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To verify the prevalence of autoimmune thyroiditis (AIT) and the ultrasound characteristics (composition and volume) of thyroid nodules with respect to the area of residence in the province of Messina, some areas having environmental issues. Fine-needle aspiration-interrogated nodules (n = 902) of 809 patients were evaluated upon stratification into 8 areas of residence. Overall, women were younger than men (55.3 ± 14.0 vs. 58.6 ± 12.6 years, P = 0.0083). Patients residing in three areas (one hosting two garbage dumps, one hosting a petrochemical complex and a thermoelectrical power plant, and one hosting several ceramic factories [CFA]) were younger than those residing in the city of Messina (MEA) (52.9 ± 13.4 vs. 57.7 ± 13.6 years, P

Graves’ disease (GD) is an autoimmune thyroid disease in which stimulation by thyrotropin-receptor antibodies (TRAb) causes thyroid enlargement and hyperfunction. GD is an uncommon condition during gestation, as it occurs in about 0.2% of pregnant women. The typical GD course during gestation is characterized by a progressive reduction of TRAb levels, with associated clinical improvement, but subsequent recurrence after delivery. Instead, gestational GD requires close monitoring, because if inadequately controlled with maternal TRAb levels remaining elevated, it is associated with adverse maternal, fetal, and neonatal outcomes. We describe the case of a 39-year-old woman, who was diagnosed with stress-triggered GD at 1st trimester of her pregnancy. At diagnosis, TRAb levels were very high (30.4 U/L, normal values 40 U/L). Three additional exacerbations of hyperthyroidism occurred at weeks 28 (TRAb > 40 U/L), 32 (TRAb 36.4 U/L), and 36 (TRAb 26.2 U/L), despite close biochemical monitoring and adjustments of ATD. An uncomplicated spontaneous delivery of a healthy boy occurred at week 37. The neonate had normal weight, length, Apgar score, and was euthyroid (TSH 1.9 mIU/mL). He remained healthy and euthyroid at the last evaluation (9 months of age). This case is unusual because of several exacerbations of GD hyperthyroidism while on ATD during gestation, due to persistently high TRAb levels. Nevertheless, thanks to close maternal and fetal monitoring, neither maternal nor fetal complication occurred.

Objective: To assess whether varicocele affects testicular 25-hydroxylase activity. Methods: Twenty normozoospermic patients with bilateral varicocele (grade III according to the Dubin and Amelar classification) without indications to undergo varicocele repair (normal sperm parameters and testicular volume; no scrotal pain) were consecutively enrolled and followed-up for four years. Serum levels of parathyroid hormone (PTH), calcium, and 25-hydroxy-cholecalciferol [25(OH)D] along with serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), conventional sperm parameters, sperm DNA fragmentation (SDF) rate, and testicular volume (TV) were measured annually for three years. PTH, calcium, and 25(OH)D serum levels over time were compared with those of age- and body mass index (BMI)-matched control group of twenty varicocelectomized patients. Main results: Both intra- and between-group analyses showed that serum PTH levels increased significantly over time in parallel with a significant decline in 25(OH)D levels. Serum calcium levels did not change significantly. At the same time, signs of mild Leydig and Sertoli cell dysfunction were found, such as an increase in gonadotropins and decreased TT and VT. However, conventional sperm parameters and SDF rate did not change significantly. Conclusion: This prospective controlled study provides the first evidence of a negative impact of bilateral grade III varicocele on testicular 25-hydroxylase activity. Accordingly, the patients included in this study showed a significant increase in PTH and a decrease in 25(OH)D levels over time. Patients with varicocele deserve endocrinologic counseling.

Graves’ disease is characterized by two sonographic features, hypoechogenicity and increased blood flow. The aim of this study was to review retrospectively ultrasound features and biochemical data of a cohort of untreated Graves’ disease patients. We reviewed charts of 42 such patients, who were referred to our Endocrinology Unit from January 2013 to May 2018. One operator performed all the thyroid sonographic scans. Serum TSH, FT3, FT4 and TSH-receptor antibodies (TRAb) levels at the time of ultrasound examination were evaluated. Over a mean follow-up of 30.9 months, about one in three patients (38%) experienced at least one recurrence of hyperthyroidism (1.4 ± 0.6 recurrence per patient), either on or off antithyroid drugs. We found that thyroid vascularization correlated directly with thyroid volume and that larger thyroids tended to be more vascularized. We also found that greater vascularization was associated with marked hypoechogenicity, and greater FT4 and TRAb levels. Patients who experienced recurrence(s) had 1.7-fold higher levels of TRAb at onset. In conclusion, thyroid hypervascularization at onset of Graves’ disease is an important sonographic feature. Keywords: Graves disease, Hyperthyroidism, Ultrasonography, Vascularization, Doppler, Ultrasonographic pattern, Hypoechoic, Echopattern

