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Introducción: El cáncer de tiroides se posiciona como una de las neoplasias más prevalentes en Ecuador, manifestándose típicamente en la cuarta década de vida, con una mayor inciden-cia en mujeres. El subtipo histológico predominante es el papilar (CPT), y diversos estudios han evidenciado que hasta un 80% de los casos de CPT presentan la mutación BRAF. Esta mutación se ha asociado con factores de pronóstico desfavorable, como la presencia de me-tástasis ganglionares, estadíos tumorales avanzados, extensión extratiroidea y característi-cas histológicas agresivas. Además, se ha observado una relación con una mayor tasa de recurrencia y una respuesta reducida al tratamiento con yodo. Ante este contexto, esta inves-tigación se propone analizar la distribución de la mutación BRAF según características epide-miológicas e histopatológicas en pacientes con diagnóstico de cáncer papilar de tiroides en Ecuador. Materiales y métodos: Este estudio se llevó a cabo de manera descriptiva y retrospectiva, abarcando a pacientes con diagnóstico de cáncer papilar de tiroides a quienes se les practicó el análisis genético para la detección de la mutación BRAF. La muestra incluyó 106 historias clínicas que cumplían con los criterios de selección establecidos Resultados: La evaluación de las historias clínicas reveló la presencia de la mutación BRAF en el 75% de los casos. Este porcentaje fue más elevado en mujeres, individuos mayores de 45 años y residentes en áreas urbanas. Respecto a la ocupación, la mayoría de los pacientes se dedicaba a labores de limpieza y no presentaban antecedentes personales de exposición a radiación ionizante ni antecedentes oncológicos familiares. El 84% se encontraba en la etapa clínica I, y en su mayoría, la neoplasia estaba localizada en el lóbulo tiroideo derecho.Conclusión:Este análisis subraya la imperiosa necesidad de identificar los factores de riesgo vinculados con la aparición del carcinoma papilar de tiroides en la población ecuatoriana. Los resultados indican una prevalencia significativa de la mutación BRAF, lo que subraya su rele-vancia comomarcador pronóstico en esta enfermedad. Estos hallazgos pueden contribuir a una mejor comprensión de la epidemiología y la patogenia del cáncer de tiroides, así como a la mejora de las estrategias de prevención y tratamiento en el ámbito local.

Introduction: Thyroid cancer is positioned as one of the most prevalent neoplasms in Ecuador, typically manifesting in the fourth decade of life, with a higher incidence in women. The pre-dominant histological subtype is papillary carcinoma (PTC), and various studies presentshown that up to 80% of PTC cases present the BRAF mutation. This mutation has been as-sociated with unfavorable prognostic factors, such as the presence of lymph node metasta-ses, advanced tumor stages, extrathyroidal extension, and aggressive histologicalfeatures. Additionally, a correlationhas been observed with a higher recurrence rate and a reduced re-sponse toiodine treatment. Given this context, this research aims to analyze the distribution of the BRAF mutation according to epidemiological and histopathological characteristics in patients diagnosed with papillary thyroid cancer in Ecuador. Materials and methods: This retrospective descriptive study involved the analysis of genetic data from 106 medical records of patients diagnosed with papillary thyroid cancer who under-went BRAF mutation detection. The sample was selected based on established criteria. Results: Evaluation of medical records revealed the presence of the BRAF mutation in 75% of cases. This percentage was higher in women, individuals over 45 years of age, and residents in urban areas. Regarding occupation, most patients were dedicated to cleaning work and had no personal history of exposure to ionizing radiation orafamily history of cancer.Additionally, 84% of the patients were in clinical stage I and the neoplasmswerelocated in the right thyroid lobe.Conclusion: This analysis highlights the urgent need to identify risk factors linked to the ap-pearance of papillary thyroid carcinoma in the Ecuadorian population. The results indicate a significant prevalence of the BRAF mutation, underlining its relevance as a prognostic marker in this disease. These findings may contribute to a better understanding of the epidemiology and pathogenesis of thyroid cancerleadingtoimprovementsinprevention and treatment strategies at the local level.

