Juliana Oliveira

Vifor Pharma (Switzerland)

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Júlio Abucham

Universidade Federal de São Paulo

Rita de Cassia Castro

Escola Superior de Saúde Egas Moniz

Pablo Lapuerta

Lexicon Pharmaceuticals (United States)

Paul Strumph

Lexicon Pharmaceuticals (United States)

John A. Stewart

Sanofi (Canada)

Helena W. Rodbard

University of Colorado Colorado Springs

Michael S. Anger

Fresenius Medical Care (United States)

Andrea Giaccari

Università Cattolica del Sacro Cuore

Oswaldo L. Bracco

Merck & Co., Inc., Rahway, NJ, USA (United States)

Rosemarie Lajara

Plano Cancer Institute

Cooperative Institutions

Eli Lilly (United States)

Universidade Federal de São Paulo

Sanofi (United States)

Universidade do Porto

Associação Paulista de Medicina

Hospital de São João

Universidade de São Paulo

Ibero American University

University of Toronto

Centro Hospitalar do Porto

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Association of CKD-Associated Pruritus (CKDaP) with More Sleep Disorders, Increased Pain, and Worse Fatigue in US Hemodialysis Patients

Journal of the American Society of Nephrology (2023)

Tejas Desai Rachel Lasky Kunal Malhotra Hans-Juergen Arens Juliana H. Oliveira

Sleep

10.1681/asn.20233411b11c

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1191-P: Sotagliflozin Reduces Glucose Variability and Risk for Hyperglycemia in Adults with Type 1 Diabetes

Diabetes (2019)

Boris Kovatchev Stella Wang Juliana H. Oliveira John A. Stewart Pablo Lapuerta

Individuals with type 1 diabetes (T1D) face daily challenges in achieving optimal glycemic control by reducing hyperglycemia while avoiding hypoglycemia. Optimization is reflected by the High/Low Blood Glucose Indices (HBGI/LBGI) - established metrics using self-monitored blood glucose, or continuous glucose monitoring (CGM) data, to assess glycemic variability (GV) and predict the risks of hyper- and hypoglycemia with intensification of therapy. In the phase 3 inTandem1 and 2 studies, sotagliflozin (SOTA), a dual SGLT1 and 2 inhibitor used as adjunct to optimized insulin therapy in adults with T1D, reduced HbA1c vs. placebo. Significant improvement of glucose time in range (70-180 mg/dL) without increasing time <70 mg/dL was previously reported in the pooled CGM substudy. In this analysis (N=265), we evaluated hyper- and hypoglycemic risks with SOTA 200 mg and 400 mg, both taken once daily, using LBGI and HBGI computed from CGM data. Compared with placebo, HBGI values were lower with SOTA 400 mg at study weeks 4, 12, and 24, and SOTA 200 mg at weeks 4 and 12 (p<0.0001) (Figure). The percentage of adults in moderate (4.5-9) or high-risk (>9) HBGI categories was reduced with SOTA throughout the study for both dosages, and minimal changes were seen in LBGI values and risk categories. The CGM profile showed that SOTA reduced GV through a favorable impact on HBGI without changing LBGI. Disclosure B. Kovatchev: Advisory Panel; Self; Sanofi. Board Member; Self; TypeZero Technologies, Inc. Consultant; Self; Sanofi, Tandem Diabetes Care. Research Support; Self; Dexcom, Inc., Roche Diabetes Care, Tandem Diabetes Care. Speaker's Bureau; Self; Dexcom, Inc. Stock/Shareholder; Self; TypeZero Technologies, Inc. Other Relationship; Self; Johnson & Johnson, Sanofi. S. Wang: Employee; Self; Sanofi US. J.H. Oliveira: Employee; Self; Sanofi. Employee; Spouse/Partner; Sanofi. J.A. Stewart: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. P. Lapuerta: Employee; Self; Lexicon Pharmaceuticals, Inc. Stock/Shareholder; Self; Lexicon Pharmaceuticals, Inc. R. Castro: Employee; Self; Sanofi US. Funding Lexicon Pharmaceuticals, Inc.; Sanofi

Dose

10.2337/db19-1191-p

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Citations (1)

Doença de Cushing por hiperplasia corticotrófica: relato de um caso

S. R. Correa Eric J. Brunner Rogério Silicani Ribeiro T. R. Picchi Juliana H. Oliveira

Source

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Changes in serum thyroid hormones levels and their mechanisms during long‐term growth hormone (GH) replacement therapy in GH deficient children

Clinical Endocrinology (2000)

