Research Institute of Rheumatology; in so doing, high-resolution computed tomography revealed lung changes as a ground glass pattern in 15 patients, reticular striation, traction bronchoectases, and lung tissue changes as honeycomb ones in 25 patients; no lung abnormalities were found in 21 patients. DAS28 was applied to determine the inflammatory activity of RA. The RA patients underwent X-ray studies of the hand, foot, and chest, by using accordingly X-Ray unit and spiral computed tomography scanner (section thickness, 0.65 mm. External respiration function (ERF indicators were studied with plethysmograph. IgM rheumatoid factor was measured using an immune nephelometer. Serum anti-cyclic citrullinated peptide antibodies were assayed by immunochemiluminescence technique on a Cobas e411 analyzer. The xMAP technology using a BioPlex200 analyzer was employed to determine the serum concentrations of 27 cytokines in 15 patients with subclinical IPI and in 25 with clinical IPI. Results and discussion. The major respiratory signs in patients with IPI proved to be cough (24 %, expectoration (20 %, dyspnea (16 %, and crepitation (64 % on auscultation. Three patients with subclinical IPI were found to have crepitation on auscultation. Respiratory symptoms were absent in the RA patients without IPI. It should be noted that there are a larger number of RA patients with a high smoking index among the RA patients with IPI than among those without IPI (p < 0.05. Investigation of ERF indicators revealed a statistically significantly lower lung diffusing capacity (LDC in the RA patients with subclinical IPI than in those without IPI (p < 0.05. Other ERF indicators showed no significant deviations of the reference values. LDC and total lung capacity appeared to be statistically

  8. Subclinical hypothyroidism causing hypertension in pregnancy.

    Science.gov (United States)

    Ramtahal, Rishi; Dhanoo, Andrew

    2016-09-01

    This is a case of a 25-year-old primigravida who was referred to the hypertension specialist for elevated blood pressures. The patient had an elevated thyroid-stimulating hormone with normal free thyroxine (T4) levels and was positive for thyroid peroxidase antibodies resulting in a diagnosis of subclinical hypothyroidism. The patient was successfully treated with levothyroxine which normalized the blood pressure without the need for antihypertensive treatment. This case illustrates a cause of secondary hypertension that is not always considered in the differential diagnosis of a patient with hypertension in pregnancy.

  9. Detection of Subclinical Ketosis in Dairy Cows

    Directory of Open Access Journals (Sweden)

    Zhigang Zhang, Guowen Liu1, Hongbin Wang, Xiaobing Li1 and Zhe Wang1*

    2012-05-01

    Full Text Available Ketosis is a common metabolic disorder frequently observed in dairy cows during the early lactation period. It is characterized by increased levels of ketone bodies in the blood, urine, and milk. Subclinical ketosis (SCK in dairy cattle is an excess level of circulating ketone bodies in the absence of clinical signs of ketosis. Usually, detection of SCK is carried out by testing the ketone concentrations in blood, urine, and milk. Here, This review overview the detection methods for SCK in dairy cows, including cowside and laboratory tests.

  10. [Should subclinical hypothyroidism in older persons be treated?

    NARCIS (Netherlands)

    Elzen, W.P. den; Smit, J.W.A.; Mooijaart, S.P.; Gussekloo, J.

    2012-01-01

    Subclinical hypothyroidism is a common finding in older persons. Clinical guidelines are inconsistent in providing recommendations for the treatment of subclinical hypothyroidism, especially in older persons. To date, there is no high-quality evidence from randomized controlled trials about the effe

  11. The Progression and Early detection of Subclinical Atherosclerosis (PESA) study

    DEFF Research Database (Denmark)

    Fernández-Ortiz, Antonio; Jiménez-Borreguero, L Jesús; Peñalvo, José L

    2013-01-01

    The presence of subclinical atherosclerosis is a likely predictor of cardiovascular events; however, factors associated with the early stages and progression of atherosclerosis are poorly defined.......The presence of subclinical atherosclerosis is a likely predictor of cardiovascular events; however, factors associated with the early stages and progression of atherosclerosis are poorly defined....

  12. Multiethnic Exome-Wide Association Study of Subclinical Atherosclerosis

    NARCIS (Netherlands)

    Natarajan, Pradeep; Bis, Joshua C.; Bielak, Lawrence F.; Cox, Amanda J.; Dorr, Marcus; Feitosa, Mary F.; Franceschini, Nora; Guo, Xiuqing; Hwang, Shih-Jen; Isaacs, Aaron; Jhun, Min A.; Kavousi, Maryam; Li-Gao, Ruifang; Lyytikainen, Leo-Pekka; Marioni, Riccardo E.; Schminke, Ulf; Stitziel, Nathan O.; Tada, Hayato; van Setten, Jessica; Smith, Albert V.; Vojinovic, Dina; Yanek, Lisa R.; Yao, Jie; Yerges-Armstrong, Laura M.; Amin, Najaf; Baber, Usman; Borecki, Ingrid B.; Carr, J. Jeffrey; Chen, Yii-Der Ida; Cupples, L. Adrienne; de Jong, Pim A.; de Koning, Harry; de Vos, Bob D.; Demirkan, Ayse; Fuster, Valentin; Franco, Oscar H.; Goodarzi, Mark O.; Harris, Tamara B.; Heckbert, Susan R.; Heiss, Gerardo; Hoffmann, Udo; Hofman, Albert; Isgum, Ivana; Jukema, J. Wouter; Kahonen, Mika; Kardia, Sharon L. R.; Kral, Brian G.; Launer, Lenore J.; Massaro, Joe; Mehran, Roxana; Mitchell, Braxton D.; Jr, Thomas H. Mosley; de Mutsert, Renee; Newman, Anne B.; Nguyen, Khanh-dung; North, Kari E.; O'Connell, Jeffrey R.; Oudkerk, Matthijs; Pankow, James S.; Peloso, Gina M.; Post, Wendy; Province, Michael A.; Raffield, Laura M.; Raitakari, Olli T.; Reilly, Dermot F.; Rivadeneira, Fernando; Rosendaal, Frits; Sartori, Samantha; Taylor, Kent D.; Teumer, Alexander; Trompet, Stella; Turner, Stephen T.; Uitterlinden, Andre G.; Vaidya, Dhananjay; van der Lugt, Aad; Volker, Uwe; Wardlaw, Joanna M.; Wassel, Christina L.; Weiss, Stefan; Wojczynski, Mary K.; Becker, Diane M.; Becker, Lewis C.; Boerwinkle, Eric; Bowden, Donald W.; Deary, Ian J.; Dehghan, Abbas; Felix, Stephan B.; Gudnason, Vilmundur; Lehtimaki, Terho; Mathias, Rasika; Mook-Kanamori, Dennis O.; Psaty, Bruce M.; Rader, Daniel J.; Rotter, Jerome I.; Wilson, James G.; van Duijn, Cornelia M.; Volzke, Henry; Kathiresan, Sekar; Peyser, Patricia A.; O'Donnell, Christopher J.

    2016-01-01

    Background-The burden of subclinical atherosclerosis in asymptomatic individuals is heritable and associated with elevated risk of developing clinical coronary heart disease. We sought to identify genetic variants in protein-coding regions associated with subclinical atherosclerosis and the risk of

  13. Subclinical hyperthyroidism: to treat or not to treat?

    NARCIS (Netherlands)

    Hoogendoorn, E.H.; Heijer, M. den; Dijk, A.P.J. van; Hermus, A.R.M.M.

    2004-01-01

    Subclinical hyperthyroidism may be defined as the presence of free thyroxine and tri-iodothyronine levels within the reference range and a reduced serum thyroid stimulating hormone (TSH) level. In this review the prevalence of low TSH in the population and health consequences of subclinical hyperthy

  14. Subclinical thyroid dysfunction and fracture risk a meta-analysis

    NARCIS (Netherlands)

    M.R. Blum (Manuel); D.C. Bauer (Douglas C.); T.-H. Collet (Tinh-Hai); H.A. Fink (Howard A.); A.R. Cappola (Anne); F.L. Da Costa (F. Leal); C.D. Wirth (Christina); R.P. Peeters (Robin); B.O. Asvold (Bjorn O.); W.P.J. den Elzen (Wendy); R.N. Luben (Robert); M. Imaizumi (Misa); A.P. Bremner (Alexandra P.); A. Gogakos (Apostolos); R. Eastell (Richard); P.M. Kearney (Patricia M.); E.S. Strotmeyer (Elsa S.); E.R. Wallace (Erin R.); M. Hoff (Mari); G. Ceresini (Graziano); F. Rivadeneira Ramirez (Fernando); A.G. Uitterlinden (André); D.J. Stott (David. J.); R.G.J. Westendorp (Rudi); K.T. Khaw; A. Langhammer (Arnuf); L. Ferrucci (Luigi); J. Gussekloo (Jacobijn); G. Williams (Graham); J.P. Walsh (John); P. Jùni (Peter); D. Aujesky (Drahomir); N. Rodondi (Nicolas)

    2015-01-01

    textabstractIMPORTANCE Associations between subclinical thyroid dysfunction and fractures are unclear and clinical trials are lacking. OBJECTIVE To assess the association of subclinical thyroid dysfunction with hip, nonspine, spine, or any fractures. DATA SOURCES AND STUDY SELECTION The databases of

  15. Subclinical hyperthyroidism in patients with type 2 diabetes.

    Science.gov (United States)

    Díez, Juan J; Iglesias, Pedro

    2012-08-01

    Both subclinical hyperthyroidism and type 2 diabetes (T2D) have been associated with an increase in cardiovascular disease risk and mortality. We aimed to assess the prevalence of newly diagnosed subclinical hyperthyroidism in a cohort of patients with T2D, and also to analyse the relationships between diabetes-related characteristics and the presence of subclinical hyperthyroidism. 933 diabetic patients without previous history of thyroid disease (45.4% females, mean age 66.3 years, median duration of diabetes 10 years) were evaluated. A sample of 911 non-diabetic subjects without known thyroid dysfunction was studied as control group. Serum concentrations of thyrotropin were measured in all subjects. Subclinical hyperthyroidism was present in 4.3% of female and 3.5% of male diabetic patients. Relative risk was significant only for the female gender (OR 3.69, 95% CI 1.56-8.71). In comparison with diabetic patients without thyroid hyperfunction, patients with subclinical hyperthyroidism were older, had longer duration of diabetes, showed lower fasting glucose levels, had greater proportion of goitre and diet therapy, and had lower proportion of treatment with oral agents. Logistic regression analysis showed that age and the presence of goitre were significantly related to subclinical hyperthyroidism in patients with T2D. The risk for subclinical hyperthyroidism is increased in women with T2D. Advanced age and the presence of goitre are significantly and independently related with the presence of subclinical hyperthyroidism in diabetic population.

  16. Pregnancy aggravates proteinuria in subclinical glomerulonephritis in the rat

    NARCIS (Netherlands)

    Faas, MM; Bakker, WW; Poelman, RT; Schuiling, GA

    1999-01-01

    Because subclinical renal disease may be aggravated during pregnancy-as reflected in the occurrence of proteinuria, for example-we investigated whether a subclinical glomerulonephritis (SG) in the non-pregnant rat (passive Heymann nephritis), a condition without proteinuria, is aggravated when the a

  17. Multiethnic Exome-Wide Association Study of Subclinical Atherosclerosis

    NARCIS (Netherlands)

    Natarajan, Pradeep; Bis, Joshua C.; Bielak, Lawrence F.; Cox, Amanda J.; Dorr, Marcus; Feitosa, Mary F.; Franceschini, Nora; Guo, Xiuqing; Hwang, Shih-Jen; Isaacs, Aaron; Jhun, Min A.; Kavousi, Maryam; Li-Gao, Ruifang; Lyytikainen, Leo-Pekka; Marioni, Riccardo E.; Schminke, Ulf; Stitziel, Nathan O.; Tada, Hayato; van Setten, Jessica; Smith, Albert V.; Vojinovic, Dina; Yanek, Lisa R.; Yao, Jie; Yerges-Armstrong, Laura M.; Amin, Najaf; Baber, Usman; Borecki, Ingrid B.; Carr, J. Jeffrey; Chen, Yii-Der Ida; Cupples, L. Adrienne; de Jong, Pim A.; de Koning, Harry; de Vos, Bob D.; Demirkan, Ayse; Fuster, Valentin; Franco, Oscar H.; Goodarzi, Mark O.; Harris, Tamara B.; Heckbert, Susan R.; Heiss, Gerardo; Hoffmann, Udo; Hofman, Albert; Isgum, Ivana; Jukema, J. Wouter; Kahonen, Mika; Kardia, Sharon L. R.; Kral, Brian G.; Launer, Lenore J.; Massaro, Joe; Mehran, Roxana; Mitchell, Braxton D.; Jr, Thomas H. Mosley; de Mutsert, Renee; Newman, Anne B.; Nguyen, Khanh-dung; North, Kari E.; O'Connell, Jeffrey R.; Oudkerk, Matthijs; Pankow, James S.; Peloso, Gina M.; Post, Wendy; Province, Michael A.; Raffield, Laura M.; Raitakari, Olli T.; Reilly, Dermot F.; Rivadeneira, Fernando; Rosendaal, Frits; Sartori, Samantha; Taylor, Kent D.; Teumer, Alexander; Trompet, Stella; Turner, Stephen T.; Uitterlinden, Andre G.; Vaidya, Dhananjay; van der Lugt, Aad; Volker, Uwe; Wardlaw, Joanna M.; Wassel, Christina L.; Weiss, Stefan; Wojczynski, Mary K.; Becker, Diane M.; Becker, Lewis C.; Boerwinkle, Eric; Bowden, Donald W.; Deary, Ian J.; Dehghan, Abbas; Felix, Stephan B.; Gudnason, Vilmundur; Lehtimaki, Terho; Mathias, Rasika; Mook-Kanamori, Dennis O.; Psaty, Bruce M.; Rader, Daniel J.; Rotter, Jerome I.; Wilson, James G.; van Duijn, Cornelia M.; Volzke, Henry; Kathiresan, Sekar; Peyser, Patricia A.; O'Donnell, Christopher J.

    2016-01-01

    Background-The burden of subclinical atherosclerosis in asymptomatic individuals is heritable and associated with elevated risk of developing clinical coronary heart disease. We sought to identify genetic variants in protein-coding regions associated with subclinical atherosclerosis and the risk of

  18. Subclinical hepatic encephalopathy: diagnosis, clinical implications, and intervention

    NARCIS (Netherlands)

    J.C. Guero Guillen

    1997-01-01

    textabstractHepatic encephalopathy (HE) is traditionally graded into four clinical stages of severity, ranging from lethargy, sleep and memory disturbances (grade 1) to coma (grade 4). In addition to the clinical grading of HE, a subclinical stage has been described. In subclinical hepatic encephalo

  19. Endogenous subclinical hyperthyroidism and cardiovascular system: time to reconsider?

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; Sturiale, Mauro

    2011-05-19

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. Exogenous sublinical hyperthyroidism is a thyroid metabolic state caused by L-thyroxine administration. Endogenous subclinical hyperthyroidism is a thyroid metabolic state in patients with autonomously functioning thyroid nodule or multinodular goiter, various forms of thyroiditis, in areas with endemic goiter and particularly in elderly subjects. Endogenous subclinical hyperthyroidism is currently the subject of numerous studies and it yet remains controversial particularly as it relates to its treatment and to cardiovascular impact nevertheless established effects have been demonstrated. Recently, acute myocardial infarction without significant coronary stenoses and recurrent acute pulmonary embolism have been reported associated with subclinical hyperthyroidism without L-thyroxine administration. So, it is very important to recognize and to treat promptly also endogenous subclinical hyperthyroidism. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  20. Cardiovascular risk with subclinical hyperthyroidism and hypothyroidism: pathophysiology and management.

    Science.gov (United States)

    Duggal, Jasleen; Singh, Sarabjeet; Barsano, Charles P; Arora, Rohit

    2007-01-01

    Previous studies have suggested that subclinical thyroid dysfunction, as manifested by abnormalities in thyroid-stimulating hormone (TSH) levels, are associated with detrimental effects on the cardiovascular system. Subclinical hypothyroidism is characterized by abnormal lipid metabolism, cardiac dysfunction, diastolic hypertension conferring an elevated risk of atherosclerosis, and ischemic heart disease. Similarly, patients with subclinical hyperthyroidism have nearly 3 times the likelihood of atrial fibrillation over a 10-year follow-up interval, raising the question of whether patients with subclinical hyperthyroidism should be treated to prevent atrial fibrillation. A single measurement of low serum TSH in individuals aged 60 years or older has been reported to be associated with increased mortality from all causes and in particular from circulatory and cardiovascular disease in a 10-year follow-up study. Subclinical thyroid dysfunction is currently the subject of numerous studies and remains controversial, particularly as it relates to cardiovascular morbidity and mortality and clinical applications.

  1. Subclinical Thyroid Dysfunction and Depressive Symptoms among Elderly

    DEFF Research Database (Denmark)

    Blum, Manuel R; Wijsman, Liselotte W; Virgini, Vanessa S

    2016-01-01

    BACKGROUND: Subclinical hypothyroidism has been associated with depressive symptoms in cross-sectional studies, but prospective data and data on subclinical hyperthyroidism are scarce. METHODS: In the Leiden sub-study of the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) among...... adults aged 70-82 years with pre-existing cardiovascular disease or known cardiovascular risk factors, TSH and free T4 levels were measured at baseline and repeated after 6 months to define persistent thyroid function status. Main outcome measures were depressive symptoms, assessed with the Geriatric...... on the association of persistent subclinical thyroid dysfunction and depression, subclinical hypothyroidism was not associated with increased depressive symptoms among older adults at high cardiovascular risk. Persistent subclinical hyperthyroidism might be associated with increased depressive symptoms, which...

  2. Hypoparathyroidism and Subclinical Hypothyroidism with Secondary Hemochromatosis

    Directory of Open Access Journals (Sweden)

    Hyung Ki Jeong

    2014-03-01

    Full Text Available Hemochromatosis is an inherited genetic disorder of iron metabolism which can also occur as a secondary result of iron-overload. It leads to organ damage such as cardiomyopathy, liver cirrhosis, hypogonadism, and diabetes. This paper discusses a case of secondary hemochromatosis associated with repeated transfusions, presenting as asymptomatic hypoparathyroidism and subclinical hypothyroidism with multiple organ involvement. The 29-year-old female, who had severe aplastic anemia, received multiple transfusions totaling approximately 1,400 units of red blood cells over 15 years. During her routine laboratory examination, hypocalcemia was detected with decreased intact parathyroid hormone and increased thyroid stimulating hormone. Serum ferritin, iron, and total iron binding capacity had increased to 27,583.03 ng/mL, 291 µg/dL, and 389 µg/dL, respectively. She had unusually bronze skin and computed tomography revealed iron deposition in the thyroid, liver, and heart. Multiorgan involvement as seen in this case is rare in hemochromatosis associated with secondary transfusions. To the best of the author's knowledge, this is the first case report in Korea of hypoparathyroidism and subclinical hypothyroidism due to iron deposition in the parathyroid and thyroid gland.

  3. Is There Any Effect on Smell and Taste Functions with Levothyroxine Treatment in Subclinical Hypothyroidism?

    OpenAIRE

    Kamil Baskoy; Seyid Ahmet Ay; Aytug Altundag; Onuralp Kurt; Murat Salihoglu; Ferhat Deniz; Hakan Tekeli; Arif Yonem; Thomas Hummel

    2016-01-01

    Subclinical hypothyroidism has been accused for coronary heart disease, lipid metabolism disorders, neuropsychiatric disorders, infertility or pregnancy related problems with various strength of evidence. Currently there is insufficient knowledge about olfaction and taste functions in subclinical hypothyroidism. Aim of the present study is to investigate the degree of smell and taste dysfunction in patients with subclinical hypothyroidism. 28 subclinical hypothyroid patients, and 31 controls ...

  4. Subclinical Hypothyroidism in PCOS: Impact on Presentation, Insulin Resistance, and Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Qun Yu

    2016-01-01

    Full Text Available Aim of Study. To assess status of thyroid function and thyroid disorders particularly subclinical hypothyroidism (SCH in subjects with polycystic ovarian syndrome (PCOS and impact of SCH on various clinical and biochemical parameters and cardiovascular risk in PCOS. Methods. Hundred females diagnosed with PCOS as per Rotterdam criteria and 100 normal controls were recruited and were subjected to elaborate anthropometric, clinical, and biochemical assessment. Results. Notable findings included significantly higher frequency of subjects with subclinical hypothyroidism (p=0.0002, autoimmune thyroiditis (p<0.001, and goitre (p=0.02 in polycystic ovarian syndrome subjects compared to control subjects. Further SCH PCOS subjects were found to harbor significantly higher HOMA-IR (p<0.05 and frequency of subjects with dyslipidemia (p<0.05 compared to both euthyroid PCOS and euthyroid control subjects. Though frequency of subjects with cardiovascular risk factors was higher in SCH PCOS group than euthyroid PCOS group, it failed to reach statistical significance. Conclusion. We concluded that PCOS is associated with high incidence of SCH and AIT compared to normal population and SCH poses increased risk of cardiovascular disorder in PCOS.

  5. 多囊卵巢综合征合并亚临床甲状腺功能减低患者胰岛素水平及血脂变化的研究%Study on the change of serum lipid and insulin levels in polycystic ovary syndrome combined with subclinical hypothyroidism

    Institute of Scientific and Technical Information of China (English)

    裴友娟; 王蔼明; 赵勇; 闫玲; 李敏

    2013-01-01

    目的 探讨多囊卵巢综合征(PCOS)合并亚临床甲状腺功能减低(SCH)患者胰岛素水平及血脂的变化.方法 采用病例-对照的研究方法,收集2011年10月至2012年6月海军总医院生殖中心就诊的育龄期妇女,年龄在25~35周岁,选取PCOS合并SCH患者54例作为观察组,PCOS不伴有甲状腺疾病功能异常者52例作为对照组,分别测定体重、血压、静息心率、血脂,并进行糖耐量及胰岛素释放试验.采用独立样本t检验及相关分析评价PCOS合并SCH患者血脂及胰岛素变化情况. 结果 (1)PCOS合并SCH组静息心率、空腹胰岛素(FINS)高于PCOS组(P<0.05),促甲状腺激素(TSH)、甘油三酯(TG)、餐后1h胰岛素(INS-1h)均显著高于PCOS组(P<0.01);(2)两组中按照体重指数(BMI)比较分析:PCOS+ SCH组中BMI≥23亚组与PCOS组BMI≥23亚组相比,心率明显增快,TSH与TG显著升高,INS-1h也有明显的升高.PCOS+ SCH组中BMI<23亚组与PCOS组BMI<23亚组相比,除TSH有显著升高外,其余指标无显著差异;(3)相关分析显示:TSH与TG、高密度脂蛋白(HDL)、FINS、INS-1h有相关性(r分别为0.360、-0.259、0.408、0.255,P均<0.01). 结论 PCOS合并SCH患者可能存在更严重的血脂异常及胰岛素水平的改变,TG水平的升高、HDL及胰岛素水平的改变可能成为PCOS合并SCH患者的独立危险因素.%Objective:To investigate the changes of lipid and insulin levels in patients with polycystic ovary syndrome (PCOS)and subclinical hypothyroidism(SCH). Methods: There were 54 patients with PCOS plus SCH as investigation group and 52 women with PCOS as control group in the study. All patients were obtained from Reproductive Medical Center,Navy General Hospital from October 2011 to June 2012. The serum lipids levels, fasting blood glucose, blood glucose after meals,fasting insulin, insulin after meals, body weight, blood pressure and resting heart rate were measured in all the patients,and compared between

  6. Occurrence of subclinical mastitis in dairy does in Duhok, Iraq

    Directory of Open Access Journals (Sweden)

    Balqees A. Ali

    2012-03-01

    Full Text Available California mastitis tests (CMT and white side test (WST were used to determine the occurrence rate of subclinical mastitis in dairy does in Duhok province of Iraq. The rate of subclinical mastitis was 40.5% and 37.5% by CMT and WST respectively. The Staphylococcus aureus was the most prevalent isolate with 72.38% followed by Klebsiella spp. (29.79% and Escherichia coli (27.65%. This is the first report on subclinical mastitis report in Duhok area of Iraq.

  7. A case report of suicidal behavior related to subclinical hyperthyroidism.

    Science.gov (United States)

    Joo, Soo-Hyun; Jeong, Jong-Hyun; Hong, Seung-Chul

    2014-01-01

    Abnormalities in thyroid function are associated with many psychiatric symptoms. We present a report of a 15-year-old girl who was admitted to the psychiatry inpatient unit with symptoms of suicidal behavior, irritability, and impulsivity. One year previously, she had become more short-tempered, and had started to cut her wrists impulsively. Laboratory tests revealed subclinical hyperthyroidism. She was treated with anxiolytic and antithyroid drugs, and her suicidal ideation and irritability resolved. This case demonstrates that subclinical hyperthyroidism can be associated with suicidal behavior as well as overt hyperthyroidism. Early intervention is required to prevent suicidal behavior in patients with subclinical hyperthyroidism.

  8. Is subclinical hypothyroidism increasing exogen obesity in children?

    Directory of Open Access Journals (Sweden)

    Ceyda Tuna Kirsaclioglu

    2015-03-01

    Conclusion:.Thyrotropin releasing hormone stimulation test may be helpful to determine subclinical hypothyroidism in exogen obese children, if basal TSH levels were elevated. [J Contemp Med 2015; 5(1.000: 1-7

  9. Subclinical Measures of Atherosclerosis: Genetics and Cardiovascular Risk Prediction

    NARCIS (Netherlands)

    M. Kavousi (Maryam)

    2013-01-01

    markdownabstract__Abstract__ Atherosclerosis is a chronic, progressive, systematic condition with a long asymptomatic phase. Atherosclerosis develops gradually as a subclinical condition over the life course and eventually becomes clinically apparent as ischemic heart disease, cerebrovascular disea

  10. Lipids in newly discovered subclinical and clinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    Marinković Snežana

    2016-01-01

    Full Text Available There is a positive correlation between the levels of TSH and cholesterol levels, while levels between TSH levels triglicrerida negative correlation with the clinical and subclinical form of reduced thyroid function.

  11. A case report of suicidal behavior related to subclinical hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Joo SH

    2014-04-01

    Full Text Available Soo-Hyun Joo, Jong-Hyun Jeong, Seung-Chul HongDepartment of Psychiatry, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, KoreaAbstract: Abnormalities in thyroid function are associated with many psychiatric symptoms. We present a report of a 15-year-old girl who was admitted to the psychiatry inpatient unit with symptoms of suicidal behavior, irritability, and impulsivity. One year previously, she had become more short-tempered, and had started to cut her wrists impulsively. Laboratory tests revealed subclinical hyperthyroidism. She was treated with anxiolytic and antithyroid drugs, and her suicidal ideation and irritability resolved. This case demonstrates that subclinical hyperthyroidism can be associated with suicidal behavior as well as overt hyperthyroidism. Early intervention is required to prevent suicidal behavior in patients with subclinical hyperthyroidism.Keywords: suicidal behavior, subclinical hyperthyroidism, anxiolytics

  12. Subclinical Measures of Atherosclerosis: Genetics and Cardiovascular Risk Prediction

    NARCIS (Netherlands)

    M. Kavousi (Maryam)

    2013-01-01

    markdownabstract__Abstract__ Atherosclerosis is a chronic, progressive, systematic condition with a long asymptomatic phase. Atherosclerosis develops gradually as a subclinical condition over the life course and eventually becomes clinically apparent as ischemic heart disease, cerebrovascular disea

  13. Subclinical bulimia predicts conduct disorder in middle adolescent girls.

    Science.gov (United States)

    Viinamäki, Anni; Marttunen, Mauri; Fröjd, Sari; Ruuska, Jaana; Kaltiala-Heino, Riittakerttu

    2013-01-01

    This study investigates the comorbidity and longitudinal associations between self-reported conduct disorder and subclinical bulimia in a community-based sample of Finnish adolescents in a 2-year prospective follow-up study. There are 2070 adolescents who participated in the survey as ninth graders (mean age 15.5) and followed-up 2 years later. The Youth Self-Report Externalizing scale was used to measure conduct disorder and DSM-IV-based questionnaire to measure bulimia. Co-occurrence of female conduct disorder and subclinical bulimia was found at ages 15 and 17. Subclinical bulimia among girls at age 15 was a risk factor for conduct disorder at age 17, but conduct disorder at age 15 was not predictive of subclinical bulimia at age 17. The pathway from bulimia to conduct disorder may be suggestive of an association with future borderline personality disorder among girls. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.

  14. Levels of Malondialdehyde and Superoxide Dismutase in Subclinical Hyperthyroidism

    OpenAIRE

    2005-01-01

    We aimed to determine whether patients with subclinical hyperthyroidism (SH) are subject to oxidative stress. Twenty-two women and 8 men having endogenous subclinical hyperthyroidism for a duration of at least 6 months, and 21 women and 9 men healthy controls were included in this study. We measured the level of plasma malondialdehyde, as one of the lipid peroxidation markers, and the activity of erythrocyte superoxide dismutase, which is an antioxidant enzyme. The activity of erythrocyte sup...

  15. Subclinical thyroid disorders--consequences and implications for treatment.

    Science.gov (United States)

    Franklyn, J A

    2007-09-01

    Subclinical hyperthyroidism is characterized by low circulating TSH concentrations, together with normal concentrations of free T4 and free T3. The clinical significance of low but detectable TSH values is likely to be different from undetectable TSH values. The question remains as to whether endogenous and exogenous (iatrogenic) causes of low serum TSH have the same clinical significance. Subclinical hypothyroidism is characterized by high serum TSH concentrations, together with normal free T4 values.

  16. Analysis of Subclinical Hyperthyroidism Influence on Parameters of Bone Metabolism

    Directory of Open Access Journals (Sweden)

    I.V. Pankiv

    2015-04-01

    Full Text Available State of subclinical hypothyroidism can be considered as the optimal model for assessing the significance of thyroid stimulating hormone (TSH for bone tissue in clinical practice. Objective: to make a comparative analysis of the impact of subclinical hyperthyroidism of various origins on the performance of bone mineral density (BMD and bone metabolism parameters. Materials and methods. The study in an outpatient setting included 112 women with a diagnosis of subclinical hyperthyroidism and duration of menopause for at least 5 years. Among the examinees, endogenous subclinical hyperthyroidism has been detected in 78 women (group I, exogenous subclinical hyperthyroidism on the background of suppressive levothyroxine therapy (group II — in 34. The control group (group III included 20 women without thyroid dysfunction. Results. The study first conducted a comparative analysis of bone metabolism, BMD indicators, as well as parameters of phosphorus and calcium, blood lipids in women with subclinical hyperthyroidism of various origins. A positive correlation between markers of bone metabolism and free triiodothyronine (fT3 as hormones necessary for the development of the skeleton and to maintain its homeostasis indicates a physiological effect of parathyroid hormone and fT3 on bone tissue. It is shown that the bone metabolism and BMD depend not only on the content of TSH, but also on the causes of subclinical hyperthyroidism.Conclusions. In postmenopausal women with endogenous subclinical hyperthyroidism, there is a significant decline in BMD indices, more pronounced in the bones with the cortical structure. A negative correlation between markers of bone metabolism and TSH has been observed among all patients included in the study.

  17. Early clinical and subclinical visual evoked potential and Humphrey's visual field defects in cryptococcal meningitis.

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    Anand Moodley

    Full Text Available Cryptococcal induced visual loss is a devastating complication in survivors of cryptococcal meningitis (CM. Early detection is paramount in prevention and treatment. Subclinical optic nerve dysfunction in CM has not hitherto been investigated by electrophysiological means. We undertook a prospective study on 90 HIV sero-positive patients with culture confirmed CM. Seventy-four patients underwent visual evoked potential (VEP testing and 47 patients underwent Humphrey's visual field (HVF testing. Decreased best corrected visual acuity (BCVA was detected in 46.5% of patients. VEP was abnormal in 51/74 (68.9% right eyes and 50/74 (67.6% left eyes. VEP P100 latency was the main abnormality with mean latency values of 118.9 (±16.5 ms and 119.8 (±15.7 ms for the right and left eyes respectively, mildly prolonged when compared to our laboratory references of 104 (±10 ms (p<0.001. Subclinical VEP abnormality was detected in 56.5% of normal eyes and constituted mostly latency abnormality. VEP amplitude was also significantly reduced in this cohort but minimally so in the visually unimpaired. HVF was abnormal in 36/47 (76.6% right eyes and 32/45 (71.1% left eyes. The predominant field defect was peripheral constriction with an enlarged blind spot suggesting the greater impact by raised intracranial pressure over that of optic neuritis. Whether this was due to papilloedema or a compartment syndrome is open to further investigation. Subclinical HVF abnormalities were minimal and therefore a poor screening test for early optic nerve dysfunction. However, early optic nerve dysfunction can be detected by testing of VEP P100 latency, which may precede the onset of visual loss in CM.

  18. Noninvasive indicators of atherosclerosis in subclinical hypothyroidism

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    Ismail Dogu Kilic

    2013-01-01

    Full Text Available Introduction: Cardiovascular system is rich in thyroid hormone receptors and is one of the major sites of action for thyroid hormones. However, the effect of subclinical hypothyroidism (SCH on atherosclerosis has not been cleared yet. Materials and Methods: SCH is defined as high thyroid-stimulating hormone (TSH levels in the presence of normal serum T4 and T3 levels. A total of 32 patients with SCH and 29 controls were included in the study. Carotid intima-media thickness, flow-mediated dilatation, and aortic distensibility were compared between the groups. Results: FMD was lower in patients with SCH than in controls. GTN-induced vasodilatation was similar in the patients with SCH and controls. There was no statistically significant difference between the patients with SCH and controls with respect to CIMT and aortic distensibility. Conclusion: SCH is associated with endothelial dysfunction as established by FMD. Inconsistent results of CIMT and aortic stiffness can be explained by these parameters being measures of structural changes whereas FMD is a dynamic measure that reflects the impact of both acute and chronic influences on endothelial function.

  19. Smoothing the mosaic subclinical melanoderma by calcipotriol.

    Science.gov (United States)

    Piérard-Franchimont, C; Paquet, P; Quatresooz, P; Piérard, G E

    2007-05-01

    The observation of photo-exposed skin under ultraviolet light reveals a mosaic pattern of varying intensity in epidermal melanization. Several patterns of mosaic subclinical melanoderma (MSM) have been described using a specially designed CCD camera and the ultraviolet light-enhanced visualization (ULEV) method. Vitamin D(3) and its analogues influence the biology of keratinocytes and melanocytes. To assess the effect of calcipotriol on MSM. This randomized split-face study was conducted in 27 men to compare the effect of once daily applications of 5% calcipotriol cream or a moisturizing cream on the heterogeneity of facial MSM. Computerized image analysis of video images was used at 1-month intervals before and during a 2-month treatment, as well as during a 3-month follow-up. At both sites, the average melanin content of the epidermis showed no significant change over time. However, the mottled appearance was smoothened at the calcipotriol site, whereas it was increased at the site receiving the moisturizer. The decreased heterogeneity in MSM after calcipotriol applications suggests a control of the epidermal melanocyte unit by the vitamin D(3) derivative.

  20. Prevalence of subclinical thyroid disorders in type 2 diabetes mellitus

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    Satvic C Manjunath

    2013-10-01

    Full Text Available Background: Subclinical thyroid disorders usually do not produce symptoms of thyroid disease until they turn into over thyroid disease. Thyroid disease is more common in people with diabetes mellitus than in the general population and it is important to detect thyroid disorder before its clinical manifestation. Subclinical hypothyroidism (SCH can produce dyslipidemia, obesity thus resulting increased predisposition to coronary artery disease. Subclinical hyperthyroidism can aggravate hyperglycemia and impair blood sugar control. Objectives: Our objective is to determine the prevalence of subclinical thyroid disorders in patients with type 2 diabetes mellitus (T2DM and to analyze the clinical and metabolic profile of patients with this dual endocrine disorder. Methods and Results: One hundred consecutive type 2 diabetic patients without clinical manifestations of thyroid disorders were screened for SCH and subclinical hyperthyroidism using serum free T 3 , free T 4 and thyroid stimulating hormone (TSH levels. Individuals of subclinical thyroid disease were further screened for thyroperoxidase (TPO antibodies. SCH was detected in 13% of type 2 diabetic patients and none had subclinical hyperthyroidism in our study. SCH was common among females with type 2 diabetes (84.6%. Elevated TPO antibody levels were present in 84.6% SCH patients. Diabetic retinopathy among SCH patients showed significant association with higher serum TSH levels. Left ventricular diastolic dysfunction was present in 30.8% of SCH patients. Conclusion: SCH is common among type 2 diabetic patients, especially in females. It is most commonly secondary to autoimmune thyroid disease. Microvascular complications are commonly observed in this group of patients with dual endocrinal disorder and treating physician should be aware of the impact and should routinely screen SCH to prevent complications.

  1. The Biochemical Prognostic Factors of Subclinical Hypothyroidism

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    Myung Won Lee

    2014-06-01

    Full Text Available BackgroundPatients with subclinical hypothyroidism (SHT are common in clinical practice. However, the clinical significance of SHT, including prognosis, has not been established. Further clarifying SHT will be critical in devising a management plan and treatment guidelines for SHT patients. Thus, the aim of this study was to investigate the prognostic factors of SHT.MethodsWe reviewed the medical records of Korean patients who visited the endocrinology outpatient clinic of Severance Hospital from January 2008 to September 2012. Newly-diagnosed patients with SHT were selected and reviewed retrospectively. We compared two groups: the SHT maintenance group and the spontaneous improvement group.ResultsThe SHT maintenance group and the spontaneous improvement group had initial thyroid-stimulating hormone (TSH levels that were significantly different (P=0.035. In subanalysis for subjects with TSH levels between 5 to 10 µIU/mL, the spontaneous improvement group showed significantly lower antithyroid peroxidase antibody (anti-TPO-Ab titer than the SHT maintenance group (P=0.039. Regarding lipid profiles, only triglyceride level, unlike total cholesterol and low density lipoprotein cholesterol, was related to TSH level, which is correlated with the severity of SHT. Diffuse thyroiditis on ultrasonography only contributed to the severity of SHT, not to the prognosis. High sensitivity C-reactive protein and urine iodine excretion, generally regarded as possible prognostic factors, did not show any significant relation with the prognosis and severity of SHT.ConclusionOnly initial TSH level was a definite prognostic factor of SHT. TPO-Ab titer was also a helpful prognostic factor for SHT in cases with mildly elevated TSH. Other than TSH and TPO-Ab, we were unable to validate biochemical prognostic factors in this retrospective study for Korean SHT patients.

  2. Comparison of QT dispersion between subclinical hypothyroid and euthyroid patients

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    Muharrem Kıskaç

    2010-06-01

    Full Text Available Objectives: The aim of this study was to investigate the relationship between subclinical hypothyroid and QTc dispersionindicating local heterogeneity in repolarization of myocardium, which is well known as independent cardiac risk factor for sudden death and ventricular arrhythmia.Materials and Methods: We compared QTc dispersion of subclinical hypothyroid patients, after treatment and healthy control group. We included a total of 50 patients with 41 women and 9 men in the study group. Electrocardiographywith 12 derivations, thyroid hormones, serum electrolytes and basic biochemical parameters were measured.The control group consisted of 25 healthy individuals.QT distances were calculated by using Bazet formula. The difference between the longest QTc and the shortest QTc distance was accepted as QTc dispersion (QTcd.Results: Comparison of subclinical hypothyroid patients, their euthyroidic period after treatment and healthy controlgroup, gave no significant differences in age, body weight, body mass index and free thyroxin values. However,significant difference was found in durations of QTd and QTcd between the subclinical hypothyroid, the control and the euthyroidic groups (p0.05.Conclusion: Our results suggested that subclinical hypothyroidpatients had longer QTc dispersion compared to euthyroidic period and healthy subjects. However there was no QTcd difference between the euthyroidic period and healthy control group.

  3. Diagnosis and management of subclinical hypothyroidism in pregnancy.

    Science.gov (United States)

    Negro, Roberto; Stagnaro-Green, Alex

    2014-10-06

    In prospective studies, the prevalence of undiagnosed subclinical hypothyroidism in pregnant women ranges from 3% to 15%. Subclinical hypothyroidism is associated with multiple adverse outcomes in the mother and fetus, including spontaneous abortion, pre-eclampsia, gestational hypertension, gestational diabetes, preterm delivery, and decreased IQ in the offspring. Only two prospective studies have evaluated the impact of levothyroxine therapy in pregnant women with subclinical hypothyroidism, and the results were mixed. Subclinical hypothyroidism is defined as raised thyrotropin combined with a normal serum free thyroxine level. The normal range of thyrotropin varies according to geographic region and ethnic background. In the absence of local normative data, the recommended upper limit of thyrotropin in the first trimester of pregnancy is 2.5 mIU/L, and 3.0 mIU/L in the second and third trimester. The thyroid gland needs to produce 50% more thyroid hormone during pregnancy to maintain a euthyroid state. Consequently, most women on levothyroxine therapy before pregnancy require an increase in dose when pregnant to maintain euthyroidism. Ongoing prospective trials that are evaluating the impact of levothyroxine therapy on adverse outcomes in the mother and fetus in women with subclinical hypothyroidism will provide crucial data on the role of thyroid hormone replacement in pregnancy.

  4. Evaluation of autonomic functions in subclinical hypothyroid and hypothyroid patients

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    Aarti S Mahajan

    2013-01-01

    Full Text Available Background: Autonomic dysfunction may contribute to cardiovascular morbidity in subclinical hypothyroid patients. It is controversial whether the abnormality exists in sympathetic or the parasympathetic function. It is also not known whether the severity of autonomic dysfunction is related to the degree of thyroid deficiency. Design of Study: Prospective case control. Materials and Methods: Autonomic functions based on heart rate (HR and blood pressure (BP responses to various maneuvers were evaluated and scored in twenty two subclinical hypothyroid patients, 30-50 years and compared with twenty hypothyroid patients. Biochemical estimation of TSH, fT 3 , fT 4 , TPO antibody was done. Result: Sympathetic function abnormalities were seen in 82% subclinical hypothyroid patients and 85%hypothyroid patients when one test was abnormal. Parasympathetic dysfunction was also recorded in eight patients in both groups. When two abnormal tests were used as the selection criteria sympathetic function abnormality was observed in about 41% subclinical hypothyroid and 65% hypothyroid patients. There were no intergroup differences in autonomic functions, score and TPO levels. The TSH levels were not related to type or degree of autonomic dysfunction. Systolic BP in both groups and diastolic BP in hypothyroid patients were higher with lower thyroxine levels but the patients were normotensive. Conclusion: Autonomic dysfunction of comparable degree was seen in subclinical hypothyroid and hypothyroid patients. Sympathetic function abnormality was more common although decreased parasympathetic function reactivity was also present. These abnormalities were unrelated to TSH levels.

  5. Brain microstructure of subclinical apathy phenomenology in healthy individuals.

    Science.gov (United States)

    Spalletta, Gianfranco; Fagioli, Sabrina; Caltagirone, Carlo; Piras, Fabrizio

    2013-12-01

    Although apathy has been extensively studied in relation to neuropsychiatric disorders, it is still unclear whether, in healthy people, it should be considered as a physiological phenomenon or whether it is a risk factor for progression to clinical disturbances. Here, we investigated subclinical apathy phenomenology and its brain microstructural correlates in healthy individuals. We submitted 72 participants to a comprehensive clinical assessment, a high-resolution structural MRI and a diffusion tensor imaging scan protocol. Data of individual microstructural (mean diffusivity and fractional anisotropy) variations were processed across genders in relation to the Apathy Rating Scale score. In females, subclinical apathy phenomenology was associated with microstructural variation of the bilateral thalami, the anterior thalamic radiation, the forceps major, and the corona radiate. These are white matter areas mostly connecting the thalami to the frontal and occipital cortices, regions that are known to be implicated in the expression of apathy in clinical samples. No significant relationship with brain microstructure was found in males who showed a positive correlation between subclinical apathy and somatic phenomenology of depression. In conclusion, our results show that in healthy individuals subclinical apathy phenomenology is associated with different mechanisms across genders, and raise the issue about whether brain microstructural changes associated with subclinical apathy in healthy females could be a precocious marker useful in the prediction of progression to more severe apathetic conditions.

  6. Association of Nonalcoholic Fatty Liver Disease with Subclinical Cardiovascular Changes: A Systematic Review and Meta-Analysis

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    Enea Bonci

    2015-01-01

    Full Text Available In the last 20 years, nonalcoholic fatty liver disease (NAFLD has become the leading cause of chronic liver disease worldwide, primarily as a result of the epidemic of obesity. NAFLD is strongly associated with insulin resistance, glucose intolerance, and dyslipidemia and is currently regarded as the liver manifestation of the metabolic syndrome, a highly atherogenic condition even at a very early age. Patients with NAFLD including pediatric subjects have a higher prevalence of subclinical atherosclerosis, as shown by impaired flow-mediated vasodilation, increased carotid artery intima-media thickness, and arterial stiffness, which are independent of obesity and other established risk factors. More recent work has identified NAFLD as a risk factor not only for premature coronary heart disease and cardiovascular events, but also for early subclinical abnormalities in myocardial structure and function. Thus, we conducted a systematic review and meta-analysis to test the hypothesis that NAFLD is associated with evidence of subclinical cardiac structural and functional abnormalities.

  7. Evaluation of endothelial function in exogenous subclinical hyperthyroidism and the effect of treatment

    Directory of Open Access Journals (Sweden)

    Sayed Mohammad Hosseini

    2016-01-01

    Conclusions: This study demonstrated that FMD decreased in exogenous subclinical hyperthyroid patients which could be partially restored by treatment. These findings suggest that treatment of subclinical hyperthyroid state could improve endothelial dysfunction and at the end decreased the cardiovascular complications.

  8. Associations between life stress and subclinical cardiovascular disease are partly mediated by depressive and anxiety symptoms

    NARCIS (Netherlands)

    Bomhof-Roordink, Hanna; Seldenrijk, Adrie; van Hout, Hein P. J.; van Marwijk, Harm W. J.; Diamant, Michaela; Penninx, Brenda W. J. H.

    2015-01-01

    Background: Stress experienced during childhood or adulthood has been associated with cardiovascular disease (CVD), but it is not clear whether associations are already prevalent on a subclinical cardiovascular level. This study investigates associations between indicators of life stress and subclin

  9. Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity

    DEFF Research Database (Denmark)

    Feldthusen, Anne-Dorthe; Pedersen, Palle L; Larsen, Jacob

    2015-01-01

    INTRODUCTION: The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb), and mild (subclinical) hypothyroidism in women from The Danish General Suburban Population Study (GESUS) on the number of children born, the number of pregnancies, and the number...... of spontaneous abortions. METHODS: Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. RESULTS: 6.7% had mild (subclinical) hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism...... with spontaneous abortions. Mild (subclinical) hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous...

  10. Subclinical Hypothyroidism and Its Association with Increased Cardiovascular Mortality

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    Alvaro Altamirano Ufion

    2017-01-01

    Full Text Available Thyroid hormones play an important role in regulating different metabolism functions and multiple organs’ performance. Changes in the thyroid hormone axis can lead to profound effects on the stability of vital organs and systems, especially the cardiovascular system. Hypothyroidism is classified according to the clinical presentation as overt and subclinical. There is some evidence supporting the benefits of thyroxine hormone replacement for subclinical hypothyroidism on cardiovascular mortality outcomes. However, the clinical relevance of measuring and treating high thyroid-stimulating hormone (TSH levels in newly diagnosed heart failure patients with preserved ejection fraction requires further study. In this report, we review the current evidence regarding the prognostic significance of subclinical hypothyroidism in heart failure patients with preserved ejection fraction.

  11. Clinical factors associated with subclinical spread of in situ melanoma.

    Science.gov (United States)

    Shin, Thuzar M; Etzkorn, Jeremy R; Sobanko, Joseph F; Margolis, David J; Gelfand, Joel M; Chu, Emily Y; Elenitsas, Rosalie; Shaikh, Waqas R; Miller, Christopher J

    2017-04-01

    Subclinical spread of in situ melanoma occurs at a wide frequency, ranging from 12% to 71%. To identify clinical factors associated with subclinical spread of in situ melanoma. We used a retrospective, cross-sectional study of 674 consecutive in situ melanomas to examine 627 patients treated with Mohs surgery and melanoma antigen recognized by T cells 1 immunostaining. The presence of subclinical spread was correlated with clinical characteristics. Univariate and multivariate logistic regression analyses were performed to generate odds ratios (ORs) and 95% confidence intervals (CIs). Both univariate and multivariate analyses demonstrated significantly increased odds for subclinical spread of in situ melanomas when they were located on the head or neck, at acral sites, or on the pretibial leg (OR 1.97, 95% CI 1.41-3.40); in persons with a history of prior treatment (OR 2.77, 95% CI 1.74-4.420); melanomas of preoperative size >1 cm (OR 1.74, 95% CI 1.23-2.46, P = .002); or in persons ≥60 years old (OR 1.47, 95% CI 1.01-2.13, P = .042). A count prediction model demonstrated that the risk for subclinical spread increased with the number of clinical risk factors. We used a single-site, retrospective study design. Clarifying the risk factors for subclinical spread might help to refine triage of in situ melanomas to the appropriate surgical techniques for margin assessment prior to reconstruction. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Should we treat mild subclinical/mild hyperthyroidism? No.

    Science.gov (United States)

    Vanderpump, Mark P J

    2011-08-01

    The management of a patient with subclinical hyperthyroidism or mild thyroid over-activity is controversial. Subclinical hyperthyroidism is defined as a serum thyrotrophin (TSH) below the reference range but a normal thyroxine (T4) and triiodothyronine (T3) level in a patient who is either asymptomatic or has only non-specific symptoms. Epidemiological studies report an overall prevalence of approximately 3%, with men and women over 65 years and those in iodine deficient regions having the highest prevalence. Approximately 50% of subjects are taking levothyroxine. The aetiology for those with endogenous subclinical hyperthyroidism is Graves' disease, toxic nodular goitre or rarely a solitary toxic adenoma or thyroiditis. Non-thyroidal illness is an important cause of false positive low serum TSH test results. Subjects with low but detectable serum TSH values (0.1-0.4 mU/L) usually recover spontaneously when re-tested. It has been estimated that in those with an undetectable serum TSH (hyperthyroidism occurs at a rate up to 5% per year. Advocates of intervening for subclinical hyperthyroidism argue that early treatment might reduce mortality, prevent the later development of atrial fibrillation, osteoporotic fractures, and overt hyperthyroidism but data supporting improvement in outcomes are sparse. No appropriately powered prospective, randomised, controlled, double-blinded trial of intervention for subclinical hyperthyroidism exists. For the vast majority of patients adopting a "wait and see" policy rather than intervention may avoid unnecessary treatment or the potential for harm. Any potential benefits of therapy in subclinical hyperthyroidism must be weighed against the significant morbidity associated with the treatment of hyperthyroidism.

  13. Haemodynamic changes following treatment of subclinical and overt hyperthyroidism

    DEFF Research Database (Denmark)

    Faber, J; Wiinberg, N; Schifter, S

    2001-01-01

    Hyperthyroidism has profound effects on the cardiovascular system, including reduced systemic vascular resistance (SVR) due to relaxation of vascular smooth muscle cells, enhanced heart rate (HR) and cardiac output (CO) due to an increase in cardiac diastolic relaxation, contractility and heart...... rate. Subclinical hyperthyroidism is characterised by reduced serum TSH levels despite free thyroxine (T4) and tri-iodothyronine (T3) estimates within the reference range, in subjects with no obvious symptoms of hyperthyroidism. We measured haemodynamic changes (using impedance cardiography......) in subjects with endogenous subclinical hyperthyroidism in order to elucidate whether these patients had signs of excess thyroid hormone at the tissue level....

  14. BENEFICIAL EFFECTS OF LEVOTHYROXINE IN THE TREATMENT OF SUBCLINICAL HYPOTHYROIDISM

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    Mulic Mersudin

    2016-12-01

    Full Text Available Introduction:Increased cardiovascular risk in thyroid dysfunction is associated with disorders of lipid and lipoproteins, endothelial dysfunction, metabolic, hormonal, hemodynamic changes and coagulation disorders. Subclinical hypothyroidism is characterized by a suprarnormal level of TSH with normal levels of thyroid hormones. The correlation between subclinical hypothyroidism of the lipid profile and cardiovascular outcomes remains unclear. Several intervention studies assessed the effect of levothyroxine therapy on the lipid profile of patients with subclinical hypothyroidism and obtained conflicting results. The aim of the research is to determine whether subclinical hypothyroidism is associated with the atherogenic lipid profile and whether these changes are reversible after the introduction of the L-thyroxine replacement therapy. Method: The study included 51 patients over 50 years of age with subclinical hypothyroidism. All the participants were subjected to an examination programme which included a detailed anamnesis and physical examination, laboratory tests (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, T3, T4, TSH. After eight weeks of levothyroxine therapy, the same laboratory parameters were determined in the patients. Results: Subjects with subclinical hypothyroidism had high average values: TSH (12.77 + 2.78 mIU / ml, total cholesterol (7.55 ± 0.79 mmol / l, LDL cholesterol (5.03 ± 0.61 mmol / l, triglycerides (2.48 ± 1.01 mmol / l; and the average value of HDL cholesterol was within reference values (1.12 ± 0.21 mmol / l. After eight weeks of levothyroxine replacement therapy, there was a statistically significant reduction of average values (p <0.0001: TSH (3.83 ± 1.33 mIU / ml, total cholesterol (6.28 ± 0.96 mmol / l, LDL cholesterol ( 4.03 ± 0.70 mmol / mmol / l l, triglycerides (1.98 ± 0.87 mmol / l; and the average value of HDL cholesterol increased significantly (p <0.0001 (1.32 ± 0.22 mmol

  15. Gentamicin Nephrotoxicity in Subclinical Renal Disease.

    Science.gov (United States)

    Frazier, Donita L.

    The purpose of the present study was to examine the pharmacokinetic disposition of gentamicin and to define the mechanisms which predispose to nephrotoxicity in subclinical renal disease. Subtotally nephrectomized beagle dogs were used as a model for human beings with compromised renal function secondary to a reduced number of functional nephrons. Using ultrastructural morphometry, light microscopy and clinical chemistry data, the model was defined and the nephrotoxic responses of intact dogs administered recommended doses of drug were compared to the response of subtotally nephrectomized dogs administered reduced doses based on each animal's clearance of drug. Lysosomal and mitochondrial morphometric changes suggested mechanisms for increased sensitivity. To determine if increased sensitivity in this model was dependent on altered serum concentrations, variable rate infusions based on individual pharmacokinetic disposition of drug were administered using computer-driven infusion pumps. Identical serum concentration-time profiles were achieved in normal dogs and subtotally nephrectomized dogs, however, toxicity was significantly greater in nephrectomized dogs. The difference in the nephrotoxic response was characterized by administering supratherapeutic doses of drug to dogs. Nephrectomized dogs given a recommended dose of gentamicin became oliguric during the second week of treatment and increasingly uremic after withdrawal of drug. In contrast, intact dogs administered 2 times the recommended dose of gentamicin become only slightly polyuric during week 4 of treatment. The need to individualize dosage regimens based on drug clearance and not serum creatinine nor creatinine clearance alone was substantiated by describing the pharmacokinetic disposition of gentamicin in spontaneously occurring disease states. Four individualized dosage regimens with differing predicted efficacy were then administered to nephrectomized dogs to determine their relative nephrotoxic

  16. Complementary Therapy in Polycystic Ovary Syndrome

    OpenAIRE

    Aquino, Carmen Imma; Nori, Stefania Lucia

    2014-01-01

    Polycystic Ovary Syndrome (PCOS) is an endocrine disease. PCOS afflicts 5 to 10 % of women of reproductive age. The symptoms are: amenorrhea, oligomenorrhea, hirsutism, obesity, infertility, chronic hyperandrogenic anovulation and acne. Other risk factors aggravate this condition: insulin resistance, obesity, hypertension, dyslipidemia, inflammation and subclinical cardiovascular disease. Anxiety, depression and reduced quality of life are also common. This review highlights the mech...

  17. Complementary Therapy in Polycystic Ovary Syndrome

    OpenAIRE

    Aquino, Carmen Imma; Nori, Stefania Lucia

    2014-01-01

    Polycystic Ovary Syndrome (PCOS) is an endocrine disease. PCOS afflicts 5 to 10 % of women of reproductive age. The symptoms are: amenorrhea, oligomenorrhea, hirsutism, obesity, infertility, chronic hyperandrogenic anovulation and acne. Other risk factors aggravate this condition: insulin resistance, obesity, hypertension, dyslipidemia, inflammation and subclinical cardiovascular disease. Anxiety, depression and reduced quality of life are also common. This review highlights the mechanisms an...

