ASSOCIATION BETWEEN HASHIMOTO'S THYROIDITIS AND PAPILLARY THYROID CANCER: A SINGLE CENTER EXPERIENCE.

Purpose: To investigate the association between papillary thyroid cancer (PTC) and Hashimoto's thyroiditis (HT). Design: This study is a retrospective study that conducted during 7 consecutive years with a median 119.5 months follow-up. Subjects and Method: Patients who underwent thyroidectomy in Dokuz Eylül University Hospital during 7 consecutive years were included. Patients' demographics, biochemical, radiological, and pathological results were retrospectively assessed. Results: Four hundred sixty nine patients were evaluated. Among 469 patients who underwent thyroidectomy, 132 (28.1%) were malignant, while 182 patients were diagnosed with HT (38.8%). PTC was ranked first at 92.4% (n: 122). The prevalence of HT was 54.9% in patients with PTC and 33.1% in patients without PTC diagnosis (p<0.001). Younger age and the presence of HT were independently associated with PTC. The presence of HT was associated with increased risk of development of PTC (OR: 2.2, %95 CI: 1.4-3.5, p<0.001) but not with TNM stage or recurrence. Lymph node metastasis at presentation was the strongest predictor of recurrence (OR: 13.9, CI: 3.5-54.6, p<0.001). Conclusions: HT was an independent risk factor for development of PTC. According to our findings, HT patients (particularly with nodular HT) should be observed carefully and thyroid fine needle aspiration biopsy (TFNAB) should be encouraged if necessary.

Thermal Imaging Following Exercise in Working Dogs.

Disaster search dogs traverse diverse and unstable surfaces found in collapsed buildings. It is unknown if the physical conditioning on a treadmill involves the same muscle groups that are involved in rubble search. This 14-week prospective cohort study was conducted to investigate changes within the thermal gradients of specific dog muscles following treadmill compared to rubble search. Nine dogs, ranging in age from 6 months to 4 years, were randomly assigned to one of two groups. Each week the two groups would participate in either 20 min of treadmill or rubble searches. Prior to exercise, the dogs were weighed and then kenneled in a temperature-controlled study room for 20 min at 21°C. Pre-exercise thermal images were then captured of the standing dog from the dorsal, left and right lateral, and caudal perspectives, and of the sitting dog from the rostral perspective. Following a 10-min warm-up period of stretches, dogs proceeded to either treadmill or search. Upon completion, dogs were kenneled in the study room for 20 min prior to post-exercise thermal images. Images were sectioned into 22 muscle regions, the pre-exercise images were subtracted from the post-exercise images to determine the temperature difference (ΔT) for that dog, on that day, for that activity. Thermography measures radiant energy, temperature, and converts this information into an image. This study looked at ΔT within a region pre and post-exercise. The study failed to find a statistically significant difference in the ΔT within each muscle group between treadmill and search activities. There was a decrease in ΔT within all muscle regions over the of the study except for the right cranial shoulder, right caudal shoulder, and right hamstring for the treadmill activity only. The decrease was significant in the pelvis, left longissimus, right cranial shoulder for the search activity, left oblique, left caudal shoulder, and left quadricep muscular regions. These findings suggest that ΔT in muscle groups are similar between treadmill exercise and rubble search. Regardless of the exercise type, 14 weeks of structured Search and Rescue training and treadmill exercise resulted in less ΔT associated with a structured weekly exercise.

A possible connection between circulating 25-hydroxy-vitamin D and molecular response in chronic myeloid leukemia.

OBJECTIVE: In this study we aimed to evaluate whether there is a link between circulating 25-OH-D levels and molecular response in chronic myeloid leukemia (CML). MATERIAL AND METHOD: A total of 61 patients with CML (31 women, 30 men) were recruited in this cross-sectional study. RESULTS: Binary logistic regression analysis demonstrated that increased vitamin D levels were independently associated with molecular response in subjects with CML. CONCLUSION: Our results indicated for the first time in the literature that severe deficiency of vitamin D was independently associated with molecular unresponsiveness in subjects with CML. 25-OH-D may be contributing to molecular response in the patients (Tab. 3, Ref. 24).

Elevated circulating levels of secreted frizzled-related protein 4 in relation to insulin resistance and androgens in women with polycystic ovary syndrome.

