Thyroid hormone resistance syndrome is characterized by a reduced target tissue response to the action of thyroid hormone, which leads to high levels of free thyroxine and free triiodothyronine with non-suppressed levels of thyrotropin (TSH). Recently, three cases of papillary thyroid carcinoma associated with thyroid hormone resistance syndrome were published. The main challenge in this situation is the difficulty of maintaining the suppression of TSH levels without producing symptoms of hyperthyroidism. We present another case of an association of thyroid hormone resistance syndrome and papillary thyroid carcinoma, and we share our experience with 3,5,3'-triiodothyroacetic acid, which made possible an easier management of the carcinoma after surgery, maintaining the TSH levels suppressed despite the resistance to thyroid hormones.

Continuous glucose monitors (CGM) have improved the management of patients with type 1 diabetes (T1D), with glucose oxidase (GOx)-based sensors being the most used. However, they are potentially subject to both electrochemical and enzymatic interferences, including those related to changes of pH. The objective of this study is to investigate the effect of ethanol, given as beer along with a mixed meal, on the accuracy of a commercial GOx-CGM. Data from 12 T1D participants in a randomized crossover trial to evaluate the effect of meal composition and alcohol consumption on postprandial glucose concentration were used. Absolute error (AE) and mean absolute relative difference (MARD) were calculated. The differences between the alcohol and nonalcohol scenarios were assessed using the Mann–Whitney U and Wilcoxon signed-rank tests. The AE in the alcohol study was low, but significantly greater as compared to the study without alcohol (p-value = 0.0418). The MARD was numerically but not significantly greater. However, both variables were greater at pH < 7.36 and significantly affected by time only in the alcohol arm. In T1D, alcohol consumption affects the accuracy of a GOx-CGM. This effect could be at least partially related to the ethanol-induced changes in pH.

Introduction: Craniopharyngiomas are benign epitelial tumors located in the suprasellar region and they are associated to several comorbidities. Our aim is to describe hormonal deficiency and complications after surgery. Design: Descriptive study of patients that underwent surgery of craniopharyngioma. Data collected included hormonal levels, clinical data and mortality. Quantitative variables with normal distribution are shown as mean and standard deviation and non-normal distribution variables are shown as median and quartiles. Qualitative variables are shown as percentage. Results: 28 patients were researched (53.6% were men), ten of them were diagnosed in childhood with mean age of 47.9 (19.1) years old. Median age at diagnosis was 40 years old (11.5–62.5) and the median of follow-up was 7 years (2.3–15.5). At the time of diagnosis, patients presented visual defects (92.5%), headache (53.8%), polyuria and polydipsia (36.4%), behavior disorders (26.9%), small stature (7.7%), paresthesia (4%) and pubertal development delay (3.8%). The median of the tumor size was 30 mm (28–40). 64% of the tumors extended to the sellar region and 76.9% of the tumors spread out other cerebral regions. After surgery, all patients presented hormonal deficiency: TSH deficiency (100%), ACTH deficiency (96.3%), diabetes insipidus (88.9%), gonadotropin deficiency (88.9%) and GH deficiency (65.4%). After surgery, 18.8% of patients presented an improvement of visual defects. After 5 years of follow-up, the mortality was 17.4%. One patient died few days after surgery. Deceased patients were older at the time of diagnosis of craniopharyngioma (a difference of 28.8 years (CI 95%: 15.6–42.6)) and they presented a bigger tumor size (a difference of 33 mm (13) (NS). Conclusion: In our study, patients that underwent surgery of craniopharyngioma presented partial hypopituitarism (46.1% of cases) and being absolute hypopituitarism in 53.8% of patients.