  18. Normal somatic cell count and subclinical mastitis in Murrah buffaloes.

    Science.gov (United States)

    Dhakal, I P

    2006-03-01

    This study was conducted to investigate the normal somatic cell count (SCC) and to define subclinical mastitis in Murrah buffaloes. Data were collected from 60 clinically normal buffaloes stationed at five farms of Chitwan Nepal and Buffalo Research Center, Hissar, India. Somatic cell count was measured using the Newman-Lampert staining technique. The upper limit of SCC was determined >or=200 000/ml of milk based on the mean +/- 2SD of a total SCC. Abnormal data of the SCC was repeatedly removed, which lie beyond the values of more than mean + 2SD until all the data come to lie within (mean + 2SD). Averages of SCC of right front and right hind quarters were significantly higher than left front and left hind quarters. Nearly 94% of California mastitis test (CMT) negative quarters were having somatic cells >or=200 000/ml. The mean SCC of CMT positive quarter was significantly higher (P CMT negative quarters. Subclinical mastitis was diagnosed on the basis of samples with SCCs >or=200 000/ml with positive bacterial cultures. Subclinical mastitis was found in 21.7% buffaloes and 8% of the quarter foremilk samples. Neutrophil counts were significantly higher in subclinical mastitis milk.

  19. Possible Subclinical Leaflet Thrombosis in Bioprosthetic Aortic Valves

    DEFF Research Database (Denmark)

    Makkar, Raj R; Fontana, Gregory; Jilaihawi, Hasan

    2015-01-01

    BACKGROUND: A finding of reduced aortic-valve leaflet motion was noted on computed tomography (CT) in a patient who had a stroke after transcatheter aortic-valve replacement (TAVR) during an ongoing clinical trial. This finding raised a concern about possible subclinical leaflet thrombosis and pr...

  20. Haemodynamic changes following treatment of subclinical and overt hyperthyroidism

    DEFF Research Database (Denmark)

    Faber, J; Wiinberg, N; Schifter, S

    2001-01-01

    Hyperthyroidism has profound effects on the cardiovascular system, including reduced systemic vascular resistance (SVR) due to relaxation of vascular smooth muscle cells, enhanced heart rate (HR) and cardiac output (CO) due to an increase in cardiac diastolic relaxation, contractility and heart......) in subjects with endogenous subclinical hyperthyroidism in order to elucidate whether these patients had signs of excess thyroid hormone at the tissue level....

  1. Characteristics of anemia in subclinical and overt hypothyroid patients.

    Science.gov (United States)

    Erdogan, Mehmet; Mehmet, Erdogan; Kösenli, Aybike; Aybike, Kosenli; Ganidagli, Sencer; Kulaksizoglu, Mustafa; Mustafa, Kulaksizoglu

    2012-01-01

    Thyroid hormones stimulate directly or indirectly growth of erythroid colonies through erythropoietin. Anemia is often the first sign of hypothyroidism. Hypothyroidism can cause a wide variety of anemic disorders. Numerous mechanisms are involved in the pathogenesis of these anemias that can be microcytic, macrocytic and normocytic. We designed this study to investigate the anemia frequency and if present, etiology of anemia in hypothyroid patients. 100 patients with overt hypothyroid, 100 patients with subclinical hypothyroid, and 200 healthy controls were enrolled in this study. Overt hypothyroidism diagnosis is done when elevated TSH and low levels of free T4 and/or free T3 have been observed. Subclinical hypothyroidism is defined as elevated serum TSH with normal free T(4) and free T(3) levels. Peripheral smears of the anemic patients were examined. Anemia prevalence was 43% in the overt hypothyroid group, 39% in the subclinical hypothyroid group, and 26% in the control group (p=0.0003 and p=0.021 respectively related to controls). Thus, the frequency of anemia in subclinical hypothyroidism is as high as that in overt hypothyroidism. There was no difference between the hypothyroid groups in terms of anemia. Vitamin B12, Fe, and folic acid were similar between these groups. According to our findings, anemia of chronic disease is the most common type of anemia in hypothyroid patients. Suspicion of hypothyroidism should be considered in anemias with uncertain etiology.

  2. Subclinical nutritional rickets among adolescents in Kaghan Valley.

    Science.gov (United States)

    Shah, Tanveer Hussain; Hassan, Mukhtiar; Siddiqui, Tahir Saeed

    2014-09-01

    To determine the occurrence of subclinical rickets and its causing factors among adolescent students of schools in Kaghan Valley, Pakistan. Observation cross-sectional study. Department of Biochemistry and Health Sciences, Hazara University, Mansehra, Ayub Medical College and Teaching Hospital, Abbottabad, from March to April 2012. Sixty seven students (34 boys and 33 girls) age between 11 - 16 years included in the study from different schools of Kaghan Valley, Pakistan. Characteristic, serum biochemical and nutritional status were measured for all the participants. On the basis of biochemical finding the boys and girls students were divided in to two groups, normal subjects and subclinical rickets (absent symptoms with altered biochemistry). Twenty six participants, 19 (73%) girls and 07 (27%) boys had biochemical abnormality but no clinical signs and symptoms of rickets. Low vitamin D and high alkaline phosphatase level were observed in 26 (100%), 21 (81%), low calcium in 17 (65%) and low phosphorus 7 (27%) subjects with subclinical rickets. None had high parathormone level above normal range. Nutritional intake of calcium, phosphorus and vitamin D was found less than the recommended daily intake in all the participants. Subclinical rickets is common problem among adolescent students especially in girls which is due to low nutritional intakes and avoidance of sunshine due to environmental and traditional impacts.

  3. Altered fructosamine and lipid fractions in subclinical hypothyroidism.

    Science.gov (United States)

    Udupa, Sridevi V; Manjrekar, Poornima A; Udupa, Vinit A; Vivian, D'Souza

    2013-01-01

    Thyroid function disorders lead to changes in the lipoprotein metabolism. To study the lipid and the glycaemic abnormalities in the subclinical hypothyroidism cases and to compare the same with the euthyroid, overt hypothyroid and the hyperthyroid subjects. Four groups, euthyroid (Group-I), hypothyroid (Group-II), subclinical hypothyroid (Group-III) and hyperthyroid (Group-IV), which consisted of 30 subjects each, of either sex, who were aged 25-55 years, underwent Fasting Plasma Glucose (FPG), fructosamine, lipid profile and total T3, T4 and TSH estimations. The subjects who were on lipid lowering or thyroid disorder drugs and known diabetics were excluded from the study. In Group-III, all the lipid fractions were comparable to those of Group-II and they were significantly deranged, as compared to those of Group-I. The fructosamine levels were significantly higher in Group-II and Group-III (p<0.05), but the subclinical hypothyroid pool had statistically lower levels than the hypothyroid pool (376.63±54.73, 587.80±65.10). In the Group-IV patients, the LDL-C levels were significantly higher as compared to those in the euthyroid pool. The fructosamine levels were significantly lower in comparison with both the euthyroid and the hypothyroid pools (both in Groups-II and III). The FPG levels were higher in all the classes of the thyroid abnormalities (subclinical hypothyroidnot significant) but within the reference range of 70-100mg/dl. Since the lipid derangement in subclinical hypothyroidism is on par with that in overt hypothyrodism, the subclinical hypothyroid cases also need to be treated similarly. The fructosamine values which are largely in excess of the FPG values, indicate a higher propensity to glycation and a decreased turnover of the proteins in the hypothyroid and the subclinical hypothyroid pools. Vice versa is true of the hyperthyroid pool. Fructosamine can be included in the thyroid work up of the patients to assess the metabolic function and the

  4. The fracture risk assessment tool (FRAX® score in subclinical hyperthyroidism

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    Polovina Snežana

    2015-01-01

    Full Text Available Background/Aim. The Fracture Risk Assessment Tool (FRAX® score is the 10-year estimated risk calculation tool for bone fracture that includes clinical data and hip bone mineral density measured by dual-energy x-ray absorptiometry (DXA. The aim of this cross-sectional study was to elucidate the ability of the FRAX® score in discriminating between bone fracture positive and negative pre- and post-menopausal women with subclinical hyperthyroidism. Methods. The bone mineral density (by DXA, thyroid stimulating hormone (TSH level, free thyroxine (fT4 level, thyroid peroxidase antibodies (TPOAb titre, osteocalcin and beta-cross-laps were measured in 27 pre- and post-menopausal women with newly discovered subclinical hyperthyroidism [age 58.85 ± 7.83 years, body mass index (BMI 27.89 ± 3.46 kg/m2, menopause onset in 46.88 ± 10.21 years] and 51 matched euthyroid controls (age 59.69 ± 5.72 years, BMI 27.68 ± 4.66 kg/m2, menopause onset in 48.53 ± 4.58 years. The etiology of subclinical hyperthyroisims was autoimmune thyroid disease or toxic goiter. FRAX® score calculation was performed in both groups. Results. In the group with subclinical hyperthyroidism the main FRAX® score was significantly higher than in the controls (6.50 ± 1.58 vs 4.35 ± 1.56 respectively; p = 0.015. The FRAX® score for hip was also higher in the evaluated group than in the controls (1.33 ± 3.92 vs 0.50 ± 0.46 respectively; p = 0.022. There was no correlations between low TSH and fracture risk (p > 0.05. The ability of the FRAX® score in discriminating between bone fracture positive and negative pre- and postmenopausal female subjects (p < 0.001 is presented by the area under the curve (AUC plotted via ROC analysis. The determined FRAX score cut-off value by this analysis was 6%, with estimated sensitivity and specificity of 95% and 75.9%, respectively. Conclusion. Pre- and postmenopausal women with subclinical hyperthyroidism have higher FRAX® scores and thus

  5. Contralateral adrenal suppression on adrenocortical scintigraphy provides good evidence showing subclinical cortisol overproduction from unilateral adenomas.

    Science.gov (United States)

    Katabami, Takuyuki; Ishii, Satoshi; Obi, Ryusei; Asai, Shiko; Tanaka, Yasushi

    2016-12-30

    Unilateral and/or predominant uptake on adrenocortical scintigraphy (ACS) may be related to autonomous cortisol overproduction in patients with subclinical Cushing's syndrome (SCS). However, there is no information regarding whether increased tracer uptake on the tumor side or decreased uptake on the contralateral side on ACS is more greatly associated with inappropriate cortisol production. Therefore, we evaluated the relationship between quantitative (131)I-6β-iodomethyl-norcholesterol ((131)I-NP-59) uptake in both adrenal glands and parameters of autonomic cortisol secretion and attempted to set a cut off for SCS detection. The study included 90 patients with unilateral adrenal adenoma who fulfilled strict criteria. The diagnosis of SCS was based on serum cortisol ≥3.0 μg/dL after 1-mg dexamethasone suppression test (DST) with at least 1 other hypothalamus-pituitary-adrenal axis function abnormality. Twenty-two (27.7%) subjects were diagnosed with SCS. The uptake rate on the affected side in the SCS group was comparable to that in the non-functioning adenoma group. In contrast, the uptake rate on the contralateral side was lower and the laterality ratio significantly higher in the SCS group. The two ACS indices were correlated with serum cortisol levels after a 1-mg DST, but uptake on the tumor side was not. Tumor size was also important for the functional statuses of adrenal tumors and NP-59 imaging patterns. The best cut-off point for the laterality ratio to detect SCS was 3.07. These results clearly indicate that contralateral adrenal suppression in ACS is good evidence showing subclinical cortisol overproduction.

  6. Factors influencing the prevalence of subclinical mastitis in lactating dromedary camels in Riyadh Region, Saudi Arabia.

    Science.gov (United States)

    Aljumaah, Riyadh S; Almutairi, Faris F; Ayadi, Moez; Alshaikh, Mohammad A; Aljumaah, Ali M; Hussein, Mansour F

    2011-12-01

    The purpose of this study was to determine the prevalence of subclinical mastitis in camels in Riyadh, Saudi Arabia and the factors influencing its incidence. A total of 740 quarter milk samples were collected from 47 camel herds belonging to Majahim, Maghatir, Shu'l, and Sufer breeds. California mastitis test (CMT) was used as a screening test for subclinical mastitis. Samples giving negative or trace CMT scores (0) were assigned to healthy quarters, while those giving positive scores of 1+ to 3+ were assigned to subclinically affected quarters. Logistic regression was used to assess the association of breed, parity, and stage of lactation with the prevalence of subclinical mastitis. Milk fat, protein, lactose, solid nonfat percentages and Na, Ca, and K concentrations were compared in CMT-positive versus healthy quarters. One third (33%) of tested quarters had subclinical mastitis based on CMT. The estimated probability of subclinical mastitis with the combined effects of breed, parity, and stage of lactation ranged from 15.8% to 54.6%. The risk of subclinical mastitis increased significantly with parity and with the early stage of lactation. The Shu'l breed had significantly higher prevalence of subclinical mastitis than other breeds. Significant decreases in protein, lactose, and solid nonfat, Ca and K concentrations and increase in Na concentrations were associated with subclinical mastitis. In conclusion, subclinical mastitis is prevalent in Saudi camels, and its incidence is influenced by breed, parity, and stage of lactation.

  7. Subclinical thyroid disorders and cognitive performance among adolescents in the United States

    Directory of Open Access Journals (Sweden)

    Wilson Jim L

    2006-04-01

    Full Text Available Abstract Background Thyroid hormone plays a crucial role in the growth and function of the central nervous system. The purpose of the study was to examine the relationships between the status of subclinical thyroid conditions and cognition among adolescents in the United States. Methods Study sample included 1,327 adolescents 13 to 16 years old who participated in the Third National Health and Nutrition Examination Survey (NHANES III. Serum thyroxine (T4 and thyroid stimulating hormone (TSH were measured and subclinical hypothyroidism, subclinical hyperthyroidism, and euthyroid groups were defined. Cognitive performance was assessed using the subscales of the Wide Range Achievement Test-Revised (WRAT-R and the Wechsler Intelligence Scale for Children-Revised (WISC-R. The age-corrected scaled scores for arithmetic, reading, block design, and digit span were derived from the cognitive assessments. Results Subclinical hypothyroidism was found in 1.7% and subclinical hyperthyroidism was found in 2.3% of the adolescents. Cognitive assessment scores on average tended to be lower in adolescents with subclinical hyperthyroidism and higher in those with subclinical hypothyroidism than the score for the euthyroid group. Adolescents with subclinical hypothyroidism had significantly better scores in block design and reading than the euthyroid subjects even after adjustment for a number of variables including sex, age, and family income level. Conclusion Subclinical hypothyroidism was associated with better performance in some areas of cognitive functions while subclinical hyperthyroidism could be a potential risk factor.

  8. Subclinical hypothyroidism and cognitive function in people over 60 years

    DEFF Research Database (Denmark)

    Akintola, Abimbola A; Jansen, Steffy W; van Bodegom, David

    2015-01-01

    Subclinical hypothyroidism (SCH), defined as elevated thyroid stimulating hormone (TSH) and normal thyroid hormone levels, and cognitive impairment are both common in older people. While the relation between overt hypothyroidism and cognitive impairment is well established, data on the association...... criteria for eligibility and methodological quality, and data were extracted using standardized forms. Of the 844 reports initially identified, 270 remained after exclusion of duplicates. Of the 270, 15 studies comprising 19,944 subjects, of whom 1,199 had subclinical hypothyroidism were included. Data...... hypothyroidism was not significantly associated with accelerated cognitive decline. This systematic review and meta-analysis provides no evidence that supports an association between SCH and cognitive impairment in relatively healthy older adults....

  9. Subclinical onychomycosis in patients with type II diabetes

    Directory of Open Access Journals (Sweden)

    Amira Elbendary

    2015-12-01

    Full Text Available Fungal organisms could be present in the nail without any clinical manifestations. As onychomycosis in diabetics has more serious complications, early detection of such infection could be helpful to prevent them. We aim in this study to assess the possibility of detecting subclinical onychomycosis in type II diabetic patients and addressing possible associated neuropathy. A cross sectional, observational study included patients with type II diabetes with normal big toe nail. All were subjected to nail clipping of the big toe nail, followed by staining with Hematoxylin and Eosin and Periodic-Acid-Schiff (PAS stains and examined microscopically. A total of 106 patients were included, fungal infection was identified in eight specimens, all were uncontrolled diabetes, and six had neuropathy. Using the nail clipping and microscopic examination with PAS stain to detect such subclinical infection could be an applicable screening test for diabetic patients, for early detection and management of onychomycosis.

  10. Intrahepatic cholestasis in subclinical and overt hyperthyroidism: two case reports

    Directory of Open Access Journals (Sweden)

    Soylu Aliye

    2008-04-01

    Full Text Available Abstract Introduction Non-specific abnormalities in liver function tests might accompany the clinical course of hyperthyroidism. Hyperthyroidism can cause the elevation of hepatic enzymes and bilirubin. Jaundice is rare in overt hyperthyroidism, especially in subclinical hyperthyroidism. On the other hand, the use of anti-thyroid drugs has rarely been associated with toxic hepatitis and cholestatic jaundice. Case presentation Here we present two cases of cholestasis that accompanied two distinct forms of clinical hyperthyroidism. The first patient had a clinical presentation of severe cholestasis in the absence of congestive failure related to hyperthyroidism. The second case had developed intrahepatic cholestasis in the presence of subclinical hyperthyroidism, and improved with rifampicin treatment. Conclusion Hyperthyroidism should be a consideration in non-specific liver dysfunction.

  11. A review on cardiovascular diseases originated from subclinical hypothyroidism.

    Science.gov (United States)

    Mansourian, Azad Reza

    2012-01-15

    Thyroid hormones play an important role on the cardiovascular systems and thyroid disorder ultimately have a profound adverse effects on myocardium and vascular functions. There are extensive reports on the role of overt thyroid dysfunction which adversely can modify the cardiovascular metabolism but even at the present of some controversial reports, the subclinical thyroid disorders are able also to manipulate cardiovascular system to some extent. The aim of this study is to review the cardiovascular disorders accompanied with subclinical hypothyroidism. It is concluded that adverse effect of thyroid malfunction on myocardium and vascular organs are through the direct role of thyroid hormone and dyslipidemia on heart muscle cells at nuclear level and vascular system, respectively. It seems many cardiovascular disorders initially would not have been occurred in the first place if the thyroid of affected person had functioned properly, therefore thyroid function tests should be one of a prior laboratory examinations in cardiovascular disorders.

  12. [Cases of clinical and subclinical mastitis due to "D" streptococci].

    Science.gov (United States)

    Aleksieva, V; Todorov, D

    1981-01-01

    Cytologic and bacteriologic investigations were carried out with a total of 364 samples of cow milk and secretion from 11 farms taken from individual quarters of the udder that have reacted positively and strongly positively with the rapid mastitis test Bernburg. It was found that in 330 of the cases there were data of clinical and subclinical mastitis of varying etiology. In 43 of the cases the causative agent (as isolated in pure cultures) proved to be "D" streptococci, giving positive reaction as judged by Schermann's criteria--from 9 cases of clinical and 34 cases of subclinical mastitis. The cell count varied from 360 000 to more than 5 million per cub. cm. Detailed studies were carried out on the cultural and biochemical properties of 31 strains of "D" streptococci, 17 strains belonging to Str. faecalis var. zymogenes, 9 strains--to Str. faecalis var. faecalis, and 5 strains--to Str. faecalis var. liquefaciens.

  13. Dietary Management of Labrador Retrievers with Subclinical Hepatic Copper Accumulation

    OpenAIRE

    Fieten, H.; Biourge, V.C.; Watson, A.L.; Leegwater, P.A.J.; van den Ingh, T.S.G.A.M.; Rothuizen, J.

    2015-01-01

    Background Genetic and environmental factors, including dietary copper intake, contribute to the pathogenesis of copper‐associated hepatitis in Labrador retrievers. Clinical disease is preceded by a subclinical phase in which copper accumulates in the liver. Objective To investigate the effect of a low‐copper, high‐zinc diet on hepatic copper concentration in Labrador retrievers with increased hepatic copper concentrations. Animals Twenty‐eight clinically healthy, client‐owned Labrador retrie...

  14. A case report of suicidal behavior related to subclinical hyperthyroidism

    OpenAIRE

    2014-01-01

    Abnormalities in thyroid function are associated with many psychiatric symptoms. We present a report of a 15-year-old girl who was admitted to the psychiatry inpatient unit with symptoms of suicidal behavior, irritability, and impulsivity. One year previously, she had become more short-tempered, and had started to cut her wrists impulsively. Laboratory tests revealed subclinical hyperthyroidism. She was treated with anxiolytic and antithyroid drugs, and her suicidal ideation and irritability ...

  15. Intrahepatic cholestasis in subclinical and overt hyperthyroidism: two case reports

    OpenAIRE

    2008-01-01

    Abstract Introduction Non-specific abnormalities in liver function tests might accompany the clinical course of hyperthyroidism. Hyperthyroidism can cause the elevation of hepatic enzymes and bilirubin. Jaundice is rare in overt hyperthyroidism, especially in subclinical hyperthyroidism. On the other hand, the use of anti-thyroid drugs has rarely been associated with toxic hepatitis and cholestatic jaundice. Case presentation Here we present two cases of cholestasis that accompanied two disti...

  16. Subclinical Bacteriuria in Older Cats and its Association with Survival.

    Science.gov (United States)

    White, J D; Cave, N J; Grinberg, A; Thomas, D G; Heuer, C

    2016-11-01

    Bacterial urinary tract infections are uncommon in cats in general but the prevalence increases to 29% in older cats with comorbidities (Veterinary Clinical Pathology 2008, 37, 317; Journal of Feline Medicine & Surgery 2007, 9, 124; Veterinary Microbiology 2009, 136, 130). Frequently, the infections are subclinical. The clinical relevance of subclinical bacteriuria (SB) is uncertain, and the optimal treatment requires clarification. Prospective, observational study to: (i) identify the prevalence and incidence count of SB in older (≥7 years), nonazotemic cats, (ii) evaluate specific risk factors for SB, and (iii) investigate the potential relationship between untreated SB and survival. Sixty-seven, nonazotemic cats were tested on 5 occasions over 3 years. Urine samples were obtained by cystocentesis for quantitative urine culture and blood samples for measurement of serum creatinine concentration. Episodes of SB were not treated. Serum creatinine concentration, body weight, urine specific gravity, sex, and age were evaluated as potential risk factors for a positive urine culture. The association between urine culture results and survival was evaluated with Cox's proportional hazard model. A total of 256 urine samples was obtained. The prevalence of SB varied between 10 and 13%, and incident infections were uncommon. Female cats were 21 times more likely to have a positive urine culture than were male cats (odds ratio [OR], 21.2; confidence interval [CI], 4.1-110; P = .00028). Subclinical bacteriuria was not significantly associated with survival. Subclinical bacteriuria is common in nonazotemic, older cats. Although antimicrobial treatment was withheld, the presence of SB was not adversely associated with survival. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  17. The Clinical Study on 39 Cases of Subclinical Hypothyroidism

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    Yu, Cheol Jae; Ahn, Weon Jeon; Lee, Houn Young; Ro, Heung Kyu [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1986-03-15

    Subclinical hypothyroidism can be defined as an asymptomatic state in which a reduction in thyroid activity has been compensated by an increased TSH output to maintain an euthyroid state. We analysed clinical features, laboratory data, and pathologic findings in 39 cases of subclinical hypothyroidism who were diagnosed at the Dept. of Internal Medicine, Chungnam National University Hospital from Aug. 1984 to June, 1985. 1) The age distribution was from sixteen to sixty-nine and mean age was 34.8. Peak incidence was in the 4th decade and 3rd, 5th, 6th decade in order. 2) The sex distribution showed female preponderance with a ratio of 18.5 to 1. 3) The major presenting manifestations were nonspecific ones such as fatigue, indigestion, and anorexia. 4) Physical examination revealed diffuse goiter in 47.6%. Major abnormalities were no gross abnormality (30.9%), nodular goiter and facial edema. 5) There was no significant difference of the basal serum T3 and T4 concentrations between subclinical hypothyroidism and normal controls (p>0.05). 6) The basal serum TSH concentration of subclinical hypothyroidism (32.61+-14.95 muU/ml) was significantly higher than that of normal controls (3.92+-1.05 muU/ml) (p<0.005). 7) Microsomal antibody was detected in 80.6% and thyroglobulin antibody was detected in 30%. 8) The pathologic findings in 26 cases revealed Hashimoto's thyroiditis in 76.9% (lymphocytic type, 34.6%; oxyphilic type, 26.9%; fibrotic type, 15.4%). The others were adenomatous goiter (15.4%), adenomatous carcinoma (3.8%) and subacute thyroiditis (3.8%).

  18. Association of Lipids with Oxidative Stress Biomarkers in Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Adriana Santi

    2012-01-01

    Full Text Available Objective. The aim of the present study was to evaluate the oxidative stress biomarkers in patients with subclinical hypothyroidism (n=20 and health controls (n=20. Subjects and Methods. Total cholesterol (TC, triglycerides (TGs, low-density lipoprotein-cholesterol (LDL-C, high-density lipoprotein cholesterol (HDL-C, thiobarbituric acid reactive substances (TBARSs, catalase (CAT, superoxide dismutase (SOD, and arylesterase (ARE were analyzed. Results. TC, LDL-C, TBARS, and CAT were higher in subclinical hypothyroidism patients, whereas SOD did not change. Arylesterase activity was significantly lower in the SH group, compared with the control group. Correlation analyses revealed the association of lipids (TC and LDL-C with both oxidative stress biomarkers and thyrotropin (TSH. Thyroid hormones were correlated only with triglyceride levels. In addition, TSH was significantly correlated with TBARS, CAT, and SOD. However, no significant correlations were observed after controlling TC levels. Conclusions. We found that SH patients are under increased oxidative stress manifested by reduced ARE activity and elevated lipoperoxidation and CAT activity. Secondary hypercholesterolemia to thyroid dysfunction and not hypothyroidism per se appears to be associated with oxidative stress in subclinical hypothyroidism.

  19. Prevalence of Pathogens Causing Subclinical Mastitis in Argentinean Dairy Herds

    Directory of Open Access Journals (Sweden)

    Silvana Andrea Dieser

    2014-01-01

    Full Text Available The objective of this study was to investigate the prevalence of different mastitis pathogens in Argentinean dairy farms. Composite milk samples were collected of 2296 cows from 51 randomly selected herds in Córdoba, Argentina. Somatic cell count was determined in all samples and bacterial examination of the milk samples with a SCC exceeding 200,000 cells/mL was performed. About 54%of cows were diagnosed with subclinical mastitis (SCC ≥200,000/mL. Bacteria were isolated in 83.1% of milk samples subjected to bacteriological analysis. The most frequently isolated pathogen was coagulase-negative staphylococci (CNS (52.1%, followed by Staphylococcus aureus (21.3%, Corynebacterium spp. (5.2%, Streptococcus agalactiae (4.4% and Streptococcus dysgalactiae (4.4%. This study demonstrates that among the major pathogens isolated, the contagious bacteria caused most of the subclinical infections of dairy cows in Cordoba, Argentina. Moreover, CNS was the most relevant group of minor pathogens causing subclinical mastitis.

  20. Serum nesfatin-1 levels in overt and subclinical hyperthyroidism.

    Science.gov (United States)

    Gungunes, A; Ozbek, M; Ginis, Z; Sahin, M; Demirci, T; Cakir Ozkaya, E; Karbek, B; Sayki Arslan, M; Ozturk Unsal, I; Tutal Akkaya, E; Ucan, B; Gultuna Ozguclu, S; Cakal, E; Topaloglu, O; Delibasi, T

    2014-09-01

    Nesfatin-1 was recently discovered anorexigenic peptide in the brain which is derived from nucleobindin-2. Central and peripheral administration of nesfatin-1, inhibits food intake, dose-dependently. Hyperthyroid patients have increased appetite and food intake with a craving for carbohydrate-rich food, at the beginning of disease, but the physiological mechanisms underlying this behavior is not known exactly. In this study, we investigated whether nesfatin-1 is involved in the regulation of appetite and body weight in hyperthyroidism, or not. A total of 70 patients with subclinical (35) and overt hyperthyroidism (35) compared with 35 control patients. Serum nesfatin-1 level was measured from all samples by commercial ELISA kit. Serum nesfatin-1 levels were similar between three groups (P=0.293). After adjusting for age and body mass index, nesfatin-1 levels in control group was not different from subclinical and overt hyperthyroid group, respectively (P=0.567 and P=0.519). These data showed that serum nesfatin-1 levels do not significant change in overt and subclinical hyperthyroidism.

  1. Effect of whole grains on markers of subclinical inflammation.

    Science.gov (United States)

    Lefevre, Michael; Jonnalagadda, Satya

    2012-07-01

    The reduction of subclinical inflammation has been suggested as a potential mechanism to explain the favorable association between whole-grain consumption and reduced risk for cardiovascular disease, diabetes, and certain cancers. This review examines evidence for the effects of whole-grain consumption on markers of subclinical inflammation derived from 13 epidemiological and 5 interventional studies retrieved from a search of the PubMed database. Epidemiological studies provide reasonable support for an association between diets high in whole grains and lower C-reactive protein (CRP) concentrations. After adjusting for other dietary factors, each serving of whole grains is estimated to reduce CRP concentrations by approximately 7%. In contrast to epidemiological studies, interventional studies do not demonstrate a clear effect of increased whole-grain consumption on CRP or other markers of inflammation. Issues related to insufficient length of intervention, extent of dietary control, population selection, types of whole grains, and lack of a direct anti-inflammatory effect may underlie these discrepant findings. Additional carefully controlled interventional studies are needed to clarify the effects of whole grains on subclinical inflammation.

  2. Treatment of Subclinical Hypothyroidism or Hypothyroxinemia in Pregnancy.

    Science.gov (United States)

    Casey, Brian M; Thom, Elizabeth A; Peaceman, Alan M; Varner, Michael W; Sorokin, Yoram; Hirtz, Deborah G; Reddy, Uma M; Wapner, Ronald J; Thorp, John M; Saade, George; Tita, Alan T N; Rouse, Dwight J; Sibai, Baha; Iams, Jay D; Mercer, Brian M; Tolosa, Jorge; Caritis, Steve N; VanDorsten, J Peter

    2017-03-02

    Background Subclinical thyroid disease during pregnancy may be associated with adverse outcomes, including a lower-than-normal IQ in offspring. It is unknown whether levothyroxine treatment of women who are identified as having subclinical hypothyroidism or hypothyroxinemia during pregnancy improves cognitive function in their children. Methods We screened women with a singleton pregnancy before 20 weeks of gestation for subclinical hypothyroidism, defined as a thyrotropin level of 4.00 mU or more per liter and a normal free thyroxine (T4) level (0.86 to 1.90 ng per deciliter [11 to 24 pmol per liter]), and for hypothyroxinemia, defined as a normal thyrotropin level (0.08 to 3.99 mU per liter) and a low free T4 level (hypothyroidism underwent randomization at a mean of 16.7 weeks of gestation, and 526 with hypothyroxinemia at a mean of 17.8 weeks of gestation. In the subclinical hypothyroidism trial, the median IQ score of the children was 97 (95% confidence interval [CI], 94 to 99) in the levothyroxine group and 94 (95% CI, 92 to 96) in the placebo group (P=0.71). In the hypothyroxinemia trial, the median IQ score was 94 (95% CI, 91 to 95) in the levothyroxine group and 91 (95% CI, 89 to 93) in the placebo group (P=0.30). In each trial, IQ scores were missing for 4% of the children. There were no significant between-group differences in either trial in any other neurocognitive or pregnancy outcomes or in the incidence of adverse events, which was low in both groups. Conclusions Treatment for subclinical hypothyroidism or hypothyroxinemia beginning between 8 and 20 weeks of gestation did not result in significantly better cognitive outcomes in children through 5 years of age than no treatment for those conditions. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke; ClinicalTrials.gov number, NCT00388297 .).

  3. Heart rate and blood pressure response to exercise and recovery in subclinical hypothyroid patients

    OpenAIRE

    Sunita,; Mahajan, Aarti Sood; Jain, AK; Singh, NP; Mishra, TK

    2013-01-01

    Background: Exercise response of asymptomatic subclinical hypothyroid patients may aid in early diagnosis of cardiovascular morbidity. Aim: To study and compare the heart rate and blood pressure changes during exercise and recovery in subclinical hypothyroid patients and euthyroid controls. Materials and Methods: For the study, 30 each cases (mean age of 40 ± 7 years) of subclinical hypothyroidism and healthy controls underwent exercise as per Bruce protocol. Heart rate (HR) and blood pressur...

  4. Subclinical depression in Urban Indian adolescents: Prevalence, felt needs, and correlates

    OpenAIRE

    Singhal, Meghna; Manjula, M.; Vijay Sagar, K. John

    2016-01-01

    Background: Subclinical depression in adolescents constitutes a risk factor for future clinical depression and hence warrants examination. However, there is a paucity of research that documents subclinical depression among adolescents in India. Objectives: (a) To investigate the prevalence of subclinical depression in urban school-going adolescents; (b) to investigate the problems and felt needs of these adolescents; (c) to examine depression-related variables; and (d) to examine the relation...

  5. Subclinical endometritis in Zebu x Friesian crossbred dairy cows: its risk factors, association with subclinical mastitis and effect on reproductive performance.

    Science.gov (United States)

    Bacha, Belachew; Regassa, Fekadu Gudeta

    2010-03-01

    A study was carried out on 59 clinically healthy Zebu x Friesian crossbred cows to determine the prevalence of subclinical endometritis, associated factors and its effect on the reproductive performance. Subclinical endometritis was diagnosed by endometrial cytology using uterine lavege technique and subclinical mastitis using CMT. The clinical, management and reproductive data were obtained from a weekly follow up visit of each cow for a period of 6 months after calving. The prevalence of subclinical endometritis, with > or =5% neutrophil count, was 47.5% and 30.5% at week 4 and 8, significantly decreasing (P = 0.002) as postpartum period advanced. Body condition score at week 4 postpartum (OR = 4.5, P = 0.017) and regular cow exercise (OR = 4.8, P = 0.026) were the significant risk factors while post-calving hygiene (P = 0.06) was poorly associated. Subclinical endometritis was also directly associated with subclinical mastitis at both week 4 (OR = 4.5, P = 0.012) and 8 (OR = 3.6, P = 0.031) postpartum. The risk of first service pregnancy (OR = 5.1, P = 0.004) was higher in cows negative for subclinical endometritis at week 8 postpartum and the proportion of cows that required more than 3 services was higher in cows with uterine inflammation. Also the proportion of cows diagnosed pregnant within 180 DIM was higher in cows with normal uterus at both week 4 (OR = 10.3, P = 0.001) and week 8(OR = 21.8, P = 0.001). These results indicated that subclinical endometritis was directly associated with poor body condition and subclinical mastitis and that it had negative effect on reproductive traits of dairy cows. This association may also reflect the possibility of translocation of bacteria/bacterial products from the uterus to the udder or vic-versa or else the presence of common cause for both endometritis and mastitis.

  6. Acute phase proteins in the diagnosis of bovine subclinical mastitis.

    Science.gov (United States)

    Safi, Shahabeddin; Khoshvaghti, Ameneh; Jafarzadeh, Seyed Reza; Bolourchi, Mahmoud; Nowrouzian, Iradj

    2009-12-01

    The California mastitis test (CMT) and somatic cell count (SCC) are commonly used for diagnosis of subclinical mastitis in cattle. Acute phase proteins (APPs), as alternative biomarkers of mastitis, may increase in concentration in the absence of macroscopic changes in the milk, or may precede the onset of clinical signs. The aim of this study was to compare the accuracy of APPs measured in milk and in serum with bacterial culture for the diagnosis of bovine subclinical mastitis. One hundred and seventy-five Holstein cows were randomly selected from 7 dairy farms. Quarter milk and serum samples were taken from all cows. Milk samples were analyzed using a CMT and SCC, and for haptoglobin (MHp) and amyloid A (MAA) concentrations, and were also submitted for bacterial culture. Serum samples obtained concurrently were analyzed for haptoglobin (SHp) and amyloid A (SAA). Two-sample Wilcoxon (Mann-Whitney) test was used to compare SCC, MAA, MHp, SAA, and SHp concentrations between culture-positive and culture-negative animals. Receiver-operating characteristic analysis was used to assess the performance of each test using bacterial culture as the reference method. MAA concentration was the most accurate of the 5 tests, with a sensitivity of 90.6% and specificity of 98.3% at concentrations >16.4 mg/L. MAA and MHp had significantly larger areas under the curve than the respective serum proteins, SAA and SHp. The results suggest that measuring haptoglobin and amyloid A in milk is more accurate than serum analysis for the diagnosis of subclinical mastitis in Holstein cows.

  7. Using milk leukocyte differentials for diagnosis of subclinical bovine mastitis.

    Science.gov (United States)

    Gonçalves, Juliano Leonel; Lyman, Roberta L; Hockett, Mitchell; Rodriguez, Rudy; Dos Santos, Marcos Veiga; Anderson, Kevin L

    2017-08-01

    This research study aimed to evaluate the use of the milk leukocyte differential (MLD) to: (a) identify quarter milks that are culture-positive; and (b) characterize the milk leukocyte responses to specific groups of pathogens causing subclinical mastitis. The MLD measures the absolute number and relative percentage of inflammatory cells in milk samples. Using the MLD in two dairy herds (170 and 172 lactating cows, respectively), we studied all lactating cows with a most recent monthly Dairy Herd Improvement Association somatic cell count (SCC) >200 × 103 cells/ml. Quarter milk samples from 78 cows meeting study criteria were analysed by MLD and aseptically collected milk samples were subjected to microbiological culture (MC). Based upon automated instrument evaluation of the number and percentage of inflammatory cells in milk, samples were designated as either MLD-positive or - negative for subclinicial mastitis. Positive MC were obtained from 102/156 (65·4%) of MLD-positive milk samples, and 28/135 (20·7%) of MLD-negative milk samples were MC-positive. When MC was considered the gold standard for mastitis diagnosis, the calculated diagnostic Se of the MLD was 65·4% (IC95% = 57·4 to 72·8%) and the Sp was 79·3% (IC95% = 71·4 to 85·7%). Quarter milks positive on MC had higher absolute numbers of neutrophils, lymphocytes and macrophages, with higher neutrophils% and lymphocytes% but lower macrophages%. The Log10 (N/L) ratios were the most useful ratio to differentiate specific subclinical mastitis quarters from healthy quarters. Use of the MLD on cows with monthly composite SCC > 200 × 103 cells/ml for screening at quarter level identified quarters more likely to be culture-positive. In conclusion, the MLD can provide an analysis of mammary quarter status more detailed than provided by SCC alone; however, the MLD response to subclinical mastitis was not found useful to specifically identify the causative pathogen.

  8. Insulin Resistance and Glucose Levels in Subjects with Subclinical Hypothyroidism.

    Science.gov (United States)

    Khan, Sikandar Hayat; Fazal, Nadeem; Ijaz, Aamir; Manzoor, Syed Mohsin; Asif, Naveed; Rafi, Tariq; Yasir, Muhammad; Niazi, Najmusaquib Khan

    2017-06-01

    To compare insulin resistance and glycemic indicators among subjects with euthyroidism and subclinical hypothyroidism. Comparative cross-sectional study. Department of Pathology and Medicine, PNS Hafeez, Islamabad, in collaboration with the Department of Chemical Pathology and Endocrinology at the Armed Forces Institute of Pathology (AFIP), Rawalpindi, from December 2015 to September 2016. Subjects referred for executive screening of apparently healthy population (without any known history of diabetes, hypertension, heart disease or other chronic ailments), were included. Subjects were grouped as euthyroidism and subclinical hypothyroidism. Median (IQR) insulin resistance indices including fasting insulin and Homeostasis Model Assessment for Insulin Resistance in subjects with group-1 (n=176, 87%, Thyroid Stimulating Hormone: 0.5 - 3.5 mIU/L) and group-2 (n=26, 13%, Thyroid Stimulating Hormone: 3.51 - 15 mIU/L) were 7.6 (6.70) vs. 11.4 (13.72, p=0.040) and 1.77 (1.79) vs. 2.8 (3.07, p=0.071). The median differences for fasting plasma glucose were 5.0 (1.0) in group-1 vs. 5.0 (1.47) for Group-2 [p=0.618], and glycated hemoglobin was 5.60 (1.1) vs. 5.60 (1.7, p=0.824). Homeostasis Model Assessment for beta sensitivity index in paradox showed slightly higher values for group-2 [median (IQR) 86.67 (92.94)] than group-1 [111.6 (189.64, p= 0.040)]. Measures of insulin resistance including Homeostasis Model Assessment for Insulin Resistance and fasting insulin levels were significantly different between subjects with euthyroidism and having subclinical hypothyroidism.

  9. Cardiovascular risk factors in patients with subclinical hypothyroidism

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    Pešić Milica

    2007-01-01

    Full Text Available Background/Aims. Overt hypothyroidism is disease associated with accelerated arteriosclerosis and coronary heart disease. Whether subclinical hypothyroidism (SH is associated with increased cardiovascular risk is contraversial. As SH is a high prevalence thyroid dysfunction, specially in older women, it is important to evaluate cardiovascular risk factors in these patients and that was the aim of this study. Methods. We examined 30 patients with SH and 20 healthy controls. Subclinical hypothireoidism was defined as an elevated thyrotropin (TSH (> 4.5 mU/L and normal free thyroxine (FT4 level. In all the participants we determined body mass index (BMI, blood pressure, TSH, FT4, antibodies to thyroid peroxidase, antibodies to thyroglobulin, total cholesterol, high density lipoprotein (HDL cholesterol, low density lipoprotein (LDL cholesterol, triglicerides, total cholesterol/HDL cholesterol ratio and LDL/HDL cholesterol ratio. Results. Mean BMI in patients with SH was significantly higher (p < 0.05, as well as diastolic blood pressure (p < 0.01 compared with the controls. Average levels of total cholesterol (5.40±0.62 vs 5.06±0.19 mmol/l, p < 0.01 and triglycerides (2.16±0.56 vs 1.89±0.24 mmol/l, p < 0.05 were also significantly higher in the group with SH. Individual analysis revealed that the percentage of patients with SH having borderline elevated total cholesterol (63.33%, hypertrigliceridemia (43.33% and elevated total cholesterol/HDL cholesterol ratio (26.67% were significantly higher than the percentage in the controls. No significant correlation between TSH and lipid parameters was detected. Conclusion. Subclinical hypothyroidism was associated with higher BMI, diastolic hypertension, higher total cholesterol and triglicerides levels and higher total cholesterol/HDL cholesterols ratio. This might increase the risk of accelerated arteriosclerosis in patients with SH.

  10. Hemodynamic changes after levothyroxine treatment in subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Faber, J; Petersen, L; Wiinberg, N

    2002-01-01

    In hypothyroidism, lack of thyroid hormones results in reduced cardiac function (cardiac output [CO]), and an increase of systemic vascular resistance (SVR). We speculated whether hemodynamic regulation in subjects with subclinical hypothyroidism (SH) (defined as mildly elevated thyrotropin [TSH.......05). These changes were qualitatively similar but quantitatively less pronounced than in 15 women with overt hypothyroidism, also studied. Taking the two groups together (n = 31), pretreatment thyroid function (expressed as either TSH or free T(4) estimate) correlated to CO and SVR as well as the changes induced...... by LT(4) (p hypothyroidism should...

  11. [Subclinical interstitial lung disease associated with rheumatoid arthritis].

    Science.gov (United States)

    Bestaev, D V

    2014-01-01

    Interstitial lung disease (ILD) in rheumatoid arthritis (RA) is its extra-articular manifestation. At the same time, ILD considerably worsens the prognosis of the disease. Mortality rates for interstitial pulmonary fibrosis are 6% of all-cause mortality in RA patients. ILD can be identified by clinical examination only in 2-6% of cases, by plain chest X-ray in 1-6%, and by high-resolution computed tomography in 50-60%. The paper deals with subclinical ILD and discusses the state-of-the-art of investigations in this area.

  12. California mastitis test in the diagnostic of subclinical mastitis

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    Adna Crisléia Rodrigues Monção de Lima

    2013-12-01

    Full Text Available Milk production in Brazil is undoubtedly one of the most important Brazilian agroindustrial complex. Moves large sums of money, the dairy industry employs millions of the people, having potential to provide the domestic and foreign markets. Besides surpassing year by year the index production. The quality of milk is increasingly demanded by consumers and there are bonus programs for milk with low somatic cell counts, which reveal, indirectely, the udder sanity. Mastitis, the udder inflamation, is the main factor that substantially compromises the milk quality. Several methods can diagnose the incidence of subclinical mastitis in dairy herds. One these methods, the California Mastitis Test (CMT has as advantages being practical, low cost and the results are immediately available. The CMT method consists of adding the anionic neutral detergent to a milk sample in order to disrupt milk somatic cell membranes and release nucleic material. The viscousity formed by this reaction allows estimating the number of somatic cells (immunity cells presents in the milk. According to the degree of gelatinization obtained in this reaction, the interpretation of the scores varies from zero, no viscosity, to three crosses, highly viscous. This study was aimed to evaluate the CMT of eight dairy herds of different farms in Sao Paulo state, described by the letters A to H. The scores 1, 2 and 3 were considered positive for subclinical mastitis, while 0 was negative. The results were determined in relative frequency (%. It is evident that the herd D is the most affected by subclinical mastitis, because of the greater number of CMT positive (60%. This may be due to the mismanagement and poor conditions of milking. The properties C, F and G require greater attention, as the result of CMT could corroborate the presence of pathogenic microorganisms and infected cows can quickly transmit the infection to the healthy ones. Note that the farms A, B and H are the ones with

  13. Depressive and anxiety disorders and risk of subclinical atherosclerosis Findings from the Netherlands Study of Depression and Anxiety (NESDA)

    NARCIS (Netherlands)

    Seldenrijk, Adrie; Vogelzangs, Nicole; van Hout, Hein P. J.; van Marwijk, Harm W. J.; Diamant, Michaela; Penninx, Brenda W. J. H.

    2010-01-01

    Objective: Current evidence regarding the association between psychopathology and subclinical atherosclerosis show inconsistent results. The present study examined whether subclinical atherosclerosis was more prevalent in a large cohort of persons with depressive or anxiety disorders as compared to

  14. Subclinical avian influenza A(H5N1) virus infection in human, Vietnam.

    Science.gov (United States)

    Le, Mai Quynh; Horby, Peter; Fox, Annette; Nguyen, Hien Tran; Le Nguyen, Hang Khanh; Hoang, Phuong Mai Vu; Nguyen, Khanh Cong; de Jong, Menno D; Jeeninga, Rienk E; Rogier van Doorn, H; Farrar, Jeremy; Wertheim, Heiman F L

    2013-10-01

    Laboratory-confirmed cases of subclinical infection with avian influenza A(H5N1) virus in humans are rare, and the true number of these cases is unknown. We describe the identification of a laboratory-confirmed subclinical case in a woman during an influenza A(H5N1) contact investigation in northern Vietnam.

  15. FEATURES PREGNANCY AND BIRTH OUTCOMES IN PATIENTS WITH SUBCLINICAL HYPOTHYROIDISM, LIVING IN THE FAR NORTH

    Directory of Open Access Journals (Sweden)

    Елена Николаевна Кравченко

    2017-02-01

    Results. The medication correction of subclinical hypothyroidism in pregnant women in extreme north indicated less thyroid gland, than in women without medication correcting this condition. In newborns of mothers with subclinical hypothyroidism, there has been an increase in the size of the thyroid gland and reduced Apgar score.

  16. Stochastic modelling to evaluate the economic efficiency of treatment of chronic subclinical mastitis

    NARCIS (Netherlands)

    Steeneveld, W.; Hogeveen, H.; Borne, van den B.H.P.; Swinkels, J.M.

    2006-01-01

    Treatment of subclinical mastitis is traditionally no common practice. However, some veterinarians regard treatment of some types of subclinical mastitis to be effective. The goal of this research was to develop a stochastic Monte Carlo simulation model to support decisions around treatment of chron

  17. Stochastic modelling to evaluate the economic efficiency of treatment of chronic subclinical mastitis

    NARCIS (Netherlands)

    Steeneveld, W.; Hogeveen, H.; Borne, van den B.H.P.; Swinkels, J.M.

    2006-01-01

    Treatment of subclinical mastitis is traditionally no common practice. However, some veterinarians regard treatment of some types of subclinical mastitis to be effective. The goal of this research was to develop a stochastic Monte Carlo simulation model to support decisions around treatment of

  18. Relationship between beta lactoglobulin and subclinical mastitis in Valle del Belice sheep breed

    NARCIS (Netherlands)

    Gigli, I.; Riggio, V.; Monteleone, G.; Cacioppo, D.; Rosa, A.J.M.; Maizon, D.O.

    2007-01-01

    The objective of the following research was to determine the effect of LGB genotypes on subclinical mastitis in Valle del Belice dairy sheep. Ewes were classified as affected or not by subclinical mastitis within a lactation based on i) a positive culture in one of the test-days and ii) more than 75

  19. Risk factors for subclinical inflammation in children with Familial Mediterranean fever.

    Science.gov (United States)

    Bayram, Meral Torun; Çankaya, Tufan; Bora, Elçin; Kavukçu, Salih; Ülgenalp, Ayfer; Soylu, Alper; Türkmen, Mehmet

    2015-08-01

    Familial Mediterranean fever (FMF) is the most common autosomal recessive inherited inflammatory disease characterized by attacks of painful inflammation. Some patients with FMF have subclinical inflammation persisting between the attacks. We aimed to identify the demographic, clinical and genetic risk factors for subclinical inflammation in children with FMF. The medical records of the children with FMF were evaluated retrospectively for acute-phase response along with gender, age at the onset of symptoms and at the time of diagnosis, clinical signs and symptoms, the presence of amyloidosis and MEFV genotype. Patients with persistently elevated acute-phase response between the attacks were considered to have subclinical inflammation. Patients with or without subclinical inflammation (Group 1 and Group 2, respectively) were compared for the parameters defined above. Independent risk factors for subclinical inflammation were identified by multivariate logistic regression analysis. There were 105 children (male/female: 52/53) who were compliant on colchicine treatment. Subclinical inflammation was detected in 22 (20 %) patients. Group 1 had significantly higher rate of myalgia, arthritis/arthralgia, erysipelas like erythema, amyloidosis, protracted febrile myalgia and M694V mutation compared with Group 2. However, only the presence of myalgia and erysipelas like erythema were found to be independent risk factors for subclinical inflammation (OR 9.8 and 5.9, respectively). Children with FMF who have myalgia and erysipelas like erythema during the attacks are particularly at risk of ongoing inflammation and should be closely monitored for subclinical inflammation even during attack-free periods.

  20. Femoral and carotid subclinical atherosclerosis association with risk factors and coronary calcium: the AWHS study

    Science.gov (United States)

    BACKGROUND: Early subclinical atherosclerosis has been mainly researched in carotid arteries. The potential value of femoral arteries for improving the predictive capacity of traditional risk factors is an understudied area. OBJECTIVES: This study sought to evaluate the association of subclinical ca...

  1. Subclinical Hypothyroidism after 131I-Treatment of Graves' Disease: A Risk Factor for Depression?

    Directory of Open Access Journals (Sweden)

    Jing Yu

    Full Text Available Although it is well accepted that there is a close relationship between hypothyroidism and depression, previous studies provided inconsistent or even opposite results in whether subclinical hypothyroidism (SCH increased the risk of depression. One possible reason is that the etiology of SCH in these studies was not clearly distinguished. We therefore investigated the relationship between SCH resulting from 131I treatment of Graves' disease and depression.The incidence of depression among 95 patients with SCH and 121 euthyroid patients following 131I treatment of Graves' disease was studied. The risk factors of depression were determined with multivariate logistic regression analysis. Thyroid hormone replacement therapy was performed in patients with thyroid-stimulating hormone (TSH levels exceeding 10 mIU/L.Patients with SCH had significantly higher Hamilton Depression Scale scores, serum TSH and thyroid peroxidase antibody (TPOAb levels compared with euthyroid patients. Multivariate logistic regression analysis revealed SCH, Graves' eye syndrome and high serum TPO antibody level as risk factors for depression. L-thyroxine treatment is beneficial for SCH patients with serum TSH levels exceeding 10 mIU/L.The results of the present study demonstrated that SCH is prevalent among 131I treated Graves' patients. SCH might increase the risk of developing depression. L-thyroxine replacement therapy helps to resolve depressive disorders in SCH patients with TSH > 10mIU/L. These data provide insight into the relationship between SCH and depression.

  2. Glycemic index role on visceral obesity, subclinical inflammation and associated chronic diseases

    Directory of Open Access Journals (Sweden)

    Patricia Feliciano Pereira

    2014-08-01

    Full Text Available Background: It is believed that the glycemic index (GI may be used as a strategy to prevent and control noncommunicable diseases (NCD. Obesity is a multifactorial condition, a risk factor for development of other NCDs. Among the different types, abdominal obesity is highlighted, which is essential for the diagnosis of metabolic syndrome, and it is related to insulin resistance, dyslipi-demia, hypertension and changes in levels of inflammatory markers. Such indicators are closely related to the development of Type 2 Diabetes and cardiovascular disease. Objectives: Discuss the role of GI as a strategy for the prevention and/or treatment of visceral obesity, subclinical inflammation and chronic diseases. Results and discussion: The intake of low GI diets is associated with glycemic decreases, and lower and more consistent postprandial insulin release, avoiding the occurrence of hypoglycemia. Moreover, consumption of a low GI diet has been indicated as beneficial for reducing body weight, total body fat and visceral fat, levels of proinflammatory markers and the occurrence of dyslipidemia and hypertension. The intake of low GI foods should be encouraged in order to prevent and control non-communicable diseases.

  3. Subclinical nigrostriatal dopaminergic denervation in the cerebellar subtype of multiple system atrophy (MSA-C).

    Science.gov (United States)

    Muñoz, Esteban; Iranzo, Alex; Rauek, Sebastian; Lomeña, Francisco; Gallego, Judith; Ros, Doménec; Santamaría, Joan; Tolosa, Eduardo

    2011-12-01

    Nigrostriatal involvement is considered an additional feature in the new consensus criteria for the diagnosis of the cerebellar variant of multiple system atrophy (MSA-C). However, so far, only a few studies, which include a relative small number of patients, give support to this criterion. Our objective was to assess nigrostriatal dopaminergic innervation in patients with MSA-C without parkinsonism by use of dopamine transporter single photon emission computed tomography (DAT SPECT). Thirteen patients that fulfilled criteria for possible or probable MSA-C and presented no parkinsonian signs, and 12 age-matched healthy controls underwent ((123)I-2-β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane ([(123)I]FP-CIT) SPECT. Patients were also evaluated through the Unified Multiple System Atrophy Rating Scale (UMSARS) and brain magnetic resonance imaging (MRI). The mean duration of the cerebellar syndrome was 3.8 ± 1.7 years. DAT SPECT showed a significant decrease of striatal [(123)I]FP-CIT uptake ratios in patients (p MSA-C patients without parkinsonism have subclinical nigrostriatal dopaminergic denervation which is not related to disease duration, cerebellar dysfunction, or pontine atrophy.

  4. Non-autoimmune subclinical hypothyroidism due to a mutation in TSH receptor: report on two brothers

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    Cerbone Manuela

    2013-01-01

    Full Text Available Abstract Subclinical hypothyroidism (SH is a condition characterized by a mild persistent thyroid failure. The main cause is represented by autoimmune thyroiditis, but mutations in genes encoding proteins involved in TSH pathway are thought to be responsible for SH, particularly in cases arising in familial settings. Patients with the syndrome of TSH unresponsiveness may have compensated or overt hypothyroidism with a wide spectrum of clinical and morphological alterations depending on the degree of impairment of TSH-receptor (TSH-R function. We describe the case of two brothers with non autoimmune SH carrying the same heterozygous mutation in the extracellular domain of TSH-R and presenting with different clinical, biochemical and morphological features. The first one had only a slight persistent elevation of TSH, a normal thyroid ultrasound and did never require l- thyroxine (L-T4 replacement treatment. The second one had a neonatal persistent moderate TSH levels increase associated with a thyroid gland hypoplasia and was treated with L-T4 since the first months of life. These two cases support the recent association of TSH-R mutations inheritance as an autosomal dominant pattern with variable expressivity and suggest that the decision to start replacement therapy in patients with persistent SH due to TSH resistance should be individualized.

  5. Subclinical mastitis causes alterations in nitric oxide, total oxidant and antioxidant capacity in cow milk.

    Science.gov (United States)

    Atakisi, Onur; Oral, Hasan; Atakisi, Emine; Merhan, Oguz; Metin Pancarci, S; Ozcan, Ayla; Marasli, Saban; Polat, Bulent; Colak, Armagan; Kaya, Semra

    2010-08-01

    The aim of this study was to investigate total antioxidant (TAC), and oxidant capacity (TOC) and nitric oxide (NO) levels in milk of cows with subclinical mastitis. Brown Swiss and Holstein breed cows were screened with California Mastitis Test (CMT) to determine mammary glands with subclinical mastitis. Moreover, somatic cell counts (SCC) were determined electronically in all milk samples. Mammary quarters were classified as healthy (n=25) or subclinical mastitis (n=35) based on CMT scores and somatic cell count (SCC: 200,000/ml) in milk. Nitric oxide, TOC and SCC levels were significantly higher (pmastitis compared to those from healthy mammary quarters. In conclusion, subclinical mastitis results in higher NO concentrations, TOC and SCC, and NO and TOC were positively correlated with SCC. Moreover, alterations in NO levels and TOC in milk could be used as an alternative diagnostic tool to screen for subclinical mastitis. Copyright 2010 Elsevier Ltd. All rights reserved.