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As neoplasias endócrinas múltiplas (NEM) são síndromes genéticas autossômicas dominantes implicadas no desenvolvimento de neoplasias benignas ou malignas, envolvendo ao menos duas glândulas endócrinas. Entre seus subtipos, está a NEM2A, que consiste em carcinoma medular de tireoide (CMT), feocromocitoma e hiperparatireoidismo. Este texto apresente o relato de caso de um paciente de 40 anos, previamente hígido, que passou a apresentar episódios de cefaleia associada a sudorese profusa, vômitos e taquicardia. Evoluiu com distensão abdominal intensa após alimentação por via oral, perda ponderal, desnutrição, astenia, obstipação, humor deprimido e picos pressóricos. Exames laboratoriais evidenciaram alterações dos hormônios tireoidianos, PTH e hormônios da adrenal. Foi levantada a suspeita clínica de NEM2A, posteriormente corroborada pelos diagnósticos anatomopatológicos de feocromocitoma e CMT, associados à presença de hiperparatireoidismo. Foi possível concluir que, a despeito de sua baixa prevalência na população geral, a NEM é uma síndrome clínica de grande relevância, tendo em vista os impactos para os pacientes e famílias acometidas. Dessa forma, é necessário que os profissionais de saúde tenham conhecimento acerca da síndrome e que o Sistema Único de Saúde (SUS) esteja apto a assistir aos pacientes portadores de NEM, possibilitando diagnóstico precoce e tratamento adequado.

Multiple endocrine neoplasias (MEN) are dominant autosomal genetic syndromes involved in the development of benign or malignant tumors in at least two endocrine glands. MEN2A is one of its subtypes, which consists of medullary thyroid carcinoma (MTC), pheochromocytoma, and hyperparathyroidism. This study reports the case of a healthy 40-year-old male patient presenting with episodes of headache associated with profuse sweating, vomiting, and tachycardia. The patient evolved with severe abdominal distension after oral feeding, weight loss, malnutrition, asthenia, constipation, depressed mood, and pressure peaks. Laboratory tests showed abnormalities in thyroid, parathyroid (PTH), and adrenal hormones ­ thus raising the hypothesis of MEN2A, which was later corroborated by the histological diagnosis of pheochromocytoma and MTC, associated with hyperparathyroidism. The results indicate that, despite its low prevalence in the general population, MEN has a great impact on affected patients and families, thus being a relevant clinical syndrome. For enabling early diagnosis and adequate treatment, health professionals must be familiarized with such a condition, and the Brazilian Unified Health System (SUS) must be able to assist affected patients.

Las neoplasias endocrinas múltiples (NEM) son síndromes genéticos autosómicos dominantes involucrados en el desarrollo de neoplasias benignas o malignas, que afectan al menos dos glándulas endocrinas. Entre sus subtipos se encuentra NEM2A, que consiste en carcinoma medular de tiroides (CMT), feocromocitoma e hiperparatiroidismo. Este es un reporte de caso de un paciente de 40 años de edad, previamente sano, que comenzó a presentar episodios de cefalea asociada a sudoración profusa, vómitos y taquicardia. Evolucionó con distensión abdominal severa después de alimentarse, pérdida de peso, desnutrición, astenia, estreñimiento, estado de ánimo deprimido y picos de presión. Las pruebas de laboratorio mostraron alteraciones en las hormonas tiroideas, PTH y hormonas suprarrenales. Se planteó la hipótesis de MEN2A, posteriormente corroborada por el diagnóstico anatomopatológico de feocromocitoma y CMT, asociado a hiperparatiroidismo. Se pudo concluir que, a pesar de su baja prevalencia en la población general, el NEM es un síndrome clínico de gran relevancia, dado el impacto que tiene en los pacientes y familiares afectados. Por tanto, es necesario que los profesionales sanitarios tengan conocimiento sobre el síndrome y que el Sistema Único de Salud (SUS) sea capaz de asistir a los pacientes con NEM, posibilitándoles diagnóstico precoz y tratamiento adecuado.