Evandro Portes Juliana H. Oliveira Paulo Henrique Galeti Maccagnan Júlio Abucham

OBJECTIVE The effects of GH therapy on thyroid function among previous reports have shown remarkable discrepancies, probably due to differences in hormone assay methods, degree of purification of former pituitary‐derived GH preparations, dosage schedules, diagnostic criteria, patient selection, duration of treatment and study design. These considerations motivated us to investigate whether and how GH replacement therapy changes serum thyroid hormone levels, including the much less studied rT3 levels, in a group of unequivocally GH‐deficient children receiving long‐term recombinant human GH therapy. PATIENTS AND DESIGN Twenty clinically and biochemically euthyroid children were studied in two therapeutic conditions: on GH replacement therapy for at least 6 months and without GH replacement, either before GH was started or after GH was withdrawn for 30–60 days. Eight patients were on thyroxine replacement treatment and thyroxine doses were kept constant during the study. Blood was collected before and after 15, 20 and 60 minutes of TRH administration in both therapeutic conditions (with GH and without GH). MEASUREMENTS Concentrations of thyroid hormone levels were determined only in sera obtained before TRH administration. FT4, T3 and TSH were measured by immunoflourimetric assays and rT2 was measured by immunoradioassay. RESULTS Patients were classified into two groups, according to basal TSH levels: group I (TSH > 0.4 mU/l, n = 12) and group II (on thyroxine and TSH < 0.05 mU/l, n = 8). In both groups, serum FT4 levels decreased (17.0 ± 1.1 vs . 14.3 ± 0.9 mU/l, P < 0.001, and 18.0 ± 1.7 vs . 14.2 ± 1.7 mU/l, P < 0.01, respectively), serum T3 levels increased (1.8 ± 0.1 vs . 2.4 ± 0.2 nmol/l, P < 0.001, and 1.9 ± 0.3 vs . 2.4 ± 0.2 nmol/l, P < 0.05, respectively), and serum rT3 levels decreased (0.35 ± 0.03 vs . 0.25 ± 0.03 nmol/l, P < 0.01, and 0.48 ± 0.06 vs . 0.34 ± 0.06 nmol/l, P < 0.01, respectively). Basal (3.2 ± 0.50 vs . 2.6 ± 0.72 mU/l, P = 0.28, paired t ‐test), TRH‐stimulated peak TSH levels (13.9 ± 5.3 vs . 15.9 ± 8.0 mU/l, P = 0.35, paired t ‐test) and TRH‐stimulated TSH secretion, expressed as area under the curve (609 ± 97 vs . 499 ± 53 mU/l.minutes −1 , P = 0.15, paired t ‐test), remained unchanged during GH replacement in group I patients. Low serum FT4 and high serum T3 levels were observed in only one patient each, but low serum rT3 levels were found in six patients (four in group I and two in group II) during GH replacement. CONCLUSIONS These results show that long‐term GH replacement therapy in children with unequivocal GHD significantly decreases serum FT4 and rT3 levels and increases serum T3 levels; that these changes are independent of TSH and result from increased peripheral conversion of T4 to T3 and that GH replacement therapy in GH deficient children does not induce hypothyroidism, but simply reveals previously unrecognized cases whose serum FT4 values fall in the low range during GH replacement.

Basal (medicine)

10.1046/j.1365-2265.2000.01071.x

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Citations (78)

Teriparatida (PTH[1-34]rh): uma nova perspectiva no tratamento da osteoporose

Acta Ortopédica Brasileira (2003)

Juliana H. Oliveira Oswaldo L. Bracco Marcia J. Kayath Roberto Guarniero

No momento, as medicações aprovadas para tratamento da osteoporose agem reduzindo a taxa de perda óssea e diminuindo a reabsorção óssea. A teriparatida é um fragmento recombinante sintético de 34 aminoácidos do hormônio paratireóide humano. A teriparatida se liga ao receptor de PTH da proteína G e estimula a formação e a ação dos osteoblastos, que são as células responsáveis pela formação dos ossos. Assim, a principal diferença entre o tratamento da osteoporose com teriparatida e o tratamento anti-reabsorção é que a teriparatida promove o crescimento de osso novo. Em estudos pré-clínicos, o uso intermitente de PTH foi associado com um aumento significativo da massa óssea gradeada em diversos locais. A exposição intermitente ao PTH durante 4 a 6 semanas em modelos de animais ovariectomizados leva a um aumento da espessura do osso gradeado. Há estudos clínicos que mostram que a teriparatida aumenta significativamente a densidade óssea e diminui a incidência de fraturas osteoporóticas vertebrais e não-vertebrais nas mulheres com osteoporose pós-menopáusica e têm risco alto de fratura, e aumenta a densidade óssea nos homens com osteoporose, tanto hipogonádica como idiopática. A teriparatida é dada por injeção subcutânea diária e foi associada com um mínimo de efeitos colaterais, além de não apresentar interações medicamentosas. Sendo assim, a teriparatida surge como uma abordagem completamente nova no tratamento da osteoporose, estimulando diretamente a formação do osso.