  6. Changing axis deviation and paroxysmal atrial flutter associated with subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-10-08

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Rarely, it has also been reported intermittent changing axis deviation during atrial fibrillation and during atrial flutter. We present a case of paroxysmal atrial flutter and changing axis deviation associated with subclinical hyperthyroidism, in a 76-year-old Italian man. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  7. Level of agency in sub-clinical checking.

    Science.gov (United States)

    Belayachi, S; Van der Linden, M

    2009-03-01

    This study examined cognitive representations of routine action, through the assessment of level of agency, in individuals with sub-clinical checking. The level of agency stems from Action Identification Theory [Vallacher, R. R., Wegner, D. M. (1989). Levels of personal agency: Individual variation in action identification. Journal of Personality and Social Psychology 57, 660-671], which states that how actions are usually identified (based on instrumental aspects or purpose) reflects the predominant accessibility of internal representation (movements executed vs. goal pursued). Furthermore, this framework proposed that altered action regulation is related to low-level of agency (i.e., action identification at an instrumental level). In the current study, the main result indicated that checking symptoms were related to a low-level of agency, that is, individuals with sub-clinical checking identified habitual actions on the basis of instrumental aspects. This seems to indicate that checkers may act with a lack of goal representations. The results are discussed in terms of the role of low-level of agency in checking phenomena and related cognitive dysfunction.

  8. The prevalence of subclinical mastitis in dairy goats in Kenya.

    Science.gov (United States)

    Ndegwa, E N; Mulei, C M; Munyua, S J

    2000-03-01

    California mastitis test (CMT), direct leukocytes counts and bacteriological examination were performed on 630 milk samples from apparently healthy mammary glands of dairy goats comprising a mixed population of German Alpine, Toggenberg, Saanen and Galla crosses to find the prevalence of subclinical mastitis. The prevalence of subclinical mastitis was 9.8% according to CMT, 9.7% according to direct leukocyte counts and 28.7% by bacterial isolation during a 3-month period. The proportion of the bacteriologically positive milk samples was significantly (P CMT and direct leukocyte counts. There was a significant (P CMT and direct leukocyte counts. There was no significant direct relationship between bacterial isolation and CMT Bacterial organisms were isolated in 22.5% of the 568 CMT-negative milk samples. The results suggest that bacterial organisms isolated from the CMT-negative milksamples were either latent infections or did not stimulate any significant increase in somatic cell counts that could be detected by either the CMT or direct leukocyte counts. The observations of this study indicate that the mere presence of bacteria in goat's milk does not mean that the udder is infected and so does not warrant antibiotic therapy.

  9. Prevalence and aetiology of subclinical mastitis in goats

    Directory of Open Access Journals (Sweden)

    Igor Štoković

    2010-01-01

    Full Text Available The study was conducted in 2006 on 20 French alpine goat farms in Croatia. Milk samples were taken from each udder half, for the mastitis test and the bacteriological test, 2120 samples in total. Subclinical mastitis was diagnosed in 211 out of 1060 goats, or in 20% of the studied population. Mastitis of one udder half was diagnosed in 84% of the affected population, while mastitis of both udder halves was diagnosed in 16% of the affected goats. A positive mastitis test reaction was identified in 605 samples (28%, and the pathogenic bacterium was isolated from 244 of these samples (36%. From 22 samples (1.5% which were negative to mastitis test, pathogenic bacteria, namely S. aureus (21 samples and Streptococcus D (1 sample, were isolated. Staphylococcus aureus was isolated from 72% mastitis test positive samples, coagulase-negative staphylococci in 16%, other bacteria were isolated from a smaller number of samples: Streptococcus D (6%, Bacillus spp. (2%, and E. coli (2%. The results of the study lead to the conclusion that the subclinical mastitis in goats has a prevalence of 20% on average which increases with higher lactation number. Staphylococcus aureus is the primary causative agent of the inflammations.

  10. Recognition memory for pictorial material in subclinical depression

    Science.gov (United States)

    Ramponi, Cristina; Murphy, Fionnuala C.; Calder, Andrew J.; Barnard, Philip J.

    2010-01-01

    Depression has been associated with impaired recollection of episodic details in tests of recognition memory that use verbal material. In two experiments, the remember/know procedure was employed to investigate the effects of dysphoric mood on recognition memory for pictorial materials that may not be subject to the same processing limitations found for verbal materials in depression. In Experiment 1, where the recognition test took place two weeks after encoding, subclinically depressed participants reported fewer know judgements which were likely to be at least partly due to a remember-to-know shift. Although pictures were accompanied by negative or neutral captions at encoding, no effect of captions on recognition memory was observed. In Experiment 2, where the recognition test occurred soon after viewing the pictures, subclinically depressed participants reported fewer remember judgements. All participants reported more remember judgements for pictures of emotionally negative content than pictures of neutral content. Together, these findings demonstrate that recognition memory for pictorial stimuli is compromised in dysphoric individuals in a way that is consistent with a recollection deficit for episodic detail and also reminiscent of that previously reported for verbal materials. These findings contribute to our developing understanding of how mood and memory interact. PMID:20728865

  11. Subclinical leptospirosis may impair athletic performance in racing horses.

    Science.gov (United States)

    Hamond, Camila; Martins, Gabriel; Lilenbaum, Walter

    2012-12-01

    The infection by Leptospira in horses, in both its acute disease and subclinical forms, is very common, particularly in endemic regions. Therefore, the objective of this study was to evaluate the effects of subclinical leptospirosis in the athletic performance of racing thoroughbred horses. Athletic performance of 119 racing Thoroughbred horses from Rio de Janeiro, Brazil, was calculated by assigning a point value for the results in racing (performance index (PI)), and serology for leptospirosis was conducted. A total of 85 (71.4 %) horses showed reactive titers (≥ 100), and of which 52 had high titers (34 with 400 and 18 with ≥ 800). Although those animals had high titers against Leptospira, no clinical signs associated with leptospirosis were observed. Seventeen (89.5 %) out of the 19 horses with substandard performance were seroreactive with high titers, in contrast with 35 % of seroreactivity in horses with good athletic performance (P horses with substandard athletic performance in contrast to those with good performance (P racing horses, and antibiotic therapy may improve the performance of affected animals.

  12. Use of thermography to screen for subclinical bumblefoot in poultry.

    Science.gov (United States)

    Wilcox, C S; Patterson, J; Cheng, H W

    2009-06-01

    Thermographic imaging is a noninvasive diagnostic tool used to document the inflammatory process in many species and may be useful in the detection of subclinical bumblefoot and other inflammatory diseases. Bumblefoot is a chronic inflammation of the plantar metatarsal or digital pads of the foot (pododermatitis), or both. It is one of the major health problems in birds including chickens and is responsible for significant economic losses in commercial poultry operations. Early diagnosis of bumblefoot is essential for the prevention of economical loss and the improvement of animal well-being. The object of this study was to determine the suitability of thermography for the identification of subclinical bumblefoot in chickens. Experiment 1 was designed to validate thermography as a tool for screening avian populations for bumblefoot. The plantar surface of the feet of 150 randomly selected hens was imaged using a thermal camera. The thermal images were identified as suspect, positive, or negative for bumblefoot based on thermal patterns of the plantar surface. Visual inspection of the feet identified as suspect followed 14 d later. A visual score of clinical, mildly clinical, or negative for bumblefoot was assigned, based on gross pathological changes in the plantar surface. A correlation between initial thermal images identified as suspect for bumblefoot and a visual score of positive 14 d later was 83% (P bumblefoot was 86.7% (P bumblefoot, early in the course of the disease, which will improve recovery percentages and bird well-being.

  13. MULTIVARIATE ANALYSIS OF RELATIONSHIPS BETWEEN IODINE BIOLOGICAL EXPOSURE AND SUBCLINICAL THYROID DYSFUNCTIONS

    Institute of Scientific and Technical Information of China (English)

    Wei Chong; Zhong-yan Shan; Wei Sun; Wei-ping Teng

    2005-01-01

    Objective To assess the relationships between iodine biological exposure and subclinical thyroid dysfunctions. Methods The cross-sectional survey was performed to obtain the epidemiologic data of population in three communities with different iodine biological exposure: mild iodine deficiency [median urinary iodine concentration (MUI) of 50 99g/L], more than adequate iodine intake (MUI of 200-299 μg/L), and excessive iodine intake (MUI over 300 μg/L). Univariate and multivariate analysis (logistic regression analysis) were used to analyze the risk factors of subclinical hypothyroidism and subclinical hyperthyroidism. Results Logistic regression analysis with sex and age controlled suggested that more than adequate iodine intake (OR = 3.172, P = 0.0004) and excessive iodine intake (OR = 6.391, P = 0.0001) increased the risk of subclinical hypothyroidism, while excessive iodine intake decreased the risk of subclinical hyperthyroidism (OR = 0.218, P= 0.0001). Logistic regression analysis including interaction of iodine intake and antibodies [tryroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb)] suggested that excessive iodine intake was an independent risk factor of subclinical hypothyroidism (OR = 6.360, P = 0.0001), but independent protect factor of subclinical hyperthyroidism (OR = 0.193, P = 0.0001). More than adequate iodine intake and it's interaction with TgAb increased the risk of subclinical hypothyroidism independently, in addition, it decreased the risk of subclinical hyperthyroidism at the present of TPOAb. Conclusion Both excessive iodine intake and more than adequate iodine intake could increase risk of subclinical hypo thyroidism, supplement of iodine should be controlled to ensure MUI within the safe range.

  14. Arrhythmia as a cardiac manifestation in MELAS syndrome.

    Science.gov (United States)

    Thomas, Tamara; Craigen, William J; Moore, Ryan; Czosek, Richard; Jefferies, John L

    2015-09-01

    A 44-year-old female with a diagnosis of mitochondrial myopathy, encephalopathy and stroke-like episodes (MELAS) syndrome had progressive left ventricular hypertrophy (LVH) on echocardiogram. A Holter monitor demonstrated episodes of non-sustained atrial tachycardia, a finding not been previously described in this population. This unique case of MELAS syndrome demonstrates the known associated cardiac manifestation of LVH and the new finding of atrial tachycardia which may represent the potential for subclinical arrhythmia in this population.

  15. Arrhythmia as a cardiac manifestation in MELAS syndrome

    Directory of Open Access Journals (Sweden)

    Tamara Thomas

    2015-09-01

    Full Text Available A 44-year-old female with a diagnosis of mitochondrial myopathy, encephalopathy and stroke-like episodes (MELAS syndrome had progressive left ventricular hypertrophy (LVH on echocardiogram. A Holter monitor demonstrated episodes of non-sustained atrial tachycardia, a finding not been previously described in this population. This unique case of MELAS syndrome demonstrates the known associated cardiac manifestation of LVH and the new finding of atrial tachycardia which may represent the potential for subclinical arrhythmia in this population.

  16. Exogenous subclinical hyperthyroidism: effect on the cardiovascular system.

    Science.gov (United States)

    Federico Moreno, Karol; Paoli de Valeri, Mariela; Odreman, Rodolfo; Núñez, Tulio; Arata-Bellabarba, Gabriela

    2008-06-01

    To evaluate the effects of exogenous subclinical hyperthyroidism on left ventricular structure and function. Twenty-three patients of both sexes, aged 27 to 70 years, with a diagnosis of exogenous subclinical hyperthyroidism (serum thyroid-stimulating hormone [TSH] ≤ 0.4mU/ml and normal free thyroxine [FT4]) were evaluated. The patients had been taking levothyroxine in suppressive doses for an average of 6.7 years (1 to 35 years). Twenty euthyroid individuals matched for age, sex and body mass index were selected as controls. A medical history was obtained and symptoms of thyrotoxicosis were quantified in all subjects. To evaluate left ventricular structure and function, as well as atrial conduction time, a two-dimensional echocardiogram and pulsed echo and tissue echo Doppler with electrocardiography monitoring were performed. The index of hemodynamic compensation of the left ventricular mass was calculated. Hyperthyroid symptom scores were significantly higher in patients than in controls (p=0.0001). A positive correlation was found between hyperthyroidism scores and FT4 (p=0.005) and ejection fraction (p=0.04) and a negative correlation was found with TSH levels (p=0.03). End-diastolic volume, stroke volume, cardiac output and stroke work were significantly higher in patients with SH (p=0.04, p=0.02, p=0.05 and p=0.01, respectively). A positive correlation was found between fractional shortening and FT4 level (p=0.022) and levothyroxine dose (p=0.016) and between stroke work and FT4 level (p=0.034). Left ventricular mass, diastolic function and atrial conduction time were similar in patients and controls. Our study suggests that patients with exogenous subclinical hyperthyroidism have hemodynamic changes resulting from adaptation to the biological effects of levothyroxine on the cardiovascular system. However, structural changes are not produced. Copyright © 2008 Sociedad Española de Endocrinología y Nutrición. Published by Elsevier Espana. All rights

  17. Prevalence of subclinical hypothyroidism in pregnant women in tehran-iran.

    Science.gov (United States)

    Yassaee, Fakhrolmolouk; Farahani, Masoumeh; Abadi, Ali Reza

    2014-07-01

    Maternal subclinical hypothyroidism during pregnancy is associated with various adverse outcomes. Recent consensus guidelines advocate universal thyroid function screening during pregnancy. There are no data from Iran about the prevalence of thyroid hypofunction in pregnancy. This study aims to find the prevalence of thyroid dysfunction. In this descriptive cross sectional study, thyrotropin (TSH) was measured in 3158 pregnant women irrespective of gestational age from October 2008-March 2012. If TSH was more than 2.5 mIU/L in the first trimester or more than 3 mIU/L in the second or third trimester, free T4 was measured to diagnose subclinical/ overt hypothyroidism. If serum free T4 was in the normal range (0.7-1.8 ng/dl) the diagnosis was subclinical hypothyroidism and if below the normal range, overt hypothyroidism was diagnosed. A total of 3158 pregnant women were evaluated. One hundred forty seven of them were diagnosed as hypothyroidism. Subclinical hypothyroidism and overt hypothyroidism were present in 131 (89.1%) and 16 (10.9%) women respectively. Prevalence of subclinical hypothyroidism was 4.15%. Most of the subclinical and overt hypothyroidism cases were diagnosed in the first trimester. It appears logical to check TSH during pregnancy due to the observed prevalence of subclinical hypothyroidism.

  18. Prevalence of Subclinical Hypothyroidism in Pregnant Women in Tehran-Iran

    Directory of Open Access Journals (Sweden)

    Fakhrolmolouk Yassaee

    2014-07-01

    Full Text Available Background: Maternal subclinical hypothyroidism during pregnancy is associated with various adverse outcomes. Recent consensus guidelines advocate universal thyroid function screening during pregnancy. There are no data from Iran about the prevalence of thyroid hypofunction in pregnancy. This study aims to find the prevalence of thyroid dysfunction. Materials and Methods: In this descriptive cross sectional study, thyrotropin (TSH was measured in 3158 pregnant women irrespective of gestational age from October 2008-March 2012. If TSH was more than 2.5 mIU/L in the first trimester or more than 3 mIU/L in the second or third trimester, free T4 was measured to diagnose subclinical / overt hypothyroidism. If serum free T4 was in the normal range (0.7-1.8 ng/dl the diagnosis was subclinical hypothyroidism and if below the normal range, overt hypothyroidism was diagnosed. Results: A total of 3158 pregnant women were evaluated. One hundred forty seven of them were diagnosed as hypothyroidism. Subclinical hypothyroidism and overt hypothyroidism were present in 131 (89.1% and 16 (10.9% women respectively. Prevalence of subclinical hypothyroidism was 4.15%. Most of the subclinical and overt hypothyroidism cases were diagnosed in the first trimester. Conclusion: It appears logical to check TSH during pregnancy due to the observed prevalence of subclinical hypothyroidism.

  19. The evaluation of left ventricular hypertrophy in hypertensive patients with subclinical hyperthyroidism.

    Science.gov (United States)

    Tamer, Ismet; Sargin, Mehmet; Sargin, Haluk; Seker, Mesut; Babalik, Erhan; Tekce, Mustafa; Yayla, Ali

    2005-08-01

    The aim of this prospective cross-sectional study was to investigate the hypertrophic effects of endogenous subclinical hyperthyroidism on myocardium and early development of left ventricular hypertrophy (LVH) in essential hypertensive patients accompanied by endogenous subclinical hyperthyroidism. A total of 31 consecutive patients with stage I hypertension were included in the study. Sixteen of them also had endogenous subclinical hyperthyroidism that they were unaware before. The patients and the controls formed out of ten healthy subjects all underwent an investigation of thyroid functions and cardiologic evaluation. The mean wall thickness of the left ventricle in the stage I hypertensive group with endogenous subclinical hyperthyroidism (group I) was significantly increased as compared with both hypertensive patients without thyroid disease (group II) and the control subjects. The mean left ventricle mass was also significantly higher in group I than group II. Both of the patients' groups had an increased prevalence of LVH as compared with the controls. In this study, hypertensive patients with subclinical hyperthyroidism presented more increase in left ventricular mass, suggesting that subclinical hyperthyroidism may contribute to left ventricular hypertrophy forming a natural progression to hypertension. The hypertensive population should always be screened for endogenous subclinical hyperthyroidism, and should be examined for the criteria of left ventricular hypertrophy by echocardiography in early stages.

  20. Scheie syndrome

    Science.gov (United States)

    ... Hurler syndrome) MPS II (Hunter syndrome) MPS IV (Morquio syndrome) MPS III (Sanfilippo syndrome) Causes Scheie syndrome ... Autosomal recessive Cloudy cornea Hearing loss Hurler syndrome Morquio syndrome Review Date 4/20/2015 Updated by: ...

  1. Subclinical status epilepticus in a child after closed head injury.

    Science.gov (United States)

    Beni, L; Constantini, S; Matoth, I; Pomeranz, S

    1996-03-01

    A 14-year-old girl with closed head injury and a normal computerized tomographic scan underwent an electroencephalographic tracing that surprisingly revealed typical status epilepticus electrical activity. No episodes of motor clinical convulsions were observed from the moment of trauma throughout the admission period. Treatment with phenytoin caused a dramatic clinical improvement. Repeated electroencephalogram (EEG) 4 days later was within normal limits. Posttraumatic seizures are reported after head injury, yet, the issue of "invisible" or "subclinical" seizures associated with trauma is not discussed. In these cases EEG, (an uncommon examination in the early period after head injury) may be the only tool for proper diagnosis and treatment with anticonvulsants. This case report raises the question of the role of EEG in the unconscious patients who does not present with obvious convulsions. Clinical indications for performing EEG after head trauma without seizures are discussed.

  2. Subclinical neurophysiological effects of manganese in welding workers.

    Science.gov (United States)

    He, S C; Niu, Q

    2004-01-01

    High-level occupational manganese (Mn) exposure has been reported to induce irreversible brain alterations determining a Parkinson-like disease. This study aimed to assess subclinical neurophysiological alterations in welding workers. They were employed in a machine building factory with an average Mn exposure rhythms significantly reduced, theta-waves markedly increased and abnormal wave activities of either localized or diffusive type. In the same workers BEAM revealed higher theta, delta and beta power values in the F7 area, lower d power values in the FP1, FP2 and C4 areas as well as dissymmetry in the central area, parietal region and occipital region. This study suggests that Mn impairs neuron activity within central nervous system. In this context, brainstem parasympathetic and sympathetic centers receiving axon projections from cortical and diencephalic areas, may reflect Mn effects on upper pathways. However, direct actions of Mn on these centers cannot be excluded.

  3. Should we treat mild subclinical/mild hyperthyroidism? Yes.

    Science.gov (United States)

    Wiersinga, Wilmar M

    2011-08-01

    Whether or not subclinical hyperthyroidism (SCH) should be treated, remains a matter of debate because there are no randomized clinical trials answering the question if treatment improves long-term health outcomes. Cross-sectional and longitudinal population-based sudies demonstrate clear associations between SCH and risk on atrial fibrillation and fractures; associations with cardiovascular and overall mortality and mental health are less consistent. Associations with adverse outcomes of cardiovascular and bone health are in all likelihood causally related to SCH in view of an observed dose-response relationship and the existence of a plausible biologic mechanism. Short-term intervention studies show improvement of surrogate outcome measurements. Against this background treatment of both endogenous and exogenous SCH is recommended when TSH is 0.1 mU/l or lower. At TSH values>0.1-65 years, post menopause, osteoporosis, cardiac disease).

  4. Submental thyroid ectopy might cause subclinical hypothyroidism in early childhood

    Directory of Open Access Journals (Sweden)

    Mirjana Kocova

    2016-12-01

    Full Text Available Objective: Thyroid ectopy is a rare condition resulting from abnormal embryologic development and migration of the gland. Sublingual is the most common thyroid ectopy; all other ectopic thyroid locations occur very rare. There are no reports in the literature that describe the clinical course of patients with congenital hypothyroidism due to thyroid ectopy. Methods and Results: We present a child with congenital hypothyroidism detected on neonatal screening which had a subclinical course during follow-up. Scintigraphy revealed submental thyroid ectopy, a rare ectopic location and no orthotopic thyroid gland. Conclusion: Our case is unique because of the rare ectopic thyroid location but also of the unexpected clinical course; however, further thyroid monitoring is required for the therapy adjustment and detection of any changes in the ectopic tissue.

  5. Prevalence of subclinical coccidiosis in broiler farms in Turkey.

    Science.gov (United States)

    Karaer, Zafer; Guven, Esin; Akcay, Aytac; Kar, Sirri; Nalbantoglu, Serpil; Cakmak, Ayse

    2012-03-01

    The presence of Eimeria spp. oocysts in fecal samples collected from 1,108 broiler houses in six regions, representing about 12% of all broiler farms in Turkey, was studied using the modified McMaster method. The age of the chickens in the 1,108 pens varied from 1 to 50 days. Oocysts were found in 602 (54.3%) of these broiler houses, and the mean OPG (oocysts per gram of feces) in those samples was 36,498.7 (50-952,000). No indication of clinical coccidiosis or other clinically evident infection or wide mortality was encountered in any of the pens studied. Further study showed that the age of the chickens, the occurrence of diarrhea on the houses and the density of broiler breeding in the area correlated with subclinical coccidiosis prevalence.

  6. Subclinical Hypothyroidism in Danish Lean and Obese Children and Adolescents

    DEFF Research Database (Denmark)

    Dahl, Maria; Ohrt, Johanne Dam; Fonvig, Cilius Esman

    2017-01-01

    OBJECTIVE: Thyroid abnormalities are common in obese children. The aim of the present study was to examine the prevalence of subclinical hypothyroidism (SH) and to determine how circulating thyroid hormone concentrations correlate with anthropometrics in Danish lean and obese children...... and adolescents. METHODS: In this cross-sectional study, we included 3006 children and adolescents, aged 6-18 years, from the Registry of the Danish Childhood Obesity Biobank. The overweight/obese group (n=1796) consisted of study participants with a body mass index (BMI) standard deviation score (SDS) ≥1...... overweight/obese study participants. The positive correlations of circulating TSH and fT4 with WHtR suggest that central obesity, independent of the overall degree of obesity, augments the risk of concurrent thyroid abnormalities in children and adolescents with obesity....

  7. Subclinical Mastitis in Dairy Animals: Incidence, Economics, and Predisposing Factors

    Directory of Open Access Journals (Sweden)

    Mukesh Kr. Sinha

    2014-01-01

    Full Text Available A study was conducted to assess the incidence and economics of subclinical form of bovine mastitis in Central Region of India. Daily milk records of 187 animals during three seasons were collected and subjected to analysis. The economic loss due to reduction in yield, clinical expenses, and additional resources used were quantified and aggregated. The losses due to mastitis in monetary terms were estimated to be INR1390 per lactation, among which around 49% was owing to loss of value from milk and 37% on account of veterinary expenses. Higher losses were observed in crossbred cows due to their high production potential that was affected during mastitis period. The cost of treating an animal was estimated to be INR509 which includes cost of medicine (31.10% and services (5.47%. Inadequate sanitation, hygiene, and veterinary services were the main predisposing factors for incidence and spread of mastitis as perceived by the respondents.

  8. Management of Patients with Subclinical Hypothyroidism in Primary Care.

    Science.gov (United States)

    McCarthy, E; Russell, A; Kearney, P M

    2016-01-01

    Subclinical hypothyroidism (SCH) is defined as a raised serum thyroid stimulating hormone level with normal thyroxine. Despite a prevalence of up to 9% of the adult population there is widespread uncertainty on how to manage it. The aim of this study was to assess how older adults with SCH are managed in primary care. A retrospective case-note review was carried out on patients attending Mallow Primary Healthcare Centre. This study identified patients 65 years and over meeting the criteria for SCH in one year. The prevalence of SCH in this study was calculated as 2.9%. 22.2% of patients were treated with thyroxine. 6.1% of untreated patients progressed to clinical hypothyroidism within the study period while 18.2% spontaneously reverted to normal TSH levels.

  9. Subclinical hyperthyroidism and cardiovascular risk: recommendations for treatment.

    Science.gov (United States)

    Palmeiro, Christopher; Davila, Maria I; Bhat, Mallika; Frishman, William H; Weiss, Irene A

    2013-01-01

    Subclinical hyperthyroidism (SHy), the mildest form of hyperthyroidism, is diagnosed in patients having a persistently low or undetectable serum concentration of thyroid-stimulating hormone (TSH) with normal free T4 and T3 concentrations. Although overt hyperthyroidism is associated with an increased risk of adverse cardiovascular outcomes, the cardiovascular risk of SHy is controversial. Multiple studies have demonstrated an increased risk of atrial fibrillation, especially in older individuals with TSH levels cause and cardiovascular mortality are not clear, but recent meta-analyses suggest a modest increase in mortality, with the risk increasing with age and associated with the lowest TSH levels. The long-term consequences of SHy in young- and middle-aged adults, and in those with TSH levels are mildly low, are uncertain. For these reasons, guidelines for treatment are based on patient age, the degree of TSH suppression, symptoms consistent with hyperthyroidism, and overall cardiovascular and osteoporotic fracture risks.

  10. Detection of sub-clinical lead toxicity in monocasters

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, B.D.; Krishnaswamy, K. [Food and Drug Toxicology Research Centre National Institute of Nutrition, Jamai Osmania (India)

    1995-06-01

    Lead poisoning has been documented since antiquity but occupational lead intoxication still continues to occur. Now there is a growing consensus that low levels of lead exposure often do not result in the manifestation of toxic symptoms, but may have subclinical toxicity on haemopoitic and renal system. Such toxicities are reported even at blood lead concentrations which were thought to be safe (60-80 {mu}g/dl) a decade ago. One of the several effects of lead, is inhibition of erythrocyte delta-aminolevulinic acid dehydratase (d-ALAD), rate limiting enzyme of the heme synthesis. Similar effect on d-ALAD has been reported even at the blood lead concentrations of 20-30 {mu}g/dl which are much below the toxic limits of 60 {mu}g/dl. Occupational lead nephropathy has been reported from several countries. Ultrastructural alteration in renal tubules, due to chronic exposure of lead, are seen in both animals and human renal biopsy samples. However, detecting early renal damage is a difficult task, since the routine renal function tests like creatine clearance, Insulin clearance (GFR) etc. are altered only after severe kidney damage. Recently increased urinary excretion of lysomal enzyme N-acetyl-B-D-glucosaminidase, a marker of early nephrotoxicity has been reported in the workers exposed to various chemicals including lead. The present study has therefore been undertaken to evaluate the subclinical lead toxicity on haemopoetic and renal system using non invassive techniques in monocasters, who are occupationally exposed to lead fumes while preparing the type set letter blocks. 23 refs., 3 figs.

  11. Hypokalaemic Periodic Paralysis in a Patient with Subclinical Hyperthyroidism: A Rare Case.

    Science.gov (United States)

    Hegde, Swati; Shaikh, Mohammed Aslam; Gummadi, Thejaswi

    2016-01-01

    Thyrotoxic Periodic Paralysis (TPP) is an uncommon disorder. Though many cases of hypokalaemic periodic paralysis are reported in overt hyperthyroidism, hypokalaemic paralysis in subclinical hyperthyroidism is very rare. Subclinical hyperthyroidism is characterised by circulating TSH levels below reference range and normal thyroid hormone levels. We describe a case of 32-year-old Asian male who presented to the emergency department with acute onset weakness and hypokalaemia with no previous history of thyroid disorder or any signs and symptoms suggestive of hyperthyroidism. He was subsequently diagnosed with Graves' disease with subclinical hyperthyroidism.

  12. A Genomic Analysis of Subclinical Hypothyroidism in Hippocampus and Neocortex of the Developing Brain -- JN

    Science.gov (United States)

    Hypothyroidism during pregnancy and the early postnatal period has severe neurological consequences for the developing offspring. The impact of milder degrees of perturbation of the thyroid axis, typically considered subclinical, however, has not been established. Thyroid hormo...

  13. Long-term outcome in levothyroxine treated patients with subclinical hypothyroidism and concomitant heart disease

    DEFF Research Database (Denmark)

    Andersen, A. M. N.; Olsen, A. M. S.; Madsen, Jesper Clausager

    2016-01-01

    Context: Subclinical hypothyroidism is a common condition that may lead to impaired cardiac function. Objective: This study sought to examine the effects of levothyroxine treatment in patients with subclinical hypothyroidism and heart disease. Design: This was a register-based historical cohort...... study. Setting and Participants: The study was composed of Danish primary care patients and hospital outpatients age 18 years and older with established heart disease who were diagnosed with subclinical hypothyroidism in 1997-2011. Patients were stratified according to whether they claimed a subsequent...... myocardial infaction and stroke, and all-cause hospital admissions. Results: Of 61 611 patients with a diagnosis of cardiac disease having their first time thyroid function testing, 1192 patients with subclinical hypothyroidism(meanage 73.6 [SD±13.3] y,63.8%female) were included, of whom 136 (11.4%) were...

  14. Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke

    DEFF Research Database (Denmark)

    Chaker, Layal; Baumgartner, Christine; den Elzen, Wendy P J

    2015-01-01

    OBJECTIVE: The objective was to determine the risk of stroke associated with subclinical hypothyroidism. DATA SOURCES AND STUDY SELECTION: Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished ...

  15. Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort

    DEFF Research Database (Denmark)

    Fernández-Friera, Leticia; Peñalvo, José L; Fernández-Ortiz, Antonio

    2015-01-01

    BACKGROUND: Data are limited on the presence, distribution, and extent of subclinical atherosclerosis in middle-aged populations. METHODS AND RESULTS: The PESA (Progression of Early Subclinical Atherosclerosis) study prospectively enrolled 4184 asymptomatic participants 40 to 54 years of age (mean...... age, 45.8 years; 63% male) to evaluate the systemic extent of atherosclerosis in the carotid, abdominal aortic, and iliofemoral territories by 2-/3-dimensional ultrasound and coronary artery calcification by computed tomography. The extent of subclinical atherosclerosis, defined as presence of plaque...... or coronary artery calcification ≥1, was classified as focal (1 site affected), intermediate (2-3 sites), or generalized (4-6 sites) after exploration of each vascular site (right/left carotids, aorta, right/left iliofemorals, and coronary arteries). Subclinical atherosclerosis was present in 63...

  16. Prevalence and pathogens of subclinical mastitis in dairy goats in China.

    Science.gov (United States)

    Zhao, Yanqing; Liu, Hui; Zhao, Xuanduo; Gao, Yang; Zhang, Miaotao; Chen, Dekun

    2015-02-01

    Subclinical mastitis, a costly disease for the dairy industry, is usually caused by intramammary bacterial infection. The aim of this study was to investigate the prevalence of and pathogens involved in subclinical mastitis in dairy goats in China. A total of 683 dairy goats in the main breeding areas of China were selected, and milk samples were collected. Out of these, 313 (45.82 %) goats were detected distinct or strong positive for subclinical mastitis by using California mastitis test. Among these positive goats, 209 milk samples were used to identify the causing agents by a multiplex PCR assay, and results were listed as follows: coagulase-negative staphylococci (59.52 %), Staphylococcus aureus (15.24 %), Escherichia coli (11.43 %), and Streptococcus spp. (10.95 %). In conclusion, subclinical mastitis is a highly prevalent disease in dairy goats in China, and coagulase-negative staphylococci are the predominant pathogens.

  17. The effect of pheochromocytoma treatment on subclinical inflammation and endocrine function of adipose tissue

    National Research Council Canada - National Science Library

    BOSANSKA, L; PETRAK, O; ZELINKA, T; MRAZ, M; WIDIMSKY, Jr, J; HALUZIK, M

    2009-01-01

    The aim of our study was to evaluate the influence of surgical removal of pheochromocytoma on the endocrine function of adipose tissue and subclinical inflammation as measured by circulating C-reactive protein (CRP) levels...

  18. Subclinical renal abnormalities in young thalassemia major and intermedia patients and its relation to chelation therapy

    Directory of Open Access Journals (Sweden)

    Amira A.M. Adly

    2014-10-01

    Conclusion: Subclinical renal affection can start earlier in TM patients compared to TI. Poor chelation is associated with early signs of renal affection. Periodic renal assessment of those patients is mandatory as they may be affected by hidden renal dysfunction.

  19. Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke : An Individual Participant Data Analysis

    NARCIS (Netherlands)

    Chaker, Layal; Baumgartner, Christine; den Elzen, Wendy P. J.; Ikram, M. Arfan; Blum, Manuel R.; Collet, Tinh-Hai; Bakker, Stephan J. L.; Dehghan, Abbas; Drechsler, Christiane; Luben, Robert N.; Hofman, Albert; Portegies, Marileen L. P.; Medici, Marco; Iervasi, Giorgio; Stott, David J.; Ford, Ian; Bremner, Alexandra; Wanner, Christoph; Ferrucci, Luigi; Newman, Anne B.; Dullaart, Robin P.; Sgarbi, Jose A.; Ceresini, Graziano; Maciel, Rui M. B.; Westendorp, Rudi G.; Jukema, J. Wouter; Imaizumi, Misa; Franklyn, Jayne A.; Bauer, Douglas C.; Walsh, John P.; Razvi, Salman; Khaw, Kay-Tee; Cappola, Anne R.; Voelzke, Henry; Franco, Oscar H.; Gussekloo, Jacobijn; Rodondi, Nicolas; Peeters, Robin P.

    2015-01-01

    Objective: The objective was to determine the risk of stroke associated with subclinical hypothyroidism. Data Sources and Study Selection: Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished stu

  20. Fourier analysis of videokeratography data : Clinical usefulness in grade I and subclinical keratoconus

    NARCIS (Netherlands)

    Sideroudi, Haris; Labiris, Georgios; Georgatzoglou, Kimon; Ditzel, Fienke; Siganos, Charalambos; Kozobolis, Vassilios

    PURPOSE: To evaluate the contribution of Fourier analysis of videokeratographic data in the diagnosis of subclinical keratoconus and keratoconus. SETTING: Eye Institute of Thrace, Democritus University, Alexandroupolis, Greece. DESIGN: Observational case series. METHODS: The following

  1. Fourier analysis of videokeratography data : Clinical usefulness in grade I and subclinical keratoconus

    NARCIS (Netherlands)

    Sideroudi, Haris; Labiris, Georgios; Georgatzoglou, Kimon; Ditzel, Fienke; Siganos, Charalambos; Kozobolis, Vassilios

    2016-01-01

    PURPOSE: To evaluate the contribution of Fourier analysis of videokeratographic data in the diagnosis of subclinical keratoconus and keratoconus. SETTING: Eye Institute of Thrace, Democritus University, Alexandroupolis, Greece. DESIGN: Observational case series. METHODS: The following Pentacam-deriv

  2. Maternal and fetal outcome in subclinical hypothyroidism in Jammu region, North India

    Directory of Open Access Journals (Sweden)

    Gagan Singh

    2016-07-01

    Conclusions: In view of adverse maternal and fetal outcome, detecting and treating the women with subclinical hypothyroidism in early pregnancy will improve the perinatal outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2362-2366

  3. Acute myocardial infarction without significant coronary stenoses associated with endogenous subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; Sturiale, Mauro

    2012-04-05

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. Nowadays, there is growing interest regarding endogenous sublinical hyperthyroidism and the cardiovascular system. We present a case of acute myocardial infarction without significant coronary stenoses in a 75-year-old Italian woman with endogenous subclinical hyperthyroidism. Also this case focuses attention on the importance of a correct evaluation of endogenous subclinical hyperthyroidism. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  4. The 2015 european thyroid association guidelines on diagnosis and treatment of endogenous subclinical hyperthyroidism

    DEFF Research Database (Denmark)

    Biondi, B.; Bartalena, L.; Cooper, D. S.

    2015-01-01

    Endogenous subclinical hyperthyroidism (SHyper) is caused by Graves' disease, autonomously functioning thyroid nodules and multinodular goitre. Its diagnosis is based on a persistently subnormal serum thyroid-stimulating hormone (TSH) level with free thyroid hormone levels within their respective...

  5. Laboratory Investigation of Invasion for Subclinical Hyperthyroidism and Subclinical Hypothyroidism%亚临床甲亢和甲减发病的实验室调查

    Institute of Scientific and Technical Information of China (English)

    唐荣德; 冯国新; 刘社炎; 张冠新; 郭爱群

    2003-01-01

    目的探讨本地区亚临床甲状腺疾病的发病情况.方法随机抽样2550例健康体检者作甲状腺功能检测,以促甲状腺素(TSH)水平异常的检出率来判断亚临床甲状腺疾病的发病率. 结果亚临床甲亢的检出率为5.45%,亚临床甲减的检出率为6.98%;两种疾病T3、T4、FT3、FT4和TSH的均数比较具有非常显著性差异(P<0.01).结论本地区具有亚临床甲状腺疾病的发病现象,亚临床甲减的发病率比亚临床甲亢稍高.%Objective To explore pathogenic state of subclinical thyroid diseases for Xinhui area. Methods The indices of thyroid function were checked up by random sampling 2550cases in physical examinee. The incidence of subclinical thyroid diseases was judged thyroidstimulating hormone (TSH) level abnormalities. Results The detectable rate of subclinical hyperthyroidism is 5.45% and the rate of slight hypothyroidism is 6.98%. The mean value comparisons of T3, T4, FT3, FT4 and TSH between the two diseases have very notably difference (all for the P < 0.01). Conclusion The Xinhui area exists the pathogenic phenomena of subclinical thyroid diseases. In comparison with subclinical hyperthyroidism, the incidence of subclinical hypothyroidism is a little height.

  6. Prevalence of Subclinical Caprine Mastitis in Bangladesh Based on Parallel Interpretation of Three Screening Tests

    OpenAIRE

    Aminul Islam; Abdus Samad; AKM Anisur Rahman

    2012-01-01

    The present study was conducted to determine the point prevalence of subclinical caprine mastitis based on parallel interpretation of results of three screening test. A total of 462 milk samples from 231 lactating Black Bengal goats comprises of three organized goat farms in Bangladesh were collected and were screened for subclinical mastitis using California Mastitis Test (CMT), White Side Test (WST) and Surf Field Mastitis Test (SFMT) simultaneously. Integrated test results yield the preval...

  7. Vitamin Supplementation Increases Risk of Subclinical Mastitis in HIV-Infected Women123

    Science.gov (United States)

    Arsenault, Joanne E.; Aboud, Said; Manji, Karim P.; Fawzi, Wafaie W.; Villamor, Eduardo

    2010-01-01

    Subclinical mastitis is common in HIV-infected women and is a risk factor for mother-to-child transmission of HIV. The purpose of this study was to examine the effect of vitamin supplementation [vitamin A + β-carotene, multivitamins (B complex, C, and E), or multivitamins, including vitamin A + β-carotene] on the risk of subclinical mastitis during the first 2 y postpartum among HIV-infected women. The study was a randomized, placebo-controlled, clinical trial including 674 HIV-infected, antiretroviral naïve Tanzanian women who were recruited during pregnancy and followed-up after delivery. Breast milk samples were obtained approximately every 3 mo. Any subclinical mastitis was defined as a ratio of the sodium to potassium (Na:K) breast milk concentrations > 0.6 and further classified as either moderate (Na:K ≥ 0.6 and ≤ 1) or severe (Na:K > 1.0). Fifty-eight percent of women had at least 1 episode of any subclinical mastitis. Women assigned to multivitamins (B complex, C, and E) had a 33% greater risk of any subclinical mastitis (P = 0.005) and a 75% greater risk of severe subclinical mastitis (P = 0.0006) than women who received the placebo. Vitamin A + β-carotene also increased the risk of severe subclinical mastitis by 45% (P = 0.03). Among women with CD4+ T-cell counts ≥ 350 cells/μL, multivitamin intake resulted in a 49% increased risk of any subclinical mastitis (P = 0.006); by contrast, there were no treatment effects among women with CD4+ T-cell counts mastitis. PMID:20739447

  8. The potential role of subclinical Bordetella Pertussis colonization in the etiology of multiple sclerosis.

    Science.gov (United States)

    Rubin, Keith; Glazer, Steven

    2016-04-01

    It is established that (1) subclinical Bordetella pertussis colonization of the nasopharynx persists in highly vaccinated populations, and (2) B. pertussis toxin is a potent adjuvant that, when co-administered with neural antigens, induces neuropathology in experimental autoimmune encephalomyelitis, the principle animal model of multiple sclerosis. Building on these observations with supporting epidemiologic and biologic evidence, we propose that, contrary to conventional wisdom that subclinical pertussis infections are innocuous to hosts, B. pertussis colonization is an important cause of multiple sclerosis.

  9. MR enterography to evaluate sub-clinical intestinal inflammation in children with spondyloarthritis

    OpenAIRE

    Stoll Matthew L; Patel Ashish S; Punaro Marilynn; Dempsey-Robertson Molly

    2012-01-01

    Abstract Background Magnetic resonance enterography (MRE) is an established tool to evaluate for changes associated with inflammatory bowel disease (IBD), but has not been studied in sub-clinical IBD. We sought to evaluate the use of MRE in children with spondyloarthritis (SpA), who are at risk of having sub-clinical gut inflammation. Methods Children with juvenile idiopathic arthritis (JIA) with evidence of intestinal inflammation as evidence by an abnormal fecal calprotectin assay were offe...

  10. Subclinical thyroid dysfunction and the risk of stroke: a systematic review and meta-analysis.

    Science.gov (United States)

    Chaker, Layal; Baumgartner, Christine; Ikram, M Arfan; Dehghan, Abbas; Medici, Marco; Visser, W Edward; Hofman, Albert; Rodondi, Nicolas; Peeters, Robin P; Franco, Oscar H

    2014-11-01

    Subclinical thyroid dysfunction has been associated with coronary heart disease, but the risk of stroke is unclear. Our aim is to combine the evidence on the association between subclinical thyroid dysfunction and the risk of stroke in prospective cohort studies. We searched Medline (OvidSP), Embase, Web-of-Science, Pubmed Publisher, Cochrane and Google Scholar from inception to November 2013 using a cohort filter, but without language restriction or other limitations. Reference lists of articles were searched. Two independent reviewers screened articles according to pre-specified criteria and selected prospective cohort studies with baseline thyroid function measurements and assessment of stroke outcomes. Data were derived using a standardized data extraction form. Quality was assessed according to previously defined quality indicators by two independent reviewers. We pooled the outcomes using a random-effects model. Of 2,274 articles screened, six cohort studies, including 11,309 participants with 665 stroke events, met the criteria. Four of six studies provided information on subclinical hyperthyroidism including a total of 6,029 participants and five on subclinical hypothyroidism (n = 10,118). The pooled hazard ratio (HR) was 1.08 (95 % CI 0.87-1.34) for subclinical hypothyroidism (I (2) of 0 %) and 1.17 (95 % CI 0.54-2.56) for subclinical hyperthyroidism (I (2) of 67 %) compared to euthyroidism. Subgroup analyses yielded similar results. Our systematic review provides no evidence supporting an increased risk for stroke associated with subclinical thyroid dysfunction. However, the available literature is insufficient and larger datasets are needed to perform extended analyses. Also, there were insufficient events to exclude clinically significant risk from subclinical hyperthyroidism, and more data are required for subgroup analyses.

  11. Subclinical hyperthyroidism and dementia: the Sao Paulo Ageing & Health Study (SPAH

    Directory of Open Access Journals (Sweden)

    Lotufo Paulo A

    2010-06-01

    Full Text Available Abstract Background Several epidemiologic studies have shown a possible association between thyroid function and cognitive decline. Our aim was to evaluate the association of subclinical hyperthyroidism and dementia in a population sample of older people Methods A cross-sectional study - São Paulo Ageing & Health Study (SPAH - in a population sample of low-income elderly people ≥ 65 years-old to evaluate presence of subclinical thyroid disease as a risk factor for dementia. Thyroid function was assessed using thyrotropic hormone and free-thyroxine as well as routine use of thyroid hormones or antithyroid medications. Cases of dementia were assessed using a harmonized one-phase dementia diagnostic procedure by the "10/66 Dementia Research Group" including Alzheimer's disease and vascular dementia. Logistic regression models were used to test a possible association between subclinical hyperthyroidism and dementia. Results and discussion Prevalence of dementia and of subclinical hyperthyroidism were respectively of 4.4% and 3.0%. After age adjustment, we found an association of subclinical hyperthyroidism and any type of dementia and vascular dementia (Odds Ratio, 4.1, 95% Confidence Interval [95% CI] 1.3-13.1, and 5.3 95% CI, 1.1-26.4; respectively. Analyzing data by gender, we found an association of subclinical hyperthyroidism with dementia and Alzheimer's disease only for men (OR, 8.0; 95% CI, 1.5-43.4; OR, 12.4; 95% CI, 1.2-128.4; respectively. No women with subclinical hypothyroidism presented Alzheimer's disease in the sample. Conclusion The results suggest a consistent association among people with subclinical hyperthyroidism and dementia.

  12. Hypokalaemic Periodic Paralysis in a Patient with Subclinical Hyperthyroidism: A Rare Case

    OpenAIRE

    2016-01-01

    Thyrotoxic Periodic Paralysis (TPP) is an uncommon disorder. Though many cases of hypokalaemic periodic paralysis are reported in overt hyperthyroidism, hypokalaemic paralysis in subclinical hyperthyroidism is very rare. Subclinical hyperthyroidism is characterised by circulating TSH levels below reference range and normal thyroid hormone levels. We describe a case of 32-year-old Asian male who presented to the emergency department with acute onset weakness and hypokalaemia with no previous h...

  13. Corneal Volume Measurements with Pentacam for Detection of Keratoconus and Subclinical Keratoconus

    OpenAIRE

    Nurullah Çağıl; Nagihan Uğurlu; Hasan Basri Çakmak; Sucattin İlker Kocamış; Hüseyin Simavlı; Şaban Şimşek

    2013-01-01

    Pur po se: To estimate the sensitivity and specificity of corneal volume (CV) measurements in discriminating keratoconus and subclinical keratoconus from normal corneas. Ma te ri al and Met hod: Clinical records and Pentacam measurements of ninety-four patients with keratoconus, 36 patients with subclinical keratoconus, and 166 refractive surgery candidates with normal corneas were evaluated retrospectively. CV within 3, 5, 7, and 10 mm circles around the central cornea was measur...

  14. Frequency of subclinical thyroid dysfunction and risk factors for cardiovascular disease among women at a workplace

    Directory of Open Access Journals (Sweden)

    Rodrigo Diaz-Olmos

    Full Text Available CONTEXT AND OBJECTIVE: Subclinical thyroid dysfunction is very common in clinical practice and there is some evidence that it may be associated with cardiovascular disease. The aim here was to evaluate the frequencies of subclinical thyroid disease and risk factors for cardiovascular disease among women at a workplace, and to evaluate the association between subclinical thyroid disease and cardiovascular risk factors among them. DESIGN AND SETTING: Cross-sectional study on 314 women aged 40 years or over who were working at Universidade de São Paulo (USP. METHODS: All the women answered a questionnaire on sociodemographic characteristics and risk factors for cardiovascular disease and the Rose angina questionnaire. Anthropometric variables were measured and blood samples were analyzed for blood glucose, total cholesterol and fractions, high-sensitivity C-reactive protein, thyroid-stimulating hormone (TSH, free thyroxine (free-T4 and anti-thyroperoxidase antibodies (anti-TPO. RESULTS: The frequencies of subclinical hypothyroidism and hyperthyroidism were, respectively, 7.3% and 5.1%. Women with subclinical thyroid disease presented higher levels of anti-TPO than did women with normal thyroid function (P = 0.01. There were no differences in sociodemographic factors and cardiovascular risk factors according to thyroid function status, except for greater sedentarism among the women with subclinical hypothyroidism. Restricting the comparison to women with subclinical hypothyroidism (TSH > 10 mIU/l did not change the results. CONCLUSION: In this sample of women, there was no association between poor profile of cardiovascular risk factors and presence of subclinical thyroid disease that would justify screening at the workplace.

  15. Stage II Chronic Maxillary Atelectasis Associated with Subclinical Visual Field Defect

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    Mangussi-Gomes, João

    2013-09-01

    Full Text Available Introduction: Chronic maxillary atelectasis (CMA is characterized by a persistent decrease in the maxillary sinus volume due to inward bowing of its walls. According to its severity, it may be classified into three clinical-radiological stages. Objective: To report a case of stage II CMA associated with subclinical visual field defect. Case Report: A 34-year-old woman presented with a 15-year history of recurrent episodes of sinusitis and intermittent right facial discomfort for the past 5 years. She denied visual complaints, and no facial deformities were observed on physical examination. Paranasal sinus computed tomography (CT demonstrated a completely opacified right maxillary sinus with inward bowing of its walls, suggesting the diagnosis of stage II CMA. A computerized campimetry (CC disclosed a scotoma adjacent to the blind spot of the right eye, indicating a possible damage to the optic nerve. The patient was submitted to functional endoscopic sinus surgery, with drainage of a thick mucous fluid from the sinus. She did well after surgery and has been asymptomatic since then. Postoperative CT was satisfactory and CC was normal. Discussion: CMA occurs because of a persistent ostiomeatal obstruction, which creates negative pressure inside the sinus. It is associated with nasosinusal symptoms but had never been described in association with any visual field defect. It can be divided into stage I (membranous deformity, stage II (bony deformity, and stage III (clinical deformity. The silent sinus syndrome is a special form of CMA. This term should only be used to describe those cases with spontaneous enophthalmos, hypoglobus, and/or midfacial deformity in the absence of nasosinusal symptoms.

  16. Atrial fibrillation and acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism and erythrocytosis.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-11-05

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that sub-clinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes but is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. Moreover increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. It has been also reported an acute myocardial infarction with normal coronary arteries associated with iatrogenic hyperthyroidism and with a myocardial bridge too. It has been also reported an acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism. Furthermore it has been reported that at highly increased hematocrit levels patients may experience hyperviscosity symptoms. We present a case of atrial fibrillation and acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism and erythrocytosis. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  17. The prevalence of subclinical endometritis and intrauterine infections in repeat breeder cows.

    Science.gov (United States)

    Pothmann, H; Prunner, I; Wagener, K; Jaureguiberry, M; de la Sota, R L; Erber, R; Aurich, C; Ehling-Schulz, M; Drillich, M

    2015-05-01

    The objectives of this study were to assess the prevalence of subclinical endometritis and the presence of common uterine pathogens in repeat breeder cows. A total of 121 cows with three or more consecutive artificial inseminations without conception and no clinical signs of disease were defined as repeat breeder cows and were enrolled in this trial. Intrauterine samples were collected with the cytobrush technique to determine the prevalence of subclinical endometritis and bacteriologic infections. Blood samples were analyzed for concentrations of progesterone and estradiol in plasma to assess ovarian activity. Furthermore, breed, parity, history of calving and postpartum uterine infection, clinical findings of transrectal palpation, and backfat thickness were analyzed as potential factors for the prevalence of subclinical endometritis in repeat breeder cows. The prevalence of subclinical endometritis in repeat breeder cows was 12.7%; but common uterine pathogens, Escherichia coli and Trueperella pyogenes, were found in only one and three cows, respectively. Ovarian activity was determined in 95.0% of all cows. Recorded variables had no effect on the prevalence of subclinical endometritis in repeat breeder cows. In conclusion, subclinical endometritis and uterine infections linked to common pathogens were playing a minor role as a cause for repeat breeder cows in this study. Alternative reasons for failure to conceive in these cows are discussed.

  18. Multiple Determinations of Sperm DNA Fragmentation Show That Varicocelectomy Is Not Indicated for Infertile Patients with Subclinical Varicocele

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    Agustín García-Peiró

    2014-01-01

    Full Text Available Varicocele is one of the most common causes of low semen quality, which is reflected in high percentages of sperm cells with fragmented DNA. While varicocelectomy is usually performed to ameliorate a patient’s fertility, its impact on sperm DNA integrity in the case of subclinical varicocele is poorly documented. In this study, multiple DNA fragmentation analyses (TUNEL, SCD, and SCSA were performed on semen samples from sixty infertile patients with varicocele (15 clinical varicoceles, 19 clinical varicoceles after surgical treatment, 16 subclinical varicoceles, and 10 subclinical varicoceles after surgical treatment. TUNEL, SCD, and SCSA assays all showed substantial sperm DNA fragmentation levels that were comparable between subclinical and clinical varicocele patients. Importantly, varicocelectomy did improve sperm quality in patients with clinical varicocele; however, this was not the case in patients with subclinical varicocele. In summary, although infertile patients with clinical and subclinical varicocele have similar sperm DNA quality, varicocelectomy should only be advised for patients with clinical varicocele.

  19. Multiple Determinations of Sperm DNA Fragmentation Show That Varicocelectomy Is Not Indicated for Infertile Patients with Subclinical Varicocele

    Science.gov (United States)

    García-Peiró, Agustín; Ribas-Maynou, Jordi; Oliver-Bonet, María; Navarro, Joaquima; Checa, Miguel A.; Nikolaou, Alexandros; Amengual, María J.; Abad, Carlos; Benet, Jordi

    2014-01-01

    Varicocele is one of the most common causes of low semen quality, which is reflected in high percentages of sperm cells with fragmented DNA. While varicocelectomy is usually performed to ameliorate a patient's fertility, its impact on sperm DNA integrity in the case of subclinical varicocele is poorly documented. In this study, multiple DNA fragmentation analyses (TUNEL, SCD, and SCSA) were performed on semen samples from sixty infertile patients with varicocele (15 clinical varicoceles, 19 clinical varicoceles after surgical treatment, 16 subclinical varicoceles, and 10 subclinical varicoceles after surgical treatment). TUNEL, SCD, and SCSA assays all showed substantial sperm DNA fragmentation levels that were comparable between subclinical and clinical varicocele patients. Importantly, varicocelectomy did improve sperm quality in patients with clinical varicocele; however, this was not the case in patients with subclinical varicocele. In summary, although infertile patients with clinical and subclinical varicocele have similar sperm DNA quality, varicocelectomy should only be advised for patients with clinical varicocele. PMID:24967335

  20. Subclinical bluetongue virus infection in domestic ruminants in Taiwan.

    Science.gov (United States)

    Lee, Fan; Ting, Lu-Jen; Jong, Ming-Hwa; Chang, Wei-Ming; Wang, Fun-In

    2010-05-19

    Bluetongue is an arthropod-borne viral disease affecting domestic and wild ruminants. Taiwan, with the Tropic of Cancer crossing through it, was considered free of bluetongue virus (BTV) before 2001. The goals of this study are to identify the serotype and phylogeny of Taiwan BTV isolates and to understand the serological status and chronology of BTV infection. Analysis of the S10 gene segment revealed that Taiwan BTV isolates are closely related to Chinese strains. Seropositive results were found in 32.7% of the cattle and 8.2% of the goats by head, and 90.7% of the cattle herds and 28.9% of the goat flocks. Anti-BTV antibodies have existed in goat sera since 1989 and in bovine sera since 1993, and over the years, the seropositive rates in rapidly urbanized districts have decreased, most likely due to the loss of vector habitats. Seropositive rates for sheep were variable, due to a small sample size and a small sheep population. Thus far, all natural BTV infections have been subclinical, consistent with experimental sheep inoculation, revealing that the Taiwan isolate is of low virulence.

