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Objective: Proton pump inhibitor (PPI) drugs reduce gastric acid secretion and lead to an increase in serum gastrin levels. Many preclinical and some clinical researches have established some positive effects of gastrin or PPI therapy on glucose regulation. The aim of this study was to prospectively investigate the short term effects of esomeprazole on glycaemic control in patients with type 2 diabetes mellitus. In addition, the presence of an association between this effect and gastrin levels was evaluated. Methods: Thirty-two subjects with type 2 diabetes mellitus were enrolled and grouped as intervention (n=16) and control (n=16). The participants in the intervention group were prescribed 40 mg of esomeprazole treatment for three months. At the beginning of the study and at the 3rd month, HbA1c level (%) and gastrin levels (pmol/L) of participants were assessed. Then, the groups were compared in terms of their baseline and 3rd month values. Results: In the intervention group, the mean gastrin level increased significantly from 34.3±14.4 pmol/L to 87.4±43.6 pmol/L (p Conclusion: Our study demonstrates that esomeprazole has no extra benefit for the controlled diabetic patient in three months. However, in only the metformin-treated subgroup, esomeprazole may prevent the rise in HbA1c level.

Objective Type 1 diabetes (T1D) is a disease characterized by severe insulin deficiency. In 2008 our group studied the prevalence of diabetes in adults between 20-80 years of age in Cyprus but data regarding this incidence in the pediatric population is lacking. The objective of this study was to report the incidence of T1D among permanent inhabitants aged 16 years or younger between 2001-2016 in Cyprus. Methods This study was a retrospective analysis. The patients were mainly evaluated and recorded at Dr. Burhan Nalbantoglu Hospital, Nicosia. Data was also reviewed from Famagusta Government Hospital, Kyrenia Government Hospital, Near East University Hospital and the Cyprus Turkish Diabetes Association. Results A total of 107 subjects were diagnosed as T1D between 2001 and 2016 in the pediatric age group. Forty-nine (45.7%) were girls and 58 (54.3%) were boys. Of these 38.7% were resident in Nicosia, 30.2% Famagusta, 12.3% Kyrenia, 9.4% Guzelyurt and 7.5% Iskele. The proportion of newly diagnosed T1D was highest among children aged 9-12 years (35.5%) followed by children aged 5-8 years (32.7%). Newly diagnosed T1D most frequently presented in March and April. The overall mean incidence rate was 11.1/100,000 between 2001 and 2016. The incidence rates were similar and comparable among the years. Conclusion This study is the first to analyze the incidence of T1D in Cyprus. Compared to other countries the incidence rate is intermediate. Our findings are similar to the incidence rates of T1D in South Cyprus and Turkey.

Background. Differentiated thyroid cancer (DTC) is one of the most frequently observed neoplasms today. Recurrence of DTC has been previously reported to be dependent on tumor characteristics, the tumor size, the presence of lymph node metastasis, the presence of extra thyroid invasion, the presence of distant metas‑ tasis, oncogenes such as B‑RAF proto‑oncogene, ad‑ vanced age and male sex. However, many studies have failed to associate many of these data with relapse. The objective of the study was to evaluate the re‑ lationship between some histopathological and mor‑ phological findings with thyroid cancer relapse or per‑ sistent disease in a cohort of 393 DTC patients. Methods. We retrospectively analyzed 393 subjects with DTC, diagnosed in our institution between January 2000 and December 2010. Results. Histopathological analysis indicated papil‑ lary carcinoma in 362 (92.1%) subjects and follicular carcinoma in 31 (7.9%) subjects. Eighty‑two (20.9%) of the subjects relapsed or had persistent disease. Male subjects had a higher trend for relapse (RR 1.739 %95 CI: 1.059‑2.856) p=0.029). 18.8% of female sub‑ jects relapsed or had persistent disease, whereas the relapse rate was 30.4% in male subjects. Every 1 cm increase in tumor size increased the risk of relapse by 25% (RR=1.25, 95% CI: 1.11‑1.41, p