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The mammary gland (MG) and female prostate are plastic reproductive organs which are highly responsive to hormones. Thus, endocrine disruptors, such as bisphenol A (BPA) and exogenous estrogens, negatively affect glandular homeostasis. In addition to previously described alterations, changes in inflammatory markers expression also trigger the development of a microenvironment that contributes to tumor progression. The current work aimed to evaluate the inflammatory responses of the MG and prostate gland to BPA (50 µg/kg) and 17-ß estradiol (35 µg/kg) exposure during the perinatal window of susceptibility. The results showed that at 6 months of age there was an increase in the number of phospho-STAT3 (P-STAT3) positive cells in the female prostate from animals perinatally exposed to 50 µg/kg BPA daily. In addition, the number of macrophages increased in these animals in comparison with nonexposed animals, as shown by the F4/80 marker. Despite an increase in the incidence of lobuloalveolar and intraductal hyperplasia, the MG did not show any difference in the expression of the four inflammatory markers evaluated: tumor necrosis factor-α, COX-2, P-STAT3, and F4/80. Analysis of both glands from the same animal led to the conclusion that exposure to endocrine disruptors during the perinatal window of susceptibility leads to different inflammatory responses in different reproductive organs. As the prostate is more susceptible to these inflammatory mechanisms, it is reasonable to affirm that possible neoplastic alterations in this organ are related to changes in the inflammatory pattern of the stroma, a characteristic that is not evident in the MG.

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We describe a pair of labial gland lobes on either side of the retrocerebral complex in the head of the Australian black field cricket, Teleogryllus commodus Walker. As the retrocerebral complex includes the corpora cardiaca and corpora allata, hormones secreted by these glands can be absorbed by these lobes. These lobes of the labial gland are connected to the thoracic lobes via a relatively long duct that enters the main duct draining the thoracic lobes. Measurement of the flow rate of dye from head to thorax in the ducts is rapid, suggesting that these glands may serve as a transport system into the thoracic region. Both serotonin and adipokinetic hormone are shown to be present in the lobes near the retrocerebral complex and the ducts of the thoracic lobes, but whether this connection between the head and thorax acts as a hormone transporter is still unclear.

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A tireoide é uma glândula endócrina que pode ser afetada por diversas lesões, que incluem doenças reativas, autoimunes e neoplásicas. Evidências mostram que a resposta imunológica, a partir da liberação de citocinas inflamatórias por células imunes e não imunes, desempenha um importante papel no desenvolvimento de diversas doenças. Dentre essas citocinas, destacam-se a IL-17 e a IL-23, as quais têm sido associadas à resposta Th17 e patogênese de diversas doenças tireoidianas. Dessa forma, esta pesquisa teve como objetivo avaliar a imunoexpressão das proteínas IL-17 e IL-23 em carcinomas papilíferos de tireoide (CPTs), adenomas foliculares (AFs), bócios coloides (BCs) e tireoidites de Hashimoto (THs) (isoladas e associadas a CPTs ou BCs), com o intuito de compreender melhor a atuação destas citocinas nestas entidades. A amostra foi composta por 30 casos de CPTs, 10 AFs, 15 BCs e 15 THs. A análise da imunoexpressão das proteínas nas células foliculares/tumorais foi realizada semiquantitativamente em toda extensão das lesões, as quais foram classificadas em três escores: 1 (≤ 33%), 2 (> 33% ­ 66%) e 3 (> 66%). Para a avaliação dos linfócitos imunopositivos, foram selecionados cinco campos com maior quantidade de linfócitos positivos, onde foi realizada a contagem. Os dados foram submetidos à análise estatística por meio dos testes de Kruskal-Wallis (KW), Mann-Whitney (U) e Spearman (r), com o nível de significância estabelecido em 5% (p < 0,05). Na análise da IL-17 entre as lesões, foi verificada maior imunoexpressão pelos linfócitos nas THs comparado aos AFs e BCs (p=0,041 e p=0,013). Na avaliação da IL-23 foi constatada uma maior imunomarcação das células foliculares/tumorais nas THs em relação aos CPTs (p=0,002), assim como, observou-se uma maior expressão desta citocina nos linfócitos das THs em comparação aos CPTs, AFs e BCs (p=0,001; p=0,023 e p=0,003). Além disso, foram observadas nas THs correlações estatisticamente significativas entre a imunoexpressão da IL-17 e IL-23 tanto nas células foliculares/tumorais, como nos linfócitos (r=0,539; p=0,038 e r=0,522; p=0,046). Sugere-se que a IL-17 e IL-23 influenciam a patogênese destas lesões tireoidianas e que em algumas delas, represente atuação da resposta Th17 (AU).