  1. Biomarkers of Subclinical Atherosclerosis in Patients with Autoimmune Disorders

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    Elisabetta Profumo

    2012-01-01

    Full Text Available Atherosclerosis is accelerated in rheumatoid arthritis (RA and psoriatic arthritis (PsA. We investigated a possible association of oxidized low-density lipoproteins (ox-LDLs, nitric oxide (NO, 3-nitrotyrosine, vitamin A, vitamin E, and β-carotene serum levels with subclinical atherosclerosis in RA and PsA. By the use of ELISA, we observed higher ox-LDL levels in patients with intima-media thickness (IMT > 1 than in patients with IMT ≤ 1 and a negative correlation between NO levels and IMT values. By the use of high-performance liquid chromatography, we determined higher levels of vitamin A in patients with PsA and IMT ≤ 1 than in controls and lower levels of β-carotene in patients with RA and PsA than in controls. β-carotene concentrations were negatively correlated to the duration of disease in RA. Our study confirms that ox-LDLs and NO may be markers of accelerated atherosclerosis in RA and PsA whereas vitamins seem to be associated only to the presence of the autoimmune disorders.

  2. Subclinical hyperthyroidism and cardiovascular manifestations: a reevaluation of the association.

    Science.gov (United States)

    Carpi, Angelo; Cini, Giuseppe; Russo, Matteo; Antonelli, Alessandro; Gaudio, Carlo; Galetta, Fabio; Franzoni, Ferdinando; Rossi, Giuseppe

    2013-04-01

    Subclinical hyperthyroidism (SH) has been reported associated with atrial fibrillation (AF), heart failure (HF) and coronary heart disease events, including mortality. An expert opinion indicates that AF is the possible link between SH and the other important cardiovascular (CV) manifestations. We analyzed the data of three recent studies including 60,883 subjects of whom 2,284 SH patients. In these subjects, the ratio between the AF events and each of the other above reported CV events varied from 0.14 to 0.4 in SH and from 0.2 to 2.4 in euthyroidism (ET). The general pattern of this ratio in 6 comparisons performed was not significantly higher for SH than ET. This data suggest that AF is not the major link between SH and the related CV manifestations. We suggest that a further link to be considered is the higher frequency of the early atherosclerosis manifestations such as carotid intima media thickness or carotid integrated back scatter, observed in SH. This atherogenic effect of SH can affect the occurrence of all the above clinical CV manifestations.

  3. Clinical, Microbiological and Hematological Findings in Ovine Subclinical Mastitis

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    Daniela Marina Mot

    2016-10-01

    Full Text Available Due to its richness in nutrients, milk represents a complete and balanced food that can be prepared from many other important products in human nutrition. But milk is also a medium of culture for numerous microorganisms. Although milk possesses antimicrobial mechanisms, in many cases it can be contaminated by endogenous or exogenous sources. This microorganism contamination of sheep milk and finished products depreciate its qualitative and produce severe food poisoning to consumers. In this study aimed a bacteriological control of five samples of milk haphazardly collected from six particular herds of sheep in the western part of the country. In parallel was carried out a clinical examination of the animal, insisting on mammary gland and examination of blood samples collected from the same animals. In laboratory was performed a bacteriological examination of milk samples and leucogram on blood samples. The identified bacterial species in milk samples were Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus uberis, Enterococcus durans, Enterococcus faecium. Although it started from the idea that the animals were healthy, it was still identified in more than half of the subjects examined subclinical mammary gland infections.

  4. Husbandry risk factors associated with subclinical coccidiosis in young cattle.

    Science.gov (United States)

    Mitchell, E S E; Smith, R P; Ellis-Iversen, J

    2012-07-01

    This paper describes an observational longitudinal study of cattle farms in England and Wales, which aimed to identify management practices associated with the presence of Eimeria spp. infection in young cattle. Thirty cattle farms situated in England and Wales were selected and one group of more than 20 young cattle aged 5-18 months of age was monitored on each farm. Three variables were identified as significantly associated with status in a multivariable model. The odds of finding Eimeria spp. were lower on farms that kept sheep on the same premises as the cattle, as was an increase in the maximum age within the sampled group. The latter probably reflects the development of post-infection immunity within the sampled animals. Good water-trough hygiene protected against Eimeria spp. oocyst excretion, with the odds of detection being higher on farms where it was reported that the water troughs were not cleaned and emptied more than once per month. The value of frequent emptying and cleaning of water troughs in reducing the exposure of calves to Eimeria spp. and thus lowering the impact of coccidiosis, both clinical and subclinical should be communicated to cattle farmers. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  5. Subclinical inflammatory response after accelerated corneal cross-linking

    Institute of Scientific and Technical Information of China (English)

    Hassan Hashemi; Nahid Ashraf; Ebrahim Jafarzadehpur; Alireza Hedayatfar; Soheila Asgari

    2016-01-01

    Background: To evaluate the inlfammatory response after accelerated collagen cross-linking (CXL) in eyes with keratoconus. Methods: Consecutive eyes with keratoconus undergoing CXL surgery were included in this non-randomized interventional study. Aqueous lfare was measured pre- and post-operatively with a laser lfare photometer at 1 week, 1, 3 and 6 months after CXL. Results: Sixty eyes of 60 patients were entered into the study. Before CXL, the mean lfare value was 4.5 photons per millisecond (ph/ms). The lfare values observed at week 1 (7.1 ph/ms; P=0.008), month 1 (6.5 ph/ms; P=0.04), month 3 (6.7 ph/ms; P=0.004) and month 6 (6.7 ph/ms; P=0.004) were signiifcantly higher compared to baseline. Flare values were not signiifcantly different from week 1 up to 6 months after CXL (P=0.930). No statistically significant correlation was detected between the amount of inlfammation and keratometric indices. Conclusions: Accelerated CXL in patients with keratoconus may cause a subclinical inflammatory response which is evident as slight but rather long-lasting rise of aqueous lfare.

  6. Subclinical primary retinal pathology in neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Jeong, In Hye; Kim, Ho Jin; Kim, Nam-Hee; Jeong, Kyoung Sook; Park, Choul Yong

    2016-07-01

    Foveal thickness may be a more sensitive indicator of primary retinal pathology than retinal nerve fiber layer thickness since the fovea contains no or sparse retinal nerve fiber layer, which coalesces into axons of the optic nerve. To our knowledge, few quantitative in vivo studies have investigated foveal thickness. By using optical coherence tomography, we measured foveal thickness to evaluate intrinsic retinal pathology. Seventy-two neuromyelitis optica spectrum disorder patients (99 eyes with optic neuritis and 45 eyes without optic neuritis) and 34 age-matched controls were included. Foveal thinning was observed both in eyes with non-optic neuritis (185.1 µm, p neuritis (185.0 µm, p neuritis did not have peripapillary retinal nerve fiber layer thinning, but showed foveal thinning (p optica spectrum disorder, foveal thickness correlated with 2.5 % low contrast visual acuity, while retinal nerve fiber layer thickness correlated with high or low contrast visual acuity, extended disability status scale, and disease duration. In this study, we observed foveal thinning irrespective of optic neuritis; thus, we believe that subclinical primary retinal pathology, prior to retinal nerve fiber layer thinning, may exist in neuromyelitis optica spectrum disorder.

  7. A review of the ongoing discussion about definition, diagnosis and pathomechanism of subclinical endometritis in dairy cows.

    Science.gov (United States)

    Wagener, Karen; Gabler, Christoph; Drillich, Marc

    2017-05-01

    In the last decade, several new aspects of the inflammation of the bovine endometrium have been investigated and described, including a new definition of subclinical endometritis. This review summarizes the recent discussion about the definition, diagnosis and pathomechanism of subclinical endometritis. Subclinical endometritis also referred to as cytological endometritis is defined by findings of endometrial cytology, which is usually performed with the cytobrush-technique or by low-volume flushing of the uterus. The sampling procedure is minimally invasive and has no negative impact on subsequent conception rate. The suggested threshold value for polymorphonuclear cells (PMN) as diagnostic for subclinical endometritis depends on the time postpartum and varies from 5 to 18%. It has also been shown that a general threshold of 5% PMN is eligible for all cows between 21 and 62 days postpartum. Accuracy and repeatability of counting PMN under the microscope have been evaluated and can be regarded as reliable. The impact of subclinical endometritis on reproductive performance is characterized by decreased conception rates, and prolonged days to first service and days open. In addition, it has been demonstrated that subclinical endometritis has an impact on survival and quality of the embryo. Some studies, however, did not confirm this negative effect of subclinical endometritis on fertility. More detailed analyses of the cytobrush samples revealed higher mRNA expression of several cytokines in cows with subclinical endometritis compared with healthy cows, and contributed to the understanding of detrimental effects of subclinical endometritis on fertility. In contrast to clinical endometritis, there are no predominant bacteria related to subclinical endometritis, but associations between the presence of α-hemolytic streptococci and Trueperella pyogenes and subclinical endometritis have been found. For the treatment of subclinical endometritis, intrauterine infusions

  8. The use of Na+ and K+ ion concentrations as potential diagnostic indicators of subclinical mastitis in dairy cows

    OpenAIRE

    Abdul Wahid Haron; Faez Firdaus Jesse Abdullah; Abdulnasir Tijjani; Yusuf Abba; Lawan Adamu; Konto Mohammed; Aisyah Munira Mohammed Amir; Mohammad Abubakar Sadiq; Mohd Azmi Mohd Lila

    2014-01-01

    Aim: This study was conducted to evaluate the concentrations of sodium (Na+) and potassium (K+) ions in milk of lactating dairy cows with and without subclinical mastitis as putative indicators for detecting subclinical mastitis in dairy cows. Materials and Methods: Thirty seven lactating dairy cows were screened for the evidence of subclinical mastitis using California mastitis test (CMT). The lactating dairy cows were categorized as CMT-Positive (CMT-P; n=20) and CMT-Negative (CMT-N; n=1...

  9. Prevalence of Subclinical Mastitis in the Local Goats in the Province of Laghouat (ALGERIA

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    Achour Yahia

    2016-11-01

    Full Text Available Subclinical mastitis is a disease of the udder that passes mostly unnoticed. Or several germs associated with it and their presence in milk constitutes a major risk to consumer health. Our study aims to determine the prevalence of subclinical mastitis in local goats in Laghouat region (Algeria. We undertook a study based on the detection of sub-clinical mastitis by Califirnian Mastitis Test (CMT in 60 goats aged 1 to 9 years and weighing 18 to 45 kg of live weight and whose lactation number varies from 2 to 8. We found a prevalence of subclinical mastitis reaching 46.6%. A clearly significant difference (P <0.05 is reported on this prevalence compared to age. The highest rate is recorded especially in goats aged between 3 to 7 years with 62% of detected subclinical mastitis, followed by the older goats (over 7 years with a prevalence of 27%, and at the end the youngest goats (1-3 years with a prevalence of 11%. A significant difference was also recorded between the different lactation ranks (P <0.05. The goats having the highest rank of lactation were most affected by subclinical mastitis. Prevalence of 46%, 31%, 11% and 8% respectively are found for the 6th rank of lactation and more, 4 lactations, 5 lactations and 1 lactation. We noticed that the majority of diagnosed mastitis were caused by poor hygiene conditions. This study allows us to conclude that there is a high prevalence of subclinical mastitis in the local goats in the province of Laghouat (Algeria.

  10. Subclinical atherosclerosis in gouty arthritis patients: a comparative study.

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    Çukurova, Selçuk; Pamuk, Ömer Nuri; Ünlü, Ercüment; Pamuk, Gülsüm Emel; Çakir, Necati

    2012-06-01

    We evaluated the incidence of subclinical atherosclerosis and associated factors in our gouty arthritis patients. We included 55 gouty arthritis patients diagnosed at our center within the last 4 years. The control group included 41 patients with rheumatoid arthritis (RA) and 34 patients with asymptomatic hyperuricemia (AHU). Atherosclerotic risk factors were determined in all subjects. Carotid intima-media thickness (IMT) and the presence of plaques were evaluated by B-mode ultrasonography. The carotid IMT in gouty arthritis patients (0.730 ± 0.19) was significantly higher than in AHU subjects (0.616 ± 0.12) (P = 0.004) and tended to be higher than the RA group (0.669 ± 0.17) (P = 0.1). Atheromatous plaques were significantly more frequent in gouty arthritis patients (16 cases, 29.1%) than in RA patients (5 cases, 12.2%) and AHU subjects (3 cases, 8.8%) (P values, 0.05 and 0.023). Gout patients with plaques were older (P = 0.006) and tended to have tophi more frequently (P = 0.06). Logistic regression analysis showed that age (OR: 1.3, 95% CI: 1.02-1.54) and the presence of tophi (OR: 12.5, 95% CI: 1.2-140) were independent risk factors for the presence of plaques. Gouty arthritis bears a higher risk of atherosclerosis than both RA and AHU.

  11. Association of Subclinical Inflammation With Polyneuropathy in the Older Population

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    Herder, Christian; Bongaerts, Brenda W.C.; Rathmann, Wolfgang; Heier, Margit; Kowall, Bernd; Koenig, Wolfgang; Thorand, Barbara; Roden, Michael; Meisinger, Christa; Ziegler, Dan

    2013-01-01

    OBJECTIVE Inflammatory processes have been implicated in the pathogenesis of diabetic distal sensorimotor polyneuropathy (DSPN), but their possible relationship has not been assessed at the population level. RESEARCH DESIGN AND METHODS We determined serum concentrations of mediators of subclinical inflammation among 1,047 participants 61–82 years of age from the population-based Cooperative Health Research in the Region of Augsburg (KORA) F4 study (Germany). Logistic and linear regression models were fitted to assess associations between immune mediators (log-transformed) and the presence of clinical DSPN (dichotomous variable) or Michigan Neuropathy Screening Instrument (MNSI) examination score (continuous variable), respectively. RESULTS Serum concentrations of the anti-inflammatory interleukin (IL)-1 receptor antagonist (IL-1RA) were positively associated with the presence of DSPN and higher MNSI scores in age-adjusted and sex-adjusted analyses, whereas IL-6, IL-18, and soluble intercellular adhesion molecule-1 were positively associated with only MNSI scores. No associations were observed for adiponectin, C-reactive protein, or tumor necrosis factor-α. Associations for IL-1RA and IL-6 with the MNSI score remained statistically significant after additional adjustment for waist circumference, height, hypertension, cholesterol, smoking, alcohol intake, physical activity, history of myocardial infarction or stroke, presence of neurological conditions, and use of nonsteroidal anti-inflammatory drugs. CONCLUSIONS We conclude that DSPN is linked to proinflammatory and anti-inflammatory, possibly compensatory, processes in the older general population. Future studies should clarify the temporal sequence and causality of these associations. PMID:24009302

  12. Subclinical mastitis may not reduce breastmilk intake during established lactation.

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    Aryeetey, Richmond N O; Marquis, Grace S; Brakohiapa, Lucy; Timms, Leo; Lartey, Anna

    2009-09-01

    This study determined the effect of subclinical mastitis (SCM) on infant breastmilk intake. Participants (60 Ghanaian lactating mothers and their infants) were from periurban communities in the Manya Krobo district of Ghana in 2006-2007. Bilateral breastmilk samples were obtained once between months 3 and 6 postpartum and tested for SCM using the California mastitis test (CMT) and the sodium/potassium (Na/K) ratio. Infants' 12-hour breastmilk intake was assessed by test weighing. CMT scoring for SCM diagnosis was scaled as >or=1 = positive (n = 37) and 1.0 (n = 14). Breastmilk intake was nonsignificantly lower among infants whose mothers had elevated Na/K ratios of >1.0 (-65.1 g; 95% confidence interval -141.3 g, 11.1 g). Infants whose mothers were positive for SCM with both CMT and Na/K ratio criteria had significantly lower breastmilk intake (-88.9 g; 95% confidence interval -171.1 g, -6.9 g) compared to those whose mothers tested either negative with both tests or positive on only one. Infant weight (p < 0.01) and frequency of feeding (p = 0.01) were independently associated with breastmilk intake. However, the effect of SCM on breastmilk intake disappeared when infant weight and feeding frequency were included in a multiple linear regression model. The results of this study did not show an effect of SCM on breastmilk intake among 3-6-month-old infants. A larger sample size with a longitudinal design will be needed in future studies.

  13. [Subclinical sensorineural hearing loss in female patients with rheumatoid arthritis].

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    Treviño-González, José Luis; Villegas-González, Mario Jesús; Muñoz-Maldonado, Gerardo Enrique; Montero-Cantu, Carlos Alberto; Nava-Zavala, Arnulfo Hernán; Garza-Elizondo, Mario Alberto

    2015-01-01

    The rheumatoid arthritis is a clinical entity capable to cause hearing impairment that can be diagnosed promptly with high frequencies audiometry. To detect subclinical sensorineural hearing loss in patients with rheumatoid arthritis. Cross-sectional study on patients with rheumatoid arthritis performing high frequency audiometry 125Hz to 16,000Hz and tympanometry. The results were correlated with markers of disease activity and response to therapy. High frequency audiometry was performed in 117 female patients aged from 19 to 65 years. Sensorineural hearing loss was observed at a sensitivity of pure tones from 125 to 8,000 Hz in 43.59%, a tone threshold of 10,000 to 16,000Hz in 94.02% patients in the right ear and in 95.73% in the left ear. Hearing was normal in 8 (6.84%) patients. Hearing loss was observed in 109 (93.16%), and was asymmetric in 36 (30.77%), symmetric in 73 (62.37%), bilateral in 107 (91.45%), unilateral in 2 (1.71%), and no conduction and/or mixed hearing loss was encountered. Eight (6.83%) patients presented vertigo, 24 (20.51%) tinnitus. Tympanogram type A presented in 88.90% in the right ear and 91.46% in the left ear, with 5.98 to 10.25% type As. Stapedius reflex was present in 75.3 to 85.2%. Speech discrimination in the left ear was significantly different (p = 0.02)in the group older than 50 years. No association was found regarding markers of disease activity, but there was an association with the onset of rheumatoid arthritis disease. Patients with rheumatoid arthritis had a high prevalence of sensorineural hearing loss for high and very high frequencies. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  14. Subclinical autism spectrum symptoms in pediatric obsessive-compulsive disorder.

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    Arildskov, Trine Wigh; Højgaard, David R M A; Skarphedinsson, Gudmundur; Thomsen, Per Hove; Ivarsson, Tord; Weidle, Bernhard; Melin, Karin Holmgren; Hybel, Katja A

    2016-07-01

    The literature on subclinical autism spectrum (ASD) symptoms in pediatric obsessive-compulsive disorder (OCD) is scarce, and it remains unclear whether ASD symptoms are related to OCD severity. The aims of the present study were to assess the prevalence of ASD symptoms and age and sex differences in children and adolescents with OCD, and to explore the relation between ASD symptoms and OCD severity. This is the largest study of ASD symptoms in an OCD population to date, and the first directly aimed at elucidating sex and age differences in this matter. The study used baseline data from the Nordic Long-term OCD Treatment Study in which parents of 257 children and adolescents with OCD aged 7-17 completed the Autism Spectrum Screening Questionnaire. OCD severity was assessed with the Children's Yale-Brown Obsessive Compulsive Scale. Pediatric OCD patients were found to exhibit elevated rates of ASD symptoms compared to a norm group of school-age children. ASD symptoms were concentrated in a subgroup with a prevalence of 10-17 %. This subgroup was characterized by a male preponderance with a sex ratio of approximately 2.6:1, while children versus adolescents with OCD exhibited similar rates. Autism-specific social and communication difficulties were not related to OCD severity, while restricted repetitive behavior was positively related to OCD severity. The results indicate that clinicians need to be aware of ASD symptoms in children and adolescents with OCD since one out of ten exhibits such symptoms at a clinical sub-threshold.

  15. Efficacy of axial and tangential corneal topography maps in detecting subclinical keratoconus.

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    Tummanapalli, Shyam Sunder; Potluri, Haresh; Vaddavalli, Pravin Krishna; Sangwan, Virender S

    2015-10-01

    To investigate and compare the efficacy of axial and tangential corneal topography maps obtained using the Orbscan IIz scanning-slit device to distinguish differences in eyes with subclinical keratoconus from normal eyes. LV Prasad Eye Institute, Hyderabad, India. Retrospective cross-sectional study. Axial and tangential maps of the anterior and posterior corneal surfaces were obtained in eyes of patients with subclinical keratoconus (normal fellow eye of an eye with clinically diagnosed keratoconus). The following measurements were obtained from each map and compared between the 2 groups: location of the corneal apex in millimeters relative to the corneal vertex, dioptric power at the corneal apex and corneal vertex, corneal irregularity indices at 3.0 mm and 5.0 mm, anterior-posterior apex ratio, and inferior-superior dioptric asymmetry value. Maps were obtained in 71 eyes (71 patients) with subclinical keratoconus and 76 normal eyes (76 patients). The tangential posterior apex curvature was significantly steeper than the axial posterior apex curvature in both groups (P keratoconus eyes from normal eyes. The anterior-posterior apex ratio on the tangential map and 5.0 mm irregularity index of the posterior corneal surface were highly sensitive and specific for early detection of subclinical keratoconus. Tangential corneal topography maps should be considered in preoperative subclinical keratoconus screening. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  16. Risk indicators associated with subclinical mastitis in smallholder dairy cows in Tanzania.

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    Kivaria, F M; Noordhuizen, J P T M; Kapaga, A M

    2004-08-01

    Smallholder dairy farmers in Tanzania appear to be unaware of the subclinical mastitis situation in their cows. A cross-sectional study was carried out between June and September 2002 on smallholder dairy herds in the Dar es Salaam region. The study objectives were to establish the prevalence of subclinical mastitis and related risk indicators, and to assess their contribution to the occurrence of subclinical mastitis. Three field procedures based on the principles of herd health and production management were followed: clinical, farm and data inspection. The California mastitis test (CMT) was carried out on quarter milk samples to determine the prevalence of subclinical mastitis. A total of 182 lactating cows from 62 herds were investigated. Clinical inspection indicated that 3.8% of the lactating cows had clinical mastitis. Subclinical mastitis was detected in 90.3% of lactating cows screened. Farm inspection revealed that water scarcity, barn size, residual suckling, single udder-towel and dairy labourers as the most substantial (p mastitis, possibly owing to sample size and the presence of confounders, the epidemiological need to address such risk indicators cannot be overemphasized.

  17. Subclinical mastitis in machine milked dairy farms in Punjab: prevalence, distribution of bacteria and current antibiogram

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    Abdul Q. Mir

    2014-05-01

    Full Text Available Aim: Mastitis, a complex disease, even at subclinical stage has a major economic impact on the dairy industry. The disease pattern at machine milking which has recently been introduced in Indian system is to be studied. Therefore the present study was conducted to see the prevalence, distribution and sensitivity pattern of bacteria at subclinical level in machine milked dairy farms in Punjab state. Materials and Methods: The study involved 10 machine milked dairy cow herds in Ludhiana, Patiala, Moga, Bathinda and Ferozpur districts of Punjab. A total 218 HF × Sahiwal cross-bred dairy cow in milk were studied. About 872 quarter foremilk samples were collected to observe the prevalence of disease, distribution of udder pathogens and antibiotic sensitivity pattern. Results: Prevalence of specific subclinical mastitis was 57.80 % and 30.73% on animal and quarter basis respectively. In specific subclinical mastitis Staphylococci (41.04% were the main organisms while in case of latent infections Corynebacteria (36.81% were found to be chief isolates. Erythromycin, Enrofloxacin and Gentamicin were found to be most sensitive, and Streptomycin was found to be the least sensitive in vitro antibiotic. Conclusion: Staphylococci were the main organisms in specific subclinical mastitis while Corynebacteria were found to be chief isolates in case of latent infections. Erythromycin, Enrofloxacin and Gentamicin were found to be most sensitive, and Streptomycin was found to be the least sensitive in vitro antibiotic.

  18. Subclinical Iodine Deficiency among Pregnant Women in Haramaya District, Eastern Ethiopia: A Community-Based Study

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    Haji Kedir

    2014-01-01

    Full Text Available Background. Iodine deficiency in pregnancy is a worldwide problem. This study aimed to assess prevalence and predictors of subclinical iodine deficiency among pregnant women in Haramaya district, eastern Ethiopia. Methods. A cross-sectional, community-based study was conducted on 435 pregnant women existing in ten randomly selected rural kebeles (kebele is the smallest administrative unit in Ethiopia. Data on the study subjects’ background characteristics, dietary habits, and gynecological/obstetric histories were collected via a structured questionnaire. UIC of <150 μg/L defined subclinical iodine deficiency. Data were analyzed by Stata 11. A multivariable logistic regression was used to identify the predictors of subclinical iodine deficiency. Results. The median urinary iodine concentration (MUIC was 58.1 μg/L and 82.8% of the women who had subclinical iodine deficiency. The risk of subclinical iodine deficiency was reduced by the use of iodized salt (AOR = 0.13 and by intake of milk twice a month or more (AOR = 0.50, but it was increased by maternal illiteracy (AOR = 3.52. Conclusion. Iodine nutritional status of the pregnant women was poor. This shows that women and their children are exposed to iodine deficiency and its adverse effects. Thus, they need urgent supplementation with iodine and improved access to and intake of iodized salt and milk during pregnancy.

  19. Association of CXCR2 polymorphisms with subclinical and clinical mastitis in dairy cattle.

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    Youngerman, S M; Saxton, A M; Oliver, S P; Pighetti, G M

    2004-08-01

    The ability to identify objectively cows that are more or less susceptible to mastitis has been a long-standing goal. Genetic markers associated with inflammatory responses during mastitis could aid in selection of these cattle. One potential marker is CXCR2, a chemokine receptor required for neutrophil migration to infection sites, which contains single nucleotide polymorphisms (SNP) within the gene. The objective of this experiment was to evaluate the association of CXCR2 SNP genotypes with subclinical and clinical mastitis. Thirty-seven Holstein and 42 Jersey cows that completed at least 2 full lactations were used. Quarter foremilk samples were collected for bacteriological examination quarterly and when cows exhibited clinical mastitis. Subclinical mastitis was defined as the presence of the same pathogen in the same quarter in at least 2 of 3 consecutive samples. A significant association was detected between CXCR2 SNP +777 genotype and percentages of subclinical mastitis cases in Holsteins. Holsteins expressing genotype GG had decreased percentages of subclinical mastitis, but genotype CC cows had increased percentages of subclinical mastitis. Significant differences in clinical mastitis incidence were not detected between genotypes for either breed. This approach of genetically identifying mastitis resistant cows may represent an effective means of marker-assisted selection for mastitis and other inflammatory diseases involving neutrophils.

  20. Recurrent acute pulmonary embolism and paroxysmal atrial fibrillation associated with subclinical hyperthyroidism.

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    Patanè, Salvatore; Marte, Filippo; Currò, Alessio; Cimino, Claudia

    2010-07-09

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Elevated D-dimer levels have been reported in acute pulmonary embolism and it has also been reported that right ventricular overload and hypoxia in acute pulmonary embolism may lead to right ventricular myocardium injury reflected by elevated cardiac troponin levels too. We present a case of recurrent pulmonary embolism associated with subclinical hyperthyroidism, in an 81-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  1. Efficacy in treatment of subclinical cervical HPV infection without intraepithelial neoplasia: systematic review

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    Fábio Russomano

    2000-07-01

    Full Text Available CONTEXT: The treatment of the subclinical Human papillomavirus (HPV infection of the uterine cervix is controversial. OBJECTIVE: To assess the efficacy of any therapy for subclinical HPV infection of the cervix without intraepithelial neoplasia, via a search in the medical literature. METHOD: We performed a systematic review with a comprehensive reference search in Medline, LILACS, Excerpta Medica, AIDSLINE, Popline, Cochrane Library and other authors' reference lists to identify experimental studies of therapy for subclinical HPV infection without intraepithelial neoplasia of the uterine cervix. In order to identify unpublished studies, we also contacted experts in the area, clinical trial registries, pharmaceutical industries, government and research institutions. We also searched on the Internet and in the book-of-abstracts of some medical conferences. The studies identified were masked and selected by inclusion criteria to help ascertain their internal validity. The data about regression or progression of HPV infection were extracted from the studies included. RESULTS: We identified 67 studies related to the treatment of subclinical HPV infection without intraepithelial neoplasia of the uterine cervix. Only five clinical trials matched the inclusion criteria and none demonstrated significant differences between the experimental group and the control group concerning regression of HPV infection (with or without CIN I or progression to higher grades of CIN. CONCLUSION: The evidence we found in the medical literature regarding the efficacy of any therapy for subclinical HPV infection without intraepithelial neoplasia of the uterine cervix was unsatisfactory.

  2. Serum thyrotrophin at baseline predicts the natural course of subclinical hyperthyroidism.

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    Das, G; Ojewuyi, T A; Baglioni, P; Geen, J; Premawardhana, L D; Okosieme, O E

    2012-07-01

    Optimal therapeutic strategies for subclinical hyperthyroidism are undecided. Overt disease develops in a minority of cases, but the risk factors for progression remain unclear. We examined whether a baseline thyrotrophin (TSH) predicted progression to overt hyperthyroidism in asymptomatic individuals with subclinical hyperthyroidism. This was a retrospective study of 323 patients with subclinical hyperthyroidism seen in our institution from 2003 to 2010 (mean age 71 years, males 26·9%, females 73·1%, mean follow-up duration 32 months, range 6-93 months). Serum TSH and free thyroxine (FT4) were documented at baseline and during follow-up. After excluding individuals with nonthyroid causes of low TSH, patients were grouped according to initial TSH as: TSH 0·10-0·39 mU/l (grade I) and TSH hyperthyroidism with annual progression rates of 0·6-3·7%. Most patients reverted to normal thyroid status (31·6%) or remained subclinically hyperthyroid (56·7%). Progression to frank hyperthyroidism was higher in grade II than in grade I patients (20·3% vs 6·8%, P hyperthyroidism (hazard ratio 3·4, confidence interval 1·6-7·0), whereas age, gender, FT4 and aetiological diagnosis were not associated with hyperthyroidism. Thyrotrophin predicts overt hyperthyroidism in asymptomatic individuals with subclinical hyperthyroidism. Patients with TSH hyperthyroidism than those with TSH 0·10-0·39 mU/l. © 2012 Blackwell Publishing Ltd.

  3. Subclinical and overt thyroid dysfunction and risk of all-cause mortality and cardiovascular events

    DEFF Research Database (Denmark)

    Selmer, Christian; Olesen, Jonas Bjerring; Hansen, Morten Lock

    2014-01-01

    ]. All-cause mortality was increased in overt and subclinical hyperthyroidism [age adjusted incidence rates of 16 and 15 per 1000 person-years, respectively; incidence rate ratios (IRRs) 1.25 [95% confidence interval (CI) 1.15-1.36] and 1.23 (95% CI 1.16-1.30)] compared with euthyroid (incidence rate...... of 12 per 1000 person-years). Risk of MACEs was elevated in overt and subclinical hyperthyroidism [IRRs 1.16 (95% CI 1.05-1.27) and 1.09 (95% CI 1.02-1.16)] driven by heart failure [IRRs 1.14 (95% CI 0.99-1.32) and 1.20 (95% CI 1.10-1.31)]. A reduction of all-cause mortality was observed in subclinical...... hypothyroidism with TSH of 5-10 mIU/L [IRR 0.92 (95% CI 0.86-0.98)]. CONCLUSIONS: Heart failure is the leading cause of an increased cardiovascular mortality in both overt and subclinical hyperthyroidism. Subclinical hypothyroidism with TSH 5-10 mIU/L might be associated with a lower risk of all-cause mortality....

  4. Dumping Syndrome

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    ... System & How it Works Digestive Diseases A-Z Dumping Syndrome What is dumping syndrome? Dumping syndrome occurs when food, especially sugar, ... the colon and rectum—and anus. What causes dumping syndrome? Dumping syndrome is caused by problems with ...

  5. Subclinical hypothyroidism in the first trimester of pregnancy in North India

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    Jubbin Jagan Jacob

    2013-01-01

    Full Text Available Subclinical hypothyroidism based on population and trimester specific cut-offs is reported to complicate 1-2% of all pregnancies. Using the recent Endocrine Society guidelines of 2.5 mIU/L of Thyroid Stimulating Hormone as the upper level of normal in the first trimester the reported prevalence of subclinical hypothyroidism is much higher. Recent publications have also emphasized that there is considerable racial variation in the prevalence of thyroid disorders in pregnancy. Among published literature North Indian women appear to have the highest rates of subclinical hypothyroidism in the first trimester of pregnancy. More widespread use of universal screening and trimester specific ranges in pregnancy for thyroid hormonal assays will lead to a large number of North Indian women requiring treatment for thyroid disorders in pregnancy.

  6. Levothyroxine substitution in patients with subclinical hypothyroidism and the risk of myocardial infarction and mortality

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    Andersen, Mette Nygaard; Olsen, Anne-Marie Schjerning; Madsen, Jesper Clausager

    2015-01-01

    BACKGROUND: Subclinical hypothyroidism is associated with a number of cardiovascular risk factors, yet only limited data exist on long-term outcome of levothyroxine treatment of this condition with respect to hard end-points. The aim of this retrospective cohort study was to determine effects...... of levothyroxine treatment on myocardial infarction (MI), cardiovascular death and all-cause mortality, in patients with subclinical hypothyroidism. METHODS AND RESULTS: Primary care patients aged 18 years and older that underwent thyroid function tests between 2000 and 2009 were enrolled. Participants were...... identified by individual-level linkage of nationwide registers. Patients with subclinical hypothyroidism at baseline were included in the study. Exclusion criteria included a history of thyroid disease, related medication or medication affecting thyroid function. The total cohort comprised 628,953 patients...

  7. Intracellular cytokine production by dengue virus-specific T cells correlates with subclinical secondary infection.

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    Hatch, Steven; Endy, Tim P; Thomas, Stephen; Mathew, Anuja; Potts, James; Pazoles, Pamela; Libraty, Daniel H; Gibbons, Robert; Rothman, Alan L

    2011-05-01

    The pathophysiology of dengue virus infection remains poorly understood, although secondary infection is strongly associated with more severe disease. In the present study, we performed a nested, case-control study comparing the responses of pre-illness peripheral blood mononuclear cells between children who would subsequently develop either subclinical or symptomatic secondary infection 6-11 months after the baseline blood samples were obtained and frozen. We analyzed intracellular cytokine production by CD4(+) and CD8(+) cells in response to stimulation with dengue antigen. We found higher frequencies of dengue virus-specific TNFα, IFNγ-, and IL-2-producing T cells among schoolchildren who subsequently developed subclinical infection, compared with those who developed symptomatic secondary dengue virus infection. Although other studies have correlated immune responses during secondary infection with severity of disease, to our knowledge this is the first study to demonstrate a pre-infection dengue-specific immune response that correlates specifically with a subclinical secondary infection.

  8. [Supra-His complete atrioventricular block in a patient with subclinical hyperthyroidism].

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    Amasyalı, Basri; Barçın, Cem; Kılıç, Ayhan

    2011-12-01

    Subclinical hyperthyroidism is a difficult entity to diagnose because of silent clinical features and it may be easily underdiagnosed unless it is suspected and thyroid hormone levels are examined. Although atrioventricular (AV) conduction abnormalities such as complete heart block may occasionally be seen in hyperthyroidism, its association with subclinical hyperthyroidism has not been reported previously. We report on a 50-year-old female patient who did not have any systemic or cardiovascular disease or history of drug use that could affect AV conduction and presented with presyncope and complete heart block with narrow QRS complexes. Thyroid function tests showed subclinical hyperthyroidism and an electrophysiological study showed the supra-His level as the site of complete AV block. After initiation of antithyroid treatment (propylthiouracil), the patient's rhythm improved to second-degree AV block on the third day and returned to normal sinus rhythm on the fourth day.

  9. Intermittent changing axis deviation with intermittent left anterior hemiblock during atrial flutter with subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2009-06-26

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes but it is usually associated with a higher heart rate and a higher risk of supraventricular arrhythmias including atrial fibrillation and atrial flutter. Intermittent changing axis deviation during atrial fibrillation has also rarely been reported. We present a case of intermittent changing axis deviation with intermittent left anterior hemiblock in a 59-year-old Italian man with atrial flutter and subclinical hyperthyroidism. To our knowledge, this is the first report of intermittent changing axis deviation with intermittent left anterior hemiblock in a patient with atrial flutter.

  10. E5 nucleotide polymorphisms suggest quasispecies occurrence in BPV-1 sub-clinically infected horses.

    Science.gov (United States)

    Savini, Federica; Federica, Savini; Gallina, Laura; Laura, Gallina; Prosperi, Alice; Alice, Prosperi; Battilani, Mara; Mara, Battilani; Bettini, Giuliano; Giuliano, Bettini; Scagliarini, Alessandra; Alessandra, Scagliarini

    2015-10-01

    BPV-1 is known as the main causative agent of equine sarcoid, but the virus has also been detected in skin and blood of healthy horses. Previous reports demonstrated the presence of E5 variants in sarcoids of donkeys and horses; we investigated whether this genetic variability might be also found in BPV-1, PBMC associated, of sub-clinically infected horses. With this aim, we analyzed the E5 gene of 21 BPV-1 strains from diseased and sub-clinically infected horses. Our analyses lead us to demonstrate that multiple sequence variants can be present in the blood of sub-clinically infected horses, with alternative bases corresponding to either synonymous or non-synonymous codons in the E5 oncogene sequences. The results give support to the proposed existence of "equine adapted" BPV-1 strains with the occurrence of viral variants, resembling quasispecies, in clinically healthy horses with viremia.

  11. One-year progression of diabetic subclinical macular edema in eyes with mild nonproliferative diabetic retinopathy

    DEFF Research Database (Denmark)

    Tejerina, Amparo Navea; Vujosevic, Stela; Varano, Monica

    2015-01-01

    PURPOSE: To characterize the 1-year progression of retinal thickness (RT) increase occurring in eyes with subclinical macular edema in type 2 diabetes. METHODS: Forty-eight type 2 diabetic eyes/patients with mild nonproliferative diabetic retinopathy (NPDR; levels 20 and 35 in the Early Treatment...... Diabetic Retinopathy Study) classified as presenting subclinical macular edema at baseline completed the 1-year follow-up period, from a sample of 194 followed in a 12-month observational and prospective study (ClinicalTrials.gov identifier: NCT01145599). Automated segmentation of the retinal layers...... in these eyes was performed, followed by verification and correction by a human grader. RESULTS: The highest increase in RT over the 1-year follow-up period for the 48 eyes/patients with subclinical macular edema was found in the inner nuclear layer (INL). Progression to clinical macular edema was also...

  12. Association of subclinical inflammation, glycated hemoglobin and risk for obstructive sleep apnea syndrome.

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    D'Aurea, Carolina Vicaria Rodrigues; Cerazi, Bruno Gion de Andrade; Laurinavicius, Antonio Gabriele; Janovsky, Carolina Castro Porto Silva; Conceição, Raquel Dilguerian de Oliveira; Santos, Raul D; Bittencourt, Márcio Sommer

    2017-01-01

    To investigate the inter-relation between high sensitivity C-reactive protein and glycated hemoglobin in prediction of risk of obstructive sleep apnea. We included all individuals participating in a check-up program at the Preventive Medicine Center of Hospital Israelita Albert Einstein in 2014. The Berlin questionnaire for risk of obstructive sleep apnea was used, and the high sensitivity C-reactive protein and glycated hemoglobin levels were evaluated. The sample included 7,115 participants (age 43.4±9.6 years, 24.4% women). The Berlin questionnaire showed changes in 434 (6.1%) individuals. This finding was associated with high sensitivity C-reactive protein and glycated hemoglobin levels (pMedicina Preventiva Hospital Israelita Albert Einstein em 2014. Foi aplicado o questionário de Berlin sobre risco de apneia do sono, e avaliadas as dosagens de hemoglobina glicada e proteína C-reativa de alta sensibilidade. Foram incluídos 7.115 participantes (idade 43,4±9,6 anos, 24,4% mulheres). A prevalência de alteração no questionário de Berlin foi de 434 (6,1%). A alteração do questionário de Berlin associou-se positivamente aos resultados da proteína C-reativa de alta sensibilidade e da hemoglobina glicada (p<0,001). No entanto, apenas a associação entre o resultado do questionário de Berlin e a hemoglobina glicada permaneceu significativa na análise multivariada ajustada tanto para fatores de risco tradicionais quanto para um modelo adicional, que incluiu também lipoproteína de alta densidade-colesterol (HDL-c) e triglicérides. A hemoglobina glicada, mesmo em valores abaixo do critério diagnóstico para diabetes mellitus, está associada de forma independente ao risco para síndrome da apneia obstrutiva do sono, mesmo após ajuste para obesidade e proteína C-reativa. Estes achados sugerem possível ligação fisiopatológica entre alterações na resistência insulínica e a síndrome da apneia obstrutiva do sono, que independe da obesidade ou inflamação de baixo grau.

  13. Clinical and pathologic factors associated with subclinical spread of invasive melanoma.

    Science.gov (United States)

    Shin, Thuzar M; Shaikh, Waqas R; Etzkorn, Jeremy R; Sobanko, Joseph F; Margolis, David J; Gelfand, Joel M; Chu, Emily Y; Elenitsas, Rosalie; Miller, Christopher J

    2017-04-01

    Indications to treat invasive melanoma with Mohs micrographic surgery (MMS) or analogous techniques with exhaustive microscopic margin assessment have not been defined. Identify clinical and histologic factors associated with subclinical spread of invasive melanoma. This retrospective, cross-sectional study evaluated 216 invasive melanomas treated with MMS and melanoma antigen recognized by T cells 1 immunostaining. Logistic regression models were used to correlate clinicopathologic risk factors with subclinical spread and construct a count prediction model. Risk factors associated with subclinical spread by multivariate analysis included tumor localization on the head and neck (OR 3.28, 95% confidence interval [CI] 1.16-9.32), history of previous treatment (OR 4.18, 95% CI 1.42-12.32), age ≥65 (OR 4.45, 95% CI 1.29-15.39), and ≥1 mitoses/mm(2) (OR 2.63, 95% CI 1.01-6.83). Tumor thickness and histologic subtype were not associated with subclinical spread. The probability of subclinical spread increased per number of risk factors, ranging from 9.22% (95% CI 2.57%-15.86%) with 1 factor to 80.32% (95% CI 68.13%-92.51%) with 5 factors. This study was conducted at a single academic institution with a small study population using a retrospective study design that was subject to potential referral bias. Clinical and histologic factors identify invasive melanomas that are at increased risk for subclinical spread and might benefit from MMS or analogous techniques prior to reconstruction. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Epicardial Adipose Tissue Thickness in Patients With Subclinical Hypothyroidism and the Relationship Thereof With Visceral Adipose Tissue Thickness.

    Science.gov (United States)

    Arpaci, Dilek; Gurkan Tocoglu, Aysel; Yilmaz, Sabiye; Korkmaz, Sumeyye; Ergenc, Hasan; Gunduz, Huseyin; Keser, Nurgul; Tamer, Ali

    2016-03-01

    Subclinical hypothyroidism (SH) is associated with cardiovascular metabolic syndromes, especially dislipidemia and abdominal obesity. Visceral abdominal adipose tissue (VAAT) and epicardial adipose tissue (EAT) have the same ontogenic origin and produce many proinflammatory and proatherogenic cytokines. We evaluated EAT and VAAT thickness in patients with SH. Forty-one patients with SH and 35 controls were included in the study. Demographical and anthropometric features of both patients and controls were recorded. Thyroid and metabolic parameters were measured. EAT was measured using 2D-transthoracic echocardiography. The age and gender distributions were similar in the two groups (P = 0.998 and P = 0.121, respectively). Body mass index (BMI), fat mass, waist circumference (WC), hip circumference (HC), the WC/HC ratio, and the thicknesses of VAAT and abdominal subcutaneous adipose tissue were higher in the case group than the control group (all P values 0.05). We found no difference between the two groups in fasting plasma glucose (FPG) level (P = 0.780), but the levels of LDL-C and TG differed significantly (P = 0.002 and P = 0.026, respectively). The serum TSH level was higher and the FT4 level was lower in the case than the control group (both P values <0.01). Increased abdominal adipose tissue thickness in patients with SH is associated with atherosclerosis. To detemine the risk of atherosclerosis in such patients, EAT measurements are valuable; such assessment is simple to perform.

  15. Risk prediction is improved by adding markers of subclinical organ damage to SCORE

    DEFF Research Database (Denmark)

    Sehestedt, Thomas; Jeppesen, Jørgen Lykke; Hansen, Tine W;

    2010-01-01

    .8-5.9)], PWV > 12 m/s [HR 1.9 (1.1-3.3) for SCORE > or = 5% and 7.3 (3.2-16.1) for SCORE or = 5% as well as subclinical organ damage, increased specificity of risk prediction from 75 to 81% (P sensitivity from 72 to 65% (P = 0.......4). Broaden primary prevention from subjects with SCORE > or = 5% to include subjects with 1% organ damage increased sensitivity from 72 to 89% (P = 0.006), but reduced specificity from 75 to 57% (P ....07). CONCLUSION: Subclinical organ damage predicted cardiovascular death independently of SCORE and the combination may improve risk prediction....

  16. Cardiovascular autonomic neuropathy and subclinical cardiovascular disease in normoalbuminuric type 1 diabetic patients

    DEFF Research Database (Denmark)

    Mogensen, Ulrik Madvig; Jensen, Tonny; Køber, Lars

    2012-01-01

    Cardiovascular autonomic neuropathy (CAN) is associated with increased mortality in diabetes. Since CAN often develops in parallel with diabetic nephropathy as a confounder, we aimed to investigate the isolated impact of CAN on cardiovascular disease in normoalbuminuric patients. Fifty......-six normoalbuminuric, type 1 diabetic patients were divided into 26 with (+) and 30 without (-) CAN according to tests of their autonomic nerve function. Coronary artery plaque burden and coronary artery calcium score (CACS) were evaluated using computed tomography. Left ventricular function was evaluated using...... with increased CACS, subclinical left ventricular dysfunction, and increased pulse pressure. In conclusion, CAN in normoalbuminuric type 1 diabetic patients is associated with distinct signs of subclinical cardiovascular disease....

  17. Prevalence of subclinical hepatic encephalopathy in cirrhotic patients in China

    Institute of Scientific and Technical Information of China (English)

    Yu-Yuan Li; Yu-Qiang Nie; Wei-Hong Sha; Zheng Zeng; Fu-Ying Yang; Li Ping; Lin Jia

    2004-01-01

    AIM: Subclinical hepatic encephalopathy (SHE) is a common complication of liver diseases. The aim of this study was to find out the normal value of psychometric test and to investigate the prevalence of SHE in Chinese patients with stabilized hepatic cirrhosis.METHODS: Four hundred and nine consecutive cirrhotic patients without overt clinical encephalopathy were screened for SHE by using number connection test part A (NCT-A) and symbol digit test (SDT). SHE was defined as presence of at least one abnormal psychometric test. The age-corrected normal values were defined as the mean±2times standard deviation (2SD), and developed in 356 healthy persons as normal controls. Four hundred and sixteen patients with chronic viral hepatitis were tested as negative controls to assess the diagnostic validity of this test battery.RESULTS: There was no significant difference in NCT scores and SDT quotients between healthy controls and chronic hepatitis group (P>0.05). In all age subgroups,the NCT and SDT measurements of cirrhotic patients differed significantly from those of the controls (P<0.05).When mean±2SD of SDT and NCT measurements from healthy control group was set as the normal range, 119cirrhotic patients (29.1%) were found to have abnormal NCT-A and SDT tests, 53 (13.0%) were abnormal only in SDT and 36 (8.8%) only in NCT-A. Taken together, SHE was diagnosed in 208 (50.9%) cirrhotic patients by this test battery. The prevalence of SHE increased from 39.9%and 55.2% in Child-Pugh's grade A and B groups to 71.8%in Child-Pugh's grade C group (P<0.05). After the adjustment of age and residential areas required from the tests, no correlation was found in the rate of SHE and causes of cirrhosis, education level and smoking habit.CONCLUSION: Psychometric tests are simple and reliable indicators for screening SHE among Chinese cirrhotic patients. By using a NCT and SDT battery, SHE could be found in 50.9% of cirrhotic patients without overt clinical encephalopathy. The

  18. Subclinical Shed of Infectious Varicella zoster Virus in Astronauts

    Science.gov (United States)

    Cohrs, Randall J.; Mehta, Satish K.; Schmid, D. Scott; Gilden, Donald H.; Pierson, Duane L.

    2007-01-01

    Aerosol borne varicella zoster virus (VZV) enters the nasopharynx and replicates in tonsillar T-cells, resulting in viremia and varicella (chickenpox). Virus then becomes latent in cranial nerve, dorsal root and autonomic nervous system ganglia along the entire neuraxis (1). Decades later, as cell-mediated immunity to VZV declines (4), latent VZV can reactivate to produce zoster (shingles). Infectious VZV is present in patients with varicella or zoster, but shed of infectious virus in the absence of disease has not been shown. We previously detected VZV DNA in saliva of astronauts during and shortly after spaceflight, suggesting stress induced subclinical virus reactivation (3). We show here that VZV DNA as well as infectious virus in present in astronaut saliva. VZV DNA was detected in saliva during and after a 13-day spaceflight in 2 of 3 astronauts (Fig. panel A). Ten days before liftoff, there was a rise in serum anti-VZV antibody in subjects 1 and 2, consistent with virus reactivation. In subject 3, VZV DNA was not detected in saliva, and there was no rise in anti-VZV antibody titer. Subject 3 may have been protected from virus reactivation by having zoster boost in cell-medicated immunity to VZV (2). No VZV DNA was detected in astronaut saliva months before spaceflight, or in saliva of 10 age/sex-matched healthy control subjects sampled on alternate days for 3 weeks (88 saliva samples). Saliva taken 2-6 days after landing from all 3 subjects was cultured on human fetal lung cells (Fig. panel B). Infectious VZV was recovered from saliva of subjects 1 and 2 on the second day after landing. Virus specificity was confirmed by antibody staining and DNA analysis which showed it to be VZV of European descent, common in the US (5). Further, both antibody staining and DNA PCR demonstrated that no HSV-1 was detected in any infected culture. This is the first report of infectious VZV shedding in the absence of clinical disease. Spaceflight presents a uniquely stressful

  19. Association of body mass index and waist circumference with subclinical atherosclerosis in retired NFL players.

    Science.gov (United States)

    Pokharel, Yashashwi; Basra, Sukhdeep; Lincoln, Andrew E; Tucker, Andrew M; Nambi, Vijay; Nasir, Khurram; Vogel, Robert A; Wong, Nathan D; Boone, Jeffrey L; Roberts, Arthur J; Ballantyne, Christie M; Virani, Salim S

    2014-10-01

    It is unknown which measure of adiposity (body mass index [BMI] or waist circumference [WC]) is associated with subclinical atherosclerosis in retired National Football League (NFL) players and whether this relation is attenuated after adjusting for components of the metabolic syndrome (elevated triglycerides, fasting glucose, and low levels of high-density lipoprotein-cholesterol [HDL-C]) that frequently coexist with obesity. Coronary artery calcium (CAC) was measured in 926 retired NFL players. BMI was calculated as weight (in kilograms)/height (in meters)(2) and WC was measured in inches. Logistic regression analyses adjusting for age, race, systolic blood pressure, high sensitivity C-reactive protein, triglycerides, HDL-C, and fasting blood glucose were performed to evaluate whether BMI or WC was independently associated with the presence of CAC (CAC score >0). The median age, BMI and WC were 54 years, 31 kg/m(2), and 40 inches, respectively. CAC was present in 61% (n = 562) of retired players. Adjusting for age, race, systolic blood pressure, high sensitivity C-reactive protein, triglycerides, HDL-C, and fasting blood glucose, each standard deviation increase in BMI (4.85 kg/m(2)) was significantly associated with CAC (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.03-1.50), but each standard deviation increase in WC (10.53 inches) was not significantly associated with CAC (OR 1.18, 95% CI 0.96-1.45). There was a significant association for the presence of CAC for highest versus lowest quartiles of both BMI (OR 1.93, 95% CI 1.13-3.28) and WC (OR 1.75, 95% CI 1.05-2.92), although the trend for the presence of CAC was significant only across increasing BMI quartiles, even in models that included WC. In retired NFL players both BMI and WC were associated with CAC. Higher BMI may be associated with an increasing trend for the presence of CAC independent of WC.

  20. Executive control, ERP and pro-inflammatory activity in emotionally exhausted middle-aged employees. Comparison between subclinical burnout and mild to moderate depression.

    Science.gov (United States)

    Gajewski, Patrick D; Boden, Sylvia; Freude, Gabriele; Potter, Guy G; Claus, Maren; Bröde, Peter; Watzl, Carsten; Getzmann, Stephan; Falkenstein, Michael

    2017-09-18

    Burnout is a syndrome occurring mainly in individuals with long-term stressful work. The main complaints are emotional exhaustion and reduced performance. Burnout also largely overlaps with depression. Both are characterized by increased incidence of infections due to dysregulation of the immune system, overexpression of pro-inflammatory cytokines and cognitive deficits, particularly related to executive functions. To distinguish between burnout and depression already at the pre-clinical stage, the present double-blinded study compared immunological and cognitive parameters in seventy-six employees from emotionally demanding occupations who were post-hoc subdivided into two groups scoring low (EE-) and high (EE+) in emotional exhaustion and low (DE-) and high (DE+) in depression. Immunological parameters were measured from blood samples. Executive functions were studied by analyzing event-related brain potentials (ERPs) and performance during a task switching paradigm. Psychosocial job parameters were measured with standardized questionnaires. Burnout and mild to moderate depression largely overlapped. However, several subjects showed burnout without depressive symptoms. Higher levels of the pro-inflammatory cytokines IL-6 and IL-12 were correlated with burnout severity and depressive symptoms in male individuals. In the switch task a trend for lower performance in the EE+ vs. EE- group and no difference between DE+ and DE- groups were found. In the ERPs, however, differences were observed which distinguished between subclinical burnout and depression: the terminal contingent negative variation (CNV), indicating preparatory activity and the P3b, related to allocation of cognitive resources were generally reduced in EE+ vs. EE-, whereas no differences were found in the DE+ vs. DE- groups. The frontal P3a was selectively reduced in switch trials in the EE+ vs. EE- group and showed only a trend in DE+ vs. DE-, indicating impairment of executive control in subclinical

  1. New diagnostic criteria for subclinical hypercortisolism using postsurgical hypocortisolism: the Co-work of Adrenal Research study.

    Science.gov (United States)

    Lee, Seung Hun; Song, Kee-Ho; Kim, Jinju; Park, Sooyoun; Ahn, Seong Hee; Kim, Hyeonmok; Cho, Yoon Young; Suh, Sunghwan; Kim, Beom-Jun; Kim, Jae Hyeon; Koh, Jung-Min

    2017-01-01

    There is no consensus on the biochemical diagnostic criteria for subclinical hypercortisolism (SH). Using parameters related to the hypothalamic-pituitary-adrenal axis, we aimed to develop a diagnostic model of SH for predicting postsurgical hypocortisolism and metabolic complications. Prospective and cross-sectional, observational, multicentre study in Korea. After exclusion of overt Cushing's syndrome, adrenal incidentaloma (AI) patients who underwent unilateral adrenalectomy (n = 99) and AI patients (n = 843) were included. Primary outcome was defined as the presence of postsurgical hypocortisolism; secondary outcome was the presence of ≥4 complications (components of the metabolic syndrome and low bone mass). Postsurgical hypocortisolism was determined on the fifth postsurgery day using the ACTH stimulation test. Thirty-three of the 99 patients developed postsurgical hypocortisolism. Analysis of the presurgery overnight 1-mg dexamethasone suppression test (1-mg DST) showed that all patients with cortisol levels of >138 nmol/l experienced postsurgical hypocortisolism, whereas those with levels of ≤61 nmol/l did not. The models of (i) 1-mg DST >138 nmol/l or (ii) >61 nmol/l with the presence of one among low levels of ACTH and dehydroepiandrosterone-sulphate had the highest accuracy (89·9%, P hypocortisolism. Finally, patients with the same criteria in the 843 AI patients showed the highest risk for having ≥4 complications (OR 3·51, 95% CI 1·84-6·69, P < 0·001), regardless of gender, age, body mass index and bilaterality. Our proposed model is able to accurately predict subtle cortisol excess and its chronic manifestations in AI patients. © 2016 John Wiley & Sons Ltd.

  2. Evaluation of parathyroid gland function using sodium bicarbonate infusion test for 22q11.2 deletion syndrome.

    Science.gov (United States)

    Nagasaki, Keisuke; Iwasaki, Yasumasa; Ogawa, Yohei; Kikuchi, Toru; Uchiyama, Makoto

    2011-01-01

    22q11.2 Deletion syndrome is a congenital malformation syndrome with hypoparathyroidism. The spectrum of parathyroid gland dysfunction ranges from severe neonatal hypocalcemia to subclinical hypoparathyroidism. The parathyroid hormone (PTH) secretory reserve is reduced in a significant number of 22q11.2 deletion syndrome patients with normocalcemia. The aim of this study was to investigate hypoparathyroid function using the bicarbonate infusion test for 22q11.2 deletion syndrome with normocalcemia. sodium bicarbonate solution [7% (w/v); 40 ml/m(2) body surface area] was infused for 2 min, and blood samples for the determination of plasma ionized calcium and plasma intact PTH were serially obtained. The test was conducted on five 22q11.2 deletion syndrome patients with normocalcemia. two patients presented increments of intact PTH levels (peak value - basal value) of 70 pg/ml or higher during the test, whereas the remaining 3 showed PTH level increments of <30 pg/ml. The former 2 patients were diagnosed as having normal parathyroid gland function, and the latter 3 patients as having subclinical hypoparathyroidism. the bicarbonate infusion test may be a valuable method for the evaluation of residual parathyroid gland function in patients with 22q11.2 deletion syndrome. Screening of subclinical hypoparathyroidism should be considered in the regular follow-up of patients with 22q11.2 deletion syndrome, even in cases with normocalcemia. 2010 S. Karger AG, Basel.