Amaç: Metabolik sendrom kriterler içinde yer almayan ve adipozite göstergesi kabul edilen parametrelerin, metabolik sendromu olan ve olmayan kadınlar arasında farklılık gösterip göstermediğini ortaya koymak ve bu parametrelerin metabolik sendromu predikte eden kesim noktalarını saptamak amaçlanmıştır. Gereç ve Yöntem: Kilo vermek için başvuran, bilinen glikoz metabolizma bozukluğu olmayan 393 kadın birey (18-70 yaş) alındı. Bu bireylerden NCEP ATPIII kriterlerine göre metabolik sendromu olan ve olmayanlar tespit edildikten sonra, tüm katılımcıların antropometrik ölçümleri ve vücut yağ dağılımı ölçüldü ve laboratuar parametrelerine bakıldı. ROC eğrileri çizildi ve eğri altındaki alanlar hesaplandı ve parametrelerin metabolik sendromu predikte eden kesim noktaları ve bu kesim noktalarının duyarlılık ve özgüllük oranları belirlendi.Bulgular: Metabolik sendromu predikte eden parametrelerden, vücut kitle indeksi, boyun çevresi, visseral yağ miktarı, gövde yağ yüzdesi, HOMAIR indeksi ve insülin düzeylerinin, eğri altındaki alanları 0,7'nin üstünde olduğu; kalça çevresi, bel-kalça oranı, konvansiyonel BİA ile ölçülen total yağ kitlesi ve yağ yüzdesinin, LDL-K ve TSH düzeyinin ise 0,7'nin altında olduğu saptanmıştır. Vücut kitle indeksi için 27,7 kg/m2, boyun çevresi için 33,8 cm, bel çevresi için 91,5 cm, visseral yağ miktarı için 10,8 birim, gövde yağ yüzdesi için %43,1, HOMAIR indeksi için 2,14 ve insülin düzeyi için 8,7 µU/mL değerlerinin metabolik sendromu predikte etmedeki duyarlılıkları %80 ve üstünde bulunmuştur.Sonuç: Vücut kitle indeksi, boyun çevresi, visseral yağ miktarı, gövde yağ yüzdesi, HOMAIR indeksi ve insülin düzeyleri metabolik sendromun alternatif prediktörü olarak kullanılabilecek pratik ve değerli ölçütlerdir., Purpose: The aim of this study is to determine whether the parameters that are not included in the criteria of metabolic syndrome and which are considered as indicators of adiposity, differ between women with and without metabolic syndrome and to determine the cut-off points predicting metabolic syndrome.Materials and Methods: A total of 393 adult women without glucose metabolism disorder were included. After determining the participants with and without metabolic syndrome, anthropometric measurements and body fat distribution of all participants were measured and laboratory parameters were examined. The ROC curves were plotted and the areas under the curve were calculated. The cut-off points predicting metabolic syndrome and the sensitivity and specificity ratios of these cut-off points were determined. Results: While the area under the curve for body mass index, neck circumference, visceral fat level, body fat percentage, HOMAIR index and insulin levels was found to be over 0.7, area under the curve for hip circumference, waist-hip ratio, total fat mass and total fat percentage, and LDL-C and TSH levels were below 0.7. The cut-off points of parameters that predict metabolic syndrome for women were found to be 27.7 kg/m2 for body mass index, 33.8 cm for neck circumference, 91.5 cm for waist circumference, 10.8 for visceral fat, 43.1% for trunk fat percentage, 2.14 for HOMAIR index and 8.7 µU/mL for insulin levels. Conclusion: Body mass index, neck circumference, visceral fat level, body fat percentage, HOMAIR index and insulin levels are valuable criteria to predict metabolic syndrome.

CONTEXT: Previous studies have associated overt/subclinical hypothyroidism and obesity but have failed to confirm a causative relationship between them. Confusion is even more for subjects with Hashimoto’s Thyroiditis (HT). OBJECTIVE: In this study, we aimed to evaluate the fat distribution and metabolic profile of subjects with euthyroid HT as well as to establish an appropriate cut-off level of TSH for the development of metabolic syndrome (Mets) in both groups. PATIENTS AND METHODS: All subjects were euthyroid whether under levothyroxine replacement or not. We recruited 301 volunteers (99 with HT and 202 without thyroid autoimmunity). Together with some metabolic variables, we measured the waist circumference, hip circumference, neck circumference manually; the total body fat with a body composition analyzer; and the visceral fat/trunk fat percentage via abdominal bioelectrical impedance analysis. RESULTS: A significant positive correlation was established between TSH levels and insulin, fasting plasma glucose, HOMA-IR and body mass index (r=0.28; p0.05). The prevalence of Mets was similar when HT subjects using levothyroxine or HT subjects with accompanying thyroid nodules were taken into consideration. Similarly, anthropometric and metabolic parameters were similar in both the HT group and the control group. We were unable to establish the TSH cut-off level by ROC analysis with desired sensitivity and specificity (AUC: 0.563 with 95% C.I. p=0.35; standard error 0.76). CONCLUSIONS: Although weight gain is frequently encountered in subjects with HT, such subjects with thyroid function tests in the euthyroid range have a similar prevalence of Mets and similar metabolic and anthropometric measurements compared to subjects without autoimmunity.