The thyroid is an endocrine gland that can be affected by several lesions, including reactive, autoimmune and neoplastic diseases. Evidence shows that the immune response, from the release of inflammatory cytokines by immune and non-immune cells, plays an important role in the development of several diseases. Among these cytokines, IL-17 and IL-23 stand out, which have been associated with the Th17 response and pathogenesis of several thyroid diseases. Hence, this research aimed to evaluate the immunoexpression of IL-17 and IL-23 proteins in papillary thyroid carcinomas (PTCs), follicular adenomas (FAs), colloid goiters (CGs) and Hashimoto's thyroiditis (HTs) (isolated and associated with PTCs or GCs), in order to better understand the role of these cytokines in these entities. The sample consisted of 30 cases of PTCs, 10 FAs, 15 CGs and 15 HTs. The analysis of protein immunoexpression in follicular/tumor cells was semiquantitatively performed in all lesions, which were classified into three scores: 1 (≤ 33%), 2 (> 33% - 66%) and 3 (> 66%). For the evaluation of immunopositive lymphocytes, five fields with the greater number of positive lymphocytes were selected, where the count was performed. The data were submitted to statistical analysis using the Kruskal-Wallis (KW), Mann-Whitney (U) and Spearman (r) tests, with the significance level set at 5% (p < 0,05). In the analysis of IL-17 between lesions, a higher immunoexpression was verified in the HT lymphocytes compared to FAs and CGs (p=0.041 and p=0.013). In the evaluation of IL-23, a higher immunostaining of follicular/tumor cells in HTs was detected in relation to PTCs (p=0.002), as well as, a greater expression of this cytokine was observed in the lymphocytes of HTs compared to PTCs, FAs and CGs (p=0.001; p=0.023 and p=0.003). In addition, statistically significant correlations between the immunoexpression of IL17 and IL-23 were observed in both follicular/tumor cells and lymphocytes (r=0.539; p=0.038 and r=0.522; p=0.046). It is therefore suggested that IL-17 and IL-23 influence the pathogenesis of these thyroid lesions and that in some of them, they represent the Th17 response (AU).

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O aparelho genital da fêmea canina está constituído por várias estruturas ou órgãos de função complexa. A fertilidade da fêmea está vinculada ao seu correto funcionamento. Diferentes aspectos relacionados a disfunções e alterações temporárias ou permanentes do sistema reprodutivo em cadelas permanecem sem explicação. O interesse clínico na compreensão e na resolução dessas questões é importante para assegurar a saúde geral e reprodutiva dos animais acometidos. Uma alteração facilmente identificada em ginecologia canina é o sangramento observado através da vagina. Muitas vezes, o sangramento, que varia em intensidade, podendo ser classificado como hemorragia nas situações de profusão, é o resultado de uma patologia genuína genital. Em outros casos, o sangramento é o resultado de uma disfunção sistêmica e/ou endócrina. O diagnóstico se baseia no histórico, na anamnese e nos achados clínicos, associado a exames complementares.

The female dog genital tract consists of several structures or organs with complex functions. The fertility of the female is linked to its correct functioning. Different aspects related to dysfunctions and temporary or permanent alterations of the reproductive system in bitches remain unexplained. The clinical interest in understanding and solving these issues is important to ensure the general and reproductive health of the affected animals. An easily identified change in canine gynecology is the bleeding observed through the vagina. Often, bleeding, which varies in intensity, and can be classified as hemorrage in situations of profusion, is the result of a genuine genital pathology. In other cases, bleeding is the result of a systemic and/or endocrine dysfunction. The diagnosis is based on the history, anamnesis and clinical findings associated with complementary tests.

