Thyroid function in Klinefelter syndrome: a multicentre study from KING group.

PURPOSE: The prevalence and the etiopathogenesis of thyroid dysfunctions in Klinefelter syndrome (KS) are still unclear. The primary aim of this study was to evaluate the pathogenetic role of hypogonadism in the thyroid disorders described in KS, with the scope to distinguish between patients with KS and hypogonadism due to other causes (Kallmann syndrome, idiopathic hypogonadotropic hypogonadism, iatrogenic hypogonadism and acquired hypogonadotropic hypogonadism after surgical removal of pituitary adenomas) called non-KS. Therefore, we evaluated thyroid function in KS and in non-KS hypogonadal patients. METHODS: This is a case-control multicentre study from KING group: Endocrinology clinics in university-affiliated medical centres. One hundred and seventy four KS, and sixty-two non-KS hypogonadal men were enrolled. The primary outcome was the prevalence of thyroid diseases in KS and in non-KS. Changes in hormonal parameters were evaluated. Exclusion criterion was secondary hypothyroidism. Analyses were performed using Student's t test. Mann-Whitney test and Chi-square test. RESULTS: FT4 was significantly lower in KS vs non-KS. KS and non-KS presented similar TSH and testosterone levels. Hashimoto's thyroiditis (HT) was diagnosed in 7% of KS. Five KS developed hypothyroidism. The ratio FT3/FT4 was similar in both groups. TSH index was 1.9 in KS and 2.3 in non-KS. Adjustment for differences in age, sample size and concomitant disease in multivariate models did not alter the results. CONCLUSIONS: We demonstrated in KS no etiopathogenic link to hypogonadism or change in the set point of thyrotrophic control in the altered FT4 production. The prevalence of HT in KS was similar to normal male population, showing absence of increased risk of HT associated with the XXY karyotype.

[The echotomographic assessment of the thyroid bed in thyroidectomized subjects]. / Valutazione ecotomografica della loggia tiroidea nei soggetti tiroidectomizzati.

This study was aimed at evaluating the US anatomy of the postoperative thyroid bed. Fifteen normal patients (group A), 25 thyroidectomized patients (group B), and 2 patients with thyroid agenesis (group C) were evaluated by means of high-resolution real-time US. The examinations were performed with a 7.5 MHz small-parts linear transducer on the transverse, longitudinal, and oblique planes. Twenty-one patients in group B underwent subtotal thyroidectomy for multinodular goiter, 2 patients underwent an almost total thyroidectomy for Basedow's disease, and 2 patients were submitted to total thyroidectomy for papillary carcinoma. The most typical finding observed in group B was the close apposition of both carotid artery and jugular vein to the trachea. This finding was not observed in the patients in group C. No clear identification of parathyroid glands and of laryngeal nerves was possible in the patients in group B.

'Water-test': a simple method to assess sperm-membrane integrity.

The functional integrity of the membrane of sperm from semen samples collected from 10 fertile men (Group A) and from 50 infertile men (Group B) was assessed by studying the swelling reaction of sperm when suspended in a medium of distilled water ('Water-test'). The results were correlated with routine semen-analysis and with the results of Eosin-Y staining. The mean values for the 'Water-test' were significantly different (P less than 0.01) between Groups A and B (84.8 +/- 3.5 versus 70.9 +/- 13.3, respectively). No significant correlations were observed in either Group A or B, between values for the 'Water-test' and values for the sperm count, the percentage of sperm with normal morphology and the percentage of motile sperm. There was a good correlation in both Group A (r = 0.86, P less than 0.01) and Group B (r = 0.92, P less than 0.01) between values for the 'Water-test' and those for the Eosin-Y test. These results indicate that the 'Water-test' is a simple and reliable test for evaluating sperm membrane integrity.

[Thucydides' syndrome]. / La sindrome di Tucidide.

The epidemic that broke out in Athens during the Peloponnesian War was certainly one of the biggest disasters described in the history of mankind. In the past numerous scholars have unsuccessfully attempted to identify the aetiological agent of the plague. Two new hypotheses have also recently been put forward but do not fully clarify all the diverse aspects of the plague whose aetiopathogenesis apparently remains a still unsolved problem.