The Influence of SARS-CoV-2 Infection on the Thyroid Gland.

It is important to acknowledge the impact that COVID-19 has on the thyroid gland and how the thyroid gland status before and during infection affects SARS-CoV-2 severity. To this day those dependencies are not fully understood. It is known that the virus uses angiotensin-converting enzyme-2 as the receptor for cellular entry and it can lead to multiple organ failures due to a cytokine storm. Levels of proinflammatory molecules (such as cytokines and chemokines) which are commonly elevated during infection were significantly higher in observed SARS-CoV-2-positive patients. In terms of hypothyroidism, hyperthyroidism, and autoimmune thyroid diseases, there is no proof that those dysfunctions have a direct impact on the more severe courses of COVID-19. Regarding hyper- and hypothyroidism there was no consequential dependency between the frequency of SARS-CoV-2 infection morbidity and more severe post-infectious complications. When it comes to autoimmune thyroid diseases, more evaluation has to be performed due to the unclear relation with the level of antibodies commonly checked in those illnesses and its binding with the mentioned before virus. Nonetheless, based on analyzed works we found that COVID-19 can trigger the immune system and cause its hyperactivity, sometimes leading to the new onset of autoimmune disorders. We also noticed more acute SARS-CoV-2 courses in patients with mainly reduced free triiodothyronine serum levels, which in the future, might be used as a mortality indicating factor regarding SARS-CoV-2-positive patients. Considering subacute thyroiditis (SAT), no statistically important data proving its direct correlation with COVID-19 infection has been found. Nevertheless, taking into account the fact that SAT is triggered by respiratory tract viral infections, it might be that SARS-CoV-2 can cause it too. There are many heterogenous figures in the symptoms, annual morbidity distribution, and frequency of new cases, so this topic requires further evaluation.

The Current Approach to the Diagnosis and Classification of Mirizzi Syndrome.

Mirizzi syndrome occurs in up to 6% of patients with cholecystolithiasis. It is generally caused by external compression of the common hepatic duct by a gallstone impacted in the neck of the gallbladder or the cystic duct, which can lead to fistulisation. The aim of this review was to highlight the proposed classifications for Mirizzi syndrome (MS) and to provide an update on modern approaches to the diagnosis of this disease. We conducted research on various internet databases and the total number of records was 993, but after a gradual process of elimination our final review consisted of 21 articles. According to the literature, the Cesendes classification is the most commonly used, but many new suggestions have appeared. Our review shows that the ultrasonography (US) is the most frequently used method of initial diagnosis, despite still having only average sensitivity. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) are good methods and are similarly effective, but only the latter can be simultaneously therapeutic. Some modern methods show very high sensitivity, but are not so commonly administered. Mirizzi syndrome is still a diagnostic challenge, despite the advancement of the available tools. Preoperative diagnosis is crucial to avoid complications during treatment. New research may bring a unification of classifications and diagnostic algorithms.

High progesterone levels are associated with family history of premature coronary artery disease in young healthy adult men.

BACKGROUND & AIMS: The offspring of patients with premature coronary artery disease (P-CAD) are at higher risk for cardiovascular disease, compared with subjects without a family history (FH) of P-CAD. The increased risk for cardiovascular disease in subjects with FH of early-onset CAD results from unfavorable genetic variants as well as social, behavioral and environmental factors, which are more prevalent in this group. Previous studies have shown that specific sex hormone levels may be associated with the risk of cardiovascular disease. The aim of this study was to compare wide range of biochemical marker levels including i.e. the levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone, estradiol, testosterone and sex-hormone binding globulin (SHBG) between young healthy male adults with and without FH of P-CAD. METHODS: The study group consisted of young healthy Polish male adults enrolled in a MAGNETIC case-control study, who were recruited between July 2015 and October 2017. The inclusion criteria were as follows: male sex, age ≥18 and ≤35 years old, FH of P-CAD (cases) or no P-CAD in first-degree relatives (controls). The comparison of continuous and categorical variables was performed using the Student's t-test or the U-Mann-Whitney test, and Fisher's exact test, respectively. The correlations between FSH, LH, testosterone, progesterone, SHBG and other laboratory parameters were assessed using the Spearman rank correlation test. Both univariable and multivariable logistic regression analyses were performed to assess the association between analyzed variables and FH of P-CAD. RESULTS: A total of 411 subjects (223 cases and 188 controls) were included in the study. There was a higher prevalence of major cardiovascular risk factors in subjects with FH of P-CAD (smoking, higher total and LDL cholesterol levels, higher body mass index and lower HDL cholesterol level). Moreover, the offspring of patients with P-CAD had lower SHBG level, and higher LH and progesterone levels in the crude comparison, compared with individuals without FH of P-CAD. After adjustment for confounding variables, progesterone and LH were determined to be independently associated with FH of P-CAD. CONCLUSION: Progesterone and LH levels are significantly associated with FH of P-CAD, independent of traditional risk factors for CAD.

Novel inflammatory biomarkers may reflect subclinical inflammation in young healthy adults with obesity.

