Osteoporosis is a common manifestation of Cushing's syndrome, but the mechanisms responsible for this abnormality have not been defined. With the objective of analyzing parathyroid hormone (PTH) secretion in chronic hypercortisolism (CH), we evaluated 11 healthy subjects and 8 patients with CH, 6 with Cushing's disease and 2 with adrenal adenoma. These volunteers were submitted to tests of PTH stimulation through hypocalcemia (EDTA), PTH suppression through hypercalcemia (iv and oral calcium), and evaluation of bone mineral density (BMD) by DEXA. During the test of PTH stimulation, the calcium and magnesium concentrations of the normal and CH groups were similar. Patients with CH showed an increased PTH response to the hypocalcemic stimulus compared to controls. PTH values were significantly higher in the CH group at 70 (17.5 ± 3.5 vs 10.2 ± 1.3 pmol/l, P = 0.04), and 120 min (26.1 ± 5.9 vs 11.3 ± 1.9 pmol/l, P = 0.008) of EDTA infusion. The area under the curve for PTH during EDTA infusion was also significantly higher in patients with CH than in normal subjects (1867 ± 453 and 805 ± 148 pmol l -1 2 h -1 , P = 0.02). During the test of PTH suppression, calcium, magnesium and PTH levels of the patients with hypercortisolism and controls were similar. BMD was decreased in patients with hypercortisolism in the spine (0.977 ± 0.052 vs 1.205 ± 0.038 g/cm 2 in controls, P<0.01). In conclusion, our results show that subjects with CH present decreased bone mass mainly in trabecular bone. The use of dynamic tests permitted the detection of increased PTH secretion in response to a hypocalcemic stimulus in CH patients that may probably be involved in the occurrence of osteoporosis in this state.

One way to generalize the boundary Yamabe problem posed by Escobar is to ask if a given metric on a compact manifold with boundary can be conformally deformed to have vanishing σ k -curvature in the interior and constant H k -curvature on the boundary. When restricting to the closure of the positive k-cone, this is a fully nonlinear degenerate elliptic boundary value problem with fully nonlinear Robin-type boundary condition. We prove a general bifurcation theorem which allows us to construct examples of compact Riemannian manifolds (X, g) for which this problem admits multiple nonhomothetic solutions in the case when 2k < dim X. Our examples are all such that the boundary with its induced metric is a Riemannian product of a round sphere with an Einstein manifold.2010 Mathematics Subject Classification. Primary 58J32; Secondary 53A30, 58J40.Thus depending on the different volume constraints, there are two types of boundary Yamabe problem. If one considers,n−1 n , then the Euler-Lagrangian equation (with suitable normalization) is given byThis boundary Yamabe problem is called the scalar flat type. This problem, as remarked by Escobar in [19], is a higher dimensional generalization of the Riemann mapping theorem. It was studied by Escobar [19,21] and Marques [31,32]. If one considers instead inf g∈[g0] X J g dvol g + M H g dvol ι * g Vol g (X) n−1 n+1, then the Euler-Lagrangian equation is given by R g = const, in X, H g = 0, on M .

RESUMOObjetivo: Relatar os efeitos endócrinos tardios em crianças e adolescentes após tratamento oncológico e associá-los à doença de base e ao tratamento. Sujeitos e métodos: Foram realizadas avaliações clínicas e laboratoriais visando à detecção de distúrbios endócrinos em 320 pacientes após terapia oncológica, seguidos por seis anos. Resultados: Em 94 pacientes, detectaram-se: 32 pacientes apresentaram baixa estatura (nove em tratamento com hormônio de crescimento), 14 tiveram puberdade precoce (10 em uso de análogo de GnRH) e 19 revelaram ser portadores de distúrbios de tireoide (12 com hipotireoidismo, seis com nódulos de tireoide e um com tireoidite linfocitária crônica). Obesidade foi encontrada em 18 deles. Seis com diabetes insípido e cinco com puberdade atrasada, três com pan-hipopituitarismo. Houve associação entre a radioterapia e a presença de endocrinopatias. Conclusão: Noventa e quatro de 320 (30%) dos pacientes fora de terapia apresentaram alteração endócrina, o que enfatiza a importância do seguimento precoce e regular, possibilitando-lhes, com tratamento, melhor qualidade de vida. Arq Bras Endocrinol Metab. 2010;54(9):819-25 Descritores Neoplasias; crianças; adolescentes; endocrinopatias; sobreviventes de câncer ABSTRACT Objective: To report the main endocrine effects after cancer treatment in children and adolescents and associate them to the disease and its treatment. Subjects and methods: Clinical and lab evaluation for endocrinopathy was performed in 320 patients after cancer therapy have been followed for six years. Results: The most prevalent endocrine late effects in patients were: 32 patients had short stature, nine of them were under growth hormone therapy. Precocious puberty was found in 14 patients, 10 of them received GnRH analog. Thyroid diseases were present in 19 patients (12 with hypothyroidism; six with thyroid nodules/cysts; one with chronic lymphocytic thyroidytis). Obesity was found in 18 patients. Six presented insipidus diabetes, five delayed puberty and three panhypopituitarism. Radiation was associated with the appearance of the aforementioned endocrinopathies. Conclusion: Ninety four of 320 (30%) patients presented endocrine late effects which emphasize the importance for these patients to be regularly followed-up in order to precociously diagnose endocrine late effects and provide them a better quality of life. Arq Bras Endocrinol Metab. 2010;54(9):819-25

We study multiplicity of constant scalar curvature metrics in products of a compact closed manifold and a compact manifold with boundary using equivariant bifurcation theory.

No abstract

No abstract

No abstract

No abstract