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Background: Higher levels of thyroid autoantibodies in follicular fluid (FF) of thyroid autoimmunity (TAI) positive women are strongly correlated with serum levels and may have effect on the post-implantation embryo development. Literature highlights that levothyroxine (LT4) treatment may attenuate the risk of adverse pregnancy outcomes. The aim of the study was to estimate the pregnancy and newborn outcomes in women with FF thyroid autoantibodies undergoing assisted reproductive technology (A RT). Methods: The study population included 24 women with confirmed clinical pregnancy, 8 TAI positive and 16 TAI negative women. LT4 supplementation was applied in 20.8% patients, TAI positive. Results: Pregnancy outcomes were: twin pregnancy rate 4 1 .7 % , early miscarriage rate 8.3% , late miscarriage rate 4.2% , preterm birth rate 16.7% , term birth rate 70.8% , live birth rate 96.0% . There was significant difference in serum and in FF TgAbs (p< 0.001)betw een the groups according to TAI, while serum fT 3 was lower in the group with TAI (p = 0 .0 4 7 ). Serum P 4 was higher in LT4 treated group (p = 0 .0 0 5 ), with TAI, and newborns in this group had higher birth weight (p = 0.001) and height (p = 0 .0 0 8 ). Maternal complications occurred in 23.8% of patients. No congenital malformations in newborns were noted. Conclusions: Thyroid autoantibodies present in FF may have an effect on the post-implantation embryo development, but have no effect on further course of pregnancy. The special benefit of LT4 treatment for successful A R T outcome was demonstrated for newborn anthropometric parameters.

Today, infertility is not only a serious health but also a psycho-social problem, one that is on the rise in the world. Thyroid autoimmunity (TAI) is the most common disease of the thyroid gland in the reproductive period, which can affect spontaneous conception as well as conception through assisted reproduction technology (ART), but also the maintenance of healthy pregnancy. It can also cause numerous maternal and fetal complications. There is a wide array of publications on the topic of the mechanisms of association between TAI and reproduction, with the question of whether thyroid autoantibodies are solely tissue-specific antibodies, whether and when to start levothyroxine treatment, and that we require more fundamental research on the direct effect of thyroid autoantibodies starting from folliculogenesis to embryogenesis and implantation as well as the post-implantation embryo development, but also the composition of the follicular fluid as a microenvironment of enormous importance for the maturation of the oocytes which thyroid autoantibodies reach via the blood-follicle barrier.

Introduction/Objective. Cardiovascular diabetic autonomic neuropathy (CDAN) mainly affects heart rhythm through sympathovagal imbalance. The objective of the study is to determine CDAN risk potential regarding electrical complications of acute myocardial ischemia (AMI), including admission glucose profile levels (AGP). Methods. Seventy-six patients suffering from type 2 diabetes mellitus were divided into two age-matched groups related to the presence of CDAN, and the influence of AGP on electrical complications was estimated. Ewing’s tests were used for diagnosis of CDAN. Results. Patients without CDAN have 42.86% risk for developing electrical complication into early post-AMI period. If it is a pre-existing condition, the risk is 63.64%, which is obvious, but not statistically significant. Considering the AGP, levels above 12.25 mmol/L as predictive for post-AMI electrical complications, in CDAN-positive patients with AGP levels above that cut-off value, the risk for electrical complications is raising up to 73.68%. The patients with CDAN who have AGP levels above the cut-off value have statistically higher risk for development electrical complications than those with lower levels (Z = 2.58, p < 0.01). On the other side, those without CDAN and with level of AGP lower than 12.25 mmol/L, the risk for electrical complications developing is as low as 23.08%. Conclusion. CDAN may be an important independent risk factor for electrical complications in postmyocardial ischemia period.

