Subclinical Hypothyroidism in Childhood — Current Knowledge and Open Issues

Subclinical hypothyroidism is defined as serum levels of TSH above the upper limit of the reference range, in the presence of normal concentrations of total T4 or free T4. This biochemical profile might be an indication of mild hypothyroidism, with a potential increased risk of metabolic abnormalities and cardiovascular disease recorded among adults. Whether subclinical hypothyroidism results in adverse health outcomes among children is a matter of debate and so management of this condition remains challenging. Mild forms of untreated subclinical hypothyroidism do not seem to be associated with impairments in growth, bone health or neurocognitive outcome. However, ongoing scientific investigations have highlighted the presence of subtle proatherogenic abnormalities among children with modest elevations in their TSH levels. Although current findings are insufficient to recommend levothyroxine treatment for all children with mild asymptomatic forms of subclinical hypothyroidism, they highlight the potential need for assessment of cardiovascular risk among children with this condition. Increased understanding of the early metabolic risk factors associated with subclinical hypothyroidism in childhood will help to improve the management of affected individuals.

Key points

• Subclinical hypothyroidism among children is often a benign and remitting condition, for which risk of progression to overt hypothyroidism depends on the underlying cause (for example, autoimmune disease)
• The optimum management of children with subclinical hypothyroidism depends on the aetiology and degree of TSH elevation and should be individually tailored
• The benefits of levothyroxine therapy are clear for the severe forms of subclinical hypothyroidism; however, uncertainty about this approach still exists for the mild forms of the condition
• In the absence of therapeutic intervention, clinical evaluation and thyroid function tests should be regularly performed to ensure early identification of children who might benefit from treatment
• Growth and neurocognitive outcomes do not seem to be affected in mild subclinical hypothyroidism; however, subtle proatherogenic abnormalities have been detected among children with modest elevations of TSH concentration
• Cardiovascular risk assessment among children and adolescents with subclinical hypothyroidism could help to prevent cardiovascular disease in adulthood

Read more: Subclinical Hypothyroidism in Childhood — Current Knowledge and Open Issues

Source: NatureReviewsEndocrinology

What is an Inguinal Hernia?

The abdominal cavity is the large hollow space in the body that contains many important organs such as the stomach and liver. An inguinal hernia occurs when part of the abdominal cavity pushes into an area of the body called the inguinal canal.

There are two inguinal canals in the body, one on either side of the groin. Different structures of the body pass through the inguinal canal depending on the person's gender.

In men, the spermatic cord passes through the canal and connects to the testicles. In women, round ligaments that support the uterus pass through the canal.

An inguinal hernia usually affects either the small intestine or the fatty tissue in the abdomen.

Read more: What is an Inguinal Hernia?

Around a quarter of men will have an inguinal hernia at some point in their lives.
Incarcerated or strangulated hernias can cause extreme pain, nausea, and vomiting. 
The only available treatment for an inguinal hernia is surgery.

Source: medicalnewstoday

How Will You Feel During HIV Treatment?

Current combinations of HIV medications have changed the nature of HIV from a terminal illness to one that allows you to live out a nearly normal life. Yet the powerful antiretroviral drugs that help control the virus are known to cause side effects once you start treatment.

Not everyone is affected the same way by the same drugs. You might find the side effects are mild and go away in a few weeks, once your body adapts to the new chemicals. Nausea, diarrhea, and headaches tend to lessen after a month or so.

Read more: How Will You Feel During HIV Treatment?

Source: healthguides

Funny Picture 14: "I Could Only Pronounce You Cured"

Source: medicalnewstoday

See more funny pics!

The Pathophysiology of Defective Proteostasis in the Hypothalamus — From Obesity to Ageing

Hypothalamic dysfunction has emerged as an important mechanism involved in the development of obesity and its comorbidities, as well as in the process of ageing and age-related diseases, such as type 2 diabetes mellitus, hypertension and Alzheimer disease. In both obesity and ageing, inflammatory signalling is thought to coordinate many of the cellular events that lead to hypothalamic neuronal dysfunction. This process is triggered by the activation of signalling via the toll-like receptor 4 pathway and endoplasmic reticulum stress, which in turn results in intracellular inflammatory signalling. However, the process that connects inflammation with neuronal dysfunction is complex and includes several regulatory mechanisms that ultimately control the homeostasis of intracellular proteins and organelles (also known as 'proteostasis'). This Review discusses the evidence for the key role of proteostasis in the control of hypothalamic neurons and the involvement of this process in regulating whole-body energy homeostasis and lifespan.

Key points

• Specialized neurons of the hypothalamus control caloric intake and energy expenditure in response to hormonal, nutritional and neural signals that reflect the energy stores in the body
• Malfunction of the hypothalamus occurs in obesity and ageing, which leads to an imbalance between caloric intake and energy expenditure resulting in positive energy balance and reduced lifespan
• The excessive consumption of certain nutrients and ageing affect different aspects of proteostasis in selected neurons of the hypothalamus, contributing to neuronal dysfunction in obesity and ageing
• Inflammation is one of the most important outcomes of disturbed proteostasis to occur in the hypothalamus during obesity and ageing
• Several genetic and pharmacological approaches used to correct the defects of proteostasis and reduce inflammation have proven effective in reducing obesity and increasing lifespan in experimental models

Read more: The Pathophysiology of Defective Proteostasis in the Hypothalamus — From Obesity to Ageing

Figure 1: Control of energy balance and lifespan by the hypothalamic network. Neurons of the
medium hypothalamus respond to systemic signals of whole-body energy status. Blood levels of
insulin fluctuate acutely in response to carbohydrates present in food and chronically in response
to increased adiposity.