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O aparelho genital da fêmea canina está constituído por várias estruturas ou órgãos de função complexa. A fertilidade da fêmea está vinculada ao seu correto funcionamento. Diferentes aspectos relacionados a disfunções e alterações temporárias ou permanentes do sistema reprodutivo em cadelas permanecem sem explicação. O interesse clínico na compreensão e na resolução dessas questões é importante para assegurar a saúde geral e reprodutiva dos animais acometidos. Uma alteração facilmente identificada em ginecologia canina é o sangramento observado através da vagina. Muitas vezes, o sangramento, que varia em intensidade, podendo ser classificado como hemorragia nas situações de profusão, é o resultado de uma patologia genuína genital. Em outros casos, o sangramento é o resultado de uma disfunção sistêmica e/ou endócrina. O diagnóstico se baseia no histórico, na anamnese e nos achados clínicos, associado a exames complementares.(AU)

The female dog genital tract consists of several structures or organs with complex functions. The fertility of the female is linked to its correct functioning. Different aspects related to dysfunctions and temporary or permanent alterations of the reproductive system in bitches remain unexplained. The clinical interest in understanding and solving these issues is important to ensure the general and reproductive health of the affected animals. An easily identified change in canine gynecology is the bleeding observed through the vagina. Often, bleeding, which varies in intensity, and can be classified as hemorrage in situations of profusion, is the result of a genuine genital pathology. In other cases, bleeding is the result of a systemic and/or endocrine dysfunction. The diagnosis is based on the history, anamnesis and clinical findings associated with complementary tests.(AU)

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Circadian clocks impose daily periodicities to animal behavior and physiology. At their core, circadian rhythms are produced by intracellular transcriptional/translational feedback loops (TTFL). TTFLs may be altered by extracellular signals whose actions are mediated intracellularly by calcium and cAMP. In mammals these messengers act directly on TTFLs via the calcium/cAMP-dependent transcription factor, CREB. In the fruit fly, Drosophila melanogaster, calcium and cAMP also regulate the periodicity of circadian locomotor activity rhythmicity, but whether this is due to direct actions on the TTFLs themselves or are a consequence of changes induced to the complex interrelationship between different classes of central pacemaker neurons is unclear. Here we investigated this question focusing on the peripheral clock housed in the non-neuronal prothoracic gland (PG), which, together with the central pacemaker in the brain, controls the timing of adult emergence. We show that genetic manipulations that increased and decreased the levels of calcium and cAMP in the PG caused, respectively, a shortening and a lengthening of the periodicity of emergence. Importantly, knockdown of CREB in the PG caused an arrhythmic pattern of eclosion. Interestingly, the same manipulations directed at central pacemaker neurons caused arrhythmicity of eclosion and of adult locomotor activity, suggesting a common mechanism. Our results reveal that the calcium and cAMP pathways can alter the functioning of the clock itself. In the PG, these messengers, acting as outputs of the clock or as second messengers for stimuli external to the PG, could also contribute to the circadian gating of adult emergence.

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Amphibians inhabiting montane riparian zones in the Neotropics are particularly vulnerable to decline, but the reasons are poorly understood. Because environmental contaminants, endocrine disruption, and pathogens often figure prominently in amphibian declines it is imperative that we understand how these factors are potentially interrelated to affect montane populations. One possibility is that increased precipitation associated with global warming promotes the deposition of contaminants in montane regions. Increased exposure to contaminants, in turn, potentially elicits chronic elevations in circulating stress hormones that could contribute to montane population declines by compromising resistance to pathogens and/or production of sex steroids regulating reproduction. Here, we test this hypothesis by examining contaminant levels, stress and sex steroid levels, and nematode abundances in male drab treefrogs, Smilisca sordida, from lowland and montane populations in Costa Rica. We found no evidence that montane populations were more likely to possess contaminants (i.e., organochlorine, organophosphate and carbamate pesticides or benzidine and chlorophenoxy herbicides) than lowland populations. We also found no evidence of elevational differences in circulating levels of the stress hormone corticosterone, estradiol or progesterone. However, montane populations possessed lower androgen levels, hosted more nematode species, and had higher nematode abundances than lowland populations. Although these results suggested that nematodes contributed to lower androgens in montane populations, we were unable to detect a significant inverse relationship between nematode abundance and androgen level. Our results suggest that montane populations of this species are not at greater risk of exposure to contaminants or chronic stress, but implicate nematodes and compromised sex steroid levels as potential threats to montane populations.