Introduction. The diseases caused by Leishmania are spread worldwide and represent a significant public health problem. Objective. The aim of this study was to present the results of epidemiological surveillance of leishmaniasis in humans in Montenegro in the period from 1992 to 2013. Methods. The study was planned and realized as a descriptive epidemiological study. The sample included patients of leishmaniasis in Montenegro in the period from 1992 to 2013. The health and demographic data were collected from medical records. The disease was microbiologically proven in the patients. For statistical analysis the χ2-test was used, which examined the significance of the incidence rate. Results. During this period, 66 cases of leishmaniasis were identified (40 men and 26 women) aged 0 to 62 (mean 15.61±16.76 years). A visceral form of the disease was diagnosed in 65 (98%) patients, and one patient was diagnosed with cutaneous leishmaniasis. The average incidence rate for the abovementioned period is 0.48 per 100,000 inhabitants. The highest average incidence rate was identified in patients up to seven years of age (3.50 per 100,000 inhabitants). The highest average incidence rates of leishmaniasis were identified in the coastal region of Montenegro, while seasonal distribution indicates that the disease occurs throughout the year with predominance in late spring and summer. Conclusion. The research has shown that Montenegro is among the countries with low incidence of leishmaniasis. Nevertheless, because of leishmaniasis re-emergence in the entire Mediterranean Basin, a comprehensive research of ecological and epidemiological characteristics of leishmaniasis, including better monitoring and notification system, is required.

Introduction: Thyroid nodular goiter Nodular goiter is clinically recognizable restricted structure changes of the thyroid gland. Numerous studies show the relationship between thyroid autoimmunity and differentiated thyroid cancer in patients with nodular thyroid goiter. One of the important clinical marker in defining thyroid autoimmunity are antibodies to thyroid peroxidase. Objective: The aim of this study was to analyze the relationship between antibodies anti peroksidaznih ii thyroid malignancies in patients with thyroid altered thyroid. Material and Methods: We retrospectively reviewed the 248 reports of thyroid FNA cytology of samples obtained by puncture of patients with nodular thyroid goiter, at Department of thyroid gland, Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia in the period from October 2007. by January 2010. year. We analyzed the relationship between findings of cytopathological diagnostic categories and serum concentrations of anti peroxidase antibodies. The data were statistically processed using the computer program SPSS 12.0 software package. Results: Of total 248 patients, 148 patients (59.7%) had anti-TPO antibody values in a reference limits (30 IU/ml), and 40.3% elevated anti-TPO antibodies (over 30 IU/ml). In the group of patients with elevated values of anti-TPO antibodies 7% (7/100) of patients had malignant cytologic findings, and in the group of patients with anti-TPO antibody values in the normal range only 1.4% (2/148) of patients had malignant cytologic findings. Conclusion: Defining the relationship between thyroid autoimmune disease and differentiated thyroid cancer, providing new insights in the field of immunotherapy of thyroid carcinoma. Enlightening the molecular mechanisms link autoimmune thyroid disease and thyroid cancer development in patients with thyroid nodule help find new therapeutic strategies against thyroid cancer.

Introduction: Nodular goiter is clinically recognizable restricted structure changes of the thyroid gland. FNA is the first line diagnostic test for an enlarged thyroid gland. TSH is known as a thyroid growth factor, but the pathogenic role of this hormone in thyroid oncogenesis is unclear. Objective: The aim of this study is to analyze the relationship between elevated serum TSH concentartions and thyroid malignancies in patients with nodular thyroid goiter. Material and Methods: We retrospectively reviewed the 637 reports of thyroid FNA cytology of samples obtained by puncture of patients with nodular thyroid goiter, at Department of thyroid gland, Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia in the period from October 2007. by January 2010. year. We analyzed the relationship between findings of cytopathological diagnostic categories and serum concentrations of TSH. The data were statistically tested using Kruskal Wallis test of differences using the computer program SPSS 12.0 software package. Results: Of total 637 patients 3.45% (22/637) had a malignant, and 4.87% patients (31/637) cytopathological indeterminate findings. 91.52% (583/637) patients were with benign findings, and only one puncture failed. The average value of TSH in a group of patients with a diagnosis of malignancy was 9.83 ± 17.48 mmol/l with a median 3.31mmol/l. In all three diagnostic categories (benign, malignant and unspecified) most patients are with the normal concentrations of serum TSH , but there is a relatively large proportion of 27.3% (6/22) of patients with malignant cytopathological findings in the group of patients with elevated TSH concentartion. Statistically significant differences between diagnostic categories by group TSH values (χ²=8.136,p=0.017). Conclusion: It is concluded that the risk of developing thyroid malignancy increases in patients with elevated serum TSH concentrations. TSH should be used as an additional diagnostic tool in identifying high-risk patients who require further investigation and / or surgical treatment.

