1,721,002 research outputs found
The presence of nonsegmental vitiligo modifies intracellular cytokine subsets in patients with chronic lymphocytic thyroiditis
No full textHelicobacter pylori infection and drugs malabsorption.
No full textDrug absorption represents an important factor affecting the efficacy of oral drug treatment. Gastric secretion and motility seem to be critical for drug absorption. A causal relationship between impaired absorption of orally administered drugs and Helicobacter pylori (H. pylori) infection has been proposed. Associations have been reported between poor bioavailability of l-thyroxine and l-dopa and H. pylori infection. According to the Maastricht Florence Consensus Report on the management of H. pylori infection, H. pylori treatment improves the bioavailability of both these drugs, whereas the direct clinical benefits to patients still await to be established. Less strong seems the association between H. pylori infection and other drugs malabsorption, such as delavirdine and ketoconazole. The exact mechanisms forming the basis of the relationship between H. pylori infection and impaired drugs absorption and/or bioavailability are not fully elucidated. H. pylori infection may trigger a chronic inflammation of the gastric mucosa, and impaired gastric acid secretion often follows. The reduction of acid secretion closely relates with the wideness and the severity of the damage and may affect drug absorption. This minireview focuses on the evidence of H. pylori infection associated with impaired drug absorption
A novel therapeutic approach for patients with gastric disorders and T4 malabsorption: thyroxine softgel preparation
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Gastrointestinal Malabsorption of Thyroxine
Full text linkLevothyroxine, a largely prescribed drug with a narrow therapeutic index, is often a lifelong treatment. The therapeutic efficacy of thyroxine may be marred by behavioral, pharmacologic and pathologic issues acting as interfering factors. Despite a continuous search for an optimal thyroxine treatment, a significant number of patients fail to show a complete chemical and/or clinical response to this reference dose of thyroxine. Gastrointestinal malabsorption of oral thyroxine represents an emerging cause of refractory hypothyroidism and may be more frequent than previously reputed.In this review article we aimed at examining the pharmacologic features of thyroxine preparations and their linkage with the intestinal absorption of the hormone. We have stressed the major biochemical and pharmacologic characteristics of thyroxine and its interaction with the putative transporter at the intestinal level. We have examined the interfering role of nutrients, foods, and drugs on thyroxine absorption at gastric and intestinal level. The impact of gastrointestinal disorders on thyroxine treatment efficacy has been also analyzed, in keeping with the site of action and the interfering mechanisms. Based on the evidence obtained from the literature, we also propose a schematic diagnostic workup for the most frequent and, often hidden, gastrointestinal diseases impairing thyroxine absorption
Regulatory B (BREG) lymphocytes are increased in patients Hashimoto's thyroiditis and related autoimmune disorders
No full textthe individually tailored thyroxine dose as a tool to unveil occult autonomous thyroid functioning areas
No full textAutonomous functioning thyroid areas (AFTA), frequently associated to heart arrhythmias, are often occult and may be associated to TSH values in the low-normal range. Despite the administration of an individually tailored dose (ITD) of thyroxine (T4) in the treatment of multinodular goitre (MNG), a serum TSH lower than expected may be obtained as a consequence of the presence of AFTA. This study was aimed at characterizing the existence of hidden AFTA in patients hyperresponding to treatment with an ITD of thyroxine. In a cohort of about 3000 consecutively examined outpatients, we assessed 94 patients (84 F and 10 M; median age=56 years) with MNG in treatment with ITD, who showed an unexpected lower serum TSH as compared to the one observed in a reference group (n = 123; 109 F and 14 M; median age=54 years) in whom iodine and drug interferences, as well as AFTA, were positively excluded. Patients in the study group showed significantly lower median TSH (0.052 vs 0.20 mU/l, P 60 years (median TSH:0.05 vs 0.22 mU/l, P < 0.0025; median T 4 dose:0.94 vs 1.33 g/Kg/day, P < 0.0005). Interestingly, when treatment was withdrawn, 86/94 patients (91.5%) had serum TSH in the normal range and the median TSH of the whole study group was 1.09 mU/l.
The presence of autonomous functioning areas has been detected, through thyroid scintiscan and radioactive iodine uptake test (RAIU- 4 th and 24 th hour), in 65 out of 94 patients (69%). RAIU at 4 th hour (17 vs 13%, P < 0.0199) and 24 th hour (33.5 vs 28%, P < 0.001) were both significantly higher in patients with autonomous functioning areas. These results show that the TD of T4 represents a novel tool to detect hidden autonomous functioning thyroid area
Cutaneous melanoma follow-up: Appropriateness of requests for ultrasound tests - The S.Gallicano national referral centre experience
Full text linkIndividually tailored dose of thyroxine: a novel tool to detect occult autonomous thyroid functioning nodules
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