Postpartum thyroid dysfunction in women with autoimmune thyroiditis

Introduction: Autoimmune thyroiditis (AIT) is a predisposing factor for developing postpartum thyroid dysfunction (PPTD).

Aim: To study the characteristics of PPTD in women with AIT.

Methods: Thirty-eight women with pre-existing AIT were included in the study. Thyroid-stimulating hormone, free triiodthyronine, free thyroxine, thyroid peroxidase antibodies, thyroglobulin antibodies were measured and ultrasound evaluation of the thyroid gland was performed in the first trimester of pregnancy and during the first year following delivery.

Results: Thyroid dysfunction was recognized in 68.4% of the patients – 28.9% presented with hypothyroidism and 39.5 % with thyrotoxicosis. The immunological and morphological parameters did not differ between euthyroid women and those with thyroid dysfunction. At the end of the postpartum period restoration of euthyroid state (being on the treatment before pregnancy) was observed in 15.4% of patients with PPTD, while 84.6% required increase of the levothyroxine dose. The analysis found a significantly lower volume of the thyroid gland, shorter duration of the disease, a lower dose of levothyroxine before and during gestation in patients with impaired thyroid function at the end of the postpartum period.

Conclusion: The risk of PPTD in women with AIT predating pregnancy is higher among women with preserved thyroid functional capacity motivating a thorough assessment of thyroid hormone levels and close follow-up of those women during the postpartum period.     

Hazards of Radioactive Mineralization Associated with Pegmatites Used as Decorative and Building Material

The present study aimed to assess the radiological hazards associated with applying the investigated granite in the building materials and the infrastructures applications. The investigated granites are classified into four categories: El-Urf, barren, colourful and opaque. El Urf monzogranite intrudes metagabbro diorite complex with sharp contacts. Based on the activity concentrations, the environmental parameters such as absorbed dose rate (D_air), annual effective dose (AED), radium equivalent activity (Ra_eq), external (H_ex) and internal (H_in) hazard indices were measured. The mineralized pegmatite is located in the southwestern foothill of the Gabal El Urf younger granite. It displays well-defined zonation of three zones: outer, middle and inner zones represented by potash feldspar, quartz and mica, respectively. The isorad map showed that El Urf monzogranite is barren (Up to 100 cps) surrounding an excavation of the studied pegmatite that exhibits moderate colorful mineralization (phase-I = 500–1500 cps) and anomalous opaque mineralization (phase-II = 1500–3500 cps) pegmatites. The obtained results of radionuclides activity concentrations illustrated that the Opaque granites have the highest values of ²³⁸U (561 ± 127 Bq kg⁻¹), ²³²Th (4289 ± 891 Bq kg⁻¹) and ⁴⁰K (3002 ± 446 Bq kg⁻¹) in the granites, which are higher than the recommended worldwide average. Many of the radiological hazard parameters were lesser than the international limits in the younger granites and barren pegmatites. All of these parameters were higher in the colorful and opaque mineralized pegmatites. The high activity and the elevated radiological hazard parameters in the mineralized pegmatites are revised to the presence of radioactive and radioelements bearing minerals, such as thorite, meta-autunite, kasolite, phurcalite, columbite, fergusonite, Xenotime and fluorapatite. Other instances of mineralization were also recorded as cassiterite, atacamite, galena, pyrite and iron oxide minerals. Thus, the granites with high radioactivity concentration cannot be applied in the different applications of building materials and ornamental stones.     

Epilepsy surgery and vagal nerve stimulation: what all neurologists should know

Epilepsy surgery treatment should be considered as standard of care for all patients with medically intractable partial-onset epilepsy who are found to be good surgical candidates based on their presurgical evaluation. Delaying surgical treatment continues to be a problem among neurologists. The early recognition of pharmacoresistance and patients' referral for presurgical evaluation can shorten the time to identify potential surgical candidates. A successful early surgery can be expected to significantly improve these patients' quality of life, not only because of a seizure-free state but also by improving psychiatric comorbidities. Vagal nerve stimulation (VNS) is currently the only FDA-approved neurostimulation treatment strategy for patients who are not considered candidates for epilepsy surgery. VNS has been shown to decrease seizure frequency by approximately 50% in 30 to 40% of implanted patients. The future of epilepsy surgery and neurostimulation for those individuals with medically intractable partial-onset epilepsy shows great promise.