Hyperandrogenism is a condition in which the levels of androgen hormones in the blood are significantly increased and could be of an adrenal or ovarian origin. The adrenal androgens, normally secreted by the zona reticularis, are steroid hormones with weak androgen activity. The causes of hyperandrogenism are diverse and could be endogenous and exogenous. Androgen excess affecting different tissues and organs results in clinical features such as acne, hirsutism, virilization, and reproductive dysfunction such as oligomenorrhoea/amenorrhoea. Although androgen excess is rarely associated with adrenal tumours, it is important as it could be predictive of malignancy. A careful evaluation of the androgen pattern, also in patients with clear signs of hyperandrogenism, could be useful. Laboratory evaluation should focus on measuring total testosterone levels, followed by the estimation of other androgens such as dehydroepiandrosterone and androstenedione, and using visualisation procedures in the further management. The treatment of adrenal hyperandrogenism is eminently surgical, in consideration of the frequent malignant origin. The aim of this review is to elaborate and summarize the prevalence and clinical management of hyperandrogenism of an adrenal origin by describing the physiological mechanisms of adrenal androgen steroidogenesis, the clinical manifestations of hyperandrogenism with a special reference to hyperandrogenism in adrenal adenomas and carcinomas, and the diagnostic methods that will lead us to establishing the correct diagnosis and different treatment options to manage this condition according to the clinical presentation of the patient. [ABSTRACT FROM AUTHOR]

Obesity is an epidemic that has led to a rise in the incidence of many comorbidities: among others, reduced fertility is often under‐evaluated in clinical practice. The mechanisms underlying the link between reduced fertility and obesity are numerous, with insulin resistance, hyperglycaemia and the frequent coexistence of polycystic ovary syndrome being the most acknowledged. However, several other factors concur, such as gut microbiome alterations, low‐grade chronic inflammation and oxidative stress. Not only do women with obesity take longer to conceive, but in vitro fertilization (IVF) is also less likely to succeed. We herein provide an updated state‐of‐the‐art regarding the molecular bases of what we could define as dysmetabolic infertility, focusing on the clinical aspects, as well as possible treatment. [ABSTRACT FROM AUTHOR]

Today, infertility is not only a serious health but also a psycho-social problem, one that is on the rise in the world. Thyroid autoimmunity (TAI) is the most common disease of the thyroid gland in the reproductive period, which can affect spontaneous conception as well as conception through assisted reproduction technology (ART), but also the maintenance of healthy pregnancy. It can also cause numerous maternal and fetal complications. There is a wide array of publications on the topic of the mechanisms of association between TAI and reproduction, with the question of whether thyroid autoantibodies are solely tissue-specific antibodies, whether and when to start levothyroxine treatment, and that we require more fundamental research on the direct effect of thyroid autoantibodies starting from folliculogenesis to embryogenesis and implantation as well as the post-implantation embryo development, but also the composition of the follicular fluid as a microenvironment of enormous importance for the maturation of the oocytes which thyroid autoantibodies reach via the blood-follicle barrier. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid nodular goiter Nodular goiter is clinically recognizable restricted structure changes of the thyroid gland. Numerous studies show the relationship between thyroid autoimmunity and differentiated thyroid cancer in patients with nodular thyroid goiter. One of the important clinical markers in defining thyroid autoimmunity is an antibody to thyroid peroxidase. Objective: The aim of this study was to analyze the relationship between antibodies anti peroksidaznih ii thyroid malignancies in patients with thyroid-altered thyroid. Material and Methods: We retrospectively reviewed the 248 reports of thyroid FNA cytology of samples obtained by puncture of patients with nodular thyroid goiter, at Department of thyroid gland, Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia in the period from October 2007. by January 2010. year. We analyzed the relationship between findings of cytopathological diagnostic categories and serum concentrations of anti peroxidase antibodies. The data were statistically processed using the computer program SPSS 12.0 software package. Results: Of total 248 patients, 148 patients (59.7%) had anti-TPO antibody values in a reference limits (30 IU / ml), and 40.3% elevated anti-TPO antibodies (over 30 IU / ml). In the group of patients with elevated values of anti-TPO antibodies 7% (7/100) of patients had malignant cytologic findings, and in the group of patients with anti-TPO antibody values in the normal range only 1.4% (2/148) of patients had malignant cytologic findings. Conclusion: Defining the relationship between thyroid autoimmune disease and differentiated thyroid cancer, providing new insights in the field of immunotherapy of thyroid carcinoma. Enlightening the molecular mechanisms link autoimmune thyroid disease and thyroid cancer development in patients with thyroid nodule help find new therapeutic strategies against thyroid cancer. [ABSTRACT FROM AUTHOR]

