Thyroid stimulating hormone levels and BRAFV600E mutation contribute to pathophysiology of papillary thyroid carcinoma: Relation to outcomes?

AimsThe aim of this study was to evaluate the relation between the level of thyroid stimulating hormone (TSH) and progression of papillary thyroid carcinoma (PTC) with or without BRAF^V600E mutation.MethodsThe medical records and laboratory data of 547 patients with PTC and 94 patients with follicular adenoma (FA) were collected. The relationship between hormones levels and such end-points as extrathyroid extension (ETE), lymphovascular invasion (LVI) and lymph node metastasis (LNM) was assessed. In addition, age, gender, BRAF^V600E mutation status, histological type and Hashimoto’s thyroiditis (HT) were considered.Key findingsMost of the patients with PTC had hormones levels within the normal range, however, serum TSH concentration was significantly higher in PTC comparing with FA (P = 0.022). High levels of TSH in PTC were more frequent among women rather than men (P = 0.03) due to the gender differences in coexisting HT rate (P = 0.003). In contrast, LNM rate was higher in men (P = 0.0014). Coexisting HT significantly decreased the risk of ETE (OR = 0.67; 95%CI 0.44–1.00; P = 0.05) and LNM (OR = 0.59; 95%CI 0.37?0.94; P = 0.028) among males with PTC. However, there was no significant relationship between HT and PTC-related ETE and LNM in females. BRAF^V600E mutation was associated with presence of lymphocytic infiltration (P < 0.001) but not with HT (P = 0.08) and violation of thyroid function.ConclusionThe present study showed the lack of significant relationship between TSH levels and PTC aggressiveness (LNM, TNM stage, BRAF^V600E mutation). Higher TSH levels were found in patients with coexisting HT that was associated with female sex and multifocality of PTC.     

Migration Flow and Its Impact on Tuberculosis Notification in Portugal

Introduction

Tuberculosis notification in Portugal has decreased in the last few years. As a consequence of the economic crisis, emigration has increased and immigration has decreased. Immigrants are a risk group for tuberculosis. Most emigrants are 20–44 years old and belong to the age group most affected by tuberculosis.

Protonated nanostructured aluminosilicate (NSAS) reduces plasma cholesterol concentrations and atherosclerotic lesions in Apolipoprotein E deficient mice fed a high cholesterol and high fat diet

The aim of this work was to assess the effect of chronic administration of protonated nanostructured aluminosilicate (NSAS) on the plasma cholesterol levels and development of atherosclerotic lesions in Apolipoprotein (ApoE) deficient mice fed a high cholesterol and high fat diet. Apolipoprotein E (ApoE) deficient mice were divided into the following treatment groups: protonated NSAS 1.4% (w/w), untreated control and 2% (w/w) stigmastanol mixed with high-cholesterol/high-fat diet. Animals were treated for 12 weeks, blood samples were withdrawn every 4 weeks for determination of plasma cholesterol and triglyceride levels. At the end of the study the aortic roots were harvested for assessment of atherosclerotic lesions. NSAS at 1.4% (w/w) and stigmastanol at 2% (w/w) treatment groups showed significant decreases in plasma cholesterol concentrations at all time points relative to the control animals. The lesion sum area in 1.4% (w/w) NSAS and 2% (w/w) stigmastanol groups were significantly less from the control animals. In conclusion, in this study, the effectiveness of chronic administration of protonated NSAS material in the reduction of plasma cholesterol levels and decrease in development of atherosclerotic lesions was demonstrated in Apo-E deficient mice model.     

Systemic lupus erythematosus in the light of the COVID-19 pandemic: infection,vaccination, and impact on disease management

Clinical Rheumatology - Patients with systemic lupus erythematosus (SLE) form a vulnerable group in terms of the impact of the COVID-19 pandemic on disease management. We conducted this overview by...     

Bilateral endogenous fungal endophthalmitis

Endogenous endophthalmitis is a rare and severe intraocular infection which can be vision-threatening. We describe a case of bilateral fungal endogenous endophthalmitis in a 64-year-old male which was successfully treated with systemic administration of fluconazole followed by pars plana vitrectomy with an intravitreous injection of amphotericin B.     

War trauma and PTSD in Ukraine’s civilian population: comparing urban-dwelling to internally displaced persons

Introduction

War in Ukraine started in March 2014 when Russia annexed Crimea and continues today in the Donbass region of Eastern Ukraine. Over 1.5 million people in these regions have been displaced from their homes. We conducted this study 36 months after the conflict began and interviewed civilians residing in Ukraine.

Purpose

This study examines the prevalence of exposure to war trauma, rates of PTSD by symptom clusters, and whether socio-demographic factors are associated with positive scores for PTSD among civilian urban-dwelling and internally displaced persons in Ukraine during the ongoing conflict in its Donbass region.

Methods

Face-to-face interviews were conducted using a multi-stage random sample of the general population in two large cities (Kharkiv and Lviv) in Ukraine (n = 1247) and a purposive sample of internally displaced persons (n = 300), half living in each city. Exposure to trauma, symptom clusters for Posttraumatic Stress Disorder (PTSD), and overall PTSD were assessed.

Results

We found widespread direct exposure to conflict-related traumatic events (65%) among internally displaced people (IDPs) compared to a sizable minority (23%) of urban-dwelling people (UDPs). We found elevated prevalence of PTSD symptoms that were also uniformly spread within several socio-demographic factors. There were, however, significant differences in PTSD between (1) IDPs compared to UDPs and (2) those UDPs with Ukrainian compared to Russian ethnic identity, the former of each pair showing increased likelihoods of positive PTSD scores.

Conclusions

Ukraine’s adult civilians, enduring the prolonged engagement in war with Russia and Russian separatists, have elevated rates of PTSD. Moreover, those who have been displaced by the ongoing conflict (IDPs) have significantly higher levels of PTSD compared to UDPs.