Serum thyroglobulin (Tg) is the key parameter used in the follow-up of subjects with differentiated thyroid cancer (DTC). Current guidelines advise its measurement to take place when Thyrotropin (TSH) levels are >30 µU/ml (stimulated Tg) and when TSH

CONTEXT: Visceral adipose tissue (VAT) is a strong predictor of carbohydrate metabolism disorders. Abdominal bioelectrical impedance analysis (A-BIA) is a simple method for the measurement of VAT and is a promising tool in screening and follow-up of abdominal obesity. However the role of A-BIA in dieting individuals has not been evaluated adequately in longitudinal follow-up studies. OBJECTIVE: The aim of this study is to determine the role of A-BIA in identifying the changes in metabolic predictors after diet and/or exercise therapy. DESIGN: All patients who sought weight loss treatment underwent baseline assessment and were prescribed a program of diet. After a mean follow-up of 3.2 months, data were analyzed. SUBJECTS AND METHODS: Ultimately, 103 participants who reported adhering to the diet, enrolled to the study. We tested associations between changes in body composition measures and changes in laboratory measures using correlations and multivariate linear regression analysis. RESULTS: Mean loss of body weight was 3.4±2.8 kg. All but waist-to-hip ratio, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels changed significantly (p

Objective: Colorectal polyps and thyroid nodules are common disorders linked to hyperinsulinemia and metabolic syndrome (Mets). The direct association between these two diseases is not clear. We aimed to analyze the prevalence of thyroid nodules in subjects with and without colorectal polyps. The secondary aim was to establish the prevalence of Mets and its parameters in both disorders and to determine if insulin resistance and hyperinsulinemia are common underlying pathophysiological mechanisms. Subjects and Methods: One hundred and five subjects with colorectal polyps (71 males, 34 females) and 68 controls (28 males, 40 females) were enrolled. The parameters of Mets together with TSH, insulin, low-density lipoprotein cholesterol, and homeostasis model for assessment of insulin resistance levels were calculated. We performed thyroid ultrasonography in all participants. Results: The prevalence of Mets was similar in the colorectal polyp and control groups (37.1 vs. 37.3%, p = 0.982). The prevalence of Mets was nonsignificantly higher in subjects with a documented thyroid nodule compared to subjects without a thyroid nodule (43.0 vs. 32.6%, p = 0.205). The prevalence of thyroid nodules in subjects with colorectal polyps was significantly higher than in subjects without polyps (52.9 vs. 35.3%, p = 0.017). Compared to subjects with no colorectal polyps, we established a significant increase in the odds of having thyroid nodules (OR 2.05; 95% CI: 1.097–3.860, p = 0.017). The presence of colorectal polyps and age in the adjusted model were established to be independent risk factors for having thyroid nodules (p = 0.025 and p = 0.007, respectively). Conclusion: These results may support the presence of other common mechanisms in the development of these two pathologies other than insulin resistance and hyperinsulinemia.

Objective: The objective of this study was to assess the antiproliferative pleiotropic effects of statins on thyroid function, volume, and nodularity. Subjects and Methods: One hundred and six hyperlipidemic patients were included in this prospective study. The 69 patients in the statin groups received atorvastatin (16 received 10 mg and 18 received 20 mg) or rosuvastatin (20 received 10 mg and 15 received 20 mg). The 37 patients in the control group, assessed as not requiring drugs, made only lifestyle changes. Upon admission and after 6 months, all patients were evaluated by ultrasonography as well as for lipid variables (total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides) and thyroid function and structure. Results: After 6 months, no differences in thyroid function, thyroid volume, the number of thyroid nodules, or nodule size were observed in the statin and control groups. In a subgroup analysis, total thyroid volume had decreased more in patients receiving 20 mg of rosuvastatin than that in the control group (p < 0.05). Maximum nodule size had decreased more in those receiving 10 mg of rosuvastatin (p < 0.05). Conclusions: Our results suggest an association between rosuvastatin treatment and smaller thyroid volume and maximum nodule diameter; this could be attributable to the antiproliferative effects of statin therapy on the thyroid.