INTRODUCTION: Obesity is often accompanied by low-grade inflammation. In recent years a few blood-based inflammatory markers - neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and monocyte-to-high-density lipoprotein ratio (MHR) - have been identified. They have been proven to correlate well with established inflammatory markers such as hsCRP and have a prognostic value among others in patients with coronary artery disease, heart failure, and malignancies. The aim of the study was to find markers associated with obesity in young heathy adults. MATERIAL AND METHODS: The study group included 321 young healthy adults aged 18-35 years (210 males and 111 females). Partial least squares regression analysis was used to find variables associated with body mass index (BMI), except MHR. Analysed variables included complete blood count, lipid profile, sex hormone levels, acute-phase protein levels, and blood-based inflammatory markers. RESULTS: Variables with the strongest association with BMI in the group of men were HDL% and apolipoprotein B, and in the group of women, HDL, HDL%, triglycerides, and MHR. Novel inflammatory markers were not associated with BMI. We found significant (p < 0.001) correlations between novel biomarkers (NLR, dNLR) and hsCRP and fibrinogen levels in the group of subjects with obesity. CONCLUSIONS: Blood-based inflammatory markers significantly correlate with hsCRP and fibrinogen in young healthy adults with obesity, which may reflect the subclinical inflammation in this group of individuals.

Family History of Premature Coronary Artery Disease (P-CAD)-A Non-Modifiable Risk Factor? Dietary Patterns of Young Healthy Offspring of P-CAD Patients: A Case-Control Study (MAGNETIC Project).

Dietary habits of healthy offspring with a positive family history of premature coronary artery disease (P-CAD) have not been studied so far. The aim of this study was twofold: (1) to identify dietary patterns in a sample of young healthy adults with (cases) and without (controls) family history of P-CAD, and (2) to study the association between dietary patterns and family history of P-CAD. The data came from the MAGNETIC case-control study. The participants were healthy adults aged 18⁻35 years old, with (n = 351) and without a family history of P-CAD (n = 338). Dietary data were collected with food frequency questionnaire FFQ-6. Dietary patterns (DP) were derived using principal component analysis (PCA). The associations between the adherence to DPs and family history of P-CAD were investigated using logistic regression. Two models were created: crude and adjusted for age, sex, smoking status, place of residence, financial situation, education, and physical activity at leisure time. Three DPs were identified: 'prudent', 'westernized traditional' and 'dairy, breakfast cereals, and treats'. In both crude and adjusted models, subjects with family history of P-CAD showed higher adherence by 31% and 25% to 'westernized traditional' DP (odds ratio (OR) 1.31, 95% confidence interval (95% CI): 1.12⁻1.53; p < 0.005; per 1 unit of standard deviation (SD) of DP score and adjOR 1.25, 95% CI: 1.06⁻1.48; p = 0.007; per 1 unit of SD of DP score, respectively). Young healthy adults with family history of P-CAD present unfavorable dietary patterns and are potentially a target group for CAD primary prevention programs.

(137)Cs, (40)K and (210)Po in marine mammals from the southern Baltic Sea.

This study provides information on baseline concentrations of the radionuclides Cesium-137, Potassium-40 and Polonium-210 in sea mammals from the Baltic Sea. The radionuclides were analyzed in the liver, kidney and muscle of harbor porpoises, striped dolphins, and gray and ringed seals from the Polish coast by γ- and α-spectrometry. Median (137)Cs activities were 14.8, 13.2 and 23.2 Bq kg(-1) w.w. in the liver, kidney and muscles, respectively. Activities of (40)K and (210)Po in the respective tissues were found to be 79.1, 79.8 and 111 Bq kg(-1) for (40)K and 58.1, 59.2 and 32.9 Bq kg(-1) for (210)Po. The measured (137)Cs concentrations were extraordinarily high in comparison to those reported in sea mammals from other locations. However, dose assessments did not imply health effects from (137)Cs exposure in Baltic Sea mammals. Correlations between (137)Cs tissue activities and reported sea water concentrations highlight the potential use of marine mammals for biomonitoring purposes.

Distribution and relationships of trace metals in the isopod Saduria entomon and adjacent bottom sediments in the southern Baltic.

The concentrations of Ag, Cd, Co, Cr, Cu, Fe, Ni, Pb, Mn and Zn in Saduria entomon and adjacent bottom sediments from the southern Baltic were determined by FAAS. In order to estimate the strength of correlations between accumulated elements in these crustaceans and surficial sediment, bioaccumulation factors (BAFs) were calculated. The results of factor analysis (FA) and the Kruskal-Wallis analysis of variance (ANOVA) clearly indicate geographical differences between the concentrations of these elements. Cd, Co, Fe, Ni, Pb and Zn levels were higher in S. entomon from the Gulf of Gdansk, whereas Cr and Mn levels were higher in the crustaceans inhabiting open Baltic waters. The concentrations of Ag and Cu were comparable in both regions. There was a tendency for metal concentrations to distinguish organisms inhabiting the muddy bottom from those living in sandy sediments. The granulometric composition of the sediment appears to influence trace metal bioavailability. The results show that S. entomon could be a valuable sentinel organism for biomonitoring heavy metal contamination in the southern Baltic.