PURPOSE: Secreted frizzled-related protein 4 (SFRP4) is an adipokine involving in apoptotic process during ovulation and energy metabolism. Polycystic ovary syndrome (PCOS) is a common reproductive and metabolic disorder associated with insulin resistance and impaired oocyte maturation as well as apoptotic dysfunctions through oocyte development. Our aim was to determine whether there was an alteration in levels of SFRP4 and if there was an association between metabolic or hormonal parameters and SFRP4 in women with PCOS. METHODS: We enrolled 80 subjects with PCOS and 80 age- and body mass index (BMI)-matched subjects with normal menstrual cycle into current case-control study. Metabolic and hormonal parameters of enrolled subjects were determined. Circulating SFRP4 levels were measured with ELISA method. RESULTS: We found that circulating SFRP4 levels were elevated in women with PCOS with respect to controls (5.87 ± 1.91 vs. 3.72 ± 1.29 ng/ml, P < 0.001). We also found a positive association between SFRP4 and insulin resistance, androgens, ovarian follicular number or ovarian volume in women with PCOS. Binary logistic regression analysis revealed that subjects with the highest tertile of SFPR4 levels displayed increased possibility of having PCOS risk compared to those subjects with the lowest tertile of SFRP4 levels. CONCLUSIONS: Increased SFRP4 levels were not only associated with higher possibility of having PCOS but also related to insulin resistance, hyperandrogenism, ovarian follicular number and ovarian volume, suggesting that SFPR4 could be a player in different pathophysiologic pathways of PCOS.

Is elevated urotensin II level a predictor for increased cardiovascular risk in subjects with acromegaly?

PURPOSE: Acromegaly is a rare disorder existed in the result of overproduction of growth hormone (GH). The disorder is associated with increased cardiovascular risk factors and metabolic abnormalities. Urotensin II (UII), a secreted vasoactive peptide hormone, belonging somatostatin superfamily, plays an essential role in atherosclerosis and glucose metabolism. The aim of this study was to ascertain whether circulating UII levels are altered in subjects with acromegaly, and to describe the relationship between UII and hormonal or cardiometabolic parameters. METHODS: This cross-sectional study included 41 subjects with active acromegaly, 28 subjects with controlled acromegaly, and 37 age- and BMI-matched controls without acromegaly. Hormonal and metabolic features of the subjects as well as carotid intima media thickness (cIMT) and epicardial fat thickness (EFT) were defined. Circulation of UII levels was determined via ELISA. RESULTS: Both active and controlled acromegalic subjects showed a significant elevation of circulating levels of UII with respect to controls. There was no remarkable difference in circulating levels of UII between active and controlled acromegalic groups. Both cIMT and EFT were remarkably increased in acromegaly subjects comparing to controls. UII positively correlated with cIMT, EFT, BMI, and HOMA-IR. There was no correlation between UII and GH, insulin-like growth factor-1. According to the results obtained from regression models, UII levels independently predicted cIMT and EFT. CONCLUSION: Elevated UII levels are associated with severity of cardiovascular risk factors including cIMT and EFT in acromegalic subjects.

A possible connection between tumor necrosis factor alpha and adropin levels in polycystic ovary syndrome.

CONTEXT: Adropin is a peptide hormone implicated in the regulation of insulin sensitivity and energy homeostasis. Polycystic ovary syndrome (PCOS) is a metabolic and reproductive disease associated with insulin resistance. It has been demonstrated that various inflammatory markers increased in PCOS including TNF-α. TNF-α regulates the secretion of certain peptides which play a crucial role in glucose and lipid homeostasis. There is also some evidence of a link between TNF-α and adropin. OBJECTIVE: To ascertain whether there is an association between circulating adropin levels and TNF-α in PCOS. PATIENTS AND DESIGN: 152 women with PCOS and 152 age- and body mass index-matched controls without PCOS were recruited for this cross-sectional study. MAIN OUTCOME MEASURES: Adropin and TNF-α levels were measured using ELISA. RESULTS: Adropin levels were lower in the PCOS group compared with the control group (7.43 ± 0.79 vs. 9.42 ± 0.76 ng/ml, P < 0.001), whereas TNF-α levels were higher (49.93 ± 3.39 vs. 35.83 ± 2.47 pg/ml, P < 0.001). A strongly negative correlation was found between circulating adropin levels and TNF-α levels in women with PCOS (r = -0.407, P < 0.001). Binary logistic regression analysis revealed that decreased adropin levels were significantly associated with high odds of having PCOS, although, after adjustment for TNF-α, this link vanished. Additionally, multiple linear regression analysis showed that HOMA-IR and TFN-α independently predicted adropin levels. CONCLUSIONS: Serum adropin levels are significantly decreased in PCOS and are inversely associated with TNF-α. Further dissection of the nature of this association can open new therapeutic options for metabolic diseases.

