Thyroiditis is a general term that refers to thyroid gland inflammation. The present research was conducted to identify the role of thyroid peroxidase antibodies (TPO-Ab) in Thyroiditis patients and ...assaying the levels of thyroid function tests (TFT), which include levels of serum triiodothyronine hormone (T3), thyroxin hormone (T4), and thyroid stimulating hormone (TSH). A total of 86 serum samples (76 thyroiditis patients and 10 controls) from August 2023 to November 2023, at Al-Haboby Teaching Hospital and some private clinics in Thi-Qar Governorate were enrolled in the present study. The sandwich-ELISA technique assayed the levels of TPO-Ab, and the levels of (TFT) T3,T4, and TSH by using a competitive binding assay. Thyroiditis patients were divided into hypothyroidism and hyperthyroidism type with 47(61.84%) and 29(38.16%) patients, respectively (P≤0.05). Hypothyroidism and hyperthyroidism groups showed elevated mean serum levels of TPO-Ab (29.78%) and (20.68%) for members of each group separately, with a mean of (478.8) and (1070), respectively. While the mean of TPO-Ab in the control group was (319.5). The means of TFT in hypothyroidism group for T3,T4 and TSH were (0.9215), (5.402), and (22.86), respectively. The means of TFT in hyperthyroidism group for T3,T4 and TSH were (1.003), (7.409) and (0.3893), respectively, compared to the control. The mean of TFT for T3,T4 and TSH was (0.781), (7.374), and (1.603), respectively.
This study aims to investigate the relationship between thyroid peroxidase antibody (TPO) and thyroid function tests (TSH, T3 and T4) in patients with type 2 diabetes mellitus (T2DM). Ninety ...women and men, with ages ranging between 35-65 years and weighing 60-80 kgs, were selected for this study. They were classified into three groups: G1 included 15 healthy control group, G2 had15 patients with T2DM and G3 had 60 patients with T2DM and hypothyroidism. Blood samples were collected from each individual via vein puncture to assess thyroid hormone and TPO-Ab. The results showed highly significant (p < 0.01) increase in TSH level in the diabetic group with hypothyroidism when compared to the other groups. There was no significant difference between diabetic and control groups. T4 and T3 levels showed highly significant (p<0.01) decrease in the diabetic group with hypothyroidism when compared to the diabetic and healthy control groups. On the other hand, there was no significant difference between the diabetic and healthy control groups. The results showed highly significant (p < 0.01) increase in the TPO-AB level in diabetic group with hypothyroidism when compared with the diabetic and healthy control groups.
The routine histomorphological assessment of follicular thyroid neoplasms has been subject to interobserver or intraobserver variability among histopathologists. Anti-thyroid peroxidase (anti-TPO) ...has emerged as a useful immunohistochemical (IHC) marker, with its expression lost in papillary thyroid carcinoma (PTC). Our study aims to determine the diagnostic accuracy of anti-TPO IHC expression in the identifying PTC and its variants, particularly the Follicular variant of papillary thyroid carcinoma (FVPTC), with H&E assessment as the gold standard. Anti-TPO IHC (DAKO-MoAb47) was performed on 110 cases, including 76 malignant tumors (classic PTC, FVPTC, follicular carcinoma (FC), and oncocytic carcinoma (OC)) and 34 benign tumors (non-invasive follicular tumor with papillary-like nuclear features (NIFTP) and follicular adenoma (FA)). The loss of expression in more than or equal to 51 % of thyrocytes was considered suggestive of a PTC profile. The sensitivity of the loss of anti-TPO expression for identifying PTC among all carcinomas was 61.7 %, specificity was 75 %, positive predictive value was 90.2 %, negative predictive value was 34.2 %, and accuracy was 64.4 %. The loss of anti-TPO IHC expression combined with routine H&E assessment, supports the identification of PTC and its variants.
•Sensitivity of anti-TPO in lesions with papillary thyroid carcinoma like nuclei is 53.7 %, specificity is 100 %.•The positive predictive value is 91.7 %, negative predictive value is 38.7 % and accuracy is 61.8 %.•Sensitivity of loss of anti-TPO in papillary thyroid carcinoma, variants is 61.7 %, specificity is 75 %.•The positive predictive value is 90.2 %, negative predictive value is 34.2 % and accuracy is 64.4 %.•Anti-TPO is a useful stain, for follicular thyroid lesions with papillary thyroid carcinoma like nuclei.
