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Objective: To investigate the relationship between selenium status, thyroid volume and gland echostructure. Design: Cross-sectional. Methods: In 792 men (45-60 years) and 1108 women (35-60 years) from the SU.VI.MAX study, thyroid volume and gland echostructure were determined ultrasonographically. At baseline, thyrotropin, free thyroxine, selenium, zinc, a-tocopherol, b-carotene, retinol, urinary iodine and thiocyanate concentrations were measured. Alcohol consumption, smoking, and menopausal status were assessed by a questionnaire. A stepwise linear and a logistic regression model were used, adjusting for antioxidant vitamins, trace elements status and age. Results: In women, there was an inverse association between selenium status and thyroid volume ðP ¼ 0:003Þ: A protective effect of selenium against goiter (odds ratio ðORÞ ¼ 0:07; 95% confidence interval ðCIÞ ¼ 0:008 -0:6) and thyroid tissue damage ðOR ¼ 0:2; 95% CI ¼ 0:06 -0:7Þ was observed. There was no evidence of an association between menopausal status and other antioxidant elements, thyroid volume or thyroid hypoechogenicity. Smoking, but not alcohol consumption, was associated with an increased risk of thyroid enlargement in women ðOR ¼ 3:94; 95% CI ¼ 1:64 -9:48Þ: No association between thyroid volume, thyroid structure or selenium was found in men. Conclusion: Our findings suggest that selenium may protect against goiter. Selenium was related to thyroid echostructure, suggesting it may also protect against autoimmune thyroid disease.

Cost-of-illness studies (COI) can identify and measure all the costs of a particular disease, including the direct, indirect and intangible dimensions. They are intended to provide estimates about the economic impact of costly disease. Alzheimer disease (AD) is a relevant example to review cost of illness studies because of its costliness.The aim of this study was to review relevant published cost studies of AD to analyze the method used and to identify which dimension had to be improved from a methodological perspective. First, we described the key points of cost study methodology. Secondly, cost studies relating to AD were systematically reviewed, focussing on an analysis of the different methods used. The methodological choices of the studies were analysed using an analytical grid which contains the main methodological items of COI studies. Seventeen articles were retained. Depending on the studies, annual total costs per patient vary from $2,935 to $52, 954. The methods, data sources, and estimated cost categories in each study varied widely. The review showed that cost studies adopted different approaches to estimate costs of AD, reflecting a lack of consensus on the methodology of cost studies. To increase its credibility, closer agreement among researchers on the methodological principles of cost studies would be desirable.

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