ABSTRACT Objective: To describe the secondary outcomes (weight loss, waist circumference [WC], and glycolipid profile) of a previous randomized controlled trial designed to investigate the impact of a high-protein, low-glycemic-index (GI) diet on lean body mass in late postmenopausal women. Subjects and methods: A total of 26 healthy women aged ≥ 65 years and with a mean body mass index (BMI) of 26.1 ± 3.5 kg/m2 were randomly assigned to follow a low-GI diet (GI < 55) with protein consumption at the current recommended dietary allowance (RDA, 0.8 g/kg body weight) or twice the RDA (2RDA, 1.6 g/kg body weight). Changes in body weight, BMI, WC, glucose, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, and triglycerides were assessed at 3- and 6-month of follow-up in all participants. An intention-to-treat analysis was performed using a linear mixed model. Results: Weight loss (mean change -1.7 kg, 95% confidence interval [CI] -2.8 to -0.5 kg, p = 0.004) was observed at 6 months, with no significant difference between the RDA and 2RDA groups. An overall significant WC decrease was observed at 6 months in all participants (mean change -3.8 cm, 95% CI -5.5 to -2.1 cm, p < 0.001), with no differences between groups. The glycolipid profile remained unchanged after 6 months of dietary intervention. Conclusion: Increasing protein intake did not lead to greater weight loss or reduction in WC in a sample of healthy postmenopausal women following a low-GI diet for 6 months. Objective , [WC] highprotein, highprotein high protein, high-protein lowglycemicindex low glycemic GI methods 2 BMI (BMI 261 1 26. 35 3 5 3. kgm2 kgm kg m2 m kg/m lowGI 55 RDA, (RDA 08 0 8 0. gkg g 2RDA, (2RDA 16 1. weight. . glucose HOMAIR, HOMAIR HOMA IR (HOMA-IR) cholesterol 6month month followup up intentiontotreat intention treat Results 1.7 17 7 -1. 95 [CI 2.8 28 -2. 0.5 05 -0. 0.004 0004 004 groups 3.8 38 -3. cm 5.5 -5. 2.1 21 0.001, 0001 0.001 001 0.001) intervention Conclusion [WC (HOMA-IR -1 9 2. -2 -0 0.00 000 00 -3 5. -5 - 0.0