Uvod: Nodozna struma je klinički prepoznatljiva ograničena promena građe štitaste žlezde. FNA je prva linija dijagnostičkih testova kod uvećane štitaste žlezde. TSH je poznat kao tiroidni faktor rasta, ali patogena uloga ovog hormona u tiroidnoj onkogenezi je nerazjašnjena. Materijal i metode: Retrospektivno je pregledano 637 tiroidnih FNA citoloških izveštaja uzoraka, dobijenih punkcijom pacijenata sa tiroidnom nodoznom bolešću Odeljenja za štitastu žlezdu, Klinike za endokrinologiju, dijabetes i bolesti metabolizma, Kliničkog centra Srbije u Beogradu, u periodu od oktobra 2007. do januara 2010. godine. Analiziran je odnos između dijagnostičkih kategorija citopatoloških nalaza i serumske koncentracije TSH. Podaci su statistički testirani Kruskal Wallis testom razlike pomoću kompjuterskog programa SPSS 12.0 softverskog paketa. Rezultati: Od ukupno 637 pacijenata 3,45% (22/637) je imalo maligni, a 4,87% pacijenta (31/637) neodređeni citopatološki nalaz. 91,52% (583/637) pacijenta je bilo sa benignim nalazom, i samo jedna neuspela punkcija. Prosečna vrednost TSH u grupi pacijenata sa malignom dijagnozom iznosila je 9,83±17,48 mmol/l sa medijanom 3,31 mmol/l. U sve tri dijagnostičke kategorije (benigno, maligno i neodređeno) najviše je pacijenata sa referentnim vrednostima TSH, ali postoji relativno veća proporcija, 27,3% (6/22) pacijenata, sa malignim citopatološkim nalazom kod grupe pacijenata sa povišenim vrednostima TSH. Postoji statistički značajna razlika između dijagnostičkih kategorija po grupama vrednosti TSH (χ²=8,136, p=0,017). Zaključak: Zaključuje se da rizik za razvoj tiroidnog maligniteta raste kod pacijenata sa povišenim serumskim koncentracijama TSH. TSH treba koristiti kao pomoćno dijagnostičko sredstvo u identifikaciji visokorizičnih pacijenata koji zahtevaju dalja ispitivanja i/ili hirurški tretman. Cilj: Cilj rada je da se analizira veza između povišenih vrednosti TSH i tireoidnog maligniteta kod osoba sa nodozno izmenjenom štitastom žlezdom. [ABSTRACT FROM AUTHOR]