Primary hyperparathyroidism is the most frequent cause of hypercalcemia in adults. Primary hyperparathyroidism generally leads to mild-moderate hypercalcemia. Severe hypercalcemia in these cases is rare. Coexistence of severe hypercalcemia and hypercalcemic encephalopathy is very unusual with very limited number of reported cases. Our case is a 50-year-old female who presented to the emergency department with the complaints of nausea and severe abdominal pain. Her serum calcium level was 19.7 mg/dL (8.8-10.2 mg/dL) and her PTH level was 73.5 ng/dL (15-65) on presentation. After her hospitalization, she was treated with saline infusions and furosemide, however, her calcium level increased to 22.4 mg/dL. Her calcium levels were also refractory to subcutaneous calcitonin 200 mg twice a day and zoledronic acid 4 mg. Ultrasonography of the neck revealed a 3.2x2.7x4.6 cm mass suspicious for a left parathyroid adenoma hardly being distinguished from a left thyroid nodule. Considering her general situation getting worse despite maximum medical treatment, she underwent an emergency parathyroidectomy and total thyroidectomy. Early postoperatively, the patient’s general condition deteriorated reaching a precoma state. Cranial computed tomography (CT) at this point revealed periventricular ischemia compatible with metabolic encephalopathy. During the follow-up postoperatively, the patient’s serum calcium levels normalized eventually requiring active vitamin D and calcium pills and she no longer had symptoms of encephalopathy. The pathology specimen was reported as a parathyroid neoplasm compatible with atypical parathyroid adenoma. Although mild-moderate hypercalcemia is frequent in primary hyperparathyroidism, it should be noted that it can be severe and refractory to maximum medical treatment requiring emergency surgical intervention. In addition, not being one of the most frequent reasons, severe hypercalcemia due to primary hyperparathyroidism should be considered as an important cause of metabolic encephalopathy. Turk Jem 2015; 19: 105-108

Malignant mesothelioma is a rare but notoriously chemoresistant tumor. An impressive activity of gemcitabine and cisplatin combination in malignant mesothelioma has been shown. However, the hematological toxicity and nephrotoxicity related to this regimen affect the patient's life negatively. The aim of this study is to investigate the efficacy and toxicity of divided dose of cisplatin combined with gemcitabine in chemo-naïve patients with malignant mesothelioma. Twenty-six eligible patients with malignant mesothelioma were enrolled onto the study. Cisplatin 35 mg/m(2) and gemcitabine 800 mg/m(2) were administered on days 1 and 8 as intravenous infusion in a 3-week cycle, up to maximum 6 cycles. Response and toxicity evaluations were performed in 26 patients. Male-female ratio was 11/15 with a mean age of 50.5 years (37-70). Locations of tumor were pleura in 16 patients, and peritoneum in 10 patients. All patients had epitheloid subtype of malignant mesothelioma. The partial response and stable disease were observed in 6 patients (23.1%) and in 13 patients (50%), respectively, with an overall tumor control rate of 73.1%. Seven patients (26.9%) had progressive disease. Median time to disease progression and survival were 4 and 19.5 months, respectively. Grade 3 nausea and vomiting were observed in one patient (3.8%), grade 4 neutropenia developed in one patient (3.8%) and grades 3-4 thrombocytopenia and nephrotoxicity did not develop. There was no treatment related death. Divided dose of cisplatin combined with gemcitabine, at the current dosage and schedule, appears to be an active regimen in chemotherapy-naïve patients with malignant mesothelioma, and well-tolerated.

