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Background. Computed tomography (CT) and magnetic resonance imaging (MRI) are used for the identification of an adrenal neoplasm. Traditionally, the adrenal gland radiological size (RS) is underestimated by any preoperative imaging compared to the actual histological size (HS). The objective of the study was to investigate whether recent and more sophisticated imaging techniques can more accurately predict adrenal tumors’ size. Material and methods. We retrospectively analyzed 129 patients (86 females, 67%) with mean age 54.2 years (median: 56; range: 6 – 82), who underwent adrenalectomy (1 bilateral adrenalectomy) during the period 11/2016 to 2/2019. The 130 adrenal tumors were divided according to their RS in: A, ≤ 3 cm, B, > 3 cm and ≤ 6 cm, C, > 6 cm. Agreement between RS and HS was evaluated by the intraclass correlation coefficient (ICC). Results. In the total population, RS underestimated HS by 34% using CT or either imaging with good agreement; 28% using MRI with fair agreement. Only for RS 3 – 6cm CT, MRI or either method underestimated HS by 35% with fair agreement; for RS > 6 cm underestimation was 15% using CT, or 6% using either imaging with fair agreement. Conclusions. In defiance of the technological progress in imaging modalities, the present study confirmed previous findings that adrenal imaging by CT or MRI, cannot predict accurately the real size of adrenal tumors. In case of an adrenal incidentaloma this disagreement has a major impact not only on achieving an effective decision- making process favoring a conservative treatment or a surgical excision, but also on deciding when surgery is the option of the appropriate approach by open or laparoscopic adrenalectomy.

Introduction. The association of autoimmune thyroid disease (AITD) with diabetes mellitus type-1 (DM1) has been previously documented. However, limited data exist regarding the association of AITD and diabetes mellitus type-2 (DM2). The objective of the study was to expose the role of AITD on DM2 and the impact of AITD in euthyroid patients with pre-diabetes. Euthyroid prediabetic patients were defined by impaired fasting glucose and/or glucose intolerance. Material and methods. We assessed static and dynamic insulin resistance (IRI) and insulin secretion indices (ISI), and the disposition index (DI). Results. Out of 166 patients studied, 31.9% had AITD; impaired fasting glucose (IFG) prevalence was the same with non-AITD patients. In contrast, impaired glucose tolerance (IGT) was less prevalent in AITD compared to non-AITD patients (9.4% versus 28.3%, p=0.008). IRI did not differ between the two groups. The dynamic ISI, 1st phase and 2nd phase insulin release, and the DI showed a worse insulin secretion in non-AITD compared to AITD patients (0.54 versus 0.45, p=0.029; 1029.3 versus 864.3, p=0.033; 354.8 versus 286.5, p=0.035; 0.09 versus 0.07, p=0.02, respectively). On the other hand, hsCRP was higher in AITD versus non-AITD individuals (p=0.008). Conclusions. Although individuals with pre-diabetes and AITD presented with higher levels of low-grade inflammation, their dynamic ISI and the DI, were less impaired.

Introduction. Conflicting findings have been published regarding the pressure wave reflection and the arterial stiffness in young women with polycystic ovary syndrome (PCOS) as opposed to the overt ab initio presence of endothelial dysfunction, which can be reversed six months after metformin administration. The aim of this study was to investigate wave reflections in women with PCOS and to evaluate the effect of metformin treatment. Material and methods. Sixty-four young women, 35 with PCOS (P) (20 lean(L), PL; 15 overweight/ obese (OWB), POWB) and 29 controls (18 CL;11 COWB) were studied. Wave reflection was assessed by the Augmentation Index (AIx) as central augmentation pressure-to-pulse height ratio corrected for heart rate (HR) 75 bpm (AIX@75) or without HR correction AIx and the central augmentation time index (Tr). The endothelial function was evaluated biochemically by plasma endothelin 1(ET-1) levels. The metabolic and hormonal profile and a dvanced glycated end-products (AGEs) levels were also assessed. Metformin (1700 mg/daily) was administered for six months in 20 (9 lean, 11 obese) women with PCOS and the measurements were repeated. Results. All subgroups had comparable age. Wave reflection indices did not differ between PCOS and controls. AIx@75 significantly improved post-metformin treatment in POWB (p=0.046). AGE levels differed between PCOS women groups and controls (p

Introduction. Arterial variations may cause significant complications during diagnostic and interventional procedures. The objective of the study. Our study examined 73 donated cadavers in the National and Kapodistrian University of Athens, in an effort to unearth possible artery alternations. Material and methods. The major branches of the abdominal aorta, the arteries of the limps and the neck were inquired. Results. In 58.9% of the cadavers no arterial variation was found, whereas one, two and three alternations at the same cadaver were observed in 21.9%, 12.3% and 6.8% respectively. The most common anatomical variations were noted in the vascular branching of the celiac trunk found in 24.7% of the cadavers. Conclusions. There was no statistically significant difference between the two genders concerning the frequency of the observed arterial variations (p

Purpose. This study aimed to quantify the deviation of an arterial pulse (pressure wave) from the „golden“ or „divine“ pulse, defined according to the golden ratio φ (phi), and to investigate whether the extent of this deviation is related to the function of autonomic nervous system (ANS) as assessed by 24-hr heart rate variability (HRV). Methods. Seventy-two healthy subjects underwent 24-hr continuous monitoring of ECG. Applanation tonometry of the radial artery and pulse wave analysis of peripheral and central (mathematically derived) aortic pressure waveforms were performed in all subjects. Time- and frequency domain indices of HRV were computed together with nonlinear dynamic parameters. Two novel indices were computed primarily based on pressure (systolic and diastolic pressure; mmHg) and time (ejection and diastolic durations-intervals; msec) values extracted from the recorded pressure waves. Results. The new phenotypic, geometrical biomarkers based on the golden ratio (φ) were associated withHRV indices and especially with those computed at the frequency domain. These associations were independent from age, gender, body mass index, mean arterial pressure, pulse pressure and mean 24-hr heart rate. Conclusion. The new proposed geometrical analysis of the arterial pulse reflects/characterizes specific 24-hr HRV features and is independently related with ANS function. Although the potential pathophysiological, underlying mechanisms of this association can be hardly explained by this study, the application of the golden ratio φ for the analysis of the arterial pulse merits further investigation and may open a new window for the evaluation of cardiovascular risk.