The environmental concern associated with waste tyre disposal and the necessity of sustainable waste management policies has promoted the development of waste tyre valorization processes in the last ...decades. Within this framework, this review analyzes the main advances in waste tyre valorization by catalytic pyrolysis. Waste tyre pyrolysis allows converting this solid waste into three product fractions of potential interest, as are gases, pyrolysis oil (TPO) and char, with their yield and features being conditioned by pyrolysis conditions. Catalytic pyrolysis is an interesting alternative to improve the quality of the products and the selectivity of the process. A wide range of catalysts have been proposed in the literature for waste tyre valorization, with zeolites being the most commonly used due to their capacity for the production of valuable chemicals, such as BTX and light olefins. This review approaches multidisciplinary aspects for the evaluation of the critical points in this process, such as those related to pyrolysis technologies, reaction mechanisms, catalyst design and products properties.
•The main advances in waste tyre valorization by catalytic pyrolysis are analyzed.•The use of catalyst improves the products quality and the process selectivity.•The effect of catalyst type and reactor design on reaction mechanisms are discussed.•Non-catalytic pyrolysis produces higher liquid oil compared to catalytic pyrolysis.•Zeolites have the greatest capacity for production of aromatics and light olefins.
Background and purpose: Fibromyalgia is a syndrome characterized by chronic musculoskeletal pain, tenderness, and other physical symptoms. We determined the frequency of Fibromyalgia in hypothyroid ...patients and the relationship between FM symptoms and hypothyroid status. Materials and methods: The current study is a cross-sectional descriptive study investigating the prevalence and demographic characteristics of fibromyalgia in hypothyroid patients referred to University clinic in Sari in 1401-1402. Ninety-one hypothyroid patients were included in the study. The sampling method was convenience sampling. The sociodemographic features and the clinical features of hypothyroid patients were recorded. Thyroid tests included T4, TSH, and Anti Tpo Ab. Patients were examined for Fibromyalgia using American College Rheumatology (ACR) criteria for FM 2010 and 1990. For the patients who were classified as FM, the FIQR questionnaire was completed. To analyze the data, descriptive statistics indicators such as central and dispersion indicators and calculation of ratios were used, and to check the relationship between qualitative variables, chi-square test and quantitative variable comparison in different groups were used by t-tests and ANOVA in SPSS-25 software was used. Results: The mean age and duration of hypothyroidism were 48.35 ± 13.8 and 9.84± 6.6 years respectively. The frequency of fibromyalgia in hypothyroid patients was 7(8%) patients based on ACR 2010 criteria. In patients with hypothyroidism and fibromyalgia, 6 patients (85.7%) were positive for Anti Tpo Ab, while in patients with hypothyroidism without fibromyalgia, 29 patients (34.5%) had this antibody (P=0.007). Conclusion: It seems that Anti Tpo Ab is more important than thyroid dysfunction, and it is suggested to check this antibody in fibromyalgia patients in addition to thyroid function tests.
Chronic spontaneous urticaria (CSU) is a debilitating mast cell-driven disease characterized by recurrent wheals and/or angioedema. Substantial progress has been made in dissecting the 2 main ...autoimmune mechanisms that drive the pathogenesis of CSU. Type I autoimmune (autoallergic) CSU is associated with IgE antibodies against autoantigens, for example, thyroid peroxidase and IL-24. Type IIb autoimmune CSU is mediated by autoantibodies that activate mast cells, for example, via IgE and FcεRI, and is present in less than 10% of patients with CSU when strict criteria are used, that is, triple positivity of autologous serum skin test, immunoassays for IgG autoantibodies, and basophil activation tests. A subpopulation of patients with CSU has both types. Type IIb autoimmune CSU is characterized by higher disease severity, concomitant autoimmune diseases, low levels of total IgE, elevated levels of IgG-anti-thyroid peroxidase, basopenia, eosinopenia, poor response to antihistamines and to omalizumab, and a good response to cyclosporine. Novel targeted therapies for CSU are under development such as ligelizumab, an anti-IgE, fenebrutinib and remibrutinib, Bruton's tyrosine kinase inhibitors, and dupilumab, an anti-IL-4Rα. Further studies should investigate the overlap between autoallergic and type IIb autoimmune CSU, optimize the diagnosis of both autoimmune endotypes using easy-to-perform, noninvasive, and inexpensive markers, and assess differences in response to therapy.
This study investigated the influence of photoinitiator types on degree of conversion (DC), rate of polymerization (RP), flexural strength (FS), flexural modulus (FM), and light transmittance (LT) of ...filled and unfilled light-curable resin cements through different thicknesses and shades of lithium disilicate ceramics.
Lithium disilicate ceramic discs (IPS Emax Press, background 0.0, 0.5, 1.0, 2.0, 3.0, and 4.0 mm, shades A1 and BL3) were prepared. Experimental resin-based cements TEGDMA/BisGMA (50/50 mass%) were prepared using either camphorquinone (CQ)/amine (0.44/1.85 mol%) or TPO (0.44 mol%), and a micro and nanofiller loads of nil (unfilled); 40/10 mass%; and 50/10 mass%). Resin cements (0.2 mm thick) were placed on the lower surface of the ceramic specimens and light-activated for 30 s from the upper surface using a Bluephase Style curing light (exitance at tip: 1236 mW/cm2 ± 1.20). LT and distribution of irradiance through the ceramics were measured using a UV–vis spectrometer and a beam profile camera, respectively (n = 3). The DC and RP were measured in real-time using mid infrared spectroscopy in attenuated total reflectance (ATR) mode (n = 3). FS and FM were measured using a universal testing machine (n = 5). Statistical analyses were performed on LT, DC, RP, FS, and FM data using a general linear model, and supplementary ANOVA and post hoc Tukey multiple comparison test were also performed (α = .05).