  3. Cushing syndrome

    Science.gov (United States)

    Hypercortisolism; Cortisol excess; Glucocorticoid excess - Cushing syndrome ... The most common cause of Cushing syndrome is taking too much ... exogenous Cushing syndrome . Prednisone, dexamethasone, and ...

  4. Serotonin syndrome

    Science.gov (United States)

    Hyperserotonemia; Serotonergic syndrome; Serotonin toxicity; SSRI - serotonin syndrome; MAO - serotonin syndrome ... two medicines that affect the body's level of serotonin are taken together at the same time. The ...

  5. Efficacy of the Therapy of Goiter with Subclinical Hypothyroidism Associated with Helicobacter pylori infection

    Directory of Open Access Journals (Sweden)

    G M Panyushkina

    2008-12-01

    Full Text Available Article presented results of the treatment (150 mcg/day KI of goitre with subclinical hypothyroidism associated with Helicobacter pylori infection in 54 women. In conclusion total eradication of Helicobacter pylori could increase efficacy of goitre treatment up to 90%.

  6. Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity: The Danish General Suburban Population Study

    Directory of Open Access Journals (Sweden)

    Anne-Dorthe Feldthusen

    2015-01-01

    Full Text Available Introduction. The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb, and mild (subclinical hypothyroidism in women from The Danish General Suburban Population Study (GESUS on the number of children born, the number of pregnancies, and the number of spontaneous abortions. Methods. Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. Results. 6.7% had mild (subclinical hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism TPOAb was significantly elevated and age at first child was older compared to controls. TSH and TPOAb were negatively linearly associated with the number of children born and the number of pregnancies in the full cohort in age-adjusted and multiadjusted models. TSH or TPOAb was not associated with spontaneous abortions. Mild (subclinical hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous abortions. Conclusion. Impaired fertility is associated with TSH, TPOAb, and mild (subclinical hypothyroidism in a Danish population of women.

  7. Well-being and depression in individuals with subclinical hypothyroidism and thyroid autoimmunity

    DEFF Research Database (Denmark)

    Fjaellegaard, Katrine; Kvetny, Jan; Allerup, Peter N.

    2014-01-01

    BACKGROUND: The association between subclinical hypothyroidism (SCH), with and without raised thyroid peroxidase antibodies (anti-TPO), and well-being or depression is still controversial, in spite of many studies on the topic. AIMS: In this large general population study of 8214 individuals, we...

  8. Subclinical Endometritis Diagnosed through Cytobrush and Reproductive Performance in Cattle from the Municipality of Pupiales, Colombia

    Directory of Open Access Journals (Sweden)

    Darío Antonio Vallejo Timarán

    2014-06-01

    Full Text Available Objective: To determine the distribution of subclinical endometritis and the reproductive behavior of dairy cattle diagnosed through endometrial cytology from the Municipality of Pupiales, Nariño. Materials and methods: A reproductive assessment was carried out (rectal palpation, ultrasonography and evaluation of vaginal mucus to determine the absence of early gestation and of clinical signs of uterine infection, and 174 cows were sampled through cervical catheterization and the technique of Cytobrush starting 30 days after birth. Consequently, the population under study was organized based on ovarian function (empty cycling normal or anestrous and the status of the uterus (with or without endometritis. Results: 43 cows (24.7% showed cellular changes indicative of an active inflammatory process originated in the endometrium. 79.06% of the animals diagnosed with subclinical endometritis were cyclic and had low reproductive performance. Conclusion: The high impact of subclinical endometritis in fertility and reproductive efficiency was determined. An early reproductive assessment must be performed, together with tests that make it possible to determine the presence of concomitant subclinical conditions.

  9. Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity: The Danish General Suburban Population Study.

    Science.gov (United States)

    Feldthusen, Anne-Dorthe; Pedersen, Palle L; Larsen, Jacob; Toft Kristensen, Tina; Ellervik, Christina; Kvetny, Jan

    2015-01-01

    The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb), and mild (subclinical) hypothyroidism in women from The Danish General Suburban Population Study (GESUS) on the number of children born, the number of pregnancies, and the number of spontaneous abortions. Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. 6.7% had mild (subclinical) hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism TPOAb was significantly elevated and age at first child was older compared to controls. TSH and TPOAb were negatively linearly associated with the number of children born and the number of pregnancies in the full cohort in age-adjusted and multiadjusted models. TSH or TPOAb was not associated with spontaneous abortions. Mild (subclinical) hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous abortions. Impaired fertility is associated with TSH, TPOAb, and mild (subclinical) hypothyroidism in a Danish population of women.

  10. Migraine and subclinical atherosclerosis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Goulart, Alessandra C; Santos, Itamar S; Bittencourt, Márcio S; Lotufo, Paulo A; Benseñor, Isabela M

    2016-08-01

    The relationship between migraine and coronary heart disease (CHD) remains controversial. We aimed to investigate the association of subclinical atherosclerosis and migraine with or without aura compared to a non-migraine subgroup (reference) in a large Brazilian multicentric cohort study, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Migraine diagnostic was based on International Headache Society criteria, and aura symptoms were validated by a medical doctor in a sub-sample of the ELSA-Brasil, who also underwent coronary artery calcium score (CAC) and carotid intima-media thickness (C-IMT) evaluations. Subclinical atherosclerosis indexes (CAC and C-IMT) were analyzed as dependent variables and migraine (all, with aura, without aura) as an independent variable in the linear and multinomial logistic regression models adjusted for possible confounders. Of 3217 ELSA participants free from CVD at baseline, we found a migraine frequency of 11.9% (5.1% with aura and 6.8% without aura). Overall, migraineurs were mostly women, younger and had lower frequency of CV risk factors, such as hypertension, diabetes and low HDL-cholesterol, compared to non-migraineurs. The strongest inverse correlation between migraine and subclinical atherosclerosis was verified with CAC score. However, all associations lost their significance after multivariate adjustment. In this cross-sectional evaluation of the ELSA study, migraine was not associated with subclinical atherosclerosis, regardless of aura symptoms. © International Headache Society 2015.

  11. Subclinical Obsessive-Compulsive Symptoms, Cognitive Processes, School Achievement, and Intelligence-Achievement Relationship in Adolescents

    Science.gov (United States)

    Malakar, Partha; Basu, Jayanti

    2017-01-01

    The aim of the study was to determine whether the general intelligence, cognitive processes, school achievement, and intelligence-achievement relationship of adolescents with subclinical levels of obsessive-compulsive symptoms differed from those of their normal counterparts. From an initial large pool of 14-year-old Bengali students in eighth…

  12. Study protocol; Thyroid hormone Replacement for Untreated older adults with Subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Stott, David J.; Gussekloo, Jacobijn; Kearney, Patricia M.

    2017-01-01

    BACKGROUND: Subclinical hypothyroidism (SCH) is a common condition in elderly people, defined as elevated serum thyroid-stimulating hormone (TSH) with normal circulating free thyroxine (fT4). Evidence is lacking about the effect of thyroid hormone treatment. We describe the protocol of a large ra...

  13. Subclinical ADHD, Stress, and Coping in Romantic Relationships of University Students

    Science.gov (United States)

    Overbey, Gail A.; Snell, William E., Jr.; Callis, Kenneth E.

    2011-01-01

    Objective: To examine how the subclinical symptoms of adult ADHD and those of oppositional-defiant disorder (ODD) affect relationship satisfaction and stress and to determine whether different patterns of coping strategies emerge when undergraduates have symptoms of one or both disorders. Method: Participants (N = 497) complete self-report surveys…

  14. Antibodies to infectious agents and the positive symptom dimension of subclinical psychosis : The TRAILS study

    NARCIS (Netherlands)

    Wang, Hao; Yolken, Robert H.; Hoekstra, Pieter J.; Burger, Huibert; Klein, Hans

    2011-01-01

    Infections have been suggested to play a role in the etiology of schizophrenia, but the evidence for this has been inconsistent. Schizophrenia patients have an increased risk of infections as a result of hospitalizations or life style factors. Therefore a study on early subclinical manifestations of

  15. Heart rate and blood pressure response to exercise and recovery in subclinical hypothyroid patients.

    Science.gov (United States)

    Sunita; Mahajan, Aarti Sood; Jain, Ak; Singh, Np; Mishra, Tk

    2013-07-01

    Exercise response of asymptomatic subclinical hypothyroid patients may aid in early diagnosis of cardiovascular morbidity. To study and compare the heart rate and blood pressure changes during exercise and recovery in subclinical hypothyroid patients and euthyroid controls. For the study, 30 each cases (mean age of 40 ± 7 years) of subclinical hypothyroidism and healthy controls underwent exercise as per Bruce protocol. Heart rate (HR) and blood pressure (BP) changes were compared every minute (min) till 3 min of stage II exercise, continued till maximum heart rate and thereafter on recovery, for 5 min after stoppage of exercise. Both groups had normal HR and BP at rest, heart rate and BP increased with exercise and remained high even after 5 min of recovery from exercise. The increase in systolic blood pressure (SBP) with exercise was less in patients at the stage of exercise where maximum HR was achieved and up to 1 min of recovery. SBP at 5 min of recovery was higher in patients (P = 0.018). Diastolic blood pressure (DBP) increased with exercise and changes were similar in both groups during exercise and recovery. HR was higher in patients at 1 min of exercise. Changes in HR from 1 min of recovery to 2-5 min of recovery were significant in both groups. The present pilot study highlights that many parameters of HR and SBP during exercise and recovery in asymptomatic subclinical hypothyroid patients may differ from euthyroid, controls.

  16. Identification of Diagnostic Protein Markers of Subclinical Mastitis in Bovine Whey Using Comparative Proteomics

    Directory of Open Access Journals (Sweden)

    Bian Yanjie

    2014-10-01

    Full Text Available The proteomics of inflammatory response in whey from cows with subclinical mastitis were analysed. Whey protein lysates were separated on 24 cm dry IPG strips (pH 3-10 linear and 24 cm dry IPG strips (pH 4-7 using two-dimensional electrophoresis. The results indicated that the whey proteins in milk from cows with subclinical mastitis are different from those in milk from healthy cows. All protein spots were found to have biologically relevant changes in relative abundance during subclinical mastitis using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry analysis, including ß-1,4 galactosyltransferase, ß-2 microglobulin, complement 3, a-1-acid glycoprotein, ß-lactoglobulin A, a-S1 casein precursor, ß-casein B, and serotransferrin precursor. The mRNA expression of these genes was verified by quantitative real-time PCR. These proteins are involved in signal transduction, binding, transport, and immune defence activity. The results suggest that the markers may be used for the diagnosis of subclinical mastitis.

  17. Clinical aspects of endogenous hypothyroidism and subclinical hyperthyroidism in patients with differentiated thyroid carcinoma

    NARCIS (Netherlands)

    Heemstra, Karen Anne

    2009-01-01

    Patients with DTC are initially treated with a total thyroidectomy and radioiodine therapy. Hereafter, all patients are treated with high doses of thyroxin aiming at significantly suppressing thyrotropin (TSH) levels, resulting in a subclinical hyperthyroid state. The rationale of this approach is

  18. [Subclinical hypothyroidism; the start of a clinical trial into the usefulness of treatment with radioactive iodine

    NARCIS (Netherlands)

    Hoogendoorn, E.H.; Wiersinga, W.M.; Prummel, M.F.; Heijer, M. den; Corstens, F.H.M.; Hermus, A.R.M.M.

    2004-01-01

    Subclinical hyperthyroidism is defined as the presence of serum free thyroxine (T4) and triiodothyronine (T3) levels within the reference range and a reduced serum thyrotrophin (TSH) level. Evidence is accumulating that it has important clinical effects. Randomised clinical trials are needed to answ

  19. [Improvement in functional capacity after levothyroxine treatment in patients with chronic heart failure and subclinical hypothyroidism].

    Science.gov (United States)

    Curotto Grasiosi, Jorge; Peressotti, Bruno; Machado, Rogelio A; Filipini, Eduardo C; Angel, Adriana; Delgado, Jorge; Cortez Quiroga, Gustavo A; Rus Mansilla, Carmen; Martínez Quesada, María del Mar; Degregorio, Alejandro; Cordero, Diego J; Dak, Marcelo; Izurieta, Carlos; Esper, Ricardo J

    2013-10-01

    To assess whether levothyroxine treatment improves functional capacity in patients with chronic heart failure (New York Heart Association class i-iii) and subclinical hypothyroidism. One hundred and sixty-three outpatients with stable chronic heart failure followed up for at least 6 months were enrolled. A physical examination was performed, and laboratory tests including thyroid hormone levels, Doppler echocardiogram, radionuclide ventriculography, and Holter monitoring were requested. Functional capacity was assessed by of the 6-min walk test. Patients with subclinical hypothyroidism were detected and, after undergoing the s6-min walk test, were given replacement therapy. When they reached normal thyrotropin (TSH) levels, the 6-min walk test was performed again. The distance walked in both tests was recorded, and the difference in meters covered by each patient was analyzed. Prevalence of subclinical hypothyroidism in patients with heart failure was 13%. These patients walked 292±63m while they were hypothyroid and 350±76m when TSH levels returned to normal, a difference of 58±11m (P<.011). Patients with normal baseline TSH levels showed no significant difference between the 2 6-min walk tests. Patients with chronic heart failure and subclinical hypothyroidism significantly improved their physical performance when normal TSH levels were reached. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  20. Virulence and genotype of a bovine herpesvirus 1 isolate from semen of a subclinically infected bull

    NARCIS (Netherlands)

    Oirschot, van J.T.; Rijsewijk, F.A.M.; Straver, P.J.; Ruuls, R.C.; Quak, J.; Davidse, A.; Westenbrink, E.; Gielkens, A.L.J.; Dijk, van J.E.; Moerman, A.

    1995-01-01

    A bovine herpesvirus 1 (BHV-1) isolate from the semen of a subclinically infected bull was administered to cattle by various routes to assess its virulence. Cattle that were artificially inseminated or inoculated intrapreputially did not develop clinical signs, but did transmit the virus to contact

  1. Early Detection of Subclinical Atherosclerosis in Asymptomatic Patients Assessed by Carotid Duplex and Coronary Computed Tomography

    Directory of Open Access Journals (Sweden)

    Cheng-Hsi Chen

    2013-03-01

    Conclusion: Carotid duplex may detect subclinical vascular atherosclerosis in more than half of asymptomatic patients without coronary artery calcification detected by coronary computed tomography. These findings have important implications for early-stage atherosclerosis screening and implementation of primary preventive intervention.

  2. Cannabis use and subclinical positive psychotic experiences in early adolescence : findings from a Dutch survey

    NARCIS (Netherlands)

    van Gastel, Willemijn A; Wigman, Johanna T W; Monshouwer, Karin; Kahn, René S; van Os, Jim; Boks, Marco P M; Vollebergh, Wilma A M

    2012-01-01

    AIMS: To investigate the association between early cannabis use and subclinical psychotic experiences, distinguishing between five levels of use: never used, discontinued use (life-time users who did not use in the preceding year), experimental use, regular use and heavy use. DESIGN: Cross-sectional

  3. Subclinical Obsessive-Compulsive Symptoms, Cognitive Processes, School Achievement, and Intelligence-Achievement Relationship in Adolescents

    Science.gov (United States)

    Malakar, Partha; Basu, Jayanti

    2017-01-01

    The aim of the study was to determine whether the general intelligence, cognitive processes, school achievement, and intelligence-achievement relationship of adolescents with subclinical levels of obsessive-compulsive symptoms differed from those of their normal counterparts. From an initial large pool of 14-year-old Bengali students in eighth…

  4. CRP and suPAR are differently related to anthropometry and subclinical organ damage

    DEFF Research Database (Denmark)

    Lyngbæk, Stig; Sehestedt, Thomas; Marott, Jacob L;

    2013-01-01

    of the inflammation associated with CVD. METHODS: We studied 2273 subjects without CVD. Log-transformed CRP and suPAR were included in general linear and logistic regression models to compare associations with measures of anthropometry and subclinical organ damage (SOD). Owing to interactions on body mass index (BMI...

  5. Clinical aspects of endogenous hypothyroidism and subclinical hyperthyroidism in patients with differentiated thyroid carcinoma

    NARCIS (Netherlands)

    Heemstra, Karen Anne

    2009-01-01

    Patients with DTC are initially treated with a total thyroidectomy and radioiodine therapy. Hereafter, all patients are treated with high doses of thyroxin aiming at significantly suppressing thyrotropin (TSH) levels, resulting in a subclinical hyperthyroid state. The rationale of this approach is

  6. Prevalence and risk factors for subclinical coccidiosis in broiler chicken farms in Mazandaran province, Iran.

    Science.gov (United States)

    Shirzad, Mohammad Reza; Seifi, Saeed; Gheisari, Hamid Reza; Hachesoo, Bahman Abdi; Habibi, Hasan; Bujmehrani, Hossein

    2011-12-01

    Coccidiosis is a disease of almost universal importance in Poultry production. The subclinical form of coccidiosis has most significant economic impact due to impaired growth rate and feed conversion. Some factors such as: age, size of flock, season, etc., may effect on severity of this disease. In this study, the relationships between some major risk factors and prevalence of subclinical coccidiosis were investigated. This study was done in 120 broiler farms in five different cities of Mazandaran province, north of Iran. Five chicks (3-8 weeks of ages) were taken randomly from every 120 farms and post-mortem and parasitological examinations were performed. Five Eimeria spp. were recognized: Eimeria tenella, Eimeria maxima, Eimeria acervulina, Eimeria brunetti, and Eimeria necatrix. The prevalence rate of subclinical coccidiosis among them is 75% (90 farms out of 120). E. acervulina was the most prevalent species (65.5%) followed by E. maxima (17.7%), E. tenella (15.5%), E. brunetti (10%), and E. necatrix (5.5%). According to what the results approve, the occurrence of subclinical coccidiosis is significantly related to the age and size of flock, whereas the other factors such as the season of year, industrial strains, chicken's keeping system, and anticoccidial drugs do not affect this phenomenon remarkably.

  7. Subclinical psychopathology and socio-economic status in unaffected twins discordant for affective disorder

    DEFF Research Database (Denmark)

    Vinberg Christensen, Maj; Kyvik, Kirsten Ohm; Vedel Kessing, Lars

    2006-01-01

    work position and tendency towards being more often unemployed and early retired than the Low-Risk twins. Furthermore, they presented higher rates of subclinical affective symptoms and were more likely to experience a minor psychiatric diagnosis. CONCLUSION: Healthy twins with a high genetic liability...

  8. Effect of sub-clinical mastitis on milk yield and composition of dairy ...

    African Journals Online (AJOL)

    Effect of sub-clinical mastitis on milk yield and composition of dairy goats in Tanzania. ... African Journal of Food, Agriculture, Nutrition and Development ... prevalence of mastitis in dairy goats appears to be high but studies on the influence of ...

  9. Guideline of the European Thyroid Association: Management of Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    V V Fadeyev

    2013-12-01

    Full Text Available Европейская Тиреоидная ассоциация (ETA, www.eurothyroid.com в последние годы стала активно заниматься созданием и публикацией клинических рекомендаций по диагностике и лечению заболеваний щитовидной железы (ЩЖ. К слову, раньше ЕТА, в отличие от ее американских сестер, выпускавших и обновлявших по 3-4 рекомендации в год, особого внимания этому не уделяла. Сейчас же только в разработке постоянно находятся 2-3 документа, которые вывешены на сайте ассоциации, и всем ее членам предлагается критиковать их предварительные версии. На сей раз перед нами рекомендации по диагностике и лечению субклинического гипотиреоза (СГ, которые бы хотелось представить и обсудить. Pearce, Brabant G, Duntas L, Monzani F, Peeters R, Razvi S, Wemeau J1L. 2013 ETA Guideline: Management of Subclinical Hypothyroidism. Eur Thyroid J 2013;2:2151-228.

  10. Preeclampsia: Syndrome or Disease?

    Science.gov (United States)

    Myatt, Leslie; Roberts, James M

    2015-11-01

    The focus on disease mechanisms underlying the hypertension and proteinuria defining preeclampsia has increased knowledge of the pathophysiology yet we lack both therapy and predictors. We propose this is in part due to the fact that diagnostic findings identify a "preeclampsia syndrome" but do not necessarily indicate the most important pathophysiology nor if organs are involved as cause or consequence. The increased risk for later life cardiovascular disease in women who develop preeclampsia suggests the stress test of pregnancy exposes pre-existing subclinical vascular disease. The dogma that inadequate trophoblast invasion and ischemia/reperfusion injury to the placenta is "the" cause of preeclampsia is more relevant to early onset preeclampsia (preeclampsia where maternal constitutive factors or susceptibility to vascular damage is more relevant. The contribution of differing disease phenotypes to the syndrome may explain the inability of biomarker studies to identify all preeclampsia. Identification of phenotypes will require large amounts of prospective clinical data and biospecimens, collected in a harmonized manner with analysis in an unbiased discovery approach.

  11. Association of claw disorders with subclinical intramammary infections in Egyptian dairy cows

    Directory of Open Access Journals (Sweden)

    Walid Refaai

    2017-03-01

    Full Text Available Aim: Bovine mastitis and lameness are the most common production diseases affecting dairy farms worldwide resulting in huge economic impact and impaired animal welfare. The objective of this field study was to investigate the association of infectious and non-infectious claw disorders with the occurrence of subclinical intramammary infections (IMIs diagnosed by California mastitis test (CMT in dairy cows under Egyptian conditions. Materials and Methods: A total of 43 dairy cows were included in this field study. Subclinical IMI was diagnosed by CMT on all lactating quarters of cows. A cow was considered to have subclinical IMI if it had at least one subclinically infected quarter (=3. Cows were inspected carefully for claw disorders that recorded based on type and site. Locomotion and body condition scores were also recorded for each cow in addition to the limb affected. The association between the CMT and other explanatory variables was tested by Fisher's exact test. Results: The prevalence of infectious and non-infectious claw disorders was 81.4% (35/43 and 32.6% (14/43, respectively. Digital dermatitis (DD and heel horn erosion were the most prevalent infectious type with 79% (34/43 and 58% (25/43, respectively, while wall fissure was the most identified non-infectious one 11.6% (5/43. The prevalence of claw disorders in hind limbs was 88.4% (38/43 and 11.6% (5/43 in the forelimbs. Infectious claw disorders were significantly associated with the subclinical IMI diagnosed by CMT (p<0.05. Non-infectious claw affections, locomotion score, body condition score, and the affected limb had no association with the occurrence of subclinical IMI. Conclusion: DD is the highest prevalent claw disorder observed in dairy cows in Egypt. The hind limbs are more susceptible to claw disorders than the forelimbs. Infectious type of claw disorders is significantly associated with subclinical IMI diagnosed by CMT in dairy cows under Egyptian conditions indicating

  12. Cushing's syndrome: why is diagnosis so difficult?

    Science.gov (United States)

    Aron, David C

    2010-06-01

    Practicing and perfecting the art of medicine demands recognition that uncertainty permeates all clinical decisions. When delivering clinical care, clinicians face a multiplicity of potential diagnoses, limitations in diagnostic capacity, and "sub-clinical" disease identified by tests rather than by clinical manifestations. In addition, clinicians must recognize the rapid changes in scientific knowledge needed to guide decisions. Cushing's syndrome is one of several disorders in which there may be considerable difficulty and delay in diagnosis. This article describes a current model of clinical reasoning, some of its challenges, and the application of the principles of clinical epidemiology to meet some of those challenges.

  13. Subclinical thyroid dysfunction and psychiatric disorders: cross-sectional results from the Brazilian Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Benseñor, Isabela M; Nunes, Maria Angélica; Sander Diniz, Maria de Fátima; Santos, Itamar S; Brunoni, André R; Lotufo, Paulo A

    2015-01-12

    To evaluate the association between subclinical thyroid dysfunction and psychiatric disorders using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Cross-sectional study. The study included 12 437 participants from the ELSA-Brasil with normal thyroid function (92·8%), 193 (1·4%) with subclinical hyperthyroidism and 784 (5·8%) with subclinical hypothyroidism, totalling 13 414 participants (50·6% of women). The mental health diagnoses of participants were assessed by trained raters using the Clinical Interview Schedule - Revised (CIS-R) and grouped according to the International Classification of Diseases 10 (ICD-10). Thyroid dysfunction was assessed using TSH and FT4 as well as routine use of thyroid hormones or antithyroid medications. Logistic models were presented using psychiatric disorders as the dependent variable and subclinical thyroid disorders as the independent variable. All logistic models were corrected for multiple comparisons using Bonferroni correction. After multivariate adjustment for possible confounders, we found a direct association between subclinical hyperthyroidism and panic disorder odds ratio [OR], 2·55; 95% confidence Interval (95% CI), 1·09-5·94; and an inverse association between subclinical hypothyroidism and generalized anxiety disorder (OR, 0·75; 95% CI, 0·59-0·96). However, both lost significance after correction for multiple comparisons. Subclinical hyperthyroidism was positively associated with panic disorder and negatively associated with anxiety disorder, although not significant after adjustment for multiple comparisons. © 2015 John Wiley & Sons Ltd.

  14. A systematic review and meta-analysis of prevalence of subclinical mastitis in dairy cows in India.

    Science.gov (United States)

    Bangar, Yogesh Chandrakant; Singh, Bishwambhar; Dohare, Amit Kumar; Verma, Med Ram

    2015-02-01

    The purpose of the study was to provide the pooled estimate of the prevalence of subclinical mastitis among dairy cows in India and to examine the consistency of those estimates between published studies. We have conducted a systematic review of prevalence of subclinical mastitis in dairy cows for the period 1995-2014 using electronic and non-electronic databases. Meta-analysis of 28 studies was done under random effects model using Metaprop package in R software. The pooled estimate of prevalence of subclinical mastitis on cow-basis was obtained using 6344 cows from 25 studies and was found to be 46.35 % (95 % CI 39.38; 53.46). Meta-analysis for quarter-wise prevalence of subclinical mastitis was carried out using 18,721 udder quarters of dairy cows from 23 studies, and the pooled estimate of prevalence of subclinical mastitis on quarter-basis was found to be 23.25 % (95 % CI 18.15; 29.27). Meta-analysis showed that there is statistically high heterogeneity for the prevalence estimates between published studies. The present study reported that there is high prevalence of subclinical mastitis in dairy cows in India, which might be responsible for low productivity in lactating cows in India over the years and needs to be controlled by adopting scientific, managemental, and therapeutic measures. Dairy farmers can reduce incidence and economic losses due to subclinical mastitis under the guidance of field veterinarians.

  15. Levothyroxine Substitution in Patients with Subclinical Hypothyroidism and the Risk of Myocardial Infarction and Mortality.

    Directory of Open Access Journals (Sweden)

    Mette Nygaard Andersen

    Full Text Available Subclinical hypothyroidism is associated with a number of cardiovascular risk factors, yet only limited data exist on long-term outcome of levothyroxine treatment of this condition with respect to hard end-points. The aim of this retrospective cohort study was to determine effects of levothyroxine treatment on myocardial infarction (MI, cardiovascular death and all-cause mortality, in patients with subclinical hypothyroidism.Primary care patients aged 18 years and older that underwent thyroid function tests between 2000 and 2009 were enrolled. Participants were identified by individual-level linkage of nationwide registers. Patients with subclinical hypothyroidism at baseline were included in the study. Exclusion criteria included a history of thyroid disease, related medication or medication affecting thyroid function. The total cohort comprised 628,953 patients of which 12,212 (1.9% had subclinical hypothyroidism (mean age 55.2 [SD ± 18.8] years; 79.8% female. Within the first six months 2,483 (20.3% patients claimed a prescription for levothyroxine. During a median follow-up of 5.0 (IQR: 5.2 years, 358 MI's and 1,566 (12.8% deaths were observed. Out of these, 766 of the deaths were cardiovascular related. No beneficial effects were found in levothyroxine treated patients on MI (IRR 1.08 [95% CI: 0.81 to 1.44], cardiovascular death (IRR 1.02 [95% CI: 0.83 to 1.25] or all-cause mortality (IRR 1.03 [95% CI: 0.90 to 1.19], except in patients under the age of 65 years (IRR 0.63 [95% CI: 0.40 to 0.99].Levothyroxine substitution in subclinical hypothyroid patients does not indicate an association with lower mortality or decreased risk of MI.

  16. Overt and subclinical hypothyroidism among Bangladeshi pregnant women and its effect on fetomaternal outcome.

    Science.gov (United States)

    Sharmeen, M; Shamsunnahar, P A; Laita, T R; Chowdhury, S B

    2014-08-01

    Thyroid disorders are among the common endocrine problems in pregnant women. It is now well established that not only overt but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are few data from Bangladesh about the prevalence of thyroid dysfunction in pregnancy. With this background, this study aims to find out thyroid dysfunction (both overt and subclinical hypothyroidism) in pregnancy and its impact on obstetrical outcome. We studied the evaluation of 50 admitted pregnancies corresponding to 29 women with subclinical hypothyroidism and rest 21 was overt hypothyroidism. Detailed history and examination were performed. Apart from routine obstetrical investigations, Thyroid Stimulating Hormone (TSH) estimation was done. Their obstetrical and perinatal outcomes were noted. Overt hypothyroidism was significantly (p hypothyroidism patients. In sub clinical hypothyroidism 86.2% conceived firstly within 2 years and 66.7% in overt hypothyroidism patients conceived firstly in between 3 to 5 years after marriage. Overt hypothyroids were prone to have pregnancy-induced hypertension 42.9%, intrauterine growth restriction (P = 0.001) and gestational diabetes (38.1%) as compared to subclinical cases. Neonatal complications were significantly more in overt hypothyroidism group. Mean TSH level was significantly (p hypothyroidism patients but mean FT4 level was almost similar in both groups. Majority of the patient underwent caesarean section in both groups due to associated medical and obstetrical complications. None of the babies showed hypothyroidism by cord blood tests. In this analysis our results showed that overt hypothyroidism among Bangladeshi pregnant women are associated with more maternal complication & adverse parental outcome than subclinical hypothyroidism. The adequate treatment of hypothyroidism during gestation minimizes risks and generally, makes it possible for pregnancies to be carried to term without complications

  17. Subclinical keratoconus detection by pattern analysis of corneal and epithelial thickness maps with optical coherence tomography.

    Science.gov (United States)

    Li, Yan; Chamberlain, Winston; Tan, Ou; Brass, Robert; Weiss, Jack L; Huang, David

    2016-02-01

    To screen for subclinical keratoconus by analyzing corneal, epithelial, and stromal thickness map patterns with Fourier-domain optical coherence tomography (OCT). Four centers in the United States. Cross-sectional observational study. Eyes of normal subjects, subclinical keratoconus eyes, and the topographically normal eye of a unilateral keratoconus patient were studied. Corneas were scanned using a 26,000 Hz Fourier-domain OCT system (RTVue). Normal subjects were divided into training and evaluation groups. Corneal, epithelial, and stromal thickness maps and derived diagnostic indices, including pattern standard deviation (PSD) variables and pachymetric map-based keratoconus risk scores, were calculated from the OCT data. Area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the diagnostic accuracy of the indices. The study comprised 150 eyes of 83 normal subjects, 50 subclinical keratoconus eyes of 32 patients, and 1 topographically normal eye of a unilateral keratoconus patient. Subclinical keratoconus was characterized by inferotemporal thinning of the cornea, epithelium, and stroma. The PSD values for corneal (P keratoconus risk score (AUC = 0.735). High-resolution Fourier-domain OCT could map corneal, epithelial, and stromal thicknesses. Corneal and sublayer thickness changes in subclinical keratoconus could be detected with high accuracy using PSD variables. These new diagnostic variables might be useful in the detection of early keratoconus. Oregon Health and Science University (OHSU) and Drs. Li, Tan, and Huang have a significant financial interest in Optovue, Inc. These potential conflicts have been reviewed and managed by OHSU. Dr. Brass receives research grants from Optovue, Inc. Drs. Chamberlain and Weiss have no financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. Prevalence of clinical and subclinical mastitis and quality of milk on smallholder dairy farms in Tanzania.

    Science.gov (United States)

    Mdegela, R H; Ryoba, R; Karimuribo, E D; Phiri, E J; Løken, T; Reksen, O; Mtengeti, E; Urio, N A

    2009-09-01

    A cross sectional study was conducted during October and November 2006 on 69 smallholder dairy farms with lactating cows in Mvomero and Njombe districts Tanzania, to determine the prevalence of mastitis and to assess the milk quality on the study farms. Clinical mastitis was investigated using clinical changes of udder and milk at animal level. Cow-side California Mastitis Test (CMT) and microbiological cultures were used to assess subclinical mastitis at quarter level. Milk quality was determined on bulk milk samples at herd level using alcohol and acidity tests, butter fat content, total solids, ash content as well as Delvotest for antimicrobial residues. Overall prevalence of clinical mastitis at herd level in both districts was 21.7% (n = 69). Based on CMT, prevalence of subclinical mastitis at animal level was 51.6% (n = 91). Prevalence of bacterial isolates at animal level was 35.2% (n = 91) while for fungal it was 16.7% (n = 90). Based on CMT results, prevalence of subclinical mastitis at quarter level was 30% (n = 353), while for bacteria and fungi it was 16% and 6% respectively. Contamination of milk with antimicrobial residues was 4.5% (n = 67). The milk quality parameters for most of the milk samples were within acceptable levels. Findings in this study have demonstrated high prevalence of subclinical mastitis that may contribute to low productivity of dairy cattle in both districts. About 20% of CMT subclinical cases had no involvement of microbial pathogens that suggested the need for minimal interventions with antimicrobial agents. These findings call for use of udder disinfectants and improved milking hygiene as intervention strategies to control mastitis on the smallholder dairy farms in Tanzania.

  19. Association of claw disorders with subclinical intramammary infections in Egyptian dairy cows

    Science.gov (United States)

    Refaai, Walid; Gad, Medhat; Mahmmod, Yasser

    2017-01-01

    Aim: Bovine mastitis and lameness are the most common production diseases affecting dairy farms worldwide resulting in huge economic impact and impaired animal welfare. The objective of this field study was to investigate the association of infectious and non-infectious claw disorders with the occurrence of subclinical intramammary infections (IMIs) diagnosed by California mastitis test (CMT) in dairy cows under Egyptian conditions. Materials and Methods: A total of 43 dairy cows were included in this field study. Subclinical IMI was diagnosed by CMT on all lactating quarters of cows. A cow was considered to have subclinical IMI if it had at least one subclinically infected quarter (≥3). Cows were inspected carefully for claw disorders that recorded based on type and site. Locomotion and body condition scores were also recorded for each cow in addition to the limb affected. The association between the CMT and other explanatory variables was tested by Fisher’s exact test. Results: The prevalence of infectious and non-infectious claw disorders was 81.4% (35/43) and 32.6% (14/43), respectively. Digital dermatitis (DD) and heel horn erosion were the most prevalent infectious type with 79% (34/43) and 58% (25/43), respectively, while wall fissure was the most identified non-infectious one 11.6% (5/43). The prevalence of claw disorders in hind limbs was 88.4% (38/43) and 11.6% (5/43) in the forelimbs. Infectious claw disorders were significantly associated with the subclinical IMI diagnosed by CMT (pCMT in dairy cows under Egyptian conditions indicating that the infectious types of claw affections may influence the udder health. PMID:28435201

  20. Prevalence of clinical and subclinical mastitis and quality of milk on smallholder dairy farms in Tanzania

    Directory of Open Access Journals (Sweden)

    R.H. Mdegela

    2009-05-01

    Full Text Available A cross sectional study was conducted during October and November 2006 on 69 smallholder dairy farms with lactating cows in Mvomero and Njombe districts Tanzania, to determine the prevalence of mastitis and to assess the milk quality on the study farms. Clinical mastitis was investigated using clinical changes of udder and milk at animal level. Cow-side California Mastitis Test (CMT and microbiological cultures were used to assess subclinical mastitis at quarter level. Milk quality was determined on bulk milk samples at herd level using alcohol and acidity tests, butter fat content, total solids, ash content as well as Delvotest® for antimicrobial residues. Overall prevalence of clinical mastitis at herd level in both districts was 21.7 % (n = 69. Based on CMT, prevalence of subclinical mastitis at animal level was 51.6 % (n = 91. Prevalence of bacterial isolates at animal level was 35.2 % (n = 91 while for fungal it was 16.7 % (n = 90. Based on CMT results, prevalence of subclinical mastitis at quarter level was 30 % (n = 353, while for bacteria and fungi it was 16 % and 6 % respectively. Contamination of milk with antimicrobial residues was 4.5 % (n =67. The milk quality parameters for most of the milk samples were within acceptable levels. Findings in this study have demonstrated high prevalence of subclinical mastitis that may contribute to low productivity of dairy cattle in both districts. About 20 % of CMT subclinical cases had no involvement of microbial pathogens that suggested the need for minimal interventions with antimicrobial agents. These findings call for use of udder disinfectants and improved milking hygiene as intervention strategies to control mastitis on the smallholder dairy farms in Tanzania.

  1. Sonographic findings in borderline changes and subclinical acute renal allograft rejection

    Energy Technology Data Exchange (ETDEWEB)

    Krejci, Karel [3rd Department of Internal Medicine and Nephrology, Faculty Hospital Olomouc, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: karel.krejci@fnol.cz; Zadrazil, Josef [3rd Department of Internal Medicine and Nephrology, Faculty Hospital Olomouc, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: josef.zadrazil@fnol.cz; Tichy, Tomas [Institute of Pathology, Faculty Hospital Olomouc, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: tomas.tichy@fnol.cz; Al-Jabry, Sadek [3rd Department of Internal Medicine and Nephrology, Faculty Hospital Olomouc, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: sadekj@seznam.cz; Horcicka, Vladko [3rd Department of Internal Medicine and Nephrology, Faculty Hospital Olomouc, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: vl.horcicka@fnol.cz; Strebl, Pavel [3rd Department of Internal Medicine and Nephrology, Faculty Hospital Olomouc, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: apolik@centrum.cz; Bachleda, Petr [2nd Surgical Department and Transplant Centrum, Faculty Hospital Olomouc, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: petr.bachleda@fnol.cz

    2009-08-15

    Purpose: A clinically manifested acute rejection is associated with graft dysfunction and with some ultrasound findings. The aim of our study was to determine the potential of ultrasound evaluation in the detection of subclinical acute rejective changes diagnosed in stable grafts by protocol biopsy. Methods: Gray-scale evaluation, color Doppler imaging (CDI) and power Doppler imaging (PDI) was performed before each of 184 protocol graft biopsies in 77 patients in the third week, third month and first year after transplantation. The group was divided into four subgroups-normal histological finding, borderline changes, subclinical acute rejection of IA grade, and a clinically manifested acute rejection of IA grade. The sonographic findings were compared with individual groups. Results: Detection of parenchymal edema using gray-scale imaging significantly differentiated borderline changes and subclinical acute rejection of IA grade from normal histological findings in the third week and in the third month (P = 0.013, P = 0.002 and P = 0.024, P < 0.001), respectively. A similar finding could be recorded in the latter group in the first year after transplantation (P = 0.024). The presence of edema and reduced peripheral parenchymal perfusion in PDI significantly more often indicated a clinically manifested acute IA rejection (P = 0.019, P = 0.004, P = 0.044). Parenchymal CDI hyperperfusion had a high specificity (89.5%) but a low sensitivity (60%) in the detection of the subclinical form of acute IA rejection. Conclusion: A composite gray-scale, PDI and CDI evaluation provide a significant differentiation of groups with borderline changes and subclinical acute rejection and groups with normal histological finding and clinically manifested acute rejection.

  2. Gardner Syndrome

    Science.gov (United States)

    ... Home > Types of Cancer > Gardner Syndrome Request Permissions Gardner Syndrome Approved by the Cancer.Net Editorial Board , 06/2014 What is Gardner syndrome? Gardner syndrome is a subtype of familial ...

  3. Is There Any Effect on Smell and Taste Functions with Levothyroxine Treatment in Subclinical Hypothyroidism?

    Science.gov (United States)

    Baskoy, Kamil; Ay, Seyid Ahmet; Altundag, Aytug; Kurt, Onuralp; Salihoglu, Murat; Deniz, Ferhat; Tekeli, Hakan; Yonem, Arif; Hummel, Thomas

    2016-01-01

    Subclinical hypothyroidism has been accused for coronary heart disease, lipid metabolism disorders, neuropsychiatric disorders, infertility or pregnancy related problems with various strength of evidence. Currently there is insufficient knowledge about olfaction and taste functions in subclinical hypothyroidism. Aim of the present study is to investigate the degree of smell and taste dysfunction in patients with subclinical hypothyroidism. 28 subclinical hypothyroid patients, and 31 controls enrolled in the prospective study in Istanbul, Turkey. Subclinical hypothyroid patients were treated with L-thyroxine for 3 months. Psychophysiological olfactory testing was performed using odor dispensers similar to felt-tip pens ("Sniffin' Sticks", Burghart, Wedel, Germany). Taste function tests were made using "Taste Strips" (Burghart, Wedel, Germany) which are basically tastant adsorbed filter paper strip. Patients scored lower on psychophysical olfactory tests than controls (odor thresholds:8.1±1.0 vs 8.9±1.1, p = 0.007; odor discrimination:12.4±1.3 vs 13.1±0.9, p = 0.016; odor identification:13.1±0.9 vs 14.0±1.1, p = 0.001; TDI score: 33.8±2.4 vs 36.9±2.1, p = 0.001). In contrast, results from psychophysical gustatory tests showed only a decreased score for "bitter" in patients, but not for other tastes (5.9±1.8 vs 6.6±1.0, p = 0.045). Three month after onset of treatment olfactory test scores already indicated improvement (odor thresholds:8.1±1.0 vs 8.6±0.6, psmell and taste, with thyroid function test were also evaluated. TSH, fT4 were found have no correlation with smell and taste changes with treatment. However bitter taste found positively correlated with T3 with treatment(r: 0.445, p: 0.018). Subclinical hypothyroid patients exhibited a significantly decreased olfactory sensitivity; in addition, bitter taste was significantly affected. Most importantly, these deficits can be remedied on average within 3 months with adequate treatment.

  4. The Intricate Relationship between Psychotic-Like Experiences and Associated Subclinical Symptoms in Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Lui Unterrassner

    2017-09-01

    Full Text Available The interplay between subclinical psychotic, negative, and affective symptoms has gained increased attention regarding the etiology of psychosis spectrum and other mental disorders. Importantly, research has tended to not differentiate between different subtypes of psychotic-like experiences (PLE although they may not have the same significance for mental health. In order to gain information on the subclinical interplay between specific PLE and other symptoms as well as the significance of PLE for mental health, we investigated their specific associations in 206 healthy individuals (20–60 years, 73 females using correlational and linear regression analyses. PLE were assessed with the Magical Ideation Questionnaire, the revised Exceptional Experiences Questionnaire, and subscales of the Schizotypal Personality Questionnaire (SPQ. The revised Symptom Checklist 90, the SPQ, and the Physical Anhedonia Scale were used to measure subclinical negative symptoms, affective symptoms, and other symptoms such as, emotional instability. As hypothesized, we found that (1 most affective symptoms and all other subclinical symptoms correlated positively with all PLE, whereas we found only partial associations between negative symptoms and PLE. Notably, (2 magical ideation and paranormal beliefs correlated negatively with physical anhedonia. In the regression analyses we found (3 similar patterns of specific positive associations between PLE and other subclinical symptoms: Suspiciousness was a specific predictor of negative-like symptoms, whereas ideas of reference, unusual perceptual experiences, and dissociative anomalous perceptions specifically predicted anxiety symptoms. Interestingly, (4 ideas of reference negatively predicted physical anhedonia. Similarly, paranormal beliefs were negatively associated with constricted affect. Moreover, odd beliefs were a negative predictor of depression, emotional instability, and unspecific symptoms. Our findings

  5. The Intricate Relationship between Psychotic-Like Experiences and Associated Subclinical Symptoms in Healthy Individuals.

    Science.gov (United States)

    Unterrassner, Lui; Wyss, Thomas A; Wotruba, Diana; Haker, Helene; Rössler, Wulf

    2017-01-01

    The interplay between subclinical psychotic, negative, and affective symptoms has gained increased attention regarding the etiology of psychosis spectrum and other mental disorders. Importantly, research has tended to not differentiate between different subtypes of psychotic-like experiences (PLE) although they may not have the same significance for mental health. In order to gain information on the subclinical interplay between specific PLE and other symptoms as well as the significance of PLE for mental health, we investigated their specific associations in 206 healthy individuals (20-60 years, 73 females) using correlational and linear regression analyses. PLE were assessed with the Magical Ideation Questionnaire, the revised Exceptional Experiences Questionnaire, and subscales of the Schizotypal Personality Questionnaire (SPQ). The revised Symptom Checklist 90, the SPQ, and the Physical Anhedonia Scale were used to measure subclinical negative symptoms, affective symptoms, and other symptoms such as, emotional instability. As hypothesized, we found that (1) most affective symptoms and all other subclinical symptoms correlated positively with all PLE, whereas we found only partial associations between negative symptoms and PLE. Notably, (2) magical ideation and paranormal beliefs correlated negatively with physical anhedonia. In the regression analyses we found (3) similar patterns of specific positive associations between PLE and other subclinical symptoms: Suspiciousness was a specific predictor of negative-like symptoms, whereas ideas of reference, unusual perceptual experiences, and dissociative anomalous perceptions specifically predicted anxiety symptoms. Interestingly, (4) ideas of reference negatively predicted physical anhedonia. Similarly, paranormal beliefs were negatively associated with constricted affect. Moreover, odd beliefs were a negative predictor of depression, emotional instability, and unspecific symptoms. Our findings indicated that

  6. Cytotoxin and Pyrogenic Toxin Superantigen Gene Profiles of Staphylococcus aureus Associated with Subclinical Mastitis in Dairy Cows and Relationships with Macrorestriction Genomic Profiles

    Science.gov (United States)

    Fueyo, J. M.; Mendoza, M. C.; Rodicio, M. R.; Muñiz, J.; Alvarez, M. A.; Martín, M. C.

    2005-01-01

    A set of 84 Staphylococcus aureus isolates collected from the milk of cows with subclinical mastitis in Asturias (a cattle region of Spain) and six control strains were tested for sequences of genes encoding hemolysins (hla, hlb, hld, hlg, and hlg-2), leukotoxins (lukPV, lukM, and lukED), toxic shock syndrome toxin (tst), and enterotoxins (sea to see, seg to ser, and seu) by conventional and multiplex PCR. It was found that 84, 83, 11, and 39 isolates carried some type of hl, luk, tst, or se gene, respectively, which were arranged in 14 exotoxin genotypes. All of the isolates were negative for lukPV, hlg, sea, sed, see, sej, sek, sep, seq, and ser. Two gene groupings could be related with pathogenicity islands—[lukED, seg, sei, sem, sen, seo ± seu] with Saβ-1 and [tst, sec, sel] with SaPIbov, present in 45 and 13.1% of the isolates, respectively—while 11.9% of them carried both islands. Only one contained seb (together with υSaβ-1), and another contained seh (together with lukED). The isolates were also analyzed by pulsed-field gel electrophoresis performed with SmaI. Thirty-nine SmaI profiles (similarity coefficient [S] = 0.94 to 0.21) were differentiated; 12, 1, and 10 of these, respectively, were generated by isolates presumptively carrying Saβ-1, SaPIbov, or both. Five SmaI profiles (S ≥ 0.8) formed a cluster, which contained 20 and 10 isolates carrying one (υSaβ-1) or both islands. These data show the high frequency of genes encoding cytotoxins and pyrogenic toxin superantigens, their relationship with pathogenicity islands, and their distribution among a diversity of genetic types of S. aureus related to subclinical mastitis. PMID:15750096

  7. Analysis of associations between major histocompatibility complex (BoLA) class I haplotypes and subclinical mastitis of dairy cows

    DEFF Research Database (Denmark)

    Aarestrup, Frank Møller; Jensen, N. E.; Østergård, H.

    1995-01-01

    The associations between BoLA class I haplotypes and subclinical mastitis were investigated using information on 333 cows from three different breeds and crossbreeds from 14 dairy herds in Denmark. Somatic cell count and bacteriological status were used as markers for subclinical mastitis....... Associations between BoLA class I haplotypes and IMI status were also determined. The association between BoLA class I haplotypes and subclinical mastitis was weak. The A10(W50), A11, A12(A30), A16, A19(A6), A21, A26, and A31(A30) alleles were associated with different markers of subclinical mastitis....... Susceptibility or resistance to the two bacteria categories was associated with different alleles. This study indicated that BoLA antigens may be involved in resistance to mastitis and that resistance may be specific for a particular pathogen....

  8. Associations between objectively measured physical activity intensity in childhood and measures of subclinical cardiovascular disease in adolescence

    DEFF Research Database (Denmark)

    Ried-Larsen, Mathias; Grøntved, Anders; Møller, Niels Christian

    2014-01-01

    BACKGROUND AND AIM: No prospective studies have investigated the association between physical activity (PA) and carotid subclinical cardiovascular disease across childhood. Therefore, the primary aim was to investigate the association between PA intensity across childhood and carotid intima media...

  9. Retinal layer location of increased retinal thickness in eyes with subclinical and clinical macular edema in diabetes type 2

    DEFF Research Database (Denmark)

    Bandello, Francesco; Tejerina, Amparo Navea; Vujosevic, Stela

    2015-01-01

    PURPOSE: To identify the retinal layer predominantly affected in eyes with subclinical and clinical macular edema in diabetes type 2. METHODS: A cohort of 194 type 2 diabetic eyes/patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20/35) were examined with Cirrus spectral......-domain optical coherence tomography (OCT) at the baseline visit (ClinicalTrials.gov identifier: NCT01145599). Automated segmentation of the retinal layers of the eyes with subclinical and clinical macular edema was compared with a sample of 31 eyes from diabetic patients with normal OCT and an age......-matched control group of 58 healthy eyes. RESULTS: From the 194 eyes in the study, 62 had subclinical macular edema and 12 had clinical macular edema. The highest increases in retinal thickness (RT) were found in the inner nuclear layer (INL; 33.6% in subclinical macular edema and 81.8% in clinical macular edema...

  10. Subclinical hypothyroidism as a risk factor for placental abruption: evidence from a low-risk primigravid population.

    LENUS (Irish Health Repository)

    Breathnach, Fionnuala M

    2013-12-01

    Subclinical thyroid hypofunction in pregnancy has been shown to have an association with neurodevelopmental delay in the offspring. It is unclear whether obstetric factors may account for this observation.

  11. Effects of coffee consumption on subclinical inflammation and other risk factors for type 2 diabetes: a clinical trial

    National Research Council Canada - National Science Library

    Kempf, Kerstin; Herder, Christian; Erlund, Iris; Kolb, Hubert; Martin, Stephan; Carstensen, Maren; Koenig, Wolfgang; Sundvall, Jouko; Bidel, Siamak; Kuha, Suvi; Tuomilehto, Jaakko

    2010-01-01

    Coffee consumption is associated with a decreased risk of type 2 diabetes. Suggested mechanisms underlying the association have included attenuation of subclinical inflammation and a reduction in oxidative stress...

  12. A comparison of somatic cell count and antimicrobial susceptibility of subclinical mastitis pathogens in organic and conventional dairy herds

    OpenAIRE

    Boutet, Philippe; Detilleux, Johann; Motkin, Michel; Deliege, M.; PIRAUX, E.; Depinois, A.; Debliquy, P.; Mainil, Jacques; Czaplicki, G.; Lekeux, Pierre

    2005-01-01

    A comparison of somatic cell count and antimicrobial susceptibility of subclinical mastitis pathogens in organic and conventional dairy herds.Bovine subclinical mastitis is the most important disease affecting dairy cows. The fluctuating increase in somatic cell count (SCC) that occurs causes major economic losses in dairy industry. This comparative study between conventional and organic dairy herds was conducted in the aim to better characterize which consequences might have different manage...

  13. Neutrophil surface adhesion molecule and toll like receptor dynamics in crossbred cows suffering from Staphylococcus aureus subclinical and clinical mastitis

    OpenAIRE

    Dilip Kumar Swain; Mohar Singh Kushwah; Ajay Kumar Dang

    2016-01-01

    Objective: The present study was an attempt to delineate the roles played by the neutrophil surface adhesion molecules and toll like receptors (TLRs) in crossbred cows suffering from Staphylococcus aureus subclinical and clinical mastitis. Materials and methods: Thirty six Karan Fries (KF) cows were categorized into three groups namely healthy (n=12), subclinical mastitis (SCM; n=12) and clinical mastitis (CM; n=12) after screening 146 cows. The grouping was done based on evaluation of co...

  14. Sensitivity and Specificity of Posterior and Anterior Corneal Elevation Measured by Orbscan in Diagnosis of Clinical and Subclinical Keratoconus

    Science.gov (United States)

    Jafarinasab, Mohammad Reza; Shirzadeh, Ebrahim; Feizi, Sepehr; Karimian, Farid; Akaberi, Arash; Hasanpour, Hosein

    2015-01-01

    Purpose: To determine the sensitivity and specificity of anterior and posterior corneal elevation parameters as determined by Orbscan II (Bausch and Lomb, Rochester, NY, USA) in discriminating between (sub) clinical keratoconus (KCN) and normal corneas. Methods: This prospective case-control study included 28 eyes with subclinical KCN, 65 with clinical KCN and 141 normal corneas. Anterior and posterior corneal elevation was measured and compared in the central 5-mm corneal zone using Orbscan II. Results: Receiver operating curves (ROC) curve analyses for posterior corneal elevation showed predictive accuracy in both KCN and subclinical KCN with an area under the curve (AUC) of 0.97 and 0.69, respectively while optimal cutoff points were 51 μm for KCN and 35 μm for subclinical KCN. These values were associated with sensitivity and specificity of 89.23% and 98.58%, respectively, for KCN; and 50.00% and 88.65% for subclinical KCN. ROC curve analyses for anterior corneal elevation showed predictive accuracy in both KCN and subclinical KCN with AUC of 0.97 and 0.69, respectively while optimal cutoff points were 19 μm for KCN and 16 μm for subclinical KCN. These values were associated with sensitivity and specificity of 93.85% and 97.16%, respectively, for KCN; and 60.71% and 87.94% for subclinical KCN. Conclusion: Anterior and posterior corneal elevation data obtained by Orbscan II can well discriminate between KCN and normal corneas, however the reliability of their indices is lower in differentiating subclinical KCN from normal cases. PMID:26005546

  15. Subclinical atherosclerosis in Latino youth: progression of carotid intima-media thickness and its relationship to cardiometabolic risk factors.

    Science.gov (United States)

    Toledo-Corral, Claudia M; Davis, Jaimie N; Alderete, Tanya L; Weigensberg, Marc J; Ayala, Christina T; Li, Yanjie; Hodis, Howard N; Goran, Michael I

    2011-06-01

    To assess carotid artery intima-media thickness (CIMT) change over 2 years in overweight Latino adolescents and examine its relationship to cardiometabolic risk. Seventy-two healthy overweight male and female Latino adolescents (mean age, 14.5 ± 1.7 years; mean body mass index, 31.5 ± 6.9 kg/m(2)) were evaluated at baseline and 2 years later for CIMT by high-resolution B-mode ultrasound, the metabolic syndrome and its features, body composition by dual-energy x-ray absorptiometry and magnetic resonance imaging, glucose/insulin measures by fasting blood, and oral and intravenous glucose tolerance tests. Baseline CIMT did not differ from 2-year follow-up; however, 38 participants increased CIMT (0.017 ± 0.003 mm; +2.8%) and 34 decreased or remained the same (-0.019 ± 0.002 mm; -3.1%). ANCOVA analyses showed that participants with CIMT progression had higher baseline low-density lipoprotein (LDL)-cholesterol and total cholesterol (91.3 ± 3.4 and 150.3 ± 3.9 mg/dL) compared with those with CIMT non-progression (78.1 ± 3.6 and 135.6 ± 4.2 mg/dL, P < .05), independent of sex, baseline CIMT, age, and height. In multivariate regression, LDL-cholesterol was the sole predictor of CIMT progression, but the effect was small (odds of CIMT progression increased by 3% for each 1 mg/dL higher baseline LDL-cholesterol; 95% CI, 1.004 to 1.006, P = .03). These results indicate a high variability in the magnitude of CIMT change in growing overweight Latino youth and support the use of LDL-cholesterol to assess subclinical atherosclerosis risk in this population. Copyright © 2011 Mosby, Inc. All rights reserved.