10.1590/s1413-78522003000300007

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Custo da fratura osteoporótica de fêmur no sistema suplementar de saúde brasileiro

Arquivos Brasileiros de Endocrinologia & Metabologia (2005)

Denizar Vianna Araújo Juliana H. Oliveira Oswaldo L. Bracco

OBJETIVO: Estimar custo direto durante hospitalização para fratura osteoporótica de fêmur no sistema privado de saúde brasileiro, pela perspectiva das empresas de planos de saúde. MÉTODOS: Estudo transversal e retrospectivo sobre custos hospitalares em pacientes acima de 50 anos com fratura osteoporótica de fêmur, entre julho 2003 e junho 2004. A amostra estudada foi extraída da base de dados de processamento eletrônico das faturas de pacientes beneficiários de planos de saúde. RESULTADOS: Houve 129.611 pacientes com diagnóstico de osteoporose. A incidência de fratura osteoporótica de fêmur foi 4,99% (mulheres). A média de permanência hospitalar foi 9,21 dias (2,13 dias na UTI). O custo médio total da hospitalização foi de R$ 24.000. O maior componente de custo foi atribuído ao material médico (61%). O impacto econômico da fratura osteoporótica de fêmur foi estimado em R$ 12 milhões. CONCLUSÃO: Os custos do tratamento da fratura osteoporótica de fêmur são consideráveis no sistema privado de saúde brasileiro. Este estudo destaca a minimização de custos para empresas de planos de saúde caso a fratura osteoporótica de fêmur possa ser evitada.

10.1590/s0004-27302005000600007

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Citations (51)

Evidence for Thyroid Hormone as a Positive Regulator of Serum Thyrotropin Bioactivity

The Journal of Clinical Endocrinology & Metabolism (2007)

Juliana H. Oliveira Erika Ribeiro Barbosa Teresa S. Kasamatsu Júlio Abucham

The regulation of TSH bioactivity in humans is not completely understood.The aim of the study was to investigate the role of serum thyroid hormones in regulating the bioactivity of TSH.We determined in vitro TSH bioactivity and glycosylation in nine patients (six females and three males, age 41.3 yr) with primary hypothyroidism before and after L-T(4) replacement, in 11 age- and sex-comparable controls (seven females and four males, age 37.6 yr), and in two thyroidectomized patients with TSH-secreting adenomas during and after L-T(4) withdrawal.In vitro TSH bioactivity was measured by a sensitive and specific bioassay based on cAMP generation by Chinese hamster ovary cells transfected with human TSH receptor. TSH glycosylation was assessed by concanavalin A lectin and ricin column affinity chromatography.In vitro TSH bioactivity in hypothyroid patients was low as compared with controls (0.48 +/- 0.1 vs. 1.1 +/- 0.2; P = 0.004) and increased during L-T(4) (0.48 +/- 0.1 vs. 0.8 +/- 0.1; P = 0.01). A strong significant correlation (r = +0.80; P = 0.004, Spearman) was observed between the absolute increments of serum TSH bioactivity and T(3) during L-T(4) replacement. The degree of sialylation was elevated in hypothyroid patients before treatment (47 +/- 2.4% vs. 29 +/- 4.3%; P = 0.002) and decreased significantly after L-T(4) (47 +/- 2.4% vs. 33 +/- 4.3%; P = 0.02). The mannose content of serum TSH in hypothyroid patients was similar to controls and did not change during L-T(4). In vitro TSH bioactivity also decreased in patients with TSH-secreting adenomas during L-T(4) withdrawal.These data indicate that serum thyroid hormone level is a positive regulator of TSH bioactivity.

Thyroid-stimulating hormone

10.1210/jc.2006-2217

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Citations (23)

Author response for "Sotagliflozin added to optimised insulin therapy leads to <scp>HbA1c</scp> reduction without weight gain in adults with type 1 diabetes: a pooled analysis of <scp>inTandem1</scp> and <scp>inTandem2</scp>"

Helena W. Rodbard Andrea Giaccari Rosemarie Lajara John Stewart Paul Strumph

10.1111/dom.14127/v2/response1

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Pacientes com osteopenia devem ser tratadas

Oswaldo L. Bracco Juliana H. Oliveira Ben‐Hur Albergaria William Habib Chahade

Osteopenia