Lower cocaine- and amphetamine-regulated transcript levels pose a risk for developing PCOS.

UNLABELLED: Cocaine- and amphetamine-regulated transcript (CART) is an anorectic neuropeptide abundantly expressed in the central, peripheral, and enteric nervous systems, as well as in several different endocrine cell types. Besides regulating food intake and endocrine function, it is also proposed to modulate ovarian function during follicular waves in cattle and has potent inhibitory effects on follicular development. Polycystic ovary syndrome (PCOS), presenting itself with multiple follicular ovarian cysts, is the most common endocrinological disorder among women of reproductive age. Here we aimed to investigate the association of this peptide with PCOS. Our research was designed as a case-control study, in which a total of 148 subjects (73 with PCOS and 75 age- and BMI-matched CONTROLS) were consecutively recruited. Fasting blood glucose (FBG), insulin, high-sensitivity C-reactive protein, lipids, follicle stimulating hormone, luteinizing hormone, estradiol, CART, and free testosterone levels were measured in all participants. Homeostasis model assessment of insulin resistance (HOMA-IR) and body mass index (BMI) were calculated. CART levels were found to be significantly lower in patients with PCOS (PCOS: 90.77 ± 5.98 pg/ml, CONTROLS: 93.24 ± 8.17 pg/ml, p=0.038). Pearson's correlation analysis showed that CART was significantly and negatively correlated with BMI and waist circumference in both (PCOS and control) groups. In CONTROLS only, CART was positively correlated with insulin and HOMA-IR, and negatively correlated with FBG. Logistic regression analysis results are suggestive of a possible protective effect of CART against PCOS (OR: 0.94, 95% CI=0.888-0.997, p=0.038).

The levels of adhesion molecules in essential thrombocythemia.

AIM: It is known that thrombocytosis is closely related to vascular complications and particularly thrombosis in essential thrombocytemia (ET) cases. The aim of this study is to investigate a possible correlation between adhesion molecules and vascular attacks as well as the relation of these molecules to the platelet count. METHODS: The study group consisted of 30 ET patients and 30 healthy controls subjects. Serum intracellular adhesion molecule-1 (ICAM-1), serum vascular adhesion molecule-1 (VCAM-1) and serum E-selectin levels were determined by ELISA method according to manufacturer's instructions. RESULTS: There were no significant differences between two groups with respect to levels of sICAM-1 and sE-selectin (P>0.05). The VCAM-1 levels and platelets were significantly higher in patients with ET compared to controls (P=0.000). Spearman's correlation analysis revealed that sVCAM-1 levels were correlated with platelet counts (r=0.574, P<0.001) CONCLUSION: High VCAM-1 level in ET and its correlation with the platelet count suggest that these may be a factor in vascular complications and thrombocytosis.

Does imatinib mesylate therapy cause growth hormone deficiency?

OBJECTIVE: The purpose of this study was to determine whether or not imatinib mesylate therapy induces growth hormone deficiency (GHD). SUBJECTS AND METHODS: Seventeen patients with chronic myloid leukemia (CML) were enrolled in the study. The glucagon stimulation test (GST), and standard deviation scores (SDSs) of insulin-like growth fac- tor 1 (IGF-I) and insulin-like growth factor binding protein (IGFBP-3) were used to determine GHD. The L-dopa test was performed on those with IGF-I SDSs above the -1.8 cut-off level. RESULTS: Of the 17 patients in the study, 12 (70%) had severe GHD (serum GH level <3 microg/l after GST). IGF-I SDSs and IGFBP-3 SDSs were below -1.8 in 12 patients (70%) and below -0.9 in 10 subjects (58%). Four of the 5 remaining subjects with IGF-I SDS >-1.8 showed insufficient GH response to L-dopa stimulation. Nine subjects (52%) had both severe GHD based on GST response and IGF-I SDS below -1.8. If an IGF-I SDS cut-off value l<-3 were used,5 out of 17 subjects (30%) would be classified as GH deficient. These same patients also showed severe GHD based on GST response. CONCLUSIONS: The data showed that a large number of patients on imatinib mesylate therapy had GH deficiency. A study involving a larger number of patients with a matched control group is needed to confirm the present observations.