  16. Does thyroid function have any relation with components of metabolic syndrome?

    Directory of Open Access Journals (Sweden)

    Yash Shah

    2015-10-01

    Results: There were 28 females and 22 males. Mean BMI was 31.51+/-5.21 kg/m2. The mean systolic blood pressure was 139.04+/-26.67 mm Hg and the diastolic pressure was 88.32+/-14.95 mm Hg. Mean waist circumference was 102+/-10.1 cm and mean waist: hip ratio was 0.97+/-0.094. HDL <50 in males and <40 in females in Euthyroid showed statistical significance (p value 0.05. Other components did not gain a statically significance. Comparing gender wise Subclinical hypothyroidism patients with Euthyroid patients, females having subclinical hypothyroidism are more likely to have metabolic syndrome (p value =0.03. This is not so in case of males. Conclusions: Female patients having subclinical hypothyroidism have higher chances of have metabolic syndrome as compared to males. Euthyroid patients with metabolic syndrome had low cholesterol. Other components of metabolic syndrome had no statically significance with thyroid function. [Int J Res Med Sci 2015; 3(10.000: 2682-2685

  17. Serum Retinol-Binding Protein 4 Concentration and Its Ratio to Serum Retinol Are Associated with Obesity and Metabolic Syndrome Components in Children

    NARCIS (Netherlands)

    Aeberli, I.; Molinari, L.; Spinas, G.; Lehmann, R.; Allemand, l' D.; Zimmermann, M.B.

    2007-01-01

    Objective: The objective of the study was to measure serum RBP4, serum retinol (SR), the RBP4-to-SR molar ratio, and dietary VA intakes in normal-weight and overweight children and investigate the relationship of these variables to IR, subclinical inflammation, and the metabolic syndrome in this age

  18. Serobiochemical Alterations in Subclinically Affected Dromedary Camels with Trypanosoma Evansi in Iran

    Directory of Open Access Journals (Sweden)

    Ali Reza Sazmand, Aria Rasooli٭1, Mohammad Nouri1, Hosein Hamidinejat2 and Seyyed Hosein Moghaddam Hekmati3

    2011-06-01

    Full Text Available The aim of this study was to investigate the effects of subclinical Trypanosoma evansi infection on serum biochemical parameters of dromedary camels. Jugular vein blood samples were taken weekly for three successive weeks from 110 apparently healthy male camels and examined for the presence of trypomastigote form of T. evansi in blood smears. The parasite was seen in 17 (15.45% blood smears. Various serum biochemical parameters i.e., glucose, urea, cholesterol, triglyceride, calcium, magnesium, sodium, potassium, phosphorus, total protein, albumin, triiodothyronine (T3, thyroxine (T4, cortisol, and activities of aspartate aminotransferase (AST, alanine aminotransferase (ALT, alkaline phosphatase (ALP, lactate dehydrogenase (LDH and creatine kinase (CK were determined. Infected camels had significantly lower serum glucose, T3 and T4 concentrations (P<0.05, and significantly higher triglycerides concentration and ALT activity (P<0.05. It was concluded that subclinical infection of camels with T. evansi can also affect some biochemical parameters.

  19. The challenge of detecting herds sub-clinically infected with Actinobacillus pleuropneumoniae.

    Science.gov (United States)

    Gottschalk, Marcelo

    2015-10-01

    The introduction into a naïve herd of animals sub-clinically infected with Actinobacillus pleuropneumoniae (App) is frequently the cause of clinical pleuropneumonia and the identification of such infected herds is a priority in the control of disease. Different serological tests for App have been developed and a number of these are routinely used. Some are species-specific whereas others identify more specifically the serotype/serogroup involved which requires updated information about important serotypes recovered from diseased pigs in a given area/country. Serotyping methods based on molecular techniques have been developed lately and are ready to be used by most diagnostic laboratories. When non-conclusive serological results are obtained, direct detection of App from tonsils is sometimes attempted. This review addresses different techniques and approaches used to monitor herds sub-clinically infected by this important pathogen. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Exercise training in childhood cancer survivors with subclinical cardiomyopathy who were treated with anthracyclines.

    Science.gov (United States)

    Smith, Webb A; Ness, Kirsten K; Joshi, Vijaya; Hudson, Melissa M; Robison, Leslie L; Green, Daniel M

    2013-11-06

    Childhood cancer survivors (CCS) treated with anthracyclines are at risk for cardiomyopathy. This case series evaluated the response of anthracycline exposed CCS with subclinical cardiomyopathy to aerobic and strength training. Body composition, strength and cardiopulmonary fitness were evaluated before and after the 12-week intervention. All equipment and materials were provided to five 10+ year CCS (3 males, mean age 38.0 ± 3.3 years) for a guideline-based home exercise program. All five completed the study with no adverse events. Compliance with exercise was 86%. These results suggest that exercise training may improve exercise capacity of CCS with subclinical cardiomyopathy. Pediatr Blood Cancer. © 2013 Wiley Periodicals, Inc. © 2013 Wiley Periodicals, Inc.

  1. Screening of bovine milk samples for sub-clinical mastitis and antibiogram of bacterial isolates

    Directory of Open Access Journals (Sweden)

    Harini H. and Sumathi B.R.

    Full Text Available The study was undertaken to find out the incidence of subclinical mastitis (SCM and to assess the antibiotic sensitivity pattern of the causative organisms in lactating cows in and around Kanakapura taluk, Ramanagara district of Karnataka state. The prevalence of subclinical mastitis was assessed by the results of 3 different screening tests and bacteriological evaluation was done for the milk samples that were found positive. The predominant bacterial isolates recovered were Staphylococcus aureus (58% and Escherichia coli (23.5% followed by Staphylococcus epidermidis (8%, Streptococcus sp. (5.5%, Klebsiella sp. (3% and Bacillus sp. (2%. The in vitro antibiogram studies of bacterial isolates revealed higher sensitivity for ciprofloxacin (89%, ofloxacin (85%, enrofloxacin (82%, gentamicin (80% and chloramphenicol (75%, resistant to colistin, neomycin, streptomycin, penicillin and tetracycline. [Vet. World 2011; 4(8.000: 358-359

  2. Association of claw disorders with subclinical intramammary infections in Egyptian dairy cows

    DEFF Research Database (Denmark)

    Mahmmod, Yasser Saadeldien Ibrahim

    2017-01-01

    with the occurrence of subclinical intramammary infections (IMIs) diagnosed by California mastitis test (CMT) in dairy cows under Egyptian conditions. Materials and Methods: A total of 43 dairy cows were included in this field study. Subclinical IMI was diagnosed by CMT on all lactating quarters of cows. A cow......Aim: Bovine mastitis and lameness are the most common production diseases affecting dairy farms worldwide resulting in huge economic impact and impaired animal welfare. The objective of this field study was to investigate the association of infectious and non-infectious claw disorders...... the CMT and other explanatory variables was tested by Fisher’s exact test. Results: The prevalence of infectious and non-infectious claw disorders was 81.4% (35/43) and 32.6% (14/43), respectively. Digital dermatitis (DD) and heel horn erosion were the most prevalent infectious type with 79% (34...

  3. Placental Histopathologic Changes Associated with Subclinical Malaria Infection and Its Impact on the Fetal Environment

    Science.gov (United States)

    Parekh, Falgunee K.; Davison, Billie B.; Gamboa, Dionicia; Hernandez, Jean; Branch, OraLee H.

    2010-01-01

    Microscopic examination of placental tissue can provide an accurate assessment of malaria infection during pregnancy. In this cross-sectional study of 193 women in Iquitos, Peru, 1.0% and 6.6% had parasites in the peripheral blood as detected by microscopy and polymerase chain reaction, respectively. However, 22% had placental malaria pigment indicating past, subclinical infections. Placental tissues with pigment from 24 cases were matched by gravidity and month of delivery to 24 controls and histopathologically examined. Cases had significantly higher number of monocytes in the intervillous space (44.7 versus 25.5; P = 0.012). Pigmented monocytes in fetal vessels were present in 33.3% of cases. This study demonstrated that subclinical malarial infection occurred frequently in pregnant women and is associated with increased presence of monocytes in the placenta. Pigmented monocytes in fetal vessels suggest parasites can breach the placental barrier and enter the fetal circulation. PMID:21036823

  4. Acute phase proteins in bovine milk in an experimental model of Staphylococcus aureus subclinical mastitis

    DEFF Research Database (Denmark)

    Eckersall, P D; Young, F J; Nolan, A M

    2006-01-01

    The objectives were to establish the origin of 2 acute phase proteins in milk during subclinical bovine mastitis and to characterize the relationship between those proteins in milk and blood. Haptoglobin (Hp) and mammary-associated serum amyloid A (M-SAA3) appear in milk during mastitis, whereas Hp...... and serum amyloid A increase in serum during mastitis. The concentrations of these proteins were determined in an experimental model using a field strain of Staphylococcus aureus to induce subclinical mastitis in dairy cows. The expression of mRNA coding for these proteins was assessed and the presence of M......-SAA3 in mammary tissues was determined using immunocytochemistry. Increases of M-SAA3 and Hp in milk occurred within 12 h of Staphylococcus aureus infusion, with peak concentrations occurring 3 d after infusion of the bacteria. The increase of acute phase proteins in milk (15 h) preceded the increase...

  5. Subclinical Posttraumatic Stress Disorder Symptoms: Relationships with Blood Pressure, Hostility, and Sleep

    Science.gov (United States)

    Zinzow, Heidi M.; Hibdon, Melissa A.; Nathan, Aaron W.; Morrison, Anastasia V.; Hayden, Gregg W.; Lindberg, Caitlyn; Switzer, Fred S.

    2016-01-01

    The purpose of this study was to examine the relationships among subclinical PTSD symptoms, blood pressure, and several variables linked to both frank PTSD and the basic psychobiological adaptation to stress. The authors recruited a sample of 91 healthy, young men and women between 18 and 35 years. We examined links among subclinical posttraumatic stress disorder symptoms, blood pressure, sleep quality, and hostility. Posttraumatic stress disorder symptoms were associated with poorer sleep quality and higher hostility scores in both women and men. In men, PTSD symptoms were also associated with elevated resting diastolic blood pressure, and sex was an important moderator of that relationship. Moreover, sleep quality and hostility are substantive mediators of the relationship between diastolic blood pressure and PTSD. Behavioral interventions designed to increase sleep quality and restructure hostile attitudes could potentially serve as preventive interventions for PTSD and the underlying cardiovascular comorbidities in young adults. PMID:27403340

  6. Bioeconomic modeling of lactational antimicrobial treatment of new bovine subclinical intramammary infections caused by contagious pathogens

    DEFF Research Database (Denmark)

    Van den Borne, B. H. P.; Hisham Beshara Halasa, Tariq; Van Schaik, G.;

    2010-01-01

    of Staphylococcus aureus, Streptococcus uberis, Streptococcus dysgalactiae, and Escherichia coli during lactation and the dry period in a 100-cow dairy herd during 1 quota year. Input parameters on cure were obtained from recent Dutch field data. The costs of clinical IMI, subclinical IMI, and intervention were....... Changing the probability of cure resulted in a nonlinear change in the cumulative incidence of IMI cases and associated costs. Lactational treatment was able to prevent IMI epidemics in dairy herds at high transmission rates of Strep. uberis, Strep. dysgalactiae, and E. coli. Lactational treatment did......This study determined the direct and indirect epidemiologic and economic effects of lactational treatment of new bovine subclinical intramammary infections (IMI) caused by contagious pathogens using an existing bioeconomic model. The dynamic and stochastic model simulated the dynamics...

  7. Association between the surfactant protein D (SFTPD) gene and subclinical carotid artery atherosclerosis

    DEFF Research Database (Denmark)

    Sorensen, Grith L; Bladbjerg, Else Marie; Steffensen, Rudi;

    2016-01-01

    OBJECTIVE: Surfactant protein D (SP-D) is a defense collectin with inflammation-modulating properties. SP-D deficiency inhibits atherosclerosis in vivo, and the circulatory SP-D levels have been previously associated with cardiovascular disease mortality. We hypothesized that plasma SP-D (p......SP-D) and SP-D gene (SFTPD) single nucleotide polymorphisms (SNPs) are risk factors for atherosclerosis. METHODS: We evaluated individuals who were all 60 years old and participated in The Glostrup Population Study. Subclinical atherosclerosis was diagnosed based on the ultrasonographic measurement of intima......: The results do not support that pSP-D levels influence the development of subclinical atherosclerosis. However, the SFTPD SNP data support previous observations from animal studies that SP-D plays a role in the etiology of atherosclerotic disease development. The nominal significant effects are likely...

  8. Controlling Subclinical Mastitis by Antibiotic Application during Dry Period of Dairy Cow

    Directory of Open Access Journals (Sweden)

    Imas Sri Nurhayati

    2015-06-01

    Full Text Available Prevention of mastitis is essential, as one of the efforts to control disease in dairy cow. Dry period has implications to understand the mastitis and its control strategies. The udder is very susceptible to be infected both at the beginning and towards the end of dry period. This is linked to physiological changes in udder. Treatment with antibiotics during the dry period can reduce new infection about 82% and has several advantages. The success rate of subclinical mastitis treatment is much higher (80-90% compared to the treatment during lactation (30-40%; the doses of antibiotic can be higher and safer, due to its retention time in udder becomes longer; the risk of antibiotic contamination in milk can be avoided because the udder is not milked. Antibiotic application during dry period is the best way to treat subclinical and chronic mastitis. Treatment during dry period is a specific mastitis control for intramammary infection to avoid economic losses.

  9. Subclinical high altitude pulmonary edema:A clinical observation of 12 cases in Yushu

    Institute of Scientific and Technical Information of China (English)

    Li Shuzhi; Zheng Bihai; Wu Tianyi; Chen Huixing; Zhang Ming

    2013-01-01

    During the Yushu Earthquake on April 14,2010,a high incidence of acute high altitude illness was observed in the mountain rescuers,and 0.73 % of these patients suffered from high altitude pulmonary edema,of which 12 patients developed subclinical pulmonary edema and concomitantly contracted acute mountain sickness.Symptoms and signs were atypically high heart rate with high respiratory rate,striking cyanosis,and significantly low oxygen saturation,whereas no moist rates were heard on auscultation,and Chest X-ray showed peripheral with a patchy distribution of mottled infiltrations in one or both lung fields.We believe that subclinical high altitude pulmonary edema is an earliest stage of pulmonary edema at high altitude.The possible pathogenesis and the diagnosis were discussed.

  10. Metabolic consequences of polycystic ovary syndrome.

    Science.gov (United States)

    Churchill, S J; Wang, E T; Pisarska, M D

    2015-12-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women and the leading cause of anovulatory infertility. The prevalence of the syndrome ranges between 6 to 15% based on broader Rotterdam diagnostic criteria verses strict NIH diagnostic criteria.1 The condition is characterized by a combination of ovulatory dysfunction, hyperandrogenism and the presence of polycystic ovaries. PCOS has been associated with multiple metabolic alterations and consequences including impaired glucose tolerance, insulin resistance, hyperinsulinemia, type II diabetes, dyslipidemia, metabolic syndrome, obesity and subclinical cardiovascular disease. It remains unclear however if these associations lead to an increased risk of clinically significant long-term cardiovascular disease. Large prospective studies to date have not detected significant differences in overall cardiovascular morbidity and mortality in PCOS. The phenotypical variability in PCOS has made researching each of these associations challenging as different aspects of the syndrome may be contributing, opposing or confounding factors. The ability to detect significant differences in long-term cardiovascular outcomes may also be due to the variable nature of the syndrome. In this review, we attempt to describe a summary of the current literature concerning the metabolic alterations and cardiovascular consequences of polycystic ovary syndrome.

  11. Feasibility of utilising an infrared-thermographic technique for early detection of subclinical mastitis in dairy camels (Camelus dromedarius).

    Science.gov (United States)

    Samara, Emad M; Ayadi, Moez; Aljumaah, Riyadh S

    2014-02-01

    Despite the proven ability of infrared thermography (IRT) technology for early detection of subclinical mastitis in dairy cows/sheep/goats, studies on its diagnostic feasibility in dairy camels are lacking. Sixty-five lactating camels in mid lactation, machine milked twice-daily and managed under intensive conditions were screened to evaluate the feasibility of utilising IRT compared with other routine indicators in detecting subclinical mastitis. Immediately before the morning milking, a portable infrared camera was used to obtain thermograms in duplicate for the front and rear left quarters to determine the udder surface temperature (UST). Thereafter, milk samples from quarters were collected, and processed for California mastitis test (CMT) score and somatic cell count (SCC). In the present study, CMT score was used to define subclinical mastitis and the feasibility of IRT to detect subclinical mastitis was compared with CMT and SCC. According to CMT score, subclinical mastitic udders had an average UST of 1·42 °C greater (Pmastitis was defined according to CMT score, and were 35·70 °C, 0·89, 0·96 and 0·94, respectively, when categorised according to the obtained SCC threshold (SCC=432 000 cells/ml). In conclusion, IRT, as an indirect non-invasive screening method, was highly feasible for distinguishing subclinical mastitic udders in dairy camels, which is crucial to treat mastitis early and efficiently.

  12. Subclinical hyperthyroidism seems not to have a significant impact on systemic anticoagulation in patients with coumarin therapy.

    Science.gov (United States)

    Bucerius, Jan; Naubereit, Anna; Joe, Alexius Y; Ezziddin, Samer; Biermann, Kim; Risse, Jörn; Palmedo, Holger; Oldenburg, Johannes; Biersack, Hans-Jürgen

    2008-11-01

    There is little data regarding the impact of subclinical hyperthyroidism on coagulation metabolism in patients undergoing systemic anticoagulation therapy with coumarin derivates. In this retrospective analysis we studied 233 patients with benign thyroid disorders receiving therapeutic iodine-131, as well as concomitant systemic anticoagulation therapy (subclinical hyperthyroidism: n = 178; overt hyperthyroidism: n = 15; euthyroidism: n = 40). Multivariate regression analyses were performed in the total study population as well as in the subgroup of patients with subclinical hyperthyroidism to identify the possible impact of several variables on anticoagulation therapy, large enough to push the International Normalized Ratio (INR) level out of the therapeutic range (INR 3.0). Therapy with antibiotics or nitrates was significantly associated with INR-values >3.0 in the total population, while ACE inhibitors were associated with lower incidence of INR-values subclinical hyperthyroidism, therapy with antibiotics was predictive of INR-values >3.0, whereas therapy with thyroid suppressive drugs or TSH-values subclinical hyperthyroidism and euthyroidism intraindividual comparison with regard to the possible impact on anticoagulation therapy was performed which failed to show any significant differences in INR-values between the two thyroid metabolic conditions. In conclusion, subclinical hyperthyroidism seems to have no significant impact on coagulation metabolism in patients receiving anticoagulation therapy.

  13. Positive psychology and subclinical eating disorders in South Africa : a literature review / Kirsten D.K.

    OpenAIRE

    2011-01-01

    Rapid escalation of Subclinical Eating Disorders (SED) in the form of high levels of body–dissatisfaction (BD) and drive for thinness (DT) globally and locally, and the at–risk status of university females are underscored by recent studies. As yet there exists no South African program tailored to the needs of afflicted female students and which includes a risk–protective focus grounded in Positive Psychology theory. In this chapter a theoretical overview on the nature and definition of SED, i...

  14. Investigation of the Incidence and Diagnosis of Subclinical Mastitis in Early Lactation Period Cows

    OpenAIRE

    BAŞTANC, Ayhan; KAÇAR, Cihan; ACAR, Duygu B.; ŞAHİN, Mithat

    2014-01-01

    The aim of this study was to compare the results of the California mastitis test (CMT) and bacteriological culture for detection of subclinical intramammary infections after 10 days postpartum. Samples were collected from 102 cows. The CMT was performed once on each cow. The results of bacteriological culture and the CMT were compared in 344 milk samples. Two hundred fifty samples were CMT (+) and 94 samples were CMT (-); 224 samples were bacteriologic culture (+) and 120 samples were culture...

  15. Subclinical mastitis changes the patterns of maternal-offspring behaviour in dairy sheep.

    Science.gov (United States)

    Gougoulis, D A; Kyriazakis, I; Papaioannou, N; Papadopoulos, E; Taitzoglou, I A; Fthenakis, G C

    2008-06-01

    Subclinical mastitis was induced by inoculating one mammary gland in dairy ewes (n=8) with a Staphylococcus simulans isolate; control ewes (n=4) were included. The milk yield of inoculated glands decreased (PMastitis Test (CMT) score increased and the organism could be recovered from the inoculated glands. With time, there was significantly increased frequency of "hindering sucking" (P=0.016) and "head up posture" (Pmastitis alters the sucking behaviour of both ewes and lambs.

  16. Sub-Clinical Hypothyroidism and Its Association With Increased Cardiovascular Mortality: Call for Action

    OpenAIRE

    Hassan, Abdalla; Altamirano-Ufion, Alvaro; Zulfiqar, Beenish; Boddu, Prajwal

    2017-01-01

    Thyroid hormones play an important role in regulating different functions regarding metabolism and performance in multiple organs. Any change in the thyroid hormones axis can lead to profound effect on the vital organ stability especially the cardiovascular system. Hypothyroidism is classified according to the clinical presentation as overt and subclinical. Currently, there exists a paucity of evidence on the beneficial effects of thyroxine hormone replacement on cardiovascular mortality outc...

  17. Thyroid hormone treatment among pregnant women with subclinical hypothyroidism: US national assessment

    Science.gov (United States)

    Maraka, Spyridoula; Mwangi, Raphael; Yao, Xiaoxi; Sangaralingham, Lindsey R; Singh Ospina, Naykky M; O’Keeffe, Derek T; De Ycaza, Ana E Espinosa; Rodriguez-Gutierrez, Rene; Coddington, Charles C; Stan, Marius N; Brito, Juan P; Montori, Victor M

    2017-01-01

    Objective To estimate the effectiveness and safety of thyroid hormone treatment among pregnant women with subclinical hypothyroidism. Design Retrospective cohort study. Setting Large US administrative database between 1 January 2010 and 31 December 2014. Participants 5405 pregnant women with subclinical hypothyroidism, defined as untreated thyroid stimulating hormone (TSH) concentration 2.5-10 mIU/L. Exposure Thyroid hormone therapy. Main outcome measure Pregnancy loss and other pre-specified maternal and fetal pregnancy related adverse outcomes. Results Among 5405 pregnant women with subclinical hypothyroidism, 843 with a mean pre-treatment TSH concentration of 4.8 (SD 1.7) mIU/L were treated with thyroid hormone and 4562 with a mean baseline TSH concentration of 3.3 (SD 0.9) mIU/L were not treated (Ppre-eclampsia (1.61, 1.10 to 2.37); other pregnancy related adverse outcomes were similar between the two groups. The adjusted odds of pregnancy loss were lower in treated women than in untreated women if their pre-treatment TSH concentration was 4.1-10 mIU/L (odds ratio 0.45, 0.30 to 0.65) but not if it was 2.5-4.0 mIU/L (0.91, 0.65 to 1.23) (P<0.01). Conclusion Thyroid hormone treatment was associated with decreased risk of pregnancy loss among women with subclinical hypothyroidism, especially those with pre-treatment TSH concentrations of 4.1-10 mIU/L. However, the increased risk of other pregnancy related adverse outcomes calls for additional studies evaluating the safety of thyroid hormone treatment in this patient population. PMID:28122781

  18. Subclinical renal abnormalities in young thalassemia major and intermedia patients and its relation to chelation therapy

    OpenAIRE

    Adly, Amira A.M.; Dalia N. Toaima; Noha Refaat Mohamed; Karim Mahmoud Abu El Seoud

    2014-01-01

    Background: Limited data are available about renal involvement in thalassemia patients. Renal dysfunction in these patients seems to be multifactorial attributed mainly to long standing anemia, chronic hypoxia, iron overload and toxicity of iron chelators. Objective: To assess the frequency of subclinical glomerular and tubular dysfunctions in children and adolescents with β-thalassemia major and intermedia, and to correlate these findings with the degree of iron overload and type of chela...

  19. GlycA Is a Novel Biomarker of Inflammation and Subclinical Cardiovascular Disease in Psoriasis.

    Science.gov (United States)

    Joshi, Aditya A; Lerman, Joseph B; Aberra, Tsion M; Afshar, Mehdi; Teague, Heather L; Rodante, Justin A; Krishnamoorthy, Parasuram; Ng, Qimin; Aridi, Tarek Z; Salahuddin, Taufiq; Natarajan, Balaji; Lockshin, Benjamin N; Ahlman, Mark A; Chen, Marcus Y; Rader, Daniel J; Reilly, Muredach P; Remaley, Alan T; Bluemke, David A; Playford, Martin P; Gelfand, Joel M; Mehta, Nehal N

    2016-11-11

    GlycA, an emerging inflammatory biomarker, predicted cardiovascular events in population-based studies. Psoriasis, an inflammatory disease associated with increased cardiovascular risk, provides a model to study inflammatory biomarkers in cardiovascular disease (CVD). Whether GlycA associates with psoriasis and how it predicts subclinical CVD beyond high-sensitivity C-reactive protein in psoriasis is unknown. To investigate the relationships between GlycA and psoriasis and between GlycA and subclinical CVD. Patients with psoriasis and controls (n=412) participated in a 2-stage study. We measured GlycA by nuclear magnetic resonance spectroscopy. National Institutes of Health (NIH) participants underwent 18-F Fluorodeoxyglucose Positron Emission Tomography Computed Tomography (18-FDG PET/CT) scans to assess vascular inflammation (VI) and coronary computed tomographic angiography to quantify coronary artery disease burden. Psoriasis cohorts were young (mean age=47.9), with low cardiovascular risk and moderate skin disease. high-sensitivity C-reactive protein and GlycA were increased in psoriasis compared with controls (GlycA: [PENN: 408.8±75.4 versus 289.4±60.2, Ppsoriasis severity. In stage 2, VI (β=0.36, Ppsoriasis. In receiver operating characteristic analysis, GlycA added value in predicting VI (P=0.01) and coronary artery disease (Ppsoriasis severity (Ppsoriasis severity and subclinical CVD beyond traditional CV risk and high-sensitivity C-reactive protein. Moreover, psoriasis treatment reduced GlycA and VI. These findings support the potential use of GlycA in subclinical CVD risk assessment in psoriasis and potentially other inflammatory diseases. © 2016 American Heart Association, Inc.

  20. Subclinical Atherosclerotic Calcification and Cognitive Functioning in Middle-Aged Adults: The CARDIA Study

    OpenAIRE

    Reis, JP; Launer, LJ; Terry, JG; Loria, CM; Zeki Al Hazzouri, A; Sidney, S. (Steve); Yaffe, K.; Jacobs, DR; Whitlow, CT; Zhu, N; Carr, JJ

    2013-01-01

    Objective: Cardiovascular risk factors in middle-age are associated with cognitive impairment and dementia in older age. Less is known about the burden of calcified subclinical atherosclerosis and cognition, especially in midlife. We examined the association of coronary artery and abdominal aortic calcified plaque (CAC and AAC, respectively) with cognitive functioning in middle-aged adults. Methods: This cross-sectional study included 2510 black and white adults (age: 43-55 years) without hea...

  1. Antibacterial susceptibility profiles of subclinical mastitis pathogens isolated in Batna and Setif Governorates (East of Algeria

    Directory of Open Access Journals (Sweden)

    Mamache Bakir

    Full Text Available Sub-clinical mastitis is a main pathology of dairy husbandry because it is not clinically recognized by the owners and the veterinarians. For this reason, its economic loss is usually underestimated in milk production. This study has been undertaken in order to evaluate the epidemiologic situation of sub-clinicalmastitis in Batna and Setif governorates (East of Algeria. For this purpose, a detailed bacteriological study of all bacterial strains isolated from sub-clinical mastitis followed by a study of their antibacterial susceptibility profiles has been undertaken. 89 bacterial strains distributed as follows were studied: 27 strains of staphylococci among which 23 were coagulase-negative staphylococci (CNS that are generally incriminated in sub-clinical mastitis. 39 strains of streptococci among which 10 were Lactococcus lactis ssp lactis strains. 23 strains of enterobacteria represented mainly by Escherichia coli (E.coli. All these bacterial strains were isolated from cow milk of 3 different farms. The antibacterial susceptibility profiles have revealed a susceptibility of the isolated strains to a large number of antibiotics mainly to the Neomycin, the Cephalexin and the Spiramycin. [Vet. World 2011; 4(12.000: 537-541

  2. Apolipoprotein-containing lipoprotein subclasses and subclinical atherosclerosis in systemic lupus erythematosus.

    Science.gov (United States)

    Kiani, Adnan N; Fang, Hong; Akhter, Ehtisham; Quiroga, Carmen; Simpson, Nancy; Alaupovic, Petar; Magder, Laurence S; Petri, Michelle

    2015-03-01

    Traditional classification of hyperlipidemia using high-density lipoprotein, low-density lipoprotein (LDL), and very low-density lipoprotein does not provide information on lipoprotein function. Apolipoproteins (Apos), which are protein components of plasma lipoproteins (including A, B, C, D, E) with their different composition, metabolic, and atherogenic properties, provide insight on lipoprotein functioning. In particular, the Apo B/A-I ratio is associated with atherogenic LDL and development of cardiovascular disease. We explored the baseline association between these nontraditional risk factors with subclinical measures of atherosclerosis (coronary artery calcification [CAC] and carotid intima-media thickness [IMT]) in systemic lupus erythematosus (SLE). A total of 58 SLE patients (97% women, 58% white, 40% African American, and 2% other, mean ± SD age 44 ± 11 years) had measurement of Apo and lipoproteins by immunoturbidimetric procedures, electroimmunoassays, and immunoprecipitation. CAC was measured by helical computed tomography and carotid IMT by carotid duplex. This study was based on the baseline assessment of subclinical atherosclerosis in the Lupus Atherosclerosis Prevention Study. The measurement of the lipoproteins was made on sera collected at the same time. There was no association between cardioprotective Apos (Apo A-I, LpA-I, LpA-I:A-II) and CAC (P Systemic Lupus Erythematosus Disease Activity Index, were not associated with CAC or carotid IMT. Neither cardioprotective nor atherogenic lipoproteins were associated with measures of subclinical atherosclerosis in this series of SLE patients. Further studies with a larger sample size are warranted to confirm our findings.

  3. Interrelation of saturated fat, trans fat, alcohol intake, and subclinical atherosclerosis.

    Science.gov (United States)

    Merchant, Anwar T; Kelemen, Linda E; de Koning, Lawrence; Lonn, Eva; Vuksan, Vlad; Jacobs, Ruby; Davis, Bonnie; Teo, Koon K; Yusuf, Salim; Anand, Sonia S

    2008-01-01

    Intake of saturated fat, trans fat, and alcohol alter cardiovascular disease risk, but their effect on subclinical atherosclerosis remains understudied. The objective was to examine and quantify the interrelation of saturated fat, trans fat, alcohol intake, and mean carotid artery intimal medial thickness (IMT). We conducted a population-based, cross-sectional study among 620 persons of Aboriginal, South Asian, Chinese, or European origin aged 35-75 y, who had lived in Canada for >or=5 y. Mean IMT was calculated from 6 well-defined segments of the right and left carotid arteries with standardized B-mode ultrasound, and saturated fat, trans fat, and alcohol intakes were measured with validated food-frequency questionnaires. For every 10-g/d increase in saturated fat intake, IMT was 0.03 mm higher (P=0.01) after multivariate adjustment. A 1-g/d higher intake of trans fat was associated with a 0.03-mm higher IMT (P=0.02) after multivariate adjustment. The ratio of polyunsaturated to saturated fat (P:S) was inversely associated with IMT after multivariate adjustment (change in IMT: -0.06 mm; PSaturated and trans fat intakes were independently associated with IMT thickness (change in IMT: 0.03 mm; Pfat intakes were unrelated to IMT. The relation between saturated fat intake and IMT strengthened (beta=0.0066, Psaturated and trans fats are independently associated with increased subclinical atherosclerosis, and alcohol intake may attenuate the relation between saturated fat and subclinical atherosclerosis.

  4. Selective, reliable blood and milk bio-markers for diagnosing clinical and subclinical bovine mastitis.

    Science.gov (United States)

    Sadek, Kadry; Saleh, Ebeed; Ayoub, Mousa

    2017-02-01

    Mastitis is positioned as the most vital ailment in dairy cows in light of conventional cost examinations. The aim of the present study was to evaluate the diagnostic value of different acute phase proteins (APPs), pro-inflammatory cytokines, and oxidative stress biomarkers in healthy cows and in those with clinical or subclinical mastitis and to localize APP gene expression in the milk of mastitic cows. Therefore, 20 subclinical mastitic cows with positive California Mastitis Test (CMT) results and no clinical signs of mastitis, 15 clinically mastitic cows, and 15 healthy cows with negative CMT results and somatic cell count (SCC) of mastitis, except for total protein, albumin, and GSH levels and the TAC, which were significantly (p mastitis, while Fb expression was absent. The present study demonstrates that APPs, pro-inflammatory cytokines, and indicators of oxidative stress may serve as biomarkers of clinical and subclinical mastitis. Interestingly, the expression of SAA and Hp indicates the local de novo synthesis of these APPs within the mammary glands. Furthermore, the presence of SAA and Hp transcripts in milk cells derived from pathogen-free mammary glands proved their constitutive expression. However, future studies with more extensive baseline sampling are still needed to establish and validate the reference values for APPs, cytokines, and oxidative stress markers in cows.

  5. Prevalence of subclinical mastitis and associated risk factors in smallholder dairy cows in Tanzania.

    Science.gov (United States)

    Karimuribo, E D; Fitzpatrick, J L; Swai, E S; Bell, C; Bryant, M J; Ogden, N H; Kambarage, D M; French, N P

    2008-07-05

    A cross-sectional study was carried out on 200 randomly selected farms in each of the Iringa and Tanga regions of Tanzania to estimate the prevalence and risk factors for subclinical mastitis in dairy cows kept by smallholders. Subclinical mastitis was assessed using the California mastitis test (cmt), and by the bacteriological culture of 1500 milk samples collected from 434 clinically normal cows. The percentages of the cows (and quarters) with subclinical mastitis were 75.9 per cent (46.2 per cent) when assessed by the cmt and 43.8 per cent (24.3 per cent) when assessed by culture. Factors significantly associated with an increased risk of a cmt-positive quarter were Boran breed (odds radio [or]=3.51), a brought-in cow (rather than homebred) (or=2.39), peak milk yield, and age. The stripping method of hand milking was associated with a significantly lower prevalence of cmt-positive quarters (or=0.51). The cmt-positive cows were more likely to be culture positive (or=4.51), as were brought-in (or=2.10) and older cows.

  6. Spontaneous remission of acromegaly or gigantism due to subclinical apoplexy of pituitary growth hormone adenoma

    Institute of Scientific and Technical Information of China (English)

    WANG Xian-ling; DOU Jing-tao; L(U) Zhao-hui; ZHONG Wen-wen; BA Jian-ming; JIN Du; LU Ju-ming; PAN Chang-yu; MU Yi-ming

    2011-01-01

    Background Subclinical apoplexy of pituitary functional adenoma can cause spontaneous remission of hormone hypersecretion.The typical presence of pituitary growth hormone (GH) adenoma is gigantism and/or acromegaly.We investigated the clinical characteristics of patients with spontaneous partial remission of acromegaly or gigantism due to subclinical apoplexy of GH adenoma.Methods Six patients with spontaneous remission of acromegaly or gigantism were enrolled.The clinical characteristics,endocrinological evaluation and imageological characteristics were retrospectively analyzed.Results In these cases,the initial clinical presences were diabetes mellitus or hypogonadism.No abrupt headache,vomiting,visual function impairment,or conscious disturbance had ever been complained of.The base levels of GH and insulin growth factor-1 (IGF-1) were normal or higher,but nadir GH levels were all still >1 μg/L in 75 g oral glucose tolerance test.Magnetic resonance imaging detected enlarged sella,partial empty sella and compressed pituitary.The transsphenoidal surgery was performed in 2 cases,and the other patients were conservatively managed.All the patients were in clinical remission.Conclusions When the clinical presences,endocrine evaluation,biochemical examination and imageology indicate spontaneous remission of GH hypersecretion in patients with gigantism or acromegaly,the diagnosis of subclinical apoplexy of pituitary GH adenoma should be presumed.To these patients,conservative therapy may be appropriate.

  7. Neural mechanisms of subclinical depressive symptoms in women: a pilot functional brain imaging study

    Directory of Open Access Journals (Sweden)

    Felder Jennifer N

    2012-09-01

    Full Text Available Abstract Background Studies of individuals who do not meet criteria for major depressive disorder (MDD but with subclinical levels of depressive symptoms may aid in the identification of neurofunctional abnormalities that possibly precede and predict the development of MDD. The purpose of this study was to evaluate relations between subclinical levels of depressive symptoms and neural activation patterns during tasks previously shown to differentiate individuals with and without MDD. Methods Functional magnetic resonance imaging (fMRI was used to assess neural activations during active emotion regulation, a resting state scan, and reward processing. Participants were twelve females with a range of depressive symptoms who did not meet criteria for MDD. Results Increased depressive symptom severity predicted (1 decreased left midfrontal gyrus activation during reappraisal of sad stimuli; (2 increased right midfrontal gyrus activation during distraction from sad stimuli; (3 increased functional connectivity between a precuneus seed region and left orbitofrontal cortex during a resting state scan; and (4 increased paracingulate activation during non-win outcomes during a reward-processing task. Conclusions These pilot data shed light on relations between subclinical levels of depressive symptoms in the absence of a formal MDD diagnosis and neural activation patterns. Future studies will be needed to test the utility of these activation patterns for predicting MDD onset in at-risk samples.

  8. Spontaneous remission of acromegaly or gigantism due to subclinical apoplexy of pituitary growth hormone adenoma.

    Science.gov (United States)

    Wang, Xian-Ling; Dou, Jing-Tao; Lü, Zhao-Hui; Zhong, Wen-Wen; Ba, Jian-Ming; Jin, Du; Lu, Ju-Ming; Pan, Chang-Yu; Mu, Yi-Ming

    2011-11-01

    Subclinical apoplexy of pituitary functional adenoma can cause spontaneous remission of hormone hypersecretion. The typical presence of pituitary growth hormone (GH) adenoma is gigantism and/or acromegaly. We investigated the clinical characteristics of patients with spontaneous partial remission of acromegaly or gigantism due to subclinical apoplexy of GH adenoma. Six patients with spontaneous remission of acromegaly or gigantism were enrolled. The clinical characteristics, endocrinological evaluation and imageological characteristics were retrospectively analyzed. In these cases, the initial clinical presences were diabetes mellitus or hypogonadism. No abrupt headache, vomiting, visual function impairment, or conscious disturbance had ever been complained of. The base levels of GH and insulin growth factor-1 (IGF-1) were normal or higher, but nadir GH levels were all still > 1 µg/L in 75 g oral glucose tolerance test. Magnetic resonance imaging detected enlarged sella, partial empty sella and compressed pituitary. The transsphenoidal surgery was performed in 2 cases, and the other patients were conservatively managed. All the patients were in clinical remission. When the clinical presences, endocrine evaluation, biochemical examination and imageology indicate spontaneous remission of GH hypersecretion in patients with gigantism or acromegaly, the diagnosis of subclinical apoplexy of pituitary GH adenoma should be presumed. To these patients, conservative therapy may be appropriate.

  9. Prevalence of Keratoconus and Subclinical Keratoconus in Subjects with Astigmatism Using Pentacam Derived Parameters

    Directory of Open Access Journals (Sweden)

    Huseyin Serdarogullari

    2013-01-01

    Full Text Available Purpose: To determine the prevalence of keratoconus (KCN and subclinical KCN among subjects with two or more diopters (D of astigmatism, and to compare Pentacam parameters among these subjects. Methods: One hundred and twenty eight eyes of 64 subjects with astigmatism ≥2D were included in the study. All subjects underwent a complete ophthalmic examination which included refraction, visual acuity measurement, slit lamp biomicroscopy, retinoscopy, fundus examination, conventional corneal topography and elevation-based topography with Pentacam. The diagnosis of KCN and subclinical KCN was made by observing clinical findings and topographic features; and confirmed by corneal thickness and elevation maps of Pentacam. Several parameters acquired from Pentacam were analyzed employing the Mann-Whitney U Test. Results: Mean age of the study population was 29.9±9.8 (range 15-45 years which included 39 (60.9% female and 25 (39.1% male subjects. Maximum corneal power, index of vertical asymmetry, keratoconus index and elevation values were significantly higher and pachymetry was significantly thinner in eyes with clinical or subclinical KCN than normal astigmatic eyes (P< 0.05. Conclusion: The current study showed that subjects with 2D or more of astigmatism who present to outpatient clinics should undergo corneal topography screening for early diagnosis of KCN even if visual acuity is not affected. Pentacam may provide more accurate information about anterior and posterior corneal anatomy especially in suspect eyes.

  10. Relationship between subclinical hypothyroidism and serum homocysteine concentration in premenopausal women

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    Ayfer Aydoğdu Çolak

    2013-09-01

    Full Text Available Objective: In our study we aimed to examine serum homocysteinelevels of patients without thyroid dysfunctionswho have high serum anti thyroid peroxidase (anti-TPOlevels and patients with subclinical hypothyroidism whohave high serum thyroid stimulating hormone (TSH andanti-TPO levels.Methods: One hundred and seven premenopause femaleoutpatients who referred to endocrine clinic of our hospitalwere included in our study. We generated 3 groups. Firstgroup (Control consists of 53 (50% patients between theages of 30-40 years. Second group (Euthyroid consistsof 31 (29% patients between the ages of 26-49. Thirdgroup (Subclinical Hypothyroidism consists of 23 (21%patients between the ages of 33-53 years. Serum totalcholesterol, triglycerides, high density lipoprotein (HDLlevels were measured by Olympus 2700 autoanalyzer.Serum TSH, free T4, anti-TPO and homocysteine levelswere measured by Siemens Immulite 2000 autoanalyzer.Results: In our study, total cholesterol, triglycerides, lowdensity lipoprotein (LDL and very low density lipoprotein(VLDL levels were not statistically significantly differentamong the groups. Although serum homocysteine levelsof the third group were higher than the other groups it wasnot statistically significantly different among the groups.Conclusion: Serum homocysteine and lipid levels of patientswith euthyroidism and subclinical hypothyroidismwho have positive anti-TPO levels may be inadequate inassessing the risk of cardiovascular diseases. J Clin ExpInvest 2013; 4 (3: 293-297Key words: Hypothyroidsm, homocysteine, premenopause

  11. PREVALENCE AND ANTIMICROBIAL RESISTANCE ASSESSMENT OF SUBCLINICAL MASTITIS IN MILK SAMPLES FROM SELECTED DAIRY FARMS

    Directory of Open Access Journals (Sweden)

    Murugaiyah Marimuthu

    2014-01-01

    Full Text Available This study was conducted in order to determine the prevalence and bacteriological assessment of subclinical mastitis and antimicrobial resistance of bacterial isolates from dairy cows in different farms around Selangor, Malaysia. A total of 120 milk samples from 3 different farms were randomly collected and tested for subclinical mastitis using California Mastitis Test (CMT, as well as for bacterial culture for isolation, identification and antimicrobial resistance. The most prevalent bacteria was Staphylococcus sp. (55%, followed by Bacillus sp., (21% and Corynebacterium sp., (7%, Yersinia sp. and Neisseria sp. both showed 5% prevalence, other species with prevalence below 5% are Acinetobacter sp., Actinobacillus sp., Vibrio sp., Pseudomonas sp., E.coli, Klebsiella sp. and Chromobacter sp. Selected Staphylococcus sp. showed a mean antimicrobial resistance of 73.3% to Ampicillin, 26.7% to Penicillin, Methicillin and Compound Sulphonamide each, 20% to Oxacillin, Amoxycillin and Cefuroxime, 13.3% to Polymyxin B, Erythromycin, Ceftriaxone and Azithromycin and 6.7% to Streptomycin, Clindamycin, Lincomycin and Tetracycline each. This study indicates the need for urgent and effective control measures to tackle the increase in prevalence of subclinical mastitis and their antimicrobial resistance in the study area.

  12. Prognostic Impact of Subclinical Microalbuminuria in Patients With Chronic Heart Failure.

    Science.gov (United States)

    Miura, Masanobu; Sakata, Yasuhiko; Miyata, Satoshi; Nochioka, Kotaro; Takada, Tsuyoshi; Tadaki, Soichiro; Ushigome, Ryoichi; Yamauchi, Takeshi; Takahashi, Jun; Shimokawa, Hiroaki

    2014-10-30

    Background:Microalbuminuria, traditionally defined as urinary albumin/creatinine ratio (UACR) ≥30 mg/g, is a risk factor for mortality even in patients with preserved glomerular filtration rate (GFR). The prognostic impact of subclinical microalbuminuria, however, remains unknown in patients with chronic heart failure (CHF).Methods and Results:In the Chronic Heart Failure Analysis and Registry in the Tohoku District 2 Study, we enrolled 2,039 consecutive symptomatic CHF patients (median age, 67.4 years; 68.9% male) after excluding those on hemodialysis. On classification and regression tree analysis, UACR=10.2 mg/g and 27.4 mg/g were identified as the first and second discriminating points to stratify the risk for composite of death, acute myocardial infarction, HF admission and stroke, therefore subclinical microalbuminuria was defined as UACR ≥10.2 and microalbuminuria was significantly associated with increased composite endpoints with hazard ratios of 1.90 (P60 ml·min(-1)·1.73 m(-2), n=1,129) or mildly reduced eGFR (30-59.9 ml·min(-1)·1.73 m(-2), n=789), respectively. In patients with severely reduced GFR (eGFR 80% had microalbuminuria or macroalbuminuria, and only 9.1% were free from any composite endpoints.Conclusions:Subclinical microalbuminuria was associated with increased risk of cardiovascular events in CHF patients with mildly reduced or preserved renal function.

  13. Microbiological analysis and sensitivity profile of Staphylococcus spp. in subclinical mastitis of dairy goats

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    S.R.S. Salaberry

    2016-04-01

    Full Text Available Subclinical mastitis in goats causes economic losses and risks to public health. Given the need for research that shows the most isolated staphylococci species and sensibility tests comparing the resistance between coagulase-negative (CNS and positive Staphylococcus (CPS goats with subclinical mastitis, the aim of this study was to identify the microorganisms isolated from milk samples of goats with subclinical mastitis, as well as define the staphylococci species and determine the sensitivity profile of Staphylococcus spp. to antimicrobials. To collect samples, tests were performed for mug of black background and California mastitis test (CMT, collecting milk from CMT positive animals. A total of 226 samples from seven herds of dairy goats was collected and forwarded to the laboratory, where they were seeded for the isolation of the microorganism and implementing the antibiotic sensibility test. Of these, 122 samples had bacterial growth and the most isolated staphylococci species were: S. epidermidis (24.55%, S. lugdunensis (15.40% and S. intermedius (13.64%. Samples showed increased resistance to antimicrobials: penicillin (81.8%, oxacillin (60.0% and ampicillin (55.5%. Greater sensitivity to: enrofloxacin (99.1%, erythromycin (98.2%, gentamicin (98.2% and vancomycin (98.2% were observed. The S. epidermidis showed higher antimicrobial resistance to amoxicillin and penicillin than S. lugdunensis and S. intermedius. Similar resistance in vitro between CNS and CPS was observed to most antimicrobials. It is important to control the overuse of antibiotics to prevent the emergence of resistant strains.

  14. Serum cholesterol and triglyceride concentrations in diabetic patients with subclinical hypothyroidism.

    Science.gov (United States)

    Díez, Juan J; Iglesias, Pedro

    2014-10-01

    To assess whether subclinical hypothyroidism is associated to elevations in serum cholesterol and triglyceride levels in patients with type 2 diabetes. From a total population of 1,112 patients with type 2 diabetes screened for thyroid dysfunction (thyrotropin measurement), a group of 325 patients with normal thyroid function and another group of 29 patients with subclinical hypothyroidism were selected. No patient had known dyslipidemia or was taking lipid lowering medication. Patients with subclinical hypothyroidism had serum levels of total cholesterol (4.88 ± 0.74 mmol/L), HDL cholesterol (1.37 ± 0.34 mmol/L), LDL cholesterol (2.94 ± 0.58 mmol/L), and triglycerides (1.05 [0.88-1.41] mmol/L) that did not significantly differ from those found in euthyroid patients (4.79 ± 0.83, 1.33 ± 0.36, 2.87 ± 0.76, and 1.11 [0.81-1.43] mmol/L, respectively). Multiple regression analysis showed no association between TSH and serum lipid levels. These results suggest that, in our population, there are no significant differences in serum cholesterol and triglyceride levels between diabetic patients with normal and reduced thyroid function. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  15. Efficacy of Levothyroxine in Migraine Headaches in Children with Subclinical Hypothyroidism

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    Mehrdad MIROULIAEI

    2012-10-01

    Full Text Available AbstractObjectiveHypothyroidism may be an exacerbating factor for primary headaches and migraine is one of the most common primary headaches in childhood. Thepurpose of this study was to evaluate the effect of treatment of subclinical hypothyroidism on children with migraine headache.Materials & MethodsIn a quasi-experimental study, the severity and monthly frequency of headache of 25 migraineur children with subclinical hypothyroidism who were referred to the pediatric neurology clinic of Shahid Sadoughi University of Medical Sciences, Yazd, Iran between January 2010 and February 2011and were treated with levothyroxine for two months were evaluated.ResultsThirteen girls (52% and 12 boys (48% with the mean age of 10.2 ± 2.76years were evaluated.In children with hypothyroidism, the monthly frequency of headache (mean± SD: 17.64 ± 9.49 times vs. 1.2 ± 1.1 times and the severity of headache(mean± SD: 6.24±1.8 scores vs. 1.33 ± 0.87 scores were significantly decreased by treatment.ConclusionBased on the results of this study, treatment of subclinical hypothyroidism was effective in reducing migraine headaches. Therefore, it is logical to check thyroid function tests in migraineur children.

  16. Subcutaneous adipose tissue plays a beneficial effect on subclinical atherosclerosis in young survivors of acute lymphocytic leukemia

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    Siviero-Miachon AA

    2015-08-01

    , CRT modified the distribution of fat and played a critical role in determining cIMT. Leptin-to-adiponectin ratio, a biomarker of abdominal obesity and metabolic syndrome, and diastolic BP also influenced cIMT, a marker of subclinical atherosclerosis. Nonetheless, adiposity-associated vascular disease might be attenuated by SAT. Changes in body fat must be evaluated in this group of patients in the early course of survivorship in order to avoid premature cardiovascular disease associated with atherosclerosis. Yet, further research as regards the possible protective effect of SAT on vascular disease is warranted. Keywords: precursor cell lymphoblastic leukemia–lymphoma/radiotherapy, abdominal fat, metabolic syndrome X, adipokines, endothelium, atherosclerosis

  17. Metabolic Syndrome

    Science.gov (United States)

    ... hypertension, hypertriglyceridemia, insulin resistance syndrome, low HDL cholesterol, Metabolic Syndrome, overweight, syndrome x, type 2 diabetes Family Health, Kids and Teens, Men, Women January 2005 Copyright © American Academy of Family PhysiciansThis ...

  18. Marfan Syndrome

    Science.gov (United States)

    Marfan syndrome is a disorder that affects connective tissue. Connective tissues are proteins that support skin, bones, ... fibrillin. A problem with the fibrillin gene causes Marfan syndrome. Marfan syndrome can be mild to severe, ...

  19. Williams syndrome

    Science.gov (United States)

    Williams-Beuren syndrome ... Williams syndrome is caused by not having a copy of several genes. Parents may not have any family history of the condition. However, people with Williams syndrome have a 50% chance of passing the ...

  20. Fahr's Syndrome

    Science.gov (United States)

    ... Page You are here Home » Disorders » All Disorders Fahr's Syndrome Information Page Fahr's Syndrome Information Page What research is being done? ... and conducts research on neurogenetic disorders such as Fahr's Syndrome. The goals of this research are to ...

  1. Analysis of the changes of serum lipid and hs-CRP in patients with subclinical hypothyroidism

    Institute of Scientific and Technical Information of China (English)

    Jin-Mian Fan; Dong-Bo Zheng; Zhou-Ping Zhang

    2016-01-01

    Objective:To analyze changes of serum lipid and hs-CRP levels in patients with subclinical hypothyroidism in order to explore their correlations with TSH level.Methods:A total of 90 patients with subclinical hypothyroidism were included in the study and divided into the mild, moderate, and severe groups according to TSH level with 30 cases in each group; meanwhile, 30 healthy individuals were served as the control groups. The changes of the levels of TSH, serum lipid indicators (TC, TG, HDL-C, LDL-C, ApoA, ApoB, and Lpa), and hs-CRP in the four groups were observed. The correlation of serum lipid and hs-CRP with TSH was analyzed. Results: The levels of TSH, TC, TG, Lpa, and hs-CRP in the subclinical hypothyroidism subgroups were significantly higher than those in the control group. The levels of HDL-C, LDL-C, ApoA, and ApoB in patients with subclinical hypothyroidism were increased when compared with the control group. The levels of HDL-C, LDL-C, and ApoB in the moderate and severe groups were significantly higher than those in the control group. ApoA level in the severe group was significantly higher than that in the control group. LDL-C in the moderate group was significantly higher than that in the mild group, and that in the severe group was significantly higher than that in the moderate group. ApoB level in the severe group was significantly higher than that in the mild group. Spearman correlation analysis showed that TC, TG, LDL-C, ApoB, Lpa, and hs-CRP were positively correlated with TSH level, while HDL-C and ApoA had no correlation with TSH level.Conclusions:The levels of serum lipid and hs-CRP are abnormally elevated in patients with subclinical hypothyroidism, and are gradually increased along with the disease progression, which is closely associated with TSH level.

  2. Association of NAFLD with subclinical atherosclerosis and coronary-artery disease: meta-analysis

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    Javier Ampuero

    Full Text Available Background: Recent studies have associated non-alcoholic fatty liver disease (NAFLD with increased risk of cardiovascular disease, using tests of subclinical atherosclerosis. Aim: To evaluate the influence of NAFLD on subclinical atherosclerosis and coronary artery disease (CAD. Methods: We reviewed Pubmed and EMBASE. According to inclusion and exclusion criteria, we selected 14 studies and were classified in two groups. Ten studies aimed the presence of subclinical atherosclerosis and four studies the presence of coronary artery disease. To assess subclinical atherosclerosis, we selected studies with pathological carotid intima-media thickness (CIMT and with presence of carotid plaques. We considered coronary artery disease when patients showed at least 50 % stenosis at one or more major coronary arteries. NAFLD was assessed by ultrasound (US and liver biopsy. Results: NAFLD showed a higher prevalence of pathological CIMT [35.1 % (351/999 vs. 21.8 % (207/948; p < 0.0001], with OR 2.04 (95 % CI: 1.65-2.51. Similarly, the presence of carotid plaques was higher in NAFLD diagnosed by US [34.2 % (101/295 vs. 12.9 % (51/394; p < 0.0001] [OR 2.82 (95 % CI: 1.87-4.27] and diagnosed by liver biopsy [64.8 % (70/108 vs. 31.3 % (59/188; p < 0.0001] [OR 4.41 (95 % CI: 2.63-7.40]. On the other hand, four studies assessed CAD in patients underwent coronary angiogram. Subjects with NAFLD showed 80.4 % (492/612 of CAD, while it was detected in 60.7 % (356/586 (p < 0.0001 in patients without NAFLD. Therefore, NAFLD was associated with a remarkably higher likelihood of CAD, using random effects model [OR 3.31 (95 % CI: 2.21-4.95] or fixed effects model [OR 3.13 (95 % CI: 2.36-4.16]. Conclusions: NAFLD increases the risk of subclinical atherosclerosis and coronary artery disease. The right management of these patients could modify the natural history both liver and cardiovascular disease.