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Contexto: el melasma es una dermatosis frecuente en el país; predomina en mujeres. A nivel mundial existe limitada y controversial información sobre la relación entre melasma y la autoinmunidad tiroidea; en el país no existen estudios sobre esta asociación. Si fuera el caso, pacientes con melasma tendrían un alto riesgo de padecer patologías tiroideas. Objetivo: caracterizar la asociación entre melasma y autoinmunidad tiroidea en mujeres mayores de 18 años. Diseño: estudio transversal, en mujeres mayores a 18 años de edad que acuden a consulta externa del servicio de Dermatología del Hospital San Francisco de Quito, perteneciente al Instituto Ecuatoriano de Seguridad Social IESS, en el periodo abril 2014-junio 2015, diagnosticadas de melasma. Mediciones principales: la información fue obtenida de la historia clínica electrónica de cada paciente y una entrevista personal; luego se obtuvieron muestras biológicas para determinar la presencia de anticuerpo antitiroperoxidasa, antitiroglobulina y hormona estimulante de tiroides en sangre. La asociación entre las titulaciones de anticuerpos, severidad y etiología de melasma se estimó mediante regresión logística. Resultados: el 47,17% de mujeres presentó algún trastorno tiroideo; son más prevalentes las pacientes eutiroideas con anticuerpos positivos. El 19,8% presentó titulaciones de TPO-Ac positivas mientras que el 25,5% tiene niveles positivos de TG-Ac; al comparar los resultados de este estudio con reportes disponibles, existe una mayor titulación de estos dos anticuerpos en pacientes con melasma, comparado con la población que no presenta esta dermatosis. Conclusión: no se encontró asociación estadística entre melasma y titulaciones de anticuerpos antitiroideos, sin embargo, se encontró una elevada proporción de anticuerpos incluso superior a la reportada en poblaciones sanas, siendo esta diferencia estadísticamente significativa para TG-Ac. (AU)

Context: Melasma is a common dermatosis in the country; predominates in women. Globally there is limited and controversial information on the relationship between melasma and thyroid autoimmunity. In the country there are no studies on this association. If it were the case, patients with melasma would have a high risk of suffering thyroid pathologies. Objective: to characterize the association between melasma and thyroid autoimmunity in women older than 18 years. Material and methods: cross-sectional study in women older than 18 years of age who attend an outpatient clinic of the Dermatology Service of the Hospital San Francisco de Quito, belonging to the Ecuadorian Institute of Social Security IESS, in the period April 2014-June 2015, diagnosed as melasma . Main measurements: information was obtained from the electronic medical record of each patient and a personal interview; then biological samples were obtained to determine the presence of antithyroperoxidase antibody, antithyroglobulin and thyroid stimulating hormone in blood. The association between antibody titers, severity and etiology of melasma was estimated by logistic regression. Results: 47.17% of women presented with thyroid disorder; euthyroid patients with positive antibodies are more prevalent. 19.8% had positive TPO-Ac titers while 25.5% had positive levels of TG-Ac. When comparing the results of this study with available reports, there is a greater titration of these two antibodies in patients with melasma, compared to the population that does not present this dermatosis. Conclusion: No statistical association was found between melasma and antithyroid antibody titres. However, a high proportion of antibodies were found to be even higher than that reported in healthy populations, and this difference was statistically significant for TG-Ac.(AU)

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