Source: Nature Reviews Endocrinology

What’s the point of the PhD thesis?

Doctoral courses are slowly being modernized. Now the thesis and viva need to catch up.

On the morning of Tom Marshall's PhD defence, he put on the suit he had bought for the occasion and climbed onto the stage in front of a 50-strong audience, including his parents and 6 examiners. He gave a 15-minute-long presentation, then faced an hour of cross-examination about his past 5 years of neuroscience research at the Donders Institute for Brain, Cognition and Behaviour in Nijmegen, the Netherlands. A lot was at stake: this oral examination would determine whether he passed or failed. “At the one-hour mark someone came in, banged a stick on the floor and said 'hora est',” says Marshall — the ceremonial call that his time was up. “But I couldn't. I had enjoyed the whole experience far too much, and ended up talking for a few extra minutes.”

Marshall's elaborate, public PhD assessment is very different from that faced by Kelsie Long, an Earth-sciences PhD candidate at the Australian National University (ANU) in Canberra. Her PhD will be assessed solely on her written thesis, which will be mailed off to examiners and returned with comments. She will do a public presentation of her work later this year, but it won't affect her final result. “It almost feels like a rite of passage,” she says.

Read more: What’s the point of the PhD thesis?

Source: nature

Viral Hepatitis Has Become a Leading Global Killer

Compared with most other communicable diseases, hepatitis has risen in global importance since the 1990s. It is now a leading cause of death and disability worldwide and kills at least as many people as tuberculosis, HIV/AIDS, or malaria.

This is the main finding of an international study - led by Imperial College London in the United Kingdom and the University of Washington in Seattle - published in The Lancet.

The study - which analyzes data from 1990-2013 on 183 countries - is timely, as the World Health Organization (WHO) launch a major new effort to tackle viral hepatitis.

The findings should prove of "crucial importance to global health policy," note the authors.

Read more: Viral Hepatitis Has Become a Leading Global Killer

At 1.45 million deaths a year, viral hepatitis now ranks among the world'sleading
infectious diseases - such as TB, AIDS/HIV, and malaria.

Source: medicalnewstoday

New 'Mutation-Tracking' Blood Test Could Predict Breast Cancer Relapse Months in Advance

Scientists have developed a blood test for breast cancer able to identify which patients will suffer a relapse after treatment, months before tumours are visible on hospital scans.

The test can uncover small numbers of residual cancer cells that have resisted therapy by detecting cancer DNA in the bloodstream.

Researchers at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust were able to track key mutations that cancer accumulates as it develops and spreads, without the need for invasive biopsy procedures.

They hope that by deciphering the DNA code found in blood samples, it should be possible to identify the particularly mutations likely to prove lethal to that patient - and tailor treatment accordingly.

Read more: New 'Mutation-Tracking' Blood Test Could Predict Breast Cancer Relapse Months in Advance

Source: medicalxpress

Breathing New Life into Cystic Fibrosis Genetic Testing

New Research Has Broadened the Number of Clinically Relevant CFTR Gene Mutations.

Imagine yourself suspended a couple of hundred feet below the surface of the ocean. The sheer weight of the immense column of water pushing down on your chest makes each breath a harrowing task. Now picture that your only recourse to collect vital oxygen is to breathe laboriously throw a narrow straw that connects you to the atmosphere above. You slowly draw in air, cautiously trying not to collapse the straw from too forceful of suction—struggling just as much to exhale the expired air. Now repeat the entire cycle for the rest of your life.

If you were able to envision how the immense difficulties of breathing in this manner would be for just a few minutes, let alone your entire life, then you may have a minute sense of what a person afflicted with cystic fibrosis (CF) endures. Gasping for air while thick, sticky mucus lines the pulmonary system, seemingly threatening to drown and suffocate patients with each inhale.

Read more: Breathing New Life into Cystic Fibrosis Genetic Testing

Accurate genetic testing for cystic fibrosis can determine if a patient has the disease and provide
needed information for potential carrier couples, clinical actionability of identified mutations, and
potential severity. [Krishna Kumar/Getty]

Source: genengnews

Prostate Cancer And DNA Mutation: New Connections Revealed

Specific mutations in the DNA of men with metastatic prostate cancer have been shown to play a larger role in the disease than previously thought. Researchers hope that this finding will help change standard therapy guidelines and open the door to drugs currently being used for other cancers.

The new study, published in the New England Journal of Medicine, examined inherited mutations in DNA repair genes.

These gene mutations were already known to occur more frequently in prostate cancer patients than the general population.

However, the present study demonstrated that mutations in DNA repair genes were even more prevalent in people with metastatic prostate cancer, specifically.

Read more: Prostate Cancer And DNA Mutation: New Connections Revealed

Gene mutation research gives a new perspective on prostate cancer.

Source: medicalnewstoday