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Objective: Treatment with interferon (IFN) of patients affected by chronic hepatitis C (CH-C) may produce alterations in thyroid function, such as hypothyroidism, Graves'-like hyperthyroidism and destructive thyrotoxicosis (DT). IFN-induced DT is characterized by suppressed serum TSH levels, normal or elevated FT4 and FT3 concentrations, with the presence or absence of thyroid peroxidase antibodies and antithyroglobulin antibodies, the absence of thyroid receptor antibodies and radioactive iodine uptake suppressed or <5%., Design: IFN-induced DT is a mild clinical disease, because thyroid-destructive processes last for a short time and involve a small portion of the gland. At present, the therapeutic approach in DT suggests IFN withdrawal and 1-2 months of methylprednisolone treatment., Methods: In consideration of possible untoward side effects of steroid treatment in patients with CH-C, we studied two groups of patients with CH-C who developed DT after treatments with various preparations of recombinant IFN (with or without ribavirin). Patients sequentially entered the study during a 4-year period, at the time of DT diagnosis, when IFN therapy was discontinued. The first 12 subjects (group A) were treated with 8-16 mg/day methylprednisolone for 30-40 days after IFN withdrawal; in the following 15 patients (group B), IFN withdrawal was not followed by any additional treatment. All patients underwent clinical and laboratory controls of thyroid function at 1, 2, 3 and 6 months after DT diagnosis., Results: The results showed restoration of euthyroidism in both group A and group B patients at 6 months after DT diagnosis, regardless of steroid treatment., Conclusions: The simple withdrawal of IFN therapy in patients with CH-C, who had developed DT, appears to be effective in the treatment of the thyroid disease. This therapeutic approach should be preferred in order to avoid possible undesired side effects of steroid therapy in patients with CH-C., (2005 S. Karger AG, Basel)

Pulsed Doppler measurements of left ventricular filling (LVF), two-dimensional and M-mode echocardiograms were performed in 189 healthy subjects, in order to evaluate factors influencing LVF Doppler indexes in normal subjects. LVF Doppler indexes (peak E, peak A, peak E/peak A, deceleration rate of peak E (ED) were related by univariate and multivariate analyses with the following parameters: age, sex, heart rate, systolic and diastolic blood pressure, aortic root and left atrial dimensions, left ventricular mass index, left ventricular shortening fraction. The stepwise analysis showed that age by itself explained up to 18% of peak E variance, 50% of peak A variance, 61% of peak E/peak A variance and 25% of ED variance. The other variables entered into the regression, slightly improved the predictive power (less than 10%). In conclusion, age is the major independent factor affecting LVF in normal subjects, although other variables show significant correlation also after age adjustment.

In order to evaluate both quantitatively and qualitatively exercise ST response in females, we have studied 232 healthy subjects (age range 35-59 years): 82 women (mean age 45.8 years) and 150 men (mean age 46.1 years). All subjects had performed a maximal treadmill exercise in 1976 and were followed up for 6 years in order to exclude the presence of subclinical coronary artery disease. Exercise ST segment responses were evaluated in a single bipolar lead (CB5) and were classified as 'positive' by visual interpretation when a 1.0-mm or greater 'ischemic' ST depression occurred. A computer system was employed to evaluate exercise ST changes quantitatively. The following ST parameters were evaluated: ST depression at R + 80 ms point (ST2); mean ST depression (STmean), and ST time-voltage integral (STarea). Computer analysis of resting ECG has shown lower ST voltages in females than in males. ST2, STarea, and STmean changes from basal to maximal exercise values were not significantly different in men and women. A similar prevalence of 'positive' responses in males and females was also found by ECG visual interpretation. In conclusion, our data show that in healthy subjects exercise ST segment response is comparable in males and females and indirectly suggest that the lower predictive value of exercise ECG in women is likely to be related to different coronary artery disease prevalence.