Thicknesses, shades, photoinitiator type, and fillers load significantly influenced the optical and mechanical characteristics of the resin-based materials (p < 0.05). The BL3 shade ceramic provided higher values of DC, RP, FS, FM, and LT compared with the A1 shade (p < 0.05). Increasing ceramic thickness decreased the properties of the resin-based materials (p < 0.05). Generally, TPO improved mechanical properties of the resin cement compared with CQ (p < 0.05).
The luting process of indirect restorations may be improved by using high molar absorptivity, more reactive, and more efficient photoinitiators such as TPO, as opposed to conventional CQ. The use of such initiator may allow the placement of thicker and more opaque indirect restorations.
•TPO is a satisfactory alternative as photoinitiator (PI) to the conventional combination of camphorquinone/amine system.•Light-curable resin cements (LCRC) could be useful on luting of thicker and more opaque materials.•Physico-mechanical properties of LCRC are affected by shade and thickness of ceramic.•Fillers load have a different performance on LCRC according to the PI type used.
Summary
Combining drugs could be an effective option for treating multirefractory ITP, that is, patients not responding to rituximab, thrombopoietin receptor agonists (TPO‐RA) and splenectomy. We ...conducted a retrospective, multicenter, observational study including multirefractory ITP patients who received a combination of a TPO‐RA and an immunosuppressive drug. We included 39 patients (67% women, median age 59 years range 21–96), with a median ITP duration of 57 months 3–393 and a median platelet count at initiation of 10 × 109/L 1–35. The combination regimen was given for a median duration of 12 months 1–103 and included eltrombopag (51%) or romiplostim (49%), associated with mycophenolate mofetil (54%), azathioprine (36%), cyclophosphamide (5%), cyclosporin (3%) or everolimus (3%). Overall, 30 patients (77%) achieved at least a response (platelet count ≥30 × 109/L and at least doubling baseline during at least 3 months), including 24 complete responses (platelet count >100 × 109/L during at least 3 months) with a median time to response of 30 days 7–270 and a median duration of response of 15 months 4–63. Severe adverse event related to ITP treatment was observed in 31%. In conclusion, this study confirms that some patients with multirefractory ITP can achieve long lasting response with this combination.
In this retrospective study, a combination of a thrombopoietin receptor agonist and an immunosuppressive drug provided some long lasting responses in patients with multirefractory ITP (i.e. not responding to rituximab, 2 thrombopoietin receptor agonists at maximum dose and splenectomy).
The management of immune thrombocytopenic purpura (ITP) in children show great variation among physicians and centers. American Society of Hematology (ASH) has recently (2019) come up with updated ...guidance on the management of ITP in children and adults. There is no major change compared to ASH 2011 guidance, except for thrombopoietic receptor agonists (TPO-RAs) finding significant space in the ITP management armamentarium in the latest guidelines and steroids being recommended as a first line therapy. The ASH 2019 guideline is discussed in this review with realworld case examples. ASH 2019 guidelines help physicians manage patients with ITP in a rational way. The limitations of ASH guidelines, especially in Indian settings, are highlighted.
We report an early childhood onset Stiff Limb Syndrome (SLS) in association with unusual polyautoimmunity of GAD-65, anti-islet cell, and Thyroid Peroxidase (TPO) autoantibodies, who has achieved a ...nearly complete neurological recovery following combined immunotherapy, symptomatic and physical therapy. The patient had normal MRIs of the brain and spinal cord and a negative paraneoplastic work-up. Subsequently, she developed hypothyroidism requiring levothyroxine supplementation. We then conducted an extensive review of literature and identified 52 previously reported pediatric Stiff Man Syndrome (SMS)/Stiff Person Syndrome (SPS) or SLS cases, which has demonstrated a common association with other systemic autoimmune conditions. In the available literature, screening for concurrent autoimmunity has only been reported infrequently. We found that a paraneoplastic process is extremely rare in pediatric cases. Timely diagnosis and initiation of immunotherapy are critical to a favorable outcome. Therefore, we recommend to include SMS/SPS or SLS as an important differential diagnosis for MRI-negative myelopathy. Further clinical and research efforts should be focused on understanding the role of both genetic predisposition and environmental insults in the autoimmunity of pediatric SMS/SPS or SLS.
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