UVOD: Dijabetes melitus tip 2 je vodeći poremećaj metabolizma, a oko 60% odraslih dijabetičara je gojazno. CILJ: Cilj rada je analiza korelacije stepena uhranjenosti i glikoregulacije kod novootkrivenih dijabetičara tipa 2. MATERIJAL I METOD: Ispitano je 100 novootkrivenih dijabetičara tip 2 oba pola, dijagnostikovanih u Kliničkom centru Crne Gore, u periodu od januara do septembra 2012. godine. Za procjenu glikoregulacije određivan je procenat gliko-ziliranog hemoglobina HbA1c (ADA preporuka 2010. godine sa zadovoljavajućom glikoregulacijom HbA1c do 6.5%, poremećenom glikoregulacijom od 6.5 do 9%, izraženom hiperglikemijom preko 9%), za procjenu stepena gojaznosti indeks tjelesne mase (BMI do 18.5 kg/m² neuhranjenost, od 18.5 kg/m² do 24.9 kg/m² normalna uhranjenost i preko 24.9 kg/m² prekomjerna uhranjenost) i za procjenu tipa gojaznosti mjerenje obima struka (etnički specifični kriterijum za centralnu gojaznost za osobe iz Evrope kod muškaraca OS do 94 cm i kod žena OS do 80 cm). Vrijednosti HbA1c određivane su turbidimetrijskim inhibitornim imunoesejom. Podaci su statistički obrađeni kompjuterskim paketom STATISTICA. REZULTATI: Povećana abdominalna gojaznost je nađena kod 56.2% muškaraca i 78.6% žena sa 6.5< HbA1c<9%, a 62.5% muškaraca i 83.3% žena koji su imali HbA1c>9%, što pokazuje da postoji statistički značajna korelacija obima struka i glikoregulacije kod oba pola. Kod 72.2% muškaraca i 76.9% žena sa BMI>24.9 kg/ m² nađen je 6.5< HbA1c<9%, a kod 76.2% muškaraca i 37.5% žena sa BMI>24.9 kg/m² nađen je HbA1c>9%, što pokazuje da postoji statistički značajna korelacija stepena uhranjenosti i glikoregulacije kod oba pola. ZAKLJUČAK: Ispitivanje je pokazalo da gojazni novootkriveni dijabetičari tip 2 oba pola imaju lošiju glikoregulaciju. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid nodular goiter Nodular goiter is clinically recognizable restricted structure changes of the thyroid gland. Numerous studies show the relationship between thyroid autoimmunity and differentiated thyroid cancer in patients with nodular thyroid goiter. One of the important clinical marker in defining thyroid autoimmunity are antibodies to thyroid peroxidase. Objective: The aim of this study was to analyze the relationship between antibodies anti peroksidaznih ii thyroid malignancies in patients with thyroid altered thyroid. Material and Methods: We retrospectively reviewed the 248 reports of thyroid FNA cytology of samples obtained by puncture of patients with nodular thyroid goiter, at Department of thyroid gland, Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia in the period from October 2007. by January 2010. year. We analyzed the relationship between findings of cytopathological diagnostic categories and serum concentrations of anti peroxidase antibodies. The data were statistically processed using the computer program SPSS 12.0 software package. Results: Of total 248 patients, 148 patients (59.7%) had anti-TPO antibody values in a reference limits (30 IU/ml), and 40.3% elevated anti-TPO antibodies (over 30 IU/ml). In the group of patients with elevated values of anti-TPO antibodies 7% (7/100) of patients had malignant cytologic findings, and in the group of patients with anti-TPO antibody values in the normal range only 1.4% (2/148) of patients had malignant cytologic findings. Conclusion: Defining the relationship between thyroid autoimmune disease and differentiated thyroid cancer, providing new insights in the field of immunotherapy of thyroid carcinoma. Enlightening the molecular mechanisms link autoimmune thyroid disease and thyroid cancer development in patients with thyroid nodule help find new therapeutic strategies against thyroid cancer. [ABSTRACT FROM AUTHOR]

Graves' ophthalmopathy (GO) is an autoimmune disease affecting ocular and orbital tissues. Overproduction of tumor necrosis factor α (TNF-α) in rheumatoid arthritis (RA) and GO has destructive consequences. The subject of this paper is a case of a female patient initially diagnosed with primary hypothyroidism substitution with levothyroxine, and subsequent diagnosis of RA with insufficient therapeutic efficacy of a standard medication. Three years later, the patient presented symptoms and signs of GO. Etanercept was administrated for RA, and after four months, an improvement of the eye symptoms and reduced exophthalmos were observed and confirmed using visual methods. Graves' ophthalmopathy association with primary hypothyroidism is uncommon. The treatment of RA using etanercept led to clinical improvement of GO symptoms, which indicates that RA and GO may share similar pathogenic features. The paper suggests that etanercept may suppress the symptoms and clinical signs of GO. However, controlled trials are needed to further evaluate the effect of TNF-α inhibitors, particularly etanercept, and to compare its side effects with the current options for medical treatment., Competing Interests: The authors declare no conflict of interest., (Copyright © 2019 Termedia.)