  3. Staphylococcus aureus spa type t267, clonal ancestor of bovine subclinical mastitis in India.

    Science.gov (United States)

    Mitra, S D; Velu, D; Bhuvana, M; Krithiga, N; Banerjee, A; Shome, R; Rahman, H; Ghosh, S K; Shome, B R

    2013-06-01

    To evaluate the virulence determinants and genetic diversity of Staphylococcus aureus from bovine subclinical mastitis milk. PCR detection of virulence genes was performed for 173 Staph. aureus from bovine subclinical mastitis milk. Further, genetic diversity was analysed by agr and spa typing followed by pulsed field gel electrophoresis (PFGE) of selected isolates. Screening of virulence genes (n = 19) showed the adherence genes viz. fnbA, clfA, fnbB and cna in 98·8, 97·1, 68·8 and 28·3 percentage of isolates, respectively, and 80 strains (46·24%) positive for enterotoxin genes were distributed as 23 toxinotypes, of which, 5 genotypes contained a single gene and the rest comprised of multiple toxin genes. Out of agr type-1 (87·3%), 74·2 per cent belonged to the three predominant spa types. Of 27 spa types, 11 were identified for the first time. The predominant spa types were t267 (N =44), t359 (N = 42) and t6877 (N =29), which together accounts to 66·5 per cent of isolates. PFGE analysis of isolates (N = 45) covering all the spa types revealed mostly similar or closely related pulsotypes. Local emergence of spa type t6877 in herd-dependant manner was observed. spa sequence-based phylogenetic analysis suggested t267 as the ancestral clone of t359, t6877 and other spa types except two. Heterogenous virulence profile of the isolates had no significant association with the genotype. High prevalence of agr group I reaffirms their association with persistent subclinical mastitis. The spa type t267 appears to be the ancestral clone endemic in the region causing subclinical mastitis. In addition, few new spa types have emerged in the geographic region. Gives an insight into the genetic and evolutionary behaviour of Staph. aureus associated with bovine subclinical mastitis in India. The study would pave the way for devising effective control strategy for bovine mastitis in Indian context. © 2013 The Society for Applied Microbiology.

  4. Subclinical hypothyroidism%亚临床甲状腺功能减退症

    Institute of Scientific and Technical Information of China (English)

    张海清; 赵家军

    2009-01-01

    Subclinical hypothyroidism is one of subclinical thyroid diseases, which is defined as "a serum thyroid stimulating hormone(TSH) concentration above the statistically defined upper limit of the ref-erence range when serum free T4 concentration is within its reference range". The average worldwide preva-lence has been reported to be in the range of 4%-10% ,mainly among women and the elderly. The most com-monly cause of subclinical hypothyroidism is Hashimoto's thyroiditis. Subclinical hypothyroidism is associated with disorders of serum lipid, development of atherosclerosis and cardiovascular disease, presence of cognitive impairment,infertility and miscarriage. L-thyroxine substitutive therapy is recommended when TSH is above 10 mIU/L. Patients with serum TSH between 4 and 10 mIU/L should be monitored frequently especially if thyroperoxidase antibody is positive. The goal of the therapy for the pregnant women with subclinical hypothy-roidism is serum TSH less than 2.5 mIU/L.%亚临床甲状腺功能减退症(甲减)是一种业临床甲状腺疾病.诊断标准是血清促甲状腺激素(TSH)水平高于正常上限而游离T4水平尚在正常范围.目前全世界业临床甲减的平均患病率为4%~10%,主要发生在女性和老年人群.桥本甲状腺炎是最常见的病因.其卡要的临床危害包括引起血脂异常、导致动脉粥样硬化和,冠心病、影响认知功能,还可导致不孕和流产.治疗主要针对血清TSH10 mIU/L的患者,应用左旋-T4替代治疗.对于血清TSH 4~10 mIU/L,特别是甲状腺自身抗体阳性者需密切监测.此外,对妊娠期亚临床甲减患者的治疗要求控制TSH<2.5 mlU/L.

  5. Determinants of Subclinical Vitamin A Deficiency among children 1-5 years in a rural community of Jammu

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    Shivali Suri

    2015-06-01

    Full Text Available Background: The burden of sub-clinical vitamin A deficiency (VAD, as evident by serum retinol levels, is huge (62% among preschool children in India. Sub-clinical VAD increases children’s' susceptibility to infections, reduces physical growth and decreases the ability to survive from serious illnesses. Aims & Objectives: To assess the burden of subclinical VAD and study the various risk factors associated with it among children 1-5 years of age. Material Methods: A cross sectional community based study was conducted among 750 children selected from 15 villages adopting multistage random sampling from January to December 2011. Heller Keller International Food Frequency Questionnaire (HKI- FFQ was used to assess intakes of 28 food-items including vitamin A rich foods for the past 7 days. Various risk factors like socio-demographic profile, dietary pattern, vitamin A supplementation and breast feeding patterns were also studied. Results: Twelve of the fifteen cluster villages studied were found to be at risk of subclinical VAD. 30.6 % of study subjects had not received even a single dose of Vitamin A. Almost one-third of the subjects had not been breast-fed for the recommended 6 months. Age and socio-economic status were significantly associated with the risk of sub-clinical VAD. Among the dietary factors, consumption of purely vegetarian foods and intake of green leafy vegetables less than thrice a week were significantly associated with enhanced risk of sub-clinical VAD. Conclusion: Sub Clinical VAD is a public health problem of wide-spread importance.   Dietary diversification along with enhanced coverage of Vitamin A supplementation can tackle the problem of subclinical VAD

  6. Acute gouty arthritis as a manifestation of immune reconstitution inflammatory syndrome after initiation of antiretroviral therapy

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    Walter de Araujo Eyer-Silva

    2012-08-01

    Full Text Available Immune reconstitution inflammatory syndrome (IRIS in HIV-infected subjects initiating antiretroviral therapy most commonly involves new or worsening manifestations of previously subclinical or overt infectious diseases. Reports of non-infectious IRIS are much less common but represent important diagnostic and treatment challenges. We report on a 34-year-old HIV-infected male patient with no history of gout who developed acute gouty arthritis in a single joint one month after initiating highly active antiretroviral therapy.

  7. DOWN SYNDROME WITH MOYAMOYA SYNDROME

    National Research Council Canada - National Science Library

    Mohan Makwana; R. K. Vishnoi; Jai Prakash Soni; Kapil Jetha; Suresh Kumar Verma; Pradeep Singh Rathore; Monika Choudhary

    2017-01-01

    ...,” in which the arterial changes are seen among patients with various syndromes or other disease processes- Down syndrome, sickle cell anaemia, neurofibromatosis type-1, congenital heart disease...

  8. Subclinical Hypothyroidism and Pregnancy Outcomes%亚临床甲状腺机能减退症与妊娠

    Institute of Scientific and Technical Information of China (English)

    何伟平(综述); 张美英(审校)

    2014-01-01

    亚临床甲状腺功能减退症(亚临床甲减)因无临床症状或仅有轻微的临床症状而不易发现,其对妊娠结局及子代神经智力发育却有着重要的影响,因此目前仍是内分泌科、妇产科、优生优育科的热点问题,本文就妊娠期亚临床甲减妊娠期甲状腺功能的变化、发生的原因、对妊娠结局及子代的影响等予以综述。%Subclinical hypothyroidism is not easy to find because it causes no symptoms or mild symptoms.Subclinical hypothyroidism has an important influence on pregnancy outcomes and de-velopment and mental health of the offspring.Therefore,it is still a hot problem in departments of endocrinology,obstetrics and gynecology,and eugenic and superior nurture.This review summari-zes the changes in thyroid function,causes of subclinical hypothyroidism and effects of subclinical hypothyroidism on pregnancy outcomes and offspring development in patients with subclinical hy-pothyroidism in pregnancy.

  9. Depressive symptoms and major depressive disorder in patients affected by subclinical hypothyroidism: a cross-sectional study.

    Science.gov (United States)

    Demartini, Benedetta; Ranieri, Rebecca; Masu, Annamaria; Selle, Valerio; Scarone, Silvio; Gambini, Orsola

    2014-08-01

    The relationship between subclinical hypothyroidism and depression is still controversial. Our objective was to compare the prevalence of depressive symptoms and major depressive disorder in a population of patients affected by subclinical hypothyroidism and a control group without thyroid disease. The authors enrolled 123 consecutive outpatients affected by subclinical hypothyroidism undergoing follow-up at the endocrinology department of San Paolo Hospital in Milan and 123 controls without thyroid disease under the charge of general physicians.All patients and controls underwent an evaluation by means of a psychiatric interview; Hamilton Rating Scale for Depression (HAM-D); Montgomery-Asberg Depression Rating Scale (MADRS); and serum thyroid stimulating hormone, free T4, and free T3 levels. Patients were also screened for thyroid peroxidase antibodies and thyroglobulin antibodies. Patients affected by subclinical hypothyroidism had a prevalence of depressive symptoms of 63.4% at HAM-D and 64.2% at MADRS; 22 patients (17.9%) had a diagnosis of depressive episode (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria). The control group had a prevalence of depressive symptoms of 27.6% at HAM-D and 29.3% at MADRS, and only seven controls had a diagnosis of depressive episode. The prevalence of depressive symptoms between these two groups was statistically different. This study underlines a strong association between subclinical hypothyroidism and depressive symptoms, which could have some important diagnostic and therapeutic implications in the clinical practice.

  10. Pattern classification of brain activation during emotional processing in subclinical depression: psychosis proneness as potential confounding factor

    Directory of Open Access Journals (Sweden)

    Gemma Modinos

    2013-02-01

    Full Text Available We used Support Vector Machine (SVM to perform multivariate pattern classification based on brain activation during emotional processing in healthy participants with subclinical depressive symptoms. Six-hundred undergraduate students completed the Beck Depression Inventory II (BDI-II. Two groups were subsequently formed: (i subclinical (mild mood disturbance (n = 17 and (ii no mood disturbance (n = 17. Participants also completed a self-report questionnaire on subclinical psychotic symptoms, the Community Assessment of Psychic Experiences Questionnaire (CAPE positive subscale. The functional magnetic resonance imaging (fMRI paradigm entailed passive viewing of negative emotional and neutral scenes. The pattern of brain activity during emotional processing allowed correct group classification with an overall accuracy of 77% (p = 0.002, within a network of regions including the amygdala, insula, anterior cingulate cortex and medial prefrontal cortex. However, further analysis suggested that the classification accuracy could also be explained by subclinical psychotic symptom scores (correlation with SVM weights r = 0.459, p = 0.006. Psychosis proneness may thus be a confounding factor for neuroimaging studies in subclinical depression.

  11. Investigations of efficacy of intramammary applied antimicrobials and glucocorticosteroides in the treatment of subclinical and clinical mastitis in cows

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    Vakanjac Slobodanka

    2013-01-01

    Full Text Available Inflammation of the mammary gland, mastitis in cows, presents one of the most acute problems in intensive dairy production, inflicting huge economic losses. In the course of one year, 80 samples were taken at investigated farms from udder quarters of cows with clinical mastitis and 160 samples from udder quarters of cows with subclinical mastitis. The efficacy of three preparations, A, B, and C, was examined in the treatment of clinical and subclinical mastitis in cows. The investigations indicate that antibiotic preparation A (neomycin, polimixine B, oleandomycin and prednisolone exhibited a greater efficacy in the treatment of clinical mastitis caused by Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus uberis and Micrococcus sp., but a smaller efficacy in the treatment of subclinical mastitis caused by Staphylococcus aureus. Preparation B (amoxicillin, clavulanic acid and prednisolone exhibited a higher efficacy in the treatment of clinical mastitis caused by Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus uberis and Micrococcus, but a weaker effect in the treatment of subclinical mastitis caused by Staphylococcus aureus. Preparation C (procaine penicillin G, streptomycin, neomycin sulfate and prednisolone acetate exihibited efficacy in the treatment of clinical and subclinical mastitis caused by Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus uberis, Micrococcus, Staphylococcus aureus and Esherichie coli. [Projekat Ministarstva nauke Republike Srbije, br. III 46002: Molekularno-genetička i ekofiziološka istraživanja u zaštiti autohtonih animalnih genetičkih resursa, očuvanju dobrobiti, zdravlja i reprodukcije gajenih životinja i proizvodnji bezbedne hrane

  12. Pattern classification of brain activation during emotional processing in subclinical depression: psychosis proneness as potential confounding factor.

    Science.gov (United States)

    Modinos, Gemma; Mechelli, Andrea; Pettersson-Yeo, William; Allen, Paul; McGuire, Philip; Aleman, Andre

    2013-01-01

    We used Support Vector Machine (SVM) to perform multivariate pattern classification based on brain activation during emotional processing in healthy participants with subclinical depressive symptoms. Six-hundred undergraduate students completed the Beck Depression Inventory II (BDI-II). Two groups were subsequently formed: (i) subclinical (mild) mood disturbance (n = 17) and (ii) no mood disturbance (n = 17). Participants also completed a self-report questionnaire on subclinical psychotic symptoms, the Community Assessment of Psychic Experiences Questionnaire (CAPE) positive subscale. The functional magnetic resonance imaging (fMRI) paradigm entailed passive viewing of negative emotional and neutral scenes. The pattern of brain activity during emotional processing allowed correct group classification with an overall accuracy of 77% (p = 0.002), within a network of regions including the amygdala, insula, anterior cingulate cortex and medial prefrontal cortex. However, further analysis suggested that the classification accuracy could also be explained by subclinical psychotic symptom scores (correlation with SVM weights r = 0.459, p = 0.006). Psychosis proneness may thus be a confounding factor for neuroimaging studies in subclinical depression.

  13. Subclinical Nonautoimmune Hyperthyroidism in a Family Segregates with a Thyrotropin Receptor Mutation with Weakly Increased Constitutive Activity

    Science.gov (United States)

    Chen, Chun-Rong; Higashiyama, Takuya; Mizutori-Sasai, Yumiko; Ito, Mitsuru; Kubota, Sumihisa; Amino, Nobuyuki; Miyauchi, Akira; Rapoport, Basil

    2010-01-01

    Background Subclinical hyperthyroidism is usually associated with Graves' disease or toxic nodular goiter. Here we report a family with hereditary subclinical hyperthyroidism caused by a constitutively activating germline mutation of the thyrotropin receptor (TSHR) gene. Methods The proband was a 64-year-old Japanese woman who presented with a thyroid nodule and was found to be euthyroid with a suppressed serum TSH. The nodule was not hot. Although antibodies to thyroid peroxidase and thyroglobulin antibodies were present, TSHR antibodies were not detected by TSH-binding inhibition or by bioassay. Two of her middle-aged sons, but not her daughter, also had subclinical hyperthyroidism without TSHR antibodies. Without therapy, the clinical condition of the affected individuals remained unchanged over 3 years without development of overt hyperthyroidism. Results A novel heterozygous TSHR point mutation causing a glutamic acid to lysine substitution at codon 575 (E575K) in the second extracellular loop was detected in the three family members with subclinical hyperthyroidism, but was absent in her one daughter with normal thyroid function. In vitro functional studies of the E575K TSHR mutation demonstrated a weak, but significant, increase in constitutive activation of the cAMP pathway. Conclusion Although hereditary nonautoimmune overt hyperthyroidism is very rare, TSHR activating mutations as a cause of subclinical hyperthyroidism may be more common and should be considered in the differential diagnosis, especially if familial. PMID:20929407

  14. Is There Any Effect on Smell and Taste Functions with Levothyroxine Treatment in Subclinical Hypothyroidism?

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    Kamil Baskoy

    Full Text Available Subclinical hypothyroidism has been accused for coronary heart disease, lipid metabolism disorders, neuropsychiatric disorders, infertility or pregnancy related problems with various strength of evidence. Currently there is insufficient knowledge about olfaction and taste functions in subclinical hypothyroidism. Aim of the present study is to investigate the degree of smell and taste dysfunction in patients with subclinical hypothyroidism. 28 subclinical hypothyroid patients, and 31 controls enrolled in the prospective study in Istanbul, Turkey. Subclinical hypothyroid patients were treated with L-thyroxine for 3 months. Psychophysiological olfactory testing was performed using odor dispensers similar to felt-tip pens ("Sniffin' Sticks", Burghart, Wedel, Germany. Taste function tests were made using "Taste Strips" (Burghart, Wedel, Germany which are basically tastant adsorbed filter paper strip. Patients scored lower on psychophysical olfactory tests than controls (odor thresholds:8.1±1.0 vs 8.9±1.1, p = 0.007; odor discrimination:12.4±1.3 vs 13.1±0.9, p = 0.016; odor identification:13.1±0.9 vs 14.0±1.1, p = 0.001; TDI score: 33.8±2.4 vs 36.9±2.1, p = 0.001. In contrast, results from psychophysical gustatory tests showed only a decreased score for "bitter" in patients, but not for other tastes (5.9±1.8 vs 6.6±1.0, p = 0.045. Three month after onset of treatment olfactory test scores already indicated improvement (odor thresholds:8.1±1.0 vs 8.6±0.6, p<0.001; odor discrimination:12.4±1.31 vs 12.9±0.8, p = 0.011; odor identification:13.1±0.9 vs 13.9±0.8, p<0.001; TDI scores:33.8±2.4 vs 35.5±1.7, p<0.001 respectively. Taste functions did not differ between groups for sweet, salty and, sour tastes but bitter taste was improved after 3 months of thyroxin substitution (patients:5.9±1.8 vs 6.6±1.2, p = 0.045. Correlation of changes in smell and taste, with thyroid function test were also evaluated. TSH, fT4 were found have no

  15. Kindler syndrome

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    Kaviarasan P

    2005-01-01

    Full Text Available Kindler syndrome is a rare autosomal recessive disorder associated with skin fragility. It is characterized by blistering in infancy, photosensitivity and progressive poikiloderma. The syndrome involves the skin and mucous membrane with radiological changes. The genetic defect has been identified on the short arm of chromosome 20. This report describes an 18-year-old patient with classical features like blistering and photosensitivity in childhood and the subsequent development of poikiloderma. The differential diagnosis of Kindler syndrome includes diseases like Bloom syndrome, Cockayne syndrome, dyskeratosis congenita, epidermolysis bullosa, Rothmund-Thomson syndrome and xeroderma pigmentosum. Our patient had classical cutaneous features of Kindler syndrome with phimosis as a complication.

  16. Five-year follow-up for women with subclinical hypothyroidism in pregnancy.

    Science.gov (United States)

    Shields, Beverley M; Knight, Bridget A; Hill, Anita V; Hattersley, Andrew T; Vaidya, Bijay

    2013-12-01

    Increasing numbers of women are being treated with l-thyroxine in pregnancy for mild thyroid dysfunction because of its association with impaired neuropsychological development in their offspring and other adverse obstetric outcomes. However, there are limited data to indicate whether treatment should be continued outside of pregnancy. We aimed to determine whether subclinical hypothyroidism and maternal hypothyroxinemia resolve postdelivery. A total of 523 pregnant healthy women with no known thyroid disorders were recruited during routine antenatal care and provided blood samples at 28 weeks of pregnancy and at a mean of 4.9 years postpregnancy. TSH, free T₄, free T₃, and thyroid peroxidase antibody levels were measured in serum taken in pregnancy and at follow-up. Subclinical hypothyroidism in pregnancy (TSH >3 mIU/L) was present in 65 of 523 (12.4%) women. Of these, 49 (75.4%) women had normal thyroid function postpregnancy; 16 of 65 (24.6%) had persistent high TSH (TSH >4.5 mIU/L postpregnancy) with 3 women receiving l-thyroxine treatment. A total of 44 of 523 (8.4%) women had isolated maternal hypothyroxinemia in pregnancy (free T₄ 4.5 mIU/L outside pregnancy. Of the women with subclinical hypothyroidism in pregnancy with antibody measurements available, those with thyroid peroxidase antibodies in pregnancy were more likely to have persistently elevated TSH or be receiving l-thyroxine replacement after pregnancy (6 of 7 [86%] vs 10 of 57 [18%], P hypothyroidism in pregnancy are transient, so treatment with l-thyroxine in these patients should be reviewed because it may not be warranted after pregnancy.

  17. Subclinical spontaneous bacterial peritonitis at the time of liver transplantation does not impact on outcomes.

    Science.gov (United States)

    McDonald, Damhnaic P; Leithead, Joanna A; Gunson, Bridget K; Ferguson, James W

    2016-01-01

    Liver transplant recipients are often screened for spontaneous bacterial peritonitis during the immediate preoperative evaluation to determine medical fitness to proceed. However, it is unknown whether subclinical spontaneous bacterial peritonitis impacts on post-transplant outcomes. Our aim was to determine whether subclinical spontaneous bacterial peritonitis detected at the preoperative evaluation influences the decision to proceed, and subsequent postoperative morbidity and mortality. This study is a single-centre study of 1231 adults attending for possible first elective single-organ liver transplantation between January 2000 and December 2011. A total of 434 patients underwent ascitic fluid sampling on 460 occasions. Nineteen samples fulfilled the diagnostic criteria for spontaneous bacterial peritonitis (4.8%), including one that was culture positive (Candida spp.). Patients with spontaneous bacterial peritonitis had a higher serum bilirubin level than nonspontaneous bacterial peritonitis patients (P=0.018). Out of the 19 patients, 16 (84.2%) with a positive sample proceeded to transplantation on that occasion; the ascitic microscopy result did not influence the decision to proceed in any clinically stable patient. The 30-day post-transplant survival was 93.8% for spontaneous bacterial peritonitis patients and 96.2% for nonspontaneous bacterial peritonitis patients (P=0.478). After adjusting for recipient age, UK Score for Patients with End-Stage Liver Disease (UKELD) and donor risk index, there was no association between a positive tap and death within 30 days (P=0.649). Subclinical spontaneous bacterial peritonitis is rare in patients admitted for elective liver transplantation, does not influence the decision to proceed and is not associated with increased post-transplant mortality. Our findings suggest that routine preoperative ascitic fluid sampling is not indicated in clinically stable potential transplant recipients.

  18. Influence of lactation stages and rain periods on subclinical mastitis in meat producing ewes

    Directory of Open Access Journals (Sweden)

    Luiz Francisco Zafalon

    Full Text Available ABSTRACT: Mastitis negatively influences the survival and weight gain of ovines for meat production. The purpose of this study was to investigate, in sheep for meat production, the occurrence of subclinical mastitis in ewes at the end of lactation and beginning of the consecutive lactation and to assess the composition and cellular characteristics of milk as a function of different rainfall indices. Mammary halves (821 of Santa Ines (479 and Morada Nova (342 ewes were examined. Milk samples were collected in two different moments of lactation: at weaning and postpartum of the consecutive lactation. Sample collection periods were called "dry" or "rainy" according to the rainfall index in the month immediately before the month of collection. The occurrence of subclinical mastitis at weaning in the Santa Ines and Morada Nova ewes were 16.4 and 12.6% in the dry period, and 17.7 and 23.5% in the rainy period, respectively. In the consecutive lactation period, the occurrences were 26.7 and 27.7% in the dry period and 41.8 and 39.1% in the rainy period, for the Santa Ines and Morada Nova ewes, respectively. Postpartum stage was critical for the occurrence of subclinical mastitis, as compared to that at the end of the previous lactation. Occurrence of the disease negatively influenced the SCC in the milk at the beginning of lactation and changed its composition, mainly in the rainiest periods, probably due to a difficulty in maintaining hygiene in the environment where the animals remained.

  19. Use of milk amyloid A in the diagnosis of subclinical mastitis in dairy ewes.

    Science.gov (United States)

    Miglio, Arianna; Moscati, Livia; Fruganti, Gabriele; Pela, Michela; Scoccia, Eleonora; Valiani, Andrea; Maresca, Carmen

    2013-11-01

    Subclinical mastitis (SM) is one of the most important diseases affecting dairy ewes worldwide, with negative impact on the animal health, farm income and public health. Animals with SM often remain untreated because the disease may not be revealed. Increase in somatic cell count (SCC) and positive bacteriology for mastitis pathogens in milk samples are indicative of SM but the evidence of only one of these alterations must suggest an uncertain SM (UM). UM is defined when positive bacteriological examination (Latent-SM) or SCC>500 000 cells/ml (non-specific-SM) are detected in milk. Nevertheless, SCC and bacteriological examination are expensive, time consuming and are not yet in use at the farm level in dairy ewes. Recently, a sensitive acute phase protein, amyloid A, displaying multiple isoforms in plasma and different body fluids including mammary secretion (milk amyloid A-MAA), has been investigated as a marker of mastitis in cows and, in a few studies, in sheep. The aim of this trial was to compare the concentration of MAA of single udder-halves in ewes with healthy udder-halves (HU-control group) and naturally occurring subclinical mastitis, both confirmed (SM group) and uncertain (UM groups: Latent-SM and non-specific-SM), for monitoring udder health. The reliability of a specific ELISA kit for the measurement of MAA was also tested. During a 3-month trial period, 153 udder halves were assigned to the experimental groups based on their health status: 25 with SM, 40 with UM (11 with latent-SM and 29 with non-specific-SM) and 88 HU. SCC and bacteriological analysis were performed to establish the control and subclinical mastitis groups. MAA concentrations in milk samples were measured using a specific commercially milk ELISA kit. The data were submitted to statistical analysis. Significant (Pmastitis and increased SCC in sheep.

  20. Differences in heart rate profile during exercise among subjects with subclinical thyroid disease.

    Science.gov (United States)

    Maor, Elad; Kivity, Shaye; Kopel, Eran; Segev, Shlomo; Sidi, Yechezkel; Goldenberg, Ilan; Olchovsky, David

    2013-10-01

    Clinical thyroid disease is associated with changes in the cardiovascular system, including changes in heart rate during exercise. However, data on the relation between subclinical thyroid disease (SCTD) and heart rate during exercise are limited. We investigated 3799 apparently healthy subjects who were evaluated in the Institute for Preventive Medicine at the Sheba Medical Center. All subjects answered standard health questionnaires; were examined by a physician; completed routine blood tests including thyrotropin, free triiodothyronine, and free thyroxine levels; and underwent a treadmill exercise according to the Bruce protocol. Subjects with known thyroid disease or those who were taking thyroid-related drugs were excluded from the analysis. Heart rate profile was compared between patients with subclinical hypothyroidism (SCHypoT), patients with normal thyroid function, and patients with subclinical hyperthyroidism (SCHyperT) using propensity score matching. Seventy patients had SCHyperT and 273 had SCHypoT. Compared with age- and sex-matched normal subjects, SCHyperT subjects had a higher resting heart rate (83±17 vs. 76±12 beats per minute [bpm], p=0.006), a significantly higher recovery heart rate (94±12 vs. 90±12 bpm, p=0.045), and a significantly lower heart rate reserve (80±20 vs. 87±18 bpm, p=0.006). Subjects with SCHypoT showed a trend toward a lower resting heart rate (75±13 vs. 77±15 bpm, p=0.09) and had a significantly lower recovery heart rate (88±12 vs. 90±13 bpm, p=0.035). There was no significant difference in exercise duration or blood pressure between subjects with SCTD and their matched normal controls. Subjects with SCTD have a significantly different heart rate profile during rest, exercise, and recovery.

  1. Inverse relationship between bioavailable testosterone and subclinical coronary artery calcification in non-obese Korean men

    Institute of Scientific and Technical Information of China (English)

    Byoung-Jin Park; Jae-Yong Shim; Yong-Jae Lee; Jung-Hyun Lee; Hye-Ree Lee

    2012-01-01

    Although low testosterone levels in men have been associated with high risk for cardiovascular disease,little is known about the association between male sex hormones and subclinical coronary disease in men with apparently low cardiometabolic risk.This study was performed to investigate the association between male sex hormones and subclinical coronary artery calcification measured as coronary calcium score in non-obese Korean men.We examined the relationship of total testosterone,sex hormone-binding globulin,bioavai lable testosterone and free testosterone with coronary calcium score in 291 non-obese Korean men (mean age:52.8±9.3 years)not having a history of cardiovascular disease.Using multiple linear regression,we evaluated associations between log (sex hormone)levels and log (coronary calcium score) after adjusting for confounding variables in 105 men with some degree of coronary calcification defined as coronary calcium score ≥ 1.In multiple linear regression analysis,bioavailable testosterone was inversely associated with coronary calcium score (P=0.046) after adjusting for age,body mass index,smoking status,alcohol consumption,regular exercise,mean blood pressure,resting heart rate,C-reactive protein,fasting plasma glucose,total cholesterol,triglyceride,high-density lipoprotein (HDL) cholesterol,hypertension medication and hyperlipidemia medication,whereas total testosterone,sex hormone-binding globulin and free testosterone were not (P=0.674,P=0.121 and P=0.102,respectively).Our findings indicate that bioavailable testosterone is inversely associated with the degree of subclinical coronary artery calcification in non-obese men.

  2. Gender impact on the correlations between subclinical thyroid dysfunction and hyperuricemia in Chinese.

    Science.gov (United States)

    Zhang, Jianping; Meng, Zhaowei; Zhang, Qing; Liu, Li; Song, Kun; Tan, Jian; Li, Xue; Jia, Qiang; Zhang, Guizhi; He, Yajing

    2016-01-01

    Overt hypothyroidism and hyperthyroidism can lead to hyperuricemia. However, few data are available regarding the association between subclinical thyroid dysfunction and hyperuricemia, especially from the perspective of gender impact. This study aimed to investigate the association between subclinical thyroid disorders and hyperuricemia with emphasized focuses on differences resulting from different gender. Eleven thousand four hundred forty-six healthy subjects (6870 male, 4576 female) were enrolled in this cross-sectional study, with exclusions of known thyroid, renal, hepatic, gastrointestinal, or oncological diseases. Clinical data including anthropometric measurements, thyroid function, uric acid, renal and liver function were collected. The associations between thyroid function and hyperuricemia of males and females were analyzed separately. Prevalence of hyperuricemia was substantially higher in male (23.17%) than that in female (9.11%). Serum uric acid was correlated well with various factors, especially with creatinine, whose coefficients were 0.283 and 0.386 for males and females. The significantly elevated risk for hyperuricemia was observed in mild hypothyroidism male participants with an odd ratio of 1.49 (1.10-2.02), whereas no statistical risk was found in female. No meaningful risk was found in mild hyperthyroidism participants. Estimated glomerular filtration rate was significantly depressed in both genders with mild hypothyroidism, while obviously increased in both genders with mild hyperthyroidism. For hyperuricemia, mild hypothyroidism is a risk factor in males while it is not in females. This difference could be caused by the protective effect of estrogen in females. Monitoring serum uric acid in subclinical hypothyroidism is more necessary in males.

  3. Virulence factors genes of Staphylococcus spp. isolated from caprine subclinical mastitis.

    Science.gov (United States)

    Salaberry, Sandra Renata Sampaio; Saidenberg, André Becker Simões; Zuniga, Eveline; Melville, Priscilla Anne; Santos, Franklin Gerônimo Bispo; Guimarães, Ednaldo Carvalho; Gregori, Fábio; Benites, Nilson Roberti

    2015-08-01

    The aim of this study was to investigate genes involved in adhesion expression, biofilm formation, and enterotoxin production in isolates of Staphylococcus spp. from goats with subclinical mastitis and associate these results with the staphylococcal species. One hundred and twenty-four isolates were identified and polymerase chain reaction (PCR) was performed to detect the following genes: cna, ebpS, eno, fib, fnbA, fnbB, bap, sea, seb, sec, sed and see. The most commonly Staphylococcus species included S. epidermidis, S. lugdunensis, S. chromogenes, S. capitis ss capitis and S. intermedius. With the exception of fnbB, the genes were detected in different frequencies of occurrence in 86.3% of the Staphylococcus spp. isolates. Eno (73.2%) and bap (94.8%) were more frequently detected in coagulase-negative staphylococci (CNS); ebpS (76%), fib (90.9%) and fnbA (87%) were the most frequent genes in coagulase-positive staphylococci (CPS). Regarding enterotoxins, genes sed (28.2%) and see (24.2%) had a higher frequency of occurrence; sec gene was more frequently detected in CPS (58.8%). There was no association between the presence of the genes and the Staphylococcus species. Different virulence factors genes can be detected in caprine subclinical mastitis caused by CNS and CPS. The knowledge of the occurrence of these virulence factors is important for the development of effective control and prevention measures of subclinical mastitis caused by CNS and CPS in goats. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. MR enterography to evaluate sub-clinical intestinal inflammation in children with spondyloarthritis

    Directory of Open Access Journals (Sweden)

    Stoll Matthew L

    2012-02-01

    Full Text Available Abstract Background Magnetic resonance enterography (MRE is an established tool to evaluate for changes associated with inflammatory bowel disease (IBD, but has not been studied in sub-clinical IBD. We sought to evaluate the use of MRE in children with spondyloarthritis (SpA, who are at risk of having sub-clinical gut inflammation. Methods Children with juvenile idiopathic arthritis (JIA with evidence of intestinal inflammation as evidence by an abnormal fecal calprotectin assay were offered MRE of their intestines. Flavored sports drink containing polyethylene glycol 3350 was used as oral contrast. Glucagon was used to arrest peristalsis. Patients were imaged in the prone position on a 1.5 T scanner. Heavily T2-weighted fat-suppressed coronal and axial images using breath-hold technique were obtained, followed by post-gadolinium fat-suppressed T1-weighted gradient echo images. Results We recruited five children with juvenile idiopathic arthritis (JIA; four had SpA, and one had poly-articular JIA. All five had evidence of intestinal inflammation based upon a positive fecal calprotectin assay and successfully completed the MRE. Three of the studies showed findings suggestive of IBD, including thickening and contrast uptake at the terminal ileum (TI in one child, contrast uptake of the distal ileum in another, and prominent vasa recta and mesenteric lymph nodes in the third. The child with evidence of inflammatory changes at the TI underwent colonoscopy, which revealed inflammatory bowel disease limited to the TI. Conclusions MRE can be used to evaluate for subclinical IBD in children with JIA. This protocol was safe and well-tolerated, and identified mild changes in three of the subjects.

  5. Subclinical Cardiac Dysfunction in Polymyositis and Dermatomyositis: A Speckle-tracking Case-control Study.

    Science.gov (United States)

    Guerra, Federico; Gelardi, Chiara; Capucci, Alessandro; Gabrielli, Armando; Danieli, Maria Giovanna

    2017-06-01

    Subclinical heart disease occurs in up to 50% of patients with idiopathic inflammatory myopathies (IIM) and is difficult to detect through conventional imaging. We investigated the usefulness of global longitudinal strain (GLS) measurement to detect a subclinical systolic ventricular dysfunction in patients with IIM. We enrolled 28 patients with IIM and 28 matched controls in a 1:1 fashion. Standard variables for the left ventricle (LV) and right ventricle (RV) systolic and diastolic function were measured and compared between cases and controls, along with speckle-tracking GLS of the LV and RV. A possible correlation between GLS and muscle strength, disease activity, cardiovascular risk factors, and other organ systems involvement was searched. Standard variables of systolic and diastolic dysfunction were similar between patients and controls. GLS was significantly lower in patients when compared with controls for both LV (-18.7 ± 4.2% vs -21.2 ± 2.1%, p = 0.006) and RV (-19.3 ± 6.3% vs -22.5 ± 3.8%, p = 0.033). Patients with IIM had a 4.9-fold increased risk for impaired left GLS [relative risk (RR) 4.9, 95% CI 1.5-15.8, p = 0.006], which involved usually basal and mid-segments of the anterior, anterior-septal, and lateral wall. Patients with IIM had a 3.4-fold increased risk for impaired right GLS (RR 3.4, 95% CI 1.1-11.7, p = 0.04) with the basal segment of the free RV wall most frequently involved. Muscle strength, disease activity, damage and duration, other organ system involvement, and previous treatment were not associated with reduced GLS. Subclinical systolic impairment is common in patients with IIM without overt LV dysfunction. In this context, GLS is a potentially useful variable.

  6. Filaria dance sign and subclinical hydrocoele in two east African communities with bancroftian filariasis.

    Science.gov (United States)

    Simonsen, Paul E; Bernhard, Peter; Jaoko, Walter G; Meyrowitsch, Dan W; Malecela-Lazaro, Mwele N; Magnussen, Pascal; Michael, Edwin

    2002-01-01

    During population-wide cross-sectional surveys for Wuchereria bancrofti microfilaremia, circulating antigenaemia, and clinical disease in a high and a low endemicity community in East Africa in 1998, a portable ultrasound scanner was used simultaneously to examine the scrotal tissue of the male populations (n = 422 and 328, respectively) for signs of adult worms. The overall microfilaria (mf) and circulating filarial antigen (CFA) prevalences in the scanned males were 30.8% and 53.6% in the high and 4.3% and 19.8% in the low endemicity community, respectively. During ultrasound examination, the filaria dance sign (FDS)--indicating the presence of live adult W. bancrofti worms--was observed in 16.1% and 6.7% of the males in these communities, respectively. This examination also revealed that subclinical hydrocoele (fluid accumulation in the scrotal sac, not detected during physical examination for clinical hydrocoele) was very common, affecting 25.3% and 15.5% of the examined males in the high and low endemicity community, respectively. Both of these ultrasonographic signs started to appear around the age of puberty and were most common in adults. In the high endemicity community, the prevalence and mean intensity of mf and CFA were considerably higher in FDS-positive than in FDS-negative adult males, whereas no obvious difference in these parameters was noted between adult males with and without subclinical or the combination of clinical and subclinical hydrocoele. Associations were less clear in the low endemicity community, probably because of the low number of infected individuals. The application of ultrasonography as a tool in bancroftian filariasis epidemiological field studies thus indicated that scrotal pathology may be much more common in endemic areas than hitherto reported.

  7. Subclinical atherosclerosis in northern and southern China:the Chinese paradox

    Institute of Scientific and Technical Information of China (English)

    Jie Huang; Stanley P Azen; Robert C Detrano; Yang-Feng Wu; Xiao-Qing Liu; Ding Ding; Lian-Cheng Zhao; Bin Lu; Man Li; Nathan D Wong; Laurie D Dustin

    2011-01-01

    Background The incidence of coronary heart disease (CHD) is higher in Northern than that in Southern China ,however differences in traditional CHD risk factors do not fully explain this.No study has examined the differences in subclinical atherosclerosis that may help explain the differences in incidence. This study examined these differences in subclinical atherosclerosis using coronary computed tomography(CT]for calcification between the Northern and Southern China.Methods.We selected a random sample of participants in a large multi-center ongoing epidemiologic study for coronary calcium scanning in one northern city (North) (Beijing,n=49) and in two southern cities (South) (Shanghai,n=50,and Guangzhou,n=50).Participants firm the three field centers (mean age 67 years) underwent coronary risk factor evaluation and cardiac CT scanning for coronary calcium measurement using the Multi-Ethnic Study of Atherosclerosis scanning protocol.Results Adjusted log-transformed coronary artery calcium score in North China (Beijing) was 3.1±0.4 and in South China (Shanghai and Guangzhou) was 2.2±0.3 (P=0.04).Mean calcium score for the northern city of Beijing was three times higher thanthat of the southern city of Guangzhou (P=0.01) and 2.5 times higher than for the southern city of Shanghai (P = 0.03).Conclusions The extent of subclinical atherosclerosis is significantly higher in the northern city of Beijing than that in the two southern cities of Guangzhou and Shanghai,even after adjusting for standard cardiac risk factors.This finding suggests that standard risk factors do not fully explain north south differences in clinical CHD incidence.

  8. [Detection of subclinical hypothyroidism in pregnant women with different gestational ages].

    Science.gov (United States)

    Andrade, Luis J O; Cruz, Thomaz; Daltro, Carla; França, Caroline S; Nascimento, Avelina O S

    2005-12-01

    To detect subclinical hypothyroidism in pregnant women. Seventy-five pregnant women who resided in the town of Itabuna, state of Bahia, were voluntarily studied. Inclusion criteria were age pregnant women. In 5.4% of them, thyroid ultrasonographic changes were documented. Based on finding of a 4% prevalence of elevated TSH during pregnancy, the authors consider important the inclusion of thyroid function laboratory evaluation in the routine prenatal examination. Further studies appear necessary to establish at what gestational age thyroid function evaluation should be started in pregnant women and how frequently it should be repeated during the course of gestation.

  9. Thyroid hormone treatment among pregnant women with subclinical hypothyroidism: US national assessment.

    Science.gov (United States)

    Maraka, Spyridoula; Mwangi, Raphael; McCoy, Rozalina G; Yao, Xiaoxi; Sangaralingham, Lindsey R; Singh Ospina, Naykky M; O'Keeffe, Derek T; De Ycaza, Ana E Espinosa; Rodriguez-Gutierrez, Rene; Coddington, Charles C; Stan, Marius N; Brito, Juan P; Montori, Victor M

    2017-01-25

     To estimate the effectiveness and safety of thyroid hormone treatment among pregnant women with subclinical hypothyroidism.  Retrospective cohort study.  Large US administrative database between 1 January 2010 and 31 December 2014.  5405 pregnant women with subclinical hypothyroidism, defined as untreated thyroid stimulating hormone (TSH) concentration 2.5-10 mIU/L.  Thyroid hormone therapy.  Pregnancy loss and other pre-specified maternal and fetal pregnancy related adverse outcomes.  Among 5405 pregnant women with subclinical hypothyroidism, 843 with a mean pre-treatment TSH concentration of 4.8 (SD 1.7) mIU/L were treated with thyroid hormone and 4562 with a mean baseline TSH concentration of 3.3 (SD 0.9) mIU/L were not treated (Pwomen (n=89; 10.6%) than among untreated women (n=614; 13.5%) (Pwomen had lower adjusted odds of pregnancy loss (odds ratio 0.62, 95% confidence interval 0.48 to 0.82) but higher odds of preterm delivery (1.60, 1.14 to 2.24), gestational diabetes (1.37, 1.05 to 1.79), and pre-eclampsia (1.61, 1.10 to 2.37); other pregnancy related adverse outcomes were similar between the two groups. The adjusted odds of pregnancy loss were lower in treated women than in untreated women if their pre-treatment TSH concentration was 4.1-10 mIU/L (odds ratio 0.45, 0.30 to 0.65) but not if it was 2.5-4.0 mIU/L (0.91, 0.65 to 1.23) (Pwomen with subclinical hypothyroidism, especially those with pre-treatment TSH concentrations of 4.1-10 mIU/L. However, the increased risk of other pregnancy related adverse outcomes calls for additional studies evaluating the safety of thyroid hormone treatment in this patient population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Recurrent exposure to subclinical lipopolysaccharide increases mortality and induces cardiac fibrosis in mice.

    Directory of Open Access Journals (Sweden)

    Wilbur Y W Lew

    Full Text Available BACKGROUND: Circulating subclinical lipopolysaccharide (LPS occurs in health and disease. Ingesting high fatty meals increases LPS that cause metabolic endotoxemia. Subclinical LPS in periodontal disease may impair endothelial function. The heart may be targeted as cardiac cells express TLR4, the LPS receptor. It was hypothesized that recurrent exposure to subclinical LPS increases mortality and causes cardiac fibrosis. METHODS: C57Bl/6 mice were injected with intraperitoneal saline (control, low dose LPS (0.1 or 1 mg/kg, or moderate dose LPS (10 or 20 mg/kg, once a week for 3 months. Left ventricular (LV function (echocardiography, hemodynamics (tail cuff pressure and electrocardiograms (telemetry were measured. Cardiac fibrosis was assessed by picrosirius red staining and LV expression of fibrosis related genes (QRT-PCR. Adult cardiac fibroblasts were isolated and exposed to LPS. RESULTS: LPS injections transiently increased heart rate and blood pressure (<6 hours and mildly decreased LV function with full recovery by 24 hours. Mice tolerated weekly LPS for 2-3 months with no change in activity, appearance, appetite, weight, blood pressure, LV function, oximetry, or blood chemistries. Mortality increased after 60-90 days with moderate, but not low dose LPS. Arrhythmias occurred a few hours before death. LV collagen fraction area increased dose-dependently from 3.0±0.5% (SEM in the saline control group, to 5.6±0.5% with low dose LPS and 9.7±0.9% with moderate dose LPS (P<0.05 moderate vs low dose LPS, and each LPS dose vs control. LPS increased LV expression of collagen Iα1, collagen IIIα1, MMP2, MMP9, TIMP1, periostin and IL-6 (P<0.05 moderate vs low dose LPS and vs control. LPS increased α-SMA immunostaining of myofibroblasts. LPS dose-dependently increased IL-6 in isolated adult cardiac fibroblasts. CONCLUSIONS: Recurrent exposure to subclinical LPS increases mortality and induces cardiac fibrosis.

  11. Subclinical mastitis effects in some dairy herds in the Upper Chicamocha River (Boyacá Department)

    OpenAIRE

    Andrey Pinzón Trujillo; Fausto Camilo Moreno Vásquez; Germán Rodríguez Martínez

    2009-01-01

    The purpose of this work was to carry out a study about the effects of subclinical mastitis in cows of 34 dairy farms in the Upper Chicamocha region (Boyacá department).The farms are registered in the livestock farmers association of Boyacá (FABEGAN). This study was done with the aim to know about the infection status of cows and establish which are the principal etiologic agents associated with the disease and its relation with the milking routine. To this aim, applied comparison even tests ...

  12. Subclinical peripheral neuropathy in type 1 diabetic adolescents and its relationship with metabolic control

    Directory of Open Access Journals (Sweden)

    Sajić Silvija

    2005-01-01

    Full Text Available Professional management of paediatric diabetology, according to consensus guidelines, involves the screening of micro-vascular complications at puberty. The subclinical form of peripheral neural dysfunction in diabetic teenagers is reported with a frequency of 50-88%, by different authors. The purpose of this study was to evaluate the frequency of subclinical distal neuropathy (DSMN in type 1 diabetic pediatric patients during the second decade of life, and its relationship with metabolic control. The Endocrinology Department and the Neurology-Physiology Laboratory of the Pediatric Clinic in Belgrade carried out a longitudinal follow-up study (lasting 18 months, beginning in November 2000 on a selection of patients with poor metabolic control. During routine clinical treatment, patients were evaluated using the electrophysiological diagnostic method on peripheral neural dysfunction, a subclinical form of neuropathy. Metabolic control was manifested through HbA1c levels, measured every 3 months, using ion-exchange chromatography. Finally, here is the data collected from the clinical follow-up investigation of 60 children, aged 13-19 (median 1S.S±2.2, with duration of diabetes from 2-16 years (median b.3±3.b, and on the following therapies: 43 CT-conventional and 17 IIT-intensive, and insulin dose/day, median 1.02 (0.6-2.1 U/kg. Detected DSMN parameters at the beginning and at the end of the study were also noted. DSMN frequency was positive, at 64% for HbA1c of 9.44; DSMN dysfunction was reversed in 5% of the patients, for HbA1c of 10.17; the worst result was the progression of DSMN at 6.7% for HbA1c of 10.52; 6.7% had negative DSMN, with improved metabolic control, for HbA1c of 8.4; 15% of the examinations were unfinished (+/*. ANOVA statistical analysis showed a significant statistical relationship between metabolic control (HbA1c levels and DSMN neuropathy (sig. 0.043, p<0.05. There was no significant relationship between the reversion of

  13. Sub-Clinical Cognitive Decline and Resting Cerebral Blood Flow in Middle Aged Men

    DEFF Research Database (Denmark)

    Henriksen, Otto Mølby; Hansen, Naja Liv; Osler, Merete

    2017-01-01

    of early sub-clinical cognitive decline with CBF. MATERIALS AND METHODS: The study participants were recruited from a cohort of Danish men born in 1953. Based on a regression model we selected men who performed better (Group A, n = 94) and poorer (Group B, n = 95) on cognitive testing at age 57 than...... expected from testing at age 20. Participants underwent supplementary cognitive testing, blood sampling and MRI including measurements of regional and global CBF. RESULTS: Regional CBF was lower in group B than in group A in the posterior cingulate gyrus and the precuneus. The associations were attenuated...

  14. Decreased Renal Function Is a Risk Factor for Subclinical Coronary Atherosclerosis in Korean Postmenopausal Women

    Science.gov (United States)

    Yun, Bo Hyon; Chon, Seung Joo; Cho, Si Hyun; Choi, Young Sik; Lee, Byung Seok

    2016-01-01

    Objectives Decreased renal function is associated with increased cardiovascular risk. Our study was planned to verify the association of decreased renal function and subclinical coronary atherosclerosis in postmenopausal women. Methods We performed a retrospective review of 251 Korean postmenopausal women who visited the health promotion center for a routine health checkup. Estimated glomerular filtration rate (eGFR) was used to show renal function, which was estimated by calculated using the Cockcroft-Gault (CG) and the modification of diet in renal disease (MDRD) formulas. Coronary atherosclerosis was assessed by 64-row multidetector computed tomography. Results Women with reduced eGFR (menopausal hormone therapy before atherosclerosis development. PMID:28119897

  15. Premature subclinical atherosclerosis in children and young adults with juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Bohr, Anna-Helene; Fuhlbrigge, Robert C; Karup Pedersen, Freddy

    2016-01-01

    Many studies show that Juvenile Idiopathic Arthritis (JIA) is associated with early subclinical signs of atherosclerosis. Chronic inflammation per se may be an important driver but other known risk factors, such as dyslipidemia, hypertension, insulin insensitivity, a physically inactive lifestyle......, were considered.We found 13 descriptive cross sectional studies with healthy controls, one intervention study and two studies on adults diagnosed with JIA. Only one study addressed obesity, and physical activity (PA) has only been assessed in one study on adults with JIA and only by self...

  16. Spectrum of Adrenal Dysfunction in Patients with Acquired Immunodeficiency Syndrome Evaluation of Adrenal and Pituitary Reserve with ACTH and Corticotropin-Releasing Hormone Testing.

    Science.gov (United States)

    Freda, P U; Papadopoulos, A D; Wardlaw, S L; Goland, R S

    1997-07-01

    Patients with acquired immunodeficiency syndrome (AIDS) have been reported to develop abnormalities of the endocrine system and in particular of the hypothalamic-pituitary-adrenal (HPA) axis. To define the abnormalities of HPA function in AIDS patients better, we performed ACTH and ovine corticotropin-releasing hormone (oCRH) testing in a group of AIDS patients and oCRH testing in a group of healthy subjects. Our study found that in AIDS patients with normal ACTH testing, oCRH testing revealed a variety of subclinical abnormalities of ACTH and cortisol responses. Although we did not find frank adrenal insufficiency in any of these AIDS patients, it remains to be determined if any of the subclinical abnormalities we identified are predictive of clinically significant adrenal insufficiency; it may be that as AIDS patients live longer, the subclinical abnormalities will progress to adrenal insufficiency. (Trends Endocrinol Metab 1997;8:173-180). (c) 1997, Elsevier Science Inc.

  17. Is suppressed thyroid-stimulating hormone (TSH) associated with subclinical depression in the Danish General Suburban Population Study?

    DEFF Research Database (Denmark)

    Kvetny, Jan; Ellervik, Christina; Bech, Per

    2015-01-01

    phase, including 14,787 individuals, we have focused on suppressed TSH (thyroid-stimulating hormone) and depression. AIMS: To evaluate to what extent suppressed TSH is associated with subclinical depression. METHODS: The total scores of the Major Depression Inventory (MDI) were used to evaluate...... subclinical depression, both by its total score and by an algorithm of the subthreshold depressed by presence of at least three of the 10 ICD-10 depression symptoms. Serum levels of TSH were used to classify the individuals into suppressed (TSH ...BACKGROUND: The first phase of the Danish General Suburban Population Study (GESUS) including 8214 individuals was an attempt to evaluate the association between subclinical hypothyroidism without or with elevated peroxidase antibodies and depression. No such association was found. In the second...

  18. Common polymorphisms in CYP2C9, subclinical atherosclerosis and risk of ischemic vascular disease in 52,000 individuals

    DEFF Research Database (Denmark)

    Kaur-Knudsen, D; Bojesen, S E; Nordestgaard, B G

    2009-01-01

    Cytochrome P450 2C9 (CYP2C9) enzymes metabolize warfarin and arachidonic acid. We hypothesized that the CYP2C9(*)2 (rs.1799853) and CYP2C9(*)3 (rs.1057910) polymorphisms with decreased enzyme activity affect risk of subclinical atherosclerosis (reduced ankle brachial index and increased C...... of follow-up; the Copenhagen General Population Study, a cross-sectional study including 21 629 participants; and the Copenhagen Ischemic Heart Disease Study, a case-control study including 5082 cases and 14 904 controls. CYP2C9 carriers versus noncarriers did not associate with subclinical atherosclerosis......% power. In conclusion, in three independent studies totaling more than 52 000 individuals, we found no association between CYP2C9(*)2 and CYP2C9(*)3 polymorphisms and risk of subclinical atherosclerosis, ischemic vascular disease or death after ischemic heart disease....

  19. Identification of new 18S rRNA strains of Babesia canis isolated from dogs with subclinical babesiosis.

    Science.gov (United States)

    Łyp, P; Adaszek, Ł; Furmaga, B; Winiarczyk, S

    2015-01-01

    In this study, we used PCR to detect and characterize B. canis from naturally infected dogs in Poland with subclinical babesiosis by amplifying and sequencing a portion of the 18S ribosomal RNA (rRNA) gene. Venous blood samples were collected from ten dogs with subclinical babesiosis. A 559-bp fragment of the B. canis 18S rRNA gene was amplified by PCR. Sequencing of the PCR products led to the identification of a new variant of Babesia canis, differing from the previously detected protozoa genotypes (18S rRNA-A and 18S rRNA-B) with nucleotide substitutions in positions 150 and 151 of the tested gene fragment. The results indicate the emergence within the Polish territory of a new, previously unencountered Babesia canis genotype responsible for the development of subclinical babesiosis.

  20. Live birth rates following in vitro fertilization in women with thyroid autoimmunity and/or subclinical hypothyroidism.

    Science.gov (United States)

    Chai, Joyce; Yeung, Wing-Yee T; Lee, Chi-Yan V; Li, Hang-Wun R; Ho, Pak-Chung; Ng, Hung-Yu E

    2014-01-01

    To investigate whether the live birth rate following in vitro fertilization (IVF) is affected by thyroid autoimmunity (TAI) and/or subclinical hypothyroidism in subfertile women. Retrospective study in a university infertility clinic. A total of 627 women without past or current history of thyroid disorder undergoing their first IVF cycle. Pre-IVF archived blood serum samples were tested for TAI and thyroid function tests. Live birth rate. The clinical pregnancy rate, live birth rate and miscarriage rate were similar among women with or without TAI and/or subclinical hypothyroidism using a TSH threshold 4·5 mIU/l. Thyroid autoantibody level did not affect these IVF outcomes. The live birth rate and miscarriage rate of women with TAI and/or subclinical hypothyroidism following IVF were not impaired. © 2013 John Wiley & Sons Ltd.

  1. The relation between bullying and subclinical psychotic experiences and the influence of the bully climate of school classes.

    Science.gov (United States)

    Horrevorts, Esther M B; Monshouwer, Karin; Wigman, Johanna T W; Vollebergh, Wilma A M

    2014-09-01

    This study aims to examine the association between the bully climate of school classes and the prevalence of subclinical psychotic experiences among students who are involved in bullying (either as bully or as victim). Data were derived from the Dutch health behavior in school-aged children survey of 2005, a nationally representative cross-sectional study with a total of 5,509 adolescents between the age of 12 and 16. The data were analyzed using a multilevel regression analysis. The study revealed that both bullying and being bullied in school classes was associated with an increased level of subclinical psychotic experiences. The bully climate of a school class moderates this effect, i.e., the higher risk for bully-victims on subclinical psychotic experiences was less strong in classes with a higher percentage of classmates involved in bullying. Thus, bully climate has to be taken into account when studying the psychological experiences associated with being bullied.

  2. Evaluation of Sialic Acid and Acute Phase Proteins (Haptoglobin and Serum Amyloid A in Clinical and Subclinical Bovine Mastitis

    Directory of Open Access Journals (Sweden)

    S. Nazifi*, M. Haghkhah1, Z. Asadi, M. Ansari-Lari2, M. R. Tabandeh3, Z. Esmailnezhad and M. Aghamiri

    2011-01-01

    Full Text Available The present study was conducted to evaluate the concentrations of sialic acids (total, lipid bound and protein bound and their correlation with acute phase proteins (haptoglobin and serum amyloid A in clinical and subclinical mastitis of cattle. Thirty subclinical mastitic cows with positive California mastitis test (CMT test and no clinical signs of mastitis, 10 clinical mastitic cows and 10 healthy cows with negative CMT test and normal somatic cell count were selected. Milk and blood samples were collected after confirmation of clinical and subclinical mastitis by somatic cell count and bacterial identification. Serum haptoglobin (Hp, serum amyloid A (SAA, total sialic acid (TSA, lipid bound sialic acid (LBSA and protein bound sialic acid (PBSA were measured by validated standard methods. Haptoglobin and SAA increased significantly in both types of mastitis compared with control group (P<0.001. However, the ratio of HP/SAA was significantly different from the control group only in clinical mastitis. The results showed that TSA and LBSA were significantly different in control group compared with clinical and subclinical mastitis (P<0.001. Protein bound sialic acid did not change in subclinical mastitis in comparison with control group (P=0.86. There was positive correlation between LBSA and PBSA in clinical mastitis (r=0.72, P=0.02 whereas significant negative correlation was observed between LBSA and PBSA in subclinical mastitis (r=-0.62, P<0.001. Results also showed no correlation between Hp and SAA with each other or with any other parameters in study groups.

  3. Early Onset Hepatocellular Disease in an Infant with Zellweger Syndrome

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    Mehri Najafi Sani

    2015-10-01

    Full Text Available Zellweger syndrome (ZS is a peroxisomal disorder with a multiple congenital anomalies, characterized by stereotypical facies, profound hypotonia, organ involvement including cerebral, retinal, hepatic, and renal. Herein, a 3-month-old female with ZS is presented who was referred because of increased liver enzymes (subclinical hepatitis, which was detected in work-up of her neck cyst, severe hypotonia, and abnormal facies. An increased concentration of very long chain fatty acid in lipid profile was detected. ZS should be considered in the list of differential diagnosis in infants with stereotypical phenotype, neurodevelopmental delay, and severe hypotonia in association with liver and other organs involvement.

