Aims: The aim of this study is to assess the applicability of shear wave elastography (SWE) in the diagnosis of chronic autoimmun thyroiditis (CAT) patients. Material and methods: The study group consisted of 50 patients with first-diagnosed CAT and 40 control subjects (CS). In all patients with CAT and CS, sonoelastographic measurements were made in both thyroid lobes. Optimal cut-off values were chosen to maximize the sum of sensitivity and specificity. Positive predictive value (PPV), negative predictive value (NPV), and accuracy values were also calculated. Results: Quantitative elastographic analysis evaluated by SWE in CAT patients (2.56 ± 0.30 m/s) was significantly higher compared with CS (1.63 ± 0.12 m/s) (p<0.001). The optimal cut-off value was 2.42 m/s. SWE had 77% sensitivity, 71% specificity, 92% PPV, 81% NPV, and 87% accuracy for the presence of CAT. Conclusions: Our data indicate that SWE correctly defines the elasticty of thyroid parenchyma, and this technique may assist in the diagnosis and treatment monitoring of CAT.

Context. Previous studies have associated overt/ subclinical hypothyroidism and obesity but have failed to confirm a causative relationship between them. Confusion is even more for subjects with Hashimoto's Thyroiditis (HT).Objective. In this study, we aimed to evaluate the fat distribution and metabolic profile of subjects with euthyroid HT as well as to establish an appropriate cut-off level of TSH for the development of metabolic syndrome (Mets) in both groups.Patients and Methods. All subjects were euthyroid whether under levothyroxine replacement or not. We recruited 301 volunteers (99 with HT and 202 without thyroid autoimmunity). Together with some metabolic variables, we measured the waist circumference, hip circumference, neck circumference manually; the total body fat with a body composition analyzer; and the visceral fat/ trunk fat percentage via abdominal bioelectrical impedance analysis.Results. A significant positive correlation was established between TSH levels and insulin, fasting plasma glucose, HOMA-IR and body mass index (r=0.28; p<0.001; r=0.27; p<0.05: r=0.32; p<0.001: r=0.13; p<0.05 respectively). The prevalence of Metabolic Syndrome (Mets) was comparable in HT and control groups (27.3% vs. 30.7%; p>0.05). The prevalence of Mets was similar when HT subjects using levothyroxine or HT subjects with accompanying thyroid nodules were taken into consideration. Similarly, anthropometric and metabolic parameters were similar in both the HT group and the control group.We were unable to establish the TSH cut-off level by ROC analysis with desired sensitivity and specificity (AUC: 0.563 with 95% C.I. p=0.35; standard error 0.76).Conclusions. Although weight gain is frequently encountered in subjects with HT, such subjects with thyroid function tests in the euthyroid range have a similar prevalence of Mets and similar metabolic and anthropometric measurements compared to subjects without autoimmunity.

Objective: The objective of this study was to assess the antiproliferative pleiotropic effects of statins on thyroid function, volume, and nodularity. Subjects and Methods: One hundred and six hyperlipidemic patients were included in this prospective study. The 69 patients in the statin groups received atorvastatin (16 received 10 mg and 18 received 20 mg) or rosuvastatin (20 received 10 mg and 15 received 20 mg). The 37 patients in the control group, assessed as not requiring drugs, made only lifestyle changes. Upon admission and after 6 months, all patients were evaluated by ultrasonography as well as for lipid variables (total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides) and thyroid function and structure. Results: After 6 months, no differences in thyroid function, thyroid volume, the number of thyroid nodules, or nodule size were observed in the statin and control groups. In a subgroup analysis, total thyroid volume had decreased more in patients receiving 20 mg of rosuvastatin than that in the control group (p < 0.05). Maximum nodule size had decreased more in those receiving 10 mg of rosuvastatin (p < 0.05). Conclusions: Our results suggest an association between rosuvastatin treatment and smaller thyroid volume and maximum nodule diameter; this could be attributable to the antiproliferative effects of statin therapy on the thyroid.

Introduction:Amiodarone is an effective drug for life-threatening arrhythmias like recurrent ventricular fibrillation and atrial fibrillation. Amiodarone creates rarely genitourinary side effects are seen. These are epididymitis, testicular dysfunction and impotance. Amiodarone aggregates and triggers inflammation in the head of the epididym.Case report:We present the case of a patient who developed epididymitis after 17 months of amiodarone therapy, using a low dose (100 mg per day). Although cessation of medication or dose lowering was not performed, remission of the patient only by analgesics is a distinct case reported in urological literature.Conclusions:This case stresses the importance of considering an adverse effect of amiodarone treatment as a cause when making a differential diagnosis of epididymitis.

Although obesity is a powerful risk factor for metabolic syndrome (MetS) it is not present in all obese individuals. Increased visceral adipose tissue is the hallmark of this syndrome. In this cross sectional survey we aimed to use abdominal bioelectrical impedance analysis to measure the visceral adipose tissue (VAT) and trunk fat percentages (TF%) in the study population, correlate these findings with traditional anthropometric measures and biochemical parameters of metabolic syndrome and estimate a cut-off value of visceral fat for development of MetS. A total of 285 subjects were enrolled. VAT and TF% were measured by the AB-140 device via abdominal bioelectrical impedance analysis. Fat% was measured by a body composition analyzer (TBF-300). VAT was significantly positively correlated with body mass index, waist circumference, TF%, HOMA IR, fat percentage, fasting plasma glucose and triglycerides. Strongest correlations were between VAT and TF%, VAT and device measured waist circumference and between VAT and manual waist circumference (r=0.95, r=0.93, r=0.92 respectively). Correlations of VAT and TF% with metabolic parameters were significant but weak. The mean VAT and TF% in MetS (+) groups were significantly higher than patients in MetS (-) groups in both sexes. The areas under the ROC curves were 0.730 (95% CI: 0.661-0.791) for female VAT and 0.702 (95% CI: 0.654-0.749) for male VAT in predicting MetS which were similar to the areas under ROC curves calculated for device and manually measured waist circumference, HOMA IR and TF% in predicting MetS (p>0.05 for all comparisons). The accuracy of VAT and TF% for predicting MetS was not sufficient. From our results we can deduce that the performance of abdominal BIA in predicting MetS is weak but could be used in the follow-up of patients with obesity and/or MetS. This has to be confirmed in future studies.