Pregnancy induces a series of physiological modifications that include a significant elevation of thyroxine-binding globulin (TBG) levels. This elevation interferes in the serum levels of total thyroxine and stresses the use of free thyroxine (FT4), together with TSH measurement, as the first line tests in the evaluation of thyroid function in pregnancy. A careful definition of the normal values for FT4 during pregnancy is paramount for the study of thyroid abnormalities, since minimal dysfunctions can result in significant fetal abnormalities. […]

Neoplastic transformation results from a series of genetic alterations involving activation of protooncogenes and inactivation of tumor suppressor genes. Activation of ras protooncogenes by point mutation is the most frequent genetic alteration in spontaneous thyroid neoplasias. The goal of this study was to evaluate ras gene expression in the nodular goiter. Seventy-nine patients submitted to thyroidectomy and with a histological diagnosis of nodular goiter were included in the study. Tissues were obtained from both tumor and normal thyroid during surgery […]

The acquisition of a new nomenclature and the development of molecular methods for the assignment of major histocompatibilty complex (MHC) alleles have widely contributed to the understanding of the extensive polymorphism of the system; however, many doubts have arisen to the non-specialist in terms of MHC and disease association. In order to understand the MHC polymorphism and the association with endocrine diseases as type 1 diabetes mellitus, Grave’s disease, Hashimoto’s thyroiditis, Addison’s disease, autoimmune polyglandular syndromes and premature ovarian failure, […]

Since the first publication, more than 40 years ago, laboratory tests for the presence of antibodies (Ab) to thyroid antigens (Ag) have played a pivotal position in the diagnosis of thyroid diseases. Thyroid is a common target for autoimmune diseases, hence the interest in the definition of the thyroid Ag that could be involved in the process. The first Ag to be recognized was thyroglobulin, followed by the “microsomal Ag”, later identified with thyroid peroxidase, the TSH receptor and, more […]

Parathyroid glands produce the parathyroid hormone (PTH) that acts on bone and kidneys controlling calcium and phosphorus serum concentration. It has long been known that PTH can act as an anabolic hormone if it is given by small and intermittent doses. Recently, there are data showing that PTH (1-34) increases bone mineral density, increases bone mass, improves trabecular connectivity, and reduces the risk of vertebral, non-vertebral and hip fractures in women with postmenopausal or corticoid-induced osteoporosis and in men with […]

Thyroid carcinoma is the most common endocrine malignancy. Approximately 90% of non-medullary thyroid malignancies are classified as well-differentiated thyroid carcinomas. Even though this type of tumor is not aggressive and usually curable after therapy, recurrence develops in 20-40% and progression to cellular de-differentiation occurs in up to 30% of patients. Poorly differentiated cancers are characterized by loss of thyroid-specific functions and properties, such as the capacity to concentrate radioiodide. Therapeutic options for de-differentiated thyroid cancer are limited and generally not […]

Although the presence of otologic symptoms associated with diabetes mellitus (DM) have been discussed for six decades, its etiology still remains obscure. Since the association between DM and hearing loss is still a matter of debate, the goal of this paper was to verify the prevalence of hearing loss in patients with DM. Therefore we studied the genesis of DM by a case-control protocol, where pure tone and impedance audiometry were employed. The hearing acuity in 97.2% of the patients […]

To evaluate the benefit of phytoestrogens (PhE) in hormone replacement therapy of menopause (HRTM), the Department of Female Endocrinology of the Brazilian Society of Endocrinology and Metabolism convened a group of specialists to perform a bibliographic review. Only articles that met strict scientific methodological criteria were included. PhE exhibit both estrogenic and antiestrogenic actions, mainly on estrogen (E) receptors b, with much less estrogenic potency than estradiol. PhE content of vegetal sources varies, depending on cultivation, harvesting, storage and industrialization. […]

Clinical guidelines for the management of gestational and pre-gestational diabetes were prepared by the Diabetes and Pregnancy Task Force, during the XI Brazilian Diabetes Congress, held in 1997. A new meeting was held in 2001 to revise recommendations for screening, diagnosis and management of gestational diabetes, based on the new evidences generated on these issues. Universal screening of pregnant women is advised beginning at the 20th week of gestation, using fasting plasma glucose. Cut points of 85mg/dl or 90mg/dl are […]

The search of the true knowledge (science) was always guided by the logic, which won powerful tools from the current biotechnology. With these new resources, nature is revealing its secret language (genetic code), its own vocabulary (gene sequences), and its characteristics from always apparent in its creatures (phenotypes). Having nature preserved in its patrimony living beings of different evolutionary periods, the investigators can compare the vestiges of substances (such as hormones), preserved in old and more recent species, and try […]

The evolution of the idea of the potential use of parathyroid hormone in the treatment of osteoporosis was a long one. It was also an example of how the concepts in medicine can take a long time to change, and the change is mainly dependant on the availability of adequate diagnostics resources. The acceptance that an hormone, that when present in excess leads to bone disease, can be a therapeutic agent that brings an increase in bone mass, is difficult. […]

The authors after presenting the magnitude of the problem of diabetes mellitus and diabetic nephropathy in Brazil and in the world made a review upon the point of view of the nephrologist about pancreas and pancreatic islet transplantation centered on the risks and benefits of the simultaneous pancreatic kidney transplantation (SPKT) for the diabetic with end-stage renal failure. In the paper it is stressed the importance of the interaction between the endocrinologist and the nephrologist for improving the survival of […]