It was recently demonstrated that treatment with levorotatory thyroxine (T4) plus triiodothyronine (T3) compared with treatment with T4 alone improves psychologic functioning in hypothyroid patients with thyroid cancer or autoimmune thyroiditis. In the present double-blind crossover study, we again compared the effects of combined thyroid replacement vs monotherapy on psychologic function, endocrine function, cardiovascular function, and body composition. The patients were women who were hypothyroid after thyroidectomy for Graves' disease. The substitution of 10 microg of T3 for 50 microg of T4 caused a statistically significant decrease in free T4 concentration but no significant change in T3 or thyroid-stimulating hormone concentration. Symptoms of hypothyroidism and of hyperthyroidism tended to decrease on a standard symptom scale after combined treatment. With combined hormone replacement, mental state tended to improve on some mood scales but not on cognitive tests. We found alterations in left ventricular diastolic function but no change in body composition after the combined treatment regimen. These preliminary findings in a small group of patients with Graves' disease are consistent with earlier findings that thyroid replacement with T4-T3 combination improves mental functioning.

Summary. The aim of this study was to evaluate leptin concentration at birth and in early

Objective: to examine cognitive functions, emotional state and quality of life of patients with Turner syndrome (TS) after growth hormone therapy discontinuation. Patients and Methods: Anthropometric measurements, cognitive functioning, emotional state and quality of life of eighteen Lithuanian patients with TS were compared to that of age-and sex-matched controls. Height and weight of girls with TS were significantly lower than in the controls, though differences in body mass index were not significant. Results: Tension-anxiety (10.61±7.21 vs. 6.72±3.98, p=0.02) and depression-dejection (14.72±11.87 vs. 8.49±6.29, p=0.02) were significantly higher, vigor-activity (13.05±4.77 vs. 16.13± 4.36, p=0.04) was significantly lower and scores of cognitive functioning (53.18±29.46 vs. 26.79±7.31 and 96.94±44.59 vs. 58.07±15.43, p=0.001) were significantly higher (showing worse psychomotoric speed)in patients with TS than in the controls. Quality of life (9.53±5.19 vs. 6.35±4.19, p=0.03) in girls with TS was significantly worse than in healthy girls of the same age. Conclusion, patients with Turner syndrome are shorter, have lower weight, higher waistto-hip ratio, impaired cognitive functions (worse psychomotoric speed), altered emotional state (higher tension-anxiety and depression-dejection, lower vigor-activity scores) and lower quality of life than age-and sex-matched controls.

Background: Correct staging of puberty is essential in order to differentiate different pathologies, as various components of the endocrine system influence breast, pubic, and axillary hair development. Aims: To determine the current timing of adrenarche and breast development in Lithuanian preadolescent schoolgirls. Methods: Cross-sectional study of 1231 schoolgirls aged 7.0-11.6 years. Puberty was staged according to the method of Tanner. Mean age at entry into each pubertal stage was calculated by probit analysis. Results: Of the 255 girls aged 7 years, two had premature adrenarche (0.8%) and one premature thelarche (0.4%). Mean age of onset of pubic/axillary hair development was 11.0 years, and for breast development (Stage 2) 10.2 years. Breast Stage 3 development was attained at 11.3 years and Stage 4 at 13.9 years. Mean BMI, height, weight, and systolic blood pressure SD scores were higher in pubertal than in prepubertal girls. Skinfold thickness was also significantly higher in girls with isolated adrenarche than in prepubertal girls. The increase in BMI and weight resulted from an increase in body fat as evidenced by measures of subscapular and triceps skinfold thickness. Girls with only signs of adrenarche or thelarche did not differ from each other from the anthropometric standpoint. Conclusions: Premature thelarche and premature adrenarche were relatively uncommon in this population. Pubertal onset was slightly earlier than the UK Tanner standards and tended to occur in girls with a higher BMI.

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