SUMMARY OBJECTIVES: The coronavirus disease pandemic has become a major global health crisis since 2019. Recent data show the association of diabetes, hypertension, and obesity with poor related outcomes in coronavirus disease infection. This descriptive study aimed to identify the clinical and laboratory parameters in patients with acute respiratory syndrome and confirmed severe acute respiratory syndrome coronavirus 2 infection. METHODS: In this cross-sectional study, we analyzed data of 409 patients admitted to a referral hospital in Rio Grande do Sul, Brazil, with coronavirus disease infection confirmed by reverse transcription polymerase chain reaction. Clinical, laboratory, and imaging data were collected retrospectively from electronic medical records using a template with the variables of interest. RESULTS: The average age was 64 years (52–73), and the body mass index was 27 kg/m² (22.1–31.2). Hypertension, diabetes, and obesity were observed in 58, 33, and 32% of the patients, respectively. Patients admitted to an intensive care unit were older [66 years (53–74) vs. 59 years (42.2–71.7)], with significantly higher impairment on chest computed tomography [75% (50–75) vs. 50% (25–60)] and received higher doses of corticosteroid therapy [39.4 mg (14.3–70.3) vs. 6 mg (6–14.7)]. Hematological parameters were lower in critically ill patients, with greater differences observed on the fifth day of hospitalization [hemoglobin 11.5 g/dL (9.5–13.1) vs. 12.8 g/dL (11.5–14.2), platelets 235,000 μL (143,000–357,000) vs. 270,000 μL (192,000–377,000), and lymphocytes 900 μL (555–1,500) vs. 1,629 μL (1,141–2,329)]. C-reactive protein levels and kidney function were also worse in intensive care unit patients. The mortality rate was significantly higher in the intensive care unit compared to the basic care unit (62.8 vs. 12.2%). CONCLUSION: Our findings suggest that metabolic and cardiovascular comorbidities, as well as abnormal hematological parameters, are common findings among patients with severe respiratory syndrome related to coronavirus disease. OBJECTIVES 2019 diabetes hypertension METHODS crosssectional cross sectional 40 Sul Brazil reaction Clinical interest RESULTS 52–73, 5273 52–73 , 52 73 (52–73) kgm² kgm kg m² m kg/m 22.1–31.2. 221312 22.1–31.2 . 22 1 31 (22.1–31.2) Hypertension 58 33 32 respectively 66 [6 53–74 5374 53 74 (53–74 vs 5 42.2–71.7, 422717 42.2–71.7 42 71 7 (42.2–71.7)] 75% 75 [75 50–75 5075 50 (50–75 25–60 2560 25 60 (25–60) 39.4 394 39 4 [39. 14.3–70.3 143703 14 3 70 (14.3–70.3 6–14.7. 6147 6–14.7 (6–14.7)] hemoglobin 115 11 11. gdL g dL 9.5–13.1 95131 9 13 (9.5–13.1 128 12 8 12. 11.5–14.2, 115142 11.5–14.2 (11.5–14.2) 235000 235 000 235,00 143,000–357,000 143000357000 143 357 (143,000–357,000 270000 270 270,00 192,000–377,000, 192000377000 192,000–377,000 192 377 (192,000–377,000) 90 555–1,500 5551500 555 500 (555–1,500 1629 629 1,62 1,141–2,329. 11412329 1,141–2,329 141 329 (1,141–2,329)] Creactive C reactive 62.8 628 62 (62. 12.2%. 122 12.2% 12.2%) CONCLUSION comorbidities 201 527 52–7 (52–73 22131 22.1–31. (22.1–31.2 [ 53–7 537 (53–7 42271 42.2–71. (42.2–71.7) [7 50–7 507 (50–7 25–6 256 (25–60 39. [39 14.3–70. 14370 (14.3–70. 614 6–14. (6–14.7) 9.5–13. 9513 (9.5–13. 11514 11.5–14. (11.5–14.2 23500 23 00 235,0 143,000–357,00 14300035700 35 (143,000–357,00 27000 270,0 19200037700 192,000–377,00 19 37 (192,000–377,000 555–1,50 555150 55 (555–1,50 162 1,6 1141232 1,141–2,32 (1,141–2,329) 62. (62 12.2 20 52– (52–7 2213 22.1–31 (22.1–31. 53– (53– 4227 42.2–71 (42.2–71.7 50– (50– 25– (25–6 [3 14.3–70 1437 (14.3–70 61 6–14 (6–14.7 9.5–13 951 (9.5–13 1151 11.5–14 (11.5–14. 2350 0 235, 143,000–357,0 1430003570 (143,000–357,0 2700 270, 1920003770 192,000–377,0 (192,000–377,00 555–1,5 55515 (555–1,5 16 1, 114123 1,141–2,3 (1,141–2,329 (6 (52– 221 22.1–3 (22.1–31 (53 422 42.2–7 (42.2–71. (50 (25– 14.3–7 (14.3–7 6–1 (6–14. 9.5–1 95 (9.5–1 11.5–1 (11.5–14 143,000–357, 143000357 (143,000–357, 192000377 192,000–377, (192,000–377,0 555–1, 5551 (555–1, 11412 1,141–2, (1,141–2,32 ( (52 22.1– (22.1–3 (5 42.2– (42.2–71 (25 14.3– (14.3– 6– (6–14 9.5– (9.5– 11.5– (11.5–1 143,000–357 14300035 (143,000–357 19200037 192,000–377 (192,000–377, 555–1 (555–1 1141 1,141–2 (1,141–2,3 22.1 (22.1– 42.2 (42.2–7 (2 14.3 (14.3 (6–1 9.5 (9.5 (11.5– 143,000–35 1430003 (143,000–35 1920003 192,000–37 (192,000–377 555– (555– 114 1,141– (1,141–2, 22. (22.1 42. (42.2– 14. (14. (6– 9. (9. (11.5 143,000–3 143000 (143,000–3 192000 192,000–3 (192,000–37 (555 1,141 (1,141–2 (22. (42.2 (14 (9 (11. 143,000– 14300 (143,000– 19200 192,000– (192,000–3 (55 1,14 (1,141– (22 (42. (1 (11 143,000 1430 (143,000 1920 192,000 (192,000– 1,1 (1,141 (42 143,00 (143,00 192,00 (192,000 (1,14 (4 143,0 (143,0 192,0 (192,00 (1,1 143, (143, 192, (192,0 (1, (143 (192, (192 (19

Objetivo O objetivo deste estudo foi avaliar a eficácia e segurança da injeção percutânea de etanol (IPE) no tratamento de nódulos tireoidianos benignos. Sujeitos e métodos Foram avaliados 120 pacientes com nódulos benignos de tireoide. Todos realizaram dosagens de TSH, T4 livre, ecografia cervical (US) e cintilografia de tireoide (em pacientes com TSH suprimido). A aplicação de etanol estéril a 99% foi guiada por US e o volume de etanol injetado correspondeu a um terço do volume nodular calculado. A resposta foi considerada completa (redução de 90%); parcial (redução entre 50 e 90%) ou ausência de resposta (redução menor que 50%). Nos nódulos autônomos, foi avaliada a normalização do TSH. Resultados Entre os nódulos estudados, 30,8% eram sólidos, 56,7% eram mistos, 12,5% eram císticos e 21,6%, nódulos hiperfuncionantes. O volume inicial dos nódulos tratados variou de 0,9 a 74,8 mL (média 13,1 ± 12,4 mL). Foram realizadas de 1 a 8 sessões de IPE (média 2,8), com aplicação média de 6,2 mL de etanol por paciente. Após dois anos de seguimento, 17% dos pacientes obtiveram resposta completa (redução de 94%), 53% obtiveram resposta parcial (redução de 70%) e 30% não responderam. Houve redução de volume nos nódulos autônomos em 70% dos casos, e 54% normalizaram o valor do TSH. Os efeitos colaterais registrados foram decorrentes apenas do desconforto no local de aplicação. Conclusão Este trabalho mostrou que a IPE é um procedimento seguro e eficaz para tratamento de nódulos benignos, sólidos ou mistos de tireoide. Na maioria dos casos, ocasiona redução do volume nodular, com melhora dos sintomas compressivos e normalização da função tireoidiana. Arq Bras Endocrinol Metab. 2014;58(9):912-7