Paget’s disease of bone (PDB) is characterized by increased bone turnover and generally affects the skeleton extensively. The diagnosis is usually made with coincidentally detected high alkaline phosphatase (ALP) levels and/or suspicious x-rays during screening for other conditions. 10-15% of cases have normal ALP levels. A 72-year-old male subject was evaluated in the Neurosurgery Outpatient division with a symptom of low back pain. Lumbar magnetic resonance imaging (MRI) detected spondylolisthesis and a lytic lesion in the L4 vertebral body. Screening for possible malignancy revealed no primary tumor site. The serum ALP level was normal. He underwent surgery for probable malignancy and the pathology report revealed PDB. PDB is a benign condition which should be considered in the differential diagnosis of bone metastasis and should be kept in mind that patients can have normal ALP levels and examination of the pathology specimen may give the final diagnosis. Turk Jem 2012; 16: 99-101

Parathyroid adenomas comprise the majority of cases of primary hyperparathyroidism. Most of these adenomas are located near the lower poles of the thyroid glands, however, mediastinal, intrathyroidal, retroesophageal and intrathymic localizations have been reported. Preoperative imaging is very important for localization of the parathyroid adenomas. The most effective imaging method in localizing ectopic parathyroid adenomas is Technetium-99m sestamibi scintigraphy. Even when localized by scintigraphy, surgical exploration may be unsuccessful in adenomas less than 2 cm in size. In our case, we have obtained a successful parathyroid imaging which guided the chest surgeons and general surgeons to perform a successful parathyroidectomy via sternotomy. The attendance of a general surgeon experienced in parathyroid surgery has provided benefit in surgical exploration of the ectopic parathyroid adenoma. Turk Jem 2012; 16: 46-8

MOUSA, UMUT/0000-0002-8078-9376 WOS: 000350789400007 PubMed: 25343266 Chronic complications are the leading causes of morbidity and mortality in the diabetic population. The intrarenal resistive index ( RI) has been reported to be increased in hypertensive subjects with microalbuminuria and limited data is present for diabetic subjects. 101 subjects with Type 2 Diabetes Mellitus were included in the study. We grouped the study population according to the urinary albumin excretion ( UAE). Group 1: UAE < 30 mg/ day ( n = 36); Group 2: UAE 30- 300 mg/ day ( n: 37); Group 3: UAE > 300 mg/ day ( n: 28). We also grouped the study population according to the intrarenal RI value. Group consisted of subjects with RI = 0.70 and group II < 0.70. The mean intrarenal RI values of patients in group 3 were higher than those of group 1 and group 2 ( 0.72 vs. 0.69 p = 0.048; 0.72 vs. 0.69; p = 0.048 respectively). The duration of diabetes, hip circumference, and hs- CRP levels were statistically significantly higher in subjects with intrarenal RI = 0.70 compared to those with intrarenal RI < 0.70 ( p: < 0.001, 0.048 and 0.0148 respectively). Presence of retinopathy and neuropathy was statistically significantly higher in subjects with intrarenal RI = 0.70 compared to those with intrarenal RI < 0.70. RI may predict the development of microvascularcomplications in diabetic subjects.

Acute myeloid leukemia (AML) is a broad range of disorders that are all characterized by a block in the differentiation and by uncontrolled proliferation of hematopoietic progenitor cells. AML is the most frequent hematological malignancy in adults, with an annual incidence of three to four cases per 100,000 individuals. In approximately 20% of AML patients, the leukemia is secondary, arising from prior myelodysplastic syndrome or other hematological disorders, or is therapy-related CONTENTS 29.

Although obesity is a powerful risk factor for metabolic syndrome (MetS) it is not present in all obese individuals. Increased visceral adipose tissue is the hallmark of this syndrome. In this cross sectional survey we aimed to use abdominal bioelectrical impedance analysis to measure the visceral adipose tissue (VAT) and trunk fat percentages (TF%) in the study population, correlate these findings with traditional anthropometric measures and biochemical parameters of metabolic syndrome and estimate a cut-off value of visceral fat for development of MetS. A total of 285 subjects were enrolled. VAT and TF% were measured by the AB-140 device via abdominal bioelectrical impedance analysis. Fat% was measured by a body composition analyzer (TBF-300). VAT was significantly positively correlated with body mass index, waist circumference, TF%, HOMA IR, fat percentage, fasting plasma glucose and triglycerides. Strongest correlations were between VAT and TF%, VAT and device measured waist circumference and between VAT and manual waist circumference (r=0.95, r=0.93, r=0.92 respectively). Correlations of VAT and TF% with metabolic parameters were significant but weak. The mean VAT and TF% in MetS (+) groups were significantly higher than patients in MetS (-) groups in both sexes. The areas under the ROC curves were 0.730 (95% CI: 0.661-0.791) for female VAT and 0.702 (95% CI: 0.654-0.749) for male VAT in predicting MetS which were similar to the areas under ROC curves calculated for device and manually measured waist circumference, HOMA IR and TF% in predicting MetS (p>0.05 for all comparisons). The accuracy of VAT and TF% for predicting MetS was not sufficient. From our results we can deduce that the performance of abdominal BIA in predicting MetS is weak but could be used in the follow-up of patients with obesity and/or MetS. This has to be confirmed in future studies.