Resveratrol (RSV) (3,4′,5 trihydroxystilbene) is a natural non-flavonoid polyphenol widely present in the Mediterranean diet. In particular, RSV is found in grapes, peanuts, berries, and red wine. Many beneficial effects of this molecule on human health have been reported. In fact, it improves some clinical aspects of various diseases, such as obesity, tumors, hypertension, Alzheimer’s disease, stroke, cardiovascular diseases, and diabetes mellitus. However, little is known about the relationship between this compound and male fertility and the few available results are often controversial. Therefore, this review evaluated the effects of RSV on human male fertility and the mechanisms through which this polyphenol could act on human spermatozoa.

In clinical practice, one of the major problems in optimizing recruitment or lung volume during HFOV in preterm infants is the inability to accurately measure direct changes in lung volume at bedside.To evaluate changes in lung volume during the recruitment phase of elective HFOV in preterm infants with RDS using respiratory inductive plethysmography.The preliminary results of an observational prospective study were reported. Newborns with GA ≤ 27 weeks requiring elective HFOV for a diagnosis of RDS were studied within the first 6 hours of life using RIP technology, before surfactant instillation. HFOV was performed with Draeger Babylog 8000 plus ventilator with "optimum lung volume strategy "(continuous distending pressure (CDP) increased step-by-step until FiO(2) ≤ 0.25 was reached). Data on ventilator settings, gas exchange and RIP volume were collected and analyzed. The analysis package used in this study visualizes measured data from the Bicore-II device (CareFusion), Pulse Oximeter Masimo, AX300 FiO(2) monitor device and TCM4 shuttle (TCM4, Radiometer, Copenaghen, Denmark).Four preterm infants (two females) with mean ± SD gestational age of 26.5 ± 1.0 weeks and mean ± SD birth weight of 978 ± 188 grams were studied. Relative FRC slightly increased during the first steps of the recruitment phase, while deeply decreased at higher CDP values (≥ 15 cm H(2)O). Notwithstanding FiO(2) decreased until 0.25 in all the newborns except one.Because RIP cannot differentiate between changes in lung fluid or intrathoracic gas, we hypothesized that as CDP increases and total lung capacity is approached, pulmonary vascular resistance increases as a consequence of the compression of intra-alveolar vessels. This increases right ventricular afterload which, combined with re-establishment of right-to left shunting, results in decreased pulmonary blood flow and then decreased lung volume. Caution should then be used when using high CDP values during the recruitment procedure.

Background: During the last years High Frequency Oscillatory Ventilation (HFOV) has been increasingly used in preterm infants with respiratory failure. In our Neonatal Intensive Care Unit (NICU) newborns with gestational age (GA) ≤ 27 weeks and/or birth weight (BW) 70 mmHg). No significant differences were found between Extubation Success and Extubation Failure Groups in terms of GA (26.2 ± 1.3 vs 25.8 ± 1.3 weeks, respectively), BW (770 ± 204 vs 614 ± 193g, respectively), day of extubation (3 [1-53] vs 3 [2-10], respectively). The only different parameter between Extubation Success and Extubation Failure Groups was DCO 2 (Vt 2 xHz/kg) before extubation, significantly higher in the first Group: 30 ± 10 vs 18 ± 12 ( p

Candida mannan (Mn) detection in bronchoalveolar lavage fluid (BALF) was shown to be useful for earlier identification and preemptive therapy targeting in preterm infants at high risk of invasive Candida infection. We investigated whether early detection of Candida Mn in BALF is associated with the presence of some neutrophilic products, as markers of prenatal infection/inflammation.BALF specimens were collected during the first 48 h of life from mechanically ventilated preterm newborns. Samples were analyzed by high-performance liquid chromatography-electrospray ionization-mass spectrometry. The relative amounts of α-defensins 1-4 and S100A proteins were measured by extracted ion current peak area. Absolute and differential white cell counts in BALF were obtained. Mn antigen concentrations were determined by the Platelia Candida antigen kit.Twenty-five studied neonates were divided into two groups: Mn-positive group and Mn-negative group. Levels of α-defensins 1-4 and S100A12 were significantly higher in the Mn-positive group than in the Mn-negative group. Moreover, positive significant correlations between the absolute number of neutrophils and the levels of α-defensins 1-4 and S100A8 were observed.The detection of Mn antigen in BALF of preterm infants is consistent with evidence of an innate immune response in their lungs as demonstrated by higher levels of α-defensins and S100A proteins.