Objective The objective of this study was to evaluate the efficacy and safety of percutaneous ethanol injection (PEI) in the treatment of benign thyroid nodules. Subjects and methods We evaluated 120 patients with benign thyroid nodules. Patients underwent evaluation of serum TSH and free T4, cervical ultrasound, and thyroid scintigraphy (in those with suppressed TSH levels). The application of sterile ethanol 99% was guided by ultrasound, with the injected volume amounting to one-third of the nodule volume. Response was considered complete (reduction of 90%); partial (reduction between 50 and 90%); or none (reduction of < 50%). Autonomous nodules were evaluated for normalization of TSH levels. Results Among the nodules studied, 30.8% were solid, 56.7% were mixed, 12.5% were cystic, and 21.6% were hyperfunctioning. The initial volume of the treated nodules ranged from 0.9 to 74.8 mL (mean 13.1 ± 12.4 mL). We performed 1-8 sessions of PEI, applying an average of 6.2 mL of ethanol for patient. After 2 years of follow-up, 17% of patients achieved a complete response (94% reduction); 53%, a partial response (70% reduction); and 30%, no response. A reduction in the volume of autonomous nodules was noted in 70% of cases, and 54% had a normalized value of TSH. The main side effect is local pain, lasting less than 24 hours in most cases. Conclusion This study showed that PEI is a safe and effective procedure for treatment of benign, solid or mixed thyroid nodules. Most cases resulted in significant reduction in nodule volume, with normalization of thyroid function. Arq Bras Endocrinol Metab. 2014;58(9):912-7

Relatamos o caso de uma mulher com rara coexistência de acromegalia, feocromocitoma (FEO), tumor do estroma gastrointestinal (GIST), polipose intestinal e adenoma folicular de tireoide. Aos 56 anos, ela foi diagnosticada com acromegalia por um macroadenoma hipofisário, tratado com cirurgia transesfenoidal, radioterapia e octreotide. Uma colonoscopia de rotina detectou múltiplos pólipos, que à histologia eram adenomas tubulares com alto grau de displasia. Anos mais tarde, uma ecografia detectou uma massa abdominal de 8.0 x 6.2 cm, que na exploração cirúrgica era uma lesão adrenal e outro tumor aderido à pequena curvatura gástrica. A patologia confirmou os diagnósticos de FEO e GIST. A imuno-histoquímica do FEO foi negativa para GHRH. No seguimento, encontrou-se um bócio nodular com níveis normais de calcitonina e citologia inconclusiva. Após tireoidectomia total o diagnóstico histológico foi de adenoma folicular. A história familiar era negativa para todos esses tumores. As análises genéticas para genes de síndromes de FEO/paragangliomas (SDH A-D, SDHAF2, RET, VHL, TMEM127 e MAX) e para hipofisárias (AIP, MEN1 e p27) foram todas negativas. Embora a presença de FEO e acromegalia com múltiplos outros tumores possa ser uma coexistência fortuita, acreditamos na possibilidade de uma nova variante de NEM com uma mutação germinativa de novo em um gene ainda não identificado Arq Bras Endocrinol Metab. 2012;56(8):507-12

We report on an adult woman with rare coexistence of acromegaly, pheochromocytoma (PHEO), gastrointestinal stromal tumor (GIST), intestinal polyposis, and thyroid follicular adenoma. At the age of 56, she was diagnosed with acromegaly caused by a pituitary macroadenoma, treated by transsphenoidal surgery, radiotherapy, and octreotide. During routine colonoscopy, multiple polyps were identified as tubular adenomas with high-grade dysplasia on histology. Years later, an abdominal mass of 8.0 x 6.2 cm was detected by routine ultrasound. Surgical exploration revealed an adrenal mass and another tumor adhered to the lesser gastric curvature, which were removed. Pathology confirmed the diagnosis of PHEO and GIST. PHEO immunohistochemistry was negative for GHRH. During follow-up, nodular goiter was found with normal levels of calcitonin and inconclusive cytology. Near-total thyroidectomy was performed, revealing a follicular adenoma. Her family history was negative for all of these tumor types. Genetic analysis for PHEO/paraganglioma genes (SDH A-D, SDHAF2, RET, VHL, TMEM127, and MAX), and pituitary-related genes (AIP, MEN1, and p27) were negative. Though the finding of PHEO and acromegaly with multiple other tumors could be a fortuitous coexistence, we suggest that this case may represent a new variant of MEN syndrome with a de novo germline mutation in a not yet identified gene. Arq Bras Endocrinol Metab. 2012;56(8):507-12