  4. Perceived supervisor’s subclinical psychopathy, and subordinate’s organizational commitment, job satisfaction and satisfaction with executive

    Directory of Open Access Journals (Sweden)

    ELŻBIETA SANECKA

    2013-12-01

    Full Text Available This study was designed to investigate the correlations between supervisor`s perceived subclinical psychopathy and subordinate`s organizational commitment, overall job satisfaction and particularly satisfaction with his/her supervisor. The results, based on a sample of 153 employees, showed that subordinates working with leaders, who can be defined as organizational (or industrial, corporate psychopaths, tended to adopt more negative work attitudes. Supervisor`s perceived subclinical psychopathy had a negative impact on subordinates’ job satisfaction, satisfaction with supervisor and their organizational commitment. The paper discusses the results and limitations of the study, and offers suggestions for future research. Keywords: ; ; ; ; ;

  5. [Prevalence of clinical and subclinical hypothyroidism during pregnancy in a pregnant women population].

    Science.gov (United States)

    Cruz-Cruz, Edgar Alonso; Ramírez-Torres, Aurora; Pimentel-Nieto, Diana; Roque Sánchez, Armando Miguel

    2014-11-01

    To determine the prevalence of hypothyroidism during pregnancy in a group of pregnant patients attending antenatal care at the National Institute of Perinatology and to meet cases not detected by universal screening. Was conducted from October 2012 to March 2013, in a group of pregnant patients attending to National Institute of Perinatology, thyroid profile was performed according to the recom- mendations of the American Thyroid Association. Patients were referred to endocrinology consultation and treatment was started in case of abnormal thyroid profile. We used central tendency and non-parametric measures for description of the sample. The prevalence of thyroid disease in pregnancy was 33.9% (n = 37), 12.8% (n = 14) with clinical hypothyroidism and 21.1% (n = 23) subclinical hypothyroidism. The 87.1% (n = 95) of patients reported at least one symptom or risk factor history for thyroid disease, only 12.8% (n = 14), had no history or symptoms related to thyroid disease. There is no relationship between a history or symptoms reported and the presence of thyroid disease. The prevalence of thyroid clinical and subclinical disease is greater than that reported in the literature. There is not relationship with each risk factor for thyroid disease. Perform universal screening detects almost twice thyroid disease during pregnancy.

  6. Subclinical Cardiovascular System Changes in Obese Patients with Juvenile Idiopathic Arthritis

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    Barbara Głowińska-Olszewska

    2013-01-01

    Full Text Available Objective. We aimed to determine the prevalence of excess body mass in juvenile idiopathic arthritis (JIA children and to investigate the influence of obesity into the early, subclinical changes in cardiovascular system in these patients. Methods. Fifty-eight JIA patients, aged median 13 years, were compared to 36 healthy controls. Traditional cardiovascular risk factors and inflammatory markers (hsCRP, IL-6, TNFα, adiponectin were studied together with IMT (intima-media thickness, FMD (flow mediated dilation, and LVMi (left ventricle mass index as surrogate markers of subclinical atherosclerosis. Results. Thirteen JIA children (22% were obese and had increased systolic blood pressure, cholesterol, triglycerides, insulin, HOMA, hsCRP, and IL-6 compared to nonobese JIA and controls. FMD was decreased compared to nonobese JIA and controls, whereas IMT and LVMi were increased. In multivariate regression analysis, TNFα, SDS-BMI, and systolic blood pressure were independent predictors of early CV changes in JIA. Conclusions. Coincident obesity is common in JIA children and is associated with insulin resistance, dyslipidemia, and increased levels of inflammatory markers leading to early changes in cardiovascular system. Thus, medical care of children with JIA should include strategies preventing cardiovascular disease by maintenance of adequate body weight.

  7. Comparison of two diets of varying glycemic index on carotid subclinical atherosclerosis in obese children.

    Science.gov (United States)

    Iannuzzi, Arcangelo; Licenziati, Maria Rosaria; Vacca, Maria; De Marco, Donata; Cinquegrana, Giorgio; Laccetti, Marco; Bresciani, Alessandro; Covetti, Giuseppe; Iannuzzo, Gabriella; Rubba, Paolo; Parillo, Mario

    2009-11-01

    Childhood obesity is associated with an increased carotid intima-media thickness (IMT) and stiffness. Increased carotid wall thickening and rigidity are considered markers of subclinical atherosclerosis. The aim of the present study was to test the effect of two hypocaloric diets of varying glycemic index on weight loss and markers of subclinical atherosclerosis in obese children. Seventy consecutive obese children attending the Outpatient Weight Clinic of the Department of Pediatrics were invited to participate in an intensive dietary protocol. Twenty-six accepted and were randomly assigned to two different groups: the first group followed a hypocaloric low-glycemic index diet and the second a hypocaloric high-glycemic index diet. Anthropometric measures and biochemical tests were performed in all children. Quantitative B-mode ultrasound scans were used to measure intima-media thickness (IMT) and diameters of the common carotid artery. Considering both groups together, at 6 months, body mass index decreased from 28.3 +/- 3.1 to 25.8 +/- 3.3 kg/m(2), systolic blood pressure from 119 +/- 12 to 110 +/- 11 mmHg (Pglycemic index diet. These results justify the advice to obese children to follow a low-glycemic index diet in order to improve their cardiometabolic profile.

  8. Measurement of thyrotropin in clinical and subclinical hyperthyroidism using a new chemiluminescent assay.

    Science.gov (United States)

    Ross, D S; Ardisson, L J; Meskell, M J

    1989-09-01

    A new commercially available chemiluminescent TSH assay demonstrates an 8- to 10-fold increase in sensitivity over a sensitive immunoradiometric assay, allowing increased ability to distinguish partial from more complete thyrotroph suppression. Sera were analyzed from 145 patients who had TSH concentrations below 0.08 mU/L in the immunoradiometric assay. Most patients with overt hyperthyroidism had undetectable TSH concentrations in the chemiluminescent assay. Three groups of patients were identified, in which a large subgroup had undetectable values in the immunoradiometric assay and detectable values in the chemiluminescent assay (12 of 17 patients under treatment for hyperthyroidism who had recently normalized their serum thyroid hormone levels, 33 of 68 patients taking L-T4, and 4 of 8 patients with endogenous subclinical hyperthyroidism). In addition, several patients with undetectable basal and detectable TRH-stimulated TSH values in the immunoradiometric assay had detectable basal TSH values in the chemiluminescent assay. The utility of first generation TSH immunometric assays was their ability to distinguish hyperthyroidism from euthyroidism. The clinical utility of increasingly sensitive TSH assays will be to distinguish degrees of thyrotroph suppression in subclinical hyperthyroidism.

  9. LGI1-antibody encephalitis is characterised by frequent, multifocal clinical and subclinical seizures.

    Science.gov (United States)

    Aurangzeb, Sidra; Symmonds, Mkael; Knight, Ravi K; Kennett, Robin; Wehner, Tim; Irani, Sarosh R

    2017-08-01

    To describe clinical and electrographic characteristics of seizures LGI1-antibody encephalitis, and their correlations with two-year outcomes. Video-electroencephalography recordings were performed on a cohort of 16 consecutive patients with LGI1-antibodies from two UK neuroscience-centers over five-years. From 14 of 16 patients (13 males; age-range 53-92years), 86 faciobrachial dystonic seizures were recorded at a median frequency of 0.4 per hour (range 0.1-9.8), and ictal EEG changes accompanied 5/86 events. In addition, 11/16 patients showed 53 other seizures - subclinical (n=18), motor (n=16), or sensory (n=19) - at a median of 0.1 per hour (range 0.1-2) associated with temporal and frontal discharges. The sensory events were most commonly thermal sensations or body-shuddering, and the motor events were frequently automatisms or vocalisations. Furthermore, multifocal interictal epileptiform discharges, from temporal, frontal and parietal regions, and interictal slow-wave activity were observed in 25% and 69% of patients, respectively. Higher observed seizure frequency correlated with poorer functional recovery at two-years (p=0.001). Multiple frequent seizure semiologies, in addition to numerous subclinical seizures and interictal epileptiform discharges, are hallmarks of LGI1-antibody encephalitis. High overall seizure frequency may predict more limited long-term recovery. These observations should encourage closer monitoring and proactive treatment of seizure activity in these patients. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Outbreak of subclinical mastitis in a flock of dairy sheep associated with Burkholderia cepacia complex infection.

    Science.gov (United States)

    Berriatua, E; Ziluaga, I; Miguel-Virto, C; Uribarren, P; Juste, R; Laevens, S; Vandamme, P; Govan, J R

    2001-03-01

    An outbreak of subclinical mastitis in a flock of 620 milking sheep was investigated. Microbiological and epidemiological analyses identified the causative agent as belonging to the Burkholderia cepacia complex (formerly Pseudomonas cepacia). Every ewe in the milking flock was individually tested for subclinical mastitis on two separate occasions, 6 weeks apart, by the California (rapid) mastitis test (CMT). The proportion of CMT-positive ewes was 69 of 393 (17.6%) on the first sampling and 27 of 490 (5.5%) on the second sampling. Pure B. cepacia cultures identified with the API 20 NE system were grown from 64 of 96 (66.7%) CMT-positive ewes and from 1 of 33 (3.0%) CMT-negative ewes. Statistical analysis confirmed the significant association between a positive CMT result and a positive culture result for B. cepacia complex. Additional polyphasic taxonomic analyses of eight isolates showed that seven belonged to B. cepacia genomovar III; the remaining isolate was identified as Burkholderia vietnamiensis (formerly B. cepacia genomovar V). Bacteriological investigation of samples from milking equipment and other environmental sites failed to identify "B. cepacia" in any of the samples taken. To our knowledge, this is the first report of an outbreak of natural infection in animals caused by B. cepacia complex and the first description of B. cepacia complex infection in sheep.

  11. Fibrinogen and ceruloplasmin in plasma and milk from dairy cows with subclinical and clinical mastitis.

    Science.gov (United States)

    Tabrizi, A Davasaz; Batavani, R A; Rezaei, S Asri; Ahmadi, M

    2008-02-15

    The potential using of Acute Phase Proteins (APPs) in the assessment of mammary gland health was studied by examining the levels of Fibrinogen (Fb) and Ceruloplasmin (Cp) in plasma and milk from dairy cows with different grades of mastitis. Plasma samples were taken from jugular vein and milk samples were collected from quarters of cows with subclinical and clinical mastitis, as well as healthy controls. California Mastitis Test (CMT) were performed on each udder quarter of cows for detection of CMT2+ and CMT3+ quarters. CMT (0) and culture negative cases were considered healthy cows. Clinical mastitis, was graded as mild (clots in milk) or moderate (clots in milk and visible signs of inflammation in the mammary gland/s). The concentrations of Fb in the plasma of the cows with subclinical and clinical mastitis were higher than in the plasma of the healthy cows (p0.05), but differences between clinical and healthy groups were significant (pmastitis were higher than in the milk of the healthy cows (pmastitis in dairy cows.

  12. Study on Correlation of Maedi-Visna Virus (MVV) with Ovine Subclinical Mastitis in Iran.

    Science.gov (United States)

    Asadpour, R; Paktinat, S; Ghassemi, F; Jafari, R

    2014-06-01

    Maedi-Visna is an important slow viral disease of sheep leading to progressive pneumonia, encephalitis and mastitis. Udder is one of the organs affected by MVV. Despite the fact that in Iran Maedi-Visna is known since 2000, to the authors' knowledge correlation of subclinical mastitis and infection with MVV has not been assayed. In this study 50 milk samples from 10 flocks in East Azerbaijan Province of Iran were tested. None of the animals exhibited any clinical signs of the disease. Forty samples were collected from CMT positive ewes and ten were taken from CMT negative ewes. Milk samples were analyzed using PCR targeting gag sequence. Presence of provirus DNA was detected in one sample from CMT negative and seven samples from CMT positive ewes. These data demonstrate that 16.5 % of sheep with subclinical mastitis were infected to MVV. Thus this virus can be considered one of the main pathogenic agents of mastitis and can be dramatically transmitted to lambs by milk.

  13. Phenotypic and genotypic characterization of Staphylococcus aureus isolates in milk from flocks diagnosed with subclinical mastitis.

    Science.gov (United States)

    Xavier, A R E O; Almeida, A C; Souza, C N; Silva, L M V; Ruas, A X A; Sanglard, D A; Júnior, A F M; Oliveira, A M E; Xavier, M A S

    2017-06-29

    The Staphylococcus aureus is the most common isolated microorganism in ruminant animal species diagnostic with clinical or subclinical mastitis. Dairy herds with these diseases can transfer S. aureus into the milk supply, which can lead to food poisoning in humans. The objective of this study was to evaluate the profile of antimicrobial susceptibility, the presence of femA gene, the genetic relationships among isolates of S. aureus obtained from milk originating from flocks diagnosed with subclinical mastitis in nine rural properties in the northern of Minas Gerais State. To this end, 498 samples of bovine milk tested positive for the California mastitis test (CMT) were subjected to morphological methods and biochemical patterns for microbiological presumptive identification of S. aureus. The PCR test with the genetic marker femA was used to confirm the species S. aureus. All the 26 isolates presumptively identified as S. aureus amplified a fragment of 132 bp corresponding to the femA gene. The profile of antimicrobial susceptibility was performed according to the disk-diffusion methodology and two isolates were susceptible to all the antibiotics tested. The drug multiresistence was found in 80.76% of the isolates. The determination of the genetic profile and the clonal relationship among the isolates was performed by the method of DNA RAPD-PCR polymorphism. The S. aureus isolates were divided into two groups with 26 distinct subgroups. The analysis of RAPD-PCR showed no genetic diversity among them, heterogeneous profile and absence of clonality.

  14. Platelet function and activation in Cavalier King Charles Spaniels with subclinical chronic valvular heart disease.

    Science.gov (United States)

    Tong, Linda J; Hosgood, Giselle L; French, Anne T; Irwin, Peter J; Shiel, Robert E

    2016-08-01

    OBJECTIVE To assess platelet closure time (CT), mean platelet component (MPC) concentration, and platelet component distribution width (PCDW) in dogs with subclinical chronic valvular heart disease. ANIMALS 89 Cavalier King Charles Spaniels (CKCSs) and 39 control dogs (not CKCSs). PROCEDURES Platelet count, MPC concentration, PCDW, and Hct were measured by use of a hematology analyzer, and CT was measured by use of a platelet function analyzer. Murmur grade and echocardiographic variables (mitral valve regurgitant jet size relative to left atrial area, left atrial-to-aortic diameter ratio, and left ventricular internal dimensions) were recorded. Associations between explanatory variables (sex, age, murmur grade, echocardiographic variables, platelet count, and Hct) and outcomes (CT, MPC concentration, and PCDW) were examined by use of multivariate regression models. RESULTS A model with 5 variables best explained variation in CT (R(2), 0.74), with > 60% of the variance of CT explained by mitral valve regurgitant jet size. The model of best fit to explain variation in MPC concentration included only platelet count (R(2), 0.24). The model of best fit to explain variation in PCDW included platelet count and sex (R(2), 0.25). CONCLUSIONS AND CLINICAL RELEVANCE In this study, a significant effect of mitral valve regurgitant jet size on CT was consistent with platelet dysfunction. However, platelet activation, as assessed on the basis of the MPC concentration and PCDW, was not a feature of subclinical chronic valvular heart disease in CKCSs.

  15. [Subclinical and manifested hypothyroidism as a consequence of thyroid autoimmune disease].

    Science.gov (United States)

    Milosević, Dragoslav P; Djurica, Snezana; Davidović, Mladen; Stević, Radmila; Rajić, Miodrag; Marković, Natasa

    2005-10-01

    Chronic thyroiditis (Hashimoto's disease) is a slowly developing persistent inflamation of the thyroid gland, which frequently leads to hypothyroidism. Some of the up-to-date knowledge about hypothyroidism, both subclinical and manifested, caused by autoimmune disease, was presented. Autoimmune thyroid gland disease can occur at any age, but predominantly affects women after periods of high emotional and physical stress or accidents, as well as during periods of hormonal changes. It can also develop in families, and having an autoimmune disease slightly increases the risk of developing another. This paper showed an increasing incidence of subclinical hypothyroidism (4.17%) in elderly, and, at the same time, the incidence of primary hypothyroidism accounting for 1%. It is very usefull to estimate the stimulated thyrotropin (TSH) response, as well as the value of fast, short time thyroid gland reserves, analyzed by T3 and T4 serum level at 60th minute after TRH stimulation. Treatment of choice for HT (hypothyroidism of any cause) is thyroid hormone replacement. Drug of choice is orally administered levothyroxine sodium, usually for life-time. The standard dose is 1.6-1.8 mcg/kg body weight per day, but is in most cases patient dependent. Elderly patients usually require smaller replacement dose of levothyroxine, sometimes less than 1 mcg/kg body weight per day with coronary dilatator at the same time.

  16. Subclinical delusional thinking predicts lateral temporal cortex responses during social reflection

    Science.gov (United States)

    Brent, Benjamin K.; Coombs, Garth; Keshavan, Matcheri S.; Seidman, Larry J.; Moran, Joseph M.; Holt, Daphne J.

    2014-01-01

    Neuroimaging studies have demonstrated associations between delusions in psychotic disorders and abnormalities of brain areas involved in social cognition, including medial prefrontal cortex (MPFC), posterior cingulate cortex, and lateral temporal cortex (LTC). General population studies have linked subclinical delusional thinking to impaired social cognition, raising the question of whether a specific pattern of brain activity during social perception is associated with delusional beliefs. Here, we tested the hypothesis that subclinical delusional thinking is associated with changes in neural function, while subjects made judgments about themselves or others [‘social reflection’ (SR)]. Neural responses during SR and non-social tasks, as well as resting-state activity, were measured using functional magnetic resonance imaging in 22 healthy subjects. Delusional thinking was measured using the Peters et al. Delusions Inventory. Delusional thinking was negatively correlated with responses of the left LTC during SR (r = −0.61, P = 0.02, Bonferroni corrected), and connectivity between the left LTC and left ventral MPFC, and was positively correlated with connectivity between the left LTC and the right middle frontal and inferior temporal cortices. Thus, delusional thinking in the general population may be associated with reduced activity and aberrant functional connectivity of cortical areas involved in SR. PMID:23160817

  17. Diagnosis of subclinical mastitis in Santa Inês and Morada Nova sheep in southeastern Brazil.

    Science.gov (United States)

    Zafalon, Luiz Francisco; Santana, Raul Costa Mascarenhas; Pilon, Lucas Eduardo; Júnior, Guilherme Aparecido Fim

    2016-06-01

    The objective of this study was to evaluate different screening limits for the California mastitis test (CMT) and the somatic cell count (SCC) in previous diagnoses of subclinical mastitis in Santa Inês and Morada Nova ewes, which were reared under the same management conditions. Additionally, cutoff points were defined for SCC in accordance with the sensitivity and specificity of the test. A total of 907 mammary halves were subjected to CMT and SCC. The disease was confirmed by means of microbiological identification. Coagulase-negative staphylococci (CNS) were the microorganisms with highest occurrence. The CMT score of 1+ provided adequate sensitivity and specificity at all periods of lactation investigated. This score showed good agreement with SCC, >400,000 cells mL(-1). Higher cell counts favored higher diagnostic specificity. They can be used when producers have financial difficulties relating to treatment or culling of sheep with subclinical mastitis. However, producers should be warned about the risk of false-negative results in the flock.

  18. Antimicrobial activity of Algerian honey on subclinical mastitis pathogens isolated from goat's milk

    Directory of Open Access Journals (Sweden)

    A. Bourabah

    2014-04-01

    Full Text Available Aim: The aim of the present study was to determine the susceptibility of subclinical mastitis pathogens isolated from goat's milk and to evaluate the antimicrobial activity of Algerian honey on mastitis causing bacteria. Materials and Methods: The antibacterial activity against the isolated bacteria was evaluated by determining the Minimal Inhibitory Concentration (MIC, using the agar incorporation method. Results: The results showed that both Micrococcus spp. and Klebsiella spp. were susceptible to Streptomycin and tetracycline, while Pseudomonas aeruginosa, E coli, Enterobacter spp., Bacillus spp., and Coagulase Negative Staphyloccoci (CNS were preferentially susceptible to Streptomycin. However, Streptococcus D was the most resistant to the tested antibiotics whereas Staphylococcus aureus was the most susceptible to all the studied antibiotics. As regards to the antimicrobial activity of honey, the measured values were comprised between 11 and 14%. Conclusion: The results reveal that antimicrobial drugs susceptibility tests in goat subclinical mastitis might be necessary before the treatment. Algerian honey exhibited in vitro antimicrobial activity against different isolated bacteria in goat mastitis.

  19. Salivary cortisol and α-amylase: subclinical indicators of stress as cardiometabolic risk

    Science.gov (United States)

    Cozma, S.; Dima-Cozma, L.C.; Ghiciuc, C.M.; Pasquali, V.; Saponaro, A.; Patacchioli, F.R.

    2017-01-01

    Currently, the potential for cardiovascular (CV) stress-induced risk is primarily based on the theoretical (obvious) side effects of stress on the CV system. Salivary cortisol and α-amylase, produced respectively by the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic-adrenomedullary (SAM) system during stress response, are still not included in the routine evaluation of CV risk and require additional and definitive validation. Therefore, this article overviews studies published between 2010 and 2015, in which salivary cortisol and α-amylase were measured as stress biomarkers to examine their associations with CV/CMR (cardiometabolic risk) clinical and subclinical indicators. A comprehensive search of PubMed, Web of Science and Scopus electronic databases was performed, and 54 key articles related to the use of salivary cortisol and α-amylase as subclinical indicators of stress and CV/CMR factors, including studies that emphasized methodological biases that could influence the accuracy of study outcomes, were ultimately identified. Overall, the biological impact of stress measured by salivary cortisol and α-amylase was associated with CV/CMR factors. Results supported the use of salivary cortisol and α-amylase as potential diagnostic tools for detecting stress-induced cardiac diseases and especially to describe the mechanisms by which stress potentially contributes to the pathogenesis and outcomes of CV diseases. PMID:28177057

  20. Subclinical delusional thinking predicts lateral temporal cortex responses during social reflection.

    Science.gov (United States)

    Brent, Benjamin K; Coombs, Garth; Keshavan, Matcheri S; Seidman, Larry J; Moran, Joseph M; Holt, Daphne J

    2014-03-01

    Neuroimaging studies have demonstrated associations between delusions in psychotic disorders and abnormalities of brain areas involved in social cognition, including medial prefrontal cortex (MPFC), posterior cingulate cortex, and lateral temporal cortex (LTC). General population studies have linked subclinical delusional thinking to impaired social cognition, raising the question of whether a specific pattern of brain activity during social perception is associated with delusional beliefs. Here, we tested the hypothesis that subclinical delusional thinking is associated with changes in neural function, while subjects made judgments about themselves or others ['social reflection' (SR)]. Neural responses during SR and non-social tasks, as well as resting-state activity, were measured using functional magnetic resonance imaging in 22 healthy subjects. Delusional thinking was measured using the Peters et al. Delusions Inventory. Delusional thinking was negatively correlated with responses of the left LTC during SR (r = -0.61, P = 0.02, Bonferroni corrected), and connectivity between the left LTC and left ventral MPFC, and was positively correlated with connectivity between the left LTC and the right middle frontal and inferior temporal cortices. Thus, delusional thinking in the general population may be associated with reduced activity and aberrant functional connectivity of cortical areas involved in SR.

  1. High prevalence of subclinical hypothyroidism in pregnant women in South India

    Directory of Open Access Journals (Sweden)

    Nabhi VR. Murty

    2015-04-01

    Full Text Available Background: Thyroid dysfunction is one of the commonest endocrinopathies seen in pregnancy and affects both maternal and fetal outcomes. There is little data available on its prevalence in Indian pregnant women. This study was conducted at Bhaskar medical college and hospital situated in a rural/suburban area near Hyderabad, Telengana, India. The aim of the study was to find out the prevalence of thyroid disease among pregnant women. Methods: All consecutive pregnant women registered from January 2014 to December 2014 were included in the study. Morning samples of serum were tested for T3, T4 and TSH. Results: A total of 1340 women were included in the study. 260 pregnant women (19.41% had TSH values more than 3.0 mIU/L, the cut-off value used for upper limit of normal in this study. Out of these, 216 had normal T4 value, hence labeled as subclinical hypothyroidism and 44 had low T4, hence termed overt hypothyroidism. Three pregnant women had overt hyperthyroidism and 11 had subclinical hyperthyroidism. Nine women had low T4 values-Isolated hypothyroidism. Conclusions: Prevalence of thyroid disease in pregnancy was found to be higher in our patients, more so the sub clinical hypothyroidism. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 453-456

  2. Effect of medicated urea molasses blocks on sub-clinical parasitic infestations in goats.

    Directory of Open Access Journals (Sweden)

    Abid R

    2016-02-01

    Full Text Available The aim of this study was to evaluate the effect of medicated urea molasses blocks (MUMB on sub-clinical parasitic infestations and urea molasses blocks (UMB to replenish nutrients scarcity. Twenty four goats were divided randomly into three groups of eight animals each (n=8 according to Completely Randomized Design (CRD a group was no supplement (control and the other were supplemented with UMB and MUMB for 90 days. Data were recorded and statistically analyzed under CRD through one way analysis of variance (ANOVA. Mean daily dry matter intake was higher (1.502 ± 0.121 kg in MUMB supplemented group and lowest in control group (Lenovo. Mean daily weight gain of goats in control, UMB, MUMB was 64 ± 23, 71 ± 22 and 85 ± 21 grams, respectively. Body condition score (BCS was recorded in 1-5 scale of meat goats. The mean BCS in control, UMB and MUMB was 2.741 ± 0.193b, 2.816 ± 0.185ab and 2.903 ± 0.248a respectively. Mean fecal egg count was lowest in MUMB as followed by UMB and control group. It is concluded that feeding of MUMB have significant effects for the control of sub-clinical gastrointestinal worm’s infestation and replenishes nutrients deficiency by providing energy and protein.

  3. Nonspecific Erysipelothrix rhusiopathiae Bacteremia in a Patient with Subclinical Alcoholic Liver Disease

    Directory of Open Access Journals (Sweden)

    Asim Ahmed Kichloo

    2013-01-01

    Full Text Available Erysipelothrix rhusiopathiae, a pleomorphic gram-positive bacillus, is found widely in nature or as a commensal pathogen. It infects domestic animals such as swine, which may be the major reservoir of the organism. E. rhusiopathiae is primarily an occupational illness; 89% of the cases are linked to high-risk epidemiological situations. Humans that are infected by this bacillus typically present with one or a combination of the following symptoms: localized skin lesion (erysipeloid, diffuse cutaneous eruptions with systemic symptoms, or bacteremia, which is often followed by endocarditis. We report a case of E. rhusiopathiae bacteremia that was present without severe clinical illness such as endocarditis, arthritis, or skin lesions. The patient was a 64-year-old male with a complicated past medical history including subclinical alcoholic liver disease. Penicillin-G therapy completely resolved the patients bacteremia. The case presented has exceptional clinical merit due to 2 key factors: the patient does not fit the occupational demographic typically affected by this bacterium, and the patient presented with subclinical septicemia, which has a high correlation with fatal endocarditis. This case brings a new prospective to E. rhusiopathiae bacteremia.

  4. Clinicopatho-Biochemical Alterations Associated with Subclinical Babesiosis in Dairy Animals

    Directory of Open Access Journals (Sweden)

    Amrita Sharma

    2016-01-01

    Full Text Available Background: Present investigation is based on the clinicopatho-biochemical alteration related to natural tick borne bovine babesiosis in Punjab state.Methods: Blood samples from jugular vein of 542 bovines (cattle 466 and buffaloes 76 having history of tick in­festation, fever, hemoglobinurea or anemia were collected and tested for Babesia bigemina by blood smear examina­tion and PCR targeting 18S rRNA gene to distinguish clinically and subclinically infected groups. Further the hemato-biochemical parameters were correlated with the status of infection.Results: Overall, of the 542 samples tested 16.42 % were positive by PCR while only 1.66 % by blood smear exami­nation. The trend of molecular prevalence was found to decrease from north-eastern towards western Punjab. Analy­sis of the hematobiochemical alterations showed significant decrease in the levels of RBC, Hb, PCV, and MCV with significant increase in TBIL, MCH and MCHC levels.Conclusion: As the transmission of B. bigemina is transovarian, presence of even few infected Rhipicephalus (Booph­ilus microplus ticks on a subclinically infection can be the nidus of infection for whole herd, causing severe economic losses, at the same time significantly affecting the physiology of carrier animal.

  5. Immunohistochemical analysis of laryngeal muscles in normal horses and horses with subclinical recurrent laryngeal neuropathy.

    Science.gov (United States)

    Rhee, Hannah S; Steel, Catherine M; Derksen, Frederik J; Robinson, N Edward; Hoh, Joseph F Y

    2009-08-01

    We used immunohistochemistry to examine myosin heavy-chain (MyHC)-based fiber-type profiles of the right and left cricoarytenoideus dorsalis (CAD) and arytenoideus transversus (TrA) muscles of six horses without laryngoscopic evidence of recurrent laryngeal neuropathy (RLN). Results showed that CAD and TrA muscles have the same slow, 2a, and 2x fibers as equine limb muscles, but not the faster contracting fibers expressing extraocular and 2B MyHCs found in laryngeal muscles of small mammals. Muscles from three horses showed fiber-type grouping bilaterally in the TrA muscles, but only in the left CAD. Fiber-type grouping suggests that denervation and reinnervation of fibers had occurred, and that these horses had subclinical RLN. There was a virtual elimination of 2x fibers in these muscles, accompanied by a significant increase in the percentage of 2a and slow fibers, and hypertrophy of these fiber types. The results suggest that multiple pathophysiological mechanisms are at work in early RLN, including selective denervation and reinnervation of 2x muscle fibers, corruption of neural impulse traffic that regulates 2x and slow muscle fiber types, and compensatory hypertrophy of remaining fibers. We conclude that horses afflicted with mild RLN are able to remain subclinical by compensatory hypertrophy of surviving muscle fibers.

  6. Treatment trial of subclinical mastitis with the herb Persicaria senegalense (Polygonaceae).

    Science.gov (United States)

    Abaineh, D; Sintayehu, A

    2001-12-01

    The possible remedial effect of Persicaria senegalense in bovine subclinical mastitis was studied by in vitro and in vivo antimicrobial tests, using crude extracts and the leaf in different forms. The in vitro test showed that isolates of Staphylococcus aureus, Candida albicans and Corynebacterium bovis from subclinical cases and an isolate of Pseudomonas aeruginosa from a clinical case of mastitis were all inhibited by the three crude extracts at 820 micrograms concentration. An in vivo trial feeding 1.5 kg of the cooked leaf per day for 5 days did not give a significant cure rate, whereas a second trial in which 0.77 kg of leaf powder, equivalent to 3 kg of wet leaf, was fed per day for 5 days resulted in an apparent cure rate of 92.8% (52.8% actual as there was a 40% spontaneous cure rate in the negative control group, in contrast to 80% (40% actual) in the positive control group treated with an intramammary antibiotic preparation. The difference in cure rate between the negative control group and the experimental group given 0.77 kg leaf powder was significant (p = 0.008).

  7. Significance of microalbuminuria in relation to subclinical coronary atherosclerosis in asymptomatic nonhypertensive, nondiabetic subjects.

    Science.gov (United States)

    Park, Hyo Eun; Heo, Nam Ju; Kim, Minkyung; Choi, Su-Yeon

    2013-03-01

    We aimed to investigate the significance of microalbuminuria and its relationship with subclinical atherosclerosis in nonhypertensive and nondiabetic patients, by using coronary artery computed tomography (CT). A total of 1,318 nonhypertensive and nondiabetic subjects who had taken coronary artery CT and measured spot urine albumin to creatinine ratio (UACR) were evaluated. The atherosclerotic changes of coronary arteries were greater in subjects with microalbuminuria, reflected by coronary artery calcium score (CACS) and significant coronary artery stenosis (CACS ≥ 100 in 15.3% vs 7.6% and stenosis ≥ 50% in 11.5% vs 4.9% of patients with vs without microalbuminuria, P = 0.008 and P = 0.011, respectively). Among various parameters that are known as a risk factor or possible biomarkers of coronary artery disease, presence of microalbuminuria, age and Framingham risk score were significantly related to coronary artery stenosis. Among them the presence of microalbuminuria showed stronger correlation than others to the coronary artery stenosis detected by CT, even after adjusting confounding factors (OR 3.397, 95% confidence interval 1.138 to 10.140, P = 0.028). The presence of microalbuminuria by UACR was significantly associated with presence of coronary artery stenosis ≥ 50% in asymptomatic, nonhypertensive and nondiabetic general population. Our study suggests that the presence of microalbuminuria may imply subclinical coronary artery disease, even in asymptomatic population.

  8. Subclinical cardiovascular system changes in obese patients with juvenile idiopathic arthritis.

    Science.gov (United States)

    Głowińska-Olszewska, Barbara; Bossowski, Artur; Dobreńko, Elżbieta; Hryniewicz, Andrzej; Konstantynowicz, Jerzy; Milewski, Robert; Łuczyński, Włodzimierz; Piotrowska-Jastrzębska, Janina; Kowal-Bielecka, Otylia

    2013-01-01

    We aimed to determine the prevalence of excess body mass in juvenile idiopathic arthritis (JIA) children and to investigate the influence of obesity into the early, subclinical changes in cardiovascular system in these patients. Fifty-eight JIA patients, aged median 13 years, were compared to 36 healthy controls. Traditional cardiovascular risk factors and inflammatory markers (hsCRP, IL-6, TNF α, adiponectin) were studied together with IMT (intima-media thickness), FMD (flow mediated dilation), and LVMi (left ventricle mass index) as surrogate markers of subclinical atherosclerosis. Thirteen JIA children (22%) were obese and had increased systolic blood pressure, cholesterol, triglycerides, insulin, HOMA, hsCRP, and IL-6 compared to nonobese JIA and controls. FMD was decreased compared to nonobese JIA and controls, whereas IMT and LVMi were increased. In multivariate regression analysis, TNF α, SDS-BMI, and systolic blood pressure were independent predictors of early CV changes in JIA. Coincident obesity is common in JIA children and is associated with insulin resistance, dyslipidemia, and increased levels of inflammatory markers leading to early changes in cardiovascular system. Thus, medical care of children with JIA should include strategies preventing cardiovascular disease by maintenance of adequate body weight.

  9. Visualization and Treatment of Subclinical Actinic Keratoses with Topical Imiquimod 5% Cream: An Observational Study

    Directory of Open Access Journals (Sweden)

    Daisy Kopera

    2014-01-01

    Full Text Available Background. Imiquimod 5% is licensed for the treatment of external genital warts, superficial basal cell carcinoma, and actinic keratosis (AK and is being used experimentally in various other dermato-oncological conditions. Objective. This observational study shall show that nonmelanoma skin cancer can be detected at its earliest subclinical stage by its reaction with imiquimod and can be cleared by finishing the course of treatment. Material and Methods. In this single arm trial 15 patients with chronically sun-exposed skin who had no clinical evidence of AK were treated with 5% imiquimod cream on the face or scalp for 4 weeks three times per week. Results. During treatment, all patients developed multiple areas with mild to moderate inflammatory skin reactions, such as erythema, induration, and scaling. Biopsies obtained from 12 patients prior to treatment revealed no malignancies. However, in cases with more pronounced inflammation during treatment, targeted biopsies indicated very early malignant alterations. Conclusion. Topical imiquimod treatment of chronically sun-exposed skin without overt clinical signs of AK is able to detect subclinical actinic keratoses (SAK and to completely clear the lesions, even before they can be clinically diagnosed as AK. In such patients, imiquimod might be able to prevent the evolution of SCC.

  10. Sympathetic nervous system activity is associated with obesity-induced subclinical organ damage in young adults.

    Science.gov (United States)

    Lambert, Elisabeth; Sari, Carolina Ika; Dawood, Tye; Nguyen, Julie; McGrane, Mariee; Eikelis, Nina; Chopra, Reena; Wong, Chiew; Chatzivlastou, Kanella; Head, Geoff; Straznicky, Nora; Esler, Murray; Schlaich, Markus; Lambert, Gavin

    2010-09-01

    Excess weight is established as a major risk factor for cardiovascular diseases, particularly in young individuals. To get a better understanding of the pathophysiology underlying increased cardiovascular disease risk, we evaluated early signs of organ damage and their possible relationship to sympathetic nervous activity. Eighteen lean (body mass index obese (body mass index >25 kg/m(2)) healthy university students were included in the study. We comprehensively assessed subclinical target organ damage, including the following: (1) assessment of renal function; (2) left ventricular structure and systolic and diastolic function; and (3) endothelial function. Muscle sympathetic nervous activity was assessed by microneurography. Participants with excess weight had decreased endothelial function (Pnervous activity (Pnervous activity (R(2)=0.244; Pnervous activity, after adjustment for body mass index, sex, and blood pressure (R(2)=0.318, P<0.01 and R(2)=0.312, P<0.05, respectively). Excess weight in young individuals is associated with subclinical alterations in renal and endothelial function, as well as in the structure of the heart, even in the absence of hypertension. Sympathetic activity is closely associated with cardiovascular and renal alterations observed in these subjects.

  11. Neuroendocrine axis of stress, metabolic syndrome and psychiatric disorders in cushing's sindrome Ejes neuroendocrinos del estrés, síndrome metabólico y alteraciones psiquiátricas del síndrome de Cushing

    OpenAIRE

    Leidy Alexandra Lezcano Tobón; Luisa Fernanda Mesa Franco; Juliana Gómez Franco; Federico Uribe Londoño

    2005-01-01

    The role of abnormalities of the hypophysishypothalamus- adrenal gland axis (HHA) in the ongoing stress and depression is analyzed. Besides, it is evidenced that some problems, until recently considered merely endocrine-metabolic such as Cushing's syndrome (either clinical or subclinical) and obesity (mainly when it is part of the metabolic syndrome) may have a common etiological basis, be it a primary event, a comorbidity or a trigger in individuals with genetic susceptibility to states of m...

  12. Epidemiological Studies on Subclinical Mastitis in Dairy cows in Assiut Governorate

    Directory of Open Access Journals (Sweden)

    Ahmed Abdel-Rady

    Full Text Available In this investigation, some epidemiological studies were run on subclinical mastitis for totally 350 dairy cows of different breeds, ages and distributed in different villages in Assiut governorate, Assiut, Egypt, along a whole year (during the period from June 2006 till July 2007 through field screening surveys by using of the California mastitis test (CMT for each quarter milk sample followed by bacteriological examination to identify the major causative agents of intramammary infection (IMI. The dairy cows were differed from the breed point of view as 230 Holstein Friesian breed and 120 native breed. Also, they were differed from the age point of view as a group of 95 cows aged from 2 to 4 years old and another group of 255 cow aged from 5 to 8 years old. All dairy cows were apparently healthy with clinically sound udder secreting apparently normal milk. All the cows lived nearly under the same conditions of breeding from the habitat, hygiene and feeding systems. The obtained results revealed that 67 cows (19.14% had 80 infected quarters (5.71%. It was found that the most frequently major causative agents isolated were Staphylococcus aureus, Streptococcus agalactiae and Escherichia coli from the positive CMT samples with prevalence 52.5, 31.25 and 16.25%, respectively. With studying the breed factor, it was found Friesian breed was sensitive towards infection (20.43% at the cow level and 6.09% at the quarter level than of native breed (16.67% at the cow level and 5% at the quarter level. It was also noticed that the prevalence of subclinical mastitis in hot weather as during summer (9.14% at the cow level and 2.64% at the quarter level and during spring (4.86% at the cow level and 1.36% at the quarter level was higher than in cold weather as during winter (2% at the cow level and 0.64% at the quarter level and during autumn (3.14% at the cow level and 1.07% at the quarter level. In relation to age susceptibility, 5-8 years old cows (15.43% at

  13. Subclinical mastitis as a risk factor for mother-infant HIV transmission.

    Science.gov (United States)

    Willumsen, J F; Filteau, S M; Coutsoudis, A; Uebel, K E; Newell, M L; Tomkins, A M

    2000-01-01

    Subclinical mastitis, as diagnosed by an elevated sodium/potassium ratio in milk accompanied by an increased milk concentration of the inflammatory cytokine, interleukin-8 (IL8), was found to be common among breast feeding women in Bangladesh and Tanzania. Subclinical mastitis results in leakage of plasma constituents into milk, active recruitment of leukocytes into milk, and possible infant gut damage from inflammatory cytokines. Therefore, we wished to investigate whether subclinical mastitis was related to known risk factors for postnatal mother-to-child HIV transmission, that is, high milk viral load or increased infant gut permeability. HIV-infected South African women were recruited at the antenatal clinic of McCord's Hospital, Durban. Risks and benefits of different feeding strategies were explained to them and, if they chose to breast feed, they were encouraged to do so exclusively. Women and infants returned to the clinic at 1, 6 and 14 weeks postpartum for an interview about infant health and current feeding pattern, a lactulose/mannitol test of infant gut permeability, and milk sample collection from each breast separately for analysis of Na/K ratio, IL8 concentration and viral load in the cell-free aqueous phase. Only preliminary cross-sectional analyses from an incomplete database are available at this point. Moderately (0.6-1.0) or greatly (>1.0) raised Na/K ratio was common and was often unilateral, although as a group right and left breasts did not differ. Considering both breasts together, normal, moderately raised or greatly raised Na/K was found, respectively, in 51%, 28%, 21% of milk samples at 1 week (n=190); 69%, 20%, 11% at 6 weeks (n=167); and 72%, 16%, 12% at 14 weeks (n=122). IL8 concentration significantly correlated with both Na/K and viral load at all times. Na/K correlated with viral load at 1 and 14, but not 6 weeks. At 1 and 14 weeks, geometric mean viral loads in samples with Na/K > 1.0 were approximately 4 times those in samples

  14. Sodium and water disturbances in patients with Sheehan's syndrome.

    Science.gov (United States)

    Pham, P C; Pham, P A; Pham, P T

    2001-09-01

    Sheehan's syndrome has been attributed to ischemic damage of the pituitary gland or hypothalamic-pituitary stalk during the peripartum period. Well-described clinical features of Sheehan's syndrome include hypothyroidism, adrenal insufficiency, hypogonadism, growth hormone deficiency, hypoprolactinemia, and different sodium and water disturbances. The occurrence of sodium and water disturbances associated with Sheehan's syndrome depends on the degree of pituitary damage, time of onset since the initial pituitary insult, and concurrent medical conditions that also may play a role in sodium and water balance. We present a patient with Sheehan's syndrome with severe chronic hyponatremia; discuss a potential problem in the patient's management; and review the literature for various sodium and water disturbances, including acute and chronic hyponatremia as well as overt and subclinical central diabetes insipidus. Although Sheehan's syndrome is more prevalent in developing countries, the increasingly large immigrant population within the United States warrants better awareness of this syndrome and its potential complicating sodium and water disturbances. Prompt diagnosis and an understanding of the pathogenic mechanisms of sodium and water disturbances associated with Sheehan's syndrome may avoid potential treatment-related complications.

  15. Subclinical phaeochromocytoma.

    NARCIS (Netherlands)

    Mannelli, M.; Lenders, J.W.M.; Pacak, K.; Parenti, G.; Eisenhofer, G.

    2012-01-01

    Phaeochromocytomas and paragangliomas are neural crest-derived tumours. Autopsy studies indicate that relatively large numbers of these tumours remain undiagnosed during life. This may reflect non-specific signs and symptoms and low medical alertness in evaluating the clinical picture or it may refl

  16. Subclinical ergotism

    DEFF Research Database (Denmark)

    Dige-Petersen, H; Lassen, N A; Noer, Ivan;

    1977-01-01

    The systolic blood-pressure at the ankle and the first toe was measured in 30 patients, mean age 42, who had taken ergotamine regularly for more than a year. With one exception, the patients had no symptoms or signs of arterial insufficiency in the limbs, but all had low-normal or abnormal foot s...

  17. Syndromic autism: II. Genetic syndromes associated with autism

    National Research Council Canada - National Science Library

    Artigas-Pallarés, J; Gabau-Vila, E; Guitart-Feliubadaló, M

    2005-01-01

    ..., tuberous sclerosis, Duchenne's disease, Timothy syndrome, 10p terminal deletion, Cowden syndrome, 45,X/46,XY mosaicism, Myhre syndrome, Sotos syndrome, Cohen syndrome, Goldenhar syndrome, Joubert...

  18. Edwards' syndrome.

    Science.gov (United States)

    Crawford, Doreen; Dearmun, Annette

    2016-12-08

    Edwards' syndrome is a serious genetic condition that affects fetal cellular functions, tissue development and organogenesis. Most infants with the syndrome are female, but there is no race predominance.

  19. Dravet Syndrome

    Science.gov (United States)

    ... Craniosynostosis Information Page Creutzfeldt-Jakob Disease Information Page Cushing's Syndrome Information Page Dandy-Walker Syndrome Information Page Deep Brain Stimulation for Parkinson's Disease Information Page Dementia Information ...

  20. Paraneoplastic Syndromes

    Science.gov (United States)

    ... dementia, seizures, sensory loss in the limbs, and vertigo or dizziness. Paraneoplastic syndromes include Lambert-Eaton myasthenic ... dementia, seizures, sensory loss in the limbs, and vertigo or dizziness. Paraneoplastic syndromes include Lambert-Eaton myasthenic ...

  1. Turner Syndrome

    Science.gov (United States)

    Turner syndrome is a genetic disorder that affects a girl's development. The cause is a missing or incomplete ... t work properly. Other physical features typical of Turner syndrome are Short, "webbed" neck with folds of skin ...

  2. Cushing's Syndrome

    Science.gov (United States)

    Cushing's syndrome is a hormonal disorder. The cause is long-term exposure to too much cortisol, a hormone ... cause your body to make too much cortisol. Cushing's syndrome is rare. Some symptoms are Upper body obesity ...

  3. Lynch Syndrome

    Science.gov (United States)

    ... colon cancer may include surgery, chemotherapy and radiation therapy. Cancer screening for people with Lynch syndrome If you ... et al. Milestones of Lynch syndrome: 1895-2015. Nature Reviews Cancer. http://www.nature.com/nrc/journal/vaop/ncurrent/ ...

  4. Metabolic Syndrome

    Science.gov (United States)

    Metabolic syndrome is a group of conditions that put you at risk for heart disease and diabetes. These ... doctors agree on the definition or cause of metabolic syndrome. The cause might be insulin resistance. Insulin is ...

  5. Meckel syndrome

    National Research Council Canada - National Science Library

    Salonen, R; Paavola, P

    1998-01-01

    Meckel syndrome (MKS) is a lethal syndrome with a central nervous system malformation, usually occipital meningoencephalocele, bilaterally large multicystic kidneys with fibrotic changes of the liver, and polydactyly in most cases...

  6. Angelman Syndrome

    Science.gov (United States)

    ... this syndrome often display hyperactivity, small head size, sleep disorders, and movement and balance disorders that can cause ... this syndrome often display hyperactivity, small head size, sleep disorders, and movement and balance disorders that can cause ...

  7. Apert Syndrome.

    Science.gov (United States)

    Datta, Saikat; Saha, Sandip; Kar, Arnab; Mondal, Souvonik; Basu, Syamantak

    2014-09-01

    Apert syndrome is one of the craniosynostosis syndromes which, due to its association with other skeletal anomalies, is also known as acrocephalosyndactyly. It is a rare congenital anomaly which stands out from other craniosynostosis due to its characteristic skeletal presentations.

  8. A Cross-Sectional Study of the Phenotypes of Obesity and Insulin Resistance in Adults with Down Syndrome

    OpenAIRE

    Diego Real de Asua; Pedro Parra; Ramón Costa; Fernando Moldenhauer; Carmen Suarez

    2014-01-01

    Background Despite the confluence of multiple cardiovascular risk factors, subclinical atherosclerotic damage and cardiovascular events remain extremely rare in adults with Down syndrome (DS). We aim to determine the prevalence of obesity and metabolic disorders in an adult cohort with DS and to compare our findings with adults without DS. Methods Cross-sectional study of 51 consecutively selected adults with DS living in the community and 51 healthy controls in an outpatient clinic of a tert...

  9. Learning about Down Syndrome

    Science.gov (United States)

    ... genetic terms used on this page Learning About Down Syndrome What is Down syndrome? What are the symptoms ... syndrome Additional Resources for Down Syndrome What is Down syndrome? Down syndrome is a chromosomal condition related to ...

  10. Velocardiofacial Syndrome

    Science.gov (United States)

    Gothelf, Doron; Frisch, Amos; Michaelovsky, Elena; Weizman, Abraham; Shprintzen, Robert J.

    2009-01-01

    Velocardiofacial syndrome (VCFS), also known as DiGeorge, conotruncal anomaly face, and Cayler syndromes, is caused by a microdeletion in the long arm of Chromosome 22. We review the history of the syndrome from the first clinical reports almost half a century ago to the current intriguing molecular findings associating genes from the…

  11. Fraser syndrome

    Directory of Open Access Journals (Sweden)

    Kalpana Kumari M

    2008-04-01

    Full Text Available Fraser syndrome or cryptophthalmos is a rare autosomal recessive disorder characterized by major features such as cryptophthalmos, syndactyly and abnormal genitalia. The diagnosis of this syndrome can be made on clinical examination and perinatal autopsy. We present the autopsy findings of a rare case of Fraser syndrome in a male infant.

  12. Rowell syndrome

    Directory of Open Access Journals (Sweden)

    Ramesh Y Bhat

    2014-01-01

    Full Text Available Rowell syndrome is a rare disease consisting of erythema multiforme-like lesions associated with lupus erythematosus. The syndrome occurs mostly in middle-aged women. The authors describe the syndrome in a 15-year-old boy who responded well to systemic steroids and hydroxychloroquine.

  13. Wallenberg's Syndrome

    Science.gov (United States)

    ... Information Page You are here Home » Disorders » All Disorders Wallenberg's Syndrome Information Page Wallenberg's Syndrome Information Page What ... better ways to prevent, treat, and ultimately cure disorders such as Wallenberg’s syndrome. Information from the National Library of Medicine’s ...

  14. Thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus: a case report

    Directory of Open Access Journals (Sweden)

    Kunii Yasuto

    2011-09-01

    Full Text Available Abstract Introduction Non-convulsive status epilepticus is a form of epileptic seizure that occurs without convulsions. Recent reviews suggest that the diagnosis of non-convulsive status epilepticus remains difficult. Here, we report the case of a patient with thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus. Case presentation Our patient was a 68-year-old Japanese woman. The results of endocrine testing after her first episode of non-convulsive status epilepticus suggested latent subclinical hypothyroidism: she had elevated thyroid-stimulating hormone with normal levels of free tri-iodothyronine and free thyroxine. On examination, a diagnosis of thyroid disorder was not supported by other test results and our patient remained untreated. A follow-up examination revealed that her thyroid-stimulating hormone levels had spontaneously normalized. When she consulted another doctor for confusion, the transient increase in thyroid-stimulating hormone levels following non-convulsive status epilepticus was mistaken for subclinical hypothyroidism, and unfortunately treated with levothyroxine. Our patient then experienced levothyroxine-induced non-convulsive status epilepticus. Conclusions In this report, we suggested possible mechanisms for latent hypothyroid-like hormone abnormality following epileptic seizures and the possibility of provoking epileptic seizures by administering levothyroxine for misdiagnosed subclinical hypothyroidism.

  15. Subclinical hypothyroidism and its relation to obesity in patients before and after Roux-en-Y gastric bypass

    NARCIS (Netherlands)

    Janssen, I.M.C.; Homan, J.; Schijns, W.; Betzel, B; Aarts, E.O.; Berends, F.J.; Boer, H

    2015-01-01

    BACKGROUND: Subclinical hypothyroidism (SH), defined as a raised serum thyroid-stimulating hormone (TSH) with a normal free thyroxine (FT4), is occasionally observed in morbidly obese patients. OBJECTIVES: It is currently not known whether thyroid hormone treatment is indicated. The aim of the prese

  16. Pattern of Altered Lipid Profile in Patients with Subclinical and Clinical Hypothyroidism and its Correlation with Body Mass Index.

    Science.gov (United States)

    Humerah, Sobia; Siddiqui, Arif; Khan, Humaira Fayyaz

    2016-06-01

    To compare the lipid profile of the subclinical and clinical hypothyroid patients and to evaluate the correlation between body mass index (BMI) and lipid profile in hypothyroidism. Cross-sectional study. Islamic International Medical College, Riphah International University, Islamabad, and Citi Laboratory, Rawalpindi, from January to December 2013. The subjects were selected through non-probability, purposive sampling. On the basis of thyroid profile, the subjects were divided into 3 groups: euthyroids (n=20), subclinical hypothyroids (n=50), and clinical hypothyroids (n=30). The blood of these subjects was then analyzed for lipid profile. Data was analyzed using SPSS version 18 statistical software. Both hypothyroid groups showed altered lipid profile which was observed to be significantly raised when compared with the euthyroid subjects. Comparison of lipid profile in euthyroid, subclinical, and clinical hypothyroid groups showed significant differences by non-parametric tests (p lipid profile with the BMI was found to be significant (p lipid profile. Clinical and subclinical hypothyroid patients have altered lipid profile as compared to euthyroids. Thyroid status monitoring is very important, since it can induce changes in lipid profile. Such dyslipidemic status is significant not only for the management of thyroid disorders but also for common diseases like obesity and coronary atherosclerosis in the population.

  17. The relation between bullying and subclinical psychotic experiences and the influence of the bully climate of school classes

    NARCIS (Netherlands)

    Horrevorts, Esther M. B.; Monshouwer, Karin; Wigman, Johanna T. W.; Vollebergh, Wilma A. M.

    2014-01-01

    This study aims to examine the association between the bully climate of school classes and the prevalence of subclinical psychotic experiences among students who are involved in bullying (either as bully or as victim). Data were derived from the Dutch health behavior in school-aged children survey o

  18. Human Lipoxygenase Pathway Gene Variation and Association with Markers of Subclinical Atherosclerosis in the Diabetes Heart Study

    Directory of Open Access Journals (Sweden)

    Kathryn P. Burdon

    2010-01-01

    Conclusions. Polymorphisms within ALOX12, ALOX5, and ALOX5AP are genetically associated with subclinical atherosclerosis and with biomarkers of disease in families with type 2 diabetes. These results suggest that variants in lipoxygenase pathway genes may have pleiotropic effects on multiple components that determine risk of cardiovascular disease.

  19. Long-Term Exposure to Ambient Air Pollution and Subclinical Cerebrovascular Disease in NOMAS (the Northern Manhattan Study).

    Science.gov (United States)

    Kulick, Erin R; Wellenius, Gregory A; Kaufman, Joel D; DeRosa, Janet T; Kinney, Patrick L; Cheung, Ying Kuen; Wright, Clinton B; Sacco, Ralph L; Elkind, Mitchell S

    2017-07-01

    Long-term exposure to ambient air pollution is associated with higher risk of cardiovascular disease and stroke. We hypothesized that long-term exposure to air pollution would be associated with magnetic resonance imaging markers of subclinical cerebrovascular disease. Participants were 1075 stroke-free individuals aged ≥50 years drawn from the magnetic resonance imaging subcohort of the Northern Manhattan Study who had lived at the same residence for at least 2 years before magnetic resonance imaging. Cross-sectional associations between ambient air pollution and subclinical cerebrovascular disease were analyzed. We found an association between distance to roadway, a proxy for residential exposure to traffic pollution, and white matter hyperintensity volume; however, after adjusting for risk factors, this relationship was no longer present. All other associations between pollutant measures and white matter hyperintensity volume were null. There was no clear association between exposure to air pollutants and subclinical brain infarcts or total cerebral brain volume. We found no evidence that long-term exposure to ambient air pollution is independently associated with subclinical cerebrovascular disease in an urban population-based cohort. © 2017 American Heart Association, Inc.

  20. Myocardial strain and strain rate in monitoring subclinical heart failure in asymptomatic long-term survivors of childhood cancer.

    NARCIS (Netherlands)

    Mavinkurve-Groothuis, A.M.C.; Groot-Loonen, J.J.; Marcus, K.A.; Bellersen, L.; Feuth, T.; Bokkerink, J.P.M.; Hoogerbrugge, P.M.; Korte, C.L. de; Kapusta, L.

    2010-01-01

    We studied the role of global myocardial strain and strain rate in monitoring subclinical heart failure in a large group of asymptomatic long-term survivors of childhood cancer. Global strain (rate) parameters of survivors were compared with those in healthy controls and were related to conventional