The purpose of this study was to evaluate the relationship between body mass index and lipid profiles with breast cancer prognosis together with the relationship of these parametres with known breast cancer prognostic indices including c-erbB2 expression.Four hundred and thirty-three patients diagnosed with breast cancer at Ankara University, Faculty of Medicine, Department of Medical Oncology made up the study population. The primary endpoints were relapse and death. Body mass index at the time of diagnosis, lipid levels at the time of diagnosis, estrogen receptor status, progesterone receptor status, c-erbB2 expression, tumor grade, patient age, axillary lymph node involvement level, tumor stage, menopausal status and surgery details were taken into account.The mean body mass indices were similar in the remission, relapse and mortality groups. Patients with body mass indices higher than 30 kg/m² had a lower incidence of c-erbB2 expression when compared to patients with body mass indices 18.5 kg/m(2) (19 vs. 50 %, p = 0.009). Survival analysis revealed that patients with body mass indices 18.5 kg/m(2) had significantly shorter disease free survivals when compared to patients with body mass indices between 25 and 29.9 kg/m(2). Mean serum lipid levels were similar in the remission, relapse and mortality groups. A trend toward relapse was shown in patients with total cholesterol 240 mg/dl, but this was statistically insignificant. Survival analysis revealed that patients with triglyceride levels lower than 150 mg/dl had a statistically significant longer disease-free survival when compared to the other groups. Again a trend towards shorter overall survival was seen in patients with total cholesterol 240 mg/dl, but this relationship was also statistically insignificant.Most large previous studies reported adverse breast cancer outcome with obesity. However in our study, patients with lower body weight had a shorter disease-free survival. This could be explained by the low number of patients in this study, genetic profile of the patient population, possible weight changes after treatment and the inverse relationship between body mass index and c-erbB2 expression.

Serum calcitonin is a tumor marker used in the diagnosis and follow-up of medullary thyroid carcinoma. Calcitonin washout evaluation is a new method used for suspicious thyroid nodules and lymph nodes. Limited clinical data are present about the efficacy of this method. A 61-year-old female patient with known Hashimoto's thyroditis and an 8-mm hypoechoic nodule was presented with one previously benign fine-needle aspiration cytology (FNAC). On referral to our department, she had a moderately high-serum calcitonin level, and we repeated the FNAC that was reported as nondiagnostic. We performed FNAC for the third time together with calcitonin washout evaluation from the thyroid nodule. The FNAC was again nondiagnostic, but the calcitonin washout level from the thyroid nodule was 152.569 pg/mL. Total thyroidectomy was performed, and the diagnosis was confirmed as medullary thyroid carcinoma. Calcitonin washout evaluation may be a useful method in the differential diagnosis of patients with thyroid nodules having moderately high-serum calcitonin levels. Diagn. Cytopathol. 2013. © 2011 Wiley Periodicals, Inc.

Thyroid disorders including iodine deficiency during pregnancy are important health problems worldwide. However, considering real life, assessment of knowledge, attitudes, and practice of physicians is lacking. We aim to evaluate knowledge, attitudes and behaviors of physicians towards thyroid disorders and requirements of iodine during pregnancy on a nationwide basis. Clinicians from different medical disciplines most likely to encounter pregnant women in daily practice (i.e., obstetricians, endocrinologists, and family physicians) were included. Family physicians were selected from primary care centers; endocrinologists and gynecologists were selected from state hospitals. Randomly selected 322 physicians from seven geographical regions of Turkey were included. Subjects filled a questionnaire which consisted of three sections about knowledge, attitudes and behaviors towards thyroid disorders and iodine requirements during pregnancy. Physicians had insufficient and/or erroneous knowledge about thyroid disorders during pregnancy. 73.1 % of endocrinologists, 32.7 % of family physicians, and 17.8 % of obstetricians knew the correct level of TSH during pregnancy (p